HOSPICE SAVANNAH INC: Form 990, tax year 2013
View the entire original 990 at ProPublica ↗
- Organization
- HOSPICE SAVANNAH INC (EIN 58-1393820)
- Tax period
- 2013-01-01 to 2013-12-31
- Filed
- 2014-11-12
- IRS object ID
- 201403169349301005
- Schema version
- 2013v3.0
- 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
- Form 990
- Schedule A
- Schedule B
- Schedule D
- Schedule H
- Schedule J
- Schedule L
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2014-11-12T07:59:15-06:00 | ReturnTs |
| Tax Period End | 2013-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 581941470 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HOLLAND HENRY & BROMLEY LLP | BusinessNameLine1 |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 8878 | AddressLine1 |
| City | SAVANNAH | City |
| State | GA | State |
| ZIP Code | 31412 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2013-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 581393820 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HOSPICE SAVANNAH INC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | HOSP | BusinessNameControlTxt |
| Phone | 9123552289 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 13190 | AddressLine1 |
| City | SAVANNAH | City |
| State | GA | State |
| ZIP Code | 31416 | ZIPCode |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | ARTHUR GNANN | PersonNm |
| Person Title | VP OF FINANCE | PersonTitleTxt |
| Phone | 9123552289 | PhoneNum |
| Signature | 2014-11-10 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | SHANNON L BRETT | PreparerPersonNm |
| PTIN | P00558136 | PTIN |
| Phone | 9122353410 | PhoneNum |
| Preparation | 2014-11-10 | PreparationDt |
| Self Employed | Yes (X) | SelfEmployedInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2013 | TaxYr |
| Build TS | 2015-11-30 17:44:51Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | ARTHUR GNANN | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 13190 | AddressLine1 |
| City | SAVANNAH | City |
| State | GA | State |
| ZIP Code | 31416 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $13,950,655 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.HOSPICESAVANNAH.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1979 | FormationYr |
| Legal Domicile State | GA | LegalDomicileStateCd |
| Activity Or Mission | TO PROVIDE MEDICAL SERVICES TO PATIENTS WITH TERMINAL ILLNESSES. | ActivityOrMissionDesc |
| Voting Members Governing Body | 22 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 22 | VotingMembersIndependentCnt |
| Total Employee | 255 | TotalEmployeeCnt |
| Total Volunteers | 0 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $257,890 | PYContributionsGrantsAmt |
| CY Contributions Grants | $392,739 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $14,191,160 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $13,467,601 | CYProgramServiceRevenueAmt |
| PY Investment Income | $4,945 | PYInvestmentIncomeAmt |
| CY Investment Income | $6,396 | CYInvestmentIncomeAmt |
| PY Other Revenue | $85,937 | PYOtherRevenueAmt |
| CY Other Revenue | $83,919 | CYOtherRevenueAmt |
| PY Total Revenue | $14,539,932 | PYTotalRevenueAmt |
| CY Total Revenue | $13,950,655 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $9,685,573 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $9,479,552 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $4,897,498 | PYOtherExpensesAmt |
| CY Other Expenses | $4,354,774 | CYOtherExpensesAmt |
| PY Total Expenses | $14,583,071 | PYTotalExpensesAmt |
| CY Total Expenses | $13,834,326 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$43,139 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $116,329 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $10,568,847 | TotalAssetsBOYAmt |
| Total Assets EOY | $10,025,423 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $1,995,880 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $1,336,127 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $8,572,967 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $8,689,296 | NetAssetsOrFundBalancesEOYAmt |
