2015-05-14T08:27:51-05:00 2014-06-30 ERNST & YOUNG US LLP 111 MONUMENT CIRCLE SUITE 4000 INDIANAPOLIS IN 46204 990 2013-07-01 520591612 Frederick Memorial Hospital Inc % Michelle K Mahan FRED 2405663300 400 WEST SEVENTH STREET Suite FREDERICK MD 21701 Michelle K Mahan Sr VP and CFO 2015-05-13 JENNIFER L LYNCH P01255855 2013 2016-02-25 16:41:14Z Thomas A Kleinhanzl 400 West Seventh Street Frederick MD 21701 355127718 false X WWW.FMH.ORG 1897 MD TO CONTRIBUTE TO THE HEALTH AND WELL-BEING OF AREA RESIDENTS BY PROVIDING QUALITY HEALTHCARE IN A CARING, COST EFFICIENT, SAFE AND CONVENIENT MANNER. 18 13 2795 716 -12372 -12372 1286310 3113985 339333256 319339606 4654109 5486185 -463760 -705559 344809915 327234217 100000 100000 0 0 180677969 160554877 48000 48000 795247 159527803 158991207 340353772 319694084 4456143 7540133 443861280 459957008 256998009 258708711 186863271 201248297 X THE MISSION OF FREDERICK MEMORIAL HOSPITAL, INC. IS TO CONTRIBUTETO THE HEALTH AND WELL-BEING OF AREA RESIDENTS BY PROVIDING QUALITYHEALTH CARE IN A CARING, COST EFFICIENT, SAFE AND CONVENIENT MANNERTHROUGH A COORDINATED PROGRAM OF PREVENTION, DIAGNOSIS AND TREATMENT, REHABILITATION, AND SUPPORT. false false 34290312 100000 51740058 Inpatient Medical/Surgical In FY2014, Frederick Memorial Hospital's Inpatient Medical-Surgical Departments provided quality, patient-centered care, regardless of ability to pay, to approximately 22,924 in patients and observation patients. Major Medical and Surgical Services include Cardiology, Congestive Heart Failure, Post-Cardiac Catheterization, Center for Chest Pain, Hemodialysis, Peritoneal Dialysis, Neurology, Neurosurgery, Pulmonology, Oncology, Orthopedics, General Medicine and Surgical Care. Inpatient care is supported by a team of Board-Certified Physician Hospitalists. The FMH Joint Works Program with it's UnitedHealth Premium Total Joint Replacement Specialty Center Designation in recognition of quality care, serving approximately XXX patients in 2014. In addition, FMH is designated as a Primary Stroke Center by the Maryland Institute of Emergency Medical Service Systems (MIEMSS) and is recognized with the Stroke Center Gold Performance Award by the American Heart Association. Our Bariatric Surgical Program is gained accreditation by the American Society for Metabolic and Bariatric Surgery as a Bariatric Surgery Center of Excellence. In addition to the program services expense listed here, FMH incurred $42.1 million of general and administrative expenses in meeting the health needs of our primary service area. 36381570 0 55912366 Perioperative Services Frederick Memorial Hospital's Perioperative Services provided high quality care to 12,796 surgical and endoscopy patients in fiscal year 2014. Procedures were performed in our state of the art facility which includes a dedicated imaging room for vascular and other procedures. We have participated in the SCIP Quality improvement project for continual improvements in care following evidence based medicine. We tracked our patient satisfaction through Press Ganey to benchmark our results to the national data base. In addition to the program services expense listed here, FMH incurred $42.1 million of general and administrative expenses in meeting the health needs of our primary service area. 23543606 0 34593501 Oncology FMH's Oncology Program provides integrated, multidisciplinary, patient centered cancer care for patients with malignancies, regardless of ability to pay. Services include medical oncology consultations, chemotherapy, radiation oncology consultations and treatment and surgical oncology consultations and treatment. We offer coordinated multidisciplinary clinics for patients with cancers of the lung, breast and prostate. Integrated palliative care and hospice services, both inpatient and outpatient are available for patients with advanced malignancies. Support services include nutrition, patient navigation and social work, as well as other forms of psychosocial support. For those with additional financial need, financial counselors and a patient assistance fund are available. The program treats approximately 800 newly diagnosed cancers per year and also has a community outreach program that includes education and screening. The program is accredited by the American College of Surgeons Commission on Cancer. In addition to the program services expense listed here, FMH incurred $42.1 million of general and administrative expenses in meeting the health needs of our primary service area. 182611137 0 178571996 276826625 true true false true false false false false false true true false true false true false false true false false true false false true false false true true true false true true false false false false false false false false false false true false false false true true true true false false true 414 0 true 2795 true true true false false false false false false false false false X 18 13 false false false false true true true true true false true true true true true true true true true true true true MD X Michelle K Mahan 2405663350 400 WEST SEVENTH STREET Frederick MD 21701 X Gregory P Dormitzer Director 2.0 0.0 X Bernard Gouin Director 2.0 5.0 X Theodore Luck Director 2.0 0.0 X J Frederick Manning Director 2.0 5.0 X P Gregory Rausch MD Chair, FMH Development Council 6.0 0.0 X E James Reinsch Vice Chairman 2.0 5.0 X X 0 0 0 Anne Herbert Rollins Chairman Of The Board 6.0 5.0 X X Neil Waravdekar MD Chief Of Staff 10.0 0.0 X X 64044 0 0 Rev Roger W Wilmer Jr Director 2.0 0.0 X 1200 0 0 Adriane Wodey Director 2.0 5.0 X X 0 0 0 Shawn Wolf Director 2.0 0.0 X Ravi Yalamanchili Vice Chief Of Staff 6.0 0.0 X 74919 0 0 Cornelius Fay Director 2.0 0.0 X 0 0 0 Terrence McPherson Director 2.0 0.0 X 0 0 0 Laura Melia Director 2.0 0.0 X 0 0 0 Donna Tisdale Director 2.0 0.0 X 0 0 0 Thomas A Kleinhanzl President and CEO 40.0 5.0 X X 792072 0 184505 Gerrit SchipperMDbeg10113 Director 2.0 0.0 X 4666 0 0 John MolesworthDOend93013 Past Chief of Staff 2.0 5.0 X 2000 0 0 John R Verbus Sr VP and COO 40.0 4.0 X 424866 0 56369 Gerald Winnan MD Secretary And Treasurer 4.0 5.0 X 0 0 0 Michelle K Mahan Sr VP and CFO 40.0 1.0 X 428706 0 61785 Jennifer G Teeter AVP Payor Contracting 40.0 0.0 X 182680 0 23727 Shirley B ThompsonEnd123113 Interim Sr VP Patient Care 20.0 0.0 X 212548 0 8065 Jim R Williams VP Business Development and