2017-05-10T22:16:59-05:00 2016-06-30 KPMG LLP 1676 INTERNATIONAL DRIVE McLean VA 22102 990 2015-07-01 522218584 THE MEDSTAR-GEORGETOWN MEDICAL CENTER INC % JOEL BRYAN MEDS 2027843000 HOSPITAL ADMIN 1 MAIN BLDG WASHINGTON DC 20007 JOEL BRYAN VP/TREASURER 2017-05-08 true JG WHITE P01498698 7032868000 2017-05-05 2015 2021-01-29 14:40:06Z MEDSTAR GEORGETOWN UNIVERSITY HOSP Michael Sachtleben HOSPITAL ADMIN 1 MAIN BLDG WASHINGTON DC 20007 1077536234 false X WWW.GEORGETOWNUNIVERSITYHOSPITAL.ORG X 2000 DC TO PROVIDE PHYSICAL AND SPIRITUAL COMFORT TO OUR PATIENTS AND THEIR FAMILIES IN THE JESUIT TRADITION OF CURA PERSONALIS, CARING FOR THE WHOLE PERSON. 24 14 6221 150 0 1042333 4394564 1894974 991933996 1064605784 909065 499289 11831525 10535368 1009069150 1077535415 0 0 0 0 485046217 508203348 5122 141372 196170 422803767 463757962 907855106 972102682 101214044 105432733 446086243 495806106 190991454 193114170 255094789 302691936 X As a proud member of MedStar Health, MedStar Georgetown University Hospitals (MedStar Georgetown) mission is to provide physical and spiritual comfort to our patients and their families in the Jesuit tradition of cura personalis, caring for the whole person. MedStar Georgetown is an acute care teaching and research hospital located in northwest Washington, D.C. In fiscal year 2016, MedStar Georgetown had 20,299 admissions and observations, and 669,957 outpatient visits including 34,106 emergency visits. false false 650142728 0 985276703 MedStar Georgetown University Hospitals largest program is the provision of acute hospital services to the communities of the northwest Washington, D.C. and the surrounding areas. In addition to the program service expenses listed above, MedStar Georgetown incurred $218.4M of management and general expenses in providing services to its communities. MedStar Georgetowns centers of excellence include neurosciences, transplantation, cancer and gastroenterology. THE HOSPITAL IS ONE OF A FEW CENTERS IN THE WORLD PROVIDING LIVING-DONOR LIVER TRANSPLANTATION, AND HAS THE LARGEST PEDIATRIC LIVER TRANSPLANT PROGRAM ON THE EAST COAST. MedStar Georgetown's Lombardi Comprehensive Cancer Center is one of only 47 centers in the U.S., and the only one designated as a Comprehensive Cancer Center by the National Cancer Institute in Washington, D.C. MedStar Georgetown was the first hospital in Washington, D.C. to attain Magnet Recognition by the American Nurses Credentialing Center, and one of a small, elite group nationwide to achieve three magnet designations (in 2004, 2008, 2014). 66555898 0 43833835 MedStar Georgetown University Hospital provided $66.6M in health professions education in fiscal year 2016. This category includes training in graduate medical education, and education for physicians, medical students, nurses, and other health professions. 36977889 35495246 MedStar Georgetown University Hospital provided $36.9M in subsidized (mission driven) health services in fiscal year 2016. These critical services, which are driven by community needs, operate at a loss. They address priorities primarily through disease prevention and improvement of health status. Services provided include outpatient primary care services and cancer services. 753676515 true true false false false false false false false false true false false true true true false true false false false false false true false false true true false false true false false false false false true false false true false false false true true true true false false true 0 0 true 6221 true true true false false false false false false false false false X 24 14 true false false false true true true true true false false true true true true true true true true false DC X JOEL BRYAN 4107726721 10980 GRANTCHESTER WAY COLUMBIA MD 21044 X HOWARD J FEDEROFF MD PHD DIRECTOR (UNTIL 10/15) 1.0 0.0 X 0 0 0 RICHARD GOLDBERG MD DIRECTOR 40.0 0.0 X X 1237803 0 30812 KENNETH A SAMET DIRECTOR 1.0 39.0 X 0 4872708 66397 Bruce Davidson MD Director 40.0 0.0 X 482209 0 33056 NADIM HADDAD MD DIRECTOR 40.0 0.0 X 1238227 0 28564 JOHN PAHIRA MD DIRECTOR 40.0 0.0 X 570146 0 31168 RUSSELL WALL MD DIRECTOR 40.0 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Aulisi MD CHIEF OF ENDOSCOPY 40.0 0.0 X 2429591 0 21516 Alexandros Powers MD PHYSICIAN 40.0 0.0 X 1311064 0 21451 John Klimkiewicz DIRECTOR, DIVISION OF SPORTS 40.0 0.0 X 1110608 0 32587 Thomas Fishbein MD DIVISION CHIEF 40.0 0.0 X 1286391 0 14696 EVAN ARGINTAR Dir of Sports Med research 40.0 0.0 X 1148243 0 14463 M Joy Drass FORMER OFFICER 1.0 39.0 X 0 3200323 37497 Oliver Johnson Former Officer 1.0 39.0 X 0 1135073 18002 13437132 11335648 543825 817 true true false NURSEFINDERS PO BOX 910738 DALLAS TX 75391 Staffing Services 15349552 Morrison Healthcare Services 4721 MORRISON DRIVE SUITE 300 MOBILE AL 36609 MEDICAL SERVICES 4834903 WASHINGTON REGIONAL TRANSPLANT 7619 Little River Turnpike 900 ANNANDALE VA 22003 MEDICAL SERVICES 3924350 CERASOLI STAFFORD MEDIA MGMT 2251 San