2024-05-14T17:15:48-05:00 2023-06-30 366055558 GRANT THORNTON LLP 1000 WILSON BOULEVARD SUITE 1500 ARLINGTON VA 22209 990 2022-07-01 520591628 TIDALHEALTH PENINSULA REGIONAL INC TIDA 3025365203 100 EAST CARROLL STREET SALISBURY MD 21801 STEPHANIE GARY CFO 3025365203 2024-05-14 1 STEPHANIE GARY 999009999 1 MARY TORRETTA P00847851 7038477500 2 AAL1 IAL1 2022 2023-04-26 12:10:37Z STEVEN LEONARD 100 EAST CARROLL STREET SALISBURY MD 21801 1034736234 0 X WWW.TIDALHEALTH.ORG X 1897 MD IMPROVE THE HEALTH OF THE COMMUNITIES WE SERVE. 14 11 0 126 8111464 1888098 6322629 8559039 482474910 505004219 44074690 13321804 1077384 842662 533949613 527727724 42000 53200 0 0 220571013 223148225 0 0 1502829 243733137 277795239 464346150 500996664 69603463 26731060 750341203 711052938 206090051 154532721 544251152 556520217 X IMPROVE THE HEALTH OF THE COMMUNITIES WE SERVE. 0 0 451804016 53200 497124655 SEE SCHEDULE OTIDALHEALTH PENINSULA REGIONAL IS A NOT-FOR-PROFIT 501(C)(3) NON-STOCK CORPORATION FOUNDED IN 1897 TO SERVE THE HEALTH CARE NEEDS OF THE COMMUNITY. THE HOSPITAL'S PRIMARY PURPOSE IS TO PROVIDE THE HIGHEST PRIMARY, SECONDARY, AND SELECTED TERTIARY HEALTH CARE SERVICES TO RESIDENTS OF AND VISITORS TO THE MID-DELMARVA PENINSULA IN A COMPETENT, COMPASSIONATE, AND COST-EFFECTIVE MANNER DESIGNED TO ELICIT A HIGH DEGREE OF CUSTOMER SATISFACTION. THE HOSPITAL'S MISSION IS TO IMPROVE THE HEALTH OF THE COMMUNITIES WE SERVE BY PROVIDING QUALITY MEDICAL CARE REGARDLESS OF RACE, CREED, SEX, NATIONAL ORIGIN, HANDICAP, OR AGE. IF A PATIENT IS UNABLE TO PAY DUE TO FINANCIAL RESOURCES, EFFORTS WILL BE TAKEN TO ASSURE CARE AT AN AFFORDABLE COST, OR OBTAINED ASSISTANCE THROUGH APPROPRIATE AGENCIES ON THE PATIENT'S BEHALF. EMERGENCY SERVICES CARE WILL BE PROVIDED TO EVERYONE REGARDLESS OF ABILITY TO PAY.TIDALHEALTH PENINSULA REGIONAL SERVED OVER 17,000 INPATIENTS AND PROVIDED MORE THAN 408,000 OUTPATIENT SERVICES DURING FISCAL 2023. FOOD SERVICE PROVIDED MORE THAN 510,000 MEALS TO PATIENTS AND EMPLOYEES. ALTHOUGH REIMBURSEMENT FOR SERVICES RENDERED IS CRITICAL TO THE OPERATION AND STABILITY OF TIDALHEALTH PENINSULA REGIONAL, IT IS RECOGNIZED THAT NOT ALL INDIVIDUALS POSSESS THE ABILITY TO PAY FOR ESSENTIAL MEDICAL SERVICES. THE HOSPITAL, IN KEEPING WITH THE COMMITMENT TO SERVE ALL MEMBERS OF THE COMMUNITY, DURING FISCAL 2023 PROVIDED:CHARITY AND OTHER ALLOWANCES TOTALING $31,206,439DISCOUNTS TO THIRD PARTY PAYORS INCLUDING PROGRAMS SUCH AS MEDICARE AND MEDICAID $50,346,755WRITE-OFF OF UNCOLLECTIBLE ACCOUNTS $9,559,541THE TOTAL UNREIMBURSED VALUE OF PROVIDING CARE TO THESE PATIENTS IS $91,112,735ALSO PROVIDED ARE MANY WELLNESS PROGRAMS, COMMUNITY EDUCATION AND FREE PROGRAMS OFFERED THROUGHOUT THE YEAR BASED UPON ACTIVITIES AND SERVICES THAT TIDALHEALTH PENINSULA REGIONAL BELIEVES WILL SERVE A BONA FIDE COMMUNITY HEALTH NEED. SOME OF THE PROGRAMS ARE AS FOLLOWS: - A VARIETY OF BROCHURES ARE DISPLAYED IN ALL HOSPITAL WAITING AREAS TO EDUCATE MEMBERS OF THE COMMUNITY REGARDING PROGRAMS AND SERVICES.- WE PROVIDE CHILDBIRTH PREPARATION CLASSES, EXERCISE CLASSES FOR PRENATAL AND POSTPARTUM WOMEN AND CPR CLASSES.- WE PROVIDE ASSISTANCE TO EDUCATORS THROUGH OUR WORK WITH STUDENT NURSES, RADIOLOGY, RESPIRATORY AND LABORATORY TECHNICIANS.PROGRAM ACTIVITYDURING FY 2023, TIDALHEALTH PENINSULA REGIONAL PERFORMED COMMUNITY OUTREACH ACTIVITIES ASSOCIATED WITH COVID-19 TESTING AND VACCINATION CLINICS, FLU CLINICS AND A MOBILE HEALTH INITIATIVE AIMED TO REDUCE UNNECESSARY USE OF THE 911 EMS SYSTEM AND EMERGENCY DEPARTMENT. SPECIFIC EXAMPLES OF EDUCATION AND OUTREACH PROGRAMS, SUPPORT GROUPS, COMMUNITY HEALTH SCREENINGS, AND FITNESS AND WELLNESS ACTIVITIES SUPPORTED BY TIDALHEALTH PENINSULA REGIONAL ARE AS FOLLOWS: COMMUNITY EDUCATIONAL AND OUTREACH PROGRAMS:- CPR - CHILDBIRTH PREPARATION CLASSES - REFRESHER COURSE - CHILDBIRTH - INFANT CARE CLASSES - SAFE SITTER PROGRAM - WOMEN'S HEALTH EDUCATION SUPPORT GROUPS:- DIABETES SUPPORT GROUP - HEAD AND NECK CANCER SUPPORT GROUP- CAREGIVER SUPPORT GROUP EVENTS: - COMMUNITY SCREENINGS - HEIGHT/WEIGHT, BLOOD PRESSURE - SKIN CANCER SCREENINGS- ORAL, HEAD AND NECK CANCER SCREENINGS- HEARING SCREENINGS- FLU CLINIC - EDUCATIONAL EXHIBITS TO PROMOTE HEALTHY LIFESTYLES BENEFITS:- UNITED WAY FITNESS/EXERCISE PROGRAMMING:- CARDIAC REHABILITATION- EXERCISES FOR STRENGTH AND ENDURANCE - STEPPING ON FALLS PREVENTION PROGRAM 451804016 1 1 0 1 0 0 0 0 0 1 1 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 X 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 X 14 11 1 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 0 0 1 1 CA MD X DEAN SWINGLE - DIRECTOR OF FINANCE 3025365203 100 EAST CARROLL STREET SALISBURY MD 21801 STEVEN LEONARD PRESIDENT/CEO 50.00 2.00 X X 0 1129120 78830 DAVID SECHLER MD BOARD MEMBER BEG 01/23 40.00 0.00 X 0 373271 43838 JULIUS ZANT MD CHAIRPERSON 2.00 0.00 X X 0 0 0 MEMO DIRIKER IMMEDIATE PAST CHAIRPERSON 5.00 1.00 X X 0 0 0 JAMES HARTSTEIN SECRETARY 1.00 3.00 X X 0 0 0 SUSAN WILGUS-MURPHY BOARD MEMBER 1.00 1.00 X 0 0 0 KAREN POISKER BOARD MEMBER 1.00 1.00 X 0 0 0 VEL NATESAN MD BOARD MEMBER THRU 12/22 1.00 1.00 X 0 274577 0 RONDALL ALLEN PHARMD BOARD MEMBER 1.00 0.00 X 0 0 0 MARY DIBARTOLO BOARD MEMBER 1.00 0.00 X 0 0 0 JANELLE BEILER BOARD MEMBER 1.00 0.00 X 0 0 0 PERCY J PURNELL BOARD MEMBER 1.00 0.00 X 0 0 0 ANTHONY ADRIGNOLO III MD BOARD MEMBER 1.00 0.00 X 0 0 0 JASON MORRIS BOARD MEMBER 1.00 0.00 X 0 0 0 DIANE TURNER BOARD MEMBER BEG 01/23 1.00 0.00 X 0 0 0 BRUCE I RITCHIE CFO THRU 01/23 50.00 2.00 X 0 732177 163746 LURA LUNSFORD V.P. OPERATIONS 50.00 2.00 X 0 748468 68177 STEPHANIE GARY V.P. FINANCE/CFO BEG 01/23 50.00 4.00 X 0 475048 43804 TRUDY HALL MD V.P. CHIEF MEDICAL OFF. BEG 07/22 50.00 2.00 X 0 260186 32931 KARIN DIBARI MD V.P. TH MEDICAL PARTNERS THRU 10/22 50.00 0.00 X 0 859394 21402 TIMOTHY FEIST V.P CHIEF COMPLIANCE OFFICER 50.00 0.00 X 0 352164 116509 SARAH SCOTT V.P. PEOPLE & ORGANIZATON DEV 50.00 2.00 X 0 378869 74781 JAMES TRUMBLE MD V.P. CLINICAL INTEGRATION 50.00 1.00 X 0 419482 28782 KATHRYN FIDDLER V.P. POPULATION HEALTH 50.00 1.00 X 0 355293 42087 ANGELA BRITTINGHAM CHIEF NURSING OFFICER BEG 04/23 50.00 1.00 X 0 161488 22932 CHARLES SILVIA JR MD FMR V.P. CHIEF MED. OFF. THRU 01/22 50.00 1.00 X 0 158693 20329 SARAH ARNETT FMR CHIEF NURSING OFFICER THRU 04/22 50.00 0.00 X 0 217782 24237 0 6896012 782385 0 1 1 0 0 4605840 3953199 8559039 NET PATIENT SERVICES 621500 492432000 487011357 5420643 AMBULATORY PHARMACY 456110 12572219 10113298 2458921 505004219 7715777 -49685 7765462 255349 340214 -84865 -84865 -84865 512251108 23215 506628519 39777 5622589 -16562 5606027 5606027 CAFETERIA 722514 628956 628956 MANAGEMENT FEES 561000 204585 204585 LIFELINE 532283 77000 77000 16986 16986 927527 527727724 497124655 8111464 13932566 X 53200 53200 5092616 4592521 484817 15278 177218188 159815362 16871171 531655 8156081 7355154 776459 24468 20126419 18150005 1916035 60379 12554921 11322028 1195228 37665 1269511 1144845 120857 3809 662390 597343 63060 1987 20920 18866 1992 62 1912036 1724274 182026 5736 90949398 82018167 8658383 272848 713939 643830 67967 2142 39982416 36056143 3806326 119947 378452 341288 36029 1135 5836994 5263801 555682 17511 300080 270612 28568 900 23998 21641 2285 72 4505313 4062891 428906 13516 28330714 25548638 2697084 84992 4947458 4461618 470998 14842 MEDICAL SUPPLIES 52126284 47007483 4962422 156379 DRUG SUPPLIES 34440280 31058245 3278715 103320 BAD DEBT 9559541 8620794 910068 28679 UBI TAXES 1479461 1334178 140845 4438 356054 321089 33896 1069 500996664 451804016 47689819 1502829 X 3943983 6612121 30208047 17003061 51718490 59468115 12023370 11774166 9252697 9403737 651172460 469964871 185715125 181207589 356298154 334590234 101181337 90993915 750341203 711052938 17150414 7582833 6325936 3230467 120857625 119855011 61756076 23864410 206090051 154532721 X 492944394 499549381 51306758 56970836 544251152 556520217 750341203 711052938 X 26731060 26642069 -41104064 X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 20920 20920 0 PART II-B, LINE 1: OTHER ACTIVITIES: TIDALHEALTH PENINSULA REGIONAL DOES NOT ENGAGE IN ANY DIRECT LOBBYING ACTIVITIES. THE ORGANIZATION PAYS MEMBERSHIP DUES TO MARYLAND HOSPITAL ASSOCIATION (MHA). MHA ENGAGES IN MANY SUPPORT ACTIVITIES INCLUDING LOBBYING AND ADVOCATING FOR ITS MEMBER HOSPITALS. THE MHA REPORTED THAT A PERCENTAGE OF MEMBER DUES WERE USED FOR LOBBYING PURPOSES AND SUCH, THE ORGANIZATION HAS REPORTED THIS AMOUNT ON SCHEDULE C PART IV AS LOBBYING ACTIVITIES. 87537245 10561995 54474 10000000 392233 87652533 102246212 -14214441 8774 485752 87537245 79165301 23584799 92960 410928 102246212 71424439 8133343 5217 387264 79165301 64583287 7263806 9245 413409 71424439 0.39140 0.09850 0.51010 0 1 1 13542854 13542854 287226572 165957851 121268721 338395458 294769524 43625934 12007576 9237496 2770080 181207589 DONOR RESTRICTED FUND 53350415 BOARD DESIGNATED INVESTMENTS 34304126 RIGHT OF USE ASSETS 2877643 INTERCOMPANY RECEIVABLES 461731 90993915 EMPLOYEE COMP RELATED PAYROLL TAXES 12030621 ADVANCES FROM THIRD PARTY PAYORS 9752719 LONG-TERM LEASE LIABILITY 2081070 23864410 X PART V, LINE 4: INTENDED USE OF ENDOWMENT FUNDS THE ORGANIZATION'S ENDOWMENT FUNDS ARE USED FOR CAPITAL, PATIENT SERVICES OR EDUCATIONAL PURPOSES. TIDALHEALTH, INC. ADMINISTERS THE ENDOWMENT FOR THE BENEFIT OF TIDALHEALTH PENINSULA REGIONAL. INC. AND TIDALHEALTH FOUNDATION. PART X, LINE 2: LIABILITY FOR UNCERTAIN TAX POSITION (ASC 740) THE ORGANIZATION IS INCLUDED IN THE CONSOLIDATED FINANCIAL STATEMENTS OF TIDALHEALTH, INC. THE RELEVANT TEXT OF THE INCOME TAX FOOTNOTE FROM THOSE FINANCIALS IS: THE HEALTH SYSTEM HAS DETERMINED THERE ARE NO MATERIAL UNCERTAIN TAX POSITIONS THAT REQUIRE RECOGNITION OR DISCLOSURE IN THE CONSOLIDATED FINANCIAL STATEMENTS AT JUNE 30, 2023 AND 2022. 