2024-05-15T15:52:07-05:00 2023-06-30 PwC US Tax LLP 2001 MARKET ST SUITE 1800 PHILADELPHIA PA 19103 990 2022-07-01 520607945 UNION HOSPITAL OF CECIL COUNTY INC % SR VP'S OFFICE UNIO 4103984000 4000 NEXUS DRIVE NW3-100 WILMINGTON DE 19803 ROBERT MCMURRAY CFO 4103984000 2024-05-13 true ROBERT MCMURRAY 999009999 ANTONIO C RUSSO P00858539 2673303000 2024-05-10 2 2022 2023-04-26 12:10:37Z AMY MARSTON 106 BOW STREET ELKTON MD 219215596 186968428 false X WWW.UHCC.COM X 1903 MD TO PROVIDE CHARITABLE HEALTHCARE SERVICES TO THE RESIDENTS OF CECIL COUNTY, MD AND THE SURROUNDING AREA. 12 9 1169 100 2424924 0 997954 902376 169542293 172643201 4746882 1580560 2759534 2719965 178046663 177846102 0 0 0 0 115682360 122030806 0 0 0 86433407 70389001 202115767 192419807 -24069104 -14573705 171242854 186066867 130401794 156038586 40841060 30028281 X UNION HOSPITAL OF CECIL COUNTY, INC.'S MISSION IS TO PROVIDE CHARITABLE HEALTHCARE SERVICES TO THE RESIDENTS OF CECIL COUNTY, MARYLAND; WESTERN NEW CASTLE COUNTY, DELAWARE; AND SOUTHERN CHESTER COUNTY, PENNSYLVANIA. false false 166707286 0 172668589 UNION HOSPITAL OF CECIL COUNTY'S MISSION IS TO PROVIDE QUALITY HEALTH CARE SERVICES TO THE RESIDENTS OF CECIL COUNTY, MARYLAND AND NEIGHBORING COMMUNITIES. SERVICES ARE PROVIDED WITH MODERN TECHNOLOGY AND COMPASSIONATE CARE FROM HEALTH CARE PROFESSIONALS. SERVICES ARE PROVIDED REGARDLESS OF RACE, GENDER, ETHNICITY, AGE, DISABILITY, RELIGION, OR ABILITY TO PAY. ALTHOUGH REIMBURSEMENT FOR SERVICES RENDERED IS VITALLY IMPORTANT TO THE OPERATION, STABILITY, AND VIABILITY OF UNION HOSPITAL OF CECIL COUNTY, IT IS RECOGNIZED THAT NOT ALL MEMBERS OF THE COMMUNITY ARE IN THE FINANCIAL POSITION TO PURCHASE HEALTH CARE SERVICES. FOR ELIGIBLE INDIVIDUALS, UNION HOSPITAL OF CECIL COUNTY OFFERS FREE AND/OR SUBSIDIZED CARE, AS WELL AS ACCESS TO COMMUNITY FINANCIAL ASSISTANCE. DURING THE YEAR, UNION HOSPITAL OF CECIL COUNTY PROVIDED $8,974,331 IN UNCOMPENSATED CARE (CHARITY CARE). IN ADDITION, COMMUNITY BENEFIT ACTIVITIES ARE PROVIDED TO SERVE VULNERABLE POPULATIONS (I.E. MEDICALLY UNDERSERVED, WORKING POOR, HOMELESS). ACTIVITIES ARE CREATED BASED ON COMMUNITY NEED AND ARE PROVIDED IN AN EFFORT TO IMPROVE THE HEALTH OF THE COMMUNITY. COMMUNITY BENEFITS INCLUDE: A) COMMUNITY SUPPORT GROUPS FOR CANCER, DIABETES, STROKE, ALZHEIMER'S, AND BREASTFEEDING B) HEALTH EDUCATION FOR DIABETES AND NUTRITION, CANCER PREVENTION, STROKE RISK, AND HOW TO CARE FOR SUBSTANCE-EFFECTED NEWBORNS C) FREE SCREENINGS IN THE COMMUNITY FOR PROSTATE CANCER, HEAD AND NECK CANCER, SKIN CANCER, AND DIABETES (EYES AND FEET) D) PROVIDING MEETING FACILITIES FOR LOCAL NONPROFITS AND AGENCIES E) ENHANCING FOOD SECURITY WITH FOOD DONATIONS TO HOMELESS SERVING PROVIDERS IN THE COMMUNITY. F) HOSPITAL STAFF PARTICIPATION ON COMMUNITY BOARDS AND COALITIONS, LIKE THE DENTAL HEALTH ADVISORY BOARD, UNITED WAY, VOICES OF HOPE, CECIL COUNTY DRUG-FREE COMMUNITIES COALITION, CORE SERVICE AGENCY MENTAL HEALTH ADVISORY BOARD, DEPARTMENT OF SOCIAL SERVICES BOARD, AND CECIL COUNTY COMMUNITY HEALTH ADVISORY COALITION. UNION HOSPITAL OF CECIL COUNTY SERVICED 5,996 DISCHARGES PROVIDING 27,044 PATIENT DAYS TO INPATIENTS IN FISCAL YEAR 2023 OF WHICH: 1) PATIENTS COVERED UNDER THE MEDICARE PROGRAM WERE 2,396 DISCHARGES AND 11,958 PATIENT DAYS 2) PATIENTS COVERED UNDER THE MEDICAID PROGRAM WERE 175 DISCHARGES AND 794 PATIENT DAYS 3) PATIENTS COVERED UNDER THE MEDICAID HMO PROGRAM WERE 1,540 DISCHARGES AND 5,561 PATIENT DAYS 4) PATIENTS COVERED UNDER THE MEDICARE HMO PROGRAM WERE 710 DISCHARGES AND 3,840 PATIENT DAYS. 166707286 true true false false false false false false false false true true false true true false false true false false false false false false false false true true false false true true false false false false false false false false false false false false false false false true false false false true X 89 0 true 1169 true true true false false false false false false false false false false false X 12 9 false false false false true true true true true false false true true true true true true true true false MD X SR VP'S OFFICE 3024282441 4000 NEXUS DRIVE NW3-100 WILMINGTON DE 19803 X SHARON T KURFUERST PRESIDENT- THRU 1/23 1.0 44.0 X X 0 967304 84880 ROBERT MCMURRAY TREASURER (EX-OFFICIO) 1.0 44.0 X 0 857940 86827 FAHD RAHMAN MD PHYSICIAN 45.0 0.0 X 842008 0 20501 JENNIFER L SCHWARTZ ESQ SECRETARY (EX-OFFICIO) 1.0 44.0 X 0 745416 78435 JUSTIN SAUSVILLE MD DIRECTOR 44.0 1.0 X 779955 0 20501 ROGER D WU MD PHYSICIAN 45.0 0.0 X 612074 0 20839 OLUMIDE OMOBO PHYSICIAN 45.0 0.0 X 566412 0 7085 RYAN GERACIMOS MD CHIEF MEDICAL OFFICER 44.0 1.0 X 544531 0 876 CLAIRE YI ZHANG PHYSICIAN 45.0 0.0 X 507250 0 0 RICHARD C SZUMEL FORMER OFFICER 0.0 0.0 X 0 465941 0 BALTEJ SINGH MD PHYSICIAN 45.0 0.0 X 426855 0 20501 JOSE MA MD DIRECTOR 44.0 1.0 X 339085 0 12272 AMY MARSTON INT. PRESIDENT- AS OF 2/23 44.0 1.0 X 156609 95719 20670 JOAN PIRRUNG MSN APRN ACNS-BC VP PAT. CARE SERVIVES-NURSING 44.0 1.0 X 238113 0 20501 DONNA MALONEY DIRECTOR OF FINANCE 1.0 44.0 X 0 221911 20501 MICHELLE TWUM-DANSO DIRECTOR OF HR - CECIL CAMPUS 44.0 1.0 X 0 226513 8956 ROBERT ASANTE DIRECTOR 1.0 44.0 X 0 211209 20501 DERON G BROWN FORMER FINANCE DIRECTOR 43.0 1.0 X 84196 102021 0 CHRISTY DRYER DNP DIRECTOR 1.0 1.0 X 0 0 0 DAVID TROLIO DIRECTOR 1.0 1.0 X 0 0 0 DWIGHT D THOMEY ESQ DIRECTOR, CHAIR 1.0 3.0 X X 0 0 0 JACQUES RENE DIRECTOR 1.0 1.0 X 0 0 0 LEO NAJERA MD DIRECTOR 1.0 2.0 X 0 0 0 MORGAN MILLER MLIS VICE CHAIR 1.0 1.0 X X 0 0 0 REVEREND R KEVIN BROWN DIRECTOR 1.0 1.0 X 0 0 0 ROBERT PALSGROVE DIRECTOR 1.0 1.0 X 0 0 0 JOHN NESS DIRECTOR (AS OF 1/1/23) 1.0 1.0 X 0 0 0 5097088 3893974 443846 229 true true false GENERAL HEALTHCARE RESOURCES LLC 2250 HICKORY RD STE 240 PLYMOUTH MEETING PA 19460 PROF. STAFFING SRVCS 9468613 UNION RADIOLOGISTS LLC 106 BOW STREET RADIOLOGY OFFICE ELKTON MD 21921 RADIOLOGY SERVICES 3323000 SP CONSULTANTS INC 15 BRAINTREE HILL OFFICE PARK STE BRAINTREE MD 02184 CONSULTING SERVICES 2355238 NORTH AMERICAN PARTNERS IN ANESTESI PO BOX 936947 ATLANTA GA 311936947 HEALTHCARE SERVICES 1792329 HOSPITAL RESCUE SERVICES LLC 5234 HARVEY LANE ELLICOTT CITY MD 21043 HEALTHCARE SERVICES 1298657 64 170563 731813 902376 NET PATIENT SERVICE REVENUE 621990 172428070 172428070 OTHER OPERATING REVENUE 621990 119731 83731 36000 ADULT DAY CARE 623990 95400 95400 172643201 1518575 67012 1451563 0 0 65755 265 65490 0 65490 65490 9183646 400 9122061 61585 400 61985 47960 14025 0 0 0 0 0 0 0 0 0 LABORATORY REVENUE 621500 2299340 25388 2273952 CAFETERIA/FOOD SERVICE REVENUE 722210 348684 348684 OTHER REVENUE 900009 6451 6451 2654475 177846102 172632589 2424924 1886213 X 0 0 0 0 2382878 2083147 299731 0 0 94557510 82663555 11893955 0 4551708 3868952 682756 0 14155350 12643502 1511848 0 6383360 5437629 945731 0 0 20725 1938 18787 0 82328 0 82328 0 0 0 117567 0 117567 0 21172967 18342795 2830172 0 75791 16760 59031 0 1643636 911187 732449 0 2142644 415517 1727127 0 0 4047076 3483167 563909 0 241397 217873 23524 0 0 147823 119141 28682 0 2351027 1942889 408138 0 0 7226175 4378353 2847822 0 2236279 2209702 26577 0 MEDICAL SUPPLIES 23366531 23219179 147352 0 REPAIRS & MAINTENANCE 3236059 3153885 82174 0 DUES & SUBSCRIPTIONS 874462 206714 667748 0 DIETARY 716431 703755 12676 0 690083 687646 2437 192419807 166707286 25712521 0 X 30464963 17608186 0 0 0 0 14033313 26368053 0 0 0 0 0 0 2934672 3952561 4305163 3219190 198267214 138980488 52680855 59286726 0 0 47193854 51737013 0 0 0 0 19630034 23895138 171242854 186066867 63932757 28768329 0 0 5627708 2444392 49121622 46814552 0 0 0 0 0 0 0 0 11719707 78011313 130401794 