2016-05-14T09:23:41-05:00 2015-06-30 GRANT THORNTON LLP 2001 MARKET STREET SUITE 700 PHILADELPHIA PA 19103 990 2014-07-01 520591484 HARFORD MEMORIAL HOSPITAL INC % JOSEPH E HOFFMAN III HARF 4436431000 501 SOUTH UNION AVENUE HAVRE DE GRACE MD 21078 Joseph E Hoffman III CFO 4108773700 2016-05-13 true Russlee Armstrong P00288383 2155614200 2016-05-09 2014 2016-08-17 19:52:53Z LYLE E SHELDON 520 UPPER CHESAPEAKE DR BEL AIR MD 21014 129346072 false X WWW.UMUCH.ORG X 1911 MD DEDICATION TO MAINTAINING AND IMPROVING THE HEALTH OF THE PEOPLE IN ITS COMMUNITIES THROUGH AN INTEGRATED HEALTH DELIVERY SYSTEM THAT PROVIDES HIGH QUALITY CARE TO ALL. 20 16 778 198 0 0 87500 161681 45736182 93117572 1068344 5150477 396300 1295540 47288326 99725270 0 0 0 0 23892784 45734259 0 0 0 18289663 40118356 42182447 85852615 5105879 13872655 132636567 132127914 76588188 68014320 56048379 64113594 X AN ACUTE CARE, NON-PROFIT HOSPITAL, HARFORD MEMORIAL HOSPITAL OFFERS A FULL COMPLEMENT OF MEDICAL, DIAGNOSTIC, AND EMERGENCY CARE SERVICES. THE HOSPITAL HAS A STATE-OF-THE-ART ICU/PCU AND A BUSY EMERGENCY DEPARTMENT THAT CARES FOR OVER 50,000 PATIENTS A YEAR. HARFORD MEMORIAL OFFERS SPECIALIZED, HOSPITAL-BASED SERVICES, INCLUDING A BARIATRIC SURGERY PROGRAM, ANTICOAGULATION MANAGEMENT, CENTER FOR WOUND CARE, INPATIENT AND OUTPATIENT BEHAVIORAL HEALTH SERVICES, JOINT CENTER FOR HIP AND KNEE REPLACEMENT, AND A SLEEP DISORDER CENTER. false false 57999910 93117572 SEE SCHEDULE O 57999910 true true false true false false false false false false true false false false true true false true false false false false false false false false true true false false true false false false false false false false true false false false false false true false false false true 348 0 true 778 true false true false false false false false false false false false X 20 16 true false false false true true true true true false false true true true true true true true true false MD X JOSEPH E HOFFMAN III 4436431000 520 UPPER CHESAPEAKE DRIVE STE 405 BEL AIR MD 21014 ROGER E SCHNEIDER MD CHAIRMAN/DIRECTOR 1.0 6.0 X X 0 0 0 JAMES LAMBDIN VICE CHAIRMAN/DIRECTOR 1.0 6.0 X X 0 0 0 ADELE WILZACK RN MS SECRETARY/DIRECTOR 1.0 5.0 X X 0 0 0 Richard P Street Jr VMD TREASURER/DIRECTOR 1.0 5.0 X X 0 0 0 LYLE E SHELDON PRESIDENT/DIRECTOR/CEO-UMUCHS 5.0 50.0 X X 0 1012005 254345 WILLIAM B ALLEN PHD DIRECTOR 0.5 3.0 X 0 0 0 John W Ashworth III Director/UMMS SVP NETWORK Dvlp 0.5 49.5 X 0 597210 21095 JASON BIRNBAUM DIRECTOR 0.5 2.5 X 0 0 0 Robert A Chrencik DIRECTOR/UMMS President & CEO 0.5 49.5 X 0 6881071 21095 Melinda L Craig DIRECTOR 0.5 3.0 X 0 0 0 Franklin J Hajek DIRECTOR 0.5 3.0 X 0 0 0 Robert J Jirsa DIRECTOR 0.5 3.5 X 0 0 0 M Scot Kaufman DIRECTOR 0.5 3.5 X 0 0 0 Bryan E Kelly DIRECTOR 0.5 3.5 X 0 0 0 Anne W Kinsley DIRECTOR 0.5 3.0 X 0 0 0 Andrew Klein DIRECTOR 0.5 4.0 X 0 0 0 Donald W Mathis DIRECTOR 0.5 3.0 X 0 0 0 Angela Poppe Ries MD DIRECTOR 5.0 45.0 X 0 168800 24713 William J Ward Jr DIRECTOR 0.5 3.0 X 0 0 0 Albert J A Young DIRECTOR 0.5 2.5 X 0 0 0 Joseph E Hoffman III SR VP/CFO 5.0 50.0 X 0 533992 133495 Joyce Fox VP - Patient SVCS/CNO 25.0 25.0 X 289055 0 48474 BEVERLY A WEHMER ASST VP - PATIENT SERVICES 50.0 0.0 X 140450 0 48708 SUSAN A COSTA DIR-PERIOPERATIVE CLINICAL SVC 50.0 0.0 X 142875 0 38076 Stephen Low Dir - Pharmaceutical Services 50.0 0.0 X 147079 0 31647 STEVEN D BOWMAN DIR - FINANCIAL ACCOUNT/BUDGET 50.0 0.0 X 129088 0 45356 ALISON A CONWAY DIR - IMAGING SERVICES 50.0 0.0 X 125779 0 40362 974326 9193078 707366 49 false true false TEAM HEALTH HOLDINGS INC 265 BROOKVIEW CENTRE WAY SUITE 400 KNOXVILLE TN 37934 PHYSICIAN FEES 666360 KPMG LLP DEPT 0522 PO BOX 120522 DALLAS TX 753120522 Audit Fees 145934 SCOTT STEINMETZ - MD PA 520 UPPER CHESAPEAKE DRIVE SUITE 4 BEL AIR MD 21014 PHYSICIAN FEES 114361 Theophilus Botwe MD 2500 Saint Joseph Drive MITCHELLVILLE MD 20721 Physician Fees 107754 Timothy Ehiabor MD 1612 Hopefield Road SILVER SPRINGS MD 20905 Physician Fees 107022 39 161681 161681 NET PATIENT SERVICE REVENUE 621110 93066105 93066105 BARIATRIC PROGRAM 621110 51467 51467 93117572 0 1077041 1077041 0 661913 765957 -104044 0 -104044 -104044 32928281 28854845 4073436 4073436 4073436 0 0 0 CAFETERIA SALES/VENDING 722514 315882 315882 INTEREST INCOME - ACCTS RECEIVABLE 900099 