2014-12-18T10:14:40-06:00 2014-06-30 410746749 CLIFTONLARSONALLEN LLP 610 WGERMANTOWN PIKE STE400 PLYMOUTH MEETING PA 19462 990 2013-07-01 510069243 NANTICOKE MEMORIAL HOSPITAL INC NANT 3026296611 801 MIDDLEFORD ROAD SEAFORD DE 19973 DEAN A SWINGLE DIR FINANCE/CHIEF TAX OFFICER 3026296611 2014-12-17 1 MATTHEW CLAEYS CPA P00025339 2156433900 2013 2015-11-30 17:44:51Z STEVEN ROSE 801 MIDDLEFORD ROAD SEAFORD DE 19973 158089214 0 X WWW.NANTICOKE.ORG X 1945 DE PROVIDE HEALTH CARE SERVICES TO THE COMMUNITY, REGARDLESS OF THE ABILITY TO PAY. 17 15 1020 438 0 0 230248 342514 125724350 134627495 814285 1889927 3032102 2967591 129800985 139827527 4907656 4659765 0 0 59577729 57948525 0 0 0 60599588 63564850 125084973 126173140 4716012 13654387 124252419 140312351 74854912 73885457 49397507 66426894 X NANTICOKE MEMORIAL HOSPITAL OPERATES IN A MANNER CONSISTENT WITH THE REQUIREMENTS OF REVENUE RULING 69-545, THROUGH ITS PROVISION OF HEALTH CARE SERVICES TO THE COMMUNITY, REGARDLESS OF THE ABILITY TO PAY. 0 0 115457559 4659765 134627495 NANTICOKE MEMORIAL HOSPITAL PROVIDES QUALITY MEDICAL CARE REGARDLESS OF RACE, CREED, SEX, NATIONAL ORIGIN, HANDICAP, AGE OR ABILITY TO PAY. ALTHOUGH REIMBURSEMENT FOR SERVICES RENDERED IS CRITICAL TO THE OPERATION AND STABILITY OF NANTICOKE MEMORIAL HOSPITAL, IT IS RECOGNIZED THAT NOT ALL INDIVIDUALS POSSESS THE ABILITY TO PURCHASE ESSENTIAL MEDICAL SERVICES. THEREFORE, IN KEEPING WITH NANTICOKE MEMORIAL HOSPITAL'S COMMITMENT TO SERVE ALL MEMBERS OF THE COMMUNITY, HEALTH ACTIVITIES AND PROGRAMS NEEDED TO SUPPORT THE INABILITY TO PAY CO-EXIST. THESE ACTIVITIES INCLUDE WELLNESS PROGRAMS, COMMUNITY EDUCATION PROGRAMS, SPECIAL PROGRAMS FOR THE UNDER SERVED, SCREENINGS AND A WIDE VARIETY OF BROAD COMMUNITY SUPPORT ACTIVITIES. NANTICOKE ALSO WORKS WITH CHOOSE DELAWARE, THE STATE HEALTH INSURANCE EXCHANGE PROGRAM.PATIENTS SEEN:INPATIENTS 5,278 ; BIRTHS 882 ; ER VISITS 37,702 ; OP VISITS 88,323 ;DAYS OF INPATIENT CARE:ADULTS & PEDIATRICS 20,137 ; NEWBORN 1,704 ;OTHER FACTS:AVERAGE PATIENT STAY 3.8 ; OPERATIONS 3,585 NANTICOKE MEMORIAL HOSPITAL PROVIDES CARE TO PERSONS COVERED BY GOVERNMENTAL PROGRAMS AT OR BELOW COST. RECOGNIZING ITS MISSION TO THE COMMUNITY, SERVICES ARE PROVIDED TO BOTH MEDICARE AND MEDICAID PATIENTS. SERVICES PROVIDED TO THOSE UNABLE TO PAY $19,593,304DISCOUNTS TO MEDICARE, MEDICAID & OTHERS $146,919,329 115457559 1 1 0 1 0 0 0 0 0 0 1 0 0 0 1 1 0 1 0 0 0 0 0 0 0 0 1 1 1 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 173 0 1020 1 0 0 0 0 0 0 0 0 0 0 X 17 15 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 DE X X DEAN A SWINGLE DIR FINANCECHIEF TAX OFFICER 3026296611 801 MIDDLEFORD ROAD SEAFORD DE 19973 STEVEN ROSE CEO 32.00 9.00 X X 653325 0 51343 JOHN ALLEN DIRECTOR 1.00 1.00 X 0 0 0 SONJA BIDDLE OD DIRECTOR 1.00 2.00 X 0 0 0 KEVIN CARSON EDD DIRECTOR 1.00 1.00 X 0 0 0 DAVID CROUSE DIRECTOR 1.00 1.00 X 0 0 0 REP TIM DUKES DIRECTOR 1.00 1.00 X 0 0 0 DONALD HOLLENBECK DIRECTOR 1.00 1.00 X 0 0 0 GREG JOHNSON DIRECTOR 1.00 1.00 X 0 0 0 TRINA JOYNER DIRECTOR 1.00 1.00 X 0 0 0 JOSEPH KIM DO DIRECTOR/PHYSICIAN 1.00 41.00 X 30000 198505 3824 HARRY LEHMAN MD DIRECTOR 1.00 2.00 X 0 0 0 LYNDA MESSICK BOARD CHAIR ELECT 1.00 1.00 X X 0 0 0 PATRICIA OLEKSZYK DIRECTOR 1.00 2.00 X 0 0 0 TAMMY PAXTON DIRECTOR 1.00 1.00 X 0 0 0 KENT PETERSON BOARD CHAIR 1.00 1.00 X X 0 0 0 MICHELE PROCINO-WELLS DIRECTOR 1.00 1.00 X 0 0 0 JACK RIDDLE SECRETARY 1.00 2.00 X X 0 0 0 THOMAS BROWN SENIOR VP 20.00 21.00 X 244706 0 22467 PENNY SHORT COO/CNO 32.00 8.00 X 228784 0 19878 DON TRICARICO VP 40.00 1.00 X 162147 0 12631 BARBARA HENDRICKS VP 30.00 10.00 X 160416 0 9220 DENISE JESTER CFO 30.00 11.00 X 164528 0 9032 IMRAN JANJUA PHYSICIAN 40.00 0.00 X 309372 0 6119 DANIAL CHAN PHYSICIAN 40.00 0.00 X 244942 0 5386 ROBERT FERBER PHYSICIAN 40.00 0.00 X 242768 