2023-05-10T07:33:06-05:00 2022-06-30 135565207 KPMG LLP 8350 BROAD STREET SUITE 900 MCLEAN VA 22102 990 2021-07-01 520591607 THE GOOD SAMARITAN HOSPITAL OF MARYLAND INC GOOD 4107726721 5601 LOCH RAVEN BLVD BALTIMORE MD 21239 JOEL BRYAN VP/TREASURER 4107726721 2023-05-09 1 JOEL BRYAN 999009999 SHAWN HUTCHINSON P01048557 7032868000 2023-05-03 3 AAL1 IAL1 2021 2023-04-26 12:10:37Z MEDSTAR GOOD SAMARITAN HOSPITAL BRADLEY CHAMBERS 5601 LOCH RAVEN BLVD BALTIMORE MD 21239 271873275 0 X WWW.GOODSAM-MD.ORG X 1920 MD SEE SCHEDULE OWE ARE GOOD SAMARITANS, GUIDED BY CATHOLIC TRADITION AND TRUSTED TO DELIVER IDEAL HEALTHCARE EXPERIENCES FOR THE PATIENTS WE SERVE. 22 14 1842 8 0 0 12049060 5880302 268878519 262933987 224819 84664 2456238 2974322 283608636 271873275 60400 63427 0 0 172092698 153901593 0 0 0 121311245 130851582 293464343 284816602 -9855707 -12943327 194293282 188457945 92198207 55777602 102095075 132680343 X SEE SCHEDULE OAS A PROUD MEMBER OF MEDSTAR HEALTH, MEDSTAR GOOD SAMARITAN HOSPITAL'S (MEDSTAR GOOD SAMARITAN) MISSION IS TO BE GOOD SAMARITANS, GUIDED BY CATHOLIC TRADITION AND TRUSTED TO DELIVER IDEAL HEALTH EXPERIENCES. MEDSTAR GOOD SAMARITAN, LOCATED IN NORTHEAST BALTIMORE CITY, MARYLAND, IS KNOWN FOR ITS SPECIALTIES IN NEPHROLOGY AND PHYSICAL MEDICINE AND REHABILITATION PROGRAMS. IN ADDITION TO GENERAL ADULT ACUTE CARE SERVICES, MEDSTAR GOOD SAMARITAN HAS A COMPREHENSIVE INPATIENT REHABILITATION UNIT. THROUGH MGSH'S CENTER FOR SUCCESSFUL AGING, INTEGRATED CARE IS PROVIDED TO PATIENTS WHO EXPERIENCE AGE-RELATED HEALTH CONDITIONS. IN FISCAL YEAR 2022, MEDSTAR GOOD SAMARITAN HAD 7,961 INPATIENT ADMISSIONS AND 197,097 OUTPATIENT VISITS INCLUDING 39,151 EMERGENCY VISITS. 0 0 211045070 63427 251113509 SEE SCHEDULE OMEDSTAR GOOD SAMARITAN'S LARGEST PROGRAM IS ACCESS TO AND THE PROVISION OF ACUTE HOSPITAL SERVICES TO THE COMMUNITIES OF NORTHEASTERN BALTIMORE CITY, MARYLAND AND THE SURROUNDING AREAS. IN ADDITION TO THE PROGRAM SERVICE EXPENSES LISTED ABOVE, MEDSTAR GOOD SAMARITAN INCURRED $52.2M OF MANAGEMENT AND GENERAL EXPENSES IN PROVIDING SERVICES TO ITS COMMUNITIES. MEDSTAR GOOD SAMARITAN IS A JOINT COMMISSION ACCREDITED ACUTE CARE COMMUNITY HOSPITAL LOCATED IN THE NORTHEAST SECTION OF BALTIMORE CITY, MARYLAND. THE HOSPITAL OFFERS CLINICAL SERVICES IN GENERAL MEDICINE AND SURGERY AND HAS SPECIALTY SERVICES IN CANCER CARE THROUGH THE MEDSTAR HEALTH CANCER NETWORK, DIABETES CARE, AND EMERGENCY MEDICINE. MEDSTAR GOOD SAMARITAN IS ALSO NATIONALLY KNOWN FOR GERIATRICS THROUGH THE CENTER FOR SUCCESSFUL AGING, A MODEL OF CARE THAT HELPS PATIENTS WITH COMPLEX MEDICAL AND SOCIAL CONCERNS AS WELL AS THEIR CAREGIVERS. THE HOSPITAL PROVIDES COMMUNITY-BASED HEALTH AND WELLNESS SERVICES THROUGH THE GOOD HEALTH CENTER, AND WOUND CARE THROUGH THE CENTER FOR WOUND HEALING, HYPERBARIC MEDICINE, AND LIMB SALVAGE IN PARTNERSHIP WITH MEDSTAR GEORGETOWN UNIVERSITY HOSPITAL. MEDSTAR GOOD SAMARITAN IS KNOWN FOR ITS HIGH-QUALITY INPATIENT REHABILITATION PROGRAM. TODAY, THE PROGRAM HAS MOVED INTO A NEW, $17.5 MILLION, STATE-OF-THE-ART INPATIENT REHABILITATION CENTER, OFFERING 60,000 SQUARE FEET OF MEDICAL CARE AND THERAPY. THE INPATIENT REHABILITATION PROGRAM, WHICH IS ACCREDITED BY THE COMMISSION ON ACCREDITATION OF REHABILITATION FACILITIES, SERVES PATIENTS FROM WITHIN CENTRAL MARYLAND. THE STROKE PROGRAM HAS RECEIVED ACCREDITATION AS A PRIMARY STROKE CENTER FROM THE STATE OF MARYLAND AND RECEIVED THE AMERICAN HEART ASSOCIATION/AMERICAN STROKE ASSOCIATION'S GET WITH THE GUIDELINES - STROKE GOLD PLUS QUALITY ACHIEVEMENT AWARD. MEDSTAR GOOD SAMARITAN HAS BEEN AWARDED THE 5 STAR RATING, THE HIGHEST POSSIBLE, BY CMS. SINCE MARCH 2020, MEDSTAR HEALTH HAS CARED FOR 1 IN 4 COVID-19 PATIENTS IN THE REGION. OPERATING AS ONE MEDSTAR AND ALIGNING WITH GUIDANCE FROM THE CENTERS FOR DISEASE CONTROL AND PREVENTION (CDC) AND LOCAL DEPARTMENTS OF HEALTH, MEDSTAR HEALTH COVID-19 PREPARATIONS AND RESPONSE CONTINUE TO BE GUIDED BY THREE CRITICAL DRIVERS: PROVIDE A SAFE CARE ENVIRONMENT FOR PATIENTS AND ASSOCIATES; MITIGATE COMMUNITY SPREAD OF COVID-19; AND ENSURE OPERATIONAL CONTINUITY TO FULFILL OUR CORE MISSION OF CARING FOR OUR COMMUNITIES.THESE EFFORTS HAVE EVOLVED AND TRANSITIONED IN MULTIPLE WAYS THROUGHOUT THE DURATION OF THE COVID-19 PANDEMIC, LEADING TO A NUMBER OF INTEGRATED CARE APPROACHES IN PLACE TODAY: UTILIZATION OF MEDSTAR HEALTH URGENT CARE, MEDSTAR EVISIT AND OUR DIGITAL CAPABILITIES TO CREATE ACCESS, TESTING SITES, AND TELEHEALTH FOR PRIMARY CARE AND FOLLOW-UP VISITS; EXPANDED MANAGEMENT OF CARE CONTINUUM NEEDS FOR PATIENTS THROUGH MEDSTAR HEALTH HOME CARE; EXECUTION OF INNOVATIVE LABORATORY APPROACHES INTEGRATED WITH OCCUPATIONAL HEALTH TO BETTER SUPPORT ASSOCIATES MANAGING THROUGH COVID-19 EXPOSURES; DEPLOYMENT OF COMMUNITY MOBILE UNITS AND CLINICS FOR COVID-19 VACCINATIONS/BOOSTERS; INCREASED MANAGEMENT OF SUPPLY AND ACQUISITION OF PERSONAL PROTECTIVE EQUIPMENT (PPE), N95 RESPIRATORS, COVID-19 VACCINES AND BOOSTERS; REINFORCEMENT OF A MANDATORY COVID-19 VACCINATION POLICY RESULTING IN COMPLIANCE OF 99% OF ASSOCIATES AND PHYSICIANS; AND ADMINISTRATION OF MORE THAN 36,800 COVID-19 VACCINATIONS/BOOSTERS TO MEDSTAR HEALTH ASSOCIATES AND PHYSICIANS AND MORE THAN 74,500 TO PATIENTS ACROSS THE REGION IN FY 2022. 20124951 11820478 MEDSTAR GOOD SAMARITAN PROVIDED $20.1M IN SUBSIDIZED (MISSION DRIVEN) HEALTH SERVICES IN FISCAL YEAR 2022. THESE CRITICAL SERVICES, WHICH ARE DRIVEN BY COMMUNITY NEEDS, OPERATE AT A LOSS. THEY ADDRESS PRIORITIES PRIMARILY THROUGH DISEASE PREVENTION AND IMPROVEMENT OF HEALTH STATUS. SERVICE INCLUDES EMERGENCY MEDICINE, HOSPITALISTS, PRIMARY CARE, WOMEN'S AND CHILDREN'S CARE, PALLIATIVE CARE AND BEHAVIORAL HEALTH. 7418602 MEDSTAR GOOD SAMARITAN PROVIDED $7.4M IN CHARITY CARE SERVICES IN FISCAL YEAR 2022. CHARITY CARE IS PROVIDED PURSUANT TO MEDSTAR HEALTH'S FINANCIAL ASSISTANCE POLICY TO MEMBERS OF THE COMMUNITY WHOSE INCOME IS BELOW CERTAIN THRESHOLDS AND FOR WHICH THE HOSPITAL IS NOT COMPENSATED. UNDER MARYLAND'S UNIQUE PAYER SYSTEM, THE AMOUNT REPORTED REPRESENTS MEDSTAR GOOD SAMARITAN'S CHARITY CARE EXPENSE AND REVENUES REPRESENT DIRECT PAYMENTS FROM THE STATE'S CHARITY CARE POOL. OTHER CHARITY CARE EXPENSES ARE INDIRECTLY REIMBURSED VIA THE STATE OF MARYLAND'S PAYMENT SYSTEM. 