2014-05-14T11:29:55-05:00 2013-06-30 232932984 PARENTEBEARD LLC 1650 MARKET STREET SUITE 4500 PHILADELPHIA PA 19103 990 2012-07-01 520607945 UNION HOSPITAL OF CECIL COUNTY INC UNIO 4103984000 106 BOW STREET ELKTON MD 219215596 LAURIE R BEYER CPA 4103984000 2014-05-14 1 JULIUS C GREEN CPA JD P00350393 2159720701 2012 2016-02-25 16:41:14Z KENNETH S LEWIS MD JD 106 BOW STREET ELKTON MD 219215596 162769500 0 X WWW.UHCC.COM X 1903 MD PROVIDE HEALTHCARE SERVICES TO THE RESIDENTS OF CECIL COUNTY, MD, AND THE SURROUNDING AREA. 16 15 1286 426 982579 -571243 358066 520133 147528194 151762502 -1015994 1412315 909475 3949188 147779741 157644138 3652832 4738934 0 0 69543149 75246162 0 0 0 74113793 76658317 147309774 156643413 469967 1000725 185901825 188229305 100850222 99544828 85051603 88684477 X UNION HOSPITAL OF CECIL COUNTY'S MISSION IS TO PROVIDE HEALTHCARE SERVICES TO THE RESIDENTS OF CECIL COUNTY, MARYLAND, WESTERN NEW CASTLE COUNTY, DELAWARE, AND SOUTHERN CHESTER COUNTY, PENNSYLVANIA. 0 0 152974263 4738934 151772348 UNION HOSPITAL OF CECIL COUNTY'S MISSION IS TO PROVIDE HEALTH CARE SERVICES TO THE RESIDENTS OF CECIL COUNTY, MARYLAND, WESTERN NEW CASTLE COUNTY, DELAWARE, AND SOUTHERN CHESTER COUNTY, PENNSYLVANIA, THAT REPRESENT QUALITY AND VALUE AND ARE PROVIDED WITH MODERN TECHNOLOGY, COMPASSIONATE NURSES AND STAFF, AND CONVENIENT TO THE CITIZENS OF OUR COMMUNITY. THESE HEALTHCARE SERVICES ARE PROVIDED REGARDLESS OF RACE, CREED, SEX, NATIONAL ORIGIN, HANDICAP, AGE, OR ABILITY TO PAY. ALTHOUGH REIMBURSEMENT FOR SERVICES RENDERED IS VITALLY IMPORTANT TO THE OPERATION, STABILITY, AND VIABILITY OF UNION HOSPITAL OF CECIL COUNTY, WE RECOGNIZE THAT NOT ALL MEMBERS OF OUR COMMUNITY ARE IN THE FINANCIAL POSITION TO PURCHASE ESSENTIAL MEDICAL SERVICES. THEREFORE, CONSISTENT WITH UNION HOSPITAL'S COMMITMENT TO SERVE ALL MEMBERS OF CECIL COUNTY, MARYLAND, FREE CARE AND/OR SUBSIDIZED CARE AND HEALTH ACTIVITIES AND PROGRAMS TO SUPPORT THE COMMUNITY WILL BE CONSIDERED WHERE THE NEED AND/OR AN INDIVIDUAL'S INABILITY TO PAY COEXISTS. THESE ACTIVITIES INCLUDE COMMUNITY EDUCATION, SPECIAL PROGRAMS FOR THE ELDERLY, SPECIAL PROGRAMS FOR THE PHYSICALLY/MENTALLY CHALLENGED, MEDICALLY UNDERSERVED AND A VARIETY OF BROAD COMMUNITY SUPPORT ACTIVITIES.UNION HOSPITAL OF CECIL COUNTY SERVICED 5,762 ADMISSIONS PROVIDING 20,994 PATIENT DAYS TO INPATIENTS IN FISCAL YEAR 2013 OF WHICH:1) PATIENTS COVERED UNDER THE MEDICARE PROGRAM WERE 2,554 ADMISSIONS AND 10,737 PATIENT DAYS2) PATIENTS COVERED UNDER THE MEDICAID PROGRAM WERE 92 ADMISSIONS AND 316 PATIENT DAYS3) PATIENTS COVERED UNDER THE MEDICAID HMO PROGRAM WERE 1,189 ADMISSIONS AND 3,634 PATIENT DAYS4) PATIENTS COVERED UNDER THE MEDICARE HMO PROGRAM WERE 135 ADMISSIONS AND 610 PATIENT DAYSCHARITY CARE IS ALSO PROVIDED THROUGH MANY REDUCED PRICE SERVICES AND FREE PROGRAMS OFFERED THROUGHOUT THE YEAR BASED UPON ACTIVITIES AND SERVICES THAT UNION HOSPITAL OF CECIL COUNTY BELIEVES WILL SERVE A BONA FIDE COMMUNITY NEED. THESE INCLUDE:A) ADULT DAY CARE SERVICES FOR THE ELDERLY AND PHYSICALLY/MENTALLY CHALLENGEDB) SUPPORT GROUPS FOR CANCER PATIENTS AND FAMILIES, DIABETES, ALCOHOLICS ANONYMOUS, OSTOMY, AND SMOKELESSC) OFFERING AND CONDUCTING FREE BLOOD PRESSURE, CHOLESTEROL SCREENINGS, AND PROSTATE SCREENINGSD) IN CONJUNCTION WITH THE STATE OF MARYLAND AND THE LOCAL DEPARTMENT OF HEALTH, OFFERING AND CONDUCTING A CANCER SCREENING PROGRAM FOR INDIGENT FEMALESE) PROVIDING MEETING FACILITIES FOR A VARIETY OF NONPROFITS AND VOLUNTEER FIRE COMPANIESF) HOSPITAL STAFF VOLUNTEERS ON NONPROFIT ORGANIZATION BOARDS SUCH AS THE AMERICAN CANCER SOCIETYDURING THE YEAR, UNION HOSPITAL OF CECIL COUNTY PROVIDED $13,136,000 IN UNCOMPENSATED CARE. 152974263 1 1 0 0 0 0 0 0 0 0 1 0 0 0 1 1 1 1 0 0 0 0 0 0 0 0 1 1 1 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 183 0 1 1286 1 1 1 0 0 0 0 0 0 0 0 0 X 16 15 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 MD X DERON G BROWN DIRECTOR OF FINANCE 4103984000 106 BOW STREET ELKTON MD 21921 JACK GOLDSTEIN 0.40 0.50 X X 0 0 0 MARTIN J HEALY 0.40 0.50 X X 0 0 0 RICHARD GUTTENDORF 0.40 0.50 X X 0 0 0 RONALD GRAYBEAL 0.50 0.50 X X 0 0 0 ALFONSO BASILE MD 0.50 0.50 X 0 0 0 MARY BOLT PHD 0.50 0.50 X 0 0 0 RON CULLIS 0.50 0.50 X 0 0 0 PHILLIP FARMER 0.50 0.50 X 0 0 0 RAYMOND HAMM 0.50 0.50 X 0 0 0 RAYMOND HEIDEL 0.30 0.70 X 0 0 0 MARTHA HOSFORD MD 0.50 0.50 X 0 0 0 TARI MOORE 0.50 0.50 X 0 0 0 HENRY PASSI 0.50 0.50 X 0 0 0 SHEELMOHAN SACHDEV MD 0.60 0.40 X 0 0 0 MICHAEL SCIBINICO 0.50 0.50 X 0 0 0 KENNETH S LEWIS MD JD 30.00 10.00 X X 0 721506 144960 LAURIE R BEYER CPA 28.00 12.00 X 0 308570 84480 CYDNEY TEAL 39.90 0.10 X 0 296876 28900 TERRANCE LOVELL 40.00 X 164085 0 16696 DAVID GIPSON 28.60 11.40 X 0 325305 85433 CAREN LEWIS 39.10 0.90 X 0 226865 54740 ROHIT SINGHANIA 40.00 X 426827 0 13479 IRFAN M HISAMUDDIN MD 40.00 X 416246 0 20192 JUSTIN SAUSVILLE 40.00 X 394870 0 23771 JAGDEEP HUNDAL 40.00 X 368569 0 23561 BERNARD J HYNES 40.00 X 367864 0 19805 2138461 1879122 516017 82 0 1 0 OWENS & MINOR INC PO BOX 79171 BALTIMORE MD 21279 MEDICAL SUPPLY DISTRIBUTOR 3710338 RADCAREEMCARE PO BOX 368 PERRY HALL MD 21128 IMAGING READINGS 2703710 MEDICAL INFORMATION TECHNOLOGY INC PO BOX 74569 CHICAGO IL 60696 SOFTWARE 2699777 CLEARPATH SOLUTIONS GROUP LLC 2465 CENTERVILLE ROAD HERNDON VA 20171 HARDWARE AND MAINTENANCE 2697158 NAVIN HAFFTY & ASSOC LLC 1900 WEST PARK DRIVE WESTBOROUGH MA 01581 SOFTWARE CONSULTING 2494415 95 480133 40000 520133 NET PATIENT SERVICE REVENUE 621990 150282645 150282645 OTHER OPERATING REVENUE 621990 849519 849519 ADULT DAY CARE 623990 540577 540577 LIFELINE 900099 89761 89761 151762502 1324410 1324410 167604 34829 132775 132775 132775 5178438 5090533 87905 87905 87905 MEANINGFUL USE REVENUE 900099 1997301 1997301 LABORATORY REVENUE 621500 972733 972733 CAFETERIA/FOOD SERVICE 722210 773133 773133 73246 9846 63400 3816413 157644138 151762502 982579 4378924 X 4738934 4738934 2572233 2572233 61139628 60311795 827833 960928 811691 149237 6238319 