LUCY WEBB HAYNES NATIONAL TRAINING SCHOOL FOR DEACONESSES AND MISSION: Form 990, tax year 2012
View the entire original 990 at ProPublica ↗
- Organization
- LUCY WEBB HAYNES NATIONAL TRAINING SCHOOL FOR DEACONESSES AND MISSION (EIN 53-0196602)
- Tax period
- 2012-07-01 to 2013-06-30
- Filed
- 2014-05-13
- IRS object ID
- 201431339349302463
- Schema version
- 2012v2.1
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
- Return header
- Form 990
- Schedule A
- Schedule B
- Schedule C
- Schedule D
- Schedule H
- Schedule I
- Schedule J
- Schedule K
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2014-05-13T11:00:31-05:00 | Timestamp |
| Tax Period End Date | 2013-06-30 | TaxPeriodEndDate |
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2012-07-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 530196602 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | LUCY WEBB HAYES NATIONAL TRAINING SCHOOL | BusinessNameLine1 |
| Business Name Line2 | FOR DEACONESSES & MISSIONARIES | BusinessNameLine2 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | LUCY | NameControl |
| Phone | 2025374000 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 5255 LOUGHBORO RD NW | AddressLine1 |
| City | WASHINGTON | City |
| State | DC | State |
| ZIP Code | 20016 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | MARTIN BASSO | Name |
| Title | RVP FINANCE & CFO | Title |
| Phone | 2025374000 | Phone |
| Date Signed | 2014-05-13 | DateSigned |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2012 | TaxYear |
| Build TS | 2015-11-30 17:44:51Z | BuildTS |
Form 990 IRS990
Doing Business As DoingBusinessAs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SIBLEY MEMORIAL HOSPITAL | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | RICHARD O DAVIS | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 5255 LOUGHBORO RD NW | AddressLine1 |
| City | WASHINGTON | City |
| State | DC | State |
| ZIP Code | 20016 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 792989345 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | WWW.SIBLEY.ORG | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1891 | YearFormation |
| State Legal Domicile | DC | StateLegalDomicile |
| Activity Or Mission Description | THE LUCY WEBB HAYES NATIONAL TRAINING SCHOOL FOR DEACONESSES AND MISSIONARIES PROVIDES ALL SERVICES WITHOUT REGARD TO RACE, CREED, SEX, NATIONAL ORIGIN, HANDICAP, AGE OR ABILITY TO PAY. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 25 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 21 | NbrIndependentVotingMembers |
| Total Nbr Employees | 1995 | TotalNbrEmployees |
| Total Nbr Volunteers | 316 | TotalNbrVolunteers |
| Total Gross UBI | 231245 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | -5725 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 110066 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 132290 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 246266626 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 241627654 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 14536799 | InvestmentIncomePriorYear |
| Investment Income Current Year | 16516958 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 4459719 | OtherRevenuePriorYear |
| Other Revenue Current Year | 4897871 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 265373210 | TotalRevenuePriorYear |
| Total Revenue Current Year | 263174773 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 697393 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 1277993 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 133235716 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 135621710 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp Prior Year | 0 | TotalProfFundrsngExpPriorYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 106148240 | OtherExpensePriorYear |
| Other Expenses Current Year | 113802643 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 240081349 | TotalExpensesPriorYear |
| Total Expenses Current Year | 250702346 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 25291861 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 12472427 | RevenuesLessExpensesCY |
| Total Assets BOY | 973001610 | TotalAssetsBOY |
| Total Assets EOY | 996154414 | TotalAssetsEOY |
| Total Liabilities BOY | 198386791 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 146230274 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 774614819 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 849924140 | NetAssetsOrFundBalancesEOY |
| Info In Schedule O Part III | X | InfoInScheduleOPartIII |
| Mission Description | THE LUCY WEBB HAYES NATIONAL TRAINING SCHOOL FOR DEACONESSES AND MISSIONARIES CONDUCTING SIBLEY MEMORIAL HOSPITAL IS A GENERAL SHORT-TERM ACUTE CARE HOSPITAL LOCATED IN N.W. WASHINGTON,DC. THE HOSPITAL PROVIDES ALL SVCS WITHOUT REGARD TO RACE, CREED, SEX, NATIONAL ORIGIN, HANDICAP, AGE OR ABILITY TO PAY. ITS MISSION IS TO PROVIDE QUALITY HEALTH SVCS AND FACILITIES FOR THE COMMUNITY, TO PROMOTE WELLNESS, RELIEVE SUFFERING, AND RESTORE HEALTH AS SWIFTLY, SAFELY AND HUMANELY AS IT CAN BE DONE CONSISTENT WITH BEST SVC POSSIBLE AT THE HIGHEST VALUE FOR ALL CONCERNED. ITS VISION IS TO MAKE AVAILABLE SUPERIOR HEALTHCARE SVC AND VALUE, WITH THE GOAL OF IMPROVING HEALTH AND WELL-BEING OF THE COMMUNITY. THE HOSPITAL PLANS TO CONTINUE TO IMPROVE THAT SVC BY USING SCIENTIFIC METHODS, TEAMWORK, AND KNOWLEDGE OF BEST PRACTICES AND CUSTOMER EXPECTATIONS. THE HOSPITAL HAS VALUES WHICH PROVIDE GUIDELINES AND PARAMETERS FOR DECISIONS NECESSARY TO IMPROVE PROCESSES AND RESPOND TO NEEDS OF ITS PATIENTS. | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 232612251 | Expense |
| Grants | 1277993 | Grants |
| Revenue | 250258257 | Revenue |
| Description | PROVIDE ACUTE CARE HEALTHCARE SERVICES TO PATIENTS IN THE NORTHWEST WASHINGTON, DC AREA. TO PROVIDE QUALITY HEALTH SERVICES AND FACILITIES TO THIS COMMUNITY, PROMOTING WELLNESS, RELIEVE SUFFERING, AND RESTORE HEALTH AS SWIFTLY, SAFELY AND HUMANELY AS IT CAN BE DONE CONSISTENT WITH THE BEST SERVICE GIVEN AT THE HIGHEST VALUE.SIBLEY HOSPITAL IS A GENERAL SHORT TERM ACUTE CARE FACILITY LOCATED IN NORTHWEST WASHINGTON, DC. THE HOSPITAL PROVIDES ALL SERVICES WITHOUT REGARD TO RACE, CREED, SEX, SEXUAL PREFERENCE, NATIONAL ORIGIN, HANDICAP, AGE OR ABILITY TO PAY. IN NOVEMBER, 2010, THE HOSPITAL BECAME INTEGRATED WITH THE JOHNS HOPKINS HEALTH SYSTEM (JHHS). ONE OF THE REQUIREMENTS OF THE INTEGRATION WAS TO ADOPT THE FISCAL YEAR ACCOUNTING PERIOD OF JULY 1 TO JUNE 30. CONSEQUENTLY, THIS RETURN IS FOR THE 12-MONTH ACCOUNTING PERIOD JULY 1, 2012 TO JUNE 30, 2013. INHERENT IN THE PURPOSE IS THE HOSPITALS WILLINGNESS TO PROVIDE HEALTHCARE SERVICES TO MEMBERS OF THE COMMUNITY WHO ARE NOT ABLE TO PAY FOR SERVICES. FOR FISCAL YEAR 2013, THE HOSPITAL PROVIDED CHARITY CARE TO MORE THAN 1,000 PATIENTS, INCURRING COSTS OVER $2.2 MILLION. TOTAL BENEFITS AND UNCOMPENSATED COST OF CARE PROVIDED TO THE COMMUNITY EXCEEDED $6.1 MILLION. SIBLEY PROVIDES CHARITY CARE TO THE CLIENTS OF THE CATHOLIC HEALTH CARE NETWORK, MARYS CENTER FOR MATERNAL AND CHILD HEALTH, THE COMMUNITY OF HOPE, COLUMBIA ROAD CLINIC, UNITY HEALTHCARE, AND BREAD FOR THE CITY. THE HOSPITAL ADMITTED ALMOST 15,000 PATIENTS IN 2013, AND PROVIDED OVER 67,000 DAYS OF INPATIENT CARE. OVER 3,400 NEW BABIES WERE DELIVERED AS WELL. OVER 34,000 PATIENTS WERE TREATED IN OUR 24/7 EMERGENCY ROOM, AND OVER 144,000 TESTS WERE RENDERED TO PATIENTS WHO RECEIVED SURGICAL, ENDOSCOPIC OR OTHER ANCILLIARY OUTPATIENT TREATMENTS OR PROCEDURES. | Description |
| Total Program Service Expense | 232612251 | TotalProgramServiceExpense |
| Described In501 C3 | 1 | DescribedIn501C3 |
| Schedule B Required | 1 | ScheduleBRequired |
| Political Activities | 0 | PoliticalActivities |
| Lobbying Activities | 1 | LobbyingActivities |
| Subject To Proxy Tax | 0 | SubjectToProxyTax |
| Donor Advised Funds | 0 | DonorAdvisedFunds |
| Conservation Easements | 0 | ConservationEasements |
| Collections Of Art | 0 | CollectionsOfArt |
| Credit Counseling | 1 | CreditCounseling |
| Term Or Permanent Endowments | 0 | TermOrPermanentEndowments |
| Report Land Bldg Equip | 1 | ReportLandBldgEquip |
| Report Invest Oth Securities | 1 | ReportInvestOthSecurities |
| Report Prog Rel Invest | 0 | ReportProgRelInvest |
| Report Other Assets | 1 | ReportOtherAssets |
| Report Other Liabilities | 1 | ReportOtherLiabilities |
| Report Fin48 Footnote | 1 | ReportFin48Footnote |
| Independent Audit Financial Stmt | 0 | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | 1 | ConsolidatedAuditFinancialStmt |
| School | 0 | School |
| Foreign Office | 0 | ForeignOffice |
| Foreign Activities | 0 | ForeignActivities |
| More Than5000 K To Organizations | 0 | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividuals |
| Professional Fundraising | 0 | ProfessionalFundraising |
| Fundraising Activities | 0 | FundraisingActivities |
| Gaming | 0 | Gaming |
| Hospital | 1 | Hospital |
| Financial Stmt Attached | 1 | FinancialStmtAttached |
| Grants To Organizations | 1 | GrantsToOrganizations |
| Grants To Individuals | 0 | GrantsToIndividuals |
| Schedule J Required | 1 | ScheduleJRequired |
| Tax Exempt Bonds | 1 | TaxExemptBonds |
| Invest Tax Exempt Bonds | 0 | InvestTaxExemptBonds |
| Escrow Account | 0 | EscrowAccount |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuer |
| Excess Benefit Transaction | 0 | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | 0 | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | 0 | LoanToOfficerOrDQP |
| Grant To Related Person | 0 | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | 0 | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | 0 | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | 0 | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | 0 | DeductibleNonCashContributions |
