2020-11-13T08:34:02-06:00 2019-12-31 990 2019-10-27 842670875 ADVENTIST HEALTHCARE FORT WASHINGTON MEDICAL CENTER INC ADVE 3013153030 820 WEST DIAMOND AVE NO 600 GAITHERSBURG MD 208781419 JAMES G LEE EXEC VICE PRESIDENT & CFO 3013153025 2020-11-13 96.231.190.138 2020-11-13 09:32:22 ES P C062B308BD402F67A9E2D8B01A21E3DE8729394D C062B308BD402F67A9E2D8B01A21E3DE8729394D 2019 2021-01-29 14:40:06Z X TERRY FORDE 820 WEST DIAMOND AVE NO 600 GAITHERSBURG MD 208781419 8527174 0 1071 X WWW.ADVENTISTHEALTHCARE.COM X 2019 MD HEALTH-CARE NETWORK: SERVICES SUCH AS ACUTE CARE, 24/7 EMERGENCY CARE, AND GENERAL SURGERY. 12 8 0 14 0 0 100518 8412422 0 14234 8527174 0 0 4902100 0 0 3221975 8124075 403099 29044506 21585996 7458510 X WE EXTEND GOD'S CARE THROUGH THE MINISTRY OF PHYSICAL, MENTAL AND SPIRITUAL HEALING. 0 0 6290154 8412422 IN 2019, ADVENTIST HEALTHCARE FORT WASHINGTON MEDICAL CENTER INC., AN ACUTE CARE HOSPITAL, PROVIDED MEDICAL AND SURGICAL SERVICES TO THE COMMUNITY. IN ADDITION, THEY PROVIDED BENEFITS TO THE COMMUNITY THAT INCLUDED, CHARITY CARE, TEACHING PRECEPTOR OPPORTUNITIES, HEALTH SCREENINGS, COMMUNITY HEALTH EDUCATION, COMMUNITY SPONSORSHIP OPPORTUNITIES, AND COMMUNITY ENGAGEMENT ACTIVITIES.THE HOSPITAL RECEIVED THE FOLLOWING HEALTH AWARDS:WORKPLACE PARTNERSHIP FOR LIFE SILVER RECOGNITION FOR EFFORTS TO INCREASE ORGAN, EYE, AND TISSUE DONOR REGISTRATIONS IN MARYLAND;U.S. NEWS & WORLD REPORT RANKS 2019-20 HIGH PERFORMING HOSPITAL FOR HEART FAILURE IN MARYLAND; CONTINUES ON SCHEDULE O.HEALTHGRADES FIVE-STAR COMMENDATION FOR ORTHOPEDIC TREATMENT;HEALTHGRADES FIVE-START FOR APPENDIX SURGERIES.IN ADDITION, IN OCTOBER 2019, ADVENTIST HEALTHCARE FORT WASHINGTON MEDICAL CENTER BECOME PART OF THE ADVENTIST HEALTHCARE SYSTEM. GIVEN THE CHANGES IN HEALTHCARE BOTH NATIONALLY AND IN MARYLAND, JOINING ADVENTIST HEALTHCARE ALLOWS ADVENTIST HEALTHCARE FORT WASHINGTON MEDICAL CENTER TO EXPAND ITS HIGH-QUALITY HEALTHCARE SERVICES IN PRINCE GEORGE'S COUNTY AND OVERCOME THE CHALLENGES OF OPERATING AS A STANDALONE COMMUNITY HOSPITAL.ADVENTIST HEALTHCARE FORT WASHINGTON MEDICAL CENTER RECEIVED A GRANT FROM GILEAD SCIENCES, INC. THE PROGRAM ADDRESSES THE HIV EPIDEMIC IN PRINCE GEORGE'S COUNTY AND HELPS PREVENT DEVELOPING COMPLICATIONS SUCH AS LIVER FAILURE, LIVER CANCER, AND CIRRHOSIS BROUGHT ON BY A HEPATITIS C DIAGNOSIS. THE PROGRAM ALSO ALLOWS FWMC TO ADMINISTER 20,000 HIV AND HEPATITIS C TESTS TO PATIENTS WHO COME THROUGH ITS EMERGENCY DEPARTMENT. THE PROGRAM HAS LINKED NEARLY 300 OF PATIENTS TO LIFE-SAVING CARE AFTER BEING DIAGNOSED IN 2019. THIS PROGRAM NOT ONLY PROVIDES DIAGNOSTIC AWARENESS, BUT IT ALSO PROVIDES NAVIGATIONAL SERVICES FOR FOLLOW UP AND CONTINUED CARE BASED ON THE TEST RESULTS. 6290154 1 1 0 0 0 0 0 0 0 0 1 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 1 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 1 X 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 X 12 8 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 0 0 0 X JAMES G LEE EXEC VP & CFO 3013153030 820 WEST DIAMOND AVE SUITE 600 GAITHERSBURG MD 208781419 TERRY FORDE CHAIR; PRESIDENT & CEO,AHC 4.00 58.00 X X 0 2189488 243245 JOHN SACKETT VICE CHAIR; EVP/COO,AHC; PRES.,SGMC 5.00 57.00 X 0 984331 69288 JAMES G LEE EVP & CFO, AHC 4.00 58.00 X X 0 772649 166044 EUNMEE SHIM SECY.; PRES.,FWMC; SVP,AMB NETWK,AHC 20.00 35.00 X 0 631733 110834 GINA BROWN BOARD MEMBER 1.00 X 0 0 0 CHARLES DAY BOARD MEMBER 1.00 X 0 0 0 PASTOR MARCUS HARRIS BOARD MEMBER 1.00 X 0 0 0 MICHELLE HEREFORD BOARD MEMBER 1.00 X 0 0 0 ALVIN KIBBLE BOARD MEMBER 1.00 X 0 0 0 KIMBERLY ROBERTSON BOARD MEMBER 1.00 X 0 0 0 SAMEER SHAMMAS BOARD MEMBER 1.00 X 0 0 0 KENNETH FISHER BOARD MEMBER 1.00 X 0 0 0 0 4578201 589411 0 0 1 0 ALLIED UNIVERSAL PO BOX 828854 PHILADELPHIA PA 19182 SECURITY SERVICES 152361 ANACOSTIA MEDICAL ASSOC LLC 8408 ADLER COURT MILLERSVILLE MD 21108 INTENSIVIST & HOSPITALIST SERVICES 150000 VIMLA BHOOSHAN MD PC 9739 AVENEL FARM DRIVE POTOMAC MD 20854 PHYSICIAN SERIVICES 131678 LABORATORY CORPORATION OF AMERICA PO BOX 12140 BURLINGTON NC 272162140 LAB MANAGEMENT 112319 GALLAGHER EVELIUS & JONES LLP 218 NORTH CHARLES ST 400 BALTIMORE MD 21201 LEGAL SERVICES 105326 5 100518 100518 PATIENT SERVICES 622110 8412422 8412422 8412422 14234 0 14234 14234 14234 8527174 8412422 0 14234 X 4070934 3474484 596450 129051 108579 20472 403428 298651 104777 298687 254793 43894 1665464 1335867 329597 19928 551 19377 24974 24974 351825 105626 246199 36636 32560 4076 3592 2838 754 208806 22962 185844 133133 304 132829 MEDICAL SUPPLIES 697971 635590 62381 COLLECTION FEES/LICENSE 79646 17349 62297 8124075 6290154 1833921 0 1478956 46000 5246936 1450231 1229493 17220803 278244 0 16942559 475000 0 2175331 0 29044506 10485503 7418015 0 3682478 0 21585996 X 7351510 107000 0 7458510 0 29044506 X 403099 7055411 