2014-10-08T09:14:02-05:00 2013-12-31 861065772 DELOITTE TAX LLP 201 E KENNEDY BLVD SUITE 1200 TAMPA FL 33602 990 2013-01-01 592490893 NORTH CENTRAL FLORIDA HOSPICE INC NORT 3523728400 SANTAFE HEALTHCAREINC PO BOX 749 GAINESVILLE FL 326270749 TIMOTHY J BOWEN PRESIDENT 3523378730 2014-09-30 1 STEVEN E ROVNER P00648526 8132738300 2013 2015-11-30 17:44:51Z HAVEN HOSPICE MICHAEL P GALLAGHER SANTAFE HEALTHCAREINC PO BOX 749 GAINESVILLE FL 326270749 63805236 0 X WWW.HAVENHOSPICE.ORG X 1982 FL HONORING LIFE BY PROVIDING COMFORT, CARE AND COMPASSION TO THOSE WE SERVE. 11 10 737 713 0 0 2775032 5096349 59236900 57585078 579200 667897 -189792 130302 62401340 63479626 0 0 0 0 32288637 32176682 0 0 643024 27526658 27182907 59815295 59359589 2586045 4120037 61063552 66205247 17682366 20146122 43381186 46059125 X THE MISSION OF NORTH CENTRAL FLORIDA HOSPICE, INC. (HAVEN HOSPICE) IS TO HONOR LIFE BY PROVIDING COMFORT, CARE AND COMPASSION TO THOSE WE SERVE.HAVEN HOSPICE HELPS PATIENTS BE AS COMFORTABLE AS POSSIBLE AND PROVIDE THEIR CAREGIVERS WITH NEEDED RESOURCES AND ASSISTANCE. HAVEN HOSPICE PROVIDES THE MOST CURRENT THERAPIES AND METHODS TO MAXIMIZE COMFORT AND CARE TO PATIENTS INCLUDING ACCESS TO PROFESSIONAL STAFF AROUND THE CLOCK. HAVEN HOSPICE PROVIDES CLINICAL EDUCATION ABOUT END-OF-LIFE AND PALLIATIVE CARE, GRIEF SUPPORT TO CHILDREN AND FAMILIES AND BEREAVEMENT PROGRAMS FOR BOTH GROUPS AND INDIVIDUALS IN ITS SERVICE AREA. 0 0 27955071 44409972 HAVEN HOSPICE PROVIDED SERVICES TO 4,359 HOSPICE PATIENTS INCLUDING 241,098 DAYS OF SERVICE AND 163,345 VISITS BY NURSES, HOME HEALTH AIDES, SOCIAL WORKERS, CHAPLAINS AND PHYSICIANS TOTALING 205,811 HOURS OF CARE. INCLUDED IN THE EXPENSES IS $168,578 OF UNREIMBURSED CARE. 10354466 11324774 HAVEN HOSPICE PROVIDED SERVICES TO 2,819 PATIENTS IN INPATIENT CARE CENTERS, INCLUDING 20,678 DAYS OF SERVICE AND 96,796 VISITS BY NURSES, HOME HEALTH AIDES, SOCIAL WORKERS, CHAPLAINS AND PHYSICIANS. INCLUDED IN THE EXPENSES IS $181,702 OF UNREIMBURSED CARE. 311089 HAVEN HOSPICE PROVIDED BEREAVEMENT SERVICES TO THE COMMUNITIES IN WHICH IT SERVES AND TO FAMILY MEMBERS OF PATIENTS WHO HAVE DIED IN ITS CARE. THE BEREAVEMENT DEPARTMENT CONDUCTED COMMUNITY EDUCATION EVENTS WITH 1452 ATTENDING. IN ADDITION, 9,689 SUPPORT MAILERS WERE DISTRIBUTED, 7,830 BEREAVEMENT SUPPORT PHONE CALLS WERE PLACED AND 1,146 INDIVIDUALS WERE PROVIDED EITHER GROUP, INDIVIDUAL, OR FAMILY GRIEF SUPPORT COUNSELING. 14 MEMORIAL SERVICES WERE HELD WITH AN AVERAGE ATTENDANCE OF 57 PARTICIPANTS PER SERVICE. 3 GRIEF CAMPS WERE HELD WITH AN ATTENDANCE OF 61 CHILDREN AND 27 ADULTS. 