2012-11-15T12:52:45-06:00 2011-12-31 420714325 MCGLADREY LLP ONE SOUTH WAKER DRIVE SUITE 800 CHICAGO IL 60606 990 2011-01-01 521127260 CAROLYN BOONE LEWIS HEALTH CARE CENTER CARO 2022795825 1380 SOUTHERN AVENUE SE WASHINGTON DC 20032 JOSEPH B TUCKER 2022795825 2012-11-15 1 WAYNE L HARDER P00294296 3126343400 2011 2016-02-24 21:20:13Z VERNA MEACHAM 1380 SOUTHERN AVENUE SE WASHINGTON DC 20032 15850715 0 X WWW.CBLHEALTH.ORG X 1978 DE CBL IS COMMITTED TO PROVIDING INNOVATIVE CARE TO RESIDENTS. OUR GOAL IS TO PROVIDE SERVICES THAT WILL ENHANCE OUR RESIDENTS' PHYSICAL AND MENTAL WELL-BEING, AS WELL AS THEIR SELF-WORTH. 14 13 280 0 0 0 22579 12987 15333879 15704025 83 113 128242 133590 15484783 15850715 0 0 0 0 7830443 7760098 0 0 0 8722590 8205808 16553033 15965906 -1068250 -115191 7449495 9555704 7412939 8472695 36556 1083009 X ADVANCE THE HEALTH AND WELLNESS OF INDIVIDUALS IN THE COMMUNITIES WE SERVE BY DELIVERING THE HIGHEST QUALITY, AND MOST COMPASSIONATE AND RESPONSIVE HEALTH CARE SERVICES. 0 0 12927189 15704025 NURSING HOME CARE CAROLYN BOONE LEWIS HEALTH CARE CENTER, INC. IS A LICENSED LONG-TERM CARE FACILITY, OPERATING 183 COMPREHENSIVE BEDS, OFFERING TRADITIONAL SKILLED NURSING SERVICES AS WELL AS NON-SKILLED SERVICES TO THE CITIZENS OF THE DISTRICT OF COLUMBIA, MARYLAND AND VIRGINIA AND THE SURROUNDING AREAS. THE ORGANIZATION'S GOAL IS TO PROVIDE A SAFE, COMFORTABLE ENVIRONMENT, WITH QUALITY SKILLED CARE FOR THOSE WHO NEED ITS SERVICES. SERVICES PROVIDED BY THE ORGANIZATION IN ADDITION TO THE SKILLED NURSING CARE ARE PHYSICAL THERAPY, SPEECH THERAPY, OCCUPATIONAL THERAPY, DENTAL CARE, PREVENTIVE CARE, DIAGNOSTIC TESTING AND RECREATIONAL THERAPY. IN 2011, THE FACILITY MAINTAINED AN AVERAGE OF 88% OCCUPANCY LEVEL, BASED ON ITS 183 BEDS REPRESENTING A TOTAL OF 58,981 RESIDENT DAYS AS OPPOSED TO THE PRIOR YEARS TOTAL RESIDENT DAYS OF 59,851. THE FACILITY RECOGNIZES THE NEEDS OF THE RESIDENTS AS A WHOLE, PHYSICALLY, MENTALLY AND EMOTIONALLY. AS THE FACILITY SERVES AS HOME TO THE RESIDENTS, COMPREHENSIVE SERVICES SUCH AS, DIETARY/MEALS, LAUNDRY AND HOUSEKEEPING ARE INCLUDED. THE ORGANIZATION'S PRIMARY ACCOMPLISHMENT HAS BEEN MEETING THE NEEDS OF ITS RESIDENTS THROUGH A CARING, RESPONSIVE, SKILLED, AND PASSIONATE TEAM OF DEDICATED AND QUALIFIED STAFF, WHO WORKED TO MAINTAIN THE HEALTH, DIGNITY AND INDEPENDENCE OF THE RESIDENTS LIVING IN THE FACILITY. 12927189 1 1 0 0 0 0 0 0 0 0 1 0 0 1 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 1 13 0 1 280 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 0 0 0 DC X THERESA PITTMAN 3016861523 174 WATERFRONT STREET SUITE 225 NATIONAL HARBOR MD 20745 X BEVERLY ANDERSON PH D 1.00 X X 0 0 0 SAMIR AZER MD 1.00 X 0 0 0 CHARLES E DAY SR 1.00 X 0 0 0 ELIAS G DEBBAS MD 1.00 X 0 0 0 LAURIE M DIPPOLD 1.00 X 0 0 0 MONICA HOLMAN EVANS ESQ 1.00 X X 0 0 0 REV ALTHEA J HAYWARD 1.00 X 0 0 0 REGINALD A JONES 1.00 X 0 0 0 YVONNE S MAGEE 1.00 X 0 0 0 VIRGIL C MCDONALD 1.00 X 0 0 0 JOHN A PETTY 1.00 X X 0 0 0 MANERVIA W RIDDICK 1.00 X X 0 0 0 KIMBERLY D ROBERTSON 1.00 X X 0 0 0 VERNA S MEACHAM 16.00 X X 0 260172 17680 HENRY W MOSLEY 1.00 X 0 0 0 JOSEPH B TUCKER 16.00 X 0 176127 7068 DENISE CHADWICK-WRIGHT 40.00 X 109343 0 16347 HAJA FORFANA 67.00 X 115746 0 0 EMMANUEL ADEPOJU 60.00 X 106542 0 0 331631 436299 41095 3 0 1 0 AEGIS THERAPIES INC PO BOX 8103 FORT SMITH AR 72902 PT, OT & SP THERAPY 969120 THI INC 7297 LEE HIGHWAYM 112 FALLS CHURCH VA 22012 HR-CONTRACT NURSES 754422 SODEXHO PO BOX 905374 CHARLOTTE NC 28290 DIETARY SERVICE 380951 REVEL ENTERPRISES INC 96 HARRY S TRUMAN DR STE 220-A LARGO MD 20744 SECURITY SERVICES 256126 TOTAL QUALITY 2610 BEECHMONT LANE SILVER SPRING MD 20906 MDS CONSULTANTS 151916 7 12987 12987 PATIENT REVENUE 