CIVISTA MEDICAL CENTER INC: Form 990, tax year 2012
View the entire original 990 at ProPublica ↗
- Organization
- CIVISTA MEDICAL CENTER INC (EIN 52-0445374)
- Tax period
- 2012-07-01 to 2013-06-30
- Filed
- 2014-05-13
- IRS object ID
- 201421339349302792
- Schema version
- 2012v2.3
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
- Return header
- Form 990
- Schedule A
- Schedule B
- Schedule C
- Schedule D
- Schedule F
- Schedule H
- Schedule I
- Schedule J
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2014-05-13T13:50:32-05:00 | Timestamp |
| Tax Period End Date | 2013-06-30 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | GRANT THORNTON LLP | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2001 MARKET STREET SUITE 700 | AddressLine1 |
| City | PHILADELPHIA | City |
| State | PA | State |
| ZIP Code | 19103 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2012-07-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 520445374 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Civista Medical Center Inc | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| In Care Of Name | % ERIK BOAS | InCareOfName |
| Name Control | CIVI | NameControl |
| Phone | 3016094130 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 5 Garrett Ave | AddressLine1 |
| Address Line2 | PO Box 1070 Suite | AddressLine2 |
| City | La Plata | City |
| State | MD | State |
| ZIP Code | 20646 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | ERIK BOAS | Name |
| Title | CFO | Title |
| Phone | 3016094130 | Phone |
| Date Signed | 2014-05-08 | DateSigned |
| Authorize Third Party | true | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | Frank Giardini | Name |
| Phone | 2155614200 | Phone |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2012 | TaxYear |
| Build TS | 2015-11-30 17:44:51Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | Noel Cervino | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 5 Garrett Ave | AddressLine1 |
| City | La Plata | City |
| State | MD | State |
| ZIP Code | 20646 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 117206743 | GrossReceipts |
| Group Return For Affiliates | false | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | www.civista.org | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1980 | YearFormation |
| State Legal Domicile | MD | StateLegalDomicile |
| Activity Or Mission Description | Civista Medical Center, Inc. is a component of a regional integrated health system serving the health needs of Charles County and the citizens of southern Maryland. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 16 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 13 | NbrIndependentVotingMembers |
| Total Nbr Employees | 1020 | TotalNbrEmployees |
| Total Nbr Volunteers | 118 | TotalNbrVolunteers |
| Total Gross UBI | 144140 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 32420 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 165000 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 528633 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 111209188 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 118309645 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 88269 | InvestmentIncomePriorYear |
| Investment Income Current Year | 796545 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 542401 | OtherRevenuePriorYear |
| Other Revenue Current Year | -2428080 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 112004858 | TotalRevenuePriorYear |
| Total Revenue Current Year | 117206743 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 34654 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 58392 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 48691670 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 53090677 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp Prior Year | 0 | TotalProfFundrsngExpPriorYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 55007273 | OtherExpensePriorYear |
| Other Expenses Current Year | 56619499 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 103733597 | TotalExpensesPriorYear |
| Total Expenses Current Year | 109768568 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 8271261 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 7438175 | RevenuesLessExpensesCY |
| Total Assets BOY | 147245093 | TotalAssetsBOY |
| Total Assets EOY | 143406844 | TotalAssetsEOY |
| Total Liabilities BOY | 116457768 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 104014817 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 30787325 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 39392027 | NetAssetsOrFundBalancesEOY |
| Info In Schedule O Part III | X | InfoInScheduleOPartIII |
| Mission Description | CIVISTA MEDICAL CENTER, INC. IS A COMPONENT OF A REGIONAL INTEGRATED HEALTHCARE SYSTEM CREATED TO PROVIDE EXCELLENCE IN ACUTE HEALTHCARE AND PREVENTIVE SERVICES IN CHARLES COUNTY AND THE SURROUNDING COMMUNITIES. | MissionDescription |
| Significant New Program Services | false | SignificantNewProgramServices |
| Significant Change | false | SignificantChange |
| Expense | 86303830 | Expense |
| Grants | 58392 | Grants |
| Revenue | 118693209 | Revenue |
| Description | Civista Health is the parent company of a regional integrated health system serving the health needs of Charles County and the citizens of Southern Maryland. Civista Medical Center's Community Benefits Program utilizes a planned, managed, organized, and measured approach to meeting the identified community needs of the area we serve. The mission is to improve overall community health by improving access to health care, enhancing the health of the community, advancing healthcare knowledge and working with health - providing agency partners. Civista Health collaborated with the Charles County Department of Health (CCDOH) to complete a comprehensive assessment of the health needs (CHNA) of Charles County, Maryland. An epidemiologist with a Master's Degree in Public Health Epidemiology was contracted to analyze the qualitative and quantitative data. Civista lead the effort and covered 80% of the cost of the CHNA. To provide a comprehensive assessment of the health needs of the county, a four method plan was developed which included four different sources of data: a long online survey of Charles County residents perceptions of health and health behaviors, a short paper survey on health perceptions throughout the county, seven focus groups with community leaders, citizens, and stakeholders, and a quantitative data analysis. The use of the multiple data collection methods strengthened the validity of the assessment's findings, as well as ensured that Charles County residents had an opportunity to participate in the assessment process and to feel invested in its outcome. Three hundred and two Charles County residents completed the 74 question online survey that was created using Survey Monkey. The link to the survey is available on the Civista Health website. The first section of the survey asked participants about their perception of health and health services within the county. The second section asked them about their health behaviors, in order to determine their risk for the development of certain health conditions. A short three question survey was distributed throughout the county regarding perceptions of health within the county. A total of 200 short surveys were completed. Surveys were located throughout the county including Civista waiting rooms, CCDOH waiting rooms, libraries, senior centers, community centers. Thirty five were completed in Spanish (17.5%). Seven focus groups were held throughout the county. The focus group topics included: age related health issues, chronic disease specific health, special populations, county leadership, substance abuse, youth through the school nurses, and the Partnerships for a Healthier Charles County (PHCC). Approximately 165 people participated in the county focus groups from a wide variety of organizations and community groups. Quantitative data was analyzed for several health topics including: mortality, population and demographic data, natality, infant mortality, heart disease, stroke, hypertension, access to health care/health uninsurance, cancer, asthma, injuries, diabetes, obesity, osteoporosis, arthritis, Childhood Obesity Program, Faith-Based Health Expo. Support groups such as Stroke Support, Parkinson's support group, Pink Ladies and Sister's at Heart and Ostomy Support Group. Clinics and clinic services such as pre natal and OB clinic, flu vaccine clinic, renal dialysis services, American Red Cross blood drives Community committees, boards, and organizations (employee participation) such as United Way, Partnerships for a Healthier Charles County, Charles County Tobacco Coalition, Leadership Maryland, Hospice of Charles County, Healthy Families, Health Partners Free Clinic Board, Fetal Infant Mortality Board, Center for Abused Persons, Juvenile Drug Court; Chamber of Commerce, Charles County Commission for Women, Charles County child advocacy partnership, healthcare roundtable community events such as Christmas Connection, Relay for Life, Alzheimer's Walk, March of Dimes, and safe nights. | Description |
| Total Program Service Expense | 86303830 | TotalProgramServiceExpense |
| Described In501 C3 | true | DescribedIn501C3 |
| Schedule B Required | true | ScheduleBRequired |
| Political Activities | false | PoliticalActivities |
| Lobbying Activities | true | LobbyingActivities |
| Subject To Proxy Tax | false | SubjectToProxyTax |
| Donor Advised Funds | false | DonorAdvisedFunds |
| Conservation Easements | false | ConservationEasements |
| Collections Of Art | false | CollectionsOfArt |
| Credit Counseling | false | CreditCounseling |
| Term Or Permanent Endowments | false | TermOrPermanentEndowments |
| Report Land Bldg Equip | true | ReportLandBldgEquip |
| Report Invest Oth Securities | false | ReportInvestOthSecurities |
| Report Prog Rel Invest | false | ReportProgRelInvest |
| Report Other Assets | true | ReportOtherAssets |
| Report Other Liabilities | true | ReportOtherLiabilities |
| Report Fin48 Footnote | true | ReportFin48Footnote |
| Independent Audit Financial Stmt | false | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | true | ConsolidatedAuditFinancialStmt |
| School | false | School |
| Foreign Office | false | ForeignOffice |
| Foreign Activities | true | ForeignActivities |
| More Than5000 K To Organizations | false | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividuals |
| Professional Fundraising | false | ProfessionalFundraising |
| Fundraising Activities | false | FundraisingActivities |
| Gaming | false | Gaming |
| Hospital | true | Hospital |
| Financial Stmt Attached | true | FinancialStmtAttached |
| Grants To Organizations | true | GrantsToOrganizations |
| Grants To Individuals | false | GrantsToIndividuals |
| Schedule J Required | true | ScheduleJRequired |
| Tax Exempt Bonds | false | TaxExemptBonds |
| Excess Benefit Transaction | false | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | false | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | false | LoanToOfficerOrDQP |
| Grant To Related Person | false | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | false | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | false | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | false | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | false | DeductibleNonCashContributions |
| Deductible Contributions Of Art | false | DeductibleContributionsOfArt |
| Terminated | false | Terminated |
| Partial Liquidation | false | PartialLiquidation |
| Disregarded Entity | false | DisregardedEntity |
| Related Entity | true | RelatedEntity |
| Related Org Controlled Entity | false | RelatedOrgControlledEntity |
| Transfers To Exempt Non Chrtbl Org | false | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | false | ActivitiesConductedPartnership |
| Schedule O Required | true | ScheduleORequired |
| Number Forms Transmitted With1096 | 202 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | true | ComplianceWithBackupWitholding |
| Number Of Employees | 1020 | NumberOfEmployees |
| Employment Tax Returns Filed | true | EmploymentTaxReturnsFiled |
| Unrelated Business Income | true | UnrelatedBusinessIncome |
| Form990-T Filed | true | Form990-TFiled |
| Foreign Financial Account | true | ForeignFinancialAccount |
| Name Of Foreign Country | CJ | NameOfForeignCountry |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTrans |
| Taxable Party Notification | false | TaxablePartyNotification |
| Non Deductible Contributions | false | NonDeductibleContributions |
| Quid Pro Quo Contributions | false | QuidProQuoContributions |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | false | FundsToPayPremiums |
| Premiums Paid | false | PremiumsPaid |
| Indoor Tanning Services | false | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 16 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 13 | NumberIndependentVotingMembers |
| Family Or Business Relationship | false | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | false | DelegationOfManagementDuties |
| Changes To Organizing Docs | false | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuse |
| Members Or Stockholders | true | MembersOrStockholders |
| Election Of Board Members | true | ElectionOfBoardMembers |
| Decisions Subject To Approval | true | DecisionsSubjectToApproval |
| Minutes Of Governing Body | true | MinutesOfGoverningBody |
| Minutes Of Committees | true | MinutesOfCommittees |
| Officer Mailing Address | false | OfficerMailingAddress |
| Local Chapters | false | LocalChapters |
| Form990 Provided To Governing Body | true | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | true | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | true | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | true | RegularMonitoringEnforcement |
| Whistleblower Policy | true | WhistleblowerPolicy |
| Document Retention Policy | true | DocumentRetentionPolicy |
| Compensation Process CEO | true | CompensationProcessCEO |
| Compensation Process Other | true | CompensationProcessOther |
| Investment In Joint Venture | false | InvestmentInJointVenture |
| States Where Copy Of Return Is Filed | MD | StatesWhereCopyOfReturnIsFiled |
| Other Website | X | OtherWebsite |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | ERIK BOAS | NamePerson |
| Telephone Number | 3016094130 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 5 GARRETT AVE | AddressLine1 |
| City | La Plata | City |
| State | MD | State |
| ZIP Code | 20646 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | X | InfoInScheduleOPartVII |
Form990 Part VII Section A Form990PartVIISectionA (27 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | OfficerOfficer | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | Average Hours Per Week RelatedAverageHoursPerWeekRelated | Key EmployeeKeyEmployee | Highest Compensated EmployeeHighestCompensatedEmployee |
|---|---|---|---|---|---|---|---|---|---|
| Shelly Culhane | |||||||||
| Vice Chair | 2.0 | X | X | 0 | 0 | 0 | |||
| B Larry Jenkins Jr | |||||||||
| Director | 1.0 | X | 0 | 0 | 0 | ||||
| R Wayne Barnes | |||||||||
| Director | 1.0 | X | 0 | 0 | 0 | ||||
| Sara A Middleton | |||||||||
| Director | 1.0 | X | 0 | 0 | 0 | ||||
| Candice Quinn Kelly | |||||||||
| Ex-Officio/Director | 1.0 | X | 0 | 0 | 0 | ||||
| Faye Reed | |||||||||
| Ex-Officio/Dir/Retired 12/1/12 | 1.0 | X | 0 | 0 | 0 | ||||
| Khadar Baig | |||||||||
| Director | 1.0 | X | 0 | 0 | 0 | ||||
| Van Mitchell | |||||||||
| Director | 1.0 | X | 0 | 0 | 0 | ||||
| Louis Jenkins Jr | |||||||||
| Chairman | 2.0 | X | X | 0 | 0 | 0 | |||
| Seetaramayya Nagula | |||||||||
| Director | 1.0 | X | 0 | 0 | 0 | ||||
| Richard Winkler | |||||||||
| Secretary/Treasurer | 2.0 | X | X | 0 | 0 | 0 | |||
| Michael Cady | |||||||||
| Director | 1.0 | X | 0 | 0 | 0 | ||||
| Ashvin J Patel MD | |||||||||
| Ex-O/ChiefStaff/End12/31/12 | 2.0 | X | X | 0 | 0 | 0 | |||
| James Burke | |||||||||
| Director | 1.0 | X | 0 | 0 | 0 | ||||
| John Ashworth | |||||||||
| Ex-Officio/Director | 1.0 | X | 0 | 588536 | 20541 | 49.0 | |||
| Robert Chrencik | |||||||||
| Ex-Officio/Director | 1.0 | X | 0 | 2174569 | 234466 | 49.0 | |||
| Noel Cervino | |||||||||
| Ex-Officio/President & CEO | 40.0 | X | X | 0 | 525741 | 66648 | 10.0 | ||
| Joel Sewchand MD | |||||||||
| Ex-O/ChiefStaff/Begin 1/1/13 | 2.0 | X | X | 0 | 0 | 0 | |||
| Erik Boas | |||||||||
| Chief Financial Officer | 40.0 | X | 0 | 265742 | 23363 | 10.0 | |||
| Mark Dumais | |||||||||
| Chief Medical Officer | 40.0 | 0 | 374083 | 43464 | X | ||||
| Gary Herbek | |||||||||
| Chief Operating Officer | 40.0 | 201210 | 0 | 22802 | X | ||||
| Melanie Sage | |||||||||
| VP Patient Care/Nurse Exec. | 40.0 | 167724 | 0 | 13920 | X | ||||
| Paul Blackwood | |||||||||
| VP Planning | 40.0 | 181054 | 0 | 21287 | X | ||||
| Katherine Middleton | |||||||||
| RN | 40.0 | 157974 | 0 | 15818 | X | ||||
| Marilyn Gregory | |||||||||
| Clinical Nurse IV | 40.0 | 171838 | 0 | 8420 | X | ||||
| Gabriel Abiola | |||||||||
| Pharmacy Clinical Manager | 40.0 | 161112 | 0 | 20526 | X | ||||
| Stacey Cook | |||||||||
| VP Human Resources | 40.0 | 170357 | 0 | 31891 | X | ||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 1211269 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 3928671 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 523146 | TotalOtherCompensation |
| Number Individuals GT100 K | 25 | NumberIndividualsGT100K |
| Formers Listed | false | FormersListed |
| Total Comp GT150 K | true | TotalCompGT150K |
| Compensation From Other Sources | false | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (5 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| Maryland Inpatient Care Specialists | |||||
| 6934 Aviation Blvd Ste B | GLEN BURNIE | MD | 21061 | Physicians | 1300000 |
| Southern MD Pulmonary Critical Ca | |||||
| 3575 Old Washington Rd Ste C | WALDORF | MD | 20602 | Respiratory | 897780 |
| Newbridge Anesthesia LLC | |||||
| 9901 Bentcross Drive | POTOMAC | MD | 20854 | Anesthesia | 560002 |
| ROI Eligibility Services Corp | |||||
| 1920 Greenspring Drive Ste 200 | TIMONIUM | MD | 21094 | Pt Acctg Purch Serv | 546125 |
| NDG Communications INC | |||||
| 105 Centennial Str Ste K | LAPLATA | MD | 20646 | Advertising | 507775 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 19 | NumberOfContractorsGT100K |
| Related Organizations | 500878 | RelatedOrganizations |
| All Other Contributions | 27755 | AllOtherContributions |
| Total Contributions | 528633 | TotalContributions |
Program Service Revenue ProgramServiceRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | NET PATIENT REVENUE | Description |
| Business Code | 900099 | BusinessCode |
| Total Revenue Column | 118309645 | TotalRevenueColumn |
| Related Or Exempt Function Income | 118309645 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 118309645 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 18876 | TotalRevenueColumn |
| Exclusion | $18,876 | ExclusionAmount |
Income From Invest Bond Proceeds IncomeFromInvestBondProceeds
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Royalties Revenue RoyaltiesRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Rental Income Or Loss RentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 0 | Real |
| Personal | 0 | Personal |
Net Rental Income Or Loss NetRentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Gross Amount Sales Assets GrossAmountSalesAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 777669 | Securities |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 777669 | Securities |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 777669 | TotalRevenueColumn |
| Exclusion | $777,669 | ExclusionAmount |
Net Income From Fundraising Events NetIncomeFromFundraisingEvents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Net Income From Gaming NetIncomeFromGaming
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Net Income Or Loss NetIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Other Revenue Misc OtherRevenueMisc (3 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Unrelated Business RevenueUnrelatedBusinessRevenue | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome |
|---|---|---|---|---|
| ANSWERING SERVICE | 561000 | 144140 | 144140 | |
| CAFETERIA & COFFEE BAR SALES | 900099 | 339080 | 339080 | |
| MEDICAL RECORD COPIES & APPLICATION FEES | 900099 | 33110 | 33110 |
Miscellaneous Revenue MiscellaneousRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -2944410 | TotalRevenueColumn |
| Related Or Exempt Function Income | 11374 | RelatedOrExemptFunctionIncome |
| Exclusion | -$2,955,784 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | -2428080 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 117206743 | TotalRevenueColumn |
| Related Or Exempt Function Income | 118693209 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 144140 | UnrelatedBusinessRevenue |
| Exclusion | -$2,159,239 | ExclusionAmount |
Grants To Domestic Orgs GrantsToDomesticOrgs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 58392 | Total |
| Program Services | 58392 | ProgramServices |
Grants To Domestic Individuals GrantsToDomesticIndividuals
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Foreign Grants ForeignGrants
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Benefits To Members BenefitsToMembers
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1343495 | Total |
| Program Services | 1047926 | ProgramServices |
| Management And General | 295569 | ManagementAndGeneral |
Comp Disqual Persons CompDisqualPersons
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 42613830 | Total |
| Program Services | 33238787 | ProgramServices |
| Management And General | 9375043 | ManagementAndGeneral |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1272144 | Total |
| Program Services | 992272 | ProgramServices |
| Management And General | 279872 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 4823686 | Total |
| Program Services | 3762475 | ProgramServices |
| Management And General | 1061211 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3037522 | Total |
| Program Services | 2369267 | ProgramServices |
| Management And General | 668255 | ManagementAndGeneral |
Fees For Services Management FeesForServicesManagement
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 449663 | Total |
| Management And General | 449663 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 17910 | Total |
| Management And General | 17910 | ManagementAndGeneral |
Fees For Services Lobbying FeesForServicesLobbying
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 13018 | Total |
| Management And General | 13018 | ManagementAndGeneral |
Fees For Services Prof Fundraising FeesForServicesProfFundraising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 8293712 | Total |
| Program Services | 6469095 | ProgramServices |
| Management And General | 1824617 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 316244 | Total |
| Program Services | 246670 | ProgramServices |
| Management And General | 69574 | ManagementAndGeneral |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 4252676 | Total |
| Program Services | 3317087 | ProgramServices |
| Management And General | 935589 | ManagementAndGeneral |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Royalties Royalties
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2671064 | Total |
| Program Services | 2083430 | ProgramServices |