Pr 40.0 0.0 X 219680 0 26003 Manual A Casiano VP Medical Staff 40.0 0.0 X 392311 0 62557 Cheryl L Cioffi VP Chief Nursing Officer 40.0 0.0 X 168809 0 23810 Kenneth R Coffey II VP Chief Development Officer 40.0 0.0 X 202430 0 27802 James S Grissom AVP OF MEDICAL AFFAIRS 20.0 0.0 X 149792 0 14040 Hannah R Jacobs VP-Finance 40.0 0.0 X 184661 0 11421 Rose A Labriolaend 63013 Former Sr VP Patient Care 20.0 0.0 X 113068 0 9724 Rachel I Mandel AVP MEDICAL AFFAIRS 20.0 0.0 X 140572 0 4799 Mary B Mann AVP PATIENT CARE SERVICES 40.0 0.0 X 164401 0 15125 Terry P O'Malley VP Human Resources 40.0 0.0 X 220257 0 44948 David JQuirke VP Chief Information Officer 40.0 0.0 X 302300 0 45969 Craig F Rosendale VP Ancillary Services 40.0 0.0 X 196155 0 23806 Donald R Schilling VP Ambulatory Services 40.0 0.0 X 204712 0 18493 Lucy A ShamashEnd5613 VP SERVICE LINE DEVELOPMENT & 40.0 0.0 X 91498 0 13023 Mark S Soberman Physician 40.0 5.0 X 528944 0 20634 Paul N Chomiak Physician 40.0 5.0 X 445144 0 17356 Mark G Goldstein Physician 40.0 2.0 X 448233 0 25532 Susan Bahl Physician 40.0 0.0 X 458371 0 8601 Kimbiz Tajkarimi Physician 40.0 0.0 X 519883 0 12232 7338922 0 760326 149 false true false TXTEAM REHAB INC 4625 EAST STOP 11 ROAD INDIANAPOLIS IN 46237 REHAB SERVICES 6471643 PRIME DOC OF FREDERICK PA PO BOX 7568 ASHEVILLE NC 28802 PHYSICIAN SERVICES 2156808 QUEST DIAGNOSTICS 12436 COLLECTIONS CENTER DRIVE CHICAGO IL 60693 DIAGNOSTIC SERVICES 1502049 INTEGRATED MEDICAL SYSTEMS INT'L PO Box 2725 COLUMBUS GA 319022725 MANAGEMENT SERVICES 1153697 SLEEPMED DIGITRACE CARE SERVICES 200 CORPORATE PLACE PEABODY MA 11960 MEDICAL SERVICES 1087779 53 0 3113985 395261 3113985 INPATIENT REVENUE 624110 148407184 148407184 0 0 OUTPATIENT REVENUE 621410 164823605 164823605 0 0 TRANSCRIPTION SERVICES 561110 5333 5333 0 0 GROUP PURCHASING -PREMIER 525990 1331739 1344111 -12372 0 HITECH AND MEDICAL HOME 621610 1746830 1746830 0 0 3024915 3024915 0 319339606 2451910 2451910 0 0 505808 505808 0 505808 505808 30927776 27778501 115000 3149275 -115000 3034275 3034275 0 0 0 CAFETERIA AND COFFEE SHOP 722511 1123173 1123173 0 0 MT. 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Central America and the Caribbean 1 Investments 12222022 Central America and the Caribbean 1 Program services SELF-INSURANCE 2693156 2 2 14915178 14915178 true false true false false false X X X X X X X true PRIDE PHILANTHROPY DEV CNSL SRVCS false 48000 48000 MD true true X true X true X true true true false true true 10752167 0 10752167 0.03360 30078569 26064929 4013640 0.01260 0 0 0 0.00000 40830736 26064929 14765807 0.04620 2399426 686720 1712706 0.00540 50053 0 50053 0.00020 14548107 920568 13627539 0.04260 0 0 0 0.00000 0 0 0 0.00000 16997586 1607288 15390298 0.04820 57828322 27672217 30156105 0.09440 false 7769016 583000 122969588 110141082 12828506 X true true 1 1 Frederick Memorial Hospital 400 West Seventh Street Frederick MD 21701 X X X Frederick Memorial Hospital true X X X X X X X X 12 true false true X www.fmh.org X X X X X X X X X true false true true 200. true 300. true X X X true true X X X X X X true false X X X X true X false false Schedule H, Part V, Section B, Line 3 Input from community representatives SEVEN FOCUS GROUPS INCLUDING THIRTY EIGHT (38) REPRESENTATIVES FROM GOVERNMENT AGENCIES, AREA NONPROFITS AND PROFESSIONAL SERVICE PROVIDERS GATHERED TO PROVIDE THEIR ASSESSMENTS OF FREDERICK COUNTY'S HUMAN NEEDS, RELATIVE TO AVAILABLE SERVICES, AND GAPS IN SERVICE PROVISION. INDIVIDUALS WHO WERE INVITED TO ATTEND BUT WERE UNABLE TO DO SO WERE INTERVIEWED BY PHONE. EIGHT KEY INFORMANT INTERVIEWS WERE CONDUCTED WITH CURRENT AND FORMER ELECTED OFFICIALS, CIVIC LEADERS, AND REPRESENTATIVES FROM UNITED WAY OF FREDERICK COUNTY, FREDERICK COUNTY JUDICIARY, AND FREDERICK COUNTY PUBLIC SCHOOLS. A SURVEY WAS CONDUCTED POLLING 111 SERVICE PROVIDERS TO COLLECT INFORMATION ABOUT AVAILABLE SERVICES. THE SURVEY INCLUDED AN OPEN-RESPONSE QUESTION: "IN YOUR PROFESSIONAL OPINION, WHAT ARE THE TOP THREE UNMET NEEDS IN ALL OF FREDERICK COUNTY?" RESPONSES TO THE SURVEY WERE RECEIVED FROM 167 PROGRAMS, WHICH REPRESENTED THE MAJORITY OF THE LARGEST PROVIDERS OF HUMAN NEEDS SERVICES. THE RESPONSES TO THE QUESTION WERE USED AS PART OF THE HUMAN NEEDS ASSESSMENT PORTION OF THE ANALYSIS. A FOCUS GROUP COMPRISED OF 15 INDIVIDUALS WHO WERE RECIPIENTS OF FREDERICK COUNTY HUMAN SERVICES PROGRAMS INCLUDING SERVICES FOR PEOPLE WHO ARE HOMELESS, FREE CLINIC PATIENTS, AND CONSUMERS OF SOUP KITCHENS AND FOOD PROGRAMS, WAS CONDUCTED. PARTICIPANTS WERE ASKED ABOUT THEIR DAILY NEEDS, PROGRAMS THAT HAVE HELPED THEM AND WHY, THEIR UNMET NEEDS, AND THE NEEDS OF COMMUNITY YOUTH. COMMUNITY FOUNDATION LEADERS WHO PARTICIPATED IN UNITED WAY OF FREDERICK COUNTY'S STRATEGIC PLANNING PROCESS CONTRIBUTED THEIR NOTES, WHICH ALSO WERE USED IN GAUGING COMMUNITY HUMAN NEEDS. A SURVEY OF THE GENERAL PUBLIC WAS CONDUCTED ASKING RESPONDENTS TO RANK UNMET NEEDS IN THE COMMUNITY FOUNDATION'S THREE CORE STRATEGIC AREAS: HEALTH, YOUTH, AND BASIC HUMAN NEEDS. ONE HUNDRED AND FOURTEEN RESPONSES WERE RECEIVED, WITH THE SURVEY'S AVAILABILITY REPORTED IN LOCAL PRINT MEDIA, ON THE COMMUNITY FOUNDATION'S WEBSITE, THROUGH EMAIL BLASTS, AND SOCIAL MEDIA. THE PRIMARY SOURCE DATA WAS SUPPLEMENTED BY THIRD PARTY FOCUS GROUPS AND SURVEYS, MOST NOTABLY THOSE OF UNITED WAY OF FREDERICK COUNTY AND THE FREDERICK COUNTY LOCAL MANAGEMENT BOARD. THE REPORT ALSO INCLUDES A PRELIMINARY AGGREGATION OF SERVICE DELIVERY ISSUES RAISED BY KEY LOCAL PARTICIPANTS IN THE ASSESSMENT, AS WELL AS SUGGESTED QUANTIFIABLE INDICATORS FOR DISCUSSION BY THE COMMUNITY FOUNDATION AND COMMUNITY PARTNERS OF HOW TO MEASURE PROGRESS AND IMPACT. THE QUALITATIVE ANALYSIS OF NEEDS, SUPPLY OF SERVICES, AND GAPS IN SERVICES RELIED TO A LARGE EXTENT ON THE KNOWLEDGE AND OPINIONS OF FREDERICK COUNTY "EXPERTS," INDIVIDUALS WHO HAVE LONG EXPERIENCE IN DELIVERING HUMAN SERVICES IN FREDERICK COUNTY OR WHO ARE CURRENTLY OR IN THE PAST HELD ELECTED OR APPOINTED POLICY MAKING POSITIONS. Schedule H, Part V, Section B, Line 7 While Frederick Memorial Hospital has responded to nearly all of the identified community health care needs from the 2012 CHNA, the one goal that has not yet been met is to increase access to dental care for the residents of Frederick County. As of June 2014, FMH was still in collaboration with University of Maryland to partner on this initiative and to determine a location of a facility with proximity to FMH emergency services. The project had been delayed but is now scheduled to launch in January 2016 to provide acute dental care to the underserved & uninsured residents of Frederick County. Schedule H, Part V, Section B, Line 18e Other efforts made before initiating collections actions Patients with balances greater than $10,000 receive a special letter stating they may qualify for charity and requests that they contact the hospital. Schedule H, Part V, Section B, Line 20d Other method for determining maximum charged amount Maryland's HSCRC determines rates charged. 