19863 19863 MEANINGFUL USE INCOME 900099 1063839 1063839 1399584 99725270 93117572 6446017 0 0 0 0 337529 337529 0 37099892 26747215 10352677 0 5521415 3979161 1542254 2775423 2006932 768491 0 0 0 0 0 341439 341439 2806880 1492869 1314011 0 767268 1016 766252 0 0 1548269 30170 1518099 30474 3048 27426 0 81532 10272 71260 1270633 918806 351827 0 5417324 3917314 1500010 1654512 1196392 458120 MEDICAL SUPPLIES 9743743 9303361 440382 PROVISION FOR BAD DEBT 6284993 6284993 MAINTENANCE CONTRACT 4464170 219999 4244171 CORPORATE FEES 3675709 3675709 0 2031410 1550833 480577 85852615 57999910 27852705 0 20837983 30276651 0 0 0 0 9277928 7296995 0 0 0 0 0 0 3187011 2875346 2039973 2631995 37514037 8819377 36117284 28694660 59005203 60352267 0 0 0 0 0 0 2171185 0 132636567 132127914 11967157 12704645 0 0 0 0 0 0 0 0 0 0 0 0 0 0 64621031 55309675 76588188 68014320 X 56048379 64113594 0 0 0 0 56048379 64113594 132636567 132127914 X 13872655 -3181710 -2625730 X false true X true X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false true 2226 2226 false OTHER ACTIVITIES Schedule 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 MGA AND AHA REPORTED THAT 4.80% AND 22.80% OF MEMBER DUES WERE USED FOR LOBBYING PURPOSES AND AS SUCH, THE ORGANIZATION HAS REPORTED THIS AMOUNT ON SCHEDULE C PART IV AS LOBBYING. 0 8473600 8473600 0 10130007 2675129 7454878 0 596825 158702 438123 0 9992210 4146346 5845864 0 8321395 1839200 6482195 28694660 0 ADVANCES FROM THIRD PARTIES 1610996 DUE TO UCMC 26064513 ASBESTOS RETIREMENT OBLIGATION 1149760 DEFINED BENEFIT PENSION PLAN 242151 MISCELLANEOUS ACCRUALS 289700 DUE TO UMMS 25952555 55309675 X 89398057 -3181710 -6986593 -10168303 99566360 158910 158910 99725270 79992140 79992140 5860475 5860475 85852615 Part X, Line 2 Fin 48 (ASC 740) Footnote 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. RECONCILIATION OF REVENUE Schedule D, Part XI LINE 2D - OTHER REVENUE ON BOOKS NOT ON RETURN RECLASS - INVESTMENT EXPENSE $ (341,439) RECLASS - PROVISIONS FOR BAD DEBTS $ (6,284,993) RECLASS - RENTAL EXPENSE $ 765,957 Loss on Early Extinguishment of Debt $ (1,126,118) ------------- TOTAL $ (6,986,593) Line 4B - OTHER REVENUE ON Return NOT ON Books Contributions received $ 158,910 RECONCILIATION OF EXPENSE Schedule D, Part XII LINE 4B - OTHER EXPENSES ON RETURN NOT ON BOOKS RECLASS - PROVISION FOR BAD DEBTS $ 6,284,993 RECLASS - INVESTMENT EXPENSE $ 341,439 RECLASS - RENTAL EXPENSE $ (765,957) --------------- $ 5,860,475 true true X true X true X true true false true true 6330330 6330330 0.07960 6330330 6330330 0.07960 954805 25397 929408 0.01170 1645710 1645710 0.02070 1350121 1350121 0.01700 226856 226856 0.00290 37715 447 37268 0.00050 4215207 25844 4189363 0.05280 10545537 25844 10519693 0.13240 785 785 32936 2700 30236 6136 6136 1215 1215 11861 11861 4290 4290 57223 2700 54523 true 6284993 909140 41740522 38475120 3265402 true true 1 1 HARFORD MEMORIAL HOSPITAL Inc 501 SOUTH UNION AVENUE HAVRE DE GRACE MD 21078 www.umuch.org 12-004 X X X HARFORD MEMORIAL HOSPITAL 1 false false true X X X X X X X X 15 true true true true X www.UMUCH.org X true 15 true www.umuch.org false false true X 200. 300. X X true true X X true X www.umuch.org X www.umuch.org X X X X true false X X X X true X false false PART V, SECTION B, QUESTION 5 THE HOSPITAL'S SECOND COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) WAS CONDUCTED IN 2015. THE PURPOSE OF THE ASSESSMENT WAS TO GATHER INFORMATION ABOUT LOCAL HEALTH NEEDS AND HEALTH BEHAVIORS. IN MARCH OF 2015, STAKEHOLDERS FROM UNIVERSITY OF MARYLAND UPPER CHESAPEAKE HEALTH SYSTEM (UMUCHS - PARENT COMPANY OF HARFORD MEMORIAL HOSPITAL AND UPPER CHESAPEAKE MEDICAL CENTER), THE HARFORD COUNTY HEALTH DEPARTMENT, HARFORD COUNTY GOVERNMENT, AND A REPRESENTATIVE FROM THE INTERFAITH COMMUNITY MET TO REVIEW THE DATA AND DISCUSS THE HEALTH PRIORITIES THAT UMUCH WOULD FOCUS ON FOR THE NEXT THREE YEARS. THE BOARD OF DIRECTORS OF UMUCH VOTES TO ADOPT THE FINAL SUMMARY REPORT AND IMPLEMENTATION STRATEGY AND PROVIDE THE NECESSARY RESOURCES AND SUPPORT TO CARRY OUT THE INITIATIVES THEREIN. UMUCHS maintains a key leadership role in Healthy Harford (an IRC Section 501(c)(3) organization labeled - The Healthy Communities Initiative of Harford County), established in 1995. In 1996, Healthy