2013-05-15T12:57:37-05:00 2012-06-30 COHEN RUTHERFORD KNIGHT PC 6903 ROCKLEDGE DRIVE SUITE 500 BETHESDA MD 208171800 990 2011-07-01 521289729 Dimensions Health Corporation % NEIL MOORE DIME 2404562245 7300 VAN DUSEN ROAD LAUREL MD 20707 NEIL MOORE 2013-05-15 TINA C ECKLOFF 3018281008 2011 2016-02-24 21:20:13Z NEIL MOORE 7300 VAN DUSEN RD LAUREL MD 20707 376604323 false X WWW.DIMENSIONSHEALTH.COM X 1982 MD our stated mission is to provide high quality, efficient healthcare services to preserve, restore and improve the health status of our community. 11 10 3020 209 0 0 34749148 33854560 328912185 341183614 180254 -419 2128049 1448002 365969636 376485757 5403 41045 0 0 187358227 197705801 0 0 0 151001275 155804846 338364905 353551692 27604731 22934065 206986139 211487005 221301652 249513475 -14315513 -38026470 OUR STATED MISSION IS TO PROVIDE HIGH QUALITY, EFFICIENT HEALTHCARE SERVICES TO PRESERVE, RESTORE AND IMPROVE THE HEALTH STATUS OF OUR COMMUNITY. THIS MISSION IS PURSUED IN COLLABORATION WITH OUR RELATED ORGANIZATIONS. WE URGE THOSE INTERESTED TO ACCESS MORE DETAILED AND COMPLETE INFORMATION AT WWW.DIMENSIONSHEALTH.ORG false false 323302367 41045 341913185 THE MAIN FUNCTION OF THE ORGANIZATION IS TO PROVIDE COMMUNITY BENEFITS THROUGH PROGRAMS AND ACTIVITIES THAT IMPROVE ACCESS TO HEALTH CARE AND IMPROVE THE OVERALL HEALTH OF THE COMMUNITIES WE SERVE. OUR STATED IS MISSION IS TO PROVIDE HIGH QUALITY, EFFICIENT HEALTHCARE SERVICES TO PRESERVE, RESTORE AND IMPROVE THE HEALTH STATUS OF OUR COMMUNITY. THIS MISSION IS PURSUED IN COLLABORATION with OUR RELATED ORGANIZATIONS, WHICH ARE LISTED IN PART VI. WHILE WE HAVE ATTEMPTED TO SUMMARIZE OUR PROGRAM SERVICE ACCOMPLISHMENTS BELOW, WE URGE THOSE INTERESTED TO ACCESS MORE DETAILED AND COMPLETE INFORMATION AT www.DIMENSIONSHEALTH.ORG. THE ORGANIZATION OPERATES LAUREL REGIONAL HOSPITAL (LRH), WHICH SERVES THE COMMUNITIES LOCATED IN PRINCE GEORGE'S, ANNE ARUNDEL, HOWARD, AND MONTGOMERY COUNTIES WITH A POPULATION OF APPROXIMATELY 2,400,000. IN ACCORDANCE WITH OUR TAX-EXEMPT PURPOSE, THE ORGANIZATION OPERATES AN EMERGENCY ROOM OPEN TO ALL PERSONS REGARDLESS OF THE ABILITY TO PAY THAT SERVED APPROXIMATELY 34,729 PATIENTS during the 2011 tax year. ALL PHYSICIANS LICENSED IN THE STATE OF MARYLAND WHO MEET THE FACILITY BYLAW REQUIREMENTS ARE ELIGIBLE TO APPLY FOR MEDICAL STAFF PRIVILEGES. APPROXIMATELY, 372 HAVE PRIVILEGES AT LRH. THE organization HAS A GOVERNING BODY PRIMARILY COMPRISED OF INDEPENDENT PERSONS REPRESENTATIVE OF THE COMMUNITY, AND PARTICIPATES IN THE MEDICARE AND MEDICAID PROGRAMS. WE HAVE IDENTIFIED SEVERAL HEALTH-RELATED TRENDS, NEEDS, AND PROBLEMS FACING OUR POPULATION, INCLUDING ACCESS TO PRENATAL CARE, ISSUES RELATED TO AGING, SUBSTANCE ABUSE, ACCESS TO SPECIALTY CARE, MATERNAL AND CHILD HEALTH ETC. THE ORGANIZATION'S STRATEGIES FOR ADDRESSING THESE ISSUES INCLUDES PROVIDING CLASSES, SEMINARS, SCREENING AND HEALTH SERVICES, DIABETES EDUCATION. MORE INFORMATION ABOUT THESE STRATEGIES IS AVAILABLE ON THE WEB SITE IDENTIFIED ABOVE. DURING THE MOST RECENT REPORTING PERIOD LRH PROVIDED over $6 million IN CHARITY CARE, at cost, TO THE COMMUNITY. ADDITIONALLY, LRH EXPENDED APPROXIMATELY $9,700,00 ON COMMUNITY BENEFIT PROGRAMS SUCH AS MISSION-DRIVEN HEALTH SERVICES, EDUCATION AND OUTREACH, GRANTS AND SCHOLARSHIPS. THESE ARE PROGRAMS AND ACTIVITIES BENEFITING THE COMMUNITIES WE SERVE, INCLUDING SCREENINGS AND SPEAKERS WHO ARE EDUCATED ON A WIDE RANGE OF TOPICS. LRH ALSO OFFERS CPR, ACLS, AND SMOKING CESSATION CLASSES. LRH IS PROUD TO PARTNER WITH OUTREACH GROUPS SUCH AS ALCOHOLICS ANONYMOUS, NARCOTICS ANONYMOUS, AND A PARKINSON'S SUPPORT GROUP. FOR MORE DETAILED INFORMATION, PLEASE VISIT THE WEB SITE IDENTIFIED ABOVE. In addition, THE ORGANIZATION OPERATES PRINCE GEORGE'S HOSPITAL CENTER (PGHC), AN ACUTE CARE HOSPITAL IN PRINCE GEORGE'S COUNTY, WHICH PROVIDES QUALITY CARE TO A POPULATION OF APPROXIMATELY 1,500,000. IN ACCORDANCE WITH OUR TAX-EXEMPT PURPOSE PGHC OPERATES AN EMERGENCY ROOM OPEN TO ALL PERSONS REGARDLESS OF ABILITY TO PAY THAT SERVED APPROXIMATELY 49,241 PATIENTS during the 2011 tax year. ALL PHYSICIANS LICENSED IN THE STATE OF MARYLAND WHO MEET THE FACILITY BYLAW REQUIREMENTS ARE ELIGIBLE TO APPLY FOR MEDICAL STAFF PRIVILEGES. APPROXIMATELY, 581 HAVE PRIVILEGES AT PGHC. THE ORGANIZATION THAT OPERATES PRINCE GEORGES HOSPITAL CENTER HAS A GOVERNING BODY PRIMARILY COMPRISED OF INDEPENDENT PERSONS REPRESENTATIVE OF THE COMMUNITY, AND PGHC PARTICIPATES IN THE MEDICARE AND MEDICAID PROGRAMS. WE HAVE IDENTIFIED SEVERAL HEALTH-RELATED TRENDS, NEEDS, AND PROBLEMS FACING THE PGHC COMMUNITY POPULATION, INCLUDING ACCESS TO PRENATAL CARE, ISSUES RELATED TO AGING, SUBSTANCE ABUSE AND ACCESS TO SPECIALTY CARE, E.G. EMERGENCY AND TRAUMA SERVICES, MATERNAL AND CHILD HEALTH. THE ORGANIZATION'S STRATEGIES FOR ADDRESSING THESE ISSUES INCLUDES PROVIDING CLASSES, SEMINARS, SCREENING AND HEALTH SERVICES, DIABETES EDUCATION. MORE INFORMATION ABOUT THESE STRATEGIES IS AVAILABLE ON THE WEB SITE IDENTIFIED ABOVE. DURING THE MOST RECENT REPORTING PERIOD pghc PROVIDED over $16 million IN CHARITY CARE, at cost, TO THE COMMUNITY. ADDITIONALLY, pghc EXPENDED APPROXIMATELY $28,500,000 TO COMMUNITY BENEFIT PROGRAMS SUCH AS EDUCATION AND outREACH, GRANTS AND SCHOLARSHIPS, AND MISSION DRIVEN HEALTH CARE SERVICES ON PROGRAMS AND ACTIVITIES BENEFITING THE COMMUNITIES PGHC SERVES. THESE PROGRAMS AND ACTIVITIES INCLUDED TRAUMA SERVICES,PREEMIE SUPPORT GROUP, SMOKING CESSATION PRESENTATIONS, PROVIDED FLU SHOTS TO THE PUBLIC, PROVIDE BLOOD PRESSURE SCREENINGS TO LOCAL CHURCHES, ETC. FOR MORE DETAILED INFORMATION, PLEASE VISIT THE WEB SITE IDENTIFIED ABOVE. 323302367 true true false false false false false false false true true false true true true false false false false true false false false true false true true false true true false false false false false false false false false false false false false true true true false false true 341 0 true 3020 false true CJ false false false true true false false false false false X 11 10 false false false false false false false true true false false true true true true true true true true false MD X NEIL MOORE 3016182109 7300 VAN DUSEN ROAD Laurel MD 20707 X Thomas HENDERSHOTT 1.0 X 0 0 0 ELIZABETH HEWLETT 1.0 X 0 0 0 BARBARA FRUSH 1.0 X 0 0 0 C PHILIPS NICHOLS JR 1.0 X 0 0 0 SAYED SADIQ MD 1.0 X 0 0 0 BENJAMIN STALLINGS MD 1.0 X 0 0 0 V PREM CHANDAR 1.0 X 48000 0 0 TAWANA GAINES 1.0 X 0 0 0 ANDREA HARRISON 1.0 X 0 0 0 BRADFORD SEAMON 1.0 X 0 0 0 FREDERICK SMALLS 1.0 X 0 0 0 NEIL MOORE 38.0 X 337842 0 23844 JOHN O'BRIEN III 40.0 X 302651 0 39488 GITA K SHAH 39.0 X 299389 0 20117 DAVID GOLDMAN 39.0 X 263552 0 35815 KANWALJIT SINGH TANEJA 20.0 X 266382 0 37963 GLORIA A CEBALLOS 40.0 X 185462 0 16396 SHEILA JARRETT 40.0 X 200607 0 26094 MANI A GOTTIPAMULA 40.0 X 184340 0 27366 MICHAEL JACOBS 20.0 X 188051 0 30738 DANIEL J O'BRIEN JR 40.0 X 184788 0 4122 GT DUNLOP ECKER 0.0 X 251309 0 10501 KENNETH GLOVER 20.0 X 459302 0 25149 3171675 0 297593 204 true true false PHOENIX 1130 EAST ARAPHAO ROAD STE 500 RICHARDSON TX 75081 INFORMATION