2014-05-08T15:42:58-05:00 2013-06-30 KPMG LLP 1676 International Drive McLean VA 22102 990 2012-07-01 520591607 The Good Samaritan Hospital of Maryland Inc % MARC BERGER GOOD 4107726719 5601 LOCH RAVEN BLVD Suite Baltimore MD 21239 Marc R Berger 4107726719 2014-05-08 true 7032868000 2012 2015-11-30 17:44:51Z MEDSTAR GOOD SAMARITAN HOSPITAL Jeffrey Matton 5601 LOCH RAVEN BLVD BALTIMORE MD 21239 310651280 false X www.goodsam-md.org X 1920 MD WE ARE GOOD SAMARITANS, GUIDED BY CATHOLIC TRADITION AND TRUSTED TO DELIVER IDEAL HEALTH EXPERIENCES. 25 20 2809 140 116388 134139 419802 323439152 296320895 1924278 3004907 4123457 10905676 329621026 310651280 0 0 0 0 155820857 159989920 150000 0 0 161899629 154257025 317870486 314246945 11750540 -3595665 171926666 172368181 57290961 50472722 114635705 121895459 X AS A PROUD MEMBER OF MEDSTAR HEALTH, MEDSTAR GOOD SAMARITAN HOSPITAL'S (MGSH) MISSION IS TO BE GOOD SAMARITANS, GUIDED BY CATHOLIC TRADITION AND TRUSTED TO DELIVER IDEAL HEALTH EXPERIENCES. MGSH, LOCATED IN NORTHEAST BALTIMORE CITY, MARYLAND, IS KNOWN FOR ITS SPECIALTIES IN ORTHOPAEDICS, RHEUMATOLOGY, NEPHROLOGY, AND PHYSICAL MEDICINE AND REHABILITATION PROGRAMS. IN ADDITION TO GENERAL ADULT ACUTE CARE SERVICES, MGSH HAS A COMPREHENSIVE INPATIENT REHABILITATION UNIT AND A SUB-ACUTE CARE UNIT. IN AUGUST 2012, MGSH OPENED THE MEDSTAR CENTER FOR WOUND HEALING. IN FISCAL YEAR 2013, MGSH HAD 13,416 INPATIENT ADMISSIONS, 304,856 OUTPATIENT VISITS, AND 61,392 EMERGENCY VISITS. false false 223920265 0 273590469 MEDSTAR GOOD SAMARITAN HOSPITAL'S LARGEST PROGRAM IS ACCESS TO AND THE PROVISION OF ACUTE HOSPITAL SERVICES TO THE COMMUNITIES OF NORTHEASTERN BALTIMORE CITY, MARYLAND AND THE SURROUNDING AREAS. IN ADDITION TO THE PROGRAM SERVICE EXPENSES LISTED ABOVE, MGSH INCURRED $52.3M OF MANAGEMENT AND GENERAL EXPENSES IN PROVIDING SERVICES TO ITS COMMUNITIES.FOR MORE INFORMATION, SEE SCHEDULE O. 29822761 0 22730426 MEDSTAR GOOD SAMARITAN HOSPITAL PROVIDED $29.8M IN SUBSIDIZED (MISSION DRIVEN) HEALTH SERVICES IN FISCAL 2013. THESE CRITICAL SERVICES, WHICH ARE DRIVEN BY COMMUNITY NEEDS, OPERATE AT A LOSS. THEY ADDRESS PRIORITIES PRIMARILY THROUGH DISEASE PREVENTION AND IMPROVEMENT OF HEALTH STATUS. SERVICES PROVIDED INCLUDE WOMEN'S HEALTH SERVICES, HOSPITALISTS, PSYCHIATRY, UROLOGY, EMERGENCY DEPARTMENT COVERAGE, OUTPATIENT RENAL CARE, AND CERTAIN SUB-ACUTE PROGRAM SUBSIDIES. 8163237 0 0 MEDSTAR GOOD SAMARITAN HOSPITAL PROVIDED $8.2M IN HEALTH PROFESSIONS EDUCATION IN FISCAL YEAR 2013. THIS CATEGORY INCLUDES TRAINING IN GRADUATE MEDICAL EDUCATION, AND EDUCATION FOR PHYSICIANS, MEDICAL STUDENTS, NURSES, AND OTHER HEALTH PROFESSIONS. 261906263 true true false false false false false false false false true false false true true true false true false false false false false false false false true true false false true false false false false false false false true false false false false true true true false false false true 0 0 true 2809 true true true false false false false false false false false false X 25 20 false false false false true true true true true false false true true true true true true true true false MD X MARC BERGER 4107726719 5565 STERRETT PL 5TH FLR COLUMBIA MD 21044 X DANIEL P CAHILL 1.0 X 0 0 0 MOIRA P LARSEN 1.0 X X 0 0 0 JEFFREY A MATTON 40.0 X X 714668 0 31533 KENNETH A SAMET 1.0 39.0 X 0 3794743 59637 WILMOT C BALL JR MD 1.0 X 0 0 0 HOWARD S FREELAND MD 1.0 39.0 X X 0 272362 20266 SHELDON M GLUSMAN MD 1.0 X 0 0 0 DAVIS M HAHN MD 1.0 X X 0 0 0 JEREMY P WEINER MD 40.0 X X 50000 0 0 ANTHONY READ 1.0 X 0 0 0 CHARLES L BAUERMANN 1.0 X 0 0 0 KAY G BEE 1.0 X 0 0 0 JEFFREY R DONNELLY 1.0 X 0 0 0 SONYA H GRAY 1.0 X 0 0 0 DENIS J MADDEN 1.0 X 0 0 0 ALLAN NOONAN MD 1.0 X 0 0 0 T EDGIE RUSSELL III 1.0 X 0 0 0 REV PM SMITH 1.0 X 0 0 0 JOHN C SMYTH 1.0 X 0 0 0 KATHLEEN J WHITING 1.0 X 0 0 0 DAVID WEISMAN 40.0 X 155892 0 22393 CHRISTOPHER T HELMRATH 1.0 X 0 0 0 REV LAWRENCE M JOHNSON 1.0 X 0 0 0 THOMAS L OWSLEY 1.0 X 0 0 0 CAROL J PACIONE 1.0 X 0 0 0 DEANA STOUT 40.0 X 308117 0 38785 MARTIN BINSTOCK MD 40.0 X 446201 0 38269 JENNIFER WILKERSON 39.0 1.0 X 198355 0 19171 SHIRLEY ROTH 40.0 X 227107 0 24710 THOMAS SENKER 40.0 X 224714 0 23713 DALE BUCHBINDER MD 40.0 X 657456 0 19736 DAVID COLL MD 40.0 X 560560 0 22807 MICHAEL JACOBS MD 40.0 X 797027 0 22936 ROBERT BRESLIN MD 40.0 X 498907 0 19638 THOMAS REID 40.0 X 446015 0 14210 LAWRENCE BECK 40.0 X 2598621 