| Management And General | 587634 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 55069 | Total |
| Program Services | 42954 | ProgramServices |
| Management And General | 12115 | ManagementAndGeneral |
Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2974635 | Total |
| Program Services | 2320215 | ProgramServices |
| Management And General | 654420 | ManagementAndGeneral |
Payments To Affiliates PaymentsToAffiliates
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3932621 | Total |
| Program Services | 3067444 | ProgramServices |
| Management And General | 865177 | ManagementAndGeneral |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2380636 | Total |
| Program Services | 1856896 | ProgramServices |
| Management And General | 523740 | ManagementAndGeneral |
Other Expenses OtherExpenses (4 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral |
|---|---|---|---|
| SUPPLIES AND DRUGS | 18686003 | 14575082 | 4110921 |
| PURCHASED SERVICES | 6648597 | 5149260 | 1499337 |
| BAD DEBT | 4922763 | 4922763 | |
| DUES & SUBSCRIPTIONS | 609137 | 475127 | 134010 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 395751 | Total |
| Program Services | 308688 | ProgramServices |
| Management And General | 87063 | ManagementAndGeneral |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 109768568 | Total |
| Program Services | 86303830 | ProgramServices |
| Management And General | 23464738 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 37974354 | BOY |
| EOY | 28125065 | EOY |
Pledges And Grants Receivable PledgesAndGrantsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 11344222 | BOY |
| EOY | 11705089 | EOY |
Receivables From Officers Etc ReceivablesFromOfficersEtc
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Receivables From Disqual Persons ReceivablesFromDisqualPersons
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Other Notes Loans Receivable Net OtherNotesLoansReceivableNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1490645 | BOY |
| EOY | 1459352 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 930555 | BOY |
| EOY | 459932 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 107621747 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 38611562 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 66994942 | BOY |
| EOY | 69010185 | EOY |
Investments Pub Traded Securities InvestmentsPubTradedSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Investments Other Securities InvestmentsOtherSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Investments Program Related InvestmentsProgramRelated
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Intangible Assets IntangibleAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 28510375 | BOY |
| EOY | 32647221 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 147245093 | BOY |
| EOY | 143406844 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 13117763 | BOY |
| EOY | 12114172 | EOY |
Grants Payable GrantsPayable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Deferred Revenue DeferredRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Tax Exempt Bond Liabilities TaxExemptBondLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 54348613 | BOY |
| EOY | 0 | EOY |
Escrow Account Liability EscrowAccountLiability
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Loans From Officers Directors LoansFromOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 21568471 | BOY |
| EOY | 20599450 | EOY |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 27422921 | BOY |
| EOY | 71301195 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 116457768 | BOY |
| EOY | 104014817 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 30770543 | BOY |
| EOY | 39182155 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 16782 | BOY |
| EOY | 209872 | EOY |
Permanently Restricted Net Assets PermanentlyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 30787325 | BOY |
| EOY | 39392027 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 147245093 | BOY |
| EOY | 143406844 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | 7438175 | ReconcilationRevenueExpenses |
| Reconciliation Unrealized Invest | -7209 | ReconciliationUnrealizedInvest |
| Reconcilation Other Changes | 1173736 | ReconcilationOtherChanges |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | false | AccountantCompileOrReview |
| FS Audited | true | FSAudited |
FS Audited Basis FSAuditedBasis
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Statement Consolidated | X | FinancialStatementConsolidated |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | true | AuditCommittee |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital170b1 Aiii | X | Hospital170b1Aiii |
Schedule B IRS990ScheduleB
Contributor Info ContributorInfo
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor Number | RESTRICTED | ContributorNumber |
Contributor Name Business ContributorNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor Address US ContributorAddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Aggregate Contributions | RESTRICTED | AggregateContributions |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Grassroots Lobbying | TotalGrassrootsLobbying | |
| Total Direct Lobbying | TotalDirectLobbying | |
| Total Lobbying Expenditures | TotalLobbyingExpenditures | |
| Other Exempt Purpose Expenditures | OtherExemptPurposeExpenditures | |
| Total Exempt Purpose Expenditures | TotalExemptPurposeExpenditures | |
| Lobbying Nontaxable | LobbyingNontaxableAmount | |
| Grassroots Nontaxable | GrassrootsNontaxableAmount | |
| Tot Lobbying Grassroot Minus Non Tx | TotLobbyingGrassrootMinusNonTx | |
| Tot Lobby Expend Mns Lobbying Nontx | TotLobbyExpendMnsLobbyingNontx | |
| Volunteers | false | Volunteers |
| Paid Staff Or Management | false | PaidStaffOrManagement |
| Media Advertisements | false | MediaAdvertisements |
| Mailings Members | false | MailingsMembers |
| Publications Or Broadcast | false | PublicationsOrBroadcast |
| Grants Other Organizations | false | GrantsOtherOrganizations |
| Direct Contact Legislators | false | DirectContactLegislators |
| Rallies Demonstrations | false | RalliesDemonstrations |
| Other Activities | true | OtherActivities |
| Other Activities | $13,018 | OtherActivitiesAmount |
| Total Lobbying Expenditures IIB | 13018 | TotalLobbyingExpendituresIIB |
| Not Described In501c3 | false | NotDescribedIn501c3 |
Form990 Schedule C Part IV Form990ScheduleCPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | Lobbying Activities | Identifier |
| Return Reference | Schedule C, Part II-B, Line 1i | ReturnReference |
| Explanation | THE ORGANIZATION DOES NOT ENGAGE IN ANY DIRECT LOBBYING ACTIVITIES. THE ORGANIZATION PAYS MEMBERSHIP DUES TO THE MARYLAND HOSPITAL ASSOCIATION (MHA) AND THE AMERICAN HOSPITAL ASSOCIATION (AHA). MHA AND AHA ENGAGE IN MANY SUPPORT ACTIVITIES INCLUDING LOBBYING AND ADVOCATING FOR THEIR MEMBER HOSPITALS. THE MHA AND AHA REPORTED THAT 7.71% AND 23.98% OF MEMBER DUES WERE USED FOR LOBBYING PURPOSES AND AS SUCH, THE ORGANIZATION HAS REPORTED THIS AMOUNT ON SCHEDULE C PART IV AS LOBBYING ACTIVITIES. | Explanation |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Art Public Exhibition Amts | ArtPublicExhibitionAmts | |
| Held Works Of Art Amts | HeldWorksOfArtAmts | |
| Current Year Minus3 Years | CurrentYearMinus3Years | |
| Current Year Minus4 Years | CurrentYearMinus4Years | |
| Land | Land |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 78614777 | OtherCostOrOtherBasis |
| Depreciation | 20792336 | Depreciation |
| Book Value | 57822441 | BookValue |
Leasehold Improvements LeaseholdImprovements
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 498563 | OtherCostOrOtherBasis |
| Depreciation | 226341 | Depreciation |
| Book Value | 272222 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 27017211 | OtherCostOrOtherBasis |
| Depreciation | 17592885 | Depreciation |
| Book Value | 9424326 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 1491196 | OtherCostOrOtherBasis |
| Book Value | 1491196 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 69010185 | TotalOfBookValueLandBuildings |
Other Assets OtherAssets (9 entries)
| DescriptionDescription | Book ValueBookValue |
|---|---|
| SECURITY DEPOSITS | 2675 |
| OTHER CURRENT RECEIVABLES | 1193245 |
| INV CHES POTOMAC HEALTHCARE | 3317448 |
| OTHER ASSETS | 7513265 |
| PHYSICIAN LOANS | 192844 |
| INVESTMENT IN JV FREESTATE | 15000 |
| INVESTMENT MARYLAND ECARE | 10000 |
| DUE FROM AFFILIATES | 15829221 |
| ECONOMIC INTEREST - NET ASSETS | 4573523 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | 32647221 | TotalBookValueOtherAssets |
| Federal Income Tax Liability | 0 | FederalIncomeTaxLiability |
Other Liabilities OtherLiabilities (6 entries)
| DescriptionDescription | AmountAmount |
|---|---|
| ADVANCES FROM THIRD PARTIES | $3,235,242 |
| ACCRUED PENSION COSTS | $5,139,192 |
| DUE TO AFFILIATES | $54,715,931 |
| LEASE LIABILITIES | $450,311 |
| MALPRACTICE IBNR | $2,764,484 |
| OTHER LIABILITIES | $4,996,035 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 71301195 | TotalOfAmounts |
| Footnote In Part XIII | X | FootnoteInPartXIII |
Form990 Schedule D Part XIII Form990ScheduleDPartXIII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | Liability for Uncertain Tax Position (ASC 740) | Identifier |
| Return Reference | Schedule D, Part X, Line 2 | ReturnReference |
| Explanation | The organization is a subsidiary of the University of Maryland Medical System Corporation (The Corporation). The Corporation adopted the provisions of ASC 740, Accounting for Uncertainty in the Income Taxes (FIN 48) on July 1, 2007. The footnote related to ASC 740 in the Corporation's audited financial statements is as follows: The Corporation follows a threshold of more-likely-than-not for recognition and derecognition of tax positions taken or expected to be taken in a tax return. Management does not believe that there are any unrecognized tax benefits that should be recognized. | Explanation |
Schedule F IRS990ScheduleF
Accts Actvs Out US Table AcctsActvsOutUSTable
| Field | Value | IRS element (for citing) |
|---|---|---|
| Region | Central America and the Caribbean | Region |
| Type Of Activities Conducted | Program Services | TypeOfActivitiesConducted |
| Specific Services Provided | Insurance | SpecificServicesProvided |
| Total Expenditures | 984413 | TotalExpenditures |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Subtotal Amount Spent | 984413 | SubtotalAmountSpent |
| Total Amount Spent | 984413 | TotalAmountSpent |
| Transfer To Foreign Corp | true | TransferToForeignCorp |
| Interest In Foreign Trust | false | InterestInForeignTrust |
| Own Foreign Corp | true | OwnForeignCorp |
| Passive Foreign Invest Co | false | PassiveForeignInvestCo |
| Foreign Partnership | false | ForeignPartnership |
| Boycott Countries | false | BoycottCountries |
Form990 Schedule F Part V Form990ScheduleFPartV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | Activities per Region | Identifier |
| Return Reference | Schedule F, Part I, Line 3 | ReturnReference |
| Explanation | Civista Medical Center, Inc. joined the University of Maryland Medical System Corporation's Malpractice program as of March 1, 2013. | Explanation |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Charity Care Policy | true | CharityCarePolicy |
| Written Policy | true | WrittenPolicy |
| FPG Reference Free Care | true | FPGReferenceFreeCare |
| Pcent200 | X | Pcent200 |
| FPG Reference Discounted Care | true | FPGReferenceDiscountedCare |
| Pcent300 | X | Pcent300 |
| Free Disc Care Medically Indigent | true | FreeDiscCareMedicallyIndigent |
| Amounts Budgeted For Charity Care | true | AmountsBudgetedForCharityCare |
| Expenses Exceeded Budget | true | ExpensesExceededBudget |
