2018-05-11T08:19:28-05:00 2017-06-30 KPMG LLP 1676 INTERNATIONAL DRIVE McLean VA 22102 990 2016-07-01 520591607 The Good Samaritan Hospital of Maryland Inc % JOEL BRYAN GOOD 4107726721 5601 LOCH RAVEN BLVD Baltimore MD 21239 JOEL BRYAN VP/Treasurer 4107726721 2018-05-10 true JG WHITE P01498698 7032868000 2018-05-10 2016 2022-09-23 18:48:47Z BRADLEY CHAMBERS 5601 LOCH RAVEN BLVD BALTIMORE MD 21239 304578129 false X www.goodsam-md.org X 1920 MD WE ARE GOOD SAMARITANS, GUIDED BY CATHOLIC TRADITION AND TRUSTED TO TRADITION AND TRUSTED TO DELIVER IDEAL HEALTHCARE EXPERIENCES FOR THE PATIENTS WE SERVE. 22 14 1906 100 160922 3058718 8877130 308986480 293106645 86197 85722 3287167 2508632 315418562 304578129 0 0 0 0 157053747 152162034 0 0 0 150501269 134882158 307555016 287044192 7863546 17533937 166104776 171590429 50399432 44142984 115705344 127447445 X AS A PROUD MEMBER OF MEDSTAR HEALTH, MEDSTAR GOOD SAMARITAN HOSPITALS (MEDSTAR GOOD SAMARITAN) MISSION IS TO BE GOOD SAMARITANS, GUIDED BY CATHOLIC TRADITION AND TRUSTED TO DELIVER IDEAL HEALTH EXPERIENCES. MEDSTAR GOOD SAMARITAN, LOCATED IN NORTHEAST BALTIMORE CITY, MARYLAND, IS KNOWN FOR ITS SPECIALTIES IN ORTHOPAEDICS, RHEUMATOLOGY, NEPHROLOGY, AND PHYSICAL MEDICINE AND REHABILITATION PROGRAMS. IN ADDITION TO GENERAL ADULT ACUTE CARE SERVICES, MEDSTAR GOOD SAMARITAN HAS A COMPREHENSIVE INPATIENT REHABILITATION UNIT AND A SUB-ACUTE CARE UNIT. THROUGH MGSHS CENTER FOR SUCCESSFUL AGING, INTEGRATED CARE IS PROVIDED TO PATIENTS WHO EXPERIENCE AGE-RELATED HEALTH CONDITIONS. IN FISCAL YEAR 2017, MEDSTAR GOOD SAMARITAN HAD 13,604 INPATIENT ADMISSIONS AND OBSERVATIONS, 311,452 OUTPATIENT VISITS, AND 51,967 EMERGENCY VISITS. false false 199378013 0 289814086 MEDSTAR GOOD SAMARITANS LARGEST PROGRAM IS ACCESS TO AND THE PROVISION OF ACUTE HOSPITAL SERVICES TO THE COMMUNITIES OF NORTHEASTERN BALTIMORE CITY, MARYLAND AND THE SURROUNDING AREAS. IN ADDITION TO THE PROGRAM SERVICE EXPENSES LISTED ABOVE, MEDSTAR GOOD SAMARITAN INCURRED $86.6M OF MANAGEMENT AND GENERAL EXPENSES IN PROVIDING SERVICES TO ITS COMMUNITIES. IT ALSO OFFERS COMMUNITY-BASED HEALTH SERVICES THROUGH THE GOOD HEALTH CENTER AND PROVIDES SENIOR LIVING SERVICES THROUGH THE GOOD SAMARITAN NURSING CENTER AND TWO SENIOR HOUSING COMPLEXES LOCATED ON ITS 43-ACRE CAMPUS. MEDSTAR GOOD SAMARITANS STROKE CARE PROGRAM HAS RECEIVED THE GOLD SEAL OF APPROVAL FROM THE JOINT COMMISSION FOR PRIMARY STROKE CENTERS. MEDSTAR GOOD SAMARITAN HAS RECEIVED THE BRONZE PERFORMANCE ACHIEVEMENT AWARD FROM THE AMERICAN STROKE ASSOCIATION FOR ITS EXCEPTIONAL CARE FOR STROKE PATIENTS. THE STROKE CENTER AT MEDSTAR GOOD SAMARITAN HOSPITAL HAS RECEIVED BOTH THE HONORED BRONZE AWARD AND SILVER PLUS AWARD FROM THE AMERICAN HEART ASSOCIATION FOR THE OUTSTANDING WORK OF THE CENTER AS WELL AS ITS PREVENTIVE AND COMMUNITY EDUCATION PROGRAMS. PRACTICE GREENHEALTH AWARDED MEDSTAR GOOD SAMARITAN HOSPITAL THE GREENHEALTH EMERALD AWARD, WHICH IS GIVEN TO HEALTHCARE FACILITIES THAT HAVE ACHIEVED IMPROVEMENTS IN MERCURY ELIMINATION, WASTE REDUCTION, RECYCLING, AND SOURCE REDUCTION PROGRAMS. WINNING FACILITIES ARE FURTHER ALONG THE PATH TO SUSTAINABILITY AND SHOW LEADERSHIP IN THE LOCAL COMMUNITY AND IN THE HEALTHCARE SECTOR. 