238588623 1 1 0 0 0 0 0 0 0 0 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 1 1 1 1 0 0 1 0 0 1 1842 1 0 0 0 0 0 0 0 0 0 0 1 0 X 22 14 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 MD X JOEL BRYAN 4107726721 10980 GRANTCHESTER WAY COLUMBIA MD 21044 BRADLEY CHAMBERS PRESIDENT/BOARD MEMBER 20.00 20.00 X X 724904 724904 56419 ELIAS SHAYA MD BOARD MEMBER 20.00 20.00 X 233462 233462 10765 SHAMS QUAZI MD PHYSICIAN 20.00 20.00 X 218245 218245 29852 GEORGE HENNAWI MD BOARD MEMBER (UNTIL 01/2022) 20.00 20.00 X 170024 170024 29690 DANIEL P CAHILL CHAIR 1.00 0.00 X 0 0 0 BISHOP DENIS J MADDEN DIRECTOR 1.00 0.00 X 0 0 0 KATHLEEN DYER BOARD MEMBER 1.00 0.00 X 0 0 0 ANTHONY READ BOARD MEMBER 1.00 0.00 X 0 0 0 LEO E GALLAGHER JR VICE CHAIR 1.00 0.00 X 0 0 0 VERONICA COOL BOARD MEMBER 1.00 0.00 X 0 0 0 KIM D SYDNOR PHD BOARD MEMBER 1.00 0.00 X 0 0 0 HOLLY TILFORD BOARD MEMBER 1.00 0.00 X 0 0 0 DAWN MOTOVIDLAK VICE CHAIR 1.00 0.00 X 0 0 0 MESFIN LEMMA MD BOARD MEMBER 20.00 20.00 X 439816 439816 10907 REBECCA PEARCE BOARD MEMBER 1.00 0.00 X 0 0 0 JEFFREY ELKIN BOARD MEMBER 1.00 0.00 X 0 0 0 JUDITH FEUSTLE BOARD MEMBER 1.00 0.00 X 0 0 0 ZEENA DORAI MD BOARD MEMBER 20.00 20.00 X 778684 778684 19052 ESKANDAR YAZAJI MD BOARD MEMBER (UNTIL 07/2022) 20.00 20.00 X 191200 191200 30145 DAVID ZACHARY MARTIN MD BOARD MEMBER 20.00 20.00 X 805865 805865 30371 KENNETH A SAMET BOARD MEMBER 1.00 39.00 X 0 15771396 96287 MICHAEL RANDOLPH MD BOARD MEMBER 1.00 0.00 X 0 0 0 DAVID WILLIS BOARD MEMBER 1.00 0.00 X 0 0 0 DEANA STOUT TREASURER/CFO 20.00 20.00 X 267168 267167 50923 LINDA HEATH ASSISTANT SECRETARY (UNTIL 05/2022) 40.00 0.00 X 116844 0 36178 STUART BELL MD VP, MEDICAL AFFAIRS 20.00 20.00 X 469913 469913 37511 BRIAN CAWLEY SENIOR VP, OPERATIONS 20.00 20.00 X 102931 223160 30080 MICHAEL JACOBS MD PHYSICIAN 40.00 0.00 X 839363 0 25868 DIWAKAR PRADHAN MD PHYSICIAN 40.00 0.00 X 367669 0 18531 BERNARD RAVITZ MD PHYSICIAN 40.00 0.00 X 289756 0 10016 RAHUL BHOITE MD PHYSICIAN 40.00 0.00 X 267059 0 17115 KAREN OWINGS CNO 20.00 20.00 X 167800 167800 36548 NEIL MACDONALD VP, OPERATIONS 20.00 20.00 X 157765 157765 30920 6608468 20619401 607178 268 1 1 0 AMN HEALTHCARE INC 4721 MORRISON DRIVE MOBILE AL 36609 STAFFING SERVICES 7315212 MEDICAL SOLUTIONS LLC 1010 NORTH 102ND STREET STE 300 OMAHA NE 68114 STAFFING SERVICES 2034315 DVA RENAL HEALTHCARE INC PO BOX 760 ARLINGTON VA 22216 MEDICAL SERVICES 1474348 CROTHALL SVCS GROUP 1500 LIBERTY RIDGE DR 210 WAYNE PA 19087 ENVIRONMENTAL SERVICES 898648 SODEXO INC & AFFILIATES 9801 WASHINGTONIAN BLVD GAITHERSBURG MD 20878 FOOD & FACILITIES MANAGEMENT 680603 25 3463009 1070751 1346542 3427 5880302 NET PATIENT SERVICE RE 621400 253972894 253972894 PHARMACY INCOME 900099 8961093 8961093 262933987 37228 37228 712470 0 712470 712470 712470 47436 0 47436 47436 47436 CHILD DAY CARE 900099 673191 673191 REBATE INCOME 900099 390370 390370 1198291 1198291 2261852 271873275 262933987 0 3058986 X 63427 63427 4860865 4473299 387566 173727 173727 122734598 112895043 9839555 2065272 1899896 165376 16159040 14941746 1217294 7908091 7188272 719819 23365753 23365753 529 529 40190407 37221495 2968912 228778 4450 224328 1990992 1245474 745518 544435 69246 475189 50805 50141 664 20473 19513 960 1779482 1779482 12948846 12948846 3065346 2609967 455379 MED/SURG SUPPLIES 24232792 24337183 -104391 MAINTENANCE 5013888 4598695 415193 UTILITIES 4705640 4468054 237586 IMPLANTS/PROSTHESES 1318106 1318106 11395310 6282561 5112749 284816602 238588623 46227979 0 54081 4001 29695101 35077556 2970778 2891168 373834 398763 293552384 225046083 73772815 68506301 2117373 1727026 85309300 79853130 194293282 188457945 15189591 17496594 1650927 1668083 75357689 36612925 92198207 55777602 X 16359807 62564335 85735268 70116008 102095075 132680343 194293282 188457945 X -12943327 -297537 43826132 X X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 106943316 68253984 38689332 1126905 723947 402958 180460027 152841046 27618981 5022136 3227106 1795030 68506301 OPERATING LEASE ROU ASSET 2137317 INTERCOMPANY RECEIVABLES 9523067 PAT/INSR REFUNDS PAYABLE 91 OTHER ASSETS 68192655 79853130 ADVANCES FROM 3RD PARTY PAYORS 24822160 ASBESTOS ABATEMENT LIABILITY 2915544 OPERATING LEASE LIABILITY 2522829 WORKERS COMPENSATION 2810916 CREDIT BALANCE PATIENT A/R 1481574 OTHER LIABILITIES 2059902 36612925 X FIN 48 FOORTNOTE PART X, LINE 2 INCOME TAXES ARE ACCOUNTED FOR UNDER THE ASSET AND LIABILITY METHOD. DEFERRED TAX ASSETS AND LIABILITIES ARE RECOGNIZED FOR THE FUTURE TAX CONSEQUENCES ATTRIBUTABLE TO DIFFERENCES BETWEEN THE FINANCIAL STATEMENT CARRYING AMOUNTS OF EXISTING ASSETS AND LIABILITIES AND THEIR RESPECTIVE TAX BASES AND OPERATING LOSS AND TAX CREDIT CARRYFORWARDS. DEFERRED TAX ASSETS AND LIABILITIES ARE MEASURED USING ENACTED TAX RATES EXPECTED TO APPLY TO TAXABLE INCOME IN THE YEARS IN WHICH THOSE TEMPORARY DIFFERENCES ARE EXPECTED TO BE RECOVERED OR SETTLED. THE EFFECT ON DEFERRED TAX ASSETS AND LIABILITIES OF A CHANGE IN TAX RATES IS RECOGNIZED IN THE PERIOD THAT INCLUDES THE ENACTMENT DATE. ANY CHANGES TO THE VALUATION ALLOWANCE ON THE DEFERRED TAX ASSET ARE REFLECTED IN THE YEAR OF CHANGE. THE CORPORATION ACCOUNTS FOR UNCERTAIN TAX POSITIONS IN ACCORDANCE WITH THE FASB ACCOUNTING STANDARDS CODIFICATION (ASC) TOPIC 740, INCOME TAXES. THERE WAS NO LIABILITY RECORDED FOR UNCERTAIN TAX POSITIONS AS OF JUNE 30, 2022. 