0 0 7883640 4067105 377804 176 true true false HUNT VALLEY ANESTHESIA ASSOC PA PO BOX 20284 TOWSON MD 21284 MEDICAL SERVICES 8418710 MORRISON MANAGEMENT SPECIALIST 4721 MORRISON DRIVE MOBILE AL 36609 FOOD SVC PROVIDER 3596912 UNIVERSITY OF MARYLAND 22 S GREENE STREET BALTIMORE MD 21201 MEDICAL SERVICES 3332954 STATE MECHANICAL CONTRACTORS 3 NASHUA COURT BALTIMORE MD 21221 mechanical ctrctor 1477254 DRS HAHN PADGETT 5601 LOCH RAVEN BOULEVARD BALTIMORE MD 21239 Medical Services 1120883 30 2174 417628 419802 NET PATIENT SERVICE REVENUE 621400 296320895 296320895 296320895 1308913 1308913 0 0 343323 343323 0 343323 343323 1642336 53658 1642336 53658 1695994 1695994 0 0 0 REBATE INCOME 900099 852633 852633 CHILD DAY CARE 900099 502856 502856 MEALS ON WHEELS 900099 130404 130404 9076460 116388 8960072 10562353 310651280 296320895 116388 13794195 0 0 0 0 2523628 2250274 273354 0 127697375 113882209 13815166 3397442 3023723 373719 16993479 15129275 1864204 9377996 8153716 1224280 21762355 15663774 6098581 150 150 0 0 0 0 44262253 24544061 19718192 1138915 59787 1079128 1776925 1456812 320113 436026 231623 204403 0 2055677 795323 1260354 396385 280629 115756 0 47430 42261 5169 2779247 2779247 0 12422154 12422154 4281106 147198 4133908 DRUGS/PHARMACEUTICALS 20847052 20844998 2054 MEDICAL/SURGICAL SUPPLIES 16065393 16041478 23915 IMPLANTS/ PROSTHESES 8969319 8969319 FOOD SERVICE 4619551 4437963 181588 12397087 10750439 1646648 314246945 261906263 52340682 0 3900 3900 0 0 0 0 44592743 36913542 0 0 0 0 0 0 2657563 2856912 556686 574030 229742027 153596292 71746850 76145735 0 0 141258 216703 0 0 0 0 52227666 55657359 171926666 172368181 28823499 29039397 0 0 976865 70623 0 0 0 0 0 0 0 0 0 0 27490597 21362702 57290961 50472722 X 66037172 66926520 48598533 54968939 0 0 114635705 121895459 171926666 172368181 X -3595665 4303088 6552331 X false true X true false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 63076353 35392511 27683842 1406586 424322 982264 131915287 97135980 34779307 33343801 20643479 12700322 76145735 CATHOLIC HEALTH CARE FUND 54752236 OPTION IT ASSET 515159 INTERCOMPANY RECEIVABLES 175 OTHER ASSETS 389789 55657359 0 ADVANCES FROM 3RD PARTY PAYORS 6521119 ASBESTOS ABATEMENT LIABILITY 2654950 STOCK OPTION PLAN 444049 WORKERS COMP 2436781 CREDIT BALANCE PATIENT A/R 1260648 DEFERRED COMPENSATION LIABILIT 364789 OTHER LIABILITIES 7680366 21362702 X FIN 48 FOOTNOTE SCHEDULE D, PART X INCOME TAXES ARE ACCOUNTED FOR UNDER THE ASSET AND LIABILITY METHOD. DEFERRED TAX ASSETS AND LIABILITIES ARE RECOGNIZED FOR THE FUTURE TAX CONSEQUENCES ATTRIBUTABLE TO DIFFERENCES BETWEEN THE FINANCIAL STATEMENT CARRYING AMOUNTS OF EXISTING ASSETS AND LIABILITIES AND THEIR RESPECTIVE TAX BASES AND OPERATING LOSS AND TAX CREDIT CARRYFORWARDS. DEFERRED TAX ASSETS AND LIABILITIES ARE MEASURED USING ENACTED TAX RATES EXPECTED TO APPLY TO TAXABLE INCOME IN THE YEARS IN WHICH THOSE TEMPORARY DIFFERENCES ARE EXPECTED TO BE RECOVERED OR SETTLED. THE EFFECT ON DEFERRED TAX ASSETS AND LIABILITIES OF A CHANGE IN TAX RATES IS RECOGNIZED IN THE PERIOD THAT INCLUDES THE ENACTMENT DATE. ANY CHANGES TO THE VALUATION ALLOWANCE ON THE DEFERRED TAX ASSET ARE REFLECTED IN THE YEAR OF CHANGE. THE CORPORATION ACCOUNTS FOR UNCERTAIN TAX POSITIONS IN ACCORDANCE WITH THE FASB ACCOUNTING STANDARDS CODIFICATION (ASC) TOPIC 740, INCOME TAXES. THERE WAS NO LIABILITY RECORDED FOR UNCERTAIN TAX POSITIONS AS OF JUNE 30, 2013. true true X true X true X true true true false true true 5655837 5655837 0.01800 5655837 5655837 0.01800 1309908 63885 1246023 0.00400 8163237 8163237 0.02600 29822761 22730426 7092335 0.02300 37630 37630 0.00010 39333536 22794311 16539225 0.05310 44989373 22794311 22195062 0.07110 716873 517486 199387 0.00010 29317 29317 0.00010 3070 3070 0.00010 749260 517486 231774 0.00030 true 13293043 true true 1 1 MAIN HOSPITAL BUILDING

5601 LOCH RAVEN BLVD BALTIMORE MD 21239

X X X MAIN HOSPITAL BUILDING 1 true X X X X X X X X X 11 true false true X X X X X X X X X X false false true true 200. true 400. true X X X X X X true true X X X X X true false true X false false 1 Transitional Care at Good Samaritan

5601 Loch Raven Blvd Baltimore MD 21239

