2024-11-11T12:26:51-06:00 2023-12-31 550621482 GRAY GRIFFITH & MAYS AC 707 VIRGINIA STREETEASTSUITE 400 CHARLESTON WV 253012711 990 2023-01-01 521114719 MONTGOMERY HOSPICE INC MONT 3019214400 1355 PICCARD DRIVE 100 ROCKVILLE MD 20850 SCOTT THELEN CFO 3019214400 2024-11-07 1 1 J RYAN LINDSAY P01835061 3043459400 2023 2024-10-15 13:58:12Z SCOTT THELEN 1355 PICCARD DRIVE 100 ROCKVILLE MD 20850 26848459 0 X WWW.MONTGOMERYHOSPICE.ORG X 1979 MD TO GENTLE THE JOURNEY THROUGH SERIOUS ILLNESS AND LOSS WITH SKILL AND COMPASSION. 16 15 340 175 0 0 8161442 2410279 21567440 23624932 347097 672921 66354 140327 30142333 26848459 0 0 0 0 22225389 24052315 0 0 434815 7428500 7580266 29653889 31632581 488444 -4784122 43787259 42434609 4203455 4657053 39583804 37777556 X TO GENTLE THE JOURNEY THROUGH SERIOUS ILLNESS AND LOSS WITH SKILL AND COMPASSION. TO BRING COMFORT BY PROVIDING COMPASSIONATE, PROFESSIONAL CARE TO COMMUNITY RESIDENTS WHO ARE FACING SERIOUS ILLNESS AND LOSS. TO PROVIDE DIGNITY FOR THE DYING AND UNCONDITIONAL COMPASSION THROUGH DEDICATION, AND COLLABORATION. 0 0 29007291 23765259 HOSPICE CARE: THE ORGANIZATION PROVIDES SPECIALIZED MEDICAL AND PSYCHOSOCIAL END-OF-LIFE CARE TO MONTGOMERY AND PRINCE GEORGE'S COUNTY, MARYLAND RESIDENTS OF ALL AGES WHO ARE LIVING WITH A LIFE LIMITING ILLNESS. PATIENTS (AND THEIR FAMILIES) ARE CARED FOR IN HOMES, EXTENDED CARE FACILITIES AND AT CASEY HOUSE, ITS INPATIENT HOSPICE FACILITY. TEAMS OF DOCTORS, NURSE PRACTITIONERS, NURSES, SPIRITUAL COUNSELORS, SOCIAL WORKERS, CERTIFIED NURSING ASSISTANTS, COMPLEMENTARY THERAPISTS, BEREAVEMENT COUNSELORS AND VOLUNTEERS WORK TOGETHER TO PROVIDE COMFORT CARE CUSTOMIZED FOR EACH PATIENT. MONTGOMERY HOSPICE INC. PROVIDES CONSULTATIVE PALLIATIVE CARE (PALLIATIVE MEDICINE CONSULTUNTS) PROVIDED BY DOCTORS, NURSE PRACTITIONORS, SOCIAL WORKERS AND SPRITUAL COUNSELORS. 29007291 1 1 0 0 0 0 0 0 0 1 1 0 0 0 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 0 0 1 21 0 340 1 0 0 0 0 0 0 0 0 0 0 X 16 15 0 0 0 0 0 0 0 1 1 0 0 0 1 1 1 1 1 1 0 0 MD X SCOTT THELEN 3019214400 1355 PICCARD DRIVE 100 ROCKVILLE MD 20850 ANN MITCHELL PRESIDENT & CEO 40.00 X X 295507 0 16354 DAVID SCHRIER CHIEF MEDICAL OFFICER 40.00 X 267770 0 37294 ANN LICHTENSTEIN ASSOCIATE MEDICAL OFFICER 40.00 X 240035 0 36153 LISSA BERROA GARCIA PHYSICIAN 32.00 X 194371 0 15381 JENNIFER PLUDE CHIEF CLINICAL OFFICER 40.00 X 195124 0 7517 VAISHNAVI PREMKUMAR PHYSICIAN 40.00 X 185479 0 15025 MARLENE BRADFORD CHIEF ADVANCEMENT OFFICER 40.00 X 185003 0 11940 CORNELIA STRONG VP OF QUALITY & COMPLIANCE 40.00 X 141118 0 34659 SOFIA MONTEBLANCO PHYSICIAN 40.00 X 149758 0 1358 DIANE K KUWAMURA CHAIRMAN 1.00 X X 0 0 0 DAWN E DOEBLER VICE CHAIR 1.00 X X 0 0 0 CHRISTOPHER N PALMER SECRETARY 1.00 X X 0 0 0 JUSTIN G REAVES TREASURER 1.00 X X 0 0 0 ELMA M LEVY IMMEDIATE PAST CHAIR 1.00 X X 0 0 0 REV JAMES E BONEY DIRECTOR 1.00 X 0 0 0 ANGELA GRAHAM DIRECTOR 1.00 X 0 0 0 DEBORAH PERHAM HOPSON DIRECTOR 1.00 X 0 0 0 SHADY JADALI DIRECTOR 1.00 X 0 0 0 AJA JERE JENKINS DIRECTOR 1.00 X 0 0 0 