2015-07-27T11:00:30-05:00 2014-12-31 350921680 CROWE HORWATH LLP 225 West Wacker Drive Suite 2600 Chicago IL 606061224 990 2014-01-01 300001703 Agrace HospiceCare Foundation Inc AGRA 6082764660 5395 E Cheryl Parkway Madison WI 53711 Lynne Myers President/CEO 2015-06-01 true Nicole Bencik P00756195 3128997000 2014 2016-02-25 16:41:14Z Lynne Myers 5395 E Cheryl Parkway Madison WI 53711 33097389 false X www.agrace.org X 2001 WI The Agrace HospiceCare Foundation, Inc.'s mission is to develop, steward and distribute charitable gifts from the community to improve quality of life for patients and (continued on Schedule O) 14 12 17 456 0 0 4363059 3813668 0 0 2199475 2340417 853685 991136 7416219 7145221 2622723 2561085 0 0 1116483 1314944 0 0 911648 406870 602699 4146076 4478728 3270143 2666493 21503532 23337504 424581 971871 21078951 22365633 The Agrace HospiceCare Foundation, Inc.'s mission is to develop, steward and distribute charitable gifts from the community to improve quality of life for patients and families throughout serious illness. We work to ensure that every individual and family receives the best possible care and support available, regardless of ability to pay. (CONTINUED ON SCHEDULE O) false false 1262500 1262500 JANESVILLE INPATIENT FACILITY: THE MISSION OF AGRACE'S "SHARING THE JOURNEY, BUILDING THE MEMORY" CAPITAL CAMPAIGN IS TO BUILD A FACILITY THAT WILL ACCOMMODATE ALL OF AGRACE'S EXISTING SERVICES AND ADD A NEW CAPABILITY- PROVIDING SHORT-TERM, ACUTE MEDICAL CARE FOR OUR HOSPICE PATIENTS. AGRACE ADDRESSED THIS NEED BY BUILDING A 12-BED FREE-STANDING INPATIENT HOSPICE FACILITY AND SERVICE CENTER IN JANESVILLE, FROM WHICH WE SERVE RESIDENTS OF ROCK COUNTY AND THE SURROUNDING REGION. THE FACILITY OPENED ON JULY 1, 2014, AND WAS COMPLETELY FUNDED BY COMMUNITY SUPPORT. 778966 778966 OTHER PROGRAM SERVICES: THE FOUNDATION PROVIDES GRANTS TO AGRACE HOSPICECARE, INC. TO SUPPORT OTHER PROGRAM SERVICES, INCLUDING: RESPITE CARE PROVIDING END-OF-LIFE CARE FOR A FAMILY MEMBER OR FRIEND CAN LEAVE CAREGIVERS FATIGUED AND STRESSED. TO GIVE THEM A BREAK OF UP TO FIVE DAYS, AGRACE OFFERS RESPITE CARE FOR HOSPICE PATIENTS. COMMUNITY GIFTS SUPPLEMENT INSURANCE REIMBURSEMENTS, WHICH COVER LESS THAN 25 PERCENT OF THE TOTAL COST OF RESPITE CARE. WISH PROGRAM THE WISH PROGRAM HELPS OUR HOSPICE PATIENTS ACHIEVE THEIR END-OF-LIFE GOALS. A WISH CAN BE SOMETHING A PATIENT COULD NOT ATTAIN DURING HIS/HER LIFE, SOMETHING HE/SHE CANNOT AFFORD OR SIMPLY A FINAL DESIRE. AGRACE HAS GRANTED MORE THAN 70 PATIENT WISHES SINCE 2010. CLINICAL EDUCATION & TRAINING IT TAKES A SPECIAL COMMITMENT TO WORK WITH PATIENTS WHO ARE SERIOUSLY ILL OR DYING. COMMUNITY DONATIONS ALLOW AGRACE TO FUND STAFF EDUCATIONAL OPPORTUNITIES AND PROFESSIONAL DEVELOPMENT PROGRAMS, WHICH INCREASE STAFF COMPETENCE AND RETENTION. VOLUNTEER TRAINING & APPRECIATION AGRACE'S 1,000+ VOLUNTEERS SERVE IN A VARIETY OF ROLES, INCLUDING DIRECT SERVICE TO PATIENTS AND FAMILIES. COMMUNITY SUPPORT FUNDS THE COMPREHENSIVE TRAINING NEEDED TO PREPARE VOLUNTEERS FOR THEIR ROLES AND ALSO FUNDS THE RECOGNITION PROGRAMS THAT SUSTAIN THEIR COMMITMENT TO SERVE. IN A TYPICAL YEAR, MORE