CIVISTA MEDICAL CENTER INC: Form 990, tax year 2015

View the entire original 990 at ProPublica ↗

Organization
CIVISTA MEDICAL CENTER INC (EIN 52-0445374)
Tax period
2015-07-01 to 2016-06-30
Filed
2017-05-11
IRS object ID
201721319349300332
Schema version
2015v3.0
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

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Return2017-05-11T08:19:32-05:00ReturnTs
Tax Period End2016-06-30TaxPeriodEndDt

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Preparer Firm Name PreparerFirmName

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Business Name Line1GRANT THORNTON LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

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Address Line12001 MARKET STREET SUITE 700AddressLine1Txt
CityPHILADELPHIACityNm
State AbbreviationPAStateAbbreviationCd
ZIP19103ZIPCd
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Return Type990ReturnTypeCd
Tax Period Begin2015-07-01TaxPeriodBeginDt

Filer Filer

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EIN520445374EIN

Business Name BusinessName

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Business Name Line1Civista Medical Center IncBusinessNameLine1Txt
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In Care Of% ERIK BOASInCareOfNm
Business Name ControlCIVIBusinessNameControlTxt
Phone3016094130PhoneNum

US Address USAddress

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Address Line15 Garrett AvenueAddressLine1Txt
CityLa PlataCityNm
State AbbreviationMDStateAbbreviationCd
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Phone3016094130PhoneNum
Signature2017-04-26SignatureDt
Discuss With Paid PreparerYes (true)DiscussWithPaidPreparerInd

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FieldValueIRS element (for citing)
Preparer PersonFrank GiardiniPreparerPersonNm
PTINP00532355PTIN
Phone2155614200PhoneNum
FieldValueIRS element (for citing)
Tax2015TaxYr
Build TS2021-01-29 14:40:06ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerNoel CervinoPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line15 Garrett AveAddressLine1Txt
CityLa PlataCityNm
State AbbreviationMDStateAbbreviationCd
ZIP20646ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$134,941,686GrossReceiptsAmt
Group Return For AffiliatesfalseGroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website Addresswww.charlesregional.orgWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1980FormationYr
Legal Domicile StateMDLegalDomicileStateCd
Activity Or MissionCivista Medical Center, Inc. is a component of a reginal integrated health system serving the health needs of Charles County and the citizens of southern Maryland.ActivityOrMissionDesc
Voting Members Governing Body17VotingMembersGoverningBodyCnt
Voting Members Independent13VotingMembersIndependentCnt
Total Employee1074TotalEmployeeCnt
Total Volunteers120TotalVolunteersCnt
Total Gross UBI$76,089TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm-$63,117NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$0PYContributionsGrantsAmt
CY Contributions Grants$0CYContributionsGrantsAmt
PY Program Service Revenue$132,649,970PYProgramServiceRevenueAmt
CY Program Service Revenue$133,783,449CYProgramServiceRevenueAmt
PY Investment Income$551,842PYInvestmentIncomeAmt
CY Investment Income$504,610CYInvestmentIncomeAmt
PY Other Revenue$557,258PYOtherRevenueAmt
CY Other Revenue$653,627CYOtherRevenueAmt
PY Total Revenue$133,759,070PYTotalRevenueAmt
CY Total Revenue$134,941,686CYTotalRevenueAmt
PY Grants And Similar Paid$52,129PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$21,000CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$54,048,003PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$53,950,667CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$64,633,320PYOtherExpensesAmt
CY Other Expenses$67,198,823CYOtherExpensesAmt
PY Total Expenses$118,733,452PYTotalExpensesAmt
CY Total Expenses$121,170,490CYTotalExpensesAmt
PY Revenues Less Expenses$15,025,618PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$13,771,196CYRevenuesLessExpensesAmt
Total Assets BOY$149,948,298TotalAssetsBOYAmt
Total Assets EOY$153,443,724TotalAssetsEOYAmt
Total Liabilities BOY$103,563,868TotalLiabilitiesBOYAmt
Total Liabilities EOY$96,591,224TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$46,384,430NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$56,852,500NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionCIVISTA MEDICAL CENTER, INC. IS A COMPONENT OF A REGIONAL INTEGRATED HEALTHCARE SYSTEM CREATED TO PROVIDE EXCELLENCE IN ACUTE HEALTHCARE AND PREVENTIVE SERVICES IN CHARLES COUNTY AND THE SURROUNDING COMMUNITIES.MissionDesc
Significant New Program SrvcfalseSignificantNewProgramSrvcInd
Significant ChangefalseSignificantChangeInd
Expense$103,180,311ExpenseAmt
Grant$21,000GrantAmt
Revenue$134,360,987RevenueAmt
DescUniversity of Maryland Charles Regional Medical Center (UM CRMC) is the parent company of a regional integrated health system serving the health needs of Charles County and the citizens of Southern Maryland. Governance is provided through a community volunteer Board of Directors and community health improvement strategies are included in the organizations strategic plan. UM CRMCs Community Benefits Program utilizes a planned, managed, organized, and measured approach to meeting the identified community needs of the area we serve. The mission is to improve overall community health by improving access to health care, enhancing the health of the community, advancing healthcare knowledge and working with health - providing agency partners. From July 2014 to March 2015, the University of Maryland Charles Regional Medical Center, in collaboration with the Charles County Department of Health (CCDOH) undertook a comprehensive assessment of the health needs of Charles County, Maryland. An epidemiologist with a Masters Degree in Public Health Epidemiology was contracted to analyze the qualitative and quantitative data.To provide a comprehensive assessment of the health needs of the county, a four method plan was developed which included 4 different sources of data: a long online survey of Charles County residents perceptions of health and health behaviors, a short paper survey on health perceptions throughout the county, 15 focus groups with community leaders, citizens, and stakeholders, and a quantitative data analysis of secondary, published data. Data collection occurred between July 2014 and February 2015. The use of the multiple data collection methods strengthened the validity of the assessments findings as well as ensuring that Charles County residents had an opportunity to participate in the assessment process and to feel invested in its outcome. Fifteen focus groups were performed throughout the county between July 2014 and February 2015. The focus group topics included: chronic disease specific health, special populations, county leadership, drug and alcohol council members, Charles County substance abuse advisory coalition members, youth through the school nurses, in-house health department nurses, fitness and nutrition, minority health and health disparities, prevention and safety, faith-based leaders, behavioral health, reproductive and infant health, cancer, and access to care. Approximately 235 people participated in the county focus groups. Attendance for those meetings ranged from 5 to 100 people. Participants represented all service organizations within the community. They provide services to all facets of the community including women, infants, school aged children, those who are incarcerated, those with mental health problems, those with financial/housing/employment/health issues, the un- and underinsured, the hungry, those with chronic health conditions, the homeless, the elderly, college students, medically underserved, all faiths and religions, and minorities, just to name a few. A complete listing of the names of the community representatives participating in the focus groups is located as an addendum to UM CRMCs CHNA (UM CRMC 2015 CHNA) beginning on page 242. 806 Charles County residents completed the 27 question online survey that was created using Survey Monkey. The link to the survey was available on the University of Maryland Charles Regional Medical Center website. The first section of the survey asked participants about their perception of health and health services within the county. The second section asked them about their health behaviors, in order to determine their risk for the development of certain health conditions. Most of the respondents are from Charles County (82.4%). The second largest percentage is from St Marys County (7.22%). Only 4% reported living outside of Southern Maryland (Charles, Calvert, St Marys, or PG). Approximately 69% of the respondents were between the ages of 35-64 years. The highest percentage was in the 45-54 year age group (30%). The overwhelming majority of the respondents were female (81%). Minorities were under-represented in the FY 2012 survey. Therefore, increased outreach was done with the help of community partners and agencies to bolster minority participation in the FY 2015 survey. These efforts were successful. Minorities made up 35% of the total 2014 survey population. African Americans comprised 30% of the respondents, followed by 4% Asian/Pacific Islander and 1% American Indian/Native American. Fourteen respondents self-reported as 2 or more races. Approximately 4% of the survey respondents self-identified as Hispanic. This is similar to the county overall Hispanic population of 5%. A short 4 question survey was distributed throughout the county regarding perceptions of health within the county. A total of 1,002 short surveys were completed. Ongoing survey collection was conducted at the Charles County Department of Healths Nursing, Substance Abuse, and Mental Health clinics; the University of Maryland Charles Regional Medical Centers Waiting Rooms and Cardiac Rehabilitation Program; the Center for Children; Health Partners Inc; the Western County Family Medical Center; and Cambridge Pediatrics. The community was also surveyed at large events such as Mission of Mercy, Charles County Homeless Resource Day, the Charles County Fair, College of Southern Maryland Health and Wellness Fair, Lifestyles Food Distribution Days, Nanjemoy Back to School Fair, Nanjemoy National Night Out, and Nanjemoy Heritage Days.A critical part of the needs assessment process is to invite the community to express their perceptions of health status. Qualitative data cumulated from this process was used in conjunction with the quantitative health data to determine the most important health issues within the county. Accomplishments: UM CRMC provided $12.8 million in charity care, health professions education, community benefit operations, community health improvement services, subsidized health services, cash and in-kind donations and community building activities in FY 2016. The hospital provided many programs, services, activities and screenings throughout the community. Listed here are program accomplishments specific to identified needs from the most recent CHNA: Chronic Disease Management and Prevention - Center for Diabetes Education: Hired Certified Diabetes Educator; Developed curriculum; Earned Accreditation by American Association of Diabetes Educators; Opened Center in FY 17 - Chronic Disease Self-Management Program (CDSMP): Trained staff in University of Stanfords program; Offered 3 free CDSMP classes with a total of 27 participants -Community Resource Guide: Developed to promote services and programs for people with chronic disease; 1000 distributed - Stroke Education and Outreach: Stroke Awareness Night at So. MD Blue Crabs; Community events; 503 educated - Better Breathers Club: Educated 210 people for COPD and asthma management - Colorectal Cancer Education: Charles County Fair inflatable colon; 550 people educated on early detection Behavioral Health - Charles County Prescription Drug Take Back: Partnered with CC Government, MD Governor's Office and local pharmacies; Planning and launch in FY 16 - Community Education and Outreach: Community events, Project Graduation, Opiate Awareness Campaign (Van Go), Community Presentation to parents @ CSM on drug awareness; 9700 educated - Mental Health First Aid Training: All CCPS School Counselors and Principals trained; Law enforcement and first responders in process of training; 237 trained - Behavioral Health Counselor in ED: Contract with Calvert Memorial Hospital; Evaluating the feasibility of tele-psych services in FY 17 Access To Care - Recruited 7 health care providers to the community - Urgent Care: Opened in September 2015; Generated 9960 visits; 34% of respondents stated going to Urgent Care instead of ED - Launched a community education campaign on when to use ED vs. Urgent Care; 20,000 distributed - Population Health Department: Hired Manager and two nurse navigators - Mobile Integrated Health Program: In partnership with CCDOH and CC EMS, secured $350,000 in 3 year grant funding for pilot to improve access to care and wrap around health care to community members with barriers. In addition to participating in the program UM CRMC will contribute financially to the program for 3 years. - Merged CRMCs Community Coalition with the Access To Care Team; Recruited 40 new members meeting monthly - Health Literacy: In partnership with the UMMS, developed and presented a health literacy education video and document checklist for health care workers: 5 group presentations to date Promoted county health resources at 24 county eventsDesc
Total Program Service Expenses$103,180,311TotalProgramServiceExpensesAmt
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Partial LiquidationfalsePartialLiquidationInd
Disregarded EntityYes (true)DisregardedEntityInd
Related EntityYes (true)RelatedEntityInd
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Indoor Tanning ServicesfalseIndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members17GoverningBodyVotingMembersCnt
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Local ChaptersfalseLocalChaptersInd
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PersonERIK BOASPersonNm
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ZIP20646ZIPCd
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Info In Schedule O Part VIIYes (X)InfoInScheduleOPartVIIInd

