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HOSPICE OF RANDOLPH COUNTY INC: Form 990, tax year 2012

View the entire original 990 at ProPublica ↗

Organization
HOSPICE OF RANDOLPH COUNTY INC (EIN 56-1376378)
Tax period
2012-01-01 to 2012-12-31
Filed
2013-11-15
IRS object ID
201333199349306808
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 ReturnHeader

FieldValueIRS element (for citing)
Timestamp2013-11-15T13:28:51-06:00Timestamp
Tax Period End Date2012-12-31TaxPeriodEndDate

Preparer Firm PreparerFirm

FieldValueIRS element (for citing)
EIN560570567EIN

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1DAVENPORT MARVIN JOYCE & CO LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line1703 GREEN VALLEY ROAD SUITE 201AddressLine1
CityGREENSBOROCity
StateNCState
ZIP Code27408ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2012-01-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN561376378EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1HOSPICE OF RANDOLPH COUNTY INCBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlHOSPNameControl
Phone3366729300Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1416 VISION DRIVEAddressLine1
CityASHEBOROCity
StateNCState
ZIP Code27203ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameRHONDA BURCH MOFFITTName
TitleCEO/PRESIDENTTitle
Phone3366729300Phone
Date Signed2013-11-15DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameERIC DUTTON CPAName
PTINP01218304PTIN
Phone3362759886Phone
FieldValueIRS element (for citing)
Tax Year2012TaxYear
Build TS2016-03-07 17:11:31ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonRHONDA BURCH MOFFITTNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1416 VISION DRIVEAddressLine1
CityASHEBOROCity
StateNCState
ZIP Code27203ZIPCode
FieldValueIRS element (for citing)
Gross Receipts6860534GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501c3XOrganization501c3
Web SiteWWW.HOSPICEOFRANDOLPH.ORGWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1981YearFormation
State Legal DomicileNCStateLegalDomicile
Activity Or Mission DescriptionMISSION: HOSPICE OF RANDOLPH COUNTY SERVES AS AN EDUCATION LEADER WHILE PROMOTING QUALITY OF LIFE AND SUPPORTING PATIENTS AND THEIR FAMILIES IN PREPARING FOR COMPLETION OF LIFE. ACTIVITIES: TO PROVIDE SUPPORT AND EMOTIONAL ASSISTANCE TO PATIENTS AND THEIR FAMILIES WITH PAIN MANAGEMENT, SYMPTOM CONTROL, AND REHABILITATION DURING EMOTIONAL CRISIS RELATED TO END-OF-LIFE CARE. SPECIAL THERAPIES, ACUTE CARE, CONTINUOUS CARE, AND RESPITE AND ROUTINE HOME CARE ARE REIMBURSED BY REVENUE RESOURCES ALONG WITH SOME SUPPLIES, DURABLE MEDICAL EQUIPMENT, AND DRUGS. SERVICES ARE DELIVERED UNDER A HOLISTIC PLAN OF CARE.ActivityOrMissionDescription
Nbr Voting Members Governing Body14NbrVotingMembersGoverningBody
Nbr Independent Voting Members13NbrIndependentVotingMembers
Total Nbr Employees111TotalNbrEmployees
Total Nbr Volunteers90TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year111169ContributionsGrantsPriorYear
Contributions Grants Current Year140949ContributionsGrantsCurrentYear
Program Service Revenue Prior Year5922859ProgramServiceRevenuePriorYear
Program Service Revenue CY6624359ProgramServiceRevenueCY
Investment Income Prior Year11797InvestmentIncomePriorYear
Investment Income Current Year7245InvestmentIncomeCurrentYear
Other Revenue Prior Year81576OtherRevenuePriorYear
Other Revenue Current Year67061OtherRevenueCurrentYear
Total Revenue Prior Year6127401TotalRevenuePriorYear
Total Revenue Current Year6839614TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year0GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year4237219SalariesEtcPriorYear
Salaries Etc Current Year4489249SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year63190TotalFundrsngExpCurrentYear