| Deductible Contributions Of Art | 0 | DeductibleContributionsOfArt |
| Terminated | 0 | Terminated |
| Partial Liquidation | 0 | PartialLiquidation |
| Disregarded Entity | 0 | DisregardedEntity |
| Related Entity | 1 | RelatedEntity |
| Related Org Controlled Entity | 1 | RelatedOrgControlledEntity |
| Transaction Related Entity | 1 | TransactionRelatedEntity |
| Transfers To Exempt Non Chrtbl Org | 0 | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | 0 | ActivitiesConductedPartnership |
| Schedule O Required | 1 | ScheduleORequired |
| Number Forms Transmitted With1096 | 170 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | 1 | ComplianceWithBackupWitholding |
| Number Of Employees | 1995 | NumberOfEmployees |
| Employment Tax Returns Filed | 1 | EmploymentTaxReturnsFiled |
| Unrelated Business Income | 1 | UnrelatedBusinessIncome |
| Form990-T Filed | 1 | Form990-TFiled |
| Foreign Financial Account | 0 | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTrans |
| Taxable Party Notification | 0 | TaxablePartyNotification |
| Non Deductible Contributions | 0 | NonDeductibleContributions |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributions |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | 0 | FundsToPayPremiums |
| Premiums Paid | 0 | PremiumsPaid |
| Indoor Tanning Services | 0 | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 25 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 21 | NumberIndependentVotingMembers |
| Family Or Business Relationship | 0 | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | 0 | DelegationOfManagementDuties |
| Changes To Organizing Docs | 0 | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuse |
| Members Or Stockholders | 0 | MembersOrStockholders |
| Election Of Board Members | 1 | ElectionOfBoardMembers |
| Decisions Subject To Approval | 1 | DecisionsSubjectToApproval |
| Minutes Of Governing Body | 1 | MinutesOfGoverningBody |
| Minutes Of Committees | 1 | MinutesOfCommittees |
| Officer Mailing Address | 0 | OfficerMailingAddress |
| Local Chapters | 0 | LocalChapters |
| Form990 Provided To Governing Body | 1 | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | 1 | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | 1 | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | 1 | RegularMonitoringEnforcement |
| Whistleblower Policy | 1 | WhistleblowerPolicy |
| Document Retention Policy | 1 | DocumentRetentionPolicy |
| Compensation Process CEO | 1 | CompensationProcessCEO |
| Compensation Process Other | 1 | CompensationProcessOther |
| Investment In Joint Venture | 0 | InvestmentInJointVenture |
| States Where Copy Of Return Is Filed | DC | StatesWhereCopyOfReturnIsFiled |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MARTIN BASSO RVP FINANCE & CFO | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 3018962333 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 5255 LOUGHBORO RD NW | AddressLine1 |
| City | WASHINGTON | City |
| State | DC | State |
| ZIP Code | 20016 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (39 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Average Hours Per Week RelatedAverageHoursPerWeekRelated | Individual Trustee Or DirectorIndividualTrusteeOrDirector | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | OfficerOfficer | Highest Compensated EmployeeHighestCompensatedEmployee | FormerFormer |
|---|---|---|---|---|---|---|---|---|---|
| REV DAVID A ARGO | |||||||||
| TRUSTEE | 5.00 | 10.00 | X | 0 | 0 | 0 | |||
| WILLIAM B BARTON ESQ | |||||||||
| TRUSTEE/VICE CHAIRMAN | 5.00 | 10.00 | X | 0 | 0 | 0 | X | ||
| GEOFFREY D BROWN | |||||||||
| TRUSTEE | 5.00 | 1.00 | X | 0 | 0 | 0 | |||
| J RENE CARTER | |||||||||
| TRUSTEE | 5.00 | 10.00 | X | 0 | 0 | 0 | |||
| CHARLES M COCHRAN JR | |||||||||
| TRUSTEE | 5.00 | 0.00 | X | 0 | 0 | 0 | |||
| PAUL R ERICKSON | |||||||||
| TRUSTEE | 5.00 | 0.00 | X | 0 | 0 | 0 | |||
| MICHAEL K FARR | |||||||||
| TRUSTEE | 5.00 | 11.00 | X | 0 | 0 | 0 | |||
| SAMUAL P HARRINGTON MD | |||||||||
| TRUSTEE/SECRETARY | 5.00 | 10.00 | X | 0 | 0 | 0 | X | ||
| BURKE F HAYES | |||||||||
| TRUSTEE | 5.00 | 0.00 | X | 0 | 0 | 0 | |||
| DALE H HOSCHEIT ESQ | |||||||||
| TRUSTEE | 5.00 | 10.00 | X | 0 | 0 | 0 | |||
| JOHN O MAY | |||||||||
| TRUSTEE | 5.00 | 0.00 | X | 0 | 0 | 0 | |||
| EDWARD J MILLER JR | |||||||||
| TRUSTEE/CHAIRMAN | 5.00 | 21.00 | X | 0 | 0 | 0 | X | ||
| A WALLACE MOORE JR | |||||||||
| TRUSTEE | 5.00 | 0.00 | X | 0 | 0 | 0 | |||
| RICHARD E MORRIS | |||||||||
| TRUSTEE/TREASURER | 5.00 | 10.00 | X | 0 | 0 | 0 | X | ||
| PRISCILLA I PAGANO | |||||||||
| TRUSTEE | 5.00 | 0.00 | X | 0 | 0 | 0 | |||
| CHARLES H ROSS | |||||||||
| TRUSTEE | 5.00 | 0.00 | X | 0 | 0 | 0 | |||
| THOMAS J SCHAEFER | |||||||||
| TRUSTEE | 5.00 | 0.00 | X | 0 | 0 | 0 | |||
| RONALD R PETERSON | |||||||||
| TRUSTEE/CORP VICE CHAIRMAN | 5.00 | 55.00 | X | 0 | 13573496 | 1812123 | X | ||
| THOMAS H SULLIVAN | |||||||||
| TRUSTEE | 5.00 | 0.00 | X | 0 | 0 | 0 | |||
| CARL L SYLVESTER JR MD | |||||||||
| TRUSTEE | 5.00 | 0.00 | X | 352050 | 0 | 0 | |||
| KIMBERLY H WALTON ESQ | |||||||||
| TRUSTEE | 5.00 | 0.00 | X | 0 | 0 | 0 | |||
| NILOOFAR RAZI HOWE | |||||||||
| TRUSTEE | 5.00 | 1.00 | X | 0 | 0 | 0 | |||
| THOMAS M MASTERSON MD | |||||||||
| TRUSTEE, EX-OFFICIO | 5.00 | 0.00 | X | 60000 | 0 | 0 | |||
| SHARON PERCY ROCKEFELLER | |||||||||
| TRUSTEE | 5.00 | 0.00 | X | 0 | 0 | 0 | |||
| RICHARD O DAVIS | |||||||||
| PRESIDENT/CEO/TRUSTEE | 58.00 | 2.00 | X | 0 | 676852 | 190015 | X | ||
| STEPHEN C MCDONNELL | |||||||||
| SR VP & CFO | 60.00 | 0.00 | 648452 | 0 | 72968 | X | |||
| JOAN VINCENT | |||||||||
| SR VP, PT. CARE SVCS & CNO | 60.00 | 0.00 | 348690 | 0 | 83732 | X | |||
| ALISON ARNOTT | |||||||||
| VP SUPPORT SERVICES | 60.00 | 0.00 | 172281 | 0 | 21595 | X | |||
| QUEENIE PLATER | |||||||||
| VP & CHIEF HR OFFICER | 60.00 | 0.00 | 290653 | 0 | 64972 | X | |||
| KENDA TAVAKOLI | |||||||||
| VP, INFO RESOURCES & CIO | 60.00 | 0.00 | 299057 | 0 | 52255 | X | |||
| PETER PETRUCCI MD | |||||||||
| VP PT SAFETY, QUALITY & MED AFFAIRS | 60.00 | 0.00 | 306850 | 0 | 21779 | X | |||
| CHRISTINE STUPPY | |||||||||
| VP BUS. DEVEL. & STRAT. PL | 60.00 | 0.00 | 223911 | 0 | 36110 | X | |||
| JEFFERY JOYNER | |||||||||
| VP PROFESSIONAL SERVICES | 60.00 | 0.00 | 225114 | 0 | 32458 | X | |||
| JEFFREY L LIN | |||||||||
| PHYSICIAN DIR GYN ONCOLOGY | 40.00 | 0.00 | 818222 | 0 | 38728 | X | |||
| REBECCA ZUURBIER | |||||||||
| PHYSICIAN DIR. BREAST IMAG | 40.00 | 0.00 | 515780 | 0 | 9454 | X | |||
| JERRY L PRICE | |||||||||
| VP REAL ESTATE & CONSTRUCT | 40.00 | 0.00 | 427294 | 0 | 61681 | X | |||
| HASAN ZIA | |||||||||
| PHYSICIAN DIR INTENSIVE/ACUTE CARE | 40.00 | 0.00 | 566020 | 0 | 39375 | X | |||
| COLETTE M MAGNANT | |||||||||
| BREAST SURGEON | 40.00 | 0.00 | 877046 | 0 | 41079 | X | |||
| ROBERT L SLOAN | |||||||||
| FORMER PRESIDENT & CEO/TRUSTEE | 0.00 | 10.00 | 1635451 | 0 | 435647 | X | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 7766871 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 14250348 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 3013971 | TotalOtherCompensation |
| Number Individuals GT100 K | 209 | NumberIndividualsGT100K |
| Formers Listed | 1 | FormersListed |
| Total Comp GT150 K | 1 | TotalCompGT150K |
| Compensation From Other Sources | 0 | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (5 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| SURGICAL ANESTHESIA ASSOCIATES | |||||
| 5255 LOUGHBORO RD NW | WASHINGTON | DC | 20016 | ANESTHESIA | 352050 |
| ROBERT S KLAPPENBACH MD | |||||
| 2337 BLAINE DRIVE | CHEVY CHASE | MD | 20815 | PATHOLOGY | 298664 |
| MARGARET M SHAFFER MD | |||||
| 11813 HAYFIELD CT | POTOMAC | MD | 20854 | PATHOLOGY | 298664 |
| LANGEVIN LARSEN HAMM & COHEN | |||||
| 5530 WISCONSIN AVE 930 | CHEVY CHASE | MD | 20815 | HEALTH CARE | 227660 |
| BOGDAHN CONSULTING LLC | |||||
| 4901 VINELAND RD STE 600 | ORLANDO | FL | 32811 | CONSULTING | 225000 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 13 | NumberOfContractorsGT100K |
| All Other Contributions | 132290 | AllOtherContributions |
| Total Contributions | 132290 | TotalContributions |
Program Service Revenue ProgramServiceRevenue (5 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome | Unrelated Business RevenueUnrelatedBusinessRevenue |
|---|---|---|---|---|
| PATIENT REVENUE | 621990 | 212736374 | 212736374 | |
| ASSISTED LIVING | 623000 | 19713796 | 19713796 | |
| PHYSICIAN BILLING | 621990 | 6496068 | 6496068 | |
| MEDICAL OFFICE | 621990 | 2466928 | 2466928 | |
| LAB REVENUE | 621500 | 214488 | 214488 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 241627654 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 7838285 | TotalRevenueColumn |
| Unrelated Business Revenue | 16757 | UnrelatedBusinessRevenue |
| Exclusion | $7,821,528 | ExclusionAmount |
Gross Amount Sales Assets GrossAmountSalesAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 538131293 | Securities |
Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 529407776 | Securities |
| Other | 44844 | Other |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 8723517 | Securities |
| Other | -44844 | Other |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 8678673 | TotalRevenueColumn |
| Related Or Exempt Function Income | 8678673 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Sales Of Inventory | 528370 | GrossSalesOfInventory |
| Cost Of Goods Sold | 361952 | CostOfGoodsSold |
Net Income Or Loss NetIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 166418 | TotalRevenueColumn |
| Related Or Exempt Function Income | 166418 | RelatedOrExemptFunctionIncome |
