2017-11-14T13:54:30-06:00 2016-12-31 990 2016-01-01 201486678 ADVENTIST REHABILITATION HOSPITAL OF MARYLAND INC ADVE 3013153030 820 WEST DIAMOND AVE NO 600 GAITHERSBURG MD 208781419 JAMES G LEE EXEC. VICE PRESIDENT & CFO 3013153025 2017-11-14 63.69.66.2 2017-11-14 14:53:42 ES P 0108930D22D4DB0F197C3F38AD1B8FC0C1A408E9 24017B035232A29B8D37CD00AF26A17C3CA678CB 2016 2017-02-10 21:41:12Z TERRY FORDE 820 WEST DIAMOND AVE NO 600 GAITHERSBURG MD 208781419 64504003 0 X WWW.ADVENTISTHEALTHCARE.COM X 2004 MD TO OPERATE A REHABILITATION HOSPITAL AND OUTPATIENT SERVICES TO SERVE THE COMMUNITY IN MARYLAND. 7 4 0 130 0 0 152504 186896 42241451 45941867 16471 133653 0 0 42410426 46262416 0 0 0 0 28122964 30124119 0 0 61 12316009 13501190 40438973 43625309 1971453 2637107 28945002 31760004 7519795 7785317 21425207 23974687 X WE EXTEND GOD'S CARE THROUGH THE MINISTRY OF PHYSICAL, MENTAL AND SPIRITUAL HEALING. 0 0 35760615 45941867 ADVENTIST HEALTHCARE PHYSICAL HEALTH AND REHABILITATION "ADVENTIST REHABILITATION" (LEGALLY KNOWN AS ADVENTIST REHABILITATION HOSPITAL OF MARYLAND, INC.), IS THE FIRST AND ONLY ACUTE REHABILITATION HOSPITAL IN MONTGOMERY COUNTY, MD, THAT OFFERS COMPREHENSIVE REHABILITATION PROGRAMS FOR TRAUMATIC BRAIN INJURIES, SPINAL CORD INJURIES, STROKES, AMPUTATION, ORTHOPEDIC INJURIES AND SURGERIES, SPORTS-RELATED INJURIES, WORK-RELATED INJURIES, CARDIOPULMONARY CONDITIONS, AND NEUROLOGICAL DISORDERS.WE BELIEVE THAT REHABILITATION IS ALL ABOUT HELPING OUR PATIENTS SET THEIR GOALS AND REACH THEM. EXPERT CARE TEAMS WORKING SIDE-BY-SIDE WITH PATIENTS, USING INNOVATIVE THERAPIES, STATE-OF-THE-ART EQUIPMENT AND GROUND-BREAKING TECHNOLOGY COMBINE TO OFFER NEW WAYS TO HEAL. ADVENTIST REHABILITATION IS BUILT AROUND OUR PATIENTS AND LEADS THE WAY BACK TO LIFE FROM STROKE, BRAIN INJURY, SPINAL CORD INJURY, AMPUTATION AND TRAUMA. EVERY DAY, WE CELEBRATE PATIENT ADVANCES, BIG AND SMALL.WE HAVE RECENTLY UPGRADED OUR SERVICES THROUGH THE ADDITION OF AN ACCESSIBLE VAN, REHABILITATION EQUIPMENT (SUCH AS POWER WHEEL CHAIRS OR LIGHT/SPORT WHEEL CHAIRS) A CAR SIMULATOR FOR PRACTICE CAR TRANSFERS AND SLEEPER CHAIRS. WE HAVE LOCATIONS IN ROCKVILLE AND TAKOMA PARK WITH OUTPATIENT SERVICES IN ROCKVILLE, GAITHERSBURG AND SILVER SPRING.WE OFFER SPECIALIZED INPATIENT AND OUTPATIENT TREATMENT FOR PERSONS WITH FUNCTIONAL LIMITATIONS, CARING FOR PATIENTS 18 AND OLDER AND, UNDER SPECIAL CIRCUMSTANCES, EMANCIPATED MINORS. OUR MANY REHABILITATION PROGRAMS AND SERVICES INCLUDE:ACUTE INPATIENT REHABILITATION,SPINAL CORD INJURY,AMPUTEE PROGRAM STROKE, BRAIN INJURY, ORTHOPEDIC PROGRAMS,ORTHOPEDIC REHABILITATION, PROSTHETICS & ORTHOTICS, OUTPATIENT SERVICES,DRIVER REHABILITATION PROGRAM, LYMPHEDEMA THERAPY, JOINT REPLACEMENT PROGRAM, SEATING & MOBILITY CLINIC, LEE SILVERMAN VOICE TREATMENT (LSVT) SPEECH LANGUAGE & SWALLOWING THERAPY.IN 2016, ADVENTIST REHABILITATION WAS GRANTED A THREE-YEAR ACCREDITATION FOR OUR INPATIENT AND OUTPATIENT FACILITIES FROM THE JOINT COMMISSION. THE ACCREDITATION PROCESS ESTABLISHED BY THE COMMISSION IS RECOGNIZED NATIONWIDE AS A SYMBOL OF QUALITY THAT REFLECTS AN ORGANIZATION'S COMMITMENT TO MEETING PERFORMANCE STANDARDS.ADVENTIST REHABILITATION IS THE FIRST HOSPITAL IN THE D.C. METROPOLITAN AREA TO EARN A SPECIALTY ACCREDITATION IN AMPUTEE REHABILITATION FROM THE COMMISSION ON ACCREDITATION OF REHABILITATION FACILITIES (CARF) INTERNATIONAL. CARF INTRODUCED ITS AMPUTEE SPECIALTY STANDARDS IN JULY 2007 WITH INPUT FROM THE AMPUTEE COALITION OF AMERICA (ACA), VETERANS HEALTH ADMINISTRATION, DEPARTMENT OF DEFENSE, AMERICAN ACADEMY OF ORTHOTISTS & PROSTHETISTS, AND PERSONS WITH LIMB LOSS. THE STANDARDS, WHICH BECAME EFFECTIVE IN JANUARY 2008, REQUIRE ACCREDITED AMPUTEE PROGRAMS TO PROVIDE A HOLISTIC, INTERDISCIPLINARY TEAM APPROACH TO CARE AND TO OFFER POST-CARE ASSISTANCE IN TRANSITIONING BACK TO THE COMMUNITY.OUR ACUTE INPATIENT REHABILITATION PROGRAM IS RUN BY A TEAM OF REHABILITATION EXPERTS WHO WILL GUIDE YOU ALONG A PRACTICAL AND PERSONAL TREATMENT PROGRAM FOCUSED ON INCREASING SELF-RELIANCE AND GAINING INDEPENDENCE. THE TEAM IS LED BY A PHYSIATRIST, A MEDICAL DOCTOR WHO SPECIALIZES IN PHYSICAL REHABILITATION. WE PROVIDE SPECIALIZED REHABILITATION NURSING 24 HOURS A DAY, SEVEN DAYS A WEEK. THERAPY SERVICES INCLUDE PHYSICAL THERAPY, OCCUPATIONAL THERAPY, SPEECH LANGUAGE PATHOLOGY, AND RECREATIONAL THERAPY.THE SPINAL CORD INJURY PROGRAM ADDRESSES BOTH TRAUMATIC SPINAL CORD INJURIES RESULT FROM A FALL OR SOME KIND OF ACCIDENT, AND NON-TRAUMATIC SPINAL CORD INJURIES THAT RESULT FROM A STROKE AND DISRUPTION TO THE SPINAL CORD, TUMOR ON SPINAL CORD, OR INFECTION. AGAIN, A TEAM APPROACH TO PUT TOGETHER AN INTERDISCIPLINARY PLAN OF CARE HELPS THE PATIENT ON THE ROAD TO RECOVERY.OUR AMPUTEE PROGRAM UTILIZES AN INTERDISCIPLINARY TEAM APPROACH TO HELP POST-AMPUTEE PATIENTS TO ADJUST PHYSICALLY AND PSYCHOLOGICALLY AFTER THE LOSS OF A LIMB AND RESUME ACTIVE AND PRODUCTIVE LIVES. INDIVIDUALS MAY BE TREATED AS INPATIENTS OR OUTPATIENTS, DEPENDING ON THEIR PERSONAL NEEDS. PATIENTS WORK TO IMPROVE STRENGTH, COORDINATION AND ENDURANCE AND ALSO LEARN PROPER WOUND CARE. WHEN READY, OUR PATIENTS ARE PRESCRIBED PROSTHETIC DEVICES THAT ARE BOTH FUNCTIONAL AND COMFORTABLE TO WEAR. ONCE TINED WITH A NEW LIMB, THE PATIENT LEARNS TO USE THE PROSTHESIS WITH CONFIDENCE AND TO INCORPORATE IT INTO DAILY LIFE.THE INTERDISCIPLINARY TEAM APPROACH OF THE BRAIN INJURY PROGRAM ADDRESSES TRAUMATIC BRAIN INJURIES CAUSED BY AN EXTERNAL PHYSICAL FORCE, SUCH AS A CAR ACCIDENT, FALL, SPORTS OR WORKPLACE INJURIES, ETC.; AS WELL AS ACQUIRED BRAIN INJURIES CAUSED BY INTERNAL TRAUMA TO THE BRAIN, SUCH AS TUMORS, BLOOD CLOTS, SEIZURES, INFECTIONS, ETC. EACH OF THESE TYPES OF BRAIN INJURIES MAY RESULT IN IMPAIRMENT OF PHYSICAL, COGNITIVE, BEHAVIORAL, AND/OR EMOTIONAL CAPABILITIES. REHABILITATION FOLLOWING A BRAIN INJURY IS VERY COMPLEX BECAUSE OF THE NEED TO ADDRESS MULTIPLE AREAS OF DEFICIT, INCLUDING PHYSICAL IMPAIRMENTS, FUNCTIONAL DEFICIENCIES (SUCH AS DIFFICULTY WALKING OR DRESSING), BEHAVIORAL DIFFICULTIES, EMOTIONAL CONSEQUENCES AND SOCIAL OR INTERPERSONAL LIMITATIONS. OFTEN, SIGNIFICANT COGNITIVE DEFICITS, SUCH AS LIMITED ATTENTION SPAN OR POOR MEMORY, UNDERLIE AND EXACERBATE THESE PROBLEMS. PATIENTS IN OUR BRAIN INJURY PROGRAM RECEIVE INTENSIVE, INTEGRATED REHABILITATION DESIGNED TO MAXIMIZE THEIR RECOVERY. TEAM MEMBERS, INCLUDING A NEUROPSYCHOLOGIST, MEET AT LEAST ONCE A WEEK TO DISCUSS GOALS, PROGRESS AND TREATMENT STRATEGIES.WE CONTINUE TO PARTNER WITH MONTGOMERY COUNTY PUBLIC SCHOOLS (MCPS) ON A CONCUSSION PROGRAM FOR COUNTY HIGH SCHOOL ATHLETES. THE PARTNERSHIP REQUIRES ALL HIGH SCHOOL ATHLETES TO UNDERGO A BASELINE EXAM PRIOR TO THEIR RESPECTIVE SPORTS SEASON.OTHER PROGRAMS OFFERED INCLUDE A STROKE PROGRAM FOR RECOVERING STROKE PATIENTS TO TAKE PART IN AN INTENSIVE COURSE OF INTEGRATED THERAPY AND MEDICAL MANAGEMENT. THE OBJECTIVE IS TO RESTORE MOVEMENT, IMPROVE SPEECH, TEACH SELF-CARE AND HOME CARE SKILLS AND IMPROVE COGNITIVE AND MEMORY FUNCTIONS. STROKE PATIENTS AND THEIR FAMILIES WILL BE GUIDED THROUGH A PATIENT-FOCUSED, COMPREHENSIVE, AND OUTCOME-ORIENTED STROKE PROGRAM BY A CARING, COMPETENT TEAM OF HEALTHCARE PROFESSIONALS.THE ORTHOPEDIC REHABILITATION PROGRAM IS DESIGNED FOR THOSE WHO HAVE UNDERGONE A TOTAL HIP OR KNEE REPLACEMENT OR HAVE SUSTAINED TRAUMA TO BONES OR JOINTS. THE PROGRAM FOCUSES ON HELPING PATIENTS REGAIN THEIR STRENGTH, MOBILITY, ENDURANCE AND RANGE OF MOTION.THE DRIVER REHABILITATION PROGRAM DETERMINES WHETHER IT IS SAFE FOR THE CLIENT TO CONTINUE DRIVING FOLLOWING AN INJURY/ILLNESS OR AGE RELATED CHANGES. A DRIVING PROGRAM MAY INCLUDE A CLINICAL EVALUATION WHICH INCLUDES AN ASSESSMENT OF VISION, VISUAL PERCEPTION, COGNITION, REACTION TIME, AND MOTOR SKILLS RELATED TO DRIVING. IT MAY ALSO INCLUDE A BEHIND-THE-WHEEL EVALUATION, IN ADDITION TO TRAINING CONDUCTED BY AN OCCUPATIONAL THERAPIST WHO SPECIALIZES IN DRIVING REHABILITATION.OUR CERTIFIED LYMPHEDEMA THERAPISTS PROVIDE A COMPLETE DECONGESTIVE TREATMENT APPROACH FOR PEOPLE SUFFERING FROM LYMPHEDEMA. THIS INVOLVES A SPECIALIZED MASSAGE TECHNIQUE CALLED MANUAL LYMPH DRAINAGE (MLD), SKIN AND NAIL CARE, COMPRESSION BANDAGING AND GARMENTS, REMEDIAL EXERCISE AND