16 FMH KLINE HOSPICE HOUSE 7000 KIMMEL ROAD MT AIRY MD 21771 INPATIENT HOSPICE PATIENT FACILITY MT AIRY HEALTH SERVICES 1502 SOUTH MAIN STREET MT AIRY MD 21771 OUTPATIENT HEALTH SERVICE FACILITY PARKVIEW MEDICAL GROUP MT AIRY 1502 SOUTH MAIN STREET MT AIRY MD 21771 PHYSICIAN PRACTICE PARKVIEW MEDICAL GROUP MYERSVILLE 3000-D VENTRIE COURT MYERSVILLE MD 21773 PHYSICIAN PRACTICE PARKVIEW MEDICAL GROUP FREDERICK 1564 OPPOSSUMTOWN PIKE FREDERICK MD 21702 PHYSICIAN PRACTICE FMH REGIONAL CANCER CARE THERAPY CTR 501 WEST SEVENTH STREET FREDERICK MD 21701 OUTPATIENT CANCER TREATMENT CENTER FMH ROSEHILL 1562 OPPOSSUMTOWN PIKE FREDERICK MD 21701 OUTPATIENT HEALTH SERVICE FACILITY UNION BRIDGE FAMILY PRACTICE 104 NORTH MAIN STREET UNION BRIDGE MD 21701 PHYSICIAN PRACTICE FMH HOME HEALTH SERVICES 605 EAST CHURCH STREET FREDERICK MD 21701 HOME HEALTH NURSING ORGANIZATION HOSPICE OF FREDERICK COUNTY 516 TRAIL AVENUE FREDERICK MD 21702 HOSPICE CARE ORGANIZATION FMH ROSE HILL REHAB SERVICES 1562 OPPOSSUMTOWN PIKE FREDERICK MD 21702 PHYSICAL REHABILITATION CLINIC FMH CRESTWOOD 7211 BANK COURT FREDERICK MD 21703 OUTPATIENT HEALTH SERVICE FACILITY FMH WELLNESS CENTER 5500 BUCKEYSTOWN PIKE FREDERICK MD 21702 HEALTH SERVICES CENTER FMH ECHO AND VASCULAR LAB 1560 OPPOSSUMTOWN PIKE FREDERICK MD 21702 HEALTH SERVICES CENTER FMH URBANA 3430 WORTHINGTON BLVD FREDERICK MD 21704 OUTPATIENT HEALTH SERVICE FACILITY FMH IMMEDIATE CARE 850 OAK STREET FREDERICK MD 21702 WALK-IN CLINIC Schedule H, Part I SUPPLEMENTAL INFORMATION FOR THE LAST 30 YEARS, MARYLAND HOSPITALS HAVE MET THEIR COMMUNITY BENEFIT OBLIGATIONS IN A UNIQUE MANNER THAT BUILDS THE COSTS OF UNCOMPENSATED CARE (CHARITY CARE AND PATIENT BAD DEBT) AND GRADUATE MEDICAL EDUCATION INTO THE RATES THAT HOSPITALS ARE REIMBURSED BY ALL PAYORS. THE SYSTEM IS BASED IN FEDERAL AND STATE LAW AND BENEFITS ALL MARYLAND RESIDENTS, INCLUDING THOSE IN NEED OF FINANCIAL ASSISTANCE TO PAY THEIR HOSPITAL BILLS. MARYLAND IS THE ONLY STATE IN WHICH ALL PAYORS (GOVERNMENTALLY-INSURED, COMMERCIALLY-INSURED, OR SELF-PAY) ARE CHARGED THE SAME PRICE FOR SERVICES AT ANY GIVEN HOSPITAL. UNDER THIS SYSTEM, MARYLAND HOSPITALS ARE REGULATED BY A STATE AGENCY, KNOWN AS THE HEALTH SERVICES COST REVIEW COMMISSION (HSCRC), THAT IS REQUIRED TO: -PUBLICLY DISCLOSE INFORMATION ON THE COST AND FINANCIAL POSITION OF HOSPITALS; -REVIEW AND APPROVE HOSPITAL RATES; -COLLECT INFORMATION DETAILING TRANSACTIONS BETWEEN HOSPITALS AND FIRMS WITH WHICH THEIR TRUSTEES HAVE A FINANCIAL INTEREST; AND, -MAINTAIN THE SOLVENCY OF EFFICIENT AND EFFECTIVE HOSPITALS. SINCE 2000, THE RATE SETTING COMMISSION HAS HAD ITS OWN FRAMEWORK FOR REPORTING HOSPITALS' COMMUNITY BENEFITS AND ISSUING A REPORT ANNUALLY REGARDING HOSPITALS' COMMUNITY BENEFIT TOTALS. THAT REPORT IS AVAILABLE ON TTP://WWW.HSCRC.STATE.MD.US/ BECAUSE OF THIS UNIQUE STRUCTURE MARYLAND HOSPITALS' COMMUNITY BENEFITS NUMBERS WILL NOT COMPARE WITH THE REST OF THE NATION'S HOSPITALS. HOWEVER, MARYLAND HOSPITALS MEET OR EXCEED THE COMMUNITY BENEFIT STANDARD ESTABLISHED BY THE IRS IN 1969. ADDITIONAL DETAIL ILLUSTRATING THIS CAN BE FOUND WITHIN THIS SCHEDULE H REPORT. Schedule H, Part I, Line 3C Criteria for Determining Eligibility for Free or Discounted Care In addition to using FPG to determine free and discounted case, patients may receive additional financial assistance if their bill is 25% or more of their annual income. Every inpatient or outpatient who accumulates $10,000 or more in charges receives a visit from a financial counselor along with a financial assistance application. We also mail these patients another financial assistance application with a cover letter stating that due to the balance of their bill, they may qualify for financial assistance. Schedule H, Part I, Line 7 Cost-To-Charge Ratio AMOUNTS WERE CALCULATED USING THE COST-TO-CHARGE RATIO DERIVED FROM WORKSHEET 2. Schedule H, Part III, Line 2 Valuation of bad debt expense Bad debt valuation was calculated using the cost-to-charge ratio derived from worksheet 2. We estimate approximately 7.5% of bad debt expense is attributable to oatients eligible under our financial assistance policy. This is estimate has been reduced from 10% reported previously as we continue efforts to qualify patients for free or reduced care. Schedule H, Part III, Line 4 Text of bad debt expense footnote The System's policy is to write off all patient accounts that have been identified as uncollectible. An allowance for doubtful accounts is recorded for accounts not yet written off that are anticipated to become uncollectible. Insurance coverage and credit information are obtained from patients when available. No collateral is obtained for accounts receivable. Schedule H, Part III, Line 8 Medicare Costing Methodology Medicare PS&R reports used as source of costs and payments. Schedule H, Part III, Line 9b COLLECTION PRACTICES TO THOSE QUALIFYING FOR FINANCIAL ASSISTANCE PATIENTS WHO QUALIFY FOR CHARITY CARE OR FINANCIAL ASSISTANCE ARE SPECIFICALLY EXCLUDED FROM THE COLLECTION PROCESS. Schedule H, Part VI, Needs Assessment Needs Assessment The 2013 Frederick County Health Assessment is a data driven approach to determining the health status of Frederick community residents by capturing and comparing statistical information from three independent community-based health focused and human needs driven organization: - The Frederick Community Foundation's Human Needs Assessment conducted in August of 2011, - The local Health Improvement Plan (L-HIP) Priorities Summit conducted in October of 2011, and - Frederick Memorial Hospital's utilization data for the Emergency room, Inpatient admissions and Outpatient service provision. The FMH data served as an evidence-based