2023-05-10T07:33:56-05:00 2022-06-30 135565207 KPMG LLP 8350 BROAD STREET SUITE 900 MCLEAN VA 22102 990 2021-07-01 520591685 THE UNION MEMORIAL HOSPITAL UNIO 4107726721 201 EAST UNIVERSITY PARKWAY BALTIMORE MD 21218 JOEL BRYAN VP/TREASURER 4107726721 2023-05-09 1 JOEL BRYAN 999009999 SHAWN HUTCHINSON P01048557 7032868000 2023-05-03 3 AAL1 IAL1 2021 2023-04-26 12:10:37Z MEDSTAR UNION MEMORIAL HOSPITAL BRADLEY CHAMBERS 201 EAST UNIVERSITY PARKWAY BALTIMORE MD 21218 413942590 0 X WWW.MEDSTARUNIONMEMORIAL.ORG X 1854 MD SEE SCHEDULE OTO BE A COMPREHENSIVE HOSPITAL WITH REGIONAL SPECIALTY SERVICES OF DISTINCTION AND QUALITY COMMUNITY SERVICES, ALL ENHANCED BY CLINICAL EDUCATION & RESEARCH. 22 14 2242 5 79541 0 22352702 6324622 435749839 401842994 2335171 2692604 3222290 3082370 463660002 413942590 65000 77927 0 0 251276716 195866316 0 0 0 218535472 238480334 469877188 434424577 -6217186 -20481987 246794667 246090994 148199827 77705903 98594840 168385091 X SEE SCHEDULE OAS A PROUD MEMBER OF MEDSTAR HEALTH, MEDSTAR UNION MEMORIAL HOSPITAL'S (MEDSTAR UNION MEMORIAL) MISSION IS TO BE A COMPREHENSIVE HOSPITAL WITH REGIONAL SPECIALTY SERVICES OF DISTINCTION AND QUALITY COMMUNITY SERVICES, ALL ENHANCED BY CLINICAL EDUCATION AND RESEARCH. MEDSTAR UNION MEMORIAL IS AN ACUTE CARE HOSPITAL LOCATED IN THE NORTH-CENTRAL SECTION OF BALTIMORE CITY, MARYLAND. IN FISCAL YEAR 2022, MEDSTAR UNION MEMORIAL HAD 9,184 INPATIENT ADMISSIONS AND 111,493 OUTPATIENT VISITS INCLUDING 44,524 EMERGENCY VISITS. 0 0 328105258 77927 388791209 SEE SCHEDULE OMEDSTAR UNION MEMORIAL LARGEST PROGRAM IS ACCESS TO AND THE PROVISION OF ACUTE HOSPITAL SERVICES TO THE COMMUNITIES OF NORTHERN BALTIMORE CITY, MARYLAND AND THE SURROUNDING AREAS. IN ADDITION TO THE PROGRAM SERVICE EXPENSES LISTED ABOVE, MEDSTAR UNION MEMORIAL INCURRED $76.1M OF MANAGEMENT AND GENERAL EXPENSES IN PROVIDING SERVICES TO ITS COMMUNITIES. MEDSTAR UNION MEMORIAL IS A CARDIAC REGIONAL TREATMENT CENTER AND IS ALIGNED WITH THE CLEVELAND CLINIC THROUGH MEDSTAR HEART & VASCULAR INSTITUTE TO SHARE BEST PRACTICES AND IMPROVE CARE FOR HEART PATIENTS. MEDSTAR UNION MEMORIAL'S CURTIS NATIONAL HAND CENTER IS DESIGNATED AS THE HAND AND UPPER EXTREMITY TRAUMA CENTER FOR THE STATE OF MARYLAND BY THE MARYLAND INSTITUTE OF EMERGENCY MEDICAL SYSTEMS THE ONLY SUCH CENTER IN THE U.S. TO EARN THIS DISTINCTION. MEDSTAR UNION MEMORIAL HAS ONE OF THE MOST COMPREHENSIVE ORTHOPAEDIC AND SPORTS MEDICINE PROGRAMS IN THE REGION. ITS PROGRAM IS JOINT COMMISSION (TJC) CERTIFIED IN HIP AND KNEE REPLACEMENT SURGERY AND WAS THE FIRST PROGRAM IN THE REGION TO BE TJC CERTIFIED IN SHOULDER REPLACEMENT SURGERY, SPINE SURGERY AND PALLIATIVE CARE. MEDSTAR UNION MEMORIAL RECEIVED HEALTHGRADES 2019 AMERICA'S 100 BEST HOSPITALS FOR ORTHOPEDIC SURGERY AWARD FOR SUPERIOR CLINICAL OUTCOMES IN BACK AND NECK SURGERY, SPINAL FUSION, HIP FRACTURE TREATMENT, HIP REPLACEMENT, AND TOTAL KNEE REPLACEMENT AND THE 2019 AMERICA'S 100 BEST HOSPITALS FOR SPINE SURGERY AWARD FOR SUPERIOR CLINICAL OUTCOMES IN BACK AND NECK SURGERIES AND SPINAL FUSION PROCEDURES. MEDSTAR UNION MEMORIAL HAS BEEN RECOGNIZED BY U.S. NEWS & WORLD REPORT AS ONE OF THE BEST HOSPITALS IN THE BALTIMORE REGION FOR HEART BYPASS, KNEE REPLACEMENT, AND ORTHOPAEDICS. MEDSTAR UNION MEMORIAL HAS THE UNIQUE DISTINCTION OF HAVING ITS OWN BIOMECHANICS RESEARCH FACILITY AND SURGICAL SKILLS TRAINING LAB. IN ADDITION, THE HOSPITAL IS RECOGNIZED BY TJC AS AN ADVANCED PRIMARY STROKE CENTER. MEDSTAR UNION MEMORIAL WAS ALSO RECOGNIZED BY PRACTICE GREENHEALTH ENVIRONMENTAL EXCELLENCE IN 2019 FOR ITS ONGOING COMMITMENT TO IMPROVING ITS ENVIRONMENTAL PERFORMANCE AND PRIDE IN REALIZING A TOP STANDARD OF EXCELLENCE IN SUSTAINABILITY.SINCE MARCH 2020, MEDSTAR HEALTH HAS CARED FOR 1 IN 4 COVID-19 PATIENTS IN THE REGION. OPERATING AS ONE MEDSTAR AND ALIGNING WITH GUIDANCE FROM THE CENTERS FOR DISEASE CONTROL AND PREVENTION (CDC) AND LOCAL DEPARTMENTS OF HEALTH, MEDSTAR HEALTH COVID-19 PREPARATIONS AND RESPONSE CONTINUE TO BE GUIDED BY THREE CRITICAL DRIVERS: PROVIDE A SAFE CARE ENVIRONMENT FOR PATIENTS AND ASSOCIATES; MITIGATE COMMUNITY SPREAD OF COVID-19; AND ENSURE OPERATIONAL CONTINUITY TO FULFILL OUR CORE MISSION OF CARING FOR OUR COMMUNITIES.THESE EFFORTS HAVE EVOLVED AND TRANSITIONED IN MULTIPLE WAYS THROUGHOUT THE DURATION OF THE COVID-19 PANDEMIC, LEADING TO A NUMBER OF INTEGRATED CARE APPROACHES IN PLACE TODAY: UTILIZATION OF MEDSTAR HEALTH URGENT CARE, MEDSTAR EVISIT AND OUR DIGITAL CAPABILITIES TO CREATE ACCESS, TESTING SITES, AND TELEHEALTH FOR PRIMARY CARE AND FOLLOW-UP VISITS; EXPANDED MANAGEMENT OF CARE CONTINUUM NEEDS FOR PATIENTS THROUGH MEDSTAR HEALTH HOME CARE; EXECUTION OF INNOVATIVE LABORATORY APPROACHES INTEGRATED WITH OCCUPATIONAL HEALTH TO BETTER SUPPORT ASSOCIATES MANAGING THROUGH COVID-19 EXPOSURES; DEPLOYMENT OF COMMUNITY MOBILE UNITS AND CLINICS FOR COVID-19 VACCINATIONS/BOOSTERS; INCREASED MANAGEMENT OF SUPPLY AND ACQUISITION OF PERSONAL PROTECTIVE EQUIPMENT (PPE), N95 RESPIRATORS, COVID-19 VACCINES AND BOOSTERS; REINFORCEMENT OF A MANDATORY COVID-19 VACCINATION POLICY RESULTING IN COMPLIANCE OF 99% OF ASSOCIATES AND PHYSICIANS; AND ADMINISTRATION OF MORE THAN 36,800 COVID-19 VACCINATIONS/BOOSTERS TO MEDSTAR HEALTH ASSOCIATES AND PHYSICIANS AND MORE THAN 74,500 TO PATIENTS ACROSS THE REGION IN FY 2022. 19973627 13051785 MEDSTAR UNION MEMORIAL PROVIDED $20.0M IN SUBSIDIZED (MISSION DRIVEN) HEALTH SERVICES IN FISCAL YEAR 2022. THESE CRITICAL SERVICES, WHICH ARE DRIVEN BY COMMUNITY NEEDS, OPERATE AT A LOSS. THEY ADDRESS PRIORITIES PRIMARILY THROUGH DISEASE PREVENTION AND IMPROVEMENT OF HEALTH STATUS. SERVICES PROVIDED INCLUDE EMERGENCY MEDICINE, HOSPITALISTS, PRIMARY CARE, WOMEN'S AND CHILDREN'S HEALTH, PALLIATIVE CARE AND BEHAVIORAL HEALTH. 18138601 MEDSTAR UNION MEMORIAL PROVIDED $18.1M IN HEALTH PROFESSIONS EDUCATION IN FISCAL YEAR 2022. THIS CATEGORY INCLUDES TRAINING IN GRADUATE MEDICAL EDUCATION, EDUCATION FOR PHYSICIANS, MEDICAL STUDENTS, NURSES, AND OTHER HEALTH PROFESSIONS. 