2020-07-15T12:42:29-05:00 2019-06-30 ERNST & YOUNG US LLP 201 NORTH FRANKLIN ST STE 2400 TAMPA FL 33602 990 2018-07-01 521164513 Frederick Health Hospice Inc % MICHELLE K MAHAN FRED 2405663030 400 WEST SEVENTH STREET FREDERICK MD 21701 MICHELLE K MAHAN CFO-FH HOSPITAL 2405663300 2020-07-13 true MELANIE A MCPEAK P01346034 8132254800 148.255.224.165 59196620201975000017 2020-07-15 P 39EE7DD29E90BE0401C8CC276E6B939C34F22AC1 721E3ACDB1620A7A66E3A23C7EDFA845AECA81ED 2018 2021-01-29 14:40:06Z MICHELLE K MAHAN 400 W 7TH STREET FREDERICK MD 21701 2062343 false X www.frederickhealthhospice.org X 1981 MD PROVIDE AND PROMOTE HOSPICE CARE FOR PEOPLE WHO ARE TERMINALLY ILL AND FOR THEIR FAMILIES. IT SERVES AS A FUNDRAISING ORG. FOR THE BENEFIT OF HOSPICE SVCS. AND THE KLINE HOUSE. 14 11 0 224 0 0 1207702 1197599 290465 304187 269282 328429 176633 197300 1944082 2027515 0 0 0 0 0 0 0 0 20482 1307238 1290100 1307238 1290100 636844 737415 5743060 6200696 123376 66877 5619684 6133819 X THE PURPOSE OF FREDERICK HEALTH HOSPICE, INC. IS TO PROVIDE AND PROMOTE HOSPICE CARE FOR INDIVIDUALS WHO ARE TERMINALLY ILL AND FOR THEIR FAMILIES. FREDERICK HEALTH HOSPICE, INC. OPERATES AS A FUNDRAISING ORGANIZATION FOR THE BENEFIT OF HOSPICE SERVICES AND OPERATES THE KLINE HOSPICE HOUSE. false false 1190099 0 304187 THE PURPOSE OF FREDERICK HEALTH HOSPICE, INC. IS TO PROVIDE AND PROMOTE HOSPICE CARE FOR INDIVIDUALS WHO ARE TERMINALLY ILL AND FOR THEIR FAMILIES. FREDERICK HEALTH HOSPICE, INC. OPERATES AS A FUNDRAISING ORGANIZATION FOR THE BENEFIT OF HOSPICE SERVICES AND OPERATES THE KLINE HOSPICE HOUSE. 1190099 true true false false false false false false false false true false false false false false false true false false false false false false true false false false false true false false false false false false false false false false false false false true true true false false true 4 0 true 0 false false false false false true true false false false false false false X 14 11 false false true false true true true true true false false true true true true true true false false false MD X MICHELLE K MAHAN 2405663300 400 WEST SEVENTH STREET FREDERICK MD 21701 X CATHY S ALEXANDER DIRECTOR 1.0 0.0 X 0 0 0 ARTHUR ANDERSON DIRECTOR 1.0 0.0 X 0 0 0 LAUREL CUCCHI DIRECTOR 2.0 0.0 X 0 0 0 WILLIAM HAUGH PRESIDENT 2.0 0.0 X X 0 0 0 THOMAS KLEINHANZL DIRECTOR 2.0 38.0 X 0 2079039 317626 PATRICK JOHANNES MANSKY DIRECTOR 1.0 40.0 X 0 549137 26360 REV TIMOTHY MAY VICE PRESIDENT 2.0 0.0 X X 0 0 0 JUSTIN SALTZMAN DIRECTOR 1.0 0.0 X 0 0 0 RICKY SANDY SECRETARY 2.0 0.0 X X 0 0 0 THOMAS SINTON DIRECTOR 1.0 