confirmation of the other two studies' findings. The comparative assessment findings were additionally verified using the current data from the State Health Improvement Plan. In addition, the assessment uses the most current statistical information available from a variety of resources including the Maryland Health Services Cost Review Commission, the Maryland Behavioral Risk Factor Surveillance System, the Maryland Department of Health and Mental Hygiene, the US Census and other state and federal agencies. The 2013 Community Health Assessment provides the information that the Frederick County Health Department, Frederick Regional Health System, the Frederick County Health Care Coalition and partner grass-roots agencies and organizations need to identify issues of greatest concern. Decisions to commit resources to those areas identified in this comparative study will ensure that our collective efforts have the greatest impact on our community's health status. Project Goals The 2013 Frederick County Health Assessment will serve as a resource and tool for reaching three goals: - To improve the health status of Frederick County residents, elevate their overall quality of life, and increase their life spans. Quality of life issues remain an important component of the plan as all agree that the measure of our community's health goes beyond addressing physical, dental, mental and behavioral health needs. - To identify the socio-economic factors which have historically had a negative impact on our residents' health. By identifying population segments that are most at-risk for various diseases and injuries we will, as a community, be better positioned to address health disparities. - To provide more accessible preventive services to assist community partners in improving the health status of Frederick County residents, and to help us as a community keep the costs of providing care for late-stage disease in check. late-stage disease in check. Schedule H, Part VI, Patient education Patient education FREDERICK MEMORIAL HOSPITAL POSTS ITS CHARITY CARE POLICY AND FINANCIAL ASSISTANCE CONTACT INFORMATION IN ADMISSION AREAS, THE FMH EMERGENCY DEPARTMENT, AND IN ALL OF OUR SATELLITE FACILITIES IN AREAS WHERE ELIGIBLE PATIENTS ARE LIKELY TO PRESENT. FMH PROVIDES A SUMMARY OF THE CHARITY CARE POLICY AND FINANCIAL ASSISTANCE CONTACT INFORMATION TO ALL PATIENTS AT THE TIME OF ADMISSION TO THE HOSPITAL. FMH ADMISSIONS PERSONNEL DISCUSS THE AVAILABILITY OF VARIOUS GOVERNMENT BENEFITS SUCH AS MEDICAID OR STATE PROGRAMS WITH PATIENTS AND/OR THEIR FAMILY MEMBERS, AND THEY ASSIST PATIENTS WITH QUALIFICATION FOR THE PROGRAMS. FREDERICK MEMORIAL HOSPITAL INCREASED ITS EFFORTS TO PROVIDE FINANCIAL ASSISTANCE TO ITS PATIENTS THROUGH A VARIETY OF INITIATIVES. FMH INCREASED ITS FINANCIAL ASSISTANCE FOR CATASTROPHIC SITUATIONS. IN OUR PROGRAM, PATIENTS MAY RECEIVE FINANCIAL ASSISTANCE IF THEIR BILL IS 25% OR MORE OF THEIR ANNUAL INCOME. IN FY11 A FINANCIAL COUNSELOR MET WITH PATIENTS WHO HAD NO INSURANCE THE DAY AFTER ADMISSION TO EXPLAIN OUR FINANCIAL ASSISTANCE PROGRAM AND THE STATE'S MEDICAL ASSISTANCE PROGRAM. BECAUSE THE MEETING WITH THE PATIENT WAS EARLY IN THEIR STAY, THE PATIENT'S ACCUMULATED CHARGES TYPICALLY DID NOT REACH A CATASTROPHIC STAGE. THEREFORE, WE HAD PATIENTS WHO LEFT THE HOSPITAL WITHOUT A DETAILED CATASTROPHIC FINANCIAL ASSISTANCE DISCUSSION AND WITHOUT A FINANCIAL ASSISTANCE APPLICATION. NOW, EVERY INPATIENT OR OUTPATIENT WHO ACCUMULATES $10,000 OR MORE IN CHARGES WILL RECEIVE A SECOND VISIT FROM A FINANCIAL COUNSELOR ALONG WITH A FINANCIAL ASSISTANCE APPLICATION. ALSO, WE MAIL THESE PATIENTS ANOTHER FINANCIAL ASSISTANCE APPLICATION WITH A COVER LETTER STATING THAT DUE TO THE BALANCE OF THEIR BILL, THEY MAY QUALIFY FOR FINANCIAL ASSISTANCE. Schedule H, Part VI, Community information Community Information IN THE YEAR ENDED JUNE 30, 2014, FREDERICK MEMORIAL HOSPITAL ADMITTED 18,614 PATIENTS. THE FMH EMERGENCY DEPARTMENT TREATED 74,079 PATIENTS. THE HOSPITAL IS THE ONLY HOSPITAL LOCATED IN ITS PRIMARY SERVICE AREA AND THE ONLY HOSPITAL WITHIN A 25-MILE RADIUS OF THE CITY OF FREDERICK. APPROX. 10% OF ALL COUNTY RESIDENTS LACK HEALTH INSURANCE AND 9% ARE MEDICAID RECIPIENTS. FMH DEFINES ITS PRIMARY SERVICE AREA AS FREDERICK COUNTY, MARYLAND, WHICH ACCOUNTED FOR APPROXIMATELY 60% OF FMH'S DISCHARGES IN FISCAL YEAR 2013. THE HOSPITAL IS THE ONLY HOSPITAL LOCATED IN ITS PRIMARY SERVICE AREA AND THE ONLY HOSPITAL WITHIN A 25-MILE RADIUS OF THE CITY OF FREDERICK. MT. AIRY THE MOUNT AIRY AREA IS PREDOMINANTLY WHITE (92.1%), WITH SMALLER HISPANIC OR LATINO (4.7%), AFRICAN AMERICAN (2.4%) AND ASIAN (2.2%) POPULATIONS. THE MEDIAN AGE IS 36, WITH APPROXIMATELY 20% OF THE POPULATION IN EACH OF TWO RANGES: 5-14 AND 40-49 YEARS OF AGE. ABOUT 10% OF ALL RESIDENTS ARE AGE 62 OR OLDER. THE POPULATION IS 51.5% FEMALE AND 48.5% MALE. 79% OF MOUNT AIRY RESIDENTS LIVE IN FAMILY HOUSEHOLDS (A HOUSEHOLDER AND ONE OR MORE OTHER PEOPLE RELATED BY BIRTH, MARRIAGE, OR ADOPTION). 86.9% OF THE HOUSING UNITS ARE OWNER-OCCUPIED. THE POVERTY LEVEL IN MOUNT AIRY IS 5.3%, WELL BELOW THE STATE-WIDE RATE OF 12.0%. LIFE EXPECTANCY IS ABOVE THE STATE AVERAGE AT 80.1%. CANCER AND HEART DISEASE (INCLUDING STROKE) RATE HIGHEST IN TERMS OF CAUSES OF DEATH AND YEARS OF POTENTIAL LIFE LOST. ABOUT 5.0% OF THE RESIDENTS IN THIS AREA LIVE WITH CHRONIC HEART DISEASE, JUST 1.3% HAVE HAD A STROKE, AND 28.5% HAVE BEEN TOLD THEY HAVE HIGH BLOOD PRESSURE. 6.1% HAVE BEEN DIAGNOSED WITH SKIN CANCER AND ANOTHER 6.8% HAVE BEEN DIAGNOSED WITH ANOTHER FORM OF CANCER. THURMONT THURMONT'S POPULATION IS FAIRLY EVENLY DISTRIBUTED IN TERMS OF AGE, WITH THE LARGEST COHORT (18%) IN THE 40-49 AGE BRACKET. RESIDENTS ARE 95.8% WHITE, 2.4% HISPANIC OR LATINO, AND 1% AFRICAN AMERICAN. NEARLY 16% OF THURMONT'S POPULATION IS AGE 62 OR OLDER. SIMILARLY TO MOUNT AIRY, THE POPULATION IS 48.4% MALE AND 51.6% FEMALE. 72% OF THURMONT RESIDENTS LIVE IN FAMILY HOUSEHOLDS, WITH 74.7% OF HOUSING UNITS OCCUPIED BY THE PROPERTY OWNER. 7.2% OF RESIDENTS IN THE AREA EARN INCOME BELOW THE POVERTY LEVEL. AGAIN, CANCER AND HEART DISEASE (INCLUDING STROKE) RATE HIGHEST IN TERMS OF CAUSES OF DEATH AND YEARS OF POTENTIAL LIFE LOST. ABOUT 4.6% OF RESIDENTS IN THIS AREA SUFFER FROM CHRONIC HEART DISEASE, 4.1% HAVE HAD A STROKE, AND 24.7% HAVE BEEN TOLD THEY HAVE HIGH BLOOD PRESSURE. 