Margaret OhrynPO Box 252502

West Bloomfield, MI 48325

Michigan Association of Healthcare Advocates (MAHA)

Cordially invites you to the68th Annual Meeting and Educational Institute

“Breakthrough to Excellence”June 13 to 15, 2017

Grand Hotel, Mackinac Island, MI

68th Annual Meeting and Educational Institute | “Breakthrough to Excellence” | June 13 to 15, 2017

TUESDAY, JUNE 13, 20171:30 – 3:30 p.m.

RegistrationHospitality Room (Terrace Room)

4:00 – 5:00 p.m.MAHA ANNUAL MEETING (Theatre)Welcome

Mary Lu Cramer, MAHA PresidentOpening Prayer & Pledge of Allegiance

Carol D’ Alberto, President ElectFlag Ceremony

(By Federal law people may not be admitted to thetheater while the flag ceremony is in process)American Legion Post K 299

Conference OrientationAnne Lorentzen, VP Education

Hotel OrientationBobbi Bruckman, Conf. Coordinator

Business MeetingMary Lu Cramer, PresidentVote on Bylaws ChangesElection of Officers

4:00 p.m.Rooms Available for Registrants

5:00 – 6:00 p.m.OPENING SPEAKER (Theatre)“HUMOR”Kay Wagner

6:30 – 8:30 p.m.Dinner (Main Dining Room)

8:30 – 9:45 p.m.District Receptions (Grand-NCD/SWD, Governor-ECD/UPD, Milliken SWD/NCD Suites)

9:45 p.m.MAHA Current Board Meeting(President’s Suite)

WEDNESDAY, JUNE 14, 20176:30 – 7:30 a.m.

Early Morning Walkers (Front Porch)

7:30 – 9:00 a.m.Breakfast (Main Dining Room)

9:15 – 10:15 a.m.LEGISLATIVE & HOSPITAL ISSUES TODAY (Theatre)MHA Representatives

10:15 – 10:30 a.m.Break

10:30 – 11:30 a.m.WORKSHOPS“When I See You With MY Heart ...

Carol Bridges, Henry Ford, Wyandotte(Terrace Room)

“The Advanced Practice Providers: The Team-BasedApproach to High-Level Care”

Melissa Murtha, NP & Ryan Murtha, PA-C(Cottage Room)

“Secrets to Success, Effective Recruitment, Recognition& Retention Strategies”

Sarah Knochel, Covenant HealthCare, Saginaw(Grand Pavilion)

11:30 a.m. – 12:45 p.m.GRAND LUNCHEON (Main Dining Room)

1:00 – 2:00 p.m.

2nd Workshops Begin2:30 – 4:00 p.m.

“TEA AND TALK” NETWORKING (Room 218)Hosted byAnne Lorentzen, VP of EdBobbi Bruckman, incoming VP of Ed

4:00 – 6:00 p.m.Free Time

5:30 p.m.New MAHA Board Photo

6:00 - 7:00 pmReception hosted by MHA

7:00 p.m.BANQUET (Theatre)Installation of Officers

9:30 p.m. (or immediately following installation)President’s Reception (Room 246)

THURSDAY, JUNE 15, 20176:30 – 7:30 a.m.

Early Morning Walkers (Front Porch)

7:30 – 9:00 a.m.Breakfast (Main Dining Room)

9:15 – 11:15 a.m.CLOSING SESSION (Theatre)MAHA RemarksMary Lu Cramer, MAHA PresidentFall Conference – Bavarian Inn, FrankenmuthCLOSING SPEAKER “Stress Management/Humor”Kay Frances

Michigan Association of Healthcare Advocates (MAHA)

Thank you for joining us at our Annual Meeting Meeting.Hope to see all of you October 18 – 20, 2017 at our Fall Conference at the Bavarian Inn, Frankenmuth.