8251420 0 3292559 MEDSTAR GOOD SAMARITAN PROVIDED $8.2M IN SUBSIDIZED (MISSION DRIVEN) HEALTH SERVICES IN FISCAL YEAR 2017. 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 HOSPITALISTS, OUTPATIENT RENAL DIALYSIS SERVICES, AND CONTINUING CARE. 8605111 0 0 MedStar Good Samaritan provided $8.6M in health professions education in fiscal year 2017. This category includes training in graduate medical education, and education for physicians, medical students, nurses, and other health professions. 216234544 true true false false false false false false false false true false false true true true false true false false false false false false false false true true false false true false false false false false true false false true false false false true true true true false false true 0 0 true 1906 true true true false false false false false false false false false X 22 14 false false false false true true true true true false false true true true true true true true true false MD X JOEL BRYAN 4107726721 10980 GRANTCHESTER WAY COLUMBIA MD 21044 X DANIEL P CAHILL VICE CHAIR 1.0 0.0 X 0 0 0 MOIRA P LARSEN MD BOARD MEMBER 40.0 0.0 X 206449 223367 5634 KENNETH A SAMET BOARD MEMBER 1.0 39.0 X 0 7675042 76815 BERNARD H RAVITZ MD BOARD MEMBER 40.0 0.0 X 279116 0 5418 HOWARD S FREELAND MD BOARD MEMBER 40.0 0.0 X 88570 262012 19744 LUIS GIMENEZ MD BOARD MEMBER 1.0 0.0 X 0 0 0 KAY G BEE BOARD MEMBER 1.0 0.0 X 0 0 0 SONYA H GRAY BOARD MEMBER 1.0 0.0 X 0 0 0 Most Rev Denis J Madden BOARD MEMBER 1.0 0.0 X 0 0 0 ALLAN NOONAN MD BOARD MEMBER 1.0 0.0 X 0 0 0 REV PM SMITH BOARD MEMBER 1.0 0.0 X 0 0 0 JOHN C SMYTH CHAIR 1.0 0.0 X 0 0 0 KATHLEEN J WHITING BOARD MEMBER 1.0 0.0 X 0 0 0 DAVID WEISMAN DO BOARD MEMBER 40.0 0.0 X 228674 0 23295 MONS ADAM J PARKER BOARD MEMBER 1.0 0.0 X 0 0 0 ELIAS SHAYA MD BOARD MEMBER 40.0 0.0 X 344684 0 9381 MICHAEL JACOBS MD BOARD MEMBER 40.0 0.0 X 803049 0 19994 BRADLEY CHAMBERS President/BOARD MEMBER 20.0 20.0 X X 559725 559724 42754 ANTHONY READ BOARD MEMBER 1.0 0.0 X 0 0 0 Anthony DAgostino BOARD MEMBER (AS OF 3/2017) 1.0 0.0 X 0 0 0 Kevin E Wesner BOARD MEMBER (AS OF 9/2016) 1.0 0.0 X 0 0 0 Holly A Tilford BOARD MEMBER (AS OF 9/2016) 1.0 0.0 X 0 0 0 DEANA STOUT CHIEF FINANCIAL OFFICER 20.0 20.0 X 207095 207095 38987 STEPHEN KOENIGSBERG vice president 20.0 20.0 X 124086 124086 22342 SHARON BOTTCHER CHIEF NURSING OFFICER 20.0 20.0 X 172915 172915 15647 MARTIN BINSTOCK VP MEDICAL AFFAIRS 40.0 0.0 X 611308 0 34970 ROBERT PEROUTKA MD PHYSICIAN 40.0 0.0 X 667861 0 18938 DALE BUCHBINDER MD MED dir of vascular SURGERY 40.0 0.0 X 635025 0 19886 MESFIN LEMMA MD PHYSICIAN 40.0 0.0 X 739694 0 1869 Carmen Pichard-Encina PHYSICIAN 40.0 0.0 X 514613 0 11411 JEFFREY A MATTON former PRESIDENT 0.0 40.0 X 0 1005282 38648 THOMAS SENKER FORMER SECRETARY 40.0 0.0 X 523370 0 