Form990 Part VII Section A Form990PartVIISectionAGrp (27 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtKey EmployeeKeyEmployeeIndHighest Compensated EmployeeHighestCompensatedEmployeeIndFormer Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd
Shelly Culhane
CHAIRMAN1.00.0Yes (X)Yes (X)$0$0$0
Richard Winkler
Vice Chair1.00.0Yes (X)Yes (X)$0$0$0
Wayne Barnes
Secretary/Treasurer1.00.0Yes (X)Yes (X)$0$0$0
Louis Jenkins Jr
Past Board Chair1.00.0Yes (X)$0$0$0
Dianna Abney MD
Director1.00.0Yes (X)$0$0$0
Khadar Baig MD
Director1.00.0Yes (X)$0$0$0
Brianna Bowling
Director1.00.0Yes (X)$0$0$0
Michael Cady
Director1.00.0Yes (X)$0$0$0
Anthony Covington
Director1.00.0Yes (X)$0$0$0
Richard Ferraro MD
Ex-Officio Director1.00.0Yes (X)$0$0$0
B Larry Jenkins Jr MD
Director1.00.0Yes (X)$0$0$0
Sara A Middleton
Director1.00.0Yes (X)$0$0$0
Ashvin J Patel MD
Director1.00.0Yes (X)$0$0$0
Joseph Slater
Director1.00.0Yes (X)$0$0$0
Robert Chrencik
Ex-Officio/Director1.049.0Yes (X)$0$2,562,797$23,637
Jon P Burns
Ex-Officio/Director1.049.0Yes (X)$0$654,203$23,637
Noel Cervino
ex-officio/President & CEO40.010.0Yes (X)Yes (X)$668,210$0$20,869
Candice Quinn Kelly
Ex-Officio Director1.00.0Yes (X)$0$0$0
Erik Boas
Chief Financial Officer40.010.0Yes (X)$339,196$0$8,801
Mark R Dumais
Chief Medical Officer40.00.0$749,963$0$21,451Yes (X)
Dana Levy
Chief Nursing Officer40.00.0$245,876$0$30,467Yes (X)
Paul Blackwood
VP Planning40.00.0$251,495$0$38,043Yes (X)
William Grimes
VP Ancilliary Services40.00.0$217,045$0$22,169Yes (X)
Marilyn Gregory
RN40.00.0$177,840$0$2,447Yes (X)
Katherine Middleton
RN40.00.0$190,606$0$2,426Yes (X)
Eugene Suwandhi MD
PEDIATRIC HOSPITALIST PHYS.40.00.0$166,973$0$20,509Yes (X)
John W Ashworth
Director49.0$0$780,732$23,637Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$3,007,204TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$3,997,732TotReportableCompRltdOrgAmt
Total Other Compensation$238,093TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K46IndivRcvdGreaterThan100KCnt
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Total Comp Greater Than150 KYes (true)TotalCompGreaterThan150KInd
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FACCHINA CONSTRUCTION COMPANY
102 CENTENNIAL ST SUITE 201LA PLATAMD20646CONSTRUCTION$4,296,699
MARYLAND INPATIENT CARE SPECIALISTS
7250 PARKWAY DRIVE SUITE 500HANOVERMD21076physicians$1,795,301
HEALOGICS WOUND CARE
3087 MOMENTUM PLACECHICAGOIL606895330WOUND CARE$925,925
EMERGENCY MEDICINE ASSOCIATES
20010 CENTURY BLVD SUITE 200GERMANTOWNMD20874CONT STAFFING$897,612
Baxter Baker Sidle Conn Jones P
120 east baltimore street ste 2100BALTIMOREMD21202Legal services$530,228
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Personal$0PersonalAmt

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Net Income Or Loss NetIncomeOrLossGrp

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Other Revenue Misc OtherRevenueMiscGrp (3 entries)

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CAFETERIA & COFFEE BAR SALES900099$344,479$344,479
CHANGE IN EQUITY OF AFFILIATES CPHA900099$202,741$202,741
ANSWERING SERVICE561000$76,089$76,089

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Related Or Exempt Func Income$30,318RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
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Total Revenue TotalRevenueGrp

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Related Or Exempt Func Income$134,360,987RelatedOrExemptFuncIncomeAmt
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Exclusion$504,610ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

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Program Services$21,000ProgramServicesAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Foreign Grants ForeignGrantsGrp

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Benefits To Members BenefitsToMembersGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
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Program Services$995,839ProgramServicesAmt
Management And General$1,007,406ManagementAndGeneralAmt

Comp Disqual Persons CompDisqualPersonsGrp

FieldValueIRS element (for citing)
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Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
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Program Services$33,496,469ProgramServicesAmt
Management And General$5,911,141ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
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Program Services$2,223,768ProgramServicesAmt
Management And General$392,430ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
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Program Services$5,757,173ProgramServicesAmt
Management And General$1,015,972ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
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Program Services$2,677,899ProgramServicesAmt
Management And General$472,570ManagementAndGeneralAmt

Fees For Services Management FeesForServicesManagementGrp

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Total$0TotalAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
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Management And General$396,648ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

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Total$0TotalAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

FieldValueIRS element (for citing)
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Management And General$6,220ManagementAndGeneralAmt

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
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Program Services$14,551,551ProgramServicesAmt
Management And General$1,854,312ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$95,161TotalAmt
Management And General$95,161ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$2,896,186TotalAmt
Management And General$2,896,186ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Royalties RoyaltiesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$2,425,651TotalAmt
Program Services$2,061,803ProgramServicesAmt
Management And General$363,848ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$75,345TotalAmt
Program Services$64,043ProgramServicesAmt
Management And General$11,302ManagementAndGeneralAmt

Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$178,651TotalAmt
Program Services$151,853ProgramServicesAmt
Management And General$26,798ManagementAndGeneralAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$2,792,280TotalAmt
Program Services$2,373,438ProgramServicesAmt
Management And General$418,842ManagementAndGeneralAmt

Payments To Affiliates PaymentsToAffiliatesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$4,749,454TotalAmt
Program Services$4,037,036ProgramServicesAmt
Management And General$712,418ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$2,901,631TotalAmt
Program Services$2,778,003ProgramServicesAmt
Management And General$123,628ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
SUPPLIES AND DRUGS$14,070,744$14,070,744
PURCHASED SERVICES$12,455,691$10,587,337$1,868,354
BAD DEBT$4,969,676$4,969,676$0
EQUIPMENT SERVICE CONTRACTS$1,237,540$1,051,909$185,631

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$1,542,082TotalAmt
Program Services$1,310,770ProgramServicesAmt
Management And General$231,312ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$121,170,490TotalAmt
Program Services$103,180,311ProgramServicesAmt
Management And General$17,990,179ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$11,899,409EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$20,680,284BOYAmt
EOY$0EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$7,944,863BOYAmt
EOY$7,721,480EOYAmt

Receivables From Officers Etc ReceivablesFromOfficersEtcGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$1,675,458BOYAmt
EOY$1,487,388EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$319,972BOYAmt
EOY$479,198EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$120,506,243LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$45,380,606LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$70,324,409BOYAmt
EOY$75,125,637EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$20,278,998BOYAmt
EOY$11,177,000EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$16,746,296EOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Intangible Assets IntangibleAssetsGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$28,724,314BOYAmt
EOY$28,807,316EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$149,948,298BOYAmt
EOY$153,443,724EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$13,697,614BOYAmt
EOY$13,136,413EOYAmt

Grants Payable GrantsPayableGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Escrow Account Liability EscrowAccountLiabilityGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Loans From Officers Directors LoansFromOfficersDirectorsGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$18,484,229BOYAmt
EOY$5,508,806EOYAmt

Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$71,382,025BOYAmt
EOY$77,946,005EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$103,563,868BOYAmt
EOY$96,591,224EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$46,291,833BOYAmt
EOY$56,759,903EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$92,597BOYAmt
EOY$92,597EOYAmt

Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$46,384,430BOYAmt
EOY$56,852,500EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$149,948,298BOYAmt
EOY$153,443,724EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss$13,771,196ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst-$583,785NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets-$2,719,341OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or ReviewfalseAccountantCompileOrReviewInd
FS AuditedYes (true)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Consolidated Basis Fincl StmtYes (X)ConsolidatedBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (true)AuditCommitteeInd
Federal Grant Audit RequiredYes (true)FederalGrantAuditRequiredInd
Federal Grant Audit PerformedYes (true)FederalGrantAuditPerformedInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
HospitalYes (X)HospitalInd

