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CAROLYN BOONE LEWIS HEALTH CARE CENTER INC: Form 990, tax year 2010

View the entire original 990 at ProPublica ↗

Organization
CAROLYN BOONE LEWIS HEALTH CARE CENTER INC (EIN 52-1127260)
Tax period
2010-01-01 to 2010-12-31
Filed
2011-06-30
IRS object ID
201101819349300615
Schema version
2010v3.2
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Timestamp2011-06-30T11:12:40-05:00Timestamp
Tax Period End Date2010-12-31TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1COHEN RUTHERFORD KNIGHT PCBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line16903 ROCKLEDGE DRIVE SUITE 500AddressLine1
CityBETHESDACity
StateMDState
ZIP Code208171800ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2010-01-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN521127260EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1CAROLYN BOONE LEWIS HEALTH CARE CENTERBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlCARONameControl
Phone2022795825Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line11380 SOUTHERN AVENUE SEAddressLine1
CityWASHINGTONCity
StateDCState
ZIP Code20032ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameJOSEPH B TUCKERName
TitleSENIOR VP/CFOTitle
Phone3016869010Phone
Date Signed2011-06-29DateSigned
Authorize Third PartytrueAuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
Phone3018281008Phone
FieldValueIRS element (for citing)
Tax Year2010TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonVERNA MEACHAMNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line11380 SOUTHERN AVENUE SEAddressLine1
CityWASHINGTONCity
StateDCState
ZIP Code20032ZIPCode
FieldValueIRS element (for citing)
Gross Receipts15484783GrossReceipts
Group Return For AffiliatesfalseGroupReturnForAffiliates
Organization501c3XOrganization501c3
Web Sitewww.cblhealth.orgWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1978YearFormation
State Legal DomicileDEStateLegalDomicile
Activity Or Mission DescriptionCBL IS COMMITTED TO BEING AN INNOVATIVE LONG-TERM CARE FACILITY, WHERE THE ENHANCEMENT OF EACH RESIDENT'S SELF WORTH, PHYSICAL AND MENTAL WELL-BEING IS MOST IMPORTANT.ActivityOrMissionDescription
Nbr Voting Members Governing Body12NbrVotingMembersGoverningBody
Nbr Independent Voting Members12NbrIndependentVotingMembers
Total Nbr Employees264TotalNbrEmployees
Total Nbr Volunteers0TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year0ContributionsGrantsPriorYear
Contributions Grants Current Year22579ContributionsGrantsCurrentYear
Program Service Revenue Prior Year14246093ProgramServiceRevenuePriorYear
Program Service Revenue CY15333879ProgramServiceRevenueCY
Investment Income Prior Year166InvestmentIncomePriorYear
Investment Income Current Year83InvestmentIncomeCurrentYear
Other Revenue Prior Year309222OtherRevenuePriorYear
Other Revenue Current Year128242OtherRevenueCurrentYear
Total Revenue Prior Year14555481TotalRevenuePriorYear
Total Revenue Current Year15484783TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year0GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year7323625SalariesEtcPriorYear
Salaries Etc Current Year7830443SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year6934266OtherExpensePriorYear
Other Expenses Current Year8722590OtherExpensesCurrentYear
Total Expenses Prior Year14257891TotalExpensesPriorYear
Total Expenses Current Year16553033TotalExpensesCurrentYear
Revenues Less Expenses Prior Year297590RevenuesLessExpensesPriorYear
Revenues Less Expenses CY-1068250RevenuesLessExpensesCY
Total Assets BOY7746893TotalAssetsBOY
Total Assets EOY7449495TotalAssetsEOY
Total Liabilities BOY6642087TotalLiabilitiesBOY
Total Liabilities EOY7412939TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY1104806NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY36556NetAssetsOrFundBalancesEOY
