2017-05-10T22:16:59-05:00 2016-06-30 KPMG LLP 1676 INTERNATIONAL DRIVE McLean VA 22102 990 2015-07-01 521272129 WASHINGTON HOSPITAL CENTER CORPORATION % JOEL BRYAN WASH 2028777000 110 Irving Street NW Washington DC 20010 JOEL BRYAN VP/TREASURER 4107726721 2017-05-08 true JG WHITE P01498698 7032868000 2015 2021-01-29 14:40:06Z MEDSTAR WASHINGTON HOSPITAL CENTER John Sullivan 110 IRVING STREET NW WASHINGTON DC 20010 1213006491 false X www.whcenter.org X 1949 DC MWHC IS DEDICATED TO PROVIDING THE REGION WITH THE HIGHEST QUALITY AND LATEST MEDICAL ADVANCES THROUGH EXCELLENCE IN PATIENT CARE, EDUCATION, AND RESEARCH. 15 9 7110 85 5249537 -744197 21674943 13715887 1136924407 1178390860 4654265 1827662 13460004 19003617 1176713619 1212938026 0 0 0 0 599575631 607848852 0 0 0 539117403 557109658 1138693034 1164958510 38020585 47979516 553794757 546120417 270969849 205237407 282824908 340883010 X As a proud member of MedStar Health, MedStar Washington Hospital Center's (MWHC) mission is to deliver exceptional patient first health care to the region with the highest quality and latest medical advances though excellence in patient care, education and research. MWHC is an acute care teaching and research hospital located in northwest Washington, D.C. It is the largest private hospital in the nation's capital and among the 50 largest hospitals in the nation. In fiscal year 2016, MWHC had 43,700 admissions and observations, and 545,211 outpatient visits including 86,771 emergency visits. false false 814271935 0 1136106361 MedStar Washington Hospital Center's is the city's largest and busiest hospital, providing acute care services to the communities of northeast Washington, D.C. and the surrounding areas. In addition to the program service expenses listed above, MWHC incurred $212.1M of management and general expenses in providing services to its communities. It offers primary, secondary and tertiary health services to adult and neonatal patients. It is a major referral center for the most complex tertiary services and operates the region's only adult burn center. MedStar Heart & Vascular Institute, headquartered at MWHC, is a national leader in the research, diagnosis and treatment of cardiovascular disease. In 2013, MedStar Heart & Vascular Institute formed a first-of-its-kind clinical and research alliance with the Sydell and Arnold Miller Family Heart & Vascular Institute at Cleveland Clinic. MWHC's organ transplantation capabilities include heart, pancreas and kidney transplants. MedStar Washington Hospital Center's cancer center offers cancer advanced treatment, therapies and access to the latest cutting-edge clinical trials. The hospital operates the largest, private, hospital-based ground and air ambulance shock-trauma service in the region. It also offers comprehensive ambulatory care through a wide range of medical and surgical specialty outpatient clinic programs. MWHC operates the region's only Joint Commission-certified Comprehensive Stroke Center and Cardiac Ventricular Assist Device Program. 55366160 0 24123120 MedStar Washington Hospital Center provided $55.4M in health professions education in fiscal year 2016. This category includes training in graduate medical education, and education for physicians, medical students, nurses, and other health professions. 31196776 0 17381175 MedStar Washington Hospital Center provided $31.2M in subsidized (mission driven) health services in fiscal year 2016. These critical services, which are driven by community needs, operate at a loss. They address priorities primarily through disease prevention and improvement of health status. 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DEFERRED TAX ASSETS AND LIABILITIES ARE RECOGNIZED FOR THE FUTURE TAX CONSEQUENCES ATTRIBUTABLE TO DIFFERENCES BETWEEN THE FINANCIAL STATEMENT CARRYING AMOUNTS OF EXISTING ASSETS AND LIABILITIES AND THEIR RESPECTIVE TAX BASES AND OPERATING LOSS AND TAX CREDIT CARRYFORWARDS. DEFERRED TAX ASSETS AND LIABILITIES ARE MEASURED USING ENACTED TAX RATES EXPECTED TO APPLY TO TAXABLE INCOME IN THE YEARS IN WHICH THOSE TEMPORARY DIFFERENCES ARE EXPECTED TO BE RECOVERED OR SETTLED. THE EFFECT ON DEFERRED TAX ASSETS AND LIABILITIES OF A CHANGE IN TAX RATES IS RECOGNIZED IN THE PERIOD THAT INCLUDES THE ENACTMENT DATE. ANY CHANGES TO THE VALUATION ALLOWANCE ON THE DEFERRED TAX ASSET ARE REFLECTED IN THE YEAR OF CHANGE. THE CORPORATION ACCOUNTS FOR UNCERTAIN TAX POSITIONS IN ACCORDANCE WITH THE FASB ACCOUNTING STANDARDS CODIFICATION (ASC) TOPIC 740, INCOME TAXES. THERE WAS NO LIABILITY RECORDED FOR UNCERTAIN TAX POSITIONS AS OF JUNE 30, 2016. 