2014-04-15T19:00:08-05:00 2013-06-30 CROWE HORWATH LLP 70 West Madison Street Suite 700 Chicago IL 606024903 990 2012-07-01 421093718 HOSPICE OF CENTRAL IOWA HOSP 5152743400 2910 Westown Parkway West Des Moines IA 502661332 NORENE MOSTKOFF 2014-04-09 true Nicole Bencik P00756195 3128997000 2012 2015-11-30 17:44:51Z HCI CARE SERVICES NORENE MOSTKOFF 2910 Westown Parkway West Des Moines IA 502661332 20121586 false X WWW.HOSPICEOFCENTRALIOWA.ORG X 1978 IA HCI CARE SERVICES' MISSION IS "PROMOTING DIGNITY, INDEPENDENCE AND QUALITY OF LIFE THROUGH COMPASSIONATE AND EFFECTIVE COMMUNITY BASED CARE." DURING THE YEAR ENDED JUNE 30, 2013, HCI CARE SERVICES PROVIDED CHARITY CARE VALUED AT $371,600 TO PATIENTS WHO ARE UNABLE TO PAY FOR THE COST OF THEIR CARE. 18 18 316 640 0 0 1099225 1120124 19140361 17166087 310733 323471 278864 392117 20829183 19001799 22423 385067 0 0 12450322 11642532 0 0 54877 8579345 8010715 21052090 20038314 -222907 -1036515 22568057 22945392 2905354 3652533 19662703 19292859 X HCI CARE SERVICES PROVIDES END-OF-LIFE CARE FOR INDIVIDUALS AND FAMILIES LIVING WITH A SERIOUS ILLNESS. THESE SERVICES PROVIDE PHYSICAL, EMOTIONAL, SOCIAL AND SPIRITUAL CARE FOR PATIENTS WITH A LIMITED LIFE EXPECTANCY. (CONTINUED IN SCHEDULE O) false false 16567152 385067 17341644 DONOR SUPPORT HELPS ENSURE ALL WHO NEED HCI CARE SERVICES' CARE RECEIVE IT; NO ONE IS TURNED AWAY DUE TO LACK OF INSURANCE OR INABILITY TO PAY. FROM JULY 1, 2012, THROUGH JUNE 30, 2013, QUALIFYING HCI CARE SERVICES PATIENTS IN NEED RECEIVED CHARITY CARE VALUED AT $371,600. THE COST OF THE CHARITY CARE, BASED ON HCI CARE SERVICES' COST-TO-CHARGE RATIO WAS APPROXIMATELY $316,000. HCI CARE SERVICES ALSO RECEIVES SIGNIFICANT IN-KIND DONATIONS OF TIME AND EFFORT THROUGH ITS VOLUNTEERS. IN THE YEAR ENDING JUNE 30, 2013, MORE THAN 600 VOLUNTEERS DONATED 25,397 VOLUNTEER HOURS, EQUAL TO $401,000 IN VALUE TO THE ORGANIZATION. (CONTINUED IN SCHEDULE O) 16567152 true true false true false false false false true true true false true false true true true false false false false false false false false false true true true false false false true false false false false true false false false true true false false false false true 169 0 true 316 true false false false false false false false false false false X 18 18 false false true false true true true true true false false true true true true true true false false false X X Kelly Dennis 5152743400 2910 Westown Parkway Suite 200 West Des Moines IA 50266 ANN M JEFFRIES 1.00 2.00 X X 0 0 0 JOHN M PAULE 1.00 2.00 X X 0 0 0 KIM M WILLIS 1.00 2.00 X X 0 0 0 MARK W BEERMAN 1.00 2.00 X X 0 0 0 BRAD WYCKOFF 1.00 2.00 X 0 0 0 CHARLES E CUTLER 1.00 2.00 X 0 0 0 CONNIE L ISAACSON 1.00 2.00 X 0 0 0 DEBRA MILLIGAN 1.00 2.00 X 0 0 0 GARY L HOFF DO 1.00 2.00 X 0 0 0 GEMECHISA M MOSA 1.00 2.00 X 0 0 0 JOHN D PITTMAN 1.00 2.00 X 0 0 0 JUDITH A RALSTON-HANSEN 1.00 2.00 X 0 0 0 KENT W MAUCK 1.00 2.00 X 0 0 0 MATTHEW J MEYER 1.00 2.00 X 0 0 0 NICK J HENDERSON 1.00 2.00 X 0 0 0 PRISCILLA L RUHE MD 1.00 2.00 X 0 0 0 REBECCA L PURNELL 1.00 2.00 X 0 0 0 RYAN L RILEY 1.00 2.00 X 0 0 0 SALLY A REAVELY 1.00 2.00 