2019-10-18T10:19:36-05:00 2018-12-31 Grant Thornton LLP 1000 WILSON BLVD SUITE 1400 ARLINGTON VA 22209 990 2018-01-01 521862406 Health Services for Children with Special Needs Inc % KIM BROWN HEAL 2024541255 1101 Vermont Ave NW Suite 1200 Washington DC 20005 KIM BROWN VP FIN & INTERIM CFO 2024672737 2019-10-15 true Mary Torretta P00847851 7038477500 209.220.136.124 54681420192915000003 2019-10-18 P AA918D8483008E32154F6CC583B06457B9AF9E42 03CBAE45BD8E2F188EB28F31E827C7F4869431D2 2018 2019-02-21 02:37:17Z Victor Fields 2013 H STREET NW STE 300 Washington DC 20006 182319051 false X http://www.hschealth.org/health-plan X 1994 DC TO PROVIDE COORDINATION OF HEALTHCARE, SOCIAL, AND EDUCATIONAL SERVICES TO PERSONS WHO HAVE DISABILITIES AND/OR COMPLEX MEDICAL AND/OR PSYCHOLOGICAL NEEDS. 4 3 243 9 0 100056 5000 105 183616892 182035004 1223 282261 2683 1681 183625798 182319051 5500 1000 0 0 16753239 13862990 0 0 0 170816351 167096536 187575090 180960526 -3949292 1358525 52584325 59462380 43608670 42128200 8975655 17334180 X TO PROVIDE COORDINATION OF HEALTHCARE, SOCIAL, AND EDUCATIONAL SERVICES FOR INFANTS, CHILDREN, ADOLESCENTS, AND YOUNG ADULTS WHO HAVE DISABILITIES AND/OR COMPLEX MEDICAL AND/OR PSYCHOLOGICAL NEEDS. false false 157440861 1000 182035004 SEE SCHEDULE O. 157440861 true false false false false false false false false false true false false true true true true true false false false false false false false false false false false true false false false false false false false false false false false false false true false false false true 419 0 true 243 true true true false false false false false false false false false false false X 4 3 false false false false true true true true true false false true true true true true true false false false X KIM BROWN 2026524224 2013 H STREET NW SUITE 300 Washington DC 20006 X Nathaniel Beers Pres & CEO, Board Member 10.0 30.0 X X 0 496659 33190 Anna Pilskaya Dunn Chairperson 1.0 1.0 X X 0 0 0 Maria Ivonne Rivera Secretary/Treasurer 1.0 1.0 X X 0 0 0 William Clyburn Commissioner 1.0 0.0 X X 0 0 0 Raymond Vicks Jr Board Member, to 4/30/18 1.0 1.0 X 0 0 0 Megan Mariotti Board Member, to 4/30/18 1.0 0.0 X 0 0 0 Victor Fields CEO, HSCSN & EVP, Managed Care 10.0 30.0 X 0 314792 33307 Kimberly Brown VP Finance & Interim CFO 15.0 25.0 X 0 201800 18637 Bradley Weaver EVP, Managed Care, to 9/20/18 40.0 0.0 X 0 338335 24443 Lynne Hostetter Piper Chief HR/Comp. Off. to 7/13/18 8.0 32.0 X 0 297843 21035 Giselle Jones Senior VP, Human Resources 15.0 25.0 X 0 204107 8157 Josephine Bias Robinson EVP, External Affairs 10.0 30.0 X 0 299981 29850 Eric Levey Chief Medical Officer 40.0 0.0 X 261995 0 5520 Salman Shamsi VP Svc Ops & Admin to 11/9/18 40.0 0.0 X 236352 0 0 Thomas W Chapman Board Member, to 4/30/17 0.0 0.0 X 