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Nonprofiteer
← Chapters Health Home Connect Inc

Form 990 for tax year 2022

Filed by Chapters Health Home Connect Inc.

Totals

Total revenue
$14,003
Total expenses
$138,177
Contributions and grants received
$0
Grants paid
$0
Program service revenue
$14,003
Investment income
$0
Other revenue
$0
Total assets, end of year
$0
Total liabilities, end of year
$0
Net assets or fund balances, end of year
$0
Program services expenses (Part IX)
$138,177
Management and general expenses
$0
Fundraising expenses
$0
Program service expenses (Part III)
$138,177

Program services were 100.0% of total expenses calculated — Part IX's program-services column over total expenses, both as filed.

Line items

Every line the filer filed in Parts VIII, IX and X, as filed and in filed order. Blank columns are left out, and the lines are not forced to add up to the totals above.

Revenue

Part VIII, the statement of revenue.

  • 2a · Program service revenue: NET PATIENT SERVICE REVENUE

    total $14,003 · related or exempt $14,003

  • 2f · All other program service revenue

    total $0 · related or exempt $0 · unrelated business $0 · excluded $0

  • 6c · Rental income or loss

    real property $0 · personal property $0

  • 7c · Gain or loss

    securities $0 · other assets $0

  • 11d · All other revenue

    total $0 · related or exempt $0 · unrelated business $0 · excluded $0

  • 11e · Other revenue, total

    $0

Functional expenses

Part IX, the statement of functional expenses.

  • 1 · Grants to domestic organizations and governments

    total $0 · program services $0

  • 2 · Grants to domestic individuals

    total $0 · program services $0

  • 3 · Grants to foreign organizations and individuals

    total $0 · program services $0

  • 4 · Benefits paid to or for members

    total $0 · program services $0

  • 5 · Compensation of officers, directors and key employees

    total $0 · program services $0 · management and general $0 · fundraising $0

  • 6 · Compensation of disqualified persons

    total $0 · program services $0 · management and general $0 · fundraising $0

  • 7 · Other salaries and wages

    total $66,436 · program services $66,436 · management and general $0 · fundraising $0

  • 8 · Pension plan contributions

    total $0 · program services $0 · management and general $0 · fundraising $0

  • 9 · Other employee benefits

    total $12,494 · program services $12,494 · management and general $0 · fundraising $0

  • 10 · Payroll taxes

    total $4,810 · program services $4,810 · management and general $0 · fundraising $0

  • 11a · Fees: management

    total $0 · program services $0 · management and general $0 · fundraising $0

  • 11b · Fees: legal

    total $0 · program services $0 · management and general $0 · fundraising $0

  • 11c · Fees: accounting

    total $0 · program services $0 · management and general $0 · fundraising $0

  • 11d · Fees: lobbying

    total $0 · program services $0 · management and general $0 · fundraising $0

  • 11e · Fees: professional fundraising services

    total $0 · fundraising $0

  • 11f · Fees: investment management

    total $0 · program services $0 · management and general $0 · fundraising $0

  • 11g · Fees: other

    total $0 · program services $0 · management and general $0 · fundraising $0

  • 12 · Advertising and promotion

    total $0 · program services $0 · management and general $0 · fundraising $0

  • 13 · Office expenses

    total $648 · program services $648 · management and general $0 · fundraising $0

  • 14 · Information technology

    total $456 · program services $456 · management and general $0 · fundraising $0

  • 15 · Royalties

    total $0 · program services $0 · management and general $0 · fundraising $0

  • 16 · Occupancy

    total $0 · program services $0 · management and general $0 · fundraising $0

  • 17 · Travel

    total $0 · program services $0 · management and general $0 · fundraising $0

  • 18 · Travel or entertainment for public officials

    total $1,681 · program services $1,681 · management and general $0 · fundraising $0

