2023-05-10T07:28:03-05:00 2022-06-30 135565207 KPMG LLP 8350 BROAD STREET SUITE 900 MCLEAN VA 22102 990 2021-07-01 520491660 HARBOR HOSPITAL INC HARB 4107726721 3001 SOUTH HANOVER STREET BALTIMORE MD 212251233 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 HARBOR HOSPITAL JILL DONALDSON 3001 SOUTH HANOVER STREET BALTIMORE MD 212251233 189467942 0 X WWW.MEDSTARHARBOR.ORG X 1903 MD HARBOR HOSPITAL IS COMMITTED TO QUALITY, CARING, AND SERVICE FOR OUR PATIENTS AND OUR COMMUNITIES. 14 7 1352 0 789058 0 3466459 6195646 191174673 176910847 39179 104794 5735338 6256655 200415649 189467942 33728 61362 0 0 118467411 101466008 0 0 0 88593325 92388938 207094464 193916308 -6678815 -4448366 84612393 93097905 54890972 40675725 29721421 52422180 X SEE SCHEDULE OAS A PROUD MEMBER OF MEDSTAR HEALTH, MEDSTAR HARBOR HOSPITAL'S (MEDSTAR HARBOR) MISSION IS TO PROVIDE QUALITY, CARING AND SERVICE FOR OUR PATIENTS AND OUR COMMUNITIES. MEDSTAR HARBOR IS LOCATED JUST SOUTH OF BALTIMORE'S INNER HARBOR, IN BALTIMORE CITY. IT IS AN ACUTE CARE HOSPITAL OFFERING CLINICAL SERVICES IN BEHAVIORAL HEALTH, INTERNAL MEDICINE, SURGERY, CARDIOLOGY, OBSTETRICS AND GYNECOLOGY, ONCOLOGY, ORTHOPAEDICS AND PEDIATRICS. IN FISCAL YEAR 2022, MEDSTAR HARBOR HAD 7,628 INPATIENT ADMISSIONS AND 69,683 OUTPATIENT VISITS INCLUDING 40,619 EMERGENCY VISITS. 0 0 140632000 61362 167165488 SEE SCHEDULE OMEDSTAR HARBOR'S LARGEST PROGRAM IS ACCESS TO AND THE PROVISION OF ACUTE HOSPITAL SERVICES TO THE COMMUNITIES OF SOUTHERN BALTIMORE CITY, SOUTHWESTERN BALTIMORE COUNTY AND NORTHERN ANNE ARUNDEL COUNTY, MARYLAND AND THE SURROUNDING AREAS. IN ADDITION TO THE PROGRAM SERVICE EXPENSES LISTED ABOVE, MEDSTAR HARBOR INCURRED $28.5M OF MANAGEMENT AND GENERAL EXPENSES IN PROVIDING SERVICES TO ITS COMMUNITIES. COLLABORATION WITH THE NATIONAL INSTITUTE ON AGING (ONE OF THE NATIONAL INSTITUTES OF HEALTH) MAKES MEDSTAR HARBOR THE HOME OF THE BALTIMORE LONGITUDINAL STUDY ON AGING, THE NATION'S LONGEST RUNNING STUDY OF AGING AND CONDITIONS AFFECTING THE ELDERLY. MEDSTAR HARBOR HOSPITAL ACHIEVED THE JOINT COMMISSION'S GOLD SEAL OF APPROVAL FOR RECERTIFICATION IN THE SPINE SURGERY PROGRAM AND HEART FAILURE PROGRAM. MEDSTAR HARBOR HOSPITAL IS CERTIFIED IN PRIMARY CARE STROKE CARE. MEDSTAR HARBOR HOSPITAL RECEIVED THE NURSES IMPROVING CARE FOR HEALTH-SYSTEM ELDERS (NICHE) SENIOR FRIENDLY AWARD, THE LEADING NURSE DRIVEN PROGRAM DESIGNED TO HELP HOSPITALS AND HEALTHCARE ORGANIZATIONS IMPROVE THE CARE OF OLDER ADULTS. MEDSTAR HARBOR HOSPITAL ACHIEVED SILVER PLUS RECOGNITION IN THE AMERICAN HEART ASSOCIATION'S GET WITH THE GUIDELINES-STROKE PROGRAM. BALTIMORE MAGAZINE AGAIN RECOGNIZED MEDSTAR HARBOR PHYSICIANS AS "THE BEST OF THE BEST" IN ITS ANNUAL "TOP DOCTORS" ISSUE. MEDSTAR HARBOR HOSPITAL HOLDS THE "PARTNER FOR CHANGE" AWARD BESTOWED BY PRACTICE GREENHEALTH. MEDSTAR HARBOR HOSPITAL HAS ACHIEVED MEMBER STATUS FOR THE MARYLAND GREEN REGISTRY.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. 18692816 9745359 MEDSTAR HARBOR PROVIDED $18.7M 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. SERVICES INCLUDE EMERGENCY MEDICINE, HOSPITALISTS, PRIMARY CARE, WOMEN'S AND CHILDREN'S CARE, PALLIATIVE CARE AND BEHAVIORAL HEALTH. 6102983 MEDSTAR HARBOR PROVIDED $6.1M 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 HARBOR'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. 