SELF-CARE TRAINING. THE GOAL OF OUR PROGRAM IS TO HELP INDIVIDUALS REDUCE INCREASE VOLUME RESULTING FROM LYMPHEDEMA, RESTORE MOBILITY, IMPROVE COSMESIS, PREVENT INFECTION, AND IMPROVE THEIR QUALITY OF LIFE.A JOINT REPLACEMENT PROGRAM AT ADVENTIST REHABILITATION HELPS PATIENTS TO ACHIEVE GOALS FOR OPTIMAL RESULTS. ONE OF THE IMPORTANT CRITICAL FACTORS FOR SUCCESSFUL OUTCOMES FOLLOWING KNEE OR HIP REPLACEMENT FOR PATIENTS IS FOR PATIENTS TO DILIGENTLY FOLLOW THE PHYSICAL REHABILITATION PROCESS. WE PROVIDE BOTH THE SUPPORT AND RESOURCES FOR A POSITIVE OUTCOME.LEE SILVERMAN VOICE TREATMENT (LSVT)-CERTIFIED SPEECH LANGUAGE PATHOLOGISTS AT ADVENTIST REHABILITATION CAN COMPLETE A COMPREHENSIVE ASSESSMENT TO DETERMINE CANDIDACY FOR LSVT. LSVT IS A HIGHLY EFFECTIVE INTENSIVE SPEECH THERAPY PROGRAM DESIGNED FOR PARKINSON'S PATIENTS. LSVT IS DESIGNED TO IMPROVE SPEECH AND VOICE FUNCTION. THE THERAPY TARGETS VOCAL LOUDNESS IN ORDER TO TRIGGER IMPROVED FUNCTION AND COORDINATION ACROSS THE VARIOUS SUBSYSTEMS OF SPEECH. LSVT COMBINES MOTOR RETRAINING WITH SENSORY RE-TRAINING TO ELICIT MAXIMUM OUTCOMES. THE TREATMENT REGIMEN INCLUDES EMPHASIS ON PATIENT EDUCATION AND CARRYOVER OF GAINS TO DAILY COMMUNICATION ENVIRONMENTS. THE LSVT PROTOCOL INVOLVES FOUR 1-HOUR THERAPY SESSIONS PER WEEK FOR 4 WEEKS. 35760615 1 1 0 0 0 0 0 0 0 0 1 0 0 0 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 1 0 0 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 X 7 4 0 0 0 0 1 1 1 1 1 0 1 1 1 1 1 1 1 1 1 1 0 X JAMES G LEE 3013153030 820 WEST DIAMOND AVE NO 600 GAITHERSBURG MD 208781419 GENE MILTON TRUSTEE 1.00 X 0 0 0 SHAMA MITTAL MD TRUSTEE 1.00 X 0 0 0 TONY TOUMA TRUSTEE (TERM ENDED 02/2016) 1.00 X 0 0 0 GENE COUNIHAN TRUSTEE 1.00 X 0 0 0 JOHN J KENNEY PHD MBA TRUSTEE 1.00 X 0 0 0 JOHN SACKETT CHAIR; EVP&COO,AHC &PRESIDENT, SGMC 4.00 51.00 X X 0 715614 154005 BRENT REITZ SECRETARY;VP&ADMINISTRATOR,ARHM 40.00 15.00 X X 0 348960 83178 ERIK WANGSNESS PRESIDENT, WAH 2.00 48.00 X 0 505339 120527 TERRY FORDE PRESIDENT & CEO, AHC 4.00 58.00 X 0 1223400 228632 JAMES G LEE EVP & CFO, AHC 3.00 59.00 X 0 656869 112003 JAMES STERLING LITSINGER VP & CFO, NON-ACUTE SERVICES 20.00 30.00 X 333681 0 15845 TANYA DEVINE CASE MANAGER 40.00 X 128725 0 0 GEORGE ROBERT GRANGE AVP, REHAB SERVICES 40.00 X 168854 0 32482 JASON MAKAROFF ASSOCIATE VP OPERATIONS 50.00 X 195134 0 8705 FARHAD OSTOVARI SENIOR PHYSICAL THERAPIST 40.00 X 135622 0 20216 VALERIE SUMMERLIN CHIEF NURSING OFFICER 40.00 X 217223 0 11179 1179239 3450182 786772 19 0 1 0 HILL-ROM COMPANY INC PO BOX 643592 PITTSBURGH PA 152643592 HOSPITAL EQUIPMENT PROVIDER 397335 SODEXO INC PO BOX 536922 ATLANTA GA 303536922 DIETARY AND PLANT OPS 199789 CRITICAL CONNECTION INC 12830 GRAND ELM STREET CLARKSBURG MD 20871 CONTRACTED PHYSICAL THERAPISTS 196489 STUDER GROUP LLC 913 GULF BREEZE PARKWAY SUITE 6 GULF BREEZE FL 32561 CONSULTING SERVICES 103772 BUTLER MEDICAL TRANSPORT LLC 27 WALKER AVE BALTIMORE MD 21208 MEDICAL TRANSPORT SERVICES 103408 5 65455 121441 186896 OCCUPATIONAL/SPEECH/PH 900099 45941867 45941867 45941867 94711 94711 18280529 18241587 38942 38942 38942 46262416 45941867 0 133653 349525 349525 24952888 21728309 3224579 601422 520677 80745 2363097 2078147 284950 1857187 1605542 251645 15523 15523 8360 8360 17318 17318 3949728 3517259 432469 73084 17090 55933 61 1499203 926905 572298 2050235 1550183 500052 1919583 1642439 277144 126645 92343 34302 125933 63822 62111 1613383 1578263 35120 91169 91169 COST ALLOC. FROM PARENT 1338265 1338265 MEDICAL SUPPLIES 547538 371507 176031 RECRUITING 125223 68129 57094 43625309 35760615 7864633 61 175865 288940 11407325 15336168 18167 24560 4842580 4937850 36258 105202 89101 78202 125936 142795 19104894 9612072 10864141 9492822 443534 443579 909915 877706 32180 32180 28945002 31760004 3017677 3283137 4502118 4502180 7519795 7785317 X 21657145 24184556 -231938 -209869 21425207 23974687 28945002 31760004 X 2637107 -87040 -587 X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 12590177 5986584 6603593 1170832 241025 929807 4550704 2284636 2266068 793181 1099827 -306646 9492822 DUE TO PARENT ORGANIZATION 4347854 COMPLIANCE LIABILITY RESERVE 154326 4502180 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 2016 OR 2015. 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 1 0 1 1 306676 306676 0.00700 306676 306676 0.00700 1559686 327093 1232593 0.02830 438927 1031 437896 0.01000 221648 221648 0.00510 2220261 328124 1892137 0.04340 2526937 328124 2198813 0.05040 3201 3201 0.00010 39296 39296 0.00090 14315 963 13352 0.00030 114639 114639 0.00260 171451 963 170488 0.00390 1 569541 24376846 24018421 358425 X 1 1 1 1 ADVENTIST REHABILITATION HOSP OF MD 9909 MEDICAL CENTER DRIVE ROCKVILLE MD 20850 SEE PART VI FOR WEBSITE 15-077 X REHAB HOSPITAL ADVENTIST REHABILITATION HOSPITAL OF MD 1 0 0 1 X X X X X X X X X 16 1 0 0 1 X SEE URL ON SECTION C X X 1 17 1 SEE URL ON SECTION C 0 1 X 200.000000000000 600.000000000000 1 1 X X X 1 X SEE URLS ON SECTION C X SEE URLS ON SECTION C X SEE URLS ON SECTION C X X X X X X X 1 X 0 X X X X 1 X 0 0 ADVENTIST REHABILITATION HOSPITAL OF MD PART V, SECTION B, LINE 5: THE FOLLOWING NARRATIVE IS BASED ON THE LAST CONDUCTED CHNA IN 2016:THROUGHOUT THE COMPLETION OF THE 2017-2019 COMMUNITY HEALTH NEEDS ASSESSMENT, INPUT FROM THE COMMUNITY WAS SOLICITED FROM MULTIPLE SOURCES. (1) HEALTHY MONTGOMERY: ADVENTIST HEALTHCARE, IN ADDITION TO THE OTHER MONTGOMERY COUNTY HOSPITALS, COLLABORATES WITH HEALTHY MONTGOMERY, WHICH SERVES AS THE LOCAL HEALTH IMPROVEMENT COALITION IN MONTGOMERY COUNTY. HEALTHY MONTGOMERY WORKS TO BRING TOGETHER THE COUNTY GOVERNMENT, HOSPITAL SYSTEMS, MINORITY HEALTH PROGRAMS, ADVOCACY GROUPS, ACADEMIC INSTITUTIONS, AND OTHER COMMUNITY BASED STAKEHOLDERS TO ACHIEVE OPTIMAL HEALTH AND WELL-BEING FOR ALL COUNTY RESIDENTS. THE GROUP WORKS TO SET A HEALTH PRIORITY AGENDA AS WELL AS AN ACTION PLAN TO ADDRESS THE PRIORITIZED NEEDS. IN DOING SO, THE GROUP HAS ESTABLISHED A CORE MEASURE SET FOR THE TOP PRIORITY AREAS AS WELL AS A COMMUNITY HEALTH DASHBOARD FOR THE COUNTY. THE DASHBOARD ENCOMPASSES INDICATORS THAT SPAN PHYSICAL AND MENTAL HEALTH, HEALTH BEHAVIORS, AND SOCIAL DETERMINANTS. ADVENTIST HEALTHCARE CONTRIBUTES ANNUALLY TO SUPPORT THE INFRASTRUCTURE OF HEALTHY MONTGOMERY. IN ADDITION TO PROVIDING FINANCIAL SUPPORT, REPRESENTATIVES FROM ADVENTIST HEALTHCARE PLAY AN ACTIVE ROLE THROUGH REPRESENTATION ON MULTIPLE COMMITTEES AND PLANNING GROUPS INCLUDING THE HEALTHY MONTGOMERY STEERING COMMITTEE WHICH SETS THE DIRECTION FOR THE GROUP. REPRESENTATIVES FROM AHC HAVE ALSO PLAYED ROLES IN THE DATA PROJECT SUBCOMMITTEE, BEHAVIORAL HEALTH WORK GROUP, AND COMMUNITY HEALTH NEEDS ASSESSMENT COMMITTEE. IN COMPLETING THIS COMMUNITY HEALTH NEEDS ASSESSMENT, REHAB UTILIZED THE HEALTHY MONTGOMERY PRIORITY AREAS NOT ONLY AS A STARTING POINT FOR IDENTIFYING THE NEEDS IN THE COMMUNITY BUT ALSO AS A FACTOR FOR CONSIDERATION WHEN COMPLETING THE PRIORITIZATION PROCESS. THE HEALTHY MONTGOMERY COMMUNITY CONVERSATIONS, WHICH PROVIDED INPUT FROM MINORITY, UNDERSERVED AND HARD TO REACH POPULATIONS, WERE ALSO UTILIZED AS A SUPPLEMENT TO THE PRIMARY SURVEY DATA THAT WAS COLLECTED BY REHAB, AS DESCRIBED IN THE PREVIOUS SECTION.