| Unable To Provide Care | false | UnableToProvideCare |
| Annual Community Benefit Report | true | AnnualCommunityBenefitReport |
| Report Publically Available | true | ReportPublicallyAvailable |
Charity Care At Cost CharityCareAtCost
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 3546328 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 3546506 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.03230 | PercentOfTotalExpense |
Total Charity Care TotalCharityCare
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 3546328 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 3546506 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.03230 | PercentOfTotalExpense |
Community Health Services CommunityHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 694485 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 694485 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00630 | PercentOfTotalExpense |
Health Professions Education HealthProfessionsEducation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 348551 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 348551 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00320 | PercentOfTotalExpense |
Subsidized Health Services SubsidizedHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 5869444 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 3316475 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 2552969 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.02330 | PercentOfTotalExpense |
Cash And In Kind Contributions CashAndInKindContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 74237 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 74237 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00070 | PercentOfTotalExpense |
Total Other Benefits TotalOtherBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 6986717 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 3316475 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 3670242 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.03350 | PercentOfTotalExpense |
Total Community Benefits TotalCommunityBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 10533045 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 3316475 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 7216748 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.06580 | PercentOfTotalExpense |
Economic Development EconomicDevelopment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Building Expense | 298 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 298 | NetCommunityBuildingExpense |
Community Support CommunitySupport
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Building Expense | 35421 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 35421 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00030 | PercentOfTotalExpense |
Coalition Building CoalitionBuilding
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Building Expense | 10333 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 10333 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00010 | PercentOfTotalExpense |
Health Improvement Advocacy HealthImprovementAdvocacy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Building Expense | 795 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 795 | NetCommunityBuildingExpense |
Workforce Development WorkforceDevelopment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Building Expense | 139564 | TotalCommunityBuildingExpense |
| Direct Offsetting Revenue | 6032 | DirectOffsettingRevenue |
| Net Community Building Expense | 133532 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00120 | PercentOfTotalExpense |
Total Total
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Building Expense | 186411 | TotalCommunityBuildingExpense |
| Direct Offsetting Revenue | 6032 | DirectOffsettingRevenue |
| Net Community Building Expense | 180379 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00160 | PercentOfTotalExpense |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | true | BadDebtExpenseReported |
| Bad Debt Expense | $3,357,621 | BadDebtExpenseAmount |
| Amount Reimbursed By Medicare | 47171538 | AmountReimbursedByMedicare |
| Cost Of Care Reimbursed By Medicare | 43581711 | CostOfCareReimbursedByMedicare |
| Medicare Surplus Or Shortfall | 3589827 | MedicareSurplusOrShortfall |
Costing Methodology Used CostingMethodologyUsed
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | X | CostToChargeRatio |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | true | WrittenDebtCollectionPolicy |
| Provision For Charity Care | true | ProvisionForCharityCare |
| Number Of Hospital Facilities | 1 | NumberOfHospitalFacilities |
Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility Number | 1 | FacilityNumber |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Civista Medical Center Inc | BusinessNameLine1 |
Address Address
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 5 Garrett Ave | AddressLine1 |
| City | La Plata | City |
| State | MD | State |
| ZIP Code | 20646 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Licensed Hospital | X | LicensedHospital |
| General Medical And Surgical | X | GeneralMedicalAndSurgical |
| Er24 Hours | X | Er24Hours |
Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Civista Medical Center Inc | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital Facility Number | 1 | HospitalFacilityNumber |
| CHNA Conducted | true | CHNAConducted |
| Community Definition | X | CommunityDefinition |
| Community Demographics | X | CommunityDemographics |
| Existing Resources | X | ExistingResources |
| How Data Obtained | X | HowDataObtained |
| Community Health Needs | X | CommunityHealthNeeds |
| Other Health Issues | X | OtherHealthIssues |
| Identifying Process | X | IdentifyingProcess |
| Consulting Process | X | ConsultingProcess |
| Information Gaps | X | InformationGaps |
| Needs Assessment Conducted | 12 | NeedsAssessmentConducted |
| Take Into Account | true | TakeIntoAccount |
| Other Facilities | true | OtherFacilities |
| CHNA Widely Available | true | CHNAWidelyAvailable |
| Own Website | X | OwnWebsite |
| On Request | X | OnRequest |
| Adopt Implement Strategy | X | AdoptImplementStrategy |
| Execute Implement Strategy | X | ExecuteImplementStrategy |
| Develop Community Plan | X | DevelopCommunityPlan |
| Participate Community Plan | X | ParticipateCommunityPlan |
| Include Operational Plans | X | IncludeOperationalPlans |
| Adopt Budget | X | AdoptBudget |
| Prioritize Health Needs | X | PrioritizeHealthNeeds |
| Prioritize Services | X | PrioritizeServices |
| All Needs Addressed | false | AllNeedsAddressed |
| Organization Incur Excise Tax | false | OrganizationIncurExciseTax |
| Eligibility Criteria Explained | true | EligibilityCriteriaExplained |
| Uses FPG Free | true | UsesFPGFree |
| FPG Free Percent | 200. | FPGFreePercent |
| Uses FPG Discounted | true | UsesFPGDiscounted |
| FPG Discount Percent | 300. | FPGDiscountPercent |
| Explains Basis | true | ExplainsBasis |
| Income Level | X | IncomeLevel |
| Asset Level | X | AssetLevel |
| Medical Indigency | X | MedicalIndigency |
| Insurance Status | X | InsuranceStatus |
| Uninsured Discount | X | UninsuredDiscount |
| Medicaid Medicare | X | MedicaidMedicare |
| State Regulation | X | StateRegulation |
| Explains Application Method | true | ExplainsApplicationMethod |
| Includes Publicity Measures | true | IncludesPublicityMeasures |
| Posted On Website | X | PostedOnWebsite |
| Attached To Invoices | X | AttachedToInvoices |
| Posted In Emergency Room | X | PostedInEmergencyRoom |
| Posted In Admission Office | X | PostedInAdmissionOffice |
| Provided On Admission | X | ProvidedOnAdmission |
| Available On Request | X | AvailableOnRequest |
| Actions On Nonpayment | true | ActionsOnNonpayment |
| Collection Activities | false | CollectionActivities |
| Notify Upon Admission | X | NotifyUponAdmission |
| Notify Before Discharge | X | NotifyBeforeDischarge |
| Notified All Patients | X | NotifiedAllPatients |
| Documented Determination | X | DocumentedDetermination |
| Nondiscrim Emergency Care Policy | true | NondiscrimEmergencyCarePolicy |
| Used Other Method | X | UsedOtherMethod |
| Amounts Generally Billed | false | AmountsGenerallyBilled |
| Gross Charges | false | GrossCharges |
Form990 Schedule H Part VI Form990ScheduleHPartVI (14 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| Related Organization Report | Schedule H, Part I, Line 6a | AN ANNUAL COMMUNITY BENEFIT REPORT IS PREPARED FOR EACH FISCAL YEAR ENDING JUNE 30. THIS REPORT IS SUBMITTED TO THE HEALTH SERVICES COST REVIEW COMMISSION (HSCRC), A STATE REGULATORY AGENCY, BY DECEMBER 31 OF EACH YEAR. IN ADDITION, THE ANNUAL COMMUNITY BENEFIT REPORT IS AVAILABLE UPON REQUEST AT THE ENTITY'S CORPORATE OFFICES. |
| Cost Attributable to a Physical Clinic | Schedule H, Part I, Line 7 | Marylands regulatory system creates a unique process for hospital payment that differs from the rest of the Nation. The Health Services Cost Review Commission (HSCRC) determines payment through a rate setting process and All Payors, including Governmental Payors, pay the same amount for the same services delivered at the same hospital. Marylands unique All Payor system includes a method for referencing uncompensated care in each Payors rates, which does not enable Maryland hospitals to breakout any offsetting revenue related to uncompensated care. Schedule H, Part I, Line 7B, Columns (C) through (F) MARYLAND'S REGULATORY SYSTEM CREATES A UNIQUE PROCESS FOR HOSPITAL PAYMENT THAT DIFFERS FROM THE REST OF THE NATION. THE HEALTH SERVICES COST REVIEW COMMISSION, (HSCRC) DETERMINES PAYMENT THROUGH A RATE SETTING PROCESS AND ALL PAYORS, INCLUDING GOVERNMENTAL PAYORS, PAY THE SAME AMOUNT FOR THE SAME SERVICES DELIVERED AT THE SAME HOSPITAL. MARYLAND'S UNIQUE ALL PAYOR SYSTEM INCLUDES A METHOD FOR REFERENCING UNCOMPENSATED CARE IN EACH PAYORS' RATES, WHICH DOES NOT ENABLE MARYLAND HOSPITALS TO BREAKOUT ANY OFFSETTING REVENUE RELATED TO UNCOMPENSATED CARE. COMMUNITY BENEFIT EXPENSES ARE EQUAL TO MEDICAID REVENUES IN MARYLAND, AS SUCH, THE NET EFFECT IS ZERO. ADDITIONALLY, NET REVENUES FOR MEDICAID SHOULD REFLECT THE FULL IMPACT ON THE HOSPITAL OF ITS SHARE OF THE MEDICAID ASSESSMENT. SCHEDULE H, PART I, LINE 7F COLUMN (C) 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. SCHEDULE H, PART I, LINE 7F COLUMN (D) MARYLAND'S REGULATORY SYSTEM CREATES A UNIQUE PROCESS FOR HOSPITAL PAYMENT THAT DIFFERS FROM THE REST OF THE NATION. THE HEALTH SERVICES COST REVIEW COMMISSION, (HSCRC) DETERMINES PAYMENT THROUGH A RATE SETTING PROCESS AND ALL PAYORS, INCLUDING GOVERNMENTAL PAYORS, PAY THE SAME AMOUNT FOR THE SAME SERVICES DELIVERED AT THE SAME HOSPITAL. MARYLAND'S UNIQUE ALL PAYOR SYSTEM INCLUDES A METHOD FOR REFERENCING UNCOMPENSATED CARE IN EACH PAYORS' RATES, WHICH DOES NOT ENABLE MARYLAND HOSPITALS TO BREAKOUT ANY OFFSETTING REVENUE RELATED TO UNCOMPENSATED CARE. |
