2017-05-11T08:15:48-05:00 2016-06-30 GRANT THORNTON LLP 2001 MARKET STREET SUITE 700 PHILADELPHIA PA 19103 990 2015-07-01 520591483 Mt Washington Pediatric Hospital Inc % S MICHELLE LEE MTWA 4105788600 1708 W Rogers Avenue Baltimore MD 21209 ALFRED A PIETSCH TREASURER 4103281376 2017-04-26 true Frank Giardini P00532355 2155614200 2015 2021-01-29 14:40:06Z Sheldon Stein 1708 W Rogers Avenue Baltimore MD 21209 73523557 false X www.mwph.org X 1926 MD Mt. WASHINGTON PEDIATRIC HOSPITAL IS DEDICATED TO MAXIMIZING THE HEALTH AND INDEPENDENCE OF THE CHILDREN WE SERVE. 12 12 714 112 0 0 1010418 1238551 58569033 56764161 739193 844705 1199631 1276904 61518275 60124321 0 0 0 0 36175970 38314447 0 0 184945 18412611 15889399 54588581 54203846 6929694 5920475 105229167 106704489 21643343 21220149 83585824 85484340 MT. WASHINGTON PEDIATRIC HOSPITAL IS DEDICATED TO MAXIMIZING THE HEALTH AND INDEPENDENCE OF THE CHILDREN WE SERVE. false false 46125930 57764697 MT. WASHINGTON PEDIATRIC HOSPITAL, INC. OFFERED PEDIATRIC INPATIENT AND OUTPATIENT SERVICES FOR CHILDREN WITH CHRONIC ILLNESSES AND REHABILITATION NEEDS. 22,347 INPATIENT DAYS OF CARE WERE PROVIDED DURING THE FISCAL YEAR. 47,755 VISITS WERE RECORDED AT ITS SPECIALIZED CLINICS. THE MAJORITY OF PATIENTS TREATED WERE SOCIOECONOMIC DISADVANTAGED CHILDREN. APPROXIMATELY 80% OF INPATIENTS RECEIVED MEDICAL ASSISTANCE. 46125930 true true false true false false false false false true false false true true true false true false false false false false false true false true true false false true true false false false false false false false false false false false false false false true true true true false false true 95 0 true 714 true false true false false false false true true false false false false X 12 12 false false false false true true false true true false false true true true true true true true true false MD X X S MICHELLE LEE 4103281376 250 W PRATT STREET SUITE 1436 Baltimore MD 21201 EDWARD B CHAMBERS TRUSTEE 1.0 0.0 X 0 0 0 ROBERT A CHRENCIK TRUSTEE 1.0 0.0 X 0 0 0 S TRACY COSTER TRUSTEE 1.0 0.0 X 0 0 0 STEVEN J CZINN MD TRUSTEE 1.0 0.0 X 0 0 0 GEORGE J DOVER MD TRUSTEE 1.0 0.0 X 0 0 0 JOHN KELLY TRUSTEE 1.0 0.0 X 0 0 0 LAWRENCE C PAKULA MD TRUSTEE 1.0 0.0 X 0 0 0 RONALD R PETERSON TRUSTEE 1.0 0.0 X 0 0 0 DR BERYL ROSENSTIEN TRUSTEE 1.0 0.0 X 0 0 0 GDANIEL SHEALER JR ESQUIRE TRUSTEE 1.0 0.0 X 0 0 0 ROSLYN STOLER TRUSTEE 1.0 1.0 X 0 0 0 FRED WOLFIII ESQUIRE TRUSTEE 1.0 1.0 X 0 0 0 SHELDON STEIN PRESIDENT CEO 40.0 0.0 X 262689 0 181397 ALFRED A PIETSCH TREASURER 1.0 0.0 X 0 0 0 MARY MILLER CFO / VP - FINANCE 40.0 0.0 X 147535 0 58379 THOMAS ELLIS VP - HUMAN RESOURCES 40.0 0.0 X 139166 0 67600 JENNIFER BOWIE VP - NURSING ADMIN 40.0 0.0 X 152199 0 23348 TIKEE APARECE ATTENDING PHYSICIAN 40.0 0.0 X 165022 0 3836 BRADFORD HARRIS ATTENDING PHYSICIAN 40.0 0.0 X 207536 0 21656 MONIQUE SATPUTE NATIONAL PROGRAM DIRECTOR 40.0 0.0 X 196235 0 25919 KAREN WILLING ATTENDING PHYSICIAN 40.0 0.0 X 208936 0 27694 STEPHEN NICHOLS MD ATTENDING PHYSICIAN 40.0 0.0 X 219920 0 44590 1699238 0 454419 21 false true false Whiting Turner Contracting PO Box 17596 BALTIMORE MD 21297 CONSTRUCTION 6712671 Pharmasource Healthcare Inc PO Box 632849 CINCINNATI OH 452632849 PHARMACY 3607611 Johns Hopkins University 600 North Wolf Street BALTIMORE MD 21287 Physician 1384052 Sleep Services of America Inc PO BOX 198320 ATLANTA GA 30384 NEUROLOGY 1133111 University Of Maryland Medical 737 West Lombard Street BALTIMORE MD 20201 Physican 444690 16 68034 670305 500212 1238551 NET PATIENT REVENUE 900099 56764161 56764161 56764161 557929 557929 0 0 0 0 0 13446250 13159474 286776 286776 286776 516130 68034 239762 276368 276368 0 0 MEDICAL RECORDS 900099 12095 12095 NET ASSETS RELEASED FOR OPERATING PURPOSES 900099 569346 569346 ALL OTHER REVENUE 900099 419095 419095 1000536 60124321 57764697 1121073 0 0 0 0 701589 596351 105238 0 29994765 25495550 4314270 184945 579405 492494 86911 5049489 4292066 757423 1989199 1690819 298380 0 26511 22534 3977 436574 371088 65486 4175 3549 626 0 0 3276567 2785082 491485 57900 49215 8685 1133196 963217 169979 0 0 816552 694069 122483 122242 103906 18336 0 19405 16494 2911 80454 68386 12068 0 3069541 2609110 460431 237762 202098 35664 SUPPLIES 4504314 3828667 675647 CLINICAL 673585 572547 101038 BAD DEBT 351077 351077 0 CAFE CATERING 327421 278308 49113 752123 639303 112820 54203846 46125930 7892971 184945 0 0 17320320 15939710 260427 244003 7701680 5995812 0 0 0 0 0 0 114830 120850 28667 169667 70196572 38054050 26746162 32142522 29952014 29249574 0 0 0 0 0 0 23105067 22842351 105229167 106704489 11913791 11991092 0 0 99805 0 5700000 5385000 0 0 0 0 0 0 0 0 3929747 3844057 21643343 21220149 X 72670079 74640440 10090574 10018729 825171 825171 83585824 85484340 105229167 106704489 X 5920475 -1269236 -2752723 X false true X true X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false true 4175 4175 false Schedule C: Lobbying Activities Part II-B, 1i The organization does not engage in any direct lobbying activities. The organization pays membership dues to the Maryland Hospital Association (MHA), the American Hospital Association (AHA) and the Children's Hospital Association (CHA). MHA, AHA and CHA engage in many support activities including lobbying and advocating for their member hospitals. The MHA, AHA and CHA reported that 6.22%, 23.65% and 15.97% of member dues were used for lobbying purposes and as such, the organization has reported this amount on Schedule C Part IV as lobbying activities. 1314687 1314687 48503955 22366384 26137571 263509 230654 32855 20114421 15457012 4657409 32142522 ASSETS LIMITED AS TO USE 4813053 ECONOMIC INTEREST IN MWPF 16726921 OTHER 875688 OTHER ACCOUNTS RECEIVABLE 426689 22842351 0 ADVANCES FROM 3RD PARTY PAYORS 3844057 3844057 X Liability for Uncertain Tax Position (ASC 740) Schedule D, Part X, Line 2 The Hospital is a not-for-profit corporation as described under Section 501c(3) of the Internal Revenue Code (the Code) and is exempt from federal income taxes on related income pursuant to Section 501(a) of the Code. The Foundation is a not-for-profit corporation formed under the laws of the state of Maryland, organized for charitable purposes and recognized by the Internal Revenue Service as a tax-exempt organization under Section 501c(3) of the Code. The Corporation follows a threshold of more likely than not for recognition and derecognition of tax positions taken or expected to be taken in a tax return. Management does not believe that there are any unrecognized tax benefits that should be recognized. 