2019-05-14T18:34:38-05:00 2018-06-30 GRANT THORNTON LLP 2001 MARKET STREET SUITE 700 PHILADELPHIA PA 19103 990 2017-07-01 520679694 Chester River Hospital Center Inc % JOANNE R HAHEY SVP AND CFO CHES 4108221000 100 Brown Street Chestertown MD 21620 JOANNE HAHEY CFO 4108221000 2019-05-14 true Frank Giardini P00532355 2155614200 2019-05-15 209.220.136.124 23695320191345000052 2019-05-14 P 6C78E5C2C9CFDA217BB1DC8554CE16A03C3903FC 8368FFE12CE24C0281507B4769D0368EE4BA05B9 2017 2019-02-21 02:37:17Z UMD Shore Medical Ctr at Chestertown Kenneth D Kozel 100 Brown Street Chestertown MD 21620 65780115 false X https://www.umms.org/shore X 1935 MD SEE SCHEDULE O. 23 18 302 114 1926427 -598162 423288 482641 54586618 55450237 512432 601715 380460 481833 55902798 57016426 0 0 0 0 17642706 16134598 0 0 0 31650990 33376448 49293696 49511046 6609102 7505380 79383661 85447757 19507121 16992556 59876540 68455201 CHESTER RIVER HOSPITAL CENTER (CRHC) IS AN ACUTE CARE HOSPITAL THAT SERVES THE RESIDENTS OF KENT AND QUEEN ANNE'S COUNTIES AND PORTIONS OF CAROLINE AND CECIL COUNTIES. false false 45835381 0 53596165 CRHC (DOING BUSINESS AS UNIVERSITY OF MARYLAND SHORE MEDICAL CENTER AT CHESTERTOWN) IS A 21-BED HOSPITAL. IT IS SERVED BY APPROXIMATELY 200 ACTIVE AND CONSULTING STAFF PHYSICIANS REPRESENTING A WIDE ARRAY OF MEDICAL SPECIALTIES. THE COMMUNITY HOSPITAL, WHICH IS FULLY ACCREDITED BY THE JOINT COMMISSION ON ACCREDITATION OF HEALTHCARE ORGANIZATIONS, PROVIDES INPATIENT MEDICAL SERVICES, 24-HOUR EMERGENCY CARE, SURGICAL SERVICES, OUTPATIENT DIAGNOSTIC SERVICES, LABORATORY SERVICES, REHABILITATION, AND ONCOLOGY TO SERVE THE LOCAL COMMUNITY'S NEEDS. THE HOSPITAL WAS ESTABLISHED IN 1935. IT IS STAFFED BY APPROXIMATELY 320 EMPLOYEES. 45835381 true true false true false false false false false false true true false true true true false true false false false false false false false false true true false false true false false false false false false false false false false false false false true false false false true 0 0 true 302 true true true false false false false false false false false false X 23 18 false false false false true true true true true false false true true true true true true false false false MD X JOANNE R HAHEY SVP AND CFO 4108221000 219 SOUTH WASHINGTON ST EASTON MD 21601 X John Dillon Chairman 1.0 21.0 X X 0 144588 0 Richard Loeffler Vice Chairman 1.0 3.0 X X 0 0 0 Marlene Feldman Secretary 1.0 3.0 X X 0 0 0 Wayne L Gardner Sr Treasurer 1.0 3.0 X X 0 0 0 John W Ashworth Director 1.0 49.0 X 0 822679 36514 Myra S Butler Director 1.0 3.0 X 0 0 0 Charles Capute Director 1.0 3.0 X 0 0 0 Art Cecil III Director 1.0 3.0 X 0 0 0 Robert A Chrencik Director 1.0 54.0 X 0 2590028 25019 Joseph J Ciotola MD Director 1.0 3.0 X 0 0 0 Kathy Deoudes Director 1.0 3.0 X 0 0 0 J Wayne Howard Director 1.0 3.0 X 0 0 0 Michael D Joyce MD Director 1.0 3.0 X 0 0 0 Ona Kareiva MD Director 1.0 3.0 X 0 0 0 Charles Macleod Director 1.0 3.0 X 0 0 0 Keith McMahan Director 1.0 3.0 X 0 0 0 David Milligan Director 1.0 3.0 X 0 0 0 William B Noll Director 1.0 4.0 X 0 0 0 Geoff Oxnam Director 1.0 3.0 X 0 0 0 Stephen Satchell Director 1.0 3.0 X 0 0 0 Thomas Stauch MD Director 1.0 3.0 X 0 0 0 Glenn L Wilson Director 1.0 3.0 X 0 0 0 Kenneth D Kozel President and CEO 20.0 25.0 X X 0 625460 19466 JoAnne R Hahey SVP Finance and CFO 20.0 25.0 X 0 367822 63544 Deborah Pippin Site Coordinator 40.0 0.0 X 126789 0 12291 Kenneth Peregoy Clinical Pharmacist 40.0 0.0 X 125024 0 12460 Stewart Seitz Dir. Shore Nursing & Rehab. 40.0 0.0 X 120926 0 9338 Radine Haynes RN 40.0 0.0 X 112547 0 12736 Robin Parker SH Administrative Supervisor 40.0 0.0 X 109318 0 14401 Scott Burleson Former SVP and COO 0.0 0.0 X 0 143295 18054 594604 4693872 223823 9 true true false MD Emergency Medical Network 110 S Paca Street BALTIMORE MD 21201 Physician Svcs 3128527 Tidewater Anesthesia Association PO Box 824639 PHILADELPHIA PA 19182 Anesthesia Svcs 1040448 Healthcare Services Group PO Box 829677 PHILADELPHIA PA 19182 Environmental Svcs 549612 Management Health Systems 1580 Sawgrass Corp Parkway SUNRISE FL 33323 Medical Staffing 270843 Chestertown Physical Therapy 818 High Street CHESTERTOWN MD 21620 Phys. Therapy 262917 13 452641 30000 482641 PATIENT SERVICE REVENUE 623000 55450237 53523810 1926427 55450237 81767 81767 0 0 328023 328023 0 328023 328023 8198552 1085085 7825057 938632 373495 146453 519948 519948 0 0 0 0 0 0 0 0 0 CAFETERIA SALES 722514 77349 77349 MEDICAL RECORDS 900099 19888 19888 MISC REVENUE 900099 72355 72355 -15782 -15782 153810 57016426 53596165 1926427 1011193 0 0 0 0 0 0 12566189 11284438 1281751 1437804 1291148 146656 1188196 1067000 121196 942409 846283 96126 0 0 0 3424 3424 0 0 18927328 17674973 1252355 925 831 94 174586 156778 17808 0 0 1403098 1259982 143116 11654 10465 1189 0 1588 1426 162 179612 161292 18320 0 4279561 3843046 436515 438212 365769 72443 MEDICAL SUPPLIES 4467715 4467715 BAD DEBT EXPENSE 2660214 2660214 REPAIRS & MAINTENANCE 432917 388759 44158 FOOD/NUTRITION SUPPLIES 160533 144159 16374 235081 211103 23978 49511046 45835381 3675665 0 0 12636581 226419 227000 0 0 2207402 6265941 0 0 0 0 0 0 695988 672166 20020 47757 55368675 34738297 25256880 20630378 6361000 7709000 10643000 11383457 0 0 0 0 33972952 25875477 79383661 85447757 7800718 4802896 0 0 13533 31851 0 0 0 0 0 0 0 0 0 0 11692870 12157809 19507121 16992556 X 55912852 63998584 2667677 3160606 1296011 1296011 59876540 68455201 79383661 85447757 X 7505380 628398 444883 X false true X true X false false false false false false false false true 3424 3424 false OTHER ACTIVITIES SCHEDULE C, PART II-B, LINE 1I THE ORGANIZATION PAYS MEMBERSHIP DUES TO THE MARYLAND HOSPITAL ASSOCIATION (MHA) AND THE AMERICAN HOSPITAL ASSOCIATION (AHA). MHA AND AHA ENGAGE IN MANY SUPPORT ACTIVITIES INCLUDING LOBBYING AND ADVOCATING FOR THEIR MEMBER HOSPITALS. THE MHA AND AHA REPORTED THAT 6.6% AND 22.98% OF MEMBER DUES WERE USED FOR LOBBYING PURPOSES AND AS SUCH, THE ORGANIZATION HAS REPORTED THIS AMOUNT ON SCHEDULE C PART II-B AS LOBBYING ACTIVITIES. 417951 417951 35769350 21737296 14032054 18195934 12077536 6118398 985440 923465 61975 20630378 ALTERNATIVE INVESTMENTS 11383457 F 11383457 SELF INSURANCE 10349655 ECONOMIC INTEREST IN FND. 7573888 ASSETS LIMITED TO USE 4214707 OTHER RECEIVABLES 3737227 25875477 0 MALPRACTICE 4226300 DUE TO UMMS 3880185 MINIMUM PENSION LIABILITY 1698418 ENVIRONMENTAL REMEDIATION 1167061 ADVANCES FROM THIRD PARTY PAYORS 620350 OTHER - CREDIT PAT AR 564141 OTHER - CURRENT LIABILITIES 1354 12157809 X LIABILITY FOR UNCERTAIN TAX POSITION (ASC 740) SCHEDULE D, PART X, LINE 2 THE ORGANIZATION IS A SUBSIDIARY OF THE UNIVERSITY OF MARYLAND MEDICAL SYSTEM CORPORATION (THE CORPORATION). THE CORPORATION ADOPTED THE PROVISIONS OF ASC 740, ACCOUNTING FOR UNCERTAINTY IN THE INCOME TAXES (FIN 48) ON JULY 1, 2007. THE FOOTNOTE RELATED TO ASC 740 IN THE CORPORATION'S AUDITED FINANCIAL STATEMENTS IS AS FOLLOWS: THE CORPORATION FOLLOWS A THRESHOLD OF MORE-LIKELY-THAN-NOT FOR RECOGNITION AND DERECOGNITION OF TAX POSITIONS TAKEN OR EXPECTED TO BE TAKEN IN A TAX RETURN. MANAGEMENT DOES NOT BELIEVE THAT THERE ARE ANY UNRECOGNIZED TAX LIABILITIES OR BENEFITS THAT SHOULD BE RECOGNIZED. true true true X true X true true false true true 338594 338594 0.00720 338594 338594 0.00720 210448 210448 0.00450 10217347 2857525 7359822 0.15710 9381 9381 0.00020 10437176 2857525 7579651 0.16180 10775770 2857525 7918245 0.16900 4088 4088 0.00010 9866 9866 0.00020 15229 15229 0.00030 4690 4690 0.00010 33873 33873 0.00070 true 1896278 24330709 17014062 7316647 X true true 1 1 CHESTER RIVER HOSPITAL CENTER 100 BROWN STREET CHESTERTOWN MD 21620 www.umms.org/shore 14-002 X X X 1 CHESTER RIVER HOSPITAL CENTER 1 false false true X X X X X X X X X 15 true true false true X WWW.UMMS.ORG/SHORE true 15 true WWW.UMMS.ORG/SHORE false true X 200. 