NORTH CENTRAL FLORIDA HOSPICE INC: Form 990, tax year 2011
View the entire original 990 at ProPublica ↗
- Organization
- NORTH CENTRAL FLORIDA HOSPICE INC (EIN 59-2490893)
- Tax period
- 2011-01-01 to 2011-12-31
- Filed
- 2012-11-14
- IRS object ID
- 201243199349302624
- Schema version
- 2011v1.2
- 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 C
- Schedule D
- Schedule G
- Schedule J
- Schedule K
- Schedule M
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2012-11-14T10:42:02-06:00 | Timestamp |
| Tax Period End Date | 2011-12-31 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 861065772 | EIN |
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | DELOITTE TAX LLP | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 201 E KENNEDY BLVD SUITE 1200 | AddressLine1 |
| City | TAMPA | City |
| State | FL | State |
| ZIP Code | 33602 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2011-01-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 592490893 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | NORTH CENTRAL FLORIDA HOSPICE INC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | NORT | NameControl |
| Phone | 3523728400 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | SANTAFE HEALTHCAREINC PO BOX 749 | AddressLine1 |
| City | GAINESVILLE | City |
| State | FL | State |
| ZIP Code | 326270749 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | RANDALL L STUART | Name |
| Title | SR VICE PRESIDENT AND CFO | Title |
| Phone | 3523378730 | Phone |
| Date Signed | 2012-11-14 | DateSigned |
| Authorize Third Party | 1 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | STEVEN E ROVNER | Name |
| PTIN | P00648526 | PTIN |
| Phone | 8132738300 | Phone |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2011 | TaxYear |
| Build TS | 2016-02-24 21:20:13Z | BuildTS |
Form 990 IRS990
Doing Business As DoingBusinessAs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HAVEN HOSPICE | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | MICHAEL P GALLAGHER | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | SANTAFE HEALTHCAREINC PO BOX 749 | AddressLine1 |
| City | GAINESVILLE | City |
| State | FL | State |
| ZIP Code | 326270749 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 62172209 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | WWW.HAVENHOSPICE.ORG | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1982 | YearFormation |
| State Legal Domicile | FL | StateLegalDomicile |
| Activity Or Mission Description | HONORING LIFE BY PROVIDING COMFORT, CARE AND COMPASSION TO THOSE WE SERVE. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 13 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 12 | NbrIndependentVotingMembers |
| Total Nbr Employees | 720 | TotalNbrEmployees |
| Total Nbr Volunteers | 651 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 0 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 2002280 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 2860145 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 54590670 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 57146734 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 495546 | InvestmentIncomePriorYear |
| Investment Income Current Year | 401913 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | -134428 | OtherRevenuePriorYear |
| Other Revenue Current Year | -181250 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 56954068 | TotalRevenuePriorYear |
| Total Revenue Current Year | 60227542 | 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 | 28947467 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 30565379 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp Prior Year | 0 | TotalProfFundrsngExpPriorYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 665023 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 26342151 | OtherExpensePriorYear |
| Other Expenses Current Year | 26237592 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 55289618 | TotalExpensesPriorYear |
| Total Expenses Current Year | 56802971 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 1664450 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 3424571 | RevenuesLessExpensesCY |
| Total Assets BOY | 41057742 | TotalAssetsBOY |
| Total Assets EOY | 50359060 | TotalAssetsEOY |
| Total Liabilities BOY | 6098728 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 11791889 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 34959014 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 38567171 | NetAssetsOrFundBalancesEOY |
| Info In Schedule O Part III | X | InfoInScheduleOPartIII |
| Mission Description | THE MISSION OF NORTH CENTRAL FLORIDA HOSPICE, INC. (HAVEN HOSPICE) IS TO HONOR LIFE BY PROVIDING COMFORT, CARE AND COMPASSION TO THOSE WE SERVE.HAVEN HOSPICE HELPS PATIENTS BE AS COMFORTABLE AS POSSIBLE AND PROVIDE THEIR CAREGIVERS WITH NEEDED RESOURCES AND ASSISTANCE. HAVEN HOSPICE PROVIDES THE MOST CURRENT THERAPIES AND METHODS TO MAXIMIZE COMFORT AND CARE TO PATIENTS INCLUDING ACCESS TO PROFESSIONAL STAFF AROUND THE CLOCK. HAVEN HOSPICE PROVIDES CLINICAL EDUCATION ABOUT END-OF-LIFE AND PALLIATIVE CARE, GRIEF SUPPORT TO CHILDREN AND FAMILIES AND BEREAVEMENT PROGRAMS FOR BOTH GROUPS AND INDIVIDUALS IN ITS SERVICE AREA. | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 28115054 | Expense |
| Revenue | 45120926 | Revenue |
| Description | HAVEN HOSPICE PROVIDED SERVICES TO 3,170 HOSPICE PATIENTS INCLUDING 254,979 DAYS OF SERVICE AND 142,734 VISITS BY NURSES, HOME HEALTH AIDES, SOCIAL WORKERS, CHAPLAINS AND PHYSICIANS TOTALING 188,240 HOURS OF CARE. INCLUDED IN THE EXPENSES IS $1,141,977 OF UNREIMBURSED CARE AND PROVISION OF PALLIATIVE MASSAGE THERAPY, VOLUNTEERS AND BEREAVEMENT SERVICES. | Description |
Activity2 Activity2
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 7780331 | Expense |
| Revenue | 9854680 | Revenue |
| Description | HAVEN HOSPICE PROVIDED SERVICES TO 1,686 PATIENTS IN INPATIENT CARE CENTERS, INCLUDING 17,940 DAYS OF SERVICE AND 143,157 VISITS BY NURSES, HOME HEALTH AIDES, SOCIAL WORKERS, CHAPLAINS AND PHYSICIANS TOTALING 150,230 HOURS OF CARE. INCLUDED IN THE EXPENSES IS $140,517 OF UNREIMBURSED CARE. | Description |
Activity3 Activity3
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 196933 | Expense |
| Revenue | 0 | Revenue |
| Description | HAVEN HOSPICE PROVIDED BEREAVEMENT SERVICES TO THE COMMUNITIES IN WHICH IT SERVES AND TO FAMILY MEMBERS OF PATIENTS WHO HAVE DIED IN ITS CARE. THE BEREAVEMENT DEPARTMENT CONDUCTED 23 ON SITE COMMUNITY EDUCATION EVENTS AND 43 OFF SITE COMMUNITY EDUCATION EVENTS. IN ADDITION, 40,080 SUPPORT MAILERS WERE DISTRIBUTED. 10,688 BEREAVEMENT SUPPORT PHONE CALLS WERE PLACED AND 8,016 BEREAVEMENT SUPPORT VISITS WERE MADE TO FAMILIES. 16 MEMORIAL SERVICES WERE HELD WITH AN AVERAGE ATTENDANCE OF 32 PARTICIPANTS PER SERVICE. 41 GRIEF SUPPORT GROUP SESSIONS WERE HELD IN 2011 WITH AN AVERAGE OF 4 PARTICIPANTS AT EACH. 504 INDIVIDUAL COUNSELING SESSIONS AND 85 FAMILY COUNSELING SESSIONS WERE CONDUCTED. SEVEN GRIEF CAMPS WERE HELD WITH AN AVERAGE ATTENDANCE OF 10 CAMP PARTICIPANTS. | Description |
