2023-05-15T11:04:12-05:00 2022-06-30 PricewaterhouseCoopers LLP 2001 MARKET ST SUITE 1800 PHILADELPHIA PA 19103 990 2021-07-01 520607945 UNION HOSPITAL OF CECIL COUNTY INC % SR VP'S OFFICE UNIO 4103984000 4000 NEXUS DRIVE NW3-100 WILMINGTON DE 19803 ROB MCMURRAY CFO 4103984000 2023-05-10 true ROB MCMURRAY 999009999 ANTONIO C RUSSO P00858539 2673303000 2023-05-09 2 2021 2023-04-26 12:10:37Z X DWIGHT THOMEY 106 BOW STREET ELKTON MD 219215596 188206527 false X WWW.UHCC.COM X 1903 MD TO PROVIDE CHARITABLE HEALTHCARE SERVICES TO THE RESIDENTS OF CECIL COUNTY, MD AND THE SURROUNDING AREA. 12 8 1411 10 2524247 0 4153841 997954 164727118 169542293 6010593 4746882 3115185 2759534 178006737 178046663 0 0 0 0 93664969 115682360 0 0 0 76275445 86433407 169940414 202115767 8066323 -24069104 184996008 171242854 118875001 130401794 66121007 40841060 X UNION HOSPITAL OF CECIL COUNTY, INC.'S MISSION IS TO PROVIDE CHARITABLE HEALTHCARE SERVICES TO THE RESIDENTS OF CECIL COUNTY, MARYLAND; WESTERN NEW CASTLE COUNTY, DELAWARE; AND SOUTHERN CHESTER COUNTY, PENNSYLVANIA. false false 131353878 0 169572493 UNION HOSPITAL OF CECIL COUNTY'S MISSION IS TO PROVIDE QUALITY HEALTH CARE SERVICES TO THE RESIDENTS OF CECIL COUNTY, MARYLAND AND NEIGHBORING COMMUNITIES. SERVICES ARE PROVIDED WITH MODERN TECHNOLOGY AND COMPASSIONATE CARE FROM HEALTH CARE PROFESSIONALS. SERVICES ARE PROVIDED REGARDLESS OF RACE, GENDER, ETHNICITY, AGE, DISABILITY, RELIGION, OR ABILITY TO PAY. ALTHOUGH REIMBURSEMENT FOR SERVICES RENDERED IS VITALLY IMPORTANT TO THE OPERATION, STABILITY, AND VIABILITY OF UNION HOSPITAL OF CECIL COUNTY, IT IS RECOGNIZED THAT NOT ALL MEMBERS OF THE COMMUNITY ARE IN THE FINANCIAL POSITION TO PURCHASE HEALTH CARE SERVICES. FOR ELIGIBLE INDIVIDUALS, UNION HOSPITAL OF CECIL COUNTY OFFERS FREE AND/OR SUBSIDIZED CARE, AS WELL AS ACCESS TO COMMUNITY FINANCIAL ASSISTANCE. DURING THE YEAR, UNION HOSPITAL OF CECIL COUNTY PROVIDED $7,087,606 IN UNCOMPENSATED CARE (CHARITY CARE). IN ADDITION, COMMUNITY BENEFIT ACTIVITIES ARE PROVIDED TO SERVE VULNERABLE POPULATIONS (I.E. MEDICALLY UNDERSERVED, WORKING POOR, HOMELESS). ACTIVITIES ARE CREATED BASED ON COMMUNITY NEED AND ARE PROVIDED IN AN EFFORT TO IMPROVE THE HEALTH OF THE COMMUNITY. COMMUNITY BENEFITS INCLUDE: A) COMMUNITY SUPPORT GROUPS FOR CANCER, DIABETES, STROKE, ALZHEIMER'S, AND BREASTFEEDING; B) HEALTH EDUCATION FOR DIABETES AND NUTRITION, CANCER PREVENTION, STROKE RISK, AND HOW TO CARE FOR SUBSTANCE-EFFECTED NEWBORNS; C) FREE SCREENINGS IN THE COMMUNITY FOR PROSTATE CANCER, HEAD AND NECK CANCER, SKIN CANCER, AND DIABETES (EYES AND FEET); D) PROVIDING MEETING FACILITIES FOR LOCAL NONPROFITS AND AGENCIES E) ENHANCING FOOD SECURITY WITH MEALS ON WHEELS AND FOOD DONATIONS TO HOMELESS SERVING PROVIDERS IN THE COMMUNITY; F) HOSPITAL STAFF PARTICIPATION ON COMMUNITY BOARDS AND COALITIONS, LIKE THE DENTAL HEALTH ADVISORY BOARD, UNITED WAY, VOICES OF HOPE, CECIL COUNTY DRUG-FREE COMMUNITIES COALITION, CORE SERVICE AGENCY MENTAL HEALTH ADVISORY BOARD, DEPARTMENT OF SOCIAL SERVICES BOARD, AND CECIL COUNTY COMMUNITY HEALTH ADVISORY COALITION. UNION HOSPITAL OF CECIL COUNTY SERVICED 4,506 DISCHARGES, PROVIDING 20,868 PATIENT DAYS TO INPATIENTS IN FISCAL YEAR 2021 OF WHICH: 1) PATIENTS COVERED UNDER THE MEDICARE PROGRAM WERE 2,028 DISCHARGES AND 10,451 PATIENT DAYS; 2) PATIENTS COVERED UNDER THE MEDICAID PROGRAM WERE 112 DISCHARGES AND 527 PATIENT DAYS; 3) PATIENTS COVERED UNDER THE MEDICAID HMO PROGRAM WERE 1,456 DISCHARGES AND 5,054 PATIENT DAYS; 4) PATIENTS COVERED UNDER THE MEDICARE HMO PROGRAM WERE 209 DISCHARGES AND 1,219 PATIENT DAYS. 131353878 true true false false false false false false false false true true false true true false false true false false false false false false false false true true false false true true false false false false false false false false false false false false false false false true false false false true X 105 0 1411 true true true false false false false false false false false false false false X 12 8 false false false false true true true true true false false true true true true true true true true false MD X SR VP'S OFFICE 3024282441 4000 NEXUS DRIVE NW3-100 WILMINGTON DE 19803 X KENNETH SILVERSTEIN MD DIRECTOR (THROUGH 12/31/21) 1.0 44.0 X 0 1543930 41860 SHARON T KURFUERST PRES & DIRECTOR (AS OF 1/1/22) 1.0 44.0 X X 0 909862 36778 ROBERT MCMURRAY TREASURER (EX-OFFICIO) 1.0 44.0 X 0 849222 43310 JUSTIN SAUSVILLE MD DIRECTOR 44.0 1.0 X 770969 0 33521 JENNIFER L SCHWARTZ ESQ SECRETARY (EX-OFFICIO) 1.0 44.0 X 0 720571 39853 RICHARD C SZUMEL FORMER OFFICER 0.0 0.0 X 720937 0 1307 ROGER D WU MD PHYSICIAN 45.0 0.0 X 664353 0 31031 FAHD RAHMAN MD PHYSICIAN 45.0 0.0 X 594491 0 32071 NAVEED HASAN MD PHYSICIAN 45.0 0.0 X 563433 0 13871 RYAN GERACIMOS MD CHIEF MEDICAL OFFICER 44.0 1.0 X 540068 0 31839 THEODORA FYNN PHYSICIAN 45.0 0.0 X 461822 0 27938 VINAY K SHARMA PHYSICIAN 45.0 0.0 X 455132 0 23216 JOSE MA MD DIRECTOR 44.0 1.0 X 305661 0 29218 JOAN PIRRUNG MSN APRN ACNS-BC VP PAT. CARE SERVIVES-NURSING 44.0 1.0 X 0 211425 62102 AMY MARSTON CAMPUS OPERATIONS OFFICER 44.0 1.0 X 0 224289 28971 MICHELLE TWUM-DANSO DIRECTOR OF HR - CECIL CAMPUS 45.0 0.0 X 221984 0 17036 ROBERT ASANTE DIRECTOR (AS OF 1/2022) 1.0 44.0 X 0 193924 34931 DERON G BROWN FORMER FINANCE DIRECTOR 44.0 1.0 X 190295 0 12359 CARL ROBERTS PHD DIRECTOR (THROUGH 4/2022) 1.0 1.0 X 0 0 0 CHRISTY DRYER DNP DIRECTOR 1.0 1.0 X 0 0 0 DAVID TROLIO DIRECTOR 1.0 1.0 X 0 0 0 DWIGHT D THOMEY ESQ CHAIR 1.0 3.0 X X 0 0 0 JACQUES RENE DIRECTOR 1.0 1.0 X 0 0 0 LEO NAJERA MD DIRECTOR 1.0 2.0 X 0 0 0 MORGAN MILLER MLIS VICE CHAIR 1.0 1.0 X X 0 0 0 REVEREND R KEVIN BROWN DIRECTOR 1.0 1.0 X 0 0 0 ROBERT PALSGROVE DIRECTOR 1.0 1.0 X 0 0 0 BETTY J CAFFO PHD DIRECTOR (THROUGH 12/31/12) 1.0 1.0 X 0 0 0 5489145 4653223 541212 143 true true false GENERAL HEALTHCARE RESOURCES LLC 2250 HICKORY RD STE 240 PLYMOUTH MEETING PA 19460 PROF. STAFFING SRVCS 10178911 UNION RADIOLOGISTS LLC 106 BOW ST RADIOLOGY OFFICE ELKTON MD 21921 RADIOLOGY SERVICES 3290021 SP CONSULTANTS INC 15 BRAINTREE HILL OFFICE PARK STE BRAINTREE MD 02184 CONSULTING SERVICES 1799673 HOSPITAL RESCUE SERVICES LLC 5234 HARVEY LANE ELLICOTT CITY MD 21043 HEALTHCARE SERVICES 1310760 XANDER HEALTHCARE SERVICES LLC 8670 SPUR LN EASTON MD 21601 HEALTHCARE SERVICES 1101650 61 213953 784001 997954 NET PATIENT SERVICE REVENUE 621990 169242468 169242468 OTHER OPERATING REVENUE 621990 204425 168425 36000 ADULT DAY CARE 623990 95400 95400 169542293 705929 211924 494005 0 0 77584 702 76882 0 76882 76882 14189773 10342 10145182 13980 4044591 -3638 4040953 4040953 0 0 0 0 0 0 0 0 0 LABORATORY REVENUE 621500 2306523 30200 2276323 CAFETERIA/FOOD SERVICE REVENUE 722210 328588 328588 OTHER REVENUE 900009 47541 47541 2682652 178046663 169536493 2524247 4987969 X 0 0 0 0 2156261 2156261 0 0 0 89577752 68812324 20765428 0 4253003 0 4253003 0 13189385 0 13189385 0 6505959 2042412 4463547 0 0 54159 10910 43249 0 306695 0 306695 0 0 0 138341 0 138341 0 32621321 26372704 6248617 0 495985 5218 490767 0 3928033 1794636 2133397 0 3061520 246081 2815439 0 0 4680703 1509698 3171005 0 267769 213791 53978 0 0 100164 61890 38274 0 1750709 0 1750709 0 700000 700000 0 0 3024523 1322599 1701924 0 3267243 554642 2712601 0 MEDICAL SUPPLIES 24598634 22630549 1968085 0 REPAIRS & MAINTENANCE 5903501 2518325 3385176 0 DIETARY 772896 217879 555017 0 DUES & SUBSCRIPTIONS 716209 176304 539905 0 45002 7655 37347 202115767 131353878 70761889 0 X 43902759 30464963 0 0 0 0 12390270 14033313 0 0 0 0 0 0 2985406 2934672 3831631 4305163 184632430 131951575 51986532 52680855 43359783 38403812 11546080 8790042 0 0 0 0 14993547 19630034 184996008 171242854 27438025 63932757 