2021-05-07T13:37:08-05:00 2020-06-30 KPMG LLP 8350 Broad Street Suite 900 McLean VA 22102 990 2019-07-01 520619006 ST MARYS HOSPITAL OF ST MARYS COUNTY INC % JOEL BRYAN STMA 3014756003 25500 POINT LOOKOUT ROAD LEONARDTOWN MD 20650 JOEL BRYAN VP/TREASURER 4107726721 2021-05-05 true JG WHITE P01498698 7032868000 2021-05-02 2019 2022-09-23 18:48:47Z MEDSTAR ST MARY'S HOSPITAL CHRISTINE WRAY 25500 POINT LOOKOUT ROAD LEONARDTOWN MD 20650 180977346 false X WWW.STMARYSHOSPITALMD.ORG X 1912 MD MEDSTAR ST. MARY'S HOSPITAL UPHOLDS ITS TRADITION OF CARING BY CONTINUOUSLY PROMOTING, MAINTAINING AND IMPROVING HEALTH THROUGH EDUCATION AND SERVICE. 13 7 1467 124 0 0 785606 848870 170639642 177372037 -3880 -55266 731655 2577709 172153023 180743350 0 23259 0 0 74053045 78009864 0 0 4518 85385560 84083868 159438605 162116991 12714418 18626359 104425495 106795587 17260995 55290623 87164500 51504964 X AS A PROUD MEMBER OF MEDSTAR HEALTH, MEDSTAR ST. MARY'S HOSPITAL'S (MEDSTAR ST. MARY'S) MISSION IS TO UPHOLD ITS TRADITION OF CARING BY CONTINUOUSLY PROMOTING, MAINTAINING, AND IMPROVING HEALTH THROUGH EDUCATION AND SERVICE WHILE ASSURING QUALITY CARE, PATIENT SAFETY AND FISCAL INTEGRITY. MEDSTAR ST. MARY'S IS LOCATED IN LEONARDTOWN, MARYLAND, IN THE SOUTHERN REGION. IN FISCAL YEAR 2020, MSMH HAD 7,786 INPATIENT ADMISSIONS AND 142,903 OUTPATIENT VISITS INCLUDING 42,942 EMERGENCY VISITS. false false 115604857 23259 175541083 MedStar St. Marys Hospitals largest program is access to and the provision of acute hospital services for communities of St. Marys County, Maryland and the surrounding areas. In addition to the program service expenses listed above, MedStar St. Marys incurred $29.2M of management and general expenses in providing services to its communities. MedStar St. Marys provides general, acute care services in medicine, surgery, obstetrics and gynecology, oncology, orthopaedics, pulmonary and cardiac rehabilitation, and psychiatry. The hospital offers kidney transplant services through the MedStar Georgetown Transplant Institute and orthopaedic services through the MedStar Orthopaedic Institute. It also provides hospice care and is partnered in a joint venture that provides home care. In addition to emergency room care, it operates an urgent care facility located 15 miles north of campus as well as on-campus and mobile community based health services. An outpatient pavilion includes cancer care and infusion services, imaging and womens health services, and community outreach and physician office space. Services also include a Center for Wound Healing. As one of the largest healthcare systems in Maryland and the Washington, D.C., region, MedStar Health and its affiliated entities cared for one in four COVID-19 patients in the region since March 2020. Operating as One MedStar and aligning with guidance from the Centers for Disease Control and Prevention (CDC) and local Departments of Health, MedStar Healths COVID-19 preparations and response were guided by two critical drivers: providing a safe care environment for patients and associates and ensuring operational continuity to fulfill our core mission of caring for our communities. These efforts included adding hospital beds in preparation for patient surges; balancing hospital admissions by using urgent care sites as frontline providers and facilitating telehealth interactions for virtual care and referrals; utilizing home health services to transition care from inpatient settings, ambulatory facilities, and a convention center field hospital; and standing up more than 40 COVID-19 testing locations. Underlying these actions is MedStar Healths commitment to the highest levels of quality and safety, reflected by the systemwide implementation of universal face masking for patients and associates, and acquisition of Personal Protective Equipment at usage levels 10 times normal use. 11367521 0 1830954 MedStar St. Marys provided $11.4M in subsidized (mission driven) health services in fiscal year 2020. 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 provided include hospital outpatient services, womens and childrens services, behavioral health, and emergency and trauma services. 