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WASHINGTON PEDIATRIC HOSPITAL Schedule H, Part V, Section B Line 5 Community Perspective The communitys perspective was obtained through two surveys offered to the public during health fairs throughout Baltimore City. A 6-item survey asked respondents to identify their top health concerns and their top barriers in accessing health care. A longer survey was also created and posted online on the public website. Methods Included a 3-item survey distributed to the public at a variety of outreach events in FY15 (Short Form) and made available in Maryland Matters publication (N=1,212). A 25-item online survey was also posted to the survey monkey and www.umm.edu website for community to complete (Long Form). The Community Advocacy actively engaged community members from attending and participating in several neighborhood meetings hosted by Baltimore City Health Department and other local community organizations. The results identified the top five health concerns, top 5 barriers to health care, and presented an opportunity for participants to provide recommendations or solutions. The top five health concerns identified were Diabetes (n=708), High Blood Pressure/Stroke (n=669), Heart Disease (n=596), Smoking/Alcohol/Drug Abuse (n=535), and Cancer (n=515). Analysis by CBSA targeted zip codes revealed the same top health concerns and top health barriers with little deviation from the overall Baltimore City data. The top five barriers to health care identified included 'No Health Insurance' (n=833), 'Too Expensive' (n=726), 'No Transportation' (n+446), 'Local MDs Not Part of Plan' (n=259), 'Couldnt get an appointment with Doctor' (n=138), 'Doctor too far away' (n=125), and '(Medical) service not available in the city' (91). There were also 103 individual responses that provided additional insight into local health disparities. Analysis by CBSA targeted zip codes identified very similar health concerns and top health barriers with little to no deviation from overall Baltimore City data, or the MWPH CHNA completed in 2012. Health Experts The Community Advocacy team facilitated focus group meetings to includes specialty clinical staff; Outpatient(Psychology, Weigh Smart, Social Work) [October 7, 2014], Traumatic Brain Injury & Recreational Therapy [September 29, 2014] as well as MWPH employees who engage in community affairs and MWPH Family Advisory Council [October 24, 2014]. There was also a telephone interview conducted Baltimore City Health Dept. Director of Chronic Disease Prevention, and finally a thorough review and include National Prevention Strategy Priorities, State Health Improvement Plan (SHIP) indicators , and Healthy Baltimore 2015 plan from BCHD. MWPH results included utilizing the following data to create direction and a guide for all future community benefit initiatives; the National Prevention Strategy (7 Priority Areas) and the SHIPs (State Health Improvement Plan) 39 Objectives in 6 Vision Areas for State, includes targets for Baltimore City, and Healthy Baltimore 2015 which identified 10 Priority Areas. Comparison of Federal, State, and Local Health Priorities National Prevention Strategy: 2011 Priority Areas -tobacco free living -preventing drug abuse & excessive alcohol use -healthy eating -active living -injury & violence free living -reproductive & sexual health -mental & emotional wellbeing Maryland State Health Improvement Plan (SHIP) 2011 -healthy babies -healthy social environments -safe physical environments -infectious diseases -chronic diseases -healthcare access Healthy Baltimore 2015 -promote access to quality health care for all -be tobacco free -redesign communities to prevent obesity -promote heart health -stop the spread of HIV & other ST infections -Recognize & treat mental health needs -reduce drug use & alcohol use -encourage early detection of cancer -promote healthy children & adolescents -create health promoting neighborhoods During the telephone interview Laura Fox, MPH, Director, Office of Chronic Disease Prevention, Baltimore City Health Department (2/17/15). MWPH was able to identify the top 4 health problems per Baltimore City Mayors health priorities: 1. Cardiovascular Disease (CVD) Decrease premature mortality (as defined as death prior to 75 years) 2. Asthma With a concentration on pediatrics specifically 3. Heroin Use while a priority, no major initiatives to date 4. Diabetes as related to CVD as a co-morbidity Top Barriers to Health identified are: 1. Knowledge deficit with respect to health insurance 2. People dont know how to use (navigate) the system- need care connectors and/or health navigators 3. People arent sure what MCOs will accept them 4. Limited minutes on phone limits calls for assistance 5. General Education/Literacy (SDoH) Community Leaders MWPH facilitated a focus group in the Park Heights Community, which is located in the community benefit service area of the hospital which included over 30 Community Partners Focus Group (October 2014). The following needs were discussed/identified during this meeting: #1 Serious Problem identified: 44.8% reported the need for Health Literacy #2 Serious Problem identified: 35.7% reported the issue of Violence MWPH identified the top 3 moderate concerns, as well, they are as follows, respectively; Behavioral/Mental Illness, Heart Disease, and Diabetes. We also were made aware that 86.7% of community get their health information from family & friends, 63% from Internet, 60% from church. The top 3 action items for this meeting that were discussed, Mobile Unit Screenings, Health Education, Community Engagement, Set up a 'Green' Neighborhood as a Model, and Mental Health services. Social Determinants of Health (SDoH) Defined by the World Health Organization as: the conditions in which people are born, grow, live, work and age Methods Reviewed data from identified 2011 Baltimore City Health Departments Baltimore City Neighborhood Profiles, Baltimore City Food Desert Map Results Utilizing the Baltimore City Neighborhood Profiles, the community advocacy team identified SDoHs for the following zip codes within the CBSA (Community Benefit Service Area) Upton/ Druid Heights (21217), SW Baltimore (21223), Mondawmin , Pimlico/ Arlington/ Hilltop (21216 & 21215) Howard Park/ W. Arlington (21207), Southern Park Heights (21215), Clifton-Berea (21206). The Top SDoHs identified were 'Low Education Attainment' (52.6% w/ less than HS degree), 'High Poverty Rate'(15.7%), 'High Unemployment Rate'(11%), Violence, and Poor Food Environment. Health Statistics/Indicators The team also regularly reviewed the following local data sources; Baltimore City Health Status Report, Baltimore Health Disparities Report Card, and the Baltimore Neighborhood Profiles. National trends and data such as the 'Healthy People 2015', 'Centers for Disease Control reports/updates', and 'F as in Fat: Executive Summary (RWJF)' were also taken into consideration. Results MWPH was able to create a Baltimore City Health Outcomes Summary for the aforementioned CBSA-targeted zip codes. The top three causes of death in Baltimore City identified, respectively were Heart Disease, Cancer, and Stroke. The number one cause of pediatric deaths is the high rate of Infant Mortality. Line 6a The MWPH was conducted with the affiliated Baltimore city hospitals of the University of MD Medical System. Specifically, the University Of MD Medical Center and University of MD Midtown Campus. Line 6b No the only organization that assisted in conducting the CHNA were the aforementioned hospitals in question Part V, Question 6a. Line 11 Based on the CHNA, findings, and priorities, the MWPH agreed to incorporate our identified priorities with Marylands State Health Improvement Plan (SHIP). Using the SHIP as a framework, the following matrix was created to show the integration of our identified priorities and their