2018-02-13T12:01:37-06:00 2017-09-30 410746749 CLIFTONLARSONALLEN LLP 420 SOUTH ORANGE AVENUE SUITE 500 ORLANDO FL 32801 990 2016-10-01 591795440 HOSPICE OF STFRANCIS HOSP 3212694240 1250-B GRUMMAN PL TITUSVILLE FL 32780 MARSHA ABELN CHIEF FINANCIAL OFFICER 3212694240 2018-02-08 1 AMY CHAPMAN P00843460 4078021200 2018-02-08 67.137.57.251 2018-02-08 16:34:15 ES P AB3B487CF876E6D678714254ABF4DA4E0998236E 13E35F17B7D82D082A2379BE64EE7EFAAC29CB0E 2016 2021-01-29 14:40:06Z JOSEPH KILLIAN 1250-B GRUMMAN PL TITUSVILLE FL 32780 22528886 0 X HOSPICEOFSTFRANCIS.COM X 1977 FL TO CARE AND SUPPORT THE TERMINALLY ILL AND THEIR LOVED ONES BY UPLIFTING LIVES, UPLIFTING EACH OTHER, AND UPLIFTING OUR COMMUNITY. 12 12 225 181 0 0 0 95000 21146971 21816285 338578 310946 310680 210167 21796229 22432398 1500000 0 0 0 11821994 13039311 0 0 0 8755654 8641761 22077648 21681072 -281419 751326 24366245 26698665 2009998 2473726 22356247 24224939 X TO CARE AND SUPPORT THE TERMINALLY ILL AND THEIR LOVED ONES BY UPLIFTING LIVES, UPLIFTING EACH OTHER, AND UPLIFTING OUR COMMUNITY. 0 0 HOSPICE OF ST. FRANCIS OFFERS A ROBUST PALLIATIVE CARE PROGRAM CALLED ST. FRANCIS PATHWAYS TO HEALTHCARE. THIS INITIATIVE ADDRESSES THE SYMPTOMS & SIDE EFFECTS OF SUCH LIFE-LIMITING MEDICAL CONDITIONS AS CANCER, FAR-ADVANCED HEART, LUNG, KIDNEY & LIVER DISEASE, NEUROLOGICAL DISORDERS, DEMENTIA, & MORE. WHEN THE FIRST IMPACT OF CHRONIC DEBILITATIVE DISEASE IS EXPERIENCED, PALLIATIVE CARE CAN HELP PATIENTS & THEIR CAREGIVERS TO SUCCESSFULLY MANAGE THEIR SELF-CARE TO MINIMIZE PROBLEMS THAT MAKE IT DIFFICULT TO PERFORM ACTIVITIES OF DAILY LIVING OR SEEK CURATIVE TREATMENT. PALLIATIVE CARE CAN ALSO CAN MINIMIZE TRIPS TO THE EMERGENCY ROOM & HOSPITAL ADMISSIONS WHILE SUPPORTING PATIENTS' GOALS FOR THEIR CARE & QUALITY OF LIFE. ST. FRANCIS PATHWAYS TO HEALTHCARE SERVED CLOSE TO 500 PATIENTS IN FISCAL YEAR 2017. PATHWAYS PROVIDES SUPPORT FOR PATIENTS & CAREGIVERS THROUGHOUT THE CONTINUUM OF CARE, INCLUDING TIMES OF TRANSITION, & COLLABORATES WITH COMMUNITY CARE PARTNERS TO PROVIDE THE BEST SERVICES TO PATIENTS AND FAMILIES. 18204937 21827602 HOSPICE OF ST. FRANCIS PROVIDES COMPREHENSIVE HOSPICE CARE SERVICES AND SERVED THE NEEDS OF 1,394 PATIENTS THIS YEAR WITH AN AVERAGE DAILY CENSUS OF 310. THE MAJORITY OF CARE IS PROVIDED IN PATIENTS' RESIDENCES, INCLUDING PRIVATE HOMES, ASSISTED LIVING FACILITIES, AND SKILLED NURSING FACILITIES. HOSPICE CARE IS ALSO PROVIDED IN THE HOSPITAL AND IN OUR EDWARD M. POE HOSPICE CARE CENTER IN TITUSVILLE. A COMPREHENSIVE, INTERDISCIPLINARY TEAM IS