Activity Other ActivityOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 7415368 | Expense |
| Revenue | 2171128 | Revenue |
| Description | MISCELLANEOUS PROGRAM SERVICES WHICH INCLUDE $4,830 IN UNREIMBURSED CARE. | Description |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Other Program Service Exp | 7415368 | TotalOfOtherProgramServiceExp |
| Total Of Other Program Service Rev | 2171128 | TotalOfOtherProgramServiceRev |
| Total Program Service Expense | 43507686 | TotalProgramServiceExpense |
| Described In501 C3 | 1 | DescribedIn501C3 |
| Schedule B Required | 1 | ScheduleBRequired |
| Political Activities | 0 | PoliticalActivities |
| Lobbying Activities | 1 | 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 | 1 | ReportFin48Footnote |
| Independent Audit Financial Stmt | 1 | 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 | 1 | FundraisingActivities |
| Gaming | 0 | Gaming |
| Hospital | 0 | Hospital |
| Grants To Organizations | 0 | GrantsToOrganizations |
| Grants To Individuals | 0 | GrantsToIndividuals |
| Schedule J Required | 1 | ScheduleJRequired |
| Tax Exempt Bonds | 1 | TaxExemptBonds |
| Invest Tax Exempt Bonds | 0 | InvestTaxExemptBonds |
| Escrow Account | 0 | EscrowAccount |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuer |
| 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 | 0 | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | 0 | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | 0 | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | 1 | 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 |
| Transaction Related Entity | 0 | TransactionRelatedEntity |
| Transfers To Exempt Non Chrtbl Org | 0 | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | 0 | ActivitiesConductedPartnership |
| Schedule O Required | 1 | ScheduleORequired |
| Number Forms Transmitted With1096 | 326 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | 1 | ComplianceWithBackupWitholding |
| Number Of Employees | 720 | 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 | 1 | QuidProQuoContributions |
| Quid Pro Quo Disclosure | 1 | QuidProQuoDisclosure |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | 0 | FundsToPayPremiums |
| Premiums Paid | 0 | PremiumsPaid |
| Indoor Tanning Services | 0 | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 13 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 12 | 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 | 1 | MembersOrStockholders |
| Election Of Board Members | 1 | ElectionOfBoardMembers |
| Decisions Subject To Approval | 1 | DecisionsSubjectToApproval |
| Minutes Of Governing Body | 1 | MinutesOfGoverningBody |
| Minutes Of Committees | 1 | MinutesOfCommittees |
| Officer Mailing Address | 0 | OfficerMailingAddress |
| Local Chapters | 1 | LocalChapters |
| Policies Reference Chapters | 1 | PoliciesReferenceChapters |
| 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 | 1 | CompensationProcessCEO |
| Compensation Process Other | 1 | CompensationProcessOther |
| Investment In Joint Venture | 0 | InvestmentInJointVenture |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PATRICIA C LAW VICE PRESIDENTCHIEF FINANCIAL OFFICER | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 3523796241 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 4200 NW 90TH BLVD | AddressLine1 |
| City | GAINESVILLE | City |
| State | FL | State |
| ZIP Code | 326065688 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | X | InfoInScheduleOPartVII |
Form990 Part VII Section A Form990PartVIISectionA (22 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | OfficerOfficer | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | Highest Compensated EmployeeHighestCompensatedEmployee | FormerFormer |
|---|---|---|---|---|---|---|---|---|
| D RAY HARRISON JR | ||||||||
| CHAIRMAN/DIRECTOR | 1.00 | X | X | 0 | 0 | 0 | ||
| G THOMAS MALLINI | ||||||||
| VICE CHAIRMAN/DIRECTOR | 1.00 | X | X | 0 | 0 | 0 | ||
| SUZANNE M NORRIS | ||||||||
| TREASURER/DIRECTOR | 1.00 | X | X | 0 | 0 | 0 | ||
| ERIC L GODET | ||||||||
| SECRETARY/DIRECTOR | 1.00 | X | X | 0 | 1000 | 0 | ||
| MICHAEL P GALLAGHER | ||||||||
| CHIEF EXECUTIVE OFFICER/DIRECTOR | 5.00 | X | X | 0 | 2101549 | 252885 | ||
| CAROL REED ASH | ||||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | |||
| GEORGE J CARANASOS MD | ||||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | |||
| JANET L CHRISTIE | ||||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | |||
| JAMES W DEFORD MD | ||||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | |||
| SUSAN D PARRISH | ||||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | |||
| FRANCES C PEPIS | ||||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | |||
| NORLENE E ROBERTS | ||||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | |||
| DALE M WILLIAMS | ||||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | |||
| JAMES L POOLE | ||||||||
| CHAIRMAN/DIRECTOR | 1.00 | X | X | 0 | 0 | 0 | ||
| TIMOTHY J BOWEN | ||||||||
| PRESIDENT | 50.00 | X | 0 | 395459 | 78096 | |||
| STEVEN M ZIEGLER | ||||||||
| ASSISTANT SECRETARY | 6.00 | X | 0 | 261721 | 76912 | |||
| DOUGLAS A ROGERS MD | ||||||||
| ASSOCIATE MEDICAL DIRECTOR | 40.00 | 252295 | 0 | 0 | X | |||
| STEPHEN A ROTHSTEIN MD | ||||||||
| CHIEF MEDICAL OFFICER | 40.00 | 250564 | 0 | 0 | X | |||
| NEEL J KARNANI MD | ||||||||
| ASSOCIATE MEDICAL DIRECTOR | 40.00 | 196025 | 0 | 0 | X | |||
| MICHELLE L BOATWRIGHT MD | ||||||||
| ASSOCIATE MEDICAL DIRECTOR | 40.00 | 193747 | 0 | 0 | X | |||
| GERALDINE S BICHIER MD | ||||||||
| ASSOCIATE MEDICAL DIRECTOR | 40.00 | 166220 | 0 | 0 | X | |||
| STEPHEN J DEMONTMOLLIN | ||||||||
| FORMER ASSISTANT SECRETARY | 0.00 | 0 | 480468 | 23983 | X | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 1058851 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 3240197 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 431876 | TotalOtherCompensation |
| Number Individuals GT100 K | 15 | NumberIndividualsGT100K |
| Formers Listed | 1 | 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 |
|---|---|---|---|---|---|
| AVMED INC | |||||
| P O BOX 749 | GAINESVILLE | FL | 326270749 | HEALTH INSURANCE | 2787420 |
| HOSPISCRIPT SERVICES INC | |||||
| 1460 ANN STREET | MONTGOMERY | AL | 36107 | PHARMACY SERVICES | 1345026 |
| SANTAFE HEALTHCARE INC | |||||
| P O BOX 749 | GAINESVILLE | FL | 326270749 | MANAGEMENT FEES | 940595 |
| BLUE CROSS BLUE SHIELD OF FLORIDA | |||||
| PO BOX 660299 | DALLAS | TX | 752660299 | HEALTH INSURANCE | 815034 |
| CHERNOFF NEWMAN LLC | |||||
| 1411 GERVAIS STREET | COLUMBIA | SC | 29201 | ADVERTISING | 730895 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 50 | NumberOfContractorsGT100K |
| Federated Campaigns | 93493 | FederatedCampaigns |
| Fundraising Events | 231682 | FundraisingEvents |
| All Other Contributions | 2534970 | AllOtherContributions |
| Noncash Contributions | 1392046 | NoncashContributions |
| Total Contributions | 2860145 | TotalContributions |
Program Service Revenue ProgramServiceRevenue (3 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome |
|---|---|---|---|
