Goodwin House Alexandria

203 Pages·2017·30.73 MB·English

January 31, 2018

2018 Disclosure Statement
4800 Fillmore Avenue
Alexandria, VA 22311
703-824-1233
www.goodwinhouse.org
Disclosure Statement
of
Goodwin House Incorporated
for
Goodwin House Alexandria
As submitted to
the Commonwealth of Virginia
State Corporation Commission
Bureau of Insurance
January 31, 2018
The filing of this Disclosure Statement with
the State Corporation Commission does not
constitute approval, recommendation or
endorsement of the facility by the State
Corporation Commission.
Tab 1 – Mission Statement
Tab 2 – Disclosure Statement
Tab 3 – Resident Agreements
Reservation Agreement
Tab 4 – Consolidated Financial
Statements and Independent
Auditors’ Report of Goodwin
House Incorporated and
Affiliates for the Years Ended
September 30, 2017 and 2016
Tab 5 – Licenses, Registration
and Accreditation
Mission Statement
ThemissionofGoodwinHouse Incorporatedis to support,honoranduplift thelives of
olderadults andthepeoplewhocareforthem througha faith-based,nonprofit
organizationaffiliatedwiththeEpiscopal Church.
Organizational Values
Service Thecalltoserviceisthefoundationofourmission.
Integrity We value the trust of others and byour actions endeavor to be
worthyofthat trust.
Community Weseektocreateandsustainstrongand caringcommunities
wherethose wholive,workandvisit will findplaces ofwelcome
andbelonging.
Individuality We believe that each person is of sacred worth. We celebrate the
uniqueness anddiversityofthemembers ofourcommunity.
Excellence What wedo,wewill dowell.Westriveforexcellencein
capabilityandexecution.
Leadership Weseektolearnso that wecanlead.
and Learning
Heritage Wehonorandremember thewisdom,charityand dedicationof
thosewhocreatedthis organization,andseektoservewiththe
purposeandfaiththeyintended.
Growth We commit to broaden and extend our charitable purpose and
missionthroughthoughtful andprudent growth.
I. CONTINUINGCARE PROVIDER
GoodwinHouseAlexandriais ownedandoperatedbyGoodwinHouse Incorporated, a
non-stock,not-for-profit Virginia corporationlocatedat 4800FillmoreAvenue,
Alexandria,Virginia22311.
Theregisteredagent for GoodwinHouse Incorporated is:
James M. Saunders
Saunders &Brown,PLC
8280GreensboroDrive,Suite601
McLean, VA 22102
II. OFFICERS,DIRECTORS,TRUSTEES,MANAGINGANDGENERAL
PARTNERS,ANDCERTAINPERSONS WHO HOLDEQUITYOR
BENEFICIAL INTEREST
Board of Trustees of Goodwin HouseIncorporated
Name Address
Mrs.MaryLewisHix 540SecondStreet,#302
Chair Alexandria,VA22314
Mr.ThomasC.West 1650Tyson’sBlvd.Suite1575
Vice-Chair McLean,VA22102
Mr.DavidR.Clarke 4020UniversityDrive
Secretary Fairfax,VA22030
Dr.JanetHansen 1144NorthInglewoodStreet
Treasurer Arlington,VA22205
Mr.DonaldR.Calloway 2117BelleHavenRoad
Alexandria,VA22307
Mr.DavidC.Canfield 2300WilsonBlvd.,7thFloor
Arlington,VA22201
Dr.CyrilleneClark 2408N.RooseveltStreet
Arlington,VA22207
Mr.TuckerEskew 207MasonicViewDrive
Alexandria,VA22301
Ms.DeborahForbes 900LanierPlace
FallsChurch,VA22046
Mrs.LisaGiesler 33213rdStreetNorth
Arlington,VA22201
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Board of Trustees of Goodwin HouseIncorporated
Name Address
Ms.KatieHorton 13WestDelRayAvenue
Alexandria,VA22301
Dr.TammyMann 10908ClaraBurtonCourt
Fairfax,VA22032
Mr.TomRegnell 1810EdgehillDrive
Alexandria,VA22307
Mr.CharlesH.Smith 604KingsCloisterCircle
Alexandria,VA22302
Dr.AnthonyTambasco 3440S.JeffersonStreet,#376
FallsChurch,VA22041
Mr.JohnM.Weaver 909VicarLane
Alexandria,VA22302
Ms.MarthaWilcox 8506HitchingPostLane
Alexandria,VA22308
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OtherOfficers of GoodwinHouseIncorporated
Name Address
Ms.KathleenS.Anderson President andCEO
GoodwinHouse Incorporated
4800FillmoreAvenue
Alexandria,VA22311
Mr.RichardT.Carter Assistant Treasurer
ChiefFinancial Officer
GoodwinHouse Incorporated
4800FillmoreAvenue
Alexandria,VA22311
Ms.HollyHanisian Assistant Secretary
GoodwinHouse Incorporated
4800FillmoreAvenue
Alexandria,VA22311
Ms.W.JeanHiggins Assistant Secretary
GoodwinHouse Incorporated
4800FillmoreAvenue
Alexandria,VA22311
III. BUSINESS EXPERIENCE OF;ACQUISITIONOFGOODS ANDSERVICES
FROM;AND CRIMINAL,CIVIL ANDREGULATORYPROCEEDINGS
AGAINST THE PROVIDER,ITS OFFICERS, DIRECTORS,TRUSTEES,
MANAGINGAND GENERAL PARTNERS,CERTAINPERSONS WHO HOLD
EQUITYORBENEFICIAL INTEREST,ANDMANAGEMENT
Goodwin House Incorporated (the "Corporation" or “Goodwin House”) is a not-for-profit
corporation organized under the laws of the Commonwealth of Virginia to establish and
operate residential homes foragedpersons inNorthernVirginia.
