2020-07-02T09:30:38-05:00 2019-06-30 346565596 ERNST & YOUNG US LLP 1101 NEW YORK AVE NW WASHINGTON DC 20005 990 2018-07-01 520591639 James Lawrence Kernan Hospital Inc JAME 4104482500 2200 Kernan Drive Baltimore MD 21207 W WALTER AUGUSTIN III CFO 2020-07-02 true JUSTIN LOWE P01866796 2023276000 2018 2020-09-23 17:36:50Z UM Rehabilitation & Orthopedic Institute CYNTHIA KELLEHER 2200 Kernan Drive Baltimore MD 21207 137926843 false X WWW.UMMS.ORG/REHAB X 1895 MD JAMES L KERNAN HOSPITAL DELIVERS INNOVATIVE, HIGH-QUALITY, AND COST EFFECTIVE REHABILITATION AND SURGICAL SERVICES TO THE COMMUNITY AND REGION. 11 9 805 77 0 0 814146 712353 114624719 113660098 1027650 1077337 1843068 1821190 118309583 117270978 0 5000 0 0 49160400 50156539 0 0 0 64426209 63249877 113586609 113411416 4722974 3859562 163537343 170959922 45375904 47780622 118161439 123179300 JAMES L KERNAN HOSPITAL, DOING BUSINESS AS UM REHABILITATION & ORTHOPEDIC INSTITUTE (UM REHAB), DELIVERS INNOVATIVE, HIGH-QUALITY, AND COST EFFECTIVE REHABILITATION AND SURGICAL SERVICES TO THE COMMUNITY AND REGION. false false 99773434 5000 115177531 UM REHAB OWNS AND OPERATES A MEDICAL, SURGICAL AND REHABILITATION HOSPITAL WITH 137 LICENSED BEDS. UM REHAB PROVIDES CHARITY CARE TO PATIENTS WHO ARE UNABLE TO PAY. SUCH PATIENTS ARE IDENTIFIED BASED ON INFORMATION OBTAINED FROM THE PATIENTS AND SUBSEQUENT ANALYSIS. BECAUSE THE HOSPITAL DOES NOT EXPECT COLLECTION OF AMOUNTS DETERMINED AS CHARITY CARE, THEY ARE NOT REPORTED AS REVENUE BASED ON ESTABLISHED RATES. UM REHAB ESTIMATES THAT $1,299,614 OF CHARITY CARE AT COST WAS PROVIDED IN THE YEAR ENDED JUNE 30, 2019. OVERALL, UM REHAB DELIVERS INNOVATIVE HIGH QUALITY, COST EFFECTIVE SURGICAL AND REHABILITATION SERVICES TO ITS COMMUNITY. 99773434 true true false true false false false false false true true false true 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 true true false false false true 0 0 805 true false false false false false false true false false false false false X 11 9 false false false false true true true true true false false true true true true true true true true false MD X ED WUENSCHELL 4434625811 900 ELKRIDGE LANDING ROAD - 3 EAST LINTHICUM MD 21090 John W Ashworth III DIRECTOR 1.0 61.0 X X 0 653119 36969 John T Chay BOARD CHAIRMAN 1.0 1.0 X X 0 0 0 Robert A Chrencik TREASURER (ENDED 04/19) 1.0 61.0 X X 0 2634806 36554 George Brouillet Jr DIRECTOR 8.0 0 X 0 0 0 Alison G Brown DIRECTOR (ENDED 08/18) 1.0 42.0 X 0 682531 33288 Anthony T Hawkins DIRECTOR 1.0 0 X 0 0 0 Leon Kaplan DIRECTOR 1.0 0 X 0 0 0 Anthony F Lehman DIRECTOR 1.0 0 X 0 0 0 William F Peck DIRECTOR 1.0 1.0 X 0 0 0 Andrew N Pollak DIRECTOR 1.0 0 X 0 0 0 Michael T Wilmot DIRECTOR 1.0 1.0 X 0 0 0 Henry York DIRECTOR, EX-OFFICIO 1.0 0 X 0 0 0 Karen E Doyle DIRECTOR 1.0 40.0 X 0 376796 41779 W Walter Augustin III VP FINANCIAL SERVICES AND CFO 40.0 0 X 318628 0 32030 Cynthia Kelleher PRESIDENT AND CEO 40.0 0 X 630580 0 32710 Krishnaj Gourab VP MEDICAL AFFAIRS AND CMO 40.0 0 X 263746 0 30743 Cheryl D Lee VP PATIENT SERVICES AND CNO 40.0 0 X 281796 0 26559 Nadeem Aslam DIRECTOR OF PHARMACY 40.0 0 X 168380 0 21661 James W Collins PHARMACIST 40.0 0 X 156234 0 38502 Sherry Lamons CLINICAL NURSE 40.0 0 X 159140 0 22548 Srinivasa Rao Piratla PHARMACIST 40.0 0 X 148782 0 34720 Lobna Zada DENTAL CLINICAL CHIEF 40.0 0 X 243148 0 30878 2370434 4347252 418941 77 false true false CROSS COUNTRY STAFFING INC PO BOX 404674 Atlanta GA 30384 STAFFING 4599424 MARYLAND INPATIENT CARE SPECIALIST LLC 7250 PARKWAY DRIVE SUITE 500 HANOVER MD 21076 HOSPITAL SERVICES 2065091 ARAMARK CORPORATION 27310 NETWORK PLACE CHICAGO IL 60673 FOOD SERVICES 1663717 MARYLAND INTERPRETING SERVICES PO BOX 840292 Dallas TX 75284 Staffing 837241 CHESAPEAKE NETCRAFTSMEN LLC PO BOX 69010 BALTIMORE MD 21264 IT CONSULTING 416335 26 X 712353 712353 PATIENT SERVICE REVENUE 900099 113660098 113660098 0 0 0 0 0 0 113660098 545486 0 0 545486 8400 8400 0 8400 0 0 8400 21187716 0 20655865 531851 0 531851 