2019-05-10T14:19:24-05:00 2018-06-30 KPMG LLP 1676 INTERNATIONAL DRIVE McLean VA 22102 990 2017-07-01 520646893 MONTGOMERY GENERAL HOSPITAL INC % JOEL BRYAN MONT 3017748640 18101 PRINCE PHILIP DRIVE OLNEY MD 20832 JOEL BRYAN VP/TREASURER 3017748640 2019-05-09 true jg white P01498698 7032868000 2019-05-08 167.68.102.5 54028020191305000005 2019-05-10 P D62EB2B59EBFD0F714CBD1204350E7D80AD80D6C EB2737A96B8F377BD085BED9F3BA68158C374A96 2017 2019-02-21 02:37:17Z THOMAS SENKER 18101 PRINCE PHILIP DRIVE OLNEY MD 20832 173639871 false X WWW.MONTGOMERYGENERAL.ORG X 2000 MD MEDSTAR MONTGOMERY MEDICAL CENTER IS DEDICATED TO ENHANCING OUR COMMUNITY'S HEALTH BY OFFERING HIGH QUALITY, COMPASSIONATE AND PERSONALIZED CARE. 19 16 1078 346 907571 -218611 1325878 2376556 159748957 169042964 35259 -204528 2727776 2424879 163837870 173639871 0 0 0 0 74462305 79635368 0 0 0 86208343 85803825 160670648 165439193 3167222 8200678 104824605 108182473 28609478 29197122 76215127 78985351 X As a proud member of MedStar Health, MedStar Montgomery Medical Centers (MedStar Montgomery) mission is to enhance our communitys health and well-being by offering high quality, compassionate and personalized care. MedStar Montgomery is located in Olney, in northeastern Montgomery County, Maryland, a suburb of Washington, D.C. After over 90 years, the hospital remains true to its roots, offering a wide range of wellness programs and outpatient services in addition to inpatient treatment. In fiscal year 2018, MedStar Montgomery had approximately 10,117 inpatient admissions and observation cases, and approximately 75,070 outpatient visits including 35,944 emergency visits. false false 114485137 0 161869148 MedStar Montgomerys largest program is access to and the provision of acute hospital services to the communities of northeastern Montgomery County, Maryland and the surrounding areas. In addition to the program service expenses listed above, MedStar Montgomery incurred $39.8M of management and general expenses in providing services to its communities. The acute care hospital offers a cardiac and vascular program, general surgery, orthopedics, cancer care, and obstetrics. With the addition of specialists from MedStar Georgetown University Hospital and MedStar Washington Hospital Center, MedStar Montgomery brings specialty care closer to its patients. MedStar Montgomery also offers inpatient and outpatient mental health services. MedStar Montgomery includes an emergency department with a dedicated Pediatric Center, a Fast-Track unit and a separate unit for crisis evaluation. 9109157 0 6393051 MedStar Montgomery provided $9.1M in subsidized (mission driven) health services in fiscal year 2018. 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 palliative care, womens and childrens services, continuing care. 2007432 0 0 MedStar Montgomery provided $2.0M in charity care services in fiscal year 2018. 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 Montgomerys 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. 125601726 true true false false false false false false false false true false false false true true false true false false true true true false false false true true false false true false false false false false false false false false false false false true true true true false false true 0 0 true 1078 true true true false false false false false false false false false X 19 16 false false false false true true true true true false false true true true true true true true true true true MD X JOEL BRYAN 4107726721 10980 GRANTCHESTER WAY COLUMBIA MD 21044 X JOSEPH BELL CHAIR 1.0 0.0 X 0 0 0 KENNETH A SAMET DIRECTOR 1.0 39.0 X 0 6538888 82240 RICHARD WEINSTEIN MD Director 1.0 0.0 X 0 0 0 JOHN FERGUSON DIRECTOR 1.0 0.0 X 0 0 0 WENDY WALKER DVM DIRECTOR 1.0 0.0 X 0 0 0 JAMES A BONIFANT DIRECTOR 1.0 0.0 X 0 0 0 