2013-11-15T17:32:04-06:00 2012-12-31 521532556 ADVENTIST HEALTHCARE INC 820 W DIAMOND AVE SUITE 600 GAITHERSBURG MD 208781419 990 2012-01-01 520986808 ADVENTIST HOME HEALTH SERVICES INC ADVE 3013153030 820 WEST DIAMOND AVE NO 600 GAITHERSBURG MD 208781419 JAMES G LEE 3013153030 2013-11-15 1 THOMAS CHAN P01461717 3013153030 2012 2016-03-07 17:11:31Z X WILLIAM G ROBERTSON 820 WEST DIAMOND AVE NO 600 GAITHERSBURG MD 208781419 14712515 0 X HTTP://WWW.ADVENTISTHEALTHCARE.ORG/AHCS/SERVICES/ X 1973 MD WE DEMONSTRATE GOD'S CARE BY IMPROVING THE HEALTH OF PEOPLE AND COMMUNITIES THROUGH ( SEE SCH O ) A MINISTRY OF PHYSICAL, MENTAL, AND SPIRITUAL HEALING. 3 0 0 20 0 0 12889 15928 15077834 14565106 130473 91445 40036 40036 15261232 14712515 0 0 0 0 11961039 11901928 0 0 0 3111769 2919160 15072808 14821088 188424 -108573 6438211 5765150 2034556 1478251 4403655 4286899 X ESTABLISHED IN 1983, ADVENTIST HOME ASSISTANCE IS LICENSEDBY THE STATE OF MARYLAND AS A PRIVATE DUTY RESIDENTIAL SERVICEAGENCY. OUR PRIVATE DUTY NURSING AGENCY PROVIDESSUPPORTIVE SERVICES, ALLOWING THE PATIENT TO MAINTAIN THEIR OPTIMUM LEVEL OF INDEPENDENCE. THESE SERVICES REDUCE HEALTH CARE SERVICE COSTS AND IMPROVE PATIENTS' ABILITY TO STAY AT A COMFORTABLE HOME ENVIRONMENT. 0 0 11410687 14565106 FOR ANY NUMBER OF REASONS, RECEIVING CARE AT HOME-WHETHER FOR ONGOING TREATMENT OR RECOVERING AFTER A HOSPITAL STAY -- CAN LIFT A PATIENT'S SPIRITS AND RECOVERY. FOR OVER 40 YEARS, ADVENTIST HOME CARE SERVICES, A MEMBER OF ADVENTIST HEALTHCARE, HAS BROUGHT HEALING HOME WITH COMPREHENSIVE SKILLED SERVICES AND COMPASSIONATE CARE. IN 1983 WE EXPANDED OUR HOME CARE DIVISION TO INCLUDE ADVENTIST HOME ASSISTANCE, WHICH PROVIDES PRIVATE DUTY NURSING SERVICES AND PERSONAL CARE FOR PATIENTS THAT REQUIRE ASSISTANCE TO STAY INDEPENDENT IN THEIR HOME. ADVENTIST CHOICE NURSING WAS ESTABLISHED IN 1995 TO OFFER A COST EFFECTIVE OPTION FOR PRIVATE DUTY AND SKILLED NURSING SERVICES.TODAY, ADVENTIST HOME CARE SERVICES TEAM OF SKILLED NURSES, THERAPISTS AND SOCIAL WORKERS DELIVER COMPREHENSIVE SERVICES INCLUDING ADULT AND PEDIATRIC NURSING CARE, CARDIAC CARE, DIABETES CARE, WOUND/OSTOMY CARE, ONCOLOGY CARE, REHABILITATION SERVICES, MEDICAL SOCIAL SERVICES, HOME HEALTH AIDE SERVICES AND NUTRITION COUNSELING SERVICES. WE SERVE PATIENTS IN THEIR HOMES THROUGHOUT MONTGOMERY, PRINCE GEORGE'S, ST. MARY'S, CHARLES, CALVERT, ANNE ARUNDEL AND HOWARD COUNTIES. WE ALSO OFFER A FALLS PREVENTION EDUCATION PROGRAM TO REDUCE THE RISK OF FALLS AND INCREASE IN-HOME SAFETY, AS WELL AS OTHER SPECIALTY PROGRAMS. 