2014-05-13T12:16:22-05:00 2013-06-30 GRANT THORNTON LLP 2001 MARKET STREET SUITE 700 PHILADELPHIA PA 19103 990 2012-07-01 520591483 Mt Washington Pediatric Hospital Inc % AL CRISP MTWA 4105788600 1708 W Rogers Avenue Suite Baltimore MD 21209 Alfred A Pietsch 4105788600 2014-05-08 true Frank Giardini 2155614200 2012 2015-11-30 17:44:51Z Sheldon Stein 1708 W Rogers Avenue Baltimore MD 21209 67583980 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 12 712 108 0 0 3747560 2515697 48091824 52120071 456993 598932 708465 2918827 53004842 58153527 0 0 0 0 34096686 34069734 0 0 0 12588162 15043260 46684848 49112994 6319994 9040533 79333030 89874095 22526178 21780416 56806852 68093679 MT. WASHINGTON PEDIATRIC HOSPITAL IS DEDICATED TO MAXIMIZING THE HEALTH AND INDEPENDENCE OF THE CHILDREN WE SERVE. false false 41826035 55032369 MT. WASHINGTON PEDIATRIC HOSPITAL, INC. OFFERED PEDIATRIC INPATIENT AND OUTPATIENT SERVICES FOR CHILDREN WITH CHRONIC ILLNESSES AND REHABILITATION NEEDS. 22,056 INPATIENT DAYS OF CARE WERE PROVIDED DURING THE FISCAL YEAR. 40,670 VISITS WERE RECORDED AT ITS SPECIALIZED CLINICS. THE MAJORITY OF PATIENTS TREATED WERE SOCIOECONOMIC DISADVANTAGED CHILDREN. 80% OF PATIENTS RECEIVED MEDICAL ASSISTANCE. 41826035 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 87 0 true 712 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 AL CRISP 4103280649 250 W PRATT STREET SUITE 1436 Baltimore MD 21201 EDWARD B CHAMBERS 1.0 X 0 0 0 ROBERT A CHRENCIK 1.0 X 0 0 0 S TRACY COSTER 1.0 X 0 0 0 STEVEN J CZINN MD 1.0 X 0 0 0 GEORGE J DOVER MD 1.0 X 0 0 0 JOHN KELLY 1.0 X 0 0 0 LAWRENCE C PAKULA MD 1.0 X 0 0 0 RONALD R PETERSON 1.0 X 0 0 0 BERYL ROSENSTIEN MD 1.0 X 0 0 0 GDANIEL SHEALERJR ESQUIRE 1.0 X 0 0 0 ROSLYN STOLER 1.0 X 0 0 0 FRED WOLFIII ESQUIRE 1.0 X 0 0 0 SHELDON STEIN 40.0 1.0 X 324220 0 195475 ALFRED A PIETSCH 1.0 X Mary Miller 40.0 1.0 X 147393 0 51034 SHARON KELLY 40.0 X 174776 0 13924 THOMAS ELLIS 40.0 X 144779 0 74615 BARINADA GIADOM 40.0 X 205025 0 35493 KATHERINE ALTER MD 32.0 X 228477 0 38108 ROBERT BLAKE 36.0 X 211244 0 11942 PATRICIA QUIGLEY MD 40.0 X 186486 0 29517 STEPHEN NICHOLS MD 40.0 X 201448 0 35813 1823848 0 485921 26 false true false Pharmasource Healthcare Inc PO Box 632849 CINCINNATI OH 45263 pharmacy 2771943 Whiting Turner Contracting PO Box 17596 BALTIMORE MD 21297 construction 1947817 Sleep Services Of America Inc PO Box 198320 ATLANTA GA 30384 neurology services 980866 Johns Hopkins University 600 North Wolf Street BALTIMORE MD 21287 physican services 910305 Maryland General Hospital 827 Linden Avenue BALTIMORE MD 21201 lab services 296070 14 58857 849587 1607253 2515697 NET PATIENT REVENUE 900099 52120071 52120071 52120071 252819 252819 0 0 0 0 0 9731297 9385184 346113 346113 346113 51798 58857 45269 6529 6529 0 0 MEDICAL RECORDS 900099 2753 2753 NET ASSETS RELEASED FOR OPERATING PURPOSES 900099 516775 516775 ALL OTHER REVENUE 900099 2392770 2392770 2912298 58153527 55032369 605461 0 0 0 0 785692 667838 117854 0 26451027 22483373 3853116 114538 592455 503587 86291 2577 4450225 3782691 648176 19358 1790335 1521785 260762 7788 0 630 536 94 410645 349048 61597 0 0 0 67331 57231 10100 149724 127265 22459 1161341 987140 174201 0 0 337579 286942 50637 118429 100665 17764 0 12318 10470 1848 83488 70965 12523 0 2024766 1721051 303715 -98447 -83680 -14767 SUPPLIES 5678815 4826993 851822 CONSULTANTS 2849653 2422205 427448 BAD DEBT 533268 533268 CLINICAL 680237 578201 102036 1033483 878461 155022 49112994 41826035 7142698 0 0 0 17653539 17215446 678872 488362 5722581 5252896 0 0 0 0 0 0 138991 137219 187426 337682 52298500 29680724 20540200 22617776 17726540 24335841 0 0 0 0 0 0 16684881 19488873 79333030 89874095 11376269 11315446 0 0 0 0 6570000 6290000 0 0 0 0 0 0 0 0 4579909 4174970 22526178 21780416 X 48099030 58467394 7882651 8801114 825171 825171 56806852 68093679 79333030 89874095 X 9040533 1018210 1228084 X false true X true X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false true 4504 4504 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) and the American Hospital Association (AHA). MHA and AHA engage in many support activities including lobbying and advocating for their member hospitals. The MHA and AHA reported that 7.71% and 23.98% 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. 