1 1 X 1 X 1 X 1 1 1 0 1 1 7418602 7418602 0.02600 7418602 7418602 0.02600 2121225 54440 2066785 0.00730 6286605 6286605 0.02210 20124951 11820478 8304473 0.02920 139911 139911 0.00050 28672692 11874918 16797774 0.05910 36091294 11874918 24216376 0.08510 9521 9521 0.00000 35193 35193 0.00010 2595 2595 0.00000 47309 47309 0.00010 1 6626770 X 1 1 1 1 GOOD SAMARITAN HOSPITAL OF MARYLAND 5601 LOCH RAVEN BLVD BALTIMORE MD 21239 X X X X GOOD SAMARITAN HOSPITAL OF MARYLAND 1 0 0 1 X X X X X X X X X 20 1 0 0 1 X WWW.GOODSAM-MD.ORG X 1 20 1 WWW.GOODSAM-MD.ORG 0 1 X 200.000000000000 400.000000000000 X X X X X X 1 1 X X X X 1 X WWW.GOODSAM-MD.ORG X WWW.GOODSAM-MD.ORG X WWW.GOODSAM-MD.ORG X X X X X X 1 X 0 X X X X 1 X 0 0 GOOD SAMARITAN HOSPITAL OF MARYLAND PART V, SECTION B, LINE 5: CHNA INPUTHOSPITAL LEADROLE DESCRIPTIONTHE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) HOSPITAL LEAD SERVES AS THE COORDINATOR OF ALL ASPECTS OF THE COMMUNITY HEALTH ASSESSMENT PROCESS. HE/SHE HELPS ESTABLISH AND COORDINATE THE ACTIVITIES OF THE ADVISORY TASK FORCE. THE LEAD ALSO HELPS PRODUCE THE HOSPITAL'S COMMUNITY HEALTH NEEDS ASSESSMENT AND IMPLEMENTATION STRATEGY. HE/SHE WORKS COLLABORATIVELY WITH REPRESENTATIVES FROM THE CORPORATE COMMUNITY HEALTH DEPARTMENT AND GEORGETOWN UNIVERSITY. THE LEAD ALSO WORKS CLOSELY WITH THE WRITER. HE/SHE REVIEWS ALL NARRATIVES PRIOR TO PUBLICATION.NAME OF HOSPITAL LEAD: TRICIA ISENNOCKEXECUTIVE SPONSORROLE DESCRIPTIONTHE EXECUTIVE SPONSOR SERVES AS THE CONDUIT BETWEEN THE ADVISORY TASK FORCE AND THE SENIOR MANAGEMENT TEAM. THE SPONSOR IS AN ACTIVE PARTICIPANT OF THE ADVISORY TASK FORCE AND HE/SHE COMMUNICATES THE HOSPITAL'S CLINICAL STRENGTHS AND PROGRAM PRIORITIES TO DIVERSE AUDIENCES.NAME OF EXECUTIVE SPONSOR: BRAD CHAMBERSADVISORY TASK FORCEROLE DESCRIPTIONTHE ADVISORY TASK FORCE (ATF) REVIEWS PRIMARY/SECONDARY DATA AND LOCAL/STATE/FEDERAL COMMUNITY HEALTH GOALS. BASED ON FINDINGS, THE ATF PROVIDES INPUT INTO THE HOSPITAL'S THREE-YEAR IMPLEMENTATION STRATEGY. AS AMBASSADORS FOR THE CHNA PROCESS, THE ATF MEMBERS SUPPORT EFFORTS TO OPTIMIZE COMMUNITY PARTICIPATION. NOTE: THE ATF SHOULD BE A COMBINATION OF COMMUNITY REPRESENTATIVES AND STAFF. COMMUNITY REPRESENTATIVES SHOULD MAKEUP AT LEAST 50% OF TOTAL PARTICIPANTS. NAME : BRAD CHAMBERS TITLE/AFFILIATION WITH HOSPITAL : PRESIDENT, MGSH AND MUMHNAME OF ORGANIZATION : MEDSTAR HEALTHNAME : DAWN MOTOVIDLAK TITLE/AFFILIATION WITH HOSPITAL : MUMH BOARD MEMBER, CHAIRNAME OF ORGANIZATION : MEDSTAR HEALTHNAME : DAN CAHILLTITLE/AFFILIATION WITH HOSPITAL : MGSH BOARD MEMBER, CHAIRNAME OF ORGANIZATION : MEDSTAR HEALTHNAME : VERONICA COOLTITLE/AFFILIATION WITH HOSPITAL : MGSH BOARD MEMBERNAME OF ORGANIZATION : MEDSTAR HEALTHNAME : KIM SYDNOR, PHD TITLE/AFFILIATION WITH HOSPITAL : DEAN, MGSH BOARD MEMBERNAME OF ORGANIZATION : MORGAN STATE UNIVERSITYNAME : RITU PRASAD, M.D. TITLE/AFFILIATION WITH HOSPITAL : PHYSICIAN ADVISOR, MUMHNAME OF ORGANIZATION : MEDSTAR HEALTHNAME : DANA FRANK, M.D.TITLE/AFFILIATION WITH HOSPITAL : CHAIRMAN, MEDICINE, MGSH/MUMHNAME OF ORGANIZATION : MEDSTAR HEALTHNAME : KEN WALSCH TITLE/AFFILIATION WITH HOSPITAL : ASSISTANT VICE PRESIDENT, QUALITY, SAFETY, RISK MANAGEMENT NAME OF ORGANIZATION : MEDSTAR HEALTHNAME : GEORGE FARLEY TITLE/AFFILIATION WITH HOSPITAL : AVP, MISSION INTEGRATION, MGSHNAME OF ORGANIZATION : MEDSTAR HEALTHNAME : DEBORAH BANGLEDORF TITLE/AFFILIATION WITH HOSPITAL : DIRECTOR, MARKETING AND COMMUNICATIONS NAME OF ORGANIZATION : MEDSTAR HEALTHNAME : APRIL BESSLING TITLE/AFFILIATION WITH HOSPITAL : DIRECTOR, CASE MANAGEMENT NAME OF ORGANIZATION : MEDSTAR HEALTHNAME : PAUL PASSTITLE/AFFILIATION WITH HOSPITAL : LEAD - COMMUNITY HEALTH ADVOCATENAME OF ORGANIZATION : MEDSTAR HEALTHNAME : ELISE BOWMANTITLE/AFFILIATION WITH HOSPITAL : DIRECTOR, ACCOUNTABLE HEALTH COMMUNITIESNAME OF ORGANIZATION : BALTIMORE CITY HEALTH DEPARTMENTNAME : PEGGY THOMAS TITLE/AFFILIATION WITH HOSPITAL : COMMUNITY RESIDENTNAME OF ORGANIZATION : COMMUNITY RESIDENTNAME : SHEILA WILLIAMS TITLE/AFFILIATION WITH HOSPITAL : PARISHIONER, HUBER MEMORIAL CHURCHNAME OF ORGANIZATION : COMMUNITY RESIDENTNAME : EVANGELINE WAIHENYA TITLE/AFFILIATION WITH HOSPITAL : PARISHIONER, ST. MATTHEW'S CHURCHNAME OF ORGANIZATION : COMMUNITY RESIDENTNAME : ASHLEY WILKESTITLE/AFFILIATION WITH HOSPITAL : EXECUTIVE DIRECTORNAME OF ORGANIZATION : HAMPDEN FAMILY CENTERNAME : SUSAN BENDERTITLE/AFFILIATION WITH HOSPITAL : COONAME OF ORGANIZATION : KESWICK - MARYLANDNAME : NICHOLE BATTLE TITLE/AFFILIATION WITH HOSPITAL : CEO NAME OF ORGANIZATION : GEDCONAME : RANDOLPH ROWEL TITLE/AFFILIATION WITH HOSPITAL : ASSOCIATE PROFESSOR, CHAIR OF DEPARTMENT OF BEHAVIORAL HEALTH SCIENCES NAME OF ORGANIZATION : MORGAN STATE UNIVERSITYNAME : SONIA FIERRO-LUPERINI TITLE/AFFILIATION WITH HOSPITAL : COMMUNITY RESIDENTNAME OF ORGANIZATION : SPANISH SPEAKING HEALTH LEADERS OF MARYLANDNAME : ISHAAN PATHAKTITLE/AFFILIATION WITH HOSPITAL : COMMUNITY PROGRAM MANAGERNAME OF ORGANIZATION : CENTRAL BALTIMORE PARTNERSHIPNAME : MARK FLETCHERTITLE/AFFILIATION WITH HOSPITAL : BALTIMORE CITY EMSNAME OF ORGANIZATION : BALTIMORE CITY NAME : MELVIN WILSON TITLE/AFFILIATION WITH HOSPITAL : EXECUTIVE DIRECTOR NAME OF ORGANIZATION : TURNAROUND TUESDAYNAME : ELLEN RAPPAPORTTITLE/AFFILIATION WITH HOSPITAL : POPULATION HEALTH DIRECTORNAME OF ORGANIZATION : HCAMNAME : ADONGO MATTHEWSTITLE/AFFILIATION WITH HOSPITAL : EXECUTIVE DIRECTORNAME OF ORGANIZATION : SHEPHERD'S CLINICNAME : MATT SMITHTITLE/AFFILIATION WITH HOSPITAL : EXECUTIVE DIRECTORNAME OF ORGANIZATION : WAVERLY MAIN STREETNAME : LISA JONESTITLE/AFFILIATION WITH HOSPITAL : COMMUNITY MEDIATION - DIRECTORNAME OF ORGANIZATION : WOODBOURNE MCCABE SAFE STREETSNAME : PAT JONESTITLE/AFFILIATION WITH HOSPITAL : DIRECTOR, IMMIGRATION OUTREACH SERVICE CENTERNAME OF ORGANIZATION : ST. MATTHEW'S CHURCHNAME : HEATHER WILSONTITLE/AFFILIATION WITH HOSPITAL : VICE PRESIDENT, OPERATIONSNAME OF ORGANIZATION : Y OF CENTRAL MDNAME : JENNIFER SIEGELTITLE/AFFILIATION WITH HOSPITAL : HOSPITAL COUNSEL, MGSH AND MUMHNAME OF ORGANIZATION : MEDSTAR HEALTHNAME : LUCAS CARLSONTITLE/AFFILIATION WITH HOSPITAL : MEDICAL DIRECTOR, COMMUNITY AND POPULATION HEALTHNAME OF ORGANIZATION : MEDSTAR HEALTHNAME : ASHLEY FUNKTITLE/AFFILIATION WITH HOSPITAL : SR. EXEC. DIRECTORNAME OF ORGANIZATION : THE Y IN CENTRAL MDNAME : MILLER J ROBERTSTITLE/AFFILIATION WITH HOSPITAL : REVITALIZATION DIRECTORNAME OF ORGANIZATION : GREENMOUNT CORRIDORNAME : JEFFREY GRIFFINTITLE/AFFILIATION WITH HOSPITAL : EXEC. DIRECTORNAME OF ORGANIZATION : FRANCISCAN CENTERNAME : RAQUEL LAMPTEYTITLE/AFFILIATION WITH HOSPITAL : COMMUNITY HEALTH SYSTEM MGR.NAME OF ORGANIZATION : MEDSTAR HEALTHNAME : DIANA QUINNTITLE/AFFILIATION WITH HOSPITAL : SR. DIRECTOR, COMMUNITY HEALTHNAME OF ORGANIZATION : MEDSTAR HEALTHNAME : CLAIRE WILSONTITLE/AFFILIATION WITH HOSPITAL : REGIONAL DIR COMMUNITY HEALTHNAME OF ORGANIZATION : MEDSTAR HEALTH - BALTIMORENAME : KRIS COWPERTHWAITETITLE/AFFILIATION WITH HOSPITAL : PHYSICIAN ADVISORNAME OF ORGANIZATION : MEDSTAR HEALTHNAME : STUART BELL MDTITLE/AFFILIATION WITH HOSPITAL : VP MEDICAL AFFAIRSNAME OF ORGANIZATION : MEDSTAR GOOD SAMARITAN/UNION MEMORIAL HOSPITALSNAME : DEBBIE BENA RNTITLE/AFFILIATION