2012-05-11T10:29:32-05:00 2011-06-30 DELOITTE TAX LLP 200 RENAISSANCE CENTER SUITE 3900 DETROIT MI 48243 990 2010-07-01 520591657 ST AGNES HEALTHCARE INC STAG 4103682491 900 CATON AVENUE NO 040 BALTIMORE MD 212295201 SCOTT FURNISS 4103683130 2012-05-11 1 JENNIFER L GILARDI 3133963000 2010 2016-02-24 21:20:13Z BONNIE PHIPPS 900 CATON AVENUE NO 040 BALTIMORE MD 212295201 426961229 0 X WWW.STAGNES.ORG X 1862 MD ST. AGNES HEALTHCARE IS COMMITTED TO SPIRITUALLY-CENTERED HEALTH CARE WHICH IS ROOTED IN THE HEALING MINISTRY OF JESUS, WITH A SPECIAL CONCERN FOR THOSE WHO ARE POOR AND VULNERABLE. AS A CATHOLIC HEALTHCARE MINISTRY, WE ARE DEDICATED TO THE ART OF HEALING TO IMPROVE THE LIVES OF THOSE THAT WE SERVE. 18 17 3342 202 4810453 -340992 3150286 2538629 370493603 390651963 23425917 29360028 3242726 4260951 400312532 426811571 220297 172827 0 0 185283470 193953318 55500 0 0 163981672 168869193 349540939 362995338 50771593 63816233 418680261 484392822 171668134 153786674 247012127 330606148 X ST. AGNES HEALTHCARE IS A SPIRITUALLY CENTERED HOSPITAL WHICH IS ROOTED IN THE HEALING MINISTRY OF JESUS. IN THE SPIRIT OF ST. ELIZABETH ANN SETON, AND IN COLLABORATION WITH OTHERS, WE CONTINUALLY REACH OUT TO ALL PERSONS IN OUR COMMUNITY WITH A SPECIAL CONCERN FOR THOSE WHO ARE POOR AND VULNERABLE. AS A CATHOLIC HEALTHCARE MINISTRY AND A MEMBER OF ASCENSION HEALTH, WE ARE DEDICATED TO THE ART OF HEALING TO SUSTAIN AND IMPROVE THE LIVES OF THE INDIVIDUALS, FAMILIES AND COMMUNITIES WE SERVE; WE ADVOCATE FOR A JUST SOCIETY.THROUGH OUR WORDS AND DEEDS, WE MINISTER IN AN ATMOSPHERE OF DEEP RESPECT, LOVE AND COMPASSION.PATIENTS ARE OUR PASSION. OUR PHYSICIANS, NURSES AND ASSOCIATES ARE OUR PRIDE. HEALING IS OUR JOY. WE ARE WIDELY KNOWN FOR THE WAY OUR PHYSICIANS, NURSES AND ASSOCIATES COMBINE SOPHISTICATED MEDICAL TECHNOLOGY WITH SPIRITUALITY AND COMPASSION. SHOULDER-TO-SHOULDER, WE STAND UNITED IN OUR COMMITMENT TO CARE FOR THOSE IN NEED. WE WILL BE A LEADER IN SERVICE EXCELLENCE. 0 0 183032490 0 232827903 ST. AGNES HOSPITAL PROVIDES A SUBSTANTIAL PORTION OF ITS SERVICES TOTHE ELDERLY AND POOR. DURING THE FISCAL YEAR ENDING JUNE 30, 2011, APPROXIMATELY 45% OF THE VALUE OF SERVICES RENDERED WAS TO ELDERLY PATIENTS UNDER THE MEDICARE PROGRAM, AND APPROXIMATELY 15% OF THE VALUE OF SERVICES WAS PROVIDED TO PATIENTS WHO WERE DEEMED INDIGENT UNDER STATE, COUNTY, OR HOSPITAL GUIDELINES. IN THE SPIRIT OF PRINCIPLES ADOPTED BY ASCENSION HEALTH, ST. AGNES HOSPITAL HAS TAKEN PROACTIVE STEPS TO ADDRESS THOSE ISSUES THAT WILL AFFECT ACCESSIBILITY, THE FINANCING, AND THE DELIVERY OF HEALTHCARE TO ALL PERSONS, ESPECIALLY THE UNINSURED, UNDERINSURED, AND THE UNDERSERVED. DURING THE FISCAL YEAR ENDING JUNE 30, 2011, THE ESTIMATED UNREIMBURSED COST OF SERVICES PROVIDED TO THE ELDERLY, UNINSURED, AND UNDERINSURED TOTALED $16,617,518, INCLUDING $12,314,893 FOR CHARITY CARE, AND $4,302,625 OF UNREIMBURSED MEDICAID. 6820772 172827 713045 COMMUNITY BENEFITS ARE PROGRAMS OR ACTIVITIES THAT PROVIDE TREATMENTAND/OR PROMOTE HEALTH AND HEALING AS A RESPONSE TO IDENTIFIED COMMUNITYNEEDS. IN AN EFFORT TO PROMOTE HEALTHY LIVING, ST. AGNES HAS MADE AVAILABLE WELLNESS PROGRAMS TO THE COMMUNITY. THESE PROGRAMS INCLUDE, BUT ARE NOT LIMITED TO: ADULT, INFANT AND CHILD CPR CLASSES; ASTHMA CURRICULA; BARIATRIC SEMINARS; BASIC LIFE SUPPORT CLASSES; BREAST HEALTH CLINICS AND SEMINARS; FIRST AID CLASSES; JOINT AND PAIN SEMINARS; RUNNING CLINICS; BABYSITTING CLASSES; BLOOD PRESSURE, CHOLESTEROL, AND BLOOD SUGAR SCREENINGS; DIABETES AND HEART DISEASE PREVENTION EDUCATION; INTERNATIONAL EARLY LUNG CARE ACTION PROJECT STUDIES; HEART HEALTH AWARENESS PROGRAMS FOR AFRICAN AMERICAN WOMEN; GASTRO ESOPHAGEAL REFLUX DISEASE SEMINARS; ACTIVITIES IN THE PEDIATRICS WAITING ROOM OF THE COMMUNITY CARE CLINIC PROMOTING EARLY DEVELOPMENT OF READING SKILLS; ACTIVITIES RELATED TO THE SUCCESSFUL DISCHARGE OF PATIENTS SUCH AS PROVIDING TRANSPORTATION, PRESCRIPTIONS, OXYGEN, DURABLE MEDICAL EQUIPMENT, AND SHORT-TERM STAYSIN NURSING OR REHABILITATION CENTERS; AND PROVIDING GYNECOLOGICAL SERVICES TO UNINSURED, LARGELY SPANISH SPEAKING PERSONS AT THE ESPERANZA CLINIC; AND THE WELL4LIFE PROGRAM, WHICH USES A MULTIDISCIPLINARY APPROACH TO WEIGHT LOSS, EXERCISE, LIFESTYLE AND MINDSET CHANGES, FOCUSED ON BATTLING OBESITY CHALLENGES.ST. AGNES HEALTHCARE HAS A LONG STANDING TRADITION OF PROVIDING MEDICALEDUCATION AND TRAINING. ST. AGNES ADMINISTERS A FIVE YEAR, FULLYACCREDITED, GENERAL SURGERY RESIDENCY PROGRAM CONSISTING OF TWENTYSURGICAL RESIDENTS. THIS ACADEMICALLY ORIENTED, COMMUNITY BASED, UNIVERSITY AFFILIATED RESIDENCY PROGRAM IS THE SECOND OLDEST SURGICAL RESIDENCY PROGRAM IN THE UNITED STATES. THE PROGRAM IS ACTIVE IN BOTH BASIC AND ADVANCED LAPAROSCOPIC SURGERY. RESIDENTS ARE OFFERED A BROAD BASED SURGICAL EXPERIENCE WITH EXPOSURE NOT ONLY TO THE FIELD OF GREATER GENERAL SURGERY, BUT ALSO TO ALL THE SURGICAL SPECIALTIES. THERE IS EXTENSIVE EXPERIENCE AND TRAINING IN MANAGING THE CRITICALLY ILL SURGICAL PATIENT. ADDITIONALLY, THE PROGRAM ALSO CONTAINS ROTATIONS IN BURN MANAGEMENT, TRAUMA, TRANSPLANT AND GASTROINTESTINAL ENDOSCOPY. THE DEPARTMENT OF SURGERY INCLUDES MORE THAN 198 SURGEONS IN 10 SURGICAL SPECIALTIES. THERE ARE TWENTY-SIX FULL-TIME SURGEONS IN THE DEPARTMENT COMPLEMENTED BY ATTENDING SURGEONS WHO ARE DEDICATED TO THE RESIDENCY-TRAINING PROGRAM AND ARE ACTIVELY INVOLVED IN THE TEACHING PROGRAM. MEDICAL STUDENTS HAVE ALSO BEEN A PART OF ST. AGNES' TRAINING PROGRAM FOR MORE THAN SIX DECADES. THE OPPORTUNITY FOR THE RESIDENTS TO TEACH THE STUDENTS CONTRIBUTES SIGNIFICANTLY TO THE PROFESSIONAL DEVELOPMENT OF THE RESIDENT AND PROVIDES A VITAL SERVICE TO THE STUDENT.ST. AGNES ALSO HAS A MEDICAL RESIDENCY PROGRAM CONSISTING OF FORTYRESIDENTS. THE DYNAMIC INTERACTION BETWEEN THE FACULTY AND THE HOUSESTAFF CREATES A STIMULATING INTELLECTUAL ENVIRONMENT CENTERED ON THEKEY PRINCIPLES OF PATIENT CARE, EDUCATION AND CLINICAL RESEARCH. SIMILAR TO THE SURGICAL RESIDENTS, THE MEDICAL RESIDENTS ARE INVOLVED IN THE TEACHING OF MEDICAL STUDENTS. DUE TO ST. AGNES' AFFILIATION WITH THE UNIVERSITY OF MARYLAND MEDICAL SCHOOL AND JOHNS HOPKINS SCHOOL OF MEDICINE, THE RESIDENTS ARE PRESENTED AN OPPORTUNITY TO ROTATE THROUGH THOSE HOSPITALS, FURTHER ENRICHING THE PATIENT CARE EXPERIENCE. THE RESIDENCY PROGRAM ALLOWS THE RESIDENTS TO BECOME PROFICIENT IN OBTAINING CLINICAL DATA BY PATIENT INTERVIEW, PHYSICAL EXAMINATION, AND INTERPRETATION OF LABORATORY DATA. THE RESIDENTS ALSO BECOME PROFICIENT IN UTILIZING CLINICAL DATA TO PRIORITIZE PROBLEMS AND FORMULATE DIFFERENTIAL DIAGNOSES. THE TRAINING PROGRAM HELPS THE RESIDENTS LEARN TO FORMULATE DIAGNOSTIC AND THERAPEUTIC PLANS DEMONSTRATING AWARENESS OF RISKS, BENEFITS, COSTS, PATIENT PREFERENCES, AND ETHICAL AND PSYCHOSOCIAL ISSUES. 