2011-08-15T15:43:25-05:00 2010-09-30 RSM MCGLADREY 400 LOCUST STREET SUITE 640 DES MOINES IA 50309 990 2009-10-01 591911574 HOSPICE OF HEALTH FIRST INC HOSP 3214345150 3300 FISKE BLVD ROCKLEDGE FL 32955 ROBERT C GALLOWAY 3214345150 2011-08-15 VIRGINIA M STRIEGEL 5155586600 2009 2016-02-24 21:20:13Z MICHAEL D MEANS 3300 FISKE BLVD ROCKLEDGE FL 32955 10734965 0 X www.health-first.org X 1978 FL OUR TEAM POSITIVELY CHANGING THE HEALTH AND WELL-BEING OF YOU AND YOUR FAMILY THROUGH EXCELLENT AND COMPASSIONATE HEALTH CARE. 13 10 0 316 0 0 205481 543536 11295466 10157622 78715 25667 35523 8140 11615185 10734965 1558555 0 4416778 4416125 0 0 3569988 3186662 7986766 9161342 3628419 1573623 27197069 28630163 3221470 2751784 23975599 25878379 OUR TEAM POSITIVELY CHANGING THE HEALTH AND WELL-BEING OF YOU ANDYOUR FAMILY THROUGH EXCELLENT AND COMPASSIONATE HEALTH CARE.FOR MORE THAN 25 YEARS, HOSPICE OF HEALTH FIRST HAS BEEN LEADINGHOSPICE CARE IN BREVARD COUNTY, FL. HOSPICE ENABLES PATIENTS TOREMAIN AT HOME DURING MOST OR ALL OF THEIR ILLNESS, RELATIVELY FREEFROM PAIN, SURROUNDED BY FAMILY AND FRIENDS, AND LIVING LIFE AS FULLYAS POSSIBLE. 0 0 7810815 1558555 10157622 HOSPICE OF HEALTH FIRST, INC. PROVIDES COMFORT CARE TO THE TERMINALLY ILL AND THEIR FAMILIES BY FURNISHING PAIN CONTROL AND SYMPTOM MANAGEMENT ACROSS THE HEALTH CARE CONTINUUM (HOSPITAL, HOME, NURSING HOME, & ALF) AS WELL AS EDUCATIONAL AND BEREAVEMENT PROGRAMS TO ENHANCE THE COPING ABILITIES OF FAMILIES.IN FISCAL YEAR 2010, HOSPICE OF HEALTH FIRST INC., WHICH INCLUDES HOMECARE AND THE WILLIAM CHILDS HOSPICE HOUSE PROVIDED 64,488 DAYS OF CARE. CONTINUOUS CARE WAS ALSO PROVIDED IN THE HOME; 1,696 HOURS OF BILLABLE CONTINUOUS CARE AND 1,736 UNBILLABLE HOURS OF RESPITE CARE. 316 VOLUNTEERS GAVE A TOTAL OF 18,217 HOURS OF SERVICE WHICH EQUALS $333,162 IN COST SAVING DOLLARS. OVER 1,085 SURVIVING CARE GIVERS WERE OFFERED BEREAVEMENT SERVICES; THIS INCLUDED SUDDENLY ALONE SUPPORT GROUPS, NEW BEGINNING SOCIAL GROUPS, AND THE BRIGHT STAR CENTER FOR GRIEVING CHILDREN AND THEIR FAMILIES. MAJOR PROGRAM ACCOMPLISHMENTS INCLUDE:IN OCTOBER 2009 HOSPICE SUCCESSFULLY IMPLEMENTED A NEW REGULATORY REQUIREMENT OF A "NARRATIVE CERTIFICATION BY THE MEDICAL DIRECTOR". A CONTRACT WITH CARE LEVEL MANAGEMENT, A HOME VISTING PHYSICIAN PROGRAM WAS ASSSIGNED TO INCREASE ACCESS TO HOSPICE SERVICES. HOSPICE OF HEALTH FIRST HIRED ITS FIRST FULL TIME CHAPLAIN WITH HOPES OF IMPACTING THE "PRESS GANEY FAMILY SATISFACTION SCORES". IN APRIL 2010 BRIGHT STAR CENTER FOR GRIEVING CHILDREN AND THEIR FAMILIES, A PROGRAM OF HOSPICE OF HEALTH FIRST, WAS THE BENEFICIARY OF THE HEALTH FIRST BALL, FUNDS RAISED WILL GO TO A MORE PERMANENT HOME.IN 2010 HOSPICE CONNECTIONS A SEMI-ANNUAL PUBLICATION, WAS PRODUCED FOR DISTRIBUTION AND TO MAINTAIN COMMUNITY AWARENESS OF HOSPICE OF HEALTH FIRST AND IT'S