(2) DIRECT INPUT FROM THE COMMUNITY: FROM JUNE-NOVEMBER OF 2015, A 19 ITEM SURVEY WAS ADMINISTERED IN THE COMMUNITY TO GARNER INPUT ON THE NEEDS, STRENGTHS, AND RESOURCES IN THE COMMUNITY. THE SURVEY CONSISTED OF THREE PARTS INCLUDING HEALTH STATUS AND ACCESS TO CARE, COMMUNITY HEALTH NEEDS AND STRENGTHS, AND DEMOGRAPHICS. A TOTAL OF 1,185 RESPONSES WERE RECEIVED AND ANALYZED. THE HEALTHY MONTGOMERY COMMUNITY CONVERSATIONS, WHICH PROVIDED INPUT FROM MINORITY, UNDERSERVED AND HARD TO REACH POPULATIONS, WERE ALSO UTILIZED AS A SUPPLEMENT TO THE PRIMARY SURVEY DATA THAT WAS COLLECTED BY REHAB. THE COMMUNITY CONVERSATIONS CONSISTED OF 15 FOCUS GROUPS: YOUTH; SENIORS; PEOPLE WITH DISABILITIES; HOMELESS MEN; HOMELESS WOMEN; LATINO COMMUNITY (TOOK PLACE IN SPANISH); KOREAN COMMUNITY (TOOK PLACE IN KOREAN); CHINESE COMMUNITY (TOOK PLACE IN MANDARIN); VIETNAMESE COMMUNITY (TOOK PLACE IN VIETNAMESE); ASIAN AMERICAN HEALTH INITIATIVE; AFRICAN AMERICAN HEALTH PROGRAM, AFRICAN ADVISORY GROUP, AND CARIBBEAN ADVISORY; FAITH COMMUNITY; GENERAL PUBLIC: EAST COUNTY; GENERAL PUBLIC: SOUTH COUNTY; GENERAL PUBLIC: UP COUNTY. A DETAILED OVERVIEW OF THE METHODS USED TO CONDUCT THE SURVEY AND COMPLETE THE PRIMARY DATA ANALYSIS IS DESCRIBED ABOVE AND THE RESULTS OF THE ANALYSIS CAN BE FOUND IN SECTION IV, PART A: PRIMARY DATA FINDINGS.CENTER FOR HEALTH EQUITY AND WELLNESS ADVISORY BOARDTHE CENTER FOR HEALTH EQUITY AND WELLNESS ADVISORY BOARD IS COMPRISED OF STAKEHOLDERS WHO REPRESENT AND ARE ABLE TO SPEAK TO THE NEEDS OF THE COMMUNITY INCLUDING MINORITY AND UNDERSERVED POPULATIONS. THE BOARD WAS CONVENED TO HELP GUIDE EFFORTS TO REDUCE AND ELIMINATE HEALTH DISPARITIES, IDENTIFY COMMUNITY NEEDS, AND TO HELP ASSESS AND DIRECT OUR RESPONSE TO THOSE NEEDS. THE BOARD WAS CONSULTED AT MULTIPLE POINTS THROUGHOUT THE COMPLETION OF THE COMMUNITY HEALTH NEEDS ASSESSMENT: > APRIL 2015: A DRAFT OF THE COMMUNITY SURVEY WAS SENT TO THE BOARD FOR INPUT. > MAY 2015: A PROGRESS UPDATE ON THE 2014-2016 IMPLEMENTATION STRATEGY WAS PROVIDED TO THE BOARD AT WHICH TIME THEY WERE ABLE TO PROVIDE INPUT ON THE STRATEGIES IMPLEMENTED AND RECOMMENDATIONS FOR FUTURE DIRECTIONS. > OCTOBER 2015: A TIMELINE AND FRAMEWORK FOR THE 2017-2019 COMMUNITY HEALTH NEEDS ASSESSMENT WAS PRESENTED FOR INPUT. > MAY 2016: A DETAILED PRESENTATION WAS DELIVERED OUTLINING THE INITIAL FINDINGS FROM THE PRIMARY DATA ANALYSIS AS WELL AS THE METHODOLOGY FOR THE OVERALL COMMUNITY HEALTH NEEDS ASSESSMENT REPORT. THE BOARD PROVIDED INPUT ON THE HEALTH NEEDS AND BARRIERS THEY VIEWED AS MOST SIGNIFICANT FOR THE MINORITY AND UNDERSERVED POPULATIONS IN THE COMMUNITY. THE MEMBERS OF THE 2015-2017 CENTER FOR HEALTH EQUITY AND WELLNESS ADVISORY BOARD REPRESENT A DIVERSE GROUP OF STAKEHOLDERS AND POPULATIONS IN THE COMMUNITY AND PROVIDE A WEALTH OF EXPERTISE IN THE HEALTH AND WELLNESS FIELD. ADVISORY BOARD MEMBERS INCLUDE:> CAROL GARVEY, MD, PRINCIPAL, GARVEY AND ASSOCIATES;> CAROLE WORKING, PRINCIPAL, QUINCE ORCHARD HIGH SCHOOL;> CHRISTOPHER KING, PHD, DIRECTOR, EXPERIENTIAL LEARNING, GEORGETOWN UNIVERSITY;> DANIEL COCHRAN, CFO, SHADY GROVE MEDICAL CENTER;> HANNAH MACK, LEARNING AND INNOVATION MANAGER, COOK ROSS;> JO CIMINO, DIRECTOR, CASE MANAGEMENT, ADVENTIST HEALTHCARE;> JOAN VINCENT, CHIEF NURSING OFFICER, SHADY GROVE MEDICAL CENTER;> KATHERINE BARMER, DIRECTOR, POPULATION HEALTH MANAGEMENT, ADVENTIST HEALTHCARE;> KEVIN SMOTHERS, MD, CHIEF MEDICAL OFFICER, SHADY GROVE MEDICAL CENTER;> LESLIE GRAHAM, PRESIDENT AND CEO, PRIMARY CARE COALITION;> LOIS WESSEL, CFNP, ASSOCIATION OF CLINICIANS FOR THE UNDERSERVED;> MARK RULLE, EDD, PRESIDENT, MARYLAND HEALTHCARE EDUCATION INSTITUTE, MARYLAND HOSPITAL ASSOCIATION;> OLIVIA CARTER-POKRAS, PHD, PROFESSOR, UNIVERSITY OF MARYLAND SCHOOL OF PUBLIC HEALTH;> PERRY CHAN, MS, PROGRAM MANAGER, ASIAN AMERICAN HEALTH INITIATIVE;> SONIA MORA, MPH, PROGRAM MANAGER, LATINO HEALTH INITIATIVE;> STEPHEN B. THOMAS, PHD, DIRECTOR, MARYLAND CENTER FOR HEALTH EQUITY;> SUSAN GLOVER, SR. VP QUALITY, ADVENTIST HEALTHCARE;> UMA AHLUWALIA, DIRECTOR, MONTGOMERY COUNTY DEPARTMENT OF HEALTH AND HUMAN SERVICES;> HEATHER ROSS, MHS, PROGRAM MANAGER, AFRICAN AMERICAN HEALTH PROGRAM. ADVENTIST REHABILITATION HOSPITAL OF MD 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 20878PART V, SECTION B, LINE 7A: THE CHNA REPORT CAN BE FOUND ON EITHER ONE OF THESE URLS: HTTP://WWW.ADVENTISTHEALTHCARE.COM/APP/FILES/PUBLIC/3951/2017-CHNA-PHR.PDF,OR,HTTP://WWW.ADVENTISTHEALTHCARE.COM/ABOUT/COMMUNITY/HEALTH-NEEDS-ASSESSMENT/#OTHER-ENTITIESPART V, SECTION B, LINE 10A: THE IMPLEMENTATION STRATEGY IS FOUND ON THIS URL: WWW.ADVENTISTHEALTHCARE.COM/APP/FILES/PUBLIC/4201/2017-CHNA-PHR-IMPLEMENTATIONSTRATEGY.PDF ADVENTIST REHABILITATION HOSPITAL OF MD PART V, SECTION B, LINE 11: BASED ON THE CHNA COMPLETED IN 2016, AN IMPLEMENTATION STRATEGY WAS ADOPTED FOCUSING ON CONCUSSION CARE.ADVENTIST HEALTHCARE REHABILITATION HAS IMPLEMENTED AN INITIATIVE TO INCREASE AWARENESS OF, AND EDUCATION AROUND, CONCUSSION FOR STUDENT ATHLETES. ADVENTIST HEALTHCARE REHABILITATION HAS PARTNERED WITH MONTGOMERY COUNTY PUBLIC SCHOOLS TO PROVIDE BASELINE CONCUSSION TESTING AND ATHLETIC TRAINERS IN 13 OF 25 HIGH SCHOOLS. BASELINE TESTING IS A PRE-SEASON EXAM CONDUCTED BY TRAINED PROFESSIONALS TO ASSESS AN ATHLETE'S COGNITIVE FUNCTIONS INCLUDING LEARNING AND MEMORY SKILLS, ABILITY TO CONCENTRATE AND PROBLEM SOLVING SKILLS. IN THE EVENT THAT THE ATHLETE SUFFERS A CONCUSSION, THE RESULTS FROM THESE TESTS CAN BE USED IN COMPARISON WITH SIMILAR POST-INJURY TESTS. ADVENTIST HEALTHCARE REHABILITATION USES IMPACT (IMMEDIATE POST-CONCUSSION ASSESSMENT COGNITIVE TEST), A WEB-BASED, COMPUTERIZED TOOL USED TO MEASURE MEMORY, PROCESSING SPEED, REACTION TIME, ATTENTION SPAN AND PROBLEM SOLVING SKILLS. IN ADDITION TO THE BASELINE TESTING, ADVENTIST HEALTHCARE REHABILITATION HAS IMPLEMENTED AN ATHLETIC TRAINER PROGRAM AT EACH OF THE 13 SCHOOLS. THIS HAS INCLUDED TRAINING AND PLACING AN ATHLETIC TRAINER IN EACH OF THE SCHOOLS TO ASSIST WITH CONCUSSION AWARENESS AND EDUCATION AS WELL AS TIMELY ON-SITE INJURY PREVENTION AND MANAGEMENT. SPECIFIC PROGRAM ACTIVITIES INCLUDE:> EDUCATION SESSIONS FOR STUDENTS TO INCREASE KNOWLEDGE AND AWARENESS OF CONCUSSION SYMPTOMS, ACUTE TREATMENTS, IMPORTANCE OF RECOVERY, AND EFFECTS ON EVERY DAY ACTIVITIES BEYOND SPORTS;> IMPLEMENTING IMPACT BASELINE TESTING FOR STUDENT ATHLETES IN 13 MONTGOMERY COUNTY HIGH SCHOOLS (WITH EACH STUDENT BASELINE TESTED EVERY 2 YEARS);> MAINTAINING AND MAKING AVAILABLE BASELINE TEST RESULTS TO STUDENTS, PARENTS, AND STUDENTS' HEALTH CARE PROVIDERS AT NO COST;> PROVIDING RETESTS FOLLOWING A CONCUSSION AT NO COST;> PROVIDING FOLLOW-UP TESTING AND ANALYSIS FOR STUDENTS AS NEEDED AT A REASONABLE RATE;> TRAINING AND PLACING FULL-TIME ATHLETIC TRAINERS IN 13 MONTGOMERY COUNTY HIGH SCHOOLS;> TRAINERS ATTEND ALL 'HOME' ATHLETIC EVENTS AS WELL AS 'AWAY' VARSITY FOOTBALL GAMES;> TRAINERS PERFORM FUNCTIONS WITHIN THE SIX DOMAINS OF ATHLETIC TRAINERS AS ESTABLISHED BY THE NATIONAL ATHLETIC TRAINERS ASSOCIATION: PREVENTION; CLINICAL EVALUATION AND DIAGNOSIS; IMMEDIATE CARE; TREATMENT, REHABILITATION, AND RECONDITIONING; ORGANIZATION AND ADMINISTRATION; AND PROFESSIONAL RESPONSIBILITIES.;> IN ADDITION, TRAINERS ASSIST IN IMPLEMENTING SCHOOL AND SYSTEM WIDE RESPONSIBILITIES RELATED TO THE HEALTH AND SAFETY OF STUDENT ATHLETES.;> PROVIDING AMERICAN HEART ASSOCIATION CPR/AED RECERTIFICATION FOR ATHLETIC STAFF AT 13 MONTGOMERY COUNTY HIGH SCHOOLS.OTHER AREAS OF NEED ADDRESSED BY ADVENTIST HEALTHCARE REHABILITATIONWHILE ADVENTIST HEALTHCARE REHABILITATION HAS IDENTIFIED CONCUSSION CARE AND PREVENTION AS ITS PRIORITY AREA FOR THIS IMPLEMENTATION STRATEGY PERIOD, THE HOSPITAL WILL CONTINUE TO ADDRESS OTHER AREAS OF NEED THROUGH EXISTING COMMUNITY HEALTH OUTREACH PROGRAMS, EDUCATION, AND FINANCIAL CONTRIBUTIONS. > TRAUMATIC BRAIN INJURY: IN ADDITION TO THE ACTIVITIES DESCRIBED IN THE IMPLEMENTATION STRATEGY ABOVE, ADVENTIST HEALTHCARE REHABILITATION PROVIDES ADDITIONAL SUPPORT IN THE COMMUNITY AROUND TRAUMATIC BRAIN INJURY.; BRAIN INJURY SUPPORT GROUP: FOR THOSE WITH BOTH TRAUMATIC AND NON-TRAUMATIC BRAIN INJURIES, THIS GROUP PROVIDES SUPPORT AND EDUCATION AS WELL AS GUIDANCE AROUND AVAILABLE COMMUNITY RESOURCES. PARTICIPANTS ARE ENCOURAGED TO BRING FAMILY AND FRIENDS.; GRUPO DE APOYO PARA PERSONAS CON UNA LESI N CEREBRAL: IN ADDITION TO THE ENGLISH LANGUAGE BRAIN INJURY SUPPORT GROUP, AN ADDITIONAL GROUP IS OFFERED IN SPANISH. > TRAUMATIC BRAIN INJURY, STROKE, & NEUROLOGY: ADVENTIST HEALTHCARE REHABILITATION ALSO OFFERS PROGRAMS TO SUPPORT INDIVIDUALS WITH COGNITIVE AND SPEECH-LANGUAGE NEEDS.; COGNITIVE GAME NIGHT: LED BY A SPEECH-LANGUAGE PATHOLOGIST, GAME NIGHTS PROVIDE A FUN ENVIRONMENT FOR COGNITIVE STIMULATING GAMES. EDUCATION AND DISCUSSION ARE ALSO PROVIDED AROUND COGNITIVE STRATEGIES AS WELL AS METHODS FOR CONTINUING COGNITIVE REHABILITATION AT HOME.; COMMUNITY APHASIA GROUP: LED BY A SPEECH-LANGUAGE PATHOLOGIST, THIS GROUP PROVIDES OPPORTUNITIES FOR INDIVIDUALS TO WORK ON SUCCESSFUL COMMUNICATION AND SOCIAL INTERACTION IN A SUPPORTIVE, POSITIVE, AND SMALL GROUP SETTING.