X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 3110000 3110000 7016057 44715 6971342 2211932 143149 2068783 2805066 85431 2719635 2077748 4949 2072799 16942559 MORTGAGE RESERVE FUND 1659265 FINANCING LEASE RIGHT-OF-USE ASSET 254535 OPERATING LEASE RIGHT-OF-USE ASSET 198798 SECURITY DEPOSIT & OTHER 62733 2175331 FINANCING LEASE OBLIGATIONS 267422 OPERATING LEASE OBLIGATIONS 198798 OTHER LONG TERM LIABILITIES 3216258 3682478 X PART X, LINE 2: FIN 48 NOTES: THE CORPORATION ACCOUNTS FOR UNCERTAINTY IN INCOME TAXES USING A RECOGNITION THRESHOLD OF MORE-LIKELY-THAN-NOT TO BE SUSTAINED UPON EXAMINATION BY THE APPROPRIATE TAXING AUTHORITY. MEASUREMENT OF THE TAX UNCERTAINTY OCCURS IF THE RECOGNITION THRESHOLD IS MET. MANAGEMENT DETERMINED THERE WERE NO TAX UNCERTAINTIES THAT MET THE RECOGNITION THRESHOLD IN 2019 OR 2018. THE CORPORATION'S POLICY IS TO RECOGNIZE INTEREST RELATED TO UNRECOGNIZED TAX BENEFITS IN INTEREST EXPENSE AND PENALTIES IN OPERATING EXPENSES. 1 1 X 1 X 1 X 600.000000000000 1 1 0 1 1 133436 133436 0.01640 604568 494366 110202 0.01360 738004 494366 243638 0.03000 21741 21741 0.00270 24106 24106 0.00300 266928 38304 228624 0.02810 312775 38304 274471 0.03380 1050779 532670 518109 0.06380 1 609029 3134811 3335638 -200827 X 1 1 1 4 AHC FORT WASHINGTON MEDICAL CENTER INC 11711 LIVINGSTON ROAD FORT WASHINGTON MD 20744 HTTPS://WWW.FORTWASHINGTONMC.ORG/ 16003 X X X AHC FORT WASHINGTON MEDICAL CENTER INC 1 0 1 1 X X X X X X X X X 19 1 1 1 1 X SEE URL ON SECTION C X X 1 19 1 SEE URL ON SECTION C 0 1 X 200.000000000000 600.000000000000 X X 1 1 X X X 1 X SEE URL ON SECTION C X SEE URL ON SECTION C X SEE URL ON SECTION C X X X X X X X 1 X 0 X X X X 1 X 0 0 AHC FORT WASHINGTON MEDICAL CENTER INC. PART V, SECTION B, LINE 2: ADVENTIST HEALTHCARE FORT WASHINGTON MEDICAL CENTER, INC., WITH EIN 84-2670875, SUCCEEDED FORT WASHINGTON MEDICAL CENTER INC., WITH EIN 52-1682858, EFFECTIVE OCTOBER 27, 2019, THROUGH AN ASSET PURCHASE AGREEMENT. AHC FORT WASHINGTON MEDICAL CENTER INC. PART V, SECTION B, LINE 5: IN 2015, THE PRINCE GEORGE'S COUNTY GOVERNMENT AND MARYLAND-NATIONAL CAPITAL PARKS AND PLANNING COMMISSION CONDUCTED A SPECIAL STUDY TO DEVELOP A PRIMARY HEALTHCARE STRATEGIC PLAN IN PREPARATION FOR ENHANCING THE HEALTHCARE DELIVERY NETWORK. A KEY RECOMMENDATION FROM THE PLAN WAS TO "BUILD COLLABORATION AMONG PRINCE GEORGE'S COUNTY HOSPITALS" WHICH INCLUDED CONDUCTING A JOINT COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) WITH THE PRINCE GEORGE'S COUNTY HEALTH DEPARTMENT. FORT WASHINGTON MEDICAL CENTER INC., ALONG WITH THE OTHER FOUR HOSPITALS LOCATED IN PRINCE GEORGE'S COUNTY, TEAMED UP WITH THE PRINCE GEORGE'S COUNTY HEALTH DEPARTMENT TO CREATE A "CORE TEAM" TO FACILITATE THE 2019 CHNA PROCESS. THE PROCESS WAS DEVELOPED TO 1) MAXIMIZE COMMUNITY INPUT, 2) LEARN FROM THE COMMUNITY EXPERTS, 3) UTILIZE EXISTING DATA, AND 4) TO ENSURE A COMPREHENSIVE COMMUNITY PRIORITIZATION. THE PROCESS INCLUDED: 1) A COMMUNITY RESIDENT SURVEY IN BOTH ENGLISH AND SPANISH, 2) AN ANALYSIS OF DEMOGRAPHICS AND POPULATION DESCRIPTIONS THROUGH SOCIOECONOMIC INDICATORS AND COMPREHENSIVE HEALTH INDICATOR PROFILE, 3) HOSPITAL SERVICE PROFILES OF RESIDENTS SERVICED BY THE CORE TEAM, 4) A COMMUNITY-BASED ORGANIZATION SURVEY AND KEY INFORMANT INTERVIEWS, AND 5) A COMMUNITY PRIORITIZATIONS PROCESS THAT INCLUDED 40 REPRESENTATIVES FROM ACROSS THE COUNTY WHO ARE IDENTIFIED BELOW.KLEINMAN, DDS, MSCD, DUSHANKA, UMD-PUBLIC HEALTH, DEPT. OF EPIDEMIOLOGY & BIOSTATISTICS;TERRY, MILLY, AFRICAN WOMEN'S CANCER AWARENESS ASSOCIATION;GRANT, TERESA, PGC DEPARTMENT OF FAMILY SERVICES;CARVANA, ANTHONY, COMMUNITY COUNSELING AND MENTORING SERVICES, INC.;MCDONOUGH, MARY LOU, PGC DEPARTMENT OF CORRECTIONS;HOWELL, MICHELLE, THE ARC;SHIVER, SANDERS, PGC PUBLIC SCHOOLS;HOBAN, EVELYN, PGC HEALTH DEPARTMENT;HALL, PHD, MPH, CLARENCE, PACANET USA;BELON-BUTLER, ELANA, PGC DEPARTMENT OF FAMILY SERVICES;GOMEZ, MARIA, MARY'S CENTER;LOBRANO, MD, MARCIA, COMMUNITY CLINIC, INC.;MALLOY, COLENTHIA, GREATER BADEN MEDICAL CENTER;MATTHEWS, SAUNDRA, COMMUNITY CLINIC, INC.;DEMUS, LESLIE, HEART TO HAND;SPANN, MONICA, PGC HEALTH DEPARTMENT HEALTH ENTERPRISE ZONE;ALDOORY, PHD, LINDA, UNIVERSITY OF MARYLAND, DEPARTMENT OF COMMUNICATION;WILSON, ALICIA, LA CLINICA DEL PUEBLO;MOORE, MAJOR ELAINE, PGC POLICE DEPARTMENT;COOPER, MD, CARNELL, DIMENSIONS HEALTHCARE SYSTEM/PRINCE GEORGE'S HOSPITAL CENTER;HALL, MD, TRUDY, LAUREL REGIONAL HOSPITAL CENTER;JOHNSON-THREAT, MD, YVETTE, MEDSTAR SOUTHERN MARYLAND HOSPITAL CENTER;MOORE, SHERRI, DOCTORS COMMUNITY HOSPITAL;SMITH, MD, SHARNELL, FORT WASHINGTON MEDICAL CENTER/NEXUS;SULLIVAN, TIFFANY, DIMENSIONS HEALTHCARE SYSTEM;WATERS, MD, JD, FCLM, VICTOR, FORT WASHINGTON MEDICAL CENTER/NEXUS;PROCTOR, NATALIE STANDINGONTHEROCK, WILD TURKEY CLAN, CEDARVILLE BAND OF PISCATAWAY CONOY;DODO, KODJO, PGC