Attach to Form 990 or Form 990-EZ.
Go to
www.irs.gov/Form990 for 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) 2014 | (b) 2015 | (c) 2016 | (d) 2017 | (e) 2018 | (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) 2014 | (b) 2015 | (c) 2016 | (d) 2017 | (e) 2018 | (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) 2014 | (b) 2015 | (c) 2016 | (d) 2017 | (e) 2018 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 1 | Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") . | 3,527,783 | 2,547,738 | 2,491,942 | 3,252,372 | 2,340,778 | 14,160,613 |
| 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 | 98,389,639 | 93,884,108 | 100,810,304 | 100,924,998 | 108,105,807 | 502,114,856 |
| 3 | Gross receipts from activities that are not an unrelated trade or business under section 513 ..... | ||||||
| 4 | Tax revenues levied for the organization's benefit and either paid to or expended on its behalf... | ||||||
| 5 | The value of services or facilities furnished by a governmental unit to the organization without charge | ||||||
| 6 | Total. Add lines 1 through 5 | 101,917,422 | 96,431,846 | 103,302,246 | 104,177,370 | 110,446,585 | 516,275,469 |
| 7a | Amounts included on lines 1, 2, and 3 received from disqualified persons | 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 | |||||
| c | Add lines 7a and 7b.. | 0 | |||||
| 8 | Public support. (Subtract line 7c from line 6.) | 516,275,469 | |||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2014 | (b) 2015 | (c) 2016 | (d) 2017 | (e) 2018 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 9 | Amounts from line 6... | 101,917,422 | 96,431,846 | 103,302,246 | 104,177,370 | 110,446,585 | 516,275,469 |
| 10a | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources.. | 497,038 | 174,941 | 97,533 | 345,965 | 549,600 | 1,665,077 |
| b | Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975. | ||||||
| c | Add lines 10a and 10b. | 497,038 | 174,941 | 97,533 | 345,965 | 549,600 | 1,665,077 |
| 11 | Net income from unrelated business activities not included in line 10b, whether or not the business is regularly carried on. | 216,225 | 216,225 | ||||
| 12 | Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.) .. | 114,596 | 134,751 | 152,140 | 114,088 | 117,525 | 633,100 |
| 13 | Total support. (Add lines 9, 10c, 11, and 12.).. | 102,529,056 | 96,741,538 | 103,551,919 | 104,637,423 | 111,329,935 | 518,789,871 |
| 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) |
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| 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): |
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| 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 2018 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-2018 |
(iii) Distributable Amount for 2018 |
|
|---|---|---|---|---|
|
1
Distributable amount for 2018 from Section C, line 6 |
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|
2
Underdistributions, if any, for years prior to 2018 (reasonable cause required-- explain in Part VI). See instructions. |
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| 3 Excess distributions carryover, if any, to 2018: | ||||
| a From 2013....... | ||||
| b From 2014....... | ||||
| c From 2015....... | ||||
| d From 2016....... | ||||
| e From 2017....... | ||||
| fTotal of lines 3a through e | ||||
| g Applied to underdistributions of prior years | ||||
| h Applied to 2018 distributable amount | ||||
|
i
Carryover from 2013 not applied (see instructions) |
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| j Remainder. Subtract lines 3g, 3h, and 3i from 3f. | ||||
| 4Distributions for 2018 from Section D, line 7: | ||||
| $ | ||||
| a Applied to underdistributions of prior years | ||||
| b Applied to 2018 distributable amount | ||||
| c Remainder. Subtract lines 4a and 4b from 4. | ||||
|
5
Remaining underdistributions for years prior to 2018, 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 2018. 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 2019. Add lines 3j and 4c. |
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| 8 Breakdown of line 7: | ||||
| a Excess from 2014...... | ||||
| b Excess from 2015..... | ||||
| c Excess from 2016..... | ||||
| d Excess from 2017..... | ||||
| e Excess from 2018..... | ||||
| Facts And Circumstances Test |
|---|
| Return Reference | Explanation |
|---|---|
| SCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME: | MISCELLANEOUS INCOME - 2014 AMOUNT: $ 114,596. 2015 AMOUNT: $ 134,751. 2016 AMOUNT: $ 152,140. 2017 AMOUNT: $ 114,088. 2018 AMOUNT: $ 117,525. |
| Software ID: | |
| Software Version: |
Attach to Form 990 or 990-EZ.