KATHERINE W FARQUHAR PHD VICE CHAIR 1.0 0.0 X 0 0 0 RICHARD KURNOT MD DIRECTOR 1.0 0.0 X 0 0 0 CYNTHIA CHROSNIAK MD DIRECTOR 1.0 0.0 X 0 0 0 Carole Derrick DIRECTOR 1.0 0.0 X 0 0 0 Daniel J Schrider DIRECTOR 1.0 0.0 X 0 0 0 Steven M Shimoura MD DIRECTOR 1.0 0.0 X 0 0 0 Ana E Maldonado MD DIRECTOR 1.0 0.0 X 0 0 0 Alok N Mathur MD DIRECTOR 1.0 0.0 X 0 0 0 THOMAS J SENKER PRESIDENT/DIRECTOR 40.0 0.0 X X 572153 0 33717 Richard M Hoffman DIRECTOR 1.0 0.0 X 0 0 0 DEBORAH S ELLINGHAUS DIRECTOR 1.0 0.0 X 0 0 0 MARC KOZAM MD DIRECTOR 1.0 0.0 X 0 0 0 SUJITHRA JAYARAJ MD DIRECTOR 40.0 0.0 X 445521 0 24145 David Havrilla CFO/Treasurer 40.0 0.0 X 359112 0 28262 CAROLINA CHAVARRIA SECRETARY 40.0 0.0 X 78366 0 18174 KEVIN MELL VP, OPERATIONS 40.0 0.0 X 109435 126643 14896 Vivian Hsia VP, HUMAN RESOURCES 40.0 0.0 X 189777 0 12926 Connie Stone VP, Patient Care Services 40.0 0.0 X 266794 0 16156 Frederick Finelli VP, Medical Affairs 40.0 0.0 X 721574 0 27836 OWEN HORNE NETWORK MANAGER 40.0 0.0 X 167750 0 20359 DENISE KINGSBURY SR DIRECTOR,CLINICAL SUPPORT 40.0 0.0 X 153579 0 3177 3064061 6665531 281888 79 false true false MERIDIAN ANESTHESIA PRACTICE 3801 International Drive SILVER SPRING MD 20906 Physican Services 4987576 Sodexo Inc LA MAISON FRANCAIS WASHINGTON DC 20007 PROFESSIONAL SVCS 1191548 CERNER CORPORATION 51 Valley Stream Parkway MALVERN PA 193351406 Medical Services 805065 AMN HEALTHCARE INC 2735 Collection Center Dr CHICAGO IL 60693 Staffing Services 1361324 EMERGENCY MEDICINE ASSOCIATES 20010 CENTURY BLVD STE 200 GERMANTOWN MD 20877 Medical Services 605052 33 987340 1389216 2376556 PATIENT SERVICE REVENUE 621300 168206723 168206723 MEANINGFUL USE INCOME 621110 20826 20826 PHYSICIAN BILLING REVENUE 621110 34650 34650 PHARMACY REVENUE 900099 780765 780765 169042964 -209779 -209779 0 0 448307 448307 0 448307 448307 5251 5251 5251 5251 0 0 0 0 0 0 0 0 0 REBATE INCOME 525990 379960 379960 EQUITY INTEREST IN AFFILIATES 900099 177363 177363 OTHER REVENUE 900099 1419249 126806 1292443 1976572 173639871 168262199 907571 2093545 X 0 0 0 0 0 1668885 1411267 257618 0 0 65133583 55096264 10037319 494504 405831 88673 8083752 6804162 1279590 4254644 3454689 799955 13691932 13691932 0 0 0 0 1523 1523 19409370 17905168 1504202 550331 928 549403 376029 794046 -418017 0 0 1195250 851748 343502 56238 34753 21485 0 72402 10623 61779 1194846 1194846 0 10487385 6414900 4072485 1186419 40011 1146408 MED/SURG SUPPLIES 20079125 20159115 -79990 MAINTENANCE 5792665 3200924 2591741 IMPLANTS/PROSTHESES 5184245 5184245 UTILITIES 2517946 2368117 149829 4008119 1464935 2543184 165439193 125601726 39837467 0 15966 315 340838 384285 0 0 18562734 23566448 0 0 0 0 0 0 3334650 3545314 1399032 890800 215789935 139366271 81171385 76423664 0 0 0 2702904 0 0 0 0 0 668743 104824605 108182473 9394740 9894324 0 0 3437029 3311428 0 0 0 0 0 0 0 0 0 0 15777709 15991370 28609478 29197122 X 76215127 78985351 0 0 0 0 76215127 78985351 104824605 108182473 X 8200678 -50899 -5379555 X false true X true false X 146581 146581 110420135 53532348 56887787 2701193 2387611 313582 89200541 73133304 14067237 13321485 8313008 5008477 76423664 0 MOB LIABILITY 7877865 ADVANCE HEALTH INSURANCE 5165979 WORKERS COMPENSATION 1023858 CREDIT BALANCES PATIENT AR 516726 GBR LIABILITY 298554 OTHER SHORT TERM LIABILITIES 510947 OTHER LONG TERM LIABILITIES 485459 UCC POOL LIABILITY 111982 15991370 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, 2018. true true X true X true X true true true false true true 2007432 2007432 0.01210 2007432 2007432 0.01210 649618 18465 631153 0.00380 238890 0 238890 0.00140 9109157 6393051 2716106 0.01640 168703 0 168703 0.00100 10166368 6411516 3754852 0.02260 12173800 6411516 5762284 0.03470 53372 53372 0.00030 21966 21966 0.00010 26385 26385 0.00020 13610 13610 0.00010 115333 115333 0.00070 true 4823807 true true 1 1 MONTGOMERY GENERAL HOSPITAL 18101 PRINCE PHILIP DRIVE OLNEY MD 20832 X X X MONTGOMERY GENERAL HOSPITAL 1 false false true X X X X X X X X X 17 true false false true X HTTP://WWW.MEDSTARMONTGOMERY.ORG/ X true 17 false HTTP://WWW.MEDSTARMONTGOMERY.ORG/ true false true X 200. 