  • 19 · Conferences, conventions and meetings

    total $79 · program services $79 · management and general $0 · fundraising $0

  • 20 · Interest

    total $0 · program services $0 · management and general $0 · fundraising $0

  • 21 · Payments to affiliates

    total $0 · program services $0 · management and general $0 · fundraising $0

  • 22 · Depreciation, depletion and amortization

    total $0 · program services $0 · management and general $0 · fundraising $0

  • 23 · Insurance

    total $0 · program services $0 · management and general $0 · fundraising $0

  • 24a · Other expenses: Therapy

    total $6,185 · program services $6,185 · management and general $0 · fundraising $0

  • 24b · Other expenses: Medical Supplies

    total $1,747 · program services $1,747 · management and general $0 · fundraising $0

  • 24c · Other expenses: Bad Debt expense

    total $43,592 · program services $43,592 · management and general $0 · fundraising $0

  • 24e · All other expenses

    total $49 · program services $49 · management and general $0 · fundraising $0

  • 26 · Joint costs (an allocation of the lines above)

    total $0 · program services $0 · management and general $0 · fundraising $0

Balance sheet

Part X, book values.

  • 1 · Cash, non-interest-bearing

    beginning of year $0 · end of year $0

  • 2 · Savings and temporary cash investments

    beginning of year $0 · end of year $0

  • 3 · Pledges and grants receivable

    beginning of year $0 · end of year $0

  • 4 · Accounts receivable

    beginning of year $87,958 · end of year $0

  • 5 · Loans and receivables from officers and key people

    beginning of year $0 · end of year $0

  • 6 · Loans and receivables from disqualified persons

    beginning of year $0 · end of year $0

  • 7 · Other notes and loans receivable

    beginning of year $0 · end of year $0

  • 8 · Inventories for sale or use

    beginning of year $0 · end of year $0

  • 9 · Prepaid expenses and deferred charges

    beginning of year $0 · end of year $0

  • 10a · Land, buildings and equipment: cost or other basis

    $0

  • 10b · Land, buildings and equipment: accumulated depreciation

    $0

  • 10c · Land, buildings and equipment, net

    beginning of year $0 · end of year $0

  • 11 · Investments: publicly traded securities

    beginning of year $0 · end of year $0

  • 12 · Investments: other securities

    beginning of year $0

  • 13 · Investments: program-related

    beginning of year $0

  • 14 · Intangible assets

    beginning of year $0 · end of year $0

  • 15 · Other assets

    beginning of year $28 · end of year $0

  • 17 · Accounts payable and accrued expenses

    beginning of year $28,932 · end of year $0

  • 18 · Grants payable

    beginning of year $0 · end of year $0

  • 19 · Deferred revenue

    beginning of year $3,846 · end of year $0

  • 20 · Tax-exempt bond liabilities

    beginning of year $0 · end of year $0

  • 21 · Escrow or custodial account liability

    beginning of year $0 · end of year $0

  • 22 · Loans and payables to officers and key people

    beginning of year $0 · end of year $0

  • 23 · Secured mortgages and notes payable

    beginning of year $0 · end of year $0

  • 24 · Unsecured notes and loans payable

    beginning of year $0 · end of year $0

  • 25 · Other liabilities

    beginning of year $366 · end of year $0

  • 27 · Net assets without donor restrictions

    beginning of year $54,842 · end of year $0

  • 28 · Net assets with donor restrictions

    beginning of year $0 · end of year $0

  • 29 · Capital stock, trust principal or current funds

    beginning of year $0 · end of year $0

  • 30 · Paid-in or capital surplus, or land, building or equipment fund

    beginning of year $0 · end of year $0

  • 31 · Retained earnings, endowment or other funds

    beginning of year $0 · end of year $0

Mission and programs · 2022

Mission

To help Hillsborough, Pasco, Pinellas, and Polk residents heal and thrive at home with quality, compassionate home care services.

  • THE ORGANIZATION HELPS PROMOTE INDEPENDENCE AND MAINTAIN THE HEALTH OF SENIOR CITIZENS WITH CHRONIC CARE NEEDS AND HELPS THEIR FAMILIES THROUGH THE PROVISION OF HOME AND COMMUNITY BASED SERVICES WHENEVER POSSIBLE. The organization ceased operations on 1/31/2022.

