2020-07-02T09:32:51-05:00 2019-06-30 346565596 ERNST & YOUNG US LLP 1101 NEW YORK AVE NW WASHINGTON DC 20005 990 2018-07-01 521362793 University of Maryland Medical System Corporation UNIV 4434625811 22 South Greene Street Baltimore MD 21201 S MICHELLE LEE SVP/CFO 2020-07-02 true JUSTIN J LOWE P01866796 2023276000 2018 2021-01-29 14:40:06Z University of Maryland Medical Center MOHAN SUNTHA MD 250 W PRATT ST BALTIMORE MD 21201 1858056322 false X WWW.UMMS.ORG X 1984 MD THE UNVERSITY OF MARYLAND MEDICAL SYSTEM CORPORATION (UMMS) PROVIDES A VARIETY OF INPATIENT/ OUTPATIENT SERVICES TO PEOPLE IN THE MARYLAND AREA REGARDLESS OF THEIR ABILITY TO PAY. REVENUES ARE USED TO HELP DEFRAY THE COSTS OF SERVICES. 22 19 12624 1129 -234554 0 36796513 16665793 1599469253 1712610515 10328422 11190566 9494565 7671549 1656088753 1748138423 498069 326115 0 0 755234772 810552136 0 0 0 860466892 877925986 1616199733 1688804237 39889020 59334186 4501112693 4618387071 2536876955 2656734883 1964235738 1961652188 UMMS PROVIDES A VARIETY OF INPATIENT/OUTPATIENT SERVICES TO PEOPLE IN THE MARYLAND AREA REGARDLESS OF THEIR ABILITY TO PAY. REVENUES ARE USED TO HELP DEFRAY THE COSTS OF SERVICES. false false 1468038217 326115 1714733827 UMMS, A PRIVATE, NON-PROFIT HEALTH SYSTEM, CONSISTS OF 13 HOSPITALS - UMMC, THE ACADEMIC 'HUB' - AND THE 12 COMMUNITY AND SPECIALTY HOSPITALS THROUGHOUT THE STATE OF MARYLAND. UMMC IS A NATIONAL AND REGIONAL REFERRAL CENTER FOR TRAUMA, CANCER CARE, NEUROCARE, CARDIAC CARE AND HEART SURGERY, WOMEN'S AND CHILDREN'S HEALTH AND ORGAN TRANSPLANTS. IT HAS ONE OF THE MOST TECHNOLOGICALLY ADVANCED OPERATING ROOM FACILITIES AND IS INTERNATIONALLY RECOGNIZED FOR ITS LEADERSHIP IN DEVELOPING AND PERFORMING MINIMALLY INVASIVE SURGICAL PROCEDURES. UMMS PROVIDES CHARITY CARE TO PATIENTS UNABLE TO PAY. CHARITY CARE FOR THE YEAR ENDED 6/30/2019 IS APPROXIMATELY $17 MILLION AT COST. 1468038217 true true false true false false false false false true false false true true true false true false false true false false false false false true true true false true true false false false true true false false false true true false false false false true true true true false false true X 1513 0 true 12624 true true true true CJ false false false false true false false false false false false false X 22 19 false false true true false false false true true false false true true true true true true true true true true MD X ED WUENSCHELL 4434625811 900 ELKRIDGE LANDING ROAD - 3 EAST LINTHICUM MD 21090 Stephen A Burch CHAIRMAN 1.0 3.0 X X 0 0 0 Michael E Busch DIRECTOR (DECEASED 04/19) 1.0 0 X 0 0 0 R Alan Butler DIRECTOR 1.0 0 X 0 0 0 August J Chiasera DIRECTOR 1.0 0 X 0 0 0 John P Coale DIRECTOR 1.0 1.0 X 0 0 0 John Dillon DIRECTOR (ENDED 04/19) 17.0 5.0 X 156375 0 0 James C Dipaula Jr DIRECTOR 1.0 0 X 0 0 0 George L Doetsch Jr DIRECTOR 1.0 0 X 0 0 0 Wayne L Gardner Sr DIRECTOR 1.0 4.0 X 0 0 0 Louise M Gonzales DIRECTOR 1.0 2.0 X 0 0 0 Barry P Gossett DIRECTOR 1.0 0 X 0 0 0 Louis P Jenkins Jr DIRECTOR 1.0 2.0 X 0 0 0 Edward J Kasemeyer DIRECTOR (ENDED 12/18) 1.0 0 X 0 0 0 Francis X Kelly DIRECTOR (ENDED 06/19) 1.0 1.0 X 0 0 0 Belkis Leong-Hong DIRECTOR 1.0 0 X 0 0 0 Kenneth V Moreland DIRECTOR 1.0 0 X 0 0 0 Kevin B O'connor DIRECTOR 1.0 0 X 0 0 0 Korkut Onal DIRECTOR 1.0 2.0 X 0 0 0 Robert L Pevenstein DIRECTOR (ENDED 03/19) 21.0 0 X 180000 0 0 D Bruce Poole DIRECTOR 1.0 0 X 0 0 0 Louise M Pope DIRECTOR 1.0 0 X 0 0 0 Catherine E Pugh DIRECTOR (ENDED 03/19) 1.0 0 X 0 0 0 Robert D Rauch DIRECTOR 1.0 4.0 X 0 0 0 Scott Rifkin DIRECTOR (ENDED 05/19) 1.0 0 X 0 0 0 James T Smith Jr DIRECTOR 1.0 1.0 X 0 0 0 James A Soltesz DIRECTOR 1.0 0 X 0 0 0 Leonard Stoler DIRECTOR 1.0 0 X 0 0 0 Walter A Tilley Jr DIRECTOR 1.0 0 X 0 0 0 Joseph D Tydings DIRECTOR (DECEASED 10/18) 1.0 0 X 0 0 0 Alexander Williams Jr DIRECTOR 1.0 3.0 X 0 0 0 Megan Arthur SVP, GEN COUNSEL AND SEC'TY (ENDED 06/19) 40.0 5.0 X 729538 0 42446 John W Ashworth III INTERIM PRESIDENT AND CEO 40.0 22.0 X 653119 0 36969 Robert A Chrencik PRESIDENT AND CEO (ENDED 04/19) 40.0 22.0 X 2634806 0 36554 Henry J Franey EVP, CFO AND TREASURER (ENDED 03/19) 40.0 9.0 X 1540548 0 34207 S Michelle Lee SVP AND CFO 40.0 0 X 510123 0 31697 Stephen T Bartlett EVP AND CMO (ENDED 12/18) 40.0 3.0 X 1767873 0 166433 Jon P Burns SVP AND CIO 40.0 2.0 X 731665 0 32353 Michelle Gourdine SVP AND INTERIM CMO - UMMS 40.0 3.0 X 508697 0 51129 Joseph E Hoffman III EVP AND CFO - UMMC 40.0 11.0 X 753107 98631 57951 Michael R Jablonover SVP AND CMO - UMMC 40.0 0 X 713575 0 43064 Kathleen M Mccann SVP, CHIEF HUMAN RESOURCE OFFICER 40.0 0 X 749505 0 33067 Keith D Persinger SVP AND CHIEF PERFORMANCE IMPROV OFFICER (ENDED 06/19) 40.0 0.0 X 1135594 0 24470 Lisa C Rowen SVP AND CNO - UMMC 40.0 0 X 1020496 0 33383 Mohan Suntha MD PRESIDENT AND CEO, UMMC 40.0 2.0 X 1927863 0 39767 Alicia J Cunningham SVP CORPORATE FINANCE 40.0 0 X 495783 0 45258 Janice M Eisele SVP DEVELOPMENT 0.0 40.0 X 444055 0 12699 Leonard Taylor Jr SVP OPERATIONS SUPPORT SERVICES 40.0 0 X 533692 0 14201 Mark L Wasserman SVP EXTERNAL AFFAIRS 40.0 1.0 X 514894 0 33379 Gerald L Wollman SVP CORP OPERATIONS (ENDED 06/19) 40.0 0 X 708329 0 39863 Walter Ettinger FORMER SVP and CMO 0.0 0 X 642534 0 0 Mark Kelemen FORMER CHIEF MED INFO OFFICER - UMMC 0.0 0 X 192702 0 0 19244873 98631 808890 1415 true true false CLARK CONSTRUCTION GROUP LLC 7500 OLD GEORGETOWN RD Bethesda MD 20814 Construction 59050747 ENVIRONMENTAL AIR SYSTEMS LLC PO BOX 2026 High Point NC 27261 Maintenance 12026688 DPR CONSTRUCTION INC 11109 SUNSET HILLS RD SUITE 200 Reston VA 20190 Construction 7809664 WOHLSEN CONSTRUCTION COMPANY PO BOX 4612 LANCASTER PA 17604 Construction 6161066 GRANT THORNTON LLP 33562 TREASURY CTR CHICAGO IL 60694 Financial Services Consultant 4992677 304 X 5376127 10335156 954510 16665793 PATIENT SERVICE REVENUE 622000 1612889138 1612168398 720740 0 PHARMACY 446110 99721377 99239141 482236 0 0 0 0 0 1712610515 8419019 0 0 8419019 3398939 2277367 1121572 0 1121572 0 -1437530 2559102 110412079 107640532 2771547 0 2771547 0 0 2771547 CAFETERIA 722210 3223689 0 0 3223689 ECARE 621400 556023 556023 0 0 INCOME FROM JOINT VENTURES 621990 190175 190175 0 0 2580090 2580090 0 0 6549977 1748138423 1714733827 -234554 16973357 326115 326115 0 0 0 0 0 0 15475140 2940277 12534863 0 0 0 0 0 663229083 537215557 126013526 0 21816203 17671124 4145079 0 60460146 48972719 11487427 0 49571564 40152967 9418597 0 0 0 0 0 4661005 3775414 885591 0 2678878 2169891 508987 0 94119 0 94119 0 0 0 0 0 0 0 61682398 61682398 0 0 7813882 6329244 1484638 0 20843525 16883255 3960270 0 916501 742366 174135 0 0 0 0 0 27914109 22610428 5303681 0 3323609 2692123 631486 0 0 0 0 0 2816228 2281145 535083 0 28150074 22801560 5348514 0 0 0 0 0 100637474 81516354 19121120 0 19349954 19000967 348987 0 MEDICAL SUPPLIES 410837293 410837293 0 0 REPAIR/MAINTENANCE 84420254 68380406 16039848 0 BAD DEBT EXPENSES 56579201 56579201 0 0 TRANSPLANT COSTS 22891650 22891650 0 0 22315832 19585763 2730069 0 1688804237 1468038217 220766020 0 235640855 231359279 100000 100000 198855097 194390842 0 0 0 0 33503321 35224491 16282164 45924587 2314582188 1226851292 926332991 1087730896 101156000 126852000 187033319 151905040 0 2802208946 2744899936 4501112693 4618387071 247662817 285799016 1684108 3197480 1585071835 1532726160 0 0 151413402 150418854 551044793 684593373 2536876955 2656734883 X 1346545923 1329741985 616001076 630221464 1688739 1688739 1964235738 1961652188 4501112693 4618387071 X 59334186 12370322 -74288058 X false true X true true true X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false true 42590 false true 51529 94119 false Schedule C, Part II-B, Line 1 DETAILED DESCRIPTION OF THE LOBBYING ACTIVITY DIRECT LOBBYING EFFORTS RELATE TO FEDERAL, STATE AND LOCAL LEGISLATION AFFECTING HEALTH CARE ISSUES. THE ORGANIZATION PAYS MEMBERSHIP DUES TO THE MARYLAND HOSPITAL ASSOCIATION (MHA) AND THE AMERICAN HOSPITAL ASSOCIATION (AHA). MHA AND AHA ENGAGE IN MANY SUPPORT ACTIVITIES INCLUDING LOBBYING AND ADVOCATING FOR THEIR MEMBER HOSPITALS. THE MHA AND AHA REPORTED THAT 4.8% AND 22.73% OF MEMBER DUES WERE USED FOR LOBBYING PURPOSES AND AS SUCH, THE ORGANIZATION HAS REPORTED THIS AMOUNT ON SCHEDULE C, PART II-B AS LOBBYING ACTIVITIES. 82083109 82083109 1169278521 624722670 544555851 8649777 4719506 3930271 819282463 596833678 222448785 235288318 575438 234712880 1087730896 INVESTMENT IN SUBSIDIARIES 796971750 AFFILIATE RECOVERY 733019073 OTHER RECEIVABLES 41946674 DEBT SERVICE FUND 308754897 ECO. INT. ASSETS LIMITED TO USE 215767795 ASSETS WHOSE USE IS LIMITED 59692135 SELF INSURANCE TRUST FUNDS 76676106 DUE TO AFFILIATES ESCROW 21774274 LT ASSET 290757442 COLLATERAL FUNDS 94786193 CONSTRUCTION FUNDS 95466010 DEFERRED FINANCING COSTS 9287587 2744899936 INT. RATE SWAPS MARK TO MARKET 196173690 OTHER MALPRACTICE 136956925 LINE OF CREDIT 161300000 ADVANCES FROM 3RD PARTY PAYORS 73408354 CAPITAL LEASE 39788541 OTHER LIABILITIES 34687134 UMHV LT LIABILITY 16881429 CREDIT BALANCES 15599869 DUE FROM AFFILAITE 9797431 684593373 X Schedule D, Part X, Line 2 FIN 48 (ASC 740) footnote THE CORPORATION ADOPTED THE PROVISIONS OF ASC 740, ACCOUNTING FOR UNCERTAINTY IN THE INCOME TAXES (FIN 48) ON JULY 1, 2007. THE FOOTNOTE RELATED TO ASC 740 IN THE CORPORATION'S AUDITED FINANCIAL STATEMENTS IS AS FOLLOWS: THE CORPORATION FOLLOWS A THRESHOLD OF MORE-LIKELY-THAN-NOT FOR RECOGNITION AND DERECOGNITION OF TAX POSITIONS TAKEN OR EXPECTED TO BE TAKEN IN A TAX RETURN. MANAGEMENT DOES NOT BELIEVE THAT THERE ARE ANY UNRECOGNIZED TAX LIABILITIES OR BENEFITS THAT SHOULD BE RECOGNIZED. Central America and the Caribbean 0 0 Program Services CAPTIVE INSURANCE 37088000 0 0 0 0 0 0 37088000 0 37088000 true false true false false false Schedule F, Part I, Line 1 SCHEDULE F, PART I, LINE 1 THE BOOK VALUE OF THE FILING ORGANIZATION'S INVESTMENT IN THE REGION AS OF 6/30/2019 WAS $10,597,000. THE FILING ORGANIZATION'S SHARE OF EXPENSES IN THE REGION WAS $26,491,000. true true true X true X true true false true true 17100704 0 17100704 0.0105 0 0 0 0.0 0 0 0 0.0 0 0 17100704 0 17100704 0.0105 2719991 440996 2278995 0.0014 186584015 0 186584015 0.1143 20235397 11152099 9083298 0.0056 0 0 0 0.0 378292 0 378292 0.0002 0 0 209917695 11593095 198324600 0.1215 0 0 227018399 11593095 215425304 0.1320 327771 0 327771 0.0002 65391 0 65391 0.0000 19059 0 19059 0.0000 0 0 0 0.0 0 0 0 0.0 36329 0 36329 0.0000 0 0 0 0.0 288369 0 288369 0.0002 0 0 0 0.0 0 0 736919 0 736919 0.0005 true 41717090 0 452274370 398113816 54160554 X true true 1 1 UNIVERSITY OF MARYLAND MEDICAL CENTER 22 S GREENE STREET BALTIMORE MD 21201 WWW.UMMS.ORG 30-068 X X X X X 1 1 1 false false true X X X X X X X X X 17 true true true true X www.umms.org/ummc/community X true 17 true https://www.umms.org/ummc/community false true X 200.0 300.0 X X X X X true true X X X true X