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X X X X X X true true X X X X true X www.medstarwashington.org X www.medstarwashington.org X www.medstarwashington.org X X X X X true X false true X false false CHNA INPUT PART V, SECTION B, LINE 5 HOSPITAL LEAD ROLE DESCRIPTION The Community Health Needs Assessment (CHNA) Hospital Lead serves as the coordinator of all aspects of the community health assessment process. He/she helps establish and coordinate the activities of the Advisory Task Force. The Lead also helps produce the hospitals Community Health Needs Assessment and Implementation Strategy. He/she works collaboratively with representatives from the Corporate Community Health Department and Georgetown University. The Lead also works closely with the writer. He/she reviews all narratives prior to publication. Name of Hospital Lead: Phronie Jackson, PhD EXECUTIVE SPONSOR ROLE DESCRIPTION The Executive Sponsor serves as the conduit between the Advisory Task Force and the Senior Management Team. The sponsor is an active participant of the Advisory Task Force and he/she communicates the hospitals clinical strengths and program priorities to diverse audiences. Name of Executive Sponsor: James Hill ADVISORY TASK FORCE ROLE DESCRIPTION The Advisory Task Force (ATF) reviews primary/secondary data and local/state/federal community health goals. Based on findings, the ATF provides input into the hospitals three-year implementation strategy. As ambassadors for the CHNA process, the ATF members support efforts to optimize community participation. Note: The ATF should be a combination of community representatives and staff. Community representatives should makeup at least 50% of total participants. NAME: Title/ AFFILIATION with Name of Organization HOSPITAL Phronie Jackson, Community Health Outreach MedStar Washington PHD Manager, Community Relations Hospital Center GREGORY J. EXECUTIVE SPONSOR MEDSTAR WASHINGTON Argyros, MD, SENIOR VICE PRESIDENT MEDICAL HOSPITAL CENTER MACP, FCCP AFFAIRS/CHIEF MEDICAL OFFICER DESIGNATED INSTITUTIONAL OFFICIAL ARTHUR WEST, MD PRESIDENT, MEDICAL AND DENTAL MEDSTAR WASHINGTON STAFF HOSPITAL CENTER Mary Farmer Allen ANC Commissioner Ward 5C 06 C. Dianne Barnes ANC Commissioner Ward 5C 07 Richard T. Associate Director, MedStar Washington Benson,MD Stroke Center Hospital Center Nitara Coleman Outreach Director Ward Five Health Coalition Ambrose Lane, Jr. EXECUTIVE DIRECTOR WARD SEVEN HEALTH ALLIANCE NETWORK KATHLEEN SAVOY, ASSISTANT DIRECTOR, MEDSTAR WASHINGTON MHA IMPROVEMENT & POPULATION HOSPITAL CENTER HEALTH PHYSICIAN PERFORMANCE Craig DeAtley, Director, Institute for MedStar Washington PA-C Public Health Emergency Hospital Center Readiness Shirley DeWitt, Neuroscience Institute MedStar Washington RN, BSN, CLNC Coordinator Hospital Center Vivian Grayton Director Seabury Ward 5 Aging SERVICES Khay Bullock Manager, Community Relations MedStar Washington Henry Hospital Center Cleopatra Jones Executive Director Neighbors of Seaton COMMUNITY EMPOWERMENT PLACE WARD 5 SPECIALIST Grace Lewis President North Michigan Civic Association MARSHALL PHILLIPS MINISTER COMMISSIONER GREATER MOUNT CALVARY HOLY CHURCH WARD 5C 08 EDGEWOOD COMMUNITY Paula Reichel DC Regional Director Capital Area Food Bank CALVIN SMITH DIRECTOR, GOVERNMENT & WARD EIGHT HEALTH COMMUNITY RELATIONS COUNCIL BRIDGEPOINT HEALTHCARE Pauline Schneider Senior Counselor Ballard Spahr, LLP Douglass Sloan Vice President, Vice- Chair DC NAACP ANC 4B Carolyn Steptoe Former Commissioner ANC Ward 5 Romaine Thomas Community Outreach Specialist Office of Aging, AGING AND DISABILITY RESOURCE GOVERNMENT OF THE CENTER DISTRICT OF COLUMBIA Tina Thompson Commissioner Emeritus ANC 4D 03 IMPLEMENTATION STRATEGIES PART V, SECTION B, LINE 11 THE IMPLEMENTATION STRATEGIES SERVE AS A ROADMAP FOR HOW COMMUNITY BENEFIT RESOURCES WILL BE ALLOCATED AND DEPLOYED. MEDSTAR'S HOSPITALS WILL BE ABLE TO MEASURE OUR CONTRIBUTION TO IMPROVING THE HEALTH OF UNDERSERVED AND VULNERABLE POPULATIONS IN THE REGIONS WE SERVE. THREE-YEAR IMPLEMENTATION STRATEGIES WITH MEASURABLE OBJECTIVES WERE DEVELOPED FOR EACH HOSPITAL'S COMMUNITY BENEFIT SERVICE AREA - A SPECIFIC COMMUNITY OR TARGET POPULATION OF FOCUS. PRIORITIES WERE BASED ON COMMUNITY NEED AS DETERMINED BY QUANTITATIVE DATA AND COMMUNITY INPUT, AS WELL AS ON HOSPITAL EXPERTISE, RESOURCES, STRENGTHS OF EXISTING PROGRAMMING AND PARTNERSHIPS, AND ALIGNMENT WITH NATIONAL, STATE, AND LOCAL HEALTH GOALS. THE MEDSTAR HEALTH CORPORATE COMMUNITY HEALTH DEPARTMENT WILL PROVIDE SYSTEM-WIDE COORDINATION AND OVERSIGHT OF COMMUNITY BENEFIT PROGRAMMING. CHARITY CARE AND CERTAIN OTHER BENEFITS AT COST PART I, LINE 7 MEDICARE COST REPORT DATA AS WELL AS COST-TO-CHARGE RATIO WERE USED TO CALCULATE FIGURES REPORTED (WHERE APPLICABLE). THE COST-TO-CHARGE RATIO WAS DERIVED FROM WORKSHEET 2 RATIO OF PATIENT CARE COST-TO-CHARGES. BAD DEBT PART III, LINE 4 MEDSTAR HEALTH AND ITS AFFILIATED ORGANIZATIONS REPORT BAD DEBT EXPENSE IN ACCORDANCE WITH ASU 2011-07, WHICH REQUIRES CERTAIN HEALTHCARE ENTITIES TO CHANGE THE PRESENTATION OF THEIR STATEMENT OF OPERATIONS BY RECLASSIFYING THE PROVISION FOR BAD DEBTS ASSOCIATED WITH PATIENT SERVICE REVENUE FROM AN OPERATING EXPENSE TO A DEDUCTION FROM PATIENT SERVICE REVENUE (NET OF CONTRACTUAL ALLOWANCES AND DISCOUNTS). HOWEVER, MEDSTAR AND ITS AFFILIATED ENTITIES DO NOT MAKE A DETERMINATION AS TO WHETHER SELF PAY AMOUNTS ARE COLLECTIBLE IN DETERMINING REVENUE RECOGNITION. RESERVE