| MEDICARE REVENUE | 623990 | 42279605 | 42279605 |
| MEDICAID REVENUE | 623990 | 12489614 | 12489614 |
| PATIENT SERVICE REVENU | 623990 | 2377515 | 2377515 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 57146734 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 382400 | TotalRevenueColumn |
| Exclusion | $382,400 | ExclusionAmount |
Gross Amount Sales Assets GrossAmountSalesAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 1700000 | Securities |
Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 1670395 | Securities |
| Other | 10092 | Other |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 29605 | Securities |
| Other | -10092 | Other |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 19513 | TotalRevenueColumn |
| Exclusion | $19,513 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Income Fundraising Events | 63639 | GrossIncomeFundraisingEvents |
| Cntrbtns Rprtd Fundraising Events | 231682 | CntrbtnsRprtdFundraisingEvents |
| Fundraising Direct Expenses | 264180 | FundraisingDirectExpenses |
Net Income From Fundraising Events NetIncomeFromFundraisingEvents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -200541 | TotalRevenueColumn |
| Exclusion | -$200,541 | ExclusionAmount |
Other Revenue Misc OtherRevenueMisc
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | ADMINISTRATIVE INCOME | Description |
| Business Code | 900099 | BusinessCode |
| Total Revenue Column | 19291 | TotalRevenueColumn |
| Exclusion | $19,291 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 19291 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 60227542 | TotalRevenueColumn |
| Related Or Exempt Function Income | 57146734 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $220,663 | ExclusionAmount |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 23646315 | Total |
| Program Services | 17986982 | ProgramServices |
| Management And General | 5349298 | ManagementAndGeneral |
| Fundraising | 310035 | Fundraising |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1528030 | Total |
| Program Services | 890234 | ProgramServices |
| Management And General | 618758 | ManagementAndGeneral |
| Fundraising | 19038 | Fundraising |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3726610 | Total |
| Program Services | 2654590 | ProgramServices |
| Management And General | 1034107 | ManagementAndGeneral |
| Fundraising | 37913 | Fundraising |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1664424 | Total |
| Program Services | 1259481 | ProgramServices |
| Management And General | 383935 | ManagementAndGeneral |
| Fundraising | 21008 | Fundraising |
Fees For Services Management FeesForServicesManagement
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 763569 | Total |
| Management And General | 763569 | ManagementAndGeneral |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 210891 | Total |
| Management And General | 210891 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 80750 | Total |
| Management And General | 80750 | ManagementAndGeneral |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 14359834 | Total |
| Program Services | 13662504 | ProgramServices |
| Management And General | 660453 | ManagementAndGeneral |
| Fundraising | 36877 | Fundraising |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 656403 | Total |
| Program Services | 646077 | ProgramServices |
| Management And General | 6457 | ManagementAndGeneral |
| Fundraising | 3869 | Fundraising |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1331816 | Total |
| Program Services | 597112 | ProgramServices |
| Management And General | 682681 | ManagementAndGeneral |
| Fundraising | 52023 | Fundraising |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 484320 | Total |
| Program Services | 8750 | ProgramServices |
| Management And General | 475570 | ManagementAndGeneral |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1670159 | Total |
| Program Services | 1035196 | ProgramServices |
| Management And General | 634963 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1700418 | Total |
| Program Services | 1269920 | ProgramServices |
| Management And General | 415364 | ManagementAndGeneral |
| Fundraising | 15134 | Fundraising |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 63167 | Total |
| Program Services | 15618 | ProgramServices |
| Management And General | 47549 | ManagementAndGeneral |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1139025 | Total |
| Program Services | 680043 | ProgramServices |
| Management And General | 458982 | ManagementAndGeneral |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 318601 | Total |
| Program Services | 133626 | ProgramServices |
| Management And General | 184975 | ManagementAndGeneral |
Other Expenses OtherExpenses (4 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral | FundraisingFundraising |
|---|---|---|---|---|
| PHARMACY SUPPLIES | 1368924 | 1368924 | ||
| COMMUNITY SUPPORT | 822199 | 419641 | 243533 | 159025 |
| MEDICAL SUPPLIES | 475066 | 475066 | ||
| BAD DEBT | 222480 | 222015 | 465 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 569970 | Total |
| Program Services | 181907 | ProgramServices |
| Management And General | 377962 | ManagementAndGeneral |
| Fundraising | 10101 | Fundraising |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 56802971 | Total |
| Program Services | 43507686 | ProgramServices |
| Management And General | 12630262 | ManagementAndGeneral |
| Fundraising | 665023 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 64866 | BOY |
| EOY | 74527 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 315094 | BOY |
| EOY | 6908582 | EOY |
Pledges And Grants Receivable PledgesAndGrantsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 35044 | BOY |
| EOY | 2456 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 7202075 | BOY |
| EOY | 4998208 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 516923 | BOY |
| EOY | 471309 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 30947307 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 7697332 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 19375658 | BOY |
| EOY | 23249975 | EOY |
Investments Pub Traded Securities InvestmentsPubTradedSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 11729221 | BOY |
| EOY | 10544496 | EOY |
Investments Program Related InvestmentsProgramRelated
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1708486 | BOY |
| EOY | 1776447 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 110375 | BOY |
| EOY | 2333060 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 41057742 | BOY |
| EOY | 50359060 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 5644208 | BOY |
| EOY | 6572865 | EOY |
Deferred Revenue DeferredRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2000 | BOY |
| EOY | 0 | EOY |
Tax Exempt Bond Liabilities TaxExemptBondLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 3537354 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 452520 | BOY |
| EOY | 1681670 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 6098728 | BOY |