X 0 0 0 KELLY DENNIS 10.00 30.00 X 140918 0 15400 NORENE MOSTKOFF 10.00 30.00 X 286794 0 28429 TRAY WADE 20.00 20.00 X 132778 0 14828 THOMAS MOUSER 40.00 0.00 X 196494 0 37273 756984 0 95930 4 false true false MAXIM HEALTHCARE SERVICES INC 12558 COLLECTIONS CENTER DRIVE CHICAGO IL 60693 CONTRACTED RN AND AIDE SERVICES 264682 CONSOLIDATED MANAGEMENT 2670 106TH ST STE 140 DES MOINES IA 50322 CONTRACTED FOOD SERVICE 137192 2 336783 503317 280024 1050 1120124 PATIENT SERVICE REVENUE 621610 17166087 17166087 0 0 0 0 0 0 0 0 17166087 118906 118906 0 0 0 0 0 1324352 1119787 204565 0 204565 204565 0 0 212385 212385 212385 VNS PURCHASED SERVICES 900999 170678 170678 EDUCATION/INSTITUTE REVENUE 611710 4879 4879 REIMBURSEMENTS FOR COPY FEES 561000 1527 1527 2648 0 0 2648 179732 19001799 17341644 0 540031 365360 365360 19707 19707 0 0 746141 381373 364768 0 8920891 7636060 1284831 238838 200988 37850 1039933 840522 199411 696729 596969 99760 0 10496 10496 71071 71071 0 0 0 1101376 934694 166682 0 163733 58234 105499 330035 234154 95881 0 0 626000 411395 199038 15567 745462 709199 36263 0 27583 23280 4303 49377 49377 0 834160 587885 246275 0 CONTRACTED FACILITY AND ROOM AND BOARD 1923639 1923639 BAD DEBT EXPENSE 90016 90016 MEMBERSHIP DUES 32490 10397 22093 PHARMACY AND DIRECT PATIENT SUPPLIES 1517098 1509660 7438 488179 33620 415249 39310 20038314 16567152 3416285 54877 0 1425 1525 144066 200187 165962 127795 1751901 2106225 11538 0 289015 118717 14067114 5710256 9470928 8356858 4152429 4479248 5414566 5870661 0 0 1177765 1672638 22568057 22945392 1926910 1535318 0 978444 2117215 0 0 2905354 3652533 X 14082168 12971663 5580535 6321196 19662703 19292859 22568057 22945392 X -1036515 165829 500842 X false true X true false X 1156581 963858 996722 1099225 1120124 5336510 19418740 19633210 20396394 19140361 17166087 95754792 7448 900 224169 359255 216560 808332 0 0 20582769 20597968 21617285 20598841 18502771 101899634 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 101899634 189645 152787 145103 136899 118904 743338 0 189645 152787 145103 136899 118904 743338 0 0 26986 33737 31059 175557 267339 20772414 20777741 21796125 20766799 18797232 102910311 0.99020 0.99110 0.00720 0.00810 X OTHER INCOME, SCHEDULE A, PART III, LINE 12, DESCRIPTION - EDUCATION/INSTITUTE REVENUE, COLUMN A - 0, COLUMN B - 23684, COLUMN C - 31904, COLUMN D - 31009, COLUMN E - 4879, COLUMN F - 91476; DESCRIPTION - MISCELLANEOUS REVENUE, COLUMN A - 0, COLUMN B - 3302, COLUMN C - 1833, COLUMN D - 50, COLUMN E - 0, COLUMN F - 5185; DESCRIPTION - VNS PURCHASED SERVICES, COLUMN A - 0, COLUMN B - 0, COLUMN C - 0, COLUMN D - 0, COLUMN E - 170678, COLUMN F - 170678;, RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false true 1100 1100 false Description of the activities reported on Lines 1a through 1i Schedule C, Part II-B, Line 1 A PORTION OF THE ORGANIZATION'S ANNUAL DUES PAID TO THE NATIONAL HOSPICE AND PALLIATIVE CARE ORGANIZATION AND THE HOSPICE AND PALLIATIVE CARE ASSOCIATION OF IOWA ARE USED FOR LOBBYING PURPOSES. THE TOTAL AMOUNT FOR THE YEAR ENDED JUNE 30, 2013, WAS $1,100 4855151 148694 494232 118592 5379485 4425852 