SYSTEM 4574109 SODEXHO PO BOX 536922 ATLANTA GA 303536922 FOOD SERVICE 3947867 HOSPITALIST MEDICINE PHYSICIANS PO BOX 645037 CINCINNATI OH 45264 STAFFING 1487500 EMCARE OF MARYLAND LLC 7032 COLLECTION CTR DR CHICAGO IL 60693 STAFFING 2350067 BROADWAY SERVICES INC 3709 EAST MONUMENT STREET BALTIMORE MD 21205 SECURITY 1848980 29 56525 31969520 1828515 33854560 NET PATIENT REVENUE 339498343 339498343 CAFETERIA/MEAL SERVICE/ VENDING 876355 876355 PARKING 310971 310971 TRAUMA FEES 497945 497945 341183614 22960 22960 0 0 756343 756343 756343 756343 750 24129 -23379 -23379 -23379 56525 51024 94437 -37912 -37912 0 0 OTHER 729571 729571 729571 376485757 341913185 718012 0 41045 41045 0 0 2043119 2043119 0 0 155124846 145932587 9192259 0 14377612 13514955 862657 0 16618365 15621263 997102 0 9541859 8969347 572512 0 784285 0 784285 0 904094 0 904094 0 29041 0 29041 0 0 0 0 26585826 18344220 8241606 380689 236027 144662 394614 284122 110492 208966 20897 188069 0 5429047 5266176 162871 158687 90452 68235 0 0 3337517 3037140 300377 0 9179793 7435632 1744161 8741932 8077397 664535 PROFESSIONAL FEES 3361340 2319325 1042015 PHYSICIAN FEES 14843437 14843437 REPAIRS AND MAINT 4076938 2813087 1263851 DUES AND MEMBERSHIPS 147257 141367 5890 77241383 76313891 927492 353551692 323302367 30249325 0 12642565 12567991 23881815 28788393 0 0 46442351 45817346 0 0 0 0 0 0 5321168 5062611 4030187 4472611 242844748 191458412 54043496 51386336 0 0 11178784 11235823 0 0 68200 56199 49377573 52099695 206986139 211487005 46387655 45636289 0 0 4259835 4360856 58575454 55685683 0 0 0 0 0 0 0 0 112078708 143830647 221301652 249513475 X -18584932 -40769571 4269419 2743101 0 0 -14315513 -38026470 206986139 211487005 X 22934065 -46645022 X false true true X true true X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 743311 743311 65532281 36738440 28793841 35236809 32438400 2798409 140089840 122281572 17808268 1242507 1242507 51386336 BOND FUNDS HELD IN TRUST 11235823 F 11235823 DUE FROM AFFILIATES 39908054 NON-CURRENT ACCOUNTS RECEIVABL 3797144 INVESTMENT AEI 4834485 INVESTMENT DAL 1000000 DEFERRED FINANCING COSTS 235304 DEFERRED COMPENSATION 0 OTHER ACCOUNTS RECEIVABLE 2324708 52099695 0 ADVANCES FROM THIRD PARTIES 11707067 CAPITAL LEASE OBLIGATIONS 3112911 DUE TO AFFILIATES 23640709 ACCRUED EMPLOYEE BENEFIT LIAB 105369960 143830647 FIN 48 DISCLOSURE SCHEDULE D, PART X, LINE 2 The Corporation is exempt from federal income tax under section 501(c)(3) of the Internal Revenue Code as a public charity. Federal tax law requires that the Corporation be operated in a manner consistent with its initial exemption application in order to maintain its exempt status. Management has analyzed the operations of the Corporation and concluded that it remains in compliance with the requirements for exemption. The state in which the Corporation operates also recognizes this exemption for state income tax purposes. Organizations otherwise exempt from federal and state income taxation are nonetheless subject to taxation at corporate tax rates at both the federal and state levels on their unrelated business income. Exemption from other state taxes, such as real and personal property tax, is separately determined. For 2012 and 2011, management has determined that it did not have any tax liability. Although exempt from federal and state income taxes, the Corporation is required to file an annual federal information return on Form 990. In addition, to the extent that the Corporation has gross income from business activities unrelated to its exempt purpose in excess of $1,000 for any tax year, it must also file a Form 990-T tax return. Generally, federal and state taxing authorities must propose any taxable adjustments within three years from the due date of the 990-T or the actual filing date, whichever is later, unless unrelated business gross income is under reported by 25% or more, in which case the relevant time period is six years. No statute of limitations applies for years for which no 990-T has been filed. The Corporation is not currently under audit by any taxing authority and has not been notified of any impending audit. Current accounting standards define the threshold for recognizing uncertain income tax return positions in the financial statements as "more likely than not" that the position is sustainable, based on its technical merits, and also provide guidance on the measurement, classification and disclosure of tax return positions in the financial statements. Management believes there is no impact on the Corporation's accompanying consolidated financial statements related to uncertain income tax positions. Central America and the Caribbean Investments 19295374 19295374 19295374 true false true false false false Part I, Line 3 THE AMOUNT INDICATED AS FOREIGN INVESTMENTS IN PART I WAS DIMENSIONS HEALTH CORPORATION'S OWNERSHIP INTEREST IN DIMENSIONS ASSURANCE COMPANY, LTD ("DAL"), A CAYMAN ISLAND CORPORATION. DAL IS A WHOLLY-OWNED SUBSIDIARY OF DIMENSIONS HEALTH CORPORATION THAT PROVIDES DIRECT COVERAGE FOR PROFESSIONAL, MALPRACTICE, AND COMPREHENSIVE GENERAL LIABILITY FOR DIMENSIONS HEALTH CORPORATION AND ITS ASSOCIATED HEALTH CARE FACILITIES. AS OF THE END OF THE 2011 TAX YEAR, THE VALUE OF DIMENSIONS HEALTH CORPORATION'S OWNERSHIP IN DAL WAS $19,295,374. golf tournament 107549 51024 56525 17129 29123 23477 24708 0 0 0 0 0 0 0 0 0 0 107549 51024 56525 0 17129 29123 23477 0 24708 94437 -37912 true true X true X true X 500. true false true true 21871702 21871702 0.06660 21871702 21871702 0.06660 466976 13280 453516 0.00140 124263 124263 0.00040 45148011 7574621 37573390 0.11440 4650 4650 45743900 7587901 38155819 0.11620 67615602 7587901 60027521 0.18280 2526 2526 2526 2526 false 17352165 106839511 87124103 19715408 X true true 2 1 PRINCE GEORGES HOSPITAL CENTER

3001 HOSPITAL DR CHEVERLY MD 20707

X X X 2 LAUREL REGIONAL HOSPITAL

7300 VAN DUSEN RD LAUREL MD 20707

X X X PRINCE GEORGES HOSPITAL CENTER 1 true true 200. true 500. true X X X X true true X X X X X X true false X X X X true X false false LAUREL REGIONAL HOSPITAL 2 true true 200. true 500. true X X X X true true X X X X X X true false X X X X true X false false 5 GLADYS SPELLMAN SPECIALTY CARE UNIT

7300 VAN DUSEN ROAD LAUREL MD 20707

ACUTE CARE DIMENSIONS SURGERY CENTER

14999 HEALTH CENTER DR STE 103 BOWIE MD 20716

AMBULATORY SURGERY CENTER CORA B WOOD SENIOR CENTER

3601 TAYLOR STREET STE 108 BRENTWOOD MD 20722

SENIOR HEALTH CENTER LARKIN CHASE CARE & REHABILITATION

15005 HEALTH CENTER DRIVE BOWIE MD 20716

REHABILITATION CENTER GLENRIDGE MEDICAL CENTER

7582 ANNAPOLIS ROAD LANHAM MD 20784