1 1 1 X 1 X 1 1 1 0 1 1 10358300 10358300 0.02110 10358300 10358300 0.02110 9469070 2368357 7100713 0.01440 13373656 13373656 0.02720 68538838 29797432 38741406 0.07880 1811358 717969 1093389 0.00220 129961 129961 0.00030 93322883 32883758 60439125 0.12290 103681183 32883758 70797425 0.14400 7698 7698 0.00000 58069 58069 0.00010 395239 395239 0.00080 142033 142033 0.00030 45750 45750 0.00010 648789 648789 0.00130 1 9559541 246514273 162843571 83670702 X 1 1 1 1 TIDALHEALTH PENINSULA REGIONAL INC 100 E CARROLL STREET SALISBURY MD 21801 WWW.TIDALHEALTH.ORG 210019 X X X TIDALHEALTH PENINSULA REGIONAL INC 1 0 0 1 X X X X X X X X 22 1 1 1 1 X SEE SUPPLEMENTAL INFORMATION X HTTP://HEALTHYDELMARVA.ORG X X 1 22 1 SEE SUPPLEMENTAL INFORMATION 0 1 X 200.000000000000 300.000000000000 X X X 1 1 X X X X 1 X SEE SUPPLEMENTAL INFORMATION X SEE SUPPLEMENTAL INFORMATION X SEE SUPPLEMENTAL INFO X X X X X X 1 X 0 X X X X 1 X 0 0 TIDALHEALTH PENINSULA REGIONAL, INC.: PART V, SECTION B, LINE 5: CONSULTING REPRESENTATIVES OF THE COMMUNITY SERVED BY THE HOSPITALIN 2021, TIDALHEALTH RETAINED CONDUENT HEALTH COMMUNITIES INSTITUTE A XEROX COMPANY TO PREPARE AND CONDUCT A NEW COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) THAT WILL COVER THE MARYLAND COMMUNITY BENEFITS SERVICE AREA OF SOMERSET, WICOMICO AND WORCESTER COUNTIES AND A NEWLY ADDED AREA WHICH INCLUDES SUSSEX COUNTY, DELAWARE. THE CHNA WAS COMPLETED BY CONDUENT IN MAY 2022 AND PLACED ON TIDALHEALTH'S WEBSITE ALONG WITH THE PREVIOUS VERSION FOR PUBLIC ACCESS. SYSTEM DESCRIPTIONTIDALHEALTH IS ANCHORED BY TWO HOSPITALS, TIDALHEALTH PENINSULA REGIONAL AND TIDALHEALTH NANTICOKE. IN ADDITION, TIDALHEALTH INCLUDES A LARGE PHYSICIAN NEWORK OF 300 PLUS PROVIDERS WITH OVER 32 LOCATIONS. TIDALHEALTH WAS FORMED WHEN THE FORMER PENINSULA REGIONAL MEDICAL CENTER, NANTICOKE MEMORIAL HOSPITAL IN SEAFORD, DE AND MCCREADY MEMORIAL HOSPITAL IN CRISFIELD, MD, UNITED TO IMPROVE THE HEALTH OF THE COMMUNITIES WE SERVE.EFFECTIVE JANUARY 1, 2020, TIDALHEALTH NANTICOKE AND TIDALHEALTH PHYSICIAN NETWORK, INC. LOCATED IN SEAFORD, DELAWARE, JOINED TIDALHEALTH. TIDALHEALTH NANTICOKE HAS 139 LICENSED ACUTE CARE BEDS (99 CURRENTLY OPERATED) AND PRIMARILY SERVES THE WESTERN SUSSEX COUNTY, DELAWARE PORTION OF THE HEALTH SYSTEM'S PRIMARY SERVICE AREA. TIDALHEALTH NANTICOKE PHYSICIAN NETWORK PROVIDES OUTPATIENT MEDICAL SERVICES IN WESTERN SUSSEX COUNTY AND FEDERALSBURG, MD. EFFECTIVE MARCH 2020, MCCREADY FOUNDATION, INC., WHICH CONSISTED OF A THREE BED HOSPITAL, ALICE BYRD TAWES NURSING HOME, A 76-LICENSED BED SKILLED NURSING HOME AND CHESAPEAKE COVE ASSISTED LIVING CENTER IN CRISFIELD, MD, BECAME PART OF TIDALHEALTH. THE MCCREADY HOSPITAL DIVISION WAS MERGED INTO TIDALHEALTH PENINSULA REGIONAL AND LIMITED ITS FUNCTIONS TO THOSE CONSISTENT WITH STATUS AS A FREE-STANDING MEDICAL CENTER. HEALTHY COMMUNITIES INSTITUTE AND TIDALHEALTH PENINSULA REGIONAL HAVE COLLABORATED SINCE 2012 TO DEVELOP THE TIDALHEALTH CREATING HEALTHY COMMUNITIES' PLATFORM. CHNA PARTNERSHIPTHE LOCAL CHNA PARTNERSHIP COMBINED PRIMARY AND SECONDARY DATA TO INFORM ITS COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA). THE CHNA PROVIDES AN UNDERSTANDING OF THE HEALTH STATUS, QUALITY OF LIFE, AND RISK FACTORS OF OUR COMMUNITY THROUGH FINDINGS FROM QUALITATIVE AND SECONDARY DATA ANALYSIS. THE THEMES AND STRENGTHS PROVIDE INSIGHTS ABOUT WHAT TOPICS AND ISSUES COMMUNITY MEMBERS FEEL ARE IMPORTANT, HOW THEY PERCEIVE THEIR QUALITY OF LIFE, AND WHAT ASSETS THEY BELIEVE CAN BE USED TO IMPROVE HEALTH. FINDINGS FROM BOTH PRIMARY AND SECONDARY DATA HELPED TO INFORM THE TOP COMMUNITY HEALTH NEEDS. EACH TYPE OF DATA WAS ANALYZED USING A DEFINED METHODOLOGY. PRIMARY DATA WAS OBTAINED THROUGH A COMMUNITY SURVEY, FOCUS GROUPS, AND KEY INFORMANT INTERVIEWS. SECONDARY DATA ARE HEALTH INDICATOR DATA THAT HAVE BEEN COLLECTED BY OTHER SOURCES, SUCH AS NATIONAL AND STATE LEVEL GOVERNMENT ENTITIES, AND MADE AVAILABLE FOR ANALYSIS.PRIMARY DATA COLLECTIONTO ENSURE THE PERSPECTIVES OF COMMUNITY MEMBERS WERE CONSIDERED, INPUT WAS COLLECTED FROM ALL THREE COUNTIES IN THE TRI-COUNTY REGION AND SUSSEX COUNTY, DE. PRIMARY DATA USED IN THIS ASSESSMENT CONSISTED OF AN ONLINE COMMUNITY SURVEY, FOCUS GROUPS, AND KEY INFORMANT INTERVIEWS. THE FINDINGS FROM THIS DATA EXPANDED UPON INFORMATION GATHERED FROM THE SECONDARY DATA ANALYSIS TO INFORM THIS COMMUNITY HEALTH NEEDS ASSESSMENT. AS THE ASSESSMENT WAS CONDUCTED DURING THE COVID-19 PANDEMIC, PRIMARY DATA COLLECTION METHODS WERE MANAGED IN A WAY TO MAINTAIN SOCIAL DISTANCING AND PROTECT THE SAFETY OF PARTICIPANTS BY ELIMINATING IN-PERSON DATA COLLECTION.TO HELP INFORM AN ASSESSMENT OF COMMUNITY ASSETS, COMMUNITY MEMBERS WERE ASKED TO LIST AND DESCRIBE RESOURCES AVAILABLE IN THE COMMUNITY. ALTHOUGH NOT REFLECTIVE OF EVERY RESOURCE AVAILABLE IN THE COMMUNITY, THE LIST CAN HELP THE PARTNERSHIP TO EXPAND AND SUPPORT EXISTING PROGRAMS AND RESOURCES. THE FOLLOWING ORGANIZATIONS ARE REPRESENTATIVE OF LOCAL PARTICIPANTS, RESOURCES, PARTNERS, AND THOSE ORGANIZATIONS WE INCLUDE IN UNDERSTANDING TOP COMMUNITY HEALTH NEEDS:- CHRISTIAN SHELTER - SALISBURY, MD- DIAKONIA - OCEAN CITY, MD- LA RED HEALTH CENTER - SUSSEX, DE- LOWER SHORE VULNERABLE POPULATIONS TASK FORCE - SALISBURY, MD - SALISBURY URBAN MINISTRIES - SALISBURY, MD - CHESAPEAKE HEALTHCARE - DEER'S HEAD HOSPITAL CENTER - HOPE, INC. - MAC, INC. - REBIRTH, INC. - RECOVERY RESOURCE CENTER - SALISBURY UNIVERSITY - SOMERSET COUNTY SCHOOLS - SUSSEX COUNTY COALITION - UNIVERSITY OF MARYLAND EASTERN SHORE (UMES) - WICOMICO COUNTY COUNCILFOCUS GROUPSTHE PROJECT TEAM DEVELOPED A FOCUS GROUP GUIDE MADE UP OF A SERIES OF QUESTIONS AND PROMPTS ABOUT THE HEALTH AND WELL-BEING OF RESIDENTS IN THE TRI-COUNTY REGION AND SUSSEX COUNTY, DE. ALL PARTICIPANTS VOLUNTEERED. ADVERTISEMENT WAS DONE VIA SOCIAL MEDIA, PRESS RELEASES AND POSTERS WITH QR CODES. PARTICIPANTS COULD SIGN UP THROUGH AN ONLINE REGISTRATION FORM OR BY PHONE. COMMUNITY MEMBERS WERE ASKED TO SPEAK ABOUT BARRIERS AND ASSETS TO THEIR HEALTH AND ACCESS TO HEALTHCARE. FOUR VIRTUAL FOCUS GROUPS WERE HOSTED IN THE FOLLOWING COUNTIES: SOMERSET, WICOMICO, WORCESTER, MD, AND SUSSEX, DE, DURING OCTOBER AND NOVEMBER 2021. A TOTAL OF 26 PARTICIPANTS TOOK PART IN THE FOUR FOCUS GROUPS, WHICH EACH LASTED APPROXIMATELY 30 - 45 MINUTES. FACILITATORS IMPLEMENTED TECHNIQUES TO ENSURE THAT EVERYONE WAS ABLE TO PARTICIPATE IN THE DISCUSSIONS.KEY INFORMANT INTERVIEWSHCI CONSULTANTS CONDUCTED KEY INFORMANT INTERVIEWS TO COLLECT COMMUNITY INPUT. INTERVIEWEES WHO WERE ASKED TO PARTICIPATE WERE RECOGNIZED AS HAVING EXPERTISE IN PUBLIC HEALTH, SPECIAL KNOWLEDGE OF COMMUNITY HEALTH NEEDS, AND/OR REPRESENTED THE BROAD INTEREST OF THE COMMUNITY SERVED BY THE HOSPITALS AND HEALTH DEPARTMENTS, AND/OR COULD SPEAK TO THE NEEDS OF MEDICALLY UNDERSERVED OR VULNERABLE POPULATIONS. A TOTAL OF 14 KEY INFORMANT INTERVIEWS WERE CONDUCTED DURING AUGUST 2021-OCTOBER 2021. YOU CAN SEE THE KEY INFORMANT ORGANIZATIONS REPRESENTED IN THE TABLE BELOW. THESE ORGANIZATIONS ARE ALSO CURRENT OR POTENTIAL COMMUNITY PARTNERS FOR THE HOSPITALS AND HEALTH DEPARTMENTS LEADING THIS ASSESSMENT. EACH INTERVIEW INCLUDED AN INTERVIEWER AND NOTETAKER AND LASTED APPROXIMATELY 30 - 60 MINUTES. DURING THE INTERVIEWS, QUESTIONS WERE ASKED TO LEARN ABOUT THE INTERVIEWEE'S BACKGROUND AND ORGANIZATION, BIGGEST HEALTH NEEDS AND BARRIERS OF CONCERN IN THE COMMUNITY, AS WELL AS THE IMPACT OF HEALTH ISSUES ON VULNERABLE POPULATIONS. KEY INFORMANT ORGANIZATION : POPULATION SERVEDCHESAPEAKE HEALTHCARE : TRI-COUNTY REGIONDEER'S HEAD HOSPITAL CENTER : TRI-COUNTY REGIONHOPE, INC. : TRI-COUNTY REGIONMAC, INC. : TRI-COUNTY REGIONREBIRTH, INC. : WICOMICO COUNTY AND SURROUNDING REGIONRECOVERY RESOURCE CENTER : WICOMICO COUNTYSALISBURY UNIVERSITY : WICOMICO COUNTYSOMERSET COUNTY DEPARTMENT OF SOCIAL SERVICES : SOMERSET COUNTYSOMERSET COUNTY HEALTH DEPARTMENT : SOMERSET COUNTYSOMERSET COUNTY SCHOOLS : SOMERSET COUNTYSUSSEX COUNTY COALITION : SUSSEX, DEUNIVERSITY OF MARYLAND EASTERN SHORE (UMES) : TRI-COUNTY REGION AND SUSSEX, DEWICOMICO COUNTY COUNCIL : WICOMICO COUNTYWICOMICO COUNTY HEALTH DEPARTMENT : WICOMICO COUNTYCOMMUNITY SURVEYCOMMUNITY INPUT WAS COLLECTED VIA AN ONLINE COMMUNITY SURVEY AVAILABLE IN ENGLISH AND SPANISH, AS WELL AS PAPER COPIES AVAILABLE IN ARABIC, CREOLE, KOREAN, AND PORTUGUESE, FROM AUGUST 2021 THROUGH NOVEMBER 2021. THE SURVEY CONSISTED OF 45 QUESTIONS RELATED TO TOP HEALTH NEEDS IN THE COMMUNITY, INDIVIDUALS' PERCEPTION OF THEIR OVERALL HEALTH, INDIVIDUALS' ACCESS TO HEALTHCARE SERVICES, AS WELL AS SOCIAL AND ECONOMIC DETERMINANTS OF HEALTH. THE SURVEY WAS SHARED VIA HEALTH DEPARTMENTS' WEBSITES, SOCIAL MEDIA, EMAIL DISTRIBUTION, AND OTHER LOCAL COMMUNITY PARTNERS. PAPER COPIES WERE ALSO DISTRIBUTED AT SEVERAL COMMUNITY OUTREACH EVENTS, LOCAL LIBRARIES, AND DIRECTLY TO PATIENTS AT TIDALHEALTH VIA COMMUNITY HEALTH WORKERS OR CARE COORDINATION SPECIALISTS. A TOTAL OF 774 RESPONSES WERE COLLECTED.PART V, SECTION B, LINE 6A:THE ORGANIZATION'S CHNA WAS CONDUCTED AS PART OF TIDALHEALTH'S CHNA OF THE GREATER AREA WHICH INCLUDED TIDALHEALTH NANTICOKE. TIDALHEALTH PENINSULA REGIONAL, INC.: PART V, SECTION B, LINE 6B: CHNA CONDUCTED WITH ONE OR MORE ORGANIZATIONS OTHER THAN HOSPITAL FACILITIESA PARTNERSHIP WAS FORMED BETWEEN TIDALHEALTH, SOMERSET COUNTY HEALTH DEPARTMENT (SCHD), AND WICOMICO COUNTY HEALTH DEPARTMENT (WICHD) FOR THE BENEFIT OF THE COMMUNITY. THESE ORGANIZATIONS HAVE BEEN PARTNERING TOGETHER ON LOCAL HEALTH ASSESSMENT EFFORTS SINCE 1995. TWO OF THE ORGANIZATIONS ARE REQUIRED TO COMPLETE A CHNA; TIDALHEALTH PENINSULA REGIONAL IS A NON-PROFIT HOSPITAL AND WICHD AS AN ACCREDITED HEALTH DEPARTMENT. SCHD IS IN THE EARLY PHASE OF PUBLIC HEALTH ACCREDITATION. IN MAY OF 2022, TIDALHEALTH, SCHD, AND WICHD PUBLISHED THEIR 2022 CHNA. THE CHNA REPORT PROVIDES AN OVERVIEW OF SIGNIFICANT HEALTH NEEDS IN THE TRI-COUNTY SERVICE AREA. THIS CHNA REPORT WAS DEVELOPED TO PROVIDE AN OVERVIEW OF THE HEALTH NEEDS IN THE TRI-COUNTY SERVICE AREA, INCLUDING SOMERSET, WICOMICO, AND WORCESTER COUNTIES IN MARYLAND AND SUSSEX COUNTY, DELAWARE. TIDALHEALTH, SCHD, AND WICHD PARTNERED WITH CONDUENT HEALTHY COMMUNITIES INSTITUTE TO CONDUCT THE CHNA. THE GOAL OF THIS REPORT IS TO OFFER A MEANINGFUL UNDERSTANDING OF THE GREATEST HEALTH NEEDS ACROSS THE FOUR COUNTY SERVICE AREA, AS WELL AS TO GUIDE PLANNING EFFORTS TO ADDRESS THOSE NEEDS. SPECIAL ATTENTION HAS BEEN GIVEN TO IDENTIFY HEALTH DISPARITIES, NEEDS OF VULNERABLE POPULATIONS, UNMET HEALTH NEEDS OR GAPS IN SERVICES, AND INPUT FROM THE COMMUNITY. PART V, LINE 7A: CHNA ON HOSPITAL FACILITY'S WEBSITE HTTPS://WWW.TIDALHEALTH.ORG/COMMUNITY-OUTREACH-PARTNERS/COMMUNITY-HEALTH-RESEARCH-DATA TIDALHEALTH PENINSULA REGIONAL, INC.: PART V, SECTION B, LINE 7D: PUBLIC AVAILABILITY OF TIDALHEALTH CHNAA PAPER COPY IS MADE AVAILABLE TO THE PUBLIC AT SEVERAL LOCATIONS WITHIN THE HOSPITAL FOR PUBLIC INSPECTION. IN ADDITION, THE REPORT IS BEING EVALUATED FOR TRANSLATION INTO SPANISH AND POSSIBLE FURTHER TRANSLATION TO HAITIAN CREOLE. WE PARTNER WITH CONDUENT HEALTHY COMMUNITIES INSTITUTE TO DISCOVER WHAT THE MOST PRESSING HEALTH CHALLENGES ARE IN SOMERSET, WORCESTER, WICOMICO COUNTIES, MD AND SUSSEX COUNTY, DE. THE PUBLIC CAN VIEW THE RESULTS OF OUR COMMUNITY HEALTH NEEDS ASSESSMENT ONLINE, AS WELL AS OUR ACTION PLAN OF STEPS WE PLAN TO TAKE BASED ON THE INFORMATION GATHERED IN THE ASSESSMENT. IN ADDITION, A COMMUNITY HEALTH DATA AND RESOURCES SECTION CAN BE ACCESSED BY THE PUBLIC. AS PART OF THIS CREATING