MODELS, WHICH HAVE BEEN DEVELOPED BASED ON HISTORICAL COLLECTION RESULTS AND WHICH ARE ADJUSTED PERIODICALLY BASED ON ACTUAL COLLECTIONS EXPERIENCE, ARE USED TO ESTIMATE UNCOLLECTIBLE AMOUNTS ACROSS ALL PAYORS INCLUDING SELF PAY. BAD DEBT DETERMINATIONS ARE MADE ONLY AFTER SUFFICIENT EVIDENCE IS OBTAINED TO SUPPORT THAT AN AMOUNT IS NOT COLLECTIBLE. MEDICARE PART III, LINE 8 THIS IS A COST-TO-CHARGE RATIO DETERMINED FROM OUR FINANCIAL REPORT. DEBT COLLECTION POLICY PART III, LINE 9 IF IT IS DETERMINED THAT A PATIENT MAY POTENTIALLY QUALIFY FOR A CHARITABLE/FINANCIAL PROGRAM, A HOLD IS PLACED ON THE ACCOUNT TO PREVENT IT FROM BEING REPORTED AS BAD DEBT UNTIL PROGRAM APPROVALS HAVE BEEN OBTAINED. IF IT IS APPROVED, THE ACCOUNT IS DOCUMENTED AND THE NECESSARY ADJUSTMENTS ARE MADE TO CLOSE THE ACCOUNT. NEEDS ASSESSMENT PART VI, LINE 2: In FY15, MedStar Washington Hospital Center (the Hospital Center) conducted a Community Health Needs Assessment (CHNA) in accordance with the guidelines established by the Patient Protection and Affordable Care Act and the Internal Revenue Service. The hospitals CHNA was led by 26 Advisory Task Force (ATF) members, which was comprised of a diverse group of individuals, including community residents, faith-based leaders, hospital representatives and public health experts. The ATF reviewed quantitative and qualitative community health data, as well as local, regional and national health goals. Based on their findings, the ATF designed a survey to identify trends in how participants perceived the severity of key health issues in the following categories: wellness and prevention, access to care, quality of life, and environment. Community members responded to the survey by attending a community input session or completing it online or via hardcopy. Based on the ATFs recommendation, the hospital identified Wards 5, 7 and 8 of the District of Columbia as its Community Benefit Service Area (CBSA) geography with a high density of low-income or vulnerable residents within close proximity of the hospital. Health priorities for the CBSA include chronic disease (heart disease/stroke, cancer, diabetes, and obesity), and teen births and child development. The hospitals FY15 CHNA and three-year Implementation Strategy was endorsed by the Hospital Centers Board of Directors and approved by the MedStar Health Board of Directors. The document became available on the hospitals official website on June 30, 2015. As a proud member of MedStar Health, representatives from the Hospital Center routinely participate in the MedStar Health community benefit workgroup. The workgroup is comprised of community health professionals who represent all ten MedStar hospitals. The team analyzes local and regional community health data, establishes system-wide community health programming performance and evaluation measures and shares best practices. PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE PART VI, LINE 3: As one of the regions leading not-for-profit healthcare systems, MedStar Health is committed to ensuring that uninsured patients within the communities we serve who lack financial resources have access to necessary hospital services. MedStar Health and its healthcare facilities will: * Treat all patients equitably, with dignity, with respect and with compassion. * Serve the emergency health care needs of everyone who presents at our facilities regardless of a patient's ability to pay for care. * Assist those patients who are admitted through our admissions process for non-urgent, medically necessary care who cannot pay for part of all of the care they receive. * Balance needed financial assistance for some patients with broader fiscal responsibilities in order to keep its hospitals' doors open for all who may need care in the community. In meeting its commitments, MedStar Healths facilities work with their uninsured patients to gain an understanding of each patients financial resources prior to admission (for scheduled services) or prior to billing (for emergency services). Based on this information and patient eligibility, MedStar Healths facilities assists uninsured patients who reside within the communities we serve in one or more of the following ways: * Assist with enrollment in publicly-funded entitlement programs (e.g., Medicaid). * Assist with enrollment in publicly-funded programs for the uninsured (e.g., D.C. Healthcare Alliance). * Assist with consideration of funding that may be available from other charitable organizations. * Provide charity care and financial assistance according to applicable guidelines. * Provide financial assistance for payment of facility charges using a sliding scale based on patient family income and financial resources. * Offer periodic payment plans to assist patients with financing their healthcare services. Each MedStar Health facility (in cooperation and consultation with the finance division of MedStar Health) specifies the communities it serves based on the geographic areas it has served historically for the purpose of