2017-05-11T09:58:39-05:00 2016-06-30 412069731 SC&H TAX & ADVISORY SERVICES LLC 910 RIDGEBROOK ROAD SPARKS MD 21152 990 2015-07-01 521392214 SHEPPARD PRATT PHYSICIANS PA SHEP 4109383344 PO BOX 6815 BALTIMORE MD 21285 RAY DZIESINSKI CHIEF FINANCIAL OFFICER 4109383344 2017-05-09 1 LORI S BURGHAUSER P00370694 4104031500 2017-05-09 2015 2021-01-29 14:40:06Z RAY DZIESINSKI PO BOX 6815 BALTIMORE MD 21285 26803507 0 X N/A X 1985 MD PROVIDE BEHAVIORAL HEALTH CARE TO PATIENTS REGARDLESS OF ABILITY TO PAY AND PROVIDE RESIDENCY TRAINING TO MEDICAL PROFESSIONALS. TREAT PATIENTS IN VARIOUS EDUCATIONAL VENUES AND ENGAGE IN RESEARCH ACTIVITIES. 11 1 198 1 0 0 506130 593731 16480048 15301098 2909 920 10275367 10907758 27264454 26803507 0 0 0 0 24877785 27916552 0 0 0 6400480 6114537 31278265 34031089 -4013811 -7227582 2343093 3532869 8582708 11020066 -6239615 -7487197 PROVIDE BEHAVIORAL HEALTH CARE TO PATIENTS REGARDLESS OF ABILITY TO PAY AND PROVIDE RESIDENCY TRAINING TO MEDICAL PROFESSIONALS. TREAT PATIENTS IN VARIOUS EDUCATIONAL VENUES AND ENGAGE IN RESEARCH ACTIVITIES. 0 0 30997772 26208856 PROVIDE BEHAVIORAL HEALTH CARE TO PATIENTS AND RESIDENCY TRAINING TO MEDICAL PROFESSIONALS. 30997772 1 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 1 0 0 0 0 0 0 1 0 0 0 1 0 0 198 1 0 0 0 0 0 0 0 0 0 0 X 11 1 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 MD X DONNA CORBETT 4109383344 6501 N CHARLES ST TOWSON MD 21285 STEVEN SHARFSTEIN MD PRESIDENT, CEO, CHAIRMAN 1.00 44.00 X X 0 890592 52807 GERALD A NOLL VP, CFO, TREASURER, TRUSTE 1.00 44.00 X X 0 318392 53558 KATHLEEN HILZENDEGER DIR PROF SVCS,SEC,TRUSTEE 1.00 44.00 X X 0 147278 28235 BONNIE KATZ VP BUS DEV, TRUSTEE 1.00 44.00 X X 0 446478 99118 ROBERT ROCA MD VP MED. AFFAIRS, TRUSTEE 40.00 1.00 X X 617964 0 84277 JASON ADDISON MD CHAIR, MED. EXEC. COM. TRU 40.00 1.00 X 239710 0 19327 JOHN BORONOW MD MED. DIRECTOR, TRUSTEE 40.00 1.00 X 193056 0 48649 FAITH DICKERSON PHD DIR. PSYCHOLOGY, TRUSTEE 40.00 1.00 X 167163 0 57856 KENNETH JONES TRUSTEE 1.00 1.00 X 0 0 0 MEENA VIMALANANDA MD MED. DIRECTOR, TRUSTEE 40.00 1.00 X 347053 0 90348 SUSAN WAIT MD SENIOR PSYCHIATRIST, TRUST 40.00 1.00 X 237510 0 33620 THOMAS FRANKLIN MEDICAL DIRECTOR RETREAT 40.00 1.00 X 529815 0 28786 LESLY H BAUGH MED. DIR JEFF SCHOOL & RTC 40.00 1.00 X 385898 0 32624 KHIZAR KHAN MD SENIOR PSYCHIATRIST 40.00 1.00 X 380157 0 33667 MOHMMAD WK MOHMAND MD