7574037 1850332 MISCELLANEOUS PROGRAM SERVICES 7574037 1850332 46194663 1 1 0 1 0 0 0 0 0 1 1 0 0 0 1 1 1 1 0 0 0 0 0 0 1 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 1 0 1 0 1 410 0 1 737 1 0 0 0 0 0 1 1 0 0 0 0 X 11 10 0 0 0 0 1 1 1 1 1 0 1 1 1 1 1 1 1 1 1 1 0 X TIMOTHY J BOWEN 3523796225 4200 NW 90TH BLVD GAINESVILLE FL 326065688 X D RAY HARRISON JR CHAIRMAN/DIRECTOR 3.00 0.00 X X 0 0 0 G THOMAS MALLINI VICE CHAIRMAN/DIRECTOR 1.00 0.00 X X 0 0 0 SUZANNE M NORRIS TREASURER/DIRECTOR 1.00 0.00 X X 0 0 0 ERIC L GODET SECRETARY/DIRECTOR 1.00 0.00 X X 0 1500 0 CAROL REED ASH DIRECTOR 1.00 0.00 X 0 0 0 GEORGE J CARANASOS MD DIRECTOR 1.00 0.00 X 0 0 0 JANET L CHRISTIE DIRECTOR 1.00 0.00 X 0 0 0 JAMES W DEFORD MD DIRECTOR 1.00 0.00 X 0 0 0 SUSAN D PARRISH DIRECTOR 1.00 0.00 X 0 0 0 FRANCES C PEPIS DIRECTOR 1.00 0.00 X 0 0 0 NORLENE E ROBERTS DIRECTOR 1.00 0.00 X 0 0 0 MICHAEL P GALLAGHER CHIEF EXECUTIVE OFFICER/DIRECTOR 5.00 55.00 X X 0 2238682 269719 TIMOTHY J BOWEN PRESIDENT 50.00 0.10 X 0 475624 87898 STEVEN M ZIEGLER ASSISTANT SECRETARY 6.00 57.00 X 0 508883 130033 FERNANDO PETRY DO CHIEF MEDICAL OFFICER 55.00 0.00 X 265269 0 31510 LINDA ROUEL MD ASSOCIATE MEDICAL DIRECTOR 40.00 0.00 X 220043 0 16795 DOUGLAS A ROGERS MD ASSOCIATE MEDICAL DIRECTOR 40.00 0.00 X 205256 0 38823 NEEL J KARNANI MD ASSOCIATE MEDICAL DIRECTOR 40.00 0.00 X 201626 0 16733 SHARON SAUCIER CHIEF OPERATING OFFICER 55.00 0.00 X 172907 0 21265 1065101 3224689 612776 13 0 1 0 PARRISH MCCALL CONSTRUCTORS INC PO BOX 142002 GAINESVILLE FL 326142002 CONSTRUCTION 1758336 SANTAFE HEALTHCARE INC PO BOX 749 GAINESVILLE FL 326270749 MANAGEMENT FEES 1565559 CATAMARAN HOSPICE SERVICES LLC 1460 ANN ST MONTGOMERY AL 36107 PHARMACY SERVICES 1123724 PHOENIX HEALTHCARE PROPERTIES OF MANDARI 10680 OLD STAUGUSTINE RD JACKSONVILLE FL 32257 NURSING HOME SERVICES 871243 HEALTH FACILITIES INC 7280 SW SR 26 TRENTON FL 32693 NURSING HOME SERVICES 698277 53 79855 247682 4768812 1840134 5096349 MEDICARE REVENUE 623990 41945633 41945633 MEDICAID REVENUE 623990 13261348 13261348 PATIENT SERVICE REVENUE 623990 2378097 2378097 57585078 578204 578204 180107 58164 32250 121943 -32250 89693 89693 54935 247682 235196 -180261 -180261 ADMINISTRATIVE INCOME 900099 310563 310563 310563 63479626 57585078 0 798199 X 25373532 19557178 5505036 311318 1385472 1075717 294182 15573 3660060 2782554 846148 31358 1757618 1366376 372531 18711 1087379 1087379 227859 227859 88994 88994 14479304 13776757 664746 37801 558148 558148 1299752 641131 607657 50964 654445 654445 1740422 1206939 533483 1446359 1072143 362256 11960 42752 24493 17864 395 255778 255778 1364448 980585 383863 357372 156747 200625 PHARMACY SUPPLIES 1634206 1634206 COMMUNITY SUPPORT 729917 369528 207831 152558 MEDICAL SUPPLIES 485569 481262 4307 FOOD COSTS 117747 117747 612456 137374 462696 12386 59359589 46194663 12521902 643024 660983 199011 3709252 7705477 878703 51627 3462311 2680067 337460 323053 41404467 9942595 29122537 31461872 19039332 19672534 2051537 2328658 1801437 1782948 61063552 66205247 6122613 8486335 9956332 9475983 1603421 2183804 17682366 20146122 X 41399077 45674754 1982109 384371 43381186 46059125 61063552 66205247 X 4120037 376816 -1818914 X X 0 1 X 1 0 X 2198110 2002280 