2012-05-10T11:48:16-05:00 2011-06-30 KPMG LLP 440 Monticello Ave Suite 1900 Norfolk VA 235102674 990 2010-07-01 520646893 Montgomery General Hospital MONT 3017748640 18101 Prince Philip Drive Olney MD 20832 Marc R Berger 2012-05-07 true 7576167000 2010 2016-02-24 21:20:13Z MedStar Montgomery Medical Center PETER MONGE 18101 PRINCE PHILIP DRIVE OLNEY MD 20832 145220481 false X www.montgomerygeneral.org X 2000 MD MEDSTAR MONTGOMERY MEDICAL CENTER IS DEDICATED TO ENHANCING OUR COMMUNITY'S HEALTH AND WELL-BEING BY OFFERING HIGH QUALITY, COMPASSIONATE AND PERSONALIZED CARE. 19 13 1824 300 378823 -42421 0 3500 136180638 143534212 724066 -1550341 1793676 1388812 138698380 143376183 0 0 0 0 64512526 67360488 0 0 0 68958256 68985723 133470782 136346211 5227598 7029972 165724138 120823935 32262425 40100635 133461713 80723300 X AS A PROUD MEMBER OF MEDSTAR HEALTH, MEDSTAR MONTGOMERY MEDICAL CENTER'S MISSION IS TO ENHANCE OUR COMMUNITY'S HEALTH AND WELL-BEING BY OFFERING HIGH QUALITY, COMPASSIONATE AND PERSONALIZED CARE. MEDSTAR MONTGOMERY MEDICAL CENTER (MMMC) IS LOCATED IN OLNEY, IN NORTHEASTERN MONTGOMERY COUNTY, MARYLAND, A SUBURB OF WASHINGTON, D.C. AFTER OVER 90 YEARS, THE HOSPITAL REMAINS TRUE TO ITS ROOTS, OFFERING A WIDE RANGE OF WELLNESS PROGRAMS AND OUTPATIENT SERVICES IN ADDITION TO INPATIENT TREATMENT. IN FISCAL YEAR 2011, MMMC HAD 10,612 INPATIENT ADMISSIONS, 65,610 OUTPATIENT VISITS, AND 38,091 EMERGENCY VISITS. false false 98920651 0 142716137 MEDSTAR MONTGOMERY MEDICAL CENTER'S LARGEST PROGRAM IS ACCESS TO AND THE PROVISION OF ACUTE HOSPITAL SERVICES TO THE COMMUNITIES OF NORTHEASTERN MONTGOMERY COUNTY, MARYLAND AND THE SURROUNDING AREAS. IN ADDITION TO THE PROGRAM SERVICE EXPENSES LISTED ABOVE, MMMC INCURRED $29.6M OF MANAGEMENT AND GENERAL EXPENSES IN PROVIDING SERVICES TO ITS COMMUNITIES. THE ACUTE CARE HOSPITAL OFFERS A CARDIAC AND VASCULAR PROGRAM, GENERAL SURGERY, ORTHOPEDICS, CANCER CARE, PSYCHIATRY AND OBSTETRICS. IN ADDITION TO ACUTE SERVICES, MMMC OFFERS OUTPATIENT MENTAL HEALTH SERVICES, HOME HEALTH AND PRIVATE DUTY NURSING SERVICES. FOR MORE INFORMATION, SEE SCHEDULE O. 5981647 0 0 MEDSTAR MONTGOMERY MEDICAL CENTER PROVIDED $6.0M IN CHARITY CARE SERVICES IN FISCAL YEAR 2011. CHARITY CARE IS PROVIDED PURSUANT TO MEDSTAR HEALTH'S FINANCIAL ASSISTANCE POLICY TO MEMBERS OF THE COMMUNITY WHOSE INCOME IS BELOW CERTAIN THRESHOLDS AND FOR WHICH THE HOSPITAL IS NOT COMPENSATED. UNDER MARYLAND'S UNIQUE PAYER SYSTEM, THE AMOUNT REPORTED REPRESENTS MMMC'S CHARITY CARE EXPENSE AND REVENUES REPRESENT DIRECT PAYMENTS FROM THE STATE'S CHARITY CARE POOL. OTHER CHARITY CARE EXPENSES ARE INDIRECTLY REIMBURSED VIA THE STATE OF MARYLAND'S PAYMENT SYSTEM. 1856070 0 0 MEDSTAR MONTGOMERY MEDICAL CENTER PROVIDED $1.9M IN SUBSIDIZED (MISSION DRIVEN) HEALTH SERVICES IN FISCAL YEAR 2011. THESE CRITICAL SERVICES, WHICH ARE DRIVEN BY COMMUNITY NEEDS, OPERATE AT A LOSS. THEY ADDRESS PRIORITIES PRIMARILY THROUGH DISEASE PREVENTION AND IMPROVEMENT OF HEALTH STATUS. SERVICES PROVIDED INCLUDED THE PROVISION OF PSYCHIATRIC CARE SERVICES, EMERGENCY ROOM SERVICES, AND HOSPITALISTS. 106758368 true false false false false false false false false true false false false true true false true false false false false false false false false true true false false true false false false true false false false false false false false false true true true true false false true 119 0 true 1824 true true true false false false false false false false false false X 19 13 false false false false true true true true true false false true true true true true true true true true MD X MARC BERGER 4107726719 5565 STERRETT PLACE 5TH FLOOR Columbia MD 21044 X PETER W MONGE 40.0 X X 776425 0 15278 KEVIN FLANNERY 1.0 X X 0 0 0 DONALD SWEENEY 1.0 X X 0 0 0 MICHAEL K KERR MD 1.0 X 10000 0 0 KEVIN MCMAHON 1.0 X 41800 132385 3311 KENNETH A SAMET 1.0 X 0 3125094 132265 CHARLES R