Go to www.irs.gov/Form990 for the latest information.
| Return Reference | Explanation |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 1 | THE BOARD OF DIRECTORS HAS AN EXECUTIVE COMMITTEE, WHICH CONSISTS OF THE CHAIRMAN OF THE BOARD, THE VICE CHAIRMAN OF THE BOARD, THE PRESIDENT/CHIEF EXECUTIVE OFFICER, THE SECRETARY, AND THE TREASURER. THE BOARD OF DIRECTORS, BY RESOLUTION ADOPTED BY A MAJORITY OF THE FULL BOARD OF DIRECTORS, MAY DESIGNATE FROM ITS MEMBERS UP TO TWO ADDITIONAL DIRECTORS TO SERVE AS MEMBERS OF THE EXECUTIVE COMMITTEE. WHEN THE BOARD OF DIRECTORS IS NOT IN SESSION, THE EXECUTIVE COMMITTEE HAS, AND MAY EXERCISE, ALL OF THE POWERS OF THE BOARD OF DIRECTORS, EXCEPT TO THE EXTENT, IF ANY, THAT SUCH AUTHORITY SHALL BE LIMITED BY A RESOLUTION ADOPTED BY A MAJORITY OF DIRECTORS IN OFFICE. |
| FORM 990, PART VI, SECTION A, LINE 2 | RAFAEL SCIULLO, MITCHEL MOREL, AND PATRICK BARMORE ARE ALL EITHER BOARD MEMBERS OF AND/OR OFFICERS OF HOSPICE SYSTEMS, INC., A RELATED, FOR-PROFIT COMPANY. |
| FORM 990, PART VI, SECTION A, LINE 6 | PURSUANT TO THE ORGANIZATION'S GOVERNING DOCUMENTS, THE SOLE VOTING MEMBER OF THE HOSPICE OF FLORIDA SUNCOAST, INC. (SUNCOAST HOSPICE) SHALL BE EMPATH HEALTH, INC. (EHI), A RELATED TAX-EXEMPT ORGGANIZATION. AS THE ORGANIZATION'S SOLE CORPORATE MEMBER, EHI HAS THE RIGHT TO PARTICIPATE IN THE ORGANIZATION'S GOVERNANCE. |
| FORM 990, PART VI, SECTION A, LINE 7A | PURSUANT TO THE ORGANIZATION'S GOVERNING DOCUMENTS, THE SOLE CORPORATE MEMBER, EHI, HAS THE RIGHT TO ELECT, APPOINT, OR REMOVE ANY DIRECTOR OF SUNCOAST HOSPICE WITHOUT CAUSE AT ANY TIME. |
| FORM 990, PART VI, SECTION A, LINE 7B | THE SOLE CORPORATE MEMBER, EHI, HAS THE RIGHT TO APPROVE OR RATIFY SIGNIFICANT DECISIONS OF THE ORGANIZATION'S GOVERNING BODY. THE BOARD OF DIRECTORS OF SUNCOAST HOSPICE SHALL NOT HAVE THE AUTHORITY TO MAKE SIGNIFICANT DECISIONS WITHOUT THE APPROVAL OF THE EHI BOARD. SIGNIFICANT DECISIONS INCLUDE, BUT ARE NOT LIMITED TO: THE RIGHT TO AMEND, REPEAL OR ALTER THEIR GOVERNING DOCUMENTS; SELL, LEASE OR OTHERWISE DISPOSE OF SUBSTANITALLY ALL OF THE ORGANIZATION'S ASSETS; AND MERGE OR CONSOLIDATE THE ORGANIZATION WITH ANOTHER ORGANIZATION. |
| FORM 990, PART VI, SECTION B, LINE 11B | THE ORGANIZATION RETAINS THE EXPERTISE OF AN INDEPENDENT TAX ADVISOR TO ASSIST IN THE PREPARATION AND REVIEW OF ITS IRS FORM 990. PRIOR TO FILING THE IRS FORM 990, MANAGEMENT AND THE INDEPENDENT TAX ADVISOR REVIEW THE TAX RETURN AND ALL REQUIRED DISCLOSURES. THE FORM 990 IS THEN REVIEWED BY THE AUDIT COMMITTEE, CONSISTING OF INDEPENDENT DIRECTORS OF THE ORGANIZATION. THE AUDIT COMMITTEE MAKES A RECCOMMENDATION TO THE BOARD OF DIRECTORS TO ACCEPT OR REJECT THE FORM 990. THE FORM 990 IS THEN PROVIDED TO THE FULL BOARD OF DIRECTORS FOR THEIR REVIEW PRIOR TO FILING WITH THE IRS. |
