2011-05-16T11:17:26-05:00 2010-06-30 COHEN RUTHERFORD KNIGHT PC 6903 ROCKLEDGE DRIVE SUITE 500 BETHESDA MD 208171800 990 2009-07-01 520591658 Mercy Medical Center MERC 4103329000 301 St Paul Place Baltimore MD 21202 JOHN TOPPER 4103329313 2011-05-11 true 3018281008 2009 2016-02-24 21:20:13Z THOMAS MULLEN 301 ST PAUL PLACE BALTIMORE MD 21202 389075442 false X www.mdmercy.com X 1949 MD Grounded in a vision of God's healing love for all people, we are committed to providing healthcare for persons of every creed, color, and economic and social condition in Balt City, Central MD and beyond. 7 1 3233 161 883607 -290565 5886074 10673654 361121789 361778126 -4474247 3206570 11611857 11860031 374145473 387518381 275833 0 0 0 162572206 166554477 0 0 0 181097930 184825680 343945969 351380157 30199504 36138224 764769042 798086962 547565010 552550779 217204032 245536183 Mercy is dedicated to carry forward the 136 - year tradition of the Sister's healing ministry in Baltimore. Grounded in a vision of God's healing love for all people, we are committed to providing healthcare for persons of every creed, color, and economic and social condition in Baltimore City, Central Maryland and beyond. In the tradition of Catholic healthcare and of the Sisters of Mercy, we continue our special commitment to poor and underserved persons. Mercy is driven by its mission to serve and will remain steadfast in its commitment to uphold its highest standards for care, its commitment ot the poor and its commitment ot Baltimore. We are here to provide excellent healthcare, with compassion and respect, to all who come to us for help. false false 265641316 361778126 To provide healthcare to patients without regard to ability to pay. Mercy strives to provide excellent clinical services across the life span within a community of compassionate care. Mercy Medical Center (MMC) has 243 licensed beds and had 18,214 inpatient admissions for the fiscal year ending JunE 30,2010. Mercy Medical Center's primary service area ( PSA) which comprises 16 ZIP codes in Baltimore City, accounts for almost 60% of its total admissions. The key demographic characteristics of the PSA are as follows: 64% of the population is black AND approximately 59% of patients served by MMC are members of a racial or ethnic minority while 66% are women and 51% are Medicaid and/or Medicare beneficiaries. 12% of the population is 65 year in age and older. The median household income of the population is $35,656, 40% of Baltimore City households reported a income of less than $30,000. Three times as many families living in Baltimore City had income that was below the poverty level compared to all familes in Maryland. Within the hospital's immediate zip codes of 21201 and 21202 35% of familIes live beLOW the federal poverty level definition. Due to its location in center city, MMC cares for many of the at-risk, low income population in the communities that immediately surround the hospital. This is best evidenced by the large percentage of emergency room visits by Medicaid, uninsured, and Medicare patients. Medicaid covered and unisured patients accounted for more than 50% of FY2010 emergency room visits. In FY 2010, the supportive housing program provided a comprehensive range couseling services and community resource linkages to 166 clients. These services incurred a direct costs of $523,381 during FY 2010, or abouT $3,000 per client. Of the 60,787 visits to MMC emergency department ( ED) in FY 2010, 39.4% were medicaid beneficiaries and 21.3% either had no insurance or ability to pay or were underinsured. The hospital's high percentage of poor persons who seek care at the ED reguires substantial emergency physician salary subsidy to support the high level of uncompensated care. This amounted to $ 1,807,369 in FY2010, one of the single largest community benefit financial contributions. MMC delivered more babies, 2,802, than any other hospital in Baltimore City in FY 2010. Of these babies, 11.2% were of low birth weight and 13.8% were premature. 60% fo the patients who delivered babies at MMC were either Medicaid beneficiaries or unisured/self pay. This population is especially linked with low birth weight and prematurity due to poverty that closely related to unhealthy lifestyles, particularly, poor nutritition and inadequate prenatal care. 265641316 true true false false false false false false false true false true false false false false false false false false true false false true true false false false false false true false false false false true false false false false true false false false true 372 0 true 3233 true true true true CJ false false false false false false false true 7 1 false false false false true true true true true false false true true true true true true true true false MD X X JOHN TOPPER 4103329313 301 ST PAUL PLACE Baltimore MD 21202 THOMAS MULLEN 40.0 X X 1095098 0 29127 AMY FREEMAN 40.0 X X 951774 0 17868 SAMUEL MOSKOWITZ 40.0 X X 675089 0 30947 SCOTT SPIER md 40.0 X 408945 0 34011 JOHN TOPPER 40.0 X X 808444 0 27512 SUSAN FINLAYSON 40.0 X 642557 0 69531 AINE OCONNOR 40.0 X 0 0 0 JUDITH WEILAND 40.0 X 326240 0 17682 ROBERT EDWARDS 40.0 X 272645 0 27286 JAMES LEVY MD 40.0 X 272736 0 37488 JESSIE REED 40.0 X 299158 0 30784 JOHN LEPLEY 40.0 X 309882 0 25438 6062568 0 347674 128 false true false WHITING TURNER PO BOX 17596 BALTIMORE MD 21297 CONSTRUCTION 121106751 ELLERBE BECKET 1001 G ST NW WASHINGTON DC 20001 ARCHITECT 2854480 UNIVERSITY OF MARYLAND MEDICAL SYST PO BOX 62163 BALTIMORE MD 212642163 MEDICAL SERVICES 3412892 CURA HOSPITALITY PO BOX 827276 PHILADELPHIA PA 19182 FOOD SERVICES 3601746 RADAMERICA II LLC 9105 FRANKLIN SQUARE DR BALTIMORE MD 21237 RADIATION THERAPY 2538811 73 7512741 1179938 1980975 1352804 10673654 PATIENT REVENUE 361150197 361150197 PEDIATRIC REVENUE 627929 627929 361778126 3215413 3215413 0 0 1551099 1557061 -5962 -5962 -31182 25220 -8843 -8843 0 0 0 MANAGEMENT FEE 561000 5458202 154121 5304081 TELEVISION SERVICE 92770 92770 CAFETERIA REVENUE 1800990 1800990 4514031 760668 3753363 11865993 387518381 361778126 883607 14182994 0 0 0 0 2406973 0 2406973 0 0 138717281 102322131 36395150 0 3062555 2348980 713575 12376709 9492935 2883774 9990959 7663066 