> AMPUTEE: AMPUTEE SUPPORT GROUP: THIS GROUP FOCUSES ON THE EMOTIONS AND CHALLENGES OF LIVING LIFE AS AN AMPUTEE. IT IS THE GROUP'S FOCUS TO BE POSITIVE, CREATIVE AND RESOURCEFUL IN EXAMINING AN AMPUTEE'S EXPERIENCES. MANY TOPICS ARE DISCUSSED INCLUDING PROSTHETIC DEVELOPMENT, THERAPEUTIC DEVICES AND TRAINING AS WELL AS EMOTIONAL COUNSELING AND SUPPORT.IN ADDITION TO THE ACTION ITEMS LISTED ABOVE, ADVENTIST HEALTHCARE REHABILITATION AS A PART OF ADVENTIST HEALTHCARE IS COMMITTED TO PROVIDING FINANCIAL SUPPORT TO IMPROVE THE HEALTH AND WELLBEING OF OUR COMMUNITY THROUGH THE COMMUNITY PARTNERSHIP FUND. THE ADVENTIST HEALTHCARE COMMUNITY PARTNERSHIP FUND PROVIDES FUNDING FOR 501(C)(3) NON-PROFIT ORGANIZATIONS WHOSE ACTIVITIES ALIGN WITH OUR MISSION AND THE FOLLOWING FUNDING OBJECTIVES:> HEALTH AND WELLNESS: SUPPORT COMMUNITY HEALTH SERVICES, EDUCATION, AND PREVENTION AND WELLNESS PROGRAMS;> PARTNERSHIPS: LEVERAGE PARTNERSHIPS TO ADDRESS SOCIOECONOMIC DISADVANTAGES THAT AFFECT HEALTH;> CAPACITY BUILDING: IMPROVE COMMUNITY HEALTH THROUGH COLLABORATIVE PARTNERSHIPS, ECONOMIC AND WORKFORCE DEVELOPMENT, AND ADVOCACY.WHEN REVIEWING APPLICATIONS, THE PRIORITIES FOR THE COMMUNITY PARTNERSHIP FUND INCLUDE:> ACTIVITIES THAT ADDRESS A PRIORITY AREA OF NEED IDENTIFIED IN OUR HOSPITALS' COMMUNITY HEALTH NEEDS ASSESSMENTS;> ACTIVITIES THAT TARGET POPULATIONS IN ADVENTIST HEALTHCARE'S SERVICE AREA THAT ARE SOCIALLY AND ECONOMICALLY DISADVANTAGED OR MEDICALLY UNDERSERVED;> ACTIVITIES THAT ALIGN WITH ADVENTIST HEALTHCARE'S COMMUNITY-BASED MISSION;> ACTIVITIES THAT HAVE A MEASURABLE IMPACT ON THE COMMUNITY BEING SERVED.AREAS OF NEED NOT DIRECTLY ADDRESSED BY ADVENTIST HEALTHCARE PHYSICAL HEALTH AND REHABILITATION AND THE RATIONALE:ADVENTIST HEALTHCARE REHABILITATION DOES NOT DIRECTLY ADDRESS THE AREAS OF NEED INCLUDED BELOW THROUGH ONGOING EDUCATION OR PROGRAMMING. HOWEVER, THESE AREAS MAY BE ADDRESSED THROUGH THE ADVENTIST HEALTHCARE COMMUNITY PARTNERSHIP FUND WHICH AIMS TO PROVIDE FUNDING FOR COMMUNITY ORGANIZATIONS WORKING TO ADDRESS NEEDS IDENTIFIED IN OUR COMMUNITY HEALTH NEEDS ASSESSMENT.> SPINAL CORD INJURY, LYMPHEDEMA, AND ORTHOPEDICS: ADVENTIST HEALTHCARE REHABILITATION DOES NOT CURRENTLY PROVIDE ONGOING COMMUNITY OUTREACH OR PROGRAMS SPECIFIC TO SPINAL CORD INJURY, LYMPHEDEMA, AND ORTHOPEDICS DUE TO LIMITED RESOURCES, AND A FOCUS ON AREAS THAT WERE IDENTIFIED AS HIGHER PRIORITY DURING THE CHNA PRIORITIZATION PROCESS.;> CARDIOVASCULAR HEALTH, CANCER, OBESITY, AND DIABETES: ADVENTIST HEALTHCARE REHABILITATION DOES NOT CURRENTLY PROVIDE ONGOING COMMUNITY OUTREACH OR PROGRAMS SPECIFIC TO CHRONIC DISEASE DUE TO LIMITED RESOURCES, AND A FOCUS ON AREAS THAT WERE IDENTIFIED AS HIGHER PRIORITY DURING THE CHNA PRIORITIZATION PROCESS. CHRONIC DISEASE IS BEING ADDRESSED BY OTHER ORGANIZATIONS IN THE COMMUNITY INCLUDING WASHINGTON ADVENTIST HOSPITAL AND SHADY GROVE MEDICAL CENTER, BOTH OF WHICH ARE PART OF THE ADVENTIST HEALTHCARE SYSTEM.;> SOCIAL DETERMINANTS OF HEALTH (HOUSING, FOOD ACCESS, EDUCATION): ADVENTIST HEALTHCARE REHABILITATION DOES NOT CURRENTLY PROVIDE ONGOING COMMUNITY OUTREACH OR PROGRAMS SPECIFIC TO HOUSING, FOOD ACCESS, AND EDUCATION DUE TO LIMITED RESOURCES, AND A FOCUS ON AREAS THAT WERE IDENTIFIED AS HIGHER PRIORITY DURING THE CHNA PRIORITIZATION PROCESS.FOR ADDITIONAL DETAILS INCLUDING THE CHNA FINDINGS, GOALS, AND RELEVANT LOCALLY AVAILABLE RESOURCES PLEASE SEE ADVENTIST HEALTHCARE REHABILITATION'S CHNA AND IMPLEMENTATION STRATEGY WHICH CAN BE FOUND HERE: HTTP://WWW.ADVENTISTHEALTHCARE.COM/ABOUT/COMMUNITY/HEALTH-NEEDS-ASSESSMENT/#OTHER-ENTITIES ADVENTIST REHABILITATION HOSPITAL OF MD PART V, SECTION B, LINE 16J: THE POLICY IS ALSO STRATEGICALLY POSTED AT OUR PATIENT FINANCIAL SERVICES OFFICE.PART V, SECTION B, LINE 16A: HTTP://WWW.ADVENTISTHEALTHCARE.COM/LOCATIONS/WASHINGTON-ADVENTIST- HOSPITAL/INFO/PATIENTS/BILLING/CHARITY-CARE/#.VZ1L_19VHHWHTTP://WWW.ADVENTISTHEALTHCARE.COM/LOCATIONS/SHADY-GROVE-MEDICAL- CENTER/INFO/PATIENTS/BILLING/CHARITY-CARE/#.VZ1MJF9VHHWPART V, SECTION B, LINE 16B: SAME URLS AS LISTED ON LINE 16APART V, SECTION B, LINE 16C: SAME URLS AS LISTED ON LINE 16A ANDHTTP://WWW.ADVENTISTHEALTHCARE.COM/LOCATIONS/PHYSICAL-HEALTH- REHABILITATION/INFO/PATIENTS/BILLING/#.VZ1UHL9VHHWHTTP://WWW.ADVENTISTHEALTHCARE.COM/INFO/#BILL-PAY,.VZ1ZYF9VHHW 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 FOLLOW:- 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: FOR PURPOSES OF PREPARING SCHEDULE H OF FORM 990, ADVENTIST REHABILITATION HOSPITAL OF MARYLAND CALCULATED A COST TO CHARGE RATIO AS REFLECTED IN ITS 2016 AUDITED FINANCIAL STATEMENTS. THE COST TO CHARGE RATIO WAS USED TO REDUCE THE YEARLY CHARITY CARE PROVISION FROM CHARGE TO COST. PART I, LINE 7G: SUBSIDIZED HEALTH SERVICES INCLUDED PAYMENTS FOR NON-EMPLOYED BUT HOSPITAL-BASED PHYSICIANS, NON-RESIDENT HOSPITAL STAFF, HOSPITALISTS, EMERGENCY ON-CALL, OFF-CAMPUS EMERGENCY CENTER, AND WOMEN'S AND CHILDREN'S SERVICES SUBSIDIES. PART II, COMMUNITY BUILDING ACTIVITIES: ADVENTIST REHABILITATION HOSPITAL OF MARYLAND, INC.'S COMMUNITY BUILDING ACTIVITIES WERE DONE JOINTLY AT THE CORPORATE LEVEL WITH ADVENTIST HEALTHCARE, INC. TO CENTRALIZE THE ACTIVITIES PERFORMED AS A SYSTEM. ADVENTIST REHABILITATION HOSPITAL OF MARYLAND, INC. PLAYED AN INTEGRAL ROLE AND CONTRIBUTED TO SEVERAL OUTREACH PROGRAMS AS PART OF ITS MISSION. ADVENTIST REHABILITATION HOSPITAL OF MARYLAND, INC. AND ADVENTIST HEALTHCARE'S MISSION IS "WE EXTEND GOD'S CARE THROUGH THE MINISTRY OF PHYSICAL, MENTAL AND SPIRITUAL HEALING." ADVENTIST REHABILITATION HOSPITAL OF MARYLAND, INC. AND ADVENTIST HEALTHCARE GO BEYOND TRADITIONAL HOSPITAL CARE TO OFFER EXPERTISE AND RESOURCES THAT HELP STRENGTHEN THE COMMUNITY'S INFRASTRUCTURE IN A WAY THAT PROMOTES HEALTH AND WELL-BEING.IN 2016, A MAJORITY OF ADVENTIST HEALTHCARE'S COMMUNITY BUILDING ACTIVITIES CONSISTED OF: POPULATION HEALTH INITIATIVES AND ASSISTING PHYSICIANS IN ESTABLISHING ELECTRONIC MEDICAL RECORDS (EMR) SYSTEMS; ADVOCATING ON COMMUNITY HEALTH IMPROVEMENTS THROUGH OUR GOVERNMENT RELATIONS AND PUBLIC POLICY DEPARTMENT; PERFORMING DISASTER PREPAREDNESS ACTIVITIES; CREATING HEALTH PARTNERSHIPS WITHIN THE COMMUNITY THROUGH OUR DIVISION OF THE CENTER FOR HEALTH EQUITY & WELLNESS DEPARTMENT; AND ESTABLISHING ADDITIONAL COMMUNITY PARTNERSHIPS.POPULATION HEALTH INITIATIVES & THE AMBULATORY CARE EMR SUPPORT (ACES) PROGRAM:1) ACCOUNTABLE CARE ORGANIZATIONS (ACO):ADVENTIST HEALTHCARE HAS A 50% INTEREST IN THE MID-ATLANTIC PRIMARY CARE ACO, LLC PARTNERSHIP. THIS ACO IS A PHYSICIAN-LED MEDICARE SHARED SAVINGS PROGRAM (MSSP) IN MONTGOMERY COUNTY, MARYLAND. THE GOAL OF AN ACO IS TO DELIVER SEAMLESS, HIGH-QUALITY CARE FOR MEDICARE BENEFICIARIES IN A PATIENT-CENTERED ENVIRONMENT, WHERE THE PATIENT AND PROVIDERS ARE TRUE PARTNERS IN CARE DECISIONS. THE GOAL OF THE ACO INCLUDES, BUT IS NOT LIMITED TO, THE PROMOTION OF EVIDENCE-BASED MEDICINE, THE PROMOTION OF PATIENT ENGAGEMENT AND THE DEVELOPMENT OF AN INFRASTRUCTURE FOR NETWORK PROVIDERS AND SUPPLIERS TO INTERNALLY REPORT ON QUALITY AND COST METRICS. THIS INTERNAL REPORTING ENABLES THE ACO TO MONITOR, PROVIDE FEEDBACK AND EVALUATE ITS NETWORK PROVIDERS AND SUPPLIERS' PERFORMANCE AND TO USE THESE RESULTS TO PROVIDE BETTER CARE FOR INDIVIDUALS, IMPROVED HEALTH FOR POPULATIONS AND LOWER PER CAPITA GROWTH IN EXPENDITURES FOR MSSP ENROLLEES.2) CLINICALLY INTEGRATED NETWORK: ADVENTIST HEALTHCARE MANAGES THE ONE HEALTH QUALITY ALLIANCE, LLC (OHQA) PARTNERSHIP 100%, A CLINICALLY INTEGRATED NETWORK DESIGNED TO HELP PROVIDERS ENHANCE THE QUALITY OF HEALTHCARE AND LOWER TOTAL COSTS FOR THE WASHINGTON, D.C. REGION. OHQA, MANAGED BY ADVENTIST HEALTHCARE, IS AN INNOVATIVE HEALTHCARE DELIVERY NETWORK IN WHICH PARTICIPATING PRACTICES AND THEIR PATIENTS BENEFIT FROM THE VALUE CREATED BY THE ALLIANCE.3) PRIMARY CARE:ADVENTIST PHYSICIAN SERVICES, INC. D/B/A ADVENTIST HEALTHCARE ADVENTIST MEDICAL GROUP IS A DIVISION OF ADVENTIST HEALTHCARE AND AN AFFILIATE OF THE GW MEDICAL FACULTY ASSOCIATES. IT INCLUDES TEN PRIMARY CARE PRACTICES AND 34 SPECIALTY PRACTICES. THE GOAL OF THESE PRACTICES IS TO PROVIDE ACCESSIBLE, HIGH-QUALITY CARE TO THE COMMUNITY. TO ACHIEVE THIS GOAL, THE STRATEGIES INCLUDE SUPERB ACCESS TO CARE, PATIENT ENGAGEMENT IN CARE, CLINICAL INFORMATION SYSTEMS INTEGRATION AND PATIENT REGISTRY CARE