THAN 70,000 HOURS ARE VOLUNTEERED, SAVING OVER $1.5 MILLION DOLLARS. PALLIATIVE MEDICINE FELLOWSHIP AGRACE IS COMMITTED TO DEVELOPING TOP-NOTCH PALLIATIVE CARE PROVIDERS IN OUR COMMUNITY. COMMUNITY GIFTS SUPPORT THE HOSPICE AND PALLIATIVE MEDICINE FELLOWSHIP, A PARTNERSHIP WITH THE UW AND VETERANS HOSPITALS; THIS PROGRAM OFFERS PALLIATIVE-CARE ROTATIONS AND CONTINUING EDUCATION OPPORTUNITIES FOR PHYSICIANS IN TRAINING. PATIENT ASSISTANCE FUND GRANTS USED TO ASSIST PATIENTS AND FAMILIES BY IMPROVING QUALITY OF LIFE AND FULFILLING END OF LIFE GOALS. EXAMPLES INCLUDE BUYING A BURIAL DRESS OR PROVIDING A BIRTHDAY CAKE. JANESVILLE INPATIENT FACILITY START-UP OPERATING ASSISTANCE GRANTS WERE PROVIDED TO FULLY FUND THE START-UP OPERATING EXPENSES OF THE NEW JANESVILLE INPATIENT FACILITY WHICH OPENED ON JULY 1, 2014. THE FUNDING WAS CRITICAL TO ENSURE QUALITY MEDICAL CARE WOULD BE PROVIDED FOR OUR PATIENTS AT THE NEW FACILITY. 419619 419619 CARE FOR ALL (CHARITY CARE) -- EACH YEAR, DOZENS OF OUR NEIGHBORS WHO CANNOT AFFORD HOSPICE OR PALLIATIVE CARE SERVICES RECEIVE THEM AT NO COST THROUGH AGRACE'S "CARE FOR ALL" PROGRAM. THOSE WE SERVE INCLUDE SOME OF OUR MOST VULNERABLE COMMUNITY MEMBERS-CHILDREN AND YOUNG ADULTS WITH NO INSURANCE, SENIORS WITHOUT CAREGIVERS, INDIVIDUALS LACKING SAFE HOUSING, AND THOSE WITH SPECIAL NEEDS. 100000 100000 COMMUNITY GRIEF SERVICES: EVERY YEAR, MORE THAN 8,000 PEOPLE, INCLUDING 300 CHILDREN, GET SUPPORT FROM AGRACE'S GRIEF SERVICES TO HELP THEM COPE WITH THE DEATH OF A LOVED ONE. ALTHOUGH GRIEF SUPPORT IS REQUIRED BY STATE AND FEDERAL REGULATIONS, IT IS NOT COVERED BY MEDICARE, MEDICAID OR PRIVATE INSURANCE. COMMUNITY DONATIONS ENABLE US TO OFFER SPECIALIZED GRIEF SUPPORT THAT IS OPEN TO EVERYONE, FREE OF CHARGE. 100000 100000 2561085 true true false false false false false false true true false false true true true false true false false false false false false true true false true false true false false false false false false false false true false false false true true false false false true 13 0 true 17 true false false false false false true true false false false false false X 14 12 false false true false true true false true true false false true true true true true true false false false WI X Jennifer Maurer 6082764660 5395 E CHERYL PARKWAY MADISON WI 53711 KEN THOMPSON CHAIR 1.00 2.00 X X 0 0 0 JAMES CRIPE CHAIR - PART YEAR 1.00 0 X X 0 0 0 LOU BERNHARDT VICE CHAIR 1.00 0 X X 0 0 0 MICHAEL SMITH TREASURER 1.00 0 X X 0 0 0 STEVE DITULLIO SECRETARY 1.00 0 X X 0 0 0 LYNNE MYERS PRESIDENT/CEO 5.00 35.00 X X 0 375945 56661 BILL ALBRIGHT DIRECTOR 1.00 0 X 0 0 0 HUGH BOYSEN DIRECTOR 1.00 0 X 0 0 0 RALPH CAGLE DIRECTOR 1.00 0 X 0 0 0 KATHY CULLEN DIRECTOR 1.00 0 X 0 0 0 ERIK JOHNSON DIRECTOR 1.00 0 X 0 0 0 LINDA KROHN DIRECTOR 1.00 0 X 0 0 0 RICK LANGER DIRECTOR 1.00 0 X 0 0 0 PETER LUNDBERG DIRECTOR 1.00 0 X 0 0 0 LINN ROTH DIRECTOR 1.00 0 X 0 0 0 PATRICK RYAN DIRECTOR 1.00 0 X 0 0 0 KATHLEEN WOIT DIRECTOR - PART YEAR 1.00 0 X 0 0 0 GORDON DERZON DIRECTOR - PART YEAR 1.00 2.00 X 0 0 0 MARCIA WHITTINGTON CDO 35.00 5.00 X 56831 0 8159 DAVID KOEHLER VP FOUNDATION - PART YEAR 35.00 5.00 