Other Revenue Misc OtherRevenueMisc (3 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | ExclusionExclusionAmount |
|---|---|---|---|
| PARKING LOT | 900099 | 1655749 | $1,655,749 |
| CAFETERIA/VENDING | 900099 | 1177321 | $1,177,321 |
| OTHER INCOME | 900099 | 1122299 | $1,122,299 |
Miscellaneous Revenue MiscellaneousRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 776084 | TotalRevenueColumn |
| Exclusion | $776,084 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 4731453 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 263174773 | TotalRevenueColumn |
| Related Or Exempt Function Income | 250258257 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 231245 | UnrelatedBusinessRevenue |
| Exclusion | $12,552,981 | ExclusionAmount |
Grants To Domestic Orgs GrantsToDomesticOrgs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1277993 | Total |
| Program Services | 1277993 | ProgramServices |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 7740381 | Total |
| Program Services | 7322400 | ProgramServices |
| Management And General | 417981 | ManagementAndGeneral |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 104906315 | Total |
| Program Services | 94936919 | ProgramServices |
| Management And General | 9969396 | ManagementAndGeneral |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 5099368 | Total |
| Program Services | 4824002 | ProgramServices |
| Management And General | 275366 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 9974972 | Total |
| Program Services | 9436322 | ProgramServices |
| Management And General | 538650 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 7900674 | Total |
| Program Services | 7474038 | ProgramServices |
| Management And General | 426636 | ManagementAndGeneral |
Fees For Services Management FeesForServicesManagement
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1146189 | Total |
| Program Services | 1084295 | ProgramServices |
| Management And General | 61894 | ManagementAndGeneral |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 930307 | Total |
| Program Services | 397632 | ProgramServices |
| Management And General | 532675 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 546470 | Total |
| Program Services | 508541 | ProgramServices |
| Management And General | 37929 | ManagementAndGeneral |
Fees For Services Lobbying FeesForServicesLobbying
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 73082 | Total |
| Management And General | 73082 | ManagementAndGeneral |
Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1458647 | Total |
| Management And General | 1458647 | ManagementAndGeneral |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 23735090 | Total |
| Program Services | 22947356 | ProgramServices |
| Management And General | 787734 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1103586 | Total |
| Program Services | 885841 | ProgramServices |
| Management And General | 217745 | ManagementAndGeneral |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1174245 | Total |
| Program Services | 1110836 | ProgramServices |
| Management And General | 63409 | ManagementAndGeneral |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3306051 | Total |
| Program Services | 3127524 | ProgramServices |
| Management And General | 178527 | ManagementAndGeneral |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 4428923 | Total |
| Program Services | 4189761 | ProgramServices |
| Management And General | 239162 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 118862 | Total |
| Program Services | 112443 | ProgramServices |
| Management And General | 6419 | ManagementAndGeneral |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 351855 | Total |
| Program Services | 332855 | ProgramServices |
| Management And General | 19000 | ManagementAndGeneral |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 4065142 | Total |
| Program Services | 3769683 | ProgramServices |
| Management And General | 295459 | ManagementAndGeneral |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 17745172 | Total |
| Program Services | 16786933 | ProgramServices |
| Management And General | 958239 | ManagementAndGeneral |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 4380559 | Total |
| Program Services | 4380559 | ProgramServices |
Other Expenses OtherExpenses (4 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral |
|---|---|---|---|
| DIRECT PATIENT SUPPLIES | 31808983 | 31808983 | 0 |
| OTHER SUPPLIES | 10135852 | 9653967 | 481885 |
| PURCHASED SERVICES | 5019717 | 3996516 | 1023201 |
| PROVIDER TAX | 1733224 | 1733224 | 0 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 540687 | Total |
| Program Services | 513628 | ProgramServices |
| Management And General | 27059 | ManagementAndGeneral |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 250702346 | Total |
| Program Services | 232612251 | ProgramServices |
| Management And General | 18090095 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 26895127 | BOY |
| EOY | 24861438 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 30869323 | BOY |
| EOY | 29926083 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1504177 | BOY |
| EOY | 3531896 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3613270 | BOY |
| EOY | 7143048 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 321171721 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 42563096 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 280754995 | BOY |
| EOY | 278608625 | EOY |
Investments Other Securities InvestmentsOtherSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 318844793 | BOY |
| EOY | 153847810 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 310519925 | BOY |
| EOY | 498235514 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 973001610 | BOY |
| EOY | 996154414 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 27758959 | BOY |
| EOY | 28387984 | EOY |
Tax Exempt Bond Liabilities TaxExemptBondLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 112365151 | BOY |
| EOY | 70549654 | EOY |
Escrow Account Liability EscrowAccountLiability
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2374182 | BOY |
| EOY | 365945 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 55888499 | BOY |
| EOY | 46926691 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 198386791 | BOY |
| EOY | 146230274 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 740671379 | BOY |
| EOY | 810539856 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 20489794 | BOY |
| EOY | 24430638 | EOY |
Permanently Restricted Net Assets PermanentlyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 13453646 | BOY |
| EOY | 14953646 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 774614819 | BOY |
| EOY | 849924140 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 973001610 | BOY |
| EOY | 996154414 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | 12472427 | ReconcilationRevenueExpenses |
| Reconciliation Unrealized Invest | 23196833 | ReconciliationUnrealizedInvest |
| Reconcilation Other Changes | 39640061 | ReconcilationOtherChanges |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | 0 | AccountantCompileOrReview |
| FS Audited | 1 | FSAudited |
FS Audited Basis FSAuditedBasis
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Statement Consolidated | X | FinancialStatementConsolidated |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | 1 | AuditCommittee |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequired |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital170b1 Aiii | X | Hospital170b1Aiii |
Schedule B IRS990ScheduleB
Contributor Info ContributorInfo
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor Number | RESTRICTED | ContributorNumber |
Contributor Name Business ContributorNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor Address US ContributorAddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Aggregate Contributions | RESTRICTED | AggregateContributions |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | 0 | Volunteers |
| Paid Staff Or Management | 0 | PaidStaffOrManagement |
| Media Advertisements | 0 | MediaAdvertisements |
| Mailings Members | 0 | MailingsMembers |
| Publications Or Broadcast | 0 | PublicationsOrBroadcast |
| Grants Other Organizations | 0 | GrantsOtherOrganizations |
| Direct Contact Legislators | 1 | DirectContactLegislators |
| Direct Contact Legislators | $49,500 | DirectContactLegislatorsAmount |
| Rallies Demonstrations | 0 | RalliesDemonstrations |
| Other Activities | 1 | OtherActivities |
| Other Activities | $23,582 | OtherActivitiesAmount |
| Total Lobbying Expenditures IIB | 73082 | TotalLobbyingExpendituresIIB |
| Not Described In501c3 | 0 | NotDescribedIn501c3 |
Form990 Schedule C Part IV Form990ScheduleCPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | EXPLANATION OF LOBBYING ACTIVITIES: | Identifier |
| Return Reference | PART II-B, LINE 1: | ReturnReference |
| Explanation | DIRECT CONTACT: SIBLEY MEMORIAL HOSPITAL RETAINS LEGAL COUNSEL TO PERFORM LOBBYING ACTIVITIES ON ITS BEHALF. THE LOBBYING ACTIVITIES RELATE TO PRESERVING AND PROTECTING THE HOSPITAL'S INTERESTS WITH REGARDS TO MATTERS AFFECTING HEALTH CARE AND HEALTH FACILITIES. OTHER ACTIVITIES: SIBLEY MEMORIAL HOSPITAL PAID $23,582 DURING THE FISCAL YEAR ENDED JUNE 30, 2013 TO THE DISTRICT OF COLUMBIA HOSPITAL ASSOCIATION FOR LOBBYING PURPOSES AS PART OF THE ANNUAL DUES. | Explanation |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Agent Trustee Etc | 0 | AgentTrusteeEtc |
| Included On FS | 1 | IncludedOnFS |
| Explanation In Part XIII | X | ExplanationInPartXIII |
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 50500000 | OtherCostOrOtherBasis |
