HOSPICE SAVANNAH INC: Form 990, tax year 2012
View the entire original 990 at ProPublica ↗
- Organization
- HOSPICE SAVANNAH INC (EIN 58-1393820)
- Tax period
- 2012-01-01 to 2012-12-31
- Filed
- 2013-08-14
- IRS object ID
- 201312269349304401
- Schema version
- 2012v2.1
- 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) |
|---|---|---|
| Timestamp | 2013-08-14T19:46:56-05:00 | Timestamp |
| Tax Period End Date | 2012-12-31 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 581941470 | EIN |
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HOLLAND HENRY & BROMLEY LLP | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| 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 | ReturnType |
| Tax Period Begin Date | 2012-01-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 581393820 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HOSPICE SAVANNAH INC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | HOSP | NameControl |
| Phone | 9123552289 | Phone |
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 |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | ARTHUR GNANN | Name |
| Title | VP OF FINANCE | Title |
| Phone | 9123552289 | Phone |
| Date Signed | 2013-08-14 | DateSigned |
| Authorize Third Party | 1 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | SHANNON L BRETT | Name |
| PTIN | P00558136 | PTIN |
| Phone | 9122353410 | Phone |
| Date Prepared | 2013-08-07 | DatePrepared |
| Self Employed | X | SelfEmployed |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2012 | TaxYear |
| Build TS | 2016-02-24 21:20:13Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | ARTHUR GNANN | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| 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 | 14539932 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | WWW.HOSPICESAVANNAH.ORG | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1979 | YearFormation |
| State Legal Domicile | GA | StateLegalDomicile |
| Activity Or Mission Description | TO PROVIDE MEDICAL SERVICES TO PATIENTS WITH TERMINAL ILLNESSES. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 22 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 22 | NbrIndependentVotingMembers |
| Total Nbr Employees | 251 | TotalNbrEmployees |
| Total Nbr Volunteers | 250 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 0 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 178100 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 257890 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 13730574 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 14191160 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 30190 | InvestmentIncomePriorYear |
| Investment Income Current Year | 4945 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 88877 | OtherRevenuePriorYear |
| Other Revenue Current Year | 85937 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 14027741 | TotalRevenuePriorYear |
| Total Revenue Current Year | 14539932 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 0 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 0 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 9558863 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 9685573 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp Prior Year | 0 | TotalProfFundrsngExpPriorYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 4754504 | OtherExpensePriorYear |
| Other Expenses Current Year | 4897498 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 14313367 | TotalExpensesPriorYear |
| Total Expenses Current Year | 14583071 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | -285626 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | -43139 | RevenuesLessExpensesCY |
| Total Assets BOY | 10227137 | TotalAssetsBOY |
| Total Assets EOY | 10568847 | TotalAssetsEOY |
| Total Liabilities BOY | 1611031 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 1995880 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 8616106 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 8572967 | NetAssetsOrFundBalancesEOY |
| Mission Description | TO PROVIDE THE BEST SERVICES AND RESOURCES FOR THE COMMUNITY ON DYING, DEATH, GRIEF AND LOSS | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 11798110 | Expense |
| Revenue | 14226850 | Revenue |
| Description | 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. | Description |
