2018-05-15T19:55:02-05:00 2017-06-30 ERNST & YOUNG US LLP 201 NORTH FRANKLIN STREET STE 2400 TAMPA FL 33602 990 2016-07-01 521164513 HOSPICE OF FREDERICK COUNTY INC % MICHELLE MAHAN HOSP 2405663030 PO BOX 1799 FREDERICK MD 21705 MICHELLE MAHAN CFO-FMH, INC. 2405663300 2018-05-14 true MELANIE A MCPEAK P01346034 8132234800 2016 2022-09-23 18:48:47Z MICHELLE MAHAN 400 WEST SEVENTH STREET FREDERICK MD 21701 3450753 false X WWW.HOSPICEOFFREDERICKCO.COM X 1981 MD Provide and promote hospice care for people who are terminally ill and for their families. it serves as a fundraising org. for the benefit of hospice svcs. and the kline house. 12 9 0 50 0 963381 1064727 184660 227073 50443 231891 191589 212638 1390073 1736329 0 0 0 0 0 0 0 0 15814 1208467 1218652 1208467 1218652 181606 517677 4936027 5331128 118913 120862 4817114 5210266 X THE PURPOSE OF THE HOSPICE OF FREDERICK COUNTY, INC. IS TO PROVIDE AND PROMOTE HOSPICE CARE FOR INDIVIDUALS WHO ARE TERMINALLY ILL AND FOR THEIR FAMILIES. HOSPICE OF FREDERICK COUNTY, INC. OPERATES AS A FUNDRAISING ORGANIZATION FOR THE BENEFIT OF HOSPICE SERVICES AND OPERATES THE KLINE HOSPICE HOUSE. false false 1088460 227073 THE PURPOSE OF THE HOSPICE OF FREDERICK COUNTY, INC. IS TO PROVIDE AND PROMOTE HOSPICE CARE FOR INDIVIDUALS WHO ARE TERMINALLY ILL AND FOR THEIR FAMILIES. HOSPICE OF FREDERICK COUNTY, INC. OPERATES AS A FUNDRAISING ORGANIZATION FOR THE BENEFIT OF HOSPICE SERVICES AND OPERATES THE KLINE HOSPICE HOUSE. 1088460 true true false false false false false false false false true false false false false false false true false false false false false false true false false false false true false false false false false false false false false false false false false true true true false false true 4 0 true 0 false false false false false true true false false false false X 12 9 false false false false true true true true true false false true true true true true true false false false MD X MICHELLE MAHAN 2405663300 400 WEST SEVENTH STREET FREDERICK MD 21701 Thomas Kleinhanzl Director 3.0 37.0 X 0 1089396 248858 Carl Miller Director 4.0 0.0 X 0 0 0 Ricky Sandy PRESIDENT 2.0 0.0 X X 0 0 0 Douglas Stauffer Director 2.0 0.0 X 0 0 0 John Verbus Director 5.0 35.0 X 0 425229 55066 Mark Goldstein MD Director 2.0 40.0 X 0 444912 32906 Rev Timothy May Secretary 2.0 0.0 X X 0 0 0 Don Butt Jr Treasurer (thru 6/22/17) 2.0 0.0 X X 0 0 0 Jeanie Cronin Director 1.0 0.0 X 0 0 0 Alyce Luck Director 1.0 0.0 X 0 0 0 Kathy Weishaar MD director 1.0 0.0 X 0 0 0 PATRICK JOHANNES MANSKY DIRECTOR (start 6/22/17) 1.0 0.0 X 0 492676 8976 Timothy A Gibian PsyD Director 1.0 0.0 X 0 0 0 William Haugh Vice President 2.0 0.0 X X 0 0 0 Carmen Hernandez MD Director (thru 6/22/17) 1.0 0.0 X 0 0 0 Laurel Cucchi Director Operations 55.0 0.0 X 0 136998 13038 Michelle Mahan Chief Financial Officer - FMH 3.0 37.0 X 0 653744 56519 0 3242955 415363 0 false true false 0 49110 1015617 0 1064727 INPATIENT - HOSPICE HOUSE 623110 227073 227073 0 0 227073 113072 113072 0 0 0 0 0 1804793 1685974 118819 118819 118819 241088 49110 28450 212638 212638 0 0 0 0 0 0 0 1736329 227073 0 444529 