| Book Value | 50500000 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 196047008 | OtherCostOrOtherBasis |
| Depreciation | 19298730 | Depreciation |
| Book Value | 176748278 | BookValue |
Leasehold Improvements LeaseholdImprovements
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 349044 | OtherCostOrOtherBasis |
| Depreciation | 10787 | Depreciation |
| Book Value | 338257 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 58399115 | OtherCostOrOtherBasis |
| Depreciation | 23192724 | Depreciation |
| Book Value | 35206391 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 15876554 | OtherCostOrOtherBasis |
| Depreciation | 60855 | Depreciation |
| Book Value | 15815699 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 278608625 | TotalOfBookValueLandBuildings |
Other Securities OtherSecurities (2 entries)
| DescriptionDescription | Book ValueBookValue | Method Of ValuationMethodOfValuation |
|---|---|---|
| JOINT VENTURES | 3255150 | F |
| OTHER SECURITIES | 150592660 | F |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Securities | 153847810 | TotalOfBookValueSecurities |
Other Assets OtherAssets (6 entries)
| DescriptionDescription | Book ValueBookValue |
|---|---|
| OTHER RECEIVABLES | 3009039 |
| INTEREST RECEIVABLE | 1015598 |
| OTHER ASSETS | 10725576 |
| BENEFICIAL INTEREST IN SIBLEY MEMORIAL HOSPITAL FDN | 314077855 |
| DUE FROM AFFILIATES | 51399 |
| LIMITED USE ASSETS | 169356047 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | 498235514 | TotalBookValueOtherAssets |
Other Liabilities OtherLiabilities (6 entries)
| DescriptionDescription | AmountAmount |
|---|---|
| ALLOW FOR MALPRACTICE CLAIMS | $14,045,188 |
| ESTIMATED THIRD PARTY SETTLE | $7,965,503 |
| DEFERRED PENSION OBLIGATION | $8,653,863 |
| MISCELLANEOUS LIABILITIES | $13,815,440 |
| INTEREST PAYABLE | $982,740 |
| DEFERRED COMPENSATION | $1,463,957 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 46926691 | TotalOfAmounts |
| Footnote In Part XIII | X | FootnoteInPartXIII |
Form990 Schedule D Part XIII Form990ScheduleDPartXIII (2 entries)
| Return ReferenceReturnReference | ExplanationExplanation | IdentifierIdentifier |
|---|---|---|
| PART IV, LINE 2B: | THE HOSPITAL ACTS AS ADMINISTRATOR/TRUSTEE FOR A CHARITABLE GIFT ANNUITY (CGA) PROGRAM. THE ASSETS ARE CUSTODIED WITH THE FIDUCIARY TRUST COMPANY. DONORS MAKE ARRANGEMENTS WITH THE HOSPITAL AND THE CUSTODIAN TO MAKE A ONE-TIME CONTRIBUTION TO THE CGA. PERIODIC ANNUITY PAYMENTS ARE THEN MADE TO THE DONOR OVER THE LIFETIME OF THE DONOR. THE HOSPITAL INCLUDES ON ITS BALANCE SHEET THE MARKET VALUE OF THE ASSETS CONTRIBUTED BY ALL DONORS IN THE PROGRAM. THE HOSPITAL ALSO INCLUDES A LIABILITY FOR ESTIMATED PAYMENTS CALCULATED TO BE PAID TO ITS DONORS IN FUTURE YEARS. THE ASSETS ARE INVESTED IN FIXED INCOME AND EQUITY SECURITIES, MONITORED REGURARLY BY THE HOSPITAL'S INVESTMENT COMMITTEE. FOR FISCAL YEAR ENDING JUNE 30, 2013, THE MARKET VALUE OF THE ASSETS INCREASED BY $16,324. | |
| PART X, LINE 2: | FASB'S GUIDANCE ON ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES CLARIFIES THE ACCOUNTING FOR UNCERTAINTY OF INCOME TAX POSITIONS. THIS GUIDANCE DEFINES THE THRESHOLD FOR RECOGNIZING TAX RETURN POSITIONS IN THE FINANCIAL STATEMENTS AS "MORE LIKELY THAN NOT" THAT THE POSITION IS SUSTAINABLE, BASED ON ITS TECHNICAL MERITS. THIS GUIDANCE ALSO PROVIDES GUIDANCE ON THE MEASUREMENT, CLASSIFICATION AND DISCLOSURE OF TAX RETURN POSITIONS IN THE FINANCIAL STATEMENTS. THERE WAS NO IMPACT ON THE ORGANIZATION'S FINANCIAL STATEMENTS DURING THE YEARS ENDED JUNE 30, 2013 AND 2012. | DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Charity Care Policy | 1 | CharityCarePolicy |
| Written Policy | 1 | WrittenPolicy |
| Policy Applied To All Hospitals | X | PolicyAppliedToAllHospitals |
| FPG Reference Free Care | 1 | FPGReferenceFreeCare |
| Pcent200 | X | Pcent200 |
| FPG Reference Discounted Care | 1 | FPGReferenceDiscountedCare |
| Pcent400 | X | Pcent400 |
| Free Disc Care Medically Indigent | 1 | FreeDiscCareMedicallyIndigent |
| Amounts Budgeted For Charity Care | 1 | AmountsBudgetedForCharityCare |
| Expenses Exceeded Budget | 0 | ExpensesExceededBudget |
| Annual Community Benefit Report | 1 | AnnualCommunityBenefitReport |
| Report Publically Available | 1 | ReportPublicallyAvailable |
Charity Care At Cost CharityCareAtCost
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 2294504 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 0 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 2294504 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00920 | PercentOfTotalExpense |
Unreimbursed Medicaid UnreimbursedMedicaid
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 5818710 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 1094385 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 4724325 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.01880 | PercentOfTotalExpense |
Total Charity Care TotalCharityCare
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 8113214 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 1094385 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 7018829 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.02800 | PercentOfTotalExpense |
Community Health Services CommunityHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 732497 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 8020 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 724477 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00290 | PercentOfTotalExpense |
Health Professions Education HealthProfessionsEducation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 1115412 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 251442 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 863970 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00340 | PercentOfTotalExpense |
Subsidized Health Services SubsidizedHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 15440618 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 11030965 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 4409653 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.01760 | PercentOfTotalExpense |
Research Research
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 1095473 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 0 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 1095473 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00440 | PercentOfTotalExpense |
Cash And In Kind Contributions CashAndInKindContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 47951 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 0 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 47951 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00020 | PercentOfTotalExpense |
Total Other Benefits TotalOtherBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 18431951 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 11290427 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 7141524 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.02850 | PercentOfTotalExpense |
Total Community Benefits TotalCommunityBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 26545165 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 12384812 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 14160353 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.05650 | PercentOfTotalExpense |
Community Support CommunitySupport
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Building Expense | 135362 | TotalCommunityBuildingExpense |
| Direct Offsetting Revenue | 0 | DirectOffsettingRevenue |
| Net Community Building Expense | 135362 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00050 | PercentOfTotalExpense |
Workforce Development WorkforceDevelopment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Building Expense | 96109 | TotalCommunityBuildingExpense |
| Direct Offsetting Revenue | 0 | DirectOffsettingRevenue |
| Net Community Building Expense | 96109 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00040 | PercentOfTotalExpense |
Total Total
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Building Expense | 231471 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 231471 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00090 | PercentOfTotalExpense |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | 1 | BadDebtExpenseReported |
| Bad Debt Expense | $8,408,839 | BadDebtExpenseAmount |
| Amount Attributable To | 0 | AmountAttributableTo |
| Amount Reimbursed By Medicare | 22811850 | AmountReimbursedByMedicare |
| Cost Of Care Reimbursed By Medicare | 44441433 | CostOfCareReimbursedByMedicare |
| Medicare Surplus Or Shortfall | -21629583 | MedicareSurplusOrShortfall |
Costing Methodology Used CostingMethodologyUsed
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | X | Other |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | 1 | WrittenDebtCollectionPolicy |
| Provision For Charity Care | 1 | ProvisionForCharityCare |
| Number Of Hospital Facilities | 1 | NumberOfHospitalFacilities |
Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility Number | 1 | FacilityNumber |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SIBLEY MEMORIAL HOSPITAL | BusinessNameLine1 |
Address Address
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 5255 LOUGHBORO RD NW | AddressLine1 |
| City | WASHINGTON | City |
| State | DC | State |
| ZIP Code | 20016 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | HTTP://WWW.SIBLEY.ORG | WebsiteAddress |
| Licensed Hospital | X | LicensedHospital |
| General Medical And Surgical | X | GeneralMedicalAndSurgical |
| Er24 Hours | X | Er24Hours |
Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SIBLEY MEMORIAL HOSPITAL | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital Facility Number | 1 | HospitalFacilityNumber |