Comprehensive Care Facility CHARITY CARE AT COST PART I, LINE 7A 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. UNREIMBURSED MEDICAID PART I, LINE 7B 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. THE EXCEPTION TO THIS IS THE IMPACT ON THE HOSPITAL OF ITS SHARE OF THE MEDICAID ASSESSMENT. IN RECENT YEARS, THE STATE OF MARYLAND HAS CLOSED FISCAL GAPS IN THE STATE MEDICAID BUDGET BY ASSESSING HOSPITALS THROUGH THE RATE-SETTING SYSTEM. HEALTH PROFESSIONS EDUCATION PART I, LINE 7F 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. PERCENT OF TOTAL EXPENSE PART I, LINE 7, COLUMN(F) BAD DEBT EXPENSE OF $13,293,043 HAS BEEN REMOVED FROM TOTAL EXPENSE TO CALCULATE THE PERCENTAGES IN COLUMN (F). BAD DEBT PART III, LINE 4 MEDSTAR HEALTH AND ITS AFFILIATED ORGANIZATIONS REPORT BAD DEBT EXPENSE IN ACCORDANCE WITH ASU 2011-07, WHICH REQUIRES CERTAIN HEALTHCARE ENTITIES TO CHANGE THE PRESENTATION OF THEIR STATEMENT OF OPERATIONS BY RECLASSIFYING THE PROVISION FOR BAD DEBTS ASSOCIATED WITH PATIENT SERVICE REVENUE FROM AN OPERATING EXPENSE TO A DEDUCTION FROM PATIENT SERVICE REVENUE (NET OF CONTRACTUAL ALLOWANCES AND DISCOUNTS). HOWEVER, MEDSTAR AND ITS AFFILIATED ENTITIES DO NOT MAKE A DETERMINATION AS TO WHETHER SELF PAY AMOUNTS ARE COLLECTIBLE IN DETERMINING REVENUE RECOGNITION. RESERVE MODELS, WHICH HAVE BEEN DEVELOPED BASED ON HISTORICAL COLLECTION RESULTS AND WHICH ARE ADJUSTED PERIODICALLY BASED ON ACTUAL COLLECTIONS EXPERIENCE, ARE USED TO ESTIMATE UNCOLLECTIBLE AMOUNTS ACROSS ALL PAYORS INCLUDING SELF PAY. BAD DEBT DETERMINATIONS ARE MADE ONLY AFTER SUFFICIENT EVIDENCE IS OBTAINED TO SUPPORT THAT AN AMOUNT IS NOT COLLECTIBLE MEDICARE PART III, LINE 8 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. AS SUCH, THE NET EFFECT FOR MEDICARE EXPENSES AND REVENUES IN MARYLAND IS ZERO. NEEDS ASSESSMENT PART V, SECTION B, LINE 7 THE IMPLEMENTATION STRATEGIES SERVE AS A ROADMAP FOR HOW COMMUNITY BENEFIT RESOURCES WILL BE ALLOCATED AND DEPLOYED. MEDSTAR'S HOSPITALS WILL BE ABLE TO MEASURE OUR CONTRIBUTION TO IMPROVING THE HEALTH OF UNDERSERVED AND VULNERABLE POPULATIONS IN THE REGIONS WE SERVE. THREE-YEAR IMPLEMENTATION STRATEGIES WITH MEASURABLE OBJECTIVES WERE DEVELOPED FOR EACH HOSPITAL'S COMMUNITY BENEFIT SERVICE AREA - A SPECIFIC COMMUNITY OR TARGET POPULATION OF FOCUS. PRIORITIES WERE BASED ON COMMUNITY NEED AS DETERMINED BY QUANTITATIVE DATA AND COMMUNITY INPUT, AS WELL AS ON HOSPITAL EXPERTISE, RESOURCES, STRENGTHS OF EXISTING PROGRAMMING AND PARTNERSHIPS, AND ALIGNMENT WITH NATIONAL, STATE, AND LOCAL HEALTH GOALS. THE MEDSTAR HEALTH CORPORATE COMMUNITY HEALTH DEPARTMENT WILL PROVIDE SYSTEM-WIDE COORDINATION AND OVERSIGHT OF COMMUNITY BENEFIT PROGRAMMING. PART VI, LINE 2 In FY12, MedStar Good Samaritan Hospital conducted a Community Health Needs Assessment (CHNA) in accordance with the guidelines established by the Patient Protection and Affordable Care Act and the Internal Revenue Service. The hospital's CHNA was led by 11 Advisory Task Force (ATF) members, which was comprised of a diverse group of individuals, including grassroots activists, community residents, faith-based leaders, hospital representatives, public health leaders, and other stakeholder organizations, such as representatives from local health departments. The ATF reviewed quantitative and qualitative community health data, as well as local, regional and national health goals. Based on their findings, the ATF designed a survey to identify trends in how participants perceived the severity of key health issues in the following categories: wellness and prevention, access to care, quality of life, and environment. Community members responded to the survey by attending a community input session or completing it online or via hardcopy. Based on the ATF's recommendation, the hospital identified Govans as its Community Benefit Service Area (CBSA) - geography with a high density of low-income or vulnerable residents within close proximity of the hospital. Health priorities for the CBSA include heart disease and diabetes. The hospital's FY12 CHNA and 3-year Implementation Strategies were endorsed by MedStar Good Samaritan's Board of Directors and approved by the MedStar Health Board of Directors. The document was published on the hospital's website on June 30, 2012. As a proud member of MedStar Health, representatives from MedStar Good Samaritan routinely participate in the MedStar Health community benefit workgroup. The workgroup is comprised of community health professionals who represent all ten MedStar hospitals. The team analyzes local and regional community health data, establishes system-wide community