2013-11-15T20:06:00-06:00 2012-12-31 420714325 MCGLADREY LLP ONE SOUTH WAKER DRIVE SUITE 800 CHICAGO IL 60606 990 2012-01-01 521682858 FORT WASHINGTON MEDICAL CENTER INC FORT 3012927000 11711 LIVINGSTON ROAD FORT WASHINGTON MD 20744 JOSEPH B TUCKER 3012927000 2013-11-15 1 WAYNE L HARDER P00294296 3126343400 2012 2016-03-07 17:11:31Z VERNA MEACHAM 174 WATERFRONT STREET SUITE 225 NATIONAL HARBOR MD 20745 42007460 0 X WWW.FORTWASHINGTONMC.ORG X 1989 MD TO ENSURE HIGH QUALITY, COMPASSIONATE AND RESPONSIVE HEALTH CARE SERVICES DEDICATED TO ADVANCING THE HEALTH OF OUR COMMUNITY CUSTOMERS. 14 13 483 13 0 0 66204 89747 42582142 40240581 -89587 808 455549 1653100 43014308 41984236 0 0 0 0 21675517 22956297 0 0 157863 20363788 17925940 42039305 40882237 975003 1101999 20580978 21750077 18662303 18729403 1918675 3020674 TO ENSURE HIGH QUALITY, COMPASSIONATE AND RESPONSIVE HEALTH CARE SERVICES DEDICATED TO ADVANCING THE HEALTH OF OUR COMMUNITY CUSTOMERS. 0 0 29593635 40320975 DURING REPORTING YEAR 2012, FORT WASHINGTON MEDICAL CENTER (FWMC) PROVIDED BENEFITS TO THE COMMUNITY THAT INCLUDED CHARITY CARE, TEACHING-PRECEPTOR OPPORTUNITIES, HEALTH SCREENINGS, COMMUNITY HEALTH EDUCATION, COMMUNITY SPONSORSHIP OPPORTUNITIES, AND COMMUNITY ENGAGEMENT ACTIVITIES.SEE SCHEDULE H. 29593635 1 0 0 1 0 0 0 0 0 0 1 0 0 1 1 1 1 0 0 0 0 0 0 0 0 0 1 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 1 48 0 1 483 1 0 0 0 0 0 0 0 0 0 0 X 14 13 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 MD X THERESA PITTMAN 3016861523 174 WATERFRONT STREET SUITE 225 NATIONAL HARBOR MD 20745 BEVERLY ANDERSON PH D 0.70 0.70 X 0 0 0 SAMIR AZER MD 0.70 0.70 X 0 0 0 VIMLA BHOOSHAN MD 40.70 0.70 X 608208 0 0 CHARLES E DAY SR 0.70 0.70 X 0 0 0 ELIAS DEBBAS MD 0.70 0.70 X 0 0 0 MONICA HOLMAN EVANS ESQ 0.70 0.70 X 0 0 0 REGINALD A JONES 0.70 0.70 X X 0 0 0 YVONNE S MAGEE PHD 0.70 0.70 X X 0 0 0 VIRGIL C MCDONALD 0.70 0.70 X 0 0 0 HENRY W MOSLEY 0.70 0.70 X 0 0 0 KIMBERLY ROBERTSON PANNELL 0.70 0.70 X X 0 0 0 JOHN A PETTY 0.70 0.70 X X 0 0 0 MANERVIA W RIDDICK 0.70 0.70 X X 0 0 0 VERNA S MEACHAM 40.00 16.00 X X 251285 0 18934 JOSEPH B TUCKER 40.00 16.00 X 177071 0 8094 MARJORIE QUINT-BOUZID 40.00 X 152833 0 18099 SOCORRO OBEDOZA 40.00 X 127655 0 5050 BEVERLY L ARCIAGA 40.00 X 140748 0 10754 FREDERICK L ASHBY 40.00 X 130489 0 27748 HOWARD L ROBINSON 40.00 X 123215 0 13863 GILBERT J MAGTIBAY 40.00 X 129255 0 0 1840759 0 102542 19 0 1 0 VIMLA BHOOSHAN 9739 AVENSEL FARM DR POTOMAC MD 20854 PHYSICIAN 608208 QUEST DIAGNOSTICS 14225 NEW BROOK DR CHANTILLY VA 20153 LAB 419585 CPSI 6600 WALL STREET MOBILE AL 36695 COMPUTER SERVICES 373180 ALPHA SECURITY 12805 OLD FORT RD SUITE 302 FORT WASHINGTON MD 20744 SECURITY 369202 COHEN RUTHERFORD & KNIGHT PC 6903 ROCKLEDGE DRIVE STE 500 BETHESDA MD 20817 ACCOUNTING/CONSULTING 273865 10 89747 89747 PATIENT SERVICES 621400 40205041 40205041 DIETARY SERVICES 900099 35540 35540 40240581 808 808 66744 23224 43520 43520 43520 MEDICARE INCENTIVE PAY 900099 1195000 1195000 REPORT AND RECORD FEES 900099 32504 32504 382076 4370 377706 1609580 41984236 40320975 0 1573514 1230789 779140 451649 18275453 14987224 3155065 133164 4945 -563 5508 2079743 1274688 797892 7163 1365367 1111800 244213 9354 69324 69324 91950 91950 5898774 3267302 2631002 470 14999 14579 420 1072138 619945 450959 1234 915285 28344 886941 37927 2657 35270 22648 8437 13001 1210 597468 597468 791247 791247 