Diego Avenue A130 SAN DIEGO CA 92110 Professional Service 2063107 CROTHALL SVCS GROUP 1500 Liberty Ridge Drive Suite 210 WAYNE PA 19087 Medical Services 1158394 136 424667 1470307 504662 1894974 NET PATIENT SERVICE 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ACCRUED EX 4594964 CREDIT BALANCES PATIENT AR 11791443 PENDING REFUNDS 6876021 ADVANCED REVENUE PAYMENTS 139464 30146590 X FIN 48 FOOTNOTE INCOME TAXES ARE ACCOUNTED FOR UNDER THE ASSET AND LIABILITY METHOD. DEFERRED TAX ASSETS AND LIABILITIES ARE RECOGNIZED FOR THE FUTURE TAX CONSEQUENCES ATTRIBUTABLE TO DIFFERENCES BETWEEN THE FINANCIAL STATEMENT CARRYING AMOUNTS OF EXISTING ASSETS AND LIABILITIES AND THEIR RESPECTIVE TAX BASES AND OPERATING LOSS AND TAX CREDIT CARRYFORWARDS. DEFERRED TAX ASSETS AND LIABILITIES ARE MEASURED USING ENACTED TAX RATES EXPECTED TO APPLY TO TAXABLE INCOME IN THE YEARS IN WHICH THOSE TEMPORARY DIFFERENCES ARE EXPECTED TO BE RECOVERED OR SETTLED. THE EFFECT ON DEFERRED TAX ASSETS AND LIABILITIES OF A CHANGE IN TAX RATES IS RECOGNIZED IN THE PERIOD THAT INCLUDES THE ENACTMENT DATE. ANY CHANGES TO THE VALUATION ALLOWANCE ON THE DEFERRED TAX ASSET ARE REFLECTED IN THE YEAR OF CHANGE. THE CORPORATION ACCOUNTS FOR UNCERTAIN TAX POSITIONS IN ACCORDANCE WITH THE FASB ACCOUNTING STANDARDS CODIFICATION (ASC) TOPIC 740, INCOME TAXES. THERE WAS NO LIABILITY RECORDED FOR UNCERTAIN TAX POSITIONS AS OF JUNE 30, 2016. X true ORR ASSOCIATES INC 2801 M Street NW washington DC 20007 consulting services false 0 141372 0 0 141372 0 DC MD true true X true X true X true true true false true true 4669640 4669640 0.00500 96766254 90732110 6034144 0.00600 2263891 980949 1282942 0.00100 103699785 91713059 11986726 0.01200 816578 3897 812681 0.00100 66555898 22722063 43833835 0.04500 36977889 35495246 1482643 0.00200 28549 250 28299 104378914 58221456 46157458 0.04800 208078699 149934515 58144184 0.06000 26386 26386 57586 57586 83972 83972 true 28745364 168135042 184156525 -16021483 X true true 1 1 DBA GEORGETOWN UNIVERSITY HOSPITAL 3800 RESERVOIR ROAD NW WASHINGTON DC 20007 X X X X X X DBA GEORGETOWN UNIVERSITY HOSPITAL 1 false false true X X X X X X X X X 14 true false false true X WWW.MEDSTARGEORGETOWN.ORG X true 14 true WWW.MEDSTARGEORGETOWN.ORG false false true X 200. 400. X X X X X X true true X X X X true X WWW.MEDSTARGEORGETOWN.ORG X WWW.MEDSTARGEORGETOWN.ORG X WWW.MEDSTARGEORGETOWN.ORG X X X X X true X false true X false false CHNA INPUT PART V, SECTION B, LINE 5 HOSPITAL LEAD ROLE DESCRIPTION The Community Health Needs Assessment (CHNA) Hospital Lead serves as the coordinator of all aspects of the community health assessment process. He/she helps establish and coordinate the activities of the Advisory Task Force. The Lead also helps produce the hospitals Community Health Needs Assessment and Implementation Strategy. He/she works collaboratively with representatives from the Corporate Community Health Department and Georgetown University. The Lead also works closely with the writer. He/she reviews all narratives prior to publication. Name of Hospital Lead: Emily Teneyck EXECUTIVE SPONSOR ROLE DESCRIPTION The Executive Sponsor serves as the conduit between the Advisory Task Force and the Senior Management Team. The sponsor is an active participant of the Advisory Task Force and he/she communicates the hospitals clinical strengths and program priorities to diverse audiences. Name of Executive Sponsor: Michael Sachtleben ADVISORY TASK FORCE ROLE DESCRIPTION The Advisory Task Force (ATF) reviews primary/secondary data and local/state/federal community health goals. Based on findings, the ATF provides input into the hospitals three-year implementation strategy. As ambassadors for the CHNA process, the ATF members support efforts to optimize community participation. Note: The ATF should be a combination of community representatives and staff. Community representatives should makeup at least 50% of total participants. NAME TITLE/AFFLIATION WITH NAME OF ORGANIZATION HOSPITAL Matthew Levy, MD DIVISION CHIEF, MEDSTAR GEORGETOWN DEPARTMENT OF PEDIATRICS UNIVERSITY HOSPITAL SUE A. MARSHALL EXECUTIVE DIRECTOR THE COMMUNITY PARTNERSHIP FOR THE PREVENTION OF HOMELESSNESS NICOLE DUNCAN ASSISTANT VICE PRESIDENT MEDSTAR GEORGETOWN university hospital PAULA REICHEL DC DIRECTOR CAPITAL AREA FOOD BANK Michael Sachtleben PRESIDENT MEDSTAR GEORGETOWN UNIVERSITY HOSPITAL LORRAINE SPENCER, CLINICAL NURSING FACULTY GEORGETOWN UNIVERSITY MSN, RN SCHOOL OF NURSING AND HEALTH STUDIES MICHAEL A. STOTO, PROFESSOR OF HEALTH GEORGETOWN UNIVERSITY PHD SYSTEMS ADMINISTRATION AND SCHOOL OF NURSING AND POPULATION HEALTH HEALTH STUDIES JAMES C. WELSH, CHAIR, DEPARTMENT OF GEORGETOWN UNIVERSITY MD, MBA, MPH FAMILY MEDICINE REGINA KNOX WOODS VICE PRESIDENT, GOVERNMENT MEDSTAR GEORGETOWN relations university hospital IMPLEMENTATION STRATEGIES PART V, SECTION B, LINE 11 THE IMPLEMENTATION STRATEGIES SERVE AS A ROADMAP FOR HOW COMMUNITY BENEFIT RESOURCES WILL BE ALLOCATED