0.0 X 0 0 0 DOUGLAS STAUFFER TREASURER 2.0 0.0 X X 0 0 0 JOHN VERBUS DIRECTOR 2.0 0.0 X 0 72773 17529 KATHY WEISHAAR MD DIRECTOR 2.0 40.0 X 0 0 0 CARL MILLER DIRECTOR 4.0 0.0 X 0 0 0 MICHELLE K MAHAN CFO-HOSPITAL 2.0 43.0 X 0 635679 64898 CARLOS T GRAVERAN EXEC DIRECTOR-HOSPICE 40.0 0.0 X 0 203713 19366 0 3540341 445779 0 false true false 0 2000 1195599 0 1197599 INPATIENT - HOSPICE HOUSE 623110 304187 304187 0 0 304187 328429 328429 0 0 0 0 0 0 232128 2000 34828 197300 197300 0 0 0 0 0 0 0 2027515 304187 0 525729 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 52377 0 52377 0 0 0 0 0 0 0 0 0 140842 113502 15271 12069 0 0 0 0 0 0 0 0 16200 16038 54 108 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 57826 57826 0 0 0 0 0 0 COGS AND SUPPLIES 110849 91725 10819 8305 CONTRACT SERVICES 912006 911008 998 0 1290100 1190099 79519 20482 0 0 0 323376 577748 0 0 48295 2501 0 0 0 0 0 0 0 0 0 0 1892606 1209848 740584 682758 4630805 4937689 0 0 0 0 0 0 0 0 5743060 6200696 123376 66877 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 123376 66877 X 5619684 6133819 0 0 0 0 5619684 6133819 5743060 6200696 X 737415 31169 0 0 0 -254449 X false true X true false X 912801 963381 1064727 1207702 1197599 5346210 243560 184660 227073 290465 304187 1249945 226239 224512 241088 207780 232128 1131747 0 0 1382600 1372553 1532888 1705947 1733914 7727902 0 0 288684 604004 100629 131707 68130 1193154 288684 604004 100629 131707 68130 1193154 6534748 175347 115311 113072 122928 328429 855087 0 175347 115311 113072 122928 328429 855087 0 0 1557947 1487864 1645960 1828875 2062343 8582989 0.76136 0.74640 0.09963 0.08127 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 145000 145000 1334057 827657 506400 227798 226611 1187 185751 155580 30171 682758 GOLF TOURNEY 234128 2000 232128 9945 21182 3701 0 234128 2000 232128 9945 21182 3701 34828 197300 false true false false false false false false false THOMAS KLEINHANZL DIRECTOR 0 1783095 0 294150 0 1794 0 296960 0 20666 0 2396665 0 993242 PATRICK JOHANNES MANSKY DIRECTOR 0 520443 0 28178 0 516 0 20500 0 5860 0 575497 0 0 MICHELLE K MAHAN CFO-HOSPITAL 0 500012 0 130519 0 5148 0 50741 0 14157 0 700577 0 0 CARLOS T GRAVERAN EXEC DIRECTOR-HOSPICE 0 177708 0 25489 0 516 0 4426 0 14940 0 223079 0 0 SCHEDULE J, PART I, LINE 3 THE EXECUTIVE COMPENSATION PROGRAM IS DESIGNED TO CARRY OUT THE HEALTH SYSTEM MISSION, TO ACHIEVE THE CHARITABLE PURPOSE, TO ATTRACT, RETAIN, MOTIVATE AND REWARD EXECUTIVE MANAGEMENT, AND TO MAINTAIN A COMPETITIVE POSITION WITH PEER ORGANIZATIONS IN THE REGION. OVERSIGHT OF THE EXECUTIVE COMPENSATION PROGRAM