MEDICAL CENTER PART I, LINE 3 In the evaluation of an application for financial assistance, a patient's total resource will be taken into account which will included an analysis of the assets held by the patient (narrowly defined under the organization's financial assistance policy as those assets that are convertible to cash and unnecessary for the patient's daily living expenses). In addition, if a self-pay patient that receives emergency or other medically necessary services does not provide the organization with sufficient information for the organization to determine whether the patient may qualify for financial assistance pursuant to the organization's financial assistance policy, and the organization determines that the account is likely uncollectible because the patient has not paid all, or a portion, of the subsequent bill for the services provided, the organization will run the patient's account through a program called ISolutions to determine whether the patient may qualify for presumptive charity care. ISolutions takes the patient's financial and demographic information and determines whether the patient is likely to qualify under the organization's financial assistance policy. If the ISolutions program indicates that a patient is likely to qualify for free or discounted care, the organization will accept that patient into its financial assistance policy and discount the patient's account from 25 to 100%, depending upon the results of the ISolutions program. PART I, LINE 5 The Organization doesn't budget a preset percentage for Charity Care. It is the organization's policy to provide financial assistance to any individual that qualifies under the organization's financial assistance policy, regardless of the amount of charity care provided by the organization during the year. It is part of our mission to serve as the safety net for the uninsured and underinsured. Part I, Line 6A Community Benefit Report The organization submits a community benefit report annually to the Maryland HSCRC. Part I, Line 7A Column D Charity Care Maryland's regulatory system creates a unique process for Hospital payment that differs from the rest of the nation. The Health Services Cost Review Commission, (HSCRC) determines payment through a rate-setting process and all payors, including governmental payors, pay the same amount for the same services delivered at the same hospital. Maryland's unique all-payor system includes a method for referencing Uncompensated Care in each payors' rates, which does not enable Maryland hospitals to breakout any offsetting revenue related to Uncompensated Care. Part I, Line 7B Columns C-F Unreimbursed Medicaid Maryland's regulatory system creates a unique process for hospital payment that differs from the rest of the nation. The Health Services Cost Review Commission, (HSCRC) determines payment through a rate-setting process and all payors, including governmental payors, pay the same amount for the same services delivered at the same hospital. Maryland's unique all-payor system includes a method for referencing Uncompensated Care in each payors' rates, which does not enable Maryland hospitals to breakout any direct 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. Part I, Line 7F Health Professions Education Column D Maryland's regulatory system creates a unique process for hospital payment that differs from the rest of the nation. The Health Services Cost Review Commission, (HSCRC) determines payment through a rate-setting process and all payors, including governmental payors, pay the same amount for the same services delivered at the same hospital. Maryland's unique all-payor system includes a method for referencing Uncompensated Care in each payors' rates, which does not enable Maryland hospitals to breakout any offsetting revenue related to Uncompensated Care. Part I, Line 7 Column F The organization's bad debt expense that was reported on Form 990, Part IX $25,214,633 was reduced from total expenses to determine the percentages of total expenses. Part I, Line 7g column c Access to primary and specialist health care services is an identified and considerable health need throughout the organization's community. For example, the national benchmark is 631 people: 1 primary care physician, whereas, for Prince George's county, the number of people per primary care physician is approximately 1077:1. This stems in large part from the county's very high uninsured and underinsured population that can afford to pay little to no reimbursement for services received. In order to meet this substantial community health need, the organization has brought in specialist and primary care physicians into the organization's community. First, the organization pays physicians to cover the bad debts they incur when providing services to patients at PGHC and LRH. In addition, the organization has employed primary care and specialist physicians through its direct tax-exempt subsidiary physician practice, Dimensions Healthcare Associates, to provide patient services to the community, including uninsured and underinsured patients that would not otherwise have access to physician services. The direct subsidies paid from the organization to DHA during the tax year to support the continued existence of the physician practice, and to help reduce the physician shortfall in the community, were $14,756,000 during the 2011 tax year. Part III, Line 4 Bad Debt The organization's footnote for "accounts receivable and contractual allowances": The Corporation's policy is to write off all patient accounts that have been identified as uncollectible. An allowance for doubtful accounts is recorded for accounts not yet written off that are anticipated to become uncollectible in future periods. Discounts ranging from 2% to 6% of hospital charges are given to Medicare, Medicaid and certain approved commercial health insurance and health maintenance organizations (HMOs). Also, these payers routinely review patient billings and deny payment for certain procedures that they deem medically unnecessary or performed without appropriate pre-authorization. Discounts and denials are recorded as reductions of net patient revenue. Accounts receivable from these third-party payers have been adjusted to reflect the difference between charges and the estimated reimbursable amounts. The amount of bad debt reported on line 2 was the cost of the bad debt expense, as determined using the ratio of patient care cost to charges determined in worksheet 2. The organization estimates that only a minimal amount of its bad debt expense was attributable to patients that would be eligible for financial assistance under the organization's financial assistance policy. As referenced in the disclosure to Schedule H, Part I, Line 3, the organization uses a computer program to help determine whether patients may qualify for presumptive charity care, and the organization believes this program helps capture the vast majority of the patients that are eligible for financial assistance under the organization's financial assistance policy that did not provide the organization with sufficient information to qualify them for financial assistance. Part III, Line 8 Medicare The costing source is the Medicare cost report and the methodology is Medicare allowable cost to Medicare revenues received. Part III, Line 9 Debt Collection Policy All self-pay patients may apply for the Financial Assistance Program. Patients may apply for the program in Patient Financial Services Customer Service area or Patient Access Department. Income, assets and