2012-05-14T08:24:12-05:00 2011-06-30 990 2010-07-01 522019696 SUBURBAN HOSPITAL FOUNDATION INC SUBU 3018963971 8600 OLD GEORGETOWN ROAD BETHESDA MD 208141497 MARTIN BASSO 3018963971 2012-05-14 2010 2016-02-24 21:20:13Z MARTIN BASSO 8600 OLD GEORGETOWN ROAD BETHESDA MD 208141497 28199529 0 X WWW.SUBURBANHOSPITAL/CHARITABLEGIVING.ORG X 1995 MD SUPPORTING ORGANIZATION FOR SUBURBAN HOSPITAL, INC. 20 19 6 75 0 0 3221002 3815592 0 0 482340 2131632 -50664 14314 3652678 5961538 2041598 2162462 0 0 756155 810070 0 0 997825 586081 423177 3383834 3395709 268844 2565829 28504114 33532347 463079 434534 28041035 33097813 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 400000 400000 THE SUBURBAN HOSPITAL FOUNDATION UNDERWROTE SEVERAL INITIATIVES WITHIN THE SUBURBAN HOSPITAL CANCER CARE PROGRAMS. THESE INCLUDED SEVERAL SUPPORT GROUPS AND CANCER EDUCATION EVENTS ATTENDED BY THOUSANDS OF PEOPLE, INCLUDING NUTRITIONIST SERVICES FOR OUTPATIENT CANCER PATIENTS, THE LIVING WITH BREAST CANCER SYMPOSIUM, AND CANCER SURVIVOR DAY. THE FOUNDATION ASSISTED IN THE PROVISION OF CHARITY CARE BY COVERING THE COSTS OF MAMMOGRAMS AND ULTRASOUND PROCEDURES FOR LOW-INCOME WOMEN, AND ANCILLARY COSTS OF TREATMENT FOR SEVERAL PATIENTS. WHEELCHAIR RENTAL, TRANSPORTATION TO APPOINTMENTS, AND RESPITE CARE WERE FACILITATED BY THE FOUNDATION AND FREE SCREENINGS FOR COMMUNITY MEMBERS FOR SKIN AND PROSTATE CANCER WERE PROVIDED. 229000 229000 THE SUBURBAN HOSPITAL FOUNDATION UNDERWROTE THE ACTIVITIES OF SUBURBAN HOSPITAL'S CASEY CENTER FOR DIAGNOSTIC CARDIOLOGY AND DIABETES EDUCATION, WHICH INCLUDES THE ACTIVITIES OF THE HOSPITAL'S POPULAR CARDIAC REHABILITATION PROGRAM. "CARDIAC REHAB" ENROLLS 400 PATIENTS EVERY WEEK, IN THREE LEVELS OF ACTIVITY. OUR MULTIDISCIPLINARY TEAM OF HEALTH PROFESSIONALS IS DEDICATED TO IMPROVING THE QUALITY OF LIFE FOR THOSE RECOVERING FROM A HEART ATTACK, HEART SURGERY, OR CARDIOVASCULAR DISEASE THROUGH CARDIAC REHABILITATION THROUGH A STRUCTURED PROGRAM OF EDUCATION, EXERCISE AND PEER SUPPORT DESIGNED TO GUIDE LIFESTYLE MODIFICATION. THE FUNDS FROM THE FOUNDATION ENSURE THAT THE CENTER AND ITS EQUIPMENT IS MAINTAINED AND THAT STAFF ARE AVAILABLE WITH THE PROPER CONTINUING EDUCATION CREDENTIALS. 499000 499000 THE SUBURBAN HOSPITAL FOUNDATION CONTRIBUTED TO EQUIPMENT PURCHASES AND UPGRADES FOR SEVERAL PROGRAMS IN SUBURBAN HOSPITAL INCLUDING EMERGENCY AND TRAUMA SERVICES, INTERVENTIONAL CARDIOLOGY, AND TELEMETRY THROUGHOUT THE FACILITY. THE SHF ALSO CONTRIBUTED FUNDS FOR THE RENOVATION OF A PATIENT CARE UNIT TO IMPROVE EFFICIENCY OF OPERATIONS AND PATIENT PRIVACY. 