2021-05-17T11:56:55-05:00 2020-06-30 366055558 GRANT THORNTON LLP 1000 WILSON BOULEVARD SUITE 1400 ARLINGTON VA 22209 990 2019-07-01 520591628 PENINSULA REGIONAL MEDICAL CENTER PENI 4105466400 100 EAST CARROLL STREET SALISBURY MD 21801 BRUCE I RITCHIE CFO 4105466400 2021-05-14 1 MARY TORRETTA P00847851 7038477500 2019 2022-09-23 18:48:47Z STEVEN LEONARD CEO 100 EAST CARROLL STREET SALISBURY MD 21801 817100355 0 X WWW.TIDALHEALTH.ORG X 1897 MD IMPROVE THE HEALTH OF THE COMMUNITIES WE SERVE. 12 10 3840 10 11175826 416803 1445254 17202254 463023019 473954597 39905644 28672909 1048884 1047978 505422801 520877738 0 0 0 0 234717145 252919271 0 0 647876 226139423 248158482 460856568 501077753 44566233 19799985 750488371 860332244 203768078 312831733 546720293 547500511 IMPROVE THE HEALTH OF THE COMMUNITIES WE SERVE. 0 0 447933540 463059797 SEE SCHEDULE O 447933540 1 1 0 1 0 0 0 0 0 1 1 0 0 1 1 0 0 1 0 1 1 0 0 0 0 0 1 1 0 0 1 1 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 1 1 1 0 0 1 279 0 1 3840 1 1 1 1 CJ 0 0 0 0 0 0 0 0 0 0 X 12 10 1 0 1 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 1 1 CA MD NC X JIM GREGORY 4109124979 100 EAST CARROLL STREET SALISBURY MD 21801 X JAMES TODD MD PHYSICIAN 40.00 0.00 X 1028511 0 100675 ZACHARY BAKER MD PHYSICIAN 40.00 0.00 X 929586 0 30562 STEVEN LEONARD PRESIDENT/CEO 40.00 1.00 X X 844182 0 97168 FAWAD KHAN MD PHYSICIAN 40.00 0.00 X 905907 0 32270 DANIEL DANIELS MD PHYSICIAN 40.00 0.00 X 820582 0 27409 KARIM ARANOUT MD PHYSICIAN 40.00 0.00 X 810087 0 37611 LURA LUNSFORD VP OF OPERATIONS 40.00 2.00 X 645759 0 58888 BRUCE I RITCHIE CFO 40.00 1.00 X 610657 0 89092 CHARLES SILVIA JR MD VP - CHIEF MEDICAL OFFICER 40.00 1.00 X 525075 0 64429 SIMONA ENG DO BOARD MEMBER THRU 12/31/19 40.00 1.00 X 477411 0 52393 KARIN DIBARI MD VP PRESIDENT PRMG 40.00 3.00 X 474530 0 28614 SARAH SCOTT VP PEOPLE & ORGANIZATION DEV. 40.00 0.00 X 305939 0 51745 JAMES TRUMBLE VP - CLINICAL INTEGRATION 40.00 1.00 X 331003 0 24802 KATHRYN FIDDLER VP - POPULATION HEALTH 40.00 1.00 X 249262 0 33511 SARAH ARNETT CHIEF NURSING OFFICER 40.00 1.00 X 196040 0 13621 HERBERT J GEARY III PAST CHAIR THRU 12/31/19 5.00 8.00 X X 23534 0 0 VEL NATESAN MD BOARD MEMBER 1.00 1.00 X 19271 0 0 DEBORAH ABBOTT CHAIRMAN THRU 12/31/19 1.00 2.00 X X 7500 0 0 MONTGOMERY SAYLER BOARD MEMBER THRU 10/31/19 1.00 2.00 X 3756 0 0 RYAN MCLAUGHLIN SECRETARY THRU 10/31/19 1.00 1.00 X X 0 0 0 DAVID ROMMEL TREASURER THRU 10/31/19 1.00 2.00 X X 0 0 0 DR RONDALL ALLEN BOARD MEMBER 1.00 1.00 X 0 0 0 TIMOTHY BENNING MD BOARD MEMBER THRU 10/31/19 1.00 1.00 X 0 0 0 THOMAS COATES BOARD MEMBER THRU 10/31/19 1.00 1.00 X 0 0 0 MEMO DIRIKER CHAIRMAN FROM 01/01/20 1.00 