FREDERICK HEALTH HOSPICE INC: Form 990, tax year 2014

View the entire original 990 at ProPublica ↗

Organization
FREDERICK HEALTH HOSPICE INC (EIN 52-1164513)
Tax period
2014-07-01 to 2015-06-30
Filed
2016-05-13
IRS object ID
201611349349308051
Schema version
2014v6.0
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

FieldValueIRS element (for citing)
Return2016-05-13T19:32:36-05:00ReturnTs
Tax Period End2015-06-30TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1ERNST & YOUNG US LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1201 NORTH FRANKLIN STREET STE 2400AddressLine1Txt
CityTAMPACityNm
State AbbreviationFLStateAbbreviationCd
ZIP33602ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2014-07-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN521164513EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Hospice of Frederick County IncBusinessNameLine1Txt
FieldValueIRS element (for citing)
In Care Of% MICHELLE MAHANInCareOfNm
Business Name ControlHOSPBusinessNameControlTxt
Phone2405663030PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1PO BOX 1799AddressLine1Txt
CityFREDERICKCityNm
State AbbreviationMDStateAbbreviationCd
ZIP21705ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonMICHELLE MAHANPersonNm
Person TitleCFO-FMH, INCPersonTitleTxt
Phone8132254800PhoneNum
Signature2016-05-13SignatureDt
Discuss With Paid PreparerYes (true)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonMELANIE A MCPEAKPreparerPersonNm
PTINP01346034PTIN
Phone8132254800PhoneNum
FieldValueIRS element (for citing)
Tax2014TaxYr
Build TS2016-08-17 19:52:53ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerLAUREL CUCCHIPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1PO BOX 1799AddressLine1Txt
CityFREDERICKCityNm
State AbbreviationMDStateAbbreviationCd
ZIP21705ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$4,180,328GrossReceiptsAmt
Group Return For AffiliatesfalseGroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.HOSPICEOFFREDERICKCO.COMWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1981FormationYr
Legal Domicile StateMDLegalDomicileStateCd
Activity Or MissionPROVIDE AND PROMOTE HOSPICE CARE FOR PEOPLE WHO ARE TERMINALLY ILL AND FOR THEIR FAMILIES. IT SERVES AS A FUNDRAISING ORG. FOR THE BENEFIT OF HOSPICE SVCS. AND THE KLINE HOUSE.ActivityOrMissionDesc
Voting Members Governing Body11VotingMembersGoverningBodyCnt
Voting Members Independent8VotingMembersIndependentCnt
Total Employee0TotalEmployeeCnt
Total Volunteers50TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
PY Contributions Grants$979,996PYContributionsGrantsAmt
CY Contributions Grants$912,801CYContributionsGrantsAmt
PY Program Service Revenue$202,260PYProgramServiceRevenueAmt
CY Program Service Revenue$243,560CYProgramServiceRevenueAmt
PY Investment Income$353,325PYInvestmentIncomeAmt
CY Investment Income$466,222CYInvestmentIncomeAmt
PY Other Revenue$18,164PYOtherRevenueAmt
CY Other Revenue$194,685CYOtherRevenueAmt
PY Total Revenue$1,553,745PYTotalRevenueAmt
CY Total Revenue$1,817,268CYTotalRevenueAmt
PY Grants And Similar Paid$0PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$0PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$0CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$15,648CYTotalFundraisingExpenseAmt
PY Other Expenses$1,196,548PYOtherExpensesAmt
CY Other Expenses$1,243,866CYOtherExpensesAmt
PY Total Expenses$1,196,548PYTotalExpensesAmt
CY Total Expenses$1,243,866CYTotalExpensesAmt
PY Revenues Less Expenses$357,197PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$573,402CYRevenuesLessExpensesAmt
Total Assets BOY$4,472,459TotalAssetsBOYAmt
Total Assets EOY$4,669,388TotalAssetsEOYAmt
Total Liabilities BOY$68,551TotalLiabilitiesBOYAmt
Total Liabilities EOY$31,576TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$4,403,908NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$4,637,812NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionTHE PURPOSE OF THE HOSPICE OF FREDERICK COUNTY, INC. IS TO PROVIDE AND PROMOTE HOSPICE CARE FOR INDIVIDUALS WHO ARE TERMINALLY ILL AND FOR THEIR FAMILIES. HOSPICE OF FREDERICK COUNTY, INC. OPERATES AS A FUNDRAISING ORGANIZATION FOR THE BENEFIT OF HOSPICE SERVICES AND OPERATES THE KLINE HOSPICE HOUSE.MissionDesc
Significant New Program SrvcfalseSignificantNewProgramSrvcInd
Significant ChangefalseSignificantChangeInd
Expense$1,115,456ExpenseAmt
Grant$0GrantAmt
Revenue$243,560RevenueAmt
DescTHE PURPOSE OF THE HOSPICE OF FREDERICK COUNTY, INC. IS TO PROVIDE AND PROMOTE HOSPICE CARE FOR INDIVIDUALS WHO ARE TERMINALLY ILL AND FOR THEIR FAMILIES. HOSPICE OF FREDERICK COUNTY, INC. OPERATES AS A FUNDRAISING ORGANIZATION FOR THE BENEFIT OF HOSPICE SERVICES AND OPERATES THE KLINE HOSPICE HOUSE.Desc
