2020-07-10T19:16:20-05:00 2019-06-30 KPMG LLP 8350 Broad Street Suite 900 McLean VA 22102 990 2018-07-01 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 2020-07-10 true JG WHITE P01498698 7032868000 2020-06-15 199.207.253.101 54028020201925000027 2020-07-10 P 1E689D1B8B5D5A3AC5E4757C082A6DABCE8C4871 3AAD66ADA2E5DF4BC89011C66E354EB32E898C52 2018 2021-01-29 14:40:06Z MEDSTAR ST MARY'S HOSPITAL CHRISTINE WRAY 25500 POINT LOOKOUT ROAD LEONARDTOWN MD 20650 172348256 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. 15 7 1442 124 0 0 578979 785606 177355105 170639642 40057 -3880 1225281 731655 179199422 172153023 0 0 0 0 76866768 74053045 0 0 2646 85062748 85385560 161929516 159438605 17269906 12714418 116068024 104425495 19416551 17260995 96651473 87164500 X As a proud member of MedStar Health, MedStar St. Marys Hospitals (MedStar St. Marys) 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. Marys is located in Leonardtown, Maryland, in the southern region. In fiscal year 2019, MSMH had 7,450 inpatient admissions and 164,994 outpatient visits including 48,962 emergency visits. false false 116279786 0 169042001 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. 10002821 0 1597641 MedStar St. Marys provided $10.0M in subsidized (mission driven) health services in fiscal year 2019. 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. 3933958 0 0 MedStar St. Marys provided $4.0M in charity care services in fiscal year 2019. 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. 130216565 true true false false false false false false false true true false false true true true false true false false false false false false true false true true false false true false false false false false false false false false false false false false true true true false false true 0 0 true 1442 true false false false false false true true false false false false false false X 15 7 false false false false true true true true true false false true true true true true true true true true false MD X JOEL BRYAN 4107726721 10980 GRANTCHESTER WAY COLUMBIA MD 21044 X CHRISTINE WRAY PRESIDENT/DIRECTOR 20.0 20.0 X X 545111 545111 41194 John Harvey MD DIRECTOR 40.0 0.0 X 840056 0 30170 AVANI SHAH MD DIRECTOR 40.0 0.0 X 616680 0 18179 CONOR LUNDERGRAN DIRECTOR (UNTIL 12/18) 40.0 0.0 X 564377 0 20626 TRACY HARRIS PHD DIRECTOR 1.0 0.0 X 0 0 0 JENNIFER BLAKE CHAIR 1.0 0.0 X 0 0 0 CHRISTINA L BROOM DIRECTOR 1.0 0.0 X 0 0 0 KRISHNA P JAYARAMAN MD DIRECTOR 40.0 0.0 X 206620 0 0 ANNA CHOI MD DIRECTOR 40.0 0.0 X 451584 0 25336 Stephen A Schmeiser DIRECTOR 1.0 0.0 X 0 0 0 Karen T Garner DIRECTOR 1.0 0.0 X 0 0 0 Micheline Lopez-Estrada DIRECTOR 1.0 0.0 X 0 0 0 Frederick A Tepel DIRECTOR (Until 5/19) 1.0 0.0 X 0 0 0 Vince Whittles Vice Chair 1.0 0.0 X 0 0 0 Tara Saggar MD DIRECTOR (AS OF 11/18) 40.0 0.0 X 274444 0 25646 Yahia Tagouri MD DIRECTOR (AS OF 4/19) 40.0 0.0 X 460129 0 32738 KENNETH A SAMET DIRECTOR 1.0 39.0 X 0 6910499 87839 Stephen Michaels MD Secretary 40.0 0.0 X 787518 0 31149 CARRIE JENNISON CFO (UNTIL 6/19) 20.0 20.0 X 87142 87142 4186 David Havrilla CFO (As of 6/19) 1.0 39.0 X 0 399383 33326 AMIR KHAN Medical Director 40.0 0.0 X 501400 0 30092 Bruce Gibson Intensivist 40.0 0.0 X 416488 0 31149 DANIEL FEELEY Asst Vice President 20.0 20.0 X 143098 143098 29944 Jean Pierre Elkhoury Intensivist 40.0 0.0 X 407898 0 36035 David Allen PHYSICIAN 40.0 0.0 X 251152 0 23215 6553697 8085233 500824 72 false true false AMN HEALTHCARE INC 2735 COLLECTION CENTER DR CHICAGO IL 60693 Staffing Services 1641907 CERNER CORPORATION 51 VALLEY STREAM PKWY MALVERN PA 19355 IT SERVICES 1017767 MORRISON MANAGEMENT SPECIALISTS 400 NORTHRIDGE RD SUITE 600 ATLANTA GA 30350 FOOD SERVICES 985843 COMPHEALTH MEDICAL STAFFING 1445 10 Norden Pl 200 NORWALK CA 06855 STAFFING SERVICES 911406 DIVERSIFIED CLINICAL SERVICES INC PO BOX 636981 CINCINNATI OH 452636981 MEDICAL SERVICES 811816 37 173959 15000 199133 397514 15003 785606 NET PATIENT SERVICE REVENUE 621400 167384528 167384528 PHARMACY REVENUE 621400 3203728 3203728 OTHER OPERATING REVENUE 900099 51386 51386 170639642 42172 42172 0 0 299601 299601 0 299601 299601 106 46158 106 -46158 -46052 -46052 96280 173959 149075 -52795 -52795 0 0 0 0 0 0 REBATE INCOME 900099 347670 347670 