944924 205905 739019 MEDICAL SUPPLIES 4698131 4693940 4191 BAD DEBT 2099182 2099182 671943 515634 151461 4848 40882237 29593635 11130739 157863 1718087 2011937 46000 46000 6354135 6743932 1032530 964235 767525 762384 24368870 17568111 6683429 6800759 3979272 4420830 20580978 21750077 7298577 7854760 9534993 9215044 407902 450369 1420831 1209230 18662303 18729403 X 1811675 2913674 107000 107000 1918675 3020674 20580978 21750077 1101999 0 X 0 1 X 1 1 1 X 0 0 0 0 0 0 0 0 1 11729 11729 0 EXPLANATION OF LOBBYING ACTIVITIES: PART II-B, LINE 1: DUES PAID TO MARYLAND HOSPITAL ASSOCIATION RELATING TO LOBBYING ACTIVITIES. 122528 122528 8873194 6415745 2457449 751841 524091 227750 12474407 10628275 1846132 2146900 2146900 6800759 DUE FROM AFFILIATES 1475017 MISCELLANEOUS ACCOUNTS RECEIVABLE 146838 ASSETS LIMITED AS TO USE 1346983 DEPOSITS 62015 DEFERRED FINANCING COSTS 1389977 4420830 ADVANCES FROM THIRD PARTY PAYEE 845952 CAPITAL LEASE 363278 1209230 X 42007460 23224 23224 41984236 0 41984236 40905461 23224 23224 40882237 0 40882237 DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X, LINE 2: THE HOSPITAL HAS ADOPTED THE ACCOUNTING STANDARD ON ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES, WHICH ADDRESSES THE DETERMINATION OF WHETHER TAX BENEFITS CLAIMED OR EXPECTED TO BE CLAIMED ON A TAX RETURN SHOULD BE RECORDED IN THE FINANCIAL STATEMENTS. UNDER THIS POLICY, THE HOSPITAL MAY RECOGNIZE THE TAX BENEFIT FROM AN UNCERTAIN TAX POSITION ONLY IF IT IS MORE-LIKELY-THAN-NOT THAT THE TAX POSITION WOULD BE SUSTAINED ON EXAMINATION BY TAXING AUTHORITIES, BASED ON THE TECHNICAL MERITS OF THE POSITION. MANAGEMENT HAS EVALUATED THE HOSPITAL'S TAX POSITIONS AND HAS CONCLUDED THAT THE HOSPITAL HAS TAKEN NO UNCERTAIN TAX POSITIONS THAT REQUIRE ADJUSTMENT TO THE FINANCIAL STATEMENTS TO COMPLY WITH PROVISIONS OF THIS GUIDANCE. THE HOSPITAL IS NO LONGER SUBJECT TO INCOME TAX EXAMINATIONS FOR THE U.S. FEDERAL, STATE OR LOCAL TAX AUTHORITIES FOR YEARS BEFORE DECEMBER 31, 2009. PART XI, LINE 2D - OTHER ADJUSTMENTS: RENTAL EXPENSES NETTED WITH REVENUE 23,224. PART XII, LINE 2D - OTHER ADJUSTMENTS: RENTAL EXPENSES NETTED WITH REVENUE 23,224. 1 1 1 X 1 X 1 1 0 1 1 1181356 556376 624980 0.01530 6650339 5624577 1025762 0.02510 7831695 6180953 1650742 0.04040 127146 127146 0.00310 355415 15000 340415 0.00830 482561 15000 467561 0.01140 8314256 6195953 2118303 0.05180 0 3334879 1181356 12017918 9614334 2403584 X 1 1 1 1 FORT WASHINGTON MEDICAL CENTER INC

11711 LIVINGSTON ROAD FORT WASHINGTON MD 20744

X X X FORT WASHINGTON MEDICAL CENTER INC 1 1 1 200.000000000000 1 400.000000000000 1 X X X X X X 1 1 X X X X 1 0 1 X 0 0 PART I, LINE 6A: THE COMMUNITY BENEFIT REPORT FOR FORT WASHINGTON MEDICAL CENTER IS FILED ANNUALLY WITH THE MARYLAND HEALTH SERVICES COST REVIEW COMMISSION WHICH ALLOWS FOR PUBLIC ACCESS TO INFORMATION FILED. PART I, 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. PART I, LINE 7B, COLUMNS B, C, D, AND 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 INCLUDING 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. THE EXCEPTION TO THIS IS THE IMPACT ON THE HOSPITAL OF ITS SHARE OF THE MEDICAID ASSESSMENT. IN RECENT YEARS, THE STATE OF MARYLAND HAS CLOSED FISCAL GAPS IN THE STATE MEDICAID BUDGET BY ASSESSING HOSPITALS THROUGH THE RATE SETTING SYSTEM. THE HOSPITAL PORTION OF THE MEDICAID ASSESSMENT FOR FORT WASHINGTON MEDICAL CENTER WAS $178,372 IN 