0 2577008 17110 498347 4730525 191249 16 true true false Wendigo Advisors 2817 Promontory Loop BROOMFIELD CO 80023 Claims processing 854831 Carpedia International Corp 230 Park Avenue 10th Floor NEW YORK NY 10169 Performance consult 582947 EMD CONSULTING GROUP 11111 CONWAY ROAD SAINT LOUIS MO 63131 Contract consulting 231437 Medi Concepts LLC 14918 Habersham Circle SILVER SPRING MD 20906 Claims review 184937 Change Healthcare LLC 3055 Lebanon Pike Suite 1000 MURRAY UT 84157 Claims processing 149415 8 105 105 MANAGED CARE REVENUE 621400 182035004 182035004 0 0 182035004 282261 282261 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 OTHER INCOME 900099 1681 0 1681 1681 182319051 182035004 0 283942 1000 1000 0 0 0 0 0 11489011 8477343 3011668 344760 344760 1131413 4000 1127413 897806 597247 300559 0 398165 39741 358424 0 0 0 4292 4292 3436147 610082 2826065 0 1708 1708 438309 57338 380971 52016 52016 0 1716048 1716048 279678 78558 201120 0 66456 57359 9097 0 0 1019773 1019773 175703 175703 HEALTHCARE SERVICE COST 147347429 147347429 0 0 SHARED SERVICES ALLOCATION 8107210 0 8107210 0 PREMIUM TAXES 3517344 0 3517344 0 FOOD 85855 15889 69966 0 450403 154875 295528 180960526 157440861 23519665 0 3000000 3009990 151493 153902 0 0 1383575 502076 0 0 0 0 0 0 0 0 197794 60630 8004016 6777130 2204181 1226886 18300000 18575601 0 0 0 0 0 0 27347282 35933295 52584325 59462380 36097264 35589402 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7511406 6538798 43608670 42128200 X 8975655 17334180 0 0 0 0 8975655 17334180 52584325 59462380 X 1358525 7000000 X false true X true false X 29550 56478 17320 5000 105 108453 154769081 164243362 179163090 183616892 182035004 863827429 0 0 0 154798631 164299840 179180410 183621892 182035109 863935882 0 0 0 863935882 271 764 1249 1223 282261 285768 0 271 764 1249 1223 282261 285768 0 283741 204700 0 2683 1681 492805 155082643 164505304 179181659 183625798 182319051 864714455 0.99910 0.99937 0.00033 0.00001 X 60628 58517 2111 7911110 6718613 1192497 32278 32278 1226886 DUE FROM AFFILIATES 30351618 DUE FROM THIRD PARTIES 5412012 DEPOSITS 169665 35933295 0 DUE TO AFFILIATES 42743 DUE TO THIRD PARTIES 6264204 SELF INSURANCE PROFESSIONAL LIAB 231851 6538798 X 182314759 182314759 4292 4292 182319051 180956234 180956234 4292 4292 180960526 LIABILITY FOR UNCERTAIN TAX POSITION (ASC 740) SCHEDULE D, PART X, LINE 2 HEALTH SERVICES FOR CHILDREN WITH SPECIAL NEEDS ("HSCSN") HAS BEEN RECOGNIZED AS A PUBLIC CHARITY GENERALLY EXEMPT FROM FEDERAL INCOME TAXATION UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE (THE "CODE"). HSCSN IS SUBJECT TO TAX ON INCOME UNRELATED TO ITS EXEMPT PURPOSE, UNLESS THAT INCOME IS OTHERWISE EXCLUDED BY THE CODE. HSCSN HAS PROCESSES PRESENTLY IN PLACE TO ENSURE THE MAINTENANCE OF ITS TAX-EXEMPT