COORDINATION.4) AMBULATORY CARE EMR SUPPORT (ACES) PROGRAM:ADVOCATING FOR COMMUNITY HEALTH IMPROVEMENTS IS A CORE STRATEGY IN ACHIEVING ADVENTIST HEALTHCARE'S MISSION. A PROGRAM THAT ADVENTIST HEALTHCARE OFFERS, WHICH IS AT THE CORE OF ADVOCATING FOR COMMUNITY HEALTH IMPROVEMENTS, IS AMBULATORY CARE EMR SUPPORT (ACES). THE ACES PROGRAM ASSISTS COMMUNITY PHYSICIANS WITH THE ACQUISITION AND IMPLEMENTATION OF ELECTRONIC MEDICAL RECORDS (EMRS). EMRS ENHANCE PATIENT CARE AND MAKES PRACTICES MORE EFFICIENT.GOVERNMENT RELATIONS AND PUBLIC POLICY DEPARTMENT INITIATIVES:THROUGHOUT 2016, ADVENTIST HEALTHCARE WAS AN ACTIVE PARTICIPANT WITHIN A NUMBER OF COMMUNITY ORGANIZATIONS AS PART OF OUR EFFORTS TO ADVOCATE FOR IMPROVEMENTS TO COMMUNITY HEALTH AND ECONOMIC DEVELOPMENT. THROUGH OUR PARTNERSHIP WITH LOCAL CHAMBERS OF COMMERCE, INCLUDING THE GAITHERSBURG?GERMANTOWN AND MONTGOMERY COUNTY CHAMBERS, WE HAVE WORKED TO SUPPORT INITIATIVES THAT PROVIDE ECONOMIC IMPROVEMENTS IN THE COMMUNITIES WE SERVE.ADVENTIST HEALTHCARE HAS ALSO BEEN A FIRM ADVOCATE FOR COMMUNITY HEALTH IMPROVEMENTS THROUGH OUR ADVOCACY WORK WITH LOCAL, STATE AND FEDERAL OFFICIALS. WHETHER WORKING DIRECTLY WITH ELECTED OFFICIALS OR THE COMMUNITY ORGANIZATIONS, WE HAVE WORKED TO SUPPORT LEGISLATION THAT IMPROVES ACCESS TO HEALTH SERVICES, STRENGTHENS INVESTMENT IN EDUCATIONAL INSTITUTIONS, EXPANDS ACCESS TO INSURANCE AND REDUCES OVERALL HEALTH CARE SPENDING. THROUGH OUR PARTNERSHIP WITH THE MARYLAND HOSPITAL ASSOCIATION, WE WORKED EXTENSIVELY ON LEGISLATION RELATED TO BEHAVIORAL HEALTH FUNDING AND SUPPORT FOR A BEHAVIORAL HEALTH TASK FORCE TO ADDRESS ISSUES AND POLICY SOLUTIONS. WE WERE ACTIVELY ENGAGED WITH THE MENTAL HEALTH ASSOCIATION OF MARYLAND TO PROVIDE GREATER ACCESS TO BEHAVIORAL HEALTH SERVICES FOR THOSE WHO NEED IT BY REDUCING BARRIERS TO ENTRY FOR CARE, SUCH AS PROVIDING TELEMEDICINE SERVICES IN UNDERSERVED AREAS, ATTRACTING MORE BEHAVIORAL HEALTH PROVIDERS TO MARYLAND AND ADDRESSING BED CAPACITY ISSUES.DISASTER PREPAREDNESS ACTIVITIES:ADVENTIST HEALTHCARE TOOK MANY MEASURES TO ENSURE OUR COMMUNITY HOSPITALS WERE READY AND PREPARED FOR EMERGENCY SITUATIONS, SUCH AS A MEDICAL SURGE IN PATIENTS, ACTIVE SHOOTER/ARMED INTRUDER SCENARIOS AND UNFORESEEN DISASTERS. THE SAFETY MANAGEMENT AND EMERGENCY PREPAREDNESS TEAM OF EMPLOYEES SPENDS A LARGE PART OF THEIR TIME ON EMERGENCY MANAGEMENT. THIS INCLUDES MONTHLY MEETINGS WITH THE HOSPITALS IN THE REGION, AS WELL AS MONTHLY MEETINGS WITH ALL ADVENTIST HEALTHCARE HOSPITALS AND OTHER RELATED AGENCIES IN THE COUNTY, SUCH AS MONTGOMERY COUNTY HEALTH DEPARTMENT AND THE MARYLAND INSTITUTE FOR EMERGENCY MEDICINE SERVICE SYSTEMS. OUR TEAM PREFORMS TWO FULL SCALE EXERCISES EVERY YEAR, TO TEST OUR EMERGENCY MANAGEMENT PROGRAMS, WHICH INVOLVES THE SIMULATION OF AN EMERGENCY OR DISASTER TO WHICH WE AND THE REST OF THE REGION MUST BE READY TO RESPOND TOGETHER. ADVENTIST HEALTHCARE ALSO HAS AN ENVIRONMENT OF CARE COMMITTEE, WHICH MEETS MONTHLY AT EACH OF OUR HOSPITALS. TIME IS ALLOCATED TO DISCUSS EMERGENCY MANAGEMENT MATTERS AT THESE MEETINGS.HEALTH PARTNERSHIPS WITHIN THE COMMUNITY - THE CENTER FOR HEALTH EQUITY & WELLNESS:THE CENTER FOR HEALTH EQUITY & WELLNESS (CHEW), A DIVISION OF ADVENTIST HEALTHCARE, AIMS TO IMPROVE THE HEALTH OF COMMUNITIES SERVED BY ADVENTIST HEALTHCARE. IT DOES THIS BY RAISING AWARENESS OF COMMUNITY HEALTH NEEDS AND LOCAL DISPARITIES, IMPROVING ACCESS TO CULTURALLY APPROPRIATE CARE AND PROVIDING COMMUNITY WELLNESS OUTREACH AND EDUCATION. A TEAM OF HEALTH EDUCATORS, CLINICAL CARE COORDINATORS, NURSES, PATIENT NAVIGATORS AND PUBLIC HEALTH RESEARCHERS AND INTERNS WORK TOGETHER TO ENSURE THE DELIVERY OF POPULATION-BASED CARE AND PROMOTE HEALTH EQUITY IN THE COMMUNITIES WE SERVE. CHEW PARTNERED WITH MANY HEALTH ORGANIZATIONS AND THE FOLLOWING IS A SUMMARY:1) FAITH COMMUNITY NURSE NETWORK (FCN):ADVENTIST HEALTHCARE, THROUGH OUR FAITH COMMUNITIES HEALTH NETWORK, SERVES THE LOCAL COMMUNITIES OF FAITH BY "PROVIDING GUIDANCE AND EXPERTISE, EMPOWERING THEM TO BECOME PLACES OF HEALTH AND HEALING, RESULTING IN IMPROVED WHOLE PERSON HEALTH" (MISSION). OUR VISION SPEAKS TO THE PARTNERSHIP WITH COMMUNITIES OF FAITH AND TOGETHER WE CAN HELP ACHIEVE A "THRIVING CULTURE DEMONSTRATING PHYSICAL, MENTAL AND SPIRITUAL HEALING." LASTLY, OUR COMMITMENT IS TO HELP OUR COMMUNITIES OF FAITH TO DEVELOP STRONG HEALTH MINISTRIES TO REACH THE MEMBERS AND SURROUNDING COMMUNITIES. THIS IS ACCOMPLISHED THROUGH THE ON-GOING TRAINING OF THE FAITH COMMUNITY NURSES, HEALTH MINISTERS, HEALTH TEAMS AND ADMINISTRATORS, SUPPLYING EVIDENCE-BASED EDUCATION AND TOOLS NECESSARY TO ASSESS THE NEEDS, OUTLINE LIFESTYLE STRATEGIES, IMPLEMENT HEALTH PROGRAMMING (BASED ON ASSESSMENT RESULTS), IDENTIFICATION AND MANAGEMENT OF DISEASE RISK FACTORS TO LOWER RISKS, ON-GOING MEASUREMENT AND EVALUATION OF HEALTH OUTCOMES, THEREBY INCREASING THE POTENTIAL FOR OPTIMAL HEALTH AND WHOLENESS. LOCAL CHURCHES CAN BRING A HOLISTIC PERSPECTIVE TO AN UNDERSTANDING OF HEALTH AS BEING IN HARMONY WITH ONES SELF, ONE'S GOD, OTHERS AND THE ENVIRONMENT. THE CHURCH IS A KNOWN AND TRUSTED PLACE WHERE PEOPLE FEEL COMFORTABLE IN THEIR MOST VULNERABLE HOUR. IT IS A NATURAL "REFERENCE POINT." IT IS NOT A NEW IDEA FOR CHURCHES TO DEVELOP AND IMPLEMENT HEALTH PROGRAMS. AT ADVENTIST HEALTHCARE, WE BELIEVE THIS TO BE A NATURAL, SYMBIOTIC PARTNERSHIP. 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 2016 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 PAYER AND ESTIMATE THE APPROPRIATE ALLOWANCE FOR DOUBTFUL COLLECTIONS. PART II, COMMUNITY BUILDING ACTIVITIES, CONTINUED: 2) INTERAGENCY COMMISSION ON HOMELESSNESS (ICH):THE INTERAGENCY COMMISSION ON HOMELESSNESS (ICH) IS A COLLABORATIVE GROUP OF REPRESENTATIVES FROM PUBLIC, PRIVATE AND GOVERNMENT ORGANIZATIONS WHO COME TOGETHER TO PROVIDE RECOMMENDATIONS TO THE COUNTY EXECUTIVE AND COUNTY COUNCIL ON BEHALF OF THE HOMELESS RESIDENTS OF MONTGOMERY COUNTY. KIM EMERSON FROM ADVENTIST HEALTHCARE SERVES AS THE HOSPITAL REPRESENTATIVE ON THE ICH, AND CHAIRS THE BEHAVIORAL HEALTH/HOSPITAL & JAIL COMMITTEE, WHERE DISCUSSIONS TAKE PLACE ABOUT THE GAPS IN RESOURCES FOR HOMELESS INDIVIDUALS DISCHARGING FROM THE HOSPITAL OR BEING RELEASED FROM THE JAIL SYSTEM. THE COMMITTEE DISCUSSES WAYS TO PARTNER TO IMPROVE COMMUNICATION BETWEEN HOSPITALS AND COMMUNITY-BASED HOMELESS PROVIDERS, AS WELL AS IMPROVES DISCHARGE PLANNING. THE COMMITTEE IS EXPLORING THE CONCEPT OF MEDICAL RESPITE CARE TO ADDRESS THE UNIQUE MEDICAL, PSYCHIATRIC AND SOCIAL SERVICES NEEDS OF HOMELESS PERSONS DISCHARGING FROM THE HOSPITAL. THROUGH ITS INVOLVEMENT IN THE ICH, ADVENTIST HEALTHCARE HAS BUILT STRONGER RELATIONSHIPS WITH COMMUNITY-BASED HOMELESS SERVICES PROVIDERS AND THE CASE MANAGEMENT DEPARTMENTS AT OTHER LOCAL HOSPITALS. 3) MARYLAND COMMUNITY RESEARCH ADVISORY BOARD (MD-CRAB):THE MARYLAND COMMUNITY RESEARCH ADVISORY BOARD (MD-CRAB) IS COMPRISED OF HEALTH PROFESSIONALS, ACADEMICS, AND COMMUNITY MEMBERS. FORMED BY THE UNIVERSITY OF MARYLAND CENTER FOR HEALTH EQUITY, THE MD-CRAB WORKS TO ENSURE THAT LOCAL HEALTH RESEARCH RESULTS BENEFIT VULNERABLE POPULATIONS, IN PARTICULAR AFRICAN AMERICANS AND LATINOS. THE MD-CRAB SERVES SEVERAL FUNCTIONS, INCLUDING GENERATING MEANINGFUL RESEARCH QUESTIONS; INCREASING AWARENESS AROUND BOTH THE RISKS AND BENEFITS OF PARTICIPATING IN PUBLIC HEALTH AND MEDICAL RESEARCH; SERVING AS A SOUNDING BOARD FOR RESEARCHERS TO PRESENT THEIR IDEAS AND RECEIVE FEEDBACK FROM COLLEAGUES AND COMMUNITY MEMBERS; AND VOICING THE CONCERNS OF UNDERSERVED POPULATIONS TO POLICY MAKERS. IN ENACTING EACH OF THESE FUNCTIONS, THE OVERARCHING GOAL OF THE MD-CRAB IS TO CONTRIBUTE TO THE ELIMINATION OF RACIAL AND ETHNIC HEALTH DISPARITIES BY BUILDING TRUST BETWEEN COMMUNITIES AND RESEARCHERS. ADVENTIST HEALTHCARE HAS BEEN WORKING CLOSELY WITH THE MD-CRAB SINCE ITS INCEPTION. MARILYN LYNK, THE EXECUTIVE DIRECTOR OF THE ADVENTIST HEALTHCARE CENTER FOR HEALTH EQUITY & WELLNESS IS A FOUNDING MEMBER. THROUGH THE WORK OF THE MD-CRAB, ADVENTIST HEALTHCARE HAS HAD THE OPPORTUNITY TO SHAPE AND GUIDE LOCAL RESEARCH THROUGH A HEALTH EQUITY LENS IN ORDER TO TRULY BENEFIT THE COMMUNITIES AT ITS CENTER. OUR WORK WITH THE MD-CRAB HAS ALSO LED TO COLLABORATION