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.") . | 1,234,859 | 388,839 | 384,646 | 98,663 | 75,365 | 2,182,372 |
| 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...... | 19,299,805 | 17,084,730 | 18,589,030 | 20,838,964 | 20,647,130 | 96,459,659 |
| 3 | Gross receipts from activities that are not an unrelated trade or business under section 513... | 0 | |||||
| 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. | 20,534,664 | 17,473,569 | 18,973,676 | 20,937,627 | 20,722,495 | 98,642,031 |
| 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.) | 98,642,031 | |||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2011 | (b) 2012 | (c) 2013 | (d) 2014 | (e) 2015 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 9 | Amounts from line 6... | 20,534,664 | 17,473,569 | 18,973,676 | 20,937,627 | 20,722,495 | 98,642,031 |
| 10a | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources.. | 13,382 | 11,458 | 6,936 | 5,895 | 9,166 | 46,837 |
| b | Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975. | 0 | |||||
| c | Add lines 10a and 10b. | 13,382 | 11,458 | 6,936 | 5,895 | 9,166 | 46,837 |
| 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.) .. | 0 | 817,757 | 880,435 | 868,443 | 825,447 | 3,392,082 |
| 13 | Total support. (Add lines 9, 10c, 11, and 12.).. | 20,548,046 | 18,302,784 | 19,861,047 | 21,811,965 | 21,557,108 | 102,080,950 |
| 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 - THRIFT SHOP REVENUE, COLUMN A - 0.0, COLUMN B - 814602.0, COLUMN C - 880435.0, COLUMN D - 868443.0, COLUMN E - 825447.0, COLUMN F - 3388927.0; DESCRIPTION - OTHER INCOME, COLUMN A - 0.0, COLUMN B - 3155.0, COLUMN C - 0.0, COLUMN D - 0.0, COLUMN E - 0.0, COLUMN F - 3155.0; |
| Software ID: | 15000238 |
| Software Version: | 2015v3.0 |
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) HOSPICE RECOGNIZES DYING AS A NORMAL PROCESS. HOSPICE EXISTS IN THE HOPE AND BELIEF THAT THROUGH APPROPRIATE CARE AND THE PROMOTION OF A CARING COMMUNITY, SENSITIVE TO THEIR NEEDS, PATIENTS AND FAMILIES MAY BE FREE TO ATTAIN A DEGREE OF MENTAL AND SPIRITUAL PREPARATION FOR DEATH THAT IS SATISFACTORY TO THEM. |
| Form 990, Part VI, Line 15a COMPENSATION OF THE TOP MANAGEMENT OFFICIAL | On a routine basis, a nationally recognized external consultant is engaged to conduct a comprehensive comparability study, and to confirm that the CEO compensation was aligned with the philosophy of the organization and market standards. The Compensation of the CEO is determined by the Compensation Committee of the Board, which shall include the Chairman of the Board and other members of the Board as appointed by the Chairman. The Chairman of the Board or his designee shall be the Chairman of the Committee. The Compensation Committee's responsibilities shall include: (a) to establish the compensation of the President & CEO of the corporation (b) review the compensation of the President & CEO of the Corporation at least annually, utilizing comparability data and establish merit increases if any in salary, incentive bonus, etc. (c) provide an annual report of finding to the full Board of Directors. THE PRESIDENT & CEO IS COMPENSATED BY HEALTH AND PALLIATIVE SERVICES OF THE TREASURE COAST (A RELATED ORGANIZATION) AND THEREFORE THIS QUESTION IS ANSWERED "NO" IN ACCORDANCE WITH FORM 990 INSTRUCTIONS. |
| Form 990, Part VI, Line 15b COMPENSATION OF OTHER OFFICERS | The organization strives to provide base salary that meets the market standard when employees are fully proficient and meeting expectations. As such, base salary for officers and key employees will be targeted at the 50th percentile of the competitive market. In addition, the organization may utilize incentive pay as a way to meet the strategic goals of the organization. The base salary plus potential incentive pay for an executive is targeted between the 50th and 75th percentile. On a routine basis, a nationally recognized external consultant is engaged to conduct a comprehensive comparability survey, and to assure that this philosophy is being met. The organization provides standard health, welfare, retirement and other benefits or perquisites that are comparable to those provided by similar organizations. The compensation of the other officers and key employees is determined by the President and CEO using the comparability report and the process and decisions are documented in each employee's file. |
| Form 990, Part VI, Line 1a Delegate broad authority to a committee | THE CHAIRMAN, VICE CHAIRMAN, SECRETARY AND TREASURER SERVE ON THE EXECUTIVE COMMITTEE OF THE BOARD OF DIRECTORS. THE EXECUTIVE COMMITTEE HAS THE AUTHORITY TO ACT FOR THE BOARD OF DIRECTORS BETWEEN REGULAR MEETINGS OF THE BOARD. THE COMMITTEE MAKES A FULL REPORT OF ALL BUSINESS TRANSACTED BY THE COMMITTEE TO THE BOARD FOR ITS APPROVAL. |
| Form 990, Part VI, Line 6 Classes of members or stockholders | The sole member of this Corporation is Health and Palliative Services of the Treasure Coast, Inc., a Florida not for profit corporation. Membership in this Corporation is not transferable or assignable. The affairs of this Corporation shall be managed by its Board of Directors, which shall possess all the powers of corporate directors under the laws of the State of Florida. All directors shall be appointed by the Board of Directors of Health and Palliative Services of the Treasure Coast, Inc., which is the sole member of Hospice of Martin & St. Lucie, Inc. |
| Form 990, Part VI, Line 7a Members or stockholders electing members of governing body | The affairs of this Corporation shall be managed by its Board of Directors, which shall possess all the powers of corporate directors under the laws of the State of Florida. All directors shall be appointed by the Board of Directors of Health and Palliative Services of the Treasure Coast, Inc., which is the sole member of Hospice of Martin & St. Lucie, Inc. |
| Form 990, Part VI, Line 7b Decisions requiring approval by members or stockholders | Health and Palliative Services of the Treasure Coast, Inc, which is the sole member of Hospice of Martin & St. Lucie, Inc., can authorize any officers or agents of Hospice of Martin & St. Lucie, Inc., to enter into any contract or execute and deliver any instrument in the name of and on behalf of Hospice of Martin & St. Lucie, Inc., and such authority may be general or confined to specific instances. |
| Form 990, Part VI, Line 11b Review of form 990 by governing body | The organization retains the expertise of an independent accounting firm to assist in the preparation and review of its IRS form 990. The accounting firm provides an overview of the completed 990 at a joint meeting of the TCH Finance Committee, Executive Committee and Foundation Executive Committee. After detailed review, the committee members make recommendations that the forms be presented for approval at the full Corporate Board meeting. The Form 990 is provided to the full Corporate Board who then votes to approve the submission of the Form 990 prior to filing. |
| Form 990, Part VI, Line 12c Conflict of interest policy | Annually each board member is given the conflict of interest policy and the CEO explains the policy in detail prior to board member signature. All vendors receive and must sign a form disclosing any related parties involved prior to doing business with the organization. Anyone with a conflict of interest is prohibited from voting on matters related to the conflict. |
| Form 990, Part VI, Line 19 Required documents available to the public | All documents are on site in either the office of the VP of Compliance or the office of the Controller. Upon request, copies are shown, mailed, faxed or emailed to the inquirer. |
| Software ID: | 15000238 |
| Software Version: | 2015v3.0 |