| Total Program Service Expense | 11798110 | TotalProgramServiceExpense |
| Described In501 C3 | 1 | DescribedIn501C3 |
| Schedule B Required | 1 | ScheduleBRequired |
| Political Activities | 0 | PoliticalActivities |
| Lobbying Activities | 0 | LobbyingActivities |
| Subject To Proxy Tax | 0 | SubjectToProxyTax |
| Donor Advised Funds | 0 | DonorAdvisedFunds |
| Conservation Easements | 0 | ConservationEasements |
| Collections Of Art | 0 | CollectionsOfArt |
| Credit Counseling | 0 | CreditCounseling |
| Term Or Permanent Endowments | 1 | TermOrPermanentEndowments |
| Report Land Bldg Equip | 1 | ReportLandBldgEquip |
| Report Invest Oth Securities | 0 | ReportInvestOthSecurities |
| Report Prog Rel Invest | 0 | ReportProgRelInvest |
| Report Other Assets | 0 | ReportOtherAssets |
| Report Other Liabilities | 1 | ReportOtherLiabilities |
| Report Fin48 Footnote | 0 | ReportFin48Footnote |
| Independent Audit Financial Stmt | 0 | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | 1 | ConsolidatedAuditFinancialStmt |
| School | 0 | School |
| Foreign Office | 0 | ForeignOffice |
| Foreign Activities | 0 | ForeignActivities |
| More Than5000 K To Organizations | 0 | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividuals |
| Professional Fundraising | 0 | ProfessionalFundraising |
| Fundraising Activities | 0 | FundraisingActivities |
| Gaming | 0 | Gaming |
| Hospital | 1 | Hospital |
| Financial Stmt Attached | 1 | FinancialStmtAttached |
| Grants To Organizations | 0 | GrantsToOrganizations |
| Grants To Individuals | 0 | GrantsToIndividuals |
| Schedule J Required | 1 | ScheduleJRequired |
| Tax Exempt Bonds | 0 | TaxExemptBonds |
| Excess Benefit Transaction | 0 | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | 0 | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | 0 | LoanToOfficerOrDQP |
| Grant To Related Person | 0 | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | 1 | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | 0 | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | 1 | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | 0 | DeductibleNonCashContributions |
| Deductible Contributions Of Art | 0 | DeductibleContributionsOfArt |
| Terminated | 0 | Terminated |
| Partial Liquidation | 0 | PartialLiquidation |
| Disregarded Entity | 1 | DisregardedEntity |
| Related Entity | 1 | RelatedEntity |
| Related Org Controlled Entity | 0 | RelatedOrgControlledEntity |
| Transfers To Exempt Non Chrtbl Org | 0 | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | 0 | ActivitiesConductedPartnership |
| Schedule O Required | 1 | ScheduleORequired |
| Number Forms Transmitted With1096 | 99 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | 1 | ComplianceWithBackupWitholding |
| Number Of Employees | 251 | NumberOfEmployees |
| Employment Tax Returns Filed | 1 | EmploymentTaxReturnsFiled |
| Unrelated Business Income | 0 | UnrelatedBusinessIncome |
| Foreign Financial Account | 0 | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTrans |
| Taxable Party Notification | 0 | TaxablePartyNotification |
| Non Deductible Contributions | 0 | NonDeductibleContributions |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributions |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOf |
| Indoor Tanning Services | 0 | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 22 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 22 | NumberIndependentVotingMembers |
| Family Or Business Relationship | 0 | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | 0 | DelegationOfManagementDuties |
| Changes To Organizing Docs | 0 | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuse |
| Members Or Stockholders | 0 | MembersOrStockholders |
| Election Of Board Members | 0 | ElectionOfBoardMembers |
| Decisions Subject To Approval | 0 | DecisionsSubjectToApproval |
| Minutes Of Governing Body | 1 | MinutesOfGoverningBody |
| Minutes Of Committees | 1 | MinutesOfCommittees |
| Officer Mailing Address | 0 | OfficerMailingAddress |
| Local Chapters | 0 | LocalChapters |
| Form990 Provided To Governing Body | 1 | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | 1 | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | 1 | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | 1 | RegularMonitoringEnforcement |
