2019-10-18T10:19:36-05:00 2018-12-31 Grant Thornton LLP 1000 WILSON BLVD SUITE 1400 ARLINGTON VA 22209 990 2018-01-01 530204670 The Hospital for Sick Children % KIM BROWN HOSP 2024541255 1731 Bunker Hill Road NE Suite 300 Washington DC 20017 KIM BROWN VP FIN & Interim CFO 2026524224 2019-10-15 true Mary Torretta P00847851 7038477500 209.220.136.124 54681420192915000002 2019-10-18 P AA918D8483008E32154F6CC583B06457B9AF9E42 03CBAE45BD8E2F188EB28F31E827C7F4869431D2 2018 2020-03-31 21:24:44Z HSC Pediatric Center Nathaniel Beers 2013 H Street NW Ste 300 Washington DC 20005 32925660 false X www.hschealth.org/medical-programs-therapy X 1888 DC THE HOSPITAL FOR SICK CHILDREN (HSCPC) PROVIDES QUALITY CARE FOR YOUTH WITH SPECIAL HEALTH CARE NEEDS IN THE WASHINGTON, D.C. AND BALTIMORE AREAS. 4 3 266 53 0 0 160257 75973 29698923 32134383 45233 61055 1444667 654249 31349080 32925660 2263 1200 0 0 19026330 17489024 0 0 0 12493960 20253841 31522553 37744065 -173473 -4818405 21583245 20170811 32962175 36417947 -11378930 -16247136 HSCPC PROVIDES QUALITY REHABILITATIVE, TRANSITIONAL, AND SPECIALTY CARE FOR CHILDREN, ADOLESCENTS, AND YOUNG ADULTS WITH SPECIAL HEALTH CARE NEEDS IN THE WASHINGTON, D.C. AND BALTIMORE AREAS. false false 20979283 1200 32134872 TO PROVIDE QUALITY REHABILITATIVE AND TRANSITIONAL CARE FOR INFANTS, CHILDREN, ADOLESCENTS, AND YOUNG ADULTS WITH SPECIAL HEALTH CARE NEEDS IN A SUPPORTIVE, CULTURALLY COMPETENT, RESPECTFUL ENVIRONMENT, AND TO PARTICIPATE IN RELATED LOCAL, REGIONAL, AND NATIONAL PROJECTS WITH GOVERNMENT, PRIVATE, AND PHILANTHROPIC ORGANIZATIONS. IN 2018, HSCPC PROVIDED 8,417 DAYS OF CARE. HSCPC ALSO PROVIDED ON AN OUTPATIENT BASIS MEDICAL CARE, APPROXIMATELY 15,338 VISITS IN 2018. 20979283 true true false false false false false false false true true false false true true true true true false false false false false false false false true true false false true true false false false false false false false false false false false false false false false true false true false true 52 0 true 266 true false false false false false false false false false false false false X 4 3 false false false false true true true true true false false true true true true true true false false false X KIM BROWN 2026524224 2013 H STREET NW SUITE 300 Washington DC 20006 X Nathaniel Beers Pres & CEO, Board Member 10.0 30.0 X X 0 496659 33190 Roger E Meyer Chairperson 1.0 1.0 X X 0 0 0 Michael D Ward Secretary/Treasurer 1.0 3.0 X X 0 0 0 Joan Christopher Board Member 1.0 0.0 X 0 0 0 Suzanne Randolph Chair, to 4/30/18 1.0 0.0 X X 0 0 0 Kenneth H Silverberg Board Member, to 4/30/18 1.0 0.0 X 0 0 0 Raymond Vicks Jr Board Member, to 4/1/18 1.0 1.0 X 0 0 0 Victor Fields EVP & CFO, to 9/23/18 10.0 30.0 X 0 314792 33307 Debbie Holson COO, Pediatric Center 40.0 0.0 X 0 235954 29905 Kimberly Brown VP Finance & Interim CFO 15.0 25.0 X 0 201800 18637 Donna Anthony EVP, Clinical Strategies 20.0 20.0 X 0 283200 36756 Lynne Hostetter Piper Chief HR/Comp. Off. to 7/13/18 8.0 32.0 X 0 297843 21035 Giselle Jones Senior VP, Human Resources 15.0 25.0 X 0 204107 8157 Josephine Bias Robinson EVP, External Affairs 10.0 30.0 X 0 299981 29850 Andrew Metinko Pediatrician 40.0 0.0 X 196564 0 5837 Samar Maamoun Pediatrician 40.0 0.0 X 201243 0 9490 Thomas W Chapman Former Pres & CEO HSCF 0.0 0.0 X 0 2577008 17110 397807 4911344 243274 32 true true false Children's National Medical Center 111 Michigan Avenue NW WASHINGTON DC 20010 Medical services 1421193 Aramark Services Inc 1101 Market Street PHILADELPHIA PA 19107 Facility services 674376 G4S Secure Solutions USA 2800 Crystal Drive Suite 210 ARLINGTON VA 22202 Security consulting 431728 Clinical Pharmacy Associates 316 Talbott Avenue Suite A LAUREL MD 20707 Pharmacy services 241941 HHS Intergrated Facilities Manageme 3838 Rogers Road SAN ANTONIO TX 78251 Facilities mgmt 203112 9 75973 75973 PATIENT SERVICE REVENUE 621300 30087518 30087518 0 0 DSH REVENUE 621300 2046865 2046865 0 0 32134383 61055 61055 0 0 13896 13896 0 13896 13986 0 0 0 0 0 0 0 0 0 0 CAFETERIA VENDING 722210 92189 0 0 92189 SETTLEMENT INTEREST 900099 267777 0 0 267777 MISCELLANEOUS 900099 280387 489 0 279898 640353 32925660 32134872 0 714905 1200 1200 0 0 0 0 0 14542550 13413440 1129110 505121 505121 1331702 7536 1324166 1109651 1012769 96882 0 240375 146990 93385 0 0 0 7258 7258 3220783 1941599 1279184 0 820 820 147278 88504 58774 42869 34295 8574 0 1221424 593201 628223 74201 29266 44935 0 87509 26685 60824 346744 346744 0 1474821 1474821 61165 176214 -115049 SHARED SERVICE ALLOCATION 8716177 0 8716177 0 BAD DEBT EXPENSE 1942283 1942283 0 0 MEDICAL SUPPLIES 659115 659115 0 FOOD, CATERING, AND MEALS 519287 479458 39829 0 1491732 425908 1065824 37744065 20979283 16764782 0 0 0 0 0 0 0 3725859 5663525 0 0 0 0 0 0 158039 165912 633714 676982 39239362 29580569 11083862 9658793 57543 112935 0 0 0 0 0 0 5924228 3892664 21583245 20170811 3841643 2765584 0 0 0 0 9483547 9137459 0 0 0 0 0 0 0 0 19636985 24514904 32962175 36417947 X -11586168 -16477642 184423 207691 22815 22815 -11378930 -16247136 21583245 20170811 X -4818405 -138342 88541 X false true X true false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 57543 -9367 1715 46461 49918 6910 -715 57543 46336 3582 49918 45770 598 32 