6.8% HAVE BEEN DIAGNOSED WITH SKIN CANCER AND ANOTHER 8.1% HAVE BEEN DIAGNOSED WITH ANOTHER FORM OF CANCER. FREDERICK CITY AND SUBURBS FREDERICK CITY AND ITS IMMEDIATE SUBURBS ARE MORE RACIALLY DIVERSE THAN EITHER THURMONT OR MT. AIRY, WITH WHITE (63.9%), AFRICAN AMERICAN (18.6%), HISPANIC OR LATINO (14.4%) AND ASIAN (5.8%) GROUPS ACCOUNTING FOR THE LARGEST PERCENTAGES. RESIDENTS ARE EVENLY DISTRIBUTED IN TERMS OF AGE, WITH THE LARGEST GROUP (17%) APPEARING IN THE 25-34 AGE BRACKET. THE POPULATION IS 48.2% MALE AND 51.8% FEMALE. JUST 60.5% OF THIS AREA'S RESIDENTS LIVE IN FAMILY HOUSEHOLDS, WITH A RELATIVELY EVEN SPLIT BETWEEN OWNER-OCCUPIED (57.6%) AND RENTER-OCCUPIED (42.4%) HOUSING. 12.1% OF RESIDENTS IN THIS AREA LIVE BELOW THE POVERTY LEVEL, WHICH IS JUST ABOVE THE STATE AVERAGE OF 12.0%. AS IN THE OTHER TWO AREAS DESCRIBED, CANCER AND HEART DISEASE (INCLUDING STROKE) RATE HIGHEST IN TERMS OF CAUSES OF DEATH AND YEARS OF POTENTIAL LIFE LOST. 6.5% OF THE RESIDENTS IN THIS AREA LIVE WITH CHRONIC HEART DISEASE, 3.1% HAVE SUFFERED A STROKE, and 30.2% HAVE BEEN TOLD THEY HAVE HIGH BLOOD PRESSURE. 4.0% REPORT BEING DIAGNOSED WITH SKIN CANCER AND ANOTHER 4.5% HAVE BEEN DIAGNOSED WITH ANOTHER FORM OF CANCER. Schedule H, Part VI, Promotion of community Promotion of Community Health The Community Needs Health Assessment identified lung disease as focus need: Camp YesUCan is a day-long event for children with asthma. The goal of the camp is to remind children with asthma that they can safely enjoy sports and many other outdoor activities without fearing the onset of an asthma attack. Eight children participated in this year's event. Under the watchful supervision of highly skilled nurses, respiratory therapists and certified asthma educators - the campers learned how asthma attacks start and how they can be avoided. They were taught how to take their medications appropriately and what to do to manage the onset of an attack. Several activities made the learning easy and demonstrated to the children that they can participate in sports without fear of an asthma attack. Games highlighted how the lungs work and what happens internally during an asthma attack. Running between educational goals with make-shift airways created a fun and safe competition. Our Frederick County Rescue Squad brought an ambulance and explained to the children the various features of the ambulance. The children were allowed to walk around in the ambulance and appropriately play with the features which will help dispel fear of our emergency rescue vehicles in case they find themselves in an emergency situation in the future. The participants in this year's Camp YesUCan were all well known to the Respiratory Therapy staff and to the nurses and physicians in the FMH Emergency Department. Each of the children had logged numerous repeat visits to the ED due an exacerbation of their asthma symptoms. In FY14, the emergency department staff in conjunction with Respiratory Therapy recorded the incidence of these patients requiring emergency intervention due to an asthma attack or an exacerbation of symptoms. The FMH Pulmonary Community Outreach Program will continue with Camp YesUCan and the other programs, events and educational opportunities to inform the community about practicing good lung health and controlling environmental triggers. The Community Needs Health Assessment identified heart disease as focus need: Stroke Workshops were provided to those communities in our service area where the incidence of heart and vascular disease are more prevalent with the goal of increasing awareness about the signs and Symptoms of stroke. Chronic disease management: Heart Disease -FMH data shows that the preponderance of heart disease strikes white men, 65 + years of age. The cohort accounts for 49% (1,628) of the 3,206 heart patients admitted to FMH in FY 2012. -The African American community is impacted by a greater degree as measured by percentage of that race's population in Frederick. -In FY 2012, the total number of cases (inpatient and outpatient) with the diagnosis of heart disease or a disease of the circulatory system equaled 28, 467. -Six percent of the Frederick County population suffers from chronic heart disease. Stroke Workshops Stroke Workshops were provided to those communities in our service area where the incidence of heart and vascular disease are more prevalent with the goal of increasing awareness about the signs and symptoms of stroke. The Director of the FMH Stroke Program attended a number of community meetings and event to educated attendees about the risk factors associated with cardiovascular disease. Attendees are given information on risk factors and steps they can take right away to change their own risk for stroke. Because the onset of coronary artery disease, vascular disease and the predilection to atherosclerosis all have a genetic component, it is difficult to ascertain what impact, if any, a focused awareness campaign about the signs and symptoms of stroke may have on a given population. An immediate evaluation tool was used to assess whether the attendees learned and retained some of the pertinent information presented in the workshops. At the conclusion of the workshops, approximately ninety-eight (98%) percent of the attendees are able to name and identify stroke signs and symptoms and know what to do in case they, or someone they know, are having a stroke. FMH will continue to offer free Stroke Workshops to the citizens of Frederick County to increase awareness and provide details on stroke care and prevention. Efforts will focus even more specifically in those underserved communities in which the incidence of cardiovascular disease is highest in Frederick County. The Community Needs Health Assessment identified lung disease as focus need: Access to care: Prenatal care. The FMH Prenatal Center provides prenatal care for Frederick County residents who are underinsured or uninsured and who may be unable to obtain prenatal care from private obstetricians. Many of the women in the Prenatal Center's programs are high-risk maternity patients, who present with medical conditions that may pose significant maternal and infant risk. FMH Prenatal Center practitioners are certified nurse midwives, under the supervision of Dr. Edwin Chen, Medical Director for the Prenatal Center, and Dr. Wayne Kramer, a