| Whistleblower Policy | 1 | WhistleblowerPolicy |
| Document Retention Policy | 1 | DocumentRetentionPolicy |
| Compensation Process CEO | 0 | CompensationProcessCEO |
| Compensation Process Other | 1 | CompensationProcessOther |
| Investment In Joint Venture | 0 | InvestmentInJointVenture |
| States Where Copy Of Return Is Filed | GA | StatesWhereCopyOfReturnIsFiled |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ARTHUR GNANN | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 9123552289 | TelephoneNumber |
Address US AddressUS
| 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 Form990PartVIISectionA (32 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | OfficerOfficer | Key EmployeeKeyEmployee | Highest Compensated EmployeeHighestCompensatedEmployee |
|---|---|---|---|---|---|---|---|---|
| NITA ANN KLEIN | ||||||||
| BOARD MEMBER | 1.00 | X | 0 | 0 | 0 | |||
| JOSEPH ROBERTS | ||||||||
| BOARD MEMBER | 1.00 | X | 0 | 0 | 0 | |||
| KACEY RATTERREE | ||||||||
| CHAIRMAN | 1.00 | X | 0 | 0 | 0 | |||
| HOLDEN HAYES | ||||||||
| PAST CHAIRMAN | 1.00 | X | 0 | 0 | 0 | |||
| MYRA HILL | ||||||||
| SECRETARY | 1.00 | X | 0 | 0 | 0 | |||
| FRAN KAMINSKY | ||||||||
| PAST CHAIRMAN | 1.00 | X | 0 | 0 | 0 | |||
| LYNN WIRTH | ||||||||
| BOARD MEMBER | 1.00 | X | 0 | 0 | 0 | |||
| PAUL MEYER | ||||||||
| TREASURER | 1.00 | X | 0 | 0 | 0 | |||
| THEODORA T GONGAWARE MD | ||||||||
| BOARD MEMBER | 1.00 | X | 0 | 0 | 0 | |||
| MARTIN GREENBURG MD | ||||||||
| BOARD MEMBER | 1.00 | X | 0 | 0 | 0 | |||
| RAMON V MEGUIAR MD | ||||||||
| BOARD MEMBER | 1.00 | X | 0 | 0 | 0 | |||
| KATHY MCCURRY | ||||||||
| BOARD MEMBER | 1.00 | X | 0 | 0 | 0 | |||
| MARK BURNS | ||||||||
| BOARD MEMBER | 1.00 | X | 0 | 0 | 0 | |||
| WILLIAM A BAKER | ||||||||
| VICE CHAIRMAN | 1.00 | X | 0 | 0 | 0 | |||
| BRUCE BARRAGAN | ||||||||
| MEMBER-AT-LARGE | 1.00 | X | 0 | 0 | 0 | |||
| KATHLEEN DELOACH BENTON | ||||||||
| BOARD MEMBER | 1.00 | X | 0 | 0 | 0 | |||
| ROENIA DELOACH | ||||||||
| BOARD MEMBER | 1.00 | X | 0 | 0 | 0 | |||
| HARVEY GILBERT | ||||||||
| BOARD MEMBER | 1.00 | X | 0 | 0 | 0 | |||
| CONNIE DARBYSHIRE | ||||||||
| BOARD MEMBER | 1.00 | X | 0 | 0 | 0 | |||
| BO RUSSOM | ||||||||
| BOARD MEMBER | 1.00 | X | 0 | 0 | 0 | |||
| JUDGE HARRIS LEWIS | ||||||||
| BOARD MEMBER | 1.00 | X | 0 | 0 | 0 | |||
| EB GAINES III | ||||||||
| BOARD MEMBER | 1.00 | X | 0 | 0 | 0 | |||
| DEBRA LARSON | ||||||||
| CEO | 40.00 | 104615 | 0 | 0 | X | |||
| ARTHUR GNANN | ||||||||
| CHIEF FINANCIAL OFFICER | 40.00 | 101174 | 0 | 0 | X | |||
| JUDSON HENDRY | ||||||||
| VP OF OPERATIONS | 40.00 | 109205 | 0 | 0 | X | |||
| MONICA ANDERSON | ||||||||
| CHIEF CLINICAL OFFICER | 40.00 | 94614 | 0 | 0 | X | |||
| JAMEY ESPINA | ||||||||
| VP OF SERVICE EXCELLENCE | 40.00 | 67972 | 0 | 0 | X | |||
| MEGAN KERLEY | ||||||||
| VP OF FOUNDATION | 40.00 | 75050 | 0 | 0 | X | |||
| LAURA WIGGINS | ||||||||
| SCPC DIRECTOR | 40.00 | 102062 | 0 | 0 | X | |||
| KELLY EROLA | ||||||||
| CHIEF MEDICAL OFFICER | 40.00 | 187770 | 0 | 0 | X | |||
| JULIA JOHNSON | ||||||||
| PHYSICIAN | 40.00 | 108112 | 0 | 0 | X | |||
| LATOYA WILLIAMS | ||||||||
| PHARMACIST | 40.00 | 103940 | 0 | 0 | X | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 1054514 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 0 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 0 | TotalOtherCompensation |
| Number Individuals GT100 K | 7 | NumberIndividualsGT100K |
| Formers Listed | 0 | FormersListed |
| Total Comp GT150 K | 1 | TotalCompGT150K |
| Compensation From Other Sources | 0 | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (5 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| BCBS | |||||
| PO BOX 100376 | ATLANTA | GA | 30384 | EMPLOYEE HEALTH INSURANCE | 1116797 |
| HOSPICE PHARMACIA LLC | |||||
| PO BOX 510818 | PHILADELPHIA | PA | 191750818 | PATIENT MEDICATIONS | 839314 |
| MUTUAL OF AMERICA | |||||
| ROCKEFELLER CTR UNIT PO BOX 2493 | NEW YORK | NY | 101850049 | 403B | 672774 |
| EDM ENTERPRISES INC | |||||
| BLDG 6 2600 CHAMBLEE ROAD SUITE 2 | ATLANTA | GA | 30341 | DURABLE MEDICAL EQUIPMENT | 504134 |
| BRYAN COUNTY HEALTH & REHAB | |||||
| 127 CARTER STREET | RICHMOND HILL | GA | 31324 | NURSING HOME | 291096 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 15 | NumberOfContractorsGT100K |
| All Other Contributions | 257890 | AllOtherContributions |
