2016-05-12T04:09:12-05:00 2015-06-30 GRANT THORNTON LLP 2001 MARKET STREET SUITE 700 PHILADELPHIA PA 19103 990 2014-07-01 520591483 Mt Washington Pediatric Hospital Inc % S MICHELLE LEE MTWA 4105788600 1708 W Rogers Avenue Baltimore MD 21209 ALFRED A PIETSCH Treasurer 4105788600 2016-05-05 true Frank Giardini P00532355 2155614200 2014 2016-08-17 19:52:53Z Sheldon Stein 1708 W Rogers Avenue Baltimore MD 21209 77927119 false X www.mwph.org X 1926 MD Mt. WASHINGTON PEDIATRIC HOSPITAL IS DEDICATED TO MAXIMIZING THE HEALTH AND INDEPENDENCE OF THE CHILDREN WE SERVE. 12 12 692 114 0 0 870170 1010418 53698556 58569033 620336 739193 1694563 1199631 56883625 61518275 0 0 0 0 36001483 36175970 0 0 163914 14852338 18412611 50853821 54588581 6029804 6929694 101073590 105229167 22862582 21643343 78211008 83585824 MT. WASHINGTON PEDIATRIC HOSPITAL IS DEDICATED TO MAXIMIZING THE HEALTH AND INDEPENDENCE OF THE CHILDREN WE SERVE. false false 46326777 59733811 MT. WASHINGTON PEDIATRIC HOSPITAL, INC. OFFERED PEDIATRIC INPATIENT AND OUTPATIENT SERVICES FOR CHILDREN WITH CHRONIC ILLNESSES AND REHABILITATION NEEDS. 23,733 INPATIENT DAYS OF CARE WERE PROVIDED DURING THE FISCAL YEAR. 43,773 VISITS WERE RECORDED AT ITS SPECIALIZED CLINICS. THE MAJORITY OF PATIENTS TREATED WERE SOCIOECONOMIC DISADVANTAGED CHILDREN. 79% OF PATIENTS RECEIVED MEDICAL ASSISTANCE. 46326777 true true false true false false false false false true false false true true true false true false false false false false false true false true true false false true true false false false false false false false false false false false false false false false true true true false false true 89 0 true 692 true false false false false false true true false false false false X 12 12 false false false false true true false true true false false true true true true true true true true false MD X X S MICHELLE LEE 4103281376 250 W PRATT STREET SUITE 1436 Baltimore MD 21201 X EDWARD B CHAMBERS TRUSTEE 1.0 0.0 X 0 0 0 ROBERT A CHRENCIK TRUSTEE 1.0 0.0 X 0 0 0 S TRACY COSTER TRUSTEE 1.0 0.0 X 0 0 0 STEVEN J CZINN MD TRUSTEE 1.0 0.0 X 0 0 0 GEORGE J DOVER MD TRUSTEE 1.0 0.0 X 0 0 0 JOHN KELLY TRUSTEE 1.0 0.0 X 0 0 0 LAWRENCE C PAKULA MD TRUSTEE 1.0 0.0 X 0 0 0 RONALD R PETERSON TRUSTEE 1.0 0.0 X 0 0 0 DR BERYL ROSENSTIEN TRUSTEE 1.0 0.0 X 0 0 0 G DANIEL SHEALER JR ESQUIRE TRUSTEE 1.0 0.0 X 0 0 0 ROSLYN STOLER TRUSTEE 1.0 0.0 X 0 0 0 FRED WOLF III ESQUIRE TRUSTEE 1.0 0.0 X 0 0 0 SHELDON STEIN PRESIDENT CEO 40.0 1.0 X 344257 0 171044 ALFRED A PIETSCH TREASURER 1.0 0.0 X 0 0 0 MARY MILLER CFO / VP - FINANCE 40.0 1.0 X 162714 0 50026 THOMAS ELLIS VP - HUMAN RESOURCES 40.0 0.0 X 163375 0 66287 JENNIFER BOWIE VP - NURSING ADMIN 40.0 0.0 X 172886 0 31542 BARINADA GIADOM ATTENDING PHYSICIAN 40.0 0.0 X 194347 0 32286 KATHERINE ALTER MD DIRECTOR PHYSICAL MEDICINE 32.0 0.0 X 235388 0 28532 SILVIA WILLIAMS MD ATTENDING PHYSICIAN 40.0 0.0 X 189917 0 17203 AJOKE AJAYI-AKINTADE MD ATTENDING PHYSICIAN 40.0 0.0 X 190892 0 10858 STEPHEN NICHOLS MD ATTENDING PHYSICIAN 40.0 0.0 X 217027 0 34641 1870803 0 442419 34 false true false Pharmasource Healthcare Inc PO Box 632849 CINCINNATI OH 452632849 pharmacy 4168571 Whiting Turner Contracting PO Box 17596 BALTIMORE MD 21297 construction 1394467 Sleep Servuces Of America Inc PO Box 198320 ATLANTA GA 30384 neurology 1216942 Johns Hopkins University 600 North Wolf Street BALTIMORE MD 21287 physican 1517196 Hord Coplan Macht Inc 750 East Pratt Street BALTIMORE MD 21202 construction 540816 15 196011 358482 455925 1010418 NET PATIENT REVENUE 900099 58569033 58569033 58569033 280672 280672 0 0 0 0 0 16701344 16242823 458521 458521 458521 200874 196011 166021 34853 34853 0 0 MEDICAL RECORDS 900099 2053 2053 NET ASSETS RELEASED FOR OPERATING PURPOSES 900099 289605 289605 ALL OTHER REVENUE 900099 873120 873120 1164778 61518275 59733811 774046 0 0 0 0 837188 711610 125578 0 28322627 23910319 4248394 163914 522320 443972 78348 4432320 3767472 664848 2061515 1752288 309227 0 49712 42255 7457 465363 395559 69804 4619 3926 693 0 0 3281243 2789057 492186 193136 164166 28970 1434453 1219285 215168 0 0 343574 292038 51536 83844 71267 12577 0 7604 6463 1141 79625 67681 11944 0 2834293 2409149 425144 233668 198618 35050 SUPPLIES 6842709 5816303 1026406 BED DEBT 602648 602648 CLINICAL 555231 471946 83285 CAFE CATERING 354388 301230 53158 1046501 889525 156976 54588581 46326777 8097890 163914 0 0 17403334 17320320 472991 260427 7851961 7701680 0 0 0 0 0 0 150913 114830 160257 28667 61730672 34984510 25361159 26746162 27194179 29952014 0 0 0 0 0 0 22478796 23105067 101073590 105229167 12162604 11913791 0 0 299416 99805 6005000 5700000 0 0 0 0 0 0 0 0 4395562 3929747 22862582 21643343 X 67493622 72670079 9892215 10090574 825171 825171 78211008 83585824 101073590 105229167 X 6929694 -1010807 -544071 X false true X true X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false true 4619 4619 false Schedule C: Lobbying Activities Part II-B, 1i The organization does not engage in any direct lobbying activities. The organization pays membership dues to the Maryland Hospital Association (MHA), the American Hospital Association (AHA) and the Children's Hospital Association (CHA). MHA, AHA and CHA engage in many support activities including lobbying and advocating for their member hospitals. The MHA, AHA and CHA reported that 6.22%, 23.65% and 15.97% of member dues were used for lobbying purposes and as such, the organization has reported this amount on Schedule C Part IV as lobbying activities. 