alignment with the SHIPs Vision Areas. MWPH will also track the progress with long-term outcome objectives measured through the Marylands Department of Health & Mental Hygiene (DHMH). Short-term programmatic objectives, including process and outcome measures will be measured annually by MWPH for each priority areas through the related programming. Adjustments will be made to annual plans as other issues emerge or through our annual program evaluation. MWPH will provide leadership and support within the communities served at sustained and strategic response levels. -Sustained Response - Ongoing response to long-term community needs, i.e. obesity and injury prevention education, health screenings. -Strategic Response - Long-term strategic leadership at legislative and corporate levels to leverage relationships to promote health-related policy or reform and build key networks Future Community Health Needs Assessments will be conducted every three years and strategic priorities will be re-evaluated then. Programmatic evaluations will occur on an ongoing basis and annually, and adjustments to programs will be as needed. All community benef Related Organization Report Schedule H, Part I, Line 6a AN ANNUAL COMMUNITY BENEFIT REPORT IS PREPARED FOR EACH FISCAL YEAR ENDING JUNE 30. THIS REPORT IS SUBMITTED TO THE HEALTH SERVICES COST REVIEW COMMISSION (HSCRC), A STATE REGULATORY AGENCY, BY DECEMBER 15 OF EACH YEAR. IN ADDITION, THE ANNUAL COMMUNITY BENEFIT REPORT IS AVAILABLE UPON REQUEST AT THE ENTITY'S CORPORATE OFFICES. Costing Methodology Schedule H, Part I, Line 7 SCHEDULE H, LINE 7A, COLUMN (D) MARYLAND'S REGULATORY SYSTEM CREATES A UNIQUE PROCESS FOR HOSPITAL PAYMENT THAT DIFFERS FROM THE REST OF THE NATION. THE HEALTH SERVICES COST REVIEW COMMISSION, (HSCRC) DETERMINES PAYMENT THROUGH A RATE SETTING PROCESS AND ALL PAYORS, INCLUDING GOVERNMENTAL PAYORS, PAY THE SAME AMOUNT FOR THE SAME SERVICES DELIVERED AT THE SAME HOSPITAL. MARYLAND'S UNIQUE ALL PAYOR SYSTEM INCLUDES A METHOD FOR REFERENCING UNCOMPENSATED CARE IN EACH PAYORS' RATES, WHICH DOES NOT ENABLE MARYLAND HOSPITALS TO BREAKOUT ANY OFFSETTING REVENUE RELATED TO UNCOMPENSATED CARE. SCHEDULE H, LINE 7B, COLUMNS (C) THROUGH (F) MARYLAND'S REGULATORY SYSTEM CREATES A UNIQUE PROCESS FOR HOSPITAL PAYMENT THAT DIFFERS FROM THE REST OF THE NATION. THE HEALTH SERVICES COST REVIEW COMMISSION, (HSCRC) DETERMINES PAYMENT THROUGH A RATE SETTING PROCESS AND ALL PAYORS, INCLUDING GOVERNMENTAL PAYORS, PAY THE SAME AMOUNT FOR THE SAME SERVICES DELIVERED AT THE SAME HOSPITAL. MARYLAND'S UNIQUE ALL PAYOR SYSTEM INCLUDES A METHOD FOR REFERENCING UNCOMPENSATED CARE IN EACH PAYORS' RATES, WHICH DOES NOT ENABLE MARYLAND HOSPITALS TO BREAKOUT ANY OFFSETTING REVENUE RELATED TO UNCOMPENSATED CARE. COMMUNITY BENEFIT EXPENSES ARE EQUAL TO MEDICAID REVENUES IN MARYLAND, AS SUCH, THE NET EFFECT IS ZERO. ADDITIONALLY, NET REVENUES FOR MEDICAID SHOULD REFLECT THE FULL IMPACT ON THE HOSPITAL OF ITS SHARE OF THE MEDICAID ASSESSMENT. SCHEDULE H, LINE 7F COLUMN (C) & (D) MARYLAND'S REGULATORY SYSTEM CREATES A UNIQUE PROCESS FOR HOSPITAL PAYMENT THAT DIFFERS FROM THE REST OF THE NATION. THE HEALTH SERVICES COST REVIEW COMMISSION, (HSCRC) DETERMINES PAYMENT THROUGH A RATE SETTING PROCESS AND ALL PAYORS, INCLUDING GOVERNMENTAL PAYORS, PAY THE SAME AMOUNT FOR THE SAME SERVICES DELIVERED AT THE SAME HOSPITAL. MARYLAND'S UNIQUE ALL PAYOR SYSTEM INCLUDES A METHOD FOR REFERENCING UNCOMPENSATED CARE IN EACH PAYORS' RATES, WHICH DOES NOT ENABLE MARYLAND HOSPITALS TO BREAKOUT ANY OFFSETTING REVENUE RELATED TO UNCOMPENSATED CARE. Community Building Activities Schedule H, Part II At MWPH, the community building activities have been primarily dedicated to utilizing our staff; at all levels, senior executives, managers, clinical and non-clinical to advocate, educate, or create programming the is focused to alleviate the burdens and disparities to the population who we receive the specialty care we provide. An example of this, is the National Advocacy Days when the hospital provides transportation and lodging for parents at the hospital to go to Washington, D.C. to meet with legislators to discuss topics that affect the pediatric special health care need population directly. Another example is a program created by the Family Advisory Council, Family Community Day when the hospital takes families with children who have special care needs on a field trip somewhere in the city so that the families can feel more inclusive. The idea is to have a combination of both families with special health care needs and families who have children that are developing typically have fun together and share an experience to work together to realize they have more in common than not. Other examples are the partnerships MWPH has developed with the Baltimore City Police Department to improve the relationship between the police and the community and address issues such as bullying and violence prevention. Over 90 children, grades Pre-K through 5th grade, successfully completed this program with a better understanding on how to reduce violence in their community and make a positive impact on it. Other initiatives include our financial support of programs that send children with special needs away to camp for free, as well as other organizations that support the inclusion, advancement, or promotion of services for this group. Bad Debt Expense SSchedule H, Part III, Lines 2 and 4 THE PROVISION FOR BAD DEBTS IS BASED UPON MANAGEMENT'S ASSESSMENT OF HISTORICAL AND EXPECTED NET COLLECTIONS CONSIDERING HISTORICAL BUSINESS AND ECONOMIC CONDITIONS, TRENDS IN HEALTH CARE COVERAGE, AND OTHER COLLECTION INDICATORS. PERIODICALLY THROUGHOUT THE YEAR, MANAGEMENT ASSESSES THE ADEQUACY OF THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS BASED UPON HISTORICAL WRITE OFF EXPERIENCE BY PAYOR CATEGORY. THE RESULTS OF THIS REVIEW ARE THEN USED TO MAKE MODIFICATIONS TO THE PROVISION FOR BAD DEBTS AND TO ESTABLISH AN ALLOWANCE FOR UNCOLLECTIBLE RECEIVABLES. AFTER COLLECTION OF AMOUNTS DUE FROM INSURERS, THE CORPORATION FOLLOWS INTERNAL GUIDELINES FOR PLACING CERTAIN PAST DUE BALANCES WITH COLLECTION AGENCIES. Medicare Cost Report Schedule H, Part III, Line 8 IN MARYLAND, THE HEALTH SERVICES COST REVIEW COMMISSION (HSCRC) STARTED SETTING HOSPITAL RATES IN 1974. AT THAT TIME, THE HSCRC APPROVED RATES APPLIED ONLY TO COMMERCIAL INSURERS. IN 1977, THE HSCRC NEGOTIATED A WAIVER FROM MEDICARE HOSPITAL PAYMENT RULES FOR MARYLAND HOSPITALS TO BRING THE FEDERAL MEDICARE PAYMENTS UNDER HSCRC CONTROL. In 2014, Marylands waiver with Medicare was renegotiated and updated to reflect the current healthcare environment. Under this new waiver, several criteria were established to monitor the success of the system in controlling healthcare costs and the continuance of the waiver itself: 1. Revenue Growth per Capita 2. Medicare Hospital Revenue per Beneficiary 3. Medicare All Provider Revenue Growth per Beneficiary 4. Medicare Readmission Rates 5. Hospital Acquired Condition Rate Collection Practices Schedule H, Part III, Line 9b THE ORGANIZATION EXPECTS PAYMENT AT THE TIME THE SERVICE IS PROVIDED. OUR POLICY IS TO COMPLY WITH ALL STATE AND FEDERAL LAW AND THIRD PARTY REGULATIONS AND