Total Program Service Expenses$1,115,456TotalProgramServiceExpensesAmt
Described In Section501c3Yes (true)DescribedInSection501c3Ind
Schedule B RequiredYes (true)ScheduleBRequiredInd
Political Campaign ActyfalsePoliticalCampaignActyInd
Lobbying ActivitiesfalseLobbyingActivitiesInd
Subject To Proxy TaxfalseSubjectToProxyTaxInd
Donor Advised FundfalseDonorAdvisedFundInd
Conservation EasementsfalseConservationEasementsInd
Collections Of ArtfalseCollectionsOfArtInd
Credit CounselingfalseCreditCounselingInd
Temp Or Permanent EndowmentsfalseTempOrPermanentEndowmentsInd
Report Land Building EquipmentYes (true)ReportLandBuildingEquipmentInd
Report Investments Other SecfalseReportInvestmentsOtherSecInd
Report Program Related InvstfalseReportProgramRelatedInvstInd
Report Other AssetsfalseReportOtherAssetsInd
Report Other LiabilitiesfalseReportOtherLiabilitiesInd
Include FIN48 FootnotefalseIncludeFIN48FootnoteInd
Independent Audit Fincl StmtfalseIndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (true)ConsolidatedAuditFinclStmtInd
School OperatingfalseSchoolOperatingInd
Foreign OfficefalseForeignOfficeInd
Foreign ActivitiesfalseForeignActivitiesInd
More Than5000 K To OrgfalseMoreThan5000KToOrgInd
More Than5000 K To IndividualsfalseMoreThan5000KToIndividualsInd
Professional FundraisingfalseProfessionalFundraisingInd
Fundraising ActivitiesYes (true)FundraisingActivitiesInd
Gaming ActivitiesfalseGamingActivitiesInd
Operate HospitalfalseOperateHospitalInd
Grants To OrganizationsfalseGrantsToOrganizationsInd
Grants To IndividualsfalseGrantsToIndividualsInd
Schedule J RequiredYes (true)ScheduleJRequiredInd
Tax Exempt BondsfalseTaxExemptBondsInd
Engaged In Excess Benefit TransfalseEngagedInExcessBenefitTransInd
PY Excess Benefit TransfalsePYExcessBenefitTransInd
Loan OutstandingfalseLoanOutstandingInd
Grant To Related PersonfalseGrantToRelatedPersonInd
Business Rln With Org MemfalseBusinessRlnWithOrgMemInd
Business Rln With Fam MemfalseBusinessRlnWithFamMemInd
Business Rln With Officer EntfalseBusinessRlnWithOfficerEntInd
Deductible Non Cash ContrifalseDeductibleNonCashContriInd
Deductible Art ContributionfalseDeductibleArtContributionInd
Terminate OperationsfalseTerminateOperationsInd
Partial LiquidationfalsePartialLiquidationInd
Disregarded EntityfalseDisregardedEntityInd
Related EntityYes (true)RelatedEntityInd
Related Organization Ctrl EntYes (true)RelatedOrganizationCtrlEntInd
Transaction With Control EntYes (true)TransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd OrgfalseTrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted PrtshpfalseActivitiesConductedPrtshpInd
Schedule O RequiredYes (true)ScheduleORequiredInd
IRP Document0IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Employee0EmployeeCnt
Unrelated Bus Incm Over LimitfalseUnrelatedBusIncmOverLimitInd
Foreign Financial AccountfalseForeignFinancialAccountInd
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTransInd
Taxable Party NotificationfalseTaxablePartyNotificationInd
Nondeductible ContributionsfalseNondeductibleContributionsInd
Quid Pro Quo ContributionsYes (true)QuidProQuoContributionsInd
Quid Pro Quo Contri DisclYes (true)QuidProQuoContriDisclInd
Form8282 Property Disposed OffalseForm8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft CntrctfalseRcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft CntrctfalsePayPremiumsPrsnlBnftCntrctInd
Indoor Tanning ServicesfalseIndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members11GoverningBodyVotingMembersCnt
Independent Voting Member8IndependentVotingMemberCnt
Family Or Business RlnfalseFamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesfalseDelegationOfMgmtDutiesInd
Change To Org DocumentsfalseChangeToOrgDocumentsInd
Material Diversion Or MisusefalseMaterialDiversionOrMisuseInd
Members Or StockholdersYes (true)MembersOrStockholdersInd
Election Of Board MembersYes (true)ElectionOfBoardMembersInd
Decisions Subject To ApprovaYes (true)DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (true)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (true)MinutesOfCommitteesInd
Officer Mailing AddressfalseOfficerMailingAddressInd
Local ChaptersfalseLocalChaptersInd
Form990 Provided To Gvrn BodyYes (true)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (true)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (true)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (true)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (true)WhistleblowerPolicyInd
Document Retention PolicyYes (true)DocumentRetentionPolicyInd
Compensation Process CEOfalseCompensationProcessCEOInd
Compensation Process OtherfalseCompensationProcessOtherInd
Investment In Joint VenturefalseInvestmentInJointVentureInd
States Where Copy Of Return Is FldMDStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