659969 659969 41754280 20590748 21163532 263509 228282 35227 19052914 14165480 4887434 26746162 ASSETS LIMITED AS TO USE 4357550 ECONOMIC INTEREST IN MWPF 17560398 OTHER 813055 OTHER ACCOUNTS RECEIVABLE 374064 23105067 0 ADVANCES FROM 3RD PARTY PAYORS 3929747 3929747 X Liability for Uncertain Tax Position (ASC 740) Schedule D, Part X, Line 2 The Hospital is a not-for-profit corporation as described under Section 501c(3) of the Internal Revenue Code (the Code) and is exempt from federal income taxes on related income pursuant to Section 501(a) of the Code. The Foundation is a not-for-profit corporation formed under the laws of the state of Maryland, organized for charitable purposes and recognized by the Internal Revenue Service as a tax-exempt organization under Section 501c(3) of the Code. The Corporation follows a threshold of more likely than not for recognition and derecognition of tax positions taken or expected to be taken in a tax return. Management does not believe that there are any unrecognized tax benefits that should be recognized. GOLF 91535 31122 60413 26259 GALA 305350 164889 140461 139762 0 396885 196011 200874 166021 166021 34853 true true true X true X 500. true true true false true true 91537 91537 0.00170 91537 91537 0.00170 215227 215227 0.00400 346500 346500 0.00640 1138492 502480 636012 0.01180 5724 5724 0.00010 36151 36151 0.00070 1742094 502480 1239614 0.02300 1833631 502480 1331151 0.02470 17619 17619 0.00030 30001 30001 0.00060 32960 32960 0.00060 80580 80580 0.00150 true 503349 8339 -8339 X true true 1 1 Mt Washington Pediatric Hospital inc 1708 W Rogers Avenue Baltimore MD 21209 www.mwph.org 30-026 X X MT WASHINGTON PEDIATRIC HOSPITAL INC 1 false false true X X X X X X X X X 15 true true true true X WWW.MWPH.ORG X true 15 true www.mwph.org false false true X 200. 500. X X X X X true true X X X X true X http://www.mwph.org X X X X true false X X X X X true X false false MT. WASHINGTON PEDIATRIC HOSPITAL Schedule H, Part V, Section B Line 13h: In compliance with the new IRC Section 501(R) regulations MT. Washington Pediatric Hospital is currently in the process of updating their Financial Assistance Policy to ensure its compliance IRS regulations. Line 22: Due to state regulations, charges are not reduced for any payer, including commerical insurance, government payers, or uninsured patients. All charges are gross charges. SCHEDULE H, PART V, SECTION B LINE 22D - ALL PATIENTS ARE CHARGED STATE REGULATED RATES, REGARDLESS OF THEIR ABILITY TO PAY. LINE 24 - AS PREVIOUSLY DISCUSSED IN AN EARLIER SCHEDULE H NARRATIVE, THE STATE OF MARYLAND IS A UNIQUE STATE IN REGARD TO THE PROVISION OF HEALTH CARE SERVICES AND THEIR RELATED CHARGES BY HOSPITALS. ALL HOSPITAL CHARGES PROCESSED TO ALL PAYORS, INCLUDING GOVERNMENTAL PAYORS, ARE SET THROUGH MARYLAND'S HEALTH SERVICES COST COMMISSION. ACCORDINGLY, ALL HOSPITAL CHARGES ARE NOT GROSS CHARGES AS DEFINED BY THE IRS UNDER INTERNAL REVENUE CODE SECTION 501(R )(5)(B). Related Organization Report Schedule H, Part I, Line 6a AN ANNUAL COMMUNITY BENEFIT REPORT IS PREPARED FOR EACH FISCAL YEAR ENDING JUNE 30. THIS REPORT IS SUBMITTED TO THE HEALTH SERVICES COST REVIEW COMMISSION (HSCRC), A STATE REGULATORY AGENCY, BY DECEMBER 15 OF EACH YEAR. IN ADDITION, THE ANNUAL COMMUNITY BENEFIT REPORT IS AVAILABLE UPON REQUEST AT THE ENTITY'S CORPORATE OFFICES. Costing Methodology Schedule H, Part I, Line 7 SCHEDULE H, LINE 7A, COLUMN (D) MARYLAND'S REGULATORY SYSTEM CREATES A UNIQUE PROCESS FOR HOSPITAL PAYMENT THAT DIFFERS FROM THE REST OF THE NATION. THE HEALTH SERVICES COST REVIEW COMMISSION, (HSCRC) DETERMINES PAYMENT THROUGH A RATE SETTING PROCESS AND ALL PAYORS, INCLUDING GOVERNMENTAL PAYORS, PAY THE SAME AMOUNT FOR THE SAME SERVICES DELIVERED AT THE SAME HOSPITAL. MARYLAND'S UNIQUE ALL PAYOR SYSTEM INCLUDES A METHOD FOR REFERENCING UNCOMPENSATED CARE IN EACH PAYORS' RATES, WHICH DOES NOT ENABLE MARYLAND HOSPITALS TO BREAKOUT ANY OFFSETTING REVENUE RELATED TO UNCOMPENSATED CARE. SCHEDULE H, LINE 7B, COLUMNS (C) THROUGH (F) MARYLAND'S REGULATORY SYSTEM CREATES A UNIQUE PROCESS FOR HOSPITAL PAYMENT THAT DIFFERS FROM THE REST OF THE NATION. THE HEALTH SERVICES COST REVIEW COMMISSION, (HSCRC) DETERMINES PAYMENT THROUGH A RATE SETTING PROCESS AND ALL PAYORS, INCLUDING GOVERNMENTAL PAYORS, PAY THE SAME AMOUNT FOR THE SAME SERVICES DELIVERED AT THE SAME HOSPITAL. MARYLAND'S UNIQUE ALL PAYOR SYSTEM INCLUDES A METHOD FOR REFERENCING UNCOMPENSATED CARE IN EACH PAYORS' RATES, WHICH DOES NOT ENABLE MARYLAND HOSPITALS TO BREAKOUT ANY OFFSETTING REVENUE RELATED TO UNCOMPENSATED CARE. COMMUNITY BENEFIT EXPENSES ARE EQUAL TO MEDICAID REVENUES IN MARYLAND, AS SUCH, THE NET EFFECT IS ZERO. ADDITIONALLY, NET REVENUES FOR MEDICAID SHOULD REFLECT THE FULL IMPACT ON THE HOSPITAL OF ITS SHARE OF THE MEDICAID ASSESSMENT. SCHEDULE H, LINE 7F COLUMN (C) & (D) MARYLAND'S REGULATORY SYSTEM CREATES A UNIQUE PROCESS FOR HOSPITAL PAYMENT THAT DIFFERS FROM THE REST OF THE NATION. THE HEALTH SERVICES COST REVIEW COMMISSION, (HSCRC) DETERMINES PAYMENT THROUGH A RATE SETTING PROCESS AND ALL PAYORS, INCLUDING GOVERNMENTAL PAYORS, PAY THE SAME AMOUNT FOR THE SAME SERVICES DELIVERED AT THE SAME HOSPITAL. MARYLAND'S UNIQUE ALL PAYOR SYSTEM INCLUDES A METHOD FOR REFERENCING UNCOMPENSATED CARE IN EACH PAYORS' RATES, WHICH DOES NOT ENABLE MARYLAND HOSPITALS TO BREAKOUT ANY OFFSETTING REVENUE RELATED TO UNCOMPENSATED CARE. Community Building Activities Schedule H, Part II COALITION BUILDING: PREMATURE INFANT HEALTH NETWORK, BALTIMORE CITY INFANTS & TODDLERS PROGRAM MWPH HAS TAKEN A PROACTIVE ROLE IN COMBATING LOW-BIRTH WEIGHT AND SUDDEN INFANT DEATH SYNDROME BY PARTIPATING AS MEMBERS OF THE PREMATURE INFANT HEALTH NETWORK. OUR PARTNERSHIP WITH BALTIMORE CITY HEALTH DEPARTMENTS B'MORE HEALTHY BABIES CAMPAIGN WAS DEVELOPED TO ADDRESS BALTIMORE CITY'S HIGH RATE OF INFANT DEATHS, AMONG THE WORST IN AMERICA. IN 2009 ALONE, MORE THAN 120 INFANTS IN BALTIMORE UNDER THE AGE OF ONE DIED, WITH MANY OF THE DEATHS BEING PREVENTABLE. THE CITY ALSO HAS A HIGH RATE OF BABIES BORN PRE-TERM AND UNDERWEIGHT - KEY FACTORS IN INFANT MORTALITY. STAFF ACTIVELY PARTICIPATES IN COMMUNITY MEETINGS AND ADVISORY GROUPS TO PROVIDE GUIDANCE IN THE DEVELOPMENT OF EDUCATIONAL MATERIALS AND OUTREACH INITIATIVES. COMMUNITY HEALTH IMPROVEMENT AND ADVOCACY: Children's Hospital ASsociation (CHA) OBESITY TASK FORCE, BRAIN INJURY ASSOCIATION OF MD PLANNING COMMITTEE CHA OBESITY TASK FORCE/WEIGH SMART AND WEIGH SMART JR. MWPH WERE ACTIVE PARTICIPANTS IN THE Children's Hospital Association OBESITY FOCUS GROUP. OUR CENTER WAS CHOSEN AS ONE OF 16 PROGRAMS NATIONWIDE TO PARTICIPATE IN THIS IMPORTANT ENDEAVOR. FINDINGS FROM THE WORK GROUP WILL BE PUBLISHED IN LARGE NATIONAL SCIENTIFIC JOURNALS THIS YEAR WITH PROGRAM STAFF BEING RECOGNIZED AS AUTHORS ON THESE IMPORTANT DOCUMENTS. OUR PRESIDENT AND CEO, SHELDON STEIN AND OUR MEDICAL DIRECTOR, DR. RICHARD KATZ, SERVE AS MEMBERS OF THE BOARD AND ADVOCACY AND LEADERSHIP COUNCILS FOR Children's Hospital Association. THE MT WASHINGTON PEDIATRIC HOSPITAL (MWPH) CENTER FOR PEDIATRIC WEIGHT MANAGEMENT AND HEALTHY LIVING (CENTER) EXPANDED THIS PAST FISCAL YEAR AND OFFERS SEVERAL COMPREHENSIVE, MULTI-DISCIPLINARY