2016-11-01T08:00:20-05:00 2015-12-31 350921680 CROWE HORWATH LLP 1455 Pennsylvania Avenue NW Suite 700 Washington DC 200041008 990 2015-01-01 530204670 THE HOSPITAL FOR SICK CHILDREN HOSP 2028324400 1731 BUNKER HILL ROAD NE WASHINGTON DC 200173096 RAY VICKS CFO 2016-11-01 true RACHEL SPURLOCK P00520729 2026245555 2015 2017-02-10 21:41:12Z HSC PEDIATRIC CENTER THOMAS CHAPMAN 1731 BUNKER HILL ROAD NE WASHINGTON DC 200173096 24800388 false X http://www.hschealth.org/medical-programs-therapy X 1997 DC THE HOSPITAL FOR SICK CHILDREN (HSC) PROVIDES QUALITY REHABILITATIVE TRANSITIONAL, AND SPECIALTY CARE FOR INFANTS, CHILDREN, ADOLESCENTS, AND YOUNG ADULTS WITH SPECIAL HEALTH CARE NEEDS IN WASHINGTON, DC AND BALTIMORE AREAS. 8 5 354 102 0 0 280947 121127 31202354 24050757 42459 234011 88722 109016 31614482 24514911 900 0 26002625 22474059 0 0 13495310 12404242 39497935 34879201 -7883453 -10364290 26617223 21742376 17996465 23654580 8620758 -1912204 THE HOSPITAL FOR SICK CHILDREN (HSC) PROVIDES QUALITY REHABILITATIVE, TRANSITIONAL, AND SPECIALTY CARE FOR INFANTS, CHILDREN, ADOLESCENTS, AND YOUNG ADULTS WITH SPECIAL HEALTH CARE NEEDS IN THE WASHINGTON, DC AND BALTIMORE AREAS. false false 30328486 900 24059021 OPEN TO PROVIDE QUALITY REHABILITATIVE AND TRANSITIONAL CARE FOR INFANTS, CHILDREN, ADOLESCENTS, AND YOUNG ADULTS WITH SPECIAL HEALTH CARE NEEDS IN A SUPPORTIVE, CULTURALLY COMPETENT, RESPECTFUL ENVIRONMENT, AND TO PARTICIPATE IN RELATED LOCAL, REGIONAL, AND NATIONAL PROJECTS WITH GOVERNMENT, PRIVATE, AND PHILANTHROPIC ORGANIZATIONS. IN 2015, HSC PROVIDED 10,022 DAYS OF CARE, AND APPROXIMATELY 80% OF THE SERVICES RENDERED IN 2015 WERE PROVIDED TO MEDICAID PATIENTS. HSC ALSO PROVIDED ON AN OUTPATIENT BASIS MEDICAL CARE, APPROXIMATELY 10,207 VISITS IN 2015. 30328486 true true false false false false false false false true true false false true true true true true false false false false false false false false true true false false true true false false false false false false false false false false false false false false false true false true false true 61 0 true 354 true false false false false false false false false false false X 8 5 false false false false false false false true true false false false true true true true true false false false X RAY VICKS 2024541255 2013 H STREET NW STE 300 WASHINGTON DC 20006 Thomas W Chapman President & CEO HSCF, Board Member 4.0 36.0 X X 0 760408 36552 Deborah Holson COO, HSCPC and Board Member 40.0 0.0 X X 143046 0 5854 John Mathewson Executive Vice President 7.0 33.0 X X 0 362925 20575 Jack Kasten Board Member 1.0 3.0 X 0 0 0 Roger E Meyer Board Member 1.0 1.0 X 0 0 0 Margaret O'Bryon Board Member 1.0 0 X 0 0 0 Suzanne Randolph Chairman 1.0 0 X 0 0 0 Pierre Vigilance Board Member 1.0 0 X 0 0 0 Khalil Bouharoun CIO 11.0 29.0 X 0 207432 24000 Raymond Vicks Jr Chief Financial Officer 10.0 30.0 X 0 280397 0 Frances P Christmon VP FINANCE, FINANCIAL PLANNING & ANALYSIS 20.0 20.0 X 0 192935 16097 Lynne Hostetter Piper VP, Human Resources 8.0 32.0 X 0 299245 22089 SAMAR AFLAR HUSSEIN MAAMOUN PEDIATRICIAN 40.0 0 X 223174 0 18000 DR Robert A Blake VP MEDICAL STRATEGIES 40.0 0 X 216093 0 8604 ROBERT D COOK VP SUPPORT AND ANCILLARY SERVICES 40.0 0 X 205923 0 24000 Erlinda S Austria Dir, Reimbursement and Business Analytics 40.0 0 X 165793 0 3280 ANTHONY A QUANDER VP, PROVIDER FINANCIAL SERVICES 40.0 0 X 162227 0 10278 Gene Greer FORMER CIO 0.0 0.0 X 0 147373 0 1116257 2250715 189329 23 true true true Anthelio Healthcare Solutions 5400 LBJ FREEWAY STE 200 DALLAS TX 75240 IT SUPPORT SERVICES 1962367 CHILDREN'S NATIONAL MEDICAL CENTER 111 MICHIGAN AVE NW WASHINGTON DC 20010 HOSPITAL & MEDICAL SPECIALTY SERVICES 958218 ADP Inc PO BOX 842875 BOSTON MA 02284 PAYROLL SERVICES 243484 Clinical Pharmacy Associates 316 TALBOTT AVE STE A LAUREL MD 20707 PHARMACY MGMT SERVICES 241941 4 X 121127 121127 PATIENT SERVICE REVENUE 621300 22952350 22952350 DSH REVENUE 621300 1098407 1098407 0 0 0 0 24050757 43435 43435 13896 13896 0 13896 13896 476053 285477 0 190576 190576 190576 CAFETERIA VENDING 722210 86856 86856 MISCELLANEOUS 900099 8264 8264 0 0 0 0 95120 24514911 24059021 0 334763 X 900 900 148901 134011 14890 18362287 16801412 1560875 965322 965322 1647332 1589252 58080 1350217 1215196 135021 174939 168174 6765 85300 17000 68300 4444192 3936259 507933 0 46418 45023 1395 152861 115671 37190 51131 40955 10176 1633235 1521809 111426 42033 40989 1044 63999 57735 6264 130735 130735 1824270 1459416 364854 1617133 408780 1208353 BAD DEBT EXPENSE 169216 169216 MEDICAL SUPPLIES 997451 997356 95 FOOD 255889 240623 15266 SPECIAL EVENTS 77541 76444 1097 637899 326943 310956 0 34879201 30328486 4550715 0 3261 0 4019577 2824002 0 0 164510 151389 410110 129691 51518604 39361097 12795658 12157507 45770 46336 0 0 9178337 6433451 26617223 21742376 3413015 3696904 10475000 10175000 4108450 9782676 17996465 23654580 X 7880381 -2092672 717562 157653 22815 22815 8620758 -1912204 26617223 21742376 X -10364290 -77058 -91614 X false true X true false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 45770 598 32 46336 33921 11849 45770 28586 5335 33921 28295 291 28586 30546 -2251 28295 1.0 false false 200000 200000 21685004 16931220 4753784 29257660 22429877 6827783 375940 375940 12157507 DUE FROM 3RD PARTY PAYERS 2168220 DEFERRED BOND INSURANCE COST 74277 DUE FROM AFFILIATES 1292295 SUNTRUST SELF INSURANCE TRUST 2898659 6433451 ESTIMATED SELF INSURANCE PROFESSIONAL LIABILITY 2355753 INTEREST RATE SWAP LIABILITY 390935 DUE TO 3RD PARTY PAYERS 2106788 DUE TO AFFILIATES 4929200 9782676 X 24177023 -77058 -260830 -337888 24514911 0 0 24514911 34709985 0 0 34709985 169216 169216 34879201 Schedule D, Part V, Line 4 Intended uses