STRATEGY STUDIO / PUBLIC DATA EXPLORER

COVENANT HOSPICE INC: Form 990, tax year 2018

View the entire original 990 at ProPublica ↗

Organization
COVENANT HOSPICE INC (EIN 59-2208300)
Tax period
2018-01-01 to 2018-12-31
Filed
2019-11-15
IRS object ID
201933199349303013
Schema version
2018v3.1
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Return2019-11-15T08:29:34-06:00ReturnTs
Tax Period End2018-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN592922169PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1SALTMARSH CLEAVELAND & GUNDBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1900 NORTH 12TH AVENUEAddressLine1Txt
CityPENSACOLACityNm
State AbbreviationFLStateAbbreviationCd
ZIP32501ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2018-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN592208300EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1COVENANT HOSPICE INCBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlCOVEBusinessNameControlTxt
Phone8504332155PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line15041 N 12TH AVEAddressLine1Txt
CityPENSACOLACityNm
State AbbreviationFLStateAbbreviationCd
ZIP32504ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonMARTY FRANKLINPersonNm
Person TitleCFOPersonTitleTxt
Phone8504332155PhoneNum
Signature2019-11-15SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonCHARLES F GUND JR CPAPreparerPersonNm
PTINP00138367PTIN
Phone8504358300PhoneNum
Preparation2019-10-25PreparationDt