30735 JENNIFER WILKERSON FORMER OFFICER 40.0 0.0 X 278011 0 21042 6984245 10229523 457510 158 true true false HUNT VALLEY ANES ASSOC PA PO BOX 20284 TOWSON MD 21284 Medical Services 6190000 MORRISON HEALTHCARE FOOD SERVICES 4721 MORRISON DRIVE MOBILE AL 36609 food services 3900384 JOHNS HOPKINS UNIVERSITY 12529 COLLECTIONS CENTER DRIVE CHICAGO IL 60693 PROFESSIONAL SVCS 3454492 UNIVERSITY OF MARYLAND 110 S PACA STREET BALTIMORE MD 21201 PROFESSIONAL SVCS 1828818 AMN HEALTHCARE INC 200 John James Audubon Pkwy BUFFALO NY 14228 STAFFING SERVICES 1180420 40 270835 8606295 39561 8877130 NET PATIENT SERVICE REVENUE 621400 284568577 284568577 PHARMACY INCOME 900099 7767174 7767174 MEANINGFUL USE INCOME 900099 688743 688743 OTHER HEALTH REVENUE 900099 82151 82151 293106645 47750 47750 0 0 372227 372227 0 372227 372227 31674 6298 31674 6298 37972 37972 0 0 0 0 0 0 0 0 0 REBATE INCOME 900099 624905 624905 CHILD DAY CARE 900099 552938 552938 REFERRAL LAB INCOME 900099 160922 160922 797640 797640 2136405 304578129 293106645 160922 2433432 0 0 0 0 3132317 2824320 307997 0 123972588 111782516 12190072 2182152 1967584 214568 14942341 13473079 1469262 7932636 6954614 978022 33945523 33945523 68500 68500 0 0 0 0 26812432 17976502 8835930 329958 16787 313171 0 2505134 1517318 987816 0 0 1235182 988339 246843 203884 178488 25396 0 93988 86665 7323 2115674 2115674 0 12367652 7180188 5187464 3463768 1749863 1713905 MED/SURG SUPPLIES 28594756 28734801 -140045 MAINTENANCE 6352691 5838755 513936 FOOD SERVICES/SUPPLIES 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610565 OTHER LIABILITIES 9064669 23982861 X FIN 48 FOOTNOTE PART X, LINE 2 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, 2017. true true X true X true X true true true false true true 3823677 3823677 0.01330 3823677 3823677 0.01330 1092104 35855 1056249 0.00370 8605111 8605111 0.03000 8251420 3292559 4958861 0.01730 28915 28915 0.00010 17977550 3328414 14649136 0.05110 21801227 3328414 18472813 0.06440 902538 552938 349600 0.00120 26386 26386 0.00010 4016 4016 932940 552938 380002 0.00130 true 11512102 true true 1 1 GOOD SAMARITAN HOSPITAL OF MARYLAND 5601 LOCH RAVEN BLVD BALTIMORE MD 21239 X X X X GOOD SAMARITAN HOSPITAL OF MARYLAND 1 false false true X X X X X X X X X 14 true false false true X WWW.MEDSTARGOODSAM.ORG X true 14 true WWW.MEDSTARGOODSAM.ORG false false true X 200. 400. X X X X X X true true X X X X true X WWW.MEDSTARGOODSAM.ORG X WWW.MEDSTARGOODSAM.ORG X WWW.MEDSTARGOODSAM.ORG 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 on all Schedule Hs. The Lead also works closely with the writer. He/she reviews all narratives prior to publication. Name of Hospital Lead: Deborah Bena 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: Bradley Chambers Advisory Task Force Role Description The Advisory Task Force (ATF) reviews primary/secondary data and local/state/federal community health goals. Based on findings, the ATF provides input into the hospital's three-year implementation strategy. As ambassadors for