FieldValueIRS element (for citing)
PersonMICHELLE MAHANPersonNm
Phone2405663300PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1400 WEST SEVENTH STREETAddressLine1Txt
CityFREDERICKCityNm
State AbbreviationMDStateAbbreviationCd
ZIP21701ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (13 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmt
Timothy A Gibian PsyD
President2.00.0Yes (X)Yes (X)$0$0$0
William Haugh
Director2.00.0Yes (X)$0$0$0
Carmen Hernandez MD
Director1.00.0Yes (X)$0$0$0
Thomas Kleinhanzl
Director5.040.0Yes (X)$0$793,936$196,036
Carl Miller
Director4.00.0Yes (X)$0$0$0
Ricky Sandy
VICE PRESIDENT1.00.0Yes (X)Yes (X)$0$0$0
Douglas Stauffer
Director2.00.0Yes (X)$0$0$0
John Verbus
Director5.035.0Yes (X)$0$427,380$62,940
Mark Goldstein MD
Director2.040.0Yes (X)$0$435,321$26,404
Rev Timothy May
Secretary2.00.0Yes (X)Yes (X)$0$0$0
Don Butt Jr
Treasurer2.00.0Yes (X)Yes (X)$0$0$0
Laurel Cucchi
Director-Operations55.00.0Yes (X)$0$111,921$18,627
Michelle Mahan
Chief Financial Officer - FMH1.040.0Yes (X)$0$444,215$63,817
FieldValueIRS element (for citing)
Total Reportable Comp From Org$0TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$2,212,773TotReportableCompRltdOrgAmt
Total Other Compensation$367,824TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K0IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedfalseFormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (true)TotalCompGreaterThan150KInd
Compensation From Other SrcsfalseCompensationFromOtherSrcsInd
Cntrct Rcvd Greater Than100 K0CntrctRcvdGreaterThan100KCnt
Fundraising$53,355FundraisingAmt
All Other Contributions$859,446AllOtherContributionsAmt
Noncash Contributions$0NoncashContributionsAmt
Total Contributions$912,801TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp

FieldValueIRS element (for citing)
DescINPATIENT - HOSPICE HOUSEDesc
Business623110BusinessCd
Total Revenue Column$243,560TotalRevenueColumnAmt
Related Or Exempt Func Income$243,560RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$0ExclusionAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$243,560TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$175,347TotalRevenueColumnAmt
Exclusion$175,347ExclusionAmt

Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Royalties Revenue RoyaltiesRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real$0RealAmt
Personal$0PersonalAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Securities$2,622,381SecuritiesAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Securities$2,331,506SecuritiesAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities$290,875SecuritiesAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$290,875TotalRevenueColumnAmt
Exclusion$290,875ExclusionAmt
FieldValueIRS element (for citing)
Fundraising Gross Income$226,239FundraisingGrossIncomeAmt
Contri Rpt Fundraising Event$53,355ContriRptFundraisingEventAmt
Fundraising Direct Expenses$31,554FundraisingDirectExpensesAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

FieldValueIRS element (for citing)
Total Revenue Column$194,685TotalRevenueColumnAmt
Exclusion$194,685ExclusionAmt

Net Income From Gaming NetIncomeFromGamingGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Net Income Or Loss NetIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt
FieldValueIRS element (for citing)
Other Revenue Total$0OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$1,817,268TotalRevenueColumnAmt
Related Or Exempt Func Income$243,560RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$660,907ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt
Program Services$0ProgramServicesAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt
Program Services$0ProgramServicesAmt

Foreign Grants ForeignGrantsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt
Program Services$0ProgramServicesAmt

Benefits To Members BenefitsToMembersGrp

FieldValueIRS element (for citing)
Total$0TotalAmt
Program Services$0ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt
Program Services$0ProgramServicesAmt
Management And General$0ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Comp Disqual Persons CompDisqualPersonsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt
Program Services$0ProgramServicesAmt
Management And General$0ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt
Program Services$0ProgramServicesAmt
Management And General$0ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt
Program Services$0ProgramServicesAmt
Management And General$0ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt
Program Services$0ProgramServicesAmt
Management And General$0ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt
Program Services$0ProgramServicesAmt
Management And General$0ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Fees For Services Management FeesForServicesManagementGrp

