2013-05-14T10:24:53-05:00 2012-06-30 990 2011-07-01 522019696 SUBURBAN HOSPITAL FOUNDATION INC SUBU 3018963971 8600 OLD GEORGETOWN ROAD BETHESDA MD 208141497 MARTIN BASSO 3018963971 2013-05-14 2011 2016-02-24 21:20:13Z MARTIN BASSO 8600 OLD GEORGETOWN ROAD BETHESDA MD 208141497 23162729 0 X WWW.SUBURBANHOSPITAL/CHARITABLEGIVING.ORG X 1995 MD SUPPORTING ORGANIZATION FOR SUBURBAN HOSPITAL, INC. 20 19 6 75 0 0 3815592 1640414 0 0 2131632 801332 14314 3862 5961538 2445608 2162462 1465842 0 0 810070 702057 0 0 830024 423177 356666 3395709 2524565 2565829 -78957 33532347 32184855 434534 69907 33097813 32114948 X THE SUBURBAN HOSPITAL FOUNDATION RAISES AND DISTRIBUTES PHILANTHROPIC GIFTS IN SUPPORT OF THE PROGRAMS AND PRIORITIES OF THE MEMBER (SUBURBAN HOSPITAL, INC. 52-0610545). THE CORPORATION SHALL HAVE SUCH OTHER OBJECTIVES AS ARE APPROVED BY THE BOARD OF TRUSTEES AND THE MEMBER. 0 0 204908 204908 SUBURBAN HOSPITAL NURSES ARE IN THE PROCESS OF UTILIZING THE FRAMEWORK OF THE MAGNET RECOGNITION TO PROVIDE OUTSTANDING CARE SUPPORTED BY CLINICAL EXPERTISE AND RESEARCH. THEY WILL DELIVER ADAPTIVE, TECHNOLOGICALLY ADVANCED CARE WHILE MAINTAINING A PERSONALIZED AND COMFORTING TOUCH. THE ORGANIZATION'S SENIOR LEADERSHIP TEAM CREATES THE VISION FOR THE FUTURE, AND THE SYSTEMS AND ENVIRONMENT NECESSARY TO ACHIEVE THAT VISION. THESE FUNDS SUPPORT EDUCATIONAL SESSIONS FOR STAFF/LEADERSHIP, HARDWARE/SOFTWARE NEEDS (COMPUTER WORKSTATIONS), FUNDING FOR NATIONAL DATABASE OF NURSING QUALITY INDICATORS AND FUNDING FOR MATERIALS TO SUPPORT LEADERSHIP PEER EVALUATION. 189977 189777 317216 A MAJOR EVENT WAS HELD ON THURSDAY, MAY 10TH TO SUPPORT LIFE-SAVING CARDIAC CARE SERVICES AND THE NIH HEART CENTER AT SUBURBAN HOSPITAL. IN ADDITION TO STATE-OF-THE-ART CARDIAC SURGERY, THE NEW NIH HEART CENTER AT SUBURBAN HOSPITAL WILL PROVIDE TRAINING FOR THE NEXT GENERATION OF CARDIAC SURGEONS AND CARDIOLOGISTS, AND, THROUGH GROUND-BREAKING RESEARCH, CONTRIBUTE TO IMPROVEMENTS IN THE TREATMENT OF CARDIAC DISEASE WORLDWIDE. THE NIH HEART CENTER ALSO COMPLEMENTS A BROAD RANGE OF EXISTING CARDIAC PROGRAMS AT SUBURBAN HOSPITAL-FROM EMERGENCY/TRAUMA CARE TO STATE-OF-THE-ART CARDIAC DIAGNOSTICS AND REHABILITATION-WHICH, OVER THE YEARS, HAVE HELPED MANY THOUSANDS OF PATIENTS RECOVER FROM HEART DISEASE. 199261 199261 SUBURBAN HOSPITAL OFFERED A COMPREHENSIVE OUTPATIENT DIABETES PROGRAM WHICH PROVIDED, INDIVIDUAL COUNSELING, MANY SUCCESSFUL STRATEGIES FOR BRINGING BLOOD SUGARS UNDER CONTROL,INSTRUCTION FOR BLOOD GLUCOSE MONITORING AND DOCUMENTATION, DIET/MEAL PLANNING, INSULIN/DIABETES MEDICATION INSTRUCTION, AND GROUP CLASSES. 