Mission DescriptionCAROLYN BOONE LEWIS HEALTH CARE CENTER (CBL) IS COMMITTED TO BEING AN INNOVATIVE LONG-TERM CARE FACILITY, WHERE THE ENHANCEMENT OF EACH RESIDENT'S SELF WORTH, PHYSICAL AND MENTAL WELL-BEING IS MOST IMPORTANT. WE ARE DEDICATED TO ADVANCING THE HEALTH, WELFARE AND WELLNESS OF INDIVIDUALS IN THE COMMUNITIES WE SERVE BY DELIVERING THE HIGHEST QUALITY, MOST COMPASSIONATE AND RESPONSIVE HEATLH CARE, IN A CARING AND HOMELIKE ENVIRONMENT.MissionDescription
Significant New Program ServicesfalseSignificantNewProgramServices
Significant ChangefalseSignificantChange
Expense14044994Expense
Revenue15462121Revenue
DescriptionNURSING HOME CARE CCAROLYN 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 2010, THE FACILITY MAINTAINED AN AVERAGE OF 90% OCCUPANCY LEVEL, BASED ON ITS 182 BEDS REPRESENTING A TOTAL OF 59,851 RESIDENT DAYS AS OPPOSED TO THE PRIOR YEARS TOTAL RESIDENT DAYS OF 56,982. THE FACILITY RECOGNIZED THE NEEDS OF THE RESIDENTS AS A WHOLE, PHYSICALLY, MENTALLY, AND EMOTIONALLY. AS TE 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, DIGNIFY AND INDEPENDENCE OF THE RESIDENTS LIVING IN THE FACILITY.Description
Total Program Service Expense14044994TotalProgramServiceExpense
Described In501 C3trueDescribedIn501C3
Schedule B RequiredtrueScheduleBRequired
Political ActivitiesfalsePoliticalActivities
Lobbying ActivitiesfalseLobbyingActivities
Donor Advised FundsfalseDonorAdvisedFunds
Conservation EasementsfalseConservationEasements
Collections Of ArtfalseCollectionsOfArt
Credit CounselingfalseCreditCounseling
Term Or Permanent EndowmentsfalseTermOrPermanentEndowments
Report Land Bldg EquiptrueReportLandBldgEquip
Report Invest Oth SecuritiesfalseReportInvestOthSecurities
Report Prog Rel InvestfalseReportProgRelInvest
Report Other AssetstrueReportOtherAssets
Report Other LiabilitiestrueReportOtherLiabilities
Report Fin48 FootnotefalseReportFin48Footnote
Independent Audit Financial StmttrueIndependentAuditFinancialStmt
Consolidated Audit Financial StmtfalseConsolidatedAuditFinancialStmt
SchoolfalseSchool
Foreign OfficefalseForeignOffice
Foreign ActivitiesfalseForeignActivities
More Than5000 K To OrganizationsfalseMoreThan5000KToOrganizations
More Than5000 K To IndividualsfalseMoreThan5000KToIndividuals
Professional FundraisingfalseProfessionalFundraising
Fundraising ActivitiesfalseFundraisingActivities
GamingfalseGaming
HospitalfalseHospital
Grants To OrganizationsfalseGrantsToOrganizations
Grants To IndividualsfalseGrantsToIndividuals
Schedule J RequiredtrueScheduleJRequired
Tax Exempt BondsfalseTaxExemptBonds
Excess Benefit TransactionfalseExcessBenefitTransaction
Prior Excess Benefit TransactionfalsePriorExcessBenefitTransaction
Loan To Officer Or DQPfalseLoanToOfficerOrDQP
Grant To Related PersonfalseGrantToRelatedPerson
Bsnss Rltnshp With OrganizationfalseBsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family MemberfalseBsnssRltnshpThruFamilyMember
Officer Entity With Bsnss RltnshpfalseOfficerEntityWithBsnssRltnshp
Deductible Non Cash ContributionsfalseDeductibleNonCashContributions
Deductible Contributions Of ArtfalseDeductibleContributionsOfArt
TerminatedfalseTerminated
Partial LiquidationfalsePartialLiquidation
Disregarded EntityfalseDisregardedEntity
Related EntitytrueRelatedEntity
Related Org Controlled EntityfalseRelatedOrgControlledEntity
Transaction Related EntityfalseTransactionRelatedEntity
Transfers To Exempt Non Chrtbl OrgfalseTransfersToExemptNonChrtblOrg
Activities Conducted PartnershipfalseActivitiesConductedPartnership
Schedule O RequiredtrueScheduleORequired
Number Forms Transmitted With10965NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup WitholdingtrueComplianceWithBackupWitholding
Number Of Employees264NumberOfEmployees
Employment Tax Returns FiledtrueEmploymentTaxReturnsFiled