other criteria are evaluated for determination of patient finances to qualify for the program. Once the collection process has begun, the organization continues to monitor whether the patient qualifies for charity care under the financial assistance policy. If the organization determines that a patient qualifies for financial assistance, including once the collection has begun, the organization will approve the patient for charity care. The write off (ranging from 25% - 100%) to charity care is according to a sliding fee scale for income. Once charity care has been approved, there is no further attempt made by the organization to collect. Part V, Line 17 Prince Georges Hospital Center THE HOSPITAL FACILITY OR AN AUTHORIZED THIRD PARTY DID NOT UNDERTAKE ANY OF THE COLLECTION ACTIONS NOTED IN PART V, SECTION B, LINE 16 BEFORE MAKING REASONABLE EFFORTS TO DETERMINE ANY PATIENT'S ELIGIBILITY UNDER THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY. IN ORDER TO HELP DETERMINE PATIENTS' ELIGIBILITY UNDER THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY, THE HOSPITAL UNDERTAKES A NUMBER OF ACTIONS, INCLUDING NOTIFYING PATIENTS OF THE FINANCIAL ASSISTANCE POLICY ON ADMISSION, NOTIFYING PATIENTS OF THE FINANCIAL ASSISTANCE POLICY PRIOR TO DISCHARGE, NOTIFYING PATIENTS OF THE FINANCIAL ASSISTANCE POLICY IN COMMUNICATIONS WITH THE PATIENTS' BILLS, AND DOCUMENTING ITS DETERMINATION OF WHETHER PATIENTS WERE ELIGIBLE FOR FINANCIAL ASSISTANCE UNDER THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY. Part V, Line 17 Laurel Regional Hospital THE HOSPITAL FACILITY OR AN AUTHORIZED THIRD PARTY DID NOT UNDERTAKE ANY OF THE COLLECTION ACTIONS NOTED IN PART V, SECTION B, LINE 16 BEFORE MAKING REASONABLE EFFORTS TO DETERMINE ANY PATIENT'S ELIGIBILITY UNDER THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY. IN ORDER TO HELP DETERMINE PATIENTS' ELIGIBILITY UNDER THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY, THE HOSPITAL UNDERTAKES A NUMBER OF ACTIONS, INCLUDING NOTIFYING PATIENTS OF THE FINANCIAL ASSISTANCE POLICY ON ADMISSION, NOTIFYING PATIENTS OF THE FINANCIAL ASSISTANCE POLICY PRIOR TO DISCHARGE, NOTIFYING PATIENTS OF THE FINANCIAL ASSISTANCE POLICY IN COMMUNICATIONS WITH THE PATIENTS' BILLS, AND DOCUMENTING ITS DETERMINATION OF WHETHER PATIENTS WERE ELIGIBLE FOR FINANCIAL ASSISTANCE UNDER THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY. Part V, Line 19D Prince Georges Hospital Center THE HOSPITAL FACILITY PROVIDES A DISCOUNT OF AT LEAST 25% OFF OF GROSS CHARGES FOR THE PROVISION OF EMERGENCY AND OTHER MEDICALLY NECESSARY CARE TO ANY INDIVIDUAL THAT IS ELIGIBLE FOR financial assistance UNDER THE HOSPITAL FACILITY'S FINANCIAL ASSISTANCE POLICY. PURSUANT TO THE HEALTH SERVICES COST REVIEW COMMISSION (HSCRC) ALL-PAYOR SYSTEM FOR HOSPITALS IN THE STATE OF MARYLAND, THE GREATEST DISCOUNT OFF OF GROSS CHARGES FOR THE PROVISION OF EMERGENCY AND OTHER MEDICALLY NECESSARY CARE PERMITTED TO ANY COMMERCIAL INSURER OR MEDICARE IS ONLY 6%. AS A RESULT, THE HOSPITAL FACILITY WAS ABLE TO DETERMINE THAT THE MAXIMUM AMOUNT CHARGED TO INDIVIDUALS THAT WERE ELIGIBLE FOR FINANCIAL ASSISTANCE UNDER THE HOSPITAL FACILITY'S FINANCIAL ASSISTANCE POLICY WAS NOT GREATER THAN THE AMOUNT GENERALLY BILLED TO INDIVIDUALS WHO HAVE INSURANCE COVERING SUCH CARE. Part V, Line 19D Laurel Regional Hospital THE HOSPITAL FACILITY PROVIDES A DISCOUNT OF AT LEAST 25% OFF OF GROSS CHARGES FOR THE PROVISION OF EMERGENCY AND OTHER MEDICALLY NECESSARY CARE TO ANY INDIVIDUAL THAT IS ELIGIBLE FOR financial assistance UNDER THE HOSPITAL FACILITY'S FINANCIAL ASSISTANCE POLICY. PURSUANT TO THE HEALTH SERVICES COST REVIEW COMMISSION (HSCRC) ALL-PAYOR SYSTEM FOR HOSPITALS IN THE STATE OF MARYLAND, THE GREATEST DISCOUNT OFF OF GROSS CHARGES FOR THE PROVISION OF EMERGENCY AND OTHER MEDICALLY NECESSARY CARE PERMITTED TO ANY COMMERCIAL INSURER OR MEDICARE IS ONLY 6%. AS A RESULT, THE HOSPITAL FACILITY WAS ABLE TO DETERMINE THAT THE MAXIMUM AMOUNT CHARGED TO INDIVIDUALS THAT WERE ELIGIBLE FOR FINANCIAL ASSISTANCE UNDER THE HOSPITAL FACILITY'S FINANCIAL ASSISTANCE POLICY WAS NOT GREATER THAN THE AMOUNT GENERALLY BILLED TO INDIVIDUALS WHO HAVE INSURANCE COVERING SUCH CARE. Part V, Line 21 Prince Georges Hospital Center The Hospital facility does not charge any individuals that it knows are eligible for financial assistance an amount equal to the gross charge for any service. The Hospital uses the charge master rates for a service as a starting point against which the discounts mandated in the hospital facility's financial assistance policy are applied to determine the amount actually billed to patients eligible under the financial assistance policy. The hospital facility will not collect payment from any patient eligible under the financial assistance policy in excess of the reduced amount that is actually billed to such financial assistance patient. Part V, Line 21 Laurel Regional Hospital The Hospital facility does not charge any individuals that it knows are eligible for financial assistance an amount equal to the gross charge for any service. The Hospital uses the charge master rates for a service as a starting point against which the discounts mandated in the hospital facility's financial assistance policy are applied to determine the amount actually billed to patients eligible under the financial assistance policy. The hospital facility will not collect payment from any patient eligible under the financial assistance policy in excess of the reduced amount that is actually billed to such financial assistance patient. Part VI, Line 2, Needs Assessment A Prince George's County Health Profile Snapshot Report was completed by PGHC in June 2006. The report was generated as a result of a collaborative effort of PGHC and the Prince Georges' County Health Department. The data referenced in the Report was acquired from US Census data and from the Public Health Quick Stats for Prince Georges' County, Maryland and the most recent Maryland Vital Statistics Report. Additionally, there have been healthcare assessment reports/studies prepared by Rand corporation in February 2009, Prince George's County Government Improvement Plan in 2011, and a public impact health study by the university of maryland school of public health in 2012. The main findings of the 2006 PG County Health Profile Snapshot report, the 2009 rand report, the Prince George's County report and the 2012 um sph public health impact study is that there are significant health diparities in prince george's county and that the county lacks a robust health safety net. A common theme is that there are healthcare disparities which include (1) rates of uninsurance that are relatively high when compared with surrounding jurisdictions (2) and a shortage of primary care physicians in the community. In March 2008, the PGHC Board of Directors established a Community Health Task Force (CHTF) committee. The CHTF includes collaborations with such organizations as the Prince George's County Health Action Forum and the Prince George's County Health Department. The purpose of the CHTF is