2019-07-29T13:21:45-05:00 2018-12-31 560570567 D M J & CO PLLC 703 GREEN VALLEY ROAD SUITE 201 GREENSBORO NC 27408 990 2018-01-01 561376378 HOSPICE OF RANDOLPH COUNTY INC HOSP 3366729300 416 VISION DRIVE ASHEBORO NC 27203 RHONDA BURCH MOFFITT CEO/PRESIDENT 3366729300 2019-07-17 1 SHIRLEY WEIGEL CPA P00838276 3362759886 174.46.138.125 2019-07-17 08:47:03 ED P 330C3B8C56B363D3B9A0A0725ECA0DCAA05DD79B E66EB5312E36191B699F4433D69CAAF4BF170306 2018 2019-02-21 02:37:17Z RHONDA BURCH MOFFITT 416 VISION DRIVE ASHEBORO NC 27203 8422772 0 X WWW.HOSPICEOFRANDOLPH.ORG X 1981 NC MISSION: HOSPICE OF RANDOLPH COUNTY SERVES AS AN EDUCATION LEADER WHILE PROMOTING QUALITY OF LIFE AND SUPPORTING PATIENTS AND THEIR FAMILIES IN PREPARING FOR COMPLETION OF LIFE. ACTIVITIES: TO PROVIDE SUPPORT AND EMOTIONAL ASSISTANCE TO PATIENTS AND THEIR FAMILIES WITH PAIN MANAGEMENT, SYMPTOM CONTROL, AND REHABILITATION DURING EMOTIONAL CRISIS RELATED TO END-OF-LIFE CARE. SPECIAL THERAPIES, ACUTE CARE, CONTINUOUS CARE, AND RESPITE AND ROUTINE HOME CARE ARE REIMBURSED BY REVENUE RESOURCES ALONG WITH SOME SUPPLIES, DURABLE MEDICAL EQUIPMENT, AND DRUGS. SERVICES ARE DELIVERED UNDER A HOLISTIC PLAN OF CARE. 14 13 113 73 0 0 146549 166545 7821615 8084053 398661 16294 131882 133364 8498707 8400256 0 0 0 0 5199825 5414773 0 0 72226 2000261 2094772 7200086 7509545 1298621 890711 10947487 11873792 614814 643358 10332673 11230434 HOSPICE OF RANDOLPH COUNTY SERVES AS AN EDUCATIONAL LEADER WHILE PROMOTING QUALITY OF LIFE AND SUPPORTING PATIENTS AND THEIR FAMILIES IN PREPARING FOR COMPLETION OF LIFE. 0 0 5151144 8084222 PROVIDE SUPPORT AND EMOTIONAL ASSISTANCE TO PATIENTS AND THEIR FAMILIES WITH PAIN MANAGEMENT, SYMPTOM CONTROL, REHABILITATION AND EMOTIONAL CRISIS. SPECIAL THERAPIES, ACUTE CARE, CONTINUOUS CARE, RESPITE AND ROUTINE HOME CARE ARE REIMBURSED BY THE ABOVE REVENUE RESOURCES ALONG WITH SOME SUPPLIES, DURABLE MEDICAL EQUIPMENT, AND DRUGS. SERVICES ARE DELIVERED UNDER A HOLISTIC PLAN OF CARE. DURING 2018, HOSPICE OF RANDOLPH COUNTY PROVIDED 48,752 DAYS OF PATIENT CARE FOR ITS 900 HOSPICE, HOME HEALTH, AND KIDS PATH PATIENTS. 