| CHNA Conducted | 1 | CHNAConducted |
| Community Definition | X | CommunityDefinition |
| Community Demographics | X | CommunityDemographics |
| Existing Resources | X | ExistingResources |
| How Data Obtained | X | HowDataObtained |
| Community Health Needs | X | CommunityHealthNeeds |
| Other Health Issues | X | OtherHealthIssues |
| Identifying Process | X | IdentifyingProcess |
| Consulting Process | X | ConsultingProcess |
| Information Gaps | X | InformationGaps |
| Needs Assessment Conducted | 12 | NeedsAssessmentConducted |
| Take Into Account | 1 | TakeIntoAccount |
| Other Facilities | 1 | OtherFacilities |
| CHNA Widely Available | 1 | CHNAWidelyAvailable |
| Own Website | X | OwnWebsite |
| On Request | X | OnRequest |
| Adopt Implement Strategy | X | AdoptImplementStrategy |
| Execute Implement Strategy | X | ExecuteImplementStrategy |
| Develop Community Plan | X | DevelopCommunityPlan |
| Participate Community Plan | X | ParticipateCommunityPlan |
| Include Operational Plans | X | IncludeOperationalPlans |
| Adopt Budget | X | AdoptBudget |
| Prioritize Health Needs | X | PrioritizeHealthNeeds |
| Prioritize Services | X | PrioritizeServices |
| All Needs Addressed | 1 | AllNeedsAddressed |
| Organization Incur Excise Tax | 0 | OrganizationIncurExciseTax |
| Eligibility Criteria Explained | 1 | EligibilityCriteriaExplained |
| Uses FPG Free | 1 | UsesFPGFree |
| FPG Free Percent | 200.000000000000 | FPGFreePercent |
| Uses FPG Discounted | 1 | UsesFPGDiscounted |
| FPG Discount Percent | 400.000000000000 | FPGDiscountPercent |
| Explains Basis | 1 | ExplainsBasis |
| Income Level | X | IncomeLevel |
| Asset Level | X | AssetLevel |
| Medical Indigency | X | MedicalIndigency |
| Insurance Status | X | InsuranceStatus |
| State Regulation | X | StateRegulation |
| Explains Application Method | 1 | ExplainsApplicationMethod |
| Includes Publicity Measures | 1 | IncludesPublicityMeasures |
| Posted On Website | X | PostedOnWebsite |
| Attached To Invoices | X | AttachedToInvoices |
| Posted In Emergency Room | X | PostedInEmergencyRoom |
| Posted In Admission Office | X | PostedInAdmissionOffice |
| Provided On Admission | X | ProvidedOnAdmission |
| Available On Request | X | AvailableOnRequest |
| Actions On Nonpayment | 1 | ActionsOnNonpayment |
| Collection Activities | 0 | CollectionActivities |
| Notify Upon Admission | X | NotifyUponAdmission |
| Notify Before Discharge | X | NotifyBeforeDischarge |
| Notified All Patients | X | NotifiedAllPatients |
| Documented Determination | X | DocumentedDetermination |
| Nondiscrim Emergency Care Policy | 1 | NondiscrimEmergencyCarePolicy |
| Used Other Method | X | UsedOtherMethod |
| Amounts Generally Billed | 0 | AmountsGenerallyBilled |
| Gross Charges | 0 | GrossCharges |
Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Other Facilities | 1 | NumberOfOtherFacilities |
Other Facilities OtherFacilities
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | GRAND OAKS | BusinessNameLine1 |
Address Address
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 5901 MACARTHUR BLVD NW | AddressLine1 |
| City | WASHINGTON | City |
| State | DC | State |
| ZIP Code | 20016 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility Type | ASSISTED LIVING FACILITY | FacilityType |
Form990 Schedule H Part VI Form990ScheduleHPartVI (15 entries)
| ExplanationExplanation | IdentifierIdentifier | Return ReferenceReturnReference |
|---|---|---|
| PART I, LINE 7: A COST-TO-CHARGE RATIO (FROM WORKSHEET 2) IS USED TO CALCULATE THE AMOUNTS ON LINE 7A-7B (FINANCIAL ASSISTANCE AND UNREIMBURSED MEDICAID). THE AMOUNTS FOR LINES 7E-7I WOULD COME FROM THE BOOKS AND RECORDS OF SPECIFIC SEGMENTS OF THE ORGANIZATION AND WOULD NOT BE BASED ON A COST-TO CHARGE RATIO. | ||
| PART I, LINE 7G: THERE ARE NO COSTS REPORTED THAT ARE ATTRIBUTABLE TO A PHYSICIANS CLINIC. | ||
| PART II: SIBLEY MEMORIAL HOSPITAL'S (SMH) COMMUNITY BUILDING ACTIVITIES PROMOTE WORKFORCE DEVELOPMENT BY OFFERING CAREER MENTORING PROGRAMS OF IT AND PROFESSIONAL SERVICES.THE HOSPITAL ALSO INCURS COST FOR BEING IN A CONSTANT STATE OF READINESS FOR ANY EMERGENCIES, SUCH AS NATURAL DISASTERS, EPIDEMICS, CHEMICAL SPILLS OR TECHNICAL DISASTERS THAT MAY ARISE. THE HOSPITAL'S DISASTER TREATMENT TEAM WORKS ROUTINELY WITH THE DISTRICT OF COLUMBIA EMERGENCY HEALTHCARE COALITION, DC HOMELAND SECURITY ORGANIZATION, DC DEPARTMENT OF HEALTH AND OTHER SIMILAR ORGANIZATIONS IN PLANNING AND TRAINING FOR TREATMENT OF PATIENTS DURING ANY POTENTIAL DISASTERS. THE HOSPITAL MAKES AVAILABLE A 24/7 EMERGENCY CARE FACILITY, PROVIDES STATE-OF-THE-ART EQUIPMENT TO TREAT PATIENTS EFFICIENTLY AND QUICKLY, AND INCURS COSTS OF EDUCATING HOSPITAL STAFF TO ADMINISTER BETTER QUALITY CARE TO THE COMMUNITY. | ||
| PART III, LINE 4: PART III, LINE 2: BAD DEBT EXPENSE ENTERED COMES FROM THE HOSPITALS BOOKS AND RECORDS.PART III, LINE 3: SMH DOES NOT REPORT AN ESTIMATE FOR THE PORTION OF BAD DEBT EXPENSE THAT MAY BE ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY. SMH 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, THEN SMH MUST ASSUME THE PATIENT DOES NOT QUALIFY.PART III, LINE 4: SMH AUDITED FINANCIAL STATEMENTS PAGES 13. | ||
| PART III, LINE 8: SIBLEY MEMORIAL HOSPITAL TREATS PATIENTS WITH MANY INSURANCE CARRIERS. HOWEVER, SMH'S MEDICARE INPATIENT VOLUME IS AMONG THE HIGHEST RATIO AMONG DISTRICT OF COLUMBIA HOSPITALS. ALTHOUGH PROVIDING THE BEST POSSIBLE CARE TO OUR MEDICARE PATIENTS CREATES A FINANCIAL LOSS, WE RELIEVE THE GOVERNMENT AND SURROUNDING OTHER HOSPITALS OF THE FINANCIAL BURDEN OF TREATING THESE PATIENTS INSURED BY THE MEDICARE PROGRAM. PART OF THE MISSION OF OUR HOSPITAL IS TO SERVE ITS ELDERLY PATIENTS WITHIN THE COMMUNITY THROUGH VARIOUS PROGRAMS THAT ARE DESIGNED TO EDUCATE AND IMPROVE THEIR HEALTH STATUS. THE HOSPITAL FEELS THAT PROVIDING THESE PROGRAMS HAS CONTRIBUTED TO THE IMPROVEMENT OF HEALTH OVERALL WITHIN THE COMMUNITY. | ||
| PART III, LINE 9B: WHEN A PATIENT ASKS FOR CHARITY CARE OR FINANCIAL ASSISTANCE, THE PATIENT MUST COMPLETE AN APPLICATION AND PROVIDE FINANCIAL INFORMATION THAT WOULD DEMONSTRATE FINANCIAL NEED. THE APPLICATION IS REVIEWED BY FINANCIAL COUNSELORS FOR ELIGIBILITY. | ||
| PART V, SECTION B, LINE 3: TO GATHER INPUT FROM PERSONS WHO REPRESENT THE BROAD INTERESTS OF THE COMMUNITY SERVED BY SMH THE FOLLOWING WAS DONE:A)FOUR FOCUS GROUPS WITH A TOTAL OF 30 PARTICIPANTS. PARTICIPANTS INCLUDED LEADERS FROM COMMUNITY-BASED ORGANIZATIONS, HEALTH AND SOCIAL SERVICE AGENCIES, AND FAITH-BASED GROUPS.B)SURVEYS TO RESIDENTSC)MACHELLE YINGLING FROM D.C. HOSPITAL ASSOCIATION PROVIDED CRITICAL HOSPITAL DATA. | SIBLEY MEMORIAL HOSPITAL | |
| PART V, SECTION B, LINE 4: THE OTHER HOSPITAL FACILITIES WITH WHICH SMH CONDUCTED ITS CHNA ARE:A)CHILDREN'S NATIONAL MEDICAL CENTERB)HOWARD UNIVERSITY HOSPITALC)PROVIDENCE HOSPITALD)COMMUNITY OF HOPE, DCE)UNITY HEALTH CARE, INC.F)BREAD FOR THE CITY | SIBLEY MEMORIAL HOSPITAL | |
| PART V, SECTION B, LINE 20D: WHEN SIBLEY HOSPITAL DETERMINES A PATIENT TO BE FAP-ELIGIBLE, BASED ON AN APPLICATION FILED BY THE PATIENT AND VERIFIED BY SIBLEY HOSPITAL, THEY ARE PROVIDED FREE CARE WHEN PATIENT INCOME IS 200% OF FPL OR LOWER. SINCE AN FAP-ELIGIBLE PATIENT IS NOT CHARGED FOR THEIR CARE THERE IS NO CALCULATION MADE FOR THE MAXIMUM AMOUNT THEY CAN BE CHARGED. FOR PATIENTS WITH INCOME AT 300% TO 400% OF FPL, THE AMOUNTS GENERALLY BILLED TO INDIVIDUALS WITH INSURANCE, THE AGB WILL BE CALCULATED USING THE LOOK BACK METHOD WHICH IS DEFINED AS ALL CLAIMS FOR EMERGENCY AND OTHER MEDICALLY NECESSARY CARE THAT HAVE BEEN PAID IN FULL TO THE HOSPITAL BY MEDICARE AND ALL PRIVATE HEALTH INSURERS TOGETHER AS THE PRIMARY PAYERS OF THESE CLAIMS, IN EACH CASE TAKING INTO ACCOUNT AMOUNTS PAID TO THE HOSPITAL IN THE FORM OF COINSURANCE OR DEDUCTIBLES. | SIBLEY MEMORIAL HOSPITAL | |
| PART VI, LINE 2: IN ORDER TO MAXIMIZE THE EFFECTIVENESS OF COMMUNITY WORK, SMH ELECTED TO COLLABORATE WITH FOUR OTHER DISTRICT OF COLUMBIA HOSPITALS AND TWO FEDERAL QUALIFIED HEALTH CLINICS. THE COLLABORATIVE, NAMED THE D.C. HEALTHY COMMUNITIES COLLABORATIVE (DHCC) CONTRACTED WITH RAND HEALTH TO PERFORM THE COMMUNITY HEALTH NEEDS ASSESSMENT.SECONDARY DATA WAS COLLECTED FROM A VARIETY OF LOCAL, COUNTY, AND STATE SOURCES TO PRESENT A COMMUNITY PROFILE, ACCESS TO HEALTH CARE, CHRONIC DISEASES, SOCIAL ISSUES, AND OTHER HEALTH INDICATORS. | ||
| PART VI, LINE 3: WHEN A PATIENT IS FIRST REGISTERED, HE/SHE MUST READ THE POSTED NOTICE ABOUT COMMUNITY/FINANCIAL ASSISTANCE. THE NOTICE IS POSTED NOTICEABLY IN THE ADMISSIONS DEPARTMENT, THE BUSINESS OFFICE, AND THE EMERGENCY DEPARTMENT. WHEN A PATIENT INQUIRES ABOUT COMMUNITY/FINANCIAL ASSISTANCE, HE/SHE IS GIVEN AN APPLICATION TO DETERMINE IF, IN FACT, HE/SHE IS ELIGIBLE FOR SUCH ASSISTANCE UNDER THE GUIDELINES ESTABLISHED BY THE DC MUNICIPAL REGULATION TITLE 22. PATIENT FINANCIAL COUNSELORS ARE ON STAFF TO ASSIST THE PATIENT WITH ANY QUESTIONS AND ULTIMATELY RECEIVE THE COMPLETED APPLICATION FOR FURTHER REVIEW. BEFORE THE BEGINNING OF ITS FISCAL YEAR, SIBLEY WILL PUBLISH A NOTICE OF AVAILABILITY OF ITS UNCOMPENSATED CARE OBLIGATION IN A NEWSPAPER OF GENERAL CIRCULATION IN THE DISTRICT OF COLUMBIA. SIBLEY WILL ALSO SUBMIT A COPY OF SUCH NOTICE TO SHPDA. THE NOTICE IS PUBLISHED IN ENGLISH AND SPANISH AND ANY OTHER LANGUAGE WHICH IS THE USUAL LANGUAGE OF HOUSEHOLDS OF TEN PERCENT OR MORE OF THE POPULATION OF THE DISTRICT OF COLUMBIA. SIBLEY WILL COMMUNICATE THE CONTENTS OF THE POSTED NOTICE TO ANY PERSON WHO SIBLEY HAS REASON TO BELIEVE CANNOT READ THE NOTICE. | ||