400. X X X X X X true true X X X X true X HTTP://WWW.MEDSTARMONTGOMERY.ORG/ X HTTP://WWW.MEDSTARMONTGOMERY.ORG/ X HTTP://WWW.MEDSTARMONTGOMERY 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: Dairy Marroquin AND DIANA SALADINI 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: FREDERICK FINELLI, MD Advisory Task Force Role Description The Advisory Task Force (ATF) reviews primary/secondary data and local/state/federal community health goals. Based on findings, the ATF provides input into the hospital's three-year implementation strategy. As ambassadors for the CHNA process, the ATF members support efforts to optimize community participation.Note: The ATF should be a combination of community representatives and staff. Community representatives should makeup at least 50% of total participants. Name: Title/AFFILIATION NAME OF ORGANIZATION WITH HOSPITAL Amy Shields Wilson Vice President of MINDOULA HEALTH Operations Dairy Marroquin (Lead) Community Outreach MMMC Coordinator Deb Otani Cancer Nurse Navigator MMMC Debbie Ellinghaus Managing Director Olney Theatre Diana Saladini Director, Population MMMC Health Edith Williams Community Member Millian United Methodist Church Frederick Finelli, MD Executive Sponsor VP Medical Affairs MMMC Jaqueline Hubbard Health Center Director Holy Cross HealthCenter- -Williams Aspen Hill Joe Podson Executive Director Homecrest House Karen Thompkins Sr. Planning Specialist Healthy Montgomery/ Montgomery County Health Department Lynda Suh Director, Quality & Risk MMMC Marsha Batista Resident Counselor III Housing Opportunities Commission Mary Jane Joseph Project Manager Primary Care Coalition Sharon Riser Case Manager Emergency MMMC Department Susan Montgomery Director of Social Services Leisure World Senior Community Thomas Brunetto (OHFL) Chair Olney Home for Life implementation strategies Part V, Section B, Line 11 The implementation strategies serve as a roadmap for how community benefit resources will be allocated and deployed. MedStar's hospitals will be able to measure our contribution to improving the health of underserved and vulnerable populations in the regions we serve. Three-year implementation strategies with measurable objectives were developed for each hospital's community benefit service area - a specific community or target population of focus. Priorities were based on community need as determined by quantitative data and community input, as well as on hospital expertise, resources, strengths of existing programming and partnerships, and alignment with national, state, and local health goals. The MedStar Health Corporate Community Health Department will provide system-wide coordination and oversight of community benefit programming. HOSPITAL ADVISORY TASK FORCES CONVENE AT LEAST ANNUALLY TO MONITOR PROGRESS OF STRATEGY EXECUTION AND TO PROVIDE ONGOING RECOMMENDATIONS RELATED TO OUTCOMES ACHIEVEMENT, PROGRAM DEVELOPMENT, PARTNERSHIP APPROACHES, AND OVERALL IMPLEMENTATION IMPROVEMENT. FOR SIGNIFICANT NEEDS IDENTIFIED IN THE CHNA THAT THE HOSPITAL HAS NOT PRIORITIZED AS FOCUS AREAS THROUGH ITS IMPLEMENTATION STRATEGY, THESE NEEDS WILL BE ADDRESSED BY COLLABORATING WITH OTHER LEADING ORGANIZATIONS, AND BY TAKING A SUPPORTER ROLE ON IDENTIFIED NEEDS THAT ARE BEYOND THE SCOPE OF THE HOSPITALS STRENGTHS. CHARITY CARE AT COST PART I, LINE 7A MARYLAND'S REGULATORY SYSTEM CREATES A UNIQUE PROCESS FOR HOSPITAL PAYMENT THAT DIFFERS FROM THE REST OF THE NATION. THE HEALTH SERVICES COST REVIEW COMMISSION (HSCRC), DETERMINES PAYMENT THROUGH A RATE-SETTING PROCESS AND ALL