5151144 1 1 0 0 0 0 0 1 0 0 1 0 0 0 0 1 1 0 0 0 0 0 0 0 1 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 36 0 113 1 0 0 0 0 0 0 0 0 0 0 0 0 X 14 13 1 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 NC X X TRACY WAGNER 3366729300 416 VISION DRIVE ASHEBORO NC 27203 JOHN S ROGERS DIRECTOR 1.00 X 0 0 0 SANDRA J ALLEN DIRECTOR 1.00 X 0 0 0 DR MALKIAT DHATT DIRECTOR 1.00 X 0 0 0 STEVE EBLIN DIRECTOR 1.00 X 0 0 0 GLENN M PUGH DIRECTOR 1.00 X 0 0 0 ROXANNE TAYLOR DIRECTOR 1.00 X 0 0 0 CURT LORIMER DIRECTOR 1.00 X 0 0 0 BEN C MORGAN DIRECTOR 1.00 X 0 0 0 BRIAN MUNLEY DIRECTOR 1.00 X 0 0 0 STANLEY BECK DIRECTOR 1.00 X 0 0 0 RHONDA BURCH MOFFITT CEO/PRESIDENT 40.00 X 132410 0 14092 TRACY B WAGNER CFO 40.00 X 70119 0 25650 RICK CRAWFORD TREASURER 1.00 X 0 0 0 AMY WILLIAMS SECRETARY 1.00 X 0 0 0 BILLIE VUNCANNON DIRECTOR - EMERITUS 1.00 X 0 0 0 RHONDA TROLLINGER BOARD CHAIR 1.00 X 0 0 0 SCOTT A MURKIN MD MEDICAL DIRECTOR 40.00 X 183384 0 25753 PATRICIA SHEVILIN MD ASSOCIATE MEDICAL DIRECTOR 40.00 X 118813 0 3432 504726 0 68927 3 0 1 0 ENCLARA PHARMACIA 1601 CHERRY ST SUITE 1700 PHILADELPHIA PA 19102 PATIENT MEDICATIONS 497440 GRAYBRIER NURSING CENTER 116 LANE DR TRINITY NC 27370 PATIENT CARE FACILITY 430611 ADVANCED HOMECARE PO BOX 18049 GREENSBORO NC 27419 MEDICAL SUPPLIES 280965 WOODLAND HILL CARE AND REHAB 400 VISION DR ASHEBORO NC 27203 PATIENT CARE FACILITY 279644 RANDOLPH HEALTH AND REHAB 230 EAST PRESNELL ST ASHEBORO NC 27203 PATIENT CARE FACILITY 172098 9 1896 164649 166545 MEDICARE PAYMENTS 621610 7703903 7703903 PRIVATE INSURANCE 621610 223291 223291 MEDICAID PAYMENTS 621610 156859 156859 8084053 16294 16294 155711 22516 133195 133195 169 169 169 8400256 8084222 0 149489 573653 573653 4000910 3261044 679849 60017 85383 72518 11530 1335 433692 319501 107931 6260 321135 222828 93693 4614 28199 28199 91915 91915 151160 143127 8033 224274 224274 31692 31692 MEDICINES AND DRUGS 497990 497990 DURABLE MEDICAL EQUIPME 265835 265835 MEDICAL AND OFFICE SUPP 140348 114608 25740 JANITORIAL AND LANDSCAP 76811 76811 586548 253693 332855 7509545 5151144 2286175 72226 2319347 2107912 2956373 4050145 988403 1042593 117268 126203 7541067 3175652 4384572 4365415 181524 181524 10947487 11873792 614814 643358 614814 643358 X 10332673 11230434 10332673 11230434 10947487 11873792 890711 7050 0 X X 0 1 X 1 0 X 248735 110449 153897 146549 166545 826175 248735 110449 153897 146549 166545 826175 180594 645581 3398 4109 5206 6650 23344 42707 868882 38205810 0.74300 0.74450 X 42964 X 0 504937 504937 5282872 1909394 3373478 1753258 1266258 487000 4365415 X 8429822 7050 22516 29566 8400256 0 8400256 7532061 22516 22516 7509545 0 7509545 PART III, LINE 4: THE ORGANIZATION HAS VARIOUS WORKS OF ART LOCATED AT ITS TWO LOCATIONS ON VISION DRIVE. THE ADMINISTRATIVE BUILDING