STATUS; TO IDENTIFY AND REPORT UNRELATED INCOME; TO DETERMINE ITS FILING AND TAX OBLIGATIONS IN JURISDICTIONS FOR WHICH IT HAS NEXUS; AND TO IDENTIFY AND EVALUATE OTHER MATTERS THAT MAY BE CONSIDERED TAX POSITIONS. HSCSN FOLLOWS GUIDANCE THAT CLARIFIES THE ACCOUNTING FOR UNCERTAINTY IN TAX POSITIONS TAKEN OR EXPECTED TO BE TAKEN IN A TAX RETURN, INCLUDING ISSUES RELATING TO FINANCIAL STATEMENT RECOGNITION AND MEASUREMENT. THIS GUIDANCE PROVIDES THAT THE TAX EFFECTS FROM AN UNCERTAIN TAX POSITION CAN ONLY BE RECOGNIZED IN THE FINANCIAL STATEMENTS IF THE POSITION IS "MORE-LIKELY-THAN-NOT" TO BE SUSTAINED IF THE POSITION WERE TO BE CHALLENGED BY A TAXING AUTHORITY. THE ASSESSMENT OF THE TAX POSITION IS BASED SOLELY ON THE TECHNICAL MERITS OF THE POSITION, WITHOUT REGARD TO THE LIKELIHOOD THAT THE TAX POSITION MAY BE CHALLENGED. THE TAX YEARS ENDING DECEMBER 31, 2018, 2017, 2016 AND 2015 ARE STILL OPEN TO AUDIT FOR BOTH FEDERAL AND STATE PURPOSES. HSCSN HAS DETERMINED THAT THERE ARE NO MATERIAL UNCERTAIN TAX POSITIONS THAT REQUIRE RECOGNITION OR DISCLOSURE IN THE FINANCIAL STATEMENTS. true true false false false false false false false Nathaniel Beers Pres & CEO, Board Member 0 496659 0 0 0 0 0 30450 0 2740 0 529849 0 0 Victor Fields CEO, HSCSN & EVP, Managed Care 0 314792 0 0 0 0 0 21500 0 11807 0 348099 0 0 Bradley Weaver EVP, Managed Care, to 9/20/18 0 169027 0 0 0 169308 0 18072 0 6371 0 362778 0 0 Lynne Hostetter Piper Chief HR/Comp. Off. to 7/13/18 0 158034 0 0 0 139809 0 17621 0 3414 0 318878 0 0 Giselle Jones Senior VP, Human Resources 0 204107 0 0 0 0 0 5507 0 2650 0 212264 0 0 Kimberly Brown VP Finance & Interim CFO 0 201800 0 0 0 0 0 10353 0 8284 0 220437 0 0 Josephine Bias Robinson EVP, External Affairs 0 299981 0 0 0 0 0 29850 0 0 0 329831 0 0 Eric Levey Chief Medical Officer 261995 0 0 0 0 0 2870 0 2650 0 267515 0 0 0 Thomas W Chapman Board Member, to 4/30/17 0 0 0 0 0 2577008 0 13696 0 3414 0 2594118 0 0 Salman Shamsi VP Svc Ops & Admin to 11/9/18 236352 0 0 0 0 0 0 0 0 0 236352 0 0 0 ARRANGEMENT USED TO ESTABLISH THE TOP MANAGEMENT OFFICIAL'S COMPENSATION SCHEDULE J, PART 1, LINE 3 THE ORGANIZATION RELIED ON A RELATED ORGANIZATION AND THAT RELATED ORGANIZATION USED THE FOLLOWING METHODS TO ESTABLISH THE CEO/PRESIDENT'S COMPENSATION: 1) COMPENSATION COMMITTEE; 2) INDEPENDENT COMPENSATION CONSULTANT; 3) COMPENSATION SURVEY OR STUDY; AND 4) APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE. SEVERANCE OR CHANGE-OF-CONTROL PAYMENT SCHEDULE J, PART I, LINE 4A DURING THE YEAR ENDED DECEMBER 30, 2018, CERTAIN INDIVIDUALS RECEIVED SEVERANCE PAYMENTS. THESE AMOUNTS ARE REPORTED AS TAXABLE COMPENSATION AND REPORTED ON SCHEDULE J, PART II, LINE B (III), OTHER REPORTABLE COMPENSATION. THE INDIVIDUALS AND AMOUNTS ARE LISTED BELOW: BRADLEY