implementing this policy. Each facility posts the policy, including a description of the applicable communities it serves, in each major patient registration area and in any other areas required by applicable regulations, communicates the information to patients as required by this policy and applicable regulations and makes a copy of the policy available to all patients. MedStar Health believes that its patients have personal responsibilities related to the financial aspects of their healthcare needs. The charity care, financial assistance, and periodic payment plans available under this policy are not available to those patients who fail to fulfill their responsibilities. For purposes of this policy, patient responsibilities include: * Completing financial disclosure forms necessary to evaluate their eligibility for publicly-funded healthcare programs, charity care programs, and other forms of financial assistance. These disclosure forms must be completed accurately, truthfully, and timely to allow MedStar Healths facilities to properly counsel patients concerning the availability of financial assistance. * Working with the facilitys financial counselors and other financial services staff to ensure there is a complete understanding of the patients financial situation and constraints. * Completing appropriate applications for publicly-funded healthcare programs. This responsibility includes responding in a timely fashion to requests for documentation to support eligibility. * Making applicable payments for services in a timely fashion, including any payments made pursuant to deferred and periodic payment schedules. * Providing updated financial information to the facilitys financial counselors on a timely basis as the patients circumstances may change. counselors on a timely basis as the patients circumstances may change. COMMUNITY INFORMATION PART VI, LINE 4 Geographic: MedStar Washington Hospital Centers CBSA includes adults age 18 or older who reside in Wards 5, 7, and 8 of the District of Columbia. Ward 5 was selected due to its close proximity to the hospital, coupled with an opportunity to build upon pre-existing and prior programs and services in Ward 5. Wards 7 and 8 were selected, because the majority of the residents of those wards are considered underserved and made up a significant number of visits to MWHC inpatient, observation, outpatient and emergency room. Demographics: Ward 5, the focal point of the CBSA, is located in the northeastern quadrant of the District of Columbia. It is the home of approximately 82,049 residents; 82% are adults age 18 and older, the concentration of adults older than 65 is high in Ward 5 (13.7%) compared to the citywide average of 11.3%. The majority of residents are Black/African American (70.4%). Twenty percent are White, and 8.5% are Hispanic. The average household income in Ward 5 ($77,329) is less than the city average ($107,594). The percent of adults with a high school diploma or higher education (86.3%) is less than the city average (89.3%). The rate of unemployment is 9.6% for the city and 14% for Ward 5, and the percentage of families living in poverty in Ward 5 is 13.5% as compared to 14.3% for the entire city. Ward 7 is the home of approximately 73,290 residents; 76.8% are adults age 18 and older, the concentration of adults older than 65 is high in Ward 7 (12.9%) compared to the citywide average of 11.3%. The majority of residents are Black/African American (94.2%). Two percent are White, and 3.0% are Hispanic. The average household income in Ward 7 ($53,093) is less than the city average ($107,594). The percent of adults with a high school diploma or higher education (83.0%) is less than the city average (89.3%). The rate of unemployment is 9.6% for the city and 19.0% for Ward 7, and the percentage of families living in poverty in Ward 7 is 23.6% as compared to 14.3% for the entire city. Ward 8 is the home of approximately 81,133 residents; 76.8% are adults age 18 and older, the concentration of adults older than 65 is low in Ward 8 (7.7%) compared to the citywide average of 11.3%. The majority of residents are Black/African American (92.8%). Five percent are White, and 2.0% are Hispanic. The average household income in Ward 8 ($44,245) is less than the city average ($107,594). The percent of adults with a high school diploma or higher education (83.0%) is less than the city average (89.3%). The rate of unemployment is 9.6% for the city and 23.0% for Ward 8, and the percentage of families living in poverty in Ward 8 is 35.3% as compared to 14.3% for the entire city. Source: U.S. Census Bureau, 2011-2015 American Community Survey (ACS) 5-Year Estimates. PROMOTION OF COMMUNITY HEALTH PART VI, LINE 5: As a community partner, MedStar Washington Hospital Center (MWHC) engages in a number of community benefit activities to improve and promote the health and wellbeing of the community. Priority areas of focus, as determined by the community health needs assessment are chronic disease, specifically targeting heart disease, cancer, diabetes