Unrelated Business IncomefalseUnrelatedBusinessIncome
Foreign Financial AccountfalseForeignFinancialAccount
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTrans
Taxable Party NotificationfalseTaxablePartyNotification
Non Deductible ContributionsfalseNonDeductibleContributions
Quid Pro Quo ContributionsfalseQuidProQuoContributions
Form8282 Property Disposed OffalseForm8282PropertyDisposedOf
Funds To Pay PremiumsfalseFundsToPayPremiums
Premiums PaidfalsePremiumsPaid
Indoor Tanning ServicesfalseIndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members12NbrVotingGoverningBodyMembers
Number Independent Voting Members12NumberIndependentVotingMembers
Family Or Business RelationshipfalseFamilyOrBusinessRelationship
Delegation Of Management DutiesfalseDelegationOfManagementDuties
Changes To Organizing DocsfalseChangesToOrganizingDocs
Material Diversion Or MisusefalseMaterialDiversionOrMisuse
Members Or StockholdersfalseMembersOrStockholders
Election Of Board MembersfalseElectionOfBoardMembers
Decisions Subject To ApprovalfalseDecisionsSubjectToApproval
Minutes Of Governing BodytrueMinutesOfGoverningBody
Minutes Of CommitteestrueMinutesOfCommittees
Officer Mailing AddressfalseOfficerMailingAddress
Local ChaptersfalseLocalChapters
Form990 Provided To Governing BodytrueForm990ProvidedToGoverningBody
Conflict Of Interest PolicytrueConflictOfInterestPolicy
Annual Disclosure Covered PersonstrueAnnualDisclosureCoveredPersons
Regular Monitoring EnforcementtrueRegularMonitoringEnforcement
Whistleblower PolicytrueWhistleblowerPolicy
Document Retention PolicytrueDocumentRetentionPolicy
Compensation Process CEOtrueCompensationProcessCEO
Compensation Process OthertrueCompensationProcessOther
Investment In Joint VenturefalseInvestmentInJointVenture
States Where Copy Of Return Is FiledDCStatesWhereCopyOfReturnIsFiled
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonTHERESA PITTMANNamePerson
Telephone Number3016861523TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1174 WATERFRONT STREET STE 225AddressLine1
CityOXON HILLCity
StateMDState
ZIP Code20745ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (15 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationOfficerOfficerHighest Compensated EmployeeHighestCompensatedEmployee
SAMIR AZER
DIRECTOR1.0X000
CHARLES E DAY SR
DIRECTOR1.0X000
MONICA HOMAN EVANS ESQ
DIRECTOR1.0X000
REV ALTHEA J HAYWARD
DIRECTOR1.0X000
YVONNE S MAGEE
DIRECTOR1.0X000
JOHN A PETTY
EXECUTIVE SECRETARY1.0X000X
SUE F WARD
DIRECTOR1.0X000
KIMBERLY D ROBERTSON
TREASURER1.0X000X
MANERVIA W RIDDICK
CHAIR-ELECT1.0X000
VIRGIL C MCDONALD
IMMEDIATE PAST CHAIR1.0X000X
BEVERLY ANDERSON
CHAIR1.0X000X
VERNA S MEACHAM
PRESIDENT AND CEO16.0X022500021561X
REV DR NANCY LEE
DIRECTOR1.0X000
JOSEPH B TUCKER
SR VICE PRESIDENT, FINANCE/CFO16.001747728843X
SUNDAY JOLAOSO
LICENSED PRACTICAL NURSE40.012541300X
FieldValueIRS element (for citing)
Total Reportable Comp From Org125413TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs399772TotalReportableCompFrmRltdOrgs
Total Other Compensation30404TotalOtherCompensation
Number Individuals GT100 K1NumberIndividualsGT100K
Formers ListedfalseFormersListed
Total Comp GT150 KtrueTotalCompGT150K
Compensation From Other SourcesfalseCompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
SODEXHO
PO BOX 905374CHARLOTTENC28290DIETARY SERVICE CONT615306
AEGIS THERAPIES INC
PO BOX 8103FORT SMITHAR72902PT, OT AND SPEECH TH605414
REVEL ENTERPRISES INC
96 HARRY S TRUMAN DRIVE SUITE 220-LARGOMD20774SECURITY SERVICES252019
THI INC
7297 LEE HIGHWAY 12FALLS CHURCHVA22012HUMAN RESOURCES420014
EMS INCORPORATED
6240 OLD DOBBIN LANECOLUMBIAMD21045ENVIRONMENTAL SERVIC139851
FieldValueIRS element (for citing)
Number Of Contractors GT100 K6NumberOfContractorsGT100K
All Other Contributions22579AllOtherContributions
Total Contributions22579TotalContributions