621400 15704025 15704025 15704025 113 113 INTERCOMPANY 900099 120000 120000 MISCELLANEOUS 900099 8588 8588 BEAUTY SHOP 900099 5002 5002 133590 15850715 15704025 0 133703 6575741 5640090 935651 42809 27919 14890 650024 485734 164290 491524 423361 68163 80000 80000 51879 51879 3513047 3319532 193515 2233 2233 361568 275693 85875 429361 429361 1561 1333 228 215902 215902 378617 226189 152428 474950 259548 215402 TAXES 942722 942722 MED/SURG/NURSING SUPPLI 919716 897135 22581 PAYMENT TO AFFILIATE 356004 356004 478248 427933 50315 15965906 12927189 3038717 0 260772 1331397 2088047 2690019 24731 27145 437936 501327 5921273 2012750 4083443 3908523 126408 120088 428158 977205 7449495 9555704 2361803 2988474 66841 60110 3516454 3377950 1467841 2046161 7412939 8472695 X 36556 1083009 36556 1083009 7449495 9555704 X -115191 1161644 X 0 1 1 X 0 X 22579 12987 35566 13333002 13686084 14246093 15333879 15704025 72303083 13333002 13686084 14246093 15356458 15717012 72338649 0 0 0 72338649 3646 701 166 83 113 4709 3646 701 166 83 113 4709 137875 135720 309222 128242 133590 844649 13474523 13822505 14555481 15484783 15850715 73188007 0.98840 0.98790 0.00010 0.00020 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 800000 800000 2883746 997978 1885768 41059 207 40852 2196468 1014565 1181903 3908523 MISC A/R OTHER 6435 ESTIMATED SETTLEMENTS WITH 3RD-PARTY PAYERS 970770 977205 ACCRUED PAYROLL AND RELATED LIABILITIES 577110 OTHER CURRENT LIABILITIES 379354 DUE TO AFFILIATES 1089697 2046161 15850715 15965906 -115191 1161644 1161644 1046453 15850715 0 15850715 0 15850715 15965906 0 15965906 0 15965906 DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X: THE CENTER 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 CENTER 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 CENTER'S TAX POSITIONS AND HAS CONCLUDED THAT THE CENTER HAS TAKEN NO UNCERTAIN TAX POSITIONS THAT REQUIRE ADJUSTMENT TO THE FINANCIAL STATEMENTS TO COMPLY WITH PROVISIONS OF THIS GUIDANCE. THE CENTER IS NO LONGER SUBJECT TO INCOME TAX EXAMINATIONS FOR THE U.S. FEDERAL, STATE OR LOCAL TAX AUTHORITIES FOR YEARS BEFORE DECEMBER 31, 2008. PART XI, LINE 8 - OTHER ADJUSTMENTS: ADJUSTMENT TO BEGINNING OF YEAR NET ASSETS 1,161,644. 0 0 0 0 0 0 0 0 0 VERNA S MEACHAM 0 260172 0 0 0 0 0 7937 0 9743 0 277852 0 0 JOSEPH B TUCKER 0 176127 0 0 0 0 0 5293 0 1775 0 183195 0 0 PART I, LINE 3 THE ORGANIZATION'S CEO IS PAID BY A RELATED ORGANIZATION AND THE RELATED ORGANIZATION USES A INDEPENDENT COMPENSATION CONSULTANT, A COMPENSATION STUDY OR SURVEY AND APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE TO ESTABLISH THE COMPENSATION OF THE CEO. 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 AND APPROVED BY THE FINANCE 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. 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 GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST. BOARD OF DIRECTORS FORM 990, PART VII, SECTION A ALL DIRECTORS OF CBL ARE ALSO DIRECTORS OF FORT WASHINGTON MEDICAL CENTER, INC., A RELATED ORGANIZATION. EXCEPT FOR VERNA MEACHAM, THE DIRECTORS SPEND ONE AND A HALF HOURS PER WEEK WORKING WITH THE RELATED ORGANIZATION. VERNA MEACHAM SPENDS APPROXIMATELY 40 HOURS PER WEEK AT THE RELATED ORGANIZATION. JOSEPH TUCKER, CFO, ALSO SPENDS APPROXIMATELY 40 HOURS PER WEEK AT THE RELATED ORGANIZATION. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 5: ADJUSTMENT TO BEGINNING OF YEAR NET ASSETS 1,161,644. TOTAL TO FORM 990, PART XI, LINE 5: 1,161,644. 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 FORT WASHINGTON MEDICAL CENTER INC 11711 LIVINGSTON ROAD FORT WASHINGTON MD 20744 521682858 HOSPITAL MD 501(C)(3) LINE 3 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 1 1 1 0 0