601327 601327 35581984 17328322 18253662 262091 223245 38846 15853098 12129157 3723941 22617776 ASSETS LIMITED AS TO USE 3420723 ECONOMIC INTEREST IN MWPF 14994108 OTHER 410928 OTHER ACCOUNTS RECEIVABLE 663114 19488873 0 ADVANCES FROM 3RD PARTY PAY 4174970 4174970 X Liability for Uncertain Tax Position (ASC 740) Schedule D, Part X, Line 2 The Corporation adopted the provisions of ASC 740, accounting for uncertainity in the income taxes (fin 48) on July 1, 2007. The footnote related to asc 740 in the corporation's audited financial statements is as follows: 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 67700 44682 23018 24943 FASHION FEVER 42955 14175 28780 20326 0 110655 58857 51798 45269 45269 6529 true true true X true X 500. true true true false true true 98285 98285 0.00200 98285 98285 0.00200 221728 221728 0.00450 355156 2500 352656 0.00720 1010066 491211 518855 0.01060 67325 67325 0.00140 1654275 493711 1160564 0.02370 1752560 493711 1258849 0.02570 72 72 15022 15022 0.00030 14997 14997 0.00030 30091 30091 0.00060 true 432927 144450 -144450 X true true 1 1 Mt Washington Pediatric Hospital

1708 W Rogers Avenue BALTIMORE MD 21209

X X MT WASHINGTON PEDIATRIC HOSPITAL INC 1 true X X X X X X X X X 12 true true true X X X X X X X X X X false false true true 200. true 500. true X X X X X X X true true X X X X X X true false X X X X true X false false 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 31 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) 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 7F 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. 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. DIABETES CAMP THE EXTREME WEEKEND FOR CHILDREN WITH DIABETES CAMP IS A CAMP DEVELOPED TO ASSIST FAMILY MEMBERS OF CHILDREN WITH DIABETES IN COPING WITH THE LIFESTYLE CHANGES THAT ACCOMPANY LIVING WITH SOMEONE WITH THE DISEASE. STAFF DEDICATED SEVERAL HOURS IN PREPARING AND PRESENTING WORKSHOPS TO CHILDREN WITH DIABETES AND THEIR FAMILIES. IN ADDITION, OUR STAFF PSYCHOLOGIST WAS ALSO AVAILABLE AS A RESOURCE FOR SUPPORT GROUPS FOR TYPE 1 DIABETES PEDIATRIC SUPPORT GROUP. COMMUNITY HEALTH IMPROVEMENT AND ADVOCACY: NATIONAL ASSOCIATION OF CHILDREN'S HOSPITALS AND RELATED INSTITUTIONS (NACHRI) OBESITY TASK FORCE, BRAIN INJURY ASSOCIATION OF MD PLANNING COMMITTEE NACHRI OBESITY TASK FORCE/WEIGH SMART AND WEIGH SMART JR. MWPH WERE ACTIVE PARTICIPANTS IN THE NATIONAL ASSOCIATION OF CHILDREN'S HOSPITALS AND RELATED INSTITUTIONS 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 NATIONAL ASSOCIATION CHILDREN'S HOSPITALS RELATED INSTITUTIONS. 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 Schedule H, Part III, Line 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. 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. 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. Mt. Washington Pediatric Hospital 1 Schedule H, Part V, Section B, Lines 20d and 22 Line 20d - All patients are charged state regulated rates, regardless of their ability to pay. Line 22 - 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). 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 Systems (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 percent 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 12 contiguous ZIP codes in Baltimore City from which we draw 54 percent of our discharges. These 10 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 and 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 and included National Prevention Strategy Priorities, Maryland State Health Improvement Plan (SHIP) indicators, and Healthy Baltimore 2015 plan from the BCHD 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 and 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 and Excessive Alcohol Use, Healthy Eating, Active Living, Injury and Violence Free Living, Reproductive and Sexual Health, and Mental and 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 and Other Sexually Transmitted Infections, Recognize and Treat Mental Health Needs, Reduce Drug Use and Alcohol Use, Encourage Early Detection of Cancer, Promote Healthy Children and 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 percent reported) the need for Affordable Health Care. The next serious problem identified (35.7 percent 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 percent of the community gets their health information from family and friends, 63 percent from Internet and 60 percent 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 percent w/ less than HS degree), High Poverty Rate (15.7 percent)/High Unemployment Rate (11 percent), Violence, and Poor Food Environment. Health Statistics/Indicators Methods MWPH regularly reviewed local data sources such as, Baltimore City Health 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. 