TUEGEL MD 1.0 X X 0 0 0 AMY AMPEY MD 1.0 X 2500 0 0 DOUGLAS FARQUHAR 1.0 X 0 0 0 JOHN FERGUSON 1.0 X 0 0 0 JULIE BAWA MPH 1.0 X 0 0 0 CHARLES F MESS SR MD 1.0 X 0 0 0 BENNETT T MORRISON MD 1.0 X 0 0 0 C THOMPSON PARDOE 1.0 X 0 0 0 ROBERT SULLIVAN 1.0 X 0 0 0 IVONNE GIULIANA CENTTY DDS 1.0 X 0 0 0 SHEILA WOODARD 1.0 X 0 0 0 M JOY DRASS MD 1.0 X 0 1247987 35303 DEE HAWKINS 1.0 X 0 0 0 David Havrilla 40.0 X 312749 0 21589 Roger Leonard 40.0 X 372889 0 11213 Connie Stone 40.0 X 175042 0 6848 Kevin Mell 40.0 X 191550 0 10372 B A SECRIST 40.0 X 140224 0 8938 Jeanne O Toole 40.0 X 157092 0 22146 Maria Elena Espina 40.0 X 130534 0 18505 Randall Bursaw 40.0 X 154216 0 18341 Owen Horn 40.0 X 139107 0 16923 JAN ROWE 40.0 X 151102 0 21281 2755230 4505466 342313 15 false true false MERIDIAN ANESTHESIA PRACTICE 3801 INTERNATIONAL DRIVE 300 SILVER SPRING MD 20906 PHYSICIAN SERVICES 3843400 DELPHI HEALTHCARE PARTNERS 170 SOUTHPORT DR MORRISVILLE NC 27560 PHYSICIAN SERVICES 1219332 MONTGOMERY MAGNETIC IMAGING 4110 ASPEN HILL RD STE 200 ROCKVILLE MD 20853 MRI 716702 INPATIENT SPECIALISTS 1201 SEVEN LOCKS RD STE 200 ROCKVILLE MD 20854 PHYSICIAN SERVICES 567678 EMERGENCY MEDICINE ASSOCIATES 20010 CENTURY BLVD STE 200 GERMANTOWN MD 20874 PHYSICIAN SERVICES 532356 10 3500 3500 PATIENT SERVICE REVENUE 621300 135086940 135086940 PHYSICIAN BILLING REVENUE 621110 7629196 7629196 LAB REVENUE 900099 658026 606871 51155 OTHER PROGRAM REVENUE 900099 160050 160050 143534212 293957 293957 0 0 241723 241723 241723 241723 1844298 -1844298 -1844298 -1844298 0 0 0 MANAGEMENT FEES 900099 225958 225958 EQUITY INTEREST IN AFFILIATES 525990 142149 142149 MISCELLANEOUS REVENUE 900099 778982 327668 451314 1147089 143376183 143483057 378823 -489197 0 0 0 0 0 56133695 51214274 4919421 2171705 1981382 190323 5006436 4567684 438752 4048652 3693838 354814 0 161441 350 161091 -26863 -27000 137 0 0 0 22802053 14142540 8659513 531207 4765 526442 0 0 0 360132 360132 36223 18950 17273 0 83507 62105 21402 625731 625731 0 8377031 8377031 1314090 1314090 SUPPLIES 24375025 24172336 202689 BAD DEBT 3373019 3373019 RECRUITMENT 524227 524 523703 OTHER 2165733 982599 1183134 EQUIPMENT RENTAL & MAINTENANCE 1748479 1747839 640 2534688 2521960 12728 136346211 106758368 29587843 0 47205461 22016428 14622539 14257611 0 60698 761657 526161 2504868 2562529 610837 858345 158870261 78744647 77961090 80125614 20965797 66391 96364 50254 995525 299904 165724138 120823935 11232636 13344100 21029789 26756535 32262425 40100635 X 131430313 79435856 2031400 1287444 133461713 80723300 165724138 120823935 X 7029972 -59768385 X X false true true X false X 146581 146581 83317458 7211663 76105795 2249815 2249815 57502443 57502443 0 15653964 14030541 1623423 80125614 0 DUE TO RELATED ORGANIZATION 11867122 MOB LIABILITY 7877865 ADVANCE HEALTH INSURANCE 3622987 WORKERS COMP 769617 SURGERY CENTER DEBT 289481 PATIENT CREDIT BALANCES 169124 OPTIMIM CHOICE IBNR 131960 OTHER LIABILITIES 2028379 26756535 FIN 48 FOOTNOTE SCHEDULE D, PART X INCOME TAXES ARE ACCOUNTED FOR UNDER THE ASSET AND LIABILITY METHOD. DEFERRED TAX ASSETS AND LIABILITIES ARE RECOGNIZED FOR THE FUTURE TAX CONSEQUENCES ATTRIBUTABLE TO DIFFERENCES BETWEEN THE FINANCIAL STATEMENT CARRYING AMOUNTS OF EXISTING ASSETS AND LIABILITIES AND THEIR RESPECTIVE TAX BASES AND OPERATING LOSS AND TAX CREDIT CARRYFORWARDS. DEFERRED TAX ASSETS AND LIABILITIES ARE MEASURED USING ENACTED TAX RATES EXPECTED TO APPLY TO TAXABLE INCOME IN THE YEARS IN WHICH THOSE TEMPORARY DIFFERENCES ARE EXPECTED TO BE RECOVERED OR SETTLED. THE EFFECT ON DEFERRED TAX ASSETS AND LIABILITIES OF A CHANGE IN TAX RATES IS RECOGNIZED IN THE PERIOD THAT INCLUDES THE ENACTMENT DATE. ANY CHANGES TO THE VALUATION ALLOWANCE ON THE DEFERRED TAX ASSET ARE REFLECTED IN TH YEAR OF CHANGE. THE CORPORATION ACCOUNTS FOR UNCERTAIN TAX POSITIONS IN ACCORDANCE WITH THE FASB ACCOUNTING STANDARDS CODIFICATION (ASC) TOPIC 740, INCOME TAXES. THERE WAS NO LIABILITY RECORDED FOR UNCERTAIN TAX POSITIONS AS OF JUNE 30, 2011. true true X true X true X true true true false true true 4837912 0 4837912 0.03640 0 0 0 0.00000 0 0 0 0.00000 4837912 0 4837912 0.03640 1225684 72294 1153390 0.00870 393737 0 393737 0.00300 1856070 0 1856070 0.01400 0 0 0 0.00000 118359 0 118359 0.00090 3593850 72294 3521556 0.02660 8431762 72294 8359468 0.06300 75391 0 75391 0.00060 258261 0 258261 0.00190 305 0 305 966 0 966 33147 0 33147 0.00020 368070 0 368070 0.00270 true 2526391 0 0 0 0 X true true 1 1 Montgomery General Hospital

18101 Prince Philip Drive Olney MD 20832

X X X Montgomery General Hospital 1 CHARITY CARE AT COST PART I, LINE 7A MARYLAND'S REGULATORY SYSTEM CREATES A UNIQUE PROCESS FOR HOSPITAL PAYMENT THAT DIFFERS FROM THE REST OF THE NATION. THE HEALTH SERVICES COST REVIEW COMMISSION (HSCRC), DETERMINES PAYMENT THROUGH A RATE-SETTING PROCESS AND ALL PAYORS, INCLUDING GOVERNMENTAL PAYORS, PAY THE SAME AMOUNT FOR THE SAME SERVICES DELIVERED AT THE SAME HOSPITAL. MARYLAND'S UNIQUE ALL-PAYOR SYSTEM INCLUDES A METHOD FOR REFERENCING UNCOMPENSATED CARE IN EACH PAYORS' RATES, WHICH DOES NOT ENABLE MARYLAND HOSPITALS TO BREAKOUT ANY OFFSETTING REVENUE RELATED TO UNCOMPENSATED CARE. UNREIMBURSED MEDICAID PART I, LINE 7B MARYLAND'S REGULATORY SYSTEM CREATES A UNIQUE PROCESS FOR HOSPITAL PAYMENT THAT DIFFERS FROM THE REST OF THE NATION. THE HEALTH SERVICES COST REVIEW COMMISSION (HSCRC), DETERMINES PAYMENT THROUGH A RATE-SETTING PROCESS AND ALL PAYORS, INCLUDING GOVERNMENTAL PAYORS, PAY THE SAME AMOUNT FOR THE SAME SERVICES DELIVERED AT THE SAME HOSPITAL. MARYLAND'S UNIQUE ALL-PAYOR SYSTEM INCLUDES A METHOD FOR REFERENCING UNCOMPENSATED CARE IN EACH PAYORS' RATES, WHICH DOES NOT ENABLE MARYLAND HOSPITALS TO BREAKOUT ANY OFFSETTING REVENUE RELATED TO UNCOMPENSATED CARE. COMMUNITY BENEFIT EXPENSES ARE EQUAL TO MEDICAID REVENUES IN MARYLAND, AS SUCH, THE NET EFFECT IS ZERO. THE EXCEPTION TO THIS IS THE IMPACT ON THE HOSPITAL OF ITS SHARE OF THE MEDICAID ASSESSMENT. IN RECENT YEARS, THE STATE OF MARYLAND HAS CLOSED FISCAL GAPS IN THE STATE MEDICAID BUDGET BY ASSESSING HOSPITALS THROUGH THE RATE-SETTING SYSTEM. HEALTH PROFESSIONS EDUCATION PART I, LINE 7F MARYLAND'S REGULATORY SYSTEM CREATES A UNIQUE PROCESS FOR HOSPITAL PAYMENT THAT DIFFERS FROM THE REST OF THE NATION. THE HEALTH SERVICES COST REVIEW COMMISSION (HSCRC), DETERMINES PAYMENT THROUGH A RATE-SETTING PROCESS AND ALL PAYORS, INCLUDING GOVERNMENTAL PAYORS, PAY THE SAME AMOUNT FOR THE SAME SERVICES DELIVERED AT THE SAME HOSPITAL. MARYLAND'S UNIQUE ALL-PAYOR SYSTEM INCLUDES A METHOD FOR REFERENCING UNCOMPENSATED CARE IN EACH PAYORS' RATES, WHICH DOES NOT ENABLE MARYLAND HOSPITALS TO BREAKOUT ANY OFFSETTING REVENUE RELATED TO UNCOMPENSATED CARE. PERCENT OF TOTAL EXPENSE PART I, LINE 7, COLUMN (F) BAD DEBT EXPENSE OF $3,373,019 HAS BEEN REMOVED FROM TOTAL EXPENSE TO CALCULATE THE PERCENTAGES IN COLUMN (F). BAD DEBT PART III, LINE 4 MEDSTAR HEALTH AND ITS AFFILIATED ORGANIZATIONS REPORT BAD DEBT EXPENSE IN ACCORDANCE WITH GENERALLY ACCEPTED ACCOUNTING PRINCIPLES (GAAP) AND HFMA 15. AMOUNTS THAT ARE NOT EXPECTED TO BE COLLECTED, FOR PATIENTS QUALIFYING UNDER MEDSTAR HEALTH'S FINANCIAL ASSISTANCE POLICY, ARE WRITTEN OFF TO CHARITY CARE AND REPORTED AS A REDUCTION TO REVENUE. BAD DEBT EXPENSE RESULTS FROM MANAGEMENT'S INABILITY TO COLLECT REVENUES THAT MEET THE GAAP CRITERIA FOR REVENUE RECOGNITION. BAD DEBT REPRESENTS AN OPERATING EXPENSE AND IS REFLECTED AS A SEPARATE LINE ITEM ON THE ORGANIZATION'S STATEMENT OF OPERATIONS. HOWEVER, MEDSTAR AND ITS AFFILIATED ENTITIES DO NOT MAKE A DETERMINATION AS TO WHETHER SELF PAY AMOUNTS ARE COLLECTIBLE IN DETERMINING REVENUE RECOGNITION. RESERVE MODELS, WHICH HAVE BEEN DEVELOPED BASED ON HISTORICAL COLLECTION RESULTS AND WHICH ARE ADJUSTED PERIODICALLY BASED ON ACTUAL