the CHNA process, the ATF members support efforts to optimize community participation. Note: The ATF should be a combination of community representatives and staff. Community representatives should makeup at least 50% of total participants. Name: Title/Affiliation with Hospital: Name of Organization Deborah Bena Health Ministries Coordinator MedStar Good Samaritan Hospital Allan Noonan, MD Chair MedStar Good Samaritan Hospital Board Sonya Gray Board Member MedStar Good Samaritan Hospital Board David Weisman, MD Physician MedStar Good Samaritan Hospital Michelle Zikusoka,Physician MedStar Good MD Samaritan Hospital Bernadette Krol, Registered Nurse MedStar Good RN Samaritan Hospital Moira Larsen, MD Physician and Board Member MedStar Good Samaritan Hospital Rachel V. Neill Resident Govans Ecumenical Corporation (GEDCO) - CARES PROGRAM Patricia Stabile Program Director HARBEL Prevention and recovery Center Randolph Rowel, Chair $ Associate Professor Department of PhD Behavioral health Sciences, Morgan state university IMPLEMENTATION STRATEGY 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. 3 Transitional Care at Good Samaritan 5601 Loch Raven Blvd Baltimore MD 21239 Comprehensive Care Facility ManorCare 6600 Ridge Rd Baltimore MD 21239 Renal Dialysis facility Lorien Frankford 5009 Frankford Ave Baltimore MD 21206 Renal Dialysis facility 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 FY15, MEDSTAR GOOD SAMARITAN HOSPITAL 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. THE HOSPITALS CHNA WAS LED BY 15 ADVISORY TASK FORCE (ATF) MEMBERS, WHICH WAS COMPRISED OF A DIVERSE GROUP OF INDIVIDUALS, INCLUDING 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 QUANTITATIVE AND QUALITATIVE COMMUNITY HEALTH DATA, AS WELL AS LOCAL, REGIONAL AND NATIONAL HEALTH GOALS. BASED ON THEIR FINDINGS, THE ATF DESIGNED A SURVEY TO IDENTIFY TRENDS IN HOW PARTICIPANTS PERCEIVED THE SEVERITY OF KEY HEALTH ISSUES IN THE FOLLOWING CATEGORIES: WELLNESS AND PREVENTION, ACCESS TO CARE, QUALITY OF LIFE, AND ENVIRONMENT. COMMUNITY MEMBERS RESPONDED TO THE SURVEY BY ATTENDING A COMMUNITY INPUT SESSION OR COMPLETING IT ONLINE OR VIA HARDCOPY. BASED ON THE ATFS RECOMMENDATION, THE HOSPITAL IDENTIFIED GOVANS AS ITS COMMUNITY BENEFIT SERVICE AREA (CBSA) GEOGRAPHY WITH A HIGH DENSITY OF LOW-INCOME OR VULNERABLE RESIDENTS WITHIN CLOSE PROXIMITY OF THE HOSPITAL. HEALTH PRIORITIES FOR THE CBSA INCLUDE CHRONIC DISEASE (HEART DISEASE/STROKE, DIABETES, AND OBESITY). THE HOSPITALS FY15 CHNA AND THREE-YEAR IMPLEMENTATION STRATEGIES WERE ENDORSED BY MEDSTAR GOOD SAMARITANS BOARD OF DIRECTORS AND APPROVED BY THE MEDSTAR HEALTH BOARD OF DIRECTORS. THE DOCUMENT WAS PUBLISHED ON THE HOSPITALS WEBSITE ON JUNE 30, 2015. AS A PROUD MEMBER OF MEDSTAR HEALTH, REPRESENTATIVES FROM MEDSTAR GOOD SAMARITAN 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 WITHIN THE COMMUNITIES WE SERVE WHO LACK FINANCIAL RESOURCES HAVE ACCESS TO NECESSARY HOSPITAL SERVICES.1 MEDSTAR HEALTH AND ITS HEALTHCARE FACILITIES WILL: * TREAT