Other Expense Prior Year1958680OtherExpensePriorYear
Other Expenses Current Year2004552OtherExpensesCurrentYear
Total Expenses Prior Year6195899TotalExpensesPriorYear
Total Expenses Current Year6493801TotalExpensesCurrentYear
Revenues Less Expenses Prior Year-68498RevenuesLessExpensesPriorYear
Revenues Less Expenses CY345813RevenuesLessExpensesCY
Total Assets BOY8621885TotalAssetsBOY
Total Assets EOY8682420TotalAssetsEOY
Total Liabilities BOY1869513TotalLiabilitiesBOY
Total Liabilities EOY1585170TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY6752372NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY7097250NetAssetsOrFundBalancesEOY
Mission DescriptionHOSPICE OF RANDOLPH COUNTY SERVES AS AN EDUCATIONAL LEADER WHILE PROMOTING QUALITY OF LIFE AND SUPPORTING PATIENTS AND THEIR FAMILIES IN PREPARING FOR COMPLETION OF LIFE.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense4497614Expense
Revenue6624692Revenue
DescriptionPROVIDE SUPPORT AND EMOTIONAL ASSISTANCE TO PATIENTS AND THEIR FAMILIES WITH PAIN MANAGEMENT, SYMPTOM CONTROL, REHABILITATION AND EMOTIONAL CRISIS. SPECIAL THERAPIES, ACUTE CARE, CONTINUOUS CARE, RESPITE AND ROUTINE HOME CARE ARE REIMBURSED BY THE ABOVE REVENUE RESOURCES ALONG WITH SOME SUPPLIES, DURABLE MEDICAL EQUIPMENT, AND DRUGS. SERVICES ARE DELIVERED UNDER A HOLISTIC PLAN OF CARE. DURING 2012, HOSPICE OF RANDOLPH COUNTY PROVIDED 50,301 DAYS OF PATIENT CARE FOR ITS 737 HOSPICE, HOME HEALTH, AND KIDS PATH PATIENTS.Description
Total Program Service Expense4497614TotalProgramServiceExpense
Described In501 C31DescribedIn501C3
Schedule B Required1ScheduleBRequired
Political Activities0PoliticalActivities
Lobbying Activities0LobbyingActivities
Subject To Proxy Tax0SubjectToProxyTax
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art1CollectionsOfArt
Credit Counseling0CreditCounseling
Term Or Permanent Endowments0TermOrPermanentEndowments
Report Land Bldg Equip1ReportLandBldgEquip
Report Invest Oth Securities0ReportInvestOthSecurities
Report Prog Rel Invest0ReportProgRelInvest
Report Other Assets0ReportOtherAssets
Report Other Liabilities0ReportOtherLiabilities
Report Fin48 Footnote1ReportFin48Footnote
Independent Audit Financial Stmt1IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt0ConsolidatedAuditFinancialStmt
School0School
Foreign Office0ForeignOffice
Foreign Activities0ForeignActivities
More Than5000 K To Organizations0MoreThan5000KToOrganizations
More Than5000 K To Individuals0MoreThan5000KToIndividuals
Professional Fundraising0ProfessionalFundraising
Fundraising Activities1FundraisingActivities
Gaming0Gaming
Hospital0Hospital
Grants To Organizations0GrantsToOrganizations
Grants To Individuals0GrantsToIndividuals
Schedule J Required1ScheduleJRequired
Tax Exempt Bonds0TaxExemptBonds
Excess Benefit Transaction0ExcessBenefitTransaction
Prior Excess Benefit Transaction0PriorExcessBenefitTransaction
Loan To Officer Or DQP0LoanToOfficerOrDQP
Grant To Related Person0GrantToRelatedPerson
Bsnss Rltnshp With Organization0BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member0BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp1OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions0DeductibleNonCashContributions
Deductible Contributions Of Art0DeductibleContributionsOfArt
Terminated0Terminated
Partial Liquidation0PartialLiquidation
Disregarded Entity0DisregardedEntity
Related Entity0RelatedEntity
Related Org Controlled Entity0RelatedOrgControlledEntity
Transfers To Exempt Non Chrtbl Org0TransfersToExemptNonChrtblOrg
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With109639NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Number Of Employees111NumberOfEmployees
Employment Tax Returns Filed1EmploymentTaxReturnsFiled