1.00 X X 0 0 0 JAMES HARSTEIN BOARD MEMBER 1.00 1.00 X 0 0 0 MARK HIGDON BOARD MEMBER THRU 12/31/19 1.00 1.00 X 0 0 0 JANELLE BEILER BOARD MEMBER 1.00 0.00 X 0 0 0 KAREN POISKER BOARD MEMBER 1.00 0.00 X 0 0 0 MARK EDNEY BOARD MEMBER 1.00 0.00 X 0 0 0 MARY DIBARTOLO BOARD MEMBER 1.00 0.00 X 0 0 0 MARTIN NEAT BOARD MEMBER THRU 12/31/19 1.00 1.00 X 0 0 0 PERCY J PURNELL BOARD MEMBER 1.00 1.00 X 0 0 0 THOMAS RICCIO MD BOARD MEMBER THRU 12/31/19 1.00 1.00 X 0 0 0 SUSAN WILLGUS-MURPHY BOARD MEMBER 1.00 1.00 X 0 0 0 ANDREA WILLIAMS BOARD MEMBER THRU 12/31/19 1.00 1.00 X 0 0 0 JULIUS ZANT MD BOARD MEMBER 1.00 1.00 X 0 0 0 9208592 0 742790 341 1 1 0 SHERIDAN ANESTHESIA OF MD PO BOX 744883 ATLANTA GA 303744883 ANESTHESIA SERVICES 6720412 INTERMED GROUP 13301 N W HWY 441 ALACHUA FL 326158512 BIOMEDICAL SERVICES 6189350 FOCUSONE SOLUTIONS LLC PO BOX 310861 DES MOINES IA 503310861 TEMP LABOR SERVICES 5103305 EPIC SYSTEMS CORP PO BOX 88314 MILWAUKEE WI 532880314 TECHNICAL SERVICES 4228083 SLEEP WAVES INC 873 E BALTIMORE PIKE STE345 KENNETT SQUARE PA 19348 SLEEP LAB SERVICES 2842800 80 1656452 15045802 500000 17202254 NET PATIENT SERVICES 621500 464221974 462983284 1238690 AMBULATORY PHARMACY 900099 9649950 9649950 INVESTMENT IN PREMIER 900099 82673 76513 6160 473954597 8391491 -150 8391641 300383 431411 -131028 -131028 -131028 316045825 26799 295758408 32798 20287417 -5999 20281418 20281418 CAFETERIA 722514 888805 888805 MANAGEMENT FEES 561000 200000 200000 LIFELINE 532283 81176 81176 9025 9025 1179006 520877738 463059797 11175826 29439861 X 4591835 4072841 509621 9373 200186568 177604282 22173638 408648 10160189 9011828 1127621 20740 24327600 21549376 2728047 50177 13653079 12164854 1464288 23937 1511822 43990 1467832 142290 142290 21221 21221 1741505 1741505 59132441 47234797 11842795 54849 727964 727964 92068327 88511547 3484105 72675 1881334 1863902 14313 3119 4642227 4534754 107473 547867 379386 164796 3685 37141 37141 5257650 5257650 29793923 29602271 191652 5355689 418321 4937368 MEDICAL SUPPLIES 38403724 38403724 BAD DEBTS 6278309 6278309 DUES 615048 215382 398993 673 501077753 447933540 52496337 647876 8705521 101915420 28985323 29158658 42498723 45372126 9104522 10182805 7401487 7887429 603323022 395009322 216237708 208313700 317793489 346155047 119761598 111347059 750488371 860332244 18752504 22171628 133622095 130687640 51393479 159972465 203768078 312831733 X 499696969 494771186 47023324 52729325 546720293 547500511 750488371 860332244 X 19799985 7962481 -26982248 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 21221 21221 0 PART II-B, LINE 1: OTHER ACTIVITIES PENINSULA REGIONAL MEDICAL CENTER DOES NOT ENGAGE IN ANY DIRECT LOBBYING ACTIVITIES. THE ORGANIZATION PAYS MEMBERSHIP DUES TO MARYLAND HOSPITAL ASSOCIATION (MHA). MHA ENGAGES IN MANY SUPPORT ACTIVITIES INCLUDING LOBBYING AND ADVOCATING FOR ITS MEMBER HOSPITALS. THE MHA REPORTED THAT 4.80% OF MEMBER DUES WERE USED FOR LOBBYING PURPOSES AND SUCH, THE ORGANIZATION HAS REPORTED THIS AMOUNT ON SCHEDULE C PART IV AS LOBBYING ACTIVITIES. 