2019-05-10T14:13:18-05:00 2018-06-30 KPMG LLP 1676 INTERNATIONAL DRIVE McLean VA 22102 990 2017-07-01 520619006 ST MARYS HOSPITAL OF ST MARYS COUNTY INC % JOEL BRYAN STMA 3014756003 25500 POINT LOOKOUT ROAD LEONARDTOWN MD 20650 JOEL BRYAN VP/Treasurer 4107726721 2019-05-09 true JG WHITE P01498698 7032868000 2019-05-08 167.68.102.5 54028020191305000009 2019-05-10 P 15B4751D585BA6CEE5203BDFCD349B04D20DAE15 FC1242D0EC2D3B2AC8280BF1A124E85FEFEE16D6 2017 2019-02-21 02:37:17Z MEDSTAR ST MARY'S HOSPITAL CHRISTINE WRAY 25500 POINT LOOKOUT ROAD LEONARDTOWN MD 20650 179221553 false X WWW.STMARYSHOSPITALMD.ORG X 1912 MD MEDSTAR ST. MARY'S HOSPITAL UPHOLDS ITS TRADITION OF CARING BY CONTINUOUSLY PROMOTING, MAINTAINING AND IMPROVING HEALTH THROUGH EDUCATION AND SERVICE. 15 8 1259 155 0 0 1514351 578979 170007586 177355105 -327709 40057 1746041 1225281 172940269 179199422 7500000 0 0 0 81676218 76866768 0 0 547 79149231 85062748 168325449 161929516 4614820 17269906 114106366 116068024 18399672 19416551 95706694 96651473 X As a proud member of MedStar Health, MedStar St. Marys Hospitals (MedStar St. Marys) mission is to uphold its tradition of caring by continuously promoting, maintaining, and improving health through education and service while assuring quality care, patient safety and fiscal integrity. MedStar St. Marys is located in Leonardtown, Maryland, in the southern region. In fiscal year 2018, MSMH had had approximately 10,588 inpatient admissions and observation cases, and approximately 167,315 outpatient visits including 49,643 emergency visits. false false 97611583 173598273 MedStar St. Marys Hospitals largest program is access to and the provision of acute hospital services for communities of St. Marys County, Maryland and the surrounding areas. In addition to the program service expenses listed above, MedStar St. Marys incurred $49.6M of management and general expenses in providing services to its communities. MedStar St. Marys provides general, acute care services in medicine, surgery, obstetrics and gynecology, oncology, orthopaedics, pulmonary and cardiac rehabilitation, and psychiatry. The hospital offers kidney transplant services through the MedStar Georgetown Transplant Institute and orthopaedic services through the MedStar Orthopaedic Institute. It also provides hospice care and is partnered in a joint venture that provides home care. In addition to emergency room care, it operates an urgent care facility located 15 miles north of campus as well as on-campus and mobile community based health services. An outpatient pavilion includes cancer care and infusion services, imaging and womens health services, and community outreach and physician office space. Services also include a Center for Wound Healing. 11916861 3756832 MedStar St. Marys provided $11.9M 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 hospital outpatient services, womens and childrens services, behavioral health, and emergency and trauma services. 3359331 0 MedStar St. Marys provided $3.4M 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 St. Marys charity care expense. Other charity care expenses are indirectly reimbursed via the state of Marylands payment system. 112887775 true true false false false false false false false true true false false true true true false true false false false false false false true false true true false false true false false false false false true false false false false false false false true true true false false true 0 0 true 1259 true true true false false false false true true false false false false X 15 8 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 CHRISTINE WRAY PRESIDENT/DIRECTOR 20.0 20.0 X X 598576 598576 36278 KENNETH A SAMET DIRECTOR 1.0 39.0 X 0 6538888 82240 John Harvey MD DIRECTOR 39.0 1.0 X 840039 0 24063 AVANI SHAH MD DIRECTOR 39.0 1.0 X 600574 0 16001 CONOR F LUNDERGRAN MD DIRECTOR 39.0 1.0 X 499309 0 22622 BARBARA R THOMPSON CHAIR (UNTIL 10/17) 1.0 0.0 X 0 0 0 JANE H SYPHER VICE CHAIR (UNTIL 10/17) 1.0 