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Total Grassroots LobbyingTotalGrassrootsLobbyingGrp
Total Direct LobbyingTotalDirectLobbyingGrp
Total Lobbying ExpendTotalLobbyingExpendGrp
Other Exempt Purpose ExpendOtherExemptPurposeExpendGrp
Total Exempt Purpose ExpendTotalExemptPurposeExpendGrp
Lobbying Nontaxable AmountLobbyingNontaxableAmountGrp
Grassroots NontaxableGrassrootsNontaxableGrp
Tot Lbbyng Grassroot Mns Non TxTotLbbyngGrassrootMnsNonTxGrp
Tot Lbby Expend Mns Lbbyng Non TxTotLbbyExpendMnsLbbyngNonTxGrp
VolunteersfalseVolunteersInd
Paid Staff Or ManagementfalsePaidStaffOrManagementInd
Media AdvertisementsfalseMediaAdvertisementsInd
Mailings MembersfalseMailingsMembersInd
Publications Or BroadcastfalsePublicationsOrBroadcastInd
Grants Other OrganizationsfalseGrantsOtherOrganizationsInd
Direct Contact LegislatorsfalseDirectContactLegislatorsInd
Rallies DemonstrationsfalseRalliesDemonstrationsInd
Other ActivitiesYes (true)OtherActivitiesInd
Other Activities$6,220OtherActivitiesAmt
Total Lobbying Expenditures$6,220TotalLobbyingExpendituresAmt
Not Described Section501c3falseNotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceLobbying ActivitiesFormAndLineReferenceDesc
ExplanationSchedule C, Part II-B, Line 1i The organization does not engage in any direct lobbying activities. 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 6.15% and 22.12% 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.ExplanationTxt

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Art Public Exhibition AmountsArtPublicExhibitionAmountsGrp
Held Works ArtHeldWorksArtGrp
CY Minus3 Yr Endwmt FundCYMinus3YrEndwmtFundGrp
CY Minus4 Yr Endwmt FundCYMinus4YrEndwmtFundGrp
LandLandGrp

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$75,680,113OtherCostOrOtherBasisAmt
Depreciation$18,924,599DepreciationAmt
Book Value$56,755,514BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$1,057,496OtherCostOrOtherBasisAmt
Depreciation$442,818DepreciationAmt
Book Value$614,678BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$38,914,525OtherCostOrOtherBasisAmt
Depreciation$26,013,189DepreciationAmt
Book Value$12,901,336BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$4,854,109OtherCostOrOtherBasisAmt
Book Value$4,854,109BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$75,125,637TotalBookValueLandBuildingsAmt
Financial DerivativesFinancialDerivativesGrp
Closely Held Equity InterestsCloselyHeldEquityInterestsGrp

Other Securities OtherSecuritiesGrp

FieldValueIRS element (for citing)
DescOTHER SECURITIESDesc
Book Value$16,746,296BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Securities$16,746,296TotalBookValueSecuritiesAmt

Other Assets Org OtherAssetsOrgGrp (7 entries)

DescDescBook ValueBookValueAmt
OTHER ASSETS$18,925,467
ECONOMIC INTEREST- NET ASSETS$4,897,254
INV. CHES POTOMAC HEALTHCARE$3,555,913
DUE FROM AFFILIATES$1,065,328
OTHER CURRENT RECEIVABLES$186,044
PHYSICIAN LOANS$165,837
SECURITY DEPOSITS$11,473
FieldValueIRS element (for citing)
Total Book Value Other Assets$28,807,316TotalBookValueOtherAssetsAmt
Federal Income Tax Liability$0FederalIncomeTaxLiabilityAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (6 entries)

DescDescAmtAmt
DUE TO AFFILIATES$56,175,298
ACCRUED PENSION COSTS$10,287,227
MALPRACTICE IBNR$3,782,002
ADVANCES FROM THIRD PARTIES$3,734,841
OTHER LIABILITIES$3,514,918
LEASE LIABILITIES$451,719
FieldValueIRS element (for citing)
Total Liability$77,946,005TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceLiability for Uncertain Tax Position (ASC 740)FormAndLineReferenceDesc
ExplanationSchedule 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 BENEFITS THAT SHOULD BE RECOGNIZED.ExplanationTxt

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Financial Assistance PolicyYes (true)FinancialAssistancePolicyInd
Written PolicyYes (true)WrittenPolicyInd
FPG Reference Free CareYes (true)FPGReferenceFreeCareInd
Percent200Yes (X)Percent200Ind
FPG Reference Discounted CareYes (true)FPGReferenceDiscountedCareInd
Percent300Yes (X)Percent300Ind
Free Care Medically IndigentYes (true)FreeCareMedicallyIndigentInd
Financial Assistance BudgetYes (true)FinancialAssistanceBudgetInd
Expenses Exceed BudgetYes (true)ExpensesExceedBudgetInd
Unable To Provide CarefalseUnableToProvideCareInd
Annual Community Bnft ReportYes (true)AnnualCommunityBnftReportInd
Report Publically AvailableYes (true)ReportPublicallyAvailableInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$2,820,688TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$2,820,688NetCommunityBenefitExpnsAmt
Total Expense0.02430TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$2,820,688TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$2,820,688NetCommunityBenefitExpnsAmt
Total Expense0.02430TotalExpensePct

Community Health Services CommunityHealthServicesGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$763,165TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$7,000DirectOffsettingRevenueAmt
Net Community Benefit Expns$756,165NetCommunityBenefitExpnsAmt
Total Expense0.00650TotalExpensePct

Health Professions Education HealthProfessionsEducationGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$336,839TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$336,839NetCommunityBenefitExpnsAmt
Total Expense0.00280TotalExpensePct

Subsidized Health Services SubsidizedHealthServicesGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$5,657,335TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$23,348DirectOffsettingRevenueAmt
Net Community Benefit Expns$5,633,987NetCommunityBenefitExpnsAmt
Total Expense0.04850TotalExpensePct

Cash And In Kind Contributions CashAndInKindContributionsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$100,089TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$100,089NetCommunityBenefitExpnsAmt
Total Expense0.00080TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$6,857,428TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$30,348DirectOffsettingRevenueAmt
Net Community Benefit Expns$6,827,080NetCommunityBenefitExpnsAmt
Total Expense0.05860TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$9,678,116TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$30,348DirectOffsettingRevenueAmt
Net Community Benefit Expns$9,647,768NetCommunityBenefitExpnsAmt
Total Expense0.08290TotalExpensePct

Economic Development EconomicDevelopmentGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$3,428TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$3,428NetCommunityBenefitExpnsAmt

Community Support CommunitySupportGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$65,491TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$30,000DirectOffsettingRevenueAmt
Net Community Benefit Expns$35,491NetCommunityBenefitExpnsAmt
Total Expense0.00030TotalExpensePct

Coalition Building CoalitionBuildingGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$3,497TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$3,497NetCommunityBenefitExpnsAmt

Health Improvement Advocacy HealthImprovementAdvocacyGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$1,129TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$1,129NetCommunityBenefitExpnsAmt

Workforce Development WorkforceDevelopmentGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$173,423TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$173,423NetCommunityBenefitExpnsAmt
Total Expense0.00140TotalExpensePct

Total Communtity Building Acty TotalCommuntityBuildingActyGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$246,968TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$30,000DirectOffsettingRevenueAmt
Net Community Benefit Expns$216,968NetCommunityBenefitExpnsAmt
Total Expense0.00170TotalExpensePct
FieldValueIRS element (for citing)
Bad Debt Expense ReportedYes (true)BadDebtExpenseReportedInd
Bad Debt Expense$3,641,346BadDebtExpenseAmt
Reimbursed By Medicare$49,182,907ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr$48,802,606CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall$380,301MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

FieldValueIRS element (for citing)
Cost To Charge RatioYes (X)CostToChargeRatioInd
FieldValueIRS element (for citing)
Written Debt Collection PolicyYes (true)WrittenDebtCollectionPolicyInd
Financial Assistance PrvsnYes (true)FinancialAssistancePrvsnInd
Hospital Facilities1HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp

FieldValueIRS element (for citing)
Facility1FacilityNum

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Civista Medical Center IncBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line15 Garrett AvenueAddressLine1Txt
CityLa PlataCityNm
State AbbreviationMDStateAbbreviationCd
ZIP20646ZIPCd
FieldValueIRS element (for citing)
Website Addresswww.charlesregional.orgWebsiteAddressTxt
State License08-001StateLicenseNum
Licensed HospitalYes (X)LicensedHospitalInd
General Medical And SurgicalYes (X)GeneralMedicalAndSurgicalInd
Emergency Room24 HrsYes (X)EmergencyRoom24HrsInd
Facility Reporting Group1FacilityReportingGroupCd

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1Civista Medical Center IncBusinessNameLine1Txt
FieldValueIRS element (for citing)
Facility1FacilityNum
First Licensed CY Or PYfalseFirstLicensedCYOrPYInd
Tax Exempt Hospital CY Or PYfalseTaxExemptHospitalCYOrPYInd
CHNA ConductedYes (true)CHNAConductedInd
Community DefinitionYes (X)CommunityDefinitionInd
Community DemographicsYes (X)CommunityDemographicsInd
Existing ResourcesYes (X)ExistingResourcesInd
How Data ObtainedYes (X)HowDataObtainedInd
Community Health NeedsYes (X)CommunityHealthNeedsInd
Other Health IssuesYes (X)OtherHealthIssuesInd
Community Hlth Needs Id ProcessYes (X)CommunityHlthNeedsIdProcessInd
Consulting ProcessYes (X)ConsultingProcessInd
Information GapsYes (X)InformationGapsInd
CHNA Conducted15CHNAConductedYr
Take Into Account Others InputYes (true)TakeIntoAccountOthersInputInd
CHNA Conducted With Other FcltsfalseCHNAConductedWithOtherFcltsInd
CHNA Conducted With Non FcltsYes (true)CHNAConductedWithNonFcltsInd
CHNA Report Widely AvailableYes (true)CHNAReportWidelyAvailableInd
Rpt Available On Own WebsiteYes (X)RptAvailableOnOwnWebsiteInd
Own Website URLHTTP://WWW.CHARLESREGIONAL.ORG/SITEASSETOwnWebsiteURLTxt
Paper Copy Public InspectionYes (X)PaperCopyPublicInspectionInd
Implementation Strategy AdoptYes (true)ImplementationStrategyAdoptInd
Implementation Strategy Adpt15ImplementationStrategyAdptYr
Strategy Posted WebsiteYes (true)StrategyPostedWebsiteInd
Strategy Website URLHTTP://WWW.CHARLESREGIONAL.ORG/SITEASSETStrategyWebsiteURLTxt
Strategy AttachedfalseStrategyAttachedInd
Organization Incur Excise TaxfalseOrganizationIncurExciseTaxInd
Elig Criteria ExplainedYes (true)EligCriteriaExplainedInd
FPG Family Incm Lmt Free DscntYes (X)FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care200.FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care300.FPGFamilyIncmLmtDscntCarePct
Income Level CriteriaYes (X)IncomeLevelCriteriaInd
Asset Level CriteriaYes (X)AssetLevelCriteriaInd
Medical Indigency CriteriaYes (X)MedicalIndigencyCriteriaInd
Insurance Status CriteriaYes (X)InsuranceStatusCriteriaInd
Underinsurance Stat CriteriaYes (X)UnderinsuranceStatCriteriaInd
Explained BasisYes (true)ExplainedBasisInd
App Financial Asst ExplnYes (true)AppFinancialAsstExplnInd
Described InfoYes (X)DescribedInfoInd
Described Suprt DocYes (X)DescribedSuprtDocInd
Provided Hospital ContactYes (X)ProvidedHospitalContactInd
Provided Nonprofit ContactYes (X)ProvidedNonprofitContactInd
Includes Publicity MeasuresYes (true)IncludesPublicityMeasuresInd
FAP Available On WebsiteYes (X)FAPAvailableOnWebsiteInd
FAP Available On Website URLhttp://www.charlesregional.orgFAPAvailableOnWebsiteURLTxt
FAP Summary On WebsiteYes (X)FAPSummaryOnWebsiteInd
FAP Summary On Website URLwww.charlesregional.orgFAPSummaryOnWebsiteURLTxt
FAP Avlbl On Request No ChargeYes (X)FAPAvlblOnRequestNoChargeInd
FAP App Avlbl On Request No ChrgYes (X)FAPAppAvlblOnRequestNoChrgInd
FAP Sum Avlbl On Request No ChrgYes (X)FAPSumAvlblOnRequestNoChrgInd
FAP Notice DisplayedYes (X)FAPNoticeDisplayedInd
Communtity Notified FAPYes (X)CommuntityNotifiedFAPInd
FAP Actions On NonpaymentYes (true)FAPActionsOnNonpaymentInd
Collection ActivitiesfalseCollectionActivitiesInd
FAP Notified Upon AdmissionYes (X)FAPNotifiedUponAdmissionInd
FAP Notified Before DischargeYes (X)FAPNotifiedBeforeDischargeInd
FAP Notified All PatientsYes (X)FAPNotifiedAllPatientsInd
Documented Elig DeterminationYes (X)DocumentedEligDeterminationInd
Nondis Emergency Care PolicyYes (true)NondisEmergencyCarePolicyInd
Other Method UsedYes (X)OtherMethodUsedInd
Amounts Generally BilledfalseAmountsGenerallyBilledInd
Gross ChargesfalseGrossChargesInd

