Attach to Form 990 or Form 990-EZ.
Information about Schedule A (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.
| (i)Name of supported organization | (ii) EIN | (iii) Type of organization (described on lines 1- 9 above (see instructions)) | (iv) Is the organization listed in your governing document? | (v) Amount of monetary support (see instructions) | (vi) Amount of other support (see instructions) | |
|---|---|---|---|---|---|---|
| Yes | No | |||||
| Total | ||||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2011 | (b) 2012 | (c) 2013 | (d) 2014 | (e) 2015 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 1 | Gifts, grants, contributions, and membership fees received. (Do not include any unusual grants.) .... | ||||||
| 2 | Tax revenues levied for the organization's benefit and either paid to or expended on its behalf....... | ||||||
| 3 | The value of services or facilities furnished by a governmental unit to the organization without charge.. | ||||||
| 4 | Total. Add lines 1 through 3 | ||||||
| 5 | The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included on line 1 that exceeds 2% of the amount shown on line 11, column (f).. | ||||||
| 6 | Public support. Subtract line 5 from line 4. | ||||||
Calendar year
(or fiscal year beginning in) ![]() |
(a) 2011 | (b) 2012 | (c) 2013 | (d) 2014 | (e) 2015 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 7 | Amounts from line 4.. | ||||||
| 8 | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources... | ||||||
| 9 | Net income from unrelated business activities, whether or not the business is regularly carried on.. | ||||||
| 10 | Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.).. | ||||||
| 11 | Total support. Add lines 7 through 10. | ||||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2011 | (b) 2012 | (c) 2013 | (d) 2014 | (e) 2015 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 1 | Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") . | 4,311,172 | 3,226,635 | 656,384 | 2,515,170 | 2,132,613 | 12,841,974 |
| 2 | Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose...... | 87,644,487 | 88,444,643 | 22,246,502 | 87,343,671 | 80,910,382 | 366,589,685 |
| 3 | Gross receipts from activities that are not an unrelated trade or business under section 513... | 46,721 | 0 | 0 | 0 | 0 | 46,721 |
| 4 | Tax revenues levied for the organization's benefit and either paid to or expended on its behalf... | 0 | |||||
| 5 | The value of services or facilities furnished by a governmental unit to the organization without charge.. | 0 | |||||
| 6 | Total. Add lines 1 through 5. | 92,002,380 | 91,671,278 | 22,902,886 | 89,858,841 | 83,042,995 | 379,478,380 |
| 7a | Amounts included on lines 1, 2, and 3 received from disqualified persons... | 0 | 0 | 0 | 0 | 0 | 0 |
| b | Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year. | 0 | 0 | 0 | 0 | 0 | 0 |
| c | Add lines 7a and 7b.. | 0 | 0 | 0 | 0 | 0 | 0 |
| 8 | Public support. (Subtract line 7c from line 6.) | 379,478,380 | |||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2011 | (b) 2012 | (c) 2013 | (d) 2014 | (e) 2015 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 9 | Amounts from line 6... | 92,002,380 | 91,671,278 | 22,902,886 | 89,858,841 | 83,042,995 | 379,478,380 |
| 10a | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources.. | 16 | 0 | 0 | 0 | 0 | 16 |
| b | Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975. | 0 | |||||
| c | Add lines 10a and 10b. | 16 | 0 | 0 | 0 | 0 | 16 |
| 11 | Net income from unrelated business activities not included in line 10b, whether or not the business is regularly carried on. | 0 | |||||
| 12 | Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.) .. | 140,384 | 9,996 | 9,597 | 10,633 | 1,700 | 172,310 |
| 13 | Total support. (Add lines 9, 10c, 11, and 12.).. | 92,142,780 | 91,681,274 | 22,912,483 | 89,869,474 | 83,044,695 | 379,650,706 |