RESPONSIBLE FOR A HIGHLY COORDINATED HOSPICE CARE EXPERIENCE FOR BOTH PATIENTS AND FAMILIES. HOSPICE OF ST. FRANCIS OFFERS A DYNAMIC GRIEF SUPPORT PROGRAM THAT IS OPEN TO THE PUBLIC COUNTY-WIDE, REGARDLESS OF WHETHER OR NOT A HOSPICE SERVICE WAS INVOLVED. IN FACT, 175 PEOPLE IN BREVARD PARTICIPATED EVEN THOUGH THEIR LOSS WAS NOT ASSOCIATED WITH OUR HOSPICE CARE. IN THIS YEAR 1,850 PEOPLE WERE SERVED BY THE LICENSED CERTIFIED SOCIAL WORKERS, THROUGH A VARIETY OF GROUP SESSIONS & THEMED WORKSHOPS SUPPORTED BY OTHER COMMUNICATIONS. IN ADDITION, THE SPECIAL NEEDS OF GRIEVING CHILDREN AGE 4-18 WERE SERVED BY THE NORTH STAR FOR CHILDREN PROGRAM WHICH FOCUSES ON THE UNIQUE WAYS IN WHICH CHILDREN GRIEVE. SEVERAL MEMORIAL SERVICES WERE CONDUCTED TO OFFER PEOPLE A PERSONAL CHANCE TO HONOR THEIR LOVED ONES. A SPECIAL PROGRAM ON SURVIVING THE HOLIDAYS WAS PRESENTED TO 135 SENIORS IN LOCATIONS ACROSS BREVARD. HOSPICE OF ST. FRANCIS IS PROUD OF THE EXTENSIVE SCOPE OF ITS BEREAVEMENT SERVICE, RECOGNIZING THAT DEALING WITH GRIEF IS AN INTEGRAL PART OF HEALING AFTER LOSS. HOSPICE OF ST. FRANCIS IS A NOT-FOR-PROFIT ORGANIZATION THAT EMBRACES A VIBRANT COMMUNITY PARTNERSHIP. MORE THAN 180 VOLUNTEERS DONATE OVER $12,648 HOURS OF TIME TO PROVIDE DIRECT PATIENT CARE SERVICES AND ADMINISTRATIVE SUPPORT FOR THE FULL ARRAY OF PROGRAMS. THE VOLUNTEER PROGRAM ALSO PROVIDE SPECIAL SERVICES FOR VETERANS. AS A LEVEL THREE MEMBER OF WE HONOR VETERANS, A COLLABORATIVE PROGRAM BETWEEN THE VETERANS ADMINISTRATION AND THE NATIONAL ASSOCIATION OF HOSPICE AND PALLIATIVE CARE ORGANIZATIONS, HOSPICE OF ST. FRANCIS PERFORMS VETERAN PINNING AND ISSUES VETERAN CERTIFICATIONS. OUR MILITARY VOLUNTEERS CONDUCTED OVER 50 PINNING CEREMONIES FOR VETERANS AND THEIR FAMILIES. THIS YEAR, WE SERVED THE NEEDS OF 680 VETERANS IN OUR VARIOUS PROGRAMS. ANOTHER ONE OF OUR VOLUNTEER INITIATIVES IS THE PET PLEDGE PROGRAM, WHICH PROVIDES PLACEMENT SERVICES FOR BELOVED PETS WHEN PATIENTS ARE NO LONGER ABLE TO CARE FOR THEM AND THERE IS NO FAMILY MEMBER ABLE TO TAKE RESPONSIBILITY. 18204937 1 1 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 1 59 0 225 1 0 0 0 0 0 0 0 0 0 0 X 12 12 0 0 0 0 0 0 0 1 1 0 0 0 1 0 1 1 1 1 1 0 FL X JOSEPH KILLIAN 3212694240 1250-B GRUMMAN PL TITUSVILLE FL 32780 DWIGHT SEVERS CHAIRPERSON 3.00 0.00 X X 0 0 0 SAMUEL HADDAD VICE CHAIRPERSON 3.00 1.00 X X 0 0 0 DAVID FERGUSON SECRATARY/TREASURER 3.00 0.00 X X 0 0 0 TONY HURT PAST CHAIR 3.00 1.00 X 0 0 0 MARY ANN ALDERMAN DIRECTOR 1.00 0.00 X 0 0 0 CHRISTOPHER MCALPINE DIRECTOR 1.00 1.00 X 0 0 0 KIM RODRIGUEZ DIRECTOR 1.00 1.00 X 0 0 0 THERESA ABRUZZO-PRICE DIRECTOR 1.00 1.00 X 0 0 0 RENE PULIDO DIRECTOR 1.00 0.00 X 0 0 0 JERRY ALLENDER DIRECTOR 1.00 0.00 X 0 0 0 LINDA WEINBERG DIRECTOR 1.00 0.00 X 0 0 0 MICHAEL AMMEN DIRECTOR 1.00 1.00 X 0 0 0 JOSEPH KILLIAN CHIEF EXECUTIVE OFFICER 40.00 1.00 X 191091 0 17362 PAULINE TAYLOR THROUGH FEB 2017 CHIEF OPERATING OFFICER 40.00 0.00 X 132576 0 6653 CAMI LEECH FLORIO APRIL 2017 CHIEF OPERATING OFFICER 40.00 0.00 X 0 0 0 MARSHA ABELN CHIEF FINANCIAL OFFICER 40.00 1.00 X 97631 0 239 ELIZABETH GALFO MD CHIEF MEDICAL DIRECTOR 40.00 0.00 X 275671 0 8341 ALICIA CATO COMPLIANCE OFFICER 40.00 0.00 X 0 0 0 JAMES BOMBARD MD PHYSICIAN 40.00 0.00 X 183551 0 2159 MINA ZEINIMD PHYSICIAN 40.00 0.00 X 216270 0 2236 GERMAIN BLAINE MD PHYSICIAN THROUGH JAN 2017 0.00 40.00 X 0 199346 10014 KENNETH SALUCK MD PHYSICIAN 40.00 40.00 X 180997 0 6635 1277787 199346 53639 6 0 1 0 VIERA HEALTH & REHAB CENTER 8050 SPYGLASS HILL RD VIERA FL 32940 NURSING HOME R&B 689873 CAPSTONE HME 2215 15TH STREET TUSCALOOSA AL 34501 DURABLE MEDICAL EQUIPMENT SERVICES 648917 VISTA MANOR 1550 JESS PARRISH CT TITUSVILLE FL 32796 NURSING HOME R&B 607100 ENCLARA PHARMACIA 1480 EMPERIAL WAY WEST DEPTFORD NJ 08066 PRESCRIPTION MEDICATIONS 598211 ROYAL OAK NURSING & REHAB CENTER 37300 ROYAL OAK LANE TITUSVILLE FL 33525 NURSING HOME R&B 523038 5 95000 95000 MEDICARE 623000 17068896 17068896 MEDICAID 623000 3910735 3910735 PRIVATE INSURANCE 623000 791188 791188 SELF-PAY 623000 208046 208046 NET OF CHARITY CARE 623000 -162580 -162580 21816285 311434 311434 294850 96000 198850 198850 198850 488 -488 -488 -488 OTHER INCOME 623000 11317 11317 11317 22432398 21827602 0 509796 782463 337265 445198 10419574 8607271 1812303 235939 196423 39516 1016614 822713 193901 584721 467777 116944 180091 144073 36018 40623 32498 8125 209251 167401 41850 88468 70774 17694 571959 457567 114392 395212 316170 79042 35823 28658 7165 468708 374966 93742 93872 75098 18774 NURSING HOME COSTS 4544049 4544049 EQUIPMENT RENTAL 801643 641314 160329 BAD DEBT EXPENSE 348052 348052 MEDICAL SUPPLIES 293317 293317 570693 279551 291142 21681072 18204937 3476135 0 3051519 2223518 278669 352178 1376214 1839829 91612 211361 9714816 2044511 7700639 7670305 11706888 13107244 35127 1075342 125577 218888 24366245 26698665 2009998 2473726 2009998 2473726 X 22356247 24224939 22356247 24224939 24366245 26698665 751326 1117366 0 X X 0 1 X 1 0 X 903288 113021 134813 95000 1246122 14641413 15777361 18954901 21146971 21816285 92336931 15544701 15890382 19089714 21146971 21911285 93583053 0 0 0 93583053 1197834 1289632 659604 744974 606284 4498328 1197834 1289632 659604 744974 606284 4498328 414704 402463 817167 2277 5039 11317 18633 17159516 17582477 19749318 21896984 22528886 98917181 0.94610 0.94280 0.04550 0.04360 X SCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME: MISCELLANEOUS REVENUE - 2012 AMOUNT: $ 2,277. 