FieldValueIRS element (for citing)
Total$0TotalAmt
Program Services$0ProgramServicesAmt
Management And General$0ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$0TotalAmt
Program Services$0ProgramServicesAmt
Management And General$0ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$0TotalAmt
Program Services$0ProgramServicesAmt
Management And General$0ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

FieldValueIRS element (for citing)
Total$0TotalAmt
Program Services$0ProgramServicesAmt
Management And General$0ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total$0TotalAmt
Fundraising$0FundraisingAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

FieldValueIRS element (for citing)
Total$40,252TotalAmt
Program Services$0ProgramServicesAmt
Management And General$40,252ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$0TotalAmt
Program Services$0ProgramServicesAmt
Management And General$0ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$115,652TotalAmt
Program Services$80,244ProgramServicesAmt
Management And General$24,491ManagementAndGeneralAmt
Fundraising$10,917FundraisingAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$0TotalAmt
Program Services$0ProgramServicesAmt
Management And General$0ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Royalties RoyaltiesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt
Program Services$0ProgramServicesAmt
Management And General$0ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$16,855TotalAmt
Program Services$16,855ProgramServicesAmt
Management And General$0ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$0TotalAmt
Program Services$0ProgramServicesAmt
Management And General$0ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp

FieldValueIRS element (for citing)
Total$0TotalAmt
Program Services$0ProgramServicesAmt
Management And General$0ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt
Program Services$0ProgramServicesAmt
Management And General$0ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$0TotalAmt
Program Services$0ProgramServicesAmt
Management And General$0ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Payments To Affiliates PaymentsToAffiliatesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt
Program Services$0ProgramServicesAmt
Management And General$0ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$62,188TotalAmt
Program Services$62,188ProgramServicesAmt
Management And General$0ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$0TotalAmt
Program Services$0ProgramServicesAmt
Management And General$0ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Other Expenses OtherExpensesGrp (2 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmtFundraisingFundraisingAmt
MEDICAL SUPPLIES$123,101$104,370$14,056$4,675
RELATED PARTY FEES SVCS$885,818$851,799$33,963$56

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$1,243,866TotalAmt
Program Services$1,115,456ProgramServicesAmt
Management And General$112,762ManagementAndGeneralAmt
Fundraising$15,648FundraisingAmt

Total Joint Costs TotalJointCostsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

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

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$224,641BOYAmt
EOY$284,396EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

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

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$95,915BOYAmt
EOY$51,917EOYAmt

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$0BOYAmt
EOY$0EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$1,855,546LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$960,083LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$800,601BOYAmt
EOY$895,463EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$3,351,302BOYAmt
EOY$3,437,612EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

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

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$0BOYAmt
EOY$0EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$4,472,459BOYAmt
EOY$4,669,388EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$68,551BOYAmt
EOY$31,576EOYAmt

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$0BOYAmt
EOY$0EOYAmt

Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp

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

Other Liabilities OtherLiabilitiesGrp

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

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$68,551BOYAmt
EOY$31,576EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$4,403,908BOYAmt
EOY$4,637,812EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

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

Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp

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

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$4,403,908BOYAmt
EOY$4,637,812EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$4,472,459BOYAmt
EOY$4,669,388EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss$573,402ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst-$339,498NetUnrlzdGainsLossesInvstAmt
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 RequiredfalseFederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Publicly Supported Org509a2Yes (X)PubliclySupportedOrg509a2Ind

Gifts Grants Contris Rcvd509 GiftsGrantsContrisRcvd509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$602,502CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$1,511,719CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$710,342CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$979,996CurrentTaxYearMinus1YearAmt
Current Tax Year$912,801CurrentTaxYearAmt
Total$4,717,360TotalAmt

Gross Receipts Admissions GrossReceiptsAdmissionsGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$226,491CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$266,420CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$237,820CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$202,260CurrentTaxYearMinus1YearAmt
Current Tax Year$243,560CurrentTaxYearAmt
Total$1,176,551TotalAmt

Gross Receipts Non Unrlt Bus GrossReceiptsNonUnrltBusGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$49,689CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$250,326CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$47,655CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$46,650CurrentTaxYearMinus1YearAmt
Current Tax Year$226,239CurrentTaxYearAmt
Total$620,559TotalAmt

Tax Rev Levied Orgnztnl Bnft509 TaxRevLeviedOrgnztnlBnft509Grp

FieldValueIRS element (for citing)
Total$0TotalAmt

Govt Furn Srvc Fclts Vl509 GovtFurnSrvcFcltsVl509Grp

FieldValueIRS element (for citing)
Total$0TotalAmt

Total509 Total509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$878,682CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$2,028,465CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$995,817CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$1,228,906CurrentTaxYearMinus1YearAmt
Current Tax Year$1,382,600CurrentTaxYearAmt
Total$6,514,470TotalAmt