WEAVER $155,000 LYNNE HOSTETTER PIPER $113,779 SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN SCHEDULE J, PART I, LINE 4B A RELATED ORGANIZATION MAINTAINS A SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (SERP) AS PART OF THE TOTAL COMPENSATION ARRANGEMENT FOR THE ORGANIZATION'S FORMER CEO, THOMAS CHAPMAN. THE SERP PLAN IS MEANT TO PROVIDE THOMAS CHAPMAN WITH A RETIREMENT BENEFIT FOR OVER 20 YEARS OF SERVICE PROVIDED TO THE RELATED ORGANIZATION. THE RELATED ORGANIZATION'S COMPENSATION COMMITTEE HAS CAREFULLY REVIEWED AND APPROVED THE SERP PLAN FOR THOMAS CHAPMAN AND CONCLUDED THAT THOMAS CHAPMAN'S ENTIRE COMPENSATION PACKAGE, INCLUDING THE BENEFITS PROVIDED BY THE SERP PLAN, IS REASONABLE WHEN COMPARED TO MARKET DATA. In 2018, Mr Chapman received distributions from a Rabbi Trust and SERP which were established long-term incentive plans as an element of his total compensation established by the board. FORM 990, PART III, LINE 4A TO PROVIDE QUALITY REHABILITATIVE AND TRANSITIONAL CARE FOR INFANTS, CHILDREN, ADOLESCENTS, AND YOUNG ADULTS WITH SPECIAL HEALTH CARE NEEDS IN A SUPPORTIVE, CULTURALLY COMPETENT, RESPECTFUL ENVIRONMENT, AND TO PARTICIPATE IN RELATED LOCAL, REGIONAL, AND NATIONAL PROJECTS WITH GOVERNMENT, PRIVATE, AND PHILANTHROPIC ORGANIZATIONS. IN 2018, HSC PROVIDED $147,347,429 OF MEDICAL SERVICES WITH NO COST TO ITS MEMBERS. HSCSN SERVED UP TO 5,307 MEMBERS DURING 2018 THROUGH INTENSE ONE ON ONE CARE MANAGEMENT SERVICES. HSCSN COLLABORATED WITH 1,400 PROVIDERS (SYSTEM AND GROUP LEVEL) IN 2018 TO PROVIDE ITS MEMBERS WITH QUALITY MEDICAL CARE. HSCSN PROVIDED $57 MILLION DOLLARS OF INPATIENT CARE, OVER $7 MILLION DOLLARS OF PRIMARY/SPECIALTY CARE, $16 MILLION DOLLARS OF OUTPATIENT CARE (INCLUDING EMERGENCY ROOM), AND $31 MILLION DOLLARS OF HOME HEALTH CARE. HSCSN MEMBERS UTILIZED 5,739 EMERGENCY DEPARTMENT VISITS AND A TOTAL OF 952 HOSPITAL ADMISSIONS. HSCSN COVERED APPROXIMATELY 70,000 PRESCRIPTIONS, WHICH TOTALED OVER $19 MILLION DOLLARS. OF THE 70,000 PRESCRIPTIONS FILLED IN 2018, 700 OR 1% WERE FOR SPECIALTY MEDICATIONS WHICH ARE REQUIRED FOR COMPLEX MEDICAL CONDITIONS - TOTALING OVER $10.5 MILLION DOLLARS. OTHER SERVICES COORDINATED INCLUDE: TRANSPORTATION TO MEDICAL APPOINTMENTS, DENTAL CARE, LAB/RADIOLOGY SERVICES, DAY TREATMENT, MEDICAL DRUGS AND MEDICAL EQUIPMENT AND SUPPLIES. DELEGATE BOARD AUTHORITY TO A COMMITTEE FORM 990, PART VI, LINE 1A THE EXECUTIVE COMMITTEE OF THE HSC FOUNDATION, THE SOLE CORPORATE MEMBER OF THE ORGANIZATION, HAS THE POWER TO EXERCISE EACH AND ALL OF THE POWERS OF THE BOARD OF DIRECTORS IN THE SAME MANNER AND TO THE SAME EXTENT AS IF THE COMMITTEE WERE IN FACT THE BOARD OF DIRECTORS, PROVIDED THAT ANY ACTION TAKEN SHALL NOT CONFLICT WITH PREVIOUSLY ESTABLISHED POLICIES OR DIRECTIVES OF