2015 AMOUNT: $ 5,039. 2016 AMOUNT: $ 11,317. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 3500000 3500000 4604595 -1104595 3500000 4391491 213104 4604595 4391491 4391491 3792504 598987 4391491 1.00000 0 0 265000 812856 1077856 6947875 1144569 5803306 1679294 899942 779352 9791 9791 7670305 22526898 94500 94500 22432398 0 22432398 21553944 96000 96000 21457944 223128 223128 21681072 PART XI, LINE 2D - OTHER ADJUSTMENTS: RENTAL EXPENSES 96,000. CONTRIBUTION EXPENSE -1,500. PART XII, LINE 2D - OTHER ADJUSTMENTS: RENTAL EXPENSES 96,000. PART XII, LINE 4B - OTHER ADJUSTMENTS: HEALTH CARE CLAIM SETTLEMENTS 221,628. CONTRIBUTION EXPENSE 1,500. X X X X X 0 0 0 0 0 0 0 0 0 JOSEPH KILLIAN CHIEF EXECUTIVE OFFICER 179221 0 10500 0 1370 0 1309 0 16053 0 208453 0 0 0 ELIZABETH GALFO MD CHIEF MEDICAL DIRECTOR 252949 0 0 0 22722 0 3376 0 4965 0 284012 0 0 0 JAMES BOMBARD MD PHYSICIAN 180981 0 0 0 2570 0 1925 0 234 0 185710 0 0 0 MINA ZEINIMD PHYSICIAN 216137 0 0 0 133 0 2205 0 31 0 218506 0 0 0 GERMAIN BLAINE MD PHYSICIAN THROUGH JAN 2017 0 196030 0 0 0 3316 0 668 0 9346 0 209360 0 0 KENNETH SALUCK MD PHYSICIAN 176642 0 0 0 4355 0 2031 0 4604 0 187632 0 0 0 PART I, LINE 3 THE BONUS RECEIVED BY THE PRESIDENT/CEO IS BASED ON SEVERAL FACTORS SUCH AS: QUALITY MEASURES, MARGIN, AND OPERATIONAL PERFORMANCE. A SPECIFIC CALCULATION IS PROVIDED BY THE BOARD OF DIRECTORS TO DETERMINE THE INCENTIVE COMPENSATION. THE TOTAL INCENTIVE AVAILABLE IS 25% OF BASE COMPENSATION, OF WHICH 40% OF THE INCENTIVE IS DRIVEN BY NET OPERATING INCOME. FORM 990, PART VI, SECTION B, LINE 11B THE 990 IS PREPARED BY AN OUTSIDE ACCOUNTING FIRM BASED ON THE INFORMATION SUBMITTED BY MANAGEMENT. THE COMPLETED 990 IS PRESENTED TO MANAGEMENT FOR INTERNAL REVIEW. ONCE APPROVED, THE 990 IS SHARED WITH THE BOARD OF DIRECTORS AND SUBMITTED TO THE IRS ELECTRONICALLY. FORM 990, PART VI, SECTION B, LINE 12C THE CONFLICT OF INTEREST POLICY IS PRESENTED TO AND SIGNED OFF BY NEW BOARD MEMBERS. DURING THE SCHEDULED ORIENTATION PERIOD FOR THE MEMBER WHEN ITEMS ARE DISCUSSED. DURING A BOARD MEETING, BOARD MEMBERS ARE REQUESTED TO DECLARE ANY CONFLICT OF INTEREST OR RELATIONSHIP TO ANY PARTY ASSOCIATED WITH THE ITEMS. IF A CONFLICT OR RELATIONSHIP