GIFT SHOP AND VENDING INCOME 900099 80441 80441 EQUITY IN SUBSIDIARIES 900099 -913138 -913138 969876 969876 484849 172153023 170639642 727775 0 0 0 0 5040195 4757959 282236 0 0 0 0 57417620 54436337 2981283 -582524 -492434 -90090 7815785 6632853 1182932 0 4361969 4136468 225501 17614769 9958 17604811 3836 3242 594 0 0 0 0 15596009 14574120 1021889 0 433620 366113 67507 1007540 543848 461046 2646 0 0 817187 709884 107303 318892 304008 14884 0 52044 43744 8300 719535 653 718882 0 7911712 6093358 1818354 1082453 972517 109936 MED/SURG SUPPLIES 23220458 23220458 IMPLANTS/PROSTHESES 4561573 4561573 MAINTENANCE 4536645 3984166 552479 UTILITIES 2181785 1830115 351670 5327502 3527625 1799877 159438605 130216565 29219394 2646 958141 1226975 0 0 453543 428580 18972829 16899706 0 0 0 0 0 0 3277501 2767287 4147219 1334054 164264156 91033586 76081641 73230570 1354145 1073868 0 0 0 0 0 0 10823005 7464455 116068024 104425495 10334201 9717216 0 0 228494 -78440 0 0 0 0 0 0 0 0 0 0 8853856 7622219 19416551 17260995 X 95771884 85866232 779589 1198268 100000 100000 96651473 87164500 116068024 104425495 X 12714418 -17692 -22183699 X X false true X true false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 113317 1252 114569 112815 502 113317 112723 92 112815 112689 34 112723 112651 38 112689 0.87280 0.12720 false false 5757222 5757222 91030401 41278131 49752270 646057 547856 98201 61166971 48066868 13100103 563505 1140731 4522774 73230570 INVESTMENTS IN CONSOLIDATED 4043053 INVESTMENTS IN UNCONSOLIDATED 3419002 OTHER ASSETS 2400 7464455 0 ADVANCES 4373224 CREDIT BALANCES PATIENT A/R 1305571 OTHER SHORT TERM LIABILITIES 1585970 OTHER LONG TERM LIABILITIES 319789 UCC POOL LIABILITY 37665 7622219 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, 2019. 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 3933958 3933958 0.02470 3933958 3933958 0.02470 1811654 21337 1790317 0.01120 251702 251702 0.00160 10002821 1597641 8405180 0.05270 60116 60116 0.00040 12126293 1618978 10507315 0.06590 16060251 1618978 14441273 0.09060 167754 167754 0.00110 519259 519259 0.00330 4445 4445 5197 5197 29927 29927 0.00020 587519 587519 0.00370 1314101 1314101 0.00830 true 4131387 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 Chief Operating/ Medical Officer 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 and underinsured patients meeting medical hardship criteria within the communities we serve who lack financial resources have access to emergency and medically necessary hospital services. MedStar Health and its healthcare facilities will: . Treat all patients equitably, with dignity, respect, and compassion; . Serve the emergency health care needs of everyone who presents to our facilities 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 Healths facilities 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 Health facilities 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 facility 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. Each facility publicizes 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 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 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: . Complying 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 the facilitys 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 the facilitys Patient Advocates or Customer Service Representatives on a timely basis as the patients financial circumstances may change. . It is the responsibility of the patient to inform the MedStar hospital of their existing eligibility under a medical hardship during the 12-month 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 or by calling 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 110,979 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 110,979 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 (78.6%), followed by Black/African American (14.3%), Hispanic (3.8%), Asian (2.5%), American Indian/Alaska Native (0.1%) 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, cancer, lower respiratory illnesses, stroke and diabetes are the leading causes of death. Most residents (76.5%) work in the county. 