156038586 X 37254152 26126386 3586908 3901895 40841060 30028281 171242854 186066867 X -14573705 3480587 280339 X false true X true false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 1134905 1134905 55330454 34925580 20404874 1813611 545549 1268062 106432167 84302608 22129559 33556077 19206751 14349326 59286726 5495491 MANAGED HEDGE FUNDS 2927305 F INVESTMENTS 43314217 F 51737013 DUE FROM AFFILIATES 13377108 INSURANCE CLAIMS RECOVERABLE 7699683 IN HOUSE LEASES 1501211 ROU LEASES 1225909 OTHER ASSETS 65609 SECURITY DEPOSITS 25618 23895138 0 INTERCOMPANY PAYABLES 67170785 EST. MEDICAL MALPRACTICE LIABILITY 9714715 ROU LEASES 902479 CAPITAL LEASE OBLIGATIONS 200654 CYBER LIABILITY 22680 78011313 true true X true X true X true true true false true true 1274789 0 1274789 0.00660 1274789 0 1274789 0.00660 127404 0 127404 0.00070 180111 0 180111 0.00090 22482803 10753067 11729736 0.06100 165209 0 165209 0.00090 22955527 10753067 12202460 0.06350 24230316 10753067 13477249 0.07010 193 193 1540 1540 1733 1733 true 6751225 64860 2861445 2572460 288985 X true true 1 1 UNION HOSPITAL OF CECIL COUNTY INC 106 BOW STREET ELKTON MD 21921 WWW.UHCC.COM LICENSE# 07-005 X X X UNION HOSPITAL OF CECIL COUNTY INC 1 false false true X X X X X X X X X 21 true true true true X SEE PART V, SECTION C X SEE PART V, SECTION C X true 22 false SEE PART V, SECTION C false false true X 200. 400. X X X X X X true true X X X X true X SEE PART V, PAGE 8 X SEE PART V, PAGE 8 X SEE PART V, PAGE 8 X X X X X X X true X false X X X X true X false false PART V, SECTION B, LINES 5, 6A & 6B (INPUT FROM COMMUNITY; JOINT CHNA) AT CHRISTIANACARE, WE ARE GUIDED BY THE CHRISTIANACARE WAY: WE SERVE OUR NEIGHBORS AS RESPECTFUL, EXPERT, CARING PARTNERS IN THEIR HEALTH. WE DO THIS BY CREATING INNOVATIVE, EFFECTIVE, AFFORDABLE AND EQUITABLE SYSTEMS OF CARE THAT OUR NEIGHBORS VALUE. TO EFFECTIVELY PARTNER WITH OUR NEIGHBORS, WE MUST LEARN FROM THEM DIRECTLY ABOUT THEIR CHALLENGES. COMPLETING THE CHNA PROVIDES THAT OPPORTUNITY. THE 2022 CHNA WAS ALSO THE FOURTH CHNA UNION HOSPITAL HAS UNDERTAKEN IN COLLABORATION WITH THE CECIL COUNTY HEALTH DEPARTMENT (CCHD). WE ARE GRATEFUL FOR THEIR EXPERTISE AND CONTINUED PARTNERSHIP AS WE WORK TOGETHER TO SERVE CECIL COUNTY. DUE TO THE SIGNIFICANT RATE OF COMMUNITY TRANSMISSION OF COVID-19 THAT WAS OCCURRING AS WE WERE COMPLETING THE CHNA, WE OPTED TO HOST VIRTUAL COMMUNITY MEETINGS TO RECEIVE COMMUNITY INPUT INSTEAD OF OUR PREFERRED FORMAT OF IN-PERSON MEETINGS AT ACCESSIBLE COMMUNITY LOCATIONS. WE HOSTED FOUR VIRTUAL MEETINGS WITH THE PARTICIPATION OF 43 COMMUNITY STAKEHOLDERS WHO REPRESENTED THE CCHD AND OTHER GOVERNMENT AGENCIES, NON-PROFIT ORGANIZATIONS, LOCAL BUSINESSES, HEALTH CARE PROVIDERS, AND THE SCHOOL SYSTEM. WE WERE ALSO ABLE TO MEET WITH FOUR TEENAGERS PARTICIPATING IN THE CECIL COUNTY PUBLIC LIBRARY'S YOUTH ADVISORY COUNCIL. IT WAS IMPORTANT TO US TO INCLUDE THE VOICES OF YOUTH AS THEY ARE ALSO PART OF THE COMMUNITY WE SERVE AND MAY HAVE DIFFERENT PERSPECTIVES THAN THOSE OF THE ADULTS. WE ALSO HELD A VIRTUAL MEETING WITH THE PARTICIPATION OF 16 UNION CAREGIVERS REPRESENTING ADMINISTRATION, NURSING, CASE MANAGEMENT, SOCIAL SERVICES, AND PROJECT MANAGEMENT. THE INTENT OF THE MEETING WAS TO GAIN THE CAREGIVERS' PERSPECTIVE ON THE COMMUNITY'S MOST SIGNIFICANT CHALLENGES AS WELL AS PROVIDE THEM WITH MORE INSIGHT INTO THE COMMUNITY. AT EACH MEETING, THE CHNA PROCESS AND THE PURPOSE OF THE MEETING WAS EXPLAINED AND SECONDARY DATA WERE PRESENTED INCLUDING A SUMMARY OF UNFAVORABLE COMMUNITY HEALTH INDICATORS. WE ASKED MEETING PARTICIPANTS FOR THEIR REACTIONS TO THE SECONDARY DATA ANALYSIS AND TO IDENTIFY COMMUNITY HEALTH ISSUES THAT MAY NOT HAVE BEEN INCLUDED IN THE DATA. EACH MEETING CONCLUDED WITH PARTICIPANTS BEING ASKED TO IDENTIFY THREE TO FIVE COMMUNITY HEALTH ISSUES THEY CONSIDER TO BE MOST SIGNIFICANT. AN ONLINE COMMUNITY HEALTH SURVEY WAS ALSO CONDUCTED IN FEBRUARY AND MARCH 2022. THE SURVEY HAD TWENTY QUESTIONS ON THE FOLLOWING TOPICS: DEMOGRAPHICS, COMMUNITY HEALTH, QUALITY OF LIFE, AND ACCESS TO HEALTH CARE SERVICES. 544 PARTICIPANTS COMPLETED THE SURVEY. MOST SURVEY RESPONDENTS WERE FEMALE (87%) AND 64% OF THE SURVEY RESPONDENTS WERE FROM THE TOWNS OF NORTH EAST AND ELKTON. FINALLY, SEVEN KEY STAKEHOLDERS WERE INTERVIEWED TO LEARN ABOUT COMMUNITY HEALTH ISSUES. THE STAKEHOLDERS WERE HEALTH OFFICERS FROM THE CCHD AND ADMINISTRATIVE AND CLINICAL STAFF FROM WEST CECIL HEALTH CENTER, A FEDERALLY QUALIFIED HEALTH CENTER. THE PARTICIPANTS WERE ASKED TO IDENTIFY AND DISCUSS COMMUNITY HEALTH ISSUES PRIOR TO THE COVID-19 PANDEMIC, AND THEN DESCRIBE THE PANDEMIC'S IMPACTS ON THE COMMUNITY AND WHAT HAS BEEN LEARNED ABOUT THE COMMUNITY'S HEALTH GIVEN THOSE IMPACTS. THE STAKEHOLDERS WERE ALSO ASKED TO DESCRIBE THE TYPES OF INITIATIVES, PROGRAMS, AND INVESTMENTS THAT SHOULD BE IMPLEMENTED TO ADDRESS THE COMMUNITY'S HEALTH ISSUES AND TO BE BETTER PREPARED FOR FUTURE RISKS. CHRISTIANACARE CONTRACTED WITH VERIT HEALTHCARE CONSULTING, LLC (VERIT) TO COMPLETE ITS 2022 CHNA. IN COOPERATION WITH CHRISTIANACARE'S OFFICE OF HEALTH EQUITY AND THE CCHD, VERIT CONDUCTED THE RESEARCH, PRIMARY AND SECONDARY DATA COLLECTION, REVIEW, AND ANALYSIS, TO DEVELOP THE CHNA. --------------- SCHEDULE H, PART V, SECTION B, LINE 7A & B (CHNA AVAILABILITY) UNION HOSPITAL OF CECIL COUNTY, INC.'S CHNA IS AVAILABLE ON ITS WEBSITE AT: HTTPS://WWW.UHCC.COM/ABOUT-US/COMMUNITY-BENEFIT/REPORTS/ UNION HOSPITAL OF CECIL COUNTY, INC.'S CHNA IS ALSO AVAILABLE AT: HTTPS://CECILCOUNTYHEALTH.ORG/RESOURCES/HEALTH-ADVISORY-COMMITTEE/ --------------- SCHEDULE H, PART V, SECTION B, LINE 10 (IMP. STRATEGY PUBLIC AVAILABILITY) UNION HOSPITAL OF CECIL COUNTY, INC.'S CHIP IS AVAILABLE ON ITS WEBSITE AT: HTTP://WWW.UHCC.COM/ABOUT-US/COMMUNITY-BENEFIT/REPORTS/ --------------- SCHEDULE H, PART V, SECTION B, LINE 11 (ADDRESSING NEEDS FROM THE CHNA) UNION'S 2022 CHNA IDENTIFIED THE FOLLOWING AS SIGNIFICANT AREAS OF NEED IN CECIL COUNTY: . ACCESS TO HEALTH SERVICES . CANCER . CHILDHOOD TRAUMA/ADVERSE CHILDHOOD EXPERIENCES (ACE) . LGBTQIA+ HEALTH DISPARITIES . MENTAL HEALTH . NUTRITION, OBESITY, AND PHYSICAL INACTIVITY . SMOKING, TOBACCO, AND VAPE PRODUCT USE . SUBSTANCE USE DISORDERS OF THESE SIGNIFICANT NEEDS, UNION PRIORITIZED: . ACCESS TO HEALTH SERVICES . CANCER . LGBTQIA+ HEALTH DISPARITIES . SUBSTANCE USE DISORDERS SELECTION FOR PRIORITIZATION WAS BASED ON RESOURCE AVAILABILITY AND PROGRAMMING UNDERWAY OR PLANNED. UNION DOES ADDRESS ALL THE SIGNIFICANT AREAS OF NEED, BUT DID NOT PRIORITIZE THE FOLLOWING AREAS OF NEED: . CHILDHOOD TRAUMA/ADVERSE CHILDHOOD EXPERIENCES (ACE) . MENTAL HEALTH . NUTRITION, OBESITY, AND PHYSICAL INACTIVITY . SMOKING, TOBACCO, AND VAPE PRODUCT USE THESE AREAS WERE NOT PRIORITIZED BECAUSE WE WERE UNABLE TO CREATE NEW OR EXPANDED COMMUNITY BENEFIT PROGRAMMING IN THESE AREAS. IF OPPORTUNITIES TO ADDRESS THESE AREAS OF NEED ARISE, PARTICULARLY THROUGH COMMUNITY PARTNERSHIPS, THEIR IDENTIFICATION AS SIGNIFICANT AREAS OF NEED WILL BE CONSIDERED. A SIGNIFICANT ACTIVITY WE UNDERTOOK IN FY2023 TO ADDRESS OUR PRIORITIZED AREAS OF NEED WAS THE CREATION AND HIRING OF A MANAGER OF COMMUNITY ENGAGEMENT POSITION. THIS POSITION WAS FILLED IN JANUARY 2023 AND HAS ALREADY MADE A CONSIDERABLE IMPACT IN UNION'S COMMUNITY ENGAGEMENT AND OUTREACH. MUCH OF THE PROGRESS THAT WILL BE DESCRIBED IN THIS SECTION HAS BEEN AS A RESULT OF THE COMMUNITY ENGAGEMENT MANAGER'S EFFORTS. ACCESS TO HEALTH SERVICES CECIL COUNTY HAS A LOW PER-CAPITA SUPPLY OF PRIMARY CARE, DENTAL HEALTH, AND MENTAL HEALTH PROFESSIONALS COMPARED TO NATIONAL AVERAGES, WHICH CREATES