| Mission | TO PROVIDE THE BEST SERVICES AND RESOURCES FOR THE COMMUNITY ON DYING, DEATH, GRIEF AND LOSS | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $11,145,174 | ExpenseAmt |
| Revenue | $13,503,102 | RevenueAmt |
| Desc | THE ORGANIZATION PROVIDED CARE FOR TERMINALLY ILL PATIENTS AND THEIR FAMILIES THROUGH HOSPICE HOUSE AND HOME CARE PROGRAMS AND PROVIDED EDUCATIONAL OPPORTUNITIES ON DEATH AND DYING, GRIEF AND LOSS. GRIEF AND LOSS PROGRAM FOR PATIENTS, FAMILY MEMBERS AND THE COMMUNITY AT LARGE. | Desc |
| Total Program Service Expenses | $11,145,174 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | 0 | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Temp Or Permanent Endowments | Yes (1) | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | 0 | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | Yes (1) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (1) | AuditedFinancialStmtAttInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | Yes (1) | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | Yes (1) | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | Yes (1) | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 92 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 255 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 22 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 22 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | 0 | MembersOrStockholdersInd |
| Election Of Board Members | 0 | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | 0 | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | 0 | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | GA | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ARTHUR GNANN | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 9123552289 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 13190 | AddressLine1 |
| City | SAVANNAH | City |
| State | GA | State |
| ZIP Code | 31416 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionAGrp (30 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | OfficerOfficerInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|
| NITA ANN KLEIN | |||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| JOSEPH ROBERTS | |||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| KACEY RATTERREE | |||||||
| PAST CHAIRMAN | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| MYRA HILL | |||||||
| VICE CHAIRMAN | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| ROSS KAMINSKY | |||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| LYNN WIRTH | |||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| PAUL MEYER | |||||||
| TREASURER | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| PHILLIPS SOLOMONS JR | |||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| EULA PARKER | |||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| RAMON V MEGUIAR MD | |||||||
| MEMBER-AT-LARGE | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| KATHY MCCURRY | |||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| MARK BURNS | |||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| WILLIAM A BAKER | |||||||
| CHAIRMAN | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| BRUCE BARRAGAN | |||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| KATHLEEN DELOACH BENTON | |||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| ROENIA DELOACH | |||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| HOLDEN HAYES | |||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| CONNIE DARBYSHIRE | |||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| BO RUSSOM | |||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| JUDGE HARRIS LEWIS | |||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| EB GAINES III | |||||||
| SECRETARY | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| RICHARD LEIGHTON MD | |||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| KELLY EROLA | |||||||
| CHIEF MEDICAL OFFICER | 40.00 | $196,978 | $0 | $0 | Yes (X) | ||
| DEBRA LARSON | |||||||
| CEO | 40.00 | $112,083 | $0 | $0 | Yes (X) | ||
| ARTHUR GNANN | |||||||
| CHIEF FINANCIAL OFFICER | 40.00 | $111,663 | $0 | $0 | Yes (X) | ||
| MONICA ANDERSON | |||||||
| CHIEF CLINICAL OFFICER | 40.00 | $96,027 | $0 | $0 | Yes (X) | ||
| JAMEY ESPINA | |||||||
