2024-05-15T10:15:18-05:00 2023-06-30 941239084 ATHERTON & ASSOCIATES LLP PO BOX 4339 MODESTO CA 953524339 990 2022-07-01 942497618 HOSPICE OF SANTA CRUZ COUNTY HOSP 8314303000 940 DISC DRIVE SCOTTS VALLEY CA 95066 ADAM SHORE CFO 8314303000 2024-05-13 1 ADAM SHORE 999009999 1 JACQUELYN HOWELL P01327223 2095774800 X 2 AAL1 IAL1 2022 2023-04-26 12:10:37Z ADAM SHORE 940 DISC DRIVE SCOTTS VALLEY CA 95066 23675630 0 X HOSPICESANTACRUZ.ORG X 1978 CA HOSPICE SERVICE AND SUPPORT FOR TERMINAL PATIENTS AND THEIR FAMILIES. 14 14 170 130 0 0 1268698 3985146 17950638 19623892 10621 14691 60582 29375 19290539 23653104 0 0 0 0 14699094 14235605 0 0 490299 7664671 8898290 22363765 23133895 -3073226 519209 12203092 10514492 4311272 2085780 7891820 8428712 HOSPICE SERVICE AND SUPPORT FOR TERMINAL PATIENTS AND THEIR FAMILIES. 0 0 14162529 0 19623892 953 PATIENTS AND FAMILIES RECEIVED 61,725 DAYS OF EXPERT END-OF-LIFE CARE FROM HOSPICE TEAMS OF MEDICAL DIRECTORS, NURSES, SOCIAL WORKERS, CHAPLAINS, HOSPICE AIDES, AND VOLUNTEERS. ADDITIONALLY, 3,162 INDIVIDUAL GRIEF SUPPORT SESSIONS AND 138 GROUP GRIEF SUPPORT SESSIONS WERE PROVIDED TO HOSPICE FAMILIES AND GRIEVING COMMUNITY MEMBERS OF ALL AGES. 14162529 1 1 0 0 0 0 0 0 0 1 1 1 0 1 1 1 1 0 0 0 0 0 0 0 1 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 63 0 170 1 0 0 0 0 0 0 0 0 0 0 0 0 X 14 14 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 CA X ADAM SHORE 8314303000 940 DISC DRIVE SCOTTS VALLEY CA 95066 JULIA COWELL RN PHD PRESIDENT 5.00 X X 0 0 0 KATHERINE GABRIEL-COX MD VICE PRESIDENT 2.00 X X 0 0 0 CARA DESIMONE SECRETARY 1.00 X X 0 0 0 RICHARD CLARK TREASURER 5.00 X X 0 0 0 SHARON TAPPER MD DIRECTOR 1.00 X 0 0 0 MICHAEL ALLARD DIRECTOR 1.00 X 0 0 0 DAISY NUNEZ DIRECTOR 1.00 X 0 0 0 SIGOLENE A ORTEGA DIRECTOR 1.00 X 0 0 0 DEAN AUSTIN DIRECTOR 1.00 X 0 0 0 SUSAN MACMILLAN DIRECTOR 1.00 X 0 0 0 CHRIS MAFFIA DIRECTOR 1.00 X 0 0 0 OWEN BROWN DIRECTOR 1.00 X 0 0 0 JAMES WILLIAM MCGOWAN DIRECTOR 1.00 X 0 0 0 BONNIE LANGE DIRECTOR 1.00 X 0 0 0 CATHY CONWAY CHIEF EXECUTIVE OFFICER 40.00 X 286721 0 16523 ADAM SHORE CHIEF FINANCIAL OFFICER 40.00 X 218386 0 14147 KARL SEGNITZ CHIEF MEDICAL OFFICER 40.00 X 333058 0 15496 JUDITH HUMBLE CHIEF COMPLIANCE OFFICER 40.00 X 179046 0 14568 SARAH PAEZ DIRECTOR OF NURSING 40.00 X 155111 0 11059 DIANE SYRCLE CHIEF MISSION OFFICER 40.00 X 175932 0 14408 ANGELA BROUSE ADMISSIONS NURSE 40.00 X 183416 0 3594 1531670 0 89795 40 0 1 0 ALLEN BUENO DEL BOSQUE 311 33RD AVE SANTA CRUZ CA 95062 PHYSICIAN 214375 BONNY MASTERS 634 SAN JUAN AVENUE SANTA CRUZ CA 95065 PHYSICIAN 163772 2 78110 2677180 1229856 280 3985146 HOSPICE SERVICES 621610 19623892 19623892 19623892 14691 14691 51901 78110 22526 29375 29375 23653104 19623892 0 44066 X 600165 600165 11241056 6919452 4033355 288249 1210851 671873 494279 44699 1183533 