PROGRAMS FOR PEDIATRIC WEIGHT MANAGEMENT. THE CENTER NOW INCLUDES MEDICAL MANAGEMENT OF BOTH MEDICAL AND SURGICAL WEIGHT MANAGEMENT OPTIONS FOR CHILDREN AND ADOLESCENTS AND SERVES PATIENTS AGES TWO TO 18. MEDICALLY SUPERVISED WEIGHT MANAGEMENT PROGRAMS INCLUDE WEIGH SMART, AS WELL AS, THE NEWLY CREATED WEIGH SMART JR. PROGRAM. THE WEIGHT SMART JR. PROGRAM WAS A DIRECT REFLECTION OF THE INPUT FROM OUR COMMUNITY PHYSICIANS IN THE COMMUNITY NEEDS ASSESSMENT. MANY PHYSICIANS INDICATED "8 (YEARS OF AGE) IS TOO" LATE IN REGARDS TO THE BEST AGE FOR INTERVENTION WHEN DEALING WITH OBESITY. THIS PROGRAM WAS ADDED TO AUGMENT THE WEIGH SMART PROGRAM AND PROVIDE CONTINUITY OF CARE FOR CHILDREN OR ALL AGES. DURING FY10, THE CENTER EVALUATED OVER 200 NEW PATIENTS AND COMPLETED MORE THAN 80 FOLLOW-UP APPOINTMENTS. TOTAL PROGRAM VISITS INCREASED BY FORTY-THREE PERCENT OVER FISCAL YEAR 2009 FROM 2,424 TO 2,642 TOTAL PROGRAM VISITS. THE STAFF HAS PRESENTED FINDINGS AT SEVERAL NATIONAL AND REGIONAL CONFERENCES. THE STAFF WAS INVITED TO PROVIDE ADDITIONAL PRESENTATIONS TO SCHOOL GROUPS IN THE FALL OF 2010. BRAIN INJURY ASSOCIATION OF MD PLANNING COMMITTEE MWPH PARTICIPATION IN THE BRAIN INJURY ASSOCIATION OF MARYLAND'S PLANNING COMMITTEE INCLUDED PROVIDING A PRESENTATION AT ITS ANNUAL CONFERENCE, AS WELL AS, ACCESS TO SEVERAL MEMBERS OF OUR STAFF AS CLINICAL RESOURCES. THIS INCLUDED, BUT WAS NOT LIMITED TO, A NEUROPSYCHOLOGIST , A SPEECH THERAPIST, AN OCCUPATIONAL THERAPIST AND A POST-DOCTORAL FELLOW IN CLINICAL NEUROPSYCHOLOGY. THERE WERE ALSO PRESENTATIONS AND OUTREACH TO LOCAL SCHOOLS AND PROFESSIONAL GROUPS ON TRAUMATIC BRAIN INJURY AND CONCUSSION MANAGEMENT, AS WELL AS, A SUPPORT GROUP WHERE A PSYCHOLOGIST WAS PROVIDED AS A RESOURCE FOR FAMILIES AND PATIENTS WHO ARE COPING WITH TRAUMATIC BRAIN INJURY (TBI). Bad Debt Expense SSchedule H, Part III, Lines 2 and 4 THE PROVISION FOR BAD DEBTS IS BASED UPON MANAGEMENT'S ASSESSMENT OF HISTORICAL AND EXPECTED NET COLLECTIONS CONSIDERING HISTORICAL BUSINESS AND ECONOMIC CONDITIONS, TRENDS IN HEALTH CARE COVERAGE, AND OTHER COLLECTION INDICATORS. PERIODICALLY THROUGHOUT THE YEAR, MANAGEMENT ASSESSES THE ADEQUACY OF THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS BASED UPON HISTORICAL WRITE OFF EXPERIENCE BY PAYOR CATEGORY. THE RESULTS OF THIS REVIEW ARE THEN USED TO MAKE MODIFICATIONS TO THE PROVISION FOR BAD DEBTS AND TO ESTABLISH AN ALLOWANCE FOR UNCOLLECTIBLE RECEIVABLES. AFTER COLLECTION OF AMOUNTS DUE FROM INSURERS, THE CORPORATION FOLLOWS INTERNAL GUIDELINES FOR PLACING CERTAIN PAST DUE BALANCES WITH COLLECTION AGENCIES. Medicare Cost Report Schedule H, Part III, Line 8 IN MARYLAND, THE HEALTH SERVICES COST REVIEW COMMISSION (HSCRC) STARTED SETTING HOSPITAL RATES IN 1974. AT THAT TIME, THE HSCRC APPROVED RATES APPLIED ONLY TO COMMERCIAL INSURERS. IN 1977, THE HSCRC NEGOTIATED A WAIVER FROM MEDICARE HOSPITAL PAYMENT RULES FOR MARYLAND HOSPITALS TO BRING THE FEDERAL MEDICARE PAYMENTS UNDER HSCRC CONTROL. MEDICARE REIMBURSES MARYLAND HOSPITALS ACCORDING TO RATES ESTABLISHED BY THE HSCRC AS LONG AS THE STATE CONTINUES TO MEET A TWO-PART TEST. THIS TWO-PART WAIVER TEST ALLOWS MEDICARE TO PARTICIPATE IN THE MARYLAND SYSTEM AS LONG AS TWO CONDITIONS ARE MET. - ALL OTHER PAYERS PARTICIPATING IN THE SYSTEM PAY HSCRC SET RATES AND - THE RATE OF GROWTH IN MEDICARE PAYMENTS TO MARYLAND HOSPITALS FROM 1981 TO THE PRESENT IS NOT GREATER THAN THE RATE OF GROWTH IN MEDICARE PAYMENTS TO HOSPITALS NATIONALLY OVER THE SAME TIME FRAME. Collection Practices Schedule H, Part III, Line 9b THE ORGANIZATION EXPECTS PAYMENT AT THE TIME THE SERVICE IS PROVIDED. OUR POLICY IS TO COMPLY WITH ALL STATE AND FEDERAL LAW AND THIRD PARTY REGULATIONS AND TO PERFORM ALL CREDIT AND COLLECTION FUNCTIONS IN A DIGNIFIED AND RESPECTFUL MANNER. Currently, Mt. Washington Pediatric Hospital is in the process of updating its billing and collections process to ensure it is in compliance with the new IRC Section 501(r) regulations. EMERGENCY SERVICES WILL BE PROVIDED TO ALL PATIENTS REGARDLESS OF ABILITY TO PAY. FINANCIAL ASSISTANCE IS AVAILABLE FOR PATIENTS BASED ON FINANCIAL NEED AS DEFINED IN THE FINANCIAL ASSISTANCE POLICY. THE ORGANIZATION DOES NOT DISCRIMINATE ON THE BASIS OF AGE, RACE, CREED, SEX OR ABILITY TO PAY. PATIENTS WHO ARE UNABLE TO PAY MAY REQUEST A FINANCIAL ASSISTANCE APPLICATION AT ANY TIME PRIOR TO SERVICE OR DURING THE BILLING AND COLLECTION PROCESS. THE ORGANIZATION MAY REQUEST THE PATIENT TO APPLY FOR MEDICAL ASSISTANCE PRIOR TO APPLYING FOR FINANCIAL ASSISTANCE. THE ACCOUNT WILL NOT BE FORWARDED FOR COLLECTION DURING THE MEDICAL ASSISTANCE APPLICATION PROCESS OR THE FINANCIAL ASSISTANCE APPLICATION PROCESS. Community Health Care Needs Assessment Schedule H, Part VI, Line 2 To complete a comprehensive assessment of the needs of the community, the Association for Community Health Improvement's (ACHI) 6-step Community Health Assessment Process was utilized as an organizing methodology. The University of Maryland Medical System (UMMS) Community Benefit Team (CBT) served as the lead team to conduct the Community Health Needs Assessment (CHNA) with input from other University of Maryland Medical System Baltimore City-based hospitals, community leaders, the academic community, the public, health experts, and the Baltimore City Health Department. MWPH adopted the following Association of Community Heath Initiatives 6-step process to lead the assessment process and the additional 5-component assessment and engagement strategy to lead the data collection methodology. According to the Patient Protection and Affordable Care Act (ACA), hospitals must perform a community health needs assessment either fiscal year 2011, 2012, or 2013, adopt an implementation strategy to meet the community health needs identified, and beginning in 2013, perform an assessment at least every three years thereafter. The needs assessment must take into account input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge of or expertise in public health, and must be made widely available to the public. For the purposes of this report, a community health needs assessment is a written document developed by a hospital facility (alone or in conjunction with others) that utilizes data to establish community health priorities, and includes the following: 1. A description of the process used to conduct the assessment. 