2013-04-30T10:15:00-05:00 2012-06-30 ERNST & YOUNG US LLP 75 BEATTIE PLACE SUITE 800 GREENVILLE SC 29601 990 2011-07-01 520591628 PENINSULA REGIONAL MEDICAL CENTER % JIM GREGORY PENI 4105466400 100 EAST CARROLL STREET SALISBURY MD 21801 Bruce Ritchie 2013-04-11 8642425740 2011 2016-03-07 17:11:31Z MARGARET NALEPPA CEO 100 EAST CARROLL STREET SALISBURY MD 21801 470888938 false X WWW.PENINSULA.ORG X 1897 MD IMPROVE THE HEALTH OF THE COMMUNITIES WE SERVE. 16 15 3242 203 1172743 0 173096 212650 382714431 380732888 13455158 7636984 945351 873844 397288036 389456366 0 0 0 0 174993931 182271785 0 0 476663 192962626 193157852 367956557 375429637 29331479 14026729 492408066 507967270 183373272 196739340 309034794 311227930 X IMPROVE THE HEALTH OF THE COMMUNITIES WE SERVE false false 339657325 380732888 Peninsula Regional Medical Center is a not-for-profit 501 (c)( 3 ) non-stock corporation founded in 1897 to serve the health care needs of the community. The Hospital's primary purpose is to provide the highest primary, secondary, and selected tertiary health care services to residents of and visitors to the Mid-Delmarva Peninsula in a competent, compassionate, and cost-effective manner designed to elicit a high degree of customer satisfaction. The Hospital's mission is to improve the health of the communities we serve by providing quality medical care regardless of race, creed, sex, national origin, handicap, or age. If a patient is unable to pay due to financial resources, efforts will be taken to assure care at an affordable cost, or obtained assistance through appropriate agencies on the patient's behalf. Emergency services care will be provided to everyone regardless of ability to pay. Peninsula Regional Medical Center served over 21,000 inpatients and provided more than 500,000 outpatient services during fiscal 2012. Food service provided more than 475,000 meals to patients and employees. Although reimbursement for services rendered is critical to the operation and stability of Peninsula Regional Medical Center, it is recognized that not all individuals possess the ability to pay for essential medical services. The Hospital, in keeping with the commitment to serve all members of the community, during fiscal 2012 provided: Charity and other allowances totaling $54,387,811 Discounts to third party payors including government programs such as Medicare and Medicaid $44,354,270 Write-off of uncollectible accounts $16,616,061 The total unreimbursed value of providing care to these patients is $115,358,142 Also provided are many wellness programs, community education and free programs offered throughout the year based upon activities and services that Peninsula Regional Medical Center believes will serve a bona fide community health need. Some of the programs are as follows: A variety of brochures are displayed in all hospital waiting areas to educate members of the community regarding programs and services. Participation in health fairs during FY 2012 in order to foster health education in the community. Being called upon to speak before community organizations on a variety of healthcare topics. We provide childbirth preparation classes, exercise classes for prenatal and postpartum women and CPR classes. We provide assistance to educators through our work with student nurses, radiology, respiratory and laboratory technicians. During FY 2012, Peninsula Regional Medical Center volunteers contributed over 45,500 hours toward the common purpose