| FORM 990, PART VI, SECTION B, LINE 12C | ALL OFFICERS, DIRECTORS, TRUSTEES, KEY EMPLOYEES, AND HIGHEST PAID EMPLOYEES (INTERESTED PERSONS) OF THE ORGANIZATION HAVE A DUTY TO AVOID CONFLICTS OF INTEREST, BOTH REAL AND PERCEIVED, WHICH MAY NEGATIVELY IMPACT THE ORGANIZATION OR THOSE IT SERVES. THE ORGANIZATION'S INTERESTED PERSONS ARE TO BE GUIDED BY THE ORGANIZATION'S MISSION, VISION AND VALUES, AND TO SERVE PATIENTS, FAMILIES, AND THE GENERAL PUBLIC WITHOUT NEED FOR ANY PERSONAL FAVOR OR GAIN. THE ORGANIZATION'S ETHICS AND COMPLIANCE PLAN EMPHASIZES THE DUTY INTERESTED PERSONS HAVE TO DISCLOSE ANY ACTUAL OR POTENTIAL CONFLICTS OF INTEREST THAT MAY BENEFIT THEIR PRIVATE INTERESTS OR RESULT IN A POSSIBLE EXCESS BENEFIT TRANSACTION. CONFLICTS ARE DISCLOSED ANNUALLY ON A CONFLICT OF INTEREST QUESTIONNAIRE THAT IS DISTRIBUTED TO THE OFFICERS, DIRECTORS, KEY EMPLOYEES, AND HIGHEST COMPENSATED EMPLOYEES. IN THE EVENT OF ANY ACTUAL OR POTENTIAL CONFLICTS OF INTEREST, INTERESTED PERSONS MUST DISCLOSE THE EXISTENCE OF THEIR FINANCIAL INTEREST AND DISCLOSE ALL MATERIAL FACTS TO THE BOARD CHAIR, CEO, OR OTHER DESIGNATED PERSONS. IF IT IS DETERMINED THAT AN ACTUAL CONFLICT OF INTEREST EXISTS BETWEEN THE ORGANIZATION AND AN INTERESTED PERSON, THE PARTY WITH A CONFLICT OF INTEREST BUT ABSTAIN FROM ANY DISCUSSION OR VOTING ON THE TRANSACTION OR ARRANGEMENT INVOLVING THE CONFLICT OF INTEREST. AT EACH BOARD MEETING, BOARD MEMBERS ARE REMINDED THAT THEY HAVE SIGNED A CONFLICT OF INTEREST DISCLOSURE AND ARE ASKED TO REVIEW THE AGENDA. AT THAT TIME, FOR THE RECORD, THEY ARE TO DISCLOSE ANY ITEMS WITH WHICH THEY MAY HAVE A CONFLICT OF INTEREST. |
| FORM 990, PART VI, SECTION B, LINE 15 | THE ORGANIZATION'S TOP MANAGEMENT OFFICIAL IS THE PRESIDENT AND CEO OF EMPATH HEALTH, INC. (EHI), A RELATED ORGANIZATION. THE CEO'S COMPENSATION IS DETERMINED BY AND PAID FOR BY EHI. THE EXECUTIVE COMMITTEE OF THE EHI BOARD MEETS ANNUALLY TO REVIEW AND APPROVE THE COMPENSATION OF THE PRESIDENT AND CEO. THE EXECUTIVE COMMITTEE'S REVIEW OF CEO COMPENSATION INCLUDES INFORMATION PROVIDED IN THE MOST RECENT EXTERNAL COMPENSATION REVIEW. THE COMPENSATION OF THE ORGANIZATION'S OTHER OFFICERS IS ALSO DETERMINED BY EHI. THE COMPENSATION OF OTHER OFFICERS IS REVIEWED ON AN ANNUAL BASIS BY THE CEO OF EHI. AFTER REVIEWING OFFICER COMPENSATION, THE CEO'S RECOMMENDATIONS ARE THEN APPROVED BY EHI'S BOARD OF DIRECTORS. THESE REVIEWS ARE DOCUMENTED IN EACH EMPLOYEE'S FILE. THE REVIEW OF OTHER OFFICERS' COMPENSATION INCLUDES INFORMATION PROVIDED IN THE MOST RECENT EXTERNAL COMPENSATION REVIEW. EXTERNAL COMPENSATION REVIEWS ARE PERFORMED ACCORDING TO THE FOLLOWING PROCESS: EVERY 3-5 YEARS HUMAN RESOURCES WILL EMPLOY A WELL-RECOGNIZED, INDEPENDENT COMPENSATION CONSULTANT TO REVIEW THE MARKET