0.0 X 0 0 0 MARY LEIGH HARLESS DIRECTOR (UNTIL 10/17) 1.0 0.0 X 0 0 0 TRACY HARRIS PHD DIRECTOR 1.0 0.0 X 0 0 0 JENNIFER BLAKE CHAIR 1.0 0.0 X 0 0 0 CHRISTINA L BROOM DIRECTOR 1.0 0.0 X 0 0 0 KRISHNA P JAYARAMAN MD DIRECTOR 40.0 0.0 X 227406 0 0 ANNA H CHOI MD DIRECTOR 40.0 0.0 X 465700 0 20794 Stephen A Schmeiser DIRECTOR 1.0 0.0 X 0 0 0 Karen T Garner DIRECTOR 1.0 0.0 X 0 0 0 Micheline Lopez-Estrada DIRECTOR 1.0 0.0 X 0 0 0 Frederick A Tepel DIRECTOR 1.0 0.0 X 0 0 0 Vince Whittles DIRECTOR 1.0 0.0 X 0 0 0 R Tomothy Storch DIRECTOR (UNTIL 10/17) 1.0 0.0 X 0 0 0 Richard Braam CFO (UNTIL 8/2017) 40.0 0.0 X 259286 0 23513 Stephen Michaels SECRETARY 39.0 1.0 X 721879 0 25290 DAN FEELEY INTERIM CFO (UNTIL 6/2018) 20.0 20.0 X 146444 146445 23804 CARRIE JENNISON CFO (AS OF 6/2018) 40.0 0.0 X 0 0 0 Mark Whitten PHYSICIAN 40.0 0.0 X 294019 0 13382 AMIR KHAN PHYSICIAN 40.0 0.0 X 514997 0 23783 Bruce Gibson PHYSICIAN 40.0 0.0 X 406270 0 24060 Amanda Lakusta PHYSICIAN 40.0 0.0 X 287289 0 703 Jean Pierre Elkhoury INTENSIVIST 40.0 0.0 X 411631 0 15855 6273419 7283909 352388 73 false true false AMN HEALTHCARE INC 2735 COLLECTION CENTER DR CHICAGO IL 60693 Staffing Services 4488840 MORRISON MANAGEMENT SPECIALISTS 400 northridge rd suite 600 ATLANTA GA 30350 FOOD SERVICES 1121165 Diversified Clinical Services Inc PO Box 636981 CINCINNATI OH 452636981 Medical Services 777520 COMPHEALTH MEDICAL STAFFING 1445 10 Norden Pl 200 NORWALK CA 06855 STAFFING SERVICES 703751 CERNER CORPORATION 51 Valley Stream Pkwy MALVERN PA 19355 MEDICAL SERVICES 584389 32 26605 292890 259484 16644 578979 NET PATIENT SERVICE REVENUE 621400 176206583 176206583 PHARMACY REVENUE 621400 1084824 1084824 OTHER OPERATING REVENUE 900099 63698 63698 177355105 41528 41528 0 0 230089 230089 0 230089 230089 13836 15037 13836 -15037 -1471 -1471 7100 26605 7094 6 6 0 0 0 0 0 0 0 REBATE INCOME 900099 364553 364553 GIFT SHOP AND VENDING INCOME 900099 83641 83641 EQUITY IN SUBSIDIARIES 900099 -121238 -121238 668230 668230 995186 179199422 177355105 0 1265338 0 0 0 0 0 4525512 3709484 816028 0 60521948 51445441 9076507 -385882 -385882 7681521 185883 7495638 4523669 3718718 804951 16710952 11243 16699709 8064 8064 0 0 0 0 15184964 10486894 4697925 145 493043 31878 461165 943727 674409 268916 402 0 0 836838 222371 614467 301431 239211 62220 0 50239 25452 24787 726363 726363 0 8482449 4244138 4238311 801152 668027 133125 MED/SURG SUPPLIES 23990044 23990044 IMPLANTS/PROSTHESES 4786717 4786717 MAINTENANCE 4058744 3498678 560066 UTILITIES 2159579 1821225 338354 5528442 3127962 2400480 161929516 112887775 49041194 547 982831 958141 0 0 479002 453543 21090043 18972829 0 0 0 0 0 0 3468620 3277501 2893072 4147219 161932182 85850541 75923962 76081641 756524 1354145 0 0 0 0 0 0 8512312 10823005 114106366 116068024 10773945 10334201 0 0 245516 228494 0 0 0 0 0 0 0 0 0 0 7380211 8853856 18399672 19416551 X 95593879 96538156 12815 13317 100000 100000 95706694 96651473 114106366 116068024 X 17269906 -14104 -16311023 X X false true X true false X 112815 502 113317 112723 92 112815 112689 34 112723 112651 38 112689 112554 97 112651 0.88200 0.11800 false false 5757222 5757222 89138443 38070463 51067980 626537 489735 136802 58556764 46317341 12239423 7853216 973002 6880214 76081641 INVESTMENTS IN CONSOLIDATED 5179610 INVESTMENTS IN UNCONSOLIDATED 3211464 PREPAID PENSION ASSET 2413417 INTERCOMPANY RECEIVABLES 15514 OTHER ASSETS 3000 10823005 0 ADVANCES 4682476 GBR LIABILITY 207028 CREDIT BALANCES PATIENT A/R 991830 OTHER SHORT TERM LIABILITIES 2418166 OTHER LONG TERM LIABILITIES 554356 8853856 X ENDOWMENT FUNDS SCHEDULE D, PART V THE ENDOWMENT IS USED TO FUND THE NEEDS OF THE HOSPITAL. FIN 48 FOOTNOTE SCHEDULE D, PART X INCOME TAXES ARE ACCOUNTED FOR UNDER THE ASSET AND LIABILITY METHOD. DEFERRED TAX ASSETS AND LIABILITIES ARE RECOGNIZED FOR THE FUTURE TAX CONSEQUENCES ATTRIBUTABLE TO DIFFERENCES BETWEEN THE FINANCIAL STATEMENT CARRYING AMOUNTS OF EXISTING ASSETS AND LIABILITIES AND THEIR RESPECTIVE TAX BASES AND OPERATING