110943315 0 192209230 ST. AGNES HOSPITAL PROVIDES THE FOLLOWING IN-PATIENT AND OUTPATIENT MEDICAL SERVICES TO THE COMMUNITY: AMBULATORY CARE CENTER SERVICES, CARDIOVASCULAR SERVICES, CANCER TREATMENT SERVICES, EMERGENCY CARE CENTER SERVICES, LABORATORY SERVICES, ORTHOPEDIC SERVICES, PAIN MANAGEMENT, PRIMARY CARE PHYSICIANS, RADIOLOGY SERVICES, REHABILITATION SERVICES, SLEEP STUDIES, STROKE SERVICES, OBSTETRICS, PHYSICAL THERAPY, OCCUPATIONAL THERAPY, SPEECH THERAPY, WOUND CARE, RESPIRATORY THERAPY, SURGERY, PEDIATRICS, IMAGING CLINIC, BARIATRIC SERVICES, RESPIRATORY THERAPY, WOMEN'S HEALTH SERVICES, DIABETES WELLNESS PROGRAMS, PALLIATIVE CARE SERVICES, AND AN ANTICOAGULATION CLINIC. SOME OF THE SERVICES LISTED OPERATE AT A LOSS IN ORDER TO ENSURE THAT ALL SERVICES ARE AVAILABLE TO MEET COMMUNITY HEALTH CARE NEEDS. DURING THE FISCAL YEAR ENDING JUNE 30, 2011, OUR HOSPITAL TREATED 19,618 INPATIENT ADULTS AND CHILDREN IN THE COMMUNITY FOR A TOTAL OF 80,500 PATIENT DAYS OF SERVICE. THE HOSPITAL ALSO PROVIDED SERVICES TO 499,369 OUTPATIENTS, INCLUDING 6,432 OUTPATIENT SURGERY PATIENTS, 68,705 EMERGENCY ROOM VISITS, AND 43,823 CLINIC VISITS. 300796577 1 1 0 1 0 0 0 0 0 1 1 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 1 1 1 1 1 0 0 0 0 0 0 1 0 0 0 0 0 0 1 1 1 0 0 1 295 0 1 3342 1 1 1 0 0 0 0 0 0 0 0 0 X 18 17 1 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 1 1 MD X SCOTT FURNISS 4103683130 900 CATON AVENUE BALTIMORE MD 21229 X SISTER PATRICIA ANN BOSSLE DC 1.40 X 0 0 0 SAM SYDNEY 2.10 X 0 0 0 MARC BUNTING 2.40 X 0 0 0 HECTOR L TORRES 1.50 X 0 0 0 A GREGORY KELLY JR 3.00 X 0 0 0 CHARLES G TILDON III 2.10 X 0 0 0 GARY N GEISEL 2.10 X 0 0 0 BRUCE R GRINDROD JR 1.50 X 0 0 0 SISTER ELLEN MARIE HAGAR 1.70 X 0 0 0 M SUE LOVELL 1.40 X 0 0 0 JAMES B SELLINGER 2.70 X 0 0 0 RONALD H SCHACK 2.80 X 0 0 0 ALBERT R COUNSELMAN 2.00 X 0 0 0 BARBARA BOZZUTO 4.40 X X 0 0 0 JOHN E WHEELER 3.70 X X 0 0 0 BONNIE PHIPPS 50.00 X X 1104994 0 27244 ADIL TOTOONCHIE MD MBA 3.10 X X 0 0 0 PAUL J CHEW 2.10 X X 0 0 0 SCOTT FURNISS 50.00 X 263838 0 25222 ADRIAN LONG 50.00 X 430702 0 32399 WILLIAM GRESKOVICH 50.00 X 265548 0 42785 YOLANDA COPELAND 50.00 X 277150 0 31518 GEORGE GRACE 50.00 X 843960 0 51498 HOWARD HESSAN 50.00 X 778208 0 43745 LAWRENCE SHIN 50.00 X 665947 0 29987 VINEY SETYA 50.00 X 561808 0 21884 ROBERT PALEY 50.00 X 520115 0 34229 5712270 0 340511 10 0 1 0 EAGLEEYE RADIOLOGY INC 12100 SUNRISE VALLEY DRIVE RESTON VA 20191 RADIOLOGY SERVICES 1168000 DRS HICKEN CRANLEY & TAYLOR PA CLINICA 3455 WILKENS AVENUE BALTIMORE MD 21229 CONTRACTUAL SERVICES 1000519 MIDATLANTIC CARDIOVASCULAR 1838 GREENE TREE ROAD BALTIMORE MD 21208 CARDIOLOGY SERVICES 711113 EMCARE INC 7032 COLLECTION CENTER DRIVE CHICAGO IL 60693 CONTRACTUAL SERVICES 534376 ACCESS NURSING SERVICES 411 MANVILLE ROAD PLEASANTVILLE NY 10570 NURSING SERVICES 326932 51 1815903 722726 2538629 PATIENT REVENUE 621990 384433913 379623460 4810453 ANCILLARY JOINT VENT. 900099 4732305 4732305 SYSTEM SUPPORT 900099 780914 780914 MEDICAL STUDENT 900099 704831 704831 390651963 29360028 29360028 710041 149658 560383 560383 560383 CAFETERIA REVENUE 900099 1428053 1428053 NET ASSETS RELEASED 900099 670409 670409 1602106 1602106 3700568 426811571 385841510 4810453 33620979 156232 156232 16595 16595 2528595 2528595 11257102 9682840 1574262 148677368 126755890 21921478 9828468 8254083 1574385 10117752 8497028 1620724 11544033 9694839 1849194 907968 89620 818348 96872 96872 36287 36287 27292637 18681003 8611634 1137338 53597 1083741 67892491 64635280 3257211 8571483 8571483 1865886 1200263 665623 216743 79660 137083 242266 171131 71135 372542 372542 2562467 2562467 14799226 8726233 6072993 2193702 2740362 -546660 BAD DEBTS 16691981 16691981 UTILIZATION 7767255 7767255 UTILITIES 4311880 4311880 RECRUITING COSTS 728017 201389 526628 CME 290726 286431 4295 10891426 3531502 7359924 362995338 300796577 62198761 0 8274448 10174402 3408039 3295641 42184727 45978875 580541 554544 4148141 4775336 1204806 1888963 341726561 129384358 171293200 212342203 2618082 3017359 13312673 16044977 1486920 171655604 184833602 418680261 484392822 34712034 48101034 11710 11710 80586587 80006845 56357803 25667085 171668134 153786674 X 235998571 319306971 10889313 11168819 124243 130358 247012127 330606148 418680261 484392822 X 63816233 19777788 X 0 1 1 X 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 36287 36287 0 EXPLANATION OF OTHER LOBBYING ACTIVITIES: PART II-B, LINE 1I: LOBBYING EXPENSES REPRESENT THE DUES PAID TO NATIONAL AND STATE HOSPITAL ASSOCIATIONS, A PORTION OF WHICH IS SPECIFICALLY ALLOCABLE TO LOBBYING. 2685977 412356 3098333 2374969 311008 2685977 2926667 -551698 2374969 0.96000 0.04000 1 0 488600 488600 141545890 23010916 118534974 2728008 1422152 1305856 78914707 53850477 25064230 118049356 51100813 66948543 212342203 INVESTMENT - DEFERRED COMPENSATION 4702427 INVESTMENT IN EXEC FLEX CAA 151016 CASH SURRENDER VALUE - LIFE 778728 HEALTH SYSTEM DEPOSITORY (HSD) 175228322 INTEREST IN FOUNDATION NET ASSETS 2164778 OTHER NON CURRENT ASSET-FICA RECEIVABLE 1795501 DUE FROM DCNHS-AHRQ GRANT 12830 184833602 PENSION 410113 CURRENT PORTION OF L/T DEBT 579742 OTHER CURRENT LIABILITIES 14108314 OTHER NON-CURRENT LIABILITIES 6417976 SELF INSURANCE LIABILITY 4150940 25667085 PART V, LINE 4, ENDOWMENT FUNDS : WHITEFORD ENDOWMENT - 50% TO BE UTILIZED TO ERECT A WING OR ADDITIONAL BUILDING, ADDITIONAL 50% MAY BE USED TO SUPPORT HOSPITAL OPERATIONS. JENKINS ENDOWMENT - THIS ENDOWMENT WAS ESTABLISHED IN 1911, A PORTION OF THE EARNINGS FROM THE FUND IS RESTRICTED FOR THE CARE OF CANCER PATIENTS. IN AUGUST 2012, THE TIME RESTRICTIONS WILL HAVE BEEN MET AND ST. AGNES PLANS TO USE THE REMAINING BALANCE TO FUND THE CAMPUS REVITILIZATION PROJECT. BROWNE ENDOWMENT - ESTABLISHED FOR USE BY CARDIAC UNIT TO AID THE INDIGENT. GITTINGS ENDOWMENT - CREATED TO PROVIDE A BED IN THE CHILDREN'S WARD. PART X, THE ORGANIZATION DOES NOT CONDUCT A SEPARATE AUDIT OF ITS FINANCIAL STATEMENTS, BUT IS INCLUDED IN THE ASCENSION HEALTH SYSTEM CONSOLIDATED AUDITED FINANCIAL STATEMENTS. PER THE FINANCIAL STATEMENTS OF ASCENSION HEALTH, THERE IS NO CURRENT YEAR ASC 740 (FORMERLY KNOWN AS FIN 48 FOOTNOTE. 1 MD 1 1 1 X 1 X 1 1 1 0 1 1 12314893 12314893 0.03560 8928787 4626162 4302625 0.01190 21243680 4626162 16617518 0.04750 2996448 46948 2949500 0.00810 2563049 524088 2038961 0.00560 443228 142009 301219 0.00080 818047 818047 0.00230 6820772 713045 6107727 0.01680 28064452 5339207 22725245 0.06430 45527 30000 15527 0.00000 45527 30000 15527 1 11783985 147658 137281270 131768096 5513174 X 1 1 1 1 ST AGNES HEALTHCARE INC