Program Service Revenue ProgramServiceRevenue

FieldValueIRS element (for citing)
DescriptionPATIENT REVENUEDescription
Total Revenue Column15333879TotalRevenueColumn
Related Or Exempt Function Income15333879RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Program Service Revenue15333879TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column83TotalRevenueColumn
Exclusion$83ExclusionAmount

Income From Invest Bond Proceeds IncomeFromInvestBondProceeds

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Royalties Revenue RoyaltiesRevenue

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income From Gaming NetIncomeFromGaming

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income Or Loss NetIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Other Revenue Misc OtherRevenueMisc (3 entries)

DescriptionDescriptionTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
INTERCOMPANY120000120000
BEAUTY SHOP50825082
MISCELLANEOUS31603160
FieldValueIRS element (for citing)
Total Other Revenue128242TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column15484783TotalRevenueColumn
Related Or Exempt Function Income15462121RelatedOrExemptFunctionIncome
Exclusion$83ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total0Total
Program Services0ProgramServices

Grants To Domestic Individuals GrantsToDomesticIndividuals

FieldValueIRS element (for citing)
Total0Total
Program Services0ProgramServices

Foreign Grants ForeignGrants

FieldValueIRS element (for citing)
Total0Total
Program Services0ProgramServices

Benefits To Members BenefitsToMembers

FieldValueIRS element (for citing)
Total0Total
Program Services0ProgramServices

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total0Total
Fundraising0Fundraising

Comp Disqual Persons CompDisqualPersons

FieldValueIRS element (for citing)
Total0Total
Fundraising0Fundraising

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total6601872Total
Program Services5927171ProgramServices
Management And General674701ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total0Total
Fundraising0Fundraising

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total744760Total
Program Services545000ProgramServices
Management And General199760ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total483811Total
Program Services425967ProgramServices
Management And General57844ManagementAndGeneral

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total0Total
Fundraising0Fundraising

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total35619Total
Program Services35619ProgramServices

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total0Total
Fundraising0Fundraising

Fees For Services Lobbying FeesForServicesLobbying

FieldValueIRS element (for citing)
Total0Total
Fundraising0Fundraising

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total0Total
Fundraising0Fundraising

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total0Total
Fundraising0Fundraising

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total175848Total
Program Services149504ProgramServices
Management And General26344ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total0Total
Fundraising0Fundraising