THE BOARD. HOWEVER, NOTHING CONTAINED IN THESE BYLAWS SHALL CONSTITUTE A DELEGATION TO THE EXECUTIVE COMMITTEE OF THE FOLLOWING POWERS OF THE BOARD OF DIRECTORS: TO INCREASE OR DECREASE THE NUMBER OF DIRECTORS; TO FILL VACANCIES ON OR REMOVE DIRECTORS FROM THE BOARD; TO ELECT OFFICERS; TO FILL OFFICERS VACANCIES; TO REMOVE OFFICERS; TO SELL, ENCUMBER OR OTHERWISE DISPOSE OF ALL OR ANY MATERIAL PART OF THE ASSETS OF THE CORPORATION; TO MERGE OR CONSOLIDATE THE CORPORATION WITH ANOTHER ENTITY; OR TO AMEND THESE BYLAWS. ALL EXECUTIVE COMMITTEE MINUTES WILL BE PROVIDED TO ALL MEMBERS OF THE BOARD OF DIRECTORS PRIOR TO THE NEXT MEETING OF THE BOARD OF DIRECTORS. THE EXECUTIVE COMMITTEE SHALL CONSIST OF THE CHAIRMAN, VICE CHAIRMAN, SECRETARY AND TREASURER OF THE HSC FOUNDATION AND UP TO FOUR (4) ADDITIONAL AT-LARGE MEMBERS WHO MAY BE APPOINTED BY THE CHAIRMAN OF THE BOARD, IN HIS OR HER DISCRETION. THE PRESIDENT SHALL BE AN EX OFFICIO MEMBER OF THE COMMITTEE. MEMBERS OR STOCKHOLDERS FORM 990, PART VI, LINE 6 THE HSC FOUNDATION IS THE SOLE MEMBER OF HEALTH SERVICES FOR CHILDREN WITH SPECIAL NEEDS, INC. ELECTION OF MEMBERS FORM 990, PART VI, LINES 7A & 7B THE SOLE MEMBER SHALL HAVE ALL OF THE POWERS SPECIFIED IN THE ARTICLES OF INCORPORATION AND BYLAWS, INCLUDING THE POWER TO: (A) ESTABLISH THE CORPORATION'S POLICIES AND GOALS; (B) APPOINT AND REMOVE THE CORPORATION'S BOARD OF DIRECTORS; (C) MONITOR THE DECISIONS OF THE CORPORATION'S BOARDS OF DIRECTORS; AND (D) APPROVE THE CORPORATION'S BUDGET. REVIEW OF FORM 990 BY GOVERNING BODY FORM 990, PART VI, LINE 11B THE FORM 990 IS PREPARED BY AN ACCOUNTING FIRM AND THEN REVIEWED BY THE VP'S FINANCE AND CFO. ONCE COMMENTS FROM VP'S FINANCE AND CFO HAVE BEEN INCORPORATED INTO THE FORM 990, THE FORM 990 IS DISTRIBUTED TO THE BOARD OF DIRECTORS PRIOR TO FILING. THE FULL BOARD OF DIRECTORS HAS DELEGATED THE REVIEW OF THE FORM 990 TO HSC FOUNDATIONS AUDIT COMMITTEE THAT FUNCTIONS ON BEHALF OF HEALTH SERVICES FOR CHILDREN WITH SPECIAL NEEDS. THE AUDIT COMMITTEE IS A PART OF THE FULL VOTING BOARD OF DIRECTORS. CONFLICT OF INTEREST POLICY FORM 990, PART VI, LINE 12C THE HSC FOUNDATION HAS A WRITTEN CONFLICT OF INTEREST POLICY THAT COVERS ITSELF AND ALL OF ITS DIRECT AND INDIRECT SUBSIDIARIES (INCLUDING HEALTH SERVICES FOR CHILDREN WITH SPECIAL NEEDS INC.) UNDER THAT POLICY, WHENEVER A POTENTIAL CONFLICT ARISES FOR HEALTH SERVICES FOR CHILDREN WITH SPECIAL NEEDS, INC. BOARD OF DIRECTORS AND OFFICERS, IT IS BROUGHT TO THE ATTENTION OF THE PRESIDENT AND EXECUTIVE COMMITTEE OF THE HSC FOUNDATION BOARD, WHO ANALYZES THE SITUATION AND MAKES A DETERMINATION OF WHETHER OR NOT AN ACTUAL CONFLICT EXISTS. IF IT IS DETERMINED THAT AN ACTUAL CONFLICT EXISTS, THE PRESIDENT AND EXECUTIVE COMMITTEE REPORTS TO THE HEALTH SERVICES FOR