WITH HOSPITAL : RN PROGRAM MANAGERNAME OF ORGANIZATION : MEDSTAR GOOD SAMARITAN/UNION MEMORIAL HOSPITALSNAME : PHYLLIS GRAYTITLE/AFFILIATION WITH HOSPITAL : AVP CARE TRANSFORMATIONNAME OF ORGANIZATION : MEDSTAR HEALTH - BALTIMORE GOOD SAMARITAN HOSPITAL OF MARYLAND PART V, SECTION B, LINE 11: IMPLEMENTATION STRATEGYTHE IMPLEMENTATION STRATEGIES SERVE AS A ROADMAP FOR HOW COMMUNITY BENEFIT RESOURCES WILL BE ALLOCATED AND DEPLOYED. MEDSTAR'S HOSPITALS WILL BE ABLE TO MEASURE OUR CONTRIBUTION TO IMPROVING THE HEALTH OF UNDERSERVED AND VULNERABLE POPULATIONS IN THE REGIONS WE SERVE. THREE-YEAR IMPLEMENTATION STRATEGIES WITH MEASURABLE OBJECTIVES WERE DEVELOPED FOR EACH HOSPITAL'S COMMUNITY BENEFIT SERVICE AREA - A SPECIFIC COMMUNITY OR TARGET POPULATION OF FOCUS. PRIORITIES WERE BASED ON COMMUNITY NEED AS DETERMINED BY QUANTITATIVE DATA AND COMMUNITY INPUT, AS WELL AS ON HOSPITAL EXPERTISE, RESOURCES, STRENGTHS OF EXISTING PROGRAMMING AND PARTNERSHIPS, AND ALIGNMENT WITH NATIONAL, STATE, AND LOCAL HEALTH GOALS. THE MEDSTAR HEALTH CORPORATE COMMUNITY HEALTH DEPARTMENT WILL PROVIDE SYSTEM-WIDE COORDINATION AND OVERSIGHT OF COMMUNITY BENEFIT PROGRAMMING.HOSPITAL ADVISORY TASK FORCES CONVENE AT LEAST ANNUALLY TO MONITOR PROGRESS OF STRATEGY EXECUTION AND TO PROVIDE ONGOING RECOMMENDATIONS RELATED TO OUTCOMES ACHIEVEMENT, PROGRAM DEVELOPMENT, PARTNERSHIP APPROACHES, AND OVERALL IMPLEMENTATION IMPROVEMENT. FOR SIGNIFICANT NEEDS IDENTIFIED IN THE CHNA THAT THE HOSPITAL HAS NOT PRIORITIZED AS FOCUS AREAS THROUGH ITS IMPLEMENTATION STRATEGY, THESE NEEDS WILL BE ADDRESSED BY COLLABORATING WITH OTHER LEADING ORGANIZATIONS, AND BY TAKING A SUPPORTER ROLE ON IDENTIFIED NEEDS THAT ARE BEYOND THE SCOPE OF THE HOSPITAL'S STRENGTHS. CHARITY CARE AT COST PART I, LINE 7AMARYLAND'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 OFFSETTING REVENUE RELATED TO UNCOMPENSATED CARE. UNREIMBURSED MEDICAID PART I, LINE 7BMARYLAND'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 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. BAD DEBT PART III, LINES 2 & 4MEDSTAR HEALTH AND ITS AFFILIATED ORGANIZATIONS REPORT BAD DEBT EXPENSE IN ACCORDANCE WITH ASU 2011-07, WHICH REQUIRES CERTAIN HEALTHCARE ENTITIES TO CHANGE THE PRESENTATION OF THEIR STATEMENT OF OPERATIONS BY RECLASSIFYING THE PROVISION FOR BAD DEBTS ASSOCIATED WITH PATIENT SERVICE REVENUE FROM AN OPERATING EXPENSE TO A DEDUCTION FROM PATIENT SERVICE REVENUE (NET OF CONTRACTUAL ALLOWANCES AND DISCOUNTS). HOWEVER, MEDSTAR AND ITS AFFILIATED ENTITIES DO NOT MAKE A DETERMINATION AS TO WHETHER SELF PAY AMOUNTS ARE COLLECTIBLE IN DETERMINING REVENUE RECOGNITION. RESERVE MODELS, WHICH HAVE BEEN DEVELOPED BASED ON HISTORICAL COLLECTION RESULTS AND WHICH ARE ADJUSTED PERIODICALLY BASED ON ACTUAL COLLECTIONS EXPERIENCE, ARE USED TO ESTIMATE UNCOLLECTIBLE AMOUNTS ACROSS ALL PAYORS INCLUDING SELF PAY. BAD DEBT DETERMINATIONS ARE MADE ONLY AFTER SUFFICIENT EVIDENCE IS OBTAINED TO SUPPORT THAT AN AMOUNT IS NOT COLLECTIBLE. MEDICARE PART III, LINE 8MARYLAND'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 OFFSETTING REVENUE RELATED TO UNCOMPENSATED CARE. AS SUCH, THE NET EFFECT FOR MEDICARE EXPENSES AND REVENUES IN MARYLAND IS ZERO. NEEDS ASSESSMENT PART VI, LINE 2IN FY21, MEDSTAR GOOD SAMARITAN HOSPITAL (MGSH) CONDUCTED A COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) IN ACCORDANCE WITH THE GUIDELINES ESTABLISHED BY THE PATIENT PROTECTION AND AFFORDABLE CARE ACT AND THE INTERNAL REVENUE SERVICE. THE HOSPITAL'S CHNA AND THREE-YEAR IMPLEMENTATION STRATEGIES WERE ENDORSED BY MGSH'S BOARD OF DIRECTORS AND APPROVED BY THE MEDSTAR HEALTH BOARD OF DIRECTORS. THE DOCUMENT BECAME AVAILABLE ON THE HOSPITAL'S WEBSITE ON JUNE 30, 2021 AND WILL GUIDE PROGRAMMING PRIORITIES IN FISCAL YEARS 2022-2024.THE CATEGORIES HEALTH AND WELLNESS, ACCESS TO CARE AND SOCIAL DETERMINANTS OF HEALTH WERE USED TO DETERMINE WHAT PROGRAMMING TO PRIORITIZE FOR THE CHNA. TWO TO THREE STRATEGIES IN EACH CATEGORY WERE SELECTED AS PRIORITIES DUE TO THE SIZE AND SCALE OF IMPACT AND MEASURABLE OUTCOMES. ALL OTHER PROGRAMMING WAS INTEGRATED AS PART OF THE HOSPITAL'S OVERALL COMMUNITY HEALTH PORTFOLIO. THESE ADDITIONAL PROGRAMS WERE CAPTURED IN THE INVENTORY FOR THE WHOLE PICTURE OF CONTRIBUTING TO THE HEALTH OF THE COMMUNITIES SERVED AS WELL AS SORTED FOR WHAT COUNTS AS COMMUNITY BENEFIT FOR REGULATORY REPORTING.THE HOSPITAL'S COMMUNITY BENEFIT SERVICE AREA (CBSA) IS BASED ON THE ADVISORY TASK FORCE (ATF) RECOMMENDATION. THE HOSPITAL IDENTIFIED ZIP CODES 21206 AND 21239 AS ITS CBSA. THE HOSPITAL SELECTED THIS GEOGRAPHIC AREA BASED ON HOSPITAL UTILIZATION DATA AND SECONDARY PUBLIC HEALTH DATA AS WELL AS ITS PROXIMITY TO THE HOSPITAL. THE ATF INCLUDED A DIVERSE GROUP OF INDIVIDUALS, INCLUDING HOSPITAL LEADERS, GRASSROOTS ACTIVISTS, COMMUNITY RESIDENTS, FAITH-BASED LEADERS, HOSPITAL REPRESENTATIVES, PUBLIC HEALTH LEADERS AND OTHER STAKEHOLDER ORGANIZATIONS, SUCH AS REPRESENTATIVES FROM LOCAL HEALTH DEPARTMENTS.HEALTH PRIORITIES FOR THE CBSA INCLUDE HEALTH AND WELLNESS (CHRONIC DISEASE PREVENTION AND MANAGEMENT, BEHAVIORAL HEALTH AND AGING AND OLDER ADULT HEALTH), ACCESS TO HEALTH CARE SERVICES (TRANSPORTATION AND ACCESS TO AFFORDABLE HEALTH CARE AND INSURANCE) AND SOCIAL DETERMINANTS OF HEALTH (EMPLOYMENT, FOOD INSECURITY AND NEIGHBORHOOD SAFETY AND COMMUNITY VIOLENCE). AS A PROUD MEMBER OF MEDSTAR HEALTH, REPRESENTATIVES FROM THE HOSPITAL ROUTINELY PARTICIPATE IN THE MEDSTAR HEALTH COMMUNITY HEALTH WORKGROUP. THE WORKGROUP IS COMPRISED OF COMMUNITY HEALTH PROFESSIONALS WHO REPRESENT ALL TEN MEDSTAR HOSPITALS. THE TEAM ANALYZES LOCAL AND REGIONAL COMMUNITY HEALTH DATA, ESTABLISHES SYSTEM-WIDE COMMUNITY HEALTH PROGRAMMING PERFORMANCE AND EVALUATION MEASURES AND SHARES BEST PRACTICES. PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE PART VI, LINE 3AS ONE OF THE REGION'S LEADING NOT-FOR-PROFIT HEALTHCARE SYSTEMS, MEDSTAR HEALTH IS COMMITTED TO ENSURING THAT UNINSURED AND UNDERINSURED PATIENTS MEETING ELIGIBILITY CRITERIA, AND PATIENTS DETERMINED ELIGIBLE FOR PRESUMPTIVE ELIGIBILITY WITHIN THE COMMUNITIES WE SERVE WHO LACK FINANCIAL RESOURCES HAVE ACCESS TO MEDICALLY NECESSARY HOSPITAL SERVICES. MEDSTAR HEALTH HOSPITALS AND HOSPITAL BASED-PHYSICIAN PRACTICES WILL:- TREAT ALL PATIENTS EQUITABLY, WITH DIGNITY, RESPECT, AND COMPASSION.