X 115787 0 518 172618 375945 65338 1 false true false 0 263703 15400 3534565 1089685 3813668 0 0 0 0 0 776836 776836 0 0 27419871 25856290 1563581 0 1563581 1563581 77657 263703 86237 -8580 -8580 24629 9641 14988 14988 984284 984284 984284 OTHER REVENUE 900099 444 444 0 0 0 0 444 7145221 0 0 3331553 2561085 2561085 181295 85304 95991 897573 422331 475242 25029 11777 13252 135678 63840 71838 75369 35463 39906 248 248 14589 14589 65173 65173 0 0 0 0 29072 29072 113427 8074 105353 4644 4644 267140 267140 14165 14165 14506 8423 6083 703 703 Bank and credit card fees 21398 18286 3112 Donation development 57634 57634 0 0 0 0 4478728 2561085 1005995 911648 913141 1749603 1659288 1524341 0 0 32916 37837 14700 7028 8374 7672 17034907 18025756 0 0 1854906 1992295 21503532 23337504 33396 19306 28362 16000 0 362823 936565 424581 971871 X 15904800 17107841 5047551 5075026 126600 182766 21078951 22365633 21503532 23337504 X 2666493 -1375116 -4695 X false true X true false X X X 1 AGRACE HOSPICECARE INC 391319537 9 true 1286116 0 1 1286116 true false false false false false false false false false false false false false false true false RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 126600 56166 182766 84453 42147 126600 62026 22427 84453 549776 487750 62026 472208 14510 66356 3298 549776 1.0 false false 14700 7028 7672 7672 Due from affiliates 736027 Beneficial interest in assets held by community foundations 155036 Cash surrender value of life insurance 1101232 1992295 0 DUE TO AFFILIATES 936565 936565 X Schedule D, Part V, Line 4 Intended uses of endowment funds The purpose of the Endowment Funds are to provide support, as needed, to Agrace HospiceCare, Inc., a related tax-exempt organization. Schedule D, Part X, Line 2 FIN 48 (ASC 740) footnote The Organization is exempt from income taxes on income from related activities under Section 501(c)(3) of the U.S. Internal Revenue Code and corresponding state tax law. Accordingly, no provision has been made for federal or state income taxes. Additionally, the Organization has been determined not to be a private foundation under Section 509(a) of the Internal Revenue Code. U.S. GAAP requires that a tax position is recognized as a benefit only if it is "more likely than not" that the tax position would be sustained in a tax examination, with a tax examination being presumed to occur. The amount recognized is the largest amount of tax benefit that is greater than 50 percent likely of being realized on examination. For tax positions not meeting the "more likely than not" test, no tax benefit is recorded. Due to its tax-exempt status, the Organization is not subject to U.S. federal income tax or state income tax. The Organization's Form 990 has not been subject to examination by the Internal Revenue Service or the state of Wisconsin for the last three years. The Organization does not expect the total amount of unrecognized tax benefits to significantly change in the next 12 months. The Organization recognizes interest and/or penalties related to income tax matters in income tax expense. The Organization did not have any amounts accrued for interest and penalties at December 