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 42629 0 42629 0 0 0 0 0 0 76725 55663 13893 7169 0 0 0 0 0 0 0 0 16166 15985 76 105 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 67919 67919 0 0 0 0 0 0 SUPPLIES & COGS 122781 99308 14933 8540 RELATED PARTY SVC FEES 892432 849585 42847 0 1218652 1088460 114378 15814 0 0 0 412412 500127 0 0 42951 10580 0 0 0 0 0 0 0 0 0 0 1892606 1093348 848086 799258 3632578 4021163 0 0 0 0 0 0 0 0 4936027 5331128 118913 120862 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 118913 120862 X 4817114 5210266 0 0 0 0 4817114 5210266 4936027 5331128 X 517677 137233 0 0 0 -261758 X false true X true false X 710342 979996 912801 963381 1064727 4631247 237820 202260 243560 184660 227073 1095373 47655 46650 226239 224512 241088 786144 0 0 995817 1228906 1382600 1372553 1532888 6512764 0 0 0 0 46936 229797 288684 604004 100629 1270050 46936 229797 288684 604004 100629 1270050 5242714 100816 112306 175347 115311 113072 616852 0 100816 112306 175347 115311 113072 616852 0 0 1096633 1341212 1557947 1487864 1645960 7129616 0.73534 0.63527 0.08652 0.07533 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 145000 145000 0 1334057 721863 612194 0 227799 225988 1810 0 185751 145497 40254 799258 GOURMET TASTE 57090 46010 11080 500 1694 3372 GOLF TOURNEY 233108 3100 230008 1916 18455 2513 0 290198 49110 241088 2416 20149 5885 28450 212638 false true false false false false false false false Thomas Kleinhanzl Director 0 834039 0 242384 0 12973 0 230527 0 18331 0 1338254 0 0 John Verbus Director 0 340381 0 81284 0 3564 0 40743 0 14323 0 480295 0 0 Laurel Cucchi Director Operations 0 136476 0 0 0 522 0 5354 0 7684 0 150036 0 0 Michelle Mahan Chief Financial Officer - FMH 0 548382 0 101798 0 3564 0 38188 0 18331 0 710263 0 0 Mark Goldstein MD Director 0 258662 0 186010 0 240 0 14575 0 18331 0 477818 0 0 PATRICK JOHANNES MANSKY DIRECTOR (start 6/22/17) 0 426815 0 65345 0 516 0 6625 0 2351 0 501652 0 0 FORM 990, SCHEDULE J, PART I, LINE 3 THE EXECUTIVE COMPENSATION PROGRAM IS DESIGNED TO CARRY OUT THE HEALTH SYSTEM MISSION, TO ACHIEVE THE CHARITABLE PURPOSE, TO ATTRACT, RETAIN, MOTIVATE AND REWARD EXECUTIVE MANAGEMENT, AND TO MAINTAIN A COMPETITIVE POSITION WITH PEER ORGANIZATIONS IN THE REGION. OVERSIGHT OF THE EXECUTIVE COMPENSATION PROGRAM IS PROVIDED BY THE EXECUTIVE COMPENSATION COMMITTEE OF THE BOARD, COMPOSED OF THE BOARD CHAIRMAN, VICE CHAIRMAN, IMMEDIATE PRECEDING CHAIRMAN, CHAIRMAN OF THE FINANCE COMMITTEE AND THE CHAIRMAN OF THE GOVERNANCE COMMITTEE. IN ADDITION TO THE BOARD'S COMPENSATION COMMITTEE, WE UTILIZED AN EXTERNAL INDEPENDENT CONSULTANT AND MARKET SURVEYS FOR ALL EXECUTIVE MANAGEMENT COMPENSATION. THE PRESIDENT AND CEO HAS A WRITTEN EMPLOYMENT CONTRACT. FORM 990, SCHEDULE J, PART I, LINE 4B FREDERICK MEMORIAL HOSPITAL HAS ONE 457(F) NON-QUALIFIED DEFERRED COMPENSATION PLAN FOR CERTAIN MEMBERS OF SENIOR MANAGEMENT. UNDER THE PLAN, THEY MAY CONTRIBUTE AMOUNTS FROM THEIR COMPENSATION TO THE PLAN AND MAY RECEIVE A DISCRETIONARY EMPLOYER CONTRIBUTION. EMPLOYEES ARE FULLY VESTED IN ALL EMPLOYEE CONTRIBUTIONS TO THE PLAN. VESTING IN