- SERVE THE EMERGENCY HEALTH CARE NEEDS OF EVERYONE WHO PRESENTS TO OUR MEDSTAR HEALTH HOSPITALS AND HOSPITAL-BASED PHYSICIAN PRACTICES REGARDLESS OF A PATIENT'S ABILITY TO PAY FOR CARE.- ASSIST THOSE PATIENTS WHO ARE ADMITTED THROUGH OUR ADMISSION PROCESS FOR NON-URGENT, MEDICALLY NECESSARY CARE WHO CANNOT PAY FOR THE CARE THEY RECEIVE.- BALANCE NEEDED FINANCIAL ASSISTANCE FOR SOME PATIENTS WITH BROADER FISCAL RESPONSIBILITIES IN ORDER TO KEEP ITS HOSPITALS' DOORS OPEN FOR ALL WHO MAY NEED CARE IN THE COMMUNITY.IN MEETING ITS COMMITMENTS, MEDSTAR HEALTH HOSPITALS AND HOSPITAL-BASED PHYSICIAN PRACTICES WILL WORK WITH THEIR PATIENTS SEEKING EMERGENCY AND MEDICALLY NECESSARY CARE TO GAIN AN UNDERSTANDING OF EACH PATIENT'S FINANCIAL RESOURCES. BASED ON THIS INFORMATION, MEDSTAR HEALTH HOSPITALS AND HOSPITAL-BASED PHYSICIAN PRACTICES WILL MAKE ELIGIBILITY DETERMINATIONS FOR FINANCIAL ASSISTANCE FOR PATIENTS WHO RESIDE WITHIN THE COMMUNITIES THAT WE SERVE. IN DETERMINING ELIGIBILITY FOR FINANCIAL ASSISTANCE, MEDSTAR HEALTH HOSPITALS AND HOSPITAL-BASED PHYSICIAN PRACTICES WILL: - DETERMINE WHETHER THE PATIENT HAS HEALTH INSURANCE. - DETERMINE WHETHER THE PATIENT IS PRESUMPTIVELY ELIGIBLE FOR FREE OR REDUCED-COST CARE. - DETERMINE WHETHER UNINSURED PATIENTS ARE ELIGIBLE FOR PUBLIC OR PRIVATE HEALTH INSURANCE. - TO THE EXTENT POSSIBLE, OFFER ASSISTANCE TO UNINSURED PATIENTS IF THE PATIENT CHOOSES TO APPLY FOR PUBLIC OR PRIVATE HEALTH INSURANCE. - USE INFORMATION IN THE POSSESSION OF THE HOSPITAL, IF AVAILABLE, TO DETERMINE WHETHER THE PATIENT IS QUALIFIED FOR FREE OR REDUCED-COST CARE UNDER THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY.MEDSTAR HEALTH WILL WIDELY PUBLICIZE THE MEDSTAR FINANCIAL ASSISTANCE POLICY BY:- PROVIDING ACCESS TO THE MEDSTAR FINANCIAL ASSISTANCE POLICY, FINANCIAL ASSISTANCE APPLICATIONS, AND MEDSTAR PATIENT INFORMATION SHEET ON ALL HOSPITAL WEBSITES AND PATIENT PORTALS.- PROVIDING HARD COPIES OF THE MEDSTAR FINANCIAL ASSISTANCE POLICY, MEDSTAR UNIFORM FINANCIAL ASSISTANCE APPLICATION, AND MEDSTAR PATIENT INFORMATION SHEET TO PATIENTS UPON REQUEST.- PROVIDING HARD COPIES OF THE MEDSTAR FINANCIAL ASSISTANCE POLICY, MEDSTAR UNIFORM FINANCIAL ASSISTANCE APPLICATION, AND MEDSTAR PATIENT INFORMATION SHEET TO PATIENTS UPON REQUEST BY MAIL AND WITHOUT CHARGE.- PROVIDING NOTIFICATION AND INFORMATION ABOUT THE MEDSTAR FINANCIAL ASSISTANCE POLICY BY: . OFFERING COPIES AS PART OF ALL REGISTRATION OR DISCHARGES PROCESSES, AND ANSWERING QUESTIONS ON HOW TO APPLY FOR ASSISTANCE. . PROVIDING WRITTEN NOTICES ON BILLING STATEMENTS. . DISPLAYING MEDSTAR FINANCIAL ASSISTANCE POLICY INFORMATION AT ALL HOSPITAL REGISTRATION POINTS, INCLUDING THE BUSINESS OFFICE, INFORMING PATIENTS OF THEIR RIGHTS TO APPLY FOR FINANCIAL ASSISTANCE AND WHO TO CONTACT AT THE HOSPITAL FOR ADDITIONAL INFORMATION. . TRANSLATING THE MEDSTAR FINANCIAL ASSISTANCE POLICY, MEDSTAR UNIFORM FINANCIAL ASSISTANCE APPLICATION, AND THE MEDSTAR PATIENT INFORMATION SHEET INTO PRIMARY LANGUAGES THAT CONSTITUTE THE LESSER OF 1000 INDIVIDUALS OR 5% OF THE OVERALL POPULATION WITHIN THE CITY OR COUNTY IN WHICH THE HOSPITAL IS LOCATED AS MEASURED BY THE MOST RECENT CENSUS.- MEDSTAR HEALTH WILL PROVIDE PUBLIC NOTICES YEARLY IN LOCAL NEWSPAPERS SERVING ALL HOSPITAL TARGET POPULATIONS.THE MEDSTAR HEALTH PATIENT INFORMATION SHEET SHALL BE PROVIDED TO THE PATIENT, THE PATIENT'S FAMILY, OR THE PATIENT'S AUTHORIZED REPRESENTATIVE: - BEFORE DISCHARGE;- WITH THE HOSPITAL BILL; - ON REQUEST; AND - IN EACH WRITTEN COMMUNICATION TO THE PATIENT REGARDING COLLECTION OF THE HOSPITAL BILL.MEDSTAR HEALTH WILL PROVIDE A FINANCIAL ASSISTANCE PROBABLE AND LIKELY ELIGIBILITY DETERMINATION TO THE PATIENT WITHIN TWO BUSINESS DAYS FROM RECEIPT OF THE INITIAL MEDSTAR HEALTH UNIFORM FINANCIAL ASSISTANCE APPLICATION. FINAL ELIGIBILITY DETERMINATIONS ARE MADE AND COMMUNICATED TO THE PATIENT BASED ON RECEIPT AND REVIEW OF A COMPLETED APPLICATION. MEDSTAR HEALTH BELIEVES THAT ITS PATIENTS HAVE PERSONAL RESPONSIBILITIES RELATED TO THE FINANCIAL ASPECTS OF THEIR HEALTHCARE NEEDS. FINANCIAL ASSISTANCE AND PERIODIC PAYMENT PLANS AVAILABLE UNDER THIS POLICY WILL NOT BE AVAILABLE TO THOSE PATIENTS WHO FAIL TO FULFILL THEIR RESPONSIBILITIES. FOR PURPOSES OF THIS POLICY, PATIENT RESPONSIBILITIES INCLUDE: - COMPLY WITH PROVIDING THE NECESSARY FINANCIAL DISCLOSURE FORMS TO EVALUATE THEIR ELIGIBILITY FOR PUBLICLY-FUNDED HEALTHCARE PROGRAMS, CHARITY CARE PROGRAMS, AND OTHER FORMS OF FINANCIAL ASSISTANCE. THESE DISCLOSURE FORMS MUST BE COMPLETED ACCURATELY, TRUTHFULLY, AND TIMELY TO ALLOW MEDSTAR HEALTH'S FACILITIES TO PROPERLY COUNSEL PATIENTS CONCERNING THE AVAILABILITY OF FINANCIAL ASSISTANCE. - WORKING WITH MEDSTAR HOSPITAL PATIENT ADVOCATES AND PATIENT FINANCIAL SERVICES STAFF TO ENSURE THERE IS A COMPLETE UNDERSTANDING OF THE PATIENT'S FINANCIAL SITUATION AND CONSTRAINTS. - MAKING APPLICABLE PAYMENTS FOR SERVICES IN A TIMELY FASHION, INCLUDING ANY PAYMENTS MADE PURSUANT TO DEFERRED AND PERIODIC PAYMENT SCHEDULES. - PROVIDING UPDATED FINANCIAL INFORMATION TO MEDSTAR HOSPITAL PATIENT ADVOCATES OR CUSTOMER SERVICE REPRESENTATIVES ON A TIMELY BASIS AS THE PATIENT'S FINANCIAL CIRCUMSTANCES MAY CHANGE. - IT IS A PATIENT'S RESPONSIBILITY, DURING THEIR 12-MONTH ELIGIBILITY PERIOD, TO NOTIFY MEDSTAR HEALTH OF THEIR EXISTING HOUSEHOLD ELIGIBILITY FOR FREE CARE, REDUCED COST-CARE, AND/OR ELIGIBILITY UNDER FINANCIAL HARDSHIP PROVISIONS FOR MEDICAL NECESSARY CARE RECEIVED DURING THE 12-MONTH ELIGIBILITY PERIOD.