HEALTHY COMMUNITIES, A MODULE IS AVAILABLE TO THE PUBLIC IN WHICH THEY CAN EXPLORE MULTIPLE DASHBOARDS THAT PROVIDE A GAUGE TO THE HEALTH OF THE COMMUNITIES SERVED, SOCIO-DEMOGRAPHICS AND PROMISING PRACTICES. THE DASHBOARDS INCLUDE FEATURES SUCH AS A CHNA GUIDE, HEALTH DATA, DEMOGRAPHIC DATA, HEALTH DISPARITIES, SOCIO NEEDS INDEXES, FINDING GRANTS, INDICATOR COMPARISONS, AND PROGRESS TRACKING. TIDALHEALTH PENINSULA REGIONAL, INC.: PART V, LINE 10A: IMPLEMENTATION STRATEGY ON HOSPITAL FACILITY'S WEBSITEHTTPS://WWW.TIDALHEALTH.ORG/COMMUNITY-OUTREACH-PARTNERS/COMMUNITY-HEALTH-RESEARCH-DATATIDALHEALTH PENINSULA REGIONAL HAS FINALIZED ITS 2023-2025 COMMUNITY HEALTH IMPROVEMENT PLAN, WHICH IS NOW PUBLISHED ON THE HOSPITAL'S WEBSITE. SOME NEW INITIATIVES HAVE BEEN INCLUDED IN THE UPDATED IMPLEMENTATION PLAN. SUCCESSFUL PROGRAMS AND INITIATIVES HAVE BEEN CARRIED OVER FROM THE PREVIOUS PLAN AS THEY HAVE PROVEN TO SUBSTANTIALLY IMPROVE THE HEALTH OF OUR COMMUNITIES. LOCAL HEALTH PARTNERSHIPS WILL ALSO REMAIN INTACT. TIDALHEALTH PENINSULA REGIONAL, INC.: PART V, SECTION B, LINE 11: HOW NEEDS IDENTIFIED IN THE CHNA ARE ADDRESSEDTIDALHEALTH PENINSULA REGIONAL HAS A FIXED VALUE OF RESOURCES AVAILABLE, AND THE HOSPITAL FOCUSES THOSE RESOURCES TO THE AREAS WITH THE GREATEST IMPACT AND THOSE WHERE TIDALHEALTH HAS SPECIFIC EXPERTISE. THEREFORE NOT ALL NEEDS, TO DATE, IDENTIFIED IN THE CHNA WERE ABLE TO BE ADDRESSED. NON-PRIORITIZED NEEDS INCLUDED CRIME AND CRIME PREVENTION, HOMELESSNESS AND UNSTABLE HOUSING, ORAL HEALTH, PREVENTION AND SAFETY. THESE NEEDS WERE NOT SELECTED BECAUSE THEY DID NOT MEET THE PRIORITIZATION CRITERIA AS STRONGLY AS THE SELECTED TOPICS. OTHER NEEDS WERE SELECTED BECAUSE OF GREATER IMPACT AND CAPACITY TO ADDRESS. EVEN THOUGH NOT ALL IDENTIFIED NEEDS ARE ADDRESSED SPECIFICALLY IN THE "IMPLEMENTATION STRATEGY COMMUNITY BENEFITS" PLAN, THERE ARE POPULATION HEALTH INITIATIVES ADOPTED THROUGH THE HEALTH SYSTEM'S STRATEGIC PLAN THAT PROMOTE HEALTH AND WELL-BEING WITHIN THE COMMUNITY, AND ADDRESS NEEDS WITHIN THE CHNA.BASED ON THE SIGNIFICANT NEEDS IDENTIFIED IN THE COMMUNITY HEALTH NEEDS ASSESSMENT, THE FOLLOWING IMPLEMENTATION INITIATIVES WERE DEVELOPED AND OUTLINED IN OUR 2023-2025 IMPLEMENTATION STRATEGY PLAN FOR TIDALHEALTH PENINSULA REGIONAL, AND ALSO IN THE COMMUNITY HEALTH IMPROVEMENT PLAN FOR SOMERSET COUNTY HEALTH DEPARTMENT AND WICOMICO COUNTY HEALTH DEPARTMENT. THIS REPORT WAS PRESENTED AND APPROVED BY THE HOSPITAL'S BOARD OF DIRECTORS AND LOCAL HEALTH IMPROVEMENT COALITIONS AND WAS PUBLISHED IN SPRING OF 2023.AFTER A THOROUGH REVIEW OF THE HEALTH STATUS IN OUR COMMUNITY THROUGH THE CHNA, WE IDENTIFIED AREAS THAT WE COULD ADDRESS USING OUR RESOURCES, EXPERTISE AND COMMUNITY PARTNERS. THE FOLLOWING ARE THE PRIORITIZED HEALTH NEEDS THAT WILL BE ADDRESSED:- ACCESS AND HEALTH EQUITY - BEHAVIORAL HEALTH (PREVENTION AND TREATMENT FOR MENTAL HEALTH AND MENTAL DISORDERS AS WELL AS SUBSTANCE ABUSE DISORDERS) - CHRONIC DISEASE AND WELLNESS TIDALHEALTH PENINSULA REGIONAL, INC.: PART V, SECTION B, LINE 13B: ELIGIBILITY CRITERIA FOR FINANCIAL ASSISTANCEFINANCIAL ASSISTANCE POLICY: IN ACCORDANCE WITH STATE AND FEDERAL GUIDELINES, TIDALHEALTH WILL PROVIDE EMERGENCY AND MEDICALLY NECESSARY FREE AND/OR REDUCED-COST CARE TO PATIENTS WHO LACK HEALTH CARE COVERAGE OR WHOSE HEALTH CARE COVERAGE DOES NOT PAY THE FULL COST OF THEIR MEDICAL BILL. A PATIENT'S PAYMENT SHALL NOT EXCEED THE AMOUNT GENERALLY BILLED (AGB). ALL HOSPITAL REGULATED SERVICES (WHICH INCLUDES EMERGENCY AND MEDICALLY NECESSARY CARE) AT TIDALHEALTH PENINSULA REGIONAL WILL BE CHARGED CONSISTENTLY AS ESTABLISHED BY THE HEALTH SERVICES COST REVIEW COMMISSION (HSCRC) WHICH EQUATES TO THE AMOUNTS GENERALLY BILLED (AGB) METHOD. ALL PATIENTS SEEN BY A TIDALHEALTH PROVIDER OR IN AN UNREGULATED AREA AT TIDALHEALTH PENINSULA REGIONAL OR ALL SERVICES AT TIDALHEALTH NANTICOKE HOSPITAL WILL BE CHARGED THE FEE SCHEDULE PLUS THE STANDARD MARK-UP WHICH IS THE AGB FOR TIDALHEALTH. SELF-PAY PATIENTS, FOR ALL SERVICES NOT REGULATED BY THE HSCRC, WILL RECEIVE A DISCOUNT TO REDUCE CHARGES TO THE AMOUNT TIDALHEALTH WOULD BE REIMBURSED BY MEDICARE WHICH IS THE PROSPECTIVE METHOD. FOR SELF-PAY PATIENTS, THE AMOUNT BILLED WILL NOT EXCEED THE MEDICARE FEE SCHEDULE FOR ALL UNREGULATED SERVICES.TIDALHEALTH WILL PROVIDE FREE MEDICALLY NECESSARY CARE TO PATIENTS WITH FAMILY INCOME AT OR BELOW 200% OF THE FEDERAL POVERTY LEVEL. PATIENTS QUALIFYING FOR FINANCIAL ASSISTANCE BASED ON INCOME AT OR BELOW 200% OF THE FEDERAL POVERTY LEVEL HAVE NO COST FOR THEIR CARE AND THEREFORE PAY LESS THAN AGB.TIDALHEALTH WILL PROVIDE REDUCED-COST MEDICALLY NECESSARY CARE TO LOW-INCOME PATIENTS WITH FAMILY INCOME BETWEEN 200% AND 300% OF THE FEDERAL POVERTY LEVEL.TIDALHEALTH WILL PROVIDE REDUCED-COST MEDICALLY NECESSARY CARE TO LOW-INCOME PATIENTS WITH FAMILY INCOME BETWEEN 301% AND 500% OF THE FEDERAL POVERTY LEVEL WHO HAVE A MEDICAL HARDSHIP AS DEFINED BY MARYLAND LAW. MEDICAL HARDSHIP IS MEDICAL DEBT, INCURRED BY A FAMILY OVER A 12-MONTH PERIOD THAT EXCEEDS 25% OF THE FAMILY INCOME.PROCEDURE:IF A PATIENT IS UNABLE TO PAY DUE TO FINANCIAL RESOURCES, ALL EFFORTS WILL BE MADE TO HELP THE PATIENT OBTAIN ASSISTANCE THROUGH APPROPRIATE AGENCIES. IN THE EVENT THAT THE PATIENT HAS APPLIED FOR AND KEPT ALL NECESSARY APPOINTMENTS AND THIRD-PARTY ASSISTANCE IS NOT AVAILABLE, TIDALHEALTH WILL PROVIDE CARE AT REDUCED OR ZERO COST. WHEN NO THIRD-PARTY ASSISTANCE IS AVAILABLE TO COVER THE TOTAL BILL AND THE PATIENT INDICATES THAT THEY HAVE INSUFFICIENT FUNDS, FINANCIAL ASSISTANCE (FA) WILL BE OFFERED. THE UNIFORM FINANCIAL ASSISTANCE APPLICATION, FINANCIAL ASSISTANCE POLICY, PATIENT COLLECTION PRACTICE POLICY, AND PLAIN LANGUAGE SUMMARY, CAN BE OBTAINED BY ONE OF THE FOLLOWING WAYS:A. AVAILABLE FREE OF CHARGE AND UPON REQUEST BY CALLING (410) 543-7436 OR (877) 729-7762.B. ARE LOCATED IN THE REGISTRATION AREAS.C. DOWNLOADED FROM THE TIDALHEALTH WEBSITE: HTTPS://WWW.TIDALHEALTH.ORG/PATIENTFORMSHTTPS://WWW.TIDALHEALTH.ORG/PATIENTBILLSD. THE PLAIN LANGUAGE SUMMARY IS INSERTED IN THE ADMISSION PACKET AND WITH ALL PATIENT STATEMENTS.E. ANNUAL NOTIFICATION IN THE LOCAL NEWSPAPER.F. THE APPLICATION IS AVAILABLE IN ENGLISH, SPANISH, AND CREOLE. NO OTHER LANGUAGE CONSTITUTES A GROUP THAT IS 5% OR MORE, OR MORE THAN 1,000 RESIDENTS (WHICHEVER IS LESS) OF THE POPULATION IN OUR PRIMARY SERVICE AREA (WORCESTER, WICOMICO AND SOMERSET COUNTIES) FOR MARYLAND BASED ON U.S. CENSUS DATA. FOR DELAWARE, THE HOSPITAL POPULATION CONSIDERED WAS 5%.G. FOR PATIENTS WHO HAVE DIFFICULTY IN FILLING OUT AN APPLICATION, THE INFORMATION CAN BE TAKEN ORALLY BY CALLING (410) 912-6957 OR IN PERSON AT THE FINANCIAL COUNSELOR'S OFFICE LOCATED IN THE FRANK B. HANNA OUTPATIENT CENTER. PART V, LINES 16A, 16B & 16C: FINANCIAL ASSISTANCE POLICY, APPLICATION FORM, PLAIN LANGUAGE SUMMARY AVAILABLE ON THE HOSPITAL'S WEBSITEWWW.TIDALHEALTH.ORG/MEDICAL-CARE/FINANCIAL-ADMIN-SERVICES/BILLING/TIDALHEALTH-FINANCIAL-ASSISTANCE SCHEDULE H, PART V, LINE 22D: MAXIMUM CHARGE AMOUNTS FOR FAP-ELIGIBLE INDIVIDUALSTIDALHEALTH PENINSULA REGIONAL IS A MARYLAND HOSPITAL. AS SUCH PATIENTS AND ALL INSURANCE COMPANIES, INCLUDING MEDICARE & MEDICAID, PAY THE SAME RATE. THIS RATE IS DETERMINED BY THE STATE AGENCY, THE MARYLAND HEALTH SERVICES COST REVIEW COMMISSION. PART I, LINE 3C: OTHER METHOD USED IN DETERMINING ELIGIBILITY FOR FINANCIAL ASSISTANCEN/A - TIDALHEALTH PENINSULA REGIONAL USES THE FPG IN DETERMINING ELIGIBILITY FOR FINANCIAL ASSISTANCE. FINANCIAL ASSISTANCE IS ALSO CONSIDERED IF A PATIENT IS OVER INCOME CRITERION BUT HAS FINANCIAL HARDSHIP BASED ON MEDICAL DEBT. PATIENTS WHO ARE BENEFICIARIES/RECIPIENTS OF CERTAIN MEANS-TESTED SOCIAL SERVICES PROGRAM ADMINISTERED BY THE STATE OF THE PATIENT'S RESIDENCE ARE DEEMED TO HAVE PRESUMPTIVE ELIGIBILITY FOR THPR'S FA PROGRAM. PART I, LINE 6A: COMMUNITY BENEFIT REPORTTIDALHEALTH PENINSULA REGIONAL FILES ANNUALLY A COMMUNITY BENEFIT REPORT WITH THE STATE OF MARYLAND. THE REPORT IS FILED WITH THE HSCRC (HEALTH SERVICES COST REVIEW COMMISSION). PART I, LINE 7, COLUMN (F) FINANCIAL ASSISTANCE AND CERTAIN OTHER COMMUNITY BENEFITS AT COSTTHE AMOUNT OF BAD DEBT EXPENSE EXCLUDED FROM THE DENOMINATOR IN THE COLUMN (F) PERCENTAGES IS $9,559,541.LINE 7B, COLUMN (C) & (F):MARYLAND'S REGULATORY SYSTEM CREATES A UNIQUE PROCESS FOR HOSPITAL PAYMENT THAT DIFFERS FROM THE REST OF THE NATION. THE HEALTH SERVICES COST REVIEW COMMISSION (HSCRC) DETERMINES PAYMENT THROUGH A RATE-SETTING PROCESS AND ALL PAYORS, INCLUDING GOVERNMENTAL PAYORS, PAY THE SAME AMOUNT FOR THE SAME SERVICES DELIVERED AT THE SAME HOSPITAL. MARYLAND'S UNIQUE ALL-PAYOR SYSTEM INCLUDES A METHOD FOR REFERENCING UNCOMPENSATED CARE IN EACH PAYORS' RATES, WHICH DOES NOT ENABLE MARYLAND HOSPITALS TO BREAKOUT ANY DIRECTED OFFSETTING REVENUE RELATED TO UNCOMPENSATED CARE. COMMUNITY BENEFIT EXPENSES ARE EQUAL TO MEDICAID REVENUES IN MARYLAND, AS SUCH, THE NET EFFECT IS ZERO. THE EXCEPTION TO THIS IS THE IMPACT ON THE HOSPITAL OF ITS SHARE OF THE MEDICAID ASSESSMENT. IN RECENT YEARS, THE STATE OF MARYLAND HAS CLOSED FISCAL GAPS IN THE STATE MEDICAID BUDGET BY ASSESSING HOSPITALS THROUGH THE RATE-SETTING SYSTEM.THE COST METHODOLOGY FOR CHARITY CARE AND CERTAIN OTHER COMMUNITY BENEFITS IS THE COST-TO-CHARGE RATIO USED FOR THE CHARITY CARE PROGRAMS AND DIRECT COST METHOD FOR THE OTHER BENEFITS/PROGRAMS. PART II, COMMUNITY BUILDING ACTIVITIES: COMMUNITY BUILDING ACTIVITIESTIDALHEALTH PENINSULA REGIONAL FUNDS A VARIETY OF PROGRAMS THAT WORK TO PROMOTE THE HEALTH AND SAFETY OF OUR COMMUNITY. THESE PROGRAMS INCLUDE ACTIVITIES IN THE AREAS OF HOUSING, ECONOMIC DEVELOPMENT, COMMUNITY SUPPORT, ENVIRONMENTAL IMPROVEMENTS, COALITION BUILDING, AND WORKFORCE DEVELOPMENT.THE NUMBER OF PERSONS SERVED BY THE COMMUNITY BUILDING ACTIVITIES WERE NOT TRACKED FOR ALL PROGRAMS THROUGHOUT THE COURSE OF THE YEAR. COALITION BUILDINGHISTORICALLY TIDALHEALTH PENINSULA REGIONAL HAS FACILITATED INVOLVEMENT WITH HEALTH IMPROVEMENT ORGANIZATIONS TO IDENTIFY, ASSESS, AND CREATE AGGREGATE ACTION PLANS TO ADDRESS LOCAL EMERGING AND CHRONIC COMMUNITY BENEFIT SERVICE AREA HEALTHCARE ISSUES. KATHRYN FIDDLER (VICE PRESIDENT OF POPULATION HEALTH) AND KATHERINE RODGERS (COMMUNITY HEALTH INITIATIVES DIRECTOR) ATTEND THE FOLLOWING LOCAL HEALTH IMPROVEMENT COALITIONS AND ADVISORY BOARDS FOCUSED ON IMPROVING POPULATION HEALTH. - EASTERN SHORE AREA HEALTH EDUCATION CENTER BOARD- LOWER SHORE VULNERABLE POPULATIONS TASK FORCE- LOWER SHORE HEALTH INSURANCE ASSISTANCE PROGRAM STEERING COMMITTEE- SWIFT ADVISORY COUNCIL- SALISBURY UNIVERSITY PUBLIC HEALTH ADVISORY COUNCIL- HEALTHCARE COUNCIL POPULATION HEALTH