2013-05-14T10:24:53-05:00 2012-06-30 990 2011-07-01 520610545 SUBURBAN HOSPITAL INC SUBU 3018963900 8600 OLD GEORGETOWN ROAD BETHESDA MD 208141497 MARTIN BASSO SR 3018963900 2013-05-14 2011 2016-02-24 21:20:13Z MARTIN BASSO SR 8600 OLD GEORGETOWN ROAD BETHESDA MD 208141497 303394088 0 X WWW.SUBURBANHOSPITAL.ORG X 1942 MD SUBURBAN HOSPITAL IS A COMMUNITY-BASED HOSPITAL SERVING MONTGOMERY COUNTY AND THE SURROUNDING AREA SINCE 1943. WE ARE A NOT-FOR-PROFIT HEALTHCARE PROVIDER GUIDED BY THE NEEDS OF OUR PATIENTS AND COMMUNITY. ON JUNE 30, 2009, SUBURBAN HOSPITAL BECAME A MEMBER OF JOHNS HOPKINS MEDICINE. THE DESIGNATED TRAUMA CENTER FOR MONTGOMERY COUNTY, SUBURBAN HOSPITAL IS AFFILIATED WITH MANY LOCAL HEALTHCARE ORGANIZATIONS, INCLUDING THE NATIONAL INSTITUTES OF HEALTH. IT IS COMMITTED TO CONTINUOUS IMPROVEMENT AND APPROPRIATE USE OF RESOURCES, AND CREATES AN ENVIRONMENT THAT ENCOURAGES THE SUCCESS AND FULFILLMENT OF OUR PHYSICIANS, STAFF, AND VOLUNTEERS.SUBURBAN HOSPITAL WILL SET THE STANDARD FOR EXCELLENCE IN HEALTHCARE IN THE WASHINGTON METROPOLITAN REGION. THROUGH OUR AFFILIATIONS, WE ASPIRE TO PROVIDE WORLD-CLASS PATIENT CARE, TECHNOLOGY, AND CLINICAL RESEARCH. 23 20 2076 683 4843051 -96899 6877323 6075697 241455970 244736696 4604228 1119041 6594515 10827093 259532036 262758527 0 4116928 0 0 118511986 119710809 0 0 0 123820337 132752552 242332323 256580289 17199713 6178238 292356616 288814341 135181202 134152554 157175414 154661787 X SUBURBAN HOSPITAL WILL DELIVER SUPERIOR HEALTHCARE ENHANCED BY TECHNOLOGY, WELLNESS EDUCATION, RESEARCH, ADN INNOVATIVE PARTNERSHIPS WITH PHYSICIANS, HOSPITALS, THE COMMUNITY, AND THE NATIONAL INSTITUTES OF HEALTH. MISSION: IMPROVING HEALTH WITH SKILL AND COMPASSION. 0 0 92262431 97604072 SURGICAL PATIENT SERVICES:SUBURBAN HOSPITAL OFFERS COMPREHENSIVE INPATIENT AND OUTPATIENT SURGICAL SERVICES. THESE INCLUDE ORTHOPEDIC SERVICES, INCLUDING SPINE, NEUROSURGERY AND JOINT REPLACEMENT, WITH THE JOINT REPLACEMENT PROGRAM SERVING OVER 1,100 PATIENTS ANNUALLY. WITH THE DAVINCI SURGICAL SYSTEM, UROLOGIC, GYNECOLOGIC AND THORACIC PROCEDURES ARE PERFORMED WITH STATE-OF-THE-ART ROBOTIC TECHNOLOGY. SUBURBAN HOSPITAL IS THE ONLY CERTIFIED TRAUMA CENTER IN MONTGOMERY COUNTY. THE LEVEL II TRAUMA CENTER TREATS 1600 MAJOR TRAUMA CASES ANNUALLY AND HAS AN ORTHOPEDIC TRAUMATOLOGIST ON STAFF. THE FOLLOWING SPECIALISTS ARE ON CALL FOR EMERGENCIES: TRAUMA SURGEONS, NEUROSURGEONS, UROLOGISTS, ENT, OB/GYN, AND CARDIOLOGISTS. DURING 2012, SUBURBAN HOSPITAL ADMITTED 4,447 SURGICAL INPATIENTS. 12,768 OPERATING ROOM CASES WERE PERFORMED. 63149578 69223597 MEDICAL PATIENT SERVICES:SUBURBAN HOSPITAL PROVIDES ACUTE AND CRITICAL CARE FOR A COMPLETE RANGE OF MEDICAL DIAGNOSES. THE HOSPITAL IS A JOINT COMMISSION CERTIFIED PRIMARY STROKE CENTER FEATURING A DEDICATED NIH STROKE TEAM, WHICH PROVIDES RAPID DIAGNOSIS AND CUTTING-EDGE TREATMENT OF STROKES. SUBURBAN HOSPITAL ALSO OPERATES A CANCER CARE PROGRAM, WHICH IS ACCREDITED WITH COMMENDATION BY THE COMMISSION ON CANCER OF THE AMERICAN COLLEGE OF SURGEONS. THE COMPREHENSIVE PROGRAM SERVICES PATIENTS WITH ALL DIAGNOSES AND OFFERS CUTTING-EDGE TECHNOLOGY AND PERSONALIZED CARE. IN 2012, SUBURBAN HOSPITAL ADMITTED 8,024 MEDICAL PATIENTS.SUBURBAN HOSPITAL'S OBJECTIVES ARE TO MEASURE AND ANALYZE VARIANCES AND IMPROVE CARE PROCESSES RELATED TO KEY TARGET ZERO QUALITY INITIATIVES: (1) FALLS WITH INJURY (2) CENTRAL-LINE ASSOCIATED BLOODSTREAM INFECTION (3) VENTILATOR ASSOCIATED PNEUMONIA (4) PRESSURE ULCER RATES. 33485626 35150196 CARDIOVASCULAR PATIENT SERVICES:SUBURBAN HOSPITAL'S SPECIALIZED CENTER FOR CARDIAC CARE, ANCHORED BY THE NIH HEART CENTER, BRINGS THE CLINICAL AND SCIENTIFIC EXCELLENCE OF TWO RENOWNED MEDICAL INSTITUTIONS TO A COMMUNITY-BASED CARDIAC PROGRAM. THROUGH COLLABORATION WITH THE NATIONAL HEART, LUNG, AND BLOOD INSTITUTE (NHLBI) OF THE NATIONAL INSTITUTES OF HEALTH AND JOHNS HOPKINS MEDICINE, SUBURBAN HOSPITAL PROVIDES PATIENTS EASY ACCESS TO ADVANCED CARDIOVASCULAR TREATMENTS AVAILABLE IN VERY FEW MEDICAL CENTERS. IN ADDITION TO STATE-OF-THE-ART CARDIAC SURGERY AND ANGIOPLASTY, THE NIH HEART CENTER AT SUBURBAN HOSPITAL COMPLEMENTS A BROAD RANGE OF EXISITING CARDIAC PROGRAMS AT SUBURBAN HOSPITAL - FROM EMERGENCY CARE TO CARDIAC DIAGNOSTICS AND REHABILITATION. DURING 2012 THERE WERE 1,442 ADMISSIONS AND 245 OPEN HEART SURGERY CASES. 