COLLECTIONS EXPERIENCE, ARE USED TO ESTIMATE UNCOLLECTIBLE AMOUNTS ACROSS ALL PAYORS INCLUDING SELF PAY. BAD DEBT DETERMINATIONS ARE MADE ONLY AFTER SUFFICIENT EVIDENCE IS OBTAINED TO SUPPORT THAT AN AMOUNT IS NOT COLLECTIBLE. MEDICARE PART III, LINE 8 MARYLAND'S REGULATORY SYSTEM CREATES A UNIQUE PROCESS FOR HOSPITAL PAYMENT THAT DIFFERS FROM THE REST OF THE NATION. THE HEALTH SERVICES COST REVIEW COMMISSION (HSCRC) DETERMINES PAYMENT THROUGH A RATE-SETTING PROCESS AND ALL PAYORS, INCLUDING GOVERNMENTAL PAYORS, PAY THE SAME AMOUNT FOR THE SAME SERVICES DELIVERED AT THE SAME HOSPITAL. MARYLAND'S UNIQUE ALL-PAYOR SYSTEM INCLUDES A METHOD FOR REFERENCING UNCOMPENSATED CARE IN EACH PAYORS' RATES, WHICH DOES NOT ENABLE MARYLAND HOSPITALS TO BREAKOUT ANY OFFSETTING REVENUE RELATED TO UNCOMPENSATED CARE. AS SUCH, THE NET EFFECT FOR MEDICARE EXPENSES AND REVENUES IN MARYLAND IS ZERO. NEEDS ASSESSMENT PART VI, LINE 1 AS A COMMUNITY PARTNER, MEDSTAR MONTGOMERY MEDICAL CENTER (MMMC) WORKS COLLABORATIVELY WITH LOCAL PARTNERS TO IDENTIFY KEY HEALTH NEEDS. PARTNERS INCLUDE, BUT ARE NOT LIMITED TO: THE MONTGOMERY COUNTY DEPARTMENT OF HEALTH, NOT-FOR-PROFIT AND SOCIAL SERVICE AGENCIES, SCHOOLS AND UNIVERSITIES, FAITH BASED ORGANIZATIONS AND COMMUNITY BASED COALITIONS. LOCAL, STATE AND NATIONAL HEALTH GOALS ARE ALSO USED TO ASSESS THE NEEDS OF THE COMMUNITY. IN ADDITION, HOSPITAL SERVICE UTILIZATION PATTERNS, SUCH AS THE CAUSES OF EMERGENCY ROOM VISITS AND INPATIENT ADMISSIONS HELP DETERMINE THE HEALTH NEEDS OF THE COMMUNITY. LED BY THE MONTGOMERY COUNTY DEPARTMENT OF HEALTH, MMMC IS A COLLABORATIVE PARTNER OF THE COMMUNITY HEALTH IMPROVEMENT PROCESS (CHIP). THE PURPOSE OF CHIP IS TO IDENTIFY THE HEALTH NEEDS OF COUNTY RESIDENTS, INCREASE ACCESS TO CARE, AND SUPPORT INTERVENTIONS TO REDUCE OR ELIMINATE HEALTH DISPARITIES. IN 2010, CHIP RELEASED QUANTITATIVE COMMUNITY HEALTH DATA BASED ON 129 HEALTH INDICATORS. THIS INFORMATION HELPS MMMC LEADERS BETTER ASSESS COMMUNITY HEALTH NEEDS, ENABLING THEM TO PRIORITIZE AND ESTABLISH MORE EFFECTIVE COMMUNITY BASED INTERVENTIONS. AS A PROUD MEMBER OF MEDSTAR HEALTH, REPRESENTATIVES FROM MMMC ALSO PARTICIPATE IN THE MEDSTAR HEALTH COMMUNITY BENEFIT WORKGROUP. THE WORKGROUP IS COMPRISED OF COMMUNITY HEALTH PROFESSIONALS WHO REPRESENT ALL NINE MEDSTAR HOSPITALS. THE TEAM ANALYZES LOCAL AND REGIONAL COMMUNITY HEALTH DATA, ESTABLISHES SYSTEM-WIDE COMMUNITY HEALTH PROGRAMMING PERFORMANCE AND EVALUATION MEASURES AND SHARES BEST PRACTICES. PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE PART VI, LINE 3 AS ONE OF THE REGION'S LEADING NOT-FOR-PROFIT HEALTHCARE SYSTEMS, MEDSTAR HEALTH IS COMMITTED TO ENSURING THAT UNINSURED PATIENTS WITHIN THE COMMUNITIES WE SERVE WHO LACK FINANCIAL RESOURCES HAVE ACCESS TO NECESSARY HOSPITAL SERVICES. MEDSTAR HEALTH AND ITS HEALTHCARE FACILITIES WILL: " TREAT ALL PATIENTS EQUITABLY, WITH DIGNITY, WITH RESPECT AND WITH COMPASSION. " SERVE THE EMERGENCY HEALTH CARE NEEDS OF EVERYONE WHO PRESENTS AT OUR FACILITIES REGARDLESS OF A PATIENT'S ABILITY TO PAY FOR CARE. " ASSIST THOSE PATIENTS WHO ARE ADMITTED THROUGH OUR ADMISSIONS PROCESS FOR NON-URGENT, MEDICALLY NECESSARY CARE WHO CANNOT PAY FOR PART OR ALL OF THE CARE THEY RECEIVE. " BALANCE NEEDED FINANCIAL ASSISTANCE FOR SOME PATIENTS WITH BROADER FISCAL RESPONSIBILITIES IN ORDER TO KEEP ITS HOSPITALS' DOORS OPEN FOR ALL WHO MAY NEED CARE IN THE COMMUNITY. IN MEETING ITS COMMITMENTS, MEDSTAR HEALTH'S FACILITIES WILL WORK WITH THEIR UNINSURED PATIENTS TO GAIN AN UNDERSTANDING OF EACH PATIENT'S FINANCIAL RESOURCES PRIOR TO ADMISSION (FOR SCHEDULED SERVICES) OR PRIOR TO BILLING (FOR EMERGENCY SERVICES). BASED ON THIS INFORMATION AND PATIENT ELIGIBILITY, MEDSTAR HEALTH'S FACILITIES WILL ASSIST UNINSURED PATIENTS WHO RESIDE WITHIN THE COMMUNITIES WE SERVE IN ONE OR MORE OF THE FOLLOWING WAYS: " ASSIST WITH ENROLLMENT IN PUBLICLY-FUNDED