Supplemental Information SupplementalInformationGrp (4 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FINANCIAL ASSISTANCE POLICYSchedule H, Part V, Section B In compliance with IRC 501 ( R) regulations, Civista Medical Center has revised their financial assistance polity to ensure compliance with IRS regulations. Input from Individuals Representing the Community Schedule H, Part V, Section B, Line 5 From July 2014 to March 2015, the University of Maryland Charles Regional Medical Center, in collaboration with the Charles County Department of Health (CCDOH) undertook a comprehensive assessment of the health needs of Charles County, Maryland. To provide a comprehensive assessment of the health needs of the county, a four method plan was developed which included 4 different sources of data: a long online survey of Charles County residents perceptions of health and health behaviors, a short paper survey on health perceptions throughout the county, 15 focus groups with community leaders, citizens, and stakeholders, and a quantitative data analysis of secondary, published data. Data collection occurred between July 2014 and February 2015. The use of the multiple data collection methods strengthened the validity of the assessments findings as well as ensuring that Charles County residents had an opportunity to participate in the assessment process and to feel invested in its outcome. Fifteen focus groups were performed throughout the county between July 2014 and February 2015. The focus group topics included: chronic disease specific health, special populations, county leadership, drug and alcohol council members, Charles County substance abuse advisory coalition members, youth through the school nurses, in-house health department nurses, fitness and nutrition, minority health and health disparities, prevention and safety, faith-based leaders, behavioral health, reproductive and infant health, cancer, and access to care. Approximately 235 people participated in the county focus groups. Attendance for those meetings ranged from 5 to 100 people. Participants represented all service organizations within the community. They provide services to all facets of the community including women, infants, school aged children, those who are incarcerated, those with mental health problems, those with financial/housing/employment/health issues, the un- and underinsured, the hungry, those with chronic health conditions, the homeless, the elderly, college students, medically underserved, all faiths and religions, and minorities, just to name a few. A complete listing of the names of the community representatives participating in the focus groups is located as an addendum to UM CRMCs CHNA (UM CRMC 2015 CHNA )beginning on page 242. 806 Charles County residents completed the 27 question online survey that was created using Survey Monkey. The link to the survey was available on the University of Maryland Charles Regional Medical Center website. The first section of the survey asked participants about their perception of health and health services within the county. The second section asked them about their health behaviors, in order to determine their risk for the development of certain health conditions. Most of the respondents are from Charles County (82.4%). The second largest percentage is from St Marys County (7.22%). Only 4% reported living outside of Southern Maryland (Charles, Calvert, St Marys, or PG). Approximately 69% of the respondents were between the ages of 35-64 years. The highest percentage was in the 45-54 year age group (30%). The overwhelming majority of the respondents were female (81%). Minorities were under-represented in the FY 2012 survey. Therefore, increased outreach was done with the help of community partners and agencies to bolster minority participation in the FY 2015 survey. These efforts were successful. Minorities made up 35% of the total 2014 survey population. African Americans comprised 30% of the respondents, followed by 4% Asian/Pacific Islander and 1% American Indian/Native American. Fourteen respondents self reported as 2 or more races. Approximately 4% of the survey respondents self identified as Hispanic. This is similar to the county overall Hispanic population of 5%. A short 4 question survey was distributed throughout the county regarding perceptions of health within the county. The A total of 1,002 short surveys were completed. Ongoing survey collection was conducted at the Charles County Department of Healths Nursing, Substance Abuse, and Mental Health clinics; the University of Maryland Charles Regional Medical Centers Waiting Rooms and Cardiac Rehabilitation Program; the Center for Children; Health Partners Inc; the Western County Family Medical Center; and Cambridge Pediatrics. The community was also surveyed at large events such as Mission of Mercy, Charles County Homeless Resource Day, the Charles County Fair, College of Southern Maryland Health and Wellness Fair, Lifestyles Food Distribution Days, Nanjemoy Back to School Fair, Nanjemoy National Night Out, and Nanjemoy Heritage Days. A critical part of the needs assessment process is to invite the community to express their perceptions of health status. Qualitative data cumulated from this process was used in conjunction with the quantitative health data to determine the most important health issues within the county. CHNA Conducted With One or More Organizations Other than Hospital Schedule H, Part V, Section B, Line 6b UM CRMC led the effort and covered 100% of the cost of the CHNA however the hospital worked collaboratively with the Charles County Department of Health and the Local Health Improvement Coalition Partnerships for a Healthier Charles County (PHCC) to complete the CHNA. Executive Leadership of PHCC consists of the CEO of UM CRMC, the County Health Officer, the Superintendent of Charles County Public Schools and the President of the College of Southern of Southern Maryland. Membership of the PHCC consists of over 30 nonprofit and county agencies. Executive Committee of LHIC -Charles County Dept. of Health, Dianna Abney, MD, Charles County Health Officer -Charles County Public Schools, Dr. Kim Hill, Superintendent -College of Southern Maryland, Dr. Brad Gottfried, President -UM CRMC, Noel Cervino, President and CEO Steering Committee of LHIC -Charles County Dept. of Health, William Leebel, Public Information Officer -Charles County Public Schools, Jennifer Conte, Coordinator of Student Intervention Programs -College of Southern Maryland, Linda Smith, Project Coordinator, Safe Communities -UM CRMC, Joyce Riggs, Dir., Community development and Planning Subcommittees: -Health Partners Clinic, Chrissie Mulcahey, Director, Chair, Access to Care -Charles County Dept. of Health, Mary Beth Klick, Tobacco Prevention Coordinator, Co-Chair, Chronic Disease Prevention and Management Subcommittee -UM CRMC, Amy Zimmerman, Co chair, Chronic Disease Sub Comm. -Charles County Core Services, Karyn Black, Director, Co-Chair, Behavioral Health Subcommittee -Charles County Dept. of Health, Angela Deal, Community Health Educator, Co-chair, Chronic Disease Prevention and Management Subcommittee -Charles County Department of Health, Laura Borawski, Community Outreach Worker, Co-Chair, Chronic Disease Prevention and Management subcommittee
Needs Not Addressed By the Most Recently Conducted CHNASchedule H, Part V, Section B, Line 11 Based on the priority score using the Hanlon Method, the health priorities chosen include: 1. Chronic Disease Prevention and Management - Major Cardiovascular Disease (Heart Disease, Hypertension, and Stroke) - Obesity and Overweight - Diabetes Prevalence - Cancer 2. Behavioral Health - Substance Use Disorders (Alcohol, Drug, and Tobacco Use) - Mental Health 3. Access to Care - Physician Recruitment and Retention - Social Determinants of Health (transportation, health literacy) All 3 priorities outlined in the CHNA are being addressed by UM CRMC either directly (Physician Recruitment), or through partnerships with other organizations (i.e. Chronic Disease Self-Management Program), or through the LHIC, Partnerships for a Healthier Charles County (PHCC) which is co-led and financially supported by UM CRMC. Where a need is appropriately addressed by another community entity, UM CRMC provides leadership and/or funding through the Charles County Health Improvement Plan and the local health coalition (PHCC) to communicate initiatives, provide financial support and/or assistance or data when needed, and review results (i.e., Substance Abuse, Mental Health).Each LHIC team has developed and implemented strategies specific to their identified priorities and reports back quarterly to the LHIC Steering Committee. The hospital provides support and oversight to the teams as a critical member of the LHIC Steering Committee. The Hospitals Director of Community Development and Planning serves as the co-chair of the county LHIC.
Individuals Eligible for Financial AssistanceSchedule H, Part V, Section B, Line 22D All patients are charged state regulated rates regardless of their ability to pay.
Individuals Eligible for Financial AssistanceSchedule H, Part V, Section B, Line 24 The State of Maryland is a unique State in regard to the provision of health care services and their related charges by hospitals. All hospital charges processed to all Payors, including Governmental Payors, are set through Marylands Health Services Cost Commission. Accordingly, all Hospital charges are NOT gross charges as defined by the IRS under Internal Revenue Code section 501(r)(5)(B).