A. Giveadescriptionofanybusinessexperienceintheoperationormanagement
of similarfacilities.
GoodwinHousehas50yearsofexperienceinoperatingthiscontinuingcareretirement
community. The complete responsibility for management of the facility under the
authorityoftheBoardofTrusteesrestsuponemployeesofthefacility.Thepositions,
experience,andcredentialsofthemanagementteamareasfollows:
KathleenS.AndersonisPresident andChiefExecutiveOfficerofGoodwin
House(February2002topresent).Ms.AndersonpreviouslyservedBaptist
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Homes ofWesternPennsylvania as President and ChiefExecutiveOfficer(1992-
2001)andExecutiveAdministrator(1986-1992). Sheservedfrom 2004to2009
onthe InovaHospital System’s HealthCareServices Boardof Directors andas
ChairoftheFairOaks Hospital QualityCommittee.Shepreviouslyserved onthe
BoardofDirectors of LeadingAgeand as Co-Chairofthe LeadingAge Leadership
Council.Shehas served as President ofthePennsylvania AssociationofNon-
Profit Homes fortheAgingand as ViceChairoftheAmericanBaptist Homes and
Hospitals Association.Ms.Anderson holds anundergraduatedegreein education
from WestminsterCollege(PA)and amaster’s degreeineducationfrom
DuquesneUniversity(Pittsburgh,PA).
RichardT.CarterisAssistantTreasurerandChiefFinancialOfficerofGoodwin
House(April2009topresent).PriortojoiningGoodwinHouse,Mr.Carterservedas
theChiefFinancialOfficerofMaryland&VirginiaMilkProducersCooperative
Association,Inc.(2002to2008),aPartnerwithTatumCFOPartners,LLP(2000to
2002),aSeniorManagerofArthurAndersenLLP(1996to2000),ChiefFinancial
OfficerofAmeribancSavingsBank(1986to1995),andaManagerofArthur
Andersen&Co.(1977to1986).Mr.Carterisacertifiedpublicaccountant.Heholds
aB.S.degreeinCommercefromtheUniversityofVirginia.
LindsayHutteris ChiefStrategyandMarketingOfficerof GoodwinHouse
Incorporated(May2017 topresent). BeforejoiningGoodwinHouse,sheserved
as SeniorVicePresident ofCommunications, PublicRelations &Structured
InnovationfortheData &MarketingAssociation wheresheidentifiedand built
programs toincreasemembervalueand accelerateindustrysuccess.Previously,
Ms. Hutterwas ExecutiveVicePresident ofChange & Internal Communications
at global consultancyHill +KnowltonStrategies whereshelaunchedandledthe
Global ChangeManagement &EmployeeEngagement Practice.Ms.Hutter
holds aB.S.degreeinJournalism andMass Communications from theUniversity
ofKansas andanM.A.inPolitical Sciencefrom Northwestern University.