2860145 2775032 3386291 13221858 50582738 54590670 57146734 59236900 57585078 279142120 52780848 56592950 60006879 62011932 60971369 292363978 0 0 0 292363978 233421 376917 382400 504167 578204 2075109 233421 376917 382400 504167 578204 2075109 -82054 -134428 -181250 -189792 130302 -457222 52932215 56835439 60208029 62326307 61679875 293981865 0.99450 0.99590 0.00710 0.00640 X SCHEDULE A, PART II, LINE 12, EXPLANATION OF OTHER INCOME: LIFELINE INCOME - 2009 AMOUNT: $ 3,628. ADMINISTRATIVE INCOME - 2009 AMOUNT: $ 7,892. 2010 AMOUNT: $ 12,271. 2011 AMOUNT: $ 19,291. 2012 AMOUNT: $ 7,188. 2013 AMOUNT: $ 310,563. SPECIAL EVENT INCOME NET - 2009 AMOUNT: $ -93,574. 2010 AMOUNT: $ -146,699. 2011 AMOUNT: $ -200,541. 2012 AMOUNT: $ -196,980. 2013 AMOUNT: $ -180,261. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 72000 72000 0 PART II-B, LINE 1: HAVEN HOSPICE IS A MEMBER OF FLORIDA HOSPICE AND PALLIATIVE CARE, INC., ALLIANCE FOR CARE, AND THE NATIONAL HOSPICE AND PALLIATIVE CARE ORGANIZATION AND PARTICIPATES IN LOBBYING AND STRATEGY DISCUSSIONS. HAVEN HOSPICE HAS ENGAGED THE SERVICES OF A REGISTERED LOBBYIST TO MONITOR DEVELOPMENTS AT THE ANNUAL GENERAL SESSION OF THE FLORIDA LEGISLATURE. 1822987 276681 2099668 1534886 288101 1822987 1489469 45417 1534886 1373367 116102 1489469 1249994 123373 1373367 1.00000 0 0 4513102 4513102 31051794 5985402 25066392 702228 419548 282680 5137343 3537645 1599698 31461872 GIFT ANNUITIES 258233 DUE TO AFFILIATES 541772 CAPITAL LEASE OBLIGATION 74145 CHARITABLE REMAINDER UNITRUST 1086000 CONTRIBUTION PAYABLE 4203 INTEREST RATE SWAP 219451 2183804 X 61654485 -115083 -115083 61769568 1710058 1710058 63479626 59246231 -113358 -113358 59359589 0 59359589 PART V, LINE 4: THE HAVEN HOSPICE ENDOWMENT IS A SEPARATE ACCOUNT OF FUNDS THAT ARE HELD TO PROVIDE CURRENT AND FUTURE INCOME TO HAVEN HOSPICE IN ORDER TO OFFSET THE BURDEN OF UNCOMPENSATED CARE PROVIDED BY HAVEN HOSPICE. THE OBJECTIVE OF THE ENDOWMENT IS TO PROVIDE TIMELY FINANCIAL ASSISTANCE WHEN NEEDED AND LONG-TERM STABILITY TO HAVEN HOSPICE. PART X, LINE 2: ASC 740 FOOTNOTE: AS OF DECEMBER 31, 2013 AND 2012, HAVEN HAD NO UNCERTAIN TAX POSITIONS. TAX YEARS 2010 THROUGH 2012 ARE SUBJECT TO EXAMINATION BY FEDERAL AND STATE TAXING AUTHORITIES. THERE ARE NO INCOME TAX EXAMINATIONS IN PROCESS AS OF THE DATE OF THIS REPORT. PART XI, LINE 2D - OTHER ADJUSTMENTS: UNREIMBURSED CARE -350,280. SPECIAL EVENT EXPENSES 235,196. ROUNDING ADJUSTMENT 1. PART XI, LINE 4B - OTHER ADJUSTMENTS: RESTRICTED CONTRIBUTIONS 1,710,058. PART XII, LINE 2D - OTHER ADJUSTMENTS: UNREIMBURSED CARE -350,280. SPECIAL EVENT EXPENSES 235,196. LOSSES ON UNCOLLECTIBLE PLEDGES 1,725. ROUNDING ADJUSTMENT 1. VIVA 160408 129688 30720 0 4058 41714 38263 16627 25875 FALL ON THE PRAIRIE 59511 52671 6840 0 13220 16453 10954 1395 7444 4 75171 60385 14786 150 9672 13512 13270 1250 16036 295090 242744 52346 150 26950 71679 62487 19272 49355 