900 CATON AVENUE BALTIMORE MD 21229

X X X X X ST AGNES HEALTHCARE INC 1 8 PLASTIC AND RECONSTRUCTIVE SURGERY

300 FREDERICK ROAD SUITE 200 CATONSVILLE MD 21228

PLASTIC SURGERY WOMEN'S CENTER IN COLUMBIA

10910 LITTLE PATUXENT PARKWAY STE 100 COLUMBIA MD 21044

BLOOD DRAWING STATION ST AGNES MEDICAL CENTER

700 GEIPE ROAD BALTIMORE MD 21228

BLOOD DRAWING STATION COMMUNITY CENTER OUTREACH AT BALTIMORE M

900 CATON AVENUE BALTIMORE MD 21229

BLOOD DRAWING STATION PINE HEIGHTS PROFESSIONAL BUILDING

1001 PINE HEIGHTS AVENUE SUITE 202 BALTIMORE MD 21229

BLOOD DRAWING STATION BENSON AVENUE MEDICAL CENTER

3421 BENSON AVENUE BALTIMORE MD 21227

WOUND CARE CENTER SETON IMAGING CENTER

3449 WILKINS AVENUE BALTIMORE MD 21229

DIAGNOSTIC IMAGING SURGERY CENTER OF ELLICOTT CITY

10025 GOVERNOR WARFIELD PKWY SUITE 410 COLUMBIA MD 21044

OUTPATIENT SURGICAL CENTER PART I, LINE 3C: GENERALLY, DISCOUNTED CARE TO LOW INCOME INDIVIDUALS IS PROVIDED ON A SLIDING SCALE FOR THOSE NOT EXCEEDING 300% OF THE FEDERAL POVERTY LEVEL. FOR EMERGENCY DEPARTMENT PATIENTS AND OTHER OUTPATIENTS (ACCOUNT BALANCES UNDER $500.00) MAY BE GRANTED CHARITY EXCLUSIVELY BASED UPON THE USE OF THE AUTOMATED ELIGIBILITY SOFTWARE ONLY. IN THOSE INSTANCES, A SIGNED/COMPLETED APPLICATION WILL NOT BE REQUIRED. ADDITIONALLY, PATIENTS MAY ALSO BE ELIGIBLE FOR CHARITY CARE IF THEY MEET CRITERIA THAT WOULD DETERMINE THAT THEY ARE EXPERIENCING A FINANCIAL HARDSHIP. FINANCIAL HARDSHIP IS DEFINED AS MEDICAL DEBT FOR MEDICALLY NECESSARY SERVICES INCURRED BY A FAMILY WITH INCOME BELOW 500% OF THE FEDERAL POVERTY LEVEL THAT EXCEEDS 25% OF THE FAMILY INCOME OVER A 12 MONTH PERIOD. MEDICAL DEBT IS OUT OF POCKET EXPENSES, EXCLUDING COPAYMENTS, COINSURANCE AND DEDUCTIBLES FOR MEDICAL COSTS BILLED BY ST. AGNES HEALTHCARE. THE PATIENT AND ANY IMMEDIATE FAMILY MEMBER OF THE PATIENT LIVING IN THE SAME HOUSEHOLD ARE ELIGIBLE. PART I, LINE 7: THE COSTING METHODOLOGY USED TO COMPLETE LINE 7A (CHARITY CARE) AND LINE 7B (UNREIMBURSED MEDICAID) IN THE TABLE WAS THE COST TO CHARGE RATIO. THE COST TO CHARGE RATIO WAS CALCULATED IN ACCORDANCE WITH WORKSHEET 2 OF THE INTERNAL REVENUE SERVICE INSTRUCTIONS FOR SCHEDULE H, WHICH SUGGESTS USING THE OPERATING EXPENSES FROM THE FILING ENTITY'S FINANCIAL STATEMENTS, EXCLUDING BAD DEBT AND CERTAIN OTHER ADJUSTMENTS, AND APPLYING THE RESULT TO THE GROSS CHARGES FROM THE FILING ENTITY'S FINANCIAL STATEMENTS. THE RESULTING RATIO IS USED TO CALCULATE CHARITY CARE AT COST AND UNREIMBURSED MEDICAID.PART I LINE 7 CHARITY CARE AT COST - LINE 7A COLUMN D MARYLAND'S REGULATORY SYSTEM CREATES A UNIQUE PROCESS FOR HOSPITAL PAYMENT THAT DIFFERS FROM THE REST OF THE NATION. THE HEALTH SERVICES COST REVIEW COMMISSION, (HSCRC) DETERMINES PAYMENT THROUGH A RATE-SETTING PROCESS AND ALL PAYORS, INCLUDING GOVERNMENTAL PAYORS, PAY THE SAME AMOUNT FOR THE SAME SERVICES DELIVERED AT THE SAME HOSPITAL. MARYLAND'S UNIQUE ALL-PAYOR SYSTEM INCLUDES A METHOD FOR REFERENCING UNCOMPENSATED CARE IN EACH PAYORS' RATES, WHICH DOES NOT ENABLE MARYLAND HOSPITALS TO BREAKOUT ANY OFFSETTING REVENUE RELATED TO UNCOMPENSATED CARE.PT I LINE 7 UNREIMBURSED MEDICAID - COLUMN C,D,E,FMARYLAND'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; MEDICAID RECOGNIZES FULL REIMBURSEMENT. 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 AMOUNTS REPORTED IN PART I,LINE 7B REPRESENT UNREIMBURSED MEDICAID COSTS FOR UNREGULATED HEALTH CARE ACTIVITIES AND THE MEDICAID ASSESSMENT.PART I LINE 7 COLUMN FBAD DEBT EXPENSE FROM PART IX, STATEMENT OF FUNCTIONAL EXPENSES,EXCLUDED FROM THE DENOMINATOR USED TO CALCULATE TOTALCHARITY CARE EXPENSE WAS $16,691,981. PART III, LINE 4: PART III SECTION A - BAD DEBT EXPENSE LINE 2 & 3THE BAD DEBT EXPENSE REPORTED AT COST WAS ESTIMATED USING THE BAD DEBT EXPENSE FROM THE CONSOLIDATED ST. AGNES HEALTHCARE FINANCIAL STATEMENTS, APPLYING THE COST TO CHARGE RATIO DEVELOPED USING WORKSHEET 2 FROM THE SCHEDULE H INSTRUCTIONS. THE STATE OF MARYLAND IS AN "ALL PAYOR" STATE REGULATED BY THE HEALTH SERVICES COST REVIEW COMMISSION (HSCRC) WHERE ALL PAYORS, INCLUDING GOVERNMENTAL PAYORS, PAY THE SAME AMOUNT FOR THE SAME SERVICES DELIVERED AT THE SAME HOSPITAL. THEREFORE, SELF PAY DISCOUNTS, ARE LARGELY NOT APPLICABLE FOR REGULATED ACTIVITY AND HAVE NO IMPACT ON BAD DEBT EXPENSE. THE ESTIMATED AMOUNT OF BAD DEBT EXPENSE, AT COST, ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE ORGANIZATION'S CHARITY CARE POLICY WAS ESTIMATED BY EXAMINING ALL BAD DEBT WRITE-OFFS AT THE PATIENT ACCOUNT LEVEL DURING THE FISCAL YEAR. THOSE ACCOUNTS THAT HAD AN INSURANCE CLASSIFICATIONS OF CHARITY, CHARITY PENDING, OR MEDICAID PENDING THAT WAS SUBSEQUENTLY WRITTEN OFF TO BAD DEBT, ARE ASSUMED TO BE PATIENTS THAT WOULD HAVE BEEN ELIGIBLE FOR ASSISTANCE UNDER THE CHARITY CARE POLICY IF SUFFICIENT INFORMATION WOULD HAVE BEEN PROVIDED TO MAKE THAT DETERMINATION. THE SUM OF THOSE ACCOUNTS, MULTIPLIED BY THE COST TO CHARGE RATIO, IS REPORTED IN SECTION A, LINE 3.PART III LINE 4 SECTION A - BAD DEBT EXPENSENET PATIENT SERVICE REVENUE IS REPORTED AT THE ESTIMATED REALIZABLE AMOUNTS FROM PATIENTS, THIRD-PARTY PAYORS, AND OTHERS FOR SERVICES PROVIDED AND INCLUDES ESTIMATED RETROACTIVE ADJUSTMENTS UNDER REIMBURSEMENT AGREEMENTS WITH THIRD-PARTY PAYORS. REVENUE UNDER CERTAIN THIRD-PARTY PAYOR AGREEMENTS IS SUBJECT TO AUDIT, RETROACTIVE ADJUSTMENTS, AND SIGNIFICANT REGULATORY ACTIONS. PROVISIONS FOR THIRD-PARTY PAYOR SETTLEMENTS AND ADJUSTMENTS ARE ESTIMATED IN THE PERIOD THE RELATED SERVICES ARE PROVIDED AND ADJUSTED IN FUTURE PERIODS AS ADDITIONAL INFORMATION BECOMES AVAILABLE AND AS FINAL SETTLEMENTS ARE DETERMINED. LAWS AND REGULATIONS GOVERNING THE MEDICARE AND MEDICAID PROGRAMS ARE COMPLEX AND SUBJECT TO INTERPRETATION. AS A RESULT, THERE IS AT LEAST A POSSIBILITY THAT RECORDED ESTIMATES WILL CHANGE BY A MATERIAL AMOUNT IN THE NEAR TERM. DURING 2011 AND 2010, APPROXIMATELY 45% AND 44%, RESPECTIVELY, OF NET PATIENT SERVICE REVENUE WAS RECEIVED UNDER THE MEDICARE PROGRAM AND 15% AND 14%, RESPECTIVELY, UNDER VARIOUS STATE MEDICAID PROGRAMS. THE HEALTH MINISTRY GRANTS CREDIT WITHOUT COLLATERAL TO ITS PATIENTS, MOST OF WHOM ARE LOCAL RESIDENTS AND ARE INSURED UNDER THIRD-PARTY PAYOR ARRANGEMENTS. SIGNIFICANT CONCENTRATIONS OF ACCOUNTS RECEIVABLE AT JUNE 30, 2011 AND 2010 INCLUDE MEDICARE (29% AND 31%, RESPECTIVELY) AND VARIOUS STATES' MEDICAID (22% AND 20%, RESPECTIVELY) PROGRAMS. THE PROVISION FOR BAD DEBTS IS BASED UPON