2012. PART I, LINE 7F, COLUMNS C AND 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. PART I, LINE 7F: BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN. PART II: THE HOSPITAL ROUTINELY PARTICIPATES IN COMMUNITY HEALTH FAIRS PROVIDING EDUCATION AND BLOOD PRESSURE SCREENINGS AT VARIOUS LOCATIONS THROUGHOUT THE SERVICE AREA. CLASSES ARE ALSO HELD TO EDUCATE THE COMMUNITY ON DIABETES, HEART DISEASE AND SMOKING CESSATION. PART III, LINE 4: PATIENT ACCOUNTS RECEIVABLE ARISE FROM HEALTH CARE SERVICES PROVIDED PRIMARILY TO RESIDENTS OF MARYLAND. THE PRINCIPAL PAYERS FOR THESE SERVICES ARE THE PATIENTS, INSURANCE COMPANIES (INCLUDING CAREFIRST) AND MEDICARE AND CERTAIN MEDICAID PROGRAMS. ACCOUNTS RECEIVABLE ARE REDUCED BY AN ALLOWANCE FOR DOUBTFUL ACCOUNTS. IN EVALUATING THE COLLECTABILITY OF ACCOUNTS RECEIVABLE, THE HOSPITAL ANALYZES ITS PAST HISTORY AND IDENTIFIES TRENDS FOR EACH OF ITS MAJOR PAYOR SOURCES OF REVENUE TO ESTIMATE THE APPROPRIATE ALLOWANCE FOR DOUBTFUL ACCOUNTS AND PROVISION FOR BAD DEBTS. MANAGEMENT REGULARLY REVIEWS DATA ABOUT THESE MAJOR PAYOR SOURCES OF REVENUE IN EVALUATING THE SUFFICIENCY OF THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. FOR RECEIVABLES ASSOCIATED WITH SERVICES PROVIDED TO PATIENTS WHO HAVE THIRD-PARTY COVERAGE, THE HOSPITAL ANALYZES CONTRACTUALLY DUE AMOUNTS AND PROVIDES AN ALLOWANCE FOR DOUBTFUL ACCOUNTS AND A PROVISION FOR BAD DEBTS, IF NECESSARY (FOR EXAMPLE, FOR EXPECTED UNCOLLECTIBLE DEDUCTIBLES AND COPAYMENTS ON ACCOUNTSFOR WHICH THE THIRD-PARTY PAYOR HAS NOT YET PAID, OR FOR PAYORS WHO ARE KNOWN TO BE HAVING FINANCIAL DIFFICULTIES THAT MAKE THE REALIZATION OF AMOUNTS DUE UNLIKELY). FOR RECEIVABLES ASSOCIATED WITH SELF-PAY PATIENTS (WHICH INCLUDES BOTH PATIENTS WITHOUT INSURANCE AND PATIENTS WITH DEDUCTIBLE AND COPAYMENT BALANCES DUE FOR WHICH THIRD-PARTY COVERAGE EXISTS FOR PART OF THE BILL), THE HOSPITAL RECORDS A SIGNIFICANT PROVISION FOR BAD DEBTS IN THE PERIOD OF SERVICE ON THE BASIS OF ITS PAST EXPERIENCE, WHICH INDICATES THAT MANY PATIENTS ARE UNABLE OR UNWILLING TO PAY THE PORTION OF THEIR BILL FOR WHICH THEY ARE FINANCIALLY RESPONSIBLE. THE DIFFERENCE BETWEEN THE STANDARD RATES AND THE AMOUNTS ACTUALLY COLLECTED AFTER ALL REASONABLE COLLECTION EFFORTS HAVE BEEN EXHAUSTED IS CHARGED OFF AGAINST THE ALLOWANCE FOR DOUBTFUL ACCOUNTS.THE HOSPITAL GRANTS CREDIT TO PATIENTS, SUBSTANTIALLY ALL OF WHOM ARE LOCAL RESIDENTS. THE HOSPITAL GENERALLY DOES NOT REQUIRE COLLATERAL OR OTHER SECURITY IN EXTENDING CREDIT; HOWEVER, IT ROUTINELY OBTAINS ASSIGNMENT OF (OR IS OTHERWISE ENTITLED TO RECEIVE) PATIENTS' BENEFITS RECEIVABLE UNDER THEIR HEALTH INSURANCE PROGRAMS, PLANS, OR POLICIES.THE MARYLAND HEALTH SERVICES COST REVIEW COMMISSION (HSCRC) REGULATES THE HOSPITAL'S RATES FOR ALL OF ITS INPATIENT AND OUTPATIENT SERVICES. AS PART OF THE REGULATORY PROCESS, THE HSCRC APPROVES UNIT RATES AND CHARGES PER CASE AMOUNTS, AND THE HOSPITAL IS REQUIRED TO CHARGE WITHIN CERTAIN LIMITS RELATED TO THESE APPROVED AMOUNTS. THE HSCRC CHARGE PER CASE METHODOLOGY RECOGNIZES CASE MIX CHANGES. ANNUAL COMPLIANCE PERIODS BEGIN ON JULY 1 AND END ON JUNE 30. VARIANCES (OVERCHARGES AND UNDERCHARGES), AS WELL AS PENALTIES AND INTEREST INCURRED, DURING A RATE YEAR ARE GENERALLY ACCOUNTED FOR IN THE FOLLOWING RATE YEAR'S APPROVED UNIT RATES AND CHARGE PER CASE. THE HOSPITAL RECEIVED A 2.01% UNIT RATE AND CHARGE PER CASE INCREASE