CIVISTA MEDICAL CENTER INC: Form 990, tax year 2014
View the entire original 990 at ProPublica ↗
- Organization
- CIVISTA MEDICAL CENTER INC (EIN 52-0445374)
- Tax period
- 2014-07-01 to 2015-06-30
- Filed
- 2016-05-12
- IRS object ID
- 201641339349300004
- 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
- Form 990
- Schedule A
- Schedule C
- Schedule D
- Schedule H
- Schedule I
- Schedule J
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2016-05-12T04:15:12-05:00 | ReturnTs |
| Tax Period End | 2015-06-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | GRANT THORNTON LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2001 MARKET STREET SUITE 700 | AddressLine1Txt |
| City | PHILADELPHIA | CityNm |
| State Abbreviation | PA | StateAbbreviationCd |
| ZIP | 19103 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2014-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 520445374 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Civista Medical Center Inc | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| In Care Of | % ERIK BOAS | InCareOfNm |
| Business Name Control | CIVI | BusinessNameControlTxt |
| Phone | 3016094130 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 5 Garrett Avenue | AddressLine1Txt |
| City | La Plata | CityNm |
| State Abbreviation | MD | StateAbbreviationCd |
| ZIP | 20646 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Erik Boas | PersonNm |
| Person Title | CFO | PersonTitleTxt |
| Phone | 3016094130 | PhoneNum |
| Signature | 2016-05-05 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | Frank Giardini | PreparerPersonNm |
| PTIN | P00532355 | PTIN |
| Phone | 2155614200 | PhoneNum |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2014 | TaxYr |
| Build TS | 2016-08-17 19:52:53Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | Noel Cervino | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 5 Garrett Ave | AddressLine1Txt |
| City | La Plata | CityNm |
| State Abbreviation | MD | StateAbbreviationCd |
| ZIP | 20646 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $133,759,070 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | www.charlesregional.org | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1980 | FormationYr |
| Legal Domicile State | MD | LegalDomicileStateCd |
| Activity Or Mission | Civista 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 Body | 17 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 14 | VotingMembersIndependentCnt |
| Total Employee | 1105 | TotalEmployeeCnt |
| Total Volunteers | 120 | TotalVolunteersCnt |
| Total Gross UBI | $134,498 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | -$10,898 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $373,966 | PYContributionsGrantsAmt |
| CY Contributions Grants | $0 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $128,305,767 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $132,649,970 | CYProgramServiceRevenueAmt |
| PY Investment Income | -$79,506 | PYInvestmentIncomeAmt |
| CY Investment Income | $551,842 | CYInvestmentIncomeAmt |
| PY Other Revenue | $510,252 | PYOtherRevenueAmt |
| CY Other Revenue | $557,258 | CYOtherRevenueAmt |
| PY Total Revenue | $129,110,479 | PYTotalRevenueAmt |
| CY Total Revenue | $133,759,070 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $87,252 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $52,129 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $52,674,539 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $54,048,003 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $65,768,408 | PYOtherExpensesAmt |
| CY Other Expenses | $64,633,320 | CYOtherExpensesAmt |
| PY Total Expenses | $118,530,199 | PYTotalExpensesAmt |
| CY Total Expenses | $118,733,452 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $10,580,280 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $15,025,618 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $158,176,511 | TotalAssetsBOYAmt |
| Total Assets EOY | $149,948,298 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $107,530,822 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $103,563,868 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $50,645,689 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $46,384,430 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | CIVISTA 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 Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $101,234,693 | ExpenseAmt |
| Grant | $52,129 | GrantAmt |
| Revenue | $133,072,730 | RevenueAmt |
| Desc | 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. UM CRMC's 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. UM CRMC collaborated with the Charles County Department of Health (CCDOH) to complete a comprehensive assessment of the health needs (CHNA) of Charles County, Maryland. An epidemiologist with a Master's Degree in Public Health Epidemiology was contracted to analyze the qualitative and quantitative data. UM CRMC lead the effort and covered 80% of the cost of the CHNA. To provide a comprehensive assessment of the health needs of the county, a four method plan was developed which included four 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, seven focus groups with community leaders, citizens, and stakeholders, and a quantitative data analysis. The use of the multiple data collection methods strengthened the validity of the assessment's findings, as well as ensured that Charles County residents had an opportunity to participate in the assessment process and to feel invested in its outcome. Three hundred and two Charles County residents completed the 74 question online survey that was created using Survey Monkey. The link to the survey was available on the UM CRMC 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 three question survey was distributed throughout the county regarding perceptions of health within the county. A total of 200 short surveys were completed. Surveys were located throughout the county including UM CRMC waiting rooms, CCDOH waiting rooms, libraries, senior centers, community centers. Thirty five were completed in Spanish (17.5%). Seven focus groups were held throughout the county. The focus group topics included: age related health issues, chronic disease specific health, special populations, county leadership, substance abuse, youth through the school nurses, and the Partnerships for a Healthier Charles County (PHCC). Approximately 165 people participated in the county focus groups from a wide variety of organizations and community groups. Quantitative data was analyzed for several 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/Alzheimer's disease, communicable disease, sexually transmitted diseases, HIV/AIDS, mental health, dental health, substance abuse, disabilities, and tobacco use. Cumulative analysis of all quantitative and qualitative data identified the top 11 health needs of Charles County which was presented to the Partnerships for a Healthier Charles County, a coalition of Charles County agencies and organizations. The direction of Partnerships for a Healthier Charles County is guided by the Steering Committee which consists of leadership from UM CRMC, Charles County Department of Health, Charles County Public Schools, the College of Southern Maryland as well as a Public Health Epidemiologist. Focus Groups Included representatives from the following organizations: Partnerships for a Healthier Charles County University of Maryland Charles Regional Medical Center UM CRMC, Board Of Directors Charles County Department of Health University of Maryland Clinical Trials Program Bel Alton Alumni Association Charles County Department of Community Services, Transportation Tri County Council for Southern Maryland Minister's Alliance of Charles County CC Department of Social services Maryland Foundation for Quality healthcare Health Partner's Clinic Shiloh Community United Methodist Church CC Nursing and Rehabilitation Center Alzheimer's Association Center for Children Chesapeake Potomac Home Health Agency College of Southern Maryland Charles County Department of Aging Priority partners Big Brothers/Big sisters Community Hispanic Advocates Black Leadership Council for Excellence Young Researchers Community Project Pinnacle Center (Mental Health) Hospice Breast Cancer Support Advocates Charles County Public Schools - School Nurses Charles County Commissioners Charles County Emergency Services Charles County Sheriff's Office So MD Delegates Charles County Community Foundation Community Physicians Charles County Fire and Rescue Board Accomplishments: UM CRMC provided $10.5 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 2015. This year, we provided and supported programs, activities and screenings such as blood pressure, glucose, cholesterol, breast and cervical cancer, prostate cancer and stroke risk reduction education. We 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 Society's Look Good Feel Better, advanced directives, arthritis, 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. We offer clinics and clinic services such as prenatal, OB clinic, 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 community events such as Christmas Connection, American Cancer Society's Relay for Life, Alzheimer's Walk, March of Dimes and Safe Nights. | Desc |
| Total Program Service Expenses | $101,234,693 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | false | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (true) | LobbyingActivitiesInd |
| Subject To Proxy Tax | false | SubjectToProxyTaxInd |
| Donor Advised Fund | false | DonorAdvisedFundInd |
| Conservation Easements | false | ConservationEasementsInd |