MANAGEMENT'S ASSESSMENT OF EXPECTED NET COLLECTIONS CONSIDERING ECONOMIC CONDITIONS, HISTORICAL EXPERIENCE, TRENDS IN HEALTH CARE COVERAGE, AND OTHER COLLECTION INDICATORS. PERIODICALLY THROUGHOUT THE YEAR, MANAGEMENT ASSESSES THE ADEQUACY OF THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS BASED UPON HISTORICAL WRITE-OFF EXPERIENCE BY PAYOR CATEGORY, INCLUDING THOSE AMOUNTS NOT COVERED BY INSURANCE. THE RESULTS OF THIS REVIEW ARE THEN USED TO MAKE ANY MODIFICATIONS TO THE PROVISION FOR BAD DEBTS TO ESTABLISH AN APPROPRIATE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS. AFTER SATISFACTION OF AMOUNTS DUE FROM INSURANCE AND REASONABLE EFFORTS TO COLLECT FROM THE PATIENT HAVE BEEN EXHAUSTED, THE HEALTH MINISTRY FOLLOWS ESTABLISHED GUIDELINES FOR PLACING CERTAIN PAST DUE PATIENT BALANCES WITH COLLECTION AGENCIES, SUBJECT TO THE TERMS OF CERTAIN RESTRICTIONS ON COLLECTION EFFORTS AS DETERMINED BY ASCENSION HEALTH. ACCOUNTS RECEIVABLE ARE WRITTEN OFF AFTER COLLECTION EFFORTS HAVE BEEN FOLLOWED IN ACCORDANCE WITH THE HEALTH MINISTRY'S POLICIES. PART III, LINE 8: INCLUDED IN LINE 5 AND 6 OF SECTION B ARE MEDICARE ALLOWABLE COSTS AND REIMBURSEMENT REPORTED ON THE HOSPITAL'S MEDICARE COST REPORT. THIS INCLUDES REIMBURSABLE ACUTE HOSPITAL SERVICES. IN ADDITION, THE HOSPITAL HAS ALSO INCLUDED MEDICARE NET REVENUES AND EXPENSES FOR NON-HOSPITAL SERVICES NECESSARY TO SUPPORT HOSPITAL OPERATIONS. THIS INCLUDES PROFESSIONAL RADIOLOGY, ANESTHESIA AND OTHER PHYSICIAN SPECIALTY SERVICES.THE MEDICARE SURPLUS OF $17,349,080 FOR HOSPITAL SERVICES WAS CALCULATED BY SUBTRACTING THE MEDICARE COSTS (GROSS MEDICARE REVENUE MULTIPLIED BY THE COST TO CHARGE RATIOS REPORTED ON THE MEDICARE COST REPORT) FROM THE MEDICARE PAYMENTS. NON-HOSPITAL SERVICES SHORTFALL OF $11,835,906 WAS CALCULATED BY MULTIPLYING EACH NON-HOSPITAL SERVICES' MEDICARE PATIENT SHARE BY THE NON-HOSPITAL SERVICES' ANNUAL OPERATING LOSS. 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. THIS UNIQUE PAYMENT SYSTEM IS DESIGNED FOR ALL PAYORS TO SHARE THE COST OF HEALTHCARE EQUALLY, MEANING THE COST SHIFTING TO PRIVATE PAYORS, THAT IS COMMONLY SEEN IN OTHER STATES, IS NOT EXPERIENCED IN MARYLAND. THIS MODEL RESULTS IN A SURPLUS OF PAYMENT OVER EXPENSE. PART III, LINE 9B: IT IS ST. AGNES HEALTHCARE'S POLICY TO PLACE ACCOUNTS THAT HAVE BEEN WRITTEN OFF TO BAD DEBT WITH A COLLECTION AGENCY FOR ADDITIONAL COLLECTION EFFORT. PATIENTS MAY APPLY FOR FINANCIAL ASSISTANCE AT ANY TIME DURING THE REVENUE CYCLE. PATIENTS WHO WORK TO APPLY FOR CHARITY CARE WHOSE ACCOUNT RESIDES AT THE AGENCY WILL BE REFERRED TO THE HOSPITAL BY THE AGENCY. THE AGENCY WILL DELETE THE ACCOUNT AND THE HOSPITAL WILL WORK WITH THE PATIENT TO COMPLETE THE CHARITY CARE APPLICATION PROCESS. EMERGENCY DEPARTMENT PATIENTS AND OTHER OUTPATIENTS (ACCOUNT BALANCES UNDER $500.00) MAY BE GRANTED CHARITY EXCLUSIVELY BASED UPON THE USE OF AN AUTOMATED ELIGIBILITY SOFTWARE. A SIGNED/ COMPLETED APPLICATION WILL NOT BE REQUIRED IN THOSE INSTANCES. PART VI, LINE 2: ST. AGNES HEALTHCARE PREPARES A COMMUNITY NEEDS ASSESSMENT EVERY THREE YEARS, WHICH WAS LAST UPDATED IN APRIL 2007. THE HEALTH STATUS OF A COMMUNITY CAN BE MEASURED BY A VARIETY OF METHODS. CONSIDERATIONS CAN INCLUDE BIRTH AND DEATH RATES, LIFE EXPECTANCY, MORBIDITY, HEALTH INSURANCE COVERAGE, HEALTH RESOURCES AVAILABILITY, AND POPULATION DATA. TO THE EXTENT POSSIBLE, ST. AGNES HEALTHCARE SEEKS TO CONSIDER MANY OF THESE FACTORS. ST. AGNES HEALTHCARE'S COMMUNITY NEEDS ASSESSMENT FOCUSES ON HEALTH STATUS INDICATORS THAT HAVE BEEN GROUPED INTO FOUR KEY AREAS: DEMOGRAPHICS, SOCIOECONOMIC STATUS, HEALTH STATUS, AND HEALTH RESOURCE UTILIZATION/PHYSICIAN MANPOWER NEEDS. TO SUPPORT THE ANALYSIS, READILY AVAILABLE DATA WAS GATHERED FROM THE U.S. CENSUS AND MARYLAND DISCHARGE DATABASES FOR INPATIENT AND EMERGENCY SERVICES, AND POPULATION FORECASTS.THE FIRST HEALTH STATUS INDICATOR GROUPING INVOLVES DEMOGRAPHICS. THE ANALYSIS OF DEMOGRAPHIC DATA INCLUDES A REVIEW OF POPULATION DENSITY, POPULATION AGE LESS THAN OR EQUAL TO FIVE YEARS OLD, POPULATION AGE GREATER THAN OR EQUAL TO SIXTY-FIVE YEARS OLD, FEMALE POPULATION AGES FIFTEEN TO FORTY-FOUR, FEMALE POPULATION GROWTH AGES FIFTEEN TO FORTY-FOUR, POPULATION GROWTH AGE GREATER THAN OR EQUAL TO SEVENTY-FIVEYEARS OLD, AND MINORITY POPULATION.THE SECOND HEALTH STATUS INDICATOR GROUPING INVOLVES SOCIOECONOMIC STATUS. THE ANALYSIS OF SOCIOECONOMIC DATA INCLUDES A REVIEW OF THE PERCENT OF HOUSEHOLDS IN POVERTY, CHILDREN LIVING IN POVERTY, AVERAGE HOUSEHOLD INCOME, POPULATION OF UNINSURED, POPULATION AGE EIGHTEEN TO TWENTY-FOUR WITH A HIGH SCHOOL DIPLOMA, TOTAL POPULATION WITHOUT A HIGH SCHOOL DIPLOMA, POPULATION WITH DISABILITIES, UNEMPLOYED CIVILIAN LABOR FORCE, LEVEL OF RENTAL HOUSING, AND LEVEL OF VACANT HOUSING.THE THIRD DATA GROUPING INVOLVES A MORE DETAILED REVIEW OF CERTAIN ADDITIONAL HEALTH STATUS INDICATORS. THE HEALTH STATUS ANALYSIS REVIEWS AMBULATORY SENSITIVE HOSPITALIZATIONS, SUCH AS ASTHMA, CONGESTIVE HEART FAILURE, CHRONIC OBSTRUCTIVE PULMONARY DISEASE, DIABETES, HYPERTENSION, AND PNEUMONIA. THE HEALTH STATUS ANALYSIS ALSO EXAMINES MATERNAL AND INFANT HEALTH, INCLUDING THE LEVEL OF BIRTHS TO TEEN MOMS, THE LEVEL OFLOW BIRTH WEIGHT INFANTS, THE LEVEL OF BIRTH DEFECTS, THE LEVEL OF INFANT MORTALITY, AND THE LEVEL OF BIRTHS WITH INSUFFICIENT PRENATAL CARE. ADDITIONALLY, MAJOR DISEASE PREVALENCE IS ALSO EXAMINED. THIS INCLUDES EXAMINING THE CANCER, CARDIOVASCULAR, AND STROKE DISCHARGES PER ONE THOUSAND POPULATION. MAJOR DISEASE PREVALENCE ALSO INCLUDES EXAMINING LIFESTYLE BEHAVIORS AND INDICATORS, SUCH AS OBESITY, MENTAL HEALTH, SUBSTANCE ABUSE, TOBACCO USE AND HIV.THE FINAL DATA GROUPING EXAMINES HEALTH RESOURCE UTILIZATION AND THE PHYSICIAN MANPOWER NEED. THIS ANALYSIS REVIEWS ACUTE CARE DISCHARGES, ACUTE CARE INPATIENT DAYS, AND OUTPATIENT EMERGENCY VISITS PER ONE THOUSAND POPULATION. FURTHERMORE, PRIMARY CARE AND SPECIALTY PHYSICIAN NEEDS ARE EVALUATED.THE ASSESSMENT PROVIDES A COMPARATIVE ANALYSIS OF THE COMMUNITIES THAT COMPRISE ST. AGNES HEALTHCARE'S SERVICE AREA. THE PRIMARY METHODOLOGY UTILIZED IS A RANKING OF THE COMMUNITY SCORES FOR EACH INDICATOR AGAINST THE CENTRAL MARYLAND AVERAGE. AN INDEX IS CREATED WHERE 1.0 IS THE AVERAGE OF CENTRAL MARYLAND. IN THE ANALYSIS, ANY SCORE ABOVE 1.0 IS WORSE THAN AVERAGE AND ANYTHING BELOW 1.0 IS BETTER THAN AVERAGE. COMPOSITE SCORES ARE DEVELOPED FOR EACH OF THE FOUR MAJOR