https://www.umms.org/ummc/community X https://www.umms.org/ummc/community X https://www.umms.org/ummc/community X X X X X X true X false X X X X true X false false Schedule H, Part V, Section B, Line 3E The significant health needs are a prioritized description of the significant health needs of the community and identified through the CHNA. Schedule H, Part V, Section B, Line 5 Facility 1, 1 Facility 1, 1 - UNIVERSITY OF MARYLAND MEDICAL CENTER. The University of Maryland Medical Center Downtown Campus (UMMC) utilized two major frameworks for completing its most recent Community Health Needs Assessment (CHNA) in fiscal year 2018. To complete this comprehensive assessment of the needs of the community, the Association for Community Health Improvement's (ACHI) 9-step Community Health Assessment Process was utilized as an organizing methodology. An additional 5-component assessment and engagement strategy was also utilized to lead the data collection methodology. The UMMC Community Health Improvement Team (CHI Team) included both the Downtown and Midtown Campuses and served as the lead team to conduct the CHNA with input from other University of Maryland Medical System Baltimore City-based hospitals, community leaders, the academic community, the public, health experts, and the Baltimore City Health Department. Data was collected from multiple sources, groups, and individuals and integrated into a comprehensive document which was utilized at a retreat on January 22, 2018 of the UMMC Downtown/Midtown Campuses' Community Health Improvement (CHI) Team. During that strategic planning retreat, priorities were identified using the collected data and an adapted version of the Catholic Health Association's (CHA) priority setting criteria. The identified priorities were also validated by a panel of UM Clinical Advisors and University of Maryland Baltimore (UMB) Campus experts. UMMC used primary and secondary sources of data as well as quantitative and qualitative data and consulted with numerous individuals and organizations during the CHNA, including other University of Maryland Medical System (UMMS) Baltimore City-based hospitals (University of Maryland Medical Center Midtown Campus, University of Maryland Rehabilitation and Orthopedic Institute, community leaders, community partners, the University of Maryland Baltimore (UMB) academic community, the general public, local health experts, and the Baltimore City Health Department. Additionally, for the first time in the city's history, nine Baltimore City hospitals joined together in fiscal year 2018 to collaborate on several key data collection strategies for a joint community health needs assessment. UMMC partnered with University of Maryland Midtown Campus, University of Maryland Rehabilitaton & Orthopedic Institute, Johns Hopkins Hospital, Sinai Hospital (Lifebridge), Medstar Health, St. Agnes Health System, and Mercy Medical Center. The above hospitals/health systems had been collaborating on several initiatives prior to the CHNA year and agreed that it would be beneficial to work on a more detailed level on a joint city-wide CHNA. This multi-hospital collaborative worked on the following data collection components together: - Public survey of Baltimore City residents - Key stakeholder interviews - Key population focus groups - Key community partner focus groups After the data was collected and analyzed jointly, each individual hospital used the collected data for their respective community benefit service areas to identify their unique priorities for their communities. The collaborating hospitals/health systems did agree to jointly focus on behavioral health as a key city-wide priority. The following describes the individual data collection strategies with the accompanying results. A) Community Perspective The community's perspective was obtained through one survey offered to the public using several methods throughout Baltimore City. A 6-item survey queried Baltimore City residents to identify their top health concerns and their top barriers in accessing health care. Methods 6-item survey distributed in FY2018 using the following methods: * Conducted from late September through November 2017 * Participating hospitals collected data throughout the city * Distributed in person and offered online * Offered in English, Spanish, and Russian * Collected 4,755 surveys * All Baltimore City zip codes were represented in the responses Analysis by CBSA targeted zip codes revealed the same top health concerns and top health barriers with little deviation from the overall Baltimore City data. The sample size was 4,755 for all of Baltimore City and 1,324 for residents from the identified UMMC CBSA. Results 1 - Community's Top Health Concerns (All Baltimore City) Alcohol/Drug Addiction Mental Health Diabetes/High Blood Sugar Overweight/Obesity Heart Disease/High Blood Pressure Smoking/Tobacco Use 1A - UMMC's Community Benefit Service Area Top Health Concerns Alcohol/Drug Addiction Diabetes/High Blood Sugar Mental Health Smoking/Tobacco Use Overweight/Obesity Heart Disease/High Blood Pressure 2 - Community's Top Social/Environmental Issues (All Baltimore City) Neighborhood Safety/Violence Lack of Job Opportunities Housing/Homelessness Availability/Access to Insurance Poverty Limited Access to Healthy Foods 2A - UMMC's Community Benefit Service Area Top Social/Environmental Issues Lack of Job Opportunities Neighborhood Safety/Violence Housing/Homelessness School Dropout/Poor Schools Access to Healthy Foods Poverty 3 - Community's Top Barriers to Healthcare (All Baltimore City) Cost/Too Expensive/Can't Afford No Insurance Insurance not Accepted Lack of Transportation 3A - UMMC's Community Benefit Service Area Top Barriers to Healthcare Cost/Too Expensive/Can't Afford No Insurance Insurance not Accepted Lack of Transportation B) Health Experts Methods Reviewed & included National Prevention Strategy Priorities, Maryland State Health Improvement Plan (SHIP) indicators, and Healthy Baltimore 2020 plan from the Baltimore City Health Department Reviewed Healthy Baltimore 2020: A blueprint for health Reviewed Baltimore City Health Department's 2017 Community Health Assessment Conducted campus-wide stakeholder retreat in January 2018, including University of Maryland Schools of Medicine, Nursing, Social Work and UMB Community Affairs office Results National Prevention Strategy - 7 Priority Areas * Tobacco Free Living * Preventing Drug Abuse and Excessive Alcohol Use * Healthy Eating * Active Living * Injury and Violence Free Living * Reproductive and Sexual Health * Mental and Emotional Well Being SHIP: 39 Objectives in 5 Vision Areas for the State, includes targets for Baltimore City - While progress has been made since 2012, measures within Baltimore City have not met identified targets; Even wider minority disparities exist within the City Healthy Baltimore 2020: Four Priority Areas for Baltimore City 1) Strategic Priority 1: Behavioral Health 2) Strategic Priority 2: Violence Prevention 3) Strategic Priority 3: Chronic Disease Prevention 4) Strategic Priority 4: Life Course Approach and Core Services Health Expert UMB Campus Panel Focus Group Top Action Items included: Continue collaborative work from the UMMC/UMB Strategic Community Plan Improve communication and synergy across campus schools and UMMC Identify ways to partner and support each other C) Community Leaders Methods Hosted two focus groups in collaboration with the other Baltimore-based hospitals for 22 community-based organization partners to share their perspectives on health needs (November 2017) Results Consensus that social determinants of health (and "upstream factors") are key elements that determine health outcomes Top needs and barriers were identified as well potential suggestions for improvement and collaboration (See Appendix 4 for details) Top Needs: Health Literacy Employment/Poverty Mental/Behavioral Health Cardiovascular Health (obesity, hypertension, stroke, & diabetes) Maternal/Child Health - focusing on promoting a healthy start for all children Top Barriers: Focusing on the outcome and not the root of the problems (i.e. SDoH) Lack of inter-agency collaboration/working in silos Suggestions for Improvement: Leverage existing resources Increase collaboration Focus on Social Determinants of Health Enhance behavioral health resources D) Social Determinants of Health (SDoH) Defined by the World Health Organization as: ....the conditions in which people are born, grow, live, work and age... Methods Reviewed data from Baltimore Neighborhood Indicator Alliance (Demographic data and SDoH data) Reviewed data from identified 2011 Baltimore City Health Department's Baltimore City Neighborhood Profiles, Reviewed Baltimore City Food Desert Map Results Baltimore City Summary of CBSA targeted zip codes Top SDoHs: Low Education Attainment (52.6% w/ less than HS degree) High Poverty Rate (15.7%)/High Unemployment Rate (11%) Violence Poor Food Environment Housing Instability Schedule H, Part V, Section B, Line 6a Facility 1, 1 Facility 1, 1 - UNIVERSITY OF MARYLAND MEDICAL CENTER. UMMC conducted its FY'18 CHNA with the University of Maryland Medical Center Midtown Campus. Additionally, most Baltimore City hospitals collaborated together for the first time to gather primary data together. So, the additional hospitals that collaborated with UMMC include: UMMC Midtown Campus, UM Rehabilitation and Orthopedic Institute, Johns Hopkins Hospital (Main Campus and Bayview), St Agnes Hospital, Sinai, Mercy Medical Center, and Medstar Health (Good Samaritan, Union Memorial, Harbor Hospital). Schedule H, Part V, Section B, Line 6b Facility 1, 1 Facility 1, 1 - UNIVERSITY OF MARYLAND MEDICAL CENTER. UMMC CONDUCTED ITS CHNA WITH ASSISTANCE FROM THE UNIVERSITY OF MARYLAND, BALTIMORE (UMB) ACADEMIC COMMUNITY AND THE BALTIMORE CITY HEALTH DEPARTMENT. Schedule H, Part V, Section B, Line 11 Facility 1, 1 Facility 1, 1 - UNIVERSITY OF MARYLAND MEDICAL CENTER. Several additional topic areas were identified by the Community Health Improvement Team during the CHNA process including: Safe housing, transportation, and poverty, behavioral health, and substance abuse were listed as high priorities. While the Medical Center will focus the majority of our efforts on the identified strategic priorities, we will review the complete set of needs identified in the CHNA for future collaboration and work. These areas, while still important to the health of the community, will be met through either existing programs (i.e. workforce development for poverty) or through collaboration with other health care and social support organizations as needed. For example, all the Baltimore City hospitals agreed to work together on behavioral health and to potentially look at housing issues throughout the City. The additional unmet needs not addressed by UMMC will also continue to be addressed by key Baltimore City governmental agencies and existing community-based organizations. The UMMC identified core priorities target the intersection of the identified community needs and the organization's key strengths and mission. Schedule H, Part V, Section B, Line 13 Facility 1, 1 Facility 1, 1 - UNIVERSITY OF MARYLAND MEDICAL CENTER. THE FINANCIAL ASSISTANCE POLICY EXPLAINS SEVERAL ELIGIBILITY CRITERIA, INCLUDING PARTICIPATION IN MEDICAID/MEDICARE PROGRAMS AS WELL AS ELIGIBILITY UNDER VARIOUS STATE REGULATIONS. IN ADDITION TO FPG, THE INCOME LEVELS DEFINED BY THE MARYLAND STATE DEPARTMENT OF HEALTH AND MENTAL HYGIENE (MD DHMH) ARE USED TO DETERMINE ELIGIBILITY FOR FINANCIAL ASSISTANCE. THE MD DHMH INCOME LEVELS ARE MORE GENEROUS THAN THE FPG INCOME LEVELS. 