EFFECTIVE JULY 1, 2011. THIS 2.01% INCLUDED RECONCILIATION OF VARIANCES FOR THE COMPLIANCE PERIOD ENDED DECEMBER 31, 2011. THE HOSPITAL RECEIVED A 1.03% UNIT RATE AND CHARGE PER CASE INCREASE EFFECTIVE JULY 1, 2012. THIS 1.03% INCLUDED RECONCILIATION OF VARIANCES FOR THE COMPLIANCE PERIOD ENDED DECEMBER 31, 2012. PART III, LINE 8: A COST-TO-CHARGE METHODOLOGY WAS USED TO DETERMINE MEDICARE ALLOWABLE COSTS. PART III, LINE 9B: ONCE THE COLLECTION PROCESS HAS BEGUN, THE ORGANIZATION CONTINUES TO MONITOR WHETHER THE PATIENT QUALIFIES FOR CHARITY CARE UNDER THE FINANCIAL ASSISTANCE POLICY. IF THE ORGANIZATION DETERMINES THAT A PATIENT QUALIFIES FOR FINANCIAL ASSISTANCE, INCLUDING ONCE THE COLLECTION PROCESS HAS BEGUN, THE ORGANIZATION WILL APPROVE THE PATIENT FOR CHARITY CARE. ONCE CHARITY CARE HAS BEEN APPROVED, THERE IS NO FURTHER ATTEMPT MADE BY THE ORGANIZATION TO COLLECT. FORT WASHINGTON MEDICAL CENTER, INC. PART V, SECTION B, LINE 20D: 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. PART VI, LINE 2: FORT WASHINGTON MEDICAL CENTER IS FOCUSING ITS EFFORTS ON MEETING THE REQUIREMENT TO CONDUCT A COMMUNITY HEALTH NEEDS ASSESSMENT BY 2013. WE HAVE INITIATED DISCUSSIONS WITH A CONSULTING FIRM TO ASSIST THE ORGANIZATION IN GAINING THE BREADTH AND DEPTH OF THE HEALTH CARE NEEDS OF THE COMMUNITIES WE SERVE.IN THE INTERIM, FWMC, CONTINUES TO USE MULTIPLE MECHANISMS TO GUAGE THE PULSE OF THE POPULATION'S HEALTH USING OUR OWN INTERNAL DATA BY ASSESSING OUR PATIENTS' TOP PRESENTING CONDITIONS; ENGAGING MEDICAL STAFF REGARDING NEEDED SERVICES; AND EVALUATING AND TRACKING REASONS FOR TRANSFERS FROM OUR FACILITY.IN ADDITION, WE ARE ACTIVELY INVOLVED WITH THE PRINCE GEORGE'S COUNTY HEALTHCARE ACTION COALITION (PGHAC) DEVELOPED BY THE MARYLAND DEPARTMENT OF HEALTH AND MENTAL HYGIENE TO ASSIST IN MAKING MARYLAND HEALTHIER. PGHAC'S MISSION IS TO IMPROVE THE HEALTH OF THE RESIDENTS OF PRINCE GEORGE'S COUNTY BY INCREASING ACCESS TO CARE, PROMOTING COLLABORATION AMONG HEALTH CARE PROVIDERS AND KEY STAKEHOLDERS, AND INTEGRATING AND COORDINATING PATIENT CARE TO REDUCE DUPLICATION OF AND ENHANCE SEAMLESS HEALTH SERVICE DELIVERY. FWMC IS INVOLVED WITH THE "ACCESS TO CARE" WORK GROUP WITH A FOCUS ON ENSURING RESIDENTS RECEIVE NEEDED HEALTH CARE, PARTICULARLY LOW INCOME, UNINSURED/UNDERINSURED ADULTS AND CHILDREN. THE ORGANIZATION HAS BEEN INVOLVED FROM THE BEGINNING OF THE INITIATIVE WORKING WITH PUBLIC HEALTH EXPERTS, AGENCIES, HOSPITAL PERSONNEL AND COMMUNITY ORGANIZATIONS TO LAY A FOUNDATION FOR ADDRESSING THIS ISSUE AND ESTABLISHING WAYS TO PROMOTE AND COMMUNICATE THE INITIATIVE AND MONITOR AND MEASURE ITS OVERALL EFFECTIVENESS.TO GAIN MORE INSIGHT INTO THE HEALTH OF THE COUNTY, IN OCTOBER 2011, THE ORGANIZATION INVITED PRINCE GEORGE'S COUNTY ACTING HEALTH OFFICER PAMELA CREEKMUR TO A PUBLIC ANNUAL MEETING TO DISCUSS THE COUNTY'S HEALTH IMPROVEMENT PLAN - ITS BLUEPRINT FOR A HEALTHIER COUNTY TO LEARN MORE ABOUT THE COUNTY'S 10 HEALTH PRIORITIES, AND HOW WE CAN WORK COLLABORATIVELY. WE HELD A ROUNDTABLE AFTER THE DISCUSSION WITH COMMUNITY FEEDBACK TO GAIN FURTHER INSIGHT ON THE ISSUES PRESENTED AND DETERMINED THAT UNINSURED AND WELLNESS PREVENTION WAS A LEADING AREA OF CONCERN. PARTICIPANTS NOTED THE AVAILABLE HEALTH SERVICES FOR THE UNINSURED AND THE LACK OF SUFFICIENT PRIMARY CARE PROVIDERS (ACCESS TO CARE), WHICH LED TO THE PGHAC INITIATIVE WE ARE INVOLVED IN TODAY. IN