0 0 24763483 5627708 51404224 49121622 0 0 0 0 0 0 0 0 15269269 11719707 118875001 130401794 X 62735295 37254152 3385712 3586908 66121007 40841060 184996008 171242854 X -24069104 -11241110 10030267 X false true X true false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 1134905 1134905 51784014 33342557 18441457 937276 420944 516332 104641447 80802045 23839402 26134788 17386029 8748759 52680855 5209826 C MANAGED HEDGE FUNDS 3580216 F 8790042 OTHER ASSETS 145344 INSURANCE CLAIMS RECOVERABLE 7699685 DUE FROM AFFILIATES 8093468 ROU LEASES 1978141 IN HOUSE LEASES 1713396 19630034 0 CAPITAL LEASE OBLIGATIONS 351019 EST. MEDICAL MALPRACTICE LIABI 9590230 ROU LEASES 1721760 CYBER LIABILITY 56698 11719707 true true X true X true X true true true false true true 1879290 0 1879290 0.00930 1879290 0 1879290 0.00930 861 34982 0 34982 0.00020 72 223781 0 223781 0.00110 22349504 10567749 11781755 0.05830 13668 0 13668 0.00010 16 138549 0 138549 0.00070 949 22760484 10567749 12192735 0.06040 949 24639774 10567749 14072025 0.06970 775 0 775 0.00000 950 0 950 0.00000 1725 0 1725 0.00000 true 6480714 95103 3156507 2569286 587221 X true true 1 1 UNION HOSPITAL OF CECIL COUNTY INC 106 BOW STREET ELKTON MD 21921 WWW.UHCC.COM LICENSE# 07-005 X X X UNION HOSPITAL OF CECIL COUNTY INC 1 false false true X X X X X X X X X 21 true true true true X SEE PART V, SECTION C X SEE PART V, SECTION C X true 22 false SEE PART V, SECTION C false false true X 200. 400. X X X X X X true true X X X X true X SEE PART V, PAGE 8 X SEE PART V, PAGE 8 X SEE PART V, PAGE 8 X X X X X X X true X false X X X X true X false false PART V, SECTION B, LINES 5, 6A & 6B (INPUT FROM COMMUNITY; JOINT CHNA) AT CHRISTIANACARE, WE ARE GUIDED BY THE CHRISTIANACARE WAY: WE SERVE OUR NEIGHBORS AS RESPECTFUL, EXPERT, CARING PARTNERS IN THEIR HEALTH. WE DO THIS BY CREATING INNOVATIVE, EFFECTIVE, AFFORDABLE AND EQUITABLE SYSTEMS OF CARE THAT OUR NEIGHBORS VALUE. TO MEET OUR MISSION, WE MUST PARTNER WITH OUR COMMUNITIES TO MEET THEIR NEEDS EFFECTIVELY. BECAUSE THE CHNA PRESENTS AN OPPORTUNITY TO LEARN DIRECTLY FROM OUR COMMUNITY, IT IS AN ASSESSMENT WE ARE EAGER TO UNDERTAKE TO ENSURE OUR UNDERSTANDING OF OUR COMMUNITY'S CHALLENGES IS ACCURATE. EVERY CHNA UNION HAS COMPLETED HAS BEEN DONE IN PARTNERSHIP WITH THE CECIL COUNTY HEALTH DEPARTMENT. WE ARE GRATEFUL FOR THAT CONTINUED PARTNERSHIP TO COMPLETE THE 2022 CHNA ESPECIALLY AS THIS WAS THE FIRST CHNA UNION HAS COMPLETED AS PART OF CHRISTIANACARE. AS WE WERE PLANNING THE PRIMARY DATA COLLECTION FOR THE 2022 CHNA, HIGH COMMUNITY TRANSMISSION OF COVID-19 REQUIRED US TO HOST VIRTUAL COMMUNITY MEETINGS TO RECEIVE COMMUNITY INPUT. OUR PREFERRED FORMAT WOULD HAVE BEEN IN-PERSON MEETINGS AT ACCESSIBLE COMMUNITY LOCATIONS, BUT COMMUNITY SAFETY BECAME THE MOST IMPORTANT CONSIDERATION. WE HELD FOUR VIRTUAL MEETINGS WITH THE PARTICIPATION OF 43 COMMUNITY STAKEHOLDERS WHO REPRESENTED THE CECIL COUNTY HEALTH DEPARTMENT AND OTHER GOVERNMENT AGENCIES, NON-PROFIT ORGANIZATIONS, LOCAL BUSINESSES, HEALTH CARE PROVIDERS, AND THE SCHOOL SYSTEM. WE WERE ALSO ABLE TO MEET WITH FOUR TEENAGERS PARTICIPATING IN THE CECIL COUNTY PUBLIC LIBRARY'S YOUTH ADVISORY COUNCIL. IT WAS IMPORTANT TO US TO INCLUDE THE VOICES OF YOUTH AS THEY TOO ARE A PART OF THE COMMUNITY WE SERVE AND MAY HAVE DIFFERENT PERSPECTIVES THAN THOSE OF THE ADULTS. FINALLY, WE ALSO HELD A VIRTUAL MEETING WITH THE PARTICIPATION OF 16 UNION CAREGIVERS REPRESENTING ADMINISTRATION, NURSING, CASE MANAGEMENT, SOCIAL SERVICES, AND PROJECT MANAGEMENT. THIS MEETING WAS HELD TO GAIN THEIR PERSPECTIVE ON THE COMMUNITY'S MOST SIGNIFICANT CHALLENGES AS WELL AS PROVIDE THEM WITH INSIGHT INTO THE COMMUNITY. EACH MEETING FOLLOWED THE SAME FORMAT. THE CHNA PROCESS AND THE PURPOSE OF THE MEETING WAS EXPLAINED. SECONDARY DATA WERE THEN PRESENTED INCLUDING A SUMMARY OF UNFAVORABLE COMMUNITY HEALTH INDICATORS. MEETING PARTICIPANTS WERE ASKED FOR FEEDBACK ON THE SECONDARY DATA ANALYSIS AND TO IDENTIFY COMMUNITY HEALTH ISSUES THAT MAY NOT HAVE BEEN FOUND BASED ON THE DATA. TO CONCLUDE, PARTICIPANTS WERE ASKED TO COMPLETE AN ONLINE SURVEY AND TO IDENTIFY THREE TO FIVE COMMUNITY HEALTH ISSUES THEY CONSIDER TO BE MOST SIGNIFICANT. AN ONLINE COMMUNITY HEALTH SURVEY WAS ALSO CONDUCTED DURING FEBRUARY AND MARCH OF 2022. THE SURVEY WAS COMPRISED OF TWENTY QUESTIONS ON THE FOLLOWING TOPICS: DEMOGRAPHICS, COMMUNITY HEALTH, QUALITY OF LIFE, AND ACCESS TO HEALTH CARE SERVICES. 544 PARTICIPANTS COMPLETED THE SURVEY. 64% OF THE SURVEY RESPONDENTS WERE FROM NORTH EAST AND ELKTON AND NEARLY 87% OF THE RESPONDENTS WERE FEMALE. FINALLY, SEVEN KEY STAKEHOLDERS WERE INTERVIEWED TO LEARN ABOUT COMMUNITY HEALTH ISSUES. THE PARTICIPANTS WERE HEALTH OFFICERS FROM THE CECIL COUNTY HEALTH DEPARTMENT AND ADMINISTRATIVE AND CLINICAL STAFF FROM WEST CECIL HEALTH CENTER, A LOCAL FEDERALLY QUALIFIED HEALTH CENTER. THE PARTICIPANTS WERE ASKED TO FIRST IDENTIFY AND DISCUSS COMMUNITY HEALTH ISSUES PRIOR TO THE COVID-19 PANDEMIC, AND THEN DESCRIBE THE PANDEMIC'S IMPACTS ON THE COMMUNITY AND WHAT HAS BEEN LEARNED ABOUT THE COMMUNITY'S HEALTH GIVEN THOSE IMPACTS. STAKEHOLDERS ALSO WERE ASKED TO DESCRIBE THE TYPES OF INITIATIVES, PROGRAMS, AND INVESTMENTS THAT SHOULD BE IMPLEMENTED TO ADDRESS THE COMMUNITY'S HEALTH ISSUES AND TO BE BETTER PREPARED FOR FUTURE RISKS. CHRISTIANACARE CONTRACTED WITH VERIT HEALTHCARE CONSULTING, LLC (VERITE) TO COMPLETE ITS 2022 CHNA. IN COOPERATION WITH CHRISTIANACARE'S OFFICE OF HEALTH EQUITY AND THE CECIL COUNTY HEALTH DEPARTMENT, VERIT CONDUCTED THE RESEARCH, PRIMARY AND SECONDARY DATA COLLECTION, REVIEW, AND ANALYSIS, TO DEVELOP THE CHNA. --------------- SCHEDULE H, PART V, SECTION B, LINE 7A & B (CHNA AVAILABILITY) UNION HOSPITAL OF CECIL COUNTY, INC.'S CHNA IS AVAILABLE ON ITS WEBSITE AT: HTTPS://WWW.UHCC.COM/ABOUT-US/COMMUNITY-BENEFIT/REPORTS/ UNION HOSPITAL OF CECIL COUNTY, INC.'S CHNA IS ALSO AVAILABLE AT: HTTPS://CECILCOUNTYHEALTH.ORG/RESOURCES/HEALTH-ADVISORY-COMMITTEE/ --------------- SCHEDULE H, PART V, SECTION B, LINE 10 (IMP. STRATEGY PUBLIC AVAILABILITY) UNION HOSPITAL OF CECIL COUNTY, INC.'S CHIP IS AVAILABLE ON ITS WEBSITE AT: HTTP://WWW.UHCC.COM/ABOUT-US/COMMUNITY-BENEFIT/REPORTS/ --------------- SCHEDULE H, PART V, SECTION B, LINE 11 (ADDRESSING NEEDS FROM THE CHNA) UNION'S 2022 CHNA IDENTIFIED THE FOLLOWING AS SIGNIFICANT AREAS OF NEED IN CECIL COUNTY: - ACCESS TO HEALTH SERVICES - CANCER - CHILDHOOD TRAUMA/ADVERSE CHILDHOOD EXPERIENCES (ACE) - LGBTQIA+ HEALTH DISPARITIES - MENTAL HEALTH - NUTRITION, OBESITY, AND PHYSICAL INACTIVITY - SMOKING, TOBACCO, AND VAPE PRODUCT USE - SUBSTANCE USE DISORDERS OF THESE SIGNIFICANT NEEDS, UNION PRIORITIZED: - ACCESS TO HEALTH SERVICES - CANCER - LGBTQIA+ HEALTH DISPARITIES - SUBSTANCE USE DISORDERS SELECTION FOR PRIORITIZATION WAS BASED ON RESOURCE AVAILABILITY AND PROGRAMMING UNDERWAY OR PLANNED. UNION DOES ADDRESS ALL THE SIGNIFICANT AREAS OF NEED, BUT DID NOT PRIORITIZE THE FOLLOWING AREAS OF NEED: - CHILDHOOD TRAUMA/ADVERSE CHILDHOOD EXPERIENCES (ACE) - MENTAL HEALTH - NUTRITION, OBESITY, AND PHYSICAL INACTIVITY - SMOKING, TOBACCO, AND VAPE PRODUCT USE THESE WERE NOT PRIORITIZED BECAUSE WE WERE UNABLE TO CREATE NEW OR EXPANDED COMMUNITY BENEFIT PROGRAMMING IN THOSE AREAS. IF OPPORTUNITIES TO ADDRESS THESE AREAS OF NEED ARISE, PARTICULARLY THROUGH COMMUNITY PARTNERSHIPS, THEIR IDENTIFICATION AS SIGNIFICANT AREAS OF NEED WILL BE CONSIDERED. ACCESS TO HEALTH SERVICES CECIL COUNTY HAS A LOW PER-CAPITA SUPPLY OF PRIMARY CARE, DENTAL HEALTH, AND MENTAL HEALTH PROFESSIONALS COMPARED TO NATIONAL AVERAGES, WHICH CREATES SIGNIFICANT BARRIERS TO CARE. LIKE HOSPITALS ACROSS THE COUNTRY, PARTICULARLY RURAL