RANGES FOR THE CEO OF EHI. THE REVIEW WILL INCLUDE A NATIONAL COMPARISON OF SIMILAR JOBS AT SIMILARLY SITUATED COMPANIES IN ORDER TO MAKE CERTAIN THAT THESE KEY EMPLOYEES ARE PAID WITHIN A REASONABLE AND APPROPRIATE RANGE. THE RESULTING RECOMMENDATIONS WILL BE REVIEWED BY THE EXECUTIVE COMMITTEE TO RECOMMEND ANY MARKET-BASED CHANGES OR TO ENSURE THAT THE CURRENT COMPENSATION OF THESE INDIVIDUALS ARE CORRECT. DURING THIS REVIEW, HUMAN RESOURCES WILL ALSO GIVE THE EXECUTIVE COMMITTEE A BROAD OVERVIEW OF THE STRUCTURE OF THE FULL ORGANIZATION'S COMPENSATION SYSTEM, INCLUDING THE PHILOSOPHY AND SYSTEMS SET IN PLACE TO MANAGE IT. |
| FORM 990, PART VI, SECTION C, LINE 19 | FINANCIAL STATEMENTS, GOVERNING DOCUMENTS, AND CONFLICT OF INTEREST POLICIES ARE NOT REQUIRED DISCLOSURES PURSUANT TO IRC SECTION 6104. THESE DOCUMENTS ARE NOT AVAILABLE TO THE PUBLIC AT THIS TIME. |
| FORM 990, PART IX, LINE 11G | CONSULTING: PROGRAM SERVICE EXPENSES 32,629. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 32,629. CONTRACT LABOR: PROGRAM SERVICE EXPENSES 693,943. MANAGEMENT AND GENERAL EXPENSES 218,414. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 912,357. PHYSICIAN SERVICES: PROGRAM SERVICE EXPENSES 659,024. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 659,024. PHYSICAL THERAPY: PROGRAM SERVICE EXPENSES 18,284. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 18,284. SPEECH THERAPY: PROGRAM SERVICE EXPENSES 22,471. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 22,471. OCCUPATIONAL THERAPY: PROGRAM SERVICE EXPENSES 10,570. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 10,570. LAB & DIAGNOSTICS: PROGRAM SERVICE EXPENSES 62,665. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 62,665. IMAGING: PROGRAM SERVICE EXPENSES 50,495. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 50,495. INPATIENT SERVICES: PROGRAM SERVICE EXPENSES 2,075,664. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,075,664. OUTPATIENT SERVICES: PROGRAM SERVICE EXPENSES 782,311. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 782,311. GOVERNMENT AUDIT: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 1,034,006. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,034,006. MEDICAL TRANSPORTATION: PROGRAM SERVICE EXPENSES 1,507,219. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,507,219. PATIENT CARE: PROGRAM SERVICE EXPENSES 17,680,270. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 17,680,270. |
| FORM 990, PART XI, LINE 9: | DEBT FORGIVENESS -1,880,286. CHANGE IN ASSETS -26,000. CHANGE IN FAIR VALUE OF INTEREST RATE SWAP -32,799. BAD DEBT RESERVE 961,000. |
| FORM 990, PART XII, LINE 2C: | OVERSIGHT OF AUDIT AND SELECTION OF INDEPENDENT ACCOUNTANT: THERE ARE NO CHANGES FROM THE PREVIOUS YEAR. |
| Software ID: | |
| Software Version: |