Unrelated Business Income0UnrelatedBusinessIncome
Foreign Financial Account0ForeignFinancialAccount
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTrans
Taxable Party Notification0TaxablePartyNotification
Non Deductible Contributions0NonDeductibleContributions
Quid Pro Quo Contributions0QuidProQuoContributions
Form8282 Property Disposed Of0Form8282PropertyDisposedOf
Funds To Pay Premiums0FundsToPayPremiums
Premiums Paid0PremiumsPaid
Indoor Tanning Services0IndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members14NbrVotingGoverningBodyMembers
Number Independent Voting Members13NumberIndependentVotingMembers
Family Or Business Relationship1FamilyOrBusinessRelationship
Delegation Of Management Duties0DelegationOfManagementDuties
Changes To Organizing Docs0ChangesToOrganizingDocs
Material Diversion Or Misuse0MaterialDiversionOrMisuse
Members Or Stockholders0MembersOrStockholders
Election Of Board Members0ElectionOfBoardMembers
Decisions Subject To Approval0DecisionsSubjectToApproval
Minutes Of Governing Body1MinutesOfGoverningBody
Minutes Of Committees1MinutesOfCommittees
Officer Mailing Address0OfficerMailingAddress
Local Chapters0LocalChapters
Form990 Provided To Governing Body1Form990ProvidedToGoverningBody
Conflict Of Interest Policy1ConflictOfInterestPolicy
Annual Disclosure Covered Persons1AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement1RegularMonitoringEnforcement
Whistleblower Policy1WhistleblowerPolicy
Document Retention Policy1DocumentRetentionPolicy
Compensation Process CEO1CompensationProcessCEO
Compensation Process Other1CompensationProcessOther
Investment In Joint Venture0InvestmentInJointVenture
States Where Copy Of Return Is FiledNCStatesWhereCopyOfReturnIsFiled
Other WebsiteXOtherWebsite
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1CAREY DURHAMBusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number3366729300TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1416 VISION DRIVEAddressLine1
CityASHEBOROCity
StateNCState
ZIP Code27203ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (17 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationOfficerOfficerKey EmployeeKeyEmployee
ROBERT A MASON
DIRECTOR1.00X000
W EDWARD BUNCH
DIRECTOR1.00X000
RICK CRAWFORD
DIRECTOR1.00X000
NEAL GRIFFIN
DIRECTOR1.00X000
CRANFORD KNOTT
DIRECTOR1.00X000
PAM HILL
DIRECTOR1.00X000
PATRICIA SHEVLIN MD
DIRECTOR1.00X000
DAVID TOWNSEND
DIRECTOR1.00X000
AW WADDELL
DIRECTOR1.00X000
LYNWOOD WHITE
DIRECTOR1.00X000
DR STUART FOUNTAIN
DIRECTOR1.00X000
RHONDA BURCH MOFFITT
CEO/PRESIDENT40.00123642011954X
CAREY M DURHAM
CFO40.0084312012752X
CYNTHIA G SCHRODER
SECRETARY1.00000X
CANDICE GARRETT
TREASURER1.00000X
CHRISTINE MCCARTY MD
BOARD CHAIR5.00785000X
SCOTT A MURKIN MD
MEDICAL DIRECTOR40.00168913022561X
FieldValueIRS element (for citing)
Total Reportable Comp From Org384717TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs0TotalReportableCompFrmRltdOrgs
Total Other Compensation47267TotalOtherCompensation
Number Individuals GT100 K2NumberIndividualsGT100K
Formers Listed0FormersListed
Total Comp GT150 K1TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
HOSPICE PHARMACIA
1601 CHERRY ST SUITE 1700PHILADELPHIAPA19102PATIENT MEDICATIONS408952
RANDOLPH HEALTH & REHAB CENTER
230 E PRESNELL STASHEBORONC27204PATIENT CARE FACILITY286033
UNITED HEALTHCARE
3803 N ELM STGREENSBORONC27455EMPLOYEE BENEFITS258597
WOODLAND HILL CARE & REHAB
400 VISION DRIVEASHEBORONC27203PATIENT CARE FACILITY207714
ADVANCED HOMECARE
PO BOX 18049GREENSBORONC27419MEDICAL SUPPLIES199165
FieldValueIRS element (for citing)
Number Of Contractors GT100 K12NumberOfContractorsGT100K
Federated Campaigns6130FederatedCampaigns
All Other Contributions134819AllOtherContributions
Total Contributions140949TotalContributions