SIGNIFICANT BARRIERS TO CARE. LIKE RURAL HOSPITALS ACROSS THE COUNTRY, UNION HAS ALSO EXPERIENCED CHALLENGES RECRUITING AND RETAINING PROVIDERS. CHRISTIANACARE CONTINUES TO RESPOND TO THIS CHALLENGE WITH A DIVERSITY OF ONGOING RECRUITMENT EFFORTS. SIMPLY ADDING MORE PROVIDERS IN THE COMMUNITY, HOWEVER, WILL NOT OVERCOME ALL BARRIERS TO CARE. LACK OF TRANSPORTATION PRESENTS AN ISSUE FOR MANY IN CECIL COUNTY. IN FY22, CHRISTIANACARE BEGAN TO ADDRESS THIS ISSUE ON A SMALL SCALE THROUGH UNION'S CARE TRANSFORMATION INITIATIVE (CTI) WHICH LAUNCHED ON JULY 1, 2021. UNION'S CTI, TRANSITIONS OF CARE, CHRONIC DISEASE NAVIGATION PROGRAM SERVES ADULT MEDICARE FFS BENEFICIARIES WHO WERE ADMITTED TO UNION AS AN INPATIENT OR FOR OBSERVATION WITH A PRIMARY OR SECONDARY DIAGNOSIS OF HEART FAILURE, CHRONIC OBSTRUCTIVE PULMONARY DISEASE (COPD), DIABETES, OR RESPIRATORY FAILURE.. TO PREVENT READMISSION, THESE PATIENTS RECEIVE A CARE TEAM APPROACH AND INTERACTIVE PATIENT TOOLS FOR 180 DAYS POST DISCHARGE. HOWEVER, SOME PATIENTS HAD DIFFICULTY PARTICIPATING DUE TO LACK OF TRANSPORTATION AND LACK OF RESOURCES TO BE ABLE TO PARTICIPATE IN VIRTUAL VISITS THAT WOULD HAVE RESOLVED THE TRANSPORTATION BARRIER. TO ADDRESS THIS BARRIER, THE CARE TEAM BEGAN USING ROUNDTRIP. ROUNDTRIP IS A COMPANY THAT PROVIDES A DIGITAL TRANSPORTATION MARKETPLACE TO CONNECT PATIENTS FACING TRANSPORTATION BARRIERS WITH NON-EMERGENCY MEDICAL TRANSPORTATION. CHRISTIANACARE HAS BEEN PARTNERED WITH ROUNDTRIP SINCE 2019 TO PROVIDE FREE TRANSPORTATION TO ELIGIBLE PATIENTS IN DELAWARE WITH TRANSPORTATION BARRIERS TO RECEIVE MEDICAL SERVICES. THE CTI IS THE FIRST UNION PROGRAM TO UTILIZE ROUNDTRIP. IN FY23, TWELVE RIDES THROUGH ROUNDTRIP WERE PROVIDED TO HELP CTI PATIENT PARTICIPANTS RECEIVE MEDICAL SERVICES. THROUGHOUT THE LATTER PART OF FY23, WE ALSO WORKED WITH ROUNDTRIP TO PREPARE FOR EXPANDED USE THROUGHOUT UNION IN EARLY FY24. THIS INVOLVED PROVIDING INFORMATION ABOUT LOCAL TRANSPORTATION AND EXPECTED TYPES OF VEHICLES THAT WILL NEED TO BE UTILIZED (TAXI, WHEELCHAIR VANS, ETC.). UNION ALSO PROVIDES TAXI VOUCHERS TO INPATIENTS AT DISCHARGE WHO HAVE NO TRANSPORTATION HOME. IN FY23, UNION PAID $3,841 TO TRANSPORT PATIENTS HOME IN TAXIS. IN FY23, UNION ALSO BEGAN PARTICIPATING IN THE MARYLAND PRIMARY CARE PROGRAM (MDPCP). MDPCP PROVIDES FUNDING AND SUPPORT FOR THE DELIVERY OF ADVANCED PRIMARY CARE THROUGHOUT MARYLAND IN SUPPORT OF THE OVERALL HEALTH CARE TRANSFORMATION PROCESS. THE GOALS ARE TO ENABLE PRIMARY CARE PROVIDERS TO PLAY AN INCREASED ROLE IN PREVENTION, MANAGEMENT OF CHRONIC DISEASE, AND PREVENTING UNNECESSARY HOSPITAL UTILIZATION. THROUGH THIS PROGRAM, UNION RECEIVES FUNDING TO ADDRESS THE SOCIAL NEED OF MEDICARE PATIENTS. HEALTH EQUITY ADVANCEMENT RESOURCE AND TRANSFORMATION (HEART) PAYMENTS ARE ALSO USED TO PROVIDE PARTICIPATING PATIENTS WITH HYPERTENSION AND DIABETES WITH MEDICALLY TAILORED FOODS, SELF-MONITORING EQUIPMENT, AND TRANSPORTATION THROUGH ROUNDTRIP TO THEIR MEDICAL APPOINTMENTS AND SERVICES. UNION'S CHILDBIRTH AND EARLY EDUCATION TEAM AND PEDIATRIC NURSES CONTINUE TO RESPOND TO OUR COMMUNITY NEEDS BY PROVIDING CHILDBIRTH AND INFANT CARE EDUCATION IN THE COMMUNITY. IN FY23, MONTHLY EDUCATION CONTINUED TO BE PROVIDED ON-SITE AT THE COMMUNITY TREATMENT PROVIDER, SERENITY HEALTH, IN ELKTON. THOSE WHO ARE PREGNANT AND RECEIVING TREATMENT ATTEND THESE CLASSES TO LEARN ABOUT CHILDBIRTH AND INFANT CARE. THEY ARE ALSO PROVIDED INFORMATION ABOUT THE PROGRAM EAT, SLEEP, CONSOLE WHICH IS AN APPROACH TO CARING FOR BABIES BORN WITH NEONATAL ABSTINENCE SYNDROME (NAS) THAT CAN REDUCE THE NEED FOR MEDICAL INTERVENTION. AT THE REQUEST OF HERITAGE PREGNANCY CENTER IN ELKTON, UNION CAREGIVERS ALSO PROVIDED AN ON-SITE BI-WEEKLY BREASTFEEDING EDUCATION SUPPORT GROUP. THE CCHD WILL ALSO OCCASIONALLY REQUEST OUR CAREGIVERS PROVIDE PRENATAL EDUCATION IN THE COMMUNITY. IN FY23, OUR CAREGIVERS PROVIDED A PRENATAL EDUCATION CLASS AT THE HERITAGE PREGNANCY CENTER IN OCTOBER 2022 AT THE REQUEST OF THE CCHD. FINALLY, UNION HAS HELD A FREE SPORTS PHYSICAL EVENT FOR CECIL COUNTY STUDENTS FOR OVER 15 YEARS. EACH YEAR THESE PHYSICALS ARE REQUESTED BY CECIL COUNTY PUBLIC SCHOOL ATHLETIC ADMINISTRATION. GIVEN THE PROVIDER SHORTAGE IN CECIL COUNTY, THIS EVENT IS SIGNIFICANT IN PROVIDING RELIEF TO CECIL COUNTY PRACTICES AND IN ENSURING STUDENTS ARE ABLE TO RECEIVE A PHYSICAL AND PARTICIPATE IN SPORTS. PHYSICAL INACTIVITY WAS ALSO A SIGNIFICANT AREA OF NEED IDENTIFIED IN CECIL COUNTY AND SO HELPING TO MAKE PARTICIPATION IN SPORTS EASIER FOR FAMILIES IS AN ADDITIONAL BENEFIT OF THIS OFFERING. ON JUNE 7, 2023, IN PARTNERSHIP WITH ATI PHYSICAL THERAPY AND THE CECIL COUNTY PUBLIC SCHOOLS, 623 STUDENTS WERE ABLE TO COMPLETE THEIR PHYSICALS, AN INCREASE OF NEARLY 100 STUDENTS FROM THE PRIOR YEAR. AT THE EVENT, ATTENDEES WERE ALSO ENCOURAGED TO ENROLL WITH A PRIMARY CARE PROVIDER IF THEY HAD NONE. CANCER CANCER RATES IN CECIL COUNTY REMAIN ABOVE THE MARYLAND AND UNITED STATES AVERAGES. THE MORTALITY RATE FOR LUNG AND BRONCHUS CANCER IN CECIL COUNTY HAS BEEN CONSIDERABLY ABOVE THE UNITED STATES AVERAGE AT 87.1 PER 100,000 IN COMPARISON TO 57.3 PER 100,000. IN RESPONSE, UNION HAS PARTNERED CLOSELY WITH THE CECIL COUNTY CANCER TASK FORCE TO CRAFT AND IMPLEMENT PUBLIC OUTREACH TO PROMOTE CANCER SCREENINGS, WITH A FOCUS ON LOW DOSE COMPUTED TOMOGRAPHY (LDCT) SCREENING, AND OTHER PREVENTION ACTIVITIES. IN FY23, UNION CAREGIVERS, LED BY NURSE MANAGER SHEELAGH STEWART, WHO ALSO SERVES AS THE CHAIR OF THE CECIL COUNTY CANCER TASK FORCE, UNDERTOOK A RESEARCH PROJECT TO GAIN AN UNDERSTANDING OF THE BARRIERS TO LDCT SCREENING. A REVIEW OF 55 LUNG CANCER PATIENTS DIAGNOSED IN 2020 AND 2021 AT UNION REVEALED THAT ONLY 1 OF THOSE PATIENTS WAS REFERRED TO LDCT SERVICES BEFORE DIAGNOSIS. BASED ON THIS, THE TEAM RECOGNIZED THAT BOTH PATIENTS AND PROVIDERS WOULD BENEFIT FROM INFORMATION ABOUT LDCT SCREENING. IN PARTNERSHIP WITH THE CECIL COUNTY CANCER TASK FORCE, A 19-QUESTION VALIDATED SURVEY WAS SELECTED AND SENT OUT TO 38 CECIL COUNTY PROVIDERS IN OCTOBER 2022 TO GAUGE THEIR UNDERSTANDING OF THE LDCT SCREEN AND BARRIERS TO SUCCESSFUL REFERRALS FOR LDCT SCREENING. THE SURVEY RESPONSE RATE WAS 26.32% WITH 10 PROVIDERS COMPLETING THE SURVEY. OVERALL, THE SURVEY DEMONSTRATED PROVIDER FAMILIARITY WITH THE SCREEN, BUT REVEALED SOME OPPORTUNITIES FOR MORE EDUCATION. FOR EXAMPLE, NEARLY HALF OF THE PROVIDERS WERE NOT SURE WHICH PATIENTS QUALIFY FOR THE SCREENING. THE SURVEY ALSO DEMONSTRATED MORE PATIENT EDUCATION IS NEEDED. SEVEN OUT OF THE 10 PROVIDERS SURVEYED SAID THEY WERE NEVER ASKED ABOUT THE LCDT SCREENING BY PATIENTS AND 6 OUT OF THE 10 PROVIDERS SURVEYED SAID PATIENTS REFUSED THE LCDT SCREENING EVEN AFTER IT WAS OFFERED TO THEM. SCHEDULE H, PART V, SECTION B, LINE 11 (ADDRESSING NEEDS FROM THE CHNA) IN RESPONSE TO THE SCREENING, THE COMMUNITY ENGAGEMENT MANGER HAS WORKED TO ENSURE THAT EVERY OPPORTUNITY UNION HAS TO PROVIDE EDUCATION IN THE COMMUNITY INCLUDES SHARING INFORMATION ABOUT CANCER SCREENING AND PREVENTION, PARTICULARLY LDCT SCANS. IN PARTNERSHIP WITH THE CANCER TASK FORCE, THE COMMUNITY ENGAGEMENT MANAGER WILL ALSO UNDERTAKE OUTREACH TO BOTH UNION AND NON-UNION PROVIDERS TO PROVIDE EDUCATION ON LDCT SCANS IN GENERAL, AND HOW TO ORDER THEM. THESE CONTINUED EFFORTS HAVE SHOWN SOME SUCCESS. IN CALENDAR YEAR 2023, THERE HAS BEEN A 20% INCREASE IN LDCT SCANS IN COMPARISON TO CALENDAR YEAR 2022. THE ACTIVITIES IN THIS AREA DEMONSTRATE A FOCUS OF THE COMMUNITY ENGAGEMENT MANAGER WHICH HAS BEEN TO PROMOTE EXISTING RESOURCES TO INTERNAL AND EXTERNAL PARTNERS. THE CHALLENGE IS SOMETIMES