0 0 531851 OUTPATIENT PHARMACY 446110 1244930 1244930 0 0 CAFE/VENDING 722514 295357 0 0 295357 MISCELLANEOUS REVENUE 900099 266914 266914 0 0 5589 5589 0 0 1812790 117270978 115177531 0 1381094 X 5000 5000 0 0 1494750 523163 971587 0 38934700 33094495 5840205 0 1560658 1326559 234099 0 5289840 4496364 793476 0 2876591 2445102 431489 0 3919 0 3919 0 135213 135213 31699298 28353156 3346142 0 217365 184760 32605 0 343106 291640 51466 0 2208145 1876923 331222 0 47255 40167 7088 0 55847 47470 8377 0 841567 715332 126235 0 6878700 5846895 1031805 0 1834655 1814590 20065 0 MEDICAL SUPPLIES 13149102 13149102 0 0 BAD DEBT 4015780 4015780 0 0 REPAIR/MAINTENANCE 1112088 945275 166813 0 OTHER EXPENSES 470491 399917 70574 0 237346 201744 35602 0 113411416 99773434 13637982 0 1797592 4783834 8171946 7352271 0 0 0 1144645 1159033 132766 136474 114033291 70709580 45093478 43323711 15342000 18719000 22485707 20879679 0 69369209 74605920 163537343 170959922 17578234 20831618 750024 0 27797670 26198980 45375904 47780622 X 82541405 86229824 35620034 36949476 118161439 123179300 163537343 170959922 X 3859562 888649 269650 X false true X true X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false true 3919 3919 false Schedule C, Part II-B, Line 1 DETAILED DESCRIPTION OF THE LOBBYING ACTIVITY THE ORGANIZATION DOES NOT ENGAGE IN ANY DIRECT LOBBYING ACTIVITIES. 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. 1273668 1273668 67430336 39280772 28149564 41771131 30923050 10848081 3558156 505758 3052398 43323711 OTHER SECURITIES 20879679 F 20879679 KERNAN ENDOWMENT 33098991 ASSETS WHOSE USE IS LIMITED 19686453 DUE FROM AFFILIATES 15600000 ECONOMIC INT IN UMMS FND 3850471 OTHER A/R 778092 Escrow 476766 Collateral Investments 1115147 74605920 DUE TO UMMS 19277655 ADVANCES FROM THIRD PARTY PAYORS 5543734 PATIENT A/R CREDIT BALANCES 1054019 FIN 47 ACCRUAL OTHER LIABILITIES 323572 26198980 X Schedule D, Part X, Line 2 FIN 48 (ASC 740) footnote THE ORGANIZATION IS A SUBSIDIARY OF THE UNIVERSITY OF MARYLAND MEDICAL SYSTEM CORPORATION (THE CORPORATION). 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. true true true X true X true true false true true 1299614 0 1299614 0.0119 0 0 0 0.0 0 0 0 0.0 0 0 1299614 0 1299614 0.0119 198548 0 198548 0.0018 8507182 0 8507182 0.0778 2133958 1023000 1110958 0.0102 0 0 0 0.0 106200 0 106200 0.0010 0 0 10945888 1023000 9922888 0.0907 0 0 12245502 1023000 11222502 0.1026 0 0 0 0.0 0 0 0 0.0 0 0 0 0.0 0 0 0 0.0 0 0 0 0.0 0 0 0 0.0 0 0 0 0.0 0 0 0 0.0 0 0 0 0.0 0 0 0 0 0 0.0 true 3128780 0 33065832 30865476 2200356 X true true 1 1 JAMES LAWRENCE KERNAN HOSPITAL INC 2200 KERNAN DRIVE BALTIMORE MD 21207 WWW.UMMS.ORG/REHAB 30-038 X X REHABILITATION 1 1 1 false false true X X X X X X X X X 17 true true true true X www.umrehabortho.org/2018CHNA X true 17 true https://www.umms.org/rehab/community false true X 200.0 300.0 X X X X X true true X X X true X https://www.umms.org/rehab/community X https://www.umms.org/rehab/community X https://www.umms.org/rehab/community X X X X X X true X false X X X X false X 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 - JAMES LAWRENCE KERNAN HOSPITAL, INC.. The University of Maryland Rehabilitation & Orthopedic Institute (UM Rehab) 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. Data was collected from multiple sources, groups, and individuals and integrated into a comprehensive document which was utilized at a meeting in January 2018 of the UM Rehab & Ortho Community Health Leadership Team. During that meeting, 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 the larger leadership team of UM Rehabilitation & Orthopedic Institute. UM Rehab & Ortho 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 Downtown and Midtown Campuses), 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. UM Rehab & Ortho worked closely with the University of Maryland Medical Center who partnered with 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 Results Top 6 Health Concerns Alcohol/Drug Addiction Mental Health Diabetes/High Blood Sugar Overweight/Obesity Heart Disease/High Blood Pressure Smoking/Tobacco Use 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 71 for individuals from the UM Rehab's disabled community. 