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total306434Total
Program Services257699ProgramServices
Management And General48735ManagementAndGeneral

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total0Total
Fundraising0Fundraising

Royalties Royalties

FieldValueIRS element (for citing)
Total0Total
Fundraising0Fundraising

Occupancy Occupancy

FieldValueIRS element (for citing)
Total415689Total
Program Services415689ProgramServices

Travel Travel

FieldValueIRS element (for citing)
Total0Total
Fundraising0Fundraising

Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials

FieldValueIRS element (for citing)
Total0Total
Fundraising0Fundraising

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total15065Total
Program Services15065ProgramServices

Interest Interest

FieldValueIRS element (for citing)
Total227266Total
Management And General227266ManagementAndGeneral

Payments To Affiliates PaymentsToAffiliates

FieldValueIRS element (for citing)
Total356729Total
Management And General356729ManagementAndGeneral
Fundraising0Fundraising

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total358624Total
Management And General358624ManagementAndGeneral
Fundraising0Fundraising

Insurance Insurance

FieldValueIRS element (for citing)
Total243370Total
Program Services243370ProgramServices

Other Expenses OtherExpenses (5 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
BAD DEBT16442421644242
MED/SURG/NURSING SUPPLIES91848789828420203
MEDICAL PURCHASED SERVICES29517062599235352471
OTHER186052690185362
TAXES887459887459

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total16553033Total
Program Services14044994ProgramServices
Management And General2508039ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY325460BOY
EOY260772EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY2564118BOY
EOY2088047EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY24731BOY
EOY24731EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY426517BOY
EOY437936EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis5723896LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec1640453LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY4260924BOY
EOY4083443EOY

Intangible Assets IntangibleAssets

FieldValueIRS element (for citing)
BOY132728BOY
EOY126408EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY12415BOY
EOY428158EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY7746893BOY
EOY7449495EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY1552092BOY
EOY2361803EOY

Deferred Revenue DeferredRevenue

FieldValueIRS element (for citing)
BOY58470BOY
EOY66841EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

FieldValueIRS element (for citing)
BOY3626383BOY
EOY3516454EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY1405142BOY
EOY1467841EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY6642087BOY
EOY7412939EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY1104806BOY
EOY36556EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY1104806BOY
EOY36556EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY7746893BOY
EOY7449495EOY
FieldValueIRS element (for citing)
Reconcilation Revenue Expenses-1068250ReconcilationRevenueExpenses
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or ReviewfalseAccountantCompileOrReview
FS AuditedtrueFSAudited
Audit CommitteetrueAuditCommittee
Financial Statement SeparateXFinancialStatementSeparate
Federal Grant Audit RequiredfalseFederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Publicly Supported Org509a2XPubliclySupportedOrg509a2

Gifts Grants Contrib Received509 GiftsGrantsContribReceived509

FieldValueIRS element (for citing)
Current Tax Year22579CurrentTaxYear
Total22579Total

Gross Receipts From Admissions GrossReceiptsFromAdmissions

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years12622753CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years13333002CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years13686084CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year14246093CurrentTaxYearMinus1Year
Current Tax Year15333879CurrentTaxYear
Total69221811Total

Total509 Total509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years12622753CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years13333002CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years13686084CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year14246093CurrentTaxYearMinus1Year
Current Tax Year15356458CurrentTaxYear
Total69244390Total
FieldValueIRS element (for citing)
Public Support Total50969244390PublicSupportTotal509

Gross Investment Income509 GrossInvestmentIncome509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years6340CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years3646CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years701CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year166CurrentTaxYearMinus1Year
Current Tax Year83CurrentTaxYear
Total10936Total

Investment Income And UBTI InvestmentIncomeAndUBTI

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years6340CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years3646CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years701CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year166CurrentTaxYearMinus1Year
Current Tax Year83CurrentTaxYear
Total10936Total