756808 403643 23082 21896 21896 112166 112166 35356 35356 2323867 1699272 607811 16784 237351 55 225256 12040 170722 2556 148197 19969 241988 241988 250519 214280 32015 4224 72140 19541 17827 34772 31465 10703 20762 270104 270104 183376 183376 ROOM & BOARD 1549313 1549313 PATIENT RELATED 1541859 1541859 BAD DEBT EXPENSE 648650 648650 COMPUTER SUPPORT 602004 8353 568958 24693 605514 130517 473972 1025 23133895 14162529 8481067 490299 462169 609430 3037138 914321 113764 0 1984266 2045018 303749 292624 5228302 2968759 2369657 2259543 3287197 3425384 159990 0 485162 968172 12203092 10514492 1181499 1416725 194503 163899 2935270 505156 4311272 2085780 X 7170797 7752815 721023 675897 7891820 8428712 12203092 10514492 519209 297317 -279634 0 X 0 1 X 1 0 X 1808791 1106587 2825299 1268698 3985146 10994521 1808791 1106587 2825299 1268698 3985146 10994521 777290 10217231 97561 52065 45248 6576 14691 216141 47477 26862 8771 60582 143692 11354354 98156143 0.89990 0.84310 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 698070 -69932 8811 619327 635181 62889 698070 511407 133480 9706 635181 535980 -17237 7336 511407 530022 15146 9188 535980 0.29430 0.70570 0.00000 0 0 565980 565980 2658159 1329326 1328833 541874 358735 183139 370583 337901 32682 1091706 942797 148909 2259543 ENDOWED AGENCY FUND HELD AT COMMUNITY FOUNDATION OF SCC 619327 F NON ENDOWED AGENCY FUND HELD AT COMMUNITY FOUNDATION OF SCC 2806057 F 3425384 DEPOSITS 22804 SELF-INSURANCE RESERVE 192984 OTHER RECEIVABLES 440212 OPERATING LEASE RIGHT-OF-USE ASSETS 29691 DEFERRED COMPENSATION ASSETS 282481 968172 SELF-INSURANCE LIABILITY 192984 OPERATING LEASE LIABILITIES 29691 DEFERRED COMPENSATION LIABILITY 282481 505156 X 23986066 297317 35645 332962 23653104 0 23653104 23169540 35645 35645 23133895 0 23133895 PART V, LINE 4: THE ORGANIZATION'S ENDOWMENT FUNDS CONSIST OF FUNDS ESTABLISHED FOR A VARIETY OF PURPOSES TO SUPPORT THE ORGANIZATION'S PROGRAMS. THE ORGANIZATION HAS A POLICY OF CLASSIFYING INVESTMENT INCOME ON THE ENDOWMENT FUNDS AS TEMPORARILY RESTRICTED UNTIL SUCH TIME AS SPECIFICALLY BUDGETED FOR SPENDING AND APPROVED BY THE BOARD. PART X, LINE 2: MANAGEMENT HAS EVALUATED HOSPICE'S TAX POSITIONS AND CONCLUDED THAT HOSPICE HAD TAKEN NO UNCERTAIN TAX POSITIONS THAT REQUIRE ADJUSTMENT TO THE FINANCIAL STATEMENTS. THEREFORE, NO PROVISION OR LIABILITY FOR INCOME TAXES HAS BEEN INCLUDED IN THE FINANCIAL STATEMENTS. HOSPICE IS NO LONGER SUBJECT TO INCOME TAX EXAMINATIONS BY THE U.S. FEDERAL, STATE, OR LOCAL TAX AUTHORITIES FOR TAX YEARS ENDING JUNE 30, 2019 AND PRIOR. PART XI, LINE 2D - OTHER ADJUSTMENTS: IN-KIND INCOME 35,645. PART XII, LINE 2D - OTHER ADJUSTMENTS: IN-KIND EXPENSES 35,645. FAIRWAYS FOR KIDS GOLF TOURNAMENT 130011 78110 51901 22526 130011 78110 51901 22526 22526 29375 X X X X X X 0 0 0 0 0 0 0 0 0 KARL SEGNITZ CHIEF MEDICAL OFFICER 333058 0 0 0 0 0 4048 0 11448 0 348554 0 0 0 CATHY CONWAY CHIEF EXECUTIVE OFFICER 286721 0 0 0 0 0 4050 0 12473 0 303244 0 0 0 ADAM SHORE CHIEF FINANCIAL OFFICER 218386 0 0 0 0 0 2699 0 11448 0 232533 0 0 0 JUDITH HUMBLE CHIEF COMPLIANCE OFFICER 179046 0 0 0 0 0 3120 0 11448 0 193614 0 0 0 DIANE SYRCLE CHIEF MISSION OFFICER 175932 0 0 0 0 0 4019 0 10389 0 190340 0 0 0 ANGELA BROUSE ADMISSIONS NURSE 183416 0 0 0 0 0 3075 0 519 0 187010 0 0 0 SARAH PAEZ DIRECTOR OF NURSING 155111 0 0 0 0 0 698 0 10361 0 166170 0 0 0 FORM 990, PART VI, SECTION A, LINE 6 THE SOLE MEMBER IS CALIFORNIA HOSPICE NETWORK, A CALIFORNIA NONPROFIT PUBLIC BENEFIT CORPORATION. FORM 990, PART VI, SECTION A, LINE 7A THE ORGANIZATION'S SOLE MEMBER IS CALIFORNIA HOSPICE NETWORK. THE ORGANIZATION ELECTS DIRECTORS, WHO ARE APPROVED BY THE MEMBER. FORM 990, PART VI, SECTION A, LINE 7B THE ORGANIZATION'S BYLAWS INCLUDE CERTAIN POWERS RESERVED BY MEMBER, WHICH INCLUDE APPOINTMENT OF THE ORGANIZATION'S DIRECTORS AND CEO, APPROVAL OF THE ANNUAL OPERATING BUDGET, AND ANY ACTION TO MERGE, DISSOLVE OR SELL SUBSTANTIALLY ALL OF THE ASSETS OF THE ORGANIZATION. FORM 990, PART VI, SECTION B, LINE 11B THE CFO AND CEO REVIEW THE FORM 990 WHEN COMPLETED BY THE CPA FIRM. A COPY OF THE FORM 990 IS FURNISHED TO THE FINANCE COMMITTEE AND TO THE BOARD OF DIRECTORS BEFORE IT IS FILED. FORM 990, PART VI, SECTION B, LINE 12C THE PURPOSE OF THE CONFLICT OF INTEREST POLICY IS TO PROTECT HSCC'S INTEREST WHEN IT IS CONTEMPLATING ENTERING INTO A TRANSACTION OR ARRANGEMENT THAT MIGHT BENEFIT THE PRIVATE INTEREST OF AN OFFICER OR DIRECTOR OF THE ORGANIZATION. OFFICERS AND DIRECTORS REVIEW AND SIGN AN ANNUAL STATEMENT INDICATING UNDERSTANDING AND ADHERENCE TO THE POLICY. FORM 990, PART VI, SECTION B, LINE 15 MARKET DATA ON SALARIES FOR CEO AND CFO POSITIONS IN THE HEALTHCARE AND HOSPICE FIELD IS COMPILED AND REVIEWED ANNUALLY BY THE HR DIRECTOR. A REPORT CONSIDERING MARKET AND GEOGRAPHIC FACTORS WAS PRESENTED TO THE ORGANIZATION'S COMPENSATION COMMITTEE, WHICH REVIEWS AND RECOMMENDS ANY SALARY ADJUSTMENT TO THE FULL BOARD OF DIRECTORS. THE BOARD OF DIRECTORS REVIEW AND VOTE ON PROPOSED SALARY CHANGES. FORM 990, PART VI, SECTION C, LINE 19 ALL GOVERNING DOCUMENTS, POLICIES, AND ANNUAL FORM 990 ARE AVAILABLE TO THE PUBLIC UPON REQUEST. ANNUAL FINANCIAL RESULTS ARE PUBLISHED IN THE ORGANIZATION'S ANNUAL REPORT. FORM 990, PART IX, LINE 11G OTHER PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 1,699,272. MANAGEMENT AND GENERAL EXPENSES 607,811. FUNDRAISING EXPENSES 16,784. TOTAL EXPENSES 2,323,867. CALIFORNIA HOSPICE NETWORK 66 BOVET RD SUITE 100 SAN MATEO CA 94402 834716484 TO PROVIDE HOSPICE SUPPORT, ADMIN, PROGRAMMATIC AND OTHER SUPPORT CA 501(C)(3) 509(A)(3) N/A 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0