229893 -177547 0 1 0 0 0 0 0 0 0 MICHAEL P GALLAGHER CHIEF EXECUTIVE OFFICER/DIRECTOR 0 879090 0 870216 0 489376 0 244268 0 25451 0 2508401 0 204750 TIMOTHY J BOWEN PRESIDENT 0 296681 0 111383 0 67560 0 64646 0 23252 0 563522 0 28137 STEVEN M ZIEGLER ASSISTANT SECRETARY 0 315764 0 182501 0 10618 0 99376 0 30657 0 638916 0 29521 FERNANDO PETRY DO CHIEF MEDICAL OFFICER 264836 0 0 0 433 0 11326 0 20184 0 296779 0 0 0 LINDA ROUEL MD ASSOCIATE MEDICAL DIRECTOR 219810 0 0 0 233 0 15898 0 897 0 236838 0 0 0 DOUGLAS A ROGERS MD ASSOCIATE MEDICAL DIRECTOR 204730 0 0 0 526 0 17163 0 21660 0 244079 0 0 0 NEEL J KARNANI MD ASSOCIATE MEDICAL DIRECTOR 201036 0 0 0 590 0 15896 0 837 0 218359 0 0 0 SHARON SAUCIER CHIEF OPERATING OFFICER 172487 0 0 0 420 0 6646 0 14619 0 194172 0 0 0 PART I, LINE 3 MICHAEL P GALLAGHER IS THE CHIEF EXECUTIVE OFFICER (CEO) OF NORTH CENTRAL FLORIDA HOSPICE, INC. (HAVEN HOSPICE). MR. GALLAGHER IS COMPENSATED BY SANTAFE HEALTHCARE, INC. (SANTAFE), A RELATED SUPPORTING ORGANIZATION. SANTAFE UTILIZES THE FOLLOWING PROCESS TO ESTABLISH THE CEO'S COMPENSATION AND BENEFITS: ANNUALLY, THE SANTAFE BOARD OF DIRECTORS RETAINS AN INDEPENDENT THIRD PARTY COMPENSATION AND BENEFITS CONSULTING FIRM TO CONDUCT A MARKET COMPETITIVENESS REVIEW OF THE CEO'S TOTAL DIRECT COMPENSATION (BASE SALARY, ANNUAL INCENTIVES, AND LONG TERM INCENTIVES) AND BENEFITS. THE COMPETITIVE ANALYSIS INCLUDES COMPARISON TO SIMILAR POSITIONS IN COMPANIES OF SIMILAR SIZE WITHIN THE SAME OR SIMILAR INDUSTRY. THE INDEPENDENT CONSULTING FIRM MAKES RECOMMENDATIONS, IF ANY, DIRECTLY TO THE BOARD OF DIRECTORS. THE BOARD OF DIRECTORS ESTABLISHES THE FINAL COMPENSATION AND BENEFIT PACKAGE FOR THE CEO TAKING INTO CONSIDERATION THE MARKET COMPETITIVENESS REVIEW AND FINAL RECOMMENDATION OF THE INDEPENDENT CONSULTING FIRM. THE INDEPENDENT CONSULTING FIRM PROVIDES AN OPINION LETTER REGARDING THE REASONABLENESS OF THE CEO'S FINAL COMPENSATION AND BENEFITS PACKAGE. THE ACTIONS OF THE BOARD ARE DOCUMENTED IN THE MINUTES OF THE BOARD MEETING. PART I, LINE 4B LISTED PERSONS PARTICIPATING IN A SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN IN THE YEAR: MICHAEL P GALLAGHER AND TIMOTHY J BOWEN ARE EMPLOYEES OF SANTAFE HEALTHCARE, INC. (SANTAFE) A RELATED SUPPORTING ORGANIZATION. MR. GALLAGHER AND MR. BOWEN PARTICIPATE IN TWO NONQUALIFIED DEFERRED COMPENSATION RETIREMENT PLANS SPONSORED BY SANTAFE FOR A CERTAIN GROUP OF EXECUTIVES. ONE PLAN RESTORES RETIREMENT BENEFITS EQUIVALENT TO QUALIFIED 401(K) BENEFITS ON INCOME EARNED IN EXCESS OF THE INTERNAL REVENUE SERVICE CODE SECTION 401 (A) (17) RECOGNIZABLE PAY LIMITS (A DEFINED CONTRIBUTION RESTORATION PLAN). VESTING FOR THIS PLAN IS ACHIEVED AT AGE 55 AND 10 YEARS OF SERVICE OR AT AGE 65 AND 5 YEARS OF SERVICE. THE SECOND SUPPLEMENTAL DEFINED CONTRIBUTION PLAN PROVIDES ADDITIONAL RETIREMENT INCOME BASED ON A PERCENTAGE OF BASE SALARY AND VESTS AT THREE AND FIVE YEARS