| Section A - Adjusted Net Income | (A) Prior Year |
(B) Current Year (optional) |
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| 1 | Net short-term capital gain | 1 | ||||
| 2 | Recoveries of prior-year distributions | 2 | ||||
| 3 | Other gross income (see instructions) | 3 | ||||
| 4 | Add lines 1 through 3 | 4 | ||||
| 5 | Depreciation and depletion | 5 | ||||
| 6 | Portion of operating expenses paid or incurred for production or collection of gross income or for management, conservation, or maintenance of property held for production of income (see instructions) | 6 | ||||
| 7 | Other expenses (see instructions) | 7 | ||||
| 8 | Adjusted Net Income (subtract lines 5, 6 and 7 from line 4) | 8 | ||||
| Section B - Minimum Asset Amount | (A) Prior Year |
(B) Current Year (optional) |
||||
| 1 | Aggregate fair market value of all non-exempt-use assets (see instructions for short tax year or assets held for part of year): | 1 | ||||
| a | Average monthly value of securities | 1a | ||||
| b | Average monthly cash balances | 1b | ||||
| c | Fair market value of other non-exempt-use assets | 1c | ||||
| d | Total (add lines 1a, 1b, and 1c) | 1d | ||||
| e |
Discount claimed for blockage or other factors (explain in detail in Part VI): |
|||||
| 2 | Acquisition indebtedness applicable to non-exempt use assets | 2 | ||||
| 3 | Subtract line 2 from line 1d | 3 | ||||
| 4 | Cash deemed held for exempt use. Enter 1-1/2% of line 3 (for greater amount, see instructions). | 4 | ||||
| 5 | Net value of non-exempt-use assets (subtract line 4 from line 3) | 5 | ||||
| 6 | Multiply line 5 by .035 | 6 | ||||
| 7 | Recoveries of prior-year distributions | 7 | ||||
| 8 | Minimum Asset Amount (add line 7 to line 6) | 8 | ||||
| Section C - Distributable Amount | Current Year | |||||
| 1 | Adjusted net income for prior year (from Section A, line 8, Column A) | 1 | ||||
| 2 | Enter 85% of line 1 | 2 | ||||
| 3 | Minimum asset amount for prior year (from Section B, line 8, Column A) | 3 | ||||
| 4 | Enter greater of line 2 or line 3 | 4 | ||||
| 5 | Income tax imposed in prior year | 5 | ||||
| 6 | Distributable Amount. Subtract line 5 from line 4, unless subject to emergency temporary reduction (see instructions) | 6 | ||||
| Section D - Distributions | Current Year | |
|---|---|---|
| 1 Amounts paid to supported organizations to accomplish exempt purposes | ||
|
2
Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in excess of income from activity |
||
| 3 Administrative expenses paid to accomplish exempt purposes of supported organizations | ||
| 4 Amounts paid to acquire exempt-use assets | ||
| 5 Qualified set-aside amounts (prior IRS approval required) | ||
| 6 Other distributions (describe in Part VI). See instructions | ||
| 7Total annual distributions. Add lines 1 through 6. | ||
|
8
Distributions to attentive supported organizations to which the organization is responsive (provide details in Part VI). See instructions |
||
| 9 Distributable amount for 2015 from Section C, line 6 | ||
| 10 Line 8 amount divided by Line 9 amount | ||
| Section E - Distribution Allocations (see instructions) |
(i) Excess Distributions |
(ii) Underdistributions Pre-2015 |
(iii) Distributable Amount for 2015 |
|
|---|---|---|---|---|
|
1
Distributable amount for 2015 from Section C, line 6 |
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|
2
Underdistributions, if any, for years prior to 2015 (reasonable cause required--see instructions) |
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| 3 Excess distributions carryover, if any, to 2015: | ||||
| a | ||||
| b | ||||
| c | ||||
| d From 2013....... | ||||
| e From 2014....... | ||||
| fTotal of lines 3a through e | ||||
| g Applied to underdistributions of prior years | ||||
| h Applied to 2015 distributable amount | ||||
|
i
Carryover from 2010 not applied (see instructions) |