IS PROVIDED BY THE EXECUTIVE COMPENSATION COMMITTEE OF THE BOARD, COMPOSED OF THE BOARD CHAIRMAN, VICE CHAIRMAN, IMMEDIATE PRECEDING CHAIRMAN, CHAIRMAN OF THE FINANCE COMMITTEE AND THE CHAIRMAN OF THE GOVERNANCE COMMITTEE. IN ADDITION TO THE BOARD'S COMPENSATION COMMITTEE, WE UTILIZED AN EXTERNAL INDEPENDENT CONSULTANT AND MARKET SURVEYS FOR ALL EXECUTIVE MANAGEMENT COMPENSATION. THE PRESIDENT AND CEO HAS A WRITTEN EMPLOYMENT CONTRACT. SCHEDULE J, PART I, LINE 4B FREDERICK HEALTH HOSPITAL HAS ONE 457(F) NON-QUALIFIED DEFERRED COMPENSATION PLAN FOR CERTAIN MEMBERS OF SENIOR MANAGEMENT. UNDER THE PLAN, THEY MAY CONTRIBUTE AMOUNTS FROM THEIR COMPENSATION TO THE PLAN AND MAY RECEIVE A DISCRETIONARY EMPLOYER CONTRIBUTION. EMPLOYEES ARE FULLY VESTED IN ALL EMPLOYEE CONTRIBUTIONS TO THE PLAN. VESTING IN EMPLOYER CONTRIBUTIONS OCCURS IN ACCORDANCE WITH THE UNDERLYING PLAN DOCUMENTS. ALL ASSETS OF THE PLAN ARE HELD IN A SEPARATE TRUST. TOTAL HOSPITAL CONTRIBUTIONS TO THIS PLAN WERE AS FOLLOWS: MICHELLE K. MAHAN $30,241 THOMAS A. KLEINHANZL $276,460 CHANGES TO GOVERNING DOCUMENTS SINCE THE PRIOR 990 WAS FILED FORM 990, PART VI, LINE 4 ON SEPTEMBER 10, 2019, THE SYSTEM FILED ARTICLES OF AMENDMENT OF ARTICLES OF INCORPORATION WITH THE MARYLAND DEPARTMENT OF ASSESSMENTS AND TAXATION FOR THE SOLE PURPOSE OF CHANGING THE NAMES OF THE FOLLOWING ENTITIES: ORIGINAL NAME NEW NAME - FREDERICK MEMORIAL HOSPITAL, INC. FREDERICK HEALTH HOSPITAL, INC. - FREDERICK REGIONAL HEALTH SYSTEM, INC.FREDERICK HEALTH, INC. - MONOCACY HEALTH PARTNERS, LLC FREDERICK HEALTH MEDICAL GROUP, LLC - HOSPICE OF FREDERICK COUNTY, INC FREDERICK HEALTH HOSPICE, INC. - CORPORATE OCCUPATIONAL HEALTH FREDERICK HEALTH EMPLOYER SOLUTIONS CORP. SOLUTIONS, CORP. MEMBERS OR STOCKHOLDERS FORM 990, PART VI, LINE 6 FREDERICK HEALTH HOSPITAL, INC, FORMERLY KNOWN AS FREDERICK MEMORIAL HOSPITAL, INC., IS THE SOLE MEMBER OF THE CORPORATION. POWER TO ELECT OR APPOINT MEMBERS FORM 990, PART VI, LINE 7A THE MEMBER (FHH, INC.) SHALL TAKE THE FOLLOWING ACTIONS ON BEHALF OF THE CORPORATION: - APPOINT, AND, AS NECESSARY, REMOVE THE PRESIDENT/CEO OF THE CORPORATION; PROVIDED, HOWEVER, THAT THE MEMBER SHALL TAKE NO SUCH ACTION WITHOUT PRIOR CONSULTATION WITH THE BOARD OF DIRECTORS THE CORPORATION MAY TAKE THE FOLLOWING ACTIONS ONLY WITH THE PRIOR APPROVAL OF THE MEMBER: - ELECTION OR REPLACEMENT OF A DIRECTOR OR THE FILLING OF A VACANCY ON THE BOARD OF DIRECTORS AT SUCH TIMES AS THE MEMBER DEEMS NECESSARY, AND PURSUANT TO THE VOTE OF AT LEAST TWO-THIRDS OF THE MEMBER'S DIRECTORS, REMOVE A DIRECTOR OF THE CORPORATION DECISIONS