Program Service Revenue ProgramServiceRevenue (3 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
MEDICARE PAYMENTS62161060965326096532
PRIVATE INSURANCE621610306788306788
MEDICAID PAYMENTS621610221039221039
FieldValueIRS element (for citing)
Total Program Service Revenue6624359TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column7245TotalRevenueColumn
Exclusion$7,245ExclusionAmount
FieldValueIRS element (for citing)
Gross Income Fundraising Events87648GrossIncomeFundraisingEvents
Fundraising Direct Expenses20920FundraisingDirectExpenses

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

FieldValueIRS element (for citing)
Total Revenue Column66728TotalRevenueColumn
Exclusion$66,728ExclusionAmount

Miscellaneous Revenue MiscellaneousRevenue

FieldValueIRS element (for citing)
Total Revenue Column333TotalRevenueColumn
Related Or Exempt Function Income333RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Other Revenue333TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column6839614TotalRevenueColumn
Related Or Exempt Function Income6624692RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$73,973ExclusionAmount

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total431985Total
Management And General431985ManagementAndGeneral

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total3295040Total
Program Services2717646ProgramServices
Management And General525374ManagementAndGeneral
Fundraising52020Fundraising

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total40490Total
Program Services37385ProgramServices
Management And General2389ManagementAndGeneral
Fundraising716Fundraising

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total455687Total
Program Services350361ProgramServices
Management And General98617ManagementAndGeneral
Fundraising6709Fundraising

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total266047Total
Program Services195629ProgramServices
Management And General66673ManagementAndGeneral
Fundraising3745Fundraising

Advertising Advertising

FieldValueIRS element (for citing)
Total24427Total
Management And General24427ManagementAndGeneral

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total62251Total
Management And General62251ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total168499Total
Program Services152280ProgramServices
Management And General16219ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total62598Total
Management And General62598ManagementAndGeneral

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total261705Total
Management And General261705ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total33402Total
Management And General33402ManagementAndGeneral

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
MEDICINES AND DRUGS407631407631
DURABLE MEDICAL EQUIPME197240197240
MEDICAL AND OFFICE SUPP14972912396625763
CATERING SERVICES8315083150

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total553920Total
Program Services232326ProgramServices
Management And General321594ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total6493801Total
Program Services4497614ProgramServices
Management And General1932997ManagementAndGeneral
Fundraising63190Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY508648BOY
EOY807371EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY1721998BOY
EOY1709589EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

FieldValueIRS element (for citing)
BOY77071BOY
EOY14663EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY876112BOY
EOY934989EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY112579BOY
EOY86832EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis6901268LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec1824476LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY5274293BOY
EOY5076792EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY51184BOY
EOY52184EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY8621885BOY
EOY8682420EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY629513BOY
EOY383609EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