LOSS AND TAX CREDIT CARRYFORWARDS. DEFERRED TAX ASSETS AND LIABILITIES ARE MEASURED USING ENACTED TAX RATES EXPECTED TO APPLY TO TAXABLE INCOME IN THE YEARS IN WHICH THOSE TEMPORARY DIFFERENCES ARE EXPECTED TO BE RECOVERED OR SETTLED. THE EFFECT ON DEFERRED TAX ASSETS AND LIABILITIES OF A CHANGE IN TAX RATES IS RECOGNIZED IN THE PERIOD THAT INCLUDES THE ENACTMENT DATE. ANY CHANGES TO THE VALUATION ALLOWANCE ON THE DEFERRED TAX ASSET ARE REFLECTED IN THE YEAR OF CHANGE. THE CORPORATION ACCOUNTS FOR UNCERTAIN TAX POSITIONS IN ACCORDANCE WITH THE FASB ACCOUNTING STANDARDS CODIFICATION (ASC) TOPIC 740, INCOME TAXES. THERE WAS NO LIABILITY RECORDED FOR UNCERTAIN TAX POSITIONS AS OF JUNE 30, 2018. GOLF TOURNAMENT 33705 26605 7100 800 1001 1599 3318 376 0 33705 26605 7100 800 1001 1599 3318 376 7094 6 true true X true X true X true true false true true 3359331 3359331 0.02070 3359331 3359331 0.02070 1796611 43561 1753050 0.01080 205996 0 205996 0.00130 11916861 3756832 8160029 0.05040 77996 0 77996 0.00050 13997464 3800393 10197071 0.06300 17356795 3800393 13556402 0.08370 177830 177830 0.00110 2034275 2034275 0.01260 158 158 1161 1161 7195 7195 31070 31070 0.00020 467567 467567 0.00290 2719256 2719256 0.01680 true 4668792 true true 1 1 ST MARYS HOSPITAL OF ST MARYS COUNTY 25500 POINT LOOKOUT ROAD LEONARDTOWN MD 20650 X X X ST MARYS HOSPITAL OF ST MARYS COUNTY 1 false false true X X X X X X X X X 17 true false false true X HTTP://WWW.MEDSTARSTMARYS.ORG/ X true 17 true http://www.medstarstmarys.org/ false true X 200. 400. X X X X X X true true X X X X true X HTTP://WWW.MEDSTARSTMARYS.ORG/ X HTTP://WWW.MEDSTARSTMARYS.ORG/ X HTTP://WWW.MEDSTARSTMARYS.OR X X X X X X true X false X X X X true X false false CHNA INPUT PART V, SECTION B, LINE 5 HOSPITAL LEAD ROLE DESCRIPTION The Community Health Needs Assessment (CHNA) Hospital Lead serves as the coordinator of all aspects of the community health assessment process. He/she helps establish and coordinate the activities of the Advisory Task Force. The Lead also helps produce the hospital's Community Health Needs Assessment and Implementation Strategy. He/she works collaboratively with representatives from the Corporate Community Health Department and Georgetown University. The Lead also works closely with the writer. He/she reviews all narratives prior to publication. Name of Hospital Lead: Lori Werrell Executive Sponsor Role Description The Executive Sponsor serves as the conduit between the Advisory Task Force and the Senior Management Team. The sponsor is an active participant of the Advisory Task Force and he/she communicates the hospital's clinical strengths and program priorities to diverse audiences. Name of Executive Sponsor: STEPHEN T. MICHAELS, M.D. Advisory Task Force Role Description The Advisory Task Force (ATF) reviews primary/secondary data and local/state/federal community health goals. Based on findings, the ATF provides input into the hospital's three-year implementation strategy. As ambassadors for the CHNA process, the ATF members support efforts to optimize community participation. Note: The ATF should be a combination of community representatives and staff. Community representatives should makeup at least 50% of total participants. NAME TITLE NAME OF ORGANIZATION Bishop Spence Pastor Christian Church Lexington Park Christine Wray President MSMH Colenthia MalloY CEO Greater Baden Medical Center Debbie Baker/ Community Health Workers MSMH , AccessHealth Darryl Miles Dr. Elizabeth Morse Chief of Nursing Officer MSMH Dr. Fahmi Fahmi Physician, Pediatrics MSMH, Primary Care Dr. Connor Lundegran Chief of Medical Staff MedStar Cardiology Associates Ella Mae Russell Director St. Marys County Department of Social Services Gerard McGloin CEO Pathways Holly Meyer Director of Marketing MSMH John Greely Director, Performance MSMH Improvement Kathleen OBrien CEO Walden Sierra Behavioral Health Lanny Lancater CEO Three Oaks Shelter Lori Werrell Director, Population and MSMH Community Health Mary Leigh