of endowment funds THE ENDOWMENT FUND CORPUS IS PERMANENTLY RESTRICTED AND WILL REMAIN INVESTED. THE INCOME DERIVED FROM THE ENDOWMENT FUND IS TO BE USED BY THE PEDIATRIC CENTER TO SUPPORT CURRENT OPERATIONS. Schedule D, Part X, Line 2 FIN 48 (ASC 740) footnote The Center was recognized as a public charity generally exempt from federal income taxation under section 501(c)(3) of the Internal Revenue Code pursuant to a determination letter issued by the IRS in July 1997. The Center is entitled to rely on this determination as long as there are no substantial changes in its character, purposes, or methods of operation. Management has concluded that there have been no such changes, and therefore the Center's status as a public charity exempt from federal income taxation remains in effect. The state in which the Center operates also provides general exemption from state income taxation for organizations that are exempt from federal income taxation. However, the Center is subject to both federal and state income taxation at corporate tax rates on its unrelated business income. Exemption from other state taxes, such as real and personal property taxes, is separately determined. The Center had no unrecognized tax benefits or such amounts were immaterial during the periods presented. For tax periods with respect to which no unrelated business income was recognized, no tax return was required. Tax periods for which no return is filed remain open for examination indefinitely. Information returns (Form 990) and tax returns (Form 990-T) for the year ended December 31, 2015 were due on May 15, 2016 and have been extended to August 15, 2016. The Center has filed information returns and tax returns for all years through 2014. Under ASC, Subtopic 740, Income Taxes, the Center must recognize the tax benefit from an uncertain tax position only if it is "more-likely-than-not" that the tax position will be sustained on examination by the applicable taxing authorities based on the technical merits of the position. The tax benefits recognized in the financial statements from such a position are measured based on the largest benefit that has a greater than 50 percent likelihood of being realized upon ultimate settlement. ASC, Subtopic 740-10, also provides guidance of derecognition, classification, interest and penalties on income taxes and accounting in interim periods and requires increased disclosure. There were no uncertain tax positions identified as of December 31, 2015 and 2014. Schedule D, Part XI, Line 2(d) Other revenues in audited financial statements not in form 990 UNREALIZED LOSS ON INTEREST RATE SWAP - -91614 BAD DEBT EXPENSE - -169216 Schedule D, Part XII, Line 4(b) Other expenses in form 990 not in audited financial statements BAD DEBT EXPENSE - 169216 true true X true X true X 500 true true true false true true 0 0 42949 0 42949 0.0012 0 0 27681606 17898002 9783604 0.2822 0 0 0 0 0 0.0 0 0 27724555 17898002 9826553 0.2834 0 0 62064 0 62064 0.0018 0 0 0 0 0 0.0 0 0 0 0 0 0.0 0 0 0 0 0 0.0 0 0 0 0 0 0.0 0 0 62064 0 62064 0.0018 0 0 27786619 17898002 9888617 0.2852 0 0 0 0 0 0.0 0 0 0 0 0 0.0 0 0 0 0 0 0.0 0 0 0 0 0 0.0 0 0 0 0 0 0.0 0 0 0 0 0 0.0 0 0 0 0 0 0.0 0 0 0 0 0 0.0 0 0 0 0 0 0.0 0 0 0 0 0 0.0 true 169216 0 0 0 0 X true true NA N/A 0.0 0.0 0.0 1 1 THE HOSPITAL FOR SICK CHILDREN 1731 BUNKER HILL RD NE WASHINGTON DC 20017 www.hschealth.org HFD01-0216 X X THE HOSPITAL FOR SICK CHILDREN 1 false false true X X X X X X X X X 15 true false false true X www.hschealth.org/foundation/publications X true 15 true www.hschealth.org/foundation/publications false false true X 200.0 500.0 X X X X X X true true X X X X true X www.hschealth.org X www.hschealth.org X www.hschealth.org X X X X X X true X false X X X X false X X X false false Schedule H, Part V, Section B, Line 5 Facility , 1 Facility , 1 - THE HOSPITAL FOR SICK CHILDREN (HSCPC). PART V, SECTION B, LINE 5: THE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) TOOK INTO ACCOUNT INPUT FROM A BROAD BASE OF HEALTH CARE EXPERTS AND COMMUNITY MEMBERS SERVED BY HSCPC INCLUDING DC AND MARYLAND PUBLIC HEALTH AGENCIES, AND HEALTH SERVICES FOR CHILDREN WITH SPECIAL NEEDS, INC. (HSCSN). CONTACTED LOCAL EXPERTS PARTICIPATED IN BOTH STRUCTURED AND INFORMAL INTERVIEWS DESIGNED TO IDENTIFY UNMET HEALTH AND RELATED SOCIAL NEEDS THAT IMPACT POSITIVE HEALTH OUTCOMES FOR THIS POPULATION. THE CHNA ALSO EXAMINED RECENT PUBLISHED LITERATURE AND RELEVANT DATA PERTAINING TO COMMUNITY HEALTH NEEDS ASSESSMENT RESULTS. Schedule H, Part V, Section B, Line 11 Facility , 1 Facility , 1 - THE HOSPITAL FOR SICK CHILDREN. PART V, SECTION B, LINE 11: THE HOSPITAL IS ADDRESSING SIGNIFICANT NEEDS IDENTIFIED IN ITS MOST RECENT 2015 CHNA BY ADOPTING AN IMPLEMENTATION STRATEGY IDENTIFIED IN THE CHNA REPORT. HSC WILL BEGIN TO EXECUTE THE IMPLEMENTATION STRATEGY BEGINNING 2016 BY UNDERTAKING THE FOLLOWING ACTIONS: CONTINUE TO PROVIDE CHARITY SERVICES FOR PATIENTS (A) NEEDING NON-COVERED MEDICAID SERVICES THAT ARE MEDICALLY NEEDY AND (B) MEETING THE CHARITY DEFINITION BASED ON FEDERAL POVERTY GUIDELINES. CONTINUE TO FOLLOW THE SPECIFIC COMMUNITY BENEFIT REQUIREMENTS FOR NON-PROFIT HOSPITALS WHICH INCLUDE FINANCIAL COUNSELING, UNIFORM CHARGING, AND PUBLISHED CHARITY CARE POLICIES AND ANNUAL AMOUNTS. OPEN AN ADVANCED CARE CENTER TO PROVIDE OUTPATIENT EARLY INTERVENTION FOR CHILDREN WITH AUTISM AND DEVELOPMENT DELAYS. COLLABORATE WITH COMMUNITY PARTNERS, AS REQUIRED, TO DEFINE AN EFFECTIVE MEDICAL HOME MODEL THAT MAY BE TESTED FOR IMPROVED HEALTH QUALITY AND COST EFFECTIVENESS. Schedule H, Part V, Section B, Line 13 Facility , 1 Facility , 1 - THE HOSPITAL FOR SICK CHILDREN. PART V, SECTION B, LINE 13B: HSC HAS A