Filing Security Information FilingSecurityInformation

IP Address IPAddress

FieldValueIRS element (for citing)
I Pv4 Address170.249.129.82IPv4AddressTxt
FieldValueIRS element (for citing)
IP2019-11-15IPDt
IP Tm08:09:04IPTm
IP TimezoneCSIPTimezoneCd
Filing License TypePFilingLicenseTypeCd
At Submission Creation Device Id485E2A1375944CFBAB9FA0C6BA2180630D642600AtSubmissionCreationDeviceId
At Submission Filing Device Id485E2A1375944CFBAB9FA0C6BA2180630D642600AtSubmissionFilingDeviceId
FieldValueIRS element (for citing)
Tax2018TaxYr
Build TS2020-04-17 16:48:07ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerJEFF MISLEVYPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line15041 N 12TH AVEAddressLine1Txt
CityPENSACOLACityNm
State AbbreviationFLStateAbbreviationCd
ZIP32504ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$65,335,983GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.CHOOSECOVENANT.ORG/HOSPICEWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1981FormationYr
Legal Domicile StateFLLegalDomicileStateCd
Activity Or MissionCOVENANT HOSPICE IS DEDICATED TO PROVIDING COMPREHENSIVE, COMPASSIONATE SERVICES (SEE SCHEDULE O) (CONTINUATION FROM PART I, LINE 1) TO PATIENTS AND THEIR LOVED ONES DURING TIMES OF LIFE-LIMITING ILLNESSES.ActivityOrMissionDesc
Voting Members Governing Body15VotingMembersGoverningBodyCnt
Voting Members Independent14VotingMembersIndependentCnt
Total Employee650TotalEmployeeCnt
Total Volunteers1118TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$0PYContributionsGrantsAmt
CY Contributions Grants$3,057,568CYContributionsGrantsAmt
PY Program Service Revenue$53,616,441PYProgramServiceRevenueAmt
CY Program Service Revenue$54,727,869CYProgramServiceRevenueAmt
PY Investment Income$862,758PYInvestmentIncomeAmt
CY Investment Income$2,248,915CYInvestmentIncomeAmt
PY Other Revenue$760,468PYOtherRevenueAmt
CY Other Revenue$51,707CYOtherRevenueAmt
PY Total Revenue$55,239,667PYTotalRevenueAmt
CY Total Revenue$60,086,059CYTotalRevenueAmt
PY Grants And Similar Paid$0PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$27,587,407PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$25,348,102CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$26,844,401PYOtherExpensesAmt
CY Other Expenses$31,191,691CYOtherExpensesAmt
PY Total Expenses$54,431,808PYTotalExpensesAmt
CY Total Expenses$56,539,793CYTotalExpensesAmt
PY Revenues Less Expenses$807,859PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$3,546,266CYRevenuesLessExpensesAmt
Total Assets BOY$55,500,060TotalAssetsBOYAmt
Total Assets EOY$58,835,656TotalAssetsEOYAmt
Total Liabilities BOY$20,670,117TotalLiabilitiesBOYAmt
Total Liabilities EOY$23,596,459TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$34,829,943NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$35,239,197NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionCOVENANT HOSPICE IS DEDICATED TO PROVIDING COMPREHENSIVE, COMPASSIONATE SERVICES TO PATIENTS AND THEIR LOVED ONES DURING TIMES OF LIFE-LIMITING ILLNESSES. SINCE DYING IS A PART OF THE NORMAL PROCESS OF LIFE, THE FOCUS OF COVENANT HOSPICE (SEE SCHEDULE O) (CONTINUATION FROM PART III, LINE 1) IS TO ENABLE OUR PATIENTS TO LIVE AS FULLY AND COMFORTABLY AS POSSIBLE, TO PROVIDE DIGNIFIED PALLIATIVE CARE, TO ASSIST PATIENT'S LOVED ONES IN COPING WITH END-OF-LIFE ISSUES, AND TO IMPROVE CARE FOR ALL PATIENTS AT THE END OF THEIR LIVES BY EXAMPLE AND EDUCATION. FOR 2018, THE ORGANIZATION PROVIDED $473,075 OF CHARITY CARE TO PATIENTS.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$39,179,146ExpenseAmt
Revenue$54,727,869RevenueAmt
DescDURING 2018, DIRECT CARE WAS PROVIDED TO 5,999 PATIENTS IN NORTHWEST FLORIDA AND SOUTH ALABAMA. COVENANT HOSPICE, INC. ALSO OFFERS A PREDIATRIC PALLIATIVE CARE PROGRAM. "PARTNERS IN CARE: TOGETHER FOR KIDS", TO CHILDREN FROM BIRTH TO AGE 21 WHO ARE COPING WITH POTENTIALLY LIFE-LIMITING CONDITIONS.Desc
Total Program Service Expenses$39,179,146TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B RequiredYes (1)ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying ActivitiesYes (1)LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Temp Or Permanent Endowments0TempOrPermanentEndowmentsInd
Report Land Building EquipmentYes (1)ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other AssetsYes (1)ReportOtherAssetsInd
Report Other LiabilitiesYes (1)ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (1)IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt0IndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (1)ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising Activities0FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate Hospital0OperateHospitalInd
Grants To Organizations0GrantsToOrganizationsInd
Grants To Individuals0GrantsToIndividualsInd
Schedule J RequiredYes (1)ScheduleJRequiredInd
Tax Exempt BondsYes (1)TaxExemptBondsInd
Invest Tax Exempt Bonds0InvestTaxExemptBondsInd
Escrow Account0EscrowAccountInd
