CALVERTHEALTH MEDICAL CENTER INC: Form 990, tax year 2009

View the entire original 990 at ProPublica ↗

Organization
CALVERTHEALTH MEDICAL CENTER INC (EIN 52-0619000)
Tax period
2009-07-01 to 2010-06-30
Filed
2011-05-16
IRS object ID
201121369349305002
Schema version
2009v1.7
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Timestamp2011-05-16T14:11:35-05:00Timestamp
Tax Period End Date2010-06-30TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1COHEN RUTHERFORD KNIGHT PCBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line16903 ROCKLEDGE DRIVE SUITE 500AddressLine1
CityBETHESDACity
StateMDState
ZIP Code208171800ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2009-07-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN520619000EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1Calvert Memorial Hospital of Calvert CountyBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlCALVNameControl
Phone4105354000Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1100 Hospital RoadAddressLine1
CityPrince FrederickCity
StateMDState
ZIP Code20678ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameJames XinisName
TitlePresident and CEOTitle
Phone4105358239Phone
Date Signed2011-05-12DateSigned
Authorize Third PartytrueAuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
Phone3018281008Phone
FieldValueIRS element (for citing)
Tax Year2009TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonJAMES XINISNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1100 HOSPITAL RDAddressLine1
CityPRINCE FREDERICKCity
StateMDState
ZIP Code20678ZIPCode
FieldValueIRS element (for citing)
Gross Receipts116817717GrossReceipts
Group Return For AffiliatesfalseGroupReturnForAffiliates
Organization501cXOrganization501c
Web Sitewww.calverthospital.orgWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1918YearFormation
State Legal DomicileMDStateLegalDomicile
Activity Or Mission DescriptionCALVERT MEMORIAL HOSPITAL PROVIDES QUALITY INPATIENT AND AMBULATORY HEALTH CARE TO THE PEOPLE OF SOUTHERN MARYLAND THAT IS ACCESSIBLE, COST-EFFECTIVE AND COMPASSIONATE.ActivityOrMissionDescription
Nbr Voting Members Governing Body19NbrVotingMembersGoverningBody
Nbr Independent Voting Members15NbrIndependentVotingMembers
Total Nbr Employees1198TotalNbrEmployees
Total Nbr Volunteers164TotalNbrVolunteers
Total Gross UBI924028TotalGrossUBI
Net Unrelated Business Txbl Income-107403NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year732900ContributionsGrantsPriorYear
Contributions Grants Current Year1032422ContributionsGrantsCurrentYear
Program Service Revenue Prior Year108791050ProgramServiceRevenuePriorYear
Program Service Revenue CY113459935ProgramServiceRevenueCY
Investment Income Prior Year645883InvestmentIncomePriorYear
Investment Income Current Year160356InvestmentIncomeCurrentYear
Other Revenue Prior Year1565713OtherRevenuePriorYear
Other Revenue Current Year2108110OtherRevenueCurrentYear
Total Revenue Prior Year111735546TotalRevenuePriorYear
Total Revenue Current Year116760823TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year699505GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year52830721SalariesEtcPriorYear
Salaries Etc Current Year57183282SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year55043257OtherExpensePriorYear
Other Expenses Current Year59650566OtherExpensesCurrentYear
Total Expenses Prior Year108573483TotalExpensesPriorYear
Total Expenses Current Year116833848TotalExpensesCurrentYear
Revenues Less Expenses Prior Year3162063RevenuesLessExpensesPriorYear
Revenues Less Expenses CY-73025RevenuesLessExpensesCY
Total Assets BOY104101832TotalAssetsBOY
Total Assets EOY102163097TotalAssetsEOY
Total Liabilities BOY74665728TotalLiabilitiesBOY
Total Liabilities EOY77807926TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY29436104NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY24355171NetAssetsOrFundBalancesEOY
Mission DescriptionCALVERT MEMORIAL HOSPITAL PROVIDES QUALITY INPATIENT AND AMBULATORY HEALTH CARE TO THE PEOPLE OF SOUTHERN MARYLAND THAT IS ACCESSIBLE, COST-EFFECTIVE AND COMPASSIONATE. CMH WORKS IN PARTNERSHIP WITH THE COMMUNITY TO IMPROVE THE HEALTH STATUS OF ITS MEMBERS.MissionDescription
Significant New Program ServicesfalseSignificantNewProgramServices
Significant ChangefalseSignificantChange
Expense109402424Expense
Revenue113976153Revenue
DescriptionCalvert Memorial Hospital's mission is for the charitable purpose of providing quality inpatient and ambulatory health care services to the citizens of Southern Maryland that is accessible, cost effective and compassionate. The Hospital works in partnership with the community to improve the health status of its members. The Hospital provides medical services to patients regardless of race, creed, sex, national origin, handicap, age or ability to pay. In FY 2010, the Hospital served 9,186 inpatients, 131,600 outpatients and provided 40,309 emergency room visits. For FY 2010, the Hospital filed with the State of Maryland a Community Benefit Report that documented $10,204,379 in community benefit provided by Calvert Memorial Hospital. The Community Benefit Report is available upon request. All financial surpluses the Hospital generates are used exclusively to further the charitable purposes of the organization. The Hospital is governed by a community board comprised of civic leaders throughout Calvert County who are committed to and represent the healthcare needs of the community. The Hospital in FY 2010 provided over $2,021,100 in charity care to residents who were unable to pay for those services and met eligibility criteria. The Hospital, as a sole community provider, provides essential healthcare services such as obstetrics, psychiatry (both inpatient and outpatient), emergency services, urgent care and long-term care that otherwise would not be provided within Calvert County or would have to be provided by the government. Many of these services by their nature are unprofitable services due to their high cost and low reimbursement. These services would not be provided if the Hospital did not step in to provide them. In addition, in FY 2010, the Hospital provided $290,753 OF free health services for Calvert Healthcare Solutions patients. Calvert Healthcare Solutions is a partnership between the local health department, local physicians and the Hospital that provides primary care services to patients who are uninsured.Description
Total Program Service Expense109402424TotalProgramServiceExpense
Described In501 C3trueDescribedIn501C3
Schedule B RequiredtrueScheduleBRequired
Political ActivitiesfalsePoliticalActivities
Lobbying ActivitiesfalseLobbyingActivities