Harford began collecting community data via a comprehensive Community Health Assessment Project (CHAP) survey that measured the incidence of disease, preventive behaviors, and lifestyle behaviors of Harford County residents with an eye towards assessing community health and establishing health priorities in the community. CHAP data was subsequently collected in 2000, 2005, and 2010. The goals of the CHAP survey were multiple: assessing the overall health of Harford County adult residents, insuring that health education and programming efforts in Harford County match actual needs, establishing a baseline of health indicators so that progress can be measured over time, and aligning community stakeholders around the common goal of improving health in our community. To meet the new Affordable Care Act requirements, in 2014 the CHAP survey was replaced with the more universal community health needs assessment (CHNA) survey which is tied nationally to hospital-based community benefit reporting. In addition to the CHNA survey, a statistical secondary data profile is used that depicts population and household statistics, education and economic measures, morbidity and mortality rates, incidence rates and other health statistics for Harford County. The data was gathered and integrated into a graphical report to portray the current health and socio-economic status of residents of Harford County. Secondary data was collected from reputable sources including the U.S. Census Bureau, Centers for Disease Control and Prevention, and the Maryland Department of Health and Mental Hygiene State Health Improvement Plan. Key community partners and influencers in creating the secondary data profile were UMUCH, Healthy Harford, the County Health Rankings and Roadmaps project, the Harford County Health Department, and the Obesity task force of the healthy community planning board. An Online community survey was conducted with Harford County residents between October 2014 and January 2015. The survey was designed to assess health status, health risk behaviors, preventive health practices and health care access primarily related to chronic disease and injury. A total of 1,549 surveys were completed throughout the county to promote geographical and ethnic diversity among respondents. Additionally, key informant interviews with 54 representatives from public health and medical services departments, non-profit and social organizations, child and youth agencies and the business community were conducted between October and November 2014. The health areas that were deemed the most pressing for our community by (1) chronic disease, (2) tobacco use, (3) mental health/addictions, (4) access to care, (5) maternal and child health, and (6) injury and illness prevention. PART V, SECTION B, QUESTION 6A HARFORD MEMORIAL HOSPITAL'S CHNA WAS CONDUCTED IN CONJUNCTION WITH ITS RELATED AFFILIATE HOSPITAL, UPPER CHESAPEAKE MEDICAL CENTER. Part V, Section B, Question 6b the hospital's CHNA was conducted with organizations other than hospital facilities as follows: Health Harford (a 501(c)(3) organization), Harford County Health Department, and the Harford County Government Agency. PART V, SECTION B, QUESTION 11 Needs Being Addressed: After the completion of the CHNA, Upper Chesapeake Health's strategic plan incorporated the following identified needs: - Chronic Disease: Heart Disease Stroke Blood Pressure Cholesterol Diabetes Obesity Cancer - Tobacco Use: Asthma/COPD - Mental Health/Addictions - Access to Care - Illness & Injury Prevention: Flu Vaccines Helmets Car safety seats Needs Not Being Addressed: UMUCHS has not identified a priority need that is not being addressed by the Health System. PART V, SECTION B, QUESTION 22D CHARGE RATES IN COMPLIANCE WITH STATE REGULATION TO ALL PAYERS. 