ADDITION, WE REVIEW STUDIES, SUCH AS THE 2009 RAND REPORT, A COMPREHENSIVE STUDY SPONSORED BY THE PRINCE GEORGE'S COUNTY COUNCIL REGARDING THE HEALTH NEEDS OF RESIDENTS WITHIN THE COUNTY AND THE CAPACITY FOR THE COUNTY'S HEALTH CARE SYSTEM TO RESPOND ACCORDINGLY. WE ALSO ENGAGE OUR FWMC COMMUNITY ADVISORY COUNCIL, WHICH CONSISTS OF CLERGY, EDUCATORS, GOVERNMENT REPRESENTATIVES AND OTHER PROFESSIONALS TO GAIN COMMUNITY FEEDBACK ON HOSPITAL GOALS, OBJECTIVES AND THE COMMUNITIIES' NEEDS. PART VI, LINE 3: FORT WASHINGTON MEDICAL CENTER COMMUNICATES THE AVAILABILITY OF FINANCIAL ASSISTANCE ON THE HOSPITAL WEBSITE AND IN HOSPITAL PUBLICATIONS. FINANCIAL ASSISTANCE PROGRAM NOTICES ARE POSTED FOR PUBLIC VIEW IN THE ADMITTING AREA, REGISTRATION AREA, PATIENT ACCOUNTS OFFICE, THE EMERGENCY DEPARTMENT AND ADMINISTRATION. FURTHERMORE, A COPY OF THE FINANCIAL ASSISTANCE POLICY IS PROVIDED TO PATIENTS OR THEIR FAMILIES AS PART OF THE ADMISSION PROCESS. ALSO, ONCE THE PATIENT IS DISCHARGED, EACH BILLING STATEMENT CONTAINS A SUMMARY OF THE FINANCIAL ASSISTANCE POLICY. STAFF HAS BEEN TRAINED TO ASSIST PATIENTS WHO WISH TO UTILIZE THE FINANCIAL ASSISTANCE PROGRAM BY REFERRING THEM TO FINANCIAL COUNSELORS THAT HELP THE PATIENTS TO COMPLETE THE FINANCIAL ASSISTANCE APPLICATIONS. PART VI, LINE 4: FORT WASHINGTON, OXON HILL AND TEMPLE HILLS COMPRISE FORT WASHINGTON MEDICAL CENTER'S COMMUNITY BASED SERVICE AREA (CBSA) AND ARE LOCATED IN PRINCE GEORGE'S COUNTY. THE SUBURBAN CITIES ARE WITHIN A SHORT DISTANCE FROM THE WASHINGTON, D.C./MARYLAND LINE. FORT WASHINGTON ENCOMPASSES A 14-SQUARE MILE RADIUS. ACCORDING TO CLARITAS.COM, IT HAS A POPULATION OF 50,463 PEOPLE. THE RACIAL DYNAMIC OF FORT WASHINGTON IS PRIMARILY AFRICAN-AMERICAN WITH 75.5% RESIDENTS; 14.6% WHITE RESIDENTS; 6.4% ASIAN, AND THE REMAINDER OF OTHER RACES ARE, NATIVE HAWAIIAN, AMERICAN INDIAN, AND PACIFIC ISLANDER. THE MEDIAN FORT WASHINGTON HOUSEHOLD INCOME IS $87,600.SURROUNDING PORTIONS OF FORT WASHINGTON IS 9-SQUARE MILES OF LAND IN OXON HILL, MARYLAND. IT EXTENDS ALONG THE 210 NORTH CORRIDORS AND ALONG SOUTHERN AVENUE, WHICH SEPARATES IT FROM WASHINGTON, D.C. ACCORDING TO THE CLARITAS.COM, ITS POPULATION IS 28,199 RESIDENTS. THE RACIAL MAKE-UP OF OXON HILL IS 84.6% AFRICAN-AMERICANS; 8.2% WHITE RESIDENTS AND 4.2% ASIAN RESIDENTS.THE MEDIAN OXON HILL HOUSEHOLD INCOME IS $52,300 AND THE AVERAGE AGE OF THE OXON HILL RESIDENT IS 35.4 YEARS.ANOTHER COMPONENT OF THE FWMC SERVICE AREA IS TEMPLE HILLS, WHICH IS 1.4 SQUARE MILES, AND IS WEST OF OXON HILL AND SOUTHEAST OF WASHINGTON, D.C. TEMPLE HILLS HAS A POPULATION OF 36,626 PEOPLE. AFRICAN-AMERICANS COMPRISE THE MAJORITY OF THE POPULATION WITH 85.4% RESIDENTS, 11.0% WHITE RESIDENTS AND 1.9% HISPANIC RESIDENTS. THERE IS A SMALL POPULATION OF NATIVE HAWAIIAN, AMERICAN INDIAN AND PACIFIC ISLANDERS. NEARLY 14% OF THE POPULATION IS CONSIDERED BELOW THE PROVERTY LINE.THE MEDIAN TEMPLE HILLS HOUSEHOLD INCOME IS $61,400 AND THE AVERAGE AGE OF THE TEMPLE HILLS RESIDENT IS 38.4 YEARS. PART VI, LINE 5: THE HOSPITAL HAS A BOARD THAT IS MADE UP OF MEMBERS OF THE COMMUNITY WHO SERVE AS THE OVERSIGHT BODY FOR THE ACTIVITIES OF THE HOSPITAL. SURPLUS HOSPITAL FUNDS ARE REINVESTED IN THE OPERATION TO SECURE REQUIRED REPLACEMENT EQUIPMENT AND BUILDING UPGRADES/REPAIRS. THE HOSPITAL EXTENDS MEDICAL STAFF PRIVILEDGES TO ALL QUALIFIED PHYSICIANS FOR ALL OF ITS DEPARTMENTS.FORT