FieldValueIRS element (for citing)
BOY1240000BOY
EOY1201561EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY1869513BOY
EOY1585170EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY6752372BOY
EOY7097250EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY6752372BOY
EOY7097250EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY8621885BOY
EOY8682420EOY
FieldValueIRS element (for citing)
Reconcilation Revenue Expenses345813ReconcilationRevenueExpenses
Reconciliation Unrealized Invest-935ReconciliationUnrealizedInvest
Reconcilation Other Changes0ReconcilationOtherChanges
Info In Schedule O Part XIIXInfoInScheduleOPartXII
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited

FS Audited Basis FSAuditedBasis

FieldValueIRS element (for citing)
Financial Statement SeparateXFinancialStatementSeparate
FieldValueIRS element (for citing)
Audit Committee1AuditCommittee
Federal Grant Audit Required0FederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Publicly Supported Org170b1 AviXPubliclySupportedOrg170b1Avi

Gifts Grants Contrib Received170 GiftsGrantsContribReceived170

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years435153CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years299520CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years299770CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year111169CurrentTaxYearMinus1Year
Current Tax Year140949CurrentTaxYear
Total1286561Total

Total170 Total170

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years435153CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years299520CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years299770CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year111169CurrentTaxYearMinus1Year
Current Tax Year140949CurrentTaxYear
Total1286561Total
FieldValueIRS element (for citing)
Amounts Subst Contributors Total497884AmountsSubstContributorsTotal
Public Support Total170788677PublicSupportTotal170

Gross Investment Income170 GrossInvestmentIncome170

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years34924CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years48575CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years23975CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year11797CurrentTaxYearMinus1Year
Current Tax Year7245CurrentTaxYear
Total126516Total

Other Income170 OtherIncome170

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years38509CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years507CurrentTaxYearMinus3Years
Total39016Total
FieldValueIRS element (for citing)
Total Support1452093TotalSupport
Gross Receipts From Admissions Etc27062922GrossReceiptsFromAdmissionsEtc
Public Support Pertcentage1700.54310PublicSupportPertcentage170
Public Support Pertcent Prior Year0.71410PublicSupportPertcentPriorYear
Thirty Three Percnt Tests CY170XThirtyThreePercntTestsCY170

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Aggregate ContributionsRESTRICTEDAggregateContributions

Schedule D IRS990ScheduleD

Art Public Exhibition Amts ArtPublicExhibitionAmts

FieldValueIRS element (for citing)
Assets In Part X42964AssetsInPartX
FieldValueIRS element (for citing)
Collect Used For Public ExhibitionXCollectUsedForPublicExhibition
Solicited Assets For Sale0SolicitedAssetsForSale

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis490711OtherCostOrOtherBasis
Book Value490711BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis5187234OtherCostOrOtherBasis
Depreciation1066159Depreciation
Book Value4121075BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis1223323OtherCostOrOtherBasis
Depreciation758317Depreciation
Book Value465006BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings5076792TotalOfBookValueLandBuildings
Footnote In Part XIIIXFootnoteInPartXIII
Tot Revenue Etc Audited Fincl Stmt6859599TotRevenueEtcAuditedFinclStmt
Net Unrealized Gains Investments-935NetUnrealizedGainsInvestments
Other Revenues20920OtherRevenues
Revenue Not Rptd F99019985RevenueNotRptdF990
Revenue Subtotal6839614RevenueSubtotal
Revenue Not Rptd On Fin Stmt0RevenueNotRptdOnFinStmt
Total Revenue Per Form9906839614TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt6514721TotExpensesEtcAuditedFinclStmt
Other Expenses Included20920OtherExpensesIncluded
Expenses Not Rptd F99020920ExpensesNotRptdF990
Expenses Subtotal6493801ExpensesSubtotal
Expenses Not Rptd On Fin Stmt0ExpensesNotRptdOnFinStmt
Total Expenses Per Form9906493801TotalExpensesPerForm990

Form990 Schedule D Part XIII Form990ScheduleDPartXIII (6 entries)