0 7418 LI ZHANG PHYSICIAN 40.00 0.00 X 218926 0 5897 ANJU BHARDWAJ PHYSICIAN 40.00 0.00 X 190651 0 436 2850565 198505 153651 41 0 1 0 CERNER CORPORATION 2800 ROCKCREEK PARKWAY KANSAS CITY MO 64141 TECHNOLOGY 3018102 MCR GROUP LLC 308 N PETERS RD KNOXVILLE TN 37922 REIMBURSEMENT CONSULTANT 1737959 ANESTHESIA SERVICES 2 READS WAY NEW CASTLE DE 19720 ANESTHESIA 1500000 SEIBERLICH TRANE 66 SOUTHGATE BLVD NEW CASTLY DE 19720 HVAC SERVICES 809544 ARAMARK MASTERPLAN 12483 COLLECTIONS CENTER DRIVE CHICAGO IL 60673 BIO-MEDICAL 733833 28 342514 342514 PATIENT REVENUE 623000 134627495 134627495 134627495 979394 979394 246968 350399 -103431 -103431 -103431 18389513 432308 17325505 585783 1064008 -153475 910533 910533 MISC 623000 2272485 2272485 CAFETERIA 623000 699245 699245 GIFT SHOP 623000 99292 99292 3071022 139827527 134627495 0 4857518 4659765 4659765 1575915 1434083 141832 44558942 40548637 4010305 8749998 7962498 787500 3063670 2787940 275730 1169477 1064224 105253 93039 93039 274035 274035 222160 222160 11864467 10796665 1067802 2235324 2034145 201179 263815 240072 23743 3163249 2878557 284692 4316833 3928318 388515 200015 182014 18001 2370535 2370535 6038618 6038618 136494 124210 12284 SUPPLIES 14693591 13371168 1322423 BAD DEBT EXPENSE 10977107 9989167 987940 HOUSEKEEPING 5411479 4924446 487033 MISCELLANEOUS 134612 122497 12115 126173140 115457559 10715581 0 5074238 10460747 13363548 16439485 1654472 1800766 2005994 1194380 118561317 71957557 47549467 46603760 48871627 56722901 347352 275147 968349 930833 4417372 5884332 124252419 140312351 19013957 19914628 47468147 47376608 6154953 4857990 2217855 1736231 74854912 73885457 X 49397507 66426894 49397507 66426894 124252419 140312351 X 13654387 3434909 -59909 X X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 1 0 0 0 1 14938 1 0 0 14938 0 SCHEDULE C, PART II-B, LINE 1I NANTICOKE MEMORIAL HOSPITAL PAYS DUES TO AHA AND DEHA: THE AMERICAN HOSPITAL ASSOCIATION AND THE DELAWARE HEALTHCARE ASSOCIATION. NANTICOKE MEMORIAL HOSPITAL'S MANAGEMENT ALSO CORRESPONDS WITH OUR STATE AND FEDERAL LEGISLATORS REGARDING CURRENT LEGISLATION AND REGULATIONS THAT MAY AFFECT THE FINANCIAL VIABILITY OF THE HOSPITAL AND ITS ABILITY TO CONTINUE TO PROVIDE QUALITY HEALTHCARE TO THE COMMUNITY. 1380076 1380076 63768174 28074290 35693884 1234700 952690 282010 51635786 42930577 8705209 542581 542581 46603760 ESTIMATED THIRD PARTY PAYOR SETTLEMENTS 722046 OTHER LIABILITIES 1014185 1736231 X 127753659 3434909 -15637016 -12202107 139955766 222160 -350399 -128239 139827527 110724272 350399 350399 110373873 222160 15577107 15799267 126173140 PART X, LINE 2: THE ORGANIZATION FOLLOWS THE STANDARD OF ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES RECOGNIZED IN AN ENTITY'S FINANCIAL STATEMENTS. THE STANDARD PRESCRIBES RECOGNITION AND MEASUREMENT OF TAX PROVISIONS TAKEN OR EXPECTED TO BE TAKEN ON A TAX RETURN THAT ARE NOT CERTAIN TO BE REALIZED. THE APPLICATION OF THE STANDARD HAD NO IMPACT ON THE ORGANIZATION'S CONSOLIDATED FINANCIAL STATEMENTS. THE ORGANIZATION'S TAX RETURNS ARE SUBJECT TO REVIEW AND EXAMINATION BY FEDERAL AND STATE AUTHORITIES. THE TAX RETURNS FOR THE YEARS 2011 TO 2013 ARE OPEN TO EXAMINATION BY FEDERAL AND STATE AUTHORITIES. PART XI, LINE 2D - OTHER ADJUSTMENTS: PROVISION FOR BAD DEBTS -10,977,107. PENSION ADJUSTMENT -59,909. CONTRIBUTIONS, GIFTS, GRANTS TO RELATED ORGANIZATIONS -4,600,000. PART XI, LINE 4B - OTHER ADJUSTMENTS: RENTAL EXPENSE -350,399. PART XII, LINE 2D - OTHER ADJUSTMENTS: RENTAL EXPENSE - INCLUDED WITH REVENUE IN PART VIII 350,399. PART XII, LINE 4B - OTHER ADJUSTMENTS: PROVISION FOR BAD DEBTS 10,977,107. CONTRIBUTIONS, GIFTS, GRANTS TO RELATED ORGANIZATIONS 4,600,000. 