300. X X X X X true true X X X true X www.umms.org/shore X www.umms.org/shore X www.umms.org/shore X X X X X X true X false X X X X true X false false CHESTER RIVER HOSPITAL CENTER SCHEDULE H, PART V, SECTION B, LINE 5 UM SHORE REGIONAL HEALTH (UMSRH) CONDUCTED A COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) FOR THE FIVE COUNTIES OF MARYLAND'S MID-SHORE: TALBOT, CAROLINE, QUEEN ANNE'S, DORCHESTER, AND KENT. THE HEALTH NEEDS OF OUR COMMUNITY WERE IDENTIFIED THROUGH A PROCESS WHICH INCLUDED COLLECTING AND ANALYZING PRIMARY AND SECONDARY DATA. IN PARTICULAR, THE CHNA INCLUDES PRIMARY DATA FROM TALBOT, CAROLINE, DORCHESTER, KENT, QUEEN ANNE'S HEALTH DEPARTMENTS AND THE COMMUNITY AT LARGE. ADDITIONALLY, UMSRH IS A PARTICIPATING MEMBER OF THE MID-SHORE SHIP COALITION, WHERE WE ARE PARTNERING WITH OTHER COMMUNITY STAKEHOLDERS INVESTED IN IMPROVING THE COMMUNITY'S OVERALL HEALTH. MEMBERS OF THE MID-SHORE SHIP COALITION INCLUDE COMMUNITY LEADERS, COUNTY GOVERNMENT REPRESENTATIVES, LOCAL NON-PROFIT ORGANIZATIONS, LOCAL HEALTH PROVIDERS, AND MEMBERS OF THE BUSINESS COMMUNITY. FEEDBACK FROM CUSTOMERS INCLUDES DATA COLLECTED FROM SURVEYS, ADVISORY GROUPS AND FROM OUR COMMUNITY OUTREACH AND EDUCATION SESSIONS. SECONDARY DATA RESOURCES REFERENCED TO IDENTIFY COMMUNITY HEALTH NEEDS INCLUDE COUNTY HEALTH RANKINGS (HTTP://WWW.COUNTYHEALTHRANKINGS.ORG), MARYLAND DEPARTMENT OF HEALTH AND MENTAL HYGIENE'S STATE HEALTH IMPROVEMENT PROCESS (SHIP) (HTTP://DHMH.MARYLAND.GOV/SHIP/), THE MARYLAND CHARTBOOK OF MINORITY HEALTH AND MINORITY HEALTH DISPARITIES (HTTP://DHMH.MARYLAND.GOV/MHHD/DOCUMENTS/2NDRESOURCE_2009.PDF) UMSRH PARTICIPATES ON THE UNIVERSITY OF MARYLAND MEDICAL SYSTEM (UMMS) COMMUNITY HEALTH IMPROVEMENT COMMITTEE (TO STUDY DEMOGRAPHICS, ASSESS COMMUNITY HEALTH DISPARITIES, INVENTORY RESOURCES AND ESTABLISH COMMUNITY BENEFIT GOALS FOR BOTH CRHC AND UMMS). UMSRH CONSULTED WITH COMMUNITY PARTNERS AND ORGANIZATIONS TO DISCUSS COMMUNITY NEEDS RELATED TO HEALTH IMPROVEMENT AND ACCESS TO CARE. THE FOLLOWING LIST OF PARTNER AGENCIES MEETS ON A QUARTERLY BASIS AS MEMBERS OF THE MID-SHORE SHIP COALITION: -CHOPTANK COMMUNITY HEALTH SYSTEMS, DR. JONATHAN MOSS, CMO -CAROLINE COUNTY MINORITY OUTREACH TECHNICAL ASSISTANCE, JANET FOUNTAIN. PROGRAM MANAGER -TALBOT COUNTY LOCAL MANAGEMENT BOARD DONNA HACKER, EXECUTIVE DIRECTOR -PARTNERSHIP FOR DRUG FREE DORCHESTER, SANDY WILSON, PROGRAM DIRECTOR -CAROLINE COUNTY COMMUNITY REPRESENTATIVE, MARGARET JOPP, FAMILY NURSE PRACTITIONER -EASTERN SHORE AREA HEALTH EDUCATION CENTER, JAKE FREGO, EXECUTIVE DIRECTOR -KENT COUNTY MINORITY OUTREACH TECHNICAL ASSISTANCE, DORA BEST, PROGRAM COORDINATOR -YMCA OF THE CHESAPEAKE, DEANNA HARRELL, EXECUTIVE DIRECTOR -UNIVERSITY OF MD EXTENSION, SARA RICH, EXECUTIVE DIRECTOR -KENT COUNTY LOCAL MANAGEMENT BOARD, HOPE CLARK, EXECUTIVE DIRECTOR -KENT COUNTY DEPARTMENT OF JUVENILE SERVICES, WILLIAM CLARK, DIRECTOR -COALITION AGAINST TOBACCO USE, CAROLYN BROOKS, MEMBER -MT. OLIVE AME CHURCH, REV. MARY WALKER -MID-SHORE MENTAL HEALTH SYSTEMS, HOLLY IRELAND LCSW-C, EXECUTIVE DIRECTOR -ASSOCIATED BLACK CHARITIES, ASHYRIA DOTSON, PROGRAM DIRECTOR -QUEEN ANNE COUNTY HOUSING AND FAMILY SERVICES, MIKE CLARK, EXECUTIVE DIRECTOR -QUEEN ANNE COUNTY HEALTH DEPARTMENT, JOSEPH CIOTOLA MD -DORCHESTER COUNTY HEALTH DEPARTMENT, ROGER L. HARRELL, HEALTH OFFICER -TALBOT COUNTY HEALTH DEPARTMENT, THOMAS MCCARTY, HEALTH OFFICER -CAROLINE COUNTY HEALTH DEPARTMENT, DR. LELAND SPENCER, HOUSE OFFICER -UMC AT EASTON, KATHLEEN MCGRATH, REGIONAL DIRECTOR OF OUTREACH -UMC AT CHESTERTOWN, CINDY BACH, DIRECTOR TRANSITIONS IN CARE UMSRH HOSTED A SERIES OF COMMUNITY LISTENING FORUMS TO GATHER COMMUNITY INPUT FOR A REGIONALIZATION STUDY THAT EXPLORES THE BENEFITS OF A REGIONAL APPROACH TO PROVIDING HEALTH CARE FOR CAROLINE, DORCHESTER, KENT, QUEEN ANNE'S AND TALBOT COUNTIES. IN ADDITION, SHORE HEALTH MEETS QUARTERLY WITH MEMBERS OF THE LOCAL HEALTH DEPARTMENTS AND COMMUNITY LEADERS, INCLUDING: CHOPTANK COMMUNITY HEALTH SYSTEM JOSEPH SHEEHAN HEALTH DEPARTMENTS HEALTH OFFICERS MID SHORE MENTAL HEALTH SYSTEMS HOLLY IRELAND EASTERN SHORE HOSPITAL CENTER RANDY BRADFORD IN ADDITION, THE FOLLOWING AGENCIES/ORGANIZATIONS ARE REFERENCED IN GATHERING INFORMATION AND DATA: -MARYLAND DEPARTMENT OF HEALTH AND MENTAL HYGIENE -MARYLAND DEPARTMENT OF PLANNING -MARYLAND VITAL STATISTICS ADMINISTRATION -HEALTHSTREAM, INC. -COUNTY HEALTH RANKINGS -MID SHORE COMPREHENSIVE ECONOMIC DEVELOPMENT STRATEGY CEDS OUR CHNA IDENTIFIED THE FOLLOWING LIST OF PRIORITIES FOR OUR COMMUNITY: 1. CANCER 2. OBESITY 3. ACCESS TO CARE 4. BEHAVIORAL HEALTH 5. DIABETES MARYLAND HEALTH CARE COMMISSION (MHCC) RURAL HEALTH STUDY DURING THE 2016 LEGISLATIVE SESSION, SENATE BILL 707 FREESTANDING MEDICAL FACILITIES- CERTIFICATE OF NEED, RATES AND DEFINITION (SB 707), PASSED INTO LAW AND WAS SIGNED BY THE GOVERNOR ON MAY 10, 2016. THE LEGISLATION ESTABLISHED A WORKGROUP ON RURAL HEALTH CARE DELIVERY TO OVERSEE A STUDY OF HEALTHCARE DELIVERY IN THE MIDDLE SHORE REGION AND TO DEVELOP A PLAN FOR MEETING THE HEALTH CARE NEEDS OF THE FIVE COUNTIES - CAROLINE, DORCHESTER, KENT, QUEEN ANNE'S AND TALBOT. THE PURPOSE OF THE STUDY WAS TO ASSESS THE HEALTH CARE OF THE RESIDENTS OF THE FIVE-COUNTY STUDY AREA AND THE CAPACITIES OF THE HEALTH SYSTEM IN THE REGION, AND PROPOSE OPTIONS FOR ENHANCING HEALTH AND HEALTH CARE DELIVERY ON THE MID-SHORE. THE RESEARCH TEAM WAS ASKED TO CONSIDER: (1) THE LIMITED AVAILABILITY OF HEALTH CARE PROVIDERS AND SERVICES; (2) THE SPECIAL NEEDS OF VULNERABLE POPULATIONS, INCLUDING THE FRAIL AND ELDERLY, RACIAL AND ETHNIC MINORITIES, IMMIGRANTS AND PATIENTS WITH PERSISTENT BEHAVIORAL ILLNESSES; (3) BARRIERS TO ACCESS CAUSED BY TRANSPORTATION LIMITATIONS; AND (4) THE ECONOMIC IMPACT OF CLOSURES, PARTIAL CLOSURES OR CONVERSIONS OF HEALTH CARE FACILITIES. THE SUMMARY REPORT PROVIDES HIGHLIGHTS OF FINDINGS FROM ALL COMPONENTS OF THE STUDY AND INTEGRATES THEM INTO KEY RECOMMENDATIONS. METHODS AND FINDINGS ARE DETAILED FOR REVIEW AT: HTTP://MHCC.MARYLAND.GOV/MHCC/PAGES/HOME/WORKGROUPS/DOCUMENTS/RURAL_HEALTH /SEPTEMBER%2025TH%202017%20MEETING/LGSRPT_20EXECUTIVESUMMARY_RPT_20170928 .PDF UMMS IN PARTNERSHIP WITH UMSRH AS MEMBERS OF THE RURAL HEALTH CARE DELIVERY WORKGROUP PRODUCED A WHITE PAPER, COMMITMENT TO MEETING THE HEALTH CARE NEEDS OF OUR VULNERABLE RURAL COMMUNITIES. THIS PAPER EXPLORES CONCERNS ABOUT THE UNIQUE NEEDS OF RURAL HOSPITALS AND COMMUNITIES AND CAN BE ACCESSED AT: HTTP://MHCC.MARYLAND.GOV/MHCC/PAGES/HOME/WORKGROUPS/DOCUMENTS/RURAL_HEALTH /JULY%2025TH%202017%20MEETING/LGSRPT_SHORE_WHITE_PAPER_RPT20170523.PDF CHNA CONDUCTED WITH OTHER HOSPITAL FACILITIES SCHEDULE H, PART V, LINE 6A UMSRH CONDUCTED A CHNA FOR THE UMSRH NETWORK WHICH SERVES THE MID-SHORE REGION, UNIVERSITY OF MARYLAND SHORE MEDICAL CENTER AT CHESTERTOWN (SMC AT CHESTERTOWN), CRHC, DOING BUISNESS AS THE UNIVERSITY OF MARYLAND SHORE MEDICAL CENTER AT DORCHESTER (SMC AT DORCHESTER), AND THE UNIVERSITY OF MARYLAND SHORE MEDICAL CENTER AT EASTON (SMC AT EASTON). SIGNIFICANT NEEDS ADDRESSED IN CHNA SCHEDULE H, PART V, LINE 11 ALL PRIMARY HEALTH NEEDS ARE BEING ADDRESSED TO THE EXTENT THAT AVAILABLE RESOURCES AND CLINICAL EXPERTISE ALLOW. THE COMMUNITY BENEFITS PLAN IS ABLE TO ADEQUATELY ADDRESS HEART DISEASE, CANCER, DIABETES, HYPERTENSION, HIGH CHOLESTEROL, ISSUES ASSOCIATED WITH AGING POPULATION. NUTRITION, WEIGHT MANAGEMENT/OBESITY IS ADDRESSED THROUGH EDUCATIONAL CLASSES AND/OR SEMINARS. TOBACCO USE/SMOKING AND ALCOHOL/BINGE DRINKING/UNDERAGE DRINKING ARE BEING ADDRESSED BY OTHER COUNTY AGENCIES AND ORGANIZATIONS AND THROUGH PARTNERSHIPS, INCLUDING THE COUNTY HEALTH DEPARTMENTS. UMSRH HOSPITALS DO NOT POSSESS THE RESOURCES AND EXPERTISE REQUIRED FOR ENVIRONMENTAL HEALTH CONCERNS AND ISSUES. MENTAL HEALTH IS BEING ADDRESSED THROUGH THE MID-SHORE MENTAL HEALTH SYSTEMS, INC., WHICH IS A PRIVATE, NOT-FOR-PROFIT ORGANIZATION SERVING THE FIVE MID-SHORE COUNTIES: CAROLINE, DORCHESTER, KENT, QUEEN ANNE'S AND TALBOT. SEVERAL ADDITIONAL TOPIC AREAS WERE IDENTIFIED BY THE COMMUNITY HEALTH PLANNING COUNCIL INCLUDING: SAFE HOUSING, TRANSPORTATION, AND SUBSTANCE ABUSE. THE UNMET NEEDS NOT ADDRESSED BY SMC AT EAsTON, SMC AT DORCHESTER, SMC AT CHESTERTOWN WILL CONTINUE TO BE ADDRESSED BY KEY GOVERNMENTAL AGENCIES AND EXISTING COMMUNITY- BASED ORGANIZATIONS. WHILE SHORE REGIONAL HEALTH HOSPITALS WILL FOCUS THE MAJORITY OF OUR EFFORTS ON THE IDENTIFIED PRIORITIES OUTLINED IN THE CHNA ACTION PLAN, WE WILL REVIEW THE COMPLETE SET OF NEEDS IDENTIFIED IN THE CHNA FOR FUTURE COLLABORATION AND WORK. THESE AREAS, WHILE STILL IMPORTANT TO THE HEALTH OF THE COMMUNITY, WILL BE MET THROUGH OTHER HEALTH CARE ORGANIZATIONS WITH OUR ASSISTANCE AS AVAILABLE. ELIGIBILITY CRITERIA FOR FINANCIAL ASSISTANCE SCHEDULE H, PART V, LINE 13B THE FINANCIAL ASSISTANCE POLICY EXPLAINS SEVERAL ELIGIBILITY CRITERIA, INCLUDING PARTICIPATION IN MEDICAID/MEDICARE PROGRAMS AS WELL AS ELIGIBILITY UNDER VARIOUS STATE REGULATIONS. IN ADDITION TO FPG, THE INCOME LEVELS DEFINED BY THE MARYLAND STATE DEPARTMENT OF HEALTH AND MENTAL HYGIENE (MD DHMH) ARE USED TO DETERMINE ELIGIBILITY FOR FINANCIAL ASSISTANCE. THE MD DHMH INCOME LEVELS ARE MORE GENEROUS THAn THE FPG INCOME LEVELS. HOSPITAL EFFORTS BEFORE INITIATING ACTION SCHEDULE H, PART V, LINE 20C IN THE CASE OF AN INCOMPLETE FAP APPLICATION, PATIENTS ARE NOT AUTOMATICALLY DENIED. A LETTER IS MAILED TO THE PATIENT REQUESTING THE MISSING DOCUMENTATION, AND FAP APPLICATIONS ARE APPROVED ONCE THE MISSING DOCUMENTATION IS PROVIDED. CRITERIA FOR FREE OR DISCOUNTED CARE SCHEDULE H, PART I, LINE 3C CRHC IS COMMITTED TO PROVIDING FINANCIAL ASSISTANCE TO PERSONS WHO HAVE HEALTH CARE NEEDS AND ARE UNINSURED, UNDERINSURED, INELIGIBLE FOR A GOVERNMENT PROGRAM, OR OTHERWISE UNABLE TO PAY, FOR MEDICALLY NECESSARY CARE BASED ON THEIR INDIVIDUAL FINANCIAL SITUATION. IN ADDITION TO FPG, THE INCOME LEVELS DEFINED BY THE MARYLAND STATE DEPARTMENT OF HEALTH AND MENTAL HYGIENE (MD