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
2016
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 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 2016 HOM dedicated approximately $750,000 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 2016 HOM provided grief support services to approximately 5200 caregivers, family or community members - of this 64% were connected to HOM with the other 36% 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 NAVIGATION SYSTEM WITHIN THE HOM CONTINUUM OF SERVICES THAT FOCUSES ON RESOURCE COORDINATION AND ASSISTANCE WITH DECISION-MAKING FOR PATIENTS AND FAMILIES WHO ARE ELIGIBLE FOR END-OF-LIFE CARE BUT "MAY OR MAY NOT BE ELIGIBLE FOR HOSPICE." THERE WERE 825 PATIENTS SERVED ON THE "CHOICES" PROGRAM IN 2016. (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 2016 Hospice of Michigan contributed $631,417 to support these three programs due to the fact that there is no reimbursement for Peds Early Care or Perinatal services. In 2016, we supported 358 pediatric patients and families in 36 counties throughout the Lower Peninsula. Pediatric Hospice, served 57 patient families. Perinatal Care cared for 13 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 2016, PEC supported 288 patients/families, 202 of them being in Southeast. (vi) In 2016, 52% of Hospice of Michigan employees participated in the annual appeal, contributing over $64,000 to support a number of the organizations significant programs of excellence, including: - Open Access - Palliative Care - Complementary Therapies - Quality of Life In addition, 64 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 had a year of transition in 2016. In June, the orientation programs of both Arbor Hospice and HOM were integrated into one program. The Education Department oriented 201 new employees and facilitated 57 presentations of prepared CE programs for the community with 1,095 people attending for CE credit (Nurses and Social Workers). The CEs for nursing are provided by the Wisconsin Nurses Association and the department transitioned the in house coordinators for this role during the transition of staff. Social work CEs were provided by relationship with VCE- Virtual Center for Excellence in collaboration with the Detroit Wayne Mental Health Authority (DWMHA). The HOMI was actively involved in planning and providing the Nursing CEs for The Caring Coalition's 15th annual conference attended by nearly 700 people in SE Michigan, in collaboration with the Jewish Hospice Chaplaincy Organization. We currently have 51 staff who are certified in Hospice and Palliative Care- representing 16% of our total clinical staff; 32 aides, 17 RNs and 2 MSWs.
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 2016 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. 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) HOM 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 in 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 with the 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 2016 the annual external compensation study was performed to assess executive compensation. 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 Beneficial interest in net assets of Arbor Hospice - 8405279;
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 51056K
Schedule O (Form 990 or 990-EZ) 2016


Additional Data


Software ID: 16000421
Software Version: 2016v3.0