Harless Board Member, ATF MSMH Chairperson Meena Brewster, MD Health Officer St. Marys County Health Department Mike Brown Community Member Community Resident Nathaniel Scroggins President Minority Outreach Coalition member Quinton Lucas Physician, Family Practice MSMH, Primary Care Stephen Michaels, MD Executive Sponsor MSMH Chief Operating/ Medical Officer Tracey Harris Board Member, ATF College of Southern Co-Chair, Dean Maryland IMPLEMENTATION STRATEGIES PART V, SECTION B, LINE 11 THE IMPLEMENTATION STRATEGIES SERVE AS A ROADMAP FOR HOW COMMUNITY BENEFIT RESOURCES WILL BE ALLOCATED AND DEPLOYED. MEDSTAR'S HOSPITALS WILL BE ABLE TO MEASURE OUR CONTRIBUTION TO IMPROVING THE HEALTH OF UNDERSERVED AND VULNERABLE POPULATIONS IN THE REGIONS WE SERVE. THREE-YEAR IMPLEMENTATION STRATEGIES WITH MEASURABLE OBJECTIVES WERE DEVELOPED FOR EACH HOSPITAL'S COMMUNITY BENEFIT SERVICE AREA - A SPECIFIC COMMUNITY OR TARGET POPULATION OF FOCUS. PRIORITIES WERE BASED ON COMMUNITY NEED AS DETERMINED BY QUANTITATIVE DATA AND COMMUNITY INPUT, AS WELL AS ON HOSPITAL EXPERTISE, RESOURCES, STRENGTHS OF EXISTING PROGRAMMING AND PARTNERSHIPS, AND ALIGNMENT WITH NATIONAL, STATE, AND LOCAL HEALTH GOALS. THE MEDSTAR HEALTH CORPORATE COMMUNITY HEALTH DEPARTMENT WILL PROVIDE SYSTEM-WIDE COORDINATION AND OVERSIGHT OF COMMUNITY BENEFIT PROGRAMMING. HOSPITAL ADVISORY TASK FORCES CONVENE AT LEAST ANNUALLY TO MONITOR PROGRESS OF STRATEGY EXECUTION AND TO PROVIDE ONGOING RECOMMENDATIONS RELATED TO OUTCOMES ACHIEVEMENT, PROGRAM DEVELOPMENT, PARTNERSHIP APPROACHES, AND OVERALL IMPLEMENTATION IMPROVEMENT. FOR SIGNIFICANT NEEDS IDENTIFIED IN THE CHNA THAT THE HOSPITAL HAS NOT PRIORITIZED AS FOCUS AREAS THROUGH ITS IMPLEMENTATION STRATEGY, THESE NEEDS WILL BE ADDRESSED BY COLLABORATING WITH OTHER LEADING ORGANIZATIONS, AND BY TAKING A SUPPORTER ROLE ON IDENTIFIED NEEDS THAT ARE BEYOND THE SCOPE OF THE HOSPITALS STRENGTHS. CHARITY CARE AT COST PART I, LINE 7A MARYLAND'S REGULATORY SYSTEM CREATES A UNIQUE PROCESS FOR HOSPITAL PAYMENT THAT DIFFERS FROM THE REST OF THE NATION. THE HEALTH SERVICES COST REVIEW COMMISSION (HSCRC), DETERMINES PAYMENT THROUGH A RATE-SETTING PROCESS AND ALL PAYORS, INCLUDING GOVERNMENTAL PAYORS, PAY THE SAME AMOUNT FOR THE SAME SERVICES DELIVERED AT THE SAME HOSPITAL. MARYLAND'S UNIQUE ALL-PAYOR SYSTEM INCLUDES A METHOD FOR REFERENCING UNCOMPENSATED CARE IN EACH PAYORS' RATES, WHICH DOES NOT ENABLE MARYLAND HOSPITALS TO BREAKOUT ANY OFFSETTING REVENUE RELATED TO UNCOMPENSATED CARE. UNREIMBURSED MEDICAID PART I, LINE 7B MARYLAND'S REGULATORY SYSTEM CREATES A UNIQUE PROCESS FOR HOSPITAL PAYMENT THAT DIFFERS FROM THE REST OF THE NATION. THE HEALTH SERVICES COST REVIEW COMMISSION (HSCRC), DETERMINES PAYMENT THROUGH A RATE-SETTING PROCESS AND ALL PAYORS, INCLUDING GOVERNMENTAL PAYORS, PAY THE SAME AMOUNT FOR THE SAME SERVICES DELIVERED AT THE SAME HOSPITAL. MARYLAND'S UNIQUE ALL-PAYOR SYSTEM INCLUDES A METHOD FOR REFERENCING UNCOMPENSATED CARE IN EACH PAYORS' RATES, WHICH DOES NOT ENABLE MARYLAND HOSPITALS TO BREAKOUT ANY OFFSETTING REVENUE RELATED TO UNCOMPENSATED CARE. COMMUNITY BENEFIT EXPENSES ARE EQUAL TO MEDICAID REVENUES IN MARYLAND, AS SUCH, THE NET EFFECT IS ZERO. THE EXCEPTION TO THIS IS THE IMPACT ON THE HOSPITAL OF ITS SHARE OF THE MEDICAID ASSESSMENT. IN RECENT YEARS, THE STATE OF MARYLAND HAS CLOSED FISCAL GAPS IN THE STATE MEDICAID BUDGET BY ASSESSING HOSPITALS THROUGH THE RATE-SETTING SYSTEM. BAD DEBT PART III, LINES 2 & 4 MEDSTAR HEALTH AND ITS AFFILIATED ORGANIZATIONS REPORT BAD DEBT EXPENSE IN ACCORDANCE WITH ASU 2011-07, WHICH REQUIRES CERTAIN HEALTHCARE ENTITIES TO CHANGE THE PRESENTATION OF THEIR STATEMENT OF OPERATIONS BY RECLASSIFYING THE PROVISION FOR BAD DEBTS ASSOCIATED WITH PATIENT SERVICE REVENUE FROM AN OPERATING EXPENSE TO A DEDUCTION FROM PATIENT SERVICE REVENUE (NET OF CONTRACTUAL ALLOWANCES AND DISCOUNTS). HOWEVER, MEDSTAR AND ITS AFFILIATED ENTITIES DO NOT MAKE A DETERMINATION AS TO WHETHER SELF PAY AMOUNTS ARE COLLECTIBLE IN