to assist management in the development of relationships and a plan to work with identified community-based health services and to make an optimal range of services more widely available to improve community health status. To date, the CHTF has focused attention on community health needs, providing improved health information, and is currently working with the National Institute of Health - National Library of Medicine (NIH - NLM) to identify sustainable community health delivery initiatives. LRH management actively solicits information from community stakeholders and other community-based organizations to assess the health needs in our community. LRH representatives serve as members of a variety of healthcare focused community organizations and provide staff expertise and other resources, including hosting meetings at our facility, and participating in events, by providing health screening services. Some of these organizations include: * Prince George's County Health Department * Prince George's Care Access Network Health Information and Resource Initiative (PG CAN) * Health Action Forum of Prince George's County * Prince George's Healthcare Action Coalition * National Capital Area Breast Health Quality Consortium * The Prince George's County Local Health Disparities Committee * The Health Empowerment Network of Maryland, Inc. (HENM) - a Community Based Organization made up of partners such as the Prince George's County Health Department, University of Maryland Prevention Resource Center, Prince George's County Area Agency on Aging, Department of Mental Health and Hygiene, Integrity Health Partners and the City of Seat Pleasant, among others. According to the Patient Protection and Affordable Care Act (ACA) hospitals must perform a Community health needs assessment (CHNA) either fiscal year 2011, 2012 or 2013, adopt an implementation strategy to meet community health needs identified beginning in 2013, perform an assessment at least every three years thereafter. A formal CHNA, per ACA guidelines, will be completed on or before June 30, 2013. Part VI, Line 3, Patient education of eligibility for assistance Dimensions Healthcare System provides compassionate care for all, regardless of an individual's ability to pay. It is our mission to serve as the safety net for the uninsured and underinsured and to help save lives and improve our patients' quality of living. Dimensions Healthcare System, through the provision of discounted or free health care services, (depending upon the established criteria set out below), provides financial assistance to those who need medical and health care services but do not have the resources to pay for that care. It does so by preserving the dignity of the individual who needs assistance. The provision of free and discounted care through our Financial Assistance Program is consistent, appropriate and essential to the execution of our mission, vision and values, and is consistent with our tax-exempt, charitable status. Dimensions Healthcare System is committed to: Communicating the organization's mission to the patient so they can more fully and freely participate in providing the needed information without fear of losing basic assets and income; assessing the patients' capacity to pay and reach payment arrangements that do not jeopardize the patients' health and basic living arrangements or undermine their capacity for self-sufficiency; upholding and honoring patients' rights to appeal decisions and seek reconsideration and to have a self-selected advocate to assist the patient throughout the process; avoiding seeking or demanding payment from or seizing income or assets from patients eligible for financial assistance; and Providing options for payment arrangements, without requiring that the patient select higher cost options for repayment. In order to promote the health and well-being of the community served, individuals with limited financial resources who are unable to access entitlement programs shall be eligible for free or discounted health care services based on established criteria. Eligibility criteria will be based upon the Federal Poverty guidelines and will be updated annually in conjunction with the published updates by the United States Department of Health and Human Services. All open self-pay balances may be considered for financial assistance. If a determination is made that the patient has the ability to pay all or a portion of the bill, such a determination does not prevent a reassessment of the person's ability to pay at a later date. The need for financial assistance is to be re-evaluated at the following times: * Subsequent rendering of services, * Income change, * Family size change, * When an account that is closed is to be reopened, or * When the last financial evaluation was completed more than six months before. Appropriate signage will be visible in the facility in order to create awareness of the financial assistance program and the assistance available. At a minimum, signage will be posted in all patient intake areas, including, but not limited to, the Emergency Department, the Billing Office, and the Admission/Patient Registration areas. Information such as brochures will be included in patient services/information folders and/or at patient intake areas. All public information and/or forms regarding the provision of financial assistance will use languages that are appropriate for the facility's service area in accordance with the state's Language Assistance Services Act. The necessity for medical treatment of any patient will be based on the clinical judgment of the provider without regard to the financial status of the patient. All patients will be treated with respect and fairness regardless of their ability to pay. Where possible, prior to the admission of the patient, the Hospital will conduct a pre-Admission interview with the patient, the guarantor, and/or his/her legal representative to determine potential eligibility under the organization's financial assistance policy. If a pre-Admission interview is not possible, this patient interview should be conducted upon admission or as soon as possible thereafter. In the case of an emergency admission, the Hospital's evaluation of payment alternatives should not take place until the required medical care has been provided. At the time of the initial interview, the following information should be gathered: a) Routine and comprehensive demographic and financial data. b) Complete information regarding all existing third party coverage. Identification of potentially financial assistance eligible patients can take place at any time during the rendering of services or during the collection process. Also, those patients who may qualify for medical assistance from a governmental program should be referred to the appropriate program, such as Medicaid, prior to consideration for financial assistance. Medicaid Eligibility All uninsured Inpatients at Dimensions are assisted by DHS Medicaid Eligibility staff to evaluate the patients for Maryland Medicaid eligibility. Once they are evaluated, the