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 | |||||
| (A)
HOPEHEALTH HOSPICE & PALLIATIVE CARE |
510192422 | 10 | Yes | 0 | 0 | |
| (B)
HOPEHEALTH VISITING NURSE |
050259111 | 10 | Yes | 0 | 0 | |
| (C)
HOPEHEALTH COMMUNITY VNA INC |
042475924 | 10 | No | 0 | 0 | |
|
Total 3
|
0 | 0 | ||||
Calendar year
(or fiscal year beginning in)
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(a) 2017 | (b) 2018 | (c) 2019 | (d) 2020 | (e) 2021 | (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)
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(a) 2017 | (b) 2018 | (c) 2019 | (d) 2020 | (e) 2021 | (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) 2017 | (b) 2018 | (c) 2019 | (d) 2020 | (e) 2021 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 1 | Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") . | ||||||
| 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 | ||||||
| 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 | ||||||
| 7a | Amounts included on lines 1, 2, and 3 received from disqualified persons | ||||||
| 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. | ||||||
| c | Add lines 7a and 7b.. | ||||||
| 8 | Public support. (Subtract line 7c from line 6.) | ||||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2017 | (b) 2018 | (c) 2019 | (d) 2020 | (e) 2021 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 9 | Amounts from line 6... | ||||||
| 10a | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources.. | ||||||
| b | Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975. | ||||||
| c | Add lines 10a and 10b. | ||||||
| 11 | Net income from unrelated business activities not included on line 10b, whether or not the business is regularly carried on. | ||||||
| 12 | Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.) .. | ||||||
| 13 | Total support. (Add lines 9, 10c, 11, and 12.).. | ||||||
| Section A - Adjusted Net Income | (A) Prior Year |
(B) Current Year (optional) |
||||
| 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 0.015 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 0.035 | 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 | 1 | |
|
2
Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in excess of income from activity |
2 | |
| 3 Administrative expenses paid to accomplish exempt purposes of supported organizations | 3 | |
| 4 Amounts paid to acquire exempt-use assets | 4 | |
| 5 Qualified set-aside amounts (prior IRS approval required - provide details in Part VI) | 5 | |
| 6 Other distributions (describe in Part VI). See instructions | 6 | |
| 7Total annual distributions. Add lines 1 through 6. | 7 | |
|
8
Distributions to attentive supported organizations to which the organization is responsive (provide details in Part VI). See instructions |
8 | |
| 9 Distributable amount for 2021 from Section C, line 6 | 9 | |
| 10 Line 8 amount divided by Line 9 amount | 10 | |
| Section E - Distribution Allocations (see instructions) |
(i) Excess Distributions |
(ii) Underdistributions Pre-2021 |
(iii) Distributable Amount for 2021 |
|
|---|---|---|---|---|
| 1 Distributable amount for 2021 from Section C, line 6 | ||||
|
2
Underdistributions, if any, for years prior to 2021 (reasonable cause required-- explain in Part VI). See instructions. |
||||
| 3 Excess distributions carryover, if any, to 2021: | ||||
| a From 2016....... | ||||
| b From 2017....... | ||||
| c From 2018....... | ||||
| d From 2019....... | ||||
| e From 2020....... | ||||
| fTotal of lines 3a through e | ||||