OPPORTUNITIES ON LOCAL PROGRAMS AND RESEARCH TAKING PLACE. MOST RECENTLY, WE HAVE HAD THE OPPORTUNITY TO WORK WITH THE MARYLAND CENTER FOR HEALTH EQUITY ON THEIR "HEALTH ADVOCATES IN-REACH AND RESEARCH" (HAIR) PROGRAM. FOCUSING ON THE AFRICAN AMERICAN POPULATION IN PRINCE GEORGE'S COUNTY, THE GOAL OF THIS PROGRAM IS TO MOBILIZE BARBERSHOPS AND BEAUTY SALONS IN PROMOTING HEALTH EDUCATION, PARTICULARLY AROUND COLORECTAL CANCER SCREENING. THROUGH THIS PROGRAM, WE HAVE BEEN ABLE TO HELP BUILD TRUST AND MEANINGFUL RELATIONSHIPS WITH THE BARBERSHOPS, SALONS, AND THE COMMUNITY. SUPPLEMENTING THE COLORECTAL CANCER EDUCATION, OUR HEALTH EDUCATORS HAVE BEEN CONDUCTING REGULAR SCREENINGS SUCH AS BLOOD PRESSURE, CARBON MONOXIDE, AND BODY COMPOSITION AT PARTICIPATING BARBERSHOP AND SALON LOCATIONS. IN ADDITION TO THE SCREENINGS, OUR HEALTH EDUCATORS ALSO CONNECT COMMUNITY MEMBERS WITH FREE HEALTH RESOURCES SUCH AS PRE-DIABETES CLASSES AND TOBACCO CESSATION PROGRAMS OFFERED BY ADVENTIST HEALTHCARE.4) HEALTHY MONTGOMERY:HEALTHY MONTGOMERY IS THE LOCAL HEALTH IMPROVEMENT COALITION FOR MONTGOMERY COUNTY, MARYLAND. ADVENTIST HEALTHCARE PARTNERS WITH AND SUPPORTS HEALTHY MONTGOMERY BOTH STRATEGICALLY AND FINANCIALLY. REPRESENTATIVES FROM ADVENTIST HEALTHCARE SIT ON THE HEALTHY MONTGOMERY STEERING COMMITTEE, THE BEHAVIORAL HEALTH WORKGROUP, AND THE COMMUNITY HEALTH NEEDS ASSESSMENT COMMITTEE, AMONG OTHERS. ADVENTIST HEALTHCARE ALSO CONTRIBUTES $50,000 ANNUALLY TO SUPPORT THE INFRASTRUCTURE OF HEALTHY MONTGOMERY. HEALTHY MONTGOMERY, IN PARTNERSHIP WITH COMMUNITY STAKEHOLDERS SUCH AS LOCAL POLICY MAKERS, HOSPITALS, ADVOCACY GROUPS AND ACADEMIC INSTITUTIONS, AMONG OTHERS, REVIEWS THE NEEDS AND RESOURCES IN THE COUNTY AND WORKS TO SET PRIORITIES FOR IMPROVING HEALTH AND WELL-BEING. THE OVERALL GOALS OF HEALTHY MONTGOMERY ARE TO IMPROVE ACCESS TO HEALTH AND SOCIAL SERVICES, ACHIEVE HEALTH EQUITY FOR ALL RESIDENTS, AND ENHANCE THE PHYSICAL AND SOCIAL ENVIRONMENT TO SUPPORT OPTIMAL HEALTH AND WELL-BEING. AMONG ITS MANY ACCOMPLISHMENTS, HEALTHY MONTGOMERY HAS BEEN ABLE TO PROVIDE LOCAL LEVEL DATA THAT IS STRATIFIED BY SEX, AGE, RACE, AND ETHNICITY. BY MAKING THIS DATA MORE EASILY AVAILABLE, COMMUNITY STAKEHOLDERS, ADVENTIST HEALTHCARE INCLUDED, ARE BETTER ABLE TO IDENTIFY NEEDS IN THE COMMUNITY THAT MAY HAVE OTHERWISE BEEN MASKED BY LESS GRANULAR DATA. THIS ALLOWS FOR MORE STRATEGIC AND TARGETED HEALTH PREVENTION AND PROMOTION PROGRAMMING TO BE DEVELOPED.ESTABLISHING ADDITIONAL COMMUNITY PARTNERSHIPS:ADVENTIST HEALTHCARE PARTNERED WITH SEVERAL ORGANIZATIONS, SUCH AS WITH WASHINGTON ADVENTIST UNIVERSITY (WAU) TO IMPROVE PATIENT CARE. WAU IS A CHRIST-CENTERED INSTITUTION OF HIGHER EDUCATION THAT SUPPORTS A CULTURE OF EXCELLENCE WHERE ALL FEEL VALUED AND WHICH HELPS EDUCATE FUTURE HEALTHCARE WORKERS.ANOTHER VITAL ORGANIZATION, WHICH ADVENTIST HEALTHCARE PARTNERED WITH, WAS WITH THE COLUMBIA UNION CONFERENCE OF SEVENTH-DAY ADVENTISTS (COLUMBIA UNION). COLUMBIA UNION OVERSEES ADVENTIST ORGANIZATIONS IN MARYLAND, VIRGINIA, NEW JERSEY, DELAWARE, AND WASHINGTON D.C. TOGETHER WITH ADVENTIST HEALTHCARE, IT HELPS PROMOTE THE IMPORTANCE OF HEALTH AND WELLNESS THROUGHOUT ITS REGION.ADVENTIST REHABILITATION HOSPITAL OF MARYLAND, INC. AND ADVENTIST HEALTHCARE AS A SYSTEM CONTINUES TO PROVIDE COMMUNITY BUILDING ACTIVITIES IN 2017. PROVIDING COMMUNITY BUILDING ACTIVITIES IS ESSENTIAL TO ACHIEVING AND MAINTAINING OUR MISSION. PART III, LINE 4: PATIENT ACCOUNTS RECEIVABLE ARE REPORTED AT NET REALIZABLE VALUE. ACCOUNTS ARE WRITTEN OFF WHEN THEY ARE DETERMINED TO BE UNCOLLECTIBLE BASED UPON MANAGEMENT'S ASSESSMENT OF INDIVIDUAL ACCOUNTS. IN EVALUATING THE COLLECTABILITY OF PATIENT ACCOUNTS RECEIVABLE, THE CORPORATION ANALYZES ITS PAST HISTORY AND IDENTIFIES TRENDS FOR EACH OF ITS MAJOR PAYOR SOURCES OF REVENUE TO ESTIMATE THE APPROPRIATE ALLOWANCE FOR DOUBTFUL COLLECTIONS AND PROVISION FOR DOUBTFUL COLLECTIONS. FOR PATIENT ACCOUNTS RECEIVABLE ASSOCIATED WITH SERVICES PROVIDED TO PATIENTS WHO HAVE THIRD-PARTY COVERAGE, THE CORPORATION ANALYZES CONTRACTUALLY DUE AMOUNTS AND PROVIDES AN ALLOWANCE FOR DOUBTFUL COLLECTIONS AND PROVISION FOR DOUBTFUL COLLECTIONS, IF NECESSARY. FOR RECEIVABLES ASSOCIATED WITH SELF-PAY PATIENTS (WHICH INCLUDES BOTH PATIENTS WITHOUT INSURANCE AND PATIENTS WITH DEDUCTIBLE AND COPAYMENT BALANCES DUE FOR WHICH THIRD-PARTY COVERAGE EXISTS FOR PART OF THE BILL), THE CORPORATION RECORDS A PROVISION FOR DOUBTFUL COLLECTIONS IN THE PERIOD OF SERVICE ON THE BASIS OF ITS PAST EXPERIENCE, WHICH INDICATES THAT MANY PATIENTS ARE UNABLE TO PAY THE PORTION OF THEIR BILL FOR WHICH THEY ARE FINANCIALLY RESPONSIBLE. THE DIFFERENCE BETWEEN THE BILLED RATES AND THE AMOUNTS ACTUALLY COLLECTED AFTER ALL REASONABLE COLLECTION EFFORTS HAVE BEEN EXHAUSTED IS CHARGED OFF AGAINST THE ALLOWANCE FOR DOUBTFUL COLLECTIONS. PART III, LINE 8: MEDICARE:IN ORDER TO DETERMINE THE COST OF PROVIDING MEDICARE SERVICES, WE MULTIPLIED TOTAL MEDICARE CHARGES PER THE HOSPITAL'S GENERAL LEDGER TIMES THE COST TO CHARGE RATIO REFLECTED IN THE ENTITY'S INCOME STATEMENT.WE ESTIMATED TOTAL PAYMENTS RECEIVED BY MULTIPLYING THE HISTORICAL COLLECTION PERCENTAGE OF MEDICARE ACCOUNTS TIMES TOTAL MEDICARE CHARGES AS REPORTED IN THE HOSPITAL'S GENERAL LEDGER.THE SURPLUS REPORTED REPRESENTS THE DIFFERENCE BETWEEN TOTAL ESTIMATED MEDICARE RECEIPTS AND TOTAL ALLOWABLE ESTIMATED COSTS INCURRED TO TREAT THE HOSPITAL'S MEDICARE PATIENTS. 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.> WHERE 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 15 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) WHERE A DEBTOR EXPRESSES A DESIRE TO COMPLETE THE APPLICATION FOR FINANCIAL ASSISTANCE, THEY WILL BE REFERRED TO THE OFFICE OF ADVENTIST HEALTHCARE'S MANAGER OF COLLECTIONS / CUSTOMER SERVICE (301-315-3660). THE COLLECTION AGENCY WILL PLACE THE ACCOUNT ON "HOLD" FOR 2 WEEKS TO ALLOW THE DEBTOR AMPLE TIME TO COMPLETE A FINANCIAL ASSISTANCE APPLICATION.4) WHERE THE DEBTOR HAS COMPLETED THE APPLICATION FOR FINANCIAL ASSISTANCE, AND BEEN APPROVED, THE AGENCY WILL RECEIVE IMMEDIATE NOTIFICATION FROM THE MANAGER OF COLLECTIONS/CUSTOMER SERVICE. NOTIFICATION WILL INCLUDE THE AMOUNT OF DEBT REDUCTION THE DEBTOR QUALIFIED FOR. THE MANAGER OF COLLECTIONS/CUSTOMER SERVICE WILL ADJUST THE DEBTOR'S BALANCE ON ADVENTIST HEALTHCARE'S BOOKS. PART VI, LINE 2: ADVENTIST HEALTHCARE REHABILITATION IS A MEMBER OF ADVENTIST HEALTHCARE, WHICH FORMED A COMMUNITY BENEFIT COUNCIL (CBC) TO GUIDE AND LEAD ITS COMMUNITY BENEFIT ACTIVITIES, INCLUDING CONDUCTING THE COMMUNITY HEALTH NEEDS ASSESSMENT. AS A STARTING POINT, THE CBC RESEARCHED TOPICS IN ALIGNMENT WITH MONTGOMERY COUNTY'S HEALTHY MONTGOMERY FOCUS AREAS OF CANCER, CARDIOVASCULAR DISEASE, DIABETES, MATERNAL AND INFANT HEALTH, BEHAVIORAL HEALTH, AND OBESITY. THE CBC ALSO DECIDED TO RESEARCH ADDITIONAL TOPICS OF INTEREST TO THE HOSPITAL INCLUDING GENERAL REHABILITATION, BRAIN INJURY, SPINAL CORD INJURY, ASTHMA, INFLUENZA, HIV/AIDS, SENIOR HEALTH, INCOME AND POVERTY, ACCESS TO CARE/HEALTH INSURANCE COVERAGE, FOOD ACCESS, HOUSING QUALITY, EDUCATION, AND TRANSPORTATION. ALL OF THE TOPICS INCLUDED IN THIS COMMUNITY HEALTH NEEDS ASSESSMENT WERE REVIEWED, DISCUSSED AND APPROVED BY THE COMMUNITY BENEFIT ADVISORY BOARD. THE ADVISORY BOARD WAS ESTABLISHED IN 2006 TO HELP GUIDE OUR EFFORTS TO REDUCE AND ELIMINATE HEALTH DISPARITIES, TO IDENTIFY COMMUNITY NEEDS, AND TO HELP ASSESS AND DIRECT OUR RESPONSES TO THOSE NEEDS. THE ADVISORY BOARD IS COMPRISED OF BOTH INTERNAL AND EXTERNAL (COMMUNITY) LEADERS WHICH INCLUDE CLINICIANS, RESEARCHERS, ADMINISTRATORS AND OTHER HOSPITAL STAFF, COMMUNITY-BASED ORGANIZATIONS, LOCAL AND STATE HEALTH DEPARTMENTS, THE UNIVERSITY OF MARYLAND, THE NATIONAL INSTITUTES OF HEALTH (SPECIFICALLY, THE NATIONAL INSTITUTE OF MINORITY HEALTH AND HEALTH DISPARITIES), AND OTHER PUBLIC HEALTH STAKEHOLDER ORGANIZATIONS. AFTER COMPLETION OF THE COMMUNITY HEALTH NEEDS ASSESSMENT, FINDINGS WERE REVIEWED BY PRESIDENT'S COUNCIL AT ADVENTIST HEALTHCARE REHABILITATION. AFTER DISCUSSION AND CONSIDERATION OF COMMUNITY INPUT AND AVAILABLE RESOURCES, BOTH INTERNAL AND THROUGH PARTNERSHIPS, IT WAS DETERMINED THAT THE MOST STRATEGICALLY IMPACTFUL AREA OF