366217486 1 1 0 0 0 0 0 0 0 0 1 1 0 0 1 1 0 1 0 0 0 0 0 0 0 0 1 1 1 1 1 0 0 0 0 0 1 0 0 1 0 0 0 1 1 1 1 0 0 1 0 0 1 2242 1 1 1 0 0 0 0 0 0 0 0 0 1 0 X 22 14 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 MD X JOEL BRYAN 4107726721 10980 GRANTCHESTER WAY COLUMBIA MD 21044 KENNETH A SAMET DIRECTOR 1.00 39.00 X 0 15771396 96287 ZEENA DORAI MD DIRECTOR 20.00 20.00 X 778684 778684 19052 SHAMS T QUAZI MD DIRECTOR 20.00 20.00 X 218245 218245 29852 GEORGE HENNAWI MD DIRECTOR (UNTIL 01/2022) 20.00 20.00 X 170024 170024 29690 DAVID MARTIN MD DIRECTOR 20.00 20.00 X 805865 805865 30371 ELIAS K SHAYA MD DIRECTOR 20.00 20.00 X 233462 233462 10765 BRADLEY CHAMBERS PRESIDENT/DIRECTOR 20.00 20.00 X X 724904 724904 56419 MESFIN A LEMMA MD DIRECTOR 20.00 20.00 X 439816 439816 10907 ESKANDAR YAZAJI MD DIRECTOR (UNTIL 07/2022) 20.00 20.00 X 191200 191200 29765 MICHAEL RANDOLPH MD DIRECTOR 1.00 0.00 X 0 0 0 DAVID NORRIS WILLIS DIRECTOR 1.00 0.00 X 0 0 0 REBECCA E PEARCE DIRECTOR 1.00 0.00 X 0 0 0 JEFFREY R ELKIN DIRECTOR 1.00 0.00 X 0 0 0 DAWN M MOTOVIDLAK VICE CHAIR 1.00 0.00 X 0 0 0 JUDITH A FEUSTLE DIRECTOR 1.00 0.00 X 0 0 0 KATHLEEN DYER DIRECTOR 1.00 0.00 X 0 0 0 LEO GALLAGHER JR DIRECTOR 1.00 0.00 X 0 0 0 ANTHONY READ DIRECTOR 1.00 0.00 X 0 0 0 HOLLY TILFORD DIRECTOR 1.00 0.00 X 0 0 0 KIM SYDNOR PHD DIRECTOR 1.00 0.00 X 0 0 0 DAN CAHILL CHAIR 1.00 0.00 X 0 0 0 VERONICA COOL DIRECTOR 1.00 0.00 X 0 0 0 BISHOP DENIS J MADDEN DIRECTOR 1.00 0.00 X 0 0 0 LINDA HEATH ASSISTANT SECRETARY (UNTIL 05/2022) 40.00 0.00 X 0 116844 36178 DEANA STOUT ASSISTANT TREASURER 20.00 20.00 X 267167 267168 50923 STUART BELL MD VP, MEDICAL AFFAIRS 20.00 20.00 X 469913 469913 25426 BRIAN CAWLEY SENIOR VP, OPERATIONS 20.00 20.00 X 102931 223160 30080 KAREN OWINGS CNO 20.00 20.00 X 167800 167800 36548 JUNG CHIN MD RESPIRATORY THERAPIST 40.00 0.00 X 107637 226949 42183 ALAN SHIKANI MD PHYSICIAN 40.00 0.00 X 333550 0 13303 PETER KUEHL MD PHYSICIAN 40.00 0.00 X 300476 0 9973 HERBERT FRIEDMAN PHYSICIAN 40.00 0.00 X 252808 0 38635 NEIL MACDONALD VP, OPERATIONS 20.00 20.00 X 157765 157765 30920 5722247 20963195 627277 322 1 1 0 AMN HEALTHCARE INC 2735 COLLECTION CENTER DR CHICAGO IL 60693 STAFFING SERVICES 13732870 CT ASSIST LLC PO BOX 524 PHILIPPI WV 21218 STAFFING SERVICES 2454124 STANDARD PARKING CORP 900 NORTH MICHIGAN AVENUE SUITE 160 CHICAGO IL 60611 PARKING SERVICES 1199265 DVA RENAL HEALTHCARE INC PO BOX 760 ARLINGTON VA 22216 MEDICAL SERVICES 1188727 CROTHALL SVCS GROUP 1500 LIBERTY RIDGE DR 210 WAYNE PA 19087 ENVIRONMENTAL SERVICES 1186198 33 2647939 3676683 69037 6324622 NET PATIENT SERVICE RE 621400 394369535 394369535 PHARMACY 900099 7473459 7473459 401842994 895908 895908 586318 0 586318 586318 586318 1796696 0 1796696 1796696 1796696 REBATE INCOME 900099 1136486 1136486 PARKING LOT REVENUE 900099 552090 79541 472549 EXPENSE RECOVERY 900099 54885 54885 752591 752591 2496052 413942590 401842994 79541 5695433 X 66427 66427 11500 11500 4665613 4279632 385981 188685 166282 22403 160691293 150438125 10253168 2907158 2721662 185496 17738422 10661310 7077112 9675145 9019223 655922 37474540 930790 36543750 2843 2843 56833124 53696308 3136816 284971 28011 256960 1749858 1604852 145006 481832 368465 113367 344742 305352 39390 96865 91459 5406 2321481 2321481 14850445 14850445 4115155 3499646 615509 MED/SURG SUPPLIES 52928065 53003801 -75736 IMPLANTS/PROSTHESES 38208601 38208601 0 MAINTENANCE 8478276 8131408 346868 UTILITIES 5212250 4722028 490222 15097286 7090678 8006608 434424577 366217486 68207091 0 47480 8903 2003775 2716847 55851094 60975284 6981443 6557647 908809 820333 421207600 333413662 90225274 87793938 84497665 76191553 6279127 11026489 246794667 246090994 24029357 29981510 3088302 2746732 121082168 44977661 148199827 77705903 X 56446491 128747746 42148349 39637345 98594840 168385091 246794667 246090994 X -20481987 -11267526 75818 101463946 X X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 1925817 1925817 162102212 123212728 38889484 1806273 1690883 115390 251310042 206722829 44587213 4063256 1787222 2276034 87793938 BOARD DESIGNATED 39049438 F RESTRICTED INVESTMENT FUNDS 37142115 F 76191553 ADVANCE FROM THIRD PARTIES 36097739 OPERATING LEASE LIABILITY 11067051 CREDIT BALANCE PATIENT A/R 2860654 WORKERS COMPENSATION 2504967 PENDING PFS REFUNDS 186627 OTHER LIABILITIES -7739377 44977661 X PART X, LINE 2: FIN 48 FOOTNOTE INCOME TAXES ARE ACCOUNTED FOR UNDER THE ASSET AND LIABILITY METHOD. DEFERRED TAX ASSETS AND LIABILITIES ARE RECOGNIZED FOR THE FUTURE TAX CONSEQUENCES ATTRIBUTABLE TO DIFFERENCES BETWEEN THE FINANCIAL STATEMENT CARRYING AMOUNTS OF EXISTING ASSETS AND LIABILITIES AND THEIR RESPECTIVE TAX BASES AND OPERATING LOSS AND TAX CREDIT CARRYFORWARDS. DEFERRED TAX ASSETS AND LIABILITIES ARE MEASURED USING ENACTED TAX RATES EXPECTED TO APPLY TO TAXABLE INCOME IN THE YEARS IN WHICH THOSE TEMPORARY DIFFERENCES ARE EXPECTED TO BE RECOVERED OR SETTLED. THE EFFECT ON DEFERRED TAX ASSETS AND LIABILITIES OF A CHANGE IN TAX RATES IS RECOGNIZED IN THE PERIOD THAT INCLUDES THE ENACTMENT DATE. ANY CHANGES TO THE VALUATION ALLOWANCE ON THE DEFERRED TAX ASSET ARE REFLECTED IN THE YEAR OF CHANGE. THE CORPORATION ACCOUNTS FOR UNCERTAIN TAX POSITIONS IN ACCORDANCE WITH THE FASB ACCOUNTING STANDARDS CODIFICATION (ASC) TOPIC 740, INCOME TAXES. THERE WAS NO LIABILITY RECORDED FOR UNCERTAIN TAX POSITIONS AS OF JUNE 30, 2022. 1 1 X 1 X 1 X 1 1 1 0 1 1 9448567 9448567 0.02170 9448567 9448567 0.02170 1710681 1710681 0.00390 18138601 18138601 0.04180 19973627 13051785 6921842 0.01590 2180540 47675 2132865 0.00490 138572 138572 0.00030 42142021 13099460 29042561 0.06680 51590588 13099460 38491128 0.08850 9364 9364 0.00000 35171 35171 0.00010 1931 1931 0.00000 46466 46466 0.00010 1 11242540 X 1 1 1 1 UNION MEMORIAL HOSPITAL 201 EAST UNIVERSITY PARKWAY BALTIMORE MD 21218 X X X X UNION MEMORIAL HOSPITAL 1 0 0 1 X X X X X X X X X 20 1 0 0 1 X WWW.MEDSTARUNIONMEMORIAL.ORG X 1 20 1 WWW. MEDSTARUNIONMEMORIAL.ORG 0 1 X 200.000000000000 400.000000000000 X X X X X X 1 1 X X X X 1 X WWW.MEDSTARUNIONMEMORIAL.ORG X WWW.MEDSTARUNIONMEMORIAL.ORG X WWW.MEDSTARUNIONMEMORIAL.ORG X X X X X X 1 X 0 X X X X 1 X 0 0 UNION MEMORIAL HOSPITAL PART V, SECTION B, LINE 5: CHNA INPUTHOSPITAL LEADROLE DESCRIPTIONTHE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) HOSPITAL LEAD SERVES AS THE COORDINATOR OF ALL ASPECTS OF THE COMMUNITY HEALTH ASSESSMENT PROCESS. HE/SHE HELPS ESTABLISH AND COORDINATE THE ACTIVITIES OF THE ADVISORY TASK FORCE. THE LEAD ALSO HELPS PRODUCE THE HOSPITAL'S COMMUNITY HEALTH NEEDS ASSESSMENT AND IMPLEMENTATION STRATEGY. HE/SHE WORKS COLLABORATIVELY WITH REPRESENTATIVES FROM THE CORPORATE COMMUNITY HEALTH DEPARTMENT AND GEORGETOWN UNIVERSITY. THE LEAD ALSO WORKS CLOSELY WITH THE WRITER. HE/SHE REVIEWS ALL NARRATIVES PRIOR TO PUBLICATION.NAME OF HOSPITAL LEAD: TRICIA ISENNOCKEXECUTIVE SPONSORROLE DESCRIPTIONTHE EXECUTIVE SPONSOR SERVES AS THE CONDUIT BETWEEN THE ADVISORY TASK FORCE AND THE SENIOR MANAGEMENT