31, 2014 or 2013. Golf 86682 82000 4682 0 0 0 5887 0 7387 Gala 159125 101535 57590 0 0 2755 35741 3000 9428 3 95553 80168 15385 0 0 1600 0 20439 341360 263703 77657 0 0 4355 41628 3000 37254 86237 -8580 24629 8726 915 true 0.85 24629 8726 915 WI true false false false 1.0 0.0 Alex Shima 5395 E Cheryl Parkway Madison WI 53711 false FINANCE DEPARTMENT EMPLOYEES 0 ACCOUNTING AND RECORDKEEPING X false 0 Schedule G, Part II FUNDRAISING EVENTS THE FOUNDATION'S FUNDRAISING EVENT TOTAL IS $270,111 WHICH AGREES WITH AUDITED INFORMATION AND IS THE SUM OF FORM 990, PART VIII, LINES 1C, 8C, AND 9C. Schedule G, Part II, Line 11 FUNDRAISING EVENTS THE FOUNDATION'S FUNDRAISING EVENT TOTAL ON LINE 11, COLUMN (D) EXCLUDES $263,703 OF CHARITABLE CONTRIBUTIONS WHICH IS REPORTED ON LINE 2, COLUMN (D). FUNDRAISING EVENT TOTAL INCOME, INCLUDING THIS CHARITABLE CONTRIBUTION AMOUNT PROCEDURES A POSITIVE NET INCOME OF $255,123. true AGRACE HOSPICECARE INC 5395 E CHERYL PKWY MADISON WI 53711 391319537 501(C)(3) 1286116 0 N/A N/A TO PROVIDE FINANCIAL SUPPORT TO AGRACE HOSPICECARE, INC. AGRACE HOSPICECARE HOLDINGS INC 5395 E CHERYL PKWY MADISON WI 53711 300001715 501(C)(3) 1274969 0 N/A N/A TO PROVIDE CAPITAL CONTRIBUTION TOWARDS AGRACE HOSPICECARE HOLDINGS, INC.'S CONSTRUCTION PROJECT. 2 0 Schedule I, Part I, Line 2 Description Of Procedure For Monitoring Use Of Grant Funds All grant proposals are presented to the Board of Directors and the Board of Directors approves all grant awards. Agrace HospiceCare Foundation Inc. is operated for the exclusive benefit and support of Agrace HospiceCare Inc. and Agrace HospiceCare Holdings Inc. Schedule I, Part I, Line 2 Procedures for monitoring use of grant funds. All grant proposals are presented to the Board of Directors and the Board of Directors approves all grant awards. Agrace HospiceCare Foundation Inc. is operated for the exclusive benefit and support of Agrace HospiceCare Inc. and Agrace HospiceCare Holdings Inc. X X X X true true false false false false true false false LYNNE MYERS PRESIDENT/CEO 0 275657 0 84438 0 15850 0 45160 0 11501 0 432606 0 0 Schedule J, Part I, Line 3 Arrangement used to establish the top management official's compensation The organization relied on Agrace HospiceCare, Inc. a related tax-exempt organization, to determine the compensation of its other officers and key employees. Below is the process used by Agrace HospiceCare, Inc. for determining compensation of the organization's top management official. Each year the organization gathers market data for compensation of the executive leadership team. This data includes benchmarks of national, regional, and local compensation that are provided from independent compensation surveys. In February of each year, the chief administrative officer presents the market data information to the executive committee of the board along with pertinent 990 compensation reporting by similar sized non-profit hospices. Based on this information, the executive committee of the board approves the pay structure for the chief executive officer for the year and contemporaneously documents their approval in writing. This process was completed