FRANCISCO NUGENT DIRECTOR 1.00 X 0 0 0 CECILIA M OTERO DIRECTOR 1.00 X 0 0 0 MICHELLE Q PROFIT DIRECTOR 1.00 X 0 0 0 DEVANG SHAH DIRECTOR 1.00 X 0 0 0 SHOBHANA SHARMA DIRECTOR 1.00 X 0 0 0 1854165 0 175681 52 0 0 0 KAISER FOUNDATION HEALTH PLAN OF THE MID 2101 E JEFFERSON ST ROCKVILLE MD 20852 EMPLOYEE HEALTHCARE 2018960 ENCLARA PHARMACIA 1601 CHERRY ST 1800 PHILADELPHIA PA 19102 PHARMACY 984848 MEDLINE INDUSTRIES INC 1040 ENTERPRISE PKWY WEST JEFFERSON OH 43162 MEDICAL SUPPLIES 623624 NETSMART TECHNOLOGIES INC 11100 NALL AVENUE LEAWOOD KS 66211 MEDICAL RECORDS SOFTWARE 523692 AMERCO REAL ESTATE COMPANY 2727 N CENTRAL AVE PHOENIX AZ 85004 OFFICE LEASE 414135 20 2410279 84765 2410279 PATIENT SERVICE REVENUE 624100 23624932 23624932 23624932 672921 672921 MISC REVENUE 900099 140327 140327 140327 26848459 23765259 0 672921 1016510 918489 82012 16009 19583758 17707657 1582363 293738 153836 138452 12307 3077 1878776 1690898 150302 37576 1419435 1277491 113555 28389 126470 112559 11382 2529 104126 92672 9371 2083 372567 331585 33531 7451 24546 24546 545218 496774 39636 8808 1106960 988349 97045 21566 504321 473021 25609 5691 330 330 207261 201572 4655 1034 164974 151058 11386 2530 PHARMACY & MEDICAL EQUI 2371579 2371579 0 0 STAFF TRAINING & TRANSP 343732 343304 350 78 COMMUNICATIONS 257473 248131 7246 2096 DUES & PUBLICATIONS 65025 59536 4491 998 1385684 1379288 5234 1162 31632581 29007291 2190475 434815 672447 1384305 6322084 2515373 289248 24024 4448229 4315531 271916 105731 5739887 2620957 3141891 3118930 27486922 30059078 1154522 911637 43787259 42434609 2743655 3638103 1390400 0 69400 1018950 4203455 4657053 X 31512149 27676662 8071655 10100894 39583804 37777556 43787259 42434609 -4784122 2977874 0 X X 0 1 X 1 0 X 3702218 12879860 12651515 8161442 2410279 39805314 24983462 23777662 20346018 21567440 23624932 114299514 28685680 36657522 32997533 29728882 26035211 154104828 11101498 1313232 3850000 1000000 17264730 0 11101498 1313232 3850000 1000000 17264730 136840098 635334 713272 693684 779708 795217 3617215 635334 713272 693684 779708 795217 3617215 39472 112579 81010 66354 1353 300768 29360486 37483373 33772227 30574944 26831781 158022811 0.86600 0.87750 0.02290 0.02080 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 23899030 1000000 3203847 932523 27170354 25083774 2000000 -2532452 652292 23899030 18113610 5398000 2201406 629242 25083774 8805557 8100000 1647153 439100 18113610 7714442 100000 1195330 204215 8805557 0.63100 0.36900 0 0 1082200 1082200 3304148 1783764 1520384 430551 211975 218576 922988 625218 297770 3118930 LEASE LIABILITY 1018950 1018950 29826333 2977874 2977874 26848459 0 26848459 31632581 0 31632581 0 31632581 X X X X X 0 0 0 0 0 0 0 0 0 ANN MITCHELL PRESIDENT & CEO 270507 0 25000 0 0 0 3131 0 13223 0 311861 0 0 0 DAVID SCHRIER CHIEF MEDICAL OFFICER 267770 0 0 0 0 0 2948 0 34346 0 305064 0 0 0 ANN LICHTENSTEIN ASSOCIATE MEDICAL OFFICER 235035 0 5000 0 0 0 2679 0 33474 0 276188 0 0 0 LISSA BERROA GARCIA PHYSICIAN 194371 0 0 0 0 0 2170 0 13211 0 209752 0 0 0 JENNIFER