1 1 1 X 250.000000000000 1 X 1 1 1 0 1 1 3581 3262188 3262188 0.02590 39444 25694916 20100827 5594089 0.04430 43025 28957104 20100827 8856277 0.07020 467 14415 809109 809109 0.00640 275 2314 88515 88515 0.00070 742 16729 897624 897624 0.00710 742 59754 29854728 20100827 9753901 0.07730 107 107 725989 725989 0.00580 107 107 725989 725989 0.00580 1 10977107 47862036 46809245 1052791 X 1 1 1 1 NANTICOKE MEMORIAL HOSPITAL 801 MIDDLEFORD ROAD SEAFORD DE 19973 X X X NANTICOKE MEMORIAL HOSPITAL 1 1 X X X X X X X X X 12 1 1 1 X SEE SECTION C X X X X X X X 0 0 1 1 250.000000000000 1 300.000000000000 1 X X 1 1 X X X X X 1 0 X X X X 1 X 0 0 NANTICOKE MEMORIAL HOSPITAL PART V, SECTION B, LINE 4: THE HOSPITAL FACILITY'S FISCAL YEAR 2013 CHNA WAS COMPLETED. TWO OTHER COUNTY HOSPITALS WORKED WITH NANTICOKE TO COLLECT AND SHARE INFORMATION. NANTICOKE MEMORIAL HOSPITAL PART V, SECTION B, LINE 5D: THE FISCAL YEAR 2013 NANTICOKE COMMUNITY NEEDS ASSESSMENT IMPLEMENTATION PLAN CAN BE FOUND AT HTTP://WWW.NANTICOKE.ORG/COMMUNITY-OUTREACH/PROGRAMS-AND-INITIATIVES.ASPX. NANTICOKE MEMORIAL HOSPITAL PART V, SECTION B, LINE 7: BECAUSE OF THE METHOD OF COLLECTION, MORE NEEDS WERE IDENTIFIED THAN WE ARE ABLE TO ADDRESS INDIVIDUALLY. FOR EXAMPLE, MENTAL HEALTH WAS IDENTIFIED AS A TOP NEED FOR THE COUNTY. THIS NEED IS NOT BEING DIRECTLY ADDRESSED BY NANTICOKE SINCE, AS A RURAL COMMUNITY HOSPITAL, WE ARE UNABLE TO FINANCIALLY SUSTAIN A SOLUTION ON OUR OWN. NANTICOKE STAFF DOES HOWEVER PARTICIPATE IN STATE WORK GROUPS ADDRESSING THIS ISSUE. MENTAL HEALTH IS A GREAT NEED THROUGHOUT THE STATE OF DELAWARE. TO ADDRESS THE BROADER NEED, NANTICOKE ALONG WITH THE OTHER TWO HOSPITALS WITHIN SUSSEX COUNTY WORK TOGETHER AS HEALTHIER SUSSEX COUNTY. THIS GROUP PRODUCED A COMBINED CHNA AND STRATEGY FOR ADDRESSING COMMUNITY NEEDS ON A COUNTY-WIDE SCALE, AND DEVELOPED AN ASSOCIATED IMPLEMENTATION PLAN WITH 2014-2016 TARGETS. NANTICOKE MEMORIAL HOSPITAL PART V, SECTION B, LINE 20D: NANTICOKE MEMORIAL HOSPITAL CHARGES PATIENTS WHO ARE UNINSURED AND WHOSE FAMILY INCOME IS LESS THAN 500% OF THE FEDERAL POVERTY LEVEL, AN AMOUNT NO GREATER THAN 115% OF THE APPLICABLE PAYMENT RATE UNDER THE FEDERAL MEDICARE PROGRAM ESTABLISHED PURSUANT TO PUB. L.89-87 (42 U.S.C.S.1395 ET SEQ.) THE AMOUNT IS IN ACCORDANCE WITH THE SLIDING SCALE BASED ON INCOME DEVELOPED BY THE DEPARTMENT OF HEALTH & SENIOR SERVICES PURSUANT TO THIS ACT. 1 MEARS HEALTH CAMPUS 200 RAWLINS DRIVE SEAFORD DE 19973 MEDICAL FACILITY PART I, LINE 7: THE COSTING METHOD USED TO CALCULATE THE AMOUNTS REPORTED WAS THE MEDICARE OPERATING COST-TO-CHARGE RATIO FOR BOTH OUTPATIENT AND INPATIENT SERVICES. PART I, LINE 7G: THE HOSPITAL DID NOT INCLUDE SUBSIDIZED HEALTH SERVICE ATTRIBUTABLE TO PHYSICIAN CLINICS. PART I, LN 7 COL(F): THE HOSPITAL DID NOT INCLUDE ANY AMOUNT OF BAD DEBT EXPENSE IN THE DENOMINATOR IN COMPUTING THE PERCENTAGE IN COLUMN (F). PART III, LINE 4: THE ORGANIZATION PROVIDES CARE WITHOUT CHARGE OR AT AMOUNTS LESS THAN ITS ESTABLISHED RATES TO PATIENTS WHO MEET CERTAIN CRITERIA UNDER ITS CHARITY CARE POLICY. BECAUSE THE ORGANIZATION DOES NOT PURSUE COLLECTION OF AMOUNTS DETERMINED TO QUALIFY AS CHARITY CARE, THOSE AMOUNTS ARE NOT REPORTED AS REVENUES. FOR THOSE PATIENTS WHO DID NOT MEET THE CHARITY CARE POLICY, THE ORGANIZATION MUST EVALUATE THEIR ABILITY TO COLLECT AMOUNTS DUE FROM PATIENTS THAT ARE PAST DUE. A PROVISION FOR BAD DEBTS IS RECORDED FOR AMOUNTS NOT YET WRITTEN OFF WHICH ARE EXPECTED TO BECOME UNCOLLECTIBLE. THE HOSPITAL'S POLICY IS TO HAVE A MINIMUM OF 2-3 STATEMENTS AND A FINAL NOTICE BEFORE SENDING PATIENT ACCOUNTS TO COLLECTIONS. ADDITIONALLY, ACCOUNTS GREATER THAN $500 ARE ATTEMPTED TO BE REACHED BY TELEPHONE. PART III, LINE 8: THE COSTING METHOD USED TO DETERMINE ALLOWABLE COSTS ARE THE COSTS IN ACCORDANCE WITH MEDICARE REQUIREMENTS AND REGULATIONS. ONLY COSTS THAT ARE CONSISTENT WITH EFFICIENT, COST-EFFECTIVE MANAGEMENT AND OPERATIONS ARE ALLOWED. ONLY OPERATING