TO PERFORM ALL CREDIT AND COLLECTION FUNCTIONS IN A DIGNIFIED AND RESPECTFUL MANNER. Currently, Mt. Washington Pediatric Hospital has updated its billing and collections process to ensure it is in compliance with the new IRC Section 501(r) regulations. EMERGENCY SERVICES WILL BE PROVIDED TO ALL PATIENTS REGARDLESS OF ABILITY TO PAY. FINANCIAL ASSISTANCE IS AVAILABLE FOR PATIENTS BASED ON FINANCIAL NEED AS DEFINED IN THE FINANCIAL ASSISTANCE POLICY. THE ORGANIZATION DOES NOT DISCRIMINATE ON THE BASIS OF AGE, RACE, CREED, SEX OR ABILITY TO PAY. PATIENTS WHO ARE UNABLE TO PAY MAY REQUEST A FINANCIAL ASSISTANCE APPLICATION AT ANY TIME PRIOR TO SERVICE OR DURING THE BILLING AND COLLECTION PROCESS. THE ORGANIZATION MAY REQUEST THE PATIENT TO APPLY FOR MEDICAL ASSISTANCE PRIOR TO APPLYING FOR FINANCIAL ASSISTANCE. THE ACCOUNT WILL NOT BE FORWARDED FOR COLLECTION DURING THE MEDICAL ASSISTANCE APPLICATION PROCESS OR THE FINANCIAL ASSISTANCE APPLICATION PROCESS. MWPH makes every effort to make financial assistance information available to our patients including, but not limited to: -signage in main admitting areas and emergency rooms of the hospital -MWPH website -patient handbook distributed to all patients -brochures explaining financial assistance are made available in all patient care areas -patient plain language sheets - newly revised in June 2016, this handout was revised and is at the 5th grade reading level (available in English, Spanish, French & chinese based on top languages spoken by UMMC patients) -appearing in print media through local newspapers Community Health Care Needs Assessment Schedule H, Part VI, Line 2 Mt. Washington Pediatric Hospital completed its Community Health Needs Assessment on May 12, 2015, on which date it was approved by the Board of Directors and implemented. The communitys perspective was obtained through two surveys offered to the public during health fairs throughout Baltimore City. A 6-item survey asked respondents to identify their top health concerns and their top barriers in accessing health care. A longer survey was also created and posted online on the public website. Methods Included a 3-item survey distributed to the public at a variety of outreach events in FY15 (Short Form) and made available in Maryland Matters publication (N=1,212). A 25-item online survey was also posted to the survey monkey and www.umm.edu website for community to complete (Long Form). The Community Advocacy actively engaged community members from attending and participating in several neighborhood meetings hosted by Baltimore City Health Department and other local community organizations. The results identified the top five health concerns, top 5 barriers to health care, and presented an opportunity for participants to provide recommendations or solutions. The top five health concerns identified were Diabetes (n=708), High Blood Pressure/Stroke (n=669), Heart Disease (n=596), Smoking/Alcohol/Drug Abuse (n=535), and Cancer (n=515). Analysis by CBSA targeted zip codes revealed the same top health concerns and top health barriers with little deviation from the overall Baltimore City data. The top five barriers to health care identified included 'No Health Insurance' (n=833), 'Too Expensive' (n=726), 'No Transportation' (n+446), 'Local MDs Not Part of Plan' (n=259), 'Couldnt get an appointment with Doctor' (n=138), 'Doctor too far away' (n=125), and '(Medical) service not available in the city' (91). There were also 103 individual responses that provided additional insight into local health disparities. Analysis by CBSA targeted zip codes identified very similar health concerns and top health barriers with little to no deviation from overall Baltimore City data, or the MWPH CHNA completed in 2012. Health Experts The Community Advocacy team facilitated focus group meetings to includes specialty clinical staff; Outpatient(Psychology, Weigh Smart, Social Work) [October 7, 2014], Traumatic Brain Injury & Recreational Therapy [September 29, 2014] as well as MWPH employees who engage in community affairs and MWPH Family Advisory Council [October 24, 2014]. There was also a telephone interview conducted Baltimore City Health Dept. Director of Chronic Disease Prevention, and finally a thorough review and include National Prevention Strategy Priorities, State Health Improvement Plan (SHIP) indicators , and Healthy Baltimore 2015 plan from BCHD. MWPH results included utilizing the following data to create direction and a guide for all future community benefit initiatives; the National Prevention Strategy (7 Priority Areas) and the SHIPs (State Health Improvement Plan) 39 Objectives in 6 Vision Areas for State, includes targets for Baltimore City, and Healthy Baltimore 2015 which identified 10 Priority Areas. Comparison of Federal, State, and Local Health Priorities National Prevention Strategy: 2011 Priority Areas -Tobacco free living -Preventing drug abuse & excessive alcohol use -healthy eating -active living -injury & violence free living -reproductive & sexual health -mental & emotional well-being Maryland State Health Improvement Plan (SHIP) 2011 -healthy babies -healthy social environments -safe physical environments -infectious diseases -chronic diseases -healthcare access Healthy Baltimore 2015 -Promote access to quality health care for all -be tobacco free -redesign communities to prevent obesity -promote heart health -stop the spread of HIV & other ST infections -recognize & treat mental health needs -reduce drug use & alcohol use -encourage early detection of cancer -promote healthy children -create health promoting neighborhoods During the telephone interview Laura Fox, MPH, Director, Office of Chronic Disease Prevention, Baltimore City Health Department (2/17/15). MWPH was able to identify the top 4 health problems per Baltimore City Mayors health priorities: 1. Cardiovascular Disease (CVD) Decrease premature mortality (as defined as death prior to 75 years) 2. Asthma With a concentration on pediatrics specifically 3. Heroin Use while a priority, no major initiatives to date 4. Diabetes as related to CVD as a co-morbidity Top Barriers to Health identified are: 6. Knowledge deficit with respect to health insurance 7. People dont know how to use (navigate) the system- need care connectors and/or health navigators 8. People arent sure what MCOs will accept them 9. Limited minutes on phone limits calls for assistance 10. General Education/Literacy (SDoH) Community Leaders MWPH facilitated a focus group in the Park Heights Community, which is located in the community benefit service area of the hospital which included over 30 Community Partners Focus Group (October 2014). The following needs were discussed/identified during this meeting: #1 Serious Problem identified: 44.8% reported the need for Health Literacy (See Chart 3) #2 Serious Problem identified: 35.7% reported the issue of Violence MWPH identified the top 3 moderate concerns, as well, they are as follows, respectively; Behavioral/Mental Illness, Heart Disease, and Diabetes. We also were made aware that 86.7% of community get their health information from family & friends, 63% from Internet, 60% from church. The top 3 action items for this meeting that were