AND DEPLOYED. MEDSTAR'S HOSPITALS WILL BE ABLE TO MEASURE OUR CONTRIBUTION TO IMPROVING THE HEALTH OF UNDERSERVED AND VULNERABLE POPULATIONS IN THE REGIONS WE SERVE. THREE-YEAR IMPLEMENTATION STRATEGIES WITH MEASURABLE OBJECTIVES WERE DEVELOPED FOR EACH HOSPITAL'S COMMUNITY BENEFIT SERVICE AREA - A SPECIFIC COMMUNITY OR TARGET POPULATION OF FOCUS. PRIORITIES WERE BASED ON COMMUNITY NEED AS DETERMINED BY QUANTITATIVE DATA AND COMMUNITY INPUT, AS WELL AS ON HOSPITAL EXPERTISE, RESOURCES, STRENGTHS OF EXISTING PROGRAMMING AND PARTNERSHIPS, AND ALIGNMENT WITH NATIONAL, STATE, AND LOCAL HEALTH GOALS. THE MEDSTAR HEALTH CORPORATE COMMUNITY HEALTH DEPARTMENT WILL PROVIDE SYSTEM-WIDE COORDINATION AND OVERSIGHT OF COMMUNITY BENEFIT PROGRAMMING. BAD DEBT PART III, LINE 4 MEDSTAR HEALTH AND ITS AFFILIATED ORGANIZATIONS REPORT BAD DEBT EXPENSE IN ACCORDANCE WITH ASU 2011-07, WHICH REQUIRES CERTAIN HEALTHCARE ENTITIES TO CHANGE THE PRESENTATION OF THEIR STATEMENT OF OPERATIONS BY RECLASSIFYING THE PROVISION FOR BAD DEBTS ASSOCIATED WITH PATIENT SERVICE REVENUE FROM AN OPERATING EXPENSE TO A DEDUCTION FROM PATIENT SERVICE REVENUE (NET OF CONTRACTUAL ALLOWANCES AND DISCOUNTS). HOWEVER, MEDSTAR AND ITS AFFILIATED ENTITIES DO NOT MAKE A DETERMINATION AS TO WHETHER SELF PAY AMOUNTS ARE COLLECTIBLE IN DETERMINING REVENUE RECOGNITION. RESERVE MODELS, WHICH HAVE BEEN DEVELOPED BASED ON HISTORICAL COLLECTION RESULTS AND WHICH ARE ADJUSTED PERIODICALLY BASED ON ACTUAL COLLECTIONS EXPERIENCE, ARE USED TO ESTIMATE UNCOLLECTIBLE AMOUNTS ACROSS ALL PAYORS INCLUDING SELF PAY. BAD DEBT DETERMINATIONS ARE MADE ONLY AFTER SUFFICIENT EVIDENCE IS OBTAINED TO SUPPORT THAT AN AMOUNT IS NOT COLLECTIBLE. MEDICARE PART III, LINE 8 THIS IS A COST-TO-CHARGE RATIO DETERMINED FROM OUR FINANCIAL REPORT. DEBT COLLECTION POLICY PART III, LINE 9B IF IT IS DETERMINED THAT A PATIENT MAY POTENTIALLY QUALIFY FOR A CHARITABLE/FINANCIAL PROGRAM, A HOLD IS PLACED ON THE ACCOUNT TO PREVENT IT FROM BEING REPORTED AS BAD DEBT UNTIL PROGRAM APPROVALS HAVE BEEN OBTAINED. IF IT IS APPROVED, THE ACCOUNT IS DOCUMENTED AND THE NECESSARY ADJUSTMENTS ARE MADE TO CLOSE THE ACCOUNT. NEEDS ASSESSMENT PART VI, LINE 2: In FY15, MedStar Georgetown University Hospital conducted a Community Health Needs Assessment (CHNA) in accordance with the guidelines established by the Patient Protection and Affordable Care Act and the Internal Revenue Service. The hospitals CHNA was led by 10 Advisory Task Force (ATF) members, which was comprised of a diverse group of individuals, including grassroots activists, community residents, hospital representatives and public health leaders. The ATF reviewed quantitative and qualitative community health data, as well as local, regional, and national health goals. Based on their findings, the ATF designed a survey to identify trends in how participants perceived the severity of key health issues in the following categories: wellness and prevention, access to care, quality of life, and environment. Community members responded to the survey by attending a community input session or completing it online or via hardcopy. Based on the ATFs recommendation, the hospital identified District of Columbia Wards 5, 6, 7 and 8 as its Community Benefit Service Area (CBSA) a geography with a high density of low-income or vulnerable residents within close proximity of the hospital. Health priorities for the CBSA include chronic disease (heart disease/stroke, cancer, diabetes, and obesity), access to pediatric care, and food insecurity and child obesity. The hospitals FY15 CHNA and three-year Implementation Strategy was endorsed by MedStar Georgetowns Board of Directors and approved by the MedStar Health Board of Directors. The document became available on the hospitals official website on June 30, 2015. As a proud member of MedStar Health, representatives from MedStar Georgetown University Hospital routinely participate in the MedStar Health community benefit workgroup. The workgroup is comprised of community health professionals who represent all ten MedStar hospitals. The team analyzes local and regional community health data, establishes system-wide community health programming performance and evaluation measures and shares best practices. PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE PART VI, LINE 3: As one of the regions leading not-for-profit healthcare systems, MedStar Health is committed to ensuring that uninsured patients within the communities we serve who lack financial resources have access to necessary hospital services. MedStar Health and its healthcare facilities will: * Treat all patients equitably, with dignity, with respect and with compassion. * Serve the emergency health care needs of everyone who presents at our facilities regardless of a patient's ability to pay for care. * Assist those patients who are admitted through our admissions process for non-urgent, medically necessary care who cannot pay for part of all of the care