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 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 UM Rehab's Disabled Community's Top Health Concerns Alcohol/Drug Addiction Diabetes/High Blood Sugar Overweight/Obesity Mental Health Smoking/Tobacco Use Heart Disease/High Blood Pressure UM Rehab's Disabled Community Top Social/Environmental Issues Availability/Access to Insurance Lack of Job Opportunities Housing/Homelessness Limited Availability of Recreational Activities Transportation Problems Limited Access to Healthy Foods UM Rehab's Disabled Community 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 Reviewed the Center for Disease Control's data on Maryland' disability status profile 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 2015, 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 Center for Disease Control's Disability Data for Maryland 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 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 Schedule H, Part V, Section B, Line 6a Facility 1, 1 Facility 1, 1 - JAMES LAWRENCE KERNAN HOSPITAL, INC.. UM Rehabilitation & Orthopedic Institute conducted its FY'18 CHNA with the University of Maryland Medical Center. Additionally, most Baltimore City hospitals collaborated together for the first time to gather primary data together. So, the additional hospitals that collaborated with UM Rehab include: the University of Maryland Medical Center Downtown and Midtown Campuses, Johns Hopkins Hospital (Main Campus and Bayview), St Agnes hospital, Sinai, Mercy Medical Center, and Medstar Health (Good Samaritan, Union Memorial, and Harbor Hospital). Schedule H, Part V, Section B, Line 6b Facility 1, 1 Facility 1, 1 - JAMES LAWRENCE KERNAN HOSPITAL, INC.. THE CHNA WAS CONDUCTED WITH THE FOLLOWING ORGANIZATIONS OTHER THAN HOSPITAL FACILITIES: -BARS -DEPT OF REHABILITATION SERVICES -MAYOR'S OFFICE ON DISABILITIES -MOUNT DE SALES ACADEMY -HOWARD COUNTY PUBLIC SCHOOLS Schedule H, Part V, Section B, Line 11 Facility 1, 1 Facility 1, 1 - JAMES LAWRENCE KERNAN HOSPITAL, INC.. Analysis of all quantitative and qualitative data described in the above section identified the following top three areas of need within Baltimore City for disabled adults. 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 UM Rehab & Ortho Community Leadership Team and validated with the larger UM Rehab & Ortho leadership team: 1) Quality of Life 2) Transition to the Community 3) Community Awareness Programming for the community is based on the identified needs above and examples include The Adapted Sports program, Living Well with Chronic Disease programs, a Dental Clinic for disabled, and several other programs. The UM Rehab & Ortho's identified core priorities and programming target the intersection of the identified community needs and the organization's key strengths and mission. Several additional topic areas were identified by the Community Health Improvement Leadership Team during the CHNA process including: Behavioral/mental health, safe housing, transportation, and substance abuse. While UM Rehab & Ortho will focus on strategic programs such as Healthy Beginnings, Healthy Communities, Quality Preventive Care, Healthy Living & Quality Preventive Care and Access to Healthcare, 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 at the Medical Center (i.e. Methadone clinics, Residential Psychiatric program) or through collaboration with other health care organizations as needed. Additionally, substance abuse programming is already integrated into existing programs such as the Think First for Teens program. The additional unmet needs not addressed by UM Rehab & Ortho will also continue to be addressed by key Baltimore City governmental agencies and existing community-based organizations. Schedule H, Part V, Section B, Line 13 Facility 1, 1 Facility 1, 1 - JAMES LAWRENCE KERNAN HOSPITAL, INC.. 