Amounts Rcvd Dsqlfy Person AmountsRcvdDsqlfyPersonGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$0CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$0CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$0CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$0CurrentTaxYearMinus1YearAmt
Current Tax Year$0CurrentTaxYearAmt
Total$0TotalAmt

Substantial Contributors Amt SubstantialContributorsAmtGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$2,482CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$1,024,044CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$46,936CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$229,797CurrentTaxYearMinus1YearAmt
Current Tax Year$0CurrentTaxYearAmt
Total$1,303,259TotalAmt

Subst And Dsqlfy Prsns Tot SubstAndDsqlfyPrsnsTotGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$2,482CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$1,024,044CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$46,936CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$229,797CurrentTaxYearMinus1YearAmt
Current Tax Year$0CurrentTaxYearAmt
Total$1,303,259TotalAmt
FieldValueIRS element (for citing)
Public Support Total509$5,211,211PublicSupportTotal509Amt

Gross Investment Income509 GrossInvestmentIncome509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$38,581CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$67,173CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$100,816CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$112,306CurrentTaxYearMinus1YearAmt
Current Tax Year$175,347CurrentTaxYearAmt
Total$494,223TotalAmt

Post1975 UBTI Post1975UBTIGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Investment Income And UBTI InvestmentIncomeAndUBTIGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$38,581CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$67,173CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$100,816CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$112,306CurrentTaxYearMinus1YearAmt
Current Tax Year$175,347CurrentTaxYearAmt
Total$494,223TotalAmt

Net Income From Other UBI NetIncomeFromOtherUBIGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Other Income509 OtherIncome509Grp

FieldValueIRS element (for citing)
Total$0TotalAmt

Total Support Calendar Year TotalSupportCalendarYearGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$917,263CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$2,095,638CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$1,096,633CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$1,341,212CurrentTaxYearMinus1YearAmt
Current Tax Year$1,557,947CurrentTaxYearAmt
Total$7,008,693TotalAmt
FieldValueIRS element (for citing)
Public Support CY5090.74353PublicSupportCY509Pct
Public Support PY5090.70780PublicSupportPY509Pct
Investment Income CY0.07052InvestmentIncomeCYPct
Investment Income PY0.05700InvestmentIncomePYPct
Thirty Thr Pct Suprt Tests CY509Yes (X)ThirtyThrPctSuprtTestsCY509Ind

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Total ContributionsRESTRICTEDTotalContributionsAmt

Schedule D IRS990ScheduleD

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

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$145,000OtherCostOrOtherBasisAmt
Book Value$145,000BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$1,332,557OtherCostOrOtherBasisAmt
Depreciation$616,069DepreciationAmt
Book Value$716,488BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$227,799OtherCostOrOtherBasisAmt
Depreciation$217,622DepreciationAmt
Book Value$10,177BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$150,190OtherCostOrOtherBasisAmt
Depreciation$126,392DepreciationAmt
Book Value$23,798BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Depreciation$0DepreciationAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$895,463TotalBookValueLandBuildingsAmt

Schedule G IRS990ScheduleG

Fundraising Event Information FundraisingEventInformationGrp

FieldValueIRS element (for citing)
Event1GOURMET TASTEEvent1Nm
Gross Receipts Event1$59,690GrossReceiptsEvent1Amt
Charitable Contri Event1$50,355CharitableContriEvent1Amt
Gross Revenue Event1$9,335GrossRevenueEvent1Amt
Non Cash Prizes Event1$618NonCashPrizesEvent1Amt
Other Direct Expenses Event1$2,966OtherDirectExpensesEvent1Amt
Event2GOLF TOURNEYEvent2Nm
Gross Receipts Event2$219,904GrossReceiptsEvent2Amt
Charitable Contri Event2$3,000CharitableContriEvent2Amt
Gross Revenue Event2$216,904GrossRevenueEvent2Amt
Rent Facility Costs Event2$17,876RentFacilityCostsEvent2Amt
Other Direct Expenses Event2$10,094OtherDirectExpensesEvent2Amt
Other Events Total0OtherEventsTotalCnt
Gross Receipts Total$279,594GrossReceiptsTotalAmt
Charitable Contributions Tot$53,355CharitableContributionsTotAmt
Gross Revenue Total Events$226,239GrossRevenueTotalEventsAmt
Non Cash Prizes Total Events$618NonCashPrizesTotalEventsAmt
Rent Fclty Costs Total Events$17,876RentFcltyCostsTotalEventsAmt
Oth Direct Expnss Total Events$13,060OthDirectExpnssTotalEventsAmt
Direct Expense Summary Events$31,554DirectExpenseSummaryEventsAmt
Net Income Summary$194,685NetIncomeSummaryAmt