FINANCIAL ASSISTANCE POLICY THAT PROVIDES FOR FREE OR DISCOUNTED CARE TO INDIVIDUALS THAT QUALIFY UNDER THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY. THE LEVEL OF FINANCIAL ASSISTANCE IS DETERMINED BY SEVERAL FACTORS, INCLUDING: THE INDIVIDUAL'S ANNUAL INCOME, FAMILY SIZE, AND LIQUID ASSETS, AS WELL AS WHETHER THE INDIVIDUAL IS COVERED BY GOVERNMENTAL OR OTHER INSURANCE. FREE CARE IS PROVIDED TO PATIENTS WHO ARE INELIGIBLE FOR GOVERNMENTAL OR OTHER INSURANCE COVERAGE, AND WHOSE FAMILY INCOME DOES NOT EXCEED 200% OF THE FEDERAL POVERTY GUIDELINES. DISCOUNTED CARE IS BASED ON A SLIDING DISCOUNTED SCALE OF GROSS CHARGES AND IS PROVIDED TO PATIENTS WHO ARE INELIGIBLE FOR GOVERNMENTAL OR OTHER INSURANCE COVERAGE AND WHOSE FAMILY INCOME IS BETWEEN 200% AND 500% OF THE POVERTY GUIDELINES. WHEN POSSIBLE, THE ORGANIZATION MAY MAKE A PROSPECTIVE DETERMINATION THAT CERTAIN PATIENTS QUALIFY FOR FREE OR DISCOUNTED CARE, ALTHOUGH THE PATIENT HAS NOT SUBMITTED A COMPLETED FINANCIAL ASSISTANCE APPLICATION. PRESUMPTIVE CHARITY CARE IS DETERMINED BASED ON DEFINED CRITERIA FOR DESTITUTE STATUS (HOMELESS, ILLEGAL ALIEN, INCARCERATED, ETC.). PATIENTS WITH SUFFICIENT ASSETS TO PAY FOR CARE WITHOUT BECOMING MEDICALLY INDIGENT, MAY NOT BE ELIGIBLE FOR FINANCIAL ASSISTANCE. HOWEVER, THE RESIDENCE WHERE A PATIENT AND/OR THE PATIENT'S FAMILY RESIDES, AUTOMOBILES NEEDED TO TRANSPORT ALL WORKING PARTIES TO AND FROM WORK, SAVINGS ACCOUNTS WITH LESS THAN TWO MONTHS OF INCOME AND RETIREMENT ACCOUNTS WITH LESS THAN $50,000 ARE ALWAYS EXEMPTED FROM CONSIDERATION AS ASSETS IN CONSIDERING WHETHER THE PATIENT QUALIFIES FOR FINANCIAL ASSISTANCE. ONCE CHARITY CARE ELIGIBILITY HAS BEEN ESTABLISHED, THE PATIENT ACCOUNT IN WHOLE OR IN PART, IS WRITTEN-OFF AND ALL COLLECTION EFFORTS ON THE WRITTEN OFF PORTION OF THE ACCOUNT CEASE. IF THE PATIENT RECEIVES PARTIAL CHARITY CARE, ALL EFFORTS WILL BE MADE TO PLACE THAT PATIENT ON AN EXTENDED PAYMENT PLAN. FURTHERMORE, HSC HAS A FINANCIAL ASSISTANCE POLICY THAT PROVIDES FOR FREE OR DISCOUNTED CARE TO THE MEDICALLY INDIGENT, WHICH IS A SEPARATE, SUPPLEMENTAL DETERMINATION OF FINANCIAL ASSISTANCE FOR PATIENTS THAT ARE NOT ELIGIBLE FOR FINANCIAL ASSISTANCE UNDER THE PRIMARY SECTION OF THE FINANCIAL ASSISTANCE POLICY, BUT FOR WHOM THE RESULTING FINANCIAL LIABILITY FOR MEDICAL TREATMENT REPRESENTS A CATASTROPHIC LOSS. "CATASTROPHIC" IS DEFINED AS A SITUATION IN WHICH THE SELF-PAY PORTION OF THE HSC MEDICAL BILL IS GREATER THAN THE PATIENT'S ABILITY TO REPAY WITH CURRENT INCOME AND LIQUID ASSETS IN 18 MONTHS OR LESS. THE FACTORS TAKEN INTO CONSIDERATION WHEN EVALUATING A CATASTROPHIC ASSISTANCE APPLICATION ARE THE FOLLOWING: CURRENT MEDICAL DEBT, LIQUID ASSETS, LIVING EXPENSES, PROJECTED MEDICAL EXPENSES, ANNUAL INCOME, FAMILY SIZE, AND SPELL OF ILLNESS. Schedule H, Part V, Section B, Line 16 Facility , 1 Facility , 1 - THE HOSPITAL FOR SICK CHILDREN. PART V, SECTION B, LINE 16I: HSC PUBLICIZES ITS FINANCIAL ASSISTANCE POLICY IN MANY DIFFERENT WAYS. FIRST, IT POSTS NOTICES REGARDING THE AVAILABILITY OF CHARITY CARE IN ADMISSIONS, PATIENT REGISTRATION, AND THE BUSINESS OFFICE. THE INFORMATION ON THE SIGNS IS IN BOTH ENGLISH AND SPANISH. IN ADDITION, THE POLICY IS DISTRIBUTED TO PATIENTS ON ADMISSION AND UPON REQUEST, AND IS AVAILABLE AT ALL PATIENT REGISTRATION DESKS AND IN ALL WAITING AREAS. FURTHERMORE, HSC, AS MANDATED BY ITS FINANCIAL ASSISTANCE POLICY, PUBLISHES A SUMMARY OF ITS FINANCIAL ASSISTANCE POLICY, ON AN ANNUAL BASIS, IN A NEWSPAPER OF GENERAL CIRCULATION IN THE HOSPITAL'S PRIMARY AND SECONDARY SERVICE AREAS. Schedule H, Part V, Section B, Line 21 Facility , 1 Facility , 1 - THE HOSPITAL FOR SICK CHILDREN. PART V, SECTION B, LINE 21D: THE HSC PEDIATRIC CENTER IS A LONG-TERM PEDIATRIC HOSPITAL FACILITY, WHICH DOES NOT PROVIDE EMERGENCY MEDICAL CARE. HOWEVER, THE HSC PEDIATRIC CENTER HAS ADOPTED A TRANSFER POLICY PURSUANT TO WHICH THE HOSPITAL WILL HELP TO TRANSFER, AS APPROPRIATE, ANY PATIENTS SHOWING SYMPTOMS OF AN EMERGENCY TO AN ACUTE CARE HOSPITAL. Schedule H, Part V, Section B, Line 22 Facility , 1 Facility , 1 - THE HOSPITAL FOR SICK CHILDREN. PART V, SECTION B, LINE 22D: THE HSC PEDIATRIC CENTER DETERMINED MAXIMUM AMOUNTS TO BE CHARGED TO FAP ELIGIBLE INDIVIDUALS IS NOT MORE THAN AMOUNTS GENERALLY BILLED TO INSURED PATIENTS. THE PROSPECTIVE MEDICAID METHOD WAS USED. 0 THE HSC OUTPATIENT CENTER 4500 FORBES BLVD SUITE 100 LANHAM MD 20706 PROVIDES OUTPATIENT REHAB SERVICES TO THE SPECIAL NEEDS COMMUNITY Schedule H, Part I, Line 4 HSC HAS A FINANCIAL ASSISTANCE POLICY THAT PROVIDES FOR FREE OR DISCOUNTED CARE TO THE MEDICALLY INDIGENT, WHICH IS A SEPARATE, SUPPLEMENTAL DETERMINATION OF FINANCIAL ASSISTANCE FOR PATIENTS THAT ARE NOT ELIGIBLE FOR FINANCIAL ASSISTANCE UNDER THE PRIMARY SECTION OF THE FINANCIAL ASSISTANCE POLICY, BUT FOR WHOM THE RESULTING FINANCIAL LIABILITY FOR MEDICAL TREATMENT REPRESENTS A CATASTROPHIC LOSS. "CATASTROPHIC" IS DEFINED AS A SITUATION IN WHICH THE SELF-PAY PORTION OF THE HSC MEDICAL BILL IS GREATER THAN THE PATIENT'S ABILITY TO REPAY WITH CURRENT INCOME AND LIQUID ASSETS IN 18 MONTHS OR LESS. THE FACTORS TAKEN INTO CONSIDERATION WHEN EVALUATING A CATASTROPHIC ASSISTANCE APPLICATION ARE THE FOLLOWING: CURRENT MEDICAL DEBT, LIQUID ASSETS, LIVING EXPENSES, PROJECTED MEDICAL EXPENSES, ANNUAL INCOME, FAMILY SIZE, AND SPELL OF ILLNESS. Schedule H, Part I, Line 3c THE HOSPITAL FOR SICK CHILDREN DBA THE HSC PEDIATRIC CENTER ("HSC") HAS A FINANCIAL ASSISTANCE POLICY THAT PROVIDES FOR FREE OR DISCOUNTED CARE TO INDIVIDUALS THAT QUALIFY UNDER THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY. THE LEVEL OF FINANCIAL ASSISTANCE IS DETERMINED BY SEVERAL FACTORS, INCLUDING: THE INDIVIDUAL'S ANNUAL INCOME, FAMILY SIZE, AND LIQUID ASSETS, AS WELL AS WHETHER THE INDIVIDUAL IS COVERED BY GOVERNMENTAL OR OTHER INSURANCE. FREE CARE IS PROVIDED TO PATIENTS WHO ARE INELIGIBLE FOR GOVERNMENTAL OR OTHER INSURANCE COVERAGE, AND WHOSE FAMILY INCOME DOES NOT EXCEED 200% OF THE FEDERAL POVERTY GUIDELINES. DISCOUNTED CARE IS BASED ON A SLIDING DISCOUNTED SCALE OF GROSS CHARGES AND IS PROVIDED TO PATIENTS WHO ARE INELIGIBLE FOR GOVERNMENTAL OR OTHER INSURANCE COVERAGE AND WHOSE FAMILY INCOME IS BETWEEN 200% AND 500% OF THE POVERTY GUIDELINES. WHEN POSSIBLE, THE ORGANIZATION MAY MAKE A PROSPECTIVE DETERMINATION THAT CERTAIN PATIENTS QUALIFY FOR FREE OR DISCOUNTED CARE, ALTHOUGH THE PATIENT HAS NOT SUBMITTED A COMPLETED FINANCIAL ASSISTANCE FORM. PRESUMPTIVE CHARITY CARE IS DETERMINED BASED ON DEFINED CRITERIA FOR DESTITUTE STATUS (HOMELESS, ILLEGAL ALIEN, INCARCERATED, ETC.). ONCE CHARITY CARE ELIGIBILITY HAS BEEN ESTABLISHED, THE PATIENT ACCOUNT IN WHOLE, OR IN PART, IS WRITTEN-OFF AND ALL COLLECTION EFFORTS ON THE WRITTEN OFF PORTION OF THE ACCOUNT CEASE. IF THE PATIENT RECEIVES PARTIAL CHARITY CARE, ALL EFFORTS WILL BE MADE TO PLACE THAT PATIENT ON AN EXTENDED PAYMENT PLAN. IN ADDITION, INDIVIDUALS THAT DO NOT QUALIFY FOR FINANCIAL ASSISTANCE UNDER THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY MAY STILL BE PROVIDED UP TO A 25% DISCOUNT ON BILLED SERVICES IN CERTAIN CIRCUMSTANCES. Schedule H, Part III, Line 8 HSC DOES NOT PARTICIPATE IN THE MEDICARE PROGRAM. Schedule H, Part V, Section B THE HOSPITAL FACILITY DOES NOT CHARGE ANY INDIVIDUALS THAT IT KNOWS ARE ELIGIBLE FOR FINANCIAL ASSISTANCE AN AMOUNT EQUAL TO THE GROSS CHARGE FOR ANY SERVICE. THE HOSPITAL USES THE CHARGE MASTER RATES FOR A SERVICE AS A STARTING POINT AGAINST WHICH THE DISCOUNTS MANDATED IN THE HOSPITAL FACILITY'S FINANCIAL ASSISTANCE POLICY ARE APPLIED TO DETERMINE THE AMOUNT ACTUALLY BILLED TO PATIENTS ELIGIBLE UNDER THE FINANCIAL ASSISTANCE POLICY. THE HOSPITAL FACILITY WILL NOT COLLECT PAYMENT FROM ANY PATIENT ELIGIBLE UNDER THE FINANCIAL ASSISTANCE POLICY IN EXCESS OF THE REDUCED AMOUNT THAT IS ACTUALLY. BILLED TO SUCH FINANCIAL ASSISTANCE PATIENT. Schedule H, Part V, Section A THE HOSPITAL FOR SICK CHILDREN D/B/A, THE HSC PEDIATRIC CENTER IS A SELF-CONTAINED LONG-TERM PEDIATRIC SPECIALTY HOSPITAL. Schedule H, Part I, Line 7g Subsidized Health Services N/A Schedule H, Part I, Line 7 Bad Debt Expense excluded from financial assistance calculation 169216 Schedule H, Part I, Line 7 Costing Methodology used to calculate financial assistance THE COST OF CHARITY CARE WAS DETERMINED BY UTILIZING THE RATIO OF COST TO CHARGES CALCULATED ON WORKSHEET 1 APPLIED TO THE CHARGES WRITTEN OFF FOR PATIENTS QUALIFYING FOR CHARITY CARE UNDER THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY. Schedule H, Part II Community Building Activities N/A Schedule H, Part III, Line 2 Bad debt expense - methodology used to estimate amount BAD DEBT EXPENSE IS DETERMINED BY ANALYZING PAST HISTORY AND IDENTIFYING TRENDS FOR EACH MAJOR PAYER SOURCE OF REVENUE. MANAGEMENT REGULARLY REVIEWS DATA ABOUT THESE MAJOR PAYER SOURCES OF REVENUE IN EVALUATING THE SUFFICIENCY OF THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS. FOR RECEIVABLES ASSOCIATED WITH SERVICES PROVIDED TO PATIENTS WHO HAVE THIRD-PARTY INSURANCE COVERAGE, THE HOSPITAL ANALYZES CONTRACTUALLY DUE AMOUNTS AND PROVIDES AN ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS AND BAD DEBT EXPENSE, IF NECESSARY. FOR RECEIVABLES ASSOCIATED WITH SELF-PAY PATIENTS, THE HOSPITAL RECORDS A SIGNIFICANT BAD DEBT EXPENSE IN THE PERIOD OF SERVICE ON THE BASIS OF ITS PAST EXPERIENCE, WHICH INDICATES THAT MANY PATIENTS ARE UNABLE OR UNWILLING TO PAY THE PORTION OF THEIR BILL FOR WHICH THEY ARE FINANCIALLY RESPONSIBLE. THE HOSPITAL REGULARLY PERFORMS HINDSIGHT PROCEDURES TO EVALUATE HISTORICAL WRITE-OFF AND COLLECTION EXPERIENCE THROUGHOUT THE YEAR TO ASSIST IN DETERMINING THE REASONABLENESS OF ITS PROCESS FOR ESTIMATING THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS. Schedule H, Part III, Line 3 Bad Debt Expense Methodology SCHEDULE H, PART III, LINE 3 THE HOSPITAL DOES NOT REPORT AN ESTIMATE FOR THE PORTION OF BAD DEBT EXPENSE THAT MAY HAVE BEEN LIKELY TO QUALIFY FOR FINANCIAL ASSISTANCE UNDER THE HOSPITAL'S CHARITY CARE POLICY. HSC TAKES THE POSITION THAT AMPLE OPPORTUNITY AND ASSISTANCE IS PROVIDED TO THE PATIENT TO QUALIFY UNDER THE FINANCIAL ASSISTANCE POLICY. IF SUFFICIENT INFORMATION IS NOT PROVIDED THE HOSPITAL MUST ASSUME THE PATIENT DOES NOT QUALIFY FOR FINANCIAL ASSISTANCE. Schedule H, Part III, Line 4 Bad debt expense - financial statement footnote THE FOOTNOTE TO THE ORGANIZATIONS FINANCIAL STATEMENTS (NOTE 2) THAT DESCRIBES BAD DEBT EXPENSE IS AS FOLLOWS: PROVISIONS FOR ESTIMATED UNCOLLECTIBLE ACCOUNTS ACCOUNTS RECEIVABLE ARE REDUCED BY AN ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS. IN EVALUATING THE COLLECTABILITY OF ACCOUNTS RECEIVABLE, THE CENTER ANALYZES ITS PAST HISTORY AND IDENTIFIES TRENDS FOR EACH OF ITS MAJOR PAYER SOURCES OF REVENUE TO ESTIMATE THE APPROPRIATE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS AND PROVISION FOR UNCOLLECTIBLE ACCOUNTS. MANAGEMENT REGULARLY REVIEWS DATA ABOUT THESE MAJOR PAYER SOURCES OF REVENUE IN EVALUATING THE SUFFICIENCY OF THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS. FOR RECEIVABLES ASSOCIATED WITH SERVICES PROVIDED TO PATIENTS WHO HAVE THIRD-PARTY INSURANCE COVERAGE, THE CENTER ANALYZES CONTRACTUALLY DUE AMOUNTS AND PROVIDES AN ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS AND A PROVISION FOR UNCOLLECTIBLE ACCOUNTS, IF NECESSARY (FOR EXAMPLE, FOR EXPECTED UNCOLLECTIBLE DEDUCTIBLES AND