441614 164926 177241 4855151 3067985 944366 720857 307356 4425852 2425658 369223 296439 23335 3067985 2974936 31715 -580993 2425658 0.92850 0.02750 0.04400 false true 999532 999532 9660263 3138535 6521728 136585 106619 29966 3270734 2465102 805632 0 8356858 0 0 BENEFICIAL INTEREST IN NET ASSETS HELD BY HCI FOUNDATION 5870661 F 5870661 DUE FROM AFFILIATES 1458616 UNEMPLOYMENT TRUST 200963 ACCRUED INTEREST RECEIVABLE 13059 1672638 0 0 X 19318368 165829 15258 778828 959915 18358453 643346 643346 19001799 19672954 0 0 19672954 365360 365360 20038314 Intended uses of endowment funds Schedule D, Part V, Line 4 HCI FOUNDATION HOLDS ENDOWMENT FUNDS FOR THE BENEFIT OF THE ORGANIZATION; THESE ENDOWMENT FUNDS CONSIST OF NUMEROUS GIFTS ESTABLISHED TO FUND AND SUPPORT THE ORGANIZATION'S MISSION. FIN 48 (ASC 740) footnote Schedule D, Part X, Line 2 THE ORGANIZATION IS EXEMPT FROM INCOME TAXES ON INCOME FROM RELATED ACTIVITIES UNDER SECTION 501(C)(3) OF THE U.S. INTERNAL REVENUE CODE AND CORRESPONDING STATE TAX LAW. ACCORDINGLY, NO PROVISION HAS BEEN MADE FOR FEDERAL OR STATE INCOME TAXES. U.S. GAAP REQUIRES THAT A TAX POSITION IS RECOGNIZED AS A BENEFIT ONLY IF IT IS "MORE LIKELY THAN NOT" THAT THE TAX POSITION WOULD BE SUSTAINED IN A TAX EXAMINATION, WITH A TAX EXAMINATION BEING PRESUMED TO OCCUR. THE AMOUNT RECOGNIZED IS THE LARGEST AMOUNT OF TAX BENEFIT THAT IS GREATER THAN 50% LIKELY OF BEING REALIZED ON EXAMINATION. FOR TAX POSITIONS NOT MEETING THE "MORE LIKELY THAN NOT" TEST, NO TAX BENEFIT IS RECORDED. DUE TO ITS TAX EXEMPT STATUS, THE ORGANIZATION IS NOT SUBJECT TO U.S. FEDERAL INCOME TAX OR STATE INCOME TAX. THE ORGANIZATION'S FORM 990 HAS NOT BEEN SUBJECT TO EXAMINATION BY THE INTERNAL REVENUE SERVICE OR THE STATE OF IOWA FOR THE LAST THREE YEARS. THE ORGANIZATION DOES NOT EXPECT THE TOTAL AMOUNT OF UNRECOGNIZED TAX BENEFITS TO SIGNIFICANTLY CHANGE IN THE NEXT 12 MONTHS. THE ORGANIZATION RECOGNIZES INTEREST AND/OR PENALTIES RELATED TO INCOME TAX MATTERS IN INCOME TAX EXPENSE. THE ORGANIZATION DID NOT HAVE ANY AMOUNTS ACCRUED FOR INTEREST AND PENALTIES AT JUNE 30, 2013 OR 2012. Other revenues in audited financial statements not in form 990 Schedule D, Part XI, Line 2d CHANGE IN BENEFICIAL INTEREST IN NET ASSETS OF HCI FOUNDATION - 751575; CHANGE IN VALUE OF CHARITABLE REMAINDER TRUSTS - 27253; Other revenues in form 990 not in audited financial statements Schedule D, Part XI, Line 4b GRANTS TO OTHER ORGANIZATIONS - 365360; ALLOWANCE FOR UNCOLLECTIBLE CONTRIBUTIONS - 277986; Other expenses in form 990 not in audited financial statements Schedule D, Part XII, Line 4b GRANTS TO OTHER ORGANIZATIONS - 365360; false AMANDA CARES 100 73RD STREET NO 12 WINDSOR HEIGHTS IA 50324 421166117 501(C)(3) 0 365360 BOOK VALUE PROPERTY & BUILDING GENERAL SUPPORT 1 0 QUALITY OF LIFE GRANTS 446 0 19707 COST MISCELLANEOUS NON-CARE ITEMS Procedures for monitoring use of grant funds Schedule I, Part I, Line 2 HCI CARE SERVICES' (HCI) QUALITY OF LIFE FUND IS MAINTAINED TO PROVIDE SERVICES AND/OR ITEMS NOT COVERED UNDER PER DIEM REIMBURSEMENT FOR HOSPICE CARE TO PATIENTS IN NEED AND TO PROVIDE OCCASIONAL SMALL