ALL PATIENTS EQUITABLY, WITH DIGNITY, WITH RESPECT AND WITH COMPASSION. * SERVE THE EMERGENCY HEALTH CARE NEEDS OF EVERYONE WHO PRESENTS AT OUR FACILITIES REGARDLESS OF A PATIENT'S ABILITY TO PAY FOR CARE. * ASSIST THOSE PATIENTS WHO ARE ADMITTED THROUGH OUR ADMISSIONS PROCESS FOR NON-URGENT, MEDICALLY NECESSARY CARE WHO CANNOT PAY FOR PART OF ALL OF 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 WORK WITH THEIR UNINSURED PATIENTS TO GAIN AN UNDERSTANDING OF EACH PATIENTS FINANCIAL RESOURCES PRIOR TO ADMISSION (FOR SCHEDULED SERVICES) OR PRIOR TO BILLING (FOR EMERGENCY SERVICES). BASED ON THIS INFORMATION AND PATIENT ELIGIBILITY, MEDSTAR HEALTHS FACILITIES ASSISTS 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). * ASSIST WITH CONSIDERATION OF FUNDING THAT MAY BE AVAILABLE FROM OTHER CHARITABLE ORGANIZATIONS. * PROVIDE CHARITY CARE AND FINANCIAL ASSISTANCE ACCORDING TO APPLICABLE GUIDELINES. * PROVIDE FINANCIAL ASSISTANCE FOR PAYMENT OF FACILITY CHARGES USING A SLIDING SCALE BASED ON PATIENT FAMILY INCOME AND FINANCIAL RESOURCES. * OFFER PERIODIC PAYMENT PLANS TO ASSIST PATIENTS WITH FINANCING THEIR HEALTHCARE SERVICES. EACH FACILITY POSTS THE POLICY, INCLUDING A DESCRIPTION OF THE APPLICABLE COMMUNITIES IT SERVES, IN EACH MAJOR PATIENT REGISTRATION AREA AND IN ANY OTHER AREAS REQUIRED BY APPLICABLE REGULATIONS, COMMUNICATES THE INFORMATION TO PATIENTS AS REQUIRED BY THIS POLICY AND APPLICABLE REGULATIONS AND MAKES A COPY OF THE POLICY AVAILABLE TO ALL PATIENTS. ADDITIONALLY, THE MARYLAND PATIENT INFORMATION SHEET/MEDSTARS PATIENT INFORMATION SHEET IS PROVIDED TO INPATIENTS ON ADMISSION AND AT TIME OF FINAL ACCOUNT BILLING. MEDSTAR HEALTH BELIEVES THAT ITS PATIENTS HAVE PERSONAL RESPONSIBILITIES RELATED TO THE FINANCIAL ASPECTS OF THEIR HEALTHCARE NEEDS. THE CHARITY CARE, FINANCIAL ASSISTANCE, AND PERIODIC PAYMENT PLANS AVAILABLE UNDER THIS POLICY ARE NOT AVAILABLE TO THOSE PATIENTS WHO FAIL TO FULFILL THEIR RESPONSIBILITIES. FOR PURPOSES OF THIS POLICY, PATIENT RESPONSIBILITIES INCLUDE: * COMPLETING FINANCIAL DISCLOSURE FORMS NECESSARY 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 FINANCIAL COUNSELORS AND OTHER FINANCIAL SERVICES STAFF TO ENSURE THERE IS A COMPLETE UNDERSTANDING OF THE PATIENTS FINANCIAL SITUATION AND CONSTRAINTS. * COMPLETING APPROPRIATE APPLICATIONS FOR PUBLICLY-FUNDED HEALTHCARE PROGRAMS. THIS RESPONSIBILITY INCLUDES RESPONDING IN A TIMELY FASHION TO REQUESTS FOR DOCUMENTATION TO SUPPORT ELIGIBILITY. * 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 FINANCIAL COUNSELORS ON A TIMELY BASIS AS THE PATIENTS 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. UNINSURED PATIENTS OF MEDSTAR HEALTHS FACILITIES MAY BE ELIGIBLE FOR CHARITY CARE OR SLIDING-SCALE FINANCIAL ASSISTANCE UNDER THIS POLICY. THE FINANCIAL COUNSELORS AND FINANCIAL SERVICES STAFF DETERMINE ELIGIBILITY FOR CHARITY CARE AND SLIDING-SCALE FINANCIAL ASSISTANCE BASED ON REVIEW OF INCOME FOR THE PATIENT AND THEIR FAMILY (HOUSEHOLD), OTHER FINANCIAL RESOURCES AVAILABLE