| Community Building Activities | Schedule H, Part II | As the only hospital serving Charles County, Maryland, Civista Medical Center supports programs and activities where the hospital's expertise and resources can influence the fundamental issues that affect the health of the community. Civista supports economic development of the community through leadership participation in organizations such as the Economic Development Commission and the Tri-County Council of Southern Maryland. Hospital Administration participates in healthcare workforce development through by serving on committees such as the Charles County Commissioner's healthcare taskforce and support of College of Southern Maryland Nursing and Allied Health programs. In addition, Civista Medical Center participates and supports the Black Leadership Council on Excellence's Young Researchers Community Project which offers disadvantage youth in high school an opportunity to shadow medical professionals. According to the 2007 Maryland Physician workforce study, the Southern Maryland region has a physician shortage for primary care physicians. Southern Maryland had the regional low requirement for primary care physicians per 100,000 residents of 56.5. The Maryland state average rate was 58.2 per 100,000 residents. Under medical specialties, the Southern Maryland region had a shortage for cardiology, dermatology, endocrinology, gastroenterology, hematology, oncology, infectious disease, nephrology, psychiatry, pulmonary medicine, and rheumatology. The only medical specialties with adequate physician supplies were allergy and neurology. Charles County has one Neurologist which is deemed adequate for the population however, the physician plans to retire which will leave the county in a critical shortage in this specialty. As a result of the prevailing physician shortage, and to mitigate the effects of the lack of access of the community to medical care, Civista Medical Center, along with the University of Maryland has developed a robust and ongoing physician recruitment and retainment program. |
| Bad Debt Expense | Schedule H, Part III, Line 2 & 4 | CIVISTA REPORTS BAD DEBT EXPENSE IN ACCORDANCE WITH GENERALLY ACCEPTED ACCOUNTING PRINCIPLES (GAAP) HFMA 15. THE PROVISION FOR BAD DEBTS IS BASED UPON MANAGEMENTS ASSESSMENT OF HISTORICAL AND EXPECTED NET COLLECTIONS CONSIDERING HISTORICAL BUSINESS AND ECONOMIC CONDITIONS, TRENDS IN HEALTH CARE COVERAGE, AND OTHER COLLECTION INDICATORS. PERIODICALLY THROUGHOUT THE YEAR, MANAGEMENT ASSESSES THE ADEQUACY OF THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS BASED UPON HISTORICAL WRITE-OFF EXPERIENCE BY PAYOR CATEGORY, AS WELL AS, THE ACCUMULATION OF RECEIVABLE BALANCES BY PERIOD OUTSTANDING. THE RESULTS OF THIS REVIEW ARE THEN USED TO MAKE ANY NECESSARY MODIFICATIONS TO THE PROVISION FOR BAD DEBTS AND THE ESTABLISHED ALLOWANCE FOR UNCOLLECTIBLE RECEIVABLES. AFTER COLLECTION OF AMOUNTS DUE FROM INSURERS, THE CORPORATION FOLLOWS INTERNAL GUIDELINES FOR PLACING CERTAIN PAST DUE BALANCES WITH COLLECTION AGENCIES. |
| Medicare Cost Report | Schedule H, Part III, Line 8 | IN MARYLAND, THE HEALTH SERVICES COST REVIEW COMMISSION (HSCRC)STARTED SETTING HOSPITAL RATES IN 1974. AT THAT TIME, THE HSCRC APPROVED RATES APPLIED ONLY TO COMMERCIAL INSURERS. IN 1977, THE HSCRC NEGOTIATED A WAIVER FROM MEDICARE HOSPITAL PAYMENT RULES FOR MARYLAND HOSPITALS TO BRING THE FEDERAL MEDICARE PAYMENTS UNDER HSCRC CONTROL. MEDICARE REIMBURSES MARYLAND HOSPITALS ACCORDING TO RATES ESTABLISHED BY THE HSCRC AS LONG AS THE STATE CONTINUES TO MEET A TWO-PART TEST. THIS TWO-PART WAIVER TEST ALLOWS MEDICARE TO PARTICIPATE IN THE MARYLAND SYSTEM AS LONG AS TWO CONDITIONS ARE MET: ALL OTHER PAYERS PARTICIPATING IN THE SYSTEM PAY HSCRC SET RATES. THE RATE OF GROWTH IN MEDICARE PAYMENTS TO MARYLAND HOSPITALS FROM 1981 TO THE PRESENT IS NOT GREATER THAN THE RATE OF GROWTH IN MEDICARE PAYMENTS TO HOSPITALS NATIONALLY OVER THE SAME TIME FRAME. |
| Collection Practices | Schedule H, Part III, Line 9b | THE ORGANIZATION EXPECTS PAYMENT AT THE TIME THE SERVICE IS PROVIDED. OUR POLICY IS TO COMPLY WITH ALL STATE AND FEDERAL LAW AND THIRD PARTY REGULATIONS AND TO PERFORM ALL CREDIT AND COLLECTION FUNCTIONS IN A DIGNIFIED AND RESPECTFUL MANNER. EMERGENCY SERVICES WILL BE PROVIDED TO ALL PATIENTS REGARDLESS OF ABILITY TO PAY. FINANCIAL ASSISTANCE IS AVAILABLE FOR PATIENTS BASED ON FINANCIAL NEED AS DEFINED IN THE FINANCIAL ASSISTANCE POLICY. THE ORGANIZATION DOES NOT DISCRIMINATE ON THE BASIS OF AGE, RACE, CREED, SEX OR ABILITY TO PAY. PATIENTS WHO ARE UNABLE TO PAY MAY REQUEST A FINANCIAL ASSISTANCE APPLICATION AT ANY TIME PRIOR TO SERVICE OR DURING THE BILLING AND COLLECTION PROCESS. THE ORGANIZATION MAY REQUEST THE PATIENT TO APPLY FOR MEDICAL ASSISTANCE PRIOR TO APPLYING FOR FINANCIAL ASSISTANCE. THE ACCOUNT WILL NOT BE FORWARDED FOR COLLECTION DURING THE MEDICAL ASSISTANCE APPLICATION PROCESS OR THE FINANCIAL ASSISTANCE APPLICATION PROCESS. |
| Individuals Eligible for Financial Assistance | Schedule H, Part V, Section B, Line 20D | All patients are charged state regulated rates regardless of their ability to pay. |
| Individuals Eligible for Financial Assistance | Schedule H, Part V, Section B, Line 22 | As previously discussed in an earlier Schedule H narrative, the State of Maryland is a unique State in regard to the provision of health care services and their related charges by hospitals. All hospital charges processed to all Payors, including Governmental Payors, are set through Marylands Health Services Cost Commission. Accordingly, all Hospital charges are NOT gross charges as defined by the IRS under Internal Revenue Code section 501(r )(5)(B). |
| Community Health Care Needs Assessment | Schedule H, Part VI, Line 2 | Community Health Needs Assessment (CHNA) and Implementation Plan (CCHIP) Description of CHNA Process: Civista Health and the Charles County Department of Health (CCDOH) collaborated to complete a comprehensive assessment of the health needs (CHNA) of Charles County, Maryland. An epidemiologist with a Master's Degree in Public Health Epidemiology was contracted to analyze the qualitative and quantitative data. Civista lead the effort and covered 80% of the cost of the CHNA. To provide a comprehensive assessment of the health needs of the county, a four method plan was developed which included 4 different sources of data: a long online survey of Charles County residents perceptions of health and health behaviors, a short paper survey on health perceptions throughout the county, 7 focus groups with community leaders, citizens, and stakeholders, and a quantitative data analysis. The use of the multiple data collection methods strengthened the validity of the assessment's findings, as well as ensured that Charles County residents had an opportunity to participate in the assessment process and to feel invested in its outcome. Three hundred and two (302) Charles County residents completed the 74 question online survey that was created using Survey Monkey. The link to the survey was available on the Civista Health website. The first section of the survey asked participants about their perception of health and health services within the county. The second section asked them about their health behaviors, in order to determine their risk for the development of certain health conditions. A short three question survey was distributed throughout the county regarding perceptions of health within the county. A total of 200 short surveys were completed. Surveys were located throughout the county including Civista waiting rooms, CCDOH waiting rooms, libraries, senior centers, community centers. Thirty five were completed in Spanish (17.5%). Seven focus groups were held throughout the county. The focus group topics included: age related health issues, chronic disease specific health, special populations, county leadership, substance abuse, youth through the school nurses, and the Partnerships for a Healthier Charles County (PHCC) (community leaders and stakeholders). Approximately 165 people participated in the county focus groups. Survey for Community Members: 302 Charles County residents completed the 74 question online survey that was created using Survey Monkey. The link to the survey was available on the Civista Health website. A short 3 question survey was distributed throughout the county regarding perceptions of health within the county. A total of 200 short surveys were completed. Surveys were located throughout the county including Civista waiting rooms, Charles County Department of Health waiting rooms, libraries, senior centers, community centers. 35 were completed in Spanish (17.5%). The CHNA was completed during the fiscal year ended June 30, 2012 and is currently being implemented. This CHNA report and implementation plan was approved by UMMC Board of Directors on June 28, 2012. The CHNA report is available on the following website: WWW.CHARLESREGIONAL.ORG/.../CHARLESCOUNTYCOMMUNITYHEALTHNEEDSASSESSMENT201 1.PDF Description of Individuals and Organizations Consulted for CHNA Input: Seven focus groups were held throughout the county with representation from the following organizations. The focus group topics included: age related health issues, chronic disease specific health, special populations, county leadership, substance abuse, youth through the school nurses, and the Partnerships for a Healthier Charles County (PHCC) (community leaders and stakeholders). Approximately 165 people participated in the county focus groups from the following organizations: Partnerships for a Healthier Charles County Civista Medical Center Civista Health, Board Of Directors Charles County Department of Health University of Maryland Clinical Trials Program Bel Alton Alumni Community Development Association Charles County Department of Community Services, Transportation Tri County Council for Southern Maryland Minister's Alliance of Charles County Charles County Department of Social Services Maryland Foundation for Quality Healthcare Health Partner's Clinic Greater Baden FQHC Shiloh Community United Methodist Church Charles County Nursing and Rehabilitation Center Alzheimer's Association Center for Children Chesapeake Potomac Home Health Agency College of Southern Maryland Charles County Department of Aging Priority Partners Big Brothers/Big Sisters Community Hispanic Advocates Black Leadership Council for Excellence Young Researchers Community Project Pinnacle Center (Mental Health) Hospice of Charles County Breast Cancer Support Advocates Charles County Public Schools School Nurses Charles County Commissioners Charles County Emergency Services Charles County Sheriff's Office So. MD Delegation Charles County Community Foundation Community Physicians Charles County Fire and Rescue Board Lifestyles, Inc. (Homeless) Prioritization of Community Health Needs Quantitative data was analyzed for several health topics including: mortality, population and demographic data, natality, infant mortality, heart disease, stroke, hypertension, access to health care/health uninsurance, cancer, asthma, injuries, diabetes, obesity, osteoporosis, arthritis, dementia/Alzheimer's disease, communicable disease, sexually transmitted diseases, HIV/AIDS, mental health, dental health, substance abuse, disabilities, and tobacco use. Cumulative analysis of all quantitative and qualitative data identified the top 11 health needs of Charles County which was presented to the PHCC, a coalition of Charles County agencies and organizations. The direction of PHCC is guided by the Steering Committee which consists of leadership from Civista Health, CCDOH, CCPS and the CSM, as well as a Public Health Epidemiologist. PHCC Executive Committee: Noel A. Cervino CEO Civista Health Dr. Devadason Health Officer CC Health Department (CCDOH) Dr. Brad Gottfried President College of Southern Maryland Jim Richmond Superintendent Charles County Public Schools PHCC Steering Committee: Joyce Riggs Dir., Community Development & Planning CHI Fay Reed, RN Deputy Health Officer CCDOH William Leebel Public Information Officer CCDOH Linda Smith Project Coordinator CSM Tanisha Saunders Coordinator of Integrated Student Serv. CCPS Amber Starn, MPH Epidemiologist CHI |
