2020-07-10T17:10:18-05:00 2019-06-30 KPMG LLP 8350 Broad Street Suite 900 McLean VA 22102 990 2018-07-01 460726303 MEDSTAR SOUTHERN MD HOSPITAL CENTER INC % JOEL BRYAN MEDS 3018688000 7503 SURRATTS ROAD CLINTON MD 20735 JOEL BRYAN VP/Treasurer 4107726721 2020-07-10 true JG WHITE P01498698 7032868000 2020-06-15 199.207.253.101 54028020201925000011 2020-07-10 P E01DF4687A93B3903456F83B07C94A87D1E36E55 3AAD66ADA2E5DF4BC89011C66E354EB32E898C52 2018 2021-01-29 14:40:06Z CHRISTINE WRAY 7503 Surratts Road Clinton MD 20735 238969870 false X MEDSTARSOUTHERNMARYLAND.ORG X 2012 MD MEDSTAR SOUTHERN MD HOSPITAL CENTER UPHOLDS ITS TRADITION OF CARING BY CONTINUOUSLY PROMOTING, MAINTAINING AND IMPROVING HEALTH THROUGH EDUCATION AND SERVICE. 10 6 1398 94 0 0 271210 1357872 235639409 235923221 62024 1755 1410678 1687022 237383321 238969870 0 0 0 0 111365473 112045514 0 0 0 136147125 134749619 247512598 246795133 -10129277 -7825263 121930477 126940958 32658534 30601185 89271943 96339773 X As a proud member of MedStar Health, MedStar Southern Maryland Hospital Centers (MedStar Southern Maryland) mission is to uphold its commitment to the community by continuously promoting, maintaining, and improving health through education and service while assuring fiscal integrity. MedStar Southern Maryland is located in southern Prince Georges County, Maryland. In fiscal year 2019, MSMHC had approximately 11,467 inpatient admissions and approximately 101,398 outpatient visits including 46,361 emergency visits. false false 155431786 253923221 MedStar Southern Marylands largest program is access to and the provision of acute hospital services to the communities of Prince Georges, Charles and Calvert County, Maryland and the surrounding areas. In addition to the program service expenses listed above, MedStar Southern Maryland incurred $78.2M of management and general expenses in providing services to its communities. The hospital offers a full range of services and is known for its cardiovascular and orthopaedic programs. The hospital also has the Women & Newborns Center, which includes an obstetrics and gynecology program with a Level 2 special care nursery and private patient rooms. Other specialty services include an emergency department and critical care unit, breast health program, outpatient radiology, surgical center, sleep disorders lab, inpatient and outpatient behavioral health programs, rehabilitative medicine, and cancer treatment services. MedStar Southern Maryland is a Primary Stroke Center. 7661991 MedStar Southern Maryland provided $7.7M 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, neonatal services, and behavioral health. 5526984 MedStar Southern Maryland provided $5.5M 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 Southern Marylands charity care expense and revenues represent direct payments from the states charity care pool. Other charity care expenses are indirectly reimbursed via the state of Marylands payment system. 168620761 true true false false false false false false false false true false false false true true false true false false false false false false false 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 1398 true false false false false false false false false false false false false X 10 6 false false false false true true true true true false false true true true true true true true true false MD X JOEL BRYAN 4107726721 10980 GRANTCHESTER WAY Columbia MD 21044 X Kenneth A Samet DIRECTOR 1.0 39.0 X 0 6910499 87839 Christine r Wray PRESIDENT/DIRECTOR 20.0 20.0 X X 545111 545111 41194 Thomas K Huisman MD Director (UNTIL 4/19) 1.0 0.0 X 0 0 0 Antonio Poag Director 1.0 0.0 X 0 0 0 John W Rollins Jr CHAIR 1.0 0.0 X 0 0 0 William Tanner MD DIRECTOR 40.0 0.0 X 463527 0 26566 TAMMY L JONES DIRECTOR 1.0 0.0 X 0 0 0 Hon MH Estepp DIRECTOR (Until 12/18) 1.0 0.0 X 0 0 0 Robert Chiaramonte MD DIRECTOR (Until 1/19) 1.0 0.0 X 0 0 0 Rosalind E Bishop DIRECTOR 