TEAM. THE SPONSOR IS AN ACTIVE PARTICIPANT OF THE ADVISORY TASK FORCE AND HE/SHE COMMUNICATES THE HOSPITAL'S CLINICAL STRENGTHS AND PROGRAM PRIORITIES TO DIVERSE AUDIENCES.NAME OF EXECUTIVE SPONSOR: BRAD CHAMBERSADVISORY TASK FORCEROLE DESCRIPTIONTHE ADVISORY TASK FORCE (ATF) REVIEWS PRIMARY/SECONDARY DATA AND LOCAL/STATE/FEDERAL COMMUNITY HEALTH GOALS. BASED ON FINDINGS, THE ATF PROVIDES INPUT INTO THE HOSPITAL'S THREE-YEAR IMPLEMENTATION STRATEGY. AS AMBASSADORS FOR THE CHNA PROCESS, THE ATF MEMBERS SUPPORT EFFORTS TO OPTIMIZE COMMUNITY PARTICIPATION. NOTE: THE ATF SHOULD BE A COMBINATION OF COMMUNITY REPRESENTATIVES AND STAFF. COMMUNITY REPRESENTATIVES SHOULD MAKEUP AT LEAST 50% OF TOTAL PARTICIPANTS. NAME : BRAD CHAMBERSTITLE/AFFILIATION WITH HOSPITAL : PRESIDENT, MGSH AND MUMHNAME OF ORGANIZATION : MEDSTAR HEALTHNAME : DAWN MOTOVIDLAKTITLE/AFFILIATION WITH HOSPITAL : MGSH/MUMH BOARD MEMBER, VICE-CHAIRNAME OF ORGANIZATION : MEDSTAR HEALTHNAME : DAN CAHILL TITLE/AFFILIATION WITH HOSPITAL : MGSH/MUMH BOARD MEMBER, CHAIRNAME OF ORGANIZATION : MEDSTAR HEALTHNAME : VERONICA COOLTITLE/AFFILIATION WITH HOSPITAL : MGSH/MUMH BOARD MEMBERNAME OF ORGANIZATION : MEDSTAR HEALTHNAME : KIM SYDNOR, PHDTITLE/AFFILIATION WITH HOSPITAL : MGSH/MUMH BOARD MEMBERNAME OF ORGANIZATION : MEDSTAR HEALTHNAME : RITU PRASAD, MDTITLE/AFFILIATION WITH HOSPITAL : PHYSICIAN ADVISOR, MUMH NAME OF ORGANIZATION : MEDSTAR HEALTHNAME : DANA FRANK, MD TITLE/AFFILIATION WITH HOSPITAL : CHAIRMAN, MEDICINE, MGSH/MUMH NAME OF ORGANIZATION : MEDSTAR HEALTHNAME : KEN WALSCH TITLE/AFFILIATION WITH HOSPITAL : ASSISTANT VICE PRESIDENT, QUALITY, SAFETY, RISK MANAGEMENT NAME OF ORGANIZATION : MEDSTAR HEALTHNAME : GEORGE FARLEY TITLE/AFFILIATION WITH HOSPITAL : AVP, MISSION INTEGRATION, MGSHNAME OF ORGANIZATION : MEDSTAR HEALTHNAME : DEBORAH BANGLEDORF TITLE/AFFILIATION WITH HOSPITAL : DIRECTOR, MARKETING AND COMMUNICATIONS NAME OF ORGANIZATION : MEDSTAR HEALTHNAME : APRIL BESSLINGTITLE/AFFILIATION WITH HOSPITAL : DIRECTOR, CASE MANAGEMENTNAME OF ORGANIZATION : MEDSTAR HEALTHNAME : PAUL PASSTITLE/AFFILIATION WITH HOSPITAL : LEAD - COMMUNITY HEALTH ADVOCATENAME OF ORGANIZATION : MEDSTAR HEALTHNAME : ELISE BOWMANTITLE/AFFILIATION WITH HOSPITAL : DIRECTOR, ACCOUNTABLE HEALTH COMMUNITIESNAME OF ORGANIZATION : BALTIMORE CITY HEALTH DEPARTMENTNAME : TRACY HOLCOMB TITLE/AFFILIATION WITH HOSPITAL : PROGRAM MANAGER, COMMUNITY HEALTH EDUCATION AND DIRECTORNAME OF ORGANIZATION : MEDSTAR HEALTH AND JOY WELLNESS CENTERNAME : PEGGY THOMAS TITLE/AFFILIATION WITH HOSPITAL : COMMUNITY RESIDENTNAME OF ORGANIZATION : COMMUNITY RESIDENTNAME : SHEILA WILLIAMS TITLE/AFFILIATION WITH HOSPITAL : PARISHIONER, HUBER MEMORIAL CHURCHNAME OF ORGANIZATION : COMMUNITY RESIDENTNAME : EVANGELINE WAIHENYA TITLE/AFFILIATION WITH HOSPITAL : PARISHIONER, ST. MATTHEW'S CHURCHNAME OF ORGANIZATION : COMMUNITY RESIDENTNAME : ASHLEY WILKESTITLE/AFFILIATION WITH HOSPITAL : EXECUTIVE DIRECTORNAME OF ORGANIZATION : HAMPDEN FAMILY CENTERNAME : SUSAN BENDERTITLE/AFFILIATION WITH HOSPITAL : COONAME OF ORGANIZATION : KESWICK - MARYLANDNAME : NICHOLE BATTLE TITLE/AFFILIATION WITH HOSPITAL : CEO NAME OF ORGANIZATION : GEDCONAME : RANDOLPH ROWEL TITLE/AFFILIATION WITH HOSPITAL : ASSOCIATE PROFESSOR, CHAIR OF DEPARTMENT OF BEHAVIORAL HEALTH SCIENCES NAME OF ORGANIZATION : MORGAN STATE UNIVERSITYNAME : SONIA FIERRO-LUPERINI TITLE/AFFILIATION WITH HOSPITAL : COMMUNITY RESIDENTNAME OF ORGANIZATION : SPANISH SPEAKING HEALTH LEADERS OF MARYLANDNAME : ISHAAN PATHAKTITLE/AFFILIATION WITH HOSPITAL : COMMUNITY PROGRAM MANAGERNAME OF ORGANIZATION : CENTRAL BALTIMORE PARTNERSHIPNAME : MARK FLETCHERTITLE/AFFILIATION WITH HOSPITAL : BALTIMORE CITY EMSNAME OF ORGANIZATION : BALTIMORE CITYNAME : MELVIN WILSON TITLE/AFFILIATION WITH HOSPITAL : EXECUTIVE DIRECTOR NAME OF ORGANIZATION : TURNAROUND TUESDAYNAME : ELLEN RAPPAPORTTITLE/AFFILIATION WITH HOSPITAL : POPULATION HEALTH DIRECTORNAME OF ORGANIZATION : HCAMNAME : ADONGO MATTHEWSTITLE/AFFILIATION WITH HOSPITAL : EXECUTIVE DIRECTORNAME OF ORGANIZATION : SHEPHERD'S CLINICNAME : MATT SMITHTITLE/AFFILIATION WITH HOSPITAL : EXECUTIVE DIRECTORNAME OF ORGANIZATION : WAVERLY MAIN STREETNAME : LISA JONESTITLE/AFFILIATION WITH HOSPITAL : COMMUNITY MEDIATION - DIRECTORNAME OF ORGANIZATION : WOODBOURNE MCCABE SAFE STREETSNAME : PAT JONESTITLE/AFFILIATION WITH HOSPITAL : DIRECTOR, IMMIGRATION OUTREACH SERVICE CENTERNAME OF ORGANIZATION : ST. MATTHEW'S CHURCHNAME : HEATHER WILSONTITLE/AFFILIATION WITH HOSPITAL : VICE PRESIDENT, OPERATIONSNAME OF ORGANIZATION : Y OF CENTRAL MDNAME : JENNIFER SIEGELTITLE/AFFILIATION WITH HOSPITAL : HOSPITAL COUNSEL, MGSH AND MUMHNAME OF ORGANIZATION : MEDSTAR HEALTHNAME : LUCAS CARLSON MDTITLE/AFFILIATION WITH HOSPITAL : MEDICAL DIRECTOR, COMMUNITY AND POPULATION HEALTHNAME OF ORGANIZATION : MEDSTAR HEALTHNAME : ASHLEY FUNKTITLE/AFFILIATION WITH HOSPITAL : SR. EXEC. DIRECTORNAME OF ORGANIZATION : THE Y IN CENTRAL MDNAME : MILLER J ROBERTSTITLE/AFFILIATION WITH HOSPITAL : REVITALIZATION DIRECTORNAME OF ORGANIZATION : GREENMOUNT CORRIDORNAME : JEFFREY GRIFFINTITLE/AFFILIATION WITH HOSPITAL : EXEC. DIRECTORNAME OF ORGANIZATION : FRANCISCAN CENTERNAME : RAQUEL LAMPTEYTITLE/AFFILIATION WITH HOSPITAL : COMMUNITY HEALTH SYSTEM MGR.NAME OF ORGANIZATION : MEDSTAR HEALTHNAME : DIANA QUINNTITLE/AFFILIATION WITH HOSPITAL : SR. DIRECTOR, COMMUNITY HEALTHNAME OF ORGANIZATION : MEDSTAR HEALTHNAME : ELIZABETH SEBASTIAOTITLE/AFFILIATION WITH HOSPITAL : REGIONAL DIR COMMUNITY HEALTHNAME OF ORGANIZATION : MEDSTAR HEALTH - BALTIMORENAME : KRIS COWPERTHWAITETITLE/AFFILIATION WITH HOSPITAL : PHYSICIAN ADVISORNAME OF ORGANIZATION : MEDSTAR HEALTHNAME : STUART BELL MDTITLE/AFFILIATION WITH HOSPITAL : VP MEDICAL AFFAIRSNAME OF ORGANIZATION : MEDSTAR GOOD SAMARITAN/UNION MEMORIAL HOSPITALSNAME : PHYLLIS GRAYTITLE/AFFILIATION WITH HOSPITAL : AVP CARE TRANSFORMATIONNAME OF ORGANIZATION : MEDSTAR HEALTH - BALTIMORE UNION MEMORIAL HOSPITAL PART V, SECTION B, LINE 11: IMPLEMENTATION STRATEGIESTHE IMPLEMENTATION STRATEGIES SERVE AS A ROADMAP FOR HOW COMMUNITY BENEFIT RESOURCES WILL BE ALLOCATED AND DEPLOYED. MEDSTAR'S HOSPITAL WILL BE ABLE TO MEASURE OUR CONTRIBUTION TO IMPROVING THE HEALTH OF UNDERSERVED AND VULNERABLE POPULATIONS IN THE REGIONS WE SERVE. THREE-YEAR IMPLEMENTATION STRATEGIES WITH MEASURABLE OBJECTIVES WERE DEVELOPED FOR EACH HOSPITAL'S COMMUNITY BENEFIT SERVICE AREA - A SPECIFIC COMMUNITY OR TARGET POPULATION OF FOCUS. PRIORITIES WERE BASED ON COMMUNITY