SCHEDULE O
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service
Supplemental Information to Form 990 or 990-EZ

Complete to provide information for responses to specific questions on
Form 990 or 990-EZ or to provide any additional information.
MediumBullet Attach to Form 990 or 990-EZ.
MediumBullet Information about Schedule O (Form 990 or 990-EZ) and its instructions is at
www.irs.gov/form990.
OMB No. 1545-0047
2015
Open to Public
Inspection
Name of the organization
Hospice of Michigan Inc
 
Employer identification number

38-2255529
Return Reference Explanation
Form 990, Part III, Line 1 ORGANIZATION MISSION OUR VISION IS THAT HOSPICE OF MICHIGAN WILL BE MICHIGAN'S LEADING PROVIDER OF COMFORT CARE SERVICES TO INDIVIDUALS AND FAMILIES COPING WITH A LIFE-LIMITING ILLNESS. OUR VALUES INCLUDE: (1) QUALITY SERVICE - TO PROVIDE THE HIGHEST QUALITY SERVICE; RESPOND TO OUR PATIENTS' AND FAMILIES' NEEDS; AND AFFIRM PATIENT SELF-DETERMINATION, EMPOWERMENT, AND CHOICE; (2) TEAMWORK - TO TREAT EVERYONE WITH RESPECT AND ENCOURAGE STAFF'S PERSONAL AND PROFESSIONAL DEVELOPMENT; (3) RESOURCE STEWARDSHIP - TO DEMONSTRATE GOOD STEWARDSHIP OF OUR RESOURCES; (4) MISSION OUTREACH - TO ACKNOWLEDGE AND EMBRACE RELIGIOUS, ETHNIC, AND CULTURAL DIVERSITY; AND (5) SACRED SPACE - TO HONOR LIFE TO THE END, VALUING EVERY FORM OF HEALING; BE WITNESS TO THE SPIRIT OF LIFE; BE PRIVILEGED TO PROTECT THE SACREDNESS OF LEAVING, HONORING THE FEELING OF LOSS; AND ASSURE THAT PATIENTS AND FAMILIES ACHIEVE THEIR QUALITY OF LIFE GOAL WHILE UNDER OUR CARE.
Form 990, Part III, Line 4a PROGRAM SERVICE DESCRIPTION As a trend, our volunteer hours are increasing and we expect to see even better results in 2016. We maintain a high engagement with volunteers who in turn better serve those who need our support. (ii) Through support from the Hospice of Michigan Institute, Volunteer Services and Marketing staff, each Hospice of Michigan clinical team has maintained Level 4, the highest level, in the "We Honor Veterans" program sponsored by the National Hospice and Palliative Care Organization and the U.S. Department of Veterans Affairs (VA). This pioneering campaign is designed to improve the services veterans receive from hospice and palliative care providers. Staff education and training are major requirements for an organization to reach each level. HOM was the first organization to achieve statewide Level 4 status. There are only 4 other programs in the state who have reached level 4. (iii) HOM provides our patients, our patient's families and families in the communities we serve Grief Support services through one on one counseling or group sessions. Grief Support is not reimbursed by any insurance, and in 2015 HOM dedicated approximately $809,000 toward providing this service. HOM Grief Support Memorial Programs continue to be a substantial benefit for our communities and families. Memorial services honor sacred space and allow the bereaved to embrace opportunities to remember. Grief Support Service Managers in the past have provided diverse memorial programs for their communities. Examples of our memorial programs include; -Fly and Remember held throughout our locations across the state allow attendees to design and fly a memorial kite. A tall ship sailing memorial service for grieving families on the waters of Traverse Bay is another example of innovative memorial programs that are offered. - Camp Good Grief is a day camp that is offered to children ages 8-17 who have experienced a loss. Children spend the day doing team building activities as well as memorial crafts and group reflection that incorporated grief education and support throughout each activity. - Memory Bears is where we have volunteer seamstresses sew together bears from articles of clothing of the loved one who was lost. This is then presented to the family and has been well received. - Programs incorporating self-care, memorial rituals, and staff participation using their own unique talents (singing, instrument playing, poetry, even cooking). In 2015 HOM provided grief support services to approximately 5300 caregivers, family or community members - of this 79% were connected to HOM with the other 21% coming from elsewhere in the community with no ties to HOM. Services offered to the bereaved community through Hospice of Michigan continue to be robust and wide ranging. (iv) Hospice of Michigan continues to experience significant growth with At Home ChoiceS a care delivery system within the HOM continuum of services that focuses on care coordination, case management, and shared decision-making for patients and families who are eligible for end-of-life care but "may or may not be eligible for hospice." The current At Home Choices program is structured to provide