27478746 4116928 47174981 27478746 4116928 47174981 216376381 1 1 0 1 0 0 0 0 0 0 1 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 1 1 1 0 1 1 0 0 0 0 0 1 0 0 0 0 0 0 0 0 1 1 0 0 0 0 1 182 0 1 2076 1 1 1 0 0 0 0 0 0 0 X 23 20 0 0 0 0 0 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 MD X MARTIN BASSO SR VP FIN TREAS 3018962333 8600 OLD GEORGETOWN RD BETHESDA MD 208141497 SUE BAILEY MD 2.50 X 0 0 0 DIANE L COLGAN MD 2.50 X 0 0 0 WILLIAM B DOCKSER 2.50 X 0 0 0 CHRISTOPHER J DOHERTY 2.50 X 0 0 0 MARY D KANE 2.50 X 0 0 0 BELLE BROOKS O'BRIEN 2.50 X 0 0 0 JOHN C OTSUKI 2.50 X 0 0 0 C ALAN PEYSER 2.50 X 0 0 0 CURTIS POLK 2.50 X 0 0 0 LILY QI 2.50 X 0 0 0 ALAN SHEFF 2.50 X 0 0 0 DAVID C SILVER 2.50 X 0 0 0 STANLEY H SNOW 2.50 X 0 0 0 PATRICIA STOCKER PHD 2.50 X 0 0 0 CHARLES ALLEN WIEBE 2.50 X 0 0 0 BRIAN A GRAGNOLATI 18.00 X X 1029347 0 285562 WILLIAM A BAUMGARTNER MD 2.50 X 0 0 0 PATRICIA MC BROWN ESQUIRE 2.50 X 0 601570 119414 HOWARD GLECKMAN 2.50 X 0 0 0 THE HON ANN S HARRINGTON 2.50 X 0 0 0 NORMAN K JENKINS 2.50 X 0 0 0 ALBERT K LEE MD 2.50 X 0 0 0 RONALD R PETERSON 2.50 X X 0 1703555 1777977 MARTIN BASSO 50.00 X 359832 0 110855 PETER B MANCINO ESQUIRE 2.50 X 0 218221 27520 DENNIS PARNELL 50.00 X 313001 0 64714 JACQUELINE SCHULTZ RN 50.00 X 396294 0 82774 LESLIE FORD WEBER 50.00 X 230476 0 58246 JOSEPH LINSTROM 50.00 X 177480 0 37658 RAUL GONZALES 50.00 X 175474 0 33901 ROBERT ROTHSTEIN 50.00 X 373327 0 100176 STEVEN COHEN 50.00 X 178303 0 33954 BARBARA STEWARD JACOBS 50.00 X 181741 0 23677 STEVEN THOMPSON 1.00 X 0 498192 210958 NANCY MILLER 50.00 X 191192 0 15742 MATTHEW POFFENROTH MD 50.00 X 0 374445 40107 EUGENE PASSAMANI MD 50.00 X 108690 0 11410 CHRISTOPHER TIMBERS 50.00 X 236263 0 82082 3951420 3395983 3116727 135 1 1 0 SUBURBAN ROCK SPRING LLC 1013 CENTRE RD WILMINGTON DE 19805 RENT 3680467 ARAMARK FACILITY SERVICES 1101 MARKET STREET PHILADELPHIA PA 19107 BIOMED ENGINEERING SRVS 1581121 ADELMAN SHEFF AND SMITH 180 ADMIRAL COCHRANE DR SUITE 370 ANNAPOLIS MD 21401 LEGAL SERVICES 897800 RCM&D 7735 OLD GEORGETOWN RD SUITE 800 BETHESDA MD 20814 CONSULTING SERVICES 893202 CROTHALL HEALTHCARE INC 955 CHESTERBROOK BLVD WAYNE PA 19087 HOUSEKEEPING MGT 824271 73 1314978 4759219 1500 6075697 NET PATIENT REVENUE 621990 239901285 239901285 LAB 541380 4835411 4835411 244736696 1272602 1272602 40482000 40287548 348013 194452 -348013 -153561 -153561 OTHER REVENUE 900099 9405122 9405122 CAFETERIA INCOME 900099 603525 603525 PARKING 900099 499981 499981 318465 7640 310825 10827093 262758527 249152846 4843051 2686933 4116928 4116928 99772873 83857961 15914912 3114067 2615890 498177 9849651 8273939 1575712 6974218 5858507 1115711 328866 3203 325663 134763 8482 126281 8076045 5644316 2431729 70933528 64187823 6745705 3191627 2580712 610915 130859 98131 32728 110553 79784 30769 874489 734591 139898 15113688 12695853 2417835 544299 544299 CONTRACTED SERVICES 19880783 13746026 6134757 BAD DEBT 9908192 9908192 OTHER 2584293 1025476 1558817 INT EXP DERIVATIVES 940567 940567 256580289 216376381 40203908 0 337119 13192 19499928 13735433 33616233 30777234 619964 619964 1150453 266751 7501763 7776102 1525776 1419523 312710100 200164487 116009981 112545613 63905218 72616866 420270 417866 320000 0 47449911 48625797 292356616 288814341 37191235 33646861 74505982 70783261 23483985 29722432 135181202 134152554 X 134290423 132468626 12094418 11357148 10790573 10836013 157175414 154661787 292356616 288814341 X 6178238 -8691865 X 0 1 1 X 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 1 145705 0 0 145705 0 EXPLANATION OF LOBBYING ACTIVITIES: PART II-B, LINE 1: THE HOSPITAL RETAINS LEGAL COUNSEL TO PERFORM LOBBYING ACTIVITIES ON ITS BEHALF. THE LOBBYING ACTIVITIES RELATE TO PRESERVING AND PROTECTING THE HOSPITAL'S INTERESTS WITH REGARDS TO MATTERS AFFECTING HEALTH CARE AND HEALTH FACILITIES, INCLUDING STATE GRANTS AND UNCOMPENSATED CARE. 345094 345094 151001668 87346351 63655317 2129176 259974 