    Expenses $138,177 · Revenue $14,003

As filed on the 2022 return. The filer continues this part on Schedule O, which is not shown here.

Listed in Part VII

  • Andrew Molosky

    PRESIDENT/CEO/CHAIR

    Total calculated
    $2,237,403
    From this org
    $0
    From related orgs
    $1,502,847
    Other
    $734,556
    Hours/week
    2 + 48 related

    Schedule J breakdown matched by us

    Base
    $0 + $717,850 related
    Bonus
    $0 + $250,132 related
    Other
    $0 + $534,866 related
    Deferred
    $0 + $688,375 related
    Nontaxable benefits
    $0 + $46,181 related
    Filer's total
    $0 + $2,237,403 related

  • Dean Forman

    Chief Operating Officer

    Total calculated
    $540,489
    From this org
    $0
    From related orgs
    $528,476
    Other
    $12,013
    Hours/week
    2 + 48 related

    Schedule J breakdown matched by us

    Base
    $0 + $397,006 related
    Bonus
    $0 + $58,000 related
    Other
    $0 + $73,470 related
    Deferred
    $0 + $9,150 related
    Nontaxable benefits
    $0 + $2,863 related
    Filer's total
    $0 + $540,489 related

  • Lilly Ho-Pehling

    Secretary

    Total calculated
    $0
    Hours/week
    2

  • James Joiner

    BOARD MEMBER

    Total calculated
    $0
    Hours/week
    2 + 4 related

  • Randall Woodruff

    BOARD MEMBER

    Total calculated
    $0
    Hours/week
    2 + 5.5 related

  • David J O'Neil

    Enterprise Chief Financial Officer

    Total calculated
    $1,056,101
    From this org
    $0
    From related orgs
    $779,111
    Other
    $276,990
    Hours/week
    2 + 48 related

    Schedule J breakdown matched by us

    Base
    $0 + $480,786 related
    Bonus
    $0 + $72,000 related
    Other
    $0 + $226,325 related
    Deferred
    $0 + $228,558 related
    Nontaxable benefits
    $0 + $48,432 related
    Filer's total
    $0 + $1,056,101 related

  • Michael Shapiro

    Chief Medical Officer - Hospice (Starting 4/2022)

    Total calculated
    $530,635
    From this org
    $0
    From related orgs
    $474,112
    Other
    $56,523
    Hours/week
    2 + 48 related

    Schedule J breakdown matched by us

    Base
    $0 + $391,364 related
    Bonus
    $0 + $82,387 related
    Other
    $0 + $360 related
    Deferred
    $0 + $8,572 related
    Nontaxable benefits
    $0 + $47,951 related
    Filer's total
    $0 + $530,635 related

  • Nicole Romence

    Chief People Officer

    Total calculated
    $474,332
    From this org
    $0
    From related orgs
    $325,861
    Other
    $148,471
    Hours/week
    2 + 48 related

    Schedule J breakdown matched by us

    Base
    $0 + $305,000 related
    Bonus
    $0 + $10,000 related
    Other
    $0 + $10,861 related
    Deferred
    $0 + $145,995 related
    Nontaxable benefits
    $0 + $2,476 related
    Filer's total
    $0 + $474,332 related

  • Paola Delp

    Chief Business Development Officer

    Total calculated
    $961,690
    From this org
    $0
    From related orgs
    $701,038
    Other
    $260,652
    Hours/week
    2 + 48 related

    Schedule J breakdown matched by us

    Base
    $0 + $397,823 related
    Bonus
    $0 + $98,000 related
    Other
    $0 + $205,215 related
    Deferred
    $0 + $243,991 related
    Nontaxable benefits
    $0 + $16,661 related
    Filer's total
    $0 + $961,689 related

  • Rhonda G White

    Chief Compliance Officer (4/2022-12/2022), Chief Operating Officer (Starting 12/2022)