HEALTH DEPARTMENT, WIC PROGRAM;HEWLETT, ELIZABETH, MARYLAND NATIONAL PARK AND PLANNING COMMISSION;BRYANT, TRACY, UNITED HEALTHCARE COMMUNITY PLAN;MOOREHEAD, CREIGHTON, NORVARTIS (FORMERLY WITH KAISER);AMIN, MENA, THE COMMUNITY FOUNDATION, PRINCE GEORGE'S COUNTY;BARRON, EREK, HOUSE OF DELEGATES;OWUSU-ASCHEAW, POKUAA, FOR SENATOR JOANNE BENSON;CREEKMUR, PAMELA B., PGC HEALTH DEPARTMENT;HARRINGTON, DAVID, PGC CHAMBER OF COMMERCE;CARTER, MD, PHD, ERNEST, PGC HEALTH DEPARTMENT;BROWN, ERIC, PGC DEPARTMENT OF HOUSING AND COMMUNITY DEVELOPMENT;WOOD, DENNIS, PGC FIRE/EMS DEPARTMENT;BATES, RN, MS, KAREN, OFFICE OF SCHOOL HEALTH, PRINCE GEORGE'S COUNTY PUBLIC SCHOOLS;BROWN, GLORIA, PGC DEPARTMENT OF SOCIAL SERVICES;BRUCE, GERALYN, PGC DEPT. PUBLIC WORKS & TRANSPORTATION;SNOWDEN, CAROL LYNN, PGC DEPARTMENT OF FAMILY SERVICES. AHC FORT WASHINGTON MEDICAL CENTER INC. PART V, SECTION B, LINE 6A: DOCTORS COMMUNITY HOSPITAL; LAUREL REGIONAL HOSPITAL; MEDSTAR SOUTHERN MARYLAND HOSPITAL CENTER; AND PRINCE GEORGE'S HOSPITAL CENTER. AHC FORT WASHINGTON MEDICAL CENTER INC. PART V, SECTION B, LINE 6B: PRINCE GEORGE'S COUNTY HEALTH DEPARTMENT;SOUTHERN MARYLAND REGIONAL COALITION FOR CARE TRANSITIONS;PRINCE GEORGE'S COMMUNITY COLLEGE HEALTH BUSINESS SCHOOL;FRIENDLY HIGH SCHOOL, BEHAVIORAL HEALTH;RIVER JORDAN PROJECT, PRINCE GEORGE'S COUNTY DISTRICT 8 HEALTH;COMMUNITY COALITION;PRINCE GEORGE'S CHAMBER OF COMMERCE AND AMERICAN DIABETES ASSOCIATION. AHC FORT WASHINGTON MEDICAL CENTER INC. PART V, SECTION B, LINE 7D: A HARD COPY OF THE CHNA IS ALSO AVAILABLE UPON REQUEST FROM THE ADVENTIST HEALTHCARE SUPPORT CENTER (CORPORATE OFFICE) WHICH IS LOCATED AT: 820 WEST DIAMOND AVENUE 4TH FLOOR, GAITHERSBURG, MD 20878;PART V, SECTION B, LINE 7A: THE CHNA REPORT IS FOUND ON THIS URL: HTTPS://WWW.FORTWASHINGTONMC.ORG/SERVICES/COMMUNITY-HEALTH/PART V, SECTION B, LINE 10A: THE IMPLEMENTATION STRATEGY IS FOUND ON THIS URL: HTTPS://WWW.FORTWASHINGTONMC.ORG/SERVICES/COMMUNITY-HEALTH/ AHC FORT WASHINGTON MEDICAL CENTER INC. PART V, SECTION B, LINE 11: THE HOSPITAL ALONE CANNOT ADDRESS ALL COMMUNITY NEEDS DUE TO BUDGET CONSTRAINTS. HOWEVER, TO ENSURE THAT ALL HEALTH NEEDS WERE MET, FWMC, ALONG WITH THE OTHER FOUR HOSPITALS IN PRINCE GEORGE'S COUNTY AND THE PRINCE GEORGE'S COUNTY HEALTH DEPARTMENT, IDENTIFIED AT LEAST ONE AND OFTEN MULTIPLE RESOURCES AVAILABLE TO MEET EACH IDENTIFIED COMMUNITY HEALTH NEED. WHILE THE CORE TEAM LEAD THE DATA GATHERING PROCESS OF THE CHNA, THERE WAS RECOGNITION THAT THERE MUST BE SHARED OWNERSHIP OF THE COUNTY'S COMMUNITY'S HEALTH. FWMC IS DIRECTLY ADDRESSING NEEDS RELATED TO DIABETES AND HEART DISEASE THROUGH DIABETIC EDUCATION AND TRAINING CLASSES, AN EXERCISE AND FITNESS PROGRAM, AND COMMUNITY OUTREACH SCREENING PROGRAMS. IN ADDITION, THE HOSPITAL ADDED INPATIENT DIALYSIS AND LITHOTRIPSY SERVICES. FWMC PARTNERS WITH PG COUNTY HEALTH DEPARTMENT AND GILEAD SCIENCES. INC., TO ADDRESS THE GROWING CONCERN OF HIV AND HEPATITIS C IN THE COMMUNITY THROUGH FREE HIV AND HEPATITIS C TESTING IN THE EMERGENCY ROOM DEPARTMENT. IN ORDER TO ASSURE THAT THE COMMUNITY HAS ACCESS TO ALL IDENTIFIED NEEDS, THOSE SERVICES THAT CANNOT BE DIRECTLY DONE BY FWMC ARE SERVICES THAT THE HOSPITAL HAS DEVELOPED A LINK TO CARE TO ASSURE THAT THEY CAN REFER ANY PATIENT TO THE SERVICES THAT ARE IDENTIFIED OR NEEDED. AHC FORT WASHINGTON MEDICAL CENTER INC. PART V, SECTION B, LINE 16J: THE POLICY IS ALSO STRATEGICALLY POSTED AT OUR PATIENT FINANCIAL SERVICES OFFICE.PART V, SECTION B, LINE 16A: HTTPS://WWW.ADVENTISTHEALTHCARE.COM/PATIENTS/BILLING/FINANCIAL-ASSISTANCE/PART V, SECTION B, LINE 16B: SAME URL AS LISTED ON LINE 16APART V, SECTION B, LINE 16C: SAME URL AS LISTED ON LINE 16A PART I, LINE 3C: IN CONSIDERATION FOR FINANCIAL ASSISTANCE TO OUR PATIENTS, ADVENTIST HEALTHCARE ALSO CONSIDERS CIRCUMSTANCES BEYOND INCOME. THE PATIENT'S CIRCUMSTANCES COULD INCLUDE THE NEEDS OF THE PATIENT AND/OR FAMILY AND OTHER FINANCIAL RESOURCES. IT IS OUR MISSION TO PROVIDE NECESSARY MEDICAL CARE TO THOSE WHO ARE UNABLE TO PAY FOR THAT CARE. IN GENERAL, ADVENTIST HEALTHCARE HAS 15 LEVELS OF FINANCIAL ASSISTANCE. THEY ARE AS FOLLOWS:- ANNUAL INCOME <= 1.0X OF FPL, 0% PATIENT RESPONSIBILITY- ANNUAL INCOME > 1.00X AND <= 1.25X OF FPL, 0% PATIENT RESPONSIBILITY- ANNUAL INCOME > 1.25X AND <= 1.50X OF FPL, 0% PATIENT RESPONSIBILITY- ANNUAL INCOME > 1.50X AND <= 1.75X OF FPL, 0% PATIENT RESPONSIBILITY- ANNUAL INCOME > 1.75X AND <= 2.00X OF FPL, 0% PATIENT RESPONSIBILITY- ANNUAL INCOME > 2.00X AND <= 2.25X OF FPL, 10% PATIENT RESPONSIBILITY- ANNUAL INCOME > 2.25X AND <= 2.50X OF FPL, 20% PATIENT RESPONSIBILITY- ANNUAL INCOME > 2.50X AND <= 2.75X OF FPL, 30% PATIENT RESPONSIBILITY- ANNUAL INCOME > 2.75X AND <= 3.00X OF FPL, 40% PATIENT RESPONSIBILITY- ANNUAL INCOME > 3.00X AND <= 3.50X OF FPL, 50% PATIENT