2015-10-07T09:32:43-05:00 2014-12-31 560747981 DIXON HUGHES GOODMAN LLP 111 ROCKVILLE PIKE 6TH FLOOR ROCKVILLE MD 20850 990 2014-01-01 521862406 HEALTH SERVICES FOR CHILDREN WITH SPECIAL NEEDS INC HEAL 2024672737 1101 VERMONT AVENUE NW NO 1200 WASHINGTON DC 20005 RAY VICKS SR VP FINANCE 2024672737 2015-09-22 1 AARON COHEN P01782580 2404033700 2015-09-22 2014 2016-02-25 16:41:14Z THOMAS CHAPMAN 2013 H STREET NW STE 300 WASHINGTON DC 20006 155082643 0 X N/A X 1994 DC TO PROVIDE COORDINATION OF HEALTHCARE, SOCIAL AND EDUCATIONAL SERVICES TO PERSONS WHO HAVE DISABILITIES AND/OR COMPLEX MEDICAL AND/OR PSYCHOSOCIAL NEEDS. 6 4 245 6 0 0 103287 29550 155049589 154769081 645 271 -43762 47914 155109759 154846816 2600 0 0 0 15302739 16889687 0 0 0 132176128 145097599 147481467 161987286 7628292 -7140470 56503279 48295342 31179469 30112002 25323810 18183340 TO PROVIDE COORDINATION OF HEALTH CARE, SOCIAL, AND EDUCATIONAL SERVICES FOR INFANTS, CHILDREN, ADOLESCENTS AND YOUNG ADULTS WHO HAVE DISABILITIES AND/OR COMPLEX MEDICAL AND/OR PSYCHOSOCIAL NEEDS. 0 0 144100736 154769081 HSCSN SERVED UP TO 5,859 MEMBERS DURING 2014 THROUGH INTENSE ONE ON ONE CARE MANAGEMENT SERVICES. THERE WERE 1,274 ACUTE HOSPITAL ADMISSIONS FOR A TOTAL OF 9,878 PATIENT DAYS COVERED DURING THE YEAR. THERE WERE ON AVERAGE 49 MEMBERS IN SUB-ACUTE AND LONG-TERM CARE FACILITIES COVERING 7,113 PATIENT DAYS DURING 2014. HSCSN ALSO COORDINATED 16,510 PRIMARY CARE AND 17,060 SPECIALTY CARE DOCTOR VISITS DURING 2014. OTHER SERVICES COORDINATED INCLUDE: MEDICAL TRANSPORTATION TO DOCTOR VISITS, EMERGENCY ROOM VISITS, DENTAL CARE, LAB/RADIOLOGY SERVICES, DAY TREATMENT, HOME HEALTH CARE, MEDICAL DRUGS AND MEDICAL EQUIPMENT AND SUPPLIES. DURING 2014, HSCSN ALSO SPONSORED CME SEMINARS TO OUR PROVIDERS AND STAFF AND EDUCATIONAL PROGRAMS TO OUR MEMBERS. 144100736 1 1 0 0 0 0 0 0 0 0 1 0 0 1 0 1 1 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 1 614 0 1 245 1 0 0 0 0 0 0 0 0 0 0 X 6 4 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 0 1 0 DC X RAY VICKS 2028324400 2013 H STREET NW STE 300 WASHINGTON DC 20006 THOMAS CHAPMAN PRESIDENT/CEO 4.00 36.00 X X 0 679462 148559 JOHN MATHEWSON EXECUTIVE VP 10.00 30.00 X X 0 320250 43559 ANA PILSKAYA BOARD MEMBER 1.00 X 0 0 0 MARIA IVONNE RIVERA SECRETARY 1.00 X 0 0 0 ELAINE CRIDER PHD CHAIRPERSON 2.00 X X 0 0 0 THOMAS WALSH BOARD MEMBER 1.00 X 0 0 0 NANCY SOUTHERS VP FINANCE 3.00 37.00 X 0 303385 41176 DANNY BELLAMY COO HSCSN 36.00 4.00 X 0 252868 37891 JESSIE MACKINNON CHIEF OPERATING OFFICER, HSCF 1.00 40.00 X 0 245492 40060 RHONIQUE HARRIS CHIEF MEDICAL OFFICER 4.00 36.00 X 275040 0 20464 LYNNE HOSTETTER VP