Supplemental Information Detail SupplementalInformationDetail (11 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Related Organization ReportSchedule H, Part I, Line 6a AN ANNUAL COMMUNITY BENEFIT REPORT IS PREPARED FOR EACH FISCAL YEAR ENDING JUNE 30. THIS REPORT IS SUBMITTED TO THE HEALTH SERVICES COST REVIEW COMMISSION (HSCRC), A STATE REGULATORY AGENCY, BY DECEMBER 15 OF EACH YEAR. IN ADDITION, THE ANNUAL COMMUNITY BENEFIT REPORT IS AVAILABLE UPON REQUEST AT THE ENTITY'S CORPORATE OFFICES.
Cost Attributable to a Physical ClinicSchedule H, Part I, Line 7 Marylands 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. Marylands 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. Schedule H, Part I, Line 7B, Columns (C) through (F) 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. SCHEDULE H, PART I, LINE 7F COLUMN (C) & (D) 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 Building ActivitiesSchedule H, Part II As the only hospital serving Charles County, Maryland, University of Maryland Charles Regional Medical Center (UM CRMC) supports programs and activities where the hospital's expertise and resources can influence the fundamental issues that affect the health of the community. UM CRMC supports economic development of the community through leadership participation in organizations such as the Chamber of Commerce, Economic Development Commission, Leadership Southern Maryland, and the Tri-County Council of Southern Maryland. UM CRMC participates in many County, State and Region-wide Emergency Preparedness planning activities and drills with our community partners such as Emergency Services, Fire and Rescue, Department of Health, County Government, FEMA and MEMA. This serves to ensure that in the event of a disaster, the hospital is ready to support and care for our community. Hospital Administration participates in healthcare workforce development by serving on committees such as the Charles County Commissioner's healthcare taskforce and support of College of Southern Maryland Nursing and Allied Health programs. In addition, UM CRMC participates and supports the Black Leadership Council on Excellence's Young Researchers Community Project which offers disadvantaged youth in high school an opportunity to shadow medical professionals. According to Maryland Health Workforce Study Phase 2 Report (January 2014), the Southern Maryland region has a physician shortage for primary care physicians. In Charles County, the primary care physician FTE demand is greater than the primary care FTE supply (7.4 vs. 6.1). There is an 18% shortfall in the primary care services supply to fulfill the current demand. Under medical specialties, the Southern Maryland region had a shortage for cardiology, dermatology, endocrinology, gastroenterology, hematology, oncology, infectious disease, nephrology, psychiatry, pulmonary medicine, and rheumatology. The FTE per 10,000 supply rates for professional counselors, social workers, and psychologists in Charles County is much lower than the rates for Maryland. The demand for psychiatrists in Charles County is much higher than the county supply for psychiatry. Charles County has a shortage between 50-75% of full time equivalent psychiatrists. As a result of the prevailing physician shortage, and to mitigate the effects of the lack of access of the community to medical care, UM CRMC has developed a robust and ongoing physician recruitment and retainment program.
Bad Debt ExpenseSchedule H, Part III, Line 2 & 4 CIVISTA REPORTS BAD DEBT EXPENSE IN ACCORDANCE WITH GENERALLY ACCEPTED ACCOUNTING PRINCIPLES (GAAP) HFMA 15. THE PROVISION FOR BAD DEBTS IS BASED UPON MANAGEMENTS ASSESSMENT OF HISTORICAL AND EXPECTED NET COLLECTIONS CONSIDERING HISTORICAL BUSINESS AND ECONOMIC CONDITIONS, TRENDS IN HEALTH CARE 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, AS WELL AS, THE ACCUMULATION OF RECEIVABLE BALANCES BY PERIOD OUTSTANDING. THE RESULTS OF THIS REVIEW ARE THEN USED TO MAKE ANY NECESSARY MODIFICATIONS TO THE PROVISION FOR BAD DEBTS AND THE ESTABLISHED 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. Medicare Cost Report Schedule H, Part III, Line 8 IN MARYLAND, 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, Marylands 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
Collection PracticesSchedule 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. Currently, Civista Medical Center is in the process of updating its billing and collections process to ensure it is in compliance with the new IRC Section 501(R) regulations. 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. 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. UMMC 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 -UMMC website -patient handbook distributed to all patients -brochures explaining financial assistance are made available in all patient care areas -patient plain language sheets - newly revised in June 2016, this handout was revised and is at the 5th grade reading level (available in English, Spanish, French & chinese based on top languages spoken by UMMC patients) -appearing in print media through local newspapers
Community Health Care Needs AssessmentSchedule H, Part VI, Line 2 From July 2014 to March 2015, the University of Maryland Charles Regional Medical Center undertook a comprehensive assessment of the health needs of Charles County, Maryland. To provide a comprehensive assessment of the health needs of the county, a four method plan was developed which included 4 different sources of data: a long online survey of Charles County residents perceptions of health and health behaviors, a short paper survey on health perceptions throughout the county, 15 focus groups with community leaders, citizens, and stakeholders, and a quantitative data analysis of secondary, published data. Data collection occurred between July 2014 and February 2015. The use of the multiple data collection methods strengthened the validity of the assessments findings as well as ensuring that Charles County residents had an opportunity to participate in the assessment process and to feel invested in its outcome. Fifteen focus groups were performed throughout the county between July 2014 and February 2015. The focus group topics included: chronic disease specific health, special populations, county leadership, drug and alcohol council members, Charles County substance abuse advisory coalition members, youth through the school nurses, in-house health department nurses, fitness and nutrition, minority health and health disparities, prevention and safety, faith-based leaders, behavioral health, reproductive and infant health, cancer, and access to care. Approximately 235 people participated in the county focus groups. 806 Charles County residents completed the 27 question online survey that was created using Survey Monkey. The link to the survey was available on the University of Maryland Charles Regional Medical Center website. The first section of the survey asked participants about their perception of health and health services within the county. The second section asked them about their health behaviors, in order to determine their risk for the development of certain health conditions. A short 4 question survey was distributed throughout the county regarding perceptions of health within the county. The A total of 1,002 short surveys were completed. Ongoing survey collection was conducted at the Charles County Department of Healths Nursing, Substance Abuse, and Mental Health clinics; the University of Maryland Charles Regional Medical Centers Waiting Rooms and Cardiac Rehabilitation Program; the Center for Children; Health Partners Inc; the Western County Family Medical Center; and Cambridge Pediatrics. The community was also surveyed at large events such as Mission of Mercy, Charles County Homeless Resource Day, the Charles County Fair, College of Southern Maryland Health and Wellness Fair, Lifestyles Food Distribution Days, Nanjemoy Back to School Fair, Nanjemoy National Night Out, and Nanjemoy Heritage Days. Quantitative data was analyzed for various health topics including: mortality, population and demographic data, natality, infant mortality, heart disease, stroke, hypertension, access to health care/health uninsurance, cancer, asthma, injuries, diabetes, obesity, osteoporosis, arthritis, dementia/Alzheimers disease, communicable disease, environmental health, sexually transmitted diseases, HIV/AIDS, mental health, dental health, substance abuse, disabilities, and tobacco use.
Eligibility EducationSchedule H, Part VI, Line 3 UM CRMC posts its charity care policy, or a summary thereof, as well as financial assistance contact information in admissions areas, emergency rooms, business offices and other areas of the facility where eligible patients are likely to present. Additionally, the policy and plain language version are available on the hospitals public website. The FAP is written in a culturally sensitive and at an appropriate reading level. It is available in English and Spanish. All Patient Access Customer Service Staff have training in the financial assistance process. During the intake or discharge process or when there is contact regarding a billing matter, if a patient discloses financial difficulty or concern with payment of the bill, the patient is provided with FAP information. A packet with the application, criteria and a documentation checklist is provided. Assistance completing the application is available. Additionally, assistance is provided for patients or their families in qualification and application of government benefits, Medicaid and other state programs. Once an application is processed and if it is deemed incomplete, a letter is sent to the patient requesting the missing or incomplete items. Patients may call the Call Center or come into the Patient Access Office for assistance.
Description of Community ServedSchedule H, Part VI, Line 4 The University of Maryland Charles Regional Medical Center is Charles Countys only hospital and, as such, serves the residents of the entire county. Geography Charles County is located 23 miles south of Washington, D.C. It is one of five Maryland counties, which are part of the Washington, DC-MD-VA metropolitan area. At 458 square miles, Charles County is the eighth largest of Marylands twenty-four counties and accounts for about 5 percent of Marylands total landmass. The northern part of the county is the development district where commercial, residential, and business growth is focused. The major communities of Charles County are La Plata (the county seat), Port Tobacco, Indian Head, and St Charles, and the main commercial cluster of Hughesville-Waldorf-White Plains. Approximately 60 percent of the countys residents live in the greater Waldorf-La Plata area. By contrast, the southern (Cobb Neck area) and western (Nanjemoy, Indian Head, Marbury) areas of the region still remain very rural with smaller populations. Population Charles County has experienced rapid growth since 1970, expanding its population from 47,678 in 1970 to 120,546 in the 2000 census and 146,551 in the 2010 census. The current 2016 Census Bureau estimates the population at 156,118 for a 6.1% increase in four years. The magnitude of growth can be seen in the changes in population density. The 1990 census showed that there were 219.4 individuals per square mile, which increased to 261.5 individuals per square mile by 2000, an increase of 19.2%, and to 320.2 individuals per square mile by 2010, an increase of 22.5%. Transportation The percent change in the population growth for Charles County has been slightly greater than the change seen in the Maryland population growth. This growth has created transportation issues for the County, in particular for the development district in the northern part of the county where many residents commute to Washington D.C. to work. The average work commute time for a Charles County resident is 42.8 minutes which is higher than the Maryland average of 32.0 minutes. Public transportation consists of commuter buses for out-of-county travel and the county-run Van Go bus service for in-county transportation. Diversity As the population of the county changes, the diversity of the county also increases. The African American population has experienced the greatest increase. In 2000, African Americans made up 26% of the total Charles County population; by 2014, they comprise 43.8% of the total county population. As of 2014, minorities comprise roughly 54% of the Charles County population. The Hispanic community has also seen increases over the past few years. They now comprise 5.3% of the total county population. This is the one of the highest percentages among the 24 Maryland jurisdictions. Charles County also has one of the largest American Indian/Native American populations in the state of Maryland at 0.8% of the total county population. The 2015 Charles County gender breakdown is approximately 50/50. Males make up 48.3% of the population, and females make up 51.7% of the county population. Economy Employment and economic indicators for the county are fairly strong. The 2010-2014 US Census American Community Survey estimates that 70.4% of the Charles County population is currently in the labor work force. The 2010-2014 5-year estimate for Charles County found that approximately 7.6% of Charles County individuals are living below the poverty level; however, this is lower than the Maryland rate of 10.0%. The Charles County median household income was $91,910, well above the Maryland median household income of $74,149.The diversity of the county is also represented in the business community with 46% of all Charles County businesses being minority-owned firms. This is higher than the State of Maryland at 38%. Education Charles County has a larger percentage of high school graduates than Maryland (91.6% vs. 89.0%); however, Charles County has a smaller percentage than Maryland of individuals with a bachelors degree or higher (26.8% vs. 37.3%). Housing There is a high level of home ownership in Charles County (77.9%); however, this is slightly down from the 2010 level (81.8%). The median value of a housing unit in Charles County is similar to the Maryland average ($287,000 vs. $287,500). Home values across Maryland have decreased and Charles County showed a similar downward trend. The average household size in Charles County is 2.86 persons. Source: 2010-2014 US Census Bureaus American Community Survey 5 year estimates Life Expectancy The life expectancy for a Charles County resident, as calculated for 2014, was 79.1 years. This is slightly below the state average life expectancy of 79.8 years. Source: 2014 Maryland Vital Statistics Report Births There were 1,844 births in Charles County in 2015. Charles County represents 44% of the births in Southern Maryland and 2.5% of the total births in Maryland for 2015. Minorities made up just over half of the babies born in Charles County in 2015 (52%) which is in line with the composition of the county. Source: 2015 Maryland Preliminary Vital Statistics Report
Promoting the Health of the CommunitySchedule H, Part VI, Line 5 University of Maryland Charles Regional Medical Center (UM CRMC) is the parent company of a regional integrated health system serving the health needs of Charles County and the citizens of Southern Maryland. Governance is provided through a community volunteer Board of Directors. UM CRMCs Community Benefits Program utilizes a planned, managed, organized, and measured approach to meeting the identified community needs of the area we serve. The mission is to improve overall community health by improving access to health care, enhancing the health of the community, advancing healthcare knowledge and collaborating with health - providing agency partners. Community health improvement strategies are included in the organizations strategic plan. UM CRMC provided $12.8 million in charity care, health professions education, community benefit operations, community health improvement services, subsidized health services, cash and in-kind donations and community building activities in FY 2016. This year, we provided and supported programs, activities and screenings such as blood pressure, glucose, breast and cervical cancer, colorectal cancer and stroke risk reduction education. Mobile Integrated Health is a program that started in FY 16 that improves access to care and wrap around health care to community members with barriers. In addition to participating in the program UM CRMC will contribute financially to the program for 3 years. UM CRMC provided health education programs on hearty healthy eating, diabetes education, cancer education, breast and cervical cancer, tobacco cessation program. In addition, we sponsored American Cancer Societys Look Good Feel Better, advanced directives, car safety seat inspections, community disaster drills, school career days, the Young Researches Community Project, and support groups such as stroke support, cardiac support, and the Better Breathers Club. A new addition in FY 16 is the Living Well Chronic disease Self-Management Program, a free, 6 week, evidence based program to improve the well-being of people living with a variety of chronic conditions. The hospital offers clinics and clinic services such as renal dialysis services and American Red Cross blood drives. We participated in community coalitions and boards such as the United Way, Partnerships for a Healthier Charles County, Charles County Tobacco Coalition, Leadership Southern Maryland, Hospice of Charles County, Healthy Families, Fetal Infant Mortality Board, Center for Abused Persons, Juvenile Drug Court, Mission of Mercy; Chamber of Commerce and Charles County Child Advocacy Partnership. We participated in and supported community events such as Christmas Connection, American Cancer Societys Relay for Life, Alzheimers Walk, March of Dimes and Safe Nights.
Affiliated Health Care System RolesSchedule H, Part VI, Line 6 Civista Medical Center (UM CRMC) is a member of the University of Maryland Medical System (UMMS). System hospitals meet monthly to coordinate and plan Community Benefit Operations such as Health Needs Assessments and Maryland State Health Improvement Plan objectives. UMMS provides leadership and guidance to local system jurisdictions regarding alignment with System and State wide goals. Southern Maryland had the highest percentage of physician shortages of all of the regions in Maryland (89.9%). To address the shortage, Civista Medical Center (UM CRMC) and UMMS have developed a recruitment and retention plan to successfully attract and retain private physicians to the community.
Community Benefit Report State FilingsSchedule H, Part VI, Line 7 Community Benefit Report was filed in the state of Maryland.