TO THE PATIENTS FAMILY, FAMILY SIZE, AND THE EXTENT OF THE MEDICAL COSTS TO BE INCURRED BY THE PATIENT. COMMUNITY INFORMATION PART VI, LINE 4 GEOGRAPHIC: MEDSTAR GOOD SAMARITAN HOSPITALS CBSA INCLUDES RESIDENTS IN ZIP CODE 21212, THE GOVANS AREA OF BALTIMORE. WHILE THE PRIMARY FOCUS FOR TARGETED PROGRAMMING WILL BE IN THIS NEIGHBORHOOD, MGSH ALSO PROVIDES SERVICES TO INDIVIDUALS IN NEED IN THE HOSPITALS PRIMARY SERVICE AREA, WHICH INCLUDES ZIP CODES 21234, 21239, 21206, AND 21214. THE CBSA WAS SELECTED DUE TO ITS CLOSE PROXIMITY TO THE HOSPITAL, COUPLED WITH A HIGH DENSITY OF RESIDENTS WITH LOW INCOMES. THE GOVANS NEIGHBORHOOD IS LOCATED IN NORTH CENTRAL BALTIMORE CITY, APPROXIMATELY TWO MILES FROM GOOD SAMARITAN HOSPITAL. THE NEIGHBORHOOD FEATURES MANY DIFFERENT HOUSING TYPES, BUSINESSES, CHURCHES, A CHARTER SCHOOL AND A NEIGHBORHOOD PARK. GOVANS HAS ALWAYS BEEN ASSOCIATED WITH YORK ROAD, FIRST AS AN INDIAN TRAIL, AND THEN AS AN IMPORTANT COMMERCIAL ROAD AND TURNPIKE LINKING THE PORT OF BALTIMORE TO PENNSYLVANIA. DEMOGRAPHICS: ACCORDING TO STATISTICS FROM THE BALTIMORE CITY 2017 NEIGHBORHOODS HEALTH PROFILE, THE TOTAL POPULATION IN GOVANS (ZIP CODE 21212) IS 10,762, THE MAJORITY OF WHICH IS AFRICAN AMERICAN (90.4%). WHITES ACCOUNT FOR 6.4% OF THE POPULATION, AND 2.6% OF THE POPULATION SELF-REPORTS AS TWO OR MORE RACES. SLIGHTLY MORE THAN ONE PERCENT (2.3%) OF THE POPULATION IS OF HISPANIC OR LATINO ORIGIN. MEDIAN HOUSEHOLD INCOME IN THE GOVANS AREA IS 36,531 WHILE BALTIMORE CITY REPORTS A MEDIAN INCOME OF 41,819. DATA ALSO SHOWS THAT THE PERCENTAGE OF HOUSEHOLDS WITH INCOMES BELOW THE FEDERAL POVERTY GUIDELINE IN GOVANS IS 30.5% AND IN BALTIMORE CITY IS 28.8%. LIFE EXPECTANCY IN GOVANS IS 73.3 (DEATHS PER 10,000 RESIDENTS) JUST SLIGHTLY LOWER THAN THE BALTIMORE CITY AT 73.6. GOVANS IS CONSIDERED A FOOD DESERT-DATA SHOWS THE PERCENTAGE of land area that is covered by a food desert IS 36.2% AS COMPARED TO BALTIMORE CITY OVERALL AT 11.4%. PROMOTION OF COMMUNITY HEALTH PART VI, LINE 5 AS A COMMUNITY PARTNER, MEDSTAR GOOD SAMARITAN HOSPITAL (MGSH) ENGAGES IN A NUMBER OF COMMUNITY BENEFIT ACTIVITIES TO IMPROVE AND PROMOTE THE HEALTH AND WELL-BEING OF THE COMMUNITY. THE PRIORITY AREA OF FOCUS, AS DETERMINED BY THE COMMUNITY HEALTH NEEDS ASSESSMENT IS CHRONIC DISEASE, SPECIFICALLY TARGETING HEART DISEASE, DIABETES, AND OBESITY. IN FY17, MEDSTAR GOOD SAMARITAN CONTINUED COMMUNITY PARTNERSHIPS WITH ORGANIZATIONS, SUCH AS SENIOR CENTERS, CHURCHES AND SENIOR HOUSING TO PROVIDE HEALTH EDUCATION CLASSES, AS WELL AS EXERCISE AND WEIGHT LOSS programs. the stanford university's evidenced-based "living well programs" were conducted at various locations in fy17 to meet the needs OF THOSE WITH GENERAL CHRONIC CONDITIONS AS WELL AS DIABETES. APPROXIMATELY 35 PEOPLE PARTICIPATED IN THESE PROGRAMS. FITNESS PROGRAMS WERE HELD WEEKLY AT THE SENIOR NETWORK OF NORTH BALTIMORE, A CLOSE COMMUNITY PARTNER LOCATED IN GOVANS. CLASSES FOCUSED ON AEROBIC/CARDIO EXERCISE, STRENGTH TRAINING AND