MONTGOMERY GENERAL HOSPITAL INC: Form 990, tax year 2011
View the entire original 990 at ProPublica ↗
- Organization
- MONTGOMERY GENERAL HOSPITAL INC (EIN 52-0646893)
- Tax period
- 2011-07-01 to 2012-06-30
- Filed
- 2013-05-10
- IRS object ID
- 201301309349300135
- Schema version
- 2011v1.5
- 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 ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2013-05-10T08:50:49-05:00 | Timestamp |
| Tax Period End Date | 2012-06-30 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | KPMG LLP | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 440 Monticello Ave Suite 1900 | AddressLine1 |
| City | Norfolk | City |
| State | VA | State |
| ZIP Code | 235102674 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2011-07-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 520646893 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MONTGOMERY GENERAL HOSPITAL INC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| In Care Of Name | % MARC BERGER | InCareOfName |
| Name Control | MONT | NameControl |
| Phone | 3017748640 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 18101 PRINCE PHILIP DRIVE | AddressLine1 |
| City | OLNEY | City |
| State | MD | State |
| ZIP Code | 20832 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | Marc R Berger | Name |
| Title | AVP, Taxation/Financial Compliance | Title |
| Date Signed | 2013-05-08 | DateSigned |
| Authorize Third Party | true | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | Scott Sherman | Name |
| Phone | 7576167000 | Phone |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2011 | TaxYear |
| Build TS | 2016-02-25 16:41:14Z | BuildTS |
Form 990 IRS990
Doing Business As DoingBusinessAs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MEDSTAR MONTGOMERY MEDICAL CENTER | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | PETER MONGE | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 18101 PRINCE PHILIP DRIVE | AddressLine1 |
| City | OLNEY | City |
| State | MD | State |
| ZIP Code | 20832 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 151735715 | GrossReceipts |
| Group Return For Affiliates | false | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | WWW.MONTGOMERYGENERAL.ORG | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 2000 | YearFormation |
| State Legal Domicile | MD | StateLegalDomicile |
| Activity Or Mission Description | MEDSTAR MONTGOMERY MEDICAL CENTER IS DEDICATED TO ENHANCING OUR COMMUNITY'S HEALTH AND WELL-BEING BY OFFERING HIGH QUALITY, COMPASSIONATE AND PERSONALIZED CARE. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 22 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 20 | NbrIndependentVotingMembers |
| Total Nbr Employees | 1444 | TotalNbrEmployees |
| Total Nbr Volunteers | 300 | TotalNbrVolunteers |
| Total Gross UBI | 347558 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | -21296 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 3500 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 50 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 143534212 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 148725768 | ProgramServiceRevenueCY |
| Investment Income Prior Year | -1550341 | InvestmentIncomePriorYear |
| Investment Income Current Year | 225097 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 1388812 | OtherRevenuePriorYear |
| Other Revenue Current Year | 2784800 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 143376183 | TotalRevenuePriorYear |
| Total Revenue Current Year | 151735715 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 0 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 0 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 67360488 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 68709649 | 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 | 68985723 | OtherExpensePriorYear |
| Other Expenses Current Year | 74023551 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 136346211 | TotalExpensesPriorYear |
| Total Expenses Current Year | 142733200 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 7029972 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 9002515 | RevenuesLessExpensesCY |
| Total Assets BOY | 120823935 | TotalAssetsBOY |
| Total Assets EOY | 142397229 | TotalAssetsEOY |
| Total Liabilities BOY | 40100635 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 52425956 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 80723300 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 89971273 | NetAssetsOrFundBalancesEOY |
| Info In Schedule O Part III | X | InfoInScheduleOPartIII |
| Mission Description | AS A PROUD MEMBER OF MEDSTAR HEALTH, MEDSTAR MONTGOMERY MEDICAL CENTER'S MISSION IS TO ENHANCE OUR COMMUNITY'S HEALTH AND WELL-BEING BY OFFERING HIGH QUALITY, COMPASSIONATE AND PERSONALIZED CARE. MEDSTAR MONTGOMERY MEDICAL CENTER (MMMC) IS LOCATED IN OLNEY, IN NORTHEASTERN MONTGOMERY COUNTY, MARYLAND, A SUBURB OF WASHINGTON, D.C. AFTER OVER 90 YEARS, THE HOSPITAL REMAINS TRUE TO ITS ROOTS, OFFERING A WIDE RANGE OF WELLNESS PROGRAMS AND OUTPATIENT SERVICES IN ADDITION TO INPATIENT TREATMENT. IN FISCAL YEAR 2012, MMMC HAD 9,932 INPATIENT ADMISSIONS, 56,159 OUTPATIENT VISITS, AND 39,763 EMERGENCY VISITS. | MissionDescription |
| Significant New Program Services | false | SignificantNewProgramServices |
| Significant Change | false | SignificantChange |
| Expense | 117086668 | Expense |
| Grants | 0 | Grants |
| Revenue | 148697471 | Revenue |
| Description | MEDSTAR MONTGOMERY MEDICAL CENTER'S LARGEST PROGRAM IS ACCESS TO AND THE PROVISION OF ACUTE HOSPITAL SERVICES TO THE COMMUNITIES OF NORTHEASTERN MONTGOMERY COUNTY, MARYLAND AND THE SURROUNDING AREAS. IN ADDITION TO THE PROGRAM SERVICE EXPENSES LISTED ABOVE, MMMC INCURRED $18.3M OF MANAGEMENT AND GENERAL EXPENSES IN PROVIDING SERVICES TO ITS COMMUNITIES. THE ACUTE CARE HOSPITAL OFFERS A CARDIAC AND VASCULAR PROGRAM, GENERAL SURGERY, ORTHOPEDICS, CANCER CARE, PSYCHIATRY AND OBSTETRICS. IN ADDITION TO ACUTE SERVICES, MMMC OFFERS OUTPATIENT MENTAL HEALTH SERVICES, HOME HEALTH AND PRIVATE DUTY NURSING SERVICES. FOR MORE INFORMATION, SEE SCHEDULE O. | Description |
Activity2 Activity2
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 4739596 | Expense |
| Grants | 0 | Grants |
| Revenue | 0 | Revenue |
| Description | MEDSTAR MONTGOMERY MEDICAL CENTER PROVIDED $4.7M IN CHARITY CARE SERVICES IN FISCAL YEAR 2012. CHARITY CARE IS PROVIDED PURSUANT TO MEDSTAR HEALTH'S FINANCIAL ASSISTANCE POLICY TO MEMBERS OF THE COMMUNITY WHOSE INCOME IS BELOW CERTAIN THRESHOLDS AND FOR WHICH THE HOSPITAL IS NOT COMPENSATED. UNDER MARYLAND'S UNIQUE PAYER SYSTEM, THE AMOUNT REPORTED REPRESENTS MMMC'S CHARITY CARE EXPENSE AND REVENUES REPRESENT DIRECT PAYMENTS FROM THE STATE'S CHARITY CARE POOL. OTHER CHARITY CARE EXPENSES ARE INDIRECTLY REIMBURSED VIA THE STATE OF MARYLAND'S PAYMENT SYSTEM. | Description |
Activity3 Activity3
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 2573730 | Expense |
| Grants | 0 | Grants |
| Revenue | 28297 | Revenue |
| Description | MEDSTAR MONTGOMERY MEDICAL CENTER PROVIDED $2.4M IN COMMUNITY HEALTH SERVICES IN FISCAL YEAR 2012. THESE CRITICAL SERVICES, WHICH ARE DRIVEN BY COMMUNITY NEEDS, ADDRESS PRIORITIES PRIMARILY THROUGH DISEASE PREVENTION AND IMPROVEMENT OF HEALTH STATUS. SERVICES PROVIDED INCLUDED COMMUNITY HEALTH EDUCATION, COMMUNITY BASED CLINICAL SERVICES, AND HEALTH CARE SUPPORT SERVICES. | Description |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expense | 124399994 | TotalProgramServiceExpense |
| Described In501 C3 | true | DescribedIn501C3 |
| Schedule B Required | false | ScheduleBRequired |
| Political Activities | false | PoliticalActivities |
| Lobbying Activities | false | LobbyingActivities |
| Subject To Proxy Tax | false | SubjectToProxyTax |
| Donor Advised Funds | false | DonorAdvisedFunds |
| Conservation Easements | false | ConservationEasements |
| Collections Of Art | false | CollectionsOfArt |
| Credit Counseling | false | CreditCounseling |
| Term Or Permanent Endowments | false | TermOrPermanentEndowments |
| Report Land Bldg Equip | true | ReportLandBldgEquip |
| Report Invest Oth Securities | false | ReportInvestOthSecurities |
| Report Prog Rel Invest | false | ReportProgRelInvest |
| Report Other Assets | false | ReportOtherAssets |
| Report Other Liabilities | true | ReportOtherLiabilities |
| Report Fin48 Footnote | true | ReportFin48Footnote |
| Independent Audit Financial Stmt | false | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | true | ConsolidatedAuditFinancialStmt |
| School | false | School |
| Foreign Office | false | ForeignOffice |
| Foreign Activities | false | ForeignActivities |
| More Than5000 K To Organizations | false | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividuals |
| Professional Fundraising | false | ProfessionalFundraising |
| Fundraising Activities | false | FundraisingActivities |
| Gaming | false | Gaming |
| Hospital | true | Hospital |
| Financial Stmt Attached | true | FinancialStmtAttached |
| Grants To Organizations | false | GrantsToOrganizations |
| Grants To Individuals | false | GrantsToIndividuals |
| Schedule J Required | true | ScheduleJRequired |
| Tax Exempt Bonds | false | TaxExemptBonds |
| Excess Benefit Transaction | false | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | false | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | false | LoanToOfficerOrDQP |