OF SERVICE. MR. GALLAGHER RECEIVED PAYMENTS FROM SUPPLEMENTAL NONQUALIFIED RETIREMENT PLANS IN 2013. THE TOTAL AMOUNT OF THESE PAYMENTS WAS $378,945. MR. BOWEN RECEIVED $52,095 FROM A SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN IN 2013. STEVEN M ZIEGLER IS AN EMPLOYEE OF AVMED, INC. (AVMED) A RELATED TAX-EXEMPT ORGANIZATION. HE PARTICIPATES IN TWO NONQUALIFIED DEFERRED COMPENSATION RETIREMENT PLANS SPONSORED BY AVMED FOR A CERTAIN GROUP OF EXECUTIVES. ONE PLAN RESTORES RETIREMENT BENEFITS EQUIVALENT TO QUALIFIED 401(K) BENEFITS ON INCOME EARNED IN EXCESS OF THE INTERNAL REVENUE SERVICE CODE SECTION 401 (A) (17) RECOGNIZABLE PAY LIMITS (A DEFINED CONTRIBUTION RESTORATION PLAN). VESTING IS ACHIEVED AT AGE 55 AND 10 YEARS OF SERVICE OR AT AGE 65 AND 5 YEARS OF SERVICE. THE SECOND SUPPLEMENTAL DEFINED CONTRIBUTION PLAN PROVIDES ADDITIONAL RETIREMENT INCOME BASED ON A PERCENTAGE OF BASE SALARY AND VESTS AT THREE AND FIVE YEARS OF SERVICE. PART I, LINE 4A: LISTED PERSONS WHO ARE EMPLOYEES OF HAVEN HOSPICE ARE NOT COVERED BY A SEVERANCE POLICY. CERTAIN LISTED PERSONS EXCLUDING OUTSIDE DIRECTORS OR EMPLOYEES OF HAVEN HOSPICE ARE EMPLOYESS OF RELATED ORGANIZATIONS AND ARE COVERED UNDER A SEVERANCE POLICY FOR THEIR RESPECTIVE RELATED ORGANIZATION. THE SEVERANCE POLICY INCLUDES MONTHLY PAYMENTS UP TO A MAXIMUM OF 12 MONTHS UNDER QUALIFYING CIRCUMSTANCES. NO ONE LISTED RECEIVED SEVERANCE OR CHANGE OF CONTROL PAYMENTS DURING 2013. SCHEDULE J, PART II: CERTAIN SENIOR EXECUTIVES ARE ACCOUNTABLE FOR AND PERFORM SERVICES FOR SANTAFE HEALTHCARE, INC. AND EACH OF ITS AFFILIATES. SANTAFE HEALTHCARE AND AFFILIATES REPRESENT A DIVERSIFIED FAMILY OF NOT-FOR-PROFIT ORGANIZATIONS WITH $2 BILLION IN GROSS RECEIPTS AND APPROXIMATELY 2,000 EMPLOYEES. THESE SENIOR EXECUTIVES ARE PAID DIRECTLY BY EITHER SANTAFE HEALTHCARE, INC. OR AVMED, INC. AND THEIR COMPENSATION AND BENEFITS ARE APPORTIONED AND CHARGED TO THE RESPECTIVE AFFILIATE BASED ON THE ESTIMATED AMOUNT OF TIME SPENT ON EACH AFFILIATE'S ACTIVITIES. FOR 2013, THE FOLLOWING PERCENTAGES OF EACH EXECUTIVE'S COMPENSATION AND BENEFITS (FOR THOSE SENIOR EXECUTIVES PAID BY A RELATED ORGANIZATION) IS APPORTIONED AND CHARGED TO HAVEN HOSPICE AS FOLLOWS: 8% - MICHAEL P GALLAGHER, CHIEF EXECUTIVE OFFICER 100% - TIMOTHY J BOWEN, PRESIDENT 10% - STEVEN M ZIEGLER, ASSISTANT SECRETARY A CLAY COUNTY DEVELOPMENT AUTHORITY 596583087 2011-12-21 10000000 CONSTRUCT HOSPICE CARE FACILITY 0 0 0 A 524017 10000000 103585 9896415 2012 0 0 1 1 A 0 0 0 0 0.00000 0.00000 0.00000 0 0 1 A 0 1 0 0 1 1 PNC BANK 18.500000000000 0 0 0 0 1 A 1 SCHEDULE K, PARTS I AND II ADDITIONAL INFORMATION REGARDING THE BOND ISSUE: THE BONDS WERE ISSUED AS A DRAW DOWN LOAN FOR THE ACQUISITION OF REAL PROPERTY AND CONSTRUCTION OF A HOSPICE FACILITY. THE FACILITY WAS COMPLETED AND PLACED IN SERVICE DURING 2012, AND THE ENTIRE BALANCE OF THE LOAN WAS DRAWN DOWN. X 1781764 RESALE VALUE 