LUCY WEBB HAYNES NATIONAL TRAINING SCHOOL FOR DEACONESSES AND MISSION: Form 990, tax year 2011

View the entire original 990 at ProPublica ↗

Organization
LUCY WEBB HAYNES NATIONAL TRAINING SCHOOL FOR DEACONESSES AND MISSION (EIN 53-0196602)
Tax period
2011-07-01 to 2012-06-30
Filed
2013-05-10
IRS object ID
201301309349301975
Schema version
2011v1.2
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

FieldValueIRS element (for citing)
Timestamp2013-05-10T12:22:19-05:00Timestamp
Tax Period End Date2012-06-30TaxPeriodEndDate
Return Type990ReturnType
Tax Period Begin Date2011-07-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN530196602EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1LUCY WEBB HAYES NATIONAL TRAINING SCHOOLBusinessNameLine1
Business Name Line2FOR DEACONESSES & MISSIONARIESBusinessNameLine2
FieldValueIRS element (for citing)
Name ControlLUCYNameControl
Phone2025374000Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line15255 LOUGHBORO RD NWAddressLine1
CityWASHINGTONCity
StateDCState
ZIP Code20016ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameROBERT L SLOANName
TitleSR VP, COO, & CFOTitle
Phone2025374000Phone
Date Signed2013-05-06DateSigned
FieldValueIRS element (for citing)
Tax Year2011TaxYear
Build TS2016-02-25 16:41:14ZBuildTS

