FREDERICK HEALTH HOSPICE INC: Form 990, tax year 2022
View the entire original 990 at ProPublica ↗
- Organization
- FREDERICK HEALTH HOSPICE INC (EIN 52-1164513)
- Tax period
- 2022-07-01 to 2023-06-30
- Filed
- 2024-05-13
- IRS object ID
- 202411349349308196
- Schema version
- 2022v5.0
- 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2024-05-13T17:22:28-05:00 | ReturnTs |
| Tax Period End | 2023-06-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 440160260 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | FORVIS LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 500 RIDGEFIELD COURT | AddressLine1Txt |
| City | ASHEVILLE | CityNm |
| State Abbreviation | NC | StateAbbreviationCd |
| ZIP | 28806 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2022-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 521164513 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | FREDERICK HEALTH HOSPICE INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | FRED | BusinessNameControlTxt |
| Phone | 2405663030 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 400 WEST SEVENTH STREET | AddressLine1Txt |
| City | FREDERICK | CityNm |
| State Abbreviation | MD | StateAbbreviationCd |
| ZIP | 21701 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | HANNAH R JACOBS | PersonNm |
| Person Title | SR VP, CFO | PersonTitleTxt |
| Phone | 2405663300 | PhoneNum |
| Signature | 2024-05-13 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | HANNAH | PersonFirstNm |
| Person Last | JACOBS | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | 999009999 | SSN |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IRS Responsible Prty Info Curr | Yes (1) | IRSResponsiblePrtyInfoCurrInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | AMY BIBBY | PreparerPersonNm |
| PTIN | P00445891 | PTIN |
| Phone | 8282542254 | PhoneNum |
| Preparation | 2024-05-13 | PreparationDt |
Additional Filer Information AdditionalFilerInformation
Trusted Customer TrustedCustomerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Trusted Customer | 0 | TrustedCustomerCd |
| Authentication Assurance Level | AAL1 | AuthenticationAssuranceLevelCd |
| Identity Assurance Level | IAL1 | IdentityAssuranceLevelCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2022 | TaxYr |
| Build TS | 2023-04-26 12:10:37Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | HANNAH R JACOBS | PrincipalOfficerNm |
| Gross Receipts | $1,919,256 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.FREDERICKHEALTHHOSPICE.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1981 | FormationYr |
| Legal Domicile State | MD | LegalDomicileStateCd |
| Activity Or Mission | TO POSITIVELY IMPACT THE WELL-BEING OF EVERY INDIVIDUAL IN OUR COMMUNITY. | ActivityOrMissionDesc |
| Voting Members Governing Body | 11 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 8 | VotingMembersIndependentCnt |
| Total Employee | 0 | TotalEmployeeCnt |
| Total Volunteers | 185 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $1,626,241 | PYContributionsGrantsAmt |
| CY Contributions Grants | $1,193,381 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $0 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $0 | CYProgramServiceRevenueAmt |
| PY Investment Income | $486,779 | PYInvestmentIncomeAmt |
| CY Investment Income | $514,695 | CYInvestmentIncomeAmt |
| PY Other Revenue | $197,723 | PYOtherRevenueAmt |
| CY Other Revenue | $178,208 | CYOtherRevenueAmt |
| PY Total Revenue | $2,310,743 | PYTotalRevenueAmt |
| CY Total Revenue | $1,886,284 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $0 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $0 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $21,354 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $474,546 | PYOtherExpensesAmt |
| CY Other Expenses | $1,554,466 | CYOtherExpensesAmt |
| PY Total Expenses | $474,546 | PYTotalExpensesAmt |