and obesity. Efforts also focus on teen births and child development. In effort to promote optimal health in the District, the Diabetes Institute at MWHC continues to offer diabetes prevention and self-management classes that aims to reduce the risk of type 2 diabetes. In FY16, 92% of participants reported losing weight. In partnership with the Department of Parks and Recreation, MWHC has also continued to provide community fitness classes to address obesity. Additionally, MWHC contributes to the Districts Million Hearts learning collaborative focused on improving hypertension control. In FY16, MWHCs Speakers Bureau program provided nine lectures on different chronic disease areas including nutrition. The program reached 173 individuals that self-reported a reduction of sodium intake and an increased readiness to improve their health behaviors. WHCs Cancer Program Get2Breast Care Program provided 50 educational events and reached nearly 2000 individuals. Nearly 130 patients received navigation for mammogram assistance. To address Teen Birth and Child Development, The TAPP program continues their partnership with the New Heights Outreach Program through school-based health centers. TAPP provided services for a total of 106 participants, conducted 212 one-on-one counseling sessions in FY16. MWHC will continue to provide resources to the community that fall outside of our community benefit service area demonstrating our commitment to promote optimal health in the overall Washington, DC community. AFFILIATED HEALTH CARE SYSTEM PART VI, LINE 6: As a proud member of MedStar Health, MedStar Washington Hospital Center is able to expand its capacity to meet the needs of the community by partnering with other MedStar hospitals and associated entities. MedStar Health resources assist the hospital in community health planning to meet the needs of the uninsured and other vulnerable populations. Through its community health function, MedStar Health provides the Hospital Center with technical support to enhance community health programming and evaluation. MedStars corporate philanthropy division identifies public and private funding sources to ensure the availability of high quality health services, regardless of ability to pay. State filing of community benefit report PART VI, LINE 7: The community benefit report for MedStar Washington Hospital Center is only filed in the District of Columbia. X X X X X X false true false false false false false false false CARMELLA A COLE MD BOARD MEMBER 301821 0 1000 0 0 0 21189 0 6070 0 330080 0 0 0 SANDRA M SWAIN MD BOARD MEMBER 471942 0 37500 0 0 0 7800 0 1477 0 518719 0 0 0 BENJAMIN I LEE MD BOARD MEMBER 418835 0 148296 0 11841 0 7800 0 13632 0 600404 0 0 0 KENNETH A SAMET BOARD MEMBER 0 1689763 0 3167094 0 15851 0 45721 0 20676 0 4939105 0 0 JOHN SULLIVAN BOARD MEMBER/PRESIDENT 762524 0 642570 0 300000 0 7800 0 4711 0 1717605 0 0 0 BILL GAYNE CHIEF FINANCIAL OFFICER 0 290620 0 92814 0 0 0 0 0 13835 0 397269 0 0 CATHERINE MONGE Former SENIOR VP OF OPERATIONS 276544 0 121344 0 0 0 7800 0 6486 0 412174 0 0 0 PRAFUL RAMINENI PHYSICIAN 294309 0 995934 0 0 0 8535 0 14585 0 1313363 0 0 0 AMMAR BAFI PHYSICIAN 780893 0 667692 0 0 0 7800 0 11869 0 1468254 0 0 0 STEVEN BOYCE PHYSICIAN 972182 0 610085 0 0 0 7800 0 15004 0 1605071 0 0 0 PAUL CORSO SECTION DIRECTOR 635397 0 375004 0 0 0 7008 0 10962 0 1028371 0 0 0 EDWARD WOO Dir, Medstar Vascular Program 893118 0 253000 0 0 0 0 0 15509 0 1161627 0 0 0 Robert Ross Chief Operating Officer 285994 0 156120 0 0 0 8824 0 8669 0 459607 0 0 0 SCHEDULE J, PART III MR. SAMET'S BONUS AND INCENTIVE COMPENSATION IN PART II, COLUMN (B) (II) INCLUDES $878,413, REPRESENTING BENEFITS RECEIVED FROM EXECUTIVE RETIREMENT PLANS THAT ARE COMPRISED OF TARGET BENEFITS DETERMINED ANNUALLY BASED ON COMPENSATION AND YEARS OF SERVICE. William Gaynes compensation is for services provided as CFO to both MedStar Washington Hospital Center and MedStar Health Research Institute. MORRISON HEALTHCARE SERVICES SEE PART V 8188983 FOOD SERVICES false WL Gore and Associates SEE PART V 3313396 Manufacturing Services false Up-To-Date Laundry SEE PART V 1016238 Laundry Services false all american ambulance transport SEE PART V 1233213 Transportation Services false Pepco Holdings SEE PART V 1459895 Energy Services false Diamond Healthcare SEE PART V 12840595 Healthcare Services false Power Solutions SEE PART V 919624 Power Solutions Services false CI Designs SEE PART V 3464427 Architectural Services false The ROI Companies SEE PART V 293654 RCM Services false international limousine svc inc SEE PART V 3298976 Limousine Services false RTKL Associates SEE PART V 267568 Architectural Services false The Bernstein Companies SEE PART V 137961 Real Estate Services false BIOTRONIK Inc SEE PART V 1479379 Medical Services false Metro Aviation Inc SEE PART V 5259512 Aircraft Services false BUSINESS TRANSACTION INVOLVING INTERESTED PERSON SCHEDULE L, PART IV Morrison Healthcare Food Services is a substantial contributor that also provided food services