DHMH) ARE USED TO DETERMINE ELIGIBILITY FOR FINANCIAL ASSISTANCE. THE MD DHMH INCOME LEVELS ARE MORE GENEROUS THAN THE FPG INCOME LEVELS. THE FAP ALSO USES A FINANCIAL HARDSHIP THRESHOLD WHEN DETERMINING ELIGIBILITY. A PATIENT WITH MEDICAL DEBT EXCEEDING 25% OF FAMILY ANNUAL HOUSEHOLD INCOME MAY BE ELIGIBLE FOR FINANCIAL ASSISTANCE. SCHEDULE H, PART I, LINE 6B THE ORGANIZATION ANNUALLY FILES A COMMUNITY BENEFIT REPORT AS REQUIRED BY THE MARYLAND HSCRC. THE REPORT CAN BE FOUND AT HTTPS://HSCRC.STATE.MD.US/PAGES/INIT_CB.ASPX. COSTING METHODOLOGY SCHEDULE H, PART I, LINE 7 MARYLAND'S REGULATORY SYSTEM CREATES A UNIQUE PROCESS FOR HOSPITAL PAYMENT THAT DIFFERS FROM THE REST OF THE NATION. THE HEALTH SERVICES COST REVIEW COMMISSION, (HSCRC) DETERMINES PAYMENT THROUGH A RATE SETTING PROCESS AND ALL PAYORS, INCLUDING GOVERNMENTAL PAYORS, PAY THE SAME AMOUNT FOR THE SAME SERVICES DELIVERED AT THE SAME HOSPITAL. MARYLAND'S UNIQUE ALL PAYOR SYSTEM INCLUDES A METHOD FOR REFERENCING UNCOMPENSATED CARE IN EACH PAYORS' RATES, WHICH DOES NOT ENABLE MARYLAND HOSPITALS TO BREAKOUT ANY OFFSETTING REVENUE RELATED TO UNCOMPENSATED CARE. COMMUNITY BENEFIT EXPENSES ARE EQUAL TO MEDICAID REVENUES IN MARYLAND, AS SUCH, THE NET EFFECT IS ZERO. ADDITIONALLY, NET REVENUES FOR MEDICAID SHOULD REFLECT THE FULL IMPACT ON THE HOSPITAL OF ITS SHARE OF THE MEDICAID ASSESSMENT. COMMUNITY BUILDING ACTIVITIES SCHEDULE H, PART II THROUGH A VARIETY OF COMMUNITY BUILDING ACTIVITIES, CRHC PROMOTES HEALTH AND WELLNESS IN THE COMMUNITY IT SERVES. THESE ACTIVITIES INCLUDE: ACTIVE ENGAGEMENT AND COLLABORATION WITH LOCAL HEALTH DEPARTMENTS, CHAMBERS OF COMMERCE, AND ORGANIZATIONS THAT WORK TO IMPROVE THE QUALITY OF LIFE FOR THE RESIDENTS OF THE MID-SHORE (TALBOT, CAROLINE, DORCHESTER, QUEEN ANNES, AND KENT COUNTIES) BECAUSE LOCAL ACTION IS ESSENTIAL TO PUBLIC HEALTH PROGRESS, CRHC IS A KEY STAKEHOLDER IN THE MID-SHORE HEALTH IMPROVEMENT COALITION, A PARTNERSHIP OF PUBLIC SECTOR AGENCIES, HEALTH CARE PROVIDERS AND COMMUNITY-BASED PARTNERS. THE COALITION WAS FORMED IN DECEMBER 2011 IN RESPONSE TO A STATEWIDE HEALTH IMPROVEMENT PROCESS (SHIP). IN ADDITION TO PROVIDING THE COALITION WITH LEADERSHIP, A VARIETY OF CLINICAL AND NON-CLINICAL CRHC ASSOCIATES SERVE ON VARIOUS COALITION WORKGROUPS. THE WORK OF THE COALITION BEGAN BY REVIEWING AND PRIORITIZING OBJECTIVES IDENTIFIED BY THE MARYLAND DEPARTMENT OF HEALTH AND MENTAL HYGIENES (DHMH) SHIP. SHIP, LAUNCHED IN SEPTEMBER 2011, FOCUSES ON IMPROVING THE HEALTH OF MARYLAND RESIDENTS IN SIX VISION AREAS: HEALTHY BABIES, HEALTHY SOCIAL ENVIRONMENTS, SAFE PHYSICAL ENVIRONMENTS, INFECTIOUS DISEASE, CHRONIC DISEASE AND HEALTH CARE ACCESS. UNDER SHIPS UMBRELLA, THE COALITION DEVELOPS AND IMPLEMENTS STRATEGIES THAT WILL IMPROVE LOCAL PUBLIC HEALTH. THE COALITION DECIDED TO FOCUS ON THREE HEALTH PRIORITIES: (1) ADOLESCENT OBESITY, (2) ADOLESCENT TOBACCO USE, AND (3) DIABETES RELATED EMERGENCY DEPARTMENT VISITS. THE COALITION FORMULATED AN ACTION PLAN THAT ARTICULATES SPECIFIC GOALS AND STRATEGIES FOR THE THREE HEALTH PRIORITIES. THROUGH COALITION WORKGROUPS AND COMMITTEES, REPRESENTATIVES FROM THE MID-SHORE COLLABORATE TO ASSESS LOCAL HEALTH NEEDS AND SERVICES; SHARE DATA AND OTHER RESOURCES; EXPLORE EVIDENCE-BASED HEALTH PRACTICES; AND ACQUIRE SUPPORT TO ENHANCE AND INITIATE HEALTH PROGRAMS THAT IMPACT TARGETED POPULATIONS AND COMMUNITIES. THE COALITION PLANS TO EFFECTIVELY LEVERAGE AND UTILIZE NEW AND EXISTING RESOURCES TO MEASURABLY IMPROVE THE HEALTH STATUS OF THE RESIDENTS OF THE MID-SHORE. IN ADDITION TO BEING AN INTEGRAL PART OF THE MID-SHORE HEALTH IMPROVEMENT COALITION, CRHC CONTINUES TO MAINTAIN OPEN COMMUNICATION WITH THE HEALTH DEPARTMENTS OF TALBOT, CAROLINE, DORCHESTER, QUEEN ANNES, AND KENT COUNTIES, MID-SHORE MENTAL HEALTH SYSTEM, CHOPTANK COMMUNITY HEALTH SYSTEM, LOCAL GOVERNMENT AND SCHOOLS. CRHC'S COMMUNITY OUTREACH PROGRAMS CAN BE FOUND IN COUNTY SCHOOLS, SENIOR CENTERS, COMMUNITY CENTERS AND CHURCHES THROUGHOUT THE MID-SHORE. CRHC'S DIRECTOR OF COMMUNITY OUTREACH PARTICIPATES IN COMMITTEES AND ADVISORY COUNCILS, PROMOTING CONTINUOUS DIALOGUE BETWEEN THE MEDICAL CENTER AND COMMUNITY STAKEHOLDERS. THIS PROVIDES OPPORTUNITIES FOR NEW IDEAS AND PROGRAMS TO BE EXCHANGED, ALLOWING UMSRH TO MAXIMIZE COMMUNITY OUTREACH EFFORTS. CRHC SEEKS INSIGHT FROM COMMUNITY MEMBERS ATTENDING EDUCATIONAL PROGRAMS THROUGH ITS OUTREACH EVENTS. PROGRAM PARTICIPANTS ARE ASKED TO COMPLETE A BRIEF SURVEY EVALUATION, PROVIDING FEEDBACK AND COMMENTS ABOUT THE PROGRAM THEY ATTENDED, AS WELL AS PROVIDING SUGGESTIONS FOR FUTURE PROGRAM TOPICS. BAD DEBT EXPENSE REPORTING IN MARYLAND SCHEDULE H, PART III, LINE 2 AND 3 THE HEALTH SERVICES COST REVIEW COMMISSION (HSCRC) STARTED SETTING HOSPITAL RATES IN 1974. AT THAT TIME, THE HSCRC APPROVED RATES APPLIED ONLY TO COMMERCIAL INSURERS. IN 1977, THE HSCRC NEGOTIATED A WAIVER FROM MEDICARE HOSPITAL PAYMENT RULES FOR MARYLAND HOSPITALS TO BRING THE FEDERAL MEDICARE PAYMENTS UNDER HSCRC CONTROL. IN 2014, MARYLAND'S WAIVER WITH MEDICARE WAS RENEGOTIATED AND UPDATED TO REFLECT THE CURRENT HEALTHCARE ENVIRONMENT. UNDER THIS NEW WAIVER, SEVERAL CRITERIA WERE ESTABLISHED TO MONITOR THE SUCCESS OF THE SYSTEM IN CONTROLLING HEALTHCARE COSTS AND THE CONTINUANCE OF THE WAIVER ITSELF: 1. REVENUE GROWTH PER CAPITA 2. MEDICARE HOSPITAL REVENUE PER BENEFICIARY 3. MEDICARE ALL PROVIDER REVENUE GROWTH PER BENEFICIARY 4. MEDICARE READMISSION RATES 5. HOSPITAL ACQUIRED CONDITION RATE BECAUSE OF THIS SYSTEM, THE HOSPITAL IS UNABLE TO ESTIMATE HOW MUCH OF THE AMOUNT REPORTED IN LINE 2 IS ATTRIBUTED TO PATIENTS WHO WOULD APPLY UNDER THE FAP. FOOTNOTE FOR BAD DEBT EXPENSE IN AUDITED FINANCIAL STATEMENTS SCHEDULE H, PART III, LINE 4 THE CORPORATION RECORDS REVENUES AND ACCOUNTS RECEIVABLE FROM PATIENTS AND THIRD-PARTY PAYORS AT THEIR ESTIMATED NET REALIZABLE VALUE. REVENUE IS REDUCED FOR ANTICIPATED DISCOUNTS UNDER CONTRACTUAL ARRANGEMENTS AND FOR CHARITY CARE. AN ESTIMATED PROVISION FOR BAD DEBTS IS RECORDED IN THE PERIOD THE RELATED SERVICES ARE PROVIDED BASED UPON ANTICIPATED UNCOMPENSATED CARE, AND IS ADJUSTED AS ADDITIONAL INFORMATION BECOMES AVAILABLE. THE PROVISION FOR BAD DEBTS IS BASED UPON MANAGEMENT'S ASSESSMENT OF HISTORICAL AND EXPECTED NET COLLECTIONS CONSIDERING HISTORICAL BUSINESS AND ECONOMIC CONDITIONS, TRENDS IN HEALTHCARE COVERAGE, AND OTHER COLLECTION INDICATORS. PERIODICALLY THROUGHOUT THE YEAR, MANAGEMENT ASSESSES THE ADEQUACY OF THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS BASED UPON HISTORICAL WRITE-OFF EXPERIENCE BY PAYOR CATEGORY. THE RESULTS OF THIS REVIEW ARE THEN USED TO MAKE MODIFICATIONS TO THE PROVISION FOR BAD DEBTS AND TO ESTABLISH AN ALLOWANCE FOR UNCOLLECTIBLE RECEIVABLES. AFTER COLLECTION OF AMOUNTS DUE FROM INSURERS, THE CORPORATION FOLLOWS INTERNAL GUIDELINES FOR PLACING CERTAIN PAST DUE BALANCES WITH COLLECTION AGENCIES. FOR RECEIVABLES ASSOCIATED WITH SERVICES PROVIDED TO PATIENTS WHO HAVE THIRD-PARTY COVERAGE, THE CORPORATION ANALYZES CONTRACTUALLY DUE AMOUNTS AND PROVIDES AN ALLOWANCE FOR BAD DEBTS, ALLOWANCE FOR CONTRACTUAL ADJUSTMENTS, PROVISION FOR BAD DEBTS, AND CONTRACTUAL ADJUSTMENTS ON ACCOUNTS FOR WHICH THE THIRD-PARTY PAYOR HAS NOT YET PAID OR FOR PAYORS WHO ARE KNOWN TO BE HAVING FINANCIAL DIFFICULTIES THAT MAKE THE REALIZATION OF AMOUNTS DUE UNLIKELY. FOR RECEIVABLES ASSOCIATED WITH SELF-PAY PATIENTS OR WITH BALANCES REMAINING AFTER THE THIRD-PARTY COVERAGE HAD ALREADY PAID, THE CORPORATION RECORDS A SIGNIFICANT PROVISION FOR BAD DEBTS IN THE PERIOD OF SERVICE ON THE BASIS OF ITS HISTOrICAL COLLECTIONS, WHICH INDICATES THAT MANY PATIENTS ULTIMATELY DO NOT PAY THE PORTION OF THEIR BILL FOR WHICH THEY ARE FINANCIALLY RESPONSIBLE. THE DIFFERENCE BETWEEN THE DISCOUNTED RATES AND THE AMOUNTS COLLECTED AFTER ALL REASONABLE COLLECTION EFFORTS HAVE BEEN EXHAUSTED IS CHARGED AGAINST THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. MEDICARE COST REPORT SCHEDULE H, PART III, LINE 8 THE ORGANIZATION FILES ANNUALLY A COMMUNITY BENEFIT REPORT WITH THE STATE OF MARYLAND'S HEALTH SERVICES COST REVIEW COMMISSION (HSCRC). THE HSCRC, WHICH OPERATES UNDER A MEDICARE WAIVER, DOES NOT CONSIDER MEDICARE SHORTFALL AS COMMUNITY BENEFIT. THE COSTING METHODOLOGY USED BY THE ORGANIZATION IS A COST-TO-CHARGE RATIO. COLLECTION PRACTICES SCHEDULE H, PART III, LINE 9B THE ORGANIZATION EXPECTS PAYMENT AT THE TIME THE SERVICE IS PROVIDED. OUR POLICY IS TO COMPLY WITH ALL STATE AND FEDERAL LAW AND THIRD PARTY REGULATIONS AND TO PERFORM ALL CREDIT AND COLLECTION FUNCTIONS IN A DIGNIFIED AND RESPECTFUL MANNER. EMERGENCY SERVICES WILL BE PROVIDED TO ALL PATIENTS REGARDLESS OF ABILITY TO PAY. FINANCIAL ASSISTANCE IS AVAILABLE FOR PATIENTS BASED ON FINANCIAL NEED AS DEFINED IN THE FINANCIAL ASSISTANCE POLICY. THE ORGANIZATION DOES NOT DISCRIMINATE ON THE BASIS OF AGE, RACE, CREED, SEX OR ABILITY TO PAY. PATIENTS WHO ARE UNABLE TO PAY MAY