    Total calculated
    $585,295
    From this org
    $0
    From related orgs
    $468,191
    Other
    $117,104
    Hours/week
    2 + 48 related

    Schedule J breakdown matched by us

    Base
    $0 + $335,777 related
    Bonus
    $0 + $126,098 related
    Other
    $0 + $6,315 related
    Deferred
    $0 + $99,261 related
    Nontaxable benefits
    $0 + $17,843 related
    Filer's total
    $0 + $585,295 related

  • Ronald S Schonwetter MD

    Chief Medical Officer (through 2/2022)

    Total calculated
    $337,546
    From this org
    $0
    From related orgs
    $331,114
    Other
    $6,432
    Hours/week
    2 + 48 related

    Schedule J breakdown matched by us

    Base
    $0 + $173,658 related
    Bonus
    $0 + $77,000 related
    Other
    $0 + $80,456 related
    Deferred
    $0 + $1,500 related
    Nontaxable benefits
    $0 + $4,932 related
    Filer's total
    $0 + $337,547 related

  • Sharon P Saucier

    Chief Clinical & Compliance Officer (through 4/2022)

    Total calculated
    $408,125
    From this org
    $0
    From related orgs
    $392,148
    Other
    $15,977
    Hours/week
    2 + 48 related

    Schedule J breakdown matched by us

    Base
    $0 + $62,258 related
    Bonus
    $0
    Other
    $0 + $329,889 related
    Deferred
    $0 + $2,039 related
    Nontaxable benefits
    $0 + $13,938 related
    Filer's total
    $0 + $408,124 related

  • Sheri Strobel Amateau

    Chief Information Officer

    Total calculated
    $455,925
    From this org
    $0
    From related orgs
    $319,720
    Other
    $136,205
    Hours/week
    2 + 48 related

    Schedule J breakdown matched by us

    Base
    $0 + $270,844 related
    Bonus
    $0 + $40,000 related
    Other
    $0 + $8,875 related
    Deferred
    $0 + $132,253 related
    Nontaxable benefits
    $0 + $3,952 related
    Filer's total
    $0 + $455,925 related

  • Tara Friedman

    Chief Medical Officer (Starting 4/2022)

    Total calculated
    $174,660
    From this org
    $0
    From related orgs
    $168,961
    Other
    $5,699
    Hours/week
    2 + 48 related

    Schedule J breakdown matched by us

    Base
    $0 + $136,396 related
    Bonus
    $0 + $30,000 related
    Other
    $0 + $2,565 related
    Deferred
    $0 + $904 related
    Nontaxable benefits
    $0 + $4,795 related
    Filer's total
    $0 + $174,660 related

  • Todd Webb

    CHIEF FINANCIAL OFFICER (starting 4/2022)

    Total calculated
    $565,141
    From this org
    $0
    From related orgs
    $452,733
    Other
    $112,408
    Hours/week
    1 + 49 related

    Schedule J breakdown matched by us

    Base
    $0 + $330,606 related
    Bonus
    $0 + $115,692 related
    Other
    $0 + $6,435 related
    Deferred
    $0 + $68,253 related
    Nontaxable benefits
    $0 + $44,154 related
    Filer's total
    $0 + $565,141 related

  • Valerie Zolman

    Chief Compliance Officer (starting 12/2022)

    Total calculated
    $359,259
    From this org
    $0
    From related orgs
    $288,032
    Other
    $71,227
    Hours/week
    2 + 48 related

    Schedule J breakdown matched by us

    Base
    $0 + $216,169 related
    Bonus
    $0 + $71,863 related
    Other
    $0
    Deferred
    $0 + $38,524 related
    Nontaxable benefits
    $0 + $32,703 related
    Filer's total
    $0 + $359,259 related

Compensation is as filed in Part VII: reportable pay from this organization and from related organizations, other compensation, and hours per week. The total, marked calculated, is our sum of the three dollar columns, with a blank column counted as $0; the form itself has no total. On a Form 990-EZ the columns are Part IV's instead, and on a Form 990-PF Part VIII's — compensation, contributions to benefit plans, and expense account — and the total sums those. A Schedule J breakdown is as filed: base pay, bonus, other, deferred compensation and nontaxable benefits from this organization, with any from related organizations beside each, and the filer's own total. It is shown with the Part VII listing of the same name on the same return. The form gives no key between the two, so that pairing is ours, and is marked matched by us.