of servicing the health care of the community. PROGRAM ACTIVITY During FY 2012, Peninsula Regional Medical Center performed over 275 community outreach activities. Specific examples of education and outreach programs, support groups, community health screenings, and fitness and wellness activities supported by Peninsula Regional Medical Center are as follows: Community Educational and Outreach Programs: - Labor & Delivery Tours (exclusive of Childbirth Class Tours) - CPR - Childbirth Preparation Classes - Refresher Course - Childbirth - Sibling Classes - Infant Care Classes - Grandparent Classes - Safe Sitter Program - Women's Health Education Support Groups: - Diabetes Support Groups - Stroke Support Group - Head and Neck Cancer Support Group Events: Community Screenings: - Height/Weight, Blood Pressure - Skin Cancer Screenings - Oral, Head and Neck Cancer Screenings - Hearing Screenings - Flu Clinic Educational Exhibits: - Diabetes Education - Trauma - Women's Health - Safe Sitter - Relay for Life Benefits: - March of Dimes Walk America - United Way - Women Supporting Women Fitness/Exercise Programming: - Cardiac Rehabilitation - Indoor Cycling and Weights - Women and Weight Training 339657325 true true false true false false false false false true true false false true true false true true false false false false false false false false true true false false true true false false false false false false false false false true false false false false false true true true false false true 226 0 true 3242 true true true false false false false false false false false false X 16 15 true false false false true true true true true false false false true true true true true true true true true CA MD NC X JIM GREGORY 4109124979 100 EAST CARROLL ST SALISBURY MD 21801 X Jeffrey F Turner 1.0 X 0 0 0 Farouk A Sultani MD 1.0 X 0 0 0 Margaret Naleppa 40.0 X X 741950 0 48904 Martin Neat 10.0 X X 22911 0 0 Herbert J Geary III 1.0 X 0 0 0 Michael E Crouch MD 1.0 X 0 0 0 Murray K Hoy 1.0 X 7968 0 0 Christjon J Huddleston MD 1.0 X 0 0 0 Hugh McLaughlin 1.0 X 0 0 0 Rene Desmarais MD 1.0 X 0 0 0 Cynthia Holloway 1.0 X 0 0 0 Marion Keenan 1.0 X 0 0 0 DebORAH Abbott 1.0 X 0 0 0 Thomas Coates 1.0 X 0 0 0 Edward W Urban 1.0 X X 0 0 0 William R McCain 1.0 X X 0 0 0 Monty Sayler 1.0 X X 0 0 0 Thomas Riccio MD 1.0 X 0 0 0 Lura Lunsford 40.0 X 353197 0 45560 Bruce I Ritchie 40.0 X 407391 0 69045 Justinian Ngaiza MD 40.0 X 557898 0 28384 Paul Zorsky MD 40.0 X 577043 0 22962 Gayatri Sonti 40.0 X 600918 0 17439 Andy Pierre MD 40.0 X 694672 0 33332 Jacek Malik MD 40.0 X 698369 0 31150 R Alan Newberry 0.0 X 688729 0 0 5351046 0 296776 144 true true false HORIZON CSA 265 PIT ROAD MOORESVILLE NC 28115 BIOMEDICAL SERVICES 4993909 SHERIDAN ANESTHESIA OF MD PO BOX 452197 SUNRISE FL 333232197 ANESTHESIA SERVICES 2146332 MAYO MEDICAL LABORATORIES PO BOX 9146 MINNEAPOLIS MN 554809146 MEDICAL SERVICES 1449422 SLEEP WAVES INC 873 E BALTIMORE PIKE STE 345 KENNETT SQUARE PA 19348 MEDICAL SERVICES 1300000 SPECIALITY CARE CARDIOVASCULAR RESO DEPT 1614 PO BOX 1614 BIRMINGHAM AL 352461614 MEDICAL SERVICES 1094750 59 149246 42857 20547 212650 NET PATIENT SERVICES 900099 379600682 378643996 956686 PURCHASING PARTNERSHIP INC FROM MEMBERS 900099 1157532 1157532 MARYLAND ECARE PARTNERSHIP INCOME 900099 -25326 -25326 380732888 5501205 5501205 0 0 122518 179333 -56815 -56815 -56815 83376324 12694 81197898 55341 2178426 -42647 2135779 2135779 0 0 0 CAFETERIA 722210 705123 705123 