Form 990 IRS990

Doing Business As DoingBusinessAs

FieldValueIRS element (for citing)
Business Name Line1SIBLEY MEMORIAL HOSPITALBusinessNameLine1
FieldValueIRS element (for citing)
Name Of Principal Officer PersonRICHARD O DAVISNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line15255 LOUGHBORO RD NWAddressLine1
CityWASHINGTONCity
StateDCState
ZIP Code20016ZIPCode
FieldValueIRS element (for citing)
Gross Receipts1107797814GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501c3XOrganization501c3
Web SiteWWW.SIBLEY.ORGWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1891YearFormation
State Legal DomicileDCStateLegalDomicile
Activity Or Mission DescriptionTHE 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 Body26NbrVotingMembersGoverningBody
Nbr Independent Voting Members22NbrIndependentVotingMembers
Total Nbr Employees2004TotalNbrEmployees
Total Nbr Volunteers197TotalNbrVolunteers
Total Gross UBI192502TotalGrossUBI
Net Unrelated Business Txbl Income-24657NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year83464ContributionsGrantsPriorYear
Contributions Grants Current Year110066ContributionsGrantsCurrentYear
Program Service Revenue Prior Year123975332ProgramServiceRevenuePriorYear
Program Service Revenue CY246266626ProgramServiceRevenueCY
Investment Income Prior Year11932629InvestmentIncomePriorYear
Investment Income Current Year14536799InvestmentIncomeCurrentYear
Other Revenue Prior Year2080340OtherRevenuePriorYear
Other Revenue Current Year4459719OtherRevenueCurrentYear
Total Revenue Prior Year138071765TotalRevenuePriorYear
Total Revenue Current Year265373210TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year100000GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY697393GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year64005732SalariesEtcPriorYear
Salaries Etc Current Year133235716SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year55067882OtherExpensePriorYear
Other Expenses Current Year106148240OtherExpensesCurrentYear
Total Expenses Prior Year119173614TotalExpensesPriorYear
Total Expenses Current Year240081349TotalExpensesCurrentYear
Revenues Less Expenses Prior Year18898151RevenuesLessExpensesPriorYear
Revenues Less Expenses CY25291861RevenuesLessExpensesCY
Total Assets BOY972401974TotalAssetsBOY
Total Assets EOY973001610TotalAssetsEOY
Total Liabilities BOY203029737TotalLiabilitiesBOY
Total Liabilities EOY198386791TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY769372237NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY774614819NetAssetsOrFundBalancesEOY
Info In Schedule O Part IIIXInfoInScheduleOPartIII
Mission DescriptionTHE 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 Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense221345186Expense
Grants697393Grants
Revenue249648680Revenue
DescriptionPROVIDE 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, 2011 TO JUNE 30, 2012. THE PREVIOUS RETURN WAS FOR THE 6 MONTH ACCOUNTING PERIOD OF JANUARY 1 TO JUNE 30, 2011. 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 2012, THE HOSPITAL PROVIDED CHARITY CARE TO MORE THAN 1,300 PATIENTS, INCURRING COSTS OVER $3.1 MILLION. TOTAL BENEFITS AND UNCOMPENSATED COST OF CARE PROVIDED TO THE COMMUNITY EXCEEDED $ 6.6 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 OVER 15,300 PATIENTS IN 2012, AND PROVIDED OVER 68,000 DAYS OF INPATIENT CARE. OVER 3,500 NEW BABIES WERE DELIVERED AS WELL. OVER 33,000 PATIENTS WERE TREATED IN OUR 24/7 EMERGENCY ROOM, AND OVER 138,000 PATIENTS RECEIVED SURGICAL, ENDOSCOPIC OR OTHER ANCILLIARY OUTPATIENT TREATMENTS OR PROCEDURES.Description
Total Program Service Expense221345186TotalProgramServiceExpense
Described In501 C31DescribedIn501C3
Schedule B Required1ScheduleBRequired
Political Activities0PoliticalActivities
Lobbying Activities0LobbyingActivities
Subject To Proxy Tax0SubjectToProxyTax
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling1CreditCounseling
Term Or Permanent Endowments0TermOrPermanentEndowments
Report Land Bldg Equip1ReportLandBldgEquip
Report Invest Oth Securities1ReportInvestOthSecurities
Report Prog Rel Invest0ReportProgRelInvest
Report Other Assets1ReportOtherAssets
Report Other Liabilities1ReportOtherLiabilities
Report Fin48 Footnote1ReportFin48Footnote
Independent Audit Financial Stmt0IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt1ConsolidatedAuditFinancialStmt
School0School
Foreign Office0ForeignOffice
Foreign Activities0ForeignActivities
More Than5000 K To Organizations0MoreThan5000KToOrganizations
More Than5000 K To Individuals0MoreThan5000KToIndividuals
Professional Fundraising0ProfessionalFundraising
Fundraising Activities0FundraisingActivities
Gaming0Gaming
Hospital1Hospital
Financial Stmt Attached1FinancialStmtAttached
Grants To Organizations1GrantsToOrganizations
Grants To Individuals0GrantsToIndividuals
Schedule J Required1ScheduleJRequired
Tax Exempt Bonds1TaxExemptBonds
Invest Tax Exempt Bonds0InvestTaxExemptBonds
Escrow Account0EscrowAccount
On Behalf Of Issuer0OnBehalfOfIssuer
Excess Benefit Transaction0ExcessBenefitTransaction
Prior Excess Benefit Transaction0PriorExcessBenefitTransaction
Loan To Officer Or DQP0LoanToOfficerOrDQP
Grant To Related Person0GrantToRelatedPerson
Bsnss Rltnshp With Organization0BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member0BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp0OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions0DeductibleNonCashContributions
Deductible Contributions Of Art0DeductibleContributionsOfArt
Terminated0Terminated
Partial Liquidation0PartialLiquidation
Disregarded Entity0DisregardedEntity
Related Entity1RelatedEntity
Related Org Controlled Entity1RelatedOrgControlledEntity
Transaction Related Entity1TransactionRelatedEntity
Transfers To Exempt Non Chrtbl Org0TransfersToExemptNonChrtblOrg
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With1096208NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup Witholding1ComplianceWithBackupWitholding
Number Of Employees2004NumberOfEmployees
Employment Tax Returns Filed1EmploymentTaxReturnsFiled
Unrelated Business Income1UnrelatedBusinessIncome
Form990-T Filed1Form990-TFiled
Foreign Financial Account0ForeignFinancialAccount
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTrans
Taxable Party Notification0TaxablePartyNotification
Non Deductible Contributions0NonDeductibleContributions
Quid Pro Quo Contributions0QuidProQuoContributions
Form8282 Property Disposed Of0Form8282PropertyDisposedOf
Funds To Pay Premiums0FundsToPayPremiums
Premiums Paid0PremiumsPaid
Indoor Tanning Services0IndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members26NbrVotingGoverningBodyMembers
Number Independent Voting Members22NumberIndependentVotingMembers
Family Or Business Relationship0FamilyOrBusinessRelationship
Delegation Of Management Duties0DelegationOfManagementDuties
Changes To Organizing Docs0ChangesToOrganizingDocs
Material Diversion Or Misuse0MaterialDiversionOrMisuse
Members Or Stockholders0MembersOrStockholders
Election Of Board Members1ElectionOfBoardMembers
Decisions Subject To Approval1DecisionsSubjectToApproval
Minutes Of Governing Body1MinutesOfGoverningBody
Minutes Of Committees1MinutesOfCommittees
Officer Mailing Address0OfficerMailingAddress
Local Chapters0LocalChapters
Form990 Provided To Governing Body1Form990ProvidedToGoverningBody
Conflict Of Interest Policy1ConflictOfInterestPolicy
Annual Disclosure Covered Persons1AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement1RegularMonitoringEnforcement
Whistleblower Policy1WhistleblowerPolicy
Document Retention Policy1DocumentRetentionPolicy
Compensation Process CEO1CompensationProcessCEO
Compensation Process Other1CompensationProcessOther
Investment In Joint Venture0InvestmentInJointVenture
States Where Copy Of Return Is FiledDCStatesWhereCopyOfReturnIsFiled
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1STEPHEN MCDONNELLBusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number2025374680TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line15255 LOUGHBORO RD NWAddressLine1
CityWASHINGTONCity
StateDCState
ZIP Code20016ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (40 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationOfficerOfficerHighest Compensated EmployeeHighestCompensatedEmployeeFormerFormer
REV DAVID A ARGO
TRUSTEE5.00X000
WILLIAM B BARTON ESQ
VICE CHAIRMAN, TRUSTEE5.00X000X
GEOFFREY D BROWN
TRUSTEE5.00X000
J RENE CARTER
TRUSTEE5.00X000
CHARLES M COCHRAN JR
TRUSTEE5.00X000
PAUL R ERICKSON
TRUSTEE5.00X000
MICHAEL K FARR
TRUSTEE5.00X000
SAMUAL P HARRINGTON MD
SECRETARY5.00X000X
BURKE F HAYES
TRUSTEE5.00X000
DALE H HOSCHEIT ESQ
TRUSTEE5.00X000
JOHN O MAY
TRUSTEE5.00X000
EDWARD J MILLER JR
CHAIRMAN/TRUSTEE5.00X000X
A WALLACE MOORE JR
TRUSTEE5.00X000
RICHARD E MORRIS
TREASURER5.00X000X
PRISCILLA I PAGANO
TRUSTEE5.00X000
CHARLES H ROSS
TRUSTEE5.00X000
THOMAS J SCHAEFER
TRUSTEE5.00X000
BISHOP JOHN R SCHOL
TRUSTEE5.00X000
ROBERT L SLOAN
PRESIDENT & CEO40.00X2344316082115X
RONALD R PETERSON
TRUSTEE/ CORP VICE CHAIRMAN5.00X017035551777977X
THOMAS H SULLIVAN
TRUSTEE5.00X000
CARL L SYLVESTER JR MD
TRUSTEE5.00X26340000
KIMBERLY H WALTON ESQ
TRUSTEE5.00X000
NILOO HOWE
TRUSTEE5.00X000
THOMAS M MASTERSON MD
TRUSTEE, EX-OFFICIO5.00X6000000
SHARON PERCY ROCKEFELLER
TRUSTEE5.00X000
STEPHEN C MCDONNELL
SR VP, COO & CFO40.00494484070897X
JOAN VINCENT
SR VP, PT. CARE SVCS & CNO40.00643977083527X
ALISON ARNOTT
VP SUPPORT SERVICES40.00150898021539X
QUEENIE PLATER
VP & CHIEF HUMAN RESOURCES OFFICER40.00268305064834X
KENDA TAVAKOLI
VP INFO. RESOURCES & CIO40.00290484055197X
PETER PETRUCCI MD
VP PATIENT SAFETY, QUALITY, MEDICAL AFFAIRS40.00260872024425X
CHRISTINE STUPPY
VP BUS. DEVEL. & STRAT. PLANNING40.00192136031298X
JEFFERY JOYNER
VP PROFESSIONAL SERVICES40.00204754031411X
JEFFREY L LIN
PHYSICIAN DIR GYN ONCOLOGY & SURGERY40.00720801047478X
REBECCA ZUURBIER
PHYSICIAN DIR. BREAST IMAGING40.00501527035744X
JERRY L PRICE
VP REAL ESTATE & CONSTRUCTION40.00619069062587X
HASAN ZIA
PHYSICIAN DIR. INTENSIVE/ACUTE CARE40.00533119030584X
COLETTE M MAGNANT
BREAST SURGEON40.00542638039968X
AUDRY CARTER
FORMER KEY EMPLOYEE40.00214475025549X
FieldValueIRS element (for citing)
Total Reportable Comp From Org8305255TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs1703555TotalReportableCompFrmRltdOrgs
Total Other Compensation2485130TotalOtherCompensation
Number Individuals GT100 K16NumberIndividualsGT100K
Formers Listed1FormersListed
Total Comp GT150 K1TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
JACKSON & CAMPBELL PC
1120 20TH STREET NW 300SWASHINGTONDC20036LEGAL488739
THOMAS A FLEURY MD
5608 OVERLEA RDBETHESDAMD20816PATHOLOGY432600
GITTLESON ZUPPAS
3 BETHESDA METRO CENTER 750BETHESDAMD20814MEDICAL REAL ESTATE378758
ROBERT S KLAPPENBACH MD
2337 BLAINE DRIVECHEVY CHASEMD20815PATHOLOGY298301
MARGARET M SHAFFER MD
11813 HAYFIELD CTPOTOMACMD20854PATHOLOGY294677
FieldValueIRS element (for citing)
Number Of Contractors GT100 K16NumberOfContractorsGT100K
All Other Contributions110066AllOtherContributions
Total Contributions110066TotalContributions