WASHINGTON MEDICAL CENTER ROUTINELY PARTICIPATES IN COMMUNITY HEALTHFAIRS, PROVIDING EDUCATION AND BLOOD PRESSURE SCREENINGS AT VARIOUSLOCATIONS THROUGH THE PATIENT SERVICE AREA. IN ADDITION, CLASSES ARE HELD TO EDUCATE THE COMMUNITY ON A NUMBER OF HEALTH ISSUES, INCLUDING:DIABETES, HEART DISEASE AND SMOKING CESSATION.FORT WASHINGTON MEDICAL CENTER HAS A BOARD OF DIRECTORS COMPRISEDPREDOMINANTLY FROM MEMBERS OF THE COMMUNITY WHO SERVE AS THE OVERSIGHTBODY FOR THE ACTIVITIES OF THE HOSPITAL. SURPLUS FUNDS ARE REINVESTED INTHE HOSPITAL TO PROVIDE REQUIRED REPLACEMENT EQUIPMENT AND BUILDINGUPGRADES/REPAIRS AS WELL AS TO CONTINUE TO PROVIDE COMMUNITY BENEFITACTIVITIES FOR THE COMMUNITY.IT IS BELIEVED THAT A SUBSTANTIAL NUMBER OF THE EMERGENCY ROOM CASES AT FWMC ARE LINKED TO DIABETES. IN AN EFFORT TO HELP PATIENTS BETTER MANAGE DIABETES, AND TO REDUCE THE INCIDENCE OF RECIDIVISM, PATIENTS NOW SEEN AT FWMC OR THROUGH THE EMERGENCY ROOM, OR IF HOSPITALIZED, ARE RECRUITED TO PARTICIPATE IN THE CLASSES.DURING THIS REPORTING YEAR, FWMC PROVIDED THE FOLLOWING PROGRAMMATICACTIVITIES RELATED TO COMMUNITY NEED:- CONDUCTED (2) 4-WEEK DIABETES MANAGEMENT SERIES HELD IN THE SPRING AND FALL.- PROVIDED A HEALTH EDUCATION PRESENTATION SPECIFICALLY ON HEART HEALTH FOCUSING ON HYPERTENSION, CONGESTIVE HEART FAILURE, AND LIFESTYLE ELEMENTS.- PROVIDED A HEALTH EDUCATION PRESENTATION ON RESPIRATORY AILMENTS, INCLUDING ASTHMA, EMPHYSEMA AND BRONCHITIS.- PROVIDED NEARLY 30 COMMUNITY-BASED EVENTS TO 450 PARTICIPANTS.- PARTNERED WITH CHURCHES, COMMUNITY AND SOCIAL GROUPS, SCHOOLS, AND SERVICE ORGANIZATIONS TO PROVIDE HEALTH EDUCATION AND SCREENINGS.- ESTABLISHED A FRAMEWORK TO HOLD COMMUNITY ENGAGEMENT ACTIVITIES.- WORKED WITH OTHER HEALTH CARE PROVIDERS, INCLUDING THE PRINCE GEORGE'S HEALTH DEPARTMENT, THE AMERICAN HEART ASSOCIATION, AND THE FWMC MEDICAL STAFF.- PROVIDED PROFESSIONAL HEALTH EDUCATION TO 108 PARTICIPANTS.EVALUATIONS ARE DONE ON PARTS OF THE PROGRAM, WHICH HAVE INCLUDED THE DIABETES AWARENESS PROGRAM, MAJOR COMMUNITY OFFERINGS AND SPECIAL MEETINGS. THE DIABETES PROGRAM AT FWMC HAS BEEN HIGHLY SUCCESSFUL. PARTICIPANTS THEMSELVES RATE THE PROGRAM HIGHLY, NOTING THE EXPERTISE OF THE INSTRUCTORS, THE DESIGN OF THE CLASS AND THE EASY ACCESS TO THE CLASS.HEALTH FAIRS AND SCREENING PROGRAMS ARE EVALUATED ON A CASE-BY-CASE BASIS TO ASCERTAIN COMMUNITY PARTICIPATION, SPONSOR FEEDBACK, CLINICAL FOLLOW-UP, EDUCATIONAL MATERIALS, COMMUNITY AWARENESS AND AFFIRMATION, AND GENERAL FEEDBACK.EVALUATION OF PRECEPTOR-SHIP PROGRAMS ARE BUILT IN AND ARE DONE ON A CONTINUAL BASIS. FORT WASHINGTON MEDICAL CENTER'S TEACHING - PRECEPTOR PROGRAM CONTINUES TO BE A MAJOR PORTION OF COMMUNITY BENEFIT. IN REPORTING YEAR 2011-2012, NURSING AND ALLIED TRAINING PRECEPTOROPPORTUNITIES HAVE CONTINUED AT FWMC. UNDER THE DIRECTION OF THE FWMC'S PERFORMANCE IMPROVEMENT DEPARTMENT, WHICH ADHERES TO THE STANDARD ESTABLISHED BY JCAHO, STUDENTS ARE REQUIRED TO MEET CERTAIN HOSPITAL STANDARDS. THE DEPARTMENT WORKS WITH THE NURSING AND ALLIED HEALTH SCHOOLS TO INSURE THAT THE STANDARDS ARE MET AND THAT THERE IS APPROPRIATE REPORTING, AS REQUIRED FROM ALL PARTICIPANTS. PART VI, LINE 6: THE NEXUS HEALTH CARE SYSTEM PROVIDES MEDICAL CARE TO COMMUNITIES IN PRINCE GEORGE'S COUNTY, MARYLAND AND WASHINGTON, D.C. THROUGH ITS OWNERSHIP IN FORT WASHINGTON MEDICAL CENTER AND CAROLYN BOONE LEWIS HEALTH CARE CENTER. CAROLYN