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Grant Records MaintainedYes (true)GrantRecordsMaintainedInd

Recipient Table RecipientTable (2 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdRecipient EINRecipientEINIRC SectionIRCSectionDescCash GrantCashGrantAmtPurpose Of GrantPurposeOfGrantTxt
Charles Regional Medical Center Foundation
PO Box 1701LaPlataMD20646521414564501(C)(3)$8,000Paint the Town Pink
March of Dimes
2110 Washington BlvdArlingtonVA22204131846366501(C)(3)$13,000March for Babies
FieldValueIRS element (for citing)
Total501c3 Org2Total501c3OrgCnt

Supplemental Information Detail SupplementalInformationDetail

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Form And Line ReferenceProcedure for Monitoring Use of Grant Funds Inside U.S.FormAndLineReferenceDesc
ExplanationPart I, Line 2 CIVISTA MEDICAL CENTER MAKES FINANCIAL AND IN-KIND CONTRIBUTIONS TO VARIOUS ORGANIZATIONS IN THE COMMUNITY. EACH OF THE CONTRIBUTION RECIPIENTS ARE EITHER GOVERNMENTAL UNITS OR SECTION 501(c)(3) CHARITABLE ORGANIZATIONS WHICH WORK TO FULFILL THE ORGANIZATION'S MISSION OF PROMOTING HEALTH WITHIN THE COMMUNITY.ExplanationTxt

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Club Dues Or FeesYes (X)ClubDuesOrFeesInd
Written Policy Ref T And E ExpnssYes (true)WrittenPolicyRefTAndEExpnssInd
Substantiation RequiredYes (true)SubstantiationRequiredInd
Compensation CommitteeYes (X)CompensationCommitteeInd
Independent ConsultantYes (X)IndependentConsultantInd
Compensation SurveyYes (X)CompensationSurveyInd
Board Or Committee ApprovalYes (X)BoardOrCommitteeApprovalInd
Severance PaymentYes (true)SeverancePaymentInd
Supplemental Nonqual Rtr PlanYes (true)SupplementalNonqualRtrPlanInd
Equity Based Comp ArrngmfalseEquityBasedCompArrngmInd
Comp Based On Revenue Of Flng OrgfalseCompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related OrgsfalseCompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng OrgfalseCompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd OrgsfalseCompBsdNetEarnsRltdOrgsInd
Any Non Fixed PaymentsYes (true)AnyNonFixedPaymentsInd
Initial Contract ExceptionfalseInitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (12 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
Robert Chrencik
Ex-Officio/Director$0$1,254,208$0$1,054,693$0$253,896$0$10,600$0$13,037$0$2,586,434$0$0
Jon P Burns
Ex-Officio/Director$0$414,431$0$179,244$0$60,528$0$10,600$0$13,037$0$677,840$0$0
Noel Cervino
ex-officio/President & CEO$386,434$0$204,375$0$77,401$0$10,600$0$10,269$0$689,079$0$0$0
Erik Boas
Chief Financial Officer$217,392$0$84,000$0$37,804$0$8,801$0$0$0$347,997$0$0$0
Mark R Dumais
Chief Medical Officer$340,634$0$107,520$0$301,809$0$10,600$0$10,851$0$771,414$0$0$0
Dana Levy
Chief Nursing Officer$190,407$0$55,080$0$389$0$25,006$0$5,461$0$276,343$0$0$0
Paul Blackwood
VP Planning$185,126$0$64,260$0$2,109$0$25,006$0$13,037$0$289,538$0$0$0
William Grimes
VP Ancilliary Services$164,518$0$47,515$0$5,012$0$21,572$0$597$0$239,214$0$0$0
Marilyn Gregory
RN$177,497$0$0$0$343$0$1,300$0$1,147$0$180,287$0$0$0
Katherine Middleton
RN$190,486$0$0$0$120$0$1,679$0$747$0$193,032$0$0$0
Eugene Suwandhi MD
PEDIATRIC HOSPITALIST PHYS.$166,880$0$0$0$93$0$2,600$0$17,909$0$187,482$0$0$0
John W Ashworth
Director$0$511,790$0$169,396$0$99,546$0$10,600$0$13,037$0$804,369$0$0

Supplemental Information Detail SupplementalInformationDetail (3 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Health or Social Club DuesSchedule J, Part I, Line 1a UMMS Executives receive a benefit package which may be used towards health club dues or other health maintenance programs. Such benefits are capped at $7,000, $5,000, or $3,000 depending on job title as described in the program documents.
SEVERANCE PAYMENT OR CHANGE OF CONTROL PAYMENTSchedule J, Part I, Line 4A During the Fiscal Year-ended June 30, 2016, certain officers and key employees have received severance payments. These amounts are reported as taxable compensation and reported on Schedule J, Part II, Line B(III), Other Reportable Compensation. The individuals and amounts are listed below: Mark R. Dumais $45,025 SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN SCHEDULE J, PART I, LINE 4B DURING THE FISCAL YEAR ENDED JUNE 30, 2016, CERTAIN OFFICERS AND KEY EMPLOYEES PARTICIPATED IN THE UNIVERSITY OF MARYLAND MEDICAL SYSTEM (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: Dana Levy Paul Blackwood William Grimes DURING THE FISCAL YEAR ENDED JUNE 30, 2016, CERTAIN OFFICERS AND KEY EMPLOYEES PARTICIPATED IN THE UNIVERSITY OF MARYLAND MEDICAL SYSTEM (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: Erik Boas Noel Cervino Robert A. Chrencik Jon P. Burns John W. Ashworth DURING THE FISCAL YEAR ENDED JUNE 30, 2016, CERTAIN OFFICERS AND KEY EMPLOYEES PARTICIPATED IN THE UNIVERSITY OF MARYLAND MEDICAL SYSTEM (UMMS) SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN. THE INDIVIDUALS LISTED BELOW HAVE VESTED IN THE PLAN IN THE REPORTING TAX YAR. THEREFORE, THE FULL VALUE OF THE PLAN, INCLUDING ANY CONTRIBUTIONS TO THE PLAN FOR THE CURRENT FISCAL YEAR, IS REPORTED AS TAXABLE COMPENSATION AND REPORTED ON SCHEDULE J, PART II, LINE B(III), OTHER REPORTABLE COMPENSATION. PRIOR YEAR CONTRIBUTIONS TO THE PLAN WERE PREVIOUSLY REPORTED ON FORM 990 AND ARE INDICATED ON SCHEDULE J, PART II, COLUMN (F). Mark R. Dumais
Non-fixed paymentsSchedule 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.

