Attach to Form 990 or Form 990-EZ.
Information about Schedule A (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.
| (i)Name of supported organization | (ii) EIN | (iii) Type of organization (described on lines 1- 9 above or IRC section (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 | |||||
| Total | ||||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2010 | (b) 2011 | (c) 2012 | (d) 2013 | (e) 2014 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 1 | Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") .... | ||||||
| 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) ![]() |
(a) 2010 | (b) 2011 | (c) 2012 | (d) 2013 | (e) 2014 | (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) 2010 | (b) 2011 | (c) 2012 | (d) 2013 | (e) 2014 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 1 | Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") . | 3,051,922 | 3,365,060 | 5,181,796 | 2,358,850 | 2,376,237 | 16,333,865 |
| 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...... | 24,273,061 | 26,403,067 | 28,489,500 | 30,552,661 | 30,022,322 | 139,740,611 |
| 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. | 27,324,983 | 29,768,127 | 33,671,296 | 32,911,511 | 32,398,559 | 156,074,476 |
| 7a | Amounts included on lines 1, 2, and 3 received from disqualified persons... | 0 | 0 | 0 | 0 | 0 | 0 |
| 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. | 0 | 0 | 0 | 0 | 0 | 0 |
| c | Add lines 7a and 7b.. | 0 | 0 | 0 | 0 | 0 | 0 |
| 8 | Public support (Subtract line 7c from line 6.) | 156,074,476 | |||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2010 | (b) 2011 | (c) 2012 | (d) 2013 | (e) 2014 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 9 | Amounts from line 6... | 27,324,983 | 29,768,127 | 33,671,296 | 32,911,511 | 32,398,559 | 156,074,476 |
| 10a | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources.. | 220,677 | 178,947 | 233,484 | 229,545 | 222,427 | 1,085,080 |
| b | Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975. | ||||||
| c | Add lines 10a and 10b. | 220,677 | 178,947 | 233,484 | 229,545 | 222,427 | 1,085,080 |
| 11 | Net income from unrelated business activities not included in 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.) .. | 43,028 | 51,203 | 48,476 | 48,619 | 95,860 | 287,186 |
| 13 | Total support. (Add lines 9, 10c, 11, and 12.).. | 27,588,688 | 29,998,277 | 33,953,256 | 33,189,675 | 32,716,846 | 157,446,742 |
| Section A - Adjusted Net Income | (A) Prior Year |
(B) Current Year (optional) |
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| 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 1-1/2% 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 .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 | ||||
| 7 | Check here if the current year is the organization's first as a non-functionally-integrated Type III supporting organization (see instructions) | |||||
| Section D - Distributions | Current Year | |
|---|---|---|
| 1 Amounts paid to supported organizations to accomplish exempt purposes | ||
|
2
Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in excess of income from activity |
||
| 3 Administrative expenses paid to accomplish exempt purposes of supported organizations | ||
| 4 Amounts paid to acquire exempt-use assets | ||
| 5 Qualified set-aside amounts (prior IRS approval required) | ||
| 6 Other distributions (describe in Part VI). See instructions | ||
| 7Total annual distributions. Add lines 1 through 6. | ||
|
8
Distributions to attentive supported organizations to which the organization is responsive (provide details in Part VI). See instructions |
||
| 9 Distributable amount for 2014 from Section C, line 6 | ||
| 10 Line 8 amount divided by Line 9 amount | ||
| Section E - Distribution Allocations (see instructions) |
(i) Excess Distributions |
(ii) Underdistributions Pre-2014 |
(iii) Distributable Amount for 2014 |
|
|---|---|---|---|---|
|
1
Distributable amount for 2014 from Section C, line 6 |
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|
2
Underdistributions, if any, for years prior to 2014 (reasonable cause required--see instructions) |
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| 3 Excess distributions carryover, if any, to 2014: | ||||
| a From 2009.......X | ||||
| b From 2010.......X | ||||
| c From 2011.......X | ||||
| d From 2012.......X | ||||
| e From 2013....... | ||||
| fTotal of lines 3a through e | ||||
| g Applied to underdistributions of prior years | ||||
| h Applied to 2014 distributable amount | ||||
|
i
Carryover from 2009 not applied (see instructions) |
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| j Remainder. Subtract lines 3g, 3h, and 3i from 3f. | ||||
| 4Distributions for 2014 from Section D, line 7: | ||||
| $ | ||||
| a Applied to underdistributions of prior years | ||||