LIFE AMENITIES THAT ENHANCE THE PATIENTS' AND FAMILIES' QUALITY OF LIFE. ALL HCI PATIENTS ARE ELIGIBLE FOR QUALITY OF LIFE FUND BENEFITS, AND ALL ATTEMPTS ARE MADE TO UTILIZE COMMUNITY RESOURCES PRIOR TO USING THE QUALITY OF LIFE FUND. BEST EFFORTS ARE USED TO ENSURE THAT ASSISTANCE IS PROVIDED FOR PATIENTS IN NEED AND WITHOUT OTHER MEANS OF ASSISTANCE OR ACCESS TO OTHER BENEFACTORS, AND THAT USE AND CIRCUMSTANCES FOR THE FUNDS IS CONSISTENT. THE AMOUNT OF FUNDS PROVIDED IS DETERMINED BY HCI FOUNDATION BOARD OF TRUSTEES WITHIN THE ANNUAL BUDGET. REPORTS OF FUND EXPENDITURES ARE SUBMITTED TO THE BOARD OF TRUSTEES ON THE STATEMENT OF REVENUE AND EXPENSE. ANY STAFF MEMBER MAY SUBMIT A WRITTEN OR VERBAL REQUEST FOR UTILIZATION OF QUALITY OF LIFE FUNDS. REQUESTS LESS THAN $100 ARE APPROVED BY THE PATIENT'S TEAM DIRECTOR. REQUESTS MORE THAN $100 ARE APPROVED BY A MEMBER OF THE EXECUTIVE TEAM, WHO ALSO ENSURES THAT APPROPRIATE OVERSIGHT AND REVIEW ARE CONDUCTED. DURING THE YEAR, THE ORGANIZATION GRANTED A BUILDING AND PROPERTY TO AMANDA CARES, A TAX-EXEMPT ORGANIZATION THAT PROVIDES GRIEF SUPPORT SERVICES TO CHILDREN, TEENS, AND ADULTS THROUGHOUT THE STATE OF IOWA. HCI CARE SERVICES DOES NOT MONITOR THE USE OF THIS GRANT, AS IT WAS UNRESTRICTED FOR THE ORGANIZATION'S USE IN SUPPORTING ITS MISSION AND TAX-EXEMPT PURPOSE. X X X X false false false false false false false true false NORENE MOSTKOFF 225650 0 44100 0 17044 0 7796 0 20633 0 315223 0 0 0 KELLY DENNIS 130425 0 10493 0 0 0 4710 0 10690 0 156318 0 0 0 THOMAS MOUSER 168726 0 15124 0 12644 0 6176 0 31097 0 233767 0 0 0 Non-fixed payments Schedule J, Part I, Line 7 DISCRETIONARY BONUSES WERE PAID TO THE CEO, CFO, VICE PRESIDENT OF PATIENT AND FAMILY CARE AND MEDICAL DIRECTOR. THE CEO'S INCENTIVES ARE BASED ON STANDARDS AND GOALS SET FORTH BY, AND ARE APPROVED BY, THE BOARD OF DIRECTORS. THE OTHER OFFICERS' INCENTIVES ARE BASED ON STANDARDS AND GOALS SET FORTH BY, AND ARE APPROVED BY, THE CEO. THOMAS MOUSER MEDICAL DIRECTOR SIGNING BONUS X 30000 11538 false true true 11538 X 4227 RESALE VALUE X 205192 RESALE VALUE X SPECIALTY/MISCELLANEOUS 159 1571 RESALE VALUE X MISCELLANEOUS 242 1395 RESALE VALUE X DECORATIONS AND SUPPLIES 4 1050 MARKET VALUE 0 false true false Explanations of reporting method for number of contributions Schedule M, Part I BOOKS AND PUBLICATIONS: N/A CLOTHING AND HOUSEHOLD GOODS: N/A OTHER: NUMBER OF ITEMS RECEIVED AND THEN RESOLD IN THE THRIFT STORE OTHER: NUMBER OF ITEMS RECEIVED AND THEN RESOLD IN THE THRIFT STORE OTHER: NUMBER OF DONATIONS Number of contributions or items contributed. Schedule M, part I, column (b), Line 4 N/A Number of contributions or items contributed. Schedule M, part I, column (b), Line 5 N/A Number of contributions or items contributed. Schedule M, part I, column (b), Line other=SPECIALTY/MISCELLANEOUS NUMBER OF ITEMS RECEIVED AND THEN RESOLD IN THE THRIFT STORE Number of contributions or items contributed. Schedule M, part I, column (b), Line other=MISCELLANEOUS NUMBER OF ITEMS RECEIVED AND THEN RESOLD IN THE THRIFT STORE ORGANIZATION'S MISSION FORM 990, PART III, LINE 1 FOUNDED IN 1978, HCI