HOUSES A FRAMED INK PRINT DONATED TO THE ORGANIZATION, AND ITS VALUE IS STATED AT $22,000 (WHICH WAS THE FAIR MARKET VALUE AT THE TIME OF THE DONATION). IN ADDITION, THE NEW INPATIENT FACILITY HOUSES SUCH PURCHASED WORKS OF ART AS FRAMED ORIGINAL PAINTINGS AND PHOTOGRAPHY, LARGE DECORATIVE POTTERY PIECES, MOUNTED MUSEUM-QUALITY HOMEMADE QUILTS, A METAL SCULPTURE, AND AN ORIGINAL HAND-PAINTED WALL MURAL. IN THE AGGREGATE, THESE PARTICULAR ITEMS ARE STATED AT THE $20,964 PRICE PAID BASED ON ARMS-LENGTH TRANSACTIONS. PART X, LINE 2: THE ORGANIZATION IS EXEMPT FROM FEDERAL AND STATE INCOME TAXES UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE AND, THEREFORE, HAS NO PROVISION FOR INCOME TAXES. THE ORGANIZATION ACCOUNTS FOR UNCERTAIN INCOME TAX POSITIONS BY PRESCRIBING A MINIMUM PROBABILITY THRESHOLD A TAX POSITION MUST MEET BEFORE A FINANCIAL STATEMENT INCOME TAX BENEFIT IS RECOGNIZED. THE MINIMUM THRESHOLD IS DEFINED AS A TAX POSITION, BASED SOLELY ON ITS TECHNICAL MERITS, THAT WOULD MORE LIKELY THAN NOT BE SUSTAINED UPON EXAMINATION BY THE RELEVANT TAX AUTHORITY WITH KNOWLEDGE OF THE SAME FACTS. THE TAX BENEFIT TO BE RECOGNIZED IS MEASURED AS THE LARGEST AMOUNT OF BENEFIT THAT IS GREATER THAN 50% LIKELY OF BEING REALIZED UPON ULTIMATE RESOLUTION. BASED ON ALL KNOWN FACTS AND CIRCUMSTANCES AND CURRENT TAX LAW, THE ORGANIZATION BELIEVES THE TOTAL AMOUNT OF UNCERTAIN INCOME TAX POSITION LIABILITIES AND RELATED ACCRUED INTEREST ARE NOT MATERIAL TO ITS FINANCIAL POSITION. PART XI, LINE 2D - OTHER ADJUSTMENTS: FUNDRAISING EXPENSES NETTED WITH REVENUE ON TAX RETURN 22,516. PART XII, LINE 2D - OTHER ADJUSTMENTS: FUNDRAISING EXPENSES NETTED WITH REVENUE ON TAX RETURN 22,516. ANNUAL AUCTION BBQ 76669 76669 5191 HOLLY RIDGE CHARITY GOLF CLASSIC 17600 17600 0 7 48518 48518 7623 142787 142787 12814 12814 129973 X X X 0 0 0 0 0 0 0 0 0 SCOTT A MURKIN MD MEDICAL DIRECTOR 183384 0 0 0 0 0 0 0 25753 0 209137 0 0 0 PART I, LINE 3 CEO/DIRECTOR COMPENSATION IS REVIEWED AND APPROVED ANNUALLY BY THE COMPENSATION COMMITTEE WHICH CONSISTS OF THREE BOARD MEMBERS APPOINTED BY THE BOARD CHAIR FOR DETERMINATION OF THIS EMPLOYEE'S COMPENSATION AMOUNT, HRC REFERS TO THE HOSPICE & HOME HEALTH SALARY & BENEFITS REPORT THAT IS PUBLISHED EVERY TWO YEARS BY THE HOSPITAL & HEALTHCARE COMPENSATION SERVICE (IN COOPERATION WITH THE NATIONAL ASSOCIATION FOR HOME CARE & HOSPICE). IN ADDITION, A REVIEW IS MADE OF BENCHMARKING DATA FROM MULTI-VIEW INC.'S