1 UNIVERSITYCARE EDMONDSON VILLAGE 4538 EDMONDSON AVE BALTIMORE MD 21229 HEALTHCARE CLINIC Schedule H, Part I, Line 3c CRITERIA FOR FREE OR DISCOUNTED CARE UMMS IS COMMITTED TO PROVIDING FINANCIAL ASSISTANCE TO PERSONS WHO HAVE HEALTH CARE NEEDS AND ARE UNINSURED, UNDERINSURED, INELIGIBLE FOR A GOVERNMENT PROGRAM, OR OTHERWISE UNABLE TO PAY, FOR MEDICALLY NECESSARY CARE BASED ON THEIR INDIVIDUAL FINANCIAL SITUATION. IN ADDITION TO FPG, THE INCOME LEVELS DEFINED BY THE MARYLAND STATE DEPARTMENT OF HEALTH AND MENTAL HYGIENE (MD DHMH) ARE USED TO DETERMINE ELIGIBILITY FOR FINANCIAL ASSISTANCE. THE MD DHMH INCOME LEVELS ARE MORE GENEROUS THAN THE FPG INCOME LEVELS. THE FAP ALSO USES A FINANCIAL HARDSHIP THRESHOLD WHEN DETERMINING ELIGIBILITY. A PATIENT WITH MEDICAL DEBT EXCEEDING 25% OF FAMILY ANNUAL HOUSEHOLD INCOME MAY BE ELIGIBLE FOR FINANCIAL ASSISTANCE. Schedule H, Part I, Line 6b COMMUNITY BENEFIT REPORT THE ORGANIZATION ANNUALLY FILES A COMMUNITY BENEFIT REPORT AS REQUIRED BY THE MARYLAND HSCRC. THE REPORT CAN BE FOUND AT HTTPS://HSCRC.STATE.MD.US/PAGES/INIT_CB.ASPX. Schedule H, Part VI, Line 5 Promotion of Community Health Analysis of all quantitative and qualitative data described in the above section identified these top six areas of need within Baltimore City. These top priorities represent the intersection of documented unmet community health needs and the organization's key strengths and mission. These priorities were identified and approved by the UMMC/Midtown CHI Team and validated with the health experts from the UMB Campus Panel and ultimately approved by the Board. Programming is based on these strategic priorities as identified in the CHNA. 1) Mental Health (in collaboration with City hospitals) 2) Substance Abuse 3) Chronic Disease Management (CVD, Diabetes, HIV) 4) Maternal/Child Health 5) Violence Prevention 6) Workforce Development The University of Maryland Medical Center has community health programming in each of the above strategic community priorities. The following is an example of key initiatives from three of the above priorities. Identified Need/Priority: Chronic Disease Prevention Identified Need: Cardiovascular Disease Prevention Currently, there is at least a 40% prevalence rate of hypertension in the targeted population and much higher rates in specific neighborhoods. Hospital Initiative: Maryland Healthy Men Primary objectives of initiative: 1) Decrease the ED visit rate due to hypertension (Maryland SHIP) 2) Engage and educate at least 400 African American men with hypertension (HTN) and refer as needed to additional treatment. Single or multi-year plan: This program is a multi-year, ongoing initiative. Key collaborators in delivery: UMMC Midtown Campus UMMC Mobile Market Hungry Harvest Shoppers Food Warehouse MAC, Inc. Impact of hospital initiative: Hypertension affects over 40% of the African American community and frequently leads to stroke, cardiac failure, kidney disease, etc. This program educates and engages AA men to take control of their health and take active steps to lower their blood pressure and prevent ED visits due to HTN. Metrics: * # of BP screenings of all Baltimore City residents * # of AA men with HTN * # of AA men educated * % of Self-reported behaviors - men taking their BPs and men knowing their BPs * # of men with decreased BP after the program Evaluation of Outcomes in FY19: * 2,178 BP screenings in the community * 186 AA men identified with HTN * 186 AA men educated * 60% of men decreased their BP (of men completing the program) * 35% of men had stable BPs (of men completing the program) * 100% of men knew and took their BP (of men completing the program) Continuation of initiative: UMMC will continue to monitor performance and outcome measures annually. This priority and the accompanying initiatives will continue until the FY18 CHNA is completed and as long as there continues to be an identified community need. Identified Need/Priority: Maternal/Child Health Identified Need: Maternal/Child Health - Infant Mortality Currently, there is an infant mortality rate (# per live births) of 10 Baltimore City wide with 13.9 and 20 in several neighborhoods of the targeted population. Hospital Initiative: Stork's Nest Primary objectives of initiative: 1) Increase % of babies born >37 weeks gestation 2) Reduce the percentage of births that are low birth weight 3) Increase the % of women breastfeeding at discharge after delivery Single or multi-year plan: This program is a multi-year, ongoing initiative. Key collaborators in delivery: Zeta Phi Beta Sorority March of Dimes B'more for Healthy Babies Impact of hospital initiative: Babies born at full-term and at healthy birth weights are less likely to die in the first year of life (Infant mortality reduction). Babies who are breastfed have fewer infections in the first year of life. Metrics: * # of women enrolled * % of Babies born >37 weeks gestation * % of Babies born at >2500 grams * % of Women breastfeeding at discharge Evaluation of Outcomes in FY19: * 76% of Babies born >37 weeks gestation * 80% of Babies born >2500 grams * 92% of Women were breastfeeding at discharge Continuation of initiative: UMMC will continue to monitor performance and outcome measures annually. This priority and the accompanying initiatives will continue until the FY18 CHNA is completed and as long as there continues to be an identified community need. Identified Need/Priority: Violence Prevention Identified Need: Violence Prevention Currently, there is an overall homicide rate of 3.9 (# of homicides/10,000 population) rate in Baltimore City. Within the targeted population, there are rates of 7.7 and 8.2 in some of the neighborhoods. Hospital Initiative: Violence Intervention Program (VIP) Primary objectives of initiative: 1) Reduce the rate of recidivism due to violent injury Single or multi-year plan: This program is a multi-year, ongoing initiative. Key collaborators in delivery: Baltimore City Police Department Baltimore City Health Department University of Maryland Baltimore Impact of hospital initiative: The participants in the VIP program receive education and social support and return to the workforce and/or high school or college. The participants get out of the cycle of violence and therefore reduce the number of return admissions to Shock Trauma and have an improved quality of life. Metrics: * # of people in the VIP program * Recidivism rate Evaluation of Outcomes in FY19: * 703 individuals in the VIP program * 0.1% Recidivism rate Continuation of initiative: UMMC will continue to monitor performance and outcome measures annually. This priority and the accompanying initiatives will continue until the FY18 CHNA is completed and as long as there continues to be an identified community need. UMMC operates under a unique regulatory system that caps hospital revenues and provides adjustments to allow for population health improvement investments. Under Maryland's global budget revenue model, UMMC reports on a regular basis how it is investing in efforts to improve population health. UMMC provides on-going services that are fundamental to addressing the identified community health needs that demonstrate the extent to which our commitment to serve our community is integrated into our care delivery model. We have a strong focus on treating patients with chronic conditions. University of Maryland Medical Center works to coordinate care, ensure smooth transitions and promote disease self-management strategies at every step of a patient's journey - whether at home, in the community, or within our hospital. We operate specialized clinics to enable access to routine outpatient care. Our transitional care services help patients newly diagnosed or those that have had a recent hospitalization transition safely back to the community. Transitional nurse navigators provide patients with disease education and self-management strategies, connect them to primary care providers and specialists, and help them overcome any barriers to making follow up appointments. An urgent care center to address off hours visits and low acuity emergencies is also available. Our coudamin clinic provides anticoagulation medication management, specifically managing and monitoring warfarin (Coumadin) therapy upon physician referral. It also provides patients with ongoing monitoring of their anticoagulation therapy to ensure desired outcomes and decrease adverse events. UMMC's congestive heart failure clinic provides similar disease-specific services. Additionally, our behavioral health clinic provides a community access point for those in need of outpatient mental health services. Resources are embedded throughout the hospital and in the community so that every patient receives the same level of care coordination. Care managers are embedded within our emergency department, community and hospitals, and provide in-home visits as needed. Community health workers reach out to patients who are identified as being high risk for readmission or in need of critical resources. Close relationships are maintained with skilled nursing facilities and home health agencies so that transfers from the hospital to these facilities are smooth, and the highest quality of care is constantly delivered. Strong relationships exist with local emergency medical service (EMS) providers through our mobile integrated health program, which delivers effective and efficient care to patients outside of the hospital. Nurses and community health workers function outside traditional emergency response roles, with a focus on maintaining individuals' health at their homes while also providing convenient access to care in the community. Additional care partners include primary care providers, specialists, local department of health, office on aging and other community based partners. Schedule H, Part VI, Line 5 Promotion of Community Health We are proudly partnered with Lyft, providing rides to patient follow up appointments. We also provide housing assistance to those in need because we know that