Maternal Fetal Medicine specialist with Mid Maryland Perinatology Associates, who are able to diagnose and treat normal pregnancies as well as high risk pregnancies. PNC medical assistants, and a Certified Spanish interpreter complete the staff members in the Prenatal Center which is under the umbrella of Women's and Children's Services supervised by a masters prepared nursing director. Access to the FMH Prenatal Center is primarily from self-referrals, as well as referrals from Frederick County Health Department (FCHD), and Mission of Mercy. This initiative was implemented after the first FCHD health needs assessment demonstrated that there were significant unmet needs for prenatal care. The FMH Auxiliary contributed significant funds for the first four years of the PNC. FMH Leadership is committed to the continuation of the PNC due to the significant improvement in access to prenatal care and improvements in infant mortality statistics for Frederick County. The goal of The Prenatal Center is to have healthy mothers and healthy newborns. Our success is assessed by the number and percentage of women who have had eight or more prenatal visits and delivered a newborn who weighs at least 2500 grams. There were 315 new maternity patients who had 2737 outpatient prenatal visits in 2014. The PNC also measures patient satisfaction and regularly achieves average scores between 95-98%. There were 175 maternity patients who received at least 8 prenatal care visits and who delivered babies of healthy birth weight (2500 grams or above). Of those women who had at least 8 prenatal care visits 97% delivered babies of healthy birth weight. In Maryland, Frederick County had the 5th lowest percentage of babies born weighing less than 2,500 grams in 2012 and the 4th lowest infant mortality rate per 1,000 live births in 2012 (DHMH most recent state wide statistics are from 2012). The Frederick Regional Health System will continue to fund operations of the FMH Prenatal Center through our commitment to serving our community and our Population Health initiatives. Total direct operating expenses for PNC staff, supplies, providers and high risk consultants exceed $335,000 annually. The Community Needs Health Assessment identified lung disease as focus need: Access to care: Care Management. One of the main reasons for hospital re-admission is the fact that discharged patients have historically received little or no guidance relative to follow-up visits with physicians, filling and taking their prescribed medications, making appointments for rehabilitation, etc. Patients identified as high ED utilizers, and/or patients returning to the hospital within 30 days of discharge, meet with either an RN or Social Work case management in an effort to understand why a patient has returned after discharge and or has frequent visits to the emergency room. The results overwhelmingly supported the need to establish a plan for access to; medications, follow up physician appointments, transportation, and other medical/social support in the community. Care Transitions 012 with 1,038 patients receiving interventions from our Care Transitions RN and 470 patients receiving some intervention from a Care Transition Pharmacist. Through the work of our Care Transitions team patients receive more focused disease management education, and intensive transition planning, which often includes financial support for medications, follow up physician appointments, transportation and various other medical and social support services in the community. As the team of Care Transitions nurses, social workers and pharmacist works closely with patients who have been identified as high risk for readmission a great deal of time and energy is spent working with patients and caregivers to establish a post discharge plan. This includes discussing affordability and acces Schedule H, Part VI, Affiliated health care Affiliated Health Care System Frederick Memorial Hospital, Inc. ("FMH") is a private, non-stock, not-for-profit 501 (c) (3) Maryland Corporation organized in 1897. As of July 1, 2011, Frederick Regional Health System became the Parent Corporation under which the entities described below exist and operate. Frederick Regional Health System is governed by a sixteen member Board of Directors. The Board meets monthly, with election of officers and members occurring at the September meeting. Much of the Board's work is accomplished through standing committees, including the Executive, Finance, Governance, Executive Compensation, Joint Conference (with medical staff), Planning, and Hospital Performance Review Committees. Frederick Memorial Hospital is a 298-bed acute care hospital located in Frederick, Maryland, approximately 50 miles west of Baltimore and 45 miles northwest of Washington D. C. The Hospital opened in 1902 and is currently the only acute care hospital in Frederick County and the only acute care hospital within a 25-mile radius of the city of Frederick. The main campus of the Hospital is located on an approximately 15.85-acre site in Frederick, Maryland. The total square footage of the Hospital is approximately 596, 000 square feet. FMH's hospital-based and off-site outpatient services account for over 350,000 visits annually. Its continuum of care services includes a 20-bed skilled nursing unit, and home health services, which makes approximately 35,000 visits per year. In addition, hospital-based hospice services handle approximately 15,000 visits per year. Frederick Regional Health System is the parent corporation for Monocacy Health Partners, a physician led enterprise composed of the following Health System owned practices Frederick Regional Health System provides a full range of acute care services including: medicine, surgery, obstetrics, gynecology, pediatrics, intensive care, coronary care, interventional cardiology, primary stroke program, wound care, joint replacement program, CyberKnife radiosurgery center, psychiatric care, medical fitness, wellness program/center and emergency services. In addition, the Health System provides a comprehensive range of outpatient services, including: emergency medicine, outpatient surgery, home health, radiation therapy, MRI, PET and CT scanning, medical oncology, and comprehensive women's services. Through the satellite locations and outpatient centers, the Health System provides: Urgent