“BREAK THROUGH TO EXELLENCE”

Michigan Association of Healthcare Advocates 68th Annual Meeting and Educational Institute

June 13th-15th, 2017 MAHA Prepaid Registration Form

All registrations MUST be prepaid in advance and received by May 15th

Name

Hospital

City District

Delegate

1st Time

Dietary Restrictions

Full conference registration includes all conference activities. Add additional names on the back or use an additional form. Full conference registration is $75. Make all checks out to “MAHA” Hotel Registrations are to be forwarded directly to the Grand Hotel. Dinner on Tuesday night; breakfast, the Grand Buffet Luncheon, and the Banquet on Wednesday night; and breakfast on Thursday are included with your separate hotel reservations which are handled through the Grand Hotel as described on the Grand Hotel registration Form. Registration for Banquet only: Individual Banquet only fee is $79.50

Name

Hospital

City

District

Dietary Restrictions

Information Submitted By: NAME PHONE# EMAIL

Mail Conference Registration forms and checks to: Margaret Ohryn P.O. Box 252502 West Bloomfield Mi 48325 For questions call: 248-6225724 or email at Margaret at margohryn@gmail.com There will be no refunds made after the conference registration deadline. Substitutions will be allowed. NOTE: This event may be photographed and/or videotaped. Your attendance will indicate your consent for the use for such photographs or videotapes for educational and/or promotional purposes.

State Zip Code Mobile Telephone ( )

Business Telephone ( )

State Zip Code Mobile Telephone ( )

Business Telephone ( )

*ONE FORM PER ROOM PLEASE*

Michigan Association of Healthcare Advocates

ARRIVE: Tuesday, June 13, 2017 DEPART: Thursday, June 15, 2017

ACCOMMODATIONS MAY BE AVAILABLE PRIOR TO AND FOLLOWING THE ABOVE DATES

If sharing a room, name and address of person sharing with you: MR. MS. MR. AND MRS.

(circle one) (please print or type)

Company/Hospital

Address

City

E-mail

If sharing a room, name and address of person sharing with you: MR. MS. MR. AND MRS.

(circle one) (please print or type)

Company/Hospital

Address

City

E-mail

Grand Hotel offers a variety of room types for conference attendees. Guests sometimes ask to arrive earlier or remain later than the conference’s official dates. We welcome your request for a specific room, room type, or room dates either prior to or following the conference. While your request will receive careful attention, please understand that it cannot be guaranteed.

ARRIVAL DATE: DEPARTURE DATE:

Please also complete the reverse side.

RETURN THIS FORM BY: MONDAY, MAY 15, 2017 To: Reservations Department

Grand Hotel Mackinac Island, Michigan 49757 Telephone: (906) 847-3331 Fax: (906) 847-0945 Email: groupforms@grandhotel.com

State Zip Code Mobile Telephone ( )

Business Telephone ( )

MR. MS. MR. AND MRS.

(circle one) (please print or type)

Company/Hospital

Address

City

E-mail

PLEASE RESERVE THE FOLLOWING ACCOMMODATIONS:

DOUBLE SINGLE Daily, Per Person, Daily

Based on Double Occupancy Standard

Deluxe

$197.00

$236.00

$319.00

$397.00 $188.00 daily, per person, based on 3 persons sharing a room

$166.00 daily, per person, based on 4 persons sharing a room

Grand Hotel operates on the Modified American Plan. This means that your daily rate includes breakfast and dinner. In addition this rate includes the Grand Luncheon Buffet on Wednesday, June 14, 2017.

RESERVATIONS FOR ADDITIONAL PERSONS: 9 years of age and under, no charge 10 through 17 years of age, $59.00 daily, per person

18 years of age and over, see above for rate For an adult staying in a guest room with one or more children, the adult will pay the single convention rate, the children will be at the appropriate children’s rates listed above. For two or more children staying in a guest room without an adult, the oldest child will be charged the single convention rate based on the category of room they are in and the remaining children will be at the additional persons rates listed above.