11410687 1 1 0 0 0 0 0 0 0 0 1 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 X 3 0 0 0 0 0 1 1 1 1 1 0 1 1 1 1 1 1 1 1 1 1 0 X JAMES G LEE 3013153030 820 W DIAMOND AVE SUITE 600 GAITHERSBURG MD 208781419 X TERRY FORDE 3.00 59.00 X X 0 645184 27990 SUSAN L GLOVER 1.00 49.00 X X 0 346211 40738 JAMES LITSINGER 50.00 X X 0 267172 30798 WILLIAM G ROBERTSON 3.00 59.00 X 0 1197474 49502 JAMES G LEE 3.00 59.00 X 0 690296 31592 KEITH BALLENGER 40.00 X 0 191111 31414 LYNETTE GODHARD 40.00 X 120641 0 29847 ROJAS AILEEN 40.00 X 117358 0 15278 JAWARA MOHAMMED 40.00 X 112549 0 0 COSTA JEAN 40.00 X 100725 0 23461 451273 3337448 280620 5 0 1 0 FAZZI ASSOCIATES INC 243 KING ST SUITE 246 NORTHHAMPTON MA 01060 EDUCATION TRAINING 129680 AMN HEALTHCARE INC P O BOX 281939 ATLANTA GA 303841939 MEDICAL SERVICES 125787 2 15928 15928 HOME CARE SERVICES 900099 6457699 6457699 8107407 8107407 14565106 91445 91445 40036 0 40036 40036 40036 14712515 14565106 0 131481 160184 160184 9810843 8687189 1123654 274650 247662 26988 883594 664928 218666 772657 645696 126961 3505 3505 11637 11637 460527 200352 260175 25447 24326 1121 477145 27563 449582 417197 312898 104299 317550 317550 253808 244439 9369 23344 8692 14652 430148 430148 116476 116476 103285 103285 MEDICAL SUPPLIES 246671 230466 16205 LOSS ON INVESTMENT 24969 24969 RECRUITMENT 7451 7451 14821088 11410687 3410401 0 998 1001 3599790 2866332 4339 0 2096838 2253410 12167 0 21540 0 55591 44184 1538630 1163215 376941 375415 202956 193980 67051 30828 6438211 5765150 1302550 945392 732006 532859 2034556 1478251 X 4403655 4286899 4403655 4286899 6438211 5765150 -108573 -8183 0 X 0 1 X 1 1 1 X 3504 7944 12889 15928 40265 13878881 14906850 14808694 15077834 14565106 73237365 13878881 14910354 14816638 15090723 14581034 73277630 0 0 0 73277630 103506 54602 124529 130473 91445 504555 103506 54602 124529 130473 91445 504555 40036 40036 40036 120108 13982387 14964956 14981203 15261232 14712515 73902293 0.99150 0.99150 0.00680 0.00690 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 433459 423759 9700 506955 320687 186268 598216 418769 179447 375415 X DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X, LINE 2: FIN 48 NOTES THE CORPORATION ACCOUNTS FOR UNCERTAINTY IN INCOME TAXES USING A RECOGNITION THRESHOLD OF MORE-LIKELY-THAN-NOT TO BE SUSTAINED UPON EXAMINATION BY THE APPROPRIATE TAXING AUTHORITY. MEASUREMENT OF THE TAX UNCERTAINTY OCCURS IF THE RECOGNITION THRESHOLD IS MET. MANAGEMENT DETERMINED THERE WERE NO TAX UNCERTAINTIES THAT MET THE RECOGNITION THRESHOLD