STRETCHING. APPROXIMATELY 90 PEOPLE PARTICIPATED IN THE FITNESS PROGRAMS IN FY17. TO ADDRESS DIABETES prevention, MGSH conducted two "national diabetes prevention programs". renamed "life balance/weight management program". the two cohorts had a TOTAL OF 38 PARTICIPANTS THAT STARTED AND 24 THAT COMPLETED ONE YEAR LATER. AFFILIATED HEALTH CARE SYSTEM PART VI, LINE 6 AS A PROUD MEMBER OF MEDSTAR HEALTH, MEDSTAR GOOD SAMARITAN 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 MEDSTAR GOOD SAMARITAN 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 GOOD SAMARITAN HOSPITAL IS ONLY FILED IN THE STATE OF MARYLAND. X true true X X X X X X false false false false false false false false false MOIRA P LARSEN MD BOARD MEMBER 202830 185867 3619 37500 0 0 0 4715 0 919 206449 229001 0 0 JEFFREY A MATTON former PRESIDENT 0 530063 0 475219 0 0 0 17077 0 21571 0 1043930 0 0 KENNETH A SAMET BOARD MEMBER 0 1739872 0 3775374 0 2159796 0 47768 0 29047 0 7751857 0 0 BERNARD H RAVITZ MD BOARD MEMBER 256116 0 23000 0 0 0 4280 0 1138 0 284534 0 0 0 HOWARD S FREELAND MD BOARD MEMBER 88570 240211 0 21801 0 0 0 7950 0 11794 88570 281756 0 0 DAVID WEISMAN DO BOARD MEMBER 209961 0 18713 0 0 0 8831 0 14464 0 251969 0 0 0 ELIAS SHAYA MD BOARD MEMBER 289684 0 55000 0 0 0 8476 0 905 0 354065 0 0 0 MICHAEL JACOBS MD BOARD MEMBER 803049 0 0 0 0 0 7950 0 12044 0 823043 0 0 0 THOMAS SENKER FORMER SECRETARY 324602 0 198768 0 0 0 7950 0 22785 0 554105 0 0 0 MARTIN BINSTOCK VP MEDICAL AFFAIRS 372320 0 238988 0 0 0 19553 0 15417 0 646278 0 0 0 DEANA STOUT CHIEF FINANCIAL OFFICER 139773 139773 67322 67322 0 0 12080 12080 7414 7413 226589 226588 0 0 ROBERT PEROUTKA MD PHYSICIAN 410751 0 257110 0 0 0 4109 0 14829 0 686799 0 0 0 DALE BUCHBINDER MD MED dir of vascular SURGERY 610025 0 25000 0 0 0 7950 0 11936 0 654911 0 0 0 MESFIN LEMMA MD PHYSICIAN 511324 0 228370 0 0 0 875 0 994 0 741563 0 0 0 JENNIFER WILKERSON FORMER OFFICER 223234 0 54777 0 0 0 6080 0 14962 0 299053 0 0 0 BRADLEY CHAMBERS President/BOARD MEMBER 290743 290742 268982 268982 0 0 9625 9626 11752 11751 581102 581101 0 0 STEPHEN KOENIGSBERG vice president 101977 101977 22109 22109 0 0 5378 5379 5793 5792 135257 135257 0 0 SHARON BOTTCHER CHIEF NURSING OFFICER 137436 137436 35479 35479 0 0 7382 7382 442 441 180739 180738 0 0 Carmen Pichard-Encina PHYSICIAN 426871 0 87742 0 0 0 0 0 11411 0 526024 0 0 0 SOCIAL CLUB DUES SCHEDULE J, PART I, LINE 1 THE ORGANIZATION PAID SOCIAL CLUB DUES FOR ONE OF ITS OFFICERS DURING THIS YEAR. PARTICIPATION IN THESE ACTIVITIES BY THE OFFICER WAS FOR BUSINESS PURPOSES, AND HELPED THE ORGANIZATION FURTHER ITS EXEMPT PURPOSES. THE AMOUNT OF DUES PAID WAS INCLUDED IN THE OFFICER'S W-2. SCHEDULE J, PART III Mr. Samet's compensation in Part II, Column (B) includes $3,752,690, 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. Bradley Chambers compensation is for services provided as President to both MedStar Good Samaritan Hospital and MedStar Union Memorial Hospital. Deana Stouts compensation is for services provided as CFO to both