THE RATE UTILIZED FOR YOUR MEETING IS A FLAT, RUN-OF-THE-HOUSE PLAN, MEANING GUEST ROOMS WILL BE RESERVED IN PRIORITY ORDER ACCORDING TO DATE RESERVATION FORM IS RECEIVED BY GRAND HOTEL.

NO TIPPING: Tipping to any employee anywhere within Grand Hotel is not required, expected or permitted. There is tipping at the following offsite restaurant locations: The Jockey Club at the Grand Stand, Woods, The Gate House, the Pool Grill, Cawthorne’s Village Inn, Sushi Grand and Fort Mackinac Tea Room.

NOTE: Michigan 6% Sales Tax applies to all charges, including the 19.5% added charge on the per person daily room. There is also a 2% Mackinac Island Assessment charge on the per person daily room rate. There is a one-time charge of $8.50 per person for transfer of luggage from the dock to the Hotel and return. Taxi transportation to and from the boat docks and the Hotel is not included in the daily rate.

The block of rooms being held for this meeting is based on estimated attendance. Please make your reservation as promptly as possible. Requests received after the block is filled will be contacted and given an option of being placed on a waitlist. The waitlist is not a guarantee of a room. All rooms in the block which have not been reserved 30 days in advance of the meeting will be released for other guests. Individual group reservations are subject to a 10-day cancellation policy. Reservation deposits will be refunded if cancelled 10 or more days prior to arrival, less a $45.00 processing fee. Reservations cancelled less than 10 days prior will forfeit the room deposit.

Once a guest confirms a departure date upon check-in, should check-out occur earlier than agreed, there will be a $400.00 charge.

DEPOSIT POLICY: A deposit of the full stays room charges must accompany this form in order to hold your room.

METHOD OF DEPOSIT:

Please charge my full stay to my credit card

Payment is from a tax exempt organization and the form is attached (Personal checks or credit cards may not be used if claiming tax exemption.)

Please split the deposit evenly between all guests on this reservation form

CREDIT CARD NUMBER: EXPIRATION DATE:

SIGNATURE: (Not valid without signature)

Grand Hotel accepts VISA, MasterCard, Discover, American Express, traveler's checks, personal checks, and cash payments for bills.

CHECK-IN TIME: After 4:00 p.m. CHECK-OUT TIME: 11:00 a.m.

Visit our Web site at http://www.grandhotel.com

Your hotel confirmation will be arriving to you via e-mail. Please check your confirmation to make sure it is correct and print it for your records. Please contact us with any questions or changes.

In accordance with Michigan law, all Grand Hotel guest rooms, meeting rooms, restaurants and bars are non-smoking.

See attached reservation processing tips letter

WORLD’S LARGEST SUMMER HOTEL

Michigan Association of Healthcare Advocates Tuesday, June 13 - Thursday, June 15, 2017

2017 Daily Rates

Double (per person) Single

Standard Guest Room $197.00 $319.00 (Hotel’s Added Charge 19.5%) $38.42 $62.20 $235.42 $381.21 (State Sales Tax 6%) $14.13 $22.87 (Assessment Charge 2%) $4.71 $7.62 $254.26 $411.70 (Baggage Handling Charge) $8.50 $8.50 Estimated Totals

$262.76 $420.20

Deluxe Guest Room $236.00 $397.00 (Hotel’s Added Charge 19.5%) $46.02 $77.42 $282.02 $474.42 (State Sales Tax 6%) $16.92 $28.47 (Assessment Charge 2%) $5.64 $9.49 $304.58 $512.38 (Baggage Handling Charge) $8.50 $8.50 Estimated Totals $313.08 $520.88