1869202 112165096 90829362 21335734 47069066 21728800 25340266 112545613 FUNDS HELD BY BOND TRUSTEES 4565751 UNAMORTIZED FINANCE COSTS 642148 EXEC RETIREMENT PLAN ASSTS 2219896 ANNUITIES HELD FOR DEF COMP 1493399 DEPOSITS 499383 OTHER RECEIVABLE 3148168 DUE FROM OTHER ENTITIES 3942100 ACCRUED INTEREST REC 5 INTEREST IN FOUNDATION NET ASSETS 32114947 48625797 ADVANCES FROM THIRD PARTIES 10727972 EXC RETIREMENT PLAN LIABILITY 2110071 LEASES PAYABLE 754390 HEDGE FAIR VALUE ADJUST 4714226 CAPITAL ACCUMULATION ACCOUNT 92302 INTEREST PAYABLE 508002 ACCRUED RENT 252191 ACCRUED PENSION LONG TERM 8564005 457B FOR DIRECTORS 17524 DUE TO AFFILIATES 665012 WORKERS COMPENSATION INSURANCE LIABILITY 1316737 29722432 262758527 256580289 6178238 -1554884 -7136981 -8691865 -2513627 262564000 0 262564000 194527 194527 262758527 251188000 0 251188000 5392289 5392289 256580289 DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: 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 HOSPITAL HAS ADOPTED THIS GUIDANCE, AND THERE WAS NO IMPACT ON ITS FINANCIAL STATEMENTS DURING THE YEARS ENDED JUNE 30, 2012 AND 2011. PART XI, LINE 8 - OTHER ADJUSTMENTS: CHANGE IN MINIMUM PENSION LIABILITY -4,910,720. FAIR VALUE ADJ ON DERIVATIVES -1,243,393. CHANGE INTEREST IN NET ASSETS OF FOUNDATION -982,865. ROUNDING -3. TOTAL TO SCHEDULE D, PART XI, LINE 8: -7,136,981. PART XII, LINE 4B - OTHER ADJUSTMENTS: GAIN ON SALE OF SECURITIES 194,452. ROUNDING 75. PART XIII, LINE 4B - OTHER ADJUSTMENTS: ROUNDING -497. INT EXP DERIVATIVES 940,567. CONTRIBUTIONS MOVED FROM NET ASSETS 4,116,928. EXPENSES TRANSFERRED 335,291. 1 1 X 1 X 1 X 270.000000000000 1 1 1 0 1 1 4699607 0 4699607 0.01830 4699607 4699607 0.01830 8652224 890199 7762025 0.03030 4942629 0 4942629 0.01930 1217870 0 1217870 0.00470 14812723 890199 13922524 0.05430 19512330 890199 18622131 0.07260 54956 0 54956 0.00020 119992 0 119992 0.00050 326630 0 326630 0.00130 20907 0 20907 0.00010 6740 0 6740 0.00000 128651 0 128651 0.00050 93175 0 93175 0.00040 187311 0 187311 0.00070 938362 938362 0.00370 0 9908192 0 106608371 103645967 2962404 X 1 1 1 1 SUBURBAN HOSPITAL INC

8600 OLD GEORGETOWN RD BETHESDA MD 208141497

X SUBURBAN HOSPITAL INC 1 0 1 1 200.000000000000 1 270.000000000000 1 X X X X 1 1 X X X X X X 1 0 1 X 0 0 PART I, LINE 7: A COST-TO-CHARGE RATIO (FROM WORKSHEET 2) IS USED TO CALCULATE THE AMOUNTS ON LINE 7A AND 7B (CHARITY CARE AND UNREIMBURSED MEDICAID). THE AMOUNTS FOR LINES 7E-7I WOULD COME FROM OUR HSCRC COMMUNITY BENEFIT REPORT FILED WITH THE STATE OF MARYLAND AND WOULD NOT BE BASED ON A COST-TO CHARGE RATIO. PART I, LINE 7G: SUBURBAN HOSPITAL, INC. DOES NOT HAVE ANY SUBSIDIZED HEALTH SERVICES. 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 $9,908,192. PART II: SHI COMMUNITY BUILDING ACTIVITIES PROMOTE THE HEALTH OF THE COMMUNITY IT SERVES THROUGH A NUMBER OF INITIATIVES THEY HAVE DEVELOPED. FOR EXAMPLE, SHI YOUTH PROJECTS ENCOURAGE THE YOUNG LEADERS THROUGH A WIDE ARRAY OF PROGRAMS, INCLUDING MEDICAL VENTURING, WHICH INTRODUCES HIGH SCHOOL STUDENTS INTERESTED IN PURSUING MEDICAL CAREERS TO DIFFERENT FACETS OF THE MEDICAL PROFESSION. THIS ALSO GIVES THEM THE OPPORTUNITY TO PARTICIPATE IN GRASSROOTS COMMUNITY SERVICE PROJECTS.SHI COMMUNITY HEALTH AND WELLNESS DEPARTMENT ENGAGES THE SENIOR POPULATION BY ENCOURAGING ACTIVE AND HEALTHY LIFESTYLES THROUGH PROGRAMS DESIGNED TO HELP OLDER ADULTS GAIN OPTIMUM HEALTH. 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.MARYLAND HOSPITALS ARE RATE REGULATED UNDER THE HSCRC, WHICH INCLUDES BAD DEBT AS PART OF THE REIMBURSEMENT FORMULA FOR EACH HOSPITAL. DUE TO THE RATE REGULATION, SUBURBAN HOSPITAL, INC (SHI) CANNOT DETERMINE THE AMOUNT THAT REASONABLE COULD BE ATTRIBUTABLE TO PATIENTS WHO LIKELY WOULD QUALIFY FOR FINANCIAL ASSISTANCE UNDER THE HOSPITALS CHARITY CARE POLICY.