| VP OF SERVICE EXCELLENCE | 40.00 | $78,778 | $0 | $0 | Yes (X) | ||
| MEGAN KERLEY | |||||||
| VP OF FOUNDATION | 40.00 | $61,334 | $0 | $0 | Yes (X) | ||
| LAURA WIGGINS | |||||||
| SCPC DIRECTOR | 40.00 | $102,469 | $0 | $0 | Yes (X) | ||
| JULIA JOHNSON | |||||||
| PHYSICIAN | 40.00 | $114,483 | $0 | $0 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $873,815 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $0 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 5 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1 | CityContractorAddress/USAddress/City | StateContractorAddress/USAddress/State | ZIP CodeContractorAddress/USAddress/ZIPCode | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| BCBS | |||||
| PO BOX 100376 | ATLANTA | GA | 30384 | EMPLOYEE HEALTH INSURANCE | $971,972 |
| HOSPICE PHARMACIA LLC | |||||
| PO BOX 510818 | PHILADELPHIA | PA | 191750818 | PATIENT MEDICATIONS | $725,888 |
| MUTUAL OF AMERICA | |||||
| ROCKEFELLER CTR UNIT PO BOX 2493 | NEW YORK | NY | 101850049 | 403B | $710,014 |
| EDM ENTERPRISES INC | |||||
| BLDG 6 2600 CHAMBLEE ROAD SUITE 2 | ATLANTA | GA | 30341 | DURABLE MEDICAL EQUIPMENT | $497,349 |
| BOAEN MECHANICAL | |||||
| PO BOX 22054 | SAVANNAH | GA | 31403 | AIR CONDITIONING | $343,800 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 5 | CntrctRcvdGreaterThan100KCnt |
| Related Organizations | $164,787 | RelatedOrganizationsAmt |
| All Other Contributions | $227,952 | AllOtherContributionsAmt |
| Total Contributions | $392,739 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| PATIENT SERVICE REVENUE | 621610 | $16,994,431 | $16,994,431 |
| CHARITY CARE | 621610 | -$535,452 | -$535,452 |
| CONTRACTUAL ADJUSTMENTS AND ALLOW | 621610 | -$2,991,378 | -$2,991,378 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $13,467,601 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $6,396 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $6,396 | RelatedOrExemptFuncIncomeAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $54,814 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $0 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $54,814 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $54,814 | TotalRevenueColumnAmt |
| Exclusion | $54,814 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| MANAGEMENT FEES | 561000 | $24,000 | $24,000 |
| SPECIAL EVENTS | 621610 | $5,105 | $5,105 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $29,105 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $13,950,655 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $13,503,102 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $54,814 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,776,958 | TotalAmt |
| Program Services | $6,601,586 | ProgramServicesAmt |
| Management And General | $1,175,372 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,702,594 | TotalAmt |
| Program Services | $1,445,272 | ProgramServicesAmt |
| Management And General | $257,322 | ManagementAndGeneralAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $21,870 | TotalAmt |
| Management And General | $21,870 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,962 | TotalAmt |
| Management And General | $3,962 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $55,584 | TotalAmt |
| Management And General | $55,584 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $98,766 | TotalAmt |
| Management And General | $98,766 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $45,516 | TotalAmt |
| Program Services | $2,671 | ProgramServicesAmt |
| Management And General | $42,845 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $48,271 | TotalAmt |
| Program Services | $45,146 | ProgramServicesAmt |
| Management And General | $3,125 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $374,744 | TotalAmt |
| Program Services | $208,048 | ProgramServicesAmt |
| Management And General | $166,696 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $138,143 | TotalAmt |
| Management And General | $138,143 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| MEDICATIONS | $760,355 | $760,355 | |
| DME | $534,627 | $534,627 | |
| MILEAGE, MEETINGS, CELL | $360,211 | $289,212 | $70,999 |