IN 2012 OR 2011. X X X X 0 1 0 0 0 0 0 0 0 TERRY FORDE 0 475406 0 50286 0 119492 0 5000 0 22990 0 673174 0 0 SUSAN L GLOVER 0 261570 0 41839 0 42802 0 12500 0 28238 0 386949 0 0 JAMES LITSINGER 0 184732 0 30000 0 52440 0 9020 0 21778 0 297970 0 0 WILLIAM G ROBERTSON 0 822694 0 157055 0 217725 0 12500 0 37002 0 1246976 0 0 JAMES G LEE 0 471913 0 78047 0 140336 0 12500 0 19092 0 721888 0 0 KEITH BALLENGER 0 157862 0 0 0 33249 0 8267 0 23147 0 222525 0 0 LYNETTE GODHARD 117001 0 0 0 3640 0 6297 0 23550 0 150488 0 0 0 PART I, LINE 3 INDEPENDENT GUIDELINES: WHEN SETTING COMPENSATION FOR THE OFFICERS, DIRECTORS, TRUSTEES, KEY EMPLOYEES, AND THE HIGHEST COMPENSATED EMPLOYEES, ADVENTIST HEALTHCARE FULLY COMPLIES WITH THE PROCEDURAL SAFE GUARDS EMBODIED IN IRS REGULATIONS. COMPENSATION FOR ADVENTIST HEALTHCARE OFFICERS, DIRECTORS, TRUSTEES, KEY EMPLOYEES, AND THE HIGHEST COMPENSATED EMPLOYEES IS ENTIRELY SET BY A COMMITTEE OF ADVENTIST HEALTHCARE BOARD OF TRUSTEES. IN SETTING COMPENSATION, THE GOVERNING BOARD COMMITTEE RELIES UPON MARKET COMPARABILITY DATA PROVIDED BY AN INDEPENDENT OUTSIDE COMPENSATION CONSULTANT WHO PROVIDES A SUMMARY OF HEALTH CARE SALARIES AND BENEFITS FOR COMPARABLE SIZED ORGANIZATIONS BOTH NATIONALLY AND IN THE BALTIMORE-WASHINGTON REGION. TO FURTHER ENSURE REASONABLENESS, BOTH COMPENSATION AND BENEFITS ARE TARGETED AT THE 50TH PERCENTILE (OR MEDIAN) OF THE MARKET. PAY PHILOSOPHY: FOR ALL ADVENTIST HEALTHCARE EMPLOYEES INCLUDING THOSE LISTED ON SCHEDULE J, THE GOAL OF ADVENTIST HEALTHCARE IS TO OFFER COMPETITIVE SALARIES IN ORDER TO ATTRACT, HIRE AND RETAIN QUALIFIED AND TALENTED INDIVIDUALS. MAINTAINING A QUALITY, STABLE WORKFORCE HAS A POSITIVE IMPACT ON THE WORKPLACE AND ON THE CARE PROVIDED TO OUR PATIENTS/RESIDENTS AND THEIR FAMILIES. IN GENERAL, NON-EXECUTIVE EMPLOYEES ARE COMPENSATED UTILIZING THE FULL WAGE SCALE FOR THEIR RESPECTIVE POSITIONS, COMPARED TO THE MARKET. HOWEVER, EXECUTIVES ARE GENERALLY LIMITED TO THE MEDIAN OF THE MARKET FOR THEIR RESPECTIVE POSITIONS. PART I, LINE 4B CUMULATIVE LUMP-SUM TAXABLE PAYMENTS MADE AS A RESULT OF TAX LAW CHANGES THAT AFFECTED THE ADMINISTRATION OF THE ADVENTIST HEALTHCARES CAPITAL ACCUMULATION ACCOUNT (CAA) PLAN ESTABLISHED PURSUANT TO SECTION 457(F) OF THE INTERNAL REVENUE CODE WERE AS FOLLOWS: WILLIAM G. ROBERTSON: $210,451 JAMES G. LEE: $108,501 TERRY FORDE: $108,935 SUSAN L. GLOVER: $39,224 JAMES LITSINGER: $27,220 KEITH BALLENGER: $20,395 SUPPLEMENTAL INFORMATION PART III COMPENSATION DEFINED. THE COMPENSATION REPORTED FOR THE EMPLOYEES SET