6136302 102017 4335054 4284363 50691 2070605 1035302 1035303 290439 290439 101664 101664 63111 63111 19621779 18897011 724768 479112 479112 1966464 1888451 78013 426990 426990 2437680 2437680 309543 280504 29039 22436 8143 14293 2688829 2688829 8970371 8970371 2515823 2515823 MEDICAL SUPPLIES/DRUGS 18918168 18918168 BAD DEBT 9628002 9628002 REPAIRS & MAINTENANCE 2336946 2336946 FOOD/DIETARY SUPPLIES 1059133 1059133 2751222 2548480 202742 156643413 152974263 3669150 0 298522 5405023 9013704 784061 18298560 15574231 1158970 561214 1805445 1759420 1619387 2253892 179685973 93292117 79944732 86393856 63033266 63626059 5060977 5112129 5668262 6759420 185901825 188229305 11415256 15108507 81847367 74136484 7587599 10299837 100850222 99544828 X 84203884 87623004 847719 1061473 85051603 88684477 185901825 188229305 X 1000725 3169351 -537202 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 1134905 1134905 70711838 27255835 43456003 774439 644543 129896 95102987 64346149 30756838 11961804 1045590 10916214 86393856 THIRD PARTY ADVANCES 2073357 CAPITAL LEASE OBLIGATIONS 696808 ESTIMATED MEDICAL MALPRACTICE CLAIMS LIABILITY 6289313 DUE TO AFFILIATES 1240359 10299837 X 150532531 3169351 -10217847 -7048496 157581027 63111 63111 157644138 146899657 0 146899657 63111 9680645 9743756 156643413 DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X, LINE 2: THE HOSPITAL ACCOUNTS FOR UNCERTAINTY IN INCOME TAXES BY PRESCRIBING A RECOGNITION THRESHOLD OF MORE-LIKELY-THAN-NOT TO BE SUSTAINED UPON EXAMINATION BY THE APPROPRIATE TAXING AUTHORITY. MEASUREMENT OF THE TAX UNCERTAINTY OCCURS IF THE RECOGNITION THRESHOLD HAS BEEN MET. THERE WERE NO TAX UNCERTAINTIES THAT MET THE RECOGNITION THRESHOLD IN 2013 AND 2012. THE HOSPITAL'S FEDERAL EXEMPT ORGANIZATION BUSINESS INCOME TAX RETURNS FOR YEARS AFTER 2009 REMAIN SUBJECT TO EXAMINATION BY THE INTERNAL REVENUE SERVICE. PART XI, LINE 2D - OTHER ADJUSTMENTS: CHANGE IN INTEREST IN NET ASSETS OF FOUNDATION & SUBSIDIARY -167,878. LOSS ON REFINANCING -322,110. PROVISION FOR BAD DEBTS NETTED AGAINST REVENUE ON FINANCIAL STATEMENTS -9,628,002. CHANGE IN PROVISION FOR UNCOLLECTIBLE PLEDGES -47,214. BANK FEES NETTED ON FINANCIAL STATEMENTS -52,643. PART XII, LINE 4B - OTHER ADJUSTMENTS: PROVISION FOR BAD DEBTS NETTED AGAINST REVENUE ON FINANCIAL STATEMENTS 9,628,002. BANK FEES NETTED ON FINANCIAL STATEMENTS 52,643. 1 1 1 X 1 X 1 1 1 0 1 1 3767210 3767210 0.02560 3767210 3767210 0.02560 487087 120756 366331 0.00250 293786 293786 0.00200 11659981 5918978 5741003 0.03910 575619 135202 440417 0.00300 13016473 6174936 6841537 0.04660 16783683 6174936 10608747 0.07220 21330 21330 0.00010 9814 9814 0.00010 102587 102587 0.00070 133731 133731 0.00090 1 7906949 203754 63796787 63796787 X 1 1 1 1 UNION HOSPITAL OF CECIL COUNTY INC

106 BOW STREET ELKTON MD 21921

X X X UNION HOSPITAL OF CECIL COUNTY INC 1 1 X X X X X X X X 12 1 0 1 X X X X X X X 0 0 1 1 200.000000000000 1 300.000000000000 1 X X X X X X 1 1 X X X X X X 1 0 X X X X 1 X 0 0 PART I, LINE 7: ALL INFORMATION IS BASED ON ACTUAL COST PLUS OVERHEAD. OVERHEAD IS A HOSPITAL AVERAGE PERCENTAGE OF OVERHEAD TO DIRECT COSTS. DIRECT COSTS EXCLUDE BAD DEBT EXPENSE. PART I, L7 COL(F): THE AMOUNT OF BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25 BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $9,628,002. PART II: ECONOMIC DEVELOPMENT (F2)MEMBERS OF UNION HOSPITAL'S EXECUTIVE MANAGEMENT TEAM ATTENDED MEETINGS WITH THE FOLLOWING ENTITIES: 1)ECONOMIC DEVELOPMENT COMMISSION FOR CECIL COUNTY. THIS COMMISSION PROMOTES ECONOMIC DEVELOPMENT IN CECIL COUNTY, FOCUSING ON BUSINESS AND INDUSTRY DEVELOPMENT BY BUILDING RELATIONSHIPS WITH LOCAL AND EXTERNAL PARTNERS. UNION HOSPITAL COLLABORATES WITH THIS COMMISSION TO PROMOTE STABILITY WITHIN THE HOSPITAL'S WORKFORCE OF HEALTH PROFESSIONALS AND TO BRING MUCH NEEDED PRACTITIONERS TO THE AREA, ESPECIALLY IN AREAS WHERE THERE ARE TOO FEW PROVIDERS OR SERVICE GAPS. 2)ELKTON ALLIANCE. ELKTON ALLIANCE WORKS TOGETHER WITH THE LOCAL GOVERNMENT AND BUSINESS COMMUNITY TO RESTORE, PROMOTE AND MAINTAIN THE DIVERSE HISTORIC DOWNTOWN AREA, WHILE ATTRACTING NEW ENTERPRISES FOR THE BENEFIT OF COMMUNITY RESIDENTS, BUSINESSES, AND VISITORS. IN COLLABORATING WITH ELKTON ALLIANCE, UNION HOSPITAL SEEKS TO MAINTAIN A POSITIVE PRESENCE IN THE COMMUNITY BY HELPING TO ADDRESS ANY COMMUNITY DEVELOPMENT ISSUES. 3)AMER-INDO ORGANIZATION. THIS IS A NON-PROFIT ORGANIZATION THAT SEEKS MUTUAL BUSINESS OPPORTUNITIES BETWEEN AMERICAN & INDONESIAN CULTURES. AS A SUPPORTER OF CULTURAL DIVERSITY, UNION HOSPITAL'S CEO BEGAN MEETING WITH THIS ORGANIZATION TO LEARN MORE ABOUT THE BARRIERS AND NEEDS THAT INDONESIAN PEOPLES IN CECIL COUNTY FACE IN THE CURRENT ECONOMY. COMMUNITY SUPPORT (F3)MEMBERS OF UNION HOSPITAL'S EXECUTIVE MANAGEMENT TEAM, AS WELL AS ADMINISTRATIVE STAFF, WORK CLOSELY WITH UNITED WAY OF CECIL COUNTY TO BUILD FUNDING AND PROGRAM CAPACITY FOR COMMUNITY-BASED PROGRAMMING FOR UNDERSERVED YOUTH IN THE COUNTY. HAVING HEALTHY YOUTH IS AN IMPORTANT FACET OF A STRONG COMMUNITY AND UNION HOSPITAL CONTINUES TO UPHOLD THIS IMPORTANCE BY FACILITATING A COLLABORATIVE PARTNERSHIP WITH UNITED WAY OF CECIL COUNTY. WORKFORCE DEVELOPMENT (F8)THERE WERE SEVERAL ACTIVITIES REPORTED UNDER WORKFORCE DEVELOPMENT DURING FISCAL YEAR 2013:1)HOLLY EMMONS, DIRECTOR OF FOOD SERVICES AT UNION HOSPITAL, AND HER STAFF MENTORED 97 MENTALLY-CHALLENGED HIGH SCHOOL STUDENTS FROM ELKTON HIGH SCHOOL AND PERRYVILLE HIGH SCHOOL AS PART OF UNION HOSPITAL'S AND CECIL COUNTY PUBLIC SCHOOLS' PARTNER PROGRAM: THE HIGH SCHOOL WORK ENRICHMENT PROGRAM. THIS PROGRAM PROVIDES WORK ASSIGNMENTS AND APPROPRIATE TRAINING IN FOOD SERVICE ACTIVITIES, LIKE DEVELOPING CULINARY SKILLS FOR FOOD PREPARATION AND DEVELOPING SANITATION RESPONSIBILITIES (DISHWARE WASHING, SANITIZATION, TRASH DISPOSAL, AND RECYCLING). THE PROGRAM IS AN IMPORTANT FACET OF THE WORK ENRICHMENT EXPERIENCE BECAUSE IT PROVIDES DIRECTION, IMPORTANT LIFE SKILLS AND ALLOWS STUDENTS TO FEEL NEEDED, USEFUL, AND CAPABLE, ESPECIALLY IN A BUSY WORK ENVIRONMENT. STUDENTS ENJOY THEIR ROLES AND LEARN THE VALUE OF PRODUCTIVITY AND TASK COMPLETION BOTH WORKING INDIVIDUALLY AND AS PART OF A TEAM. 2)HUMAN RESOURCES STAFF MEMBERS PARTICIPATED IN WORKSHOPS WHERE THEY PROVIDED NEEDS-BASED CAREER COUNSELING FOR COMMUNITY MEMBERS. THIS INCLUDED HOW TO CONSTRUCT A RESUME, PROVIDING INTERVIEWING SKILLS, AND DISCUSSING WORKFORCE RESOURCES. STAFF PARTICULARLY VOLUNTEERED FOR THIS WORK BECAUSE THEY WERE SEEKING TO SHARE KNOWLEDGE AND PROVIDE INSIGHT FOR THE LESS FORTUNATE WHO WERE TRYING TO BETTER THEIR LIFE SITUATIONS BY GETTING JOBS OR AT LEAST BEING PREPARED FOR GETTING A JOB. FOR THE HUMAN RESOURCES STAFF THIS WAS ALSO A WAY FOR THEM TO PROMOTE THE VALUE OF SHARED LEARNING THAT UNION HOSPITAL EMPHASIZES ALL STAFF SHOULD DEMONSTRATE. 3)A MEMBER OF UNION HOSPITAL'S EXECUTIVE MANAGEMENT TEAM ATTENDS MEETINGS WITH THE SUSQUEHANNA WORKFORCE BOARD IN CECIL COUNTY. SUSQUEHANNA WORKFORCE IS A NON-PROFIT ORGANIZATION THAT PLANS WORKFORCE DEVELOPMENT PROGRAMS AND SERVICES FOR INDIVIDUALS AND BUSINESSES IN CECIL COUNTY AND HARTFORD COUNTY. UNION HOSPITAL CONTINUES TO UPHOLD THE NECESSITY OF THIS RESOURCE IN THE CECIL COUNTY COMMUNITY. 4)A MEMBER OF UNION HOSPITAL'S EXECUTIVE MANAGEMENT TEAM ATTENDS MEETINGS WITH THE BUSINESS EDUCATION PARTNERSHIP ADVISORY COUNCIL (BEPAC), WHICH SERVES TO IDENTIFY STRENGTHS, NEEDS AND TRENDS IN JOB READINESS AS IT CORRELATES TO STUDENT SUCCESS UPON GRADUATION FROM HIGH SCHOOL. BEPAC STRIVES TO PREPARE STUDENTS TO MEET JOB MARKET NEEDS, SELECT SATISFYING CAREERS, AND BE GOOD CITIZENS IN THEIR COMMUNITIES. UNION HOSPITAL HAS BEEN A PARTNER IN THIS PROCESS FOR SEVERAL YEARS. 5)UNION HOSPITAL REPORTS PHYSICIAN RECRUITMENT UNDER WORKFORCE DEVELOPMENT BECAUSE IT ADDRESSES GAPS IN SERVICES, ESPECIALLY WHERE THERE ARE TOO FEW PROVIDERS TO PRACTICE (IN UNDERSERVED AREAS, ETC.). PART III, LINE 4: COSTING METHODOLOGY USED IN DETERMINING BAD DEBT EXPENSE AMOUNTS: THE METHODOLOGY ASSUMES THAT THE PERCENTAGE OF CHARITY CARE TO TOTAL REVENUE CAN BE APPLIED TO THE AMOUNT OF BAD DEBT EXPENSE FOR THE YEAR. OTHER BAD DEBT AMOUNTS ARE NOT INCLUDED IN COMMUNITY BENEFITS.HOW THE ORGANIZATION ACCOUNTS FOR DISCOUNTS AND PAYMENTS ON PATIENT ACCOUNTS IN DETERMINING BAD DEBT EXPENSE: DISCOUNTS AND PAYMENTS ARE OFFSET AGAINST BAD DEBT EXPENSE.METHOD USED TO DETERMINE THE AMOUNT THAT REASONABLY COULD BE ATTRIBUTABLE TO PATIENTS WHO LIKELY WOULD QUALIFY FOR FINANCIAL ASSISTANCE UNDER THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY: THE HOSPITAL USES THE AVERAGE CHARITY CARE WRITE-OFF PER CHARITY CASE MULTIPLIED BY THE NUMBER OF CASES NOT APPROVED DUE TO LACK OF DOCUMENTATION.FOOTNOTE TO THE ORGANIZATION'S FINANCIAL STATEMENTS THAT DESCRIBES BAD DEBT EXPENSE: ACCOUNTS RECEIVABLE, PATIENTS ARE REPORTED AT NET REALIZABLE VALUE. ACCOUNTS ARE WRITTEN OFF WHEN THEY ARE DETERMINED TO BE UNCOLLECTIBLE BASED UPON MANAGEMENT'S ASSESSMENT OF INDIVIDUAL ACCOUNTS. THE ALLOWANCE FOR DOUBTFUL ACCOUNTS IS ESTIMATED BASED UPON A PERIODIC REVIEW OF THE ACCOUNTS RECEIVABLE AGING, PAYOR CLASSIFICATIONS AND APPLICATION OF HISTORICAL WRITE-OFF PERCENTAGES. PART III, LINE 8: COSTING METHODOLOGY USED TO DETERMINE AMOUNT OF MEDICARE ALLOWABLE COSTS: MEDICARE ALLOWABLE COSTS EQUAL MEDICARE REVENUE ADJUSTED FOR THE HOSPITAL TOTAL RATIO OF PATIENT CARE COSTS TO CHARGES DUE TO THE FACT THAT MEDICARE PAYS FULL CHARGES IN MARYLAND.EXTENT TO WHICH MEDICARE SHORTFALL SHOULD BE TREATED AS COMMUNITY BENEFIT: IN THE STATE OF MARYLAND, MEDICARE PAYS FULL CHARGES. THERE IS NO SHORTFALL THAT SHOULD BE TREATED AS A COMMUNITY BENEFIT. PART III, LINE 9B: IN ACCORDANCE WITH THE COLLECTION POLICY, BAD DEBT ACCOUNTS WILL BE ELIGIBLE FOR A CHARITY CARE DISCOUNT IF THE PATIENT MEETS CHARITY CARE POLICY GUIDELINES. THE PATIENT WILL NEED TO SUPPLY INCOME INFORMATION IN ORDER TO DETERMINE ELIGIBILITY FOR CHARITY CARE PER POLICY. ALSO SEE RESPONSE TO PART III LINE 4 ABOVE. UNION HOSPITAL OF CECIL COUNTY, INC. PART V, SECTION B, LINE 3: CONDUCTING THE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) WAS A COLLABORATIVE EFFORT BETWEEN UNION HOSPITAL OF CECIL COUNTY AND THE CECIL COUNTY HEALTH DEPARTMENT. UNION HOSPITAL'S COMMUNITY BENEFITS COORDINATOR MET WITH CECIL COUNTY HEALTH DEPARTMENT'S PUBLIC HEALTH OFFICER, DEPUTY PUBLIC HEALTH OFFICER, AND EPIDEMIOLOGIST TO CONDUCT THE COMMUNITY HEALTH NEEDS ASSESSMENT. THIS TEAM FACILITATED A SERIES OF MEETINGS WITH BOTH COMMUNITY LEADERS AND COMMUNITY RESIDENTS TO GAIN FIRST-HAND KNOWLEDGE OF IMPORTANT HEALTH NEEDS IN CECIL COUNTY. THE CHNA PROCESS BEGAN IN JANUARY 2012 (DURING THE 3RD QUARTER OF FISCAL YEAR 2012). SECONDARY DATA WAS ANALYZED AND USED IN CONJUNCTION WITH ALL COMMUNITY MEETINGS AS PART OF THE SUPPORTING DATA PLATFORM. USE OF SECONDARY DATA WAS ALSO INTEGRAL TO THE HEALTH NEEDS PRIORITIZATION PROCESS CONDUCTED BY UNION HOSPITAL. INPUT FROM COMMUNITY PARTNERS ENGAGED IN CECIL COUNTY'S LOCAL HEALTH IMPROVEMENT COALITION MEETINGS WAS INCLUDED TO FURTHER VERIFY AND SUPPORT CONDUCTION OF THE CHNA. THE COMMUNITY PARTNERS CONSULTED WERE AS FOLLOWS: AMERICAN CANCER SOCIETY CECIL COLLEGE CECIL COUNTY COMMISSIONERS CECIL COUNTY DEPARTMENT OF EMERGENCY SERVICES CECIL COUNTY DEPARTMENT OF JUVENILE SERVICES CECIL COUNTY DEPARTMENT OF SOCIAL SERVICES CECIL COUNTY HEALTH DEPARTMENT CECIL COUNTY LIQUOR BOARD CECIL COUNTY LOCAL MANAGEMENT BOARD CECIL COUNTY PARKS AND RECREATIONAL SERVICES CECIL COUNTY PUBLIC SCHOOLS CECIL COUNTY SHERIFF'S OFFICE ELKTON HOUSING AUTHORITY JOHNS HOPKINS HEALTH CARE MARYLAND STATE DELEGATION MARYLAND STATE SENATE PRIVATE HEALTH CARE PROVIDERS PROJECT CROSSROAD UNION HOSPITAL EMPLOYED PROVIDERS, STAFF, AND EXECUTIVE MANAGEMENT UNIVERSITY OF MARYLAND STATEWIDE HEALTH NETWORK UPPER BAY COUNSELING AND SUPPORT SERVICES WEST CECIL HEALTH CENTER (FQHC) YMCATHE LOCAL HEALTH IMPROVEMENT COALITION WAS SURVEYED TO DETERMINE WHICH HEALTH NEEDS WERE PROMINENT IN CECIL COUNTY. DATA GATHERED FROM THE