| EOY | 11791889 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 34947909 | BOY |
| EOY | 38244794 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 11105 | BOY |
| EOY | 322377 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 34959014 | BOY |
| EOY | 38567171 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 41057742 | BOY |
| EOY | 50359060 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | 3424571 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | 183586 | ReconcilationOtherChanges |
| Info In Schedule O Part XII | X | InfoInScheduleOPartXII |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | 0 | AccountantCompileOrReview |
| FS Audited | 1 | FSAudited |
| Audit Committee | 1 | AuditCommittee |
| Financial Statement Both | X | FinancialStatementBoth |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequired |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Publicly Supported Org509a2 | X | PubliclySupportedOrg509a2 |
Gifts Grants Contrib Received509 GiftsGrantsContribReceived509
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 1130815 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 2778953 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 2198110 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 2002280 | CurrentTaxYearMinus1Year |
| Current Tax Year | 2860145 | CurrentTaxYear |
| Total | 10970303 | Total |
Gross Receipts From Admissions GrossReceiptsFromAdmissions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 44081014 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 47775904 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 50582738 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 54590670 | CurrentTaxYearMinus1Year |
| Current Tax Year | 57146734 | CurrentTaxYear |
| Total | 254177060 | Total |
Total509 Total509
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 45211829 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 50554857 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 52780848 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 56592950 | CurrentTaxYearMinus1Year |
| Current Tax Year | 60006879 | CurrentTaxYear |
| Total | 265147363 | Total |
Amts Recd From Disqual Persons AmtsRecdFromDisqualPersons
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Amts From Subst Contributors AmtsFromSubstContributors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Support From DQ Ps Etc SupportFromDQPsEtc
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total509 | 265147363 | PublicSupportTotal509 |
Gross Investment Income509 GrossInvestmentIncome509
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 472182 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 306721 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 233421 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 376917 | CurrentTaxYearMinus1Year |
| Current Tax Year | 382400 | CurrentTaxYear |
| Total | 1771641 | Total |
Investment Income And UBTI InvestmentIncomeAndUBTI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 472182 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 306721 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 233421 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 376917 | CurrentTaxYearMinus1Year |
| Current Tax Year | 382400 | CurrentTaxYear |
| Total | 1771641 | Total |
Other Income509 OtherIncome509
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 838709 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | -49004 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | -82054 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | -134428 | CurrentTaxYearMinus1Year |
| Current Tax Year | -181250 | CurrentTaxYear |
| Total | 391973 | Total |
Total Support Total TotalSupportTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 46522720 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 50812574 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 52932215 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 56835439 | CurrentTaxYearMinus1Year |
| Current Tax Year | 60208029 | CurrentTaxYear |
| Total | 267310977 | Total |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Percentage509 | 0.99190 | PublicSupportPercentage509 |
| Prior Year Support Percentage | 0.98690 | PriorYearSupportPercentage |
| Investment Income Percentage | 0.00660 | InvestmentIncomePercentage |
| Prior Yr Invest Income Percentage | 0.00750 | PriorYrInvestIncomePercentage |
| Thirty Three Percnt Tests CY509 | X | ThirtyThreePercntTestsCY509 |
| General Explanation | SCHEDULE A, PART IV, SUPPLEMENTAL INFORMATION: SCHEDULE A, PART III, LINE 12, EXPLANATION FOR OTHER INCOME IN 2011: ADMINISTRATIVE INCOME $ 19,291 SPECIAL EVENT INCOME, NET $-200,541 | GeneralExplanation |
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 C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | 0 | Volunteers |
| Paid Staff Or Management | 0 | PaidStaffOrManagement |
| Media Advertisements | 0 | MediaAdvertisements |
| Mailings Members | 0 | MailingsMembers |
| Publications Or Broadcast | 0 | PublicationsOrBroadcast |
| Grants Other Organizations | 0 | GrantsOtherOrganizations |
| Direct Contact Legislators | 0 | DirectContactLegislators |
| Rallies Demonstrations | 0 | RalliesDemonstrations |
| Other Activities | 1 | OtherActivities |
| Other Activities | $30,968 | OtherActivitiesAmount |
| Total Lobbying Expenditures IIB | 30968 | TotalLobbyingExpendituresIIB |
| Not Described In501c3 | 0 | NotDescribedIn501c3 |
Form990 Schedule C Part IV Form990ScheduleCPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | EXPLANATION OF LOBBYING ACTIVITIES: | Identifier |
| Return Reference | PART II-B, LINE 1: | ReturnReference |
| Explanation | HAVEN HOSPICE IS A MEMBER OF FLORIDA HOSPICES AND PALLIATIVE CARE, INC. AND THE NATIONAL HOSPICE AND PALLIATIVE CARE ORGANIZATION AND PARTICIPATES IN LOBBYING AND STRATEGY DISCUSSIONS. HAVEN HOSPICE HAS ENGAGED THE SERVICES OF A REGISTERED LOBBYIST TO MONITOR DEVELOPMENTS AT THE ANNUAL GENERAL SESSION OF THE FLORIDA LEGISLATURE. | Explanation |
Schedule D IRS990ScheduleD
Current Year CurrentYear
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 1489469 | BeginningOfYearBalance |
| Investment Earnings Or Losses | 45417 | InvestmentEarningsOrLosses |
| End Of Year Balance | 1534886 | EndOfYearBalance |
Current Year Minus1 Year CurrentYearMinus1Year
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 1373367 | BeginningOfYearBalance |
| Investment Earnings Or Losses | 116102 | InvestmentEarningsOrLosses |
| End Of Year Balance | 1489469 | EndOfYearBalance |
Current Year Minus2 Years CurrentYearMinus2Years
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 1249994 | BeginningOfYearBalance |
| Investment Earnings Or Losses | 123373 | InvestmentEarningsOrLosses |
| End Of Year Balance | 1373367 | EndOfYearBalance |
Current Year Minus3 Years CurrentYearMinus3Years
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 1292160 | BeginningOfYearBalance |
| Investment Earnings Or Losses | -42166 | InvestmentEarningsOrLosses |
| End Of Year Balance | 1249994 | EndOfYearBalance |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Designated EOY Balance | 1.00000 | BoardDesignatedEOYBalance |