| PART VI, LINE 4: SMH GEOGRAPHIC SERVICE AREA IS URBAN.THE HOSPITAL CONSIDERS ITS COMMUNITY BENEFIT SERVICE AREA (CBSA) AS SPECIFIC POPULATIONS OR COMMUNITIES OF NEED TO WHICH THE HOSPITAL ALLOCATES RESOURCES THROUGH ITS COMMUNITY BENEFIT PLAN. THE CBSA IS DEFINED BY THE GEOGRAPHIC AREA CONTAINED WITHIN THE FOLLOWING ZIP CODES: 20016, 20815, 20008, 20015, 20816, 20007, 20009, 20817, 20002, 20854, 20011, 20814, 20003, 20852, 20001, 20010, 20910, 22101, 22207, AND 20895. THE GENERAL DATA FOR THIS COMMUNITY BENEFIT SERVICE AREA ARE AS FOLLOWS: TOTAL POPULATION WAS 632,323 OF WHICH 47.3% WERE MALES AND 52.7% WERE FEMALES, AVERAGE HOUSEHOLD INCOME WAS $61,835, 7.6% OF RESIDENTS ARE UNINSURED, 35.0% OF RESIDENTS ARE COVERED BY MEDICAID/MEDICARE, 18.2% OF HOUSEHOLDS WITH INCOMES BELOW THE FEDERAL POVERTY GUIDELINES.NUMBER OF OTHER HOSPITALS SERVING THE COMMUNITY OR COMMUNITIES: 4FEDERALLY-DESIGNATED MEDICALLY UNDERSERVED AREAS OR POPULATIONS ARE PRESENT IN THE COMMUNITY . | ||
| PART VI, LINE 5: SIBLEY HOSPITAL ENSURES THAT ITS BOARD MEMBERS ARE LEADERS WITHIN THE LOCAL BUSINESS COMMUNITY AND HAVE EXPERTISE IN MANY DIFFERENT AREAS. THE SKILLS, DEDICATION AND LEADERSHIP OF THE BOARD OF TRUSTEES FORM THE FOUNDATION OF THE HOSPITAL'S ABILITY TO PROVIDE NEEDED SERVICES TO THE COMMUNITY. BEFORE BEING APPOINTED TO THE BOARD, POTENTIAL MEMBERS EXPERIENCE A RIGOROUS SCREENING PROCESS, ENSURING THAT THEY ARE NEITHER FAMILY MEMBERS OF CURRENT BOARD MEMBERS NOR CONTRACTORS OF SIBLEY. TO FURTHER BENEFIT THE COMMUNITY, THE HOSPITAL PROVIDES, THROUGH ITS EXCESS FUNDS, MANY PROGRAMS FOR THE CITIZENS OF THE COMMUNITY THAT ARE OF LITTLE OR NO COST TO ATTENDEES. THESE PROGRAMS ARE DESIGNED TO EDUCATE, COMFORT, IMPROVE HEALTH AND PROVIDE SUPPORT TO THOSE WHO ATTEND. A NUMBER OF FREE HEALTH AND WELLNESS SEMINARS ARE PROVIDED REGULARLY TO MEMBERS OF THE COMMUNITY, SUCH AS DIABETES EDUCATION, HEART HEALTHY EATING AND ARTHRITIS. PHYSICIANS AND STAFF DONATE THEIR TIME TO EDUCATE ATTENDEES ON WAYS TO MAINTAIN OR IMPROVE INDIVIDUAL HEALTH. CHILDBIRTH AND NEW PARENTING CLASSES ARE CONDUCTED REGULARLY, PREPARING NEW PATIENTS (AND GRANDPARENTS) ON VARIOUS ASPECTS OF CHILD REARING AND BABY CARE. THERE ARE SEVERAL ONGOING SUPPORT GROUPS THAT MEET REGULARLY. EXISTING AND NEW MEMBERS ARE STRONGLY ENCOURAGED TO ATTEND. INDIVIDUALS EXPERIENCING ALZHEIMER'S, ARTHRITIS, LYME DISEASE, MACULAR DEGENERATION, OR PARKINSON'S DISEASE ARE INVITED TO EXPERIENCE NEW WAYS OF FEELING BETTER. IN ADDITION TO HAVING A NATIONALLY-KNOWN BREAST CANCER TREATMENT CENTER, AT LEAST FIVE CANCER SUPPORT GROUPS MEET ON A REGULAR BASIS. MEMBERS OF THE HOSPITAL STAFF AND PHYSICIANS ALSO TRAVEL OFF CAMPUS TO CONDUCT OR BE PART OF COMMUNITY HEALTH EVENTS HELD AT LOCAL CHURCHES OR COMMUNITY SOCIAL GATHERINGS. FINALLY, THE HOSPITAL PROVIDES ADDITIONAL FREE BENEFITS TO MEMBERS OF ITS SIBLEY SENIOR ASSOCIATION, CURRENTLY HAVING MORE THAN 7,000 ACTIVE MEMBERS. BENEFITS INCLUDE FREE HEALTH SCREENING, EDUCATIONAL PROGRAMS, A WIDOWED PERSONS SERVICE, AND SEMINARS ON HEALTH RELATED SUBJECTS. IN THE SUMMER OF 2012, THE HOSPITAL OPENED A NEW RADIATION ONCOLOGY FACILITY AS PART THE NEXT PHASE OF OUR CAMPUS REDEVELOPMENT. THIS FACILITY OFFERS ADVANCED MODALITIES FOR RADIATION THERAPY, 3-D IMAGING AND OTHER TREATMENT SERVICES. THE NEXT PHASE IN CONSTRUCTION IS THE NEW SIBLEY HOSPITAL, EXPECTED TO BE COMPLETED IN THREE YEARS. INCLUDED IN THE PLAN IS A NEW EMERGENCY DEPARTMENT DESIGNED WITH A "FAST TRACK" AREA TO ACCOMMODATE PATIENTS HAVING A MINOR ILLNESS OR INJURY. OUR EMERGENCY ROOM HAS CONTINUALLY STRIVED TO PROVIDE QUALITY TREATMENT QUICKLY AND EFFICIENTLY, ACHIEVING A 99TH PERCENTILE PRESS GANEY RANKING IN PATIENT SATISFACTION, WHILE RECEIVING TREATMENT IN 30 MINUTES OR LESS. IN THE SPRING OF 2013, THE JOINT COMMISSION, IN CONJUNCTION WITH THE AMERICAN HEART ASSOCIATION, RECOGNIZED SIBLEY WITH ADVANCED CERTIFICATION FOR PRIMARY STROKE CENTERS. THE ADVANCED STROKE CENTER CERTIFICATION HAS DEMONSTRATED THAT OUR PROGRAM MEETS THE ELEMENTS OF PERFORMANCE TO ACHIEVE LONG-TERM SUCCESS IN IMPROVING STROKE PATIENTS. ALSO IN THE SPRING OF 2013, THE SULLIVAN BREAST CENTER RECEIVED A THREE-YEAR ACCREDITATION FOR ITS MAMMOGRAPHY MACHINES, INCLUDING 3D. THE ACCREDITATION PROVIDES FACILITIES WITH PEER REVIEW AND CONSTRUCTIVE FEEDBACK ON ITS STAFF QUALIFICATIONS, EQUIPMENT, QUALITY CONTROL, QUALITY ASSURANCE AND IMAGE RADIATION DOSE AS PRESCRIBED BY THE AMERICAN COLLEGE OF RADIOLOGY COMMITTEE ON MAMMOGRAPHY. | ||
| PART VI, LINE 6: THE JOHNS HOPKINS HEALTH SYSTEM CORPORATION (JHHSC) IS INCORPORATED IN THE STATE OF MARYLAND TO, AMONG OTHER THINGS, FORMULATE POLICY AMONG AND PROVIDE CENTRALIZED MANAGEMENT FOR JHHSC AND AFFILIATES (JHHS). JHHS IS ORGANIZED AND OPERATED FOR THE PURPOSE OF PROMOTING HEALTH BY FUNCTIONING AS A PARENT HOLDING COMPANY OF AFFILIATES WHOSE COMBINED MISSION IS TO PROVIDE PATIENT CARE IN THE TREATMENT AND PREVENTION OF HUMAN ILLNESS WHICH COMPARES FAVORABLY WITH THAT RENDERED BY ANY OTHER INSTITUTION IN THIS COUNTRY OR ABROAD.JHHSC IS THE SOLE MEMBER OF THE JOHNS HOPKINS HOSPITAL (JHH), AN ACADEMIC MEDICAL CENTER, JOHNS HOPKINS BAYVIEW MEDICAL CENTER, INC. (JHBMC), A COMMUNITY BASED TEACHING HOSPITAL AND LONG-TERM CARE FACILITY, HOWARD COUNTY GENERAL HOSPITAL, INC. (HCGH), A COMMUNITY BASED HOSPITAL, SUBURBAN HOSPITAL, INC. (SHI), A COMMUNITY BASED HOSPITAL, SIBLEY MEMORIAL HOSPITAL (SMH), A D.C. COMMUNITY BASED HOSPITAL, AND ALL CHILDRENS HOSPITAL, INC (ACH), A FL ACADEMIC CHILDRENS HOSPITAL. | ||
| DC | REPORTS FILED WITH STATES | PART VI, LINE 7 |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Records Maintained | 1 | RecordsMaintained |
Recipient Table RecipientTable (3 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EIN Of RecipientEINOfRecipient | IRC SectionIRCSection | Amount Of Cash GrantAmountOfCashGrant | Purpose Of GrantPurposeOfGrant |
|---|---|---|---|---|---|---|---|
| THE WISTAR INSTITUTE OF ANATOMY AND BIOLOGY | |||||||
| 3601 SPRUCE STREET | PHILADELPHIA | PA | 19104 | 236434390 | 501(C)(3) | 100000 | RESEARCH |
| JOHNS HOPKINS UNIVERSITY | |||||||
| 3910 KESWICK ROAD N-4327B | BALTIMORE | MD | 21211 | 520595110 | 501(C)(3) | 600035 | RESEARCH |
| JOHNS HOPKINS COMMUNITY PHYSICIANS INC | |||||||
| 3910 KESWICK ROAD STE 4300A | BALTIMORE | MD | 21211 | 521467441 | 501(C)(3) | 568260 | GENERAL OPERATIONS |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Nbr Of501 C3 And Govt Grants | 3 | TotalNbrOf501C3AndGovtGrants |
Form990 Schedule I Part IV Form990ScheduleIPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | PROCEDURE FOR MONITORING GRANTS IN THE U.S.: | Identifier |
| Return Reference | PART I, LINE 2: | ReturnReference |
| Explanation | SCHEDULE I, PART I, LINE 2: THE PROCEDURES IN PLACE TO MONITOR THE USE OF GRANT FUNDS GIVEN TO THE ORGANIZATIONS LISTED CONSIST OF ANNUAL STATUS REPORTS. THESE REPORTS WILL CONTAIN A) PROGRESS ON THE RESEARCH CONDUCTED, B) FULL ACCOUNTING OF FUNDS SPENT, C) ACHIEVEMENT OF MEASURABLE OUTCOMES AND ANY CHANGES FROM THE ORIGINAL PROPOSAL, D) DATA GATHERING AND THE METHODS OR STRATEGIES USED, AND E) FINDINGS AND CONCLUSIONS. IN ADDITION, THE GRANTEES ARE REQUIRED TO MAINTAIN ACCOUNTING RECORDS WITH PRUDENT RECORD-KEEPING PROCEDURES AS REQUIRED BY ANY APPLICABLE FEDERAL, STATE, OR LOCAL LAWS, RULES OR REGULATIONS. THE GRANTOR (SIBLEY HOSPITAL) RESERVES THE RIGHT TO HAVE ACCESS TO AND EXAMINE ALL BOOKS AND RECORDS TO ASCERTAIN IF GRANT FUNDS ARE BEING DISBURSED PURSUANT TO THE TERMS OF THE AGREEMENTS. | Explanation |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Club Dues Or Fees | X | ClubDuesOrFees |
| Written Policy Re T And E Expenses | 1 | WrittenPolicyReTAndEExpenses |
| Substantiation Required | 1 | SubstantiationRequired |
| Compensation Committee | X | CompensationCommittee |
| Independent Consultant | X | IndependentConsultant |
| Form990 Of Other Organizations | X | Form990OfOtherOrganizations |
| Written Employment Contract | X | WrittenEmploymentContract |
| Compensation Survey | X | CompensationSurvey |
| Board Or Committee Approval | X | BoardOrCommitteeApproval |
| Severance Payment | 0 | SeverancePayment |
| Supplemental Nonqual Retire Plan | 1 | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | 0 | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | 0 | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | 0 | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | 0 | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | 0 | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | 0 | AnyNonFixedPayments |
| Initial Contract Exception | 0 | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (17 entries)
| TitleTitle | Base Compensation Filing OrgBaseCompensationFilingOrg | Comp Based On Related OrgsCompBasedOnRelatedOrgs | Bonus Filing OrgBonusFilingOrg | Bonus Related OrgsBonusRelatedOrgs | Other Compensation Filing OrgOtherCompensationFilingOrg | Other Compensation Related OrgsOtherCompensationRelatedOrgs | Deferred Comp Filing OrgDeferredCompFilingOrg | Deferred Comp Related OrgsDeferredCompRelatedOrgs | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg | Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs | Total Compensation Filing OrgTotalCompensationFilingOrg | Total Compensation Related OrgsTotalCompensationRelatedOrgs | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrg | Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| RONALD R PETERSON | ||||||||||||||
| TRUSTEE/CORP VICE CHAIRMAN | 0 | 1203070 | 0 | 455714 | 0 | 11914712 | 0 | 1788537 | 0 | 23586 | 0 | 15385619 | 0 | 3148877 |
| CARL L SYLVESTER JR MD | ||||||||||||||
| TRUSTEE | 0 | 0 | 0 | 0 | 352050 | 0 | 0 | 0 | 0 | 0 | 352050 | 0 | 0 | 0 |
| RICHARD O DAVIS | ||||||||||||||
| PRESIDENT/CEO/TRUSTEE | 0 | 380636 | 0 | 124326 | 0 | 171890 | 0 | 177521 | 0 | 12494 | 0 | 866867 | 0 | 0 |
| STEPHEN C MCDONNELL | ||||||||||||||