Program Service Revenue ProgramServiceRevenue (5 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncomeUnrelated Business RevenueUnrelatedBusinessRevenue
PATIENT REVENUE621990219094300219094300
ASSISTED LIVING6230001879535818795358
PHYSICIAN BILLING62199064036116403611
MEDICAL OFFICE62199017875941787594
LAB REVENUE621500185763185763
FieldValueIRS element (for citing)
Total Program Service Revenue246266626TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column11098214TotalRevenueColumn
Unrelated Business Revenue6739UnrelatedBusinessRevenue
Exclusion$11,091,475ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities845525152Securities
Other20303Other

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Securities842106870Securities
Other0Other

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities3418282Securities
Other20303Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column3438585TotalRevenueColumn
Related Or Exempt Function Income3438585RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Gross Sales Of Inventory446966GrossSalesOfInventory
Cost Of Goods Sold317734CostOfGoodsSold

Net Income Or Loss NetIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column129232TotalRevenueColumn
Related Or Exempt Function Income129232RelatedOrExemptFunctionIncome

Other Revenue Misc OtherRevenueMisc (3 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnExclusionExclusionAmount
PARKING LOT9000991505404$1,505,404
CAFETERIA/VENDING9000991210169$1,210,169
OTHER INCOME900099966546$966,546

Miscellaneous Revenue MiscellaneousRevenue

FieldValueIRS element (for citing)
Total Revenue Column648368TotalRevenueColumn
Exclusion$648,368ExclusionAmount
FieldValueIRS element (for citing)
Total Other Revenue4330487TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column265373210TotalRevenueColumn
Related Or Exempt Function Income249648680RelatedOrExemptFunctionIncome
Unrelated Business Revenue192502UnrelatedBusinessRevenue
Exclusion$15,421,962ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total697393Total
Program Services697393ProgramServices

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total5469297Total
Program Services5173955ProgramServices
Management And General295342ManagementAndGeneral

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total104973164Total
Program Services94837568ProgramServices
Management And General10135596ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total6016461Total
Program Services5691572ProgramServices
Management And General324889ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total9013364Total
Program Services8357670ProgramServices
Management And General655694ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total7763430Total
Program Services7344205ProgramServices
Management And General419225ManagementAndGeneral

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total976200Total
Program Services923485ProgramServices
Management And General52715ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total317280Total
Program Services145193ProgramServices
Management And General172087ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total227714Total
Program Services215417ProgramServices
Management And General12297ManagementAndGeneral

Fees For Services Lobbying FeesForServicesLobbying

FieldValueIRS element (for citing)
Total25823Total
Management And General25823ManagementAndGeneral

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total1930667Total
Management And General1930667ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total20276247Total
Program Services18881143ProgramServices
Management And General1395104ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total935066Total
Program Services861965ProgramServices
Management And General73101ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total1220868Total
Program Services369945ProgramServices
Management And General850923ManagementAndGeneral

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total3726843Total
Program Services3525593ProgramServices
Management And General201250ManagementAndGeneral

Occupancy Occupancy

FieldValueIRS element (for citing)
Total4753709Total
Program Services4497009ProgramServices
Management And General256700ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total75148Total
Program Services71090ProgramServices
Management And General4058ManagementAndGeneral

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total310908Total
Program Services294119ProgramServices
Management And General16789ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total4857790Total
Program Services4595471ProgramServices
Management And General262319ManagementAndGeneral

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total15342964Total
Program Services14514444ProgramServices
Management And General828520ManagementAndGeneral

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
DIRECT PATIENT SUPPLIES30730745307307450
OTHER SUPPLIES104687599940163528596
BAD DEBTS75659407565940
PROVIDER TAX14881511488151

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total917418Total
Program Services622950ProgramServices
Management And General294468ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total240081349Total
Program Services221345186ProgramServices
Management And General18736163ManagementAndGeneral
Fundraising0Fundraising

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY24524916BOY
EOY26895127EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY29934901BOY
EOY30869323EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY1215706BOY
EOY1504177EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY4343951BOY
EOY3613270EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis305566252LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec24811257LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY257910984BOY
EOY280754995EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
BOY608387482BOY
EOY318844793EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY46084034BOY
EOY310519925EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY972401974BOY
EOY973001610EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY29460553BOY
EOY27758959EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

FieldValueIRS element (for citing)
BOY115406276BOY
EOY112365151EOY

Escrow Account Liability EscrowAccountLiability

FieldValueIRS element (for citing)
BOY2374605BOY
EOY2374182EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY55788303BOY
EOY55888499EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY203029737BOY
EOY198386791EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY740886058BOY
EOY740671379EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY16121562BOY
EOY20489794EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY12364617BOY
EOY13453646EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY769372237BOY
EOY774614819EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY972401974BOY
EOY973001610EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses25291861ReconcilationRevenueExpenses
Reconcilation Other Changes-20049279ReconcilationOtherChanges
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited
Audit Committee1AuditCommittee
Financial Statement ConsolidatedXFinancialStatementConsolidated
Federal Grant Audit Required0FederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Hospital170b1 AiiiXHospital170b1Aiii

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Aggregate ContributionsRESTRICTEDAggregateContributions

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Other Activities1OtherActivities
Other Activities$25,823OtherActivitiesAmount
Total Lobbying Expenditures IIB25823TotalLobbyingExpendituresIIB
Not Described In501c30NotDescribedIn501c3

Form990 Schedule C Part IV Form990ScheduleCPartIV

FieldValueIRS element (for citing)
IdentifierEXPLANATION OF LOBBYING ACTIVITIES:Identifier
Return ReferencePART II-B, LINE 1:ReturnReference
ExplanationSIBLEY MEMORIAL HOSPITAL PAID $25,823 DURING THE FISCAL YEAR ENDED JUNE 30, 2012 TO THE DISTRICT OF COLUMBIA HOSPITAL ASSOCIATION FOR LOBBYING PURPOSES AS PART OF THE ANNUAL DUES.Explanation

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Agent Trustee Etc0AgentTrusteeEtc
Included On FS1IncludedOnFS

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis50500000OtherCostOrOtherBasis
Book Value50500000BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis169078320OtherCostOrOtherBasis
Depreciation10743777Depreciation
Book Value158334543BookValue

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Other Cost Or Other Basis364066OtherCostOrOtherBasis
Depreciation6742Depreciation
Book Value357324BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis56271323OtherCostOrOtherBasis
Depreciation14021054Depreciation
Book Value42250269BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis29352543OtherCostOrOtherBasis
Depreciation39684Depreciation
Book Value29312859BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings280754995TotalOfBookValueLandBuildings

Other Securities OtherSecurities (2 entries)

DescriptionDescriptionBook ValueBookValueMethod Of ValuationMethodOfValuation
JOINT VENTURES3186904F
OTHER SECURITIES315657889F
FieldValueIRS element (for citing)
Total Of Book Value Securities318844793TotalOfBookValueSecurities

Other Assets OtherAssets (5 entries)

DescriptionDescriptionBook ValueBookValue
OTHER RECEIVABLES11464846
INTEREST RECEIVABLE1287411
OTHER ASSETS11278897
BENEFICIAL INTEREST IN SIBLEY MEMORIAL HOSPITAL FDN285994630
DUE FROM AFFILIATES494141
FieldValueIRS element (for citing)
Total Book Value Other Assets310519925TotalBookValueOtherAssets