| Collections Of Art | false | CollectionsOfArtInd |
| Credit Counseling | false | CreditCounselingInd |
| Temp Or Permanent Endowments | false | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (true) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | false | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | Yes (true) | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (true) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (true) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | false | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (true) | ConsolidatedAuditFinclStmtInd |
| School Operating | false | SchoolOperatingInd |
| Foreign Office | false | ForeignOfficeInd |
| Foreign Activities | false | ForeignActivitiesInd |
| More Than5000 K To Org | false | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividualsInd |
| Professional Fundraising | false | ProfessionalFundraisingInd |
| Fundraising Activities | false | FundraisingActivitiesInd |
| Gaming Activities | false | GamingActivitiesInd |
| Operate Hospital | Yes (true) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (true) | AuditedFinancialStmtAttInd |
| Grants To Organizations | Yes (true) | GrantsToOrganizationsInd |
| Grants To Individuals | false | GrantsToIndividualsInd |
| Schedule J Required | Yes (true) | ScheduleJRequiredInd |
| Tax Exempt Bonds | false | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | false | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | false | PYExcessBenefitTransInd |
| Loan Outstanding | false | LoanOutstandingInd |
| Grant To Related Person | false | GrantToRelatedPersonInd |
| Business Rln With Org Mem | false | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | false | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | false | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | false | DeductibleNonCashContriInd |
| Deductible Art Contribution | false | DeductibleArtContributionInd |
| Terminate Operations | false | TerminateOperationsInd |
| Partial Liquidation | false | PartialLiquidationInd |
| Disregarded Entity | false | DisregardedEntityInd |
| Related Entity | Yes (true) | RelatedEntityInd |
| Related Organization Ctrl Ent | false | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | false | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| IRP Document | 167 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (true) | BackupWthldComplianceInd |
| Employee | 1105 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (true) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | Yes (true) | UnrelatedBusIncmOverLimitInd |
| Form990 T Filed | Yes (true) | Form990TFiledInd |
| Foreign Financial Account | false | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | false | TaxablePartyNotificationInd |
| Nondeductible Contributions | false | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | false | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | false | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | false | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | false | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 17 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 14 | IndependentVotingMemberCnt |
| Family Or Business Rln | false | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | false | DelegationOfMgmtDutiesInd |
| Change To Org Documents | false | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (true) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (true) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (true) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (true) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (true) | MinutesOfCommitteesInd |
| Officer Mailing Address | false | OfficerMailingAddressInd |
| Local Chapters | false | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (true) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (true) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (true) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (true) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (true) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (true) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (true) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (true) | CompensationProcessOtherInd |
| Investment In Joint Venture | false | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | MD | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | ERIK BOAS | PersonNm |
| Phone | 3016094130 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 5 GARRETT AVE | AddressLine1Txt |
| City | La Plata | CityNm |
| State Abbreviation | MD | StateAbbreviationCd |
| ZIP | 20646 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | Yes (X) | InfoInScheduleOPartVIIInd |
Form990 Part VII Section A Form990PartVIISectionAGrp (29 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Key EmployeeKeyEmployeeInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|---|
| Louis Jenkins Jr | |||||||||
| Chairman | 1.0 | 0.0 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| Shelly Culhane | |||||||||
| Vice Chair | 1.0 | 0.0 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| Richard Winkler | |||||||||
| Secretary/Treasurer | 1.0 | 0.0 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| Dianna Abney MD | |||||||||
| Director | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | |||
| Khadar Baig MD | |||||||||
| Director | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | |||
| Wayne Barnes | |||||||||
| Director | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | |||
| Michael Cady | |||||||||
| Director | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | |||
| Anthony Covington | |||||||||
| Director | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | |||
| B Larry Jenkins Jr MD | |||||||||
| Director | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | |||
| Sara A Middleton | |||||||||
| Director | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | |||
| Ashvin J Patel MD | |||||||||
| Director | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | |||
| Joseph Slater | |||||||||
| Director | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | |||
| Richard Ferraro MD | |||||||||
| Chief of Staff | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | |||
| Joel Sewchand MD | |||||||||
| Chief of Staff (THRU 12/31/14) | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | |||
| Candice Quinn Kelly | |||||||||
| Ex-Officio/Director | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | |||
| Jon P Burns | |||||||||
| Ex-Officio/Director | 1.0 | 49.0 | Yes (X) | $0 | $591,209 | $20,269 | |||
| John W Ashworth III | |||||||||
| Ex-Officio/Dir. (thru 1/31/15) | 1.0 | 49.0 | Yes (X) | $0 | $597,210 | $21,095 | |||
| Robert Chrencik | |||||||||
| Ex-Officio/Director | 1.0 | 49.0 | Yes (X) | $0 | $6,881,071 | $21,095 | |||
| Noel Cervino | |||||||||
| Ex-Officio/President & CEO | 40.0 | 10.0 | Yes (X) | Yes (X) | $881,764 | $0 | $16,975 | ||
| Erik Boas | |||||||||
| Chief Financial Officer | 40.0 | 10.0 | Yes (X) | $405,276 | $0 | $8,169 | |||
| Mark R Dumais | |||||||||
| Chief Medical Officer | 40.0 | 0.0 | $406,517 | $0 | $55,136 | Yes (X) | |||
| Dana Levy | |||||||||
| Chief Nursing Officer | 40.0 | 0.0 | $221,998 | $0 | $30,464 | Yes (X) | |||
| Paul Blackwood | |||||||||
| VP Planning | 40.0 | 0.0 | $214,558 | $0 | $34,226 | Yes (X) | |||
| William Grimes | |||||||||
| VP Ancilliary Services | 40.0 | 0.0 | $196,399 | $0 | $20,767 | Yes (X) | |||
| Stacey Cook | |||||||||
| VP Human Resources | 40.0 | 0.0 | $207,763 | $0 | $38,799 | Yes (X) | |||
| Marilyn Gregory | |||||||||
| RN | 40.0 | 0.0 | $190,924 | $0 | $7,545 | Yes (X) | |||
| Katherine Middleton | |||||||||
| RN | 40.0 | 0.0 | $185,666 | $0 | $13,465 | Yes (X) | |||
| Eugene Suwandhi MD | |||||||||
| pediatric hospitalist phys. | 40.0 | 0.0 | $173,967 | $0 | $7,553 | Yes (X) | |||
| Gabriel Abiola | |||||||||
| Pharmacist Manager | 40.0 | 0.0 | $159,900 | $0 | $21,968 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $3,244,732 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $8,069,490 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $317,526 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 55 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | false | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (true) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| Maryland Inpatient Care Specialists | |||||
| 6934 Aviation Blvd Ste B | GLEN BURNIE | MD | 21061 | Physicians | $1,300,000 |
| Southern MD Pulmonary Critical Ca | |||||
| 4475 Regency Place Ste 303 | WHITE PLAINS | MD | 20695 | Respiratory | $1,091,196 |
| Healogics Wound Care | |||||
| 3087 Momentum Place | CHICAGO | IL | 60689 | Wound Care | $750,503 |
| NDG Communications Inc | |||||
| 105 Centennial Str Ste K | LA PLATA | MD | 20646 | Marketing | $625,406 |
| ROI Eligibility Services Corp | |||||
| 1920 Greenspring Dr Ste 200 | TIMONIUM | MD | 21094 | PT Acctg Purc Svc | $606,799 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 26 | CntrctRcvdGreaterThan100KCnt |
| Total Contributions | $0 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | NET PATIENT REVENUE | Desc |
| Business | 900099 | BusinessCd |
| Total Revenue Column | $132,649,970 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $132,649,970 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $132,649,970 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $213,406 | TotalRevenueColumnAmt |
| Exclusion | $213,406 | ExclusionAmt |
Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Royalties Revenue RoyaltiesRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $0 | RealAmt |