CHILDREN WITH SPECIAL NEEDS, INC. BOARD OF DIRECTORS REGARDING THE NATURE OF THE CONFLICT AND THAT PERSON IS HEREAFTER RECUSED FROM ANY DISCUSSION AND VOTE REGARDING THE MATTER. WHENEVER A POTENTIAL CONFLICT ARISES FOR EMPLOYEES OF HEALTH SERVICES FOR CHILDREN WITH SPECIAL NEEDS, INC. MANAGEMENT TEAM IT WILL BE BROUGHT TO THE BOARD CHAIR BY THE PRESIDENT WHO ANALYZES THE SITUATION AND MAKES A DETERMINATION OF WHETHER OR NOT AN ACTUAL CONFLICT EXISTS. IF IT IS DETERMINED THAT AN ACTUAL CONFLICT EXISTS, STEPS WILL BE TAKEN TO ELIMINATE THE CONFLICT AND COMMUNICATE TO THE EMPLOYEE INVOLVED. THE BOARD CHAIR AND PRESIDENT WILL REPORT ALL CONFLICTS OF INTEREST TO THE EXECUTIVE COMMITTEE FOUNDATION. PROCESS FOR DETERMINING COMPENSATION FORM 990, PART VI, LINE 15 THE ORGANIZATION RELIED ON A RELATED ORGANIZATION, HSC FOUNDATION, TO DETERMINE COMPENSATION OF THE ORGANIZATION'S CEO. IN ADDITION, THE ORGANIZATION DETERMINES THE COMPENSATION OF OTHER OFFICERS AND KEY EMPLOYEES OF THE ORGANIZATION, AS DISCUSSED BELOW. THE ORGANIZATION AND HSC FOUNDATION BOTH USE A FOUR STEP APPROACH TO EXECUTIVE COMPENSATION: 1. THE EXECUTIVE COMMITTEE IS MADE UP OF INDEPENDENT BOARD MEMBERS WITHOUT A CONFLICT OF INTEREST. THE COMMITTEE ESTABLISHES AND DETERMINES THE REASONABLENESS OF TOTAL COMPENSATION FOR THE SYSTEM'S DISQUALIFIED EXECUTIVES AND FORWARDS PROPOSED COMPENSATION TO THE FULL BOARD FOR APPROVAL. 2. PERIODICALLY, THE EXECUTIVE COMMITTEE WILL ENGAGE AN INDEPENDENT CONSULTANT TO PREPARE A DETAILED WRITTEN REPORT ON APPROPRIATE COMPARABILITY DATA FOR COMPARABLE POSITIONS. 3. THE EXECUTIVE COMMITTEE REVIEWS AND RELIES UPON THE REPORT OF THE INDEPENDENT CONSULTANT, ALONG WITH OTHER INDIVIDUAL AND MARKET DATA, THEN DEBATES AND FULLY DOCUMENTS ITS DECISION ABOUT WHAT IS REASONABLE COMPENSATION FOR DISQUALIFIED EXECUTIVES. 4. ONCE THE EXECUTIVE COMMITTEE DEVELOPS EXECUTIVE COMPENSATION RECOMMENDATIONS, THEY ARE PRESENTED TO THE SYSTEM'S FULL BOARD FOR APPROVAL. REQUIRED DOCUMENTS MADE AVAILABLE TO THE PUBLIC FORM 990, PART VI, LINE 19 THIS ORGANIZATION MAKES ITS CONFLICT OF INTEREST POLICY, FINANCIAL STATEMENTS AND ORGANIZATIONAL DOCUMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. OTHER CHANGES IN NET ASSETS OR FUND BALANCES FORM 990, PART XI, LINE 9 RISK-BASED CAPITAL EQUITY TRANSFER $7,000,000 The Hospital for Sick Children 1731 Bunker Hill Road NE Washington DC 20017 530204670 Hospital DC 501(c)(3) 3 HSC FNDN false The HSC Foundation 2013 H Street NW Suite 300 Washington DC 20006 521346603 Healthcare DC 502(c)(3) 12-III FI NA false 2013 Holdings Inc 2013 H Street NW SUITE 300 Washington DC 20006 272882469 Holding Co. DC 503(c)(2) N/A HSC FNDN false false false false false false false false false false false false false false false true true true false false