1.0 0.0 X 0 0 0 Clyde Pray DIRECTOR (AS OF 1/19) 40.0 0.0 X 549747 0 20714 Kerry R Watson Vice Chair (As of 9/18) 1.0 0.0 X 0 0 0 Sonya Williams Director (As of 4/19) 1.0 0.0 X 0 0 0 Carrie Jennison CFO (Until 6/19) 20.0 20.0 X 87142 87142 4186 Annette Broner SECRETARY 20.0 20.0 X 116719 116720 26649 DAVID HAVRILLA CFO (AS OF 6/19) 1.0 39.0 X 0 399383 33326 Louis Mavromatis MD VP - IT 40.0 0.0 X 339192 0 32861 Patricia Scalfari CNO 40.0 0.0 X 301165 0 18003 Dan Feeley Asst Vice President 20.0 20.0 X 143098 143098 29945 Grant Mcclure VP, PROF SVCS & PLANT OPS 40.0 0.0 X 269486 0 16894 CHILEDUM AHAGHOTU VP, MEDICAL AFFAIRS 40.0 0.0 X 572605 0 22552 3387792 8201953 360729 135 false true false AMN HEALTHCARE 2735 COLLECTION CENTER DR CHICAGO IL 60693 STAFFING SERVICES 14136445 DIAMOND HEALTHCARE PO BOX 85050 RICHMOND VA 23285 MEDICAL STAFFING 5265799 TOTAL RENAL CARE INC 2438 North Ponderosa Drive Suite C CAMARILLO CA 930102465 Medical services 1242813 ROLYN COMPANIES INC 7 Crozerville Rd Suite C ASTON PA 19014 Facilities services 939325 AXIS HEALTHCARE GROUP PO BOX 640200 PITTSBURGH PA 15264 MEDICAL SERVICES 708392 27 1162921 194951 0 1357872 PATIENT SERVICE REVENUE 621300 235923221 235923221 235923221 869 869 0 0 0 0 0 886 886 886 886 0 0 0 0 0 0 0 0 0 REBATE INCOME 900099 422044 422044 CAFETERIA SALES 900099 232460 232460 GIFT SHOP SALES 900099 211690 211690 820828 820828 1687022 238969870 235923221 1688777 X 0 0 0 0 1845541 1616714 228827 158070 137737 20333 93039453 81896839 11142614 976436 840588 135848 10585990 8326804 2259186 5440024 4718145 721879 19244648 19244648 112317 112317 0 0 0 0 49226848 28459228 20767620 373244 373244 1432220 1134813 297407 0 0 0 152469 131263 21206 0 29394 3775 25619 6759870 6759870 0 11283418 3613037 7670381 3042694 104000 2938694 MED/SURG SUPPLIES 20441580 20290948 150632 IMPLANTS/PROSTHESES 6535307 6535307 MAINTENANCE 6567647 5055858 1511789 UTILITIES 2760962 2327085 433877 6787001 3428620 3358381 246795133 168620761 78174372 0 38644 12192 0 0 390218 211960 26810949 25892851 0 0 0 0 0 0 3357679 3537434 896831 918627 134010739 61606664 62220405 72404075 0 0 0 0 0 0 25821072 23836786 2394679 127033 121930477 126940958 14155250 15198945 0 0 1016653 189925 0 0 0 0 0 0 0 0 0 0 17486631 15212315 32658534 30601185 X 89271943 96339773 0 0 0 0 89271943 96339773 121930477 126940958 X -7825263 4408 14888685 X false true X true false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 3140000 3140000 41178460 13177858 28000602 3781978 1301098 2480880 74598043 47029300 27568743 11312258 98408 11213850 72404075 0 ADVANCES 8938856 CREDIT BALANCES PATIENT AR 1200183 OTHER LIABILITIES 5073276 15212315 X 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. true true X true X true X true true true false true true 5526984 0 5526984 0.02240 5526984 0 5526984 0.02240 1001372 1001372 0.00410 963572 963572 0.00390 7661991 7661991 0.03100 39628 39628 0.00020 9666563 9666563 0.03920 9 15193547 0 15193547 0.06160 1793 1793 2650 2650 26386 26386 0.00010 211363 211363 0.00090 242192 242192 0.00100 true 8367838 true true 1 1 MEDSTAR SOUTHERN MD HOSPITAL CENTER 7503 SURRATTS ROAD CLINTON MD 20735 X X X MEDSTAR SOUTHERN MD HOSPITAL CENTER 1 false false true X X X X X X X X X 17 true false false true X WWW.MEDSTARHEALTH.ORG/MSMHC X true 17 true WWW.MEDSTARHEALTH.ORG/MSMHC false true X 200. 400. X X X X X X true true X X X X true X WWW.MEDSTARHEALTH.ORG/MSMHC X WWW.MEDSTARHEALTH.ORG/MSMHC X WWW.MEDSTARHEALTH.ORG/MSMHC 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: CHANTAL TUELL 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: DR. CHILEDUM AHAGHOTU. 