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: THE TRIAL BALANCE EXPENSES ARE ADJUSTED TO ALLOWABLE EXPENSE IN ACCORDANCE WITH THE MEDICARE COST REPORTING RULES AND REGULATIONS. PART III, LINE 9B: THE HOSPITAL CONFORMS TO THE PRINCIPLES AND STANDARDS OF THE MHA HOSPITAL BILLING AND DEBT COLLECTION PRACTICES PRINCIPLES AS WELL AS THE MHA MINIMUM STANDARDS FOR FINANCIAL ASSISTANCE IN MARYLAND HOSPITALS. SUBURBAN HOSPITAL, INC. PART V, SECTION B, LINE 19D: MARYLAND IS THE ONLY STATE IN WHICH ALL PAYORS (GOVERNMENTALLY-INSURED, COMMERCIALLY INSURED, OR SELF-PAY) ARE CHARGED THE SAME PRICE FOR SERVICES AT ANY GIVEN HOSPITAL.UNDER THIS SYSTEM, MARYLAND HOSPITALS ARE REGULATED BY A STATE AGENCY: THE HEALTH SERVICES COST REVIEW COMMISSION (HSCRC). PART VI, LINE 2: SHI RELIES ON A NUMBER OF RESOURCES TO IDENTIFY THE HEALTH NEEDS OF OUR COMMUNITY.UTILIZING THE HEALTHY PEOPLE 2020 GUIDELINES AS VITAL INFORMATION SOURCES, SHI MAINTAINS A CLOSE RELATIONSHIP WITH THE MONTGOMERY COUNTY HEALTH DEPARTMENT AND HUMAN SERVICES (MCDHHS) IN ORDER TO IDENTIFY COMMUNITY HEALTH NEEDS AND SET COMMUNITY BENEFIT STRATEGIC PROGRAMS AND ACTIVITIES. INITIATED BY THE MCDHHS AND THE URBAN INSTITUTE, HEALTHY MONTGOMERY IS A COMMUNITY HEALTH NEEDS ASSESSMENT PROCESS AND IS ACCESSIBLE ONLINE TO THE PUBLIC. THIS FORMAL NEEDS ASSESSMENT SERVES AS A STANDARD SET OF POPULATION-BASED HEALTH AND SOCIAL SERVICES DATA. AGREED UPON BY LOCAL STAKEHOLDERS, ONE HUNDRED HEALTH INDICATORS AND SOCIAL DETERMINATES WERE IDENTIFIED AS ISSUES AT BOTH THE MACRO- AND MICRO-LEVELS OF THE COUNTY. THE FORMAL NEEDS ASSESSMENT WAS COMPLETED IN JUNE 2011.THE HEALTHY MONTGOMERY NEEDS ASSESSMENT SERVES AS A BAROMETER OF MONTGOMERY COUNTY RESIDENTS AND THEIR HEALTH. COLLABORATING WITH NON-PROFIT ORGANIZATIONS, CORPORATIONS, COMMUNITY COALITIONS, COUNTY GOVERNMENT AND PUBLIC HEALTH OFFICIALS, THIS NEEDS ASSESSMENT BUILDS ON ALL PAST AND CURRENT EFFORTS, INCLUDING ENVIRONMENTAL SCANS, COMPREHENSIVE NEEDS ASSESSMENTS, COMMUNITY HEALTH-RELATED WORK, AND PARTICIPATION FROM THE HEALTH-CARE PROVIDER ORGANIZATIONS IN THE COUNTY. IN DEVELOPING AND IMPLEMENTING IMPROVEMENT STAGES, HEALTHY MONTGOMERY WORKS WITH COMMUNITY GROUPS AND LOCAL EXPERTS AND USES BEST-PRACTICE STRATEGIES AND TECHNIQUES DEVELOPED BY OTHER RELATED NEEDS ASSESSMENTS, INCLUDING AN EXAMINATION OF THE COMMUNITY HEALTH IMPROVEMENT TOOLS AND TECHNIQUES THAT HAVE DEMONSTRATED SUCCESS IN OTHER PARTS OF THE COUNTRY. THE PROCESS GUARANTEES ACCOUNTABILITY BY IDENTIFYING AND USING PERFORMANCE INDICATORS THAT MEASURE PROGRESS TOWARD ACHIEVING ITS GOALS. HEALTHY MONTGOMERY IS AN ONGOING PROCESS THAT INCLUDES PERIODIC NEEDS ASSESSMENT, DEVELOPMENT AND IMPLEMENTATION OF IMPROVEMENT PLANS AND MONITORING OF THE RESULTING ACHIEVEMENTS. IN ADDITION TO WORKING CLOSELY WITH THE MCDHHS AND THE USE OF NEEDS ASSESSMENTS THAT IDENTIFY AND RESPOND TO LOCAL NEEDS, SHI IDENTIFIES COMMUNITY UNMET OR POTENTIAL HEALTH NEEDS BY COLLABORATING IN PARTNERSHIPS, TAKING AN ACTIVE AND LEADERSHIP ROLE IN COMMUNITY COALITIONS, BOARDS, COMMITTEES, PANELS, ADVISORY GROUPS, AND SERVING ON LOCAL COUNTY COMMISSIONS.SECONDARY DATA WAS COLLECTED FROM A VARIETY OF LOCAL, COUNTY, AND STATE SOURCES TO PRESENT AN INTEGRAL COMMUNITY PROFILE SUCH AS ACCESS TO HEALTH CARE, CHRONIC DISEASES, SOCIAL ISSUES, AND OTHER HEALTH INDICATORS. PART VI, LINE 3: SHI PROVIDES EACH PATIENT REGISTERED FOR EMERGENCY CARE, SAME DAY CARE, OR INPATIENT CARE A COPY OF OUR FINANCIAL ASSISTANCE INFORMATION SHEET. SIGNS ARE ALSO POSTED IN ENGLISH AND SPANISH EXPLAINING THE AVAILABILITY OF FINANCIAL ASSISTANCE AND CONTACT INFORMATION; THEY ARE LOCATED IN THE EMERGENCY, PEDIATRICS, CATH LAB, AND FINANCIAL COUNSELING DEPARTMENTS, AS WELL AS THE MAIN REGISTRATION DESK. THE FINANCIAL ASSISTANCE APPLICATION IS GIVEN TO EVERY SELF PAY PATIENT WILL INSTRUCTIONS ON HOW TO APPLY AND CONTACT INFORMATION. THE SAME INFORMATION IS PROVIDED TO ALL OTHER PATIENTS UPON REQUEST. THIS INFORMATION IS ALSO AVAILABLE IN SPANISH.IN ADDITION, OUR FINANCIAL COUNSELORS AND SOCIAL WORKERS ARE TRAINED TO ANSWER PATIENTS QUESTIONS REGARDING FINANCIAL ASSISTANCE AND LINKAGE TO OTHER COMMUNITY ASSISTANCE RESOURCES PRIOR TO DISCHARGE. REGISTRATION STAFF IS TRAINED TO ANSWER QUESTIONS REGARDING FINANCIAL ASSISTANCE AND WHO TO CONTACT WITH BILLING QUESTIONS OR OTHER FINANCIAL QUESTIONS. PATIENT ACCOUNTING STAFF IS ALSO TRAINED TO ANSWER QUESTIONS AND PROVIDED INFORMATION TO PATIENTS REGARDING FINANCIAL ASSISTANCE AND