On Behalf Of Issuer0OnBehalfOfIssuerInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org MemYes (1)BusinessRlnWithOrgMemInd
Business Rln With Fam Mem0BusinessRlnWithFamMemInd
Business Rln With Officer Ent0BusinessRlnWithOfficerEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded Entity0DisregardedEntityInd
Related EntityYes (1)RelatedEntityInd
Related Organization Ctrl EntYes (1)RelatedOrganizationCtrlEntInd
Transaction With Control Ent0TransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document226IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (1)BackupWthldComplianceInd
Employee650EmployeeCnt
Employment Tax Returns FiledYes (1)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit0UnrelatedBusIncmOverLimitInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo Contributions0QuidProQuoContributionsInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Indoor Tanning Services0IndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht Pymt0SubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst Inc0SubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members15GoverningBodyVotingMembersCnt
Independent Voting Member14IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or StockholdersYes (1)MembersOrStockholdersInd
Election Of Board MembersYes (1)ElectionOfBoardMembersInd
Decisions Subject To ApprovaYes (1)DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn Body0Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (1)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (1)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (1)WhistleblowerPolicyInd
Document Retention PolicyYes (1)DocumentRetentionPolicyInd
Compensation Process CEO0CompensationProcessCEOInd
Compensation Process Other0CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1MARTY FRANKLINBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone8504332155PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line15401 N 12TH AVEAddressLine1Txt
CityPENSACOLACityNm
State AbbreviationFLStateAbbreviationCd
ZIP32504ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (23 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtHighest Compensated EmployeeHighestCompensatedEmployeeInd
TOM OWENS
CHAIRMAN4.0012.00Yes (X)Yes (X)$0$0$0
RODNEY GUTMAN
VICE-CHAIRMAN4.0012.00Yes (X)Yes (X)$0$0$0
CAREY KING
SECRETARY4.0012.00Yes (X)Yes (X)$0$0$0
XAN SMITH
TREASURER4.0012.00Yes (X)Yes (X)$0$0$0
JEFFREY M MISLEVY
PRESIDENT/CEO40.0016.00Yes (X)Yes (X)$0$774,470$58,427
SUSAN DAVIS
DIRECTOR4.004.00Yes (X)$0$0$0
TERESA DOS SANTOS
DIRECTOR4.004.00Yes (X)$0$0$0
DON HAFERKAMP
DIRECTOR4.004.00Yes (X)$0$0$0
WANDA KAYE HAMBRICK
DIRECTOR4.004.00Yes (X)$0$0$0
JANET KINNEY
DIRECTOR4.004.00Yes (X)$0$0$0
BRETT PARA MD
DIRECTOR4.004.00Yes (X)$0$0$0
ROGER POISTRAS
DIRECTOR4.004.00Yes (X)$0$0$0
STEVE SARROS
DIRECTOR4.004.00Yes (X)$0$0$0
KENT SKOLROOD
DIRECTOR4.004.00Yes (X)$0$0$0
PATRICE VILLEMURE
DIRECTOR4.004.00Yes (X)$0$0$0
ODIN BERG
CSO40.0016.00Yes (X)$0$328,853$20,589
MARTIN FRANKLIN
CFO40.0012.00Yes (X)$0$179,624$16,832
TODD FISHER
CIO40.0012.00Yes (X)$0$279,239$30,248
JAMES SMITH
PHYSICIAN40.00$311,317$0$35,365Yes (X)
SAUL RODRIGUEZ
PHYSICIAN40.00$258,731$0$1,601Yes (X)
STEPHEN DILL
PHYSICIAN40.00$233,100$0$4,237Yes (X)
RICK HARRELSON
PHYSICIAN40.00$249,429$0$4,267Yes (X)
JAMES TORRISI
PHYSICIAN40.00$211,097$0$7,887Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$1,263,674TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$1,562,186TotReportableCompRltdOrgAmt
Total Other Compensation$179,453TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K5IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
ENCLARA PHARMECIA
1601 CHERRY STREETPHILADELPHIAPA19102PATIENT DRUGS$1,679,809
NATIONAL HME INC
7501 ESTERS BLVDIRVINGTX75063PATIENT DME$1,461,990
ENTERPRISE FLEET MANAGEMENT
PO BOX 800089KANSAS CITYMO641800089FLEET CARS$586,636
FIRST CHOICE MEDICAL SUPPLY
127 INTERSTATE DRRICHLANDMS39218PATIENT MEDICAL SUPPLIES$573,304
APPLEYARD AGENCY
4400 BAYOU BLVD SUITE 34PENSACOLAFL32503ADVERTISING$571,409
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K50CntrctRcvdGreaterThan100KCnt
Related Organizations$3,055,901RelatedOrganizationsAmt
All Other Contributions$1,667AllOtherContributionsAmt
Total Contributions$3,057,568TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (2 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
PATIENT SERVICES621610$54,417,578$54,417,578
RENTAL FROM AFFILIATES632299$310,291$310,291
FieldValueIRS element (for citing)
Total Program Service Revenue$54,727,869TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$396,583TotalRevenueColumnAmt
Exclusion$396,583ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Securities$7,102,256SecuritiesAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Securities$5,249,924SecuritiesAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities$1,852,332SecuritiesAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$1,852,332TotalRevenueColumnAmt
Exclusion$1,852,332ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp

FieldValueIRS element (for citing)
DescPURCHASE CARD REBATEDesc
Business900099BusinessCd
Total Revenue Column$51,707TotalRevenueColumnAmt
Exclusion$51,707ExclusionAmt
FieldValueIRS element (for citing)
Other Revenue Total$51,707OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$60,086,059TotalRevenueColumnAmt
Related Or Exempt Func Income$54,727,869RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$2,300,622ExclusionAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$20,921,720TotalAmt
Program Services$17,889,358ProgramServicesAmt
Management And General$3,032,362ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$145,328TotalAmt
Program Services$123,643ProgramServicesAmt
Management And General$21,685ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$2,268,345TotalAmt
Program Services$1,914,853ProgramServicesAmt
Management And General$353,492ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$2,012,709TotalAmt
Program Services$1,784,416ProgramServicesAmt
Management And General$228,293ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$254,272TotalAmt
Management And General$254,272ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$76,667TotalAmt
Management And General$76,667ManagementAndGeneralAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

FieldValueIRS element (for citing)
Total$24,911TotalAmt
Management And General$24,911ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$237,962TotalAmt
Management And General$237,962ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$392,703TotalAmt
Management And General$392,703ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$2,325,810TotalAmt
Management And General$2,325,810ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$2,440,375TotalAmt
Management And General$2,440,375ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$1,446,159TotalAmt
Program Services$1,040,006ProgramServicesAmt
Management And General$406,153ManagementAndGeneralAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$20,671TotalAmt
Management And General$20,671ManagementAndGeneralAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$360,788TotalAmt
Management And General$360,788ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$1,733,205TotalAmt
Management And General$1,733,205ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$413,025TotalAmt
Management And General$413,025ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
ROOM & BOARD$9,937,685$9,937,685
MEDICATION AND MEDICAL$4,375,561$4,375,561
SALARY ALLOCATION$4,186,950$4,186,950
LAB SERVICES AND TREATM$1,362,690$1,362,690

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$1,602,257TotalAmt
Program Services$750,934ProgramServicesAmt
Management And General$851,323ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$56,539,793TotalAmt
Program Services$39,179,146ProgramServicesAmt
Management And General$17,360,647ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$8,150BOYAmt
EOY$2,594EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$1,151,489BOYAmt
EOY$3,500,696EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

FieldValueIRS element (for citing)
BOY$2,568,083BOYAmt
EOY$2,082,461EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$9,286,848BOYAmt
EOY$12,171,777EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$136,992BOYAmt
EOY$102,683EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$986,819BOYAmt
EOY$1,413,121EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$30,309,883LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$14,606,305LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$17,221,365BOYAmt
EOY$15,703,578EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$17,245,944BOYAmt
EOY$15,047,600EOYAmt

Intangible Assets IntangibleAssetsGrp

FieldValueIRS element (for citing)
BOY$435,169BOYAmt
EOY$390,779EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$6,459,201BOYAmt
EOY$8,420,367EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$55,500,060BOYAmt
EOY$58,835,656EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$13,616,221BOYAmt
EOY$13,002,338EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$5,951,892BOYAmt
EOY$5,134,569EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$399,664BOYAmt
EOY$3,878,625EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$702,340BOYAmt
EOY$1,580,927EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$20,670,117BOYAmt
EOY$23,596,459EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$32,261,311BOYAmt
EOY$33,163,657EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$2,568,632BOYAmt
EOY$2,075,540EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$34,829,943BOYAmt
EOY$35,239,197EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$55,500,060BOYAmt
EOY$58,835,656EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss$3,546,266ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst-$2,672,406NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets-$464,606OtherChangesInNetAssetsAmt
Info In Schedule O Part XIIYes (X)InfoInScheduleOPartXIIInd
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Consolidated Basis Fincl StmtYes (X)ConsolidatedBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (1)AuditCommitteeInd
Federal Grant Audit Required0FederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Public Organization170Yes (X)PublicOrganization170Ind

Gifts Grants Contri Rcvd170 GiftsGrantsContriRcvd170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$2,160,698CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$1,579,900CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$1,270,186CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$0CurrentTaxYearMinus1YearAmt
Current Tax Year$1,667CurrentTaxYearAmt
Total$5,012,451TotalAmt

Total Calendar Year170 TotalCalendarYear170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$2,160,698CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$1,579,900CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$1,270,186CurrentTaxYearMinus2YearsAmt
Current Tax Year$1,667CurrentTaxYearAmt
Total$5,012,451TotalAmt
FieldValueIRS element (for citing)
Public Support Total170$5,012,451PublicSupportTotal170Amt

Gross Investment Income170 GrossInvestmentIncome170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$702,211CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$583,030CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$422,365CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$387,513CurrentTaxYearMinus1YearAmt
Current Tax Year$396,583CurrentTaxYearAmt
Total$2,491,702TotalAmt

Other Income170 OtherIncome170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$82,531CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$116,624CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$253,751CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$760,468CurrentTaxYearMinus1YearAmt
Current Tax Year$51,707CurrentTaxYearAmt
Total$1,265,081TotalAmt
FieldValueIRS element (for citing)
Total Support$8,769,234TotalSupportAmt
Public Support CY1700.57160PublicSupportCY170Pct
Public Support PY1700.68460PublicSupportPY170Pct
Thirty Thr Pct Suprt Tests CY170Yes (X)ThirtyThrPctSuprtTestsCY170Ind

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Total ContributionsRESTRICTEDTotalContributionsAmt