2327893 1382970 1382970 969523 17143 952380 452892 176065 276827 0 0 216143 216143 24024844 16900806 7124038 1590216 1582786 7430 76625207 72256913 4368294 1052021 1052021 0 8318384 7585143 733241 412002 276426 135576 0 282949 77309 205640 6739340 6739340 0 20901059 20901059 5914741 5185505 729236 REPAIRS AND MAINT 7985962 6995827 990135 OTHER 5223208 3679689 1543519 DONATIONS 97877 97877 BAD DEBT 20975211 20975211 GARAGE TOWNE PARK EXPENSES 1661131 1661131 351380157 265641316 85738841 0 59805697 58933702 23247708 21652316 150000 75000 222901 201120 5046103 5477366 3026104 3196298 667017651 213166930 326492725 453850721 206063767 144993940 80135909 51670718 60578128 58035781 764769042 798086962 46440491 48512885 444488377 440856541 362672 0 56273470 63181353 547565010 552550779 X 179182648 210431026 36856312 33981727 1165072 1123430 217204032 245536183 764769042 798086962 X false true true X true true X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 8067791 8067791 248892043 98885350 150006693 154157999 114281580 39876419 255899818 255899818 453850721 RESTRICTED INVESTMENTS 32335040 F RESTRICTED CASH 19335678 F 51670718 INTEREST IN MERCY HEALTH FOUND 32683840 DUE FROM RELATED ENTITIES 9906910 OTHER RECEIVABLES 2770880 DEPOSITS 733200 DEFERRED FINANCING COSTS 3034987 OTHER CURRENT ASSETS 229274 OTHER ASSETS 179059 INVEST UNCONSOLID SUBS 868380 DEFERRED COMP PLAN ASSETS 5908447 CARDINAL SHEHAN SEC DEPOSIT 1720804 58035781 0 CONSTRUCTION RETAINAGE 10467327 POST RETIREMENT OBLIGATION 5537624 DEFERRED COMPENSATION 5908441 MERRILL LYNCH SWAP 32599933 MALPRACTICE TAIL LIABILITY 327536 CARDINAL DEPOSIT 3436302 RETIREMENT ANNUITY PLAN OBLIGA 3904190 ESTIMATED TAIL LIAB GIC 1000000 63181353 true true true X true X true true false true true 8407003 8407003 0.02390 8407003 8407003 0.02390 4080198 215181 3865017 0.01100 15630 13483181 13483181 0.03840 5 36883 4025733 1156263 2869470 0.00820 1575847 1575847 0.00450 5 52513 23164959 1371444 21793515 0.06210 5 52513 31571962 1371444 30200518 0.08600 1139782 1139782 166 882074 457308 424686 15 138261 138261 135 176049 176049 348101 348101 316 2684267 457308 2226879 false 20975000 94723674 73519537 21204137 X true true MERCY MEDICAL CENTER

301 ST PAUL PLACE BALTIMORE MD 21202

X FINANCIAL ASSISTANCE WILL BE PROVIDED AT NO CHARGE OR AT A REDUCED CHARGE TO PATIENTS WHO ARE UNABLE TO PAY BASED ON A SLIDING SCALE THAT WILL BE APPLIED FOR INCOMES UP TO APPROXIMATELY 400% ABOVE THE HHS POVERTY GUIDELINES. THE POVERTY GUIDELINES ARE ISSUED EACH YEAR BY THE DEPARTMENT OF HEALTH AND HUMAN SERVICES (HSS). IN ORDER TO QUALIFY FOR FINANCIAL ASSISTANCE, ONE OF THE FOLLOWING CONDITIONS MUST BE MET: 1. PATIENT'S INCOME LEVEL IS UP TO 400% OF THE HHS POVERTY GUIDELINES AND THE PATIENT HAS LESS THAN $10,000 IN NET ASSETS TO QUALIFY FOR FULL FINANCIAL ASSISTANCE. 2. PATIENT'S INCOME LEVEL IS AT OR ABOVE THE PARAMETERS OF THE SLIDING SCALE, AND THEIR FINANCIAL PROFILE INDICATES THAT EXPENSES RELATED TO THE NECESSITIES OF LIFE (FOOD, HOUSING, UTILITIES, ETC) EXCEED INCOME. 3. PATIENT IS HOMELESS. 4. PATIENT IS DECEASED, WITH NO PERSON DESIGNATED AS DIRECTOR OF FINANCIAL AFFAIRS, OR NO ESTATE NUMBER ON FILE AT THE APPLICABLE REGISTRAR OF WILLS DEPARTMENT. 5. PATIENT HAS A REMAINING BALANCE AFTER MEDICAL ASSISTANCE. IN ADDITION, THE FOLLOWING CONDITIONS MUST BE MET AND IT WILL THEN BE DETERMINED IF THE PATIENT QUALIFIES FOR FULL OR PARTIAL ASSSISTANCE: A) FIXED INCOME SUCH AS SOCIAL SECURITY, RETIREMENT OR DISABILITY WITH NO ADDITIONAL INCOME SOURCE AVAILABLE. B) MEDICAL EXPENSES WHICH EXCEED 50% OF NET MONTHLY INCOME. IN DETERMINING ELIGIBILITY, THE SIZE OF THE PATIENT'S BILL RELATIVE TO THE PATIENT'S ABILITY TO PAY WILL BE CONSIDERED. FINANCIAL ASSISTANCE WILL BE GRANTED FOR NECESSARY HOSPITAL SERVICES AND IT WILL BE PROVIDED TO THOSE WHO PROPERLY DOCUMENT ELIGIBILITY AND COOPERATE WITH MERCY MEDICAL CENTER'S FINANCIAL ASSISTANCE APPLICATION PROCESS. WITHIN TWO BUSINESS DAYS FOLLOWING A PATIENT'S INITIAL REQUEST FOR FINANCIAL ASSISTANCE SERVICES, APPLICATION FOR MEDICAL ASSISTANCE, OR BOTH, THE FACILITY MUST MAKE A DETERMINATION OF PROBABLE ELIGIBILITY. NOTICE OF THE AVAILABILITY OF FINANCIAL ASSISTANCE IS BE POSTED IN THE ADMISSIONS OFFICE, BUSINESS OFFICE, AND EMERGENCY AREAS OF THE HOSPITAL. SUCH NOTICE IS POSTED IN ENGLISH, SPANISH AND/OR ANY OTHER LANGUAGE THAT WILL BE UNDERSTANDABLE TO TARGET POPULATIONS OF PATIENTS UTILIZING HOSPITAL SERVICES. INDIVIDUAL NOTICE OF THE AVAILABLILITY OF FINANCIAL ASSISTANCE, THE POTENTIAL FOR MEDICAID ELIGIBILITY, AND THE AVAILABILITY OF ASSISTANCE FROM OTHER GOVERNMENT FUNDED PROGRAMS SHALL BE PROVIDED TO EACH PERSON WHO SEEKS SERVICES IN THE HOSPITAL AT THE TIME OF COMMUNITY OUTREACH EFFORTS, PRENATAL SERVICES, PREADMISSION, OR ADMISSION. SUCH NOTICE WILL BE PRINTED IN ENGLISH, SPANISH, AND/OR ANY OTHER LANGUAGE THAT WILL BE UNDERSTANDABLE TO TARGET POPULATIONS OF PATIENTS UTILIZING HOSPITAL SERVICES. MERCY MEDICAL CENTER WILL MAKE AN EFFORT TO PROVIDE THE FINANCIAL ASSISTANCE APPLICATION, POLICIES, PROCEDURES, AND INFORMATION AVAILABLE IN ENGLISH, SPANISH, AND/OR ANY OTHER LANGUAGE THAT WILL BE UNDERSTANDABLE TO TARGET POPULATIONS OF PATIENTS UTILIZING HOSPITAL SERVICES. MERCY MEDICAL CENTER PREPARES ITS COMMUNITY BENEFIT REPORT ANNUALLY AND IT IS MADE AVAILABLE TO THE PUBLIC. IN TABLE 7, A COST-TO-CHARGE RATIO WAS USED IN ALL CALCULATIONS. THERE ARE NO COSTS REPORTED THAT ARE ATTRIBUTABLE TO A PHYSICIAN CLINIC. THE BAD DEBT EXPENSE AS REPORTED ON FORM 990, PART IX, IS $20,975,211. THE COST OF BAD DEBTS ON LINE 2 AND 3 OF SCHEDULE H WAS DETERMINED BASED ON THE COST TO CHARGE RATIO FROM MMC'S ANNUAL FILING WITH THE MHSCRC. THE COSTING SOURCE IS THE MEDICARE COST REPORT AND THE METHODOLOGY IS MC ALLOWABLE COST TO MC REVENUES RECEIVED. Once the collection process has begun, the organization continues to monitor whether the patient qualifies for charity care under the financial assistance policy. If the organization determines that a patient qualifies for financial assistance, including once the collection process has begun, the organization will approve the patient for charity care. Once charity care has been approved, there is no further attempt made by the organization to collect. Collection efforts will be stopped at any time during the collection process if the patient qualifies for charity care under the financial assistance policy. Furthermore, if a patient's financial situation changes at any point during the collection process, the patient may qualify for financial assistance at such point. MERCY MEDICAL CENTER (MMC) IS A LICENSED HOSPITAL. MMC PROVIDES INPATIENT, OUTPATIENT AND EMERGENCY CARE SERVICES PRIMARILY FOR THE CITIZENS OF THE BALTIMORE METROPOLITAN AREA. 7A. CHARITY CARE AT COST AND 7F. HEALTH PROFESSIONS EDUCATION ARE EXPLAINED IN THE FOLLOWING: 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. 