EMPLOYER CONTRIBUTIONS OCCURS IN ACCORDANCE WITH THE UNDERLYING PLAN DOCUMENTS. ALL ASSETS OF THE PLAN ARE HELD IN A SEPARATE TRUST. TOTAL HOSPITAL CONTRIBUTIONS TO THIS PLAN WERE AS FOLLOWS: THOMAS A. KLEINHANZL $214,627 MICHELLE K. MAHAN $23,613 JOHN R. VERBUS $26,168 MEMBERS OR STOCKHOLDER FORM 990, PART VI, LINE 6 FREDERICK MEMORIAL HOSPITAL, INC. IS THE SOLE MEMBER OF THE CORPORATION. POWER TO ELECT OR APPOINT MEMBERS THE MEMBER (FMH, INC.) SHALL TAKE THE FOLLOWING ACTIONS ON BEHALF OF THE CORPORATION: -APPOINT, AND, AS NECESSARY, REMOVE THE PRESIDENT/CEO OF THE CORPORATION; PROVIDED, HOWEVER, THAT THE MEMBER SHALL TAKE NO SUCH ACTION WITHOUT PRIOR CONSULTATION WITH THE BOARD OF DIRECTORS -FORMULATE, COMMUNICATE AND IMPLEMENT STRATEGIC PLANNING AND FINANCIAL MANAGEMENT -SELECT A FISCAL AUDITOR THE CORPORATION MAY TAKE THE FOLLOWING ACTIONS ONLY WITH THE PRIOR APPROVAL OF THE MEMBER: -EXPEND OR DIVEST ITS CAPITAL ASSETS, IF THE VALUE OF SUCH EXPENDITURE OR DIVESTITURE IS IN EXCESS OF AN AMOUNT TO BE DESIGNATED BY THE MEMBER FROM TIME TO TIME -INCUR DEBT OR GUARANTEE DEBT, IF THE AGGREGATE AMOUNT OF SUCH DEBT DURING ANY TWELVE MONTH PERIOD IS IN EXCESS OF AN AMOUNT TO BE DESIGNATED BY THE MEMBER FROM TIME TO TIME -EXPEND AMOUNTS IN EXCESS OF THE CORPORATION'S APPROVED ANNUAL OPERATING BUDGET IF SUCH AMOUNTS EXCEED AN AMOUNT TO BE DESIGNATED BY THE MEMBER FROM TIME TO TIME -DISSOLVE OR LIQUIDATE -CREATE, DISSOLVE OR DIVEST ANY SUBSIDIARY, PARTNERSHIP OR LLC -AMEND THE ARTICLES OF INCORPORATION AND/OR BY LAWS OF THE CORPORATION THE FOLLOWING SHALL NOT BE DEEMED TO HAVE TAKEN PLACE ABSENT SUBSEQUENT RATIFICATION BY THE MEMBER: -THE ADOPTION BY THE CORPORATION OF ITS ANNUAL OPERATING BUDGET OR CAPITAL BUDGET -ELECTION OR REPLACEMENT OF A DIRECTOR OR THE FILLING OF A VACANCY ON THE BOARD OF DIRECTORS -AT SUCH TIMES AS THE MEMBER DEEMS NECESSARY, AND PURSUANT TO THE VOTE OF AT LEAST TWO-THIRDS OF THE MEMBER'S DIRECTORS, REMOVE A DIRECTOR OF THE CORPORATION -CHANGE THE MISSION OF THE THE FOLLOWING SHALL NOT BE DEEMED TO HAVE TAKEN PLACE ABSENT SUBSEQUENT RATIFICATION BY THE MEMBER: -THE ADOPTION BY THE CORPORATION OF ITS ANNUAL OPERATING BUDGET OR CAPITAL BUDGET -ELECTION OR REPLACEMENT OF A DIRECTOR OR THE FILLING OF A VACANCY ON THE BOARD OF DIRECTORS -AT SUCH TIMES AS THE MEMBER DEEMS NECESSARY, AND PURSUANT TO THE VOTE OF AT LEAST TWO-THIRDS OF THE MEMBER'S DIRECTORS, REMOVE A DIRECTOR OF THE CORPORATION -CHANGE THE MISSION OF THE CORPORATION DECISIONS RESERVED TO MEMBERS OR STOCKHOLDERS FORM 990, PART VI, LINE 11B THE 990 IS PREPARED IN CONJUNCTION WITH OUTSIDE TAX ACCOUNTANTS AND IS REVIEWED BY UPPER MANAGEMENT PRIOR TO PROVIDING A COPY TO THE BOARD. A COPY OF THE FORM 990 WAS PROVIDED TO ALL MEMBERS OF THE BOARD PRIOR TO FILING. Form 990, Part vi, line 12c THE HOSPICE OF FREDERICK COUNTY, INC. BOARD OF DIRECTORS IS COMMITTED TO MEETING ITS FIDUCIARY RESPONSIBILITIES AND MAINTAINING ITS DUTY OF LOYALTY TO THE HOSPITAL AND THE COMMUNITY IT SERVES. TO THIS END, THE BOARD WILL EXERCISE VIGILANCE IN IDENTIFYING ANY CONFLICTS OF INTEREST. THE BOARD WILL ALSO MAINTAIN TRANSPARENCY