Hospice of Jackson

“The Corporation is organized on a membership basis. The sole corporate Member of the Corporation is HealthLink.”

“Member has the power to approve changes in those provisions of the Corporations Bylaws which affect the size, composition, and method of selection of the Board of Directors. Member has the power to elect and remove, with or without cause, the Corporation's Directors.”

“Member has the power to approve any change in the Articles of Incorporation, purposes or philosophy of the Corporation; Approve plans of merger, consolidation or dissolution of the Corporation. Authorize the sale, lease, mortgage or other disposition of all or substantially all of the assets owned, held or leased by or to the Corporation. Ratify or reject operating and capital budgets developed by the Board and any non-budgetary expenditures or creations of debt in excess of an amount designated by the Member from time to time. Authorize the formation or acquisition of new subsidiaries of the Corporation or the sale or other disposition of existing subsidiaries. Select the auditors for the Corporation. The Member may also take action without a meeting. Any action required or permitted to be taken at an annual or special meeting of the Member of the Corporation, may be taken without a meeting, without prior notice, and without a vote, if a consent in writing, setting forth the action so taken, is signed by the Member of the Corporation.”

“The organization is an affiliate of Henry Ford Health System (HFHS) and the tax department of HFHS prepares the organization's Form 990. As part of the preparation and review process prior to filing the return, the following review process is conducted: - Reviewed by the Organization's Director and VP of Finance, Chief Executive Officer, General Counsel, and Compliance Officer. - Review of the entire return with the HFHS and organization's Senior Vice President Financial Operations and Chief Financial Officer, - Review of all compensation matters and disclosures with the Compensation Committee of the HFHS Board of directors - Review of the return with the HFHS Audit and Compliance Committee of the Board of director, including the CEO and COO - Final copies of the return are distributed to the Hospital's Board of Trustees before the return is filed.”

“The organization is an affiliate of Henry Ford Health System (HFHS) who oversees the conflict of interest process with regard to the organization. HFHS has a standing Conflict of Interest Committee (the Committee) that is responsible for oversight of all conflict of interest matters. The HFHS Conflict of Interest Policy applies to all Directors and employees. Annually, Directors, employees of a management level, researchers, as well as employees associated with procurement, or in certain other predefined roles must complete an annual disclosure designed to identify activities and relationships that could potentially give rise to a conflict of interest. It is the responsibility of the Committee to review these disclosures and determine the need for any action to manage the potential conflict. The Committee annually reports the results of its activities to the Audit and Compliance Committee of the HFHS Board of Directors.”

“The organization is an affiliate of Henry Ford Health System (HFHS) who has responsibility to oversee the compensation practices of the organization. HFHS has a Compensation Committee of the Board of Directors consisting of all external directors. They meet periodically throughout the year. They are charged with approval of the organization's overall compensation and benefit programs as well as the specific review and approval of the compensation of certain employees including the Chief Executive Officer, all officers and key employees of the organization. They directly engage an independent compensation advisor to assist with this process. The process includes evaluation of the individual's performance, utilization of compensation studies of similarly situated positions, as well as comparisons to compensation as reported by other health care organizations. The reasonableness of compensation is evaluated based upon these and other factors. The Committee also reviews the compensation disclosures to be made on Form 990 in advance of filing.”

“Forms 1023 and 990 are available upon request. The Organization's conflict of interest policy is not available to the public.”

“Average hours per week devoted to related organizations: Many executive employees of Henry Ford Health System and affiliates provide services to multiple affiliated entities. Henry Ford Health System and affiliates use estimates for reporting average hours per week in all sections of Form 990. Generally 60 hours are reported for the hours associated for the organization that the individual has principal responsibility for. Hours associated with other hospitals or affiliates are reported at between 1 to 5 hours per week.”

“Other Purchased Services: Program service expenses 866,236. Management and general expenses 488,033. Fundraising expenses 0. Total expenses 1,354,269.”

“A Form 5713, International Boycott Report, has been filed on our behalf the organization by Henry Ford Health System (parent of controlled group of which the organization is a member). The organization did not itself have any activities associated with an international boycott country.”

“Henry Ford Allegiance Hospice is included in the consolidated financial statements of Henry Ford Health System (the sole member of Henry Ford Allegiance Health Group). The governing body of Henry Ford Allegiance Health has delegated the oversight of its financial statements, including the choice of independent auditors, to its audit committee.”

“The organization is an element of the external audit report obtained for the consolidated operations of Henry Ford Health System.”

“The return is being amended to correct the compensation amounts previously reported for Chrissy Siders (Director-Chair) on Part VII, Section A. She had no reportable compensation amounts in 2019.”