- IN THE EVENT A PATIENT FAILS TO MEET THESE RESPONSIBILITIES, MEDSTAR RESERVES THE RIGHT TO PURSUE ADDITIONAL BILLING AND COLLECTION EFFORTS. IN THE EVENT OF NON-PAYMENT BILLING, AND COLLECTION EFFORTS ARE DEFINED IN THE MEDSTAR BILLING AND COLLECTION POLICY. A FREE COPY IS AVAILABLE ON ALL HOSPITAL WEBSITES AND PATIENT PORTALS VIA THE FOLLOWING URL: WWW.MEDSTARHEALTH.ORG/FINANCIALASSISTANCE , OR BY CALLING CUSTOMER SERVICE AT 1-800-280-9006.PATIENTS OF MEDSTAR HEALTH'S HOSPITALS AND HOSPITAL-BASED PHYSICIAN PRACTICES MAY BE ELIGIBLE FOR FULL FINANCIAL ASSISTANCE OR PARTIAL SLIDING-SCALE FINANCIAL ASSISTANCE AS SET FORTH UNDER THIS POLICY. THE PATIENT ADVOCATE AND PATIENT FINANCIAL SERVICES STAFF WILL DETERMINE ELIGIBILITY FOR FULL FINANCIAL ASSISTANCE AND PARTIAL SLIDING-SCALE FINANCIAL ASSISTANCE BASED ON REVIEW OF INCOME FOR THE PATIENT AND THEIR FAMILY (HOUSEHOLD), OTHER FINANCIAL RESOURCES AVAILABLE TO THE PATIENT'S FAMILY, FAMILY SIZE, AND THE EXTENT OF THE MEDICAL COSTS TO BE INCURRED BY THE PATIENT. COMMUNITY INFORMATION PART VI, LINE 4GEOGRAPHIC AND DEMOGRAPHIC:THE COMMUNITIES THE ORGANIZATION SERVES INCLUDES ZIP CODES 21239 AND 21206, BOTH URBAN GEOGRAPHIC SERVICE AREAS. THERE ARE 18 HOSPITALS SERVING BALTIMORE CITY, AND 14 FEDERALLY DESIGNATED MEDICALLY UNDERSERVED AREAS PRESENT IN THE COMMUNITY. THERE ARE 28,793 PEOPLE IN 21239 (LOCH RAVEN VILLAGE/NORTHWOOD) AND THE AVERAGE INCOME IS $51,331. THERE ARE 50,846 PEOPLE IN 21206 (CEDONIA/FRANKFORD AREA) AND THE AVERAGE INCOME IS $48,428. BALTIMORE CITY INCLUDES RESIDENTS WITH INCOMES BELOW THE FEDERAL POVERTY GUIDELINE (17.2%), UNINSURED (8%) AND MEDICAID RECIPIENTS (42.5%). PROMOTION OF COMMUNITY HEALTH PART VI, LINE 5AS A COMMUNITY PARTNER, MEDSTAR GOOD SAMARITAN HOSPITAL ENGAGES IN SEVERAL COMMUNITY BENEFIT ACTIVITIES TO IMPROVE AND PROMOTE THE HEALTH AND WELLBEING OF THE COMMUNITY. PRIORITY AREAS, AS DETERMINED BY THE CHNA, FALL UNDER THREE AREAS OF FOCUS INCLUDING HEALTH AND WELLNESS, ACCESS TO CARE, AND SOCIAL DETERMINANTS OF HEALTH. PROGRAMS INCLUDE (BUT ARE NOT LIMITED TO):HEALTH AND WELLNESS:MEDSTAR GOOD SAMARITAN HOSPITAL ADDRESSES HEALTH AND WELLNESS BY OFFERING A VARIETY OF PROGRAMS AND RESOURCES THAT SEEK TO ADDRESS CHRONIC DISEASE PREVENTION AND MANAGEMENT. MEDSTAR GOOD SAMARITAN HOSPITAL SERVES AS A HUB TO SCREEN INDIVIDUALS FOR BREAST, CERVICAL, AND COLON CANCER. A UNIQUE ASPECT OF THIS PROGRAM IS THAT IT PROVIDES SCREENING TO INDIVIDUALS WITHOUT INSURANCE AND/OR DOCUMENTATION. AS A RESULT, MORE THAN 50% OF PEOPLE SERVED ARE HISPANIC/LATINO. MEDSTAR GOOD SAMARITAN HOSPITAL'S COMMUNITY-BASED EDUCATION COURSES ARE OFFERED TO SUPPORT HEALTHY LIFESTYLE CHANGES FOR COMMUNITY MEMBERS. PROGRAMS INCLUDE CENTERS FOR DISEASE CONTROL DIABETES PREVENTION, DIABETES SELF-MANAGEMENT EDUCATION, FLU VACCINATION CLINICS, YOGA SERVICES, SENIOR PHYSICAL FITNESS, AND SMOKING CESSATION. ACCESS TO CARE:THE PRIORITY AREA IS ADDRESSING ACCESS TO BEHAVIORAL HEALTH SERVICES, INCLUDING MENTAL HEALTH AND SUBSTANCE USE. MEDSTAR GOOD SAMARITAN OFFERS A SCREENING, BRIEF INTERVENTION, AND REFERRAL TO TREATMENT (SBIRT) PROGRAM TO SUPPORT THOSE EXPERIENCING SUBSTANCE USE DISORDER. AN ENHANCEMENT OF SBIRT INCLUDES THE OPIOID OVERDOSE SURVIVOR OUTREACH PROGRAM (OSOP). OSOP LINKS COMMUNITY MEMBERS WITH A HISTORY OF SUBSTANCE ABUSE TREATMENT WITH THE RESOURCES THEY NEED TO PREVENT A FUTURE OVERDOSE. MEDSTAR GOOD SAMARITAN HOSPITAL ALSO ADDRESSES ACCESS TO CARE BY HELPING TO REDUCE THE FINANCIAL BURDEN FOR PATIENTS AND THEIR FAMILIES. PATIENT FINANCIAL SERVICES PROVIDES FINANCIAL ASSISTANCE TO UNINSURED PATIENTS WHO RESIDE WITHIN THE COMMUNITY BY ASSISTING WITH ENROLLMENT IN PUBLICLY FUNDED ENTITLEMENT PROGRAMS, REFERRING PATIENTS TO STATE OR FEDERAL INSURANCE EXCHANGE NAVIGATOR RESOURCES AND ASSISTING WITH CONSIDERATION OF FUNDING THAT MAY BE AVAILABLE FROM OTHER CHARITABLE ORGANIZATIONS.THE HOSPITAL SUBSIDIZES HEALTH SERVICES TO ENSURE RESIDENTS HAVE ACCESS TO THE CLINICAL CARE THEY NEED.SOCIAL DETERMINANTS OF HEALTH:MEDSTAR GOOD SAMARITAN HOSPITAL'S OTHER PRIORITY IS ADDRESSING THE SOCIAL DETERMINANTS OF HEALTH OF THE COMMUNITY. COMMUNITY RESIDENTS SURROUNDING THE HOSPITAL HAVE BEEN TRAINED AND HIRED AS EITHER A COMMUNITY HEALTH ADVOCATE OR PEER RECOVERY COACH AS PART OF THE POPULATION HEALTH WORKFORCE DEVELOPMENT PROGRAM. THESE POSITIONS SERVE TO EMPOWER INDIVIDUALS AND THEIR FAMILIES INTO BETTER ECONOMIC CONDITIONS. AS PART OF THEIR RESPONSIBILITIES, THE COMMUNITY HEALTH ADVOCATE ROLES CONDUCT SOCIAL NEEDS SCREENINGS. SOCIAL NEEDS SCREENINGS ARE PROVIDED TO SCREEN FOR FOOD AND HOUSING INSECURITY, AND BARRIERS RELATED TO TRANSPORTATION, EMPLOYMENT, AND UTILITIES. IDENTIFIED NEEDS ARE ADDRESSED BY CONNECTING THE PARTICIPANT TO SOCIAL SERVICES AND OTHER RESOURCES IN THE COMMUNITY. MEDSTAR GOOD SAMARITAN HOSPITAL HAS A PARTNERSHIP WITH UBER TO ADDRESS TRANSPORTATION BARRIERS TO ACCESS MEDICAL SERVICES. THROUGH THIS PARTNERSHIP, RIDES ARE PROVIDED TO PATIENTS AND/OR FAMILIES WITH FINANCIAL NEED. THE TRANSPORTATION ASSISTANCE ENABLES PATIENTS TO ATTEND NECESSARY APPOINTMENTS WITH THEIR HEALTH CARE PROVIDERS. FURTHER, MEDSTAR GOOD SAMARITAN HOSPITAL ADDRESSES FOOD INSECURITY BY ENROLLING PATIENTS INTO A FOOD PRESCRIPTION DELIVERY PROGRAM THROUGH ITS PARTNER HUNGRY HARVEST. THIS TEMPORARY SOURCE OF FOOD ASSISTANCE ALLOWS COMMUNITY HEALTH ADVOCATES TO ADDRESS A LONG-TERM STRATEGY FOR FOOD ACCESS (E.G. MEALS ON WHEELS, ETC.)MEDSTAR GOOD SAMARITAN HOSPITAL ALSO PROVIDES PATHWAYS FOR HEALTHCARE CAREERS FOR THE YOUTH IN ITS SURROUNDING COMMUNITY. THIS ALLOWS STUDENTS TO DEMONSTRATE SKILL DEVELOPMENT AND EXPERIENCE WORKING IN THE MEDICAL FIELD, INCLUDING THE HOSPITAL'S PARTNERSHIP WITH MERCY HIGH SCHOOL. DISASTER READINESS:THE HOSPITAL STRENGTHENED THE COMMUNITY HEALTH RESILIENCE BY IMPROVING THE ABILITY OF THE COMMUNITY TO WITHSTAND AND RECOVER FROM CORONAVIRUS, A PUBLIC HEALTH EMERGENCY THAT SURFACED IN MARCH 2020. LEADERSHIP PARTICIPATED IN COMMUNITY-WIDE TASK FORCES AND STAFF IMPLEMENTED PROGRAMS ASSOCIATED WITH ADDRESSING HEALTH NEEDS ARISING FROM CORONAVIRUS. STAFF PLANNED AND IMPLEMENTED COMMUNITY RESPONSE EFFORTS INCLUDING COVID-19 TESTING AND VACCINATION EVENTS AND PUBLIC EDUCATION EFFORTS. EVENTS AND OUTREACH OCCURRED AT HOSPITAL CAMPUSES AND AT TARGETED COMMUNITY LOCATIONS SUCH AS SENIOR COMPLEXES, CHURCHES AND COMMUNITY CENTERS TO BEST REACH UNDERSERVED AND AT-RISK POPULATIONS. PPE (PERSONAL PROTECTIVE EQUIPMENT) AND CLINICAL EQUIPMENT WERE ALSO DONATED TO OTHER NON-PROFITS SUPPORTING DISASTER RELIEF EFFORTS. AFFILIATED HEALTH CARE SYSTEM PART VI, LINE 6AS A PROUD MEMBER OF MEDSTAR HEALTH, MEDSTAR GOOD SAMARITAN HOSPITAL IS ABLE TO EXPAND ITS CAPACITY TO MEET THE NEEDS OF THE COMMUNITY BY PARTNERING WITH OTHER MEDSTAR HOSPITALS AND ASSOCIATED ENTITIES. MEDSTAR HEALTH RESOURCES ASSIST THE HOSPITAL IN COMMUNITY HEALTH PLANNING TO MEET THE NEEDS OF THE UNINSURED AND OTHER VULNERABLE POPULATIONS. THROUGH ITS COMMUNITY HEALTH FUNCTION, MEDSTAR HEALTH PROVIDES MEDSTAR GOOD SAMARITAN HOSPITAL TECHNICAL SUPPORT TO ENHANCE COMMUNITY HEALTH PROGRAMMING AND EVALUATION. MEDSTAR'S CORPORATE PHILANTHROPY DEPARTMENT IDENTIFIES AND SEEKS PUBLIC AND PRIVATE FUNDING SOURCES TO ENSURE THE AVAILABILITY OF HIGH-QUALITY HEALTH SERVICES, REGARDLESS OF ABILITY TO PAY. STATE FILING OF COMMUNITY BENEFIT REPORT PART VI, LINE 7THE COMMUNITY BENEFIT REPORT FOR MEDSTAR GOOD SAMARITAN HOSPITAL IS FILED IN THE STATE OF MARYLAND. 