PAYORS, INCLUDING GOVERNMENTAL PAYORS, PAY THE SAME AMOUNT FOR THE SAME SERVICES DELIVERED AT THE SAME HOSPITAL. MARYLAND'S UNIQUE ALL-PAYOR SYSTEM INCLUDES A METHOD FOR REFERENCING UNCOMPENSATED CARE IN EACH PAYORS' RATES, WHICH DOES NOT ENABLE MARYLAND HOSPITALS TO BREAKOUT ANY OFFSETTING REVENUE RELATED TO UNCOMPENSATED CARE. UNREIMBURSED MEDICAID PART I, LINE 7B MARYLAND'S REGULATORY SYSTEM CREATES A UNIQUE PROCESS FOR HOSPITAL PAYMENT THAT DIFFERS FROM THE REST OF THE NATION. THE HEALTH SERVICES COST REVIEW COMMISSION (HSCRC), DETERMINES PAYMENT THROUGH A RATE-SETTING PROCESS AND ALL PAYORS, INCLUDING GOVERNMENTAL PAYORS, PAY THE SAME AMOUNT FOR THE SAME SERVICES DELIVERED AT THE SAME HOSPITAL. MARYLAND'S UNIQUE ALL-PAYOR SYSTEM INCLUDES A METHOD FOR REFERENCING UNCOMPENSATED CARE IN EACH PAYORS' RATES, WHICH DOES NOT ENABLE MARYLAND HOSPITALS TO BREAKOUT ANY OFFSETTING REVENUE RELATED TO UNCOMPENSATED CARE. COMMUNITY BENEFIT EXPENSES ARE EQUAL TO MEDICAID REVENUES IN MARYLAND, AS SUCH, THE NET EFFECT IS ZERO. THE EXCEPTION TO THIS IS THE IMPACT ON THE HOSPITAL OF ITS SHARE OF THE MEDICAID ASSESSMENT. IN RECENT YEARS, THE STATE OF MARYLAND HAS CLOSED FISCAL GAPS IN THE STATE MEDICAID BUDGET BY ASSESSING HOSPITALS THROUGH THE RATE-SETTING SYSTEM. BAD DEBT PART III, LINES 2 & 4 MEDSTAR HEALTH AND ITS AFFILIATED ORGANIZATIONS REPORT BAD DEBT EXPENSE IN ACCORDANCE WITH ASU 2011-07, WHICH REQUIRES CERTAIN HEALTHCARE ENTITIES TO CHANGE THE PRESENTATION OF THEIR STATEMENT OF OPERATIONS BY RECLASSIFYING THE PROVISION FOR BAD DEBTS ASSOCIATED WITH PATIENT SERVICE REVENUE FROM AN OPERATING EXPENSE TO A DEDUCTION FROM PATIENT SERVICE REVENUE (NET OF CONTRACTUAL ALLOWANCES AND DISCOUNTS). HOWEVER, MEDSTAR AND ITS AFFILIATED ENTITIES DO NOT MAKE A DETERMINATION AS TO WHETHER SELF PAY AMOUNTS ARE COLLECTIBLE IN DETERMINING REVENUE RECOGNITION. RESERVE MODELS, WHICH HAVE BEEN DEVELOPED BASED ON HISTORICAL COLLECTION RESULTS AND WHICH ARE ADJUSTED PERIODICALLY BASED ON ACTUAL COLLECTIONS EXPERIENCE, ARE USED TO ESTIMATE UNCOLLECTIBLE AMOUNTS ACROSS ALL PAYORS INCLUDING SELF PAY. BAD DEBT DETERMINATIONS ARE MADE ONLY AFTER SUFFICIENT EVIDENCE IS OBTAINED TO SUPPORT THAT AN AMOUNT IS NOT COLLECTIBLE. MEDICARE PART III, LINE 8 MARYLAND'S REGULATORY SYSTEM CREATES A UNIQUE PROCESS FOR HOSPITAL PAYMENT THAT DIFFERS FROM THE REST OF THE NATION. THE HEALTH SERVICES COST REVIEW COMMISSION (HSCRC) DETERMINES PAYMENT THROUGH A RATE-SETTING PROCESS AND ALL PAYORS, INCLUDING GOVERNMENTAL PAYORS, PAY THE SAME AMOUNT FOR THE SAME SERVICES DELIVERED AT THE SAME HOSPITAL. MARYLAND'S UNIQUE ALL-PAYOR SYSTEM INCLUDES A METHOD FOR REFERENCING UNCOMPENSATED CARE IN EACH PAYORS' RATES, WHICH DOES NOT ENABLE MARYLAND HOSPITALS TO BREAKOUT ANY OFFSETTING REVENUE RELATED TO UNCOMPENSATED CARE. AS SUCH, THE NET EFFECT FOR MEDICARE EXPENSES AND REVENUES IN MARYLAND IS ZERO. PART III, LINE 9B IF IT IS DETERMINED THAT A PATIENT MAY POTENTIALLY QUALIFY FOR A CHARITABLE/FINANCIAL PROGRAM, A HOLD IS PLACED ON THE ACCOUNT TO PREVENT IT FROM BEING REPORTED AS BAD DEBT UNTIL PROGRAM APPROVALS HAVE BEEN OBTAINED. IF IT IS APPROVED, THE ACCOUNT IS DOCUMENTED AND THE NECESSARY ADJUSTMENTS ARE MADE TO CLOSE THE ACCOUNT. NEEDS ASSESSMENT PART VI, LINE 2 In FY18, MedStar Montgomery Medical Center (MMMC) 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. A 16 member Advisory Task Force (ATF) led the MMMC CHNA process. 