FORTH ON SCHEDULE J IS COMPRISED OF THE FOLLOWING: BASE COMPENSATION INCLUDES NONDISCRETIONARY PAYMENTS, AGREED UPON IN ADVANCE, CONTINGENT ONLY UPON THE PAYEES PERFORMANCE OF AGREED UPON SERVICES (SUCH AS SALARY OR FEES). INCENTIVE COMPENSATION INCLUDES PAYMENTS BASED ON SATISFACTION OF PRE-DETERMINED PERFORMANCE TARGETS SUCH AS QUALITY/PATIENT SAFETY GOALS, EMPLOYEE AND CUSTOMER ENGAGEMENT GOALS, ORGANIZATIONAL GROWTH, AND FINANCIAL PERFORMANCE, AMONG OTHER THINGS. OTHER REPORTABLE COMPENSATION INCLUDES CERTAIN CUMULATIVE LUMP-SUM TAXABLE PAYMENTS MADE AS A RESULT OF TAX LAW CHANGES THAT AFFECTED THE ADMINISTRATION OF ADVENTIST HEALTHCARE CAPITAL ACCUMULATION ACCOUNT (CAA) PLAN ESTABLISHED PURSUANT TO SECTION 457(F) OF THE INTERNAL REVENUE CODE. IN ADDITION, OTHER REPORTABLE COMPENSATION INCLUDES LONG-TERM DISABILITY COVERAGE, CELL PHONE ALLOWANCES, CASH-OUT OF UNUSED PAID TIME OFF (PTO) HOURS, IMPUTED VALUE OF LIFE INSURANCE BENEFITS, OUT-OF-STATE COMMUTE, AND SEVERANCE, AS APPLICABLE. NON-TAXABLE BENEFITS INCLUDES PRE-TAX PAYROLL DEDUCTIONS (SUCH AS FLEXIBLE MEDICAL SPENDING, DEPENDENT CARE, AND EMPLOYEE HEALTH BENEFIT PREMIUM), AND THE EMPLOYER PORTION OF CERTAIN EMPLOYEE BENEFITS SUCH AS HEALTH INSURANCE, DENTAL INSURANCE, VISION INSURANCE, LIFE INSURANCE, BASE CONTRIBUTIONS TO RETIREMENT PLANS, MATCHING OF EMPLOYEES RETIREMENT CONTRIBUTIONS, ETC. PAY PRACTICE: ADVENTIST HEALTHCARE UTILIZES A SINGLE EMPLOYER ID FOR ALL OF ITS AFFILIATED ENTITIES FOR EMPLOYMENT PURPOSES. AS SUCH, ACTUAL COMPENSATION AND BENEFITS ARE CHARGED TO THE RESPECTIVE ENTITIES AND THE RESULTING COMPENSATION AND BENEFITS ARE REPORTED ON EACH AFFILIATE IRS FORM 990 AS IF PAID DIRECTLY BY SUCH AFFILIATE. AS APPLICABLE, THE SAME AND NON-ADDITIVE COMPENSATION AND EMPLOYMENT BENEFIT PLAN CONTRIBUTION AMOUNTS WERE ALSO DISCLOSED IN THE ADVENTIST HEALTHCARE INC. RELATED ENTITIES RETURNS. FORM 990, PART VI, SECTION A, LINE 6 BY LAWS, ARTICLE II - THE BOARD OF TRUSTEES APPROVES ALL ACTIONS OF MANAGEMENT. FORM 990, PART VI, SECTION A, LINE 7A ADVENTIST HEALTHCARE, INC, AS SOLE CORPORATE MEMBER OF AHHS, WITH THE AUTHORITY TO APPROVE ITS BOARD MEMBERSHIP. FORM 990, PART VI, SECTION A, LINE 7B THE BOARD OF TRUSTEES APPROVES ALL ACTIONS OF MANAGEMENT. THE ACTIONS OF THE AHHS GOVERNING BOARD IS SUBJECT TO THE REVIEW OF THE BOARD OF THE ADVENTIST HEALTHCARE, INC. FORM 990, PART VI, SECTION B, LINE 11 DURING THE PREPARATION PROCESS, EXECUTIVE MANAGEMENT TEAM REVIEWED VARIOUS SECTIONS OF THE DRAFT FORM 990 BASED ON A PLANNED COMPLETION TIME TABLE. IN