REQUEST A FINANCIAL ASSISTANCE APPLICATION AT ANY TIME PRIOR TO SERVICE OR DURING THE BILLING AND COLLECTION PROCESS, EVEN IN EXCESS OF 240 DAYS FOLLOWING THE FIRST POST-DISCHARGE BILLING STATEMENT. THE ORGANIZATION MAY REQUEST THE PATIENT TO APPLY FOR MEDICAL ASSISTANCE PRIOR TO APPLYING FOR FINANCIAL ASSISTANCE. THE ACCOUNT WILL NOT BE FORWARDED FOR COLLECTION DURING THE MEDICAL ASSISTANCE APPLICATION PROCESS OR THE FINANCIAL ASSISTANCE APPLICATION PROCESS. NO EXTRAORDINARY COLLECTION ACTIONS (ECAS) WILL OCCUR EARLIER THAN 120 DAYS FROM SUBMISSION OF FIRST BILL TO THE PATIENT AND WILL BE PRECEDED BY NOTICE 30 DAYS PRIOR TO COMMENCEMENT OF THE ACTION. AVAILABILITY OF FINANCIAL ASSISTANCE WILL BE COMMUNICATED TO THE PATIENT AND A PRESUMPTIVE ELIGIBILITY REVIEW WILL OCCUR PRIOR TO ANY ACTION BEING TAKEN. IF A PATIENT IS DETERMINED TO BE ELIGIBLE FOR FINANCIAL ASSISTANCE AFTER AN ECA IS INITIATED, THE ORGANIZATION WILL TAKE REASONABLE MEASURES TO REVERSE THE ECAS AGAINST THE PATIENT ACCOUNT. COMMUNITY HEALTH NEEDS ASSESSMENT SCHEDULE H, PART VI, LINE 2 UMSRH CONDUCTED A CHNA FOR THE FIVE COUNTIES OF MARYLAND'S MID-SHORE: TALBOT, CAROLINE, QUEEN ANNE'S, DORCHESTER, AND KENT. THE HEALTH NEEDS OF OUR COMMUNITY WERE IDENTIFIED THROUGH A PROCESS WHICH INCLUDED COLLECTING AND ANALYZING PRIMARY AND SECONDARY DATA. IN PARTICULAR, THE CHNA INCLUDES PRIMARY DATA FROM TALBOT, CAROLINE, DORCHESTER, KENT, QUEEN ANNE'S HEALTH DEPARTMENTS AND THE COMMUNITY AT LARGE. ADDITIONALLY, UMSRH IS A PARTICIPATING MEMBER OF THE MID-SHORE SHIP COALITION, WHERE WE ARE PARTNERING WITH OTHER COMMUNITY STAKEHOLDERS INVESTED IN IMPROVING THE COMMUNITY'S OVERALL HEALTH. MEMBERS OF THE MID-SHORE SHIP COALITION INCLUDE COMMUNITY LEADERS, COUNTY GOVERNMENT REPRESENTATIVES, LOCAL NON-PROFIT ORGANIZATIONS, LOCAL HEALTH PROVIDERS, AND MEMBERS OF THE BUSINESS COMMUNITY. FEEDBACK FROM CUSTOMERS INCLUDES DATA COLLECTED FROM SURVEYS, ADVISORY GROUPS AND FROM OUR COMMUNITY OUTREACH AND EDUCATION SESSIONS. SECONDARY DATA RESOURCES REFERENCED TO IDENTIFY COMMUNITY HEALTH NEEDS INCLUDE COUNTY HEALTH RANKINGS (HTTP://WWW.COUNTYHEALTHRANKINGS.ORG), MARYLAND DEPARTMENT OF HEALTH AND MENTAL HYGIENE'S STATE HEALTH IMPROVEMENT PROCESS (SHIP) (HTTP://DHMH.MARYLAND.GOV/SHIP/), THE MARYLAND CHARTBOOK OF MINORITY HEALTH AND MINORITY HEALTH DISPARITIES (HTTP://DHMH.MARYLAND.GOV/MHHD/DOCUMENTS/2NDRESOURCE_2009.PDF) UMSRH PARTICIPATES ON THE UMMS COMMUNITY HEALTH IMPROVEMENT COMMITTEE (TO STUDY DEMOGRAPHICS, ASSESS COMMUNITY HEALTH DISPARITIES, INVENTORY RESOURCES AND ESTABLISH COMMUNITY BENEFIT GOALS FOR BOTH UMSRH AND UMMS. UMSRH CONSULTED WITH COMMUNITY PARTNERS AND ORGANIZATIONS TO DISCUSS COMMUNITY NEEDS RELATED TO HEALTH IMPROVEMENT AND ACCESS TO CARE. THE FOLLOWING LIST OF PARTNER AGENCIES MEETS ON A QUARTERLY BASIS AS MEMBERS OF THE MID-SHORE SHIP COALITION: -CHOPTANK COMMUNITY HEALTH SYSTEMS, DR. JONATHAN MOSS, CMO -CAROLINE COUNTY MINORITY OUTREACH TECHNICAL ASSISTANCE, JANET FOUNTAIN. PROGRAM MANAGER -TALBOT COUNTY LOCAL MANAGEMENT BOARD DONNA HACKER, EXECUTIVE DIRECTOR -PARTNERSHIP FOR DRUG FREE DORCHESTER, SANDY WILSON, PROGRAM DIRECTOR -CAROLINE COUNTY COMMUNITY REPRESENTATIVE, MARGARET JOPP, FAMILY NURSE PRACTITIONER -EASTERN SHORE AREA HEALTH EDUCATION CENTER, JAKE FREGO, EXECUTIVE DIRECTOR -KENT COUNTY MINORITY OUTREACH TECHNICAL ASSISTANCE, DORA BEST, PROGRAM COORDINATOR -YMCA OF THE CHESAPEAKE, DEANNA HARRELL, EXECUTIVE DIRECTOR -UNIVERSITY OF MD EXTENSION, SARA RICH, EXECUTIVE DIRECTOR -KENT COUNTY LOCAL MANAGEMENT BOARD, HOPE CLARK, EXECUTIVE DIRECTOR -KENT COUNTY DEPARTMENT OF JUVENILE SERVICES, WILLIAM CLARK, DIRECTOR -COALITION AGAINST TOBACCO USE, CAROLYN BROOKS, MEMBER -MT. OLIVE AME CHURCH, REV. MARY WALKER -MID- SHORE MENTAL HEALTH SYSTEMS, HOLLY IRELAND LCSW-C, EXECUTIVE DIRECTOR -ASSOCIATED BLACK CHARITIES, ASHYRIA DOTSON, PROGRAM DIRECTOR -QUEEN ANNE COUNTY HOUSING AND FAMILY SERVICES, MIKE CLARK, EXECUTIVE DIRECTOR -QUEEN ANNE COUNTY HEALTH DEPARTMENT, JOSEPH CIOTOLA MD -DORCHESTER COUNTY HEALTH DEPARTMENT, ROGER L. HARRELL, HEALTH OFFICER -TALBOT COUNTY HEALTH DEPARTMENT, THOMAS MCCARTY, HEALTH OFFICER -CAROLINE COUNTY HEALTH DEPARTMENT, DR. LELAND SPENCER, HOUSE OFFICER -UMC AT EASTON, KATHLEEN MCGRATH, REGIONAL DIRECTOR OF OUTREACH -UMC AT CHESTERTOWN, CINDY BACH, DIRECTOR TRANSITIONS IN CARE UMSRH HOSTED A SERIES OF COMMUNITY LISTENING FORUMS TO GATHER COMMUNITY INPUT FOR A REGIONALIZATION STUDY THAT EXPLORES THE BENEFITS OF A REGIONAL APPROACH TO PROVIDING HEALTH CARE FOR CAROLINE, DORCHESTER, KENT, QUEEN ANNE'S AND TALBOT COUNTIES. IN ADDITION, SHORE HEALTH MEETS QUARTERLY WITH MEMBERS OF THE LOCAL HEALTH DEPARTMENTS AND COMMUNITY LEADERS, INCLUDING: -CHOPTANK COMMUNITY HEALTH SYSTEM, JOSEPH SHEEHAN -HEALTH DEPARTMENTS- HEALTH OFFICERS -MID SHORE MENTAL HEALTH SYSTEMS, HOLLY IRELAND -EASTERN SHORE HOSPITAL CENTER, RANDY BRADFORD IN ADDITION, THE FOLLOWING AGENCIES/ORGANIZATIONS ARE REFERENCED IN GATHERING INFORMATION AND DATA: -MARYLAND DEPARTMENT OF HEALTH AND MENTAL HYGIENE -MARYLAND DEPARTMENT OF PLANNING -MARYLAND VITAL STATISTICS ADMINISTRATION -HEALTHSTREAM, INC. -COUNTY HEALTH RANKINGS -MID SHORE COMPREHENSIVE ECONOMIC DEVELOPMENT STRATEGY CEDS OUR CHNA IDENTIFIED THE FOLLOWING LIST OF PRIORITIES FOR OUR COMMUNITY: 1. CANCER 2. OBESITY 3. ACCESS TO CARE 4. BEHAVIORAL HEALTH 5. DIABETES MARYLAND HEALTH CARE COMMISSION (MHCC) RURAL HEALTH STUDY DURING THE 2016 LEGISLATIVE SESSION, SENATE BILL 707 FREESTANDING MEDICAL FACILITIES- CERTIFICATE OF NEED, RATES AND DEFINITION (SB 707), PASSED INTO LAW AND WAS SIGNED BY THE GOVERNOR ON MAY 10, 2016. THE LEGISLATION ESTABLISHED A WORKGROUP ON RURAL HEALTH CARE DELIVERY TO OVERSEE A STUDY OF HEALTHCARE DELIVERY IN THE MIDDLE SHORE REGION AND TO DEVELOP A PLAN FOR MEETING THE HEALTH CARE NEEDS OF THE FIVE COUNTIES -- CAROLINE, DORCHESTER, KENT, QUEEN ANNE'S AND TALBOT. THE PURPOSE OF THE STUDY WAS TO ASSESS THE HEALTH CARE OF THE RESIDENTS OF THE FIVE-COUNTY STUDY AREA AND THE CAPACITIES OF THE HEALTH SYSTEM IN THE REGION, AND PROPOSE OPTIONS FOR ENHANCING HEALTH AND HEALTH CARE DELIVERY ON THE MID-SHORE. THE RESEARCH TEAM WAS ASKED TO CONSIDER: (1) THE LIMITED AVAILABILITY OF HEALTH CARE PROVIDERS AND SERVICES; (2) THE SPECIAL NEEDS OF VULNERABLE POPULATIONS, INCLUDING THE FRAIL AND ELDERLY, RACIAL AND ETHNIC MINORITIES, IMMIGRANTS AND PATIENTS WITH PERSISTENT BEHAVIORAL ILLNESSES; (3) BARRIERS TO ACCESS CAUSED BY TRANSPORTATION LIMITATIONS; AND (4) THE ECONOMIC IMPACT OF CLOSURES, PARTIAL CLOSURES OR CONVERSIONS OF HEALTH CARE FACILITIES. THE SUMMARY REPORT PROVIDES HIGHLIGHTS OF FINDINGS FROM ALL COMPONENTS OF THE STUDY AND INTEGRATES THEM INTO KEY RECOMMENDATIONS. METHODS AND FINDINGS ARE DETAILED FOR REVIEW AT: HTTP://MHCC.MARYLAND.GOV/MHCC/PAGES/HOME/WORKGROUPS/DOCUMENTS/RURAL_HEALTh SEPTEMBER%2025TH%202017%20MEETING/LGSRP_%20EXECUTIVESUMMARY_RPT_20170928. PDF THE UMMS SYSTEM IN PARTNERSHIP WITH UMSRH AS MEMBERS OF THE RURAL HEALTH CARE DELIVERY WORKGROUP PRODUCED A WHITE PAPER, COMMITMENT TO MEETING THE HEALTH CARE NEEDS OF OUR VULNERABLE RURAL cOMMUNITIES. THIS PAPER EXPLORES CONCERNS ABOUT THE UNIQUE NEEDS OF RURAL HOSPITALS AND COMMUNITIES AND CAN BE ACCESSED AT: HTTP://MHCC.MARYLAND.GOV/MHCC/PAGES/HOME/WORKGROUPS/DOCUMENTS/RURAL_HEALTH /JULY%2025TH%202017%20MEETING/LGSRPT_SHORE_WHITE_PAPER_RPT20170523.PDF ELIGIBILITY EDUCATION & FINANCIAL ASSISTANCE SCHEDULE H, PART VI, LINE 3 CRHC MAKES EVERY EFFORT TO MAKE FINANCIAL ASSISTANCE INFORMATION AVAILABLE TO OUR PATIENTS INCLUDING, BUT NOT LIMITED TO: -SIGNAGE IN MAIN ADMITTING AREAS AND EMERGENCY ROOMS OF THE HOSPITAL -THE ORGANIZATION'S WEBSITE -PATIENT HANDBOOK DISTRIBUTED TO ALL PATIENTS -BROCHURES EXPLAINING FINANCIAL ASSISTANCE ARE MADE AVAILABLE IN ALL PATIENT CARE AREAS -PATIENT PLAIN LANGUAGE SHEETS (AVAILABLE IN ENGLISH, AS WELL AS LANGUAGES SPOKEN BY UMMS PATIENTS WITH LIMITED ENGLISH PROFICIENCY) -APPEARING IN PRINT MEDIA THROUGH LOCAL NEWSPAPERS DESCRIPTION OF COMMUNITY SERVED SCHEDULE H, PART VI, LINE 4 SITUATED ON MARYLAND'S EASTERN SHORE, UMSRH'S THREE HOSPITALS, UMC AT EASTON, UMC AT DORCHESTER, and CRHC (UMC AT CHESTERTOWN) ARE NOT FOR PROFIT HOSPITALS OFFERING A COMPLETE RANGE OF INPATIENT AND OUTPATIENT SERVICES TO OVER 170,000 PEOPLE THROUGHOUT THE MID-SHORE OF MARYLAND. UMSRH'S SERVICE AREA IS DEFINED AS THE MARYLAND COUNTIES OF CAROLINE, DORCHESTER, TALBOT, QUEEN ANNE'S AND KENT. SMC AT EASTON IS SITUATED AT THE CENTER OF THE MID-SHORE AREA AND THUS SERVES A LARGE RURAL GEOGRAPHICAL AREA (ALL 5 COUNTIES OF THE MID-SHORE). SMC AT DORCHESTER IS LOCATED APPROXIMATELY 18 MILES FROM EASTON AND PRIMARILY SERVES DORCHESTER COUNTY AND PORTIONS OF CAROLINE COUNTY. CRHC IS LOCATED IN CHESTERTOWN, IN KENT COUNTY MERGED WITH UMSRH IN JULY 2013. CRHC SERVES THE RESIDENTS OF KENT COUNTY, PORTIONS OF QUEEN ANNE'S AND CAROLINE COUNTIES AND THE SURROUNDING AREAS. THE FIVE COUNTIES OF