| Personal | $0 | PersonalAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $338,436 | SecuritiesAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $338,436 | SecuritiesAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $338,436 | TotalRevenueColumnAmt |
| Exclusion | $338,436 | ExclusionAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Net Income From Gaming NetIncomeFromGamingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Net Income Or Loss NetIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Other Revenue Misc OtherRevenueMiscGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Unrelated Business RevenueUnrelatedBusinessRevenueAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|---|
| ANSWERING SERVICE | 561000 | $134,498 | $134,498 | |
| CAFETERIA & COFFEE BAR SALES | 900099 | $355,975 | $355,975 | |
| CHANGE IN EQUITY OF AFFILIATES CPHA | 900099 | $74,010 | $74,010 |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$7,225 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | -$7,225 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $557,258 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $133,759,070 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $133,072,730 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $134,498 | UnrelatedBusinessRevenueAmt |
| Exclusion | $551,842 | ExclusionAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $52,129 | TotalAmt |
| Program Services | $52,129 | ProgramServicesAmt |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Foreign Grants ForeignGrantsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Benefits To Members BenefitsToMembersGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,244,732 | TotalAmt |
| Program Services | $628,515 | ProgramServicesAmt |
| Management And General | $2,616,217 | ManagementAndGeneralAmt |
Comp Disqual Persons CompDisqualPersonsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $39,706,094 | TotalAmt |
| Program Services | $35,879,687 | ProgramServicesAmt |
| Management And General | $3,826,407 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,743,629 | TotalAmt |
| Program Services | $1,482,085 | ProgramServicesAmt |
| Management And General | $261,544 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,202,687 | TotalAmt |
| Program Services | $5,272,284 | ProgramServicesAmt |
| Management And General | $930,403 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,150,861 | TotalAmt |
| Program Services | $2,678,232 | ProgramServicesAmt |
| Management And General | $472,629 | ManagementAndGeneralAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $459,255 | TotalAmt |
| Management And General | $459,255 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $18,631 | TotalAmt |
| Management And General | $18,631 | ManagementAndGeneralAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,869 | TotalAmt |
| Management And General | $4,869 | ManagementAndGeneralAmt |
Fees For Services Prof Fundraising FeesForServicesProfFundraising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,375,295 | TotalAmt |
| Program Services | $6,269,001 | ProgramServicesAmt |
| Management And General | $1,106,294 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $344,943 | TotalAmt |
| Program Services | $293,202 | ProgramServicesAmt |
| Management And General | $51,741 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,538,121 | TotalAmt |
| Management And General | $3,538,121 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Royalties RoyaltiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,300,029 | TotalAmt |
| Program Services | $2,805,025 | ProgramServicesAmt |
| Management And General | $495,004 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $52,433 | TotalAmt |
| Program Services | $44,568 | ProgramServicesAmt |
| Management And General | $7,865 | ManagementAndGeneralAmt |
Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $188,438 | TotalAmt |
| Program Services | $160,172 | ProgramServicesAmt |
| Management And General | $28,266 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,791,954 | TotalAmt |
| Program Services | $2,373,161 | ProgramServicesAmt |
| Management And General | $418,793 | ManagementAndGeneralAmt |
Payments To Affiliates PaymentsToAffiliatesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,197,028 | TotalAmt |
| Program Services | $3,567,474 | ProgramServicesAmt |
| Management And General | $629,554 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $45,758 | TotalAmt |
| Program Services | $38,894 | ProgramServicesAmt |
| Management And General | $6,864 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| SUPPLIES AND DRUGS | $16,586,737 | $16,586,737 | |
| PURCHASED SERVICES | $13,800,506 | $11,730,430 | $2,070,076 |
| BAD DEBT | $8,221,156 | $8,221,156 | |
| EQUIPMENT SERVICE CONTRACTS | $1,674,918 | $1,423,680 | $251,238 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,033,249 | TotalAmt |
| Program Services | $1,728,261 | ProgramServicesAmt |
| Management And General | $304,988 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $118,733,452 | TotalAmt |
| Program Services | $101,234,693 | ProgramServicesAmt |
| Management And General | $17,498,759 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $21,245,679 | BOYAmt |
| EOY | $20,680,284 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,988,094 | BOYAmt |
| EOY | $7,944,863 | EOYAmt |
Receivables From Officers Etc ReceivablesFromOfficersEtcGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,586,764 | BOYAmt |
| EOY | $1,675,458 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $205,947 | BOYAmt |
| EOY | $319,972 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $110,981,019 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $40,656,610 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $70,840,719 | BOYAmt |
| EOY | $70,324,409 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $20,457,797 | BOYAmt |
| EOY | $20,278,998 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $35,851,511 | BOYAmt |
| EOY | $28,724,314 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $158,176,511 | BOYAmt |
| EOY | $149,948,298 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $13,949,677 | BOYAmt |
| EOY | $13,697,614 | EOYAmt |
Grants Payable GrantsPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Escrow Account Liability EscrowAccountLiabilityGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Loans From Officers Directors LoansFromOfficersDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $19,523,669 | BOYAmt |
| EOY | $18,484,229 | EOYAmt |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $74,057,476 | BOYAmt |
| EOY | $71,382,025 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $107,530,822 | BOYAmt |
| EOY | $103,563,868 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $50,553,092 | BOYAmt |
| EOY | $46,291,833 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $92,597 | BOYAmt |
| EOY | $92,597 | EOYAmt |
Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $50,645,689 | BOYAmt |
| EOY | $46,384,430 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $158,176,511 | BOYAmt |
| EOY | $149,948,298 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $15,025,618 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | -$684,431 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | -$18,602,446 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | false | AccountantCompileOrReviewInd |
| FS Audited | Yes (true) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (true) | AuditCommitteeInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Grassroots Lobbying | TotalGrassrootsLobbyingGrp | |
| Total Direct Lobbying | TotalDirectLobbyingGrp | |
| Total Lobbying Expend | TotalLobbyingExpendGrp | |
| Other Exempt Purpose Expend | OtherExemptPurposeExpendGrp | |
| Total Exempt Purpose Expend | TotalExemptPurposeExpendGrp | |
| Lobbying Nontaxable Amount | LobbyingNontaxableAmountGrp | |
| Grassroots Nontaxable | GrassrootsNontaxableGrp | |
| Tot Lbbyng Grassroot Mns Non Tx | TotLbbyngGrassrootMnsNonTxGrp | |
| Tot Lbby Expend Mns Lbbyng Non Tx | TotLbbyExpendMnsLbbyngNonTxGrp | |
| Volunteers | false | VolunteersInd |
| Paid Staff Or Management | false | PaidStaffOrManagementInd |
| Media Advertisements | false | MediaAdvertisementsInd |
| Mailings Members | false | MailingsMembersInd |
| Publications Or Broadcast | false | PublicationsOrBroadcastInd |
| Grants Other Organizations | false | GrantsOtherOrganizationsInd |
| Direct Contact Legislators | false | DirectContactLegislatorsInd |
| Rallies Demonstrations | false | RalliesDemonstrationsInd |
| Other Activities | Yes (true) | OtherActivitiesInd |
| Other Activities | $4,869 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $4,869 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | false | NotDescribedSection501c3Ind |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Lobbying Activities | FormAndLineReferenceDesc |
| Explanation | 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 MHA 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 II-B as lobbying activities. | ExplanationTxt |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Art Public Exhibition Amounts | ArtPublicExhibitionAmountsGrp | |
| Held Works Art | HeldWorksArtGrp | |
| CY Minus3 Yr Endwmt Fund | CYMinus3YrEndwmtFundGrp | |
| CY Minus4 Yr Endwmt Fund | CYMinus4YrEndwmtFundGrp | |
| Land | LandGrp |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $75,134,563 | OtherCostOrOtherBasisAmt |
| Depreciation | $17,208,521 | DepreciationAmt |
| Book Value | $57,926,042 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $498,563 | OtherCostOrOtherBasisAmt |