| Grant To Related Person | false | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | false | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | false | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | false | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | false | DeductibleNonCashContributions |
| Deductible Contributions Of Art | false | DeductibleContributionsOfArt |
| Terminated | false | Terminated |
| Partial Liquidation | false | PartialLiquidation |
| Disregarded Entity | true | DisregardedEntity |
| Related Entity | true | RelatedEntity |
| Related Org Controlled Entity | true | RelatedOrgControlledEntity |
| Transaction Related Entity | true | TransactionRelatedEntity |
| Transfers To Exempt Non Chrtbl Org | false | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | false | ActivitiesConductedPartnership |
| Schedule O Required | true | ScheduleORequired |
| Number Forms Transmitted With1096 | 119 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | true | ComplianceWithBackupWitholding |
| Number Of Employees | 1444 | NumberOfEmployees |
| Employment Tax Returns Filed | true | EmploymentTaxReturnsFiled |
| Unrelated Business Income | true | UnrelatedBusinessIncome |
| Form990-T Filed | true | Form990-TFiled |
| Foreign Financial Account | false | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTrans |
| Taxable Party Notification | false | TaxablePartyNotification |
| Non Deductible Contributions | false | NonDeductibleContributions |
| Quid Pro Quo Contributions | false | QuidProQuoContributions |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | false | FundsToPayPremiums |
| Premiums Paid | false | PremiumsPaid |
| Indoor Tanning Services | false | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 22 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 20 | NumberIndependentVotingMembers |
| Family Or Business Relationship | false | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | false | DelegationOfManagementDuties |
| Changes To Organizing Docs | true | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuse |
| Members Or Stockholders | true | MembersOrStockholders |
| Election Of Board Members | true | ElectionOfBoardMembers |
| Decisions Subject To Approval | true | DecisionsSubjectToApproval |
| Minutes Of Governing Body | true | MinutesOfGoverningBody |
| Minutes Of Committees | true | MinutesOfCommittees |
| Officer Mailing Address | false | OfficerMailingAddress |
| Local Chapters | false | LocalChapters |
| Form990 Provided To Governing Body | true | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | true | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | true | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | true | RegularMonitoringEnforcement |
| Whistleblower Policy | true | WhistleblowerPolicy |
| Document Retention Policy | true | DocumentRetentionPolicy |
| Compensation Process CEO | true | CompensationProcessCEO |
| Compensation Process Other | true | CompensationProcessOther |
| Investment In Joint Venture | true | InvestmentInJointVenture |
| Written Policy Or Procedure | true | WrittenPolicyOrProcedure |
| States Where Copy Of Return Is Filed | MD | StatesWhereCopyOfReturnIsFiled |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | MARC BERGER | NamePerson |
| Telephone Number | 4107726719 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 5565 STERRETT PLACE 5TH FLOOR | AddressLine1 |
| City | COLUMBIA | City |
| State | MD | State |
| ZIP Code | 21044 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | X | InfoInScheduleOPartVII |
Form990 Part VII Section A Form990PartVIISectionA (31 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | OfficerOfficer | Key EmployeeKeyEmployee | Highest Compensated EmployeeHighestCompensatedEmployee |
|---|---|---|---|---|---|---|---|---|
| CHARLES R TUEGEL MD | ||||||||
| DIRECTOR THRU 3/2012 | 1.0 | X | 0 | 0 | 0 | |||
| JULIE BAWA MPH | ||||||||
| DIRECTOR THRU 6/2012 | 1.0 | X | 0 | 0 | 0 | |||
| KEVIN MCMAHON MD | ||||||||
| EX-OFFICIO DIRECTOR THRU 12/11 | 1.0 | X | 0 | 346841 | 3311 | |||
| DOUGLAS FARQUHAR | ||||||||
| DIRECTOR THRU 10/2011 | 1.0 | X | 0 | 0 | 0 | |||
| C THOMPSON PARDOE | ||||||||
| DIRECTOR THRU 10/2011 | 1.0 | X | 0 | 0 | 0 | |||
| ROBERT SULLIVAN | ||||||||
| DIRECTOR THRU 10/2011 | 1.0 | X | 0 | 0 | 0 | |||
| JOSEPH BELL | ||||||||
| DIRECTOR | 1.0 | X | 0 | 0 | 0 | |||
| DEE HAWKINS | ||||||||
| DIRECTOR | 1.0 | X | 0 | 0 | 0 | |||
| MICHAEL K KERR MD | ||||||||
| DIRECTOR | 1.0 | X | 10000 | 0 | 0 | |||
| KENNETH A SAMET | ||||||||
| DIRECTOR | 1.0 | X | 0 | 6126151 | 183379 | |||
| AMY AMPEY MD | ||||||||
| DIRECTOR | 1.0 | X | 3750 | 0 | 0 | |||
| CHARLES F MESS SRMD | ||||||||
| DIRECTOR | 1.0 | X | 0 | 0 | 0 | |||
| BENNETT MORRISON MD | ||||||||
| DIRECTOR | 1.0 | X | 0 | 130968 | 2856 | |||
| RICHARD WEINSTEIN MD | ||||||||
| DIRECTOR | 1.0 | X | 900 | 0 | 0 | |||
| DONALD SWEENEY | ||||||||
| DIRECTOR | 1.0 | X | 0 | 0 | 0 | |||
| KEVIN FLANNERY | ||||||||
| CHAIR | 1.0 | X | 0 | 0 | 0 | |||
| SHEILA WOODARD | ||||||||
| DIRECTOR | 1.0 | X | 0 | 0 | 0 | |||
| GIULIANA CENTTY DDS | ||||||||
| DIRECTOR | 1.0 | X | 0 | 0 | 0 | |||
| JOHN FERGUSON | ||||||||
| DIRECTOR | 1.0 | X | 0 | 0 | 0 | |||
| FADIA KINKEL | ||||||||
| DIRECTOR | 1.0 | X | 0 | 0 | 0 | |||
| WENDY WALKER DVM | ||||||||
| DIRECTOR | 1.0 | X | 0 | 0 | 0 | |||
| PETER W MONGE | ||||||||
| PRESIDENT/DIRECTOR | 40.0 | X | 778883 | 0 | 18101 | X | ||
| DAVID HAVRILLA | ||||||||
| CFO | 40.0 | 324605 | 0 | 30548 | X | |||
| ROGER LEONARD | ||||||||
| VP, MEDICAL AFFAIRS | 40.0 | 376851 | 0 | 12241 | X | |||
| KEVIN MELL | ||||||||
| VP, HUMAN RESOURCES | 40.0 | 211836 | 0 | 13552 | X | |||
| CONNIE STONE | ||||||||
| VP, PATIENT CARE SERVICES | 40.0 | 218080 | 0 | 11220 | X | |||
| RANDALL BURSAW | ||||||||
| SUPERVISOR, NUCLEAR MEDICINE | 40.0 | 163123 | 0 | 12784 | X | |||
| SETH KREVAT | ||||||||
| AVP CLINICAL EXCELLENCE | 40.0 | 153968 | 0 | 684 | X | |||
| MELISSA YEAGER HORN | ||||||||
| VP, MARKETING, PLANNING ,BUS D | 40.0 | 146775 | 0 | 13695 | X | |||
| HELEN OSBORN | ||||||||
| DIRECTOR, PHARMACY | 40.0 | 140702 | 0 | 9010 | X | |||
| BETTY ANN SECRIST | ||||||||
| VP, QUALITY,SAFETY, COMPLIANCE | 40.0 | 175688 | 0 | 1353 | X | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 2705161 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 6603960 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 312734 | TotalOtherCompensation |
| Number Individuals GT100 K | 432 | NumberIndividualsGT100K |
| Formers Listed | false | FormersListed |
| Total Comp GT150 K | true | TotalCompGT150K |
| Compensation From Other Sources | false | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (5 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| MERIDIAN ANESTHESIA PRACTICE L | |||||
| 3801 INTERNATIONAL DR300 | SILVER SPRING | MD | 20906 | PHYSICIAN SERVICES | 4435333 |
| DELPHI HEALTHCARE PARTNERS | |||||
| 170 SOUTHPORT DR | MORRISVILLE | NC | 27560 | PHYSICIAN SERVICES | 1129679 |
| MONTGOMERY MAGNETIC IMAGING | |||||
| 4110 ASPEN HILL RD STE 200 | ROCKVILLE | MD | 20853 | MRI | 953064 |
| INPATIENT SPECIALISTS PA | |||||
| 1201 SEVEN LOCKS RD STE 200 | ROCKVILLE | MD | 20854 | PHYSICIAN SERVICES | 701279 |
| EMERGENCY MEDICINE ASSOCIATES | |||||
| 20010 CENTURY BLVD STE 200 | GERMANTOWN | MD | 20874 | PHYSICIAN SERVICES | 540822 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 5 | NumberOfContractorsGT100K |
| Related Organizations | 50 | RelatedOrganizations |
| Total Contributions | 50 | TotalContributions |
Program Service Revenue ProgramServiceRevenue (4 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome | Unrelated Business RevenueUnrelatedBusinessRevenue |
|---|---|---|---|---|
| PATIENT SERVICE REVENUE | 621300 | 139613337 | 139613337 | |
| PHYSICIAN BILLING REVENUE | 621110 | 8369768 | 8369768 | |
| LAB REVENUE | 900099 | 617470 | 576808 | 40662 |
| OTHER PROGRAM REVENUE | 900099 | 125193 | 125193 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 148725768 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 210722 | TotalRevenueColumn |
| Exclusion | $210,722 | ExclusionAmount |
Income From Invest Bond Proceeds IncomeFromInvestBondProceeds
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Royalties Revenue RoyaltiesRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Gross Rents GrossRents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 204000 | Real |
Rental Income Or Loss RentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 204000 | Real |
Net Rental Income Or Loss NetRentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 204000 | TotalRevenueColumn |
| Exclusion | $204,000 | ExclusionAmount |
Gross Amount Sales Assets GrossAmountSalesAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 14375 | Securities |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 14375 | Securities |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 14375 | TotalRevenueColumn |
| Exclusion | $14,375 | ExclusionAmount |
Net Income From Fundraising Events NetIncomeFromFundraisingEvents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Net Income From Gaming NetIncomeFromGaming
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Net Income Or Loss NetIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Other Revenue Misc OtherRevenueMisc (3 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | ExclusionExclusionAmount | Unrelated Business RevenueUnrelatedBusinessRevenue |