NEED AS DETERMINED BY QUANTITATIVE DATA AND COMMUNITY INPUT, AS WELL AS ON HOSPITAL EXPERTISE, RESOURCES, STRENGTHS OF EXISTING PROGRAMMING AND PARTNERSHIPS, AND ALIGNMENT WITH NATIONAL, STATE, AND LOCAL HEALTH GOALS. THE MEDSTAR HEALTH CORPORATE COMMUNITY HEALTH DEPARTMENT WILL PROVIDE SYSTEM-WIDE COORDINATION AND OVERSIGHT OF COMMUNITY BENEFIT PROGRAMMING.HOSPITAL ADVISORY TASK FORCES CONVENE AT LEAST ANNUALLY TO MONITOR PROGRESS OF STRATEGY EXECUTION AND TO PROVIDE ONGOING RECOMMENDATIONS RELATED TO OUTCOMES ACHIEVEMENT, PROGRAM DEVELOPMENT, PARTNERSHIP APPROACHES, AND OVERALL IMPLEMENTATION IMPROVEMENT.FOR SIGNIFICANT NEEDS IDENTIFIED IN THE CHNA THAT THE HOSPITAL HAS NOT PRIORITIZED AS FOCUS AREAS THROUGH ITS IMPLEMENTATION STRATEGY, THESE NEEDS WILL BE ADDRESSED BY COLLABORATING WITH OTHER LEADING ORGANIZATIONS, AND BY TAKING A SUPPORTER ROLE ON IDENTIFIED NEEDS THAT ARE BEYOND THE SCOPE OF THE HOSPITAL'S STRENGTHS. CHARITY CARE AT COST PART I, LINE 7AMARYLAND'S REGULATORY SYSTEM CREATES A UNIQUE PROCESS FOR HOSPITAL PAYMENT THAT DIFFERS FROM THE REST OF THE NATION. THE HEALTH SERVICES COST REVIEW COMMISSION (HSCRC), DETERMINES PAYMENT THROUGH A RATE-SETTING PROCESS AND ALL PAYORS, INCLUDING GOVERNMENTAL PAYORS, PAY THE SAME AMOUNT FOR THE SAME SERVICES DELIVERED AT THE SAME HOSPITAL. MARYLAND'S UNIQUE ALL-PAYOR SYSTEM INCLUDES A METHOD FOR REFERENCING UNCOMPENSATED CARE IN EACH PAYORS' RATES, WHICH DOES NOT ENABLE MARYLAND HOSPITALS TO BREAKOUT ANY OFFSETTING REVENUE RELATED TO UNCOMPENSATED CARE. UNREIMBURSED MEDICAID PART I, LINE 7BMARYLAND'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. BAD DEBT PART III, LINES 2 & 4MEDSTAR HEALTH AND ITS AFFILIATED ORGANIZATIONS REPORT BAD DEBT EXPENSE IN ACCORDANCE WITH ASU 2011-07, WHICH REQUIRES CERTAIN HEALTHCARE ENTITIES TO CHANGE THE PRESENTATION OF THEIR STATEMENT OF OPERATIONS BY RECLASSIFYING THE PROVISION FOR BAD DEBTS ASSOCIATED WITH PATIENT SERVICE REVENUE FROM AN OPERATING EXPENSE TO A DEDUCTION FROM PATIENT SERVICE REVENUE (NET OF CONTRACTUAL ALLOWANCES AND DISCOUNTS). HOWEVER, MEDSTAR AND ITS AFFILIATED ENTITIES DO NOT MAKE A DETERMINATION AS TO WHETHER SELF PAY AMOUNTS ARE COLLECTIBLE IN DETERMINING REVENUE RECOGNITION. RESERVE MODELS, WHICH HAVE BEEN DEVELOPED BASED ON HISTORICAL COLLECTION RESULTS AND WHICH ARE ADJUSTED PERIODICALLY BASED ON ACTUAL COLLECTIONS EXPERIENCE, ARE USED TO ESTIMATE UNCOLLECTIBLE AMOUNTS ACROSS ALL PAYORS INCLUDING SELF PAY. BAD DEBT DETERMINATIONS ARE MADE ONLY AFTER SUFFICIENT EVIDENCE IS OBTAINED TO SUPPORT THAT AN AMOUNT IS NOT COLLECTIBLE. MEDICARE PART III, LINE 8MARYLAND'S REGULATORY SYSTEM CREATES A UNIQUE PROCESS FOR HOSPITAL PAYMENT THAT DIFFERS FROM THE REST OF THE NATION. THE HEALTH SERVICES COST REVIEW COMMISSION (HSCRC) DETERMINES PAYMENT THROUGH A RATE-SETTING PROCESS AND ALL PAYORS, INCLUDING GOVERNMENTAL PAYORS, PAY THE SAME AMOUNT FOR THE SAME SERVICES DELIVERED AT THE SAME HOSPITAL. MARYLAND'S UNIQUE ALL-PAYOR SYSTEM INCLUDES A METHOD FOR REFERENCING UNCOMPENSATED CARE IN EACH PAYORS' RATES, WHICH DOES NOT ENABLE MARYLAND HOSPITALS TO BREAKOUT ANY OFFSETTING REVENUE RELATED TO UNCOMPENSATED CARE. AS SUCH, THE NET EFFECT FOR MEDICARE EXPENSES AND REVENUES IN MARYLAND IS ZERO. PART III, LINE 9B IF IT IS DETERMINED THAT A PATIENT MAY POTENTIALLY QUALIFY FOR A CHARITABLE/FINANCIAL PROGRAM, A HOLD IS PLACED ON THE ACCOUNT TO PREVENT IT FROM BEING REPORTED AS BAD DEBT UNTIL PROGRAM APPROVALS HAVE BEEN OBTAINED. IF IT IS APPROVED, THE ACCOUNT IS DOCUMENTED AND THE NECESSARY ADJUSTMENTS ARE MADE TO CLOSE THE ACCOUNT. NEEDS ASSESSMENT PART VI, LINE 2IN FY21, MEDSTAR UNION MEMORIAL HOSPITAL (MUMH) CONDUCTED A COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) IN ACCORDANCE WITH THE GUIDELINES ESTABLISHED BY THE PATIENT PROTECTION AND AFFORDABLE CARE ACT AND THE INTERNAL REVENUE SERVICE. THE HOSPITAL'S CHNA AND THREE-YEAR IMPLEMENTATION STRATEGIES WERE ENDORSED BY MUMH'S BOARD OF DIRECTORS AND APPROVED BY THE MEDSTAR HEALTH BOARD OF DIRECTORS. THE DOCUMENT BECAME AVAILABLE ON THE HOSPITAL'S WEBSITE ON JUNE 30, 2021 AND WILL GUIDE PROGRAMMING PRIORITIES IN FISCAL YEARS 2022-2024.THE CATEGORIES HEALTH AND WELLNESS, ACCESS TO CARE AND SOCIAL DETERMINANTS OF HEALTH WERE USED TO DETERMINE WHAT PROGRAMMING TO PRIORITIZE FOR THE CHNA. TWO TO THREE STRATEGIES IN EACH CATEGORY WERE SELECTED AS PRIORITIES DUE TO THE SIZE AND SCALE OF IMPACT AND MEASURABLE OUTCOMES. ALL OTHER PROGRAMMING WAS INTEGRATED AS PART OF THE HOSPITAL'S OVERALL COMMUNITY HEALTH PORTFOLIO. THESE ADDITIONAL PROGRAMS WERE CAPTURED IN THE INVENTORY FOR THE WHOLE PICTURE OF CONTRIBUTING TO THE HEALTH OF THE COMMUNITIES SERVED AS WELL AS SORTED FOR WHAT COUNTS AS COMMUNITY BENEFIT FOR REGULATORY REPORTING.THE HOSPITAL'S COMMUNITY BENEFIT SERVICE AREA (CBSA) IS BASED ON THE ADVISORY TASK FORCE (ATF) RECOMMENDATION. THE HOSPITAL IDENTIFIED NORTH CENTRAL BALTIMORE CITY AS ITS CBSA, WHICH INCLUDES ALL RESIDENTS LIVING IN ZIP CODES 21213 AND 21218. THE HOSPITAL SELECTED THIS GEOGRAPHIC AREA BASED ON HOSPITAL UTILIZATION DATA AND SECONDARY PUBLIC HEALTH DATA AS WELL AS ITS PROXIMITY TO THE HOSPITAL. THE ATF INCLUDED A DIVERSE GROUP OF INDIVIDUALS, INCLUDING HOSPITAL LEADERS, GRASSROOTS ACTIVISTS, COMMUNITY RESIDENTS, FAITH-BASED LEADERS, HOSPITAL REPRESENTATIVES, PUBLIC HEALTH LEADERS AND OTHER STAKEHOLDER ORGANIZATIONS, SUCH AS REPRESENTATIVES FROM LOCAL HEALTH DEPARTMENTS.MEDSTAR UNION MEMORIAL HOSPITAL'S HEALTH PRIORITIES FOR THE CBSA INCLUDE HEALTH AND WELLNESS (CHRONIC DISEASE PREVENTION AND MANAGEMENT, BEHAVIORAL HEALTH AND AGING AND OLDER ADULT HEALTH), ACCESS TO HEALTH CARE AND SERVICES (TRANSPORTATION AND ACCESS TO AFFORDABLE HEALTH CARE AND INSURANCE) AND SOCIAL DETERMINANTS OF HEALTH (NEIGHBORHOOD SAFETY AND COMMUNITY VIOLENCE, EMPLOYMENT AND FOOD INSECURITY). HEALTH PRIORITIES FOR THE CBSA INCLUDE HEALTH AND WELLNESS (CHRONIC DISEASE PREVENTION AND MANAGEMENT, BEHAVIORAL HEALTH, MATERNAL AND CHILD HEALTH), ACCESS TO HEALTH CARE SERVICES (TRANSPORTATION AND ACCESS TO AFFORDABLE HEALTH CARE AND INSURANCE) AND SOCIAL DETERMINANTS OF HEALTH (HOUSING, EMPLOYMENT AND RACIAL DISCRIMINATION). AS A PROUD MEMBER OF MEDSTAR HEALTH, REPRESENTATIVES FROM THE HOSPITAL ROUTINELY PARTICIPATE IN THE MEDSTAR HEALTH COMMUNITY HEALTH WORKGROUP. THE WORKGROUP IS COMPRISED OF COMMUNITY HEALTH PROFESSIONALS WHO REPRESENT ALL TEN MEDSTAR HOSPITALS. THE TEAM ANALYZES LOCAL AND REGIONAL COMMUNITY HEALTH DATA, ESTABLISHES SYSTEM-WIDE COMMUNITY HEALTH PROGRAMMING PERFORMANCE AND EVALUATION MEASURES AND SHARES BEST PRACTICES. PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE PART VI, LINE 3AS ONE OF THE REGION'S LEADING NOT-FOR-PROFIT HEALTHCARE SYSTEMS, MEDSTAR HEALTH IS COMMITTED TO ENSURING THAT UNINSURED AND UNDERINSURED PATIENTS MEETING ELIGIBILITY CRITERIA, AND PATIENTS DETERMINED ELIGIBLE FOR PRESUMPTIVE ELIGIBILITY WITHIN THE COMMUNITIES WE SERVE WHO LACK FINANCIAL RESOURCES HAVE ACCESS TO MEDICALLY NECESSARY HOSPITAL SERVICES. MEDSTAR HEALTH HOSPITALS AND HOSPITAL BASED-PHYSICIAN PRACTICES WILL:- TREAT ALL PATIENTS EQUITABLY, WITH DIGNITY, RESPECT, AND COMPASSION.