COSTS THAT ARE DIRECTLY RELATED TO THE DELIVERY OF HEALTH CARE SERVICES TO MEDICARE AND MEDICAID PATIENTS WERE ALLOWED. PART III, LINE 9B: THE COLLECTION POLICY PERTAINS TO ALL PATIENTS WITH A SELF PAY BALANCE. IF A PATIENT APPLIES FOR EITHER CHARITY CARE OR ANY OTHER ASSISTANCE PROGRAM SUCH AS MEDICARE AND MEDICAID, ALL COLLECTION ACTIVITY IS PUT ON HOLD UNTIL A DETERMINATION OF ELIGIBILITY IS MADE. PART VI, LINE 2: NEEDS ASSESSMENT-NANTICOKE HEALTH SERVICES CURRENTLY USES AVAILABLE STATE DATA ON COMMUNITY HEALTH NEEDS. THE STATE OF DELAWARE CURRENTLY CONDUCTS STATEWIDE REPORTS ON HEALTH DISPARITIES FOR THOSE WITHOUT INSURANCE. THIS REPORT IS PRODUCED ABOUT EVERY FIVE YEARS. ADDITIONALLY, THE STATE OF DELAWARE PUBLISHED "RACIAL AND ETHNIC DISPARITIES HEALTH STATUS REPORT CARD" IN 2008. THIS REPORT INCLUDES COUNTY LEVEL DETAIL. THE STATE OF DELAWARE ALSO PRODUCES HEALTH NEED DATA ON DIABETES, CANCER, WOMEN'S AND CHILDREN'S HEALTH AND PROVIDER ACCESS. IN ADDITION TO STATE DATA, HOSPITAL DATA IS USED. MUCH OF DELAWARE'S DATA IS AVAILABLE BY COUTY AT WWW.DELAWAREHEALTHTRACKER.COM. NANTICOKE MEMORIAL HOSPITAL TREATS A LARGE NUMBER OF MEDICAID PATIENTS. IN ADDITION, NANTICOKE CONTINUALLY CONDUCTS COMMUNITY NEEDS ASSESSMENT SURVEYS. RESULTS ARE USED WITH THE ABOVE MENTIONED STATE DATA FOR THE PURPOSES OF PLANNING FOR COMMUNITY HEALTH OUTREACH NEEDS. COMMUNITY SURVEYS ARE CONDUCTED ON AN ON-GOING BASIS. PART VI, LINE 3: PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE-NANTICOKE MEMORIAL HOSPITAL PROVIDES INFORMATION IN THEIR PATIENT INFORMATION AND VISITORS GUIDE UNDER THE "FINANCIAL ARRANGEMENT/INSURANCE" SECTION CONCERNING THE AVAILABILITY OF FINANCIAL COUNSELORS TO DISCUSS PAYMENT ARRANGEMENTS. AT THIS TIME, PATIENTS ARE INFORMED ABOUT ALL THE PROGRAMS AVAILABLE TO THEM, BOTH VERBALLY AND IN WRITTEN FORMAT. IN POSSIBLE ELIGIBILITY FOR DELAWARE MEDICAID ASSISTANCE. THE FOLLOWING DEPARTMENTS OFFER THIS TYPE OF ASSISTANCE TO OUR PATIENTS: BUSINESS OFFICE, REGISTRATION, CASE MANAGEMENT, CHAPS COORDINATOR, CANCER CARE COORDINATOR, CANCER NURSE NAVIGATOR (SCREENING APPROACH), AND PRESCRIPTION ASSISTANCE PROGRAM. IN ADDITION, VARIOUS ORGANIZATIONS WERE INTERVIEWED FOR INPUT, INCLUDING: ALZHEIMER'S ASSOCIATION, AMERICAN CANCER SOCIETY, AMERICAN DIABETES ASSOCIATION, BAYHEALTH, BEEBE AND NANTICOKE SOCIAL WORKERS, DELAWARE ASSOCIATION OF HISPANIC NURSES, DELAWARE BREAST CANCER COALITION, DELAWARE HEALTHCARE ASSOCIATION, DELAWARE HOSPICE, DIVISION OF PUBLIC HEALTH - GEORGETOWN, EASTER SEALS, ELLENDALE RECOVERY CENTER, LA ESPERANZA, LA RED FEDERAL QUALIFIED HEALTH CENTERS, LAW ENFORCEMENT AGENCIES, MID-ATLANTIC AIDS TRAINIG CENTER, MOUNTAIRE & PERDUE CHICKEN PLANTS, NANTICOKE INDIAN CENTER, PENINSULA HOME CARE, PEOPLE'S PLACE, PUBLIC HEALTH NURSES - GEORGETOWN, SOUTHERN DELAWARE TOURISM, STRONG COMMUNITIES, SUSSEX COUNT ASSOCIATION OF TOWNS, SUSSEX CHILD HEALTH, SUSSEX COUNTY CHURCHES, SUSSEX COUNTY CHAMBER OF COMMERCE, SUSSEX COUNTY EMS, SUSSEX COUNTY LIBRARIES, SUSSEX COUNTY FIRE STATIONS, SUSSEX COUNTY SENIOR CENTERS, SUSSEX COUNTY VETERANS GROUP, VFW/AMERICAN LEGION. PART VI, LINE 4: USING THE INFORMATION PROVIDED THROUGH NANTICOKE'S FISCAL YEAR 2013 CHNA, NANTICOKE'S COMMUNITY BENEFIT COMMITTEE (CBC) OF THE BOARD CONTINUED TO FOCUS OUTREACH EFFORTS AND BUILD STRUCTURE AROUND THE COMMUNITY BENEFIT PROCESS. DURING CALENDAR YEAR 2013, THE COMMUNITY BENEFIT IMPLEMENTATION PLAN WAS DEVELOPED AND APPROVED BY THE NHS BOARD OF DIRECTORS IN JUNE 2013. THIS ESTABLISHED TARGET STRATEGIES AND MEASURES FOR IDENTIFIED OUTREACH INITIATIVES FROM THE CHNA. REPORTING OF MEASURES WILL BE USED TO DETERMINE IF PROGRESS IS BEING MADE IN IMPROVING HEALTH OR ACCESS TO CARE IN THESE AREAS.IN ADDITION TO IDENTIFYING HEALTH NEEDS, THE 2013 CHNA ALSO IDENTIFIED BOTH THE GROWING HISPANIC POPULATION