Other Income509 OtherIncome509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years127034CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years137875CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years135720CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year309222CurrentTaxYearMinus1Year
Current Tax Year128242CurrentTaxYear
Total838093Total

Total Support Total TotalSupportTotal

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years12756127CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years13474523CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years13822505CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year14555481CurrentTaxYearMinus1Year
Current Tax Year15484783CurrentTaxYear
Total70093419Total
FieldValueIRS element (for citing)
Public Support Percentage5090.98789PublicSupportPercentage509
Prior Year Support Percentage0.98761PriorYearSupportPercentage
Investment Income Percentage0.00016InvestmentIncomePercentage
Prior Yr Invest Income Percentage0.00022PriorYrInvestIncomePercentage
Thirty Three Percnt Tests CY509XThirtyThreePercntTestsCY509

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Aggregate ContributionsRESTRICTEDAggregateContributions

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Art Public Exhibition AmtsArtPublicExhibitionAmts
Held Works Of Art AmtsHeldWorksOfArtAmts

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis800000OtherCostOrOtherBasis
Book Value800000BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis2863177OtherCostOrOtherBasis
Depreciation0Depreciation
Book Value2011099BookValue
FieldValueIRS element (for citing)
Leasehold ImprovementsLeaseholdImprovements

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis2048855OtherCostOrOtherBasis
Depreciation0Depreciation
Book Value1260480BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis11864OtherCostOrOtherBasis
Book Value11864BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings4083443TotalOfBookValueLandBuildings

Other Assets OtherAssets (2 entries)

DescriptionDescriptionBook ValueBookValue
COST REPORT SETTLEMENT RECEIVA410027
MISC AR OTHER18131
FieldValueIRS element (for citing)
Total Book Value Other Assets428158TotalBookValueOtherAssets
Federal Income Tax Liability0FederalIncomeTaxLiability

Other Liabilities OtherLiabilities (3 entries)

DescriptionDescriptionAmountAmount
ACCRUED PAYROLL AND RELATED LI$524,501
OTHER CURRENT LIABILITIES$257,068
INTERCOMPANY AP CURRENT$686,272
FieldValueIRS element (for citing)
Total Of Amounts1467841TotalOfAmounts
Total Revenue15484783TotalRevenue
Total Expenses16553033TotalExpenses
Excess Or Deficit For Year-1068250ExcessOrDeficitForYear
Excess Or Deficit Per FS-1068250ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt15484783TotRevenueEtcAuditedFinclStmt
Revenue Subtotal15484783RevenueSubtotal
Total Revenue Per Form99015484783TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt16553033TotExpensesEtcAuditedFinclStmt
Expenses Subtotal16553033ExpensesSubtotal
Total Expenses Per Form99016553033TotalExpensesPerForm990

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Severance PaymentfalseSeverancePayment
Supplemental Nonqual Retire PlanfalseSupplementalNonqualRetirePlan
Equity Based Comp ArrangementfalseEquityBasedCompArrangement
Comp Based On Revenue Of Filing OrgfalseCompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related OrgsfalseCompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing OrgfalseCompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate OrgsfalseCompBasedNetEarningsRelateOrgs
Any Non Fixed PaymentsfalseAnyNonFixedPayments
Initial Contract ExceptionfalseInitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (2 entries)

Base Compensation Filing OrgBaseCompensationFilingOrgComp Based On Related OrgsCompBasedOnRelatedOrgsBonus Filing OrgBonusFilingOrgBonus Related OrgsBonusRelatedOrgsOther Compensation Filing OrgOtherCompensationFilingOrgOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Filing OrgDeferredCompFilingOrgDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Filing OrgTotalCompensationFilingOrgTotal Compensation Related OrgsTotalCompensationRelatedOrgsComp Report Prior990 Filing OrgCompReportPrior990FilingOrgComp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
JOSEPH B TUCKER
017477200000524303600018361500
VERNA S MEACHAM
0225000000002337019224024656100