PSYCHIATRIST 40.00 1.00 X 385640 0 11412 EDWARD ZUZARTE PSYCHIATRIST 40.00 1.00 X 354100 0 43117 3838066 1802740 717401 88 0 1 0 GREATER BALTIMORE MEDICAL CENTER 6545 N CHARLES ST STE 201 BALTIMORE MD 21204 MEDICAL SERVICES 625330 BARTON & ASSOCIATES PO BOX 417844 BOSTON MA 02241 NURSE PRACTITIONER SERVICES 240861 2 593731 593731 PATIENT SERVICE REVENUE 621400 12193165 12193165 CONTRACTUAL PHYSICIAN SERVICE REV 621990 3107933 3107933 15301098 920 920 INTERCOMPANY REVENUE 621990 10907758 10907758 10907758 26803507 26208856 0 920 2070168 2013630 56538 206260 206260 21657731 21061470 596261 1810128 1760692 49436 927617 901407 26210 1244648 1210655 33993 300 300 35000 35000 1652315 1562285 90030 60000 60000 INTERCOMPANY CHARGES 4366622 2221373 2145249 MISCELLANEOUS EXPENSES 300 300 34031089 30997772 3033317 0 1118936 2415273 833520 753430 355407 325778 35230 38388 2343093 3532869 3384686 4675332 5198022 6344734 8582708 11020066 X -6239615 -7487197 -6239615 -7487197 2343093 3532869 X -7227582 5980000 X X 0 1 X 1 0 X 473137 486980 514863 506130 593731 2574841 18378342 16581727 16434340 16480048 15301098 83175555 18851479 17068707 16949203 16986178 15894829 85750396 0 0 0 85750396 17071 12456 1359 2909 920 34715 17071 12456 1359 2909 920 34715 8627127 9495881 9848520 10275367 10907758 49154653 27495677 26577044 26799082 27264454 26803507 134939764 0.63550 0.66130 0.00030 0.00030 X SCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME: INTERCORPORATE RECEIPTS RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 ACCRUED PENSION 6311556 DUE TO AFFILIATES 33178 6344734 26803507 0 26803507 0 26803507 34031089 0 34031089 0 34031089 PARTS XI AND XII PARTS XI AND XII RECONCILE TO SEPARATE COMPANY FINANCIAL STATEMENTS OF SHEPPARD PRATT PHYSICIANS, P.A. 0 1 0 0 0 0 0 0 0 STEVEN SHARFSTEIN MD PRESIDENT, CEO, CHAIRMAN 0 875189 0 0 0 15403 0 46381 0 6426 0 943399 0 0 GERALD A NOLL VP, CFO, TREASURER, TRUSTE 0 315000 0 0 0 3392 0 38000 0 15558 0 371950 0 0 KATHLEEN HILZENDEGER DIR PROF SVCS,SEC,TRUSTEE 0 146016 0 0 0 1262 0 7349 0 20886 0 175513 0 0 BONNIE KATZ VP BUS DEV, TRUSTEE 0 362885 0 0 0 83593 0 82818 0 16300 0 545596 0 75000 ROBERT ROCA MD VP MED. AFFAIRS, TRUSTEE 518626 0 0 0 99338 0 67238 0 17039 0 702241 0 75000 0 JASON ADDISON MD CHAIR, MED. EXEC. COM. TRU 234526 0 0 0 5184 0 11182 0 8145 0 259037 0 0 0 JOHN BORONOW MD MED. DIRECTOR, TRUSTEE 188090 0 0 0 4966 0 