2. Who the hospital has collaborated with to complete the assessment 3. How the hospital took into account input from community members and public health experts 4. A description of the community served 5. A description of the health needs identified through the assessment process. Data was collected from the five major areas illustrated above to complete a comprehensive assessment of the community's needs. The MWPH participates in a wide variety of local coalitions including, several sponsored by the Baltimore City Health Department, Cancer Coalition, Baltimore Healthy Start Program, Kids in Safety Seats (KISS), Coalition to End Lead Poisoning, as well as partnerships with many community-based organizations like Children's Hospital Association (CHA), Traumatic Brain Injury Society, Injury Free Coalition for Kids, Greater Baltimore Asthma Alliance (GBAA), American Diabetes Association (ADA), American Heart Association (AHA), B'More Healthy Babies, Text4baby, and Safe Kids to name a few. To effectively reach the mission, MWPH conducted a formal community health needs assessment (CHNA) during FY 2012. Despite the larger regional patient mix of MWPH, for purposes of community benefits programming and this report, the Community Benefit Service Area (CBSA) of MWPH is within Baltimore City. The Mt Washington Pediatric Hospital serves a large portion of Baltimore County and Baltimore City; We draw 59% of our discharges from a defined market area with four sub-areas within the Baltimore County and Baltimore City. Our core market is defined as 13 contiguous ZIP codes in Baltimore City from which we draw 54% of our discharges. These 13 targeted zip codes are the primary community benefit service area. (CBSA) and comprise the geographic scope of this assessment. The community's perspective was obtained through two surveys offered to the public during health fairs throughout Baltimore City. A 6-item survey asked respondents to identify their top health concerns and their top barriers in accessing health care. A longer survey was also created and posted online on the public website. Methods A 6-item written survey distributed to health fair participants in FY2012 (Short Form), N = 871 and a 25-item online survey posted to www.umm.edu website for community to complete (Long Form). The Community Advocacy & Injury Prevention Coordinator attended neighborhood meetings hosted by the Baltimore City Health Department which discussed major health needs in discreet Baltimore neighborhoods within MWPH's CBSA. Results Analysis by CBSA targeted zip codes revealed the same top health concerns and top health barriers with little deviation from the overall Baltimore City data. The top health concerns vocalized by the community through survey were overweight/obesity, high blood pressure/stroke, diabetes/sugar, smoking cessation/drug ac, and heart disease. They also felt that the barriers to accessing health care services included, respectively, No Health Insurance, (service) Too Expensive, inaccessible Transportation, Local doctors not part of health insurance plan and that the doctor was too far from home. Health Experts Methods A community stakeholder meeting was hosted that included community organizers, faith-based organization leaders, community-based non-profit organization members/leaders. Attendees reviewed & included National Prevention Strategy Priorities, Maryland State Health Improvement Plan (SHIP) indicators, and Healthy Baltimore 2015 plan from the Baltimore City Health Department. Results As a recommendation, a National Prevention Strategy with 7 Priority Areas established, a State Health Improvement Process (SHIP) which includes 39 Objectives in 6 Vision Areas for the State, includes targets for Baltimore City, and Healthy Baltimore 2015 that identifies 10 Priority Areas for health disparity. Health Experts from University of Maryland at Baltimore Campus Panel Focus Group Top Action Items also included improve communication and synergy across campus schools and MWPH. Include MWPH on Community Action Council and consider intensively working with one neighborhood to improve health and social determinates of health outcomes. As well as to continue to look for ways to partner, collaborate and support each other. We then aligned Federal, State, and Local Health Priorities; National Prevention Strategy (NPS): 2011 Priority Areas, Maryland State Health Improvement Plan (SHIP) 2011, and the Healthy Baltimore 2015 For example, Tobacco Free Living (NPS) aligned perfectly with the priorities identified by the SHIP priority Preventing Drug Abuse & Excessive Alcohol Use and Healthy Baltimore 2015's Be Tobacco Free. The National health priority areas that were identified for MWPH are Tobacco Free Living Preventing Drug Abuse & Excessive Alcohol Use, Healthy Eating, Active Living, Injury & Violence Free Living, Reproductive & Sexual Health, and Mental & Emotional Well-Being. The State health priority areas that were identified included Healthy Babies, Healthy Social Environments, Safe Physical Environments, Infectious Diseases, Chronic Diseases and Healthcare Access. On the local level, the priority areas identified by Healthy Baltimore 2015 were Promote Access to Quality Health Care for All, Be Tobacco Free, Redesign Communities to Prevent Obesity, Promote Heart Health, Stop the Spread of HIV & Other Sexually Transmitted Infections, Recognize & Treat Mental Health Needs, Reduce Drug Use & Alcohol Use, Encourage Early Detection of Cancer, Promote Healthy Children & Adolescents and Creating Health Promoting Neighborhoods. Faith-Based Community Leaders Our organization community stakeholder meeting of faith-based leaders to include their communities' perspectives on health needs (October 2011) and participated in UMMS Community Partner Focus Group (April 2012). Results included the most serious problem identified (44.8% reported) the need for Affordable Health Care. The next serious problem identified (35.7% reported) was the issue of violence with in the community. The next three problems, that were to be considered of moderate importance included, respectively, Behavioral/Mental Illness, Heart Disease and Diabetes. We also found out that 86.7% of the community gets their health information from family & friends, 63% from Internet and 60% from church. After