| Endowments Held By Unrelated Orgs | 0 | EndowmentsHeldByUnrelatedOrgs |
| Endowments Held By Related Orgs | 0 | EndowmentsHeldByRelatedOrgs |
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 4513102 | OtherCostOrOtherBasis |
| Book Value | 4513102 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 22010193 | OtherCostOrOtherBasis |
| Depreciation | 4650279 | Depreciation |
| Book Value | 17359914 | BookValue |
Leasehold Improvements LeaseholdImprovements
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 400460 | OtherCostOrOtherBasis |
| Depreciation | 202558 | Depreciation |
| Book Value | 197902 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 4023552 | OtherCostOrOtherBasis |
| Depreciation | 2844495 | Depreciation |
| Book Value | 1179057 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 23249975 | TotalOfBookValueLandBuildings |
Other Liabilities OtherLiabilities (6 entries)
| DescriptionDescription | AmountAmount |
|---|---|
| GIFT ANNUITIES | $219,393 |
| DUE TO AFFILIATES | $138,369 |
| CAPITAL LEASE OBLIGATION | $172,012 |
| PLEDGES | $140,000 |
| CHARITABLE REMAINDER UNITRUST | $1,006,000 |
| CONTRIBUTION PAYABLE | $5,896 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 1681670 | TotalOfAmounts |
| Total Revenue | 60227542 | TotalRevenue |
| Total Expenses | 56802971 | TotalExpenses |
| Excess Or Deficit For Year | 3424571 | ExcessOrDeficitForYear |
| Net Unrealized GL On Investments | 129766 | NetUnrealizedGLOnInvestments |
| Other | $53,820 | OtherAmount |
| Total Adjustments | 183586 | TotalAdjustments |
| Excess Or Deficit Per FS | 3608157 | ExcessOrDeficitPerFS |
| Tot Revenue Etc Audited Fincl Stmt | 59804747 | TotRevenueEtcAuditedFinclStmt |
| Other Revenues | -143082 | OtherRevenues |
| Revenue Not Rptd F990 | -143082 | RevenueNotRptdF990 |
| Revenue Subtotal | 59947829 | RevenueSubtotal |
| Other Revenues Not Included | 279713 | OtherRevenuesNotIncluded |
| Revenue Not Rptd On Fin Stmt | 279713 | RevenueNotRptdOnFinStmt |
| Total Revenue Per Form990 | 60227542 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 56661344 | TotExpensesEtcAuditedFinclStmt |
| Other Expenses Included | -141627 | OtherExpensesIncluded |
| Expenses Not Rptd F990 | -141627 | ExpensesNotRptdF990 |
| Expenses Subtotal | 56802971 | ExpensesSubtotal |
| Expenses Not Rptd On Fin Stmt | 0 | ExpensesNotRptdOnFinStmt |
| Total Expenses Per Form990 | 56802971 | TotalExpensesPerForm990 |
Form990 Schedule D Part XIV Form990ScheduleDPartXIV (6 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| DESCRIPTION OF INTENDED USE OF ENDOWMENT FUNDS: | PART V, LINE 4: | THE HAVEN HOSPICE ENDOWMENT IS A SEPARATE ACCOUNT OF FUNDS THAT ARE HELD TO PROVIDE CURRENT AND FUTURE INCOME TO HAVEN HOSPICE IN ORDER TO OFFSET THE BURDEN OF UNCOMPENSATED CARE PROVIDED BY HAVEN HOSPICE. THE OBJECTIVE OF THE ENDOWMENT IS TO PROVIDE TIMELY FINANCIAL ASSISTANCE WHEN NEEDED AND LONG-TERM STABILITY TO HAVEN HOSPICE. |
| DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: | PART X: | FIN 48 FOOTNOTE: AS OF DECEMBER 31, 2011 OR 2010, HAVEN HAD NO UNCERTAIN TAX POSITIONS. TAX YEARS 2008 THROUGH 2011 ARE SUBJECT TO EXAMINATION BY FEDERAL AND STATE TAXING AUTHORITIES. THERE ARE NO INCOME TAX EXAMINATIONS IN PROCESS AS OF THE DATE OF THIS REPORT. |
| PART XI, LINE 8 - OTHER ADJUSTMENTS: | CHANGE IN VALUE OF RESTRICTED PLEDGES -7,261. NET ASSETS RELEASED FROM RESTRICTION USED FOR SERVICES -10,284. CHANGE IN VALUE OF DONOR RESTRICTED CONTRIBUTIONS 69,860. CHANGE IN FAIR VALUE OF CHARITABLE REMAINDER UNITRUST 6,846. CHANGE IN NET UNREALIZED GAINS/LOSSES ON CRUT INVESTMENT -3,886. LOSSES ON UNCOLLECTIBLE PLEDGES -1,455. TOTAL TO SCHEDULE D, PART XI, LINE 8: 53,820. | |
| PART XII, LINE 2D - OTHER ADJUSTMENTS: | UNREIMBURSED CARE -407,262. SPECIAL EVENT EXPENSES 264,180. | |
| PART XII, LINE 4B - OTHER ADJUSTMENTS: | CONTRIBUTION REVENUE OF RESTRICTED CHARITABLE REMAINDER UNITRUST 279,713. | |
| PART XIII, LINE 2D - OTHER ADJUSTMENTS: | UNREIMBURSED CARE -407,262. SPECIAL EVENT EXPENSES 264,180. LOSSES ON UNCOLLECTIBLE PLEDGES 1,455. |
Schedule G IRS990ScheduleG
Events Information EventsInformation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Event1 | VIVA | NameOfEvent1 |
| Gross Receipts Event1 | 183506 | GrossReceiptsEvent1 |
| Charitable Contributions Event1 | 148625 | CharitableContributionsEvent1 |
| Gross Revenue Event1 | 34881 | GrossRevenueEvent1 |
| Other Direct Expenses Event1 | 123282 | OtherDirectExpensesEvent1 |
| Name Of Event2 | FALL AT THE LODGE | NameOfEvent2 |
| Gross Receipts Event2 | 54683 | GrossReceiptsEvent2 |
| Charitable Contributions Event2 | 46433 | CharitableContributionsEvent2 |
| Gross Revenue Event2 | 8250 | GrossRevenueEvent2 |
| Other Direct Expenses Event2 | 44330 | OtherDirectExpensesEvent2 |
| Total Number Of Other Events | 5 | TotalNumberOfOtherEvents |
| Gross Receipts Other Events | 53512 | GrossReceiptsOtherEvents |
| Charitable Contrib Other Events | 35072 | CharitableContribOtherEvents |
| Gross Revenue Other Events | 18440 | GrossRevenueOtherEvents |
| Other Direct Expenses Other Events | 79893 | OtherDirectExpensesOtherEvents |
| Gross Receipts Total | 291701 | GrossReceiptsTotal |
| Charitable Contributions Total | 230130 | CharitableContributionsTotal |
| Gross Revenue Total Events | 61571 | GrossRevenueTotalEvents |
| Other Direct Expenses Total Events | 247505 | OtherDirectExpensesTotalEvents |
| Direct Expense Summary Events | 247505 | DirectExpenseSummaryEvents |
| Net Income Summary | -185934 | NetIncomeSummary |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | 1 | SeverancePayment |
| Supplemental Nonqual Retire Plan | 1 | 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 (9 entries)
| Base Compensation Filing OrgBaseCompensationFilingOrg | Comp Based On Related OrgsCompBasedOnRelatedOrgs | Bonus Filing OrgBonusFilingOrg | Bonus Related OrgsBonusRelatedOrgs | Other Compensation Filing OrgOtherCompensationFilingOrg | Other Compensation Related OrgsOtherCompensationRelatedOrgs | Deferred Comp Filing OrgDeferredCompFilingOrg | Deferred Comp Related OrgsDeferredCompRelatedOrgs | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg | Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs | Total Compensation Filing OrgTotalCompensationFilingOrg | Total Compensation Related OrgsTotalCompensationRelatedOrgs | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrg | Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| MICHAEL P GALLAGHER | |||||||||||||
| 0 | 825126 | 0 | 795972 | 0 | 480451 | 0 | 229162 | 0 | 23723 | 0 | 2354434 | 0 | 174240 |
| TIMOTHY J BOWEN | |||||||||||||
| 0 | 280332 | 0 | 84178 | 0 | 30949 | 0 | 57238 | 0 | 20858 | 0 | 473555 | 0 | 12581 |
| STEVEN M ZIEGLER | |||||||||||||
| 0 | 252730 | 0 | 0 | 0 | 8991 | 0 | 59043 | 0 | 17869 | 0 | 338633 | 0 | 0 |
| DOUGLAS A ROGERS MD | |||||||||||||
| 251805 | 0 | 0 | 0 | 490 | 0 | 17060 | 0 | 20447 | 0 | 289802 | 0 | 0 | 0 |
| STEPHEN A ROTHSTEIN MD | |||||||||||||
| 213834 | 0 | 18480 | 0 | 18250 | 0 | 3616 | 0 | 12093 | 0 | 266273 | 0 | 0 | 0 |
| NEEL J KARNANI MD | |||||||||||||