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| j Remainder. Subtract lines 3g, 3h, and 3i from 3f. | ||||
| 4Distributions for 2015 from Section D, line 7: | ||||
| $ | ||||
| a Applied to underdistributions of prior years | ||||
| b Applied to 2015 distributable amount | ||||
| c Remainder. Subtract lines 4a and 4b from 4. | ||||
|
5
Remaining underdistributions for years prior to 2015, if any. Subtract lines 3g and 4a from line 2 (if amount greater than zero, see instructions) |
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|
6
Remaining underdistributions for 2015. Subtract lines 3h and 4b from line 1 (if amount greater than zero, see instructions) |
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|
7 Excess distributions carryover to 2016. Add lines 3j and 4c. |
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| 8 Breakdown of line 7: | ||||
| a | ||||
| b | ||||
| c Excess from 2013....... | ||||
| d From 2014....... | ||||
| e From 2015....... | ||||
| Facts And Circumstances Test |
|---|
| Return Reference | Explanation |
|---|---|
| Schedule A, Part III, Line 12 Other Income | DESCRIPTION - OTHER INCOME, COLUMN A - 140384.0, COLUMN B - 9996.0, COLUMN C - 9597.0, COLUMN D - 10633.0, COLUMN E - 1700.0, COLUMN F - 172310.0; |
| Software ID: | 15000238 |
| Software Version: | 2015v2.1 |
Attach to Form 990 or 990-EZ.
Information about Schedule O (Form 990 or 990-EZ) and its instructions is at| Return Reference | Explanation |
|---|---|
| Form 990, Part III, Line 1 Organization's Mission | (continued from part III) HPBC provides a coordinated, comprehensive program including physical, psychosocial, spiritual, music, and bereavement support to terminally ill patients and their families in Palm Beach County, Florida. |
| Form 990, Part VI, Line 15a PROCESS FOR DETERMINING COMPENSATION OF TOP MANAGEMENT OFFICIAL | THE CEO IS PAID BY TRUSTBRIDGE, INC., A RELATED TAX-EXEMPT ORGANIZATION. TRUSTBRIDGE, INC. USES A COMPENSATION COMMITTEE, COMPARABILITY DATA, AN INDEPENDENT COMPENSATION CONSULTANT, AND APPROVAL BY THE BOARD, TO DETERMINE THE COMPENSATION. THIS REVIEW LAST TOOK PLACE IN MArch 2015 AND IS DOCUMENTED IN THE BOARD AND COMMITTEE MINUTES. BECAUSE COMPENSATION IS DETERMINED BY A RELATED ENTITY , THIS QUESTION IS ANSWERED "NO" IN ACCORDANCE WITH FORM 990 INSTRUCTIONS. |
| Form 990, Part VI, Line 15b COMPENSATION PAID TO OTHER OFFICERS | the compensation of ALL OTHER OFFICERS is determined by THE CEO OF TRUSTBRIDGE, inc., a related organization. THE CEO USES COMPARABILITY DATA and AN INDEPENDENT COMPENSATION CONSULTANT TO DETERMINE THE COMPENSATION. THE DECISIONS ARE DOCUMENTED IN EACH EMPLOYEE'S FILE. |
| Form 990, Part VI, Line 6 Classes of members or stockholders | The sole member of Hospice of Palm Beach County, Inc. shall be TrustBridge, Inc. (sole member), a related tax-exempt organization. |
| Form 990, Part VI, Line 7a Members or stockholders electing members of governing body | At the annual meeting, the Sole Member shall elect members of the Board of Directors and transact such other business as may properly be brought before the meeting. The Directors shall be elected to serve a three (3) year term, or until such Director submits his or her written resignation to the Chairperson of the Corporation. Any Director may be removed, with or without cause, by the sole member at the meeting of the sole member, or by the affirmative vote of two-thirds (2/3) of the Directors then in office. The sole member shall not have any form of equity or ownership interest in the organization or any right, title or interest in its assets at any time during the course of its active operation. All rights of the person or entity designated as Sole Member shall cease on the termination of the Sole Membership. Only the sole member shall be entitled to share in the distribution of corporate assets upon any dissolution of the organization. |