Schedule J

Answered yes

  • 4a · Severance or change-of-control payment
  • 4b · Supplemental nonqualified retirement plan

Answered no

  • 4c · Equity-based compensation arrangement
  • 5a · Pay contingent on this organization's revenues
  • 5b · Pay contingent on a related organization's revenues
  • 6a · Pay contingent on this organization's net earnings
  • 6b · Pay contingent on a related organization's net earnings
  • 7 · Other non-fixed payments
  • 8 · Paid under the initial-contract exception

The filer's explanations (Part III)

Schedule J, Part I, Line 3 Arrangement used to establish the top management official's compensation
THE PRESIDENT & CEO IS PAID BY CHAPTERS HEALTH SYSTEM, INC. (A RELATED ORGANIZATION). CHAPTERS HEALTH SYSTEM USES A COMPENSATION COMMITTEE, INDEPENDENT COMPENSATION CONSULTANT, COMPENSATION SURVEY OR STUDY, FORMS 990 OF OTHER ORGANIZATIONS, AND APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE TO DETERMINE HIS COMPENSATION. CHAPTERS HEALTH HOME CONNECT, INC. RELIES ON CHAPTERS HEALTH SYSTEM TO ENSURE COMPENSATION IS REASONABLE.
Schedule J, Part I, Line 4a Severance or change-of-control payment
DURING THE YEAR, CHS PAID SEVERANCE TO: SHARON SAUCIER $183,185
Schedule J, Part I, Line 4b Supplemental nonqualified retirement plan
CHS (A RELATED ORGANIZATION) HAS A SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (SERP) IN WHICH SOME OF THE INTERESTED PERSONS PARTICIPATE. DURING THE YEAR, THE FOLLOWING PAYMENTS WERE MADE BY CHS INTO THE SERP PLANS OF THE PARTICIPANTS: A.Molosky $315,306 D.O'Neil $106,294 P.Delp $104,287 S.Strobel $46,897 N.Romence $47,250

Part I's answers as filed. A line not listed was left unanswered; on lines 1a and 3 that means the box was not checked.

Grants on this return

No itemized grants to organizations on this return.

Related organizations on this return

Schedule R Part II: tax-exempt organizations related to the filer by control. It does not record shared board members or money.

Taxable family on this return

Schedule R Parts I, III and IV, as filed. These record ownership and control, not shared board members or money moved.

Disregarded entities

Part I: entities that legally are the filer and file no return of their own.

  • Achieve Home Care LLC

    Home health care service · FL · income $14,003 · assets $0

    Directly controlled by Chapters Health Home Connect Inc

Related partnerships

Part III: related organizations taxable as a partnership, with the filer's share.

  • Allcare Medical of Florida LLC

    N/A · Medical Services · FL

    Directly controlled by NA

  • Assurity DCE

    N/A · Medical Services · FL

    Directly controlled by NA

Related corporations and trusts

Part IV: related organizations taxable as a corporation or trust.

  • Chapters CareNu Inc

    C Corporation · POPULATION HEALTH · FL

    Directly controlled by NA

  • SECUR INC

    C Corporation · POPULATION HEALTH · FL

    Directly controlled by NA

Assets distributed on this return

Schedule N, as filed: what the organization did with its assets when it liquidated or dissolved, or disposed of more than a quarter of them, and who received them. A recipient with an EIN is usually a successor organization; filers also list expenses such as legal fees here.

1 distribution to a recipient named as a person, $69,332. Counted where the filer named the recipient as a person, as filed. Who received them, and what, are not published.

Provenance

Return type
form_990
Tax year
2022
Filed
19 October 2023
IRS schema version
2022v5.0
Source object
202312929349300341

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