165427799 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 1 1 0 0 0 0 0 1 0 0 0 0 0 0 1 1 1 1 0 0 1 0 0 1 1352 1 1 1 0 0 0 0 0 0 0 0 0 0 0 X 14 7 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 KENNETH A SAMET DIRECTOR 1.00 39.00 X 0 15771396 96287 JILL DONALDSON PRESIDENT 40.00 0.00 X X 712078 0 45608 CARLOS D ZIGEL MD DIRECTOR 40.00 0.00 X 7664 0 2083 DAWN M GRETZ DPM DIRECTOR 1.00 0.00 X 0 0 0 TIMOTHY R BARNHILL DIRECTOR (UNTIL 10/2021) 1.00 0.00 X 0 0 0 THOMAS A GEDDES CHAIR 1.00 0.00 X 0 0 0 JAMES H FIELDS DIRECTOR 1.00 0.00 X 0 0 0 SWATA J GANDHI DIRECTOR 1.00 0.00 X 0 0 0 FATEH HRAKY MD DIRECTOR 1.00 0.00 X 64110 0 6206 VINCENT CONNELLY VICE CHAIR 1.00 0.00 X 0 0 0 MOHSEN GHARIB MD DIRECTOR 40.00 0.00 X 462896 0 28390 KERUNNE S KETLOGETSWE MD DIRECTOR 1.00 0.00 X 395289 0 10621 MEREDITH CHAIKEN DIRECTOR (AS OF 06/2022) 1.00 0.00 X 0 0 0 CHRISTOPHER GIBSON DIRECTOR 1.00 0.00 X 0 0 0 DEANA STOUT CFO 1.00 39.00 X X 0 534335 50923 ROBERT LALLY TREASURER 20.00 20.00 X 238074 238074 54729 KEITH SHINER SECRETARY 20.00 20.00 X 140592 140592 29733 DAWN OWENS CHIEF NURSING OFFICER 1.00 0.00 X 268199 0 24673 DANIEL TESFAMARIAM CLINICAL NURSE II 1.00 0.00 X 252477 0 22384 LARA Q BARRINGER MD VP OF MEDICAL AFFAIRS AND CMO 1.00 0.00 X 588983 0 6755 CHRIS GOOD PA-C 1.00 0.00 X 190455 0 15567 DEBORAH MCKENZIE REGISTERED NURSE 1.00 0.00 X 182022 0 35405 STUART LEVINE MD FORMER OFFICER 40.00 0.00 X 1156749 0 42306 JILL JOHNSON FORMER VP OF OPS (SINCE 04/2020) 40.00 0.00 X 425506 0 33907 5085094 16684397 505577 174 1 1 0 AMN HEALTHCARE INC 2735 COLLECTION CENTER DR CHICAGO IL 60693 STAFFING SERVICES 3694002 CROTHALL SVCS GROUP 201 EAST UNIVERSITY PARKWAY BALTIMORE MD 212182891 ENVIRONMENTAL SERVICES 964151 SODEXO INC & AFFILIATES PO BOX 360170 PITTSBURGH PA 152516170 FOOD & FACILITIES MANAGEMENT 774823 STERIS INSTRUMENT MANAGEMENT SERVICES 3316 2ND AVE N BIRMINGHAM AL 35222 INSTRUMENT REPAIRS AND SERVICES 456108 WINDRUSH BEHAVIORAL HEALTH LLC 1447 YORK RD STE 506 LUTHERVILLE TIMONIUM MD 21093 PROFESSIONAL SERVICES 376553 26 2820761 3374885 6195646 NET PATIENT SERVICE RE 621400 173319345 173319345 PHARMACY 621400 3591502 3591502 176910847 87304 87304 2801833 0 2801833 2801833 2801833 17265 225 0 0 17265 225 17490 17490 OPERATING EXPENSE RECO 900099 1859806 1859806 OUTSIDE LAB REVENUE 621500 789058 789058 REBATE INCOME 900099 406991 406991 398967 398967 3454822 189467942 176910847 789058 5572391 X 47427 47427 13935 13935 2207719 2020011 187708 1658468 1517459 141009 81077523 74183996 6893527 1217928 1114375 103553 9900451 9058787 841664 5403919 4932955 470964 15529381 20450 15508931 11290 11290 25976442 25576748 399694 130147 49778 80369 376711 739670 -362959 -949823 37552 -987375 58533 15754 42779 19920 8990 10930 1362191 1362191 8712431 8712431 8074911 7724799 350112 MED/SURG SUPPLIES 15882214 15847986 34228 UTILITIES 4239567 3902384 337183 MAINTENANCE 2986087 2979235 6852 MAINTENANCE CONTRACTS 2330167 1925519 404648 7648769 3635367 4013402 193916308 165427799 28488509 0 2852 2780 823583 1250813 20955589 21132928 2411496 2582110 485978 518817 241595098 181299602 57771502 60295496 759185 806736 415715 161059 986493 6347166 84612393 93097905 10485116 11608872 1330684 1899923 43075172 27166930 54890972 40675725 X 28842236 51559029 879185 863151 29721421 52422180 84612393 93097905 X -4448366 -114237 27263362 X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 3415538 3415538 94490746 64546039 29944707 751389 581510 169879 133857071 112339688 21517383 9080354 3832365 5247989 60295496 INTERCOMPANY DUE TO/FROM 5539739 AR-MISC RECEIVABLES 591521 AR-REMS 13552 AR-NON-PATIENT 229076 AR ALLOWANCE-NON-PATIENT -26722 6347166 ADVANCES FROM THIRD PARTIES 10939870 ASBESTOS ABATEMENT LIABILITY 4966334 CREDIT BALANCES PATIENT A/R 1693667 WORKERS COMPENSATION 1173390 OTHER SHORT TERM LIABILITIES 8294735 OTHER LONG TERM LIABILITIES 98934 27166930 X 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 6102983 6102983 0.03150 6102983 6102983 0.03150 3595764 231628 3364136 0.01730 4954541 4954541 0.02550 18692816 9745359 8947457 0.04610 73991 73991 0.00040 27317112 9976987 17340125 0.08930 33420095 9976987 23443108 0.12080 4154 4154 0.00000 859 859 0.00000 20604 20604 0.00010 35172 35172 0.00020 60789 60789 0.00030 1 5362568 X 1 1 1 1 HARBOR HOSPITAL INC 3001 SOUTH HANOVER STREET BALTIMORE MD 21225 X X X X HARBOR HOSPITAL INC 1 0 0 1 X X X X X X X X X 20 1 0 0 1 X HTTP://WWW.MEDSTARHARBOR.ORG/ X 1 20 1 HTTP://WWW.MEDSTARHARBOR.ORG/ 0 1 X 200.000000000000 400.000000000000 X X X X X X 1 1 X X X X 1 X HTTP://WWW.MEDSTARHARBOR.ORG/ X HTTP://WWW.MEDSTARHARBOR.ORG/ X HTTP://WWW.MEDSTARHARBOR.ORG/ X X X X X X 1 X 0 X X X X 1 X 0 0 HARBOR HOSPITAL, INC. 