THAT RESOURCES EXIST BUT ARE NOT KNOWN. ENSURING OUR PROVIDERS ARE AWARE OF COMMUNITY RESOURCES AND THAT OUR COMMUNITY PARTNERS ARE AWARE OF UNION'S PROGRAMS WAS AN IMMEDIATE NEED OUR COMMUNITY ENGAGEMENT MANAGER RECOGNIZED AND HAS BEEN WORKING TO ADDRESS. LGBTQIA+ HEALTH DISPARITIES THE DATA IN THE 2022 CHNA WAS VERY CLEAR THAT LESBIAN, GAY, TRANSGENDER, QUEER/QUESTIONING, INTERSEX AND ASEXUAL, ETC. (LGBTQIA+) COMMUNITY FACE SIGNIFICANT CHALLENGES. LGBTQIA+ YOUTH ARE MORE THAN TWICE AS LIKELY TO BE BULLIED AND THREATENED WITH A WEAPON ON SCHOOL PROPERTY COMPARED TO YOUTH WHO IDENTIFY AS STRAIGHT. LGBTQIA+ YOUTH ARE ALSO MORE LIKELY TO ENGAGE IN HIGH-RISK BEHAVIORS SUCH AS TOBACCO, ALCOHOL, AND OTHER DRUG USE AND TO REPORT SIGNIFICANTLY LOWER RATES OF PHYSICAL ACTIVITY. THE STAKEHOLDERS INTERVIEWED IN THE 2022 CHNA ALSO IDENTIFIED AS SIGNIFICANT THE DISCRIMINATION IN HEALTHCARE FACED BY THE LGBTQIA+ COMMUNITY, WHICH LEADS TO AVOIDING HEALTH CARE SERVICES. TO BEGIN TO ADDRESS THOSE DISPARITIES, UNION CAREGIVERS ARE PARTICIPATING IN THE PRIDE AMBASSADORS PROGRAM. CREATED BY CHRISTIANACARE'S OFFICE OF HEALTH EQUITY, THE PRIDE AMBASSADORS PROGRAM OFFERS SIX HOURS OF INSTRUCTION INCLUDING EXPLORATION OF LGBTQIA+ HEALTH TOPICS AS THEY RELATE TO CREATING MORE EQUITABLE HEALTHCARE FOR OUR LGBTQIA+ PATIENTS AND FAMILIES. THE FIRST COHORT OF UNION CAREGIVERS BECAME PRIDE AMBASSADORS IN JULY 2021. IN MAY 2023, AN ADDITIONAL 15 UNION CAREGIVERS COMPLETED THE PRIDE AMBASSADORS PROGRAM. ALL THESE CAREGIVERS WILL USE THAT KNOWLEDGE TO BETTER SERVE THEIR PATIENTS AND ACT AS AMBASSADORS FOR THEIR COLLEAGUES BY SHARING WHAT THEY LEARNED. IN LATE FY23, OUR COMMUNITY ENGAGEMENT MANAGER ALSO ACCEPTED AN INVITATION FROM THE CCHD TO SERVE ON A COMMITTEE THEY CREATED TO ENSURE CECIL COUNTY BECOMES MORE INCLUSIVE FOR THIS POPULATION. THE FIRST MEETING WAS HELD IN JUNE 2023. THIS PARTICIPATION WILL ALSO PROVIDE THE OPPORTUNITY FOR THE COMMUNITY ENGAGEMENT MANAGER TO WORK WITH PARTNERS TO ORGANIZE A PRIDE AMBASSADORS TRAINING FOR COMMUNITY PROVIDERS AND THE HEALTH DEPARTMENT. SUBSTANCE USE DISORDERS THERE HAS BEEN CONSIDERABLE SUFFERING AMONG CECIL COUNTY RESIDENTS BECAUSE OF SUBSTANCE USE DISORDERS AND THE OPIOID EPIDEMIC IN PARTICULAR. TO ADDRESS THIS INTRACTABLE COMMUNITY ISSUE, UNION HAS LONG PARTNERED WITH CCHD'S ALCOHOL & DRUG RECOVERY CENTER TO MAKE AVAILABLE A DESIGNATED PEER RECOVERY SPECIALIST FOR REFERRALS ON BEHALF OF UNION PATIENTS. CAREGIVERS CONTACT THE PEER RECOVERY SPECIALIST ON BEHALF OF THE PATIENT IF THEY EXPRESS AN INTEREST IN SPEAKING WITH THEM OR TREATMENT. IF AVAILABLE, THE PEER RECOVERY SPECIALIST CAN COME TO THE HOSPITAL TO MEET WITH THE PATIENT OR FOLLOW UP WITH THEM IN THE COMMUNITY. WHEN A PATIENT EXPRESSES AN INTEREST IN RECOVERY OUTSIDE OF REGULAR BUSINESS HOURS, THE CAREGIVER ENCOURAGES THEM TO CALL CATCH (CECIL ADDICTION TREATMENT COORDINATION HOTLINE) WHICH IS AVAILABLE 24 HOURS-A-DAY, 7 DAYS-A-WEEK. IN FY23, 284 PATIENTS WERE REFERRED TO THE PEER RECOVERY SPECIALIST WHO COMPLETED 1,187 BEDSIDE ENCOUNTERS. MUCH OF FY23 WAS ALSO SPENT WORKING WITH THE CCHD TO BUILD UPON THIS PROGRAM. THE CCHD SUCCESSFULLY APPLIED FOR A NATIONAL ASSOCIATION OF COUNTY & CITY HEALTH OFFICIALS (NACCHO) SUSTAINING PEERS IN EMERGENCY DEPARTMENTS GRANT THAT WILL ALLOW OUR PATIENTS A SIGNIFICANT INCREASE IN ACCESS TO RESOURCES TO ADDRESS THEIR SUBSTANCE USE DISORDER. THROUGH THIS GRANT, THE CCHD ASKED THAT WE CONTINUE TO PARTNER WITH THEM ON THIS INITIATIVE AS WELL AS INCLUDE VOICES OF HOPE, A COMMUNITY ORGANIZATION MADE OF PEOPLE IN RECOVERY, FAMILY MEMBERS, AND ALLIES WHO SUPPORT INDIVIDUALS IN RECOVERY. WE WORKED WITH CCHD AND VOICES OF HOPE TO DESIGN THE GRANT PROGRAM WHICH WILL ALLOW 5 PEERS, FROM BOTH CCHD AND VOICES OF HOPE, TO BE PRESENT IN THE EMERGENCY DEPARTMENT (ED), AS WELL AS AVAILABLE ON ANY FLOOR IN THE HOSPITAL SHOULD A PATIENT REQUEST A CONSULT, FROM 8:00 A.M. TO 1:00 A.M. EVERY DAY OF THE WEEK. THIS INITIATIVE BEGAN IN AUGUST 2023, AND WE LOOK FORWARD TO SHARING MORE ABOUT ITS SUCCESS NEXT YEAR. LAST FISCAL YEAR, WE SHARED THAT UNION ALSO BEGAN PROVIDING MEDICATION ASSISTED TREATMENT (MAT) INDUCTIONS WITHIN THE ED IN AUGUST 2022. WHILE THESE INDUCTIONS ARE NOT YET ROUTINE IN EDS THROUGHOUT THE COUNTRY, GIVEN OUR COMMUNITY'S HIGH RATE OF OVERDOSE DEATHS, WE THOUGHT IT NECESSARY TO PROVIDE A CONVENIENT ACCESS POINT TO TREATMENT. FOR THIS REASON, WE ALSO PARTNERED WITH CCHD LAST FISCAL YEAR TO PROVIDE NALOXONE TO PATIENTS AND VISITORS IN OUR HOSPITAL. NEITHER INITIATIVE HAS SERVED A CONSIDERABLE NUMBER OF PATIENTS, BUT WE EXPECT THAT THE EXPANDED PEER SERVICES NOW AVAILABLE IN THE HOSPITAL WILL SERVE TO PROMOTE THESE RESOURCES AND INCREASE USAGE. AS PREVIOUSLY DESCRIBED, UNION CAREGIVERS ALSO PROVIDE CHILDBIRTH AND INFANT EDUCATION TO PREGNANT WOMEN RECEIVING SUBSTANCE USE DISORDER TREATMENT AT SERENITY HEALTH ELKTON. A REGISTERED NURSE GOES TO SERENITY HEALTH TO PROVIDE MONTHLY EDUCATIONAL SESSIONS ON TOPICS SUCH AS BREASTFEEDING, NEONATAL ABSTINENCE SYNDROME (NAS), AND SAFE SLEEP, AMONG OTHERS. UNION SOCIAL WORKERS ALSO ATTEND SOME OF THE SESSIONS WITH THE REGISTERED NURSES TO PROVIDE INFORMATION ON TOPICS LIKE CHILD PROTECTIVE SERVICES AND ANSWER QUESTIONS ON ASSESSING SOCIAL SERVICES. IN FY23, ELEVEN EDUCATION SESSIONS WERE HELD AT SERENITY HEALTH ELKTON WITH 1 TO 3 PREGNANT PARTICIPANTS IN EACH COURSE. IN FY23, CAREGIVERS ALSO WORKED TO DEVELOP PARTNERSHIPS WITH OTHER TREATMENT PROVIDERS IN CECIL COUNTY TO PROVIDE THE SAME EDUCATION. PROVIDING THIS EDUCATION IS IMPORTANT TO EMPOWER THESE MOTHERS TO TAKE THE BEST CARE OF THEIR BABY INSTEAD OF FEELING ISOLATED AND ASHAMED. ON BEHALF OF UNION, REGISTERED NURSES ALSO CONTINUE TO ATTEND MONTHLY LOCAL OVERDOSE FATALITY REVIEW TEAMS (LORFT) MEETINGS TO DISCUSS AND CASE REVIEW ALL UNINTENTIONAL OVERDOSE DEATHS RELATED TO STREET DRUGS AND ALCOHOL IN CECIL COUNTY. MEMBERS ARE STAKEHOLDERS FROM LAW ENFORCEMENT, THE COMMUNITY, GOVERNMENT AGENCIES, AND PROVIDERS. SOCIAL DETERMINANTS OF HEALTH (SDOH) WERE NOT IDENTIFIED AS A SIGNIFICANT AREA OF NEED IN OUR 2022 CHNA, BUT SDOH CAUSE AND/OR EXACERBATE ALL THE SIGNIFICANT AREAS OF NEED. IN FY23 UNION COMPLETED THE PROCESS OF INTEGRATION WITH CHRISTIANACARE'S ELECTRONIC HEALTH RECORD. AMONG THE MANY BENEFITS OF THIS INTEGRATION IS THAT UNION NOW HAS ACCESS TO CHRISTIANACARE'S SOCIAL DETERMINANTS OF HEALTH SCREENING TOOL. THIS SCREENING WILL PROVIDE US WITH MORE INSIGHT INTO THE CHALLENGES OUR PATIENTS FACE. AS UNION HAS NOT PREVIOUSLY HAD A UNIFORM SDOH SCREENING, THE ADOPTION AND IMPLEMENTATION OF THIS TOOL WILL TAKE TIME. WE EXPECT THAT THE PATIENT CARE COORDINATORS, HIRED THROUGH THE PREVIOUSLY DESCRIBED MDPCP, WILL PILOT THE SDOH SCREENING AT UNION. IMPORTANTLY, WE DO NOT WANT TO SIMPLY COLLECTION INFORMATION ABOUT OUR PATIENTS' BARRIERS TO GOOD HEALTH. WE WANT TO HELP PATIENTS ADDRESS THESE BARRIERS. IN DECEMBER 2021, UNION BEGAN USING UNITE MARYLAND, AN ELECTRONIC CARE COORDINATION NETWORK LAUNCHED BY UNITE US. THE UNITE US NETWORKS CONNECT SOCIAL SERVICES AND CLINICAL CARE PROVIDERS. BY PARTICIPATING IN THESE NETWORKS, HEALTHCARE PROVIDERS AND SOCIAL SERVICE ORGANIZATIONS CAN HELP INDIVIDUALS ADDRESS THEIR DIVERSE NEEDS BY SENDING AN ELECTRONIC REFERRAL ON THEIR BEHALF TO THE APPROPRIATE ORGANIZATION. THE SENDER OF THAT REFERRAL WILL BE ABLE TO TRACK WHETHER THAT NEED WAS MET OR NOT AND TAKE ADDITIONAL ACTION IF NEEDED TO HELP THE PATIENT MEET THEIR NEED. UNION'S USE OF UNITE MARYLAND EXPANDED IN FEBRUARY 2023 WITH THE ONBOARDING OF 5 ADDITIONAL PROGRAMS/DEPARTMENTS INCLUDING SOCIAL WORK, CASE