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Severance PaymentfalseSeverancePaymentInd
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 PaymentsfalseAnyNonFixedPaymentsInd
Initial Contract ExceptionfalseInitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (4 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
Thomas Kleinhanzl
Director$0$610,432$0$176,344$0$7,160$0$180,232$0$15,804$0$989,972$0$0
John Verbus
Director$0$359,625$0$65,433$0$2,322$0$48,763$0$14,177$0$490,320$0$0
Michelle Mahan
Chief Financial Officer - FMH$0$367,941$0$73,952$0$2,322$0$48,013$0$15,804$0$508,032$0$0
Mark Goldstein MD
Director$0$434,959$0$146$0$216$0$10,838$0$15,566$0$461,725$0$0

Supplemental Information Detail SupplementalInformationDetail (3 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
form 990, schedule J, part I, line 1aFREDERICK MEMORIAL HOSPITAL HOLDS TWO CORPORATE MEMBERSHIPS TO A LOCAL GOLF/COUNTRY CLUB THAT ARE USED BY THE CHIEF EXECUTIVE OFFICER AND THE CHIEF FUND DEVELOPMENT OFFICER OF THE HOSPITAL. WHILE THE MAJORITY OF THE FEES ASSOCIATED WITH THE CLUB DUES, ETC. ARE BUSINESS RELATED, GENERAL PERSONAL USE EXPENSES ARE REIMBURSED BACK TO THE HOSPITAL BY THESE INDIVIDUALS AS NEEDED.
form 990, schedule J, part I, line 3THE EXECUTIVE COMPENSATION PROGRAM IS DESIGNED TO CARRY OUT THE HEALTH SYSTEM MISSION, TO ACHIEVE THE CHARITABLE PURPOSE, TO ATTRACT, RETAIN, MOTIVATE AND REWARD EXECUTIVE MANAGEMENT, AND TO MAINTAIN A COMPETITIVE POSITION WITH PEER ORGANIZATIONS IN THE REGION. OVERSIGHT OF THE EXECUTIVE COMPENSATION PROGRAM IS PROVIDED BY THE EXECUTIVE COMPENSATION COMMITTEE OF THE BOARD, COMPOSED OF THE BOARD CHAIRMAN, VICE CHAIRMAN, IMMEDIATE PRECEDING CHAIRMAN, CHAIRMAN OF THE FINANCE COMMITTEE AND THE CHAIRMAN OF THE GOVERNANCE COMMITTEE. IN ADDITION TO THE BOARD'S COMPENSATION COMMITTEE, WE UTILIZED AN EXTERNAL INDEPENDENT CONSULTANT AND MARKET SURVEYS FOR ALL EXECUTIVE MANAGEMENT COMPENSATION. THE PRESIDENT AND CEO HAVE A WRITTEN EMPLOYMENT CONTRACT.
form 990, schedule J, part I, line 4bFREDERICK MEMORIAL HOSPITAL HAS ONE 457(F) NON-QUALIFIED DEFERRED COMPENSATION PLAN FOR CERTAIN MEMBERS OF SENIOR MANAGEMENT. UNDER THE PLAN, THEY MAY CONTRIBUTE AMOUNTS FROM THEIR COMPENSATION TO THE PLAN AND MAY RECEIVE A DISCRETIONARY EMPLOYER CONTRIBUTION. EMPLOYEES ARE FULLY VESTED IN ALL EMPLOYEE CONTRIBUTIONS TO THE PLAN. VESTING IN EMPLOYER CONTRIBUTIONS OCCURS IN ACCORDANCE WITH THE UNDERLYING PLAN DOCUMENTS. ALL ASSETS OF THE PLAN ARE HELD IN A SEPARATE TRUST. TOTAL HOSPITAL CONTRIBUTIONS TO THIS PLAN WERE AS FOLLOWS: MANUEL A. CASIANO 34,270 CHERYL L. CIOFFI 25,000 MICHELLE K. MAHAN 18,150 TERRY P. O'MALLEY 17,448 DAVID J. QUIRKE 15,656 THOMAS A. KLEINHANZL 148,519 JOHN R. VERBUS 17,266