Three Persons Sharing A Room $188.00

(Hotel’s Added Charge 19.5%) $36.66 $224.66

(State Sales Tax 6%) $13.48

(Assessment Charge 2%) $4.49 $242.63

(Baggage Handling Charge) $8.50

Estimated Total $251.13

Four Persons Sharing A Room $166.00

(Hotel’s Added Charge 19.5%) $32.37 $198.37

(State Sales Tax 6%) $11.90

(Assessment Charge 2%) $3.97 $214.24

(Baggage Handling Charge) $8.50 Estimated Total $222.74

WORLDʼS LARGEST SUMMER HOTEL

GRAND HOTEL RESERVATION PROCESSING TIPS1. Group reservations with group deposit should use the following guideline:

a. Complete one reservation form per room and list all the roommates on one form. Do not use one form formultiple rooms or one form for each roommate.

b. Indicate your organization’s name on the reservation form with a contact name and telephone number.c. Indicate roommate, type of room (standard, deluxe, single, double, 3 or 4 person), and the amount of

deposit to be applied to each room reservation.d. Complete the deposit information section on the reservation form.e. Return the reservation form (one per room), group listing, and deposit payment to Grand Hotel.f. Your hotel confirmation will be arriving to you via e-mail. Please check your confirmation to make sure it

is correct and print it for your records.g. Contact the Reservation Department if you have any questions or changes.

2. FOR GROUPS OR INDIVIDUALS WISHING A TAX EXEMPT BILL, WE REQUEST A TAX-EXEMPTFORM BE SUBMITTED WITH THE RESERVATION FORM. CONTACT ALESSA PERKINS AT GRANDHOTEL IF YOU NEED A TAX-EXEMPT FORM. PLEASE INCLUDE A LIST OF ALL GUESTS THAT WILLFALL UNDER YOUR TAX EXEMPT STATUS. AND ALSO INCLUDE A COPY OF THE CHECK OR CREDIT CARD BEING USED FOR PAYMENT. PAYMENT FROM A PERSONAL CREDIT CARD OR PERSONAL CHECK IS NOT ELIGIBLE FOR TAX EXEMPTION UNDER MICHIGAN LAW. TO ACHIEVETAX EXEMPT STATUS, THE NAME ON THE METHOD OF PAYMENT MUST MATCH THE TAXEXEMPT FORM.

3. Our Reservation Department is instructed not to make reservations by telephone. Individuals may call to have areservation form faxed or e-mailed to them.

4. Reservation deposits are per room, not per person. Credit cards are charged as soon as the reservations is made.We consider all room reservations to be definite upon receipt of the reservation form. Reservation deposits will berefunded if canceled 10 or more days prior to arrival, less a $45.00 processing fee. Reservations canceled less than 10days prior to arrival will forfeit room deposit.

5. Individuals are requested to submit a credit card number at check-in to assure all charges are paid upon departure.Final balances may be paid by credit card, cash, check or traveler's check.

6. Individuals who have questions or concerns regarding their final bill should contact our Accounts ReceivableDepartment.

I have read and understand the above regarding possible tax exemption status for the MAHA conference.

Signature: _________________________________________________________________________

Michigan Department of TreasuryForm 3372 (Rev. 08-12)

Michigan Sales and Use Tax Certifi cate of ExemptionDO NOT send to the Department of Treasury. Certifi cate must be retained in the seller’s records. This certifi cate is invalid unless all four sections are completed by the purchaser.

SECTION 1: TYPE OF PURCHASEA. One-Time Purchase C. Blanket Certifi cate

Order or Invoice Number: _____________________ Expiration Date (maximum of four years):_________________

B. Blanket Certifi cate. Recurring Business Relationship

The purchaser hereby claims exemption on the purchase of tangible personal property and selected services made from the vendor listed below. This certifi es that this claim is based upon the purchaser’s proposed use of the items or services, OR the status of the purchaser.