MANAGEMENT, AND INSURANCE NAVIGATION. OUR SUPPORT OF UNITE MARYLAND ALSO BENEFITS THE BROADER COMMUNITY AS COMMUNITY ORGANIZATIONS ARE ABLE TO PARTICIPATE ON THE NETWORK FOR FREE. AS OF JUNE 30, 2023, THE UNITE MARYLAND NETWORK HAD 57 LOCAL ORGANIZATIONS WITH 66 PROGRAMS OPEN TO RECEIVE REFERRALS SERVING THE CECIL COUNTY COMMUNITY. CHRISTIANACARE ALSO ESTABLISHED THE COMMUNITY INVESTMENT FUND IN DECEMBER 2019 TO ADDRESS SDOH BY GIVING FUNDING TO COMMUNITY ORGANIZATIONS THAT PROVIDE VITAL SERVICES IN OUR COMMUNITIES. THAT YEAR, CHRISTIANACARE AWARDED NEARLY $2 SCHEDULE H, PART V, SECTION B, LINE 13B (DETAIL OF INCOME LEVEL) PATIENTS WITH A HOUSEHOLD INCOME UP TO 500% OF FPL AND WITH A FINANCIAL HARDSHIP (MEDICAL DEBT, INCURRED BY A FAMILY OVER A 12-MONTH PERIOD THAT EXCEEDS 25 PERCENT OF THE FAMILY INCOME) WILL RECEIVE A 25% ADJUSTMENT. --------------- SCHEDULE H, PART V, SECTION B, LINE 16A (FAP AVAILABILITY) FAP WEBSITE: HTTPS://WWW.UHCC.COM/PATIENT-FINANCIAL-SERVICES/FINANCIAL-ASSISTANCE/ --------------- SCHEDULE H, PART V, SECTION B, LINE 16B (FAP APPLICATION AVAILABILITY) FAP APPLICATION WEBSITE: HTTPS://WWW.UHCC.COM/PATIENT-FINANCIAL-SERVICES/FINANCIAL-ASSISTANCE/ --------------- SCHEDULE H, PART V, SECTION B, LINE 16C (FAP PLS AVAILABILITY) FAP PLAIN LANGUAGE SUMMARY WEBSITE: HTTPS://WWW.UHCC.COM/PATIENT-FINANCIAL-SERVICES/FINANCIAL-ASSISTANCE/ --------------- SCHEDULE H, PART V, SECTION B, LINE 16J (FAP OTHER AVAILABILITY) UNION HOSPITAL PLACES AN ADVERTISEMENT ONCE A YEAR IN THE LOCAL NEWSPAPERS OUTLINING THE FAP AND HOW TO APPLY. FAP IS PUBLICIZED ON ALL BILLING STATEMENTS, INVOICES, AND FINANCIAL CONSENT FORMS. FAP IS COMMUNICATED TO PATIENTS UPON DISCHARGE FROM INPATIENT, OBSERVATION, AND SURGICAL SERVICES. --------------- PART I, LINE 7 (BAD DEBT EXPENSE, COSTING METHODOLOGY USED) IMPLICIT PRICE CONCESSIONS ARE TREATED AS A CONTRA-REVENUE ITEM ON THE STATEMENT OF REVENUE. AS A RESULT, THERE ARE NO BAD DEBT EXPENSES INCLUDED ON FORM 990, PART IX THAT NEED TO BE SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGES LISTED. THE COSTING METHODOLOGY USED IN CALCULATING THE AMOUNTS REPORTED ON THE LINE 7 TABLE ARE BASED ON ACTUAL COST PLUS OVERHEAD. OVERHEAD IS A HOSPITAL AVERAGE PERCENTAGE OF OVERHEAD TO DIRECT COSTS. DIRECT COSTS EXCLUDE BAD DEBT EXPENSE. --------------- PART II (DETAIL OF COMMUNITY BUILDING ACTIVITIES) IN FY2023, UNION HOSPITAL REPORTED EXPENDITURES IN THE COMMUNITY BUILDING CATEGORIES OF ECONOMIC DEVELOPMENT AND WORKFORCE DEVELOPMENT. THIS COST REPRESENTS TIME SPENT BY THE DIRECTOR OF HUMAN RESOURCES PARTICIPATING ON TWO COMMUNITY BOARDS: THE BOARD OF THE ECONOMIC DEVELOPMENT COMMISSION FOR CECIL COUNTY AND THE SUSQUEHANNA WORKFORCE NETWORK. THE ECONOMIC DEVELOPMENT COMMISSION FOCUSES ON BUSINESS AND INDUSTRY DEVELOPMENT BY BUILDING RELATIONSHIPS WITH LOCAL PARTNERS IN CECIL COUNTY. THE CORE FUNCTION OF LOCAL MANAGEMENT BOARDS (LMBS) IS TO IDENTIFY COMMUNITY DRIVEN PRIORITIES AND TARGET RESOURCES FOR THEIR COMMUNITIES, AS WELL AS SERVE AS THE COORDINATOR OF COLLABORATION FOR CHILD AND FAMILY SERVICES. THERE IS A LOCAL MANAGEMENT BOARD IN EACH COUNTY IN MARYLAND, INCLUDING BALTIMORE CITY. THE SUSQUEHANNA WORKFORCE NETWORK OVERSEES, COORDINATES, AND PLANS WORKFORCE DEVELOPMENT PROGRAMS AND SERVICES FOR BUSINESSES AND INDIVIDUALS IN CECIL AND HARFORD COUNTIES. IT IDENTIFIES NEEDS AND DEVELOPS SOLUTIONS THAT MAXIMIZE REGIONAL ECONOMIC SUCCESS AND WORKER POTENTIAL. THEY REPRESENT AN AFFILIATION OF OVER 50 LOCAL AGENCIES, BUSINESSES, AND ORGANIZATIONS THAT WORK COLLABORATIVELY TO EXECUTE A SYSTEM OF EDUCATION, TRAINING, EMPLOYMENT, AND OUTREACH PROGRAMS AND SERVICES THAT ARE RESPONSIVE TO LOCAL ECONOMIC CHALLENGES AND MEET THE NEEDS OF BUSINESSES, WORKERS, AND YOUTH. --------------- PART III, SECTION A, LINE 2 (IMPLICIT PRICE CONCESSIONS/BAD DEBT EXPENSE) THE COSTING METHODOLOGY USED IN DETERMINING THE AMOUNTS REPORTED ON LINES 2 AND 3 ARE BASED ON ACTUAL CHARGES WRITTEN OFF (AMOUNTS THAT ARE DEEMED TO BE UNCOLLECTIBLE AND RECORDED AS IMPLICIT PRICE CONCESSIONS UNDER ACCOUNTING PRONOUNCEMENT ASC 606) TIMES THE COST TO CHARGE RATIO. --------------- PART III, SECTION A, LINE 3 (IMPLICIT PRICE CONCESSION METHODOLOGY) THE IMPLICIT PRICE CONCESSION METHODOLOGY ASSUMES THAT THE PERCENTAGE OF CHARITY CARE TO TOTAL REVENUE CAN BE APPLIED TO THE AMOUNT OF IMPLICIT PRICE CONCESSIONS FOR THE YEAR. OTHER IMPLICIT PRICE CONCESSION AMOUNTS ARE NOT INCLUDED IN COMMUNITY BENEFITS. --------------- PART III, SECTION A, LINE 4 (IMPLICIT PRICE CONCESSION FOOTNOTE) THE TEXT OF THE IMPLICIT PRICE CONCESSION (BAD DEBT EXPENSE) FOOTNOTE CAN BE FOUND STARTING ON PAGE 13 OF THE ELECTRONICALLY ATTACHED AUDITED FINANCIAL STATEMENTS. --------------- PART III, SECTION B, LINE 8 (COSTING METHODOLOGY, MEDICARE SHORTFALL) COSTING METHODOLOGY USED TO DETERMINE AMOUNT OF MEDICARE ALLOWABLE COSTS: MEDICARE ALLOWABLE COSTS EQUAL MEDICARE REVENUE ADJUSTED FOR THE HOSPITAL TOTAL RATIO OF PATIENT CARE COSTS TO CHARGES DUE TO THE FACT THAT MEDICARE PAYS FULL CHARGES IN MARYLAND. EXTENT TO WHICH MEDICARE SHORTFALL SHOULD BE TREATED AS COMMUNITY BENEFIT: IN THE STATE OF MARYLAND, MEDICARE PAYS FULL CHARGES. THERE IS NO SHORTFALL THAT SHOULD BE TREATED AS A COMMUNITY BENEFIT. --------------- PART III, SECTION B, LINE 9B (COLLECTION PRACTICES) UNION HOSPITAL'S F-416 CREDIT AND COLLECTION POLICY AND PROCEDURE HAS A SECTION CALLED, "INTERNAL COLLECTION EFFORTS" WHICH STATES: "UPON DISCHARGE, PATIENTS RECEIVE AN ITEMIZED BILL FOR INPATIENT ADMISSIONS IN ACCORDANCE WITH THE MARYLAND HOSPITAL COST REVIEW COMMISSION REQUIREMENTS. WHEN INSURANCE PAYMENTS ARE RECEIVED LEAVING A SELF-PAY BALANCE, OR THE ACCOUNT IS STRICTLY SELF-PAY, IT IS OUTSOURCED FOR FOLLOW-UP BUT REMAINS ON THE HOSPITAL'S ACTIVE ACCOUNTS RECEIVABLE. AGENTS WORK THE ACCOUNTS IN THE HOSPITAL'S NAME AND REPRESENTATIVES ARE DIRECTED TO ACCEPT MONTHLY PAYMENTS UNTIL THE ACCOUNT IS PAID IN FULL. COLLECTION EFFORTS CONSIST OF PHONE CALLS AND MONTHLY STATEMENTS. THE PATIENT MAY ALSO APPLY FOR FINANCIAL ASSISTANCE AT ANY TIME DURING THIS PROCESS (SEE POLICY F-415, FINANCIAL ASSISTANCE)." IN THE F-415 FINANCIAL ASSISTANCE POLICY AND PROCEDURE, UNDER SECTION, "ACTION IN THE EVENT OF NON-PAYMENT," IT IS EXPLAINED THAT: "A. UNION HOSPITAL MAY CONTRACT WITH OUTSIDE COLLECTION SERVICES TO PURSUE COLLECTION OF DELINQUENT ACCOUNTS. ALL UNPAID ACCOUNTS WITHOUT EXCEPTION OR PAYMENT ARRANGEMENTS ARE PLACED IN OUTSIDE COLLECTION AFTER A MINIMUM OF 90 DAYS FROM THE INITIAL BILLING STATEMENT AND DELIVERY OF ALL SCHEDULED PATIENT ACCOUNT STATEMENTS TO THE PATIENT/GUARANTOR. B. UNION HOSPITAL DOES NOT CONDUCT, OR PERMIT COLLECTION AGENCIES TO CONDUCT ON THEIR BEHALF, EXTRAORDINARY COLLECTIONS EFFORTS AGAINST INDIVIDUALS." IN ADDITION, IN THE F-416 POLICY, UNDER THE SECTION, "EXTERNAL COLLECTION (BAD DEBT WRITE-OFF)," IT EXPLAINS THAT PATIENTS WITH BALANCES BEING COLLECTED BY AN ASSIGNED COLLECTION AGENCY WILL HAVE THEIR BALANCES WRITTEN OFF IF THEY ARE DETERMINED TO BE INDIGENT. --------------- PART VI, LINE 2 (NEEDS ASSESSMENT) AS MENTIONED IN THE PRIOR SECTION, CAREGIVERS AT UNION WILL UTILIZE THE SDOH SCREENING INSTRUMENT TO LEARN ABOUT AND ADDRESS OUR PATIENTS' NEEDS. AS DEMONSTRATED BY OUR YEARS OF PRODUCING JOINT CHNAS AND THE DIFFERENT INITIATIVES WE HAVE UNDERTAKEN TOGETHER, UNION ALSO HAS A STRONG RELATIONSHIP WITH THE CECIL COUNTY HEALTH DEPARTMENT. THIS ALLOWS US TO COORDINATE EFFORTS WHEN POSSIBLE AND TO LEARN FROM THEIR INSIGHT ABOUT OUR COMMUNITY AS WELL. OUR NEW COMMUNITY ENGAGEMENT MANAGER IS ALSO FOCUSED ON ENGAGING WITH OUR COMMUNITY AND DEVISING STRATEGIES TO