| Eligibility Education | Schedule H, Part VI, Line 3 | Civista Medical Center posts its Financial Assistance Policy (FAP), or a summary thereof, as well as financial assistance contact information, in admissions areas, emergency rooms, business offices and other areas of the facility where eligible patients are likely to present. In addition, the policy is available on the Civista website and is posted in the local paper twice each year. The FAP is written in a culturally sensitive and at an appropriate reading level. It is available in English and Spanish. During the intake or discharge process or when there is contact regarding a billing matter, if a patient discloses financial difficulty or concern with payment of the bill, the patient is provided with FAP information. Additionally, assistance is provided for patients or their families in qualification and application of government benefits, Medicaid and other state programs. |
| Description of Community Served | Schedule H, Part VI, Line 4 | The Community Benefit Service Area for Civista Medical Center is all 28 zip codes located within the borders of Charles County. This includes the six zip codes identified as the Primary Service Area. Civista Medical Center is Charles County's only hospital and, as such, serves the residents of the entire county. Geography Charles County is located 23 miles south of Washington, D.C. It is one of five Maryland counties, which are part of the Washington, DC MD VA metropolitan area. At 458 square miles, Charles County is the eighth largest of Maryland's twenty four counties and accounts for about 5 percent of Maryland's total landmass. The northern part of the county is the "development district" where commercial, residential, and business growth is focused. The major communities of Charles County are La Plata (the county seat), Port Tobacco, Indian Head, and St Charles, and the main commercial cluster of Hughesville Waldorf White Plains. Approximately 60 percent of the county's residents live in the greater Waldorf La Plata area. By contrast, the southern (Cobb Neck area) and western (Nanjemoy, Indian Head, Marbury) areas of the region still remain very rural with smaller populations. Population Charles County has experienced rapid growth since 1970, expanding its population from 47,678 in 1970 to 120,546 in the 2000 census and 146,551 in the 2010 census. The current Census Bureau 2012 estimates the population at 150,592 for a 2.8% increase in two years. The magnitude of growth can be seen in the changes in population density. The 1990 census showed that there were 219.4 individuals per square mile, which increased to 261.5 individuals per square mile by 2000, an increase of 19.2%, and to 320.2 individuals per square mile by 2010, an increase of 22.5%. Transportation The percent change in the population growth for Charles County has been slightly greater than the change seen in the Maryland population growth. This growth has created transportation issues for the County in particular for the "development district" in the northern part of the county where many residents commute to Washington D.C. to work. The average work commute time for a Charles County resident is 42.3 minutes which is higher than the Maryland average by slightly more than 10 minutes. Public transportation consists of commuter bus for out of county travel and the county run Van Go bus service for in county transportation. Diversity As the population of the county changes, the diversity of the county also increases. The African American population has experienced the greatest increase. In 2000, African Americans made up 26% of the total Charles County population; by 2012, they comprise 42.4% of the total county population. As of 2012, minorities make up roughly 54% of the Charles County population. The Hispanic community has also seen increases over the past few years. They now comprise 4.7% of the total county population. This is the one of the highest percentages among the 24 Maryland jurisdictions. Economy Employment and economic indicators for the county are fairly strong. The 2010 US Census estimates found that 73.8% of the Charles County population is currently in the labor work force. The 2011 update estimates that approximately 5.6% of Charles County individuals are living below the poverty level, up 0.4% from 2010, however this is lower than the Maryland rate of 9% in 2011. The Charles County median household income was $92,135, an increase of $3,310 over the 2010 estimates and still well above the Maryland median household income of $72,419. The diversity of the county is also represented in the business community with 29.3% of all Charles County businesses being Black owned firms. This is higher than the State of Maryland at 19.3%. Education Charles County has a larger percentage of high school graduates than Maryland (90.6% vs. 88.2%); however, Charles County has a smaller percentage than Maryland of individuals with a bachelor's degree or higher (26.3% vs. 36.1%). Housing There is a high level of home ownership in Charles County (80.1%), however, this is slightly down from the 2010 level of 81.8%. The median value of a housing unit in Charles County is higher than the Maryland average ($341,200 vs. $319,800). Home values across Maryland have decreased and Charles County showed a slightly larger decrease than the Maryland average (4% vs. 3%). The average household size in Charles County is 2.86 persons. Life Expectancy The life expectancy for a Charles County resident, as calculated for 2009 2011, was 78.4 years. This is similar to the state average life expectancy of 79.2 years. Births There were 1,923 births in Charles County in 2012. Charles County represents 54% of the births in Southern Maryland (up 11% from 2009) and 2.6% of the total births in Maryland for 2012. Minorities made up just over half of the babies born in Charles County in 2012 (51.5%) which is in line with the composition of the county. Source: 2012 Maryland Vital Statistics Report |
| Promoting the health of the community | Schedule H, Part VI, Line 5 | Implementation Strategy: The Charles County Health Improvement Plan (CCHIP): Upon completion of the CHNA, the Steering Committee of Partnerships for a Healthier Charles County (PHCC) reviewed the results and the identified top 11 health needs. The Steering Committee set county objectives through 2014 based on Maryland SHIP objectives and Healthy People 2020 Goals. The results and goals were presented to the PHCC membership at the quarterly General Membership Meeting. Six teams were formed based on expertise and interest to formulate 3 year action plans to address the following health needs using one or more of the "Seven Strategies for Community Change" found on the last page of the Charles County Health Improvement Plan . 1. Reproductive Health a. Healthy Babies (Infant Mortality Disparity) b. STD Reduction/Prevention 2. Chronic Disease a. Heart Disease b. Diabetes c. Obesity 3. Access to Care a. Dental health b. Transportation c. Physician Shortage 4. Cancer Team a. Lung Cancer b. Prostate Cancer c. Colorectal Cancer 5. Injury and Violence free Community a. Roadway incidents b. Injuries and Fall Prevention 6. Behavioral Health a. Substance Abuse b. Mental Health The Charles County Health Needs Assessment and Health Improvement Plan were presented to the Civista Health Board of Directors and approved. Annual updates to the Plan are reviewed and approved. The CCHIP objectives are the Charles County Health Improvement Plan and available at: http://www.charlesregional.org/index.cfm?fuseaction=HealthResources.showHe althActionPlans The Health Improvement Team Action Plans (Implementation Plans) are available at: http://www.charlesregional.org/index.cfm?fuseaction=HealthResources.showHe althActionPlans All the primary needs outlined in the Needs Assessment are being addressed by Civista Health either directly (i.e., OB Clinic, Physician Recruitment) or through partnerships with other organizations (i.e., Childhood Obesity Program, Fetal Infant Mortality, Prostate Cancer) or through the PHCC which is led and primarily financed by Civista Health. Where a need is appropriately addressed by another entity, Civista provides leadership through the Charles County Health Improvement Plan and the local health coalition (PHCC) to communicate initiatives, provide financial support and/or assistance when needed and review results (i.e., Substance Abuse, Mental Health). All the primary needs outlined in the Needs Assessment are being addressed and funded by Civista either directly (i.e., OB Clinic, Physician Recruitment) or through partnerships with other organizations (i.e., Childhood Obesity Program, Fetal Infant Mortality). Where a need is appropriately addressed by another entity, Civista provides leadership through the Charles County Health Improvement Plan and the coalition of Partnerships for a Healthier Charles County to communicate initiatives, provide assistance when needed and review results (i.e., Substance Abuse, Mental Health). The majority of the governing body, the Board of Directors, of Civista Medical Center is comprised of persons who reside in the community served by the hospital and who are neither employees nor contractors of the organization. Civista Medical Center extends medical privileges to all qualified medical staff in the community. Continuing Medical Education seminars and Grand Rounds are open to all community physicians. |
| Affiliated Health Care System Roles | Schedule H, Part VI, Line 6 | Civista Medical Center is a member of the University of Maryland Medical System (UMMS). System hospitals meet monthly to coordinate and plan Community Benefit Operations such as Health Needs Assessments and Maryland State Health Improvement Plan objectives. UMMS provides leadership and guidance to local system jurisdictions regarding alignment with System and State wide goals. Southern Maryland had the highest percentage of physician shortages of all of the regions in Maryland (89.9%). To address the shortage, Civista Medical Center and UMMS have developed a recruitment and retention plan to successfully attract and retain private physicians to the community. |
| Community Benefit Report State Filings | Schedule H, Part VI, Line 7 | Community Benefit Report was filed in the state of Maryland. |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Records Maintained | true | RecordsMaintained |
Recipient Table RecipientTable (3 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EIN Of RecipientEINOfRecipient | IRC SectionIRCSection | Amount Of Cash GrantAmountOfCashGrant | Purpose Of GrantPurposeOfGrant |
|---|---|---|---|---|---|---|---|
| March of Dimes | |||||||
| 2120 Washington Blvd Ste 425 | Arlington | VA | 22204 | 131846366 | 501(c)(3) | 11000 | March for Babies sponsorship |
| Charles County Chamber of Commerce | |||||||
| 101 Centennial Street Ste A | LaPlata | MD | 20646 | 520699475 | 501(c)(3) | 6450 | 2013 Expo Sponsorship |
| Civista Health Foundation | |||||||
| 6 Garrett Avenue | La Plata | MD | 20646 | 521414564 | 501(c)(3) | 13000 | Southern MD Caregivers Sponsor |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Nbr Of501 C3 And Govt Grants | 3 | TotalNbrOf501C3AndGovtGrants |
Form990 Schedule I Part IV Form990ScheduleIPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | Procedure for Monitoring Use of Grant Funds Inside U.S. | Identifier |
| Return Reference | Part I, Line 2 | ReturnReference |
| Explanation | CIVISTA MEDICAL CENTER MAKES FINANCIAL AND IN-KIND CONTRIBUTIONS TO VARIOUS ORGANIZATIONS IN THE COMMUNITY. | Explanation |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | X | CompensationCommittee |
| Independent Consultant | X | IndependentConsultant |
| Compensation Survey | X | CompensationSurvey |
| Board Or Committee Approval | X | BoardOrCommitteeApproval |
| Severance Payment | false | SeverancePayment |
| Supplemental Nonqual Retire Plan | true | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | false | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | false | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | false | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | false | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | false | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | true | AnyNonFixedPayments |