ONES, UNION HAS EXPERIENCED CHALLENGES RECRUITING AND RETAINING PROVIDERS. CHRISTIANACARE IS RESPONDING WITH A DIVERSITY OF RECRUITMENT EFFORTS THAT INCLUDE DEDICATED RECRUITERS, PARTICIPATION IN CAREER EVENTS AND ADVERTISING, AND THE UTILIZATION OF CONTINGENCY AND RETAINED SEARCH FIRMS WHEN NECESSARY. THESE EFFORTS WILL BE ONGOING AS WE SEEK TO RECRUIT PROVIDERS. HAVING MORE PROVIDERS TO MEET THE COMMUNITY NEED WILL NOT OVERCOME ALL BARRIERS TO CARE. LACK OF TRANSPORTATION PRESENTS AN ISSUE FOR MANY OF OUR CECIL COUNTY NEIGHBORS. WE ARE ADDRESSING THIS ISSUE ON A SMALL SCALE THROUGH UNION'S CARE TRANSFORMATION INITIATIVE (CTI) WHICH LAUNCHED ON JULY 1, 2021. UNION'S CTI, TRANSITIONS OF CARE, CHRONIC DISEASE NAVIGATION PROGRAM SERVES ADULT MEDICARE FFS BENEFICIARIES WITH A PRIMARY OR SECONDARY DIAGNOSIS OF HEART FAILURE, CHRONIC OBSTRUCTIVE PULMONARY DISEASE (COPD), DIABETES, AND RESPIRATORY FAILURE WHO WERE ADMITTED TO UNION AS AN INPATIENT OR FOR OBSERVATION. FOR 180 DAYS POST DISCHARGE, THESE PATIENTS RECEIVE A CARE TEAM APPROACH AND INTERACTIVE PATIENT TOOLS TO PREVENT READMISSION. WE EXPECT THIS INITIATIVE TO PROVIDE COST SAVINGS AND IMPROVE THE HEALTH OF THE PATIENTS. AFTER LAUNCH, WE RECOGNIZED THAT AN IMPEDIMENT TO PATIENT PARTICIPATION FOR SOME WAS LACK OF TRANSPORTATION. THESE PATIENTS DID NOT HAVE RELIABLE TRANSPORTATION TO GET TO APPOINTMENTS, AND THEY ALSO DID NOT HAVE THE RESOURCES TO PARTICIPATE IN VIRTUAL VISITS THAT WOULD HAVE RESOLVED THE TRANSPORTATION BARRIER. TO ADDRESS THIS BARRIER, THE CARE TEAM BEGAN USING ROUNDTRIP FOR THIS PATIENT POPULATION. ROUNDTRIP IS A COMPANY THAT PROVIDES A DIGITAL TRANSPORTATION MARKETPLACE TO CONNECT PATIENTS FACING TRANSPORTATION BARRIERS WITH NON-EMERGENCY MEDICAL TRANSPORTATION. CHRISTIANACARE HAS BEEN PARTNERED WITH ROUNDTRIP SINCE 2019 TO PROVIDE FREE TRANSPORTATION TO ELIGIBLE PATIENTS IN DELAWARE WITH TRANSPORTATION BARRIERS TO RECEIVE MEDICAL SERVICES. THE CTI IS THE FIRST UNION PROGRAM TO UTILIZE ROUNDTRIP. IN FY2022, 19 RIDES THROUGH ROUNDTRIP WERE PROVIDED TO HELP CTI PATIENT PARTICIPANTS RECEIVE MEDICAL SERVICES. WE ARE EXPLORING THE FEASIBILITY OF IMPLEMENTING ROUNDTRIP IN OTHER AREAS OF THE HOSPITAL. FOR YEARS, UNION HAS ALSO PROVIDED TRANSPORTATION TO INPATIENTS AT DISCHARGE WHO HAD NO TRANSPORTATION HOME. IN FY2022, UNION PAID $11,244 TO TRANSPORT PATIENTS HOME IN TAXIS. THE CECIL COUNTY HEALTH DEPARTMENT (CCHD) HAS ALSO PRIORITIZED ACCESS TO HEALTH SERVICES IN THEIR IMPLEMENTATION PLAN WHICH WILL PROVIDE THE OPPORTUNITY TO COLLABORATE IN THIS AREA. IN JANUARY 2023, UNION CAREGIVERS, PARTICIPATED IN THE CCHD'S ACCESS TO HEALTH SERVICES WORKING GROUP TO IDENTIFY GOALS, OBJECTIVES, AND STRATEGIES TO ADDRESS ACCESS ISSUES WITHIN CECIL COUNTY. THE GROUP AGREED ON THE GOALS OF INCREASING ACCESS TO BEHAVIORAL HEALTH SERVICES, DIABETES PREVENTION AND MANAGEMENT SERVICES, AND CANCER SCREENING SERVICES ALONG WITH INCREASING ACCESS TO TRANSPORTATION SERVICES FOR MEDICAL SERVICES. OUR PARTICIPATION IN THIS COLLABORATIVE EFFORT WILL BE ONGOING. UNION'S CHILDBIRTH AND EARLY EDUCATION TEAM AND PEDIATRIC NURSES HAVE LONG BEEN RESPONSIVE TO OUR COMMUNITY'S NEED FOR CHILDBIRTH AND INFANT CARE EDUCATION. SIGNIFICANTLY, THIS EDUCATION IS PROVIDED IN RESPONSE TO REQUESTS FROM THE COMMUNITY AND IN PARTNERSHIP WITH OTHER COMMUNITY ORGANIZATIONS. EDUCATION IS PRIMARILY PROVIDED IN THE COMMUNITY WHERE IT IS REQUESTED. FY2022 WAS A BUSY YEAR FOR THESE TEAMS. AS WILL BE DESCRIBED IN MORE DETAIL IN THE SECTION THAT DESCRIBES OUR EFFORTS ADDRESSING SUBSTANCE USE DISORDER, UNION CAREGIVERS PROVIDE MONTHLY EDUCATION TO PREGNANT WOMEN RECEIVING SUBSTANCE USE DISORDER TREATMENT AT A TREATMENT FACILITY IN ELKTON. BEGINNING IN JUNE 2022, A UNION LACTATION CONSULTANT PROVIDED BI-WEEKLY BREASTFEEDING EDUCATION SESSIONS AT THE HERITAGE PREGNANCY CENTER IN RISING SUN. IN ANOTHER EXAMPLE OF COMMUNITY PARTNERSHIP, THE CCHD ALSO REQUESTED OUR LACTATION CONSULTANT PROVIDE BREASTFEEDING EDUCATION TO A MOM-TO-BE GROUP ALSO HELD AT THE HERITAGE PREGNANCY CENTER IN RISING SUN. IN THE FALL OF 2022, A NEW OPPORTUNITY AROSE TO SERVE WOMEN WHOSE CHILDREN ARE ATTENDING A HEAD START PROGRAM AT HOLLINGSWORTH MANOR IN ELKTON. OUR CHILDBIRTH AND EARLY EDUCATION TEAM RECEIVED A REQUEST TO PROVIDE A WEEKLY GROUP THAT WOULD BE FOCUSED NOT JUST ON CARING FOR YOUNG CHILDREN, BUT ON WOMEN'S OVERALL HEALTH. A UNION CAREGIVER SPENT TIME WITH THE STAFF OF THE HEAD START PROGRAM TO THINK OF ENGAGEMENT STRATEGIES TO PROMOTE THE IDEA THAT A PARENT'S GOOD HEALTH WOULD NOT ONLY BE GOOD FOR THEM, BUT ALSO HAVE A POSITIVE IMPACT ON THEIR CHILDREN. WE EXPECT TO KEEP WORKING WITH THIS GROUP TO FIGURE OUT WAYS TO ENGAGE THESE MOTHERS. HEAD START PROGRAMS SERVE FAMILIES WHOSE INCOMES ARE AT OR BELOW THE FEDERAL POVERTY GUIDELINES OR WHO PARTICIPATE IN TEMPORARY ASSISTANCE FOR NEEDY FAMILIES. PROVIDING CONVENIENT ACCESS TO EDUCATION THAT WOULD BE HELPFUL TO THE HEALTH AND WELLNESS OF THESE FAMILIES IS WHAT WE HOPE TO ACCOMPLISH. LAST YEAR, A HIGH SCHOOL IN CECIL COUNTY HAD A NOTABLE NUMBER OF PREGNANT STUDENTS DURING THE SCHOOL YEAR. STAFF AT THE HIGH SCHOOL REQUESTED THAT UNION PROVIDE THESE STUDENTS WITH CHILDBIRTH AND INFANT CARE EDUCATION. TO DO THIS, OUR TEAM HAD TO RECEIVE APPROVAL FROM THE SCHOOL BOARD TO PROVIDE THIS EDUCATION, AND ONCE APPROVED, THE EDUCATION SESSIONS HAD TO BE DESIGNED TO MEET THE NEEDS OF TEENAGE MOTHERS. ONCE THE APPROVAL PROCESS WAS COMPLETE, UNION CAREGIVERS WERE ABLE TO PROVIDE FOUR EDUCATION SESSIONS AT THE SCHOOL BEFORE THE SUMMER BREAK. THE YOUNG MOTHERS, MANY OF WHOM WENT ON TO DELIVER AT UNION, SHARED THAT WHAT THEY LEARNED PREPARED THEM AND HELPED DECREASE THEIR FEAR. FINALLY, UNION HAS HELD A FREE SPORTS PHYSICAL EVENT FOR CECIL COUNTY STUDENTS FOR OVER 15 YEARS. EACH YEAR THESE PHYSICALS ARE REQUESTED BY CECIL COUNTY PUBLIC SCHOOL ATHLETIC ADMINISTRATION. GIVEN THE PROVIDER SHORTAGE IN CECIL COUNTY, THIS YEAR'S EVENT WAS SIGNIFICANT IN ENSURING STUDENTS WERE PROVIDED WITH THE PHYSICALS THAT WERE REQUIRED TO PARTICIPATE IN SCHOOL SPORTS AND ALSO PROVIDED RELIEF TO MEDICAL PRACTICES IN CECIL COUNTY. ON JUNE 8, 2022, IN PARTNERSHIP WITH ATI PHYSICAL THERAPY AND THE CECIL COUNTY PUBLIC SCHOOLS, 530 STUDENTS WERE ABLE TO COMPLETE THEIR PHYSICALS. CANCER WHILE SOME IMPROVEMENTS HAVE BEEN MADE, CANCER RATES IN CECIL COUNTY REMAIN ABOVE THE MARYLAND AND UNITED STATES AVERAGES. THE MORTALITY RATE FOR LUNG AND BRONCHUS CANCER IN CECIL COUNTY HAS BEEN CONSIDERABLY ABOVE THE UNITED STATES AVERAGE AT 87.1 PER 100,000 IN COMPARISON TO 57.3 PER 100,000. TO ADDRESS THIS HIGH MORTALITY RATE, UNION CAREGIVERS HAVE BEEN WORKING TO PROMOTE ANNUAL LOW DOSE COMPUTED TOMOGRAPHY (LDCT) SCREENING TO ADULTS AGED 50 TO 80 YEARS OLD, WHO HAVE A 20 PACK A YEAR SMOKING HISTORY AND CURRENTLY SMOKE OR HAVE QUIT WITHIN THE PAST YEAR. PROMOTING THE LDCT SCREENING WAS ALSO AN OBJECTIVE OF UNION'S 2019 CHIP. A NEW ASPECT TO THIS PROMOTION IS TO CONSIDER THE PROVIDER, AS WELL AS PATIENT, PERSPECTIVE ON SCREENING BARRIERS. AFTER NOTICING MORE PATIENTS PRESENT TO UNION'S CANCER PROGRAM FOR THE FIRST TIME WITH LATE-STAGE LUNG CANCER, UNION CAREGIVERS, LED BY NURSE MANAGER SHEELAGH STEWART, WHO ALSO SERVES AS THE CHAIR OF THE CECIL COUNTY CANCER TASK FORCE, UNDERTOOK A RESEARCH INITIATIVE TO ATTEMPT TO GAIN AN UNDERSTANDING OF THE BARRIERS TO SCREENING. IN JULY AND AUGUST OF 2022, CAREGIVERS REVIEWED PATIENT RECORDS OF THOSE WHO WERE DIAGNOSED WITH LUNG CANCER TO SEE THE STAGE OF LUNG CANCER PRESENT AT DIAGNOSIS AND IF THE PATIENT HAD HAD AN LDCT SCREENING OR HAD RECE SCHEDULE H, PART V, SECTION B, LINE 11 (ADDRESSING NEEDS FROM THE CHNA) (CONT.) JUST AS UNION AND THE CECIL