7B. UNREIMBURSED MEDICAID IS EXPLAINED IN THE FOLLOWING: 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. MERCY MEDICAL CENTER EMPLOYED A MULTI-PRONGED APPROACH IN IDENTIFYING COMMUNITY NEEDS. THESE APPROACHES ARE AS FOLLOWS: 1. ACCESSING EXISTING DATA SOURCES ON HEALTH CARE STATUS IN PSA As previously referenced, "Baltimore City's Health Status Report: 2008" was the main statistical document that provided the Hospital with key data on the most critical health care conditions affecting the population. Accessed and reviewed other State of Maryland health care data bases related to health care needs of communities that Mercy Medical Center serves beyond its PSA. Publications and data available from organizations in which Mercy Medical Center physician and administrative leadership are active participants and members such as B'More for Healthy Babies, Journey Home, Family Crisis Center of Baltimore, and Baltimore Homeless Services, amoung others. 2. Partnerships, Workgroups, and Membership in Organizations Through the workgroups and partnerships that have been established with key organizations such as Health Care for the Homeless, the Hospital received significant input and feedback on the health care needs of its immediate surrounding neighborhoods and communities. This was achieved through regular meetings and discussions throughout FY 2010. Through participation of the Hospital's executive leadership team in business forums such as The Downtown Partnership and membership in other organizations, significant feedback and information on health care needs and gaps was also gathered. 3. Mercy Health Services Mission and Corporate Ethics Committee The Mission and Corporate Ethics Committee of the Board of Trustees meets regularly to review and coordinate issues related to mission integration and coordination. This Board committee is informed and clearly understands the scope and depth of the Hospital's community benefit need initiatives. In summary, through a quantitative assessment of needs based on review of current data sources and active participation in several community based organizations, Mercy Medical Center was able to determine and prioritize its community need focus. Mercy attempts to be very proactive in communicating its charity care policy and financial assistance contact information to patients. The charity care policy and financial assistance contact information is posted in all admissions areas, including the emergency room. A copy of the policy and financial assistance contact information is also provided to patients or their families during the pre-admission, pre-surgery and admissions process. Mercy utilizes a third party, as well as in-house financial counseling staff, to contact and support patients in understanding and completing the financial assistance requirements. They also discuss with patients or their families the availability of various government benefits and assist patients with understanding the qualifications for such programs. Even after the patient is discharged, each billing statement contains an overview of Mercy's Financial Assistance Policy, a patient's rights and obligations, and contact numbers for financial assistance, financial counseling, and Maryland Medicaid. Follow-up phone calls by hospital billing/collection staff made to patients with unpaid balances also stress the availability of financial assistance and charity care availability. MERCY MEDICAL CENTER PROVIDES AND PROMOTES HEALTH SERVICES FOR THE PEOPLE OF BALTIMORE OF EVERY CREED, RACE, ECONOMIC, AND SOCIAL CONDITION. IN THE SPIRIT OF THE SISTERS OF MERCY WHO ARE ITS SPONSORS, MERCY CONTINUES A SPECIAL COMMITMENT TO THE UNDERSERVED AND THE UNINSURED. CONSISTENT WITH THIS MISSION, IT HAS BEEN THE POLICY OF MERCY MEDICAL CENTER TO ACCEPT, WITHIN THE LIMITS OF ITS FINANCIAL RESOURCES, ALL PATIENTS WHO REQUIRE ITS SERVICES, WITHOUT REGARD TO THEIR ABILITY TO PAY FOR SUCH SERVICES. EMERGENCY CARE WILL BE RENDERED TO ALL PATIENTS WITHOUT REGARD TO THE LIMITATION OF FINANCIAL RESOURCES. THIS POLICY, HOWEVER, DOES NOT PRECLUDE AN ATTEMPT TO REVIEW: 1. THE PATIENT'S ABILITY TO PAY 2. THE AVAILABILITY OF INSURANCE BENEFITS 3. THE ELIGIBILITY OF MEDICAL ASSISTANCE FOR THE PATIENT LOCATED IN THE HEART OF DOWNTOWN BALTIMORE, MERCY MEDICAL CENTER DRAWS PATIENTS FROM THE GREATER BALTIMORE METROPOLITAN AREA FOR ITS LONGSTANDING TRADITION OF COMPASSIONATE CARE, COMMITMENT TO QUALITY AND PATIENT SAFETY, AS WELL AS ITS PRIMARY CARE AND SPECIALIST PHYSICIANS. MERCY MEDICAL CENTER'S PRIMARY SERVICE AREA (PSA) WHICH COMPRISES 16 ZIP CODES IN BALTIMORE CITY, ACCOUNTS FOR ALMOST 60% OF ITS TOTAL ADMISSIONS. KEY DEMOGRAPHIC CHARACTERISTICS OF THE PSA ARE AS FOLLOWS: POPULATION 1. THE PSA 2009 POPULATION IS 535,038. 2. PSA POPULATION GROWTH IS PROJECTED TO DECLINE BY 1.2% FROM 2009 TO 2014. THIS IS IN CONTRAST TO A 3.1% PROJECTED GROWTH FOR THE STATE OF MARYLAND. 3. SINCE 1990, THE DISTRIBUTION OF BALTIMORE CITY RESIDENTS HAS SHIFTED TOWARDS OLDER AGE GROUPS WITH A 6% INCREASE IN THE 40 YEARS AND OLDER POPULATION. THIS TREND OF AN INCREASING OLDER POPULATION GROWTH IS EXPECTED THROUGH 2020. ETHNICITY AND AGE 1. 64% BLACK; 32% CAUCASIAN IN PSA. BALTIMORE CITY'S BLACK POPULATION HAS INCREASED BY 5% SINCE 1990. 2. APPROXIMATELY 59% OF PATIENTS SERVED BY MERCY MEDICAL CENTER ARE MEMBERS OF A RACIAL OR ETHNIC MINORITIES; 66% ARE WOMEN AND 51% ARE MEDICAID AND/OR MEDICARE BENEFICIARIES. 3. 12% OF THE POPULATION IS 65 YEARS IN AGE AND OLDER. INCOME 1. PSA MEDIAN HOUSEHOLD INCOME $35,656 2. 