3903558 0 0 MedStar St. Marys provided $3.9M in charity care services in fiscal year 2020. Charity care is provided pursuant to MedStar Healths Financial Assistance Policy to members of the community whose income is below certain thresholds and for which the hospital is not compensated. Under Marylands unique payer system, the amount reported represents MedStar St. Marys charity care expense. Other charity care expenses are indirectly reimbursed via the state of Marylands payment system. 130875936 true true false false false false false false false true true false true false true true false true false false false false false false true false true true false true true false false false false false false false false true false false false false true true true false false true 0 0 true 1467 true false false false false false true true false false false false true false X 13 7 false false false false true true true true true false false true true true true true true true true true true MD X JOEL BRYAN 4107726721 10980 GRANTCHESTER WAY COLUMBIA MD 21044 X KENNETH A SAMET DIRECTOR 1.0 39.0 X 0 7598800 90696 CHRISTINE R WRAY PRESIDENT/DIRECTOR 20.0 20.0 X 584325 584325 36483 John Harvey MD DIRECTOR 40.0 0.0 X 845864 0 34280 Stephen Michaels MD SECRETARY 40.0 0.0 X 834800 0 35180 Yahia Tagouri MD DIRECTOR 40.0 0.0 X 564478 0 36569 AMIR KHAN Medical Director 40.0 0.0 X 501179 0 34351 Robert Lally CFO (2/2020 - 5/2020) 1.0 39.0 X 0 441802 60761 ANNA CHOI MD DIRECTOR 40.0 0.0 X 437596 0 28389 DAVID HAVRILLA CFO (UNTIL 2/2020) 10.0 30.0 X 106168 318503 36843 Bruce Gibson Intensivist 40.0 0.0 X 415270 0 34305 JEAN PIERRE ELKHOURY INTENSIVIST 40.0 0.0 X 400158 0 33905 DAVID ALLEN MD PHYSICIAN 40.0 0.0 X 360435 0 28321 DANIEL FEELEY Former CFO 0.0 40.0 X 0 281372 34050 KRISHNA P JAYARAMAN MD DIRECTOR 40.0 0.0 X 272109 0 0 DAWN YEITRAKIS CNO PHYSICIAN 40.0 0.0 X 223907 0 21154 Tara Saggar MD DIRECTOR 40.0 0.0 X 157285 0 33966 Carrie Jennison Former CFO 0.0 0.0 X 80076 80076 12762 TRACY HARRIS PHD DIRECTOR 1.0 0.0 X 0 0 0 JENNIFER L BLAKE CHAIR 1.0 0.0 X 0 0 0 CHRISTINA L BROOM DIRECTOR 1.0 0.0 X 0 0 0 KAREN T GARNER DIRECTOR 1.0 0.0 X 0 0 0 STEPHEN A SCHMEISER DIRECTOR 1.0 0.0 X 0 0 0 VINCE WHITTLES VICE CHAIR 1.0 0.0 X 0 0 0 MICHAEL MEISEL CFO (As of 5/2020) 40.0 0.0 X 0 0 0 5783650 9304878 592015 47 true true false SODEXO INC AFFILIATES 9801 Washingtonian Blvd GAITHERSBURG MD 20878 Food&Facilities Mgt 1714739 AMN HEALTHCARE INC 2735 COLLECTION CENTER DR CHICAGO IL 60693 Staffing services 1340223 DIVERSIFIED CLINICAL SERVICES PO BOX 636981 CINCINNATI OH 452636981 Medical services 840828 NOOR SERVICES LLC 813 Constellation Dr GREAT FALLS VA 22066 Medical services 582903 CERNER CORPORATION 51 VALLEY STREAM PKWY MALVERN PA 19355 IT services 490468 46 173959 25450 649461 42345 848870 NET PATIENT SERVICE REVENUE 621400 174119792 174119792 PHARMACY REVENUE 621400 3199945 3199945 OTHER OPERATING REVENUE 900099 52300 52300 177372037 19115 19115 0 0 295198 295198 0 295198 295198 10540 84921 10540 -84921 -74381 -74381 96280 173959 149075 -52795 -52795 0 0 0 0 0 0 REBATE INCOME 900099 349460 349460 EQUITY IN SUBSIDIARIES 900099 110340 110340 GIFT SHOP AND VENDING INCOME 900099 58605 58605 1816901 1816901 2335306 180743350 177372037 2522443 0 23259 23259 0 0 3998459 3819473 178986 0 0 61374211 58578177 2796034 1213097 1157832 55265 7068525 6861002 207523 0 4355572 4108689 246883 17757366 5947 17751419 3731 3731 0 0 0 0 15358737 13966036 1392701 0 444670 373442 71075 153 946289 727731 214193 4365 0 0 788869 673538 115331 294294 265076 29218 0 57751 29932 27819 657098 657098 0 7831264 5819254 2012010 1501261 48 1501213 MED /SURG SUPPLIES 21433713 20328853 1104860 MAINTENANCE / REPAIRS 5358573 4869471 489102 IMPLANTS/PROSTHESES 4696726 4695622 1104 UTILITIES 2045671 1695938 349733 4907855 2876616 2031239 162116991 130875936 31236537 4518 1226975 1055272 0 0 428580 378781 16899706 17415014 0 0 0 0 0 0 2767287 3157781 1334054 411313 170175412 97566593 73230570 72608819 1073868 1094521 0 0 7462055 7582275 0 0 2400 3091811 104425495 106795587 9717216 10109638 0 0 -78440 75768 0 0 0 0 0 0 0 0 0 0 7622219 