OF THE ORGANIZATION RESERVED TO MEMBERS FORM 990, PART VI, LINE 7B THE MEMBER (FHH, INC.) SHALL TAKE THE FOLLOWING ACTIONS ON BEHALF OF THE CORPORATION: - FORMULATE, COMMUNICATE AND IMPLEMENT STRATEGIC PLANNING AND FINANCIAL MANAGEMENT - SELECT A FISCAL AUDITOR THE CORPORATION MAY TAKE THE FOLLOWING ACTIONS ONLY WITH THE PRIOR APPROVAL OF THE MEMBER: - EXPEND OR DIVEST ITS CAPITAL ASSETS, IF THE VALUE OF SUCH EXPENDITURE OR DIVESTITURE IS IN EXCESS OF AN AMOUNT TO BE DESIGNATED BY THE MEMBER FROM TIME TO TIME - INCUR DEBT OR GUARANTEE DEBT, IF THE AGGREGATE AMOUNT OF SUCH DEBT DURING ANY TWELVE MONTH PERIOD IS IN EXCESS OF AN AMOUNT TO BE DESIGNATED BY THE MEMBER FROM TIME TO TIME - EXPEND AMOUNTS IN EXCESS OF THE CORPORATION'S APPROVED ANNUAL OPERATING BUDGET IF SUCH AMOUNTS EXCEED AN AMOUNT TO BE DESIGNATED BY THE MEMBER FROM TIME TO TIME - DISSOLVE OR LIQUIDATE - CREATE, DISSOLVE OR DIVEST ANY SUBSIDIARY, PARTNERSHIP OR LLC - AMEND THE ARTICLES OF INCORPORATION AND/OR BY LAWS OF THE CORPORATION THE FOLLOWING SHALL NOT BE DEEMED TO HAVE TAKEN PLACE ABSENT SUBSEQUENT RATIFICATION BY THE MEMBER: - THE ADOPTION BY THE CORPORATION OF ITS ANNUAL OPERATING BUDGET OR CAPITAL BUDGET - CHANGE THE MISSION CORPORATION PROCESS USED TO REVIEW THE FORM 990 FORM 990, PART VI, LINE 11B THE 990 IS PREPARED IN CONJUNCTION WITH OUTSIDE TAX ACCOUNTANTS AND IS REVIEWED BY UPPER MANAGEMENT PRIOR TO PROVIDING A COPY TO THE BOARD. A COPY OF THE FORM 990 WAS PROVIDED TO ALL MEMBERS OF THE BOARD PRIOR TO FILING. MONITORING AND ENFORCEMENT OF COMPLIANCE WITH CONFLICT OF INTEREST POLICY FORM 990, PART VI, LINE 12C THE FREDERICK HEALTH HOSPICE, INC. BOARD OF DIRECTORS IS COMMITTED TO MEETING ITS FIDUCIARY RESPONSIBILITIES AND MAINTAINING ITS DUTY OF LOYALTY TO THE HOSPITAL AND THE COMMUNITY IT SERVES. TO THIS END, THE BOARD WILL EXERCISE VIGILANCE IN IDENTIFYING ANY CONFLICTS OF INTEREST. THE BOARD WILL ALSO MAINTAIN TRANSPARENCY AND OBJECTIVITY IN MAKING DECISIONS ABOUT CONFLICTS OF INTEREST SO THAT THE ORGANIZATION'S MISSION IS ALWAYS THE FIRST PRIORITY. THE CHAIRPERSON (OR VICE CHAIRPERSON IF THE CHAIR IS INVOLVED) WILL NOTIFY ALL DIRECTORS OF A REPORTED CONFLICT OF INTEREST AND WILL DECIDE WHETHER TO TAKE THE MATTER TO THE FULL BOARD TO DECIDE WHETHER A CONFLICT EXISTS AND, IF SO, TO DECIDE WHAT ACTION TO TAKE. ALTERNATIVELY, THE CHAIR PERSON WILL REFER THE MATTER TO THE GOVERNANCE COMMITTEE FOR AN IN-DEPTH EXAMINATION, SUMMARY, AND RECOMMENDATION PRIOR TO A FULL BOARD DISCUSSION AND DECISION. IF TIME IS OF THE ESSENCE, THE CHAIRPERSON WILL TAKE THE MATTER TO THE EXECUTIVE COMMITTEE, AND