1034462 5961538 1034462 5961538 2162462 1 1 0 0 0 0 0 0 0 1 0 0 0 1 1 1 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 0 0 0 0 0 0 0 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 FUTROVSKY 4.00 X 0 0 0 ROBERT EASBY-SMITH 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 GRANT BOTTENSTEIN 4.00 X 0 0 0 CURTIS 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 1034836 278394 PHYLLIS DONOGHUE 4.00 X 0 0 0 BOI CARPENTER-MELLADY 4.00 X 0 0 0 MICHAEL HIBLER 4.00 X 0 0 0 STEVEN RUM 4.00 X 0 0 0 LESLIE WEBER 32.00 X 0 213200 41825 MARTY BASSO 4.00 X 0 361009 86427 SHIRA EOLER 40.00 X 122935 0 22114 REBECCA BULL 40.00 X 111511 0 28872 234446 1609045 457632 2 0 1 0 0 182664 3632928 8075 3815592 457868 457868 23802000 22128236 1673764 1673764 1673764 119820 182664 109755 10065 10065 OTHER 900099 4249 4249 4249 5961538 1678013 0 467933 2162462 2162462 145050 2901 142149 497263 33110 464153 130635 7324 123311 37122 2081 35041 26832 26832 19096 19096 121268 121268 1215 1215 1530 1530 786 44 742 OTHER 170653 123617 47036 PURCHASED SERVICES 51720 20417 31303 REPAIRS & MAINTENANCE 30077 30077 3395709 2162462 235422 997825 3605 321 1833737 1941902 841600 955452 59447 53686 0 5761 25825172 30628911 28504114 33532347 220544 225439 242535 209095 463079 434534 X 8473266 10212822 8875095 12094418 10692674 10790573 28041035 33097813 28504114 33532347 X 2565829 2490949 X 0 1 1 X 0 X X X 0 0 0 SUBURBAN HOSPITAL INC 520610545 3 1 1 1 2019335 1 2019335 RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 59447 53686 5761 5761 ANNUITIES PAYABLE 209095 209095 5961538 3395709 2565829 2490949 2490949 5056778 4268678 0 4268678 1692860 1692860 5961538 2987612 109755 109755 2877857 517852 517852 3395709 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, 2011 AND 2010. PART XI, LINE 8 - OTHER ADJUSTMENTS: UNREALIZED GAIN ON INVESTMENT 2,990,000. ROUNDING -51. NET ASSETS RELEASED FROM RESTRICTIONS -499,000. PART XII, LINE 4B - OTHER ADJUSTMENTS: INVESTMENT FEES 19,096. GAIN ON REALIZED SECURTIES 1,673,764. PART XIII, LINE 2D - OTHER ADJUSTMENTS: SPECIAL EVENTS 109,755. PART XIII, LINE 4B - OTHER ADJUSTMENTS: INVESTMENT FEES 19,096. SHI GRANT 498,756. KEY TO THE CURE 90187 64373 25814 16544 GOLF 140710 107941 32769 67258 4 71587 10350 61237 25953 302484 182664 119820 109755 109755 10065 1 SUBURBAN HOSPITAL INC 8600 OLD GEORGETOWN ROAD BETHESDA MD 208141497 520610545 501(C)(3) 2019335 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 SOCIAL SERVICE AGENCY 200 WOOD HILL ROAD ROCKVILLE MD 20850 530196598 501(C)(3) 8000 COMMUNITY BENEFIT AMERICAN HEART ASSOCIATION 4217 PARK PLACE COURT GLEN ALLEN VA 23060 530213318 501(C)(3) 10000 COMMUNITY BENEFIT MONTGOMERY COUNTY FIRE RESCUE SERVICE 101 MONROE STREET 12TH FLOOR ROCKVILLE MD 20850 526000980 501(C)(3) 11762 COMMUNITY BENEFIT 5 0 SCHOLARSHIPS 14 86500 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 643767 0 361996 0 29073 0 252268 0 26126 0 1313230 0 0 LESLIE WEBER 0 180715 0 20423 0 12062 0 39956 0 1869 0 255025 0 0 MARTY BASSO 0 271090 0 76998 0 12921 0 63698 0 22729 0 447436 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 $53,898.00; BRIAN GRAGNOLATI $242,468.00; AND LESLIE FORD WEBER $31,428.00 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. 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 2,990,000. ROUNDING -51. NET ASSETS RELEASED FROM RESTRICTIONS -499,000. TOTAL TO FORM 990, PART XI, LINE 5: 2,490,949. 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