45105217 17260995 55290623 X 85866232 50276629 1298268 1228335 87164500 51504964 104425495 106795587 X 18626359 2314 -54288209 X X false true X true false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 114569 778 115347 113317 1252 114569 112815 502 113317 112723 92 112815 112689 34 112723 0.86690 0.13310 false false 5733422 5733422 93158640 44498413 48660227 662122 609729 52393 64951801 51236083 13715718 5669427 1222368 4447059 72608819 INVESTMENTS IN CONSOLIDATED 3959781 F INVESTMENTS IN UNCONSOLIDATED 3622494 F 7582275 0 ADVANCES 35768449 OPERATING LEASE LIABILITY 3114287 L/T PENSION LIABILITY 3108021 CREDIT BALANCES PATIENT A/R 1154537 GBR LIABILITY 445521 UCC POOL LIABILITY 25739 OTHER LIABILITIES 1488663 45105217 X ENDOWMENT FUNDS SCHEDULE D, PART V THE ENDOWMENT IS USED TO FUND THE NEEDS OF THE HOSPITAL. FIN 48 FOOTNOTE SCHEDULE D, PART X 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, 2020. Gala 270239 173959 96280 6960 103367 15650 23098 0 270239 173959 96280 6960 103367 15650 23098 149075 -52795 true true X true X true X true true false true true 3903558 3903558 0.02410 3903558 3903558 0.02410 2000327 241653 1758674 0.01080 81040 81040 0.00050 11367521 1830954 9536567 0.05880 479539 479539 0.00300 13928427 2072607 11855820 0.07310 17831985 2072607 15759378 0.09720 156189 156189 0.00100 516305 516305 0.00320 3500 3500 30072 30072 0.00020 477059 477059 0.00290 1183125 1183125 0.00730 true 2576541 true true 1 1 ST MARYS HOSPITAL OF ST MARYS COUNTY 25500 POINT LOOKOUT ROAD LEONARDTOWN MD 20650 X X X ST MARYS HOSPITAL OF ST MARYS COUNTY 1 false false true X X X X X X X X X 17 true false false true X HTTP://WWW.MEDSTARSTMARYS.ORG/ X true 17 true http://www.medstarstmarys.org/ false true X 200. 400. X X X X X true true X X X X true X HTTP://WWW.MEDSTARSTMARYS.ORG/ X HTTP://WWW.MEDSTARSTMARYS.ORG/ X HTTP://WWW.MEDSTARSTMARYS.OR X X X X X X true X false X X X X true X false false CHNA INPUT PART V, SECTION B, LINE 5 HOSPITAL LEAD ROLE DESCRIPTION The 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: Lori Werrell Executive Sponsor Role Description The Executive Sponsor serves as the conduit between the Advisory Task Force and the Senior Management Team. The sponsor is an active participant of the Advisory Task Force and he/she communicates the hospital's clinical strengths and program priorities to diverse audiences. Name of Executive Sponsor: STEPHEN T. MICHAELS, M.D. Advisory Task Force Role Description The 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 TITLE NAME OF ORGANIZATION Bishop Spence Pastor Christian Church Lexington Park Christine Wray President MSMH Colenthia MalloY CEO Greater Baden Medical Center Debbie Baker/ Community Health Workers MSMH, AccessHealth Darryl Miles Dr. Elizabeth Morse Chief of Nursing Officer MSMH Dr. Fahmi Fahmi Physician, Pediatrics MSMH, Primary Care Dr. Connor Lundegran Chief of Medical Staff MedStar Cardiology Associates Ella Mae Russell Director St. Marys County Department of Social Services Gerard McGloin CEO Pathways Holly Meyer Director of Marketing MSMH John Greely Director, Performance MSMH Improvement Kathleen OBrien CEO Walden Sierra Behavioral Health Lanny Lancater CEO Three Oaks Shelter Lori Werrell Director, Population and MSMH Community Health Mary Leigh Harless Board Member, ATF MSMH Chairperson Meena Brewster, MD Health Officer St. Marys County Health Department Mike Brown Community Member Community Resident Nathaniel Scroggins President Minority Outreach Coalition member Quinton Lucas Physician, Family Practice MSMH, Primary Care Stephen Michaels, MD Executive Sponsor MSMH COO/CMO Tracey Harris Board Member, ATF College of Southern Co-Chair, Dean Maryland IMPLEMENTATION STRATEGIES PART V, SECTION B, LINE 11 THE 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 HOSPITALS STRENGTHS. CHARITY CARE AT COST PART I, LINE 7A MARYLAND'S REGULATORY SYSTEM CREATES A UNIQUE PROCESS FOR HOSPITAL PAYMENT THAT DIFFERS FROM THE REST OF THE NATION. THE HEALTH SERVICES COST REVIEW COMMISSION (HSCRC), DETERMINES PAYMENT THROUGH A RATE-SETTING PROCESS AND ALL PAYORS, INCLUDING GOVERNMENTAL PAYORS, PAY THE SAME AMOUNT FOR THE SAME