PROGRAM.FOR A COPY OF OUR COMMUNITY BENEFIT REPORT SEEHTTP://WWW.HEALTH-FIRST.ORG/ABOUT_US/COMMUNITY_REPORT 7810815 1 1 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 1 0 0 0 0 0 0 0 1 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 13 10 1 1 0 0 1 1 1 1 0 0 0 1 1 1 1 1 1 0 0 0 X GINGER BONHAM 3214345150 3300 FISKE BLVD ROCKLEDGE FL 32955 CHRISTOPHER S KENNEDY 1.00 X 0 0 0 EDWARD A ANDRE 1.00 X 0 0 0 JOHN CAMPBELL 1.00 X 0 222200 0 JOHN THISTLE 1.00 X X 0 0 0 JUDY ROACH 1.00 X 0 0 0 LEONOR ZIES 1.00 X 0 0 0 MADELINE CHILDS 1.00 X 0 0 0 MICHAEL BROWNLIE 1.00 X 0 0 0 MICHAEL D MEANS 1.00 X 0 1355789 51799 PATRICIA PRUITT 1.00 X X 0 0 0 ROBERT BRUCKART 1.00 X 0 0 0 ROBIN PETERSON 1.00 X X 0 0 0 STEPHEN BATCHELOR 1.00 X 0 0 0 R ROY WRIGHT 1.00 X 0 316146 137036 ROBERT CGALLOWAY 40.00 X 0 623587 43839 ROBERTA VANDUSEN 40.00 X 0 125452 12118 0 2643174 244792 0 0 1 0 HEALTH FIRST INC 3300 FISKE BLVD ROCKLEDGE FL 329554305 MANAGEMENT SUPPORT 6399779 HEALTH FIRST FOUNDATION INC 3300 FISKE BLVD ROCKLEDGE FL 329554305 FINANCIAL SUPPORT 145694 2 543536 543536 PATIENT SERVICE REVENU 624100 10157622 10157622 10157622 25667 25667 3194 3194 3194 3194 OTHER INCOME - CORPORA 900099 4946 4946 4946 10734965 10157622 0 33807 1558555 1558555 145521 145521 3058789 2890701 168088 142998 121403 21595 810382 688684 121698 258435 235214 23221 609 609 15830 15830 861071 814235 46836 18092 7048 11044 1075417 1065679 9738 669016 12709 656307 210445 209503 942 12453 12453 202332 182762 19570 92831 491 92340 28566 23831 4735 9161342 7810815 1350527 0 11735100 13805162 1559240 1051030 4562346 1269954 3444889 3292392 10437304 10462970 20536 18609 27197069 28630163 616808 594694 2604662 2157090 3221470 2751784 X 22555361 24113916 1420238 1764463 23975599 25878379 27197069 28630163 X 0 1 1 X 0 X 395726 267754 543536 1207016 10154059 10952774 11221391 11295466 10157622 53781312 10154059 11348500 11489145 11295466 10701158 54988328 0 0 0 54988328 433223 495858 350078 78715 28861 1386735 433223 495858 350078 78715 28861 1386735 35523 4946 40469 10587282 11844358 11839223 11409704 10734965 56415532 0.97470 0.02460 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 3730515 695874 3034641 16440 12916 3524 791891 561164 230727 23500 23500 3292392 DEMAND NOTE - HEALTH FIRST, INC. 10462970 C 10462970 DUE TO AFFILIATES 2144588 OTHER CURRENT LIABILITIES 12502 2157090 10734965 9161342 1573623 329156 329156 1902779 Part X: Description of Uncertain Tax Positions Under FIN 48: FIN 48 FOOTNOTE: THE PARENT AND ITS TAX-EXEMPT AFFILIATES ARE GENERALLY EXEMPT FROM FEDERAL AND STATE INCOME TAXES APPLICABLE UNDER SECTION 501(A), AS ORGANIZATIONS DESCRIBED IN SECTION 501(C)(3), OF THE INTERNAL REVENUE CODE AND SECTION 220.13 OF THE FLORIDA STATUTES, RESPECTIVELY. THE TAXABLE AFFILIATES, EXCEPT CHP, FILE A CONSOLIDATED INCOME TAX RETURN