EXISTS, THEN THE POLICY TERMS ARE FOLLOWED BY THE BOARD. THE BOARD MEMBERS PROVIDE AN ANNUAL DISCLOSURE AND CONFIRMATION THAT IS USED FOR ONGOING CONFIRMATION OF CONFLICTS. THIS POLICY IS MONITORED BY THE PRESIDENT/CEO. FORM 990, PART VI, SECTION B, LINE 15 THE CEO COMPENSATION IS BASED ON BASE AND BONUS SYSTEM. THE CEO'S PAY RANGE IS COMPARED TO THE REGIONAL HOMECARE AND HOSPICE ANNUAL SALARY AND BENEFITS REPORT, PUBLISHED BY HOSPITAL & HEALTHCARE COMPENSATION SERVICE. THE DATA IN THIS REPORT INCLUDES THE RELEVANT DATA FROM HOSPICE OF ST. FRANCIS. THE RANGE FOR THE CEO IS COMPARED TO THE REGIONAL AND STATE COMPENSATION LEVELS. THEN THE BONUS STRUCTURE IS ESTABLISHED TO PROVIDE INCREMENTAL REIMBURSEMENT UPON ATTAINING OBJECTIVE GOALS. ALL OF THE INFORMATION IS REVIEWED ANNUALLY WITH THE BOARD OF DIRECTORS PERSONNEL COMMITTEE, WHICH IS MADE UP OF EIGHT INDEPENDENT MEMBERS, AND DOCUMENTED IN THE BOARD MINUTES. OTHER KEY EMPLOYEE COMPENSATION ALSO USES THE REGIONAL HOMECARE AND HOSPICE ANNUAL SALARY AND BENEFITS REPORT, PUBLISHED BY HOSPITAL & HEALTHCARE COMPENSATION SERVICE. THE DATA IN THIS REPORT INCLUDES THE RELEVANT DATA FROM HOSPICE OF ST FRANCIS. THE RANGE FOR THESE STAFF ARE COMPARED TO THE REGIONAL AND STATE COMPENSATION LEVELS. ALL OF THE INFORMATION IS REVIEWED ANNUALLY WITH THE BOARD OF DIRECTORS PERSONNEL COMMITTEE, WHICH IS MADE UP OF EIGHT INDEPENDENT MEMBERS, AND DOCUMENTED IN THE BOARD MINUTES. FORM 990, PART VI, SECTION C, LINE 19 HOSPICE OF ST. FRANCIS' FORM 990 CAN BE FOUND AT GUIDESTAR.ORG. ALL OTHER DOCUMENTS CAN BE OBTAINED UPON REQUEST. FORM 990, PART XII, LINE 2C THE OVERSIGHT AND SELECTION PROCESS FOR THE AUDIT OCCURS DURING THE YEAR. THE RESULTS OF THE AUDIT ARE PRESENTED TO AND REVIEWED BY THE BOARD OF DIRECTORS. THIS PROCESS REMAINED THE SAME AS PRIOR YEAR. FORM 990, PART VII, SECTION A TIME DEVOTED TO THE HOSPICE OF ST. FRANCIS FOUNDATION, INC. - EIN#47-5116106: NAME TITLE HRS/WK DEVOTED TONY HURT CHAIRPERSON 1.00 CHRIS MCALPINE VICE CHAIRPERSON 1.00 THERESA ABRUZZO-PRICE SECRETARY 1.00 SAMUAL HADDAD TREASURER 1.00 KIM RODRIGUEZ DIRECTOR 1.00 MICHAEL AMMEN DIRECTOR 1.00 JOSEPH KILLIAN CHIEF EXECUTIVE OFFICER 1.00 MARSHA ABELN CHIEF FINANCIAL OFFICER 1.00 ST FRANCIS PATHWAYS TO HEALTHCARE LLC 1250 B GRUMMAN PLACE TITUSVILLE FL 32780 473461176 PROVIDE PALLIATIVE CARE FL -312551 195067 HOSPICE OF ST FRANCIS THE HOSPICE OF ST FRANCIS FOUNDATION INC 1250 B GRUMMAN PLACE TITUSVILLE FL 32780 475116106 ORGANIZED TO SUPPORT HOSPICE OF ST. FRANCIS FL 501(C)(3) LINE 12A, I 0 0 0 1 1 0 0 0 0 0 0 0 1 0 1 1 0 1 0 0