| Total Contributions | 257890 | TotalContributions |
Program Service Revenue ProgramServiceRevenue (3 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome |
|---|---|---|---|
| PATIENT SERVICE REVENU | 621610 | 18234972 | 18234972 |
| CHARITY CARE | 621610 | -343579 | -343579 |
| CONTRACTUAL ADJUSTMENTS AND ALLOW | 621610 | -3700233 | -3700233 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 14191160 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 4945 | TotalRevenueColumn |
| Related Or Exempt Function Income | 4945 | RelatedOrExemptFunctionIncome |
Gross Rents GrossRents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 55192 | Real |
Less Rental Expenses LessRentalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 0 | Real |
Rental Income Or Loss RentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 55192 | Real |
Net Rental Income Or Loss NetRentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 55192 | TotalRevenueColumn |
| Exclusion | $55,192 | ExclusionAmount |
Other Revenue Misc OtherRevenueMisc (2 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome |
|---|---|---|---|
| MANAGEMENT FEES | 561000 | 24000 | 24000 |
| SPECIAL EVENTS | 621610 | 6745 | 6745 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 30745 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 14539932 | TotalRevenueColumn |
| Related Or Exempt Function Income | 14226850 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $55,192 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | X | InfoInScheduleOPartIX |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1054514 | Total |
| Program Services | 359013 | ProgramServices |
| Management And General | 695501 | ManagementAndGeneral |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 6948469 | Total |
| Program Services | 6341905 | ProgramServices |
| Management And General | 606564 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1682590 | Total |
| Program Services | 1408837 | ProgramServices |
| Management And General | 273753 | ManagementAndGeneral |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 19178 | Total |
| Management And General | 19178 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 56712 | Total |
| Management And General | 56712 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 108856 | Total |
| Management And General | 108856 | ManagementAndGeneral |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 42471 | Total |
| Program Services | 3549 | ProgramServices |
| Management And General | 38922 | ManagementAndGeneral |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 10710 | Total |
| Management And General | 10710 | ManagementAndGeneral |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 55972 | Total |
| Program Services | 50479 | ProgramServices |
| Management And General | 5493 | ManagementAndGeneral |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 349496 | Total |
| Program Services | 202889 | ProgramServices |
| Management And General | 146607 | ManagementAndGeneral |
Other Expenses OtherExpenses (4 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral |
|---|---|---|---|
| MEDICATIONS | 908848 | 908848 | |
| DME | 581184 | 581184 | |
| MILEAGE, MEETINGS, CELL | 405380 | 328955 | 76425 |
| CONTRIBUTION TO FOUNDAT | 294490 | 294490 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2064201 | Total |
| Program Services | 1317961 | ProgramServices |
| Management And General | 746240 | ManagementAndGeneral |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 14583071 | Total |
| Program Services | 11798110 | ProgramServices |
| Management And General | 2784961 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2351735 | BOY |
| EOY | 2627479 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1606190 | BOY |
| EOY | 1796934 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 19916 | BOY |
| EOY | 0 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 56477 | BOY |
| EOY | 40867 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 10458219 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 4525364 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 6028077 | BOY |
| EOY | 5932855 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 164742 | BOY |
| EOY | 170712 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 10227137 | BOY |