CARE SERVICES IS THE STATE'S OLDEST HOSPICE CARE PROVIDER. AN INDEPENDENT, NOT-FOR-PROFIT, COMMUNITY-BASED ORGANIZATION, THE ORGANIZATION'S MISSION IS: "PROMOTING DIGNITY, INDEPENDENCE AND QUALITY OF LIFE THROUGH COMPASSIONATE AND EFFECTIVE COMMUNITY BASED CARE." THE ORGANIZATION IS ALSO GUIDED BY ITS VALUES: WE ACT WITH INTEGRITY AND RESPECT. WE SERVE WITH COMPASSION. WE LEAD THROUGH EXCELLENCE. WE UNITE THROUGH TEAMWORK. PROGRAM SERVICE ACCOMPLISHMENTS FORM 990, PART III, LINE 4A HCI CARE SERVICES OFFERS THE FOLLOWING SERVICES. HCI HOSPICE CARE SERVICES: - HCI HOSPICE CARE SERVICES IS A NON-PROFIT, COMMUNITY-BASED SERVICE SERVING 35 COUNTIES. - IN-HOME HOSPICE SERVICES, INCLUDING VISITS FROM NURSES, SOCIAL WORKERS, HOSPICE AIDES, SPIRITUAL CARE COUNSELORS, BEREAVEMENT COUNSELORS, VOLUNTEERS AND THERAPISTS. FOR THE FISCAL YEAR ENDING JUNE 30, 2013, HCI HOSPICE CARE SERVICES PROVIDED END OF LIFE CARE TO APPROXIMATELY 1,400 PATIENTS. - ACCESS TO CLINICIANS WHO HAVE RECEIVED SPECIALIZED TRAINING IN END-OF-LIFE CARE; MANY ARE CERTIFIED IN HOSPICE AND PALLIATIVE CARE. - TEAM PHYSICIANS AND NURSE PRACTITIONERS ON STAFF. - EXPERT PAIN AND SYMPTOM MANAGEMENT. - INTERDISCIPLINARY CARE TEAMS WHO PROVIDE PERSONALIZED, COORDINATED CARE. - DEDICATED HOSPICE ROOMS WITHIN HOSPITALS AND CARE FACILITIES IN OUR SERVICE AREA. - GRIEF SUPPORT GROUPS AND EDUCATIONAL RESOURCES. - ACCESS TO HIGHLY-SKILLED CLINICAL STAFF 24 HOURS A DAY, SEVEN DAYS A WEEK. - MEDICAL EQUIPMENT, SUPPLIES AND MEDICATIONS RELATED TO THE LIFE-LIMITING ILLNESS. - TWO RESIDENTIAL HOSPICE CARE FACILITIES IN DES MOINES, IOWA -- KAVANAGH HOUSE ON 56TH STREET OFFERS 15 PRIVATE PATIENTS ROOMS, AND BRIGHT KAVANAGH HOUSE HAS 24 PRIVATE ROOMS. - SPECIALIZED SERVICES FOR PATIENTS WHO ARE MILITARY VETERANS AND FOR PATIENTS WHO OWN PETS. -IN 2012 HCI CARE SERVICES RECEIVED A 2012 IOWA'S TOP WORKPLACES AWARD. THE AWARD WAS BASED SOLELY ON EMPLOYEE FEEDBACK THROUGH A SURVEY CONDUCTED BY AN INDEPENDENT THIRD PARTY. HCI EXTRACARE SERVICES: - HCI EXTRACARE SERVICES IS A NON-PROFIT, PRIVATE DUTY SERVICE WHICH SUPPORTS INDIVIDUALS' EFFORTS TO CONTINUE LIVING AT THEIR CURRENT PLACE OF RESIDENCE. IN THE FISCAL YEAR ENDING JUNE 30, 2013, HCI EXTRA CARE PROVIDED OVER 16,661 HOURS OF CARE TO PATIENTS. - NURSES, HOME HEALTH AIDES AND TRAINED HOMEMAKERS OFFER EXPERTISE AND COMPANIONSHIP RANGING FROM ONE HOUR/DAY TO 24-HOUR ASSISTANCE. - EXAMPLES OF SERVICES INCLUDE SKILLED NURSING SERVICES, ASSISTANCE WITH BATHING, GROOMING, DRESSING, TOILETING, LAUNDRY, LIGHT HOUSEKEEPING AND CHRONIC DISEASE CASE MANAGEMENT. - HCI EXTRACARE SERVICES IS A PRIVATE PAY SERVICE. CLIENTS PAY ONLY FOR THE SERVICES THEY SELECT. HCI GIVING TREE: - HCI GIVING TREE IS A NON-PROFIT THRIFT STORE, LOCATED AT 3330 100TH ST. IN URBANDALE, IOWA. - THE STORE SELLS AND ACCEPTS DONATIONS OF GENTLY-USED FURNITURE, CLOTHING AND HOME FURNISHINGS. - ALL PROCEEDS FROM STORE SALES SUPPORT SERVICES PROVIDED TO PATIENTS OF HCI HOSPICE CARE SERVICES, ENSURING CARE IS AVAILABLE TO ALL WHO NEED HOSPICE CARE SERVICES - REGARDLESS OF THEIR ABILITY TO PAY. - WITH THE EXCEPTION OF TWO PAID STAFF, THE