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Volunteers0VolunteersInd
Paid Staff Or Management0PaidStaffOrManagementInd
Media Advertisements0MediaAdvertisementsInd
Mailings Members0MailingsMembersInd
Publications Or Broadcast0PublicationsOrBroadcastInd
Grants Other Organizations0GrantsOtherOrganizationsInd
Direct Contact LegislatorsYes (1)DirectContactLegislatorsInd
Rallies Demonstrations0RalliesDemonstrationsInd
Other ActivitiesYes (1)OtherActivitiesInd
Total Lobbying Expenditures$0TotalLobbyingExpendituresAmt
Not Described Section501c30NotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART II-B, LINE 1:FormAndLineReferenceDesc
ExplanationLINE 1G DIRECT CONTACT WITH LEGISLATORS, THEIR STAFFS, GOVERNMENT OFFICIALS, OR A LEGISLATIVE BODY: THE ORGANIZATION PAYS CONSULTANTS TO LOBBY FOR LEGISLATION THAT PROMOTES HOSPICES. LINE 1L OTHER ACTIVITIES: THE ORGANIZATION PAYS DUES TO THE NATIONAL HOSPICE AND PALLIATIVE CARE ORGANIZATION ALONG WITH STATE HOSPICE ORGANIZATIONS. A PORTION OF THESE DUES ARE USED FOR LOBBYING ACTIVITIES.ExplanationTxt

Schedule D IRS990ScheduleD

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$1,936,722OtherCostOrOtherBasisAmt
Book Value$1,936,722BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$14,667,880OtherCostOrOtherBasisAmt
Depreciation$14,606,305DepreciationAmt
Book Value$61,575BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$4,166,334OtherCostOrOtherBasisAmt
Book Value$4,166,334BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$9,434,525OtherCostOrOtherBasisAmt
Book Value$9,434,525BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$104,422OtherCostOrOtherBasisAmt
Book Value$104,422BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$15,703,578TotalBookValueLandBuildingsAmt

Other Assets Org OtherAssetsOrgGrp (8 entries)

DescDescBook ValueBookValueAmt
CASH VALUE OF LIFE INSURANCE$1,259,130
DUE FROM COVENANT HOSPICE FOUNDATIO$66,144
DUE FROM ALZHEIMER'S FAMILY SERVICE$534,382
DUE FROM COVENANT HEALTH AND COMMUN$4,327,822
DUE FROM COVENANT HOME HEALTH HOLDI$989,839
DUE FROM MEMORY CARE CLINIC$799,216
DUE FROM COVENANT HOME CARE$259,605
DUE FROM COVENANT PALLIATIVE CARE$184,229
FieldValueIRS element (for citing)
Total Book Value Other Assets$8,420,367TotalBookValueOtherAssetsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp

FieldValueIRS element (for citing)
DescDUE TO PEOPLES HOME HEALTHDesc
Amt$1,580,927Amt
FieldValueIRS element (for citing)
Total Liability$1,580,927TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART X, LINE 2:FormAndLineReferenceDesc
ExplanationCHCS, HOSPICE, THE FOUNDATION, AFS AND CPCS ARE EXEMPT FROM FEDERAL INCOME TAXES UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE.ExplanationTxt

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Club Dues Or FeesYes (X)ClubDuesOrFeesInd
Written Policy Ref T And E Expnss0WrittenPolicyRefTAndEExpnssInd
Substantiation RequiredYes (1)SubstantiationRequiredInd
Independent ConsultantYes (X)IndependentConsultantInd
Compensation SurveyYes (X)CompensationSurveyInd
Board Or Committee ApprovalYes (X)BoardOrCommitteeApprovalInd
Severance Payment0SeverancePaymentInd
Supplemental Nonqual Rtr Plan0SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm0EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org0CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs0CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org0CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs0CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments0AnyNonFixedPaymentsInd
Initial Contract Exception0InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (9 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
JEFFREY M MISLEVY
PRESIDENT/CEO$0$393,283$0$345,613$0$35,574$0$2,700$0$55,727$0$832,897$0$0
ODIN BERG
CSO$0$254,285$0$64,542$0$10,026$0$2,700$0$17,889$0$349,442$0$0
MARTIN FRANKLIN
CFO$0$157,327$0$22,297$0$0$0$0$0$16,832$0$196,456$0$0
TODD FISHER
CIO$0$213,758$0$56,827$0$8,654$0$1,663$0$28,585$0$309,487$0$0
JAMES SMITH
PHYSICIAN$293,554$0$17,763$0$0$0$2,313$0$33,052$0$346,682$0$0$0
SAUL RODRIGUEZ
PHYSICIAN$258,731$0$0$0$0$0$0$0$1,601$0$260,332$0$0$0
STEPHEN DILL
PHYSICIAN$233,100$0$0$0$0$0$0$0$4,237$0$237,337$0$0$0
RICK HARRELSON
PHYSICIAN$233,661$0$0$0$15,768$0$0$0$4,267$0$253,696$0$0$0
JAMES TORRISI
PHYSICIAN$211,097$0$0$0$0$0$0$0$7,887$0$218,984$0$0$0