871696 871696 871696 871696 1465842 1 1 0 0 0 0 0 0 0 0 1 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 0 0 0 0 0 0 1 0 0 0 0 1 0 0 0 0 1 0 0 6 1 0 0 0 0 1 1 0 0 0 X 20 19 0 0 0 0 0 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 MD X LESLIE FORD WEBER EXEC VP 3018963971 8710 OLD GEORGETOWN ROAD BETHESDA MD 20814 MARK FUTROVKSY 4.00 X 0 0 0 STEPHEN CEASTHAM 4.00 X 0 0 0 LARA EISENBERG MD 4.00 X 0 0 0 GARY ROGGIN MD 4.00 X 0 0 0 JUDITH WALKER 4.00 X 0 0 0 CHRISTOPHER J DOHERTY 4.00 X 0 0 0 CALVIN LAROCHE 4.00 X 0 0 0 ALBERT LEE MD 4.00 X 0 0 0 JOHN J JACK MCDONNELL 4.00 X 0 0 0 JUAN LITVAK MD 4.00 X 0 0 0 AMANDA POLK 4.00 X 0 0 0 CHARLES POSTAL 4.00 X X 0 0 0 DAVID A RUBEN 4.00 X 0 0 0 SABRINA WEGER 4.00 X 0 0 0 BRIAN A GRAGNOLATI 10.00 X 0 1029347 285562 PHYLLIS DONOGHUE 4.00 X 0 0 0 DAVE CARRERA 4.00 X 0 0 0 MICHAEL HIBLER 4.00 X 0 0 0 STEVEN RUM 4.00 X 0 0 0 LINDA V COURIE 4.00 X 0 0 0 MARTY BASSO 4.00 X 0 359832 110855 JUNE FALB 40.00 X 0 0 0 JACKY SCHULTZ 24.00 X 0 396294 82774 REBECCA BULL 40.00 X 114443 0 33456 LESLIE WEBER 32.00 X 0 230476 58246 114443 2015949 570893 1 1 1 0 0 355023 54635 1230756 31711 1640414 534607 534607 20723000 20455738 537 267262 -537 266725 266725 264708 355023 260846 3862 3862 2445608 266725 0 538469 1465842 1465842 549999 30010 519989 118300 6455 111845 33758 1842 31916 26832 26832 51713 51713 1457 1457 880 880 786 43 743 OTHER 176113 142109 34004 PURCHASED SERVICES 54534 21408 33126 REPAIRS & MAINTENANCE 44351 44351 2524565 1465842 228699 830024 321 8379 1941902 1314933 955452 835620 56762 51786 5761 4976 30628911 30020947 33532347 32184855 225439 69907 209095 0 434534 69907 X 10212822 9921786 12094418 11357149 10790573 10836013 33097813 32114948 33532347 32184855 X -78957 -903908 X 0 1 1 X 0 X X X 0 0 0 SUBURBAN HOSPITAL INC 520610545 3 1 1 1 1314978 1 1314978 RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 31757 26782 4975 25005 25004 1 4976 2445608 2524565 -78957 -903908 -903908 -982865 2178346 0 2178346 267262 267262 2445608 2785411 260846 260846 2524565 0 2524565 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 FOUNDATION 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: UNREALIZED GAIN ON INVESTMENT -643,062. FUNDRAISING - SPECIAL EVENTS -260,846. TOTAL TO SCHEDULE D, PART XI, LINE 8: -903,908. PART XII, LINE 4B - OTHER ADJUSTMENTS: GAIN ON REALIZED SECURITIES 267,262. PART XIII, LINE 2D - OTHER ADJUSTMENTS: FUNDRAISING - SPECIAL EVENTS 260,846. KEY TO THE CURE 136748 69575 67173 30082 SHOWCASE 381528 285448 96080 197695 1 101455 0 101455 33069 619731 355023 264708 260846 260846 3862 1 SUBURBAN HOSPITAL INC 8600 OLD GEORGETOWN ROAD BETHESDA MD 208141497 520610545 501(C)(3) 1314978 SUPPORT FOR THE HOSPITAL ST JANE FRANCES DE CHANTEL CHURCH 9701 OLD GEORGETOWN RD BETHESDA MD 20814 520623158 501(C)(3) 8000 COMMUNITY BENEFIT JEWISH CHAPLINARY SERVICES 6123 MONTROSE ROAD ROCKVILLE MD 20852 530196598 501(C)(3) 8000 COMMUNITY BENEFIT