| g Applied to underdistributions of prior years | ||||
| h Applied to 2021 distributable amount | ||||
|
i
Carryover from 2016 not applied (see instructions) |
||||
| j Remainder. Subtract lines 3g, 3h, and 3i from line 3f. | ||||
| 4Distributions for 2021 from Section D, line 7: | ||||
| $ | ||||
| a Applied to underdistributions of prior years | ||||
| b Applied to 2021 distributable amount | ||||
| c Remainder. Subtract lines 4a and 4b from line 4. | ||||
|
5
Remaining underdistributions for years prior to 2021, 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 2021. Subtract lines 3h and 4b from line 1. If the amount is greater than zero, explain in Part VI. See instructions. |
||||
|
7 Excess distributions carryover to 2022. Add lines 3j and 4c. |
||||
| 8 Breakdown of line 7: | ||||
| a Excess from 2017..... | ||||
| b Excess from 2018..... | ||||
| c Excess from 2019..... | ||||
| d Excess from 2020..... | ||||
| e Excess from 2021..... | ||||
| Facts And Circumstances Test |
|---|
| Return Reference | Explanation |
|---|---|
| PART IV, SECTION A, LINE 1: | ARTICLE I OF THE THIRD AMENDED AND RESTATED BYLAWS STATES THE FOLLOWING: TO SUPPORT AND BENEFIT HOPEHEALTH HOSPICE & PALLIATIVE CARE (F/K/A HOPE HOSPICE & PALLIATIVE CARE RHODE ISLAND) ("HHHPC") AND HOPEHEALTH VISITING NURSE (F/K/A VISITING NURSE OF HOPEHEALTH) ("HHVN"), EACH DULY INCORPORATED UNDER THE LAWS OF THE COMMONWEALTH OF MASSACHUSETTS, AND EACH AN EXEMPT CORPORATION UNDER SECTION 501(C)(3) OF THE CODE IN A MANNER CONSISTENT WITH SECTION 509(A)(3) OF SAID CODE AS WELL AS ANY OTHER ENTITIES ESTABLISHED BY OR AFFILIATED WITH THE CORPORATION WHOSE PURPOSES ARE CONSISTENT WITH THOSE OF HHHPC, HHVN AND HH-MA, OR WHOSE FUNCTIONS PROMOTE THE PURPOSES OF HHHPC, HHVN, HH-MA AND/OR THOSE SUBSEQUENTLY ESTABLISHED OR AFFILIATED ENTITIES (TOGETHER WITH HHHPC, HHVN, AND HH-MA, THE "SUBSIDIARIES"). DURING THE YEAR ENDED SEPTEMBER 30, 2021, HOPEHEALTH BECAME THE SOLE MEMBER OF COMMUNITY VISITING NURSE ASSOCIATION (CVNA) A 501(C)(3) ORGANIZATION. CVNA BECAME PART OF THE INTEGRATED HOPEHEALTH SYSTEM, TO BE KNOWN AS HOPEHEALTH COMMUNITY VNA, INC., AND THE BYLAWS WERE AMENDED TO REFLECT THIS ON DECEMBER 7, 2022. HOPEHEALTH'S INCLUSION AS A SUPPORTING ORGANIZATION MEETS THE REQUIREMENTS OF ARTICLE 1 AS IT IS A SUPPORTED AFFILIATED ORGANIZATION AS REFLECTED ON THE FORM 990 FOR THE YEAR ENDED SEPTEMBER 30, 2022. |
| Software ID: | |
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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 2 | BOARD OF DIRECTOR MEMBERS KEITH KELLY AND BARBARA COTTAM HAVE A BUSINESS RELATIONSHIP WITH THE ORGANIZATION. |
| FORM 990, PART VI, SECTION B, LINE 11B | THE 990 IS REVIEWED BY THE ORGANIZATION'S AUDIT COMMITTEE PRIOR TO SUBMISSION. EACH MEMBER OF THE BOARD IS PROVIDED A COPY OF THE FORM 990 PRIOR TO SUBMISSION. |
| FORM 990, PART VI, SECTION B, LINE 12C | AT OR PRIOR TO CONSIDERATION BY THE BOARD OR A COMMITTEE OF A MATTER, TRANSACTION OR ARRANGEMENT AS TO WHICH ANY DIRECTOR, OFFICER, MEMBER, EMPLOYEE OR VOLUNTEER HAS A POTENTIAL CONFLICT OF INTEREST, THE INDIVIDUAL HAVING SUCH CONFLICT SHALL DISCLOSE THE SAME TO THE BOARD/ COMMITTEE, COMPLIANCE OFFICER IF EMPLOYEE OR VOLUNTEER AS THE CASE MAY BE. IF IT IS DETERMINED THAT AN ACTUAL CONFLICT OF INTEREST EXISTS, THE INDIVIDUAL WITH SUCH CONFLICT SHALL NOT BE PRESENT DURING DISCUSSION OR VOTING ON SUCH MATTER AS RELATES TO THE CONFLICT. APPROVAL OF ANY TRANSACTION OR ARRANGEMENT THAT INVOLVES A CONFLICT SHALL