| Initial Contract Exception | false | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (12 entries)
| TitleTitle | Base Compensation Filing OrgBaseCompensationFilingOrg | Comp Based On Related OrgsCompBasedOnRelatedOrgs | Bonus Filing OrgBonusFilingOrg | Bonus Related OrgsBonusRelatedOrgs | Other Compensation Filing OrgOtherCompensationFilingOrg | Other Compensation Related OrgsOtherCompensationRelatedOrgs | Deferred Comp Filing OrgDeferredCompFilingOrg | Deferred Comp Related OrgsDeferredCompRelatedOrgs | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg | Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs | Total Compensation Filing OrgTotalCompensationFilingOrg | Total Compensation Related OrgsTotalCompensationRelatedOrgs | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrg | Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| John Ashworth | ||||||||||||||
| Ex-Officio/Director | 0 | 368549 | 0 | 157673 | 0 | 62314 | 0 | 10000 | 0 | 10541 | 0 | 609077 | 0 | 0 |
| Robert Chrencik | ||||||||||||||
| Ex-Officio/Director | 0 | 1166972 | 0 | 994524 | 0 | 13073 | 0 | 223385 | 0 | 11081 | 0 | 2409035 | 0 | 0 |
| Noel Cervino | ||||||||||||||
| Ex-Officio/President & CEO | 0 | 337544 | 0 | 167621 | 0 | 20576 | 0 | 61499 | 0 | 5149 | 0 | 592389 | 0 | 0 |
| Erik Boas | ||||||||||||||
| Chief Financial Officer | 0 | 192019 | 0 | 58118 | 0 | 15605 | 0 | 23363 | 0 | 0 | 0 | 289105 | 0 | 0 |
| Mark Dumais | ||||||||||||||
| Chief Medical Officer | 0 | 271296 | 0 | 100341 | 0 | 2446 | 0 | 36148 | 0 | 7316 | 0 | 417547 | 0 | 0 |
| Gary Herbek | ||||||||||||||
| Chief Operating Officer | 199180 | 0 | 0 | 0 | 2030 | 0 | 9271 | 0 | 13531 | 0 | 224012 | 0 | 0 | 0 |
| Melanie Sage | ||||||||||||||
| VP Patient Care/Nurse Exec. | 147832 | 0 | 19630 | 0 | 262 | 0 | 7670 | 0 | 6250 | 0 | 181644 | 0 | 0 | 0 |
| Paul Blackwood | ||||||||||||||
| VP Planning | 161783 | 0 | 17215 | 0 | 2056 | 0 | 5494 | 0 | 15793 | 0 | 202341 | 0 | 0 | 0 |
| Katherine Middleton | ||||||||||||||
| RN | 157904 | 0 | 0 | 0 | 70 | 0 | 6481 | 0 | 9337 | 0 | 173792 | 0 | 0 | 0 |
| Marilyn Gregory | ||||||||||||||
| Clinical Nurse IV | 171637 | 0 | 0 | 0 | 201 | 0 | 6456 | 0 | 1964 | 0 | 180258 | 0 | 0 | 0 |
| Gabriel Abiola | ||||||||||||||
| Pharmacy Clinical Manager | 154269 | 0 | 6062 | 0 | 781 | 0 | 6995 | 0 | 13531 | 0 | 181638 | 0 | 0 | 0 |
| Stacey Cook | ||||||||||||||
| VP Human Resources | 149013 | 0 | 20859 | 0 | 485 | 0 | 7526 | 0 | 24365 | 0 | 202248 | 0 | 0 | 0 |
Form990 Schedule J Part III Form990ScheduleJPartIII (2 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| Supplemental Nonqualified Retirement Plan | Schedule J, Part I, Line 4B | DURING THE FISCAL YEAR-ENDED JUNE 30, 2013, CERTAIN OFFICERS AND KEY EMPLOYEES PARTICIPATED IN THE UNIVERSITY OF MARYLAND MEDICAL SYSTEM (UMMS) SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN. THE INDIVIDUALS LISTED BELOW HAVE VESTED IN THE PLAN IN A PRIOR YEAR, THEREFORE THE CONTRIBUTIONS TO THE PLAN FOR THE FISCAL YEAR ARE REPORTED AS TAXABLE COMPENSATION AND REPORTED ON SCHEDULE J, PART II, LINE B(III), OTHER REPORTABLE COMPENSATION: JOHN W. ASHWORTH THE INDIVIDUAL LISTED BELOW HAS NOT VESTED IN THE PLAN THEREFORE THE ACCRUED CONTRIBUTION TO THE PLAN FOR THE FISCAL YEAR IS REPORTED ON SCHEDULE J, PART II, COLUMN C, RETIREMENT AND OTHER DEFERRED COMPENSATION: ROBERT A. CHRENCIK |
| Non-fixed payments | Schedule J, Part I, Line 7 | Bonuses paid are based on a number of variables including but not limited to individual goal achievements as well as organization operation achievements. The final determination of the bonus amount is determined and approved by the Board as part of the overall compensation review of the officers and key employees. |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (8 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| Tax Exempt Bond Issues | Form 990, Part IV, Question 24 | Pursuant to a Master Loan Agreement dated June 20, 1991 (The "Master Loan Agreement"), as Amended, The University Of Maryland Medical System Corporation (The "Corporation") and several of its subsidiaries have issued debt through the Maryland Health and Higher Education Facility Authority (the "Authority"). As Security for the performance of the bond obligation under the Master Loan Agreement, The Authority maintains a security interest in the revenue of the obligors. The Master Loan Agreement contains certain restrictive covenants. These covenants require that rates and charges be set at certain levels, limit incurrence of additional debt, require compliance with certain operating ratios and restrict the disposition of assets. The obligated group under the Master Loan Agreement includes the Corporation, The James Lawrence Kernan Hospital, Inc., Maryland General Hospital, Inc., Baltimore Washington Medical Center, Inc., Shore Health System, Inc., Chester River Hospital Center, Inc., Civista Medical Center, Inc., University of Maryland St. Joseph Medical Center, LLC and the University of Maryland Medical System Foundation, Inc. Each member of the obligated Group is jointly and severally liable for the repayment of the obligations under the Master Loan Agreement of the Corporation's $1,267,185,000 of outstanding Authority Bonds on June 30, 2013. All of the bonds were issued in the name of the University of Maryland Medical System Corporation. As of June 30, 2013, Civista Medical Center refinanced its Maryland Health and Higher Education Facility Authority bonds. The issuance of debt was made by the University of Maryland Medical System Corporation for the obligated group, of which Civista Medical Center is a member. |
| Members or Stockholders | Form 990, Part VI, Line 6, 7a, and 7b | Civista medical Center, Inc. and University of Maryland Medical System Corporation may elect members and approve decisions of the Civista Medical Center board. |
| Form 990 Review Process | Form 990, Part VI, Line 11b | The I.R.S. form 990 is prepared and reviewed by the accounting firm of Grant Thornton. Accounting personnel in finance shared services at the university of Maryland medical system gather the information needed to complete the return and input the data into the Grant Thornton tax organizer. When all data has been entered, the information is submitted to Grant Thornton for importation into their tax software. At this point, Grant Thornton staff members review the data, ask for additional information if needed and prepare the tax return. Each return is reviewed at several levels at Grant Thornton including the tax partner. After their review process, a draft return is sent to the accounting staff at UMMS for an in-house review. Upon completion of the in-house review, Grant Thornton is instructed to make any necessary changes and to prepare the final tax return. The final return undergoes another review by the accounting staff at finance shared services and is also reviewed by the accounting manager, the director of financial reporting, the vice president of finance and the CFO, who signs the return. Prior to filing the I.R.S. Form 990, the organization's board chairman, treasurer, audit committee chairman, executive committee chairman or other member of the board with similar authority will review the I.R.S. Form 990. At the discretion of the reviewing board member, such member will bring any issues or questions related to the completed I.R.S. Form 990 to the attention of the board. Notwithstanding the above, a board resolution is not required for the filing of the organization's I.R.S. form 990. Each board member is provided with a copy of the final I.R.S. Form 990 before filing. |
| Conflict of Interest Policy Monitoring & Enforcement | Form 990, Part VI, Line 12c | THE ORGANIZATION'S OFFICERS, DIRECTORS, EMPLOYEES AND MEDICAL STAFF MEMBERS, AS APPLICABLE, SHALL DISCLOSE CONFLICTS OF INTEREST OR POTENTIAL CONFLICTS OF INTEREST BETWEEN THEIR PERSONAL INTERESTS AND THE INTERESTS OF THE ORGANIZATION, OR ANY ENTITY CONTROLLED BY OR OWNED IN SUBSTANTIAL PART BY THE ORGANIZATION. A QUESTIONNAIRE WHICH DISCLOSES POTENTIAL CONFLICTS OF INTEREST IS DISTRIBUTED ANNUALLY TO ALL OFFICERS, DIRECTORS AND KEY EMPLOYEES. THE GENERAL COUNSEL OF THE UNIVERSITY OF MARYLAND MEDICAL SYSTEM CORPORATION (UMMSC) REVIEWS THE RESPONSES FOR UMMSC, UNIVERSITY SPECIALTY HOSPITAL AND JAMES LAWRENCE KERNAN HOSPITAL. THE CEO OR CFO OF EACH OF THE OTHER ENTITIES IN THE UNIVERSITY OF MARYLAND MEDICAL SYSTEM REVIEWS THE RESPONSES FOR THOSE ENTITIES. THE GENERAL COUNSEL, IN CONSULTATION WITH THE AUDIT COMMITTEE, IF NECESSARY, WOULD DETERMINE IF A CONFLICT OF INTEREST EXISTED FOR UMMSC, UNIVERSITY SPECIALTY HOSPITAL AND JAMES LAWRENCE KERNAN HOSPITAL. WITH RESPECT TO THE OTHER ENTITIES IN THE UNIVERSITY OF MARYLAND MEDICAL SYSTEM, THE GENERAL COUNSEL MAY BE CALLED FOR CONSULT. IF SO, THE GENERAL COUNSEL MAY CONSULT THE AUDIT COMMITTEE, IF NECESSARY. WHENEVER A CONFLICT OR POTENTIAL CONFLICT OF INTEREST EXISTS, THE NATURE OF THE CONFLICT OR POTENTIAL CONFLICT OF INTEREST MUST BE DISCLOSED IN WRITING TO THE ORGANIZATION'S BOARD, BOARD COMMITTEE, AN OFFICER OF THE ORGANIZATION OR OTHER APPROPRIATE EXECUTIVE. SUCH INDIVIDUAL HAVING A POTENTIAL CONFLICT OF INTEREST SHALL PLAY NO ROLE ON BEHALF OF THE ORGANIZATION, OR ANY ORGANIZATION CONTROLLED OR SUBSTANTIALLY OWNED, IN ANY TRANSACTION IN WHICH A CONFLICT EXISTS. ALL INVITATIONS FOR BIDS, PROPOSALS OR SOLICITATIONS FOR OFFERS INCLUDE THE FOLLOWING PROVISION: ANY VENDOR, SUPPLIER OR CONTRACTOR MUST DISCLOSE ANY ACTUAL OR POTENTIAL TRANSACTION WITH ANY ORGANIZATION OFFICER, DIRECTOR, EMPLOYEE OR MEMBER OF THE MEDICAL STAFF, INCLUDING FAMILY MEMBERS WITHIN FIVE DAYS OF THE TRANSACTION. FAILURE TO COMPLY WITH THIS PROVISION IS A MATERIAL BREACH OF AGREEMENT. IN ADDITION, A BOARD DISCLOSURE REPORT IS FILED WITH THE MARYLAND HEALTH SERVICES COST REVIEW COMMISSION ON AN ANNUAL BASIS SHOWING ANY BUSINESS TRANSACTIONS BETWEEN THE BOARD MEMBERS AND THE ORGANIZATION. |
| Process for Determining Compensation | Form 990, Part VI, Line 15a & 15b | The organization determines the executive compensation paid to its executives in the following manner prescribed in the I.R.S. regulations: executive compensation packages are determined by a committee of the board that is composed entirely of board members who have no conflict of interest. The committee acquires credible comparability market data concerning the compensation packages of similarly situated executives. The committee carefully reviews that data, the executive's performance and the proposed compensation packages during the decision making process. The committee memorializes its deliberations in detailed minutes reviewed and adopted at the next-following meeting. The committee seeks an opinion of counsel that it has met the requirements of the I.R.S. intermediate sanctions regulations. This process is used to determine the compensation packages for all management employees from the vice president level and up. |