COUNTY HEALTH DEPARTMENT BOTH IDENTIFIED ACCESS TO CARE AS A PRIORITIZED NEED, CANCER IS ANOTHER AREA OF NEED THAT WAS ALSO PRIORITIZED BY BOTH. WE WILL CONTINUE TO WORK TOGETHER TO PROMOTE LDCT SCREENS THROUGH THE CANCER TASK FORCE. IN 2022, UNION PERFORMED 340 LDCT SCREENS AT ITS THREE IMAGING LOCATIONS. THIS IS A SIGNIFICANT INCREASE FROM THE NUMBER OF LDCT SCREENED PROVIDED IN PRIOR YEARS: - 2019: 306 INDIVIDUALS SCREENED - 2020: 256 INDIVIDUALS SCREENED - 2021: 287 INDIVIDUALS SCREENED - 2022: 340 INDIVIDUALS SCREENED IN FY2022, THE CORONAVIRUS PANDEMIC CONTINUED TO DISRUPT OUR USUAL PARTICIPATION IN HEALTH FAIRS AND OTHER COMMUNITY EVENTS AS WELL AS OUR CANCER SUPPORT GROUP. IN FY2022, OUR CAREGIVERS PROVIDED EDUCATION AT 3 COMMUNITY EVENTS. WE EXPECT MORE COMMUNITY EVENT PARTICIPATION THIS YEAR. CAREGIVERS HAVE ALREADY PROVIDED BREAST CANCER SCREENING EDUCATION AT PLEASANT VIEW BAPTIST CHURCH IN PORT DEPOSIT IN AUGUST, AND GENERAL CANCER PREVENTION INFORMATION AT THE ELKTON SENIOR CENTER IN NOVEMBER. THE COPING WITH CANCER SUPPORT GROUP RESUMED WEEKLY MEETINGS IN JULY 2022. UNION PARTNERED WITH CECIL COUNTY PUBLIC SCHOOLS FOR THE SECOND YEAR TO PROMOTE EDUCATOR MAMMOGRAMS. EMPLOYEES OF THE PUBLIC SCHOOL SYSTEM WERE ENCOURAGED TO SCHEDULE A MAMMOGRAM ON CERTAIN DAYS AT UNION. THIS PROMOTION WAS HELD ON AUGUST 31, 2021 AND DUE TO INCREASED RESPONSE WAS AGAIN HELD ON JULY 13, 2022 AND AUGUST 23RD AND 31ST, 2022. LGBTQIA+ HEALTH DISPARITIES IN THE 2022 CHNA, WE LEARNED THAT LESBIAN, GAY, TRANSGENDER, QUEER/QUESTIONING, INTERSEX AND ASEXUAL, ETC. (LGBTQIA+) YOUTH ARE MORE THAN TWICE AS LIKELY TO BE BULLIED AND THREATENED WITH A WEAPON ON SCHOOL PROPERTY COMPARED TO YOUTH WHO IDENTIFY AS STRAIGHT. THESE YOUTH ARE ALSO MORE LIKELY TO ENGAGE IN HIGH-RISK BEHAVIORS SUCH AS TOBACCO, ALCOHOL, AND OTHER DRUG USE AND TO REPORT SIGNIFICANTLY LOWER RATES OF PHYSICAL ACTIVITY. IN THE 2022 CHNA, THE STAKEHOLDERS INTERVIEWED ALSO IDENTIFIED AS SIGNIFICANT THE DISCRIMINATION IN HEALTHCARE FACED BY THE LGBTQIA+ COMMUNITY, WHICH LEADS TO AVOIDING HEALTH CARE SERVICES. GIVEN THE LIKELIHOOD OF POOR HEALTH OUTCOMES FOR THIS POPULATION AND OUR COMMITMENT TO PROVIDING A WELCOMING AND INCLUSIVE ENVIRONMENT IN ALL OUR CHRISTIANACARE LOCATIONS, WE MADE THE DECISION TO PRIORITIZE THIS AREA OF NEED. THROUGHOUT THE YEAR, A SMALL GROUP OF UNION CAREGIVERS HAVE BEEN PROMOTING GENDER INCLUSIVENESS TO OTHER CAREGIVERS, PATIENTS, AND VISITORS BY PROVIDING EDUCATION THROUGH ACTIVITIES LIKE PASSING OUT PRONOUN PINS IN THE HOSPITAL LOBBY AND INPATIENT FLOORS. IN A SMALL COMMUNITY, UNION'S ACTIONS TO RAISE AWARENESS AND UNDERSTANDING CAN HAVE A SIGNIFICANT IMPACT AS WE STRIVE TO BETTER SERVE EVERYONE IN OUR COMMUNITY. CHRISTIANACARE'S OFFICE OF HEALTH EQUITY CREATED A PRIDE AMBASSADORS PROGRAM WHICH OFFERS SIX HOURS OF INSTRUCTION INCLUDING EXPLORATION OF LGBTQIA+ HEALTH TOPICS AS THEY RELATE TO CREATING MORE EQUITABLE HEALTHCARE FOR OUR LGBTQIA+ PATIENTS AND FAMILIES. AFTER A SESSION LAST JULY, THE FIRST COHORT OF UNION CAREGIVERS BECAME PRIDE AMBASSADORS. THESE CAREGIVERS WILL BE ABLE TO USE THAT KNOWLEDGE TO BETTER SERVE THEIR PATIENTS AND ACT AS AMBASSADORS FOR THEIR COLLEAGUES BY SHARING WHAT THEY LEARNED. WE ARE CURRENTLY IN THE PROCESS OF PROMOTING AND SCHEDULING THE NEXT PRIDE AMBASSADORS SESSION FOR UNION CAREGIVERS. WE ARE GOING TO OPEN IT UP TO OTHER CECIL COUNTY PROVIDERS AS WELL TO ENSURE THESE PROVIDERS ALSO HAVE ACCESS TO THE KNOWLEDGE AND TOOLS TO BEST SERVE THE LGBTQIA+ POPULATION OF CECIL COUNTY. SUBSTANCE USE DISORDERS SUBSTANCE USE DISORDER HAS BEEN AN INTRACTABLE ISSUE IN CECIL COUNTY AND UNION IS WORKING TO ADDRESS IT WITH COMMUNITY PARTNERS. UNION HAS PARTNERED WITH CECIL COUNTY HEALTH DEPARTMENT'S ALCOHOL & DRUG RECOVERY CENTER TO HAVE A DESIGNATED PEER RECOVERY SPECIALIST AVAILABLE FOR REFERRALS ON BEHALF OF UNION PATIENTS. CAREGIVERS WILL CONTACT THE PEER RECOVERY SPECIALIST ON BEHALF OF THE PATIENT IF THEY EXPRESS AN INTEREST IN SPEAKING WITH THEM OR AN INTEREST IN TREATMENT. IF AVAILABLE, THE PEER RECOVERY SPECIALIST CAN COME TO THE HOSPITAL TO MEET WITH THE PATIENT OR FOLLOW UP WITH THEM IN THE COMMUNITY WITH THE BASIC DEMOGRAPHIC AND CONTACT INFORMATION PROVIDED BY THE CAREGIVER. WHEN A PATIENT EXPRESSES AN INTEREST IN RECOVERY OUTSIDE OF REGULAR BUSINESS HOURS, THE CAREGIVER WILL ENCOURAGE THEM TO CALL CATCH (CECIL ADDICTION TREATMENT COORDINATION HOTLINE) WHICH IS AVAILABLE 24 HOURS-A-DAY, 7 DAYS-A-WEEK. IN FY2022, 184 REFERRALS WERE MADE TO THE PEER RECOVERY SPECIALIST. FOR SEVERAL YEARS, UNION CAREGIVERS HAVE PROVIDED CHILDBIRTH AND INFANT EDUCATION TO PREGNANT WOMEN RECEIVING SUBSTANCE USE DISORDER TREATMENT AT SERENITY HEALTH ELKTON. A REGISTERED NURSE GOES TO SERENITY HEALTH TO PROVIDE MONTHLY EDUCATIONAL SESSIONS ON TOPICS SUCH AS BREASTFEEDING, NEONATAL ABSTINENCE SYNDROME (NAS), AND SAFE SLEEP, AMONG OTHERS. UNION SOCIAL WORKERS ALSO ATTEND SOME OF THE SESSIONS WITH THE REGISTERED NURSES TO PROVIDE INFORMATION ON TOPICS LIKE CHILD PROTECTIVE SERVICES AND ANSWER QUESTIONS ON ACCESSING SOCIAL SERVICES. IN FY2022, TEN EDUCATION SESSIONS WERE HELD AT SERENITY HEALTH ELKTON WITH 2 TO 5 PREGNANT PARTICIPANTS IN EACH COURSE. THE REGISTERED NURSES SPENT 19.5 HOURS PROVIDING THESE SESSIONS AND TWO SOCIAL WORKERS SPENT 6 HOURS WITH THE PARTICIPANTS. IT IS IMPORTANT TO PROVIDE THESE MOTHERS WITH THE EDUCATION TO EMPOWER THEM TO TAKE THE BEST CARE OF THEIR BABY. HAVING A SUBSTANCE USE DISORDER WHILE PREGNANT CAN BE ISOLATING BECAUSE OF THE SHAME THE EXPECTANT MOTHER MAY FEEL. CAREGIVERS WORK TO MAKE SURE THESE EXPECTANT MOTHERS KNOW THAT THEY CAN TAKE GOOD CARE OF THEIR CHILDREN JUST LIKE ANY OTHER MOTHER. IN SEPTEMBER 2022, UNION PARTNERED WITH THE CECIL COUNTY HEALTH DEPARTMENT TO PARTICIPATE IN THE OVERDOSE RESPONSE PROGRAM TO BEGIN DISTRIBUTING NALOXONE IN THE EMERGENCY DEPARTMENT. THE NALOXONE KITS ARE PROVIDED BY THE CECIL COUNTY HEALTH DEPARTMENT AND ALONG WITH THE MEDICATION, HAVE RESOURCE INFORMATION TO ENSURE THE INDIVIDUAL KNOWS HOW TO ACCESS THE HELP AVAILABLE TO SUPPORT THEIR RECOVERY. THE NURSE MANAGERS DISTRIBUTING THE NALOXONE KITS ALSO TRAIN THE INDIVIDUALS RECEIVING THE KIT ON ITS USE. THESE KITS ARE PROVIDED TO PATIENTS, THEIR FAMILY AND FRIENDS, AND ANY INDIVIDUAL WHO MAY HAVE CAUSE TO USE NALOXONE. IN AUGUST 2022, UNION ALSO BEGAN PROVIDING MEDICATION ASSISTED TREATMENT (MAT) INDUCTIONS WITHIN THE EMERGENCY DEPARTMENT. MAT IS THE USE OF MEDICATIONS ALONG WITH COUNSELING AND BEHAVIORAL HEALTH THERAPIES TO TREAT SUBSTANCE USE DISORDER. MAT INDUCTION IS A MEDICAL INTERVENTION THAT CAN BEGIN IN THE HOSPITAL AND BE SUSTAINED BY OUTPATIENT PROVIDERS IN THE COMMUNITY. WHILE MAT INDUCTIONS ARE NOT YET ROUTINELY OFFERED IN EMERGENCY DEPARTMENTS, UNION MADE THE DECISION TO PROVIDE THIS SERVICE BECAUSE OF THE COMMUNITY NEED AND OUR STRONG COMMUNITY PARTNERSHIPS THAT PROVIDE US WITH THE ASSURANCE THAT THE PATIENTS' MAT WILL CONTINUE. WE ARE PARTNERING CLOSELY WITH CECIL COUNTY HEALTH DEPARTMENT'S ALCOHOL & DRUG RECOVERY CENTER TO ENSURE THE PATIENT HAS A PLAN FOR CONTINUED MAT IN THE COMMUNITY. THOSE WHO WANT TO BE INDUCTED AT THE HOSPITAL CAN WORK WITH THE UNION ASSIGNED PEER RECOVERY SPECIALIST DURING BUSINESS HOURS OR CALL THE 24/7 CATCH HOTLINE IN THE EVENINGS AND WEEKENDS TO RECEIVE SUPPORT IN CONTINUING THEIR TREATMENT. ON BEHALF OF UNION, A REGISTERED NURSE ALSO ATTENDS MONTHLY LOCAL OVERDOSE FATALITY REVIEW TEAMS (LORFT) MEETINGS TO DISCUSS AND CONDUCT A CASE REVIEW OF ALL UNINTENTIONAL OVERDOSE DEATHS RELATED TO STREET DRUGS AND ALCOHOL IN CECIL COUNTY. MEMBERS ARE STAKEHOLDERS FROM LAW ENFORCEMENT, THE COMMUNITY, GOVERNMENT AGENCIES, AND PROVIDERS. WHILE