| MEDICAL SUPPLIES | $266,178 | $266,178 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,646,547 | TotalAmt |
| Program Services | $992,079 | ProgramServicesAmt |
| Management And General | $654,468 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $13,834,326 | TotalAmt |
| Program Services | $11,145,174 | ProgramServicesAmt |
| Management And General | $2,689,152 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,627,479 | BOYAmt |
| EOY | $1,851,065 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,796,934 | BOYAmt |
| EOY | $1,565,094 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $40,867 | BOYAmt |
| EOY | $366,249 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $10,947,543 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $4,900,108 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,932,855 | BOYAmt |
| EOY | $6,047,435 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $170,712 | BOYAmt |
| EOY | $195,580 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $10,568,847 | BOYAmt |
| EOY | $10,025,423 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,995,380 | BOYAmt |
| EOY | $1,335,627 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $500 | BOYAmt |
| EOY | $500 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,995,880 | BOYAmt |
| EOY | $1,336,127 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,564,842 | BOYAmt |
| EOY | $8,682,247 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,125 | BOYAmt |
| EOY | $7,049 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,572,967 | BOYAmt |
| EOY | $8,689,296 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $10,568,847 | BOYAmt |
| EOY | $10,025,423 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $116,329 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule D IRS990ScheduleD
CY Endwmt Fund CYEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $8,125 | BeginningYearBalanceAmt |
| Contributions | $6,000 | ContributionsAmt |
| Other Expenditures | $7,353 | OtherExpendituresAmt |
| End Year Balance | $6,772 | EndYearBalanceAmt |
CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributions | $10,000 | ContributionsAmt |
| Other Expenditures | $1,875 | OtherExpendituresAmt |
| End Year Balance | $8,125 | EndYearBalanceAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Term Endowment Balance EOY | 1.00000 | TermEndowmentBalanceEOYPct |
| Endowments Held Unrelated Org | 0 | EndowmentsHeldUnrelatedOrgInd |
| Endowments Held Related Org | 0 | EndowmentsHeldRelatedOrgInd |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | $8,836,305 | InvestmentCostOrOtherBasisAmt |
| Depreciation | $3,238,857 | DepreciationAmt |
| Book Value | $5,597,448 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | $1,952,125 | InvestmentCostOrOtherBasisAmt |
| Depreciation | $1,661,251 | DepreciationAmt |
| Book Value | $290,874 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | $159,113 | InvestmentCostOrOtherBasisAmt |
| Book Value | $159,113 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $6,047,435 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | DUE TO RELATED PARTIES | Desc |
| Amt | $500 | Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $500 | TotalLiabilityAmt |
| Total Rev Etc Audited Fincl Stmt | $13,950,655 | TotalRevEtcAuditedFinclStmtAmt |
| Revenue Not Reported | $0 | RevenueNotReportedAmt |
| Revenue Subtotal | $13,950,655 | RevenueSubtotalAmt |
| Revenue Not Reported Fincl Stmt | $0 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $13,950,655 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $13,834,326 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Not Reported | $0 | ExpensesNotReportedAmt |
| Expenses Subtotal | $13,834,326 | ExpensesSubtotalAmt |
| Expenses Not Rpt Fincl Stmt | $0 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $13,834,326 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART XI, LINE 4B - OTHER ADJUSTMENTS: | CONTRIBUTION TO FOUNDATION |
| PART XII, LINE 4B - OTHER ADJUSTMENTS: | CONTRIBUTION TO FOUNDATION |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (1) | FinancialAssistancePolicyInd |
| Written Policy | Yes (1) | WrittenPolicyInd |