Return ReferenceReturnReferenceExplanationExplanationIdentifierIdentifier
PART III, LINE 4:THE ORGANIZATION HAS VARIOUS WORKS OF ART LOCATED AT ITS TWO LOCATIONS ON VISION DRIVE. THE ADMINISTRATIVE BUILDING HOUSES A FRAMED INK PRINT DONATED TO THE ORGANIZATION, AND ITS VALUE IS STATED AT $22,000. IN ADDITION, THE NEW INPATIENT FACILITY HOUSES SUCH PURCHASED WORKS OF ART AS FRAMED ORIGINAL PAINTINGS AND PHOTOGRAPHY, LARGE DECORATIVE POTTERY PIECES, MOUNTED MUSEUM-QUALITY HOMEMADE QUILTS, A METAL SCULPTURE, AND AN ORIGINAL HAND-PAINTED WALL MURAL. IN THE AGGREGATE, THESE PARTICULAR ITEMS ARE STATED AT THE $20,964 PRICE PAID BASED ON ARMS-LENGTH TRANSACTIONS.
PART X, LINE 2:THE ORGANIZATION IS EXEMPT FROM FEDERAL AND STATE INCOME TAXES UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE AND, THEREFORE, HAS NO PROVISION FOR INCOME TAXES. THE ORGANIZATION ACCOUNTS FOR UNCERTAIN INCOME TAX POSITIONS BY PRESCRIBING A MINIMUM PROBABILITY THRESHOLD A TAX POSITION MUST MEET BEFORE A FINANCIAL STATEMENT INCOME TAX BENEFIT IS RECOGNIZED. THE MINIMUM THRESHOLD IS DEFINED AS A TAX POSITION, BASED SOLELY ON ITS TECHNICAL MERITS, THAT WOULD MORE LIKELY THAN NOT BE SUSTAINED UPON EXAMINATION BY THE RELEVANT TAX AUTHORITY WITH KNOWLEDGE OF THE SAME FACTS. THE TAX BENEFIT TO BE RECOGNIZED IS MEASURED AS THE LARGEST AMOUNT OF BENEFIT THAT IS GREATER THAN 50% LIKELY OF BEING REALIZED UPON ULTIMATE RESOLUTION. BASED ON ALL KNOWN FACTS AND CIRCUMSTANCES AND CURRENT TAX LAW, THE ORGANIZATION BELIEVES THE TOTAL AMOUNT OF UNCERTAIN INCOME TAX POSITION LIABILITIES AND RELATED ACCRUED INTEREST ARE MATERIAL TO ITS FINANCIAL POSITION.DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48:
FUNDRAISING EXPENSES NETTED WITH REVENUE ON TAX RETURNPART XI, LINE 2D - OTHER ADJUSTMENTS:
FUNDRAISING EXPENSES NETTED WITH REVENUE ON TAX RETURNPART XII, LINE 2D - OTHER ADJUSTMENTS:
PAGE 4, PART XII, LINE 2D DIRECT EXPENSES RELATED TO FUNDRAISING REVENUE IS NETTED AGAINST THE FUNDRAISING REVENUE ON PAGE 1, FORM 990.
PAGE 4, PART XIII, LINE 2D DIRECT EXPENSES RELATED TO FUNDRAISING REVENUE IS NETTED AGAINST THE FUNDRAISING REVENUE ON PAGE 1, FORM 990.

Schedule G IRS990ScheduleG

Events Information EventsInformation

FieldValueIRS element (for citing)
Name Of Event1ANNUAL AUCTION BBQNameOfEvent1
Gross Receipts Event134352GrossReceiptsEvent1
Gross Revenue Event134352GrossRevenueEvent1
Other Direct Expenses Event14795OtherDirectExpensesEvent1
Name Of Event2HUMAN RACENameOfEvent2
Gross Receipts Event214386GrossReceiptsEvent2
Gross Revenue Event214386GrossRevenueEvent2
Other Direct Expenses Event250OtherDirectExpensesEvent2
Total Number Of Other Events2TotalNumberOfOtherEvents
Gross Receipts Other Events13909GrossReceiptsOtherEvents
Gross Revenue Other Events13909GrossRevenueOtherEvents
Other Direct Expenses Other Events3049OtherDirectExpensesOtherEvents
Gross Receipts Total62647GrossReceiptsTotal
Gross Revenue Total Events62647GrossRevenueTotalEvents
Other Direct Expenses Total Events7894OtherDirectExpensesTotalEvents
Direct Expense Summary Events7894DirectExpenseSummaryEvents
Net Income Summary54753NetIncomeSummary