discussed, Mobile Unit Screenings, Health Education, Community Engagement, Set up a 'Green' Neighborhood as a Model, and Mental Health services. Social Determinants of Health (SDoH) Defined by the World Health Organization as: the conditions in which people are born, grow, live, work and age Methods Reviewed data from identified 2011 Baltimore City Health Departments Baltimore City Neighborhood Profiles, Baltimore City Food Desert Map Results Utilizing the Baltimore City Neighborhood Profiles, the community advocacy team identified SDoHs for the following zip codes within the CBSA (Community Benefit Service Area) Upton/ Druid Heights (21217), SW Baltimore (21223), Mondawmin/Pimlico/ Arlington/ Hilltop (21216 & 21215) Howard Park/ W. Arlington (21207), Southern Park Heights (21215), Clifton-Berea (21206). The Top SDoHs identified were 'Low Education Attainment' (52.6% w/ less than HS degree), 'High Poverty Rate(15.7%), 'High Unemployment Rate'(11%), Violence, and Poor Food Environment. Health Statistics/Indicators The team also regularly reviewed the following local data sources; Baltimore City Health Status Report, Baltimore Health Disparities Report Card, and the Baltimore Neighborhood Profiles. National trends and data such as the 'Healthy People 2015', 'Centers for Disease Control reports/updates', and 'F as in Fat: Executive Summary (RWJF)' were also taken into consideration. Results MWPH was able to create a Baltimore City Health Outcomes Summary for the aforementioned CBSA-targeted zip codes. The top three causes of death in Baltimore City identified, respectively were Heart Disease, Cancer, and Stroke. The number one cause of pediatric deaths is the high rate of Infant Mortality. Eligibility Education Schedule H, Part VI, Line 3 The Patient Financial Assistance Policy at Mt. Washington Pediatric Hospital is a comprehensive policy designed to assess the needs of patients and families that have expressed concerns about their ability to pay for needed medical services. Mt. Washington Pediatric Hospital makes every effort to make financial assistance information available to our patients/families. These efforts include signage at our outpatient desks and inpatient welcome areas, notices on patient bills and admissions documents, and information on our web site. Description of how MWPH informs Patients of the Charity Care Policy Notices informing the patient about the availability of financial assistance have been posted in certain locations within the Hospital. Notices were posted on the outpatient registration desk at Rogers Avenue, the outpatient registration desk at PG Hospital, the inpatient family welcome room at Rogers Avenue, and the inpatient nurses station at PG Hospital. The posted notices state the following: 'Mount Washington Pediatric Hospital has a Patient Financial Assistance Program established to help patients obtain financial aid when it is beyond their ability to pay for services. An application and further information is available from the financial counselor in the admissions office.' Other means of informing the patients of availability of financial assistance include handouts, notification by the admissions office, social work staff, and patient accounting representatives, and/or billing company staff. Also, an information sheet is provided to the patients, the patients family, or the patients authorized representative before discharge, with hospital bill, or on request. The information sheet included the following items: a. A description of the Hospitals financial assistance policy; b. A description of the patients rights and obligations with regard to Hospital billing and collection; c. Contact information for the individual or office at the Hospital that is available to assist the patient or the patient representative in understanding the hospital bill and how to apply for free and reduced cost care; d. Contact information for the Maryland Medical Assistance Program; e. A statement that physician charges are not included in the Hospital bill and are billed separately. Description of Community Served Schedule H, Part VI, Line 4 MWPH is a regional leader in pediatric specialty care and is a jointly owned corporate affiliate of the University of Maryland Medical Systems (UMMS) and Johns Hopkins Health System (Hopkins). The majority of MWPH patients are residents of Baltimore city. According American Community Survey 2010, African Americans or Blacks make up 63% of Baltimore Citys population. Respectively, Whites are 32.6% of the population followed by Hispanics/Latinos with 2.8%. The remaining 4% racial make-up is comprised of Asian, American Indian, and Native Hawaiian/Pacific Islanders. Mt Washington Pediatric Hospital 5 MWPH patient race demographics reflect those of Baltimore city. Last year, 48% of our patients were Black or African American, 39% were Caucasian, 4% of patients were Latino or Hispanic and 4% were identified as Asian. Approximately 3% were identified as Other/Biracial, with a total of 6,936 unique patients served. MWPH is a specialty pediatric facility and our patients come from all over the state of Maryland, and in many cases from out of state. We are a small, family-focused hospital with approximately 604 employees. Where many hospitals define their Community Benefit Service Area (CBSA) by their discharges or by the community of which they reside, MWPH is slightly different. MWPH is located in the Mt Washington area of Baltimore City which according to the 2011 Baltimore City Health Department Healthy Neighborhood Profiles is one of the healthiest neighborhoods in the city, however surrounding this neighborhood, are several of the unhealthiest neighborhoods in the city and state, according their health outcomes and social determinants of health. As previously stated, MWPH is located in the northwest quadrant of Baltimore City, serving both its immediate neighbors and others from throughout the Baltimore City and County region. The neighborhoods surrounding MWPH are identified by the Baltimore Neighborhood Indicators Alliance (BNIA) as Southern Park Heights (SPH), Upton Druid Heights (UDH) and Pimlico/Arlington/Hilltop (PAH). Together they constitute an area that is predominately African American with a below average median family income, but above average rates for unemployment, and other social determinants of poor health. BNIAs statistical information for Baltimore City and its neighborhoods indicates SPHs median household income was $27,635, UDHs was $13,388, and PAH$29,031. It should be noted that nearly 50% of the people living in the UDH neighborhood meet the federal poverty guideline. This is compared to Baltimore Citys median household income of $30,078, which by comparison is significantly lower than the median income of other counties in the state of Maryland. The percent of families earning less than the federal self-sufficiency standard in SPH was 56% for married couples with 1-5 children and 85% for 'other' families with 1-5 children; in PAH these indicators were 59% for married couples and 83% for 'other' families. The unemployment rate for Baltimore City was 15.7 % while UDH had an unemployment rate of 17.5% and PAH 17.0%. Since MWPHs last CHNA there has been an increase