COMMITTEE- SOMERSET COUNTY LHIC- SOMERSET COUNTY LMB- REACH COALITION FOR PATHWAYS TO HEALTH EQUITY- WICOMICO COUNTY LHIC- WORCESTER COUNTY LHIC- TRI COUNTY ALLIANCE FOR THE HOMELESS- PROJECT LIVING WELL ADVISORY COMMITTEE MAC (MAINTAINING ACTIVE CITIZENS)ADDITIONALLY, TIDALHEALTH PARTICIPATES IN THE INSTITITE FOR HEALTHCARE IMPROVEMENT'S INTERNATIONAL PURSUING EQUITY LEARNING COLLABORATIVE. PHYSICIAN RECRUITING TIDALHEALTH PENINSULA REGIONAL FEELS IT IS IMPORTANT TO CONTINUALLY MONITOR SPECIALTIES WHERE A SIGNIFICANT AMOUNT OF PATIENT CARE WITHIN THE SERVICE AREA IS PROVIDED BY OLDER PHYSICIANS, AS A SUDDEN OR UNEXPECTED LOSS OF COVERAGE COULD HAVE AN ADVERSE EFFECT ON THE PROVISION OF MEDICAL SERVICES TO THE COMMUNITY. SUCCESSION PLANNING AND RECRUITMENT GO HAND-IN-HAND, AS DOES SOCIO-DEMOGRAPHICS AND GOVERNMENTAL INITIATIVES ALL OF WHICH MUST BE CONSIDERED TO ASSESS APPROPRIATE PHYSICIAN RECRUITMENT. ACCORDING TO TIDALHEALTH'S MOST RECENT MEDICAL STAFF DEVELOPMENT PLAN (2021), THE CONSULTING ENGAGEMENT RECOMMEDED TIDALHEALTH EVALUATE RECRUITING 6-9 ADULT PRIMARY CARE PHYSICIANS IN OUR PRIMARY SERVICE AREA AND ALSO LOOK AT OPPORTUNITIES TO ALIGN WITH INDEPENDENT PHYSICIANS. TIDALHEALTH HAS RECENTLY ENGAGED WHITECAP, A HEALTHCARE CONSULTING FIRM, TO CONDUCT AN ANALYSIS OF PHYSICIAN REQUIREMENTS, ENCOMPASSING BOTH PRIMARY AND SPECIALTY CARE, THROUGHOUT OUR ENTIRE SERVICE AREA. WHITECAP OFFERS AN EXTENSIVE RANGE OF SERVICES THAT SUPPORT STRATEGIC DECISION-MAKING, FOCUSING ON THE OPTIMAL GEOGRAPHIC PLACEMENT OF PROVIDERS AND THE ENGAGEMENT OF PATIENTS WITHIN THEIR OWN COMMUNITIES. COMMUNITY NEEDS PLACES EMPHASIS ON PRIMARY AND FAMILY PRACTICE PROVIDERS TO ENGAGE IN CHRONIC DISEASE MANAGEMENT AS PART OF OUR POPULATION HEALTH INITIATIVES. SUCCESSION PLANNING IS A KEY OBJECTIVE AS A SUBSTANIAL NUMBER OF PRIMARY CARE PHYSICIANS ARE ABOVE THE AGE OF 55 WHICH WILL LEAVE A VOID IN AN ALREADY UNDERSERVED AREA. DEMOGRAPHICS PLAYS A KEY ROLE AS THE MEDICARE POPULATION IS GROWING AT A FASTER RATE THAN THE STATE OF MARYLAND AND THE NATION. AS A GROWING RETIREMENT COMMUNITY, THERE IS AN INCREASED NEED FOR ADDITIONAL PRIMARY CARE PHYSICIANS AND CERTAIN SPECIALTIES. THERE WILL BE A 20%-28% GROWTH OF SENIORS 65+ OVER THE NEXT 5 YEARS WITHIN OUR TOTAL SERVICE AREA. TIDALHEALTH PHYSICIAN NETWORK OPTIMIZATION WAS DETERMINED BY CALCULATING USING THE CURRENT SUPPLY OF PHYSICIANS AND APPLYING PHYSICIAN TO-POPULATION RATIO BENCHMARKS, PHYSICIAN PATIENT VOLUMES, POPULATION DATA, AND OTHER DATA. MANAGEMENT CONSULTANTS RECOMMENDED EVALUATING POTENTIAL RECRUITMENT OF PRIMARY CARE FAMILY MEDICINE, PRIMARY CARE INTERNAL MEDICINE AND PRIMARY CARE PEDIATRICS OVER THE NEXT FIVE YEARS. MEDICAL SPECIALTY NEEDS ARE DRIVEN BY THE OVERALL MARKET SUPPLY, WAIT TIMES FOR NEW PATIENT APPOINTMENTS, AND CALL COVERAGE AND INPATIENT CONSULTATION NEEDS. CURRENT MEDICAL SPECIALTY RECOMMENDATIONS INCLUDE RECRUITMENT OF THE FOLLOWING PHYSICIAN SPECIALTIES DUE TO COMMUNITY NEEDS ASSESSMENT, MARKET DEMAND AND RETIREMENT: ALLERGY/IMMUNOLOGY, DERMATOLOGY, ENDOCRINOLOGY, HEMATOLOGY/ONCOLOGY, INFECTIOUS DISEASE, INTERVENTIONAL RADIOLOGY, NEUROLOGY, OB/GYN, GENERAL SURGERY, ORTHOPAEDICS, OTOLARYNGOLOGY, PAIN MANAGEMENT, PSYCHIATRY AND RHEUMATOLOGY. OF THE MEDICAL STAFF, 30%+ IS EITHER AT OR ABOVE THE AGE OF 55, WHICH POSES SUCCESSION RISK. TIDALHEALTH PENINSULA REGIONAL, A RURAL HOSPITAL, AND OTHER LIKE-KIND RURAL COMMUNITIES ARE TYPICALLY CHALLENGED IN BOTH RECRUITMENT AND RETENTION OF PHYSICIANS DUE TO NUMEROUS FACTORS. SOME OF THESE CHALLENGES ARE DUE TO THE LOCATION AND GEOGRAPHY OF THE AREA AND AVAILABILITY OF HEALTHCARE RESOURCES. RETAINING AND RECRUITING RESOURCES IN SUB-SPECIALTIES CAN BE HARD FOR REGIONAL RURAL HOSPITALS AND TIDALHEALTH PENINSULA REGIONAL IS NO EXCEPTION. TO ADDRESS SPECIFIC COMMUNITY HEALTHCARE NEEDS THE MEDICAL CENTER HAS HAD TO RECRUIT, RETAIN, EMPLOY AND SUBSIDIZE SOME OF THE FOLLOWING SUB-SPECIALTIES; NEONATOLOGY, PULMONARY, NEURO-HOSPITALIST, NEUROSURGERY, MEDICAL ONCOLOGY & HEMATOLOGY, RADIATION ONCOLOGY, GASTROENTEROLOGY, PEDIATRIC SPECIALTIES, ENDOCRINOLOGY, CARDIOLOGY, CARDIOVASCULAR SURGERY, ANESTHESIOLOGY AND PAIN MANAGEMENT. RURAL COMMUNITIES LACK THE CULTURAL AND EDUCATIONAL RESOURCES THAT LARGER URBAN CENTERS PROVIDE MAKING IT HARDER TO RETAIN AND RECRUIT THESE PHYSICIANS. LOW POPULATION PATTERNS BY GEOGRAPHY MAKE IT MORE COSTLY AND HARDER FOR COMMUNITIES AND BUSINESSES TO PROVIDE VARIOUS TYPES OF SERVICES ESPECIALLY SPECIALTY PHYSICIAN SERVICES. OVERALL, OUR LOCAL ECONOMY IS NOT AS ROBUST AS THE URBAN CENTERS AS INDICATED BY OUR LOW AVERAGE HOUSEHOLD INCOME IN THE TRI-COUNTY AREA.DISASTER READINESSTIDALHEALTH PENINSULA REGIONAL IS A MEMBER OF DRHMAG (DELMARVA REGIONAL HEALTH MUTUAL AID GROUP) WHICH IS A COALITION OF LOCAL HEALTH DEPARTMENTS, HOSPITALS AND NURSING HOMES. THEY MEET QUARTERLY TO DISCUSS ISSUES OF DISASTER PREPAREDNESS IN THE DELMARVA REGION. TIDALHEALTH PENINSULA REGIONAL HAS AN INTERNAL EMERGENCY MANAGEMENT COMMITTEE THAT MEETS MONTHLY WHOSE MEMBERS INCLUDE THE SAFETY COORDINATOR, CHIEF OF SECURITY, EMERGENCY DEPARTMENT RN, RISK MANAGEMENT, INFECTION PREVENTION, EXECUTIVE TEAM REPRESENTATIVE, PHARMACIST, EMERGENCY MANAGEMENT COORDINATOR, FIREFIGHTER, AND A COUNTY HEALTH DEPARTMENT REPRESENTATIVE. THPR ALSO MEETS QUARTERLY WITH OUR LOCAL PARTNERS THAT INCLUDE FIRE, POLICE, EMERGENCY MEDICAL SERVICES, AND WICOMICO COUNTY EMERGENCY MANAGEMENT TO FACILITATE DISASTER PLANNING AND MOCK DRILLS WITHIN THE COMMUNITY. PART III, LINES 2 AND 3: SEE RESPONSE BELOW TO LINE 4 REGARDING THE METHODOLOGY USED BY THE ORGANIZATION REGARDING BAD DEBT. PART III, LINE 4: BAD DEBT FOOTNOTE IN THE AUDITED FINANCIAL STATEMENTSA RECEIVABLE IS RECOGNIZED WHEN THERE IS AN UNCONDITIONAL RIGHT TO PAYMENT, SUBJECT ONLY TO THE PASSAGE OF TIME. PATIENT ACCOUNTS RECEIVABLE, INCLUDING BILLED ACCOUNTS AND UNBILLED ACCOUNTS, WHICH HAVE THE UNCONDITIONAL RIGHT TO PAYMENT, AND ESTIMATED AMOUNTS DUE FROM THIRD-PARTY PAYORS FOR RETROACTIVE ADJUSTMENTS, ARE RECORDED AS RECEIVABLES SINCE THE RIGHT TO CONSIDERATION IS UNCONDITIONAL AND ONLY THE PASSAGE OF TIME IS REQUIRED BEFORE PAYMENT OF THAT CONSIDERATION IS DUE. THE ESTIMATED UNCOLLECTIBLE AMOUNTS ARE GENERALLY CONSIDERED IMPLICIT PRICE CONCESSIONS THAT ARE RECORDED AS A DIRECT REDUCTION TO PATIENT ACCOUNTS RECEIVABLE.DISCOUNTS RANGING FROM 2.0% TO 7.7% OF CHARGES ARE GIVEN TO MEDICARE, MEDICAID, AND CERTAIN APPROVED COMMERCIAL HEALTH INSURANCE AND HEALTH MAINTENANCE ORGANIZATION PROGRAMS FOR REGULATED SERVICES. DISCOUNTS IN VARYING PERCENTAGES ARE GIVEN FOR CERTAIN UNREGULATED SERVICES. PART III, LINE 8: MEDICARE COSTING METHODOLOGYMEDICARE ALLOWABLE COSTS WERE CALCULATED USING A COST TO CHARGE RATIO. TIDALHEALTH PENINSULA REGIONAL PROVIDES QUALITY MEDICAL SERVICES TO ALL PATIENTS REGARDLESS OF WHAT INSURANCE THEY HAVE. APPROXIMATELY, 54.66% OF THE MEDICAL CENTER'S REVENUE IS ATTRIBUTABLE TO MEDICARE PATIENTS DURING THE YEAR ENDED JUNE 30, 2023. PART III, LINE 9B: COLLECTION POLICYTHE TIDALHEALTH PENINSULA REGIONAL COLLECTION POLICY INCLUDES INFORMATION ABOUT OUR FINANCIAL ASSISTANCE POLICY (FAP) AND HOW TO FIND THE FAP. THE DEBT COLLECTION POLICY APPLIES TO ALL PATIENTS. ADDITIONALLY, OUR COLLECTION POLICY INSTRUCTS THAT EXTRAORDINARY COLLECTION ACTIONS (ECA) WILL BE SUSPENDED WHEN A PATIENT REQUESTS INFORMATION ON OUR FAP OR SUBMITS A FINANCIAL ASSISTANCE APPLICATION WITHIN 240 DAYS OF THE FIRST POST-DISCHARGE BILLING STATEMENT. OUR POLICY DESCRIBES WHAT TO DO IF THE FINANCIAL ASSISTANCE APPLICATION IS INCOMPLETE AND WHAT IS REQUIRED TO BE REFUNDED (AMOUNTS OVER $5) IF THE PATIENT QUALIFIES FOR FINANCIAL ASSISTANCE AFTER MAKING A PAYMENT. WE INCLUDE CLARIFICATION OF WHAT DATES OF SERVICES ARE INCLUDED IN THE FINANCIAL ASSISTANCE SO THAT WE UNDERSTAND WHEN NORMAL COLLECTION EFFORTS ARE APPROPRIATE.WITHIN OUR COLLECTION POLICY WE DESCRIBE THAT A PATIENT DENIED FINANCIAL ASSISTANCE MAY REQUEST A RECONSIDERATION. FOR DATES OF SERVICES APPROVED FOR FINANCIAL ASSISTANCE COLLECTIONS PROCESSES ARE HALTED AS THE ACCOUNT IS ADJUSTED TO ZERO DUE FROM PATIENT. THE POLICY STATES HOW TO PROCESS THE PATIENT BALANCE WHEN ONLY A PORTION OF THE CHARGE QUALIFIED FOR FINANCIAL ASSISTANCE; COLLECTIONS WILL ONLY BE PURSUED ON THE AMOUNT THAT DID NOT QUALIFY FOR FINANCIAL ASSISTANCE. PART VI, LINE 2: NEEDS ASSESSMENTTIDALHEALTH PENINSULA REGIONAL ASSESSES COMMUNITY HEALTH NEEDS IN PARTNERSHIP WITH THE LOCAL COUNTY HEALTH DEPARTMENTS (WICOMICO, WORCESTER, SOMERSET). WE MEET ON A REGULAR BASIS TO DISCUSS AND FORMULATE STRATEGIES AND ACTION PLANS IN WHICH WE COLLABORATE WITH EACH OTHER AND LOCAL ENTITIES TO ADDRESS RESIDENTS' MOST UNDERSERVED AND CRITICAL HEALTHCARE AND SOCIAL NEEDS. DEVELOPING RELATIONSHIPS WITH COMMUNITY PARTNERS IS CRITICAL TO CONTINUED IDENTIFICATION OF UNDERSERVED NEEDS AND POPULATION HEALTH MANAGEMENT SUCCESS; A CORNERSTONE OF TIDALHEALTH PENINSULA REGIONAL STRATEGY. THE FOLLOWING LOCAL RELATIONSHIPS, PARTNERSHIPS AND MEMBERSHIPS HAS CREATED SYNERGY PRODUCING LOCAL HEALTHCARE DIVIDENDS, EXAMPLES OF THESE RELATIONSHIPS INCLUDE THE FOLLOWING: TRI-COUNTY DIABETES ALLIANCE, SWIFT (SALISBURY WICOMICO INTEGRATED FIRSTCARE TEAM), FEDERALLY QUALIFIED HEALTH CENTERS, YMCA, PATIENT CARE ADVISORY COUNCIL, LOCAL SNFS, FAITH BASED ENTITIES, MAC (MAINTAINING ACTIVE CITIZENS), SHELTERS (HALO, HOPE), LOCAL COLLEGES & HIGH SCHOOLS. WE ARE WORKING WITH DIVERSE AND DISPARATE LOCAL ENTITIES FOR THE UNITED BUT COMMON GOAL OF MEETING RESIDENTS' UNDERSERVED NEEDS. OUR GOAL IS A HEALTHIER COMMUNITY.IN ADDITION TO THE CHNA (DISCUSSED IN PREVIOUS SECTION), TIDALHEALTH PENINSULA REGIONAL HAS EMBARKED ON IDENTIFYING AND TARGETING "SUPER UTILIZERS" WITHIN OUR CBSA (COMMUNITY BENEFIT SERVICE AREA); THESE RESIDENTS WILL BE IDENTIFIED, AND TARGETED FOR POPULATION HEALTH MANAGEMENT. - DEMOGRAPHICS (CENSUS TRACK, ZIP CODES)- DISPARITIES AND HEALTH EQUITY, USING A DEPRIVATION INDEX - RACE/ETHNICITY- AGE-COHORTS- CHRONIC CONDITIONSTHE TARGET POPULATION INCLUDES PATIENTS THAT HAVE CHRONIC CONDITIONS WHO HAVE DEMONSTRATED TO HAVE BEEN HIGH UTILIZERS AT TIDALHEALTH PENINSULA REGIONAL OR ARE IDENTIFIED AS BEING AT RISK OF HIGH UTILIZATION BASED ON HIS/HER CHRONIC CONDITIONS AND PATTERNS OF CARE. CURRENT DATA INDICATES AN "OVERRELIANCE" BY LOCAL RESIDENTS ON TIDALHEALTH PENINSULA REGIONAL'S EMERGENCY ROOM FOR PRIMARY AND CHRONIC CONDITION NEEDS. IN RESPONSE, TIDALHEALTH PENINSULA REGIONAL HAS INTRODUCED INTERVENTIONS, CARE MANAGEMENT PROGRAMS, EDUCATION, AND FOLLOW-UP WITH MEASUREMENT AND OUTCOMES. BASED UPON A CURRENT ASSESSMENT THERE ARE MANY RESIDENTS THAT MEET THE CRITERIA OF "SUPER UTILIZERS" STRATIFIED BY SOCIO-DEMOGRAPHICS