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/AFFILIATION NAME OF ORGANIZATION WITH HOSPITAL Beatrice Tignor, Municipal Liaison Office of the County Ed.D. Executive Carmen Spenser House of Delegates Maryland State Delegate Member Carolyn Lowe Coordinator District "V" Coffee Club Cheryl Brown Medical Wellness Union Bethal AME Church, Ministry Brandywine Chiledum Ahaghotu, Executive Sponsor, Vice MSMHC MD Vice President of Medical Affairs Chrisie Mulcahey Executive Director Health Partners Christine R. Wray President MSMHC Gloria Brown- Director of Social Prince George's County Burnett Services Health Department John OBrien Director of Community New Beginnings Recovery Health Center Kevin Reed, MD Physician MSMHC, ED Mary Jobson-Oliver Stroke Coordinator MSMHC Octavia Peterson Community Health MSMHC Manager Pamela Creekmur Health Officer Prince George's County Health Department Ronnie Barnes-Bey Local Resident, Stroke Fort Washington, MD Survivor Tara Saggar, MD Physician MSMHC Valarie Barnes Director, Case MSMHC Management Veda Belton, RN Community Health Coalition of Metropolitan Coordinator Minister's Alliance Willie Hunt Reverend Coalition of Metropolitan Minister's Alliance 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.ARE BEYOND THE SCOPE OF THE HOSPITALS STRENGTHS. CHARITY CARE AND CERTAIN OTHER BENEFITS AT COST PART I, LINE 7 MEDICARE COST REPORT DATA AS WELL AS COST-TO-CHARGE RATIO WERE USED TO CALCULATE FIGURES REPORTED (WHERE APPLICABLE). THE COST-TO-CHARGE RATIO WAS DERIVED FROM WORKSHEET 2 RATIO OF PATIENT CARE COST-TO-CHARGES. 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. DEBT COLLECTION POLICY 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 Southern Maryland Hospital Center (MSMHC) 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 MSMHCs 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 Southern Prince Georges County as its CBSA, which includes all residents living in ZIP codes 20735 and 20747. 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. MSMHCs health priorities for the CBSA include health and wellness (chronic disease prevention and management, behavioral health, maternal and child health programming) and social determinants of health (community health worker program). As a proud member of MedStar Health, representatives from MSMHC 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: MSMHCs CBSA includes residents of southern Prince Georges County, specifically Clinton, Maryland (ZIP code 20735) and District Height, Maryland (ZIP code 20747). The community was selected based on its proximity to the hospital, and the availability of pre-existing programs and services. Prince Georges County was established in the 17th century and encompasses a mix of urban, suburban, and rural communities. The county is predominately African American with an increasing Hispanic, immigrant, and non-English speaking population. The countys once rural geography is rapidly evolving into a suburban area, with an increased presence of commercial and residential dwellings. MSMHC serves approximately 30% of Charles County residents. Demographics: Prince George's County, MD has a population of 919,583 people with a median age of 37.2 and a median household income of $81,240. The population of Prince George's County, MD has grown 6.5% from 908,049 in 2010 and its median household income grew from $79,184 to $81,240, a 2.6% increase. The population of Prince George's County, MD is 62% Black or African American, 18.5% Hispanic or Latino, and 12.6% White. 27.1% of the people in Prince George's County, MD speak a non-English language, and 87.7% are U.S. citizens. Prince George's County, MD borders Fairfax County, VA, Montgomery County, MD, District of Columbia, DC, Anne Arundel County, MD, Charles County, MD, Alexandria city, VA, Calvert County, MD, and Howard County, MD. The economy of Prince George's County, MD employs 491k people. The largest industries in Prince George's County, MD are Public Administration (67,228 people), Health Care & Social Assistance (64,084 people), and Educational Services (45,271 people), and the highest paying industries are Public Administration ($81,629), Utilities ($71,028), and Professional, Scientific, & Technical Services ($70,341). District Heights (ZIP code 20747) has an approximate population of 6,000 with a median age of 29. The median household income is $69,358. The population of District Heights, MD is 88.4% Black or African American, 7.6% Hispanic or Latino, and 2.05% two or more races. 