1 UC HEALTHLINK CLINIC(dissolved Nov 2014) 2027 PULASKI HWY SUITE 206 HAVRE DE GRACE MD 21078 PRIMARY CARE CLINIC FOR LOW INCOME INDIVIDUALS PART III, SECTION A, LINE 2-4: bad debt expense The Hospital grants credit to patients, substantially all of whom are local residents. The Hospital generally does not require collateral or other security in extending credit; however, the Hospital routinely obtains assignment of (or are otherwsie entitled to receive) patients' benefits receivable under their health insurance programs, plans or policies. Please refer to the attached Audited financial statements, Footnote (1)(n), Net Patient Service Revenue & Provision for Uncollectible Accounts, Pages 15-16 for the description regarding the Organization's bad debt expense. PART III, SECTION B, LINE 8: COMMUNITY BENEFIT AND SHORTFALL The Hospital did not have a Medicare shortfall. PART III, SECTION C, LINE 9B: FAP AND COLLECTION PROCESS IT IS THE POLICY OF THE HOSPITAL TO ATTEMPT TO COLLECT PAYMENT FOR ALL SERVICES RENDERED TO PATIENTS IN THE MOST EFFICIENT AND PATIENT FRIENDLY MANNER. THE HOSPITAL IS COMMITTED TO PROVIDE FINANCIAL ASSISTANCE TO PERSONS WHO HAVE HEALTH CARE NEEDS AND ARE: UNINSURED, UNDERINSURED, INELIGIBLE FOR GOVERNMENT PROGRAMS, OR OTHERWISE UNABLE TO PAY FOR MEDICALLY NECESSARY CARE BASED ON INDIVIDUAL FINANCIAL SITUATION. THE HOSPITAL WILL FIRST ATTEMPT TO COLLECT PAYMENT FROM THE PATIENT'S INSURANCE COMPANY. IN THE EVENT THE PATIENT HAS NO INSURANCE OR LIMITED INSURANCE COVERAGE, THE HOSPITAL WILL ATTEMPT TO QUALIFY THE PATIENT FOR THE MARYLAND MEDICAL ASSISTANCE PROGRAM AND/OR THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY. THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY'S PROCEDURES ARE AS FOLLOWS: -FINANCIAL ASSISTANCE IS MADE AVAILABLE TO ALL OF UPPER CHESAPEAKE HEALTH'S CUSTOMERS -APPLICATIONS ARE PROVIDED TO EVERY UNINSURED PATIENT AND UPON REQUEST -NOTICES OF AVAILABILITY ARE AT ALL PATIENT ACCESS POINTS, BILLING OFFICES AND CASHIER'S STATIONS -NOTICE OF AVAILABILITY PROVIDED TO PATIENTS ON PATIENTS BILLS AND BEFORE DISCHARGE -FREE CARE IS AVAILABLE TO PATIENTS IN HOUSEHOLDS BETWEEN 0 PERCENT AND 200 PERCENT OF FEDERAL POVERTY LEVEL -REDUCED COST CARE IS AVAILABLE TO UNINSURED PATIENTS BETWEEN 200 PERCENT AND 300 PERCENT OF FEDERAL POVERTY LEVEL -INTEREST FREE PAYMENT PLANS ARE AVAILABLE TO UNINSURED PATIENTS WITH INCOME BETWEEN 200 PERCENT AND 500 PERCENT OF FEDERAL POVERTY LEVEL -FINANCIAL ASSISTANCE DETERMINATION APPEAL PROCESS IN PLACE -MEDICAL HARDSHIP / CATASTROPHIC CARE POLICY IN PLACE PATIENTS WHO ARE LEFT WITH A BALANCE AFTER ALL INSURANCES HAVE BEEN PURSUED AND FINANCIAL ASSISTANCE HAS BEEN OFFERED, THEIR ACCOUNTS WILL BE HANDLED IN THE FOLLOWING MANNER: -THE ORGANIZATION WILL REFER THESE ACCOUNTS TO ITS EARLY-OUT VENDOR. THIS EARLY-OUT VENDOR IS NOT A COLLECTION AGENCY; IT IS AN EXTENSION OF THE HOSPITAL'S PATIENT ACCOUNTING OFFICE. -THE EARLY-OUT VENDOR WILL FACILITATE THE NEGOTIATION OF SELF-PAY NO-INTEREST PAYMENT ARRANGEMENTS THROUGH A SERIES OF LETTERS AND PHONE CALLS. -AN INITIAL NOTICE WILL BE SENT TO THE PATIENT'S GUARANTOR PROVIDING OPTIONS FOR RESOLUTION. IF GUARANTOR IS UNABLE TO PAY THE BALANCE IN FULL, AN ATTEMPT WILL BE MADE TO HAVE THE BALANCE RESOLVED WITHIN 3 TO 6 MONTHS. THE MINIMUM PAYMENT GUIDELINES REQUIRE THE ACCOUNT BALANCE BE PAID IN 12 MONTHS WITH A MINIMUM PAYMENT OF FIFTY DOLLARS. THERE IS EXCEPTIONS FOR CANCER CENTER PATIENTS. -IF A VALID ADDRESS AND OR PHONE NUMBER IS LISTED A TOTAL OF 3 LETTERS AND 3 PHONE CALL ATTEMPTS WILL BE MADE ON ACCOUNTS THAT HAVE NOT BEEN PAID IN FULL OR WHERE AN APPROVED PAYMENT ARRANGEMENT HAS NOT BEEN MADE. DAY 15 TO 30 ONE PHONE CALL CAMPAIGN WILL BE MADE; DAY 68 TO 80 IF ACCOUNT HAS NOT BEEN PAID IN FULL OR HAS NOT BEEN SET UP ON AN APPROVED PAYMENT PLAN, THE EARLY-OUT VENDOR WILL RECOMMEND THAT THE ACCOUNT BE PLACED WITH A COLLECTION AGENCY. -ACCOUNTS MAINTAINED UNDER AN APPROVED PAYMENT ARRANGEMENT WILL RECEIVE MONTHLY STATEMENTS 30 DAYS PRIOR TO THE PAYMENT DUE DATE. AS A LAST RESORT, ACCOUNTS THAT ARE FORWARDED TO A COLLECTION AGENCY, HAVE THE FOLLOWING PROCEDURES: -TWO COLLECTION AGENCIES ARE EMPLOYED BY THE HOSPITAL; EACH RECEIVING APPROXIMATELY FIFTY PERCENT OF THE ACCOUNT (BASED ON THE FIRST LETTER OF THE LAST NAME OF EACH PATIENT). ACCOUNTS PLACED WITH ONE OF THE COLLECTION AGENCIES ARE CLASSIFIED AS BAD DEBTS AND REMOVED FROM ACCOUNTS RECEIVABLE. -AFTER THE INITIAL PLACEMENT WITH A COLLECTION AGENCY, AN INITIAL NOTICE WILL BE SENT TO THE GUARANTOR ADVISING THAT THE AGENCY HAS BEEN CONTRACTED TO MANAGE THE ACCOUNT AND THE NOTICE WILL PROVIDE THE GUARANTOR WITH OPTIONS FOR RESOLUTION. IN RARE CASES, ACCOUNTS MAY WARRANT LEGAL ACTION. ONCE AN ACCOUNT HAS MET THE FOLLOWING CRITERIA, THE ACCOUNT IS CLOSED BY