2011-10-13T16:04:08-05:00 2010-12-31 DELOITTE TAX LLP 201 E KENNEDY BLVD SUITE 1200 TAMPA FL 33602 990 2010-01-01 592490893 NORTH CENTRAL FLORIDA HOSPICE INC NORT 3523728400 SANTAFE HEALTHCAREINC PO BOX 749 GAINESVILLE FL 326270749 RANDALL L STUART 3523378730 2011-10-11 1 STEVEN E ROVNER 8132738300 2010 2016-03-07 17:11:31Z X HAVEN HOSPICE MICHAEL P GALLAGHER SANTAFE HEALTHCAREINC PO BOX 749 GAINESVILLE FL 326270749 61974218 0 X WWW.HAVENHOSPICE.ORG X 1982 FL TO PROVIDE COMPASSIONATE CARE TO PEOPLE & THEIR COMMUNITIES AFFECTED BY LIFE-LIMITING ILLNESS.THE MISSION OF NORTH CENTRAL FLORIDA HOSPICE, INC. IS TO SERVE PEOPLE AND THEIR COMMUNITIES AFFECTED BY LIFE-LIMITING ILLNESS AND LOSS BY PROVIDING COMPREHENSIVE, COMPASSIONATE CARE, WHILE RESPECTING EACH PERSON'S NEEDS, BELIEFS AND WISHES. SEE PART III, LINE 1 FOR MORE INFORMATION. 14 13 681 1135 0 0 2198110 2002280 50582738 54590670 276381 495546 -82054 -134428 52975175 56954068 0 0 0 0 27739652 28947467 0 0 621999 24500622 26342151 52240274 55289618 734901 1664450 38608995 41057742 5651698 6098728 32957297 34959014 X THE MISSION OF NORTH CENTRAL FLORIDA HOSPICE, INC. (HAVEN HOSPICE) IS TO SERVE PEOPLE AND THEIR COMMUNITIES AFFECTED BY LIFE-LIMITING ILLNESS AND LOSS BY PROVIDING COMPREHENSIVE, COMPASSIONATE CARE, WHILE RESPECTING EACH PERSON'S NEEDS, BELIEFS AND WISHES. 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 PARTICIPATED IN A DEMONSTRATION GRANT (UNFUNDED) THROUGH THE CENTERS FOR MEDICARE AND MEDICAID SERVICES TO IMPROVE DELIVERY OF HOSPICE CARE IN RURAL AREAS. HAVEN HOSPICE PROVIDES CLINICAL EDUCATION ABOUT END-OF-LIFE AND PALLIATIVE CARE, GRIEF SUPPORT TO CHILDREN AND FAMILIES AND BEREAVEMENT PROGRAMS FOR BOTH GROUPS AND INDIVIDUALS IN ITS SERVICE AREA. 0 0 27397705 42974362 HAVEN HOSPICE PROVIDED SERVICES TO 3,370 HOSPICE PATIENTS INCLUDING 242,616 DAYS OF SERVICE AND 124,984 VISITS BY NURSES, HOME HEALTH AIDES, SOCIAL WORKERS, CHAPLAINS AND PHYSICIANS TOTALING 236,402 HOURS OF CARE. INCLUDED IN THE EXPENSES IS $223,289 OF UNREIMBURSED CARE AND PROVISION OF PALLIATIVE MASSAGE THERAPY, VOLUNTEERS AND BEREAVEMENT SERVICES. 8176019 9689843 HAVEN HOSPICE PROVIDED SERVICES TO 1,273 PATIENTS IN INPATIENT CARE CENTERS, INCLUDING 18,874 DAYS OF SERVICE AND 125,443 VISITS BY NURSES, HOME HEALTH AIDES, SOCIAL WORKERS, CHAPLAINS AND PHYSICIANS TOTALING 181,499 HOURS OF CARE. INCLUDED IN THE EXPENSES IS $386,681 OF UNREIMBURSED CARE. 88637 HAVEN HOSPICE PROVIDED BEREAVEMENT SERVICES TO THE COMMUNITIES IN WHICH WE SERVE AND TO FAMILY MEMBERS OF PATIENTS WHO HAVE DIED IN OUR CARE. 14 MEMORIAL SERVICES WERE HELD WITH AN AVERAGE ATTENDANCE OF 79 PARTICIPANTS PER SERVICE. 117 GRIEF SUPPORT GROUP SESSIONS WERE HELD IN 2010 WITH AN AVERAGE OF 4 PARTICIPANTS AT EACH AND 465 INDIVIDUAL COUNSELING SESSIONS WERE CONDUCTED. SIX CHILDREN'S GRIEF CAMPS WERE HELD WITH AN AVERAGE ATTENDANCE OF 20 CHILDREN. 