| b Applied to 2014 distributable amount | ||||
| c Remainder. Subtract lines 4a and 4b from 4. | ||||
|
5
Remaining underdistributions for years prior to 2014, if any. Subtract lines 3g and 4a from line 2 (if amount greater than zero, see instructions) |
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|
6
Remaining underdistributions for 2014. Subtract lines 3h and 4b from line 1 (if amount greater than zero, see instructions) |
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|
7 Excess distributions carryover to 2015. Add lines 3j and 4c. |
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| 8 Breakdown of line 7: | ||||
| a From 2010.......X | ||||
| b From 2011.......X | ||||
| c From 2012.......X | ||||
| d From 2013....... | ||||
| e From 2014....... | ||||
| Facts And Circumstances Test |
|---|
| Return Reference | Explanation |
|---|---|
| Schedule A, Part III, Line 12 Other Income | DESCRIPTION - GROSS RECEIPTS FROM FUNDRAISING EVENTS, COLUMN A - 43028.0, COLUMN B - 51203.0, COLUMN C - 48476.0, COLUMN D - , COLUMN E - 95860.0, COLUMN F - 238567.0; DESCRIPTION - FUNDRAISING REVENUE, COLUMN A - , COLUMN B - , COLUMN C - , COLUMN D - 44704.0, COLUMN E - , COLUMN F - 44704.0; DESCRIPTION - GAMING REVENUE, COLUMN A - , COLUMN B - , COLUMN C - , COLUMN D - 3915.0, COLUMN E - , COLUMN F - 3915.0; |
| Software ID: | 14000329 |
| Software Version: | 2014v1.0 |
Attach to Form 990 or 990-EZ.
Information about Schedule O (Form 990 or 990-EZ) and its instructions is at| Return Reference | Explanation |
|---|---|
| program service accomplishments - general information | Patients are informed of the availability of free and subsidized care at their initial referral for services; application forms are included with admissions forms; and admissions staff are available to assist patients or families with completing the applications. Midwest CareCenter promotes its charity care and subsidized care programs aggressively through advertising and promotional materials. Midwest CareCenter builds relationships with other providers to enhance healthcare services for patients and families in its service area. The organization contracted with eight area hospitals to deliver hospice care in the hospital setting and provided care to residents of more than 100 senior care facilities in its service area. In addition, outreach activities included collaborations with Howard Brown Health Center on Halsted, CJE SeniorLife, Heartland Alliance and Rush University Medical Center to provide healthcare and resources for lesbian, gay, bisexual and transgendered older adults in Chicago through "Aging as We Are." Central to the Midwest CareCenter mission are education, training and research. The organization sponsors and conducts seminars and training sessions, free of charge, on a variety of topics related to end-of-life care for medical professionals and for members of the general public. Over 2,500 healthcare professionals, students and community members learned about hospice, advance directives, how to help grieving children and adults, and other related healthcare topics in 2014. Education and research is largely supported through patient revenues, with some grant support. Midwest CareCenter also participates in an integrated fellowship program with Northwestern Memorial Hospital to train physicians to demonstrate competence in specialist-level expertise in palliative care. The program is accredited by the Accreditation Council for Graduate Medical Education. |
| program service accomplishments - general information | (CONTINUED FROM FORM 990, PART III, LINE 4A) The organization strives to ensure continued access to services for anyone in the community. In 2014, $4,561,000 of free and subsidized care was provided through charity care and community-funded, complementary programming, which included music services and culturally sensitive initiatives. Music-thanatologists held 688 vigils and music therapists provided 1,435 music therapy sessions to benefit patients and families. Additionally, through the organization's Jewish Care Services program, 554 patients received hospice care with an emphasis on Jewish customs and traditions. Midwest CareCenter, a community-based provider of hospice, palliative care and grief support services, is organized and operated exclusively for charitable, educational and medical purposes within the meaning of Section 501(c)(3) of the Internal Revenue Code. Midwest CareCenter provides services to all patients regardless of race, color, national ancestry, religion, age, handicapping condition, gender, sexual orientation or source of payment. In 2014, the organization served patients and families in 150 communities in Cook and Lake counties. Midwest CareCenter operates one of the largest non profit, non-hospital-affiliated