NOT IDENTIFIED AS A SIGNIFICANT AREA OF NEED, EACH AREA OF NEED IS EXACERBATED, IF NOT CAUSED BY, SOCIAL DETERMINANTS OF HEALTH (SDOH). CHRISTIANACARE HAS UNDERTAKEN SEVERAL INITIATIVES TO ADDRESS SDOH THAT ARE BEING IMPLEMENTED AT UNION. CHRISTIANACARE DESIGNED AND IMPLEMENTED AN SDOH SCREENING INSTRUMENT TO BE ADMINISTERED TO PATIENTS. TO IMPROVE THE FACILITATION OF THE SDOH SCREENING INSTRUMENT, PATIENT SELF-ADMINISTRATION OF THE SDOH SCREENING INSTRUMENT WAS RECENTLY INTRODUCED AT OUR DELAWARE LOCATIONS. ALLOWING PATIENTS TO COMPLETE THE SCREENING ON THEIR OWN WILL INCREASE THE NUMBER OF SDOH SCREENS COMPLETED, IMPROVE EFFICIENCY, AND PROVIDE A BETTER PATIENT EXPERIENCE, AS PATIENTS MAY FEEL MORE COMFORTABLE ENTERING ANSWERS TO QUESTIONS THAT CAN FEEL INVASIVE. UNION IS NEAR THE END OF THE PROCESS OF INTEGRATING WITH CHRISTIANACARE'S ELECTRONIC HEALTH RECORD. THIS WAS COMPLETED IN MARCH 2023, AND UNION CAREGIVERS NOW HAVE ACCESS TO THE SDOH SCREENING INSTRUMENT. WITH THIS TOOL, A BETTER UNDERSTANDING OF THE CHALLENGES FACED BY UNION PATIENTS AND THE COMMUNITY WILL BE GAINED. IMPORTANTLY, WE WOULD NOT WANT TO ASK THESE QUESTIONS IF THERE WAS NO ABILITY TO ADDRESS THE ISSUES THE PATIENTS REVEAL. OUR UNION CAREGIVERS ARE ALREADY SCHEDULE H, PART V, SECTION B, LINE 13B (DETAIL OF INCOME LEVEL) PATIENTS WITH A HOUSEHOLD INCOME UP TO 500% OF FPL AND WITH A FINANCIAL HARDSHIP (MEDICAL DEBT, INCURRED BY A FAMILY OVER A 12-MONTH PERIOD THAT EXCEEDS 25 PERCENT OF THE FAMILY INCOME) WILL RECEIVE A 25% ADJUSTMENT. --------------- SCHEDULE H, PART V, SECTION B, LINE 16A (FAP AVAILABILITY) FAP WEBSITE: HTTPS://WWW.UHCC.COM/PATIENT-FINANCIAL-SERVICES/FINANCIAL-ASSISTANCE/ --------------- SCHEDULE H, PART V, SECTION B, LINE 16B (FAP APPLICATION AVAILABILITY) FAP APPLICATION WEBSITE: HTTPS://WWW.UHCC.COM/PATIENT-FINANCIAL-SERVICES/FINANCIAL-ASSISTANCE/ --------------- SCHEDULE H, PART V, SECTION B, LINE 16C (FAP PLS AVAILABILITY) FAP PLAIN LANGUAGE SUMMARY WEBSITE: HTTPS://WWW.UHCC.COM/PATIENT-FINANCIAL-SERVICES/FINANCIAL-ASSISTANCE/ --------------- SCHEDULE H, PART V, SECTION B, LINE 16J (FAP OTHER AVAILABILITY) UNION HOSPITAL PLACES AN ADVERTISEMENT ONCE A YEAR IN THE LOCAL NEWSPAPERS OUTLINING THE FAP AND HOW TO APPLY. FAP IS PUBLICIZED ON ALL BILLING STATEMENTS, INVOICES, AND FINANCIAL CONSENT FORMS. FAP IS COMMUNICATED TO PATIENTS UPON DISCHARGE FROM INPATIENT, OBSERVATION, AND SURGICAL SERVICES. --------------- PART I, LINE 7 (BAD DEBT EXPENSE, COSTING METHODOLOGY USED) IMPLICIT PRICE CONCESSIONS ARE TREATED AS A CONTRA-REVENUE ITEM ON THE STATEMENT OF REVENUE. AS A RESULT, THERE ARE NO BAD DEBT EXPENSES INCLUDED ON FORM 990, PART IX THAT NEED TO BE SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGES LISTED. THE COSTING METHODOLOGY USED IN CALCULATING THE AMOUNTS REPORTED ON THE LINE 7 TABLE ARE BASED ON ACTUAL COST PLUS OVERHEAD. OVERHEAD IS A HOSPITAL AVERAGE PERCENTAGE OF OVERHEAD TO DIRECT COSTS. DIRECT COSTS EXCLUDE BAD DEBT EXPENSE. --------------- PART II (DETAIL OF COMMUNITY BUILDING ACTIVITIES) IN FY2022, UNION HOSPITAL REPORTED EXPENDITURES IN THE COMMUNITY BUILDING CATEGORIES OF ECONOMIC DEVELOPMENT AND COMMUNITY SUPPORT. THIS EXPENDITURE REPRESENTS TIME SPENT BY THE UNION HOSPITAL PRESIDENT PARTICIPATING ON TWO COMMUNITY BOARDS: THE BOARD OF THE ECONOMIC DEVELOPMENT COMMISSION FOR CECIL COUNTY AND THE LOCAL MANAGEMENT BOARD OF CECIL COUNTY. THE ECONOMIC DEVELOPMENT COMMISSION FOCUSES ON BUSINESS AND INDUSTRY DEVELOPMENT BY BUILDING RELATIONSHIPS WITH LOCAL PARTNERS IN CECIL COUNTY. THE CORE FUNCTION OF LOCAL MANAGEMENT BOARDS (LMBS) IS TO IDENTIFY COMMUNITY DRIVEN PRIORITIES AND TARGET RESOURCES FOR THEIR COMMUNITIES, AS WELL AS SERVE AS THE COORDINATOR OF COLLABORATION FOR CHILD AND FAMILY SERVICES. THERE IS A LOCAL MANAGEMENT BOARD IN EACH COUNTY IN MARYLAND, INCLUDING BALTIMORE CITY. --------------- PART III, SECTION A, LINE 2 (IMPLICIT PRICE CONCESSIONS/BAD DEBT EXPENSE) THE COSTING METHODOLOGY USED IN DETERMINING THE AMOUNTS REPORTED ON LINES 2 AND 3 ARE BASED ON ACTUAL CHARGES WRITTEN OFF (AMOUNTS THAT ARE DEEMED TO BE UNCOLLECTIBLE AND RECORDED AS IMPLICIT PRICE CONCESSIONS UNDER ACCOUNTING PRONOUNCEMENT ASC 606) TIMES THE COST TO CHARGE RATIO. --------------- PART III, SECTION A, LINE 3 (IMPLICIT PRICE CONCESSION METHODOLOGY) THE IMPLICIT PRICE CONCESSION METHODOLOGY ASSUMES THAT THE PERCENTAGE OF CHARITY CARE TO TOTAL REVENUE CAN BE APPLIED TO THE AMOUNT OF IMPLICIT PRICE CONCESSIONS FOR THE YEAR. OTHER IMPLICIT PRICE CONCESSION AMOUNTS ARE NOT INCLUDED IN COMMUNITY BENEFITS. --------------- PART III, SECTION A, LINE 4 (IMPLICIT PRICE CONCESSION FOOTNOTE) THE TEXT OF THE IMPLICIT PRICE CONCESSION (BAD DEBT EXPENSE) FOOTNOTE CAN BE FOUND STARTING ON PAGE 13 OF THE ELECTRONICALLY ATTACHED AUDITED FINANCIAL STATEMENTS. --------------- PART III, SECTION B, LINE 8 (COSTING METHODOLOGY, MEDICARE SHORTFALL) COSTING METHODOLOGY USED TO DETERMINE AMOUNT OF MEDICARE ALLOWABLE COSTS: MEDICARE ALLOWABLE COSTS EQUAL MEDICARE REVENUE ADJUSTED FOR THE HOSPITAL TOTAL RATIO OF PATIENT CARE COSTS TO CHARGES DUE TO THE FACT THAT MEDICARE PAYS FULL CHARGES IN MARYLAND. EXTENT TO WHICH MEDICARE SHORTFALL SHOULD BE TREATED AS COMMUNITY BENEFIT: IN THE STATE OF MARYLAND, MEDICARE PAYS FULL CHARGES. THERE IS NO SHORTFALL THAT SHOULD BE TREATED AS A COMMUNITY BENEFIT. --------------- PART III, SECTION B, LINE 9B (COLLECTION PRACTICES) UNION HOSPITAL'S F-416 CREDIT AND COLLECTION POLICY AND PROCEDURE HAS A SECTION CALLED, "INTERNAL COLLECTION EFFORTS" WHICH STATES: "UPON DISCHARGE, PATIENTS RECEIVE AN ITEMIZED BILL FOR INPATIENT ADMISSIONS IN ACCORDANCE WITH THE MARYLAND HOSPITAL COST REVIEW COMMISSION REQUIREMENTS. WHEN INSURANCE PAYMENTS ARE RECEIVED LEAVING A SELF-PAY BALANCE, OR THE ACCOUNT IS STRICTLY SELF-PAY, IT IS OUTSOURCED FOR FOLLOW-UP BUT REMAINS ON THE HOSPITAL'S ACTIVE ACCOUNTS RECEIVABLE. AGENTS WORK THE ACCOUNTS IN THE HOSPITAL'S NAME AND REPRESENTATIVES ARE DIRECTED TO ACCEPT MONTHLY PAYMENTS UNTIL THE ACCOUNT IS PAID IN FULL. COLLECTION EFFORTS CONSIST OF PHONE CALLS AND MONTHLY STATEMENTS. THE PATIENT MAY ALSO APPLY FOR FINANCIAL ASSISTANCE AT ANY TIME DURING THIS PROCESS (SEE POLICY F-415, FINANCIAL ASSISTANCE)." IN THE F-415 FINANCIAL ASSISTANCE POLICY AND PROCEDURE, UNDER SECTION, "ACTION IN THE EVENT OF NON-PAYMENT," IT IS EXPLAINED THAT: "A. UNION HOSPITAL MAY CONTRACT WITH OUTSIDE COLLECTION SERVICES TO PURSUE COLLECTION OF DELINQUENT ACCOUNTS. ALL UNPAID ACCOUNTS WITHOUT EXCEPTION OR PAYMENT ARRANGEMENTS ARE PLACED IN OUTSIDE COLLECTION AFTER A MINIMUM OF 90 DAYS FROM THE INITIAL BILLING STATEMENT AND DELIVERY OF ALL SCHEDULED PATIENT ACCOUNT STATEMENTS TO THE PATIENT/GUARANTOR. B. UNION HOSPITAL DOES NOT CONDUCT, OR PERMIT COLLECTION AGENCIES TO CONDUCT ON THEIR BEHALF, EXTRAORDINARY COLLECTIONS EFFORTS AGAINST INDIVIDUALS." IN ADDITION, IN THE F-416 POLICY, UNDER THE SECTION, "EXTERNAL COLLECTION (BAD DEBT WRITE-OFF)," IT EXPLAINS THAT PATIENTS WITH BALANCES BEING COLLECTED BY AN ASSIGNED COLLECTION AGENCY WILL HAVE THEIR BALANCES WRITTEN OFF IF THEY ARE DETERMINED TO BE INDIGENT. --------------- PART VI, LINE 2 (NEEDS ASSESSMENT) UNION ABIDES BY THE CHRISTIANACARE WAY: WE SERVE OUR NEIGHBORS AS EXPERT, CARING PARTNERS IN THEIR HEALTH. WE DO THIS BY CREATING INNOVATIVE, EFFECTIVE, AFFORDABLE, AND EQUITABLE SYSTEMS OF CARE THAT OUR NEIGHBORS VALUE. TO MEET THIS MISSION, WE MUST PARTNER WITH OUR NEIGHBORS TO BETTER UNDERSTAND THEIR NEEDS AND GOALS FOR HEALTH. THIS REQUIRES ROUTINE COMMUNICATION WITH COMMUNITY PARTNERS AND OUR PATIENTS. AS MENTIONED IN THE PRIOR SECTION, CAREGIVERS AT UNION WILL SOON BE ABLE TO UTILIZE THE SDOH SCREENING