BILLING. SUBURBAN HOSPITAL USES A CONTRACTOR FROM FINANCIAL HEALTH SERVICES WHO ASSISTS PATIENTS IN APPLYING FOR MARYLAND MEDICAL ASSISTANCE. THE FINANCIAL HEALTH SERVICES CONTRACTOR INTERVIEWS ALL SELF PAY PATIENTS UPON ADMISSION AND PROVIDES THEM WITH INFORMATION AND REFERRAL FOR FINANCIAL ASSISTANCE.THIS PAST MARCH, SUBURBAN HOSPITAL INVITED UNINSURED CITIZENS TO PARTICIPATE IN A TWO DAY FINANCIAL ASSISTANCE INFORMATION EVENT. THE TWO DAY PROGRAM WAS HELD AT SUBURBAN HOSPITAL WHERE FINANCIAL ASSISTANCE CONSULTATION WAS PROVIDED TO COMMUNITY MEMBERS INCLUDING DISSEMINATION INFORMATION ON OUR FINANCIAL ASSISTANCE ELIGIBILITY CRITERIA, MEDICAID AND OTHER COMMUNITY RESOURCES. THIS EVENT IS HELD ANNUALLY. PART VI, LINE 4: SHI GEOGRAPHIC SERVICE AREA IS SUBURBAN.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 THIRTEEN ZIP CODES: 20814, 20817, 20852, 20854, 20815, 20850, 20895, 20906, 20902, 20878, 20853, 20910, AND 20851. THE GENERAL DATA FOR THIS COMMUNITY BENEFIT SERVICE AREA ARE AS FOLLOWS: TOTAL POPULATION WAS 514,137 OF WHICH 48.2% WERE MALES AND 51.8% WERE FEMALES, AVERAGE HOUSEHOLD INCOME WAS $126,017, 7.71% OF RESIDENTS ARE UNINSURED, 10.0% OF RESIDENTS ARE COVERED BY MEDICAID/MEDICARE, 6.0% OF HOUSEHOLDS WITH INCOMES BELOW THE FEDERAL POVERTY GUIDELINES.NUMBER OF OTHER HOSPITALS SERVING THE COMMUNITY OR COMMUNITIES: 5FEDERALLY-DESIGNATED MEDICALLY UNDERSERVED AREAS OR POPULATIONS ARE PRESENT IN THE COMMUNITY . PART VI, LINE 5: FOR THE LAST 30 YEARS, MARYLAND HOSPITALS HAVE MET THEIR COMMUNITY BENEFIT OBLIGATIONS IN A UNIQUE MANNER THAT BUILDS THE COSTS OF UNCOMPENSATED CARE CHARITY CARE AND PATIENT BAD DEBT AND GRADUATE MEDICAL EDUCATION INTO THE RATES THAT HOSPITALS ARE REIMBURSED BY ALL PAYORS. THE SYSTEM IS BASED IN FEDERAL AND STATE LAW AND BENEFITS ALL MARYLAND RESIDENTS, INCLUDING THOSE IN NEED OF FINANCIAL ASSISTANCE TO PAY THEIR HOSPITAL BILLS. MARYLAND IS THE ONLY STATE IN WHICH ALL PAYORS GOVERNMENTALLY INSURED, COMMERCIALLY INSURED, OR SELF PAY ARE CHARGED THE SAME PRICE FOR SERVICES AT ANY GIVEN HOSPITAL.UNDER THIS SYSTEM, MARYLAND HOSPITALS ARE REGULATED BY A STATE AGENCY THE HEALTH SERVICES COST REVIEW COMMISSION (HSCRC) THAT IS REQUIRED TO:1) PUBLICLY DISCLOSE INFORMATION ON THE COST AND FINANCIAL POSITION OF HOSPITALS;2) REVIEW AND APPROVE HOSPITAL RATES;3) COLLECT INFORMATION DETAILING TRANSACTIONS BETWEEN HOSPITALS AND FIRMS WITH WHICH THEIR TRUSTEES HAVE A FINANCIAL INTEREST; AND,4) MAINTAIN THE SOLVENCY OF EFFICIENT AND EFFECTIVE HOSPITALS.SINCE 2000, THE RATE SETTING COMMISSION HAS HAD ITS OWN FRAMEWORK FOR REPORTING HOSPITALS COMMUNITY BENEFITS AND ISSUING A REPORT ANNUALLY REGARDING HOSPITALS COMMUNITY BENEFIT TOTALS. THAT REPORT IS AVAILABLE ON HTTP://WWW.HSCRC.STATE.MD.US/COMMUNITY_BENEFITS/DOCUMENTS/ CBR_FY2007_FINAL_REPORT.PDF. BECAUSE OF THIS UNIQUE STRUCTURE MARYLAND HOSPITALS COMMUNITY BENEFITS NUMBERS WILL NOT COMPARE WITH THE REST OF THE NATIONS HOSPITALS. HOWEVER, MARYLAND HOSPITALS MEET OR EXCEED THE COMMUNITY BENEFIT STANDARD ESTABLISHED BY THE IRS IN 1969. ADDITIONAL DETAIL ILLUSTRATING THIS CAN BE FOUND WITHIN THIS SCHEDULE H REPORT.LINE 7B - MARYLAND 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 UNIQUE ALL-PAYOR SYSTEM INCLUDES A METHOD FOR REFERENCING UNCOMPENSATED CARE IN EACH PAYORS RATES, WHICH DOES NOT ENABLE MARYLAND HOSPITALS TO BREAKOUT ANY DIRECTED 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.LINE 7F COLUMN (D) MARYLAND 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 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 HEALTH PROFESSIONS EDUCATION. 