gathering this data, three action items were proposed; a Mobile Unit that would provide screenings, health education, and encourage community engagement. Possibly setting up a Green Neighborhood as a Model, and focusing on providing more Mental Health services. Social Determinants of Health (SDoH) defined by the World Health Organization as: the conditions in which people are born, grow, live, work and age, to identify SDoH, MWPH Reviewed data from identified 2011 Baltimore City Health Department's Baltimore City Neighborhood Profiles, Baltimore City Food Desert Map. We concluded that the Top SDoHs were Low Education Attainment (52.6% w/ less than HS degree), High Poverty Rate (15.7%)/High Unemployment Rate (11%), Violence, and Poor Food Environment. Health Statistics/Indicators Methods MWPH regularly reviewed local data sources such as, the Baltimore City Health Status Report, the Baltimore Hea Eligibility Education Schedule H, Part VI, Line 3 The Patient Financial Assistance Policy at Mt. Washington Pediatric Hospital is a comprehensive policy designed to assess the needs of patients and families that have expressed concerns about their ability to pay for needed medical services. In compliance with the new IRC section 501(r) regulations Mt. Washington Pediatric Hospital is currently in the process of updating their Financial Assistance Policy to ensure its compliance with IRS regulations. Mt. Washington Pediatric Hospital makes every effort to make financial assistance information available to our patients/families. These efforts include signage at our outpatient desks and inpatient welcome areas, notices on patient bills and admissions documents, and information on our web site. Description of how MWPH informs Patients of the Charity Care Policy Notices informing the patient about the availability of financial assistance have been posted in certain locations within the Hospital. Notices were posted on the outpatient registration desk at Rogers Avenue, the outpatient registration desk at PG Hospital, the inpatient family welcome room at Rogers Avenue, and the inpatient nurse's station at PG Hospital. The posted notices state the following: "Mount Washington Pediatric Hospital has a Patient Financial Assistance Program established to help patients obtain financial aid when it is beyond their ability to pay for services. An application and further information is available from the financial counselor in the admissions office". Other means of informing the patients of availability of financial assistance include handouts, notification by the admissions office, social work staff, and patient accounting representatives, and/or billing company staff. Also, an information sheet is provided to the patients, the patient's family, or the patient's authorized representative before discharge, with hospital bill, or on request. The information sheet included the following items: a. A description of the Hospital's financial assistance policy; b. A description of the patient's rights and obligations with regard to Hospital billing and collection; c. Contact information for the individual or office at the Hospital that is available to assist the patient or the patient representative in understanding the hospital bill and how to apply for free and reduced cost care; d. Contact information for the Maryland Medical Assistance Program; e. A statement that physician charges are not included in the Hospital bill and is billed separately. Description of Community Served Schedule H, Part VI, Line 4 MWPH is located in the northwest quadrant of Baltimore City, serving both its immediate neighbors and others from throughout Baltimore City, County and several other counties in the region. The neighborhoods surrounding MWPH are identified by the Baltimore Neighborhood Indicators Alliance (BNIA) as Southern Park Heights (SPH) and Pimlico/Arlington/Hiltop (PAH). The primary service area zip codes does not necessarily determine eligibility for community benefit services, because we are specialty pediatric facility, our patients residence span the state of Maryland and many from out of the state. MWPH determined that the specific zip codes of 21215 & 21216 defines the hospitals Community Benefit Service Area (CBSA) and constitute an area that is predominantly African American with below average median family income, but above average rates for unemployment, and other social determinants of poor health. Relying on data from the 2009 American Community Survey , SPHs median household income was $27,365 and PAHs median household was $29,031. This is compared to Baltimore Citys median household income of $37,395 in 2009. The percentage of families had incomes below the federal poverty guidelines in SPH was 25.9% ; in PAH, 21.3% of rates for SPH and PAH, were 17.5% and 17.0% respectively while the Baltimore City unemployment rate recorded in 2010 was 10.9%. The racial composition and income distribution of the zip codes described below reflect the segregation and income disparity characteristic of the Baltimore metropolitan region. As indicated above, those zip codes that have a predominantly African American population, including 21215, reflect the racial segregation and poverty representative of Baltimore City. This is in contrast to neighboring Baltimore County zip codes (21208 &21209) in which the hospital is located, the median household income is much higher, and in which the population is predominately white. The Baltimore City Health Department uses the Community Statistical Areas (CSA) when analyzing health outcomes and risk factors. The CSAs represent clusters of neighborhoods based on census track data rather than zip code and were developed by Baltimore City Planning Department based on recognizable city neighborhood perimeters. One zip code (21207) spans city and county lines (see footnote below chart). Baltimore County does not provide CSAs. The presence of health disparities is a major key factor in determining who the target population for our CBSA is and how MWPH might serve it best as a pediatric specialty hospital. Unlike most other hospitals that share one or more of our primary service area zip codes and because of the specialty services we provide, our patients come to us from all over the state of Maryland and Pennsylvania. MWPH is also located in the 21209 zip code which is