HUMAN RESOURCES 7.00 33.00 X 0 174730 34082 GENE GREER CIO 16.00 24.00 X 0 241009 24673 SARIKA JOSHI UTILIZATION MANAGEMENT PHYSICAN 40.00 X 204648 0 11868 ROBIN PIRTLE DIRECTOR CARE MGT UTILIZATION MGT 40.00 X 165786 0 16872 ROBERT LARONDE ASSISTANT VP FINANCE 40.00 X 159571 0 9488 BRUCE ARDIS VP CONTRACTING 40.00 X 153349 0 13285 FRANCES CHRISTMON VP FINANCE 40.00 X 183423 0 16231 1141817 2217196 458208 12 0 1 0 TRIZETTO PO BOX 122140 DALLAS TX 753122140 IT SERVICE 2251134 URBAN BEHAVIORAL HEALTH SERVICES INC 2310 NORTH CHARLES STREET BALTIMORE MD 21218 CONSULTING 807370 MB STAFFING PO BOX 50170 WASHINGTON DC 20091 STAFFING 179236 COGNOSANTE LLC 6263 N SCOTTSDALE RD 200 SCOTTSDALE AZ 85250 CONSULTING 170497 SYDNEY WATKINS 931 MONROE DR 102-355 ATLANTA GA 30308 CONSULTING 165407 9 23550 6000 29550 MANAGED CARE REVENUE 154769081 154769081 154769081 271 271 235827 235827 0 OTHER REVENUE 47704 47704 MED TRANSCRIPTS 210 210 47914 154846816 154816995 0 271 275040 275040 13096384 8654438 4441946 1061449 701434 360015 1482428 338899 1143529 974386 692035 282351 3334187 1359273 1974914 159246 159246 62459 62459 395437 65273 330164 22739 22739 2603386 695028 1908358 4200661 4200661 1831296 1831296 381692 127887 253805 36781 8673 28108 755678 755678 90081 90081 HEALTHCARE SERVICE COST 128135533 128135533 PREMIUM TAXES 3047223 3047223 GENERAL & ADMINISTRATIV 41200 41200 161987286 144100736 17886550 0 700 700 1530848 4190784 207071 7512150 4890537 3121637 2621613 252970 253279 51597124 41021895 56503279 48295342 31179469 30112002 31179469 30112002 X 25282878 18139701 40932 43639 25323810 18183340 56503279 48295342 -7140470 0 X 0 1 X 1 0 X 157755 52400 131863 103287 29550 474855 100212158 117657391 127983433 155049589 154769081 655671652 100369913 117709791 128115296 155152876 154798631 656146507 0 0 0 656146507 52 427 645 271 1395 52 427 645 271 1395 375 125 47914 48414 100369965 117709791 128116098 155153646 154846816 656196316 0.99990 0.99990 0.00000 0.00000 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 185587 144798 40789 7189725 4745739 2443986 136838 136838 2621613 DEPOSITS 413882 DUE FROM AFFILIATES 40607987 ACCRUED INTEREST RECEIVABLE 26 41021895 X 155082643 0 155082643 -235827 -235827 154846816 162223113 235827 235827 161987286 0 161987286 PART X, LINE 2: HSCSN WAS RECOGNIZED AS A PUBLIC CHARITY GENERALLY EXEMPT FROM FEDERAL INCOME TAXATION UNDER 501(C)(3) OF THE INTERNAL REVENUE CODE PURSUANT TO A DETERMINATION LETTER ISSUED BY THE IRS ON AUGUST 30, 1999. HSCSN 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 HSCSN'S STATUS AS A PUBLIC CHARITY EXEMPT FROM FEDERAL INCOME TAXATION REMAINS IN