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (5 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
DESCRIPTION OF CLASSES OF MEMBERS OR STOCKHOLDERSFORM 990, PART VI, LINE 6 FREDERICK MEMORIAL HOSPITAL, INC. IS THE SOLE MEMBER OF THE CORPORATION.
DESCRIPTION OF CLASSES OF PERSON AND THE NATURE OF THEIR RIGHTSFORM 990, PART VI, LINE 7A & 7B THE MEMBER (FMH, INC.) SHALL TAKE THE FOLLOWING ACTIONS ON BEHALF OF THE CORPORATION: -APPOINT, AND, AS NECESSARY, REMOVE THE PRESIDENT/CEO OF THE CORPORATION; PROVIDED, HOWEVER, THAT THE MEMBER SHALL TAKE NO SUCH ACTION WITHOUT PRIOR CONSULTATION WITH THE BOARD OF DIRECTORS -FORMULATE, COMMUNICATE AND IMPLEMENT STRATEGIC PLANNING AND FINANCIAL MANAGEMENT -SELECT A FISCAL AUDITOR THE CORPORATION MAY TAKE THE FOLLOWING ACTIONS ONLY WITH THE PRIOR APPROVAL OF THE MEMBER: -EXPEND OR DIVEST ITS CAPITAL ASSETS, IF THE VALUE OF SUCH EXPENDITURE OR DIVESTITURE IS IN EXCESS OF AN AMOUNT TO BE DESIGNATED BY THE MEMBER FROM TIME TO TIME -INCUR DEBT OR GUARANTEE DEBT, IF THE AGGREGATE AMOUNT OF SUCH DEBT DURING ANY TWELVE MONTH PERIOD IS IN EXCESS OF AN AMOUNT TO BE DESIGNATED BY THE MEMBER FROM TIME TO TIME -EXPEND AMOUNTS IN EXCESS OF THE CORPORATION'S APPROVED ANNUAL OPERATING BUDGET IF SUCH AMOUNTS EXCEED AN AMOUNT TO BE DESIGNATED BY THE MEMBER FROM TIME TO TIME -DISSOLVE OR LIQUIDATE -CREATE, DISSOLVE OR DIVEST ANY SUBSIDIARY, PARTNERSHIP OR LLC -AMEND THE ARTICLES OF INCORPORATION AND/OR BYLAWS OF THE CORPORATION THE FOLLOWING SHALL NOT BE DEEMED TO HAVE TAKEN PLACE ABSENT SUBSEQUENT RATIFICATION BY THE MEMBER: -THE ADOPTION BY THE CORPORATION OF ITS ANNUAL OPERATING BUDGET OR CAPITAL BUDGET -ELECTION OR REPLACEMENT OF A DIRECTOR OR THE FILLING OF A VACANCY ON THE BOARD OF DIRECTORS -AT SUCH TIMES AS THE MEMBER DEEMS NECESSARY, AND PURSUANT TO THE VOTE OF AT LEAST TWO-THIRDS OF THE MEMBER'S DIRECTORS, REMOVE A DIRECTOR OF THE CORPORATION -CHANGE THE MISSION OF THE CORPORATION
PROCESS USED BY MANAGEMENT AND/OR GOVERNING BODYTO REVIEW 990form 990, part VI, LINE 11B THE 990 IS PREPARED IN CONJUNCTION WITH OUTSIDE TAX ACCOUNTANTS AND IS REVIEWED BY UPPER MANAGEMENT PRIOR TO PROVIDING A COPY TO THE BOARD. A COPY OF THE FORM 990 WAS PROVIDED TO ALL MEMBERS OF THE BOARD PRIOR TO FILING.
DESCRIPTION OF PROCESS TO MONITOR TRANSACTIONS FOR CONFLICTS OF INTERESTform 990, part VI, line 12c THE HOSPICE OF FREDERICK COUNTY, INC. BOARD OF DIRECTORS IS COMMITTED TO MEETING ITS FIDUCIARY RESPONSIBILITIES AND MAINTAINING ITS DUTY OF LOYALTY TO THE HOSPITAL AND THE COMMUNITY IT SERVES. TO THIS END, THE BOARD WILL EXERCISE VIGILANCE IN IDENTIFYING ANY CONFLICTS OF INTEREST. THE BOARD WILL ALSO MAINTAIN TRANSPARENCY AND OBJECTIVITY IN MAKING DECISIONS ABOUT CONFLICTS OF INTEREST SO THAT THE ORGANIZATION'S MISSION IS ALWAYS THE FIRST PRIORITY. THE CHAIRPERSON (OR VICE CHAIRPERSON IF THE CHAIR IS INVOLVED) WILL NOTIFY ALL DIRECTORS OF A REPORTED CONFLICT OF INTEREST AND WILL DECIDE WHETHER TO TAKE THE MATTER TO THE FULL BOARD TO DECIDE WHETHER A CONFLICT EXISTS AND, IF SO, TO DECIDE WHAT ACTION TO TAKE. ALTERNATIVELY, THE CHAIR PERSON WILL REFER THE MATTER TO THE GOVERNANCE COMMITTEE FOR AN IN-DEPTH EXAMINATION, SUMMARY, AND RECOMMENDATION PRIOR TO A FULL BOARD DISCUSSION AND DECISION. IF TIME IS OF THE ESSENCE, THE CHAIRPERSON WILL TAKE THE MATTER TO THE EXECUTIVE COMMITTEE, AND THE CHAIRPERSON WILL NOTIFY THE FULL BOARD OF SUCH ACTION. WHERE A CONFLICT OF INTEREST HAS BEEN IDENTIFIED THE BOARD MEMBER SHALL NOT VOTE OR BE PRESENT FOR THE DISCUSSION OR THE VOTE REGARDING THE TRANSACTION AT EITHER THE FULL BOARD, EXECUTIVE COMMITTEE, OR GOVERNANCE COMMITTEE MEETINGS EXCEPT TO ANSWER QUESTIONS THAT MAY BE ASKED OF HIM OR HER. TO PREVENT ACTUAL OR PERCEIVED INFLUENCE ON THE BOARD'S DECISION, THE CONFLICTED MEMBER IS PROHIBITED, AFTER INITIAL DISCLOSURE, FROM DISCUSSING THE CONFLICT OF INTEREST EITHER FORMALLY OR INFORMALLY WITH FELLOW DIRECTORS OR WITH MEMBERS OF THE MANAGEMENT. THERE WILL BE AN ANNUAL REVIEW OF ALL BOARD MEMBERS' AND OFFICERS' TRANSACTIONS PREPARED BY THE ADMINISTRATION AND REVIEWED BY THE GOVERNANCE COMMITTEE AND THE FULL BOARD OF DIRECTORS. AT THAT TIME, ALL DIRECTORS WILL BE REMINDED OF THE IRS INTERMEDIATE SANCTIONS REGULATION THAT ESTABLISHES EXCISE TAXES AS A SANCTION AGAINST ADMINISTRATORS AND DIRECTORS OF TAX-EXEMPT ORGANIZATIONS WHO PARTICIPATE IN 'EXCESS BENEFIT TRANSACTIONS' (E.G., UNREASONABLE HIGH EMPLOYMENT COMPENSATION OR BUSINESS DEALS).
PROCESS FOR MAKING DOCUMENTS AVAILABLE TO THE PUBLICFORM 990, PART VI, LINE 19 THE GOVERNING DOCUMENTS AND THE CONFLICT OF INTEREST POLICY ARE AVAILABLE UPON REQUEST. FREDERICK REGIONAL HEALTH SYSTEM, INC'S CONSOLIDATED ANNUAL AUDITED FINANCIAL STATEMENTS ARE AVAILABLE AT WWW.FMH.ORG.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (3 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtControlled OrganizationControlledOrganizationInd
Frederick Memorial Hospital Inc
400 West Seventh StreetFrederickMD21701520591612HospitalMD501(c)(3)3FRHSfalse
Frederick Regional Health System Inc
400 West Seventh StreetFrederickMD21701454133096Health SystemMD501(c)(3)11bnafalse
Monocacy Health Partners LLC
400 West Seventh StreetFrederickMD21701453007639Physician OrgMD501(c)(3)7FRHSYes (true)

