Attach to Form 990 or Form 990-EZ.
Go to
www.irs.gov/Form990 for instructions and the latest information.
| (i) Name of supported organization | (ii) EIN | (iii) Type of organization (described on lines 1- 10 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 |
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Calendar year (or fiscal year beginning in) ![]() |
(a) 2015 | (b) 2016 | (c) 2017 | (d) 2018 | (e) 2019 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 1 | Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grant.") .. | ||||||
| 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) 2015 | (b) 2016 | (c) 2017 | (d) 2018 | (e) 2019 | (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) 2015 | (b) 2016 | (c) 2017 | (d) 2018 | (e) 2019 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 1 | Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") . | 3,383,000 | 910,000 | 1,863,015 | 1,359,006 | 1,293,759 | 8,808,780 |
| 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 | 57,369,840 | 61,910,407 | 73,926,757 | 81,860,681 | 86,286,164 | 361,353,849 |
| 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 | 60,752,840 | 62,820,407 | 75,789,772 | 83,219,687 | 87,579,923 | 370,162,629 |
| 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.) | 370,162,629 | |||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2015 | (b) 2016 | (c) 2017 | (d) 2018 | (e) 2019 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 9 | Amounts from line 6... | 60,752,840 | 62,820,407 | 75,789,772 | 83,219,687 | 87,579,923 | 370,162,629 |
| 10a | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources.. | 9,903 | 18,993 | 24,489 | 29,575 | 68,977 | 151,937 |
| b | Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975. | 31,840 | 31,840 | ||||
| c | Add lines 10a and 10b. | 9,903 | 18,993 | 24,489 | 29,575 | 100,817 | 183,777 |
| 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.) .. | 5,421 | 56,573 | 1,913 | 0 | 0 | 63,907 |
| 13 | Total support. (Add lines 9, 10c, 11, and 12.).. | 60,768,164 | 62,895,973 | 75,816,174 | 83,249,262 | 87,680,740 | 370,410,313 |
| 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 2019 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-2019 |
(iii) Distributable Amount for 2019 |
|
|---|---|---|---|---|
| 1 Distributable amount for 2019 from Section C, line 6 | ||||
|
2
Underdistributions, if any, for years prior to 2019 (reasonable cause required-- explain in Part VI). See instructions. |
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| 3 Excess distributions carryover, if any, to 2019: | ||||
| a From 2014....... | ||||
| b From 2015....... | ||||
| c From 2016....... | ||||
| d From 2017....... | ||||
| e From 2018....... | ||||
| fTotal of lines 3a through e | ||||
| g Applied to underdistributions of prior years | ||||
| h Applied to 2019 distributable amount | ||||
|
i
Carryover from 2014 not applied (see instructions) |
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| j Remainder. Subtract lines 3g, 3h, and 3i from 3f. | ||||
| 4Distributions for 2019 from Section D, line 7: | ||||
| $ | ||||
| a Applied to underdistributions of prior years | ||||
| b Applied to 2019 distributable amount | ||||
| c Remainder. Subtract lines 4a and 4b from 4. | ||||
|
5
Remaining underdistributions for years prior to 2019, if any. Subtract lines 3g and 4a from line 2. If the amount is greater than zero, explain in Part VI. See instructions. |
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|
6
Remaining underdistributions for 2019. Subtract lines 3h and 4b from line 1. If the amount is greater than zero, explain in Part VI. See instructions. |
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|
7 Excess distributions carryover to 2020. Add lines 3j and 4c. |
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| 8 Breakdown of line 7: | ||||
| a Excess from 2015..... | ||||
| b Excess from 2016..... | ||||
| c Excess from 2017..... | ||||
| d Excess from 2018..... | ||||
| e Excess from 2019..... | ||||
| Facts And Circumstances Test |
|---|
| Return Reference | Explanation |
|---|---|
| Schedule A, Part III, Line 12 Other Income | DESCRIPTION - MISCELLANEOUS REVENUE, COLUMN A - 5421.0, COLUMN B - 56573.0, COLUMN C - 1913.0, COLUMN D - 0.0, COLUMN E - 0.0, COLUMN F - 63907.0; |
| Software ID: | 17005876 |
| Software Version: | 2017v2.2 |
Attach to Form 990 or 990-EZ.