EFFECT. THE STATES IN WHICH HSCSN OPERATES ALSO PROVIDE GENERAL EXEMPTION FROM STATE INCOME TAXATION FOR ORGANIZATIONS THAT ARE EXEMPT FROM FEDERAL INCOME TAXATION. HOWEVER, HSCSN 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. HSCSN 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, 2014 ARE DUE ON MAY 15, 2015. MANAGEMENT FILED AN EXTENSION THROUGH AUGUST 15, 2015. HSCSN HAS FILED INFORMATION RETURNS AND TAX RETURNS FOR TAX YEAR 2013. CURRENT ACCOUNTING STANDARDS ADDRESS UNCERTAIN INCOME TAX POSITIONS IN FINANCIAL STATEMENTS BY PRESCRIBING THE MINIMUM RECOGNITION THRESHOLD A TAX POSITION IS REQUIRED TO MEET BEFORE BEING RECOGNIZED IN THE FINANCIAL STATEMENTS. MANAGEMENT BELIEVES THERE IS NO IMPACT ON HSCSN'S FINANCIAL STATEMENTS RELATED TO UNCERTAIN INCOME TAX POSITIONS. PART XI, LINE 4B - OTHER ADJUSTMENTS: RENT EXPENSE -235,827. PART XII, LINE 2D - OTHER ADJUSTMENTS: RENT EXPENSE 235,827. 1 1 0 0 0 0 0 0 0 THOMAS CHAPMAN PRESIDENT/CEO 0 658444 0 6750 0 14268 0 133369 0 15190 0 828021 0 0 JOHN MATHEWSON EXECUTIVE VP 0 307000 0 13250 0 0 0 30228 0 13331 0 363809 0 0 NANCY SOUTHERS VP FINANCE 0 296635 0 6750 0 0 0 29335 0 11841 0 344561 0 0 DANNY BELLAMY COO HSCSN 0 246118 0 6750 0 0 0 23850 0 14041 0 290759 0 0 JESSIE MACKINNON CHIEF OPERATING OFFICER, HSCF 0 238742 0 6750 0 0 0 28729 0 11331 0 285552 0 0 RHONIQUE HARRIS CHIEF MEDICAL OFFICER 274790 0 250 0 0 0 5153 0 15311 0 295504 0 0 0 LYNNE HOSTETTER VP HUMAN RESOURCES 0 167980 0 6750 0 0 0 27369 0 6713 0 208812 0 0 GENE GREER CIO 0 234259 0 6750 0 0 0 15615 0 9058 0 265682 0 0 SARIKA JOSHI UTILIZATION MANAGEMENT PHYSICAN 204398 0 250 0 0 0 10204 0 1664 0 216516 0 0 0 ROBIN PIRTLE DIRECTOR CARE MGT UTILIZATION MGT 163036 0 2750 0 0 0 8387 0 8485 0 182658 0 0 0 ROBERT LARONDE ASSISTANT VP FINANCE 156821 0 2750 0 0 0 8081 0 1407 0 169059 0 0 0 BRUCE ARDIS VP CONTRACTING 150599 0 2750 0 0 0 5298 0 7987 0 166634 0 0 0 FRANCES CHRISTMON VP FINANCE 180673 0 2750 0 0 0 8609 0 7622 0 199654 0 0 0 PART I, LINE 3 THE ORGANIZATION RELIED ON A RELATED ORGANIZATION AND THAT RELATED ORGANIZATION USED THE FOLLOWING METHODS TO ESTABLISH THE CEO/PRESIDENT OFFICIAL COMPENSATION: 1) COMPENSATION COMMITTEE 2) INDEPENDENT COMPENSATION CONSULTANT 3) COMPENSATION SURVEY OR STUDY 4) APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE PART I, LINES 4A-B CYD CAMPBELL RECEIVED A SEVERANCE PAYMENT OF $35,584 DURING THE 2014 TAX YEAR. 