in January 2014, and last undertaken in February 2015. Schedule J, Part I, Line 4a Severance or change-of-control payment Severance payments made during 2014 were: $42,917 for David Koehler. Schedule J, Part I, Line 4b Supplemental nonqualified retirement plan Lynne Myers participated in a 457(f) deferred compensation plan under Agrace HospiceCare, Inc., a related organization. No distributions were made from the plan during 2014. Schedule J, Part I, Line 6b Compensation contigent on net earnings of a related organization The cash bonus under the Plan is determined in part by two factors: company operating margin performance and individual employee performance. X 984284 Market value X 14 92682 Market value X SPECIAL EVENT RELATED ITEMS 6 12719 Market value 0 false true false Schedule M, Part I Explanations of reporting method for number on contributions Clothing and household goods: CLOTHING AND HOUSEHOLD GOODS: AGRACE HOSPICECARE FOUNDATION, INC. IS REPORTING THE NUMBER OF CONTRIBUTIONS RECEIVED IN 2014. THIS AMOUNT REPRESENTS A VERY HIGH NUMBER OF RELATIVELY LOW-VALUE THRIFT STORE ITEMS. Securities - Publicly traded: SECURITIES - PUBLICLY TRADED: AGRACE HOSPICECARE FOUNDATION, INC. IS REPORTING THE NUMBER OF CONTRIBUTIONS RECEIVED IN 2014. Other: OTHER: AGRACE HOSPICECARE FOUNDATION, INC. IS REPORTING THE NUMBER OF CONTRIBUTIONS RECEIVED IN 2014. Schedule M, Part I, Line 5 Number of contributions or items contributed CLOTHING AND HOUSEHOLD GOODS: AGRACE HOSPICECARE FOUNDATION, INC. IS REPORTING THE NUMBER OF CONTRIBUTIONS RECEIVED IN 2014. THIS AMOUNT REPRESENTS A VERY HIGH NUMBER OF RELATIVELY LOW-VALUE THRIFT STORE ITEMS. Schedule M, Part I, Line 9 Number of contributions or items contributed SECURITIES - PUBLICLY TRADED: AGRACE HOSPICECARE FOUNDATION, INC. IS REPORTING THE NUMBER OF CONTRIBUTIONS RECEIVED IN 2014. Schedule M, Part I Number of contributions or items contributed OTHER: AGRACE HOSPICECARE FOUNDATION, INC. IS REPORTING THE NUMBER OF CONTRIBUTIONS RECEIVED IN 2014. Form 990, Part I, Line 1 MISSION (CONTINUED) FAMILIES THROUGHOUT SERIOUS ILLNESS. PRIORITY PROGRAMS INCLUDE FUNDING FOR: HOSPICE AND PALLIATIVE CARE SERVICES FOR ANYONE IN NEED; GRIEF SERVICES FOR COMMUNITY MEMBERS; RESPITE FOR CARE PROVIDERS; HOSPICE WISH PROGRAM; VOLUNTEER TRAINING; HOSPICE AND PALLIATIVE CARE TRAINING AND EDUCATION; AND A HOST OF OTHER PROGRAMS THAT SUPPORT INDIVIDUALS AND FAMILIES IMPACTED BY END OF LIFE. ALL FUNDS RAISED SUPPORT AGRACE HOSPICECARE, INC., A RELATED TAX-EXEMPT ORGANIZATION, TO ENSURE THAT EVERY INDIVIDUAL AND FAMILY RECEIVES THE BEST POSSIBLE CARE AND SUPPORT, REGARDLESS OF ABILITY TO PAY. PRIORITY ACTIVITIES FOR THE AGRACE FOUNDATION INCLUDE: CARE FOR ALL, A FUND TO PROVIDE HOSPICE AND PALLIATIVE CARE SERVICES AND ROOM AND BOARD FOR SOME OF OUR MOST VULNERABLE NEIGHBORS - CHILDREN AND YOUNG ADULTS WITH INADEQUATE OR NO INSURANCE, SENIORS WITHOUT CAREGIVERS, INDIVIDUALS WITHOUT SAFE HOUSING, AND PEOPLE WITH SPECIAL NEEDS. THROUGH GIFTS FROM THE COMMUNITY, WE'VE NEVER TURNED AWAY A HOSPICE PATIENT WHO COULDN'T AFFORD CARE. THE AGRACE FOUNDATION ALSO HELPS THOUSANDS OF PEOPLE RECEIVE GRIEF SUPPORT AND