staff will assist the patients with the completion of the Medicaid application. The application is presented to DSS for review and certification. The staff monitors the application process to ensure that a determination is made on the application. DHS patients do not receive a bill during this process. Once the Medicaid application determination has been made, patients who qualify will receive a bill. If a patient is deemed ineligible for medicaid, the patient will be categorized as Self Pay and assessed for possible eligibility under the Financial Assistance Program. Part VI, Line 4, Community information DIMENSIONS HEALTHCARE SYSTEM (DHS) IS THE LARGEST NOT-FOR-PROFIT PROVIDER OF HEALTH CARE SERVICES IN PRINCE GEORGE'S COUNTY. ADDITIONAL COUNTIES AND AREAS SERVED INCLUDE ANNE ARUNDEL, HOWARD, MONTGOMERY COUNTIES AND THE DISTRICT OF COLUMBIA. DHS HOSPITALS' PRIMARY COVERAGE AREA IS PRINCE GEORGE'S COUNTY. THE POPULATION ESTIMATE FOR PRINCE GEORGE'S COUNTY IN 2010 WAS 863,420. IN PRINCE GEORGE'S COUNTY, THE MEDIAN HOUSEHOLD INCOME WAS $70,715 AND THE PERCENTAGE OF PERSONS BELOW POVERTY LEVEL WAS 7.9%. Of the counties and areas served, PRINCE GEORGE'S COUNTY HAS THE HIGHEST PERCENTAGE OF HOUSEHOLDS WITH INCOME BELOW THE FEDERAL POVERTY LINE AS WELL AS HIGHER PERCENTAGE OF UNINSURED (15%), MEDICAID RECIPIENTS (15.7%) AND THE HIGHEST MORTALITY RATE (747.8%/100,000). IN THE OTHER SERVICE AREAS, ANNE ARUNDEL COUNTY, THE DISTRICT OF COLUMBIA, HOWARD AND MONTGOMERY COUNTIES, MEDIAN HOUSEHOLD INCOME WAS $83,456, $63,124, $103,273, THE PERCENTAGE OF PERSONS BELOW POVERTY LEVEL BEING 5.3%, 18.5%, 4.2% AND 6% RESPECTIVELY (US CENSUS BUREAU STAT AND COUNTY QUICK FACTS). FOR each of the counties and areas comprising the SERVICE AREA, 9.8%-11.4% OF THE POPULATION IS 65 YEARS OF AGE OR OLDER AND APPROXIMATELY 7%-27.4% REPRESENT MEDICAID PATIENTS. In Prince George's and the other service areas, smoking, obesity and excessive alcohol consumption are health risk factors. There are Risk factors for premature death; such as High Blood pressure ranging between 26.2% -28.2%; Obesity 23.3% - 34%; Smoker 11.9% - 22.4%. Access to primary health care services remains an issue of concern in Prince George's County. Prince George's County has substantially lower per capita numbers of primary care physicians when compared to neighboring jurisdictions. The National benchmark is 631:1 for access to primary care physician, compared to 1,077:1 for Prince George's County. The number of safety net clinics in Prince George's Hospital is 5, which compares to 38-40 in the District of Columbia and 11 in Montgomery County. In light of the County's high uninsured or underinsured population that pays little to no reimbursement for services received, the County's level of private-practice primary care doctors and primary care clinics has not kept pace with the health care needs of County residents. The capacity of community-based care, including safety-net clinics, remains severely limited. This lack of primary care services and patient "medical homes" has resulted in increased use of the Hospital's emergency departments and other specialty health care services. For the fiscal year ending June 30, 2012, PGHC and LRH, had a patient and third party payer mix that included 56.1% and 41.8%, respectively, for Medicaid and uninsured self-pay patients. Community Challenges & Health Statistics: Despite the higher than average median household income, educational attainment, and percentage of individuals in the work force represented by Prince Georgians in comparison with national figures, the County does contain several pockets of low socioeconomic status. The 2009 Community Health Status Report data reveal that medically vulnerable Prince Georgian's (uninsured and Medicaid enrolled individuals) number approximately 297,784 or 35.7% of the population. As a result, issues such as diabetes mortality, heart disease, hypertension, stroke, and deaths from breast, colorectal and prostate cancers, HIV and infant mortality all represent significant health challenges for community members. Furthermore, persistent disparities in mortality and health status for several health indices are seen in various racial and ethnic populations. The racial and ethnic minorities are approximately 2/3 of Prince George's County Medicaid beneficiaries. County and Maryland State health statistics are similar to national trends regarding the status of minority health. Part VI, Line 5, Promotion of community health Dimensions Health Corporation (DHC) maintains clinical affiliation agreements with and supports clinical placements for both nursing and ancillary programs in and out of state. In addition, with state support, DHC participates in the NSP II grant which is a partnership designed to promote BSN and MSN completion for RNs. DHC also participated in the NSP I grant. One of the provisions in this grant is the availability of $4,000 per year for up to 15 Prince George's County residents who are enrolled in an entry level nursing program. In terms of community-based mentoring DHC staff members participate on a small scale in career days at local county schools. Additionally, DHC has established collaborations with such organizations as the Prince Georges County (Maryland) Health Action Forum and the Prince Georges County Health Department. The purpose of the collaborations is to assist management in the development of relationships and a plan to work with identified community-based health services and to make an optimal range of services more widely available to improve community health status. To date, this effort has focused attention on community health needs, provided improved health information, and DHC is currently working with the National Institute of Health - National Library of Medicine to identify sustainable community health information delivery initiatives. DHC also provided a number of health fairs, health employee internships, and other programs to promote health in the surrounding communities. Dimensions Health is comprised of an 11 member board. None are employed by Dimensions. Membership of the Board includes people who live in Prince Georges' county. The Dimensions Health System provides a broad array of inpatient and community based services to residents in the metropolitan region. The System operates several facilities including two acute care hospitals. All physicians licensed in the State of Maryland who meet the facility bylaw requirements are eligible to apply for privileges. Approximately, 372 hold privileges at the Dimensions' Laurel Regional Hospital and 581 have privileges at the Prince George's Hospital Center. Although PGHC has one of the largest populations of uninsured patients in the State, we believe that all patients should receive the highest level of care regardless of economic standing. This goal can only be achieved with experienced specialist physicians caring for all of our patients even when so many of our patients cannot afford to pay. To overcome this obvious dilemma, we pay physicians to cover their bad debts so the "gap" exists