DETERMINING REVENUE RECOGNITION. RESERVE MODELS, WHICH HAVE BEEN DEVELOPED BASED ON HISTORICAL COLLECTION RESULTS AND WHICH ARE ADJUSTED PERIODICALLY BASED ON ACTUAL COLLECTIONS EXPERIENCE, ARE USED TO ESTIMATE UNCOLLECTIBLE AMOUNTS ACROSS ALL PAYORS INCLUDING SELF PAY. BAD DEBT DETERMINATIONS ARE MADE ONLY AFTER SUFFICIENT EVIDENCE IS OBTAINED TO SUPPORT THAT AN AMOUNT IS NOT COLLECTIBLE. MEDICARE PART III, LINE 8 MARYLAND'S REGULATORY SYSTEM CREATES A UNIQUE PROCESS FOR HOSPITAL PAYMENT THAT DIFFERS FROM THE REST OF THE NATION. THE HEALTH SERVICES COST REVIEW COMMISSION (HSCRC) DETERMINES PAYMENT THROUGH A RATE-SETTING PROCESS AND ALL PAYORS, INCLUDING GOVERNMENTAL PAYORS, PAY THE SAME AMOUNT FOR THE SAME SERVICES DELIVERED AT THE SAME HOSPITAL. MARYLAND'S UNIQUE ALL-PAYOR SYSTEM INCLUDES A METHOD FOR REFERENCING UNCOMPENSATED CARE IN EACH PAYORS' RATES, WHICH DOES NOT ENABLE MARYLAND HOSPITALS TO BREAKOUT ANY OFFSETTING REVENUE RELATED TO UNCOMPENSATED CARE. AS SUCH, THE NET EFFECT FOR MEDICARE EXPENSES AND REVENUES IN MARYLAND IS ZERO. PART III, LINE 9B IF IT IS DETERMINED THAT A PATIENT MAY POTENTIALLY QUALIFY FOR A CHARITABLE/FINANCIAL PROGRAM, A HOLD IS PLACED ON THE ACCOUNT TO PREVENT IT FROM BEING REPORTED AS BAD DEBT UNTIL PROGRAM APPROVALS HAVE BEEN OBTAINED. IF IT IS APPROVED, THE ACCOUNT IS DOCUMENTED AND THE NECESSARY ADJUSTMENTS ARE MADE TO CLOSE THE ACCOUNT. NEEDS ASSESSMENT PART VI, LINE 2 In FY18, MedStar St. Mary's Hospital (MSMH) conducted a Community Health Needs Assessment (CHNA) in accordance with the guidelines established by the Patient Protection and Affordable Care Act and the Internal Revenue Service. A 22 member Advisory Task Force (ATF) led the MSMH 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 Lexington Park as its Community Benefit Service Area (CBSA), which includes residents living in ZIP code 20653. The hospital selected this geographic area based on hospital utilization and secondary public health data as well as the fact that it has the greatest number of medically underserved citizens in the area, with approximately 9.1 percent of the population living below the federal poverty level. 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 (mental and behavioral health services, primary care services, dental services, transportation), social determinants of health (employment, housing). The hospital's FY18 CHNA and three-year Implementation Strategies were endorsed by MSMH 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 MSMH 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: St. Marys County is located on a peninsula in Southern Maryland with over 400 miles of shoreline on the Patuxent River, Potomac River and Chesapeake Bay. MedStar St.Marys Hospital, located in Leonardtown, Maryland, is the only acute care hospital in the county. The county is designated by the Bureau of Primary Care as a health professions shortage area for dental and mental health. The southern half of the county is designated as a primary care shortage area. The hospitals CBSA includes the 109,614 residents of St. Marys County, Maryland, with a focus on the Lexington Park community (ZIP code 20653). The Lexington Park community was selected due to a high density of low-income residents. Demographics: St. Marys County has a population of 110,675 citizens. St. Marys County is a state designated rural area with a diverse population. Farmers, waterman, high tech scientists, defense contractors/engineers and military members live alongside Amish and Mennonite communities, making the St. Marys County population unique. The residents of St. Marys County are majority White (79.2%), followed by Black/African American (14.1%), Hispanic (4.6%), Asian (2.7%), American Indian/Alaska Native (0.2%) and Native Hawaiian and other Pacific Islander (0.03%). St. Marys County has been the fastest growing county in Maryland within the past 10 years - with a population increase of 22% since 2000, and 4.3% growth in the last three years. The county