FOR BOTH FEDERAL AND STATE INCOME TAX PURPOSES. THE PROVISION FOR INCOME TAXES AND INCOME TAXES PAID INCLUDED IN THESE CONSOLIDATED FINANCIAL STATEMENTS IS NOT SIGNIFICANT. ASC TOPIC 740, INCOME TAXES, PRESCRIBES THE ACCOUNTING FOR UNCERTAINTY IN INCOME TAX POSITIONS RECOGNIZED IN FINANCIAL STATEMENTS. ASC TOPIC 740 PROVIDES GUIDANCE FOR RECOGNITION THRESHOLD AND MEASUREMENT ATTRIBUTES FOR THE FINANCIAL STATEMENT RECOGNITION AND MEASUREMENT OF A TAX POSITION TAKEN OR EXPECTED TO BE TAKEN IN A TAX RETURN. PART XI, LINE 8: CHANGE IN NET ASSETS - $329,156 1 HEALTH FIRST INC 3300 FISKE BLVD ROCKLEDGE FL 32955 593336894 501(C)(3) 1558555 SUPPORT TO PARENT 1 Procedure for Monitoring Grants in the U.S.: Part I, Line 2: Schedule I, Part I, Line 2: THE HOSPICE OF HEALTH FIRST BOARD MONITORS USAGE BY EACH ENTITY TO ASSURE FUNDS RAISED ARE USED APPROPRIATELY. 0 0 0 0 0 0 0 0 0 JOHN CAMPBELL 0 222200 0 0 0 0 0 0 0 0 0 222200 0 0 MICHAEL D MEANS 0 1340762 0 0 0 15027 0 32947 0 18852 0 1407588 0 1089 R ROY WRIGHT 0 302112 0 0 0 14034 0 119054 0 17982 0 453182 0 0 ROBERT CGALLOWAY 0 607946 0 0 0 15641 0 25996 0 17843 0 667426 0 8212 Supplemental Information Part III COMPENSATION IS PAID BY HEALTH FIRST, INC. EIN: 59-3336894 AND REIMBURSED BY HOSPICE OF HEALTH FIRST, INC. SALARY AND BENEFIT EXPENSES DISCLOSED IN PART IX IS ALLOCATED TO THIS ENTITY. BECAUSE COMPENSATION IS REPORTED ON A CALENDAR YEAR BASIS AND HOSPICE OF HEALTH FIRST, INC.'S YEAR END IS SEPTEMBER 30, 2010, A PORTION OF THE COMPENSATION REPORT IN COLUMNS (B) WAS REPORTED IN THE PRIOR YEAR. THE FILING ORGANIZATION RELIED ON HEALTH FIRST FOR ESTABLISHING THE TOP MANAGEMENT OFFICIAL'S COMPENSATION. SEE CORE 990, PART VI, SECTION B, NUMBER 15 FOR FURTHER INFORMATION REGARDING THE PROCESS UTILIZED. AMOUNTS REPORTED IN COLUMN F REPRESENT DEFERRED COMPENSATION PREVIOUSLY REPORTED ON PRIOR YEARS' FORM 990. JOHN CAMPBELL BOARD MEMBER 172200 DR. JOHN CAMPBELL RECEIVES PHYSICIAN REIMBURSEMENT FOR THE HOSPICE HOUSE VISITS MADE THROUGHOUT THE YEAR. 0 Form 990, Part VI, Section A, line 2 DUE TO OVERLAP OF BOARD MEMBERSHIP AND/OR EMPLOYMENT ON RELATED ENTITIES, THE FOLLOWING INDIVIDUALS HAVE/HAS A BUSINESS RELATIONSHIP: R. ROY WRIGHT ROBERT C. GALLOWAY Form 990, Part VI, Section A, line 3 HEALTH FIRST RELATED ENTITIES ROUTINELY DELEGATED VARIOUS MANAGMENT AND SUPPORT FUNCTION TO HEALTH FIRST, INC. THE PARENT COMPANY. Form 990, Part VI, Section A, line 6 THE SOLE MEMBER OF HOSPICE OF HEALTH FIRST, INC. IS HEALTH FIRST, INC., A FLORIDA NOT-FOR-PROFIT CORPORATION THAT SERVES AS THE CORPORATE PARENT OF THE HEALTH SYSTEM. Form 990, Part VI, Section A, line 7a HEALTH FIRST, INC. (HFI), A SECTION 501(C)(3) EXEMPT ORGANIZATION AND THE PARENT OF THE EXEMPT HEALTHCARE SYSTEM, IS THE SOLE CORPORATE MEMBER OF THE FILING ORGANIZATION. Form 990, Part VI, Section A, line 7b PER