Schedule L IRS990ScheduleL

Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp

Name Of Interested NameOfInterested

FieldValueIRS element (for citing)
PersonJoseph SlaterPersonNm
FieldValueIRS element (for citing)
Relationship DescriptionBOARD MEMBERRelationshipDescriptionTxt
Transaction$906,743TransactionAmt
TransactionPRESIDENT AND CEO OF A VENDORTransactionDesc
Sharing Of RevenuesfalseSharingOfRevenuesInd

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePart IVFormAndLineReferenceDesc
ExplanationJoseph Slater is the president and CEO of one of our vendors, Southern Maryland Electric Cooperative, Inc.ExplanationTxt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (13 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Tax Exempt Bond IssuesForm 990, Part IV, Question 24 Pursuant to a Master Loan Agreement dated June 20, 1991 (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, The James Lawrence Kernan Hospital, Inc., Maryland General Hospital, Inc., Baltimore Washington Medical Center, Inc., Shore Health System, Inc., Chester River Hospital Center, Inc., Civista Medical Center, Inc., University of Maryland St. Joseph Medical Center, LLC, Upper Chesapeake Medical Center, Inc., Harford Memorial Hospital, Inc. and the University of Maryland Medical System Foundation, Inc. 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 $1,417,355,000 of outstanding Authority Bonds on June 30, 2016. 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 StockholdersForm 990, Part VI, Line 6, 7A AND 7B University of Maryland Charles Regional Health, Inc. and University of Maryland Medical System Corporation may elect members and approve decisions of the Civista Medical Center board.
Form 990 Review ProcessForm 990, Part VI, Line 11b THE IRS FORM 990 IS PREPARED AND REVIEWED BY THE ACCOUNTING FIRM OF GRANT THORNTON. ACCOUNTING PERSONNEL IN FINANCE SHARED SERVICES AT THE UNIVERSITY OF MARYLAND MEDICAL SYSTEM GATHER THE INFORMATION NEEDED TO COMPLETE THE RETURN AND INPUT THE DATA INTO THE GRANT THORNTON TAX ORGANIZER, WHICH IS AN EXCEL-BASED SYSTEM. WHEN ALL DATA HAS BEEN ENTERED, THE INFORMATION IS SUBMITTED TO GRANT THORNTON FOR IMPORTATION INTO THEIR TAX SOFTWARE. AT THIS POINT, GRANT THORNTON STAFF MEMBERS REVIEW THE DATA, ASK FOR ADDITIONAL INFORMATION IF NEEDED AND PREPARE THE TAX RETURN. EACH RETURN IS REVIEWED AT SEVERAL LEVELS AT GRANT THORNTON INCLUDING THE TAX PARTNER. AFTER THEIR REVIEW PROCESS, A DRAFT RETURN IS SENT TO THE ACCOUNTING STAFF AT UMMS FOR AN IN-HOUSE REVIEW. UPON COMPLETION OF THE IN-HOUSE REVIEW, GRANT THORNTON IS INSTRUCTED TO MAKE ANY NECESSARY CHANGES AND TO PREPARE THE FINAL TAX RETURN. THE FINAL RETURN UNDERGOES ANOTHER REVIEW BY THE ACCOUNTING STAFF AT FINANCE SHARED SERVICES AND IS ALSO REVIEWED BY THE ACCOUNTING MANAGER, THE DIRECTOR OF FINANCIAL REPORTING, THE VICE PRESIDENT OF FINANCE AND THE CFO, WHO SIGNS THE RETURN. 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. AT THE DISCRETION OF THE REVIEWING BOARD MEMBER, SUCH MEMBER WILL BRING ANY ISSUES OR QUESTIONS RELATED TO THE COMPLETED IRS FORM 990 TO THE ATTENTION OF THE BOARD. NOTWITHSTANDING THE ABOVE, A BOARD RESOLUTION IS NOT REQUIRED FOR THE FILING OF THE ORGANIZATION'S IRS FORM 990. EACH BOARD MEMBER IS PROVIDED WITH A COPY OF THE FINAL IRS FORM 990 BEFORE FILING.
Conflict of Interest Policy Monitoring & EnforcementForm 990, Part VI, Line 12c THE ORGANIZATION'S OFFICERS, DIRECTORS, EMPLOYEES 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 ALL OFFICERS, DIRECTORS AND KEY EMPLOYEES. THE GENERAL COUNSEL OF THE UNIVERSITY OF MARYLAND MEDICAL SYSTEM CORPORATION (UMMSC) REVIEWS THE RESPONSES FOR UMMSC, UNIVERSITY SPECIALTY HOSPITAL AND JAMES LAWRENCE KERNAN HOSPITAL. THE CEO OR CFO OF EACH OF THE OTHER ENTITIES IN THE UNIVERSITY OF MARYLAND MEDICAL 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 FOR UMMSC, UNIVERSITY SPECIALTY HOSPITAL AND JAMES LAWRENCE KERNAN HOSPITAL. WITH RESPECT TO THE OTHER ENTITIES IN THE UNIVERSITY OF MARYLAND MEDICAL 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 CompensationForm 990, Part VI, Line 15a & 15b 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 PublicForm 990, Part VI, Line 19 IN GENERAL, FINANCIAL AND TAX INFORMATION RELATING TO THE ORGANIZATION IS DEEMED PROPRIETARY AND NOT SUBJECT TO DISCLOSURE UPON REQUEST. HOWEVER, SPECIFIC PROVISIONS OF FEDERAL AND STATE LAW REQUIRE THE ORGANIZATION TO DISCLOSE CERTAIN LIMITED FINANCIAL AND TAX DATA UPON A SPECIFIC REQUEST FOR THAT INFORMATION. REQUESTS FOR FORM 990 AND FORM 1023: A REQUESTOR SEEKING TO REVIEW AND/OR OBTAIN A COPY OF THE ORGANIZATION'S IRS FORM 990 OR FORM 1023 AS FILED WITH THE INTERNAL REVENUE SERVICE, INCLUDING ALL SCHEDULES AND ATTACHMENTS, MAY APPEAR IN PERSON OR SUBMIT A WRITTEN REQUEST. THE MOST RECENT THREE YEARS OF IRS FORM 990 MAY BE REQUESTED. IF THE REQUESTER APPEARS IN PERSON, THE INDIVIDUAL IS DIRECTED TO THE OFFICE OF THE CHIEF FINANCIAL OFFICER FOR THE ORGANIZATION AND THE FORM 990 AND/OR FORM 1023 ARE MADE AVAILABLE FOR INSPECTION. THE INDIVIDUAL IS PERMITTED TO REVIEW THE RETURN, TAKE NOTES AND REQUEST A COPY. IF REQUESTED, A COPY IS PROVIDED ON THE SAME DAY. A NOMINAL FEE IS CHARGED FOR MAKING THE COPIES. THE ORGANIZATION MAY HAVE AN EMPLOYEE PRESENT DURING THE PUBLIC INSPECTION OF THE DOCUMENT. WRITTEN REQUESTS FOR AN ENTITY'S FORM 990 OR FORM 1023 ARE DIRECTED IMMEDIATELY TO THE OFFICE OF THE CHIEF FINANCIAL OFFICER FOR THE ORGANIZATION. THE REQUESTED COPIES ARE MAILED WITHIN 30 DAYS OF THE REQUEST. REPRODUCTION FEES AND MAILING COSTS ARE CHARGED TO THE REQUESTOR. CONFLICT OF INTEREST POLICY AND GOVERNING DOCUMENTS: IF THE GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY OF OUR ORGANIZATION ARE SUBJECT TO THE FEDERAL PUBLIC DISCLOSURE RULES (OR STATE PUBLIC DISCLOSURE RULES), THESE DOCUMENTS WILL BE MADE PUBLICLY AVAILABLE AS APPLICABLE LAW MAY REQUIRE. OTHERWISE, THE GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY WILL BE PROVIDED TO THE PUBLIC AT THE DISCRETION OF MANAGEMENT.
Hours on Related EntitiesFORM 990, PART VII, SECTION A, COLUMN B THE UNIVERSITY OF MARYLAND MEDICAL SYSTEM (UMMS) IS A MULTI-ENTITY HEALTH CARE SYSTEM THAT INCLUDES 11 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.
Other Changes in Net Assets or Fund BalancesForm 990, Part XI, Line 9 Pension Liability Adjustment ($3,697,344) net Assets Released from Restrictions $2,150,360 Change in Intercompany - Equity Transfer ($867,271) Change in Equity of Affiliates, Foundation ($33,005) Change in FMV of Alternative Investments ($272,081) ------------- ($2,719,341) =============
FORM 990 PART IX LINE 11GDESCRIPTION:AGENCY EXPENSE/CONTRACTUAL STA TOTAL FEES:4777352
FORM 990 PART IX LINE 11GDESCRIPTION:PROFESSIONAL FEES TOTAL FEES:5086408
FORM 990 PART IX LINE 11GDESCRIPTION:CONSULTING SERVICES TOTAL FEES:590941
FORM 990 PART IX LINE 11GDESCRIPTION:OTHER FEES TOTAL FEES:700327
FORM 990 PART IX LINE 11GDESCRIPTION:SHARED SERVICES TOTAL FEES:5250835

Schedule R IRS990ScheduleR

Id Disregarded Entities IdDisregardedEntitiesGrp

Disregarded Entity Name DisregardedEntityName

FieldValueIRS element (for citing)
Business Name Line1U MD CHARLES REGIONAL URGENT CARE LLCBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1500 CHARLES STREETAddressLine1Txt
CityLA PLATACityNm
State AbbreviationMDStateAbbreviationCd
ZIP20646ZIPCd
FieldValueIRS element (for citing)
EIN474492342EIN
Primary ActivitiesURGENT CAREPrimaryActivitiesTxt
Legal Domicile StateMDLegalDomicileStateCd
Total Income$954,514TotalIncomeAmt
End Of Year Assets$1,700,210EndOfYearAssetsAmt

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1CIVSITA MEDBusinessNameLine1Txt