ASSESSMENT AREAS AND THESE ARE THEN SUMMARIZED TO GENERATE A COMPOSITE OVERALL NEED INDEX. THIS METHODOLOGY IS MODELED AFTER THE APPROACH FORMERLY UTILIZED BY THE MARYLAND DEPARTMENT OF HEALTH AND MENTAL HYGIENE FOR THE STATEWIDE PRIMARY CARE ACCESS PLAN. PART VI, LINE 3: ST. AGNES HEALTHCARE DISPLAYS SIGNAGE, IN BOTH ENGLISH AND SPANISH IN ALL REGISTRATION AREAS THAT INFORM PATIENTS OF THE AVAILABILITY OF FINANCIAL ASSISTANCE PROGRAMS AND CONTACT INFORMATION. THE SIGNAGE IS ACCOMPANIED BY BROCHURES THAT EXPLAIN THE VARIOUS FINANCIAL ASSISTANCE PROGRAMS THAT ARE AVAILABLE. THE MARYLAND STATE FINANCIAL ASSISTANCE APPLICATION IS ALSO AVAILABLE. REGISTRATION AREAS ARE ROUTINELY CHECKED TO INSURE THESE MATERIALS ARE PROMINENTLY DISPLAYED. ST. AGNES HEALTHCARE HAS EMPLOYEES WHO ARE RESPONSIBLE FOR SCREENING ADMISSIONS TO IDENTIFY PATIENTS WHO MAY BE ELIGIBLE FOR CHARITY, MEDICAID, OR OTHER STATE PROGRAMS. ONCE THESE PATIENTS ARE IDENTIFIED, ST. AGNES HEALTHCARE EMPLOYEES ASSIST THEM WITH COMPLETING THE ELIGIBILITY PROCESS.ALL INPATIENTS ARE PROVIDED THE PATIENT BILLING AND FINANCIAL ASSISTANCE INFORMATION SHEET AT THE TIME OF ADMISSION. IT IS ALSO MAILED TO THE PATIENT WITH THE SUMMARY BILL THAT IS SENT AFTER DISCHARGE. THE INFORMATION SHEET IS PROVIDED IN BOTH ENGLISH AND SPANISH AND PROVIDES THE PATIENT WITH INFORMATION REGARDING ST. AGNES HEALTHCARE'S FINANCIAL ASSISTANCE POLICY, HOW TO APPLY FOR FINANCIAL ASSISTANCE AND MEDICAL ASSISTANCE AND THE PATIENT'S RIGHTS AND OBLIGATIONS. A PUBLIC NOTICE IS ALSO PUBLISHED ANNUALLY IN THE BALTIMORE SUN NEWSPAPER NOTIFYING THE PUBLIC OF THE AVAILABILITY OF UNCOMPENSATED CARE AT ST. AGNES HEALTHCARE. PART VI, LINE 4: THE AREAS SURROUNDING ST. AGNES HEALTHCARE HAVE A DIVERSE SOCIOECONOMIC COMPOSITION WITH A MIX OF URBAN AND SUBURBAN COMMUNITIES THAT ARE CONSISTENT WITH THE RANGE OF COMMUNITIES FOUND IN ANY LARGE METROPOLITAN REGION. FOR ST. AGNES HEALTHCARE, THE CHALLENGE OF SERVING THESE COMMUNITIES LIES IN MEETING THE DIFFERENT NEEDS ASSOCIATED BETWEEN SOME OF THE POOREST AND MOST AFFLUENT NEIGHBORHOODS IN CENTRAL MARYLAND ALL LOCATED WITHIN A THREE MILE RADIUS OF THE HOSPITAL CAMPUS. A FURTHER CHALLENGE IS THE RAPIDLY CHANGING COMPOSITION OF THE NEIGHBORHOODS LOCATED MOST IMMEDIATE TO ST. AGNES HEALTHCARE, WHICH OVER THE LAST FIVE YEARS, HAVE EXPERIENCED INCREASING URBAN BLIGHT.ST. AGNES HEALTHCARE'S SERVICE AREA SPANS FIVE MARYLAND COUNTIES INCLUDING BALTIMORE COUNTY, BALTIMORE CITY, ANNE ARUNDEL COUNTY, HOWARD COUNTY, AND CARROLL COUNTY. WITHIN THOSE COUNTIES, ELEVEN COMMUNITIES ARE SERVED REPRESENTING 22 POSTAL ZIP CODES. THOSE COMMUNITIES INCLUDE ARBUTUS, BROOKLYN/LINTHICUM, CATONSVILLE, ELLICOTT CITY, GLEN BURNIE, SOUTH CARROLL, PASADENA, SOUTH BALTIMORE CITY, SOUTHWEST BALTIMORE CITY, WEST BALTIMORE CITY, AND WOODLAWN. THIS STUDY AREA REPRESENTS APPROXIMATELY 81% OF THE DISCHARGES FOR ST. AGNES HEALTHCARE, WITH ARBUTUS AND CATONSVILLE RELYING MOST HEAVILY ON ST. AGNES HEALTHCARE FOR THEIR INPATIENT HEALTH CARE NEEDS. THE DEMOGRAPHICS OF ST. AGNES HEALTHCARE'S SERVICE AREA AVERAGE OUT TO BE THE SAME AS CENTRAL MARYLAND OVERALL. HOWEVER, INDEPENDENTLY EACH INDICATOR VARIES SUBSTANTIALLY FROM CENTRAL MARYLAND. THE SERVICE AREA SHOWS A SIGNIFICANTLY HIGHER THAN AVERAGE POPULATION DENSITY OF 2,345 PER SQUARE MILE, COMPARED TO 1,155 FOR CENTRAL MARYLAND.CHILDREN UNDER AGE FIVE AND ADULTS SIXTY-FIVE AND OLDER TOTALED 49,793 AND 89,932 RESPECTIVELY, COMPARED TO CENTRAL MARYLAND AVERAGES OF 165,227 AND 314,862 RESPECTIVELY. FEMALES AGES FIFTEEN TO FORTY-FOUR TOTALED 157,576 FOR THE SERVICE AREA WHILE THE CENTRAL MARYLAND AVERAGE WAS 554,037. THE SERVICE AREA IS SIGNIFICANTLY MORE RACIALLY AND ETHNICALLY DIVERSE THAN THE CENTRAL MARYLAND AVERAGES. SPECIFICALLY, COMMUNITIES THAT COMPRISE THE SOUTHWEST CORNER OF BALTIMORE CITY AND BALTIMORE COUNTY CONTAIN POPULATIONS WHERE 90% OF THE POPULATIONS CONSIST OF NONWHITE RACIAL OR ETHNIC GROUPS.TYPICAL TO THE URBAN ENVIRONMENT, EACH COMMUNITY LOCATED IN BALTIMORE CITY IS PROJECTED TO EXPERIENCE A POPULATION DECLINE, WHILE SUBURBAN AREAS LIKE ELLICOTT CITY, SOUTH CARROLL, AND PASADENA ARE PROJECTED TO HAVE POPULATION GROWTH. THE OVERALL POPULATION GROWTH IS EXPECTED TO EXCEED THE CENTRAL MARYLAND AVERAGE, BUT THE GROWTH RATE OF PERSONS OVER THE AGE OF SEVENTY-FIVE IS EXPECTED TO LAG BEHIND. THE DEMOGRAPHIC ANALYSIS SHOWS THAT WEST BALTIMORE CITY CONTINUES TO EXHIBIT DEMOGRAPHIC CHARACTERISTICS WITH HIGHER NEED, WHILE ARBUTUS AND CATONSVILLE EXHIBIT COMPARITIVELY LOWER NEED CHARACTERISTICS. LOWER SOCIOECONOMIC STATUS IS HIGHLY CORRELATED WITH POOR HEALTH OUTCOMES, DECREASED ACCESS TO HEALTH SERVICES, AND UNHEALTHY LIFESTYLES. OVERALL, THE ST. AGNES HEALTHCARE SERVICE AREA IS MARKED BY A LESS FAVORABLE SOCIOECONOMIC STATUS THAN THAT OF CENTRAL MARYLAND AS A WHOLE. THE INDICES ARE DIVIDED AS URBAN COMMUNITIES ARE LESS FAVORABLE AND SUBURBAN COMMUNITIES ARE MORE FAVORABLE THAN THE CENTRAL MARYLAND AVERAGE. THE PERCENTAGE OF HOUSEHOLDS WITH LOW INCOME WAS 40% FOR THE SERVICE AREA, COMPARED TO 30% FOR THE CENTRAL MARYLAND AVERAGE. THE AVERAGE HOUSEHOLD INCOME IN THE SERVICE AREA WAS LOWEST IN WEST BALTIMORE CITY AT $39,014 AND HIGHEST IN ELLICOTT CITY AT $101,620. THE OVERALL AVERAGE FOR THE SERVICE AREA WAS $68,017 COMPARED TO THE CENTRAL MARYLAND AVERAGE WHICH WAS $83,587. THE RATE OF UNINSURED PATIENTS WAS CLOSELY TIED TO AVERAGE HOUSEHOLD INCOME WITH WEST BALTIMORE CITY SHOWING THE HIGHEST UNINSURED RATE, 39%, AND ELLICOTT CITY SHOWING THE LOWEST UNINSURED RATE, 6%. OVERALL, THE SERVICE AREA HAD A 20% UNINSURED RATE WHILE THE CENTRAL MARYLAND AVERAGE HAD A 16% RATE.INCOME AND EDUCATION ATTAINMENT CAN BE CAUSAL FACTORS FOR MANY HEALTH DISPARITIES IN THE COMMUNITY. HIGHER EDUCATION PROVIDES GREATER POTENTIAL FOR HIGHER INCOME, WHICH ENABLES INCREASED ACCESS TO MEDICAL CARE, BETTER HOUSING, ACCESS TO SAFER NEIGHBORHOODS, AND INCREASED LIKELIHOOD OF DEVELOPING HEALTHIER LIFESTYLE BEHAVIORS. THE NEEDS ASSESSMENT DATA SHOWED THAT ST. AGNES HEALTHCARE'S SERVICE AREA UNDERPERFORMED THE CENTRAL MARYLAND AVERAGE IN OTHER SOCIOECONOMIC MEASURES. THIS INCLUDES THE PERCENTAGE OF INDIVIDUALS AGE TWENTY-FIVE AND OLDER WITH LESS THAN A HIGH SCHOOL DIPLOMA, THE UNEMPLOYMENT RATE, THE PERCENTAGE OF RENTED HOUSING, AND THE PERCENTAGE OF VACANT HOUSING. ST. AGNES HEALTHCARE ALSO PERFORMS A COMMUNITY HEALTH STATUS ASSESSMENT. THIS ASSESSMENT CAPTURES DATA FOR WHITE AND NONWHITE POPULATIONS