of patients coming from other parts of the city that are not in the northwest quadrant of Baltimore city. This is not necessarily atypical because, as aforementioned MWPH is a specialty hospital and does receive patients from all across the city, its surrounding counties, and states. It should also be noted that this may also be a result of MWPHs coaffiliation with Johns Hopkins Hospitals and University of Maryland Medical Systems that our largest patient admissions are from different parts of the city. Specifically speaking the largest increase was seen in two neighborhoods that have equally disparaging health outcomes, Clifton-Berea (CFB) and Southwest Baltimore (SWB). According to the Baltimore Healthy Neighborhood Profiles CBs the percent of families earning less than the federal self-sufficiency standard in CFB and SWB was 18.4% and 26.2% respectively. The unemployment rate for both neighborhoods is around 20%, and all of these neighborhoods have homicide rates nearly 30% or more with CFB leading at 61% (# 0f homicides/per 10,000 people). The six zip codes that represent the largest number of admissions to the hospital in calendar year 2011 are, in descending order of admissions 21215, 21217, 21207, 21216, 21223, 21206. The Baltimore City Health Department uses Neighborhood Health Profiles (NHP) when analyzing health outcomes and risk factors. The NHPs are based on census track data and do not follow zip code boundaries. MWPH identified the NHP that are contained within the zip codes of the primary service area for MWPH. Two of the zip codes (21207 and 21208) span city/county lines. Baltimore County does not provide NHPs. The data provided in the chart below for the primary racial composition, median income and households below poverty level was obtained from the US Census Bureau, based on census data from 2010. The life expectancy data, unless otherwise noted, was obtained from the Baltimore City Health Departments 2011 neighborhood health profiles. *The life expectancy provided for the 21207 zip code is not for the entire zip code, but for the CBSA Howard Park/W. Arlington, the city segment of that zip code. Life expectancy is not available at the zip code level in Baltimore County. The racial composition and income distribution of these zip codes reflect the segregation and income disparity characteristics of the Baltimore metropolitan region. As indicated above, those zip codes that have a predominantly African American population reflect the racial segregation and poverty with regard to health disparities and poor health outcomes that are reflective of Baltimore City. This is in direct contrast to neighboring Baltimore City/Baltimore County zip codes (21208 & 21209) in which the hospital is located. The median household income 2.5 times higher, and in the population is predominantly white. Promoting the Health of the Community Schedule H, Part VI, Line 5 MWPH has many programs that demonstrate how the hospital is promoting health in the community. For example our 'Safety Baby Showers' partner with existing agencies in Community Benefit Service Area that are currently providing services for pre/post natal women and provide safety baby showers to women and/or their families to educate them about injury prevention topics such as choking, poisoning, child passenger safety, burning/scalding, infant sleep safety and falls and other residential injuries. There MWPH provides materials on proper nutrition, physical activity, and stress management to encourage healthy full-term pregnancies. At the event, talks are given on behavior management, developmentally appropriate toys/play, baby sign language, and a resource guide to parents of free resources in the community to provide parents with skills and tools required to be better and more engaged parents. Participants were evaluated by Pre and Post tests that focused on various injury prevention topics which also included safe sleep and shaken baby syndrome. The BMore Healthy program provided parents with a 15 min. video about sleep safety and a talk about nutrition physical activity and stress management. A total of eighteen 2-hour talks were conducted with a total of 196 participants. On the pre-talk test, 80 of the participants answered at least one of the 12 questions wrong. 101 of the participants answered enough questions correctly to earn a passing score on the post-talk survey. 7 of the participants answered four or fewer questions correctly. On the post-talk test 199 of the participants answered all 12 questions correctly and 5 person answered. 11 of 12 correctly All participants earned a passing score on the post test. Safety Baskets provided with prevention materials (latches, bath hot water thermometers, poisoning control magnets) and educational materials on how to safety proof home provided to 123 families after participating in talk/presentation at the shower. Dinner or breakfast was provided to families as well (depending on time of the event), costing approximately $15,000 to support this initiative. Another example of MWPH promoting community health and wellness are the Weigh Smart and Weigh Smart Jr. programs. Meeting the national and local identified need of reducing the proportion of youth who are obese, and increasing the proportion of adults who are at a healthy weight; the Weigh Smart program investigated diet quality before and after participation in a pediatric weight management program by identifying poor diet quality that is associated with obesity such as inadequate fruit and vegetable intake, excessive sugar-sweetened beverages (SSB) and fast food intake. An inter-professional psycho-educational weight management program was facilitated involving medicine, nutrition, physical therapy, and psychology. The program established a coordinated holistic approach to management of diagnoses that have a nutritional component. Coordinators engaged targeted communities on healthy lifestyles by sponsoring community meetings, advocating for health policy and legislation, providing food nutrition label reading sessions, and providing heart healthy cooking demos and/or tastings. To reach out to communities in the CBSA, educational materials were developed and distributed at various health fairs. Program was evaluated by Childrens Dietary Questionnaire (CDQ) was administered to caregivers of patients ages 2-17 years during initial consultation. Results included change in body composition for participants- weight, height, BMI, body fatness, as well as a change in quality of life, change in dietary quality, and change in behaviors by child and parent report (according to parent and child self report). A total of 3671 participants, 78% show decreased Body Mass Index z score at 1 yr, 21% decreased mean insulin levels, 4% decreased mean cholesterol level, 14% decreased mean triglyceride level. Diet changes French fries decreased from 1.06 to 0.49 (p=0.023) over last 7 days, Fast food decreased from 1.55 to 0.75 (p=0.000) over last 7 days, Fruit juice/fruit drink decreased from 2.15 to 1.53 (p=0.021) in the past 24 hours, Soft drink/sweet tea/koolaid/lemonade (not diet) decreased 1.77 to 1.23 per wk (p=0.073), Potato chips, other chips (e.g. Fritos, Doritos) or crackers