| Depreciation | $292,665 | DepreciationAmt |
| Book Value | $205,898 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $35,113,499 | OtherCostOrOtherBasisAmt |
| Depreciation | $23,155,424 | DepreciationAmt |
| Book Value | $11,958,075 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $234,394 | OtherCostOrOtherBasisAmt |
| Book Value | $234,394 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $70,324,409 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp (7 entries)
| DescDesc | Book ValueBookValueAmt |
|---|---|
| SECURITY DEPOSITS | $11,473 |
| OTHER CURRENT RECEIVABLES | $665,753 |
| INV. CHES POTOMAC HEALTHCARE | $3,353,172 |
| OTHER ASSETS | $19,619,520 |
| PHYSICIAN LOANS | $134,136 |
| INVESTMENT MARYLAND ECARE | $10,000 |
| ECONOMIC INTEREST- NET ASSETS | $4,930,260 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $28,724,314 | TotalBookValueOtherAssetsAmt |
| Federal Income Tax Liability | $0 | FederalIncomeTaxLiabilityAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (6 entries)
| DescDesc | AmtAmt |
|---|---|
| ADVANCES FROM THIRD PARTIES | $4,161,675 |
| ACCRUED PENSION COSTS | $6,702,525 |
| DUE TO AFFILIATES | $52,689,467 |
| LEASE LIABILITIES | $457,331 |
| MALPRACTICE IBNR | $739,274 |
| OTHER LIABILITIES | $6,631,753 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $71,382,025 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Liability for Uncertain Tax Position (ASC 740) | FormAndLineReferenceDesc |
| Explanation | Schedule 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (true) | FinancialAssistancePolicyInd |
| Written Policy | Yes (true) | WrittenPolicyInd |
| FPG Reference Free Care | Yes (true) | FPGReferenceFreeCareInd |
| Percent200 | Yes (X) | Percent200Ind |
| FPG Reference Discounted Care | Yes (true) | FPGReferenceDiscountedCareInd |
| Percent300 | Yes (X) | Percent300Ind |
| Free Care Medically Indigent | Yes (true) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (true) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | Yes (true) | ExpensesExceedBudgetInd |
| Unable To Provide Care | false | UnableToProvideCareInd |
| Annual Community Bnft Report | Yes (true) | AnnualCommunityBnftReportInd |
| Report Publically Available | Yes (true) | ReportPublicallyAvailableInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,400,571 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $1,400,571 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01270 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,400,571 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $1,400,571 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01270 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $742,003 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $742,003 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00670 | TotalExpensePct |
Health Professions Education HealthProfessionsEducationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $502,991 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $502,991 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00460 | TotalExpensePct |
Subsidized Health Services SubsidizedHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $9,089,619 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $4,951,905 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $4,137,714 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.03740 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $58,611 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $58,611 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00050 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $10,393,224 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $4,951,905 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $5,441,319 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.04920 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $11,793,795 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $4,951,905 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $6,841,890 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.06190 | TotalExpensePct |
Economic Development EconomicDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $105 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $105 | NetCommunityBenefitExpnsAmt |
Community Support CommunitySupportGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $104,630 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $104,630 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00090 | TotalExpensePct |
Coalition Building CoalitionBuildingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $11,773 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $11,773 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00010 | TotalExpensePct |
Health Improvement Advocacy HealthImprovementAdvocacyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $735 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $735 | NetCommunityBenefitExpnsAmt |
Workforce Development WorkforceDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $36,794 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $36,794 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00030 | TotalExpensePct |
Total Communtity Building Acty TotalCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $154,037 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $154,037 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00130 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (true) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $5,959,787 | BadDebtExpenseAmt |
| Reimbursed By Medicare | $49,198,261 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $48,003,359 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | $1,194,902 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | Yes (X) | CostToChargeRatioInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (true) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (true) | FinancialAssistancePrvsnInd |
| Hospital Facilities | 1 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Civista Medical Center Inc | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 5 Garrett Avenue | AddressLine1Txt |
| City | La Plata | CityNm |
| State Abbreviation | MD | StateAbbreviationCd |
| ZIP | 20646 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | www.charlesregional.org | WebsiteAddressTxt |
| State License | 08-001 | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Civista Medical Center Inc | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| First Licensed CY Or PY | false | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | false | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | Yes (true) | CHNAConductedInd |
| Community Definition | Yes (X) | CommunityDefinitionInd |
| Community Demographics | Yes (X) | CommunityDemographicsInd |
| Existing Resources | Yes (X) | ExistingResourcesInd |
| How Data Obtained | Yes (X) | HowDataObtainedInd |
| Community Health Needs | Yes (X) | CommunityHealthNeedsInd |
| Other Health Issues | Yes (X) | OtherHealthIssuesInd |
| Community Hlth Needs Id Process | Yes (X) | CommunityHlthNeedsIdProcessInd |
| Consulting Process | Yes (X) | ConsultingProcessInd |
| Information Gaps | Yes (X) | InformationGapsInd |
| CHNA Conducted | 15 | CHNAConductedYr |
| Take Into Account Others Input | Yes (true) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | false | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | false | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (true) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | http://www.charlesregional.org/siteasset | OwnWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Implementation Strategy Adopt | Yes (true) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 15 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (true) | StrategyPostedWebsiteInd |
| Strategy Website URL | http://www.charlesregional.org/siteasset | StrategyWebsiteURLTxt |
| Strategy Attached | false | StrategyAttachedInd |
| Organization Incur Excise Tax | false | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (true) | EligCriteriaExplainedInd |
| FPG Family Incm Lmt Free Dscnt | Yes (X) | FPGFamilyIncmLmtFreeDscntInd |
| FPG Family Incm Lmt Free Care | 200. | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 300. | FPGFamilyIncmLmtDscntCarePct |
| Income Level Criteria | Yes (X) | IncomeLevelCriteriaInd |
| Asset Level Criteria | Yes (X) | AssetLevelCriteriaInd |
| Medical Indigency Criteria | Yes (X) | MedicalIndigencyCriteriaInd |
| Insurance Status Criteria | Yes (X) | InsuranceStatusCriteriaInd |
| Underinsurance Stat Criteria | Yes (X) | UnderinsuranceStatCriteriaInd |
| Explained Basis | Yes (true) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (true) | AppFinancialAsstExplnInd |
| Described Info | Yes (X) | DescribedInfoInd |
| Described Suprt Doc | Yes (X) | DescribedSuprtDocInd |
| Provided Hospital Contact | Yes (X) | ProvidedHospitalContactInd |
| Provided Nonprofit Contact | Yes (X) | ProvidedNonprofitContactInd |
| Includes Publicity Measures | Yes (true) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | http://www.charlesregional.org | FAPAvailableOnWebsiteURLTxt |
| FAP Avlbl On Request No Charge | Yes (X) | FAPAvlblOnRequestNoChargeInd |
| FAP App Avlbl On Request No Chrg | Yes (X) | FAPAppAvlblOnRequestNoChrgInd |
| FAP Notice Displayed | Yes (X) | FAPNoticeDisplayedInd |
| Communtity Notified FAP | Yes (X) | CommuntityNotifiedFAPInd |
| FAP Actions On Nonpayment | Yes (true) | FAPActionsOnNonpaymentInd |
| Collection Activities | false | CollectionActivitiesInd |
| FAP Notified Upon Admission | Yes (X) | FAPNotifiedUponAdmissionInd |
| FAP Notified Before Discharge | Yes (X) | FAPNotifiedBeforeDischargeInd |