Donor Advised FundsfalseDonorAdvisedFunds
Conservation EasementsfalseConservationEasements
Collections Of ArtfalseCollectionsOfArt
Credit CounselingfalseCreditCounseling
Term Or Permanent EndowmentsfalseTermOrPermanentEndowments
Balance Sheet Amounts ReportedtrueBalanceSheetAmountsReported
Independent Audit Financial StmtfalseIndependentAuditFinancialStmt
Consolidated Audit Financial StmttrueConsolidatedAuditFinancialStmt
SchoolfalseSchool
Foreign OfficefalseForeignOffice
Foreign ActivitiesfalseForeignActivities
More Than5000 K To OrganizationsfalseMoreThan5000KToOrganizations
More Than5000 K To IndividualsfalseMoreThan5000KToIndividuals
Professional FundraisingfalseProfessionalFundraising
Fundraising ActivitiesfalseFundraisingActivities
GamingfalseGaming
HospitaltrueHospital
Grants To OrganizationsfalseGrantsToOrganizations
Grants To IndividualsfalseGrantsToIndividuals
Schedule J RequiredtrueScheduleJRequired
Tax Exempt BondstrueTaxExemptBonds
Invest Tax Exempt BondsfalseInvestTaxExemptBonds
Escrow AccountfalseEscrowAccount
On Behalf Of IssuerfalseOnBehalfOfIssuer
Excess Benefit TransactionfalseExcessBenefitTransaction
Prior Excess Benefit TransactionfalsePriorExcessBenefitTransaction
Loan To Officer Or DQPfalseLoanToOfficerOrDQP
Grant To Related PersonfalseGrantToRelatedPerson
Bsnss Rltnshp With OrganizationfalseBsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family MemberfalseBsnssRltnshpThruFamilyMember
Officer Entity With Bsnss RltnshptrueOfficerEntityWithBsnssRltnshp
Deductible Non Cash ContributionsfalseDeductibleNonCashContributions
Deductible Contributions Of ArtfalseDeductibleContributionsOfArt
TerminatedfalseTerminated
Partial LiquidationfalsePartialLiquidation
Disregarded EntitytrueDisregardedEntity
Related EntitytrueRelatedEntity
Related Org Controlled EntitytrueRelatedOrgControlledEntity
Transfers To Exempt Non Chrtbl OrgfalseTransfersToExemptNonChrtblOrg
Activities Conducted PartnershipfalseActivitiesConductedPartnership
Schedule O RequiredtrueScheduleORequired
Number Forms Transmitted With1096113NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup WitholdingtrueComplianceWithBackupWitholding
Number Of Employees1198NumberOfEmployees
Employment Tax Returns FiledtrueEmploymentTaxReturnsFiled
Unrelated Business IncometrueUnrelatedBusinessIncome
Form990-T FiledtrueForm990-TFiled
Foreign Financial AccountfalseForeignFinancialAccount
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTrans
Taxable Party NotificationfalseTaxablePartyNotification
Non Deductible ContributionsfalseNonDeductibleContributions
Quid Pro Quo ContributionsfalseQuidProQuoContributions
Form8282 Property Disposed OffalseForm8282PropertyDisposedOf
Funds To Pay PremiumsfalseFundsToPayPremiums
Premiums PaidfalsePremiumsPaid
Nbr Voting Governing Body Members19NbrVotingGoverningBodyMembers
Number Independent Voting Members15NumberIndependentVotingMembers
Family Or Business RelationshipfalseFamilyOrBusinessRelationship
Delegation Of Management DutiesfalseDelegationOfManagementDuties
Changes To Organizing DocsfalseChangesToOrganizingDocs
Material Diversion Or MisusefalseMaterialDiversionOrMisuse
Members Or StockholdersfalseMembersOrStockholders
Election Of Board MembersfalseElectionOfBoardMembers
Decisions Subject To ApprovalfalseDecisionsSubjectToApproval
Minutes Of Governing BodytrueMinutesOfGoverningBody
Minutes Of CommitteestrueMinutesOfCommittees
Officer Mailing AddressfalseOfficerMailingAddress
Local ChaptersfalseLocalChapters
Form990 Provided To Governing BodytrueForm990ProvidedToGoverningBody
Conflict Of Interest PolicytrueConflictOfInterestPolicy
Annual Disclosure Covered PersonstrueAnnualDisclosureCoveredPersons
Regular Monitoring EnforcementtrueRegularMonitoringEnforcement
Whistleblower PolicytrueWhistleblowerPolicy
Document Retention PolicytrueDocumentRetentionPolicy
Compensation Process CEOtrueCompensationProcessCEO
Compensation Process OtherfalseCompensationProcessOther
Investment In Joint VenturefalseInvestmentInJointVenture
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonROBERT KERTISNamePerson
Telephone Number4105354000TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1100 HOSPITAL ROADAddressLine1
CityPRINCE FREDERICKCity
StateMDState
ZIP Code20678ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (30 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationOfficerOfficerKey EmployeeKeyEmployeeHighest Compensated EmployeeHighestCompensatedEmployee
CLIFF STEWART
DIRECTOR2.0X000
DEAN SCHLEICHER
CHAIRPERSON2.0X000X
KEVIN BETZ
VICE CHAIRPERSON2.0X000X
GAIL GIBSON
SECRETARY2.0X000X
EMAD AL BANNA
DIRECTOR5.0X7070000
CHARLES JUDGE
DIRECTOR2.0X1473800
MARY KRUG
DIRECTOR2.0X000
VICTOR CORNELLIER
DIRECTOR2.0X000
KEVIN NIETMANN
TREASURER3.0X000X
MARSHA PLATER
DIRECTOR2.0X681000
SALLY SHOWALTER
CHAIRPERSON3.0X000X
LAURIE UHEREK
VICE CHAIRPERSON, TREASURER7.0X000X
JAMES XINIS
PRESIDENT AND CEO40.0X4386860422965X
PETER DALY
DIRECTOR4.0X000
PAMELA LUCAS
DIRECTOR2.0X000
JOHN WEIGEL
DIRECTOR3.0X000
MARIE KIMBALL THOMAS
DIRECTOR2.0X000
ANWAR MUNSHI
DIRECTOR2.0X000
HENRY TRENTMAN
DIRECTOR3.0X000
ROBERT KERTIS
VP FINANCE40.0000X
ROBERT MCWHIRT
VP CNE PATIENT CARE SERVICES40.0171179047797X
SUSAN DOHONY
VP CQO PERFORM IMPROVEMENT40.0155277051253X
EDWARD GROGAN
VP IT40.0155028027459X
ROBERT SCHLAGER
VP MEDICAL AFFAIRS40.0171858022752X
D KIRK BLANDFORD
VP FINANCE40.0262329039717X
SEYED ALI MOHAMMADI
PHYSICIAN40.0268741021470X
MARA DAIDONE
PHYSICIAN40.0345674019383X
FAISAL BHINDER
PHYSICIAN40.0336036029762X
APARAJI MAHATA
PHYSICIAN40.0297165022570X
MITRA NASSIRAEE
PHYSICIAN40.0202913017004X
FieldValueIRS element (for citing)
Total Reportable Comp From Org2897134TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs0TotalReportableCompFrmRltdOrgs
Total Other Compensation722132TotalOtherCompensation
Number Individuals GT100 K52NumberIndividualsGT100K
Formers ListedfalseFormersListed
Total Comp GT150 KtrueTotalCompGT150K
Compensation From Other SourcesfalseCompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
MEDQUIST TRANSCRIPTIONS LTD
PO BOX 29307NEW YORKNY100879307MEDICAL RECORD TRAN497329
EMERGENCY MEDICINE ASSOCIATES PA PC
20010 CENTURY BLD STE 200GERMANTOWNMD20874URGENT CARE PHYS STF479371
MARYLAND INPATIENT CARE SPECIALISTS
2007 TIDEWATER COLONY DRIVEANNAPOLISMD21401HOSPITALIST408502
ERDMAN COMPANY
600 MARSHALL DRIVEWAUNAKEEWI53597BUILDING CONTRACTOR356712
MAYO MEDICAL LABORATORIES
PO BOX 9146MINNEAPOLISMN554809146LAB TESTING343931
FieldValueIRS element (for citing)
Number Of Contractors GT100 K25NumberOfContractorsGT100K
Related Organizations258495RelatedOrganizations
Government Grants773927GovernmentGrants
Total Contributions1032422TotalContributions