health programming performance and evaluation measures and shares best practices. PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE PART VI, LINE 3 As one of the region's leading not-for-profit healthcare systems, MedStar Health is committed to ensuring that uninsured patients within the communities we serve who lack financial resources have access to necessary hospital services. MedStar Health and its healthcare facilities will: " Treat all patients equitably, with dignity, with respect and with compassion. " Serve the emergency health care needs of everyone who presents at our facilities regardless of a patient's ability to pay for care. " Assist those patients who are admitted through our admissions process for non-urgent, medically necessary care who cannot pay for part of all of the care they receive. " Balance needed financial assistance for some patients with broader fiscal responsibilities in order to keep its hospitals' doors open for all who may need care in the community. In meeting its commitments, MedStar Health's facilities will work with their uninsured patients to gain an understanding of each patient's financial resources prior to admission (for scheduled services) or prior to billing (for emergency services). Based on this information and patient eligibility, MedStar Health's facilities will assist uninsured patients who reside within the communities we serve in one or more of the following ways: " Assist with enrollment in publicly-funded entitlement programs (e.g., Medicaid). " Assist with consideration of funding that may be available from other charitable organizations. " Provide charity care and financial assistance according to applicable guidelines. " Provide financial assistance for payment of facility charges using a sliding scale based on patient family income and financial resources. " Offer periodic payment plans to assist patients with financing their healthcare services. Each facility will post the policy, including a description of the applicable communities it serves, in each major patient registration area and in any other areas required by applicable regulations, will communicate the information to patients as required by this policy and applicable regulations and will make a copy of the policy available to all patients. Additionally, the Maryland Patient Information Sheet/MedStar's Patient Information Sheet will be provided to inpatients on admission and at time of final account billing. MedStar Health believes that its patients have personal responsibilities related to the financial aspects of their healthcare needs. The charity care, financial assistance, and periodic payment plans available under this policy will not be available to those patients who fail to fulfill their responsibilities. For purposes of this policy, patient responsibilities include: " Completing financial disclosure forms necessary to evaluate their eligibility for publicly-funded healthcare programs, charity care programs, and other forms of financial assistance. These disclosure forms must be completed accurately, truthfully, and timely to allow MedStar Health's facilities to properly counsel patients concerning the availability of financial assistance. " Working with the facility's financial counselors and other financial services staff to ensure there is a complete understanding of the patient's financial situation and constraints. " Completing appropriate applications for publicly-funded healthcare programs. This responsibility includes responding in a timely fashion to requests for documentation to support eligibility. " Making applicable payments for services in a timely fashion, including any payments made pursuant to deferred and periodic payment schedules. " Providing updated financial information to the facility's financial counselors on a timely basis as the patient's circumstances may change. " It is the responsibility of the patient to inform the MedStar hospital of their existing eligibility under a medical hardship during the 12 month period. Uninsured patients of MedStar Health's facilities may be eligible for charity care or sliding-scale financial assistance under this policy. The financial counselors and financial services staff will determine eligibility for charity care and sliding-scale financial assistance based on review of income for the patient and their family (household), other financial resources