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (3 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtEntity TypeEntityTypeTxtShare Of Total IncomeShareOfTotalIncomeAmtShare Of EOY AssetsShareOfEOYAssetsAmtOwnershipOwnershipPctControlled OrganizationControlledOrganizationIndAddress Line1ForeignAddress/AddressLine1TxtCityForeignAddress/CityNmProvince Or StateForeignAddress/ProvinceOrStateNmCountryForeignAddress/CountryCdLegal Domicile Foreign CountryLegalDomicileForeignCountryCd
Frederick Health Services Corp
400 West Seventh StreetFrederickMD21701521851661Health CareMDFRHSC Corp$0$00.00000Yes (true)
Frederick Surgical Services Corp
400 West Seventh StreetFrederickMD21701521642334Health CareMDFHSCC Corp$0$00.00000Yes (true)
Monocacy Insurance LTD
981011570Self InsuranceFRHSC Corp$0$00.00000Yes (true)PO Box 1159Grand CaymanKY1-1102CJCJ
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
Asset Sale To Other OrgfalseAssetSaleToOtherOrgInd
Asset Purchase From Other OrgfalseAssetPurchaseFromOtherOrgInd
Asset ExchangefalseAssetExchangeInd
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 FacilitiesfalseSharingOfFacilitiesInd
Paid Employees SharingYes (true)PaidEmployeesSharingInd
Reimbursement Paid To Other OrgfalseReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other OrgfalseReimbursementPaidByOtherOrgInd
Transfer To Other OrgfalseTransferToOtherOrgInd
Transfer From Other OrgfalseTransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp

Other Organization Name OtherOrganizationName

FieldValueIRS element (for citing)
Business Name Line1FREDERICK MEMORIAL HOSPITAL INCBusinessNameLine1Txt
FieldValueIRS element (for citing)
Transaction TypeoTransactionTypeTxt
Involved$857,327InvolvedAmt
Method Of Amount DeterminationDIRECT COSTINGMethodOfAmountDeterminationTxt

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