COPAYMENTS ON ACCOUNTS FOR WHICH THE THIRD-PARTY PAYER HAS NOT YET PAID, OR FOR PAYERS WHO ARE KNOWN TO BE HAVING FINANCIAL DIFFICULTIES THAT MAKE THE REALIZATION OF AMOUNTS DUE UNLIKELY). FOR RECEIVABLES ASSOCIATED WITH SELF-PAY PATIENTS (WHICH INCLUDE BOTH PATIENTS WITHOUT INSURANCE AND PATIENTS WITH DEDUCTIBLE AND COPAYMENT BALANCES DUE FOR WHICH THIRD-PARTY COVERAGE EXISTS FOR PART OF THE BILL), THE CENTER RECORDS A SIGNIFICANT PROVISION FOR UNCOLLECTIBLE ACCOUNTS IN THE PERIOD OF SERVICE ON THE BASIS OF ITS PAST EXPERIENCE, WHICH INDICATES THAT MANY PATIENTS ARE UNABLE OR UNWILLING TO PAY THE PORTION OF THEIR BILL FOR WHICH THEY ARE FINANCIALLY RESPONSIBLE. THE CENTER REGULARLY PERFORMS HINDSIGHT PROCEDURES TO EVALUATE HISTORICAL WRITE-OFF AND COLLECTION EXPERIENCE THROUGHOUT THE YEAR TO ASSIST IN DETERMINING THE REASONABLENESS OF ITS PROCESS FOR ESTIMATING THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS. THE DIFFERENCE BETWEEN THE STANDARD RATES (OR THE DISCOUNTED RATES IF NEGOTIATED) AND THE AMOUNTS ACTUALLY COLLECTED AFTER ALL REASONABLE COLLECTION EFFORTS HAVE BEEN EXHAUSTED IS CHARGED OFF AGAINST THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS. Schedule H, Part III, Line 8 Community benefit & methodology for determining medicare costs THE DETERMINATION OF A PATIENT'S QUALIFICATION UNDER THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY IS ATTEMPTED PRIOR TO THE PATIENT BEING DISCHARGED FROM THE HOSPITAL. THIS MAY INCLUDE A PROSPECTIVE DETERMINATION THAT CERTAIN PATIENTS QUALIFY FOR FINANCIAL ASSISTANCE, ALTHOUGH THE PATIENT HAS NOT SUBMITTED A COMPLETE FINANCIAL ASSISTANCE POLICY. AS SOON AS THE PATIENT'S FINANCIAL ASSISTANCE ELIGIBILITY HAS BEEN ESTABLISHED, THE PATIENT'S ACCOUNT IN WHOLE OR IN PART, IS WRITTEN-OFF AND ALL COLLECTION EFFORTS CEASE ON THE PORTION OF THE ACCOUNT THAT HAS BEEN WRITTEN-OFF. IF THE PATIENT RECEIVES DISCOUNTED CARE, ALL EFFORTS WILL BE MADE TO PLACE THAT PATIENT ON AN EXTENDED PAYMENT PLAN. FOR THOSE PATIENTS THAT DO NOT INITIALLY APPLY OR QUALIFY FOR FINANCIAL ASSISTANCE, THE ORGANIZATION CONTINUES TO MONITOR WHETHER THE PATIENT MAY QUALIFY FOR FINANCIAL ASSISTANCE THROUGHOUT THE COLLECTION PROCESS. IF THE PATIENT IS FOUND TO BE ELIGIBLE FOR FINANCIAL ASSISTANCE AT ANY POINT (INCLUDING ONCE COLLECTION EFFORTS HAVE BEGUN), THE ORGANIZATION WILL APPROVE THE PATIENT FOR FINANCIAL ASSISTANCE IMMEDIATELY. Schedule H, Part III, Line 9b Collection practices for patients eligible for financial assistance THE DETERMINATION OF A PATIENT'S QUALIFICATION UNDER THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY IS ATTEMPTED PRIOR TO THE PATIENT BEING DISCHARGED FROM THE HOSPITAL. THIS MAY INCLUDE A PROSPECTIVE DETERMINATION THAT CERTAIN PATIENTS QUALIFY FOR FINANCIAL ASSISTANCE, ALTHOUGH THE PATIENT HAS NOT SUBMITTED A COMPLETE FINANCIAL ASSISTANCE POLICY. AS SOON AS THE PATIENT'S FINANCIAL ASSISTANCE ELIGIBILITY HAS BEEN ESTABLISHED, THE PATIENT ACCOUNT IN WHOLE OR IN PART, IS WRITTEN-OFF AND ALL COLLECTION EFFORTS CEASE ON THE PORTION OF THE ACCOUNT THAT HAS BEEN WRITTEN-OFF. IF THE PATIENT RECEIVES DISCOUNTED CARE, ALL EFFORTS WILL BE MADE TO PLACE THAT PATIENT ON AN EXTENDED PAYMENT PLAN. FOR THOSE PATIENTS THAT DO NOT INITIALLY APPLY OR QUALIFY FOR FINANCIAL ASSISTANCE, THE ORGANIZATION CONTINUES TO MONITOR WHETHER THE PATIENT MAY QUALIFY FOR FINANCIAL ASSISTANCE THROUGHOUT THE COLLECTION PROCESS. IF THE PATIENT IS FOUND TO BE ELIGIBLE FOR FINANCIAL ASSISTANCE AT ANY POINT (INCLUDING ONCE COLLECTION EFFORTS HAVE BEGUN), THE ORGANIZATION WILL APPROVE THE PATIENT FOR FINANCIAL ASSISTANCE IMMEDIATELY. Schedule H, Part V, Section B, Line 16a FAP website - THE HOSPITAL FOR SICK CHILDREN: Line 16a URL: www.hschealth.org; Schedule H, Part V, Section B, Line 16b FAP Application website - THE HOSPITAL FOR SICK CHILDREN: Line 16b URL: www.hschealth.org; Schedule H, Part V, Section B, Line 16c FAP plain language summary website - THE HOSPITAL FOR SICK CHILDREN: Line 16c URL: www.hschealth.org; Schedule H, Part VI, Line 2 Needs assessment HSC PEDIATRIC CENTER USES A VARIETY OF METHODS TO ASSESS HEALTH CARE NEEDS OF THE COMMUNITY IT SERVES. NEEDS ARE IDENTIFIED THROUGHT A FORMAL COMMUNITY HEALTH NEEDS ASSESSMENT, PARTNERSHIPS AND COLLABORATIONS WITH OTHER MEDICAL, NON-PROFIT AND PUBLIC HEALTH AGENCIES. HSC PEDIATRIC CENTER ASSUMES THE RESPONSIBILITY OF LEADING THE REGION IN THE PROVISION OF CHRONIC CARE FOR PEDIATRIC PATIENTS AND IS TRUSTED THROUGHOUT ITS COMMUNITY AS A RESOURCE READY AND WILLING TO ADDRESS ESTABLISHED AND EMERGENT PEDIATRIC NEEDS WHEREVER AND HOWEVER THEY ARE IDENTIFIED. HSC PEDIATRIC CENTER'S CURRENT COMMUNITY NEEDS ASSESSMENT AND IMPLEMENTATION STRATEGY CAN BE FOUND AT WWW.HSCHEALTH.ORG/FOUNDATION/PUBLICATIONS. Schedule H, Part VI, Line 3 Patient education of eligibility for assistance THE HSC PEDIATRIC CENTER HAS A STRONG COMMITMENT TO PROVIDING SERVICES TO FAMILIES AT NO COST TO THEM IF AT ALL POSSIBLE. MANY OF THE FAMILIES WHO RECEIVE SERVICES FROM HSC HAVE ALREADY QUALIFIED FOR MEDICAID BY THE TIME OF THEIR ARRIVAL AT HSC DUE TO PRIOR SERVICES AT OTHER FACILITIES. IF A FAMILY ARRIVES AT HSC WITH PRIVATE INSURANCE, OFTEN TIMES THEY QUALIFY FOR MEDICAID BY THE TIME THEY ARE DISCHARGED TO CARE AT HOME. FAMILIES ARE INFORMED OF THE AVAILABILITY OF FINANCIAL ASSISTANCE AT THE TIME OF THEIR ADMISSION TO HSC. THEY ARE GIVEN WRITTEN COPIES OF THE STATEMENT: "NOTICE OF AVAILABILITY OF UNCOMPENSATED SERVICES" IN THE APPROPRIATE LANGUAGE. IF THEY BELIEVE THEY MAY BE IN NEED OF THE SERVICES, AN APPLICATION IS FILLED OUT AT THE TIME OF ADMISSION. IF A FAMILY DOES NOT QUALIFY FOR MEDICAID THEY WOULD BE ELIGIBLE TO PURSUE THE AVAILABLE UNCOMPENSATED SERVICES. IF