| EOY | 10568847 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1610531 | BOY |
| EOY | 1995380 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 500 | BOY |
| EOY | 500 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1611031 | BOY |
| EOY | 1995880 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 8616106 | BOY |
| EOY | 8564842 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 8125 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 8616106 | BOY |
| EOY | 8572967 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 10227137 | BOY |
| EOY | 10568847 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expenses | -43139 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | 0 | ReconcilationOtherChanges |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | 0 | AccountantCompileOrReview |
| FS Audited | 1 | FSAudited |
FS Audited Basis FSAuditedBasis
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Statement Consolidated | X | FinancialStatementConsolidated |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | 1 | AuditCommittee |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequired |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital170b1 Aiii | X | Hospital170b1Aiii |
Schedule B IRS990ScheduleB
Contributor Info ContributorInfo
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor Number | RESTRICTED | ContributorNumber |
Contributor Name Business ContributorNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor Address US ContributorAddressUS
| 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) |
|---|---|---|
| Aggregate Contributions | RESTRICTED | AggregateContributions |
Schedule D IRS990ScheduleD
Current Year CurrentYear
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributions | 10000 | Contributions |
| Other Expenditures | 1875 | OtherExpenditures |
| End Of Year Balance | 8125 | EndOfYearBalance |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Designated EOY Balance | 0.00000 | BoardDesignatedEOYBalance |
| Permanent Endowment EOY Balance | 0.00000 | PermanentEndowmentEOYBalance |
| Term Endowment EOY Balance | 1.00000 | TermEndowmentEOYBalance |
| Endowments Held By Unrelated Orgs | 0 | EndowmentsHeldByUnrelatedOrgs |
| Endowments Held By Related Orgs | 0 | EndowmentsHeldByRelatedOrgs |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | 8605318 | InvestmentCostOrOtherBasis |
| Depreciation | 2940995 | Depreciation |
| Book Value | 5664323 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | 1762062 | InvestmentCostOrOtherBasis |
| Depreciation | 1584369 | Depreciation |
| Book Value | 177693 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | 90839 | InvestmentCostOrOtherBasis |
| Book Value | 90839 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 5932855 | TotalOfBookValueLandBuildings |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | DUE TO RELATED PARTIES | Description |
| Amount | $500 | Amount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 500 | TotalOfAmounts |
| Tot Revenue Etc Audited Fincl Stmt | 14245442 | TotRevenueEtcAuditedFinclStmt |
| Revenue Not Rptd F990 | 0 | RevenueNotRptdF990 |
| Revenue Subtotal | 14245442 | RevenueSubtotal |
| Other Revenues Not Included | 294490 | OtherRevenuesNotIncluded |
| Revenue Not Rptd On Fin Stmt | 294490 | RevenueNotRptdOnFinStmt |
| Total Revenue Per Form990 | 14539932 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 14288581 | TotExpensesEtcAuditedFinclStmt |
| Expenses Not Rptd F990 | 0 | ExpensesNotRptdF990 |
| Expenses Subtotal | 14288581 | ExpensesSubtotal |
| Other Expenses Not Included | 294490 | OtherExpensesNotIncluded |
| Expenses Not Rptd On Fin Stmt | 294490 | ExpensesNotRptdOnFinStmt |
| Total Expenses Per Form990 | 14583071 | TotalExpensesPerForm990 |
Form990 Schedule D Part XIII Form990ScheduleDPartXIII (2 entries)
| IdentifierIdentifier | ExplanationExplanation |
|---|---|
| PART XI, LINE 4B - OTHER ADJUSTMENTS: | CONTRIBUTION TO FOUNDATION 294,490. |
| PART XII, LINE 4B - OTHER ADJUSTMENTS: | CONTRIBUTION TO FOUNDATION 294,490. |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Charity Care Policy | 1 | CharityCarePolicy |
| Written Policy | 1 | WrittenPolicy |
| Policy Applied To All Hospitals | X | PolicyAppliedToAllHospitals |
| FPG Reference Free Care | 0 | FPGReferenceFreeCare |