they receive. * Balance needed financial assistance for some patients with broader fiscal responsibilities in order to keep its hospitals' doors open for all who may need care in the community. In meeting its commitments, MedStar Healths facilities work with their uninsured patients to gain an understanding of each patients financial resources prior to admission (for scheduled services) or prior to billing (for emergency services). Based on this information and patient eligibility, MedStar Healths facilities assists uninsured patients who reside within the communities we serve in one or more of the following ways: * Assist with enrollment in publicly-funded entitlement programs (e.g., Medicaid). * Assist with enrollment in publicly-funded programs for the uninsured (e.g., D.C. Healthcare Alliance). * Assist with consideration of funding that may be available from other charitable organizations. * Provide charity care and financial assistance according to applicable guidelines. * Provide financial assistance for payment of facility charges using a sliding scale based on patient family income and financial resources. * Offer periodic payment plans to assist patients with financing their healthcare services. Each MedStar Health facility (in cooperation and consultation with the finance division of MedStar Health) specifies the communities it serves based on the geographic areas it has served historically for the purpose of implementing this policy. Each facility posts the policy, including a description of the applicable communities it serves, in each major patient registration area and in any other areas required by applicable regulations, communicates the information to patients as required by this policy and applicable regulations and makes a copy of the policy available to all patients. MedStar Health believes that its patients have personal responsibilities related to the financial aspects of their healthcare needs. The charity care, financial assistance, and periodic payment plans available under this policy are not available to those patients who fail to fulfill their responsibilities. For purposes of this policy, patient responsibilities include: * Completing financial disclosure forms necessary to evaluate their eligibility for publicly-funded healthcare programs, charity care programs, and other forms of financial assistance. These disclosure forms must be completed accurately, truthfully, and timely to allow MedStar Healths facilities to properly counsel patients concerning the availability of financial assistance. * Working with the facilitys financial counselors and other financial services staff to ensure there is a complete understanding of the patients financial situation and constraints. * Completing appropriate applications for publicly-funded healthcare programs. This responsibility includes responding in a timely fashion to requests for documentation to support eligibility. * Making applicable payments for services in a timely fashion, including any payments made pursuant to deferred and periodic payment schedules. * Providing updated financial information to the facilitys financial counselors on a timely basis as the patients circumstances may change. counselors on a timely basis as the patients circumstances may change. COMMUNITY INFORMATION PART VI, LINE 4 Geographic: MedStar Georgetown University Hospitals CBSA includes children and adults who reside in Wards 5, 6, 7, and 8 of the District of Columbia. This area was selected to expand upon pre-existing primary care services that are offered to underinsured, uninsured, and low-income persons. Demographics: According to the US Census Bureau, there are 292,686 residents in Wards 5 through 8 (Ward 5 74,308 residents, Ward 6 76,598, Ward 7 71,068, and Ward 8 70,712). The concentration of adults older than 65 is higher in Ward 5 (15%) and Ward 7 (13%) compared to the city overall (11%). Wards 5 though 8 have the highest rates of unemployment in the District of Columbia, as well as the lowest life expectancy, which is below the District average of 77.5 years. Residents of Wards 5-8 have worse health outcomes compared to residents in other wards: Ward 5: Highest death rate from heart disease (323.0 per 100,000) Highest death rate from cancer (259.7 per 100,000) Second highest death rate from diabetes (40.4 per 100,000) Third highest obesity rate (29.9%) Highest percent of residents without a primary healthcare provider (21.3% without primary healthcare provider) Highest percentage of uninsured residents (13.8% uninsured) Ward 6: Third lowest percentage of residents getting routine healthcare checkup (76.1% received routine checkups) Ward 7: Second highest death rate from heart disease (309.6 per 100,000) Highest death rate from diabetes (43.6 per 100,000) Second highest obesity rate (35.3%) Third highest death rate from cancer (212.5 per 100,000) Third highest percent of residents without a primary healthcare provider (17.1% without