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. REPORTS FILED WITH STATES PART VI, LINE 7 MD 1 JOHNS HOPKINS COMMUNITY PHYSICIANS INC 3910 KESWICK ROAD SOUTH BLDG BALTIMORE MD 21211 521467441 501(C)(3) 4116928 SERVICES TO UNINSURED PATIENTS 1 0 X X X X X 1 1 0 0 0 0 0 1 0 BRIAN A GRAGNOLATI 667174 0 309917 0 52256 0 260401 0 25161 0 1314909 0 0 0 PATRICIA MC BROWN ESQUIRE 0 387024 0 132914 0 81632 0 105551 0 13863 0 720984 0 0 RONALD R PETERSON 0 1101197 0 451124 0 151234 0 1754885 0 23092 0 3481532 0 0 MARTIN BASSO 281849 0 64598 0 13385 0 89550 0 21305 0 470687 0 0 0 PETER B MANCINO ESQUIRE 0 185699 0 24194 0 8328 0 7640 0 19880 0 245741 0 0 DENNIS PARNELL 233975 0 64737 0 14289 0 51053 0 13661 0 377715 0 0 0 JACQUELINE SCHULTZ RN 283959 0 68536 0 43799 0 74350 0 8424 0 479068 0 0 0 LESLIE FORD WEBER 184144 0 35135 0 11197 0 56613 0 1633 0 288722 0 0 0 JOSEPH LINSTROM 164414 0 12430 0 636 0 13726 0 23932 0 215138 0 0 0 RAUL GONZALES 174785 0 0 0 689 0 11051 0 22850 0 209375 0 0 0 ROBERT ROTHSTEIN 321588 0 40021 0 11718 0 77510 0 22666 0 473503 0 0 0 STEVEN COHEN 136646 0 0 0 41657 0 12690 0 21264 0 212257 0 0 0 BARBARA STEWARD JACOBS 169250 0 11846 0 645 0 11183 0 12494 0 205418 0 0 0 STEVEN THOMPSON 0 326115 0 158755 0 13322 0 191304 0 19654 0 709150 0 0 NANCY MILLER 178860 0 11717 0 615 0 14155 0 1587 0 206934 0 0 0 MATTHEW POFFENROTH MD 0 316343 0 57282 0 820 0 18050 0 22057 0 414552 0 0 EUGENE PASSAMANI MD 0 0 0 0 108690 0 6527 0 4883 0 120100 0 0 0 CHRISTOPHER TIMBERS 187087 0 38183 0 10993 0 62332 0 19750 0 318345 0 0 0 PART I, LINES 4A-B THE FOLLOWING INDIVIDUAL RECEIVED A CHANGE-OF-CONTROL PAYMENT FROM SUBURBAN HOSPITAL, INC.: EUGENE PASSAMANI $108,211.80 THE SUBURBAN HOSPITAL, INC. SERP PLAN IS A NON-TAX QUALIFIED DEFINED CONTRIBUTION PLANS. THE PLAN PROVIDES A FIXED PERCENTAGE OF SALARY AS SUPPLEMENTAL RETIREMENT BENEFIT FOR EACH PARTICIPANT. IN THE MANNER REQUIRED BY APPLICABLE IRS RULES, THE DESIGN OF EACH OF THESE ARRANGEMENTS WAS APPROVED AS REASONABLE, IN ADVANCE, BY AN INDEPENDENT COMPENSATION COMMITTEE, WHICH BASED ITS DECISION ON DATA PROVIDED BY AN INDEPENDENT COMPENSATION CONSULTANT. PARTICIPANTS' INTERESTS UNDER THESE ARRANGEMENTS ARE NOT GUARANTEED OR SECURED AT ANY WAY AND AT ALL TIMES ARE SUBJECT TO CLAIMS OF EMPLOYER'S BANKRUPTCY/INSOLVENCY CREDITORS. IF A PARTICIPANT VOLUNTARILY TERMINATES EMPLOYMENT AND FAILS TO SATISFY CERTAIN NON-COMPETE PROVISIONS, THE PARTICIPANT'S ACCOUNT IS FORFEITED. IN ADDITION, UNDER CURRENT LAW, INTERESTS UNDER THESE ARRANGEMENTS ARE REPORTABLE AS TAXABLE COMPENSATION WHEN THEY BECOME VESTED, EVEN IF THOSE AMOUNTS ARE NOT YET PAYABLE TO THE PARTICIPANT (AND EVEN IF THOSE AMOUNTS ARE NEVER PAID TO THE PARTICIPANT). NO ROLLOVER OR OTHER TAX-DEFERRAL OPTIONS ARE AVAILABLE TO PARTICIPANTS. NOTE THAT ANY SERP PLAN VESTED AMOUNT OR PAYMENT BEING REPORTED AS COMPENSATION WAS ALSO REPORTED IN PREVIOUS YEAR(S) WHEN THAT INTEREST ACCRUED UNDER THE PLAN. THE FOLLOWING INDIVIDUALS LISTED ON FORM 990, PART VII, SECTION A, LINE 1A PARTICIPATED IN A NONQUALIFIED RETIREMENT PLAN AND RECEIVED ACCRUED DEFERRED COMPENSATION THAT IS REPORTED ON SCHEDULE J, PART II, COLUMN (C): MARTIN BASSO $71,864; BRIAN GRAGNOLATI $242,468; DENNIS PARNELL $35,108; JACQUELINE SCHULTZ $58,008; CHRISTOPHER TIMBERS $47,156; ROBERT ROTHSTEIN $62,810.00 AND LESLIE FORD WEBER $41,904 THE JOHNS HOPKINS HEALTH SYSTEM CORPORATION'S MAKE WHOLE AND SERP I PLANS ARE FROZEN, NON-TAX QUALIFIED DEFINED BENEFIT PLANS. PARTICIPATION IN THE PLANS IS LIMITED TO THE EXISTING PLAN PARTICIPANTS. THE BENEFITS UNDER THE PLANS ARE BASED UPON THE PARTICIPANT'S LENGTH OF SERVICE AND COMPENSATION. THE MAKE WHOLE PLAN WAS DESIGNED TO REPLACE THE BENEFITS THE PARTICIPANTS LOST DUE TO THE COMPENSATION LIMITS IMPOSED BY LAW UPON OUR QUALIFIED DEFINED BENEFIT PLAN. IN THE MANNER REQUIRED BY APPLICABLE IRS RULES, THE DESIGN OF EACH OF THESE ARRANGEMENTS WAS APPROVED AS REASONABLE, IN ADVANCE, BY AN INDEPENDENT COMPENSATION COMMITTEE, WHICH BASED ITS DECISION ON DATA PROVIDED BY AN INDEPENDENT COMPENSATION CONSULTANT. PARTICIPANTS' INTERESTS UNDER THESE ARRANGEMENTS ARE NOT GUARANTEED OR SECURED AT ANY WAY AND AT ALL TIMES ARE SUBJECT TO CLAIMS OF EMPLOYER'S BANKRUPTCY/INSOLVENCY CREDITORS. FURTHERMORE, IF A PARTICIPANT VOLUNTARILY TERMINATES EMPLOYMENT OR IS TERMINATED BY THE EMPLOYER FOR CAUSE PRIOR TO THE APPLICABLE VESTING DATE UNDER THE MAKE WHOLE PLAN, THE PARTICIPANT'S ENTIRE MAKE WHOLE PLAN BENEFIT IS FORFEITED. IF A PARTICIPANT TERMINATES EMPLOYMENT FOR ANY REASON PRIOR TO THE APPLICABLE VESTING DATE UNDER THE SERP I, THE PARTICIPANT'S ENTIRE SERP I BENEFIT IS FORFEITED. IN ADDITION, UNDER CURRENT LAW, INTERESTS UNDER THESE ARRANGEMENTS ARE