one of the most wealthy and healthy neighborhoods in the city of Baltimore. Interestingly enough, MWPH is within walking distance from the 21215 zip code and Pimlico/Arlington/Hilltop neighborhood which as the aforementioned data demonstrates has several health disparities, poverty, and vulnerable populations. Promoting the Health of the Community Schedule H, Part VI, Line 5 MWPH created a Baltimore City Health Outcomes Summary for the aforementioned CBSA-targeted zip codes. The top three causes of death in Baltimore City identified, respectively, were Heart Disease, Cancer, and Stroke. The number one cause of pediatric deaths is the high rate of Infant Mortality. Based on our community needs assessment, MWPH prioritized and identified the community needs as follows: 1) Education/Health Literacy/Outreach 2) Access to Health Care 3) Chronic Disease/Obesity/Diabetes 4) Maternal and Child Health 5) Lead Poisoning 6) Asthma 7) Injury Prevention The communitys perspective was obtained through two surveys offered to the public during health fairs throughout Baltimore City. A 6-item survey asked respondents to identify their top health concerns and their top barriers in accessing health care. A longer survey was also created and posted online on the public website. Methods Included a 3-item survey distributed to the public at a variety of outreach events in FY15 (Short Form) and made available in Maryland Matters publication (N=1,212). A 25-item online survey was also posted to the survey monkey and www.umm.edu website for community to complete (Long Form). The Community Advocacy actively engaged community members from attending and participating in several neighborhood meetings hosted by Baltimore City Health Department and other local community organizations. The results identified the top five health concerns, top 5 barriers to health care, and presented an opportunity for participants to provide recommendations or solutions. The top five health concerns identified were Diabetes (n=708), High Blood Pressure/Stroke (n=669), Heart Disease (n=596), Smoking/Alcohol/Drug Abuse (n=535), and Cancer (n=515). Analysis by CBSA targeted zip codes revealed the same top health concerns and top health barriers with little deviation from the overall Baltimore City data. The top five barriers to health care identified included 'No Health Insurance' (n=833), 'Too Expensive' (n=726), 'No Transportation' (n+446), 'Local MDs Not Part of Plan' (n=259), 'Couldnt get an appointment with Doctor' (n=138), 'Doctor too far away' (n=125), and '(Medical) service not available in the city' (91). There were also 103 individual responses that provided additional insight into local health disparities. Analysis by CBSA targeted zip codes identified very similar health concerns and top health barriers with little to no deviation from overall Baltimore City data, or the MWPH CHNA completed in 2012. Analysis of all quantitative and qualitative data described in the above section identified these top six areas of need within Baltimore City. These top priorities represent the intersection of documented unmet community health needs and the organizations key strengths and mission. These priorities were identified and approved by the MWPH Community Empowerment Team and validated with the health experts from the Baltimore City Department of Health, local schools medicine, and nursing, rehabilitation, social work and MWPH employees who engage in community affairs. A prioritization meeting was held on April 30, 2015 with a cross section of clinicians, community stakeholders/activists, as well as community health educators. Participants were provided all the data collected for the fiscal year CHNA which included the community perspective, health experts/focus groups/interviews, as well as national and local health prevention strategies. The group was charged with prioritizing the health needs of the CBSA using the following criteria: -Magnitude: the number of people impacted by the problem -Severity: the risk of morbidity and mortality with the problem -Historical trends -Alignment of the problem with the MWPHs strengths and priorities -Impact of the problem on the vulnerable populations of the CBSA -Importance of the problem in the community -Relationship of the problem to other community issues -Feasibility of change, availability of tested approaches -Value if immediate intervention vs. any delay, especially for long-term or complex threats. Participants were asked to select six priorities based on this criteria where 1 is the most important/significant and 6 is not as urgent an need. As a result there were 15 different priorities identified. A matrix was then utilized (see chart below) to better identify in what order we would prioritize our services and/or programming and the feasibility of having so many. The Community Advocacy team facilitated focus group meetings to includes specialty clinical staff; Outpatient(Psychology, Weigh Smart, Social Work) [October 7, 2014], Traumatic Brain Injury & Recreational Therapy [September 29, 2014] as well as MWPH employees who engage in community affairs and MWPH Family Advisory Council [October 24, 2014]. There was also a telephone interview conducted Baltimore City Health Dept. Director of Chronic Disease Prevention, and finally a thorough review and include National Prevention Strategy Priorities, State Health Improvement Plan (SHIP) indicators , and Healthy Baltimore 2015 plan from BCHD MWPH results included utilizing the following data to create direction and a guide for all future community benefit initiatives; the National Prevention Strategy (7 Priority Areas) and the SHIPs (State Health Improvement Plan) 39 Objectives in 6 Vision Areas for State, includes targets for Baltimore City, and Healthy Baltimore 2015 which identified 10 Priority Areas. Comparison of Federal, State, and Local Health Priorities -National Prevention Strategy: 2011 Priority Areas -Maryland State Health Improvement Plan (SHIP) -2011 Healthy Baltimore 2015 -Tobacco Free Living Healthy Babies Promote Access to Quality Health Care for All -Preventing Drug Abuse & Excessive Alcohol Use Healthy Social Environments Be Tobacco Free -Healthy Eating Safe Physical Environments Redesign Communities to Prevent Obesity -Active Living Infectious Diseases Promote Heart Health -Injury & Violence Free Living