PARTNERSHIP INCOME 900099 16057 16057 MANAGEMENT FEES 561000 200000 200000 9479 9479 930659 389456366 379776202 1172743 8294771 0 0 0 0 1782643 1614106 164667 3870 292558 264899 27024 635 144174017 130543351 13317684 312982 5460128 4943910 504365 11853 20572478 18625517 1902256 44705 9989961 9156042 814356 19563 0 549485 981 548504 182776 182776 28836 28836 0 1111235 1111235 0 0 102395853 100090204 2248983 56666 778303 769605 8698 0 4820033 4820033 560640 377322 175654 7664 0 80300 80300 6212928 6212928 0 21715233 21669139 46094 4079547 750087 3329460 PROFESSIONAL FEES 33484700 22920946 10545551 18203 BAD DEBTS 16616061 16616061 DUES 541922 173058 368342 522 375429637 339657325 35295649 476663 150629 272321 25487082 24436989 0 0 35831829 39259952 0 0 0 0 0 0 7612015 7526666 4722221 5696943 445417663 245183046 206153752 200234617 141953184 160583035 0 0 0 0 0 0 70497354 69956747 492408066 507967270 13928109 19292791 0 0 0 0 134315588 131216694 0 0 0 0 0 0 60000 45000 35069575 46184855 183373272 196739340 X 286634592 287902813 14335033 15254167 8065169 8070950 309034794 311227930 492408066 507967270 X 14026729 -11833593 X false true true X false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false true 28836 28836 false OTHER ACTIVITIES PART II-B, LINE 1I PENINSULA REGIONAL MEDICAL CENTER PAYS DUES TO ORGANIZATIONS THAT LOBBY FEDERAL AND STATE LEGISLATORS ON BEHALF OF HOSPITALS AND HEALTH SYSTEMS. THE PORTION OF DUES PAID TO THE AMERICAN HOSPITAL ASSOCIATION AND THE MARYLAND HOSPITAL ASSOCIATION ATTRIBUTABLE TO LOBBYING DURING FY 2012 TOTALED $28,836. 34191392 12685 801060 271030 34734107 28295999 105500 6047698 257805 34191392 25231843 206865 3074487 217196 28295999 29317177 110900 -4000545 195689 25231843 0.50825 0.00153 0.49022 false false 10636389 10636389 199046366 58823259 140223107 221877626 180781833 41095793 13857282 5577954 8279328 200234617 INVESTMENT IN PARTNERSHIP 950793 UNAMORTIZED FINANCING COSTS 2352419 OTHER ASSETS 3104051 DEBT SERVICE RESERVE FUND 9311461 DONOR RESTRICTED FUND 24488500 SELF-INSURANCE FUND 13003852 BOARD DESIGNATED INVESTMENTS 16745671 69956747 0 ADVANCES FROM THIRD PARTY PAYORS 9957866 ACCRUED SELF INSURANCE LIABILITIES 11069951 OTHER LIABILITIES 2539346 EMP. COMP. RELATED PAYROLL TAX 13505228 PENSION FUNDING LIABILITY 9112464 46184855 389456366 375429637 14026729 -868468 -10965125 -11833593 2193136 389954664 -868468 2614558 1746090 388208574 1111235 136557 1247792 389456366 374161168 179333 179333 373981835 1111235 336567 1447802 375429637 INTENDED USE OF ENDOWMENT FUNDS PART V, LINE 4 THE ORGANIZATION'S ENDOWMENT FUNDS ARE USED FOR CAPITAL, PATIENT SERVICES OR EDUCATIONAL PURPOSES. FIN 48 FOOTNOTE PART X, LINE 2 The organization did not have any uncertain tax positions that were material to the financial statements. Accordingly, the organization did not include a FIN 48 footnote in its audited financial statements. RECONCILIATION PARTS XI - XIII PART XI, LINE 8 - PENSION ADJUSTMENT - FAS 158 $(14,092,708) INVESTMENT INCOME SWAP 2,131,445 CHANGE IN EQUITY INTEREST OF FOUNDATION 931,783 CAPITAL CAMPAIGN TRANSFERS FROM FOUNDATION 332 U/R NET ASSETS RELEASED FROM RESTRICTION 40,325 ENDOWMENT DONATIONS (12,685) NET ASSETS RELEASED FROM RESTRICTION (267,401) PARTNERSHIP K-1 INCOME ON RETURN NOT ON BOOKS 303,790 ROUNDING (6) ---------- TOTAL $(10,965,125) ============= PART XII, LINE 2D - RENT EXPENSE NETTED AGAINST REVENUE $ 179,333 PARTNERSHIP K-1 BOOK TO TAX 303,790 BASIS SWAP INCOME $2,131,435 --------- $2,614,558 ========== PART XII - LINE 4B - FOUNDATION CONTRIBUTIONS $136,557 ======== PART XIII - LINE 2D - RENT EXPENSE NETTED AGAINST REVENUE $179,333 ======== PART XIII - LINE 4B - OTHER EXPENSES ON PREMIER K-1 $ 10 FOUNDATION CONTRIBUTIONS 136,557 MANAGEMENT FEES RECLASSED FROM EXPENSES 200,000 -------- $336,567 ======== true true X true X true X true true true false true true 15312109 0 15312109 0.04270 15312109 0 15312109 0.04270 52872 1692659 316904 1375755 0.00380 1466 804863 43028 761835 0.00210 27258 9414847 3237036 6177811 0.01720 0 3973 0 3973 5258 145303 420 144883 0.00040 86854 12061645 3597388 8464257 0.02350 86854 27373754 3597388 23776366 0.06620 910 0 910 0.00000 11776 0 11776 0.00000 143802 0 143802 0.00040 17506 0 17506 0.00000 2028 0 2028 0.00000 176022 0 176022 0.00040 true 16616061 0 229798559 211176281 18622278 X true true 1 1 PENINSULA REGIONAL MEDICAL CENTER

100 E CARROLL STREET SALISBURY MD 218015493

X X X PENINSULA REGIONAL MEDICAL CENTER 1 true X X X X X X 08 true true true X X X X X X X X X X X X true true true 200. true 300. true X X X X X true true X X X X X X X true false X X X true X X false true SUPPLEMENTAL INFORMATION PART I, LINE 3C N/A PART I, LINE 6A PENINSULA REGIONAL MEDICAL CENTER FILES ANNUALLY A COMMUNITY BENEFIT REPORT WITH THE STATE OF MARYLAND. THE REPORT IS FILED WITH THE HSCRC (HEALTH SERVICES COST REVIEW COMMISSION). PART I, LINE 7: LINE 7, COLUMN (F) - THE AMOUNT OF BAD DEBT EXPENSE EXCLUDED FROM THE DENOMINATOR IN THE COLUMN (F) PERCENTAGES IS $16,616,061. LINE 7B COLUMN (C) & (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 DIRECTED OFFSETTING REVENUE RELATED TO UNCOMPENSATED CARE. COMMUNITY BENEFIT EXPENSES ARE EQUAL TO MEDICAID REVENUES IN MARYLAND, AS SUCH, THE NET EFFECT IS ZERO. THE EXCEPTION TO THIS IS THE IMPACT ON THE HOSPITAL OF ITS SHARE OF THE MEDICAID ASSESSMENT. IN RECENT YEARS, THE STATE OF MARYLAND HAS CLOSED FISCAL GAPS IN THE STATE MEDICAID BUDGET BY ASSESSING HOSPITALS THROUGH THE RATE-SETTING SYSTEM. THE COST METHODOLOGY FOR CHARITY CARE AND CERTAIN OTHER COMMUNITY BENEFITS IS THE COST-TO-CHARGE RATIO USED FOR THE CHARITY CARE PROGRAMS AND DIRECT COST METHOD FOR THE OTHER BENEFITS/PROGRAMS. PART III, LINE 4 THE HOSPITAL PROVIDES SERVICES TO PATIENTS IN THE EASTERN SHORE AREA OF MARYLAND, DELAWARE AND VIRGINIA, THE MAJORITY OF WHOM ARE COVERED BY THIRD-PARTY HEALTH INSURANCE. THE HOSPITAL BILLS THE INSURER DIRECTLY FOR SERVICES PROVIDED. INSURANCE COVERAGE AND FINANCIAL INFORMATION IS OBTAINED FROM PATIENTS UPON ADMISSION WHEN AVAILABLE. THE HOSPITAL'S POLICY IS TO PERFORM IN-HOUSE COLLECTION PROCEDURES FOR APPROXIMATELY 85 DAYS. A DETERMINATION IS MADE AT THAT TIME AS TO WHAT ADDITIONAL COLLECTION EFFORTS TO PURSUE. A PROVISION FOR UNCOLLECTIBLE ACCOUNTS IS RECORDED FOR AMOUNTS NOT YET WRITTEN OFF, WHICH ARE EXPECTED TO BECOME UNCOLLECTIBLE. DISCOUNTS RANGING FROM 2% TO 6% OF CHARGES ARE GIVEN TO MEDICARE, MEDICAID AND CERTAIN APPROVED COMMERCIAL HEALTH INSURANCE AND HEALTH MAINTENANCE ORGANIZATION PROGRAMS FOR REGULATED SERVICES. DISCOUNTS IN VARYING PERCENTAGES ARE GIVEN FOR CERTAIN UNREGULATED SERVICES. THESE MAJOR PAYORS ROUTINELY REVIEW PATIENT BILLINGS AND DENY PAYMENT FOR CERTAIN CHARGES AS MEDICALLY UNNECESSARY OR AS PERFORMED WITHOUT APPROPRIATE PREAUTHORIZATION. DISCOUNTS AND DENIALS ARE RECORDED AS REDUCTIONS OF NET PATIENT SERVICE REVENUE. ACCOUNTS RECEIVABLE FROM THESE THIRD-PARTY PAYORS HAVE BEEN ADJUSTED TO REFLECT