RESPOND TO THEIR NEEDS. UNION CAREGIVERS PARTICIPATE IN CECIL COUNTY'S COMMUNITY HEALTH ADVISORY COMMITTEE (CHAC) AND ITS TASK FORCES CREATED TO ADDRESS PROMINENT ISSUES IN THE COUNTY SUCH AS THE HEALTHY LIFESTYLES AND TOBACCO TASK FORCES. FOR SEVERAL YEARS, A UNION CAREGIVER HAS CHAIRED THE CANCER TASK FORCE. UNION CAREGIVERS ALSO PARTICIPATE IN DIFFERENT COMMUNITY BOARDS AND COMMITTEES THAT FOCUS ON DIFFERENT AREAS OF COMMUNITY NEED. ALONG WITH THE CHAC TASK FORCES. UNION CAREGIVERS ALSO PARTICIPATED IN THESE ADDITIONAL COMMUNITY GROUPS: . CECIL COUNTY BEHAVIORAL HEALTH PROVIDERS . CECIL COUNTY BEHAVIORAL HEALTH ADVISORY BOARD . CECIL COUNTY HEALTH DEPARTMENT ADVISORY COMMITTEE . CECIL COUNTY CHILD ADVOCACY CENTER . CECIL COUNTY ECONOMIC DEVELOPMENT COMMISSION . LOCAL MANAGEMENT BOARD . LOCAL OVERDOSE FATALITY REVIEW TEAM . CHILD FATALITY REVIEW BOARD --------------- PART VI, LINE 3 (PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE) UNION'S FINANCIAL ASSISTANCE POLICY (FAP) ENSURES A UNIFORM AND EQUITABLE PROCESS IN GRANTING FINANCIAL ASSISTANCE TO APPROPRIATE PATIENTS WHILE RESPECTING THE INDIVIDUAL'S DIGNITY. THE FAP ALIGNS WITH FEDERAL AND STATE REGULATIONS. INDIVIDUALS WHO NEED EMERGENCY OR MEDICALLY NECESSARY TREATMENT AND HAVE A HOUSEHOLD INCOME BELOW 400% OF THE FEDERAL POVERTY LEVEL (FPL) ARE ELIGIBLE FOR FREE OR DISCOUNTED CARE. UNION DOES NOT PURSUE EXTRAORDINARY COLLECTION ACTIONS AGAINST ANY INDIVIDUAL. A PLAIN LANGUAGE SUMMARY OF THE FAP, THE FULL POLICY, THE FINANCIAL ASSISTANCE APPLICATION IN ENGLISH AND SPANISH, AND THE MOST RECENT FINANCIAL ASSISTANCE SCALE ARE ALL AVAILABLE ON UNION'S WEBSITE AT: https://www.uhcc.com/about-us/patient-financial-services/financial-assista nce/ UNION'S WEBSITE ALSO PROVIDES PATIENTS WITH DETAILED DESCRIPTIONS OF HOW THEY CAN OBTAIN THE FAP AND APPLICATION IN PERSON AND GET HELP IN THE APPLICATION PROCESS. UNION FINANCIAL COUNSELORS ARE AVAILABLE MONDAY THROUGH FRIDAY, FROM 8 A.M. TO 4:30 P.M. TO DISCUSS THE APPLICATION PROCESS BY PHONE OR AT THE HOSPITAL. THE WEBSITE ALSO PROVIDES A MAILING ADDRESS, TELEPHONE NUMBER, EMAIL ADDRESS, AND IN-PERSON LOCATIONS WHERE INDIVIDUALS CAN RECEIVE OR REQUEST THE FAP AND APPLICATION. INFORMATION ABOUT THE FAP IS INCLUDED ON THE FINANCIAL CONSENT FORM, ON BILLING STATEMENTS/INVOICES, UPON DISCHARGE FROM INPATIENT, OBSERVATION, OR SURGICAL SERVICES, AND ON ELECTRONIC AND PAPER SIGNS AT REGISTRATION LOCATIONS IN THE HOSPITAL. PATIENTS RECEIVE FINANCIAL COUNSELING, REFERRALS, AND ASSISTANCE TO IDENTIFY PUBLIC OR PRIVATE HEALTHCARE PROGRAMS TO ASSIST WITH LONG TERM NEEDS. IF THE PATIENT IS UNINSURED, THEY WILL BE ASSISTED TO DETERMINE MARYLAND MEDICAID OR QUALIFIED HEALTH PLAN ELIGIBILITY THROUGH THE APPROPRIATE MARYLAND HEALTH CONNECTION CONNECTOR ENTITY OR OTHER QUALIFIED HEALTH INSURANCE MARKETPLACE. UNION'S INSURANCE PROGRAM NAVIGATORS ALSO ATTEND COMMUNITY EVENTS TO PROVIDE INFORMATION ABOUT MARYLAND HEALTH CONNECTION. --------------- PART VI, LINE 4 (COMMUNITY INFORMATION) UNION PRIMARILY SERVES CECIL COUNTY, MARYLAND. IN FY22, CECIL COUNTY RESIDENTS ACCOUNTED FOR APPROXIMATELY 85% OF THE HOSPITAL'S TOTAL INPATIENT VOLUMES AND 84% OF TOTAL EMERGENCY DEPARTMENT VISITS. UNION HOSPITAL IS THE ONLY HOSPITAL IN THE COUNTY AND IS LOCATED IN ELKTON, THE MOST POPULOUS TOWN IN CECIL COUNTY. CECIL COUNTY IS RURAL AND BORDERS DELAWARE AND PENNSYLVANIA. IN 2021, THE TOTAL POPULATION OF CECIL COUNTY WAS APPROXIMATELY 102,722 PERSONS. BETWEEN 2020 AND 2030, THE CECIL COUNTY POPULATION IS EXPECTED TO GROW BY 8.5% WITH THE POPULATION OF THOSE 65 YEARS AND OLDER PROJECTED TO GROW AT A MORE RAPID RATE OF 43.1%. FROM 2016 TO 2020, THE POVERTY RATE IN CECIL COUNTY (9.5%) WAS SLIGHTLY ABOVE THE MARYLAND POVERTY RATE (9%), BUT BELOW THE UNITED STATES AVERAGE (12.8%). SIGNIFICANT DISPARITIES EXIST IN CECIL COUNTY WITH THE POVERTY RATES FOR BLACK (15.8%) AND HISPANIC (18.1%) PEOPLE SIGNIFICANTLY HIGHER THAN THOSE FOR WHITE (8.5%) RESIDENTS. LOW-INCOME CENSUS TRACTS ARE MOST PREVALENT IN ELKTON, NORTH EAST, AND PORT DEPOSIT. MOST OF THESE CENSUS TRACTS ARE WHERE MORE THAN ONE-HALF OF HOUSEHOLDS ARE "RENT BURDENED," ARE CATEGORIZED AS "HIGH NEED" BY THE DIGNITY HEALTH COMMUNITY NEED INDEXT (CNI) AND ARE IN THE TOP QUARTILE NATIONALLY FOR "SOCIAL VULNERABILITY" ACCORDING TO THE CENTERS FOR DISEASE CONTROL SOCIAL VULNERABILITY INDEX. THERE ARE CONSIDERABLE SUBSTANCE USE DISORDER ISSUES IN CECIL COUNTY. ADULT SMOKING RATES ARE HIGHER IN CECIL COUNTY THAN IN MARYLAND AND THE UNITED STATES. YOUTH TOBACCO AND NICOTINE USE ALSO COMPARES UNFAVORABLY IN COMPARISON TO NATIONAL AVERAGES. THE PERCENT OF CECIL COUNTY YOUTH THAT CURRENTLY USE SMOKELESS TOBACCO IS MORE THAN 50% ABOVE THE UNITED STATES AVERAGE. THE DRUG OVERDOSE DEATH RATE IS ALSO CONSIDERABLY HIGHER IN CECIL COUNTY THAN THE RATE IN MARYLAND AND THE UNITED STATES. BETWEEN 2016 AND 2020, THE DRUG OVERDOSE DEATH RATE MORE THAN DOUBLED. --------------- PART VI, LINE 5 (INFORMATION REGARDING PROMOTION OF COMMUNITY HEALTH) CHRISTIANACARE IS CENTERED ON IMPROVING HEALTH OUTCOMES, MAKING HIGH-QUALITY CARE MORE ACCESSIBLE, AND LOWERING HEALTH CARE COSTS. GUIDED BY OUR VALUES, LOVE AND EXCELLENCE, UNION CONTINUES TO SERVE OUR CECIL COUNTY NEIGHBORS AS THEIR COMMUNITY HOSPITAL. EACH FISCAL YEAR, UNION SERVES CECIL COUNTY BY PROVIDING ACTIVITIES, PROGRAMS, AND INITIATIVES THAT SEEK TO IMPROVE COMMUNITY HEALTH. THE FOLLOWING IS A SUMMARY OF THE COMMUNITY BENEFIT ACTIVITIES, PROGRAMS, AND INITIATIVES THAT UNION HOSPITAL PROVIDED IN CECIL COUNTY DURING FY23: . A1: COMMUNITY HEALTH EDUCATION - UNION HOSPITAL PROVIDED: HEALTH EDUCATION PRESENTATIONS IN THE COMMUNITY ON TOPICS SUCH AS DIABETES AND NUTRITION, CANCER PREVENTION AND SCREENING, CHILDBIRTH AND INFANT EDUCATION INCLUDING NEONATAL ABSTINENCE SYNDROME AND LACTATION SUPPORT, AND INFORMATION ON MARYLAND HEALTH CONNECTION. . A2: COMMUNITY-BASED CLINICAL SERVICES - TWO FREE EYE SCREENINGS FOR DIABETICS - A FREE SPORTS PHYSICALS CLINIC FOR COUNTY PUBLIC AND PRIVATE MIDDLE SCHOOL AND HIGH SCHOOL STUDENTS . A3: HEALTH CARE SUPPORT SERVICES - PARTICIPATION ON CHILD ADVOCACY CENTER INVESTIGATIONS/MEETINGS - PARTNERSHIP WITH CCHD TO SUPPORT THE PEER RECOVERY ADVOCATES PROGRAM AND IMPLEMENT A NEW GRANT INITIATIVE THAT WILL PROVIDE MORE CONNECTIONS TO PEERS IN THE COMMUNITY . A4: SOCIAL AND ENVIRONMENTAL IMPROVEMENTS - TRANSPORTATION DONATIONS FOR ELIGIBLE PATIENTS . B1-B3: HEALTH PROFESSIONS EDUCATION - UNION CAREGIVERS OFFERED TRADITIONAL CLINICAL ROTATIONS TO 64 UNDERGRADUATE NURSING STUDENTS. . C: MISSION DRIVEN HEALTH SERVICES - UNION PROVIDED SUBSIDIZED OUTPATIENT SERVICES TO MEET IDENTIFIED NEEDS IN THE COMMUNITY, EVEN THOUGH THEY OPERATE AT A LOSS. THESE INCLUDE PRIMARY CARE, PSYCH-OUTPATIENT AND ENDOCRINOLOGY, AMONG OTHERS. . E3: IN-KIND CONTRIBUTIONS - PROVIDED FREE AMBULANCE TRANSPORTS AND FREE SUPPLIES FOR AMBULANCE STOCK-UPS - PARTICIPATION IN COMMUNITY BOARDS/COMMITTEES/TASK FORCES AND OTHER GROUPS --------------- PART VI, LINE 6 (AFFILIATED HEALTHCARE SYSTEM INFORMATION) UNION HOSPITAL OF CECIL COUNTY, INC. IS PART OF AN AFFILIATED HEALTH CARE SYSTEM IN WHICH AFFINITY HEALTH ALLIANCE, INC. (AHA) IS THE PARENT ENTITY. AHA'S PURPOSE IS TO SUPPORT THE UNION HOSPITAL OF CECIL COUNTY IN PROVIDING HEALTH CARE AND HEALTH CARE RELATED SERVICES THROUGH THE EFFECTIVE MANAGEMENT OF ALL AFFILIATED CORPORATIONS. SPECIFICALLY, THIS INVOLVES COORDINATING SYSTEM WIDE POLICIES, FUNDRAISING AND STRATEGIC PLANNING PROGRAMS TO PROVIDE HEALTH CARE SERVICES IN RESPONSE TO THE MEDICAL, HUMAN AND RELATED SERVICE NEEDS OF THE COMMUNITY. OTHER TAX-EXEMPT