Vendor’s Name and Address

SECTION 2: ITEMS COVERED BY THIS CERTIFICATECheck one of the following:

1. All items purchased.

2. Limited to the following items: _________________________________________________________________________

SECTION 3: BASIS FOR EXEMPTION CLAIMCheck one of the following:

1. For Resale at Retail. Enter Sales Tax License Number: _______________________

2. For Lease. Enter Use Tax Registration Number:_______________________________

The following exemptions DO NOT require the purchaser to provide a number:

3. For Resale at Wholesale.

4. Agricultural Production. Enter percentage: ______%

5. Industrial Processing. Enter percentage: ______%

6. Church, Government Entity, Nonprofi t School, or Nonprofi t Hospital (Circle type of organization).

7. Nonprofi t Internal Revenue Code Section 501(c)(3) or 501(c)(4) Exempt Organization (must provide IRS authorized letter with this form).

8. Nonprofi t Organization with an authorized letter issued by the Michigan Department of Treasury prior to June 1994 (must provide copy of letter with this form).

9. Rolling Stock purchased by an Interstate Motor Carrier.

10. Other (explain):

SECTION 4: CERTIFICATIONI declare, under penalty of perjury, that the information on this certifi cate is true, that I have consulted the statutes, administrative rules and other sources of law applicable to my exemption, and that I have exercised reasonable care in assuring that my claim of exemption is valid under Michigan law. In the event this claim is disallowed, I accept full responsibility for the payment of tax, penalty and any accrued interest, including, if necessary, reimbursement to the vendor for tax and accrued interest.

Business Name Type of Business (see codes on page 2)

Business Address City, State, ZIP Code

Business Telephone Number (include area code) Name (Print or Type)

Signature and Title Date Signed

3372, Page 2

Instructions for completing Michigan Sales and Use Tax Certifi cate of ExemptionPurchasers may use this form to claim exemption from Michigan sales and use tax on qualifi ed transactions. It is the Purchaser’s responsibility to ensure the eligibility of the exemption being claimed. All claims are subject to audit. Non-qualifi ed transactions are subject to tax, statutory penalty and interest.

Sellers are required to maintain records, paper or electronic, of completed exemption certifi cates for a period of four years. Michigan does not issue “tax exempt numbers” and a seller may not rely on a number for substitution of an exemption certifi cate. Other documentation that sellers in the State of Michigan may accept are the Uniform Sales and Use Tax Certifi cate approved by the Multistate Tax Commission, the Streamlined Sales and Use Tax Agreement Certifi cate of Exemption, the same information in another format from the purchaser, or resale or exemption certifi cates or other written evidence of exemption authorized by another state or country.

SECTION 1:Place a check in the box that describes how you will use this certifi cate. A) Choose “One-Time Purchase” and include the invoice number this certifi cate covers.B) Choose “Blanket Certifi cate” if there is a “recurring business relationship.” This exists when a period of not more than 12 months elapses between sales transactions between the seller and purchaser. C) Choose “Blanket Certifi cate” and enter the expiration date (maximum four years) when there is a period of more than 12 months between sales transactions.

Print the vendor’s name and address in the area provided.

SECTION 2:Place a check in the box for “All items purchased” or choose “Limited to” and list the items that are covered by the exemption claim.

SECTION 3:Place a check in the box that applies and provide the additional information requested for that exemption. The exemptions listed are the most common. If the exemption you are claiming is not listed use “Other” and enter the qualifying exemption.

SECTION 4: Use the number that describes your business or explain any other business type not provided.

01 Accommodations 09 Transportation02 Agricultural 10 Utilities03 Construction 11 Wholesale04 Manufacturing 12 Advertising, newspaper05 Government 13 Non-Profi t Hospital06 Rental or leasing 14 Non-Profi t Educational07 Retail 15 Non-Profi t 501(c)(3) or 501(c)(4)08 Church 16 Other

Print the name of the business, address, city, state and zip code. Sign and provide your title (i.e. owner, president, treasurer, etc.). Provide your printed name and date the certifi cate.

DO NOT SEND THIS EXEMPTION CERTIFICATE TO THE DEPARTMENT OF TREASURY.