AND CHRONIC DISEASE.TIDALHEALTH PENINSULA REGIONAL IS TARGETING CBSA ZIP CODES BASED UPON SOCIAL AND ECONOMIC DETERMINANTS OF HEALTH TO INCLUDE THE UNINSURED, INDIGENT POPULATION, RESIDENTS WHO LACK TRANSPORTATION, LACK OF EDUCATION AND AVAILABILITY OF HEALTHY FOODS. TARGETING THIS BY CLUSTER AND CENSUS TRACK, WE SEEK TO IMPACT HEALTH BY PROVIDING PRIMARY HEALTH SERVICES, EDUCATION, ACCESS AND MORE IMPORTANTLY BY FOSTERING RELATIONSHIPS WITHIN THE COMMUNITY WE SERVE. FOR EXAMPLE, OUR WAGNER WELLNESS VAN TRAVELS LOCALLY TO CENSUS TRACK WHERE THERE WAS AN IDENTIFIED NEED FOR BASIC HEALTH SERVICES, IN ADDITION TO PROVIDING HEALTH SERVICES AND EDUCATION TO LOCAL ETHNIC CHURCHES AND CIVIC ORGANIZATIONS.WHILE IDENTIFYING WHICH BARRIERS AND DISPARITIES ARE CRITICAL COMPONENTS IN ASSESSING THE NEEDS OF A COMMUNITY, IT IS ALSO IMPORTANT TO UNDERSTAND THE SOCIAL DETERMINANTS OF HEALTH AND OTHER UPSTREAM FACTORS THAT INFLUENCE A COMMUNITY'S HEALTH AS WELL. THE CHALLENGES AND BARRIERS FACED BY A COMMUNITY MUST BE BALANCED BY IDENTIFYING PRACTICAL, COMMUNITY-DRIVEN SOLUTIONS. TOGETHER, THESE FACTORS COME TOGETHER TO INFORM AND FOCUS STRATEGIES TO POSITIVELY IMPACT A COMMUNITY'S HEALTH. TIDALHEALTH AND PARTNERS ARE OUTLINING OPPORTUNITIES FOR ON-GOING WORK AS WELL AS POTENTIAL FOR FUTURE IMPACT. PART VI, LINE 3: PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCEIF A PATIENT IS UNABLE TO PAY DUE TO FINANCIAL RESOURCES, ALL EFFORTS WILL BE MADE TO HELP THE PATIENT OBTAIN ASSISTANCE THROUGH APPROPRIATE AGENCIES. IN THE EVENT THAT THE PATIENT HAS APPLIED FOR AND KEPT ALL NECESSARY APPOINTMENTS AND THIRD-PARTY ASSISTANCE IS NOT AVAILABLE, TIDALHEALTH WILL PROVIDE CARE AT REDUCED OR ZERO COST. WHEN NO THIRD-PARTY ASSISTANCE IS AVAILABLE TO COVER THE TOTAL BILL AND THE PATIENT INDICATES THAT THEY HAVE INSUFFICIENT FUNDS, FINANCIAL ASSISTANCE (FA) WILL BE OFFERED. THE UNIFORM FINANCIAL ASSISTANCE APPLICATION, FINANCIAL ASSISTANCE POLICY, PATIENT COLLECTION PRACTICE POLICY, AND PLAIN LANGUAGE SUMMARY, CAN BE OBTAINED BY ONE OF THE FOLLOWING WAYS:A. AVAILABLE FREE OF CHARGE AND UPON REQUEST BY CALLING (410) 543-7436 OR (877) 729-7762.B. ARE LOCATED IN THE REGISTRATION AREAS.C. DOWNLOADED FROM THE TIDALHEALTH WEBSITE:HTTPS://WWW.TIDALHEALTH.ORG/PATIENTFORMSHTTPS://WWW.TIDALHEALTH.ORG/PATIENTBILLSD. THE PLAIN LANGUAGE SUMMARY IS INSERTED IN THE ADMISSION PACKET AND WITH ALL PATIENT STATEMENTS.E. ANNUAL NOTIFICATION IN THE LOCAL NEWSPAPER.F. THE APPLICATION IS AVAILABLE IN ENGLISH, SPANISH, AND CREOLE. NO OTHER LANGUAGE CONSTITUTES A GROUP THAT IS 5% OR MORE, OR MORE THAN 1,000 RESIDENTS (WHICHEVER IS LESS) OF THE POPULATION IN OUR PRIMARY SERVICE AREA (WORCESTER, WICOMICO AND SOMERSET COUNTIES) FOR MARYLAND BASED ON U.S. CENSUS DATA. FOR DELAWARE, THE HOSPITAL POPULATION CONSIDERED WAS 5%.G. FOR PATIENTS WHO HAVE DIFFICULTY IN FILLING OUT AN APPLICATION, THE INFORMATION CAN BE TAKEN ORALLY BY CALLING (410) 912-6957 OR IN PERSON AT THE FINANCIAL COUNSELOR'S OFFICE LOCATED IN THE FRANK B. HANNA OUTPATIENT CENTER.SIGNS WILL BE POSTED IN VARIOUS LOCATIONS THROUGHOUT TIDALHEALTH TO INFORM PATIENTS WHERE TO CALL OR APPLY FOR FINANCIAL ASSISTANCE.THE PATIENT'S INCOME WILL BE COMPARED TO CURRENT FEDERAL POVERTY GUIDELINES (ON FILE WITH THE COLLECTION COORDINATOR). THE COLLECTION COORDINATOR REPRESENTATIVE WILL CONSULT WITH THE PATIENT AS NEEDED TO MAKE ASSESSMENT OF ELIGIBILITY.IT IS THE INTENTION OF TIDALHEALTH TO MAKE AVAILABLE TO ALL PATIENTS THE HIGHEST QUALITY OF MEDICAL CARE POSSIBLE WITHIN THE RESOURCES AVAILABLE. IF A PATIENT IS UNABLE TO PAY DUE TO FINANCIAL RESOURCES, ALL EFFORTS WILL BE MADE TO HELP THE PATIENT OBTAIN ASSISTANCE THROUGH APPROPRIATE AGENCIES, OR, IF NO HELP IS AVAILABLE, TO RENDER CARE AT A REDUCED OR ZERO COST FOR EMERGENCY AND MEDICALLY NECESSARY CARE. PART VI, LINE 4: COMMUNITY INFORMATIONTIDALHEALTH PENINSULA REGIONAL, AT 283 LICENSED BEDS, FUNCTIONS AS THE PRIMARY ACUTE TERTIARY CARE HOSPITAL PROVIDER FOR THE RURAL SOUTHERNMOST THREE COUNTIES OF THE EASTERN SHORE OF MARYLAND, WHICH INCLUDES WICOMICO, WORCESTER AND SOMERSET COUNTIES. APPROXIMATELY 77% OF THE PATIENTS DISCHARGED FROM THE MEDICAL CENTER ARE RESIDENTS OF THE PRIMARY SERVICE AREA, WHICH HAS AN ESTIMATED POPULATION OF APPROXIMATELY 182,371 IN 2023 AND IS EXPECTED TO INCREASE TO 183,580 (0.7%) BY 2028. THE MEDICAL CENTER ALSO HAS A SECONDARY SERVICE AREA INCLUDING, DORCHESTER COUNTY, MARYLAND, SUSSEX COUNTY, DELAWARE AND ACCOMACK COUNTY, VIRGINIA. WITH THE SECONDARY SERVICE AREA HAVING AN ESTIMATED POPULATION OF APPROXIMATELY 320,384 IN 2023 AND IS EXPECTED TO INCREASE TO 331,471 OR BY 3.5% BY 2028.TIDALHEALTH PENINSULA REGIONAL'S COMMUNITY BENEFITS SERVICE AREA CONSISTS OF THOSE ZIP CODES WITHIN OUR PRIMARY SERVICE AREA. MOST OF THE POPULATION RESIDES IN WICOMICO COUNTY (105,132) WITH SALISBURY SERVING AS THE CAPITAL OF THE EASTERN SHORE. SALISBURY IS LOCATED ON THE HEADWATERS OF THE WICOMICO RIVER AND IT IS LOCATED AT THE CROSSROADS OF THE BAY AND THE OCEAN. THE REGION IS UNIQUE; THE CITY OF SALISBURY HAS SIMILAR SOCIO-ECONOMIC AND DEMOGRAPHIC CHARACTERISTICS OF A LARGE CITY, HOWEVER, THE AREA SURROUNDING SALISBURY IS RURAL AND HAS LIKE-KIND CHARACTERISTICS OF SMALL-TOWN AMERICA. DUE TO THIS DICHOTOMY, SERVING BOTH SOMETIMES PRESENTS A CHALLENGE IN DELIVERING HEALTHCARE. THE TWO OTHER COUNTIES IN TIDALHEALTH PENINSULA REGIONAL'S CBSA INCLUDE WORCESTER COUNTY, WITH A POPULATION OF 52,888 AND SOMERSET COUNTY WITH A POPULATION OF 24,351. THE GREATER "METROPOLITAN" SALISBURY AREA (ZIP CODES 21801, 21804) HAS A HIGHER POPULATION DENSITY THAN THE SURROUNDING RURAL AREAS. THIS AREA HAS A VULNERABLE POPULATION THAT INCLUDES THE INDIGENT AND A HIGHER MEDICAID MIX. MOVING EAST TOWARDS THE BEACH, LOCATED IN WORCESTER COUNTY ARE SEVERAL LARGER TOWNS, LIKE BERLIN (21811) AND OCEAN CITY (21842) THAT HAVE A HIGH POPULATION DENSITY. SOUTH OF SALISBURY, LOCATED IN SOMERSET COUNTY, ARE THE LARGER TOWNS OF PRINCESS ANNE (21853) AND CRISFIELD (21817). EXCLUDING THE GREATER SALISBURY AREA, THE LANDSCAPE AND ENVIRONMENT IS CONSIDERED RURAL, MADE UP OF SMALL BUSINESSES AND AGRICULTURE.ALL THREE COUNTIES CAN BE CLASSIFIED AS RURAL WITH HISTORIC ECONOMIC FOUNDATION IN AGRICULTURE, POULTRY AND TOURISM. WATERMEN AND FARMERS HAVE ALWAYS COMPRISED A LARGE PERCENTAGE OF THE PENINSULA POPULATION, HOWEVER, THEIR NUMBERS HAVE BEEN DECLINING WITH A GROWTH IN THE POPULATION AND EXPANSION OF OTHER SMALL TO MIDSIZE BUSINESSES. OCEAN CITY, MD LOCATED IN WORCESTER COUNTY, IS A MAJOR TOURIST DESTINATION. DURING THE SUMMER WEEKENDS, THE CITY HOSTS BETWEEN 320,000 AND 345,000 VACATIONERS, AND UP TO 8 MILLION VISITORS ANNUALLY.THE THREE COUNTIES HAVE A DIVERSIFIED ECONOMIC BASE; HOWEVER, IT IS PREDOMINATELY MADE UP OF SMALL EMPLOYERS (COMPANIES WITH LESS THAN 50 EMPLOYEES). MAJOR EMPLOYERS INCLUDE LOCAL HOSPITALS, THE POULTRY INDUSTRY, LOCAL COLLEGES AND TEACHING INSTITUTIONS. THE MEDIAN HOUSEHOLD INCOME OF $65,197 IN OUR COMMUNITY BENEFITS SERVICE AREA IS CONSIDERABLY LESS THAN MARYLAND'S MEDIAN INCOME OF $91,431. IN ADDITION, JUNE 2023 UNEMPLOYMENT RATES WERE HIGHER FOR MARYLAND'S MOST EASTERN SHORE COUNTIES. THE UNEMPLOYMENT RATE IN MARYLAND WAS 1.9%, THE NATION 3.6% COMPARED TO WICOMICO 4.2% WORCESTER 7.7% AND SOMERSET 5.4% (US BUREAU OF LABOR STATISTICS). RESEARCH INDICATES LOWER MEDIAN INCOMES AND HIGHER UNEMPLOYMENT RATES CONTRIBUTE TO A DISPARITY IN ACCESS TO MEDICAL CARE AND A PREVALENCE OF UNTREATED CHRONIC DISEASE.THE BABY BOOMER POPULATION (THOSE AGED 55+) REPRESENT A GREATER PORTION OF THE TOTAL POPULATION IN TIDALHEALTH PENINSULA REGIONAL'S CBSA AS COMPARED TO THE NATION. THE EASTERN SHORE OF MARYLAND IS BECOMING A POPULAR RETIREMENT DESTINATION AND THE TREND IS LIKELY TO CONTINUE. THE CHRONIC CONDITIONS OF THIS AGE GROUPING CONSUME HEALTHCARE RESOURCES AT MUCH HIGHER RATES THAN SOME OF THE OTHER YOUNGER AGE-COHORTS.TIDALHEALTH PENINSULA REGIONAL'S PRIMARY SERVICE AREA (WICOMICO, WORCESTER, SOMERSET) REPRESENT SOME OF THE NEEDIEST COUNTIES IN THE STATE OF MARYLAND (HTTPS://WWW.COUNTYHEALTHRANKINGS.ORG/HEALTH-DATA/MARYLAND?YEAR=2022), BASED UPON A SOCIONEEDS INDEX INCOME, POVERTY, UNEMPLOYMENT, OCCUPATION, EDUCATIONAL ATTAINMENT AND LINGUISTIC BARRIERS THAT ARE ASSOCIATED WITH POOR HEALTH OUTCOMES, INCLUDING PREVENTABLE HOSPITALIZATIONS AND PREMATURE DEATH. PENINSULA REGIONAL HAS ZIP CODES IN EACH OF ITS PRIMARY SERVICE AREA COUNTIES WITH HIGH SOCIONEEDS INDEX LEVELS. DEPLOYMENT OF RESOURCES IS KEY IN THESE COMMUNITIES WITH HIGH SOCIOECONOMIC NEEDS AS WE FOCUS AND TARGET PREVENTION AND OUTREACH SERVICES. TO MEET ITS MISSION OF IMPROVING THE HEALTH OF THE COMMUNITIES IT SERVES, TIDALHEALTH PENINSULA REGIONAL HAS DEVELOPED A POPULATION HEALTH DIVISION AND HAS ENGAGED IN POPULATION HEALTH STRATEGIES TO SUPPORT THE MARYLAND TOTAL COST OF CARE MODEL, WHICH AIMS TO IMPROVE OUTCOMES, IMPROVE THE PATIENT EXPERIENCE AND REDUCE THE TOTAL COST OF CARE. THE HOSPITAL IS COORDINATING CARE, INCLUDING MENTAL HEALTH AND POST-ACUTE CARE, ACROSS HOSPITAL AND NON-HOSPITAL SETTINGS. THE POPULATION HEALTH DIVISION INCORPORATES A MULTIDISCIPLINARY TEAM OF NURSES, SOCIAL WORKERS AND COMMUNITY HEALTH WORKERS SUPPORTING THE COMMUNITY WITH A BROAD RANGE OF PRIMARY CARE SERVICES. THE DIVISION ALSO FOSTERS COMMUNITY PARTNERSHIPS WITH LOCAL HOSPITALS, IN ADDITION TO COMMUNITY-BASED ORGANIZATIONS INCLUDING LOCAL HEALTH DEPARTMENTS, FIRE DEPARTMENTS, THE MARYLAND STATE AREA AGENCY ON AGING AND OTHER AGENCIES TO PROVIDE PATIENT SUPPORT ALIGNED WITH SOCIAL DETERMINANTS OF HEALTH. PART VI, LINE 5: PROMOTION OF COMMUNITY HEALTHTIDALHEALTH PENINSULA REGIONAL IS COMMITTED TO THE HEALTH OF THE RURAL COMMUNITIES IT SERVES. IN FY 2023, THE HOSPITAL'S CHARITY CARE WAS $7,361,099; COMBINED CHARITY AND BAD DEBT FOR FY 2023 WAS $16,920,640. AS PART OF TIDALHEALTH PENINSULA REGIONAL'S ONGOING COMMITMENT AND MISSION STATEMENT "TO IMPROVE THE HEALTH OF THE COMMUNITIES WE SERVE," WE CONTINUE TO ASSESS THE HEALTH NEEDS OF THE COMMUNITY THROUGH BUILDING RELATIONSHIPS AND COLLABORATIONS WITH ORGANIZATIONS THAT ARE ADDRESSING UNMET HEALTH NEEDS.TIDALHEALTH USES DATA FROM THE COMMUNITY HEALTH NEEDS ASSESSMENT AND DATA FROM ITS EPIC EHR STRATIFIED BY RACE, ETHNICITY, AGE, LANGUAGE AND GENDER TO IDENTIFY SIGNIFICANT HEALTH DISPARITIES IN THE PATIENT POPULATION. THE POPULATION HEALTH DIVISION IN PARTNERSHIP WITH COMMUNITY-BASED ORGANIZATIONS, MANAGED CARE ORGANIZATIONS, THE LOCAL HEALTH IMPROVEMENT COALITIONS, AND LOCAL HEALTH DEPARTMENTS, HAS INITIATIVES UNDERWAY TO ADDRESS DISPARITIES AND HEALTH ISSUES PRIORITIZED AND INCLUDED IN THE CHNA AND COMMUNITY HEALTH IMPROVEMENT PLAN. TIDALHEALTH WAS AWARDED