THE DIFFERENCE BETWEEN CHARGES AND THE ESTIMATED REIMBURSABLE AMOUNTS. APPROXIMATELY 37% AND 33%, RESPECTIVELY, OF ACCOUNTS RECEIVABLE WERE DUE FROM THE MEDICARE PROGRAM AS OF JUNE 30, 2012 AND 2011, RESPECTIVELY. LAWS AND REGULATIONS GOVERNING MEDICARE AND MEDICAID PROGRAMS ARE COMPLEX AND SUBJECT TO INTERPRETATION. THE HOSPITAL BELIEVES THAT IT IS IN COMPLIANCE WITH ALL APPLICABLE LAWS AND REGULATIONS AND IS NOT AWARE OF ANY PENDING OR THREATENED INVESTIGATIONS INVOLVING ALLEGATIONS OF POTENTIAL WRONGDOING THAT WOULD HAVE A MATERIAL EFFECT ON THE FINANCIAL STATEMENTS. COMPLIANCE WITH SUCH LAWS AND REGULATIONS CAN BE SUBJECT TO FUTURE GOVERNMENT REVIEW AND INTERPRETATION AS WELL AS SIGNIFICANT REGULATORY ACTION INCLUDING FINES, PENALTIES AND EXCLUSION FROM MEDICARE AND MEDICAID PROGRAMS. BAD DEBT METHODOLOGY - PENINSULA REGIONAL MEDICAL CENTER IS A TAX-EXEMPT NOT-FOR-PROFIT HOSPITAL THAT PROVIDES QUALITY MEDICAL SERVICES TO PATIENTS REGARDLESS OF THEIR ABILITY TO PAY. BY PROVIDING MEDICAL SERVICES TO ALL COMMUNITY MEMBERS REGARDLESS OF THEIR ABILITY TO PAY, THE HOSPITAL'S BAD DEBT EXPENSE QUALIFIES AS A COMMUNITY BENEFIT. THE BAD DEBT EXPENSE CALCULATED ON LINE 2 WAS CALCULATED USING THE PATIENT CARE COST TO CHARGES METHODOLOGY PART III, LINE 8 MEDICARE ALLOWABLE COSTS WERE CALCULATED USING A COST TO CHARGE RATIO. PENINSULA REGIONAL MEDICAL CENTER PROVIDES QUALITY MEDICAL SERVICES TO ALL PATIENTS REGARDLESS OF WHAT INSURANCE THEY HAVE. APPROXIMATELY, 48.2% OF THE MEDICAL CENTER'S REVENUE IS ATTRIBUTABLE TO MEDICARE PATIENTS during the year ended June 30, 2012. PART III, LINE 9B COLLECTION POLICIES ARE THE SAME FOR ALL PATIENTS. IF A PATIENT NOTIFIES THE MEDICAL CENTER ABOUT THEIR INABILITY TO PAY, THE MEDICAL CENTER WILL SEND THEM THE CHARITY CARE AND FINANCIAL ASSISTANCE FORMS TO FILL OUT. ONCE THE FORMS ARE COMPLETE AND RETURNED TO THE MEDICAL CENTER AND THE PATIENT QUALIFIES FOR FINANCIAL ASSISTANCE, THEN THE PATIENT'S ACCOUNT WILL BE REMOVED FROM COLLECTIONS AND THE ACCOUNT WILL BE WRITTEN OFF. PART V, LINE 13G PENINSULA REGIONAL MEDICAL CENTER PUBLISHES ANNUALLY AN ADVERTISEMENT IN THE LOCAL NEWSPAPER ANNOUNCING THE AVAILABILITY OF FREE OR REDUCED COST CARE. PART V, LINE 19D PENINSULA REGIONAL MEDICAL CENTER IS A MARYLAND HOSPITAL. AS SUCH PATIENTS AND ALL INSURANCE COMPANIES, INCLUDING MEDICARE & MEDICAID, PAY THE SAME RATE. THIS RATE IS DETERMINED BY THE STATE AGENCY, THE MARYLAND HEALTH SERVICES COST REVIEW COMMISSION. PART V, LINE 21 PENINSULA REGIONAL MEDICAL CENTER IS A MARYLAND HOSPITAL. AS SUCH, PATIENTS AND ALL INSURANCE COMPANIES INCLUDING MEDICARE & MEDICAID PAY THE GROSS CHARGE. PART VI, LINE 2 PENINSULA REGIONAL MEDICAL CENTER IN COOPERATION WITH THE WICOMICO, WORCESTER AND SOMERSET COUNTIES, HEALTH DEPARTMENTS, THE ATLANTIC GENERAL HOSPITAL AND THE EDWARD W. MCCREADY MEMORIAL HOSPITAL, HAS BEEN CONDUCTING COMMUNITY HEALTH SURVEYS OF THE TRI-COUNTY AREA SINCE 1995. THESE SURVEYS, ADMINISTERED BY PROFESSIONAL RESEARCH CONSULTANTS (PRC) OF OMAHA, NEBRASKA WERE ADMINISTERED IN 1995, 2000, 2004 AND 2009. IN ADDITION TO THESE ADULT SURVEYS, A SEPARATE ADOLESCENT SURVEY WAS CONDUCTED IN 2000, 2005, AND 2010. RESULTS OF THESE SURVEYS ARE USED BY THE PARTICIPANTS TO ASSESS COMMUNITY HEALTH NEEDS AND PLAN FUTURE SERVICES. OF PARTICULAR NOTE WAS THE DEVELOPMENT OF THE TRI-COUNTY DIABETES ALLIANCE, WHICH IS A COOPERATIVE VENTURE BETWEEN ALL THE PARTNERS AND COMMUNITY AGENCIES TO REDUCE THE INCIDENCES OF DIABETES IN THE