ENTITLEMENT PROGRAMS (E.G., MEDICAID). " ASSIST WITH ENROLLMENT IN PUBLICLY-FUNDED PROGRAMS FOR THE UNINSURED (E.G., D.C. HEALTHCARE ALLIANCE). " ASSIST WITH CONSIDERATION OF FUNDING THAT MAY BE AVAILABLE FROM OTHER CHARITABLE ORGANIZATIONS. " PROVIDE CHARITY CARE AND FINANCIAL ASSISTANCE ACCORDING TO APPLICABLE GUIDELINES. " PROVIDE FINANCIAL ASSISTANCE FOR PAYMENT OF FACILITY CHARGES USING A SLIDING SCALE BASED ON PATIENT FAMILY INCOME AND FINANCIAL RESOURCES. " OFFER PERIODIC PAYMENT PLANS TO ASSIST PATIENTS WITH FINANCING THEIR HEALTHCARE SERVICES. EACH MEDSTAR HEALTH FACILITY (IN COOPERATION AND CONSULTATION WITH THE FINANCE DIVISION OF MEDSTAR HEALTH) WILL SPECIFY THE COMMUNITIES IT SERVES BASED ON THE GEOGRAPHIC AREAS IT HAS SERVED HISTORICALLY FOR THE PURPOSE OF IMPLEMENTING THIS POLICY. EACH FACILITY WILL POST THE POLICY, INCLUDING A DESCRIPTION OF THE APPLICABLE COMMUNITIES IT SERVES, IN EACH MAJOR PATIENT REGISTRATION AREA AND IN ANY OTHER AREAS REQUIRED BY APPLICABLE REGULATIONS, WILL COMMUNICATE THE INFORMATION TO PATIENTS AS REQUIRED BY THIS POLICY AND APPLICABLE REGULATIONS AND WILL MAKE A COPY OF THE POLICY AVAILABLE TO ALL PATIENTS. MEDSTAR HEALTH BELIEVES THAT ITS PATIENTS HAVE PERSONAL RESPONSIBILITIES RELATED TO THE FINANCIAL ASPECTS OF THEIR HEALTHCARE NEEDS. THE CHARITY CARE, FINANCIAL ASSISTANCE, AND PERIODIC PAYMENT PLANS AVAILABLE UNDER THIS POLICY WILL NOT BE AVAILABLE TO THOSE PATIENTS WHO FAIL TO FULFILL THEIR RESPONSIBILITIES. FOR PURPOSES OF THIS POLICY, PATIENT RESPONSIBILITIES INCLUDE: " COMPLETING FINANCIAL DISCLOSURE FORMS NECESSARY TO EVALUATE THEIR ELIGIBILITY FOR PUBLICLY-FUNDED HEALTHCARE PROGRAMS, CHARITY CARE PROGRAMS, AND OTHER FORMS OF FINANCIAL ASSISTANCE. THESE DISCLOSURE FORMS MUST BE COMPLETED ACCURATELY, TRUTHFULLY, AND TIMELY TO ALLOW MEDSTAR HEALTH'S FACILITIES TO PROPERLY COUNSEL PATIENTS CONCERNING THE AVAILABILITY OF FINANCIAL ASSISTANCE. " WORKING WITH THE FACILITY'S FINANCIAL COUNSELORS AND OTHER FINANCIAL SERVICES STAFF TO ENSURE THERE IS A COMPLETE UNDERSTANDING OF THE PATIENT'S FINANCIAL SITUATION AND CONSTRAINTS. " COMPLETING APPROPRIATE APPLICATIONS FOR PUBLICLY-FUNDED HEALTHCARE PROGRAMS. THIS RESPONSIBILITY INCLUDES RESPONDING IN A TIMELY FASHION TO REQUESTS FOR DOCUMENTATION TO SUPPORT ELIGIBILITY. " MAKING APPLICABLE PAYMENTS FOR SERVICES IN A TIMELY FASHION, INCLUDING ANY PAYMENTS MADE PURSUANT TO DEFERRED AND PERIODIC PAYMENT SCHEDULES. " PROVIDING UPDATED FINANCIAL INFORMATION TO THE FACILITY'S FINANCIAL COUNSELORS ON A TIMELY BASIS AS THE PATIENT'S CIRCUMSTANCES MAY CHANGE. COMMUNITY INFORMATION PART VI, LINE 4 GEOGRAPHIC: LOCATED IN MONTGOMERY COUNTY MARYLAND, MEDSTAR MONTGOMERY MEDICAL CENTER SERVES THE GREATER BALTIMORE AND WASHINGTON, D.C. METRO AREAS, WITH THE LARGE MAJORITY OF PATIENTS ORIGINATING IN MONTGOMERY COUNTY. DEMOGRAPHIC: THE POPULATION OF MONTGOMERY COUNTY IS SPLIT ALMOST EVENLY BETWEEN MALES (48.5%) AND FEMALES (51.5%) AND RELATIVELY DIVERSE, WITH 57.5% CAUCASIAN, 17.2% AFRICAN AMERICAN, 13.9% ASIAN, 0.4% AMERICAN INDIAN/ALASKA NATIVE AND 0.1% NATIVE HAWAIIAN/OTHER PACIFIC ISLANDER. COMPARED TO THE STATE AVERAGE (8.2%), THE COUNTY ALSO HAS A LARGE AND GROWING HISPANIC POPULATION (17%). THE MEDIAN AGE IS 36.8 YEARS, WITH A LIFE EXPECTANCY OF 83.8. WHILE THE MEDIAN ANNUAL HOUSEHOLD INCOME IS $93,774, THERE ARE POCKETS OF POVERTY; 6.7% OF HOUSEHOLDS HAVE ANNUAL INCOMES AT OR BELOW THE FEDERAL POVERTY LINE. ADDITIONALLY, 11.5% OF THE POPULATION IS UNINSURED AND 6.9% RECEIVE MEDICAID. PROMOTION OF COMMUNITY HEALTH PART VI, LINE 5 AS A COMMUNITY PARTNER, MMMC ENGAGES IN A NUMBER OF COMMUNITY BENEFIT ACTIVITIES TO IMPROVE AND PROMOTE THE HEALTH AND WELLBEING OF THE COMMUNITY. FOR EXAMPLE, THE HOSPITAL PROVIDES FREE SCREENINGS FOR BLOOD PRESSURE, BODY FAT/WAIST HIP RATIO, PODIATRY, SLEEP APNEA, VISION, CHOLESTEROL, BONE DENSITY AND ORAL HEALTH AT THE