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 HOSPITAL LEAD: JILL DONALDSON AND LARA BARRINGER, MDADVISORY 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 : JILL DONALDSON TITLE/AFFILIATION : PRESIDENT, MHH NAME OF ORGANIZATION : MEDSTAR HARBOR HOSPITALNAME : ANANTHAKUMAR NUTHALAPATI, MDTITLE/AFFILIATION : VICE PRESIDENT, MEDICAL AFFAIRS NAME OF ORGANIZATION : MEDSTAR HARBOR HOSPITALNAME : ANTHONY MEADOR TITLE/AFFILIATION : ASSISTANT VICE PRESIDENT OF OPERATIONSNAME OF ORGANIZATION : MEDSTAR HARBOR HOSPITALNAME : ANTOINE N. LANGLEY TITLE/AFFILIATION : COMMUNITY HEALTH ADVOCATE, MHHNAME OF ORGANIZATION : MEDSTAR HARBOR HOSPITALNAME : DEBRA SCHINDLER TITLE/AFFILIATION : REGIONAL DIRECTOR PUBLIC RELATION BALTIMORENAME OF ORGANIZATION : MEDSTAR HARBOR HOSPITALNAME : DIANA C. QUINNTITLE/AFFILIATION : SR. DIRECTOR, COMMUNITY HEALTHNAME OF ORGANIZATION : MEDSTAR HEALTHNAME : NAISHA VINSON TITLE/AFFILIATION : AVP PHILANTHROPY AND GRANT DEV.NAME OF ORGANIZATION : MEDSTAR HARBOR HOSPITALNAME : RAQUEL P. LAMPTEYTITLE/AFFILIATION : COMMUNITY HEALTH SYSTEM MANAGERNAME OF ORGANIZATION : MEDSTAR HEALTHNAME : PHYLLIS GRAYTITLE/AFFILIATION : AVP CARE TRANSFORMATION NAME OF ORGANIZATION : MEDSTAR HEALTHNAME : TRACY HOLCOMB, RNTITLE/AFFILIATION : HEALTH EDUCATORNAME OF ORGANIZATION : MEDSTAR HARBOR HOSPITALNAME : CARA MILLER, RNTITLE/AFFILIATION : EMERGENCY DEPARTMENTNAME OF ORGANIZATION : MEDSTAR HARBOR HOSPITALNAME : CHRISTOPHER WILBERT, MDTITLE/AFFILIATION : EMERGENCY DEPARTMENTNAME OF ORGANIZATION : MEDSTAR HARBOR HOSPITALNAME : KERUNNE KETLOGETSWE, MDTITLE/AFFILIATION : CARDIOLOGYNAME OF ORGANIZATION : MEDSTAR HARBOR HOSPITALNAME : SUSAN JENNINGS TITLE/AFFILIATION : DIRECTOR, CASE MANAGEMENTNAME OF ORGANIZATION : MEDSTAR HARBOR HOSPITALNAME : SWATA GANDHITITLE/AFFILIATION : MHH BOARD MEMBERNAME OF ORGANIZATION : MEDSTAR HARBOR HOSPITALNAME : ANDREA MAYERTITLE/AFFILIATION : COMMUNITY PARTNERNAME OF ORGANIZATION : CONCERNED CITIZENS OF BROOKLYNNAME : BETTY BAZETITLE/AFFILIATION : CHERRY HILL COMMUNITY RESIDENTNAME OF ORGANIZATION : COMMUNITY RESIDENTNAME : FAITH CUNNINGHAMTITLE/AFFILIATION : COMMUNITY PARTNERNAME OF ORGANIZATION : CHERRY HILL / CHDCNAME : JEN BERGTITLE/AFFILIATION : FRIENDS OF GARRETT PARK, BROOKLYN COMMUNITY MEMBERNAME OF ORGANIZATION : COMMUNITY RESIDENTNAME : ADRIENNE BREIDENSTINETITLE/AFFILIATION : VICE PRESIDENTNAME OF ORGANIZATION : BEHAVIORAL HEALTH SYSTEMS, BALTIMORENAME : BILLIE PENLEY TITLE/AFFILIATION : CHIEF FINANCIAL OFFICERNAME OF ORGANIZATION : ANNE ARUNDEL COUNTY HEALTH DEPARTMENTNAME : BRAD ROGERSTITLE/AFFILIATION : EXECUTIVE DIRECTORNAME OF ORGANIZATION : SOUTH BALTIMORE GATEWAY PARTNERSHIPNAME : BRENT FLICKINGERTITLE/AFFILIATION : PLANNING SUPERVISOR, SOUTHERN DISTRICTNAME OF ORGANIZATION : CITY OF BALTIMORE NAME : ELLEN RAPPAPORTTITLE/AFFILIATION : DIRECTOR, COMPLEX CARE AND SOCIAL NEEDSNAME OF ORGANIZATION : HEALTHCARE ACCESS MARYLANDNAME : ERIC JACKSONTITLE/AFFILIATION : PRESIDENT AND CO-FOUNDERNAME OF ORGANIZATION : BLACK YIELD INSTITUTENAME : FANON HILL TITLE/AFFILIATION : CO-FOUNDER/ EXECUTIVE DIRECTORNAME OF ORGANIZATION : THE YOUTH RESILIENCY INSTITUTE.NAME : TIA BRISBONTITLE/AFFILIATION : COMMUNITY SCHOOL COORDINATORNAME OF ORGANIZATION : ELEV8 BALTIMORENAME : ELISE BOWMANTITLE/AFFILIATION : DIRECTOR, ACCOUNTABLE HEALTH COMMUNITIESNAME OF ORGANIZATION : BALTIMORE CITY HEALTH DEPARTMENTNAME : KELLY G.E. OGLESBEETITLE/AFFILIATION : COMMUNITY