TRI-COUNTY AREA. OTHER OUTCOMES RESULTING FROM THE SURVEY FINDINGS INCLUDE SMOKING CESSATION PROGRAMS, OTHER EARLY DETECTION AND SCREENING PROGRAMS FOR HEART AND CANCER, AS WELL AS HEALTH PROMOTION AND EDUCATION WITH A FOCUS ON PREVENTION. THE PRC COMMUNITY HEALTH ASSESSMENT IS A SYSTEMATIC, DATA-DRIVEN APPROACH TO DETERMINING THE HEALTH STATUS, BEHAVIORS AND NEEDS OF OUR COMMUNITY RESIDENTS. SURVEY RESULTS ARE SHARED WITH THE COMMUNITY AND ARE POSTED TO THE PARTICIPANTS WEBSITES. THIS COMMUNITY HEALTH ASSESSMENT SERVES AS A TOOL TOWARDS REACHING THE FOLLOWING THREE GOALS: 1. TO IMPROVE RESIDENTS' HEALTH STATUS, INCREASE THEIR LIFE SPANS, AND ELEVATE THEIR OVERALL QUALITY OF LIFE. 2. REDUCE THE HEALTH DISPARITIES AMONG RESIDENTS BY GATHERING DEMOGRAPHIC INFORMATION ALONG WITH HEALTH STATUS AND BEHAVIOR DATA. 3. TO INCREASE ACCESSIBILITY TO PREVENTIVE SERVICES FOR ALL COMMUNITY RESIDENTS. PART VI, LINE 3 PENINSULA REGIONAL MEDICAL CENTER MAKES AVAILABLE TO ALL PATIENTS THE HIGHEST QUALITY OF MEDICAL CARE POSSIBLE WITHIN THE RESOURCES AVAILABLE. IF A PATIENT IS UNABLE TO PAY DUE TO FINANCIAL RESOURCES, ALL EFFORTS WILL BE MADE TO HELP THE PATIENT OBTAIN ASSISTANCE THROUGH APPROPRIATE AGENCIES, OR, IF HELP IS NOT AVAILABLE, TO PROVIDE CARE AT REDUCED OR ZERO COST. ONE OF PENINSULA REGIONAL'S OVERALL GUIDING PRINCIPLES IS THAT CONCERN OVER A HOSPITAL BILL SHOULD NEVER PREVENT ANY INDIVIDUAL FROM RECEIVING EMERGENCY HEALTH SERVICES THE MEDICAL CENTER WILL COMMUNICATE THIS MESSAGE CLEARLY TO PROSPECTIVE PATIENTS AND TO LOCAL COMMUNITY SERVICE AGENCIES AND MAKE IT CLEAR THAT EMERGENCY SERVICES WILL BE PROVIDED WITHOUT REGARD TO ABILITY TO PAY. THE MEDICAL CENTER WILL ENSURE THAT AN EMERGENCY ADMISSION OR TREATMENT IS NOT DELAYED OR DENIED PENDING DETERMINATION OF COVERAGE OR REQUIREMENT FOR PREPAYMENT OR DEPOSIT. THE MEDICAL CENTER WILL POST ADEQUATE NOTICE OF THE AVAILABILITY OF MEDICAL SERVICES, AND THE GENERAL OBLIGATION OF THE HOSPITAL TO PROVIDE CHARITY CARE. PENINSULA REGIONAL'S "FINANCIAL ASSISTANCE POLICY" INCLUDES THE REQUIRED LANGUAGE OF DETERMINATION OF PROBABLE ELIGIBILITY WITHIN TWO BUSINESS DAYS. ON PAGE 2, THE "FINANCIAL ASSISTANCE POLICY" STATES THAT UPON RECEIPT OF THE FINANCIAL ASSISTANCE REQUEST, THE REPRESENTATIVE WILL REVIEW INCOME AND ALL DOCUMENTATION. THE PATIENT MUST BE NOTIFIED WITHIN TWO BUSINESS DAYS OF THEIR PROBABLE ELIGIBILITY. IN ACCORDANCE WITH SECTION 1, 2 AND 3, PENINSULA REGIONAL PROVIDES PUBLIC NOTICE AND INFORMATION REGARDING ITS CHARITY CARE POLICY IN DELMARVA'S LARGEST PAPER "THE DAILY TIMES", POSTED SIGNS IN THE ADMISSION, BUSINESS OFFICE EMERGENCY ROOM AND OTHER MAJOR SERVICE AREAS OF THE MEDICAL CENTER; ADDITIONALLY INDIVIDUAL NOTICE IS PROVIDED TO EACH PERSON WHO SEEK X X true true X X X X X X false true false false false true true true false Margaret Naleppa 566819 0 160411 0 14720 0 35172 0 13732 0 790854 0 0 0 Lura Lunsford 290065 0 59234 0 3898 0 33215 0 12345 0 398757 0 0 0 Bruce I Ritchie 334335 0 69158 0 3898 0 48254 0 20791 0 476436 0 0 0 R Alan Newberry 688729 0 0 0 0 0 0 0 0 0 688729 0 0 0 Justinian Ngaiza MD 556680 0 0 0 1218 0 13504 0 14880 0 586282 0 0 0 Paul Zorsky MD 575825 0 0 0 1218 0 9601 0 13361 0 600005 0 0 0 Gayatri Sonti 599700 0 0 0 1218 0 10018 0 7421 0 618357 0 0 0 Andy Pierre MD 643454 0 50000 0 1218 0 15733 0 17599 0 728004 0 0 0 Jacek Malik MD 647151 0 50000 0 1218 0 18183 0 12967 0 729519 0 0 0 Supplemental Compensation Information PART I, LINE 4B Margaret Naleppa