PLUDE CHIEF CLINICAL OFFICER 195124 0 0 0 0 0 2171 0 5346 0 202641 0 0 0 VAISHNAVI PREMKUMAR PHYSICIAN 185479 0 0 0 0 0 0 0 15025 0 200504 0 0 0 MARLENE BRADFORD CHIEF ADVANCEMENT OFFICER 180003 0 5000 0 0 0 2125 0 9815 0 196943 0 0 0 CORNELIA STRONG VP OF QUALITY & COMPLIANCE 141118 0 0 0 0 0 1700 0 32959 0 175777 0 0 0 SOFIA MONTEBLANCO PHYSICIAN 149758 0 0 0 0 0 0 0 1358 0 151116 0 0 0 X 5 84765 PUBLISHED MARKET VALUE 0 0 0 PART I, COLUMN (B): FIVE STOCK CONTRIBUTIONS WERE DONATED TO THE ORGANIZATION. THREE FROM CHRISTINE RAPHAEL ESTATE ON 4/18/23 TOTALING $64.879.73, ONE FROM LOUISE GOODING ON 12/5/23 IN THE AMOUNT OF $18,643.87 AND ONE FROM MARGA LINOTTE PASTEMAK ON 11/30/23 IN THE AMOUNT OF $1,241.49. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 IS REVIEWED BY THE PRESIDENT AND MEMBERS OF THE FINANCE COMMITTEE BEFORE FILING. THE CHAIPERSON GIVES A SUMMARY REPORT TO THE BOARD. BOARD MEMBERS CAN REQUEST A COPY OF THE FORM 990 RETURN. THE FORM 990 IS PREPARED BY AN INDEPENDENT ACCOUNTING FIRM. FORM 990, PART VI, SECTION B, LINE 12C ALL INDIVIDUALS, UPON APPOINTMENT TO THE BOARD OF DIRECTORS, ANY BOARD DESIGNATED COMMITTEE, OR MONTGOMERY HOSPICE SENIOR STAFF SHALL BE REQUIRED TO EXAMINE AND SIGN AN INDIVIDUAL STATEMENT REGARDING CONFLICT OF INTEREST. IN THE EVENT A CONFLICT OF INTEREST OR POTENTIAL CONFLICT ARISES, THE CONFLICT OF INTEREST STATEMENT MUST PROMPTLY BE UPDATED AND BROUGHT TO THE ATTENTION OF THE PRESIDENT/CEO AND/OR CHAIRPERSON OF THE BOARD. IF THE MATTER CONCERNS A STAFF MEMBER, THE CHANGE SHOULD BE PRESENTED TO THE INDIVIDUAL'S SUPERVISOR. THE INDIVIDUAL BOARD MEMBERS, WHO HAVE A CONFLICT OF INTEREST WITH THEIR CURRENT BUSINESS RELATIONSHIP AND THE HOSPICE, WILL WITHDRAW THEMSELVES FROM BOARD DISCUSSIONS AND VOTING. FORM 990, PART VI, SECTION B, LINE 15A REVIEW FOR PRESIDENT/CEO IS CONDUCTED ANNUALLY BY CERTAIN MEMBERS OF THE EXECUTIVE COMMITTEE. MEMBERS MAY INTERVIEW PRESIDENT/CEO'S COLLEAGUES CONCERNING THEIR INTERACTION AND RELATIONSHIP WITH PRESIDENT/CEO. OTHER ANALYSIS INCLUDES A WRITTEN EMPLOYMENT CONTRACT, COMPENSATION SURVEY OR STUDY AND APPROVAL BY THE EXECUTIVE COMMITTEE. KEY EMPLOYEES ARE GIVEN ANNUAL PERFORMANCE REVIEWS BY THEIR IMMEDIATE SUPERVISOR INCLUDING THE PRESIDENT/CEO. THE PERFORMANCE SUMMARY IS REVIEWED AND DISCUSSED WITH THE PRESIDENT/CEO. AN ANALYSIS OF COMPARABLE STAFF POSITIONS AND SIMILAR HOSPICE ORGANIZATIONS IS DONE BY HR DEPARTMENT. DATA FROM BENCHMARK REPORTS PROVIDED BY NHPCO ARE ALSO USED IN THIS ANALYSIS. THE MOST RECENT YEAR IN WHICH THE COMPENSATION PROCESS WAS REVIEWED WAS 2021. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS AVAILABLE UPON REQUEST. THE ORGANIZATION'S FINANCIAL STATEMENTS ARE ALSO SUMMARIZED ON THE ORGANIZATION'S WEBSITE IN A WRITTEN ANNUAL REPORT. PART XII, LINE 2C NO CHANGE FROM THE PRIOR YEAR. PALLIATIVE MEDICINE CONSULTANTS OF GREATER WASHINGTON LLC 1355 PICCARD DR SUITE 100 ROCKVILLE MD 20850 522343635 TO OFFER A CONTINUUM OF CARE FOR PATIENTS WITH ADVANCED ILLNESS MD 13187 72996 MONTGOMERY HOSPICE INC