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 The licensed bed designation of Mt Washington Pediatric Hospital (MWPH) is 102, which includes pediatric specialty, pediatric chronic illness, and neonatal transitional care. Inpatient admissions for FY 13 were 790 admissions. Medicaid patients accounted for 79.11 percent of the total MWPH admissions in FY13 and 5 percent of these Medicaid patients live in the 21215 zip code which is a target area of the hospital's community benefit service area (CBSA). 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 do 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 and 21216 defines the hospital's 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, SPH's median household income was $27,365 and PAH's median household was $29,031. This is compared to Baltimore City's median household income of $37,395 in 2009. The percentage of families had incomes below the federal poverty guidelines in SPH was 25.9 percent ; in PAH, 21.3 percent of rates for SPH and PAH, were 17.5 percent and 17.0 percent respectively while the Baltimore City unemployment rate recorded in 2010 was 10.9 percent. 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 and21209) 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. In the chart below, we represent the community benefit activities at MWPH. One zip code (21207) spans city and county lines (see footnote below chart). Baltimore County does not provide CSAs. CBSA Zip Codes: 21215 21216 21217 21207 21209 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. Please note that 21207 and 21209 span city/county lines; however, MWPH community benefit activities primarily serve the city-portion of the zip code. The Howard Park/West Arlington is the Baltimore City portion of the 21207 CBSA. Promoting the Health of the Community Schedule H, Part VI, Line 5 MWPH has many programs that demonstrate how the hospital is promoting health in the community. For example our Safety Baby Showers partner with existing agencies in Community Benefit Service Area that are currently providing services for pre/post natal women and provide safety baby showers to women and/or their families to educate them about injury prevention topics such as choking, poisoning, child passenger safety, burning/scalding, infant sleep safety and falls and other residential injuries. There MWPH provides materials on proper nutrition, physical activity, and stress management to encourage healthy full-term pregnancies. At the event, talks are given on behavior management, developmentally appropriate toys/play, baby sign language, and a resource guide to parents of free resources in the community to provide parents with skills and tools required to be better and more engaged parents. Participants were evaluated by Pre and Post tests that focused on various injury prevention topics which also included safe sleep and shaken baby syndrome. The B'More Healthy program provided parents with a 15 min. video about sleep safety and a talk about nutrition physical activity and stress management. A total of sixteen 2-hour talks were conducted with a total of 178 participants. On the pre-talk test, 72 of the participants answered at least one of the 12 questions wrong. 99 of the participants answered enough questions correctly to earn a passing score on the post-talk survey. 7 of the participants answered four or fewer questions correctly. On the post-talk test 177 of the participants answered all 12 questions correctly and 1 person answered 11 of 12 correctly All participants earned a passing score on the post test. Safety Baskets were given to each parent filled with prevention materials (latches, bath hot water thermometers, poisoning control magnets) and educational materials on how to safety proof home provided to 78 families after participating in talk/presentation at the shower. Dinner and/or breakfast was provided to families as well (depending on time of the event), costing approximately $15,000 to support this initiative. Another example of MWPH promoting community health and wellness are the Weigh Smart and Weigh Smart Jr. programs. Meeting the national and local identified need of reducing the proportion of youth who are obese, and increasing the proportion of adults who are at a healthy weight; the Weigh Smart program investigated diet quality before and after participation in a pediatric weight management program by identifying poor diet quality that is associated with obesity such as inadequate fruit and vegetable intake, excessive sugar-sweetened beverages (SSB) and fast food intake. An inter-professional psycho-educational weight management program was facilitated involving medicine, nutrition, physical therapy, and psychology. The program established a coordinated holistic approach to management of diagnoses that have a nutritional component. Coordinators