is a participant in the 457F non qualified plan. Part I, Lines 6A and 6B Officers and key employees of Peninsula Regional Medical Center are paid compensation determined by the net earnings activity of the Medical Center and Peninsula Regional Health System. During calendar year 2011 the following bonuses were paid based on earnings: Margaret Naleppa $160,411, Lura Lunsford $59,234 and Bruce Ritchie $69,158. Part I, Line 7 During calendar year 2011, Andy Pierre, M.D. and Jacek Malik, M.D. each received a $50,000 sign-on bonus. MARYLAND HEALTH & HIGHER EDUCATION FACILITY 520936091 574217WT8 2006-02-09 146668251 SEE PART VI false false false 154822905 0 154822905 11127422 0 0 1167501 0 0 100184165 0 0 2009 true false true true false false true false true true 0.00870 0.00120 0.00990 true false false true MORGAN STANLEY 20.4 false false false 0 false true SCHEDULE K, PART I, COLUMN F 0 THE PROCEEDS OF THE ISSUE, AFTER PAYMENT OF FINANCING COSTS, WERE USED PRIMARILY (I) TO FINANCE AND REFINANCE A PORTION OF THE COSTS OF CONSTRUCTION, RENOVATION, ACQUISITION AND EQUIPPING OF HEALTHCARE FACILITIES; (II) TO REFUND OUTSTANDING 1993 BONDS (ISSUED 10/28/93); (III) TO PAY A PORTION OF THE INTEREST ACCRUING ON THE SERIES 2006 BONDS FOR A PERIOD TO EXTEND TO JANUARY 1, 2009; AND (IV) TO PAY THE COUNTERPARTY A TERMINATION PAYMENT OF $1,575 IN CONNECTION WITH A FORWARD STARTING INTEREST RATE EXCHANGE AGREEMENT ENTERED INTO ON AUGUST 9, 2005 AND UNWOUND ON JANUARY 24, 2006. SCHEDULE K, PART II, LINE 10 0 OF THE AMOUNT REPORTED ON PART II, LINE 10, $12,281,895 IS CAPITALIZED INTEREST. PENINSULA CARDIOLOGY ASSOCIATES SEE PART V 159994 RENTAL FEES false SCHEDULE L, PART IV RENE DESMARIAS, M.D., A TRUSTEE OF THE MEDICAL CENTER, IS A MORE THAN 5% OWNER OF PENINSULA CARDIOLOGY ASSOCIATES. FORM 990, PART VI, SECTION A, LINE 2 BUSINESS RELATIONSHIPS MARGARET NALEPPA, MARTIN NEAT, AND HUGH MCLAUGHLIN are members of the board of directors of Peninsula Health Ventures, a wholly-owned taxable subsidiary of Peninsula Regional Health System. FORM 990, PART VI, SECTION A, LINE 6 MEMBERS OF THE ORGANIZATION PENINSULA REGIONAL HEALTH SYSTEM IS THE SOLE CORPORATE MEMBER OF THE MEDICAL CENTER. FORM 990, PART VI, SECTION A, LINE 7A MEMBER'S ABILITY TO ELECT MEMBERS OF THE GOVERNING BODY IN ITS CAPACITY AS THE SOLE CORPORATE MEMBER OF THE MEDICAL CENTER, PENINSULA REGIONAL HEALTH SYSTEM HAS THE ABILITY TO ELECT MEMBERS OF THE MEDICAL CENTER'S GOVERNING BODY. FORM 990, PART VI, SECTION A, LINE 7B DECISIONS SUBJECT TO APPROVAL BY MEMBERS AS THE SOLE CORPORATE MEMBER, PENINSULA REGIONAL HEALTH SYSTEM HAS THE ABILITY TO APPROVE MAJOR EXPENDITURES AND LONG TERM BORROWINGS OF THE MEDICAL CENTER. FORM 990, PART VI, SECTION B, LINE 11B REVIEW PROCESS OF FORM 990 OVERSIGHT OF THE COMPLETION OF THE ORGANIZATION'S FORM 990 HAS BEEN DELEGATED TO THE CHIEF FINANCIAL OFFICER OF PENINSULA REGIONAL MEDICAL CENTER BY THE PRESIDENT OF THE ORGANIZATION. ONCE THE FORM 990 AND ALL SCHEDULES HAVE BEEN PREPARED BY THE ORGANIZATION'S INDEPENDENT TAX SERVICES PROVIDER, THEY ARE REVIEWED BY THE PRESIDENT PRIOR TO FILING. FORM 990, PART VI, SECTION B, LINE 12C MONITORING AND ENFORCEMENT OF CONFLICT OF INTEREST POLICY THE BOARD OF TRUSTEES ARE REQUIRED TO DISCLOSE ANNUALLY, IN WRITING, ANY AND ALL INTERESTS WHICH THEY OR ANY IMMEDIATE MEMBER OF THEIR FAMILY MAY HAVE IN ANY BUSINESS ENTITY WHICH HAS OR SEEKS A CONTRACTUAL OR COMPETITIVE RELATIONSHIP WITH THE ORGANIZATION. THE BOARD HAS THE