REPORTABLE AS TAXABLE COMPENSATION WHEN THEY BECOME VESTED, EVEN IF THOSE AMOUNTS ARE NOT YET PAYABLE TO THE PARTICIPANT (AND EVEN IF THOSE AMOUNTS ARE NEVER PAID TO THE PARTICIPANT). NO ROLLOVER OR OTHER TAX-DEFERRAL OPTIONS ARE AVAILABLE TO PARTICIPANTS. NOTE THAT ANY MAKE WHOLE PLAN OR SERP I VESTED AMOUNT OR PAYMENT BEING REPORTED AS COMPENSATION WAS ALSO REPORTED IN PREVIOUS YEAR(S) WHEN THAT INTEREST ACCRUED UNDER THE PLAN. THE JOHNS HOPKINS HEALTH SYSTEM CORPORATION'S SERP II AND SRP PLANS ARE ACTIVE; NON-TAX QUALIFIED DEFINED CONTRIBUTION TARGET BENEFIT PLANS. THE PLANS ARE DESIGNED TO ACHIEVE A REASONABLE TARGETED RETIREMENT BENEFIT LEVEL FOR EACH PARTICIPANT (IN COMBINATION WITH THE OTHER RETIREMENT PROGRAMS OF THE EMPLOYER) BASED UPON CERTAIN CRITERIA, SUCH AS EACH PARTICIPANT'S LENGTH OF SERVICE AND COMPENSATION. IN THE MANNER REQUIRED BY APPLICABLE IRS RULES, THE DESIGN OF EACH OF THESE ARRANGEMENTS WAS APPROVED AS REASONABLE, IN ADVANCE, BY AN INDEPENDENT COMPENSATION COMMITTEE, WHICH BASED ITS DECISION ON DATA PROVIDED BY AN INDEPENDENT COMPENSATION CONSULTANT. PARTICIPANTS' INTERESTS UNDER THESE ARRANGEMENTS ARE NOT GUARANTEED OR SECURED AT ANY WAY AND AT ALL TIMES ARE SUBJECT TO CLAIMS OF EMPLOYER'S BANKRUPTCY/INSOLVENCY CREDITORS. IF A PARTICIPANT VOLUNTARILY TERMINATES EMPLOYMENT OR IS TERMINATED BY THE EMPLOYER FOR CAUSE PRIOR TO THE APPLICABLE VESTING DATE UNDER EACH ARRANGEMENT, THE PARTICIPANT'S ACCOUNT IS FORFEITED. IN ADDITION, UNDER CURRENT LAW, INTERESTS UNDER THESE ARRANGEMENTS ARE REPORTABLE AS TAXABLE COMPENSATION WHEN THEY BECOME VESTED, EVEN IF THOSE AMOUNTS ARE NOT YET PAYABLE TO THE PARTICIPANT (AND EVEN IF THOSE AMOUNTS ARE NEVER PAID TO THE PARTICIPANT). NO ROLLOVER OR OTHER TAX-DEFERRAL OPTIONS ARE AVAILABLE TO PARTICIPANTS. NOTE THAT ANY SERP II OR SRP PLAN VESTED AMOUNT OR PAYMENT BEING REPORTED AS COMPENSATION WAS ALSO REPORTED IN PREVIOUS YEAR(S) WHEN THAT INTEREST ACCRUED UNDER THE PLAN. 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; PATRICIA BROWN $43,742.00; AND STEVEN THOMPSON $172,756.00 THE FOLLOWING INDIVIDUALS LISTED ON FORM 990, PART VII, SECTION A, LINE 1A PARTICIPATED IN A NON QUALIFIED RETIREMENT PLAN AND RECEIVED PAYMENT FROM THE PLAN, IT IS REPORTED ON SCHEDULE J, PART II, COLUMN (B)(III) AS WELL AS SCHEDULE J, PART II, COLUMN (F) IF THEY WERE REQUIRED TO BE DISCLOSED ON PRIOR YEAR'S FORMS 990: PATRICIA M.C. BROWN $51,908.72 PART I, LINE 7 EXECUTIVES, CEO AND DIRECTORS PARTICIPATE IN AN ANNUAL INCENTIVE PLAN. THE ANNUAL INCENTIVE PLAN HAS THREE POTENTIAL PAYOUT LEVELS - THRESHOLD, TARGET AND MAXIMUM. EACH YEAR SPECIFIC TARGETS ARE ESTABLISHED IN THE AREAS OF QUALITY PATIENT SATISFACTION, FINANCE, HUMAN RESOURCES AND INDIVIDUAL PERFORMANCE. THE INCENTIVE AMOUNT DEPENDS ON THE LEVEL ACCOMPLISHED DURING THE YEAR. THERE IS A 3 YEAR EXECUTIVE LONG TERM INCENTIVE PLAN ONLY AVAILABLE TO CEO AND SENIOR VICE PRESIDENTS. PAYOUT LEVELS ARE THE SAME AS THE ANNUAL PLAN EXCEPT THAT THE PAYOUTS UNDER THE PLAN ARE MADE IN TWO PARTS - 50% OF THE PAYOUT IS MADE AT THE END OF THE 3 YEAR CYCLE AND THE REMAINING 50% IS PAID OUT THE FOLLOWING YEAR. SUPPLEMENTAL INFORMATION PART III THE FLEXIBLE BENEFIT ALLOWANCE PLAN IS A NON-TAX QUALIFIED FLEXIBLE BENEFIT PLAN. THE PLAN IS DESIGNED TO PROVIDE A FIXED PERCENTAGE OF SALARY FOR SUPPLEMENTAL HEALTH WELFARE BENEFITS FOR EACH PARTICIPANT. IN THE MANNER REQUIRED BY APPLICABLE IRS RULES, THE DESIGN OF EACH OF THESE ARRANGEMENTS WAS APPROVED AS REASONABLE, IN ADVANCE, BY AN INDEPENDENT COMPENSATION COMMITTEE, WHICH BASED ITS DECISION ON DATA PROVIDED BY AN INDEPENDENT COMPENSATION CONSULTANT. PARTICIPANTS' INTERESTS UNDER THESE ARRANGEMENTS ARE NOT GUARANTEED OR SECURED AT ANY WAY AND AT ALL TIMES ARE SUBJECT TO CLAIMS OF EMPLOYER'S BANKRUPTCY/INSOLVENCY CREDITORS. IF A PARTICIPANT VOLUNTARILY TERMINATES EMPLOYMENT AND FAILS TO SATISFY CERTAIN NON-COMPETE PROVISIONS, THE PARTICIPANT'S ACCOUNT IS FORFEITED. IN ADDITION, UNDER CURRENT LAW, INTERESTS UNDER THESE ARRANGEMENTS ARE REPORTABLE AS TAXABLE COMPENSATION WHEN THEY BECOME VESTED, EVEN IF THOSE AMOUNTS ARE NOT YET PAYABLE TO THE PARTICIPANT (AND EVEN