46336 33921 11849 45770 1.00000 false false 200000 200000 22524591 18096934 4427657 16415257 11483635 4931622 99514 99514 9658793 SUNTRUST SELF INSURANCE TRUST 2916057 DUE FROM THIRD PARTY PAYERS 909917 DUE FROM AFFILIATES 66690 3892664 0 DUE TO AFFILIATES 18326216 DUE TO THIRD PARTY PAYERS 4548015 EST SELF INS PROF LIAB 1549876 INTEREST RATE SWAP LIABILITY 90797 24514904 X 30837777 -138342 -1942283 -2080625 32918402 7258 7258 32925660 35817792 35817792 7258 1919015 1926273 37744065 INTENDED USES OF ENDOWMENT FUNDS SCHEDULE D, PART V, LINE 4 THE ENDOWMENT FUND CORPUS IS PERMANENTLY RESTRICTED AND WILL REMAIN INVESTED. THE INCOME DERIVED FROM THE ENDOWMENT FUND IS TO BE USED BY THE PEDIATRIC CENTER TO SUPPORT CURRENT OPERATIONS. LIABILITY FOR UNCERTAIN TAX POSITION (ASC 740) SCHEDULE D, PART X, LINE 2 The Hospital for Sick Children d/b/a HSC Pediatric Center ("The Center") HAS BEEN RECOGNIZED AS A PUBLIC CHARITY GENERALLY EXEMPT FROM FEDERAL INCOME TAXATION UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE (THE "CODE"). THE CENTER IS SUBJECT TO TAX ON INCOME UNRELATED TO ITS EXEMPT PURPOSE, UNLESS THAT INCOME IS OTHERWISE EXCLUDED BY THE CODE. THE CENTER HAS PROCESSES PRESENTLY IN PLACE TO ENSURE THE MAINTENANCE OF ITS TAX-EXEMPT STATUS; TO IDENTIFY AND REPORT UNRELATED INCOME; TO DETERMINE ITS FILING AND TAX OBLIGATIONS IN JURISDICTIONS FOR WHICH IT HAS NEXUS; AND TO IDENTIFY AND EVALUATE OTHER MATTERS THAT MAY BE CONSIDERED TAX POSITIONS. THE CENTER FOLLOWS GUIDANCE THAT CLARIFIES THE ACCOUNTING FOR UNCERTAINTY IN TAX POSITIONS TAKEN OR EXPECTED TO BE TAKEN IN A TAX RETURN, INCLUDING ISSUES RELATING TO FINANCIAL STATEMENT RECOGNITION AND MEASUREMENT. THIS GUIDANCE PROVIDES THAT THE TAX EFFECTS FROM AN UNCERTAIN TAX POSITION CAN ONLY BE RECOGNIZED IN THE FINANCIAL STATEMENTS IF THE POSITION IS "MORE-LIKELY-THAN-NOT" TO BE SUSTAINED IF THE POSITION WERE TO BE CHALLENGED BY A TAXING AUTHORITY. THE ASSESSMENT OF THE TAX POSITION IS BASED SOLELY ON THE TECHNICAL MERITS OF THE POSITION, WITHOUT REGARD TO THE LIKELIHOOD THAT THE TAX POSITION MAY BE CHALLENGED. THE TAX YEARS ENDING DECEMBER 31, 2018, 2017, 2016 AND 2015 ARE STILL OPEN TO AUDIT FOR BOTH FEDERAL AND STATE PURPOSES. THE CENTER HAS DETERMINED THAT THERE ARE NO MATERIAL UNCERTAIN TAX POSITIONS THAT REQUIRE RECOGNITION OR DISCLOSURE IN THE FINANCIAL STATEMENTS. OTHER REVENUE ON BOOKS BUT NOT ON RETURN SCHEDULE D, PART XI, LINE 2D BAD DEBT EXPENSE RECLASS ($1,942,283) OTHER EXPENSE ON RETURN BUT NOT ON BOOKS SCHEDULE D, PART XII, LINE 4B Temp Restricted Asset Adjustment to Expenses ($23,268) BAD DEBT EXPENSE RECLASS $1,942,283 ----------- TOTAL: $1,919,015 true true true X true X 500. true true true false false 28497419 21900817 6596602 0.18430 28497419 21900817 6596602 0.18430 2006 2006 0.00010 2006 2006 0.00010 28499425 21900817 6598608 0.18440 true 1942283 0 0 0 0 true true NA 1 1 The Hospital for Sick Children 1731 Bunker Hill Road NE Washington DC 20017 www.hschealth.org LICENSE #: HFD01-0 X X THE HOSPITAL FOR SICK CHILDREN 1 false false true X X X X X X X X 16 true false false true X hschealth.org/foundation/publications X dchealthmatters.org X true 16 true See Part V, Section C false true X 200. 500. X X X X X true true X X X true X www.hschealth.org X www.hschealth.org X www.hschealth.org X X X X X X X true X false X X X X false X X X false false INPUT FROM PERSONS WHO REPRESENT THE COMMUNITY SCHEDULE H, PART V, SECTION B, LINE 5 THE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) TOOK INTO ACCOUNT INPUT FROM A BROAD BASE OF HEALTH CARE EXPERTS AND COMMUNITY MEMBERS SERVED BY HSCPC INCLUDING DC AND MARYLAND PUBLIC HEALTH AGENCIES, AND HEALTH SERVICES FOR CHILDREN WITH SPECIAL NEEDS, INC. (HSCSN). CONTACTED LOCAL EXPERTS PARTICIPATED IN BOTH STRUCTURED AND INFORMAL INTERVIEWS DESIGNED TO IDENTIFY UNMET HEALTH AND RELATED SOCIAL NEEDS THAT IMPACT POSITIVE HEALTH OUTCOMES FOR THIS POPULATION. THE CHNA ALSO EXAMINED RECENT PUBLISHED LITERATURE AND RELEVANT DATA PERTAINING TO COMMUNITY HEALTH NEEDS ASSESSMENT RESULTS. CHNA and Implementation Strategy Schedule H, Part V, Lines 3 and 10 HSCPC adopted the DC Health Matters 2016 CHNA and CHIP during the fiscal year ending 12/31/2018. Schedule H is completed using this information since the adoption occurred during the tax year 2018 reporting period. HSCPC will complete the 2019 CHNA and CHIP as part of the DC Health Matters initiative and include this information on its return for the 12/31/2019 reporting period. The 2016 CHIP can be found here: http://www.dchealthmatters.org/tiles/index/display?alias=CHIPPriorityAreaL andingPageProgressTracker HOW THE HOSPITAL ADDRESSES SIGNIFICANT NEEDS SCHEDULE H, PART V, SECTION B, LINE 11 The hospital is addressing significant needs identified in its 2015 CHNA by adopting an implementation strategy identified in the CHNA report. HSC began executing the implementation strategy by undertaking the following actions: -Continue to provide charity services for patients (a) needing non-covered Medicaid services that are medically needy and (b) meeting the charity definition based on federal poverty guidelines. -Continue to follow the specific community benefit requirements for non-profit hospitals which include financial