Schedule K IRS990ScheduleK

Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp (2 entries)

Bond ReferenceBondReferenceCdBond Issuer EINBondIssuerEINBond IssuedBondIssuedDtIssue PriceIssuePriceAmtPurposePurposeDescDefeasedDefeasedIndOn Behalf Of IssuerOnBehalfOfIssuerIndPool FinancingPoolFinancingInd
ESCAMBIA COUNTY HEALTH FACILITIES AUTHORITY
A5213788152005-08-23$900,000RENOVATE INPATIENT FACILITY000
ESCAMBIA COUNTY HEALTH FACILITIES AUTHORITY
B5213788152005-08-23$8,600,000BUILDING ACQUISITION000

Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp (2 entries)

Bond ReferenceBondReferenceCdTotal ProceedsTotalProceedsAmtIssuance Costs From ProceedsIssuanceCostsFromProceedsAmtCapital ExpendituresCapitalExpendituresAmtSubstantial CompletionSubstantialCompletionYrRefunding Tax Exempt BondsRefundingTaxExemptBondsIndRefunding Taxable BondsRefundingTaxableBondsIndFinal Allocation MadeFinalAllocationMadeIndAdequate Books And Rec MaintAdequateBooksAndRecMaintInd
A$900,000$17,900$882,100200800Yes (1)Yes (1)
B$8,600,000$117,139$8,482,861200700Yes (1)Yes (1)

Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp (2 entries)

Bond ReferenceBondReferenceCdOwning Bond Financed PropertyOwningBondFinancedPropertyIndAny Lease ArrangementsAnyLeaseArrangementsIndMgmt Contract Bond Fincd PropMgmtContractBondFincdPropIndAny Research AgreementsAnyResearchAgreementsIndBond Iss Meet Prvt Sec Pymt TestBondIssMeetPrvtSecPymtTestIndChange In Use Bond Financed PropChangeInUseBondFinancedPropIndProcs Nonqualified Bond RemdtdProcsNonqualifiedBondRemdtdInd
A0000000
B0000000

Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp (2 entries)

Bond ReferenceBondReferenceCdForm8038 T FiledForm8038TFiledIndRebate Not Due YetRebateNotDueYetIndException To RebateExceptionToRebateIndNo Rebate DueNoRebateDueIndVariable Rate IssueVariableRateIssueIndHedge Identified In Bks And RecHedgeIdentifiedInBksAndRecIndGross Proceeds Invested In GICGrossProceedsInvestedInGICIndGross Proceeds InvestedGrossProceedsInvestedIndWritten Proc To Monitor ReqsWrittenProcToMonitorReqsInd
A000Yes (1)00000
B000Yes (1)00000

Procedures Corrective Action ProceduresCorrectiveActionGrp (2 entries)

Bond ReferenceBondReferenceCdProcedures Corrective ActionProceduresCorrectiveActionInd
A0
B0

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceDATE REBATE COMPUTATION PERFORMEDFormAndLineReferenceDesc
ExplanationISSUER NAME: ESCAMBIA COUNTY HEALTH FACILITIES AUTHORITY DATE THE REBATE COMPUTATION WAS PERFORMED: 05/10/2010 ISSUER NAME: ESCAMBIA COUNTY HEALTH FACILITIES AUTHORITY DATE THE REBATE COMPUTATION WAS PERFORMED: 05/10/2010ExplanationTxt

Schedule L IRS990ScheduleL

Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp (3 entries)

Relationship DescriptionRelationshipDescriptionTxtTransactionTransactionDescSharing Of RevenuesSharingOfRevenuesInd
SUSAN DAVIS
BOARD MEMBERSUSAN DAVIS IS THE CEO OF SACRED HEART HEALTH SYSTEM. COVENANT HOSPICE PAYS SACRED HEART HEALTH SYSTEM FOR PATIENT RELATED EXPENSES.0
ROGER POITRAS
BOARD MEMBERROGER POITRAS IS THE CSO OF GULF COAST HEALTH SYSTEM. COVENANT HOSPICE PAYS GULF COAST HEALTH SYSTEM FOR PATIENT RELATED EXPENSES.0
DON HAFERKAMP
BOARD MEMBERDON HAFERKAMP IS THE CEO CROWN HEALTH CARE LAUNDRY SERVICES. COVENANT HOSPICE PAYS CROWN HEALTH CARE LAUNDRY SERVICES FOR PATIENT RELATED EXPENSES.0