hospice in the Chicago area, and is recognized as a leader in the provision of hospice care, palliative medicine, bereavement services, and education in end-of-life issues and practice both locally and nationally. In recognition of its leadership role, Midwest CareCenter was awarded the prestigious Circle of Life Award (2001) by the American Hospital Association for excellence in end-of-life care. Midwest CareCenter offers hospice services for the benefit of patients and families who are coping with the challenges of a terminal illness. The organization's goals are to care for the patient and family as a whole and to promote the patient's dignity and quality of life by managing symptoms, relieving pain and providing total patient care. In 2014, 2,695 patients received hospice care from Midwest CareCenter physicians, nurses, social workers, chaplains and volunteers. The organization first earned accreditation from The Joint Commission in 1996, and its hospice services have continuously received full accreditation in subsequent survey visits, most recently in June 2014. In addition to the core hospice services required by the federal government under the Medicare Hospice Benefit-nursing, medical management, social work, spiritual care and volunteer services-the Midwest CareCenter patient base benefited from additional complementary therapies, including, music and music-thanatology. These services are provided at no additional cost to the patient. Through the organization's Jewish Care Services program, 554 patients received hospice care with an emphasis on Jewish customs and traditions. A partnership with the Jewish Healing Network of Chicago has made it possible for Midwest CareCenter to offer more information and support for those with advanced illness in the Jewish community. Additionally, to improve access to hospice care and palliative medicine for non-English-speaking immigrant populations, Midwest CareCenter provides bi-lingual materials to populations in its service area. Through its Palliative Care Services program, Midwest CareCenter supports the effective medical practice of area physicians by providing consultations on pain and symptom management for patients facing serious, complex illness. In 2014, 1,993 patients received palliative care consultations to define, manage and coordinate healthcare goals and plans. On-site palliative care consultations were provided to patients who were hospitalized in eight area hospitals. Midwest CareCenter offers community bereavement services at no charge to the public. In addition to individual counseling, group support, artistic and expressive therapies and other counselor-facilitated modalities for family members of hospice patients, the organization offers grief support services free to any grieving person in its service area. Midwest CareCenter offers community bereavement services at no charge to the public. In 2014, 497 adults and 262 youth received bereavement services. Midwest CareCenter also continued its "Navigating Grief" workshop in 2014 to help grieving adults find their bearings immediately after a loss. Through its Families with Children program, Midwest CareCenter counselors provided bereavement counseling to grieving children and teens in 2014. CampCare, the organization's grief support summer program for youth, offered a four-day overnight camp and a four-day adventure canoe trip, serving a total of 52 children and teens (4th- 12th grade) who were impacted by loss. As part of the organization's educational outreach programs in 2014, FWC conducted several education programs at area schools on children's grief and assisted the schools of the Archdiocese of Chicago when death impacted their communities. Volunteers are an integral force in advancing the mission of the organization through direct care or administrative support. In 2014, 611 volunteers provided 25,618 hours of service through Midwest CareCenter patient care, office support, fundraising, governance and youth outreach services. Direct patient care was provided to 450 patients in their homes by 240 volunteers. Through Midwest CareCenter charity care and subsidized programs, services are provided to all individuals regardless of their ability to pay. Because Midwest CareCenter serves an older patient base as an end-of-life provider, most of its patient services are paid for by Medicare. Nonetheless, while over 90% of patients who sought services from Midwest CareCenter in 2014 were covered by governmental plans or by private insurance, patients received $4,561,000 of free care or subsidized care under the program. Patients seeking hospice and palliative care services without governmental or private insurance qualify for charity care and receive services free of charge. Patients with inadequate insurance or with other financial need receive care at reduced rates, based on a sliding scale. Determination of need is based on individualized assessment of assets and total costs for care; primary residences are excluded from assets. |