| 195462 | 0 | 0 | 0 | 563 | 0 | 15637 | 0 | 684 | 0 | 212346 | 0 | 0 | 0 |
| MICHELLE L BOATWRIGHT MD | |||||||||||||
| 183709 | 0 | 0 | 0 | 10038 | 0 | 8238 | 0 | 21555 | 0 | 223540 | 0 | 0 | 0 |
| GERALDINE S BICHIER MD | |||||||||||||
| 165964 | 0 | 0 | 0 | 256 | 0 | 13833 | 0 | 18587 | 0 | 198640 | 0 | 0 | 0 |
| STEPHEN J DEMONTMOLLIN | |||||||||||||
| 0 | 25426 | 0 | 0 | 0 | 455042 | 0 | 23676 | 0 | 307 | 0 | 504451 | 0 | 0 |
Form990 Schedule J Part III Form990ScheduleJPartIII (3 entries)
| Return ReferenceReturnReference | ExplanationExplanation | IdentifierIdentifier |
|---|---|---|
| PART I, LINE 3 | PART I, LINE 3: MICHAEL P. GALLAGHER IS THE CHIEF EXECUTIVE OFFICER (CEO) OF NORTH CENTRAL FLORIDA HOSPICE, INC. MR. GALLAGHER IS COMPENSATED BY SANTAFE HEALTHCARE, INC. (SANTAFE), A RELATED SUPPORTING ORGANIZATION. SANTAFE UTILIZES THE FOLLOWING PROCESS TO ESTABLISH THE CEO'S COMPENSATION AND BENEFITS: ANNUALLY, THE SANTAFE BOARD OF DIRECTORS RETAINS AN INDEPENDENT COMPENSATION AND BENEFITS CONSULTING FIRM TO CONDUCT A MARKET COMPETITIVENESS REVIEW OF THE CEO'S TOTAL DIRECT COMPENSATION (BASE SALARY, ANNUAL INCENTIVES, AND LONG TERM INCENTIVES) AND BENEFITS. THE COMPETITIVE ANALYSIS INCLUDES COMPARISON TO SIMILAR POSITIONS IN COMPANIES OF SIMILAR SIZE WITHIN THE SAME OR SIMILAR INDUSTRY. THE INDEPENDENT CONSULTING FIRM MAKES RECOMMENDATIONS, IF ANY, DIRECTLY TO THE BOARD OF DIRECTORS. THE BOARD OF DIRECTORS ESTABLISHES THE FINAL COMPENSATION AND BENEFIT PACKAGE FOR THE CEO TAKING INTO CONSIDERATION THE MARKET COMPETITIVENESS REVIEW AND FINAL RECOMMENDATION OF THE INDEPENDENT CONSULTING FIRM. THE INDEPENDENT CONSULTING FIRM PROVIDES AN OPINION LETTER REGARDING THE REASONABLENESS OF THE CEO'S FINAL COMPENSATION AND BENEFITS PACKAGE. THE ACTIONS OF THE BOARD ARE DOCUMENTED IN THE MINUTES OF THE BOARD MEETING. | |
| PART I, LINES 4A-B | (RELATES TO PART I, LINE 4A): LISTED PERSONS, WHO ARE EMPLOYEES OF HAVEN HOSPICE, ARE NOT COVERED BY A SEVERANCE POLICY. CERTAIN LISTED PERSONS EXCLUDING OUTSIDE DIRECTORS OR EMPLOYEES OF HAVEN HOSPICE, ARE EMPLOYEES OF RELATED ORGANIZATIONS AND ARE COVERED BY A SEVERANCE POLICY FOR THEIR RESPECTIVE ORGANIZATION. THE SEVERANCE POLICY INCLUDES MONTHLY PAYMENTS UP TO A MAXIMUM OF 12 MONTHS UNDER QUALIFYING CIRCUMSTANCES. LISTED PERSONS RECEIVING A SEVERANCE PAYMENT OR CHANGE OF CONTROL PAYMENT IN THE YEAR: STEPHEN DEMONTMOLLIN RECEIVED $370,540 IN COMPENSATION PAYMENTS FROM AVMED, INC., A RELATED TAX-EXEMPT ORGANIZATION, DUE TO HIS RESIGNATION AND RETIREMENT FROM EMPLOYMENT IN ACCORDANCE WITH BOARD-APPROVED RESIGNATION AND RETIREMENT AGREEMENTS. PART I, LINE 4B: LISTED PERSONS PARTICIPATING IN A SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN IN THE YEAR: MICHAEL P. GALLAGHER AND TIMOTHY J. BOWEN ARE EMPLOYEES OF SANTAFE HEALTHCARE, INC. (SANTAFE), A RELATED SUPPORTING ORGANIZATION. MR. GALLAGHER AND MR. BOWEN PARTICIPATE IN TWO NONQUALIFIED DEFERRED COMPENSATION RETIREMENT PLANS SPONSORED BY SANTAFE FOR A CERTAIN GROUP OF EXECUTIVES. ONE PLAN RESTORES RETIREMENT BENEFITS EQUIVALENT TO QUALIFIED 401(K) BENEFITS ON INCOME EARNED IN EXCESS OF THE INTERNAL REVENUE SERVICE CODE SECTION 401(A)(17) RECOGNIZABLE PAY LIMITS (A DEFINED CONTRIBUTION RESTORATION PLAN)VESTING FOR THIS PLAN IS ACHIEVED AT AGE 55 AND 10 YEARS OF SERVICE OR AT AGE 65 AND 5 YEARS OF SERVICE. THE SECOND SUPPLEMENTAL DEFINED CONTRIBUTION PLAN PROVIDES ADDITIONAL RETIREMENT INCOME BASED ON A PERCENTAGE OF BASE SALARY AND VESTS AT THREE AND FIVE YEARS OF SERVICE. MR. GALLAGHER RECEIVED PAYMENTS FROM THE NONQUALIFIED DEFINED CONTRIBUTION RESTORATION AND THE SUPPLEMENTAL RETIREMENT PLANS IN 2011. THE TOTAL AMOUNT OF THESE PAYMENTS WAS $373,453. MR. BOWEN VESTED AND RECEIVED $17,688 FROM THE SUPPLEMENTAL RETIREMENT PLAN IN 2011 . STEVEN M. ZIEGLER IS AN EMPLOYEE OF AVMED, INC. (AVMED), A RELATED TAX-EXEMPT ORGANIZATION. HE PARTICIPATES IN TWO NONQUALIFIED DEFERRED COMPENSATION RETIREMENT PLANS SPONSORED BY AVMED FOR A CERTAIN GROUP OF EXECUTIVES. ONE PLAN RESTORES RETIREMENT BENEFITS EQUIVALENT TO QUALIFIED 401(K) BENEFITS ON INCOME EARNED IN EXCESS OF THE INTERNAL REVENUE SERVICE CODE SECTION 401(A)(17) RECOGNIZABLE PAY LIMITS (DEFINED CONTRIBUTION RESTORATION PLAN). VESTING IS ACHIEVED AT AGE 55 AND 10 YEARS OF SERVICE OR AT AGE 65 AND 5 YEARS OF SERVICE. THE SECOND SUPPLEMENTAL DEFINED CONTRIBUTION PLAN PROVIDES ADDITIONAL RETIREMENT INCOME BASED ON A PERCENTAGE OF BASE SALARY AND VESTS AT THREE AND FIVE YEARS OF SERVICE. MR. DEMONTMOLLIN RECEIVED $35,992 FROM THE DEFINED CONTRIBUTION RESTORATION AND SUPPLEMENTAL RETIREMENT INCOME PLANS IN 2011 . | |
| PART III | SCHEDULE J, PART II: CERTAIN SENIOR EXECUTIVES ARE ACCOUNTABLE FOR AND PERFORM SERVICES FOR SANTAFE HEALTHCARE, INC. AND EACH OF ITS AFFILIATES. SANTAFE HEALTHCARE AND AFFILIATES REPRESENT A DIVERSIFIED FAMILY OF NOT-FOR-PROFIT ORGANIZATIONS WITH $2 BILLION IN REVENUE AND APPROXIMATELY 2,000 EMPLOYEES. THESE SENIOR EXECUTIVES ARE PAID DIRECTLY BY EITHER SANTAFE HEALTHCARE, INC. OR AVMED, INC. AND THEIR COMPENSATION AND BENEFITS ARE APPORTIONED AND CHARGED TO THE RESPECTIVE AFFILIATE BASED ON THE ESTIMATED AMOUNT OF TIME SPENT ON EACH AFFILIATE'S ACTIVITIES. FOR 2011, THE FOLLOWING PERCENTAGES OF EACH EXECUTIVE'S COMPENSATION AND BENEFITS (FOR THOSE SENIOR EXECUTIVES PAID BY A RELATED ORGANIZATION) IS APPORTIONED AND CHARGED TO HAVEN HOSPICE, AS FOLLOWS: << 8% - MICHAEL P. GALLAGHER, CHIEF EXECUTIVE OFFICER << 100% - TIMOTHY J. BOWEN, PRESIDENT << 10% - STEVEN M. ZIEGLER, ASSISTANT SECRETARY | SUPPLEMENTAL INFORMATION |
Schedule K IRS990ScheduleK
Form990 Schedule K Part I Form990ScheduleKPartI
Issuer Name IssuerName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CLAY COUNTY DEVELOPMENT AUTHORITY | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Issuer EIN | 596583087 | IssuerEIN |
| Date Issued | 2011-12-21 | DateIssued |
| Issue Price | 10000000 | IssuePrice |
| Description Of Purpose | CONSTRUCT HOSPICE CARE FACILITY | DescriptionOfPurpose |
| Defeased | 0 | Defeased |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuer |
| Pool Financing | 0 | PoolFinancing |
Form990 Schedule K Part II Form990ScheduleKPartII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Proceeds | 10000000 | TotalProceeds |
| Issuance Costs From Proceeds | 103585 | IssuanceCostsFromProceeds |
| Capital Expenditures | 3433768 | CapitalExpenditures |
| Amount Unspent | 6462647 | AmountUnspent |
| Current Refunding | 0 | CurrentRefunding |
| Advance Refunding | 0 | AdvanceRefunding |
| Final Allocation Made | 0 | FinalAllocationMade |
| Adequate Books And Recds Maintaind | 1 | AdequateBooksAndRecdsMaintaind |
Form990 Schedule K Part III Form990ScheduleKPartIII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Owning Bond Financed Property | 0 | OwningBondFinancedProperty |
| Any Lease Arrangements | 0 | AnyLeaseArrangements |
| Mngment Cntrct Bond Financd Prprty | 0 | MngmentCntrctBondFinancdPrprty |
| Any Research Agreements | 0 | AnyResearchAgreements |
| Post Issuance Compliance Procdrs | 1 | PostIssuanceComplianceProcdrs |