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. The ATF reviewed national, state, and local health and disparity data, public health priorities and community health improvement plans as well as county-level ZIP code and neighborhood level data (when available). Based on their findings, ATF members designed a CHNA survey tool consisting of open and closed-ended questions about healthcare access, health equity, health condition concerns, social determinants and community strengths and assets. Community members responded to the survey by attending a community input session or completing it online or via hardcopy. Based on the ATF's recommendation, the hospital identified Aspen Hill and Bel Pre as its Community Benefit Service Area (CBSA), which includes residents living in ZIP codes 20906 and 20853. The hospital selected this geographic area based on hospital utilization and secondary public health data as well as its close proximity to the hospital, coupled with a high density of low-income residents. The ATF used population-level data, community health needs survey findings and feedback from community input sessions to create recommendations for the hospital's health priorities, potential implementation strategies, and to identify key partners. Based on the ATF's recommendation, the hospital health priorities for the CBSA include health and wellness (chronic disease prevention and management, behavioral health), access to care and services (emergency and primary care, mental health services, transportation, medication adherence) and social determinants of health (employment, housing). The hospital's FY18 CHNA and three-year Implementation Strategies were endorsed by MMMC Board of Directors and approved by the MedStar Health Board of Directors. The document became available on the hospital's website on June 30, 2018. As a proud member of MedStar Health, representatives from MMMC routinely participate in the MedStar Health community benefit 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: MedStar Montgomery Medical Centers CBSA includes residents in the Aspen Hill/Bel Pre/Rockville neighborhoods of Montgomery County, Maryland (zip codes 20906 and 20853). This geographic area was selected based on hospital utilization and secondary public health data, as well as its close proximity to the hospital, coupled with a high density of low-income residents, underserved seniors and an ethnically diverse population. Demographics: The area encompassed by ZIP code 20906 has 69,112 residents. Over 19.5% of residents are age 65 and older, compared to 13.71% of Montgomery County. The population is racially diverse, with 34.6% White, 25.8% Black/African American, 12.1% Asian, while 31.5% are of Hispanic origin. Relative to Montgomery County, there are a larger proportion of Black/African American and Hispanic residents. The median income in the CBSA $70,133 is lower than the countywide median $100,352 and a higher proportion of residents in Aspen Hill/Bel Pre live in poverty 7.5% compared to 4.7% in Montgomery County. The area encompassed by ZIP code 20853 has 30,286 residents. Over 16.8% of residents are age 65 and older, compared to 13.71% of Montgomery County. The population is racially diverse, with 62.2% White, 13.7% Black/African American, 11.8% Asian, while 22.4% are of Hispanic origin. The population is racially diverse with close to 40.0% non-white residents. The median income in the CBSA $70,133 is lower than the countywide median $100,352 and a higher proportion of residents in Aspen Hill/Bel Pre live in poverty 7.5% compared to 4.7% in Montgomery County. PROMOTION OF COMMUNITY HEALTH PART VI, LINE 5 As a community partner, MMMC engages in a number of community benefit activities to improve and promote the health and wellbeing of the community. Priority areas, as determined by the FY18 CHNA, fall under three areas of focus including Health and wellness, Access to Care and Services, as well as Social Determinants of Health. Specific priorities include Chronic Disease prevention and Management, Behavioral and Mental Health, Emergency and Primary Care Access, Transportation, Employment and Medication Adherence. In effort to educate the community about chronic disease prevention and management, The