stable housing leads to better health. We are proud to serve our community and appreciate our partners who allow us to fulfill our mission. We will always do what is right for the patient, no matter where they are in their health journey, and will always strive to have our patients receive care in the community they reside. As a part of the University of Maryland Medical System (UMMS) we are shaping a new paradigm in care delivery that we believe should be the future standard of care. Schedule H, Part I, Line 7 Bad Debt Expense excluded from financial assistance calculation 56579201 Schedule H, Part I, Line 7 Costing Methodology used to calculate financial assistance 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. Additionally, net revenues for Medicaid should reflect the full impact on the hospital of its share of the Medicaid assessment. Schedule H, Part II Community Building Activities COMMUNITY BUILDING ACTIVITIES INCLUDE THE NUMEROUS WORKFORCE/CAREER DEVELOPMENT PROGRAMS THAT ARE IN PLACE AT UMMC (UNIVERSITY AND MIDTOWN CAMPUSES). THESE PROGRAMS PROMOTE LITERACY, HEALTH LITERACY, AND JOB SKILLS TO PREPARE YOUNG ADULTS AND CURRENT EMPLOYEES FOR A VARIETY OF POSITIONS WITHIN EITHER THE MEDICAL CENTER OR IN THE HEALTHCARE INDUSTRY. THE HEALTH OF THE COMMUNITY IS IMPACTED BY HAVING INDIVIDUALS PREPARED FOR JOBS THAT ENABLE THEM TO OBTAIN HEALTH INSURANCE WHILE ALSO ASSISTING THEM TO BE MORE AWARE OF THEIR OWN HEALTHCARE NEEDS. WORKFORCE/CAREER DEVELOPMENT PROGRAMS INCLUDE: YOUTHWORKS BACH FELLOWS PROJECT SEARCH HEALTHCARE CAREER ALLIANCE PATIENT CARE TECHNICIAN TRAINING/SURGICAL TECH TRAINING BALTIMORE CITY SCHOOL PARTNERSHIPS (5 LOCAL SCHOOLS) Schedule H, Part III, Line 2 Bad debt expense - methodology used to estimate amount THE HEALTH SERVICES COST REVIEW COMMISSION (HSCRC) STARTED SETTING HOSPITAL RATES IN 1974. AT THAT TIME, THE HSCRC APPROVED RATES APPLIED ONLY TO COMMERCIAL INSURERS. IN 1977, THE HSCRC NEGOTIATED A WAIVER FROM MEDICARE HOSPITAL PAYMENT RULES FOR MARYLAND HOSPITALS TO BRING THE FEDERAL MEDICARE PAYMENTS UNDER HSCRC CONTROL. IN 2014, MARYLAND'S WAIVER WITH MEDICARE WAS RENEGOTIATED AND UPDATED TO REFLECT THE CURRENT HEALTHCARE ENVIRONMENT. UNDER THIS NEW WAIVER, SEVERAL CRITERIA WERE ESTABLISHED TO MONITOR THE SUCCESS OF THE SYSTEM IN CONTROLLING HEALTHCARE COSTS AND THE CONTINUANCE OF THE WAIVER ITSELF: 1. REVENUE GROWTH PER CAPITA 2. MEDICARE HOSPITAL REVENUE PER BENEFICIARY 3. MEDICARE ALL PROVIDER REVENUE GROWTH PER BENEFICIARY 4. MEDICARE READMISSION RATES 5. HOSPITAL ACQUIRED CONDITION RATE BECAUSE OF THIS SYSTEM, THE HOSPITAL IS UNABLE TO ESTIMATE HOW MUCH OF THE AMOUNT REPORTED IN LINE 2 IS ATTRIBUTED TO PATIENTS WHO WOULD APPLY UNDER THE FAP. Schedule H, Part III, Line 3 Bad Debt Expense Methodology THE HEALTH SERVICES COST REVIEW COMMISSION (HSCRC) STARTED SETTING HOSPITAL RATES IN 1974. AT THAT TIME, THE HSCRC APPROVED RATES APPLIED ONLY TO COMMERCIAL INSURERS. IN 1977, THE HSCRC NEGOTIATED A WAIVER FROM MEDICARE HOSPITAL PAYMENT RULES FOR MARYLAND HOSPITALS TO BRING THE FEDERAL MEDICARE PAYMENTS UNDER HSCRC CONTROL. IN 2014, MARYLAND'S WAIVER WITH MEDICARE WAS RENEGOTIATED AND UPDATED TO REFLECT THE CURRENT HEALTHCARE ENVIRONMENT. UNDER THIS NEW WAIVER, SEVERAL CRITERIA WERE ESTABLISHED TO MONITOR THE SUCCESS OF THE SYSTEM IN CONTROLLING HEALTHCARE COSTS AND THE CONTINUANCE OF THE WAIVER ITSELF: 1. REVENUE GROWTH PER CAPITA 2. MEDICARE HOSPITAL REVENUE PER BENEFICIARY 3. MEDICARE ALL PROVIDER REVENUE GROWTH PER BENEFICIARY 4. MEDICARE READMISSION RATES 5. HOSPITAL ACQUIRED CONDITION RATE BECAUSE OF THIS SYSTEM, THE HOSPITAL IS UNABLE TO ESTIMATE HOW MUCH OF THE AMOUNT REPORTED IN LINE 2 IS ATTRIBUTED TO PATIENTS WHO WOULD APPLY UNDER THE FAP. Schedule H, Part III, Line 4 Bad debt expense - financial statement footnote THE CORPORATION RECORDS REVENUES AND ACCOUNTS RECEIVABLE FROM PATIENTS AND THIRD-PARTY PAYORS AT THEIR ESTIMATED NET REALIZABLE VALUE. REVENUE IS REDUCED FOR ANTICIPATED DISCOUNTS UNDER CONTRACTUAL ARRANGEMENTS AND FOR CHARITY CARE. AN ESTIMATED PROVISION FOR BAD DEBTS IS RECORDED IN THE PERIOD THE RELATED SERVICES ARE PROVIDED BASED UPON ANTICIPATED UNCOMPENSATED CARE, AND IS ADJUSTED AS ADDITIONAL INFORMATION BECOMES AVAILABLE. THE PROVISION FOR BAD DEBTS IS BASED UPON MANAGEMENT'S ASSESSMENT OF HISTORICAL AND EXPECTED NET COLLECTIONS CONSIDERING HISTORICAL BUSINESS AND ECONOMIC CONDITIONS, TRENDS IN HEALTHCARE COVERAGE, AND OTHER COLLECTION INDICATORS. PERIODICALLY THROUGHOUT THE YEAR, MANAGEMENT ASSESSES THE ADEQUACY OF THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS BASED UPON HISTORICAL WRITE-OFF EXPERIENCE BY PAYOR CATEGORY. THE RESULTS OF THIS REVIEW ARE THEN USED TO MAKE MODIFICATIONS TO THE PROVISION FOR BAD DEBTS AND TO ESTABLISH AN ALLOWANCE FOR UNCOLLECTIBLE RECEIVABLES. AFTER COLLECTION OF AMOUNTS DUE FROM INSURERS, THE CORPORATION FOLLOWS INTERNAL GUIDELINES FOR PLACING CERTAIN PAST DUE BALANCES WITH COLLECTION AGENCIES. FOR RECEIVABLES ASSOCIATED WITH SERVICES PROVIDED TO PATIENTS WHO HAVE THIRD-PARTY COVERAGE, THE CORPORATION ANALYZES CONTRACTUALLY DUE AMOUNTS AND PROVIDES AN ALLOWANCE FOR BAD DEBTS, ALLOWANCE FOR CONTRACTUAL ADJUSTMENTS, PROVISION FOR BAD DEBTS, AND CONTRACTUAL ADJUSTMENTS ON ACCOUNTS FOR WHICH THE THIRD-PARTY PAYOR HAS NOT YET PAID OR FOR PAYORS WHO ARE KNOWN TO BE HAVING FINANCIAL DIFFICULTIES THAT MAKE THE REALIZATION OF AMOUNTS DUE UNLIKELY. FOR RECEIVABLES ASSOCIATED WITH SELF-PAY PATIENTS OR WITH BALANCES REMAINING AFTER THE THIRD-PARTY COVERAGE HAD ALREADY PAID, THE CORPORATION RECORDS A SIGNIFICANT PROVISION FOR BAD DEBTS IN THE PERIOD OF SERVICE ON THE BASIS OF ITS HISTORICAL COLLECTIONS, WHICH INDICATES THAT MANY PATIENTS ULTIMATELY DO NOT PAY THE PORTION OF THEIR BILL FOR WHICH THEY ARE FINANCIALLY RESPONSIBLE. THE DIFFERENCE BETWEEN THE DISCOUNTED RATES AND THE AMOUNTS COLLECTED AFTER ALL REASONABLE COLLECTION EFFORTS HAVE BEEN EXHAUSTED IS CHARGED AGAINST THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. Schedule H, Part III, Line 8 Community benefit & methodology for determining medicare costs THE ORGANIZATION FILES ANNUALLY A COMMUNITY BENEFIT REPORT WITH THE STATE OF MARYLAND'S HEALTH SERVICES COST REVIEW COMMISSION (HSCRC). THE HSCRC, WHICH OPERATES UNDER A MEDICARE WAIVER, DOES NOT CONSIDER MEDICARE SHORTFALL AS COMMUNITY BENEFIT. THE COSTING METHODOLOGY USED BY THE ORGANIZATION IS A COST-TO-CHARGE RATIO. Schedule H, Part III, Line 9b Collection practices for patients eligible for financial assistance THE ORGANIZATION EXPECTS PAYMENT AT THE TIME THE SERVICE IS PROVIDED. OUR POLICY IS TO COMPLY WITH ALL STATE AND FEDERAL LAW AND THIRD PARTY REGULATIONS AND TO PERFORM ALL CREDIT AND COLLECTION FUNCTIONS IN A DIGNIFIED AND RESPECTFUL MANNER. EMERGENCY SERVICES WILL BE PROVIDED TO ALL PATIENTS REGARDLESS OF ABILITY TO PAY. FINANCIAL ASSISTANCE IS AVAILABLE FOR PATIENTS BASED ON FINANCIAL NEED AS DEFINED IN THE FINANCIAL ASSISTANCE POLICY. THE ORGANIZATION DOES NOT DISCRIMINATE ON THE BASIS OF AGE, RACE, CREED, SEX OR ABILITY TO PAY. PATIENTS WHO ARE UNABLE TO PAY MAY REQUEST A FINANCIAL ASSISTANCE APPLICATION AT ANY TIME PRIOR TO SERVICE OR DURING THE BILLING AND COLLECTION PROCESS, EVEN IN EXCESS OF 240 DAYS FOLLOWING THE FIRST POST-DISCHARGE BILLING STATEMENT. THE ORGANIZATION MAY REQUEST THE PATIENT TO APPLY FOR MEDICAL ASSISTANCE PRIOR TO APPLYING FOR FINANCIAL ASSISTANCE. THE ACCOUNT WILL NOT BE FORWARDED FOR COLLECTION DURING THE MEDICAL ASSISTANCE APPLICATION PROCESS OR THE FINANCIAL ASSISTANCE APPLICATION PROCESS. NO EXTRAORDINARY COLLECTION ACTIONS (ECAS) WILL OCCUR EARLIER THAN 120 DAYS FROM SUBMISSION OF FIRST BILL TO THE PATIENT AND WILL BE PRECEDED BY NOTICE 30 DAYS PRIOR TO COMMENCEMENT OF THE ACTION. AVAILABILITY OF FINANCIAL ASSISTANCE WILL BE COMMUNICATED TO THE PATIENT AND A PRESUMPTIVE ELIGIBILITY REVIEW WILL OCCUR PRIOR TO ANY ACTION BEING TAKEN. IF A PATIENT IS DETERMINED TO BE ELIGIBLE FOR FINANCIAL ASSISTANCE AFTER AN ECA IS INITIATED, THE ORGANIZATION WILL TAKE REASONABLE MEASURES TO REVERSE THE ECAS AGAINST THE PATIENT ACCOUNT. Schedule H, Part V, Section B, Line 16a FAP website 1 - UNIVERSITY OF MARYLAND MEDICAL CENTER: Line 16a URL: https://www.umms.org/ummc/community; Schedule H, Part V, Section B, Line 16b FAP Application website 1 - UNIVERSITY OF MARYLAND MEDICAL CENTER: Line 16b URL: https://www.umms.org/ummc/community; Schedule H, Part V, Section B, Line 16c FAP plain language summary website 1 - UNIVERSITY OF MARYLAND MEDICAL CENTER: Line 16c URL: https://www.umms.org/ummc/community; Schedule H, Part VI, Line 2 Needs assessment Since fiscal year 2012, the University of Maryland Medical Center Downtown Campus has completed a comprehensive community health needs assessment (CHNA) every three years. To complete this comprehensive assessment of the needs of the community, the Association for Community Health Improvement's (ACHI) 9-step Community Health Assessment Process was utilized as an organizing methodology. An additional 5-component assessment and engagement strategy was also utilized to lead the data collection methodology. The UMMC Community Health Improvement Team (CHI Team) included both the Downtown and Midtown Campuses and served as the lead team to conduct the Community Health Needs Assessment (CHNA) with input from other University of Maryland Medical System Baltimore City-based hospitals, community leaders, the academic community, the public, health experts, and the Baltimore City Health Department. Data was collected from the major areas of the community's perspective, health experts' opinions, and community leaders' perspectives along with a review of social determinants of health and epidemiologic data to complete a comprehensive assessment of the community's needs. Data includes primary and secondary sources of data. This community health needs assessment report was approved by the UMMC Board of Directors Community Engagement Committee on June 4, 2018. Schedule H, Part VI, Line 3 Patient education of eligibility for assistance Patient Education of Eligibility for Assistance - Patients are informed of their eligibility for assistance through signage in admitting and registration areas, online, in the Patient Handbooks, in local newspapers, and with Patient Information Sheets. LANGUAGE TRANSLATIONS - UMMC translated its financial assistance policy into the following languages: English, Spanish, French, and Chinese. PLAIN LANGUAGE SUMMARY - UMMC created a new plain language summary of its financial assistance policy in addition to its already-existing patient information sheet. Schedule H, Part VI, Line 4 Community information Despite the larger regional patient mix of UMMC from the metropolitan area, state, and region, for purposes of community benefits programming and this report, the Community Benefit Service Area (CBSA) of UMMC is within Baltimore City, specifically West Baltimore. The top eight zip codes within Baltimore City represent the top 60% of all Baltimore City admissions in FY'17. These eight targeted zip codes (21201, 21215, 21216, 21217, 21218, 21223, 21229, and 21230) are the primary community benefit service area (CBSA) and comprise the geographic scope of the assessment. These zip codes are shared with the UMMC Midtown Campus as well. Both the CHNA and programming for both campuses are targeted to these identified West Baltimore communities. The residents in these identified communities have life expectancy rates of nearly 20 years less than residents in other parts of Baltimore City. High rates of unemployment, poverty, healthy food access issues, substance use, and violence are major social barriers to health. Residents in these communities have some of the worst health outcomes when compared to the City and the State of Maryland. Schedule H, Part VI, Line 6 Affiliated health care system The University of Maryland Medical System Corporation (UMMS) is a private, not-for-profit corporation providing comprehensive healthcare services through an integrated regional network of hospitals and related clinical enterprises. UMMS was created in 1984 when its founding hospital was privatized by the State of Maryland. Over its 30-year history, UMMS evolved into a multi-hospital system with academic, community and specialty service missions reaching primarily across Maryland. As part of the University of Maryland Medical System (UMMS), the University of Maryland Medical Center understands that health care goes beyond the walls of the hospital and into the community it serves. UMMS hospitals are committed to strengthening their neighboring communities. In doing so, the UMMC assesses the community's health needs, identifies key priorities, and responds with services, programs and initiatives which make a positive, sustained impact on the health of the community. With representation from all UMMS hospitals, the Medical System's Community Health Improvement Council coordinates the effective and efficient utilization and deployment of resources for community-based activities and evaluates how services and activities meet targeted community needs within defined geographic areas. The UMMC is committed to health education, advocacy, community partnerships, and engaging programs which focus on promoting health and wellness in an effort to eliminate health disparities for the West Baltimore community. Schedule H, Part VI, Line 7 State filing of community benefit report MD true BALTIMORE CITY FOUNDATION INC 7 E Redwood St 9th Floor Baltimore MD 21202 521212473 501(c)(3) 56250 General Assistance BALTIMORE SYMPHONY ORCHESTRA 1212 Cathedral St Baltimore MD 21201 520629696 501(c)(3) 6000 General Assistance BALTIMORE WASHINGTON MEDICAL CNTR FOUNDATION 300 Hospital Drive Glen Burnie MD 21061 521813656 501(c)(3) 10000 General Assistance CAL RIPKEN SR FOUNDATION 1427 Clarkview Rd Baltimore MD 21209 522310500 501(c)(3) 11250 General Assistance CHARLES REGIONAL MEDICAL CENTER FOUNDATION PO Box 1701 La Plata MD 20646 521414564 501(c)(3) 10000 General Assistance GREATER BALTIMORE COMMITTEE 111 S Calvert St Baltimore MD 21202 520645650 501(c)(4) 44115 General Assistance LIVING LEGACY FOUNDATION 1730 Twin Springs Rd Halethorpe MD 21227 521736533 501(c)(3) 15000 General Assistance MT WASHINGTON PEDIATRIC HOSPITAL 1708 W Rogers Ave Baltimore MD 21209 520591483 501(c)(3) 10000 General Assistance RONALD MCDONALD HOUSE BALTIMORE 1 Aisquith St Baltimore MD 21202 521184957 501(c)(3) 70000 General Assistance SOUTHWEST PARTNERSHIP INC 1138 Hollins St Baltimore MD 21223 474390017 501(c)(3) 15000 General Assistance UNITED WAY OF CENTRAL MARYLAND FOR THE JOURNEY HOME 1800 Washington Blvd SUITE 340 Baltimore MD 21230 520591543 501(c)(3) 12500 General Assistance UNIVERSITY OF MARYLAND COLLEGE PARK FOUNDATION 4603 Calvert Rd College Park MD 20740 522197313 501(c)(3) 7500 General Assistance UNIVERSITY OF MARYLAND BALTIMORE FOUNDATION INC 3300 Metzerott Road Adelphi MD 20783 311678679 501(c)(3) 13000 General Assistance UPPER CHESAPEAKE HEALTH FOUNDATION INC 520 Upper Chesapeake Dr Bel Air MD 21014 521398507 501(c)(3) 7500 General Assistance BALTIMORE AREA COUNCIL BSA 701 Wyman Park Drive Baltimore MD 21211 520591572 501(c)(3) 8000 General Assistance AMERICAN HEART ASSOCIATION PO Box 4002906 Des Moines IA 50340 135613797 501(c)(3) 30000 General Assistance 15 1 Schedule I, Part I, Line 2 Procedures for monitoring use of grant funds. UMMS FOLLOWS STANDARD PROCEDURES TO PERIODICALLY COMMUNICATE WITH GRANTEES TO MONITOR HOW GRANT MONEY IS UTILIZED FOR THEIR INTENDED PURPOSE. X X X X true true false false false false false true false John Dillon DIRECTOR (ENDED 04/19) 156375 0 0 0 0 0 0 0 0 0 156375 0 0 0 Robert L Pevenstein DIRECTOR (ENDED 03/19) 180000 0 0 0 0 0 0 0 0 0 180000 0 0 0 Megan Arthur SVP, GEN COUNSEL AND SEC'TY (ENDED 06/19) 475888 0 172913 0 80737 0 11000 0 31446 0 771984 0 0 0 John W Ashworth III INTERIM PRESIDENT AND CEO 422013 0 160212 0 70894 0 11000 0 25969 0 690088 0 0 0 Robert A Chrencik PRESIDENT AND CEO (ENDED 04/19) 1355350 0 995365 0 284091 0 11000 0 25554 0 2671360 0 0 0 Henry J Franey EVP, CFO AND TREASURER (ENDED 03/19) 902962 0 395891 0 241695 0 11000 0 23207 0 1574755 0 0 0 S Michelle Lee SVP AND CFO 340683 0 113715 0 55725 0 11000 0 20697 0 541820 0 0 0 Walter Ettinger FORMER SVP and CMO 0 0 0 0 642534 0 0 0 0 0 642534 0 0 0 Mark Kelemen FORMER CHIEF MED INFO OFFICER - UMMC 0 0 0 0 192702 0 0 0 0 0 192702 0 0 0 Stephen T Bartlett EVP AND CMO (ENDED 12/18) 1449968 0 301306 0 16599 0 139022 0 27411 0 1934306 0 0 0 Jon P Burns SVP AND CIO 486243 0 170347 0 75075 0 11000 0 21353 0 764018 0 0 0 Michelle Gourdine SVP AND INTERIM CMO - UMMS 403692 0 92728 0 12277 0 49385 0 1744 0 559826 0 0 0 Joseph E Hoffman III EVP AND CFO - UMMC 492748 76383 195000 0 65359 22248 11000 17142 23393 6416 787500 122189 0 0 Michael R Jablonover SVP AND CMO - UMMC 470188 0 163863 0 79524 0 11000 0 32064 0 756639 0 0 0 Kathleen M Mccann SVP, CHIEF HUMAN RESOURCE OFFICER 401662 0 140790 0 207053 0 11000 0 22067 0 782572 0 163574 0 Keith D Persinger SVP AND CHIEF PERFORMANCE IMPROV OFFICER (ENDED 06/19) 725269 0 302400 0 107925 0 11000 0 13470 0 1160064 0 0 0 Lisa C Rowen SVP AND CNO - UMMC 466710 0 175950 0 377836 0 11000 0 22383 0 1053879 0 182819 0 Mohan Suntha MD PRESIDENT AND CEO, UMMC 1184928 0 523480 0 219455 0 11000 0 28767 0 1967630 0 0 0 Alicia J Cunningham SVP CORPORATE FINANCE 316569 0 113715 0 65499 0 11000 0 34258 0 541041 0 0 0 Janice M Eisele SVP DEVELOPMENT 303711 0 97536 0 42808 0 11000 0 1699 0 456754 0 0 0 Leonard Taylor Jr SVP OPERATIONS SUPPORT SERVICES 377212 0 98297 0 58183 0 11000 0 3201 0 547893 0 0 0 Mark L Wasserman SVP EXTERNAL AFFAIRS 334922 0 126610 0 53362 0 11000 0 22379 0 548273 0 0 0 Gerald L Wollman SVP CORP OPERATIONS (ENDED 06/19) 469113 0 169144 0 70072 0 11000 0 28863 0 748192 0 0 0 Schedule J, Part I, Line 4a Severance or change-of-control payment DURING THE FISCAL YEAR-ENDED JUNE 30, 2019, CERTAIN OFFICERS AND KEY EMPLOYEES HAVE RECEIVED SEVERANCE PAYMENTS. THESE AMOUNTS ARE REPORTED AS TAXABLE COMPENSATION AND REPORTED ON SCHEDULE J, PART II, LINE B(III), OTHER REPORTABLE COMPENSATION. THE INDIVIDUALS AND AMOUNT ARE LISTED BELOW: WALTER ETTINGER $624,240. MARK KELEMEN $182,782 Schedule J, Part I, Line 4b Supplemental nonqualified retirement plan DURING THE FISCAL YEAR- ENDED JUNE 30, 2019, CERTAIN OFFICERS AND KEY EMPLOYEES PARTICIPATED IN THE UMMS SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN. THE INDIVIDUALS LISTED BELOW HAVE NOT VESTED IN THE PLAN THEREFORE THE ACCRUED CONTRIBUTION TO THE PLAN FOR THE FISCAL YEAR IS REPORTED ON SCHEDULE J, PART II, COLUMN C, RETIREMENT AND OTHER DEFERRED COMPENSATION: STEPHEN T. BARTLETT MICHELLE GOURDINE DURING THE FISCAL YEAR ENDED JUNE 30, 2019, CERTAIN OFFICERS AND KEY EMPLOYEES PARTICIPATED IN THE UMMS SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN. THE INDIVIDUALS LISTED BELOW HAVE VESTED IN THE PLAN IN THE REPORTING TAX YEAR, THEREFORE THE FULL VALUE OF THE PLAN, INCLUDING ANY CONTRIBUTIONS TO THE PLAN FOR THE CURRENT FISCAL YEAR ARE REPORTED AS TAXABLE COMPENSATION AND REPORTED ON SCHEDULE J, PART II, LINE B(III), OTHER REPORTABLE COMPENSATION. PRIOR YEAR CONTRIBUTIONS TO THE PLAN WERE PREVIOUSLY REPORTED ON FORM 990 AND ARE INDICATED ON SCHEDULE J, PART II, COLUMN (F). LISA C ROWEN, $370,732 KATHLEEN M MCCANN, $196,276 DURING THE FISCAL YEAR-ENDED JUNE 30, 2019, CERTAIN OFFICERS AND KEY EMPLOYEES PARTICIPATED IN THE UNIVERSITY OF MARYLAND MEDICAL SYSTEM (UMMS) SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN. THE INDIVIDUALS LISTED BELOW HAVE VESTED IN THE PLAN IN A PRIOR YEAR, THEREFORE THE CONTRIBUTIONS TO THE PLAN FOR THE FISCAL YEAR ARE REPORTED AS TAXABLE COMPENSATION AND REPORTED ON SCHEDULE J, PART II, LINE B (III), OTHER REPORTABLE COMPENSATION: JOHN W. ASHWORTH ROBERT A. CHRENCIK HENRY J. FRANEY MEGAN M. ARTHUR S. MICHELLE LEE JON P. BURNS MICHAEL R. JABLONOVER KEITH D. PERSINGER MOHANAKUMAR SUNTHARALINGAM JOSEPH E. HOFFMAN III KATHLEEN MCCANN MARK WASSERMAN GERALD L. WOLLMAN JANICE EISELE LEONARD TAYLOR ALICIA CUNNINGHAM Schedule J, Part I, Line 7 Non-fixed payments BONUSES PAID ARE BASED ON A NUMBER OF VARIABLES INCLUDING BUT NOT LIMITED TO INDIVIDUAL GOAL ACHIEVEMENTS AS WELL AS ORGANIZATION OPERATION ACHIEVEMENTS. THE FINAL DETERMINATION OF THE BONUS AMOUNT IS DETERMINED AND APPROVED BY THE BOARD AS PART OF THE OVERALL COMPENSATION REVIEW OF THE OFFICERS AND KEY EMPLOYEES. A MHHEFA (SERIES 2007A&B) 520936091 574217G74 2007-09-12 137795000 ADVANCED REFUNDING OF SERIES 2002 BONDS, AND SERIES 2001 BONDS false false false B MHHEFA (SERIES 2008A-E) 520936091 574217U78 2008-05-21 280000000 CURRENT REFUNDING- 2006B-F BONDS false false false C MHHEFA (SERIES 2008F) 520936091 574217Y66 2008-07-10 89764001 CURRENT REFUNDING- 2006B-F BONDS false false false D MHHEFA (SERIES 2010) 520936091 5742175D3 2010-01-07 241441656 FINANCE 2010 FACILITY COSTS; AND REFUND SERIES 2008G, SERIES 2008H AND SERIES 2004A BONDS false false false A 17180000 41175000 137849502 1120731 19824 136708947 false true true true B 175000000 280000000 1586410 188590 278225000 true false true true C 59790000 89951422 792457 89158965 true false true true D 95645000 243598715 17980097 2656305 130000000 92962313 2012 true false false true A false false false false 0.0 false false true B false false false false 0.0 false false true C false false false false 0.0 false false true D false false false false 0.0 false false true A false false false true true true JP MORGAN BANK OF AMERICA 27.0 false false false false true B false false false true true true JP MORGAN BANK OF AMERICA 34.6 false false false false true C false false false true false false false false