|---|---|---|---|---|
| MANAGEMENT FEES | 900099 | 191276 | $191,276 | |
| EQUITY INTEREST IN AFFILIATES | 525990 | 89852 | $89,852 | |
| MISCELLANEOUS REVENUE | 900099 | 2299672 | $1,992,776 | 306896 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 2580800 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 151735715 | TotalRevenueColumn |
| Related Or Exempt Function Income | 148685106 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 347558 | UnrelatedBusinessRevenue |
| Exclusion | $2,703,001 | ExclusionAmount |
Grants To Domestic Orgs GrantsToDomesticOrgs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Grants To Domestic Individuals GrantsToDomesticIndividuals
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Foreign Grants ForeignGrants
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Benefits To Members BenefitsToMembers
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2122490 | Total |
| Program Services | 1946324 | ProgramServices |
| Management And General | 176166 | ManagementAndGeneral |
Comp Disqual Persons CompDisqualPersons
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 54903085 | Total |
| Program Services | 50348264 | ProgramServices |
| Management And General | 4554821 | ManagementAndGeneral |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1616555 | Total |
| Program Services | 1482442 | ProgramServices |
| Management And General | 134113 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 5953182 | Total |
| Program Services | 5459294 | ProgramServices |
| Management And General | 493888 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 4114337 | Total |
| Program Services | 3773007 | ProgramServices |
| Management And General | 341330 | ManagementAndGeneral |
Fees For Services Management FeesForServicesManagement
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 249150 | Total |
| Management And General | 249150 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 15000 | Total |
| Program Services | 15000 | ProgramServices |
Fees For Services Lobbying FeesForServicesLobbying
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Prof Fundraising FeesForServicesProfFundraising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 24725148 | Total |
| Program Services | 15425568 | ProgramServices |
| Management And General | 9299580 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 391109 | Total |
| Program Services | 5100 | ProgramServices |
| Management And General | 386009 | ManagementAndGeneral |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Royalties Royalties
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 588090 | Total |
| Management And General | 588090 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 61186 | Total |
| Program Services | 16456 | ProgramServices |
| Management And General | 44730 | ManagementAndGeneral |
Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 67329 | Total |
| Program Services | 10220 | ProgramServices |
| Management And General | 57109 | ManagementAndGeneral |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1354339 | Total |
| Program Services | 1354339 | ProgramServices |
Payments To Affiliates PaymentsToAffiliates
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 8550265 | Total |
| Program Services | 8550265 | ProgramServices |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1322890 | Total |
| Program Services | 1322890 | ProgramServices |
Other Expenses OtherExpenses (4 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral |
|---|---|---|---|
| SUPPLIES | 24708347 | 24517242 | 191105 |
| BAD DEBT | 5066781 | 5066781 | 0 |
| UTILITIES (INCL TELEPHONE) | 2596969 | 2578675 | 18294 |
| OTHER ADMINISTRATIVE EXPENSE | 2188227 | 810147 | 1378080 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2138721 | Total |
| Program Services | 1717980 | ProgramServices |
| Management And General | 420741 | ManagementAndGeneral |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 142733200 | Total |
| Program Services | 124399994 | ProgramServices |
| Management And General | 18333206 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 22016428 | BOY |
| EOY | 35964739 | EOY |
Pledges And Grants Receivable PledgesAndGrantsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 14257611 | BOY |
| EOY | 16724696 | EOY |
Receivables From Officers Etc ReceivablesFromOfficersEtc
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 60698 | BOY |
| EOY | 0 | EOY |
Receivables From Disqual Persons ReceivablesFromDisqualPersons
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Other Notes Loans Receivable Net OtherNotesLoansReceivableNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 526161 | BOY |
| EOY | 0 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2562529 | BOY |
| EOY | 2499352 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 858345 | BOY |
| EOY | 831544 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 171451107 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 85366918 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 80125614 | BOY |
| EOY | 86084189 | EOY |
Investments Pub Traded Securities InvestmentsPubTradedSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 66391 | BOY |
| EOY | 0 | EOY |
Investments Other Securities InvestmentsOtherSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 50254 | BOY |
| EOY | 146728 | EOY |
Investments Program Related InvestmentsProgramRelated
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Intangible Assets IntangibleAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 299904 | BOY |
| EOY | 145981 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 120823935 | BOY |
| EOY | 142397229 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 13344100 | BOY |
| EOY | 15101566 | EOY |
Grants Payable GrantsPayable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Deferred Revenue DeferredRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Tax Exempt Bond Liabilities TaxExemptBondLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Escrow Account Liability EscrowAccountLiability
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Loans From Officers Directors LoansFromOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 26756535 | BOY |
| EOY | 37324390 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 40100635 | BOY |
| EOY | 52425956 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 79435856 | BOY |
| EOY | 89971273 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1287444 | BOY |
| EOY | 0 | EOY |
Permanently Restricted Net Assets PermanentlyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 80723300 | BOY |
| EOY | 89971273 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 120823935 | BOY |
| EOY | 142397229 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | 9002515 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | 245458 | ReconcilationOtherChanges |
| Info In Schedule O Part XII | X | InfoInScheduleOPartXII |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | false | AccountantCompileOrReview |
| FS Audited | true | FSAudited |
| Audit Committee | true | AuditCommittee |
| Financial Statement Consolidated | X | FinancialStatementConsolidated |
| Federal Grant Audit Required | false | FederalGrantAuditRequired |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital170b1 Aiii | X | Hospital170b1Aiii |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Art Public Exhibition Amts | ArtPublicExhibitionAmts | |
| Held Works Of Art Amts | HeldWorksOfArtAmts | |
| Current Year Minus3 Years | CurrentYearMinus3Years |
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | 0 | InvestmentCostOrOtherBasis |
| Other Cost Or Other Basis | 146581 | OtherCostOrOtherBasis |
| Book Value | 146581 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 83796052 | OtherCostOrOtherBasis |
| Depreciation | 7526783 | Depreciation |
| Book Value | 76269269 | BookValue |
Leasehold Improvements LeaseholdImprovements
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 2630203 | OtherCostOrOtherBasis |
| Book Value | 2630203 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 66783894 | OtherCostOrOtherBasis |
| Depreciation | 66783894 | Depreciation |
| Book Value | 0 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 18094377 | OtherCostOrOtherBasis |
| Depreciation | 11056241 | Depreciation |
| Book Value | 7038136 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 86084189 | TotalOfBookValueLandBuildings |
| Federal Income Tax Liability | 0 | FederalIncomeTaxLiability |
Other Liabilities OtherLiabilities (10 entries)
| DescriptionDescription | AmountAmount |
|---|---|
| DUE TO RELATED ORGANIZATION | $21,630,609 |
| MOB LIABILITY | $7,877,865 |
| ADVANCE HEALTH INSURANCE | $4,557,207 |
| WORKERS COMP | $0 |
| SURGERY CENTER DEBT | $226,011 |
| PATIENT CREDIT BALANCES | $272,703 |
| OPTIMUM CHOICE IBNR | $131,960 |
| PATIENT CREDIT BALANCES | $389,875 |
| ARR SEED PAYABLE | $496,044 |
| OTHER LIABILITIES | $1,742,116 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 37324390 | TotalOfAmounts |
Form990 Schedule D Part XIV Form990ScheduleDPartXIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | FIN 48 FOOTNOTE | Identifier |
| Return Reference | SCHEDULE D, PART X | ReturnReference |