ANNUAL HEALTH EXPO. INFORMATION ON PREVENTION, EARLY DETECTION, TREATMENT, DIAGNOSIS AND CARE FOR VARIOUS DISEASES WAS ALSO OFFERED. ATTENDEES ENJOY PHYSICIAN LECTURES BY MGH MEDICAL STAFF, GIVEAWAYS, AND MULTIPLE INTERACTIVE HEALTH BOOTHS. EDUCATING THE COMMUNITY ABOUT CANCER PREVENTION AND TREATMENT IS A PRIORITY AT MMMC. AN ONCOLOGY CERTIFIED REGISTERED NURSE IS AVAILABLE TO GUIDE PATIENTS' FAMILIES AND PHYSICIANS THROUGH THE MANY FACETS OF TESTS AND TREATMENTS THAT OFTEN ACCOMPANY A CANCER DIAGNOSIS. THIS CANCER CARE NAVIGATOR NOT ONLY EDUCATES PATIENTS ABOUT CANCER AND TREATMENTS BUT PROVIDES EMOTIONAL SUPPORT AND ENCOURAGEMENT. A COMMUNITY OUTREACH SPECIALIST WITH A PUBLIC HEALTH BACKGROUND PLAYS AN IMPORTANT ROLE PROVIDING EDUCATION AND SUPPORT SERVICES TO UNDERSERVED/LOW-INCOME COMMUNITIES. MMMC IS COMMITTED TO MEETING THE NEEDS OF VULNERABLE POPULATIONS BY ESTABLISHING STRATEGIC PARTNERSHIPS AND ALLIANCES. A PARTNERSHIP WITH PROYECTO SALUD, A NOT-FOR-PROFIT PRIMARY CARE CLINIC IN WHEATON, ENABLES LOW-INCOME, UNINSURED, SPANISH SPEAKING RESIDENTS TO RECEIVE FREE OR LOW COST CULTURALLY SENSITIVE HEALTHCARE SERVICES AT A SATELLITE SITE ON THE GROUNDS OF MMMC. UNDER THE TERMS OF THE AGREEMENT, MMMC PROVIDES PROYECTO SALUD WITH FREE SPACE TO PROVIDE PATIENT CARE. THE MEDICAL CENTER ALSO PROVIDES PARTIAL FINANCIAL SUPPORT FOR OPERATIONS AND MARKETING. THE CLINIC'S SERVICES FOCUS ON PRIMARY ADULT HEALTHCARE INCLUDING PHYSICAL EXAMINATIONS, HEALTH COUNSELING AND EDUCATION, AND BASIC LABORATORY SERVICES. IN ADDITION, THE CLINIC OFFERS A SEASONAL FLU CLINIC FOCUSED ON PREVENTION WITH VACCINATIONS. PRESCRIPTION MEDICATIONS ARE MADE AVAILABLE THROUGH THE MONTGOMERY CARES PROGRAM. THE CLINIC ALSO PROVIDES REFERRALS FOR COUNTY SPECIALTY SERVICES, STD, HIV PROGRAMS, WOMEN'S CANCER CONTROL PROGRAM, FAMILY PLANNING AND AFFORDABLE ALCOHOL TREATMENT AND REHABILITATION. AFFILIATED HEALTH CARE SYSTEM PART VI, LINE 6 AS A PROUD MEMBER OF MEDSTAR HEALTH, MEDSTAR MONTGOMERY MEDICAL CENTER IS ABLE TO EXPAND ITS CAPACITY TO MEET THE NEEDS OF THE COMMUNITY BY PARTNERING WITH OTHER MEDSTAR HOSPITALS AND ASSOCIATED ENTITIES. MEDSTAR HEALTH RESOURCES ASSIST THE HOSPITAL IN COMMUNITY HEALTH PLANNING TO MEET THE NEEDS OF THE UNINSURED AND OTHER VULNERABLE POPULATIONS. THROUGH ITS COMMUNITY HEALTH FUNCTION, MEDSTAR HEALTH PROVIDES MONTGOMERY GENERAL HOSPITAL WITH TECHNICAL SUPPORT TO ENHANCE COMMUNITY HEALTH PROGRAMMING AND EVALUATION. MEDSTAR'S CORPORATE PHILANTHROPY DIVISION IDENTIFIES PUBLIC AND PRIVATE FUNDING SOURCES TO ENSURE THE AVAILABILITY OF HIGH QUALITY HEALTH SERVICES, REGARDLESS OF ABILITY TO PAY. STATE FILING OF COMMUNITY BENEFIT REPORT PART VI, LINE 7 THE COMMUNITY BENEFIT REPORT FOR MEDSTAR MONTGOMERY MEDICAL CENTER IS ONLY FILED IN THE STATE OF MARYLAND. X X X X X X false true false false false false false false false PETER W MONGE 459924 0 316501 0 0 0 5432 0 9846 0 791703 0 0 0 Roger Leonard 270251 0 102638 0 0 0 901 0 10312 0 384102 0 0 0 Connie Stone 143807 0 31235 0 0 0 331 0 6517 0 181890 0 0 0 Kevin Mell 161471 0 30079 0 0 0 3922 0 6450 0 201922 0 0 0 KEVIN MCMAHON 41800 132385 0 0 0 0 0 0 0 3311 41800 135696 0 0 KENNETH A SAMET 0 1180163 0 1354791 0 590140 0 112797 0 19468 0 3257359 0 0 Jeanne O Toole 127223 0 29869 0 0 0 11579 0 10567 0 179238 0 0 0 Randall Bursaw 153216 0 1000 0 0 0 8063 0 10278 0 172557 0 0 0 Owen Horn 139107 0 0 0 0 0 6372 0 10551 0 156030 0 0 0 David Havrilla 215211 0 97538 0 0 0 5310 0 16279 0 334338 0 0 0 JAN ROWE 122307 0 28795 0 0 0 10749 0 10532 0 172383 0 0 0 M JOY DRASS MD 0 681636 0 566351 0 0 0 16263 0 19040 0 1283290 0 0 SUPPLEMENTAL RETIREMENT PLAN SCHEDULE J, PART I, LINE 4B KENNETH SAMET KENNETH SAMET'S OTHER REPORTABLE COMPENSATION IN PART II, COLUMN (B) (III) INCLUDES $568,506 REPRESENTING MR. SAMET'S ACCRUED BENEFIT IN A SUPPLEMENTAL RETIREMENT PLAN, WHICH WAS EARNED DURING THE PAST 22 YEARS