HEBREW HOME OF GREATER WASHINGTON 6121 MONTROSE ROAD ROCKVILLE MD 20852 530196508 501(C)(3) 7500 COMMUNITY BENEFIT 4 0 SCHOLARSHIPS 18 101250 PROCEDURE FOR MONITORING GRANTS IN THE U.S.: PART I, LINE 2: SCHEDULE I, PART I, LINE 2: THE BOARD OF TRUSTEES HAS DELEGATED THE FACILITATION AND ACCOUNTING FOR ALL GRANT PROGRAMS ADMINISTERED BY SUBURBAN HOSPITAL FOUNDATION, INC. TO THE OFFICERS, DIRECTORS, AND KEY EMPLOYEES OF THE ORGANIZATION. X X X X X 0 1 0 0 0 0 0 1 0 BRIAN A GRAGNOLATI 0 667174 0 309917 0 52256 0 260401 0 25161 0 1314909 0 0 MARTY BASSO 0 281849 0 64598 0 13385 0 89550 0 21305 0 470687 0 0 JACKY SCHULTZ 0 283959 0 68536 0 43799 0 74350 0 8424 0 479068 0 0 LESLIE WEBER 0 184144 0 35135 0 11197 0 56613 0 1633 0 288722 0 0 PART I, LINE 4B THE SERP PLANS 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 WITH THE RELATED ORGANIZATION SUBURBAN HOSPITAL, INC. AND RECEIVED ACCRUED DEFERRED COMPENSATION THAT IS REPORTED ON SCHEDULE J, PART II, COLUMN (C): MARTIN BASSO $71,864; BRIAN GRAGNOLATI $242,468.00; JACQUILINE SCHULTZ $58,008.00; AND LESLIE FORD WEBER $41,904.00 PART I, LINE 7 THE EXECUTIVES AND DIRECTORS THAT ARE PAID BY THE RELATED ORGANIZATION SUBURBAN HOSPITAL, INC. 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. THE EMPLOYEES OF SUBURBAN FOUNDATION PARTICIPATE IN AN ANNUAL INCENTIVE PROGRAM THAT IS BASED ON BUSINESS ACTIVITY AND INDIVIDUAL PERFORMANCE. THE ANNUAL INCENTIVE PLAN HAS THREE POTENTIAL PAYOUT LEVELS - THRESHOLD, TARGET AND MAXIMUM. 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. X 2 25711 MEAN VALUE OF STOCK X ONE NIGHT ON YACHT 1 6000 PROFIT FROM DONATION 0 0 0 FORM 990, PART VI, SECTION A, LINE 7A SUBURBAN HOSPITAL, INC., THE IRC 501C (3) TAX EXEMPT SUPPORTED ORGANIZATION OF SUBURBAN HOSPITAL FOUNDATION, INC. ELECTS THE MAJORITY OF THE BOARD OF TRUSTEES AT THE ANNUAL MEETING. 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 PARENT ORGANIZATION 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 A 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 INTERST POLICY, ARE PROVIDED TO THE PUBLIC ON THE ORGANIZATION'S 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: UNREALIZED GAIN ON INVESTMENT -643,062. FUNDRAISING - SPECIAL EVENTS -260,846. TOTAL TO FORM 990, PART XI, LINE 5: -903,908. NUMBER OF EMPLOYEES REPORTED AND REQUIRED FEDERAL EMPLOYMENT TAX: FORM 990, PART V, LINES 2A & 2B: THE 6 EMPLOYEES REPORTED ON LINE 2A ARE PAID AND REPORTED ON FORM W-3 BY THE SUPPORTED ORGANIZATION SUBURBAN HOSPITAL, INC. (52-0610545). ALL REQUIRED FEDERAL AND STATE EMPLOYMENT TAX RETURNS ARE FILED BY SUBURBAN HOSPITAL, INC. SUBURBAN HOSPITAL INC 8600 OLD GEORGETOWN ROAD BETHESDA MD 208141497 520610545 HOSPITAL MD 501 (C)(3) 3 JOHNS HOPKINS HEALTH SYSTEM CORPORATION 0 0 1 0 0 0 0 0 0 0 0 1 0 0 0 1 0 1 0