| SR VP & CFO | 476173 | 0 | 151077 | 0 | 21202 | 0 | 62889 | 0 | 10079 | 0 | 721420 | 0 | 0 | 0 |
| JOAN VINCENT | ||||||||||||||
| SR VP, PT. CARE SVCS & CNO | 267403 | 0 | 65140 | 0 | 16147 | 0 | 72500 | 0 | 11232 | 0 | 432422 | 0 | 0 | 0 |
| ALISON ARNOTT | ||||||||||||||
| VP SUPPORT SERVICES | 139863 | 0 | 31689 | 0 | 729 | 0 | 15994 | 0 | 5601 | 0 | 193876 | 0 | 0 | 0 |
| QUEENIE PLATER | ||||||||||||||
| VP & CHIEF HR OFFICER | 237599 | 0 | 46548 | 0 | 6506 | 0 | 59300 | 0 | 5672 | 0 | 355625 | 0 | 0 | 0 |
| KENDA TAVAKOLI | ||||||||||||||
| VP, INFO RESOURCES & CIO | 259543 | 0 | 30000 | 0 | 9514 | 0 | 45435 | 0 | 6820 | 0 | 351312 | 0 | 0 | 0 |
| PETER PETRUCCI MD | ||||||||||||||
| VP PT SAFETY, QUALITY & MED AFFAIRS | 256306 | 0 | 50544 | 0 | 0 | 0 | 17312 | 0 | 4467 | 0 | 328629 | 0 | 0 | 0 |
| CHRISTINE STUPPY | ||||||||||||||
| VP BUS. DEVEL. & STRAT. PL | 185591 | 0 | 37456 | 0 | 864 | 0 | 25337 | 0 | 10773 | 0 | 260021 | 0 | 0 | 0 |
| JEFFERY JOYNER | ||||||||||||||
| VP PROFESSIONAL SERVICES | 187516 | 0 | 37598 | 0 | 0 | 0 | 22617 | 0 | 9841 | 0 | 257572 | 0 | 0 | 0 |
| JEFFREY L LIN | ||||||||||||||
| PHYSICIAN DIR GYN ONCOLOGY | 683366 | 0 | 134856 | 0 | 0 | 0 | 24686 | 0 | 14042 | 0 | 856950 | 0 | 0 | 0 |
| REBECCA ZUURBIER | ||||||||||||||
| PHYSICIAN DIR. BREAST IMAG | 401086 | 0 | 0 | 0 | 114694 | 0 | 0 | 0 | 9454 | 0 | 525234 | 0 | 0 | 0 |
| JERRY L PRICE | ||||||||||||||
| VP REAL ESTATE & CONSTRUCT | 331167 | 0 | 96127 | 0 | 0 | 0 | 55500 | 0 | 6181 | 0 | 488975 | 0 | 0 | 0 |
| HASAN ZIA | ||||||||||||||
| PHYSICIAN DIR INTENSIVE/ACUTE CARE | 480946 | 0 | 84677 | 0 | 397 | 0 | 30047 | 0 | 9328 | 0 | 605395 | 0 | 0 | 0 |
| COLETTE M MAGNANT | ||||||||||||||
| BREAST SURGEON | 527071 | 0 | 157008 | 0 | 192967 | 0 | 39097 | 0 | 1982 | 0 | 918125 | 0 | 0 | 0 |
| ROBERT L SLOAN | ||||||||||||||
| FORMER PRESIDENT & CEO/TRUSTEE | 1426204 | 0 | 209247 | 0 | 0 | 0 | 432000 | 0 | 3647 | 0 | 2071098 | 0 | 0 | 0 |
Form990 Schedule J Part III Form990ScheduleJPartIII (2 entries)
| Return ReferenceReturnReference | ExplanationExplanation | IdentifierIdentifier |
|---|---|---|
| PART I, LINE 4B | DURING 2012 THE FORMER PRESIDENT/CEO ROBERT SLOAN RECEIVED $154,227.05 FROM A NONQUALIFIED RETIREMENT PLAN WHICH IS BASED ON BENEFITS EARNED FROM PRIOR YEARS. THE FOLLOWING INDIVIDUALS LISTED ON FORM 990, PART VII, SECTION A, LINE 1A PARTICIPATED IN A NONQUALIFIED RETIREMENT PLAN WITH THE RELATED ORGANIZATION JOHNS HOPKINS HEALTH SYSTEM CORPORATION AND RECEIVED ACCRUED DEFERRED COMPENSATION THAT IS REPORTED ON SCHEDULE J, PART II, COLUMN (C): RONALD PETERSON $1,636,472.00 AND RICHARD DAVIS $121,726.58 THE FOLLOWING INDIVIDUAL LISTED ON FORM 990, PART VII, SECTION A, LINE 1A PARTICIPATED IN A NON QUALIFIED RETIREMENT PLAN WITH THE RELATED ORGANIZATION JOHNS HOPKINS HEALTH SYSTEM CORPORATION AND RECEIVED PAYMENT, IT IS REPORTED ON SCHEDULE J, PART II, COLUMN (B)(III) AS WELL AS SCHEDULE J, PART II, COLUMN (F) IF THEY WERE REQUIRED TO BE DISCLOSED ON PRIOR YEAR'S FORMS 990: RICHARD DAVIS $91,226.55 LISTED ON FORM 990, SCHEDULE J, PART II, B(III) IS RONALD PETERSON $11,914,712.00. MR. PETERSON HAS 40 YEARS OF SERVICE AND HAS ACCRUED BUT NOT YET RECEIVED HIS NONQUALIFIED RETIREMENT PLAN IN THE AMOUNT OF $11,746,615.00. THIS DEFERRED COMPENSATION IS REPORTED ON FORM 990, PART VII, SECTION A AND INCLUDED ON SCHEDULE J, PART II, COLUMN E AND REPORTED IN BOX 5, W-2, FOR THE PURPOSES OF PREPAYING THE MEDICARE TAX. | |
| PART III | AFTER 27 YEARS OF SERVICE AS THE PRESIDENT AND CHIEF EXECUTIVE OFFICER OF SIBLEY MEMORIAL HOSPITAL, ROBERT L. SLOAN RETIRED DURING JULY 2012. HE MAINTAINS HIS ROLE AS THE PRESIDENT OF THE JANE BANCROFT ROBISON FOUNDATION. | SUPPLEMENTAL INFORMATION |
Schedule K IRS990ScheduleK
Form990 Schedule K Part I Form990ScheduleKPartI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
Issuer Name IssuerName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | DISTRICT OF COLUMBIA | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Issuer EIN | 536001131 | IssuerEIN |
| CUSIP Number | 254764HX4 | CUSIPNumber |
| Date Issued | 2009-07-15 | DateIssued |
| Issue Price | 62798209 | IssuePrice |
| Description Of Purpose | CONSTRUCTION OF MEDICAL BLDG FOR OUTPATIENT SVCS AND OFFICES | DescriptionOfPurpose |
| Defeased | 0 | Defeased |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuer |
| Pool Financing | 0 | PoolFinancing |
Form990 Schedule K Part II Form990ScheduleKPartII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Total Proceeds | 62798209 | TotalProceeds |
| Amount In Reserve Fund | 4955186 | AmountInReserveFund |
| Issuance Costs From Proceeds | 315000 | IssuanceCostsFromProceeds |
| Capital Expenditures | 57542090 | CapitalExpenditures |
| Year Of Subst Completion | 2011 | YearOfSubstCompletion |
| Current Refunding | 0 | CurrentRefunding |
| Advance Refunding | 0 | AdvanceRefunding |
| Final Allocation Made | 0 | FinalAllocationMade |
| Adequate Books And Recds Maintaind | 1 | AdequateBooksAndRecdsMaintaind |
Form990 Schedule K Part III Form990ScheduleKPartIII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Owning Bond Financed Property | 0 | OwningBondFinancedProperty |
| Any Lease Arrangements | 1 | AnyLeaseArrangements |
| Mngment Cntrct Bond Financd Prprty | 1 | MngmentCntrctBondFinancdPrprty |
| Engage Bond Counsel Contracts | 1 | EngageBondCounselContracts |
| Any Research Agreements | 0 | AnyResearchAgreements |
| Prcntge Prvt Business Use By Others | 0.00310 | PrcntgePrvtBusinessUseByOthers |
| Total Private Business Use | 0.00310 | TotalPrivateBusinessUse |
| Bond Iss Meet Prvt Security Pay Test | 0 | BondIssMeetPrvtSecurityPayTest |
| Change In Use Bond Financed Prop | 0 | ChangeInUseBondFinancedProp |
| Non Qualified Bond Remed Procdrs | 0 | NonQualifiedBondRemedProcdrs |
Form990 Schedule K Part IV Form990ScheduleKPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Form8038 T Filed | 0 | Form8038TFiled |
| Rebate Not Due Yet | 0 | RebateNotDueYet |
| Exception To Rebate | 0 | ExceptionToRebate |
| No Rebate Due | 0 | NoRebateDue |
| Variable Rate Issue | 0 | VariableRateIssue |
| Hedge Identified In Books And Recds | 0 | HedgeIdentifiedInBooksAndRecds |
| Gross Proceeds Invested In GIC | 0 | GrossProceedsInvestedInGIC |
| Gross Proceeds Invested | 0 | GrossProceedsInvested |
| Written Proc To Monitor Reqs | 0 | WrittenProcToMonitorReqs |
Form990 Schedule K Part V Form990ScheduleKPartV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Proc To Undertk Corrective Action | 1 | ProcToUndertkCorrectiveAction |
Form990 Schedule K Part VI Form990ScheduleKPartVI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | SCHEDULE K, PART III LINES 7-9 | Identifier |
| Return Reference | NONQUALIFIED BONDS | ReturnReference |
| Explanation | THE ORGANIZATION ANSWERED 'NO' BECAUSE IT HAS NO NONQUALIFIED BONDS. | Explanation |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (7 entries)
| Return ReferenceReturnReference | ExplanationExplanation | IdentifierIdentifier |
|---|---|---|
| FORM 990, PART VI, SECTION A, LINE 7A | DURING THE TRANSITION PERIOD JOHNS HOPKINS HEALTH SYSTEM CORPORTION, AN IRC 501C(3) TAX EXEMPT PARENT ORGANIZATION OF SIBLEY MEMORIAL HOSPITAL MAY ELECT ONE TRUSTEE. AFTER THE STATED TRANSITION PERIOD, JOHNS HOPKINS HEALTH SYSTEM CORPORATION ELECTS THE BOARD OF TRUSTEES. | |
| FORM 990, PART VI, SECTION A, LINE 7B | THE GOVERNING BODY OF SIBLEY MEMORIAL HOSPITAL IS EMPOWERED BY ITS BY-LAWS TO MAKE CERTAIN DECISIONS; ALL OTHER DECISIONS ARE SUBJECT TO APPROVAL OF THE PARENT ORGANIZATION JOHNS HOPKINS HEALTH SYSTEM CORPORATION. | |
| FORM 990, PART VI, SECTION B, LINE 11 | A COPY OF THE FORM 990 WAS PROVIDED TO THE FINANCE COMMITTEE BEFORE IT WAS FILED. | |
| FORM 990, PART VI, SECTION B, LINE 12C | THE HOSPITAL HAS AN EXISTING POLICY (#02-25-09) WHICH SPECIFICALLY ADDRESSES POTENTIAL CONFLICT(S) OF INTEREST FOR DECISION MAKERS AT ALL LEVELS WITHIN ITS BORDERS. THIS COVERAGE INCLUDES MEMBERS OF THE GOVERNING BOARD, ADMINISTRATION, MEDICAL STAFF, AND ALL OTHER EMPLOYEES. DISCLOSURE FORMS ASKING FOR POTENTIAL CONFLICTS OF INTEREST ARE DISTRIBUTED AT LEAST ANNUALLY SO THAT APPROPRIATE ACTION MAY BE TAKEN TO ENSURE THAT SUCH POTENTIAL CONFLICTS DO NOT INFLUENCE IMPORTANT DECISIONS. THE HOSPITAL'S BOARD MEMBERS ARE ASKED TO SUBMIT DISCLOSURE FORMS SEMI-ANNUALLY AND ON A CASE-BY-CASE BASIS. THE GOVERNING BOARD, SENIOR MANAGEMENT, AND THE EXECUTIVE COMMITTEE OF THE MEDCAL STAFF (AS APPROPRATE) BEAR RESPONSIBILITY FOR ADDRESSING AND REVIEWING ALL POTENTIAL CONFLICTS AND TAKING APPROPRIATE ACTION. WHEN CONFLICTS DO ARISE, THE MATTER IS BROUGHT BEFORE THE APPROPRIATE GOVERNING BODY AND DISCUSSED, AND THE CONFLICT IS ELIMINATED. | |
| FORM 990, PART VI, SECTION B, LINE 15 | THE ORGANIZATION USES AN INDEPENDENT COMPENSATION COMMITTEE, AN INDEPENDENT COMPENSATION CONSULTANT, A WRITTEN EMPLOYMENT CONTRACT, A COMPENSATION SURVEY OR STUDY, APPROVAL BY THE BOARD AND CONTEMPORANEOUS WRITTEN SUBSTANTIATION OF THE DECISION-MAKING PROCESS WHEN DETERMINING COMPENSATION FOR THE CEO AND OTHER OFFICERS OF THE ORGANIZATION. | |
| FORM 990, PART VI, SECTION C, LINE 19 | THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. | |
| FORM 990, PART XI, LINE 9: | CHANGE IN BENEFICIAL INTEREST IN FOUNDATION 36,083,225. PREMIER PURCHASING PARTNERS K-1 -577,663. COLONIAL REGIONAL ALLIANCE K-1 19,401. ROCKVILLE IMAGING K-1 33,886. CHEVY CHASE IMAGING K-1 67,520. CHANGE IN MINIMUM PENSION LIABILITY 3,890,700. NET ASSETS RELEASED 549,464. INTERCOMPANY TRANSFERS -426,472. | CHANGES IN NET ASSETS OR FUND BALANCES: |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII (22 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivities | Legal Domicile StateLegalDomicileState | Exempt Code SectionExemptCodeSection | Public Charity StatusPublicCharityStatus | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Controlled OrgControlledOrg | Direct Controlling Entity NADirectControllingEntityNA |