Chronic Diseases Stop the Spread of HIV & Other ST Infections -Reproductive & Sexual Health Healthcare Access Recognize & Treat Mental Health Needs -Mental & Emotional Well-Being Reduce Drug Use & Alcohol Use -Encourage Early Detection of Cancer -Promote Healthy Children & Adolescents -Create Health Promoting Neighborhoods During the telephone interview with Laura Fox, MPH, Director, Office of Chronic Disease Prevention, Baltimore City Health Department (2/17/15), MWPH was able to identify the top 4 health problems per Baltimore City Mayors health priorities: 1. Cardiovascular Disease (CVD) Decrease premature mortality (as defined as death prior to 75 years) 2. Asthma With a concentration on pediatrics specifically 3. Heroin Use while a priority, no major initiatives to date 4. Diabetes as related to CVD as a co-morbidity Top Barriers to Health identified are: 1. Knowledge deficit with respect to health insurance 2. People dont know how to use (navigate) the system- need care connectors and/or health navigators 3. People arent sure what MCOs will accept them 4. Limited minutes on phone limits calls for assistance 5. General Education/Literacy (SDoH) Community Leaders MWPH facilitated a focus group in the Park Heights Community, which is located in the community benefit service area of the hospital which included over 30 Community Partners Focus Group (October 2014). The following needs were discussed/identified during this meeting: #1 Serious Problem identified: 44.8% reported the need for Health Literacy (See Chart 3) #2 Serious Problem identified: 35.7% reported the issue of Violence MWPH identified the top 3 moderate concerns and they are as follows, respectively; Behavioral/Mental Illness, Heart Disease, and Diabetes. We also were made aware that 86.7% of community received their health information from family & friends, 63% from Internet, 60% from church. The top 3 action items for this meeting that were discussed, Mobile Unit Screenings, Health Education, Community Engagement, Set up a Green Neighborhood as a Model, and Mental Health services. Social Determinants of Health (SDoH) Defined by the World Health Organization as: 'the conditions in which people are born, grow, live, work and age.' Methods Reviewed data from identified 2011 Baltimore City Health Departments Baltimore City Neighborhood Profiles, Baltimore City Food Desert Map (See Figure 5) Results Utilizing the Baltimore City Neighborhood Profiles, the community advocacy team identified SDoHs for the following zip codes within the CBSA (Community Benefit Service Area) Upton/ Druid Heights (21217), SW Baltimore (21223), Mondawmin Pimlico/ Arlington/ Hilltop (21216 & 21215) Howard Park/ W. Arlington (21207), Southern Park Heights (21215), Clifton-Berea (21206). The Top SDoHs identified were 'Low Education Attainment' (52.6% w/ less than HS degree), 'High Poverty Rate'(15.7%), 'High Unemployment Rate'(11%), Violence, and Poor Food Environment. Heal Affiliated Health Care System Roles Schedule H, Part VI, Line 6 MWPH is a regional leader in pediatric specialty care and is a jointly owned corporate affiliate of the University of Maryland Medical Systems (UMMS) and Johns Hopkins Health System (Hopkins). state filing of community benefit report schedule h, part vi, line 7 Maryland X X X X false false false false false false false true false SHELDON STEIN PRESIDENT CEO 247539 0 93204 0 3514 0 154245 0 16799 0 515301 0 0 0 MARY MILLER CFO / VP - FINANCE 137518 0 24572 0 624 0 26693 0 23333 0 212740 0 0 0 THOMAS ELLIS VP - HUMAN RESOURCES 138333 0 23389 0 1653 0 46074 0 20213 0 229662 0 0 0 BARINADA GIADOM ATTENDING PHYSICIAN 193908 0 0 0 439 0 8953 0 23333 0 226633 0 0 0 KATHERINE ALTER MD DIRECTOR PHYSICAL MEDICINE 234438 0 0 0 950 0 11733 0 16799 0 263920 0 0 0 SILVIA WILLIAMS MD ATTENDING PHYSICIAN 189212 0 0 0 705 0 7870 0 9333 0 207120 0 0 0 AJOKE AJAYI-AKINTADE MD ATTENDING PHYSICIAN 190258 0 0 0 634 0 10858 0 0 0 201750 0 0 0 STEPHEN NICHOLS MD ATTENDING PHYSICIAN 216752 0 0 0 275 0 11308 0 23333 0 251668 0 0 0 JENNIFER BOWIE VP - NURSING ADMIN 147054 0 25579 0 253 0 14450 0 17092 0 204428 0 0 0 Non Fixed Payments Schedule J, Part I, Line 7 BONUSES PAID ARE BASED ON A NUMBER OF VARIABLES INCLUDING BUT NOT LIMITED TO INDIVIDUAL GOAL ACHIEVEMENTS AS WELL AS ORGANIZATION OPERATION ACHIEVEMENTS. THE FINAL DETERMINATION OF THE BONUS AMOUNT IS DETERMINED AND APPROVED BY THE BOARD AS PART OF THE OVERALL COMPENSATION REVIEW OF THE OFFICERS AND KEY EMPLOYEES. A Maryland Health & Higher Educational Facilities 500936091 574216LR6 2007-11-01 7585000 Construction false false false A 0 7585000 0 0 0 0 0 0 0 0 0 0 1985 false false true true A false false false false 0 true false false true A false false false true true false 0 false 0 false true A true Members or Stockholders Form 990, Part VI, Line 6 and 7a JOHNS HOPKINS HEALTH SYSTEM (JHHS) AND THE UNIVERSITY OF MARYLAND MEDICAL SYSTEM (UMMS) ARE EQUAL MEMBERS OF MT. WASHINGTON PEDIATRIC HOSPITAL (MWPH). JHHS AND UMMS EACH ELECT AN EQUAL NUMBER OF MEMBERS TO THE BOARD OF MWPH. Form 990 Review Process Form 990, Part VI, Line 11b THE IRS FORM 990 IS PREPARED AND REVIEWED BY THE ACCOUNTING FIRM OF GRANT THORNTON. ACCOUNTING PERSONNEL IN FINANCE SHARED SERVICES AT THE UNIVERSITY OF MARYLAND MEDICAL SYSTEM GATHER THE INFORMATION NEEDED TO COMPLETE THE RETURN AND INPUT THE DATA INTO THE GRANT THORNTON TAX ORGANIZER, WHICH IS AN EXCEL-BASED SYSTEM. WHEN ALL DATA HAS BEEN ENTERED, THE INFORMATION IS SUBMITTED TO GRANT THORNTON FOR IMPORTATION INTO THEIR TAX SOFTWARE. AT THIS POINT, GRANT THORNTON STAFF MEMBERS REVIEW THE DATA, ASK FOR ADDITIONAL INFORMATION IF NEEDED AND PREPARE THE TAX RETURN. EACH RETURN IS REVIEWED AT SEVERAL LEVELS AT GRANT THORNTON INCLUDING THE TAX PARTNER. AFTER THEIR REVIEW PROCESS, A DRAFT RETURN IS SENT TO THE ACCOUNTING STAFF AT UMMS FOR AN IN-HOUSE REVIEW. UPON COMPLETION OF THE IN-HOUSE REVIEW, GRANT THORNTON IS INSTRUCTED TO MAKE ANY NECESSARY CHANGES AND TO PREPARE THE FINAL TAX RETURN. THE FINAL RETURN UNDERGOES ANOTHER REVIEW BY THE ACCOUNTING STAFF AT FINANCE SHARED SERVICES AND IS ALSO REVIEWED BY THE ACCOUNTING MANAGER, THE DIRECTOR OF FINANCIAL REPORTING, THE VICE PRESIDENT OF FINANCE AND THE CFO, WHO SIGNS THE RETURN. PRIOR TO FILING THE IRS FORM 990, THE ORGANIZATION'S BOARD CHAIRMAN, TREASURER, AUDIT COMMITTEE CHAIRMAN, EXECUTIVE