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). With approximately 8.2% of the population living below the federal poverty level, Lexington Park has the greatest number of medically underserved citizens in the area. Approximately 11% (12,678 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 (13.7%) 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 $67,097, as compared to the median annual family income in St. Marys County of $86,508. 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. U.S. Census Bureau, 2013-2017 American Community Survey 5-year estimates https://factfinder.census.gov/faces/nav/jsf/pages/community_facts.xhtml PROMOTION OF COMMUNITY HEALTH PART VI, LINE 5 As a community partner, MSMH engages in a number of community benefit activities to improve and promote the health and wellbeing of the community. Priority areas of focus, as determined by the 2018 CHNA, are Health and Wellness; Access to Care Services; and Social Determinants of Health. Addressing Health and Wellness, MSMH has implemented the use of the evidence-based Diabetes Self-Management Program (DSMP) at East Run Medical Center in FY 2019. For Access to Care, Health Connections (the Population and Community Health division of MSMH) has expanded programmatic services to a medically underserved region of the community. Located at East Run Medical Center, patients have been able to enroll and participate in Parents to Be workshops and DSMP. A Smoking Cessation group was also offered at this location in FY 2019. Finally, through the efforts of the Access Health Program, patients were able to receive clinical care coordination services through RN level professionals. To address any social barriers, patients were referred to the Community Health Workers (CHWs) and the accompanying transportation program. The CHWs were able to connect patients to resources needed to achieve all services that support the management of chronic conditions, including but not limited to medical transports to and from community care providers (i.e. primary and specialized clinical services). 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 PART VI, LINE 7 The community benefit report for MedStar St. Marys Hospital is filed in the state of Maryland. X X X X X X false false false false false false false false false CHRISTINE WRAY PRESIDENT/DIRECTOR 284172 284172 260939 260939 0 0 4125 4125 16472 16472 565708 565708 0 0 John Harvey MD DIRECTOR 415326 0 419475 0 5255 0 8250 0 21920 0 870226 0 0 0 AVANI SHAH MD DIRECTOR 209531 0 405801 0 1348 0 8250 0 9929 0 634859 0 0 0 CONOR LUNDERGRAN DIRECTOR (UNTIL 12/18) 389415 0 171629 0 3333 0 6500 0 14126 0 585003 0 0 0 KRISHNA P JAYARAMAN MD DIRECTOR 206620 0 0 0 0 0 0 0 0 0 206620 0 0 0 ANNA CHOI MD DIRECTOR 411584 0 40000 0 0 0 8250 0 17086 0 476920 0 0 0 Stephen Michaels MD Secretary 448922 0 338596 0 0 0 8250 0 22899 0 818667 0 0 0 AMIR KHAN Medical Director 471400 0 30000 0 0 0 8250 0 21842 0 531492 0 0 0 Bruce Gibson Intensivist 405988 0 10500 0 0 0 8250 0 22899 0 447637 0 0 0 DANIEL FEELEY Asst Vice President 117041 117041 26057 26057 0 0 4125 4125 10847 10847 158070 158070 0 0 CARRIE JENNISON CFO (UNTIL 6/19) 87142 87142 0 0 0 0 0 0 2093 2093 89235 89235 0 0 Jean Pierre Elkhoury Intensivist 396648 0 11250 0 0 0 8250 0 27785 0 443933 0 0 0 David Allen PHYSICIAN 235652 0 15500 0 0 0 7655 0 15560 0 274367 0 0 0 Tara Saggar MD DIRECTOR (AS OF 11/18) 256944 0 17500 0 0 0 8250 0 17396 0 300090 0 0 0 Yahia Tagouri MD DIRECTOR (AS OF 4/19) 340578 0 119466 0 85 0 8250 0 24488 0 492867 0 0 0 KENNETH A SAMET DIRECTOR 0 1887489 0 5002733 0 20277 0 52149 0 35690 0 6998338 0 0 David Havrilla CFO (As of 6/19) 0 264358 0 125933 0 9092 0 16095 0 17231 0 432709 0 SCHEDULE J, PART III: MR. Samet's compensation in Part II, Column (B) includes $1,950,307 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. CARRIE JENNISON'S COMPENSATION IS FOR SERVICES PROVIDED AS INTERIM CFO TO BOTH MEDSTAR ST. MARY'S HOSPITAL AND MEDSTAR SOUTHERN MARYLAND HOSPITAL CENTER. 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...............................$(15,778,451) MINIMUM PENSION LIABILITY ADJUSTMENT............$(6,614,939) ACCUMULATED NET ASSETS..........................$ 209,691 ============= TOTAL $(22,183,699) 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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