OF SUSSEX COUNTY AS WELL AS THE AFRICAN AMERICAN POPULATION AS GROUPS WITH INCREASED COMMUNITY HEALTH NEEDS. IN THE 2013 CHNA, NANTICOKE REFERENCED THE "HISPANIC HEALTH IN DELAWARE: BARRIERS TO CARE FOR THE HISPANIC POPULATION". IN 2012 AND CONTINUING INTO 2013, NANTICOKE IS WORKING ON INITIATIVES WITH BOTH LA RED AND LA ESPERANZA, ORGANIZATIONS THAT PROVIDE HEALTH AND SOCIAL SERVICES FOR THE GROWING HISPANIC POPULATION WITHIN THE COUNTY. HISPANIC REPRESENTATION ON BOTH THE NHS BOARD OF DIRECTORS AND THE COMMUNITY BENEFIT COMMITTEE HAS BEEN INCREASED. IN ADDITION IN 2013, NANTICOKE IS SPECIFICALLY TARGETING INCREASED PARTNERSHIPS TO ADDRESS THE NEEDS OF THE AFRICAN AMERICAN POPULATION AS WELL. THIS BEGAN WITH A COMMUNITY MEETING WITH CLERGY AND OTHER AFRICAN AMERICAN COMMUNITY REPRESENTATIVES TO OPENLY DISCUSS PRESSING NEEDS FOR THIS POPULATION. THE AFRICAN AMERICAN POPULATION IS A TARGET AREA FOR OUTREACH RELATED TO INCREASING MAMMOGRAPHY SCREENINGS SINCE THIS POPULATION IS AT HIGHER RISK TO DISCOVER THE CANCER IN LATER STAGES, WHICH INCREASES THE RISK OF DEATH FROM THE DISEASE.HEALTHIER SUSSEX COUNTY IS A GROUP THAT BRINGS TOGETHER THE THREE HOSPITALS AND OTHER HEALTH PROVIDERS AND RESOURCES TO TARGET HEALTH ISSUES THAT IMPACT NOT JUST INDIVIDUAL HOSPITAL SERVICE AREA POPULATIONS, BUT RESIDENTS THROUGHOUT THE COUNTY. IN 2013, HEALTHIER SUSSEX COUNTY HOSPITAL PARTICIPANTS COMPLETED A COMBINED, APPREVIATED CHNA AND ARE TOGETHER WORKING ON (1) A DIABETES TASK FORCE WORKING TOWARD INCREASING COMPLIANCE AND FOLLOW UP FOR DIAGNOSED DIABETICS; (2) AWARENES CAMPAIGN AND ACTIVITIES AROUND PHYSICAL ACTIVITY; AND (3) A MAMMOGRAPHY TASK FORCE WORKING TO INCREASE THE NUMBER OF WOMEN COMPLETING HAVE THEIR ANNUAL MAMMOGRAM, PARTICULARLY THOSE FROM MINORITY POPULATIONS AND/OR THOSE WITHOUT INSURANCE. THESE INITIATIVES COMBINE THE RESOURCES OF ALL THREE HOSPITALS AS WELL AS OTHER HEALTH PROVIDERS IN THE AREA INCLUDING LA RED, DELAWARE BREAST CANCER COALITION, SUSAN G. KOMEN, AMERICAN DIABETES ASSOCIATION REPRESENTATIVES, COMMUNITY CLINICIANS, INSURERS, AND STATE HEALTH RESOURCES. MORE INFORMATION ABOUT HEALTHIER SUSSEX COUNTY CAN BE FOUND AT WWW.HEALTHIERSUSSEXCOUNTY.COM. PART VI, LINE 5: FOR THE 2013 CHNA, STATE DATA FROM DELAWARE HEALTH AND SOCIAL SERVICES. THIS INCLUDED COUNTY LEVEL DATA AND WAS THE PRIMARY SOURCE OF INFORMATION RELATED TO TRENDS AND SERVICE AREA HEALTH NEEDS. NO INDIVIDUAL AT DHSS WAS INTERVIEWED. IN ADDITION TO THE ABOVE, NANTICOKE REFERENCED THE "HISPANIC HEALTH IN DELAWARE: BARRIERS TO CARE FOR THE HISPANIC POPULATION" PRODUCED BY THE GOVERNOR COMMISSION ON HISPANIC AFFAIRS.TO BETTER UNDERSTAND LOCAL NEEDS OF SEAFORD, DELAWARE AND THE SURROUNDING AREAS NANTICOKE CONDUCTED THREE SURVEYS WITHIN OUR PRIMARY SERVICE AREA. FIRST WE SURVEYED THE COMMUNITY AT LARGE DURING A NUMBER OF COMMUNITY HEALTH EVENT AND RECEIVED OVER 500 RESPONSES TO THE COMMUNITY SURVEY. A COPY OF NANTICOKE'S CURRENT CHNA CAN BE FOUND AT WWW.NANTICOKE.ORG. PART VI, LINE 6: THE HOSPITAL IS NOT PART OF AN AFFILIATED HEALTH CARE SYSTEM. 0 AMERICAN HEART ASSOCIATION 1109 MATTLIND WAY MILFORD DE 19963 135613797 501(C)(3) 8000 HEART DISEASE MID-SUSSEX MEDICAL CENTER INC 801 MIDDLEFORD ROAD SEAFORD DE 19973 510224470 501(C)(3) 4600000 TO PROVIDE FUNDS FOR MID-SUSSEX MEDICAL CENTER, INC. DELAWARE TECHNICAL AND COMMUNITY COLLEGE PO BOX 610 GEORGETOWN DE 19947 516000279 501(C)(3) 5000 EDUCATION FOUNDATION 3 0 X 1 1 X X X X X 0 0 0 0 0 0 0 0 0 STEVEN ROSE CEO 457770 0 61625 0 133930 0 0 0 51343 0 704668 0 0 0 JOSEPH KIM DO DIRECTOR/PHYSICIAN 0 198505 0 0 30000 0 0 0 0 3824 30000 202329 0 0 THOMAS BROWN SENIOR VP 223255 0 20677 0 774 0 0 0 22467 0 267173 0 0 0 PENNY SHORT COO/CNO 210334 0 18036 0 414 0 0 0 19878 0 248662 0 0 0 DON TRICARICO VP 147870 0 13503 0 774 0 0 0 12631 0 174778 0 0 0 BARBARA