RESPONSIBILITY- ANNUAL INCOME > 3.50X AND <= 4.00X OF FPL, 60% PATIENT RESPONSIBILITY- ANNUAL INCOME > 4.00X AND <= 4.50X OF FPL, 70% PATIENT RESPONSIBILITY- ANNUAL INCOME > 4.50X AND <= 5.00X OF FPL, 80% PATIENT RESPONSIBILITY- ANNUAL INCOME > 5.00X AND <= 5.50X OF FPL, 90% PATIENT RESPONSIBILITY- ANNUAL INCOME > 5.50X AND <= 6.00X OF FPL, 95% PATIENT RESPONSIBILITY PART I, LINE 7: MARYLAND'S UNIQUE ALL PAYER SYSTEM INCLUDES A METHOD FOR INCLUDING UNCOMPENSATED CARE IN EACH PROVIDER'S RATES. FOR PURPOSES OF COMPLETING THIS FORM 990, THESE UNCOMPENSATED CARE ADJUSTMENTS TO OUR APPROVED RATE ORDER ARE NOT PRESENTED AS AN OFFSET TO THE LEVEL OF UNCOMPENSATED CARE WE PROVIDED.SINCE THE HSCRC ASSESSES HOSPITALS TO SUBSIDIZE THE STATE'S MEDICAID BUDGET DEFICIT, THESE ASSESSMENTS (NET OF AMOUNTS BUILT IN RATES) ARE ALSO COUNTED TOWARD COMMUNITY BENEFITS.FOR PURPOSES OF PREPARING SCHEDULE H OF FORM 990, ADVENTIST HEALTHCARE FORT WASHINGTON MEDICAL CENTER CALCULATED A COST TO CHARGE RATIO AS REFLECTED IN ITS 2019 AUDITED FINANCIAL STATEMENTS. THE COST TO CHARGE RATIO WAS USED TO REDUCE THE YEARLY CHARITY CARE PROVISION FROM CHARGE TO COST.IN ADDITION, ADVENTIST HEALTHCARE FORT WASHINGTON MEDICAL CENTER ALSO CONSIDERED GOVERNMENT ASSESSMENTS THROUGH THE STATE'S HEALTH SERVICE COST REGULATORY AGENCY AND OTHER RELATED STATE GOVERNMENT AGENCIES. PART III, LINE 2: TO ESTIMATE THE COST OF BAD DEBT THAT WE HAVE REPORTED ON SCHEDULE H, WE MULTIPLIED THE ORGANIZATION'S COST TO CHARGE RATIO (CCR) TIMES THE BAD DEBT PROVISION THAT HAS BEEN REPORTED IN THE 2019 AUDITED FINANCIAL STATEMENTS. THE ORGANIZATION'S CCR IS THE QUOTIENT THAT RESULTS WHEN TOTAL OPERATING EXPENSE IS DIVIDED BY TOTAL CHARGES AS REFLECTED ON THE ORGANIZATION'S AUDITED INCOME STATEMENT.THE BAD DEBT EXPENSE THAT IS RECORDED IN THE GENERAL LEDGER REFLECTS THE AMOUNT OF PROVISION MANAGEMENT DEEMS NECESSARY TO REPORT PATIENT ACCOUNTS RECEIVABLE AT THEIR NET REALIZABLE VALUE. IN EVALUATING THE COLLECTABILITY OF PATIENT ACCOUNTS RECEIVABLE, WE ANALYZE PAST HISTORY AND TRENDS FOR EACH MAJOR PAYOR AND ESTIMATE THE APPROPRIATE ALLOWANCE FOR DOUBTFUL COLLECTIONS. PART III, LINE 4: THE CORPORATION ASSESSES COLLECTABILITY ON PATIENT CONTRACTS PRIOR TO THE RECOGNITION OF NET PATIENT SERVICE REVENUES. PATIENT ACCOUNTS RECEIVABLE ARE REPORTED AT THEIR NET REALIZABLE VALUE. ACCOUNTS ARE WRITTEN OFF THROUGH BAD DEBT EXPENSE WHEN THE CORPORATION HAS EXHAUSTED ALL COLLECTION EFFORTS AND DETERMINES ACCOUNTS ARE IMPAIRED BASED ON CHANGES IN PATIENT CREDIT WORTHINESS. PATIENT ACCOUNTS RECEIVABLE ALSO INCLUDES MANAGEMENT'S ESTIMATE OF THE IMPACT OF CERTAIN UNDERCHARGES TO BE RECOUPED OR OVERCHARGES TO BE PAID BACK FOR INPATIENT AND OUTPATIENT SERVICES IN SUBSEQUENT YEARS RATES AS DISCUSSED EARLIER. PART III, LINE 8: ACUTE CARE HOSPITALS IN MARYLAND ARE EXEMPT FROM MEDICARE REIMBURSEMENT METHODOLOGY AND ALL PAYORS (INCLUDING MEDICARE AND MEDICAID) PAY HOSPITALS' CHARGES, WHICH ARE REGULATED BY THE STATE'S HEALTH SERVICES COST REVIEW COMMISSION (HSCRC). SPECIFICALLY, MEDICARE IS AWARDED A DISCOUNT OF 7.7% OF CHARGES WITHOUT AN ADVANCE FUNDING DEPOSIT WITH PROVIDERS, AS WELL AS A 2% REDUCTION FOR SEQUESTRATION. THERE SHOULD BE NO SHORTFALL AND THEREFORE NOTHING TO COUNT TOWARD COMMUNITY BENEFIT. PART III, LINE 9B: > THAT ALL PATIENTS RECEIVE A NOTICE ON FINANCIAL ASSISTANCE AND A PHONE CALL, BY ADVENTIST HEALTHCARE'S STAFF AND OUTSOURCED VENDORS, MENTIONING THE OPPORTUNITY TO HAVE THEIR BILL REDUCED IF THE DEBTOR QUALIFIES FOR ADVENTIST HEALTHCARE'S FINANCIAL ASSISTANCE.> WHEN A DEBTOR HAS AFFIRMED A DEBT AND HAS BEEN GIVEN AN OPPORTUNITY TO APPLY FOR ADVENTIST HEALTHCARE'S FINANCIAL ASSISTANCE, AND HAS APPLIED FOR AND BEEN GRANTED ASSISTANCE THAT REDUCED THE OUTSTANDING BALANCE BUT LEAVING AN AMOUNT STILL OWED TO AN ADVENTIST HEALTHCARE FACILITY OR HAS NOT APPLIED FOR ASSISTANCE IN THE ALLOTTED TIME PERIOD:1) FOR EXISTING ACCOUNTS, THE COLLECTION AGENCY WILL RECEIVE "DAILY NOTIFICATION TO REDUCE THE OUTSTANDING BALANCE OF ANY DEBTOR WHO QUALIFIES FOR ADVENTIST HEALTHCARE'S FINANCIAL ASSISTANCE. THE AGENCY WILL SEND A LETTER TO THE DEBTOR, ACKNOWLEDGING THE NEW BALANCE WITHIN 30 DAYS OF THE NOTICE TO ADJUST.2) ONCE THE DEBTOR AFFIRMS THE DEBT, THE AGENCY WILL INFORM THE DEBTOR ABOUT ADVENTIST HEALTHCARE'S FINANCIAL ASSISTANCE POLICY AND ASK IF THEY HAD RECEIVED INFORMATION ON HOW TO COMPLETE THE APPLICATION, OR THE CRITERIA FOR QUALIFICATION.3) WHEN A DEBTOR EXPRESSES A DESIRE TO COMPLETE THE APPLICATION FOR FINANCIAL ASSISTANCE, THEY WILL BE REFERRED TO ADVENTIST HEALTHCARE'S FINANCIAL COUNSELOR (301)-203-3475. THE COLLECTION AGENCY WILL PLACE THE ACCOUNT ON "HOLD" FOR 60 DAYS UNTIL THE FINANCIAL ASSISTANCE APPLICATION IS COMPLETE. 