SCHOOL COORDINATORNAME OF ORGANIZATION : BENJAMIN FRANKLIN HIGH SCHOOLNAME : LAUREN ROBINSON TITLE/AFFILIATION : DIRECTOR, COMMUNITY HEALTHNAME OF ORGANIZATION : FAMILY HEALTH CENTER BALTIMORE NAME : MALIKA JONES TITLE/AFFILIATION : COMMUNITY ORGANIZERNAME OF ORGANIZATION : CHERRY HILL DEVELOPMENT CORPORATIONNAME : MEREDITH CHAIKEN TITLE/AFFILIATION : EXECUTIVE DIRECTORNAME OF ORGANIZATION : GREATER BAYBROOK ALLIANCENAME : MICHAEL MIDDLETONTITLE/AFFILIATION : EXECUTIVE DIRECTORNAME OF ORGANIZATION : CHERRY HILL DEVELOPMENT CORPORATIONNAME : NATALIE MCCABETITLE/AFFILIATION : MANAGERNAME OF ORGANIZATION : CHERRY HILL COMMUNITY ACTION CENTERNAME : TIA BRISBONTITLE/AFFILIATION : OUT OF SCHOOL TIME COORDINATORNAME OF ORGANIZATION : ARUNDEL ELEMENTARY/MIDDLE SCHOOLNAME : MANDY MEMMELTITLE/AFFILIATION : EXECUTIVE DIRECTORNAME OF ORGANIZATION : DRINK AT THE WELL (CURTIS BAY)NAME : MARC BROADYTITLE/AFFILIATION : VP, COMMUNITY AFFAIRSNAME OF ORGANIZATION : WELLER DEVELOPMENTNAME : CRYSTAL BRANCHTITLE/AFFILIATION : PRESIDENTNAME OF ORGANIZATION : CHERRY HILL TENANT HOMESNAME : MALLORY ZIMMERMANTITLE/AFFILIATION : DIRECTOR OF OPERATIONSNAME OF ORGANIZATION : THE TRANSFORMATION CENTERNAME : CATHERINE MACNAMARATITLE/AFFILIATION : COMMUNITY MEMBERNAME OF ORGANIZATION : BROOKLYN PARK LIBRARYNAME : MIZETTA WILSONTITLE/AFFILIATION : DIRECTORNAME OF ORGANIZATION : COMMUNITY OF HOPENAME : SHAVONNE BERKELYTITLE/AFFILIATION : COORDINATORNAME OF ORGANIZATION : WESTPORT ACADEMYNAME : ANA ZANDARINTITLE/AFFILIATION : COORDINATORNAME OF ORGANIZATION : LAKELAND STEAM CENTERNAME : TONII GEDINTITLE/AFFILIATION : DEPUTY HEALTH OFFICERNAME OF ORGANIZATION : ANNE ARUNDEL COUNTY HEALTH DEPT.NAME : BILLY HUMPHREYTITLE/AFFILIATION : CEONAME OF ORGANIZATION : CITY OF REFUGE BALTIMORENAME : JILL BRADLEY PALMORETITLE/AFFILIATION : ADVISORY COMMITTEE MEMBERNAME OF ORGANIZATION : BAYBROOK ELEMENTARY/MIDDLE SCHOOLNAME : CLAIRE WILSONTITLE/AFFILIATION : REGIONAL DIRECTOR COMMUNITY HEALTHNAME OF ORGANIZATION : MEDSTAR HEALTH NAME : ROBERT DARTTITLE/AFFILIATION : MED DIRECTOR NAME OF ORGANIZATION : MEDSTAR HEALTH FEDERAL HILL HARBOR HOSPITAL, INC. PART V, SECTION B, LINE 11: IMPLEMENTATION STRATEGIESTHE 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 III, LINEPART 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 (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. 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.PART III, LINE 9BIF IT IS DETERMINED THAT A PATIENT MAY POTENTIALLY QUALIFY FOR A CHARITABLE/FINANCIAL PROGRAM, A HOLD IS PLACED ON THE ACCOUNT TO PREVENT IT FROM BEING REPORTED AS BAD DEBT UNTIL PROGRAM APPROVALS HAVE BEEN OBTAINED. IF IT IS APPROVED, THE ACCOUNT IS DOCUMENTED AND THE NECESSARY ADJUSTMENTS ARE MADE TO CLOSE THE ACCOUNT. NEEDS ASSESSMENT PART VI, LINE 2IN FY21, MEDSTAR HARBOR HOSPITAL (MHH) 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 MHH'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 SOUTHERN BALTIMORE CITY AND NORTHERN ANNE ARUNDEL COUNTY AS ITS CBSA, WHICH INCLUDES ALL RESIDENTS LIVING IN ZIP CODE 21225. 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, MATERNAL AND CHILD HEALTH), ACCESS TO HEALTH CARE SERVICES (TRANSPORTATION, FEAR AND MISTRUST OF PROVIDERS AND ACCESS TO AFFORDABLE HEALTH CARE AND INSURANCE) AND SOCIAL DETERMINANTS OF HEALTH (HOUSING, 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. . TO THE EXTENT PRACTICABLE, DETERMINE WHETHER THE PATIENT IS ELIGIBLE FOR OTHER PUBLIC PROGRAMS THAT MAY ASSIST WITH HEALTH CARE COSTS.. 