also has the highest percentage of veterans in Maryland, one of the lowest median ages, and an emerging Hispanic population, all of which influence health and delivery of health services. Heart disease, cancer, lower respiratory illnesses, stroke and diabetes are the leading causes of death. Most residents (76.5%) work in the county. The high paying jobs associated with the Patuxent River Naval Air Station mask a growing underserved area located outside the base gates in the Lexington Park community (ZIP code 20653). With approximately 9.1% of the population living below the federal poverty level, Lexington Park has the greatest number of medically underserved citizens in the area. Approximately 11% (12,678 residents) of the St. Marys population lives in the Lexington Park Census Designated Place (CDP), which is the single largest center of population in the county, with a disproportionate number living in poverty or near poverty levels. The largest number of minorities (30.6% Black/African American and 9.8% Hispanic) live within this census tract. The median annual family income for Lexington Park is $68,818, as compared to the median annual family income in St. Marys County of $86,810. Certain census tracts within the Lexington Park area have a high concentration of poverty, with one having a median annual family income as low as $42,766. Lexington Park has a lower per capita income and a higher unemployment rate than the rest of St. Marys County, a combination contributing to the countys health disparities. U.S. Census Bureau, 2012-2016 American Community Survey 5-year estimates https://factfinder.census.gov/faces/tableservices/jsf/pages/productview.xh tml?src=CF PROMOTION OF COMMUNITY HEALTH PART VI, LINE 5 As a community partner, MSMH engages in a number of community benefit activities to improve and promote the health and wellbeing of the community. Priority areas of focus, as determined by the 2018 CHNA, are * Health and Wellness * Chronic disease prevention and Management * Conduct the Living Well Chronic Disease Self Management Program * Deliver the National Diabetes Prevention Program * Deliver Health Connections Programs including Parents to be, support groups, and diabetes and nutrition program * Behavioral Health * Substance Use Disorders: Expand the Screening, Brief Intervention, and Referral to treatment (SBIRT) program * Access to Care and Services * Mental Health Services * Offer Mindoula care coordination services to appropriate persons * Dental, Primary Care and Behavioral Health Services * Provide dental, primary care and behavioral health practices at the East Run location * Transportation (collaboration) * Provide appropriate medical transportation for qualified persons through partnerships and hospital resources * Social Needs Screening * Conduct social needs screenings and support linkages to social needs services as part of care coordination (community health workers), care delivery and chronic disease self management programming * Social Determinants of Health * Transportation (collaboration) * Provide appropriate medical transportation for qualified persons through partnerships and hospital resources * Employment * Conduct RX for Success summer intern program for underserved high school students * Housing (Participation) * Medical Respite for Homeless program AFFILIATED HEALTH CARE SYSTEM PART VI, LINE 6 As a proud member of MedStar Health, MSMH is able to expand its capacity to meet the needs of the community by partnering with other MedStar hospitals and associated entities. MedStar Health resources assist the hospital in community health planning to meet the needs of the uninsured and other vulnerable populations. Through its community health function, MedStar Health provides MSMH with technical support to enhance community health programming and evaluation. MedStars corporate philanthropy department identifies and seeks public and private funding sources to ensure the availability of high quality health