A TWO-YEAR GRANT THROUGH THE MARYLAND COMMUNITY HEALTH RESOURCES COMMISSION'S NEW PATHWAYS TO HEALTH EQUITY PROGRAM TO ENHANCE AND EXPAND EFFORTS TO ADDRESS HEALTH DISPARITIES AND ADVANCE HEALTH EQUITY. THE PROGRAM, RURAL EQUITY AND ACCESS TO COMMUNITY HEALTH (REACH), LAUNCHED IN MAY 2022 AND IS A COLLABORATIVE, REGIONAL PROJECT TO PREVENT AND REDUCE DISPARITIES PARTICULARLY AMONG BLACK/AFRICAN AMERICAN AND HAITIAN RESIDENTS OF THE LOWER EASTERN SHORE WITH DIABETES AND/OR HYPERTENSION. REACH INVOLVES MULTI-LEVEL, CROSS-SECTOR APPROACHES TO ADDRESS DISPARITIES AND IMPROVE POPULATION HEALTH. AT THE INDIVIDUAL LEVEL, THE PROJECT INCLUDES INCREASED CARE COORDINATION AND FOLLOW-UP FOR HIGH-RISK PATIENTS WITH DIABETES AND/OR HYPERTENSION WHO HAVE BEEN DISCHARGED FROM THE HOSPITAL. COMMUNITY HEALTH WORKERS ARE DEPLOYED TO SCREEN AND ADDRESS SOCIAL DETERMINANTS OF HEALTH (SDOH).AT THE COMMUNITY-LEVEL, TIDALHEALTH WORKS WITH COMMUNITY PARTNERS TO INCREASE ACCESS TO EVIDENCE-BASED CHRONIC DISEASE PREVENTION AND MANAGEMENT OR HEALTHY LIFESTYLE PROGRAMMING IN UNDERSERVED COMMUNITIES. AT THE SYSTEM LEVEL, TIDALHEALTH AND COMMUNITY PARTNERS USE A SOCIAL CARE COORDINATION PLATFORM TO IMPROVE PROCESSES FOR SDOH SCREENING AND REFERRALS. THE POPULATION HEALTH DIVISION INCLUDES THE COMMUNITY WELLNESS DEPARTMENT AND IS FOCUSED ON ADDRESSING DISPARITIES AND SDOH FACTORS THROUGH COMMUNITY-INTEGRATED STRATEGIES. COMMUNITY WELLNESS INCLUDES A NURSE PRACTITIONER, REGISTERED NURSES, COMMUNITY HEALTH WORKERS, AND A SOCIAL WORKER. THE COMMUNITY WELLNESS TEAM THE COMMUNITY WELLNESS TEAM CONDUCTS HOME VISITS OF HIGH-RISK PATIENTS IN THE COMMUNITY. THESE ASSESSMENTS INCLUDE SCREENING FOR SDOH (SOCIAL DETERMINANTS OF HEALTH) AND ADDRESSING GAPS IDENTIFIED BY CONNECTING PATIENTS TO COMMUNITY-BASED RESOURCES AND SUPPORTS AND CHRONIC DISEASE SELF-MANAGEMENT EDUCATION. ADDITIONALLY, THE COMMUNITY WELLNESS TEAM OPERATES A MOBILE CLINIC CALLED THE WAGNER WELLNESS VAN TO VISIT LOCAL SHELTERS, CHURCHES, AND OTHER AREAS IN TIDALHEALTH PENINSULA REGIONAL'S COMMUNITY BENEFITS SERVICE AREA WHERE UNDERSERVED RESIDENTS CAN RECEIVE NON-EMERGENCY MEDICAL CARE, CHRONIC CARE MANAGEMENT AND HEALTHY LIFESTYLES EDUCATION. THE VAN VISITS AREAS WHERE THE SOCIAL DETERMINANTS OF HEALTH INDICATE THE GREATEST AMOUNT OF NEED. IT PROVIDES CARE IN AREAS WITH A HIGHER PREVALENCE OF ER VISITS, LOWER MEDIAN INCOMES, INDIGENT POPULATION, ACCESS ISSUES, COMMUNICATION BARRIERS AND OVERALL POOR HEALTH OUTCOMES. THE COMMUNITY WELLNESS TEAM STRIVES TO EDUCATE PATIENTS BY PROVIDING NUTRITIONAL AND HEALTHY LIFESTYLE COUNSELING, IN ADDITION TO MEDICATION COMPLIANCE TO CONTROL DIABETES AND HYPERTENSION. HEALTH SCREENINGS ARE PERFORMED ON RESIDENTS TO HELP DETERMINE APPROPRIATE EDUCATION, SELF-MANAGEMENT CLASS INFORMATION OR REFERRALS TO COMMUNITY RESOURCES AND SERVICES. THESE SCREENINGS INCLUDE DIABETES RISK ASSESSMENTS, HYPERTENSION, AND OBESITY. WHEN WARRANTED, DRUG AND ALCOHOL MISUSE SCREENINGS ARE ALSO CONDUCTED, AND COUNSELING IS AVAILABLE. NARCAN IS PROVIDED TO RESIDENTS TO SUPPORT EFFORTS TO PREVENT OPIOID MISUSE AND OVERDOSE. FLU SHOTS ARE PROVIDED TO COMMUNITY MEMBERS THROUGH THE COMMUNITY WELLNESS OUTREACH EFFORTS TO UNDERSERVED COMMUNITIES AND HOMEBOUND RESIDENTS. SWIFTSWIFT IS A MOBILE INTEGRATED HEALTH INITIATIVE IN PARTNERSHIP WITH THE CITY OF SALISBURY AND THE WICOMICO COUNTY HEALTH DEPARTMENT. THE PROGRAM REDUCES UNNECESSARY USE OF THE 911 EMS SYSTEM AND HEALTH SYSTEM EMERGENCY DEPARTMENT BY ADDRESSING MEDICAL AND PSYCHOSOCIAL NEEDS OF THOSE IDENTIFIED AS HIGH UTILIZERS OF EMS AND/OR THE ED. AN INTERDISCIPLINARY TEAM INCLUDING A NURSE PRACTITIONER, REGISTERED NURSE, PARAMEDIC, COMMUNITY HEALTH WORKER AND SOCIAL WORKER WORK TOGETHER TO ADDRESS UNDERLYING CONDITIONS OR SOCIAL DETERMINANTS OF HEALTH CONTRIBUTING TO EXCESSIVE CALLS TO 911 AND VISITS TO THE ED. THE TEAM CONNECTS THE PROGRAM PARTICIPANTS TO PRIMARY CARE, BEHAVIORAL HEALTH, CHRONIC DISEASE PREVENTION AND MANAGEMENT, MEDICATION MANAGEMENT, AND SOCIAL DETERMINANTS OF HEALTH NEEDS SUCH AS HOUSING, TRANSPORTATION, FOOD, UTILITY ASSISTANCE AND OTHER SERVICES. THE PROGRAM SAVES LIVES BY TAKING A TEAM APPROACH TO SUPPORT PARTICIPANTS IN ACHIEVING THEIR OWN GOALS FOR BETTER QUALITY OF LIFE. THE TEAM BUILDS TRUST WITH PARTICIPANTS OVER TIME BY SHOWING UP, MEETING THEM WHERE THEY ARE, AND HELPING THEM GET THE SUPPORT THEY NEED TO STAY WELL. NEW FOR THE PROGRAM IN FISCAL 2023 WAS THE EXANSION OF THE MINOR DEFINITIVE CARE NOW (MDCN) MODEL WHICH INCLUDED A PARAMEDIC-NP TEAM RESPONDING TO LOW ACUITY 911 CALLS AND PROVIDING CARE AT HOME. THIS MODEL AVOIDS UNNECESSARY TRANSPORTS AND ED VISITS. THE EXPANSION IS FUNDED THROUGH A GRANT FROM THE RURAL MARYLAND COUNCIL. SMITH ISLAND TELEHEALTH - SMITH ISLAND IS KNOWN FOR ITS WATERMEN, SMITH ISLAND CAKE, EXCEPTIONAL SEAFOOD AND BEING ISOLATED WITH LIMITED CONTACT FROM MAINLAND VISITORS. FOR THIS REASON, TIDALHEALTH PENINSULA REGIONAL'S COMMUNITY WELLNESS NURSE PRACTITIONER COORDINATES WITH A MEDICAL ASSISTANT WHO RESIDES ON THE ISLAND TO PROVIDE PREVENTATIVE HEALTH SCREENING, ACUTE VISITS, AND CONSULT WITH PATIENTS. THE GOAL OF THE PROGRAM IS TO IMPROVE THE HEALTH OF SMITH ISLAND RESIDENTS, WITH THE TARGET OF EFFECTIVELY REDUCING POTENTIALLY AVOIDABLE ED UTILIZATION. THE COMMUNITY WELLNESS TEAM AND PARTNERS SUCH AS A TIDALHEALTH PHARMACIST PROVIDE CHRONIC DISEASE EDUCATION, MANAGEMENT AND CONNECTS APPROXIMATELY 250 RESIDENTS OF SMITH ISLAND VIA TELEHEALTH AND IN-PERSON VISITS. THE MEDICAL ASSISTANT WHO RESIDES ON THE ISLAND IS CROSS TRAINED AS A COMMUNITY HEALTH WORKER. SHE IS ABLE TO EFFECTIVELY BRIDGE RELATIONSHIPS WITH THE RESIDENTS OF SMITH ISLAND. IN HER COMMUNITY HEALTH WORKER ROLE, SHE IS ESSENTIALLY A PERSONAL HEALTH COACH THAT ASSISTS RESIDENTS WITH MEDICATION MANAGEMENT, TIMELY COMPLIANCE AND ULTIMATELY HELPING GUIDE RESIDENTS THROUGH PRESCRIBED HEALTHCARE PLANS. FLU SHOTS WERE ADMINISTERED ENSURING THE RESIDENTS OF SMITH ISLAND WERE PROTECTED DURING THE FLU SEASON, EFFECTIVELY REDUCING ED VISITS. THE TEAM ALSO WORKS WITH THE HEALTH DEPARTMENT TO PROVIDE COVID-19 SCREENING AND VACCINATIONS. SINCE INCEPTION, THE PARTNERSHIP HAS HAD GREAT SUCCESSES. FOR EXAMPLE, THERE HAS BEEN SUBSTANTIAL REDUCTIONS IN A1C LEVELS IN RESIDENTS DIAGNOSED WITH DIABETES; A PRIME EXAMPLE OF THE "TRIPLE AIM" IMPROVING HEALTH, PROVIDING ACCESS, CHRONIC DISEASE EDUCATION, AND REDUCING THE PROBABILITY OF A FUTURE EMERGENCY DEPARTMENT VISIT. RESIDENTS ARE LEARNING HOW TO SELF-MANAGE THEIR CHRONIC DISEASES AND ARE BEING EXPOSED TO THE PRINCIPLES OF LEADING HEALTHY LIFESTYLES. A TEAM OF PROVIDERS INCLUDING A PHYSICIAN, NURSE PRACTITIONER AND PHARMACIST, VISIT THE ISLAND ON AVERAGE EVERY OTHER WEEK FROM APRIL - NOVEMBER. NEW PRIMARY CARE PROVIDER APPOINTMENTS ARE OFFERED TO COMMUNITY MEMBERS WITHOUT A PCP. IN FISCAL 2023 TIDALHEALTH BROUGHT BACK ITS ANNUAL HEALTH FAIR WHICH INCLUDED ACCESS TO A WIDE RANGE OF SCREENINGS, HEALTH PROMOTION INFORMATION, AND COMMUNITY RESOURCES. PEARLS PEARLS STANDS FOR PROGRAMS TO ENCOURAGE ACTIVE AND REWARDING LIVES. THIS PROGRAM, RUN BY MAC INC., THE AGENCY ON AGING, IS AN EVIDENCE-BASED PROGRAM THAT HELPS RESIDENTS AGED 60 AND OVER COMBAT DEPRESSION FROM LOSS OR FEELINGS OF ISOLATION. THE PROGRAM PROVIDES ONE-ON-ONE COUNSELING SESSIONS TO PARTICIPANTS WHO MAY FEEL DEPRESSED, FRUSTRATED, RESTLESS, OR ANXIOUS FROM DUE TO EVENTS IN THEIR LIFE. AS ONE AGES, THERE ARE LOSSES SUCH AS LOSS OF HEALTH, LOVED ONES, AND/OR INDEPENDENCE. A GRIEVING WIDOW WHO LOST THEIR SPOUSE OF FORTY YEARS MAY FEEL DEPRESSED AND LONELY NOW THAT THEIR PARTNER IS GONE. ANOTHER OLDER GENTLEMAN MAY FEEL FRUSTRATION AT NOT BEING ABLE TO BE AS INDEPENDENT AS HE ONCE WAS AT A YOUNGER AGE. PEARLS HELPS COUNSEL THE PATIENT AND PROVIDE GUIDANCE ON HOW TO MANAGE THEIR FEELINGS. ESPECIALLY DURING THE COVID-19 EPIDEMIC, MANY OLDER RESIDENTS IN THE TRI-COUNTY AREA ARE FEELING LONELY, DUE TO THE RESTRICTIONS ON NURSING HOMES AND FAMILIES NOT BEING ABLE TO GET TOGETHER WITH OLDER FAMILY MEMBERS. COVID-19 AFFECTS OLDER POPULATIONS WORSE THAN YOUNGER PEOPLE, AND BY THE ADVICE OF HEALTHCARE OFFICIALS, MANY FAMILIES ARE HAVING TO KEEP THEIR DISTANCE. WITH HELP FROM MAC, INC., THESE OLDER ADULTS CAN TALK TO A COUNSELOR AND IMPROVE THEIR QUALITY OF LIFE. TO EXPAND OUR "HEALTHY LIVING" MESSAGE, TIDALHEALTH PENINSULA REGIONAL SPONSORS AND PARTICIPATES IN MANY COMMUNITY-BASED HEALTH FAIRS PROVIDING NUTRITION EDUCATION, WEIGHT LOSS, DIABETES ASSESSMENT, MULTIPLE SCREENINGS AND HEALTH LITERACY. PARTICIPATION IN HEALTH FAIRS INCLUDE UNDERSERVED AREAS LIKE SMITH ISLAND, AN ISLAND ON THE CHESAPEAKE BAY WITH A POPULATION OF ONLY 250, A HAITIAN-CREOLE HEALTH FAIR, HEALTHFEST, DRIVE THRU FLU CLINICS, HEALTH SCREENING AND OUTREACH EVENTS IN LOCAL CHURCHES AND UNDERSERVED NEIGHBORHOODS TRANSFORMING THE CULTURE THROUGH PARTICIPATION AND SPONSORSHIP OF HEALTHY LIFESTYLES AND SCREENINGS, MEETING RESIDENTS AT COMMUNITY EVENTS LOCATED THROUGHOUT THE TRI-COUNTY AREA. THESE ACTIVITIES IMPROVE TRUST AMONG UNDERSERVED RESIDENTS. HEALTH ASSESSMENTS AVAILABLE AT THESE EVENTS INCLUDE, BUT ARE NOT LIMITED TO:- CHOLESTEROL, HDL, TRIGLYCERIDES - RESTING 12-LEAD EKG - BODY FAT / MASS INDEX - BLOOD PRESSURE TESTING - PULSE OXIMETRY TESTING - 10-YEAR RISK ANALYSIS - REVIEW CURRENT MEDICATIONS - FOLLOW-UP CARE PLAN - EXERCISE/NUTRITION WALK WICOMICO PROMOTES WALKING TRAILS, PERSONAL CHALLENGES, AND AVENUES TO ENJOY THE OUTDOORS- THE PRIMARY OBJECTIVE IS TO INCREASE AWARENESS OF AND ENGAGEMENT IN HEALTHY LIFESTYLE BEHAVIORS PROMOTING EXERCISE TO HELP WITH WEIGHT LOSS, INCREASE ENERGY, REDUCE RISK OF CHRONIC DISEASE AND MAKE PEOPLE FEEL HAPPIER. WALKWICOMICO IS PRIMARILY TARGETING THOSE THAT RESIDE IN THE COUNTY (POP. 100,000+); HOWEVER, IT WOULD ALSO BE AN ATTRACTION FOR ADJACENT COUNTIES INCLUDING VISITORS. TIDALHEALTH PENINSULA REGIONAL, AS A PARTICIPANT, HAS A COMMON GOAL TO TRANSFORM THE COMMUNITY'S CULTURE BY PROVIDING EDUCATION, GUIDANCE AND RESOURCES TOWARDS PROMOTING EXERCISE THROUGH WALKABILITY AS AN INTEGRAL PART OF A HEALTHY LIFESTYLE. THE COALITION'S INITIATIVES INCLUDED CREATING A WEBSITE AND PHONE APP SPECIFIC TO WALKING IN WICOMICO COUNTY; COMMUNICATING WITH THE COMMUNITY VIA SOCIAL MEDIA; WORKING WITH CIVIC ORGANIZATIONS, CHURCHES, LOCAL BUSINESSES, TOWNS, COUNTY HEALTH DEPARTMENTS AND OTHER GROUPS TO ENCOURAGE LOCAL WALKABILITY. WALKWICOMICO HAS MARKED WALKING ROUTES, INCREASED THE NUMBER OF WALKING ROUTES, PARTICIPATED IN AND LAUNCHED WALKING EVENTS, AND IS ENGAGED WITH DECISION MAKERS THROUGH INPUT AND FEEDBACK ABOUT MAKING WALKING SAFER EASIER AND MORE ACCESSIBLE. MAC, INC. CHRONIC DISEASE PROGRAMS