Program Service Revenue ProgramServiceRevenue (5 entries)

DescriptionDescriptionTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
INPATIENT REVENUE2462222924622229
OUTPATIENT REVENUE2649446226494462
EMERGENCY REVENUE1320670813206708
OTHER PATIENT REVENUE577638577638
MEDICARE/MEDICAID REVENUE4855889848558898
FieldValueIRS element (for citing)
Total Program Service Revenue113459935TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column160356TotalRevenueColumn
Exclusion$160,356ExclusionAmount

Income From Invest Bond Proceeds IncomeFromInvestBondProceeds

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Royalties Revenue RoyaltiesRevenue

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Gross Rents GrossRents

FieldValueIRS element (for citing)
Real40013Real

Less Rental Expenses LessRentalExpenses

FieldValueIRS element (for citing)
Real56894Real

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real-16881Real

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column-16881TotalRevenueColumn
Unrelated Business Revenue-19361UnrelatedBusinessRevenue
Exclusion$2,480ExclusionAmount

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income From Gaming NetIncomeFromGaming

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income Or Loss NetIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Other Revenue Misc OtherRevenueMisc (3 entries)

DescriptionDescriptionTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncomeBusiness CodeBusinessCodeUnrelated Business RevenueUnrelatedBusinessRevenue
OTHER REVENUE516218516218
PHARMACY SALES1022844611010228
EMERGENCY PSYCH SERVICES9400062140094000

Miscellaneous Revenue MiscellaneousRevenue

FieldValueIRS element (for citing)
Total Revenue Column1504545TotalRevenueColumn
Unrelated Business Revenue839161UnrelatedBusinessRevenue
Exclusion$665,384ExclusionAmount
FieldValueIRS element (for citing)
Total Other Revenue2124991TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column116760823TotalRevenueColumn
Related Or Exempt Function Income113976153RelatedOrExemptFunctionIncome
Unrelated Business Revenue924028UnrelatedBusinessRevenue
Exclusion$828,220ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total0Total

Grants To Domestic Individuals GrantsToDomesticIndividuals

FieldValueIRS element (for citing)
Total0Total

Foreign Grants ForeignGrants

FieldValueIRS element (for citing)
Total0Total

Benefits To Members BenefitsToMembers

FieldValueIRS element (for citing)
Total0Total

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total1929396Total
Management And General1929396ManagementAndGeneral

Comp Disqual Persons CompDisqualPersons

FieldValueIRS element (for citing)
Total0Total

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total45286006Total
Program Services42866530ProgramServices
Management And General2419476ManagementAndGeneral
Fundraising0Fundraising

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total2320753Total
Program Services2109108ProgramServices
Management And General211645ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total4209686Total
Program Services3821944ProgramServices
Management And General387742ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total3437441Total
Program Services3120828ProgramServices
Management And General316613ManagementAndGeneral

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total508344Total
Program Services508344ProgramServices

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total100302Total
Management And General100302ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total117460Total
Management And General117460ManagementAndGeneral

Fees For Services Lobbying FeesForServicesLobbying

FieldValueIRS element (for citing)
Total0Total

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total0Total

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total0Total

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total3221948Total
Program Services3221948ProgramServices

Advertising Advertising

FieldValueIRS element (for citing)
Total173350Total
Program Services120602ProgramServices
Management And General52748ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total25275814Total
Program Services25030195ProgramServices
Management And General245619ManagementAndGeneral

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total1185476Total
Program Services962251ProgramServices
Management And General223225ManagementAndGeneral

Royalties Royalties

FieldValueIRS element (for citing)
Total0Total

Occupancy Occupancy

FieldValueIRS element (for citing)
Total2990261Total
Program Services2752621ProgramServices
Management And General237640ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total121153Total
Program Services97283ProgramServices
Management And General23870ManagementAndGeneral

Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials

FieldValueIRS element (for citing)
Total0Total

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total87211Total
Program Services69742ProgramServices
Management And General17469ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total2940264Total
Program Services2940264ProgramServices

Payments To Affiliates PaymentsToAffiliates

FieldValueIRS element (for citing)
Total0Total

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total6694656Total
Program Services6694656ProgramServices

Insurance Insurance

FieldValueIRS element (for citing)
Total1230102Total
Program Services1201185ProgramServices
Management And General28917ManagementAndGeneral

Other Expenses OtherExpenses (5 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
PURCHASED SERVICES43838743979907403967
BAD DEBT57651275765127
REPAIRS AND MAINTENANCE24678432366726101117
OTHER23794191773163606256
K-1 MD ECARE39033903