services, regardless of ability to pay. STATE FILING OF COMMUNITY BENEFIT REPORT PART VI, LINE 7 The community benefit report for MedStar St. Marys Hospital is only filed in the state of Maryland. X X X X X X false false false false false false false false false CHRISTINE WRAY PRESIDENT/DIRECTOR 274948 274948 261984 261984 61644 61644 3975 3975 14164 14164 616715 616715 0 0 KENNETH A SAMET DIRECTOR 0 1818529 0 4346350 0 374009 0 49758 0 32482 0 6621128 0 0 John Harvey MD DIRECTOR 421139 0 407987 0 10913 0 7950 0 16113 0 864102 0 0 0 AVANI SHAH MD DIRECTOR 209422 0 388353 0 2799 0 7950 0 8051 0 616575 0 0 0 CONOR F LUNDERGRAN MD DIRECTOR 348724 0 108885 0 41700 0 6500 0 16122 0 521931 0 0 0 KRISHNA P JAYARAMAN MD DIRECTOR 227406 0 0 0 0 0 0 0 0 0 227406 0 0 0 ANNA H CHOI MD DIRECTOR 404946 0 56400 0 4354 0 7950 0 12844 0 486494 0 0 0 Richard Braam CFO (UNTIL 8/2017) 165493 0 72239 0 21554 0 7950 0 15563 0 282799 0 0 0 Stephen Michaels SECRETARY 416546 0 305333 0 0 0 7950 0 17340 0 747169 0 0 0 Mark Whitten PHYSICIAN 221431 0 0 0 72588 0 7950 0 5432 0 307401 0 0 0 AMIR KHAN PHYSICIAN 471497 0 43500 0 0 0 7950 0 15833 0 538780 0 0 0 Bruce Gibson PHYSICIAN 381272 0 24998 0 0 0 7950 0 16110 0 430330 0 0 0 Amanda Lakusta PHYSICIAN 287289 0 0 0 0 0 531 0 172 0 287992 0 0 0 Jean Pierre Elkhoury INTENSIVIST 391631 0 20000 0 0 0 0 0 15855 0 427486 0 0 0 DAN FEELEY INTERIM CFO (UNTIL 6/2018) 120225 120225 26219 26220 0 0 3975 3975 7927 7927 158346 158347 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. Christine Wrays compensation is for services provided as President to both MedStar Southern Maryland Hospital Center and MedStar St. Marys Hospital. Dan Feeley's compensation is for services provided as Interim CFO to both MedStar Southern Maryland Hospital Center and MedStar St. Mary's Hospital. BURCH OIL CO INC SEE PART V 380445 HEATING SERVICES false BUSINESS TRANSACTIONS INVOLVING INTERESTED PERSONS SCHEDULE L, PART IV BURCH OIL CO., INC. IS A SUBSTANTIAL CONTRIBUTOR (IN EXCESS OF $5,000) THAT ALSO PROVIDED HEATING SERVICES TO THE HOSPITAL VALUED AT $380,445. PER THE CONFLICT OF INTEREST POLICY, ALL TRANSACTIONS BETWEEN THE HOSPITAL AND OUTSIDE VENDORS SHOULD BE AT ARMS-LENGTH FOR FAIR MARKET VALUE. ORGANIZATION MEMBERS PART VI, LINE 6 THE ORGANIZATION IS AN AFFILIATE AND SUBSIDIARY OF MEDSTAR HEALTH, INC., A TAX-EXEMPT MARYLAND NON-STOCK CORPORATION. MEDSTAR HEALTH, INC., OR ONE OF ITS AFFILIATES AND SUBSIDIARIES, IS THE SOLE MEMBER OF THE ORGANIZATION. DESCRIPTION OF MEMBERS PART VI, LINE 7A AS AN AFFILIATE AND SUBSIDIARY OF MEDSTAR HEALTH, INC., A TAX-EXEMPT MARYLAND NON-STOCK CORPORATION, THE ORGANIZATION MAY RECOMMEND PERSON(S) FOR MEMBERSHIP ON THE ORGANIZATION'S GOVERNING BODY. ANY SUCH RECOMMENDATION BY THE ORGANIZATION IS SUBJECT TO APPROVAL BY THE GOVERNANCE COMMITTEE OF THE BOARD OF DIRECTORS OF MEDSTAR HEALTH, INC. THE BOARD OF MEDSTAR HEALTH, INC. HAS DELEGATED CERTAIN APPROVAL AUTHORITY TO THE GOVERNANCE COMMITTEE AND THE PRESIDENT & CEO OF MEDSTAR HEALTH, INC. DECISIONS OF GOVERNING BODY PART VI, LINE 7B AS AN AFFILIATE AND SUBSIDIARY OF MEDSTAR HEALTH, INC., A TAX-EXEMPT MARYLAND NON-STOCK CORPORATION, THE BYLAWS OF THE ORGANIZATION ARE SUBJECT TO CERTAIN RESERVED POWERS, WHICH PROVIDE THAT THE SOLE MEMBER OF THE ORGANIZATION MUST APPROVE CERTAIN DECISIONS, INCLUDING BUT NOT LIMITED TO MATTERS CONCERNING THE SALE OR PURCHASE OF REAL OR PERSONAL PROPERTY, CAPITAL BUDGETS, STRATEGIC PLANNING, INVESTMENTS, AND CORPORATE GOVERNANCE. PROCESS FOR REVIEWING FORM 990 PART VI, LINE 11B THE PROCESS FOR REVIEWING THE FORM 990 INCLUDED EDUCATION AND TRANSPARENCY. SENIOR FINANCIAL EXECUTIVES, WORKING WITH INDEPENDENT OUTSIDE EXPERTS, THOROUGHLY REVIEWED FORM 990 AND ACCOMPANYING INSTRUCTIONS. IN ADDITION, SENIOR EXECUTIVES REVIEWED THE RELEVANT SECTIONS OF THE FORM 990 WITH THE FOLLOWING COMMITTEES OF THE ORGANIZATION'S GOVERNING BODY: FINANCE, AUDIT, GOVERNANCE, STRATEGIC PLANNING, AND EXECUTIVE COMPENSATION. FOLLOWING THESE MEETINGS, THE GOVERNING BODY