| FAP Notified All Patients | Yes (X) | FAPNotifiedAllPatientsInd |
| Documented Elig Determination | Yes (X) | DocumentedEligDeterminationInd |
| Other Actions Taken | Yes (X) | OtherActionsTakenInd |
| Nondis Emergency Care Policy | Yes (true) | NondisEmergencyCarePolicyInd |
| Other Method Used | Yes (X) | OtherMethodUsedInd |
| Amounts Generally Billed | false | AmountsGenerallyBilledInd |
| Gross Charges | false | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FINANCIAL ASSISTANCE POLICY | Schedule H, Part V, Section B In compliance with the new IRC Section 501(r) regulations Civista Medical Center is currently in the process of updating their Financial ASsistance Policy to ensure its compliance with IRS regulations. Input from Individuals Representing the Community Schedule H, Part V, Section B, Line 5 Civista Medical Center DBA University of Maryland Charles Regional Medical Center (CRMC) completed the Community Health Needs Assessment CHNA) in FY 2015. This process involved the following people: PHCC Executive Committee: Noel A. Cervino CEO Civista Health (CRMC) Dr. Devadason Health Officer CC Health Department (CCDOH) Dr. Brad Gottfried President College of Southern Maryland (CSM) Jim Richmond Superintendent Charles County Public Schools PHCC Steering Committee: Joyce Riggs Dir., Community Dev./ Planning Civista (CRMC) Fay Reed, RN Deputy Health Officer CCDOH William Leebel Public Information Officer CCDOH Linda Smith Project Coordinator CSM Tanisha Saunders Coordinator of Integrated Student Services CCPS Amber Starn, MPH Epidemiologist (Contract) Civista (CRMC) Partnerships for a Healthier Charles County: Civista Medical Center Civista Health, Board Of Directors Charles County Department of Health University of Maryland Clinical Trials Program Bel Alton Alumni Community Development Association Charles County Department of Community Services, Transportation Tri County Council for Southern Maryland Ministers Alliance of Charles County Charles County Department of Social Services Maryland Foundation for Quality Healthcare Health Partners Clinic Greater Baden FQHC Shiloh Community United Methodist Church Charles County Nursing and Rehabilitation Center Alzheimers Association Center for Children Chesapeake Potomac Home Health Agency College of Southern Maryland Charles County Department of Aging Priority Partners Big Brothers/Big Sisters Community Hispanic Advocates Black Leadership Council for Excellence Young Researchers Community Project Pinnacle Center (Mental Health) Hospice of Charles County Breast Cancer Support Advocates Charles County Public Schools School Nurses Charles County Commissioners Charles County Emergency Services Charles County Sheriffs Office So. MD Delegation Charles County Community Foundation Community Physicians Charles County Fire and Rescue Board Lifestyles, Inc. (Homeless) The plan was presented and approved by the Board of Directors on 01/28/2015. |
| Needs Not Addressed By the Most Recently Conducted CHNA | Schedule H, Part V, Section B, Line 11 All the primary needs outlined in the Community Health Needs Assessment are being addressed and funded by Civista Regional Medical Center either directly (i.e., OB Clinic, Physician Recruitment) or through partnerships with other organizations (i.e., Childhood Obesity Program, Fetal Infant Mortality). Policy to ensure its compliance with IRS regulations. |
| Individuals Eligible for Financial Assistance | Schedule H, Part V, Section B, Line 22D All patients are charged state regulated rates regardless of their ability to pay. |
| Individuals Eligible for Financial Assistance | Schedule 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 ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Related Organization Report | Schedule 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 31 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 Clinic | Schedule 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 Activities | Schedule 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 the 2007 Maryland Physician workforce study, the Southern Maryland region has a physician shortage for primary care physicians. Southern Maryland had the regional low requirement for primary care physicians per 100,000 residents of 56.5. The Maryland state average rate was 58.2 per 100,000 residents. Under medical specialties, the Southern Maryland region has a shortage for cardiology, dermatology, endocrinology, gastroenterology, hematology, oncology, infectious disease, nephrology, psychiatry, pulmonary medicine, and rheumatology. The only medical specialties with adequate physician supplies were allergy and neurology. Charles County has one Neurologist which is deemed adequate for the population; however, the physician plans to retire which will leave the county in a critical shortage in this specialty. 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 Expense | Schedule 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. MEDICARE REIMBURSES MARYLAND HOSPITALS ACCORDING TO RATES ESTABLISHED BY THE HSCRC AS LONG AS THE STATE CONTINUES TO MEET A TWO-PART TEST. THIS TWO-PART WAIVER TEST ALLOWS MEDICARE TO PARTICIPATE IN THE MARYLAND SYSTEM AS LONG AS TWO CONDITIONS ARE MET: ALL OTHER PAYERS PARTICIPATING IN THE SYSTEM PAY HSCRC SET RATES. THE RATE OF GROWTH IN MEDICARE PAYMENTS TO MARYLAND HOSPITALS FROM 1981 TO THE PRESENT IS NOT GREATER THAN THE RATE OF GROWTH IN MEDICARE PAYMENTS TO HOSPITALS NATIONALLY OVER THE SAME TIME FRAME. |
| Collection Practices | Schedule 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. |
| Community Health Care Needs Assessment | Schedule H, Part VI, Line 2 Civista Medical Center completed a comprehensive community health needs assessment (CHNA) for fiscal year 2015 completed on 6/30/16. Fiscal year 2016 completes the first year of the implementation plan, which will be reported in the fiscal year 2016 community benefit report. The following summarizes the results of the community benefit report issued in fiscal year 2015, based on the fiscal year 2012 CHNA. These results represent the third and final year of the 2012 CHNA implementation plan. This process involved the following people: PHCC Executive Committee: Noel A. Cervino CEO Civista Health (CRMC) Dr. Devadason Health Officer CC Health Department (CCDOH) Dr. Brad Gottfried President College of Southern Maryland (CSM) Jim Richmond Superintendent Charles County Public Schools PHCC Steering Committee: Joyce Riggs Dir., Community Dev./ Planning Civista CRMC Fay Reed, RN Deputy Health Officer CCDOH William Leebel Public Information Officer CCDOH Linda Smith Project Coordinator CSM Tanisha Saunders Coordinator of Integrated Student Services CCPS Amber Starn, MPH Epidemiologist (Contract) Civista CRMC Partnerships for a Healthier Charles County: Civista Medical Center Civista Health, Board Of Directors Charles County Department of Health University of Maryland Clinical Trials Program Bel Alton Alumni Community Development Association Charles County Department of Community Services, Transportation Tri County Council for Southern Maryland Minister's Alliance of Charles County Charles County Department of Social Services Maryland Foundation for Quality Healthcare Health Partner's Clinic Greater Baden FQHC Shiloh Community United Methodist Church Charles County Nursing and Rehabilitation Center Alzheimer's Association Center for Children Chesapeake Potomac Home Health Agency College of Southern Maryland Charles County Department of Aging Priority Partners Big Brothers/Big Sisters Community Hispanic Advocates Black Leadership Council for Excellence Young Researchers Community Project Pinnacle Center (Mental Health) Hospice of Charles County Breast Cancer Support Advocates Charles County Public Schools School Nurses Charles County Commissioners Charles County Emergency Services Charles County Sheriff's Office So. MD Delegation Charles County Community Foundation Community Physicians Charles County Fire and Rescue Board Lifestyles, Inc. (Homeless) The plan was presented and approved by the Board of Directors on 11/28/2011. Hospital identified the following as needs of the community: - Reproductive Health - Healthy Babies (Infant Mortality Disparity) - STD Reduction/Prevention - Chronic Disease - Heart Disease - Diabetes - Obesity - Access to Care - Dental health - Transportation - Physician Shortage - Cancer Team - Lung Cancer - Prostate Cancer - Colorectal Cancer - Injury and Violence free Community - Roadway incidents - Injuries and Fall Prevention - Behavioral Health - Substance Abuse - Mental Health Hospital publicized the CHNA via website (www.charlesregional.org) and is available printed upon request. Did Civista Medical Center (CRMC) take into account input from representatives of the community it serves while conducting its CHNA? If yes, please describe how and by whom input was taken. Civista Health (CRMC) and the Charles County Department of Health (CCDOH) collaborated to complete a comprehensive assessment of the health needs (CHNA) of Charles County, Maryland. An epidemiologist with a Master's Degree in Public Health Epidemiology was contracted to analyze the qualitative and quantitative data. Civista lead the effort and covered 80% of the cost of the CHNA. 