BOONE LEWIS HEALTH CENTER IS A 183-BED TEACHING NURSING HOME LOCATED ON THE MARYLAND-WASHINGTON, D.C. LINE IN SOUTHEAST WASHINGTON D.C. IT PROVIDES SKILLED NURSING, REHABILITATION SERVICES, AND LONG-TERM CARE. FORT WASHINGTON MEDICAL CENTER IS A 37-BED HOSPITAL, CURRENTLY LICENSED FOR 31 BEDS. THE HOSPITAL UTILIZES 33 ACUTE CARE BEDS, WITH FOUR BEDS DESIGNATED FOR INTENSIVE CARE. THE HOSPITAL PROVIDES MEDICAL AND SURGICAL SERVICES, INCLUDING SPECIALTY SERVICES SUCH AS ENDOCRINOLOGY, PATHOLOGY AND HEMATOLOGY ON BOTH AN INPATIENT AND OUTPATIENT BASIS. ADDITIONALLY, THE HOSPITAL PROVIDES 24/7 EMERGENCY ROOM SERVICES. REPORTS FILED WITH STATES PART VI, LINE 7 MD X X X 0 0 0 0 0 0 0 0 0 VIMLA BHOOSHAN MD 608208 0 0 0 0 0 0 0 0 0 608208 0 0 0 VERNA S MEACHAM 251285 0 0 0 0 0 7648 0 11286 0 270219 0 0 0 JOSEPH B TUCKER 177071 0 0 0 0 0 5322 0 2772 0 185165 0 0 0 MARJORIE QUINT-BOUZID 152833 0 0 0 0 0 547 0 17552 0 170932 0 0 0 BEVERLY L ARCIAGA 140748 0 0 0 0 0 4323 0 6431 0 151502 0 0 0 FREDERICK L ASHBY 130489 0 0 0 0 0 4118 0 23630 0 158237 0 0 0 FORM 990, PART VI, SECTION B, LINE 11 UPON COMPLETION OF THE FORM 990 BY THE EXTERNAL ACCOUNTING FIRM, A REVIEW OF THE RETURN IS COMPLETED BY THE CORPORATE FINANCE DEPARTMENT AS WELL AS THE SENIOR VICE PRESIDENT FOR FINANCE AND THE PRESIDENT & CEO. THE 990 IS THEN REVIEWED BY THE AUDIT COMMITTEE OF THE BOARD OF TRUSTEES. THE FINAL VERSION OF THE DOCUMENTS ARE THEN MADE AVAILABLE TO ALL BOARD MEMBERS PRIOR TO FILING WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C IN CONNECTION WITH ACTUAL OR POSSIBLE CONFLICTS OF INTEREST, AN INTERESTED PERSON MUST DISCLOSE THE EXISTENCE OF AND NATURE OF HIS OR HER FINANCIAL INTEREST TO THE PRESIDENT, DIRECTORS AND/OR MEMBERS OF COMMITTEES WITH BOARD DELEGATED POWERS CONSIDERING THE PROPOSED TRANSACTION OR ARRANGEMENT. INTERESTED PERSONS ALSO SHOULD BE ALERT TO DISCLOSE ANY SITUATION THAT, BY VIRTUE OF A TRANSACTION OR ARRANGEMENT UNDER CONSIDERATION, COULD BE PERCEIVED BY ANYONE AS A CONFLICT OF INTEREST. A. DURING THE YEAR ALL INTERESTED PERSONS ARE OBLIGATED TO MONITOR THEIR OUTSIDE ACTIVITIES WITH REGARD TO ENTITIES THAT DO BUSINESS WITH NEXUS HEALTH, INC OR ITS SUBSIDIARIES. AT ANY TIME DURING THE YEAR, INTERESTED PERSONS MAY HAVE A CHANGE IN A FINANCIAL ARRANGEMENT OR ADDITION OF A NEW POTENTIAL CONFLICT OF INTEREST THAT MAY HAVE AN EFFECT ON BUSINESS. IT IS THE RESPONSIBILITY OF THE INDIVIDUAL TO REPORT THIS INFORMATION TO THE CHAIR PERSON OF THE BOARD OF TRUSTEES, PRESIDENT OR COMPLIANCE OFFICER. THE INDIVIDUAL WILL BE PROVIDED WITH THE APPROPRIATE DOCUMENTS TO REPORT THE POTENTIAL CONFLICT. B. ANNUAL REPORTING ON AN ANNUAL BASIS, EACH TRUSTEE, OFFICER, SENIOR MANAGER, DIRECTOR, MEMBER OF THE MEDICAL STAFF EXECUTIVE COMMITTEE, OR MEDICAL DIRECTOR, SHALL COMPLETE A CONFLICT OF INTEREST DISCLOSURE AND REVIEW THE CONFLICTS OF INTEREST POLICY. TRUSTEES SHOULD ALSO REVIEW THE CORPORATION BYLAWS. THE CONFLICT OF INTEREST DISCLOSURE AND POLICY WILL BE ISSUED TO EACH INTERESTED PERSON DURING THE MONTH OF NOVEMBER BY THE EXECUTIVE ASSISTANT TO THE CEO. ALL FORMS ARE TO BE RETURNED TO THE EXECUTIVE ASSISTANT TO THE CEO NO LATER THAN DECEMBER 31ST. MANAGEMENT OF CONFLICTS: IF AN INTERESTED PERSON HAS A POTENTIAL CONFLICT OF INTEREST, IT MUST BE DISCLOSED. THE INTERESTED PERSON INVOLVED IN THE CONFLICT MAY NOT PARTICIPATE IN ANY PROCESS LEADING TO THE APPROVAL OR DISAPPROVAL OF