THE CHAIRPERSON WILL NOTIFY THE FULL BOARD OF SUCH ACTION. WHERE A CONFLICT OF INTEREST HAS BEEN IDENTIFIED THE BOARD MEMBER SHALL NOT VOTE OR BE PRESENT FOR THE DISCUSSION OR THE VOTE REGARDING THE TRANSACTION AT EITHER THE FULL BOARD, EXECUTIVE COMMITTEE, OR GOVERNANCE COMMITTEE MEETINGS EXCEPT TO ANSWER QUESTIONS THAT MAY BE ASKED OF HIM OR HER. TO PREVENT ACTUAL OR PERCEIVED INFLUENCE ON THE BOARD'S DECISION, THE CONFLICTED MEMBER IS PROHIBITED, AFTER INITIAL DISCLOSURE, FROM DISCUSSING THE CONFLICT OF INTEREST EITHER FORMALLY OR INFORMALLY WITH FELLOW DIRECTORS OR WITH MEMBERS OF THE MANAGEMENT. THERE WILL BE AN ANNUAL REVIEW OF ALL BOARD MEMBERSOFFICERS' TRANSACTIONS PREPARED BY THE ADMINISTRATION AND REVIEWED BY THE GOVERNANCE COMMITTEE AND THE FULL BOARD OF DIRECTORS. AT THAT TIME, ALL DIRECTORS WILL BE REMINDED OF THE IRS INTERMEDIATE SANCTIONS REGULATION THAT ESTABLISHES EXCISE TAXES AS A SANCTION AGAINST ADMINISTRATORS AND DIRECTORS OF TAX-EXEMPT ORGANIZATIONS WHO PARTICIPATE IN 'EXCESS BENEFIT TRANSACTIONS' (E.G., UNREASONABLE HIGH EMPLOYMENT COMPENSATION OR BUSINESS DEALS). PROCESS FOR MAKING DOCUMENTS AVAILABLE TO THE PUBLIC FORM 990, PART VI, LINE 19 THE GOVERNING DOCUMENTS AND THE CONFLICT OF INTEREST POLICY ARE AVAILABLE UPON REQUEST. FREDERICK HEALTH, INC'S CONSOLIDATED ANNUAL AUDITED FINANCIAL STATEMENTS ARE AVAILABLE AT www.frederickhealth.org FORM 990, PART VII DIRECTOR PATRICK JOHANNES MANSKY RECEIVED COMPENSATION FROM FREDERICK HEALTH MEDICAL GROUP, LLC FOR PHYSICIAN SERVICES. DIRECTOR JOHN VERBUS RECEIVED COMPENSATION FROM FREDERICK HEALTH HOSPITAL, INC. FOR SERVING AS A SPECIAL PROJECTS MANAGER. OTHER CHANGES IN NET ASSETS OR FUND BALANCES FORM 990, PART XI, LINE 9 FUNDRAISER NET INCOME $(202,981) FUNDRAISER EXPENSE $(31,147) GIFTS IN KIND EXPENSE $(20,321) ---------------- TOTAL $(254,449) FREDERICK HEALTH HOSPITAL INC 400 WEST SEVENTH STREET FREDERICK MD 21701 520591612 HOSPITAL MD 501(c)(3) 3 FHI false FREDERICK HEALTH INC 400 WEST SEVENTH STREET FREDERICK MD 21701 454133096 HEALTH SYSTEM MD 501(c)(3) 12b NA false FREDERICK HEALTH MEDICAL GROUP LLC 400 WEST SEVENTH STREET FREDERICK MD 21701 453007639 PHYS ORG MD 501(c)(3) 7 FHI true FREDERICK HEALTH SERVICES CORPORATION 400 WEST SEVENTH STREET FREDERICK MD 21701 521851661 HEALTHCARE MD FHI C Corp 0 0 true MONOCACY INSURANCE LTD PO BOX 1159 GRAND CAYMAN CJ KY1-1102 981011570 SELF INSURANCE CJ FHI C Corp 0 0 true false false false false false false false false false false false false false false true false false false false FREDERICK HEALTH HOSPITAL INC o 906556 DIRECT COSTING