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. THE AMOUNT OF THE SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN BENEFIT DURING THE 2014 TAX YEAR WAS $103,700. FORM 990, PART VI, SECTION B, LINE 11 THE FORM 990 IS PREPARED BY AN ACCOUNTING FIRM AND THEN REVIEWED BY THE VP FINANCE AND SENIOR VP FINANCE. ONCE COMMENTS FROM THE ASSISTANT VP FINANCE AND VP FINANCE HAVE BEEN INCORPORATED INTO THE FORM 990, THE FORM 990 IS MADE AVAILABLE TO THE FINANCE COMMITTEE OF ITS PARENT ORGANIZATION, THE HSC FOUNDATION, FOR THEIR REVIEW, FOLLOWED BY A MEETING OF THE HSC FOUNDATION FINANCE COMMITTEE IN WHICH THE FORM 990 IS PRESENTED AND ANY QUESTIONS ARE ANSWERED. AFTER THE FINANCE COMMITTEE MEETING, THE FORM 990 IS MADE AVAILABLE TO ALL MEMBERS OF THE ORGANIZATION'S BOARD OF DIRECTORS FOR THEIR REVIEW AND COMMENTS. ANY COMMENTS OR QUESTIONS FROM BOARD MEMBERS ARE INCORPORATED INTO THE FORM 990 PRIOR TO FILING. FORM 990, PART VI, SECTION B, LINE 12C THE HSC FOUNDATION HAS A WRITTEN CONFLICT OF INTEREST POLICY THAT COVERS ITSELF AND ALL OF ITS DIRECT AND INDIRECT SUBSIDIARIES (INCLUDING HEALTH SERVICES FOR CHILDREN WITH SPECIAL NEEDS INC.) UNDER THAT POLICY, WHENEVER A POTENTIAL CONFLICT ARISES FOR HEALTH SERVICES FOR CHILDREN WITH SPECIAL NEEDS, INC. BOARD OF DIRECTORS AND OFFICERS, IT IS BROUGHT TO THE ATTENTION OF THE PRESIDENT AND EXECUTIVE COMMITTEE OF THE HSC FOUNDATION BOARD, 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 HEALTH SERVICES FOR CHILDREN WITH SPECIAL NEEDS, INC. 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 HEALTH SERVICES FOR CHILDREN WITH SPECIAL NEEDS, INC. 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, SECTION B, LINE 15B 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, SECTION C, LINE 19 THIS ORGANIZATION MAKES ITS CONFLICT OF INTEREST POLICY, FINANCIAL STATEMENTS AND ORGANIZATIONAL DOCUMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. THE HOSPITAL FOR SICK CHILDREN 1731 BRUNKER HILL ROAD NE WASHINGTON DC 20017 530204670 HOSPITAL DC 501(C)(3) 170B1(A)III THE HSC FDN 1 THE HSC FOUNDATION 2013 H STREET NW SUITE 300 WASHINGTON DC 20006 521346603 FACILITATE ACCESS TO HEALTH CARE SERVICES DC 501(C)(3) 509(A)(3) NONE 0 2013 HOLDINGS INC 2013 H STREET NW WASHINGTON DC 20006 272882469 HOLDING COMPANY DC 501(C)(2) NONE THE HSC FDN 1 SPECIAL NEEDS CONSULTING SERVICES INC 1150 18TH STREET NW STE 775 WASHINGTON DC 20036 451143185 CONSULTING DC THE HSC FDN C 1 0 0 1 0 0 0 0 0 0 0 0 1 1 0 1 1 1 0 0 THE HOSPITAL FOR SICK CHILDREN L 6002982 FMV THE HOSPITAL FOR SICK CHILDREN O 143509 FMV THE HOSPITAL FOR SICK CHILDREN P 1979467 FMV THE HOSPITAL FOR SICK CHILDREN Q 62703 FMV THE HSC FOUNDATION O 887046 FMV THE HSC FOUNDATION P 3665529 FMV THE HSC FOUNDATION Q 81036 FMV THE HSC FOUNDATION L 8675603 FMV THE HOSPITAL FOR SICK CHILDREN O 108827 FMV THE HOSPITAL FOR SICK CHILDREN O 6888 FMV