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total4059Total
Management And General4059ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total116833848Total
Program Services109402424ProgramServices
Management And General7431424ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY11981660BOY
EOY9149690EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY5045BOY
EOY5820EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY12080509BOY
EOY14221984EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

FieldValueIRS element (for citing)
BOY42944BOY
EOY24149EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY2573220BOY
EOY2374648EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY754272BOY
EOY964074EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis124330892LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec61628149LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY62129862BOY
EOY62702743EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY4752463BOY
EOY6046239EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
BOY3690612BOY
EOY2711990EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY6091245BOY
EOY3961760EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY104101832BOY
EOY102163097EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY9684157BOY
EOY8355957EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

FieldValueIRS element (for citing)
BOY54493425BOY
EOY53755445EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY10488146BOY
EOY15696524EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY74665728BOY
EOY77807926EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY29026535BOY
EOY24057029EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY409569BOY
EOY298142EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY29436104BOY
EOY24355171EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY104101832BOY
EOY102163097EOY
FieldValueIRS element (for citing)
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or ReviewfalseAccountantCompileOrReview
FS AuditedtrueFSAudited
Audit CommitteetrueAuditCommittee
Financial Statement ConsolidatedXFinancialStatementConsolidated
Federal Grant Audit RequiredfalseFederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Hospital170b1 AiiiXHospital170b1Aiii

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Aggregate ContributionsRESTRICTEDAggregateContributions

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Art Public Exhibition AmtsArtPublicExhibitionAmts
Held Works Of Art AmtsHeldWorksOfArtAmts

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis4881046OtherCostOrOtherBasis
Book Value4881046BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis63394366OtherCostOrOtherBasis
Depreciation24449834Depreciation
Book Value38944532BookValue

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Other Cost Or Other Basis801354OtherCostOrOtherBasis
Depreciation141323Depreciation
Book Value660031BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis50660584OtherCostOrOtherBasis
Depreciation36158756Depreciation
Book Value14501828BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis4593542OtherCostOrOtherBasis
Depreciation878236Depreciation
Book Value3715306BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings62702743TotalOfBookValueLandBuildings
Federal Income Tax Liability0FederalIncomeTaxLiability

Other Liabilities OtherLiabilities (3 entries)

DescriptionDescriptionAmountAmount
EXECUTIVE 457B 457F PLANS$3,849,515
ADVANCES FROM THIRD PARTIES$3,739,286
ACCRUED PENSION COSTS$8,107,723
FieldValueIRS element (for citing)
Total Of Amounts15696524TotalOfAmounts

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Charity Care PolicytrueCharityCarePolicy
Written PolicytrueWrittenPolicy
FPG Reference Free CaretrueFPGReferenceFreeCare
Pcent200XPcent200
FPG Reference Discounted CaretrueFPGReferenceDiscountedCare
Pcent300XPcent300
Free Disc Care Medically IndigenttrueFreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity CaretrueAmountsBudgetedForCharityCare
Expenses Exceeded BudgettrueExpensesExceededBudget
Unable To Provide CarefalseUnableToProvideCare
Annual Community Benefit ReporttrueAnnualCommunityBenefitReport
Report Publically AvailabletrueReportPublicallyAvailable

Charity Care At Cost CharityCareAtCost

FieldValueIRS element (for citing)
Total Community Benefit Expense1540108TotalCommunityBenefitExpense
Net Community Benefit Expense1540108NetCommunityBenefitExpense
Percent Of Total Expense0.01310PercentOfTotalExpense

Total Charity Care TotalCharityCare

FieldValueIRS element (for citing)
Total Community Benefit Expense1540108TotalCommunityBenefitExpense
Net Community Benefit Expense1540108NetCommunityBenefitExpense
Percent Of Total Expense0.01310PercentOfTotalExpense

Community Health Services CommunityHealthServices

FieldValueIRS element (for citing)
Total Community Benefit Expense1027903TotalCommunityBenefitExpense
Direct Offsetting Revenue27600DirectOffsettingRevenue
Net Community Benefit Expense1000303NetCommunityBenefitExpense
Percent Of Total Expense0.00850PercentOfTotalExpense

Health Professions Education HealthProfessionsEducation

FieldValueIRS element (for citing)
Total Community Benefit Expense839292TotalCommunityBenefitExpense
Net Community Benefit Expense839292NetCommunityBenefitExpense
Percent Of Total Expense0.00710PercentOfTotalExpense

Subsidized Health Services SubsidizedHealthServices

FieldValueIRS element (for citing)
Total Community Benefit Expense10977860TotalCommunityBenefitExpense
Direct Offsetting Revenue3290812DirectOffsettingRevenue
Net Community Benefit Expense7687048NetCommunityBenefitExpense
Percent Of Total Expense0.06500PercentOfTotalExpense

Cash And In Kind Contributions CashAndInKindContributions

FieldValueIRS element (for citing)
Total Community Benefit Expense19558TotalCommunityBenefitExpense
Net Community Benefit Expense19558NetCommunityBenefitExpense
Percent Of Total Expense0.00020PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense12864613TotalCommunityBenefitExpense
Direct Offsetting Revenue3318412DirectOffsettingRevenue
Net Community Benefit Expense9546201NetCommunityBenefitExpense
Percent Of Total Expense0.08080PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense14404721TotalCommunityBenefitExpense
Direct Offsetting Revenue3318412DirectOffsettingRevenue
Net Community Benefit Expense11086309NetCommunityBenefitExpense
Percent Of Total Expense0.09390PercentOfTotalExpense

Community Support CommunitySupport

FieldValueIRS element (for citing)
Total Community Building Expense34587TotalCommunityBuildingExpense
Net Community Building Expense34587NetCommunityBuildingExpense

Coalition Building CoalitionBuilding

FieldValueIRS element (for citing)
Total Community Building Expense60319TotalCommunityBuildingExpense
Net Community Building Expense60319NetCommunityBuildingExpense

Health Improvement Advocacy HealthImprovementAdvocacy

FieldValueIRS element (for citing)
Total Community Building Expense25440TotalCommunityBuildingExpense
Direct Offsetting Revenue12000DirectOffsettingRevenue
Net Community Building Expense13440NetCommunityBuildingExpense

Workforce Development WorkforceDevelopment

FieldValueIRS element (for citing)
Total Community Building Expense22092TotalCommunityBuildingExpense
Net Community Building Expense22092NetCommunityBuildingExpense