- SERVE THE EMERGENCY HEALTH CARE NEEDS OF EVERYONE WHO PRESENTS TO OUR MEDSTAR HEALTH HOSPITALS AND HOSPITAL-BASED PHYSICIAN PRACTICES REGARDLESS OF A PATIENT'S ABILITY TO PAY FOR CARE.- ASSIST THOSE PATIENTS WHO ARE ADMITTED THROUGH OUR ADMISSION PROCESS FOR NON-URGENT, MEDICALLY NECESSARY CARE WHO CANNOT PAY FOR THE CARE THEY RECEIVE.- BALANCE NEEDED FINANCIAL ASSISTANCE FOR SOME PATIENTS WITH BROADER FISCAL RESPONSIBILITIES IN ORDER TO KEEP ITS HOSPITALS' DOORS OPEN FOR ALL WHO MAY NEED CARE IN THE COMMUNITY.IN MEETING ITS COMMITMENTS, MEDSTAR HEALTH HOSPITALS AND HOSPITAL-BASED PHYSICIAN PRACTICES WILL WORK WITH THEIR PATIENTS SEEKING EMERGENCY AND MEDICALLY NECESSARY CARE TO GAIN AN UNDERSTANDING OF EACH PATIENT'S FINANCIAL RESOURCES. BASED ON THIS INFORMATION, MEDSTAR HEALTH HOSPITALS AND HOSPITAL-BASED PHYSICIAN PRACTICES WILL MAKE ELIGIBILITY DETERMINATIONS FOR FINANCIAL ASSISTANCE FOR PATIENTS WHO RESIDE WITHIN THE COMMUNITIES THAT WE SERVE. IN DETERMINING ELIGIBILITY FOR FINANCIAL ASSISTANCE, MEDSTAR HEALTH HOSPITALS AND HOSPITAL-BASED PHYSICIAN PRACTICES WILL:- DETERMINE WHETHER THE PATIENT HAS HEALTH INSURANCE. - DETERMINE WHETHER THE PATIENT IS PRESUMPTIVELY ELIGIBLE FOR FREE OR REDUCED-COST CARE. - DETERMINE WHETHER UNINSURED PATIENTS ARE ELIGIBLE FOR PUBLIC OR PRIVATE HEALTH INSURANCE. - TO THE EXTENT POSSIBLE, OFFER ASSISTANCE TO UNINSURED PATIENTS IF THE PATIENT CHOOSES TO APPLY FOR PUBLIC OR PRIVATE HEALTH INSURANCE.- TO THE EXTENT PRACTICABLE, DETERMINE WHETHER THE PATIENT IS ELIGIBLE FOR OTHER PUBLIC PROGRAMS THAT MAY ASSIST WITH HEALTH CARE COSTS. - USE INFORMATION IN THE POSSESSION OF THE HOSPITAL, IF AVAILABLE, TO DETERMINE WHETHER THE PATIENT IS QUALIFIED FOR FREE OR REDUCED-COST CARE UNDER THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY.MEDSTAR HEALTH WILL WIDELY PUBLICIZE THE MEDSTAR FINANCIAL ASSISTANCE POLICY BY:- PROVIDING ACCESS TO THE MEDSTAR FINANCIAL ASSISTANCE POLICY, FINANCIAL ASSISTANCE APPLICATIONS, AND MEDSTAR PATIENT INFORMATION SHEET ON ALL HOSPITAL WEBSITES AND PATIENT PORTALS.- PROVIDING HARD COPIES OF THE MEDSTAR FINANCIAL ASSISTANCE POLICY, MEDSTAR UNIFORM FINANCIAL ASSISTANCE APPLICATION, AND MEDSTAR PATIENT INFORMATION SHEET TO PATIENTS UPON REQUEST.- PROVIDING HARD COPIES OF THE MEDSTAR FINANCIAL ASSISTANCE POLICY, MEDSTAR UNIFORM FINANCIAL ASSISTANCE APPLICATION, AND MEDSTAR PATIENT INFORMATION SHEET TO PATIENTS UPON REQUEST BY MAIL AND WITHOUT CHARGE.- PROVIDING NOTIFICATION AND INFORMATION ABOUT THE MEDSTAR FINANCIAL ASSISTANCE POLICY BY: . OFFERING COPIES AS PART OF ALL REGISTRATION OR DISCHARGES PROCESSES, AND ANSWERING QUESTIONS ON HOW TO APPLY FOR ASSISTANCE. . PROVIDING WRITTEN NOTICES ON BILLING STATEMENTS. . DISPLAYING MEDSTAR FINANCIAL ASSISTANCE POLICY INFORMATION AT ALL HOSPITAL REGISTRATION POINTS, INCLUDING THE BUSINESS OFFICE, INFORMING PATIENTS OF THEIR RIGHTS TO APPLY FOR FINANCIAL ASSISTANCE AND WHO TO CONTACT AT THE HOSPITAL FOR ADDITIONAL INFORMATION. . TRANSLATING THE MEDSTAR FINANCIAL ASSISTANCE POLICY, MEDSTAR UNIFORM FINANCIAL ASSISTANCE APPLICATION, AND THE MEDSTAR PATIENT INFORMATION SHEET INTO PRIMARY LANGUAGES THAT CONSTITUTE THE LESSER OF 1000 INDIVIDUALS OR 5% OF THE OVERALL POPULATION WITHIN THE CITY OR COUNTY IN WHICH THE HOSPITAL IS LOCATED AS MEASURED BY THE MOST RECENT CENSUS.- MEDSTAR HEALTH WILL PROVIDE PUBLIC NOTICES YEARLY IN LOCAL NEWSPAPERS SERVING ALL HOSPITAL TARGET POPULATIONS.THE MEDSTAR HEALTH PATIENT INFORMATION SHEET SHALL BE PROVIDED TO THE PATIENT, THE PATIENT'S FAMILY, OR THE PATIENT'S AUTHORIZED REPRESENTATIVE: - BEFORE DISCHARGE;- WITH THE HOSPITAL BILL;- ON REQUEST; AND- IN EACH WRITTEN COMMUNICATION TO THE PATIENT REGARDING COLLECTION OF HOSPITAL BILL.MEDSTAR HEALTH WILL PROVIDE A FINANCIAL ASSISTANCE PROBABLE AND LIKELY ELIGIBILITY DETERMINATION TO THE PATIENT WITHIN TWO BUSINESS DAYS FROM RECEIPT OF THE INITIAL MEDSTAR HEALTH UNIFORM FINANCIAL ASSISTANCE APPLICATION. FINAL ELIGIBILITY DETERMINATIONS ARE MADE AND COMMUNICATED TO THE PATIENT BASED ON RECEIPT AND REVIEW OF A COMPLETED APPLICATION. MEDSTAR HEALTH BELIEVES THAT ITS PATIENTS HAVE PERSONAL RESPONSIBILITIES RELATED TO THE FINANCIAL ASPECTS OF THEIR HEALTHCARE NEEDS. FINANCIAL ASSISTANCE AND PERIODIC PAYMENT PLANS AVAILABLE UNDER THIS POLICY WILL NOT BE AVAILABLE TO THOSE PATIENTS WHO FAIL TO FULFILL THEIR RESPONSIBILITIES. FOR PURPOSES OF THIS POLICY, PATIENT RESPONSIBILITIES INCLUDE: - COMPLY WITH PROVIDING THE NECESSARY FINANCIAL DISCLOSURE FORMS TO EVALUATE THEIR ELIGIBILITY FOR PUBLICLY-FUNDED HEALTHCARE PROGRAMS, CHARITY CARE PROGRAMS, AND OTHER FORMS OF FINANCIAL ASSISTANCE. THESE DISCLOSURE FORMS MUST BE COMPLETED ACCURATELY, TRUTHFULLY, AND TIMELY TO ALLOW MEDSTAR HEALTH'S FACILITIES TO PROPERLY COUNSEL PATIENTS CONCERNING THE AVAILABILITY OF FINANCIAL ASSISTANCE. - WORKING WITH MEDSTAR HOSPITAL PATIENT ADVOCATES AND PATIENT FINANCIAL SERVICES STAFF TO ENSURE THERE IS A COMPLETE UNDERSTANDING OF THE PATIENT'S FINANCIAL SITUATION AND CONSTRAINTS. - MAKING APPLICABLE PAYMENTS FOR SERVICES IN A TIMELY FASHION, INCLUDING ANY PAYMENTS MADE PURSUANT TO DEFERRED AND PERIODIC PAYMENT SCHEDULES. - PROVIDING UPDATED FINANCIAL INFORMATION TO MEDSTAR HOSPITAL PATIENT ADVOCATES OR CUSTOMER SERVICE REPRESENTATIVES ON A TIMELY BASIS AS THE PATIENT'S FINANCIAL CIRCUMSTANCES MAY CHANGE. - IT IS A PATIENT'S RESPONSIBILITY, DURING THEIR 12-MONTH ELIGIBILITY PERIOD, TO NOTIFY MEDSTAR HEALTH OF THEIR EXISTING HOUSEHOLD ELIGIBILITY FOR FREE CARE, REDUCED COST-CARE, AND/OR ELIGIBILITY UNDER FINANCIAL HARDSHIP PROVISIONS FOR MEDICAL NECESSARY CARE RECEIVED DURING THE 12-MONTH ELIGIBILITY PERIOD..