to the hospital. W.L. Gore and Associates is a substantial contributor that also provided manufacturing services to the hospital. Up-To-Date Laundry is a substantial contributor that also provided laundry services to the hospital. All American Ambulance and Transport is a substantial contributor that also provided transportation services to the hospital. Pepco Holdings is a substantial contributor that also provided energy services to the hospital. Diamond Healthcare is a substantial contributor that also provided healthcare services to the hospital. Power Solutions is a substantial contributor that also provided power solutions services to the hospital. C.I. Designs is a substantial contributor that also provided architectural services to the hospital. The ROI Companies is a substantial contributor that also provided RCM Services to the hospital. International Limousine Service, Inc. is a substantial contributor that also provided limousine services to the hospital. RTKL Associates is a substantial contributor that also provided architectural services to the hospital. The Bernstein Companies is a substantial contributor that also provided real estate services to the hospital. BIOTRONIK, Inc. is a substantial contributor that also provided medical services to the hospital. Metro Aviation, Inc. is a substantial contributor that also provided aircraft services to the hospital. Per the conflict of interest policy, all transactions between the hospital and outside vendors should be at Arms-length for fair market value. ORGANIZATION MEMBERS PART VI, LINE 6 THE ORGANIZATION IS AN AFFILIATE AND SUBSIDIARY OF MEDSTAR HEALTH, INC., A TAX-EXEMPT MARYLAND NON-STOCK CORPORATION. MEDSTAR HEALTH, INC., OR ONE OF ITS AFFILIATES AND SUBSIDIARIES, IS THE SOLE MEMBER OF THE ORGANIZATION. DESCRIPTION OF MEMBERS PART VI, LINE 7A AS AN AFFILIATE AND SUBSIDIARY OF MEDSTAR HEALTH, INC., A TAX-EXEMPT MARYLAND NON-STOCK CORPORATION, THE ORGANIZATION MAY RECOMMEND PERSON(S) FOR MEMBERSHIP ON THE ORGANIZATION'S GOVERNING BODY. ANY SUCH RECOMMENDATION BY THE ORGANIZATION IS SUBJECT TO APPROVAL BY THE GOVERNANCE COMMITTEE OF THE BOARD OF DIRECTORS OF MEDSTAR HEALTH, INC. THE BOARD OF MEDSTAR HEALTH, INC. HAS DELEGATED CERTAIN APPROVAL AUTHORITY TO THE GOVERNANCE COMMITTEE AND THE PRESIDENT & CEO OF MEDSTAR HEALTH, INC. DECISION OF GOVERNING BODY PART VI, LINE 7B AS AN AFFILIATE AND SUBSIDIARY OF MEDSTAR HEALTH, INC., A TAX-EXEMPT MARYLAND NON-STOCK CORPORATION, THE BYLAWS OF THE ORGANIZATION ARE SUBJECT TO CERTAIN RESERVED POWERS, WHICH PROVIDE THAT THE SOLE MEMBER OF THE ORGANIZATION MUST APPROVE CERTAIN DECISIONS, INCLUDING BUT NOT LIMITED TO MATTERS CONCERNING THE SALE OR PURCHASE OF REAL OR PERSONAL PROPERTY, CAPITAL BUDGETS, STRATEGIC PLANNING, INVESTMENTS, AND CORPORATE GOVERNANCE. PROCESS FOR REVIEWING FORM 990 PART VI, LINE 11 THE PROCESS FOR REVIEWING THE FORM 990 INCLUDED EDUCATION AND TRANSPARENCY. SENIOR FINANCIAL EXECUTIVES, WORKING WITH INDEPENDENT OUTSIDE EXPERTS, THOROUGHLY REVIEWED FORM 990 AND ACCOMPANYING INSTRUCTIONS. IN ADDITION, SENIOR EXECUTIVES REVIEWED THE RELEVANT SECTIONS OF THE FORM 990 WITH THE FOLLOWING COMMITTEES OF THE ORGANIZATION'S GOVERNING BODY: FINANCE, AUDIT, GOVERNANCE, STRATEGIC PLANNING, AND EXECUTIVE COMPENSATION. FOLLOWING THESE MEETINGS, THE GOVERNING BODY WAS PROVIDED A COPY OF THE FORM 990 IN ITS FINAL FORM AND GIVEN AN OPPORTUNITY TO PROVIDE ANY INPUT OR COMMENTS RELATING TO THE FORM 990 PRIOR TO ITS FILING. CONFLICT OF INTEREST POLICY PART VI, LINE 12C APPOINTMENT OF BOARDS OF DIRECTORS MEDSTAR HEALTH (AND ITS SUBSIDIARIES) REQUIRE ALL NOMINATED DIRECTORS, PRIOR TO THEIR APPOINTMENT OR ELECTION, TO DISCLOSE THE EXISTENCE OF (OR POTENTIAL EXISTENCE OF) ANY TRANSACTION WITH MEDSTAR THAT WOULD RESULT IN A CONFLICT OF INTEREST. SUCH DISCLOSURES (IF ANY) ARE REVIEWED BY THE GOVERNANCE COMMITTEE OF THE MEDSTAR HEALTH BOARD OF DIRECTORS WHICH DETERMINES HOW THE MATTER SHOULD BE RESOLVED. ANNUAL DISCLOSURES - ALL OFFICERS, DIRECTORS, AND SENIOR MANAGERS ALL OFFICERS, DIRECTORS AND SENIOR MANAGERS ARE REQUIRED, NOT LESS THAN ANNUALLY, TO COMPLETE A SURVEY OF QUESTIONS CONCERNING ANY TRANSACTIONS OR RELATIONSHIPS WHICH WOULD OR COULD REPRESENT A CONFLICT OF INTEREST. SUCH DISCLOSURES (IF ANY) RELATED TO DIRECTORS ARE REVIEWED BY THE GOVERNANCE COMMITTEE OF THE MEDSTAR HEALTH BOARD OF DIRECTORS WHICH DETERMINES HOW THE MATTER SHOULD BE RESOLVED. SUCH DISCLOSURES (IF ANY) RELATED TO OFFICERS AND SENIOR MANAGERS ARE REVIEWED BY AN APPROPRIATE EXECUTIVE WHO DETERMINES HOW THE MATTER SHOULD BE RESOLVED. IN ADDITION, OFFICERS AND DIRECTORS OF MARYLAND HOSPITALS AND NURSING CENTERS ARE REQUIRED TO ANNUALLY DISCLOSE ADDITIONAL INFORMATION RELATING TO POTENTIAL CONFLICTS OF INTEREST AND SUCH DISCLOSURES ARE REPORTED TO THE MARYLAND HEALTH SERVICES COST REVIEW COMMISSION (HSCRC). EXECUTIVE COMPENSATION PROCESS PART VI, LINE 15 THE EXECUTIVE COMPENSATION COMMITTEE OF THE BOARD OF DIRECTORS OF MEDSTAR HEALTH, INC. (THE "COMMITTEE") HAS OVERSIGHT OVER THE EXECUTIVE COMPENSATION