IF THOSE AMOUNTS ARE NEVER PAID TO THE PARTICIPANT). NO ROLLOVER OR OTHER TAX-DEFERRAL OPTIONS ARE AVAILABLE TO PARTICIPANTS. NOTE THAT ANY FLEXIBLE BENEFIT ALLOWANCE PLAN VESTED AMOUNT OR PAYMENT BEING REPORTED AS COMPENSATION WAS ALSO REPORTED IN PREVIOUS YEAR(S) WHEN THAT INTEREST ACCRUED UNDER THE PLAN. MARYLAND HEALTH AND HIGHER EDUCATIONAL FACILITIES AUTHORITY 520936091 5742173L7 2008-11-19 58515000 ACQUISITION, CONSTRUCTION, RENOVATION AND EQUIPPING OF HEALTHCARE FACILITIES 0 0 0 MARYLAND HEALTH AND HIGHER EDUCATIONAL FACILITIES AUTHORITY 520936091 574217SB2 2004-06-30 32445000 REFUND PRIOR ISSUE 10/14/1993 0 0 0 3660000 58515000 485323 29677 18000000 2010 1 0 1 1 16517000 32445000 351215 1 0 1 1 0 1 1 1 1 1 0.02860 0.01180 0.04040 1 0 0 0 0 1 0 1 1 JP MORGAN 13.000000000000 0 0 0 0 0 0 0 0 0 1 0 X SCHEDULE K, PART III, LINE 4 PRIVATE BUSINESS USE PERCENTAGE ON THE ADVICE OF BOND COUNSEL SUBURBAN HOSPITAL, INC. HAS ADDED COST OF ISSUANCE REPORTED IN PART II TO THE PRIVATE BUSINESS USE PERCENTAGE. WEBER INSURANCE POLICIES X 8437 42185 0 1 1 BASSO INSURANCE POLICIES X 14465 104725 0 1 1 GRAGNOLATI INSURANCE POLICIES X 50177 250885 0 1 1 PARNELL INSURANCE POLICIES X 32655 121362 0 1 1 SCHULTZ INSURANCE POLICIES X 18213 72852 0 1 1 TIMBERS INSURANCE POLICIES X 27955 27955 0 1 1 619964 FORM 990, PART VI, SECTION A, LINE 7A JOHNS HOPKINS HEALTH SYSTEM CORPORATION, AN IRC 501C (3) TAX EXEMPT ORGANIZATION AND THE SOLE MEMBER OF SUBURBAN HOSPITAL, INC. ELECTS THE MAJORITY OF THE BOARD OF TRUSTEES. FORM 990, PART VI, SECTION A, LINE 7B THE GOVERNING BODY OF SUBURBAN HOSPITAL, INC. IS EMPOWERED BY ITS BY-LAWS TO MAKE CERTAIN DECISIONS; ALL OTHER DECISIONS ARE SUBJECT TO APPROVAL OF THE SOLE MEMBER JOHNS HOPKINS HEALTH SYSTEM CORPORATION. FORM 990, PART VI, SECTION B, LINE 11 A COPY OF THE FORM 990 WAS PROVIDED TO THE EXECUTIVE COMMITTEE BEFORE IT WAS FILED. FORM 990, PART VI, SECTION B, LINE 12C THE CONFLICT OF INTEREST POLICY IS PART OF THE ANNUAL FINANCIAL AUDIT CONFIRMATION PROCESS PROVIDED ONLINE. ALL OFFICERS, DIRECTORS, TRUSTEES, AND KEY EMPLOYEES ARE REQUIRED TO COMPLY ON AN ANNUAL BASIS. FORM 990, PART VI, SECTION B, LINE 15 EVERY THREE YEARS AN INDEPENDENT STUDY IS CONDUCTED GATHERING INDUSTRY COMPENSATION AVERAGES FROM SELECT PEER INSTITUTIONS. EVERY YEAR THE JOHNS HOPKINS BOARD OF TRUSTEES COMPENSATION COMMITTEE REVIEWS COMPENSATION AMOUNTS FOR OFFICERS AND ALL EMPLOYEES AT THE DIRECTOR AND HIGHER LEVELS. FORM 990, PART VI, SECTION C, LINE 19 INTERNAL POLICIES, INCLUDING CONFLICT OF INTEREST POLICY, ARE PROVIDED TO THE PUBLIC ON THE ORGANIZATIONS WEBSITE. FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST, THE GOVERNING DOCUMENTS HAVE BEEN MADE AVAILABLE IN OUR PUBLIC FILING WITH THE STATE OF MARYLAND AND THE INTERNAL REVENUE SERVICE. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 5: NET UNREALIZED LOSSES ON INVESTMENTS: -1,554,884. CHANGE IN MINIMUM PENSION LIABILITY -4,910,720. FAIR VALUE ADJ ON DERIVATIVES -1,243,393. CHANGE INTEREST IN NET ASSETS OF FOUNDATION -982,865. ROUNDING -3. TOTAL TO FORM 990, PART XI, LINE 5: -8,691,865. SUBURBAN PHYSICIAN ASSISTANT ASSOCIATES LLC 8600 OLD GEORGETOWN ROAD BETHESDA MD 20814 010642496 MEDICAL SERVICES MD 209218 47448 SUBURBAN HOSPITAL INC SUBURBAN HOSPITAL FOUNDATION INC 8600 OLD GEORGETOWN ROAD BETHESDA MD 20814 522019696 SUPPORTING ORGANIZATION MD 501(C)(3) LINE 11A, I SUBURBAN HOSPITAL INC 1 JOHNS HOPKINS HEALTH SYSTEM CORPORATION 3910 KESWICK RD SOUTH BLDG 4TH FL S BALTIMORE MD 21211 521465301 SUPPORTING ORGANIZATION MD 501(C)(3) LINE 11C, III-FI JOHNS HOPKINS HEALTH SYSTEM CORPORATION 0 HOWARD COUNTY GENERAL HOSPITAL INC 3910 KESWICK RD SOUTH BLDG 4TH FL S BALTIMORE MD 21211 522093120 HOSPITAL MD 501(C)(3) LINE 3 JOHNS HOPKINS HEALTH SYSTEM CORPORATION 0 HOWARD COUNTY LIQUIDATION CORPORATION 3910 KESWICK RD SOUTH BLDG 4TH FL S BALTIMORE MD 21211 520892284 INACTIVE TAX-EXEMPT ORGANIZATION MD 501(C)(3) LINE 3 JOHNS HOPKINS HEALTH SYSTEM CORPORATION 0 JOHNS HOPKINS BAYVIEW MEDICAL CENTER INC 3910 KESWICK RD SOUTH BLDG 4TH FL S BALTIMORE MD 21211 521341890 HOSPITAL MD 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