INSTRUMENT TO LEARN ABOUT AND ADDRESS OUR PATIENTS' NEEDS. TO EFFECTIVELY SERVE OUR COMMUNITY, WE HAVE ALSO DEVELOPED A STRONG RELATIONSHIP WITH THE CECIL COUNTY HEALTH DEPARTMENT (CCHD) TO AMPLIFY SERVICES AND BETTER UNDERSTAND OUR COMMUNITY. SINCE 2013, WE HAVE COMPLETED OUR CHNAS IN PARTNERSHIP WITH THE CCHD. EVEN THOUGH WE DID NOT PRODUCE A JOINT CHIP, WE ARE WORKING COLLABORATIVELY ON OUR SHARED PRIORITIES, INCLUDING ACCESS TO CARE, AS DESCRIBED IN A PRIOR SECTION. UNION CAREGIVERS ALSO PARTICIPATE IN CECIL COUNTY'S COMMUNITY HEALTH ADVISORY COMMITTEE (CHAC) AND ITS TASK FORCES. A UNION CAREGIVER CHAIRS THE CANCER TASK FORCE AND UNION CAREGIVERS PARTICIPATE IN THE HEALTHY LIFESTYLES AND TOBACCO TASK FORCES OF THE CHAC AS WELL. THIS PARTICIPATION PROVIDES INSIGHT INTO THE COMMUNITY'S STRENGTHS AND CHALLENGES IN THESE AREAS AND AN OPPORTUNITY TO WORK TOGETHER TO IMPROVE THE COMMUNITY'S HEALTH. UNION CAREGIVERS ALSO PARTICIPATE IN DIFFERENT COMMUNITY BOARDS AND COMMITTEES THAT FOCUS ON DIFFERENT AREAS OF COMMUNITY NEED. ALONG WITH THE CHAC TASK FORCES. UNION CAREGIVERS ALSO PARTICIPATED IN THESE ADDITIONAL COMMUNITY GROUPS FOR A TOTAL OF 87.5 HOURS IN FY2022: - CECIL COUNTY BEHAVIORAL HEALTH PROVIDERS - CECIL COUNTY RESOURCE NETWORK - CECIL COUNTY BEHAVIORAL HEALTH ADVISORY BOARD - CECIL COUNTY CHILD ADVOCACY CENTER - CECIL COUNTY ECONOMIC DEVELOPMENT COMMISSION - ADULT DISABILITY RESOURCE COMMITTEE - LOCAL MANAGEMENT BOARD - LOCAL OVERDOSE FATALITY REVIEW TEAM - CECIL COUNTY PREVENTION OVERDOSE RESPONSE TEAM THE NEW MANAGER OF COMMUNITY ENGAGEMENT WILL ALSO BE A CONSTANT PRESENCE IN THE COMMUNITY. --------------- PART VI, LINE 3 (PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE) UNION PROVIDES EMERGENCY AND MEDICALLY NECESSARY SERVICES TO PATIENTS WITHOUT DISCRIMINATION, REGARDLESS OF THE PATIENT'S FINANCIAL ASSISTANCE ELIGIBILITY. UNION'S FINANCIAL ASSISTANCE POLICY (FAP) ENSURES A CONSISTENT AND EQUITABLE PROCESS IN GRANTING FINANCIAL ASSISTANCE TO APPROPRIATE PATIENTS WHILE RESPECTING THE INDIVIDUAL'S DIGNITY. THE FAP ALIGNS WITH FEDERAL AND STATE REGULATIONS. UNION'S FAP, A PLAIN LANGUAGE SUMMARY OF THE FAP, THE FINANCIAL ASSISTANCE APPLICATION IN ENGLISH AND SPANISH, AND THE FINANCIAL ASSISTANCE SCALE ARE ALL AVAILABLE ON UNION'S WEBSITE AT: HTTPS://WWW.UHCC.COM/ABOUT-US/PATIENT-FINANCIAL-SERVICES/FINANCIAL-ASSISTA NCE/. UNION'S WEBSITE ALSO PROVIDES INFORMATION ABOUT HOW PATIENTS CAN OBTAIN THE FAP AND APPLICATION. UNION FINANCIAL COUNSELORS ARE AVAILABLE MONDAY THROUGH FRIDAY, FROM 8 A.M. TO 4:30 P.M. TO DISCUSS THE APPLICATION PROCESS BY PHONE OR AT THE HOSPITAL. THE WEBSITE ALSO PROVIDES A MAILING ADDRESS, TELEPHONE NUMBER, EMAIL ADDRESS, AND IN-PERSON LOCATIONS WHERE INDIVIDUALS CAN RECEIVE OR REQUEST THE FAP AND APPLICATION. INFORMATION ABOUT THE FAP IS INCLUDED ON THE FINANCIAL CONSENT FORM, ON BILLING STATEMENTS/INVOICES, UPON DISCHARGE FROM INPATIENT, OBSERVATION, OR SURGICAL SERVICES, AND ON ELECTRONIC AND PAPER SIGNS AT REGISTRATION LOCATIONS IN THE HOSPITAL. PATIENTS RECEIVE FINANCIAL COUNSELING, REFERRALS, AND ASSISTANCE TO IDENTIFY PUBLIC OR PRIVATE HEALTHCARE PROGRAMS TO ASSIST WITH LONG TERM NEEDS. IF THE PATIENT IS UNINSURED, THEY WILL BE PROVIDED ASSISTANCE TO DETERMINE MARYLAND MEDICAID OR QUALIFIED HEALTH PLAN ELIGIBILITY THROUGH THE APPROPRIATE MARYLAND HEALTH CONNECTION CONNECTOR ENTITY OR OTHER QUALIFIED HEALTH INSURANCE MARKETPLACE. --------------- PART VI, LINE 4 (COMMUNITY INFORMATION) UNION PRIMARILY SERVES CECIL COUNTY, MARYLAND. IN FY2022, CECIL COUNTY RESIDENTS ACCOUNTED FOR APPROXIMATELY 85% OF THE HOSPITAL'S TOTAL INPATIENT VOLUMES AND 84% OF TOTAL EMERGENCY DEPARTMENT VISITS. UNION HOSPITAL IS THE ONLY HOSPITAL IN THE COUNTY AND IS LOCATED IN ELKTON, THE COUNTY SEAT. THERE ARE EIGHT TOWNS AND SEVEN UNINCORPORATED COMMUNITIES IN THE COUNTY. CECIL COUNTY IS RURAL, AND IT BORDERS DELAWARE AND PENNSYLVANIA. ELKTON IS THE MOST POPULOUS TOWN IN CECIL COUNTY WITH 45,225 RESIDENTS AND THE SMALLEST TOWN IN CECIL COUNTY, PERRY POINT, HAS 262 RESIDENTS. THE TOTAL POPULATION OF CECIL COUNTY IN 2021 WAS APPROXIMATELY 102,722 PERSONS. BETWEEN 2020 AND 2030, THE CECIL COUNTY POPULATION IS EXPECTED TO GROW BY 8.5% WITH THE POPULATION OF THOSE 65 YEARS AND OLDER PROJECTED TO GROW AT A MORE RAPID RATE OF 43.1%. FROM 2016 TO 2020, THE POVERTY RATE IN CECIL COUNTY (9.5%) WAS SLIGHTLY ABOVE THE MARYLAND POVERTY RATE (9%), BUT BELOW THE UNITED STATES AVERAGE (12.8%). CECIL COUNTY POVERTY RATES FOR BLACK (15.8%) AND HISPANIC (18.1%) PEOPLE WERE SIGNIFICANTLY HIGHER THAN THOSE FOR WHITE (8.5%) RESIDENTS DEMONSTRATING SIGNIFICANT RACIAL DISPARITIES. LOW-INCOME CENSUS TRACTS ARE MOST PREVALENT IN ELKTON, NORTH EAST, AND PORT DEPOSIT. MOST OF THESE CENSUS TRACTS ARE WHERE MORE THAN ONE-HALF OF HOUSEHOLDS ARE "RENT BURDENED," ARE CATEGORIZED AS "HIGH NEED" BY THE DIGNITY HEALTH COMMUNITY NEED INDEXT (CNI) AND ARE IN THE TOP QUARTILE NATIONALLY FOR "SOCIAL VULNERABILITY" ACCORDING TO THE CENTERS FOR DISEASE CONTROL SOCIAL VULNERABILITY INDEX. THERE ARE CONSIDERABLE SUBSTANCE USE DISORDER ISSUES IN CECIL COUNTY. ADULT SMOKING RATES ARE HIGHER IN CECIL COUNTY THAN IN MARYLAND AND THE UNITED STATES. YOUTH TOBACCO AND NICOTINE USE ALSO COMPARES UNFAVORABLY IN COMPARISON TO NATIONAL AVERAGES. THE PERCENT OF CECIL COUNTY YOUTH THAT CURRENTLY USE SMOKELESS TOBACCO IS MORE THAN 50% ABOVE THE UNITED STATES AVERAGE. THE DRUG OVERDOSE DEATH RATE IS ALSO CONSIDERABLY HIGHER IN CECIL COUNTY THAN THE RATE IN MARYLAND AND THE UNITED STATES. BETWEEN 2016 AND 2020, THE DRUG OVERDOSE DEATH RATE MORE THAN DOUBLED. CECIL COUNTY'S PERCENTAGE OF THE POPULATION WITHOUT HEALTH INSURANCE IS 4.2% WHICH IS LOWER THAN THE PERCENTAGE OF THE POPULATION WITHOUT HEALTH INSURANCE IN MARYLAND, 5.9%. --------------- PART VI, LINE 5 (INFORMATION REGARDING PROMOTION OF COMMUNITY HEALTH) CHRISTIANACARE IS CENTERED ON IMPROVING HEALTH OUTCOMES, MAKING HIGH-QUALITY CARE MORE ACCESSIBLE, AND LOWERING HEALTH CARE COSTS. GUIDED BY OUR VALUES, LOVE AND EXCELLENCE, UNION CONTINUES TO SERVE OUR CECIL COUNTY NEIGHBORS AS THEIR COMMUNITY HOSPITAL. EACH FISCAL YEAR, UNION SERVES CECIL COUNTY BY PROVIDING ACTIVITIES, PROGRAMS, AND INITIATIVES THAT SEEK TO IMPROVE COMMUNITY HEALTH. THE FOLLOWING IS A SUMMARY OF THE COMMUNITY BENEFIT ACTIVITIES, PROGRAMS, AND INITIATIVES THAT UNION HOSPITAL PROVIDED IN CECIL COUNTY DURING FY2022: A1: COMMUNITY HEALTH EDUCATION - UNION HOSPITAL PROVIDED: HEALTH EDUCATION PRESENTATIONS IN THE COMMUNITY ON TOPICS SUCH AS DIABETES AND NUTRITION, CANCER PREVENTION AND SCREENING, CHILDBIRTH AND INFANT EDUCATION INCLUDING NEONATAL ABSTINENCE SYNDROME AND LACTATION SUPPORT A2: COMMUNITY-BASED CLINICAL SERVICES - TWO FREE EYE SCREENINGS FOR DIABETICS - A FREE SPORTS PHYSICALS CLINIC FOR COUNTY PUBLIC AND PRIVATE MIDDLE SCHOOL AND HIGH SCHOOL STUDENTS A3: HEALTH CARE SUPPORT SERVICES - PARTICIPATION ON CHILD ADVOCACY CENTER INVESTIGATIONS/MEETINGS - PARTNERSHIP WITH CCHD TO SUPPORT THE PEER RECOVERY ADVOCATES PROGRAM A4: SOCIAL AND ENVIRONMENTAL IMPROVEMENTS - TRANSPORTATION DONATIONS FOR ELIGIBLE (NEEDS-BASED) PATIENTS B1-B3: HEALTH PROFESSIONS EDUCATION - UNION CAREGIVERS OFFERED TRADITIONAL CLINICAL ROTATIONS TO 72 UNDERGRADUATE NURSING STUDENTS. C: MISSION DRIVEN HEALTH SERVICES - UNION PROVIDED SUBSIDIZED OUTPATIENT SERVICES TO MEET IDENTIFIED NEEDS IN THE COMMUNITY, EVEN THOUGH THEY OPERATE AT A LOSS. THESE INCLUDE SERVICES LIKE PRIMARY CARE AND RHEUMATOLOGY. E3: IN-KIND CONTRIBUTIONS - PROVIDED FREE AMBULANCE TRANSPORTS AND FREE SUPPLIES FOR AMBULANCE STOCK-UPS - PROVIDED FREE NOTARY SERVICES TO PATIENTS - PARTICIPATION IN COMMUNITY BOARDS/COMMITTEES/TASK FORCES AND