4) WHEN THE DEBTOR HAS COMPLETED THE APPLICATION FOR FINANCIAL ASSISTANCE AND BEEN APPROVED, THE AGENCY WILL RECEIVE IMMEDIATE NOTIFICATION FROM THE PATIENT FINANCIAL SERVICES DEPARTMENT. NOTIFICATION WILL INCLUDE THE AMOUNT OF DEBT REDUCTION THE DEBTOR QUALIFIED FOR. THE PATIENT FINANCIAL SERVICE LEADER WILL APPROVE THE ADJUSTMENT AND THE DEBTOR'S BALANCE WILL BE ADJUSTED ON ADVENTIST HEALTHCARE'S BOOKS. PART VI, LINE 2: FORT WASHINGTON MEDICAL CENTER (FWMC) PARTICIPATED AS A MEMBER OF A "CORE TEAM" COMPRISED OF 5 HOSPITALS IN PRINCE GEORGE'S COUNTY AND THE PRINCE GEORGE'S COUNTY HEALTH DEPARTMENT, TO CONDUCT A COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) IN 2019. AS REQUIRED TO IDENTIFY THE NEEDS OF THOSE LIVING IN ITS PRIMARY AND SECONDARY SERVICE AREAS IN PRINCE GEORGE'S COUNTY, CHARLES COUNTY, AND WASHINGTON, D.C. THIS COMMUNITY HEALTH NEEDS ASSESSMENT WAS CONDUCTED TO IDENTIFY HEALTH NEEDS AND DEVELOP STRATEGIES TO IMPROVE HEALTH CONDITIONS IN THE SURROUNDING COMMUNITIES SERVICED BY THE HOSPITAL. IN ADDITION, WE ARE ACTIVELY INVOLVED WITH THE PRINCE GEORGE'S COUNTY HEALTHCARE ACTION COALITION (PGHAC) DEVELOPED BY THE MARYLAND DEPARTMENT OF HEALTH AND MENTAL HYGIENE TO ASSIST IN MAKING MARYLAND HEALTHIER. PGHAC'S MISSION IS TO IMPROVE THE HEALTH OF THE RESIDENTS OF PRINCE GEORGE'S COUNTY BY INCREASING ACCESS TO CARE, PROMOTING COLLABORATION AMONG HEALTH CARE PROVIDERS AND KEY STAKEHOLDERS, AND INTEGRATING AND COORDINATING PATIENT CARE TO REDUCE DUPLICATION OF AND ENHANCE SEAMLESS HEALTH SERVICE DELIVERY. FWMC IS INVOLVED WITH THE "ACCESS TO CARE" WORK GROUP WITH A FOCUS ON ENSURING RESIDENTS RECEIVE NEEDED HEALTH CARE, PARTICULARLY LOW INCOME, UNINSURED/UNDERINSURED ADULTS AND CHILDREN. THE ORGANIZATION HAS BEEN INVOLVED FROM THE BEGINNING OF THE INITIATIVE WORKING WITH PUBLIC HEALTH EXPERTS, AGENCIES, HOSPITAL PERSONNEL AND COMMUNITY ORGANIZATIONS TO LAY A FOUNDATION FOR ADDRESSING THIS ISSUE AND ESTABLISHING WAYS TO PROMOTE AND COMMUNICATE THE INITIATIVE AND MONITORAND MEASURE ITS OVERALL EFFECTIVENESS. PART VI, LINE 3: PATIENT EDUCATION OF ELIGIBILITY:ADVENTIST HEALTHCARE EDUCATES OUR PATIENTS AND COMMUNITY RESIDENTS ABOUT CHARITY CARE AND FINANCIAL ASSISTANCE IN MANY WAYS. THEY INCLUDE, BUT ARE NOT LIMITED TO, THE FOLLOWING: (1) ADVENTIST HEALTHCARE HAS FINANCIAL ASSISTANCE SIGNAGE IN ALL ITS FACILITIES, ON ALL PATIENT STATEMENTS AND ON OUR HOSPITALS' WEBSITES; (2) DURING PRE-REGISTRATION AND REGISTRATION, PATIENTS WHO ARE REGISTERED AS SELF-PAY, OR EXPRESS A FINANCIAL HARDSHIP, ARE INFORMED ABOUT THE HOSPITAL'S CHARITY CARE POLICY AND MAILED OR GIVEN A CHARITY APPLICATION. ADDITIONALLY, AN ADVENTIST HEALTHCARE PATIENT FINANCIAL ADVISOR WILL VISIT ADMITTED PATIENTS TO REVIEW FINANCIAL OPTIONS, INCLUDING AHC'S FINANCIAL ASSISTANCE PROGRAM; (3) WHEN GOING THROUGH THE MEDICAID ELIGIBILITY SCREENING, SELF-PAY PATIENTS ARE GIVEN A CHARITY APPLICATION DURING THAT PROCESS JUST IN CASE THE PATIENT DOES NOT QUALIFY FOR MEDICAID; (4) WHEN PATIENTS WITH A BALANCE RECEIVES A STATEMENT, THE PATIENT STATEMENT INCLUDES NOTIFICATION OF THE AVAILABILITY OF FINANCIAL ASSISTANCE AND THE CONTACT INFORMATION TO SPEAK WITH A REPRESENTATIVE OR OBTAIN A FINANCIAL ASSISTANCE PACKAGE; (5) WHEN PATIENTS WITH A BALANCE CONTACT THE COLLECTION DEPARTMENT AND EXPRESS FINANCIAL HARDSHIP, CUSTOMER SERVICE REPS AND SELF-PAY COLLECTORS WILL NOTIFY THE PATIENT OF THE AVAILABILITY OF ADVENTIST HEALTHCARE'S FINANCIAL ASSISTANCE AND MAIL A CHARITY APPLICATION TO THE PATIENT AND (6) RESIDENTS WHO PARTICIPATE IN OUR COMMUNITY PROGRAMS, SUCH AS BREAST CANCER, MATERNITY, ETC., ARE INFORMED OF ADVENTIST HEALTHCARE'S CHARITY PROGRAM PRIOR TO RECEIVING SERVICES. PART VI, LINE 4: FORT WASHINGTON, OXON HILL AND TEMPLE HILLS COMPRISE FORT WASHINGTON MEDICAL CENTER'S COMMUNITY-BASED SERVICE AREA (CBSA) AND ARE LOCATED IN PRINCE GEORGE'S COUNTY. THE SUBURBAN CITIES ARE WITHIN A SHORTDISTANCE FROM THE WASHINGTON, D.C/MARYLAND LINE. FORT WASHINGTON ENCOMPASSES A 14-SQUARE MILE RADIUS. ACCORDING TO CLARITAS.COM, IT HAS A POPULATION OF 54,890 PEOPLE. THE RACIAL DYNAMIC OF FORT WASHINGTON IS PRIMARILY AFRICAN AMERICAN WITH 73.6% RESIDENTS; 10.49% WHITE RESIDENTS; 6.4% ASIAN, AND THE REMAINDER OF OTHER RACES ARE, NATIVE HAWAIIAN, AMERICAN INDIAN, AND PACIFIC ISLANDER. THE MEDIAN FORT WASHINGTON HOUSEHOLD INCOME IS $59,291 AND THE MEDIAN AGE OF THE FORT WASHINGTON RESIDENT IS 44 YEARS. SURROUNDING PORTIONS OF FORT WASHINGTON IS 9-SQUARE MILES OF LAND IN OXON HILL, MARYLAND. IT EXTENDS ALONG THE 210 NORTH CORRIDORS AND ALONG SOUTHERN AVENUE, WHICH SEPARATES IT FROM WASHINGTON, D.C. ACCORDING TO THE CLARITAS.COM, ITS POPULATION IS 30,187 RESIDENTS. THE RACIAL MAKE-UP OF OXON HILL IS 74.95% AFRICAN AMERICANS; 9.56% WHITE RESIDENTS AND 5.10% ASIAN RESIDENTS. THE MEDIAN OXON HILL HOUSEHOLD INCOME IS $86,714 AND THE AVERAGE AGE OF THE OXON HILL RESIDENT IS 38 YEARS. ANOTHER