HOSPICE COMPENSATION SURVEY AS WELL AS COMPARABLE SALARIES ON PUBLICLY-ACCESSIBLE FORM 990S SUBMITTED BY HOSPICES OF OUR SIMILAR SIZE AND SCOPE. THEN THE COMPENSATION COMMITTEE MAKES THE RECOMMENDATION TO THE BOARD FOR APPROVAL. FORM 990, PART VI, SECTION A, LINE 2 SEVERAL OF THE BOARD MEMBERS DO BUSINESS WITH HOSPICE OF RANDOLPH COUNTY AND WITH EACH OTHER. FOR EXAMPLE, THERE ARE DOCTORS ON THE BOARD WHO MAY REFER THEIR PATIENTS FOR HOSPICE CARE WHEN APPROPRIATE. BOARD MEMBERS ARE PROHIBITED FROM VOTING ON ANY ISSUES WHERE A POTENTIAL CONFLICT EXISTS. FORM 990, PART VI, SECTION B, LINE 11B BOARD MEMBERS REVIEW A DRAFT FORM OF THE 990 PRIOR TO FILING. THE REVIEW EITHER OCCURS DURING A BOARD MEETING OR THE RETURN IS SENT TO THE BOARD MEMBERS INDIVIDUALLY. FILING DOES NOT OCCUR UNTIL ALL BOARD MEMBERS HAVE INDICATED THEIR APPROVAL. FORM 990, PART VI, SECTION B, LINE 12C INDIVIDUALS IN CERTAIN SENSITIVE POSITIONS WHO MAKE SUBSTANTIAL AND FREQUENT DECISIONS AFFECTING THE INTERESTS OF HRC ARE REQUIRED TO COMPLETE AND SIGN AN ANNUAL CONFLICT OF INTEREST DISCLOSURE FORM. THE FORMS ARE DISTRIBUTED AND COLLECTED BY THE CORPORATE COMPLIANCE OFFICER (CCO). THE CCO REVIEWS WITH THE CEO/PRESIDENT ANY DISCLOSED CONFLICTS TO DETERMINE WHETHER DISQUALIFICATION FROM CERTAIN DECISIONS IS APPROPRIATE. FORM 990, PART VI, SECTION B, LINE 15 CEO/DIRECTOR COMPENSATION IS REVIEWED AND APPROVED ANNUALLY BY THE COMPENSATION COMMITTEE WHICH CONSISTS OF THREE BOARD MEMBERS APPOINTED BY THE BOARD CHAIR FOR DETERMINATION OF THIS EMPLOYEE'S COMPENSATION AMOUNT, HRC REFERS TO THE HOSPICE & HOME HEALTH SALARY & BENEFITS REPORT THAT IS PUBLISHED EVERY TWO YEARS BY THE HOSPITAL & HEALTHCARE COMPENSATION SERVICE (IN COOPERATION WITH THE NATIONAL ASSOCIATION FOR HOME CARE & HOSPICE). IN ADDITION, A REVIEW IS MADE OF BENCHMARKING DATA FROM MULTI-VIEW INC.'S HOSPICE COMPENSATION SURVEY AS WELL AS COMPARABLE SALARIES ON PUBLICLY-ACCESSIBLE FORM 990S SUBMITTED BY HOSPICES OF OUR SIMILAR SIZE AND SCOPE. THEN THE COMPENSATION COMMITTEE MAKES THE RECOMMENDATION TO THE BOARD FOR APPROVAL. FORM 990, PART VI, SECTION C, LINE 19 CFO HAS A COPY OF THE AGENCY'S 990 TAX RETURN, COPY OF AUDITED FINANCIAL STATEMENTS, COPY OF CONFLICT OF INTEREST POLICY AT THE AGENCY'S OFFICE FOR ANYONE TO REVIEW PLUS THE 990 TAX RETURN CAN BE ACCESSED VIA GUIDESTAR. FORM 990, PART XII, LINE 2C: THE PROCESS FOR REVIEWING THE AUDIT AND SELECTING AN INDEPENDENT ACCOUNTANT HAS NOT CHANGED.