Go to www.irs.gov/Form990 for the latest information.
| Return Reference | Explanation |
|---|---|
| Form 990, Part VI, Line 1a Delegate broad authority to a committee | The executive committee shall act in matters where timeliness is essential or where a quorum of the full board cannot practically be convened. The executive committee shall consist of the chair, vice chair, secretary, treasurer, immediate past chair the foundation board president and two board members at large. The executive committee shall report to the board of directors but the actions of the executive committee are not required to be ratified by the full board. |
| Form 990, Part VI, Line 2 Family/business relationships amongst interested persons | ROB ADRID AND JAMES NOVELL - Business relationship |
| Form 990, Part VI, Line 3 Delegation of management duties | Cornerstone Hospice and Palliative Care, Inc. contracted with the Teleios Group, LLC, a hospice management and consulting organization, for the CFO services provided to the hospice by Todd Webb. Mr. Webb received $41,148 in compensation from the Teleios Group, LLC during calendar year 2017 for the CFO services that he provided to the Hospice. This $41,148 represents compensation paid by The Teleios Group, LLC to Mr. Webb from January-April 2017. In April 2017, Mr. Webb became an employee of Cornerstone Hospice. Therefore, Cornerstone Hospice began compensating Mr. Webb directly beginning in April 2017. |
| Form 990, Part VI, Line 4 Significant changes to organizational documents | CORNERSTONE COMPANION SERVICES, LLC (FEIN 81-3183408), A DISREGARDED ENTITY OF CORNERSTONE HOSPICE AND PALLIATIVE CARE, INC., CHANGED ITS NAME TO ALEXA HOME CARE, LLC EFFECTIVE SEPTEMBER 2018. AN AMENDMENT TO THIS LLC'S ARTICLES OF ORGANIZATION WERE FILED WITH THE STATE OF FLORIDA ACCORDINGLY. ARTICLES OF CONVERSION WERE FILED WITH THE STATE OF FLORIDA IN OCTOBER 2017 FOR THE TELEIOS GROUP, LLC (FEIN 47-1963571), FORMERLY ORGANIZED AS A PARTNERSHIP, TO CONVERT TO A DISREGARDED ENTITY OF CORNERSTONE HOSPICE AND PALLIATIVE CARE, INC., AND TO CHANGE ITS NAME TO CARE PARTNERS, LLC. THESE CHANGES WERE EFFECTIVE OCTOBER 2017. |
| Form 990, Part VI, Line 11b Review of form 990 by governing body | ALL BOARD MEMBERS ARE PROVIDED A DRAFT COPY OF THE FORM 990 FOR THEIR REVIEW. UPON BOARD'S REVIEW AND FOLLOWING UP ON ANY CHANGES, THE FULL BOARD VOTES TO APPROVE THE FINAL FORM 990. THE FINAL FORM 990 IS THEN FILED WITH THE IRS UPON SIGNATURE OF AN AUTHORIZED OFFICER. |
| Form 990, Part VI, Line 12c Conflict of interest policy | PROPOSED OR ONGOING TRANSACTIONS ARE MONITORED BY THE CFO FOR CONFLICTS OF INTEREST. BOARD MEMBERS ARE NOTIFIED IMMEDIATELY IF ANY ISSUES ARISE SO THAT APPROPRIATE ACTION MAY BE TAKEN. 1. PERSONS COVERED BY THIS POLICY ARE THE ORGANIZATION'S OFFICERS, DIRECTORS, CEO AND LEADERSHIP/EXECUTIVE STAFF. 