| All Hospitals Policy | Yes (X) | AllHospitalsPolicyInd |
| FPG Reference Free Care | 0 | FPGReferenceFreeCareInd |
| FPG Reference Discounted Care | 0 | FPGReferenceDiscountedCareInd |
| Free Care Medically Indigent | Yes (1) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (1) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | Yes (1) | ExpensesExceedBudgetInd |
| Unable To Provide Care | 0 | UnableToProvideCareInd |
| Annual Community Bnft Report | 0 | AnnualCommunityBnftReportInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $280,782 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $280,782 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.02000 | TotalExpensePct |
Unreimbursed Costs UnreimbursedCostsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $561,939 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $561,939 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.04100 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $842,721 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $842,721 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.06100 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $165,484 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $165,484 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01200 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $165,484 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $165,484 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01200 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,008,205 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $1,008,205 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.07300 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (1) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $382,197 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $280,577 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $11,604,346 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $11,753,141 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$148,795 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | Yes (X) | OtherInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (1) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (1) | FinancialAssistancePrvsnInd |
| Hospital Facilities | 1 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HOSPICE SAVANNAH INC | BusinessNameLine1 |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1352 EISENHOWER DRIVE | AddressLine1 |
| City | SAVANNAH | City |
| State | GA | State |
| ZIP Code | 31406 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | HOSPICE CARE INPATIENT UNIT | OtherDesc |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HOSPICE SAVANNAH INC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| CHNA Conducted | 0 | CHNAConductedInd |
| Elig Criteria Explained | Yes (1) | EligCriteriaExplainedInd |
| FPG Used Deter Elig Free Care | 0 | FPGUsedDeterEligFreeCareInd |
| FPG Used Determ Elig Dscnt Care | 0 | FPGUsedDetermEligDscntCareInd |
| Explained Basis | Yes (1) | ExplainedBasisInd |
| Income Level | Yes (X) | IncomeLevelInd |
| Asset Level | Yes (X) | AssetLevelInd |
| App Financial Asst Expln | Yes (1) | AppFinancialAsstExplnInd |
| Includes Publicity Measures | Yes (1) | IncludesPublicityMeasuresInd |
| Provided On Admission | Yes (X) | ProvidedOnAdmissionInd |
| FAP Actions On Nonpayment | Yes (1) | FAPActionsOnNonpaymentInd |
| Permit Other Actions | Yes (X) | PermitOtherActionsInd |
| Collection Activities | 0 | CollectionActivitiesInd |
| Nondis Emergency Care Policy | 0 | NondisEmergencyCarePolicyInd |
| Other Reason | Yes (X) | OtherReasonInd |
| Other Method Used | Yes (X) | OtherMethodUsedInd |
| Amounts Generally Billed | 0 | AmountsGenerallyBilledInd |
| Gross Charges | Yes (1) | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| HOSPICE SAVANNAH, INC. | PART V, SECTION B, LINE 16E: HOSPICE'S COLLECTION POLICY IS TO SEND THREE STATEMENTS AND PAST DUE LETTERS ONCE AN ACCOUNT IS DEEMED PAST DUE. IF NO PAYMENT IS RECEIVED AFTER STATEMENTS AND LETTERS ARE SENT, THE ACCOUNT IS WRITTEN OFF. |
| HOSPICE SAVANNAH, INC. | PART V, SECTION B, LINE 19D: HOSPICE SAVANNAH IS NOT A HOSPITAL AND PROVIDES HOSPICE SERVICES, NOT EMERGENCY CARE SERVICES. |