SURVEY REFLECTED CONCERNS RELATED TO PRESCRIPTION DRUG AND SUBSTANCE ABUSE, MENTAL HEALTH ACCESS, CHILD ABUSE, AND CHILDHOOD OBESITY. FOUR FOCUS GROUPS WERE ALSO CONDUCTED WITH COMMUNITY RESIDENTS. THESE FOCUS GROUPS INCLUDED RESIDENTS FROM ELKTON, CHARLESTOWN, NORTH EAST, CHESAPEAKE CITY, CECILTON, PERRYVILLE, RISING SUN, AND PORT DEPOSIT. FOCUS GROUP PARTICIPANTS INCLUDED YOUNG ADULTS, SENIOR CITIZENS, MEMBERS FROM VARIOUS LOCAL COMMUNITY ORGANIZATIONS AND CHURCHES, HOMEMAKERS, SMALL BUSINESS OWNERS, LIFE COACHES, RETIREES, AND COMMUNITY ORGANIZERS. THE FOCUS GROUPS WERE FACILITATED/MODERATED BY UNION HOSPITAL'S COMMUNITY BENEFITS COORDINATOR AND CECIL COUNTY HEALTH DEPARTMENT'S PUBLIC HEALTH OFFICER. THE HEALTH DEPARTMENT'S EPIDEMIOLOGIST PROVIDED TECHNICAL SUPPORT AND TRANSCRIPTION OF MEETING NOTES. EACH FOCUS GROUP SESSION BEGAN WITH A DESCRIPTION OF THE CHNA. PARTICIPANTS WERE THEN PRESENTED WITH DATA GATHERED FROM THE LOCAL HEALTH IMPROVEMENT COALITION SURVEY MEETINGS AND OTHER SECONDARY HEALTH DATA. AFTER REVIEW OF THE DATA, PARTICIPANTS WERE ASKED TO RESPOND BASED ON THEIR OWN PERSONAL UNDERSTANDING OF HEALTH IN THEIR COMMUNITIES AND WHAT NEEDED TO BE DONE TO ADDRESS IDENTIFIED HEALTH NEEDS. LISTED BELOW ARE THE DIFFERENT HEALTH NEEDS IDENTIFIED PER FOCUS GROUP. FOCUS GROUP HEALTH NEEDS IDENTIFIEDELKTON FOCUS GROUP SUBSTANCE ABUSE MENTAL HEALTH CARE ACCESS HOMELESSNESS SMOKING NUTRITION LUNG CANCER CHESAPEAKE CITY FOCUS GROUP GERIATRIC CARE IMPROVEMENTS MEDICAL TRANSPORTATION ACCESS CANCER TOBACCO USE SUBSTANCE ABUSE OBESITY MENTAL HEALTH CARE ACCESS GENERAL ACCESS TO HEALTH CARE FOR RESIDENTS THAT LIVE BELOW THE C & D CANALPERRYVILLE FOCUS GROUP CANCER SMOKING OBESITY ACCESS TO HEALTHIER FOODS MENTAL HEALTH CARE ACCESS CHILD NEGLECT SUBSTANCE ABUSERISING SUN FOCUS GROUP MENTAL HEALTH CARE ACCESS SUICIDE PREVENTION CANCER OBESITY DIABETES PRESCRIPTION DRUG ABUSE HEALTH COMMUNICATION IMPROVEMENTS ADDRESSING HEALTH DISPARITIESDATA FROM THE FOCUS GROUPS WAS ANALYZED, COMPARED TO SECONDARY HEALTH DATA FROM LOCAL, STATE AND NATIONAL SOURCES, AND PRESENTED TO UNION HOSPITAL'S INTERNAL COMMUNITY BENEFITS WORKGROUP TO COMPLETE THE HEALTH NEEDS PRIORITIZATION PROCESS. SECONDARY HEALTH DATA PROVIDED BY HEALTHY COMMUNITIES INSTITUTE FOR CECIL COUNTY FROM A VARIETY OF LOCAL, STATE AND NATIONAL SOURCES WAS ANALYZED ACCORDING TO HEALTH INDICATORS IDENTIFIED AS HIGH RISK FOR THE CECIL COUNTY POPULATION. UNION HOSPITAL'S INTERNAL COMMUNITY BENEFITS WORKGROUP WAS ESTABLISHED TO MONITOR THE PROGRESSION OF COMMUNITY BENEFITS PLANNING AND REPORTING ACTIVITIES. IT WAS ALSO ESTABLISHED TO SET THE FRAMEWORK FOR ACCOUNTABILITY AND TRANSPARENCY BOTH INTERNALLY AND EXTERNALLY TO THE HOSPITAL. THE WORKGROUP'S MAIN ROLE DURING THE CHNA WAS TO HELP PRIORITIZE HEALTH NEEDS IDENTIFIED FROM BOTH THE COMMUNITY AND THE ANALYSIS OF SECONDARY HEALTH DATA SOURCES. THE FINAL PRIORITIZATION OF HEALTH NEEDS WAS BASED ON THE FOLLOWING CRITERIA:- SIZE. THE NUMBER OF PERSONS AFFECTED BY THE HEALTH NEED (INCIDENCE AND PREVALENCE). - SERIOUSNESS. LEVEL OF SEVERITY AS INDICATED BY MORBIDITY AND MORTALITY RATES AND ECONOMIC AND/OR SOCIAL IMPACT. - ECONOMIC FEASIBILITY. COSTS OF INTERNAL RESOURCES AND POTENTIAL COSTS OF EXTERNAL RESOURCES. - POTENTIAL FOR IMPACT. COULD THE HOSPITAL MAKE AN IMPORTANT CONTRIBUTION? DID IT HAVE THE EXPERTISE, TIME, AND RESOURCES FOR PLANNING, IMPLEMENTATION OF PROGRAMS/ACTIVITIES, AND EVALUATION OF ALL INITIATIVES?- AVAILABILITY OF COMMUNITY ASSETS. WERE THERE PROGRAMS ALREADY IN EXISTENCE THAT WERE ADDRESSING THE IDENTIFIED HEALTH NEEDS?- PROBABILITY OF SUCCESS. WHAT WAS THE LIKELIHOOD OF ACHIEVING OBJECTIVES AND GOALS CREATED FOR A COMMUNITY BENEFIT IMPLEMENTATION PLAN?- VALUE. SUBJECTIVE MEASURES THAT INDICATED IMPORTANCE. AFTER CAREFUL CONSIDERATION OF ALL DATA AND PRIORITIZATION CRITERIA, THE INTERNAL COMMUNITY BENEFITS WORKGROUP CHOSE THE FOLLOWING TOP THREE RANKED HEALTH PRIORITIES FOR CECIL COUNTY:1) RESPIRATORY HEALTH;2) HEART DISEASE; AND 3) OBESITY.UNION HOSPITAL WILL ADDRESS THESE HEALTH PRIORITIES THROUGH THE COMMUNITY BENEFIT IMPLEMENTATION PLAN OVER THE NEXT THREE FISCAL YEARS. UNION HOSPITAL OF CECIL COUNTY, INC. PART V, SECTION B, LINE 6I: COLLABORATIVE COMMUNITY PARTNERS HAVE ALSO BEEN IDENTIFIED IN THE IMPLEMENTATION PLAN. UNION HOSPITAL OF CECIL COUNTY, INC. PART V, SECTION B, LINE 7: HEALTH NEEDS IDENTIFIED BUT NOT ADDRESSEDTHE CHNA REVEALED SEVERAL HEALTH NEEDS THAT WERE NOT SELECTED FOR PRIORITIZATION BY UNION HOSPITAL. BELOW WE DISCUSS WHICH NEEDS WERE IDENTIFIED AND WHY THEY WERE NOT CHOSEN FOR PRIORITIZATION. HEALTH NEEDS NOT INCLUDED AND REASONS HEALTH NEEDS WERE NOT PRIORITIZEDLOCAL HEALTH IMPROVEMENT COALITION HEALTH NEEDS: PRESCRIPTION DRUG ABUSE SUBSTANCE ABUSE MENTAL HEALTH ACCESS TO TREATMENT CHILD NEGLECT THESE HEALTH NEEDS WERE NOT PRIORITIZED BECAUSE THE LOCAL HEALTH IMPROVEMENT COALITION WAS ABLE TO PRODUCE A COMMUNITY HEALTH ACTION PLAN TO ADDRESS THEM. MEMBER ORGANIZATIONS IN THE COALITION ARE CURRENTLY WORKING TOGETHER TO INCORPORATE STRATEGIES TO ADDRESS THESE HEALTH NEEDS, AS WELL AS ACHIEVE MEASURABLE OUTCOMES. UNION HOSPITAL IS REPRESENTED ON THE COALITION AND IS CURRENTLY WORKING IN PARTNERSHIP WITH SEVERAL COMMUNITY PARTNERS ON ALL OF THESE HEALTH NEEDS. SUICIDE PREVENTION UNION HOSPITAL RESPONDS TO SUICIDAL TENDENCIES EXHIBITED BY PATIENTS ON AN INPATIENT LEVEL. HOWEVER, MORE WORK IS BEING DONE TO ADDRESS THESE PATIENTS IN THEIR HOME BY WORKING IN PARTNERSHIP WITH MOBILE HEALTH CRISIS, A TEAM OF MENTAL HEALTH PROFESSIONALS DEDICATED TO ADDRESSING CRISIS ONSITE IN THE PATIENT'S HOME. HOMELESSNESS THE ELKTON ALLIANCE (CHAMBER OF COMMERCE) HAS DEVELOPED A COALITION TO BETTER IDENTIFY AND ADDRESS THE HEALTH AND SOCIAL NEEDS OF THE HOMELESS POPULATION IN CECIL COUNTY. UNION HOSPITAL STAFF ACTIVELY PARTICIPATES ON THIS COALITION. ACCESS TO CARE ADDRESSING ACCESS TO CARE ISSUES, INCLUDING TRANSPORTATION NEEDS, IS A MISSION DRIVEN CONCERN FOR UNION HOSPITAL, AND