Wednesday, August 30, 2017

Boo Boo talks $$ and non-profit hospice

"Also, too: send flowers while someone's still alive to enjoy them."

I haven't had a chance to talk hospice with Boo Boo since earlier in the month. She stopped by yesterday, and agreed to share her thoughts after a piece of cheese, some peanut butter, and a few minutes of scratching behind the ears.

"I'd like to change the subject a bit, and turn to the non-profit hospice world," she said while settling on my lap. "They use money, too."

"Here's the thing - publicly-traded for-profit hospice companies have to file financial information and other disclosures with the SEC. It's all there, but you have to dig. It also helps if you're a lawyer or an accountant, or both. An MBA doesn't hurt, either."

I know what she means. It can be a real challenge to just read through a company's annual report, and while they also provide plenty of information and links at their websites, it's like having someone lead you down to a huge basement filled with filling cabinets and saying, "Go for it," before they head back up the stairs quietly chuckling to themselves.

Warren Buffett writes an informative and very readable letter to shareholders that's included in Berkshire Hathaway's annual reports that help explain his thinking as well as the business. But not everyone is Warren Buffett.

Boo Boo agreed, "That's when an investment advisory service might be helpful. Of course, you have to trust their work, and also hope they're not talking up a company they also have an interest in. People get very weird when there's money involved. That also includes analysts who follow companies."

"Sometimes, you can find a resource that's either more clearly independent, or that tempers the rosy picture corporate executives like to paint. But always remember 'buyer beware' and 'do your due diligence' when it comes to stocks and other financial investments. And none if this is intended to be advice of any kind. I'm a freaking dog, after all."

I reminded Boo Boo that she wanted to talk about non-profit hospices.

"I know, I know. Relax. I'm getting to it." Boo Boo can be kind of prickly sometimes.

"Here's that thing - non-profit organizations still have to file with the IRS, using Form-990. They have to disclose their financial information, describe their mission, and report who's getting how much money - executives, key employees, vendors, and the like. They also have to talk about their fundraising, and how they're governed. The whole point is to make sure they deserve their non-profit status, and that they're not engaged in sleazy acts like self-dealing. You'd be surprised at how some people use a non-profit organization for their own benefit. Disgusting." Boo Boo spat on the floor.

I wiped up the cheese/peanut butter spit as she continued. "The information on the 990 is much more straightforward and easier to understand. It's a little bit of work, but not much. It helps to understand basic stuff, like what an income statement and a balance sheet are. But it's not rocket science."

"Non-profits have to make their 990's available to the public. Some make it easy and post them as pdf's on their websites, like two of my favorites - Partners in Health and Doctors Without Borders. That's true transparency."

I told her I haven't found a non-profit hospice that's included a 990 on their websites. How can I get the information?

"You probably have to call them to make an appointment, then go to the office and read the paper copy. Some might be happy to accommodate, but if they're not making it easy, it could be because they're lazy, or just don't want people to know."

That didn't sound promising.

"There's another way," Boo Boo said. "Sign up for an account at a service like Guidestar. They sell detailed reports, but you can look up any organization's recent 990's for free. Now please excuse me, it's time for a nap."

Boo Boo closed her eyes and was sound asleep in a minute. I eased her off my lap, signed up with Guidestar, and started poking around.

I thought I'd compare several different agencies I'm familiar with, either as a former employee or spousal caregiver. Here's what I found for 2015, with some notes and disclosures following. Click the image to enlarge...




Notes
Care Dimensions lists 1 employee over $300,000 and 7 over $200,000 of their 10 most highly compensated. All are senior executives and/or physicians. The CEO in this Form-990 has retired.

VNA Care Network information also includes home care services. They merged with/acquired VNA Boston (scroll), which filed a separate Form-990.

Parmenter was acquired by CareGroup in 2015.

Community Nurse information includes home care services. The CEO in this Form-990 is no longer with the agency.

Seasons Hospice is a privately-held for-profit agency based in Illinois, and is not required to file with the SEC. Financial information is not available. They established the Seasons Hospice Foundation to "raise funds to help cover the cost of special acts of kindness." (link) The organization's mission is stated on Line 1, "Support end of life care for individuals with limited means as well as sponsor educational programs regarding end of life care and the role of hospice in this process."

The total grants paid was $102,586 (Line 13). The revenue listed above is the sum of contributions and grants ($863,762 - Line 8), and investment income ($134,941 - Line 10). The net assets listed above reflects total assets ($6,207,798 - Line 20) minus reported liabilities ($6,101,073 - Line 21). Liabilities include $3,815,212 as secured mortgages and notes payable to unrelated third parties (Part X Line 23), and $2,187,452 as other liabilities (Part X Line 25). This amount is also listed on Part X Schedule D as "due to/from affiliates." Salaries, other compensation, and benefits is listed as $308,226 (Line 15). This was a pretty complicated Form-990 for me as a non-accounting type person.

The Organizations
Care Dimensions
VNA Care Network and Hospice
Good Shepherd Community Care
Parmenter Home Care and Hospice
Community Nurse Home Care and Hospice
Seasons Hospice Foundation

Disclosures
I was employed by Care Dimensions and Good Shepherd as an RN hospice case manager, by VNA Care Network and Seasons Hospice as a hospice educator. I was a spousal caregiver and received services for my wife, Jeanne, from Care Dimensions (palliative care), Community Nurse (home health aide), and Parmenter (hospice).

My profile on LinkedIn

I am currently providing services under contract to Good Shepherd.

I own shares of Berkshire Hathaway (BRK-B), and am a member of the Motley Fool.

Update: Argh! I'm having trouble sizing the spreadsheet so it's readable. My latest attempt is to export it as an image, but it still acts weird and looks tiny. I'm going to try a few more things...

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