| FPG Reference Discounted Care | 0 | FPGReferenceDiscountedCare |
| Free Disc Care Medically Indigent | 1 | FreeDiscCareMedicallyIndigent |
| Amounts Budgeted For Charity Care | 1 | AmountsBudgetedForCharityCare |
| Expenses Exceeded Budget | 0 | ExpensesExceededBudget |
| Annual Community Benefit Report | 0 | AnnualCommunityBenefitReport |
Charity Care At Cost CharityCareAtCost
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 176956 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 176956 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.01240 | PercentOfTotalExpense |
Total Charity Care TotalCharityCare
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 176956 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 176956 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.01240 | PercentOfTotalExpense |
Community Health Services CommunityHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 657193 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 657193 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.04600 | PercentOfTotalExpense |
Health Professions Education HealthProfessionsEducation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 181092 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 181092 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.01270 | PercentOfTotalExpense |
Total Other Benefits TotalOtherBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 838285 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 838285 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.05870 | PercentOfTotalExpense |
Total Community Benefits TotalCommunityBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 1015241 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 1015241 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.07110 | PercentOfTotalExpense |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | 1 | BadDebtExpenseReported |
| Bad Debt Expense | $244,880 | BadDebtExpenseAmount |
| Amount Attributable To | 176956 | AmountAttributableTo |
| Amount Reimbursed By Medicare | 12631208 | AmountReimbursedByMedicare |
| Cost Of Care Reimbursed By Medicare | 12639406 | CostOfCareReimbursedByMedicare |
| Medicare Surplus Or Shortfall | -8198 | MedicareSurplusOrShortfall |
Costing Methodology Used CostingMethodologyUsed
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | X | Other |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | 1 | WrittenDebtCollectionPolicy |
| Provision For Charity Care | 1 | ProvisionForCharityCare |
| Number Of Hospital Facilities | 1 | NumberOfHospitalFacilities |
Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility Number | 1 | FacilityNumber |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HOSPICE SAVANNAH INC | BusinessNameLine1 |
Address Address
| 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 | Other |
Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HOSPICE SAVANNAH INC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital Facility Number | 1 | HospitalFacilityNumber |
| CHNA Conducted | 0 | CHNAConducted |
| Eligibility Criteria Explained | 1 | EligibilityCriteriaExplained |
| Uses FPG Free | 0 | UsesFPGFree |
| Uses FPG Discounted | 0 | UsesFPGDiscounted |
| Explains Basis | 1 | ExplainsBasis |
| Income Level | X | IncomeLevel |
| Asset Level | X | AssetLevel |
| Explains Application Method | 1 | ExplainsApplicationMethod |
| Includes Publicity Measures | 1 | IncludesPublicityMeasures |
| Provided On Admission | X | ProvidedOnAdmission |
| Actions On Nonpayment | 1 | ActionsOnNonpayment |
| Permit Other Actions | X | PermitOtherActions |
| Collection Activities | 0 | CollectionActivities |
| Nondiscrim Emergency Care Policy | 0 | NondiscrimEmergencyCarePolicy |
| Other Reason | X | OtherReason |
| Used Other Method | X | UsedOtherMethod |
| Amounts Generally Billed | 0 | AmountsGenerallyBilled |
| Gross Charges | 1 | GrossCharges |
Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Other Facilities | 2 | NumberOfOtherFacilities |
Other Facilities OtherFacilities (2 entries)
| Address Line1Address/AddressLine1 | CityAddress/City | StateAddress/State | ZIP CodeAddress/ZIPCode | Facility TypeFacilityType |
|---|---|---|---|---|
| HOSPICE SAVANNAH INC | ||||
| 1674 CHATHAM PARKWAY | SAVANNAH | GA | 31405 | ADMINISTRATIVE OFFICES |
| HOSPICE SAVANNAH INC | ||||