primary healthcare provider) Third highest percentage of uninsured residents (8.4%) Ward 8: Third highest death rate from diabetes (41.0 per 100,000) Highest obesity rate (44.4% obese) Second highest percentage of uninsured residents (10.3%) Sources: U.S. Census Bureau, 2010-2014, District of Columbia Community Needs Assessment 2015, Neighborhood Information DC PROMOTION OF COMMUNITY HEALTH PART VI, LINE 5: As a community partner, MedStar Georgetown engages in a number of community benefit activities to improve and promote the health and well-being of the community. Priority areas of focus, as determined by the community health needs assessment, include: chronic disease, specifically heart disease/stroke, cancer, diabetes, and obesity, access to pediatric care, and food insecurity and child obesity. Over the past year, MedStar Georgetowns Neuroscience Department has provided several stroke awareness and prevention lectures to the community to address the high rate of heart disease and stroke in the communities served. MedStar Georgetowns Pediatric Department partnered with the Capital Area Food Bank and held monthly nutrition education health fairs in Wards 5-8 and covered topics that range from diabetes and obesity prevention to food insecurity. They also gave away reusable water bottles, healthy recipe cards and healthy snacks. Nurses recruitment also participated in a program that distributes food at no cost to people in the community in order to reduce food insecurity. The program travels to a different location in either Ward 5, 6, 7, or 8 each week. The hospital also operates a pediatric mobile clinic that visits some of the most disenfranchised communities in the District. The mobile clinic travels to four public housing communities, one public high school and an emergency family shelter. Services are provided free of charge and include patient checkups, immunizations, ophthalmology exams, and referrals to specialists. An on-call pediatrician will be made available to this population 24 hours a day, seven days per week. The clinic primarily serves the uninsured and homeless in Wards 6, 7 and 8. AFFILIATED HEALTH CARE SYSTEM PART VI, LINE 6 As a proud member of MedStar Health, MedStar Georgetown University Hospital is able to expand its capacity to meet the needs of the community by partnering with other MedStar hospitals and associated entities. MedStar Health resources assist the hospital in community health planning to meet the needs of the uninsured and other vulnerable populations. Through its community health function, MedStar Health provides MedStar Georgetown University Hospital with technical support to enhance community health programming and evaluation. MedStars corporate philanthropy division identifies public and private funding sources to ensure the availability of high quality health services, regardless of ability to pay. STATE FILING OF COMMUNITY BENEFIT REPORT PART VI, LINE 7: The community benefit report for MedStar Georgetown University Hospital is only filed in the District of Columbia. X X X X X X false false false false false false false false false RICHARD GOLDBERG MD DIRECTOR 675869 0 561934 0 0 0 20949 0 9863 0 1268615 0 0 0 KENNETH A SAMET DIRECTOR 0 1689763 0 3167094 0 15851 0 45721 0 20676 0 4939105 0 0 Bruce Davidson MD Director 362410 0 119724 0 75 0 18575 0 14481 0 515265 0 0 0 NADIM HADDAD MD DIRECTOR 562057 0 676095 0 75 0 15876 0 12688 0 1266791 0 0 0 JOHN PAHIRA MD DIRECTOR 365448 0 204623 0 75 0 20704 0 10464 0 601314 0 0 0 RUSSELL WALL MD DIRECTOR 531485 0 52233 0 75 0 19220 0 10373 0 613386 0 0 0 CIRRELDA COOPER MD DIRECTOR 349512 0 38228 0 75 0 18215 0 765 0 406795 0 0 0 Matthew Cooper MD DIRECTOR 486474 0 75000 0 75 0 7800 0 14605 0 583954 0 0 0 M Joy Drass FORMER OFFICER 0 1106293 0 1094030 0 1000000 0 28556 0 8941 0 3237820 0 0 MICHAEL C SACHTLEBEN PRESIDENT/DIRECTOR 395781 0 175498 0 75 0 17712 0 13614 0 602680 0 0 0 PAUL WARDA Treasurer/CFO 360451 0 157813 0 75 0 13464 0 6098 0 537901 0 0 0 Oliver Johnson Former Officer 0 560663 0 574410 0 0 0 7800 0 10202 0 1153075 0 0 Stephen Evans VP MEDICAL AFFAIRS 0 759387 0 711810 0 15500 0 15876 0 28255 0 1530828 0 0 Edward Aulisi MD CHIEF OF ENDOSCOPY 1140130 0 1289386 0 75 0 7800 0 13716 0 2451107 0 0 0 Alexandros Powers MD PHYSICIAN 1246734 0 64255 0 75 0 7800 0 13651 0 1332515 0 0 0 John Klimkiewicz DIRECTOR, DIVISION OF SPORTS 550533 0 560000 0 75 0 18878 0 13709 0 1143195 0 0 0 Thomas Fishbein MD DIVISION CHIEF 884746 0 401570 0 75 0 13464 0 1232 0 1301087 0 0 0 Edward Healton Director 0 229617 0 0 0 0 0 7800 0 915 0 238332 0 0 EVAN ARGINTAR Dir of Sports Med research 389410 0 758758 0 75 0 7800 0 6663 0 1162706 0 0 0 KERRY RICHARD SECRETARY 0 285973 0 125257 0 0 0 7800 0 11104 0 430134 0 0 SCHEDULE J, PART III Mr. Samet's bonus and incentive compensation in Part II, Column (B) (ii) includes $878,413, representing benefits received from executive retirement plans that are comprised of target benefits determined