| HOSPICE SAVANNAH, INC. | PART V, SECTION B, LINE 20D: HOSPICE SAVANNAH USES A FINANCIAL ASSESSMENT FORM TO DETERMINE THE AMOUNT OWED. SEE EXPLANATION ABOVE UNDER PART I, LINE 3C FOR ADDITIONAL DETAIL. |
| HOSPICE SAVANNAH, INC. | PART V, SECTION B, LINE 22: ALL SELF PAY PATIENTS THAT DO NOT QUALIFY FOR A REDUCED RATE AFTER COMPLETING THE FINANCIAL ASSESSMENT FORM ARE CHARGED FULL PRICE. |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 2 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp (2 entries)
| Address Line1USAddress/AddressLine1 | CityUSAddress/City | StateUSAddress/State | ZIP CodeUSAddress/ZIPCode | FacilityFacilityTxt |
|---|---|---|---|---|
| HOSPICE SAVANNAH INC | ||||
| 1674 CHATHAM PARKWAY | SAVANNAH | GA | 31405 | ADMINISTRATIVE OFFICES |
| HOSPICE SAVANNAH INC | ||||
| 450 MALL BLVD SUITE H | SAVANNAH | GA | 31416 | BEREAVEMENT CENTER |
Supplemental Information Detail SupplementalInformationDetail (11 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 3C: | THE FOLLOWING POLICY IS USED TO DETERMINE ELIGIBILITY FOR FREE OR DISCOUNTED CARE. A FINANCE REPRESENTATIVE OR SOCIAL WORKER WILL MEET WITH THE PATIENT AND/OR RESPONSIBLE PARTY PRIOR TO PATIENT BEING ADMITTED TO COMPLETE A FINANCIAL ASSESSMENT FORM. THIS FORM DETERMINES THE LEVEL OF PAY THAT IS REQUIRED PER DAY FROM THE PATIENT OR FAMILY, DEPENDING ON THE FINANCIAL RESOURCES AVAILABLE. THE PATIENT/FAMILY WILL PROVIDE VERIFICATION AND APPROPRIATE PROOF OF RESOURCES AND COMMITMENTS.THE FINANCIAL ASSESSMENT FORM IS SIGNED BY THE PATIENT OR RESPONSIBLE PARTY AND A HOSPICE SAVANNAH REPRESENTATIVE. SIGNING THE FORM IS AN AGREEMENT TO PAY THE AMOUNT DETERMINED. REFUSAL TO PAY THE AGREED TO AMOUNT WILL RESULT IN APPROPRIATE MEASURES BEING TAKEN TO COLLECT THE FUNDS.REFUSAL TO COMPLETE AND SIGN THE FORM WILL RESULT IN THE PATIENT BEING CHARGED THE FULL RATE PER DAY.THE ORIGNIAL AGREEMENT WILL BE PLACED IN THE PATIENT'S FINANICAL CHART. THE PATIENT OR RESPONSIBLE PARTY WILL BE BILLED MONTHLY BASED ON THE PER DIEM RATE ESTABLISHED USING THE FINANCIAL ASSESSMENT FORM. |
| PART I, LINE 7: | WORKSHEET 2 FROM FORM 990 INSTRUCTIONS IS USED AS COSTING METHODOLOGY. THERE WERE NO SUBSIDIZED HEALTH SERVICES. |
| PART II, COMMUNITY BUILDING ACTIVITIES: | THERE WERE NO COMMUNITY BUILDING ACTIVITIES HELD IN 2012. |
| PART III, LINE 4: | WORKSHEET 2 IN THE FORM 990 INSTRUCTIONS WAS USED AS THE COSTING METHODOLOGY FOR PART III, LINE 4. |
| PART III, LINE 8: | THERE WAS NO SHORTFALL ON PART III, LINE 7. THE MEDICARE ALLOWABLE COSTS OF CARE WERE DERIVED FROM THE CMS PUBLISHED PER DIEM RATE. |
| PART III, LINE 9B: | HOSPICE'S COLLECTION POLICY IS TO SEND THREE STATEMENTS AND PAST DUE LETTERS. IF NO PAYMENT IS RECEIVED AFTER STATEMENTS AND LETTERS ARE SENT, THE ACCOUNT IS WRITTEN OFF. |
| PART VI, LINE 2: | HOSPICE SAVANNAH PREPARES AN ANNUAL MARKET ANALYSIS ON DEMOGRAPHICS IN THE REGION. CUSTOMER SATISFACTION SURVEYS ARE USED TO PROVIDE FEEDBACK ON EFFECTIVITY OF SERVICES PROVIDED. NHPCO AND GHPCO RESOURCES ARE USED TO TRACK TRENDS IN HOSPICE CARE AND BEST PRACTICES. |
| PART VI, LINE 3: | PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE IS DONE THROUGH THE ADMISSIONS PROCESS. THEY RECEIVE A FAMILY RESOURCE GUIDE EXPLAINING FINANCIAL OPTIONS. HOSPICE SAVANNAH ALSO ASSISTS PATIENTS WITH COMPLETING MEDICAID APPLICATIONS. |
| PART VI, LINE 4: | HOSPICE SAVANNAH SERVES A 5 COUNTY AREA IN SOUTHEAST GEORGIA. CHATHAM, BRYAN, EFFINGHAM, LIBERTY AND LONG COUNTIES ARE ALL SERVED BY HOSPICE SAVANNAH. MOST OF THE POPULATION IS IN CHATHAM COUNTY IN AN URBAN SETTING. |
| PART VI, LINE 5: | HOSPICE SAVANNAH OFFERS GRIEF AND LOSS SERVICES TO NOT ONLY HOSPICE SAVANNAH PATIENTS AND THEIR FAMILIES BUT THE COMMUNITY AT LARGE AT NO COST TO THE PARTICIPANTS. THESE SERVICES INCLUDE, BUT ARE NOT LIMITED TO, INDIVIDUAL AND GROUP COUNSELING, MASSAGE THERAPY, MUSIC THERAPY, STORYTELLING, ETC. SCHOOLS, HOSPITALS, NURSING HOMES AND WORD OF MOUTH ARE USED TO INFORM THE COMMUNITY OF THESE SERVICES. |
| PART VI, LINE 6: | N/A |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Independent Consultant | Yes (X) | IndependentConsultantInd |