PROGRAM (THE "PROGRAM") OF MEDSTAR HEALTH, INC. AND ITS AFFILIATES. TOTAL COMPENSATION FOR THE TOP MANAGEMENT OFFICIALS, OFFICERS AND KEY EMPLOYEES OF MEDSTAR HEALTH, INC. AND ITS AFFILIATES ARE REVIEWED AND APPROVED BY THE COMMITTEE WITH ASSISTANCE AND GUIDANCE FROM AN INDEPENDENT THIRD PARTY ADVISOR. THE MEMBERS OF THE COMMITTEE ARE INDEPENDENT FROM ALL OF THE PARTICIPANTS IN THE PROGRAM. THE MAIN OBJECTIVE OF THE PROGRAM IS TO PROVIDE MARKET COMPETITIVE TOTAL COMPENSATION THAT IS INTERNALLY EQUITABLE AND HAS A STRONG PAY-FOR-PERFORMANCE LINKAGE. PERFORMANCE IS EVALUATED AT THE SYSTEM, OPERATING UNIT, AND INDIVIDUAL LEVELS. THE OVERALL TOTAL COMPENSATION PHILOSOPHY IS MANAGED AT THE 75TH PERCENTILE OF THE COMPETITIVE MARKET FOR COMPARABLE SIZE (NET REVENUE) AND TYPE ("TAX-EXEMPT HEALTHCARE ORGANIZATIONS"). WHERE APPROPRIATE, ADDITIONAL INDUSTRY DATA IS CONSIDERED (GENERAL BUSINESS AND/OR TAXABLE HEALTHCARE) FOR SELECTED POSITIONS THAT CAN BE RECRUITED FROM OR POTENTIALLY LOST TO THESE INDUSTRIES (E.G., INFORMATION TECHNOLOGY, FINANCE, ETC.). THE COMMITTEE HAS ENGAGED ERNST & YOUNG LLP ("E&Y") TO SERVE AS AN ADVISOR ON THE REASONABLENESS AND COMPETITIVENESS OF THE PROGRAM. IN DETERMINING REASONABLENESS AND COMPETITIVENESS, E&Y REVIEWS MARKET PRACTICES AND TRENDS, AND MAKES RECOMMENDATIONS RELATED TO THE PROGRAM. E&Y UTILIZES INFORMATION FROM CUSTOM SURVEYS, NATIONAL COMPENSATION SURVEYS, PROPRIETARY DATABASES, AND CLIENT EXPERIENCES TO DETERMINE ITS FINAL RECOMMENDATIONS. E&Y PRESENTS THEIR FINDINGS AND RECOMMENDATIONS TO THE COMMITTEE. THE COMMITTEE MAKES THE FINAL DECISIONS ON ALL OF THE COMPENSATION DETERMINATIONS OF THE PROGRAM. ALL DECISIONS MADE BY THE COMMITTEE ARE CONTEMPORANEOUSLY DOCUMENTED. FINANCIAL STATEMENT AVAILABILITY PART VI, LINE 19 MEDSTAR HEALTH POSTS ITS ANNUAL FINANCIAL AUDIT AND QUARTERLY FINANCIAL REPORTS TO THE ELECTRONIC MUNICIPAL MARKET ACCESS (EMMA) SYSTEM. THE ORGANIZATION ALSO E-MAILS ITS ANNUAL AND QUARTERLY DISCLOSURES TO HOLDERS OF THE COMPANY'S PUBLICLY TRADED DEBT. THE COMPANY'S GOVERNANCE DOCUMENTS AND CONFLICTS OF INTEREST POLICIES ARE AVAILABLE UPON REQUEST THROUGH ITS CORPORATE (OR AS APPLICABLE ENTITY) PUBLIC INFORMATION OFFICES. OTHER CHANGES IN NET ASSETS PART XI, LINE 9 EQUITY TRANSFERS - NET ASSETS.................13,992,204 Physician Imaging of Washington Hosp Ctr 1201 Seven Locks Road Rockville MD 20854 562616090 HEALTH SVCS MD 0 0 NA CHURCH HOME CORPORATION 10980 GRANTCHESTER WAY COLUMBIA MD 21044 237374724 MEDICAL FUND MD 501(c)(3) PF NA true FRANKLIN SQUARE HOSPITAL CENTER INC 9000 FRANKLIN SQUARE DRIVE BALTIMORE MD 21237 520608007 HOSPITAL MD 501(c)(3) 3 NA true HARBOR HOSPITAL INC 3001 SOUTH HANOVER STREET BALTIMORE MD 21225 520491660 HOSPITAL MD 501(c)(3) 3 NA true MEDSTAR HEALTH INC 10980 GRANTCHESTER WAY COLUMBIA MD 21044 522087445 MEDICAL SVCS MD 501(c)(3) 11C III NA false MONTGOMERY GENERAL HOSPITAL 18101 PRINCE PHILIP DRIVE OLNEY MD 20832 520646893 HOSPITAL MD 501(c)(3) 3 NA true THE GOOD SAMARITAN HOSPITAL OF MARYLAND 5601 LOCH RAVEN BLVD BALTIMORE MD 21239 520591607 HOSPITAL MD 501(c)(3) 3 NA true THE UNION MEMORIAL HOSPITAL 201 EAST UNIVERSITY PARKWAY BALTIMORE MD 21218 520591685 HOSPITAL MD 501(c)(3) 3 NA true MEDSTAR HEALTH RESEARCH INSTITUTE 108 IRVING STREET NW WASHINGTON DC 20010 526056274 HOSPITAL DC 501(c)(3) 4 NA true THE MEDSTAR-GEORGETOWN MEDICAL CENTER I HOPSITAL ADMIN 1 MAIN BLDG WASHINGTON DC 20007 522218584 HOSPITAL DC 501(c)(3) 3 NA true HH MEDSTAR HEALTH INC 10980 GRANTCHESTER WAY COLUMBIA MD 21044 521542230 MEDICAL SVCS MD 501(c)(3) 11C III NA true MEDSTAR AMBULATORY SERVICES INC 10980 GRANTCHESTER WAY COLUMBIA MD 21044 521132992 ADMIN SVCS MD 501(c)(3) 11C III NA true BAY LIFE SERVICES INC 10980 GRANTCHESTER WAY COLUMBIA MD 21044 521496539 MENTAL HEALTH MD 501(c)(3) 9 NA true MEDSTAR SURGERY CENTER INC 4061 POWDERMILL ROAD SUITE 210 CALVERTON MD 20705 521061679 MEDICAL SVCS MD 501(c)(3) 9 NA true CHURCH HOME AND HOSPITAL OF THE CITY OF 10980 GRANTCHESTER WAY COLUMBIA MD 21044 520591600 HOSPITAL MD 501(c)(3) 11A I NA true FRANKLIN SQUARE HOSPITAL CENTER FOUNDATI 9000 FRANKLIN SQUARE DRIVE BALTIMORE MD 21237 522329546 FOUNDATION MD 501(c)(3) 7 NA true GOOD SAMARITAN HOSPITAL FOUNDATION INC 5601 LOCH RAVEN BLVD BALTIMORE MD 21239 522307122 FOUNDATION MD 501(c)(3) 11a I NA true GOOD SAMARITAN NURSING CENTER INC 5601 LOCH RAVEN BLVD BALTIMORE MD 21239 521672866 MEDICAL SVCS MD 501(c)(3) 9 NA true GS HOUSING INC 5601 LOCH RAVEN BLVD BALTIMORE MD 21239 521481656 ELDER HOUSING MD 501(c)(3) 9 NA true GS PROPERTIES INC 5601 LOCH RAVEN BLVD BALTIMORE MD 21239 521429853 ADMIN SVCS MD 501(c)(3) 11a I NA true HARBOR HOSPITAL FOUNDATION INC 3001 SOUTH HANOVER STREET BALTIMORE MD 21225 521284532 FOUNDATION MD 501(c)(3) 11A I NA true MEDSTAR HEALTH INFUSION INC 4061 POWDERMILL ROAD SUITE 210 CALVERTON MD 20705 521980510 MEDICAL SVCS MD 501(c)(3) 9 NA true MEDSTAR HEALTH VISITING NURSES ASSOCIATI 4061 POWDERMILL ROAD CALVERTON MD 20705 530196597 MEDICAL SVCS MD 501(c)(3) 9 NA true MEDSTAR VNA HEALTHCARE 4061 