33035 0 15614 0 241705 0 0 0 FAITH DICKERSON PHD DIR. PSYCHOLOGY, TRUSTEE 162275 0 0 0 4888 0 56019 0 1837 0 225019 0 0 0 MEENA VIMALANANDA MD MED. DIRECTOR, TRUSTEE 337413 0 0 0 9640 0 72378 0 17970 0 437401 0 0 0 SUSAN WAIT MD SENIOR PSYCHIATRIST, TRUST 231587 0 0 0 5923 0 21794 0 11826 0 271130 0 0 0 THOMAS FRANKLIN MEDICAL DIRECTOR RETREAT 520649 0 0 0 9166 0 8477 0 20309 0 558601 0 0 0 LESLY H BAUGH MED. DIR JEFF SCHOOL & RTC 377881 0 0 0 8017 0 15312 0 17312 0 418522 0 0 0 KHIZAR KHAN MD SENIOR PSYCHIATRIST 371720 0 0 0 8437 0 13000 0 20667 0 413824 0 0 0 MOHMMAD WK MOHMAND MD PSYCHIATRIST 385640 0 0 0 0 0 11412 0 0 0 397052 0 0 0 EDWARD ZUZARTE PSYCHIATRIST 346785 0 0 0 7315 0 19794 0 23323 0 397217 0 0 0 PART I, LINE 3 THE ORGANIZATION'S CEO WAS NOT PAID BY THE FILING ORGANIZATION BUT WAS PAID BY A RELATED ORGANIZATION, SHEPPARD PRATT HEALTH SYSTEM, INC. THE RELATED ENTITY CHECKED THE FOLLOWING BOXES FOR SCHEDULE J, QUESTION 3 ON ITS FORM 990: COMPENSATION COMMITTEE, INDEPENDENT COMPENSATION CONSULTANT, FORM 990 OF OTHER ORGANIZATIONS, WRITTEN EMPLOYMENT CONTRACT, COMPENSATION SURVEY OR STUDY, APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE. PART I, LINE 4B DURING CALENDAR YEAR 2015, THE FOLLOWING PARTICIPATED IN SHEPPARD PRATT'S 457(F) PLAN: GERALD NOLL $25,000 BONNIE KATZ $25,000 ROBERT ROCA $25,000 DURING CALENDAR YEAR 2015, THE FOLLOWING OFFICERS RECEIVED PAYMENTS AS PART OF THEIR PARTICIPATION IN SHEPPARD PRATT'S 457(F) PLAN: BONNIE KATZ $77,278 ROBERT ROCA $86,664 PATRICIA L CARLSON FAMILY 206260 THE ORGANIZATION EMPLOYED MS. CARLSON AS A PHYSICIAN DURING THE FISCAL YEAR. MS. CARLSON IS THE SISTER OF MS. HILZENDEGER, A BOARD MEMBER. 0 FORM 990, PART VI, SECTION A, LINE 6 THE ORGANIZATION IS ULTIMATELY CONTROLLED BY THE SHEPPARD AND ENOCH PRATT FOUNDATION, INC. FORM 990, PART VI, SECTION A, LINE 7A THE SHEPPARD AND ENOCH PRATT FOUNDATION, INC. HOLDS RESERVED RIGHTS WHICH INCLUDE THE POWERS TO APPOINT BOARD MEMBERS. FORM 990, PART VI, SECTION A, LINE 7B THE SHEPPARD AND ENOCH PRATT FOUNDATION, INC. HOLDS RESERVED RIGHTS WHICH INCLUDE THE POWERS TO APPOINT AND REMOVE BOARD MEMBERS. THEY ALSO HOLD THE RIGHT TO APPROVE CERTAIN SELECT TRANSACTIONS OF ITS SUBSIDIARIES. FORM 990, PART VI, SECTION B, LINE 11 THE FINANCE COMMITTEE OF THE BOARD OF TRUSTEES REVIEWS THE FORM 990 AT THE APRIL MEETING. FOLLOWING FINANCE COMMITTEE REVIEW OF THE FORM 990, THE