counseling, uniform charging, and published charity care policies and annual amounts. -Increase participation in local community partnerships to aid in the development of more effective care-coordination or wrap-around care models. -Behavioral health resources have grown in the past 3 years to include psychology and Applied Behavioral Analysis. -Additional needs for place-based care for this population were addressed by applying in 2018 to establish the first pediatric skilled nursing facility in the region, which is set to open in August 2019. ELIGIBILITY CRITERIA EXPLAINED IN THE FINANCIAL ASSISTANCE POLICY SCHEDULE H, PART V, SECTION B, LINE 13B HSCPC HAS A FINANCIAL ASSISTANCE POLICY THAT PROVIDES FOR FREE OR DISCOUNTED CARE TO INDIVIDUALS THAT QUALIFY UNDER THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY. THE LEVEL OF FINANCIAL ASSISTANCE IS DETERMINED BY SEVERAL FACTORS, INCLUDING: THE INDIVIDUAL'S ANNUAL INCOME, FAMILY SIZE, AND LIQUID ASSETS, AS WELL AS WHETHER THE INDIVIDUAL IS COVERED BY GOVERNMENTAL OR OTHER INSURANCE. FREE CARE IS PROVIDED TO PATIENTS WHO ARE INELIGIBLE FOR GOVERNMENTAL OR OTHER INSURANCE COVERAGE, AND WHOSE FAMILY INCOME DOES NOT EXCEED 200% OF THE FEDERAL POVERTY GUIDELINES. DISCOUNTED CARE IS BASED ON A SLIDING DISCOUNTED SCALE OF GROSS CHARGES AND IS PROVIDED TO PATIENTS WHO ARE INELIGIBLE FOR GOVERNMENTAL OR OTHER INSURANCE COVERAGE AND WHOSE FAMILY INCOME IS BETWEEN 200% AND 500% OF THE POVERTY GUIDELINES. WHEN POSSIBLE, THE ORGANIZATION MAY MAKE A PROSPECTIVE DETERMINATION THAT CERTAIN PATIENTS QUALIFY FOR FREE OR DISCOUNTED CARE, ALTHOUGH THE PATIENT HAS NOT SUBMITTED A COMPLETED FINANCIAL ASSISTANCE APPLICATION. PRESUMPTIVE CHARITY CARE IS DETERMINED BASED ON DEFINED CRITERIA FOR DESTITUTE STATUS (HOMELESS, ILLEGAL ALIEN, INCARCERATED, ETC.). PATIENTS WITH SUFFICIENT ASSETS TO PAY FOR CARE WITHOUT BECOMING MEDICALLY INDIGENT MAY NOT BE ELIGIBLE FOR FINANCIAL ASSISTANCE. HOWEVER, THE RESIDENCE WHERE A PATIENT AND/OR THE PATIENT'S FAMILY RESIDES, AUTOMOBILES NEEDED TO TRANSPORT ALL WORKING PARTIES TO AND FROM WORK, SAVINGS ACCOUNTS WITH LESS THAN TWO MONTHS OF INCOME AND RETIREMENT ACCOUNTS WITH LESS THAN $50,000 ARE ALWAYS EXEMPTED FROM CONSIDERATION AS ASSETS IN CONSIDERING WHETHER THE PATIENT QUALIFIES FOR FINANCIAL ASSISTANCE. ONCE CHARITY CARE ELIGIBILITY HAS BEEN ESTABLISHED, THE PATIENT ACCOUNT IN WHOLE OR IN PART, IS WRITTEN-OFF AND ALL COLLECTION EFFORTS ON THE WRITTEN OFF PORTION OF THE ACCOUNT CEASE. IF THE PATIENT RECEIVES PARTIAL CHARITY CARE, ALL EFFORTS WILL BE MADE TO PLACE THAT PATIENT ON AN EXTENDED PAYMENT PLAN. FURTHERMORE, HSCPC HAS A FINANCIAL ASSISTANCE POLICY THAT PROVIDES FOR FREE OR DISCOUNTED CARE TO THE MEDICALLY INDIGENT, WHICH IS A SEPARATE, SUPPLEMENTAL DETERMINATION OF FINANCIAL ASSISTANCE FOR PATIENTS THAT ARE NOT ELIGIBLE FOR FINANCIAL ASSISTANCE UNDER THE PRIMARY SECTION OF THE FINANCIAL ASSISTANCE POLICY, BUT FOR WHOM THE RESULTING FINANCIAL LIABILITY FOR MEDICAL TREATMENT REPRESENTS A CATASTROPHIC LOSS. "CATASTROPHIC" IS DEFINED AS A SITUATION IN WHICH THE SELF-PAY PORTION OF THE HSCPC MEDICAL BILL IS GREATER THAN THE PATIENT'S ABILITY TO REPAY WITH CURRENT INCOME AND LIQUID ASSETS IN 18 MONTHS OR LESS. THE FACTORS TAKEN INTO CONSIDERATION WHEN EVALUATING A CATASTROPHIC ASSISTANCE APPLICATION ARE THE FOLLOWING: CURRENT MEDICAL DEBT, LIQUID ASSETS, LIVING EXPENSES, PROJECTED MEDICAL EXPENSES, ANNUAL INCOME, FAMILY SIZE, AND SPELL OF ILLNESS. AVAILABILITY OF FINANCIAL ASSISTANCE POLICY SCHEDULE H, PART V, SECTION B, LINE 16J HSCPC PUBLICIZES ITS FINANCIAL ASSISTANCE POLICY IN MANY DIFFERENT WAYS. FIRST, IT POSTS NOTICES REGARDING THE AVAILABILITY OF CHARITY CARE IN ADMISSIONS, PATIENT REGISTRATION, AND THE BUSINESS OFFICE. THE INFORMATION ON THE SIGNS IS IN BOTH ENGLISH AND SPANISH. IN ADDITION, THE POLICY IS DISTRIBUTED TO PATIENTS ON ADMISSION AND UPON REQUEST, AND IS AVAILABLE AT ALL PATIENT REGISTRATION DESKS AND IN ALL WAITING AREAS. FURTHERMORE, HSCPC, AS MANDATED BY ITS FINANCIAL ASSISTANCE POLICY, PUBLISHES A SUMMARY OF ITS FINANCIAL ASSISTANCE POLICY, ON AN ANNUAL BASIS, IN A NEWSPAPER OF GENERAL CIRCULATION IN THE HOSPITAL'S PRIMARY AND SECONDARY SERVICE AREAS. POLICY RELATING TO EMERGENCY MEDICAL CARE SCHEDULE H, PART V, SECTION B, LINE 21D THE HSC PEDIATRIC CENTER IS A LONG-TERM PEDIATRIC HOSPITAL FACILITY, WHICH DOES NOT PROVIDE EMERGENCY MEDICAL CARE. HOWEVER, THE HSC PEDIATRIC CENTER HAS ADOPTED A TRANSFER POLICY PURSUANT TO WHICH THE HOSPITAL WILL HELP TO TRANSFER, AS APPROPRIATE, ANY PATIENTS SHOWING SYMPTOMS OF AN EMERGENCY TO AN ACUTE CARE HOSPITAL. MAXIMUM AMOUNTS TO BE CHARGED TO FAP ELIGIBLE INDIVIDUALS SCHEDULE H, PART V, SECTION B, LINE 22D THE HSC PEDIATRIC CENTER DETERMINED MAXIMUM AMOUNTS TO BE CHARGED TO FAP ELIGIBLE INDIVIDUALS IS NOT MORE THAN AMOUNTS GENERALLY BILLED TO INSURED PATIENTS. THE PROSPECTIVE MEDICAID METHOD WAS USED. 1 The HSC Outpatient Center 4500 Forbes Blvd Suite 100 Lanham MD 20706 PROVIDES OUTPATIENT REHAB SERVICES TO THE SPECIAL NEEDS COMMUNITY OTHER CRITERIA USED FOR DETERMINING ELIGIBILITY SCHEDULE H, PART I, LINE 3C THE HOSPITAL FOR SICK CHILDREN DBA THE HSC PEDIATRIC CENTER (HSCPC) HAS A FINANCIAL ASSISTANCE POLICY THAT PROVIDES FOR