6959682 1926465 MISCELLANEOUS PROGRAM SERVICES 6959682 1926465 42622043 1 1 0 1 0 0 0 0 1 1 0 0 0 1 1 1 1 0 0 0 0 0 0 1 0 0 0 0 1 0 0 0 0 0 0 0 0 1 0 0 0 0 1 0 0 0 0 1 310 0 1 681 1 0 0 0 0 0 1 1 0 0 0 0 X 14 13 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 X PATRICIA C LAW VICE PRESIDENTCHIEF FINANCIAL OFFICER 3523796241 4200 NW 90TH BLVD GAINESVILLE FL 326065688 X JAMES L POOLE 1.00 X X 0 0 0 D RAY HARRISON JR 1.00 X X 0 0 0 ERIC L GODET 1.00 X X 0 2000 0 MICHAEL P GALLAGHER 4.00 X X 0 2382570 245651 GEORGE J CARANASOS MD 1.00 X 0 0 0 JANET L CHRISTIE 1.00 X 0 0 0 JAMES W DEFORD MD 1.00 X 0 0 0 G THOMAS MALLINI 1.00 X X 0 0 0 SUZANNE M NORRIS 1.00 X 0 0 0 SUSAN D PARRISH 1.00 X 0 0 0 NORLENE E ROBERTS 1.00 X 0 0 0 DALE M WILLIAMS 1.00 X 0 0 0 CAROL REED ASH 1.00 X 0 0 0 FRANCIS C PEPIS 1.00 X 0 0 0 STEPHEN J DEMONTMOLLIN 2.00 X 0 574723 63105 TIMOTHY J BOWEN 50.00 X 0 347858 75804 NEEL KARNANI MD 40.00 X 191061 0 16315 MICHELE BOATWRIGHT MD 40.00 X 183501 0 38744 CASSANDRA DONOVAN RN 40.00 X 144384 0 23586 ANDREA FINDLATER MD 40.00 X 173635 0 40014 GERALDINE BICHIER MD 40.00 X 163906 0 31785 PATRICIA C LAW 40.00 X 144138 0 18593 1000625 3307151 553597 17 0 1 0 AVMED INC P O BOX 749 GAINESVILLE FL 326270749 HEALTH INSURANCE 3102500 SANTAFE HEALTHCARE INC P O BOX 749 GAINESVILLE FL 326270749 MANAGEMENT FEES 887380 GAINESVILLE REHABILITATION AND NURSING C 1000 SW 16TH AVENUE GAINESVILLE FL 32601 MEDICAL 795911 HEALTH SERVICES OF PALATKAINC 110 KAY LARKIN DRIVE PALATKA FL 32177 MEDICAL 696864 BLUE CROSS BLUE SHIELD OF FLORIDA PO BOX 660299 DALLAS TX 752660299 HEALTH INSURANCE 683801 48 84921 191315 1726044 1040851 2002280 MEDICARE REVENUE 623990 38862495 38862495 MEDICAID REVENUE 623990 13500530 13500530 PATIENT SERVICE REVENU 623990 2227645 2227645 54590670 376917 376917 4944000 4809780 15591 134220 -15591 118629 118629 48080 191315 194779 -146699 -146699 ADMINISTRATIVE INCOME 900099 12271 12271 12271 56954068 54590670 0 361118 216469 216469 21951989 16450560 5244837 256592 1718267 931672 774177 12418 3554725 2519530 998513 36682 1506017 1140935 350119 14963 716278 716278 195250 195250 89640 89640 14679223 14081528 552555 45140 787639 778157 988 8494 1361294 650730 657609 52955 526504 2101 524403 1311661 933255 378406 1473110 1149608 313004 10498 71343 22530 48664 149 94 94 1226299 693438 532861 318936 141317 177619 PHARMACY SUPPLIES 1332626 1332626 COMMUNITY SUPPORT 843248 621029 61341 160878 MEDICAL SUPPLIES 404996 404996 BAD DEBT 377710 365796 627 11287 FOOD COSTS 106397 106397 519903 79369 428591 11943 55289618 42622043 12045576 621999 46125 64866 3281042 315094 98801 35044 4499989 7202075 519658 516923 26897673 7522015 19553766 19375658 8746732 11729221 1584197 1708486 278685 110375 38608995 41057742 5392229 5644208 4000 2000 255469 452520 5651698 6098728 X 32914293 34947909 43004 11105 32957297 34959014 38608995 41057742 X 1664450 337267 X X 0 1 1 X 0 X 1772746 1130815 2778953 2198110 2002280 9882904 39609568 44081014 47775904 50582738 54590670 236639894 41382314 45211829 50554857 52780848 56592950 246522798 0 0 0 246522798 483957 472182 306721 233421 376917 1873198 483957 472182 306721 233421 376917 1873198 821948 838709 -49004 -82054 -134428 1395171 42688219 46522720 50812574 52932215 56835439 249791167 0.98690 0.98230 0.00750 0.00800 X SCHEDULE A, PART IV, SUPPLEMENTAL INFORMATION: SCHEDULE A, PART III, LINE 12, EXPLANATION FOR OTHER INCOME IN 2010: ADMINISTRATIVE INCOME: $12,271 SPECIAL EVENT INCOME, NET: $-146,699 RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 30525 30525 0 EXPLANATION OF OTHER LOBBYING ACTIVITIES: PART II-B, LINE 1I: 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. 