0 0 1 0 FORM 990, PART VI, SECTION A, LINE 6 THE SOLE MEMBER OF NORTH CENTRAL FLORIDA HOSPICE, INC., AS STATED IN ARTICLE IV OF ITS BYLAWS IS SANTAFE HEALTHCARE, INC. SANTAFE HEALTHCARE, INC. IS A FLORIDA NOT-FOR-PROFIT CORPORATION AND THE 509(A)(3) SUPPORTING ORGANIZATION OF NORTH CENTRAL FLORIDA HOSPICE, INC. FORM 990, PART VI, SECTION A, LINE 7A SANTAFE HEALTHCARE, INC., A 509(A)(3) SUPPORTING ORGANIZATION TO NORTH CENTRAL FLORIDA HOSPICE, INC., HAS RESERVED POWERS AS DELINEATED IN THE ARTICLES OF INCORPORATION AND BYLAWS THAT PERMITS IT TO ELECT ONE OR MORE MEMBERS OF THE GOVERNING BODY OF NORTH CENTRAL FLORIDA HOSPICE, INC. FORM 990, PART VI, SECTION A, LINE 7B THE RESERVED POWERS OF SANTAFE HEALTHCARE, INC., AS DELINEATED IN THE ARTICLES OF INCORPORATION AND BYLAWS, PERMIT IT TO APPROVE OR RATIFY THE GOVERNING BODY'S DECISIONS RELATED TO BOARD MEMBER ELECTIONS OR REMOVALS, THE DECISION TO DISSOLVE THE ORGANIZATION AND OTHER MATTERS THAT MAY COME BEFORE THE BOARD OF DIRECTORS. FORM 990, PART VI, SECTION B, LINE 11 THE ORGANIZATION'S PROCESS FOR ENSURING THE ACCURATE PREPARATION, REVIEW AND APPROVAL OF THE 2013 FORM 990 BEGAN WITH PROFESSIONAL DEVELOPMENT OF STAFF (SEVERAL OF WHICH ARE CPAS) WHICH WERE INVOLVED IN THE PREPARATION OF THE 2013 FORM 990. IN ADDITION TO STAFF DEVELOPMENT, WHICH INCLUDED ATTENDING TAX SEMINARS AND CLASSES, MANAGEMENT ALSO CONSULTED WITH INDEPENDENT ACCOUNTING FIRMS AND TAX LEGAL COUNSEL REGARDING THE IRS FORM 990 CODE AND FILING REQUIREMENTS. THE ORGANIZATION ALSO PREVIOUSLY EDUCATED ITS MANAGEMENT TEAM, OFFICERS AND DIRECTORS, WITH THE ASSISTANCE OF DELOITTE TAX LLP, REGARDING THE FORM 990 AND THEIR INVOLVEMENT IN REVIEWING THE RETURN. FOLLOWING MANAGEMENT'S PREPARATION OF THE 2013 FORM 990, DELOITTE TAX LLP REVIEWED THE 2013 FORM 990. A COPY OF THE 2013 FORM 990 AND ATTACHMENTS WERE PROVIDED TO THE ORGANIZATION'S CURRENT BOARD OF DIRECTORS FOR THEIR REVIEW AND COMMENT. EXECUTIVE MANAGEMENT ADDRESSED ANY QUESTIONS RAISED BY THE BOARD MEMBERS PRIOR TO FILING THE 2013 FORM 990 AND ATTACHMENTS WITH THE INTERNAL REVENUE SERVICE. FORM 990, PART VI, SECTION B, LINE 12C HAVEN HOSPICE'S CONFLICT OF INTEREST POLICY (THE POLICY) COVERS BOARD MEMBERS, OFFICERS, ALL EMPLOYEES AND VOLUNTEERS. THE HUMAN RESOURCES DEPARTMENT IS RESPONSIBLE FOR PROVIDING EACH EMPLOYEE WITH A COPY OF THE POLICY AND OBTAINING THE EMPLOYEE'S ACKNOWLEDGMENT STATEMENT AND SIGNATURE AT THE TIME OF HIRE AND ANNUALLY THEREAFTER. THE VOLUNTEER SERVICES DEPARTMENT IS RESPONSIBLE FOR PROVIDING EACH VOLUNTEER WITH A COPY OF THE POLICY AND OBTAINING THE VOLUNTEER'S ACKNOWLEDGMENT STATEMENT AND SIGNATURE DURING ORIENTATION. ON AN ANNUAL BASIS, ALL BOARD MEMBERS MUST ACKNOWLEDGE AND SIGN A COPY OF THE POLICY. EMPLOYEES, VOLUNTEERS AND BOARD MEMBERS WILL REPORT SUSPECT CONDUCT OR ACTIVITY OF A KNOWN VIOLATION OF THE POLICY, INCLUDING THOSE AFFECTING A PROPOSED OR ONGOING OPERATIONAL OR