THE COLLECTION AGENCY AS UNCOLLECTIBLE AND FORWARDED BACK TO PATIENT ACCOUNTING FOR REVIEW TO ESTABLISH GROUNDS FOR LEGAL ACTION. THIS ONLY OCCURS AFTER ALL EFFORTS TO RESOLVE THE DEBT HAVE BEEN EXHAUSTED. CRITERIA: THE DEBT IS VALID; THE ACCOUNT IS EQUAL TO OR GREATER THAN 120 DAYS OLD; PATIENTS REFUSES TO ACKNOWLEDGE THE DEBT; UPON REVIEW AND INVESTIGATION, THE HOSPITAL HAS DETERMINED THAT LIQUID ASSETS ARE AVAILABLE; AND THE HOSPITAL'S VP OF FINANCE MUST AUTHORIZE LEGAL ACTION. PART VI, LINE 2: NEEDS ASSESSMENT EVERY THREE YEARS A COMMUNITY HEALTH ASSESSMENT SURVEY/PLAN IS PERFORMED. PART VI, LINE 3: PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE The Hospital displays signs at every registration point, the patient accounting office, on all patient bills, and other key patient access areas informing the patients about the availability of the various financial and medical assistance programs. A patient billing and financial assistance information sheet will be provided before discharge and will be available to all patients upon request. The Hospital offers every self-pay patient or any patient who inquires the financial assistance informational packet and application. The cover sheet for the financial assistance packet also includes information on obtaining Medical Assistance. In addition, the Hospital has a financial counselor that visits the self-pay patient in the emergency department or in the patient's room to discuss what is available to them. The Hospital also employs a medical assistance advocacy company to assist the hospital's patients get medical assistance. Determination for financial assistance eligibility is based on assets, income and family size. A few items to note as follows: -liquid assets greater than $15,000 for individuals, and $25,000 for families will disqualify the patient for 100% assistance -equity of $150,000 in a primary residence will be excluded from the calculation for determination of financial assistance -retirement assets will not be used for determination of financial assistance -there is special qualifications for non-citizens/non-residents of the United States Patients may also be considered for presumptive financial assistance eligibility with proof of enrollment in one of the programs listed below: -active medical assistance pharmacy coverage -special low income medicare beneficiary coverage -primary adult care coverage -homelessness -medical assistance and medicaid managed care patients -maryland public health system emergency petition patients -participating in women, infants and children program -supplemental nutritional assistance program -eligibility for other state or local assistance programs -deceased with no known estate -eligibility for state only medical assistance program -households with children in the free or reduced lunch program -low income household energy assistance program -self-administered drugs -medical assistance spenddown amounts PART VI, LINE 4: COMMUNITY INFORMATION The service area of the Upper Chesapeake Health System, which includes HARFORD MEMORIAL HOSPITAL, Inc., consists of the northeast part of Maryland, including Harford County, western Cecil County and portion of Baltimore County. This service area is located at the apex of the Chesapeake Bay and is spread across 536 square miles. It contains, among others, the cities and towns of Havre de Grace, Aberdeen, Bel Air, Fallston, and Edgewood. The service area enjoys a diverse economic base, ranging from concentrations in service, manufacturing, distribution, and retail, to Federal government employment. Harford Community College provides a local venue for advanced education and Harford County's proximity to Baltimore gives it access to nationally recognized universities which help provide a skilled workforce. The Service Area is served by Interstate 95, Amtrak and freight rail lines along the busy east-coast transportation corridor between New York and Washington, DC. In 2013, the Service Area had a total population of 249,215 people with historical annual growth rates of approximately 1.8% per year. This growth has been characterized by an influx of young families seeking suburban environment in which to live and is complemented by a growth in businesses and other services that follow young, middle class families. In 2010, the Service Area had an estimated 90,218 households with a median family income of $80,441. 