40% OF BALTIMORE CITY HOUSEHOLDS REPORTED AN INCOME OF LESS THAN $30,000. THIS IS ONLY 44% OF THE STATEWIDE MEDIAN INCOME OF $68,080 3. THREE TIMES AS MANY FAMILIES LIVING IN BALTIMORE CITY HAD INCOME THAT WAS BELOW THE POVERTY LEVEL COMPARED TO ALL FAMILIES IN MARYLAND. 4. WITHIN THE HOSPITAL'S IMMEDIATE ZIP CODES OF 21201 AND 21202, 35% OF FAMILIES LIVE BENEATH THE FEDERAL POVERTY LEVEL DEFINITION. OF NOTE, THE MAJOR COMMUNITY BENEFIT PROGRAMS THAT ARE IDENTIFIED IN QUESTION #4 DIRECTLY ADDRESS KEY HEALTH CARE NEEDS OF THE POPULATION IN MERCY MEDICAL CENTER'S PSA. KEY FINDINGS FROM THE "BALTIMORE CITY HEALTH STATUS REPORT 2008" BALTIMORE CITY VS. STATE OF MARYLAND ON KEY HEALTH OUTCOME MEASURES 1. OVERALL MORTALITY RATE: BALTIMORE IS 37% HIGHER 2. LIFE EXPECTANCY: BALTIMORE IS 8% LOWER 3. INFANT MORTALITY: BALTIMORE IS 41% HIGHER 4. LOW BIRTH WEIGHT: BALTIMORE IS 36% HIGHER 5. TEEN BIRTH RATE: BALTIMORE IS TWICE AS HIGH 6. HIV/AIDS MORTALITY: BALTIMORE IS FIVE TIMES HIGHER AS SHOWN BY THESE SELECT INDICATORS, THERE IS A SIGNIFICANT HEALTH STATUS DISPARITY BETWEEN BALTIMORE CITY'S RESIDENTS AND THE REST OF THE STATE OF MARYLAND. DUE TO ITS LOCATION IN CENTER CITY, MERCY MEDICAL CENTER CARES FOR MANY OF THE AT-RISK, LOW INCOME POPULATION IN THE COMMUNITIES THAT IMMEDIATELY SURROUND THE HOSPITAL. THIS IS BEST EVIDENCED BY THE LARGE PERCENTAGE OF EMERGENCY ROOM VISITS BY THE MEDICAID, UNINSURED, AND MEDICARE PATIENTS. MEDICAID COVERED AND UNINSURED PATIENTS ACCOUNTED FOR MORE THAN 50% OF THE FY2010 EMERGENCY ROOM VISITS. 1. BALTIMORE CITY'S LARGEST HOMELESS SHELTER AT GUILFORD AVENUE IS WITHIN THREE BLOCKS OF THE HOSPITAL 2. MERCY MEDICAL CENTER PROVIDES ALL OF THE MEDICAL STAFF (PHYSICIANS AND NURSING PERSONNEL) FOR HEALTHCARE FOR THE HOMELESS(HCH), A FEDERALLY QUALIFIED HEALTH CENTER, WHICH DELIVERS OUTPATIENT CARE TO A LARGE NUMBER OF HOMELESS PERSONS IN BALTIMORE CITY. THE HCH CLINIC IS LOCATED TWO BLOCKS FROM THE HOSPITAL. MERCY SUPPORTIVE HOUSING PROGRAM -------------------------------- THE SUPPORTIVE HOUSING PROGRAM AT MERCY MEDICAL CENTER HAS A STAFF OF EIGHT EXPERIENCED HUMAN SERVICES PERSONNEL WHO WORK IN CONJUNCTION WITH OTHER HOMELESS AND HUMAN SERVICE PROVIDERS TO COORDINATE SERVICES FOR HOMELESS FAMILIES AND FAMILIES AT RISK FOR HOMELESSNESS. THE PROGRAM'S GOAL IS TO HOUSE HOMELESS FAMILIES AND TO PROVIDE SUPPORTIVE SERVICES FOR A DEFINED PERIOD TO PREVENT A RETURN TO HOMELESSNESS. IN FY 2010, THE SUPPORTIVE HOUSING PROGRAM AT MERCY PROVIDED A COMPREHENSIVE RANGE OF COUNSELING SERVICES AND COMMUNITY RESOURCE LINKAGES TO 166 CLIENTS. THESE SERVICES INCURRED DIRECT COSTS OF $523,381 DURING FY2010, OR ABOUT $3,000 PER CLIENT. MERCY FAMILY VIOLENCE RESPONSE PROGRAM THE MERCY FAMILY VIOLENCE RESPONSE PROGRAM WAS DEVELOPED BY A MULTIDISCIPLINARY STAFF TASK FORCE AT MERCY MEDICAL CENTER TO PROVIDE CRISIS INTERVENTION AND SAFETY PLANNING FOR VICTIMS OF FAMILY VIOLENCE (DOMESTIC VIOLENCE, CHILD ABUSE, ELDER AND VULNERABLE ADULT ABUSE) AND SEXUAL ASSAULT WHO COME TO MERCY MEDICAL CENTER AND ITS PHYSICIANS FOR TREATMENT. THIS PROGRAM IMPROVES BALTIMORE'S COORDINATED COMMUNITY RESPONSE TO VICTIMS OF VIOLENCE, AND CREATES AN ALERT WORKFORCE AT MERCY MEDICAL CENTER, SKILLED AT IDENTIFYING AND RESPONDING TO VICTIMS OF FAMILY VIOLENCE. EMERGENCY DEPARTMENT SERVICES AT MERCY MEDICAL CENTER ----------------------------------------------------- OF THE 60,787 VISITS TO MERCY MEDICAL CENTER'S EMERGENCY DEPARTMENT (ED) IN FY 2010, 39.4% WERE MEDICAID BENEFICIARIES AND 21.3% EITHER HAD NO INSURANCE OR ABILITY TO PAY OR WERE UNDERINSURED. THE HOSPITAL'S HIGH PERCENTAGE OF POOR PERSONS WHO SEEK CARE AT THE ED REQUIRES SUBSTANTIAL EMERGENCY PHYSICIAN SALARY SUBSIDY TO SUPPORT THE HIGH LEVEL OF UNCOMPENSATED CARE. THIS AMOUNTED TO $1,807,369 IN FY 2010, ONE OF THE SINGLE LARGEST COMMUNITY BENEFIT FINANCIAL CONTRIBUTIONS. DUE TO ITS LOCATION WITHIN THREE BLOCKS OF THE CITY'S LARGEST HOMELESS SHELTER AT GUILFORD AVENUE AND CLOSE PROXIMITY TO HCH, MERCY MEDICAL CENTER'S ED RECEIVES MANY VISITS FROM HOMELESS PERSONS. WITH DECADES OF EXPERIENCE IN PROVIDING EMERGENT AND URGENT CARE TO POOR AND HOMELESS POPULATIONS, THE HOSPITAL HAS ESTABLISHED KEY SERVICES FOR THE MEDICALLY UNDERSERVED INCLUDING THE FOLLOWING: A FULL TIME SOCIAL WORKER IS A PART OF THE ED TEAM TO COORDINATE CARE AND OTHER SERVICES FOR HOMELESS PATIENTS WHO ARRIVE AT THE ED. ED PHYSICIANS AND NURSES MAKE VISITS TO BALTIMORE CITY SHELTERS TO PROVIDE THE FOLLOWING SERVICES: 1. ADMINISTRATION OF FLU VACCINATIONS TO RESIDENTS 2. PRESENTATIONS ON PARASITES AND INFECTIOUS DISEASE 3. INFECTIOUS DISEASE PREVENTION THE FORENSIC NURSE EXAMINER PROGRAM (FNE) IS HOUSED AT THE HOSPITAL'S ED AND PROVIDES 24/7 CARE TO PATIENTS WHO ARE VICTIMS OF SEXUAL, DOMESTIC, CHILD, ELDER, AND INSTITUTIONAL VIOLENCE. FORENSIC NURSES PROVIDE COMPREHENSIVE FORENSIC MEDICAL INTERVIEWS, MEDICAL ASSESSMENTS, AND EVIDENCE COLLECTION, AND ASSURE CRISIS INTERVENTION TO AN EVER INCREASING VOLUME OF UNDERSERVED PATIENTS. DURING FY 2010, THE FNE PROGRAM CONDUCTED 502 EXAMINATIONS AND IS THE DESIGNATED SITE FOR PATIENTS IN BALTIMORE CITY. LOW BIRTH WEIGHT PROGRAM- DEPARTMENT OF OBSTETRICS -------------------------------------------------- MERCY MEDICAL CENTER DELIVERED MORE BABIES, 2,802, THAN ANY OTHER HOSPITAL IN BALTIMORE CITY IN FY 201O. OF THESE BABIES, 11.2% WERE OF LOW BIRTH WEIGHT AND 13.8% WERE PREMATURE. LOW BIRTH WEIGHT AND PREMATURITY ARE INTERTWINED AND CORRELATED. AS CITED IN QUESTION #2, LOW BIRTH WEIGHT IS A KEY HEALTH STATUS INDICATOR THAT IS MEASURED AND TRACKED BY THE BALTIMORE CITY DEPARTMENT OF HEALTH THAT MUST BE DECREASED IN INCIDENCE. FY2010 RATE MERCY MARYLAND NATIONAL LOW BIRTH WEIGHT 11.2% 9.15% 8.2% PREMATURITY 13.8% 13.40% 12.7% THE HOSPITAL HAS TAKEN A LEADERSHIP ROLE THROUGH ITS ACTIVE PARTICIPATION IN "B'MORE FOR HEALTHY BABIES", A LONG TERM INITIATIVE LED BY THE MAYOR'S OFFICE AND MANAGED BY THE BALTIMORE CITY HEALTH DEPARTMENT TO REDUCE TO INCIDENTS OF LOW BIRTH WEIGHT. DR. ROBERT ATLAS, CHAIRMAN OF MERCY MEDICAL CENTER'S DEPARTMENT OF OBSTETRICS AND GYNECOLOGY, HAS A LEADERSHIP ROLE WITHIN THIS WORKGROUP. THE GOALS OF "B'MORE FOR HEALTHY BABIES" ARE REDUCTION IN THE FOLLOWING: 1. RATE OF PRE-TERM BIRTHS