FINANCIAL TRANSACTION, TO HAVEN HOSPICE'S DIRECTOR OF CORPORATE COMPLIANCE AS SOON AS POSSIBLE OR PRACTICAL. WILLFUL VIOLATIONS OF THE POLICY WILL RESULT IN DISCIPLINARY ACTION UP TO AND INCLUDING TERMINATION. THE PRESIDENT OF HAVEN HOSPICE AND THE CHIEF EXECUTIVE OFFICER OF SANTAFE HEALTHCARE, INC. (THE SUPPORTING ORGANIZATION FOR HAVEN HOSPICE) ARE VESTED WITH ULTIMATE AUTHORITY AND RESPONSIBILITY TO DETERMINE THE APPLICABILITY OF THE POLICY TO ANY SET OF FACTS THAT MAY ARISE, AND TO DETERMINE ANY STEPS THAT SHOULD BE TAKEN TO CORRECT A SITUATION DEEMED NOT IN THE BEST INTEREST OF HAVEN HOSPICE, INCLUDING, IF DEEMED APPROPRIATE, DISCIPLINARY ACTION. FORM 990, PART VI, SECTION B, LINE 15 LINE 15A: MICHAEL P GALLAGHER IS THE CHIEF EXECUTIVE OFFICER (CEO) OF HAVEN HOSPICE. MR. GALLAGHER IS COMPENSATED BY SANTAFE HEALTHCARE, INC. (SANTAFE), A RELATED SUPPORTING ORGANIZATION. SANTAFE UTILIZES THE FOLLOWING PROCESS TO ESTABLISH THE CEO'S COMPENSATION AND BENEFITS: THE SANTAFE BOARD OF DIRECTORS ANNUALLY RETAINS AN INDEPENDENT THIRD PARTY COMPENSATION AND BENEFITS CONSULTING FIRM TO CONDUCT A MARKET COMPETITIVENESS REVIEW OF THE CEO'S TOTAL DIRECT COMPENSATION (BASE SALARY, ANNUAL INCENTIVES, AND LONG TERM INCENTIVES) AND BENEFITS. THE COMPETITIVE ANALYSIS INCLUDES COMPARISON TO SIMILAR POSITIONS IN COMPANIES OF SIMILAR SIZE WITHIN THE SAME OR SIMILAR INDUSTRY. THE INDEPENDENT CONSULTING FIRM MAKES RECOMMENDATIONS, IF ANY, DIRECTLY TO THE BOARD OF DIRECTORS. THE BOARD OF DIRECTORS ESTABLISHES THE FINAL COMPENSATION AND BENEFIT PACKAGE FOR THE CEO TAKING INTO CONSIDERATION THE MARKET COMPETITIVENESS REVIEW AND FINAL RECOMMENDATION OF THE INDEPENDENT CONSULTING FIRM. THE INDEPENDENT CONSULTING FIRM PROVIDES AN OPINION LETTER REGARDING THE REASONABLENESS OF THE FINAL COMPENSATION AND BENEFITS PACKAGE. THE ACTIONS OF THE BOARD ARE DOCUMENTED IN THE MINUTES OF THE BOARD MEETING. FORM 990, PART VI, SECTION B, LINE 15B: PROCESS FOR DETERMINING COMPENSATION FOR THE ASSISTANT SECRETARY AND PRESIDENT OF HAVEN HOSPICE IS AS FOLLOWS: THE SANTAFE BOARD OF DIRECTORS ANNUALLY RETAINS AN INDEPENDENT THIRD PARTY COMPENSATION AND BENEFITS FIRM (FIRM) TO CONDUCT A MARKET COMPETITIVENESS REVIEW OF THE AFOREMENTIONED OFFICERS OF TOTAL DIRECT COMPENSATION (BASE SALARY, ANNUAL INCENTIVES, AND LONG-TERM INCENTIVES) AND BENEFITS. THE COMPETITIVE ANALYSIS INCLUDES COMPARISONS TO SIMILAR POSITIONS IN COMPANIES OF SIMILAR SIZE WITHIN THE SAME OR SIMILAR INDUSTRY. AFTER COMPLETION OF ITS REVIEW, THE INDEPENDENT CONSULTING FIRM MAKES RECOMMENDATIONS, IF ANY, DIRECTLY TO THE SANTAFE BOARD OF DIRECTORS. THE INDEPENDENT CONSULTING FIRM PROVIDES AN OPINION LETTER REGARDING THE REASONABLENESS OF TOTAL DIRECT COMPENSATION AND EXECUTIVE BENEFITS. THE ACTIONS OF THE BOARD ARE DOCUMENTED IN THE MINUTES OF THE BOARD MEETINGS. THE COMPENSATION FOR THE HAVEN HOSPICE CHIEF MEDICAL OFFICER IS DETERMINED BY A MARKET