OF SERVICE. THIS AMOUNT WAS NOT ACTUALLY PAID TO MR. SAMET, BUT WAS REPORTED AS COMPENSATION UNDER FICA TAX-REPORTING RULES. DR KEVIN MCMAHON (FIN ASSISTANCE) X 63892 60698 false false true 60698 LOAN TO BOARD MEMBER SCHEDULE L, PART II DR. KEVIN MCMAHON, A BOARD MEMBER AT MONTGOMERY GENERAL HOSPITAL, HAS AN OUTSTANDING LOAN FROM THE HOSPITAL. THE GENERAL PURPOSE OF THE LOAN WAS TO PROVIDE FINANCIAL ASSISTANCE FOR PAYMENT OF DR. MCMAHON'S MALPRACTICE TAIL INSURANCE. THE ORIGINAL PRINCIPAL AMOUNT OF THE LOAN WAS $63,892. THE BALANCE DUE ON THE LOAN AT JUNE 30, 2011 WAS $60,698. THE LOAN IS NOT IN DEFAULT. THERE IS A WRITTEN AGREEMENT SUPPORTING THIS LOAN. EXEMPT PURPOSE ACHIEVEMENTS PART III, LINE 4A MMMC IS ACCREDITED BY THE SOCIETY OF CHEST PAIN CENTERS AND IS A RECIPIENT OF THE JOINT COMMISSION PRIMARY STROKE CENTER CERTIFICATION. FOR THE SECOND CONSECUTIVE YEAR, MMMC WAS THE RECIPIENT OF THE DELMARVA FOUNDATION MEDICARE EXCELLENCE AWARD FOR QUALITY IMPROVEMENT. ORGANIZATION MEMBERS PART VI, LINE 6 THE ORGANIZATION IS AN AFFILIATE AND SUBSIDIARY OF MEDSTAR HEALTH, INC., A TAX-EXEMPT MARYLAND NON-STOCK CORPORATION. MEDSTAR HEALTH, INC., OR ONE OF ITS AFFILIATES AND SUBSIDIARIES, IS THE SOLE MEMBER OF THE ORGANIZATION. DESCRIPTION OF MEMBERS PART VI, LINES 7A AS AN AFFILIATE AND SUBSIDIARY OF MEDSTAR HEALTH, INC., A TAX-EXEMPT MARYLAND NON-STOCK CORPORATION, THE ORGANIZATION MAY RECOMMEND PERSON(S) FOR MEMBERSHIP ON THE ORGANIZATION'S GOVERNING BODY. ANY SUCH RECOMMENDATION BY THE ORGANIZATION IS SUBJECT TO APPROVAL BY THE GOVERNANCE COMMITTEE OF THE BOARD OF DIRECTORS OF MEDSTAR HEALTH, INC. THE BOARD OF MEDSTAR HEALTH, INC. HAS DELEGATED CERTAIN APPROVAL AUTHORITY TO THE GOVERNANCE COMMITTEE AND THE PRESIDENT & CEO OF MEDSTAR HEALTH, INC. DECISIONS OF GOVERNING BODY PART VI, LINES 7B AS AN AFFILIATE AND SUBSIDIARY OF MEDSTAR HEALTH, INC., A TAX-EXEMPT MARYLAND NON-STOCK CORPORATION, THE BYLAWS OF THE ORGANIZATION ARE SUBJECT TO CERTAIN RESERVED POWERS, WHICH PROVIDE THAT THE SOLE MEMBER OF THE ORGANIZATION MUST APPROVE CERTAIN DECISIONS, INCLUDING BUT NOT LIMITED TO MATTERS CONCERNING THE SALE OR PURCHASE OF REAL OR PERSONAL PROPERTY, CAPITAL BUDGETS, STRATEGIC PLANNING, INVESTMENTS, AND CORPORATE GOVERNANCE. FORM 990 REVIEW PROCESS PART VI, LINE 11A THE PROCESS FOR REVIEWING THE FORM 990 INCLUDED EDUCATION AND TRANSPARENCY. SENIOR FINANCIAL EXECUTIVES, WORKING WITH INDEPENDENT OUTSIDE EXPERTS, THOROUGHLY REVIEWED FORM 990 AND ACCOMPANYING INSTRUCTIONS. IN ADDITION, SENIOR EXECUTIVES REVIEWED THE RELEVANT SECTIONS OF THE FORM 990 WITH THE FOLLOWING COMMITTEES OF THE ORGANIZATION'S GOVERNING BODY: FINANCE, AUDIT, GOVERNANCE, STRATEGIC PLANNING, AND EXECUTIVE COMPENSATION. FOLLOWING THESE MEETINGS, THE GOVERNING BODY WAS PROVIDED A COPY OF THE FORM 990 IN ITS FINAL FORM AND GIVEN AN OPPORTUNITY TO PROVIDE ANY INPUT OR COMMENTS RELATING TO THE FORM 990 PRIOR TO ITS FILING. CONFLICT OF INTEREST POLICY PART VI, LINE 12C APPOINTMENT OF BOARDS OF DIRECTORS MEDSTAR HEALTH (AND ITS SUBSIDIARIES) REQUIRE ALL NOMINATED DIRECTORS, PRIOR TO THEIR APPOINTMENT OR ELECTION, TO DISCLOSE THE EXISTENCE OF (OR POTENTIAL EXISTENCE OF) ANY TRANSACTION WITH MEDSTAR THAT WOULD RESULT IN A CONFLICT OF INTEREST. SUCH DISCLOSURES (IF ANY) ARE REVIEWED BY THE GOVERNANCE COMMITTEE OF THE MEDSTAR HEALTH BOARD OF DIRECTORS WHICH DETERMINES HOW THE MATTER SHOULD BE RESOLVED. ANNUAL DISCLOSURES - ALL OFFICERS, DIRECTORS, AND SENIOR MANAGERS ALL OFFICERS, DIRECTORS AND SENIOR MANAGERS ARE REQUIRED, NOT LESS THAN ANNUALLY, TO COMPLETE A SURVEY OF QUESTIONS CONCERNING ANY TRANSACTIONS OR RELATIONSHIPS WHICH WOULD OR COULD REPRESENT A CONFLICT OF INTEREST. SUCH DISCLOSURES (IF ANY) ARE REVIEWED BY THE GOVERNANCE COMMITTEE OF THE MEDSTAR HEALTH BOARD OF DIRECTORS WHICH DETERMINES HOW THE MATTER SHOULD BE RESOLVED. IN ADDITION, OFFICERS AND DIRECTORS OF MARYLAND HOSPITALS