Attach to Form 990 or Form 990-EZ.
Go to
www.irs.gov/Form990 for instructions and the latest information.
| (i) Name of supported organization | (ii) EIN | (iii) Type of organization (described on lines 1- 10 above (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 |
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Calendar year
(or fiscal year beginning in)
![]() |
(a) 2020 | (b) 2021 | (c) 2022 | (d) 2023 | (e) 2024 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 1 | Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grant.") .. | 991,875 | 1,115,585 | 1,107,403 | 1,013,099 | 772,394 | 5,000,356 |
| 2 | Tax revenues levied for the organization's benefit and either paid to or expended on its behalf .... | 0 | 0 | 0 | |||
| 3 | The value of services or facilities furnished by a governmental unit to the organization without charge.. | 0 | 0 | 0 | |||
| 4 | Total. Add lines 1 through 3 | 991,875 | 1,115,585 | 1,107,403 | 1,013,099 | 772,394 | 5,000,356 |
| 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) .. | 285,225 | |||||
| 6 | Public support. Subtract line 5 from line 4. | 4,715,131 | |||||
Calendar year
(or fiscal year beginning in)
![]() |
(a) 2020 | (b) 2021 | (c) 2022 | (d) 2023 | (e) 2024 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 7 | Amounts from line 4.. | 991,875 | 1,115,585 | 1,107,403 | 1,013,099 | 772,394 | 5,000,356 |
| 8 | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources... | 48,351 | 183,830 | 42,153 | 311,356 | 248,153 | 833,843 |
| 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.).. | 277,037 | 302,250 | 435,804 | 276,044 | 313,716 | 1,604,851 |
| 11 | Total support. Add lines 7 through 10 | 7,439,050 | |||||
Calendar year (or fiscal
year beginning in) ![]() |
(a) 2020 | (b) 2021 | (c) 2022 | (d) 2023 | (e) 2024 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 1 | Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") . | ||||||
| 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 | ||||||
| 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 | ||||||
| 7a | Amounts included on lines 1, 2, and 3 received from disqualified persons | ||||||
| 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. | ||||||
| c | Add lines 7a and 7b.. | ||||||
| 8 | Public support. (Subtract line 7c from line 6.) | ||||||
Calendar year
(or fiscal year beginning in)
![]() |
(a) 2020 | (b) 2021 | (c) 2022 | (d) 2023 | (e) 2024 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 9 | Amounts from line 6... | ||||||
| 10a | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources.. | ||||||
| b | Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975. | ||||||
| c | Add lines 10a and 10b. | ||||||
| 11 | Net income from unrelated business activities not included on 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.) .. | ||||||
| 13 | Total support. (Add lines 9, 10c, 11, and 12.).. | ||||||
| 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) |
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| 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): |
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| 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 0.015 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 0.035 | 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 | ||||
| Section D - Distributions | Current Year | |
|---|---|---|
| 1 Amounts paid to supported organizations to accomplish exempt purposes | 1 | |
|
2
Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in excess of income from activity |
2 | |
| 3 Administrative expenses paid to accomplish exempt purposes of supported organizations | 3 | |
| 4 Amounts paid to acquire exempt-use assets | 4 | |
| 5 Qualified set-aside amounts (prior IRS approval required - provide details in Part VI) | 5 | |
| 6 Other distributions (describe in Part VI). See instructions | 6 | |
| 7Total annual distributions. Add lines 1 through 6. | 7 | |
|
8
Distributions to attentive supported organizations to which the organization is responsive (provide details in Part VI). See instructions |
8 | |
| 9 Distributable amount for 2024 from Section C, line 6 | 9 | |
| 10 Line 8 amount divided by Line 9 amount | 10 | |
| Section E - Distribution Allocations (see instructions) |
(i) Excess Distributions |
(ii) Underdistributions Pre-2024 |
(iii) Distributable Amount for 2024 |
|
|---|---|---|---|---|
| 1 Distributable amount for 2024 from Section C, line 6 | ||||
|
2
Underdistributions, if any, for years prior to 2024 (reasonable cause required-- explain in Part VI).