Form990 Schedule J Part III Form990ScheduleJPartIII

FieldValueIRS element (for citing)
IdentifierCEO COMPENSATIONIdentifier
Return ReferenceSCHEDULE J, PART III, EXPLANATION FOR COMPENSATIONReturnReference
ExplanationThe organization's CEO is paid by a related organization and the related organization uses a compensation committee, written employment contract, compensation study or survey and approval by the board or compensation committee to establish the compensation of the CEO.Explanation

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (3 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
MONITOR AND ENFORCE COMPLIANCE WITH THE POLICYPART IV, SECTION B. POLICIES, LINE 12 C and LINE 15LINE 12 C --------- Conflict of Interest: DISCLOSURE 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. 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. 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, or Senior Vice President. 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.
Process of reviewing returnPart VIUPON 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 FINANCE COMMITTEE OF THE BOARD OF TRUSTEES AND THE COMMITTEE REPORTS ON THEIR REVIEW OF THE 990 TO THE FULL BOARD AT A REGULARLY SCHEDULED MEETING PRIOR TO THE FILING DEADLINE. THE FINAL VERSION OF THE DOCUMENTS ARE THEN MADE AVAILABLE TO ALL BOARD MEMBERS FOR INSPECTION/REVIEW PRIOR TO FILING WITH THE IRS.
DETERMINING COMPENSATIONPART VI, SECTION B, LINES 15A AND 15BFORT WASHINGTON MEDICAL CENTER, INC DETERMINES THE COMPENSATION FOR THE CEO, OFFICERS AND KEY EMPLOYEES.

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (2 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusBusiness Name Line1DirectControllingEntityName/BusinessNameLine1
NEXUS HEALTH INC
6196 OXON HILL ROAD SUITE 210OXON HILLMD20745520238460CONTROLLING EMD501(C)(3)509(A)(2)NONE
FORT WASHINGTON MEDICAL CENTER INC
11711 LIVINGSTON ROADFORT WASHINGTONMD20744521682858AMBULATORY ANMD501(C)(3)7NEXUS HEALTH

Form990 Schedule R Part IV Form990ScheduleRPartIV

Name Of Related Org NameOfRelatedOrg

FieldValueIRS element (for citing)
Business Name Line1CONSULTING INCBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line16196 OXON HILL RD STE 210AddressLine1
CityOXON HILLCity
StateMDState
ZIP Code20745ZIPCode
FieldValueIRS element (for citing)
EIN521602159EIN
Primary ActivityCURRENT INACTPrimaryActivity
Legal Domicile StateDELegalDomicileState

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1NABusinessNameLine1
FieldValueIRS element (for citing)
Type Of EntityC CORPTypeOfEntity
Share Of Total Income0ShareOfTotalIncome
Share Of EOY Assets0ShareOfEOYAssets
Percentage Ownership0.00000PercentageOwnership
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents RoyaltiesfalseReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other OrgfalseGiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other OrgfalseGiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other OrgfalseLoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other OrgfalseLoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other OrgfalseSaleOfAssetsToOtherOrg
Purchase Of Assets From Other OrgfalsePurchaseOfAssetsFromOtherOrg
Exchange Of AssetsfalseExchangeOfAssets
Rental Of Facilities To Other OrgsfalseRentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other OrgsfalseRentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other OrgsfalsePerformOfServicesForOtherOrgs
Perform Of Services By Other OrgsfalsePerformOfServicesByOtherOrgs
Sharing Of FacilitiesfalseSharingOfFacilities
Sharing Of Paid EmployeestrueSharingOfPaidEmployees
Reimbursement Paid To Other OrgtrueReimbursementPaidToOtherOrg
Reimbursement Paid By Other OrgtrueReimbursementPaidByOtherOrg
Other Transfer To Other OrgfalseOtherTransferToOtherOrg
Other Transfer From Other OrgfalseOtherTransferFromOtherOrg