10.1% of the population for whom poverty status is determined in District Heights, MD (600 out of 5.93k people) live below the poverty line, a number that is lower than the national average of 13.4%. The largest demographic living in poverty is females 12 - 14, followed by females 35 - 44 and then females 6 - 11. As for Clinton, MD (ZIP code 20735), there are approximately 39,000 residents living in this CBSA with a median age of 42 and a median household income of $104,854. Between 2016 and 2017 the population of Clinton, MD declined from 39,256 to 39,230, a 0.0662% decrease and its median household income grew from $102,534 to $104,854, a 2.26% increase. The population of Clinton, MD is 82.6% Black or African American, 7.64% White, and 6.07% Hispanic or Latino. The unemployment rate is similar to that of the nation, at 8%, and lower than the county average. Of the employed population, 73.1% commute to work alone, 14.4% utilize public transportation (excluding taxicab) and 7.4% carpool. Faith based organizations have a prominent presence in the CBSA. There are approximately 19 faith-based organizations of various denominations located within the ZIP code. Promotion of community health Part VI, line 5 As a community partner, MSMHC 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 (chronic disease prevention and management, behavioral health services, maternal and child health programming) and social determinants of health (community health worker program). To address health and wellness, MSMHC offers the Walk with Ease, Mall Walker's Program at St. Charles. The program is designed to help people living with arthritis and other chronic diseases manage their pain. It was designed to make walking a regular habit among participants while reducing the pain and discomfort of arthritis, increase balance, strength, and walking pace, build confidence to be physically active and improve overall health reducing the risk of stroke. Chronic disease prevention programs are offered throughout the year at low or no cost to the participants to influence education, self-management and promote living healthy. The Diabetes Prevention Program (DPP) addresses the increasing burden of prediabetes and type 2 diabetes in Prince Georges County. It offers evidence-based, cost-effective interventions that help prevent type 2 diabetes in the CBSA. To address maternal and child health, the hospital supports positive birth outcomes through educational programs before and after birth and in collaboration with Prince Georges Health Department for the Healthy Babies Initiative, which provides safe sleep support packages and community health education. To address behavioral health, MSMHCs Screening, Brief Intervention, Referral to Treatment (SBIRT) program is conducted in the emergency department. The program identifies people with at-risk and dependent substance and/or alcohol use behaviors and provides brief early intervention services to those who screen positively for risky drug and alcohol use. Peer Recovery Coaches are integral to hospital care teams to assist with improving access to substance use treatment and social service linkage and support community education efforts. To address the social determinants of health, Community Health Workers were hired to provide support to individuals and advocate to connect them to resources in the community, such as food pantries, paying for prescription medications and transportation assistance throughout Charles and Prince Georges counties. Additionally, each summer MSMHC provides internship programs for high school and college students from the surrounding