STORE IS OPERATED BY A DEDICATED CORE OF UNPAID VOLUNTEERS. - HCI GIVING TREE VOLUNTEERS PROVIDED 6,633 HOURS OF SERVICE TO THE STORE - A VALUE OF $146,900. HCI CARE SERVICES ALSO OFFERS: - CAREGIVER TRAINING AND SUPPORT; - EDUCATIONAL CONFERENCES, SEMINARS AND RESOURCES; - FREE ADVANCE CARE PLANNING RESOURCES; AND - GRIEF SUPPORT GROUPS, WHICH ARE FREE OF CHARGE AND ARE OPEN TO THE PUBLIC STRUCTURE: HCI CARE SERVICES IS COMMITTED TO THE COMMUNITIES IT SERVES AND TAKES ADVANTAGE OF EXPERT RESOURCES WITHIN THOSE COMMUNITIES FOR GUIDANCE, ADVOCACY AND ASSISTANCE. HCI CARE SERVICES EMPLOYEES ARE GUIDED BY A VOLUNTEER BOARD OF DIRECTORS. THE ORGANIZATION'S FUNDRAISING SUPPORT COMES FROM THE HCI FOUNDATION, WHICH RECEIVES OVERSIGHT FROM ITS VOLUNTEER BOARD OF TRUSTEES. IN RURAL IOWA, EACH HCI CARE SERVICES OFFICE SERVES A MULTI-COUNTY AREA AND IS GUIDED BY A VOLUNTEER ADVISORY BOARD. SOURCES OF FUNDING: HCI CARE SERVICES IS SUPPORTED PRIMARILY THROUGH THIRD PARTY REIMBURSEMENTS. FOR THE FISCAL YEAR ENDING JUNE 30, 2013, APPROXIMATELY 80 PERCENT OF THE ORGANIZATION'S NET PATIENT REVENUE WAS DERIVED FROM MEDICARE AND MEDICAID PROGRAMS. HOWEVER, HCI CARE SERVICES ALSO RECEIVES SIGNIFICANT SUPPORT FROM DONOR CONTRIBUTIONS, BEQUESTS, GRANTS AND FUNDRAISING ACTIVITIES CONDUCTED THROUGH THE HCI FOUNDATION. DONORS MAY DESIGNATE THEIR GIFTS TO SPECIFIC AREAS SERVED BY HCI CARE SERVICES, WHICH REFLECTS THE ORGANIZATION'S COMMITMENT TO COMMUNITY-BASED CARE. HCI CARE SERVICE'S ADVISORY BOARDS HELP DETERMINE HOW LOCALLY-DESIGNATED DONATIONS ARE SPENT - BENEFITING THE ORGANIZATION AND THE COMMUNITY BY FUNDING, FOR EXAMPLE, BOOK DONATIONS ON END-OF-LIFE CARE TO LOCAL LIBRARIES OR HELPING ESTABLISH HOSPICE ROOMS IN LOCAL HOSPITALS AND NURSING CARE FACILITIES. GRIEF SUPPORT SERVICES: THROUGHOUT ITS SERVICE AREA, HCI CARE SERVICES OFFERS BEREAVEMENT CARE FOR PATIENTS, THEIR FAMILIES AND THE COMMUNITY AT LARGE. GRIEF SUPPORT GROUPS ARE OFFERED IN THE COMMUNITIES WE SERVE AT NO COST TO PARTICIPANTS, AND ARE OPEN TO ALL WHO HAVE LOST A LOVED ONE - REGARDLESS OF WHETHER THEY HAVE BEEN SERVED BY HCI CARE SERVICES. GRIEF EDUCATION AND SPECIAL SUPPORT GROUPS ARE ALSO OFFERED TO YOUTHS AND TO NURSING CARE FACILITY STAFF. IN THE YEAR ENDING JUNE 30, 2013, BEREAVEMENT COUNSELORS HELD 255 SUPPORT GROUP MEETINGS, MADE 1,023 VISITS AND 4,896 CALLS TO SURVIVORS SERVED BY HCI CARE SERVICES, AND PROVIDED 1,108 SERVICES TO NON-SERVED SURVIVORS. Delegate broad authority to a committee Form 990, Part VI, Section A, Line 1a THE BOARD OF DIRECTORS MAY ESTABLISH ONE OR MORE COMMITTEES OF THE BOARD, INCLUDING AN EXECUTIVE COMMITTEE, AND APPOINT MEMBERS OF THE BOARD TO SERVE ON THEM. EACH COMMITTEE SHALL HAVE THE POWERS AND DUTIES DELEGATED TO IT BY THE BOARD OF DIRECTORS. EACH COMMITTEE SHALL HAVE A SEPARATE CHARTER ESTABLISHED BY THE BOARD OF DIRECTORS SPECIFYING THE SCOPE OF THE COMMITTEE'S AUTHORITY. THE CURRENT COMMITTEES CONSIST OF AN EXECUTIVE, GOVERNANCE, FINANCE, AUDIT, QUALITY AND COMPLIANCE. Significant changes to organizational documents Form 990, Part VI, Section A, Line 4 THE ARTICLES AND BYLAWS WERE AMENDED IN THE