engaged targeted communities on healthy lifestyles by sponsoring community meetings, advocating for health policy and legislation, providing food nutrition label reading sessions, and providing heart healthy cooking demos and/or tastings. To reach out to communities in the CBSA, educational materials were developed and distributed at various health fairs. Program was evaluated by Children's Dietary Questionnaire (CDQ) was administered to caregivers of patients ages 2-17 years during initial consultation. Results included change in body composition for participants- weight, height, BMI, body fatness, as well as a change in quality of life, change in dietary quality, and change in behaviors by child and parent report (according to parent and child self report). Program included a total of 50 participants, outcomes were 70 percent show decreased Body Mass Index z score at 1 yr 21 percent down mean insulin levels 4 percent down mean cholesterol level 14 percent down mean triglyceride level. Diet changes French fries Went down from 1.06 to 0.49 (p=0.023) over last 7 days Fast food down from 1.55 to 0.75 (p=0.000) over last 7 days Fruit juice/fruit drink down from 2.15 to 1.53 (p=0.021) in the past 24 hours Soft drink/sweet tea/Kool-Aid/lemonade (not diet) down 1.77 to 1.23 per wk (p=0.073) Potato chips, other chips (e.g. Fritos, Doritos) or crackers down 1.49 to 1.05 per wk (p=0.096) Ice-cream/Popsicles down 1.14 to 0.69 per wk (p=0.069) There were also statistically significant improvements in quality of life measurements. Community Advocacy coordinator 76 health fairs and distributed materials as well as provided demonstration of proper food portions with food models. The total cost for the program is $752,962. Healthy Living Academy (HLA) The after-school health program known as Healthy Living Academy (HLA) concluded in July 2012, having enrolled 158 students from five Baltimore area schools - Mt Washington Elementary School, Robert Coleman Elementary School, Rosemont Elementary/Middle School, St. Francis Academy, and Edmonson High School. The Center's program partner was Baltimore City Community College, where students from the education, counseling, allied health, nursing, and physical education programs were recruited to train as coaches, to the school children and to develop/ teach the curriculum under the guidance of Center staff and BCCC faculty. HLA also used BCCC sports facilities to house the program. HLA created an advisory board of professionals with expertise in program development who assisted in overseeing design and implementation of this program. These experts were the director of community relations for the Baltimore Ravens, director of sales and marketing for Merritt Athletic Clubs, and the executive director of B'More Fit, a nonprofit organization that provides mentoring and training for at-risk youth to become fitness experts while they work toward a GED. The advisory panel helped develop a thorough evaluation matrix to measure the success of the HLA. Participants' success was evaluated by examining changes in their knowledge of healthy lifestyles based on comparison of pre- and post-test scores and by changes in their body composition. Results demonstrated that HLA helped participants learn about and develop healthier eating and physical activity habits and achieve improved overall health. A written questionnaire on nutrition, exercise, and stress management was administered to students before and after HLA to evaluate changes in knowledge in these areas. Scores on the post-test improved 19 points on average from pre-test scores for children in the first session and 24 points on average for students in the second session. In addition to changes in knowledge, students showed positive improvements in body composition. These positive changes included decreases in the high school students' average weight, body mass index, waist and hip circumference, and changes among elementary school students including decreases in waist and hip circumference and increases in the number of sit-ups and push-ups per minute. Students in HLA learned valuable lessons about the dangers of obesity and importance of healthy lifestyles. Lessons included taking responsibility for one's own health, fitness and safety; motivation and goal setting; risks of obesity; stress management; fast food; and food portions. Staff expanded recruitment to five area schools in an effort to reach enrollment numbers. The impact was broad in that HLA reached students at five area schools. Many students planned to take health messages back to their schools to teach other students as part of their required