| CY Total Expenses | $1,554,466 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $1,836,197 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $331,818 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $11,736,591 | TotalAssetsBOYAmt |
| Total Assets EOY | $13,517,328 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $55,050 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $384,032 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $11,681,541 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $13,133,296 | NetAssetsOrFundBalancesEOYAmt |
| Mission | TO POSITIVELY IMPACT THE WELL-BEING OF EVERY INDIVIDUAL IN OUR COMMUNITY | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $1,470,873 | ExpenseAmt |
| Desc | THE PURPOSE OF FREDERICK HEALTH HOSPICE, INC. IS TO PROVIDE AND PROMOTE HOSPICE CARE FOR INDIVIDUALS WHO ARE TERMINALLY ILL AND FOR THEIR FAMILIES. FREDERICK HEALTH HOSPICE, INC. OPERATES AS A FUNDRAISING ORGANIZATION FOR THE BENEFIT OF HOSPICE SERVICES AND OWNERSHIP OF THE KLINE HOSPICE HOUSE. | Desc |
| Total Program Service Expenses | $1,470,873 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | 0 | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | 0 | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | 0 | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | Yes (1) | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | 0 | OperateHospitalInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | 0 | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | Yes (1) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | Yes (1) | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 3 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 0 | EmployeeCnt |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | Yes (1) | QuidProQuoContributionsInd |
| Quid Pro Quo Contri Discl | Yes (1) | QuidProQuoContriDisclInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | 0 | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | 0 | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 11 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 8 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (1) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (1) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (1) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | 0 | CompensationProcessCEOInd |
| Compensation Process Other | 0 | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | MD | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HANNAH R JACOBS | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 2405663030 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 400 WEST SEVENTH STREET | AddressLine1Txt |
| City | FREDERICK | CityNm |
| State Abbreviation | MD | StateAbbreviationCd |
| ZIP | 21701 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | Yes (X) | InfoInScheduleOPartVIIInd |
Form990 Part VII Section A Form990PartVIISectionAGrp (17 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt |
|---|---|---|---|---|---|---|---|
| THOMAS A KLEINHANZL | |||||||
| PRESIDENT AND CEO FHH | 2.00 | 49.00 | Yes (X) | Yes (X) | $0 | $1,134,727 | $366,456 |
| MICHELLE K MAHAN | |||||||
| SR. VP & CFO THROUGH 8/6/22 | 2.00 | 48.00 | Yes (X) | $0 | $643,631 | $44,464 | |
| PATRICK J MANSKY | |||||||
| DIRECTOR THROUGH 6/23 | 2.00 | 40.00 | Yes (X) | $0 | $508,923 | $20,102 | |
| HANNAH R JACOBS | |||||||
| SR. VP & CFO START 4/4/22 | 2.00 | 49.00 | Yes (X) | $0 | $391,111 | $46,751 | |
| HEATHER R KIRBY | |||||||
| VP INTEGRATED CARE & CPHO | 4.00 | 36.00 | Yes (X) | $0 | $311,495 | $24,277 | |
| CARLOS GRAVERAN | |||||||
| DIRECTOR-HOSPICE | 16.00 | 24.00 | Yes (X) | $0 | $214,243 | $27,723 | |
| REV TIMOTHY MAY | |||||||
| PRESIDENT | 2.00 | 0.00 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| CATHY S ALEXANDER | |||||||
| VICE PRESIDENT | 2.00 | 0.00 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| JOHN VERBUS | |||||||
| VICE PRESIDENT | 2.00 | 0.00 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| ARTHUR ANDERSON | |||||||