AND OBJECTIVITY IN MAKING DECISIONS ABOUT CONFLICTS OF INTEREST SO THAT THE ORGANIZATION'S MISSION IS ALWAYS THE FIRST PRIORITY. THE CHAIRPERSON (OR VICE CHAIRPERSON IF THE CHAIR IS INVOLVED) WILL NOTIFY ALL DIRECTORS OF A REPORTED CONFLICT OF INTEREST AND WILL DECIDE WHETHER TO TAKE THE MATTER TO THE FULL BOARD TO DECIDE WHETHER A CONFLICT EXISTS AND, IF SO, TO DECIDE WHAT ACTION TO TAKE. ALTERNATIVELY, THE CHAIR PERSON WILL REFER THE MATTER TO THE GOVERNANCE COMMITTEE FOR AN IN-DEPTH EXAMINATION, SUMMARY, AND RECOMMENDATION PRIOR TO A FULL BOARD DISCUSSION AND DECISION. IF TIME IS OF THE ESSENCE, THE CHAIRPERSON WILL TAKE THE MATTER TO THE EXECUTIVE COMMITTEE, AND THE CHAIRPERSON WILL NOTIFY THE FULL BOARD OF SUCH ACTION. WHERE A CONFLICT OF INTEREST HAS BEEN IDENTIFIED THE BOARD MEMBER SHALL NOT VOTE OR BE PRESENT FOR THE DISCUSSION OR THE VOTE REGARDING THE TRANSACTION AT EITHER THE FULL BOARD, EXECUTIVE COMMITTEE, OR GOVERNANCE COMMITTEE MEETINGS EXCEPT TO ANSWER QUESTIONS THAT MAY BE ASKED OF HIM OR HER. TO PREVENT ACTUAL OR PERCEIVED INFLUENCE ON THE BOARD'S DECISION, THE CONFLICTED MEMBER IS PROHIBITED, AFTER INITIAL DISCLOSURE, FROM DISCUSSING THE CONFLICT OF INTEREST EITHER FORMALLY OR INFORMALLY WITHFELLOW DIRECTORS OR WITH MEMBERS OF THE MANAGEMENT. THERE WILL BE AN ANNUAL REVIEW OF ALL BOARD MEMBERSOFFICERS' TRANSACTIONS PREPARED BY THE ADMINISTRATION AND REVIEWED BY THE GOVERNANCE COMMITTEE AND THE FULL BOARD OF DIRECTORS. AT THAT TIME, ALL DIRECTORS WILL BE REMINDED OF THE IRS INTERMEDIATE SANCTIONS REGULATION THAT ESTABLISHES EXCISE TAXES AS A SANCTION AGAINST ADMINISTRATORS AND DIRECTORS OF TAX-EXEMPT ORGANIZATIONS WHO PARTICIPATE IN 'EXCESS BENEFIT TRANSACTIONS' (E.G., UNREASONABLE HIGH EMPLOYMENT. PROCESS FOR MAKING DOCUMENTS AVAILABLE TO THE PUBLIC FORM 990, PART VI, LINE 19 THE GOVERNING DOCUMENTS AND THE CONFLICT OF INTEREST POLICY ARE AVAILABLE UPON REQUEST. FREDERICK REGIONAL HEALTH SYSTEM, INC'S CONSOLIDATED ANNUAL AUDITED FINANCIAL STATEMENTS ARE AVAILABLE AT WWW.FMH.ORG. OTHER CHANGES IN NET ASSETS Form 990, Part Xi, line 9 GIFTS IN KIND EXPENSE -20,670 FUnDRAISER EXPENSE -28,450 Fundraiser Net Income -212,638 ---------- TOTAL -261,758 FREDERICK MEMORIAL HOSPITAL INC 700 West Seventh Street FREDERICK MD 21701 520591612 Hospital MD 501(c)(3) 3 FRHS INC false FREDERICK REGIONAL HEALTH SYSTEM INC 400 WEST SEVENTH STREET FREDERICK MD 21701 454133096 HEALTH SYSTEM MD 501(c)(3) 12b na false MONOCACY HEALTH PARTNERS 400 WEST SEVENTH STREET FREDERICK MD 21701 453007639 PHYS ORG MD 501(c)(3) 7 FRHS INC true FREDERICK HEALTH SERVICES CORPORATION 400 WEST SEVENTH STREET FREDERICK MD 21701 521851661 HEALTH CARE MD FRHS INC C Corp 0 0 0.00000 true FREDERICK SURGICAL SERVICES CORPORATION 400 W 7TH STREET FREDERICK MD 21701 521642334 HEALTH CARE MD FHSC INC C Corp 0 0 0.00000 true Monocacy Insurance LTD PO BOX 1159 Grand Cayman KY1-1102 CY 981011570 Self Insurance CY FRHS INC C Corp 0 0 0.00000 true false false false false false false false false false false false false false false true false false false false FREDERICK MEMORIAL HOSPITAL INC o 892432 DIRECT COSTING