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation CommitteeXCompensationCommittee
Form990 Of Other OrganizationsXForm990OfOtherOrganizations
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance Payment0SeverancePayment
Supplemental Nonqual Retire Plan0SupplementalNonqualRetirePlan
Equity Based Comp Arrangement0EquityBasedCompArrangement
Comp Based On Revenue Of Filing Org0CompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related Orgs0CompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing Org0CompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate Orgs0CompBasedNetEarningsRelateOrgs
Any Non Fixed Payments0AnyNonFixedPayments
Initial Contract Exception0InitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII

FieldValueIRS element (for citing)
Name PersonSCOTT A MURKIN MDNamePerson
TitleMEDICAL DIRECTORTitle
Base Compensation Filing Org168913BaseCompensationFilingOrg
Comp Based On Related Orgs0CompBasedOnRelatedOrgs
Bonus Filing Org0BonusFilingOrg
Bonus Related Orgs0BonusRelatedOrgs
Other Compensation Filing Org0OtherCompensationFilingOrg
Other Compensation Related Orgs0OtherCompensationRelatedOrgs
Deferred Comp Filing Org0DeferredCompFilingOrg
Deferred Comp Related Orgs0DeferredCompRelatedOrgs
Nontaxable Benefits Filing Org22561NontaxableBenefitsFilingOrg
Nontaxable Benefits Related Orgs0NontaxableBenefitsRelatedOrgs
Total Compensation Filing Org191474TotalCompensationFilingOrg
Total Compensation Related Orgs0TotalCompensationRelatedOrgs
Comp Report Prior990 Filing Org0CompReportPrior990FilingOrg
Comp Report Prior990 Related Orgs0CompReportPrior990RelatedOrgs

Form990 Schedule J Part III Form990ScheduleJPartIII

FieldValueIRS element (for citing)
Return ReferencePART I, LINE 3ReturnReference
ExplanationCEO/DIRECTOR COMPENSATION IS REVIEWED AND APPROVED ANNUALLY BY THE ASSESSMENT COMMITTEE WHICH CONSISTS OF THREE BOARD MEMBERS APPOINTED BY THE BOARD CHAIR. FOR DETERMINATION OF THESE EMPLOYEES' COMPENSATION AMOUNTS, HRC REFERS TO THE HOSPICE & HOME HEALTH SALARY & BENEFITS REPORT THAT IS PUBLISHED EVERY TWO YEARS BY THE HOSPITAL & HEALTHCARE COMPENSATION SERVICE (IN COOPERATION WITH THE NATIONAL ASSOCIATION FOR HOME CARE & HOSPICE). IN ADDITION, A REVIEW IS MADE OF BENCHMARKING DATA FROM MULTI-VIEW INC.'S HOSPICE COMPENSATION SURVEY AS WELL AS COMPARABLE SALARIES ON PUBLICLY-ACCESSIBLE FORM 990S SUBMITTED BY HOSPICES OF OUR SIMILAR SIZE AND SCOPE.Explanation

Schedule L IRS990ScheduleL

Form990 Schedule L Part IV Form990ScheduleLPartIV

Name Of Interested Person NameOfInterestedPerson

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1RANDOLPH HOSPITALBusinessNameLine1
FieldValueIRS element (for citing)
RelationshipBOARD MEMBER LYNWOOD WHITE IS CFO OF RANDOLPH HOSPITALRelationship
Amount Of Transaction109461AmountOfTransaction
Description Of TransactionHOSPICE OF RANDOLPH COUNTY PAID RANDOLPH HOSPITAL FOR INPATIENT ACUTE AND RESPITE CARE FOR HOSPICE PATIENTS.DescriptionOfTransaction
Sharing Of Revenues0SharingOfRevenues