| SECRETARY | 2.00 | 0.00 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| TEJAL GANDHI | |||||||
| DIRECTOR THROUGH 10/22 | 2.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |
| WILLIAM HAUGH | |||||||
| DIRECTOR | 2.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |
| ALLISON ZERR | |||||||
| DIRECTOR THROUGH 8/22 | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |
| DOUGLAS BROWN | |||||||
| DIRECTOR | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |
| SHANE WEEKS | |||||||
| DIRECTOR | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |
| DAN TIPSORD | |||||||
| DIRECTOR | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |
| CHARLES SMITH III | |||||||
| DIRECTOR | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $0 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $3,204,130 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $529,773 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 0 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
| Cntrct Rcvd Greater Than100 K | 0 | CntrctRcvdGreaterThan100KCnt |
| All Other Contributions | $1,193,381 | AllOtherContributionsAmt |
| Total Contributions | $1,193,381 | TotalContributionsAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $514,695 | TotalRevenueColumnAmt |
| Exclusion | $514,695 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fundraising Gross Income | $211,180 | FundraisingGrossIncomeAmt |
| Fundraising Direct Expenses | $32,972 | FundraisingDirectExpensesAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $178,208 | TotalRevenueColumnAmt |
| Exclusion | $178,208 | ExclusionAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $1,886,284 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $0 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $692,903 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $12,738 | TotalAmt |
| Management And General | $12,738 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,190,406 | TotalAmt |
| Program Services | $1,153,667 | ProgramServicesAmt |
| Management And General | $36,739 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $193,183 | TotalAmt |
| Program Services | $177,195 | ProgramServicesAmt |
| Management And General | $5,137 | ManagementAndGeneralAmt |
| Fundraising | $10,851 | FundraisingAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $19,815 | TotalAmt |
| Program Services | $19,428 | ProgramServicesAmt |
| Management And General | $275 | ManagementAndGeneralAmt |
| Fundraising | $112 | FundraisingAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $59,612 | TotalAmt |
| Program Services | $59,612 | ProgramServicesAmt |
Other Expenses OtherExpensesGrp (2 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt | FundraisingFundraisingAmt |
|---|---|---|---|---|
| SUPPLIES | $78,191 | $60,450 | $7,350 | $10,391 |
| COST OF GOODS SOLD | $521 | $521 |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,554,466 | TotalAmt |
| Program Services | $1,470,873 | ProgramServicesAmt |
| Management And General | $62,239 | ManagementAndGeneralAmt |
| Fundraising | $21,354 | FundraisingAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,893,012 | BOYAmt |
| EOY | $473,763 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $1,910,464 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $1,445,021 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $525,055 | BOYAmt |
| EOY | $465,443 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,318,524 | BOYAmt |
| EOY | $12,334,372 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $243,750 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $11,736,591 | BOYAmt |
| EOY | $13,517,328 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $19,706 | BOYAmt |
| EOY | $282,512 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $35,344 | BOYAmt |
| EOY | $101,520 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $55,050 | BOYAmt |