SERVICES DELIVERED AT THE SAME HOSPITAL. MARYLAND'S UNIQUE ALL-PAYOR SYSTEM INCLUDES A METHOD FOR REFERENCING UNCOMPENSATED CARE IN EACH PAYORS' RATES, WHICH DOES NOT ENABLE MARYLAND HOSPITALS TO BREAKOUT ANY OFFSETTING REVENUE RELATED TO UNCOMPENSATED CARE. UNREIMBURSED MEDICAID PART I, LINE 7B MARYLAND'S REGULATORY SYSTEM CREATES A UNIQUE PROCESS FOR HOSPITAL PAYMENT THAT DIFFERS FROM THE REST OF THE NATION. THE HEALTH SERVICES COST REVIEW COMMISSION (HSCRC), DETERMINES PAYMENT THROUGH A RATE-SETTING PROCESS AND ALL PAYORS, INCLUDING GOVERNMENTAL PAYORS, PAY THE SAME AMOUNT FOR THE SAME SERVICES DELIVERED AT THE SAME HOSPITAL. MARYLAND'S UNIQUE ALL-PAYOR SYSTEM INCLUDES A METHOD FOR REFERENCING UNCOMPENSATED CARE IN EACH PAYORS' RATES, WHICH DOES NOT ENABLE MARYLAND HOSPITALS TO BREAKOUT ANY OFFSETTING REVENUE RELATED TO UNCOMPENSATED CARE. COMMUNITY BENEFIT EXPENSES ARE EQUAL TO MEDICAID REVENUES IN MARYLAND, AS SUCH, THE NET EFFECT IS ZERO. THE EXCEPTION TO THIS IS THE IMPACT ON THE HOSPITAL OF ITS SHARE OF THE MEDICAID ASSESSMENT. IN RECENT YEARS, THE STATE OF MARYLAND HAS CLOSED FISCAL GAPS IN THE STATE MEDICAID BUDGET BY ASSESSING HOSPITALS THROUGH THE RATE-SETTING SYSTEM. BAD DEBT PART III, LINES 2 & 4 MEDSTAR 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 8 MARYLAND'S REGULATORY SYSTEM CREATES A UNIQUE PROCESS FOR HOSPITAL PAYMENT THAT DIFFERS FROM THE REST OF THE NATION. THE HEALTH SERVICES COST REVIEW COMMISSION (HSCRC) DETERMINES PAYMENT THROUGH A RATE-SETTING PROCESS AND ALL PAYORS, INCLUDING GOVERNMENTAL PAYORS, PAY THE SAME AMOUNT FOR THE SAME SERVICES DELIVERED AT THE SAME HOSPITAL. MARYLAND'S UNIQUE ALL-PAYOR SYSTEM INCLUDES A METHOD FOR REFERENCING UNCOMPENSATED CARE IN EACH PAYORS' RATES, WHICH DOES NOT ENABLE MARYLAND HOSPITALS TO BREAKOUT ANY OFFSETTING REVENUE RELATED TO UNCOMPENSATED CARE. AS SUCH, THE NET EFFECT FOR MEDICARE EXPENSES AND REVENUES IN MARYLAND IS ZERO. PART III, LINE 9B IF 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 2 In FY18, MedStar St. Marys Hospital (MSMH) 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 hospitals FY18 CHNA and three-year Implementation Strategies were endorsed by MSMHs Board of Directors and approved by the MedStar Health Board of Directors. The document became available on the hospitals website on June 30, 2018. During FY19, key revisions were made across MedStar Health to more effectively impact the communities served throughout Maryland and Washington, DC. Several internal meetings were convened with leadership from each MedStar Health Hospital to review current practices and strategies. As a result of these meetings, the approach to the current CHNA for the remainder of the three-year cycle (FY19-FY21) was revised. A key revision to the CHNA is a greater focus on hospital area strategies that are most appropriate for the local communities served. The number of strategies each hospital is accountable for executing was reduced to encourage more meaningful reach within key areas contrasted with broader reach with reduced impact. Using the standard categories, Health and Wellness, Access to Care and Social Determinants of Health to determine what to prioritize for the CHNA IRS requirements, each hospital agreed to select two to three strategies as priorities that have size and scale impact and measurable outcomes. All other programming was integrated as part of the hospitals 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 hospitals Community Benefit Service Area (CBSA) remains the same, based on the Advisory Task Force (ATF) recommendation. The hospital identified Lexington Park as its CBSA, which includes all residents living in ZIP code 20653. 