FREE OR DISCOUNTED CARE TO INDIVIDUALS THAT QUALIFY UNDER THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY. THE LEVEL OF FINANCIAL ASSISTANCE IS DETERMINED BY SEVERAL FACTORS, INCLUDING: THE INDIVIDUAL'S ANNUAL INCOME, FAMILY SIZE, AND LIQUID ASSETS, AS WELL AS WHETHER THE INDIVIDUAL IS COVERED BY GOVERNMENTAL OR OTHER INSURANCE. FREE CARE IS PROVIDED TO PATIENTS WHO ARE INELIGIBLE FOR GOVERNMENTAL OR OTHER INSURANCE COVERAGE, AND WHOSE FAMILY INCOME DOES NOT EXCEED 200% OF THE FEDERAL POVERTY GUIDELINES. DISCOUNTED CARE IS BASED ON A SLIDING DISCOUNTED SCALE OF GROSS CHARGES AND IS PROVIDED TO PATIENTS WHO ARE INELIGIBLE FOR GOVERNMENTAL OR OTHER INSURANCE COVERAGE AND WHOSE FAMILY INCOME IS BETWEEN 200% AND 500% OF THE POVERTY GUIDELINES. WHEN POSSIBLE, THE ORGANIZATION MAY MAKE A PROSPECTIVE DETERMINATION THAT CERTAIN PATIENTS QUALIFY FOR FREE OR DISCOUNTED CARE, ALTHOUGH THE PATIENT HAS NOT SUBMITTED A COMPLETED FINANCIAL ASSISTANCE FORM. PRESUMPTIVE CHARITY CARE IS DETERMINED BASED ON DEFINED CRITERIA FOR DESTITUTE STATUS (HOMELESS, ILLEGAL ALIEN, INCARCERATED, ETC.). ONCE CHARITY CARE ELIGIBILITY HAS BEEN ESTABLISHED, THE PATIENT ACCOUNT IN WHOLE, OR IN PART, IS WRITTEN-OFF AND ALL COLLECTION EFFORTS ON THE WRITTEN OFF PORTION OF THE ACCOUNT CEASE. IF THE PATIENT RECEIVES PARTIAL CHARITY CARE, ALL EFFORTS WILL BE MADE TO PLACE THAT PATIENT ON AN EXTENDED PAYMENT PLAN. IN ADDITION, INDIVIDUALS THAT DO NOT QUALIFY FOR FINANCIAL ASSISTANCE UNDER THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY MAY STILL BE PROVIDED UP TO A 25% DISCOUNT ON BILLED SERVICES IN CERTAIN CIRCUMSTANCES. FINANCIAL ASSISTANCE POLICY FOR THE MEDICALLY INDIGENT SCHEDULE H, PART I, LINE 4 HSCPC HAS A FINANCIAL ASSISTANCE POLICY THAT PROVIDES FOR FREE OR DISCOUNTED CARE TO THE MEDICALLY INDIGENT, WHICH IS A SEPARATE, SUPPLEMENTAL DETERMINATION OF FINANCIAL ASSISTANCE FOR PATIENTS THAT ARE NOT ELIGIBLE FOR FINANCIAL ASSISTANCE UNDER THE PRIMARY SECTION OF THE FINANCIAL ASSISTANCE POLICY, BUT FOR WHOM THE RESULTING FINANCIAL LIABILITY FOR MEDICAL TREATMENT REPRESENTS A CATASTROPHIC LOSS. "CATASTROPHIC" IS DEFINED AS A SITUATION IN WHICH THE SELF-PAY PORTION OF THE HSCPC MEDICAL BILL IS GREATER THAN THE PATIENT'S ABILITY TO REPAY WITH CURRENT INCOME AND LIQUID ASSETS IN 18 MONTHS OR LESS. THE FACTORS TAKEN INTO CONSIDERATION WHEN EVALUATING A CATASTROPHIC ASSISTANCE APPLICATION ARE THE FOLLOWING: CURRENT MEDICAL DEBT, LIQUID ASSETS, LIVING EXPENSES, PROJECTED MEDICAL EXPENSES, ANNUAL INCOME, FAMILY SIZE, AND SPELL OF ILLNESS. EXPLANATION OF COSTING METHODOLOGY USED FOR CALCULATING LINE 7 TABLE SCHEDULE H, PART I, LINE 7 THE COST OF CHARITY CARE WAS DETERMINED BY UTILIZING THE RATIO OF COST TO CHARGES CALCULATED ON WORKSHEET 2 APPLIED TO THE CHARGES WRITTEN OFF FOR PATIENTS QUALIFYING FOR CHARITY CARE UNDER THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY. SCHEDULE H, PART I, LINE 7, COL (F) BAD DEBT EXPENSE EXCLUDED FROM FINANCIAL ASSISTANCE CALCULATION $1,942,283. METHODOLOGY USED TO ESTIMATE BAD DEBT SCHEDULE H, PART III, LINE 2 BAD DEBT EXPENSE IS DETERMINED BY ANALYZING PAST HISTORY AND IDENTIFYING TRENDS FOR EACH MAJOR PAYER SOURCE OF REVENUE. MANAGEMENT REGULARLY REVIEWS DATA ABOUT THESE MAJOR PAYER SOURCES OF REVENUE IN EVALUATING THE SUFFICIENCY OF THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS. FOR RECEIVABLES ASSOCIATED WITH SERVICES PROVIDED TO PATIENTS WHO HAVE THIRD-PARTY INSURANCE COVERAGE, THE HOSPITAL ANALYZES CONTRACTUALLY DUE AMOUNTS AND PROVIDES AN ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS AND BAD DEBT EXPENSE, IF NECESSARY. FOR RECEIVABLES ASSOCIATED WITH SELF-PAY PATIENTS, THE HOSPITAL RECORDS A SIGNIFICANT BAD DEBT EXPENSE IN THE PERIOD OF SERVICE ON THE BASIS OF ITS PAST EXPERIENCE, WHICH INDICATES THAT MANY PATIENTS ARE UNABLE OR UNWILLING TO PAY THE PORTION OF THEIR BILL FOR WHICH THEY ARE FINANCIALLY RESPONSIBLE. THE HOSPITAL REGULARLY PERFORMS HINDSIGHT PROCEDURES TO EVALUATE HISTORICAL WRITE-OFF AND COLLECTION EXPERIENCE THROUGHOUT THE YEAR TO ASSIST IN DETERMINING THE REASONABLENESS OF ITS PROCESS FOR ESTIMATING THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS. FAP ELIGIBLE PATIENT BAD DEBT CALCULATION METHODOLOGY SCHEDULE H, PART III, LINE 3 THE HOSPITAL DOES NOT REPORT AN ESTIMATE FOR THE PORTION OF BAD DEBT EXPENSE THAT MAY HAVE BEEN LIKELY TO QUALIFY FOR FINANCIAL ASSISTANCE UNDER THE HOSPITAL'S CHARITY CARE POLICY. HSCPC TAKES THE POSITION THAT AMPLE OPPORTUNITY AND ASSISTANCE IS PROVIDED TO THE PATIENT TO QUALIFY UNDER THE FINANCIAL ASSISTANCE POLICY. IF SUFFICIENT INFORMATION IS NOT PROVIDED THE HOSPITAL MUST ASSUME THE PATIENT DOES NOT QUALIFY FOR FINANCIAL ASSISTANCE. FOOTNOTE IN ORGANIZATION'S FINANCIAL STATEMENTS DESCRIBING BAD DEBT SCHEDULE H, PART III, LINE 4 THE FOOTNOTE TO THE ORGANIZATION'S FINANCIAL STATEMENTS (NOTE 2) THAT DESCRIBES BAD DEBT EXPENSE IS AS FOLLOWS: PROVISIONS FOR ESTIMATED UNCOLLECTIBLE ACCOUNTS Accounts receivable are reduced by an allowance for uncollectible accounts. In evaluating the collectability of accounts receivable, the Center analyzes its past history and identifies trends for each of its major payer sources of revenue to estimate the appropriate allowance for uncollectible