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:THE COMMUNITIES THE ORGANIZATION SERVES INCLUDES ZIP CODE 21225. THE ZIP CODE SPANS SOUTHERN BALTIMORE CITY AND NORTHERN ANNE ARUNDEL COUNTY, AND INCLUDES FOUR NEIGHBORHOODS: BROOKLYN, BROOKLYN PARK, CHERRY HILL AND CURTIS BAY. THERE ARE 18 HOSPITALS SERVING BALTIMORE CITY, AND 14 FEDERALLY DESIGNATED MEDICALLY UNDERSERVED AREAS PRESENT IN THE COMMUNITY.THERE ARE 33,545 PEOPLE IN 21225 AND THE MEDIAN INCOME IS $37,487. BALTIMORE CITY INCLUDES RESIDENTS WITH INCOMES BELOW THE FEDERAL POVERTY GUIDELINE (17.2%), UNINSURED (8%) AND MEDICAID RECIPIENTS (42.5%). DEMOGRAPHICS: CHERRY HILL IS HISTORICALLY A BLACK/AFRICAN AMERICAN NEIGHBORHOOD, WITH ROOTS GOING BACK TO THE 17TH CENTURY. AFTER WORLD WAR II, MORE THAN 600 HOUSING UNITS WERE BUILT THERE BY THE UNITED STATES WAR HOUSING ADMINISTRATION, SPECIFICALLY FOR AFRICAN AMERICAN WAR WORKERS. SHORTLY AFTER THE WAR, THESE UNITS WERE MADE INTO LOW-INCOME HOUSING. ADDITIONAL LOW-INCOME HOUSING UNITS HAVE BEEN ADDED THROUGHOUT THE YEARS, MAKING CHERRY HILL ONE OF THE LARGEST HOUSING PROJECTS EAST OF CHICAGO.FOR A VARIETY OF REASONS, INCLUDING THE HIGH POVERTY RATE AND LOW RATE OF HEALTH INSURANCE COVERAGE, MANY RESIDENTS OFTEN USE THE MEDSTAR HARBOR HOSPITAL EMERGENCY DEPARTMENT FOR PRIMARY CARE SERVICES. PROMOTION OF COMMUNITY HEALTH PART VI, LINE 5AS A COMMUNITY PARTNER, MEDSTAR HARBOR 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 HARBOR HOSPITAL ADDRESSES HEALTH AND WELLNESS BY OFFERING A VARIETY OF PROGRAMS AND RESOURCES THAT SEEK TO ADDRESS CHRONIC DISEASE PREVENTION AND MANAGEMENT. MEDSTAR HARBOR 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 HARBOR HOSPITAL'S COMMUNITY-BASED EDUCATION COURSES, SUCH AS DIABETES SELF-MANAGEMENT EDUCATION AND SMOKING CESSATION PROGRAMS ARE OFFERED TO SUPPORT HEALTHY LIFESTYLE CHANGES FOR COMMUNITY MEMBERS. ADDITIONALLY, THE HOSPITAL ACTIVELY PARTICIPATES IN PROVIDING HEALTH EDUCATION AT EVENTS ACROSS ITS CBSA. ACCESS TO CARE THE PRIORITY AREA IS ADDRESSING ACCESS TO BEHAVIORAL HEALTH SERVICES, INCLUDING MENTAL HEALTH AND SUBSTANCE USE TREATMENT. PATIENTS ARE SCREENED FOR SUBSTANCE USE IN THE EMERGENCY DEPARTMENT THROUGH THE SCREENING, BRIEF INTERVENTION, AND REFERRAL TO TREATMENT (SBIRT) PROGRAM. MEDSTAR HARBOR HOSPITAL EXPANDED ITS SBIRT PROGRAM TO INPATIENT LABOR AND DELIVERY, AS WELL AS 4 OUTPATIENT OB/GYN CLINICS ASSOCIATED WITH THE HOSPITAL. MEDSTAR HARBOR HOSPITAL'S COMMUNITY HEALTH TEAM LAUNCHED A NEW MOBILE VAN SERVICE IN FY21 TO PROVIDE PRIMARY CARE SERVICES AND COVID-19 VACCINATIONS TO RESIDENTS. TARGETING VULNERABLE POPULATIONS, THE MOBILE VAN HAS PROVIDED CARE TO INSURED, UNINSURED, UNDERINSURED, AND UNDOCUMENTED RESIDENTS WITHIN THE COMMUNITY. MEDSTAR HARBOR 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 HARBOR 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 HARBOR HOSPITAL PARTNERS WITH UBER HEALTH TO PROMOTE ACCESS TO CARE FOR VULNERABLE POPULATIONS. 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 HARBOR 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.). 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 HARBOR HOSPITAL CAN 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 HARBOR HOSPITAL WITH 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 HARBOR HOSPITAL IS FILED IN THE STATE OF MARYLAND. 0 THE BALTIMORE CITY FOUNDATION 11 E MT ROYAL AVE BALTIMORE MD 21202 521212473 501(C)(3) 16000 0 HOMELESS SERVICES BALTIMORE CITY HEALTH DEPARTMENT 1001 E FAYETTE ST BALTIMORE MD 21202 841568566 501(C)(3) 15000 0 BALTIMORE NURSE PRACTITIONER PROGRAM BALTIMORE CITY HEALTH DEPARTMENT 1001 E FAYETTE ST BALTIMORE MD 21202 841568566 501(C)(3) 15000 0 BALTIMORE NURSE PRACTITIONER PROGRAM 3 0 SCHOLARSHIPS 8 13935 SCHEDULE I, PART I, LINE 2 EACH YEAR, THE ORGANIZATION AWARDS SCHOLARSHIPS TO QUALIFIED INDIVIDUALS WISHING TO SEEK AN EDUCATION OR DEGREE IN THE HEALTHCARE FIELD. CLINICAL AND MEDICAL STAFF, NURSES AND PHYSICIANS ARE ESSENTIAL TO THE HOSPITAL'S GOAL TO PROVIDE HIGH QUALITY PATIENT CARE. SCHOLARSHIPS ARE AWARDED ON THE BASIS OF FINANCIAL NEED, ACADEMIC ACHIEVEMENT, AND THE GOAL OF PURSUING A