ADDITION, THE EXECUTIVE COMMITTEE OF THE BOARD REVIEWED CERTAIN KEY SECTIONS OF THE FORM. PRIOR TO FILING, ALL MEMBERS OF THE BOARD ARE PROVIDED A COPY OF THIS FORM 990 THROUGH EMAIL, WHICH IS LINKED TO THE COMPANY'S INTRANET WEBSITE. FORM 990, PART VI, SECTION B, LINE 12C PURSUANT TO THE ORGANIZATIONS CONFLICT OF INTEREST POLICY, EACH FACILITY BOARD MEMBER, OFFICER, DIRECTOR AND ANY EMPLOYEE IN A POSITION THAT REQUIRES COORDINATION AND/OR NEGOTIATION WITH CONTRACTORS OR SUPPLIES, IS REQUIRED ON AN ANNUAL BASIS TO DISCLOSE ANY BUSINESS OR FINANCIAL RELATIONSHIP OUTSIDE OF THE ORGANIZATION. COMPLIANCE WITH POLICY IS MONITORED AND ENFORCED BY THE HUMAN RESOURCES DEPARTMENT, CORPORATE INTEGRITY DEPARTMENT AND THE LEGAL DEPARTMENT. FORM 990, PART VI, SECTION B, LINE 15 WHEN SETTING EXECUTIVE COMPENSATION, THE ORGANIZATION FULLY COMPLIES WITH THE PROCEDURAL SAFEGUARDS EMBEDDED IN THE IRS REGULATIONS. EXECUTIVE COMPENSATION IS ENTIRELY SET BY A COMMITTEE OF THE BOARD OF TRUSTEES OF ADVENTIST HEALTHCARE, INC. IN SETTING COMPENSATION, THE GOVERNING BOARD COMMITTEE RELIES UPON MARKET COMPARABILITY DATA PROVIDED BY AN INDEPENDED OUTSIDE COMPENSATION CONSULTANT. TO ENSURE REASONABLENESS, COMPENSATION IS SET AT THE 50TH PERCENTILE OF THE NATURAL MARKET. FORM 990, PART VI, SECTION C, LINE 19 THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS, ARE AVAILABLE TO THE PUBLIC UPON REQUEST. GENERAL EXPLANATION EMPLOYEES OF ANY OF THE ADVENTIST HEALTHCARE INC. AND AFFILIATED TAX EXEMPT ENTITIES IN THE STATE OF MARYLAND (INCLUDING ADVENTIST HOME HEALTH SERVICES, INC) ARE PAID THROUGH A COMMON PAYMASTER, ADVENTIST HEALTHCARE, INC. AND ARE REPORTED ON ITS FORM 941. SALARY AND BENEFIT EXPENSES REPORTED ON THEIR RESPECTIVE RETURNS ARE ACTUAL CHARGES RELATED TO THE EMPLOYEES WORKING ON THE SPECIFIC TAX EXEMPT ENTITY. COMPENSATION INCLUDED REGULAR BASE SALARY, BONUS, PAID TIME OFF CASH OUT, TAXABLE RELOCATION ALLOWANCE, HOLIDAY GIFT, RETROACTIVE COMPENSATION ADJUSTMENT, BEREAVEMENT LEAVE, EDUCATION, AND WITHDRAWAL OF DEFERRED COMPENSATION, AS APPLICABLE. THE SAME AND NON-ADDITIVE COMPENSATION AND EMPLOYMENT BENEFIT PLAN CONTRIBUTIOON AMOUNTS WERE ALSO DISCLOSED IN THE ADVENTIST HEALTHCARE INC.'S RELATED ENTITIES RETURNS. VENDORS PAYMENT FOR ANY OF THE ADVENTIST HEALTHCARE, INC. AND RELATED ENTITIES IN THE STATE OF MARYLAND ARE MADE THROUGH A COMMON PAYMASTER, ADVENTIST HEALTHCARE, INC. ADVENTIST HEALTHCARE INC 820 WEST DIAMOND AVE SUITE 600 GAITHERSBURG MD 208781919 521532556 HEALTHCARE SERVICES MD 501 ( C) (3) LINE 3 N/A 0 