INVOLVE A CONSENSUS OF THOSE REMAINING THAT THE TRANSACTION IS IN THE INTERESTS OF THE ORGANIZATION AND FOR ITS BENEFIT, IS FAIR AND REASONABLE TO THE ORGANIZATION, AND THAT THE ORGANIZATION COULD NOT OBTAIN A MORE ADVANTAGEOUS TRANSACTION OR ARRANGEMENT WITH REASONABLE EFFORT. THE BOARD OR COMMITTEE MAY, IF DEEMED APPROPRIATE, APPOINT A NON-INTERESTED COMMITTEE OR INDIVIDUAL TO INVESTIGATE ALTERNATIVES TO SUCH TRANSACTION OR ARRANGEMENT. THE BOARD SHALL, IN THE CASE OF VIOLATION OF THIS POLICY BY ANY INDIVIDUAL TAKE SUCH DISCIPLINARY OR OTHER CORRECTIVE ACTION AS IS NECESSARY TO PROTECT THE INTERESTS OF ORGANIZATION. THE MINUTES OF THE BOARD AND COMMITTEE MEETINGS SHALL RECORD DISCLOSURES AND OTHER PROCEEDINGS DESCRIBED ABOVE, INCLUDING THE NAMES OF ALL PERSONS PRESENT AND PARTICIPATING THEREIN AND ALL DETERMINATION, MADE PURSUANT TO SUCH PROCEDURES. ANNUALLY ALL CONFLICT OF INTEREST DISCLOSURE STATEMENTS WILL BE REVIEWED AT A MINIMUM, BY THE PRESIDENT/CHIEF EXECUTIVE OFFICE AND CHAIRMAN OF THE BOARD TO ENSURE THAT SUCH CONFLICTS ARE REASONABLE AND CONSISTENT WITH GENERAL KNOWLEDGE AND UNDERSTAND. |
| FORM 990, PART VI, SECTION B, LINE 15 | THE ORGANIZATION HAS THE FOLLOWING POLICY TO DETERMINE COMPENSATION: THE COMPENSATION COMMITTEE OF THE BOARD OF DIRECTORS REVIEWS SALARIES FOR THE CEO AND OTHER KEY MEMBERS OF SENIOR LEADERSHIP. THE PROCESS INCLUDES PERIODIC PROCUREMENT OF COMPARABILITY DATA FROM EXTERNAL INDEPENDENT SOURCES INCLUDING THE REVIEW OF FORM 990 OF OTHER ORGANIZATIONS. THE BOARD OF DIRECTORS REVIEW AND APPROVE THE SALARY OF THE CEO AND ANNUALLY APPROVES THE BUDGET WHICH INCLUDES SALARIES FOR THE OTHER MEMBERS OF THE SENIOR MANAGEMENT TEAM. SULLIVANCOTTER WAS RETAINED BY THE COMPENSATION COMMITTEE (COMMITTEE) OF THE BOARD OF DIRECTORS (BOARD) OF HOPEHEALTH TO CONDUCT A COMPETITIVE ASSESSMENT OF THE TOTAL COMPENSATION PROGRAM FOR ITS TOP LEADERSHIP POSITIONS. THE MARKET DATA ARE COMPILED FROM RELIABLE AND INDEPENDENT SURVEYS. THE DATA WERE DRAWN FROM NATIONAL PUBLISHED COMPENSATION SURVEYS AND REGIONAL IRS FORM 990 DATA (IF AVAILABLE). AS OF JANUARY 1, 2021, THE OFFICERS ARE NO LONGER PAID BY A RELATED ORGANIZATION, BUT ARE INSTEAD PAID DIRECTLY BY HOPEHEALTH INC. HOWEVER, THOSE EXPENSES WILL SUBSEQUENTLY BE ALLOCATED OUT TO THE RELATED OPERATING ENTITIES. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE ORGANIZATION MAKES AVAILABLE ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICIES, AND FINANCIAL STATEMENTS FOR PUBLIC INSPECTION UPON REQUEST AT ITS ADMINISTRATIVE OFFICES IN PROVIDENCE, RHODE ISLAND. |
| FORM 990, PART IX, LINE 5 | BEGINNING JANUARY 1, 2021, HOPEHEALTH INC ISSUES FORMS W-2 TO THE OVERHEAD DEPARTMENT OF ALL HOPEHEALTH ENTITIES, BUT THE AMOUNT OF SALARY, BENEFITS, AND OTHER DIRECT EXPENSES HAVE BEEN ALLOCATED TO THE RESPECTIVE OPERATING ENTITIES THEY RELATE TO, AS IS REFLECTED ON SCHEDULE R OF THIS RETURN. FOR PURPOSES OF FORM 990, PART VII AND IN SCHEDULE J, PART II, AMOUNTS FROM HOPEHEALTH'S W-2S ARE REPORTED AS PAID BY THIS ORGANIZATION RATHER THAN BY THE RELATED ORGANIZATION TO WHICH THEY ARE ALLOCATED ON FORM 990, PART IX. HOWEVER, AS A RESULT OF THE ALLOCATION TO THE OPERATING ENTITIES, THE EXPENSES ARE CORRECTLY REPORTED HERE AS $0. |
| FORM 990, PART XII, LINE 2C: | THE AUDIT COMMITTEE OF THE BOARD OF DIRECTORS IS CHARGED WITH THE RESPONSIBILITY FOR THE SELECTION OF THE ORGANIZATION'S INDEPENDENT AUDITORS, AND FOR THE OVERSIGHT OF ITS FINANCIAL STATEMENTS. |
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