SEPARATELY, WHICH HIGHLIGHTS THE RACIAL DISPARITIES PRESENT WITHIN EACH COMMUNITY AND THE INFLUENCE ON HEALTH STATUS AND HOSPITALIZATION RATES. ST. AGNES HEALTHCARE EVALUATES AMBULATORY SENSITIVE HOSPITALIZATIONS, WHICH ARE ACUTE CARE HOSPITAL ADMISSIONS THAT POTENTIALLY COULD HAVE BEEN PREVENTED THROUGH BETTER OVERALL PATIENT MANAGEMENT, PRIMARILY THROUGH PRIMARY CARE SYSTEMS. ST. AGNES HEALTHCARE COLLECTED DATA ON SIX DIFFERENT CHRONIC ILLNESSES, WHICH INCLUDE ASTHMA, CONGESTIVE HEART FAILURE, CHRONIC OBSTRUCTIVE PULMONARY DISEASE, DIABETES, HYPERTENSION, AND PNEUMONIA. FOR EACH CHRONIC ILLNESS EXAMINED, ST. AGNES HEALTHCARE'S SERVICE AREA HAD HIGHER RATES OF ILLNESS, FOR BOTH WHITE AND NONWHITE POPULATIONS, WHEN COMPARED TO THE CENTRAL MARYLAND AVERAGE. IN COMPARING THE RACIAL DISPARITIES, THE RATE OF HOSPITALIZATION IN THE ST. AGNES HEALTHCARE SERVICE AREA PROVES TO BE INFLUENCED BY SOCIOECONOMIC FACTORS MORE SO THAN RACE. IN LESS AFFLUENT COMMUNITIES, THE NONWHITE POPULATION HAD A HIGHER RATE OF HOSPITALIZATION THAN THE WHITE POPULATION OF THE SAME COMMUNITY. HOWEVER, THE INVERSE IS TRUE IN THE AFFLUENT COMMUNITIES WHERE THE NONWHITE POPULATION HAS A LOWER ADMISSION RATE THAN THEIR WHITE COUNTERPARTS.ST. AGNES HEALTHCARE COMPILES AND ANALYZES MATERNAL AND INFANT HEALTH DATA. ONE OF THE MOST POTENTIALLY VULNERABLE POPULATIONS IN THE SERVICE AREA IS POVERTY-STRICKEN WOMEN AND THEIR CHILDREN, ESPECIALLY THOSE LIVING IN POVERTY. THE SOCIOECONOMIC ANALYSIS REVEALED THAT AN ESTIMATED 40% OF CHILDREN IN THE SERVICE AREA ARE LIVING IN POVERTY, WITH THE URBAN AREAS EXPERIENCING RATES OF GREATER THAN 50%. THE QUALITY OF LIFE AND HEALTH STATUS OF WOMEN HAS FAR REACHING IMPLICATIONS. TEEN PREGNANCY,ACCESS TO ADEQUATE PRENATAL CARE, LOW BIRTH WEIGHT AND BIRTH DEFECTS GENERATE INCREASED DEMANDS FOR FUTURE HEALTH CARE NEEDS AND IMPACT NOT JUST THIS GENERATION, BUT SUBSEQUENT GENERATIONS AS THE CYCLE OF POVERTY IS CONTINUED. THE HEALTH STATUS ASSESSMENT EXAMINED THE PERCENTAGE OF BIRTHS TO TEEN MOMS, PERCENTAGE OF NEWBORNS WITH LOW BIRTH WEIGHTS, THEPERCENTAGE OF BIRTH DEFECTS, INFANT MORTALITY, AND THE PERCENTAGE OF MOTHERS WITH INSUFFICIENT PRENATAL CARE. IN NEARLY EVERY CATEGORY, THE SERVICE AREA HAD MORE INCIDENCES THAN THE CENTRAL MARYLAND AVERAGE. THE PERCENTAGE OF INFANTS WITH LOW BIRTH WEIGHT, FOR WHITE POPULATIONS, AND THE INFANT MORTALITY RATES, WITH NONWHITE POPULATIONS, WERE THE ONLY TWO AREAS THAT HAD SLIGHTLY LESS INCIDENCES THAN THE CENTRAL MARYLAND AVERAGE. UNLIKE AMBULATORY HOSPITALIZATION, THE NONWHITE POPULATIONS HAVE SUBSTANTIALLY HIGHER RATES OF BIRTHS TO TEEN MOTHERS, INFANTS WITH LOW BIRTH WEIGHT, INFANTS WITH BIRTH DEFECTS, AS WELL AS BIRTHS WITH INSUFFICIENT PRENATAL CARE IN ALL COMMUNITIES WITHIN THE SERVICE AREA.ST. AGNES HEALTHCARE ALSO ANALYZES MAJOR DISEASE PREVALENCE. TRADITIONALLY, MORTALITY DATA IS UTILIZED TO EVALUATE THE IMPACT OF LEADING CAUSES OF DISEASE AND ILLNESS IN THE COMMUNITY. HOWEVER, VITAL STATISTIC DATA IS NOT READILY AVAILABLE AT THE ZIP CODE LEVEL. THEREFORE, AS A PROXY, THE ASSESSMENT UTILIZED ACUTE CARE DISCHARGE DATA FROM THE LEADING CAUSES OF MORTALITY, INCLUDING CANCER, CARDIOVASCULAR, AND STROKE. THE ANALYSIS REVEALED ONCE AGAIN THAT THE SERVICE AREA EXPERIENCEDHIGHER DISEASE PREVALENCE OF CANCER, CARDIOVASCULAR, AND STROKE THAN THE CENTRAL MARYLAND AVERAGE, WITH STROKE BEING THE LEAST FAVORABLE. FURTHERMORE, NONWHITE POPULATIONS SHOWED A GREATER NEED IN EACH OF THE THREE MAJOR DISEASE CATEGORIES THAN WHITE POPULATIONS. ALSO, CONTINUING THE TREND, THE URBAN AREAS OF WEST BALTIMORE, SOUTH BALTIMORE, SOUTHWESTBALTIMORE, AND BROOKLYN HAVE THE LEAST FAVORABLE INDICES FOR THESE MAJOR DISEASES.FINALLY, THE NEEDS ASSESSMENT ALSO EXAMINES LIFESTYLE BEHAVIOR AS A COMPONENT OF THE OVERALL HEALTH STATUS, WHICH INCLUDES INDICATORS RELATED TO OBESITY, MENTAL HEALTH, HIV, SUBSTANCE ABUSE, AND TOBACCO USE. THIS DATA IS ACCUMULATED BY EXAMINING ICD-9 DIAGNOSIS CODING. SIMILAR TO THE OTHER HEALTH AND WELLNESS MEASURES, THE SERVICE AREA WAS LESS FAVORABLE THAN THE CENTRAL MARYLAND AVERAGE FOR EVERY LIFESTYLE BEHAVIOR INDICATOR. PART VI, LINE 6: THE INFORMATION PROVIDED AS COMMUNITY SUPPORT, IN PART II, COMMUNITY BUILDING ACTIVITIES, REPRESENTS FUNDS SPENT FOR DISASTER READINESS AND PUBLIC HEALTH EMERGENCY ACTIVITIES. THESE COSTS, WHICH ARE PARTIALLY FUNDED BY THE DEPARTMENT OF HEALTH AND MENTAL HYGIENE, SUPPORT ACTIVITIES SUCH AS EDUCATION AND PREPAREDNESS TRAINING, DECONTAMINATION EQUIPMENT AND SUPPLIES NEEDED FOR VICTIM'S EASE, COMFORT AND TRACKING DURING DECONTAMINATION.PART VI, LINE 5: ST. AGNES HEALTHCARE FURTHERS ITS EXEMPT PURPOSE BY PROMOTING THE HEALTH OF THE COMMUNITY IN VARIOUS WAYS. A MAJORITY OF THE ORGANIZATION'S GOVERNING BODY RESIDES IN ST. AGNES HEALTHCARE'S SERVICE AREA AND IS NEITHER COMPOSED OF EMPLOYEES NOR CONTRACTORS OF THE ORGANIZATION. THE GOVERNING BODY HAD EIGHTEEN VOTING MEMBERS, SEVENTEEN OF WHICH WERE INDEPENDENT COMMUNITY MEMBERS. ADDITIONALLY, ST. AGNES HEALTHCARE HAS AN OPEN MEDICAL STAFF AND CREDENTIALS ALL QUALIFIED MEDICAL STAFF, INCLUDING COMMUNITY BASED PROVIDERS. ST. AGNES HEALTHCARE APPLIES SURPLUS FUNDS TO IMPROVE PATIENT CARE IN VARIOUS WAYS. FOR INSTANCE, SURPLUS FUNDS ARE USED TO REINVEST IN THE LATEST EQUIPMENT AND TECHNOLOGIES TO IMPROVE PATIENT SAFETY, COMFORT, AND OUTCOMES. SURPLUS FUNDS ARE ALSO USED TO RENOVATE EXISTING FACILITIES AND CONSTRUCT NEW FACILITIES IN ORDER TO IMPROVE THE HEALTHCARE ENVIRONMENT. AS A MEMBER OF A NATIONAL HEALTH SYSTEM, ASCENSION HEALTH, SURPLUS FUNDS GENERATED BY ST. AGNES HEALTHCARE MAY ALSO BE DIRECTED TO ASCENSION HEALTH TO APPLY TOWARDS STRATEGIC INITIATIVES OR TO BE RE-DISTRIBUTED TO OTHER MEMBER HEALTHCARE PROVIDERS WITHIN ASCENSION HEALTH. THIS ALLOWS ST. AGNES TO NOT ONLY SERVICE THE SURROUNDING COMMUNITY, BUT ALSO HELP FUND THE CARE FOR THE UNDERPRIVILEGED THROUGHOUT MANY PARTS OF THE UNITED STATES. PART VI, LINE 7: ST. AGNES HEALTHCARE IS A MEMBER OF ASCENSION HEALTH, A NATIONAL HEALTH CARE SYSTEM. ASCENSION HEALTH IS THE SOLE CORPORATE MEMBER OF ST. AGNES HEALTHCARE. ST. AGNES HEALTHCARE IS THE SOLE CORPORATE MEMBER OF SETON MEDICAL GROUP INC., WHICH PROVIDES PRIMARY CARE, GYNECOLOGY AND OBSTETRICS CARE FOR PATIENTS IN ST. AGNES HEALTHCARE'S SERVICE AREA. ST. AGNES HEALTHCARE IS ALSO THE SOLE CORPORATE MEMBER OF ST. AGNES FOUNDATION, THE PHILANTHROPIC ARM OF ST. AGNES HEALTHCARE. PART VI, LINE 4, CONTINUED: ALSO, CONSISTENT