hospital's community health outreach efforts are focused on initiatives that address and minimize health disparities through increased awareness of symptoms and prevention, utilizing community education and physical activity programs, and also helping individuals take steps to reduce those risks by connecting them to appropriate care when follow up care is necessary. Some of the Identified programs include the following. Living Well Chronic Disease Prevention and Management, a free seven-week health education and behavior change program focused on chronic disease self-management for people living with one or more chronic diseases. The program is designed for adults living with a chronic condition, such as heart disease, diabetes, cancer, depression, chronic pain, arthritis, lung disease, multiple sclerosis or any chronic health concern. Senior Strength and Balance programs are also programmed to be offered on an ongoing basis. This initiative focuses on providing free weekly exercise classes for persons 55 and older, composed of low-impact aerobics movements, concentrating on improving cardiovascular health, weight loss, strength, balance and flexibility. In effort to support mental health and wellness as well as access to mental health programs established Screening, Brief Intervention, and Referral to Treatment (SBIRT) Program offers a triage process of point of entry where patients are screened for addiction and substance abuse, followed by a brief intervention by a peer recovery coach. When appropriate, patient is referred to addiction treatment services. In addition, MedStar Montgomery offers the Mindoula Behavioral Health Program, a 30 days of virtually or in-person case management services to the first thirty patients with a diagnosis of depression, schizophrenia and and/or Bipolar disorder. Furthermore, in efforts to support access to care among our community, MedStar Montgomery has identified the following as resource for connecting our patients and community to proper care, including established Emergency Department (ED) - Primary Care (PC) Connect initiative, a coordinated referral program focusing on connecting uninsured and underserved self-pay patients to primary care and chronic disease management programs. Bilingual Population Health Navigator provided real time navigation during ED visits, working with patients to assist them in scheduling appointments at local safety-net clinics, and educating them on ways to access care in a non-emergency settings. MedStar Montgomery will also focus on identifying available resource programs for our patients. One way of doing this is by identifying patients in need using Aunt Bertha resource finder within our Emergency Department. Aunt Bertha is a social needs screening tool that helps identify nearby resource and support programs available at low cost or free of charge to our patients. The hospital will also continue to support viable partnerships, such as Olney Home for Life and Manor Connections transportation programs, focusing on free transportation services for seniors who need to attend their medical appointments, as well as community health programs. MedStar Montgomery is a committed to meeting the needs of vulnerable populations by establishing strategic partnerships and alliances. The hospital will continue to provide financial support to Holy Cross Health Center - Aspen Hill, which enables the clinic to treat low-income, uninsured, ethnically diverse residents at free or low cost. The hospital also provides in-kind space for day-to-day operation of Proyecto Salud's clinical space. With a focus on persons who speak Spanish as a primary language, services include physical examinations, health counseling, education, and laboratory services. In addition, Proyecto Salud offers a seasonal flu clinic. Prescription medications