| Form 990, Part VI, Line 7b Decisions requiring approval by members or stockholders | The sole member has the right to approve decisions of the Board. |
| Form 990, Part VI, Line 11b Review of form 990 by governing body | THE FORM 990 IS PREPARED AND INITIALLY REVIEWED BY THE VP OF FINANCE AND THE TAX ACCOUNTING FIRM. WHEN A FINAL DRAFT IS READY, IT IS SENT TO THE AUDIT COMMITTEE OF THE BOARD OF DIRECTORS FOR FINAL REVIEW AND APPROVAL. THE AUDIT COMMITTEE THEN PRESENTS THE 990 TO THE FULL BOARD OF DIRECTORS FOR APPROVAL, AFTER WHICH THE 990 IS FILED WITH THE IRS. |
| Form 990, Part VI, Line 12c Conflict of interest policy | The organization sends out the conflict of interest questionnaires to board members and officers annually. The responses to the questionnaires are monitored and collected by the VP of Finance. Should a conflict exist the person with the conflict will abstain from voting on the issue in question. |
| Form 990, Part VI, Line 19 Required documents available to the public | Financial statements, governing documents, and conflict of interest policies are not required disclosures pursuant to Internal Revenue Code (IRC) Section 6104. These documents are not available to the public at this time. |
| Form 990, Part VII, Section A ADDITIONAL INFORMATION REGARDING COMPENSATION | David Fielding Mr. Fielding serves as CEO for TrustBridge, Inc., Hospice of Palm Beach County, hospice by the sea, inc., Focus Care Home Health, Inc., Harbor Palliative Care Services, Inc. and The Medical Store, Inc. His time is shared by all entities. Other Compensation is for his employee health and retirement benefits which are under the same plans provided to all employees. In addition the organization offers a 457f retirement plan for Management and officers. Randy Prange Mr. Prange serves as COO for TrustBridge, Inc, Hospice of Palm Beach County, Hospice BY THE SEA, INC., Focus Care Home Health, Inc., Harbor Palliative Care Services, Inc. and The Medical Store, Inc. His time is shared equally by all entities. Other Compensation is for his employee health and retirement benefits which are under the same plans provided to all employees. In addition the organization offers a 457f retirement plan for Management and officers. Richard Calcote Mr. Calcote served as the CFO for TrustBridge, Inc, Hospice of Palm Beach County Foundation, Inc., Hospice of Palm Beach County, Hospice BY THE SEA, INC., HOSPICE BY THE SEA FOUNDATION, INC., Focus Care Home Health, Inc., Harbor Palliative Care Services, Inc. and The Medical Store. His time was shared equally by all entities. Other Compensation is for his employee health and retirement benefits which are under the same plans provided to all employees. In addition the organization offers a 457f retirement plan for Management and officers. Mr. Calcote is no longer with the organization. PEDRO A. HERRERA Mr. HERRERA serves as the VP OF FINANCE for TrustBridge, Inc, Hospice of Palm Beach County Foundation, Inc., Hospice of Palm Beach County, Hospice BY THE SEA, INC., HOSPICE BY THE SEA FOUNDATION, INC., Focus Care Home Health, Inc., Harbor Palliative Care Services, Inc. and The Medical Store. His time is shared equally by all entities. Other Compensation is for his employee health and retirement benefits which are under the same plans provided to all employees. Dr. Faustino Gonzalez, M.D. Dr. Gonzalez serves as a Chief Medical Officer for TrustBridge, Inc., Hospice of Palm Beach County and Hospice by The Sea, Inc. His time is shared equally by all entities. A portion of his Compensation is from his Physician Fees for Service. Other Compensation is for his employee health and retirement benefits which are under the same plans provided to all employees. In addition the organization offers a 457f retirement plan for Management and officers. Fred Watson Mr. Watson serves as