annually based on compensation and years of service. Morrison Healthcare Services See Part V 4834903 FOOD SERVICES false Georgetown University See Part V 100648 Academic Services false Up-to-date Laundry See Part V 1001630 Laundry Services false The ROI Companies See Part V 200578 RCM Services false BUSINESS TRANSACTION INVOLVING INTERESTED PERSON SCHEDULE L, PART IV Morrison Healthcare Food services is a substantial contributor that also provided food services to the hospital. Georgetown University is a substantial contributor that also provided academic services to the hospital. Up-to-date Laundry is a substantial contributor that also provided laundry services to the hospital. The ROI Companies is a substantial contributor that also provided RCM Services to the hospital. Per the conflict of interest policy, all transactions between the hospital and outside vendors should be at Arms-length for fair market value. X 504662 FMV false false false BUSINESS RELATIONSHIPS FORM 990, PART VI, LINE 2 Dalbert Ginsberg provides tax preparation services for Ken Samet. This relationship is not related to any business transactions with MedStar Georgetown University Hospital. Dalbert Ginsberg provides tax preparation services for Richard Frank. This relationship is not related to any business transactions with MedStar Georgetown University Hospital. ORGANIZATION MEMBERS PART VI, LINE 6 THE ORGANIZATION IS AN AFFILIATE AND SUBSIDIARY OF MEDSTAR HEALTH, INC., A TAX-EXEMPT MARYLAND NON-STOCK CORPORATION. MEDSTAR HEALTH, INC., OR ONE OF ITS AFFILIATES AND SUBSIDIARIES, IS THE SOLE MEMBER OF THE ORGANIZATION. DESCRIPTION OF MEMBERS FORM 990, PART VI, LINE 7A AS AN AFFILIATE AND SUBSIDIARY OF MEDSTAR HEALTH, INC., A TAX-EXEMPT MARYLAND NON-STOCK CORPORATION, THE ORGANIZATION MAY RECOMMEND PERSON(S) FOR MEMBERSHIP ON THE ORGANIZATION'S GOVERNING BODY. ANY SUCH RECOMMENDATION BY THE ORGANIZATION IS SUBJECT TO APPROVAL BY THE GOVERNANCE COMMITTEE OF THE BOARD OF DIRECTORS OF MEDSTAR HEALTH, INC. THE BOARD OF MEDSTAR HEALTH, INC. HAS DELEGATED CERTAIN APPROVAL AUTHORITY TO THE GOVERNANCE COMMITTEE AND THE PRESIDENT & CEO OF MEDSTAR HEALTH, INC. AS AN AFFILIATE AND SUBSIDIARY OF MEDSTAR HEALTH, INC., A TAX-EXEMPT MARYLAND NON-STOCK CORPORATION, THE ORGANIZATION MAY RECOMMEND PERSON(S) FOR MEMBERSHIP ON THE ORGANIZATION'S GOVERNING BODY. ANY SUCH RECOMMENDATION BY THE ORGANIZATION IS SUBJECT TO APPROVAL BY THE GOVERNANCE COMMITTEE OF THE BOARD OF DIRECTORS OF MEDSTAR HEALTH, INC. THE BOARD OF MEDSTAR HEALTH, INC. HAS DELEGATED CERTAIN APPROVAL AUTHORITY TO THE GOVERNANCE COMMITTEE AND THE PRESIDENT & CEO OF MEDSTAR HEALTH, INC. DECISIONS OF THE GOVERNING BODY FORM 990, PART VI, LINE 7B AS AN AFFILIATE AND SUBSIDIARY OF MEDSTAR HEALTH, INC., A TAX-EXEMPT MARYLAND NON-STOCK CORPORATION, THE BYLAWS OF THE ORGANIZATION ARE SUBJECT TO CERTAIN RESERVED POWERS, WHICH PROVIDE THAT THE SOLE MEMBER OF THE ORGANIZATION MUST APPROVE CERTAIN DECISIONS, INCLUDING BUT NOT LIMITED TO MATTERS CONCERNING THE SALE OR PURCHASE OF REAL OR PERSONAL PROPERTY, CAPITAL BUDGETS, STRATEGIC PLANNING, INVESTMENTS, AND CORPORATE GOVERNANCE. PROCESS FOR REVIEWING FORM 990 FORM 990 PART VI, LINE 11B THE PROCESS FOR REVIEWING THE FORM 990 INCLUDED EDUCATION AND TRANSPARENCY. SENIOR FINANCIAL EXECUTIVES, WORKING WITH INDEPENDENT OUTSIDE EXPERTS, THOROUGHLY REVIEWED FORM 990 AND ACCOMPANYING INSTRUCTIONS. IN ADDITION, SENIOR EXECUTIVES REVIEWED THE RELEVANT SECTIONS OF THE FORM 990 WITH THE FOLLOWING COMMITTEES OF THE ORGANIZATION'S GOVERNING BODY: FINANCE, AUDIT, GOVERNANCE, STRATEGIC PLANNING, AND EXECUTIVE COMPENSATION. FOLLOWING THESE MEETINGS, THE GOVERNING BODY WAS PROVIDED A COPY OF THE FORM 990 IN ITS FINAL FORM AND GIVEN AN OPPORTUNITY TO PROVIDE ANY INPUT OR COMMENTS RELATING TO THE FORM 990 PRIOR TO ITS FILING. CONFLICT OF INTEREST POLICY FORM 990, PART VI, LINE 12C APPOINTMENT OF BOARDS OF DIRECTORS MEDSTAR HEALTH (AND ITS SUBSIDIARIES) REQUIRE ALL NOMINATED DIRECTORS, PRIOR TO THEIR APPOINTMENT OR ELECTION, TO DISCLOSE THE EXISTENCE OF (OR POTENTIAL EXISTENCE OF) ANY TRANSACTION WITH MEDSTAR THAT WOULD RESULT IN A CONFLICT OF INTEREST. SUCH DISCLOSURES (IF ANY) ARE REVIEWED BY THE GOVERNANCE COMMITTEE OF THE MEDSTAR HEALTH BOARD OF DIRECTORS WHICH DETERMINES HOW THE MATTER SHOULD BE RESOLVED. ANNUAL DISCLOSURES - ALL OFFICERS, DIRECTORS, AND SENIOR MANAGERS ALL OFFICERS, DIRECTORS AND SENIOR MANAGERS ARE REQUIRED, NOT LESS THAN ANNUALLY, TO COMPLETE A SURVEY OF QUESTIONS CONCERNING ANY TRANSACTIONS OR RELATIONSHIPS WHICH WOULD OR COULD REPRESENT A CONFLICT OF INTEREST. SUCH DISCLOSURES (IF ANY) ARE REVIEWED BY THE GOVERNANCE COMMITTEE OF THE MEDSTAR HEALTH BOARD OF DIRECTORS WHICH DETERMINES HOW THE MATTER SHOULD BE RESOLVED. EXECUTIVE COMPENSATION PROCESS FORM 990, PART VI, LINE 15 THE EXECUTIVE COMPENSATION COMMITTEE OF THE BOARD OF DIRECTORS OF MEDSTAR HEALTH, INC. (THE "COMMITTEE") HAS OVERSIGHT OVER THE EXECUTIVE COMPENSATION PROGRAM (THE "PROGRAM") OF MEDSTAR HEALTH, INC. AND ITS AFFILIATES. TOTAL COMPENSATION FOR THE TOP MANAGEMENT OFFICIALS, OFFICERS AND KEY EMPLOYEES OF MEDSTAR HEALTH, INC. AND ITS AFFILIATES ARE REVIEWED AND APPROVED BY THE COMMITTEE WITH ASSISTANCE AND GUIDANCE FROM AN INDEPENDENT THIRD PARTY ADVISOR. THE MEMBERS OF THE COMMITTEE ARE INDEPENDENT FROM ALL OF THE PARTICIPANTS IN THE PROGRAM. THE MAIN OBJECTIVE OF THE PROGRAM IS TO PROVIDE MARKET COMPETITIVE TOTAL COMPENSATION THAT IS INTERNALLY EQUITABLE AND HAS A STRONG PAY-FOR-PERFORMANCE LINKAGE. PERFORMANCE IS EVALUATED AT THE SYSTEM, OPERATING UNIT, AND INDIVIDUAL LEVELS. THE OVERALL TOTAL COMPENSATION PHILOSOPHY IS MANAGED AT THE 75TH PERCENTILE OF THE COMPETITIVE MARKET FOR COMPARABLE SIZE (NET REVENUE) AND TYPE (TAX-EXEMPT HEALTHCARE ORGANIZATIONS). WHERE APPROPRIATE, ADDITIONAL INDUSTRY DATA IS CONSIDERED (GENERAL BUSINESS AND/OR TAXABLE HEALTHCARE) FOR SELECTED POSITIONS THAT CAN BE RECRUITED FROM OR POTENTIALLY LOST TO THESE INDUSTRIES (E.G., INFORMATION TECHNOLOGY, FINANCE, ETC.). THE COMMITTEE HAS ENGAGED ERNST & YOUNG LLP ("E&Y") TO SERVE AS AN ADVISOR ON THE REASONABLENESS AND COMPETITIVENESS OF THE PROGRAM. IN DETERMINING REASONABLENESS AND COMPETITIVENESS, E&Y REVIEWS MARKET PRACTICES AND TRENDS, AND MAKES RECOMMENDATIONS RELATED TO THE PROGRAM. E&Y UTILIZES INFORMATION FROM CUSTOM SURVEYS, NATIONAL COMPENSATION SURVEYS, PROPRIETARY DATABASES, AND CLIENT EXPERIENCES TO DETERMINE ITS FINAL RECOMMENDATIONS. E&Y PRESENTS THEIR FINDINGS AND RECOMMENDATIONS TO THE COMMITTEE. THE COMMITTEE MAKES THE FINAL DECISIONS ON ALL OF THE COMPENSATION DETERMINATIONS OF THE PROGRAM. ALL DECISIONS MADE BY THE COMMITTEE ARE CONTEMPORANEOUSLY DOCUMENTED FINANCIAL STATEMENT AVAILABILITY FORM 990, PART VI, LINE 19 MEDSTAR HEALTH POSTS ITS ANNUAL FINANCIAL AUDIT AND QUARTERLY FINANCIAL REPORTS TO THE ELECTRONIC MUNICIPAL MARKET ACCESS (EMMA) SYSTEM. THE ORGANIZATION ALSO E-MAILS ITS ANNUAL AND QUARTERLY DISCLOSURES TO HOLDERS OF THE COMPANY'S PUBLICLY TRADED DEBT. THE COMPANY'S GOVERNANCE DOCUMENTS AND CONFLICTS OF INTEREST POLICIES ARE AVAILABLE UPON REQUEST THROUGH ITS CORPORATE (OR AS APPLICABLE ENTITY) PUBLIC INFORMATION OFFICES. OTHER CHANGES IN NET ASSETS FORM 990, PART XI, LINE 9 EQUITY TRANSFER - NET ASSETS..............$ (57,090,229) MGMC LLC 3800 Reservoir Road NW Washington DC 20007 522228444 Hospital DC 247770327 42601901 NA GUHKids Mobile Medical Clinic Program 10980 Grantchester Way columbia MD 21044 522228444 PHYSICIANS MD 0 0 NA CHURCH HOME CORPORATION 10980 GRANTCHESTER WAY COLUMBIA MD 21044 237374724 MEDICAL FUND MD 501(C)(3) PF NA true FRANKLIN SQUARE HOSPITAL CENTER INC 9000 FRANKLIN SQUARE DRIVE BALTIMORE MD 21237 520608007 HOSPITAL MD 501(C)(3) 3 NA true HARBOR HOSPITAL INC 3001 SOUTH HANOVER STREET BALTIMORE MD 21225 520491660 HOSPITAL MD 501(C)(3) 3 NA true MEDSTAR HEALTH INC 10980 GRANTCHESTER WAY COLUMBIA MD 21044 522087445 MEDICAL SVCS MD 501(C)(3) 11C III NA false MONTGOMERY GENERAL HOSPITAL 18101 PRINCE PHILIP DRIVE OLNEY MD 20832 520646893 HOSPITAL MD 501(C)(3) 3 NA true THE GOOD SAMARITAN HOSPITAL OF MARYLAND 5601 LOCH RAVEN BLVD BALTIMORE MD 21239 520591607 HOSPITAL MD 501(C)(3) 3 NA true THE UNION MEMORIAL HOSPITAL 201 EAST UNIVERSITY PARKWAY BALTIMORE MD 21218 520591685 HOSPITAL MD 501(C)(3) 3 NA true MEDSTAR HEALTH RESEARCH INSTITUTE 108 IRVING STREET NW WASHINGTON DC 20010 526056274 HOSPITAL DC 501(C)(3) 4 NA true WASHINGTON HOSPITAL CENTER CORPORATION 110 IRVING STREET NW WASHINGTON DC 20010 521272129 HOSPITAL DC 501(C)(3) 3 NA true HH MEDSTAR HEALTH INC 10980 GRANTCHESTER WAY COLUMBIA MD 21044 521542230 MEDICAL SVCS MD 501(C)(3) 11C III NA true MEDSTAR AMBULATORY SERVICES INC 10980 GRANTCHESTER WAY COLUMBIA MD 21044 521132992 ADMIN SVCS MD 501(C)(3) 11C III NA true BAY LIFE SERVICES INC 10980 GRANTCHESTER WAY COLUMBIA MD 21044 521496539 MENTAL HEALTH MD 501(C)(3) 9 NA true MEDSTAR SURGERY CENTER INC 4061 POWDERMILL ROAD SUITE 210 CALVERTON MD 20705 521061679 MEDICAL SVCS MD 501(C)(3) 9 NA true CHURCH HOME AND HOSPITAL OF THE CITY OF 10980 GRANTCHESTER WAY COLUMBIA MD 21044 520591600 MEDICAL FUND MD 501(C)(3) 11A I NA true FRANKLIN SQUARE HOSPITAL CENTER FOUNDATI 9000 FRANKLIN SQUARE DRIVE BALTIMORE MD 21237 522329546 FOUNDATION MD 501(C)(3) 11A I NA true GOOD SAMARITAN HOSPITAL FOUNDATION INC 5601 LOCH RAVEN BLVD BALTIMORE MD 21239 522307122 FOUNDATION MD 501(C)(3) 11a I NA true GOOD SAMARITAN NURSING CENTER INC 5601 LOCH RAVEN BLVD BALTIMORE MD 21239 521672866 MEDICAL SVCS MD 501(C)(3) 9 NA true GS HOUSING INC 5601 LOCH RAVEN BLVD BALTIMORE MD 21239 521481656 ELDER HOUSING MD 501(C)(3) 9 NA true GS PROPERTIES INC 5601 LOCH RAVEN BLVD BALTIMORE MD 21239 521429853 ADMIN SVCS MD 501(C)(3) 11a I NA true HARBOR HOSPITAL FOUNDATION INC 3001 SOUTH HANOVER STREET BALTIMORE MD 21225 521284532 FOUNDATION MD 501(C)(3) 11A I NA true MEDSTAR HEALTH INFUSION INC 4061 POWDERMILL ROAD SUITE 210 CALVERTON MD 20705 521980510 MEDICAL SVCS MD 501(C)(3) 