THE MID-SHORE COMPRISE 20% OF THE LANDMASS OF THE STATE OF MARYLAND AND 2% OF THE POPULATION. THE ENTIRE REGION HAS OVER 4,400 EMPLOYERS WITH NEARLY 45,000 WORKERS. ONLY 50 OF THOSE EMPLOYERS EMPLOY 100 OR MORE WORKERS. THE ECONOMIC CONDITION VARIES SIGNIFICANTLY THROUGHOUT THE REGION, ESPECIALLY FOR CAROLINE, DORCHESTER, AND KENT COUNTIES. IT SHOULD BE NOTED THAT TALBOT COUNTY APPEARS TO HAVE A SIGNIFICANTLY HIGHER MEDIAN INCOME THAN CAROLINE AND DORCHESTER, HOWEVER, A LARGE PERCENTAGE OF THE POPULATION HAS INCOMES IN LINE WITH THOSE OF CAROLINE AND DORCHESTER. THE FIGURES FOR TALBOT ARE SOMEWHAT SKEWED DUE TO LARGE INCOMES OF A FEW INDIVIDUAL FAMILIES AND HIGH NET WORTH INDIVIDUALS. UMSRH'S SERVICE AREA HAS A HIGHER PERCENTAGE OF POPULATION AGED 65 AND OLDER AS COMPARED TO MARYLAND OVERALL. TALBOT COUNTY HAS A 27.2% RATE FOR THIS AGE GROUP AND KENT COUNTY HAS 25.3% OF ITS RESIDENTS AGE 65 YEARS OR OLDER. THESE RATES ARE 65% HIGHER THAN MARYLAND'S PERCENTAGE, AND HIGHER THAN OTHER RURAL AREAS IN THE STATE BY ALMOST A QUARTER. TODAY, MORE THAN TWO-THIRDS OF ALL HEALTH CARE COSTS ARE FOR TREATING CHRONIC ILLNESSES. AMONG HEALTH CARE COSTS FOR OLDER AMERICANS, 95% ARE FOR CHRONIC DISEASES. THE COST OF PROVIDING HEALTH CARE FOR ONE PERSON AGED 65 OR OLDER IS THREE TO FIVE TIMES HIGHER THAN THE COST FOR SOMEONE YOUNGER THAN 65. SOURCE:HTTP://WWW.CDC.GOV/FEATURES/AGINGANDHEALTH/STATE_OF_AGING_AND_HEALT H_IN_AMERICA_2013.PDF HOFFMAN C, RICE D, SUNG HY. PERSONS WITH CHRONIC CONDITIONS: THEIR PREVALENCE AND COSTS. JAMA. 1996;276(18):1473-1479 WHILE PROGRESS IS BEING MADE, THE MID-SHORE ECONOMY STILL FACES A MYRIAD OF CHALLENGES THAT INCLUDE LIMITED ACCESS TO AFFORDABLE HIGH SPEED BROADBAND SERVICES, A SHORTAGE OF AFFORDABLE HOUSING, AN INADEQUATE SUPPLY OF SKILLED WORKERS, LOW PER CAPITA INCOME, AND MORE LAYOFFS IN THE MANUFACTURING SECTOR.(SOURCE: MID SHORE COMPREHENSIVE ECONOMIC DEVELOPMENT STRATEGY CEDS) COUNTY HEALTH RANKINGS FOR THE MID-SHORE COUNTIES ALSO REVEAL THE LARGE DISPARITIES BETWEEN COUNTIES FOR HEALTH OUTCOMES IN THE SERVICE AREA. OVERALL, QUEEN ANNE'S COUNTY RANKS 9TH; TALBOT COUNTY RANKS 10TH; DORCHESTER RANKS 21TH; CAROLINE RANKS 22RD, KENT RANKS 16TH (OUT OF 24 COUNTIES INCLUDING BALTIMORE CITY) IN HEALTH OUTCOMES THAT INDICATE THE OVERALL HEALTH OF THE COUNTY (SOURCE:HTTP://WWW.COUNTYHEALTHRANKINGS.ORG/MARYLAND/ 2018). SMC AT EASTON'S PRIMARY SERVICE AREA: 21601, 21613, 21629, 21632, 21655, 21639, 21643 UMC AT DORCHESTER'S PRIMARY SERVICE AREA: 21613, 21643, 21631 UMC at Chestertown's primary service area: 21620, 21661, 21651, 21678 COMMUNITY BENEFIT SERVICE AREA (CBSA) TARGET POPULATION: 170,000+ TALBOT COUNTY TOTAL POPULATION: 37,278 MALE: 47.4%, FEMALE: 52.6% WHITE, NOT HISPANIC (NH): 83.3% BLACK, NH: 13.0% HISPANIC: 6.6% ASIAN, NH: 1.4% AMERICAN INDIAN, NH: 0.4% MEDIAN AGE: 43.3 MEDIAN HOUSEHOLD INCOME: $58,228 DORCHESTER COUNTY TOTAL POPULATION: 32,258 MALE: 47.5%, FEMALE: 52.5% WHITE, NOT HISPANIC (NH): 67.4% BLACK, NH: 28.7% HISPANIC: 5.3% ASIAN, NH: 1.2% AMERICAN INDIAN, NH: 0.5% MEDIAN AGE: 40.7 MEDIAN HOUSEHOLD INCOME: $47,093 CAROLINE COUNTY TOTAL POPULATION: 32,850 MALE: 48.8%, FEMALE: 51.2% WHITE, NOT HISPANIC (NH): 81.3% BLACK, NH: 14.0% HISPANIC: 7.2% ASIAN, NH: 1.1% AMERICAN INDIAN, NH: 0.3% MEDIAN AGE: 37 MEDIAN HOUSEHOLD INCOME: $52,465 QUEEN ANNE'S COUNTY TOTAL POPULATION: 48,929 MALE: 49.7%, FEMALE: 50.3% WHITE, NOT HISPANIC (NH): 89.7% BLACK, NH: 6.6% HISPANIC: 3.6% ASIAN, NH: 0.5% AMERICAN INDIAN, NH: 0.3% MEDIAN AGE: 38.8 MEDIAN HOUSEHOLD INCOME: $85,963 KENT COUNTY TOTAL POPULATION: 19,730 MALE: 47.9%, FEMALE: 52.1% WHITE, NOT HISPANIC (NH): 81.3% BLACK, NH: 15.3% HISPANIC: 4.5% ASIAN, NH: 1.2% AMERICAN INDIAN, NH: 0.3% MEDIAN AGE: 45.6 MEDIAN HOUSEHOLD INCOME: $58,145 (SOURCE: HTTP://QUICKFACTS.CENSUS.GOV/) PERCENTAGE OF HOUSEHOLDS WITH INCOMES BELOW THE FEDERAL POVERTY GUIDELINES WITHIN THE CBSA: TALBOT 10.4%, DORCHESTER 18.1%, CAROLINE 14.4%, QUEEN ANNE'S 7.2%, KENT 14.8% SOURCE: HTTPS://WWW.CENSUS.GOV/QUICKFACTS/FACT/TABLE/US PERCENTAGE OF UNINSURED PEOPLE BY COUNTY WITHIN THE CBSA: TALBOT 8%, DORCHESTER 8%, CAROLINE 12%, QUEEN ANNE'S 6%, KENT 8% SOURCE: HTTP://WWW.TOWNCHARTS.COM/MARYLAND/MARYLAND-STATE-HEALTHCARE-DATA.HTML PERCENTAGE OF MEDICAID RECIPIENTS BY COUNTY WITHIN THE CBSA: TALBOT 12%, DORCHESTER 22%, CAROLINE 21%, QUEEN ANNE'S 6%, KENT 14% SOURCE: HTTP://WWW.TOWNCHARTS.COM/MARYLAND/MARYLAND-STATE-HEALTHCARE-DATA.HTML LIFE EXPECTANCY BY COUNTY WITHIN THE CBSA: TALBOT COUNTY: ALL RACES 80.8 WHITE 81.6, BLACK 76.5 DORCHESTER COUNTY: ALL RACES 77.6, WHITE 78.2, BLACK 75.7 CAROLINE COUNTY: ALL RACES 76.1, WHITE 76.3, BLACK 75.4 QUEEN ANNE'S COUNTY: ALL RACES 79.6, WHITE 79.7, BLACK 77.2 KENT COUNTY: ALL RACES 79.5, WHITE 80.6, BLACK 74.5 (SOURCE: HTTP://DHMH.MARYLAND.GOV) MORTALITY RATES BY COUNTY WITHIN THE CBSA (AGE -ADJUSTED RATES PER 100,000 POPULATION): TALBOT COUNTY: ALL RACES 1228.9, WHITE 1340.7, BLACK 1129.3 DORCHESTER COUNTY: ALL RACES 1222.8, WHITE 1418.0, BLACK 1005.8 CAROLINE COUNTY: ALL RACES 1009.9, WHITE. 1095.4, BLACK 971.1 QUEEN ANNE'S COUNTY: ALL RACES 799.5, WHITE 824.7, BLACK 883.9 KENT COUNTY: ALL RACES 1248.3, WHITE 1303.9, BLACK 1373.4 (SOURCE: HTTPS://HEALTH.MARYLAND.GOV/VSA/DOCUMENTS/REPORTS%20AND%20DATA/ANNUAL%20RE PORTS/2017ANNUAL.PDF) ACCESS TO HEALTHY FOOD, POPULATION THAT IS FOOD INSECURE: TALBOT COUNTY: 10.5% DORCHESTER COUNTY: 15.8% CAROLINE COUNTY: 12.1% QUEEN ANNE'S COUNTY: 7.5% KENT COUNTY: 11.5% (SOURCE: URL: HTTP://WWW.MDFOODSYSTEMMAP.ORG) QUALITY OF HOUSING HOME OWNERSHIP RATE: TALBOT COUNTY: 68.6% DORCHESTER COUNTY: 65.6% CAROLINE COUNTY: 70.5% QUEEN ANNE'S COUNTY: 83.8% KENT COUNTY: 71.9% SOURCE: MID SHORE COMPREHENSIVE ECONOMIC DEVELOPMENT STRATEGY CEDS SOURCE: HTTP://WWW.MIDSHORE.ORG/REPORTS/ ACCESS TO TRANSPORTATION WITHIN THE CBSA: TRANSIT SERVICES IN THE THREE COUNTY AREAS ARE PROVIDED UNDER CONTRACT BY DELMARVA COMMUNITY TRANSIT. SERVICES INCLUDE MEDICAL AND SENIOR CITIZEN DEMAND SERVICES AND FIXED ROUTE COUNTY AND REGIONAL SERVICE. WHILE MOST OF THE REGION IS SERVED BY THE FIXED ROUTES, THERE ARE GAPS IN COVERAGE IN THE LESS POPULATED AREAS OF THE COUNTIES. THE REGIONAL SYSTEM, MARYLAND UPPER SHORE TRANSIT (MUST), PROVIDES LOW COST AND SEAMLESS SERVICE FOR THE GENERAL PUBLIC FROM KENT ISLAND TO OCEAN CITY WITH CONVENIENT FREE TRANSFER POINTS AT KEY LOCATIONS ON THE SHORE. MUST IS A COORDINATED EFFORT OF SEVERAL UPPER SHORE AGENCIES AND GOVERNMENTS TO PROVIDE A REGIONAL TRANSIT SYSTEM FOR KENT, QUEEN ANNE'S, TALBOT, CAROLINE, AND DORCHESTER COUNTIES. TRANSIT SERVICES ARE PROVIDED BY QUEEN ANNE'S COUNTY RIDE (OPERATED BY THE COUNTY) AND DELMARVA COMMUNITY TRANSIT (DCT), A PRIVATE COMPANY UNDER CONTRACT TO THE COUNTIES. THE SYSTEM ALSO INCLUDES SHORE TRANSIT, WHICH PROVIDES SCHEDULED ROUTES ON THE LOWER SHORE. THE MTA AND THE MARYLAND DEPARTMENT OF HUMAN RESOURCES HAVE PROVIDED FUNDING. OVERALL MANAGEMENT OF THE REGIONAL SYSTEM IS THE RESPONSIBILITY OF THE TRANSPORTATION ADVISORY GROUP (TAG). THE COUNTY COMMISSIONERS OF THE FIVE UPPER SHORE COUNTIES APPOINT THE MEMBERS OF THE TAG. (SOURCE: MID SHORE COMPREHENSIVE ECONOMIC DEVELOPMENT STRATEGY CEDS(REVISED MARCH 2012) HTTP://WWW.MIDSHORE.ORG/REPORTS) ANNUAL AVERAGE CBSA UNEMPLOYMENT RATE: TALBOT 4.0%, DORCHESTER 5.2%, CAROLINE 4.2%, QUEEN ANNE'S 3.8%, KENT 4.3%(SOURCE: HTTP://WWW.DLLR.STATE.MD.US/) ACCESS TO QUALITY HEALTH CARE: HOSPITALS: UM SHORE REGIONAL HEALTH PENINSULA REGIONAL MEDICAL CENTER ANNE ARUNDEL MEDICAL CENTER FEDERALLY QUALIFIED HEALTH CENTERS (FQHCS): CHOPTANK COMMUNITY HEALTH (SOURCE: HTTP://WWW.DHMH.STATE.MD/US/GETHEALTHCARE/FQHC.PDF) PROMOTING THE HEALTH OF THE COMMUNITY SCHEDULE H, PART VI, LINE 5 THE ANALYSIS OF LOCAL DATA INDICATED THAT DIABETES, HEART DISEASE, CANCER, BEHAVIORAL HEALTH AND ACCESS TO CARE WERE ALL HEALTH IMPROVEMENT PRIORITIES FOR THE MID-SHORE. AFTER CAREFUL REVIEW OF COUNTY HEALTH DATA, THE MID-SHORE SHIP COALITION PRIORITIZED THE POTENTIAL HEALTH IMPROVEMENT AREAS AND DECIDED TO FOCUS THE COALITION'S EFFORTS ON THREE AREAS: (1) ADOLESCENT OBESITY, (2) ADOLESCENT TOBACCO USE, AND (3) DIABETES RELATED EMERGENCY DEPARTMENT VISITS. THE COALITION IS COMMITTED TO EXAMINING WHAT EVIDENCE-BASED INITIATIVES CAN IMPROVE THE COUNTY'S HEALTH IN THESE THREE AREAS RELATED TO RACIAL, ETHNIC AND OTHER DEMOGRAPHIC AND GEOGRAPHIC-RELATED HEALTH DISPARITIES. MARYLAND'S SHIP PROVIDES A FRAMEWORK FOR CONTINUAL PROGRESS TOWARD A HEALTHIER MARYLAND. MARYLAND'S SHIP BEGAN WITH NATIONAL, STATE AND LOCAL DATA BEING REVIEWED AND ANALYZED BY THE MARYLAND DMMH OFFICE OF POPULATION HEALTH AS WELL AS BY THE 5 DEPARTMENTS OF HEALTH (TALBOT, CAROLINE, DORCHESTER, QUEEN ANNE'S, KENT). IT HAS THREE MAIN COMPONENTS: ACCOUNTABILITY, LOCAL ACTION AND PUBLIC ENGAGEMENT. SHIP INCLUDES 39 MEASURES THAT PROVIDE A FRAMEWORK TO IMPROVE THE HEALTH OF MARYLAND RESIDENTS. TWENTY-EIGHT OF THE MEASURES HAVE BEEN IDENTIFIED AS CRITICAL