THE BYLAWS AND THE LAWS OF THE STATE OF FLORIDA, THE ADMINISTRATIVE POWER OF THE CORPORATION SHALL BE VESTED IN THE BOARD OF DIRECTORS WHICH SHALL HAVE CHARGE, CONTROL AND MANAGEMENT OF PROPERTY, AFFAIRS AND FUNDS OF THE CORPORATION. THE BOARD OF DIRECTORS SHALL NOT TAKE ANY ACTION WITH RESPECT TO THE FOLLOWING WITHOUT APPROVAL OF THE MEMBER. -CHANGE IN THE MISSION, PURPOSE OR SCOPE OF THE CORPORATION AND ITS OPERATION; -INCURRENCE OF LONG-TERM DEBT OR GUARANTEE THE DEBT OF ANOTHER; -APPROVAL OF THE SALE, LEASE, PURCHASE, CONVEYANCE OR OTHER DISPOSITION OF ANY REAL OR PERSONAL PROPERTY HAVING FMV IN EXCESS OF $1,000,000; -APPROVAL OF THE SALE, LEASE, PURCHASE, CONVEYANCE OR OTHER DISPOSITION OF THE ASSETS OF THE ORGANIZATION; -APPROVAL OF ANNUAL OPERATING AND CAPITAL EXPENDITURE BUDGETS; -APPOINTMENT OR ENGAGEMENT OF AUDITORS, LEGAL COUNSEL OR CONSULTANTS INVOLVING EXPENDITURES GREATER THAN $50,000 ANNUALLY; -APPROVAL OF CHANGES OF HUMAN RESOURCE, EMPLOYEE BENEFITS, ACCOUNTING, FINANCIAL AND OTHER POLICIES PROCEDURES; -APPROVAL OF STRATEGIC AND LONG-RANGE PLANS, MAJOR FUND RAISING PROGRAMS AND FINANCIAL COMMITMENTS GREATER THAN $1,000,000; -CREATION, ACQUISITION, SALE, PURCHASE DISSOLUTION OR OTHER DISPOSITION OF ANY AFFILIATED OR CONTROLLED ENTITY OR JOINT VENTURE; -RELOCATION, IMPLEMENTATION OR DISCONTINUATION OF A MAJOR PROGRAM SERVICE. Form 990, Part VI, Section A, line 8b THE BOARD OF DIRECTORS IS THE ONLY COMMITTEE RESIDING IN HOSPICE OF HEALTH FIRST, INC. ALL OTHER COMMITTEES BELONG TO HEALTH FIRST, INC. WHICH SERVES AS THE CORPORATE PARENT OF THE HEALTH SYSTEM. Form 990, Part VI, Section B, line 11 THE FORM 990 IS REVIEWED BY THE CHIEF FINANCIAL OFFICER AND ONCE APPROVED IT IS DISTRIBUTED TO ALL OF THE MEMBERS OF THE BOARD OF DIRECTORS FOR THEIR REVIEW AND APPROVAL. Form 990, Part VI, Section B, line 12c A COPY OF THE CONFLICT OF INTEREST POLICY IS PROVIDED TO ALL BOD MEMBERS, OFFICERS, MANAGEMENT, AND ASSOCIATES IN WHICH THEY REVIEW AND SIGN THAT THEY HAVE AGREED TO THE TERMS NOTED IN THE POLICY ON AN ANNUAL BASIS. IN ADDITION, ALL MANAGEMENT, OFFICERS, AND BOD MEMBERS ON AN ANNUAL BASIS ARE REQUIRED TO FILL OUT A CONFLICT OF INTEREST QUESTIONNAIRE PREPARED AND MONITORED BY THE CHIEF COMPLIANCE OFFICER. FORM 990, PART VI, SECTION B, LINE 15 OUR CEO AND THE HEALTH FIRST EXECUTIVES' SALARIES ARE REVIEWED AND RECOMMENDED ANNUALLY BY THE COMPENSATION COMMITTEE OF THE BOARD OF DIRECTORS AND APPROVED IN EXECUTIVE SESSION BY THE FULL BOARD OF HEALTH FIRST. THE COMPENSATION COMMITTEE CONTRACTS ANNUALLY WITH AN INDEPENDENT CONSULTANT TO ENSURE THAT OUR EXECUTIVES ARE COMPENSATED FAIRLY AND COMPETITIIVELY WHEN COMPARED TO SIMILAR ROLES IN OTHER HEALTHCARE ORGANIZATIONS NATIONALLY. THE COMPENSATION COMMITTEE IS INDEPENDENT FOR INTERNAL REVENUE CODE SECTION 4958 FOR THE INDIVIDUALS WHOSE SALARY IS