HEALTHCARE CAREER. X 1 1 X X X X X X 0 0 0 0 0 0 0 0 0 KENNETH A SAMET DIRECTOR 0 2030199 0 7462050 0 6279147 0 59518 0 36769 0 15867683 0 0 STUART LEVINE MD FORMER OFFICER 677625 0 479124 0 0 0 8700 0 33606 0 1199055 0 0 0 JILL DONALDSON PRESIDENT 408502 0 303576 0 0 0 16873 0 28735 0 757686 0 0 0 LARA Q BARRINGER MD VP OF MEDICAL AFFAIRS AND CMO 384884 0 204099 0 0 0 336 0 6419 0 595738 0 0 0 DEANA STOUT CFO 0 323946 0 166195 0 44194 0 29388 0 21535 0 585258 0 0 ROBERT LALLY TREASURER 162937 162937 75137 75137 0 0 0 37559 0 17170 238074 292803 0 0 MOHSEN GHARIB MD DIRECTOR 420626 0 41500 0 770 0 8700 0 19690 0 491286 0 0 0 JILL JOHNSON FORMER VP OF OPS (SINCE 04/2020) 318586 0 106920 0 0 0 8700 0 25207 0 459413 0 0 0 KERUNNE S KETLOGETSWE MD DIRECTOR 314205 0 80334 0 750 0 8700 0 1921 0 405910 0 0 0 KEITH SHINER SECRETARY 112639 112639 27953 27953 0 0 0 8700 0 21033 140592 170325 0 0 DAWN OWENS CHIEF NURSING OFFICER 216129 0 52070 0 0 0 0 0 24673 0 292872 0 0 0 DANIEL TESFAMARIAM CLINICAL NURSE II 247647 0 4080 0 750 0 2600 0 19784 0 274861 0 0 0 DEBORAH MCKENZIE REGISTERED NURSE 140788 0 40484 0 750 0 25371 0 10034 0 217427 0 0 0 CHRIS GOOD PA-C 184985 0 0 0 5470 0 5533 0 10034 0 206022 0 0 0 PART I, LINE 1A HEALTH OR SOCIAL CLUB DUES: THE ORGANIZATION PAID SOCIAL CLUB DUES FOR ONE OF ITS OFFICERS. PARTICIPATION IN THESE ACTIVIES BY THE OFFICER WAS FOR BUSINESS PURPOSES AND HELPED THE ORGANIZATION FURTHER ITS EXEMPT PURPOSE. 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. ROBERT LALLY'S COMPENSATION IS FOR SERVICES PROVIDED AS CFO TO BOTH MEDSTAR FRANKLIN SQUARE MEDICAL CENTER AND MEDSTAR HARBOR HOSPITAL. KEITH SHINER'S COMPENSATION IS FOR SERVICES PROVIDED AS ATTORNEY TO BOTH MEDSTAR FRANKLIN SQUARE MEDICAL CENTER AND MEDSTAR HARBOR HOSPITAL. DEANA STOUT'S COMPENSATION IS FOR SERVICES PROVIDED AS CFO RESPECTIVELY, AT BOTH MEDSTAR GOOD SAMARITAN HOSPITAL AND MEDSTAR UNION MEMORIAL HOSPITAL. ACME PAPER & SUPPLY CO SEE PART V 547649 PACKAGING SUPPLIES VENDOR 0 BUSINESS TRANSACTIONS INVOLVING INTERESTED PERSONS SCHEDULE L, PART IVTHE FOLLOWING IS A SUBSTANTIAL CONTRIBUTOR (IN EXCESS OF $5,000) THAT ALSO PROVIDED SERVICES TO MEDSTAR HARBOR HOSPITAL VALUED IN EXCESS OF $100,000: ACME PAPER & SUPPLY CO. PER MEDSTAR'S CONFLICT OF INTEREST POLICY, THESE TRANSACTIONS ARE AT ARMS-LENGTH FOR FAIR MARKET VALUE. 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 DESCRIPTION OF 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 ENFORCEMENT 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 3,027,522. MANAGEMENT AND GENERAL EXPENSES 233,787. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 3,261,309. PHYSICIAN SERVICES: PROGRAM SERVICE EXPENSES 582,824. MANAGEMENT AND GENERAL EXPENSES 226,509. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 809,333. TESTING & DIAGNOSTIC SERVICES: PROGRAM SERVICE EXPENSES 579,362. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 579,362. PHARMACY SERVICES: PROGRAM SERVICE EXPENSES 12,126. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 12,126. LAB SERVICES: PROGRAM SERVICE EXPENSES 527,140. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 527,140. SUBSIDY EXPENSE - INTERCOMPANY: PROGRAM SERVICE EXPENSES 17,465,263. MANAGEMENT AND GENERAL EXPENSES 42,765. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 17,508,028. MISC FIXED PURCH SRVCS: PROGRAM SERVICE EXPENSES 636,103. MANAGEMENT AND GENERAL EXPENSES 54,572. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 690,675. CONSULTING FEES: PROGRAM SERVICE EXPENSES 81,424. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 81,424. MISCELLANEOUS: PROGRAM SERVICE EXPENSES 2,664,984. MANAGEMENT AND GENERAL EXPENSES -157,939. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,507,045. FORM 990, PART XI, LINE 9: EQUITY TRANSFER-NET ASSETS 27,263,362. MEDSTAR HEALTH ANESTHESIA SERVICES C LLC 3001 SOUTH HANOVER STREET BALTIMORE MD 21225 205909818 HEALTH SVCS MD 0 HARBOR CHURCH HOME CORPORATION 10980 GRANTCHESTER WAY COLUMBIA MD 21044 237374724 MEDICAL FUND MD 501(C)(3) PF N/A 1 FRANKLIN SQUARE HOSPITAL CENTER INC 9000 FRANKLIN SQUARE DRIVE BALTIMORE MD 21237 520608007 HOSPITAL MD 501(C)(3) LINE 3 N/A 1 MEDSTAR HEALTH INC 10980 GRANTCHESTER WAY COLUMBIA MD 21044 522087445 MEDICAL SVCS MD 501(C)(3) LINE 12C, III-FI N/A 0 MONTGOMERY GENERAL HOSPITAL 18101 PRINCE PHILIP DRIVE OLNEY MD 20832 520646893 HOSPITAL MD 501(C)(3) LINE 3 N/A 1 THE GOOD SAMARITAN HOSPITAL OF MARYLAND 5601 LOCH RAVEN BLVD BALTIMORE MD 21239 520591607 HOSPITAL MD 501(C)(3) LINE 3 N/A 1 THE UNION MEMORIAL HOSPITAL 201 EAST UNIVERSITY PARKWAY BALTIMORE MD 21218 520591685 HOSPITAL MD 501(C)(3) LINE 3 N/A 1 MEDSTAR HEALTH RESEARCH INSTITUTE 108 IRVING STREET NW WASHINGTON DC 20010 526056274 HOSPITAL DC 501(C)(3) LINE 4 N/A 1 THE MEDSTAR-GEORGETOWN MEDICAL CENTER I HOPSITAL ADMIN 1 MAIN BLDG WASHINGTON DC 20007 522218584 HOSPITAL DC 501(C)(3) LINE 3 N/A 1 WASHINGTON HOSPITAL CENTER CORPORATION 110 IRVING STREET NW WASHINGTON DC 20010 521272129 HOSPITAL DC 501(C)(3) LINE 3 N/A 1 HH MEDSTAR HEALTH INC 10980 GRANTCHESTER WAY COLUMBIA MD 21044 521542230 MEDICAL SVCS MD 501(C)(3) LINE 12C, III-FI N/A 1 MEDSTAR AMBULATORY SERVICES INC 10980 GRANTCHESTER WAY COLUMBIA MD 21044 521132992 ADMIN SVCS MD 501(C)(3) LINE 12C, III-FI N/A 1 BAY LIFE SERVICES INC 10980 GRANTCHESTER WAY COLUMBIA MD 21044 521496539 MENTAL HEALTH MD 501(C)(3) LINE 10 N/A 1 CHURCH HOME AND HOSPITAL OF THE CITY OF 10980 GRANTCHESTER WAY COLUMBIA MD 21044 520591600 MEDICAL FUND MD 501(C)(3) LINE 12A, I N/A 1 GOOD SAMARITAN NURSING CENTER INC 5601 LOCH RAVEN BLVD BALTIMORE MD 21239 521672866 MEDICAL SVCS MD 501(C)(3) LINE 10 N/A 1 GS HOUSING INC 5601 LOCH RAVEN BLVD BALTIMORE MD 21239 521481656 ELDER HOUSING MD 501(C)(3) LINE 10 N/A 1 GS PROPERTIES INC 5601 LOCH RAVEN BLVD BALTIMORE MD 21239 521429853 ADMIN SVCS MD 501(C)(3) LINE 12A, I N/A 1 MEDSTAR HEALTH VISITING NURSES ASSOCIATI 4061 POWDERMILL ROAD CALVERTON MD 20705 530196597 MEDICAL SVCS MD 501(C)(3) LINE 10 N/A 1 MEDSTAR VNA HEALTHCARE 4061 POWDERMILL ROAD SUITE 210 CALVERTON MD 20705 521458516 MEDICAL SVCS MD 501(C)(3) LINE 10 N/A 1 MGH WOMEN'S BOARD 18101 PRINCE PHILIP DRIVE OLNEY MD 20832 526039600 FOUNDATION MD 501(C)(3) LINE 12C, III-FI N/A 1 NATIONAL REHABILITATION HOSPITAL 102 IRVING STREET NW WASHINGTON DC 20010 521369749 HOSPITAL DC 501(C)(3) LINE 3 N/A 1 REGIONAL REHAB AT OLNEY INC 18101 PRINCE PHILIP DRIVE OLNEY MD 20832 522310902 MEDICAL SVCS MD 501(C)(3) LINE 3 N/A 1 SUBURBAN NRH MEDICAL REHABILITATION I 102 IRVING STREET NW WASHINGTON DC 20010 521931151 MEDICAL SVCS DC 501(C)(3) LINE 3 N/A 1 THE THOMAS O'NEIL CATHOLIC HEALTH CARE F 5601 LOCH RAVEN BLVD BALTIMORE MD 21239 521104382 FOUNDATION MD 501(C)(3) LINE 12D, III-O N/A 1 VNA INC 4061 POWDERMILL ROAD SUITE 210 CALVERTON MD 20705 521332411 ADMIN SVCS MD 501(C)(3) LINE 12A, I N/A 1 WOODBOURNE WOODS INC 5601 LOCH RAVEN BLVD BALTIMORE MD 21239 522299070 ELDER HOUSING MD 501(C)(3) LINE 10 N/A 1 HOSPICE OF ST MARY'S INC PO BOX 527 LEONARDTOWN MD 20650 522153926 SUPPORT ORG MD 501(C)(3) LINE 12A, I N/A 1 ST MARY'S HOSPITAL OF ST MARY'S COUNTY 25500 POINT LOOKOUT ROAD LEONARDTOWN MD 20650 520619006 HOSPITAL MD 501(C)(3) LINE 3 N/A 1 MEDSTAR SOUTHERN MD HOSPITAL CENTER 7503 SURRATTS ROAD CLINTON MD 20735 460726303 HOSPITAL MD 501(C)(3) LINE 3 N/A 1 MEDSTAR HEALTH INC AND AFFILIATES 10980 GRANTCHESTER WAY COLUMBIA MD 21044 477454613 RET. TRUST MD 501(C)(3) N/A N/A 1 MEDSTAR SHAH MSO LLC 10980 GRANTCHESTER WAY COLUMBIA MD 21044 462700536 MGMT SVCS MD N/A N/A 0 0 22590 SHADY COURT LLC 24035 THREE NOTCH ROAD HOLLYWOOD MD 20636 473361777 REAL ESTATE MD N/A N/A 0 0 24035 THREE NOTCH ROAD LLC 24035 THREE