| EOY | $384,032 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows FASB117 | Yes (X) | OrganizationFollowsFASB117Ind |
No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $11,681,541 | BOYAmt |
| EOY | $12,889,546 | EOYAmt |
Donor Restriction Net Assets DonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $243,750 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $11,681,541 | BOYAmt |
| EOY | $13,133,296 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $11,736,591 | BOYAmt |
| EOY | $13,517,328 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $331,818 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $876,187 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | $243,750 | OtherChangesInNetAssetsAmt |
| Info In Schedule O Part XII | Yes (X) | InfoInScheduleOPartXIIInd |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Publicly Supported Org509a2 | Yes (X) | PubliclySupportedOrg509a2Ind |
Gifts Grants Contris Rcvd509 GiftsGrantsContrisRcvd509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $1,197,599 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $2,816,445 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $3,066,067 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $1,626,241 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $1,193,381 | CurrentTaxYearAmt |
| Total | $9,899,733 | TotalAmt |
Gross Receipts Admissions GrossReceiptsAdmissionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $304,187 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $377,519 | CurrentTaxYearMinus3YearsAmt |
| Total | $681,706 | TotalAmt |
Gross Receipts Non Unrlt Bus GrossReceiptsNonUnrltBusGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $232,128 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $234,900 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $247,120 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $232,120 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $211,180 | CurrentTaxYearAmt |
| Total | $1,157,448 | TotalAmt |
Total509 Total509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $1,733,914 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $3,428,864 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $3,313,187 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $1,858,361 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $1,404,561 | CurrentTaxYearAmt |
| Total | $11,738,887 | TotalAmt |
Amounts Rcvd Dsqlfy Person AmountsRcvdDsqlfyPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Substantial Contributors Amt SubstantialContributorsAmtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Subst And Dsqlfy Prsns Tot SubstAndDsqlfyPrsnsTotGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total509 | $11,738,887 | PublicSupportTotal509Amt |
Gross Investment Income509 GrossInvestmentIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $328,429 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $27,096 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $876,558 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $413,826 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $514,695 | CurrentTaxYearAmt |
| Total | $2,160,604 | TotalAmt |
Investment Income And UBTI InvestmentIncomeAndUBTIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $328,429 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $27,096 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $876,558 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $413,826 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $514,695 | CurrentTaxYearAmt |
| Total | $2,160,604 | TotalAmt |
Total Support Calendar Year TotalSupportCalendarYearGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $2,062,343 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $3,455,960 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $4,189,745 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $2,272,187 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $1,919,256 | CurrentTaxYearAmt |