- IN THE EVENT A PATIENT FAILS TO MEET THESE RESPONSIBILITIES, MEDSTAR RESERVES THE RIGHT TO PURSUE ADDITIONAL BILLING AND COLLECTION EFFORTS. IN THE EVENT OF NON-PAYMENT BILLING, AND COLLECTION EFFORTS ARE DEFINED IN THE MEDSTAR BILLING AND COLLECTION POLICY. A FREE COPY IS AVAILABLE ON ALL HOSPITAL WEBSITES AND PATIENT PORTALS VIA THE FOLLOWING URL: WWW.MEDSTARHEALTH.ORG/FINANCIALASSISTANCE, OR BY CALLING CUSTOMER SERVICE AT 1-800-280-9006.PATIENTS OF MEDSTAR HEALTH'S HOSPITALS AND HOSPITAL-BASED PHYSICIAN PRACTICES MAY BE ELIGIBLE FOR FULL FINANCIAL ASSISTANCE OR PARTIAL SLIDING-SCALE FINANCIAL ASSISTANCE AS SET FORTH UNDER THIS POLICY. THE PATIENT ADVOCATE AND PATIENT FINANCIAL SERVICES STAFF WILL DETERMINE ELIGIBILITY FOR FULL FINANCIAL ASSISTANCE AND PARTIAL SLIDING-SCALE FINANCIAL ASSISTANCE BASED ON REVIEW OF INCOME FOR THE PATIENT AND THEIR FAMILY (HOUSEHOLD), OTHER FINANCIAL RESOURCES AVAILABLE TO THE PATIENT'S FAMILY, FAMILY SIZE, AND THE EXTENT OF THE MEDICAL COSTS TO BE INCURRED BY THE PATIENT. COMMUNITY INFORMATION PART VI, LINE 4GEOGRAPHIC AND DEMOGRAPHIC:THE COMMUNITIES THE ORGANIZATION SERVES INCLUDES ZIP CODES 21213 AND 21218, BOTH URBAN GEOGRAPHIC SERVICE AREAS. THERE ARE 18 HOSPITALS SERVING BALTIMORE CITY, AND 14 FEDERALLY DESIGNATED MEDICALLY UNDERSERVED AREAS PRESENT IN THE COMMUNITY.THERE ARE 32,733 PEOPLE IN 21213 (BELAIR/EDISON AREA) AND THE AVERAGE INCOME IS $34,046. THERE ARE 49,796 PEOPLE IN 21218 (THE WAVERLIES AREA) AND THE AVERAGE INCOME IS $38,261. BALTIMORE CITY INCLUDES RESIDENTS WITH INCOMES BELOW THE FEDERAL POVERTY GUIDELINE (17.2%), UNINSURED (8%) AND MEDICAID RECIPIENTS (42.5%). PROMOTION OF COMMUNITY HEALTH PART VI, LINE 5AS A COMMUNITY PARTNER, MEDSTAR UNION MEMORIAL HOSPITAL ENGAGES IN SEVERAL COMMUNITY BENEFIT ACTIVITIES TO IMPROVE AND PROMOTE THE HEALTH AND WELLBEING OF THE COMMUNITY. PRIORITY AREAS, AS DETERMINED BY THE CHNA, FALL UNDER THREE AREAS OF FOCUS INCLUDING HEALTH AND WELLNESS, ACCESS TO CARE, AND SOCIAL DETERMINANTS OF HEALTH. PROGRAMS INCLUDE (BUT ARE NOT LIMITED TO):HEALTH AND WELLNESSMEDSTAR UNION MEMORIAL HOSPITAL ADDRESSES HEALTH AND WELLNESS BY OFFERING A VARIETY OF PROGRAMS AND RESOURCES THAT SEEK TO ADDRESS CHRONIC DISEASE PREVENTION AND MANAGEMENT. MEDSTAR UNION MEMORIAL HOSPITAL'S COMMUNITY-BASED EDUCATION COURSES ARE OFFERED TO SUPPORT HEALTHY LIFESTYLE CHANGES FOR COMMUNITY MEMBERS. PROGRAMS INCLUDE THE CENTERS FOR DISEASE CONTROL LED DIABETES PREVENTION PROGRAM, DIABETES SELF-MANAGEMENT EDUCATION, FLU VACCINATION CLINICS, YOGA SERVICES, SENIOR PHYSICAL FITNESS, AND SMOKING CESSATION. MEDSTAR UNION MEMORIAL HOSPITAL HAS COLLABORATED WITH OTHER AREA PROVIDERS TO ESTABLISH A HEALTH AND WELLNESS CENTER IN THE J VAN STORY BRANCH APARTMENTS FOR THE SENIOR AND DISABLED RESIDENTS. HEALTH CARE NAVIGATION, SOCIAL DETERMINANTS OF HEALTH RESOURCE PROVISION, AND MENTAL HEALTH SERVICES ARE MADE AVAILABLE ONSITE TO ADDRESS THE RESIDENTS' COMPLEX HEALTH CARE NEEDS.ACCESS TO CARETHE PRIORITY AREA IS ADDRESSING ACCESS TO BEHAVIORAL HEALTH SERVICES, INCLUDING MENTAL HEALTH AND SUBSTANCE USE TREATMENT. MEDSTAR UNION MEMORIAL HOSPITAL OFFERS SCREENING, BRIEF INTERVENTION, AND REFERRAL TO TREATMENT (SBIRT) PROGRAM TO SUPPORT INDIVIDUALS WITH SUBSTANCE USE DISORDER. AN ENHANCEMENT OF SBIRT INCLUDES THE OPIOID OVERDOSE SURVIVOR OUTREACH PROGRAM (OSOP). OSOP LINKS COMMUNITY MEMBERS WITH A HISTORY OF SUBSTANCE ABUSE TREATMENT WITH THE RESOURCES THEY NEED TO PREVENT A FUTURE OVERDOSE. MEDSTAR UNION MEMORIAL IS ALSO A FOUNDING AND CURRENT PARTNER OF SHEPHERD'S CLINIC, A FREE CLINIC FOR UNDERINSURED AND UNINSURED RESIDENTS OF THE HOSPITAL'S PRIMARY AND CBSA. STAFF ARE PROVIDED TO SUPPORT CLINIC OPERATIONS, INCLUDING A PROVIDER, WELLNESS DIRECTOR, AND ADMINISTRATIVE PERSONNEL. PATIENTS ARE SEEN THROUGH MEDICAL PERSONNEL PROVIDED BY THE HOSPITALS WHILE ALSO ABLE TO TAKE ADVANTAGE OF WELLNESS PROGRAM OFFERINGS AT JOY WELLNESS CENTER. MEDSTAR UNION MEMORIAL ALSO ADDRESSES ACCESS TO CARE BY HELPING TO REDUCE THE FINANCIAL BURDEN FOR PATIENTS AND THEIR FAMILIES. PATIENT FINANCIAL SERVICES PROVIDES FINANCIAL ASSISTANCE TO UNINSURED PATIENTS WHO RESIDE WITHIN THE COMMUNITY BY ASSISTING WITH ENROLLMENT IN PUBLICLY FUNDED ENTITLEMENT PROGRAMS, REFERRING PATIENTS TO STATE OR FEDERAL INSURANCE EXCHANGE NAVIGATOR RESOURCES AND ASSISTING WITH CONSIDERATION OF FUNDING THAT MAY BE AVAILABLE FROM OTHER CHARITABLE ORGANIZATIONS.THE HOSPITAL SUBSIDIZES HEALTH SERVICES TO ENSURE RESIDENTS HAVE ACCESS TO THE CLINICAL CARE THEY NEED.SOCIAL DETERMINANTS OF HEALTHMEDSTAR UNION MEMORIAL HOSPITAL'S OTHER PRIORITY IS ADDRESSING THE SOCIAL DETERMINANTS OF HEALTH OF THE COMMUNITY. COMMUNITY RESIDENTS SURROUNDING THE HOSPITAL HAVE BEEN TRAINED AND HIRED AS EITHER A COMMUNITY HEALTH ADVOCATE OR PEER RECOVERY COACH AS PART OF THE POPULATION HEALTH WORKFORCE DEVELOPMENT PROGRAM. THESE POSITIONS SERVE TO EMPOWER INDIVIDUALS AND THEIR FAMILIES INTO BETTER ECONOMIC CONDITIONS. AS PART OF THEIR RESPONSIBILITIES, THE COMMUNITY HEALTH ADVOCATE ROLES CONDUCT SOCIAL NEEDS SCREENINGS. SOCIAL NEEDS SCREENINGS ARE PROVIDED TO SCREEN FOR FOOD AND HOUSING INSECURITY, AND BARRIERS RELATED TO TRANSPORTATION, EMPLOYMENT, AND UTILITIES. IDENTIFIED NEEDS ARE ADDRESSED BY CONNECTING THE PARTICIPANT TO SOCIAL SERVICES AND OTHER RESOURCES IN THE COMMUNITY. MEDSTAR UNION MEMORIAL HOSPITAL HAS A PARTNERSHIP WITH UBER TO ADDRESS TRANSPORTATION BARRIERS TO ACCESS MEDICAL SERVICES. THROUGH THIS PARTNERSHIP, RIDES ARE PROVIDED TO PATIENTS AND/OR FAMILIES WITH FINANCIAL NEED. THE TRANSPORTATION ASSISTANCE ENABLES PATIENTS TO ATTEND NECESSARY APPOINTMENTS WITH THEIR HEALTH CARE PROVIDERS. FURTHER, MEDSTAR UNION MEMORIAL HOSPITAL ADDRESSES FOOD INSECURITY BY ENROLLING PATIENTS INTO A FOOD PRESCRIPTION DELIVERY PROGRAM THROUGH ITS PARTNER HUNGRY HARVEST. THIS TEMPORARY SOURCE OF FOOD ASSISTANCE ALLOWS COMMUNITY HEALTH ADVOCATES TO ADDRESS A LONG-TERM STRATEGY FOR FOOD ACCESS (E.G. MEALS ON WHEELS, ETC.). DISASTER READINESSTHE HOSPITAL STRENGTHENED THE COMMUNITY HEALTH RESILIENCE BY IMPROVING THE ABILITY OF THE COMMUNITY TO WITHSTAND AND RECOVER FROM CORONAVIRUS, A PUBLIC HEALTH EMERGENCY THAT SURFACED IN MARCH 2020. LEADERSHIP PARTICIPATED IN COMMUNITY-WIDE TASK FORCES AND STAFF IMPLEMENTED PROGRAMS ASSOCIATED WITH ADDRESSING HEALTH NEEDS ARISING FROM CORONAVIRUS. STAFF PLANNED AND IMPLEMENTED COMMUNITY RESPONSE EFFORTS INCLUDING COVID-19 TESTING AND VACCINATION EVENTS AND PUBLIC EDUCATION EFFORTS. EVENTS AND OUTREACH OCCURRED AT HOSPITAL CAMPUSES AND AT TARGETED COMMUNITY LOCATIONS SUCH AS SENIOR COMPLEXES, CHURCHES AND COMMUNITY CENTERS TO BEST REACH UNDERSERVED AND AT-RISK POPULATIONS. PPE (PERSONAL PROTECTIVE EQUIPMENT) AND