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. MSMHs health priorities for the CBSA include health and wellness (chronic disease prevention and management), access to care (community health programs at East Run Health Center) and social determinants of health (AccessHealth, community health worker program and transportation). As a proud member of MedStar Health, representatives from MSMH 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 3 As one of the regions leading not-for-profit healthcare systems, MedStar Health is committed to ensuring that uninsured patients; underinsured patients meeting medical hardship criteria; and patients determined eligible for presumptive eligibility within the communities we serve who lack financial resources have access to emergency and medically necessary hospital services. MedStar 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 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 hospitals and hospital-based physician practices will work with their uninsured patients seeking emergency and medically necessary care to gain an understanding of each patients financial resources. Based on this information and eligibility determination, MedStar hospitals and hospital-based physician practices will provide financial assistance to uninsured patients who reside within the communities we serve in one or more of the following ways: . Assist with enrollment in publicly-funded entitlement programs (e.g., Medicaid); . Refer patients to State or Federal Insurance Exchange Navigator resources; . Assist with consideration of funding that may be available from other charitable organizations; . Provide financial assistance according to applicable policy guidelines; . Provide financial assistance for payment of MedStar hospital and hospital-based physician practice charges using a sliding-scale based on the patients household income and financial resources; . Offer periodic payment plans to assist patients with financing their healthcare services. 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; . Translating the MedStar Financial Assistance Policy, MedStar Uniform Financial Assistance Application, and the Medstar Patient Information Sheet into primary languages of all significant populations with Limited English Proficiency. . MedStar Health will provide public notices yearly in local newspapers serving all hospital target populations. MedStar Health provides a financial assistance probable and likely eligibility determination to the patient within two business days from receipt of the initial 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 Healths 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 patients 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 patients financial circumstances may change. . It is a patients 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 medical 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 call customer service at 1-800-280-9006. Uninsured patients of MedStar Healths facilities may be eligible for full financial assistance or partial sliding-scale financial assistance 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 patients family, family size, and the extent of the medical costs to be incurred by the patient. COMMUNITY INFORMATION PART VI, LINE 4 Geographic: St. Marys County is located on a peninsula in Southern Maryland with over 400 miles of shoreline on the Patuxent River, Potomac River and Chesapeake Bay. MSMH, located in Leonardtown, Maryland, is the only acute care hospital in the county. The county is designated by the Bureau of Primary Care as a health professions shortage area for dental and mental health. The southern half of the county is designated as a primary care shortage area. The hospitals CBSA includes the 113,510 residents of St. Marys County, Maryland, with a focus on the Lexington Park community (ZIP code 20653). The Lexington Park community was selected due to a high density of low-income residents. Demographics: St. Marys County has a population of 113,510 citizens. St. Marys County is a state designated rural area with a diverse population. Farmers, waterman, high tech scientists, defense contractors/engineers and military members live alongside Amish and Mennonite communities, making the St. Marys County population unique. The residents of St. Marys County are majority White (78.1%), followed by Black/African American (14.9%), Hispanic (5.6%), Asian (2.9%), American Indian/Alaska Native (0.5%) and Native Hawaiian and other Pacific Islander (0.1%). St. Marys County continues to maintain steady population growth. After an