Other Liabilities OtherLiabilities (7 entries)

DescriptionDescriptionAmountAmount
ALLOW FOR MALPRACTICE CLAIMS$15,818,993
ESTIMATED THIRD PARTY SETTLE$8,029,625
DEFERRED PENSION OBLIGATION$24,810,296
MISCELLANEOUS LIABILITIES$4,417,197
INTEREST PAYABLE$1,158,323
DEFERRED COMPENSATION$1,622,204
CONT RETENTION MOB GARAGE$31,861
FieldValueIRS element (for citing)
Total Of Amounts55888499TotalOfAmounts

Form990 Schedule D Part XIV Form990ScheduleDPartXIV (2 entries)

Return ReferenceReturnReferenceExplanationExplanationIdentifierIdentifier
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, 2012, THE MARKET VALUE OF THE ASSETS DECREASED BY $160,735.
PART X: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. THE ORGANIZATION HAS ADOPTED THIS GUIDANCE, AND THERE WAS NO IMPACT ON ITS FINANCIAL STATEMENTS DURING THE YEAR ENDED JUNE 30, 2012.DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48:

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Charity Care Policy1CharityCarePolicy
Written Policy1WrittenPolicy
Policy Applied To All HospitalsXPolicyAppliedToAllHospitals
FPG Reference Free Care1FPGReferenceFreeCare
Pcent200XPcent200
FPG Reference Discounted Care1FPGReferenceDiscountedCare

Discounted Other DiscountedOther

FieldValueIRS element (for citing)
OtherXOther
Discounted Other Percentage500.000000000000DiscountedOtherPercentage
FieldValueIRS element (for citing)
Free Disc Care Medically Indigent1FreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity Care1AmountsBudgetedForCharityCare
Expenses Exceeded Budget0ExpensesExceededBudget
Annual Community Benefit Report1AnnualCommunityBenefitReport
Report Publically Available1ReportPublicallyAvailable

Charity Care At Cost CharityCareAtCost

FieldValueIRS element (for citing)
Total Community Benefit Expense3232573TotalCommunityBenefitExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Benefit Expense3232573NetCommunityBenefitExpense
Percent Of Total Expense0.01390PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

FieldValueIRS element (for citing)
Total Community Benefit Expense5754230TotalCommunityBenefitExpense
Direct Offsetting Revenue2838689DirectOffsettingRevenue
Net Community Benefit Expense2915541NetCommunityBenefitExpense
Percent Of Total Expense0.01250PercentOfTotalExpense

Total Charity Care TotalCharityCare

FieldValueIRS element (for citing)
Total Community Benefit Expense8986803TotalCommunityBenefitExpense
Direct Offsetting Revenue2838689DirectOffsettingRevenue
Net Community Benefit Expense6148114NetCommunityBenefitExpense
Percent Of Total Expense0.02640PercentOfTotalExpense

Community Health Services CommunityHealthServices

FieldValueIRS element (for citing)
Total Community Benefit Expense783717TotalCommunityBenefitExpense
Direct Offsetting Revenue1200DirectOffsettingRevenue
Net Community Benefit Expense782517NetCommunityBenefitExpense
Percent Of Total Expense0.00340PercentOfTotalExpense

Health Professions Education HealthProfessionsEducation

FieldValueIRS element (for citing)
Total Community Benefit Expense928158TotalCommunityBenefitExpense
Direct Offsetting Revenue260132DirectOffsettingRevenue
Net Community Benefit Expense668026NetCommunityBenefitExpense
Percent Of Total Expense0.00290PercentOfTotalExpense

Subsidized Health Services SubsidizedHealthServices

FieldValueIRS element (for citing)
Total Community Benefit Expense15174492TotalCommunityBenefitExpense
Direct Offsetting Revenue11301918DirectOffsettingRevenue
Net Community Benefit Expense3872574NetCommunityBenefitExpense
Percent Of Total Expense0.01670PercentOfTotalExpense

Research Research

FieldValueIRS element (for citing)
Total Community Benefit Expense1192385TotalCommunityBenefitExpense
Direct Offsetting Revenue100980DirectOffsettingRevenue
Net Community Benefit Expense1091405NetCommunityBenefitExpense
Percent Of Total Expense0.00470PercentOfTotalExpense

Cash And In Kind Contributions CashAndInKindContributions

FieldValueIRS element (for citing)
Total Community Benefit Expense14200TotalCommunityBenefitExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Benefit Expense14200NetCommunityBenefitExpense
Percent Of Total Expense0.00010PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense18092952TotalCommunityBenefitExpense
Direct Offsetting Revenue11664230DirectOffsettingRevenue
Net Community Benefit Expense6428722NetCommunityBenefitExpense
Percent Of Total Expense0.02780PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense27079755TotalCommunityBenefitExpense
Direct Offsetting Revenue14502919DirectOffsettingRevenue
Net Community Benefit Expense12576836NetCommunityBenefitExpense
Percent Of Total Expense0.05420PercentOfTotalExpense
FieldValueIRS element (for citing)
Bad Debt Expense Reported1BadDebtExpenseReported
Bad Debt Expense$7,565,940BadDebtExpenseAmount
Amount Attributable To0AmountAttributableTo
Amount Reimbursed By Medicare58849642AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare74940016CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall-16090374MedicareSurplusOrShortfall

Costing Methodology Used CostingMethodologyUsed

FieldValueIRS element (for citing)
OtherXOther
FieldValueIRS element (for citing)
Written Debt Collection Policy1WrittenDebtCollectionPolicy
Provision For Charity Care1ProvisionForCharityCare
Number Of Hospital Facilities1NumberOfHospitalFacilities

Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA

FieldValueIRS element (for citing)
Facility Number1FacilityNumber

Name Name

FieldValueIRS element (for citing)
Business Name Line1SIBLEY MEMORIAL HOSPITALBusinessNameLine1

Address Address

FieldValueIRS element (for citing)
Address Line15255 LOUGHBORO RD NWAddressLine1
CityWASHINGTONCity
StateDCState
ZIP Code20016ZIPCode
FieldValueIRS element (for citing)
Licensed HospitalXLicensedHospital
General Medical And SurgicalXGeneralMedicalAndSurgical
Er24 HoursXEr24Hours

Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1SIBLEY MEMORIAL HOSPITALBusinessNameLine1
FieldValueIRS element (for citing)
Hospital Facility Number1HospitalFacilityNumber
CHNA Conducted0CHNAConducted
Eligibility Criteria Explained1EligibilityCriteriaExplained
Uses FPG Free1UsesFPGFree
FPG Free Percent200.000000000000FPGFreePercent
Uses FPG Discounted1UsesFPGDiscounted
FPG Discount Percent500.000000000000FPGDiscountPercent
Explains Basis1ExplainsBasis
Income LevelXIncomeLevel
Asset LevelXAssetLevel
Medical IndigencyXMedicalIndigency
Insurance StatusXInsuranceStatus
State RegulationXStateRegulation
Explains Application Method1ExplainsApplicationMethod
Includes Publicity Measures1IncludesPublicityMeasures
Posted On WebsiteXPostedOnWebsite
Attached To InvoicesXAttachedToInvoices
Posted In Emergency RoomXPostedInEmergencyRoom
Posted In Admission OfficeXPostedInAdmissionOffice
Provided On AdmissionXProvidedOnAdmission
Available On RequestXAvailableOnRequest
Actions On Nonpayment1ActionsOnNonpayment
Collection Activities0CollectionActivities
Nondiscrim Emergency Care Policy1NondiscrimEmergencyCarePolicy
Used Other MethodXUsedOtherMethod
Amounts Generally Billed0AmountsGenerallyBilled
Gross Charges0GrossCharges

Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC

FieldValueIRS element (for citing)
Number Of Other Facilities1NumberOfOtherFacilities

Other Facilities OtherFacilities

Name Name

FieldValueIRS element (for citing)
Business Name Line1GRAND OAKSBusinessNameLine1

Address Address

FieldValueIRS element (for citing)
Address Line15901 MACARTHUR BLVD NWAddressLine1
CityWASHINGTONCity
StateDCState
ZIP Code20016ZIPCode
FieldValueIRS element (for citing)
Facility TypeASSISTED LIVING FACILITYFacilityType

Form990 Schedule H Part VI Form990ScheduleHPartVI (14 entries)

ExplanationExplanationIdentifierIdentifierReturn 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 I, L7 COL(F): THE AMOUNT OF BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $7,565,940.
PART II: SIBLEY HOSPITAL DOES NOT PARTICIPATE IN COMMUNITY BUILDING ACTIVITIES NOR DO WE HAVE THE RESOURCES TO DO SO.
PART III, LINE 4: BAD DEBT EXPENSE ENTERED COMES FROM THE HOSPITALS BOOKS AND RECORDS.DISCOUNTS AND ALLOWANCES ARE ACCOUNTED FOR SEPARATELY FROM BAD DEBT EXPENSE.THE ORGANIZATIONS FINANCIAL STATEMENTS DO NOT INCLUDE A FOOTNOTE ON BAD DEBT EXPENSE. THE FINANCIAL STATEMENTS SHOW THE PROVISION FOR BAD DEBTS AS A SEPARATE LINE ITEM IN THE STATEMENTS OF OPERATIONS AND CHANGES IN NET ASSETS UNDER OPERATING EXPENSES.
PART III, LINE 8: SIBLEY MEMORIAL HOSPITAL TREATS PATIENTS WITH MANY INSURANCE CARRIERS. HOWEVER, THE MEDICARE TOTAL VOLUME IS 39% OF TOTAL PATIENT VOLUME, WE BELIEVE THIS IS AMONG THE HIGHEST RATIO FOR THE 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.IN ADDITION TO PROVIDING EDUCATIONAL AND OTHER SELF IMPROVEMENT SEMINARS AND CLINICS FOR OUR MEDICARE PATIENT POPULATION, THE HOSPITAL 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 HOSPITALS 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 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 19D: 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. SINCE AN FAP-ELIGIBLE PATIENT IS NOT CHARGED FOR THEIR CARE THERE IS NO CALCULATION MADE FOR THE MAXIMUM AMOUNT THEY CAN BE CHARGED.SIBLEY MEMORIAL HOSPITAL
PART VI, LINE 2: SIBLEY MEMORIAL HOSPITAL AND FOUR OTHER HOSPITALS AND TWO FEDERAL QUALIFIED HEALTH CLINICS IN THE DISTRICT OF COLUMBIA ARE UNDERTAKING AN EFFORT TO CONVENE STRATEGIC LEADERS TO WORK TOGETHER COLLABORATIVELY TO BETTER UNDERSTAND, MEASURE AND IMPACT THE HEALTH OF THE COMMUNITY WE JOINTLY SERVE. TO THAT END, STARTING IN 2011, THE ORGANIZATIONS BEGAN MEETING TO GATHER INFORMATION AND OPINIONS FROM PERSONS WHO REPRESENT BROADER INTERESTS OF THE COMMUNITY SERVED BY OUR HOSPITALS. BY NOVEMBER 30, 2012, THE ORGANIZATIONS DID DEVELOP A COMMUNITY HEALTH NEEDS ASSESSMENT STRATEGY FOR THE ENTIRE DISTRICT OF COLUMBIA AND WILL BEGIN WORKING COLLABORATIVELY ON DEVELOPING AN IMPLEMENTATION PLAN TO BEST SERVE THE DISTRICT OF COLUMBIA.SECONDARY DATA WERE 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.IN ADDITION TO THE EFFORTS TO ESTABLISH A DC HEALTH COLLABORATIVE, SIBLEY MEMORIAL HOSPITAL CONSULTS WITH LOCAL AND RESPECTED SENIOR SERVING AGENCIES SUCH AS IONA SENIOR SERVICES, SEABURY RESOURCES FOR AGING, MARYS CENTER FOR MATERNAL AND CHILD CARE, THE COMMUNITY OF HOPE, COLUMBIA ROAD CLINIC, UNITY HEALTHCARE (FORMERLY HEALTHCARE FOR THE HOMELESS), BREAD FOR THE CITY, CATHOLIC CHARITIES AND SOMOS AMIGOS MEDICAL MISSION. SIBLEY HAS ALSO WORKED SIDE-BY-SIDE WITH NON-PROFIT AGENCIES LIKE AMERICAN LUNG ASSOCIATION.
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 THE STATE HEALTH PLANNING AND DEVELOPMENT AGENCY (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 COMMUNICATES 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 786,229 OF WHICH 48.28% WERE MALES AND 51.72% WERE FEMALES, AVERAGE HOUSEHOLD INCOME WAS $55,251, 8.0% OF RESIDENTS ARE UNINSURED, 18.0% OF RESIDENTS ARE COVERED BY MEDICAID/MEDICARE, 19.2% 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 HOSPITALS 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 ALZHEIMERS, ARTHRITIS, LYME DISEASE, MACULAR DEGENERATION, OR PARKINSONS 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. IN JANUARY, 2012, SIBLEY PARTICIPATED IN THE NBC4 HEALTH AND FITNESS EXPO HELD AT THE WASHINGTON CONVENTION CENTER FOR THE GENERAL PUBLIC. SIBLEY AND OTHER HEALTH CARE PROVIDERS OFFERED MULTIPLE HEALTH SCREENINGS, INFORMATIVE HEALTH RELATED DISCUSSIONS AND WAYS TO STAY HEALTHY AND FIT. 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 SPRING OF 2011, THE HOSPITAL BROKE GROUND TO CONSTRUCT A NEW RADIATION ONCOLOGY FACILITY AS PART THE NEXT PHASE OF OUR CAMPUS REDEVELOPMENT. THIS FACILITY IS SUBSTANTIALLY COMPLETED AS OF JUNE 30, 2012. IT WILL OFFER ADVANCED MODALITIES FOR RADIATION THERAPY, 3-D IMAGING AND OTHER TREATMENT SERVICES. THE NATIONAL CAPITAL REGIONAL PLANNING COMMITTEE WAS FORMED, COORDINATING ACUTE CARE AND OUTPATIENT SERVICES BETWEEN THE SUBURBAN HOSPITAL AND THE JOHNS HOPKINS HEALTH SYSTEM (JHHS). THE NEWLY CONSTRUCTED SIBLEY MEDICAL BUILDING BECAME FULLY OPERATIONAL IN JULY, 2011, AND OFFERS THE LATEST BREAKTHROUGHS IN OUTPATIENT SURGERY, IMAGING TECHNOLOGY, A COMMUNITY PHARMACY AND PHYSICIAN OFFICES. A NEW GIFT SHOP OFFERS COMFORT-CARE PRODUCTS FOR MATERNITY AND FEMALE ONCOLOGY PATIENTS. 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. THE HOSPITAL ALSO BEGAN ACTIVE PARTICIPATION IN THE GYNECOLOGICAL ONCOLOGY GROUP, A COOPERATIVE GROUP SPONSORED BY THE NATIONAL CANCER INSTITUTE TO SUPPORT RESEARCH STUDIES OF NEW CANCER TREATMENTS IN GYNECOLOGICAL CANCERS. IN THE FALL OF 2011, SIBLEY UNDERWENT AN UNANNOUNCED ON-SITE SURVEY BY A TEAM FROM THE JOINT COMMISSION. SIBLEY EARNED A 3-YEAR ACCREDITATION BY DEMONSTRATING COMPLIANCE WITH THEIR NATIONAL STANDARDS FOR HEALTH CARE QUALITY AND SAFETY. IN THE WINTER OF 2012, BETHESDA MAGAZINE VOTED SIBLEY AS BEST PLACE TO HAVE A BABY. IN CONJUNCTION WITH JHHS, THE HOSPITAL INCREASED COMPLIANCE WITH QUALITY SAFETY MEASURES, WHICH WILL RESULT IN MEASURABLE BENEFITS TO THE COMMUNITY.
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.
DCREPORTS FILED WITH STATESPART VI, LINE 7