WITH THE PREVIOUS MEASURES, THE URBAN AREAS EXPERIENCED THE LEAST FAVORABLE RESULTS. THE LEAST FAVORABLE OVERALL WAS SOUTH BALTIMORE CITY, WHICH WAS FOUND TO HAVE THE HIGHEST UTILIZATION RATES FOR MENTAL HEALTH, HIV, AND EMERGENCY ROOM SUBSTANCE ABUSE VISITS. RACIAL DISPARITIES ARE EVIDENT IN URBAN AREAS, WHERE THE RATE OF ADMISSION FOR THE NONWHITE POPULATION IS SIGNIFICANTLY HIGHER THAN THAT OF THE WHITE POPULATION, ESPECIALLY IN THE CASES OF OBESITY, HIV AND TOBACCO USE. THE MOST FAVORABLE COMPOSITE INDEX SCORES WERE IN SUBURBAN AREAS LIKE ELLICOTT CITY AND SOUTH CARROLL, WHICH WERE NEARLY 100% BELOW THEIR URBAN COMMUNITY COUNTERPARTS.THE FINAL COMPONENT OF THE COMMUNITY NEEDS ASSESSMENT EXAMINED HEALTH RESOURCE UTILIZATION AND PHYSICIAN MANPOWER NEED. THIS ANALYSIS UTILIZES ACUTE CARE ADMISSION RATES, ACUTE CARE DAYS, AND OUTPATIENT EMERGENCY ROOM VISIT RATES. THE LOGIC UNDERLYING OUR ANALYSIS OF THESE INDICATORS IS THAT COMMUNITIES WITH HIGH UTILIZATION RATES HAVE A GREATER NEED FOR HEALTH CARE RESOURCES. ALL THREE MEASURES SHOWED LESS FAVORABLE RESULTS THAN THE CENTRAL MARYLAND AVERAGE. THE INDEX SCORES WERE 1.12, 1.22,AND 1.22 FOR ADMISSIONS, DAYS, AND EMERGENCY ROOM VISITS, RESPECTIVELY. THE PHYSICIAN MANPOWER NEED INDEX SCORE WAS .89. THE CENTRAL MARYLAND AVERAGE IS INDEXED AT 1.0, WITH SCORES GREATER THAN 1.0 INDICATING LESS FAVORABLE RESULTS AND SCORES LESS THAN 1.0 INDICATING FAVORABLE RESULTS. THE OVERALL AVERAGE INDEX SCORE FOR HEALTH RESOURCE UTILIZATION AND PHYSICIAN MANPOWER NEED WAS .89. IN SUMMARY, ALL OF THE COMPONENTS OF THE NEEDS ASSESSMENT WERE SUMMARIZED AND INDEXED RESULTING IN AN OVERALL INDEX SCORE OF 1.09. OVERALL, THE ST. AGNES HEALTHCARE SERVICE AREA HAS HIGHER DEMONSTRATED NEED ACROSS ALL MEASURES WHEN COMPARED TO THE CENTRAL MARYLAND REGION. THE OVERALL NEED IS HIGHLY CORRELATED TO SOCIOECONOMIC STATUS, WITH RACIAL DIVERSITY ALONE HAVING LESS OF AN INFLUENCE ON HEALTH CARE STATUS. PART VI, LINE 8 SUPPLEMENT INFORMATION: ST. AGNES HEALTHCARE FILES A COMMUNITY BENEFITS REPORT WITH THE HEALTH SERVICES COST REVIEW COMMISSION (HSCRC), THE REGULATORY AGENCY IN THE STATE OF MARYLAND. THE REPORT IS THEN MADE PUBLIC BY THE HSCRC. ADDITIONALLY, COMMUNITY BENEFIT INFORMATION IS AVAILABLE IN THE ST. AGNES HEALTHCARE ANNUAL REPORT AND THE ST. AGNES HEALTHCARE FACT SHEET. BOTH DOCUMENTS ARE AVAILABLE ON THE HOSPITAL WEBSITE.PT V PART V LINE 13G: A NOTICE OF CHARITY IS POSTED WITHIN THE BALTIMORE SUN ON AN ANNUAL BASIS.PT V PART V LINES 19 AND 21: MARYLAND HOSPITAL REGULATED RATES ARE DETERMINED BY THE HSCRC. BY LAW, REGULATED RATES CHARGED TO ALL PAYORS,INCLUDING SELF PAY PATIENTS, ARE THE SAME. 1 MHEI WHO WILL CARE 6820 DEERPATH ROAD ELKRIDGE MD 21075 520901664 501(C)(3) 50000 0 FMV NURSING AMERICAN HEART ASSOCIATION 415 N CHARLES STREET BALTIMORE MD 21203 135613797 501(C)(3) 11376 0 FMV HEART WALK ST BONIFACE HAITI FOUNDATION 400 MAIN STREET RANDOLPH MA 02368 043067595 501(C)(3) 8550 0 FMV HAITI RELIEF GREATER BALTIMORE COMMITTEE 111 SOUTH CALVERT STREET BALTIMORE MD 21202 520645650 501(C)(4) 6000 0 FMV SPONSORSHIP ASSOCIATED BLACK CHARITIES 1114 CATHEDRAL STREET BALTIMORE MD 21201 521427774 501(C)(3) 5525 0 FMV SPONSORSHIP 4 1 NURSING SCHOLARSHIP/WORKSTUDY PROGRAM 4 16595 0 FMV PROCEDURE FOR MONITORING GRANTS IN THE U.S.: PART I, LINE 2: SCHEDULE I, PART I, LINE 2: DISCRETIONARY GRANTS OR ASSISTANCE TO OTHER ORGANIZATIONS ARE APPROVED BY EITHER THE CHIEF EXECUTIVE OFFICER OR THE CHIEF FINANICAL OFFICER. THE NURSING WORKSTUDY PROGRAM IS AVAILABLE TO NURSING STUDENTS IN THEIR SENIOR YEAR OF SCHOOLING. AVAILABILITY IS LIMITED AND AWARDED ON A FIRST COME FIRST SERVE BASIS. X X X 1 1 X X X 0 1 0 0 0 0 0 0 0 BONNIE PHIPPS 531006 0 210613 0 363375 0 11025 0 16219 0 1132238 0 0 0 SCOTT FURNISS 234831 0 28145 0 862 0 6307 0 18915 0 289060 0 0 0 ADRIAN LONG 339907 0 37317 0 53478 0 11392 0 21007 0 463101 0 0 0 WILLIAM GRESKOVICH 231856 0 30346 0 3346 0 23018 0 19767 0 308333 0 0 0 YOLANDA COPELAND 220600 0 29255 0 27295 0 10196 0 21322 0 308668 0 0 0 GEORGE GRACE 718967 0 119743 0 5250 0 27525 0 23973 0 895458 0 0 0 HOWARD HESSAN 767616 0 8105 0 2487 0 27525 0 16220 0 821953 0 0 0 LAWRENCE SHIN 684428 0 0 0 -18481 0 6125 0 23862 0 695934 0 0 0 VINEY SETYA 558676 0 0 0 3132 0 11392 0 10492 0 583692 0 0 0 ROBERT PALEY 516051 0 0 0 4064 0 11025 0 23204 0 554344 0 21463 0 PART I, LINE 1A TRAVEL FOR COMPANIONS IS AVAILABLE FOR SENIOR LEADERSHIP AND MUST BE PRE-APPROVED BY THE CHIEF FINANCIAL OFFICER. IT IS RECORDED AS A TAXABLE FRINGE BENEFIT. PART I, LINE 1A THE AMOUNT OF PERSONAL USAGE OF CELL PHONES IS GROSSED-UP AND RECORDED AS TAXABLE INCOME FOR INDIVIDUALS IDENTIFIED AS DISQUALIFIED PERSONS. DISQUALIFIED PERSONS INCLUDE THOSE LISTED ON PART VII AS WELL AS ANY OTHER PHYSICIANS WITH SIGNIFICANT ADMISSIONS. PART I, LINE 1A CLUB DUES ARE AVAILABLE TO SENIOR LEADERSHIP AND ARE SHOWN AS A TAXABLE FRINGE BENEFIT. AVERAGE HOURS PER WEEK; ALL PERSONS LISTED AT PART VII AND SCHEDULE J AS WORKING 50 HOURS ARE FULL-TIME EMPLOYEES OF THE ORGANIZATION. THE USE OF 50 HOURS ON THIS RETURN IS INTENDED TO DENOTE THAT SUCH PERSONS MAY WORK SIGNIFICANTLY MORE HOURS DURING THE WEEK ON AVERAGE. ST. AGNES HEALTHCARE IS A MEMBER OF ASCENSION HEALTH. BONNIE PHIPPS, PRESIDENT AND CEO OF ST. AGNES HEALTHCARE, ALSO SERVES IN AN OVERSIGHT ROLE TO OTHER ASCENSION HEALTH FACILITIES AS A MINISTRY MARKET LEADER. THE COMPENSATION EARNED AS A MINISTRY MARKET LEADER IS PAID THROUGH ST. AGNES HEALTHCARE, AND THEREFORE, REPORTED ON THIS FORM 990. THE COMPENSATION HAS NOT BEEN ALLOCATED BACK TO THE ENTITIES DERIVING THE BENEFIT. PART I, LINE 3 THE COMPENSATION FOR THE CHIEF EXECUTIVE OFFICER (CEO) OF ST. AGNES HEALTHCARE IS DETERMINED BY ASCENSION HEALTH, THE PARENT COMPANY OF ST. AGNES HEALTHCARE. ASCENSION HEALTH USES INDEPENDENT COMPENSATION CONSULTANTS, WHO USE COMPENSATION SURVEYS AND STUDIES, TO ESTABLISH THE PAY RANGE FOR THE CEO OF ST. AGNES HEALTHCARE. THE ASCENSION HEALTH EXECUTIVE COMPENSATION COMMITTEE APPROVES THE RECOMMENDED SALARY FOR THE CEO OF ST. AGNES HEALTHCARE. THE ASCENSION HEALTH EXECUTIVE COMPENSATION COMMITTEE PROVIDES THE LOCAL ST. AGNES HEALTHCARE COMPENSATION COMMITTEE THE ANALYSIS PERFORMED BY THE INDEPENDENT CONSULTANT FOR REVIEW AND APPROVAL. PART I, LINE 4B ROBERT PALEY, HOWARD HESSAN, GEORGE GRACE AND BILL GRESKOVICH PARTICIPATED IN 457F SUPPLEMENTAL NON-QUALIFIED RETIREMENT PLANS. ROBERT PALEY'S NON-VESTED PLAN VALUE WAS $66,167.46. HOWARD