FORM 990 IS POSTED TO THE SHEPPARD PRATT WEBSITE PORTAL FOR THE BOARD OF DIRECTORS REVIEW PRIOR TO FILING. FORM 990, PART VI, SECTION B, LINE 12C MEMBERS ARE REQUIRED TO ORALLY DISCLOSE ANY POTENTIAL CONFLICTS OF INTEREST AT EACH MEETING. IF THERE IS A CONFLICT OF INTEREST, THE MEMBER IS REQUIRED TO DISQUALIFY HIM OR HERSELF FROM ANY FURTHER DISCUSSION ON THE MATTER. THE CHAIRPERSON WILL SELECT A DISINTERESTED PERSON TO INVESTIGATE ALTERNATIVES TO THE TRANSACTION THAT POSES THE POTENTIAL CONFLICT. IF AFTER EXERCISING DUE DILIGENCE THE BOARD DETERMINES THAT IT IS UNABLE TO SECURE A MORE ADVANTAGEOUS TRANSACTION WITH AN ENTITY THAT WOULD NOT GIVE RISE TO A CONFLICT OF INTEREST, THE BOARD WILL DETERMINE WHETHER OR NOT TO ENTER INTO THE TRANSACTION, IF IT IS IN THE BEST INTEREST OF THE ORGANIZATION. THE ORGANIZATION REQUIRES ALL TRUSTEES AND KEY EXECUTIVE PERSONNEL TO COMPLETE A CONFLICT OF INTEREST QUESTIONNAIRE ANNUALLY. THE COMPLETED QUESTIONNAIRES ARE REVIEWED BY THE CFO WHO SUMMARIZES THE REPORTED CONFLICTS. THIS INFORMATION IS THEN PRESENTED TO THE CEO AND THE CHAIRMAN OF THE BOARD FOR REVIEW. FORM 990, PART VI, SECTION B, LINE 15 SALARIES OF THE CEO AND TOP MANAGEMENT ARE REVIEWED BY THE EMPLOYEE COMPENSATION COMMITTEE OF THE BOARD OF TRUSTEES. THIS COMMITTEE IS COMPRISED OF INDEPENDENT TRUSTEES. THE TRUSTEES REVIEW COMPENSATION FOR REASONABLENESS. THEY USE COMPARATIVE INDUSTRY DATA AND FORM 990S OF OTHER ORGANIZATIONS IN THEIR REVIEW PROCESS. THE PROCESS FOR EMPLOYEE COMPENSATION INCLUDES DEVELOPMENT OF COMPENSATION RECOMMENDATIONS BASED ON MARKET SURVEYS AND OTHER COMPARATIVE INDUSTRY DATA AS WELL AS WRITTEN EMPLOYMENT CONTRACTS. THE SALARY INFORMATION FOR THIS GROUP IS OBTAINED BY A CONSULTANT THAT IS ENGAGED BY THE EXECUTIVE COMPENSATION COMMITTEE. THIS CONSULTANT USES CURRENT MARKET COMPENSATION SURVEYS AND OTHER COMPARATIVE INDUSTRY DATA TO MAKE RECOMMENDATIONS. THE RECOMMENDATIONS ARE THEN PRESENTED TO THE EXECUTIVE COMPENSATION COMMITTEE FOR APPROVAL. THE EXECUTIVE COMPENSATION COMMITTEE REPORTS THAT COMPENSATION WAS APPROVED TO THE FULL BOARD. THERE IS CONTEMPORANEOUS DOCUMENTATION AND RECORDKEEPING FOR DELIBERATIONS AND DECISIONS REGARDING THE COMPENSATION ARRANGEMENTS. FORM 990, PART VI, SECTION C, LINE 19 FINANCIAL STATEMENTS, GOVERNING DOCUMENTS, AND OTHER POLICIES INCLUDING THE CONFLICT OF INTEREST POLICY ARE AVAILABLE UPON REQUEST. FORM 990, PART