1373367 116102 1489469 1249994 123373 1373367 1292160 -42166 1249994 1.00000 0 0 1866351 1866351 19882687 4102809 15779878 280479 123198 157281 4868156 3296008 1572148 19375658 GIFT ANNUITIES 152506 DUE TO AFFILIATES 82132 CAPITAL LEASE OBLIGATION 217882 452520 56954068 55289618 1664450 359577 -22310 337267 2001717 56538878 -415190 -415190 56954068 0 56954068 54874428 -415190 -415190 55289618 0 55289618 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: HAVEN HAD NO UNCERTAIN TAX POSITIONS AS OF DECEMBER 31, 2010. TAX YEARS 2007 THROUGH 2010 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 -18,396. NET ASSETS RELEASED FROM RESTRICTION USED FOR SERVICES -3,914. PART XII, LINE 2D - OTHER ADJUSTMENTS: UNREIMBURSED CARE -609,971. SPECIAL EVENT EXPENSES 194,781. PART XIII, LINE 2D - OTHER ADJUSTMENTS: UNREIMBURSED CARE -609,971. SPECIAL EVENT EXPENSES 194,781. VIVA 143328 114558 28770 120840 FALL AT FARM 52472 45252 7220 36524 3 43595 31505 12090 37415 239395 191315 48080 194779 194779 -146699 0 1 0 0 0 0 0 0 0 MICHAEL P GALLAGHER 0 801182 0 697001 0 884387 0 223059 0 22592 0 2628221 0 132300 STEPHEN J DEMONTMOLLIN 0 300994 0 159291 0 114438 0 47125 0 15980 0 637828 0 0 TIMOTHY J BOWEN 0 270321 0 48893 0 28644 0 56060 0 19744 0 423662 0 12488 NEEL KARNANI MD 189035 0 1727 0 299 0 14803 0 1512 0 207376 0 0 0 MICHELE BOATWRIGHT MD 182850 0 541 0 110 0 15684 0 23060 0 222245 0 0 0 CASSANDRA DONOVAN RN 131626 0 11440 0 1318 0 12043 0 11543 0 167970 0 0 0 ANDREA FINDLATER MD 171852 0 541 0 1242 0 14119 0 25895 0 213649 0 0 0 GERALDINE BICHIER MD 163239 0 507 0 160 0 13340 0 18445 0 195691 0 0 0 PATRICIA C LAW 124243 0 19276 0 619 0 11361 0 7232 0 162731 0 0 0 PART I, LINE 4B (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. 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 VESTED AND RECEIVED PAYMENTS FROM A FROZEN NONQUALIFIED DEFINED BENEFIT RESTORATION PLAN IN 2010. MR. GALLAGHER ALSO VESTED AND RECEIVED PAYMENTS FROM THE NONQUALIFIED DEFINED CONTRIBUTION RESTORATION AND THE SUPPLEMENTAL RETIREMENT PLANS IN 2010. THE TOTAL AMOUNT OF THESE PAYMENTS WAS $831,870. MR. BOWEN VESTED AND RECEIVED $15,468 FROM THE SUPPLEMENTAL RETIREMENT PLAN IN 2010. STEPHEN J. DEMONTMOLLIN WAS 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 $101,761 FROM THE DEFINED CONTRIBUTION RESTORATION AND SUPPLEMENTAL RETIREMENT INCOME PLANS IN 2010. SUPPLEMENTAL INFORMATION PART III 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 EXTERNAL 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 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 CONSULTING FIRM. THE 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. X 995916 RESALE VALUE 0 1 0 FORM 990, PART VI, SECTION A, LINE 6 THE SOLE MEMBER OF NORTH CENTRAL FLORIDA HOSPICE, INC., AS STATED IN ARTICLE IV OF ITS BYLAWS IS SANTAFE HEALTHCARE, INC. SANTAFE HEALTHCARE, INC. IS A FLORIDA NOT-FOR-PROFIT CORPORATION AND THE 509(A)(3) SUPPORTING ORGANIZATION OF NORTH CENTRAL FLORIDA HOSPICE, INC. FORM 990, PART VI, SECTION A, LINE 7A SANTAFE HEALTHCARE, INC., A 