Form990 Schedule K Part IV Form990ScheduleKPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form8038 T Filed | 0 | Form8038TFiled |
| Variable Rate Issue | 1 | VariableRateIssue |
| Hedge Identified In Books And Recds | 0 | HedgeIdentifiedInBooksAndRecds |
| Gross Proceeds Invested In GIC | 0 | GrossProceedsInvestedInGIC |
| Gross Proceeds Invested | 0 | GrossProceedsInvested |
| Exception To Rebate | 0 | ExceptionToRebate |
Form990 Schedule K Part VI Form990ScheduleKPartVI (2 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| SCHEDULE K, PARTS I AND II | ADDITIONAL INFORMATION REGARDING THE BOND ISSUE: | THE BONDS WERE ISSUED AS A DRAW-DOWN LOAN. THE ISSUE PRICE AND PROCEEDS AMOUNTS SHOWN ON PARTS I AND II ARE THE MAXIMUM AMOUNT OF THE LOAN. AS OF THE END OF THE REPORTING YEAR, LESS THAN THE ENTIRE BALANCE OF THE LOAN HAD BEEN DRAWN DOWN. |
| SCHEDULE K, PART II, LINE 17 | EXPLANATION FOR FINAL ALLOCATION OF THE PROCEEDS: | ALTHOUGH A FINAL ALLOCATION OF THE PROCEEDS WAS NOT COMPLETE AS OF 12/31/2011, THE ORGANIZATION MAINTAINED ADEQUATE BOOKS AND RECORDS TO SUPPORT THE ALLOCATIONS MADE THROUGH 12/31/2011. ONCE THE ALLOCATION OF PROCEEDS IS COMPLETE, THE BOOKS AND RECORDS WILL SUPPORT THE FINAL ALLOCATION. |
Schedule M IRS990ScheduleM
Clothing And Household Goods ClothingAndHouseholdGoods
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | X | NonCashCheckbox |
| Noncash Contribs Rptd F990 | 1348807 | NoncashContribsRptdF990 |
| Method Of Determining Revenues | RESALE VALUE | MethodOfDeterminingRevenues |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Any Property That Must Be Held | 0 | AnyPropertyThatMustBeHeld |
| Review Process Unusual NC Gifts | 1 | ReviewProcessUnusualNCGifts |
| Third Parties Used | 0 | ThirdPartiesUsed |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (11 entries)
| Return ReferenceReturnReference | ExplanationExplanation | IdentifierIdentifier |
|---|---|---|
| FORM 990, PART VI, SECTION A, LINE 6 | THE SOLE MEMBER OF NORTH CENTRAL FLORIDA HOSPICE, INC., AS STATED IN ARTICLE IV OF ITS BYLAWS IS SANTAFE HEALTHCARE, INC. SANTAFE HEALTHCARE, INC. IS A FLORIDA NOT-FOR-PROFIT CORPORATION AND THE 509(A)(3) SUPPORTING ORGANIZATION OF NORTH CENTRAL FLORIDA HOSPICE, INC. | |
| FORM 990, PART VI, SECTION A, LINE 7A | SANTAFE HEALTHCARE, INC., A 509(A)(3) SUPPORTING ORGANIZATION TO NORTH CENTRAL FLORIDA HOSPICE, INC., HAS RESERVED POWERS AS DELINEATED IN THE ARTICLES OF INCORPORATION AND BYLAWS THAT PERMITS IT TO ELECT ONE OR MORE MEMBERS OF THE GOVERNING BODY OF NORTH CENTRAL FLORIDA HOSPICE, INC. | |
| FORM 990, PART VI, SECTION A, LINE 7B | THE RESERVED POWERS OF SANTAFE HEALTHCARE, INC., AS DELINEATED IN THE ARTICLES OF INCORPORATION AND BYLAWS, PERMIT IT TO APPROVE OR RATIFY THE GOVERNING BODY'S DECISIONS RELATED TO BOARD MEMBER ELECTIONS OR REMOVALS, THE DECISION TO DISSOLVE THE ORGANIZATION AND OTHER MATTERS THAT MAY COME BEFORE THE BOARD OF DIRECTORS. | |
| FORM 990, PART VI, SECTION B, LINE 11 | THE ORGANIZATION'S PROCESS FOR ENSURING THE ACCURATE PREPARATION, REVIEW AND APPROVAL OF THE 2011 FORM 990 BEGAN WITH PROFESSIONAL DEVELOPMENT OF STAFF (SEVERAL OF WHICH ARE CPAS) WHICH WERE INVOLVED IN THE PREPARATION OF THE 2011 FORM 990. IN ADDITION TO STAFF DEVELOPMENT, WHICH INCLUDED ATTENDING TAX SEMINARS AND CLASSES, MANAGEMENT ALSO CONSULTED WITH INDEPENDENT ACCOUNTING FIRMS AND TAX LEGAL COUNSEL REGARDING THE IRS FORM 990 CODE AND FILING REQUIREMENTS. THE ORGANIZATION ALSO PREVIOUSLY EDUCATED ITS MANAGEMENT TEAM, OFFICERS AND DIRECTORS, WITH THE ASSISTANCE OF DELOITTE TAX LLP, REGARDING THE FORM 990 AND THEIR INVOLVEMENT IN REVIEWING THE RETURN. FOLLOWING MANAGEMENT'S PREPARATION OF THE 2011 FORM 990, DELOITTE TAX LLP REVIEWED THE 2011 FORM 990. A COPY OF THE 2011 FORM 990 AND ATTACHMENTS WERE PROVIDED TO THE ORGANIZATION'S CURRENT BOARD OF DIRECTORS FOR THEIR REVIEW AND COMMENT. EXECUTIVE MANAGEMENT ADDRESSED ANY QUESTIONS RAISED BY THE BOARD MEMBERS PRIOR TO FILING THE 2011 FORM 990 AND ATTACHMENTS WITH THE IRS. | |
| FORM 990, PART VI, SECTION B, LINE 12C | HAVEN HOSPICE'S CONFLICT OF INTEREST POLICY (THE POLICY) COVERS BOARD MEMBERS, OFFICERS, ALL EMPLOYEES AND VOLUNTEERS. THE HUMAN RESOURCES DEPARTMENT IS RESPONSIBLE FOR PROVIDING EACH EMPLOYEE WITH A COPY OF THE POLICY AND OBTAINING THE EMPLOYEE'S ACKNOWLEDGMENT STATEMENT AND SIGNATURE AT THE TIME OF HIRE AND ANNUALLY THEREAFTER. THE VOLUNTEER SERVICES DEPARTMENT IS RESPONSIBLE FOR PROVIDING EACH VOLUNTEER WITH A COPY OF THE POLICY AND OBTAINING THE VOLUNTEER'S ACKNOWLEDGMENT STATEMENT AND SIGNATURE DURING ORIENTATION. ON AN ANNUAL BASIS, ALL BOARD MEMBERS MUST ACKNOWLEDGE AND SIGN A COPY OF THE POLICY. EMPLOYEES, VOLUNTEERS AND BOARD MEMBERS WILL REPORT SUSPECT CONDUCT OR ACTIVITY OF A KNOWN VIOLATION OF THE POLICY, INCLUDING THOSE AFFECTING A PROPOSED OR ONGOING OPERATIONAL OR FINANCIAL TRANSACTION, TO HAVEN HOSPICE'S DIRECTOR OF CORPORATE COMPLIANCE AS SOON AS POSSIBLE OR PRACTICAL. WILLFUL VIOLATIONS OF THE POLICY WILL RESULT IN DISCIPLINARY ACTION UP TO AND INCLUDING TERMINATION. THE PRESIDENT OF HAVEN HOSPICE AND THE CHIEF EXECUTIVE OFFICER OF SANTAFE HEALTHCARE, INC. (THE SUPPORTING ORGANIZATION FOR HAVEN HOSPICE) ARE VESTED WITH ULTIMATE AUTHORITY AND RESPONSIBILITY TO DETERMINE THE APPLICABILITY OF THE POLICY TO ANY SET OF FACTS THAT MAY ARISE, AND TO DETERMINE ANY STEPS THAT SHOULD BE TAKEN TO CORRECT A SITUATION DEEMED NOT IN THE BEST INTEREST OF HAVEN HOSPICE, INCLUDING, IF DEEMED APPROPRIATE, DISCIPLINARY ACTION. | |
| FORM 990, PART VI, SECTION B, LINE 15 | LINE 15A: MICHAEL P. GALLAGHER IS THE CHIEF EXECUTIVE OFFICER (CEO) OF HAVEN HOSPICE. MR. GALLAGHER IS COMPENSATED BY SANTAFE HEALTHCARE, INC. (SANTAFE), A RELATED SUPPORTING ORGANIZATION. SANTAFE UTILIZES THE FOLLOWING PROCESS TO ESTABLISH THE CEO'S COMPENSATION AND BENEFITS: THE SANTAFE BOARD OF DIRECTORS ANNUALLY RETAINS AN INDEPENDENT THIRD PARTY COMPENSATION AND BENEFITS CONSULTING FIRM TO CONDUCT A MARKET COMPETITIVENESS REVIEW OF THE CEO'S TOTAL DIRECT COMPENSATION (BASE SALARY, ANNUAL INCENTIVES, AND LONG TERM INCENTIVES) AND BENEFITS. THE COMPETITIVE ANALYSIS INCLUDES COMPARISON TO SIMILAR POSITIONS IN COMPANIES OF SIMILAR SIZE WITHIN THE SAME OR SIMILAR INDUSTRY. THE INDEPENDENT CONSULTING FIRM MAKES RECOMMENDATIONS, IF ANY, DIRECTLY TO THE BOARD OF DIRECTORS. THE BOARD OF DIRECTORS ESTABLISHES THE FINAL COMPENSATION AND BENEFIT PACKAGE FOR THE CEO TAKING INTO CONSIDERATION THE MARKET COMPETITIVENESS REVIEW AND FINAL RECOMMENDATION OF THE INDEPENDENT CONSULTING FIRM. THE INDEPENDENT CONSULTING FIRM PROVIDES AN OPINION LETTER REGARDING THE REASONABLENESS OF THE FINAL COMPENSATION AND BENEFITS PACKAGE. THE ACTIONS OF THE BOARD ARE DOCUMENTED IN THE MINUTES OF THE BOARD MEETING. FORM 990, PART VI, SECTION B, LINE 15B: PROCESS FOR DETERMINING COMPENSATION FOR THE ASSISTANT SECRETARY AND PRESIDENT OF HAVEN HOSPICE IS AS FOLLOWS: THE SANTAFE BOARD OF DIRECTORS ANNUALLY RETAINS AN INDEPENDENT THIRD PARTY COMPENSATION AND BENEFITS FIRM (FIRM) TO CONDUCT A MARKET COMPETITIVENESS REVIEW OF THE AFOREMENTIONED OFFICERS OF TOTAL DIRECT COMPENSATION (BASE SALARY, ANNUAL INCENTIVES, AND LONG-TERM INCENTIVES) AND BENEFITS. THE COMPETITIVE ANALYSIS INCLUDES COMPARISONS TO SIMILAR POSITIONS IN COMPANIES OF SIMILAR SIZE WITHIN THE SAME OR SIMILAR INDUSTRY. AFTER COMPLETION OF ITS REVIEW, THE INDEPENDENT CONSULTING FIRM MAKES RECOMMENDATIONS, IF ANY, DIRECTLY TO THE SANTAFE BOARD OF DIRECTORS. THE INDEPENDENT CONSULTING FIRM PROVIDES AN OPINION LETTER REGARDING THE REASONABLENESS OF TOTAL DIRECT COMPENSATION AND EXECUTIVE BENEFITS. THE ACTIONS OF THE BOARD ARE DOCUMENTED IN THE MINUTES OF THE BOARD MEETINGS. THE COMPENSATION FOR THE HAVEN HOSPICE MEDICAL DIRECTOR IS DETERMINED BY A MARKET COMPETITIVENESS STUDY CONDUCTED BY AN INDEPENDENT THIRD PARTY COMPENSATION CONSULTANT. THE COMPETITIVENESS ANALYSIS INCLUDES COMPARISONS TO SIMILAR POSITIONS IN COMPANIES OF SIMILAR SIZE WITHIN THE HOSPICE INDUSTRY. THE ANALYSIS ALSO INCLUDES FORM 990 DATA COMPARISON FOR HOSPICES WITHIN A SIMILAR REVENUE SIZE AND/OR MARKET LOCATION. THE MOST RECENT COMPENSATION REVIEW WAS COMPLETED IN 2011. | |