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Records Maintained1RecordsMaintained

Recipient Table RecipientTable (2 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEIN Of RecipientEINOfRecipientIRC SectionIRCSectionAmount Of Cash GrantAmountOfCashGrantPurpose Of GrantPurposeOfGrant
THE WISTAR INSTITUTE OF ANATOMY AND BIOLOGY
3601 SPRUCE STREETPHILADELPHIAPA19104236434390501(C)(3)100000RESEARCH
JOHNS HOPKINS UNIVERSITY
3910 KESWICK ROAD N-4327BBALTIMOREMD21211520595110501(C)(3)597393RESEARCH
FieldValueIRS element (for citing)
Total Nbr Of501 C3 And Govt Grants2TotalNbrOf501C3AndGovtGrants

Form990 Schedule I Part IV Form990ScheduleIPartIV

FieldValueIRS element (for citing)
IdentifierPROCEDURE FOR MONITORING GRANTS IN THE U.S.:Identifier
Return ReferencePART I, LINE 2:ReturnReference
ExplanationSCHEDULE 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

FieldValueIRS element (for citing)
Club Dues Or FeesXClubDuesOrFees
Written Policy Re T And E Expenses1WrittenPolicyReTAndEExpenses
Substantiation Required1SubstantiationRequired
Compensation CommitteeXCompensationCommittee
Independent ConsultantXIndependentConsultant
Form990 Of Other OrganizationsXForm990OfOtherOrganizations
Written Employment ContractXWrittenEmploymentContract
Compensation SurveyXCompensationSurvey
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance Payment0SeverancePayment
Supplemental Nonqual Retire Plan1SupplementalNonqualRetirePlan
Equity Based Comp Arrangement0EquityBasedCompArrangement
Comp Based On Revenue Of Filing Org0CompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related Orgs0CompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing Org0CompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate Orgs0CompBasedNetEarningsRelateOrgs
Any Non Fixed Payments0AnyNonFixedPayments
Initial Contract Exception0InitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (17 entries)

Base Compensation Filing OrgBaseCompensationFilingOrgComp Based On Related OrgsCompBasedOnRelatedOrgsBonus Filing OrgBonusFilingOrgBonus Related OrgsBonusRelatedOrgsOther Compensation Filing OrgOtherCompensationFilingOrgOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Filing OrgDeferredCompFilingOrgDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Filing OrgTotalCompensationFilingOrgTotal Compensation Related OrgsTotalCompensationRelatedOrgsComp Report Prior990 Filing OrgCompReportPrior990FilingOrgComp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
ROBERT L SLOAN
86443703732290110665007100001111502426431000
RONALD R PETERSON
0110119704511240151234017548850230920348153200
CARL L SYLVESTER JR MD
000026340000000263400000
STEPHEN C MCDONNELL
4004880726860213100605500103470565381000
JOAN VINCENT
31479403265802965250710000125270727504000
ALISON ARNOTT
1372400614907509015710058290172437000
QUEENIE PLATER
24471801709806489057315075190333139000
KENDA TAVAKOLI
256249024175010060046997082000345681000
PETER PETRUCCI MD
2484210118690582019065053600285297000
CHRISTINE STUPPY
1772700141800686022380089180223434000
JEFFERY JOYNER
1871010171760477021884095270236165000
JEFFREY L LIN
6206830100118000361790112990768279000
REBECCA ZUURBIER
42043800081089026132096120537271000
JERRY L PRICE
313825000305244054500080870681656000
HASAN ZIA
45174100081378021136094480563703000
COLETTE M MAGNANT
50851303412500037598023700582606000
AUDRY CARTER
152711016267045497020037055120240024000

Form990 Schedule J Part III Form990ScheduleJPartIII

FieldValueIRS element (for citing)
Return ReferencePART I, LINE 4BReturnReference
ExplanationDURING 2011 THE PRESIDENT/CEO ROBERT SLOAN RECEIVED $1,106,649.60, THE VICE PRESIDENT REAL ESTATE & CONSTRUCTION, JERRY L. PRICE RECEIVED $305,344.32 AND VICE PRESIDENT OF PATIENT CARE SERVICES, JOAN VINCENT RECEIVED $286,038.00 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 $1,626,957.00Explanation

Schedule K IRS990ScheduleK

Form990 Schedule K Part I Form990ScheduleKPartI (3 entries)

Issuer EINIssuerEINCUSIP NumberCUSIPNumberDate IssuedDateIssuedIssue PriceIssuePriceDescription Of PurposeDescriptionOfPurposeDefeasedDefeasedOn Behalf Of IssuerOnBehalfOfIssuerPool FinancingPoolFinancing
DISTRICT OF COLUMBIA
536001131254764HX42009-07-1562798209CONSTRUCTION OF MEDICAL BLDG FOR OUTPATIENT SVCS AND OFFICES000
DISTRICT OF COLUMBIA
5360011312010-12-2930000000REISSUE PRIOR ISSUE 7/24/02000
DISTRICT OF COLUMBIA
5360011312010-12-295398555REISSUE PRIOR ISSUE 7/24/02000

Form990 Schedule K Part II Form990ScheduleKPartII (3 entries)