are made available through the Montgomery Cares program. The clinic also provides referrals for county specialty services, sexually transmitted infections and Human Immunodeficiency Virus (HIV) programs, Women's Cancer Control Program, Family Planning, and alcohol treatment and rehabilitation. In efforts to meet the social determinants of health needs of our community, MedStar Montgomery has identified the RX for Success program as an implementation project in efforts to meet access to employment need in our community. The Rx for Success Program is a pipeline summer internship program for underserved high school students at Kennedy High School, located in our community benefit area. In partnership with MedStar Pharmacy, MMMC offers bedside delivery of medications for patients being discharged from the hospital, where a dedicated technician works with patients, nurses, physicians, and case managers, to ensure that patients leaving the hospital have their discharge medications before they leave. MMMC also collaborates with Giant Pharmacy to provide discounted medications to discharged patients who cannot afford the cost during hours MedStar Outpatient Pharmacy is not open. This ensures that patients get their prescriptions in a timely manner and avoids having patients return to the hospital the next day to pick up prescriptions. In addition, MMMC collaborates with Family and Nursing Care for proper in home medication administration, in order to decrease drug interactions, adverse effects and non-compliance of discharged patients. AFFILIATED HEALTH CARE SYSTEM PART VI, LINE 6 As a proud member of MedStar Health, MMMC is able to expand its capacity to meet the needs of the community by collaborating 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 MMMC 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 MMMC 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 1818529 0 4346350 0 374009 0 49758 0 32482 0 6621128 0 0 Vivian Hsia VP, HUMAN RESOURCES 160429 0 29323 0 25 0 5898 0 7028 0 202703 0 0 0 Connie Stone VP, Patient Care Services 211132 0 55637 0 25 0 7950 0 8206 0 282950 0 0 0 David Havrilla CFO/Treasurer 255464 0 103623 0 25 0 15421 0 12841 0 387374 0 0 0 KEVIN MELL VP, OPERATIONS 109435 76719 0 49924 0 0 0 7702 0 7194 109435 141539 0 0 Frederick Finelli VP, Medical Affairs 510935 0 210639 0 0 0 7950 0 19886 0 749410 0 0 0 THOMAS J SENKER PRESIDENT/DIRECTOR 352462 0 219691 0 0 0 7950 0 25767 0 605870 0 0 0 OWEN HORNE NETWORK MANAGER 166975 0 750 0 25 0 5091 0 15268 0 188109 0 0 0 DENISE KINGSBURY SR DIRECTOR,CLINICAL SUPPORT 152804 0 750 0 25 0 2600 0 577 0 156756 0 0 0 SUJITHRA JAYARAJ MD DIRECTOR 372466 0 73055 0 0 7950 0 16195 0 469666 0 0 0 SCHEDULE J, PART III MR. SAMET'S compensation in Part II, Column (B) includes $1,914,117 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. ORGANIZATION MEMBERS PART VI, LINE 6 THE ORGANIZATION IS AN AFFILIATE AND SUBSIDIARY OF MEDSTAR HEALTH, INC. MEDSTAR HEALTH, INC., OR ONE OF ITS AFFILIATES AND SUBSIDIARIES, IS THE SOLE MEMBER OF THE ORGANIZATION. DESCRIPTION OF MEMBERS PART VI, LINES 7A AS AN AFFILIATE AND SUBSIDIARY OF MEDSTAR HEALTH, INC., 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, LINES 7B AS AN AFFILIATE AND SUBSIDIARY OF MEDSTAR HEALTH, INC., 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. FORM 990 REVIEW PROCESS 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 PPart 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) RELATED TO DIRECTORS ARE REVIEWED BY THE GOVERNANCE COMMITTEE OF THE MEDSTAR HEALTH BOARD OF DIRECTORS WHICH DETERMINES HOW THE MATTER SHOULD BE RESOLVED. SUCH DISCLOSURES (IF ANY) RELATED TO OFFICERS AND SENIOR MANAGERS ARE REVIEWED BY AN APPROPRIATE EXECUTIVE WHO 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). EXECUTIVE COMPENSATION PROCESS PART VI, LINE 15 THE