true D false false false true false false false false true A true B true C true D true Schedule K, Part I, Column (f) Description of purpose ISSUER NAME: MHHEFA (SERIES 2013A) ACQUISITION COSTS RELATED TO ST. JOSEPH MEDICAL CENTER; FINANCE CAPITAL PROJECTS; AND REFUND SERIES 1998, SERIES 2004B AND SERIES 2005. Schedule K, Part I, Column (f) Description of Purpose ISSUER NAME: MHHEFA (SERIES 2017D) BONDS TO FINANCE A PORTION OF ACQUISITION COSTS RELATED TO UM CAPITAL REGION AND CONSTRUCTION COSTS OF NEW REGIONAL MEDICAL CENTER AND NEW FREESTANDING MEDICAL FACILITY. Schedule K, Part II, Line 3 MHHEFA (Series 2007A&B) The difference between the issue price and the total proceeds of issue is investment earnings in the amount of $54,502. Schedule K, Part II, Line 3 MMHEFA (Series 2008F) The difference between the issue price and the total proceeds of issue is investment earnings in the amount of $187,421. Schedule K, Part II, Line 3 MHHEFA (SERIES 2010) The difference between the issue price and the total proceeds of issue is investment earnings in the amount of $2,157,059. Schedule K, Part II, Line 3 MHHEFA (SERIES 2013A) The difference between the issue price and the total proceeds of issue is investment earnings in the amount of $72,288. Schedule K, Part II, Line 3 MHHEFA (SERIES 2015) The difference between the issue price and the total proceeds of issue is investment earnings in the amount of $3,496. Schedule K, Part II, Line 3 MHHEFA (Series 2017B) The difference between the issue price and the total proceeds of issue is investment earnings in the amount of $5,958. Schedule K, Part II, Line 3 MHHEFA (Series 2017D) The difference between the issue price and the total proceeds of issue is investment earnings in the amount of $2,989,131. Schedule K, Part IV, Line 2c COLUMN A Issuer name: MHHEFA (SERIES 2007A&B) The calculation for computing no rebate due was performed on 07/01/2017 Schedule K, Part IV, Line 2c COLUMN B Issuer name: MHHEFA (SERIES 2008A-E) The calculation for computing no rebate due was performed on 07/01/2017 Schedule K, Part IV, Line 2c COLUMN C Issuer name: MHHEFA (SERIES 2008F) The calculation for computing no rebate due was performed on 07/01/2018 Schedule K, Part IV, Line 2c COLUMN D Issuer name: MHHEFA (SERIES 2010) The calculation for computing no rebate due was performed on 04/01/2019 Schedule K, Part IV, Line 2c COLUMN A Issuer name: MHHEFA (SERIES 2013A) The calculation for computing no rebate due was performed on 07/01/2017 A MHHEFA (SERIES 2013A) 520936091 574218MH3 2013-03-08 265377428 (See Statement) false false false B MHHEFA (SERIES 2015) 520936091 574218WD1 2015-05-21 86603677 ADVANCED REFUNDING OF SERIES 2006A BONDS AND SERIES 2008C (UCHS) BONDS false false false C MHHEFA (SERIES 2016A-D) 520936091 2016-09-27 212785000 REFUNDING OF SERIES- 2012A-D BONDS false false false D MHHEFA (SERIES 2016E&F) 520936091 2016-10-13 108730000 REFUNDING OF SERIES 2011B/C (UCHS) BONDS false false false A 22870000 265449715 2662975 173100000 89686740 true true true true B 5085000 86607173 9475 86597698 false true true true C 2435000 212785000 720000 212065000 true false true true D 4810000 108730000 310000 108420000 true false true true A false false true true true true 0.0 false false true B false true false false 0.0 false false true C false false false false 0.0 false false true D false false false false 0.0 false false true A false false false true false false false false true B false true false false true false false false true C false true false false false false false false true D false true false false false false false false true A true B true C true D true A MHHEFA (SERIES 2017A) 520936091 2017-01-01 44010000 REFUNDING OF SERIES 2011A (UCHS) BONDS false false false B MHHEFA (SERIES 2017B) 520936091 574218V75 2017-02-02 165070579 ADVANCED REFUNDING OF SER. 1991B BONDS, A PORTION OF SER. 2005 BONDS & A PORTION OF SER. 2010 BONDS false false false C MHHEFA (SERIES 2017D) 520936091 5742184J9 2017-12-19 147182498 (SEE STATEMENT) false false false A 2210000 44010000 44010000 true false true true B 4045000 165076538 164998598 77940 false true true true C 150171629 1570898 145611600 2989131 false false false true A false false false false 0.0 false false true B false true false false 0.0 false false true C false false false false 0.0 false false true A false true false false true false false false true B false true false false false false false false true C false true false false false false false false true A true B true C true Catherine Pugh Board Member Catherine Pugh ("Pugh") served on the UMMS Board of Directors from 2002 until her resignation in March 2019. Between November 2011 and 2018, while Pugh was on the board of UMMS, UMMS entered into contractual agreements with Pugh and her wholly owned entity to purchase a total of 100,000 copies of Healthy Holly books written by Pugh. The books were purchased by UMMS on the understanding that they would be delivered to the Baltimore City Public School System and made available to children in Baltimore City Public Schools. Five $100,000 payments (each for 20,000 books) were made in each of 2011, 2012, 2015, 2016 and 2018, for an aggregate amount of $500,000. In March 2019, UMMS became aware that Pugh was under investigation by law enforcement authorities. In March 2019, Pugh returned $100,000 of the payments made by UMMS. In November 2019, Pugh entered into a plea agreement with the government and pleaded guilty to (1) conspiracy to commit wire fraud, (2) conspiracy to defraud the United States, and (3) two counts of tax evasion. As necessary for the count on the conspiracy to commit wire fraud, Pugh acknowledged in the Stipulation of Facts that accompanied the plea agreement that she did not deliver all copies of books intended for Baltimore City Public Schools, but instead kept thousands of copies for her later personal use; that she resold copies of books intended for Baltimore City Public Schools; and that, in years 2016 and 2018, she did not deliver any copies of books for which UMMS had paid. Pugh stipulated that she defrauded UMMS of the $500,000 paid for books that were not delivered as agreed. Pugh's admitted fraud demonstrates that any approval or participation in these transactions by UMMS directors and management was not knowing. As part of the sentencing process following the plea agreement, UMMS was awarded a $400,000 judgment of restitution by court order reflecting UMMS' full outstanding claim against Pugh. UMMS will take all necessary and appropriate steps to enforce the judgment. true 125000 0 KELLY & ASSOCIATES INSURANCE GROUP SEE PART V 1671538 SEE PART V false DR SARAH KLEIST SEE Part V 48031 SEE PART V false Soltesz Inc SEE Part V 158462 See Part V false Matthew Irby See Part V 99767 See Part V false Schedule L, Part IV Line 1, COLUMN B AND COLUMN D Francis Kelly is a director of the filing organization, and an owner of Kelly & Associates Insurance Group. Kelly & Associates Insurance Group was paid commissions and adminstrative fees, at or below fair market value, related to employee benefits. Schedule L, Part IV LINE 2, Column B and Column D Dr. Sarah Kleist is a family member of Kenneth Moreland, a director of the filing organization. Dr. Sarah Kleist was paid reasonable compensation as an employee of the filing organization. Schedule L, Part IV Line 3, Column B and Column D James Soltesz is a director of the filing organization, and an owner of Soltesz, Inc. Soltesz, Inc. was paid fees, at or below fair market value, for engineering services. Schedule L, Part IV Line 4, Column B and Column D Matthew Irby is a family member of John Ashworth, an officer of the filing organization. Matthew Irby was paid reasonable compensation as an employee of the filing organization. Form 990, Part VI, Line 4 Significant changes to organizational documents During its tax year ended June 30, 2019, UMMS implemented comprehensive governance changes addressing significant, widely publicized governance failures involving transactions between UMMS and nine of its 30 board members. A number of these changes were statutory, resulting from oversight and legislation enacted by the Maryland State Legislature in April 2019. Unlike other nonprofit hospital systems, UMMS' governance is largely dictated and overseen by the Maryland State Legislature. Prior to 1984, UMMS was an integral part of the University of Maryland, a state university. In 1984, the Maryland Legislature converted the University of Maryland Hospital into the University of Maryland Medical System, a private nonprofit corporation recognized as a section 501(c)(3) tax exempt hospital. A primary objective of the conversion was to prompt creation of a single, integrated hospital system serving the entire State of Maryland. UMMS was also formed because the legislature sought to "separate the operations, revenues and obligations of the medical system from the State," because it "ha[d] proven unnecessarily costly and administratively cumbersome for the University [of Maryland] to finance, manage, and carry out the patient care activities of an academic institution within the existing framework of a State agency...." Md.Code (1978, 2008 Repl.Vol.), § 13-302(5), (6) of the Education Article ("Educ."). While the 1984 legislation created a separate, private entity, the State maintained substantial control of UMMS' governance and operations, including, for example, by (i) requiring that UMMS' articles of incorporation and initial asset transfer be approved by Maryland's Board of Public Works; (ii) vesting appointment of Board members in the Governor; and (iii) requiring that the Chancellor of the University System of Maryland and other University officials serve as ex officio members of the UMMS Board. See 98 Opinions of the Attorney General 114, at 117-20 (November 21, 2013) (identifying examples and stating, "Although it established UMMS as an ostensibly private corporation, the General Assembly ensured that the State would continue to play a prominent role in the System's governance"). In addition to statutory changes, other governance changes were the result of two independent reviews commissioned by the UMMS Board. The Nygren Report, completed and released to the public in June 2019, identified transactions between UMMS and nine of UMMS' 30 Board members that were not presented to, reviewed by, and/or approved by the UMMS Board or an appropriate UMMS Board committee as required by UMMS' bylaws, policies and procedures. See https://www.umms.org/-/media/files/umms/about-us/leadership/board-updates/nygren-report.pdf?upd=20190621155341&la=en&hash=A6C8E300FF486C78F751A9F6EB1FF22639AF1824. A second report commissioned by the Special Committee of the newly constituted UMMS Board was a comprehensive governance review that was completed and released to the public in December 