1 AMERICAN HEART ASSOCIATION NATIONAL CENTER 7272 GREENVILLE AVENUE DALLAS TX 75231 135613797 501(C)(3) 40000 0 SPONSORSHIP: HEART WALK 2022 CRISTO REY JESUIT HIGH SCHOOL 420 SOUTH CHESTER STREET BALTIMORE MD 21231 205300491 501(C)(3) 22000 0 CORPORATE INTERNSHIP PROGRAM 2 0 SCHEDULE I, PART I, LINE 2 OUR GRANT MONITORING PROCEDURE BRINGS TOGETHER ALL KEY PERSONNEL INVOLVED IN THE GRANT AT THE ONSET OF THE AWARD TO DISCUSS MANAGEMENT, RESPONSIBILITIES, BUDGETS, AND REPORTING. THIS INITIAL MEETING IS DOCUMENTED AND DISBURSED TO ALL INVOLVED. THE ACTUAL GRANT MONITORING IS DONE BY THE HOSPITAL DEPARTMENT IMPLEMENTING THE GRANT. MEDSTAR CORPORATE'S GRANTS AND PHILANTHROPY DEPARTMENT ENSURES THAT EACH GRANT HAS A COST CENTER AND/OR GRANT ACCOUNT SET UP BASED ON THE TERMS OF THE GRANT AWARD. MEDSTAR CORPORATE'S GRANTS AND PHILANTHROPY DEPARTMENT ALSO TRACKS AND REMINDS HOSPITAL DEPARTMENTS WHEN PROGRESS REPORTS ARE DUE THROUGHOUT THE LIFE OF THE GRANT. X 1 1 X X X X X X 0 0 0 0 0 0 0 0 0 KENNETH A SAMET BOARD MEMBER 0 2030199 0 7462050 0 6279147 0 59518 0 36769 0 15867683 0 0 DAVID ZACHARY MARTIN MD BOARD MEMBER 768847 768847 34172 34172 2846 2846 8700 0 21671 0 836236 805865 0 0 ZEENA DORAI MD BOARD MEMBER 607440 607439 132611 132611 38633 38634 8700 0 10352 0 797736 778684 0 0 BRADLEY CHAMBERS PRESIDENT/BOARD MEMBER 371954 371954 352950 352950 0 0 23124 0 33295 0 781323 724904 0 0 STUART BELL MD VP, MEDICAL AFFAIRS 275289 275288 194624 194625 0 0 16780 0 20731 0 507424 469913 0 0 MESFIN LEMMA MD BOARD MEMBER 344299 344299 95142 95142 375 375 8700 0 2207 0 450723 439816 0 0 MICHAEL JACOBS MD PHYSICIAN 838613 0 0 0 750 0 8700 0 17168 0 865231 0 0 0 DEANA STOUT TREASURER/CFO 161973 161973 83098 83097 22097 22097 29388 0 21535 0 318091 267167 0 0 ELIAS SHAYA MD BOARD MEMBER 220587 220587 12500 12500 375 375 9372 0 1393 0 244227 233462 0 0 SHAMS QUAZI MD PHYSICIAN 192870 192870 25000 25000 375 375 8700 0 21152 0 248097 218245 0 0 ESKANDAR YAZAJI MD BOARD MEMBER (UNTIL 07/2022) 175293 175293 15532 15532 375 375 8700 0 21445 0 221345 191200 0 0 DIWAKAR PRADHAN MD PHYSICIAN 341919 0 25000 0 750 0 8700 0 9831 0 386200 0 0 0 KAREN OWINGS CNO 133426 133426 34374 34374 0 0 19671 0 16877 0 204348 167800 0 0 GEORGE HENNAWI MD BOARD MEMBER (UNTIL 01/2022) 157549 157549 12100 12100 375 375 8700 0 20990 0 199714 170024 0 0 BRIAN CAWLEY SENIOR VP, OPERATIONS 102931 163144 0 60016 0 0 0 8700 0 21380 102931 253240 0 0 NEIL MACDONALD VP, OPERATIONS 117771 117771 39994 39994 0 0 9479 0 21441 0 188685 157765 0 0 BERNARD RAVITZ MD PHYSICIAN 263006 0 26000 0 750 0 8699 0 1317 0 299772 0 0 0 RAHUL BHOITE MD PHYSICIAN 238429 0 27880 0 750 0 8113 0 9002 0 284174 0 0 0 LINDA HEATH ASSISTANT SECRETARY (UNTIL 05/2022) 116094 0 0 0 750 0 17372 0 18806 0 153022 0 0 0 PART I, LINE 1A HEALTH OR SOCIAL CLUB DUES: THE ORGANIZATION PAID BUSINESS CLUB DUES FOR ONE OF ITS OFFICERS DURING THIS YEAR. PARTICIPATION IN THESE ACTIVITIES BY THE OFFICER WAS FOR BUSINESS PURPOSES, AND HELPED THE ORGANIZATION FURTHER ITS EXEMPT PURPOSES. SCHEDULE J, PART III DETAILED BELOW ARE SEVERAL ONE-TIME PAYMENTS TO CERTAIN EXECUTIVES RELATED TO VARIOUS RETIREMENT, RETENTION AND LONG-TERM INCENTIVE PLANS. THESE PLANS AND PAYMENTS ARE NOT A ROUTINE PART OF THE TYPICAL MEDSTAR EXECUTIVE COMPENSATION PROGRAM, AND SUPPORTED IMPORTANT OBJECTIVES OF OUR ORGANIZATION. MR. SAMET'S OTHER REPORTABLE COMPENSATION IN PART II, COLUMN (B)(II) AND (III) INCLUDES A PAYMENT OF $4,215,823, WHICH REPRESENTS BENEFITS ACCRUED THROUGH AN EXECUTIVE RETIREMENT PLAN THAT IS COMPRISED OF TARGET BENEFITS CALCULATED ANNUALLY USING COMPENSATION AND YEARS OF SERVICE, $1,500,823, WHICH REPRESENTS THE EXERCISED VALUE OF OPTION PLAN SHARES, BASED ON DEFERRED COMPENSATION EARNED APPROXIMATELY 20 YEARS AGO AND INVESTMENT RETURNS ON THIS COMPENSATION EARNED OVER THIS PERIOD OF TIME, AND $4,740,000 REPRESENTING A LONG-TERM RETENTION ARRANGEMENT. BRADLEY CHAMBERS' COMPENSATION IS FOR SERVICES PROVIDED AS PRESIDENT TO BOTH MEDSTAR GOOD SAMARITAN HOSPITAL AND MEDSTAR UNION MEMORIAL HOSPITAL. DEANA STOUT'S COMPENSATION IS FOR SERVICES PROVIDED AS CFO TO BOTH MEDSTAR GOOD SAMARITAN HOSPITAL AND MEDSTAR UNION MEMORIAL HOSPITAL. STUART BELL AND NEIL MACDONALD'S COMPENSATION IS FOR SERVICES PROVIDED AS VP MEDICAL AFFAIRS AND VP OPERATIONS, RESPECTIVELY, AT BOTH MEDSTAR GOOD SAMARITAN HOSPITAL AND MEDSTAR UNION MEMORIAL HOSPITAL. FORM 990, PART VI, SECTION A, LINE 6 ORGANIZATION MEMBERS THE ORGANIZATION IS AN AFFILIATE AND SUBSIDIARY OF MEDSTAR HEALTH, INC., A TAX-EXEMPT MARYLAND NON-STOCK CORPORATION. MEDSTAR HEALTH, INC., OR ONE OF ITS AFFILIATES AND SUBSIDIARIES, IS THE SOLE MEMBER OF THE ORGANIZATION. FORM 990, PART VI, SECTION A, LINE 7A DESCRIPTION OF MEMBERS AS AN AFFILIATE AND SUBSIDIARY OF MEDSTAR HEALTH, INC., A TAX-EXEMPT MARYLAND NON-STOCK CORPORATION, THE ORGANIZATION MAY RECOMMEND PERSON(S) FOR MEMBERSHIP ON THE ORGANIZATION'S GOVERNING BODY. ANY SUCH RECOMMENDATION BY THE ORGANIZATION IS SUBJECT TO APPROVAL BY THE GOVERNANCE COMMITTEE OF THE BOARD OF DIRECTORS OF MEDSTAR HEALTH, INC. THE BOARD OF MEDSTAR HEALTH, INC. HAS DELEGATED CERTAIN APPROVAL AUTHORITY TO THE GOVERNANCE COMMITTEE AND THE PRESIDENT & CEO OF MEDSTAR HEALTH, INC. FORM 990, PART VI, SECTION A, LINE 7B DECISIONS OF GOVERNING BODY AS AN AFFILIATE AND SUBSIDIARY OF MEDSTAR HEALTH, INC., A TAX-EXEMPT MARYLAND NON-STOCK CORPORATION, THE BYLAWS OF THE ORGANIZATION ARE SUBJECT TO CERTAIN RESERVED POWERS, WHICH PROVIDE THAT THE SOLE MEMBER OF THE ORGANIZATION MUST APPROVE CERTAIN DECISIONS, INCLUDING BUT NOT LIMITED TO MATTERS CONCERNING THE SALE OR PURCHASE OF REAL OR PERSONAL PROPERTY, CAPITAL BUDGETS, STRATEGIC PLANNING, INVESTMENTS, AND CORPORATE GOVERNANCE. FORM 990, PART VI, SECTION B, LINE 11B PROCESS FOR REVIEWING FORM 990 THE PROCESS FOR REVIEWING THE FORM 990 INCLUDED EDUCATION AND