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 THAT THE FPG INCOME LEVELS. 0 Schedule H, Part I, Line 3c CRITERIA FOR FREE OR DISCOUNTED CARE UM REHAB 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 RELATED ORGANIZATION 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 I, Line 7 Bad Debt Expense excluded from financial assistance calculation 4015780 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 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 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 HISTOICAL 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 - JAMES LAWRENCE KERNAN HOSPITAL, INC.: Line 16a URL: https://www.umms.org/rehab/community; Schedule H, Part V, Section B, Line 16b FAP Application website 1 - JAMES LAWRENCE KERNAN HOSPITAL, INC.: Line 16b URL: https://www.umms.org/rehab/community; Schedule H, Part V, Section B, Line 16c FAP plain language summary website 1 - JAMES LAWRENCE KERNAN HOSPITAL, INC.: Line 16c URL: https://www.umms.org/rehab/community; Schedule H, Part VI, Line 2 Needs assessment Since fiscal year 2012, UM Rehabilitation & Orthopedic Institute has completed a comprehensive community health needs assessment (CHNA) every three years. To complete this comprehensive assessment of the needs of the community in fiscal year 2018, the Association for Community Health Improvement's (ACHI) 9-step Community Health Assessment Process was utilized as an organizing methodology. The UM Rehab & Ortho's Community Health Leadership Team served as the lead team to oversee 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. University of Maryland Rehabilitation & Orthopedic Institute adopted the Association for Community Health Improvement (ACHI) 9-step process to lead the assessment process and an additional 5-component assessment and engagement strategy to lead the data collection methodology. 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 UM Rehab Community Health Leadership Team in May and by the Board of Directors on May 24, 2018. www.umrehabortho.org/2018CHNA 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 Requirement: The 501(r) regulations lowered the language translation threshold for limited English proficient (LEP) populations to the lower of 5% of LEP individuals in the community served/1000-LEP individuals. University of Maryland Rehabilitation & Orthopedic Institute translated its financial assistance policy into the following languages: English, Spanish, French, Russian, Chinese, Korean, Vietnamese, and Tagalog. * PLAIN LANGUAGE SUMMARY Requirement: The 501(r) regulations require a plain language summary of the FAP that is clear, concise, and easy for a patient to understand. University of Maryland Rehabilitation & Orthopedic Institute 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 The larger regional patient mix of University of Maryland Rehabilitation & Orthopedic Institute consists of disabled adults from the metropolitan area, state, and region. For purposes of community benefits programming and the FY'18 Community Health Needs Assessment (CHNA), the Community Benefit Service Area (CBSA) of UM Rehab & Ortho includes disabled adults from Baltimore City and the surrounding counties of Baltimore, Howard, and Anne Arundel. It is estimated that 7.3% of Marylanders under 65 years of age have some type of disability. This prevalence accounts for 441,808 Marylanders who need some type of support and/or resources to improve their daily quality of life. These individuals report barriers to health which include mobility, transportation, limited recreational options, unemployment, insurance coverage, and mental health issues. Disability in the UM Rehab & Ortho Service Area- Anne Arundel Co, Baltimore City, Baltimore Co and Howard Co Under 21 years - 12%, 19.8%, 13.6% and 8.5% 21 to 64 