available to the patient's family, family size, and the extent of the medical costs to be incurred by the patient. COMMUNITY INFORMATION PART VI, LINE 4 Geographic The Govans neighborhood is located in North Central Baltimore City, approximately two miles from MedStar Good Samaritan. The neighborhood features many different housing types, businesses, churches, a charter school and a neighborhood park. Govans has always been associated with York Road, first as an Indian trail, and then as an important commercial road and turnpike linking the Port of Baltimore to Pennsylvania. Demographics: According to statistics from the Baltimore City 2011 Neighborhood Health Profile, the total population in Govans is just over 10,000 and the majority of residents are African American (91.3%). Caucasians make up 5.7% of the population, 0.5% is Asian, 1.3% is Hispanic, and 2.5% is two or more races or other. Adults over the age of 18 years old make up three-quarters (75.6%) of the population, with seniors over age 65 years at 12.8%. Children under the age of 18 account for 24.4% of the Govans population. The median annual household income is $37,000, about the same as Baltimore City, while unemployment is 14.9%, higher than the Baltimore City average (11.0%). Just over one-quarter (26.9%) of households are headed by a single-parent. The poverty rate is 11.6%, slightly less than Baltimore City (15.7%). In 2011, approximately 1,400 families in the Govans area received assistance from CARES, a combination Food Pantry and Emergency Financial Assistance center. Over two-thirds (62.2%) of residents over 25 years of age have attained high school as the highest level of education. Life expectancy is 73.9, just longer than that of Baltimore City (71.8). The leading causes of death are heart disease (24.9 per 10,000), cancer (19.5 per 10,000), HIV/AIDS (4.9 per 10,000), stroke (4.2 per 10,000), and diabetes (2.6 per 10,000). PROMOTION OF COMMUNITY HEALTH PART VI, LINE 5 As a community partner, MedStar Good Samaritan engages in a number of community benefit activities to improve and promote the health and well-being of the community. Blood Pressure Screening Program MedStar Good Samaritan's Community Outreach and Parish Nurse Program partner with many churches and community organizations, such as senior centers and senior housing, to offer free blood pressure screenings on a monthly basis. The program raises awareness, educates participants about the dangers of hypertension, and identifies those with high blood pressure. In FY13 approximately 1,200 people were screened for hypertension and approximately 10% of those with elevated readings were not previously diagnosed with hypertension. Persons not previously diagnosed were referred to their primary care provider for follow up. For participants who did not have a primary care provider due to lack of insurance or other reasons, names and phone numbers of physicians or free clinics were offered as well as MedStar Good Samaritan Hospital's Primary Care Center. Diabetes Education Program Diabetes education classes were held at various locations in the Govans area of Baltimore City. Locations included CARES, a food pantry and financial assistance center, Senior Network of North Baltimore, a local senior center and Govans Manor, a senior residence building. Classes provided information related to diabetes prevention and management. Participants included those with Type 2 diabetes and also those who wanted to learn more about prevention of the disease. Twelve education classes were held with a total of 111 community residents attending. Post tests were given to participants after each education class. MedStar Good Samaritan Hospital Know Stroke Program The Know Stroke Program is a one hour lecture on stroke prevention presented by a speech pathologist from the MedStar Good Samaritan rehabilitation department. Programs are presented in senior centers and libraries. Topics presented include risk factors, signs and symptoms, treatments, and lifestyle choices related to prevention. In FY13 programs were presented at 4 senior centers with a total of 87 participants. Participants took post tests to gauge understanding and retention of information presented in the lecture. MedStar Good Samaritan's commitment to the community is also demonstrated through a variety of subsidized health services. These include, but are not limited to: Psychiatric/Behavioral Health Subsidies The overall cost of 24/7 Psychiatry physician coverage is disproportionate to the total collections from the patients seen by these physicians during off hours. Many of these patients are uninsured. The hospital absorbs the cost of providing psychiatric supervision for the Emergency Department on a 24/7 basis. If those services were not provided, the patient would be transported to another facility. Renal Dialysis Services Demand for dialysis services in the immediate area surrounding MedStar Good Samaritan Hospital is high and is expected to increase. The outpatient dialysis center at the hospital is usually full and is one of the largest in the area. Eligible patients may also qualify for free transportation as well as free or low cost medications. AFFILIATED HEALTH CARE SYSTEM PART VI, LINE 6 As a proud member of MedStar Health, MedStar Good Samaritan is able to expand its capacity to meet the needs of the community by partnering with other MedStar hospitals and associated entities. MedStar Health resources assist the hospital in community health planning to meet the needs of the uninsured and other vulnerable populations. Through its community health function, MedStar Health provides MedStar Good Samaritan with technical support to enhance community health programming and evaluation. MedStar's corporate philanthropy department identifies and seeks public and private funding sources to ensure the availability of high quality health services, regardless of ability to pay. STATE FILING OF COMMUNITY BENEFIT REPORT PART VI, LINE 7 The community benefit report for MedStar Good Samaritan Hospital is only filed in the state of Maryland. X X X X X X false true false false false false false false false JEFFREY A MATTON 420191 0 294477 0 0 0 16674 0 14859 0 746201 0 0 0 KENNETH A SAMET 0 1264204 0 1589134 0 941405 0 40108 0 19529 0 3854380 0 208524 HOWARD S FREELAND MD 0 272362 0 0 0 0 0 5365 0 14901 0 292628 0 0 DALE BUCHBINDER MD 629296 0 28160 0 0 0 7350 0 12386 0 677192 0 0 0 DAVID COLL MD 560560 0 0 0 0 0 7350 0 15457 0 583367 0 0 0 DEANA STOUT 213721 0 94396 0 0 0 20686 0 18099 0 346902 0 0 0 LAWRENCE BECK 0 0 17017 0 2581604 0 0 0 0 0 2598621 0 0 0 MARTIN BINSTOCK MD 317232 0 128969 0 0 0 16896 0 21373 0 484470 0 0 0 MICHAEL JACOBS MD 797027 0 0 0 0 0 7350 0 15586 0 819963 0 0 0 ROBERT BRESLIN MD 446907 0 52000 0 0 0 7350 0 12288 0 518545 0 0 0 SHIRLEY ROTH 191777 0 35330 0 0 0 6619 0 18091 0 251817 0 0 0 THOMAS SENKER 186379 0 38335 0 0 0 6768 0 16945 0 248427 0 0 0 JENNIFER WILKERSON 165142 0 33213 0 0 0 5431 0 13740 0 217526 0 0 0 DAVID WEISMAN 144773 0 11119 0 0 0 7598 0 14795 0 178285 0 0 0 THOMAS REID 446015 0 0 0 0 0 0 0 14210 0 460225 0 0 0 OTHER REPORTABLE COMPENSATION FORM 990, SCHEDULE J, PART I, LINE 4B KENNETH SAMET MR. SAMET'S OTHER REPORTABLE COMPENSATION IN PART II, COLUMN (B) (III) INCLUDES $928,678 REPRESENTING HIS RECEIVED BENEFIT FROM A SUPPLEMENTAL RETIREMENT PLAN, WHICH WAS EARNED DURING THE PAST 24 YEARS OF SERVICE. A PORTION OF THIS AMOUNT, $208,524 WAS ALSO REPORTED ON FORM 990 IN PRIOR YEARS. LAWRENCE BECK LAWRENCE BECK'S OTHER REPORTABLE COMPENSATION IN PART II, COLUMN (B) (III) INCLUDES $208,436 REPRESENTING THE AMOUNT OF SUPPLEMENTAL RETIREMENT BENEFIT PAYMENTS RELATING TO PRIOR YEARS OF SERVICE. IN ADDITION, PART II, COLUMN (B) (III) INCLUDES $2,370,989 RELATING TO INCOME REALIZED IN THE CURRENT YEAR ON THE APPRECIATION OF CERTAIN INVESTMENTS THAT WERE GRANTED TO MR. BECK IN PRIOR YEARS AND WHICH RELATED TO SERVICES PERFORMED IN PRIOR YEARS. DRS HAHN PADGETT PC DIRECTOR MEDICAL SERVICES GS SURGICAL SERVICES LLC DIRECTOR SURGICAL SERVICES Pathology Associates LaboratorieS DIRECTOR Lab Services BUSINESS TRANSACTIONS INVOLVING INTERESTED PERSONS SCHEDULE L, PART IV DR. JEREMY WEINER, A BOARD MEMBER AT MEDSTAR GOOD SAMARITAN HOSPITAL, OWNS MORE THAN 5% OF GS SURGICAL SERVICES, LLC (GSS), WHICH PROVIDES MEDICAL AND SURGICAL SERVICES TO MEDSTAR GOOD SAMARITAN HOSPITAL. GSS'S GROSS REVENUES RECEIVED FROM THE HOSPITAL FOR THE YEAR WAS $1.0 MILLION. DR. DAVIS HAHN, A BOARD MEMBER AT MEDSTAR GOOD SAMARITAN HOSPITAL, OWNS MORE THAN 5% OF DRS. HAHN & PADGETT, P.C. (PC), WHICH PROVIDES ONCOLOGY SERVICES TO MEDSTAR GOOD SAMARITAN HOSPITAL. PC'S GROSS REVENUES RECEIVED FROM THE HOSPITAL FOR THE YEAR WAS $1.0 MILLION. DR. MOIRA LARSEN, A BOARD MEMBER AT MEDSTAR GOOD SAMARITAN HOSPITAL, OWNS MORE THAN 