COUNSELING WHEN EXPERIENCING LOSS, FUNDS RESPITE FOR INDIVIDUALS CARING FOR LOVED ONES, GRANTS SPECIAL WISHES TO PATIENTS AND FAMILIES AT END-OF-LIFE, TRAINS VOLUNTEERS, AND INVESTS IN EDUCATION AND OTHER PROGRAMS TO ADVANCE HOSPICE AND PALLIATIVE CARE AND SUPPORT PATIENTS AND FAMILIES IN OUR COMMUNITY. Form 990, Part I, Line 8 Contributions The consolidated Agrace entities' contributions for 2014 are $4,930,280 which does not include 195,169 of donated in-kind services. The $3,813,668 of contributions reported on line 8 of page of this Form 990 does not include donated merchandise sales proceeds of $984,284 which is included on line 10. The balance of the $125,476 of consolidated contributions relates to donations made directly to one of the other Agrace affiliates: Agrace HospiceCare, Inc. and Agrace HospiceCare Holdings. Form 990, Part III, Line 1 MISSION AGRACE HOSPICECARE FOUNDATION IS OPERATED EXCLUSIVELY FOR THE SUPPORT AND BENEFIT OF AGRACE HOSPICECARE, INC., A RELATED 501(C)(3) ORGANIZATION CARING FOR MORE THAN 600 PATIENTS PER DAY. THE AGRACE HOSPICECARE FOUNDATION IS SUPPORTED BY A COMMUNITY OF DONORS WHO SHARE THE VISION OF ACCESS TO A QUALITY END-OF-LIFE JOURNEY FOR EVERYONE. THE FOUNDATION'S SUPPORT HAS HELPED AGRACE HOSPICECARE BUILD INPATIENT AND RESIDENTIAL FACILITIES, ENHANCE THE BREADTH AND QUALITY OF ITS SERVICES, AND EXPAND ITS REACH TO THOSE WHO NEED AGRACE HOSPICECARE SERVICES THROUGHOUT SOUTH CENTRAL WISCONSIN, REGARDLESS OF ABILITY TO PAY. IN ADDITION TO THE GRANT SUPPORT THAT THE FOUNDATION PROVIDES TO AGRACE HOSPICECARE, INC. AND AGRACE HOSPICECARE HOLDINGS, INC., THE FOUNDATION HAS HELPED BUILD AND MAINTAIN AN EIGHT-MONTH OPERATING RESERVE TO ENSURE THAT AGRACE HOSPICECARE, INC. HAS THE ABILITY TO SERVE PATIENTS AND FAMILIES IF FACED WITH FINANCIAL CHALLENGES. CoreFormPartIII_PartIIILine4d Description of other program services (Expenses $ 1,262,500 including grants of $ 1,262,500) JANESVILLE INPATIENT FACILITY: THE MISSION OF AGRACE'S "SHARING THE JOURNEY, BUILDING THE MEMORY" CAPITAL CAMPAIGN IS TO BUILD A FACILITY THAT WILL ACCOMMODATE ALL OF AGRACE'S EXISTING SERVICES AND ADD A NEW CAPABILITY- PROVIDING SHORT-TERM, ACUTE MEDICAL CARE FOR OUR HOSPICE PATIENTS. AGRACE ADDRESSED THIS NEED BY BUILDING A 12-BED FREE-STANDING INPATIENT HOSPICE FACILITY AND SERVICE CENTER IN JANESVILLE, FROM WHICH WE SERVE RESIDENTS OF ROCK COUNTY AND THE SURROUNDING REGION. THE FACILITY OPENED ON JULY 1, 2014, AND WAS COMPLETELY FUNDED BY COMMUNITY SUPPORT. Form 990, Part V, Line 1a FORMS W-2 THE NUMBER OF FORMS W-2 REPORTED BY THE ORGANIZATION WERE SUBMITTED UNDER THE FEIN OF AGRACE HOSPICECARE, INC. WHO SERVES AS A PAYROLL AGENT FOR THE ORGANIZATION. Form 990, Part VI, Line 15a PROCESS USED TO ESTABLISH COMPENSATION FOR TOP MANAGEMENT OFFICIAL THE ORGANIZATION RELIED ON AGRACE HOSPICECARE, A RELATED TAX-EXEMPT ORGANIZATION, TO DETERMINE THE COMPENSATION OF ITS OTHER OFFICERS AND KEY EMPLOYEES. BELOW IS THE PROCESS USED BY AGRACE HOSPICECARE FOR DETERMINING COMPENSATION OF THE ORGANIZATION'S TOP MANAGEMENT OFFICIAL. EACH YEAR THE ORGANIZATION GATHERS MARKET DATA FOR COMPENSATION OF THE EXECUTIVE