FOCUS FOR THE IMPLEMENTATION STRATEGY WOULD BE COMPREHENSIVE CONCUSSION CARE. IN ADDITION TO INPUT FROM OUR ADVISORY BOARD, THE COMMUNITY PERSPECTIVE WAS OBTAINED THROUGH A COMMUNITY HEALTH NEEDS ASSESSMENT SURVEY OFFERED BOTH IN PERSON AT COMMUNITY EVENTS AND ELECTRONICALLY VIA SOCIAL MEDIA, NEWSLETTERS, EMAIL LISTSERVS, MEETINGS WITH COMMUNITY LEADERS, AND HEALTH FAIRS. ADDITIONAL COMMUNITY FEEDBACK WAS RECEIVED THROUGH FOCUS GROUPS CONDUCTED BY HEALTHY MONTGOMERY, THE LOCAL HEALTH IMPROVEMENT COALITION FOR MONTGOMERY COUNTY, MARYLAND.AT ADVENTIST HEALTHCARE REHABILITATION, WE STRIVE TO PROVIDE THE BEST CUSTOMER SERVICE EXPERIENCE POSSIBLE FOR OUR PATIENTS AND THEIR LOVED ONES. WE FOCUS ON EACH PATIENT INDIVIDUALLY AND CARE FOR THE WHOLE PERSON THROUGH THE REHABILITATIVE PROCESS. HEALTHSTREAM ADMINISTERS OUR CUSTOMER SATISFACTION SURVEYS AND WE CONTINUOUSLY ANALYZE OUR SCORES TO IMPROVE OUR OUTCOMES. ACUTE REHABILITATION HOSPITALS THROUGHOUT THE COUNTRY ENTER DATA INTO A NATIONAL DATABASE AS A MEANS TO REPORT OUTCOMES AND AS A WAY TO EVALUATE AND IMPROVE OVERALL RESULTS. WE STRIVE TO GET EACH PATIENT BACK TO THE COMMUNITY AS QUICKLY AND SAFELY AS POSSIBLE. OUR OUTCOMES FOR PATIENTS DISCHARGED DURING A SPECIFIED PERIOD WERE REPORTED IN OUR 2013 AND 2016 CHNAS.THE CENTERS FOR MEDICARE AND MEDICAID SERVICES (CMS) BREAKS DOWN THE DIAGNOSTIC CATEGORIES FOR PATIENTS THAT UTILIZE ACUTE REHABILITATION SERVICES INTO 21 REHAB IMPAIRMENT CATEGORIES CALLED RIC'S. THE 21 RIC'S ARE FURTHER GROUPED INTO CMGS OR CASE MIX GROUPS. ALL ACUTE REHAB HOSPITALS SUBMIT THEIR DATA TO CMS; THUS, WE CAN COMPARE OURSELVES TO OTHERS NATIONWIDE AS WELL AS TO OUR REGIONAL AREA, WHICH INCLUDES DE, MD, VA, DC, NC, SC, WV, GA AND FL. OUR VOLUMES ARE COMPARABLE TO THE NATION AND REGION. WE ARE PROUD TO HAVE A HIGHER PERCENTAGE OF BRAIN INJURY PATIENTS WHO ARE DISCHARGED TO COMMUNITY THAN THE NATION - THIS SPEAKS TO STRONG CLINICAL OUTCOMES WITH OUR BRAIN INJURY PROGRAM. OUR SPINAL CORD INJURY VOLUMES AND OUR STROKE VOLUMES ARE ALSO HIGHER DISCHARGED HOME AT A HIGHER RATE THAN THE NATION AND REGION.LOCALLY, WE WORKED WITH MONTGOMERY COUNTY'S HEALTH AND HUMAN SERVICES, COMMUNITY HEALTH IMPROVEMENT PROCESS (CHIP), TO REVIEW THE STATE OF MARYLAND'S STATE HEALTH IMPROVEMENT PROCESS' (SHIP) 39 HEALTH INDICATORS. ADVENTIST HEALTHCARE HAS REPRESENTATION ON THE HEALTHY MONTGOMERY STEERING COMMITTEE. THIS GROUP DEVELOPED THE HEALTHY MONTGOMERY WEBSITE: HTTP://WWW.HEALTHYMONTGOMERY.ORG. THIS WEBSITE IS A ONE-STOP SOURCE OF POPULATION-BASED DATA AND INFORMATION ABOUT COMMUNITY HEALTH AND OUTLINES THIRTY-THREE COMMUNITY INDICATORS. THE PURPOSE OF THE MONTGOMERY COUNTY HEALTHY MONTGOMERY COMMUNITY HEALTH IMPROVEMENT PROCESS IS TO ADDRESS THE NEED OF ORGANIZATIONS TO HAVE VALID, RELIABLE, AND USER-FRIENDLY DATA RELATED TO HEALTH AND THE SOCIAL DETERMINANTS OF HEALTH, AND TO COORDINATE EFFORTS OF PUBLIC AND PRIVATE ORGANIZATIONS TO IDENTIFY AND ADDRESS HEALTH ISSUES IN MONTGOMERY COUNTY. 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; (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: ADVENTIST HEALTHCARE REHABILITATION PRIMARILY SERVES RESIDENTS OF MONTGOMERY AND PRINCE GEORGE'S COUNTIES IN MARYLAND. IN 2016, 64.2 PERCENT OF DISCHARGES WERE FROM MONTGOMERY COUNTY, 18.2 PERCENT FROM PRINCE GEORGE'S COUNTY, AND 4.2 PERCENT FROM THE DISTRICT OF COLUMBIA. OUR COMMUNITY BENEFIT SERVICE AREA (CBSA) IS BASED ON 85 PERCENT OF OUR DISCHARGES. THE CBSA IS DIVIDED INTO PRIMARY AND SECONDARY SERVICE AREAS. SIXTY PERCENT OF DISCHARGES FALL INTO THE PRIMARY SERVICE AREA, WHICH INCLUDED THE FOLLOWING ZIP CODES AND CITIES IN 2016: BETHESDA (20814, 20817); CHEVY CHASE (20815); DERWOOD (20855); GAITHERSBURG (20878, 20877); GERMANTOWN (20874, 20876); HYATTSVILLE (20782, 20783); MONTGOMERY VILLAGE (20886); POTOMAC (20854); ROCKVILLE (20850, 20852, 20853); SILVER SPRING (20906, 20904, 20902, 20901, 20910, 20905); TAKOMA PARK (20912); OLNEY (20832). THE SECONDARY SERVICE AREA ACCOUNTS FOR 25 PERCENT OF DISCHARGES AND INCLUDED THE FOLLOWING ZIP CODES AND CITIES IN 2016: BELTSVILLE (20705); BOWIE (20721); BOYDS (20841); BURTONSVILLE (20866); CAPITOL HEIGHTS (20743); CLARKSBURG (20871); COLLEGE PARK (20740); DAMASCUS (20872); DISTRICT HEIGHTS (20747); FORT WASHINGTON (20744); FREDERICK (21701, 21702, 21703); GAITHERSBURG (20882, 20879); GREENBELT (20770); HYATTSVILLE (20781, 20784, 20785); KENSINGTON (20895); LANHAM (20706); LAUREL (20707); MOUNT AIRY (21771); MOUNT RAINIER (20712); POOLESVILLE (20837); RIVERDALE (20737); ROCKVILLE (20851); SILVER SPRING (20903); TEMPLE HILLS (20748); UPPER MARLBORO (20774); WASHINGTON (20002, 20011, 20016, 20019, 20020).OUR COMMUNITY BENEFIT SERVICE AREA (CBSA), ENCOMPASSING 85 PERCENT OF ALL DISCHARGES, INCLUDES 1,093,497 PEOPLE FROM THE FOLLOWING RACIAL/ETHNIC CATEGORIES: 31.13% WHITE, 51.95% BLACK, 14% HISPANIC/LATINO, 5.63% ASIAN, 0.41% NATIVE AMERICAN, AND 0.07% NATIVE HAWAIIAN/PACIFIC ISLANDER (POPULATION ESTIMATES BASED ON DISCHARGES IN 2016). PART VI, LINE 5: PROMOTION OF COMMUNITY HEALTH.ADVENTIST HEALTHCARE REHABILITATION PARTNERS WITH COMMUNITY ORGANIZATIONS AND AGENCIES TO PROVIDE EDUCATION ON PREVENTION AND REHABILITATION FOR MANY HEALTH AND DISEASE-RELATED ISSUES FOR VALUABLE INPUT ON THE HEALTH NEEDS OF COMMUNITY MEMBERS. THIS INCLUDES SENIOR CENTERS, CHURCHES, SCHOOLS, SUPPORT GROUPS AND PROFESSIONAL ORGANIZATIONS. THE ADVENTIST HEALTHCARE REHABILITATION-ROCKVILLE SITE IS ALSO THE HOST FACILITY FOR A VARIETY OF SUPPORT GROUPS AND SPECIALTY THERAPEUTIC GROUPS FOR PATIENTS PAST AND PRESENT ALONG WITH THEIR FAMILIES AND CAREGIVER NETWORKS. WE PARTNER WITH CLINICS THAT SERVE THE LOW-INCOME RESIDENTS OF MONTGOMERY COUNTY, MANY OF WHOM ARE LIMITED ENGLISH PROFICIENT AND/OR RACIAL AND ETHNIC MINORITIES. ONE OF ADVENTIST HEALTHCARE REHABILITATION'S SAFETY NET CLINIC PARTNERS IS MERCY HEALTH CLINIC, WHICH PROVIDES PRIMARY CARE TO UNINSURED, LOW-INCOME ADULT RESIDENTS OF MONTGOMERY COUNTY. WE ALSO PARTNER WITH MERCY HEALTH CLINIC BY PROVIDING FREE DIAGNOSTIC SERVICES/LAB WORK TO THEIR UNINSURED PATIENTS. ANOTHER KEY PARTNER IS MOBILE MEDICAL CARE (MOBILE MED), WHICH OPERATES THREE MOBILE HEALTHCARE VEHICLES AND PROVIDES PRIMARY AND PREVENTATIVE HEALTHCARE TO THE UNINSURED, LOW INCOME, WORKING POOR, AND HOMELESS IN MONTGOMERY COUNTY. WE ALSO PARTNER WITH MOBILE MED BY PROVIDING FREE DIAGNOSTIC SERVICES/LAB WORK TO THEIR UNINSURED PATIENTS. IN 2016, THESE CLINICS WERE ALSO SUPPORTED WITH CASH DONATIONS FROM ADVENTIST HEALTHCARE THROUGH OUR COMMUNITY PARTNERSHIP FUND.AS PART OF A PARTNERSHIP WITH THE MONTGOMERY CARES/PRIMARY CARE COALITION INITIATIVE, ADVENTIST HEALTHCARE REHABILITATION PROVIDES ALMOST 200 PHYSICAL THERAPY VISITS ANNUALLY FOR UNINSURED, LOW-INCOME MONTGOMERY COUNTY RESIDENTS. AN ADDITIONAL KEY COMMUNITY PARTNERSHIP IS THAT WITH MONTGOMERY COUNTY PUBLIC SCHOOLS. BEGINNING IN 2013, ADVENTIST HEALTHCARE REHABILITATION BEGAN PROVIDING BASELINE CONCUSSION TESTING FOR STUDENT ATHLETES. IN THE EVENT THAT AN INJURY OCCURS, THE EXAMS ARE USED TO COMPARE WITH POST-INJURY TESTS. ADVENTIST HEALTHCARE REHABILITATION ALSO PROVIDES SUPPORT IN THE FORM OF ATHLETIC TRAINERS ON SITE AT THE SCHOOLS TO WORK TO KEEP ATHLETES SAFE FROM THE DANGERS OF CONCUSSIONS AND OTHER SPORTS INJURIES, PROVIDE SIDELINE CARE AT GAMES, AND MANAGE RETURN-TO-PLAY PROTOCOL. ADVENTIST HEALTHCARE REHABILITATION IS CURRENTLY PROVIDING THESE SERVICES TO 13 MONTGOMERY COUNTY HIGH SCHOOLS.IN ADDITION TO THE FORMAL ADVISORY BOARD THAT HELPS ADDRESS COMMUNITY NEEDS, THE STAFF OF ADVENTIST HEALTHCARE AND ADVENTIST HEALTHCARE REHABILITATION PARTICIPATES IN VARIOUS WAYS IN THE COMMUNITY. IN ORDER TO OBTAIN INPUT AND GUIDANCE FROM THOSE WE SERVE, WE ESTABLISHED A PATIENT-FAMILY ADVISORY COUNCIL WHICH KEEPS OUR PROGRAMS AND SERVICES RELEVANT TO THE COMMUNITY'S HEALTH NEEDS. FURTHER, WE ACTIVELY PARTICIPATE IN NUMEROUS COMMITTEES, COALITIONS, AND PARTNERSHIPS THAT PROVIDE INFORMATION ON THE HEALTH NEEDS IN THE COMMUNITY, SUCH AS HEALTHY MONTGOMERY, THE LOCAL HEALTH IMPROVEMENT COALITION. THE HEALTH PROFESSIONALS THAT PROVIDE PROGRAMS IN THE COMMUNITY ALSO PROVIDE VALUABLE INFORMATION AND KNOWLEDGE OF COMMUNITY NEEDS. 