alarming 22% population increase over the past 15 years, the growth rate has steadied to 5% since 2010.The county also has the highest percentage of veterans in Maryland, one of the lowest median ages, and an emerging Hispanic population, all of which influence health and delivery of health services. Heart disease and stroke, obesity, diabetes, cancer, and lower respiratory illnesses, are the leading causes of death. The high paying jobs associated with the Patuxent River Naval Air Station mask a growing underserved area located outside the base gates in the Lexington Park community (ZIP code 20653). Within the county, 76.5% of employed individuals remain in the county for their employment. Lexington Park, the CBSA, has the greatest number of medically underserved citizens in the region. Approximately 11% (12,906 residents) of the St. Marys population lives in the Lexington Park Census Designated Place (CDP), which is the single largest center of population in the county, with a disproportionate number (15.3%) living in poverty or near poverty levels. The largest number of minorities (30.6% Black/African American and 9.8% Hispanic) live within this census tract. The median annual family income for Lexington Park is $68,804, as compared to the median annual family income in St. Marys County of $90,438. Certain census tracts within the Lexington Park area have a high concentration of poverty, with one having a median annual family income as low as $42,766. Lexington Park has a lower per capita income and a higher unemployment rate than the rest of St. Marys County, a combination contributing to the countys health disparities. Source: U.S. Census Bureau, 2010-2019 Population Estimates https://www.census.gov PROMOTION OF COMMUNITY HEALTH PART VI, LINE 5 As a community partner, MSMH engages in several community benefit activities to improve and promote the health and wellbeing of the community. Priority areas, as determined by the 2018 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 Educational Programs are offered with the goal of improving community health and well-being. For example, the Living Well: Chronic Disease Self-Management is a free seven-week health education and behavior change program focused on the management of diagnosed diseases. The program is designed for adults living with a chronic condition, such as heart disease, diabetes, cancer, depression, chronic pain, arthritis, lung disease, multiple sclerosis or any chronic health concern. We have offered this program at multiple locations including at East Run where our CBSA is located. The Diabetes Prevention Program is a yearlong program that provides lifestyle change education for patients who have elevated A1C levels, though are not officially identified as a Type 2 Diabetic. Often, and beyond the benefit of staving off a diagnosis of Type 2 Diabetes, participants achieve weight loss which helps to further delay the onset of other chronic diseases. Support groups are offered to community members for a variety of topics including multiple sclerosis, breastfeeding, cancer, Parkinsons and stroke. In response to COVID 19, these support groups have been offered in a telehealth platform so participants at risk of contracting illnesses can still receive the needed support while remaining safely in their homes. Associates participate in community health events such as educational days, community sponsored events and expositions where screenings are performed, and health information is shared. Outreach is also provided in-person and virtually, hospital staff share their knowledge with the community through engaging interviews, seminars, blogs and videos. Access to Care East Run Medical Center is home to a Primary Care, Behavioral Health, and safety-net Dental Clinic in the CBSA. These services, along with Transitional Care Outpatient Nurses and Community Health Advocates assist in bridging the gaps in services our most vulnerable community members face. Beyond these services, the Diabetes Self-Management Program was offered at this location affording the same level of services provided at the hospital in an effort to reach individuals