| Explanation | INCOME TAXES ARE ACCOUNTED FOR UNDER THE ASSET AND LIABILITY METHOD. DEFERRED TAX ASSETS AND LIABILITIES ARE RECOGNIZED FOR THE FUTURE TAX CONSEQUENCES ATTRIBUTABLE TO DIFFERENCES BETWEEN THE FINANCIAL STATEMENT CARRYING AMOUNTS OF EXISTING ASSETS AND LIABILITIES AND THEIR RESPECTIVE TAX BASES AND OPERATING LOSS AND TAX CREDIT CARRYFORWARDS. DEFERRED TAX ASSETS AND LIABILITIES ARE MEASURED USING ENACTED TAX RATES EXPECTED TO APPLY TO TAXABLE INCOME IN THE YEARS IN WHICH THOSE TEMPORARY DIFFERENCES ARE EXPECTED TO BE RECOVERED OR SETTLED. THE EFFECT ON DEFERRED TAX ASSETS AND LIABILITIES OF A CHANGE IN TAX RATES IS RECOGNIZED IN THE PERIOD THAT INCLUDES THE ENACTMENT DATE. ANY CHANGES TO THE VALUATION ALLOWANCE ON THE DEFERRED TAX ASSET ARE REFLECTED IN THE YEAR OF CHANGE. THE CORPORATION ACCOUNTS FOR UNCERTAIN TAX POSITIONS IN ACCORDANCE WITH THE FASB ACCOUNTING STANDARDS CODIFICATION (ASC) TOPIC 740, INCOME TAXES. THERE WAS NO LIABILITY RECORDED FOR UNCERTAIN TAX POSITIONS AS OF JUNE 30, 2012. | Explanation |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Charity Care Policy | true | CharityCarePolicy |
| Written Policy | true | WrittenPolicy |
| Policy Applied To All Hospitals | X | PolicyAppliedToAllHospitals |
| FPG Reference Free Care | true | FPGReferenceFreeCare |
| Pcent200 | X | Pcent200 |
| FPG Reference Discounted Care | true | FPGReferenceDiscountedCare |
| Pcent400 | X | Pcent400 |
| Free Disc Care Medically Indigent | true | FreeDiscCareMedicallyIndigent |
| Amounts Budgeted For Charity Care | true | AmountsBudgetedForCharityCare |
| Expenses Exceeded Budget | true | ExpensesExceededBudget |
| Unable To Provide Care | false | UnableToProvideCare |
| Annual Community Benefit Report | true | AnnualCommunityBenefitReport |
| Report Publically Available | true | ReportPublicallyAvailable |
Charity Care At Cost CharityCareAtCost
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 4515938 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 4515938 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.03160 | PercentOfTotalExpense |
Total Charity Care TotalCharityCare
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 4515938 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 4515938 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.03160 | PercentOfTotalExpense |
Community Health Services CommunityHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 24 | NumberOfActivitiesOrPrograms |
| Persons Served | 18308 | PersonsServed |
| Total Community Benefit Expense | 2573730 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 28297 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 2545433 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.01780 | PercentOfTotalExpense |
Health Professions Education HealthProfessionsEducation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 4 | NumberOfActivitiesOrPrograms |
| Persons Served | 111 | PersonsServed |
| Total Community Benefit Expense | 323310 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 323310 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00230 | PercentOfTotalExpense |
Subsidized Health Services SubsidizedHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 3 | NumberOfActivitiesOrPrograms |
| Total Community Benefit Expense | 1686266 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 1686266 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.01180 | PercentOfTotalExpense |
Cash And In Kind Contributions CashAndInKindContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 5 | NumberOfActivitiesOrPrograms |
| Persons Served | 1851 | PersonsServed |
| Total Community Benefit Expense | 95101 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 95101 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00070 | PercentOfTotalExpense |
Total Other Benefits TotalOtherBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 36 | NumberOfActivitiesOrPrograms |
| Persons Served | 20270 | PersonsServed |
| Total Community Benefit Expense | 4678407 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 28297 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 4650110 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.03260 | PercentOfTotalExpense |
Total Community Benefits TotalCommunityBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 36 | NumberOfActivitiesOrPrograms |
| Persons Served | 20270 | PersonsServed |
| Total Community Benefit Expense | 9194345 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 28297 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 9166048 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.06420 | PercentOfTotalExpense |
Community Support CommunitySupport
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 1 | NumberOfActivitiesOrPrograms |
| Total Community Building Expense | 75518 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 75518 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00050 | PercentOfTotalExpense |
Environmental Improvements EnvironmentalImprovements
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 6 | NumberOfActivitiesOrPrograms |
| Persons Served | 2000 | PersonsServed |
| Total Community Building Expense | 388370 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 388370 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00270 | PercentOfTotalExpense |
Coalition Building CoalitionBuilding
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 1 | NumberOfActivitiesOrPrograms |
| Persons Served | 97 | PersonsServed |
| Total Community Building Expense | 4477 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 4477 | NetCommunityBuildingExpense |
Health Improvement Advocacy HealthImprovementAdvocacy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 2 | NumberOfActivitiesOrPrograms |
| Total Community Building Expense | 29652 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 29652 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00020 | PercentOfTotalExpense |
Total Total
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 10 | NumberOfActivitiesOrPrograms |
| Persons Served | 2097 | PersonsServed |
| Total Community Building Expense | 498017 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 498017 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00340 | PercentOfTotalExpense |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | true | BadDebtExpenseReported |
| Bad Debt Expense | $5,066,781 | BadDebtExpenseAmount |
| Amount Attributable To | 0 | AmountAttributableTo |
| Amount Reimbursed By Medicare | 0 | AmountReimbursedByMedicare |
| Cost Of Care Reimbursed By Medicare | 0 | CostOfCareReimbursedByMedicare |
| Medicare Surplus Or Shortfall | 0 | MedicareSurplusOrShortfall |
Costing Methodology Used CostingMethodologyUsed
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | X | CostToChargeRatio |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | true | WrittenDebtCollectionPolicy |
| Provision For Charity Care | true | 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 | MONTGOMERY GENERAL HOSPITAL | BusinessNameLine1 |
Address Address
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 18101 PRINCE PHILIP DRIVE | AddressLine1 |
| City | OLNEY | City |
| State | MD | State |
| ZIP Code | 20832 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| 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 | MONTGOMERY GENERAL HOSPITAL | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital Facility Number | 1 | HospitalFacilityNumber |
| CHNA Conducted | true | 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 | true | TakeIntoAccount |
| Other Facilities | false | OtherFacilities |
| CHNA Widely Available | true | 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 |
| Eligibility Criteria Explained | true | EligibilityCriteriaExplained |
| Uses FPG Free | true | UsesFPGFree |
| FPG Free Percent | 200. | FPGFreePercent |
| Uses FPG Discounted | true | UsesFPGDiscounted |
| FPG Discount Percent | 400. | FPGDiscountPercent |
| Explains Basis | true | ExplainsBasis |
| Income Level | X | IncomeLevel |
| Asset Level | X | AssetLevel |
| Medical Indigency | X | MedicalIndigency |
| Insurance Status | X | InsuranceStatus |
| Uninsured Discount | X | UninsuredDiscount |
| Medicaid Medicare | X | MedicaidMedicare |
| Explains Application Method | true | ExplainsApplicationMethod |
| Includes Publicity Measures | true | IncludesPublicityMeasures |
| 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 | true | ActionsOnNonpayment |
| Collection Activities | false | CollectionActivities |
| Nondiscrim Emergency Care Policy | true | NondiscrimEmergencyCarePolicy |
| Average Negotiated Rates | X | AverageNegotiatedRates |
| Amounts Generally Billed | false | AmountsGenerallyBilled |
| Gross Charges | false | GrossCharges |
Form990 Schedule H Part VI Form990ScheduleHPartVI (11 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| CHARITY CARE AT COST | PART I, LINE 7A | MARYLAND'S REGULATORY SYSTEM CREATES A UNIQUE PROCESS FOR HOSPITAL PAYMENT THAT DIFFERS FROM THE REST OF THE NATION. THE HEALTH SERVICES COST REVIEW COMMISSION (HSCRC), DETERMINES PAYMENT THROUGH A RATE-SETTING PROCESS AND ALL PAYORS, INCLUDING GOVERNMENTAL PAYORS, PAY THE SAME AMOUNT FOR THE SAME SERVICES DELIVERED AT THE SAME HOSPITAL. MARYLAND'S UNIQUE ALL-PAYOR SYSTEM INCLUDES A METHOD FOR REFERENCING UNCOMPENSATED CARE IN EACH PAYORS' RATES, WHICH DOES NOT ENABLE MARYLAND HOSPITALS TO BREAKOUT ANY OFFSETTING REVENUE RELATED TO UNCOMPENSATED CARE. |