Total Total

FieldValueIRS element (for citing)
Total Community Building Expense142438TotalCommunityBuildingExpense
Direct Offsetting Revenue12000DirectOffsettingRevenue
Net Community Building Expense130438NetCommunityBuildingExpense
FieldValueIRS element (for citing)
Bad Debt Expense ReportedtrueBadDebtExpenseReported
Bad Debt Expense$5,755,395BadDebtExpenseAmount
Amount Attributable To1858993AmountAttributableTo
Amount Reimbursed By Medicare31278444AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare31108215CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall170229MedicareSurplusOrShortfall

Costing Methodology Used CostingMethodologyUsed

FieldValueIRS element (for citing)
OtherXOther
FieldValueIRS element (for citing)
Written Debt Collection PolicytrueWrittenDebtCollectionPolicy
Provision For Charity CaretrueProvisionForCharityCare

Form990 Schedule H Part V Form990ScheduleHPartV

Name Name

FieldValueIRS element (for citing)
Business Name Line1Calvert Memorial Hospital of Calvert CoBusinessNameLine1

Address Address

FieldValueIRS element (for citing)
Address Line1100 Hospital RoadAddressLine1
CityPrince FrederickCity
StateMDState
ZIP Code20678ZIPCode
FieldValueIRS element (for citing)
Licensed HospitalXLicensedHospital
General Medical And SurgicalXGeneralMedicalAndSurgical
Er24 HoursXEr24Hours
Otherskilled nursing fac urgent care centers family practice clinOther