ADVENTIST PHYSICIAN SERVICES INC 820 WEST DIAMOND AVE SUITE 600 GAITHERSBURG MD 208781919 204600646 PHYSICIAN SERVICES MD 501 ( C) (3) LINE 9 N/A 0 ADVENTIST REHABILITATION HOSPITAL OF MARYLAND 820 WEST DIAMOND AVE SUITE 600 GAITHERSBURG MD 208781919 201486678 REHABILITATION HOSPITAL MD 501 ( C) (3) LINE 3 N/A 0 ADVENTIST SENIOR LIVING SERVICES 820 WEST DIAMOND AVE SUITE 600 GAITHERSBURG MD 208781919 521739959 LTC MANAGEMENT MD 501 ( C) (3) LINE 9 N/A 0 GLADE VALLEY NURSING AND REHABILITATION CENTER 820 WEST DIAMOND AVE SUITE 600 GAITHERSBURG MD 208781919 521924309 NURSING HOME MD 501 ( C) (3) LINE 9 N/A 0 HACKETTSTOWN COMMUNITY HOSPITAL 651 WILLOW GROVE STREET HACKETTSTOWN NJ 07840 226106281 HOSPITAL NJ 501 ( C) (3) LINE 3 N/A 0 HACKETTSTOWN COMMUNITY HOSPITAL FOUNDATION 651 WILLOW GROVE STREET HACKETTSTOWN NJ 07840 222333410 FUNDRAISING NJ 501 ( C) (3) LINE 11A, I N/A 0 HCH EMERGENCY MEDICAL SERVICES 651 WILLOW GROVE STREET HACKETTSTOWN NJ 07840 270820164 AMBULANCE SERVICE NJ 501 ( C) (3) LINE 11B, II N/A 0 MID-ATLANTIC ADVENTIST HEALTHCARE CORPORATION 820 WEST DIAMOND AVE SUITE 600 GAITHERSBURG MD 208781919 511884153 HOLDING COMPANY MD 501 ( C) (3) LINE 9 N/A 0 MEDICAL CENTER PARTNERS INC 820 WEST DIAMOND AVE SUITE 600 GAITHERSBURG MD 208781919 454789273 PHYSICIAN SERVICES NJ 501 ( C) (3) LINE 9 N/A 0 ADVENTIST BEHAVIORAL HEALTH FOUNDATION INC 820 WEST DIAMOND AVE SUITE 600 GAITHERSBURG MD 208781919 205479860 FUNDRAISING MD 501 ( C) (3) LINE 11A, I N/A 0 REGINALD S LOURIE CENTER FOR INFANTS AND YOUNG CHILDREN 820 WEST DIAMOND AVE SUITE 600 GAITHERSBURG MD 208781919 521255870 BEHAVIORAL CARE MD 501 ( C) (3) LINE 9 N/A 0 SHADY GROVE ADVENTIST HOSPITAL FOUNDATION 820 WEST DIAMOND AVE SUITE 600 GAITHERSBURG MD 208781919 521216429 FUNDRAISING MD 501 ( C) (3) LINE 11A, I N/A 0 WASHINGTON ADVENTIST HOSPITAL FOUNDATION 820 WEST DIAMOND AVE SUITE 600 GAITHERSBURG MD 208781919 521692158 FUNDRAISING MD 501 ( C) (3) LINE 11A, I N/A 0 GERMANTOWN OUTPATIENT IMAGING 820 WEST DIAMOND AVE STE 600 GAITHERSBURG MD 208781419 204395818 OUTPATIENT IMAGING MD SHADY GROVE RADIOLOGY CONSULTANTS PC RELATED 0 0 ADVENTIST MANAGEMENT SERVICES INC 820 WESGT DIAMOND AVE SUITE 600 GAITHERSBURG MD 208781419 521575694 MANAGEMENT SERVICES MD N/A C 0 LIFEWORKS STRATEGY INC 820 WESGT DIAMOND AVE SUITE 600 GAITHERSBURG MD 208781419 521704500 EMPLOYEE ASSISTANCE MD N/A C 0 PREMIER MEDICAL NETWORK 820 WESGT DIAMOND AVE SUITE 600 GAITHERSBURG MD 208781419 521952469 JOINT PHYSICIAN CONT MD N/A C 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0