| UNREIMBURSED MEDICAID | PART I, LINE 7B | MARYLAND'S REGULATORY SYSTEM CREATES A UNIQUE PROCESS FOR HOSPITAL PAYMENT THAT DIFFERS FROM THE REST OF THE NATION. THE HEALTH SERVICES COST REVIEW COMMISSION (HSCRC), DETERMINES PAYMENT THROUGH A RATE-SETTING PROCESS AND ALL PAYORS, INCLUDING GOVERNMENTAL PAYORS, PAY THE SAME AMOUNT FOR THE SAME SERVICES DELIVERED AT THE SAME HOSPITAL. MARYLAND'S UNIQUE ALL-PAYOR SYSTEM INCLUDES A METHOD FOR REFERENCING UNCOMPENSATED CARE IN EACH PAYORS' RATES, WHICH DOES NOT ENABLE MARYLAND HOSPITALS TO BREAKOUT ANY OFFSETTING REVENUE RELATED TO UNCOMPENSATED CARE. COMMUNITY BENEFIT EXPENSES ARE EQUAL TO MEDICAID REVENUES IN MARYLAND, AS SUCH, THE NET EFFECT IS ZERO. THE EXCEPTION TO THIS IS THE IMPACT ON THE HOSPITAL OF ITS SHARE OF THE MEDICAID ASSESSMENT. IN RECENT YEARS, THE STATE OF MARYLAND HAS CLOSED FISCAL GAPS IN THE STATE MEDICAID BUDGET BY ASSESSING HOSPITALS THROUGH THE RATE-SETTING SYSTEM. |
| HEALTH PROFESSIONS EDUCATION | PART I, LINE 7F | MARYLAND'S REGULATORY SYSTEM CREATES A UNIQUE PROCESS FOR HOSPITAL PAYMENT THAT DIFFERS FROM THE REST OF THE NATION. THE HEALTH SERVICES COST REVIEW COMMISSION (HSCRC), DETERMINES PAYMENT THROUGH A RATE-SETTING PROCESS AND ALL PAYORS, INCLUDING GOVERNMENTAL PAYORS, PAY THE SAME AMOUNT FOR THE SAME SERVICES DELIVERED AT THE SAME HOSPITAL. MARYLAND'S UNIQUE ALL-PAYOR SYSTEM INCLUDES A METHOD FOR REFERENCING UNCOMPENSATED CARE IN EACH PAYORS' RATES, WHICH DOES NOT ENABLE MARYLAND HOSPITALS TO BREAKOUT ANY OFFSETTING REVENUE RELATED TO UNCOMPENSATED CARE. PERCENT OF TOTAL EXPENSE PART I, LINE 7, COLUMN (F) BAD DEBT EXPENSE OF $5,066,781 HAS BEEN REMOVED FROM TOTAL EXPENSE TO CALCULATE THE PERCENTAGES IN COLUMN (F). |
| BAD DEBT | PART III, LINE 4 | MEDSTAR HEALTH AND ITS AFFILIATED ORGANIZATIONS REPORT BAD DEBT EXPENSE IN ACCORDANCE WITH GENERALLY ACCEPTED ACCOUNTING PRINCIPLES (GAAP) AND HFMA 15. AMOUNTS THAT ARE NOT EXPECTED TO BE COLLECTED, FOR PATIENTS QUALIFYING UNDER MEDSTAR HEALTH'S FINANCIAL ASSISTANCE POLICY, ARE WRITTEN OFF TO CHARITY CARE AND REPORTED AS A REDUCTION TO REVENUE. BAD DEBT EXPENSE RESULTS FROM MANAGEMENT'S INABILITY TO COLLECT REVENUES THAT MEET THE GAAP CRITERIA FOR REVENUE RECOGNITION. BAD DEBT REPRESENTS AN OPERATING EXPENSE AND IS REFLECTED AS A SEPARATE LINE ITEM ON THE ORGANIZATION'S STATEMENT OF OPERATIONS. HOWEVER, MEDSTAR AND ITS AFFILIATED ENTITIES DO NOT MAKE A DETERMINATION AS TO WHETHER SELF PAY AMOUNTS ARE COLLECTIBLE IN DETERMINING REVENUE RECOGNITION. RESERVE MODELS, WHICH HAVE BEEN DEVELOPED BASED ON HISTORICAL COLLECTION RESULTS AND WHICH ARE ADJUSTED PERIODICALLY BASED ON ACTUAL COLLECTIONS EXPERIENCE, ARE USED TO ESTIMATE UNCOLLECTIBLE AMOUNTS ACROSS ALL PAYORS INCLUDING SELF PAY. BAD DEBT DETERMINATIONS ARE MADE ONLY AFTER SUFFICIENT EVIDENCE IS OBTAINED TO SUPPORT THAT AN AMOUNT IS NOT COLLECTIBLE. |
| MEDICARE | PART III, LINE 8 | MARYLAND'S REGULATORY SYSTEM CREATES A UNIQUE PROCESS FOR HOSPITAL PAYMENT THAT DIFFERS FROM THE REST OF THE NATION. THE HEALTH SERVICES COST REVIEW COMMISSION (HSCRC) DETERMINES PAYMENT THROUGH A RATE-SETTING PROCESS AND ALL PAYORS, INCLUDING GOVERNMENTAL PAYORS, PAY THE SAME AMOUNT FOR THE SAME SERVICES DELIVERED AT THE SAME HOSPITAL. MARYLAND'S UNIQUE ALL-PAYOR SYSTEM INCLUDES A METHOD FOR REFERENCING UNCOMPENSATED CARE IN EACH PAYORS' RATES, WHICH DOES NOT ENABLE MARYLAND HOSPITALS TO BREAKOUT ANY OFFSETTING REVENUE RELATED TO UNCOMPENSATED CARE. AS SUCH, THE NET EFFECT FOR MEDICARE EXPENSES AND REVENUES IN MARYLAND IS ZERO. |
| NEEDS ASSESSMENT | Part V, Section B, Line 7 | The implementation strategies serve as a roadmap for how community benefit resources will be allocated and deployed. MedStar's hospitals will be able to measure our contribution to improving the health of underserved and vulnerable populations in the regions we serve. Three-year implementation strategies with measurable objectives were developed for each hospital's community benefit service area - a specific community or target population of focus. Priorities were based on community need as determined by quantitative data and community input, as well as on hospital expertise, resources, strengths of existing programming and partnerships, and alignment with national, state, and local health goals. The MedStar Health Corporate Community Health Department will provide system-wide coordination and oversight of community benefit programming. PART VI, LINE 1 IN FY12, MEDSTAR MONTGOMERY MEDICAL CENTER (MEDSTAR MONTGOMERY) CONDUCTED A COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) IN ACCORDANCE WITH THE GUIDELINES ESTABLISHED BY THE PATIENT PROTECTION AND AFFORDABLE CARE ACT AND THE INTERNAL REVENUE SERVICE. THE HOSPITAL'S CHNA WAS LED BY NINE ADVISORY TASK FORCE (ATF) MEMBERS, WHICH WAS COMPRISED OF A DIVERSE GROUP OF INDIVIDUALS, INCLUDING GRASSROOTS ACTIVISTS, COMMUNITY RESIDENTS, HOSPITAL REPRESENTATIVES, PUBLIC HEALTH LEADERS, AND OTHER STAKEHOLDER ORGANIZATIONS, SUCH AS REPRESENTATIVES FROM THE U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES. THE ATF REVIEWED QUANTITATIVE AND QUALITATIVE COMMUNITY HEALTH DATA, AS WELL AS LOCAL, REGIONAL AND NATIONAL HEALTH GOALS. BASED ON THEIR FINDINGS, ATF MEMBERS DESIGNED A SURVEY TO IDENTIFY TRENDS IN HOW PARTICIPANTS PERCEIVED THE SEVERITY OF KEY HEALTH ISSUES IN THE FOLLOWING CATEGORIES: WELLNESS AND PREVENTION, ACCESS TO CARE, QUALITY OF LIFE, AND ENVIRONMENT. COMMUNITY MEMBERS RESPONDED TO THE SURVEY BY ATTENDING A COMMUNITY INPUT SESSION OR COMPLETING IT ONLINE OR VIA HARDCOPY. BASED ON THE ATF'S RECOMMENDATION, THE HOSPITAL IDENTIFIED ASPEN HILL AND BEL PRE AS ITS COMMUNITY BENEFIT SERVICE AREA (CBSA) - A GEOGRAPHY WITH A HIGH DENSITY OF LOW-INCOME OR VULNERABLE RESIDENTS WITHIN CLOSE PROXIMITY OF THE HOSPITAL. HEART DISEASE WAS CHOSEN AS THE HEALTH PRIORITY FOR THE CBSA. THE HOSPITAL'S FY12 CHNA AND 3-YEAR IMPLEMENTATION STRATEGIES WERE ENDORSED BY MEDSTAR MONGOMERY'S BOARD OF DIRECTORS AND APPROVED BY THE MEDSTAR HEALTH BOARD OF DIRECTORS. THE DOCUMENT WAS PUBLISHED ON THE HOSPITAL'S WEBSITE ON JUNE 30, 2012. AS A PROUD MEMBER OF MEDSTAR HEALTH, REPRESENTATIVES FROM MEDSTAR MONTGOMERY ROUTINELY PARTICIPATE IN THE MEDSTAR HEALTH COMMUNITY BENEFIT WORKGROUP. THE WORKGROUP IS COMPRISED OF COMMUNITY HEALTH PROFESSIONALS WHO REPRESENT ALL NINE MEDSTAR HOSPITALS. THE TEAM ANALYZES LOCAL AND REGIONAL COMMUNITY HEALTH DATA, ESTABLISHES SYSTEM-WIDE COMMUNITY HEALTH PROGRAMMING PERFORMANCE AND EVALUATION MEASURES AND SHARES BEST PRACTICES. |
| PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE | PART VI, LINE 3 | AS ONE OF THE REGION'S LEADING NOT-FOR-PROFIT HEALTHCARE SYSTEMS, MEDSTAR HEALTH IS COMMITTED TO ENSURING THAT UNINSURED PATIENTS WITHIN THE COMMUNITIES WE SERVE WHO LACK FINANCIAL RESOURCES HAVE ACCESS TO NECESSARY HOSPITAL SERVICES. MEDSTAR HEALTH AND ITS HEALTHCARE FACILITIES WILL: " TREAT ALL PATIENTS EQUITABLY, WITH DIGNITY, WITH RESPECT AND WITH COMPASSION. " SERVE THE EMERGENCY HEALTH CARE NEEDS OF EVERYONE WHO PRESENTS AT OUR FACILITIES REGARDLESS OF A PATIENT'S ABILITY TO PAY FOR CARE. " ASSIST THOSE PATIENTS WHO ARE ADMITTED THROUGH OUR ADMISSIONS PROCESS FOR NON-URGENT, MEDICALLY NECESSARY CARE WHO CANNOT PAY FOR PART OF ALL OF THE CARE THEY RECEIVE. " BALANCE NEEDED FINANCIAL ASSISTANCE FOR SOME PATIENTS WITH BROADER FISCAL RESPONSIBILITIES IN ORDER TO KEEP ITS HOSPITALS' DOORS OPEN FOR ALL WHO MAY NEED CARE IN THE COMMUNITY. IN MEETING ITS COMMITMENTS, MEDSTAR HEALTH'S FACILITIES WILL WORK WITH THEIR UNINSURED PATIENTS TO GAIN AN UNDERSTANDING OF EACH PATIENT'S FINANCIAL RESOURCES PRIOR TO ADMISSION (FOR SCHEDULED SERVICES) OR PRIOR TO BILLING (FOR EMERGENCY SERVICES). BASED ON THIS INFORMATION AND PATIENT ELIGIBILITY, MEDSTAR HEALTH'S FACILITIES WILL ASSIST UNINSURED PATIENTS WHO RESIDE WITHIN THE COMMUNITIES WE SERVE IN ONE OR MORE OF THE FOLLOWING WAYS: " ASSIST WITH ENROLLMENT IN PUBLICLY-FUNDED ENTITLEMENT PROGRAMS (E.G., MEDICAID). " ASSIST WITH CONSIDERATION OF FUNDING THAT MAY BE AVAILABLE FROM OTHER CHARITABLE ORGANIZATIONS. " PROVIDE CHARITY CARE AND FINANCIAL ASSISTANCE ACCORDING TO APPLICABLE GUIDELINES. " PROVIDE FINANCIAL ASSISTANCE FOR PAYMENT OF FACILITY CHARGES USING A SLIDING SCALE BASED ON PATIENT FAMILY INCOME AND FINANCIAL RESOURCES. " OFFER PERIODIC PAYMENT PLANS TO ASSIST PATIENTS WITH FINANCING THEIR HEALTHCARE SERVICES. EACH FACILITY WILL POST THE POLICY, INCLUDING A DESCRIPTION OF THE APPLICABLE COMMUNITIES IT SERVES, IN EACH MAJOR PATIENT REGISTRATION AREA AND IN ANY OTHER AREAS REQUIRED BY APPLICABLE REGULATIONS, WILL COMMUNICATE THE INFORMATION TO PATIENTS AS REQUIRED BY THIS POLICY AND APPLICABLE REGULATIONS AND WILL MAKE A COPY OF THE POLICY AVAILABLE TO ALL PATIENTS. ADDITIONALLY, THE MARYLAND PATIENT INFORMATION SHEET/MEDSTAR'S PATIENT INFORMATION SHEET WILL BE PROVIDED TO INPATIENTS ON ADMISSION AND AT TIME OF FINAL ACCOUNT BILLING. MEDSTAR HEALTH BELIEVES THAT ITS PATIENTS HAVE PERSONAL RESPONSIBILITIES RELATED TO THE FINANCIAL ASPECTS OF THEIR HEALTHCARE NEEDS. THE CHARITY CARE, FINANCIAL ASSISTANCE, AND PERIODIC PAYMENT PLANS AVAILABLE UNDER THIS POLICY WILL NOT BE AVAILABLE TO THOSE PATIENTS WHO FAIL TO FULFILL THEIR RESPONSIBILITIES. FOR PURPOSES OF THIS POLICY, PATIENT RESPONSIBILITIES INCLUDE: " COMPLETING FINANCIAL DISCLOSURE FORMS NECESSARY TO