Total ProceedsTotalProceedsAmount In Reserve FundAmountInReserveFundIssuance Costs From ProceedsIssuanceCostsFromProceedsCapital ExpendituresCapitalExpendituresYear Of Subst CompletionYearOfSubstCompletionCurrent RefundingCurrentRefundingAdvance RefundingAdvanceRefundingFinal Allocation MadeFinalAllocationMadeAdequate Books And Recds MaintaindAdequateBooksAndRecdsMaintaindAmount RetiredAmountRetired
6279820949546863150005754209020110001
30000000200510111175910
539855520051011204546

Form990 Schedule K Part III Form990ScheduleKPartIII (3 entries)

Owning Bond Financed PropertyOwningBondFinancedPropertyAny Lease ArrangementsAnyLeaseArrangementsMngment Cntrct Bond Financd PrprtyMngmentCntrctBondFinancdPrprtyEngage Bond Counsel ContractsEngageBondCounselContractsAny Research AgreementsAnyResearchAgreementsPrcntge Prvt Business Use By OthersPrcntgePrvtBusinessUseByOthersPercentage Of Prvt Business Re UBIPercentageOfPrvtBusinessReUBITotal Private Business UseTotalPrivateBusinessUsePost Issuance Compliance ProcdrsPostIssuanceComplianceProcdrs
011100.003100.000000.003101
011101
011101

Form990 Schedule K Part IV Form990ScheduleKPartIV (3 entries)

Form8038 T FiledForm8038TFiledVariable Rate IssueVariableRateIssueHedge Identified In Books And RecdsHedgeIdentifiedInBooksAndRecdsGross Proceeds Invested In GICGrossProceedsInvestedInGICGross Proceeds InvestedGrossProceedsInvestedException To RebateExceptionToRebate
000000
000000
000000
FieldValueIRS element (for citing)
Fed Tax Requirements ComplianceXFedTaxRequirementsCompliance

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (7 entries)

Return ReferenceReturnReferenceExplanationExplanationIdentifierIdentifier
FORM 990, PART VI, SECTION A, LINE 7ADURING 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 7BTHE 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 11A COPY OF THE FORM 990 WAS PROVIDED TO THE FINANCE COMMITTEE BEFORE IT WAS FILED.
FORM 990, PART VI, SECTION B, LINE 12CTHE 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 15THE 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 19THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST.
FORM 990, PART XI, LINE 5:NET UNREALIZED GAINS ON INVESTMENTS: 691,768. CHANGE IN BENEFICIAL INTEREST IN FOUNDATION -1,423,292. PREMIER PURCHASING PARTNERS K-1 -507,119. COLONIAL REGIONAL ALLIANCE K-1 20,738. ROCKVILLE IMAGING K-1 11,494. CHEVY CHASE IMAGING K-1 59,934. CHANGE IN MINIMUM PENSION LIABILITY -9,615,014. NET ASSETS RELEASED 1,355,624. INTERCOMPANY TRANSFERS -10,643,412. TOTAL TO FORM 990, PART XI, LINE 5: -20,049,279.CHANGES IN NET ASSETS OR FUND BALANCES:

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (21 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Controlled OrgControlledOrgDirect Controlling Entity NADirectControllingEntityNA
JOHNS HOPKINS HEALTH SYSTEM CORPORATION
3910 KESWICK RD SOUTH BLDG 4TH FL SBALTIMOREMD21211521465301SUPPORTING ORGANIZATIONMD501(C)(3)LINE 11C, III-FIJOHNS HOPKINS HEALTH SYSTEM CORPORATION0
JOHNS HOPKINS BAYVIEW MEDICAL CENTER INC
3910 KESWICK RD SOUTH BLDG 4TH FL SBALTIMOREMD21211521341890HOSPITALMD501(C)(3)LINE 3JOHNS HOPKINS HEALTH SYSTEM CORPORATION0
JOHNS HOPKINS COMMUNITY PHYSICIANS INC
3910 KESWICK RD SOUTH BLDG 4TH FL SBALTIMOREMD21211521467441HEALTHCARE SERVICESMD501(C)(3)LINE 11C, III-FIJOHNS HOPKINS HEALTH SYSTEM CORPORATION0
JOHNS HOPKINS MEDICAL SERVICES CORPORATION
3910 KESWICK RD SOUTH BLDG 4TH FL SBALTIMOREMD21211521232569HEALTHCARE SERVICESMD501(C)(3)LINE 3JOHNS HOPKINS HEALTH SYSTEM CORPORATION0
THE JOHNS HOPKINS HOSPITAL
3910 KESWICK RD SOUTH BLDG 4TH FL SBALTIMOREMD21211520591656HOSPITALMD501(C)(3)LINE 3JOHNS HOPKINS HEALTH SYSTEM CORPORATION0
SUBURBAN HOSPITAL HEALTHCARE SYSTEM INC
8600 OLD GEORGETOWN ROADBETHESDAMD20814522052354HEALTHCARE SERVICESMD501(C)(3)LINE 11C, III-FIJOHNS HOPKINS HEALTH SYSTEM CORPORATION0
HOWARD COUNTY LIQUIDATION CORPORATION
3910 KESWICK RD SOUTH BLDG 4TH FL SBALTIMOREMD21211520892284INACTIVE TAX-EXEMPT ORGANIZATIONMD501(C)(3)LINE 3JOHNS HOPKINS HEALTH SYSTEM CORPORATION0
SUBURBAN HOSPITAL INC
8600 OLD GEORGETOWN ROADBETHESDAMD20814520610545HOSPITALMD501(C)(3)LINE 3JOHNS HOPKINS HEALTH SYSTEM CORPORATION0
HOWARD COUNTY GENERAL HOSPITAL INC
3910 KESWICK RD SOUTH BLDG 4TH FL SBALTIMOREMD21211522093120HOSPITALMD501(C)(3)LINE 3JOHNS HOPKINS HEALTH SYSTEM CORPORATION0
THE STACY MARK REED FOUNDATION
5255 LOUGHBORO ROAD NWWASHINGTONDC20016273818765FINANCIAL SUPPORTDC501(C)(3)LINE 11A, ILUCY WEBB HAYES NATIONAL TRAINING SCHOOL FOR DEACONESSES & MISSIONARIES1
SIBLEY MEMORIAL HOSPITAL FOUNDATION
5255 LOUGHBORO ROAD NWWASHINGTONDC20016450562642FINANCIAL SUPPORTDC501(C)(3)LINE 7LUCY WEBB HAYES NATIONAL TRAINING SCHOOL FOR DEACONESSES & MISSIONARIES1
THE JANE BANCROFT ROBINSON FOUNDATION
5255 LOUGHBORO ROAD NWWASHINGTONDC20016273818431FINANCIAL SUPPORTDC501(C)(3)LINE 11C, III-FILUCY WEBB HAYES NATIONAL TRAINING SCHOOL FOR DEACONESSES & MISSIONARIES1
POTOMAC HOME SUPPORT INC
6001 MONTROSE ROAD NO 1020ROCKVILLEMD20852521750383HOME HEALTH CAREMD501(C)(3)LINE 90N/A
SIBLEY SUBURBAN HOME HEALTH AGENCY
6001 MONTROSE ROAD NO 307ROCKVILLEMD20852521450142HOME HEALTH CAREMD501(C)(3)LINE 90N/A
PEDIATRIC PHYSICIAN SERVICES INC
501 SIXTH AVENUE SOUTHST PETERSBURGFL33701593425191PEDIATRIC MEDICAL SERVICESFL501(C)(3)LINE 9ALL CHILDREN'S HEALTH SYSTEM INC0
ALL CHILDREN'S HOSPITAL FOUNDATION INC
501 SIXTH AVENUE SOUTHST PETERSBURGFL33701592481738FOUNDATIONFL501(C)(3)LINE 7ALL CHILDREN'S HEALTH SYSTEM INC0
ALL CHILDREN'S HOSPITAL INC
501 SIXTH AVENUE SOUTHST PETERSBURGFL33701590683252HOSPITALFL501(C)(3)LINE 3JOHNS HOPKINS HEALTH SYSTEM CORPORATION0
ALL CHILDREN'S RESEARCH INSTITUTE INC
501 SIXTH AVENUE SOUTHST PETERSBURGFL33701592481742RESEARCHFL501(C)(3)LINE 4ALL CHILDREN'S HEALTH SYSTEM INC0
SURGIKID OF FLORIDA INC
501 SIXTH AVENUE SOUTHST PETERSBURGFL33701593441883MEDICAL SERVICESFL501(C)(3)LINE 9ALL CHILDREN'S HEALTH SYSTEM INC0
KIDS HOME CARE INC
501 SIXTH AVENUE SOUTHST PETERSBURGFL33701593476049HOME HEALTH CAREFL501(C)(3)LINE 9ALL CHILDREN'S HEALTH SYSTEM INC0
WEST COAST NEONATOLOGY INC
501 SIXTH AVENUE SOUTHST PETERSBURGFL33701593398308HEALTHCARE SERVICESFL501(C)(3)LINE 11C, III-FIALL CHILDREN'S HEALTH SYSTEM INC0