HESSAN'S NON-VESTED PLAN VALUE WAS $49,288.99. GEORGE GRACE'S NON-VESTED VALUE WAS $19,906.04. BILL GRESKOVICH'S NON-VESTED VALUE WAS $156,005.18 AT JUNE 30, 2011. ALBERT COUNSELMAN FORMER BOARD MEMBER/FAMILY MEMBER 43649 COMPENSATION 0 FORM 990, PART VI, SECTION A, LINE 2 CERTAIN PERSONS REPORTED ON PART VII ARE EMPLOYED BY AND/OR SERVE AS OFFICER, DIRECTOR, TRUSTEE, OR KEY EMPLOYEE AT A RELATED TAX EXEMPT ORGANIZATION. FORM 990, PART VI, SECTION A, LINE 6 ST. AGNES HEALTHCARE HAS A SOLE CORPORATE MEMBER, ASCENSION HEALTH. FORM 990, PART VI, SECTION A, LINE 7A ST. AGNES HEALTHCARE HAS A SOLE CORPORATE MEMBER, ASCENSION HEALTH, WHO HAS THE ABILITY TO ELECT MEMBERS TO THE GOVERNING BODY OF ST. AGNES HEALTHCARE. FORM 990, PART VI, SECTION A, LINE 7B ASCENSION HEALTH HAS DESIGNED A SYSTEM AUTHORITY MATRIX WHICH ASSIGNS AUTHORITY FOR KEY DECISIONS THAT ARE NECESSARY IN THE OPERATION OF THE SYSTEM. SPECIFIC AREAS THAT ARE IDENTIFIED IN THE AUTHORITY MATRIX ARE: NEW ORGANIZATIONS AND MAJOR TRANSACTIONS; GOVERNING DOCUMENTS; APPOINTMENTS/REMOVALS; EVALUATION; DEBT LIMITS; STRATEGIC AND FINANCIAL PLANS; SYSTEM POLICIES AND PROCEDURES. THESE AREAS ARE SUBJECT TO CERTAIN LEVELS OF APPROVAL BY ASCENSION HEALTH PER THE SYSTEM AUTHORITY MATRIX. FORM 990, PART VI, SECTION B, LINE 11 MANAGEMENT,INCLUDING CERTAIN OFFICERS, WORKS DILIGENTLY TO COMPLETE THE FORM 990 AND ATTACHED SCHEDULES IN A THOROUGH MANNER. MANAGEMENT PRESENTS THE FORM TO THE FINANCE COMMITTEE AND CERTAIN MEMBERS OF THE AUDIT COMMITTEE AND ADDRESSES ANY QUESTIONS THAT ARISE. ONCE THE FINANCE COMMITTEE AND AUDIT COMMITTEE REVIEW IS COMPLETED, THE FORM 990 IS THEN MADE AVAILABLE TO THE FULL BOARD OF DIRECTORS VIA A SECURE WEBSITE. MANAGEMENT TEAM MEMBERS ARE AVAILABLE TO ANSWER ANY BOARD MEMBER QUESTIONS. AFTER THE BOARD OF DIRECTORS REVIEW IS COMPLETE, MANAGEMENT FILES THE FORM 990 WITH THE INTERNAL REVENUE SERVICE. FORM 990, PART VI, SECTION B, LINE 12C ANNUALLY, A CONFLICTS OF INTEREST DISCLOSURE FORM IS DISTRIBUTED TO BOARD MEMBERS, THE EXECUTIVE TEAM, BOARD COMMITTEES, PURCHASING AGENTS, LEGAL COUNSEL, MEDICAL LEADERSHIP, AND CERTAIN MEMBERS OF MANAGEMENT. OFFICERS, DIRECTORS AND KEY EMPLOYEES ARE REQUIRED TO COMPLETE THE ANNUAL DISCLOSURE. ANY CONFLICTS, OR POTENTIAL CONFLICTS THAT ARE IDENTIFIED ARE EXAMINED BY THE CORPORATE RESPONSIBILITY OFFICER AND APPROPRIATE MEASURES ARE TAKEN. FORM 990, PART VI, SECTION B, LINE 15 THE COMPENSATION FOR THE CHIEF EXECUTIVE OFFICER (CEO) OF ST. AGNES HEALTHCARE IS DETERMINED BY ASCENSION HEALTH, THE PARENT COMPANY OF ST. AGNES HEALTHCARE. ASCENSION HEALTH USES INDEPENDENT COMPENSATION CONSULTANTS, WHO USE COMPENSATION SURVEYS AND STUDIES, TO ESTABLISH THE PAY RANGE FOR THE CEO OF ST. AGNES HEALTHCARE. THE ASCENSION HEALTH EXECUTIVE COMPENSATION COMMITTEE APPROVES THE RECOMMENDED SALARY FOR THE CEO OF ST. AGNES HEALTHCARE. THE ASCENSION HEALTH EXECUTIVE COMPENSATION COMMITTEE PROVIDES THE LOCAL ST. AGNES HEALTHCARE COMPENSATION COMMITTEE THE ANALYSIS PERFORMED BY THE INDEPENDENT CONSULTANT FOR REVIEW AND APPROVAL. FORM 990, PAART VI, SECTION B, LINE 15B: THE ANNUAL COMPENSATION REVIEW FOR OFFICER LEVEL STAFF IS PERFORMED BY AN OUTSIDE COMPENSATION CONSULTING FIRM, WHICH SPECIALIZES IN EXECUTIVE COMPENSATION. ON AN ANNUAL BASIS, THE COMPENSATION COMMITTEE OF THE BOARD OF DIRECTORS, SENDS AN ENGAGEMENT LETTER OUTLINING THE POSITIONS REQUIRING COMPENSATION ANALYSIS, AND SEEKS ANALYSIS AND RECOMMENDATIONS. THE CONSULTING FIRM THEN PERFORMS A MARKET ANALYSIS OF COMPENSATION AND BENEFITS FOR THE EXECUTIVES WITH RECOMMENDED SALARY RANGES BY EXECUTIVE POSITION, AND THOSE ARE REVIEWED AND APPROVED BY THE COMPENSATION COMMITTEE. THE SENIOR VP/CHIEF FINANCIAL OFFICER, EXECUTIVE VP/CHIEF MEDICAL OFFICER, VP OPERATIONS & CAPITAL PROJECTS, SENIOR VP PATIENT CARE SERVICES ARE ALL INCLUDED IN THE GROUP OF PERSONS WHOSE COMPENSATION IS REVIEWED BY AN OUTSIDE CONSULTING FIRM. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION WILL PROVIDE ANY DOCUMENTS OPEN TO PUBLIC INSPECTION UPON WRITTEN REQUEST. HOURS DEVOTED TO A RELATED ORGANIZATION BOARD MEMBER, BONNIE PHIPPS, AND KEY EMPLOYEES SCOTT FURNISS, YOLANDA COPELAND AND ADRIAN LONG WORK AT ST. AGNES HEALTHCARE AS WELL AS RELATED ORGANIZATIONS, SETON MEDICAL GROUP AND ST. AGNES FOUNDATION. FOR DISCLOSURE PURPOSES, THE AVERAGE HOURS WORKED AT RELATED ORGANIZATIONS IS ESTIMATED BY USING THE NUMBER OF HOURS SERVCED ON BOARD COMMITTEES FOR RELATED ORGANIZATIONS. BONNIE PHIPPS WORKS 3.77 HOURS PER WEEK, ON AVERAGE, SERVING ON COMMITTEES AT SETON MEDICAL GROUP AND ST. AGNES FOUNDATION. SCOTT FURNISS WORKS 2.76 HOURS PER WEEK, ON AVERAGE, SERVING ON COMMITTEES AT SETON MEDICAL GROUP AND ST. AGNES FOUNDATION. YOLANDA COPELAND WORKS 0.92 HOURS PER WEEK, ON AVERAGE, SERVING ON COMMITTEES AT ST. AGNES FOUNDATION. ADRIAN LONG WORKS 1.38 HOURS PER WEEK, ON AVERAGE, SERVING ON COMMITTEES AT SETON MEDICAL GROUP. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 5: TRANSFER TO ASCENSION HEALTH -6,884,840. TRANSFER TO SPONSOR -548,045. DEFERRED PENSION COSTS 36,593,482. STATE GRANT 560,000. CAPITAL TRANSFER TO SETON MEDICAL GROUP -6,581,495. LAB OUTREACH EXPENSES -4,756,079. LAB OUTREACH UTILIZATION -395,366. DONATED EQUIPMENT 1,504,506. NET CHANGE IN INTEREST IN FOUNDATION ASSETS -260,269. SPECIAL PURPOSE FUNDS UNREALIZED GAINS 421,375. SPECIAL PURPOSE FUNDS RESTRICTED CONTRIBUTIONS 803,945. NET ASSETS RELEASED FROM RESTRICTION -670,408. SPECIAL PURPOSE FUNDS INVESTMENT INCOME -9,018. TOTAL TO FORM 990, PART XI, LINE 5: 19,777,788. ASCENSION HEALTH PO BOX 45998 ST LOUIS MO 63145 311662309 NATIONAL HEALTH OFFICE MO 501(C)(3) BOX 11A N/A 0 SETON MEDICAL GROUP 900 CATON AVENUE BALTIMORE MD 21229 392064992 PROVIDE HEALTH CARE SERVICES TO THE COMMUNITY MD 501(C)(3) BOX 3-HOSPITAL ST AGNES HOSPITAL 1 ST AGNES FOUNDATION 900 CATON AVENUE BALTIMORE MD 21229 521415083 PROVIDES FUNDING TO THE HOSPITAL AND THE COMMUNITY MD 501(C)(3) BOX 11-509(A)3-TYPE ST AGNES HOSPITAL 1 ST AGNES AUXILIARY 900 CATON AVENUE BALTIMORE MD 21229 520643673 FUNDRAISING MD 501(C)(3) BOX 9 ST AGNES HOSPITAL 1 ST AGNES HEALTH VENTURES INC 900 CATON AVENUE BALTIMORE MD 21229 521733632 HOLDING COMPANY MD N/A C 11233 1119531 1.00000 0 1 1 0 0 0 0 0 0 0 0 1 1 1 1 1 0 0 SETON MEDICAL GROUP B 6581495 FAIR MARKET VALUE ST AGNES FOUNDATION C 1815903 FAIR MARKET VALUE ST AGNES FOUNDATION L 522366 FAIR MARKET VALUE ST AGNES FOUNDATION P 595550 FAIR MARKET VALUE