EVALUATE THEIR ELIGIBILITY FOR PUBLICLY-FUNDED HEALTHCARE PROGRAMS, CHARITY CARE PROGRAMS, AND OTHER FORMS OF FINANCIAL ASSISTANCE. THESE DISCLOSURE FORMS MUST BE COMPLETED ACCURATELY, TRUTHFULLY, AND TIMELY TO ALLOW MEDSTAR HEALTH'S FACILITIES TO PROPERLY COUNSEL PATIENTS CONCERNING THE AVAILABILITY OF FINANCIAL ASSISTANCE. " WORKING WITH THE FACILITY'S FINANCIAL COUNSELORS AND OTHER FINANCIAL SERVICES STAFF TO ENSURE THERE IS A COMPLETE UNDERSTANDING OF THE PATIENT'S FINANCIAL SITUATION AND CONSTRAINTS. " COMPLETING APPROPRIATE APPLICATIONS FOR PUBLICLY-FUNDED HEALTHCARE PROGRAMS. THIS RESPONSIBILITY INCLUDES RESPONDING IN A TIMELY FASHION TO REQUESTS FOR DOCUMENTATION TO SUPPORT ELIGIBILITY. " MAKING APPLICABLE PAYMENTS FOR SERVICES IN A TIMELY FASHION, INCLUDING ANY PAYMENTS MADE PURSUANT TO DEFERRED AND PERIODIC PAYMENT SCHEDULES. " PROVIDING UPDATED FINANCIAL INFORMATION TO THE FACILITY'S FINANCIAL COUNSELORS ON A TIMELY BASIS AS THE PATIENT'S CIRCUMSTANCES MAY CHANGE. " IT IS THE RESPONSIBILITY OF THE PATIENT TO INFORM THE MEDSTAR HOSPITAL OF THEIR EXISTING ELIGIBILITY UNDER A MEDICAL HARDSHIP DURING THE 12 MONTH PERIOD. UNINSURED PATIENTS OF MEDSTAR HEALTH'S FACILITIES MAY BE ELIGIBLE FOR CHARITY CARE OR SLIDING-SCALE FINANCIAL ASSISTANCE UNDER THIS POLICY. THE FINANCIAL COUNSELORS AND FINANCIAL SERVICES STAFF WILL DETERMINE ELIGIBILITY FOR CHARITY CARE AND SLIDING-SCALE FINANCIAL ASSISTANCE BASED ON REVIEW OF INCOME FOR THE PATIENT AND THEIR FAMILY (HOUSEHOLD), OTHER FINANCIAL RESOURCES AVAILABLE TO THE PATIENT'S FAMILY, FAMILY SIZE, AND THE EXTENT OF THE MEDICAL COSTS TO BE INCURRED BY THE PATIENT. |
| COMMUNITY INFORMATION | PART VI, LINE 4 | GEOGRAPHIC LOCATED IN MONTGOMERY COUNTY MARYLAND, MEDSTAR MONTGOMERY SERVES THE GREATER BALTIMORE AND WASHINGTON, D.C. METRO AREAS, WITH THE LARGE MAJORITY OF PATIENTS RESIDING IN MONTGOMERY COUNTY. DEMOGRAPHIC THE POPULATION OF MONTGOMERY COUNTY IS SPLIT ALMOST EVENLY BETWEEN MALES (48.1%) AND FEMALES (51.9%) AND RELATIVELY DIVERSE, WITH 63.6% CAUCASIAN, 18.2% AFRICAN AMERICAN, 14.4% ASIAN, 0.7% AMERICAN INDIAN/ALASKA NATIVE AND 0.1% NATIVE HAWAIIAN/OTHER PACIFIC ISLANDER. COMPARED TO THE STATE AVERAGE (8.2%), THE COUNTY ALSO HAS A LARGE AND GROWING HISPANIC POPULATION (17.5%). THE MEDIAN AGE IS 38.6 YEARS, WITH A LIFE EXPECTANCY OF 83.7. WHILE THE MEDIAN ANNUAL HOUSEHOLD INCOME IS $92,909, THERE ARE POCKETS OF POVERTY; 6.7% OF HOUSEHOLDS HAVE ANNUAL INCOMES AT OR BELOW THE FEDERAL POVERTY LINE. ADDITIONALLY, 11.5% OF THE POPULATION IS UNINSURED AND 6.9% RECEIVE MEDICAID. |
| PROMOTION OF COMMUNITY HEALTH | PART VI, LINE 5 | AS A COMMUNITY PARTNER, MEDSTAR MONTGOMERY ENGAGES IN A NUMBER OF COMMUNITY BENEFIT ACTIVITIES TO IMPROVE AND PROMOTE THE HEALTH AND WELLBEING OF THE COMMUNITY. EDUCATING THE COMMUNITY ABOUT CANCER PREVENTION AND TREATMENT IS A TOP PRIORITY FOR THE HOSPITAL. AN ONCOLOGY CERTIFIED REGISTERED NURSE GUIDES PATIENTS' FAMILIES AND PHYSICIANS THROUGH THE MANY FACETS OF TESTS AND TREATMENTS THAT OFTEN ACCOMPANY A CANCER DIAGNOSIS. THE CANCER CARE NAVIGATOR NOT ONLY EDUCATES PATIENTS ABOUT CANCER AND TREATMENTS, BUT PROVIDES EMOTIONAL SUPPORT AND ENCOURAGEMENT. THE HOSPITAL IS COMMITTED TO MEETING THE NEEDS OF VULNERABLE POPULATIONS BY ESTABLISHING STRATEGIC PARTNERSHIPS AND ALLIANCES. FOR EXAMPLE, PROYECTO SALUD, A NONPROFIT SAFETY-NET CLINIC, ENABLES LOW-INCOME, UNINSURED RESIDENTS TO RECEIVE FREE OR LOW COST CULTURALLY COMPETENT HEALTHCARE SERVICES. LOCATED ON THE CAMPUS OF THE HOSPITAL, MEDSTAR MONTGOMERY SUPPORTS THE CLINIC BY PROVIDING FREE SPACE AND PARTIAL FUNDING TO SUPPORT GENERAL OPERATION. SERVICES CONSIST OF PRIMARY CARE, INCLUDING PHYSICAL EXAMINATIONS, HEALTH COUNSELING AND EDUCATION, BEHAVIORAL HEALTH, ACCESS TO AFFORDABLE MEDICATIONS AND BASIC LABORATORY SERVICES. A NUMBER OF PREVENTIVE SERVICES ARE ALSO AVAILABLE, SUCH AS SEASONAL FLU VACCINATIONS. THROUGH ITS PARTNERSHIP WITH PROYECTO SALUD, MEDSTAR MONTGOMERY MANAGES THE WOMEN'S HEALTH IMPROVEMENT PROGRAM (WHIP), WHICH PROVIDES FREE MAMMOGRAM SCREENINGS FOR MEDICALLY UNDERSERVED WOMEN OVER AGE 40. THE PROGRAM ALSO PROVIDES BREAST CARE EDUCATION AND A TRAINED CLINICIAN TO HELP PROVIDE NEXT STEPS FOR DIAGNOSTIC AND TREATMENT FOLLOW-UP. WHIP STAFF IS ACTIVE IN THE COMMUNITY, PROVIDING FREE PRESENTATIONS AND WORKSHOPS TO SHARE NEW RESEARCH AND EDUCATION REGARDING BREAST HEALTH. SPECIALTY CARE IS A VAST NEED AMONGST THE LOW-INCOME, UNINSURED POPULATION IN MEDSTAR MONTGOMERY'S SERVICE AREA. THE HOSPITAL PARTNERS WITH A LOCAL SPECIALTY CARE NETWORK, PROJECT ACCESS, WHICH COORDINATES AND SCREENS PATIENTS BEFORE REFERRING THEM TO THE HOSPITAL. THROUGH THIS NETWORK, THE HOSPITAL ENSURES PATIENTS' PROCEDURES ARE SCHEDULED AND FINANCIAL ASSESSMENTS ARE EFFICIENTLY PROCESSED. |
| AFFILIATED HEALTH CARE SYSTEM | PART VI, LINE 6 | AS A PROUD MEMBER OF MEDSTAR HEALTH, MEDSTAR MONTGOMERY IS ABLE TO EXPAND ITS CAPACITY TO MEET THE NEEDS OF THE COMMUNITY BY PARTNERING WITH OTHER MEDSTAR HOSPITALS AND ASSOCIATED ENTITIES. MEDSTAR HEALTH RESOURCES ASSIST THE HOSPITAL IN COMMUNITY HEALTH PLANNING TO MEET THE NEEDS OF THE UNINSURED AND OTHER VULNERABLE POPULATIONS. THROUGH ITS COMMUNITY HEALTH FUNCTION, MEDSTAR HEALTH PROVIDES MEDSTAR MONTGOMERY WITH TECHNICAL SUPPORT TO ENHANCE COMMUNITY HEALTH PROGRAMMING AND EVALUATION. MEDSTAR'S CORPORATE PHILANTHROPY DEPARTMENT IDENTIFIES AND SEEKS PUBLIC AND PRIVATE FUNDING SOURCES TO ENSURE THE AVAILABILITY OF HIGH QUALITY HEALTH SERVICES, REGARDLESS OF ABILITY TO PAY. |
| STATE FILING OF COMMUNITY BENEFIT REPORT | PART VI, LINE 7 | THE COMMUNITY BENEFIT REPORT FOR MEDSTAR MONTGOMERY MEDICAL CENTER IS ONLY FILED IN THE STATE OF MARYLAND. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| 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 | false | SeverancePayment |
| Supplemental Nonqual Retire Plan | true | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | false | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | false | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | false | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | false | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | false | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | false | AnyNonFixedPayments |
| Initial Contract Exception | false | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (11 entries)
| 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| KEVIN MCMAHON MD | |||||||||||||
| 0 | 346841 | 0 | 0 | 0 | 0 | 0 | 3311 | 0 | 0 | 0 | 350152 | 0 | 0 |
| KENNETH A SAMET | |||||||||||||
| 0 | 1166887 | 0 | 1481670 | 0 | 3477594 | 0 | 163987 | 0 | 19392 | 0 | 6309530 | 0 | 0 |
| RANDALL BURSAW | |||||||||||||
| 163123 | 0 | 0 | 0 | 0 | 0 | 471 | 0 | 12313 | 0 | 175907 | 0 | 0 | 0 |
| SETH KREVAT | |||||||||||||
| 153968 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 684 | 0 | 154652 | 0 | 0 | 0 |
| MELISSA YEAGER HORN | |||||||||||||
| 146775 | 0 | 0 | 0 | 0 | 0 | 1434 | 0 | 12261 | 0 | 160470 | 0 | 0 | 0 |
| PETER W MONGE | |||||||||||||
| 434628 | 0 | 341935 | 0 | 2320 | 0 | 5508 | 0 | 12593 | 0 | 796984 | 0 | 0 | 0 |
| DAVID HAVRILLA | |||||||||||||
| 324605 | 0 | 0 | 0 | 0 | 0 | 12925 | 0 | 17623 | 0 | 355153 | 0 | 0 | 0 |
| ROGER LEONARD | |||||||||||||
| 264915 | 0 | 111936 | 0 | 0 | 0 | 913 | 0 | 11328 | 0 | 389092 | 0 | 0 | 0 |
| KEVIN MELL | |||||||||||||
| 159553 | 0 | 52283 | 0 | 0 | 0 | 3977 | 0 | 9575 | 0 | 225388 | 0 | 0 | 0 |
| CONNIE STONE | |||||||||||||
| 165166 | 0 | 52914 | 0 | 0 | 0 | 336 | 0 | 10884 | 0 | 229300 | 0 | 0 | 0 |
| BETTY ANN SECRIST | |||||||||||||
| 175688 | 0 | 0 | 0 | 0 | 0 | 761 | 0 | 592 | 0 | 177041 | 0 | 0 | 0 |
Form990 Schedule J Part III Form990ScheduleJPartIII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | SUPPLEMENTAL RETIREMENT PLAN | Identifier |
| Return Reference | SCHEDULE J, PART I, LINE 4B | ReturnReference |
| Explanation | KENNETH SAMET MR. SAMET'S OTHER REPORTABLE COMPENSATION IN PART II, COLUMN (B) (III) INCLUDES $3,465,504 REPRESENTING HIS ACCRUED BENEFIT IN A SUPPLEMENTAL RETIREMENT PLAN, WHICH WAS EARNED DURING THE PAST 23 YEARS OF SERVICE. THIS AMOUNT WAS NOT ACTUALLY PAID DURING THIS REPORTING PERIOD, BUT WAS REPORTED AS COMPENSATION UNDER FICA TAX-REPORTING RULES. | Explanation |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (10 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| EXEMPT PURPOSE ACHIEVEMENTS | PART III, LINE 4A | MMMC IS AN ACCREDITED COMMUNITY CANCER CENTER BY THE COMMISSION ON CANCER, COLLEGE OF SURGEONS, AND THE SOCIETY OF CHEST PAIN CENTERS. IT IS ALSO A RECIPIENT OF THE JOINT COMMISSION PRIMARY STROKE CENTER CERTIFICATION. FOR THE THIRD CONSECUTIVE YEAR, MMMC WAS THE RECIPIENT OF THE DELMARVA FOUNDATION FOR MEDICAL CARE'S EXCELLENCE AWARD FOR QUALITY IMPROVEMENT IN HOSPITALS. |