decreased 1.49 to 1.05 per wk (p=0.096), Ice-cream/Popsicles decreased 1.14 to 0.69 per wk (p=0.069). Also statistically significant improvements in quality of life measurements. Community Advocacy coordinator 76 health fairs and distributed materials as well as provided demonstration of proper food portions with food models. The total cost for the program is $1,321,302. Healthy Living Academy (HLA) The after-school health program known as Healthy Living Academy (HLA) concluded in July 2012, having enrolled 158 students from five Baltimore area schools Mt Washington Elementary School, Robert Coleman Elementary School, Rosemont Elementary/Middle School, St. Francis Academy, and Edmonson High School. The Centers program partner was Baltimore City Community College, where students from the education, counseling, allied health, nursing, and physical education programs were recruited to train as coaches, to the school children and to develop/ teach the curriculum under the guidance of Center staff and BCCC faculty. HLA also used BCCC sports facilities to house the program. HLA created an advisory board of professionals with expertise in program development who assisted in overseeing design and implementation of this program. These experts were the director of community relations for the Baltimore Ravens, director of sales and marketing for Merritt Athletic Clubs, and the executive director of BMore Fit, a nonprofit organization that provides mentoring and training for at-risk youth to become fitness experts while they work toward a GED. The advisory panel helped develop a thorough evaluation matrix to measure the success of the HLA. Participants success was evaluated by examining changes in their knowledge of healthy lifestyles based on comparison of pre- and post-test scores and by changes in their body composition. Results demonstrated that HLA helped participants learn about and develop healthier eating and physical activity habits and achieve improved overall health. A written questionnaire on nutrition, exercise, and stress management was administered to students before and after HLA to evaluate changes in knowledge in these areas. Scores on the post-test improved 19 points on average from pre-test scores for children in the first session and 24 points on average for students in the second session. In addition to changes in knowledge, students showed positive improvements in body composition. These positive changes included decreases in the high school students average weight, body mass index, waist and hip circumference, and changes among elementary school students including decreases in waist and hip circumference and increases in the number of sit-ups and push-ups per minute. Students in HLA learned valuable lessons about the dangers of obesity and importance of healthy lifestyles. Lessons included taking responsibility for ones own health, fitness and safety; motivation and goal setting; risks of obesity; stress management; fast food; and food portions. Staff expanded recruitment to five area schools in an effort to reach enrollment numbers. The impact was broad in that HLA reached students at five area schools. Many students planned to take health messages back to their schools to teach other students as part of their required community service project. In addition to educating youth about fitness and healthy eating, HLA staff shared key health messages with the students families via several Family Day events. A total of 142 families attended Family Day events. The director of community relations for the Baltimore Ravens acted as an Advisory Board member and arranged for a Ravens player to appear at one of the Family Days and talk to the audience about importance of good nutrition and a healthy lifestyle. Students prepared readings and poems about key health messages they had learned in order to teach their families about healthy lifestyles, and they demonstrated yoga to show families some of the new physical skills they were learning. Families received a written health profile for their child with fitness and body composition measures. Staff distributed referral information for pediatric weight management programs at MWPH to families whose child needed obesity services beyond HLA. This information allowed families of children overweight or obese to secure services to improve their health. Family Day events were successful in extending key health messages into the community. HLA successfully impacted 142 families by providing them with the tools and resources to spread health messages to their communities and contributed to the improv Affiliated Health Care System Roles Schedule H, Part VI, Line 6 MWPH is a regional leader in pediatric specialty care and is a jointly owned corporate affiliate of the University of Maryland Medical Systems (UMMS) and Johns Hopkins Health System (Hopkins). state filing of community benefit report schedule h, part vi, line 7 Maryland X X X X false false false false false false false true false SHELDON STEIN PRESIDENT CEO 167620 0 95069 0 0 0 160295 0 22243 0 445227 0 0 0 MARY MILLER CFO / VP - FINANCE 119485 0 28050 0 0 0 29060 0 30359 0 206954 0 0 0 THOMAS ELLIS VP - HUMAN RESOURCES 122286 0 16880 0 0 0 46498 0 22179 0 207843 0 0 0 TIKEE APARECE ATTENDING PHYSICIAN 165022 0 0 0 0 0 3836 0 535 0 169393 0 0 0 BRADFORD HARRIS ATTENDING PHYSICIAN 207536 0 0 0 0 0 9464 0 13246 0 230246 0 0 0 MONIQUE SATPUTE NATIONAL PROGRAM DIRECTOR 196235 0 0 0 0 0 8501 0 18511 0 223247 0 0 0 KAREN WILLING ATTENDING PHYSICIAN 208936 0 0 0 0 0 11453 0 17107 0 237496 0 0 0 STEPHEN NICHOLS MD ATTENDING PHYSICIAN 219920 0 0 0 0 0 15271 0 30358 0 265549 0 0 0 JENNIFER BOWIE VP - NURSING ADMIN 130455 0 21744 0 0 0 15919 0 8577 0 176695 0 0 0 Non Fixed Payments Schedule J, Part I, Line 7 BONUSES PAID ARE BASED ON A NUMBER OF VARIABLES INCLUDING BUT NOT LIMITED TO INDIVIDUAL GOAL ACHIEVEMENTS AS WELL AS ORGANIZATION OPERATION ACHIEVEMENTS. THE FINAL DETERMINATION OF THE BONUS AMOUNT IS DETERMINED AND APPROVED BY THE BOARD AS PART OF THE OVERALL COMPENSATION REVIEW OF THE OFFICERS AND KEY EMPLOYEES. A Maryland Health & Higher Educational Facilities 500936091 574216LR6 2007-11-01 7585000 Construction false false false A 0 7585000 0 0 0 0 0 0 0 0 0 0 1985 false false true true A false false false false 0 true false false true A false false false true true false 0 false 0 false true A true Members or Stockholders Form 990, Part VI, Line 6 and 7a JOHNS HOPKINS HEALTH SYSTEM (JHHS) AND THE UNIVERSITY OF MARYLAND MEDICAL SYSTEM (UMMS) ARE EQUAL MEMBERS OF MT. WASHINGTON PEDIATRIC HOSPITAL (MWPH). JHHS AND UMMS EACH ELECT AN EQUAL NUMBER OF MEMBERS TO THE BOARD OF MWPH. Form 990 Review Process Form 990, Part VI, Line 11b THE IRS FORM 990 IS PREPARED AND REVIEWED BY THE ACCOUNTING FIRM OF GRANT THORNTON. ACCOUNTING PERSONNEL IN FINANCE SHARED SERVICES AT THE UNIVERSITY OF MARYLAND MEDICAL SYSTEM GATHER THE INFORMATION NEEDED TO COMPLETE THE RETURN AND INPUT THE DATA INTO THE GRANT THORNTON TAX ORGANIZER, WHICH IS AN EXCEL-BASED SYSTEM. WHEN ALL DATA HAS BEEN ENTERED, THE INFORMATION IS SUBMITTED TO GRANT THORNTON FOR IMPORTATION INTO THEIR TAX SOFTWARE. AT THIS POINT, GRANT THORNTON STAFF MEMBERS REVIEW THE DATA, ASK FOR ADDITIONAL