NOTCH ROAD HOLLYWOOD MD 20636 473375076 REAL ESTATE MD N/A N/A 0 0 37767 MARKET DRIVE LLC 37767 MARKET DRIVE CHARLOTTE HALL MD 20622 REAL ESTATE MD N/A N/A 0 0 26840 POINT LOOKOUT ROAD LLC 24035 THREE NOTCH ROAD HOLLYWOOD MD 20636 473393670 REAL ESTATE MD N/A N/A 0 0 MONTGOMERY COMMUNITY MRI LP 4110 ASPEN HILL ROAD ROCKVILLE MD 20853 521534253 MRI SCREENING MD N/A N/A 0 0 PHYSIOTHERAPY ASSOCIATES NRH REHAB LLC 4714 GETTYSBURG ROAD MECHANICSBURG PA 17055 522212036 PHYSIOTHERAPY PA N/A N/A 0 0 PHYSICIAN IMAGING OF WASHINGTON HOSPITAL CENTER LLC 840 CRESCENT CENTRE DR FRANKLIN TN 37067 562616090 RADIOLOGY SVC TN N/A N/A 0 0 FRANKLIN IMAGING LLC 7253 AMBASSADOR RD BALTIMORE MD 21244 521588688 IMAGING MD N/A N/A 0 0 10 ST PATRICK'S DRIVE LLC 10 ST PATRICKS DRIVE WALDORF MD 20603 832261766 REAL ESTATE MD N/A N/A 0 0 MEDSTAR ENDOSCOPY CTR AT LUTHERVILLELLC 1300 BELLONA AVE LUTHERVILLE MD 21093 823193901 SURGERY MD N/A N/A 0 0 CAPITAL ENDOSCOPY LLC 6475 NEW HAMPSHIRE AVE HYATTSVILLE MD 20783 134244093 SURGERY MD N/A N/A 0 0 4240 ALTAMONT PLACE LLC 103 CENTENNIAL STREET SUITE K LA PLATA MD 20646 861202310 REAL ESTATE MD N/A N/A 0 0 MEDSTAR ENDOSCOPY CENTER-SILVER SPRING LLC 12002 VEIRS MILL ROAD SILVER SPRING MD 20906 872341245 SURGERY MD N/A N/A 0 0 MEDSTAR PHARMACIES INC 10980 GRANTCHESTER WAY COLUMBIA MD 21044 521513056 DRUG SALES MD N/A C 0 EXTENCARE INC 10980 GRANTCHESTER WAY COLUMBIA MD 21044 521556228 MEDICAL SVCS MD N/A C 0 HELIX RESOURCES MANAGEMENT INC 10980 GRANTCHESTER WAY COLUMBIA MD 21044 521913070 ADMIN SVCS MD N/A C 0 HELIXCARE MEDICAL GROUP LLC 10980 GRANTCHESTER WAY COLUMBIA MD 21044 521955580 MEDICAL SVCS MD N/A C 0 HELIXCARE PROPERTIES LLC 10980 GRANTCHESTER WAY COLUMBIA MD 21044 521966695 MEDICAL SVCS MD N/A C 0 PARKWAY VENTURES INC 10980 GRANTCHESTER WAY COLUMBIA MD 21044 521893569 HOLDING CO. MD N/A C 0 PHYSICIANS ADMINISTRATIVE SERVICES INC 10980 GRANTCHESTER WAY COLUMBIA MD 21044 237042074 BILLING SVCS MD N/A C 0 MEDSTAR FAMILY CHOICE INC 10980 GRANTCHESTER WAY COLUMBIA MD 21044 521995521 MANAGED CARE MD N/A C 0 MEDSTAR ENTERPRISES INC 4061 POWDERMILL ROAD SUITE 210 CALVERTON MD 20705 522139841 ADMIN SERVICE MD N/A C 0 SITEL INC 10980 GRANTCHESTER WAY COLUMBIA MD 21044 900753340 EDUCATIONAL MD N/A C 0 STAR BILLING INC 4061 POWDERMILL ROAD SUITE 210 CALVERTON MD 20705 521850113 BILLING SVCS MD N/A C 0 WASHINGTON RISK NETWORK MANAGEMENT INC 4061 POWDERMILL ROAD SUITE 210 CALVERTON MD 20705 522132677 MEDICAL SVCS MD N/A C 0 WASHINGTON HOSPITAL CENTER PHYSICIAN HOS 100 IRVING STREET NW WASHINGTON DC 20010 521931000 MEDICAL SVCS DC N/A C 0 MEDSTAR PHYSICIAN PARTNERS INC 4061 POWDERMILL ROAD SUITE 210 CALVERTON MD 20705 522030809 MEDICAL SVCS MD N/A C 0 FRANKLIN SQUARE DRIVE LAND CONDO ASSOCIA 10980 GRANTCHESTER WAY COLUMBIA MD 21044 760756352 CONDOMINIUMS MD N/A C 0 MGH DIVERSIFIED SERVICES INC 18101 PRINCE PHILIP DRIVE OLNEY MD 20832 521943602 MEDICAL SVCS MD N/A C 0 ST MARY'S HEALTH ALLIANCE INC 25500 POINT LOOKOUT ROAD LEONARDTOWN MD 20650 521930331 MEDICAL SVCS MD N/A C 0 ST MARY'S CONDO ASSOCIATION 25500 POINT LOOKOUT RD LEONARDTOWN MD 20650 273377216 CONDOMINIUMS MD N/A C 0 GREENSPRING FINANCIAL INSURANCE LIMITED 878 WEST BAY RD PO BOX 1159 GRAND CAYMAN CJ KY1-1102 980188617 INSURANCE CJ N/A C 0 MEDSTAR HEALTH MASTER RETIREMENT TRUST 103 SOUTH CHURCH ST GRAND CAYMAN CJ KY1-1002 981371657 INVESTMENTS CJ N/A C 0 MEDSTAR HEALTH INC - INVESTMENT FUND I 103 SOUTH CHURCH ST GRAND CAYMAN CJ KY1-1002 981310273 INVESTMENTS CJ N/A C 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1 1 1 0 HH MEDSTAR HEALTH P 73485120 FMV FRANKLIN SQUARE HOSPITAL CENTER INC P 2848217 FMV NATIONAL REHABILITATION HOSPITAL P 1019721 FMV MEDSTAR SOUTHERN MD HOSPITAL CENTER INC Q 8224952 FMV THE UNION MEMORIAL HOSPITAL P 358086 FMV WASHINGTON HOSPITAL CENTER CORPORATION Q 187424 FMV