2019, and recommended significant governance, management and operational reforms (the "Special Committee Report"). See https://cdn.s3-media.wbal.com/Media/2019/12/13/f92dad8e-9486-4119-b64b-1f079a56475d/original.pdf. On a parallel track, beginning in August 2019 the UMMS Board retained McDermott, Will & Emery to advise on modifications and enhancements to UMMS governance policies and procedures, based on a review of UMMS' then existing policies and procedures and transactions identified in the Nygren Report. The recommendations, amplified by and aligned with the Special Committee Report recommendations, have been adopted and are being implemented by the UMMS Board and management. Below is a summary of governance changes mandated unanimously by the Maryland State Legislature and signed into law by the Governor in April 2019, as well as governance changes implemented by the UMMS Board in response to the Nygren and Special Committee Reports and McDermott review. Statutory Governance Changes: * UMMS was required to adopt a new conflict of interest policy (described herein on Schedule O) including certain statutorily mandated provisions such as standards on recusal from voting and conflicts disclosures. Educ. § 13-303(n). The new statute mandated that, on or before May 31, 2019 (and each time a change is made to the policy), the new conflict of interest policy be adopted and provided to the Governor, the President of the Maryland Senate and Speaker of the Maryland House. * The UMMS Board was reconstituted to consist of not less than 22 and not more than 25 voting members and six non-voting ex officio members. Educ. § 13-304(b)(1). * All UMMS Board members were required to be replaced by January 1, 2020 with new members appointed or reappointed by the Governor with the advice and consent of the Maryland Senate. Sections 5(a) and (b) of Chapter 19 (House Bill 1428) of the Acts of 2019. * UMMS Board members are prohibited from being State or local elected officials and three voting members must include the Governor's designee, an appointment by the President of the Maryland Senate and an appointment by the Speaker of Maryland's House of Delegates. Educ. § 13-304(c). Form 990, Part VI, Line 5 Diversion of organization assets An UMMS board of directors member (the "director") served on the UMMS board of directors from 2002 until her resignation in March 2019. Between November 2011 and 2018, while the director was on the board of UMMS, UMMS entered into contractual agreements with her and her wholly owned entity to purchase a total of 100,000 copies of children's books written by the director. The books were purchased by UMMS on the understanding that they would be delivered to the Baltimore City Public School System and made available to children in Baltimore City Public Schools. Five $100,000 payments (each for 20,000 books) were made in each of 2011, 2012, 2015, 2016 and 2018, for an aggregate amount of $500,000. In March 2019, UMMS became aware that the director was under investigation by law enforcement authorities. In March 2019, the director returned $100,000 of the payments made by UMMS. In November 2019, the director entered into a plea agreement with the government and pleaded guilty to (1) conspiracy to commit wire fraud, (2) conspiracy to defraud the United States, and (3) two counts of tax evasion. As necessary for the count on the conspiracy to commit wire fraud, the director acknowledged in the Stipulation of Facts that accompanied the plea agreement that she did not deliver all copies of books intended for Baltimore City Public Schools, but instead kept thousands of copies for her later personal use; that she resold copies of books intended for Baltimore City Public Schools; and that, in years 2016 and 2018, she did not deliver any copies of books for which UMMS had paid. The director stipulated that she defrauded UMMS of the $500,000 paid for books that were not delivered as agreed. As part of the sentencing process following the plea agreement, UMMS was awarded a $400,000 judgment of restitution by court order reflecting UMMS' full outstanding claim against the director. UMMS will take all necessary and appropriate steps to enforce the judgment. Form 990, Part VI, Line 11b Review of form 990 by governing body The University of Maryland Medical System ("UMMS") prepares the IRS Form 990 for UMMS and its affiliates. Information needed to complete the return is gathered by accounting personnel in the Finance Shared Services department under the supervision of the UMMS tax director. Draft returns are prepared using IRS-approved tax software. Once a draft return is prepared, it undergoes multiple levels of review both internally by UMMS tax & finance personnel, and externally by Ernst & Young LLP. Following any necessary changes to the return, a final draft is reviewed by each affiliate's vice president of finance and/or CFO. Prior to filing the IRS Form 990, the organization's board chairman, treasurer, governance committee chairman, finance committee chairman or other member of the board with similar authority will review the IRS Form 990. All board members are provided with a copy of the final IRS Form 990 before filing. Form 990, Part VI, Line 12c Conflict of interest policy The organization requires that all Covered Persons disclose conflicts of interest or potential conflicts of interest between their personal interests and the interests of the organization, or any entity controlled by or owned in substantial part by the organization. Covered Persons means any member of the organization's Board of Directors, a member of a committee of the Board, an officer, or an employee of organization (including subsidiaries) at the VP level or above. The Governance Committee of the Board is responsible for administering and enforcing the Conflicts of Interest Policy (Policy). The Chair of the Governance Committee, having reviewed any and all conflicts with the Committee, shall report annually to the full Board on the administration, infractions, and enforcement of the Policy and shall report at the earliest opportunity all matters of concern to the full Board in executive session while interested parties are recused. The organization's Compliance Officer is the responsible administrative authority to assist the Board in administering and enforcing the Conflicts of Interest Policy and bringing concerns to the Governance Committee. A questionnaire which discloses potential conflicts of interest is distributed annually to Covered Persons. The Chief Compliance Officer of the University of Maryland Medical System Corporation (UMMS) distributes and collects the responses for UMMS and other affiliates. The Chief Compliance Officer reviews all disclosure statements for compliance with the Conflict of Interest Policy and any/all related UMMS policies to identify all actual or potential conflicts of interest. The Chief Compliance Officer prepares and submits to the Governance Committee annual and updated (where applicable) reports summarizing all relevant information contained in the disclosure statements. With respect to the other entities in the University of Maryland Medical System, the Chief Compliance Officer may be called for consult. If the Governance Committee determines that a Conflict of Interest exists, the Governance Committee shall notify the Covered Person, the UMMS Chief Executive Officer, and the UMMS Board Chair and further will notify the full Board at its next meeting. Furthermore, in the event the Governance Committee determines that an actual or perceived Conflict of Interest exists, the Committee shall decide how to address the Conflict of Interest. If the Governance Committee determines that a Conflict of Interest exists but that UMMS may enter into the subject transaction or arrangement, the interested Covered Person shall be recused from all deliberations and decisions concerning said transaction or arrangement, any arrangements with that entity, and compensation or benefits for officers, directors, and trustees. Furthermore, the Chair of the Board and the Chairs of the Governance Committee and the Audit and Compliance Committee shall not have any Business Transactions with UMMS, nor shall their Family Members. If the Governance Committee determines that a Covered Person has used their position to accrue Excess Benefits or to knowingly assist others in accruing Excess Benefits in any way at the expense of UMMS, the Governance Committee shall recommend to the Executive Committee appropriate corrective action to be taken. All invitations for bids, proposals or solicitations for offers include the following provision: Any vendor, supplier or contractor must disclose any actual or potential transaction with any organization officer, director, employee or member of the medical staff, including family members within five days of the transaction. Failure to comply with this provision is a material breach of agreement. In addition, a board disclosure report is filed with the Maryland Health Services Cost Review Commission on an annual basis showing any business transactions totaling in excess of $10,000 between the board members and/or their related entities and the organization. Form 990, Part VI, Line 15a Process to establish compensation of top management official The organization determines the executive compensation paid to its executives in the following manner prescribed in the IRS regulations: Executive compensation packages are determined by a committee of the board that is composed entirely of board members who have no conflict of interest. The committee acquires credible comparability market data concerning the compensation packages of similarly situated executives. The committee carefully reviews that data, the executive's performance and the proposed compensation packages during the decision making process. The committee memorializes its deliberations in detailed minutes reviewed and adopted at the next-following meeting. The committee seeks an opinion of counsel that it has met the requirements of the IRS intermediate sanctions regulations. This process is used to determine the compensation packages for all management employees from the Vice President level and up. Form 990, Part VI, Line 15b Process to establish compensation of other employees The organization determines the executive compensation paid to its executives in the following manner prescribed in the IRS regulations: Executive compensation packages are determined by a committee of the board that is composed entirely of board members who have no conflict of interest. The committee acquires credible comparability market data concerning the compensation packages of similarly situated executives. The committee carefully reviews that data, the executive's performance and the proposed compensation packages during