PATIENTS ARE NOT ELIGIBLE FOR MEDICAID AND OTHER GOVERNMENTAL PROGRAMS SUBSEQUENT TO DISCHARGE, HSC BOTH INFORMS AND ATTEMPTS TO QUALIFY THEM PROSPECTIVELY FOR THE CHARITY CARE SERVICES PROVIDED BY HSC. Schedule H, Part VI, Line 4 Community information THE HSC PEDIATRIC CENTER SERVES CHILDREN AND YOUNG ADULTS UP TO THE AGE OF 21 IN THE WASHINGTON DC METRO AREA WHO HAVE SPECIAL HEALTH CARE NEEDS. HSC SERVES THE WASHINGTON DC METRO AREA WHICH IS A DIVERSE COMMUNITY THAT COVERS TWO STATES AND THE DISTRICT OF COLUMBIA. SPECIFIC GEOGRAPHIC AND DEMOGRAPHIC CHARACTERISTICS OF THE COMMUNITY WE SERVICE INCLUDE THE FOLLOWING: 1. THERE ARE APPROXIMATELY 59,000 SSI AND SPECIAL NEEDS CHILDREN UNDER THE AGE OF 18 IN THE WASHINGTON, DC METRO AREA. 2. OF THOSE 59,000 CHILDREN, 6,065 WERE DISTRICT OF COLUMBIA SPECIAL NEEDS CHILDREN. OF THE DC SPECIAL NEEDS CHILDREN APPROXIMATELY OVER 5,000 WERE ENROLLED IN HEALTH SERVICES FOR CHILDREN WITH SPECIAL NEEDS, INC. , HSC'S SISTER ORGANIZATION THAT PROVIDES CARE MANAGEMENT SERVICES TO CHILDREN WHO HAVE SSI OR SSI RELATED DIAGNOSES. 3. MARYLAND HAS A HIGHER PREVALENCE OF CHILDREN WITH SPECIAL HEALTH CARE NEEDS (CYSHCN) THAN DOES THE NATION AS A WHOLE. ACCORDING TO 2010 US CENSUS DATA AND ESTIMATES FOR 2014, MORE FAMILIES OF CYSHCN IN MARYLAND ARE LIVING IN POVERTY THAN IN THE FIVE PREVIOUS YEARS. 4. PRINCE GEORGES COUNTY IN MARYLAND, A COUNTY BORDERING WASHINGTON, DC IS AN ETHNICALLY AND SOCIOECONOMICALLY DIVERSE POPULATION WITH A HIGHER RATE OF BEING UNINSURED THAN SURROUNDING MD COUNTIES. THERE ARE 12,381 SPECIAL NEEDS CHILDREN IN PRINCE GEORGES COUNTY MARYLAND. 5. OF THE 59,119 CHILDREN WITH SPECIAL HEALTH CARE NEEDS 34,880 HAVE BEHAVIORAL HEALTH DIAGNOSES, 4,138 HAVE CEREBRAL PALSY, DEVELOPMENTAL DELAYS, OR FAILURE TO THRIVE. THE OTHER 20,100 CHILDREN HAVE VARIOUS OTHER MEDICAL CONDITIONS. THE PRIMARY CSHCN CONDITIONS TREATED AT THE HSCPC ARE CONDITIONS REQUIRING LONGER TERM TRANSITIONAL CARE AND/OR SPECIALTY REHABILITATION CARE PRIOR TO THEIR DISCHARGE TO HOME OR NURSING/GROUP HOME. THESE CONDITIONS INCLUDE CEREBRAL PALSY, ANOXIC BRAIN DAMAGE SPINA BIFIDA, FAILURE TO THRIVE RELATED TO PREMATURITY, CHRONIC LUNG DISEASE AND INTESTINAL OR OTHER FEEDING DISORDERS. 6. IN 2015, 85% OF HSC'S PATIENTS WERE COVERED BY MEDICAID. (I.E. DC, MD OR VA MEDICAID). 7. 229 CHILDREN WERE ADMITTED TO HSC IN 2015. 10,022 DAYS OF CARE WERE PROVIDED TO THOSE CHILDREN. Schedule H, Part VI, Line 5 Promotion of community health THE HSC PEDIATRIC CENTER'S GOVERNING BODY IS COMPRISED OF PERSONS WHO RESIDE IN THE ORGANIZATIONS PRIMARY SERVICE AREA WHO ARE NEITHER EMPLOYEES NOR INDEPENDENT CONTRACTORS OF THE ORGANIZATION OR ITS AFFILIATES, NOR FAMILY MEMBERS THEREOF. THE HOSPITAL EXTENDS MEDICAL STAFF PRIVILEGES TO ALL QUALIFIED PHYSICIANS IN ITS COMMUNITY FOR SOME OR ALL OF ITS DEPARTMENTS OR SPECIALITIES. THE ORGANIZATIONS SURPLUS FUNDS ARE USED TO FURTHER ITS EXEMPT PURPOSE, MEDICAL EDUCATION AND COMMUNITY PROGRAMS. Schedule H, Part VI, Line 6 Affiliated health care system HSC IS PART OF THE HSC HEALTHCARE SYSTEM WHICH CONSISTS OF SIX SEPARATE LEGAL ENTITIES: THE HSC FOUNDATION (HSCF), THE HSC PEDIATRIC CENTER (HSC), THE HEALTH SERVICES FOR CHILDREN WITH SPECIAL NEEDS, INC. (HSCSN), THE HSC HOME CARE, LLC. (HSCHC), 2013 HOLDINGS, AND SPECIAL NEEDS CONSULTING SERVICES, INC (SNCS). THE HSC HEALTH CARE SYSTEM IS DESIGNED AND DEDICATED TO PROVIDING QUALITY MEDICAL CARE SERVICES, INNOVATIVE CARE MANAGEMENT, HOME CARE AND OTHER RELATED SERVICES TAILORED TO THE NEEDS OF INFANTS, CHILDREN AND ADOLESCENTS WITH DISABILITIES AND CHRONIC MEDICAL CONDITIONS AND THEIR FAMILIES. IN ADDITION, THE HSC HEALTH CARE SYSTEM STRIVES TO IMPROVE ACCESS TO MEDICAL CARE AND TO IMPROVE THE HEALTHCARE STATUS OF THE GROSSLY UNDERSERVED PEDIATRIC POPULATION IN WHICH THE HSC HEALTHCARE SYSTEM SERVES. HSCF: THE MISSION OF HSCF IS TO FACILITATE ACCESS TO SERVICES FOR INDIVIDUALS WITH SPECIAL NEEDS AND THEIR FAMILIES IN THE WASHINGTON DC METROPOLITAN AREA, WHILE CONDUCTING REGIONAL AND NATIONAL PROJECTS WITH GOVERNMENT AND PHILANTHROPIC ORGANIZATIONS. IT ALSO, SERVES AS THE SUPPORTING ORGANIZATION FOR THE OTHER THREE NON-PROFIT ENTITIES AS STATED ABOVE AND IT ALSO OPERATES A YOUTH TRANSITION INITIATIVE. HSCF IS A SECTION 501(C)(3) TAX-EXEMPT ORGANIZATION. HSC: HSC IS A HOSPITAL FACILITY THAT PROVIDES REHABILITATION AND TRANSITIONAL CARE FOR CHILDREN AND ADOLESCENTS WITH DISABILITIES AND CHRONIC ILLNESS . FURTHER, HSC PROVIDES ASSISTANCE WITH ACCESSING RELATED CARE SERVICES FOR ALL PATIENTS AND THEIR FAMILIES IN A NURTURING ENVIRONMENT OF FAMILY-CENTERED CARE WITHIN THE WASHINGTON METROPOLITAN AREA. HSCSN: HSCSN IS AN INNOVATIVE CARE MANAGEMENT ORGANIZATION THAT COORDINATES HEALTH, SOCIAL, AND EDUCATION SERVICES FOR THE PEDIATRIC SUPPLEMENTAL SECURITY INCOME (SSI) AND SSI ELIGIBLE POPULATIONS IN THE WASHINGTON, DC AREA. BENEFITS PROVIDED TO MEMBERS AND THEIR FAMILIES, AND COMMUNITIES INCLUDE ALL TRADITIONAL MEDICAID BENEFITS, PLUS INDIVIDUALIZED CARE MANAGEMENT SERVICES, 24 HOUR ACCESS TO CARE COORDINATION, OUTREACH, AND RESPITE CARE SERVICES FOR ITS MEMBERS AND THEIR FAMILIES. HSCSN IS A SECTION 501(C)(3) TAX-EXEMPT ORGANIZATION. HSC HOME CARE, LLC: HSC HOME CARE, LLC'S MISSION IS TO PROVIDE ACCESS TO QUALITY REHABILITAT IVE AND SPECIALTY SERVICES FOR INFANTS, CHILDREN AND ADOLESCENTS WITH SPECIAL NEEDS AND THEIR FAMILIES IN A MANNER. THAT IS CULTURALLY AND LINGUISTICALLY APPROPRIATE THROUGH THE OFFERING OF A VAST ARRAY OF REHABILITATIVE, MEDICAL, SOCIAL, AND EDUCATIONAL SERVICES. THE ORGANIZATION RECOGNIZES THE VALUE OF CARE IN THE HOME AND RECONNECTING PATIENTS BACK INTO THEIR COMMUNITY. HSC HOME CARE, LLC IS WHOLLY OWNED BY HSCF. 2013 HOLDINGS: IS