AND NURSING CENTERS ARE REQUIRED TO ANNUALLY DISCLOSE ADDITIONAL INFORMATION RELATING TO POTENTIAL CONFLICTS OF INTEREST AND SUCH DISCLOSURES ARE REPORTED TO THE MARYLAND HEALTH SERVICES COST REVIEW COMMISSION (HSCRC). EXECUTIVE COMPENSATION PROCESS PART VI, LINE 15 THE EXECUTIVE COMPENSATION COMMITTEE OF THE BOARD OF DIRECTORS OF MEDSTAR HEALTH, INC. (THE "COMMITTEE") HAS OVERSIGHT OVER THE EXECUTIVE COMPENSATION PROGRAM (THE "PROGRAM") OF MEDSTAR HEALTH, INC. AND ITS AFFILIATES. TOTAL COMPENSATION FOR THE TOP MANAGEMENT OFFICIALS, OFFICERS AND KEY EMPLOYEES OF MEDSTAR HEALTH, INC. AND ITS AFFILIATES ARE REVIEWED AND APPROVED BY THE COMMITTEE WITH ASSISTANCE AND GUIDANCE FROM AN INDEPENDENT THIRD PARTY ADVISOR. THE MEMBERS OF THE COMMITTEE ARE INDEPENDENT FROM ALL OF THE PARTICIPANTS IN THE PROGRAM. THE MAIN OBJECTIVE OF THE PROGRAM IS TO PROVIDE MARKET COMPETITIVE TOTAL COMPENSATION THAT IS INTERNALLY EQUITABLE AND HAS A STRONG PAY-FOR-PERFORMANCE LINKAGE. PERFORMANCE IS EVALUATED AT THE SYSTEM, OPERATING UNIT, AND INDIVIDUAL LEVELS. THE OVERALL TOTAL COMPENSATION PHILOSOPHY IS MANAGED AT THE 75TH PERCENTILE OF THE COMPETITIVE MARKET FOR COMPARABLE SIZE (NET REVENUE) AND TYPE ("TAX-EXEMPT HEALTHCARE ORGANIZATIONS"). WHERE APPROPRIATE, ADDITIONAL INDUSTRY DATA IS CONSIDERED (GENERAL BUSINESS AND/OR TAXABLE HEALTHCARE) FOR SELECTED POSITIONS THAT CAN BE RECRUITED FROM OR POTENTIALLY LOST TO THESE INDUSTRIES (E.G., INFORMATION TECHNOLOGY, FINANCE, ETC.). THE COMMITTEE HAS ENGAGED ERNST & YOUNG LLP ("E&Y") TO SERVE AS AN ADVISOR ON THE REASONABLENESS AND COMPETITIVENESS OF THE PROGRAM. IN DETERMINING REASONABLENESS AND COMPETITIVENESS, E&Y REVIEWS MARKET PRACTICES AND TRENDS, AND MAKES RECOMMENDATIONS RELATED TO THE PROGRAM. E&Y UTILIZES INFORMATION FROM CUSTOM SURVEYS, NATIONAL COMPENSATION SURVEYS, PROPRIETARY DATABASES, AND CLIENT EXPERIENCES TO DETERMINE ITS FINAL RECOMMENDATIONS. E&Y PRESENTS THEIR FINDINGS AND RECOMMENDATIONS TO THE COMMITTEE. THE COMMITTEE MAKES THE FINAL DECISIONS ON ALL OF THE COMPENSATION DETERMINATIONS OF THE PROGRAM. ALL DECISIONS MADE BY THE COMMITTEE ARE CONTEMPORANEOUSLY DOCUMENTED. FINANCIAL STATEMENT AVAILABILITY PART VI, LINE 19 MEDSTAR HEALTH POSTS ITS ANNUAL FINANCIAL AUDIT AND QUARTERLY FINANCIAL REPORTS TO THE ELECTRONIC MUNICIPAL MARKET ACCESS (EMMA) SYSTEM. THE ORGANIZATION ALSO E-MAILS ITS ANNUAL AND QUARTERLY DISCLOSURES TO HOLDERS OF THE COMPANY'S PUBLICLY TRADED DEBT. THE COMPANY'S GOVERNANCE DOCUMENTS AND CONFLICTS OF INTEREST POLICIES ARE AVAILABLE UPON REQUEST THROUGH ITS CORPORATE (OR AS APPLICABLE ENTITY) PUBLIC INFORMATION OFFICES OTHER CHANGES IN NET ASSETS PART XI, LINE 5 UNREALIZED GAIN - OTHER INVESTMENTS.....................$ 2,396,879 EQUITY TRANSFERS - NET ASSETS........................... (61,511,106) PRIOR PERIOD ADJUSTMENTS................................ (654,158) ============= TOTAL $ (59,768,385) HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:KENNETH A SAMET TITLE:Director HOURS:40 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:M JOY DRASS MD TITLE:DIRECTOR HOURS:40 Medstar Health Anesthesia Services E LLC 18101 Prince Philip Drive Olney MD 20832 262918268 Health SVCS MD 3867887 495783 na Church Home Corporation 5565 Sterrett Place 5th Floor Columbia MD 21044 237374724 Medical Fund MD 501(c)(3) PF NA Franklin Square Hospital Center Inc 9000 Franklin Square Drive Baltimore MD 21237 520608007 Hospital MD 501(c)(3) 3 NA Harbor Hospital Inc 3001 South Hanover Street Baltimore MD 21225 520491660 Hospital MD 501(c)(3) 3 NA Medstar Health Inc 5565 Sterrett Place 5th Floor Columbia MD 21044 522087445 Medical Svcs MD 501(c)(3) 11b II NA The Good Samaritan Hospital of Maryland 5601 Loch Raven Blvd Baltimore MD 21239 520591607 Hospital MD 501(c)(3) 3 NA The Union Memorial Hospital 201 East University Parkway 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