ORGANIZATIONS IN THE GROUP INCLUDE THE UNION HOSPITAL OF CECIL COUNTY FOUNDATION, INC., UNION HOSPITAL OF CECIL COUNTY HEALTH SERVICES, INC., AND UNION HOSPITAL OF CECIL COUNTY ONCOLOGY, INC. THE FOUNDATION CONDUCTS AND SUPERVISES FUNDRAISING ACTIVITIES ON BEHALF OF ITS TAX-EXEMPT AFFILIATES. THE FOUNDATION ENGAGES IN CORPORATE FUNDRAISING, CAPITAL CAMPAIGNS, SPECIAL EVENTS, ACTIVITIES, AND A MULTI-FACETED COMMUNICATION PROGRAM THAT APPEALS TO PRIVATE AND CORPORATE CONTRIBUTORS. UNION HOSPITAL OF CECIL COUNTY HEALTH SERVICES, INC.'S MISSION IS TO OWN, MANAGE AND MAINTAIN PROPERTIES FOR HEALTH RELATED VENTURES TO SERVICE CECIL COUNTY AND THE SURROUNDING AREAS. THE ACTIVITIES OF THIS CORPORATION COMPLEMENT AND AUGMENT THE HEALTH CARE ACTIVITIES OF THE HOSPITAL. UNION HOSPITAL OF CECIL COUNTY ONCOLOGY, INC'S (ONCOLOGY") DUTY AND MISSION IS TO PROVIDE HIGH QUALITY, ADVANCED RADIATION ONCOLOGY SERVICES TO THE CECIL COUNTY AREA IN ORDER TO FOSTER THE BEST CANCER TREATMENT PROCESS CLOSE TO HOME. CANCER-RELATED DEATHS ARE AMONG THE HIGHEST CAUSES OF MORTALITY IN CECIL COUNTY, SO IT IS UNION ONCOLOGY'S MISSION TO BRING SOME OF THE MOST ADVANCED RADIATION THERAPIES TO CECIL COUNTY TO PROVIDE THE MOST COMPREHENSIVE CANCER CARE POSSIBLE TO THE PEOPLE LIVING WITH CANCER HERE AND IN NEIGHBORING COMMUNITIES. BY OFFERING THESE ADVANCED CANCER TREATMENT OPTIONS, UNION ONCOLOGY FURTHERS ITS CHARITABLE PURPOSE OF PROVIDING MEDICAL SERVICES TO PROMOTE THE HEALTH AND WELFARE OF THE RESIDENTS OF CECIL COUNTY AND NEIGHBORING COMMUNITIES. UNION HOSPITAL OF CECIL COUNTY VENTURES, INC. IS A FOR-PROFIT STOCK CORPORATION. ITS PURPOSE IS TO ENGAGE IN ANY BUSINESS OR TRANSACTION WHICH WILL BENEFIT THE ACTIVITIES AND GOALS OF ITS AFFILIATES. OPERATIONS CONSIST PRIMARILY OF PROVIDING MANAGEMENT SUPPORT SERVICES FOR PHYSICIAN PRACTICES AND PROVIDING IMAGING SERVICES TO PHYSICIANS AND HEALTH CENTERS THROUGH ITS WHOLLY OWNED SUBSIDIARIES, TRIANGLE ALLIANCE LLC AND OPEN MRI AND IMAGING CENTER OF ELKTON LLC. ON JANUARY 1, 2020, AHA BECAME A MEMBER OF CHRISTIANA CARE HEALTH SYSTEM. CHRISTIANA CARE IS A MAJOR TEACHING HEALTH SYSTEM WITH MORE THAN 1,600 MEDICAL-STAFF MEMBERS AND 265 MEDICAL-DENTAL RESIDENTS AND FELLOWS AND INCLUDES A NUMBER OF ENTITIES INCLUDING CHRISTIANA CARE HEALTH SERVICES, INC. --------------- PART VI, LINE 7 (STATES FILING OF COMMUNITY BENEFIT REPORT) LIST OF STATES RECEIVING COMMUNITY BENEFIT REPORT: MD true true false false false false false true false JENNIFER L SCHWARTZ ESQ SECRETARY (EX-OFFICIO) 0 543248 0 197288 0 4880 0 57934 0 20501 0 823851 0 0 JOSE MA MD DIRECTOR 243710 0 92946 0 2429 0 0 0 12272 0 351357 0 0 0 JUSTIN SAUSVILLE MD DIRECTOR 583596 0 174158 0 22201 0 0 0 20501 0 800456 0 0 0 ROBERT ASANTE DIRECTOR 0 179571 0 30620 0 1018 0 0 0 20501 0 231710 0 0 SHARON T KURFUERST PRESIDENT- THRU 1/23 0 691616 0 248907 0 26781 0 71217 0 13663 0 1052184 0 0 ROBERT MCMURRAY TREASURER (EX-OFFICIO) 0 624494 0 226794 0 6652 0 66326 0 20501 0 944767 0 0 RYAN GERACIMOS MD CHIEF MEDICAL OFFICER 444002 0 96743 0 3786 0 0 0 876 0 545407 0 0 0 JOAN PIRRUNG MSN APRN ACNS-BC VP PAT. CARE SERVIVES-NURSING 186068 0 40659 0 11386 0 0 0 20501 0 258614 0 0 0 AMY MARSTON INT. PRESIDENT- AS OF 2/23 120502 73650 26178 16000 9929 6069 0 0 12829 7841 169438 103560 0 0 MICHELLE TWUM-DANSO DIRECTOR OF HR - CECIL CAMPUS 0 191842 0 33506 0 1165 0 0 0 8956 0 235469 0 0 DERON G BROWN FORMER FINANCE DIRECTOR 71339 86442 12440 15073 417 506 0 0 0 0 84196 102021 0 0 RICHARD C SZUMEL FORMER OFFICER 0 0 0 0 0 465941 0 0 0 0 0 465941 0 0 ROGER D WU MD PHYSICIAN 556611 0 52865 0 2598 0 0 0 20839 0 632913 0 0 0 FAHD RAHMAN MD PHYSICIAN 491660 0 347973 0 2375 0 0 0 20501 0 862509 0 0 0 DONNA MALONEY DIRECTOR OF FINANCE 0 175811 0 32590 0 13510 0 0 0 20501 0 242412 0 0 OLUMIDE OMOBO PHYSICIAN 529550 0 35702 0 1160 0 0 0 7085 0 573497 0 0 0 CLAIRE YI ZHANG PHYSICIAN 445423 0 59663 0 2164 0 0 0 0 0 507250 0 0 0 BALTEJ SINGH MD PHYSICIAN 393595 0 32102 0 1158 0 0 0 20501 0 447356 0 0 0 FORM 990, SCHEDULE J, PART I, LINE 3 TOP MANAGEMENT COMPENSATION AS PROVIDED IN THE FORM 990, SCHEDULE J INSTRUCTIONS, SINCE THE ORGANIZATION RELIES ON A RELATED ORGANIZATION WHICH USES ONE OR MORE OF THE METHOD DESCRIBED IN LINE 3 TO ESTABLISH THE TOP MANAGEMENT OFFICIALS' COMPENSATION, THIS QUESTION HAS BEEN LEFT UNANSWERED. REFER TO SCHEDULE O FOR A DESCRIPTION OF THE COMPENSATION REVIEW AND APPROVAL PROCESS. --------------- FORM 990, SCHEDULE J, PART I, LINE 4A DETAIL OF SEVERANCE PAYMENTS SHARON KURFUERST (PRESIDENT) RECEIVED A SEVERANCE PAYMENT OF $168,230 DURING THE YEAR. KENNETH SILVERSTEIN (MEMBER) RECEIVED A SEVERANCE PAYMENT OF $173,170 DURING THE YEAR. RICHARD SZUMEL (FORMER OFFICER) RECEIVED A SEVERANCE PAYMENT OF $465,941 DURING THE YEAR. --------------- FORM 990, SCHEDULE J, PART I, LINE 4B SUPP. NONQUALIFIED PLAN PARTICIPATION THIS ORGANIZATION IS AN AFFILIATE OF CHRISTIANA CARE HEALTH SERVICES, INC. ("CCHS"). CCHS MAINTAINS AN IRC SECTION 457(F) DEFERRED COMPENSATION PLAN. THE FOLLOWING INDIVIDUALS LISTED ON FORM 990, PART VII, SECTION A, LINE 1A PARTICIPATED AND/OR RECEIVED DISTRIBUTIONS FROM THE 457(F) PLAN DURING THE YEAR: SHARON T. KURFUERST- $21,575 ROBERT MCMURRAY- NO DISTRIBUTION JENNIFER L. SCHWARTZ, ESQ.- NO DISTRIBUTION --------------- FORM 990, SCHEDULE J, PART I, LINE 7 NONFIXED PAYMENTS THIS ORGANIZATION IS AN AFFILIATE OF CHRISTIANA CARE HEALTH SYSTEM, INC. ("SYSTEM") AND CHRISTIANA CARE HEALTH SERVICES, INC. ("CCHS"). ALL OFFICER/TRUSTEE COMPENSATION ARRANGEMENTS, INCLUDING THE PAYMENT OF DISCRETIONARY BONUS AND/OR INCENTIVE COMPENSATION PAYMENTS TO ELIGIBLE EMPLOYEES, ARE DETERMINED BY THE SYSTEM BOARD AND PAID EITHER THROUGH CCHS OR THIS ORGANIZATION. PAYMENTS MADE TO ANY DISQUALIFIED PERSON ARE APPROVED BY THE COMPENSATION COMMITTEE OF SYSTEM THROUGH THE PROCESS DESCRIBED IN FORM 990, PART VI, SECTION B, LINE 15. --------------- A TOWN OF ELKTON - SERIES 2012A 526000790 2012-05-18 10000000 REFUND PORTION OF SERIES 2009 BOND false false false B TOWN OF ELKTON - SERIES 2012B1B2 526000790 2012-05-18 8662336 REFUND SERIES 2009 & 2000 BONDS false false false C TOWN OF ELKTON - SERIES 2012C 526000790 2012-05-18 9000000 REFUND ESCROW TO REPAY 2002 BoND false false false D MD HEALTH & HIGHER EDUCATION FACILITIES AUTHORITY 520936091 2012-07-18 9924000 REFUND PORTION OF SERIES 2002 BOND false false false A 3804760 0 10000000 0 0 0 0 0 0 0 10000000 0 2012 true false true true B 5041900 0 8662336 0 0 0 0 0 0 0 8662336 0 2012 true false true true C 911370 0 9000000 0 0 0 0 0 0 0 9000000 0 2012 true false true true D 9924000 0 9924000 0 0 0 0 0 0 0 9924000 0 2012 true false true true A false false true true false 0.00000 0.00000 0.00000 false false 0.00000 false true B false false true true false 0.00000 0.00000 0.00000 false false 0.00000 false true C false false true true false 0.00000 0.00000 0.00000 false false 0.00000 false true D false false true true false 0.00000 0.00000 0.00000 false false 0.00000 false true A false false true false false false 0 false 0 false true B false false true false false false 0 false 0 false true C false false true false false false 0 false 0 false true D false false true false false false 0 false 0 false true A true B true C true D true A MD HEALTH & HIGHER EDUCATION FACILITIES AUTHORITY 520936091 2012-07-18 4007000 FINANCE ACQUISITION OF EQUIPMENT false false false B MD HEALTH & HIGHER EDUCATION FACILITIES AUTHORITY 520936091 2014-12-01 30778000 REFINANCE THE 2005 BOND false false false A 4007000 0 4007000 0 0 0 0 0 0 0 4007000 0 2012 true false true true B 1693000 0 30778000 0 0 0 0 0 0 0 30778000 0 2014 