MAC, INC. THE AREA AGENCY ON AGING OFFERS A PLETHORA OF SERVICES TO HELP MORE ACTIVE SENIORS LIVE THEIR LIVES TO THE FULLEST. THE COLLABORATION BETWEEN TIDALHEALTH PENINSULA REGIONAL AND MAC, INC., HAS BEEN IN PLACE FOR SEVERAL YEARS. MAC, INC. OFFERS A VARIETY OF CLASSES, EVENTS, ACTIVITIES, AND MEALS FOR THE SENIOR POPULATIONS OF THE AREA. THE PROGRAMS RUN BY MAC INCLUDE CHRONIC DISEASE SELF-MANAGEMENT, STEPPING ON FALLS PREVENTION, HEALTHY LIVING WITH HYPERTENSION, AND OTHER EXERCISE AND NUTRITION CLASSES. THE CHRONIC DISEASE SELF-MANAGEMENT EDUCATION PROGRAMS, WHICH INCLUDES CHRONIC CONDITIONS, DIABETES, AND CHRONIC PAIN, WERE DEVELOPED BY STANFORD UNIVERSITY IN 1990 AND HAVE GONE THROUGH RIGOROUS RANDOM CONTROLLED TRIALS TO SHOW EFFICACY AND EVIDENCE OF HEALTH IMPROVEMENT AMONG PARTICIPANTS. PARTICIPANTS LEARN TO COPE WITH THE FATIGUE, FRUSTRATION AND PAIN THAT ACCOMPANY CHRONIC DISEASE, AND EXERCISES FOR IMPROVING STRENGTH AND ENDURANCE, ALL WHICH HAVE BEEN SHOWN TO IMPROVE HEALTH AND DECREASE THE NUMBER OF HOSPITAL STAYS. THE STEPPING ON FALLS PREVENTION PROGRAM BUILDS SKILLS AND EXERCISES TO REDUCE FALLS AND INCREASE SELF-CONFIDENCE AND BEHAVIORAL CHANGE TO REDUCE RISK OF FALLING. STRENGTH AND BALANCE EXERCISES ARE TAUGHT BY PHYSICAL THERAPISTSOTHER PROGRAMS THAT MAC INC. OFFERS INCLUDE CHRONIC PAIN SELF-MANAGEMENT, DIABETES PREVENTION, DIABETES SELF-MANAGEMENT AND WALKING WITH EASE. THESE PROGRAMS HAVE A SIMILAR FORMAT TO THE CHRONIC DISEASE SELF-MANAGEMENT PROGRAM. MANY PARTICIPANTS ARE ENROLLED IN MULTIPLE EVIDENCE-BASED PROGRAMS THROUGH MAC.A SUBSTANTIAL NUMBER OF PARTICIPANTS IN THESE PROGRAMS HAVE COMORBIDITIES SUCH AS DIABETES, CHRONIC PAIN, HEART DISEASE, STROKE, HYPERTENSION, ETC. THE EVIDENCE-BASED PROGRAMS OFFERED BY MAC, INC. ARE ESSENTIAL TO IMPROVING THE HEALTH OF THE COMMUNITIES WE SERVE AND ARE A GOOD FIRST STEP IN HELPING PEOPLE BECOME MORE EDUCATED ABOUT THEIR HEALTH. THIS COLLABORATION BETWEEN MAC, INC. THE AREA AGENCY ON AGING AND TIDALHEALTH PENINSULA REGIONAL IS A COMMUNITY BENEFIT THAT HAS MULTIPLE TOUCH POINTS THAT AFFECT THE OVERALL HEALTH OF OUR SENIOR AND OLDER ADULT COMMUNITY IN THE TRI-COUNTY AREA. ADULT DIABETES SUPPORT GROUPTHE ADULT DIABETES SUPPORT GROUP IS A PROGRAM GEARED TOWARDS ADULTS WITH DIABETES AND THEIR CAREGIVERS. THE PROGRAM HELPS TO PROVIDE SUPPORT, NETWORKING, EDUCATION, FELLOWSHIP AND TO PROMOTE COMMUNITY UNITY TO THESE ADULTS WITH DIABETES AND THEIR CAREGIVERS. KIDS AND TEENS DIABETES SUPPORT GROUPTHE KIDS AND TEENS DIABETES SUPPORT GROUP IS A PROGRAM GEARED TOWARDS KIDS, TEENS, AND THEIR CAREGIVERS. THE PROGRAM HELPS TO PROVIDE SUPPORT, NETWORKING, EDUCATION, FELLOWSHIP AND TO PROMOTE COMMUNITY UNITY TO THESE KIDS, TEENS, AND THEIR CAREGIVERS. THE PROGRAM STARTED IN FY 2021 WITH THE DIABETES AND NUTRITION TEAM AT TIDALHEALTH PENINSULA REGIONAL AND THEN TRANSITIONED INTO A LOCAL "HOME GROWN" COMMUNITY-BASED SUPPORT GROUP. NUTRITION AND DIABETES EDUCATION COMMUNITY EDUCATION PRESENTATIONSNUTRITION AND DIABETES EDUCATION DEPARTMENT PROVIDES COMMUNITY PRESENTATIONS AND EDUCATIONAL OPPORTUNITIES TO INCREASE AWARENESS AND EFFICACY AMONG PARTICIPANTS TO UNDERSTAND THE RISKS OF DIABETES, PREDIABETES AND HOW TO BETTER MANAGE THE CONDITIONS. A MEMBER OF THE NUTRITION AND DIABETES EDUCATION TEAM WAS THE PRECEPTOR FOR A LOCAL COLLEGE'S DIETETIC INTERNSHIP PROGRAM TO EDUCATE ON THE IMPORTANCE OF DIABETES EDUCATION IN THE TRI-COUNTY AREA.TRIBETRIBE STANDS FOR TRI-COUNTY BEHAVIORAL HEALTH ENGAGEMENT. THIS NEWLY FORMED COLLABORATION IS A REGIONAL PARTNERSHIP BETWEEN TIDALHEALTH PENINSULA REGIONAL, ATLANTIC GENERAL HOSPITAL AND NINE BEHAVIORAL HEALTH COMMUNITY PARTNER AGENCIES IN SOMERSET, WICOMICO, AND WORCESTER COUNTIES. THE IMMEDIATE GOAL IS TO DESIGN BEHAVIORAL HEALTH CRISIS STABILIZATION CENTERS OR BEHAVIORAL HEALTH URGENT CARE CENTERS WITHIN THE TRI-COUNTY AREA. THE PRIMARY OBJECTIVES OF THIS PROGRAM ARE TO REDUCE ED UTILIZATION, HOSPITAL ADMISSIONS TO BOTH TIDALHEALTH PENINSULA REGIONAL AND ATLANTIC GENERAL HOSPITAL AND READMISSIONS FOR INDIVIDUALS EXPERIENCING BEHAVIORAL HEALTH ISSUES IN THE TRI-COUNTY AREA. TRIBE MET THROUGHOUT THE YEAR TO DISCUSS AND IDENTIFY GAPS AND FRAGMENTATION OF SERVICES IN THE AREA WITH THE GOAL OF PROVIDING MORE SEAMLESS AND "REAL TIME" BEHAVIORAL HEALTH URGENT CARE AND BEHAVIORAL HEALTH CARE SERVICES.HEALING SEATED YOGAA PROGRAM THROUGH WHICH CANCER PATIENTS AND THEIR CAREGIVERS PRACTICE YOGA. STUDIES HAVE INDICATED THAT YOGA CAN COMPLEMENT CANCER TREATMENT AND IT IS USEFUL IN HELPING HEAL THE BODY AND SPIRIT. THE GOAL IS TO HELP THE PATIENT AND THEIR CAREGIVERS REDUCE STRESS, LOWER FATIGUE, IMPROVE DAILY LIVING ACTIVITIES AND IMPROVE SLEEP. WHAT'S COOKING THE WHAT'S COOKING PROGRAM TEACHES CANCER PATIENTS AND THEIR CAREGIVERS HOW TO MODIFY THEIR DIETS TO HELP BUILD STRENGTH TO WITHSTAND THE EFFECT OF CANCER TREATMENTS. THIS EDUCATIONAL CLASS STRESSES THE IMPORTANCE OF LIMITING SUGAR, ALCOHOL, AND SALT. A REGISTERED DIETICIAN LEADS THE CLASS AND TEACHES CANCER PATIENTS AND THEIR CAREGIVERS HOW TO PREPARE HEALTHY FOOD DISHES USING FRUITS, VEGETABLES, BEANS, AND HEALTHY GRAINS. THE REGISTERED DIETICIAN ALSO HAS TOPICS OF DISCUSSION DURING THESE SESSIONS AND THE PARTICIPANTS CAN TASTE TEST THE DISHES AND ASK QUESTIONS.TAI CHI FOR BETTER BALANCETHE TAI CHI FOR BETTER BALANCE PROGRAM IMPROVES PHYSICAL STRENGTH, BALANCE, CIRCULATION, STRESS LEVELS AND AMBULATION AMONG CANCER PATIENTS. THE PROGRAM IS LED BY AN INSTRUCTOR WHO TEACHES HOUR LONG CLASSES FOR A VARIETY OF PATIENT LEVELS. TAI CHI CLASSES ARE OFFERED IN MANY HOSPITALS AND CANCER CENTERS. THE CLASSES HELP SUPPORT RECOVERY AND AMBULATION, WHICH IS CRITICAL FOR CANCER PATIENTS IN THEIR BATTLE. PROSTATE CANCER SUPPORT GROUPTHIS PROGRAM MEETS BI-MONTHLY FOR PATIENTS AND THEIR CAREGIVERS WHO HAVE BEEN AFFECTED BY PROSTATE CANCER. THE GOAL OF THIS SUPPORT GROUP IS TO PROVIDE EMOTIONAL SUPPORT TO FAMILIES OF PROSTATE CANCER PATIENTS IN ADDITION TO HELPING LOVED ONES ADJUST TO SUPPORTING THEIR FAMILY MEMBER WHO HAS PROSTATE CANCER. IT HAS IMPROVED PSYCHOLOGICAL WELLBEING OF PATIENTS, REDUCED ANXIETY AND DEPRESSION, AND OVERALL IMPROVED THE QUALITY OF LIFE FOR THESE PATIENTS GOING THROUGH PROSTATE CANCER. CANCER THRIVING AND SURVIVINGTHIS CLASS IS FOR CURRENT CANCER PATIENTS AND THEIR CAREGIVERS TO EDUCATE ABOUT THE DIFFICULTIES ASSOCIATED WITH CANCER DIAGNOSIS AND CANCER TREATMENT. CANCER PATIENTS AND THEIR FAMILIES ARE PROVIDED WITH THE TOOLS NEEDED TO LIVE A HEALTHIER LIFE. CANCER SURVIVOR CAREGIVER SUPPORT GROUPTHIS PROGRAM GATHERS SURVIVORS, CURRENT CANCER PATIENTS AND CAREGIVERS FROM PAST AND PRESENT TO OFFER SUPPORT AND CONNECT WITH EACH OTHER. THE WEEKLY SUPPORT GROUP'S FOCUSES ARE TO EDUCATE, NETWORK AND ENJOY FELLOWSHIP WITH PAST AND PRESENT CANCER PATIENTS AND THEIR CAREGIVERS. THIS NETWORK CAN PROVIDE ADVICE ABOUT CURRENT AND FUTURE DIFFICULTIES THAT CURRENT CANCER PATIENTS AND THEIR CAREGIVERS MAY FACE.FOOD DISTRIBUTIONTHIS PROGRAM IS USED TO PROVIDE CLEAN, NUTRITIOUS FOOD TO NOURISH PATIENTS IN THEIR FIGHT AGAINST CANCER. A SHARE OF ORGANIC VEGETABLES IS PROVIDED TO CANCER PATIENTS AND CANCER SURVIVORS. DURING THE MONTHS OF MAY-OCTOBER, VEGETABLES ARE PRIMARILY PROVIDED FROM THE HEALING ROSE GARDEN. DURING THE MONTHS OF DECEMBER-APRIL OR DURING PERIODS OF LOW VEGETABLE PRODUCTION, VEGETABLES ARE PURCHASED BY A LOCAL ORGANIZATION TO PROVIDE FOR CANCER PATIENTS. THIS PROGRAM IS ESPECIALLY VALUABLE FOR CANCER PATIENTS WHO HAVE FOOD INSECURITIES OR COME FROM A POORER QUALITY OF LIFE AND CANNOT AFFORD THESE NUTRITIOUS FOODS. THESE WHOLESOME, CLEAN FOOD HELPS TO OVERCOME FOOD INSECURITY AND GET CANCER PATIENTS HEALTHIER.TIDALHEALTH PENINSULA REGIONAL PARTICIPATES WITH MANY PARTNERS THAT MAKE IT POSSIBLE TO CREATE AND DELIVER POPULATION PROGRAMS THAT IMPROVE THE HEALTH OF THE COMMUNITIES WE SERVE. THESE PARTNERS HAVE PROVIDED EXPERTISE AND ALLOCATED RESOURCES TO MEET THOSE URGENT HEALTHCARE NEEDS WITHIN OUR COMMUNITY. SOME OF THESE PARTNERS INCLUDE: WICOMICO COUNTY HEALTH DEPARTMENT, SOMERSET COUNTY HEALTH DEPARTMENT, WORCESTER COUNTY HEALTH DEPARTMENT, WICOMICO COUNTY LOCAL HEALTH IMPROVEMENT COALITION, THE CITY OF SALISBURY, YMCA, CRISFIELD CLINIC, CHESAPEAKE HEALTH CARE, SWIFT, SALISBURY FIRE DEPARTMENT/EMS, ATLANTIC GENERAL HOSPITAL, FAITH BASED ORGANIZATIONS, MAC (MAINTAINING ACTIVE CITIZENS), LOCAL COLLEGES/ AND SCHOOLS, C.O.A.T., NATIONAL KIDNEY FOUNDATION, PENINSULA REGIONAL EMPLOYEES, POST-ACUTE CARE FACILITIES, HALO, WALK WICOMICO (COALITION), LOWER SHORE CLINIC, WICOMICO COUNTY SHERIFF'S OFFICE, RESOURCE AND RECOVERY CENTER AND OTHERS. SHERIFF'S OFFICE, RESOURCE AND RECOVERY CENTER AND OTHERS.REMOTE PATIENT MONITORING THE REMOTE PATIENT MONITORING PROGRAM AT TIDALHEALTH HELPS MEDICARE PATIENTS WITH CHRONIC CONDITIONS LIKE DIABETES, COPD, CHF, OR RESPIRATORY FAILURE ADHERE TO PROTOCOLS, MEDICATIONS, AND MEDICAL INSTRUCTIONS. EQUIPMENT IS RENTED TO THE PATIENT FREE OF CHARGE AFTER DISCHARGE FROM THE HOSPITAL FOR 60 DAYS. DURING THE 60-DAY PERIOD, HEALTHCARE WORKERS HELP TO EDUCATE THE PATIENT ON MONITORING THEIR VITALS, MEDICATIONS, ETC. TO REDUCE READMISSION RATES TO THE HOSPITAL AND INCREASE PATIENT/CAREGIVER ENGAGEMENT. AFTER THE 60-DAY PERIOD, PATIENTS ARE ENCOURAGED TO PURCHASE THEIR OWN MONITORING EQUIPMENT WHICH THEN CAN BE USED IN THE FUTURE FOR SELF-MONITORING. GRADUATE MEDICAL EDUCATIONTIDALHEALTH LAUNCHED ITS GRADUATE MEDICAL EDUCATION PROGRAM TO HOST RESIDENCY AND FELLOWSHIP TRAINING PROGRAMS IN A SELECT NUMBER OF SPECIALTIES. CURRENTLY, TIDALHEALTH HAS GME PROGRAMS FOR INTERNAL MEDICINE, GENERAL SURGERY, AND ANESTHESIOLOGY, WITH A PLAN TO ADD MORE SPECIALTIES IN THE COMING YEARS. THE GME PROGRAM HAS TWO PRIMARY GOALS: TO TRAIN THE NEXT GENERATION OF PHYSICIANS AND TO ADDRESS THE ISSUE OF DISPARITY AND PHYSICIAN SHORTAGE ON THE EASTERN SHORE. IT IS OUR HOPE THAT THE RESIDENCY AND FELLOWSHIP PROGRAMS ATTRACT AND KEEP OUTSTANDING PHYSICIANS IN OUR COMMUNITY AFTER THE COMPLETION OF THEIR GME PROGRAM TO PROVIDE HIGH-QUALITY CARE AND IMPROVE POPULATION HEALTH AND ACCESS TO CARE.HEALTH FAIRS AND COMMUNITY WELLNESS OUTREACHTIDALHEALTH HOSTS AND ATTENDS NUMEROUS HEALTH FAIRS AND COMMUNITY BASED WELLNESS EVENTS, SUCH AS THE SALISBURY HEALTH FEST, SMITH ISLAND HEALTH FAIR, AND HOSTS DRIVE-THRU FLU CLINICS. THESE INITIATIVES ALLOW HEALTHCARE PROFESSIONALS TO PROVIDE SCREENING SERVICES TO THE GENERAL PUBLIC AND HELP REFER THEM TO THE NECESSARY RESOURCES IF UNFAVORABLE OR ABNORMAL SCREENING RESULTS ARE OBTAINED. THIS OUTREACH ALSO ADDRESSES OVERALL COMMUNITY WELLNESS BY ENCOURAGING INDIVIDUALS TO BE CONSIOUS OF THEIR HEALTH AND TAKE A MORE ACTIVE ROLE IN PREVENTION AND OVERALL WELLBEING. PART VI, LINE 6: AFFILIATED HEALTH CARE SYSTEM ROLESTIDALHEALTH IS ANCHORED BY TWO HOSPITALS, TIDALHEALTH PENINSULA REGIONAL AND TIDALHEALTH NANTICOKE. IN ADDITION, TIDALHEALTH INCLUDES AN EXPANSIVE PHYSICIAN NETWORK (TIDALHEALTH PENINSULA MEDICAL GROUP) WITH MORE THAN 300 PROVIDERS IN 24 SPECIALTIES ACROSS 32 LOCATIONS.TIDALHEALTH PENINSULA REGIONAL IS PART OF TIDALHEALTH. THE SYSTEM INCLUDES A FOUNDATION AND ENTITIES WITH INTERESTS IN VARIOUS HEALTH CARE JOINT VENTURES. IN ADDITION TO THE COMMUNITY BENEFITS PROVIDED BY THE MEDICAL CENTER, THE HEALTH SYSTEM EVALUATES THE NEEDS OF THE COMMUNITY AND WILL PARTICIPATE IN COMMUNITY BENEFIT PROGRAMS AS NEEDED AS COLLABORATORS WITH OUR OTHER ENTITIES AND THOSE PARTNERS OUTSIDE OF OUR SYSTEM.PART VI, LINE 7:COMMUNITY BENEFIT REPORT STATE FILINGSSTATE(S) WITH WHICH THE ORGANIZATION FILES A COMMUNITY BENEFIT REPORT:MARYLAND 1 CHESAPEAKE HOUSING MISSION PO BOX 1061 SALISBURY MD 21801 263435626 501(C)(3) 25000 0 HEALTHY HOMES INITIATIVE JUNIOR ACHIEVEMENT OF THE EASTERN SHORE 327 TILGHMAN RD STE 100 SALISBURY MD 21801 521461040 501(C)(3) 10000 0 FINANCE PARK VIRTUAL AND INSPIRE CAMPAIGN DONATIONS 2 PART I, LINE 2: THE ORGANIZATION CHOOSES TO SUPPORT OTHER ORGANIZATIONS WHICH ALSO ARE WORKING TO IMPROVE THE LOCAL COMMUNITY SERVED. 