CLINICAL EQUIPMENT WERE ALSO DONATED TO OTHER NON-PROFITS SUPPORTING DISASTER RELIEF EFFORTS. AFFILIATED HEALTH CARE SYSTEM PART VI, LINE 6AS A PROUD MEMBER OF MEDSTAR HEALTH, MEDSTAR UNION MEMORIAL HOSPITAL IS ABLE TO EXPAND ITS CAPACITY TO MEET THE NEEDS OF THE COMMUNITY BY PARTNERING WITH OTHER MEDSTAR HOSPITALS AND ASSOCIATED ENTITIES. MEDSTAR HEALTH RESOURCES ASSIST THE HOSPITAL IN COMMUNITY HEALTH PLANNING TO MEET THE NEEDS OF THE UNINSURED AND OTHER VULNERABLE POPULATIONS. THROUGH ITS COMMUNITY HEALTH FUNCTION, MEDSTAR HEALTH PROVIDES MEDSTAR UNION MEMORIAL HOSPITAL WITH TECHNICAL SUPPORT TO ENHANCE COMMUNITY HEALTH PROGRAMMING AND EVALUATION. MEDSTAR'S CORPORATE PHILANTHROPY DEPARTMENT IDENTIFIES AND SEEKS PUBLIC AND PRIVATE FUNDING SOURCES TO ENSURE THE AVAILABILITY OF HIGH-QUALITY HEALTH SERVICES, REGARDLESS OF ABILITY TO PAY. STATE FILING OF COMMUNITY BENEFIT REPORT PART VI, LINE 7THE COMMUNITY BENEFIT REPORT FOR MEDSTAR UNION MEMORIAL HOSPITAL IS FILED IN THE STATE OF MARYLAND. 1 AMERICAN HEART ASSOCIATION 7272 GREENVILLE AVENUE DALLAS DALLAS TX 75231 135613797 501(C)(3) 65000 0 SPONSORSHIP: HEART WALK 2022 1 0 SCOLARSHIPS 5 11500 SCHEDULE I, PART I, LINE 2 OUR GRANT MONITORING PROCEDURE BRINGS TOGETHER ALL KEY PERSONNEL INVOLVED IN THE GRANT AT THE ONSET OF THE AWARD TO DISCUSS MANAGEMENT, RESPONSIBILITIES, BUDGETS, AND REPORTING. THIS INITIAL MEETING IS DOCUMENTED AND DISBURSED TO ALL INVOLVED. THE ACTUAL GRANT MONITORING IS DONE BY THE HOSPITAL DEPARTMENT IMPLEMENTING THE GRANT. MEDSTAR CORPORATE'S GRANTS AND PHILANTHROPY DEPARTMENT ENSURES THAT EACH GRANT HAS A COST CENTER AND/OR GRANT ACCOUNT SET UP BASED ON THE TERMS OF THE GRANT AWARD. MEDSTAR CORPORATE'S GRANTS AND PHILANTHROPY DEPARTMENT ALSO TRACKS AND REMINDS HOSPITAL DEPARTMENTS WHEN PROGRESS REPORTS ARE DUE THROUGOUT THE LIFE OF THE GRANT. X 1 1 X X X X X X 0 0 0 0 0 0 0 0 0 KENNETH A SAMET DIRECTOR 0 2030199 0 7462050 0 6279147 0 59518 0 36769 0 15867683 0 0 DAVID MARTIN MD DIRECTOR 768847 768847 34172 34172 2846 2846 8700 0 21671 0 836236 805865 0 0 ZEENA DORAI MD DIRECTOR 607440 607439 132611 132611 38633 38634 8700 0 10352 0 797736 778684 0 0 BRADLEY CHAMBERS PRESIDENT/DIRECTOR 371954 371954 352950 352950 0 0 23124 0 33295 0 781323 724904 0 0 STUART BELL MD VP, MEDICAL AFFAIRS 275289 275288 194624 194625 0 0 16525 0 8901 0 495339 469913 0 0 MESFIN A LEMMA MD DIRECTOR 344299 344299 95142 95142 375 375 8700 0 2207 0 450723 439816 0 0 DEANA STOUT ASSISTANT TREASURER 161973 161973 83097 83098 22097 22097 29388 0 21535 0 318090 267168 0 0 ELIAS K SHAYA MD DIRECTOR 220587 220587 12500 12500 375 375 9372 0 1393 0 244227 233462 0 0 SHAMS T QUAZI MD DIRECTOR 192870 192870 25000 25000 375 375 8700 0 21152 0 248097 218245 0 0 ESKANDAR YAZAJI MD DIRECTOR (UNTIL 07/2022) 175293 175293 15532 15532 375 375 0 8700 0 21065 191200 220965 0 0 JUNG CHIN MD RESPIRATORY THERAPIST 106887 226949 0 0 750 0 0 33222 0 8961 107637 269132 0 0 KAREN OWINGS CNO 133426 133426 34374 34374 0 0 19671 0 16877 0 204348 167800 0 0 GEORGE HENNAWI MD DIRECTOR (UNTIL 01/2022) 157549 157549 12100 12100 375 375 8700 0 20990 0 199714 170024 0 0 BRIAN CAWLEY SENIOR VP, OPERATIONS 102931 163144 0 60016 0 0 0 8700 0 21380 102931 253240 0 0 ALAN SHIKANI MD PHYSICIAN 332800 0 0 0 750 0 13303 0 0 0 346853 0 0 0 NEIL MACDONALD VP, OPERATIONS 117771 117771 39994 39994 0 0 9479 0 21441 0 188685 157765 0 0 PETER KUEHL MD PHYSICIAN 299726 0 0 0 750 0 8700 0 1273 0 310449 0 0 0 HERBERT FRIEDMAN PHYSICIAN 245856 0 6202 0 750 0 22132 0 16503 0 291443 0 0 0 LINDA HEATH ASSISTANT SECRETARY (UNTIL 05/2022) 0 116094 0 0 0 750 0 17372 0 18806 0 153022 0 0 SOCIAL CLUB DUES SCHEDULE J, PART I, LINE 1 THE ORGANIZATION PAID BUSINESS CLUB DUES FOR ONE OF ITS OFFICERS DURING THIS YEAR. PARTICIPATION IN THESE ACTIVITIES BY THE OFFICER WAS FOR BUSINESS PURPOSES, AND HELPED THE ORGANIZATION FURTHER ITS EXEMPT PURPOSES. SCHEDULE J, PART III DETAILED BELOW ARE SEVERAL ONE-TIME PAYMENTS TO CERTAIN EXECUTIVES RELATED TO VARIOUS RETIREMENT, RETENTION AND LONG-TERM INCENTIVE PLANS. THESE PLANS AND PAYMENTS ARE NOT A ROUTINE PART OF THE TYPICAL MEDSTAR EXECUTIVE COMPENSATION PROGRAM, AND SUPPORTED IMPORTANT OBJECTIVES OF OUR ORGANIZATION. MR. SAMET'S OTHER REPORTABLE COMPENSATION IN PART II, COLUMN (B)(II) AND (III) INCLUDES A PAYMENT OF $4,215,823, WHICH REPRESENTS BENEFITS ACCRUED THROUGH AN EXECUTIVE RETIREMENT PLAN THAT IS COMPRISED OF TARGET BENEFITS CALCULATED ANNUALLY USING COMPENSATION AND YEARS OF SERVICE, $1,500,823, WHICH REPRESENTS THE EXERCISED VALUE OF OPTION PLAN SHARES, BASED ON DEFERRED COMPENSATION EARNED APPROXIMATELY 20 YEARS AGO AND INVESTMENT RETURNS ON THIS COMPENSATION EARNED OVER THIS PERIOD OF TIME, AND $4,740,000 REPRESENTING A LONG-TERM RETENTION ARRANGEMENT. BRADLEY CHAMBERS' COMPENSATION IS FOR SERVICES PROVIDED AS PRESIDENT TO BOTH MEDSTAR GOOD SAMARITAN HOSPITAL AND MEDSTAR UNION MEMORIAL HOSPITAL. DEANA STOUT'S COMPENSATION IS FOR SERVICES PROVIDED AS CFO TO BOTH MEDSTAR GOOD SAMARITAN HOSPITAL AND MEDSTAR UNION MEMORIAL HOSPITAL. STUART BELL AND NEIL MACDONALD'S COMPENSATION IS FOR SERVICES PROVIDED AS VP MEDICAL AFFAIRS AND VP OPERATIONS, RESPECTIVELY, AT BOTH MEDSTAR GOOD SAMARITAN HOSPITAL AND MEDSTAR UNION MEMORIAL HOSPITAL. ACME PAPER & SUPPLY CO INC SEE PART V 918597 PACKAGING SUPPLIES VENDOR 0 GREATER CHESAPEAKE HAND SPECIALISTS PA SEE PART V 560904 CALL COVERAGE 0 BUSINESS TRANSACTION INVOLVING INTERESTED PERSONS SCHEDULE L, PART IVTHE FOLLOWING ARE SUBSTANTIAL CONTRIBUTORS (IN EXCESS OF $5,000) THAT ALSO PROVIDED SERVICES TO MEDSTAR UNION MEMORIAL HOSPITAL VALUED IN EXCESS OF $100,000: ACME PAPER & SUPPLY CO., GREATER CHESAPEAKE HAND SPECIALIST, P.A., AND SUBSTANTIAL CONTRIBUTORS. PER MEDSTAR'S CONFLICT OF INTEREST POLICY, THESE TRANSACTIONS ARE AT ARMS-LENGTH FOR FAIR MARKET VALUE. X 7 69037 FMV 0 1 0 FORM 990, PART VI, SECTION A, LINE 6 ORGANIZATION MEMBERS THE ORGANIZATION IS AN AFFILIATE AND SUBSIDIARY OF MEDSTAR HEALTH, INC. MEDSTAR HEALTH, INC., OR ONE OF ITS AFFILIATES AND SUBSIDIARIES, IS THE SOLE MEMBER OF THE ORGANIZATION. FORM 990, PART VI, SECTION A, LINE 7A DESCRIPTION OF MEMBERS AS AN AFFILIATE AND SUBSIDIARY OF MEDSTAR HEALTH, INC, THE ORGANIZATION MAY RECOMMEND PERSON(S) FOR MEMBERSHIP ON THE ORGANIZATION'S GOVERNING BODY. ANY SUCH RECOMMENDATION BY THE ORGANIZATION IS SUBJECT TO APPROVAL BY THE GOVERNANCE COMMITTEE OF THE BOARD OF DIRECTORS OF MEDSTAR HEALTH, INC. THE BOARD OF MEDSTAR HEALTH, INC. HAS DELEGATED CERTAIN APPROVAL