BY AT LEAST 10% 2. RATE OF LOW BIRTH WEIGHT INFANTS BY AT LEAST 10% 3. THE NUMBER OF DEATHS FROM UNSAFE SLEEP BY AT LEAST 10% OF NOTE, 60% OF THE PATIENTS WHO DELIVERED BABIES AT MERCY MEDICAL CENTER WERE EITHER MEDICAID BENEFICIARIES OR UNINSURED/SELF PAY. THIS POPULATION IS ESPECIALLY LINKED WITH LOW BIRTH RATE AND PREMATURITY DUE TO POVERTY THAT CLOSELY RELATES TO UNHEALTHY LIFESTYLES, PARTICULARLY, POOR NUTRITION AND INADEQUATE PRENATAL CARE. IN ORDER TO ENSURE 24/7 COVERAGE FOR ITS OBSTETRICAL PATIENTS, REGARDLESS OF THEIR ABILITY TO PAY, MERCY MEDICAL CENTER PROVIDED $1,415,617 IN PHYSICIAN SUBSIDY FOR THIS SPECIALTY; A 12% INCREASE FROM FY 2009. DETERMINING THE NEEDS IN THE COMMUNITY TO BE ADDRESSED ------------------------------------------------------ SINCE THE INCEPTION OF COMMUNITY BENEFIT REPORTING TO THE HSCRC, MERCY MEDICAL CENTER HAS CONSISTENTLY RANKED AMONG THE TOP FIVE HOSPITALS IN THE STATE OF MARYLAND IN TERMS OF THE PERCENTAGE OF OPERATING REVENUE DEVOTED TO COMMUNITY NEED PROGRAMS. OF NOTE, COMMUNITY BENEFIT AND CHARITY CARE SPENDING AS A PERCENTAGE OF TOTAL OPERATING EXPENSES INCREASED TO 12.2% IN FY2010 FROM 11.9% IN FY2009. A KEY REASON FOR THE HIGHER PERCENTAGE OF MONEY SPENT ON COMMUNITY NEED PROJECTS RELATES DIRECTLY TO THE HOSPITAL'S MISSION AND VALUE STATEMENTS. ACCESS TO CARE FOR AT-RISK, UNDERSERVED POPULATIONS HAS LONG BEEN A CORNERSTONE MISSION FOR MERCY MEDICAL CENTER. MAJOR PROGRAMS TO SERVE THIS NEED INCLUDE OUR FUNDING OF DIRECT PHYSICIAN CHARITY CARE ACROSS ALL SPECIALTIES AND THE PHARMACY CHARITY FUND TO PATIENTS WHO ARE UNINSURED AND UNABLE TO PAY. IN ADDITION, THE FAMILY HEALTH CENTERS OF BALTIMORE (FCHB) IS A FEDERALLY QUALIFIED HEALTH CENTER (FQHC), WHICH RECEIVES SIGNIFICANT FINANCIAL SUPPORT FROM THE HOSPITAL. FCHB, WITH A CLINIC LOCATED ADJACENT TO THE MERCY CAMPUS, LARGELY SERVES THE MEDICAID AND UNINSURED POPULATIONS IN SURROUNDING COMMUNITIES. BASED UPON THE NEEDS ASSESSEMENT, MERCY MEDICAL CENTER IDENTIFIED THREE KEY AREAS OF FOCUS FOR "MISSION DRIVEN HEALTH SERVICES" IN FY 2010; THEY ARE AS FOLLOWS: HOMELESSNESS: THE NEED TO RESPOND TO AND ACTIVELY SUPPORT THE MEDICAL PROFESSIONAL NEEDS OF ORGANIZATIONS THAT SERVE THE HOMELES POPULATION OF BALTIMORE. EMERGENCY SERVICES: AS PROVIDED THROUGH THE EMERGENCY DEPARTMENT, GIVEN THE LARGE PERCENTAGE OF POOR AND UNINSURED PATIENTS WHO ACCESS THIS SERVICE. LOW BIRTH WEIGHT: MERCY MEDICAL CENTER DELIVERS MORE BABIES TO WOMEN AT OR BELOW THE POVERTY LINE THAN ANY OTHER HOSPITAL IN BALTIMORE. A SIGNIFICANT PERCENTAGE (>10%) OF THESE BIRTHS ARE PREMATURE AND OF LOW BIRTH WEIGHT. ALL OF THESE PROGRAMS ARE INTERTWINED AS THEY SHARE A COMMON THREAD IN THAT THE UNDERSERVED AND POOR POPULATIONS OF BALTIMORE ARE THE PRIMARY RECIPIENTS OF MEDICAL SERVICES PROVIDED BY MERCY MEDICAL CENTER ON AND OFF ITS CAMPUS. HOMELESSNESS ------------ THE NUMBER OF PEOPLE EXPERIENCING HOMELESSNESS HAS GROWN STEADILY OVER THE PAST 20 YEARS IN BALTIMORE AND THROUGHOUT THE ENTIRE NATION. THIS NUMBER IS EXPECTED TO CONTINUE TO RISE GIVEN THE DETERIORATING ECONOMIC CONDITIONS LOCALLY AND NATIONALLY THAT CAUSE HIGH UNEMPLOYMENT, LOSS OF HOMES, REDUCED FEDERAL ASSISTANCE TO MEDICAID AND OTHER SAFETY NET PROGRAMS. BALTIMORE'S HOMELESS POPULATION EXTENDS GREATLY BEYOND THOSE WHO CAN FIND BEDS IN CITY AND OTHER NONPROFIT RUN SHELTERS. MERCY MEDICAL CENTER IS DIRECTLY INVOLVED IN THE PROVISION OF MEDICAL SERVICES TO THE HOMELESS POPULATION THROUGH THREE KEY AREAS. HEALTH CARE FOR THE HOMELESS ---------------------------- HEALTH CARE FOR THE HOMELESS (HCH) WAS ESTABLISHED IN 1985 AND PROVIDES ADULT, PEDIATRIC, AND GERIATRIC MEDICAL CARE, DENTAL CARE, MENTAL HEALTH, HIV SERVICES, SOCIAL WORK AND CASE MANAGEMENT, ADDICTION TREATMENT, OUTREACH, PRISON RE-ENTRY, SUPPORTIVE HOUSING, AND ACCESS TO EDUCATION AND EMPLOYMENT. IN 2009, HCH SAW 6,196 PATIENTS WHO ACCOUNTED FOR 65,430 VISITS. WITH ITS NEW LOCATION TWO BLOCKS FROM MERCY MEDICAL CENTER, HCH IS EXPECTED TO PROVIDE SIGNIFICANTLY MORE CARE ACROSS ITS SPECTRUM OF SERVICES DUE TO EXPANDED SPACE AND INCREASED STAFFING. SINCE ITS INCEPTION IN 1985 (A 25-YEAR PARTNERSHIP), MERCY MEDICAL CENTER HAS DIRECTLY EMPLOYED AND PROVIDED ALL OF THE PHYSICIAN AND NURSING STAFF TO HCH FOR MEDICAL SERVICES. WHILE THE HOSPITAL IS REIMBURSED FOR THE DIRECT COSTS OF ITS EMPLOYED CLINICIANS FROM HCH, INDIRECT AND OTHER NON COMPENSATED COSTS CONTRIBUTED TO HCH WERE $886,762 IN FY 2010. AS OF DECEMBER 2009, THE HOSPITAL EMPLOYS AND PROVIDES FOUR PRIMARY CARE PHYSICIANS, TWO NURSE PRACTITIONERS, ONE PHYSICIAN ASSISTANT, AND THREE REGISTERED NURSES TO WORK AT HCH. IN FY2011 AND BEYOND, MERCY MEDICAL CENTER WILL RESPOND AND EXPAND ITS LEVEL OF DIRECT AND INDIRECT SUPPORT TO HCH AS NEEDED: 1. HCH PROJECTS A 10% INCREASE IN THE NUMBER OF PATIENT VISITS TO ITS MAIN CENTER IN DOWNTOWN BALTIMORE IN FY2011. 2. HCH PLANS TO PLACE MID-LEVEL PRACTITIONER STAFFING AT TWO OF THE MAIN HOMELESS SHELTERS IN THE DOWNTOWN AREA. Mercy Medical Center, through its sole member MHS, is governed by a community board comprised of civic leaders who are committed to and represent the healthcare needs of the community. Mercy Medical Center extends medical staff privileges to all qualified physicians for all of its departments. All financial surpluses Mercy Medical Center generates are used exclusively to further the mission of the organization." MERCY SUPPORTIVE HOUSING PROGRAM -------------------------------- THE SUPPORTIVE HOUSING PROGRAM AT MERCY MEDICAL CENTER HAS A STAFF OF EIGHT EXPERIENCED HUMAN SERVICES PERSONNEL WHO WORK IN CONJUNCTION WITH OTHER HOMELESS AND HUMAN SERVICE PROVIDERS TO COORDINATE SERVICES FOR HOMELESS FAMILIES AND FAMILIES AT RISK FOR HOMELESSNESS. THE PROGRAM'S GOAL IS TO HOUSE HOMELESS FAMILIES AND TO PROVIDE SUPPORTIVE SERVICES FOR A DEFINED PERIOD TO PREVENT A RETURN TO HOMELESSNESS. IN FY 2010, THE SUPPORTIVE HOUSING PROGRAM AT MERCY PROVIDED A COMPREHENSIVE RANGE COUNSELING SERVICES AND COMMUNITY RESOURCE LINKAGES TO 166 CLIENTS. THESE SERVICES INCURRED DIRECT COSTS OF $523,381 DURING FY2010, OR ABOUT $3,000 PER CLIENT. MERCY FAMILY VIOLENCE RESPONSE PROGRAM THE MERCY FAMILY VIOLENCE RESPONSE PROGRAM WAS DEVELOPED BY A MULTIDISCIPLINARY STAFF