THE TRANSACTION CREATING THE CONFLICT, INCLUDING ANY VOTE OR OTHER SUBMISSION OF OPINION. IN ADDITION, THE INTERESTED PERSON MUST NOT INDIRECTLY ATTEMPT TO INFLUENCE THE DECISION-MAKING PROCESS. INTERESTED PERSONS WHO FAIL TO DISCLOSE POTENTIAL CONFLICTS OF INTEREST AND AVOID ANY DIRECT OR INDIRECT INFLUENCE IN ACCORDANCE WITH THIS POLICY SHALL BE APPROPRIATELY DISCIPLINED. VIOLATION OF THIS POLICY WILL SUBJECT THE INDIVIDUAL TO DISCIPLINARY ACTION INCLUDING POSSIBLE DISMISSAL AND MEMBERS OF THE BOARD OF TRUSTEES WILL BE SUBJECT TO REMOVAL. DISCIPLINE WILL BE COMMENSURATE WITH THE SERIOUSNESS OF THE ACTION. ALL REPORTS OF CONFLICTS OR POTENTIAL CONFLICTS OF INTEREST WILL BE REVIEWED BY THE CHAIRMAN OF THE BOARD OF TRUSTEES, PRESIDENT AND THE COMPLIANCE OFFICER. CONFLICT DISCLOSURES WILL ALSO BE REVIEWED BY LEGAL COUNSEL. THE CHAIRMAN, PRESIDENT, COMPLIANCE OFFICER, AND LEGAL COUNSEL WILL DETERMINE IF ANY ACTION MUST BE TAKEN TO PROTECT NEXUS HEALTH, INC. OR ITS AFFECTED AFFILIATES. A REPORT OF ALL CONFLICTS OF INTEREST SHALL BE SHARED WITH THE EXECUTIVE COMMITTEE OF THE BOARD OF TRUSTEES ANNUALLY. FORM 990, PART VI, SECTION B, LINE 15 EXECUTIVE COMPENSATION: PURPOSE: THE WAGE AND SALARY STRUCTURE GOVERNING EXECUTIVE COMPENSATION IS ESTABLISHED AND APPROVED BY THE BOARD OF DIRECTORS OF NEXUS HEALTH, INC. VIA THE EXECUTIVE COMPENSATION COMMITTEE IN CONSULTATION WITH THE CEO. PHILOSOPHY: THE INTENT OF THIS POLICY IS TO GUIDE THE EXECUTIVE COMPENSATION PRACTICES OF THE ORGANIZATION TO ASSURE A FAIR AND EQUITABLE, WELL-DEFINED PROCESS FOR DETERMINING COMPENSATION, AND TO PROVIDE A STANDARDIZED STRUCTURE FOR MANAGING THIS ISSUE. 1. COMPENSATION OF THE PRESIDENT AND CEO OF THE ORGANIZATION IS GOVERNED BY CONTRACT. THE COMPENSATION COMMITTEE USES AN INDEPENDENT STUDY AS PART OF THEIR PROCESS IN DETERMINING THE COMPENSATION OF THE CEO. 2. COMPENSATION FOR THE SENIOR EXECUTIVE STAFF IS ESTABLISHED AS FOLLOWS: THE HUMAN RESOURCES DEPARTMENT, OR AN EXTERNAL ORGANIZATION WILL DETERMINE THE CURRENT MARKET SALARY RANGES FOR EXECUTIVE LEVEL POSITIONS BY CONDUCTING PERIODIC SALARY SURVEYS. A RANGE SHALL BY ESTABLISHED FOR EACH EXECUTIVE POSITION. THIS SHALL BE PRESENTED TO THE BOARD THROUGH THE EXECUTIVE COMPENSATION COMMITTEE ON AN ANNUAL BASIS AT THE APRIL BOARD MEETING. 3. THE CEO HAS THE AUTHORITY TO SET EXECUTIVE COMPENSATION AND SALARY INCREASES WITHIN THE RANGES DETERMINED BY THE HR DEPARTMENT AND APPROVED BY THE BOARD. SENIOR EXECUTIVE STAFF IS DEFINED AS AN INDIVIDUAL WITH THE TITLE VICE PRESIDENT, CHIEF FINANCIAL OFFICER, SENIOR VICE PRESIDENT, OR CORPORATE DIRECTOR. 4. EXECUTIVES SHALL BE ENTITLED TO ALL BENEFITS BEYOND SALARY AS EXTENDED TO OTHER EMPLOYEES OF THE CORPORATION. THESE INCLUDE HEALTH AND MEDICAL BENEFITS, 403B MATCH FOR RETIREMENT SAVINGS, LIFE, SHORT AND LONG-TERM DISABILITY INSURANCES OR ANY OTHER BENEFITS THAT MAY BE OFFERED AT SOME FUTURE DATE. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. NEXUS HEALTH INC 174 WATERFRONT STREET SUITE 225 NATIONAL HARBOR MD 20745 520238460 PARENT ORGANIZATION MD 501(C)(3) 509(A)(2) N/A 0 CAROLYN BOONE LEWIS HEALTH CARE CENTER 1380 SOUTHERN AVE SE WASHINGTON DC 20032 521127260 NURSING HOME DC 501(C)(3) LINE 9 NEXUS HEALTH 0 NEXUS CONSULTING SERVICES INC 174 WATERFRONT STREET SUITE 225 NATIONAL HARBOR MD 20745 521602159 CURRENTLY INACTIVE DE N/A C 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0