where they are. The seven-week program was offered to residents who had a vested interest in managing their diabetes and was well-received. Tobacco Cessation was offered, in partnership with the local Health Department but ultimately was transitioned to virtual meetings to better serve the entire community, especially due to the pandemic. Finally, the Parents to Be Workshop, a full day program that offers the basics for new parents including, Infant CPR, Childbirth, Breastfeeding Basics and Baby Care Basics, was offered at East Run until March when classes were suspended as less than 20% of participants were CBSA residents. Social Determinants of Health The Screening, Brief Intervention, and Referral to Treatment (SBIRT) Program is provided to support substance abuse recovery in the community and promote access to behavioral health programs. This program includes three main components: screening, brief intervention, and referral to treatment. Those who screen positive for high-risk behaviors are connected to peer recovery coaches who conduct a brief intervention and refer to treatment if appropriate. Opioid Overdose Survivor Outreach Coaches link community members with a history of substance abuse treatment with the resources they need to prevent a future overdose. This team works in coordination with our Community Health Workers as well as Transitional Care Nurses as they re-enter the community setting, equipped with the needed resources to manage their addictions and promote recovery. Our hospital partners with a local entity to promote access to care for vulnerable populations. Through this partnership, door-to-door transportation is provided to patients and/or families who are connected with Transitional Care Nurses and /or the Community Health workers that have an identified financial need. This transportation assistance allows patients to attend necessary appointments with their health care providers in an effort to maintain compliance with their health plan. Community Health Workers improve the health of their communities by educating others on disease and injury prevention and linking community members to healthcare and social services, including food access, transportation, housing, and utility assistance. Participating in daily Inter-Disciplinary Model of Care (IMOC) rounds allows the CHWs to meet face to face with medical staff and ultimately the patients to address barriers to care they may have. Rx for Success provides robust student internship experiences for high-risk youth attending High School, located in our CBSA. This eight-week summer internship connects the course curriculum with tangible onsite experience. This allows students to demonstrate skill development and experience working in the medical field while receiving a comparable wage. 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 and following their care through the Community Health Worker team, AccessHealth. Utilizing the Aunt Bertha online platform allows our associates the ability to refer, track and manage connections with local nonprofit groups and public service agencies that may be able to provide assistance to those requiring support. 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. AFFILIATED HEALTH CARE SYSTEM PART VI, LINE 6 As a proud member of MedStar Health, MSMH is able to expand its capacity to meet the needs of the community by partnering with other MedStar hospitals and associated entities. MedStar Health resources assist the hospital in community health planning to meet the needs of the uninsured and other vulnerable populations. Through its community health function, MedStar Health provides MSMH with technical support to enhance community health programming and evaluation. MedStars 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 ART VI, LINE 7 The community benefit report for MSMH is filed in the state of Maryland. true Scholarships 9 23259 FMV Monitoring Funds We have an employee scholarship ("ES") program at St. Mary's Hospital. The employee scholarships undergo a thorough review and approval phase dependent upon proper submissions by the requesting recipient. Any changes to