| FORM 990, PART VI, SECTION C, LINE 19 | UPDATED ARTICLES OF INCORPORATION FOR HAVEN HOSPICE ARE AVAILABLE ON THE STATE OF FLORIDA, SECRETARY OF STATE WEBSITE WWW.SUNBIZ.ORG. | |
| FORM 990, PART VII, SECTION A, LINE 1A: | CERTAIN SENIOR EXECUTIVES ARE ACCOUNTABLE FOR AND PERFORM SERVICES FOR SANTAFE HEALTHCARE, INC. AND EACH OF ITS AFFILIATES. SANTAFE HEALTHCARE AND AFFILIATES REPRESENT A DIVERSIFIED FAMILY OF NOT-FOR-PROFIT ORGANIZATIONS WITH $2 BILLION IN REVENUE AND APPROXIMATELY 2,000 EMPLOYEES. THESE SENIOR EXECUTIVES ARE PAID DIRECTLY BY EITHER SANTAFE HEALTHCARE, INC. OR AVMED, INC. AND THEIR COMPENSATION AND BENEFITS ARE APPORTIONED AND CHARGED TO THE RESPECTIVE AFFILIATE BASED ON THE ESTIMATED AMOUNT OF TIME SPENT ON EACH AFFILIATE'S ACTIVITIES. FOR 2011, THE FOLLOWING PERCENTAGES OF EACH EXECUTIVE'S COMPENSATION AND BENEFITS (FOR THOSE SENIOR EXECUTIVES PAID BY A RELATED ORGANIZATION) IS APPORTIONED AND CHARGED TO HAVEN HOSPICE, AS FOLLOWS: << 8% - MICHAEL P. GALLAGHER, CHIEF EXECUTIVE OFFICER << 100% - TIMOTHY J. BOWEN, PRESIDENT << 10% - STEVEN M. ZIEGLER, ASSISTANT SECRETARY | |
| FORM 990, PART VII, SECTION A, COLUMN B: | MICHAEL P GALLAGHER DEVOTED AN AVERAGE OF 55 HOURS PER WEEK TO RELATED ORGANIZATIONS. STEVEN M ZIEGLER DEVOTED AN AVERAGE OF 57 HOURS PER WEEK TO RELATED ORGANIZATIONS. | AVERAGE HOURS PER WEEK DEVOTED TO RELATED ORGANIZATIONS: |
| FORM 990, PART XI, LINE 5: | NET UNREALIZED GAINS ON INVESTMENTS: 129,766. CHANGE IN VALUE OF RESTRICTED PLEDGES -7,261. NET ASSETS RELEASED FROM RESTRICTION USED FOR SERVICES -10,284. CHANGE IN VALUE OF DONOR RESTRICTED CONTRIBUTIONS 69,860. CHANGE IN FAIR VALUE OF CHARITABLE REMAINDER UNITRUST 6,846. CHANGE IN NET UNREALIZED GAINS/LOSSES ON CRUT INVESTMENT -3,886. LOSSES ON UNCOLLECTIBLE PLEDGES -1,455. TOTAL TO FORM 990, PART XI, LINE 5: 183,586. | CHANGES IN NET ASSETS OR FUND BALANCES: |
| FORM 990, PART XII, LINE 2C: | THERE HAS BEEN NO CHANGE FROM THE PRIOR YEAR TO THE PROCESS RELATED TO AUDIT OVERSIGHT AND SELECTION OF THE INDEPENDENT ACCOUNTANT FOR THE ORGANIZATION. | AUDIT COMMITTEE OVERSIGHT OF THE FINANCIAL STATEMENT AUDIT: |
Schedule R IRS990ScheduleR
Form990 Schedule R Part I Form990ScheduleRPartI
Name Of Disregarded Entity NameOfDisregardedEntity
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HAVEN MEDICAL GROUP LLC | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | P O BOX 749 | AddressLine1 |
| City | GAINESVILLE | City |
| State | FL | State |
| ZIP Code | 326270749 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 592490893 | EIN |
| Primary Activities | CONDUCT A MEDICAL PRACTICE SPECIALIZING IN PALLIATIVE CARE | PrimaryActivities |
| Legal Domicile State | FL | LegalDomicileState |
| Total Income | 0 | TotalIncome |
| EOY Assets | 0 | EOYAssets |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | NORTH CENTRAL FLORIDA HOSPICE INC | BusinessNameLine1 |
Form990 Schedule R Part II Form990ScheduleRPartII (8 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivities | Legal Domicile StateLegalDomicileState | Exempt Code SectionExemptCodeSection | Public Charity StatusPublicCharityStatus | Direct Controlling Entity NADirectControllingEntityNA | Controlled OrgControlledOrg |
|---|---|---|---|---|---|---|---|---|---|---|
| SANTAFE HEALTHCARE INC | ||||||||||
| PO BOX 749 | GAINESVILLE | FL | 326270749 | 592317607 | MANAGEMENT AND FINANCIAL SUPPORT FOR NOT-FOR-PROFIT AFFILIATES | FL | 501(C)(3) | 11B TYPE II | N/A | 0 |
| AVMED INC | ||||||||||
| PO BOX 749 | GAINESVILLE | FL | 326270749 | 592742907 | HEALTH CARE | FL | 501(C)(4) | N/A | N/A | 0 |
| NORTH FLORIDA RETIREMENT VILLAGE INC | ||||||||||
| PO BOX 749 | GAINESVILLE | FL | 326270749 | 591912330 | RETIREMENT COMMUNITY | FL | 501(C)(3) | 9 | N/A | 0 |
| SANTAFE SENIOR LIVING INC | ||||||||||
| PO BOX 749 | GAINESVILLE | FL | 326270749 | 203700526 | MANAGEMENT AND FINANCIAL SUPPORT FOR NOT-FOR-PROFIT AFFILIATES | FL | 501(C)(3) | 11A TYPE I | N/A | 0 |
| BVG ACQUISITION INC | ||||||||||
| PO BOX 749 | GAINESVILLE | FL | 326270749 | 203701186 | RETIREMENT COMMUNITY | FL | 501(C)(3) | 9 | N/A | 0 |
| EAST RIDGE RETIREMENT VILLAGE INC | ||||||||||
| PO BOX 749 | GAINESVILLE | FL | 326270749 | 590903331 | RETIREMENT COMMUNITY | FL | 501(C)(3) | 9 | N/A | 0 |
| BONITA SPRINGS RETIREMENT VILLAGE INC | ||||||||||
| PO BOX 749 | GAINESVILLE | FL | 326270749 | 262386152 | RETIREMENT COMMUNITY | FL | 501(C)(3) | 9 | N/A | 0 |
| SANTAFE SENIOR LIVING FOUNDATION INC | ||||||||||
| PO BOX 749 | GAINESVILLE | FL | 326270749 | 264464727 | CHARITABLE & EDUCATIONAL PURPOSES | FL | 501(C)(3) | 7 | N/A | 0 |
Form990 Schedule R Part IV Form990ScheduleRPartIV
Name Of Related Org NameOfRelatedOrg
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SF HOLDING CORPINC & SUBSIDIARY | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 749 | AddressLine1 |
| City | GAINESVILLE | City |
| State | FL | State |
| ZIP Code | 326270749 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 592903901 | EIN |
| Primary Activity | HOLDING COMPANY | PrimaryActivity |
| Legal Domicile State | FL | LegalDomicileState |
| Direct Controlling Entity NA | N/A | DirectControllingEntityNA |
| Type Of Entity | C | TypeOfEntity |
| 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 | 0 | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | 0 | LoansOrGuaranteesFromOtherOrg |
| 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 | 1 | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | 1 | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | 0 | SharingOfFacilities |
| Sharing Of Paid Employees | 0 | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | 1 | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | 0 | OtherTransferToOtherOrg |
| Other Transfer From Other Org | 0 | OtherTransferFromOtherOrg |
Transactions Related Orgs Table TransactionsRelatedOrgsTable (2 entries)
| Transaction TypeTransactionType | Amount InvolvedAmountInvolved | Method Of Amt DeterminationMethodOfAmtDetermination |
|---|---|---|
| AVMED INC | ||
| L | 2343538 | FAIR MARKET VALUE |
| AVMED INC | ||
| K | 105085 | FAIR MARKET VALUE |