TASK FORCE AT MERCY MEDICAL CENTER TO PROVIDE CRISIS INTERVENTION AND SAFETY PLANNING FOR VICTIMS OF FAMILY VIOLENCE (DOMESTIC VIOLENCE, CHILD ABUSE, ELDER AND VULNERABLE ADULT ABUSE) AND SEXUAL ASSAULT WHO COME TO MERCY MEDICAL CENTER AND ITS PHYSICIANS FOR TREATMENT. THIS PROGRAM IMPROVES BALTIMORE'S COORDINATED COMMUNITY RESPONSE TO VICTIMS OF VIOLENCE, AND CREATES AN ALERT WORKFORCE AT MERCY MEDICAL CENTER, SKILLED AT IDENTIFYING AND RESPONDING TO VICTIMS OF FAMILY VIOLENCE. EMERGENCY DEPARTMENT SERVICES AT MERCY MEDICAL CENTER ----------------------------------------------------- OF THE 60,787 VISITS TO MERCY MEDICAL CENTER'S EMERGENCY DEPARTMENT (ED) IN FY 2010, 39.4% WERE MEDICAID BENEFICIARIES AND 21.3% EITHER HAD NO INSURANCE OR ABILITY TO PAY OR WERE UNDERINSURED. THE HOSPITAL'S HIGH PERCENTAGE OF POOR PERSONS WHO SEEK CARE AT THE ED REQUIRES SUBSTANTIAL EMERGENCY PHYSICIAN SALARY SUBSIDY TO SUPPORT THE HIGH LEVEL OF UNCOMPENSATED CARE. THIS AMOUNTED TO $1,807,369 IN FY 2010, ONE OF THE SINGLE LARGEST COMMUNITY BENEFIT FINANCIAL CONTRIBUTIONS. DUE TO ITS LOCATION WITHIN THREE BLOCKS OF THE CITY'S LARGEST HOMELESS SHELTER AT GUILFORD AVENUE AND CLOSE PROXIMITY TO HCH, MERCY MEDICAL CENTER'S ED RECEIVES MANY VISITS FROM HOMELESS PERSONS. WITH DECADES OF EXPERIENCE IN PROVIDING EMERGENT AND URGENT CARE TO POOR AND HOMELESS POPULATIONS, THE HOSPITAL HAS ESTABLISHED KEY SERVICES FOR THE MEDICALLY UNDERSERVED INCLUDING THE FOLLOWING: A FULL TIME SOCIAL WORKER IS A PART OF THE ED TEAM TO COORDINATE CARE AND OTHER SERVICES FOR HOMELESS PATIENTS WHO ARRIVE AT THE ED. ED PHYSICIANS AND NURSES MAKE VISITS TO BALTIMORE CITY SHELTERS TO PROVIDE THE FOLLOWING SERVICES: ...ADMINISTRATION OF FLU VACCINATIONS TO RESIDENTS ...PRESENTATIONS ON PARASITES AND INFECTIOUS DISEASE ...INFECTIOUS DISEASE PREVENTION THE FORENSIC NURSE EXAMINER PROGRAM (FNE) IS HOUSED AT THE HOSPITAL'S ED AND PROVIDES 24/7 CARE TO PATIENTS WHO ARE VICTIMS OF SEXUAL, DOMESTIC, CHILD, ELDER, AND INSTITUTIONAL VIOLENCE. FORENSIC NURSE PROVIDE COMPREHENSIVE FORENSIC MEDICAL INTERVIEWS, MEDICAL ASSESSMENTS, AND EVIDENCE COLLECTION, AND ASSURE CRISIS INTERVENTION TO AN EVER INCREASING VOLUME OF UNDERSERVED PATIENTS. DURING FY 2010, THE FNE PROGRAM CONDUCTED 502 EXAMINATIONS AND IS THE DESIGNATED SITE FOR PATIENTS IN BALTIMORE CITY. LOW BIRTH WEIGHT PROGRAM- DEPARTMENT OF OBSTETRICS -------------------------------------------------- MERCY MEDICAL CENTER DELIVERED MORE BABIES, 2,802, THAN ANY OTHER HOSPITAL IN BALTIMORE CITY IN FY 201O. OF THESE BABIES, 11.2% WERE OF LOW BIRTH WEIGHT AND 13.8% WERE PREMATURE. LOW BIRTH WEIGHT AND PREMATURELY ARE INTERTWINED AND CORRELATED. AS CITED IN QUESTION #2, LOW BIRTH WEIGHT IS A KEY HEALTH STATUS INDICATOR THAT IS MEASURED AND TRACKED BY THE BALTIMORE CITY DEPARTMENT OF HEALTH THAT MUST BE DECREASED IN INCIDENCE. FY2010 RATE MERCY MARYLAND NATIONAL LOW BIRTH WEIGHT 11.2% 9.15% 8.2% PREMATURITY 13.8% 13.40% 12.7% THE HOSPITAL HAS TAKEN A LEADERSHIP ROLE THROUGH ITS ACTIVE PARTICIPATION IN "B'MORE FOR HEALTHY BABIES", A LONG TERM INITIATIVE LED BY THE MAYOR'S OFFICE AND MANAGED BY THE BALTIMORE CITY HEALTH DEPARTMENT TO REDUCE TO INCIDENCE OF LOW BIRTH WEIGHT. DR. ROBERT ATLAS, CHAIRMAN OF MERCY MEDICAL CENTER'S DEPARTMENT OF OBSTETRICS AND GYNECOLOGY, HAS A LEADERSHIP ROLE WITHIN THIS WORKGROUP. THE GOALS OF "B'MORE FOR HEALTHY BABIES" ARE REDUCTION IN THE FOLLOWING: ...RATE OF PRE-TERM BIRTHS BY AT LEAST 10% ...RATE OF LOW BIRTH WEIGHT INFANTS BY AT LEAST 10% ...THE NUMBER OF DEATHS FROM UNSAFE SLEEP BY AT LEAST 10% OF NOTE, 60% OF THE PATIENTS WHO DELIVERED BABIES AT MERCY MEDICAL CENTER WERE EITHER MEDICAID BENEFICIARIES OR UNINSURED/SELF PAY. THIS POPULATION IS ESPECIALLY LINKED WITH LOW BIRTH RATE AND PREMATURELY DUE TO POVERTY THAT CLOSELY RELATES TO UNHEALTHY LIFESTYLES, PARTICULARLY, POOR NUTRITION AND INADEQUATE PRENATAL CARE. IN ORDER TO ENSURE 24/7 COVERAGE FOR ITS OBSTETRICAL PATIENTS, REGARDLESS OF THEIR ABILITY TO PAY, MERCY MEDICAL CENTER PROVIDED $1,415,617 IN PHYSICIAN SUBSIDY FOR KEY MERCY HEALTH SERVICES (MHS) PARTNERSHIPS/WORK GROUPS GROUP NAME: JOURNEY HOME PURPOSE AND MMC PARTICIPATION: SISTER HELEN AMOS, RSM, EXECUTIVE CHAIR OF THE MERCY HEALTH SERVICES (MHS) BOARD OF TRUSTEES AND FORMER CEO OF MHS, SERVES AS CHAIR OF THE LEADERSHIP ADVISORY GROUP FOR THE ORGANIZATION WHOSE PURPOSE IS TO END HOMELESSNESS IN BALTIMORE. GROUP NAME: HEALTH CARE FOR THE HOMELESS PURPOSE AND MMC PARTICIPATION: HEALTH CARE FOR THE HOMELESS (HCH) PROVIDES HEALTH-RELATED SERVICES TO REDUCE THE INCIDENCE AND BURDENS OF HOMELESSNESS; ITS MAIN SITE IS WITHIN TWO BLOCKS OF MERCY MEDICAL CENTER (MMC). CATHERINE KELLY, DIRECTOR OF COMMUNITY OUTREACH OF MMC SERVES ON HCH'S BOARD OF DIRECTORS. GROUP NAME: BALTIMORE HOMELESS SERVICES PURPOSE AND MMC PARTICIPATION: A PROGRAM WITHIN THE CITY OF BALTIMORE CONSISTING OF PROVIDERS AND STAKEHOLDERS INVOLVED IN ADDRESSING HOMELESSNESS. GROUP NAME: GUILFORD AVENUE SHELTER PURPOSE AND MMC PARTICIPATION: BALTIMORE CITY'S LARGEST SHELTER, WHERE MMC HAS ESTABLISHED CLINICAL OUTREACH SERVICES ON-SITE. GROUP NAME: MAYOR'S OFFICE ON EMERGENCY MANAGEMENT PURPOSE AND MMC PARTICIPATION: MMC SERVES ON THE EMERGENCY PREPAREDNESS TASK FORCE FOR BALTIMORE CITY. GROUP NAME: SEX AND FAMILY CRIMES DIVISION OF THE BALTIMORE CITY POLICE DEPARTMENT PURPOSE AND MMC PARTICIPATION: MERCY'S FAMILY VIOLENCE RESPONSE PROGRAM WORKS CLOSELY WITH THE CITY'S POLICE DEPARTMENT AS THE HOSPITAL HAS THE ONLY FORENSIC NURSE EXAMINER PROGRAM IN BALTIMORE CITY. GROUP NAME: FAMILY CRISIS CENTER OF BALTIMORE (FCCB) PURPOSE AND MMC PARTICIPATION: FCCB IS A MAJOR REFERRAL PARTNER TO MERCY'S FORENSIC NURSE EXAMINER AND SUPPORTIVE HOUSING PROGRAMS. GROUP NAME: DOMESTIC VIOLENCE COORDINATING COUNCIL PURPOSE AND MMC PARTICIPATION: MARY CATHERINE-WEBB, DIRECTOR OF SOCIAL SERVICES AT MMC SERVES ON THE ORGANIZATION'S STEERING COMMITTEE. GROUP NAME: B'MORE FOR HEALTHY BABIES (BHB) PURPOSE AND MMC PARTICIPATION: BHB IS A COALITION OF PHYSICIANS AMONG BALTIMORE CITY'S MAJOR HOSPITALS THAT ADDRESS WAYS TO REDUCE INFANT MORTALITY, PREMATURITY, AND LOW BIRTH WEIGHT. ROBERT ATLAS, M.D., MMC'S CHAIRMAN OF OBSTETRICS AND GYNECOLOGY IS A LEADER WITHIN BHB. GROUP