TRANSPARENCY. SENIOR FINANCIAL EXECUTIVES, WORKING WITH INDEPENDENT OUTSIDE EXPERTS, THOROUGHLY REVIEWED FORM 990 AND ACCOMPANYING INSTRUCTIONS. IN ADDITION, SENIOR EXECUTIVES REVIEWED THE RELEVANT SECTIONS OF THE FORM 990 WITH THE FOLLOWING COMMITTEES OF THE ORGANIZATION'S GOVERNING BODY: FINANCE, AUDIT, GOVERNANCE, STRATEGIC PLANNING, AND EXECUTIVE COMPENSATION. FOLLOWING THESE MEETINGS, THE GOVERNING BODY WAS PROVIDED A COPY OF THE FORM 990 IN ITS FINAL FORM AND GIVEN AN OPPORTUNITY TO PROVIDE ANY INPUT OR COMMENTS RELATING TO THE FORM 990 PRIOR TO ITS FILING. FORM 990, PART VI, SECTION B, LINE 12C CONFLICT OF INTEREST POLICY APPOINTMENT OF BOARDS OF DIRECTORS MEDSTAR HEALTH (AND ITS SUBSIDIARIES) REQUIRE ALL NOMINATED DIRECTORS, PRIOR TO THEIR APPOINTMENT OR ELECTION, TO DISCLOSE THE EXISTENCE OF (OR POTENTIAL EXISTENCE OF) ANY TRANSACTION WITH MEDSTAR THAT WOULD RESULT IN A CONFLICT OF INTEREST. SUCH DISCLOSURES (IF ANY) ARE REVIEWED BY THE GOVERNANCE COMMITTEE OF THE MEDSTAR HEALTH BOARD OF DIRECTORS WHICH DETERMINES HOW THE MATTER SHOULD BE RESOLVED. ANNUAL DISCLOSURES - ALL OFFICERS, DIRECTORS, AND SENIOR MANAGERS ALL OFFICERS, DIRECTORS AND SENIOR MANAGERS ARE REQUIRED, NOT LESS THAN ANNUALLY, TO COMPLETE A SURVEY OF QUESTIONS CONCERNING ANY TRANSACTIONS OR RELATIONSHIPS WHICH WOULD OR COULD REPRESENT A CONFLICT OF INTEREST. SUCH DISCLOSURES (IF ANY) RELATED TO DIRECTORS ARE REVIEWED BY THE GOVERNANCE COMMITTEE OF THE MEDSTAR HEALTH BOARD OF DIRECTORS WHICH DETERMINES HOW THE MATTER SHOULD BE RESOLVED. SUCH DISCLOSURES (IF ANY) RELATED TO OFFICERS AND SENIOR MANAGERS ARE REVIEWED BY AN APPROPRIATE EXECUTIVE WHO DETERMINES HOW THE MATTER SHOULD BE RESOLVED IN ADDITION, OFFICERS AND DIRECTORS OF MARYLAND HOSPITALS AND NURSING CENTERS ARE REQUIRED TO ANNUALLY DISCLOSE ADDITIONAL INFORMATION RELATING TO POTENTIAL CONFLICTS OF INTEREST AND SUCH DISCLOSURES ARE REPORTED TO THE MARYLAND HEALTH SERVICES COST REVIEW COMMISSION (HSCRC). FORM 990, PART VI, SECTION B, LINE 15 DESCRIPTION OF EXECUTIVE COMPENSATION PROCESS THE EXECUTIVE COMPENSATION COMMITTEE OF THE BOARD OF DIRECTORS OF MEDSTAR HEALTH, INC. (THE "COMMITTEE") HAS OVERSIGHT OF THE EXECUTIVE COMPENSATION PROGRAM (THE "PROGRAM") OF MEDSTAR HEALTH, INC. AND ITS AFFILIATES. TOTAL COMPENSATION FOR THE TOP MANAGEMENT OFFICIALS, OFFICERS AND KEY EMPLOYEES OF MEDSTAR HEALTH, INC. AND ITS AFFILIATES ARE REVIEWED AND APPROVED BY THE COMMITTEE WITH ASSISTANCE AND GUIDANCE FROM AN INDEPENDENT THIRD PARTY ADVISOR. THE MEMBERS OF THE COMMITTEE ARE INDEPENDENT FROM ALL OF THE PARTICIPANTS IN THE PROGRAM. THE MAIN OBJECTIVE OF THE PROGRAM IS TO PROVIDE MARKET COMPETITIVE TOTAL COMPENSATION THAT IS INTERNALLY EQUITABLE AND HAS A STRONG PAY-FOR-PERFORMANCE LINKAGE. PERFORMANCE IS EVALUATED AT THE SYSTEM, OPERATING UNIT, AND INDIVIDUAL LEVELS. THE OVERALL TOTAL COMPENSATION PHILOSOPHY IS MANAGED AT THE 75TH PERCENTILE OF THE COMPETITIVE MARKET FOR COMPARABLE SIZE (NET REVENUE) AND TYPE (TAX-EXEMPT HEALTHCARE ORGANIZATIONS). WHERE APPROPRIATE, ADDITIONAL INDUSTRY DATA IS CONSIDERED (GENERAL BUSINESS AND/OR TAXABLE HEALTHCARE) FOR SELECTED POSITIONS THAT CAN BE RECRUITED FROM OR POTENTIALLY LOST TO THESE INDUSTRIES (E.G., INFORMATION TECHNOLOGY, FINANCE, ETC.). THE COMMITTEE HAS ENGAGED ERNST & YOUNG LLP ("E&Y") TO SERVE AS AN ADVISOR ON THE REASONABLENESS AND COMPETITIVENESS OF THE PROGRAM. IN DETERMINING REASONABLENESS AND COMPETITIVENESS, E&Y REVIEWS MARKET PRACTICES AND TRENDS, AND MAKES RECOMMENDATIONS RELATED TO THE PROGRAM. E&Y UTILIZES INFORMATION FROM CUSTOM SURVEYS, NATIONAL COMPENSATION SURVEYS, PROPRIETARY DATABASES, AND CLIENT EXPERIENCES TO DETERMINE ITS FINAL RECOMMENDATIONS. E&Y PRESENTS THEIR FINDINGS AND RECOMMENDATIONS TO THE COMMITTEE. THE COMMITTEE MAKES THE FINAL DECISIONS ON ALL OF THE COMPENSATION DETERMINATIONS OF THE PROGRAM. ALL DECISIONS MADE BY THE COMMITTEE ARE CONTEMPORANEOUSLY DOCUMENTED. FORM 990, PART VI, SECTION C, LINE 19 FINANCIAL STATEMENT AVAILABILITY MEDSTAR HEALTH POSTS ITS ANNUAL FINANCIAL AUDIT AND QUARTERLY FINANCIAL REPORTS TO THE ELECTRONIC MUNICIPAL MARKET ACCESS (EMMA) SYSTEM. THE ORGANIZATION ALSO E-MAILS ITS ANNUAL AND QUARTERLY DISCLOSURES TO HOLDERS OF THE COMPANY'S PUBLICLY TRADED DEBT. THE COMPANY'S GOVERNANCE DOCUMENTS AND CONFLICTS OF INTEREST POLICIES ARE AVAILABLE UPON REQUEST THROUGH ITS CORPORATE (OR AS APPLICABLE ENTITY) PUBLIC INFORMATION OFFICES. FORM 990, PART IX, LINE 11G PURCHASED PROFESSIONAL SERVICE: PROGRAM SERVICE EXPENSES 3,608,706. MANAGEMENT AND GENERAL EXPENSES 268,863. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 3,877,569. PHYSICIAN SERVICES: PROGRAM SERVICE EXPENSES 37,109. MANAGEMENT AND GENERAL EXPENSES 216,574. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 253,683. TESTING & DIAGNOSTIC SERVICES: PROGRAM SERVICE EXPENSES 178,131. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 178,131. PHARMACY SERVICES: PROGRAM SERVICE EXPENSES 31,598. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 31,598. LAB SERVICES: PROGRAM SERVICE EXPENSES 507,786. MANAGEMENT AND GENERAL EXPENSES 114,777. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 622,563. SUBSIDY EXPENSE - INTERCOMPANY: PROGRAM SERVICE EXPENSES 25,185,731. MANAGEMENT AND GENERAL EXPENSES 2,295,473. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 27,481,204. NON-PHYS INTERCO PURCH SRVS: PROGRAM SERVICE EXPENSES 5,299,731. MANAGEMENT AND GENERAL EXPENSES 25. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 5,299,756. MISC FIXED PURCH SRVCS: PROGRAM SERVICE EXPENSES 124,510. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 124,510. CONSULTING FEES: PROGRAM SERVICE EXPENSES 163,263. MANAGEMENT AND GENERAL EXPENSES 12,121. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 175,384. MISCELLANEOUS: PROGRAM SERVICE EXPENSES 2,084,930. MANAGEMENT AND GENERAL EXPENSES 61,079. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,146,009. FORM 990, PART XI, LINE 9: EQUITY TRANSFERS - NET ASSETS 58,615,275. O'NEILL EQUITY -14,789,143. FINANCIAL STATEMENTS AND REPORTING PART XII, LINE 2C THE GOOD SAMARITAN HOSPITAL OF MARYLAND, INC. IS AN AFFILIATE OF THE MEDSTAR HEALTH, INC. AUDIT AND SUBJECT TO OVERSIGHT BY THE AUDIT COMMITTEE OF THE MEDSTAR BOARD. 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