| 450 MALL BLVD SUITE H | SAVANNAH | GA | 31416 | BEREAVEMENT CENTER |
Form990 Schedule H Part VI Form990ScheduleHPartVI (15 entries)
| ExplanationExplanation | IdentifierIdentifier |
|---|---|
| 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: 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 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. | HOSPICE SAVANNAH, INC. |
| 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 | X | IndependentConsultant |
| Severance Payment | 1 | SeverancePayment |
| Supplemental Nonqual Retire Plan | 0 | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | 0 | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | 0 | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | 0 | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | 0 | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | 0 | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | 0 | AnyNonFixedPayments |
| Initial Contract Exception | 0 | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | KELLY EROLA | NamePerson |
| Title | CHIEF MEDICAL OFFICER | Title |
| Base Compensation Filing Org | 187770 | BaseCompensationFilingOrg |
| Comp Based On Related Orgs | 0 | CompBasedOnRelatedOrgs |
| Bonus Filing Org | 0 | BonusFilingOrg |
| Bonus Related Orgs | 0 | BonusRelatedOrgs |
| Other Compensation Filing Org | 0 | OtherCompensationFilingOrg |
| Other Compensation Related Orgs | 0 | OtherCompensationRelatedOrgs |
| Deferred Comp Filing Org | 0 | DeferredCompFilingOrg |
| Deferred Comp Related Orgs | 0 | DeferredCompRelatedOrgs |
| Nontaxable Benefits Filing Org | 0 | NontaxableBenefitsFilingOrg |
| Nontaxable Benefits Related Orgs | 0 | NontaxableBenefitsRelatedOrgs |
| Total Compensation Filing Org | 187770 | TotalCompensationFilingOrg |
| Total Compensation Related Orgs | 0 | TotalCompensationRelatedOrgs |
| Comp Report Prior990 Filing Org | 0 | CompReportPrior990FilingOrg |
| Comp Report Prior990 Related Orgs | 0 | CompReportPrior990RelatedOrgs |
Schedule L IRS990ScheduleL
Form990 Schedule L Part IV Form990ScheduleLPartIV
Name Of Interested Person NameOfInterestedPerson
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HOLDEN HAYES | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Relationship | PAST CHAIRMAN OF HOSPICE AND PRESIDENT OF BANK WHERE CASH ACCOUNTS ARE HELD | Relationship |
| Description Of Transaction | EMPLOYED BY BANK AND VOLUNTEERS AS BOARD MEMBER FOR HOSPICEEMPLOYED BY BANK AND VOLUNTEERS AS BOARD MEMBER FOR HOSPICE | DescriptionOfTransaction |
| Sharing Of Revenues | 0 | SharingOfRevenues |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (5 entries)
| Return ReferenceReturnReference | ExplanationExplanation | IdentifierIdentifier |
|---|---|---|
| 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 | MEDICAL SUPPLIES: PROGRAM SERVICE EXPENSES 271,306. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 271,306. CLEANING AND EXTERMINATING: PROGRAM SERVICE EXPENSES 126,938. MANAGEMENT AND GENERAL EXPENSES 30,643. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 157,581. UTILITIES: PROGRAM SERVICE EXPENSES 83,862. MANAGEMENT AND GENERAL EXPENSES 61,786. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 145,648. INSURANCE: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 142,081. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 142,081. BAD DEBT: PROGRAM SERVICE EXPENSES 131,891. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 131,891. TELEPHONE: PROGRAM SERVICE EXPENSES 315. MANAGEMENT AND GENERAL EXPENSES 125,252. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 125,567. PASS THROUGHS: PROGRAM SERVICE EXPENSES 123,230. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 123,230. EQUIPMENT: PROGRAM SERVICE EXPENSES 79,881. MANAGEMENT AND GENERAL EXPENSES 29,578. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 109,459. CABLE AND LINEN: PROGRAM SERVICE EXPENSES 99,517. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 99,517. COMPUTER: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 86,109. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 86,109. CONTINUING EDUCATION: PROGRAM SERVICE EXPENSES 56,797. MANAGEMENT AND GENERAL EXPENSES 21,543. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 78,340. AMBULANCE: PROGRAM SERVICE EXPENSES 69,353. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 69,353. FACILITY RELATED CONTRACTS: PROGRAM SERVICE EXPENSES 40,010. MANAGEMENT AND GENERAL EXPENSES 28,683. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 68,693. DIETARY AND FOOD: PROGRAM SERVICE EXPENSES 63,905. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 63,905. CONSULTING AND SERVICE CONTRACTS: PROGRAM SERVICE EXPENSES 8,159. MANAGEMENT AND GENERAL EXPENSES 54,222. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 62,381. DUES AND SUBSCRIPTIONS: PROGRAM SERVICE EXPENSES 10,243. MANAGEMENT AND GENERAL EXPENSES 46,954. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 57,197. SECURITY EXPENSE: PROGRAM SERVICE EXPENSES 36,443. MANAGEMENT AND GENERAL EXPENSES 18,935. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 55,378. CONTRACT LABOR: PROGRAM SERVICE EXPENSES 11,241. MANAGEMENT AND GENERAL EXPENSES 36,028. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 47,269. REPAIRS & MAINTENANCE: PROGRAM SERVICE EXPENSES 27,797. MANAGEMENT AND GENERAL EXPENSES 14,392. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 42,189. MISCELLANEOUS: PROGRAM SERVICE EXPENSES 5,508. MANAGEMENT AND GENERAL EXPENSES 30,124. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 35,632. THERAPIES: PROGRAM SERVICE EXPENSES 34,848. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 34,848. LAB AND IMAGING: PROGRAM SERVICE EXPENSES 26,415. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 26,415. POSTAGE AND PRINTING: PROGRAM SERVICE EXPENSES 2,478. MANAGEMENT AND GENERAL EXPENSES 15,992. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 18,470. WASTE DISPOSAL: PROGRAM SERVICE EXPENSES 4,779. MANAGEMENT AND GENERAL EXPENSES 3,918. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 8,697. PATIENT RELATED PROGRAMS: PROGRAM SERVICE EXPENSES 2,092. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,092. OUTPATIENT: PROGRAM SERVICE EXPENSES 953. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 953. | ALL OTHER FUNCTIONAL EXPENSES |
Schedule R IRS990ScheduleR
Form990 Schedule R Part I Form990ScheduleRPartI
Name Of Disregarded Entity NameOfDisregardedEntity
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | OLD RIVER HOSPICE PROPERTIES LLC | BusinessNameLine1 |
Address US AddressUS
| 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 | PrimaryActivities |
| Legal Domicile State | GA | LegalDomicileState |
| Total Income | 2493 | TotalIncome |
| EOY Assets | 390707 | EOYAssets |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HOSPICE SAVANNAH INC | BusinessNameLine1 |
Form990 Schedule R Part II Form990ScheduleRPartII (2 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivities | Legal Domicile StateLegalDomicileState | Exempt Code SectionExemptCodeSection | Public Charity StatusPublicCharityStatus | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Controlled OrgControlledOrg | Direct Controlling Entity NADirectControllingEntityNA |
|---|---|---|---|---|---|---|---|---|---|---|---|
| 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 Ann Rents Royalties | 0 | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | 0 | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | 1 | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | 0 | LoansOrGuaranteesFromOtherOrg |
| Dividends Related Organization | 0 | DividendsRelatedOrganization |
| Sale Of Assets To Other Org | 0 | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | 0 | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | 0 | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | 0 | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | 0 | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | 0 | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | 0 | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | 1 | SharingOfFacilities |
| Sharing Of Paid Employees | 1 | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | 1 | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | 0 | OtherTransferToOtherOrg |
| Other Transfer From Other Org | 0 | OtherTransferFromOtherOrg |
Transactions Related Orgs Table TransactionsRelatedOrgsTable (7 entries)
| Transaction TypeTransactionType | Amount InvolvedAmountInvolved | Method Of Amt DeterminationMethodOfAmtDetermination |
|---|---|---|
| HOSPICE SAVANNAH FOUNDATION INC | ||
| C | 50389 | 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 | 120323 | FMV |
| (no name) | ||
| P | ||