IS ADDRESSED ON A DAILY BASIS. OTHER HEALTH BASED ORGANIZATIONS IN CECIL COUNTY ALSO WORK TO PROVIDE ADEQUATE ACCESS TO CARE (I.E., THE CECIL COUNTY HEALTH DEPARTMENT, SCHOOL-BASED HEALTH CENTERS IN BAINBRIDGE AND GILPIN ELEMENTARY SCHOOLS, AND WEST CECIL HEALTH CENTER, A FEDERALLY QUALIFIED HEALTH CENTER). ACCESS TO HEALTHY FOODS ACCESS TO HEALTHY FOODS COULD BE INCLUDED IN STRATEGIES TO REDUCE OBESITY, WHICH IS A PRIORITY HEALTH NEED FOR BOTH UNION HOSPITAL AND THE LOCAL HEALTH IMPROVEMENT COALITION'S COMMUNITY HEALTH ACTION PLAN. PROMOTION OF HEALTHY FOOD ACCESS CAN ALSO BE PROMOTED IN THE WORKPLACE, AT SCHOOL, AND AT HOME. ACCESS TO MEDICAL TRANSPORTATIONTHE CECIL COUNTY HEALTH DEPARTMENT OFFERS MEDICAL TRANSPORTATION FOR INDIVIDUALS WITH INSURANCE THAT COVERS IT. ALSO, SOME PRIVATE ORGANIZATIONS OFFER MEDICAL TRANSPORT ACCORDING TO BOTH INSURANCE COVERAGE AND LOCAL NEED. UNION HOSPITAL DOES NOT HAVE TRANSPORT VEHICLES NOR THE CAPITAL TO START AND MAINTAIN SUCH AN ENDEAVOR. RESOURCE ALLOCATION IS BETTER SERVED BY COLLABORATING WITH OTHER ENTITIES THAT HAVE VEHICLES OR BRINGING ISSUES OF ACCESS TO THE LOCAL GOVERNMENT TO ADVOCATE FOR BETTER PUBLIC TRANSPORTATION. GERIATRIC CARE IMPROVEMENTS GERIATRIC CARE IMPROVEMENTS REFLECT CONCERNS RELATED TO FALLS, ISOLATION, DEPRESSION, IMPROPER DIET AND POOR CHRONIC DISEASE MANAGEMENT. INCIDENTALLY, THE CECIL COUNTY HEALTH DEPARTMENT AND SEVERAL LOCAL COMMUNITY ORGANIZATIONS HAVE PROGRAMS TAILORED TO ADDRESSING, DEPRESSION, ISOLATION, CHRONIC DISEASE MANAGEMENT AND FALLS PREVENTION. UNION HOSPITAL ALSO WORKS ON CHRONIC DISEASE MANAGEMENT AMONG THE ELDERLY AND FALLS PREVENTION. DIABETESPREVENTION OF AND AWARENESS AROUND DIABETES IS ALREADY INCORPORATED IN MANY OF THE NUTRITION EDUCATION PROGRAMS AND ACTIVITIES THAT UNION HOSPITAL PROVIDES IN THE COMMUNITY. DIABETES CARE, MANAGEMENT, AND AWARENESS ARE ALSO INTEGRAL PARTS OF ACTIVITIES BEING CONSIDERED FOR THE 2ND AND 3RD HEALTH PRIORITIES OF HEART DISEASE AND OBESITY IN THE COMMUNITY BENEFIT IMPLEMENTATION PLAN. CANCERUNION HOSPITAL ALREADY PROVIDES FREE CANCER SCREENINGS FOR THE COMMUNITY AND IS CONTINUOUSLY WORKING ON NEW WAYS TO SCREEN AND IDENTIFY SYMPTOMS FOR VARIOUS CANCERS. UNION HOSPITAL STAFF ALSO COLLABORATES WITH COMMUNITY PARTNERS AND AGENCIES TO BRING ACCESS TO CANCER CARE TO THE COMMUNITY. HEALTH COMMUNICATION IMPROVEMENTS EFFORTS TO IMPROVE HEALTH COMMUNICATION ARE A CONSTANT TASK FOR UNION HOSPITAL AND ALL COMMUNITY ORGANIZATIONS. IT DOES NOT GO UNNOTICED. ADDRESSING DISPARITIES IN HEALTH CARE HEALTH DISPARITIES HAVE BEEN IDENTIFIED WHERE APPLICABLE IN THE LOCAL HEALTH IMPROVEMENT COALITION'S COMMUNITY HEALTH ACTION PLAN. UNION HOSPITAL ACTIVELY SEEKS TO REDUCE HEALTH DISPARITIES BOTH IN ITS DAILY FUNCTIONING AND IN PARTNERSHIP WITH CECIL COUNTY'S LOCAL HEALTH IMPROVEMENT COALITION. UNION HOSPITAL OF CECIL COUNTY, INC. PART V, SECTION B, LINE 20D: MARYLAND IS AN ALL-PAYOR STATE AND THE HEALTH SERVICES COST REVIEW COMMISSION (HSCRC) SETS THE RATES FOR UNION HOSPITAL. PART VI, LINE 2: CONDUCTING THE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) WAS A COLLABORATIVE EFFORT BETWEEN UNION HOSPITAL OF CECIL COUNTY AND THE CECIL COUNTY HEALTH DEPARTMENT. UNION HOSPITAL'S COMMUNITY BENEFITS COORDINATOR MET WITH CECIL COUNTY HEALTH DEPARTMENT'S PUBLIC HEALTH OFFICER, DEPUTY PUBLIC HEALTH OFFICER, AND EPIDEMIOLOGIST TO CONDUCT THE COMMUNITY HEALTH NEEDS ASSESSMENT. THIS TEAM FACILITATED A SERIES OF MEETINGS WITH BOTH COMMUNITY LEADERS AND COMMUNITY RESIDENTS TO GAIN FIRST-HAND KNOWLEDGE OF IMPORTANT HEALTH NEEDS IN CECIL COUNTY. THE CHNA PROCESS BEGAN IN JANUARY 2012 (DURING THE 3RD QUARTER OF FISCAL YEAR 2012). SECONDARY DATA WAS ANALYZED AND USED IN CONJUNCTION WITH ALL COMMUNITY MEETINGS AS PART OF THE SUPPORTING DATA PLATFORM. USE OF SECONDARY DATA WAS ALSO INTEGRAL TO THE HEALTH NEEDS PRIORITIZATION PROCESS CONDUCTED BY UNION HOSPITAL.SEE ADDITIONAL DETAIL REGARDING THE NEEDS ASSESSMENT IN OUR RESPONSE TO PART V, SECTION B, LINE 3. PART VI, LINE 3: UNION HOSPITAL OF CECIL COUNTY UTILIZES A COMMUNITY FINANCIAL ASSISTANCE (CHARITY CARE) POLICY TO ENSURE THAT THE HOSPITAL'S STAFF FOLLOWS A CONSISTENT AND EQUITABLE PROCESS IN GRANTING CHARITY CARE/FINANCIAL ASSISTANCE TO APPROPRIATE PATIENTS, WHILE RESPECTING THE INDIVIDUAL'S DIGNITY. THE POLICY IS IN AGREEMENT WITH THE ESTABLISHED MARYLAND STATE FINANCIAL ASSISTANCE GUIDELINES REGARDING CHARITY CARE.THE POLICY DESCRIBES THE APPLICATION PROCESS FOR THE FINANCIAL ASSISTANCE PROGRAM, THE INFORMATION REQUIRED TO VERIFY INCOME AND ASSETS, THE TIMELINE FOR APPLICATION REVIEW AND TIERED ADJUSTMENTS BASED ON FEDERAL POVERTY GUIDELINES.THE APPLICATION FOR FINANCIAL ASSISTANCE IS AVAILABLE TO ALL UNDERINSURED AND UNINSURED PATIENTS OF UNION HOSPITAL. APPLICATIONS AND SIGNAGE ARE LOCATED THROUGHOUT THE HOSPITAL, EMERGENCY ROOM, AND OUTPATIENT AREAS. THE FINANCIAL ASSISTANCE APPLICATION AND BROCHURE (IN ENGLISH AND SPANISH) ARE AVAILABLE ON THE HOSPITAL'S WEBSITE: HTTP://WWW.UHCC.COM/ABOUT/PATIENTS-VISITORS/ADMISSION/FINANCIAL-ASSISTANCE. IN ADDITION, THE HOSPITAL PLACES AN ADVERTISEMENT TWICE A YEAR IN THE LOCAL NEWSPAPERS OUTLINING ITS FINANCIAL ASSISTANCE POLICY. ALL FINANCIAL ASSISTANCE APPLICATIONS RECEIVED ARE PROCESSED FOR ELIGIBILITY. PATIENTS WHO ARE NOT ELIGIBLE FOR CHARITY CARE ARE REFERRED TO CECIL COUNTY HEALTH DEPARTMENT TO DETERMINE IF OTHER ASSISTANCE IS AVAILABLE. ANY INDIVIDUAL WHO PRESENTS TO THE BUSINESS OFFICE OF UNION HOSPITAL IN PERSON TO DISCUSS HIS/HER BILL IS PROVIDED WITH A FINANCIAL ASSISTANCE APPLICATION. ALL INPATIENT, SELF-PAY PATIENTS ARE VISITED BY FINANCE STAFF AND SCREENED FOR THE FINANCIAL ASSISTANCE PROGRAM, AS WELL AS FOR MEDICAID AND OTHER STATE AND COUNTY PROGRAMS. FOLLOWING DISCHARGE FROM THE HOSPITAL, EACH PATIENT RECEIVES A SUMMARY OF CHARGES WHICH INCLUDES NOTICE OF THE FINANCIAL ASSISTANCE PROGRAM AND A DESIGNATED CONTACT TELEPHONE NUMBER. PART VI, LINE 4: UNION HOSPITAL'S COMMUNITY BENEFIT SERVICE AREA (CBSA) INCLUDES THE TOWNS OF ELKTON, ELK MILLS, CHILDS, CHESAPEAKE CITY, EARLEVILLE, WARWICK, CECILTON, NORTH EAST, CHARLESTOWN, PERRYVILLE, AND RISING SUN. UNION HOSPITAL ALSO SERVES TOWNS IN WESTERN CECIL COUNTY: CONOWINGO, COLORA, PORT DEPOSIT, AND PERRY POINT. UNION HOSPITAL IS THE ONLY HOSPITAL IN CECIL COUNTY. IN 2013, THE TOTAL POPULATION OF CECIL COUNTY IS 102,349 PERSONS. OF THE TOTAL COUNTY POPULATION, 50.3% IS FEMALE (49.7% MALE). THE MEDIAN AGE IS 39 YEARS. THE RACIAL MAKE-UP OF THE COUNTY IS AS FOLLOWS: -WHITE: 88.19% -BLACK/AFRICAN AMERICAN: 6.76% -AMERICAN INDIAN/ALASKAN NATIVE: 0.28% -ASIAN: 1.17%THERE ARE 37,360 HOUSEHOLDS. THE MEDIAN HOUSEHOLD INCOME IS $62,660. APPROXIMATELY 7.11% OF HOUSEHOLDS AND 5.92% OF FAMILIES WITH CHILDREN LIVE BELOW THE POVERTY LEVEL. DATA FROM THE 2011 AMERICAN COMMUNITY SURVEY SHOWS THAT 10.2% OF THE POPULATION IN CECIL COUNTY IS UNINSURED AND 15.3% RECEIVE MEDICAID. PART VI, LINE 5: EACH FISCAL YEAR, UNION HOSPITAL SERVES THE CECIL COUNTY COMMUNITY BY PROVIDING ACTIVITIES, PROGRAMS, AND INITIATIVES THAT AIM TO IMPROVE COMMUNITY HEALTH, SERVING UNDERSERVED AREAS. THE FOLLOWING IS A BRIEF SUMMARY OF SOME OF THE COMMUNITY BENEFIT ACTIVITIES, PROGRAMS, AND INITIATIVES THAT UNION HOSPITAL PROVIDED DURING FISCAL YEAR 2013:* COMMUNITY HEALTH EDUCATION - A VARIETY OF HEALTH EDUCATION TOPICS HELD IN THE COMMUNITY - EXPLORER POST AT UNION HOSPITAL FOR HIGH SCHOOL STUDENTS SEEKING EXPOSURE TO MEDICAL OR HEALTH SCIENCE EXPERIENCES - SUPPORT GROUPS TO SUPPORT VARIOUS HEALTH NEEDS - HEALTH FAIRS IN THE COMMUNITY * COMMUNITY-BASED CLINICAL SERVICES - FREE SCREENINGS FOR CANCERS, DIABETES, AND HEARING LOSS - A FREE HEALTH CARE CLINIC FOR UNINSURED PERSONS - SPORTS PHYSICALS IN UNDERSERVED AREAS* HEALTH CARE SUPPORT SERVICES - COMMUNITY ASSISTED MEDICATIONS PROGRAM - PROVIDING CARE COORDINATION FOR VULNERABLE PERSONS OUTSIDE OF THE HOSPITAL VISIT - PROVIDING LIFE LINE INSTALLATIONS - FACILITATING A PEER COUNSELOR PARTNERSHIP WITH THE EMERGENCY DEPARTMENT AND THE CECIL COUNTY HEALTH DEPARTMENT - PROVIDING SCHOOL-BASED HEALTH CENTERS IN TWO TITLE 1 ELEMENTARY SCHOOLS - PROVIDING TRANSPORTATION DONATIONS FOR NEEDS-BASED PATIENTS AND THEIR FAMILIES* SOCIAL AND ENVIRONMENTAL IMPROVEMENTS - HOSPITAL STAFF VOLUNTEER TO PARTICIPATE WITH THE FOLLOWING OUTDOOR AND/OR LABOR-INTENSIVE INITIATIVES: > HABITAT-FOR-HUMANITY > CHRISTMAS IN APRIL > PROJECT ECHO > ADOPT-A-HIGHWAY - HOSPITAL STAFF ALSO VOLUNTEER TO MENTOR AT-RISK YOUTH DURING THE SCHOOL DAY - HOSPITAL STAFF PROVIDE LEADERSHIP DEVELOPMENT IN CONJUNCTION WITH THE CECIL LEADERSHIP INSTITUTE - HOSPITAL STAFF ALSO SERVES ON THE FOLLOWING COMMUNITY BOARDS THAT SEEK TO IMPROVE THE SOCIAL DETERMINANTS OF HEALTH: > CECIL HUMAN SERVICES AGENCY > FAMILY SERVICES ASSOCIATION > DEPARTMENT OF SOCIAL SERVICES > HOMELESSNESS COALITION * HEALTH PROFESSIONS EDUCATION - UNION HOSPITAL PRECEPTS AND MENTORS STUDENTS THROUGH A VARIETY OF STUDENT EXPERIENCES, FROM NURSING AND OTHER MEDICAL/CLINICAL ROTATIONS TO GRADUATE STUDENT INTERNSHIPS TO HIGH SCHOOL CAPSTONE PROJECTS. * MISSION DRIVEN HEALTH SERVICES - UNION HOSPITAL PROVIDES THESE SERVICES EVEN THOUGH THEY OPERATE AT A LOSS. THE FOLLOWING SERVICES ARE PROVIDED BECAUSE THEY MEET IDENTIFIED NEEDS IN THE COMMUNITY: > A FREE OSTOMY CLINIC > ACCESS TO PEDIATRIC HOSPITALISTS > ADULT DAY SERVICES > OUTPATIENT PALLIATIVE CARE SERVICES * FINANCIAL/IN-KIND CONTRIBUTIONS - UNION HOSPITAL PROVIDED DONATIONS OF TIME (STAFF VOLUNTEER HOURS) AND MONEY (CASH AND EQUIPMENT DONATIONS) FOR THE LOCAL COMMUNITY AND FOREIGN ONES. EXAMPLES OF SOME IN-KIND CONTRIBUTIONS IN THE LOCAL COMMUNITY INCLUDE: > PROVISION OF FREE AMBULANCE SERVICES AND SUPPLIES > BLOOD DONATIONS > ATTENDING MEETINGS FOR COMMUNITY HEALTH IMPROVEMENT > SERVING THE HOMELESS > PROVIDING MEALS ON WHEELS > PROVIDING FREE NOTARY SERVICES FOR THE COMMUNITY > VOLUNTEERING WITH LOCAL ORGANIZATIONS TO IMPROVE COMMUNITY HEALTH* FUNDRAISING FOR COMMUNITY BENEFIT PROGRAMMING - UNION HOSPITAL, IN CONJUNCTION WITH THE CECIL COUNTY HEALTH DEPARTMENT, PARTICIPATED IN SEVERAL GRANT-WRITING OPPORTUNITIES TO SUPPORT LOCAL INITIATIVES TO IMPROVE ACCESS TO CARE IN CECIL COUNTY. THE GRANTS SUBMITTED WERE AS FOLLOWS: > LOCAL HEALTH IMPROVEMENT COALITION - 1ST ROUND FUNDING (GRANTED) > LOCAL HEALTH IMPROVEMENT COALITION - 2ND ROUND FUNDING TO SUPPORT COUNTY MENTAL HEALTH SERVICE ACCESS (GRANTED) > LOCAL HEALTH IMPROVEMENT COALITION - 2ND ROUND FUNDING TO SUPPORT THE UNION HOSPITAL/CECIL COUNTY HEALTH DEPARTMENT COMMUNITY CASE MANAGEMENT PILOT (GRANTED) > HEALTH ENTERPRISE ZONE (NOT GRANTED)SURPLUS FUNDS OF THE HOSPITAL ARE USED TO DEVELOP EMPLOYEES AND FURTHER EDUCATE STAFF TO KEEP UP WITH THE EVER CHANGING HEALTHCARE TECHNOLOGY AND NEW TREATMENT PLANS FOR DISEASES, AS WELL AS TO PROVIDE FOR CAPITAL NEEDS OF THE ORGANIZATION TO KEEP THE NECESSARY NEW MEDICAL EQUIPMENT AVAILABLE TO BETTER TREAT THE PATIENTS OF THE COMMUNITY. PART VI, LINE 6: UNION HOSPITAL OF CECIL COUNTY, INC. IS PART OF AN AFFILIATED HEALTH CARE SYSTEM IN WHICH AFFINITY HEALTH ALLIANCE, INC. IS THE PARENT ENTITY. AFFINITY HEALTH ALLIANCE, INC.'S PURPOSE IS TO SUPPORT THE UNION HOSPITAL OF CECIL COUNTY IN PROVIDING HEALTH CARE AND HEALTH CARE RELATED SERVICES THROUGH THE EFFECTIVE MANAGEMENT OF ALL AFFILIATED CORPORATIONS. SPECIFICALLY, THIS INVOLVES COORDINATING SYSTEM WIDE POLICIES, FUNDRAISING AND STRATEGIC PLANNING PROGRAMS TO PROVIDE HEALTH CARE SERVICES IN RESPONSE TO THE MEDICAL, HUMAN AND RELATED SERVICE NEEDS OF THE COMMUNITY.OTHER TAX-EXEMPT ORGANIZATIONS IN THE GROUP INCLUDE THE UNION HOSPITAL OF CECIL COUNTY FOUNDATION, INC., CECIL COUNTY BREEDERS FAIR AND UNION HOSPITAL OF CECIL COUNTY HEALTH SERVICES, INC.THE FOUNDATION CONDUCTS AND SUPERVISES FUNDRAISING ACTIVITIES ON BEHALF OF ITS TAX-EXEMPT AFFILIATES. THE FOUNDATION ENGAGES IN CORPORATE FUNDRAISING, CAPITAL CAMPAIGNS, SPECIAL EVENTS, ACTIVITIES, AND A MULTI-FACETED COMMUNICATION PROGRAM THAT APPEALS TO PRIVATE AND CORPORATE