91% of the service area's adults over the age of 25 are high school graduates or higher; 30% achieved bachelor's degrees or higher. The service area's growth and geographic location explain its ability to attract major east-coast distribution center and industry, which have provided additional employment opportunities in the service area. PART VI, LINE 5: PROMOTION OF COMMUNITY HEALTH Monies spent for hospital and community preparedness for hazardous accidents, natural disasters, and coalition building in the community. PART VI, LINE 6: AFFILIATED HEALTH CARE SYSTEM Harford Memorial Hospital, Inc. (HMH) is one hospital in an "Affiliated Health Care System" that includes a second hospital, Upper Chesapeake Medical Center, Inc. (UCMC), a physician services organization (Upper Chesapeake Medical Services, Inc.), a property holding company (Upper Chesapeake Properties, Inc.), a hospice residence (Upper Chesapeake Residential Hospice House, Inc. & Hospice of Harford County LLC) and a for-profit venture with investments in private imaging services (Upper Chesapeake Health Ventures, Inc.). The "System" provides a broad range of community health care services, including preventive, ambulatory, acute and hospice services, through an integrated health care delivery system in Harford County and parts of Baltimore and Cecil Counties, in northeast Maryland. HMH and UCMC are the only hospitals in Harford County, Maryland. HMH offers acute care services, including intensive care, emergency and other outpatient services, and has the only acute care behavioral health unit in Harford County. PART VI, Line 7: STATE FILING OF COMMUNITY BENEFIT REPORT The Health Services Cost Review Commission, the State agency that regulates hospital rates in Maryland, requires a Community Benefit Report to be filed annually. false true false false false false false true false LYLE E SHELDON PRESIDENT/DIRECTOR/CEO-UMUCHS 0 554023 0 384386 0 73596 0 228237 0 26108 0 1266350 John W Ashworth III Director/UMMS SVP NETWORK Dvlp 0 373547 0 155458 0 68205 0 10400 0 10695 0 618305 Robert A Chrencik DIRECTOR/UMMS President & CEO 0 1183796 0 1004469 0 4692806 0 10400 0 10695 0 6902166 0 4526360 Angela Poppe Ries MD DIRECTOR 0 168651 0 0 0 149 0 24298 0 415 0 193513 Joyce Fox VP - Patient SVCS/CNO 204941 0 72255 0 11859 0 48474 0 0 0 337529 0 Joseph E Hoffman III SR VP/CFO 0 321604 0 194293 0 18095 0 108739 0 24756 0 667487 BEVERLY A WEHMER ASST VP - PATIENT SERVICES 107578 0 24727 0 8145 0 23308 0 25400 0 189158 0 SUSAN A COSTA DIR-PERIOPERATIVE CLINICAL SVC 121062 0 16323 0 5490 0 15656 0 22420 0 180951 0 Stephen Low Dir - Pharmaceutical Services 129125 0 17845 0 109 0 7158 0 24489 0 178726 0 STEVEN D BOWMAN DIR - FINANCIAL ACCOUNT/BUDGET 108108 0 17267 0 3713 0 20401 0 24955 0 174444 0 ALISON A CONWAY DIR - IMAGING SERVICES 109023 0 16662 0 94 0 17166 0 23196 0 166141 0 SCHEDULE J, PART I, QUESTION 3 THIS ORGANIZATION DOES NOT HAVE A PAID CHIEF EXECUTIVE OFFICER. ALL COMPENSATION TO THE CHIEF EXECUTIVE OFFICER REPORTED ON PART VII OF THE FORM 990 WAS PAID BY A RELATED ORGANIZATION, UPPER CHESAPEAKE HEALTH SYSTEM. UPPER CHESAPEAKE HEALTH SYSTEM UNDERTAKES A THOROUGH PROCESS TO ENSURE THAT THE EXECUTIVE COMPENSATION IT PAYS TO ITS TOP MANAGEMENT OFFICIALS IS REASONABLE GIVEN THE MARKET IN WHICH THE ORGANIZATION OPERATES. UPPER CHESAPEAKE HEALTH SYSTEM CHECKS THE FOLLOWING BOXES FOR SCHEDULE J, PART I, QUESTION 3 ON ITS FORM 990: COMPENSATION COMMITTEE WRITTEN EMPLOYMENT CONTRACT INDEPENDENT COMPENSATION CONSULTANT COMPENSATION SURVEY OR STUDY APPROVAL BY THE BOARD OF COMPENSATION COMMITTEE SCHEDULE J, PART I, QUESTION 4B DURING THE FISCAL YEAR ENDED JUNE 30, 2015, CERTAIN OFFICERS, KEY EMPLOYEES AND HIGHEST COMPENSATED EMPLOYEES PARTICIPATED IN A SUPPLEMENTAL NONQUALIFIED PLAN. THE INDIVIDUALS, LISTED BELOW, HAVE NOT VESTED IN THE PLAN THEREFORE THE ACCRUED CONTRIBUTION TO THE PLAN FOR THE CALENDAR YEAR 2014 IS REPORTED ON SCHEDULE J, PART II, COLUMN (C), RETIREMENT AND OTHER DEFERRED COMPENSATION. LYLE E. SHELDON JOSEPH E. HOFFMAN, III JOYCE FOX During the fiscal year ended June 30, 2015, certain officers and key employees participated in a supplemental