CURRENT YEAR WHEN HCI VNS CARE SERVICES WAS ADDED AS A SUPPORTING ORGANIZATION AND BECAME THE SOLE MEMBER OF HCI CARE SERVICES. Classes of members or stockholders Form 990, Part VI, Section A, Line 6 THE ORGANIZATION'S SOLE MEMBER IS HCI VNS CARE SERVICES, AN IOWA NONPROFIT CORPORATION. Members or stockholders electing members of governing body Form 990, Part VI, Section A, Line 7a ALL CORPORATION DIRECTORS ARE APPOINTED BY HCI VNS CARE SERVICES, THE ORGANIZATION'S SOLE MEMBER; ANY DIRECTOR OF THE ORGANIZATION MAY BE REMOVED EITHER FOR OR WITHOUT CAUSE BY HCI VNS CARE SERVICES. Decisions requiring approval by members or stockholders Form 990, Part VI, Section A, Line 7b NONE OF THE CORPORATION'S ASSETS OR ANY OTHER RIGHTS THERETO, WHETHER REAL, PERSONAL OR INTANGIBLE, SHALL BE SOLD, CONVEYED, ASSIGNED, TRANSFERRED, MORTGAGED, ENCUMBERED, EXCHANGED, ALIENATED, OR LEASED WITHOUT THE PRIOR APPROVAL OF HCI VNS CARE SERVICES, THE CORPORATION'S SOLE CORPORATE MEMBER. THE CORPORATION SHALL NOT BE A PARTY TO ANY MERGER, ACQUISITION, CONSOLIDATION, JOINT VENTURE, REORGANIZATION, RESTRUCTURING OR SIMILAR EVENT, NOR SHALL IT BECOME A MEMBER, PARTNER, SHAREHOLDER, TRUSTEE OR OTHER FIDUCIARY OF ANY OTHER ORGANIZATION OR ENTITY, WITHOUT THE PRIOR APPROVAL OF HCI VNS CARE SERVICES, THE CORPORATION'S SOLE CORPORATE MEMBER. NO AMENDMENT, ALTERATION OR REPEAL OF ANY OF THE PROVISIONS OF THE CORPORATION'S BYLAWS SHALL BE ADOPTED WITHOUT THE PRIOR APPROVAL OF HCI VNS CARE SERVICES, THE CORPORATION'S SOLE CORPORATE MEMBER. Review of form 990 by governing body Form 990, Part VI, Section B, Line 11b THE FULL FORM 990 IS PROVIDED TO THE ORGANIZATION'S PRESIDENT AND CEO, CFO, AND AUDIT COMMITTEE FOR INITIAL REVIEW. AFTER ALL QUESTIONS HAVE BEEN ADDRESSED AND ANY CHANGES HAVE BEEN MADE, THE ORGANIZATION'S TAX ADVISORS PRESENT A FINAL DRAFT OF THE FULL FORM 990 TO THE FULL BOARD OF DIRECTORS FOR FINAL REVIEW AND APPROVAL PRIOR TO SUBMISSION TO THE IRS. Conflict of interest policy Form 990, Part VI, Section B, Line 12c ALL MEMBERS OF THE BOARD OF DIRECTORS ARE REQUIRED TO PROMPTLY REPORT ANY ONGOING OR INCIDENTAL MATERIAL INTERESTS OR AFFILIATIONS WHICH COULD RESULT IN A POTENTIAL CONFLICT OF INTEREST; MEMBERS OF THE BOARD OF DIRECTORS ARE ALSO REQUIRED TO SIGN AN ANNUAL CONFLICT OF INTEREST DECLARATION. THE BOARD OF DIRECTORS AND OFFICERS ALSO COMPLETE AN ANNUAL AUTOMATED CONFLICT OF INTEREST QUESTIONNAIRE AS PART OF THE 990 COMPLETION PROCESS. THE DECLARATIONS AND QUESTIONNAIRE RESPONSES ARE REVIEWED BY THE PRESIDENT AND CEO AND CFO TO DETERMINE IF ANY POTENTIAL OR ACTUAL CONFLICTS OF INTEREST EXIST. ANY BOARD MEMBER DETERMINED TO HAVE A CONFLICT OF INTEREST IS REQUIRED TO ABSTAIN FROM ANY DECISION OR VOTING PROCESS RELATED TO THE CONFLICTING ISSUE. PROCESS USED TO ESTABLISH COMPENSATION OF TOP MANAGEMENT OFFICIAL FORM 990, PART VI, LINE 15A EVERY TWO YEARS, THE ORGANIZATION'S BOARD OF DIRECTORS ENGAGES AN INDEPENDENT COMPENSATION CONSULTANT TO PERFORM A COMPENSATION SURVEY FOR THE ORGANIZATION'S OFFICERS. VERISIGHT COMPLETED THE ORGANIZATION'S COMPENSATION SURVEYS IN 2009, 2011 AND 2013. THE FINDINGS OF THE