CONTRIBUTORS.CECIL COUNTY BREEDERS FAIR, INC. IS ORGANIZED FOR THE PURPOSE OF SUPPORTING THE UNION HOSPITAL OF CECIL COUNTY THROUGH FUNDRAISING ACTIVITIES CONSISTING OF THE RUNNING OF THE FAIR HILL RACES.UNION HOSPITAL OF CECIL COUNTY HEALTH SERVICES, INC.'S MISSION IS TO OWN, MANAGE AND MAINTAIN PROPERTIES FOR HEALTH RELATED VENTURES TO SERVE CECIL COUNTY AND THE SURROUNDING AREAS. THE ACTIVITIES OF THIS CORPORATION COMPLEMENT AND AUGMENT THE HEALTH CARE ACTIVITIES OF THE HOSPITAL. REPORTS FILED WITH STATES PART VI, LINE 7 MD 1 UNION HOSPITAL OF CECIL COUNTY HEALTH SERVICES INC 106 BOW STREET ELKTON MD 21921 521794553 501(C)(3) 4115149 CHARITABLE ACTIVITIES UNION HOSPITAL OF CECIL COUNTY VENTURES INC 106 BOW STREET ELKTON MD 21921 521793691 623785 CAPITAL CONTRIBUTION 1 1 PROCEDURE FOR MONITORING GRANTS IN THE U.S.: PART I, LINE 2: SCHEDULE I, PART I, LINE 2: THE ORGANIZATION ONLY PROVIDES ASSISTANCE TO ITS AFFILIATED ENTITIES. IT DOES NOT PROVIDE GRANTS TO OTHER ORGANIZATIONS. USE OF FUNDS IS MONITORED BY MANAGEMENT. X X 1 1 X X X X X 0 1 0 0 0 0 0 1 0 KENNETH S LEWIS MD JD 0 478821 0 102839 0 139846 0 111750 0 33210 0 866466 0 0 LAURIE R BEYER CPA 0 242996 0 45198 0 20376 0 58066 0 26414 0 393050 0 0 CYDNEY TEAL 0 235346 0 49769 0 11761 0 3472 0 25428 0 325776 0 0 TERRANCE LOVELL 133349 0 23813 0 6923 0 0 0 16696 0 180781 0 0 0 DAVID GIPSON 0 251625 0 46305 0 27375 0 58885 0 26548 0 410738 0 0 CAREN LEWIS 0 188750 0 28213 0 9902 0 43480 0 11260 0 281605 0 0 ROHIT SINGHANIA 398755 0 21895 0 6177 0 3750 0 9729 0 440306 0 0 0 IRFAN M HISAMUDDIN MD 384245 0 31802 0 199 0 0 0 20192 0 436438 0 0 0 JUSTIN SAUSVILLE 359920 0 14773 0 20177 0 3750 0 20021 0 418641 0 0 0 JAGDEEP HUNDAL 323014 0 45333 0 222 0 3750 0 19811 0 392130 0 0 0 BERNARD J HYNES 330783 0 36859 0 222 0 0 0 19805 0 387669 0 0 0 PART I, LINE 1A THE ORGANIZATION'S PRESIDENT & CEO, DR. KENNETH LEWIS, HAS A DISCRETIONARY SPENDING ACCOUNT FOR FLEXIBLE BENEFITS WHICH INCLUDED: A) LEASED CAR PAYMENTS, GAS, REPAIRS AND INSURANCE B) TAX RETURN PREPARATION C) ATTORNEY REGISTRATION FEE D) MEDICAL LICENSE RENEWAL E) FINGERPRINTING/CRIMINAL INVESTIGATION FOR DELAWARE PHYSICIAN LICENSE F) BJ'S MEMBERSHIP G) CASH ALL BENEFITS HAVE BEEN INCLUDED IN TAXABLE WAGES. PART I, LINE 4B THE FOLLOWING PEOPLE PARTICIPATE IN A SUPPLEMENTAL, NON-QUALIFIED RETIREMENT PLAN UNDER SECTION 457(F) OF THE INTERNAL REVENUE CODE: DR. KENNETH LEWIS, PRESIDENT & CEO LAURIE BEYER, SENIOR VP/CFO DAVID GIPSON, SENIOR VP/COO CAREN LEWIS, SENIOR VP OF PATIENT CARE SERVICES THE FOLLOWING PAYMENTS HAVE BEEN CONTRIBUTED TO THE PLAN EACH CALENDAR YEAR SINCE 2007: 12/31/2007 - $90,000 (DR. KENNETH LEWIS) 12/31/2008 - $90,000 (DR. KENNETH LEWIS) 12/31/2009 - $90,000 (DR. KENNETH LEWIS) 12/31/2010 - $90,000 (DR. KENNETH LEWIS) 12/31/2011 - $108,000 (DR. KENNETH LEWIS) 12/31/2012 - $108,000 (DR. KENNETH LEWIS) 12/31/2011 - $51,431 (LAURIE BEYER) 12/31/2012 - $54,576 (LAURIE BEYER) 12/31/2011 - $51,968 (DAVID GIPSON) 12/31/2012 - $55,135 (DAVID GIPSON) 12/31/2011 - $35,649 (CAREN LEWIS) 12/31/2012 - $40,178 (CAREN LEWIS) THE RIGHT TO RECEIVE PAYMENTS UNDER THE PLAN SHALL BE FORFEITED IN THE EVENT THAT EMPLOYMENT WITH THE HOSPITAL TERMINATES PRIOR TO THE VESTING DATE FOR ANY REASON OTHER THAN INVOLUNTARY TERMINATION WITHOUT CAUSE, DEATH, OR DISABILITY. CAREN LEWIS LEFT THE ORGANIZATION ON JUNE 15TH, 2013. SHE RECEIVED SEVARANCE PAY THROUGH OCTOBER 1, 2013 IN THE AMOUNT OF $45,509. SHE ALSO RECEIVED, DURING THIS TIME, THE BALANCE OF HER PTO IN THE AMOUNT OF $9,098 AND A BONUS IN THE AMOUNT OF $33,150 THAT HAD BEEN EARNED PRIOR TO HER LEAVING. PART I, LINE 7 A PORTION OF THE BONUSES AND MERIT INCREASE ARE TIED TO THE ORGANIZATIONAL GOALS, SUCH AS PATIENT SATISFACTION, QUALITY, EMPLOYEE TURNOVER, ETC. A PORTION OF THE BONUSES AND MERIT INCREASE ARE ALSO TIED TO EXPENSES PER EQUIVALENT INPATIENT DAYS OF UNION HOSPITAL OF CECIL COUNTY. A MARYLAND HEALTH & HIGHER EDUCATION FACILITIES AUTHORITY 520936091 5742168A8 2005-07-14 31401189 SEE PART VI 0 0 0 B TOWN OF ELKTON 526000790 2012-05-18 10000000 SEE PART VI 0 0 0 C TOWN OF ELKTON 526000790 2012-05-18 8662336 SEE PART VI 0 0 0 D TOWN OF ELKTON 526000790 2012-05-18 9000000 SEE PART VI 0 0 0 A 35836388 3933718 576473 33640038 2007 0 0 1 1 B 10000000 10000000 2012 1 0 1 1 C 8662336 8662336 2012 1 0 1 1 D 9000000 9000000 2012 1 0 1 1 A 0 0 1 1 0 0.00000 0.00000 0.00000 0 0 1 B 0 0 1 1 0 0.00000 0.00000 0.00000 0 0 1 C 0 0 1 1 0 0.00000 0.00000 0.00000 0 0 1 D 0 0 1 1 0 0.00000 0.00000 0.00000 0 0 1 A 0 0 0 1 0 1 BANK OF AMERICA NA 35.000000000000 0 0 0 0 1 B 0 0 1 0 0 0 0 0 1 C 0 0 1 0 0 0 0 0 1 D 0 0 1 0 0 0 0 0 1 A 1 B 1 C 1 D 1 SCHEDULE K PART IV, ARBITRAGE, LINE 2C DATE REBATE COMPUTATION PERFORMED ISSUER NAME: MARYLAND HEALTH & HIGHER EDUCATION FACILITIES AUTHORITY DATE THE REBATE COMPUTATION WAS PERFORMED: 07/01/2010 PART I, COLUMN (F) PURPOSE OF BONDS ISSUE A: THE PURPOSE OF THE ISSUE WAS FINANCING AND REFINANCING THE ACQUISITION, CONSTRUCTION, RENOVATION AND EQUIPPING OF HOSPITAL FACILITIES. ISSUE B: TO REFUND PORTION OF SERIES 2009 BONDS. ISSUE C: TO REFUND REMAINING PORTION OF SERIES 2009 BONDS AND ALL OF SERIES 2000 BONDS. ISSUE D: TO FUND AN ESCROW WHICH REPAYS A PORTION OF THE SERIES 2002 BONDS AND INTEREST THEREON. ISSUE E: TO REFUND REMAINING PORTION OF SERIES 2002 BONDS. ISSUE F: TO FINANCE ACQUISITION OF EQUIPMENT AND CLOSING COSTS. PART II, LINE 3 DIFFERENCE IN PROCEEDS ISSUE A: THIS NUMBER REPRESENTS SALE PROCEEDS PLUS INVESTMENT EARNINGS IN THE CONSTRUCTION FUND, PLUS INVESTMENT EARNINGS IN THE COST OF ISSUANCE FUND, PLUS INVESTMENT EARNINGS IN THE DEBT SERVICE RESERVE FUND DURING THE CONSTRUCTION PERIOD. PART II, LINE 10 CAPITAL EXPENDITURES FROM PROCEEDS ISSUE A: THIS NUMBER REPRESENTS TOTAL PROCEEDS LESS PROCEEDS DEPOSITED INTO A RESERVE FUND LESS PROCEEDS SPENT ON ISSUANCE COSTS. PART IV, LINES 3(B) AND 3(C) HEDGE ISSUE A: THE ORGANIZATION ENTERED INTO AN INTEREST RATE HEDGE WITH BANK OF AMERICA, N.A. ON MARCH 28, 2005. THE TERM