A TITLE-HOLDING COMPANY, WHICH HOLDS TITLE TO THE REAL PROPERTY LOCATED AT 2013 H STREET, NW, WASHINGTON, DC 20006, COLLECTS INCOME FROM SUCH PROPERTY, AND REMITS THE ENTIRE AMOUNT OF INCOME FROM SUCH PROPERTY, LESS EXPENSES, TO HSCF. 2013 HOLDINGS IS A SECTION 501(C)(2) TAX-EXEMPT ORGANIZATION. SPECIALS NEEDS CONSULTING SERVICES (SNCS) : COMMENCED OPERATIONS IN APRIL, 2011. ITS MISSION IS TO PROVIDE CONSULTING SERVICES TO IMPROVE ACCESS TO MEDICAL CARE AND TO IMPROVE THE HEALTHCARE STATUS OF THE SPECIAL NEEDS POPULATION BY ASSISTING TO TRANSITION COVERAGE FOR THIS HIGH NEED POPULATION FROM A TRADITIONAL FEE-FOR-SERVICE SETTING INTO COORDINATED CARE THAT IS USED EFFECTIVELY WITHIN THESE HIGH-COST SUBGROUPS. SNCS WAS FORMED TO OFFER HEALTHCARE CONSULTING SERVICES ON A NATION-WIDE PLATFORM TO ASSIST OTHER HEALTHCARE PROVIDERS IN A VARIETY OF HEALTHCARE RELATED PROJECTS. HOWEVER, THE CONSULTING WORK DONE BY SNCS STRENGTHENS THE COST-EFFECTIVENESS OF THE COORDINATED CARE PROGRAMS PROVIDED BY THE HSC HEALTHCARE SYSTEM ITSELF. Schedule H, Part VI, Line 7 State filing of community benefit report DC true true false false false false false false false Thomas W Chapman President & CEO HSCF, Board Member 0 760408 0 0 0 0 0 24000 0 12552 0 796960 0 0 John Mathewson Executive Vice President 0 362925 0 0 0 0 0 18772 0 1803 0 383500 0 0 Khalil Bouharoun CIO 0 207432 0 0 0 0 0 24000 0 0 0 231432 0 0 Raymond Vicks Jr Chief Financial Officer 0 280397 0 0 0 0 0 0 0 0 0 280397 0 0 Frances P Christmon VP FINANCE, FINANCIAL PLANNING & ANALYSIS 0 192935 0 0 0 0 0 9329 0 6768 0 209033 0 0 Lynne Hostetter Piper VP, Human Resources 0 299245 0 0 0 0 0 18000 0 4089 0 321334 0 0 Gene Greer FORMER CIO 0 0 0 0 0 147373 0 0 0 0 0 147373 0 0 SAMAR AFLAR HUSSEIN MAAMOUN PEDIATRICIAN 223174 0 0 0 0 0 18000 0 0 0 241174 0 0 0 DR Robert A Blake VP MEDICAL STRATEGIES 216093 0 0 0 0 0 8604 0 0 0 224697 0 0 0 ROBERT D COOK VP SUPPORT AND ANCILLARY SERVICES 205923 0 0 0 0 0 24000 0 0 0 229923 0 0 0 Erlinda S Austria Dir, Reimbursement and Business Analytics 165793 0 0 0 0 0 3280 0 0 0 169073 0 0 0 ANTHONY A QUANDER VP, PROVIDER FINANCIAL SERVICES 162227 0 0 0 0 0 10278 0 0 0 172505 0 0 0 Schedule J, Part I, Line 3 Arrangement used to establish the top management official's compensation THE ORGANIZATION RELIED ON A RELATED ORGANIZATION AND THAT RELATED ORGANIZATION USED THE FOLLOWING METHODS TO ESTABLISH THE CEO/PRESIDENT'S COMPENSATION: 1) INDEPENDENT COMPENSATION CONSULTANT; 2) WRITTEN EMPLOYMENT CONTRACT; 3) COMPENSATION SURVEY OR STUDY; AND 4) APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE. Schedule J, Part I, Line 4a Severance or change-of-control payment GENE GREER RECEIVED A SEVERANCE PAYMENT IN THE AMOUNT OF 147,373 AS A RESULT OF A SEPARATION OF SERVICE. Schedule J, Part I, Line 4b Supplemental nonqualified retirement plan A RELATED ORGANIZATION MAINTAINS A SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (SERP) AS PART OF THE TOTAL COMPENSATION ARRANGEMENT FOR THE ORGANIZATION'S CEO, THOMAS CHAPMAN. THE SERP PLAN IS MEANT TO PROVIDE THOMAS CHAPMAN WITH A RETIREMENT BENEFIT FOR OVER 15 YEARS OF SERVICE PROVIDED TO THE RELATED ORGANIZATION. THE RELATED ORGANIZATION'S COMPENSATION COMMITTEE HAS CAREFULLY REVIEWED AND APPROVED THE SERP PLAN FOR THOMAS CHAPMAN AND CONCLUDED THAT THOMAS CHAPMAN'S ENTIRE COMPENSATION PACKAGE, INCLUDING THE BENEFITS PROVIDED BY THE SERP PLAN, IS REASONABLE WHEN COMPARED TO MARKET DATA. NO SERP DISTRIBUTIONS WERE MADE IN 2015. A DISTRICT OF COLUMBIA 536001131 000000000 2010-12-17 11525000 REFUND SERIES 2005 BOND false false false A 1050000 0 11525000 0 0 0 0 0 0 0 11525000 0 1992 true false true true A false false false false 0.0 0.0 0.0 false false true A false false false true true false false false false false A false Schedule K, Part III, Line 7 ALL COSTS OF ISSUANCE WITH RESPECT TO THE BONDS WERE PAID FROM FUNDS OTHER THAN PROCEEDS OF THE BONDS. Schedule K, Part IV, Line 7 THE TAX-EXEMPT BOND ISSUANCE UNDERTAKEN BY THE ORGANIZATION IN 2010 CURRENTLY REFUNDED A PRIOR TAX-EXEMPT BOND ISSUANCE FROM 2005, WHICH 2005 BOND ISSUANCE HAD CURRENTLY REFUNDED THE HOSPITAL REVENUE BONDS SERIES 1991A, ISSUED BY THE ORGANIZATION ON JUNE 12, 1991 TO FINANCE THE CONSTRUCTION OF A HOSPITAL FACILITY. ALL OF THE PROCEEDS OF THE 2010 TAX-EXEMPT BOND ISSUANCE WERE SPENT IMMEDIATELY UPON RECEIPT TO CURRENTLY REFUND THE 2005 BOND ISSUANCE. AS OF THE ISSUANCE DATE OF THE 2010 TAX-EXEMPT BONDS, THERE WERE NO UNEXPENDED PROCEEDS OF THE 2005 BONDS, AND THERE WERE NO TRANSFERRED PROCEEDS TO THE 2010 TAX-EXEMPT BOND ISSUANCE FROM PRIOR BOND ISSUANCES. AS A RESULT OF THE FOREGOING, NONE OF THE PROCEEDS OF THE TAX-EXEMPT BOND ISSUANCE WERE USED TO MAKE ANY HIGHER YIELDING INVESTMENTS OR NONPURPOSE INVESTMENTS, WHICH ARE REGULATE DUNDER SECTION 148 OF THE INTERNAL REVENUE CODE. SINCE THE ORGANIZATION HAS NOT USED THE PROCEEDS FROM THE BOND ISSUANCE TO MAKE ANY HIGHER YIELDING INVESTMENTS OR NONPURPOSE INVESTMENTS, THE ORGANIZATION HAS NOT YET ESTABLISHED WRITTEN PROCEDURES TO MONITOR THE REQUIREMENTS OF SECTION 148. IT IS THE ORGANIZATION'S INVENTION TO ADOPT SUCH A POLICY AT SUCH TIME AS ANOTHER TAX-EXEMPT BOND ISSUANCE IS UNDERTAKEN BY THE ORGANIZATION, PURSUANT TO WHICH THE PROCEEDS OF THE TAX-EXEMPT BOND ISSUANCE WILL NOT BE SPENT IMMEDIATELY UPON PURPOSE INVESTMENTS. Schedule K, Part IV, Line 2c COLUMN A Issuer name: DISTRICT OF COLUMBIA The calculation for computing no rebate due was performed on 07/27/2015 Form 990, Part VI, Line 15 PROCESS TO ESTABLISH COMPENATION OF CEO, OTHER OFFICERS AND KEY EMPLOYEES THE ORGANIZATION RELIED ON A RELATED ORGANIZATION, HSC FOUNDATION, TO DETERMINE COMPENSATION OF THE ORGANIZATION'S CEO. IN ADDITION, THE ORGANIZATION DETERMINES THE COMPENSATION OF OTHER OFFICERS AND KEY EMPLOYEES OF THE ORGANIZATION, AS DISCUSSED BELOW. THE ORGANIZATION AND HSC FOUNDATION BOTH USE A FOUR STEP APPROACH TO EXECUTIVE COMPENSATION: 1. THE EXECUTIVE COMMITTEE IS MADE UP OF INDEPENDENT BOARD MEMBERS WITHOUT A CONFLICT OF INTEREST, TO ESTABLISH AND DETERMINE THE REASONABLENESS OF TOTAL COMPENSATION FOR THE SYSTEM'S DISQUALIFIED EXECUTIVES AND FORWARDS TO THE FULL BOARD FOR APPROVAL. 