|---|---|---|---|---|---|---|---|---|---|---|---|
| JOHNS HOPKINS HEALTH SYSTEM CORPORATION | |||||||||||
| 3910 KESWICK RD SOUTH BLDG 4TH FL S | BALTIMORE | MD | 21211 | 521465301 | SUPPORTING ORGANIZATION | MD | 501(C)(3) | LINE 11C, III-FI | JOHNS HOPKINS HEALTH SYSTEM CORPORATION | 0 | |
| JOHNS HOPKINS BAYVIEW MEDICAL CENTER INC | |||||||||||
| 3910 KESWICK RD SOUTH BLDG 4TH FL S | BALTIMORE | MD | 21211 | 521341890 | HOSPITAL | MD | 501(C)(3) | LINE 3 | JOHNS HOPKINS HEALTH SYSTEM CORPORATION | 0 | |
| JOHNS HOPKINS COMMUNITY PHYSICIANS INC | |||||||||||
| 3910 KESWICK RD SOUTH BLDG 4TH FL S | BALTIMORE | MD | 21211 | 521467441 | HEALTHCARE SERVICES | MD | 501(C)(3) | LINE 11C, III-FI | JOHNS HOPKINS HEALTH SYSTEM CORPORATION | 0 | |
| JOHNS HOPKINS MEDICAL SERVICES CORPORATION | |||||||||||
| 3910 KESWICK RD SOUTH BLDG 4TH FL S | BALTIMORE | MD | 21211 | 521232569 | HEALTHCARE SERVICES | MD | 501(C)(3) | LINE 3 | JOHNS HOPKINS HEALTH SYSTEM CORPORATION | 0 | |
| THE JOHNS HOPKINS HOSPITAL | |||||||||||
| 3910 KESWICK RD SOUTH BLDG 4TH FL S | BALTIMORE | MD | 21211 | 520591656 | HOSPITAL | MD | 501(C)(3) | LINE 3 | JOHNS HOPKINS HEALTH SYSTEM CORPORATION | 0 | |
| SUBURBAN HOSPITAL HEALTHCARE SYSTEM INC | |||||||||||
| 8600 OLD GEORGETOWN ROAD | BETHESDA | MD | 20814 | 522052354 | HEALTHCARE SERVICES | MD | 501(C)(3) | LINE 11C, III-FI | JOHNS HOPKINS HEALTH SYSTEM CORPORATION | 0 | |
| HOWARD COUNTY LIQUIDATION CORPORATION | |||||||||||
| 3910 KESWICK RD SOUTH BLDG 4TH FL S | BALTIMORE | MD | 21211 | 520892284 | INACTIVE TAX-EXEMPT ORGANIZATION | MD | 501(C)(3) | LINE 3 | JOHNS HOPKINS HEALTH SYSTEM CORPORATION | 0 | |
| SUBURBAN HOSPITAL INC | |||||||||||
| 8600 OLD GEORGETOWN ROAD | BETHESDA | MD | 20814 | 520610545 | HOSPITAL | MD | 501(C)(3) | LINE 3 | JOHNS HOPKINS HEALTH SYSTEM CORPORATION | 0 | |
| HOWARD COUNTY GENERAL HOSPITAL INC | |||||||||||
| 3910 KESWICK RD SOUTH BLDG 4TH FL S | BALTIMORE | MD | 21211 | 522093120 | HOSPITAL | MD | 501(C)(3) | LINE 3 | JOHNS HOPKINS HEALTH SYSTEM CORPORATION | 0 | |
| THE STACY MARK REED FOUNDATION | |||||||||||
| 5255 LOUGHBORO ROAD NW | WASHINGTON | DC | 20016 | 273818765 | FINANCIAL SUPPORT | DC | 501(C)(3) | LINE 11A, I | LUCY WEBB HAYES NATIONAL TRAINING SCHOOL FOR DEACONESSES & MISSIONARIES | 1 | |
| SIBLEY MEMORIAL HOSPITAL FOUNDATION | |||||||||||
| 5255 LOUGHBORO ROAD NW | WASHINGTON | DC | 20016 | 450562642 | FINANCIAL SUPPORT | DC | 501(C)(3) | LINE 7 | LUCY WEBB HAYES NATIONAL TRAINING SCHOOL FOR DEACONESSES & MISSIONARIES | 1 | |
| THE JANE BANCROFT ROBINSON FOUNDATION | |||||||||||
| 5255 LOUGHBORO ROAD NW | WASHINGTON | DC | 20016 | 273818431 | FINANCIAL SUPPORT | DC | 501(C)(3) | LINE 11C, III-FI | LUCY WEBB HAYES NATIONAL TRAINING SCHOOL FOR DEACONESSES & MISSIONARIES | 1 | |
| POTOMAC HOME SUPPORT INC | |||||||||||
| 6001 MONTROSE ROAD NO 1020 | ROCKVILLE | MD | 20852 | 521750383 | HOME HEALTH CARE | MD | 501(C)(3) | LINE 9 | 0 | N/A | |
| SIBLEY SUBURBAN HOME HEALTH AGENCY | |||||||||||
| 6001 MONTROSE ROAD NO 307 | ROCKVILLE | MD | 20852 | 521450142 | HOME HEALTH CARE | MD | 501(C)(3) | LINE 9 | 0 | N/A | |
| PEDIATRIC PHYSICIAN SERVICES INC | |||||||||||
| 501 SIXTH AVENUE SOUTH | ST PETERSBURG | FL | 33701 | 593425191 | PEDIATRIC MEDICAL SERVICES | FL | 501(C)(3) | LINE 9 | ALL CHILDREN'S HEALTH SYSTEM INC | 0 | |
| ALL CHILDREN'S HOSPITAL FOUNDATION INC | |||||||||||
| 501 SIXTH AVENUE SOUTH | ST PETERSBURG | FL | 33701 | 592481738 | FOUNDATION | FL | 501(C)(3) | LINE 7 | ALL CHILDREN'S HEALTH SYSTEM INC | 0 | |
| ALL CHILDREN'S HOSPITAL INC | |||||||||||
| 501 SIXTH AVENUE SOUTH | ST PETERSBURG | FL | 33701 | 590683252 | HOSPITAL | FL | 501(C)(3) | LINE 3 | JOHNS HOPKINS HEALTH SYSTEM CORPORATION | 0 | |
| ALL CHILDREN'S RESEARCH INSTITUTE INC | |||||||||||
| 501 SIXTH AVENUE SOUTH | ST PETERSBURG | FL | 33701 | 592481742 | RESEARCH | FL | 501(C)(3) | LINE 4 | ALL CHILDREN'S HEALTH SYSTEM INC | 0 | |
| SURGIKID OF FLORIDA INC | |||||||||||
| 501 SIXTH AVENUE SOUTH | ST PETERSBURG | FL | 33701 | 593441883 | MEDICAL SERVICES | FL | 501(C)(3) | LINE 9 | ALL CHILDREN'S HEALTH SYSTEM INC | 0 | |
| KIDS HOME CARE INC | |||||||||||
| 501 SIXTH AVENUE SOUTH | ST PETERSBURG | FL | 33701 | 593476049 | HOME HEALTH CARE | FL | 501(C)(3) | LINE 9 | ALL CHILDREN'S HEALTH SYSTEM INC | 0 | |
| WEST COAST NEONATOLOGY INC | |||||||||||
| 501 SIXTH AVENUE SOUTH | ST PETERSBURG | FL | 33701 | 593398308 | HEALTHCARE SERVICES | FL | 501(C)(3) | LINE 11C, III-FI | ALL CHILDREN'S HEALTH SYSTEM INC | 0 | |
| ALL CHILDREN'S HEALTH SYSTEM INC | |||||||||||
| 501 SIXTH AVENUE SOUTH | ST PETERSBURG | FL | 33701 | 592481740 | MANAGEMENT SERVICES | FL | 501(C)(3) | LINE 11C, III-FI | JOHNS HOPKINS HEALTH SYSTEM CORPORATION | 0 | |
Form990 Schedule R Part III Form990ScheduleRPartIII (6 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivityPrimaryActivity | Legal Domicile StateLegalDomicileState | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Predominant Income TypePredominantIncomeType | Disproportionate AllocationsDisproportionateAllocations | General Or Managing PartnerGeneralOrManagingPartner | Percentage OwnershipPercentageOwnership | Direct Controlling Entity NADirectControllingEntityNA |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| SIBLEY HEALTH NETWORK LLC | ||||||||||||
| 5255 LOUGHBORO ROAD NW | WASHINGTON | DC | 20016 | 521932344 | HEALTHCARE SERVICES | DC | SIBLEY HEALTHCARE AFFILIATES | INVESTMENT | 0 | 0 | 0.01000 | |
| OPHTHALMOLOGY ASSOCIATES LLC | ||||||||||||
| 3910 KESWICK RD SOUTH BLDG 4TH FL S | BALTIMORE | MD | 21211 | 521890957 | OPHTHALMOLOGY SERVICES | MD | N/A | |||||
| SUBURBAN WELLNESS CENTER LLC | ||||||||||||
| 20500 GOLDENROD LANE | GERMANTOWN | MD | 20874 | 562296930 | REAL ESTATE | MD | N/A | |||||
| GCM SURBURBAN IMAGING LLC | ||||||||||||
| 1201 SEVEN LOCKS ROAD STE 200 | ROCKVILLE | MD | 20854 | 522326237 | OUTPATIENT RADIOLOGY | MD | N/A | |||||
| ROCKVILLE IMAGING LLC | ||||||||||||
| 1201 SEVEN LOCKS ROAD STE 200 | ROCKVILLE | MD | 20854 | 141944128 | OUTPATIENT RADIOLOGY | MD | N/A | |||||
| CHEVY CHASE IMAGING LLC | ||||||||||||
| 1201 SEVEN LOCKS ROAD STE 200 | ROCKVILLE | MD | 20854 | 141944126 | RADIOLOGY SERVICES | MD | N/A | |||||
Form990 Schedule R Part IV Form990ScheduleRPartIV (8 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivityPrimaryActivity | Legal Domicile StateLegalDomicileState | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Type Of EntityTypeOfEntity | Percentage OwnershipPercentageOwnership | Controlled OrgControlledOrg | Direct Controlling Entity NADirectControllingEntityNA |
|---|---|---|---|---|---|---|---|---|---|---|---|
| SIBLEY HEALTHCARE AFFILIATES | |||||||||||
| 5255 LOUGHBORO RD NW | WASHINGTON | DC | 20016 | 521928494 | HEALTHCARE SERVICES | DC | LUCY WEBB HAYES NATIONAL TRAINING SCHOOL FOR DEACONESSES & MISSIONARIES | C | 1.00000 | 0 | |
| HCP VENTURE ONE CORPORATION | |||||||||||
| 3910 KESWICK RD SOUTH BLDG 4TH FL S | BALTIMORE | MD | 21211 | 521558858 | MEDICAL SERVICES | MD | C | 0 | N/A | ||
| HSI MEDICAL SERVICES CORPORATION | |||||||||||
| 3910 KESWICK RD SOUTH BLDG 4TH FL S | BALTIMORE | MD | 21211 | 521847705 | HEALTHCARE-SLEEP DIAGNOSTICS | MD | C | 0 | N/A | ||
| HOWARD COUNTY HEALTH SERVICES INC | |||||||||||
| 3910 KESWICK RD SOUTH BLDG 4TH FL S | BALTIMORE | MD | 21211 | 521434783 | HEALTHCARE MANAGEMENT | MD | C | 0 | N/A | ||
| JOHNS HOPKINS MEDICAL MANAGEMENT CORPORATION | |||||||||||
| 3910 KESWICK RD SOUTH BLDG 4TH FL S | BALTIMORE | MD | 21211 | 521250028 | NURSING SERVICES | MD | C | 0 | N/A | ||
| JOHNS HOPKINS EMPLOYER HEALTH PROGRAM | |||||||||||
| 3910 KESWICK RD SOUTH BLDG 4TH FL S | BALTIMORE | MD | 21211 | 521947678 | BENEFIT PLANS | MD | C | 0 | N/A | ||
| TCAS INC | |||||||||||
| 3910 KESWICK RD SOUTH BLDG 4TH FL S | BALTIMORE | MD | 21211 | 521979344 | NURSING SERVICES | MD | C | 0 | N/A | ||
| SUBURBAN HEALTH ENTERPRISES INC | |||||||||||
| 8600 OLD GEORGETOWN ROAD | BETHESDA | MD | 20814 | 522052352 | MEDICAL OFFICE LEASING AND RELEASING | MD | C | 0 | N/A | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | 0 | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | 1 | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | 1 | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | 0 | LoansOrGuaranteesFromOtherOrg |
| Dividends Related Organization | 0 | DividendsRelatedOrganization |
| Sale Of Assets To Other Org | 0 | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | 0 | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | 0 | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | 1 | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | 0 | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | 0 | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | 1 | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | 1 | SharingOfFacilities |
| Sharing Of Paid Employees | 1 | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | 1 | OtherTransferToOtherOrg |
| Other Transfer From Other Org | 1 | OtherTransferFromOtherOrg |
Transactions Related Orgs Table TransactionsRelatedOrgsTable (4 entries)
| Transaction TypeTransactionType | Amount InvolvedAmountInvolved | Method Of Amt DeterminationMethodOfAmtDetermination |
|---|---|---|
| THE JANE BANCROFT ROBINSON FOUNDATION | ||
| B | 319316 | FMV |
| THE STACY MARK REED FOUNDATION | ||
| C | 8000000 | FMV |
| SIBLEY MEMORIAL HOSPITAL FOUNDATION | ||
| M | 6229199 | FMV |
| SIBLEY MEMORIAL HOSPITAL FOUNDATION | ||
| S | 780856 | FMV |
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