accounts and provision for uncollectible accounts. Management regularly reviews data about these major payer sources of revenue in evaluating the sufficiency of the allowance for uncollectible accounts. For receivables associated with services provided to patients who have third-party insurance coverage, the Center analyzes contractually due amounts and provides an allowance for uncollectible accounts and a provision for uncollectible accounts, if necessary (for example, for expected uncollectible deductibles and copayments on accounts for which the third-party payer has not yet paid, or for payers who are known to be having financial difficulties that make the realization of amounts due unlikely). For receivables associated with self-pay patients (which include both patients without insurance and patients with deductible and copayment balances due for which third-party coverage exists for part of the bill), the Center records a significant provision for uncollectible accounts in the period of service on the basis of its past experience, which indicates that many patients are unable or unwilling to pay the portion of their bill for which they are financially responsible. The Center regularly performs hindsight procedures to evaluate historical write-off and collection experience throughout the year to assist in determining the reasonableness of its process for estimating the allowance for uncollectible accounts. The difference between the standard rates (or the discounted rates if negotiated) and the amounts actually collected after all reasonable collection efforts have been exhausted is charged off against the allowance for uncollectible accounts. In 2018, management revised its allowance model based upon improved collections, resulting in an increase in net patient service revenue of $2,100,000. SHORTFALL TREATED AS COMMUNITY BENEFIT AND COSTING METHOD USED SCHEDULE H, PART III, LINE 8 HSCPC DOES NOT PARTICIPATE IN THE MEDICARE PROGRAM. PROVISIONS ON COLLECTION PRACTICES FOR PATIENTS WHO ARE KNOWN TO QUALIFY FOR ASSISTANCE SCHEDULE H, PART III, LINE 9B THE DETERMINATION OF A PATIENT'S QUALIFICATION UNDER THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY IS ATTEMPTED PRIOR TO THE PATIENT BEING DISCHARGED FROM THE HOSPITAL. THIS MAY INCLUDE A PROSPECTIVE DETERMINATION THAT CERTAIN PATIENTS QUALIFY FOR FINANCIAL ASSISTANCE, ALTHOUGH THE PATIENT HAS NOT SUBMITTED A COMPLETE FINANCIAL ASSISTANCE POLICY. AS SOON AS THE PATIENT'S FINANCIAL ASSISTANCE ELIGIBILITY HAS BEEN ESTABLISHED, THE PATIENT ACCOUNT IN WHOLE OR IN PART, IS WRITTEN-OFF AND ALL COLLECTION EFFORTS CEASE ON THE PORTION OF THE ACCOUNT THAT HAS BEEN WRITTEN-OFF. IF THE PATIENT RECEIVES DISCOUNTED CARE, ALL EFFORTS WILL BE MADE TO PLACE THAT PATIENT ON AN EXTENDED PAYMENT PLAN. FOR THOSE PATIENTS THAT DO NOT INITIALLY APPLY OR QUALIFY FOR FINANCIAL ASSISTANCE, THE ORGANIZATION CONTINUES TO MONITOR WHETHER THE PATIENT MAY QUALIFY FOR FINANCIAL ASSISTANCE THROUGHOUT THE COLLECTION PROCESS. IF THE PATIENT IS FOUND TO BE ELIGIBLE FOR FINANCIAL ASSISTANCE AT ANY POINT (INCLUDING ONCE COLLECTION EFFORTS HAVE BEGUN), THE ORGANIZATION WILL APPROVE THE PATIENT FOR FINANCIAL ASSISTANCE IMMEDIATELY. HOSPITAL FACILITIES SCHEDULE H, PART V, SECTION A THE HOSPITAL FOR SICK CHILDREN D/B/A, THE HSC PEDIATRIC CENTER IS A SELF-CONTAINED LONG-TERM PEDIATRIC SPECIALTY 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. NEEDS ASSESSMENT SCHEDULE H, PART VI, LINE 2 HSC PEDIATRIC CENTER USES A VARIETY OF METHODS TO ASSESS HEALTH CARE NEEDS OF THE COMMUNITY IT SERVES. NEEDS ARE IDENTIFIED THROUGH A FORMAL COMMUNITY HEALTH NEEDS ASSESSMENT, PARTNERSHIPS AND COLLABORATIONS WITH OTHER MEDICAL, NON-PROFIT AND PUBLIC HEALTH AGENCIES. HSC PEDIATRIC CENTER ASSUMES THE RESPONSIBILITY OF LEADING THE REGION IN THE PROVISION OF CHRONIC CARE FOR PEDIATRIC PATIENTS AND IS TRUSTED THROUGHOUT ITS COMMUNITY AS A RESOURCE READY AND WILLING TO ADDRESS ESTABLISHED AND EMERGENT PEDIATRIC NEEDS WHEREVER AND HOWEVER THEY ARE IDENTIFIED. HSC PEDIATRIC CENTER'S CURRENT COMMUNITY NEEDS ASSESSMENT AND IMPLEMENTATION STRATEGY CAN BE FOUND AT WWW.HSCHEALTH.ORG/FOUNDATION/PUBLICATIONS. PATIENT EDUCATION SCHEDULE H, PART VI, LINE 3 THE HSC PEDIATRIC CENTER HAS A STRONG COMMITMENT TO PROVIDING SERVICES TO FAMILIES AT NO COST TO THEM IF AT ALL POSSIBLE. MANY OF THE FAMILIES WHO RECEIVE SERVICES FROM HSC HAVE ALREADY QUALIFIED FOR MEDICAID BY THE TIME OF THEIR ARRIVAL AT HSC DUE TO PRIOR SERVICES AT OTHER FACILITIES. IF A FAMILY ARRIVES AT HSC WITH PRIVATE INSURANCE, OFTEN TIMES THEY QUALIFY FOR MEDICAID BY THE TIME THEY ARE DISCHARGED TO CARE AT HOME. FAMILIES ARE INFORMED OF THE AVAILABILITY OF FINANCIAL ASSISTANCE AT THE TIME OF THEIR ADMISSION TO HSCPC. THEY ARE GIVEN WRITTEN COPIES OF THE STATEMENT: "NOTICE OF AVAILABILITY OF UNCOMPENSATED SERVICES" IN THE APPROPRIATE LANGUAGE. IF THEY BELIEVE THEY MAY BE IN NEED OF THE SERVICES, AN APPLICATION IS FILLED OUT AT THE TIME OF ADMISSION. IF A FAMILY DOES NOT QUALIFY FOR MEDICAID THEY WOULD BE ELIGIBLE TO PURSUE THE AVAILABLE UNCOMPENSATED SERVICES. IF PATIENTS ARE NOT ELIGIBLE FOR MEDICAID AND OTHER GOVERNMENTAL PROGRAMS SUBSEQUENT TO DISCHARGE, HSCPC BOTH INFORMS AND ATTEMPTS TO QUALIFY THEM