RACIAL/ETHNIC HEALTH DISPARITIES. EACH MEASURE HAS A DATA SOURCE AND A TARGET, AND WHERE POSSIBLE, CAN BE ASSESSED AT THE COUNTY LEVEL. UMSRH'S PRIORITIES ARE ALIGNED WITH THE MARYLAND STATE HEALTH IMPROVEMENT PROCESS VISION AREAS AND THOSE OBJECTIVES OUTLINED BY THE LOCAL HEALTH IMPROVEMENT COALITION. UMSRH'S PRIORITIES: 1. CHRONIC DISEASES (OBESITY, HYPERTENSION, DIABETES, SMOKING) 2. BEHAVIORAL HEALTH 3. ACCESS TO CARE 4. CANCER 5. OUTREACH & EDUCATION (PREVENTIVE CARE, SCREENINGS, HEALTH LITERACY) SEVERAL ADDITIONAL TOPIC AREAS WERE IDENTIFIED BY THE COMMUNITY HEALTH PLANNING COUNCIL INCLUDING: SAFE HOUSING, TRANSPORTATION, AND SUBSTANCE ABUSE. THE UNMET NEEDS NOT ADDRESSED BY UMSRH WILL CONTINUE TO BE ADDRESSED BY KEY GOVERNMENTAL AGENCIES AND EXISTING COMMUNITY- BASED ORGANIZATIONS. WHILE UM SRH WILL FOCUS THE MAJORITY OF OUR EFFORTS ON THE IDENTIFIED PRIORITIES OUTLINED IN THE CHNA ACTION PLAN, WE WILL REVIEW THE COMPLETE SET OF NEEDS IDENTIFIED IN THE CHNA FOR FUTURE COLLABORATION AND WORK. THESE AREAS, WHILE STILL IMPORTANT TO THE HEALTH OF THE COMMUNITY, WILL BE MET THROUGH OTHER HEALTH CARE ORGANIZATIONS WITH OUR ASSISTANCE AS AVAILABLE. INITIATIVE 1 IDENTIFIED NEED: HEALTH PRIORITY #4. CANCER; HEALTH PRIORITY #3. ACCESS TO CARE; HEALTH PRIORITY #5. OUTREACH AND EDUCATION HOW WAS THE NEED IDENTIFIED: IDENTIFIED THROUGH THE CHNA PROCESS NAME OF HOSPITAL INITIATIVE: SHORE REGIONAL WELLNESS FOR WOMEN OUTREACH AND WELLNESS FOR WOMEN SCREENING DESCRIBE THE CHARACTERISTICS OF THE TARGET POPULATION: FEMALE POPULATION OF 5 COUNTY AREA OUTREACH= AGE 25+ (APPROXIMATELY 32,000) SCREENINGS= AGE 40-65, UNINSURED/ELIGIBLE = 2,800 AGE-ADJUSTED MORTALITY RATE FROM CANCER (PER 100,000 POPULATION) IN MARYLAND IS HIGHER THAN THE US CANCER MORTALITY RATE. CANCER IMPACTS PEOPLE ACROSS ALL POPULATION GROUPS, HOWEVER WIDE RACIAL DISPARITIES EXIST. MARYLAND 2017 GOAL 147.4 MARYLAND RATE: 159.3 CAROLINE COUNTY: 173.5 DORCHESTER COUNTY: 195.2 KENT COUNTY: 149.7 QUEEN ANNE'S COUNTY: 160.4 TALBOT COUNTY: 143 TOTAL NUMBER OF PEOPLE REACHED BY THE INITIATIVE: WELLNESS FOR WOMEN OUTREACH: 4,277 LIVES TOUCHED SCREENINGS: 111 PRIMARY OBJECTIVE OF INITIATIVE: REDUCE OVERALL CANCER DEATH RATE AGE-ADJUSTED MORTALITY RATE FROM CANCER (PER 100,000 POPULATION). MARYLAND IS HIGHER THAN THE US CANCER MORTALITY RATE. CANCER IMPACTS PEOPLE ACROSS ALL POPULATION GROUPS, HOWEVER WIDE RACIAL DISPARITIES EXIST. MARYLAND 2017 GOAL 147.4 MARYLAND RATE: 159.3 CAROLINE COUNTY: 173.5 DORCHESTER COUNTY: 195.2 KENT COUNTY: 149.7 QUEEN ANNE'S COUNTY: 160.4 TALBOT COUNTY: 143.8 WELLNESS FOR WOMEN OUTREACH: 1. INCREASE THE NUMBER OF WOMEN SURVIVING BREAST CANCER BY DIAGNOSING THEM AT AN EARLIER STAGE THROUGH EDUCATION AND PROMOTION OF PREVENTATIVE MEASURES AND EARLY DETECTION. 2. DIAGNOSE AFRICAN AMERICAN AND HISPANIC WOMEN AT EARLIER STAGES OF BREAST CANCER, EQUIVALENT TO CAUCASIAN WOMEN. 3. EDUCATE LATINA WOMEN IN BREAST SELF- EXAMINATION WITH THE ASSISTANCE OF A TRANSLATOR. SCREENINGS: 1. THE PROGRAM SERVES AS A POINT OF ACCESS INTO CARE FOR AGE AND RISK SPECIFIC MAMMOGRAPHY SCREENING, CLINICAL BREAST EXAM, AND GENETIC TESTING FOR BREAST CANCER. 2. OFFERS NO COST MAMMOGRAMS TO ELIGIBLE WOMEN: THOSE UNDER THE AGE OF 40 AND OVER 65 WHO HAVE NO INSURANCE AND LATINA WOMEN OF ALL AGES WHO WILL BE SCREENED ANNUALLY THEREAFTER. THOSE WOMEN NEEDING FURTHER DIAGNOSTIC TESTS OR WHO NEED TREATMENT FOR BREAST CANCER ARE ENROLLED IN THE STATE OF MARYLAND DIAGNOSIS AND TREATMENT PROGRAM THROUGH THE CASE MANAGER. KEY COLLABORATORS IN DELIVERY: PARTICIPATING HOSPITAL STAFF; TALBOT, QA, KENT, DORCHESTER, CAROLINE COUNTIES HEALTH DEPARTMENTS FOR FIVE COUNTIES IMPACT OF HOSPITAL INITIATIVE: REDUCE CANCER MORTALITY EVALUATION OF OUTCOMES: THE STAGE AT DIAGNOSIS AS REPORTED BY THE TUMOR REGISTRY FOR THE CANCER CENTER INDICATES DISPARITY FOR WOMEN IN CAROLINE AND DORCHESTER COUNTY. THE OUTREACH PROGRAM INCREASED THE COMMUNITY'S AWARENESS OF BREAST CANCER PREVENTION, DETECTION AND TREATMENTS. OUTCOME: OUTREACH 3,465 LIVES TOUCHED (SOME EVENTS INCLUDED BOTH COMMUNITY AND PROFESSIONAL AUDIENCES) -72 COMMUNITY EVENTS -7 PROFESSIONAL PRESENTATIONS OUTCOME: THE OUTREACH PROGRAM INCREASED THE COMMUNITY'S AWARENESS OF BREAST CANCER PREVENTION, DETECTION AND TREATMENTS. 4,277 LIVES TOUCHED (SOME EVENTS INCLUDED BOTH COMMUNITY AND PROFESSIONAL AUDIENCES) 72 COMMUNITY EVENTS 7 PROFESSIONAL PRESENTATIONS OUTCOME: SCREENING 330 PATIENT'S CASE MANAGED # OF PEOPLE CONTACTED - 330 # OF TIMES PEOPLE CONTACTED - 776 # OF APPLICATIONS SENT TO STATE - 68 # OF NEW APPLICATIONS - 32 # OF RENEWED APPLICATIONS - 36 TALBOT COUNTY: # OF EVENTS=37; # OF BREAST CANCER DIAGNOSES=48; CAUCASIAN=7; AA/OTHER=7/1; STAGE 3 OR 4=5 CAROLINE COUNTY: # OF EVENTS=9; # OF BREAST CANCER DIAGNOSES=25; CAUCASIAN=16; AA/OTHER=9; STAGE 3 OR 4=2 DORCHESTER COUNTY: # OF EVENTS=19; # OF BREAST CANCER DIAGNOSES=28; CAUCASIAN=19; AA/OTHER=8/1; STAGE 3 OR 4=4 KENT COUNTY: # OF EVENTS=3; # OF BREAST CANCER DIAGNOSES=16; CAUCASIAN=15; AA/OTHER=1; STAGE 3 OR 4=4 QUEEN ANNE'S COUNTY: # OF EVENTS=4; # OF BREAST CANCER DIAGNOSES=9; CAUCASIAN=9; AA/OTHER=0; STAGE 3 OR 4=1 CONTINUATION OF INITIATIVE: YES, THE INITIATIVE IS CONTINUING EXPENSE: OUTREACH $46,694: SCREENINGS, CASE MANAGEMENT $132,566 INITIATIVE 2 IDENTIFIED NEED: HEALTH PRIORITY #2. BEHAVIORAL HEALTH #5. OUTREACH AND EDUCATION HOW WAS THE NEED IDENTIFIED: IDENTIFIED THROUGH THE CHNA PROCESS NAME OF HOSPITAL INITIATIVE: UM SRH PARTNERSHIP WITH RECOVERY FOR SHORE (RFS) PROGRAM- PROMOTES RECOVERY THROUGH ADVOCACY, EDUCATION AND SUPPORT TOTAL NUMBER OF PEOPLE WITHIN TARGET POPULATION: MARYLAND ADULT RESIDENTS IN NEED OF TREATMENT, BY REGION 5 - EASTERN SHORE (N=260,715) 25,624 SOURCE: HTTPS://BHA.HEALTH.MARYLAND.GOV/STATE%20DRUG%20AND%20ALCOHOL%20ABUSE%20COU NCIL/DOCUMENTS/SDAACWEB/FORMULAWORKGROUP/REUTER_ESTIMATING%20TREATMENT%20N EED.PDF *ESTIMATED LESS THAN ONE-QUARTER, ARE ACTUALLY IN TREATMENT PROGRAMS TOTAL NUMBER OF PEOPLE REACHED BY THE INITIATIVE: SUPPORT 15-20 COMMUNITY EVENTS RAISING AWARENESS AND PROVIDING SUPPORT FOR THOSE AFFECTED BY SUBSTANCE ABUSE PRIMARY OBJECTIVE OF INITIATIVE: INDICATORS SUGGEST THE QUALITY OF LIFE FOR THE TARGET POPULATION OF THOSE IN LONG-TERM RECOVERY FROM ALCOHOL OR OTHER DRUG ADDICTION, IMPROVE AS A RESULT OF THE SUPPORT AND ADVOCACY PROVIDED BY RFS PROGRAMS. THE PRIMARY OBJECTIVE OF THIS INITIATIVE IS TO: -RAISE THE AWARENESS ABOUT ADDICTION AND RECOVERY -REDUCE THE STIGMA ABOUT ADDICTION AND MENTAL DISORDERS -ADVOCACY FOR THOSE IN RECOVERY -ENGAGE IN COMMUNITY ACTIVITIES THAT CELEBRATE RECOVERY AND WELLNESS SINGLE OR MULTI-YEAR PLAN: MULTI-YEAR INITIATIVE AND ONGOING 2010-PRESENT KEY COLLABORATORS IN DELIVERY: -CAROLINE COUNSELING CENTER -CAROLINE COUNTY PREVENTION SERVICES -CHESAPEAKE TREATMENT SERVICES -CHESAPEAKE VOYAGERS, INC. -CIRCUIT COURT OF TALBOT COUNTY, PROBLEM SOLVING COURT -COMMUNITY NEWSPAPER PROJECT (CHESTERTOWN SPY AND TALBOT SPY) -DORCHESTER COUNTY ADDICTIONS PROGRAM -DRI-DOCK RECOVERY AND WELLNESS CENTER -KENT COUNTY DEPARTMENT OF HEALTH ADDICTION SERVICES -MID SHORE MENTAL HEALTH SYSTEMS, INC. -QUEEN ANNE'S COUNTY DEPARTMENT OF HEALTH - ADDICTIONS TREATMENT AND PREVENTION SERVICES UMSRH BEHAVIORAL HEALTH OUTPATIENT ADDICTIONS -TALBOT ASSOCIATION OF CLERGY AND LAITY -TALBOT COUNTY HEALTH DEPARTMENT ADDICTIONS PROGRAM (TCAP) AND PREVENTION -PAROLE AND PROBATION -TALBOT PARTNERSHIP FOR ALCOHOL AND OTHER DRUG ABUSE PREVENTION -UMSRH WARWICK MANOR BEHAVIORAL HEALTH IMPACT OF HOSPITAL INITIATIVE: REDUCTION OF UTILIZATION OF EMERGENCY ROOM SERVICES FOR ONGOING TREATMENT. EVALUATION OF OUTCOME: EVENTS AND PROGRAMS PARTICIPATION IN 15-20 COMMUNITY EVENTS RAISING AWARENESS AND PROVIDING SUPPORT TO THOSE AFFILIATED HEALTH CARE SYSTEM ROLES SCHEDULE H, PART VI, LINE 6 CRHC IS A PRIVATE, NOT-FOR-PROFIT CORPORATION PROVIDING COMPREHENSIVE HEALTHCARE SERVICES THROUGH AN INTEGRATED REGIONAL NETWORK OF HOSPITALS AND RELATED CLINICAL ENTERPRISES. UMMS WAS CREATED IN 1984 WHEN ITS FOUNDING HOSPITAL WAS PRIVATIZED BY THE STATE OF MARYLAND. OVER ITS 30-YEAR HISTORY, UMMS EVOLVED INTO A MULTI-HOSPITAL SYSTEM WITH ACADEMIC, COMMUNITY AND SPECIALTY SERVICE MISSIONS REACHING PRIMARILY ACROSS MARYLAND. AS PART OF UMMS, CRHC UNDERSTANDS THAT HEALTH CARE GOES BEYOND THE WALLS OF THE HOSPITAL AND INTO THE COMMUNITY IT SERVES. UMMS HOSPITALS ARE COMMITTED TO STRENGTHENING THEIR NEIGHBORING COMMUNITIES. IN DOING SO, CRHC ASSESSES THE COMMUNITY'S HEALTH NEEDS, IDENTIFIES KEY PRIORITIES, AND RESPONDS WITH SERVICES, PROGRAMS AND INITIATIVES WHICH MAKE A POSITIVE, SUSTAINED IMPACT ON THE HEALTH OF THE COMMUNITY. WITH REPRESENTATION FROM ALL UMMS HOSPITALS, THE MEDICAL SYSTEM'S COMMUNITY HEALTH IMPROVEMENT COUNCIL COORDINATES THE EFFECTIVE AND EFFICIENT UTILIZATION AND DEPLOYMENT OF RESOURCES FOR COMMUNITY-BASED ACTIVITIES AND EVALUATES HOW SERVICES AND ACTIVITIES MEET TARGETED COMMUNITY NEEDS WITHIN DEFINED