LEADERSHIP TEAM. THIS DATA INCLUDES BENCHMARKS OF NATIONAL, REGIONAL, AND LOCAL COMPENSATION THAT ARE PROVIDED FROM INDEPENDENT COMPENSATION SURVEYS. IN FEBRUARY OF EACH YEAR, THE CHIEF ADMINISTRATIVE OFFICER PRESENTS THE MARKET DATA INFORMATION TO THE EXECUTIVE COMMITTEE OF THE BOARD ALONG WITH PERTINENT 990 COMPENSATION REPORTING BY SIMILAR SIZED NON-PROFIT HOSPICES. BASED ON THIS INFORMATION, THE EXECUTIVE COMMITTEE OF THE BOARD APPROVES THE PAY STRUCTURE FOR THE CHIEF EXECUTIVE OFFICER FOR THE YEAR AND CONTEMPORANEOUSLY DOCUMENTS THEIR APPROVAL IN WRITING. THIS PROCESS WAS LAST UNDERTAKEN IN FEBRUARY 2015. Form 990, Part VI, Line 1b NON-INDEPENDENT MEMBERS LYNNE MYERS AND KATHY CULLEN ARE THE NON-INDEPENDENT BOARD MEMBERS. MS. MYERS IS NOT INDEPENDENT BY VIRTUE OF HER EMPLOYMENT. MS. CULLEN IS A MORE THAN 35% OWNER, BY ATTRIBUTION, OF THE CONSTRUCTION COMPANY THAT COMPLETED THE JANESVILLE FACILITY IN JULY 2014. THE FOUNDATION IS FUNDING THE JANESVILLE FACILITY. Form 990, Part VI, Line 15b PROCESS TO ESTABLISH COMPENSATION OF OFFICERS THE ORGANIZATION RELIED ON AGRACE HOSPICECARE, A RELATED TAX-EXEMPT ORGANIZATION, TO DETERMINE THE COMPENSATION OF ITS OTHER OFFICERS. BELOW IS THE PROCESS USED BY AGRACE HOSPICECARE FOR DETERMINING COMPENSATION OF THE ORGANIZATION'S OTHER OFFICERS. EACH YEAR THE ORGANIZATION GATHERS MARKET DATA FOR COMPENSATION OF THE EXECUTIVE LEADERSHIP TEAM. THIS DATA INCLUDES BENCHMARKS OF NATIONAL, REGIONAL, AND LOCAL COMPENSATION THAT ARE PROVIDED FROM INDEPENDENT COMPENSATION SURVEYS. IN FEBRUARY OF EACH YEAR, THE CHIEF ADMINISTRATIVE OFFICER PRESENTS THE MARKET DATA INFORMATION TO THE EXECUTIVE COMMITTEE OF THE BOARD ALONG WITH PERTINENT 990 COMPENSATION REPORTING BY SIMILAR SIZED NON-PROFIT HOSPICES. BASED ON THIS INFORMATION, THE EXECUTIVE COMMITTEE OF THE BOARD APPROVES THE PAY STRUCTURE FOR THE CHIEF EXECUTIVE OFFICER FOR THE YEAR AND CONTEMPORANEOUSLY DOCUMENTS THEIR APPROVAL IN WRITING. THIS PROCESS WAS COMPLETED IN FEBRUARY 2014 AND LAST UNDERTAKEN IN FEBRUARY 2015. Form 990, Part VI, Line 4 Significant changes to organizational documents Agrace HospiceCare Foundation, Inc. is organized and operated exclusively for the support of Agrace HospiceCare, Inc. In 2014, Agrace HospiceCare Foundation, Inc. amended its bylaws to clarify it is a supporting organization that is operated, supervised and controlled by Agrace HospiceCare, Inc. , which is the sole member of Agrace HospiceCare Foundation, Inc. and has the power to appoint and replace a majority of the directors or trustees of Agrace HospiceCare Foundation, Inc. The reference to Agrace HospiceCare Holdings, Inc. as an additional supported organization was removed from the amended bylaws. As the result, Agrace HospiceCare Foundation, Inc. was approved by IRS as a Type 1 Organization in 2014. Form 990, Part VI, Line 6 Classes of members or stockholders Agrace HospiceCare, Inc. a related 501(c)(3) organization, is the sole member of Agrace HospiceCare Foundation, Inc. and has the authority to appoint, remove, and replace any director on Foundation Board. Agrace HospiceCare, Inc. also has the sole authority to amend the Agrace HospiceCare