AUTHORITY TO THE GOVERNANCE COMMITTEE AND THE PRESIDENT & CEO OF MEDSTAR HEALTH, INC. FORM 990, PART VI, SECTION A, LINE 7B DECISIONS OF GOVERNING BODY AS AN AFFILIATE AND SUBSIDIARY OF MEDSTAR HEALTH, INC., THE BYLAWS OF THE ORGANIZATION ARE SUBJECT TO CERTAIN RESERVED POWERS, WHICH PROVIDE THAT THE SOLE MEMBER OF THE ORGANIZATION MUST APPROVE CERTAIN DECISIONS, INCLUDING BUT NOT LIMITED TO MATTERS CONCERNING THE SALE OR PURCHASE OF REAL OR PERSONAL PROPERTY, CAPITAL BUDGETS, STRATEGIC PLANNING, INVESTMENTS, AND CORPORATE GOVERNANCE. FORM 990, PART VI, SECTION B, LINE 11B PROCESS FOR REVIEWING FORM 990 THE PROCESS FOR REVIEWING THE FORM 990 INCLUDED EDUCATION AND TRANSPARENCY. SENIOR FINANCIAL EXECUTIVES, WORKING WITH INDEPENDENT OUTSIDE EXPERTS, THOROUGHLY REVIEWED FORM 990 AND ACCOMPANYING INSTRUCTIONS. IN ADDITION, SENIOR EXECUTIVES REVIEWED THE RELEVANT SECTIONS OF THE FORM 990 WITH THE FOLLOWING COMMITTEES OF THE ORGANIZATION'S GOVERNING BODY: FINANCE, AUDIT, GOVERNANCE, STRATEGIC PLANNING, AND EXECUTIVE COMPENSATION. FOLLOWING THESE MEETINGS, THE GOVERNING BODY WAS PROVIDED A COPY OF THE FORM 990 IN ITS FINAL FORM AND GIVEN AN OPPORTUNITY TO PROVIDE ANY INPUT OR COMMENTS RELATING TO THE FORM 990 PRIOR TO ITS FILING. FORM 990, PART VI, SECTION B, LINE 12C CONFLICT OF INTEREST POLICY APPOINTMENT OF BOARDS OF DIRECTORS MEDSTAR HEALTH (AND ITS SUBSIDIARIES) REQUIRE ALL NOMINATED DIRECTORS, PRIOR TO THEIR APPOINTMENT OR ELECTION, TO DISCLOSE THE EXISTENCE OF (OR POTENTIAL EXISTENCE OF) ANY TRANSACTION WITH MEDSTAR THAT WOULD RESULT IN A CONFLICT OF INTEREST. SUCH DISCLOSURES (IF ANY) ARE REVIEWED BY THE GOVERNANCE COMMITTEE OF THE MEDSTAR HEALTH BOARD OF DIRECTORS WHICH DETERMINES HOW THE MATTER SHOULD BE RESOLVED. ANNUAL DISCLOSURES - ALL OFFICERS, DIRECTORS, AND SENIOR MANAGERS ALL OFFICERS, DIRECTORS AND SENIOR MANAGERS ARE REQUIRED, NOT LESS THAN ANNUALLY, TO COMPLETE A SURVEY OF QUESTIONS CONCERNING ANY TRANSACTIONS OR RELATIONSHIPS WHICH WOULD OR COULD REPRESENT A CONFLICT OF INTEREST. SUCH DISCLOSURES (IF ANY) ARE REVIEWED BY THE GOVERNANCE COMMITTEE OF THE MEDSTAR HEALTH BOARD OF DIRECTORS WHICH DETERMINES HOW THE MATTER SHOULD BE RESOLVED. FORM 990, PART VI, SECTION B, LINE 15 EXECUTIVE COMPENSATION PROCESS THE EXECUTIVE COMPENSATION COMMITTEE OF THE BOARD OF DIRECTORS OF MEDSTAR HEALTH, INC. (THE "COMMITTEE") HAS OVERSIGHT OF THE EXECUTIVE COMPENSATION PROGRAM (THE "PROGRAM") OF MEDSTAR HEALTH, INC. AND ITS AFFILIATES. TOTAL COMPENSATION FOR THE TOP MANAGEMENT OFFICIALS, OFFICERS AND KEY EMPLOYEES OF MEDSTAR HEALTH, INC. AND ITS AFFILIATES ARE REVIEWED AND APPROVED BY THE COMMITTEE WITH ASSISTANCE AND GUIDANCE FROM AN INDEPENDENT THIRD PARTY ADVISOR. THE MEMBERS OF THE COMMITTEE ARE INDEPENDENT FROM ALL OF THE PARTICIPANTS IN THE PROGRAM. THE MAIN OBJECTIVE OF THE PROGRAM IS TO PROVIDE MARKET COMPETITIVE TOTAL COMPENSATION THAT IS INTERNALLY EQUITABLE AND HAS A STRONG PAY-FOR-PERFORMANCE LINKAGE. PERFORMANCE IS EVALUATED AT THE SYSTEM, OPERATING UNIT, AND INDIVIDUAL LEVELS. THE OVERALL TOTAL COMPENSATION PHILOSOPHY IS MANAGED AT THE 75TH PERCENTILE OF THE COMPETITIVE MARKET FOR COMPARABLE SIZE (NET REVENUE) AND TYPE ("TAX-EXEMPT HEALTHCARE ORGANIZATIONS"). WHERE APPROPRIATE, ADDITIONAL INDUSTRY DATA IS CONSIDERED (GENERAL BUSINESS AND/OR TAXABLE HEALTHCARE) FOR SELECTED POSITIONS THAT CAN BE RECRUITED FROM OR POTENTIALLY LOST TO THESE INDUSTRIES (E.G., INFORMATION TECHNOLOGY, FINANCE, ETC.). THE COMMITTEE HAS ENGAGED ERNST & YOUNG LLP ("E&Y") TO SERVE AS AN ADVISOR ON THE REASONABLENESS AND COMPETITIVENESS OF THE PROGRAM. IN DETERMINING REASONABLENESS AND COMPETITIVENESS, E&Y REVIEWS MARKET PRACTICES AND TRENDS, AND MAKES RECOMMENDATIONS RELATED TO THE PROGRAM. E&Y UTILIZES INFORMATION FROM CUSTOM SURVEYS, NATIONAL COMPENSATION SURVEYS, PROPRIETARY DATABASES, AND CLIENT EXPERIENCES TO DETERMINE ITS FINAL RECOMMENDATIONS. E&Y PRESENTS THEIR FINDINGS AND RECOMMENDATIONS TO THE COMMITTEE. THE COMMITTEE MAKES THE FINAL DECISIONS ON ALL OF THE COMPENSATION DETERMINATIONS OF THE PROGRAM. ALL DECISIONS MADE BY THE COMMITTEE ARE CONTEMPORANEOUSLY DOCUMENTED. FORM 990, PART VI, SECTION C, LINE 19 FINANCIAL STATEMENTS AVAILABILITY MEDSTAR HEALTH POSTS ITS ANNUAL FINANCIAL AUDIT AND QUARTERLY FINANCIAL REPORTS TO THE ELECTRONIC MUNICIPAL MARKET ACCESS (EMMA) SYSTEM. THE ORGANIZATION ALSO E-MAILS ITS ANNUAL AND QUARTERLY DISCLOSURES TO HOLDERS OF THE COMPANY'S PUBLICLY TRADED DEBT. THE COMPANY'S GOVERNANCE DOCUMENTS AND CONFLICTS OF INTEREST POLICIES ARE AVAILABLE UPON REQUEST THROUGH ITS CORPORATE (OR AS APPLICABLE ENTITY) PUBLIC INFORMATION OFFICES. FORM 990, PART IX, LINE 11G PURCHASED PROFESSIONAL SERVICE: PROGRAM SERVICE EXPENSES 4,702,959. MANAGEMENT AND GENERAL EXPENSES 310,781. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 5,013,740. PHYSICIAN SERVICES: PROGRAM SERVICE EXPENSES 1,552,635. MANAGEMENT AND GENERAL EXPENSES 10,500. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,563,135. TESTING & DIAGNOSTIC SERVICES: PROGRAM SERVICE EXPENSES 4,827. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 4,827. LAB SERVICES: PROGRAM SERVICE EXPENSES 345,607. MANAGEMENT AND GENERAL EXPENSES 59,631. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 405,238. MISC PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 214,068. MANAGEMENT AND GENERAL EXPENSES 55,854. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 269,922. SUBSIDY EXPENSE - INTERCOMPANY: PROGRAM SERVICE EXPENSES 40,886,940. MANAGEMENT AND GENERAL EXPENSES 36,184. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 40,923,124. NON-PHYS INTERCO PURCH SRVS: PROGRAM SERVICE EXPENSES 1,734,711. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,734,711. MISC FIXED PURCH SRVCS: PROGRAM SERVICE EXPENSES 263,249. MANAGEMENT AND GENERAL EXPENSES 1,300. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 264,549. CONSULTING FEES: PROGRAM SERVICE EXPENSES 129,581. MANAGEMENT AND GENERAL EXPENSES 106,901. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 236,482. MISCELLANEOUS: PROGRAM SERVICE EXPENSES 3,861,731. MANAGEMENT AND GENERAL EXPENSES 2,555,665. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 6,417,396. FORM 990, PART XI, LINE 9: EQUITY TRANSFERS 101,463,946. FINANCIAL STATEMENTS AND REPORTING PART XII, LINE 2C THE UNION MEMORIAL HOSPITAL IS PART OF THE MEDSTAR HEALTH, INC. AUDIT AND SUBJECT TO OVERSIGHT BY THE AUDIT COMMITTEE OF THE MEDSTAR BOARD. 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