SURVEYS ARE PRESENTED TO THE EXECUTIVE COMMITTEE OF THE BOARD OF DIRECTORS. THE EXECUTIVE COMMITTEE MEMBERS USE THE SURVEY TO REVIEW AND ESTABLISH THE AMOUNT OF COMPENSATION FOR THE PRESIDENT. THE REVIEW PROCESS IS DOCUMENTED IN THE EXECUTIVE COMMITTEE MEETING MINUTES AND WAS COMPLETED IN OCTOBER 2013. PROCESS USED TO ESTABLISH COMPENSATION OF OTHER OFFICERS/KEY EMPLOYEES FORM 990, PART VI, LINE 15B EVERY TWO YEARS, THE ORGANIZATION'S BOARD OF DIRECTORS ENGAGES AN INDEPENDENT COMPENSATION CONSULTANT TO PERFORM A COMPENSATION SURVEY FOR THE ORGANIZATION'S OFFICERS. VERISIGHT COMPLETED THE ORGANIZATION'S COMPENSATION SURVEYS IN 2009, 2011 AND 2013. THE RESULTS OF THE SURVEY ARE USED BY THE PRESIDENT AND CEO TO ESTABLISH COMPENSATION FOR THE FOLLOWING OFFICERS AND KEY EMPLOYEES, CHIEF FINANCIAL OFFICER, SENIOR VICE PRESIDENT OF PATIENT AND FAMILY CARE, AND CHIEF MEDICAL DIRECTOR. Governing documents, conflict of interest policy and financial statements available to the public Form 990, Part VI, Section C, Line 19 THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST. Other changes in net assets or fund balances Form 990 , Part XI, Line 9 CHANGE IN BENEFICIAL INTEREST IN NET ASSETS OF HCI FOUNDATION - 751575; CHANGE IN VALUE OF CHARITABLE REMAINDER TRUSTS - 27253; ALLOWANCE FOR UNCOLLECTIBLE CONTRIBUTIONS - -277986; Number of contributions or items contributed. Schedule M, part I, column (b), Line other=DECORATIONS AND SUPPLIES NUMBER OF DONATIONS Number of contributions or items contributed. Schedule M, part I, column (b), Line 4 N/A Number of contributions or items contributed. Schedule M, part I, column (b), Line 5 N/A Number of contributions or items contributed. Schedule M, part I, column (b), Line other=SPECIALTY/MISCELLANEOUS NUMBER OF ITEMS RECEIVED AND THEN RESOLD IN THE THRIFT STORE Number of contributions or items contributed. Schedule M, part I, column (b), Line other=MISCELLANEOUS NUMBER OF ITEMS RECEIVED AND THEN RESOLD IN THE THRIFT STORE Number of contributions or items contributed. Schedule M, part I, column (b), Line other=DECORATIONS AND SUPPLIES NUMBER OF DONATIONS HOSPICE OF CENTRAL IOWA THRIFT STORE LLC DBA HCI GIVING TREE 3330 100TH STREET URBANDALE IA 503223854 273099690 RESALE OF DONATED MERCHANDISE TO THE PUBLIC IA 212385 17700 HOSPICE OF CENTRAL IOWA HCI EXTRACARE LLC 2910 WESTOWN PARKWAY SUITE 200 WEST DES MOINES IA 50266 300661072 PRIVATE DUTY NURSING AND COMPANION SERVICES IA 462455 0 HOSPICE OF CENTRAL IOWA HOSPICE OF CENTRAL IOWA FOUNDATION DBA HCI FOUNDATION 2910 WESTOWN PARKWAY SUITE 200 WEST DES MOINES IA 502661332 FUNDRAISING TO SUPPORT HOSPICE OF CENTRAL IOWA AND VISITING NURSE SERVICES OF IOWA IA 501(C)(3) 7 HCI VNS CARE SERVICES false HCI VNS CARE SERVICES 2910 WESTOWN PARKWAY SUITE 200 WEST DES MOINES IA 50266 ADMINISTRATIVE AND MANAGEMENT SERVICES (MSO) IA 501(C)(3) 11 - Type II NA false VISITING NURSE SERVICES OF IOWA 1111 9TH STREET SUITE 320 DES MOINES IA 50314 HEALTH AND HEALTH RELATED SERVICES IA 501(C)(3) 7 HCI VNS CARE SERVICES false false false false true false false false false false true false false true true true true true false false