5% OF PATHOLOGY ASSOCIATES LABORATORIES, PC (PAL), WHICH PROVIDES LAB SERVICES TO MEDSTAR GOOD SAMARITAN HOSPITAL. PAL'S GROSS REVENUES RECEIVED FROM THE HOSPITAL FOR THE YEAR WAS $0.7 MILLION. EXEMPT PURPOSE ACHIEVEMENTS PART III, LINE 4A IT ALSO OFFERS COMMUNITY-BASED HEALTH SERVICES THROUGH THE GOOD HEALTH CENTER AND PROVIDES SENIOR LIVING SERVICES THROUGH THE GOOD SAMARITAN NURSING CENTER AND TWO SENIOR HOUSING COMPLEXES LOCATED ON ITS 43-ACRE CAMPUS. MGSH IS RECOGNIZED BY THE JOINT COMMISSION AS AN ADVANCED PRIMARY STROKE CENTER. IN 2013, US NEWS AND WORLD REPORT RECOGNIZED MGSH AS A HIGH PERFORMING HOSPITAL IN CANCER, DIABETES & ENDOCRINOLOGY, GASTROENTEROLOGY & GI SERVICES, GERIATRICS, NEPHROLOGY, NEUROLOGY NEUROSURGERY, ORTHOPAEDICS, PULMONOLOGY, AND UROLOGY. ORGANIZATION MEMBERS PART VI, LINE 6 THE ORGANIZATION IS AN AFFILIATE AND SUBSIDIARY OF MEDSTAR HEALTH, INC., A TAX-EXEMPT MARYLAND NON-STOCK CORPORATION. MEDSTAR HEALTH, INC., OR ONE OF ITS AFFILIATES AND SUBSIDIARIES, IS THE SOLE MEMBER OF THE ORGANIZATION. DESCRIPTION OF MEMBERS PART VI, LINE 7A AS AN AFFILIATE AND SUBSIDIARY OF MEDSTAR HEALTH, INC., A TAX-EXEMPT MARYLAND NON-STOCK CORPORATION, THE ORGANIZATION MAY RECOMMEND PERSON(S) FOR MEMBERSHIP ON THE ORGANIZATION'S GOVERNING BODY. ANY SUCH RECOMMENDATION BY THE ORGANIZATION IS SUBJECT TO APPROVAL BY THE GOVERNANCE COMMITTEE OF THE BOARD OF DIRECTORS OF MEDSTAR HEALTH, INC. THE BOARD OF MEDSTAR HEALTH, INC. HAS DELEGATED CERTAIN APPROVAL AUTHORITY TO THE GOVERNANCE COMMITTEE AND THE PRESIDENT & CEO OF MEDSTAR HEALTH, INC. DECISIONS OF GOVERNING BODY PART VI, LINE 7B AS AN AFFILIATE AND SUBSIDIARY OF MEDSTAR HEALTH, INC., A TAX-EXEMPT MARYLAND NON-STOCK CORPORATION, THE BYLAWS OF THE ORGANIZATION ARE SUBJECT TO CERTAIN RESERVED POWERS, WHICH PROVIDE THAT THE SOLE MEMBER OF THE ORGANIZATION MUST APPROVE CERTAIN DECISIONS, INCLUDING BUT NOT LIMITED TO MATTERS CONCERNING THE SALE OR PURCHASE OF REAL OR PERSONAL PROPERTY, CAPITAL BUDGETS, STRATEGIC PLANNING, INVESTMENTS, AND CORPORATE GOVERNANCE. PROCESS FOR REVIEWING FORM 990 PART VI, LINE 11A THE PROCESS FOR REVIEWING THE FORM 990 INCLUDED EDUCATION AND TRANSPARENCY. SENIOR FINANCIAL EXECUTIVES, WORKING WITH INDEPENDENT OUTSIDE EXPERTS, THOROUGHLY REVIEWED FORM 990 AND ACCOMPANYING INSTRUCTIONS. IN ADDITION, SENIOR EXECUTIVES REVIEWED THE RELEVANT SECTIONS OF THE FORM 990 WITH THE FOLLOWING COMMITTEES OF THE ORGANIZATION'S GOVERNING BODY: FINANCE, AUDIT, GOVERNANCE, STRATEGIC PLANNING, AND EXECUTIVE COMPENSATION. FOLLOWING THESE MEETINGS, THE GOVERNING BODY WAS PROVIDED A COPY OF THE FORM 990 IN ITS FINAL FORM AND GIVEN AN OPPORTUNITY TO PROVIDE ANY INPUT OR COMMENTS RELATING TO THE FORM 990 PRIOR TO ITS FILING. CONFLICT OF INTEREST POLICY PART VI, LINE 12C APPOINTMENT OF BOARDS OF DIRECTORS MEDSTAR HEALTH (AND ITS SUBSIDIARIES) REQUIRE ALL NOMINATED DIRECTORS, PRIOR TO THEIR APPOINTMENT OR ELECTION, TO DISCLOSE THE EXISTENCE OF (OR POTENTIAL EXISTENCE OF) ANY TRANSACTION WITH MEDSTAR THAT WOULD RESULT IN A CONFLICT OF INTEREST. SUCH DISCLOSURES (IF ANY) ARE REVIEWED BY THE GOVERNANCE COMMITTEE OF THE MEDSTAR HEALTH BOARD OF DIRECTORS WHICH DETERMINES HOW THE MATTER SHOULD BE RESOLVED. ANNUAL DISCLOSURES - ALL OFFICERS, DIRECTORS, AND SENIOR MANAGERS ALL OFFICERS, DIRECTORS AND SENIOR MANAGERS ARE REQUIRED, NOT LESS THAN ANNUALLY, TO COMPLETE A SURVEY OF QUESTIONS CONCERNING ANY TRANSACTIONS OR RELATIONSHIPS WHICH WOULD OR COULD REPRESENT A CONFLICT OF INTEREST. SUCH DISCLOSURES (IF ANY) RELATED TO DIRECTORS ARE REVIEWED BY THE GOVERNANCE COMMITTEE OF THE MEDSTAR HEALTH BOARD OF DIRECTORS WHICH DETERMINES HOW THE MATTER SHOULD BE RESOLVED. SUCH DISCLOSURES (IF ANY) RELATED TO OFFICERS AND SENIOR MANAGERS ARE REVIEWED BY AN APPROPRIATE EXECUTIVE WHO DETERMINES HOW THE MATTER SHOULD BE RESOLVED IN ADDITION, OFFICERS AND DIRECTORS OF MARYLAND HOSPITALS AND NURSING CENTERS ARE REQUIRED TO ANNUALLY DISCLOSE ADDITIONAL INFORMATION RELATING TO POTENTIAL CONFLICTS OF INTEREST AND SUCH DISCLOSURES ARE REPORTED TO THE MARYLAND HEALTH SERVICES COST REVIEW COMMISSION (HSCRC). DESCRIPTION OF EXECUTIVE COMPENSATION PROCESS PART VI, LINE 15 THE EXECUTIVE COMPENSATION COMMITTEE OF THE BOARD OF DIRECTORS OF MEDSTAR HEALTH, INC. (THE "COMMITTEE") HAS OVERSIGHT OVER THE EXECUTIVE COMPENSATION PROGRAM (THE "PROGRAM") OF MEDSTAR HEALTH, INC. AND ITS AFFILIATES. TOTAL COMPENSATION FOR THE TOP