OTHER GROUPS --------------- PART VI, LINE 6 (AFFILIATED HEALTHCARE SYSTEM INFORMATION) UNION HOSPITAL OF CECIL COUNTY, INC. IS PART OF AN AFFILIATED HEALTH CARE SYSTEM IN WHICH AFFINITY HEALTH ALLIANCE, INC. (AHA) IS THE PARENT ENTITY. AHA'S PURPOSE IS TO SUPPORT THE UNION HOSPITAL OF CECIL COUNTY IN PROVIDING HEALTH CARE AND HEALTH CARE RELATED SERVICES THROUGH THE EFFECTIVE MANAGEMENT OF ALL AFFILIATED CORPORATIONS. SPECIFICALLY, THIS INVOLVES COORDINATING SYSTEM WIDE POLICIES, FUNDRAISING AND STRATEGIC PLANNING PROGRAMS TO PROVIDE HEALTH CARE SERVICES IN RESPONSE TO THE MEDICAL, HUMAN AND RELATED SERVICE NEEDS OF THE COMMUNITY. OTHER TAX-EXEMPT ORGANIZATIONS IN THE GROUP INCLUDE THE UNION HOSPITAL OF CECIL COUNTY FOUNDATION, INC., UNION HOSPITAL OF CECIL COUNTY HEALTH SERVICES, INC., AND UNION HOSPITAL OF CECIL COUNTY ONCOLOGY, INC. THE FOUNDATION CONDUCTS AND SUPERVISES FUNDRAISING ACTIVITIES ON BEHALF OF ITS TAX-EXEMPT AFFILIATES. THE FOUNDATION ENGAGES IN CORPORATE FUNDRAISING, CAPITAL CAMPAIGNS, SPECIAL EVENTS, ACTIVITIES, AND A MULTI-FACETED COMMUNICATION PROGRAM THAT APPEALS TO PRIVATE AND CORPORATE CONTRIBUTORS. UNION HOSPITAL OF CECIL COUNTY HEALTH SERVICES, INC.'S MISSION IS TO OWN, MANAGE AND MAINTAIN PROPERTIES FOR HEALTH RELATED VENTURES TO SERVICE CECIL COUNTY AND THE SURROUNDING AREAS. THE ACTIVITIES OF THIS CORPORATION COMPLEMENT AND AUGMENT THE HEALTH CARE ACTIVITIES OF THE HOSPITAL. UNION HOSPITAL OF CECIL COUNTY ONCOLOGY, INC'S (ONCOLOGY") DUTY AND MISSION IS TO PROVIDE HIGH QUALITY, ADVANCED RADIATION ONCOLOGY SERVICES TO THE CECIL COUNTY AREA IN ORDER TO FOSTER THE BEST CANCER TREATMENT PROCESS CLOSE TO HOME. CANCER-RELATED DEATHS ARE AMONG THE HIGHEST CAUSES OF MORTALITY IN CECIL COUNTY, SO IT IS UNION ONCOLOGY'S MISSION TO BRING SOME OF THE MOST ADVANCED RADIATION THERAPIES TO CECIL COUNTY TO PROVIDE THE MOST COMPREHENSIVE CANCER CARE POSSIBLE TO THE PEOPLE LIVING WITH CANCER HERE AND IN NEIGHBORING COMMUNITIES. BY OFFERING THESE ADVANCED CANCER TREATMENT OPTIONS, UNION ONCOLOGY FURTHERS ITS CHARITABLE PURPOSE OF PROVIDING MEDICAL SERVICES TO PROMOTE THE HEALTH AND WELFARE OF THE RESIDENTS OF CECIL COUNTY AND NEIGHBORING COMMUNITIES. UNION HOSPITAL OF CECIL COUNTY VENTURES, INC. IS A FOR-PROFIT STOCK CORPORATION. ITS PURPOSE IS TO ENGAGE IN ANY BUSINESS OR TRANSACTION WHICH WILL BENEFIT THE ACTIVITIES AND GOALS OF ITS AFFILIATES. OPERATIONS CONSIST PRIMARILY OF PROVIDING MANAGEMENT SUPPORT SERVICES FOR PHYSICIAN PRACTICES AND PROVIDING IMAGING SERVICES TO PHYSICIANS AND HEALTH CENTERS THROUGH ITS WHOLLY OWNED SUBSIDIARIES, TRIANGLE ALLIANCE LLC AND OPEN MRI AND IMAGING CENTER OF ELKTON LLC. ON JANUARY 1, 2020, AHA BECAME A MEMBER OF CHRISTIANA CARE HEALTH SYSTEM. CHRISTIANA CARE IS A MAJOR TEACHING HEALTH SYSTEM WITH MORE THAN 1,600 MEDICAL-STAFF MEMBERS AND 265 MEDICAL-DENTAL RESIDENTS AND FELLOWS AND INCLUDES A NUMBER OF ENTITIES INCLUDING CHRISTIANA CARE HEALTH SERVICES, INC. --------------- PART VI, LINE 7 (STATES FILING OF COMMUNITY BENEFIT REPORT) LIST OF STATES RECEIVING COMMUNITY BENEFIT REPORT: MD true true false false false false false true false JENNIFER L SCHWARTZ ESQ SECRETARY (EX-OFFICIO) 0 504545 0 216026 0 0 0 16843 0 23010 0 760424 0 0 JOSE MA MD DIRECTOR 236711 0 68950 0 0 0 20300 0 8918 0 334879 0 0 0 JUSTIN SAUSVILLE MD DIRECTOR 748469 0 22500 0 0 0 20300 0 13221 0 804490 0 0 0 ROBERT ASANTE DIRECTOR (AS OF 1/2022) 0 159203 0 34721 0 0 0 24050 0 10881 0 228855 0 0 SHARON T KURFUERST PRES & DIRECTOR (AS OF 1/1/22) 0 654345 0 255517 0 0 0 20300 0 16478 0 946640 0 0 ROBERT MCMURRAY TREASURER (EX-OFFICIO) 0 600633 0 248589 0 0 0 20300 0 23010 0 892532 0 0 RYAN GERACIMOS MD CHIEF MEDICAL OFFICER 421800 0 118268 0 0 0 18850 0 12989 0 571907 0 0 0 JOAN PIRRUNG MSN APRN ACNS-BC VP PAT. CARE SERVIVES-NURSING 0 175138 0 36287 0 0 0 23010 0 39092 0 273527 0 0 AMY MARSTON CAMPUS OPERATIONS OFFICER 0 188481 0 35808 0 0 0 22152 0 6819 0 253260 0 0 MICHELLE TWUM-DANSO DIRECTOR OF HR - CECIL CAMPUS 191262 0 30722 0 0 0 17036 0 0 0 239020 0 0 0 DERON G BROWN FORMER FINANCE DIRECTOR 164705 0 25590 0 0 0 12359 0 0 0 202654 0 0 0 RICHARD C SZUMEL FORMER OFFICER 720937 0 0 0 0 0 1307 0 0 0 722244 0 0 0 ROGER D WU MD PHYSICIAN 584886 0 79467 0 0 0 18850 0 12181 0 695384 0 0 0 FAHD RAHMAN MD PHYSICIAN 594491 0 0 0 0 0 18850 0 13221 0 626562 0 0 0 NAVEED HASAN MD PHYSICIAN 529433 0 34000 0 0 0 0 0 13871 0 577304 0 0 0 THEODORA FYNN PHYSICIAN 432422 0 29400 0 0 0 19241 0 8697 0 489760 0 0 0 VINAY K SHARMA PHYSICIAN 430632 0 24500 0 0 0 19121 0 4095 0 478348 0 0 0 KENNETH SILVERSTEIN MD DIRECTOR (THROUGH 12/31/21) 0 1227165 0 316765 0 0 0 18850 0 23010 0 1585790 0 0 FORM 990, SCHEDULE J, PART I, LINE 3 TOP MANAGEMENT COMPENSATION AS PROVIDED IN THE FORM 990, SCHEDULE J INSTRUCTIONS, SINCE THE ORGANIZATION RELIES ON A RELATED ORGANIZATION WHICH USES ONE OR MORE OF THE METHOD DESCRIBED IN LINE 3 TO ESTABLISH THE TOP MANAGEMENT OFFICIALS' COMPENSATION, THIS QUESTION HAS BEEN LEFT UNANSWERED. REFER TO SCHEDULE O FOR A DESCRIPTION OF THE COMPENSATION REVIEW AND APPROVAL PROCESS. --------------- FORM 990, SCHEDULE J, PART I, LINE 4A DETAIL OF SEVERANCE PAYMENTS RICHARD C. SZUMEL, MD (FORMER PRESIDENT & CEO) RECEIVED A SEVERANCE PAYMENT OF $456,980 DURING THE YEAR. --------------- FORM 990, SCHEDULE J, PART I, LINE 4B SUPP. NONQUALIFIED PLAN PARTICIPATION THIS ORGANIZATION IS AN AFFILIATE OF CHRISTIANA CARE HEALTH SERVICES, INC. ("CCHS"). CCHS MAINTAINS AN IRC SECTION 457(F) DEFERRED COMPENSATION PLAN. THE FOLLOWING INDIVIDUALS LISTED ON FORM 990, PART VII, SECTION A, LINE 1A PARTICIPATED AND/OR RECEIVED DISTRIBUTIONS FROM THE 457(F) PLAN DURING THE YEAR: RYAN GERACIMOS, MD- $11,448 SHARON T. KURFUERST- $23,571 ROBERT MCMURRAY- NO DISTRIBUTION JENNIFER L. SCHWARTZ, ESQ.- NO DISTRIBUTION KENNETH SILVERSTEIN, MD- NO DISTRIBUTION --------------- FORM 990, SCHEDULE J, PART I, LINE 7 NONFIXED PAYMENTS THIS ORGANIZATION IS AN AFFILIATE OF CHRISTIANA CARE HEALTH SYSTEM, INC. ("SYSTEM") AND CHRISTIANA CARE HEALTH SERVICES, INC. ("CCHS"). ALL OFFICER/TRUSTEE COMPENSATION ARRANGEMENTS, INCLUDING THE PAYMENT OF DISCRETIONARY BONUS AND/OR INCENTIVE COMPENSATION PAYMENTS TO ELIGIBLE EMPLOYEES, ARE DETERMINED BY THE SYSTEM BOARD AND PAID EITHER THROUGH CCHS OR THIS ORGANIZATION. PAYMENTS MADE TO ANY DISQUALIFIED PERSON ARE APPROVED BY THE COMPENSATION COMMITTEE OF SYSTEM THROUGH THE PROCESS DESCRIBED IN FORM 990, PART VI, SECTION B, LINE 15. --------------- A TOWN OF ELKTON - SERIES 2012A 526000790 2012-05-18 10000000 REFUND PORTION OF SERIES 2009 BOND false false false B TOWN OF ELKTON - SERIES 2012B1B2 526000790 2012-05-18 8662336 REFUND SERIES 2009 & 2000 BONDS false false false C TOWN OF ELKTON - SERIES 2012C 526000790 2012-05-18 9000000 REFUND ESCROW TO REPAY 2002 BoND false false false D MD HEALTH & HIGHER EDUCATION FACILITIES AUTHORITY 520936091 2012-07-18 9924000 REFUND PORTION OF SERIES 2002 BOND false false false A 3417204 0 10000000 0 0 0 0 0 0 0 10000000 0 2012 true false true true B 4816306 0 8662336 0 0 0 0 0 0 0 8662336 0 2012 true false true true C 0 0 9000000 0 0 0 0 0 0 0 9000000 0 2012 true false true true D 9924000 0 9924000 0 0 0 0 0 0 0 9924000 0 2012 true false true true A false false true true false 0.00000 0.00000 0.00000 false false 0.00000 false true B false false true true false 0.00000 0.00000 0.00000 false false 0.00000 false true C false false true true false 0.00000 0.00000 0.00000 false false 0.00000 false true D false false true true false 0.00000 0.00000 0.00000 false false 0.00000 false true A false false true false false false 0 false 0 false true B false false true false false false 0 false 0 false true C false false true false