COMPETITIVENESS STUDY CONDUCTED BY AN INDEPENDENT THIRD PARTY COMPENSATION CONSULTANT. THE COMPETITIVENESS ANALYSIS INCLUDES COMPARISONS TO SIMILAR POSITIONS IN COMPANIES OF SIMILAR SIZE WITHIN THE HOSPICE INDUSTRY. THE ANALYSIS ALSO INCLUDES FORM 990 DATA COMPARISON FOR HOSPICES WITHIN A SIMILAR REVENUE SIZE AND/OR MARKET LOCATION. THE MOST RECENT COMPENSATION REVIEW WAS COMPLETED IN 2012. FORM 990, PART VI, SECTION C, LINE 19 UPDATED ARTICLES OF INCORPORATION FOR HAVEN HOSPICE ARE AVAILABLE ON THE STATE OF FLORIDA, SECRETARY OF STATE WEBSITE WWW.SUNBIZ.ORG. FORM 990, PART VII, SECTION A, LINE 1A: CERTAIN SENIOR EXECUTIVES ARE ACCOUNTABLE FOR AND PERFORM SERVICES FOR SANTAFE HEALTHCARE, INC. AND EACH OF ITS AFFILIATES. SANTAFE HEALTHCARE AND AFFILIATES REPRESENT A DIVERSIFIED FAMILY OF NOT-FOR-PROFIT ORGANIZATIONS WITH $2 BILLION IN GROSS RECEIPTS AND APPROXIMATELY 2,000 EMPLOYEES. THESE SENIOR EXECUTIVES ARE PAID DIRECTLY BY EITHER SANTAFE HEALTHCARE, INC. OR AVMED, INC. AND THEIR COMPENSATION AND BENEFITS ARE APPORTIONED AND CHARGED TO THE RESPECTIVE AFFILIATE BASED ON THE ESTIMATED AMOUNT OF TIME SPENT ON EACH AFFILIATE'S ACTIVITIES. FOR 2013, THE FOLLOWING PERCENTAGES OF EACH EXECUTIVE'S COMPENSATION AND BENEFITS (FOR THOSE SENIOR EXECUTIVES PAID BY A RELATED ORGANIZATION) IS APPORTIONED AND CHARGED TO HAVEN HOSPICE AS FOLLOWS: 8% - MICHAEL P GALLAGHER, CHIEF EXECUTIVE OFFICER 100% - TIMOTHY J BOWEN, PRESIDENT 10% - STEVEN M ZIEGLER, ASSISTANT SECRETARY FORM 990, PART IX, LINE 11G MEDICAL : PROGRAM SERVICE EXPENSES 12,612,786. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 12,612,786. CONTRACT LABOR : PROGRAM SERVICE EXPENSES 990,790. MANAGEMENT AND GENERAL EXPENSES 39,036. FUNDRAISING EXPENSES 37,801. TOTAL EXPENSES 1,067,627. CONSULTING : PROGRAM SERVICE EXPENSES 54,766. MANAGEMENT AND GENERAL EXPENSES 623,000. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 677,766. SECURITY : PROGRAM SERVICE EXPENSES 2,945. MANAGEMENT AND GENERAL EXPENSES 2,710. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 5,655. OTHER PURCHASED SERVICES : PROGRAM SERVICE EXPENSES 115,470. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 115,470. FORM 990, PART XI, LINE 9: CHANGE IN VALUE OF RESTRICTED PLEDGES -828,934. NET ASSETS RELEASED FROM RESTRICTION USED FOR SERVICES -1,956. NET ASSETS RELEASED FROM RESTRICTION USED FOR PROPERTY & EQUIPMENT -1,710,058. CHANGE IN VALUE OF DONOR RESTRICTED CONTRIBUTIONS 960,469. CHANGE IN FAIR VALUE OF CHARITABLE REMAINDER UNITRUST -110,249. CHANGE IN NET UNREALIZED GAINS/LOSSES ON CRUT INVESTMENT 92,990. LOSSES ON UNCOLLECTIBLE PLEDGES -1,725. CHANGE IN NET UNREALIZED GAINS/LOSSES ON INTEREST RATE SWAP -219,451. FORM 990, PART XII, LINE 2C: THERE HAS BEEN NO CHANGE FROM THE PRIOR YEAR TO THE PROCESS RELATED TO AUDIT OVERSIGHT AND SELECTION OF THE INDEPENDENT ACCOUNTANT FOR THE ORGANIZATION. 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