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, 7 focus groups with community leaders, citizens, and stakeholders, and a quantitative data analysis. The use of the multiple data collection methods strengthened the validity of the assessment's findings, as well as ensured that Charles County residents had an opportunity to participate in the assessment process and to feel invested in its outcome. Three hundred and two (302) Charles County residents completed the 74 question online survey that was created using Survey Monkey. The link to the survey was available on the Civista Health (CRMC) 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 three question survey was distributed throughout the county regarding perceptions of health within the county. A total of 200 short surveys were completed. Surveys were located throughout the county including Civista (CRMC) waiting rooms, CCDOH waiting rooms, libraries, senior centers, community centers. Thirty five were completed in Spanish (17.5%). Seven focus groups were held throughout the county. The focus group topics included: age related health issues, chronic disease specific health, special populations, county leadership, substance abuse, youth through the school nurses, and the Partnerships for a Healthier Charles County (PHCC) (community leaders and stakeholders). Approximately 165 people participated in the county focus groups. Survey for Community Members: 302 Charles County residents completed the 74 question online survey that was created using Survey Monkey. The link to the survey was available on the Civista Health (CRMC) website. A short 3 question survey was distributed throughout the county regarding perceptions of health within the county. A total of 200 short surveys were completed. Surveys were located throughout the county including Civista waiting rooms, Charles County Department of Health waiting rooms, libraries, senior centers, community centers. 35 were completed in Spanish (17.5%). Description of Individuals and Organizations Consulted for CHNA Input: Seven focus groups were held throughout the county with representation from the following organizations. The focus group topics included: age related health issues, chronic disease specific health, special populations, county leadership, substance abuse, youth through the school nurses, and the Partnerships for a Healthier Charles County (PHCC) (community leaders and stakeholders). Approximately 165 people participated in the county focus groups from the following Organizations. Organization Representative Name Title Amber Starn Epidemiologist CC Dept of Health Faye Grillo Deputy Health Officer Bel Alton Community Development Center Judy Rudolf Dept. of Community Services Brenda Walcott Van Go Jeff Barnett Donna Harris Tri County Council for So MD Elaine Lancaster First Gospel Church of Bryans Road Rev. James Briscoe Pastor Department of Social Services Juan Thompson Ombudsman Danielle Green Terry Sullivan Lifestyles, Inc. (Homeless) Sandy Washington Ex. Director Marie Robinson Renee Curry Health Partners Clinic Dr. Howard Haft Medical Director Chrissie Mulcahey Ex. Director Hispanic Community Representative Maria Michletec Community member CC Nursing and Rehab. Bud Zimmerman Ex. Director Bill Holman Denise McCann Alzheimer's Association Linda Gottfried Director Center for Children Colleen Wilburn UM CRMC Maureen Jenkins Mgr, Labor and Delivery Chesapeake Potomac Home Health Kelly Winters College of Southern MD Linda Smith CC Dept. Of Aging Bonnie Hampton CC Dept. of Health Linda Blake Director Priority Partners Angela Deale Outreach worker Big Brothers Big Sisters Cynthia Graham Black leadership Council for Excellence Bonita Adeeb Rose Haft Young Researchers CP Anthony Quick Community member Pinnacle Counseling Center Jackie Burson Lic. Counselor Hospice Colleen Wilson CC Dept. of Health Mary Beth Klick Tobacco Counselor UM CRMC Betsy Wolford CDE CCDOH Dawn Cox Breast and Cervical Cancer UM CRMC Dr. Rich Ferraro Med. Dir. ED. Sisters at Heart Roberta Kieliger Chair Cambridge Pediatrics Diana Abney, MD Pediatrician UM CRMC Angie Booker Respiratory Therapist UM CRMC Teresa Brannigan Director of Nursing School Nurses - Sheila Brockman - Cheryl Smith - Peggy Bird - Tammy Dilling - Carolyn Engleson - Tammy Crozier - Jennifer Ledford - Lisa Bazzare - Kathleen DeBolt - Patricia Horner - Karl J.Muehlfeld - Lucy Wathen - Charlene Falken - Joanne Collins - Marge Charron - Elizabeth Gallacher - Erica Hadley - Jan Siewertsen - Lenure Petty - Natasha Williams - Kofo Williams - Nadja De Los Santos - Phyliss Renard - Karen Grace - Deborah Heim - Constance Larsen - Diane Gardiner - Shelley Presnell - Laurie Mulert - Betsy Keesler - Edith Patten - Barbara Balazek - Carole Noyes - Katie Popp - Dorothy Reeves - Kim Jameson - Stephanie Kiesel - Carol A. Dawn Charles Coun |
| Eligibility Education | Schedule H, Part VI, Line 3 Civista Medical Center DBA University of Maryland Charles Regional Medical Center (UM CRMC). 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. In addition, the policy is available on the UM CRMC website and is posted in the local paper twice each year. 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. In compliance with the new IRC Section 501(R) regulations Civista Medical Center is currently in the process of updating their Financial Assistance Policy to ensure its compliance with IRS regulations. |
| Description of Community Served | Schedule H, Part VI, Line 4 The Community Benefit Service Area for Civista Medical Center (UM CRMC) is all 28 zip codes located within the borders of Charles County. This includes the six zip codes identified as the Primary Service Area. Civista Medical Center (UM CRMC) is Charles County's 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 Maryland's twenty four counties and accounts for about 5 percent of Maryland's 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 county's 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 Census Bureau 2012 estimates the population at 150,592 for a 2.8% increase in two 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 42.3 minutes which is higher than the Maryland average by slightly more than 10 minutes. Public transportation consists of commuter bus 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 2012, they comprise 42.4% of the total county population. As of 2012, minorities make up roughly 54% of the Charles County population. The Hispanic community has also seen increases over the past few years. They now comprise 4.7% of the total county population. This is the one of the highest percentages among the 24 Maryland jurisdictions. Economy Employment and economic indicators for the county are fairly strong. The 2010 US Census estimates found that 73.8% of the Charles County population is currently in the labor work force. The 2011 update estimates that approximately 5.6% of Charles County individuals are living below the poverty level, up 0.4% from 2010, however this is lower than the Maryland rate of 9% in 2011. The Charles County median household income was $92,135, an increase of $3,310 over the 2010 estimates and still well above the Maryland median household income of $72,419. The diversity of the county is also represented in the business community with 29.3% of all Charles County businesses being Black owned firms. This is higher than the State of Maryland at 19.3%. Education Charles County has a larger percentage of high school graduates than Maryland (90.6% vs. 88.2%); however, Charles County has a smaller percentage than Maryland of individuals with a bachelor's degree or higher (26.3% vs. 36.1%). Housing There is a high level of home ownership in Charles County (80.1%), however, this is slightly down from the 2010 level of 81.8%. The median value of a housing unit in Charles County is higher than the Maryland average ($341,200 vs. $319,800). Home values across Maryland have decreased and Charles County showed a slightly larger decrease than the Maryland average (4% vs. 3%). The average household size in Charles County is 2.86 persons. Life Expectancy The life expectancy for a Charles County resident, as calculated for 2009 2011, was 78.4 years. This is similar to the state average life expectancy of 79.2 years. Births There were 1,923 births in Charles County in 2012. Charles County represents 54% of the births in Southern Maryland (up 11% from 2009) and 2.6% of the total births in Maryland for 2012. Minorities made up just over half of the babies born in Charles County in 2012 (51.5%) which is in line with the composition of the county. Source: 2012 Maryland Vital Statistics Report |