MANAGEMENT OFFICIALS, OFFICERS AND KEY EMPLOYEES OF MEDSTAR HEALTH, INC. AND ITS AFFILIATES ARE REVIEWED AND APPROVED BY THE COMMITTEE WITH ASSISTANCE AND GUIDANCE FROM AN INDEPENDENT THIRD PARTY ADVISOR. THE MEMBERS OF THE COMMITTEE ARE INDEPENDENT FROM ALL OF THE PARTICIPANTS IN THE PROGRAM. THE MAIN OBJECTIVE OF THE PROGRAM IS TO PROVIDE MARKET COMPETITIVE TOTAL COMPENSATION THAT IS INTERNALLY EQUITABLE AND HAS A STRONG PAY-FOR-PERFORMANCE LINKAGE. PERFORMANCE IS EVALUATED AT THE SYSTEM, OPERATING UNIT, AND INDIVIDUAL LEVELS. THE OVERALL TOTAL COMPENSATION PHILOSOPHY IS MANAGED AT THE 75TH PERCENTILE OF THE COMPETITIVE MARKET FOR COMPARABLE SIZE (NET REVENUE) AND TYPE (TAX-EXEMPT HEALTHCARE ORGANIZATIONS). WHERE APPROPRIATE, ADDITIONAL INDUSTRY DATA IS CONSIDERED (GENERAL BUSINESS AND/OR TAXABLE HEALTHCARE) FOR SELECTED POSITIONS THAT CAN BE RECRUITED FROM OR POTENTIALLY LOST TO THESE INDUSTRIES (E.G., INFORMATION TECHNOLOGY, FINANCE, ETC.). THE COMMITTEE HAS ENGAGED ERNST & YOUNG LLP ("E&Y") TO SERVE AS AN ADVISOR ON THE REASONABLENESS AND COMPETITIVENESS OF THE PROGRAM. IN DETERMINING REASONABLENESS AND COMPETITIVENESS, E&Y REVIEWS MARKET PRACTICES AND TRENDS, AND MAKES RECOMMENDATIONS RELATED TO THE PROGRAM. E&Y UTILIZES INFORMATION FROM CUSTOM SURVEYS, NATIONAL COMPENSATION SURVEYS, PROPRIETARY DATABASES, AND CLIENT EXPERIENCES TO DETERMINE ITS FINAL RECOMMENDATIONS. E&Y PRESENTS THEIR FINDINGS AND RECOMMENDATIONS TO THE COMMITTEE. THE COMMITTEE MAKES THE FINAL DECISIONS ON ALL OF THE COMPENSATION DETERMINATIONS OF THE PROGRAM. ALL DECISIONS MADE BY THE COMMITTEE ARE CONTEMPORANEOUSLY DOCUMENTED. FINANCIAL STATEMENT AVAILABILITY PART VI, LINE 19 MEDSTAR HEALTH POSTS ITS ANNUAL FINANCIAL AUDIT AND QUARTERLY FINANCIAL REPORTS TO THE ELECTRONIC MUNICIPAL MARKET ACCESS (EMMA) SYSTEM. THE ORGANIZATION ALSO E-MAILS ITS ANNUAL AND QUARTERLY DISCLOSURES TO HOLDERS OF THE COMPANY'S PUBLICLY TRADED DEBT. THE COMPANY'S GOVERNANCE DOCUMENTS AND CONFLICTS OF INTEREST POLICIES ARE AVAILABLE UPON REQUEST THROUGH ITS CORPORATE (OR AS APPLICABLE ENTITY) PUBLIC INFORMATION OFFICES. FINANCIAL STATEMENTS AND REPORTING PART XII, LINE 2C THE GOOD SAMARITAN HOSPITAL OF MARYLAND, INC. IS AN AFILLIATE OF THE MEDSTAR HEALTH, INC. AUDIT AND SUBJECT TO OVERSIGHT BY THE AUDIT COMMITTEE OF THE MEDSTAR BOARD. OTHER CHANGES IN NET ASSETS PART XI, LINE 9 EQUITY TRANSFERS - NET ASSETS.....................$ 6,552,331 MEDSTAR HEALTH ANESTHESIA SERVICES A LLC 5601 LOCH RAVEN BLVD BALTIMORE MD 21239 205909017 HEALTHCARE MD 7921975 676717 Church Home Corporation 5565 Sterrett Place 5th Floor Columbia MD 21044 237374724 Medical Fund MD 501(C)(3) PF NA true Franklin Square Hospital Center Inc 9000 Franklin Square Drive Baltimore MD 21237 520608007 Hospital MD 501(C)(3) 3 NA true Harbor Hospital Inc 3001 South Hanover Street Baltimore MD 21225 520491660 Hospital MD 501(C)(3) 3 NA true Medstar Health Inc 5565 Sterrett Place 5th Floor Columbia MD 21044 522087445 Medical Svcs MD 501(C)(3) 11b II NA false Montgomery General Hospital 18101 Prince Philip Drive Olney MD 20832 520646893 Hospital MD 501(C)(3) 3 NA true The Union Memorial Hospital 201 East University Parkway Baltimore MD 21218 520591685 Hospital MD 501(C)(3) 3 NA true Medstar health Research Institute 108 Irving Street NW Washington DC 20010 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Community Health Inc 18101 Prince Philip Drive Olney MD 20832 521372467 Medical Svcs MD 501(C)(3) 9 NA true MGH Health Foundation Inc 18101 Prince Philip Drive Olney MD 20832 521129959 Foundation MD 501(C)(3) 7 NA true MGH Health Services Inc 18101 Prince Philip Drive Olney MD 20832 521366812 Foundation MD 501(C)(3) 11a I NA true MGH Women's Board 18101 Prince Philip Drive Olney MD 20832 526039600 Foundation MD 501(C)(3) 11a I NA true National Rehabilitation Hospital 102 Irving Street NW Washington DC 20010 521369749 Hospital DC 501(C)(3) 3 NA true Regional Rehab at Olney Inc 18101 Prince Philip Drive Olney MD 20832 522310902 Medical Svcs MD 501(C)(3) 3 NA true Suburban NRH Medical Rehabilitation I 102 Irving Street NW Washington DC 20010 521931151 Medical Svcs DC 501(C)(3) 3 NA true The Thomas O'Neil Catholic Health Care F 5601 Loch Raven Blvd Baltimore MD 21239 521104382 Foundation MD 501(C)(3) 11a I NA true Union Memorial Hospital Foundation Inc 201 East University Parkway Baltimore 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