| Total | $13,899,491 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support CY509 | 0.84460 | PublicSupportCY509Pct |
| Public Support PY509 | 0.55930 | PublicSupportPY509Pct |
| Investment Income CY | 0.15540 | InvestmentIncomeCYPct |
| Investment Income PY | 0.13000 | InvestmentIncomePYPct |
| Thirty Thr Pct Suprt Tests CY509 | Yes (X) | ThirtyThrPctSuprtTestsCY509Ind |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $145,000 | OtherCostOrOtherBasisAmt |
| Book Value | $145,000 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,334,057 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,039,244 | DepreciationAmt |
| Book Value | $294,813 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $227,798 | OtherCostOrOtherBasisAmt |
| Depreciation | $227,182 | DepreciationAmt |
| Book Value | $616 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $203,609 | OtherCostOrOtherBasisAmt |
| Depreciation | $178,595 | DepreciationAmt |
| Book Value | $25,014 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $465,443 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | INTERCOMPANY LIABILITIES | Desc |
| Amt | $101,520 | Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $101,520 | TotalLiabilityAmt |
Schedule G IRS990ScheduleG
Fundraising Event Information FundraisingEventInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Event1 | GOLF TOURNEY | Event1Nm |
| Gross Receipts Event1 | $211,180 | GrossReceiptsEvent1Amt |
| Gross Revenue Event1 | $211,180 | GrossRevenueEvent1Amt |
| Cash Prizes Event1 | $600 | CashPrizesEvent1Amt |
| Non Cash Prizes Event1 | $8,879 | NonCashPrizesEvent1Amt |
| Rent Facility Costs Event1 | $21,672 | RentFacilityCostsEvent1Amt |
| Other Direct Expenses Event1 | $1,821 | OtherDirectExpensesEvent1Amt |
| Gross Receipts Total | $211,180 | GrossReceiptsTotalAmt |
| Gross Revenue Total Events | $211,180 | GrossRevenueTotalEventsAmt |
| Cash Prizes Total Events | $600 | CashPrizesTotalEventsAmt |
| Non Cash Prizes Total Events | $8,879 | NonCashPrizesTotalEventsAmt |
| Rent Fclty Costs Total Events | $21,672 | RentFcltyCostsTotalEventsAmt |
| Oth Direct Expnss Total Events | $1,821 | OthDirectExpnssTotalEventsAmt |
| Direct Expense Summary Events | $32,972 | DirectExpenseSummaryEventsAmt |
| Net Income Summary | $178,208 | NetIncomeSummaryAmt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (1) | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (6 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| THOMAS A KLEINHANZL | ||||||||||||||
| PRESIDENT AND CEO FHH | $0 | $870,555 | $0 | $260,818 | $0 | $3,354 | $0 | $351,433 | $0 | $15,023 | $0 | $1,501,183 | $0 | $0 |
| MICHELLE K MAHAN | ||||||||||||||
| SR. VP & CFO THROUGH 8/6/22 | $0 | $431,445 | $0 | $206,090 | $0 | $6,096 | $0 | $36,107 | $0 | $8,357 | $0 | $688,095 | $0 | $0 |
| PATRICK J MANSKY | ||||||||||||||
| DIRECTOR THROUGH 6/23 | $0 | $463,245 | $0 | $44,094 | $0 | $1,584 | $0 | $13,541 | $0 | $6,561 | $0 | $529,025 | $0 | $0 |
| HANNAH R JACOBS | ||||||||||||||
| SR. VP & CFO START 4/4/22 | $0 | $344,255 | $0 | $45,062 | $0 | $1,794 | $0 | $34,126 | $0 | $12,625 | $0 | $437,862 | $0 | $0 |
| HEATHER R KIRBY | ||||||||||||||
| VP INTEGRATED CARE & CPHO | $0 | $261,278 | $0 | $48,423 | $0 | $1,794 | $0 | $9,254 | $0 | $15,023 | $0 | $335,772 | $0 | $0 |
| CARLOS GRAVERAN | ||||||||||||||
| DIRECTOR-HOSPICE | $0 | $192,433 | $0 | $21,018 | $0 | $792 | $0 | $11,011 | $0 | $16,712 | $0 | $241,966 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 3 | THE EXECUTIVE COMPENSATION PROGRAM IS DESIGNED TO CARRY OUT THE HEALTH SYSTEM MISSION, TO ACHIEVE THE CHARITABLE PURPOSE, TO ATTRACT, RETAIN, MOTIVATE, AND REWARD EXECUTIVE MANAGEMENT, AND TO MAINTAIN A COMPETITIVE POSITION WITH PEER ORGANIZATIONS IN THE REGION. OVERSIGHT OF THE EXECUTIVE COMPENSATION PROGRAM IS PROVIDED BY THE EXECUTIVE COMPENSATION COMMITTEE OF THE BOARD, COMPOSED OF THE BOARD CHAIRMAN, VICE CHAIRMAN, IMMEDIATE PRECEDING CHAIRMAN, CHAIRMAN OF THE FINANCE COMMITTEE, AND THE CHAIRMAN OF THE GOVERNANCE COMMITTEE. IN ADDITION TO THE BOARD'S COMPENSATION COMMITTEE, WE UTILIZED AN EXTERNAL INDEPENDENT CONSULTANT AND MARKET SURVEYS FOR ALL EXECUTIVE MANAGEMENT COMPENSATION. THE PRESIDENT AND CEO HAS A WRITTEN EMPLOYMENT CONTRACT. |