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (6 entries)

Return ReferenceReturnReferenceExplanationExplanation
FORM 990, PART VI, SECTION A, LINE 2SEVERAL OF THE BOARD MEMBERS DO BUSINESS WITH HOSPICE OF RANDOLPH COUNTY AND WITH EACH OTHER. FOR EXAMPLE, THERE ARE SEVERAL DOCTORS ON THE BOARD WHO MAY REFER THEIR PATIENTS FOR HOSPICE CARE WHEN APPROPRIATE. BOARD MEMBERS ARE PROHIBITED FROM VOTING ON ANY ISSUES WHERE A POTENTIAL CONFLICT EXISTS.
FORM 990, PART VI, SECTION B, LINE 11BOARD MEMBERS REVIEW A DRAFT FORM OF THE 990 PRIOR TO FILING. THE REVIEW EITHER OCCURS DURING A BOARD MEETING OR THE RETURN IS SENT TO THE BOARD MEMBERS INDIVIDUALLY. FILING DOES NOT OCCUR UNTIL ALL BOARD MEMBERS HAVE INDICATED THEIR APPROVAL.
FORM 990, PART VI, SECTION B, LINE 12CINDIVIDUALS IN CERTAIN SENSITIVE POSITIONS WHO MAKE SUBSTANTIAL AND FREQUENT DECISIONS AFFECTING THE INTERESTS OF HRC ARE REQUIRED TO COMPLETE AND SIGN AN ANNUAL CONFLICT OF INTEREST DISCLOSURE FORM. THE FORMS ARE DISTRIBUTED AND COLLECTED BY THE CORPORATE COMPLIANCE OFFICER (CCO). THE CCO REVIEWS WITH THE CEO/PRESIDENT ANY DISCLOSED CONFLICTS TO DETERMINE WHETHER DISQUALIFICATION FROM CERTAIN DECISIONS IS APPROPRIATE.
FORM 990, PART VI, SECTION B, LINE 15CEO/DIRECTOR COMPENSATION IS REVIEWED AND APPROVED ANNUALLY BY THE ASSESSMENT COMMITTEE WHICH CONSISTS OF THREE BOARD MEMBERS APPOINTED BY THE BOARD CHAIR. FOR DETERMINATION OF THESE EMPLOYEES' COMPENSATION AMOUNTS, HRC REFERS TO THE HOSPICE & HOME HEALTH SALARY & BENEFITS REPORT THAT IS PUBLISHED EVERY TWO YEARS BY THE HOSPITAL & HEALTHCARE COMPENSATION SERVICE (IN COOPERATION WITH THE NATIONAL ASSOCIATION FOR HOME CARE & HOSPICE). IN ADDITION, A REVIEW IS MADE OF BENCHMARKING DATA FROM MULTI-VIEW INC.'S HOSPICE COMPENSATION SURVEY AS WELL AS COMPARABLE SALARIES ON PUBLICLY-ACCESSIBLE FORM 990S SUBMITTED BY HOSPICES OF OUR SIMILAR SIZE AND SCOPE.
FORM 990, PART VI, SECTION C, LINE 19CFO HAS A COPY OF THE AGENCY'S 990 TAX RETURN, COPY OF AUDITED FINANCIAL STATEMENTS, COPY OF CONFLICT OF INTEREST POLICY AT THE AGENCY'S OFFICE FOR ANYONE TO REVIEW PLUS THE 990 TAX RETURN CAN BE ACCESSED VIA GUIDESTAR AND THE FEDERAL GOVERNMENT'S WEBSITE.
THE PROCESS FOR REVIEWING THE AUDIT AND SELECTING AN INDEPENDENT ACCOUNTANT HAS NOT CHANGED.