| How Documents are Made Available to the Public | Form 990, Part VI, Line 19 | IN GENERAL, FINANCIAL AND TAX INFORMATION RELATING TO THE ORGANIZATION IS DEEMED PROPRIETARY AND NOT SUBJECT TO DISCLOSURE UPON REQUEST. HOWEVER, SPECIFIC PROVISIONS OF FEDERAL AND STATE LAW REQUIRE THE ORGANIZATION TO DISCLOSE CERTAIN LIMITED FINANCIAL AND TAX DATA UPON A SPECIFIC REQUEST FOR THAT INFORMATION. REQUESTS FOR FORM 990 AND FORM 1023: A REQUESTOR SEEKING TO REVIEW AND/OR OBTAIN A COPY OF THE ORGANIZATION'S IRS FORM 990 OR FORM 1023 AS FILED WITH THE INTERNAL REVENUE SERVICE, INCLUDING ALL SCHEDULES AND ATTACHMENTS, MAY APPEAR IN PERSON OR SUBMIT A WRITTEN REQUEST. THE MOST RECENT THREE YEARS OF IRS FORM 990 MAY BE REQUESTED. IF THE REQUESTER APPEARS IN PERSON, THE INDIVIDUAL IS DIRECTED TO THE OFFICE OF THE CHIEF FINANCIAL OFFICER FOR THE ORGANIZATION AND THE FORM 990 AND/OR FORM 1023 ARE MADE AVAILABLE FOR INSPECTION. THE INDIVIDUAL IS PERMITTED TO REVIEW THE RETURN, TAKE NOTES AND REQUEST A COPY. IF REQUESTED, A COPY IS PROVIDED ON THE SAME DAY. A NOMINAL FEE IS CHARGED FOR MAKING THE COPIES. THE ORGANIZATION MAY HAVE AN EMPLOYEE PRESENT DURING THE PUBLIC INSPECTION OF THE DOCUMENT. WRITTEN REQUESTS FOR AN ENTITY'S FORM 990 OR FORM 1023 ARE DIRECTED IMMEDIATELY TO THE OFFICE OF THE CHIEF FINANCIAL OFFICER FOR THE ORGANIZATION. THE REQUESTED COPIES ARE MAILED WITHIN 30 DAYS OF THE REQUEST. REPRODUCTION FEES AND MAILING COSTS ARE CHARGED TO THE REQUESTOR. CONFLICT OF INTEREST POLICY AND GOVERNING DOCUMENTS: IF THE GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY OF OUR ORGANIZATION ARE SUBJECT TO THE FEDERAL PUBLIC DISCLOSURE RULES (OR STATE PUBLIC DISCLOSURE RULES), THESE DOCUMENTS WILL BE MADE PUBLICLY AVAILABLE AS APPLICABLE LAW MAY REQUIRE. OTHERWISE, THE GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY WILL BE PROVIDED TO THE PUBLIC AT THE DISCRETION OF MANAGEMENT. |
| Hours on Related Entities | Form 990, Part VII, Section A, Column B | THE UNIVERSITY OF MARYLAND MEDICAL SYSTEM (UMMS) IS A MULTI-ENTITY HEALTH CARE SYSTEM THAT INCLUDES 10 ACUTE CARE HOSPITALS, 3 ACUTE CARE HOSPITALS OWNED IN JOINT VENTURE ARRANGEMENTS AND VARIOUS SUPPORTING ENTITIES. A NUMBER OF INDIVIDUALS PROVIDE SERVICES TO VARIOUS ENTITIES WITHIN THE SYSTEM. IN GENERAL, THE OFFICERS AND KEY EMPLOYEES OF UMMS AVERAGE IN EXCESS OF 40 HOURS PER WEEK SERVING THE DIFFERENT ENTITIES THAT COMPRISE UMMS. |
| Other Changes in net assets or fund balances | Form 990, Part XI, Line 5 | Swap Costs Bond Refinancing -76,924 Change in Pension Liability 3,625,800 Net assets released from restrictions -117,482 Change in temp. restricted net assets -247,450 Change in Equity of Affiliates, Foundation 500,878 Change in Equity of affiliates, CPHA 411,250 Unrealized Bonds FMV Adjustment -2,916,360 Miscellaneous -5,976 ------------------------------------ ------------ Total change in net assets 1,173,736 |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII (30 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivities | Legal Domicile StateLegalDomicileState | Exempt Code SectionExemptCodeSection | Public Charity StatusPublicCharityStatus | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Controlled OrgControlledOrg |
|---|---|---|---|---|---|---|---|---|---|---|
| Baltimore Washington Emergency Phys Inc | ||||||||||
| 301 Hospital Drive | Glen Burnie | MD | 21061 | 521756326 | Healthcare | MD | 501(c)(3) | 11A | BWMS | false |
| Baltimore Washington Healthcare Services | ||||||||||
| 301 Hospital Drive | Glen Burnie | MD | 21061 | 521830243 | Healthcare | MD | 501(c)(3) | 11A | BWMS | false |
| Baltimore Washington Medical Center Inc | ||||||||||
| 301 Hospital Drive | Glen Burnie | MD | 21061 | 520689917 | Healthcare | MD | 501(c)(3) | 03 | BWMS | false |
| Baltimore Washington Medical System Inc | ||||||||||
| 301 Hospital Drive | Glen Burnie | MD | 21061 | 521830242 | Healthcare | MD | 501(c)(3) | 11A | UMMSC | false |
| BW Medical Center Foundation Inc | ||||||||||
| 301 Hospital Drive | Glen Burnie | MD | 21061 | 521813656 | Fundraising | MD | 501(c)(3) | 11C | BWMS | false |
| North Arundel Development Corporation | ||||||||||
| 301 Hospital Drive | Glen Burnie | MD | 21061 | 521318404 | Real Estate | MD | 501(c)(2) | NCC | false | |
| North County Corporation | ||||||||||
| 301 Hospital Drive | Glen Burnie | MD | 21061 | 521591355 | Real Estate | MD | 501(c)(2) | BWMS | false | |
| Chester River Health Foundation Inc | ||||||||||
| 100 Brown Street | Chestertown | MD | 21620 | 521338861 | Fundraising | MD | 501(c)(3) | 07 | CRHS | false |
| Univ of MD Shore Regional Health Inc | ||||||||||
| 100 Brown Street | Chestertown | MD | 21620 | 522046500 | Healthcare | MD | 501(c)(3) | 11A | UMMSC | false |
| Chester River Hospital Center Inc | ||||||||||
| 100 Brown Street | Chestertown | MD | 21620 | 520679694 | Healthcare | MD | 501(c)(3) | 03 | CRHS | false |
| Chester River Manor Inc | ||||||||||
| 200 Morgnec Road | Chestertown | MD | 21620 | 526070333 | Healthcare | MD | 501(c)(3) | 09 | CRHS | false |
| Maryland General Clinical Practice Group | ||||||||||
| 827 Linden Avenue | Baltimore | MD | 21201 | 521566211 | Healthcare | MD | 501(c)(3) | 11B | MGHS | false |
| Maryland General Comm Health Foundation | ||||||||||
| 827 Linden Avenue | Baltimore | MD | 21201 | 522147532 | Fundraising | MD | 501(c)(3) | 11C | MGHS | false |
| University of Maryland Midtown Health | ||||||||||
| 827 Linden Avenue | Baltimore | MD | 21201 | 521175337 | Healthcare | MD | 501(c)(3) | 11B | UMMSC | false |
| Maryland General Hospital Inc | ||||||||||
| 827 Linden Avenue | Baltimore | MD | 21201 | 520591667 | Healthcare | MD | 501(c)(3) | 03 | MGHS | false |
| Care Health Services Inc | ||||||||||
| 219 South Washington Street | Easton | MD | 21601 | 521510269 | Healthcare | MD | 501(c)(3) | 09 | SHS | false |
| Dorchester General Hospital Foundation | ||||||||||
| 219 South Washington Street | Easton | MD | 21601 | 521703242 | Fundraising | MD | 501(c)(3) | 11D | SHS | false |
| Memorial Hospital Foundation Inc | ||||||||||
| 219 South Washington Street | Easton | MD | 21601 | 521282080 | Fundraising | MD | 501(c)(3) | 11A | SHS | false |
| Shore Clinical Foundation Inc | ||||||||||
| 219 South Washington Street | Easton | MD | 21601 | 521874111 | Healthcare | MD | 501(c)(3) | 03 | SHS | false |
| Shore Health System Inc | ||||||||||
| 219 South Washington Street | Easton | MD | 21601 | 520610538 | Healthcare | MD | 501(c)(3) | 03 | UMMSC | false |
| James Lawrence Kernan Hosp Endow Fd | ||||||||||
| 2200 Kernan Drive | Baltimore | MD | 21207 | 237360743 | Fundraising | MD | 501(c)(3) | 11B | UMMSC | false |
| James Lawrence Kernan Hospital Inc | ||||||||||
| 2200 Kernan Drive | Baltimore | MD | 21207 | 520591639 | Healthcare | MD | 501(c)(3) | 03 | UMMSC | false |
| Shipleys Choice Medical Park Inc | ||||||||||
| 22 South Greene Street | Baltimore | MD | 21201 | 043643849 | Real Estate | MD | 501(c)(2) | UMMSC | false | |
| UMMS Foundation Inc | ||||||||||
| 22 South Greene Street | Baltimore | MD | 21201 | 522238893 | Fundraising | MD | 501(c)(3) | 11A | UMMSC | false |
| University of MD Medical System Corp | ||||||||||
| 22 South Greene Street | Baltimore | MD | 21201 | 521362793 | Healthcare | MD | 501(c)(3) | 03 | NA | false |
| University Specialty Hospital | ||||||||||
| 611 South Charles Street | Baltimore | MD | 21230 | 520882914 | Healthcare | MD | 501(c)(3) | 03 | UMMSC | false |
| Civista Health Inc | ||||||||||
| PO Box 1070 | La Plata | MD | 20646 | 522155576 | Healthcare | MD | 501(c)(3) | 11C | UMMSC | false |
| Civista Health Foundation Inc | ||||||||||
| PO Box 1070 | La Plata | MD | 20646 | 521414564 | Fundraising | MD | 501(c)(3) | 03 | CIVHS | false |
| Civista Health Auxiliary Inc | ||||||||||
| PO Box 1070 | La Plata | MD | 20646 | 521131193 | Fundraising | MD | 501(c)(3) | 11A | CIVHS | false |
| Univ of MD St Joseph Foundation Inc | ||||||||||
| 7601 Osler Drive | Towson | MD | 21204 | 521681044 | Fundraising | MD | 501(c)(3) | 11A | UMMSC | false |
Form990 Schedule R Part III Form990ScheduleRPartIII (9 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivityPrimaryActivity | Legal Domicile StateLegalDomicileState | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Predominant Income TypePredominantIncomeType |
|---|---|---|---|---|---|---|---|---|
| Arundel Physicians Associates LLC | ||||||||
| 301 Hospital Drive | Glen Burnie | MD | 20161 | 522000762 | Healthcare | MD | NA | N/A |
| Baltimore Washington Imaging LLC | ||||||||
| 301 Hospital Drive | Glen Burnie | MD | 20161 | 200806027 | Healthcare | MD | NA | N/A |
| Central Maryland Radiology Oncology LLC | ||||||||
| 10710 Charter Drive | Columbia | MD | 21044 | 270879418 | Healthcare | MD | NA | N/A |
| Innovative Health LLC | ||||||||
| 29165 Canvasback Drive Suite 100 | Easton | MD | 21601 | 521997287 | Billing | MD | NA | N/A |
| NAHSunrise of Severna Park LLC | ||||||||
| 301 Hospital Drive | Glen Burnie | MD | 20161 | 541810729 | Healthcare | MD | NA | N/A |
| North Arundel Senior Living LLC | ||||||||
| 301 Hospital Drive | Glen Burnie | MD | 20161 | 541810728 | Healthcare | MD | NA | N/A |
| Shipley's Imaging Center LLC | ||||||||
| 22 South Greene Street | Baltimore | MD | 21201 | 522040338 | Healthcare | MD | NA | N/A |
| Universitycare LLC | ||||||||
| 22 South Greene Street | Baltimore | MD | 21201 | 521914892 | Healthcare | MD | NA | N/A |
| O'Dea Medical Arts Limited Partnership | ||||||||
| 7601 Osler Drive | Towson | MD | 21204 | 521682964 | Rental | MD | NA | N/A |
Form990 Schedule R Part IV Form990ScheduleRPartIV (9 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivityPrimaryActivity | Legal Domicile StateLegalDomicileState | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Type Of EntityTypeOfEntity | Address Line1AddressForeign/AddressLine1 | CityAddressForeign/City | CountryAddressForeign/Country | Postal CodeAddressForeign/PostalCode | Legal Domicile Foreign CountryLegalDomicileForeignCountry |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Arundel Physicians Associates Inc | |||||||||||||
| 301 Hospital Drive | Glen Burnie | MD | 21061 | 521992649 | Healthcare | MD | NA | C Corp | |||||
| Baltimore Washington Health Enterprises | |||||||||||||
| 301 Hospital Drive | Glen Burnie | MD | 21061 | 521936656 | Healthcare | MD | NA | C Corp | |||||
| BW Professional Services Inc | |||||||||||||
| 301 Hospital Drive | Glen Burnie | MD | 21061 | 521655640 | Healthcare | MD | NA | C Corp | |||||
| Civista Care Partners Inc | |||||||||||||
| PO Box 1070 | La Plata | MD | 20646 | 522176314 | Healthcare | MD | NA | C Corp | |||||
| Univ Midtown Prof Center A Condominium | |||||||||||||
| 827 Linden Avenue | Baltimore | MD | 21201 | 521891126 | Real Estate | MD | NA | C Corp | |||||
| Shore Health Enterprises Inc | |||||||||||||
| 219 South Washington Street | Easton | MD | 21601 | 521363201 | Real Estate | MD | NA | C Corp | |||||
| NA Executive Building Condo Assn Inc | |||||||||||||
| 301 Hospital Drive | Glen Burnie | MD | 21061 | Real Estate | MD | NA | C Corp | ||||||
| Terrapin Insurance Company | |||||||||||||
| 980129232 | Insurance | NA | C Corp | PO Box 1109 | Grand Cayman | CJ | KY1-1102 | CJ | |||||
| UMMS Self Insurance Trust | |||||||||||||
| 22 South Greene Street | Baltimore | MD | 21201 | 526315433 | Insurance | MD | NA | Trust | |||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | false | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | false | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | false | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | false | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | false | LoansOrGuaranteesFromOtherOrg |
| Dividends Related Organization | false | DividendsRelatedOrganization |
| Sale Of Assets To Other Org | false | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | false | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | true | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | false | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | false | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | false | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | false | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | true | SharingOfFacilities |
| Sharing Of Paid Employees | true | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | false | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | true | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | true | OtherTransferToOtherOrg |
| Other Transfer From Other Org | true | OtherTransferFromOtherOrg |
Comments