XI, LINE 9: TRANSFER FROM AFFILIATE 5,980,000. FORM 990, PART XII, LINE 2C: THE PARENT ENTITY, SHEPPARD AND ENOCH PRATT FOUNDATION, INC., HAS A FINANCE COMMITTEE THAT ASSUMES RESPONSIBILITY FOR THE CONSOLIDATED AUDITED FINANCIAL STATEMENTS. THIS PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. SHEPPARD & ENOCH PRATT FOUNDATION INC PO BOX 6815 BALTIMORE MD 21285 521357109 CONDUCT FUNDRAISING ACTIVITIES TO SUPPORT AFFILIATED ORGANIZATIONS MD 501(C)(3) 7 N/A 0 SHEPPARD PRATT HEALTH SYSTEM INC PO BOX 6815 BALTIMORE MD 21285 520591684 PROVIDES INPATIENT/OUTPATIENT CARE, EDUC. SVCS & RESID. SVCS MD 501(C)(3) 3 SHEPPARD AND ENOCH PRATT FOUNDATION INC 0 SHEPPARD PRATT INVESTMENT INC PO BOX 6815 BALTIMORE MD 21285 521388935 HOLD AND MANAGE ENDOWMENT FUNDS OF RELATED NONPROFIT ENTITIES MD 501(C)(3) 11A SHEPPARD AND ENOCH PRATT FOUNDATION INC 0 MOSAIC COMMUNITY SERVICES INC 1925 GREENSPRING DRIVE TIMONIUM MD 21093 521338141 PROVIDES THERAPEUTIC RESIDENTIAL, REHAB, & SUPPORT SERVICES MD 501(C)(3) 7 SHEPPARD AND ENOCH PRATT FOUNDATION INC 0 WAY STATION INC PO BOX 3826 FREDERICK MD 21705 521162749 PROVIDES REHABILIATION AND TREATMENT SERVICES MD 501(C)(3) 7 SHEPPARD AND ENOCH PRATT FOUNDATION INC 0 FAMILY SERVICES INC 610 EAST DIAMOND AVENUE GAITHERSBURG MD 20877 520730225 FOSTER HEALTHY FAMILIES THROUGH EDUCATION, BEHAVIORAL HEALTH SERVICES MD 501(C)(3) 7 SHEPPARD AND ENOCH PRATT FOUNDATION INC 0 REVISIONS COMMUNITY HOUSING DEVELOPMENT ORGANIZATION INC 1925 GREENSPRING DRIVE TIMONIUM MD 21093 521849336 PROVIDE AFFORDABLE HOUSING TO CHRONICALLY MENTALLY DISABLED INDIVIDUALS MD 501(C)(3) 9 MOSAIC COMMUNITY SERVICES INC 0 DULANEY STATION COMMUNITY HOUSING DEVELOPMENT ORGANIZATION INC 1925 GREENSPRING DRIVE TIMONIUM MD 21093 020650286 CREATES AFFORDABLE HOUSING FOR LOW INCOME ADULTS W/ PSYCHIATRIC DISABILITIES MD 501(C)(3) 9 MOSAIC COMMUNITY SERVICES INC 0 ALLIANCE INC 8003 CORPORATE DRIVE NOTTINGHAM MD 21236 521277262 EDUC., VOC., & RESID. SERVICES FOR INDIVIDUALS WITH DISABILITIES MD 501(C)(3) 7 SHEPPARD AND ENOCH PRATT FOUNDATION INC 0 WAY STATION FOUNDATION INC 230 W PATRICK ST PO BOX 3826 FREDERICK MD 21705 521857765 SOLICIT AND ACCEPT FUNDS AND PROPERTY TO SUPPORT AFFILIATED ORGANIZATION MD 501(C)(3) 7 WAY STATION INC 0 SHEPPARD PRATT PREFERRED RESOURCES INC 6501 N CHARLES STREET TOWSON MD 21285 521757742 INACTIVE MD N/A C 0 0 0 0 0 0 0 0 0 0 0 0 1 0 1 0 1 1 0 1