REVIEWED. Form 990, Part VI, Section C, line 19 QUARTERLY AND ANNUALLY CONSOLIDATED FINANCIALS AND CONSOLIDATED STATISTICAL INFORMATION IS FILED ELECTRONICALLY ON WWW.DACBOND.COM AND IS AVAILABLE TO THE PUBLIC. IN ADDITION, ANY REQUESTS MADE TO THE CHIEF FINANCIAL OFFICER FOR THE ABOVE REFERENCED ITEMS ARE PROVIDED UPON REQUEST IN A TIMELY MANNER. A COPY OF THE CONFLICTS OF INTEREST POLICY AND GOVERNING DOCUMENTS IS AVAILABLE UPON REQUEST TO THE COMPLIANCE OFFICER. PART VII, SECTION A COMPENSATION PAID TO BOARD MEMBERS IS PRIMARILY FOR PROFESSIONAL RESPONSIBILTIES AS BOARD MEMBERS, ADMINISTRATORS, AND/OR PHYSICIANS OF A RELATED ORGANIZATION. PART VII, SECTION A, COLUMN E JOHN CAMPBELL PAYMENTS FOR PROFESSIONAL FEE'S CONSISTING OF: MEDICAL DIRECTOR FEES $50,000 PHYSICIAN PAYMENTS $172,200 FORM 990, PART XI, QUESTION 2B AUDITED FINANCIAL STATEMENT HOSPICE OF HEALTH FIRST, INC.'S FINANCIAL STATEMENTS WERE AUDITED BY AN INDEPENDENT PUBLIC ACCOUNTING FIRM AS PART OF THE CONSOLIDATED AUDIT OF HEALTH FIRST, INC. AND SUBSIDIARIES. FORM 990, PART XI, QUESTION 2C AUDITED FINANCIAL STATEMENT THE AUDIT COMMITTEE OF HEALTH FIRST REVIEWS AND APPROVES THE ANNUAL AUDIT AND COMPLIANCE AUDIT PLANS THEN MAKES ITS REPORT TO THE HEALTH FIRST BOARD OF DIRECTORS. THE AUDIT COMMITTEE IS RESPONSIBLE FOR THE SELECTION OF THE INDEPENDENT AUDITORS. THERE WAS NO CHANGE FROM PRIOR YEAR. FORM 990, PART V, QUESTION 2A NUMBER OF EMPLOYEES EMPLOYEES AT HOSPICE OF HEALTH FIRST, INC. ARE INCLUDED IN THE FORM 941 FILED BY HEALTH FIRST, INC. EIN: 59-3336894, WHICH SERVES AS COMMON PAY AGENT. FORM 990, SCHEDULE R, PART V SCHEDULE R DISCLOSURES ALL TRANSACTIONS REPORTED IN THIS SECTION ARE BASED UPON CORPORATE BOOKS AND RECORDS WHICH ARE KEPT ACCORDING TO GENERALLY ACCEPTED ACCOUNTING STANDARDS. HOLMES REGIONAL MEDICAL CENTER INC 3300 FISKE BLVD ROCKLEDGE FL 329554305 590624371 HOSPITAL FL 501(C)(3) 3 N/A CAPE CANAVERAL HOSPITAL INC 3300 FISKE BLVD ROCKLEDGE FL 329554305 592477479 HOSPITAL FL 501(C)(3) 3 N/A HEALTH FIRST FOUNDATION INC 3300 FISKE BLVD ROCKLEDGE FL 329554305 593528774 FUNDRAISING FL 501(C)(3) 7 N/A HEALTH FIRST INC 3300 FISKE BLVD ROCKLEDGE FL 329554305 593336894 SUPPORT ORG. FL 501(C)(3) 11 TYPE III N/A HEALTH FIRST HOLDING COMPANY & SUBS 3300 FISKE BLVD ROCKLEDGE FL 329554305 593509709 HOLDING CORP. FL N/A C CAPE HEALTH PROPERTIES 3300 FISKE BLVD ROCKLEDGE FL 329554305 593086711 REAL ESTATE FL N/A C 0 1 1 0 0 0 0 0 0 1 1 1 0 0 1 0 0 0 HEALTH FIRST FOUNDATION INC C 543536 CAPE HEALTH PROPERTIES J 11605 HEALTH FIRST HEALTH PLANS K 12881 HEALTH FIRST FOUNDATION INC L 145694 HEALTH FIRST INC L 670410 HOLMES REGIONAL MEDICAL CENTER INC O 57635 HEALTH FIRST INC O 5729369 CAPE CANAVERAL HOSPITAL INC O 7726 CAPE HEALTH PROPERTIES O 967 HEALTH FIRST PHYSICIANS INC O 8050 HOLMES REGIONAL ENTERPRISES O 26594 HEALTH FIRST INC B 1558555