Form990 Schedule R Part III Form990ScheduleRPartIII (6 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivityPrimaryActivityLegal Domicile StateLegalDomicileStateBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Predominant Income TypePredominantIncomeTypeShare Of Total IncomeShareOfTotalIncomeDisproportionate AllocationsDisproportionateAllocationsGeneral Or Managing PartnerGeneralOrManagingPartnerPercentage OwnershipPercentageOwnershipDirect Controlling Entity NADirectControllingEntityNA
SIBLEY HEALTH NETWORK LLC
5255 LOUGHBORO ROAD NWWASHINGTONDC20016521932344HEALTHCARE SERVICESDCSIBLEY HEALTHCARE AFFILIATESINVESTMENT-8000.01000
OPHTHALMOLOGY ASSOCIATES LLC
3910 KESWICK RD SOUTH BLDG 4TH FL SBALTIMOREMD21211521890957OPHTHALMOLOGY SERVICESMDN/A
SUBURBAN WELLNESS CENTER LLC
20500 GOLDENROD LANEGERMANTOWNMD20874562296930REAL ESTATEMDN/A
GCM SURBURBAN IMAGING LLC
1201 SEVEN LOCKS ROAD STE 200ROCKVILLEMD20854522326237OUTPATIENT RADIOLOGYMDN/A
ROCKVILLE IMAGING LLC
1201 SEVEN LOCKS ROAD STE 200ROCKVILLEMD20854141944128OUTPATIENT RADIOLOGYMDN/A
CHEVY CHASE IMAGING LLC
1201 SEVEN LOCKS ROAD STE 200ROCKVILLEMD20854141944126RADIOLOGY SERVICESMDN/A

Form990 Schedule R Part IV Form990ScheduleRPartIV (11 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivityPrimaryActivityLegal Domicile StateLegalDomicileStateBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Type Of EntityTypeOfEntityShare Of EOY AssetsShareOfEOYAssetsPercentage OwnershipPercentageOwnershipDirect Controlling Entity NADirectControllingEntityNA
SIBLEY HEALTHCARE AFFILIATES
5255 LOUGHBORO RD NWWASHINGTONDC20016521928494HEALTHCARE SERVICESDCLUCY WEBB HAYES NATIONAL TRAINING SCHOOL FOR DEACONESSES & MISSIONARIESC85541.00000
HCP VENTURE ONE CORPORATION
3910 KESWICK RD SOUTH BLDG 4TH FL SBALTIMOREMD21211521558858MEDICAL SERVICESMDCN/A
HSI MEDICAL SERVICES CORPORATION
3910 KESWICK RD SOUTH BLDG 4TH FL SBALTIMOREMD21211521847705HEALTHCARE-SLEEP DIAGNOSTICSMDCN/A
HOWARD COUNTY HEALTH SERVICES INC
3910 KESWICK RD SOUTH BLDG 4TH FL SBALTIMOREMD21211521434783HEALTHCARE MANAGEMENTMDCN/A
JOHNS HOPKINS MEDICAL MANAGEMENT CORPORATION
3910 KESWICK RD SOUTH BLDG 4TH FL SBALTIMOREMD21211521250028NURSING SERVICESMDCN/A
JOHNS HOPKINS EMPLOYER HEALTH PROGRAM
3910 KESWICK RD SOUTH BLDG 4TH FL SBALTIMOREMD21211521947678BENEFIT PLANSMDCN/A
TCAS INC
3910 KESWICK RD SOUTH BLDG 4TH FL SBALTIMOREMD21211521979344NURSING SERVICESMDCN/A
SUBURBAN CONTRACTING CORP INC
8600 OLD GEORGETOWN ROADBETHESDAMD20814522188022MEDICARE CONTRACTINGMDCN/A
SUBURBAN HEALTH ENTERPRISES INC
8600 OLD GEORGETOWN ROADBETHESDAMD20814522052352MEDICAL OFFICE LEASING AND RELEASINGMDCN/A
SUBURBAN SPECIALTY CARE PHYSICIANS PC
8600 OLD GEORGETOWN ROADBETHESDAMD20814522116011MULTI SPECIALTY MEDICAL PRACTICEMDCN/A
ACHPOB INC
501 SIXTH AVENUE SOUTHST PETERSBURGFL33701592427749MEDICAL OFFICE BUILDING MANAGEMENTFLCN/A
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents Royalties0ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org1GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org1GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org0LoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other Org0SaleOfAssetsToOtherOrg
Purchase Of Assets From Other Org0PurchaseOfAssetsFromOtherOrg
Exchange Of Assets0ExchangeOfAssets
Rental Of Facilities To Other Orgs1RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs0RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs0PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs0PerformOfServicesByOtherOrgs
Sharing Of Facilities1SharingOfFacilities
Sharing Of Paid Employees1SharingOfPaidEmployees
Reimbursement Paid To Other Org1ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrg
Other Transfer To Other Org1OtherTransferToOtherOrg
Other Transfer From Other Org1OtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable (5 entries)

Transaction TypeTransactionTypeAmount InvolvedAmountInvolvedMethod Of Amt DeterminationMethodOfAmtDetermination
SIBLEY MEMORIAL HOSPITAL FOUNDATION
O13611FMV
SIBLEY MEMORIAL HOSPITAL FOUNDATION
Q25851FMV
SIBLEY MEMORIAL HOSPITAL FOUNDATION
C928922FMV
THE STACY MARK REED FOUNDATION
B250000000FMV
THE JANE BANCROFT ROBINSON FOUNDATION
B75000000FMV

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