in the hospital's profits but not in patient care. We get no funds from the regulated system to offset these physician payments but, in light of PGHC's safety net mission, we will always put the patients first. The largest community benefit expenditure is the mission-driven, non-reimbursed subsidies paid to its physicians to guarantee the continuation of the System's safety net mission. We have identified several health-related trends, needs, and problems facing our population, including access to prenatal care, issues related to aging, substance abuse, access to specialty care, Maternal and Child health etc. The organization's strategies for addressing these issues includes providing classes, seminars, screening and health services, diabetes education, CPR, ACLS, preemie support group, smoking cessation presentations, provide flu shots to the Public, provide blood pressure screenings to local churches. Prince George's Hospital Center (PGHC) and Laurel Regional Hospital (LRH) have partnered with community-based organizations to increase their capacity to provide services to the community. This includes providing healthcare providers at various Federally Qualified Health Centers (FQHC) sites in Prince George's County to facilitate access to sub-specialty services for uninsured and underinsured residents. We are also proud to partner with outreach groups such as Alcoholics Anonymous, Narcotics Anonymous, and a Parkinson's Support group. The Hospitals have also worked with local and state health officials to develop the Prince George's County and the State Health Improvement Plans and continues to work closely with the Health Department to implement programs that address the health plan goals. PGHC and LRH are improving and adapting current health programs into sustainable community-based programs to impact the overall health and wellness of the community in a positive way. This service expansion and adaptation is being achieved through collaborative partnerships with community organizations as well as state and local health agencies. Part VI, Line 6, Affiliated health care system Prince George's Hospital Center , Laurel Regional Hospital, Gladys Spellman Care Unit, and Bowie Health Center are all facilities operated by the Dimensions Healthcare System, the largest not-for-profit provider of health care services in Prince George's County. Dimensions Health Corporation provides many different services to the Community it serves. PGHC offers a comprehensive range of inpatient and outpatient medical and surgical services including: Emergency and trauma services (designated Level II regional trauma center for southern Maryland), Critical care services, Cardiac care services (comprehensive cardiac care - only program of its kind in the County). Laurel Regional Hospital offers a comprehensive range of inpatient and outpatient medical and surgical services including Emergency services, Critical care services, Cardiac care services, laboratory and pathology testing, Medical and surgical services, Maternal and child health, Physical rehabilitation center (only hospital-based CARF accredited rehab unit in the County), Pulmonary rehabilitation program, Wound care center (94 percent healing rate). Gladys Spellman, which is now located within LRH's facility, provides nursing home care. Bowie Health Center is a hospital-based emergency service center. In addition, Dimensions Healthcare Associates, Inc., a subsidiary of Dimensions Health Corporation, employs multi-specialty physicians, including primary care physicians, to provide patient services to the Community, including uninsured and underinsured patients that would not otherwise have access to physician services. The cost to DHC of funding the shortfall of this physician practice that meets an identified community need for additional physicians in the community was $14,756,000 during the 2011 tax year. STATE FILING OF COMMUNITY BENEFIT REPORT 990 SCHEDULE H, PART VI MD, true SCHOLARSHIPS 14 41045 PROCEDURES FOR MONITORING GRANT USE SCHEDULE I, PART I, LINE 2 PURSUANT TO THE NSP I GRANT PARTICIPATED IN BY DHC, DHC PAYS on a continuing basis for the cost of tuition and related expenses such as books, licensing fees, and examinations, up to $4,000.00 per fiscal year. Students must be enrolled in the Associate/Bachelors degree Nursing program or completing pre-requisites with Nursing as their stated field of study. As a condition of Dimensions Healthcare System's obligations described above, Scholarship Recipient agrees: 1.To supply evidence of current enrollment in a Nursing Program of study and/or pre-requisite study for acceptance into the school of Nursing Program. A copy of your course registration meets this requirement. 2.To write a 200 word essay on how this scholarship is enabling you to pursue your nursing education and an update on your progress through your nursing program. 3.To maintain a full-time course of study for the period of time covered by this Agreement. 4.To maintain a cumulative GPA of at least 2.5 on a scale of 4.0 throughout the duration of this Agreement. Such evidence will require submission of a copy of the transcript for each quarter or semester. 5.To interview, if requested, with Nursing and Human Resources representatives as appointed by the Corporation. 6.To successfully graduate with an Associate degree (or higher) in Nursing. Such evidence will require submission of an original diploma, which will be copied by the Corporation. 7.To take the NCLEX-RN Examination at the first available testing date after graduation. If the scholarship recipient is unsuccessful in passing the NCLEX-RN examination on the first attempt, he/she must schedule retesting at the first available date. 8.That she/he will meet all conditions of employment as a Registered Nurse as required by Dimensions Healthcare System. As part of the application process for employment, she/he will be required to complete pre-employment drug testing and undergo a criminal background check. 9.That she/he will be subject to and comply with all policies, rules, and regulations of Dimensions Healthcare System. 10.If she/he does not comply with the conditions as described in paragraphs 1 through 10 of Section B, withdraws from the program, does not graduate from the program or does not begin employment with Dimensions Healthcare System within three (3) months of graduation, this Agreement becomes null and void and scholarship recipient agrees to repay any and all funds remitted by Dimensions Healthcare System through this scholarship program to Dimensions Healthcare System within three (3) months of graduation or withdrawal from the program. 