INFORMATION IF NEEDED AND PREPARE THE TAX RETURN. EACH RETURN IS REVIEWED AT SEVERAL LEVELS AT GRANT THORNTON INCLUDING THE TAX PARTNER. AFTER THEIR REVIEW PROCESS, A DRAFT RETURN IS SENT TO THE ACCOUNTING STAFF AT UMMS FOR AN IN-HOUSE REVIEW. UPON COMPLETION OF THE IN-HOUSE REVIEW, GRANT THORNTON IS INSTRUCTED TO MAKE ANY NECESSARY CHANGES AND TO PREPARE THE FINAL TAX RETURN. THE FINAL RETURN UNDERGOES ANOTHER REVIEW BY THE ACCOUNTING STAFF AT FINANCE SHARED SERVICES AND IS ALSO REVIEWED BY THE ACCOUNTING MANAGER, THE DIRECTOR OF FINANCIAL REPORTING, THE VICE PRESIDENT OF FINANCE AND THE CFO, WHO SIGNS THE RETURN. PRIOR TO FILING THE IRS FORM 990, THE ORGANIZATION'S BOARD CHAIRMAN, TREASURER, AUDIT COMMITTEE CHAIRMAN, EXECUTIVE COMMITTEE CHAIRMAN OR OTHER MEMBER OF THE BOARD WITH SIMILAR AUTHORITY WILL REVIEW THE IRS FORM 990. AT THE DISCRETION OF THE REVIEWING BOARD MEMBER, SUCH MEMBER WILL BRING ANY ISSUES OR QUESTIONS RELATED TO THE COMPLETED IRS FORM 990 TO THE ATTENTION OF THE BOARD. NOTWITHSTANDING THE ABOVE, A BOARD RESOLUTION IS NOT REQUIRED FOR THE FILING OF THE ORGANIZATION'S IRS FORM 990. EACH BOARD MEMBER IS PROVIDED WITH A COPY OF THE FINAL IRS FORM 990 BEFORE FILING. Conflict of Interest Policy Monitoring & Enforcement Form 990, Part VI, Line 12c THE ORGANIZATION'S OFFICERS, DIRECTORS, EMPLOYEES AND MEDICAL STAFF MEMBERS, AS APPLICABLE, SHALL DISCLOSE CONFLICTS OF INTEREST OR POTENTIAL CONFLICTS OF INTEREST BETWEEN THEIR PERSONAL INTERESTS AND THE INTERESTS OF THE ORGANIZATION, OR ANY ENTITY CONTROLLED BY OR OWNED IN SUBSTANTIAL PART BY THE ORGANIZATION. A QUESTIONNAIRE WHICH DISCLOSES POTENTIAL CONFLICTS OF INTEREST IS DISTRIBUTED ANNUALLY TO ALL OFFICERS, DIRECTORS AND KEY EMPLOYEES. THE GENERAL COUNSEL OF THE UNIVERSITY OF MARYLAND MEDICAL SYSTEM CORPORATION (UMMSC) REVIEWS THE RESPONSES FOR UMMSC, AND JAMES LAWRENCE KERNAN HOSPITAL. THE CEO OR CFO OF EACH OF THE OTHER ENTITIES IN THE UNIVERSITY OF MARYLAND MEDICAL SYSTEM REVIEWS THE RESPONSES FOR THOSE ENTITIES. THE GENERAL COUNSEL, IN CONSULTATION WITH THE AUDIT COMMITTEE, IF NECESSARY, WOULD DETERMINE IF A CONFLICT OF INTEREST EXISTED FOR UMMSC, AND JAMES LAWRENCE KERNAN HOSPITAL. WITH RESPECT TO THE OTHER ENTITIES IN THE UNIVERSITY OF MARYLAND MEDICAL SYSTEM, THE GENERAL COUNSEL MAY BE CALLED FOR CONSULT. IF SO, THE GENERAL COUNSEL MAY CONSULT THE AUDIT COMMITTEE, IF NECESSARY. WHENEVER A CONFLICT OR POTENTIAL CONFLICT OF INTEREST EXISTS, THE NATURE OF THE CONFLICT OR POTENTIAL CONFLICT OF INTEREST MUST BE DISCLOSED IN WRITING TO THE ORGANIZATION'S BOARD, BOARD COMMITTEE, AN OFFICER OF THE ORGANIZATION OR OTHER APPROPRIATE EXECUTIVE. SUCH INDIVIDUAL HAVING A POTENTIAL CONFLICT OF INTEREST SHALL PLAY NO ROLE ON BEHALF OF THE ORGANIZATION, OR ANY ORGANIZATION CONTROLLED OR SUBSTANTIALLY OWNED, IN ANY TRANSACTION IN WHICH A CONFLICT EXISTS. ALL INVITATIONS FOR BIDS, PROPOSALS OR SOLICITATIONS FOR OFFERS INCLUDE THE FOLLOWING PROVISION: ANY VENDOR, SUPPLIER OR CONTRACTOR MUST DISCLOSE ANY ACTUAL OR POTENTIAL TRANSACTION WITH ANY ORGANIZATION OFFICER, DIRECTOR, EMPLOYEE OR MEMBER OF THE MEDICAL STAFF, INCLUDING FAMILY MEMBERS WITHIN FIVE DAYS OF THE TRANSACTION. FAILURE TO COMPLY WITH THIS PROVISION IS A MATERIAL BREACH OF AGREEMENT. IN ADDITION, A BOARD DISCLOSURE REPORT IS FILED WITH THE MARYLAND HEALTH SERVICES COST REVIEW COMMISSION ON AN ANNUAL BASIS SHOWING ANY BUSINESS TRANSACTIONS BETWEEN THE BOARD MEMBERS AND THE ORGANIZATION. Process for Determining Compensation Form 990, Part VI, Lines 15a and 15b THE ORGANIZATION DETERMINES THE EXECUTIVE COMPENSATION PAID TO ITS EXECUTIVES IN THE FOLLOWING MANNER PRESCRIBED IN THE IRS REGULATIONS: EXECUTIVE COMPENSATION PACKAGES ARE DETERMINED BY A COMMITTEE OF THE BOARD THAT IS COMPOSED ENTIRELY OF BOARD MEMBERS WHO HAVE NO CONFLICT OF INTEREST. THE COMMITTEE ACQUIRES CREDIBLE COMPARABILITY MARKET DATA CONCERNING THE COMPENSATION PACKAGES OF SIMILARLY SITUATED EXECUTIVES. THE COMMITTEE CAREFULLY REVIEWS THAT DATA, THE EXECUTIVE'S PERFORMANCE AND THE PROPOSED COMPENSATION PACKAGES DURING THE DECISION MAKING PROCESS. THE COMMITTEE MEMORIALIZES ITS DELIBERATIONS IN DETAILED MINUTES REVIEWED AND ADOPTED AT THE NEXT-FOLLOWING MEETING. THE COMMITTEE SEEKS AN OPINION OF COUNSEL THAT IT HAS MET THE REQUIREMENTS OF THE IRS INTERMEDIATE SANCTIONS REGULATIONS. THIS PROCESS IS USED TO DETERMINE THE COMPENSATION PACKAGES FOR ALL MANAGEMENT EMPLOYEES FROM THE VICE PRESIDENT LEVEL AND UP. How Documents are Made Available to the Public Form 990, Part VI, Line 19 IN GENERAL, FINANCIAL AND TAX INFORMATION RELATING TO THE ORGANIZATION IS DEEMED PROPRIETARY AND NOT SUBJECT TO DISCLOSURE UPON REQUEST. HOWEVER, SPECIFIC PROVISIONS OF FEDERAL AND STATE LAW REQUIRE THE ORGANIZATION TO DISCLOSE CERTAIN LIMITED FINANCIAL AND TAX DATA UPON A SPECIFIC REQUEST FOR THAT INFORMATION. REQUESTS FOR FORM 990 AND FORM 1023: A REQUESTOR SEEKING TO REVIEW AND/OR OBTAIN A COPY OF THE ORGANIZATION'S IRS FORM 990 OR FORM 1023 AS FILED WITH THE INTERNAL REVENUE SERVICE, INCLUDING ALL SCHEDULES AND ATTACHMENTS, MAY APPEAR IN PERSON OR SUBMIT A WRITTEN REQUEST. THE MOST RECENT THREE YEARS OF IRS FORM 990 MAY BE REQUESTED. IF THE REQUESTER APPEARS IN PERSON, THE INDIVIDUAL IS DIRECTED TO THE OFFICE OF THE CHIEF FINANCIAL OFFICER FOR THE ORGANIZATION AND THE FORM 990 AND/OR FORM 1023 ARE MADE AVAILABLE FOR INSPECTION. THE INDIVIDUAL IS PERMITTED TO REVIEW THE RETURN, TAKE NOTES AND REQUEST A COPY. IF REQUESTED, A COPY IS PROVIDED ON THE SAME DAY. A NOMINAL FEE IS CHARGED FOR MAKING THE COPIES. THE ORGANIZATION MAY HAVE AN EMPLOYEE PRESENT DURING THE PUBLIC INSPECTION OF THE DOCUMENT. WRITTEN REQUESTS FOR AN ENTITY'S FORM 990 OR FORM 1023 ARE DIRECTED IMMEDIATELY TO THE OFFICE OF THE CHIEF FINANCIAL OFFICER FOR THE ORGANIZATION. THE REQUESTED COPIES ARE MAILED WITHIN 30 DAYS OF THE REQUEST. REPRODUCTION FEES AND MAILING COSTS ARE CHARGED TO THE REQUESTOR. CONFLICT OF INTEREST POLICY AND GOVERNING DOCUMENTS: IF THE GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY OF OUR ORGANIZATION ARE SUBJECT TO THE FEDERAL PUBLIC DISCLOSURE RULES (OR STATE PUBLIC DISCLOSURE RULES), THESE DOCUMENTS WILL BE MADE PUBLICLY AVAILABLE AS APPLICABLE LAW MAY REQUIRE. OTHERWISE, THE GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY WILL BE PROVIDED TO THE PUBLIC AT THE DISCRETION OF MANAGEMENT. Reconciliation of Net Assets Form 990, Part XI, Line 9 Unrestricted: Unrealized Gains (loss)- Other than Trading Securities (286,776) Change in Funded Status of Defined Benefit Plan (989,519) Change in Economic Interest- MWPF Unrestricted (743,973) Net Assets Released for purchase of equipment 130,786 ------------- Restricted: Change in Economic Interest- MWPF Restricted (89,507) Net Assets Released for Operations (642,948) Net Assets Released for purchase of equipment (130,786) ----------- Total (2,752,723) MWPCH 1708 W Rogers Avenue Baltimore MD 21209 383987088 Healthcare MD 2471 3250 MWPH Mount Washington Pediatric Foundation 1708 West Rogers Avenue Baltimore MD 21209 521736672 Fundraising MD 501(c)(3) 11A MWPH true false false true false false false false false false false false false false false false false false false false MT WASHINGTON PEDIATRIC FOUNDATION c 670305 FMV