the ES program must go through the president's office for approval. All applicants will be assigned a HRD associate that will receive and stamp applications when received. All applicants will be interviewed by HRD Department Leader of the Nursing Recruiter/HR Generalist for review of the application and agreement expectations. Applicants may be interviewed if needed by the selection committee. Within 10 days applicant is notified in writing of scholarship decision and the HRD associate will review with each recipient the requirements of the program. All invoices will be reviewed for required information and verification before processing, the payment is requested. X X X X X X false false false false false false false false false CHRISTINE R WRAY PRESIDENT/DIRECTOR 293881 293881 290444 290444 0 0 4200 4200 14041 14042 602566 602567 0 0 KENNETH A SAMET DIRECTOR 0 1965427 0 5633373 0 0 0 54494 0 36202 0 7689496 0 0 John Harvey MD DIRECTOR 433386 0 410216 0 2262 0 8400 0 25880 0 880144 0 0 0 KRISHNA P JAYARAMAN MD DIRECTOR 272109 0 0 0 0 0 0 0 0 0 272109 0 0 0 ANNA CHOI MD DIRECTOR 398846 0 38750 0 0 0 8400 0 19989 0 465985 0 0 0 Stephen Michaels MD SECRETARY 482374 0 352426 0 0 0 8400 0 26780 0 869980 0 0 0 AMIR KHAN Medical Director 471179 0 30000 0 0 0 8400 0 25951 0 535530 0 0 0 Bruce Gibson Intensivist 410020 0 5250 0 0 0 8400 0 25905 0 449575 0 0 0 Tara Saggar MD DIRECTOR 134785 0 22500 0 0 0 8400 0 25566 0 191251 0 0 0 Yahia Tagouri MD DIRECTOR 416522 0 147946 0 10 0 8400 0 28169 0 601047 0 0 0 DAVID HAVRILLA CFO (UNTIL 2/2020) 72347 217040 31421 94262 2400 7201 4159 12478 5052 15154 115379 346135 0 0 JEAN PIERRE ELKHOURY INTENSIVIST 394908 0 5250 0 0 0 8400 0 25505 0 434063 0 0 0 DAVID ALLEN MD PHYSICIAN 344935 0 15500 0 0 0 8400 0 19921 0 388756 0 0 0 DAWN YEITRAKIS CNO PHYSICIAN 189969 0 33938 0 0 0 1300 0 19854 0 245061 0 0 0 DANIEL FEELEY Former CFO 0 227696 0 53676 0 0 0 8400 0 25650 0 315422 0 0 Robert Lally CFO (2/2020 - 5/2020) 0 314629 0 127173 0 0 0 34576 0 26185 0 502563 0 0 Carrie Jennison Former CFO 72396 72397 0 0 7680 7679 0 0 6381 6381 86457 86457 0 0 SCHEDULE J, PART III: Mr. Samet's compensation in Part II, Column (B) includes $2,636,097, representing benefits received from executive retirement plans that are comprised of target benefits determined annually based on compensation and years of service and long-term retention arrangements. Christine Wrays compensation is for services provided as President to both MedStar Southern Maryland Hospital Center and MedStar St. Marys Hospital. David Havrillas compensation is for services provided as CFO to MedStar Montgomery Medical Center, MedStar St. Marys Hospital, and MedStar Southern Maryland Hospital Center. false false false ORGANIZATION MEMBERS PART VI, LINE 6 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. DESCRIPTION OF MEMBERS PART VI, LINE 7A 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. DECISIONS OF GOVERNING BODY PART VI, LINE 7B 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. PROCESS FOR REVIEWING FORM 990 PART VI, LINE 11B 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. CONFLICT OF INTEREST POLICY PART VI, LINE 12C 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) ARE REVIEWED BY THE GOVERNANCE COMMITTEE OF THE MEDSTAR HEALTH BOARD OF DIRECTORS WHICH DETERMINES HOW THE MATTER SHOULD BE RESOLVED. EXECUTIVE COMPENSATION PROCESS PART VI, LINE 15 THE EXECUTIVE COMPENSATION COMMITTEE OF THE BOARD OF DIRECTORS OF MEDSTAR HEALTH, INC. (THE "COMMITTEE") HAS OVERSIGHT OVER 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. FINANCIAL STATEMENT AVAILABILITY PART VI, LINE 19 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. OTHER CHANGES IN NET ASSETS PART XI, LINE 9 EQUITY TRANSFERS...............................$(49,516,792) MINIMUM PENSION LIABILITY ADJUSTMENT...........$ (4,771,417) ============= TOTAL $(54,288,209) FINANCIAL STATEMENTS AND REPORTING PART XII, LINE 2 ST. MARYS HOSPITAL OF ST. MARYS COUNTY INC. IS AN AFFILIATE OF THE MEDSTAR HEALTH, INC. AUDIT AND SUBJECT TO OVERSIGHT BY THE AUDIT COMMITTEE OF THE MEDSTAR BOARD. 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