AUTHORITY TO DETERMINE IF A VIOLATION HAS OCCURRED AND WHETHER ANY INTEREST WHICH SHOULD BE DISCLOSED SHOULD DISQUALIFY A DIRECTOR FROM PARTICIPATING IN ANY SPECIFIC BOARD DISCUSSION OR BOARD MEMBERSHIP. FORM 990, PART VI SECTION B, LINES 15A & 15B PROCESS USED TO DETERMINE COMPENSATION THE ORGANIZATION USES A COMPENSATION COMMITTEE TO DETERMINE THE COMPENSATION OF THE CEO/EXECUTIVE DIRECTOR AND OTHER KEY EMPLOYEES. THE CEO OF THE ORGANIZATION HAS A WRITTEN EMPLOYMENT CONTRACT. THE COMPENSATION COMMITTEE USES AN INDEPENDENT CONSULTANT, COMPENSATION SURVEYS AND OTHER ORGANIZATION'S FORM 990 IN THE DETERMINATION PROCESS. FORM 990, PART VI, SECTION C, LINE 19 AVAILABILITY OF DOCUMENTS, POLICIES & FINANCIAL STATEMENTS TO THE PUBLIC THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST TO THE PUBLIC INFORMATION OFFICE OF PENINSULA REGIONAL MEDICAL CENTER AT 100 EAST CARROLL STREET, SALISBURY, MD 21801. FORM 990, PART VII, SECTION A, COLUMN (B) AVERAGE HOURS PER WEEK DEVOTED TO RELATED ORGANIZATIONS MURRAY K. HOY PENINSULA REGIONAL MEDICAL CENTER FOUNDATION - 1 HR/WK PENINSULA REGIONAL HEALTH SYSTEM - 1 HR/WK MARTIN NEAT PENINSULA REGIONAL HEALTH SYSTEM - 1HR/WK PENINSULA HEALTH VENTURES - 1 HR/WK EDWARD URBAN PENINSULA REGIONAL HEALTH SYSTEM - 1 HR/WK WILLIAM MCCAIN PENINSULA REGIONAL HEALTH SYSTEM - 1 HR/WK MICHAEL CROUCH, M.D. PENINSULA REGIONAL HEALTH SYSTEM - 1 HR/WK DEBORAH ABBOTT PENINSULA REGIONAL HEALTH SYSTEM - 1 HR/WK PENINSULA REGIONAL MEDICAL CENTER FOUNDATION - 1 HR/WK HERBERT J. GEARY III PENINSULA REGIONAL HEALTH SYSTEM - 1 HR/WK CHRISTJON J. HUDDLESTON, M.D. PENINSULA REGIONAL HEALTH SYSTEM - 1 HR/WK MARION KEENAN PENINSULA REGIONAL HEALTH SYSTEM - 1 HR/WK HUGH MCLAUGHLIN PENINSULA REGIONAL HEALTH SYSTEM - 1 HR/WK PENINSULA HEALTH VENTURES - 1 HR/WK MONTY SAYLOR PENINSULA REGIONAL HEALTH SYSTEM - 1 HR/WK THOMAS COATES PENINSULA REGIONAL HEALTH SYSTEM - 1 HR/WK MARGARET NALEPPA PENINSULA REGIONAL HEALTH SYSTEM - 10 HRS/WK PENINSULA HEALTH VENTURES - 1 HR/WK FORM 990, PART XI, LINE 5 OTHER CHANGES IN NET ASSETS OR FUND BALANCE Pension Adjustment - FAS 158 $(14,092,708) Unrealized loss on investments (868,468) Investment income Swap 2,131,445 Change in equity interest of Foundation 931,783 Capital campaign transfers from Foundation 332 U/R Net assets released from restriction 40,325 Endowment Donations (12,685) Net assets released from restriction (267,401) Partnership K-1 Income oN return NOT ON BOOKS 303,790 ROUNDING (6) ------------- Net Change in fund balance $(11,833,593) ============= PENINSULA REGIONAL MED CTR FOUNDATION 100 EAST CARROLL ST SALISBURY MD 21801 521851935 FUNDRAISING MD 501(C)(3) 11 TYPE I PRHS false PENINSULA REGIONAL HEALTH SYSTEM (PRHS) 100 EAST CARROLL ST SALISBURY MD 21801 522132761 PARENT MD 501(C)(3) 11 TYPE II NA false PENINSULA GENERAL HOSPITAL INS TRUST 100 EAST CARROLL ST SALISBURY MD 21801 526321234 INSURANCE MD 501(C)(3) 11 TYPE III PRHS true DELMARVA SURG CTR 641 S SALISBURY SALISBURY MD 21801 522251436 HEALTHCARE MD PHV PENINSULA HEALTH VENTURES (PHV) 100 EAST CARROLL ST SALISBURY SALISBURY MD 21801 522250012 P'SHIP INV MD PRHS C CORP PRLTC INC 100 EAST CARROLL ST SALISBURY MD 21801 522190588 LONG TERM CARE MD PHV C CORP false false false false false false false false false false true true true true false true false true PENINSULA REGIONAL MEDICAL CENTER FOUNDATION L, R 189567 FMV PENINSULA REGIONAL MEDICAL CENTER FOUNDATION M, N, 418908 FMV PENINSULA HEALTH VENTURES K 200000 FMV