nonqualified retirement plan. The individual listed below has vested in the plan in a prior year, therefore the contributions to the plan for the CALENDAR YEAR 2014 are reported as taxable compensation and reported on Schedule J, Part II, Line B(III), Other Reportable Compensation: John W. Ashworth, III During the Fiscal Year ended June 30, 2015, 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 year, 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). Robert A. Chrencik SCHEDULE J, PART I, QUESTION 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. ROGER E SCHNEIDER MD VASC SURG ASSOC PARTNER 273493 PHYSICIAN FEES PAID TO VSA LLC false JASON M BIRNBAUM MD PULMONARY CCA PARTNER 1040283 PHYSICIAN FEES PAID TO PCCA false PART VI, SECTION A, GOVERNING BODY & MANAGEMENT QUESTION 2 FAMILY OR BUSINESS RELATIONSHIP LYLE E. SHELDON AND JOSEPH E. HOFFMAN, III ARE OFFICERS IN a few of THE SAME BUSINESS ENTITIES. PART VI, SECTION A, GOVERNING BODY & MANAGEMENT QUESTION 6, 7A & 7B EXISTENCE OF MEMBERS University of Maryland medical system corporation (UMMS) is the sole member of Harford Memorial Hospital, Inc. UMMS may elect one or more board members of the governing body and all decisions of the governing body must be approved by UMMS. PART VI, SECTION B, POLICIES QUESTION 11B ORGANIZATIONAL REVIEW OF FORM 990 THE BOARD OF UPPER CHESAPEAKE HEALTH SYSTEM, INC. ("HEALTH SYSTEM") related to the filling organization, HAS ASSIGNED THE EXECUTIVE COMMITTEE OF THE HEALTH SYSTEM'S BOARD TO REVIEW AND APPROVE ALL CONTENTS OF FORM 990 ON BEHALF OF THE BOARDS OF ALL HEALTH SYSTEM'S TAX-EXEMPT AFFILIATES. IN TURN, ONCE THE FORM 990 HAS BEEN APPROVED BY HEALTH SYSTEM'S EXECUTIVE COMMITTEE, A FINAL VERSION OF THE FORM 990 WILL BE MADE AVAILABLE TO ALL BOARD MEMBERS OF THE RESPECTIVE HEALTH SYSTEM'S TAX-EXEMPT AFFILIATES. PART VI, SECTION B, POLICIES QUESTION 12C CONFLICT OF INTEREST POLICY The organization's written conflict of interest policy covers the following individuals: Directors, Principal Officers, and Senior Management. Furthermore, the policy extends to the family members (per Internal Revenue Service definition) of such Directors, Principal Officers, and Senior Management. The Board of Directors and any committee considering a contract, transaction or arrangement to which a known or potential conflict of interest relates, determines whether a conflict exists. Actual conflicts are reviewed by the Chairman of the Board. An individual with a known or potential conflict of interest must refrain from participating in, or acting on, the decision on any matter in which a conflict of interest, or even the appearance of such a conflict of interest, is present with respect to such individual and will remove himself or herself from any meeting or deliberations on the matter. PART VI, SECTION B, POLICIES QUESTION 15 PROCESS FOR DETERMINING COMPENSATION The executive compensation committee of the board of directors approves compensation for the Chief Executive Officer, Chief Operating Officer, Chief Financial Officer, and all key employees. The executive compensation committee utilizes but is not limited to the following resources in evaluating and establishing reasonable compensation: independent compensation consultants, compensation surveys and compensation studies. This organization and its tax-exempt affiliates strive to maintain an arm's length relationship between itself and its employees. It is the goal of the executive compensation committee to ensure that total compensation (compensation and benefits) paid to its employees is fair and reasonable. Finally, the process of setting and approving such compensation is performed annually by the board's executive compensation committee. PART VI, SECTION C, DISCLOSURE QUESTION 19 DOCUMENTS AVAILABLE TO THE PUBLIC THE ORGANIZATION WILL MAKE THE FOLLOWING DOCUMENTS AVAILABLE TO THE PUBLIC UPON REQUEST: ARTICLES OF INCORPORATION, BYLAWS, CONFLICT OF INTEREST POLICY, AND AUDITED FINANCIAL STATEMENTS. PART VIII STATEMENT OF REVENUE LINE 2A - PROGRAM SERVICE REVENUE GROSS PATIENT REVENUE $ 104,859,735 LESS: ALLOWANCES & CHARITY POLICIES (10,717,462) LESS: ASSESSMENTS & GME Pool ( 1,076,168) ------------- NET PATIENT REVENUE $ 93,066,105 Reconciliation of Net Assets PART XI, LINE 9, Other changes