Form990 Schedule H Part VI Form990ScheduleHPartVI

FieldValueIRS element (for citing)
Income Based CriteriaN/AIncomeBasedCriteria
Costing Method UsedThe costing methodology used to calculate amounts reported in line 7 was a cost-to-charge ratio derived from Worksheet 2, Ratio of Patient Care Cost-to-Charges.CostingMethodUsed
Subsidized Health Services ExplnIn FY 2010, Calvert Memorial Hospital contributed $1,492,402 to the Maryland Uncompensated Care Fund. The Uncompensated Care Fund provides healthcare to individuals who qualify for financial assistance in the state of Maryland. Subsidized health services include the following clinics: Woman's Wellness Center, Dunkirk Urgent Care, GYN-Oncology Clinic, Pediatric Orthopedic Clinic, Solomons Urgent Care, Spine Clinic and TWIN BEACHES COMMUNITY HEALTH CENTER. Costs attributable to the clinics totaled $1,533,774.SubsidizedHealthServicesExpln
Percent Of Total Expense ExplnBad debt expense included on Form 990, Part IX, line 25, column (A), but subtracted for purposes of calculating the percentage in this column - $5,675,692.PercentOfTotalExpenseExpln
Bad Debt FootnoteCalvert Memorial Hospital has studied uncompensated care to track and trend financial performance at any specified period. This has included ensuring that the system is in compliance with all state requirements regarding CMH's tax-exempt status and the deliverance of financial assistance to patients who may be unable to reimburse the provider for their health care needs. CMH provides a board approved financial assistance program that provides some level of discount services for patients that are 300% or below the federal poverty level. This includes the review of several documents submitted by patients, the acceptance of need based government or community assistance that proves the patient's probable eligibility, and the utilization of software that examines several financial factors and places them in an algorithym to determine their probability to meet CMH's 100% level of financial assistance. This information was utilized over a 2 quarter period to determine the estimate of the amount of CMH's bad debt expense attributable to patients eligible under the charity care policy. The financial statements for Calvert Memorial Hospital do not contain a footnote regarding bad debt expense. Bad debt expense is classified as an operating expense, "Provision for Uncollectible Accounts," in the Hospital's Statement of Operations.BadDebtFootnote
Shortfall As Community BenefitThe costing source is the Medicare Cost Report and the methodology is Medicare allowable cost to Medicare revenues received.ShortfallAsCommunityBenefit
Debt Collection PolicyAs stated in Calvert Memorial Hospital's Financial Assistance Policy, Part V, Section G: Calvert Memorial Hospital's management shall develop policies and procedures for internal and external collection practices that take into account the extent to which the patient qualifies for financial assistance, a patient's good faith effort to apply for a governmental program or for financial assistance from Calvert Memorial Hospital, and a patient's good faith effort to comply with his or her payment agreements with Calvert Memorial Hospital. For patients who are cooperating with applying and qualifying for either Medical Assistance or financial assistance, Calvert Memorial Hospital will not send unpaid bills to outside collection agencies and will cease all collection activities.DebtCollectionPolicy
General ExplanationPart 1, 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. Part 1, Line 7b, columns (c), (d), (e) and (f) - Maryland's regulatory system creates a unique process for hospital payment that differs from the rest of the nation. The Health Services Cost Review Commission (HSCRC) determines payment through a rate setting process and all payors, including governmental payors, pay the same amount for the same services delivered at the same hospital. Maryland's unique all payor system includes a method for referencing Uncompensated Care in each payors' rates, which does not enable Maryland hospitals to breakout any 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. Part 1, Line 7f, column (c), (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.GeneralExplanation
General ExplanationCalvert Memorial Hospital offers charity care to patients who are unable to pay for their services and meet the eligibility criteria regardless of the amount budgeted for charity care in the Hospital's annual Operating Plan.GeneralExplanation
Needs AssessmentCalvert Memorial Hospital (CMH) uses a variety of resources to identify the health needs of its community. As stated in 2009's Community Benefit Report narrative, between July 2007and November 2007, CMH in collaboration with the Calvert County Community Health Improvement Roundtable completed a comprehensive community health assessment. This is done by the Roundtable approximately every five years and takes about one year to complete. On a quarterly basis, Roundtable partners provide an action plan update. A community health assessment interim report is planned for FY11. The Roundtable membership is representative of the major community partners for health and human services and includes the leadership from the Calvert County Health Department, Calvert County Public Schools, Calvert County Office on Aging, Calvert County of Community Resources, the Calvert County Department of Social Services, Calvert Hospice, Calvert Alliance Against Drug Abuse, the Calvert County Traffic Safety Council and the ARC of Southern MD with CMH as the primary facilitator of the Roundtable. The purpose of the assessment was to determine the current status of community health in the county, to project future needs and to identify areas where their gaps in services. The assessment consisted of two components: the first being the collection of data on the health status of the county as available through local, state and national data sources. It also consisted of personal interviews with key leaders in the community in order to gather information on their perception of the health of this community. These leaders included a county commissioner, the Superintendent of Schools, the County Health Officer, a leading clergy representative from a minority church, the Director of Aging Services at the Office on Aging and the CEO of CMH. The second phase was the development of a public community survey designed to determine resident's views about their health and the local health care system. It utilized face-to face methods, online availability and a paper system. The survey was distributed by community agencies such as the United Way, the local Interagency Council, local churches and employers as well as at a community health forum at the College of Southern Maryland. A total of 1,418 surveys were returned to CMH. In October 2007, the Community Health Improvement Roundtable held a community health forum at the College of Southern Maryland, Calvert County campus. It consisted of a panel presentation by the county's health officer, a private physician and the hospital's president with a question and answer period afterwards. Approximately 50 people attended this forum. In the fall of 2007, the Community Wellness Department of CMH surveyed its Faith-Based Ministry Council for their concerns and perceptions regarding the health of the community and what recommendations they had for CMH to address in future planning. In January 2008, CMH's 2004 Medical Staff Development Plan was updated. This process is completed every 4 years. Applying very specific quantitative analysis along with qualitative medical staff input, the study showed the need for a significant number of primary care physicians as well as medical and surgical sub-specialties. In the spring of 2008, CMH's Board of Directors initiated a strategic planning process for the years 2009-2012. The purpose of the Plan is to amalgamate and synthesize the essential findings and recommendations of key studies and to present a "roll-up" of recommended actions that remain to be implemented. The plan was completed in FY-09 and serves as a guide for service development, implementation and continuation. The local health department is integral to the assessment and planning of health care services at CMH. Through active participation on the Community Health Roundtable and other collaborative efforts the hospital and the health department work closely to improve the health of the community. For example, both the county health officer and the hospital's CEO presented the results of the community health assessment to the county commissioner's at their meeting on December 16, 2008.NeedsAssessment
Patient Education AssistanceNotification about the availability of financial assistance from Calvert Memorial Hospital includes a contact number and is disseminated by Calvert Memorial Hospital by various means, which includes, but is not limited to, the publication of notices in patient bills and by posting notices in the Emergency Department, Urgent Care Centers, admitting and registration departments, and patient financial services offices. Information is also included on the hospital's website and in the Patient Handbook. In addition, notification of the Hospital's financial assistance program is also provided to each patient through an information sheet provided to each patient at the time of registration. Such information is provided in the primary languages spoken by the population serviced by Calvert Memorial Hospital. Referral of patients for financial assistance may be made by any member of the Calvert Memorial Hospital staff or medical staff, including physicians, nurses, financial counselors, social workers, case managers, and chaplains. A request for financial assistance may be made by the patient or a family member, close friend, or associate of the patient, subject to applicable privacy laws.PatientEducationAssistance
Community InformationCalvert Memorial Hospital (CMH) is the sole hospital provider in Calvert County, Maryland. Calvert County is located in Southern Maryland and is essentially a peninsula bordered on the east by the Chesapeake Bay and on the west by the Patuxent River. With a long and skinny topography, the county's "spine" is Maryland Routes 2/4 running from Dunkirk in the north to Solomons Island in the south for approximately 45 miles. This topography presents challenges to both transportation and service delivery that are unique to Calvert County. In response to this unique topography, CMH's strategic goal is to ensure access to primary care services within a 15 minute drive from any county location and specialty care within 30 minutes. In addition, CMH's secondary market area includes the surrounding areas of southern Prince Georges and Anne Arundel Counties, St Mary's County on its southern border and Charles County on its western border. Calvert County is in the outer ring of suburban Washington, D.C. Population estimates from the U.S. Census Bureau for 2009 is 89,212. Population density increased in the county from 346.5 to 412 people per square mile over the period of 2000-2009. Population projections are for Calvert to continue to grow to 100,700 people in 2020. The future is projected to bring small growth in population of young people, large increases (on a percentage basis) of the elderly, and modest growth in total number of households and in size of the labor force. Calvert County's estimated median household income is $89,049 in 2008 inflation adjusted dollars. Despite its relative high income level, Calvert County is home to pockets of people who live in poverty. US Census American Community Survey data indicated that individuals living below the poverty level were 5.6% of the population. The age distribution of those living below the poverty level reveals the following: Under age 19 25.7% Age 19-64 64.1% Age 65-84 9.1% Age 85+ 1.2% The Community Health Status Report from DHHS indicates that there are 9207 uninsured individuals under age 65 in Calvert County. It also reports that there are 8,311 Medicare beneficiaries and 8,887 Medicaid beneficiaries. Financial analysis of FY2010 for Calvert Memorial Hospital reveals that 5.1% of gross revenue is from self-pay or uninsured patients, 11.6% of gross revenue is from Medicaid recipients and 36.9% is from Medicare recipients. In 2009, Maryland Vital Statistics report that Calvert County's crude death rate for all causes of death is 656.9 per 100,000 people which is below the state average of 767.8 deaths per 100,000 people. Heart disease, cancer, cerebrovascular disease and chronic lower respiratory disease are the leading causes of death in Calvert. Death from heart disease, cancers and chronic lower respiratory disease in Calvert County is higher than the Maryland state average.CommunityInformation
Community Building ActivitiesCalvert Memorial Hospital (CMH) is recognized as a leader in the provision of health care in the local area. It partners with many organizations and agencies to expand the reach for improving the health of its community. Activities include: 1. Developing and leading a health ministry team program with 15 local area churches. 2. Supporting staff participation on local area boards, coalitions and collaboratives, such as the United Way of Calvert County, Hospice of Calvert County, Maryland Rural Health Association, the Office on Aging, Southern Maryland Community Network, Calvert County Oral Health Coalition, Tri-County Council, EMS Council, Maryland Perinatal Patient Safety Collaborative, Comptroller's Advisory Board and the Calvert Cancer Coalition. 3. Leader with Calvert County HealthCare Career Partnership - coordinating meetings, annual expo and student mentorships. Purpose is to expose more students to a variety of health career opportunities with the goal to attract them to future careers in healthcare. 4. Chair of the Calvert County Improved Pregnancy Outcome Program that is a partnership with physicians, the local health department, child care providers and CMH that performs case reviews of deliveries with potential poor outcome to identify trends. These trends then serve as a guide for program and service development. Two areas of recent attention have been safe sleep education for parents and identification of early labor and action plan for the maternity patient. 4. Calvert County Nuclear Power Plant Disaster Preparedness is an ongoing program for CMH since CMH is the designated receiving hospital for accidents or emergencies. CMH provides salaries and travel expenses for Emergency Department staff to train offsite for such emergencies. It also drills at least annually with the county, the power plant and FEMA on accident management. The hospital has a part of its Emergency Department a decontamination unit that is fully equipped and available 24/7 for handling patients needing this procedure. These are just a few of CMH's community building activities. Improving the health of the community is a priority area for the hospital and therefore drives many of our strategic plans.CommunityBuildingActivities
Other InformationThe Hospital is governed by a community board comprised of civic leaders throughout Calvert County who are committed to and represent the healthcare needs of the community. The Hospital extends medical staff privileges to all qualified physicians for all of its departments. All financial surpluses the Hospital generates are used exclusively to further the charitable purposes of the organization.OtherInformation
Reports Filed With StatesMDReportsFiledWithStates