COMPONENT OF THE FWMC SERVICE AREA IS TEMPLE HILLS, WHICH IS 1.4 SQUARE MILES, AND IS WEST OF OXON HILL AND SOUTHEAST OF WASHINGTON, D.C. TEMPLE HILLS HAS A POPULATION OF 37,588 PEOPLE, AFRICAN AMERICAN COMPRISE THE MAJORITY OF THE POPULATION WITH 85.36% RESIDENTS, 6.48% WHITE RESIDENTS AND 6.80% HISPANIC RESIDENTS. THERE IS A SMALL POPULATION OF NATIVE HAWAIIAN, ASIANS, AMERICAN INDIAN AND PACIFIC ISLANDERS. NEARLY 16.8% OF THE POPULATION IS CONSIDERED BELOW THE POVERTY LINE. THE MEDIAN TEMPLE HILLS HOUSEHOLD INCOME IS $60,920 AND THE AVERAGE AGE OF THE TEMPLE HILLS RESIDENT IS 31 YEARS. PART VI, LINE 6: AFFILIATED HEALTH CARE:ADVENTIST HEALTHCARE, BASED IN GAITHERSBURG, MD., IS A FAITH-BASED, NOT-FOR-PROFIT ORGANIZATION OF DEDICATED PROFESSIONALS WHO WORK TOGETHER EACH DAY TO PROVIDE EXCELLENT WELLNESS, DISEASE MANAGEMENT AND HEALTH-CARE SERVICES TO THE COMMUNITY. WE WERE FOUNDED UPON THE PRINCIPLE OF WELLNESS MORE THAN 100 YEARS AGO AND TODAY PROVIDE INNOVATIVE CARE TO HEART-ATTACK VICTIMS, CANCER PATIENTS, PREMATURE BABIES AND THE COMMUNITY AS A WHOLE. OUR UNWAVERING FOCUS HAS ALWAYS BEEN ON THE HEALTH AND WELLNESS OF THE COMMUNITIES WE SERVE. WE ARE ALREADY A STEP AHEAD AS HEALTH CARE REFORM IS CHALLENGING HOSPITAL SYSTEMS NATIONWIDE TO IMPROVE THE HEALTH OF POPULATIONS; OUR INTEGRATED, HEALTH-CARE DELIVERY NETWORK INCLUDES FOUR NATIONALLY ACCREDITED, ACUTE-CARE AND SPECIALTY HOSPITALS, MENTAL HEALTH SERVICES, HOME HEALTH AGENCIES AND URGENT CARE CENTERS, SERVING THE WASHINGTON, D.C. METROPOLITAN AREA.ADVENTIST HEALTHCARE INCLUDES: ADVENTIST HEALTHCARE SHADY GROVE MEDICAL CENTER, ADVENTIST HEALTHCARE WHITE OAK MEDICAL CENTER, ADVENTIST HEALTHCARE FORT WASHINGTON MEDICAL CENTER, ADVENTIST HEALTHCARE REHABILITATION, ADVENTIST HEALTHCARE HOME CARE SERVICES, THE REGINALD S. LOURIE CENTER FOR CHILDREN'S SOCIAL & EMOTIONAL WELLNESS, ADVENTIST HEALTHCARE URGENT CARE CENTERS, AND OTHER HEALTH SERVICES. TOGETHER, WITH OUR CENTER FOR HEALTH EQUITY AND WELLNESS, AND MORE THAN 2,000 AFFILIATED PRIMARY AND SPECIALTY CARE PHYSICIANS, ADVENTIST HEALTHCARE ENCOMPASSES MANY OF THE NECESSARY CARE DELIVERY COMPONENTS NEEDED TO DELIVER POPULATION-BASED CARE ACROSS THE CONTINUUM.OUR COMMITMENT TO THE COMMUNITY EXTENDS BEYOND OUR WALLS TO ENCOMPASS THE MOST VULNERABLE AND UNDERSERVED. IN 2019, THERE WERE APPROXIMATELY 766,906 OVERALL ENCOUNTERS ACROSS ALL OF OUR FACILITIES AND PROGRAMS. WE ALSO PROVIDED SIGNIFICANT CHARITY CARE AND COMMUNITY BENEFIT OF MORE THAN $79.9 MILLION. AS ONE OF THE LARGEST EMPLOYERS IN THE STATE OF MARYLAND, WE ARE GRATEFUL TO HAVE THE DEDICATED COMMITMENT OF 6,555 EMPLOYEES AND NUMEROUS VOLUNTEERS PROVIDING OVER 99,000 HOURS OF TIME, THROUGHOUT ADVENTIST HEALTHCARE WHO PROVIDE COMPASSIONATE, HIGH-QUALITY CARE EACH AND EVERY DAY.IN ADDITION TO PROVIDING CHARITY CARE AT OUR FACILITIES, ADVENTIST HEALTHCARE IS INVOLVED IN NUMEROUS OUTREACH INITIATIVES DESIGNED TO IMPROVE ACCESS TO HEALTH CARE FOR LOW-INCOME AND UNINSURED INDIVIDUALS, AS WELL AS HISTORICALLY UNDER-SERVED COMMUNITIES INCLUDING MINORITIES AND IMMIGRANTS. OUR GOAL IS EFFECTIVE PREVENTION, TREATMENT AND CARE PROGRAMS FOR ALL INDIVIDUALS, REGARDLESS OF THEIR ECONOMIC, CULTURAL, LINGUISTIC OR DEMOGRAPHIC CHARACTERISTICS.VISIT WWW.ADVENTISTHEALTHCARE.COM TO LEARN EVEN MORE ABOUT OUR SERVICES AND OUR LONGSTANDING BELIEF THAT A HEALTHY LIFESTYLE IS THE BEST WAY TO PREVENT DISEASE, AND THAT PREVENTION IS MUCH BETTER THAN A CURE. PART VI, LINE 7, REPORTS FILED WITH STATES MD 0 1 0 0 0 0 0 1 0 TERRY FORDE CHAIR; PRESIDENT & CEO,AHC 0 913484 0 334272 0 941732 0 207889 0 35356 0 2432733 0 0 JOHN SACKETT VICE CHAIR; EVP/COO,AHC; PRES.,SGMC 0 580510 0 171882 0 231939 0 25000 0 44288 0 1053619 0 0 JAMES G LEE EVP & CFO, AHC 0 509963 0 160415 0 102271 0 138955 0 27089 0 938693 0 0 EUNMEE SHIM SECY.; PRES.,FWMC; SVP,AMB NETWK,AHC 0 374302 0 173145 0 84286 0 85580 0 25254 0 742567 0 0 PART I, LINE 3 PAY PRACTICE: ADVENTIST HEALTHCARE UTILIZES A SINGLE EMPLOYER ID FOR ALL ITS AFFILIATED ENTITIES FOR EMPLOYMENT PURPOSES. AS SUCH, ACTUAL COMPENSATION AND BENEFITS ARE CHARGED TO THE RESPECTIVE ENTITIES AND THE RESULTING COMPENSATION AND BENEFITS ARE REPORTED ON EACH AFFILIATE IRS FORM 990 AS IF PAID DIRECTLY BY SUCH AFFILIATE. AS APPLICABLE, THE SAME AND NON-ADDITIVE COMPENSATION AND EMPLOYMENT BENEFIT PLAN CONTRIBUTION AMOUNTS WERE ALSO DISCLOSED IN THE ADVENTIST HEALTHCARE INC. RELATED ENTITIES RETURNS. INDEPENDENT GUIDELINES: WHEN SETTING COMPENSATION FOR THE OFFICERS, DIRECTORS, TRUSTEES, KEY EMPLOYEES, AND THE HIGHEST COMPENSATED EMPLOYEES, ADVENTIST HEALTHCARE FULLY COMPLIES WITH THE PROCEDURAL SAFEGUARDS EMBODIED IN IRS REGULATIONS. COMPENSATION FOR ADVENTIST HEALTHCARE OFFICERS, DIRECTORS, TRUSTEES, KEY EMPLOYEES, AND THE HIGHEST COMPENSATED EMPLOYEES IS ENTIRELY SET BY A COMMITTEE