NAME: FRIENDS OF PATTERSON PARK PURPOSE AND MMC PARTICIPATION: MERCY IS ACTIVELY INVOLVED IN AND FINANCIALLY SUPPORTS THE "HEALTHY LIVING INITIATIVE" OF FPP. GROUP NAME: FAMILY HEALTH CENTERS OF BALTIMORE (FCHB) PURPOSE AND MMC PARTICIPATION: SAM MOSKOWITZ, MMC'S CHIEF OPERATING OFFICER SERVES ON THE BOARD OF DIRECTORS OF FCHB, A FEDERALLY QUALIFIED HEALTH CENTER THAT SERVES CENTRAL AND SOUTH BALTIMORE CITY. X X X X false true false false false false false true false THOMAS MULLEN 676902 0 0 0 418196 0 7350 0 21777 0 1124225 0 261258 AMY FREEMAN 328859 0 0 0 622915 0 7350 0 10518 0 969642 0 571502 SAMUEL MOSKOWITZ 437074 0 0 0 238015 0 7350 0 23597 0 706036 0 169540 SCOTT SPIER md 353668 0 0 0 55277 0 10822 0 23189 0 442956 0 0 JOHN TOPPER 336898 0 0 0 471546 0 7350 0 20162 0 835956 0 418969 SUSAN FINLAYSON 265726 0 0 0 376831 0 38350 0 31181 0 712088 0 311892 JUDITH WEILAND 260723 0 0 0 65517 0 13974 0 3708 0 343922 0 31341 ROBERT EDWARDS 235295 0 0 0 37350 0 7124 0 20162 0 299931 0 0 JAMES LEVY MD 240736 0 24000 0 8000 0 10956 0 26532 0 310224 0 0 JESSIE REED 195546 0 0 0 103612 0 19396 0 11388 0 329942 0 84187 JOHN LEPLEY 200022 0 0 0 109860 0 6179 0 19259 0 335320 0 78861 NONQUALIFIED RETIREMENT PLAN SCH J LINE 4B The Corporation maintained a nonqualified plan of deferred compensation for certain employees. The Plan only permits deferrals (that is, no contributions are made by the Corporation). Due to the changes in tax laws, the plan was terminated during the year and participating employees were paid and taxed on the entirety of their accounts. Schedule J reports the amounts distributed, which amounts were reflected as contributions in prior periods. The following individuals received distributions from the nonqualified deferred compensation plan in the following amounts: THOMAS MULLEN $261,258 JOHN TOPPER $418,969 SAMUEL MOSKOWITZ $169,540 AMY FREEMAN $571,502 SUSAN FINLAYSON $311,892 JUDITH WEILAND $ 31,341 JESSIE REED $ 84,187 JOHN LEPLEY $ 78,861 NON-FIXED PAYMENTS SCH J LINE 7 The Compensation Committee approves non-fixed payments for management based on the degree of meeting corporate priorities established by the Board of Trustees. The corporate objectives are designed to advance the organization in the areas of quality care, patient safety, patient satisfaction, business development and financial strength. MARYLAND HEALTH & HIGHER EDUCATIONAL FAC AUTHORITY 520936091 574217XX8 2006-08-03 35000000 2006 REPLACEMENT GARAGE AND RO false false MARYLAND HEALTH & HIGHER EDUCATIONAL FAC AUTHORITY 520936091 574217L29 2007-11-08 155000000 2007 A REPLACEMENT TOWER AND R false false MARYLAND HEALTH & HIGHER EDUCATIONAL FAC AUTHORITY 520936091 574217L37 2007-11-08 150000000 2007 B C D REPLACEMENT PATIENT false false MARYLAND HEALTH & HIGHER EDUCATIONAL FAC AUTHORITY 520936091 574217Y41 2008-07-16 35325000 2008 REFUNDING OF 2003 BONDS false false MARYLAND HEALTH & HIGHER EDUCATIONAL FACILITY AUTH 520936091 5742174Z5 2009-12-16 30000000 2009 PARTIAL CONVERSION 2008 BONDS false false 35952865 330107 35622758 2008 false false true true 168743062 12498309 8812500 48660602 1508050 97263600 2011 true false false true 155940666 4527890 896739 150516037 2011 false false false true 35457518 35070000 387518 2008 true false true true 30000000 30000000 2009 true false true true false true true false true 0.00000 0.00000 0.00000 true false true true false true 0.00000 0.00000 0.00000 true false true true false true 0.00000 0.00000 0.00000 true false true true false true 0.00500 0.00100 0.00600 true false true true false true 0.00500 0.00100 0.00600 true false false true MERRILL LYNCH 30. false false true false false true MERRILL LYNCH 30. true GE FUNDING 4.25 true false true false true true MERRILL LYNCH 35. true GE FUNDING 2. true false true false true false false false true false false false false false true SUSAN FINLAYSON RELOCATION X 250000 75000 false true true 75000 X Cost savings false false false DESCRIPTION OF 990 REVIEW PROCESS PART VI, LINE 11 Mercy Health Services, Inc. ("MHS), the sole parent of the Corporation, has a policy which requires the Corporation's 990 to be made available for review by the MHS Board and/or the MHS Board Executive Committee prior to its filing. At its March 23, 2011 meeting, MHS Board Executive Committee members received a copy of the Corporation's draft form 990. The MHS CFO provided a power point presentation regarding the draft and there was an opportunity for questions and discussion. Following further revision of the draft 990 and prior to its filing, it was made available in final form to all members of the MHS Board and the Corporation's Board. CONFLICTS OF INTEREST MONITORING AND ENFORCEMENT PART VI, LINE 12C MHS HAS A WRITTEN CONFLICT OF INTEREST POLICY THAT COVERS MHS AND ALL OF ITS DIRECT AND INDIRECT SUBSIDIARIES. THE INDIVIDUALS COVERED UNDER THE POLICY INCLUDE ALL TRUSTEES, DIRECTORS, OFFICERS (INCLUDING ALL SENIOR AND EXECUTIVE VICE PRESIDENTS) AND MEMBERS OF ANY COMMITTEE WITH BOARD-DELEGATED POWERS. UNDER THE POLICY, EACH SUCH PERSON IS REQUIRED TO COMPLETE AN ANNUAL DISCLOSURE FORM REGARDING BUSINESS RELATIONSHIPS THAT HE OR SHE, OR ANY FAMILY MEMBER, HAS WITH ANY OTHER ORGANIZATION THAT DOES BUSINESS WITH MHS OR ITS SUBSIDIARIES AND RELATIONSHIPS BETWEEN AND AMONG OFFICERS, TRUSTEES AND DIRECTORS. THE COMPLETED DISCLOSURE FORMS ARE REVIEWED BY THE MHS BOARD CHAIR AND BY THE MHS CEO OR A DESIGNEE. IN ADDITION TO THE ANNUAL DISCLOSURE, ANY PERSON WHO IS COVERED BY THE CONFLICT OF INTEREST POLICY HAS AN ONGOING OBLIGATION TO DISCLOSE THE EXISTENCE OF ANY ACTUAL OR POTENTIAL CONFLICT TO THE BOAURD OR THE BOARD COMMITTEE IN WHICH THE MATTER ARISES. FOLLOWING THE DISCLOSURE, THE PERSON MAY MAKE A PRESENTATION, BUT MUST THEN LEAVE THE MEETING AND THE OTHER MEMBERS OF THE BOARD OR COMMITTEE SHALL DETERMINE WHETHER A CONFLICT EXISTS. UNDER THE POLICY, A CONFLICT OF INTEREST EXISTS WHEN AN INDIVIDUAL'S OWN PERSONAL INTERST WOULD, OR MAY, INTERFERE WITH HIS OR HER IMPARTIALITY REGARDING THE MATTER. IF A CONFLICT EXISTS, THE PERSON MAY NOT BY PRESENT DURING DELIBERATIONS ON THE MATTER OR VOTE ON IT. THE BOARD OR COMMITTEE, AFTER CONDUCTING SUCH ADDITIONAL DUE DILIGENCE AS IT DETERMINES IS