years - 9.5%, 18.2%, 10.4% and 6.9% 64 + years - 9.3%, 17.2%, 10% and 6.8% *Disability defined as mild to severe visual, hearing, ambulatory, cognitive, self-care, and independent living. Source: Local Disability Data for Planners (http://disabilityplanningdata.com) Schedule H, Part VI, Line 5 Promotion of community health The UM Rehabilitation & Orthopedic Institute promotes the health of its community in a variety of ways. Programming is based on the strategic priorities identified in the CHNA. The following three programs highlight the major community health initiatives to address the three major priorities of: * Quality of Life * Transition to the Community * Community Awareness The University of Maryland Rehabilitation & Orthopedic Institute 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: Quality of Life: Active Lifestyle Identified Need: Adapted Sports Program Through patient and community resident surveys as well as key informant interviews, the Adapted Sports Program was identified as part of the Community Health Needs Assessment FY'18 as a valued service which addresses a need for physical activity in the disabled population. A need to expand the program was also identified to further meet health, fitness, social and overall quality of life needs. Hospital Initiative: The Adapted Sports Programs provide exposure and opportunities to participate in adapted sports to improve health, fitness, social and overall quality of life for individuals with physical disabilities. - Adapted Sports Festival - Wheelchair Rugby Team - Wheelchair Basketball Clinic - Adapted Golf Program - Amputee Walking/Running Clinic Primary objectives of initiative: Adapted Sports Program 1) Increase physical activity (Maryland SHIP) 2) Increase awareness & benefits of adapted sports for disabled individuals 3) Increase self-reported quality of life of disabled adults Single or multi-year plan: All programs are multi-year, ongoing initiatives. Key collaborators in delivery: United States Olympic Committee United States Paralympic Committee Baltimore Municipal Golf Corporation - Forest Park Golf Course Baltimore City Recreation and Parks Baltimore County Recreation and Parks Impact of hospital initiative: The Adapted Sports Program maximizes participation for individuals with disabilities in adapted recreational and competitive sports, in order to promote independence, self-confidence, health and overall well-being through structured, individual and team sports Metrics: * # of participants * % of participants who report learning about adapted sports that they can participate in * % of participants who report positive impact on life (Participants of the adapted sports program complete a survey regarding the impact of the program on awareness of programs available in the community, impact on health, fitness, socialization and overall quality of life.) Evaluation of Outcomes FY19: * 263 participants in all programs * 80% of participants reported learning about the benefit of physical and psychosocial health as a result of participating in the Adapted Sports Program. Continuation of initiative: UM Rehab 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 interest and perceived benefit to our participants. Identified Need: Transition to the Community - Living Well with Chronic Disease Programs Through patient and resident surveys as well as key informant interviews, a need for ongoing education on how to live with a disability was identified as part of the Community Health Needs Assessment FY'18. Hospital Initiative: Living Well with Chronic Disease Programs The UM Rehabilitation & Orthopedic Institute serve disabled adults who have limited access to ongoing support and education in the community. The Living Well with Chronic Disease Program is an evidence-based series of workshops for individuals with a chronic condition like a disability along with their caregivers. This evidence-based initiative was developed by Stanford University and is