OF ADVENTIST HEALTHCARE BOARD OF TRUSTEES. IN SETTING COMPENSATION, THE GOVERNING BOARD COMMITTEE RELIES UPON MARKET COMPARABILITY DATA PROVIDED BY AN INDEPENDENT OUTSIDE COMPENSATION CONSULTANT WHO PROVIDES A SUMMARY OF HEALTH CARE SALARIES AND BENEFITS FOR COMPARABLE SIZED ORGANIZATIONS BOTH NATIONALLY AND IN THE BALTIMORE-WASHINGTON REGION. TO FURTHER ENSURE REASONABLENESS, BOTH COMPENSATION AND BENEFITS ARE TARGETED AT THE 50TH PERCENTILE (OR MEDIAN) OF THE MARKET. PART I, LINE 4B CERTAIN EMPLOYEES RECEIVED COMPENSATION FROM A DISTRIBUTION UNDER AN EXECUTIVE RETENTION 457F PLAN, WHICH BECAME EFFECTIVE ON JANUARY 1, 2015. PRE-TAX CONTRIBUTIONS ARE ACCUMULATED ANNUALLY AND ARE DISTRIBUTED ON JANUARY 1ST OF THE 2ND YEAR, IF STILL EMPLOYED OR SOONER BASED ON CERTAIN EXCEPTIONS. THERE IS TYPICALLY A 2-YEAR DEFERRAL PERIOD BEFORE PAYMENTS ARE RELEASED. CONTRIBUTIONS ACCUMULATED IN 2017 WERE GENERALLY DISTRIBUTED ON JANUARY 1, 2019 AND CONTRIBUTIONS ACCUMULATED IN 2018 WILL GENERALLY BE DISTRIBUTED ON JANUARY 1, 2020. AMOUNTS LISTED UNDER PART II, COLUMN F INCLUDE PAYOUT AMOUNTS WHICH WERE CONSIDERED DEFERRED COMPENSATION FROM THE 457F PLAN IN OUR PRIOR YEAR RETURNS AND THESE AMOUNTS ARE NOW BEING SHOWN UNDER THE OTHER REPORTABLE INCOME, COLUMN B (III). THE FOLLOWING EMPLOYEE RECEIVED AN EARLY LUMP-SUM CASH PAYMENT ON THEIR 457F PLAN DUE TO HAVING REACHED NORMAL RETIREMENT AGE. JOHN SACKETT: $103,703 - EARLY LUMP-SUM. PART I, LINE 7 THE ANNUAL INCENTIVE COMPENSATION INCLUDES PAYMENTS BASED ON SATISFACTION OF PRE-DETERMINED PERFORMANCE TARGETS SUCH AS QUALITY/PATIENT SAFETY GOALS, EMPLOYEE AND PATIENT ENGAGEMENT GOALS, ORGANIZATIONAL GROWTH, AND FINANCIAL PERFORMANCE, AMONG OTHER THINGS. THE ANNUAL INCENTIVE COMPENSATION APPLIES TO DIRECTORS AND ABOVE. SUPPLEMENTAL INFORMATION: OTHER REPORTABLE COMPENSATION INCLUDES DISTRIBUTION UNDER AN EXECUTIVE RETENTION 457F PLAN, WHICH BECAME EFFECTIVE ON JANUARY 1, 2015. PRE-TAX CONTRIBUTIONS ARE ACCUMULATED ANNUALLY AND ARE DISTRIBUTED ON JANUARY 1ST OF THE 2ND YEAR, IF STILL EMPLOYED OR SOONER BASED ON CERTAIN EXCEPTIONS. THERE IS TYPICALLY A 2-YEAR DEFERRAL PERIOD BEFORE PAYMENTS ARE RELEASED. CONTRIBUTIONS ACCUMULATED IN 2017 WERE GENERALLY DISTRIBUTED ON JANUARY 1, 2019 AND CONTRIBUTIONS ACCUMULATED IN 2018 WILL GENERALLY BE DISTRIBUTED ON JANUARY 1, 2020. IN ADDITION, OTHER REPORTABLE COMPENSATION INCLUDES RETENTION PAYMENTS AND LUMP-SUM ADJUSTMENTS IN LIEU OF THE ACROSS-THE-BOARD INCREASE (FOR EMPLOYEES WHO ARE AT OR REACH THE RANGE MAXIMUM FOR THEIR POSITION). OTHER REPORTABLE COMPENSATION ALSO INCLUDES LONG-TERM DISABILITY COVERAGE, CELL PHONE ALLOWANCES, CASH-OUT OF UNUSED PAID TIME OFF (PTO) HOURS (ONLY FOR EMPLOYEES WHO LEAVE OUR ORGANIZATION), IMPUTED VALUE OF LIFE INSURANCE BENEFITS, AND SEVERANCE, AS APPLICABLE. CERTAIN EXECUTIVES CAN ALSO RECEIVE REPORTABLE COMPENSATION THROUGH A SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (SERP), ONCE THEY HAVE VESTED IN THE PLAN. NON-TAXABLE BENEFITS INCLUDES PRE-TAX PAYROLL DEDUCTIONS (SUCH AS FLEXIBLE MEDICAL SPENDING, DEPENDENT CARE, AND EMPLOYEE HEALTH BENEFIT PREMIUMS), AND THE EMPLOYER PORTION OF CERTAIN EMPLOYEE BENEFITS SUCH AS HEALTH INSURANCE, DENTAL INSURANCE, VISION INSURANCE, AND LIFE INSURANCE, ETC. PART V, LINE 1A, 2A, AND 2B GENERAL EXPLANATION: EMPLOYEES OF ANY OF THE ADVENTIST HEALTHCARE INC. AND AFFILIATED TAX EXEMPT ENTITIES IN THE STATE OF MARYLAND (INCLUDING ADVENTIST HEALTHCARE FORT WASHINGTON MEDICAL CENTER INC.) ARE PAID THROUGH A COMMON PAYMASTER, ADVENTIST HEALTHCARE, INC. AND ARE REPORTED ON ITS FORM 941. SALARY AND BENEFIT EXPENSES REPORTED ON THEIR RESPECTIVE RETURNS ARE ACTUAL CHARGES RELATED TO THE EMPLOYEES WORKING ON THE SPECIFIC TAX EXEMPT ENTITY. VENDOR PAYMENTS FOR ANY OF THE ADVENTIST HEALTHCARE, INC. AND RELATED ENTITIES IN THE STATE OF MARYLAND ARE MADE THROUGH A COMMON PAYMASTER, ADVENTIST HEALTHCARE, INC. FORM 990, PART VI, SECTION A, LINE 1 THE GOVERNING BODY HAS DELEGATED BROAD AUTHORITY TO AN EXECUTIVE COMMITTEE DURING SUCH TIMES WHEREBY IT IS IMPRACTICABLE TO CONVENE THE FULL BOARD, AND WHEN IT IS NECESSARY TO CARRY OUT THE GOVERNANCE FUNCTIONS OF THE BOARD. THE EXECUTIVE COMMITTEE SHALL HAVE ALL THE POWERS OF THE BOARD IN THE MANAGEMENT AND DIRECTION OF THE AFFAIRS OF ADVENTIST HEALTHCARE FORT WASHINGTON MEDICAL CENTER INC., PROVIDED SUCH ACTIONS ARE NOT IN CONFLICT WITH GENERAL POLICIES ENACTED BY THE BOARD OF TRUSTEES. THE EXECUTIVE COMMITTEE SHALL BE CHAIRED BY THE CHAIR OF THE BOARD OF TRUSTEES, AND SHALL CONSIST OF THE BOARD OFFICERS, A PHYSICIAN BOARD MEMBER, THE CHAIR OF THE FINANCE COMMITTEE, AND ANOTHER BOARD MEMBER DESIGNATED BY THE CHAIR OF THE BOARD OF TRUSTEES. EXCEPT FOR EX-OFFICIO MEMBERS, ALL COMMITTEE MEMBERS SHALL BE APPOINTED BY THE CHAIR OF THE BOARD OF TRUSTEES AND SERVE FOR A TERM