11.If she/he begins employment with Dimensions Healthcare System, but does not remain an employee for ONE (1) YEAR, she/he agrees to repay any and all funds remitted by Dimensions Healthcare System through this scholarship program to Dimensions Healthcare System on a prorated basis, based on the amount of time worked at time of separation. This payment will be remitted to Dimensions Healthcare System within three (3) months of separation. X false false X X X true false false false false false false false false NEIL MOORE 337842 0 0 0 0 0 0 0 23844 0 361686 0 GT DUNLOP ECKER 251309 0 0 0 0 0 0 0 10501 0 261810 0 JOHN O'BRIEN III 302651 0 0 0 0 0 21475 0 18013 0 342139 0 KANWALJIT SINGH TANEJA 266382 0 0 0 0 0 22000 0 15963 0 304345 0 GITA K SHAH 291861 0 0 0 7528 0 8892 0 11225 0 319506 0 DAVID GOLDMAN 263552 0 0 0 0 0 10478 0 25337 0 299367 0 KENNETH GLOVER 459302 0 0 0 0 0 0 0 25149 0 484451 0 GLORIA A CEBALLOS 185462 0 0 0 0 0 6754 0 9642 0 201858 0 SHEILA JARRETT 200607 0 0 0 0 0 9788 0 16306 0 226701 0 MANI A GOTTIPAMULA 184340 0 0 0 0 0 22000 0 5366 0 211706 0 MICHAEL JACOBS 188051 0 0 0 0 0 11758 0 18980 0 218789 0 DANIEL J O'BRIEN JR 184788 0 0 0 0 0 0 0 4122 0 188910 0 SEVERANCE PAYMENT SCHEDULE J, PART I, LINE 4A A SEVERANCE PAYMENT WAS MADE TO THE FOLLOWING INDIVIDUAL: GT DUNLOP ECKER $261,810 DESCRIPTION OF 990 REVIEW PROCESS PART VI, LINE 11 A DRAFT OF THE 990 IS PREPARED IN COORDINATION BETWEEN THE ORGANIZATION'S FINANCE DEPARTMENT, THE ORGANIZATION'S OPERATIONS DEPARTMENT, AND THE ORGANIZATION'S OUTSIDE ACCOUNTANTS. THE EXECUTIVE VICE PRESIDENT AND CHIEF FINANCIAL OFFICER REVIEWS THE DRAFT 990 THAT IS PREPARED AND ANY COMMENTS OR QUESTIONS ARE REFLECTED IN A FURTHER REVISED 990. THE LATEST VERSION OF THE 990 IS MADE AVAILABLE TO ALL MEMBERS OF THE BOARD OF DIRECTORS FOR THEIR REVIEW AND COMMENTS PRIOR TO FILING. ANY ADDITIONAL COMMENTS FROM BOARD MEMBERS ARE RESPONDED TO PRIOR TO FILING THE FORM 990. CONFLICTS MONITORING AND ENFORCEMENT PART VI, LINE 12 THE ORGANIZATION HAS ADOPTED A CONFLICT OF INTEREST POLICY THAT COVERS THE ORGANIZATION AND ITS SUBSIDIARIES. ANY POSSIBLE CONFLICT OF INTEREST ON THE PART OF ANY DIRECTOR SHOULD BE DISCLOSED IN WRITING TO THE MEMBERS OF THE BOARD OF DIRECTORS AND MADE A MATTER OF RECORD. ANY MEMBER OF THE BOARD OF DIRECTORS HAVING A POTENTIAL CONFLICT OF INTEREST ON ANY MATTER UNDER CONSIDERATION WILL NOT VOTE OR USE HIS OR HER PERSONAL INFLUENCE ON THE MATTER, AND HE OR SHE SHOULD NOT BE COUNTED IN DETERMINING THE QUORUM FOR THE MEETING. DETERMINATION OF COMPENSATION PART VI, LINE 15 THE ORGANIZATION HAS ADOPTED A PROCESS FOR DETERMINING EXECUTIVE COMPENSATION THAT COVERS THE ORGANIZATION AND ITS SUBSIDIARIES. THE ORGANIZATION UTILIZES A WRITTEN EMPLOYMENT CONTRACT, A COMPENSATION SURVEY OR STUDY, AN APPROVAL BY BOARD/COMPENSATION COMMITTEE AND CONTEMPORANEOUS WRITTEN SUBSTANTIATION OF THE DECISION-MAKING PROCESS. DOCUMENT AVAILABILITY PART VI, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. net asset reconciliation part xi, line 5 change in minimum pension liability $(31,888,000) forgiveness of due from DHA (14,755,890) unrealized loss (12,000) rounding 10,868 ------------ total $(46,645,022) AUDITS PART XII, QUESTIONS 2 AND 3 DIMENSIONS HEALTH CORPORATION AND ITS SUBSIDIARES UNDERWENT A CONSOLIDATED AUDIT OF THEIR FINANCIAL STATEMENT THAT COMPLIED WITH SINGLE AUDIT ACT/OMB CIRCULAR A-133 REQUIREMENTS DUE TO THE EXPENDITURE OF FEDERAL AWARDS. THE ACCOUNTING FIRM OF COHEN, RUTHERFORD + KNIGHT P.C. HAS ISSUED AN UNMODIFIED OPINION REGARDING THE CONSOLIDATED FINANCIAL STATEMENTS IN CONFORMANCE WITH GENERALLY ACCEPTED AUDIT STANDARDS AND Government Auditing Standards and unmodified report related to the schedule of expenditures of federal awards in accordance with THE SINGLE AUDIT ACT/OMB CIRCULAR A-133 REQUIREMENTS FOR THE FISCAL YEAR THAT CORRESPONDS TO THE TAX REPORTING YEAR GOVERNED BY THIS FORM 990. HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Thomas HENDERSHOTT TITLE:DIRECTOR HOURS:1 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:ELIZABETH HEWLETT TITLE:DIRECTOR HOURS: HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:BARBARA FRUSH TITLE:SECRETARY HOURS:1 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:C PHILIPS NICHOLS JR TITLE:CHAIRMAN OF THE BOARD HOURS: HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:SAYED SADIQ MD TITLE:DIRECTOR HOURS: HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:BENJAMIN STALLINGS MD TITLE:TREASURER HOURS: HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:V PREM CHANDAR TITLE:DIRECTOR HOURS: HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:TAWANA GAINES TITLE:VICE CHAIR HOURS: HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:ANDREA HARRISON TITLE:DIRECTOR HOURS: HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:BRADFORD SEAMON TITLE:DIRECTOR HOURS: HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:FREDERICK SMALLS TITLE:Director HOURS: HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:NEIL MOORE TITLE:ceo/cfo HOURS:2 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:JOHN O'BRIEN III TITLE:COO HOURS: HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:GITA K SHAH TITLE:VP MEDICAL AFFAIRS HOURS:1 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:DAVID GOLDMAN TITLE:VICE PRESIDENT QUALITY HOURS:1 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:KANWALJIT SINGH TANEJA TITLE:COO - PGHC HOURS:20 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:GLORIA A CEBALLOS TITLE:VP CNO HOURS: HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:SHEILA JARRETT TITLE:RN HOURS: HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:MANI A GOTTIPAMULA TITLE:RN HOURS: HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:MICHAEL JACOBS TITLE:PRESIDENT DHA HOURS:20 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:DANIEL J O'BRIEN JR TITLE:GENERAL COUNSEL HOURS: HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:GT DUNLOP ECKER TITLE:PRES & CEO HOURS: HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:KENNETH GLOVER TITLE:CEO HOURS:20 OTHER EXPENSES FORM 990 PART IX DESCRIPTION:SUPPLIES TOTAL EXPENSES:49748307 PROGRAM SERVICES:49250824 MANAGEMENT AND GENERAL:497483 OTHER EXPENSES FORM 990 PART IX DESCRIPTION:EQUP RENT AND MAINT TOTAL EXPENSES:1956081 PROGRAM SERVICES:1740912 MANAGEMENT AND GENERAL:215169 OTHER EXPENSES FORM 990 PART IX DESCRIPTION:EDUCATION HONORARIUM TOTAL EXPENSES:14983 MANAGEMENT AND GENERAL:14983 OTHER EXPENSES FORM 990 PART IX DESCRIPTION:BAD DEBT TOTAL EXPENSES:25214633 PROGRAM SERVICES:25214633 OTHER EXPENSES FORM 990 PART IX DESCRIPTION:PERMITS AND LIC TOTAL EXPENSES:24591 MANAGEMENT AND GENERAL:24591 OTHER EXPENSES FORM 990 PART IX DESCRIPTION:TAXES TOTAL EXPENSES:126959 MANAGEMENT AND GENERAL:126959 OTHER EXPENSES FORM 990 PART IX DESCRIPTION:OTHER TOTAL EXPENSES:155829 PROGRAM SERVICES:107522 MANAGEMENT AND GENERAL:48307 DIMENSIONS HEALTHCARE ASSOCIATES 7300 VAN DUSEN RD LAUREL MD 20707 521902711 HEALTHCARE MD 501(c)(3) 509(a)(3) dhc true AFFILIATED ENTERPRISES 7300 DUSEN RD LAUREL MD 20707 521542144 HEALTHCARE MD DHC C CORP 1073459 4205852 1.00000 DIMENSIONS ASSURANCE PO BOX 1363 GENESIS BUILDING GEORGE TOWN GRAND CAYMAN CJ 980348082 insurance CJ DHC c corp 7178039 43617421 1.00000 MADISON MANOR 7300 VAN DUSEN RD LAUREL MD 20707 521269059 HEALTHCARE MD DHC C CORP 658919 3248882 1.00000 false false false false false false false false false false true false true true true true false false dimensions healthcare associates n,p,k 14755980 fmv