See instructions. |
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| 3 Excess distributions carryover, if any, to 2024: | ||||
| a From 2019....... | ||||
| b From 2020....... | ||||
| c From 2021....... | ||||
| d From 2022....... | ||||
| e From 2023....... | ||||
| fTotal of lines 3a through e | ||||
| g Applied to underdistributions of prior years | ||||
| h Applied to 2024 distributable amount | ||||
|
i
Carryover from 2019 not applied (see instructions) |
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| j Remainder. Subtract lines 3g, 3h, and 3i from line 3f. | ||||
| 4Distributions for 2024 from Section D, line 7: | ||||
| $ | ||||
| a Applied to underdistributions of prior years | ||||
| b Applied to 2024 distributable amount | ||||
| c Remainder. Subtract lines 4a and 4b from line 4. | ||||
|
5
Remaining underdistributions for years prior to 2024, if any. Subtract lines 3g and 4a from line 2. If the amount is greater than zero, explain in Part VI. See instructions. |
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|
6
Remaining underdistributions for 2024. Subtract lines 3h and 4b from line 1. If the amount is greater than zero, explain in Part VI. See instructions. |
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|
7 Excess distributions carryover to 2025. Add lines 3j and 4c. |
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| 8 Breakdown of line 7: | ||||
| a Excess from 2020..... | ||||
| b Excess from 2021..... | ||||
| c Excess from 2022..... | ||||
| d Excess from 2023..... | ||||
| e Excess from 2024..... | ||||
| Facts And Circumstances Test |
|---|
| Return Reference | Explanation |
|---|---|
| Schedule A, Part II, Line 10 Other Income | DESCRIPTION - OTHER INCOME, COLUMN A - 277037.0, COLUMN B - 279529.0, COLUMN C - 277141.0, COLUMN D - 251494.0, COLUMN E - 279591.0, COLUMN F - 1364792.0; DESCRIPTION - FUNDRAISING INCOME, COLUMN A - 0.0, COLUMN B - 22721.0, COLUMN C - 158663.0, COLUMN D - 24550.0, COLUMN E - 34125.0, COLUMN F - 240059.0; |
| Software ID: | 24020961 |
| Software Version: | 2024v5.1 |
| Return Reference | Explanation |
|---|---|
| Form 990, Part VI, Line 15 PROCESS TO ESTABLISH COMPENSATION OF OFFICERS | The President/CEO and other officers are compensated by Hospice of Michigan, a related party. The Executive Committee of the Board of Trustees meets annually in April subsequent to the acceptance of the audited financial statements 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 a vote/decision is made in regards to compensation. In addition, in 2024 an 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 American Society of Employers (ASE). Market data was gathered through at least three external surveys and nationally compared 990's of the largest hospices nationally as well as the top Michigan hospitals with revenues of similar size. |
| Form 990, Part VI, Line 6 Classes of members or stockholders | The Corporation is organized on a non-stock basis as a nonprofit membership corporation. The sole member is Hospice of Michigan, Inc. ("HOM the "Member"). |
| Form 990, Part VI, Line 7a Members or stockholders electing members of governing body | The Corporation is organized on a non-stock basis as a nonprofit membership corporation. The sole member is Hospice of Michigan, Inc. ("HOM the "Member"). Pursuant to Section 3.2 of the Bylaws, approval by the Member shall be required for the election of voting members of the Corporation's Board, including the filling of vacancies. Pursuant to Section 4.5 of the Bylaws, at the Member's sole discretion, HOM may appoint up to two directors from either the HOM executive team or HOM board of directors. |
| Form 990, Part VI, Line 7b Decisions requiring approval by members or stockholders | Reserved Powers: Pursuant to Section 3.2 of the Bylaws, in addition to other rights reserved to the Member by law, approval by the Member shall be required for the following actions: a. The election of voting members of the Corporation's Board, including the filling of vacancies; b. Any amendments to the Corporation's Articles of Incorporation or Bylaws; c. A change in the Corporation's mission statement; d. Adoption or approval of any plan or dissolution of the Corporation; and e. Adoption or approval of any plan of merger, consolidation, or sale of all or substantially all of the assets or property of the Corporation. |
| Form 990, Part VI, Line 8b Documentation of meetings held by committees of governing body | The organization does not have any committees with authority to act on behalf of the governing body. Therefore, this question has been answered "no" in accordance with Form 990 instructions. |
| Form 990, Part VI, Line 11b Review of form 990 by governing body | A DRAFT COPY OF THE 990 IS PRESENTED TO THE MEMBER'S BOARD OF DIRECTORS BEFORE THE RETURNS ARE TRANSMITTED TO 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 TRUSTEES, HAVE A FUNDAMENTAL OBLIGATION TO ACT IN THE BEST INTEREST OF PATIENT CARE AND ARBOR HOSPICE. EVERY BOARD TRUSTEE 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) ARBOR HOSPICE REQUIRES THAT ALL MEMBERS OF ITS BOARDS OF TRUSTEES AND EMPLOYEES DISCLOSE INTERESTS THAT COULD RESULT IN A CONFLICT. ANNUALLY, ALL BOARD TRUSTEES 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 990 Tracker, A TOOL PROVIDED BY OUR TAX ADVISORS, TO SEND CONFLICT OF INTEREST SURVEYS TO ALL VOTING BOARD TRUSTEES, EXECUTIVES, AND THE HIGHEST PAID STAFF. (2) ALL BOARD TRUSTEES 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 TRUSTEE 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) ARBOR HOSPICE 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 ARBOR HOSPICE WHICH MAY RESULT IN A PERSONAL BENEFIT TO THE EMPLOYEE AT THE EXPENSE OF ARBOR HOSPICE OR MAY INFLUENCE THE EMPLOYEE'S DECISIONS ON MATTERS INVOLVING ARBOR HOSPICE AND A VENDOR OR SUPPLIER BUSINESS. |
| Form 990, Part VI, Line 19 Required documents available to the public | THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST. |
| Form 990, Part IX, Line 11g Other Fees | CONTRACTED RESPITE - Total Expense: 110979, Program Service Expense: 110979, Management and General Expenses: , Fundraising Expenses: ; INFUSION AND EXTERNAL FEEDING - Total Expense: -24287, Program Service Expense: -24287, Management and General Expenses: , Fundraising Expenses: ; PHARMACY - Total Expense: 743329, Program Service Expense: 743329, Management and General Expenses: , Fundraising Expenses: ; OTHER PURCHASED SERVICES - Total Expense: 1266605, Program Service Expense: 986452, Management and General Expenses: 280153, Fundraising Expenses: ; CONSULTING - Total Expense: 164133, Program Service Expense: 5712, Management and General Expenses: 124541, Fundraising Expenses: 33880; CONTRACTED ROOM AND BOARD - Total Expense: 2694580, Program Service Expense: 2694580, Management and General Expenses: , Fundraising Expenses: ; |
| Software ID: | 24020961 |
| Software Version: | 2024v5.1 |