care, laboratory, diagnostic radiology, ambulatory surgery, vascular imaging, rehabilitation services, pain and palliative care. Chronic disease management: Breast Cancer -FMH data shows that cancer strikes white women, 65 + years of age. That cohort accounts for 55% (329) of the 596 patients admitted to FMH in FY2012 with a cancer diagnosis. -Caucasians are impacted by a greater degree as measured by percentage of that race's population in Frederick. -In FY 2012, the total number of cases (inpatient and outpatient) with the diagnosis of neoplasm equaled 14,761. -Eight percent of the Frederick County population is currently listed in the FMH Cancer Registry. Breast Cancer is the most prevalent site of cancer diagnosed and treated at FMH. In 2012, the total number of breast cancer patients at FMH was 211, or 25.5% of the total number of cancer patients diagnosed and treated at FMH. This represents an 18% increase in volumes from the total seen in 2011. The increase in volume is evidence that the hospital's awareness and educational programs are working well, especially given the fact that analysis of Stage at Diagnosis shows the largest proportion - 41% - are diagnosed at Stage I. The 9th Annual Breast Cancer Symposium The theme for this free and open to the public event was "Celebrating Life and Embracing Challenges: Hand in Hand in Hope." Dr. Susan Bahl, Medical Director of the Center for Breast Care discussed the advantages of the FMH Multidisciplinary Breast Cancer Clinic and the FMH High Risk Clinic; Dr. Meredith Wernick, Radiation Oncologist, discussed recent advances in Radiation Treatment for Breast Cancer; Dr. Lawrence Wickerham discussed measuring your risk for Breast Cancer. 120 women attended the event. The purpose of these outreach efforts is to influence a woman's decision to practice monthly breast self-examinations, be examined yearly by a health care provider, have a yearly mammogram as indicated by screening protocols. The overarching goal is to decrease the incidence of late-stage breast cancer diagnosis in Frederick County. Over the past 5 years, the FMH cancer registry has recorded an increase in the number of breast cancers diagnosed in Stage I and Stage II. Given the favorable outcomes as measured by the number of breast cancer patients presenting in the early stages of the disease, FMH plans to continue hosting the Breast Cancer Symposium for many years to come. Schedule H, Part VI, State filing MARYLAND true Frederick Community College 7932 Opossumtown Pike Frederick MD 21702 520743590 501(c)(3) 100000 0 1 Procecedures for Monitoring the Use of Grants The Hospital provides funding to a local Community College (501(c)(3) in an effort to enhance its allied health program. Through this program a formal education forum is established resulting in fully accredited programs that meet the Hospital's needs. X true true X X X X false true false false false false false false false Mark S Soberman Physician 502817 0 25095 0 1032 0 5298 0 15336 0 549578 0 0 0 Jennifer G Teeter AVP Payor Contracting 161440 0 19998 0 1242 0 11018 0 12709 0 206407 0 0 0 Shirley B ThompsonEnd123113 Interim Sr VP Patient Care 185690 0 20000 0 6858 0 0 0 8065 0 220613 0 0 0 John R Verbus Sr VP and COO 350449 0 72095 0 2322 0 47616 0 8753 0 481235 0 0 0 Jim R Williams VP Business Development and Pr 193330 0 22786 0 3564 0 13041 0 12962 0 245683 0 0 0 Manual A Casiano VP Medical Staff 321503 0 68486 0 2322 0 46440 0 16117 0 454868 0 0 0 Paul N Chomiak Physician 406085 0 38507 0 552 0 11309 0 6047 0 462500 0 0 0 Cheryl L Cioffi VP Chief Nursing Officer 149403 0 19316 0 90 0 8758 0 15052 0 192619 0 0 0 Kenneth R Coffey II VP Chief Development Officer 176401 0 23707 0 2322 0 12152 0 15650 0 230232 0 0 0 Mark G Goldstein Physician 246903 0 201114 0 216 0 10434 0 15098 0 473765 0 0 0 James S Grissom AVP OF MEDICAL AFFAIRS 135239 0 13383 0 1170 0 7285 0 6755 0 163832 0 0 0 Hannah R Jacobs VP-Finance 163014 0 21107 0 540 0 9218 0 2203 0 196082 0 0 0 Thomas A Kleinhanzl President and CEO 575212 0 212603 0 4257 0 168150 0 16355 0 976577 0 452082 0 Susan Bahl Physician 347309 0 110846 0 216 0 6250 0 2351 0 466972 0 0 0 Kimbiz Tajkarimi Physician 519481 0 162 0 240 0 0 0 12232 0 532115 0 0 0 Michelle K Mahan Sr VP and CFO 353041 0 73343 0 2322 0 46569 0 15216 0 490491 0 0 0 Mary B Mann AVP PATIENT CARE SERVICES 146086 0 17073 0 1242 0 9544 0 5581 0 179526 0 0 0 Terry P O'Malley VP Human Resources 189135 0 24264 0 6858 0 32020 0 12928 0 265205 0 0 0 David JQuirke VP Chief Information Officer 246350 0 55140 0 810 0 34877 0 11092 0 348269 0 0 0 Craig F Rosendale VP Ancillary Services 170651 0 21940 0 3564 0 11724 0 12082 0 219961 0 0 0 Donald R Schilling VP Ambulatory Services 180582 0 21808 0 2322 0 5508 0 12985 0 223205 0 0 0 Form 990, Schedule J, Part I, Line 1a Compensation provided by org listed in Form 990, Part VII, Section A FREDERICK MEMORIAL HOSPITAL HOLDS TWO CORPORATE MEMBERSHIPS TO A LOCAL GOLF/COUNTRY CLUB THAT ARE USED BY THE CHIEF EXECUTIVE OFFICER AND THE CHIEF FUND DEVELOPMENT OFFICER OF THE HOSPITAL. WHILE THE MAJORITY OF THE FEES ASSOCIATED WITH THE CLUB DUES, ETC. IS BUSINESS RELATED, GENERAL PERSONAL USE EXPENSES ARE REIMBURSED BACK TO THE HOSPITAL BY THESE INDIVIDUALS AS NEEDED. FORM 990, SCHEDULE J, PART I, LINE 4B PAYMENT FROM A SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN FREDERICK MEMORIAL HOSPITAL HAS ONE 457(F) NON-QUALIFIED DEFERRED COMPENSATION PLAN FOR CERTAIN MEMBERS OF SENIOR MANAGEMENT. UNDER THE PLAN, THEY MAY CONTRIBUTE AMOUNTS FROM THEIR COMPENSATION TO THE PLAN AND MAY RECEIVE A DISCRETIONARY EMPLOYER CONTRIBUTION. EMPLOYEES ARE FULLY VESTED IN ALL EMPLOYEE CONTRIBUTIONS TO THE PLAN. VESTING IN EMPLOYER CONTRIBUTIONS OCCURS IN ACCORDANCE WITH THE UNDERLYING PLAN DOCUMENTS. ALL ASSETS OF THE PLAN ARE HELD IN A SEPARATE TRUST. TOTAL HOSPITAL CONTRIBUTIONS TO THIS PLAN WERE $313,000 FOR THE YEAR. A MARYLAND HEALTH & HIGHER EDU FACILITIES AUTH 2012A 520936091 574218LY7 2012-12-05 96240000 SEE PART VI false false false B MARYLAND HEALTH & HIGHER EDU FACILITIES AUTH 2012B 520936091 2012-12-05 70020000 SEE PART VI false false false A 68293488 0 108345805 0 1648756 0 1203561 0 0 14450568 0 22749432 2014 true false false false B 70020000 0 70690852 0 0 320948 349253 0 0 0 0 0 2012 true false true true A false true true true true true 0.00000 0.00630 0.00630 false