CHRO for TrustBridge, Inc, Hospice of Palm Beach County, HOSPICE BY THE SEA, INC., Focus Care Home Health, Inc. AND Harbor Palliative Care Services, Inc. His time is shared equally by all entities. Other Compensation is for his employee health and retirement benefits which are under the same plans provided to all employees. In addition the organization offers a 457f retirement plan for Management and officers. Amy CANNIZZO-Brennan MRs. Cannizzo-Brennan serves as the VP SUSTAINING INNOVATION for TrustBridge, Inc., Hospice of Palm Beach County AND HOSPICE BY THE SEA, INC. Her time is shared equally by all entities. Other Compensation is for her employee health and retirement benefits which are under the same plans provided to all employees. In addition the organization offers a 457f retirement plan for Management and officers. PAULA ALDERSON. Mrs. Alderson served as a president for TrustBridge, Inc., Hospice of Palm Beach County, Hospice by the Sea, inc., hospice by the sea foundation, inc., Focus Care Home Health, Inc., and Harbor Palliative Care Services, Inc. Her time was shared equally by all entities. Other Compensation is for her employee health and retirement benefits which are under the same plans provided to all employees. In addition the organization offers a 457f retirement plan for Management and officers. Mrs. Alderson is no longer with the organization. JAQUELINE DEVINE Mrs. DEVINE serves as the Chief Clinical officer for Hospice by the Sea, Inc. AND Hospice of Palm Beach County. Her time is provided equally to all entities. Other Compensation is for her employee health and retirement benefits which are under the same plans provided to all employees. Gail Cooney Mrs. Cooney serves as the Vice president of Access for Hospice by the Sea, Inc. AND Hospice of Palm Beach County. Her time is provided equally to all entities. Other Compensation is for her employee health and retirement benefits which are under the same plans provided to all employees. In addition the organization offers a 457f retirement plan for Management and officers. DOMINIQUE CAMPBELL Mrs. Campbell serves as the Vice president of Access SERVICES for Hospice by the Sea, Inc., TRUSTBRIDGE, INC. AND Hospice of Palm Beach County. Her time is provided equally to all entities. Other Compensation is for her employee health and retirement benefits which are under the same plans provided to all employees. In addition the organization offers a 457f retirement plan for Management and officers. RAYMOND ZELHOF Mr. ZELHOF serves as the DIRECTOR OF PharmacY SERVICES FOR Hospice of Palm Beach County. His time is provided equally to all entities. Other Compensation is for his employee health and retirement benefits which are under the same plans provided to all employees. HENRY RESNIK Ms. Resnik serves as the Pharmacist for Hospice of Palm Beach County. Other Compensation is for hIS employee health and retirement benefits which are under the same plans provided to all employees. STEVEN WHYTE Mr. WHYTE serves as the Pharmacist for Hospice of Palm Beach County. Other Compensation is for hIS employee health and retirement benefits which are under the same plans provided to all employees. CRYSTAL GATES Ms. GATES serves as the Pharmacist for Hospice of Palm Beach County. Other Compensation is for her employee health and retirement benefits which are under the same plans provided to all employees. EILEEN DELROSARIO Ms. DELROSARIO serves as the SENIOR DIRECTOR OF CARE CONNECTION for Hospice of Palm Beach County. Other Compensation is for her employee health and retirement benefits which are under the same plans provided to all employees. |
| Form 990, Part XI, Line 9 Other changes in net assets or fund balances | Change in Interest in Net Assets of HFPBC - 827189; Net Asset Transfer from Affiliates - 7000000; |
| Software ID: | 15000238 |
| Software Version: | 2015v2.1 |