| PART I, LINE 4B | FREDERICK HEALTH HOSPITAL HAS ONE 457(F) NON-QUALIFIED DEFERRED COMPENSATION PLAN FOR CERTAIN MEMBERS OF SENIOR MANAGEMENT. UNDER THE PLAN, THEY MAY CONTRIBUTE AMOUNTS FROM THEIR COMPENSATION TO THE PLAN AND MAY RECEIVE A DISCRETIONARY EMPLOYER CONTRIBUTION. EMPLOYEES ARE FULLY VESTED IN ALL EMPLOYEE CONTRIBUTIONS TO THE PLAN. VESTING IN EMPLOYER CONTRIBUTIONS OCCURS IN ACCORDANCE WITH THE UNDERLYING PLAN DOCUMENTS. ALL ASSETS OF THE PLAN ARE HELD IN A SEPERATE TRUST. TOTAL HOSPITAL CONTRIBUTIONS TO THIS PLAN WERE AS FOLLOWS: MICHELLE K MAHAN - $2,052 THOMAS A KLEINHANZL - $315,683 HANNAH JACOBS - $21,000 |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (10 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 6 | FREDERICK HEALTH HOSPITAL, INC IS THE SOLE MEMBER OF THE CORPORATION. |
| FORM 990, PART VI, SECTION A, LINE 7A | THE MEMBER (FHH, INC.) SHALL TAKE THE FOLLOWING ACTIONS ON BEHALF OF THE CORPORATION: - APPOINT, AND AS NECESSARY, REMOVE THE EXECUTIVE DIRECTOR OF THE CORPORATION; PROVIDED, HOWEVER, THAT THE MEMBER SHALL TAKE NO SUCH ACTION WITHOUT PRIOR CONSULTATION WITH THE BOARD OF DIRECTORS; - FORMULATE, COMMUNICATE AND IMPLEMENT STRATEGIC PLANNING AND FINANCIAL MANAGEMENT; AND - SELECT A FISCAL AUDITOR. THE CORPORATION MAY TAKE THE FOLLOWING ACTIONS ONLY WITH THE PRIOR APPROVAL OF THE MEMBER: - DISOLVE OR LIQUIDATE; AND - CREATE, DISSOLVE OR DIVEST ANY SUBSIDIARY, PARTNERSHIP OR LLC. |
| FORM 990, PART VI, SECTION A, LINE 7B | THE FOLLOWING SHALL NOT BE DEEMED TO HAVE TAKEN PLACE ABSENT SUBSEQUENT RATIFICATION BY THE MEMBER: - ELECTION OR REPLACEMENT OF A DIRECTOR OR THE FILLING OF A VACANCY ON THE BOARD OF DIRECTORS; OR - AT SUCH TIMES AS THE MEMBER DEEMS NECESSARY, AND PURSUANT TO THE VOTE OF AT LEAST TWO-THIRDS OF THE MEMBER'S DIRECTORS, REMOVE A DIRECTOR OF THE CORPORATION; OR - CHANGE THE MISSION OF THE CORPORATION, OR - AMEND THE ARTICLES OF INCORPORATION AND/OR BYLAWS OF THE CORPORATION. |
| FORM 990, PART VI, SECTION B, LINE 11B | THE 990 IS PREPARED IN CONJUNCTION WITH OUTSIDE TAX ACCOUNTANTS AND IS REVIEWED BY UPPER MANAGEMENT PRIOR TO PROVIDING A COPY TO THE BOARD. A COPY OF THE FORM 990 WAS PROVIDED TO ALL MEMBERS OF THE BOARD PRIOR TO FILING. |
| FORM 990, PART VI, SECTION B, LINE 12C | THE FREDERICK HEALTH HOSPICE, INC. BOARD OF DIRECTORS IS COMMITTED TO MEETING ITS FIDUCIARY RESPONSIBILITIES AND MAINTAINING ITS DUTY OF LOYALTY TO THE HOSPITAL AND THE COMMUNITY IT SERVES. TO THIS END, THE BOARD WILL EXERCISE VIGILANCE IN IDENTIFYING ANY CONFLICTS OF INTEREST. THE BOARD WILL ALSO MAINTAIN TRANSPARENCY AND OBJECTIVITY IN MAKING DECISIONS ABOUT CONFLICTS OF INTEREST SO THAT THE ORGANIZATION'S MISSION IS ALWAYS THE FIRST PRIORITY. THE CHAIRPERSON (OR VICE CHAIRPERSON IF THE CHAIR IS INVOLVED) WILL NOTIFY ALL DIRECTORS OF A REPORTED CONFLICT OF INTEREST AND WILL DECIDE WHETHER TO TAKE THE MATTER TO THE FULL BOARD TO DECIDE WHETHER A CONFLICT EXISTS AND, IF SO, TO DECIDE WHAT ACTION TO TAKE. ALTERNATIVELY, THE CHAIR PERSON WILL REFER THE MATTER TO THE GOVERNANCE COMMITTEE FOR AN IN-DEPTH EXAMINATION, SUMMARY, AND RECOMMENDATION PRIOR TO A FULL BOARD DISCUSSION AND DECISION. IF TIME IS OF THE ESSENCE, THE CHAIRPERSON WILL TAKE THE MATTER TO THE EXECUTIVE COMMITTEE, AND THE CHAIRPERSON WILL NOTIFY THE FULL BOARD OF SUCH ACTION. WHERE A CONFLICT OF INTEREST HAS BEEN IDENTIFIED THE BOARD MEMBER SHALL NOT VOTE OR BE PRESENT FOR THE DISCUSSION OR THE VOTE REGARDING THE TRANSACTION AT EITHER THE FULL BOARD, EXECUTIVE COMMITTEE, OR GOVERNANCE COMMITTEE MEETINGS EXCEPT TO ANSWER QUESTIONS THAT MAY BE ASKED OF HIM OR HER. TO PREVENT ACTUAL OR PERCEIVED INFLUENCE