PROSPECTIVELY FOR THE CHARITY CARE SERVICES PROVIDED BY HSCPC. STAFF OF THE ORGANIZATION HELP IDENTIFY GOVERNMENT OR NON-PROFIT ASSISTANCE WHICH MAY BE AVAILABLE, AND THE ORGANIZATION WILL ASSIST PATIENTS' FAMILIES WITH APPLYING FOR SUCH PROGRAMS, SUCH AS MEDICAID. COMMUNITY INFORMATION SCHEDULE H, PART VI, LINE 4 THE HSC PEDIATRIC CENTER SERVES CHILDREN AND YOUNG ADULTS UP TO THE AGE OF 21 IN THE WASHINGTON DC METRO AREA WHO HAVE SPECIAL HEALTH CARE NEEDS. HSCPC SERVES THE WASHINGTON DC METRO AREA WHICH IS A DIVERSE COMMUNITY THAT COVERS TWO STATES AND THE DISTRICT OF COLUMBIA. OF THE DC SPECIAL NEEDS CHILDREN APPROXIMATELY 5,500 WERE ENROLLED IN HEALTH SERVICES FOR CHILDREN WITH SPECIAL NEEDS, INC., HSCPC'S SISTER ORGANIZATION THAT PROVIDES CARE MANAGEMENT SERVICES TO CHILDREN WHO HAVE SSI OR SSI RELATED DIAGNOSES. THE PRIMARY CONDITIONS OF CHILDREN WITH SPECIAL HEALTH CARE NEEDS TREATED AT THE HSCPC ARE CONDITIONS REQUIRING LONGER TERM TRANSITIONAL CARE AND/OR SPECIALTY REHABILITATION CARE PRIOR TO THEIR DISCHARGE TO HOME OR NURSING/GROUP HOME. THESE CONDITIONS INCLUDE CEREBRAL PALSY, ANOXIC BRAIN DAMAGE, SPINA BIFIDA, FAILURE TO THRIVE RELATED TO PREMATURITY, CHRONIC LUNG DISEASE AND INTESTINAL OR OTHER FEEDING DISORDERS. IN 2018, APPROXIMATELY 68% OF HSCPC'S PATIENTS WERE COVERED BY MEDICAID (I.E. DC, MD OR VA MEDICAID). IN 2018, HSCPC PROVIDED 8,417 DAYS OF CARE. HSCPC ALSO PROVIDED ON AN OUTPATIENT BASIS MEDICAL CARE, APPROXIMATELY 15,338 VISITS IN 2018. PROMOTION OF COMMUNITY HEALTH SCHEDULE H, PART VI, LINE 5 THE HSC PEDIATRIC CENTER'S GOVERNING BODY IS COMPRISED OF PERSONS WHO RESIDE IN THE ORGANIZATION'S PRIMARY SERVICE AREA WHO ARE NEITHER EMPLOYEES NOR INDEPENDENT CONTRACTORS OF THE ORGANIZATION OR ITS AFFILIATES, NOR FAMILY MEMBERS THEREOF. THE HOSPITAL EXTENDS MEDICAL STAFF PRIVILEGES TO ALL QUALIFIED PHYSICIANS IN ITS COMMUNITY FOR SOME OR ALL OF ITS DEPARTMENTS OR SPECIALTIES. THE ORGANIZATIONS SURPLUS FUNDS ARE USED TO FURTHER ITS EXEMPT PURPOSE, MEDICAL EDUCATION AND COMMUNITY PROGRAMS. DESCRIPTION OF AFFILIATED GROUP SCHEDULE H, PART VI, LINE 6 HSCPC IS PART OF THE HSC HEALTHCARE SYSTEM WHICH CONSISTS OF SIX SEPARATE LEGAL ENTITIES: THE HSC FOUNDATION (HSCF), THE HSC PEDIATRIC CENTER (HSCPC), THE HEALTH SERVICES FOR CHILDREN WITH SPECIAL NEEDS, INC. (HSCSN), HSC SERVICES, LLC (HSCS), THE HSC HOME CARE, LLC (HSCHC), AND 2013 HOLDINGS. THE HSC HEALTH CARE SYSTEM IS DESIGNED AND DEDICATED TO PROVIDING QUALITY MEDICAL CARE SERVICES, INNOVATIVE CARE MANAGEMENT, HOME CARE AND OTHER RELATED SERVICES TAILORED TO THE NEEDS OF INFANTS, CHILDREN AND ADOLESCENTS WITH DISABILITIES AND CHRONIC MEDICAL CONDITIONS AND THEIR FAMILIES. IN ADDITION, THE HSC HEALTH CARE SYSTEM STRIVES TO IMPROVE ACCESS TO MEDICAL CARE AND TO IMPROVE THE HEALTHCARE STATUS OF THE GROSSLY UNDERSERVED PEDIATRIC POPULATION IN WHICH THE HSC HEALTHCARE SYSTEM SERVES. HSCF: THE MISSION OF HSCF IS TO FACILITATE ACCESS TO SERVICES FOR INDIVIDUALS WITH SPECIAL NEEDS AND THEIR FAMILIES IN THE WASHINGTON DC METROPOLITAN AREA, WHILE CONDUCTING REGIONAL AND NATIONAL PROJECTS WITH GOVERNMENT AND PHILANTHROPIC ORGANIZATIONS. IT ALSO SERVES AS THE SUPPORTING ORGANIZATION FOR THE OTHER THREE NON-PROFIT ENTITIES AS STATED ABOVE AND IT ALSO OPERATES A YOUTH TRANSITION INITIATIVE. HSCF IS A SECTION 501(C)(3) TAX-EXEMPT ORGANIZATION. HSCPC: HSCPC IS A HOSPITAL FACILITY THAT PROVIDES REHABILITATION AND TRANSITIONAL CARE FOR CHILDREN AND ADOLESCENTS WITH DISABILITIES AND CHRONIC ILLNESS. FURTHER, HSCPC PROVIDES ASSISTANCE WITH ACCESSING RELATED CARE SERVICES FOR ALL PATIENTS AND THEIR FAMILIES IN A NURTURING ENVIRONMENT OF FAMILY-CENTERED CARE WITHIN THE WASHINGTON METROPOLITAN AREA. HSCPC IS A SECTION 501(C)(3) TAX-EXEMPT ORGANIZATION. HSCSN: HSCSN IS AN INNOVATIVE CARE MANAGEMENT ORGANIZATION THAT COORDINATES HEALTH, SOCIAL, AND EDUCATION SERVICES FOR THE PEDIATRIC SUPPLEMENTAL SECURITY INCOME (SSI) AND SSI ELIGIBLE POPULATIONS IN THE WASHINGTON, DC AREA. BENEFITS PROVIDED TO MEMBERS AND THEIR FAMILIES, AND COMMUNITIES INCLUDE ALL TRADITIONAL MEDICAID BENEFITS, PLUS INDIVIDUALIZED CARE MANAGEMENT SERVICES, 24 HOUR ACCESS TO CARE COORDINATION, OUTREACH, AND RESPITE CARE SERVICES FOR ITS MEMBERS AND THEIR FAMILIES. HSCSN IS A SECTION 501(C)(3) TAX-EXEMPT ORGANIZATION. HSCS: HSCS CONTROLS HSC HOME CARE, LLC AND IS ITS SOLE MEMBER. HSCS IS WHOLLY OWNED BY HSCF, WHICH IS ITS SOLE MEMBER. HSC HOME CARE, LLC: HSC HOME CARE, LLC'S MISSION IS TO PROVIDE ACCESS TO QUALITY REHABILITATIVE AND SPECIALTY SERVICES FOR INFANTS, CHILDREN AND ADOLESCENTS WITH SPECIAL NEEDS AND THEIR FAMILIES IN A MANNER. THAT IS CULTURALLY AND LINGUISTICALLY APPROPRIATE THROUGH THE OFFERING OF A VAST ARRAY OF REHABILITATIVE, MEDICAL, SOCIAL, AND EDUCATIONAL SERVICES. THE ORGANIZATION RECOGNIZES THE VALUE OF CARE IN THE HOME AND RECONNECTING PATIENTS BACK INTO THEIR COMMUNITY. 