palliative approaches to care for patients with advanced cancers, end-stage lung and heart conditions, and HIV/AIDS. In addition, the program provides supportive services for patients with progressive, end-stage degenerative and multi-morbidity conditions. Our At Home Choice program - which serves patients in our statewide communities -encourages and supports patient and family-centered "choices." Whereas the current system forces patients and families to choose between continued treatment and supportive care, At Home Choice eliminates difficult decisions by providing patients and families with a desirable alternative option - to receive supportive care while seeking active treatment for disease conditions. The overall goal of At Home Choice is to improve access to supportive care and hospice services. There were 702 patients served on the "Choices" program in 2015. (v) One area that continues to be unique to Hospice of Michigan is our pediatric program, which includes a Pediatric Hospice program, a Pediatric Early Care program, and a Perinatal Program. In 2015 Hospice of Michigan contributed $630,000 to support these three programs due to the fact that there is no reimbursement for Peds Early Care or Perinatal services. In 2015, we supported 325 pediatric patients and families in 36 counties throughout the Lower Pennisula. Pediatric Hospice, served 52 patient families. Perinatal Care cared for 14 patients/families. Our Pediatric Early Care program experienced significant growth, primarily due to the generous gift provided to support expansion of the program to SE and Northern Michigan. In 2015, PEC supported 258 patient/families, 172 of them being in Southeast. (vi) In 2015, 33% of Hospice of Michigan employees participated in the annual appeal, contributing over $50,000 to support a number of the organizations significant programs of excellence, including: - Open Access - At Home Support - Home Health Aide Certification - At Home Choices - Quality of Life In addition 189 hours of vacation and float time were donated to the Heart from HOMe program to support the Emergency Time-Off Bank for employees. (vii) The Hospice of Michigan Institute (HOMI) had a busy year. On top of training 127 new hires, they redesigned the content and materials combining hospice and At Home as well as developed and education plan to meet ACHC requirements. In conjunction with orientation and continuing education, the Institute created and tested a skills/simulation lab at the corporate office. Certified Hospice and Palliative Care Nursing Assistant certification is extended to all hospice aides at no cost to them. Currently we have 55% of our aides certified. There has also been significant multicultural work being done in SE and Western Michigan to educate staff and care givers on hospice care.
Form 990, Part VI, Line 15b PROCESS USED TO ESTABLISH COMPENSATION OF OTHER OFFICERS/KEY EMPLOYEES THE EXECUTIVE COMMITTEE OF THE BOARD OF TRUSTEES MEETS ANNUALLY IN MARCH TO REVIEW AND APPROVE AS APPROPRIATE, FUNDS TO BE ALLOCATED FOR TOTAL COMPENSATION FOR THE ORGANIZATION'S CHIEF FINANCIAL OFFICER, CHIEF OPERATING OFFICER, CHIEF MEDICAL OFFICER, CHIEF MARKETING OFFICER AND CHIEF FUNDRAISING OFFICER, INCLUDING BASE SALARY, BONUS, CAR ALLOWANCE, AND OTHER BENEFITS. MINUTES ARE TAKEN UP UNTIL THE POINT WHERE DISCUSSION OF COMPENSATION TAKES PLACE AND VOTE/DECISION IS MADE IN REGARDS TO COMPENSATION. THE CEO AND EXECUTIVE ASSISTANT ARE EXCUSED FROM THE MEETING AT THIS POINT WHILE DISCUSSION AND DECISION IS MADE. IN ADDITION, IN 2015 AN EXTERNAL COMPENSATION STUDY WAS PERFORMED TO ASSESS EXECUTIVE COMPENSATION; THIS EXTERNAL COMPENSATION STUDY IS PLANNED TO BE PERFORMED ANNUALLY. THE COMPENSATION STUDY AIMS TO PRICE POSITIONS AT MARKET BY USING LOCAL, NATIONAL, AND INDUSTRY SPECIFIC SURVEY DATA. AN OUTSIDE CONSULTANT IS ENGAGED THROUGH AN AFFILIATION WITH AMERICAN SOCIETY OF EMPLOYERS (ASE). MARKET DATA WAS GATHERED THROUGH CRAINS TOP NON-PROFIT SURVEY, ASE NATIONAL EXECUTIVE COMPENSATION SURVEY, NATIONALLY COMPARED 990'S OF THE 37 LARGEST HOSPICE'S, AS WELL AS THE TOP 32 HOSPITALS WITH REVENUE $150 MILLION OR LESS. TWO OPTIONS ARE PRESENTED BY THE PRESIDENT/CEO TO THE EXECUTIVE COMMITTEE BASED ON THE MARKET DATA THAT WAS GATHERED.