used nationally. The workshop is scripted to deliver high fidelity but is also very interactive with small groups. The results have been very positive throughout the US. Primary Objectives of Initiative: 1) To improve health literacy and self-care of individuals with chronic conditions, reduce health complications and the need for emergency room visits. Single or Multi-year Plan: Ongoing initiative Key Collaborators in Delivery: University of Maryland Medical Center MAC, Inc. Impact of Hospital Initiative: Outcomes are evaluated by tracking the number of visits that take place in the Dental Clinic each year, and measuring the percent of visits that are preventive. Metrics: * # of participants * % of participants completing program Evaluation of Outcomes FY19: * 38 participants * 94% of participants reported that they now have a better understanding of how to manage their symptoms of their chronic condition. * 100% of participants also reported that they feel more motivated to take care of their health since they took the workshop. Continuation of initiative: This is an ongoing initiative which is slated to continue indefinitely because it addresses the unique educational needs of physically disabled adults. Identified Need: Transition to the Community - Dental Clinic Through patient and staff focus groups as well as key informant interviews, the Dental Clinic was identified as part of the Community Health Needs Assessment FY'18 as a valued service currently provided. Hospital Initiative: Dental Clinic The UM Rehabilitation & Orthopedic Institute Dental Clinic serves children and adults who have limited access to oral health care in the community. This population includes special health care needs (SHCN) patients (individuals who are mentally and/or physically disabled), as well as many children in the Maryland Medicaid Program. The Dental Clinic at UM Rehab is one of the few providers in the state who serves both pediatric and adult SHCN populations. These individuals may not receive care otherwise as many dentists in the community are not comfortable performing dental services for special health care needs patients. Primary Objectives of Initiative: 1) Increase children receiving dental care (Maryland SHIP) 2) Decrease emergency department visit rate for dental care (Maryland SHIP) 3) Increase number of dental treatments available to disabled population 4) Improve the oral health for those patients with special needs and who have limited access to good dental care. Single or Multi-year Plan: Ongoing initiative; has existed for many years and will continue indefinitely. Key Collaborators in Delivery: University of Maryland School of Dentistry * Hygienist program * 4th year dental students (externship program) Baltimore City Community College * Hygienist program Community College of Baltimore County, Dundalk * Hygienist program Impact of Hospital Initiative: Patients with limited access to good dental care experience reduced health care costs and improved patient care by receiving treatment for dental disease in the Dental Clinic instead of in the ER. Outcomes are evaluated by tracking the number of visits that take place in the Dental Clinic each year, and measuring the percent of visits that are preventive. Metrics: * # of visits * % of visits which were preventive * % of visits which were emergent Evaluation of Outcomes in FY19: * 6,971 total visits * 55% were preventive * 44% restorative * 1% were emergent Continuation of initiative: The Dental Clinic has existed for many years and will continue indefinitely UM Rehabilitation & Orthopedic Institute 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, UM Rehabilitation & Orthopedic Institute reports on a regular basis how it is investing in efforts to improve population health. UM Rehabilitation & Orthopedic Institute 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 Rehabilitation and Orthopedic Institute 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. Resources are embedded throughout the hospital and in the community so that every patient receives the same level of care coordination. Community health workers reach out to patients who are identified as being high risk for readmission or in need of critical resources. 