in net assets LOSS ON EARLY EXTINGUISHMENT OF DEBT $ (1,126,118) Defined Benefit Pension Plan Adjustment (1,668,619) Fund Balance Transfer 175,000 Perm Restricted Foundation Endowments-Income for PP&E 152,917 Contribution not in book income (158,910) ----------- Total $ (2,625,730) PART III, PROGRAM SERVICE ACCOMPLISHMENTS TO PROVIDE HEALTHCARE SERVICES TO PATIENTS REGARDLESS OF THEIR ABILITY TO PAY FOR SUCH SERVICES. FOR MORE THAN 90 YEARS, UNIVERSITY OF MARYLAND UPPER CHESAPEAKE HEALTH SYSTEM (THE SYSTEM) HAS BEEN PROVIDING COMPREHENSIVE, HIGH QUALITY HEALTH CARE. ITS TWO HOSPITALS, HARFORD MEMORIAL HOSPITAL AND UPPER CHESAPEAKE MEDICAL CENTER OFFER SOME OF THE AREA'S MOST ADVANCED INPATIENT AND OUTPATIENT SERVICES SO THAT PATIENTS CAN ENJOY THE SUPERIOR WELLNESS RESOURCES A HEALTHY LIFESTYLE NEEDS, WITHOUT LEAVING THEIR NEIGHBORHOOD. THE SYSTEM IS A COMMUNITY-BASED, NON-PROFIT HEALTH SYSTEM LOCATED IN HARFORD COUNTY, MARYLAND. OUR VISION IS BASED ON CREATING THE HEALTHIEST COMMUNITY IN MARYLAND. BUILDING ON THAT VISION, WE HAVE A STRONG COMMITMENT TO SERVICE EXCELLENCE. SO MUCH SO THAT IT HAS BECOME PART OF THE FABRIC OF THE HEALTHCARE EXPERIENCE AT THE SYSTEM. THE SYSTEM HAS OVER 2,500 PHYSICIANS AND HEALTHCARE PROFESSIONALS WHO ARE DELIVERING CARE FOR THE MIND, BODY AND SPIRIT IN SETTINGS FROM OFFICES, TO OUTPATIENT CENTERS, TO HOSPITALS, TO SHOPPING CENTERS, TO BUSINESSES AND HOMES. HARFORD MEMORIAL HOSPITAL IS A MEMBER OF THE SYSTEM. HARFORD MEMORIAL HOSPITAL (THE HOSPITAL) IS AN ACUTE CARE, NON-PROFIT FACILITY OFFERING A FULL COMPLEMENT OF MEDICAL, DIAGNOSTIC AND EMERGENCY CARE SERVICES. THE HOSPITAL IS FULLY ACCREDITED BY THE JOINT COMMISSION ON THE ACCREDITATION OF HEALTHCARE ORGANIZATIONS (JCAHO). IN ADDITION TO MEDICAL/SURGICAL ACUTE CARE BEDS, THE HOSPITAL HAS A STATE-OF-THE-ART ICU/PCU AND A BUSY EMERGENCY DEPARTMENT THAT CARES FOR OVER 35,000 PATIENTS EACH YEAR. THE HOSPITAL OFFERS VERY SPECIALIZED, ONE OF A KIND, HOSPITAL BASED SERVICES, INCLUDING A JOINT CENTER FOR PATIENTS UNDERGOING HIP OR KNEE JOINT REPLACEMENT SURGERY, A SLEEP DISORDER CENTER FOR THE DIAGNOSIS AND TREATMENT OF SLEEP DISORDERS, AND INPATIENT AND OUTPATIENT BEHAVIORAL HEALTH SERVICES. HARFORD MEMORIAL AND UPPER CHESAPEAKE MEDICAL CENTER MAINTAIN CHARITY CARE PROGRAMS AND, IN ADDITION, CONDUCT MANY COMMUNITY OUTREACH AND COMMUNITY BUILDING ACTIVITIES INCLUDING: - COMMUNITY HEALTH EDUCATION PROGRAMS WHICH INCLUDE NEWBORN BABY CARE, SITTER SAFETY PROGRAM, INFANT CPR, INFANT SAFETY, STOP SMOKING CLASS, KIDS SAFETY CLASS, AND PRENATAL BREAST FEEDING CLASS - SUPPORT GROUPS INCLUDING BREAST FEEDING SUPPORT, BREAST CANCER AWARENESS GROUPS, PERINATAL BEREAVEMENT, ASTHMA SUPPORT GROUP, WIDOW AND WIDOWERS SUPPORT GROUP, GRIEF SUPPORT GROUP, PROSTATE CANCER SUPPORT GROUP, AMPUTEE NETWORK, BRAIN INJURY SUPPORT GROUP, STROKE CLUB, LUPUS SUPPORT GROUP, AND OTHERS - HEALTH SCREENINGS INCLUDING SCREENINGS FOR OSTEOPOROSIS, CARDIAC PROBLEMS, BLOOD PRESSURE, AND OTHER ISSUES - FREE AND MOBILE CLINICS Baltimore Washington Emergency Phys Inc 301 Hospital Drive Glen Burnie MD 21061 521756326 Healthcare MD 501(c)(3) 11A UMBWMS false Baltimore Washington Healthcare Services 301 Hospital 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3 UMUCHS false Upper Chesapeake Medical Services Inc 520 Upper Chesapeake Dr Bel Air MD 21014 521501734 Healthcare MD 501(c)(3) 9 UMUCHS false Upper Chesapeake Properties Inc 520 Upper Chesapeake Dr Bel Air MD 21014 521907237 Real Estate MD 501(c)(2) UMUCHS false Upper Ches Residential Hospice House In 520 Upper Chesapeake Dr Bel Air MD 21014 260737028 Hospice MD 501(c)(3) 7 UMUCHS false Upper ChesapeakeSt Joe's Home CareInc 520 Upper Chesapeake Dr Bel Air MD 21014 521229742 Hospice MD 501(c)(3) 9 UMUCHS false UMSJ Health System LLC 7601 Osler Drive Towson MD 21204 460797956 Healthcare MD 501(c)(3) 11A UMMSC false Arundel Physicians Associates LLC 301 Hospital Drive Glen Burnie MD 20161 522000762 Healthcare MD NA Baltimore Washington Imaging LLC 301 Hospital Drive Glen Burnie MD 20161 200806027 Healthcare MD NA NAHSunrise of Severna Park LLC 301 Hospital Drive Glen Burnie MD 20161 541810729 Healthcare MD NA North Arundel Senior Living LLC 301 Hospital Drive Glen Burnie MD 20161 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