HENDRICKS VP 145029 0 14973 0 414 0 0 0 9220 0 169636 0 0 0 DENISE JESTER CFO 142808 0 21125 0 595 0 0 0 9032 0 173560 0 0 0 IMRAN JANJUA PHYSICIAN 309372 0 0 0 0 0 0 0 6119 0 315491 0 0 0 DANIAL CHAN PHYSICIAN 244942 0 0 0 0 0 0 0 5386 0 250328 0 0 0 ROBERT FERBER PHYSICIAN 242768 0 0 0 0 0 0 0 7418 0 250186 0 0 0 LI ZHANG PHYSICIAN 218926 0 0 0 0 0 0 0 5897 0 224823 0 0 0 ANJU BHARDWAJ PHYSICIAN 190651 0 0 0 0 0 0 0 436 0 191087 0 0 0 PART I, LINE 1A STEVE ROSE- HEALTH OR SOCIAL CLUB DUES FOR $2,800 A DELAWARE HEALTH FACILITIES AUTHORITY 510272458 246388RD6 2013-06-11 47475775 DEBT REFINANCING 0 0 0 A 99167 47475775 930010 46545765 2013 0 1 1 1 A 0 0 0 0 0 0 1 A 0 1 0 0 0 0 0 0 1 A 0 FORM 990, PART VI, SECTION A, LINE 6 NANTICOKE HEALTH SERVICES, INC IS THE SOLE MEMBER. FORM 990, PART VI, SECTION A, LINE 7A SHAREHOLDER / GOVERNING BODY HAS POWER TO SELECT THE DIRECTORS, OFFICERS, AND AGENTS OF THE HOSPITAL AND DEFINE THEIR DUTIES. FORM 990, PART VI, SECTION A, LINE 7B SHAREHOLDER / GOVERNING BODY HAS POWER TO: MANAGE SUPERVISE AND DIRECT BUSINESS AFFAIRS; ESTABLISH POLICIES, PROCEDURES AND PROGRAMS; DETERMINE HOSPITAL SERVICES; AUTHORIZE AND EXECUTE DEBT AGREEMENTS; DETERMINE POLICIES OF HOSPITAL; HAVE RESPONSIBILITY FOR QUALITY PATIENT CARE; TO PROVIDE FOR ADEQUATE FINANCING; DECIDE STRATEGIC PLANS; PROTECT HOSPITAL PROPERTY; PROVIDE FINANCIAL STABILITY; APPROVE ANNUAL BUDGET; ESTABLISH HOSPITAL POLICY; APPROVE BY-LAWS; PROVIDE FOR APPOINTMENT OF MEDICAL STAFF; REQUIRE MEDICAL STAFF MAINTAIN HIGH STANDARDS; AVOID PROFITING FROM HOSPITAL RELATIONSHIP; ESTABLISH COMMUNICATION AMONG SHAREHOLDERS; MAINTAIN RECORDS; IMPLEMENT EXPENDITURE PLANS; EVALUATE PERFORMANCE; SELECT CHIEF EXECUTIVE OFFICER; ASSESS AND REVIEW COMPETENCIES OF STAFF; ENSURE AGE-APPROPRIATE CARE IS DELIVERED; PROVIDE SINGLE LEVEL OF PATIENT CARE; REQUIRE STAFF TO REPORT ON MEDICAL CARE; PROVIDE RESOURCES FOR RISK MANAGEMENT; APPROVE AUXILIARY ORGANIZATION ACTIVITIES; TO REMOVE HOSPITAL DIRECTOR OR STAFF WITHOUT CAUSE; AUTHORIZE ISSUANCE OF SHARES OF STOCK; APPROVE ACTIVITES OF HOSPITAL DIRECTOR; AMEND CERTIFICATE OF ORGANIZATION; AUTHORIZE LIQUIDATION OF ASSETS; RESOLVE CONFLICTS; AUTHORIZE ACQUISITION OF SUBSIDIARIES; PROVIDE FOR COMPLIANCE WITH LAWS; PROVIDE FOR THE COLLABORATION OF LEADERS; EXERCISE POWERS OF BOARD OF DIRECTORS; EXERCISE POWERS OF NANTICOKE HEALTH SERVICES, INC. FORM 990, PART VI, SECTION B, LINE 11 ORGANIZATION'S PROCESS TO REVIEW FORM 990: THE COMPLIANCE COMMITTEE REVIEWS AND APPROVES THE FORM. AFTER THE REVIEW, IT IS PRESENTED TO THE FULL BOARD OF DIRECTORS FOR APPROVAL BEFORE BEING FILED. FORM 990, PART VI, SECTION B, LINE 12C THIS POLICY IS APPLICABLE TO THE BOARD OF DIRECTORS, INCLUDING COMMUNITY AND PHYSICIAN MEMBERS OF BOARD COMMITTEES, AND ADMINISTRATION (COLLECTIVELY REFERRED TO AS "BOARD, COMMITTEE MEMBERS, AND ADMINISTRATION") OF NANTICOKE HEALTH SERVICES, NANTICOKE MEMORIAL HOSPITAL, AND MID-SUSSEX MEDICAL CENTER, ALL OF WHICH ARE TAX-EXEMPT CHARITABLE ORGANIZATIONS (REFERRED TO HEREIN AS "NHS"). POLICY: THE POLICY OF NHS IS TO REQUIRE THAT EACH INDIVIDUAL SUBJECT TO THIS POLICY STATEMENT PROMPTLY AND FULLY DISCLOSE (IN THE MANNER PROVIDED HEREIN) ANY ACTUAL, APPARENT, OR POTENTIAL CONFLICT OF INTEREST, AND THAT NHS WILL NOT ENGAGE IN ANY CONTRACT, TRANSACTION, OR ARRANGEMENT INVOLVING A CONFLICT OF INTEREST UNLESS THE DISINTERESTED MEMBERS OF THE BOARD OF DIRECTORS (ACTING AT A DULY CONSTITUTED MEETING THEREOF) (WITH THE ADVICE OF LEGAL COUNSEL) DETERMINE BY A MAJORITY VOTE THAT APPROPRIATE SAFEGUARDS TO PROTECT THE CHARITABLE MISSION OF NHS HAVE BEEN IMPLEMENTED. VIOLATIONS OF THE CONFLICTS OF INTEREST POLICY: IF THE BOARD OF DIRECTORS OR A COMMITTEE HAS REASON TO BELIEVE THAT AN INTERESTED PERSON HAS FAILED TO COMPLY WITH THE DISCLOSURE OBLIGATION OF THIS