false false true B false true true true true true 0.00210 0.00050 0.00260 false false false true A false true false false 0 false 0 false true B false true true true UBS AG STAMFORD 3.804 false false false 0 false true A true B true DESCRIPTION OF TAX EXEMPT BONDS SCHEDULE K PART I COLUMN F MARYLAND HEALTH & HIGHER ED AUTHORITY 2012A: FINANCE 2012 PROJECT AND CURRENT REFUND 2002 BONDS WHICH FUNDED THE 2002 PROJECT. MARYLAND HEALTH & HIGHER ED AUTHORITY 2012B: REFUND THE 2008 SERIES BONDS WHICH WERE USED TO FINANCE THE 2006 AND PRIOR PROJECTS. SCHEDULE K, PART II, LINE 3 Difference Between issue Price and Total Proceeds MARYLAND HEALTH & HIGHER ED AUTHORITY 2012A: ORIGINAL ISSUE PREMIUM OF $3,989,854 AND PREVIOUSLY TRUSTEED HELD FUNDS OF $8,115,951. MARYLAND HEALTH & HIGHER ED AUTHORITY 2012B: PREVIOUSLY TRUSTEED HELD funds of $670,852 SCHEDULE K PART III LINE 9 MANAGEMENT PRACTICES AND PROCEDURES THE ORGANIZATION HAS POLICIES AND PROCEDURES IN PLACE TO ENSURE TAX EXEMPT BOND POST ISSUANCE COMPLIANCE, WRITTEN POLICIES WERE CREATED AND ADOPTED DURING THE TAX YEAR. X 13 395261 FAIR MARKET VALUE false true false Form 990, Part VI, Line 6 Members or stockholders THE SOLE MEMBER OF THE ORGANIZATION IS FREDERICK REGIONAL HEALTH SYSTEM. Form 990, Part VI, Line 7a Power to elect or appoint members THE SOLE MEMBER, FREDERICK REGIONAL HEALTH SYSTEM, HAS THE POWER TO APPOINT THE PRESIDENT/CEO AND THE DIRECTORS OF FREDERICK MEMORIAL HOSPITAL. Form 990, Part VI, Line 7b Decisions reserved to members or stockholders THE MEMBER, FREDERICK REGIONAL HEALTH SYSTEM, MUST APPROVE THE INCURRENCE OF DEBT IF SUCH DEBT EXCEEDS A CERTAIN AMOUNT TO BE DESIGNATED BY THE MEMBER, CAPITAL EXPENDITURES EXCEEDING A CERTAIN AMOUNT TO BE DESIGNATED BY THE MEMBER, THE DECISION TO DISSOLVE OR LIQUIDATE, THE CREATION OF A SUBSIDIARY, AND AMENDMENTS TO THE BYLAWS. Form 990, Part VI, Line 11b Process used to review the Form 990 THE 990 IS PREPARED IN CONJUNCTION WITH OUTSIDE TAX ACCOUNTANTS AND REVIEWED BY UPPER MANAGEMENT PRIOR TO PROVIDING A COPY TO THE BOARD. A COPY OF FORM 990 IS PROVIDED TO ALL MEMBERS OF THE BOARD PRIOR TO FILING. Form 990, Part VI, Line 12c Monitoring and enforcement of compliance with conflict of interest policy The Frederick memorial hospital, Inc. board of directors is committed to meeting its fiduciary responsibilities and maintaining its duty of loyalty to the hospital and the community it serves. To this end, the board will exercise vigilance in identifying any conflicts of interest. The board will also maintain transparency and objectivity in making decisions about conflicts of interest so that the organization's mission is always the first priority. the chairperson (or vice chairperson if the chair is involved) will notify all directors of a reported conflict of interest and decide whether to take the matter to the full board to decide whether a conflict exists and, if so, what action to take, or will refer the matter to the governance committee for an in-depth examination, summary, and recommendation prior to a full board discussion and decision. If time is of the essence, the chairperson or vice chairperson will take the matter to the executive committee for discussion and a decision, and will then notify the full board. Where a conflict of interest has been identified, the board member shall not vote or be present for the discussion or the vote regarding the transaction at the full board, executive committee, or governance committee meetings, except to answer questions that may be asked of him or her. To prevent actual or perceived influence on the board's decision, the conflicted member is prohibited, after initial disclosure, from discussing the conflict of interest either formally or informally with fellow directors or with members of the management. There will be an annual review of all board members and officers transactions prepared by the administration and reviewed by the governance committee and the full board of directors. at that time, all directors will be reminded of the irs intermediate sanctions regulation that establishes excise taxes as a sanction against administrators and directors of tax-exempt organizations who participate in 'excess benefit transactions' (e.g., unreasonably high employment compensation or business deals). Form 990, Part VI, Line 15 Process for determining compensation The executive compensation program is designed to carry out the health system mission, to achieve the charitable purpose, to attract, retain, motivate and reward executive management, and to maintain a competitive position with peer organizations in the region. Oversight of the executive compensation program is provided by the executive compensation committee of the board, composed of the board chairman, vice chairman, immediate preceding chairman, chairman of the finance committee and the chairman of the governance committee. The executive compensation philosophy of the board provides for base compensation at the 50th to 60th percentile of our peer group. In addition to the board's compensation committee, we utilized an external independent consultant and market surveys for all executive management compensation. The president and ceo have a written employment contract. Form 990, Part VI, Line 19 Process for making documents available to the public GOVERNING DOCUMENTS AND THE CONFLICT OF INTEREST POLICY ARE AVAILABLE UPON REQUEST. FREDERICK MEMORIAL HOSPITAL, INC. CONSOLIDATED ANNUAL AUDITED FINANCIAL STATEMENTS ARE AVAILABLE AT WWW.FMH.ORG. Form 990, Part XI, Line 9 Other Changes in Net Assets or Fund Balances UNREALIZED GAIN ON INTEREST RATE SWAP: 389,007 PENSION ADJUSTMENT: (3,738,295) Other changes in net assets: (2,073) --------------- (3,351,361). EMMITSBURG PROPERTIES LLC 400 WEST SEVENTH STREET FREDERICK MD 21701 521910823 HOLDINGINVEST MD -3119 401430 FMH HOSPICE OF FREDERICK COUNTY INC 400 WEST SEVENTH STREET FREDERICK MD 21701 521164513 HOSPICE CARE MD 501(c)(3) 9 FRHS true FREDERICK REGIONAL HEALTH SYSTEM INC 400 WEST SEVENTH STREET FREDERICK MD 21701 454133096 HEALTH SYSTEM MD 501(c)(3) 11b NA false MONOCACY HEALTH PARTNERS 400 WEST SEVENTH STREET FREDERICK MD 21701 453007639 PHYSICIAN ORG MD 501(c)(3) 9 FRHS true FREDERICK HEALTH SERVICES CORPORATION 400 WEST SEVENTH STREET FREDERICK MD 21701 521851661 MANAGEMENT CO. 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