the decision making process. The committee memorializes its deliberations in detailed minutes reviewed and adopted at the next-following meeting. The committee seeks an opinion of counsel that it has met the requirements of the IRS intermediate sanctions regulations. This process is used to determine the compensation packages for all management employees from the Vice President level and up. Form 990, Part VI, Line 19 Required documents available to the public THE ORGANIZATION'S GOVERNING DOCUMENTS ARE MADE PUBLICLY AVAILABLE THROUGH THE STATE OF MARYLAND VIA THE SECRETARY OF STATE'S OFFICE. THE CONFLICT OF INTEREST POLICY IS GENERALLY AVAILABLE ON THE ORGANIZATION'S OR AFFILIATE'S WEBSITE. FINANCIAL STATEMENTS ARE MADE PUBLICLY AVAILABLE ON A QUARTERLY BASIS THROUGH FILINGS ON THE ELECTRONIC MUNICIPAL MARKET ACCESS ("EMMA") SYSTEM. Form 990, Part VII, Section A HOURS ON RELATED ENTITIES UMMS IS A MULTI-ENTITY HEALTH CARE SYSTEM THAT INCLUDES 13 ACUTE CARE HOSPITALS, 1 ACUTE CARE HOSPITAL OWNED IN A JOINT VENTURE ARRANGEMENT AND VARIOUS SUPPORTING ENTITIES. A NUMBER OF INDIVIDUALS PROVIDE SERVICES TO VARIOUS ENTITIES WITHIN THE SYSTEM. IN GENERAL, THE OFFICERS AND KEY EMPLOYEES OF UMMS AVERAGE IN EXCESS OF 40 HOURS PER WEEK SERVING THE DIFFERENT ENTITIES THAT COMPRISE UMMS. Form 990, Part VIII, Line 11d Other Miscellaneous Revenue MEDICAL RECORDS - Total Revenue: 573173, Related or Exempt Function Revenue: 573173, Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: ; OTHER - Total Revenue: 1636678, Related or Exempt Function Revenue: 1636678, Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: ; RESIDENT REIMBURSEMENT - Total Revenue: 370239, Related or Exempt Function Revenue: 370239, Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: ; Form 990, Part XI, Line 9 Other changes in net assets or fund balances IT ENTERPRISE - 24861178; STRATEGIC PRIORITIES - 3999996; CHANGE IN ECON INT FOUNDATION - 13042686; INVESTMENT IN MWPH - 1110091; EQUITY TRANSFER - -45529619; CORP DEPRECIATION ALLOCATION - -9518378; UCHS CAPITAL CONTRIBUTION ESCROW - -15000000; SWAP VALUATION AND EXPENSE - -52830825; ELIMINATION ADJUSTMENT - 5576813; Form 990, Part VI, Line 4 Significant changes to organizing documents (continued) * A prior requirement that two voting Board members also be members of the General Assembly was repealed. Section 1 of Chapter 19 (House Bill 1428) of the Acts of 2019. * UMMS was required to retain a certified public accounting firm through a competitive bid process to conduct a performance audit of administrative and financial offices at UMMS. Any certified public accounting firm doing business with UMMS was prohibited from submitting a bid. The certified public accounting firm retained by UMMS was required to consult with the General Assembly's Joint Audit Committee and Office of Legislative Audits on the scope and objectives of the performance audit. UMMS was required to submit a certified copy of the performance audit to the Governor, the President of the Senate and the Speaker of the House by December 31, 2019, and is required to do so again in 2022. Section 2 of Chapter 19 (House Bill 1428) of the Acts of 2019. * UMMS must undergo a forensic audit by the Maryland Office of Legislative Audits covering the period January 1, 2016 through April 18, 2019, and the audit findings must be provided to the Governor, President of the Senate and Speaker of the House. Section 3 of Chapter 19 (House Bill 1428) of the Acts of 2019. * UMMS Board members must annually submit a statement of financial interest (including disclosing conflicts of interest) to the State Health Services Cost Review Commission ("HSCRC"), an independent state agency governed by seven commissioners appointed by the Governor and tasked with establishing hospital rates, for public disclosure on HSCRC's website. Educ. § 13-304(l). The General Assembly required also that UMMS' Board of Directors and compliance officer review each disclosure statement for compliance with UMMS' conflict of interest policy and that the HSCRC provide a summary of the annual statements to the Governor, President of the Senate and Speaker of the House. Id. * The UMMS Board must "develop a policy governing contracts with and payments to a member of the Board of Directors or members of the board of directors of hospitals affiliated with the Medical System Corporation by" UMMS or its affiliated hospitals and annually submit (by December 1) a report to the Governor and specific General Assembly leaders and committees involving the policy and how the Board has maintained compliance with the policy at UMMS' affiliated hospitals and the boards of its affiliated hospitals. Educ. § 13-304(o). * During calendar year 2019 UMMS' Board must conduct an internal review of Board policies and procedures and report findings and recommendations to state government officials by December 31, 2019. The Office of Legislative Audits must review and comment on the report. Section 4 of Chapter 19 (House Bill 1428) of the Acts of 2019. UMMS Board Changes Based on Reports and Assessments: * UMMS' Board unanimously adopted a new conflict of interest policy, which was provided to the Governor on May 31, 2019. * UMMS adopted a Board member Code of Conduct. * UMMS has adopted a new "governance handbook" that is, along with regular training, aimed at educating Board members on their roles and responsibilities and strong governance, among other things. * UMMS has adopted new policies or amended existing policies to strengthen its internal controls around procurement, expenditures, and travel and expense reimbursement. * UMMS also has revised its policies on reporting of potential compliance issues and compliance oversight so as to, together with the other improvements described above, eliminate both the appearance and occurrence of interested party transactions that pose conflicts of interest without appropriate approvals and to prevent the occurrence of transactions that are prohibited under U.S. federal tax rules applicable to UMMS. In the wake of press reporting regarding conflicts of interest with certain UMMS' Board members in March 2019, several UMMS Board members, the President and CEO (Robert Chrencik), General Counsel (Megan Arthur), Chief Compliance Officer (Christine Bachrach), Chief Administrative Officer (Jerry Wollman), and Chief Performance Improvement Officer (Keith Persinger), resigned. By the end of calendar year 2019, UMMS' 25-person Board was comprised of five members who had previously served, had not engaged in transactions with UMMS and were not named in the Nygren Report, and were re-appointed by the Governor; and 20 new members appointed by the Governor who had not previously served on the UMMS Board. UMMS appointed a new CEO, Dr. Mohan Suntha, effective December 1, 2019. In March 2020, the Maryland General Assembly's Office of Legislative Audits ("OLA") released findings from a Special Review of UMMS mandated by the April 2019 legislation (see https://www.ola.state.md.us/). The legislation required that the OLA identify all members of the UMMS Board of Directors over the period January 1, 2016 to April 18, 2019, review all transactions with those individuals and their associated businesses, and recommend any necessary improvements to the procurement and disbursement processes. The OLA Report states that "[t]he listing of Board members and associated businesses . . . is intended to provide a comprehensive summary of the payments identified by our review, and not to establish that the Board members were aware of, involved in, or benefitted from the payments, nor that the transactions were improper." The OLA Report concludes that if UMMS successfully implements the recommendations contained in the Special Committee Report and University of Maryland Medical System Financial Management Practices Audit Report, "further recommendations regarding UMMS' procurement and contracting processes, additional business relationships, and other related parties should not be necessary." UMMS has carefully reviewed each interested party transaction identified in the Nygren, Special Committee and OLA Reports to determine whether they constitute excess benefit transactions under section 4958. While many of those transactions were undertaken pursuant to deficient governance and control processes (which have since been addressed, as described above), the section 4958 inquiry looks to whether the transaction was, in fact, at fair market value, or whether an excessive economic benefit was conveyed to the interested party. Of the 18 Board members that OLA identified as having a "direct financial relationship" with an entity that received payments from UMMS, 11 were previously identified in the Nygren and/or Special Committee Reports. The additional 7 individuals were included in OLA's scope because OLA defined "associated business" broadly to include "any entity, regardless of whether it operated as for-profit or not-for-profit, with which the Board members or their immediate family member (spouses and adult children) (a) held an ownership interest (excluding non-controlling interests in publicly traded stock), (b) was employed, (c) received income, or (d) served as a member of the entity's board of directors or equivalent governing body." That definition includes serving as a Board member of a charity that received a donation from UMMS and holding an investment in a public company. Based on its review of each identified transaction, UMMS concluded that none of the transactions with these 7 directors involved actual or potential excess benefits to the UMMS director in question. Of the 11 directors originally identified in the Nygren and/or Special Committee Reports, one director defrauded UMMS in what constitutes not only an excess benefit transaction, but also a significant diversion of assets. That transaction is reported in Part IV, lines 25 (a) and (b) and corresponding Schedule L; Part VI, Sec. A, line 5, and this Schedule O; and Form 4720. Of the remaining 10 directors, the transactions with respect to which 8 directors were identified, were with associated businesses entered into and conducted in the ordinary course of business, which UMMS has concluded did not convey an excess benefit. The transactions with the remaining 2 directors, each of which is described in detail in the Nygren, Special Committee and OLA Reports, involved personal services performed directly by the director in question. These transactions did not follow appropriate governance procedures including adequate contemporaneous documentation. Nonetheless, after extensive review of these transactions, UMMS has made the judgment that substantial evidence supports the conclusion that none of these two directors' arrangements conveyed an excess benefit. 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