POLICY, THE BOARD OF DIRECTORS SHALL INFORM THAT PERSON OF THE BASIS FOR ITS BELIEF AND PROVIDE THAT PERSON AN OPPORTUNITY TO ADDRESS THE ALLEGED FAILURE TO DISCLOSE. AFTER HEARING THE RESPONSE OF SUCH PERSON AND CONDUCTING SUCH FURTHER INVESTIGATION AS MAY BE WARRANTED UNDER THE CIRCUMSTANCES, THE BOARD OF DIRECTORS SHALL DETERMINE WHETHER SUCH PERSON HAS, IN FACT, VIOLATED THE DISCLOSURE REQUIREMENTS OF THIS CONFLICT OF INTEREST POLICY. IF THE BOARD DETERMINES THAT THERE HAS BEEN A VIOLATION, THE BOARD SHALL TAKE APPROPRIATE DISCIPLINARY AND CORRECTIVE ACTION, WHICH MAY INCLUDE REMOVAL (IF THE INTERESTED PERSON IS A BOARD OR COMMITTEE MEMBER) OR TERMINATION (IF THE INTERESTED PERSON IS AN EMPLOYEE). INTENTIONALLY OR REPEATEDLY FAILING TO ADHERE TO THIS POLICY IS GROUNDS FOR REMOVAL FROM THE BOARD. FORM 990, PART VI, SECTION B, LINE 15 ON AN ANNUAL BASIS, THE BOARD OF DIRECTORS' CHAIRMAN AND CHAIRMAN-ELECT REVIEW THE EXECUTIVE COMPENSATION OF THE CEO, SENIOR VP'S AND VP'S. AS PART OF THAT PROCESS, THE FACILITY'S OPERATIONS AND PERFORMANCE ARE TAKEN INTO CONSIDERATION, WHICH INCLUDE REVIEW OF HOSPITAL QUALITY INDICATORS, FINANCIAL PERFORMANCE, EMPLOYEE SATISFACTION SCORES AND PHYSICIAN SATISFACTION SCORES. THE PROCESS INCLUDES A REVIEW OF ACCOMPLISHMENTS OF EACH OF THE EXECUTIVES AND THEIR IMPORTANCE TO THE OVERALL ORGANIZATION. IN DETERMINING THE REASONABLENESS OF COMPENSATION, OTHER AREA HOSPITAL FORM 990'S ARE REVIEWED FOR THEIR EXECUTIVE COMPENSATION, AS WELL AS PUBLISHED NATIONAL SALARY SURVEY DATA. AFTER THE REVIEW AND RECOMMENDATION OF THE CHAIRMAN AND VICE CHAIRMAN, IT IS THEN PRESENTED TO THE FULL BOARD OF DIRECTORS, WHO REVIEW THE ANNUAL COMPENSATION REQUESTS AND EITHER APPROVE OR RECOMMEND APPROPRIATE CHANGES FOR IMPLEMENTATION. THE SAME PROCESS GOES FOR OTHER KEY EMPLOYEES AND OFFICERS. THIS WAS LAST COMPLETED IN SEPTEMBER 2014. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS FINANCIAL STATEMENTS AND GOVERNING DOCUMENTS AVAILABLE TO THE PUBLIC VIA ANOTHER'S WEBSITE OR UPON REQUEST. FORM 990, PART XI, LINE 9: PENSION AND POSTRETIREMENT ADJUSTMENT -59,909. FORM 990, PART XII, LINE 2C THE OVERSIGHT AND SELECTION PROCESS HAVE NOT CHANGED FROM THE PRIOR YEAR. ABOUT NANTICOKE NANTICOKE MEMORIAL HOSPITAL, ORIGINALLY INCORPORATED IN 1945, IS ORGANIZED UNDER THE CORPORATE TITLE OF NANTICOKE HEALTH SERVICES. WHAT STARTED AS A 32-BED HOSPITAL IN 1952 HAS GROWN TO INPATIENT SERVICES, OUTPATIENT SERVICES, MEDICAL CENTERS ACROSS SUSSEX COUNTY DELAWARE, BUSINESS SERVICES AND A HOST OF PREVENTATIVE MEDICINE AND HEALTH EDUCATION PROGRAMS. EACH PART OF NANTICOKE HEALTH SERVICES WORKS TOGETHER TO FOCUS ON FULFILLING OUR MISSION STATEMENT: "WE EXIST TO POSITIVELY IMPACT OUR COMMUNITIES QUALITY OF LIFE THROUGH SUPERIOR HEALTH SERVICES." TODAY, PATIENTS AND BUSINESSES ARE CONTINUALLY SEEKING SUPERIOR HEALTH CARE AT AN AFFORDABLE PRICE. NANTICOKE HEALTH SERVICES STANDS COMMITTED TO PROVIDING THAT CARE. AS A PARTICIPANT IN THE CMS AND JOINT COMMISSION CORE MEASURE PROJECTS, NANTICOKE MEMORIAL HOSPITAL HAS ACHIEVED THE TOP SCORES IN THE STATE OF DELAWARE FOR CARDIAC CARE, AND HAS BEEN BY THE AMERICAN HERT ASSOCIATIONS GETWITH THE GUIDELINES FOR BOTH STROKE (GOLD ACHEIVEMENT AWARE) AND INTEVERNTIONAL CARDIOLOGY (SILVER ACHIEVEMENT AWARD). FEEDBACK FROM OUR PATIENTS OVERWHELMINGLY COMPLIMENTS US ON THE CARE AND FRIENDLINESS OF OUR STAFF IN ALL OF OUR ENTITIES. OUR DEDICATION TO SERVING OUR PATIENTS IS EVIDENCED THROUGH A COORDINATED SYSTEM OF CARE OUR ORGANIZATION IS ABLE TO TREAT YOU AND YOUR FAMILY ACROSS THE COMPLETE SPECTRUM OF HEALTHCARE NEEDS. OUR GROWTH IS EVIDENCED NOT ONLY THROUGH THE CONTINUED ADDITION TO MEDICAL PROGRAMS, BUT ALSO THROUGH SUCCESSFUL PHYSICIAN RECRUITMENT - OVER 65 PHYSICANS IN THE LAST 15 YEARS. AS OUR COMMUNITIES' HEALTHCARE NEEDS CHANGE, NANTICOKE