OF ONE YEAR AND/OR UNTIL THEIR SUCCESSORS ARE APPOINTED AND QUALIFIED. FORM 990, PART VI, SECTION A, LINE 6 ADVENTIST HEALTHCARE, INC. IS THE SOLE MEMBER OF ADVENTIST HEALTHCARE FORT WASHINGTON MEDICAL CENTER INC. FORM 990, PART VI, SECTION A, LINE 7A ADVENTIST HEALTHCARE, INC. CAN ELECT MEMBERS OF THE BOARD. FORM 990, PART VI, SECTION A, LINE 7B DECISIONS SUBJECT TO APPROVAL. SEE BY LAWS, ARTICLE II, SECTION 2: RESERVED AUTHORITY AND RESPONSIBILITY. THE FOLLOWING ACTIONS SHALL BE RESERVED TO THE MEMBER: A. THE ADOPTION, ALTERING, AMENDING OR REPLACING OF THE ARTICLES OF INCORPORATION OR THE BYLAWS OF THE CORPORATION; B. THE LIQUIDATION, DISSOLUTION, WINDING UP, OR ABANDONMENT OF THE CORPORATION; C. APPOINTMENT OF MEMBERS OF THE BOARD OF DIRECTORS FROM NOMINEES SUBMITTED BY THE NOMINATING COMMITTEE (AS DEFINED HEREUNDER); D. REMOVAL OF MEMBERS OF THE BOARD OF DIRECTORS; E. APPOINTMENT AND REMOVAL OF THE PRESIDENT OF THE CORPORATION, IN CONSULTATION WITH THE BOARD OF DIRECTORS; F. THE PURCHASE, SALE OR DISPOSITION OF REAL PROPERTY OF THE CORPORATION; G. AUTHORIZATION AND APPROVAL OF THE ISSUANCE OF DEBT AND THE USE OF PROCEEDS OF SUCH DEBT FOR AND ON BEHALF OF THE CORPORATION; H. DEVELOPMENT OF CAPITAL INVESTMENT, CAPITAL ALLOCATION AND BORROWING POLICIES FOR THE CORPORATION; I. CEASING THE PROVISION OF HEALTH CARE SERVICES NECESSARY FOR OPERATION AS A LICENSED GENERAL ACUTE CARE FACILITY AT ANY SITE; J. ADOPTING THE HOSPITAL CORPORATION'S ANNUAL AND LONG-TERM CAPITAL AND OPERATION BUDGETS; K. MAKING ANY CHANGES IN ANY OF THE CORPORATION'S INSURANCE PROGRAM; AND L. RECOMMENDING ANY UNBUDGETED CAPITAL EXPENDITURE OF THE HOSPITAL CORPORATION'S CAPITAL BUDGET IN EXCESS OF $50,000. ALL MEMBERS HAVE RIGHTS TO VOTE. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 WAS REVIEWED IN DETAIL PRIOR TO FILING. VARIOUS SECTIONS WERE REVIEWED BY THE EXECUTIVE MANAGEMENT TEAM AND CERTAIN KEY SECTIONS BY THE EXECUTIVE COMMITTEE OF THE BOARD OF DIRECTORS. AN OVERALL REVIEW WAS CONDUCTED BY THE ORGANIZATION'S FINANCE DEPARTMENT WITH THE ORGANIZATION'S OUTSIDE TAX ADVISORS. PRIOR TO FILING, ALL MEMBERS OF THE BOARD ARE PROVIDED A COPY OF THIS FORM 990 THROUGH EMAIL, WITH A LINK TO THE COMPANY'S INTRANET WEBSITE. FORM 990, PART VI, SECTION B, LINE 12C PURSUANT TO THE ORGANIZATION'S CONFLICT OF INTEREST POLICY, EACH FACILITY BOARD MEMBER, OFFICER, DIRECTOR AND ANY EMPLOYEE IN A POSITION THAT REQUIRES COORDINATION AND/OR NEGOTIATION WITH CONTRACTORS OR SUPPLIES, IS REQUIRED ON AN ANNUAL BASIS TO DISCLOSE ANY BUSINESS OR FINANCIAL RELATIONSHIP OUTSIDE OF THE ORGANIZATION. AN ACTUAL OR POTENTIAL CONFLICT OF INTEREST, OR THE PERCEPTION OR APPEARANCE OF A CONFLICT OF INTEREST, OCCURS WHEN A COVERED PERSON IS IN A POSITION TO INFLUENCE A DECISION THAT MAY RESULT IN A PERSONAL GAIN FOR THAT EMPLOYEE, A RELATIVE, OR OTHER PERSON LIVING IN THE SAME HOUSEHOLD, AS A RESULT OF ADVENTIST HEALTHCARE'S BUSINESS ACTIVITIES. A RELATIVE IS DEFINED AS ANY PERSON WHO IS RELATED BY BLOOD OR MARRIAGE, OR WHOSE RELATIONSHIP WITH THE COVERED PERSON IS SIMILAR TO THAT OF PERSONS WHO ARE RELATED BY BLOOD OR MARRIAGE. NO "PRESUMPTION OF GUILT" IS CREATED BY THE MERE EXISTENCE OF A RELATIONSHIP BETWEEN AN ADVENTIST HEALTHCARE EMPLOYEE AND AN OUTSIDE FIRM OR BUSINESS ENDEAVOR, OR OTHER POTENTIAL CONFLICT OF INTEREST. HOWEVER, IF A COVERED PERSON HAS ANY BUSINESS, FINANCIAL, OR OTHER RELATIONSHIP WITH ANY ORGANIZATION WHEREBY THE EXISTENCE OF THAT RELATIONSHIP EITHER CREATES A CONFLICT OF INTEREST OR IS PERCEIVED TO CREATE A CONFLICT OF INTEREST, THE COVERED PERSON MUST DISCLOSE THIS RELATIONSHIP TO THE DESIGNATED SENIOR MANAGER, OR GOVERNING BOARD, AS THE CASE MAY BE, AT THE LOCATION WHERE THE EMPLOYEE IS ASSIGNED. THE SENIOR MANAGER WILL REVIEW THE RELATIONSHIP, MAKE COMMENTS AND RECOMMENDATIONS, AND FORWARD ALL DOCUMENTATION TO THE ORGANIZATIONAL INTEGRITY COMMITTEE FOR A FINAL DECISION. COMPLIANCE WITH THE CONFLICT OF INTEREST POLICY IS MONITORED AND ENFORCED BY THE HUMAN RESOURCES DEPARTMENT, CORPORATE INTEGRITY DEPARTMENT AND THE LEGAL DEPARTMENT. FORM 990, PART VI, SECTION C, LINE 19 THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS, ARE AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART IX, LINE 11G CONTRACT LABOR AND PHYSICIAN PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 621,798. MANAGEMENT AND GENERAL EXPENSES 13,800. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 635,598. CONSULTING AND PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 714,069. MANAGEMENT AND GENERAL EXPENSES 315,797. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,029,866. FORM 990, PART XI, LINE 9: CUMULATIVE EFFECT OF CHANGE IN ACCOUNTING PRINCIPLE 9,891. INTRANSFER OF NET ASSETS THROUGH BUSINESS COMBINATION 7,045,520. 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