Linda L. Lateanais ChiefOperatingOfficerofGoodwinHouseBailey’s
Crossroads. Sheis a graduateofSouthernMethodist UniversityinDallas, Texas,
andsheearned aMasters ofSocial Workfrom the UniversityofArkansas,
GraduateSchool ofSocial Work.Sheis aclinical social worker andhas worked
withcommunity-basedservices andinlong-term care forover30 years. She
joinedthestaffofGoodwinHouseBailey’s Crossroads in1987andbecamea
licensedNursingHome Administratorin1990.Shehas servedas an evaluatorfor
theContinuingCareAccreditationCommission’snationwideaccreditation
process forretirement communities. Ms.Lateanais aNursingHome
AdministratorandPreceptor,licensedbytheCommonwealthofVirginia, Past
ViceChairofthe Board ofDirectors oftheVirginiaAssociationofNonprofit
Homes fortheAgingand apast memberoftheHouseofDelegates ofthe
AmericanAssociationof Homes andServices for theAging.
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Barbara D’Agostinois ExecutiveDirectorofGoodwinHouseAlexandria. Ms.
D’Agostino’s commitment toservingseniors is supportedbyher active
participationintheseniorlivingfieldin general,includingBoardparticipationin
thestateaffiliates with LeadingAge,the AmericanHealthcareAssociationand
TheBeacon Board.Sheservedas President/Chair of LeadingAgeDC and
TreasurerandSecretaryoftheDistrict ofColumbiaHealthCareAssociation
(DCHCA).Shealso was aFellowoftheAmerican Collegeof Healthcare
Administrators, andproudtohavebeen recognizedas theDCHCAAdministrator
oftheYearin2014. Ms.D’Agostinois a Licensed NursingHomeAdministrator
intheCommonwealthofVirginia,the District of Columbia,Floridaand
Maryland.Sheholds a B.S.degreein Biologyfrom SyracuseUniversityanda
Masters inHealthServices Administrationfrom TheGeorgeWashington
University.
Dr.MariatuKoroma-Nelson, M.Dis theMedical DirectorforGoodwinHouse
Alexandria.Dr.Nelson is aGeriatricMedicineSpecialist practicinginFairfax,
Virginia.Dr.NelsonreceivedherDoctorofMedicinefromtheAmerican
Universityof IntegrativeSciencesin2010andwillreceiveherMasterofPublic
HealthfromCreightonUniversityin2017.Dr.Nelsoncompletedherresidency
trainingatHowardUniversityHospital,whereshewasnamed“Residentofthe
Year”in2013.Shehasalso completedfellowshiptraininginPalliativeMedicine,
GeriatricMedicine,andIntegrativeMedicineatGeorgeWashingtonUniversity.
Priortobecomingaphysician,Dr.Nelsonworkedas anurseforalmosttenyears
inseverallong-term carefacilities.
B. Givethenameandaddressofanyprofessionalservice,firm,association,
foundation,trust,partnershiporcorporationoranyotherbusinessorlegal
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entityin which such person has, orwhich hasinsuch person,aten percentor
greaterdirectorindirectinterestand whichitis presentlyintended will or
mayprovidegoods, leases orservices totheproviderof avalueof $500or
more,within anyyear,including:
(1) Adescription of thegoods, leases orservices and theprobableor
anticipated costthereof totheprovider;
(2) Theprocess bywhich thecontractwas awarded;
(3) Anyadditional offers thatwerereceived;and
(4) Anyadditional information requested bytheCommission detailing
how andwhyacontractwas awarded.
None.
C.Giveadescription ofanymatterin which such person:
(1) Hasbeen convictedofafelonyorpleadednolo contenderetoafelony
charge,orbeenheldliableorenjoinedinacivilactionbyfinal
judgmentifthefelonyorcivilactioninvolvedfraud,embezzlement,
fraudulentconversionormisappropriationofproperty;or
(2) Is subjecttoan injunctiveorrestrictiveorderof acourtof record,or
within thepastfiveyears had anystateorfederal licenseorpermit
suspended orrevoked as aresultof an action broughtbya
governmental agencyordepartment,arisingoutof orrelatingto
business activityorhealth care,includingwithoutlimitation actions
affectingalicensetooperateafostercarefacility,nursinghome,
retirementhome,home fortheaged orfacilityregistered underthis
chapterorsimilarlaw as in anotherstate;or
(3) Is currentlythesubject of anystateorfederal prosecution or
administrativeinvestigation involvingallegations offraud,
embezzlement,fraudulentconversion,or misappropriation of
property.
None,tothebest ofourknowledgeandbelief.
IV. OWNERSHIPOFREAL PROPERTY
The real propertyis owned byGoodwin House. Substantiallyall the propertyof Goodwin
HouseAlexandriaiscollateralunderthetermsofeachoftheSeries2015,and2016bonds.