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | 0 | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | KELLY EROLA | PersonNm |
| Title | CHIEF MEDICAL OFFICER | TitleTxt |
| Base Compensation Filing Org | $196,978 | BaseCompensationFilingOrgAmt |
| Compensation Based On Rltd Orgs | $0 | CompensationBasedOnRltdOrgsAmt |
| Bonus Filing Organization | $0 | BonusFilingOrganizationAmount |
| Bonus Related Organizations | $0 | BonusRelatedOrganizationsAmt |
| Other Compensation Filing Org | $0 | OtherCompensationFilingOrgAmt |
| Other Compensation Rltd Orgs | $0 | OtherCompensationRltdOrgsAmt |
| Deferred Compensation Flng Org | $0 | DeferredCompensationFlngOrgAmt |
| Deferred Comp Rltd Orgs | $0 | DeferredCompRltdOrgsAmt |
| Nontaxable Benefits Filing Org | $0 | NontaxableBenefitsFilingOrgAmt |
| Nontaxable Benefits Rltd Orgs | $0 | NontaxableBenefitsRltdOrgsAmt |
| Total Compensation Filing Org | $196,978 | TotalCompensationFilingOrgAmt |
| Total Compensation Rltd Orgs | $0 | TotalCompensationRltdOrgsAmt |
| Comp Report Prior990 Filing Org | $0 | CompReportPrior990FilingOrgAmt |
| Comp Report Prior990 Rltd Orgs | $0 | CompReportPrior990RltdOrgsAmt |
Schedule L IRS990ScheduleL
Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp
Name Of Interested NameOfInterested
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HOLDEN HAYES | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Relationship Description | BOARD MEMBER OF HOSPICE AND PRESIDENT OF BANK WHERE CASH ACCOUNTS ARE HELD | RelationshipDescriptionTxt |
| Transaction | EMPLOYED BY BANK AND VOLUNTEERS AS BOARD MEMBER FOR HOSPICEEMPLOYED BY BANK AND VOLUNTEERS AS BOARD MEMBER FOR HOSPICE | TransactionDesc |
| Sharing Of Revenues | 0 | SharingOfRevenuesInd |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION B, LINE 11 | THE FORM 990 WILL BE REVIEWED AND APPROVED BY CEO, VP OF FINANCE AND EXECUTIVE/FINANCE COMMITTEE OF BOARD OF DIRECTORS VIA EMAIL PRIOR TO SUBMISSION TO IRS. |
| FORM 990, PART VI, SECTION B, LINE 12C | AN ACKNOWLEDGEMENT IS SIGNED BY ALL EMPLOYEES AND BOARD MEMBERS. THIS FORM IS MAINTAINED IN THE HUMAN RESOURCES DEPARTMENT. |
| FORM 990, PART VI, SECTION B, LINE 15B | HOSPICE SAVANNAH TYPICALLY UTILIZES AN OUTSIDE AGENCY TO PERFORM A COMPENSATION SURVEY. THIS SURVEY ENSURES THAT ALL SALARIES ARE COMPARABLE WITH AVERAGE GOING RATES FOR ORGANIZATIONS OF SIMILAR SIZE AND IN THE SAME INDUSTRY. ALL SALARIES ARE BASED ON RELEVANT EXPERIENCE AND EDUCATION WITHIN COMPENSATION STRUCTURE. THE COMPENSATION SURVEY IS PERFORMED EVERY TWO YEARS. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST FROM THE ADMINSTRATIVE OFFICE. |
| FORM 990, PART IX, LINE 24E | BAD DEBT: PROGRAM SERVICE EXPENSES 193,931. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 193,931. CLEANING AND EXTERMINATING: PROGRAM SERVICE EXPENSES 123,401. MANAGEMENT AND GENERAL EXPENSES 29,371. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 152,772. UTILITIES: PROGRAM SERVICE EXPENSES 73,862. MANAGEMENT AND GENERAL EXPENSES 65,789. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 139,651. TELEPHONE: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 125,458. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 125,458. CONTRACT LABOR: PROGRAM SERVICE EXPENSES 4,750. MANAGEMENT AND GENERAL EXPENSES 97,379. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 102,129. CABLE AND LINEN: PROGRAM SERVICE EXPENSES 101,389. MANAGEMENT AND GENERAL EXPENSES 624. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 102,013. COMPUTER: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 94,190. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 94,190. EQUIPMENT: PROGRAM SERVICE EXPENSES 67,180. MANAGEMENT AND GENERAL EXPENSES 23,980. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 91,160. FACILITY RELATED CONTRACTS: PROGRAM SERVICE EXPENSES 40,667. MANAGEMENT AND GENERAL EXPENSES 25,465. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 66,132. CONSULTING AND SERVICE CONTRACTS: PROGRAM SERVICE EXPENSES 6,815. MANAGEMENT AND GENERAL EXPENSES 57,679. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 64,494. THERAPIES: PROGRAM SERVICE EXPENSES 62,917. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 62,917. AMBULANCE: PROGRAM SERVICE EXPENSES 61,868. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 61,868. DIETARY AND FOOD: PROGRAM SERVICE EXPENSES 58,278. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 58,278. SECURITY EXPENSE: PROGRAM SERVICE EXPENSES 36,064. MANAGEMENT AND GENERAL EXPENSES 18,565. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 54,629. DUES AND SUBSCRIPTIONS: PROGRAM SERVICE EXPENSES 10,854. MANAGEMENT AND GENERAL EXPENSES 43,725. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 54,579. CONTINUING EDUCATION: PROGRAM SERVICE EXPENSES 37,299. MANAGEMENT AND GENERAL EXPENSES 13,380. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 50,679. LAB AND IMAGING: PROGRAM SERVICE EXPENSES 49,463. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 49,463. REPAIRS & MAINTENANCE: PROGRAM SERVICE EXPENSES 25,004. MANAGEMENT AND GENERAL EXPENSES 14,160. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 39,164. POSTAGE AND PRINTING: PROGRAM SERVICE EXPENSES 2,921. MANAGEMENT AND GENERAL EXPENSES 20,936. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 23,857. MISCELLANEOUS: PROGRAM SERVICE EXPENSES 2,375. MANAGEMENT AND GENERAL EXPENSES 19,290. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 21,665. PASS THROUGHS: PROGRAM SERVICE EXPENSES 16,277. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 16,277. WASTE DISPOSAL: PROGRAM SERVICE EXPENSES 6,095. MANAGEMENT AND GENERAL EXPENSES 4,477. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 10,572. OUTPATIENT: PROGRAM SERVICE EXPENSES 7,469. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 7,469. PATIENT RELATED PROGRAMS: PROGRAM SERVICE EXPENSES 3,200. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 3,200. |
Schedule R IRS990ScheduleR
Id Disregarded Entities IdDisregardedEntitiesGrp
Disregarded Entity Name DisregardedEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | OLD RIVER HOSPICE PROPERTIES LLC | BusinessNameLine1 |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 24 DRAYTON STREET SUITE 712 | AddressLine1 |
| City | SAVANNAH | City |
| State | GA | State |
| ZIP Code | 31410 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 270888923 | EIN |
| Primary Activities | PROPERTY MANAGEMENT | PrimaryActivitiesTxt |
| Legal Domicile State | GA | LegalDomicileStateCd |
| Total Income | $3,125 | TotalIncomeAmt |
| End Of Year Assets | $484,803 | EndOfYearAssetsAmt |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HOSPICE SAVANNAH INC | BusinessNameLine1 |
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (2 entries)
| Address Line1USAddress/AddressLine1 | CityUSAddress/City | StateUSAddress/State | ZIP CodeUSAddress/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Controlled OrganizationControlledOrganizationInd | Direct Controlling NADirectControllingNACd |
|---|---|---|---|---|---|---|---|---|---|---|---|
| THE STEWARD CENTER FOR PALLIATIVE CARE INC | |||||||||||
| POST OFFICE BOX 13190 | SAVANNAH | GA | 31416 | 510545338 | COUNSELING | GA | 501(C)(3) | LINE 9 | HOSPICE SAVANNAH INC | 0 | |
| HOSPICE SAVANNAH FOUNDATION INC | |||||||||||
| POST OFFICE BOX 13190 | SAVANNAH | GA | 31416 | 582215819 | FUNDING ASSISTANCE FOR HOSPICE SAVANNAH, INC. AND THE STEWARD CENTER | GA | 501(C)(3) | LINE 11A, I | 0 | N/A | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | 0 | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | Yes (1) | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | 0 | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | Yes (1) | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (1) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | Yes (1) | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp (7 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|
| HOSPICE SAVANNAH FOUNDATION INC | ||
| C | $22,954 | FMV |
| HOSPICE SAVANNAH FOUNDATION INC | ||
| N | ||
| THE STEWARD CENTER FOR PALLIATIVE CARE INC | ||
| N | ||
| HOSPICE SAVANNAH FOUNDATION INC | ||
| O | ||
| THE STEWARD CENTER FOR PALLIATIVE CARE INC | ||
| O | ||
| THE STEWARD CENTER FOR PALLIATIVE CARE INC | ||
| Q | $172,621 | FMV |
| (no name) | ||
| P | ||