APPROPRIATE, SHALL MAKE A DECISION ON THE MATTER BASED UPON WHETHER THE PARTICULAR PROPOSAL IS FAIR, REASONABLE AND IN THE BEST INTEREST OF THE ORGANIZATION. PROCESS OF DETERMINING COMPENSATION PART VI, LINE 15 THE ORGANIZATION'S BOARD HAS ADOPTED A COMPENSATION POLICY (THE "POLICY") FOR COVERED INDIVIDUALS. PURSUANT TO THE POLICY, A COMPENATION COMMITTEE OF INDEPENDENT DIRECTORS OF THE BOARD OF THE ORGANIZATION'S PARENT CORPORATION WAS ESTABLISHED TO REVIEW THE COMPENSATION OF ALL EMPLOYEES SPECIFIED AS HAVING A SUBSTANTIAL INFLUENCE OVER THE ORGANIZATION AND WHO RECEIVE REMUNERATION FROM THE ORGANIZATION. THE COMPENSATION COMMITTEE IS ADVISED BY AN INDEPENDENT COMPENSATION CONSULTANT, WHICH OPINES TO THE COMPENSATION COMMITTEE THAT THE LEVEL OF COMPENSATION PAID AND THE PROCESS BY WHICH COMPENSATION IS ESTABLISHED MEET APPLICABLE IRS REASONABLENESS AND "SAFE HARBOR" STANDARDS. THE OUTSIDE COMPENSATION CONSULTANT PROVIDES DATA OF COMPENSATION PROVIDED AT SIMILAR ORGANIZATIONS TO ENSURE THAT THE ORGANIZATION DOES NOT COMPENSATE IN EXCESS OF MARKET NORMS. Mercy Health Services, Inc. (the Corporation's sole member) has a written policy regarding the review of physician compensation titled "Amended and Restated Physician Compensation Review." The policy applies to all MHS subsidiaries, including the Corporation, and it sets out the process and procedures for ensuring that physician compensation is appropriately reviewed and determined to be consistent with fair market value. Under the policy the review and determination must be documented in writing. The policy addresses internal reviews through benchmarking of physician compensation against nationally recognized compensation survey data, the use of independent compensation consultants and review by the MHS Board Compensation Committee. The policy further requires that all compensation reviews be performed in accordance with the MHS Conflict of Interest Policy. DOCUMENT AVAILABILITY PART VI, LINE 19 The governing documents of the organization, its conflicts of interest policy, and its financial statements are available from the organization upon request. AUDITS PART XI, QUSTIONS 2 AND 3 MERCY HEALTH SYSTEM, INC. AND ITS SUBSIDIARES INCLUDING THE ORGANIZATION FILING THIS FORM 990, UNDERGO A CONSOLIDATED AUDIT OF THEIR FINANCIAL STATEMENT THAT COMPLIES WITH SINGLE AUDIT ACT/OMB CIRCULAR A-133 REQUIREMENTS DUE TO THE EXPENDITURE OF FEDERAL AWARDS. THE ACCOUNTING FIRM OF COHEN, RUTHERFORD + KNIGHT P.C. HAS ISSUED AN UNQUALIFIED OPINION REGARDING THE CONSOLIDATED FINANCIAL STATEMENTS IN CONFORMANCE WITH GENERALLY ACCEPTED AUDIT STANDARDS AND THE SINGLE AUDIT ACT/OMB CIRCULAR A-133 REQUIREMENTS FOR THE FISCAL YEAR THAT CORRESPONDS TO THE TAX REPORTING YEAR GOVERNED BY THIS FORM 990. SUPPLEMENTAL INFORMATION FOR SCHEDULE K SCHEDULE K, PART I, COLUMN G, LINE C AND D LINE C AND D HAS BEEN CHECKED SINCE THESE BOND ISSUES HAVE NOT BEEN FULLY REFUNDED; HOWEVER, THEY HAVE BEEN PARTIALLY REFUNDED, AND THE BOND ISSUES TO PARTIALLY REFUND BONDS LISTED ON LINES C AND D OF PART I ARE SHOWN ON LINE E AND A. SUPPLEMENTAL FOR SCHEDULE K SCHEDULE K, PART II, LINE 3 PROCEEDS FROM THE "2007 A REPLACEMENT TOWERS" BONDS AND "2008 REFUNDING OF 2003 BONDS" WERE USED TO REFUND BOND ISSUES NOT LISTED ON SCHEDULE K BECAUSE THESE UNLISTED BOND ISSUES WERE FULLY DEFEASED AS OF JUNE 30TH, 2010. PART VI, LINE 1B Mercy Health Services, Inc. ("MHS"), a 501(c)(3) corporation, is the sole member of Mercy Medical Center, Inc. ("MMC"). MHS is governed by a 26-person Board of Trustees, of whom 21 are independent board members. The Board of Directors of MMC is currently made of 7 directors. The President of MHS serves as an ex officio member of MMC's Board and the balance of the MMC Board members are elected by, and subject to removal by, the Board of Trustees of MHS. One of the members of the MFC Board is independent. Seven of the Board members are compensated as employees either of MFC or a related organization listed in Schedule R, Part II. PART VI, LINE 6 MHS is the sole member of MMC. PART VI, LINE 7A The President of MHS serves as an ex officio voting member of the Board of Directors of MMC. As the member of MMC, the Board of Trustees of MHS elects all of the other members of the Board of MMC. All of the members of the MMC Board serve at the pleasure of the Board of Trustees of MHS and are subject to removal by the MHS Board. PART VI, LINE 7B The Board of Trustees of MHS exercises authority over MMC through its right to appoint and remove MMC Board members. In addition, MHS, as the member, is responsible for the following actions: a) to appoint members to MMC's Board of Directors; b) to review and approve or disapprove the strategic plan, annual budget and the annual operating goals and objectives of MMC as recommended to MHS by MMC's Board of Directors; c) to evaluate the performance of MMC's Board of Directors, officers, and operating management; d) to remove Board members of MMC in its discretion at any time; e) to approve the mission and vision that govern MMC's operations; f) to have ultimate responsibility for MMC's quality assurance, performance improvement, utilization review and risk management; and g) to appoint, reappoint and take any corrective action related to the Medical Staff of MMC (the "Medical Staff") in accordance with the Medical Staff Bylaws of MMC. The following actions require the approval of and affirmative corporate action by MHS: a) any disposition of all or substantially all of MMC's assets, dissolution, liquidation, winding up or abandonment of MMC; b) any amendment of the Articles of Incorporation or Bylaws of MMC or of the Medical Staff Bylaws of MMC; c) any borrowing or lending by MMC or the issuance of any guarantee by MMC in an amount in excess of an amount specified by MHS from time to time; d) any merger, consolidation or institutional affiliation with any other corporation or other entity; and e) the purchase or sale of assets for an amount in excess of an amount specified from time to time by MHS. Ultimately, the Corporation is controlled by MHS's 26-person community board, which includes 21 independent directors as noted above. 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