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (38 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtControlled OrganizationControlledOrganizationInd
Baltimore Washington Emergency Phys Inc
301 Hospital DriveGlen BurnieMD21061521756326HealthcareMD501(c)(3)11AUMBWMSfalse
Baltimore Washington Healthcare Services
301 Hospital DriveGlen BurnieMD21061521830243HealthcareMD501(c)(3)11AUMBWMSfalse
Baltimore Washington Medical Center Inc
301 Hospital DriveGlen BurnieMD21061520689917HealthcareMD501(c)(3)03UMBWMSfalse
UM Baltimore Washington Medical System
301 Hospital DriveGlen BurnieMD21061521830242HealthcareMD501(c)(3)11AUMBWMSfalse
BW Medical Center Foundation Inc
301 Hospital DriveGlen BurnieMD21061521813656FundraisingMD501(c)(3)11CUMBWMSfalse
North Arundel Development Corporation
301 Hospital DriveGlen BurnieMD21061521318404Real EstateMD501(c)(2)NCCfalse
North County Corporation
301 Hospital DriveGlen BurnieMD21061521591355Real EstateMD501(c)(2)UMBWMSfalse
Chester River Health Foundation Inc
100 Brown StreetChestertownMD21620521338861FundraisingMD501(c)(3)08UMSRHfalse
Univ of MD Shore Regional HealthInc
100 Brown StreetChestertownMD21620522046500HealthcareMD501(c)(3)11AUMMSCfalse
Chester River Hospital Center
100 Brown StreetChestertownMD21620520679694HealthcareMD501(c)(3)03UMSRHfalse
Chester River Manor Inc
200 Morgnec RoadChestertownMD21620526070333HealthcareMD501(c)(3)09UMSRHfalse
Maryland General Clinical Practice Group
827 Linden AvenueBaltimoreMD21201521566211HealthcareMD501(c)(3)11BUMMTHfalse
Maryland General Comm Health Foundation
827 Linden AvenueBaltimoreMD21201522147532FundraisingMD501(c)(3)11CUMMTHfalse
University of Maryland Midtown Health I
827 Linden AvenueBaltimoreMD21201521175337HealthcareMD501(c)(3)11BUMMSCfalse
Maryland General Hospital Inc
827 Linden AvenueBaltimoreMD21201520591667HealthcareMD501(c)(3)03UMMTHfalse
Care Health Services Inc
219 South Washington StreetEastonMD21601521510269HealthcareMD501(c)(3)09UMSRHfalse
Dorchester General Hospital Foundation
219 South Washington StreetEastonMD21601521703242FundraisingMD501(c)(3)11DUMSRHfalse
Memorial Hospital Foundation Inc
219 South Washington StreetEastonMD21601521282080FundraisingMD501(c)(3)11AUMSRHfalse
University of Maryland Community Medical
22 South Greene StreetBaltimoreMD21601521874111HealthcareMD501(c)(3)03UMMSCfalse
Shore Health System Inc
219 South Washington StreetEastonMD21601520610538HealthcareMD501(c)(3)03UMMSCfalse
James Lawrence Kernan Hosp Endow Fd
2200 Kernan DriveBaltimoreMD21207237360743FundraisingMD501(c)(3)11BUMMSCfalse
James Lawrence Kernan Hospital Inc
2200 Kernan DriveBaltimoreMD21207520591639HealthcareMD501(c)(3)03UMMSCfalse
UMMS Foundation Inc
22 South Greene StreetBaltimoreMD21201522238893FundraisingMD501(c)(3)11AUMMSCfalse
University of MD Medical System Corp
22 South Greene StreetBaltimoreMD21201521362793HealthcareMD501(c)(3)03NAfalse
University of Maryland Charles Regional
PO Box 1070La PlataMD20646522155576HealthcareMD501(c)(3)11CUMMSCfalse
Charles Regional Medical Center Foundati
PO Box 1070La PlataMD20646521414564FundraisingMD501(c)(3)11AUMCRHfalse
Charles Regional Medical Center Auxiliar
PO Box 1070La PlataMD21204521131193FundraisingMD501(c)(3)11AUMCRHfalse
Univ of MD St Joseph Foundation Inc
7601 Osler DriveTowsonMD21014521681044FundraisingMD501(c)(3)11AUMMSCfalse
Harford Memorial Hospital Inc
520 Upper Chesapeake DrBel AirMD21014520591484HealthcareMD501(c)(3)03UMUCHSfalse
UCH Legacy Funding Corporation
520 Upper Chesapeake DrBel AirMD21014520882914FundraisingMD501(c)(3)11AUMUCHSfalse
UNIV OF MD UPPER CHESAPEAKE HEALTH SYS
520 Upper Chesapeake DrBel AirMD21014521398513HealthcareMD501(c)(3)11C; III-FIUMUCHSfalse
Upper Chesapeake Health Foundation Inc
520 Upper Chesapeake DrBel AirMD21014521398507FundraisingMD501(c)(3)11AUMUCHSfalse
Upper Chesapeake Medical Center Inc
520 Upper Chesapeake DrBel AirMD21014521253920HealthcareMD501(c)(3)03UMUCHSfalse
Upper Chesapeake Medical Services Inc
520 Upper Chesapeake DrBel AirMD21014521501734HealthcareMD501(c)(3)09UMUCHSfalse
Upper Chesapeake Properties Inc
520 Upper Chesapeake DrBel AirMD21014521907237Real EstateMD501(c)(2)UMUCHSfalse
Upper Ches Residential Hospice House In
520 Upper Chesapeake DrBel AirMD21014260737028HospiceMD501(c)(3)07UMUCHSfalse
Upper ChesapeakeSt Joseph Home Care I
520 Upper Chesapeake DrBel AirMD21204521229742HOSPICEMD501(c)(3)09UMUCHSfalse
UMSJ Health System LLC
7601 Osler DriveTowsonMD21204460797956HealthcareMD501(c)(3)03UMMSCfalse

Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (9 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtPredominant Income TypePredominantIncomeTypeTxt
Arundel Physicians Associates LLC
301 Hospital DriveGlen BurnieMD20161522000762HealthcareMDNAN/A
Baltimore Washington Imaging LLC
301 Hospital DriveGlen BurnieMD20161200806027HealthcareMDNAN/A
Innovative Health LLC
29165 Canvasback Drive Suite 100EastonMD21601521997287BillingMDNAN/A
Central Maryland Radiology Oncology LLC
10710 Charter DriveColumbiaMD21044270879418HealthcareMDNAN/A
Universitycare LLC
22 South Greene StreetBaltimoreMD21201521914892HealthcareMDNAN/A
O'Dea Medical Arts Limited Partnership
7601 Osler DriveTowsonMD21204521682964RentalMDNAN/A
Advanced Imaging at St Joseph Medical C
7601 Osler DriveTowsonMD21204521958002HealthcareMDNAN/A
UCHSUMMS Real Estate Trust
520 Upper Chesapeake DrBel AirMD21014276803540Real EstateMDNAN/A
University of Maryland Charles Regional
PO Box 1070LaPlataMD20646300956382HealthcareMDNAN/A

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (16 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtEntity TypeEntityTypeTxtAddress Line1ForeignAddress/AddressLine1TxtCityForeignAddress/CityNmCountryForeignAddress/CountryCdForeign PostalForeignAddress/ForeignPostalCdLegal Domicile Foreign CountryLegalDomicileForeignCountryCd
Arundel Physicians Associates Inc
301 Hospital DriveGlen BurnieMD21061521992649HealthcareMDBWHEC Corp
Baltimore Washington Health Enterprises
301 Hospital DriveGlen BurnieMD21061521936656HealthcareMDBWMSC Corp
BW Professional Services Inc
301 Hospital DriveGlen BurnieMD21061521655640HealthcareMDBWHEC Corp
Univ of Maryland Charles Regional Care P
PO Box 1070La PlataMD20646522176314HealthcareMDCHIC Corp
University Midtown Prof Center A Condom
827 Linden AvenueBaltimoreMD21201521891126Real EstateMDMGHSC Corp
NA Executive Building Condo Assn Inc
301 Hospital DriveGlen BurnieMD21061Real EstateMDNADCOC Corp
Terrapin Insurance Company
980129232InsuranceUMMSC CorpPO Box 1109GRAND CAYMANCJKYI-1102CJ
UMMS Self Insurance Trust
22 South Greene StreetBaltimoreMD21201526315433InsuranceMDUMMSTrust
Upper Chesapeake Insurance Company
520 Upper Chesapeake DrBel AirMD21014980468438InsuranceMDUMUCHSS Corp
Upper Chesapeake Health Ventures Inc
520 Upper Chesapeake DrBel AirMD21014522031264HealthcareMDUMUCHSC Corp
Upper Chesapeake Medical Center Land Con
520 Upper Chesapeake DrBel AirMD21014770674478Real EstateMDUC Med CrtC Corp
Upper Chesapeake Medical Office Building
520 Upper Chesapeake DrBel AirMD21014521946829Real EstateMDUC Hlth VentC Corp
University of Maryland Health Advantage
22 South Greene StreetBaltimoreMD21201461411902InsuranceMDUMMSC Corp
University of Maryland Health Partners
22 South Greene StreetBaltimoreMD21201452815803InsuranceMDUMMSC Corp
University of Maryland Medical System He
22 South Greene StreetBaltimoreMD21201452815722InsuranceMDUMMSC Corp
Shore Orthopedics Inc
219 S Washington StreetEastonMD21601371817260HealthcareMDSHSC Corp
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts RyltsfalseReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth OrgfalseGiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth OrgfalseGiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other OrgfalseLoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth OrgfalseLoansOrGuaranteesFromOthOrgInd
Div Related OrganizationfalseDivRelatedOrganizationInd
Asset Sale To Other OrgfalseAssetSaleToOtherOrgInd
Asset Purchase From Other OrgfalseAssetPurchaseFromOtherOrgInd
Asset ExchangeYes (true)AssetExchangeInd
Rental Of Facilities To Oth OrgfalseRentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth OrgfalseRentalOfFcltsFromOthOrgInd
Perform Of Services For Oth OrgfalsePerformOfServicesForOthOrgInd
Perform Of Services By Other OrgfalsePerformOfServicesByOtherOrgInd
Sharing Of FacilitiesYes (true)SharingOfFacilitiesInd
Paid Employees SharingYes (true)PaidEmployeesSharingInd
Reimbursement Paid To Other OrgfalseReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other OrgYes (true)ReimbursementPaidByOtherOrgInd
Transfer To Other OrgYes (true)TransferToOtherOrgInd
Transfer From Other OrgYes (true)TransferFromOtherOrgInd

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