| Promoting the Health of the Community | Schedule H, Part VI, Line 5 Implementation Strategy: The Charles County Health Improvement Plan (CCHIP): Upon completion of the CHNA, the Steering Committee of Partnerships for a Healthier Charles County (PHCC) reviewed the results and the identified top 11 health needs. The Steering Committee set county objectives through 2015 based on Maryland SHIP objectives and Healthy People 2020 Goals. The results and goals were presented to the PHCC membership at the quarterly General Membership Meeting. Six teams were formed based on expertise and interest to formulate 3 year action plans to address the following health needs using one or more of the "Seven Strategies for Community Change" found on the last page of the Charles County Health Improvement Plan. 1. Reproductive Health A. Healthy Babies (Infant Mortality Disparity) B. STD Reduction/Prevention 2. Chronic Disease A. Heart Disease B. Diabetes C. Obesity 3. Access to Care A. Dental health B. Transportation C. Physician Shortage 4. Cancer Team A. Lung Cancer B. Prostate Cancer C. Colorectal Cancer 5. Injury and Violence free Community A. Roadway incidents B. Injuries and Fall Prevention 6. Behavioral Health A. Substance Abuse B. Mental Health The Charles County Health Needs Assessment and Health Improvement Plan were presented to the Civista Health Board (UM CRMC) of Directors and approved. Annual updates to the Plan are reviewed and approved. The CCHIP objectives are the Charles County Health Improvement Plan and available at: http://www.charlesregional.org/index.cfm? fuseaction=HealthResources.showHealthActionPlans The Health Improvement Team Action Plans (Implementation Plans) are available at: http://www.charlesregional.org/index.cfm?fuseaction=HealthResources. showHealthActionPlans All the primary needs outlined in the Needs Assessment are being addressed by Civista Health (UM CRMC) either directly (i.e., OB Clinic, Physician Recruitment) or through partnerships with other organizations (i.e., Childhood Obesity Program, Fetal Infant Mortality, Prostate Cancer) or through the PHCC which is led and primarily financed by Civista Health (UM CRMC). Where a need is appropriately addressed by another entity, Civista provides leadership through the Charles County Health Improvement Plan and the local health coalition (PHCC) to communicate initiatives, provide financial support and/or assistance when needed and review results (i.e., Substance Abuse, Mental Health). All the primary needs outlined in the Needs Assessment are being addressed and funded by Civista (UM CRMC) either directly (i.e., OB Clinic, Physician Recruitment) or through partnerships with other organizations (i.e., Childhood Obesity Program, Fetal Infant Mortality). Where a need is appropriately addressed by another entity, Civista provides leadership through the Charles County Health Improvement Plan and the coalition of Partnerships for a Healthier Charles County to communicate initiatives, provide assistance when needed and review results (i.e., Substance Abuse, Mental Health). The majority of the governing body, the Board of Directors, of Civista Medical Center (UM CRMC) is comprised of persons who reside in the community served by the hospital and who are neither employees nor contractors of the organization. Civista Medical Center (UM CRMC) extends medical privileges to all qualified medical staff in the community. Continuing Medical Education seminars and Grand Rounds are open to all community physicians. |
| Affiliated Health Care System Roles | Schedule 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 Filings | Schedule H, Part VI, Line 7 Community Benefit Report was filed in the state of Maryland. |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (true) | GrantRecordsMaintainedInd |
Recipient Table RecipientTable (2 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | Recipient EINRecipientEIN | Cash GrantCashGrantAmt | Purpose Of GrantPurposeOfGrantTxt | IRC SectionIRCSectionDesc |
|---|---|---|---|---|---|---|---|
| Charles County Chamber of Commerce | |||||||
| 101 Centennial St Ste A laplata | La Plata | MD | 20646 | 520699475 | $11,150 | 2015 Sponsorship | |
| Charles Regional Medical Center Foundation | |||||||
| 5 Garrett Avenue | La Plata | MD | 20646 | 521414564 | $8,000 | Paint the Town Pink | 501(c)(3) |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total501c3 Org | 2 | Total501c3OrgCnt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Procedure for Monitoring Use of Grant Funds Inside U.S. | FormAndLineReferenceDesc |
| Explanation | Part I, Line 2 CIVISTY 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Club Dues Or Fees | Yes (X) | ClubDuesOrFeesInd |
| Written Policy Ref T And E Expnss | Yes (true) | WrittenPolicyRefTAndEExpnssInd |
| Substantiation Required | Yes (true) | SubstantiationRequiredInd |
| Compensation Committee | Yes (X) | CompensationCommitteeInd |
| Independent Consultant | Yes (X) | IndependentConsultantInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | false | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (true) | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | false | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | false | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | false | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | false | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | false | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | Yes (true) | AnyNonFixedPaymentsInd |
| Initial Contract Exception | false | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (14 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Jon P Burns | ||||||||||||||
| Ex-Officio/Director | $0 | $381,339 | $0 | $154,634 | $0 | $55,236 | $0 | $10,400 | $0 | $9,869 | $0 | $611,478 | $0 | $0 |
| John W Ashworth III | ||||||||||||||
| Ex-Officio/Dir. (thru 1/31/15) | $0 | $373,547 | $0 | $155,458 | $0 | $68,205 | $0 | $10,400 | $0 | $10,695 | $0 | $618,305 | $0 | $0 |
| Robert Chrencik | ||||||||||||||
| Ex-Officio/Director | $0 | $1,183,796 | $0 | $1,004,469 | $0 | $4,692,806 | $0 | $10,400 | $0 | $10,695 | $0 | $6,902,166 | $0 | $4,526,360 |
| Noel Cervino | ||||||||||||||
| Ex-Officio/President & CEO | $356,893 | $0 | $182,000 | $0 | $342,871 | $0 | $10,400 | $0 | $6,575 | $0 | $898,739 | $0 | $0 | $253,407 |
| Erik Boas | ||||||||||||||
| Chief Financial Officer | $202,281 | $0 | $75,000 | $0 | $127,995 | $0 | $8,169 | $0 | $0 | $0 | $413,445 | $0 | $88,982 | $0 |
| Mark R Dumais | ||||||||||||||
| Chief Medical Officer | $283,580 | $0 | $122,005 | $0 | $932 | $0 | $44,441 | $0 | $10,695 | $0 | $461,653 | $0 | $0 | $0 |
| Dana Levy | ||||||||||||||
| Chief Nursing Officer | $179,270 | $0 | $40,014 | $0 | $2,714 | $0 | $23,558 | $0 | $6,906 | $0 | $252,462 | $0 | $0 | $0 |
| Paul Blackwood | ||||||||||||||
| VP Planning | $173,501 | $0 | $40,015 | $0 | $1,042 | $0 | $23,598 | $0 | $10,628 | $0 | $248,784 | $0 | $0 | $0 |
| William Grimes | ||||||||||||||
| VP Ancilliary Services | $154,255 | $0 | $37,500 | $0 | $4,644 | $0 | $20,357 | $0 | $410 | $0 | $217,166 | $0 | $0 | $0 |
| Stacey Cook | ||||||||||||||
| VP Human Resources | $160,449 | $0 | $45,010 | $0 | $2,304 | $0 | $22,435 | $0 | $16,364 | $0 | $246,562 | $0 | $0 | $0 |
| Marilyn Gregory | ||||||||||||||
| RN | $190,595 | $0 | $0 | $0 | $329 | $0 | $2,700 | $0 | $4,845 | $0 | $198,469 | $0 | $0 | $0 |
| Katherine Middleton | ||||||||||||||
| RN | $185,590 | $0 | $0 | $0 | $76 | $0 | $13,300 | $0 | $165 | $0 | $199,131 | $0 | $0 | $0 |
| Eugene Suwandhi MD | ||||||||||||||
| pediatric hospitalist phys. | $173,867 | $0 | $0 | $0 | $100 | $0 | $3,085 | $0 | $4,468 | $0 | $181,520 | $0 | $0 | $0 |
| Gabriel Abiola | ||||||||||||||
| Pharmacist Manager | $159,120 | $0 | $0 | $0 | $780 | $0 | $17,500 | $0 | $4,468 | $0 | $181,868 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Health or Social Club Dues | Schedule 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. |
| SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN | SCHEDULE J, PART I, LINE 4B 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 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: MARK R DUMAIS DANA LEVY PAUL BLACKWOOD WILLIAM GRIMES 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 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: JOHN W. ASHWORTH, III JON BURNS 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 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). ROBERT CHRENCIK NOEL CERVINO ERIK BOAS |
| Non-fixed payments | Schedule 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 O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (8 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Tax Exempt Bond Issues | Form 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, 2015. 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 Stockholders | Form 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 Process | Form 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 & Enforcement | Form 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 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, 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 Compensation | Form 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 Public | Form 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 Entities | FORM 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 Balances | Form 990, Part XI, Line 9 Change in Equity of Affiliates, ccs -3,489,794 Change in Equity of Affiliates, chi -10,000,000 Change in Equity of Affiliates, ccp -4,061,250 Change in Equity of Affiliates, Foundation -11,752 Change in FMV of Alternative Investments -47,986 Pension liability adjustment -991,664 ------------ -18,602,446 |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (39 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|---|
| 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 Drive | Glen Burnie | MD | 21061 | 521830243 | Healthcare | MD | 501(c)(3) | 11a | UMBWMS | false |
| Baltimore Washington Medical Center Inc | ||||||||||
| 301 Hospital Drive | Glen Burnie | MD | 21061 | 520689917 | Healthcare | MD | 501(c)(3) | 03 | UMBWMS | false |
| UMD Baltimore Washington Medical Center | ||||||||||
| 301 Hospital Drive | Glen Burnie | MD | 21061 | 521830242 | Healthcare | MD | 501(c)(3) | 11a | UMMSC | false |
| BW Medical Center Foundation Inc | ||||||||||
| 301 Hospital Drive | Glen Burnie | MD | 21061 | 521813656 | Fundraising | MD | 501(c)(3) | 11c | UMBWMS | false |
| North Arundel Development Corporation | ||||||||||
| 301 Hospital Drive | Glen Burnie | MD | 21061 | 521318404 | Real Estate | MD | 501(c)(2) | ncc | false | |
| North County Corporation | ||||||||||
| 301 Hospital Drive | Glen Burnie | MD | 21061 | 521591355 | Real Estate | MD | 501(c)(2) | UMBWMS | false | |
| Shipleys Choice Medical Park Inc | ||||||||||
| 22 South Greene Street | Baltimore | MD | 21201 | 043643849 | Real Estate | MD | 501(c)(2) | ncc | false | |
| Chester River Health Foundation Inc | ||||||||||
| 100 Brown Street | Chestertown | MD | 21620 | 521338861 | Fundraising | MD | 501(c)(3) | 08 | umsrh | false |