509(A)(3) SUPPORTING ORGANIZATION TO NORTH CENTRAL FLORIDA HOSPICE, INC., HAS RESERVED POWERS AS DELINEATED IN THE ARTICLES OF INCORPORATION AND BYLAWS THAT PERMITS IT TO ELECT ONE OR MORE MEMBERS OF THE GOVERNING BODY OF NORTH CENTRAL FLORIDA HOSPICE, INC. FORM 990, PART VI, SECTION A, LINE 7B THE RESERVED POWERS OF SANTAFE HEALTHCARE, INC., AS DELINEATED IN THE ARTICLES OF INCORPORATION AND BYLAWS, PERMIT IT TO APPROVE OR RATIFY THE GOVERNING BODY'S DECISIONS RELATED TO BOARD MEMBER ELECTIONS OR REMOVALS, THE DECISION TO DISSOLVE THE ORGANIZATION AND OTHER MATTERS THAT MAY COME BEFORE THE BOARD OF DIRECTORS. FORM 990, PART VI, SECTION B, LINE 11 THE ORGANIZATION'S PROCESS FOR ENSURING THE ACCURATE PREPARATION, REVIEW AND APPROVAL OF THE 2010 FORM 990 BEGAN WITH PROFESSIONAL DEVELOPMENT OF STAFF (SEVERAL OF WHICH ARE CPAS) WHICH WERE INVOLVED IN THE PREPARATION OF THE 2010 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 2010 FORM 990, DELOITTE TAX LLP PERFORMED A DETAILED REVIEW OF THE 2010 FORM 990. A COPY OF THE 2010 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 2010 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 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 CONSULTING FIRM. THE 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 FIRM MAKES RECOMMENDATIONS, IF ANY, DIRECTLY TO THE SANTAFE BOARD OF DIRECTORS. THE 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 2008. 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: THE ORGANIZATION'S TOP MANAGEMENT OFFICIAL, MICHAEL P. GALLAGHER, IS EMPLOYED BY SANTAFE HEALTHCARE, INC. (SANTAFE), THE PRINCIPAL SUPPORTING ORGANIZATION FOR NORTH CENTRAL FLORIDA HOSPICE, INC. (D/B/A HAVEN HOSPICE). MR. GALLAGHER'S COMPENSATION IS PAID DIRECTLY BY SANTAFE. SANTAFE CHARGES HAVEN HOSPICE A MANAGEMENT FEE FOR SERVICES PROVIDED BY MR. GALLAGHER. ONE OF THE ORGANIZATION'S OFFICERS, STEPHEN J. DEMONTMOLLIN, IS EMPLOYED BY AVMED, INC. (AVMED), A RELATED TAX-EXEMPT ORGANIZATION. MR. DEMONTMOLLIN'S COMPENSATION IS PAID DIRECTLY BY AVMED. NONE OF MR. DEMONTMOLLIN'S COMPENSATION WAS CHARGED TO HAVEN HOSPICE. ONE OF THE ORGANIZATION'S OFFICERS, TIMOTHY J. BOWEN, IS EMPLOYED BY SANTAFE, THE PRINCIPAL SUPPORTING ORGANIZATION FOR HAVEN HOSPICE. MR. BOWEN'S COMPENSATION IS PAID DIRECTLY BY SANTAFE. SANTAFE CHARGES HAVEN HOSPICE A MANAGEMENT FEE FOR SERVICES PROVIDED BY MR. BOWEN. AVERAGE HOURS PER WEEK DEVOTED TO RELATED ORGANIZATIONS: FORM 990, PART VII, SECTION A, COLUMN B: MICHAEL P GALLAGHER DEVOTED AN AVERAGE OF 56 HOURS PER WEEK TO RELATED ORGANIZATIONS. STEPHEN J DEMONTMOLLIN DEVOTED AN AVERAGE OF 58 HOURS PER WEEK TO RELATED ORGANIZATIONS. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 5: NET UNREALIZED GAINS ON INVESTMENTS: 359,577. CHANGE IN VALUE OF RESTRICTED PLEDGES -18,396. NET ASSETS RELEASED FROM RESTRICTION USED FOR SERVICES -3,914. TOTAL TO FORM 990, PART XI, LINE 5: 337,267. AUDIT COMMITTEE OVERSIGHT OF THE FINANCIAL STATEMENT AUDIT: FORM 990, PART XII, LINE 2C: THERE HAS BEEN NO CHANGE FROM THE PRIOR YEAR TO THE PROCESS RELATED TO AUDIT OVERSIGHT AND SELECTION OF THE INDEPENDENT ACCOUNTANT FOR THE ORGANIZATION. 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