Foundation Bylaws and Articles of Incorporation. Agrace HospiceCare, Inc. has no other responsibilities or voting rights with respect to the operations of Agrace HospiceCare Foundation. Form 990, Part VI, Line 7a Members or stockholders electing members of governing body Please see narrative for Part VI, Line 6 Form 990, Part VI, Line 11b Review of form 990 by governing body The Controller and CFO performed a detailed review of Form 990 and the related schedules prior to filing the return. This included verification of all amounts for accuracy and completeness. The form and schedules were also reviewed for content, presentation and reasonableness. The entire Form 990 is made available to the entire executive leadership team and an entity specific highlights summary is provided. The entire Form 990 is provided to the entire Board of Directors prior to filing and is accompanied by a 990 highlight summary. The audit committee reviewed the Form 990 and related schedules for reasonableness. Representatives from the accounting firm of Crowe Horwath prepared a detailed summary of the Form 990 that was presented to the board of directors by the Management. Form 990, Part VI, Line 12c Conflict of interest policy Directors, officers and key employees (interested persons) are required to annually review the organization's Code of Conduct, including the conflict of interest policy/statement. Interested persons are required to disclose potential or actual conflicts with the organization in writing via the annual questionnaire distributed electronically to each interested person. When a disclosure arises, the person shall promptly make disclosure of the interest to the governing board or committee. After disclosure and discussion the interested person shall leave the governing board or committee meeting while the determination of a conflict of interest is further discussed and voted upon by the remaining disinterested governing board or committee members. Once an actual conflict of interest exists with respect to a particular contract, transaction or arrangement the disinterested members of the board exercise due diligence to determine whether said contract, transaction or arrangement is reasonable. The conflict of interest questionnaires are reviewed by the Controller and governance coordinator. The controller and governance coordinator determine whether a potential conflict exists based on the completed questionnaires submitted by each interested person. 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 may be made available to the public upon receipt of a written request. Form 990, Part XI, Line 9 Other changes in net assets or fund balances Uncollectible Pledges - -4695; AGRACE HOSPICECARE THRIFT STORE LLC 5395 E CHERYL PARKWAY MADISON WI 53711 300001703 THRIFT STORE WI 984284 60084 NA AGRACE HOSPICECARE INC 5395 E CHERYL PARKWAY MADISON WI 53711 391319537 HEALTHCARE WI 501(c)(3 9 NA false AGRACE HOSPICECARE HOLDINGS INC 5395 E CHERYL PARKWAY MADISON WI 53711 300001715 PROPERTY HOLDING WI 501(c)(3 Type I AHCI false false true true false false false false false false false true true true true true true true false false