OF THE HEDGE WAS FROM JUNE 22, 2005 THROUGH JULY 1, 2040. THE HEDGE WAS TERMINATED IN CONNECTION WITH THE ISSUANCE OF THE BONDS. A MARYLAND HEALTH & HIGHER EDUCATION FACILITIES AUTHORITY 520936091 2012-07-18 9924000 SEE PART VI 0 0 0 B MARYLAND HEALTH & HIGHER EDUCATION FACILITIES AUTHORITY 520936091 2012-07-18 4007000 SEE PART VI 0 0 0 A 9924000 9924000 2012 1 0 1 1 B 4007000 4007000 2012 1 0 1 1 A 0 0 1 1 0 0.00000 0.00000 0.00000 0 0 1 B 0 0 1 1 0 0.00000 0.00000 0.00000 0 0 1 A 0 0 1 0 0 0 0 0 1 B 0 0 1 0 0 0 0 0 1 A 1 B 1 FORM 990, PART VI, SECTION A, LINE 6 AFFINITY HEALTH ALLIANCE, INC. ("AHA"), A TAX-EXEMPT ORGANIZATION, IS THE SOLE MEMBER OF THE UNION HOSPITAL OF CECIL COUNTY, INC. FORM 990, PART VI, SECTION A, LINE 7A THE BYLAWS OF THE HOSPITAL PROVIDE THAT ITS DIRECTORS ARE APPOINTED BY ITS SOLE MEMBER, AHA. FORM 990, PART VI, SECTION A, LINE 7B THE BYLAWS OF THE HOSPITAL PROVIDE THAT ITS SOLE MEMBER (AHA) MAY AMEND ITS BYLAWS. FORM 990, PART VI, SECTION B, LINE 11 THE FORM 990 IS REVIEWED BY THE CHIEF FINANCIAL OFFICER. IT IS THEN PRESENTED TO THE BOARD AT THE NEXT BOARD MEETING PRIOR TO FILING WITH THE INTERNAL REVENUE SERVICE. FORM 990, PART VI, SECTION B, LINE 12C BOARD MEMBERS ARE REQUIRED TO ANNUALLY DISCLOSE ANY POTENTIAL CONFLICT OF INTEREST. THE ORGANIZATION'S CEO REVIEWS THE SIGNED ANNUAL DISCLOSURES. THE CORPORATE COMPLIANCE OFFICER IS MADE AWARE OF ANY DISCLOSED CONFLICT, INVESTIGATES THE CONFLICT, AND REPORTS BACK TO THE BOARD OF DIRECTORS. THE BOARD CONSIDERS THE FACTS AND MAKES AN APPROPRIATE FINDING. ANY BOARD MEMBER WITH A CONFLICT MUST ABSTAIN FROM BOARD DELIBERATIONS AND VOTING ON THE MATTER. ALL VICE PRESIDENTS ANNUALLY RECEIVE A LIST OF THE INDIVIDUALS UNDER THEIR SUPERVISION WHO MAY HAVE A POTENTIAL CONFLICT OF INTEREST. THE LIST IS COMPRISED OF ALL MANAGERS, CERTAIN PROFESSIONAL STAFF WHO MAY HAVE RESPONSIBILITY NEGOTIATING WITH VENDORS, AND ANY OTHER PERSONS THAT HOSPITAL EXECUTIVES DEEM APPROPRIATE. EACH VICE PRESIDENT REVIEWS THE CONFLICT OF INTEREST POLICY WITH THEIR DESIGNATED EMPLOYEES, AND EACH EMPLOYEE IS REQUIRED TO SIGN A FORM STIPULATING WHETHER OR NOT THEY HAVE A CONFLICT. THE FORMS ARE REVIEWED BY THE VICE PRESIDENT OF HUMAN RESOURCES. IF A CONFLICT IS NOTED, IT IS BROUGHT TO THE ATTENTION OF THE APPROPRIATE VICE PRESIDENT AND THE CEO TO DETERMINE WHETHER OPERATIONAL CHANGES NEED TO OCCUR BECAUSE OF THE POTENTIAL CONFLICT. FORM 990, PART VI, SECTION B, LINE 15 THE COMPENSATION COMMITTEE OF THE ORGANIZATION'S BOARD OF DIRECTORS IS RESPONSIBLE FOR SETTING THE OVERALL COMPENSATION PHILOSOPHY OF THE ORGANIZATION, AS WELL AS SETTING, MONITORING AND REVIEWING THE COMPENSATION PACKAGE OF THE ORGANIZATION'S CEO AND OTHER MEMBERS OF THE EXECUTIVE MANAGEMENT TEAM. THE COMMITTEE USES RELEVANT MARKET INFORMATION, INCLUDING THE USE OF AN INDEPENDENT COMPENSATION CONSULTANT AND COMPENSATION STUDIES OR SURVEYS, TO SET COMPENSATION. DURING THE FISCAL YEAR ENDED JUNE 30, 2012, AN INDEPENDENT COMPENSATION CONSULTANT PROVIDED THE FOLLOWING SERVICES: EXECUTIVE COMPENSATION AND PERFORMANCE EVALUATION. COMPENSATION REVIEW AND APPROVAL IS DOCUMENTED VIA BOARD MINUTES. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION WILL MAKE ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. OTHER FEES FORM 990, PART IX, LINE 11G CONTRACTED SERVICES: PROGRAM SERVICE EXPENSES 4,753,559. MANAGEMENT AND GENERAL EXPENSES 724,768. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 5,478,327. PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 4,817,893. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 4,817,893. PHYSICIAN FEES: PROGRAM SERVICE EXPENSES 4,788,960. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 4,788,960. PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 1,569,828. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,569,828. AGENCY EMPLOYEES: PROGRAM SERVICE EXPENSES 2,328,650. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,328,650. TRANSCRIPTION: PROGRAM SERVICE EXPENSES 435,769. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 435,769. RECORD FILE STORAGE: PROGRAM SERVICE EXPENSES 202,352. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 202,352. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 9: CHANGE IN INTEREST IN NET ASSETS OF FOUNDATION & SUBSIDIARY -167,878. LOSS ON REFINANCING -322,110. CHANGE IN PROVISION FOR UNCOLLECTIBLE PLEDGES -47,214. STATEMENT PURSUANT TO SECTION 1.351-3(A): STATEMENT PURSUANT TO SECTION 1.351-3(A) BY SCHUYLKILL MEDICAL CENTER - SOUTH JACKSON STREET 23-1352202 (1) NAME AND EMPLOYER IDENTIFICATION NUMBER OF THE TRANSFEREE CORPORATION: NAME: UNION HOSPITAL OF CECIL COUNTY, INC. EIN: 52-0607945 (2) DATE(S) OF TRANSFER(S) OF ASSETS: TRANSFER DATE(S): VARIOUS FROM 7/1/12 THROUGH 6/30/13 (3) AGGREGATE FAIR MARKET VALUE AND BASIS OR PROPERTY TRANSFERRED: FAIR MARKET VALUE: $1,582,248 BASIS: $1,582,248 (4) DATE AND CONTROL NUMBER OF PRIVATE LETTER RULING(S) ISSUED BY THE IRS IN CONNECTION WITH THE EXCHANGE: DATE(S) AND CONTROL NUMBER(S): NONE UNION HOSPITAL OF CECIL COUNTY FOUNDATION INC 106 BOW STREET ELKTON MD 21921 521794552 FUNDRAISING & SUPPORT MD 501(C)(3) LINE 11C, III-FI AFFINITY HEALTH ALLIANCE INC 0 UNION HOSPITAL OF CECIL COUNTY HEALTH SERVICES INC 106 BOW STREET ELKTON MD 21921 521794553 HEALTHCARE PROPERTY MANAGEMENT MD 501(C)(3) LINE 9 AFFINITY HEALTH ALLIANCE INC 0 CECIL COUNTY BREEDERS FAIR INC 106 BOW STREET ELKTON MD 21921 516018180 FUNDRAISING & SUPPORT MD 501(C)(4) UNION HOSPITAL OF CECIL COUNTY FOUNDATION INC 0 AFFINITY HEALTH ALLIANCE INC 106 BOW STREET ELKTON MD 21921 521794697 MANAGEMENT & SUPPORT MD 501(C)(3) LINE 11C, III-FI N/A 0 UNION HOSPITAL OF CECIL COUNTY VENTURES INC 106 BOW STREET ELKTON MD 21921 521793691 MEDICAL SERVICES MD N/A C 0 CECIL COUNTY ANESTHESIOLOGISTS INC 106 BOW STREET ELKTON MD 21921 521886386 INACTIVE MD N/A C 0 EMERGENCY MEDICAL SPECIALISTS OF CECIL COUNTY 106 BOW STREET ELKTON MD 21921 521881684 INACTIVE MD N/A C 0 0 1 1 0 0 0 0 0 0 0 1 0 1 0 1 0 0 1 1