communities exposure to careers in healthcare. Affiliated health care system Part VI, line 6 As a proud member of MedStar Health, MSMHC 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 MSMHC 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 MSMHC is filed in the state of Maryland. X X X X X X false false false false false false false false false Kenneth A Samet DIRECTOR 0 1887489 0 5002733 0 20277 0 52149 0 35690 0 6998338 0 0 Louis Mavromatis MD VP - IT 269067 0 70125 0 0 0 8250 0 24611 0 372053 0 0 0 Patricia Scalfari CNO 248020 0 53145 0 0 0 8250 4125 9753 10848 319168 14973 0 0 Dan Feeley Asst Vice President 117041 117041 26057 26057 0 0 4125 4125 10847 10848 158070 158071 0 0 Christine r Wray PRESIDENT/DIRECTOR 284172 284172 260939 260939 0 0 4125 4125 16472 16472 565708 565708 0 0 William Tanner MD DIRECTOR 208066 0 253938 0 1523 0 9466 0 17100 0 490093 0 0 0 Grant Mcclure VP, PROF SVCS & PLANT OPS 225152 0 44334 0 0 0 0 0 16894 0 286380 0 0 0 CHILEDUM AHAGHOTU VP, MEDICAL AFFAIRS 381010 0 191595 0 0 0 0 0 22552 0 595157 0 0 0 Clyde Pray DIRECTOR (AS OF 1/19) 534747 0 15000 0 0 0 8250 0 12464 0 570461 0 0 0 Carrie Jennison CFO (Until 6/19) 87142 87142 0 0 0 0 0 0 2093 2093 89235 89235 0 0 Annette Broner SECRETARY 94790 94790 21929 21930 0 0 4241 4242 9083 9083 130043 130045 0 0 DAVID HAVRILLA CFO (AS OF 6/19) 0 264358 0 125933 0 9092 0 16095 0 17231 0 432709 0 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 CFO TO BOTH MEDSTAR SOUTHERN MARYLAND HOSPITAL CENTER AND MEDSTAR ST. MARY'S HOSPITAL. 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. IN ADDITION, OFFICERS AND DIRECTORS OF MARYLAND HOSPITALS AND NURSING CENTERS ARE REQUIRED TO ANNUALLY DISCLOSE ADDITIONAL INFORMATION RELATING TO POTENTIAL CONFLICTS OF INTEREST AND SUCH DISCLOSURES ARE REPORTED TO THE MARYLAND HEALTH SERVICES COST REVIEW COMMISSION (HSCRC). DESCRIPTION OF EXECUTIVE COMPENSATION 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..............................$ 14,912,289 Income Tax Provision-Federal....................$ (23,604) ------------- TOTAL $ 14,888,685 FORM 990 PART IX LINE 11G DESCRIPTION:MANAGEMENT FEE EXPENSE TOTAL FEES:17353992 FORM 990 PART IX LINE 11G DESCRIPTION:PURCHASED PROFESSIONAL SVCS TOTAL FEES:11320034 FORM 990 PART IX LINE 11G DESCRIPTION:SUBSIDY EXPENSE - INTERCOMPANY TOTAL FEES:11299667 FORM 990 PART IX LINE 11G DESCRIPTION:PHYSICAN SERVICES TOTAL FEES:3176176 FORM 990 PART IX LINE 11G DESCRIPTION:MISC PURCHASED SVCS TOTAL FEES:2012583 FORM 990 PART IX LINE 11G DESCRIPTION:NON-PHYS INTERCO PURCH SVCS TOTAL FEES:1994246 FORM 990 PART IX LINE 11G DESCRIPTION:COMMERCIAL LAUNDRY TOTAL FEES:532754 FORM 990 PART IX LINE 11G DESCRIPTION:LAB SERVICES TOTAL FEES:287495 FORM 990 PART IX LINE 11G DESCRIPTION:PROTECTION SERVICE TOTAL FEES:281406 FORM 990 PART IX LINE 11G DESCRIPTION:PRINTING SERVICES TOTAL FEES:266646 FORM 990 PART IX LINE 11G DESCRIPTION:COMPUTER SERVICE TOTAL FEES:255124 FORM 990 PART IX LINE 11G DESCRIPTION:BANK FEES TOTAL FEES:115505 FORM 990 PART IX LINE 11G DESCRIPTION:MISCELLANEOUS FEES FOR SERVICE TOTAL FEES:331220 CHURCH HOME CORPORATION 10980 GRANTCHESTER WAY COLUMBIA MD 21044 237374724 MEDICAL FUND MD 501(c)(3) PF NA true FRANKLIN SQUARE HOSPITAL CENTER INC 9000 FRANKLIN SQUARE DRIVE BALTIMORE MD 21237 520608007 HOSPITAL MD 501(c)(3) 3 NA true HARBOR HOSPITAL INC 3001 SOUTH HANOVER STREET BALTIMORE MD 21225 520491660 HOSPITAL MD 501(c)(3) 3 NA true MEDSTAR HEALTH INC 10980 GRANTCHESTER WAY COLUMBIA MD 21044 522087445 MEDICAL SVCS MD 501(c)(3) 12C III NA false MONTGOMERY GENERAL HOSPITAL 18101 PRINCE PHILIP DRIVE OLNEY MD 20832 520646893 HOSPITAL MD 501(c)(3) 3 NA true THE GOOD SAMARITAN HOSPITAL OF MARYLAND 5601 LOCH RAVEN BLVD BALTIMORE MD 21239 520591607 HOSPITAL MD 501(c)(3) 3 NA true THE UNION MEMORIAL HOSPITAL 201 EAST UNIVERSITY PARKWAY BALTIMORE MD 21218 520591685 HOSPITAL MD 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