false false 0 false 0 false true D false false true false false false 0 false 0 false true A true B true C true D true A MD HEALTH & HIGHER EDUCATION FACILITIES AUTHORITY 520936091 2012-07-18 4007000 FINANCE ACQUISITION OF EQUIPMENT false false false B MD HEALTH & HIGHER EDUCATION FACILITIES AUTHORITY 520936091 2014-12-01 30778000 REFINANCE THE 2005 BOND true false false A 4007000 0 4007000 0 0 0 0 0 0 0 4007000 0 2012 true false true true B 900000 0 30778000 0 0 0 0 0 0 0 30778000 0 2014 true false true true A false false true true false 0.00000 0.00000 0.00000 false false 0.00000 false true B false false true true false 0.00000 0.00000 0.00000 false false 0.00000 false true A false false true false false false 0 false 0 false true B false false true false false false 0 false 0 false true A true B true FORM 990, PART VI, SECTION A, LINES 6 & 7A,7B GOVERNING BODY AND MANAGEMENT CHRISTIANA CARE HEALTH SERVICES, INC. ("CCHS") IS THE SOLE MEMBER OF AFFINITY HEALTH ALLIANCE, INC. ("AHA"), THE SOLE MEMBER OF THE UNION HOSPITAL OF CECIL COUNTY, INC. ("UHCC"). CCHS AND AHA ARE BOTH TAX-EXEMPT ORGANIZATIONS. THE BOARD OF DIRECTORS OF CCHS ELECTS THE DIRECTORS OF UHCC AT ITS ANNUAL MEETING. THE ANNUAL OPERATING BUDGET OF UHCC IS APPROVED BY THE UHCC BOARD, THE FINANCE COMMITTEE OF THE CCHS BOARD, THE CCHS BOARD, THE FINANCE COMMITTEE OF THE BOARD OF CHRISTIANA CARE HEALTH SYSTEM, INC. ("SYSTEM"), THE SOLE MEMBER OF CCHS, AND THE SYSTEM BOARD. --------------- FORM 990, PART VI, SECTION B, LINE 11B FORM 990 REVIEW PROCESS INFORMATION RELATED TO THE UHCC FORM 990 IS GATHERED BY FINANCE STAFF AND PROVIDED TO PRICEWATERHOUSECOOPERS LLP FOR REVIEW. THE FINAL 2021 FORM 990 FOR THE FISCAL YEAR ENDING JUNE 30, 2022 WAS REVIEWED AND APPROVED BY VARIOUS SENIOR MANAGEMENT OFFICIALS. THE ORGANIZATION'S GOVERNING BOARD WAS ALSO PROVIDED ACCESS TO THE APPROVED 2021 FORM 990 VIA ITS BOARD OF DIRECTORS PORTAL. --------------- FORM 990, PART VI, SECTION B, LINE 12C CONFLICT OF INTEREST POLICY OUR CONFLICT OF INTEREST ("COI") POLICY IS LOCATED IN THE CAREGIVER RESOURCE CENTER ON THE EMPLOYEE PORTAL. THERE IS AN ANNUAL MANDATORY EDUCATION FOR REQUIRED INDIVIDUALS, WHICH INCLUDES AN ELECTRONIC SIGN OFF ACKNOWLEDGING COMPLETION OF THE EDUCATION, REPORTING OF A REAL OR PERCEIVED CONFLICT OR THAT NO CONFLICTS OF INTEREST EXIST. THE HR/EMPLOYEE RELATIONS TEAM FOLLOWS UP WITH ANYONE WHO HAS A CONFLICT OR PERCEIVED CONFLICT OR DOES NOT COMPLETE THE EDUCATION IN ORDER TO RESOLVE. THE EMPLOYEE HANDBOOK SETS EXPECTATIONS FOR EMPLOYEE CONFLICTS OF INTEREST AND EXPECTATIONS. SEVERAL REPORTING MECHANISMS ALSO EXIST FOR EMPLOYEES TO REPORT CONCERNS. THE BOARD OF DIRECTORS HAS THEIR OWN COI POLICY. COI IS A STANDING AGENDA ITEM ON EACH BOARD OR BOARD COMMITTEE MEETING. BOARD MEMBERS EXPECTATIONS FOR COI ARE CLEARLY COMMUNICATED. --------------- FORM 990, PART VI, SECTION B, LINE 15 COMPENSATION REVIEW AND APPROVAL PROCESS THE BOARD OF DIRECTORS OF CHRISTIANA CARE HEALTH SYSTEM, INC. ("SYSTEM"), THE SOLE MEMBER OF CHRISTIANA CARE HEALTH SERVICES, INC. ("CCHS"), THE SOLE MEMBER OF AFFINITY HEALTH ALLIANCE, INC. ("AHA"), THE SOLE MEMBER OF UNION HOSPITAL OF CECIL COUNTY, INC. ("UHCC") ESTABLISHES UHCC'S COMPETITIVE TOTAL COMPENSATION POLICY AND PRACTICE. THE EXECUTIVE COMPENSATION COMMITTEE ("ECC") OF THE SYSTEM BOARD ENGAGES AN INDEPENDENT THIRD PARTY ANNUALLY WHO ASSESSES DATA FROM SEVERAL MAJOR SURVEYS TO ENSURE TOTAL REMUNERATION IS MARKET COMPETITIVE AND QUALIFIES FOR THE "REBUTTABLE PRESUMPTION OF REASONABLENESS" UNDER THE INTERMEDIATE SANCTIONS RULE, SECTION 4958 OF THE INTERNAL REVENUE CODE. AFTER DELIBERATION, THE ECC DOCUMENTS THEIR DECISIONS IN MEETING MINUTES. --------------- FORM 990, PART VI, SECTION C, LINE 19 GOVERNANCE, MANAGEMENT & DISCLOSURE THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. --------------- FORM 990, PART XI, LINE 9 DETAIL OF OTHER CHANGES IN NET ASSETS TRANSFER TO AFFILIATES $ 10,382,025 CHANGE IN NET ASSETS - FDN (374,915) OTHER CHANGES 23,157 ____________ TOTAL $ 10,030,267 --------------- FORM 990, SCHEDULE C DETAIL OF LOBBYING ACTIVITIES UHCC IS A MEMBER OF THE MARYLAND HOSPITAL ASSOCIATION ("MHA"). A PORTION OF THE MEMBERSHIP DUES PAID BY UHCC MAY BE USED BY MHA FOR LOBBYING PURPOSES. --------------- FORM 990 PART IX LINE 11G DESCRIPTION:CONTRACTED SERVICES TOTAL FEES:12408 FORM 990 PART IX LINE 11G DESCRIPTION:PHYSICIAN SERVICES TOTAL FEES:11759573 FORM 990 PART IX LINE 11G DESCRIPTION:PURCHASED SERVICES & FEES TOTAL FEES:20096065 FORM 990 PART IX LINE 11G DESCRIPTION:AGENCY EMPLOYEES TOTAL FEES:197038 FORM 990 PART IX LINE 11G DESCRIPTION:TRANSCRIPTION SERVICES TOTAL FEES:214884 FORM 990 PART IX LINE 11G DESCRIPTION:CLEANING SERVICES TOTAL FEES:49140 FORM 990 PART IX LINE 11G DESCRIPTION:BILLING & COLLECTIONS SERVICES TOTAL FEES:290818 FORM 990 PART IX LINE 11G DESCRIPTION:ADMINISTRATIVE SERVICES TOTAL FEES:1395 UNION HOSPITAL OF CECIL COUNTY FDN INC 4000 NEXUS DR NW3-100 WILMINGTON DE 19803 521794552 FUNDRAISING MD 501(C)(3) 7 AFFINITY false UNION HOSPITAL OF CECIL COUNTY HLTH SVCS 4000 NEXUS DR NW3-100 WILMINGTON DE 19803 521794553 PROPERTY MGMT MD 501(C)(3) 10 AFFINITY false AFFINITY HEALTH ALLIANCE INC 4000 NEXUS DR NW3-100 WILMINGTON DE 19803 521794697 MANAGEMENT MD 501(C)(3) 12B,II CCH SERVICES false UNION HOSPITAL OF CECIL COUNTY ONCOLOGY 4000 NEXUS DR NW3-100 WILMINGTON DE 19803 812662359 HEALTHCARE MD 501(C)(3) 3 AFFINITY false CHRISTIANA CARE HEALTH SYSTEM INC 4000 NEXUS DR NW3-100 WILMINGTON DE 19803 521479538 FUNDRAISING DE 501(C)(3) 7 NA false CHRISTIANA CARE HLTH INITIATIVES INC 4000 NEXUS DR NW3-100 WILMINGTON DE 19803 510295186 OUTPATIENT SV DE 501(C)(3) 10 CCH SYSTEM false CHRISTIANA CARE HOME HEALTH & COM SRVCS 4000 NEXUS DR NW3-100 WILMINGTON DE 19803 510064334 HOME HLTHCARE DE 501(C)(3) 7 CCH SYSTEM false CHRISTIANA CARE HEALTH SERVICES INC 4000 NEXUS DR NW3-100 WILMINGTON DE 19803 510103684 HOSPITAL DE 501(C)(3) 3 CCH SYSTEM false CHRISTIANA CARE WEST GROVE INC 4000 NEXUS DR NW3-100 WILMINGTON DE 19803 510275944 HEALTHCARE PA 501(C)(3) 12C,III-FI CCH SERVICES false CHRISTIANACARE GOHEALTH URGENT CARE LLC 5555 GLENRIDGE CONNECTOR STE 700 ATLANTA GA 30342 844061485 URGENT CARE SRVCS DE CCH SERVICES false CHRISTIANACARE VALUE HEALTH JV LLC 11221 ROE AVE LEAWOOD KS 66211 851100149 AMBULATORY SRVCS DE CCH SERVICES false CLINERGY LLC 4755 OGLETOWN STANTON RD NEWARK DE 19718 852698063 GROUP PURCHASING DE CCH SERVICES false LEEWARD HEALTH LLC 4000 NEXUS DRIVE STE C3-300 WILMINGTON DE 19803 MED ADV RISK DE CCH SYSTEM false UNION HOSPITAL OF CECIL COUNTY VENTURES 4000 NEXUS DR NW3-100 WILMINGTON DE 19803 521793691 MEDICAL SERVICES MD AFFINITY C CORP false THE DE CTR FOR MAT FETAL MED OF CC INC 4000 NEXUS DR NW3-100 WILMINGTON DE 19803 205891272 HEALTHCARE DE CCH SERVICES C CORP false CHRISTIANA CARE HEALTH PLANS 4000 NEXUS DR STE NW3-100 WILMINGTON DE 19803 510352728 INSURANCE DE CCH SYSTEM C CORP false CHRISTIANA CARE DEFERRED COMP PLAN 4755 OGLETOWN STANTON RD NEWARK DE 19718 816359549 DEF COMP PLAN DE CCH SERVICES TRUST false CHRISTIANA CARE EXEC DEFERRED COMP PLAN 4755 OGLETOWN STANTON RD NEWARK DE 19718 357048822 DEF COMP PLAN DE CCH SERVICES TRUST false CARE ASSOCIATES DEFERRED COMP PLAN 4755 OGLETOWN STANTON RD NEWARK DE 19718 357048714 DEF COMP PLAN DE CCH SERVICES TRUST false CHRISTIANA CARE INSURANCE CO LTD PO BOX 1159 878 W BAY RD GRAND CAYMAN CJ KY1-1102 981489490 SELF-INSURANCE CJ CCH SERVICES C CORP false CHRISTIANA CARE STRATEGIC INVESTMENTS 4000 NEXUS DR STE NW3-100 WILMINGTON DE 19803 853348300 STRATEGY DE CCH SYSTEM C CORP false false false true false false false false false false true true false false true true true true true true