WAS PROVIDED A COPY OF THE FORM 990 IN ITS FINAL FORM AND GIVEN AN OPPORTUNITY TO PROVIDE ANY INPUT OR COMMENTS RELATING TO THE FORM 990 PRIOR TO ITS FILING. CONFLICT OF INTEREST POLICY PART VI, LINE 12C APPOINTMENT OF BOARDS OF DIRECTORS MEDSTAR HEALTH (AND ITS SUBSIDIARIES) REQUIRE ALL NOMINATED DIRECTORS, PRIOR TO THEIR APPOINTMENT OR ELECTION, TO DISCLOSE THE EXISTENCE OF (OR POTENTIAL EXISTENCE OF) ANY TRANSACTION WITH MEDSTAR THAT WOULD RESULT IN A CONFLICT OF INTEREST. SUCH DISCLOSURES (IF ANY) ARE REVIEWED BY THE GOVERNANCE COMMITTEE OF THE MEDSTAR HEALTH BOARD OF DIRECTORS WHICH DETERMINES HOW THE MATTER SHOULD BE RESOLVED. ANNUAL DISCLOSURES - ALL OFFICERS, DIRECTORS, AND SENIOR MANAGERS ALL OFFICERS, DIRECTORS AND SENIOR MANAGERS ARE REQUIRED, NOT LESS THAN ANNUALLY, TO COMPLETE A SURVEY OF QUESTIONS CONCERNING ANY TRANSACTIONS OR RELATIONSHIPS WHICH WOULD OR COULD REPRESENT A CONFLICT OF INTEREST. SUCH DISCLOSURES (IF ANY) ARE REVIEWED BY THE GOVERNANCE COMMITTEE OF THE MEDSTAR HEALTH BOARD OF DIRECTORS WHICH DETERMINES HOW THE MATTER SHOULD BE RESOLVED. EXECUTIVE COMPENSATION PROCESS PART VI, LINE 15 THE EXECUTIVE COMPENSATION COMMITTEE OF THE BOARD OF DIRECTORS OF MEDSTAR HEALTH, INC. (THE "COMMITTEE") HAS OVERSIGHT OVER THE EXECUTIVE COMPENSATION PROGRAM (THE "PROGRAM") OF MEDSTAR HEALTH, INC. AND ITS AFFILIATES. TOTAL COMPENSATION FOR THE TOP MANAGEMENT OFFICIALS, OFFICERS AND KEY EMPLOYEES OF MEDSTAR HEALTH, INC. AND ITS AFFILIATES ARE REVIEWED AND APPROVED BY THE COMMITTEE WITH ASSISTANCE AND GUIDANCE FROM AN INDEPENDENT THIRD PARTY ADVISOR. THE MEMBERS OF THE COMMITTEE ARE INDEPENDENT FROM ALL OF THE PARTICIPANTS IN THE PROGRAM. THE MAIN OBJECTIVE OF THE PROGRAM IS TO PROVIDE MARKET COMPETITIVE TOTAL COMPENSATION THAT IS INTERNALLY EQUITABLE AND HAS A STRONG PAY-FOR-PERFORMANCE LINKAGE. PERFORMANCE IS EVALUATED AT THE SYSTEM, OPERATING UNIT, AND INDIVIDUAL LEVELS. THE OVERALL TOTAL COMPENSATION PHILOSOPHY IS MANAGED AT THE 75TH PERCENTILE OF THE COMPETITIVE MARKET FOR COMPARABLE SIZE (NET REVENUE) AND TYPE (TAX-EXEMPT HEALTHCARE ORGANIZATIONS). WHERE APPROPRIATE, ADDITIONAL INDUSTRY DATA IS CONSIDERED (GENERAL BUSINESS AND/OR TAXABLE HEALTHCARE) FOR SELECTED POSITIONS THAT CAN BE RECRUITED FROM OR POTENTIALLY LOST TO THESE INDUSTRIES (E.G., INFORMATION TECHNOLOGY, FINANCE, ETC.). THE COMMITTEE HAS ENGAGED ERNST & YOUNG LLP ("E&Y") TO SERVE AS AN ADVISOR ON THE REASONABLENESS AND COMPETITIVENESS OF THE PROGRAM. IN DETERMINING REASONABLENESS AND COMPETITIVENESS, E&Y REVIEWS MARKET PRACTICES AND TRENDS, AND MAKES RECOMMENDATIONS RELATED TO THE PROGRAM. E&Y UTILIZES INFORMATION FROM CUSTOM SURVEYS, NATIONAL COMPENSATION SURVEYS, PROPRIETARY DATABASES, AND CLIENT EXPERIENCES TO DETERMINE ITS FINAL RECOMMENDATIONS. E&Y PRESENTS THEIR FINDINGS AND RECOMMENDATIONS TO THE COMMITTEE. THE COMMITTEE MAKES THE FINAL DECISIONS ON ALL OF THE COMPENSATION DETERMINATIONS OF THE PROGRAM. ALL DECISIONS MADE BY THE COMMITTEE ARE CONTEMPORANEOUSLY DOCUMENTED. FINANCIAL STATEMENT AVAILABILITY PART VI, LINE 19 MEDSTAR HEALTH POSTS ITS ANNUAL FINANCIAL AUDIT AND QUARTERLY FINANCIAL REPORTS TO THE ELECTRONIC MUNICIPAL MARKET ACCESS (EMMA) SYSTEM. THE ORGANIZATION ALSO E-MAILS ITS ANNUAL AND QUARTERLY DISCLOSURES TO HOLDERS OF THE COMPANY'S PUBLICLY TRADED DEBT. THE COMPANY'S GOVERNANCE DOCUMENTS AND CONFLICTS OF INTEREST POLICIES ARE AVAILABLE UPON REQUEST THROUGH ITS CORPORATE (OR AS APPLICABLE ENTITY) PUBLIC INFORMATION OFFICES. OTHER CHANGES IN NET ASSETS PART XI, LINE 9 EQUITY TRANSFERS...............................$(19,856,780) MINIMUM PENSION LIABILITY ADJUSTMENT............$ 2,413,417 ACCUMULATED NET ASSETS..........................$ 1,132,340 ============= TOTAL $(16,311,023) FINANCIAL STATEMENTS AND REPORTING PART XII, LINE 2 ST. MARYS HOSPITAL OF ST. MARYS COUNTY INC. IS AN AFFILIATE OF THE MEDSTAR HEALTH, INC. AUDIT AND SUBJECT TO OVERSIGHT BY THE AUDIT COMMITTEE OF THE MEDSTAR BOARD. 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