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (10 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART VI, SECTION A, LINE 6THE ORGANIZATION'S SOLE MEMBER IS COVENANT HEALTH AND COMMUNITY SERVICES, INC. (CHCS). CHCS ELECTS THE BOARD MEMBERS OF COVENANT HOSPICE, INC.
FORM 990, PART VI, SECTION A, LINE 7ACOVENANT HEALTH AND COMMUNITY SERVICES, INC. ELECTS THE BOARD MEMBERS OF COVENANT HOSPICE, INC.
FORM 990, PART VI, SECTION A, LINE 7BTHE FOLLOWING ACTIONS REQUIRE APPROVAL FROM COVENANT HEALTH AND COMMUNITY SERVICES, INC.: - THE APPOINTMENT OR REMOVAL OF A MEMBER OF THE BOARD OF DIRECTORS; - THE INCURRENCE OF ANY SINGLE INDEBTNESS OR OTHER OBLIGATIONS IN EXCESS OF $500,000 OR IN THE AGGREGATE DURING ANY 12 MONTHS OF INDEBTNESS OR OBLIGATIONS IN EXCESS OF $1,000,000; - THE TRANSFER OF ASSETS OF THE CORPORATION IN ONE OR MORE TRANSACTIONS WITH A VALUE IN EXCESS OF $1,000,000 OR ANY TRANSFER IF THE AGGREGATE TRANSFER IN THE PRECEDING 12 MONTHS EXCEEDS A VALUE IS EXCESS OF $2,000,000; - ANY SINGLE CAPITAL EXPENDITURE IN EXCESS OF $500,000 OR ANY CAPITAL EXPENDITURES IF, IN THE AGGREGATE, THERE WILL BE CAPITAL EXPENDITURES IN EXCESS OF $1,000,000 FOR THE PRIOR 12 MONTHS; - DISSOLUTION OF THE CORPORATION; - A MERGER OF THE CORPORATION INTO ANOTHER ENTITY WHERE THE CORPORATION IS NOT THE SURVIVING ENTITY; AND - AN AMENDMENT TO THE ARTICLES OF INCORPORATION OR THE BYLAWS.
FORM 990, PART VI, SECTION B, LINE 11BTHE FORM 990 IS REVIEWED BY STAFF WITH THE ASSISTANCE OF AND REVIEW BY AN INDEPENDENT ACCOUNTING FIRM BEFORE IT IS SIGNED AND SUBMITTED.
FORM 990, PART VI, SECTION B, LINE 12CCONFLICT OF INTEREST STATEMENTS ARE SENT ANNUALLY TO MEMBERS OF THE BOARD OF DIRECTORS, AND ALL KEY STAFF MEMBERS REPORTABLE ON THE FORM 990. THE FORMS ARE REVIEWED FOR RESPONSES INDICATING A POSSIBLE CONFLICT OF INTEREST. IN ADDITION, THE DIRECTOR OF ACCOUNTING REVIEWS TRANSACTIONS WITH VENDORS WITH WHICH THE BOARD MAY BE AFFILIATED TO DETERMINE THAT ALL TRANSACTIONS ARE MADE AT ARM'S LENGTH. IF A POSSIBLE CONFLICT IS IDENTIFIED, THE PERSON WITH A CONFLICT IS PROHIBITED FROM PARTICIPATING IN THE BOARD OF DIRECTORS DELIBERATIONS AND DECISIONS IN THE TRANSACTION.
FORM 990, PART VI, SECTION B, LINE 15THE ORGANIZATION'S TOP MANAGEMENT OFFICIAL AND OTHER OFFICERS ARE PAID BY COVENANT HEALTH AND COMMUNITY SERVICES, INC. TO DETERMINE THE CEO'S, OTHER OFFICERS', AND OTHER EMPLOYEES' COMPENSATION, COVENANT HEALTH AND COMMUNITY SERVICES, INC. PROCURES SALARY COMPARABILITY DATA AND HIRES AN INDEPENDENT FIRM TO DO A SALARY COMPARISON FOR ALL SENIOR ADMINISTRATIVE STAFF. THE SALARY COMPARISON WITH THE INDEPENDENT FIRM IS UNDERTAKEN ANNUALLY. THE CEO'S COMPENSATION IS REVIEWED AND APPROVED BY THE BOARD WITH INSIGHT GIVEN FROM THE SALARY COMPARISON OF THE INDEPENDENT FIRM. THIS PROCESS IS DONE ANNUALLY AND IS DOCUMENTED. THE PROCESS WAS LAST PERFORMED IN 2018. BECAUSE THE ORGANIZATION'S TOP MANAGEMENT OFFICIAL AND OTHER OFFICERS ARE NOT COMPENSATED BY THE FILING ORGANIZATION, THIS QUESTION WAS MARKED "NO" IN ACCORDANCE WITH FORM 990 INSTRUCTIONS.
FORM 990, PART VI, SECTION C, LINE 18GOVERNING DOCUMENTS, FINANCIAL STATEMENTS AND THE ORGANIZATION'S CONFLICT OF INTEREST POLICY ARE AVAILABLE ON WRITTEN REQUEST.
FORM 990, PART VI, SECTION C, LINE 19GOVERNING DOCUMENTS, FINANCIAL STATEMENTS AND THE ORGANIZATION'S CONFLICT OF INTEREST POLICY ARE AVAILABLE ON WRITTEN REQUEST.
FORM 990, PART XI, LINE 9:CHANGE IN CASH SURRENDER VALUE 28,036. CHANGE IN VALUE OF TRUST RECEIVABLE -492,642.
FORM 990, PART XII, LINE 2C:THE EXECUTIVE COMMITTEE ASSUMES RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT. THIS PROCESS HAS NOT CHANGED DURING THE YEAR.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (4 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtControlled OrganizationControlledOrganizationIndDirect Controlling NADirectControllingNACd
COVENANT HOSPICE FOUNDATION INC
5041 N 12TH AVEPENSACOLAFL32504593060139FUNDRAISINGFL501(C)(3)7COVENANT HEALTH AND COMMUNITY SERVICES INC0
ALZHEIMER'S FAMILY SERVICES INC
5041 N 12TH AVEPENSACOLAFL32504593394242SUPPORT TO ALZHEIMERS PATIENTS AND FAMILIESFL501(C)(3)7COVENANT HEALTH AND COMMUNITY SERVICES INC0
COVENANT AT HOME INC
5041 N 12TH AVEPENSACOLAFL32504352543765HOME HEALTH CAREFL501(C)(3)10COVENANT HEALTH AND COMMUNITY SERVICES INC0
COVENANT HEALTH AND COMMUNITY SERVICES INC
5041 N 12TH AVEPENSACOLAFL32504465132177SEE SCHEDULE R, PART VIIFL501(C)(3)100N/A