HEALTH SERVICES CONTINUES TO CHANGE AND EXPAND SERVICES TO MEET COMMUNITY NEEDS. RECOGNIZED NATIONALLY FOR OUR ACCOMPLISHMENTS BY ORGANIZATIONS SUCH AS THE AMERICAN HOSPITAL ASSOCIATION AND THE CENTER FOR CASE MANAGEMENT, OUR STAFF WELCOMES THE OPPORTUNITY TO MEET YOUR HEALTHCARE NEEDS. COMMUNITY OUTREACH NANTICOKE HEALTH SERVICES' TRAINED STAFF GOES INTO THE COMMUNITY TO PRESENT HEALTH EDUCATION SEMINARS AND HEALTH SCREENINGS. WE HAVE WORKED WITH AREA SCHOOLS, SENIOR CENTERS AND CIVIC ORGANIZATIONS IN OUR EFFORTS TO EDUCATE OUR COMMUNITY ON PREVENTION AND WELLNESS. PHYSICIANS, NURSES, ANCILLARY STAFF AND ADMINISTRATIVE PERSONNEL HAVE ALL RESPONDED TO REQUESTS TO MEET WITH THESE VARIOUS ORGANIZATIONS. THERE ARE MANY SUPPORT GROUPS AND EDUCATIONAL MEETINGS WHICH ARE HELD IN THE HOSPITAL AS WELL. OUR MATERNITY EDUCATION PROGRAM IS VERY STRONG, AND INCLUDES CHILDBIRTH PREPARATION, SIBLING PREPARATION AND BREAST-FEEDING SUPPORT. NANTICOKE ALSO HOST DIABETES EDUCATION CLASSES CERTIFIED THROUGH THE AMERICAN DIABETES ASSOCIATION ALONG WITH STROKE , CHF, CANCER, AND MANY OTHER SUPPORT GROUPS. WE CONDUCT REGULAR CHOLESTEROL, DIABETES, AND BLOOD PRESSURE SCREENINGS AND ADULT AND INFANT / CHILD CPR INSTRUCTION ON A REGULAR BASIS. IN 2013-2014 NANTICOKE COMPLETED AN UPDATED COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) AND ASSOCIATED IMPLEMENTATION PLAN. NEEDS IDENTIFIED INCLUDED A CONTINUING NEED FOR PROGRAMMING AROUND HEALTH AND WELLNESS AND OBESITY AND DIABETES. ADDITIONALLY, WORK IS BEING DONE TO SUSTAIN EDUCATIONAL PROGRAMS FOR EXPECTING MOTHERS AND NEWBORNS FROM THE HISPANIC POPULATION. NANTICOKE IS ALSO WORKING THROUGH A COUNTY-WIDE PARTNERSHIP KNOWN AS HEALTHIER SUSSEX COUNTY ON OBESITY, WOMEN'S HEALTH AND PHYSICIAN EDUCATION REGARDING SCREENINGS FOR PROSTATE CANCER. THESE PROGRAMS HAVE BEEN ESTABLISHED AND ARE MEASURED ON AN ANNUAL BASIS. OTHER PARTNERSHIPS ALSO CONTINUE AS NANTICOKE CONTINUES CONNECTIONS WITH COMMUNITY PARTNERS ON HEALTH NEEDS SUCH AS PARTNERING WITH THE SUSSEX CHILD HEALTH PROMOTION COALITION IN THE DEVELOPMENT OF THE PRESCRIPTION FOR HEALTH PROGRAM AND WORKPLACE WELLNESS PROGRAM, AND PARTNERING WITH THE DELAWARE BREAST CANCER COALITION TO PROVIDE ACCESS TO MAMMOGRAMS FOR UNDERSERVED POPULATIONS. NANTICOKE CONTINUES TO BE A LEAD PARTNER IN A GROUP KNOWN AS HEALTHIER SUSSEX COUNTY, A PARTNERSHIP OF VARIOUS HEALTH CARE PROVIDERS IN THE AREA TO COMMONLY ADDRESS COUNTY HEALTH CARE NEEDS (WWW.HEALTHERSUSSEXCOUNTY.COM). HEALTHIER SUSSEX COUNTY SHARED FINDINGS FROM EACH OF THE COUNTY'S HOSPITAL'S HEALTH NEEDS ASSESSMENT AND DEVELOPED CORE STRATEGIES FOR THE TASK FORCE WHICH INCLUDED PHYSICAL ACTIVITY AND PHYSICIAN EDUCATION ON CANCER SCREENINGS. PATIENT EDUCATION PATIENT AND FAMILY EDUCATION HAS BECOME AN INTEGRAL PART OF THE CLINICAL PATHWAY PROCESS UTILIZED THROUGHOUT NANTICOKE HEALTH SERVICES. THROUGH THE PATIENT EDUCATION CENTER, OUR PATIENT CARE STAFF HAS BEEN TRAINED TO TEACH OUR PATIENTS AND THEIR FAMILIES ABOUT THEIR ILLNESSES AND TREATMENTS. UTILIZING AN ASSORTMENT OF PRINTED MATERIALS AND CLOSED CIRCUIT TELEVISION, WE ARE ABLE TO EFFECTIVELY TRANSFER CRITICAL INFORMATION DURING ALL PHASES OF CARE. NANTICOKE CONTINUES TO EXPLORE WAYS TO PROVIDE PATIENT EDUCATION THAT IS EASIER TO ACCESS THROUGH TODAY'S TECHNOLOGIES. NANTICOKE HEALTH SERVICES 801 MIDDLEFORD ROAD SEAFORD DE 19973 510293888 HEALTH SERVICES DE 501(C)(3) LINE 11B, II N/A 0 MID-SUSSEX MEDICAL CENTER 801 MIDDLEFORD ROAD SEAFORD DE 19973 510224470 HEALTH SERVICES DE 501(C)(3) LINE 9 NHS 0 NANTICOKE INSURANCE CO PO BOX 1109 GT GEORGETOWN CAYMAN ISLANDS CJ 980446259 INSURANCE CJ 501(C)(15) N/A NHS 0 PROPRIETARY ENTERPRISES 801 MIDDLEFORD ROAD SEAFORD DE 19973 510293887 INACTIVE DE N/A C 0 0 1 0 0 0 0 0 0 0 1 0 1 1 1 1 1 1 0 0 MID-SUSSEX MEDICAL MEDICAL CENTER INC B 4600000 FMV