MedStar Good Samaritan Hospital and MedStar Union Memorial Hospital. Stephen Koenigsbergs compensation is for services provided as a Key Employee to both MedStar Good Samaritan Hospital and MedStar Union Memorial Hospital. Sharon Bottchers compensation is for services provided as a Key Employee to both MedStar Good Samaritan Hospital and MedStar Union Memorial Hospital MORRISON HEALTHCARE FOOD SERVICES SEE PART V 3736903 FOOD SERVICES false WEBBMASON SEE PART V 280404 MARKETING STRATEGIES SERVICES false BUSINESS TRANSACTIONS INVOLVING INTERESTED PERSONS SCHEDULE L, PART IV MORRISON HEALTHCARE FOOD SERVICES IS A SUBSTANTIAL CONTRIBUTOR THAT ALSO PROVIDED FOOD SERVICES TO THE GOOD SAMARITAN HOSPITAL, INC. Webb/Mason is a substantial contributor that also provided marketing strategies services to the hospital. Per the conflict of interest policy, all transactions between the hospital and outside vendors should be at Arms-length for fair market value. X 1 39561 FMV false true false 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 11A 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) RELATED TO DIRECTORS ARE REVIEWED BY THE GOVERNANCE COMMITTEE OF THE MEDSTAR HEALTH BOARD OF DIRECTORS WHICH DETERMINES HOW THE MATTER SHOULD BE RESOLVED. SUCH DISCLOSURES (IF ANY) RELATED TO OFFICERS AND SENIOR MANAGERS ARE REVIEWED BY AN APPROPRIATE EXECUTIVE WHO DETERMINES HOW THE MATTER SHOULD BE RESOLVED IN ADDITION, OFFICERS AND DIRECTORS OF MARYLAND HOSPITALS AND NURSING CENTERS ARE REQUIRED TO ANNUALLY DISCLOSE ADDITIONAL INFORMATION RELATING TO POTENTIAL CONFLICTS OF INTEREST AND SUCH DISCLOSURES ARE REPORTED TO THE MARYLAND HEALTH SERVICES COST REVIEW COMMISSION (HSCRC). DESCRIPTION OF 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. FINANCIAL STATEMENTS AND REPORTING PART XII, LINE 2C THE GOOD SAMARITAN HOSPITAL OF MARYLAND, INC. IS AN AFFILIATE OF THE MEDSTAR HEALTH, INC. AUDIT AND SUBJECT TO OVERSIGHT BY THE AUDIT COMMITTEE OF THE MEDSTAR BOARD. OTHER CHANGES IN NET ASSETS PART XI, LINE 9 EQUITY TRANSFERS - NET ASSETS.....................$(10,614,625) O'NEILL EQUITY.....................................$ 4,646,237 ------------- TOTAL OTHER CHANGES IN NET ASSETS.................$ (5,968,388) MEDSTAR HEALTH ANESTHESIA SERVICES A LLC 5601 LOCH RAVEN BLVD BALTIMORE MD 21239 205909017 HEALTHCARE MD 3936702 254042 Church Home Corporation 10980 GRANTCHESTER WAY Columbia MD 21044 237374724 Medical Fund MD 501(C)(3) PF NA true Franklin Square Hospital Center Inc 9000 Franklin Square Drive Baltimore MD 21237 520608007 Hospital MD 501(C)(3) 3 NA true Harbor Hospital Inc 3001 South Hanover Street Baltimore MD 21225 520491660 Hospital MD 501(C)(3) 3 NA true Medstar Health Inc 10980 GRANTCHESTER WAY Columbia MD 21044 522087445 Medical Svcs MD 501(C)(3) 12C III NA false Montgomery General Hospital 18101 Prince Philip Drive Olney MD 20832 520646893 Hospital MD 501(C)(3) 3 NA true The Union Memorial Hospital 201 East University Parkway 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