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 FIVE 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 WASHINGTON ADVENTIST HOSPITAL, ADVENTIST HEALTHCARE BEHAVIORAL HEALTH & WELLNESS SERVICES, ADVENTIST HEALTHCARE PHYSICAL HEALTH & REHABILITATION, ADVENTIST HEALTHCARE HOME CARE SERVICES, THE REGINALD S. LOURIE CENTER FOR CHILDREN'S SOCIAL & EMOTIONAL WELLNESS, CENTRACARE ADVENTIST HEALTHCARE URGENT CARE, AND OTHER HEALTH SERVICES. TOGETHER, WITH OUR CENTER FOR HEALTH EQUITY AND WELLNESS, AND MORE THAN 2,000 AFFILIATED 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 2016, APPROXIMATELY 913,486 RESIDENTS CAME TO ONE OF OUR FACILITIES OR ATTENDED A HEALTH CLASS OR PROGRAM. WE ALSO PROVIDED SIGNIFICANT CHARITY CARE AND COMMUNITY BENEFIT OF MORE THAN $83.3 MILLION. AS ONE OF THE LARGEST EMPLOYERS IN THE STATE OF MARYLAND, WE ARE GRATEFUL TO HAVE THE DEDICATED COMMITMENT OF 5,300 EMPLOYEES AND ALMOST 1,625 VOLUNTEERS 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 X X X X 0 1 0 0 0 0 0 0 0 JOHN SACKETT CHAIR; EVP&COO,AHC &PRESIDENT, SGMC 0 528948 0 180270 0 6396 0 105519 0 48486 0 869619 0 0 BRENT REITZ SECRETARY;VP&ADMINISTRATOR,ARHM 0 277052 0 68451 0 3457 0 56731 0 26447 0 432138 0 0 ERIK WANGSNESS PRESIDENT, WAH 0 398917 0 101245 0 5177 0 87247 0 33280 0 625866 0 0 TERRY FORDE PRESIDENT & CEO, AHC 0 858253 0 345275 0 19872 0 192324 0 36308 0 1452032 0 0 JAMES G LEE EVP & CFO, AHC 0 486641 0 164696 0 5532 0 78265 0 33738 0 768872 0 0 JAMES STERLING LITSINGER VP & CFO, NON-ACUTE SERVICES 40163 0 47282 0 246236 0 2150 0 13695 0 349526 0 29375 0 GEORGE ROBERT GRANGE AVP, REHAB SERVICES 142314 0 25059 0 1481 0 7430 0 25052 0 201336 0 0 0 JASON MAKAROFF ASSOCIATE VP OPERATIONS 143676 0 32173 0 19285 0 7092 0 1613 0 203839 0 0 0 FARHAD OSTOVARI SENIOR PHYSICAL THERAPIST 90431 0 45127 0 64 0 4739 0 15477 0 155838 0 0 0 VALERIE SUMMERLIN CHIEF NURSING OFFICER 183632 0 31338 0 2253 0 9182 0 1997 0 228402 0 0 0 PART I, LINE 3 COMPENSATION DEFINED. THE COMPENSATION REPORTED FOR THE EMPLOYEES SET FORTH ON SCHEDULE J IS COMPRISED OF THE FOLLOWING: BASE COMPENSATION INCLUDES NONDISCRETIONARY PAYMENTS, AGREED UPON IN ADVANCE, CONTINGENT ONLY UPON THE PAYEES' PERFORMANCE OF AGREED UPON SERVICES (SUCH AS SALARY OR FEES). INCENTIVE COMPENSATION INCLUDES PAYMENTS BASED ON SATISFACTION OF PRE-DETERMINED PERFORMANCE TARGETS SUCH AS QUALITY/PATIENT SAFETY GOALS, EMPLOYEE AND CUSTOMER ENGAGEMENT GOALS, ORGANIZATIONAL GROWTH, AND FINANCIAL PERFORMANCE, AMONG OTHER THINGS. OTHER REPORTABLE COMPENSATION INCLUDES 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. THE FIRST PAYMENT ON THE EXECUTIVE RETENTION PLAN, RELATED TO CONTRIBUTIONS ACCUMULATED IN 2015, WILL GENERALLY BE DISTRIBUTED ON JANUARY 1, 2017 AND CONTRIBUTIONS ACCUMULATED IN 2016 WILL GENERALLY BE DISTRIBUTED ON JANUARY 1, 2018. IN ADDITION, OTHER REPORTABLE COMPENSATION 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, TAXABLE PAYABLE PAY, 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; HOWEVER EXECUTIVES LISTED ON THIS TAX RETURN HAVE NOT YET RECEIVED THIS BENEFIT SINCE THEY HAVE MET THE VESTING REQUIREMENTS. NON-TAXABLE BENEFITS INCLUDES PRE-TAX PAYROLL DEDUCTIONS (SUCH AS FLEXIBLE MEDICAL SPENDING, DEPENDENT CARE, AND EMPLOYEE HEALTH BENEFIT PREMIUM), AND THE EMPLOYER PORTION OF CERTAIN EMPLOYEE BENEFITS SUCH AS HEALTH INSURANCE, DENTAL INSURANCE, VISION INSURANCE, LIFE INSURANCE, BASE CONTRIBUTIONS TO RETIREMENT PLANS, MATCHING OF EMPLOYEES' RETIREMENT CONTRIBUTIONS, ETC. PAY PRACTICE: ADVENTIST HEALTHCARE UTILIZES A SINGLE EMPLOYER ID FOR ALL OF 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 SAFE GUARDS 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 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. THE FIRST PAYMENT ON THE EXECUTIVE RETENTION PLAN, RELATED TO CONTRIBUTIONS ACCUMULATED IN 2015, WILL GENERALLY BE DISTRIBUTED ON JANUARY 1, 2017 AND CONTRIBUTIONS ACCUMULATED IN 2016 WILL GENERALLY BE DISTRIBUTED ON JANUARY 1, 2018. THE FOLLOWING EMPLOYEES LISTED BELOW RECEIVED EARLY LUMP-SUM CASH PAYMENTS ON THEIR 457F PLANS: JAMES STERLING LITSINGER: $ 31,007 ALSO, IN 2016, SEVERANCE PAYMENTS WERE MADE TO: JAMES STERLING LITSINGER: $ 180,563 FORM 990, PART III, LINE 4A, PROGRAM SERVICE ACCOMPLISHMENTS, CONTINUED: ADVENTIST REHABILITATION IS BUILT AROUND OUR PATIENTS AND LEADS THE WAY BACK TO LIFE FROM STROKE, BRAIN INJURY, SPINAL CORD INJURY, AMPUTATION AND TRAUMA. EXPERT CARE TEAMS WORKING SIDE-BY-SIDE WITH PATIENTS, USING INNOVATIVE THERAPIES, STATE-OF-THE-ART EQUIPMENT AND GROUND-BREAKING TECHNOLOGY COMBINE TO OFFER NEW WAYS TO HEAL. AS A NONPROFIT ORGANIZATION, ADVENTIST REHABILITATION HOSPITAL DEPENDS ON THIS SUPPORT AND DOLLAR FOR DOLLAR, EVERY DONATION MAKES A DIFFERENCE BY HELPING US MAINTAIN OUTSTANDING PROGRAMS AND SERVICES AND KEEP PACE WITH THE LATEST ADVANCES IN TECHNOLOGY AND EQUIPMENT FOR REHABILITATIVE CARE. ADVENTIST REHABILITATION ALSO FEATURES OUTPATIENT SERVICES AT RIO SPORT & HEALTH IN GAITHERSBURG, MD. EXPERT SERVICES ARE PROVIDED BY PHYSICAL THERAPISTS AND PHYSICIANS WHO SPECIALIZE IN ORTHOPEDIC AND SPORTS-RELATED INJURIES. THE REHABILITATION SERVICES PROVIDE CLIENTS WITH EVIDENCE-BASED TREATMENT APPROACHES THAT ARE BOTH SAFE AND EFFECTIVE FOR MANY SPORTS-RELATED INJURIES. COMMON CONDITIONS WE TREAT INCLUDE: MUSCLE TEARS & TENDONITIS; BACK & NECK PAIN; LIGAMENT SPRAINS; SPINAL DISC INJURIES; POST-SURGERY BONE FRACTURES & JOINT REPLACEMENT; POST-SURGICAL LIGAMENT RECONSTRUCTION; SPORTS-RELATED INJURIES; AND SCIATICA. OUR OUTPATIENT SERVICES INCLUDE: CERTIFIED MANUAL THERAPISTS; FREE INJURY SCREENINGS; DRY NEEDLING FOR PAIN MANAGEMENT AND ANTI-GRAVITY TREADMILL EQUIPMENT. FORM 990, PART VI, SECTION A, LINE 6 ADVENTIST HEALTHCARE, INC. IS THE SOLE CORPORATE MEMBER OF ADVENTIST REHABILITATION HOSPITAL OF MARYLAND, INC. WITH THE AUTHORITY TO APPROVE ITS BOARD MEMBERSHIP. FORM 990, PART VI, SECTION A, LINE 7A THE BOARD OF TRUSTEES OF ADVENTIST HEALTHCARE, INC. APPOINTS THE MEMBERS OF ADVENTIST REHABILITATION HOSPITAL OF MARYLAND GOVERNING BODY. FORM 990, PART VI, SECTION A, LINE 7B THE BOARD OF TRUSTEES APPROVES ALL ACTIONS OF MANAGEMENT. FORM 990, PART VI, SECTION B, LINE 11B DURING THE PREPARATION PROCESS, EXECUTIVE MANAGEMENT TEAM REVIEWED VARIOUS SECTIONS OF THE DRAFT FORM 990 BASED ON A PLANNED COMPLETION TIME TABLE. IN ADDITION, THE EXECUTIVE COMMITTEE OF THE BOARD REVIEWED CERTAIN KEY SECTIONS OF THE FORM. PRIOR TO FILING, ALL MEMBERS OF THE BOARD ARE PROVIDED A COPY OF THIS FORM 990 THROUGH EMAIL, WHICH IS LINKED 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. COMPLIANCE WITH POLICY IS MONITORED AND ENFORCED BY THE HUMAN RESOURCES DEPARTMENT, CORPORATE INTEGRITY DEPARTMENT AND THE LEGAL DEPARTMENT. FORM 990, PART VI, SECTION B, LINE 15 WHEN SETTING COMPENSATION FOR EXECUTIVES, OFFICERS, KEY EMPLOYEES, AND ALL EMPLOYEES, THE ORGANIZATION FULLY COMPLIES WITH THE PROCEDURAL SAFEGUARDS EMBEDDED IN THE IRS REGULATIONS. COMPENSATION IS ENTIRELY SET BY A COMMITTEE OF THE BOARD OF TRUSTEES. IN SETTING COMPENSATION, THE GOVERNING BOARD COMMITTEE RELIES UPON MARKET COMPARABILITY DATA PROVIDED BY AN INDEPENDENT OUTSIDE COMPENSATION CONSULTANT. TO ENSURE REASONABLENESS, COMPENSATION IS SET AT THE 50TH PERCENTILE OF THE NATURAL MARKET. GENERAL EXPLANATION: EMPLOYEES OF ANY OF THE ADVENTIST HEALTHCARE INC. AND AFFILIATED TAX EXEMPT ENTITIES IN THE STATE OF MARYLAND (INCLUDING ADVENTIST REHABILITATION HOSPITAL OF MARYLAND, 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. COMPENSATION INCLUDED REGULAR BASE SALARY, BONUS, PAID TIME OFF CASH OUT (ONLY FOR EMPLOYEES WHO LEAVE OUR ORGANIZATION), TAXABLE RELOCATION ALLOWANCE, HOLIDAY GIFT, RETROACTIVE COMPENSATION ADJUSTMENT, BEREAVEMENT LEAVE, EDUCATION, AND WITHDRAWAL OF DEFERRED COMPENSATION, AS APPLICABLE. THE SAME AND NON-ADDITIVE COMPENSATION AND EMPLOYMENT BENEFIT PLAN CONTRIBUTION AMOUNTS WERE ALSO DISCLOSED IN THE ADVENTIST HEALTHCARE INC.'S RELATED ENTITIES RETURNS. 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 C, LINE 19 THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS, ARE AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART XI, LINE 9: OTHER UNRESTRICTED NET ASSETS ACTIVITY -587. 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