9 NA true MEDSTAR HEALTH VISITING NURSES ASSOCIATI 4061 POWDERMILL ROAD CALVERTON MD 20705 530196597 MEDICAL SVCS MD 501(C)(3) 9 NA true MEDSTAR VNA HEALTHCARE 4061 POWDERMILL ROAD SUITE 210 CALVERTON MD 20705 521458516 MEDICAL SVCS MD 501(C)(3) 9 NA true MGH COMMUNITY HEALTH INC 18101 PRINCE PHILIP DRIVE OLNEY MD 20832 521372467 MEDICAL SVCS MD 501(C)(3) 9 NA true MGH HEALTH FOUNDATION INC 18101 PRINCE PHILIP DRIVE OLNEY MD 20832 521129959 FOUNDATION MD 501(C)(3) 7 NA true MGH HEALTH SERVICES INC 18101 PRINCE PHILIP DRIVE OLNEY MD 20832 521366812 FOUNDATION MD 501(C)(3) 11B II NA true MGH WOMEN'S BOARD 18101 PRINCE PHILIP DRIVE OLNEY MD 20832 526039600 FOUNDATION MD 501(C)(3) 11C III NA true NATIONAL REHABILITATION HOSPITAL 102 IRVING STREET NW WASHINGTON DC 20010 521369749 HOSPITAL DC 501(C)(3) 3 NA true NRH REGIONAL REHAB AT OLNEY INC 18101 PRINCE PHILIP DRIVE OLNEY MD 20832 522310902 MEDICAL SVCS MD 501(C)(3) 3 NA true SUBURBAN NRH MEDICAL REHABILITATION I 102 IRVING STREET NW WASHINGTON DC 20010 521931151 MEDICAL SVCS DC 501(C)(3) 3 NA true THE THOMAS O'NEIL CATHOLIC HEALTH CARE F 5601 LOCH RAVEN BLVD BALTIMORE MD 21239 521104382 FOUNDATION MD 501(C)(3) 11D III NA true VNA INC 4061 POWDERMILL ROAD SUITE 210 CALVERTON MD 20705 521332411 ADMIN SVCS MD 501(C)(3) 11A I NA true WHC FOUNDATION INC 110 IRVING STREET NW WASHINGTON DC 20010 521791670 FOUNDATION DC 501(C)(3) 7 NA true WOODBOURNE WOODS INC 5601 LOCH RAVEN BLVD BALTIMORE MD 21239 522299070 ELDER HOUSING MD 501(C)(3) 9 NA true HOSPICE OF ST MARY'S INC PO BOX 527 LEONARDTOWN MD 20650 522153926 SUPPORT ORG MD 501(C)(3) 11A I NA true ST MARY'S HOSPITAL OF ST MARY'S COUNTY 25500 POINT LOOKOUT ROAD LEONARDTOWN MD 20650 520619006 HOSPITAL MD 501(C)(3) 3 NA true ST MARY'S HOSPITAL FOUNDATION INC PO BOX 527 LEONARDTOWN MD 20650 521051368 SUPPORT ORG MD 501(C)(3) 11A I NA true MEDSTAR SOUTHERN MD HOSPITAL CENTER INC 7503 SURRATTS ROAD CLINTON MD 20735 460726303 HOSPITAL MD 501(C)(3) 3 NA true MEDSTAR HEALTH INC AND AFFILIATES MASTER 10980 GRANTCHESTER WAY COLUMBIA MD 21044 467454613 RET. TRUST MD 501(A) N/A NA true Physician Imaging of Washington Hospital 6525 Belcrest Road Suite G 50 Hyattsville MD 20782 562616090 lab services MD NA false MedStar Pharmacies Inc 10980 GRANTCHESTER WAY Columbia MD 21044 521513056 Drug Sales MD NA C Corp ExtenCare Inc 10980 GRANTCHESTER WAY Columbia MD 21044 521556228 Medical Services MD NA C Corp Helix Resources Management Inc 10980 GRANTCHESTER WAY Columbia MD 21044 521913070 Admin Services MD NA C Corp HelixCare Medical Group LLC 10980 GRANTCHESTER WAY Columbia MD 21044 521955580 Medical Services MD NA C Corp HelixCare Properties LLC 10980 GRANTCHESTER WAY Columbia MD 21044 521966695 Medical Services MD NA C Corp Parkway Ventures Inc 10980 GRANTCHESTER WAY Columbia MD 21044 521893569 Holding Company MD NA C Corp Physicians Administrative Services Inc 10980 GRANTCHESTER WAY Columbia MD 21044 237042074 Billing Services MD NA C Corp MedStar Family Choice Inc 10980 GRANTCHESTER WAY Columbia MD 21044 521995521 Managed Care MD NA C Corp Medstar Enterprises Inc 4061 Powdermill Road Suite 210 Calverton MD 20705 522139841 Admin Services MD NA C Corp SITEL INC 10980 GRANTCHESTER WAY COLUMBIA MD 21044 900753340 MEDICAL SERVIces MD NA C Corp Star Billing Inc 4061 Powdermill Road Suite 210 Calverton MD 20705 521850113 Billing Services MD NA C Corp Washington Risk Network Management Inc 4061 Powdermill Road Suite 210 Calverton MD 20705 522132677 Medical Services MD NA C Corp Washington Hospital Center Physician Hos 100 Irving Street NW Washington DC 20010 521931000 Medical Services MD NA C Corp Medstar Physician Partners Inc 4061 Powdermill Road Suite 210 Calverton MD 20705 522030809 Medical Services MD NA C Corp Franklin Square Drive Land Condo Associa 10980 GRANTCHESTER WAY Columbia MD 21044 760756352 Condo Owner Assoc MD NA C Corp MGH Diversified Services Inc 18101 Prince Philip Drive Olney MD 20832 521943602 Medical Services MD NA C Corp St Mary's Health Alliance Inc 25500 Point Lookout Road Leonardtown MD 20650 521930331 Medical Services MD NA C Corp Greenspring Financial Insurance Limited 23 LIME TREE BAY AVENUE PO BOX 1051 GRAND CAYMAN CJ 980188617 Insurance CJ NA C Corp ST MARY'S CONDO ASSOCIATION 25500 POINT LOOKOUT RD LEONARDTOWN MD 20650 273377216 CONDOMINIUMS MD na c corp MEDSTAR HEALTH MASTER RETIREMENT TRUST 102 South Church St Grand Cayman CJ KY1-1002 999999999 INVESTMENTS CJ NA C CORP MEDSTAR HEALTH INC - INVESTMENT FUND I 102 South Church St Grand Cayman CJ KY1-1002 981310273 INVESTMENTS CJ NA C CORP false false false false false false false false false false false false true false false true true false false HH MedStar HEALTH INC Q 116293 FMV MedStar Health Inc P 4052625 FMV MedStar Health Research Institute P 8168294 FMV MedStar Health Research Institute Q 4024898 FMV MONTGOMERY GENERAL HOSPITAL Q 1230267 FMV MEDSTAR SOUTHERN MD HOSPITAL CENTER INC Q 323462 FMV WASHINGTON HOSPITAL CENTER CORPORATION Q 316914 FMV