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp

Related Organization Name RelatedOrganizationName

FieldValueIRS element (for citing)
Business Name Line1CHARITABLE REMAINDER TRUSTBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line15041 N 12TH AVEAddressLine1Txt
CityPENSACOLACityNm
State AbbreviationFLStateAbbreviationCd
ZIP32504ZIPCd
FieldValueIRS element (for citing)
Primary ActivitiesTRUSTPrimaryActivitiesTxt
Legal Domicile StateFLLegalDomicileStateCd

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1COVENANT HOSPICE INCBusinessNameLine1Txt
FieldValueIRS element (for citing)
Entity TypeTEntityTypeTxt
Controlled OrganizationYes (1)ControlledOrganizationInd
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts Rylts0ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org0GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth OrgYes (1)GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other OrgYes (1)LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org0LoansOrGuaranteesFromOthOrgInd
Div Related Organization0DivRelatedOrganizationInd
Asset Sale To Other Org0AssetSaleToOtherOrgInd
Asset Purchase From Other Org0AssetPurchaseFromOtherOrgInd
Asset Exchange0AssetExchangeInd
Rental Of Facilities To Oth OrgYes (1)RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org0RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org0PerformOfServicesForOthOrgInd
Perform Of Services By Other OrgYes (1)PerformOfServicesByOtherOrgInd
Sharing Of FacilitiesYes (1)SharingOfFacilitiesInd
Paid Employees SharingYes (1)PaidEmployeesSharingInd
Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other OrgYes (1)ReimbursementPaidByOtherOrgInd
Transfer To Other Org0TransferToOtherOrgInd
Transfer From Other Org0TransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp (6 entries)

Transaction TypeTransactionTypeTxtInvolvedInvolvedAmtMethod Of Amount DeterminationMethodOfAmountDeterminationTxt
COVENANT HOSPICE FOUNDATION INC
C$3,055,901FMV
MEMORY CARE CLINIC
J$263,160FMV
COVENANT ALZHEIMER'S FAMILY SERVICES
J$6,000FMV
COVENANT HOME HEALTH CARE
J$36,756FMV
PRIVATE DUTY
J$4,375FMV
COVENANT HEALTH AND COMMUNITY SERVICES
O$4,186,950FMV