EXECUTIVE COMPENSATION COMMITTEE OF THE BOARD OF DIRECTORS OF MEDSTAR HEALTH, INC. (THE "COMMITTEE") HAS OVERSIGHT OVER THE EXECUTIVE COMPENSATION PROGRAM (THE "PROGRAM") OF MEDSTAR HEALTH, INC. AND ITS AFFILIATES. TOTAL COMPENSATION FOR THE TOP MANAGEMENT OFFICIALS, OFFICERS AND KEY EMPLOYEES OF MEDSTAR HEALTH, INC. AND ITS AFFILIATES ARE REVIEWED AND APPROVED BY THE COMMITTEE WITH ASSISTANCE AND GUIDANCE FROM AN INDEPENDENT THIRD PARTY ADVISOR. THE MEMBERS OF THE COMMITTEE ARE INDEPENDENT FROM ALL OF THE PARTICIPANTS IN THE PROGRAM. THE MAIN OBJECTIVE OF THE PROGRAM IS TO PROVIDE MARKET COMPETITIVE TOTAL COMPENSATION THAT IS INTERNALLY EQUITABLE AND HAS A STRONG PAY-FOR-PERFORMANCE LINKAGE. PERFORMANCE IS EVALUATED AT THE SYSTEM, OPERATING UNIT, AND INDIVIDUAL LEVELS. THE OVERALL TOTAL COMPENSATION PHILOSOPHY IS MANAGED AT THE 75TH PERCENTILE OF THE COMPETITIVE MARKET FOR COMPARABLE SIZE (NET REVENUE) AND TYPE ("TAX-EXEMPT HEALTHCARE ORGANIZATIONS"). WHERE APPROPRIATE, ADDITIONAL INDUSTRY DATA IS CONSIDERED (GENERAL BUSINESS AND/OR TAXABLE HEALTHCARE) FOR SELECTED POSITIONS THAT CAN BE RECRUITED FROM OR POTENTIALLY LOST TO THESE INDUSTRIES (E.G., INFORMATION TECHNOLOGY, FINANCE, ETC.). THE COMMITTEE HAS ENGAGED ERNST & YOUNG LLP ("E&Y") TO SERVE AS AN ADVISOR ON THE REASONABLENESS AND COMPETITIVENESS OF THE PROGRAM. IN DETERMINING REASONABLENESS AND COMPETITIVENESS, E&Y REVIEWS MARKET PRACTICES AND TRENDS, AND MAKES RECOMMENDATIONS RELATED TO THE PROGRAM. E&Y UTILIZES INFORMATION FROM CUSTOM SURVEYS, NATIONAL COMPENSATION SURVEYS, PROPRIETARY DATABASES, AND CLIENT EXPERIENCES TO DETERMINE ITS FINAL RECOMMENDATIONS. E&Y PRESENTS THEIR FINDINGS AND RECOMMENDATIONS TO THE COMMITTEE. THE COMMITTEE MAKES THE FINAL DECISIONS ON ALL OF THE COMPENSATION DETERMINATIONS OF THE PROGRAM. ALL DECISIONS MADE BY THE COMMITTEE ARE CONTEMPORANEOUSLY DOCUMENTED. FINANCIAL STATEMENT AVAILABILITY PART VI, LINE 19 MEDSTAR HEALTH POSTS ITS ANNUAL FINANCIAL AUDIT AND QUARTERLY FINANCIAL REPORTS TO THE ELECTRONIC MUNICIPAL MARKET ACCESS (EMMA) SYSTEM. THE ORGANIZATION ALSO E-MAILS ITS ANNUAL AND QUARTERLY DISCLOSURES TO HOLDERS OF THE COMPANY'S PUBLICLY TRADED DEBT. THE COMPANY'S GOVERNANCE DOCUMENTS AND CONFLICTS OF INTEREST POLICIES ARE AVAILABLE UPON REQUEST THROUGH ITS CORPORATE (OR AS APPLICABLE ENTITY) PUBLIC INFORMATION OFFICES. OTHER CHANGES IN NET ASSETS PART XI, LINE 9 Net Equity Transfer .......................... $(12,437,117) TRNA - Pledge Receivable ..................... $ 3,076,748 CHANGE IN ACCUMULATED NET ASSETS............. $ 2,960,814 Distribution from Partnership ................ $ 1,020,000 -------------- TOTAL $ (5,379,555) FORM 990 PART IX LINE 11G DESCRIPTION:PURCHASED PROFESSIONAL SERVICE TOTAL FEES:6201232 FORM 990 PART IX LINE 11G DESCRIPTION:PHYSICIAN SERVICES TOTAL FEES:3759931 FORM 990 PART IX LINE 11G DESCRIPTION:SUBSIDY EXPENSE - INTERCO. TOTAL FEES:3103458 FORM 990 PART IX LINE 11G DESCRIPTION:PROFESSIONAL FEES-OTHER TOTAL FEES:2451756 FORM 990 PART IX LINE 11G DESCRIPTION:NON-PHYS INTERCO PURCH SRVS TOTAL FEES:1811511 FORM 990 PART IX LINE 11G DESCRIPTION:BILLING SERVICE EXPENSE TOTAL FEES:500573 FORM 990 PART IX LINE 11G DESCRIPTION:LAB SERVICES TOTAL FEES:461348 FORM 990 PART IX LINE 11G DESCRIPTION:COMMERCIAL LAUNDRY TOTAL FEES:216638 FORM 990 PART IX LINE 11G DESCRIPTION:MISC PURCHASED SERVICES TOTAL FEES:147047 FORM 990 PART IX LINE 11G DESCRIPTION:PROFESSIONAL FEE-NON MD TOTAL FEES:126058 FORM 990 PART IX LINE 11G DESCRIPTION:CLEANING-CONTRACT SERVICE TOTAL FEES:117955 FORM 990 PART IX LINE 11G DESCRIPTION:MISCELLANEOUS TOTAL FEES:511863 MEDSTAR HEALTH ANESTHESIA SERVICES E LLC 18101 PRINCE PHILIP DRIVE OLNEY MD 20832 262918268 HEALTH SVCS MD 3013442 139228 NA 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 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