2. PERSONS COVERED BY THIS POLICY WILL ANNUALLY DISCLOSE OR UPDATE TO THE CEO & CHAIRMAN OF THE BOARD OF DIRECTORS ON A FORM PROVIDED BY THE ORGANIZATION THEIR INTERESTS THAT COULD GIVE RISE TO CONFLICTS OF INTEREST, SUCH AS A LIST OF FAMILY MEMBERS, SUBSTANTIAL BUSINESS OR INVESTMENT HOLDINGS, AND OTHER TRANSACTIONS OR AFFILIATIONS WITH BUSINESSES AND OTHER ORGANIZATIONS OR THOSE OF FAMILY MEMBERS. 3. ON AN ANNUAL BASIS (PREFERABLY DURING THE FIRST CALENDAR QUARTER), THE PRESIDENT/CEO WILL SEND TO ALL APPLICABLE INDIVIDUALS: (A) A COPY OF THE POLICY AND MEMORANDUM AVAILABLE UPON REQUEST. (B) CONFLICT OF INTEREST QUESTIONNAIRE AVAILABLE UPON REQUEST. 4. WHEN PERSONNEL ASSUME POSITIONS RELEVANT TO THE CONFLICT OF INTEREST POLICY DURING THE YEAR, THE SAME PROCEDURE WILL BE FOLLOWED. THIS PROCEDURE IS APPLICABLE TO ANY NEW BOARD MEMBER, PRESIDENT/CEO AND LEADERSHIP STAFF. 5. FOR EACH INTEREST DISCLOSED TO THE CEO & CHAIRMAN OF THE BOARD OF DIRECTORS, THEY WILL DETERMINE WHETHER TO: (A) TAKE NO ACTION; (B) ASSURE FULL DISCLOSURE TO THE BOARD OF DIRECTORS AND OTHER INDIVIDUALS COVERED BY THIS POLICY; (C) ASK THE PERSON TO RECUSE FROM PARTICIPATION IN RELATED DISCUSSIONS OR DECISIONS WITHIN THE ORGANIZATION; OR (D) ASK THE PERSON TO RESIGN FROM HIS OR HER POSITION IN THE ORGANIZATION OR, IF THE PERSON REFUSES TO RESIGN, BECOME SUBJECT TO POSSIBLE REMOVAL IN ACCORDANCE WITH THE ORGANIZATION'S REMOVAL PROCEDURES. 6. THE ORGANIZATION'S CHIEF EMPLOYED EXECUTIVE AND CHIEF EMPLOYED FINANCE EXECUTIVE WILL MONITOR PROPOSED OR ONGOING TRANSACTIONS FOR CONFLICTS OF INTEREST AND DISCLOSE THEM TO THE CHAIRMAN OF THE BOARD OF DIRECTORS IN ORDER TO DEAL WITH POTENTIAL OR ACTUAL CONFLICTS, WHETHER DISCOVERED BEFORE OR AFTER THE TRANSACTION HAS OCCURRED. |
| Form 990, Part VI, Line 15a Process to establish compensation of top management official | PRESIDENT/CEO COMPENSATION IS REVIEWED ON AN ANNUAL BASIS BY THE EXECUTIVE COMMITTEE. PRESIDENT/CEO COMPENSATION IS BASED ON PERFORMANCE, AND IS COMPARED WITH THE COMPENSATION REPORTED ON THE FORMS 990 OF SIMILAR ORGANIZATIONS FOR COMPARABLE POSITIONS ACROSS THE STATE. THIS PROCESS WAS LAST UNDERTAKEN IN JULY-AUGUST 2018, AND IS DOCUMENTED IN EXECUTIVE COMMITTEE MEETING MINUTES. |
| Form 990, Part VI, Line 15b Process to establish compensation of other employees | OTHER OFFICER/KEY EMPLOYEE COMPENSATION IS REVIEWED ON AN ANNUAL BASIS BY THE EXECUTIVE COMMITTEE. OTHER OFFICER/KEY EMPLOYEE COMPENSATION IS BASED ON PERFORMANCE, AND IS COMPARED WITH THE COMPENSATION REPORTED ON THE FORMS 990 OF SIMILAR ORGANIZATIONS FOR COMPARABLE POSITIONS ACROSS THE STATE. THIS PROCESS WAS LAST UNDERTAKEN IN JULY 2018, AND IS DOCUMENTED IN EXECUTIVE COMMITTEE MEETING MINUTES. |
| Form 990, Part VI, Line 19 Required documents available to the public | GOVERNING DOCUMENTS, POLICIES, AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST. |
| Form 990, Part XI, Line 9 Other changes in net assets or fund balances | CHANGE IN NET ASSETS OF CORNERSTONE HOSPICE FOUNDATION - 5071415; |
| Software ID: | 17005876 |
| Software Version: | 2017v2.2 |