2. PERIODICALLY, THE EXECUTIVE COMMITTEE WILL ENGAGE AN INDEPENDENT CONSULTANT TO PREPARE A DETAILED WRITTEN REPORT ON APPROPRIATE COMPARABILITY DATA FOR COMPARABLE POSITIONS. 3. THE EXECUTIVE COMMITTEE REVIEWS AND RELIES UPON THE REPORT OF THE INDEPENDENT CONSULTANT, ALONG WITH OTHER INDIVIDUAL AND MARKET DATA, THEN DEBATES AND FULLY DOCUMENTS ITS DECISION ABOUT WHAT IS REASONABLE COMPENSATION FOR DISQUALIFIED EXECUTIVES. 4. ONCE THE EXECUTIVE COMMITTEE DEVELOPS EXECUTIVE COMPENSATION RECOMMENDATIONS, THEY ARE PRESENTED TO THE SYSTEM'S FULL BOARD FOR APPROVAL. Form 990, Part VI, Line 1a Delegate broad authority to a committee The Executive Committee of the HSC Foundation, the sole corporate member of the organization, has the power to exercise each and all of the powers of the Board of Directors in the same manner and to the same extent as if the Committee were in fact the Board of Directors, provided that any action taken shall not conflict with previously established policies or directives of the Board. However, nothing contained in these Bylaws shall constitute a delegation to the Executive Committee of the following powers of the Board of Directors: to increase or decrease the number of Directors; to fill vacancies on or remove Directors from the Board; to elect officers; to fill officers' vacancies; to remove officers; to sell, encumber or otherwise dispose of all or any material part of the assets of the Corporation; to merge or consolidate the Corporation with another entity; or to amend these Bylaws. All Executive Committee minutes will be provided to all members of the Board of Directors prior to the next meeting of the Board of Directors. The Executive Committee shall consist of the Chairman, Vice Chairman, Secretary and Treasurer of the HSC Foundation and up to four (4) additional at-large members who may be appointed by the Chairman of the Board, in his or her discretion. The President shall be an ex officio member of the Committee. Form 990, Part VI, Line 11b Review of form 990 by governing body THE FORM 990 IS PREPARED BY AN ACCOUNTING FIRM AND THEN REVIEWED BY THE VP'S FINANCE. ONCE COMMENTS FROM VP'S FINANCE HAVE BEEN INCORPORATED INTO THE FORM 990, THE FORM 990 IS MADE AVAILABLE TO THE AUDIT COMMITTEE FOLLOWED BY A MEETING IN WHICH THE FORM 990 IS PRESENTED. THE FULL BOARD OF DIRECTORS HAS DELEGATED THE REVIEW OF THE FORM 990 TO THE AUDIT COMMITTEE. THE AUDIT COMMITTEE IS A PART OF THE FULL VOTING BOARD OF DIRECTORS. A COPY OF THE FORM 990 IS PROVIDED TO ANY OTHER BOARD MEMBERS UPON REQUEST. Form 990, Part VI, Line 12c Conflict of interest policy THE HSC FOUNDATION HAS A WRITTEN CONFLICT OF INTEREST POLICY THAT COVERS ITSELF AND ALL OF ITS DIRECT AND INDIRECT SUBSIDIARIES (INCLUDING THE HOSPITAL FOR SICK CHILDREN). UNDER THAT POLICY, WHENEVER A POTENTIAL CONFLICT ARISES FOR THE HSC PEDIATRIC CENTER BOARD OF DIRECTORS AND OFFICERS, IT IS BROUGHT TO THE ATTENTION OF THE PRESIDENT AND EXECUTIVE COMMITTEE OF THE HSC FOUNDATION BOARD, WHICH ANALYZES THE SITUATION AND MAKES A DETERMINATION OF WHETHER OR NOT AN ACTUAL CONFLICT EXISTS. IF IT IS DETERMINED THAT AN ACTUAL CONFLICT EXISTS, THE PRESIDENT AND EXECUTIVE COMMITTEE REPORTS TO THE HSC PEDIATRIC CENTER BOARD OF DIRECTORS REGARDING THE NATURE OF THE CONFLICT AND THAT PERSON IS THEREAFTER RECUSED FROM ANY DISCUSSION AND VOTE REGARDING THE MATTER. WHENEVER A POTENTIAL CONFLICT ARISES FOR EMPLOYEES OF THE HSC PEDIATRIC CENTER MANAGEMENT TEAM, IT WILL BE BROUGHT TO THE BOARD CHAIR BY THE PRESIDENT WHICH ANALYZES THE SITUATION AND MAKES A DETERMINATION OF WHETHER OR NOT AN ACTUAL CONFLICT EXISTS. IF IT IS DETERMINED THAT AN ACTUAL CONFLICT EXISTS, STEPS WILL BE TAKEN TO ELIMINATE THE CONFLICT AND COMMUNICATED TO THE EMPLOYEE INVOLVED. THE BOARD CHAIR AND PRESIDENT WILL REPORT ALL COI TO THE EXECUTIVE COMMITTEE FOUNDATION. Form 990, Part VI, Line 19 Required documents available to the public THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. Form 990, Part VIII, Line 2f Other Program Service Revenue OTHER - Total Revenue: , Related or Exempt Function Revenue: , Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: ; Form 990, Part IX, Line 11g Other Fees CONTRACT SERVICES - Total Expense: 3957119, Program Service Expense: 3477124, Management and General Expenses: 479995, Fundraising Expenses: ; CONSULTING - Total Expense: 487073, Program Service Expense: 459135, Management and General Expenses: 27938, Fundraising Expenses: ; - Total Expense: , Program Service Expense: , Management and General Expenses: , Fundraising Expenses: ; Form 990, Part XI, Line 9 Other changes in net assets or fund balances UNREALIZED LOSS ON INTEREST RATE SWAP - -91614; THE HSC FOUNDATION 2013 H STREET NW SUITE 300 WASHINGTON DC 20006 521346603 FACILITATE ACCESS TO HEALTH CARE SERVICES DC 501(c)(3 Type III-FI NA false HEALTH SERVICES FOR CHILDREN WITH SPECIAL NEEDS INC 1101 VERMONT AVE NW WASHINGTON DC 20005 521862406 HEALTHCARE DC 501(c)(3 9 THE HSC FOUNDATION false 2013 HOLDINGS INC 2013 H STREET NW WASHINGTON DC 20006 272882469 HOLDING COMPANY DC 501(c)(2 THE HSC FOUNDATION false false false false false false false false false false true false false false true true true true true true 2013 HOLDINGS INC Q 85347 FMV