COMMITTEE CHAIRMAN OR OTHER MEMBER OF THE BOARD WITH SIMILAR AUTHORITY WILL REVIEW THE IRS FORM 990. AT THE DISCRETION OF THE REVIEWING BOARD MEMBER, SUCH MEMBER WILL BRING ANY ISSUES OR QUESTIONS RELATED TO THE COMPLETED IRS FORM 990 TO THE ATTENTION OF THE BOARD. NOTWITHSTANDING THE ABOVE, A BOARD RESOLUTION IS NOT REQUIRED FOR THE FILING OF THE ORGANIZATION'S IRS FORM 990. EACH BOARD MEMBER IS PROVIDED WITH A COPY OF THE FINAL IRS FORM 990 BEFORE FILING. Conflict of Interest Policy Monitoring & Enforcement Form 990, Part VI, Line 12c THE ORGANIZATION'S OFFICERS, DIRECTORS, EMPLOYEES AND MEDICAL STAFF MEMBERS, AS APPLICABLE, SHALL DISCLOSE CONFLICTS OF INTEREST OR POTENTIAL CONFLICTS OF INTEREST BETWEEN THEIR PERSONAL INTERESTS AND THE INTERESTS OF THE ORGANIZATION, OR ANY ENTITY CONTROLLED BY OR OWNED IN SUBSTANTIAL PART BY THE ORGANIZATION. A QUESTIONNAIRE WHICH DISCLOSES POTENTIAL CONFLICTS OF INTEREST IS DISTRIBUTED ANNUALLY TO ALL OFFICERS, DIRECTORS AND KEY EMPLOYEES. THE GENERAL COUNSEL OF THE UNIVERSITY OF MARYLAND MEDICAL SYSTEM CORPORATION (UMMSC) REVIEWS THE RESPONSES FOR UMMSC AND JAMES LAWRENCE KERNAN HOSPITAL. THE CEO OR CFO OF EACH OF THE OTHER ENTITIES IN THE UNIVERSITY OF MARYLAND MEDICAL SYSTEM REVIEWS THE RESPONSES FOR THOSE ENTITIES. THE GENERAL COUNSEL, IN CONSULTATION WITH THE AUDIT COMMITTEE, IF NECESSARY, WOULD DETERMINE IF A CONFLICT OF INTEREST EXISTED FOR UMMSC, AND JAMES LAWRENCE KERNAN HOSPITAL. WITH RESPECT TO THE OTHER ENTITIES IN THE UNIVERSITY OF MARYLAND MEDICAL SYSTEM, THE GENERAL COUNSEL MAY BE CALLED FOR CONSULT. IF SO, THE GENERAL COUNSEL MAY CONSULT THE AUDIT COMMITTEE, IF NECESSARY. WHENEVER A CONFLICT OR POTENTIAL CONFLICT OF INTEREST EXISTS, THE NATURE OF THE CONFLICT OR POTENTIAL CONFLICT OF INTEREST MUST BE DISCLOSED IN WRITING TO THE ORGANIZATION'S BOARD, BOARD COMMITTEE, AN OFFICER OF THE ORGANIZATION OR OTHER APPROPRIATE EXECUTIVE. SUCH INDIVIDUAL HAVING A POTENTIAL CONFLICT OF INTEREST SHALL PLAY NO ROLE ON BEHALF OF THE ORGANIZATION, OR ANY ORGANIZATION CONTROLLED OR SUBSTANTIALLY OWNED, IN ANY TRANSACTION IN WHICH A CONFLICT EXISTS. ALL INVITATIONS FOR BIDS, PROPOSALS OR SOLICITATIONS FOR OFFERS INCLUDE THE FOLLOWING PROVISION: ANY VENDOR, SUPPLIER OR CONTRACTOR MUST DISCLOSE ANY ACTUAL OR POTENTIAL TRANSACTION WITH ANY ORGANIZATION OFFICER, DIRECTOR, EMPLOYEE OR MEMBER OF THE MEDICAL STAFF, INCLUDING FAMILY MEMBERS WITHIN FIVE DAYS OF THE TRANSACTION. FAILURE TO COMPLY WITH THIS PROVISION IS A MATERIAL BREACH OF AGREEMENT. IN ADDITION, A BOARD DISCLOSURE REPORT IS FILED WITH THE MARYLAND HEALTH SERVICES COST REVIEW COMMISSION ON AN ANNUAL BASIS SHOWING ANY BUSINESS TRANSACTIONS BETWEEN THE BOARD MEMBERS AND THE ORGANIZATION. Process for Determining Compensation Form 990, Part VI, Lines 15a and 15b THE ORGANIZATION DETERMINES THE EXECUTIVE COMPENSATION PAID TO ITS EXECUTIVES IN THE FOLLOWING MANNER PRESCRIBED IN THE IRS REGULATIONS: EXECUTIVE COMPENSATION PACKAGES ARE DETERMINED BY A COMMITTEE OF THE BOARD THAT IS COMPOSED ENTIRELY OF BOARD MEMBERS WHO HAVE NO CONFLICT OF INTEREST. THE COMMITTEE ACQUIRES CREDIBLE COMPARABILITY MARKET DATA CONCERNING THE COMPENSATION PACKAGES OF SIMILARLY SITUATED EXECUTIVES. THE COMMITTEE CAREFULLY REVIEWS THAT DATA, THE EXECUTIVE'S PERFORMANCE AND THE PROPOSED COMPENSATION PACKAGES DURING THE DECISION MAKING PROCESS. THE COMMITTEE MEMORIALIZES ITS DELIBERATIONS IN DETAILED MINUTES REVIEWED AND ADOPTED AT THE NEXT-FOLLOWING MEETING. THE COMMITTEE SEEKS AN OPINION OF COUNSEL THAT IT HAS MET THE REQUIREMENTS OF THE IRS INTERMEDIATE SANCTIONS REGULATIONS. THIS PROCESS IS USED TO DETERMINE THE COMPENSATION PACKAGES FOR ALL MANAGEMENT EMPLOYEES FROM THE VICE PRESIDENT LEVEL AND UP. How Documents are Made Available to the Public Form 990, Part VI, Line 19 IN GENERAL, FINANCIAL AND TAX INFORMATION RELATING TO THE ORGANIZATION IS DEEMED PROPRIETARY AND NOT SUBJECT TO DISCLOSURE UPON REQUEST. HOWEVER, SPECIFIC PROVISIONS OF FEDERAL AND STATE LAW REQUIRE THE ORGANIZATION TO DISCLOSE CERTAIN LIMITED FINANCIAL AND TAX DATA UPON A SPECIFIC REQUEST FOR THAT INFORMATION. REQUESTS FOR FORM 990 AND FORM 1023: A REQUESTOR SEEKING TO REVIEW AND/OR OBTAIN A COPY OF THE ORGANIZATION'S IRS FORM 990 OR FORM 1023 AS FILED WITH THE INTERNAL REVENUE SERVICE, INCLUDING ALL SCHEDULES AND ATTACHMENTS, MAY APPEAR IN PERSON OR SUBMIT A WRITTEN REQUEST. THE MOST RECENT THREE YEARS OF IRS FORM 990 MAY BE REQUESTED. IF THE REQUESTER APPEARS IN PERSON, THE INDIVIDUAL IS DIRECTED TO THE OFFICE OF THE CHIEF FINANCIAL OFFICER FOR THE ORGANIZATION AND THE FORM 990 AND/OR FORM 1023 ARE MADE AVAILABLE FOR INSPECTION. THE INDIVIDUAL IS PERMITTED TO REVIEW THE RETURN, TAKE NOTES AND REQUEST A COPY. IF REQUESTED, A COPY IS PROVIDED ON THE SAME DAY. A NOMINAL FEE IS CHARGED FOR MAKING THE COPIES. THE ORGANIZATION MAY HAVE AN EMPLOYEE PRESENT DURING THE PUBLIC INSPECTION OF THE DOCUMENT. WRITTEN REQUESTS FOR AN ENTITY'S FORM 990 OR FORM 1023 ARE DIRECTED IMMEDIATELY TO THE OFFICE OF THE CHIEF FINANCIAL OFFICER FOR THE ORGANIZATION. THE REQUESTED COPIES ARE MAILED WITHIN 30 DAYS OF THE REQUEST. REPRODUCTION FEES AND MAILING COSTS ARE CHARGED TO THE REQUESTOR. CONFLICT OF INTEREST POLICY AND GOVERNING DOCUMENTS: IF THE GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY OF OUR ORGANIZATION ARE SUBJECT TO THE FEDERAL PUBLIC DISCLOSURE RULES (OR STATE PUBLIC DISCLOSURE RULES), THESE DOCUMENTS WILL BE MADE PUBLICLY AVAILABLE AS APPLICABLE LAW MAY REQUIRE. OTHERWISE, THE GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY WILL BE PROVIDED TO THE PUBLIC AT THE DISCRETION OF MANAGEMENT. Reconciliation of Net Assets Form 990, Part XI, Line 9 Unrestricted: Change in Funded Status of Defined Benefit Plan (115,530) Change in Economic Interest- MWPF Unrestricted (221,856) Net Assets Released for purchase of equipment 147,482 ------------ Restricted: Change in Economic Interest- MWPF Restricted 214,333 Net Assets Released for Operations (421,018) Net Assets Released for purchase of equipment (147,482) ------------ TOTAL CHANGE TO NET ASSETS (544,071) Mount Washington Pediatric Foundation 1708 West Rogers Avenue Baltimore MD 21209 521736672 Fundraising MD 501(c)(3) 11a MWPH true false false true false false false false false false false false false false false false false false false false Mt Washington Pediatric Foundation c 358482 fmv