ON THE BOARD'S DECISION, THE CONFLICTED MEMBER IS PROHIBITED, AFTER INITIAL DISCLOSURE, FROM DISCUSSING THE CONFLICT OF INTEREST EITHER FORMALLY OR INFORMALLY WITH FELLOW DIRECTORS OR WITH MEMBERS OF THE MANAGEMENT. THERE WILL BE AN ANNUAL REVIEW OF ALL BOARD MEMBERS AND OFFICERS' TRANSACTIONS PREPARED BY THE ADMINISTRATION AND REVIEWED BY THE GOVERNANCE COMMITTEE AND THE FULL BOARD OF DIRECTORS. AT THAT TIME, ALL DIRECTORS WILL BE REMINDED OF THE IRS INTERMEDIATE SANCTIONS REGULATION THAT ESTABLISHES EXCISE TAXES AS A SANCTION AGAINST ADMINISTRATORS AND DIRECTORS OF TAX-EXEMPT ORGANIZATIONS WHO PARTICIPATE IN 'EXCESS BENEFIT TRANSACTIONS' (E.G., UNREASONABLE HIGH EMPLOYMENT COMPENSATION OR BUSINESS DEALS). |
| FORM 990, PART VI, SECTION C, LINE 19 | THE GOVERNING DOCUMENTS AND THE CONFLICT-OF-INTEREST POLICY ARE AVAILABLE UPON REQUEST. FREDERICK HEALTH, INC'S CONSOLIDATED ANNUAL AUDITED FINANCIAL STATEMENTS ARE AVAILABLE AT WWW.FREDERICKHEALTH.ORG |
| FORM 990, PART VII, SECTION A | DIRECTOR PATRICK J. MANSKY RECEIVED COMPENSATION FROM FREDERICK MEDICAL GROUP, LLC FOR PHYSICIAN SERVICES. DIRECTOR THOMAS A. KLEINHANZL RECEIVED COMPENSATION FROM FREDERICK HEALTH HOSPITAL, INC. FOR EMPLOYMENT AS PRESIDENT AND CEO. DIRECTOR HEATHER R. KIRBY RECEIVED COMPENSATION FROM FREDERICK HEALTH HOSPITAL, INC. FOR EMPLOYMENT AS VP INTEGRATED CARE CPHO. HANNAH JACOBS AND MICHELLE MAHAN RECEIVED COMPENSATION FROM FREDERICK HEALTH HOSPITAL, INC. FOR EMPLOYMENT AS SVP AND CFO. |
| FORM 990, PART IX, LINE 11G | CONTRACT SERVICES: PROGRAM SERVICE EXPENSES 1,153,667. MANAGEMENT AND GENERAL EXPENSES 36,739. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,190,406. |
| FORM 990, PART XI, LINE 9: | OTHER CHANGE IN RESTRICTED NET ASSET 243,750. |
| FORM 990, PART XII, LINE 2C: | THE PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (3 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Controlled OrganizationControlledOrganizationInd | Direct Controlling NADirectControllingNACd |
|---|---|---|---|---|---|---|---|---|---|---|---|
| FREDERICK HEALTH HOSPITAL INC | |||||||||||
| 400 WEST SEVENTH STREET | FREDERICK | MD | 21701 | 520591612 | HOSPITAL | MD | 501(C)(3) | LINE 3 | FREDERICK HEALTH INC | Yes (1) | |
| FREDERICK HEALTH INC | |||||||||||
| 400 WEST SEVENTH STREET | FREDERICK | MD | 21701 | 454133096 | HEALTH SYSTEM | MD | 501(C)(3) | TYPE II | 0 | N/A | |
| FREDERICK HEALTH MEDICAL GROUP LLC | |||||||||||
| 400 WEST SEVENTH STREET | FREDERICK | MD | 21701 | 453001639 | PHYSICIAN ORG | MD | 501(C)(3) | LINE 7 | FREDERICK HEALTH INC | Yes (1) | |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (2 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Direct Controlling NADirectControllingNACd | Entity TypeEntityTypeTxt | Controlled OrganizationControlledOrganizationInd | Address Line1ForeignAddress/AddressLine1Txt | Province Or StateForeignAddress/ProvinceOrStateNm | CountryForeignAddress/CountryCd | Legal Domicile Foreign CountryLegalDomicileForeignCountryCd |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| FREDERICK HEALTH SERVICES CORPORATION | |||||||||||||
| 400 WEST SEVENTH STREET | FREDERICK | MD | 21701 | 521851661 | HEALTH CARE | MD | N/A | C | Yes (1) | ||||
| MONOCACY INSURANCE LTD | |||||||||||||
| 981011570 | SELF INSURANCE | N/A | C | Yes (1) | PO BOX 1159 | GRAND CAYMAN KY11 | CJ | CJ | |||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | 0 | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | 0 | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | 0 | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | 0 | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (1) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | Yes (1) | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp (2 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|
| FREDERICK HEALTH HOSPITAL INC | ||
| O | $327,339 | DIRECT COSTING |
| FREDERICK HEALTH HOSPITAL INC | ||
| R | $330,000 | CASH |
Comments