| Univ of MD Shore Regional HealthInc | ||||||||||
| 100 Brown Street | Chestertown | MD | 21620 | 522046500 | Healthcare | MD | 501(c)(3) | 11a | UMMSC | false |
| Chester River Hospital Center | ||||||||||
| 100 Brown Street | Chestertown | MD | 21620 | 520679694 | Healthcare | MD | 501(c)(3) | 03 | umsrh | false |
| Chester River Manor Inc | ||||||||||
| 200 Morgnec Road | Chestertown | MD | 21620 | 526070333 | Healthcare | MD | 501(c)(3) | 09 | umsrh | false |
| Maryland General Clinical Practice Group | ||||||||||
| 827 Linden Avenue | Baltimore | MD | 21201 | 521566211 | Healthcare | MD | 501(c)(3) | 11b | ummth | false |
| Maryland General Comm Health Foundation | ||||||||||
| 827 Linden Avenue | Baltimore | MD | 21201 | 522147532 | Fundraising | MD | 501(c)(3) | 11c | ummth | false |
| University of Maryland Midtown Health | ||||||||||
| 827 Linden Avenue | Baltimore | MD | 21201 | 521175337 | Healthcare | MD | 501(c)(3) | 11b | UMMSC | false |
| Maryland General Hospital Inc | ||||||||||
| 827 Linden Avenue | Baltimore | MD | 21201 | 520591667 | Healthcare | MD | 501(c)(3) | 03 | ummth | false |
| Care Health Services Inc | ||||||||||
| 219 South Washington Street | Easton | MD | 21601 | 521510269 | Healthcare | MD | 501(c)(3) | 09 | umsrh | false |
| Dorchester General Hospital Foundation | ||||||||||
| 219 South Washington Street | Easton | MD | 21601 | 521703242 | Fundraising | MD | 501(c)(3) | 11d | umsrh | false |
| Memorial Hospital Foundation Inc | ||||||||||
| 219 South Washington Street | Easton | MD | 21601 | 521282080 | Fundraising | MD | 501(c)(3) | 11a | umsrh | false |
| UM Community Medical Group Inc | ||||||||||
| 920 Elkridge Landing Road | Linthicum | MD | 21090 | 521874111 | Healthcare | MD | 501(c)(3) | 03 | UMMSC | false |
| Shore Health System Inc | ||||||||||
| 219 South Washington Street | Easton | MD | 21601 | 520610538 | Healthcare | MD | 501(c)(3) | 03 | UMMSC | false |
| James Lawrence Kernan Hosp Endow Fd | ||||||||||
| 2200 Kernan Drive | Baltimore | MD | 21207 | 237360743 | Fundraising | MD | 501(c)(3) | 11b | UMMSC | false |
| James Lawrence Kernan Hospital Inc | ||||||||||
| 2200 Kernan Drive | Baltimore | MD | 21207 | 520591639 | Healthcare | MD | 501(c)(3) | 03 | UMMSC | false |
| UMMS Foundation Inc | ||||||||||
| 22 South Greene Street | Baltimore | MD | 21201 | 522238893 | Fundraising | MD | 501(c)(3) | 11a | UMMSC | false |
| University of MD Medical System Corp | ||||||||||
| 22 South Greene Street | Baltimore | MD | 21201 | 521362793 | Healthcare | MD | 501(c)(3) | 03 | NA | false |
| University of Maryland Charles Regional | ||||||||||
| PO Box 1070 | La Plata | MD | 20646 | 522155576 | Healthcare | MD | 501(c)(3) | 11c | UMMSC | false |
| Charles Regional Medical Center Foundati | ||||||||||
| PO Box 1070 | La Plata | MD | 20646 | 521414564 | Fundraising | MD | 501(c)(3) | 11a | umcrh | false |
| Charles Regional Medical Center Auxiliar | ||||||||||
| PO Box 1070 | La Plata | MD | 21204 | 521131193 | Fundraising | MD | 501(c)(3) | 11a | umcrh | false |
| Univ of MD St Joseph Foundation Inc | ||||||||||
| 7601 Osler Drive | Towson | MD | 21014 | 521681044 | Fundraising | MD | 501(c)(3) | 11a | UMMSC | false |
| Harford Memorial Hospital Inc | ||||||||||
| 520 Upper Chesapeake Dr | Bel Air | MD | 21014 | 520591484 | Healthcare | MD | 501(c)(3) | 03 | UMUCHS | false |
| UCH Legacy Funding Corporation | ||||||||||
| 520 Upper Chesapeake Dr | Bel Air | MD | 21014 | 520882914 | Fundraising | MD | 501(c)(3) | 11a | UMUCHS | false |
| Univ of MD Upper Chesapeake Health Sys | ||||||||||
| 520 Upper Chesapeake Dr | Bel Air | MD | 21014 | 521398513 | Healthcare | MD | 501(c)(3) | 11c; III-FI | UMUCHS | false |
| Upper Chesapeake Health Foundation Inc | ||||||||||
| 520 Upper Chesapeake Dr | Bel Air | MD | 21014 | 521398507 | Fundraising | MD | 501(c)(3) | 11a | UMUCHS | false |
| Upper Chesapeake Medical Center Inc | ||||||||||
| 520 Upper Chesapeake Dr | Bel Air | MD | 21014 | 521253920 | Healthcare | MD | 501(c)(3) | 03 | UMUCHS | false |
| Upper Chesapeake Medical Services Inc | ||||||||||
| 520 Upper Chesapeake Dr | Bel Air | MD | 21014 | 521501734 | Healthcare | MD | 501(c)(3) | 09 | 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 | ||||||||||
| 520 Upper Chesapeake Dr | Bel Air | MD | 21014 | 260737028 | Hospice | MD | 501(c)(3) | 07 | UMUCHS | false |
| Upper ChesapeakeSt Joe's Home Careinc | ||||||||||
| 520 Upper Chesapeake Dr | Bel Air | MD | 21204 | 521229742 | Hospice | MD | 501(c)(3) | 09 | UMUCHS | false |
| UMSJ Health System LLC | ||||||||||
| 7601 Osler Drive | Towson | MD | 21204 | 460797956 | Healthcare | MD | 501(c)(3) | 03 | UMMSC | false |
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (10 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Predominant Income TypePredominantIncomeTypeTxt |
|---|---|---|---|---|---|---|---|---|
| Arundel Physicians Associates LLC | ||||||||
| 301 Hospital Drive | Glen Burnie | MD | 20161 | 522000762 | Healthcare | MD | NA | N/A |
| Baltimore Washington Imaging LLC | ||||||||
| 301 Hospital Drive | Glen Burnie | MD | 20161 | 200806027 | Healthcare | MD | NA | N/A |
| NAHSunrise of Severna Park LLC | ||||||||
| 301 Hospital Drive | Glen Burnie | MD | 20161 | 541810729 | Healthcare | MD | NA | N/A |
| North Arundel Senior Living LLC | ||||||||
| 301 Hospital Drive | Glen Burnie | MD | 20161 | 541810728 | Healthcare | MD | NA | N/A |
| Innovative Health LLC | ||||||||
| 29165 Canvasback Drive Suite 100 | Easton | MD | 21601 | 521997287 | Billing | MD | NA | N/A |
| Central Maryland Radiology Oncology LLC | ||||||||
| 10710 Charter Drive | Columbia | MD | 21044 | 270879418 | Healthcare | MD | NA | N/A |
| Universitycare LLC | ||||||||
| 22 South Greene Street | Baltimore | MD | 21201 | 521914892 | Healthcare | MD | NA | N/A |
| O'Dea Medical Arts Limited Partnership | ||||||||
| 7601 Osler Drive | Towson | MD | 21204 | 521682964 | Rental | MD | NA | N/A |
| Advanced Imaging at St Joseph Medical C | ||||||||
| 7601 Osler Drive | Towson | MD | 21204 | 521958002 | Healthcare | MD | NA | N/A |
| UCHSUMMS Real Estate Trust | ||||||||
| 520 Upper Chesapeake Dr | Bel Air | MD | 21014 | 276803540 | Real Estate | MD | NA | N/A |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (12 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Entity TypeEntityTypeTxt | Address Line1ForeignAddress/AddressLine1Txt | CityForeignAddress/CityNm | Province Or StateForeignAddress/ProvinceOrStateNm | CountryForeignAddress/CountryCd | Legal Domicile Foreign CountryLegalDomicileForeignCountryCd |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Arundel Physicians Associates Inc | |||||||||||||
| 301 Hospital Drive | Glen Burnie | MD | 21061 | 521992649 | Healthcare | MD | NA | C Corp | |||||
| Baltimore Washington Health Enterprises | |||||||||||||
| 301 Hospital Drive | Glen Burnie | MD | 21061 | 521936656 | Healthcare | MD | NA | C Corp | |||||
| BW Professional Services Inc | |||||||||||||
| 301 Hospital Drive | Glen Burnie | MD | 21061 | 521655640 | Healthcare | MD | NA | C Corp | |||||
| Univ of Maryland Charles Regional Care P | |||||||||||||
| PO Box 1070 | La Plata | MD | 20646 | 522176314 | Healthcare | MD | NA | C Corp | |||||
| University Midtown Prof Center A Condo | |||||||||||||
| 827 Linden Avenue | Baltimore | MD | 21201 | 521891126 | Real Estate | MD | NA | C Corp | |||||
| NA Executive Building Condo Assn Inc | |||||||||||||
| 301 Hospital Drive | Glen Burnie | MD | 21061 | Real Estate | MD | NA | C Corp | ||||||
| Terrapin Insurance Company | |||||||||||||
| 980129232 | Insurance | NA | C Corp | ||||||||||
| UMMS Self Insurance Trust | |||||||||||||
| 22 South Greene Street | Baltimore | MD | 21201 | 526315433 | Insurance | MD | NA | Trust | |||||
| Upper Chesapeake Insurance Company | |||||||||||||
| 980468438 | Captive Insurance | NA | ltd | PO Box 1109 | Grand Cayman | Cayman Islands | CJ | CJ | |||||
| Upper Chesapeake Health Ventures Inc | |||||||||||||
| 520 Upper Chesapeake Dr | Bel Air | MD | 21014 | 522031264 | Healthcare | MD | NA | C Corp | |||||
| Upper Chesapeake Medical Center Land Con | |||||||||||||
| 520 Upper Chesapeake Dr | Bel Air | MD | 21014 | 770674478 | Real Estate | MD | NA | C Corp | |||||
| Upper Chesapeake Medical Office Building | |||||||||||||
| 520 Upper Chesapeake Dr | Bel Air | MD | 21014 | 521946829 | Real Estate | MD | NA | C Corp | |||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | false | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | false | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | false | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | false | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | false | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | false | DivRelatedOrganizationInd |
| Asset Sale To Other Org | false | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | false | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | Yes (true) | AssetExchangeInd |
| Rental Of Facilities To Oth Org | false | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | false | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | false | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | false | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | Yes (true) | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (true) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | false | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | Yes (true) | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | Yes (true) | TransferToOtherOrgInd |
| Transfer From Other Org | Yes (true) | TransferFromOtherOrgInd |
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