POWDERMILL ROAD SUITE 210 CALVERTON MD 20705 521458516 MEDICAL SVCS MD 501(c)(3) 9 NA true MGH COMMUNITY HEALTH INC 18101 PRINCE PHILIP DRIVE OLNEY MD 20832 521372467 MEDICAL SVCS MD 501(c)(3) 9 NA true MGH HEALTH FOUNDATION INC 18101 PRINCE PHILIP DRIVE OLNEY MD 20832 521129959 FOUNDATION MD 501(c)(3) 7 NA true MGH HEALTH SERVICES INC 18101 PRINCE PHILIP DRIVE OLNEY MD 20832 521366812 FOUNDATION MD 501(c)(3) 11B II NA true MGH WOMEN'S BOARD 18101 PRINCE PHILIP DRIVE OLNEY MD 20832 526039600 FOUNDATION MD 501(c)(3) 11C III NA true NATIONAL REHABILITATION HOSPITAL 102 IRVING STREET NW WASHINGTON DC 20010 521369749 HOSPITAL DC 501(c)(3) 3 NA true REGIONAL REHAB AT OLNEY INC 18101 PRINCE PHILIP DRIVE OLNEY MD 20832 522310902 MEDICAL SVCS MD 501(c)(3) 3 NA true SUBURBAN NRH MEDICAL REHABILITATION I 102 IRVING STREET NW WASHINGTON DC 20010 521931151 MEDICAL SVCS DC 501(c)(3) 3 NA true THE THOMAS O'NEIL CATHOLIC HEALTH CARE F 5601 LOCH RAVEN BLVD BALTIMORE MD 21239 521104382 FOUNDATION MD 501(c)(3) 11D III NA true VNA INC 4061 POWDERMILL ROAD SUITE 210 CALVERTON MD 20705 521332411 ADMIN SVCS MD 501(c)(3) II A I NA true WHC FOUNDATION INC 110 IRVING STREET NW WASHINGTON DC 20010 521791670 FOUNDATION DC 501(c)(3) 7 NA true WOODBOURNE WOODS INC 5601 LOCH RAVEN BLVD BALTIMORE MD 21239 522299070 ELDER HOUSING MD 501(c)(3) 9 NA true HOSPICE OF ST MARY'S INC PO BOX 527 LEONARDTOWN MD 20650 522153926 SUPPORT ORG MD 501(c)(3) 11A I NA true ST MARY'S HOSPITAL OF ST MARY'S COUNTY 25500 POINT LOOKOUT ROAD LEONARDTOWN MD 20650 520619006 HOSPITAL MD 501(c)(3) 3 NA true ST MARY'S HOSPITAL FOUNDATION INC PO BOX 527 LEONARDTOWN MD 20650 521051368 SUPPORT ORG MD 501(c)(3) 11A I NA true MEDSTAR SOUTHERN MD HOSPITAL CENTER 7503 SURRATTS ROAD CLINTON MD 20735 460726303 HOSPITAL MD 501(C)(3) 3 NA true MEDSTAR HEALTH INC AND AFFILIATES MASTER 10980 GRANTCHESTER WAY COLUMBIA MD 21044 467454613 RET. TRUST MD 501(A) N/A NA true PHYSICIAN IMAGING OF WASHINGTON 6525 BELCREST ROAD SUITE G 50 Hyattsville MD 20782 562616090 LAB SERVICES MD NA RELATED false 0.51000 MedStar Pharmacies Inc 10980 GRANTCHESTER WAY Columbia MD 21044 521513056 Drug Sales MD NA C Corp ExtenCare Inc 10980 GRANTCHESTER WAY Columbia MD 21044 521556228 Medical Services MD NA C Corp Helix Resources Management Inc 10980 GRANTCHESTER WAY Columbia MD 21044 521913070 Admin ServiCEs MD NA C Corp HelixCare Medical Group LLC 10980 GRANTCHESTER WAY Columbia MD 21044 521955580 Medical Services MD NA C Corp HelixCare Properties LLC 10980 GRANTCHESTER WAY Columbia MD 21044 521966695 Medical Services MD NA C Corp Parkway Ventures Inc 10980 GRANTCHESTER WAY Columbia MD 21044 521893569 Holding Company MD NA C Corp Physicians Administrative Services Inc 10980 GRANTCHESTER WAY Columbia MD 21044 237042074 Billing Services MD NA C Corp MedStar Family Choice Inc 10980 GRANTCHESTER WAY Columbia MD 21044 521995521 Managed Care MD NA C Corp Medstar Enterprises Inc 4061 Powdermill Road Suite 210 Calverton MD 20705 522139841 Admin ServiCEs MD NA C Corp SiTeL Inc 10980 GRANTCHESTER WAY COLUMBIA MD 21044 900753340 EDUCATIONAL Svcs MD NA C Corp Star Billing Inc 4061 Powdermill Road Suite 210 Calverton MD 20705 521850113 Billing Services MD NA C Corp Washington Risk Network Management Inc 4061 Powdermill Road Suite 210 Calverton MD 20705 522132677 Medical Services MD NA C Corp Washington Hospital Center Physician Hos 100 Irving Street NW Washington DC 20010 521931000 Medical Services MD NA C Corp Medstar Physician Partners Inc 4061 Powdermill Road Suite 210 Calverton MD 20705 522030809 Medical Services MD NA C Corp Franklin Square Drive Land Condo Associa 10980 GRANTCHESTER WAY Columbia MD 21044 760756352 Condo Owner Assoc MD NA C Corp MGH Diversified Services Inc 18101 Prince Philip Drive Olney MD 20832 521943602 Medical Services MD NA C Corp St Mary's Health Alliance Inc 25500 Point Lookout Road Leonardtown MD 20650 521930331 Medical Services MD NA C Corp Greenspring Financial Insurance Limited 23 LIME TREE BAY AVENUE PO BOX 1051 KY1-1102 GRAND CAYMAN CJ 980188617 Insurance CJ NA C Corp ST MARY'S CONDO ASSN 25500 POINT LOOKOUT RD LEONARDTOWN MD 20650 273377216 CONDOMINIUMS MD NA C CORP MEDSTAR HEALTH MASTER RETIREMENT TRUST 102 South Church St Grand Cayman CJ KY1-1002 999999999 INVESTMENTS CJ NA C CORP MEDSTAR HEALTH INC - INVESTMENT FUND I 102 South Church St Grand Cayman CJ KY1-1002 981310273 INVESTMENTS CJ NA C CORP false false false false false false false false false false false false true false false true true false false FRANKLIN SQUARE HOSPITAL CENTER INC Q 1433052 FMV THE GOOD SAMARITAN HOSPITAL OF MARYLAND INC Q 978001 FMV HARBOR HOSPITAL INC Q 714675 FMV HH MEDSTAR HEALTH INC Q 282690 FMV MedStar Family Choice INC Q 160496 FMV The MedStar-Georgetown Medical Center INC P 316914 FMV MedStar Health Inc P 18949846 FMV MedStar Health Research Institute P 6005397 FMV NATIONAL REHABILITATION HOSPITAL Q 237617 FMV PARKWAY VENTURES INC Q 124019 FMV ST MARY'S HOSPITAL OF ST MARY'S COUNTY Q 196602 FMV THE Union Memorial Hospital Q 1206446 FMV VNA Inc Q 128188 FMV