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 UM Rehabilitation & Orthopedic Institute 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 UM Rehabilitation & Orthopedic Institute 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 UM Rehabilitation & Orthopedic Institute is committed to health education, advocacy, community partnerships, and engaging programs which focus on health and wellness for the disabled adult community in Baltimore City and Baltimore, Howard, and Anne Arundel counties. Schedule H, Part VI, Line 7 State filing of community benefit report MD X X X X false true false false false false false true false John W Ashworth III DIRECTOR 0 422013 0 160212 0 70894 0 11000 0 25969 0 690088 0 0 Robert A Chrencik TREASURER (ENDED 04/19) 0 1355350 0 995365 0 284091 0 11000 0 25554 0 2671360 0 0 Alison G Brown DIRECTOR (ENDED 08/18) 0 434231 0 174787 0 73513 0 11000 0 22288 0 715819 0 0 Karen E Doyle DIRECTOR 0 254291 0 83637 0 38868 0 10551 0 31228 0 418575 0 0 W Walter Augustin III VP FINANCIAL SERVICES AND CFO 218157 0 73972 0 26499 0 9049 0 22981 0 350658 0 0 0 Cynthia Kelleher PRESIDENT AND CEO 302979 0 147130 0 180471 0 11000 0 21710 0 663290 0 126737 0 Krishnaj Gourab VP MEDICAL AFFAIRS AND CMO 263300 0 0 0 446 0 27804 0 2939 0 294489 0 0 0 Cheryl D Lee VP PATIENT SERVICES AND CNO 191465 0 64152 0 26179 0 7848 0 18711 0 308355 0 0 0 Nadeem Aslam DIRECTOR OF PHARMACY 150598 0 17660 0 122 0 3457 0 18204 0 190041 0 0 0 James W Collins PHARMACIST 155497 0 0 0 737 0 7129 0 31373 0 194736 0 0 0 Sherry Lamons CLINICAL NURSE 150559 0 8500 0 81 0 4283 0 18265 0 181688 0 0 0 Srinivasa Rao Piratla PHARMACIST 148293 0 0 0 489 0 7229 0 27491 0 183502 0 0 0 Lobna Zada DENTAL CLINICAL CHIEF 241805 0 0 0 1343 0 12325 0 18553 0 274026 0 0 0 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 INDIVIDUAL LISTED BELOW HAS 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: KRISHNAB GOURAB DURING THE FISCAL YEAR ENDED JUNE 30, 2019, CERTAIN OFFICERS AND KEY EMPLOYEES PARTICIPATED IN THE UMMS SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN. THE INDIVIDUAL LISTED BELOW HAS 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). CYNTHIA KELLEHER, $175,964 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: ROBERT A. CHRENCIK ALISON GATES BROWN KAREN DOYLE JOHN W. ASHWORTH III W. WALTER AUGUSTIN, III CHERYL D. LEE 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. Form 990, Part IV, Line 24a TAX EXEMPT BOND ISSUE PURSUANT TO A MASTER LOAN AGREEMENT DATED DECEMBER 1, 2017 (THE "MASTER LOAN AGREEMENT"), AS AMENDED, UMMS AND SEVERAL OF ITS SUBSIDIARIES HAVE ISSUED DEBT THROUGH THE MARYLAND HEALTH AND HIGHER EDUCATIONAL FACILITIES AUTHORITY (THE "AUTHORITY"). AS SECURITY FOR THE PERFORMANCE OF THE BOND OBLIGATION UNDER THE MASTER LOAN AGREEMENT, THE AUTHORITY MAINTAINS A SECURITY INTEREST IN THE REVENUE OF THE OBLIGORS. THE MASTER LOAN AGREEMENT CONTAINS CERTAIN RESTRICTIVE COVENANTS. THESE COVENANTS REQUIRE THAT RATES AND CHARGES BE SET AT CERTAIN LEVELS, LIMIT INCURRENCE OF ADDITIONAL DEBT, REQUIRE COMPLIANCE WITH CERTAIN OPERATING RATIOS AND RESTRICT THE DISPOSITION OF ASSETS. THE OBLIGATED GROUP UNDER THE MASTER LOAN AGREEMENT INCLUDES UMMS, ROI, UM MIDTOWN, UM BALTIMORE WASHINGTON, SHORE HEALTH (UM MEMORIAL AND UM DORCHESTER), UM CHESTER RIVER, UM CHARLES REGIONAL, UM ST. JOSEPH, UM UPPER CHESAPEAKE, UM HARFORD MEMORIAL, UM LAUREL, UM PRICE GEORGE'S, BOWIE HEALTH CENTER (BOWIE), AND THE UMMS FOUNDATION. EACH MEMBER OF THE OBLIGATED GROUP IS JOINTLY AND SEVERALLY LIABLE FOR THE REPAYMENT OF THE OBLIGATIONS UNDER THE MASTER LOAN AGREEMENT OF THE CORPORATION'S $1,680,179,000 OF OUTSTANDING AUTHORITY BONDS ON JUNE 30, 2019. ALL OF THE BONDS