community service project. In addition to educating youth about fitness and healthy eating, HLA staff shared key health messages with the students' families via several Family Day events. A total of 142 families attended Family Day events. The director of community relations for the Baltimore Ravens acted as an Advisory Board member and arranged for a Ravens player to appear at one of the Family Days and talk to the audience about importance of good nutrition and a healthy lifestyle. Students prepared readings and poems about key health messages they had learned in order to teach their families about healthy lifestyles, and they demonstrated yoga to show families some of the new physical skills they were learning. Families received a written health profile for their child with fitness and body composition measures. Staff distributed referral information for pediatric weight management programs at MWPH to families whose child needed obesity services beyond HLA. This information allowed families of children overweight or obese to secure services to improve their health. Family Day events were successful in extending key health messages into the community. HLA successfully impacted 142 families by providing them with the tools and resources to spread health messages to their communities and con Affiliated Health Care System Roles Schedule H, Part VI, Line 6 In 2006, in an unprecedented collaboration, Maryland's leading academic medical systems - the University of Maryland Medical System (UMMS) and Johns Hopkins Health System (Hopkins) - agreed to share equal interests in MWPH. While MWPH remains financially self-sufficient, the presence of UMMS and Hopkins medical experts and other resources at MWPH has created a synergy that has enabled the hospital to strengthen its position as a leader in pediatric specialty care and serve many of the youngest, most vulnerable members of our community. A physician's leadership group meets regularly with the medical director of MWPH, as well as, the CEO. Reports are presented from this leadership group to the board of trustees and are fundamental in determining the needs of our community on a regional and national level. With a staff of nearly 500, MWPH is firmly committed to its mission of improving the health and well-being of our regions children. Mt. Washington Pediatric Hospital 2 Schedule H, Part V, Section B, 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. 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 239101 0 82915 0 2204 0 179924 0 15551 0 519695 0 SHARON KELLY 159918 0 13000 0 1858 0 0 0 13924 0 188700 0 THOMAS ELLIS 126164 0 17570 0 1045 0 52762 0 21853 0 219394 0 BARINADA GIADOM 205025 0 0 0 0 0 13692 0 21801 0 240518 0 KATHERINE ALTER MD 227564 0 0 0 913 0 17021 0 21087 0 266585 0 ROBERT BLAKE 210965 0 0 0 279 0 2256 0 9686 0 223186 0 PATRICIA QUIGLEY MD 186118 0 0 0 368 0 14521 0 14996 0 216003 0 STEPHEN NICHOLS MD 201273 0 0 0 175 0 13911 0 21902 0 237261 0 Mary Miller 127024 0 20000 0 369 0 29201 0 21833 0 198427 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 0 7585000 0 0 0 0 0 0 0 0 0 1985 false false true true A false false false false 0.00000 0.00000 0.00000 true false false true A false false false true true false 0 false 0 false false A false SCHEDULE K, PART III, LINE 9, PART IV, LINE 9 AND PART V 0 THE ORGANIZATION IS IN THE PROCESS OF ESTABLISHING WRITTEN PROCEDURES, TO BE EFFECTIVE BY THE END OF THE FISCAL YEAR JUNE 30, 2014, TO ENSURE THE FOLLOWING: 1) ALL NONQUALIFIED BONDS OF THE ISSUE ARE REMEDIATED IN ACCORDANCE WITH THE REQUIREMENTS UNDER REGULATIONS SECTIONS 1.141-12 AND 1.145-2; 2) VIOLATIONS OF FEDERAL TAX REQUIREMENTS ARE TIMELY IDENTIFIED AND CORRECTED THROUGH THE VOLUNTARY CLOSING AGREEMENT PROGRAM IF SELF-REMEDIATION IS NOT AVAILABLE UNDER APPLICABLE REGULATION; AND 3.) ENSURE COMPLIANCE BY MONITORING THE REQUIREMENT OF SECTION 148. 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. 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, University Specialty Hospital 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, University Specialty Hospital 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 Change in Funded Status of Defined Benefit Plan 548,729 Change in Economic Interest- MWPF Unrestricted 759,605 Net Assets Released for purchase of equipment 1,372,801 ------------ Restricted: Change in Economic Interest- MWPF Restricted 436,526 Net Assets Released for Operations (516,776) Net Assets Released for purchase of equipment (1,372,801) ------------ TOTAL CHANGE TO NET ASSETS 1,228,084 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 Mt Washington Pediatric Foundation c 849587 FMV