Form 990, Part VI, Line 1a Delegate broad authority to a committee The Executive Committee shall consist of the Chairperson of the Board, the Vice Chairperson, the Secretary-Treasurer, the Immediate Past Chairperson of the Board, the President and the Chairs of the Clinical Services and Organizational Quality, Finance and Audit, Board Development and Evaluation, and Nominating Committees as well as the Chairperson of the Hospice of Michigan Foundation Board of Trustees. The Executive Committee shall possess and exercise the authority and powers of the Board of Trustees in the management and direction of the Corporation in the interim periods between meetings of the Board and shall discharge the duties of said Board during such interim periods, except that the Executive Committee shall not have power or authority to: (a) amend the Articles of Incorporation; (b) dissolve the Corporation or revoke a dissolution; (c) amend the Bylaws of the Corporation; or (d) fill vacancies in the Board.
Form 990, Part VI, Line 11b Review of form 990 by governing body A final draft of the full Form 990 is reviewed with our tax advisors and approved by an Executive Committee of the board, and then a copy of the full Form 990 draft is sent out to each voting member of the governing body. These reviews take place prior to filing the Form 990 with the IRS.
Form 990, Part VI, Line 12c Conflict of interest policy Procedure: Employees, both paid and unpaid (from here forward referred to as "employee"), and Board members, have a fundamental obligation to act in the best interest of patient care and Hospice Of Michigan (HOM). Every Board member and employee is responsible for acting consistent with this obligation when engaging in activities, and should not let other personal and financial interests interfere with this obligation. General Practice Guidelines: (1) Hospice of Michigan requires that all members of its Boards of Trustees and employees disclose interests that could result in a conflict. Annually, all board members sign off on a Conflict of Interest policy and disclose any situation which may represent a conflict. The Corporate Compliance Officer (CCO) also has access to the Board at least annually. The organization also utilizes C-TRAC (Crowe Tax Risk Assessment and Control), a tool provided by our tax advisors, to send conflict of interest surveys to all voting board members, executives, and the highest paid staff. (2) All Board members and employees are required to submit a disclosure statement, if there is a conflict of interest that meets the stated definition, at the beginning of employment or term. (3) If a matter arises in which a member of the Board or employee has a conflict of interest, the individual shall promptly disclose it to the CEO, or the case of the CEO, the Board Chairperson. (4) An individual with a potential conflict of interest shall not proceed to make any decision or take any action on behalf of the organization without approval of the Board of Trustees. (5) HOM employees are precluded from engaging in activities with any "Vendor or Supplier Business" (as that term is defined in the policy) that does or seeks business with HOM which may result in a personal benefit to the employee at the expense of HOM or may influence the employee's decisions on matters involving HOM and a Vendor or Supplier Business.
Form 990, Part VI, Line 15a Process to establish compensation of top management official The Executive Committee of the Board of Trustees meets annually in March to review and approve as appropriate, funds to be allocated for total compensation for the organization's President/CEO, including base salary, bonus, car allowance, and other benefits. The Executive Committee also determines if the President/CEO's contract needs to be updated or renewed at this time. Minutes are taken up until the point where discussion of compensation takes place and vote/decision is made in regards to compensation. The CEO and Executive Assistant are excused from the meeting at this point while discussion and decision is made. In addition, in 2015 an external compensation study was performed to assess Executive Compensation; this external compensation study is planned to be performed annually. The compensation study aims to price positions at market by using local, national, and industry specific survey data. An outside consultant is engaged through an affiliation with American Society of Employers (ASE). Market data was gathered through Crains Top Non-Profit survey, ASE National Executive Compensation Survey, Nationally compared 990's of the 37 largest hospice's, as well as the top 32 hospitals with revenue $150 million or less. Two options are presented to the Executive Committee based on the market data that was gathered.
Form 990, Part VI, Line 19 Required documents available to the public The organization's governing documents, conflict of interest policy, and audited financial statements can be available upon request.
Form 990, Part XI, Line 9 Other changes in net assets or fund balances Change in Pledge Discount - -14713;
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 51056K
Schedule O (Form 990 or 990-EZ) 2015


Additional Data


Software ID: 15000238
Software Version: 2015v2.1