1 1 0 0 0 0 0 0 0 STEVEN LEONARD PRESIDENT/CEO 0 827741 0 201322 0 100057 0 59239 0 19591 0 1207950 0 0 BRUCE I RITCHIE CFO THRU 01/23 0 587979 0 98932 0 45266 0 150388 0 13358 0 895923 0 0 KARIN DIBARI MD V.P. TH MEDICAL PARTNERS THRU 10/22 0 524379 0 76218 0 258797 0 16511 0 4891 0 880796 0 0 LURA LUNSFORD V.P. OPERATIONS 0 643959 0 90988 0 13521 0 62423 0 5754 0 816645 0 0 STEPHANIE GARY V.P. FINANCE/CFO BEG 01/23 0 413584 0 56372 0 5092 0 32654 0 11150 0 518852 0 0 TIMOTHY FEIST V.P CHIEF COMPLIANCE OFFICER 0 309434 0 41512 0 1218 0 103632 0 12877 0 468673 0 0 SARAH SCOTT V.P. PEOPLE & ORGANIZATON DEV 0 312392 0 41203 0 25274 0 63403 0 11378 0 453650 0 0 JAMES TRUMBLE MD V.P. CLINICAL INTEGRATION 0 368617 0 50865 0 0 0 15923 0 12859 0 448264 0 0 DAVID SECHLER MD BOARD MEMBER BEG 01/23 0 365554 0 6727 0 990 0 32460 0 11378 0 417109 0 0 KATHRYN FIDDLER V.P. POPULATION HEALTH 0 307474 0 46601 0 1218 0 39719 0 2368 0 397380 0 0 TRUDY HALL MD V.P. CHIEF MEDICAL OFF. BEG 07/22 0 239999 0 0 0 20187 0 11344 0 21587 0 293117 0 0 VEL NATESAN MD BOARD MEMBER THRU 12/22 0 274577 0 0 0 0 0 0 0 0 0 274577 0 0 SARAH ARNETT FMR CHIEF NURSING OFFICER THRU 04/22 0 100823 0 0 0 116959 0 22233 0 2004 0 242019 0 0 ANGELA BRITTINGHAM CHIEF NURSING OFFICER BEG 04/23 0 140165 0 16127 0 5196 0 17317 0 5615 0 184420 0 0 CHARLES SILVIA JR MD FMR V.P. CHIEF MED. OFF. THRU 01/22 0 38494 0 0 0 120199 0 20329 0 0 0 179022 0 0 PART I, LINE 3 PROCESS FOR DETERMINING COMPENSATION A COMPENSATION COMMITTEE OF TIDALHEALTH INC. (THI), THE SOLE CORPORATE MEMBER OF THE FILING ORGANIZATION, DETERMINES THE COMPENSATION OF THE CEO/EXECUTIVE DIRECTOR OF THE ORGANIZATION. THE COMPENSATION COMMITTEE USES AN INDEPENDENT CONSULTANT, COMPENSATION SURVEYS, AND OTHER ORGANIZATION'S FORM 990 IN THE DETERMINATION PROCESS AND KEEPS CONTEMPROANEOUS RECORDS OF DECISIONS MADE. PART I, LINE 4A-B SEVERANCE THE FOLLOWING INDIVIDUALS RECEIVED SEVERANCE PAYMENTS DURING 2022. THESE AMOUNTS ARE REPORTED IN SCHEDULE J, PART II, COLUMN (B) (III): SARAH ARNETT $67,229 KARIN DIBARI $201,490 SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN THI HAS A NON-QUALIFIED SUPPLEMENTAL RETIREMENT PLAN (UNDER SECTION 457 (F)). THIS PLAN WAS APPROVED BY THE COMPENSATION COMMITTEE OF THE THI BOARD OF DIRECTORS TO SUPPLEMENT THE EXECUTIVE'S RETIREMENT INCOME. THE SUPPLEMENTAL RETIREMENT PLAN WAS DEVELOPED BASED ON AN INDEPENDENT CONSULTANT REPORT ON MARKET-BASED PRACTICES FOR SUPPLEMENTAL RETIREMENT PLANS. THE PERCENTAGE OF FINAL AVERAGE PAY, THE REQUIREMENTS FOR VESTING, PARTICIPANTS, AND PAY-OUT PROVISIONS WERE ESTABLISHED, REVIEWED, AND APPROVED BY THE COMPENSATION COMMITTEE. THE CONTRIBUTIONS TO THE SUPPLEMENTAL NON-QUALIFIED RETIREMENT PLAN ARE INCLUDED IN SCHEDULE J, PART II, COLUMN C OR IN SCHEDULE J, PART II, COLUMN B(III) AS PART OF DEFERRED COMPENSATION. THE FOLLOWING INDIVIDUALS PARTICIPATED IN THIS SUPPLEMENTAL NON-QUALIFIED RETIREMENT PLAN: STEVEN LEONARD BRUCE RITCHIE KARIN DIBARI PART I, LINE 6A, 6B AND 7: CONTINGENT COMPENSATION AND NON-FIXED PAYMENTS OFFICERS AND KEY EMPLOYEES OF THE FILING ORGANIZATION ARE PAID BY THI. THE COMPENSATION IS DETERMINED BY A NUMBER OF VARIABLES INCLUDING BUT NOT LIMITED TO INDIVIDUAL GOALS AS WELL AS ORGANIZATION OPERATIONAL ACHIEVEMENTS IN SERVICE, QUALITY, SAFETY, EMPLOYEE SATISFACTION, AND COST. THE FINAL DETERMINATION OF THE CONTINGENT COMPENSATION AMOUNT IS DETERMINED AND APPROVED BY THE BOARD AS PART OF THE OVERALL COMPENSATION REVIEW OF OFFICERS AND KEY EMPLOYEES. FORM 990, PART V, LINES 1A & 2A THE FILING ORGANIZATION HAS ENTERED "0" IN PART V, LINE 1A AND LINE 2A BECAUSE THE ORGANIZATION'S 1099 AND W-2 RETURNS ARE FILED BY AND UNDER THE NAME AND EIN OF TIDALHEALTH, INC., A RELATED ENTITY, UNDER A SHARED SERVICES AGREEMENT. ACCORDINGLY, THE REQUIRED DISCLOSURES RELATED TO EMPLOYEES AND INDEPENDENT CONTRACTORS ARE INCLUDED ON THE FORM 990 OF TIDALHEALTH, INC. FORM 990, PART VI, SECTION A, LINE 2 BUSINESS RELATIONSHIPS STEVEN LEONARD AND MEMO DIRIKER ARE MEMBERS OF THE BOARD OF DIRECTORS OF PENINSULA HEALTH VENTURES, A WHOLLY-OWNED TAXABLE SUBSIDIARY OF TIDALHEALTH, INC. STEPHANIE GARY, TPR'S CFO, ALSO SERVES AS SECRETARY/TREASURER OF PENINSULA HEALTH VENTURES. FORM 990, PART VI, SECTION A, LINE 6 MEMBERS OR STOCKHOLDERS TIDALHEALTH, INC. IS THE SOLE CORPORATE MEMBER OF TIDALHEALTH PENINSULA REGIONAL, INC. FORM 990, PART VI, SECTION A, LINE 7A ELECTION OF MEMBERS OF GOVERNING BODY IN ITS CAPACITY AS THE SOLE CORPORATE MEMBER OF THE ORGANIZATION, TIDALHEALTH, INC. HAS THE ABILITY TO ELECT MEMBERS OF THE ORGANIZATION'S GOVERNING BODY. FORM 990, PART VI, SECTION A, LINE 7B DECISIONS SUBJECT TO APPROVAL AS THE SOLE CORPORATE MEMBER, TIDALHEALTH, INC. HAS THE ABILITY TO APPROVE MAJOR EXPENDITURES AND LONG TERM BORROWINGS OF THE ORGANIZATION. FORM 990, PART VI, SECTION B, LINE 11B FORM 990 REVIEW PROCESS OVERSIGHT OF THE COMPLETION OF THE ORGANIZATION'S FORM 990 HAS BEEN DELEGATED TO THE CHIEF FINANCIAL OFFICER OF TIDALHEALTH, INC. BY THE PRESIDENT OF THE ORGANIZATION. ONCE THE FORM 990 AND ALL SCHEDULES HAVE BEEN PREPARED BY THE ORGANIZATION'S INDEPENDENT TAX SERVICES PROVIDER, THEY ARE REVIEWED BY THE PRESIDENT PRIOR TO FILING. A COPY OF THE FORM 990 WAS MADE AVAILABLE TO ALL MEMBERS OF THE GOVERNING BODY PRIOR TO THE FILING WITH IRS. FORM 990, PART VI, SECTION B, LINE 12C CONFLICT OF INTEREST POLICY MONITORING & ENFORCEMENT THE BOARD OF DIRECTORS ARE REQUIRED TO DISCLOSE ANNUALLY, IN WRITING, ANY AND ALL INTERESTS WHICH THEY OR ANY IMMEDIATE MEMBER OF THEIR FAMILY MAY HAVE IN ANY BUSINESS ENTITY WHICH HAS OR SEEKS A CONTRACTUAL OR COMPETITIVE RELATIONSHIP WITH THE ORGANIZATION. THE BOARD HAS THE AUTHORITY TO DETERMINE IF A VIOLATION HAS OCCURRED AND WHETHER ANY INTEREST WHICH SHOULD BE DISCLOSED SHOULD DISQUALIFY A DIRECTOR FROM PARTICIPATING IN ANY SPECIFIC BOARD DISCUSSION OR BOARD MEMBERSHIP. ALL DISCLOSURES ARE REVIEWED BY THE ORGANIZATION'S CHIEF COMPLIANCE OFFICER. ANY CONFLICTS ARE PRESENTED TO THE BOARD. IF A PERSON IS CONFLICTED, THEY WILL RECUSE THEMSELVES FROM ALL DISCUSSIONS AND DELIBERATIONS TO WHICH THEY WOULD APPEAR TO BE CONFLICTED. FORM 990, PART VI, SECTION B, LINE 15 PROCESS FOR DETERMINING COMPENSATION A COMPENSATION COMMITTEE OF TIDALHEALTH INC. (THI), THE SOLE CORPORATE MEMBER OF THE FILING ORGANIZATION, DETERMINES THE COMPENSATION OF THE CEO/EXECUTIVE DIRECTOR OF THE ORGANIZATION. THE COMPENSATION COMMITTEE USES AN INDEPENDENT CONSULTANT, COMPENSATION SURVEYS, AND OTHER ORGANIZATION'S FORM 990 IN THE DETERMINATION PROCESS AND KEEPS CONTEMPROANEOUS RECORDS OF DECISIONS MADE. FORM 990, PART VI, SECTION C, LINE 19 HOW DOCUMENTS ARE MADE AVAILABLE TO THE PUBLIC THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, FINANCIAL STATEMENTS, AND FORM 990 ARE AVAILABLE TO THE PUBLIC UPON REQUEST TO THE PUBLIC INFORMATION OFFICE OF TIDALHEALTH PENINSULA REGIONAL AT 100 EAST CARROLL STREET, SALISBURY, MD 21801. FORM 990, PART IX, LINE 11G PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 82,018,167. MANAGEMENT AND GENERAL EXPENSES 8,658,383. FUNDRAISING EXPENSES 272,848. TOTAL EXPENSES 90,949,398. FORM 990, PART X, LINE 20: TAX EXEMPT BONDS IN FEBRUARY 2015 MARYLAND HEALTH AND HIGHER EDUCATIONAL FACILITIES TIDALHEALTH PENINSULA REGIONAL, INC. 52-0591628 AUTHORITY ("MHHEFA") AUTHORIZED THE ISSUANCE OF $126,665,000 AGGREGATE PRINCIPAL AMOUNT OF REVENUE BONDS (SERIES 2015 REVENUE BONDS) AT A PREMIUM OF $20,770,000. IN MAY 2020, MHHEFA AUTHORIZED THE ISSUANCE OF $95,995,000 AGGREGATE PRINCIPAL AMOUNT OF REVENUE BONDS (SERIES 2020A REVENUE BONDS) AT A PREMIUM OF $5,944,000. THE OBLIGATED GROUP FOR THE 2020A AND 2015 BONDS (COLLECTIVELY THE "BONDS") CONSISTS OF TIDALHEALTH, INC., TPR, AND TN AND THE OBLIGATED GROUP FOR THE SERIES 2021A AND B TAXABLE NOTES (COLLECTIVELY THE "TAXABLE NOTES"), CONSISTS OF TIDALHEALTH, TPR, TMP, TN AND MCCREADY FOUNDATION, INC. SUPPLEMENTAL INFORMATION ON TAX-EXEMPT BONDS REPORTED ON SCHEDULE K OF FORM 990 FOR TIDALHEALTH INC., THE PARENT ORGANIZATION. FORM 990, PART XI, LINE 9: PENSION ADJUSTMENT 2,547,480. CHANGE IN ENDOWMENT -307,915. INVESTMENT IN SUBSIDIARIES -43,343,629. TIDALHEALTH INC 100 EAST CARROLL STREET SALISBURY MD 21801 522132761 PARENT MD 501(C)(3) LINE 10 N/A 0 TIDALHEALTH FOUNDATION INC 100 EAST CARROLL STREET SALISBURY MD 21801 521851935 FUNDRAISING MD 501(C)(3) LINE 7 TIDALHEALTH INC 0 TIDALHEALTH PHYSICIAN NETWORK 801 MIDDLEFORD ROAD SEAFORD DE 19973 510224470 HEALTH SERVICES DE 501(C)(3) LINE 10 TIDALHEALTH INC 0 TIDALHEALTH NANTICOKE INC 801 MIDDLEFORD ROAD SEAFORD DE 19973 510069243 HOSPITAL DE 501(C)(3) LINE 3 TIDALHEALTH INC 0 DELMARVA PENINSULA INSURANCE COMPANY PO BOX 1159 GRAND CAYMAN GRAND CAYMAN CJ KY1-1102 981110617 INSURANCE CJ 501(C)(3) TIDALHEALTH INC 0 PENINSULA GENERAL HOSPITAL INS TRUST 100 EAST CARROLL STREET SALISBURY MD 21801 526321234 INSURANCE MD 501(C)(3) LINE 12C, III-FI TIDALHEALTH INC 0 MCCREADY FOUNDATION INC 201 HALL HIGHWAY CRISFIELD MD 21817 520607921 HEALTH SERVICES MD 501(C)(3) LINE 10 TIDALHEALTH INC 0 DELMARVA ENDOSC CTR 11103 CATHAGE ROAD BERLIN MD 21801 831509115 HEALTH CARE MD N/A 0 0 PENINSULA HEALTH VENTURES (PHV) 100 EAST CARROLL STREET SALISBURY MD 21801 522250012 P'SHIP INVESTMENT MD N/A C 0 PRLTC INC 100 EAST CARROLL STREET SALISBURY MD 21801 522190588 LONG TERM CARE MD N/A C 0 0 0 1 0 0 0 0 0 0 0 0 1 1 1 1 0 1 1 1