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Travel For CompanionsXTravelForCompanions
Club Dues Or FeesXClubDuesOrFees
Written Policy Re T And E ExpensestrueWrittenPolicyReTAndEExpenses
Substantiation RequiredtrueSubstantiationRequired
Compensation CommitteeXCompensationCommittee
Independent ConsultantXIndependentConsultant
Written Employment ContractXWrittenEmploymentContract
Compensation SurveyXCompensationSurvey
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance PaymentfalseSeverancePayment
Supplemental Nonqual Retire PlantrueSupplementalNonqualRetirePlan
Equity Based Comp ArrangementfalseEquityBasedCompArrangement
Comp Based On Revenue Of Filing OrgfalseCompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related OrgsfalseCompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing OrgfalseCompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate OrgsfalseCompBasedNetEarningsRelateOrgs
Any Non Fixed PaymentsfalseAnyNonFixedPayments
Initial Contract ExceptionfalseInitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (11 entries)

Base Compensation Filing OrgBaseCompensationFilingOrgComp Based On Related OrgsCompBasedOnRelatedOrgsBonus Filing OrgBonusFilingOrgBonus Related OrgsBonusRelatedOrgsOther Compensation Filing OrgOtherCompensationFilingOrgOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Filing OrgDeferredCompFilingOrgDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Filing OrgTotalCompensationFilingOrgTotal Compensation Related OrgsTotalCompensationRelatedOrgsComp Report Prior990 Filing OrgCompReportPrior990FilingOrg
JAMES XINIS
26919609450007499004055310174340861651074801
ROBERT MCWHIRT
14584000025339038911088860218976024564
SUSAN DOHONY
15018100050960440300722302065300
EDWARD GROGAN
142431012597000184930896601824870
ROBERT SCHLAGER
1637710789901880179620479001946100
SEYED ALI MOHAMMADI
2685910001500156540581602902110
MARA DAIDONE
289146050260062680134950588803650570
FAISAL BHINDER
33603600000224360732603657980
APARAJI MAHATA
236465000607000167880578203197350
MITRA NASSIRAEE
19081301000002100084140859002199170
D KIRK BLANDFORD
195451016849050029034220054970302046050029

Form990 Schedule J Part III Form990ScheduleJPartIII (2 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
NONQUALIFIED RETIREMENT PAYMENTPART I, LINE 4THE FOLLOWING EMPLOYEES PARTICIPATED IN THE ORGANIZATION'S 457(b) AND/OR 457(f)DEFERRED COMPENSATION PLANS AND WERE PAID AND/OR CREDITED WITH THE FOLLOWING AMOUNTS: D KIRK BLANDFORD $ 65,900 ROBERT McWHIRT $ 48,208 JAMES XINIS $441,044 SUSAN DOHONY $ 9,700 EDWARD GROGAN $ 7,542 ROBERT SCHLAGER $ 8,040
BENEFITSPART I LINE 1ATHE PRESIDENT/CEO RECEIVED THE FOLLOWING BENEFITS: TRAVEL FOR COMPANIONS HEALTH OR SOCIAL CLUB DUES OR INITIATION FEES

Schedule K IRS990ScheduleK

Form990 Schedule K Part I Form990ScheduleKPartI

Issuer Name IssuerName

FieldValueIRS element (for citing)
Business Name Line1maryland health & higher edcuational fac authorityBusinessNameLine1
FieldValueIRS element (for citing)
Issuer EIN520936091IssuerEIN
CUSIP Number574127sp1CUSIPNumber
Date Issued2004-07-01DateIssued
Issue Price32925000IssuePrice
Description Of PurposeACQUIRE, RENOVATE AND CONSTRUCDescriptionOfPurpose
DefeasedfalseDefeased
On Behalf Of IssuerfalseOnBehalfOfIssuer

Form990 Schedule K Part II Form990ScheduleKPartII

FieldValueIRS element (for citing)
Total Proceeds34646470TotalProceeds
Amount In Reserve Fund1848842AmountInReserveFund
Issuance Costs From Proceeds260239IssuanceCostsFromProceeds
Working Capital Expenditures762919WorkingCapitalExpenditures
Capital Expenditures31774470CapitalExpenditures
Year Of Subst Completion2008YearOfSubstCompletion
Current RefundingfalseCurrentRefunding
Advance RefundingfalseAdvanceRefunding
Final Allocation MadetrueFinalAllocationMade
Adequate Books And Recds MaintaindtrueAdequateBooksAndRecdsMaintaind

Form990 Schedule K Part III Form990ScheduleKPartIII

FieldValueIRS element (for citing)
Owning Bond Financed PropertyfalseOwningBondFinancedProperty
Any Lease ArrangementsfalseAnyLeaseArrangements
Mngment Cntrct Bond Financd PrprtyfalseMngmentCntrctBondFinancdPrprty
Any Research AgreementsfalseAnyResearchAgreements
Bond Counsel Routinely EngagedfalseBondCounselRoutinelyEngaged
Post Issuance Compliance ProcdrstruePostIssuanceComplianceProcdrs

Form990 Schedule K Part IV Form990ScheduleKPartIV

FieldValueIRS element (for citing)
Form8038 T FiledfalseForm8038TFiled
Variable Rate IssuefalseVariableRateIssue
Hedge Identified In Books And RecdsfalseHedgeIdentifiedInBooksAndRecds
Gross Proceeds Invested In GICtrueGrossProceedsInvestedInGIC