true false true true A false false true true false 0.00000 0.00000 0.00000 false false 0.00000 false true B false false true true false 0.00000 0.00000 0.00000 false false 0.00000 false true A false false true false false false 0 false 0 false true B false false true false false false 0 false 0 false true A true B true FORM 990, PART VI, SECTION A, LINES 6 & 7A,7B GOVERNING BODY AND MANAGEMENT CHRISTIANA CARE HEALTH SERVICES, INC. ("CCHS") IS THE SOLE MEMBER OF AFFINITY HEALTH ALLIANCE, INC. ("AHA"), THE SOLE MEMBER OF THE UNION HOSPITAL OF CECIL COUNTY, INC. ("UHCC"). CCHS AND AHA ARE BOTH TAX-EXEMPT ORGANIZATIONS. THE BOARD OF DIRECTORS OF CCHS ELECTS THE DIRECTORS OF UHCC AT ITS ANNUAL MEETING. THE ANNUAL OPERATING BUDGET OF UHCC IS APPROVED BY THE UHCC BOARD, THE FINANCE COMMITTEE OF THE CCHS BOARD, THE CCHS BOARD, THE FINANCE COMMITTEE OF THE BOARD OF CHRISTIANA CARE HEALTH SYSTEM, INC. ("SYSTEM"), THE SOLE MEMBER OF CCHS, AND THE SYSTEM BOARD. --------------- FORM 990, PART VI, SECTION B, LINE 11B FORM 990 REVIEW PROCESS INFORMATION RELATED TO THE UHCC FORM 990 IS GATHERED BY FINANCE STAFF AND PROVIDED TO PWC US TAX LLP FOR REVIEW. THE FINAL 2022 FORM 990 FOR THE FISCAL YEAR ENDING JUNE 30, 2023 WAS REVIEWED AND APPROVED BY VARIOUS SENIOR MANAGEMENT OFFICIALS. THE ORGANIZATION'S GOVERNING BOARD WAS ALSO PROVIDED ACCESS TO THE APPROVED 2022 FORM 990 VIA ITS BOARD OF DIRECTORS PORTAL. --------------- FORM 990, PART VI, SECTION B, LINE 12C CONFLICT OF INTEREST POLICY OUR CONFLICT OF INTEREST ("COI") POLICY IS LOCATED IN THE CAREGIVER RESOURCE CENTER ON THE EMPLOYEE PORTAL. THERE IS AN ANNUAL MANDATORY EDUCATION FOR REQUIRED INDIVIDUALS, WHICH INCLUDES AN ELECTRONIC SIGN OFF ACKNOWLEDGING COMPLETION OF THE EDUCATION, REPORTING OF A REAL OR PERCEIVED CONFLICT OR THAT NO CONFLICTS OF INTEREST EXIST. THE HR/EMPLOYEE RELATIONS TEAM FOLLOWS UP WITH ANYONE WHO HAS A CONFLICT OR PERCEIVED CONFLICT OR DOES NOT COMPLETE THE EDUCATION IN ORDER TO RESOLVE. THE EMPLOYEE HANDBOOK SETS EXPECTATIONS FOR EMPLOYEE CONFLICTS OF INTEREST AND EXPECTATIONS. SEVERAL REPORTING MECHANISMS ALSO EXIST FOR EMPLOYEES TO REPORT CONCERNS. THE BOARD OF DIRECTORS HAS THEIR OWN COI POLICY. COI IS A STANDING AGENDA ITEM ON EACH BOARD OR BOARD COMMITTEE MEETING. BOARD MEMBERS EXPECTATIONS FOR COI ARE CLEARLY COMMUNICATED. --------------- FORM 990, PART VI, SECTION B, LINE 15 COMPENSATION REVIEW AND APPROVAL PROCESS THE BOARD OF DIRECTORS OF CHRISTIANA CARE HEALTH SYSTEM, INC. ("SYSTEM"), THE SOLE MEMBER OF CHRISTIANA CARE HEALTH SERVICES, INC. ("CCHS"), THE SOLE MEMBER OF UNION HOSPITAL OF CECIL COUNTY, INC. ("UHCC"), ESTABLISHES UHCC'S COMPETITIVE TOTAL COMPENSATION POLICY AND PRACTICE. THE EXECUTIVE COMPENSATION COMMITTEE ("ECC") OF THE SYSTEM BOARD ENGAGES AN INDEPENDENT THIRD PARTY ANNUALLY WHO ASSESSES DATA FROM SEVERAL MAJOR SURVEYS TO ENSURE TOTAL REMUNERATION IS MARKET COMPETITIVE AND QUALIFIES FOR THE "REBUTTABLE PRESUMPTION OF REASONABLENESS" UNDER THE INTERMEDIATE SANCTIONS RULE, SECTION 4958 OF THE INTERNAL REVENUE CODE. AFTER DELIBERATION, THE ECC DOCUMENTS THEIR DECISIONS IN MEETING MINUTES. --------------- FORM 990, PART VI, SECTION C, LINE 19 GOVERNANCE, MANAGEMENT & DISCLOSURE THE GOVERNING DOCUMENTS, AUDITED FINANCIAL STATEMENTS, AND CONFLICT OF INTEREST POLICY ARE AVAILABLE TO THE PUBLIC UPON REQUEST. --------------- FORM 990, PART XI, LINE 9 OTHER CHANGES IN NET ASSETS OR FUND BALANCES CHANGE IN NET ASSETS OF FOUNDATION $285,664 OTHER CHANGES (5,325) -------- TOTAL $280,339 --------------- FORM 990, SCHEDULE C DETAIL OF LOBBYING ACTIVITIES UHCC IS A MEMBER OF THE MARYLAND HOSPITAL ASSOCIATION ("MHA"). A PORTION OF THE MEMBERSHIP DUES PAID BY UHCC MAY BE USED BY MHA FOR LOBBYING PURPOSES. --------------- FORM 990 PART IX LINE 11G DESCRIPTION:ADMINISTRATION FEES TOTAL FEES:4185 FORM 990 PART IX LINE 11G DESCRIPTION:AMBULANCE TOTAL FEES:290 FORM 990 PART IX LINE 11G DESCRIPTION:AMBULANCE TRANSPORT SRVS TOTAL FEES:99186 FORM 990 PART IX LINE 11G DESCRIPTION:BILLING FEES TOTAL FEES:-196019 FORM 990 PART IX LINE 11G DESCRIPTION:COLLECTION FEES TOTAL FEES:491544 FORM 990 PART IX LINE 11G DESCRIPTION:CONSULTING FEES TOTAL FEES:-450 FORM 990 PART IX LINE 11G DESCRIPTION:FLEX ADMINISTRATION TOTAL FEES:17104 FORM 990 PART IX LINE 11G DESCRIPTION:PHYSICIAN FEES TOTAL FEES:9618602 FORM 990 PART IX LINE 11G DESCRIPTION:PURCHASED ANCILLARY SRVS TOTAL FEES:223365 FORM 990 PART IX LINE 11G DESCRIPTION:PURCHASED LABOR TOTAL FEES:3325419 FORM 990 PART IX LINE 11G DESCRIPTION:PURCHASED SERVICES TOTAL FEES:7467969 FORM 990 PART IX LINE 11G DESCRIPTION:SNOW REMOVAL TOTAL FEES:1694 FORM 990 PART IX LINE 11G DESCRIPTION:TYPING & SUBSCRIPTION TOTAL FEES:120078 UNION HOSPITAL OF CECIL COUNTY FDN INC 4000 NEXUS DR NW3-100 WILMINGTON DE 19803 521794552 FUNDRAISING MD 501(C)(3) 7 AFFINITY false UNION HOSPITAL OF CECIL COUNTY HLTH SVCS 4000 NEXUS DR NW3-100 WILMINGTON DE 19803 521794553 PROPERTY MGMT MD 501(C)(3) 10 AFFINITY false AFFINITY HEALTH ALLIANCE INC 4000 NEXUS DR NW3-100 WILMINGTON DE 19803 521794697 MANAGEMENT MD 501(C)(3) 12B,II CCH SERVICES false UNION HOSPITAL OF CECIL COUNTY ONCOLOGY 4000 NEXUS DR NW3-100 WILMINGTON DE 19803 812662359 HEALTHCARE MD 501(C)(3) 3 AFFINITY false CHRISTIANA CARE HEALTH SYSTEM INC 4000 NEXUS DR NW3-100 WILMINGTON DE 19803 521479538 FUNDRAISING DE 501(C)(3) 7 NA false CHRISTIANA CARE HLTH INITIATIVES INC 4000 NEXUS DR NW3-100 WILMINGTON DE 19803 510295186 OUTPATIENT SV DE 501(C)(3) 10 CCH SYSTEM false CHRISTIANA CARE HOME HEALTH & COM SRVCS 4000 NEXUS DR NW3-100 WILMINGTON DE 19803 510064334 HOME HLTHCARE DE 501(C)(3) 7 CCH SYSTEM false CHRISTIANA CARE HEALTH SERVICES INC 4000 NEXUS DR NW3-100 WILMINGTON DE 19803 510103684 HOSPITAL DE 501(C)(3) 3 CCH SYSTEM false CHRISTIANA CARE WEST GROVE INC 4000 NEXUS DR NW3-100 WILMINGTON DE 19803 510275944 HEALTHCARE PA 501(C)(3) PENDING CCH SERVICES false CHRISTIANA CARE GENE EDITING INSTITUTE 4000 NEXUS DR NW3-100 WILMINGTON DE 19803 883110655 HEALTHCARE DE 501(C)(3) PENDING CCH SYSTEM false CHRISTIANACARE GOHEALTH URGENT CARE LLC 5555 GLENRIDGE CONNECTOR STE 700 ATLANTA GA 30342 844061485 URGENT CARE S DE CCH SERVICES false CHRISTIANACARE VALUE HEALTH JV LLC 11221 ROE AVE LEAWOOD KS 66211 851100149 AMBULATORY SR DE CCH SERVICES false CLINERGY LLC 4755 OGLETOWN STANTON RD NEWARK DE 19718 852698063 GROUP PURCHAS DE CCH SERVICES false LEEWARD HEALTH LLC 4000 NEXUS DRIVE STE C3-300 WILMINGTON DE 19803 MED ADV RISK DE CCH SYSTEM false UNION HOSPITAL OF CECIL COUNTY VENTURES 4000 NEXUS DR NW3-100 WILMINGTON DE 19803 521793691 MEDICAL SERVICES MD AFFINITY C CORP false THE DE CTR FOR MAT FETAL MED OF CC INC 4000 NEXUS DR NW3-100 WILMINGTON DE 19803 205891272 HEALTHCARE DE CCH SERVICES C CORP false CHRISTIANA CARE HEALTH PLANS 4000 NEXUS DR STE NW3-100 WILMINGTON DE 19803 510352728 INSURANCE DE CCH SYSTEM C CORP false CHRISTIANA CARE DEFERRED COMP PLAN 4755 OGLETOWN STANTON RD NEWARK DE 19718 816359549 DEF COMP PLAN DE CCH SERVICES TRUST false CHRISTIANA CARE EXEC DEFERRED COMP PLAN 4755 OGLETOWN STANTON RD NEWARK DE 19718 357048822 DEF COMP PLAN DE CCH SERVICES TRUST false CARE ASSOCIATES DEFERRED COMP PLAN 4755 OGLETOWN STANTON RD NEWARK DE 19718 357048714 DEF COMP PLAN DE CCH SERVICES TRUST false CHRISTIANA CARE INSURANCE CO LTD PO BOX 1159 878 W BAY RD GRAND CAYMAN CJ KY1-1102 981489490 SELF-INSURANCE CJ CCH SERVICES C CORP false CHRISTIANA CARE STRATEGIC INVESTMENTS 4000 NEXUS DR STE NW3-100 WILMINGTON DE 19803 853348300 STRATEGY DE CCH SYSTEM C CORP false false false true false false false false false false true true false false true true true true true true