GEOGRAPHIC AREAS. CRHC IS COMMITTED TO HEALTH EDUCATION, ADVOCACY, COMMUNITY PARTNERSHIPS, AND ENGAGING PROGRAMS WHICH FOCUS ON HEALTH AND WELLNESS WITH THE GOAL OF ELIMINATING HEALTH CARE DISPARITIES ON MARYLAND'S MID-EASTERN SHORE. STATE FILING OF COMMUNITY BENEFIT REPORT SCHEDULE H, PART VI, LINE 7 AS REQUIRED BY MARYLAND STATUTE FOR ALL HOSPITALS, CRHC FILES AN ANNUAL COMMUNITY BENEFIT REPORT WITH MARYLANDS HEALTH SERVICES COST REVIEW COMMISSION (HSCRC) BY DECEMBER 15TH EACH YEAR. X X X false true false false false false false true false John W Ashworth Director 0 597242 0 128170 0 97267 0 10800 0 25714 0 859193 0 0 Robert A Chrencik Director 0 1318061 0 995265 0 276702 0 10800 0 14219 0 2615047 0 0 Kenneth D Kozel President and CEO 0 421390 0 127717 0 76353 0 10800 0 8666 0 644926 0 0 JoAnne R Hahey SVP Finance and CFO 0 287797 0 62783 0 17242 0 47527 0 16017 0 431366 0 0 Scott Burleson Former SVP and COO 0 122348 0 20337 0 610 0 7872 0 10182 0 161349 0 0 SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN SCHEDULE J, PART I, LINE 4B DURING THE FISCAL YEAR ENDED JUNE 30, 2018, CERTAIN OFFICERS AND KEY EMPLOYEES PARTICIPATED IN THE UMMS SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN. THE INDIVIDUALS LISTED BELOW HAVE NOT VESTED IN THE PLAN. THEREFORE, THE ACCRUED CONTRIBUTION TO THE PLAN FOR THE FISCAL YEAR IS REPORTED ON SCHEDULE J, PART II, COLUMN C, RETIREMENT AND OTHER DEFERRED COMPENSATION: - JOANNE R. HAHEY DURING THE FISCAL YEAR ENDED JUNE 30, 2018, CERTAIN OFFICERS AND KEY EMPLOYEES PARTICIPATED IN THE UMMS SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN. THE INDIVIDUALS LISTED BELOW HAVE VESTED IN THE PLAN IN A PRIOR YEAR. THEREFORE, THE CONTRIBUTIONS TO THE PLAN FOR THE FISCAL YEAR ARE REPORTED AS TAXABLE COMPENSATION AND REPORTED ON SCHEDULE J, PART II, LINE B (III), OTHER REPORTABLE COMPENSATION: - JOHN W. ASHWORTH - ROBERT A. CHRENCIK - KENNETH D. KOZEL NON-FIXED PAYMENTS SCHEDULE J, PART I, LINE 7 BONUSES PAID ARE BASED ON A NUMBER OF VARIABLES INCLUDING BUT NOT LIMITED TO INDIVIDUAL GOAL ACHIEVEMENTS AS WELL AS ORGANIZATION OPERATION ACHIEVEMENTS. THE FINAL DETERMINATION OF THE BONUS AMOUNT IS DETERMINED AND APPROVED BY THE BOARD AS PART OF THE OVERALL COMPENSATION REVIEW OF THE OFFICERS AND KEY EMPLOYEES. MISSION STATEMENT FORM 990, PART I, LINE 1 CHESTER RIVER HOSPITAL CENTER (CRHC) IS AN ACUTE CARE HOSPITAL THAT SERVES THE RESIDENTS OF KENT AND QUEEN ANNE'S COUNTIES AND PORTIONS OF CAROLINE AND CECIL COUNTIES. TAX EXEMPT BOND ISSUE FORM 990, PART IV, line 24 Pursuant to a master loan agreement dated December 1, 2017 (the "master loan agreement"), as amended, the University of Maryland Medical System corporation (the "corporation") and several of its subsidiaries have issued debt through the Maryland Health and Higher Educational Facilities Authority (the "authority"). As security for the performance of the bond obligation under the master loan agreement, the authority maintains a security interest in the revenue of the obligors. The master loan agreement contains certain restrictive covenants. These covenants require that rates and charges be set at certain levels, limit incurrence of additional debt, require compliance with certain operating ratios and restrict the disposition of assets. The obligated group under the master loan agreement includes the corporation, ROI, UM Midtown, UM Baltimore Washington, Shore Health (UM Memorial and UM Dorchester), UM Chester River, UM Charles Regional, UM St. Joseph, UM Upper Chesapeake, UM Harford Memorial, UM Laurel, UM Price George's, Bowie Health Center (Bowie), and the UMMS Foundation. Each member of the obligated group is jointly and severally liable for the repayment of the obligations under the master loan agreement of the corporation's $1,745,628,000 of outstanding authority bonds on June 30, 2018. All of the bonds were issued in the name of the University of Maryland Medical System Corporation and are reported on Schedule K of its form 990. MEMBERS OR STOCKHOLDERS FORM 990, PART VI, LINES 6, 7A, AND 7B UM SHORE REGIONAL HEALTH (UMSRH) IS THE SOLE MEMBER OF CRHC. UMSRH MAY ELECT MEMBERS AND APPROVE DECISIONS OF CRHC. FORM 990 REVIEW PROCESS FORM 990, PART VI, SECTION B, LINE 11B UMMS ENGAGES THE ACCOUNTING FIRM GRANT THORNTON TO PREPARE AND REVIEW THE IRS FORM 990 FOR UMMS AND ITS AFFILIATES. INFORMATION NEEDED TO COMPLETE THE RETURN IS GATHERED BY ACCOUNTING PERSONNEL IN THE FINANCE SHARED SERVICES DEPARTMENT UNDER THE SUPERVISION OF THE UMMS TAX DIRECTOR AND PROVIDED TO GRANT THORNTON. ONCE A DRAFT RETURN IS PREPARED, IT UNDERGOES MULTIPLE LEVELS OF REVIEW BOTH INTERNALLY BY UMMS TAX & FINANCE PERSONNEL, AND EXTERNALLY BY GRANT THORNTON, INCLUDING AT THE PARTNER LEVEL. FOLLOWING ANY NECESSARY CHANGES TO THE RETURN, A FINAL DRAFT IS REVIEWED BY EACH AFFILIATES VICE PRESIDENT OF FINANCE AND/OR CFO. PRIOR TO FILING THE IRS FORM 990, THE ORGANIZATION'S BOARD CHAIRMAN, TREASURER, AUDIT COMMITTEE CHAIRMAN, EXECUTIVE COMMITTEE CHAIRMAN OR OTHER MEMBER OF THE BOARD WITH SIMILAR AUTHORITY WILL REVIEW THE IRS FORM 990. ALL BOARD MEMBERS ARE PROVIDED WITH A COPY OF THE FINAL IRS FORM 990 BEFORE FILING. CONFLICT OF INTEREST POLICY MONITORING & ENFORCEMENT FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION'S OFFICERS, DIRECTORS AND MEDICAL STAFF MEMBERS, AS APPLICABLE, SHALL DISCLOSE CONFLICTS OF INTEREST OR POTENTIAL CONFLICTS OF INTEREST BETWEEN THEIR PERSONAL INTERESTS AND THE INTERESTS OF THE ORGANIZATION, OR ANY ENTITY CONTROLLED BY OR OWNED IN SUBSTANTIAL PART BY THE ORGANIZATION. A QUESTIONNAIRE WHICH DISCLOSES POTENTIAL CONFLICTS OF INTEREST IS DISTRIBUTED ANNUALLY TO OFFICERS, DIRECTORS AND KEY EMPLOYEES. THE GENERAL COUNSEL OF UMMS REVIEWS THE RESPONSES FOR UMMS AND CERTAIN OTHER AFFILIATES. THE CEO OR CFO OF EACH OF THE OTHER ENTITIES IN THE UMMS SYSTEM REVIEWS THE RESPONSES FOR THOSE ENTITIES. THE GENERAL COUNSEL, IN CONSULTATION WITH THE AUDIT COMMITTEE, IF NECESSARY, WOULD DETERMINE IF A CONFLICT OF INTEREST EXISTED. WITH RESPECT TO THE OTHER ENTITIES IN THE UMMS SYSTEM, THE GENERAL COUNSEL MAY BE CALLED FOR CONSULT. IF SO, THE GENERAL COUNSEL MAY CONSULT THE AUDIT COMMITTEE, IF NECESSARY. WHENEVER A CONFLICT OR POTENTIAL CONFLICT OF INTEREST EXISTS, THE NATURE OF THE CONFLICT OR POTENTIAL CONFLICT OF INTEREST MUST BE DISCLOSED IN WRITING TO THE ORGANIZATION'S BOARD, BOARD COMMITTEE, AN OFFICER OF THE ORGANIZATION OR OTHER APPROPRIATE EXECUTIVE. SUCH INDIVIDUAL HAVING A POTENTIAL CONFLICT OF INTEREST SHALL PLAY NO ROLE ON BEHALF OF THE ORGANIZATION, OR ANY ORGANIZATION CONTROLLED OR SUBSTANTIALLY OWNED, IN ANY TRANSACTION IN WHICH A CONFLICT EXISTS. ALL INVITATIONS FOR BIDS, PROPOSALS OR SOLICITATIONS FOR OFFERS INCLUDE THE FOLLOWING PROVISION: ANY VENDOR, SUPPLIER OR CONTRACTOR MUST DISCLOSE ANY ACTUAL OR POTENTIAL TRANSACTION WITH ANY ORGANIZATION OFFICER, DIRECTOR, EMPLOYEE OR MEMBER OF THE MEDICAL STAFF, INCLUDING FAMILY MEMBERS WITHIN FIVE DAYS OF THE TRANSACTION. FAILURE TO COMPLY WITH THIS PROVISION IS A MATERIAL BREACH OF AGREEMENT. IN ADDITION, A BOARD DISCLOSURE REPORT IS FILED WITH THE MARYLAND HEALTH SERVICES COST REVIEW COMMISSION ON AN ANNUAL BASIS SHOWING ANY BUSINESS TRANSACTIONS BETWEEN THE BOARD MEMBERS AND THE ORGANIZATION. PROCESS FOR DETERMINING COMPENSATION FORM 990, PART VI, SECTION B, LINEs 15A & 15B THE ORGANIZATION DID NOT COMPENSATE ITS EXECUTIVES DIRECTLY, BUT RATHER, THE EXECUTIVES RECEIVED COMPENSATION FROM A RELATED ORGANIZATION. THE ORGANIZATION DETERMINES THE EXECUTIVE COMPENSATION PAID TO ITS EXECUTIVES IN THE FOLLOWING MANNER PRESCRIBED IN THE IRS REGULATIONS: EXECUTIVE COMPENSATION PACKAGES ARE DETERMINED BY A COMMITTEE OF THE BOARD THAT IS COMPOSED ENTIRELY OF BOARD MEMBERS WHO HAVE NO CONFLICT OF INTEREST. THE COMMITTEE ACQUIRES CREDIBLE COMPARABILITY MARKET DATA CONCERNING THE COMPENSATION PACKAGES OF SIMILARLY SITUATED EXECUTIVES. THE COMMITTEE CAREFULLY REVIEWS THAT DATA, THE EXECUTIVE'S PERFORMANCE AND THE PROPOSED COMPENSATION PACKAGES DURING THE DECISION MAKING PROCESS. THE COMMITTEE MEMORIALIZES ITS DELIBERATIONS IN DETAILED MINUTES REVIEWED AND ADOPTED AT THE NEXT-FOLLOWING MEETING. THE COMMITTEE SEEKS AN OPINION OF COUNSEL THAT IT HAS MET THE REQUIREMENTS OF THE IRS INTERMEDIATE SANCTIONS REGULATIONS. THIS PROCESS IS USED TO DETERMINE THE COMPENSATION PACKAGES FOR ALL MANAGEMENT EMPLOYEES FROM THE VICE PRESIDENT LEVEL AND UP. HOW DOCUMENTS ARE MADE AVAILABLE TO THE PUBLIC FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATIONS GOVERNING DOCUMENTS ARE MADE PUBLICLY AVAILABLE THROUGH THE STATE OF MARYLAND VIA THE SECRETARY OF STATES OFFICE. THE CONFLICT OF INTEREST POLICY IS GENERALLY AVAILABLE ON THE ORGANIZATIONS OR AFFILIATES WEBSITE. FINANCIAL STATEMENTS ARE MADE PUBLICLY AVAILABLE ON A QUARTERLY BASIS THROUGH FILINGS ON THE ELECTRONIC MUNICIPAL MARKET ACCESS ("EMMA") SYSTEM. HOURS ON RELATED ENTITIES PART VII, SECTION