| BYLAWS REVISIONS - 2012 - MEDSTAR HEALTH, INC. AND AFFILIATED HOSPITALS | PART VI, LINE 4 | DURING THE FISCAL YEAR ENDING JUNE 30, 2012, MEDSTAR HEALTH, INC., A MARYLAND NON-STOCK CORPORATION ("MEDSTAR") REVIEWED ITS BYLAWS AND THE BYLAWS OF NINE MEDSTAR-AFFILIATED HOSPITALS, INCLUDING FRANKLIN SQUARE HOSPITAL CENTER, INC., HARBOR HOSPITAL, INC., MEDSTAR-GEORGETOWN MEDICAL CENTER, INC., MONTGOMERY GENERAL HOSPITAL, INC., NATIONAL REHABILITATION HOSPITAL, INC., ST. MARY'S HOSPITAL OF ST. MARY'S COUNTY, INC., THE GOOD SAMARITAN HOSPITAL OF MARYLAND, INC., THE UNION MEMORIAL HOSPITAL AND WASHINGTON HOSPITAL CENTER CORPORATION (COLLECTIVELY THE "HOSPITALS"). THE REVISED BYLAWS OF MEDSTAR AND THE HOSPITALS WERE DEVELOPED USING A COMMON TEMPLATE BASED ON THE EXISTING MEDSTAR BYLAWS. THE BOARD OF DIRECTORS OF MEDSTAR AND THE BOARD OF DIRECTORS OF EACH HOSPITAL VOTED AND APPROVED THE CHANGES TO THEIR BYLAWS. A SUMMARY OF THE CHANGES TO THE BYLAWS OF MEDSTAR AND THE HOSPITALS IS SET FORTH BELOW. THE BYLAWS CHANGES: (A) CONFORM PROVISIONS TO MARYLAND, DELAWARE AND DISTRICT OF COLUMBIA LAW, AS APPLICABLE, IN MANY CASES TO GIVE GREATER FLEXIBILITY TO MEDSTAR AND THE BOARD OF DIRECTORS OF EACH HOSPITAL); (B) CONFORM PROVISIONS TO MAXIMIZE UNIFORMITY AMONG THE HOSPITAL BYLAWS (TO THE EXTENT POSSIBLE); (C) REFLECT RECENT DEVELOPMENTS IN CORPORATE/HOSPITAL GOVERNANCE; (D) CLARIFY CERTAIN CORPORATE PROCEDURES; AND (E) CONFORM LANGUAGE AND STYLE. |
| ORGANIZATION MEMBERS | PART VI, LINE 6 | THE ORGANIZATION IS AN AFFILIATE AND SUBSIDIARY OF MEDSTAR HEALTH, INC., A TAX-EXEMPT MARYLAND NON-STOCK CORPORATION. MEDSTAR HEALTH, INC., OR ONE OF ITS AFFILIATES AND SUBSIDIARIES, IS THE SOLE MEMBER OF THE ORGANIZATION. |
| DESCRIPTION OF MEMBERS | PART VI, LINES 7A | AS AN AFFILIATE AND SUBSIDIARY OF MEDSTAR HEALTH, INC., A TAX-EXEMPT MARYLAND NON-STOCK CORPORATION, THE ORGANIZATION MAY RECOMMEND PERSON(S) FOR MEMBERSHIP ON THE ORGANIZATION'S GOVERNING BODY. ANY SUCH RECOMMENDATION BY THE ORGANIZATION IS SUBJECT TO APPROVAL BY THE GOVERNANCE COMMITTEE OF THE BOARD OF DIRECTORS OF MEDSTAR HEALTH, INC. THE BOARD OF MEDSTAR HEALTH, INC. HAS DELEGATED CERTAIN APPROVAL AUTHORITY TO THE GOVERNANCE COMMITTEE AND THE PRESIDENT & CEO OF MEDSTAR HEALTH, INC. DECISIONS OF GOVERNING BODY PART VI, LINES 7B AS AN AFFILIATE AND SUBSIDIARY OF MEDSTAR HEALTH, INC., A TAX-EXEMPT MARYLAND NON-STOCK CORPORATION, THE BYLAWS OF THE ORGANIZATION ARE SUBJECT TO CERTAIN RESERVED POWERS, WHICH PROVIDE THAT THE SOLE MEMBER OF THE ORGANIZATION MUST APPROVE CERTAIN DECISIONS, INCLUDING BUT NOT LIMITED TO MATTERS CONCERNING THE SALE OR PURCHASE OF REAL OR PERSONAL PROPERTY, CAPITAL BUDGETS, STRATEGIC PLANNING, INVESTMENTS, AND CORPORATE GOVERNANCE. |
| FORM 990 REVIEW PROCESS | PART VI, LINE 11A | THE PROCESS FOR REVIEWING THE FORM 990 INCLUDED EDUCATION AND TRANSPARENCY. SENIOR FINANCIAL EXECUTIVES, WORKING WITH INDEPENDENT OUTSIDE EXPERTS, THOROUGHLY REVIEWED FORM 990 AND ACCOMPANYING INSTRUCTIONS. IN ADDITION, SENIOR EXECUTIVES REVIEWED THE RELEVANT SECTIONS OF THE FORM 990 WITH THE FOLLOWING COMMITTEES OF THE ORGANIZATION'S GOVERNING BODY: FINANCE, AUDIT, GOVERNANCE, STRATEGIC PLANNING, AND EXECUTIVE COMPENSATION. FOLLOWING THESE MEETINGS, THE GOVERNING BODY WAS PROVIDED A COPY OF THE FORM 990 IN ITS FINAL FORM AND GIVEN AN OPPORTUNITY TO PROVIDE ANY INPUT OR COMMENTS RELATING TO THE FORM 990 PRIOR TO ITS FILING. |
| CONFLICT OF INTEREST POLICY | PART VI, LINE 12C | APPOINTMENT OF BOARDS OF DIRECTORS MEDSTAR HEALTH (AND ITS SUBSIDIARIES) REQUIRE ALL NOMINATED DIRECTORS, PRIOR TO THEIR APPOINTMENT OR ELECTION, TO DISCLOSE THE EXISTENCE OF (OR POTENTIAL EXISTENCE OF) ANY TRANSACTION WITH MEDSTAR THAT WOULD RESULT IN A CONFLICT OF INTEREST. SUCH DISCLOSURES (IF ANY) ARE REVIEWED BY THE GOVERNANCE COMMITTEE OF THE MEDSTAR HEALTH BOARD OF DIRECTORS WHICH DETERMINES HOW THE MATTER SHOULD BE RESOLVED. ANNUAL DISCLOSURES - ALL OFFICERS, DIRECTORS, AND SENIOR MANAGERS ALL OFFICERS, DIRECTORS AND SENIOR MANAGERS ARE REQUIRED, NOT LESS THAN ANNUALLY, TO COMPLETE A SURVEY OF QUESTIONS CONCERNING ANY TRANSACTIONS OR RELATIONSHIPS WHICH WOULD OR COULD REPRESENT A CONFLICT OF INTEREST. SUCH DISCLOSURES (IF ANY) RELATED TO DIRECTORS ARE REVIEWED BY THE GOVERNANCE COMMITTEE OF THE MEDSTAR HEALTH BOARD OF DIRECTORS WHICH DETERMINES HOW THE MATTER SHOULD BE RESOLVED. SUCH DISCLOSURES (IF ANY) RELATED TO OFFICERS AND SENIOR MANAGERS ARE REVIEWED BY AN APPROPRIATE EXECUTIVE WHO DETERMINES HOW THE MATTER SHOULD BE RESOLVED. IN ADDITION, OFFICERS AND DIRECTORS OF MARYLAND HOSPITALS AND NURSING CENTERS ARE REQUIRED TO ANNUALLY DISCLOSE ADDITIONAL INFORMATION RELATING TO POTENTIAL CONFLICTS OF INTEREST AND SUCH DISCLOSURES ARE REPORTED TO THE MARYLAND HEALTH SERVICES COST REVIEW COMMISSION (HSCRC). |
| EXECUTIVE COMPENSATION PROCESS | PART VI, LINE 15 | THE EXECUTIVE COMPENSATION COMMITTEE OF THE BOARD OF DIRECTORS OF MEDSTAR HEALTH, INC. (THE "COMMITTEE") HAS OVERSIGHT OVER THE EXECUTIVE COMPENSATION PROGRAM (THE "PROGRAM") OF MEDSTAR HEALTH, INC. AND ITS AFFILIATES. TOTAL COMPENSATION FOR THE TOP MANAGEMENT OFFICIALS, OFFICERS AND KEY EMPLOYEES OF MEDSTAR HEALTH, INC. AND ITS AFFILIATES ARE REVIEWED AND APPROVED BY THE COMMITTEE WITH ASSISTANCE AND GUIDANCE FROM AN INDEPENDENT THIRD PARTY ADVISOR. THE MEMBERS OF THE COMMITTEE ARE INDEPENDENT FROM ALL OF THE PARTICIPANTS IN THE PROGRAM. THE MAIN OBJECTIVE OF THE PROGRAM IS TO PROVIDE MARKET COMPETITIVE TOTAL COMPENSATION THAT IS INTERNALLY EQUITABLE AND HAS A STRONG PAY-FOR-PERFORMANCE LINKAGE. PERFORMANCE IS EVALUATED AT THE SYSTEM, OPERATING UNIT, AND INDIVIDUAL LEVELS. THE OVERALL TOTAL COMPENSATION PHILOSOPHY IS MANAGED AT THE 75TH PERCENTILE OF THE COMPETITIVE MARKET FOR COMPARABLE SIZE (NET REVENUE) AND TYPE ("TAX-EXEMPT HEALTHCARE ORGANIZATIONS"). WHERE APPROPRIATE, ADDITIONAL INDUSTRY DATA IS CONSIDERED (GENERAL BUSINESS AND/OR TAXABLE HEALTHCARE) FOR SELECTED POSITIONS THAT CAN BE RECRUITED FROM OR POTENTIALLY LOST TO THESE INDUSTRIES (E.G., INFORMATION TECHNOLOGY, FINANCE, ETC.). THE COMMITTEE HAS ENGAGED ERNST & YOUNG LLP ("E&Y") TO SERVE AS AN ADVISOR ON THE REASONABLENESS AND COMPETITIVENESS OF THE PROGRAM. IN DETERMINING REASONABLENESS AND COMPETITIVENESS, E&Y REVIEWS MARKET PRACTICES AND TRENDS, AND MAKES RECOMMENDATIONS RELATED TO THE PROGRAM. E&Y UTILIZES INFORMATION FROM CUSTOM SURVEYS, NATIONAL COMPENSATION SURVEYS, PROPRIETARY DATABASES, AND CLIENT EXPERIENCES TO DETERMINE ITS FINAL RECOMMENDATIONS. E&Y PRESENTS THEIR FINDINGS AND RECOMMENDATIONS TO THE COMMITTEE. THE COMMITTEE MAKES THE FINAL DECISIONS ON ALL OF THE COMPENSATION DETERMINATIONS OF THE PROGRAM. ALL DECISIONS MADE BY THE COMMITTEE ARE CONTEMPORANEOUSLY DOCUMENTED. |
| FINANCIAL STATEMENT AVAILABILITY | PART VI, LINE 19 | MEDSTAR HEALTH POSTS ITS ANNUAL FINANCIAL AUDIT AND QUARTERLY FINANCIAL REPORTS TO THE ELECTRONIC MUNICIPAL MARKET ACCESS (EMMA) SYSTEM. THE ORGANIZATION ALSO E-MAILS ITS ANNUAL AND QUARTERLY DISCLOSURES TO HOLDERS OF THE COMPANY'S PUBLICLY TRADED DEBT. THE COMPANY'S GOVERNANCE DOCUMENTS AND CONFLICTS OF INTEREST POLICIES ARE AVAILABLE UPON REQUEST THROUGH ITS CORPORATE (OR AS APPLICABLE ENTITY) PUBLIC INFORMATION OFFICES |
| OTHER CHANGES IN NET ASSETS | PART XI, LINE 5 | UNREALIZED GAIN - OTHER INVESTMENTS.........................$ 2,159 EQUITY TRANSFER........................................... $243,299 ============= TOTAL $245,458 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:KENNETH A SAMET TITLE:DIRECTOR HOURS:40 |
Schedule R IRS990ScheduleR
Form990 Schedule R Part I Form990ScheduleRPartI
Name Of Disregarded Entity NameOfDisregardedEntity
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MEDSTAR HEALTH ANESTHESIA SERVICES E LLC | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 18101 PRINCE PHILIP DRIVE | AddressLine1 |
| City | OLNEY | City |
| State | MD | State |
| ZIP Code | 20832 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 262918268 | EIN |
| Primary Activities | HEALTH SVCS | PrimaryActivities |
| Legal Domicile State | MD | LegalDomicileState |
| Total Income | 4199423 | TotalIncome |
| EOY Assets | 389833 | EOYAssets |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | NA | BusinessNameLine1 |
Form990 Schedule R Part II Form990ScheduleRPartII (38 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 |
|---|---|---|---|---|---|---|---|---|---|---|
| CHURCH HOME CORPORATION | ||||||||||
| 5565 STERRETT PLACE 5TH FLOOR | COLUMBIA | MD | 21044 | 237374724 | MEDICAL FUND | MD | 501(c)(3) | PF | NA | true |
| FRANKLIN SQUARE HOSPITAL CENTER INC | ||||||||||
| 9000 FRANKLIN SQUARE DRIVE | BALTIMORE | MD | 21237 | 520608007 | HOSPITAL | MD | 501(c)(3) | 3 | NA | true |
| HARBOR HOSPITAL INC | ||||||||||
| 3001 SOUTH HANOVER STREET | BALTIMORE | MD | 21225 | 520491660 | HOSPITAL | MD | 501(c)(3) | 3 | NA | true |
| MEDSTAR HEALTH INC | ||||||||||
| 5565 STERRETT PLACE 5TH FLOOR | COLUMBIA | MD | 21044 | 522087445 | MEDICAL SVCS | MD | 501(c)(3) | 11b II | NA | false |
| THE GOOD SAMARITAN HOSPITAL OF MARYLAND | ||||||||||
| 5601 LOCH RAVEN BLVD | BALTIMORE | MD | 21239 | 520591607 | HOSPITAL | MD | 501(c)(3) | 3 | NA | true |
| THE UNION MEMORIAL HOSPITAL | ||||||||||
| 201 EAST UNIVERSITY PARKWAY | BALTIMORE | MD | 21218 | 520591685 | HOSPITAL | MD | 501(c)(3) | 3 | NA | true |
| MEDSTAR HEALTH RESEARCH INSTITUTE | ||||||||||
| 108 IRVING STREET NW | WASHINGTON | DC | 20010 | 526056274 | HOSPITAL | DC | 501(c)(3) | 3 | NA | true |
| THE MEDSTAR-GEORGETOWN MEDICAL CENTER I | ||||||||||
| HOPSITAL ADMIN 1 MAIN BLDG | WASHINGTON | DC | 20007 | 522218584 | HOSPITAL | DC | 501(c)(3) | 3 | NA | true |
| WASHINGTON HOSPITAL CENTER CORPORATION | ||||||||||
| 110 IRVING STREET NW | WASHINGTON | DC | 20010 | 521272129 | HOSPITAL | DC | 501(c)(3) | 3 | NA | true |
| HH MEDSTAR HEALTH INC | ||||||||||
| 5565 STERRETT PLACE 5TH FLOOR | COLUMBIA | MD | 21044 | 521542230 | MEDICAL SVCS | MD | 501(c)(3) | 11b II | NA | true |
| BAY DEVELOPMENT CORP | ||||||||||