WERE ISSUED IN THE NAME OF UMMS AND ARE REPORTED ON SCHEDULE K OF ITS FORM 990. Form 990, Part VI, Line 6 Classes of members or stockholders UMMS IS THE SOLE MEMBER OF UM REHAB. UMMS MAY ELECT ONE OR MORE BOARD MEMBERS OF THE GOVERNING BODY AND ALL DECISIONS OF THE GOVERNING BODY MUST BE APPROVED BY UMMS. Form 990, Part VI, Line 7a Members or stockholders electing members of governing body UMMS IS THE SOLE MEMBER OF UM REHAB. UMMS MAY ELECT ONE OR MORE BOARD MEMBERS OF THE GOVERNING BODY AND ALL DECISIONS OF THE GOVERNING BODY MUST BE APPROVED BY UMMS. Form 990, Part VI, Line 7b Decisions requiring approval by members or stockholders UMMS IS THE SOLE MEMBER OF UM REHAB. UMMS MAY ELECT ONE OR MORE BOARD MEMBERS OF THE GOVERNING BODY AND ALL DECISIONS OF THE GOVERNING BODY MUST BE APPROVED BY UMMS. 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, finance committee or other member(s) 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 filing organization follows the University of Maryland Medical System (UMMS) Conflicts of Interest Policy, which 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 organization or its sole member is responsible for administering and enforcing the Conflicts of Interest Policy (Policy). The Governance Committee (or other Board committee having similar authority) reviews any and all conflicts, 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 or its sole member'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. 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. 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. 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 VII, Section B, Line 1 INDEPENDENT CONTRACTORS INDEPENDENT CONTRACTORS OF THE FILING ORGANIZATION ARE PAID AND REPORTED BY THE PARENT CORPORATION, UMMS. UMMS ISSUES THE FORMS 1099 FOR THESE VENDOR PAYMENTS, WHILE THE FILING ORGANIZATION REPORTS THE EXPENSES FOR ITS INDEPENDENT CONTRACTORS ON PART VII, SECTION B, LINE 1 ON ITS FORM 990. Form 990, Part VIII, Line 11d Other Miscellaneous Revenue OTHER REVENUE - Total Revenue: 5589, Related or Exempt Function Revenue: 5589, Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: ; Form 990, Part IX, Line 11g Other Fees CONTRACT SERVICES - Total Expense: 9136477, Program Service Expense: 7766005, Management and General Expenses: 1370472, Fundraising Expenses: ; PHYSICIAN SERVICES - Total Expense: 9391689, Program Service Expense: 9391689, Management and General Expenses: , Fundraising Expenses: ; CORPORATE ALLOCATIONS - Total Expense: 8501135, Program Service Expense: 7225965, Management and General Expenses: 1275170, Fundraising Expenses: ; TEMP LABOR - Total Expense: 4140399, Program Service Expense: 3519339, Management and General Expenses: 621060, Fundraising Expenses: ; OTHER - Total Expense: 529598, Program Service Expense: 450158, Management and General Expenses: 79440, Fundraising Expenses: ; Form 990, Part XI, Line 9 Other changes in net assets or fund balances CHANGE IN UMMS FOUNDATION - 34880; CHANGE IN KERNAN ENDOWMENT SUPPORT - 1294562; CORP DEPRECIATION ALLOCATION - 565337; FY19 IT ENTERPRISE AND ROAD MAP ALLOCATION - -1388908; ROI - FY19 STRATEGIC PRIORITIES FUNDING - -200004; CMG EQUITY TRANSFER - 13276; OTHER - 11209; Non Operating Swap Expense - -60702; SHIPLEY'S PHYSICAL THERAPY CENTER LLC 2200 KERNAN DRIVE BALTIMORE MD 21207 522061788 HEALTHCARE MD 437000 0 UM REHAB UM REHAB INSTITUTE OF SOUTHERN MARYLAND 2200 KERNAN DRIVE BALTIMORE MD 20207 HEALTHCARE MD 0 0 UM REHAB BALTIMORE WASHINGTON EMERGENCY PHYS INC 301 HOSPITAL DRIVE GLEN BURNIE MD 21061 521756326 HEALTHCARE MD 501(c)(3) Type I BWHS false BALTIMORE WASHINGTON HEALTHCARE SERVICES 301 HOSPITAL DRIVE GLEN BURNIE MD 21061 521830243 HEALTHCARE MD 501(c)(3) Type I UMBWMS false BALTIMORE WASHINGTON MEDICAL CENTER INC 301 HOSPITAL DRIVE GLEN BURNIE MD 21061 520689917 HEALTHCARE MD 501(c)(3) 3 UMBWMS false UM BALTIMORE WASHINGTON MEDICAL SYSTEM 301 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