A, COL (B) UMMS IS A MULTI-ENTITY HEALTH CARE SYSTEM THAT INCLUDES 13 ACUTE CARE HOSPITALS, 1 ACUTE CARE HOSPITAL OWNED IN A JOINT VENTURE ARRANGEMENT AND VARIOUS SUPPORTING ENTITIES. A NUMBER OF INDIVIDUALS PROVIDE SERVICES TO VARIOUS ENTITIES WITHIN THE SYSTEM. IN GENERAL, THE OFFICERS AND KEY EMPLOYEES OF UMMS AVERAGE IN EXCESS OF 40 HOURS PER WEEK SERVING THE DIFFERENT ENTITIES THAT COMPRISE UMMS. INDEPENDENT CONTRACTORS FORM 990, PART VII, SECTION B, LINE 1 INDEPENDENT CONTRACTORS OF THE FILING ORGANIZATION ARE PAID AND REPORTED BY THE PARENT CORPORATION, UNIVERSITY OF MARYLAND MEDICAL SYSTEM CORPORATION (UMMS). UMMS ISSUES THE FORMS 1099 FOR THESE VENDOR PAYMENTS, WHILE THE FILING ORGANIZATION REPORTS THE EXPENSES FOR ITS INDEPENDENT CONTRACTORS ON PART VII, SECTION B, LINE 1 ON ITS FORM 990. OTHER CHANGES IN NET ASSETS FORM 990, PART XI, LINE 9 CHANGE IN BENEFICIAL INTEREST $ 1,304,336 FUNDING PPE $ 450,527 CHANGE IN PENSION BENEFITS $ (885,496) OTHER CHANGES in Net assets $ (424,484) --------------- TOTAL OTHER CHANGE IN NET ASSETS $ 444,883 =============== FORM 990 PART IX LINE 11G DESCRIPTION:SHARED SERVICES TOTAL FEES:10744052 FORM 990 PART IX LINE 11G DESCRIPTION:PHYSICIAN SERVICE CONTRACTS TOTAL FEES:6090207 FORM 990 PART IX LINE 11G DESCRIPTION:MEDICAL AND CONTRACT SERVICES TOTAL FEES:1651975 FORM 990 PART IX LINE 11G DESCRIPTION:MEDICAL STAFFING SERVICE TOTAL FEES:244662 FORM 990 PART IX LINE 11G DESCRIPTION:OTHER SERVICES TOTAL FEES:196432 Baltimore Washington Emergency Phys Inc 301 Hospital Drive Glen Burnie MD 21061 521756326 Healthcare MD 501(c)(3) 12A BWHS false Baltimore Washington Healthcare Services 301 Hospital Drive Glen Burnie MD 21061 521830243 Healthcare MD 501(c)(3) 12A UMBWMS false Baltimore Washington Medical Center Inc 301 Hospital Drive Glen Burnie MD 21061 520689917 Healthcare MD 501(c)(3) 03 UMBWMS false UM Baltimore Washington Medical System 301 Hospital Drive Glen Burnie MD 21061 521830242 Healthcare MD 501(c)(3) 12A UMMSC false North Arundel Development Corporation 301 Hospital Drive Glen Burnie MD 21061 521318404 Real Estate MD 501(c)(2) NCC false North County Corporation 301 Hospital Drive Glen Burnie MD 21061 521591355 Real Estate MD 501(c)(2) UMBWMS false Chester River Health Foundation Inc 100 Brown Street Chestertown MD 21620 521338861 Fundraising MD 501(c)(3) 08 UMSRH false Univ of MD Shore Regional HealthInc 100 Brown Street Chestertown MD 21620 522046500 Healthcare MD 501(c)(3) 12A UMMSC false Chester River Manor Inc 200 Morgnec Road Chestertown MD 21620 526070333 Healthcare MD 501(c)(3) 10 UMSRH false Maryland General Clinical Practice Group 827 Linden Avenue Baltimore MD 21201 521566211 Healthcare MD 501(c)(3) 12B UMMTH false University of Maryland Midtown Health I 827 Linden Avenue Baltimore MD 21201 521175337 Healthcare MD 501(c)(3) 12B UMMSC false Maryland General Hospital Inc 827 Linden Avenue Baltimore MD 21201 520591667 Healthcare MD 501(c)(3) 03 UMMTH false Care Health Services Inc 219 South Washington Street Easton MD 21601 521510269 Healthcare MD 501(c)(3) 10 SHS false Memorial Hospital Foundation Inc 219 South Washington Street Easton MD 21601 521282080 Fundraising MD 501(c)(3) 12A SHS false Shore Health System Inc 219 South Washington Street Easton MD 21601 520610538 Healthcare MD 501(c)(3) 03 UMSRH false University of Maryland Community Medical 22 South Greene Street Baltimore MD 21201 521874111 Healthcare MD 501(c)(3) 03 UMMSC false James Lawrence Kernan Hospital Inc 22 South Greene Street Baltimore MD 21207 520591639 Healthcare MD 501(c)(3) 03 UMMSC false UMMS Foundation Inc 22 South Greene Street Baltimore MD 21201 522238893 Fundraising MD 501(c)(3) 12A UMMSC false University of MD Medical System Corp 22 South Greene Street Baltimore MD 21201 521362793 Healthcare MD 501(c)(3) 03 NA false University of Maryland Charles Regional PO Box 1070 La Plata MD 20646 522155576 Healthcare MD 501(c)(3) 12C UMMSC false Civista Medical Center Inc PO Box 1070 La Plata MD 20646 520445374 Healthcare MD 501(c)(3) 03 UMCRH false Charles Regional Medical Center Foundati PO Box 1070 La Plata MD 20646 521414564 Fundraising MD 501(c)(3) 12A UMCRH false Charles Regional Medical Center Auxiliar PO Box 1070 La Plata MD 20646 521131193 Fundraising MD 501(c)(3) 12A UMCRH false Univ of MD St Joseph Foundation Inc 7601 Osler Drive Towson MD 21204 521681044 Fundraising MD 501(c)(3) 12A UMSJHS false UMSJ Health System LLC 7601 Osler Drive Towson MD 21204 462097818 Healthcare MD 501(c)(3) 03 UMMSC false Harford Memorial Hospital Inc 520 Upper Chesapeake Dr Bel Air MD 21014 520591484 Healthcare MD 501(c)(3) 03 UMUCHS false UM Upper Chesapeake Health System Inc 520 Upper Chesapeake Dr Bel Air MD 21014 521398513 Healthcare MD 501(c)(3) 12C;III-FI UMMSC false Upper Chesapeake Health Foundation Inc 520 Upper Chesapeake Dr Bel Air MD 21014 521398507 Fundraising MD 501(c)(3) 12A UMUCHS false Upper Chesapeake Medical Center Inc 520 Upper Chesapeake Dr Bel Air MD 21014 521253920 Healthcare MD 501(c)(3) 03 UMUCHS false Upper Chesapeake Medical Services Inc 520 Upper Chesapeake Dr Bel Air MD 21014 521501734 Healthcare MD 501(c)(3) 10 UMUCHS false Upper Chesapeake Properties Inc 520 Upper Chesapeake Dr Bel Air MD 21014 521907237 Real Estate MD 501(c)(2) UMUCHS false Upper Ches Residential Hospice House In 520 Upper Chesapeake Dr Bel Air MD 21014 260737028 Hospice MD 501(c)(3) 07 UMUCHS false Upper ChesapeakeSt Joseph Home Care I 520 Upper Chesapeake Dr Bel Air MD 21014 521229742 Home Care MD 501(c)(3) 10 UMUCHS false Dimensions Health Corporation 3001 Hospital Drive Cheverly MD 20785 521289729 Healthcare MD 501(c)(3) 03 UMMSC false Dimensions Healthcare Associates 3001 Hospital Drive Cheverly MD 20785 521902711 Healthcare MD 501(c)(3) 12A UMCAPRH false UM Capital Region Health Inc 250 W Pratt St Ste 2400 Baltimore MD 21201 823596114 Healthcare MD 501(c)(3) 12C UMMSC false Arundel Physicians Associates LLC 301 Hospital Drive Glen Burnie MD 20161 522000762 Healthcare MD APA Inc Baltimore Washington Imaging LLC 301 Hospital Drive Glen Burnie MD 20161 200806027 Healthcare MD UMBWMS Universitycare LLC 22 South Greene Street Baltimore MD 21201 521914892 Healthcare MD UMMSC O'Dea Medical Arts Limited Partnership 7601 Osler Drive Towson MD 21204 521682964 Rental MD SJMC Prop Advanced Imaging at St Joseph Medical C 7601 Osler Drive Towson MD 21204 521958002 Healthcare MD UMSJMC University of Maryland Charles Regional PO Box 1070 LaPlata MD 20646 300956382 Healthcare MD UMCRCP Baltimore ASC Ventures LLC 7620 York Road Towson MD 21204 824133899 Healthcare DE UMSJMC Arundel Physicians Associates Inc 301 Hospital Drive Glen Burnie MD 21061 521992649 Healthcare MD BWHE C Corp false Baltimore Washington Health Enterprises 301 Hospital Drive Glen Burnie MD 21061 521936656 Healthcare MD UMBWMS C Corp false BW Professional Services Inc 301 Hospital Drive Glen Burnie MD 21061 521655640 Healthcare MD BWHE C Corp false NA Executive Building Condo Assn Inc 301 Hospital Drive Glen Burnie MD 21061 Real Estate MD NADCO C Corp false UM Charles Regional Care Partners PO Box 1070 La Plata MD 20646 522176314 Healthcare MD UMCRH C Corp false University Midtown Prof Center A Condo 827 Linden Avenue Baltimore MD 21201 521891126 Real Estate MD UMMH C Corp false University of Maryland Health Advantage 22 South Greene Street Baltimore MD 21201 461411902 Insurance MD UMMSHP C Corp false University of Maryland Health Partners 22 South Greene Street Baltimore MD 21201 452815803 Insurance MD UMMSHP C Corp false University of Maryland Medical System He 22 South Greene Street Baltimore MD 21201 452815722 Insurance MD UM Hlth Vent C Corp false Upper Chesapeake Insurance Company 520 Upper Chesapeake Dr Bel Air MD 21014 980468438 Insurance MD UMUCHS LTD false Upper Chesapeake Health Ventures Inc 520 Upper Chesapeake Dr Bel Air MD 21014 522031264 Healthcare MD UMUCHS C Corp false Upper Chesapeake Medical Center Land Con 520 Upper Chesapeake Dr Bel Air MD 21014 770674478 Real Estate MD UC Med Crt C Corp false Upper Chesapeake Medical Office Building 520 Upper Chesapeake Dr Bel Air MD 21014 521946829 Real Estate MD UC Hlth Vent C Corp false Shore Orthopedics Inc 219 S Washington Street Easton MD 21601 371817262 Healthcare MD SHS C Corp false Madison Manor Inc 5801 42nd Ave Hyattsville MD 20781 521269059 Healthcare MD UMCAPRH C Corp false Affiliated Enterprises Inc 3001 Hospital Drive Cheverly MD 20785 521542144 Healthcare MD UMCAPRH C Corp false Dimensions Assurance LTD PO Box 1363 Genesis Bldg Grand Cayman CJ 980348082 Insurance CJ UMMSC C Corp false Riverside Health of Delaware Inc 1966 Greenspring Drive Ste 600 Timonium MD 21093 463205820 Healthcare DE UMMSHP C Corp false Riverside Health of DC Inc 1966 Greenspring Drive Ste 600 Timonium MD 21093 461411713 Healthcare DC UMMSHP C Corp false false false true true false false false false false false false true true true true true false true false