| 5565 STERRETT PLACE 5TH FLOOR | COLUMBIA | MD | 21044 | 521132992 | FOUNDATION | MD | 501(c)(3) | 11a I | NA | true |
| BAY LIFE SERVICES INC | ||||||||||
| 5565 STERRETT PLACE 5TH FLOOR | COLUMBIA | MD | 21044 | 521496539 | MENTAL HEALTH | MD | 501(c)(3) | 9 | NA | true |
| MEDSTAR SURGERY CENTER INC | ||||||||||
| 4061 POWDERMILL ROAD SUITE 210 | CALVERTON | MD | 20705 | 521061679 | MEDICAL SVCS | MD | 501(c)(3) | 9 | NA | true |
| CHURCH HOME AND HOSPITAL OF THE CITY OF | ||||||||||
| 5565 STERRETT PLACE 5TH FLOOR | COLUMBIA | MD | 21044 | 520591600 | HOSPITAL | MD | 501(c)(3) | 3 | NA | true |
| FRANKLIN SQUARE HOSPITAL CENTER FOUNDATI | ||||||||||
| 9000 FRANKLIN SQUARE DRIVE | BALTIMORE | MD | 21237 | 522329546 | FOUNDATION | MD | 501(c)(3) | 11a I | NA | true |
| GOOD SAMARITAN HOSPITAL FOUNDATION INC | ||||||||||
| 5601 LOCH RAVEN BLVD | BALTIMORE | MD | 21239 | 522307122 | FOUNDATION | MD | 501(c)(3) | 11a I | NA | true |
| GOOD SAMARITAN NURSING CENTER INC | ||||||||||
| 5601 LOCH RAVEN BLVD | BALTIMORE | MD | 21239 | 521672866 | MEDICAL SVCS | MD | 501(c)(3) | 9 | NA | true |
| GS HOUSING INC | ||||||||||
| 5601 LOCH RAVEN BLVD | BALTIMORE | MD | 21239 | 521481656 | ELDER HOUSING | MD | 501(c)(3) | 9 | NA | true |
| GS PROPERTIES INC | ||||||||||
| 5601 LOCH RAVEN BLVD | BALTIMORE | MD | 21239 | 521429853 | ADMIN SVCS | MD | 501(c)(3) | 11a I | NA | true |
| HARBOR HOSPITAL FOUNDATION INC | ||||||||||
| 3001 SOUTH HANOVER STREET | BALTIMORE | MD | 21225 | 521284532 | FOUNDATION | MD | 501(c)(3) | 11a I | NA | true |
| MEDSTAR HEALTH INFUSION INC | ||||||||||
| 4061 POWDERMILL ROAD SUITE 210 | CALVERTON | MD | 20705 | 521980510 | MEDICAL SVCS | MD | 501(c)(3) | 9 | NA | true |
| MEDSTAR HEALTH VISITING NURSES ASSOCIATI | ||||||||||
| 4061 POWDERMILL ROAD | CALVERTON | MD | 20705 | 530196597 | MEDICAL SVCS | MD | 501(c)(3) | 9 | NA | true |
| MEDSTAR VNA HEALTHCARE | ||||||||||
| 4061 POWDERMILL ROAD SUITE 210 | CALVERTON | MD | 20705 | 521458516 | MEDICAL SVCS | MD | 501(c)(3) | 9 | NA | true |
| MGH COMMUNITY HEALTH INC | ||||||||||
| 18101 PRINCE PHILIP DRIVE | OLNEY | MD | 20832 | 521372467 | MEDICAL SVCS | MD | 501(c)(3) | 9 | NA | true |
| MGH HEALTH FOUNDATION INC | ||||||||||
| 18101 PRINCE PHILIP DRIVE | OLNEY | MD | 20832 | 521129959 | FOUNDATION | MD | 501(c)(3) | 7 | NA | true |
| MGH HEALTH SERVICES INC | ||||||||||
| 18101 PRINCE PHILIP DRIVE | OLNEY | MD | 20832 | 521366812 | FOUNDATION | MD | 501(c)(3) | 11a I | NA | true |
| MGH WOMEN'S BOARD | ||||||||||
| 18101 PRINCE PHILIP DRIVE | OLNEY | MD | 20832 | 526039600 | FOUNDATION | MD | 501(c)(3) | 11a I | NA | true |
| NATIONAL REHABILITATION HOSPITAL | ||||||||||
| 102 IRVING STREET NW | WASHINGTON | DC | 20010 | 521369749 | HOSPITAL | DC | 501(c)(3) | 3 | NA | true |
| REGIONAL REHAB AT OLNEY INC | ||||||||||
| 18101 PRINCE PHILIP DRIVE | OLNEY | MD | 20832 | 522310902 | MEDICAL SVCS | MD | 501(c)(3) | 3 | NA | true |
| SUBURBAN NRH MEDICAL REHABILITATION I | ||||||||||
| 102 IRVING STREET NW | WASHINGTON | DC | 20010 | 521931151 | MEDICAL SVCS | DC | 501(c)(3) | 3 | NA | true |
| THE THOMAS O'NEIL CATHOLIC HEALTH CARE F | ||||||||||
| 5601 LOCH RAVEN BLVD | BALTIMORE | MD | 21239 | 521104382 | FOUNDATION | MD | 501(c)(3) | 11a I | NA | true |
| UNION MEMORIAL HOSPITAL FOUNDATION INC | ||||||||||
| 201 EAST UNIVERSITY PARKWAY | BALTIMORE | MD | 21218 | 521446828 | FOUNDATION | MD | 501(c)(3) | 11a I | NA | true |
| VNA INC | ||||||||||
| 4061 POWDERMILL ROAD SUITE 210 | CALVERTON | MD | 20705 | 521332411 | ADMIN SVCS | MD | 501(c)(3) | 11a I | NA | true |
| WHC FOUNDATION INC | ||||||||||
| 110 IRVING STREET NW | WASHINGTON | DC | 20010 | 521791670 | FOUNDATION | DC | 501(c)(3) | 11a I | NA | true |
| WOODBOURNE WOODS INC | ||||||||||
| 5601 LOCH RAVEN BLVD | BALTIMORE | MD | 21239 | 522299070 | ELDER HOUSING | MD | 501(c)(3) | 9 | NA | true |
| HOSPICE OF ST MARY'S INC | ||||||||||
| PO BOX 527 | LEONARDTOWN | MD | 20650 | 522153926 | SUPPORT ORG | MD | 501(c)(3) | 11b II | NA | true |
| ST MARY'S HOSPITAL OF ST MARY'S COUNTY | ||||||||||
| 25500 POINT LOOKOUT ROAD | LEONARDTOWN | MD | 20650 | 520619006 | HOSPITAL | MD | 501(c)(3) | 3 | NA | true |
| ST MARY'S HOSPITAL FOUNDATION INC | ||||||||||
| PO BOX 527 | LEONARDTOWN | MD | 20650 | 521051368 | SUPPORT ORG | MD | 501(c)(3) | 11d III | NA | true |
Form990 Schedule R Part III Form990ScheduleRPartIII (3 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 |
|---|---|---|---|---|---|---|---|---|---|
| SURGICENTER AT PASADENA LLC | |||||||||
| 5565 STERRETT PLACE 5TH FLOOR | COLUMBIA | MD | 21044 | 522009504 | MEDICAL SERVI | MD | NA | RELATED | false |
| SJMC-RA LLC | |||||||||
| 5565 STERRETT PLACE 5TH FLOOR | COLUMBIA | MD | 21044 | 753160895 | RADIATION THE | MD | NA | RELATED | false |
| PHYSICIAN IMAGING OF WASHINGTON HOSPITAL | |||||||||
| 6525 BELCREST ROAD SUITE G 50 | HYATTSVILLE | MD | 20782 | 562616090 | LAB SERVICES | MD | NA | RELATED | false |
Form990 Schedule R Part IV Form990ScheduleRPartIV (19 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivityPrimaryActivity | Legal Domicile StateLegalDomicileState | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Type Of EntityTypeOfEntity | Share Of Total IncomeShareOfTotalIncome | Share Of EOY AssetsShareOfEOYAssets | Percentage OwnershipPercentageOwnership |
|---|---|---|---|---|---|---|---|---|---|---|---|
| MEDSTAR PHARMACIES INC | |||||||||||
| 5565 STERRETT PLACE 5TH FLOOR | COLUMBIA | MD | 21044 | 521513056 | DRUG SALES | MD | NA | C CORP | |||
| EXTENCARE INC | |||||||||||
| 5565 STERRETT PLACE 5TH FLOOR | COLUMBIA | MD | 21044 | 521556228 | MEDICAL SERVI | MD | NA | C CORP | |||
| HELIX RESOURCES MANAGEMENT INC | |||||||||||
| 5565 STERRETT PLACE 5TH FLOOR | COLUMBIA | MD | 21044 | 521913070 | ADMIN SERVICE | MD | NA | C CORP | |||
| HELIXCARE MEDICAL GROUP LLC | |||||||||||
| 5565 STERRETT PLACE 5TH FLOOR | COLUMBIA | MD | 21044 | 521955580 | MEDICAL SERVI | MD | NA | C CORP | |||
| HELIXCARE PROPERTIES LLC | |||||||||||
| 5565 STERRETT PLACE 5TH FLOOR | COLUMBIA | MD | 21044 | 521966695 | MEDICAL SERVI | MD | NA | C CORP | |||
| PARKWAY VENTURES INC | |||||||||||
| 5565 STERRETT PLACE 5TH FLOOR | COLUMBIA | MD | 21044 | 521893569 | HOLDING COMPA | MD | NA | C CORP | |||
| PHYSICIANS ADMINISTRATIVE SERVICES INC | |||||||||||
| 5565 STERRETT PLACE 5TH FLOOR | COLUMBIA | MD | 21044 | 237042074 | BILLING SERVI | MD | NA | C CORP | |||
| MEDSTAR FAMILY CHOICE INC | |||||||||||
| 5565 STERRETT PLACE 5TH FLOOR | COLUMBIA | MD | 21044 | 521995521 | MANAGED CARE | MD | NA | C CORP | |||
| MEDSTAR ENTERPRISES INC | |||||||||||
| 4061 POWDERMILL ROAD SUITE 210 | CALVERTON | MD | 20705 | 522139841 | ADMIN SERVICE | MD | NA | C CORP | |||
| NASCOTT INC | |||||||||||
| 4061 POWDERMILL ROAD SUITE 210 | CALVERTON | MD | 20705 | 521693808 | MEDICAL SERVI | MD | NA | C CORP | |||
| STAR BILLING INC | |||||||||||
| 4061 POWDERMILL ROAD SUITE 210 | CALVERTON | MD | 20705 | 521850113 | BILLING SERVI | MD | NA | C CORP | |||
| WASHINGTON RISK NETWORK MANAGEMENT INC | |||||||||||
| 4061 POWDERMILL ROAD SUITE 210 | CALVERTON | MD | 20705 | 522132677 | MEDICAL SERVI | MD | NA | C CORP | |||
| WASHINGTON HOSPITAL CENTER PHYSICIAN HOS | |||||||||||
| 100 IRVING STREET NW | WASHINGTON | DC | 20010 | 521931000 | MEDICAL SERVI | MD | NA | C CORP | |||
| MEDSTAR PHYSICIAN PARTNERS INC | |||||||||||
| 4061 POWDERMILL ROAD SUITE 210 | CALVERTON | MD | 20705 | 522030809 | MEDICAL SERVI | MD | NA | C CORP | |||
| NRH AMBULATORY SERVICES INC | |||||||||||
| 102 IRVING STREET NW | WASHINGTON | DC | 20010 | 521930165 | REHAB SERVICE | MD | NA | C CORP | |||
| FRANKLIN SQUARE DRIVE LAND CONDO ASSOCIA | |||||||||||
| 5565 STERRETT PLACE 5TH FLOOR | COLUMBIA | MD | 21044 | 760756352 | CONDO OWNER A | MD | NA | C CORP | |||
| MGH DIVERSIFIED SERVICES INC | |||||||||||
| 18101 PRINCE PHILIP DRIVE | OLNEY | MD | 20832 | 521943602 | MEDICAL SERVI | MD | NA | C CORP | 132340 | 3182316 | 1.00000 |
| ST MARY'S HEALTH ALLIANCE INC | |||||||||||
| 25500 POINT LOOKOUT ROAD | LEONARDTOWN | MD | 20650 | 521930331 | MEDICAL SERVI | MD | NA | C CORP | |||
| GREENSPRING FINANCIAL INSURANCE LIMITED | |||||||||||
| 5601 LOCH RAVEN BLVD | BALTIMORE | MD | 21239 | 980188617 | INSURANCE | MD | NA | C CORP | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | false | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | false | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | false | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | false | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | false | LoansOrGuaranteesFromOtherOrg |
| Sale Of Assets To Other Org | false | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | false | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | false | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | false | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | false | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | false | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | false | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | false | SharingOfFacilities |
| Sharing Of Paid Employees | false | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | true | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | true | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | false | OtherTransferToOtherOrg |
| Other Transfer From Other Org | false | OtherTransferFromOtherOrg |
Comments