Name Of GIC Provider NameOfGICProvider

FieldValueIRS element (for citing)
Business Name Line1MORGAN STANLEYBusinessNameLine1
FieldValueIRS element (for citing)
Term Of GIC2.2TermOfGIC
Regulatory Safe Harbor SatisfiedfalseRegulatorySafeHarborSatisfied
Gross Proceeds InvestedfalseGrossProceedsInvested
Exception To RebatefalseExceptionToRebate

Schedule L IRS990ScheduleL

Form990 Schedule L Part IV Form990ScheduleLPartIV

Name Of Interested Person NameOfInterestedPerson

FieldValueIRS element (for citing)
Name PersonJames XinisNamePerson
FieldValueIRS element (for citing)
RelationshipDirector and officerRelationship
Amount Of Transaction23353000AmountOfTransaction
Description Of TransactionCareFirst transactions (on bd)DescriptionOfTransaction
Sharing Of RevenuesfalseSharingOfRevenues

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (5 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
DESCRIPTION OF 990 REVIEW PROCESSPART VI, LINE 11The 990 is reviewed by the Audit Committee of the Calvert Health System, Inc. Board of Directors after completion and prior to submission to the IRS. The document is delivered to the Committee members prior to the Committee meeting so that they can review the information and respond to or question any or all of the data. The Chief Executive Officer and Chief Financial Officer are present at the Audit Committee meeting.
CONFLICTS MONITORING AND ENFORCEMENTPART VI, LINE 12CCalvert Health System, Inc. has a Conflict Management Policy which describes how the organization will manage or resolve conflict at all leadership levels in the organization including management staff, medical staff leadership and Board members. This policy requires all organizational leadership to disclose any conflict of interest that exists at the time of business decisions, medical staff credentialing, and strategic planning. Annual disclosures are required and documented. In addition when any conflict arises there is an internal mediation process available to resolve a potential conflict as well as external conflict management resources to assist the organization. Internal methods include utilizing trained mediators to facilitate conflict resolution and external resources are available to bring into the organization if required. These resources include trained crisis communication/management counselors, employee assistance counselors and community based professionals trained in conflict resolution and legal representation if appropriate.
PROCESS FOR DETERMINING COMPENSATIONPART VI, LINE 15THE ORGANIZATION UTILIZES A COMPENSATION COMMITTEE, AN INDEPENDENT COMPENSATION CONSULTANT, A WRITTEN EMPLOYMENT CONTRACT, A COMPENSATION SURVEY OR STUDY,AND APPROVAL BY BOARD/COMPENSATION COMMITTEE TO DETERMINE COMPENSATION.
DOCUMENT AVAILABILITYPART VI, LINE 19THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST.
AUDITED FINANCIAL STATEMENTSPart XI line 2bThe organizations financial statements are audited by an independent accounting firm as part of the consolidated audit of the health system.

Schedule R IRS990ScheduleR

Form990 Schedule R Part I Form990ScheduleRPartI

Name Of Disregarded Entity NameOfDisregardedEntity

FieldValueIRS element (for citing)
Business Name Line1CALVERT PHYSICIANS ASSOCIATESBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1100 HOSPITAL RDAddressLine1
CityPRINCE FREDERICKCity
StateMDState
ZIP Code20678ZIPCode
FieldValueIRS element (for citing)
EIN263828176EIN
Primary ActivitiesHEALTHCAREPrimaryActivities
Legal Domicile StateMDLegalDomicileState
Total Income2362947TotalIncome
EOY Assets2007295EOYAssets

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1CMHBusinessNameLine1

Form990 Schedule R Part II Form990ScheduleRPartII (4 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusDirect Controlling Entity NADirectControllingEntityNABusiness Name Line1DirectControllingEntityName/BusinessNameLine1
CALVERT HEALTH SYSTEM INC
100 HOSPITAL RDPRINCE FREDERICKMD20678522347324HEALTHCAREMD501(C)(3)170B1AiiiN/A
CMH HOLDING CO
100 HOSPITAL RDPRINCE FREDERICKMD20678522176827REAL ESTATEMD501(C)(2)CHS
CMH II HOLDING CO
100 HOSPITAL RDPRINCE FREDERICKMD20678522178784REAL ESTATEMD501(C)(2)CHS
CALVERT MEMORIAL HOSPITAL FOUNDATION INC
100 HOSPITAL RDPRINCE FREDERICKMD20678521680647FUND RAISINGMD501(C)(3)509(A)(3)CMH

Form990 Schedule R Part IV Form990ScheduleRPartIV (2 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivityPrimaryActivityLegal Domicile StateLegalDomicileStateBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Type Of EntityTypeOfEntityShare Of Total IncomeShareOfTotalIncomeShare Of EOY AssetsShareOfEOYAssetsPercentage OwnershipPercentageOwnership
CALVERT HEALTH VENTURES INC
100 HOSPITAL RDPRINCE FREDERICKMD20678521625432HEALTHCAREMDCMHC CORP568489455629511.00000
CALVERT COMMUNITY HEALTH INC
100 HOSPITAL RDPRINCE FREDERICKMD20678521996371HEALTHCAREMDCMHC CORP001.00000
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents RoyaltiesfalseReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other OrgtrueGiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other OrgtrueGiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other OrgfalseLoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other OrgfalseLoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other OrgfalseSaleOfAssetsToOtherOrg
Purchase Of Assets From Other OrgfalsePurchaseOfAssetsFromOtherOrg
Exchange Of AssetsfalseExchangeOfAssets
Rental Of Facilities To Other OrgsfalseRentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other OrgstrueRentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other OrgsfalsePerformOfServicesForOtherOrgs
Perform Of Services By Other OrgstruePerformOfServicesByOtherOrgs
Sharing Of FacilitiestrueSharingOfFacilities
Sharing Of Paid EmployeestrueSharingOfPaidEmployees
Reimbursement Paid To Other OrgtrueReimbursementPaidToOtherOrg
Reimbursement Paid By Other OrgtrueReimbursementPaidByOtherOrg
Other Transfer To Other OrgfalseOtherTransferToOtherOrg
Other Transfer From Other OrgfalseOtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable (3 entries)

Transaction TypeTransactionTypeAmount InvolvedAmountInvolved
CALVERT PHYSICIANS ASSOCIATES
b2911000
CALVERT HEALTH VENTURES
j,n,p162578
calvert memorial hospital foundation
c,l258495

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