2013 HOLDINGS: IS A TITLE-HOLDING COMPANY, WHICH HOLDS TITLE TO THE REAL PROPERTY LOCATED AT 2013 H STREET, NW, WASHINGTON, DC 20006, COLLECTS INCOME FROM SUCH PROPERTY, AND REMITS THE ENTIRE AMOUNT OF INCOME FROM SUCH PROPERTY, LESS EXPENSES, TO HSCF. 2013 HOLDINGS IS A SECTION 501(C) (2) TAX-EXEMPT ORGANIZATION. STATE FILING OF COMMUNITY BENEFIT REPORT SCHEDULE H, PART VI, LINE 7 DC true true false false false false false false false Nathaniel Beers Pres & CEO, Board Member 0 496659 0 0 0 0 0 30450 0 2740 0 529849 0 0 Victor Fields EVP & CFO, to 9/23/18 0 314792 0 0 0 0 0 21500 0 11807 0 348099 0 0 Debbie Holson COO, Pediatric Center 0 235954 0 0 0 0 0 28270 0 1635 0 265859 0 0 Donna Anthony EVP, Clinical Strategies 0 283200 0 0 0 0 0 25154 0 11602 0 319956 0 0 Lynne Hostetter Piper Chief HR/Comp. Off. to 7/13/18 0 158034 0 0 0 139809 0 17621 0 3414 0 318878 0 0 Giselle Jones Senior VP, Human Resources 0 204107 0 0 0 0 0 5507 0 2650 0 212264 0 0 Josephine Bias Robinson EVP, External Affairs 0 299981 0 0 0 0 0 29850 0 0 0 329831 0 0 Kimberly Brown VP Finance & Interim CFO 0 201800 0 0 0 0 0 10353 0 8284 0 220437 0 0 Andrew Metinko Pediatrician 196564 0 0 0 0 0 5837 0 0 0 202401 0 0 0 Thomas W Chapman Former Pres & CEO HSCF 0 0 0 0 0 2577008 0 13696 0 3414 0 2594118 0 0 Samar Maamoun Pediatrician 201243 0 0 0 0 0 9490 0 0 0 210733 0 0 0 ARRANGEMENT USED TO ESTABLISH THE TOP MANAGEMENT OFFICIAL'S COMPENSATION SCHEDULE J, PART I, LINE 3 THE ORGANIZATION RELIED ON A RELATED ORGANIZATION AND THAT RELATED ORGANIZATION USED THE FOLLOWING METHODS TO ESTABLISH THE CEO/PRESIDENT'S COMPENSATION: 1) Compensation committee; 2) INDEPENDENT COMPENSATION CONSULTANT; 2) COMPENSATION SURVEY OR STUDY; AND 3) APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE. SEVERANCE OR CHANGE-OF-CONTROL PAYMENT SCHEDULE J, PART I, LINE 4A DURING THE YEAR ENDED DECEMBER 31, 2018, CERTAIN INDIVIDUALS RECEIVED SEVERANCE PAYMENTS. THESE AMOUNTS ARE REPORTED AS TAXABLE COMPENSATION AND REPORTED ON SCHEDULE J, PART II, LINE B(III), OTHER REPORTABLE COMPENSATION. THE INDIVIDUALS AND AMOUNTS ARE LISTED BELOW: LYNNE HOSTETTER PIPER $113,779 SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN SCHEDULE J, PART I, LINE 4B A RELATED ORGANIZATION MAINTAINS A SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (SERP) AS PART OF THE TOTAL COMPENSATION ARRANGEMENT FOR THE ORGANIZATION'S FORMER CEO, THOMAS CHAPMAN. THE SERP PLAN IS MEANT TO PROVIDE THOMAS CHAPMAN WITH A RETIREMENT BENEFIT FOR OVER 20 YEARS OF SERVICE PROVIDED TO THE RELATED ORGANIZATION. THE RELATED ORGANIZATION'S COMPENSATION COMMITTEE HAS CAREFULLY REVIEWED AND APPROVED THE SERP PLAN FOR THOMAS CHAPMAN AND CONCLUDED THAT THOMAS CHAPMAN'S ENTIRE COMPENSATION PACKAGE, INCLUDING THE BENEFITS PROVIDED BY THE SERP PLAN, IS REASONABLE WHEN COMPARED TO MARKET DATA. In 2018, Mr Chapman received distributions from a Rabbi Trust and SERP which were established long-term incentive plans as an element of his total compensation established by the board. A District of Columbia 536001131 254839J53 2010-12-17 12450000 refund series 2005 bond false false false A 1050000 0 12450000 0 0 0 0 0 0 0 11525000 0 1992 true false true true A false false false false 0 false false false false A false false false true true false 0 false 0 false false A true Schedule K, Part III, Line 7 ALL COSTS OF ISSUANCE WITH RESPECT TO THE BONDS WERE PAID FROM FUNDS OTHER THAN PROCEEDS OF THE BONDS. Schedule K, Part IV, Line 2c - COlumn A ISSUER NAME: DISTRICT OF COLUMBIA THE CALCULATION FOR COMPUTING NO REBATE DUE WAS PERFORMED ON 7/27/2015. Schedule K, Part IV, Line 7 THE TAX-EXEMPT BOND ISSUANCE UNDERTAKEN BY THE ORGANIZATION IN 2010 CURRENTLY REFUNDED A PRIOR TAX-EXEMPT BOND ISSUANCE FROM 2005, WHICH 2005 BOND ISSUANCE HAD CURRENTLY REFUNDED THE HOSPITAL REVENUE BONDS SERIES 1991A, ISSUED BY THE ORGANIZATION ON JUNE 12, 1991 TO FINANCE THE CONSTRUCTION OF A HOSPITAL FACILITY. ALL OF THE PROCEEDS OF THE 2010 TAX-EXEMPT BOND ISSUANCE WERE SPENT IMMEDIATELY UPON RECEIPT TO CURRENTLY REFUND THE 2005 BOND ISSUANCE. AS OF THE ISSUANCE DATE OF THE 2010 TAX-EXEMPT BONDS, THERE WERE NO UNEXPENDED PROCEEDS OF THE 2005 BONDS, AND THERE WERE NO TRANSFERRED PROCEEDS TO THE 2010 TAX-EXEMPT BOND ISSUANCE FROM PRIOR BOND ISSUANCES. AS A RESULT OF THE FOREGOING, NONE OF THE PROCEEDS OF THE TAX-EXEMPT BOND ISSUANCE WERE USED TO MAKE ANY HIGHER YIELDING INVESTMENTS OR NONPURPOSE INVESTMENTS, WHICH ARE REGULATED UNDER SECTION 148 OF THE INTERNAL REVENUE CODE. SINCE THE ORGANIZATION HAS NOT USED THE PROCEEDS FROM THE BOND ISSUANCE TO MAKE ANY HIGHER YIELDING INVESTMENTS OR NONPURPOSE INVESTMENTS, THE ORGANIZATION HAS NOT YET ESTABLISHED WRITTEN PROCEDURES TO MONITOR THE REQUIREMENTS OF SECTION 148. IT IS THE ORGANIZATION'S INTENTION TO ADOPT SUCH A POLICY AT SUCH TIME AS ANOTHER TAX-EXEMPT BOND ISSUANCE IS UNDERTAKEN BY THE ORGANIZATION, PURSUANT TO WHICH THE PROCEEDS OF THE TAX-EXEMPT BOND ISSUANCE WILL NOT BE SPENT IMMEDIATELY UPON PURPOSE INVESTMENTS. DELEGATE BROAD AUTHORITY TO A COMMITTEE FORM 990, PART VI, SECTION A, LINE 1A THE EXECUTIVE COMMITTEE OF THE HSC FOUNDATION, THE SOLE CORPORATE MEMBER OF THE ORGANIZATION, HAS THE POWER TO EXERCISE EACH AND ALL OF THE POWERS OF THE BOARD OF DIRECTORS IN THE SAME MANNER AND TO THE SAME EXTENT AS IF THE COMMITTEE WERE IN FACT THE BOARD OF DIRECTORS, PROVIDED THAT ANY ACTION TAKEN SHALL NOT CONFLICT WITH PREVIOUSLY ESTABLISHED POLICIES OR DIRECTIVES OF THE BOARD. HOWEVER, NOTHING CONTAINED IN THESE BYLAWS SHALL CONSTITUTE A DELEGATION TO THE EXECUTIVE COMMITTEE OF THE FOLLOWING POWERS OF THE BOARD OF DIRECTORS: TO INCREASE OR DECREASE THE NUMBER OF DIRECTORS; TO FILL VACANCIES ON OR REMOVE DIRECTORS FROM THE BOARD; TO ELECT OFFICERS; TO FILL OFFICERS' VACANCIES; TO REMOVE OFFICERS; TO SELL, ENCUMBER OR OTHERWISE DISPOSE OF ALL OR ANY MATERIAL PART OF THE ASSETS OF THE CORPORATION; TO MERGE OR CONSOLIDATE THE CORPORATION WITH ANOTHER ENTITY; OR TO AMEND THESE BYLAWS. ALL EXECUTIVE COMMITTEE MINUTES WILL BE PROVIDED TO ALL MEMBERS OF THE BOARD OF DIRECTORS PRIOR TO THE NEXT MEETING OF THE BOARD OF DIRECTORS. THE EXECUTIVE COMMITTEE SHALL CONSIST OF THE CHAIRMAN, VICE CHAIRMAN, SECRETARY AND TREASURER OF THE HSC FOUNDATION AND UP TO FOUR (4) ADDITIONAL AT-LARGE MEMBERS WHO MAY BE APPOINTED BY THE CHAIRMAN OF THE BOARD, IN HIS OR HER DISCRETION. THE PRESIDENT SHALL BE AN EX OFFICIO MEMBER OF THE COMMITTEE. MEMBERS OR STOCKHOLDERS FORM 990, PART VI, SECTION A, LINE 6 THE HSC FOUNDATION IS THE SOLE MEMBER OF THE HOSPITAL FOR SICK CHILDREN. ELECTION OF MEMBERS FORM 990, PART VI, SECTION A, LINES 7A & 7B THE SOLE MEMBER SHALL HAVE ALL OF THE POWERS SPECIFIED IN THE ARTICLES OF INCORPORATION AND BYLAWS, INCLUDING THE POWER TO: (A) ESTABLISH THE HOSPITAL'S POLICIES AND GOALS, AND APPROVE THE BYLAWS INCLUDING ANY AMENDMENTS THERETO; (B) APPOINT AND REMOVE THE HOSPITAL'S BOARD OF DIRECTORS; (C) MONITOR THE DECISIONS OF THE HOSPITAL'S BOARDS OF DIRECTORS; AND (D) APPROVE THE HOSPITAL'S BUDGET. FORM 990 REVIEW PROCESS FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 IS PREPARED BY AN ACCOUNTING FIRM AND THEN REVIEWED BY THE COO'S, VP FINANCE AND CFO. ONCE COMMENTS FROM THE COO'S, VP FINANCE AND CFO HAVE BEEN INCORPORATED INTO THE FORM 990, THE FORM 990 IS DISTRIBUTED TO THE BOARD OF DIRECTORS PRIOR TO FILING. THE FULL BOARD OF DIRECTORS HAS DELEGATED THE REVIEW OF THE FORM 990 TO HSC FOUNDATIONS AUDIT COMMITTEE THAT FUNCTIONS ON BEHALF OF THE HOSPITAL FOR SICK CHILDREN. THE AUDIT COMMITTEE IS A PART OF THE FULL VOTING BOARD OF DIRECTORS. CONFLICT OF INTEREST POLICY FORM 990, PART VI, SECTION B, LINE 12C THE HSC FOUNDATION HAS A WRITTEN CONFLICT OF INTEREST POLICY THAT COVERS ITSELF AND ALL OF ITS DIRECT AND INDIRECT SUBSIDIARIES (INCLUDING THE HOSPITAL FOR SICK CHILDREN). UNDER THAT POLICY, WHENEVER A POTENTIAL CONFLICT ARISES FOR THE HSC PEDIATRIC CENTER BOARD OF DIRECTORS AND OFFICERS, IT IS BROUGHT TO THE ATTENTION OF THE PRESIDENT AND EXECUTIVE COMMITTEE OF THE HSC FOUNDATION BOARD, WHICH ANALYZES THE SITUATION AND MAKES A DETERMINATION OF WHETHER OR NOT AN ACTUAL CONFLICT EXISTS. IF IT IS DETERMINED THAT AN ACTUAL CONFLICT EXISTS, THE PRESIDENT AND EXECUTIVE COMMITTEE REPORTS TO THE HSC PEDIATRIC CENTER BOARD OF DIRECTORS REGARDING THE NATURE OF THE CONFLICT AND THAT PERSON IS THEREAFTER RECUSED FROM ANY DISCUSSION AND VOTE REGARDING THE MATTER. WHENEVER A POTENTIAL CONFLICT ARISES FOR EMPLOYEES OF THE HSC PEDIATRIC CENTER MANAGEMENT TEAM, IT WILL BE BROUGHT TO THE BOARD CHAIR BY THE PRESIDENT WHICH ANALYZES THE SITUATION AND MAKES A DETERMINATION OF WHETHER OR NOT AN ACTUAL CONFLICT EXISTS. IF IT IS DETERMINED THAT AN ACTUAL CONFLICT EXISTS, STEPS WILL BE TAKEN TO ELIMINATE THE CONFLICT AND COMMUNICATED TO THE EMPLOYEE INVOLVED. THE BOARD CHAIR AND PRESIDENT WILL REPORT ALL COI TO THE EXECUTIVE COMMITTEE FOUNDATION. PROCESS FOR DETERMINING COMPENSATION FORM 990, PART VI, SECTION B, LINES 15A AND 15B THE ORGANIZATION RELIED ON A RELATED ORGANIZATION, HSC FOUNDATION, TO DETERMINE COMPENSATION OF THE ORGANIZATION'S CEO. IN ADDITION, THE ORGANIZATION DETERMINES THE COMPENSATION OF OTHER OFFICERS AND KEY EMPLOYEES OF THE ORGANIZATION, AS DISCUSSED BELOW. THE ORGANIZATION AND HSC FOUNDATION BOTH USE A FOUR STEP APPROACH TO EXECUTIVE COMPENSATION: 1. The Executive Committee is made up of independent board members without a conflict of interest. The Committee establishes and determines the reasonableness of total compensation for the system's disqualified executives and forwards proposed compensation to the full board for approval. 2. PERIODICALLY, THE EXECUTIVE COMMITTEE WILL ENGAGE AN INDEPENDENT CONSULTANT TO PREPARE A DETAILED WRITTEN REPORT ON APPROPRIATE COMPARABILITY DATA FOR COMPARABLE POSITIONS. 3. THE EXECUTIVE COMMITTEE REVIEWS AND RELIES UPON THE REPORT OF THE INDEPENDENT CONSULTANT, ALONG WITH OTHER INDIVIDUAL AND MARKET DATA, THEN DEBATES AND FULLY DOCUMENTS ITS DECISION ABOUT WHAT IS REASONABLE COMPENSATION FOR DISQUALIFIED EXECUTIVES. 4. ONCE THE EXECUTIVE COMMITTEE DEVELOPS EXECUTIVE COMPENSATION RECOMMENDATIONS, THEY ARE PRESENTED TO THE SYSTEM'S FULL BOARD FOR APPROVAL. REQUIRED DOCUMENTS AVAILABLE TO THE PUBLIC FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. OTHER CHANGES IN NET ASSETS OR FUND BALANCES FORM 990, PART XI, LINE 9 Change in fair value of interest rate swap $88,541 The HSC Foundation 2013 H Street NW Suite 300 Washington DC 20006 521346603 Healthcare DC 501(c)(3) 12-III FI NA false Hlth Svcs for Children with Special Need 1101 Vermont Ave NW Ste 1200 Washington DC 20005 521862406 Healthcare DC 501(c)(3) 10 HSC Fndn false 2013 Holdings Inc 2013 H Street NW Suite 300 Washington DC 20006 272882469 Holding Co. DC 501(c)(2) N/A HSC Fndn false false false false false false false false false false true false false false true true true true false false