| Form 990, Part VI, Line 11b Review of form 990 by governing body | There was a merger of three hospice agencies on June 1, 2015. The prior board of directors was dissolved and a new board of directors was formed. Due to the merger, members of the management team of the succeeding organization reviewed and approved the Form 990. |
| Form 990, Part VI, Line 12c Conflict of interest policy | Annually, the organization requires all interested persons to disclose any potential or actual conflicts of interest. The Chief Financial Officer then reviews the potential or actual conflicts to determine if an actual conflict of interest exists. Additionally, any possible conflict of interest of any director (or member of the director's immediate family) shall be fully disclosed to the other directors and made a matter of record. When any possible conflict of interest becomes relevant to any matter requiring board of directors or committee action, the director shall not vote on the matter, shall not use personal influence in connection with the matter, and shall not be counted in determining the quorum for the meeting. However, the director may briefly state the director's position in the matter and answer pertinent questions when the director's knowledge of the matter will assist the board or committee. The minutes of the meeting shall reflect that a disclosure was made, and that the interested director abstained from voting and was not counted in determining the quorum for the meeting. This policy shall also apply to any person, other than a director, who is serving as a member of a board committee. A conflict of interest arises when a director, officer, or management employee holds a direct or indirect financial interest in or will receive a benefit from a business furnishing goods or services to Midwest CareCenter. A direct financial interest is the receipt of remuneration of any sort. An indirect financial interest exists if a director, officer, or management employee, or a member of his/her immediate family, has a material financial interest in, or a substantial business relationship with, or is an officer, director, or general partner of a person or entity transacting business with Midwest CareCenter. It is permissible for a director, officer, or staff to be a direct or indirect party to a transaction which might create the appearance of a conflict of interest if the above disclosure and other requirements are met and if the transaction is fair as determined by the board. |
| Form 990, Part VI, Line 15a Process to establish compensation of top management official | The Human Resources Committee (an independent group of Board Members) reviews and approves the compensation of the Chief Executive Officer, the Chief Financial Officer and the Chief Medical Officer on an annual basis. The last review was conducted in April 2014 and the prior review was conducted in January of 2013. The review and approval of compensation by the Human Resources Committee includes comparability data and surveys provided by independent compensation consultants. The process for determining, reviewing and approving compensation is documented on a timely basis. The compensation arrangement for the top management official is documented in a written employment contract. |
| Form 990, Part VI, Line 15b Process to establish compensation of other employees | USING THE DATA PROVIDED BY A COMPENSATION CONSULTANT AND INPUT FROM THE ORGANIZATION'S DIRECTOR OF HUMAN RESOURCES, THE CEO CONDUCTED ANNUAL PERFORMANCE REVIEWS OF THE ORGANIZATION'S OTHER OFFICERS AND KEY EMPLOYEES. THE RESULTS OF THE PERFORMANCE REVIEWS ARE THE BASIS FOR THE DETERMINATION OF THE OTHER OFFICERS AND KEY EMPLOYEES' COMPENSATION PACKAGES AND ANY ADJUSTMENTS TO ESTABLISHED AMOUNTS. In 2013 an independent subcommittee of the organization's board of directors reviewed and approved the compensation packages of the organization's other officers and key employees. |
| Form 990, Part VI, Line 19 Required documents available to the public | Financial statements, governing documents, and conflict of interest policies are not required disclosures pursuant to Internal Revenue Code (IRC) Section 6104. These documents are not available to the public at this time. The organization includes its Annual Report on its website that is available to the public. |
| Schedule M, Part I, Line 20 Number of contributions or items contributed | Number of contributions |
| Schedule M, Part I Number of contributions or items contributed | Number of contributions |
| Software ID: | 14000329 |
| Software Version: | 2014v1.0 |