71424439 8133343 5217 387264 79165301 64583287 7263806 9245 413409 71424439 56672686 257832 8059133 900 405464 64583287 49801243 250000 6985039 363596 56672686 50044611 500000 -399685 343683 49801243 0.47640 0.10870 0.41490 0 1 1 12378600 12378600 276619755 139085197 137534558 302320763 248384629 53936134 12003904 7539496 4464408 208313700 DONOR RESTRICTED FUND 49064009 BOARD DESIGNATED INVESTMENTS 37711890 INTERCOMPANY RECEIVABLES 8970131 OTHER ASSETS 7720489 SELF INSURANCE FUND 6220004 INVESTMENT IN PARTNERSHIPS 1660536 111347059 ADVANCES FROM THIRD PARTY PAYORS 110120531 ACCRUED SELF INSURANCE LIABILITY 3946059 OTHER LIABILITIES 18300547 EMPLOYEE COMP RELATED PAYROLL TAXES 27605328 159972465 X 519689737 8785498 431411 9216909 510472828 1741505 8663405 10404910 520877738 493289350 431411 431411 492857939 1741505 6478309 8219814 501077753 PART V, LINE 4: INTENDED USE OF ENDOWMENT FUNDS THE ORGANIZATION'S ENDOWMENT FUNDS ARE USED FOR CAPITAL, PATIENT SERVICES OR EDUCATIONAL PURPOSES. PART X, LINE 2: LIABILITY FOR UNCERTAIN TAX POSITION (ASC 740) THE ORGANIZATION IS PART OF THE CONSOLIDATED FINANCIAL STATEMENTS FOR PENINSULA REGIONAL HEALTH SYSTEM AND ITS FOOTNOTE STATES: THE TAX YEARS ENDING JUNE 30, 2020, 2019 AND 2018 ARE STILL OPEN TO AUDIT FOR BOTH FEDERAL AND STATE PURPOSES. THE HEALTH SYSTEM HAS DETERMINED THAT THERE ARE NO MATERIAL UNCERTAIN TAX POSITIONS THAT REQUIRE RECOGNITION OR DISCLOSURE IN THE CONSOLIDATED FINANCIAL STATEMENTS FOR THE YEARS ENDED JUNE 30, 2020 AND 2019. PART XI, LINE 2D - OTHER ADJUSTMENTS: RENT EXPENSES 431,411. PART XI, LINE 4B - OTHER ADJUSTMENTS: BAD DEBT EXPENSES 6,278,309. NON OPERATING INCOME 28,794. UBTI FROM ESHP K-1 -150. CONTRIBUTION REVENUE FROM PENINSULA FOUNDATION 1,656,452. DONATIONS RECEIVED AS TEMPORARY NET ASSETS 500,000. RECOVERY OF EXPENSES 200,000. PART XII, LINE 2D - OTHER ADJUSTMENTS: RENT EXPENSES 431,411. PART XII, LINE 4B - OTHER ADJUSTMENTS: BAD DEBT EXPENSES 6,278,309. RECOVERY OF EXPENSES 200,000. CENTRAL AMERICA/CARIBBEAN 1 1 INVESTMENTS 5314879 1 1 0 0 1 1 5314879 0 5314879 1 0 1 0 0 0 PART I, LINE 3: ACTIVITIES PER REGION THE AMOUNTS IN COLUMN F WERE DETERMINED USING AN ACCRUAL METHOD OF ACCOUNTING. THE TOTAL AMOUNT REPRESENTS A CAPTIVE INSURANCE INVESTMENT. PART III ACCOUNTING METHOD: 1 1 1 X 1 X 1 1 1 0 1 1 11411503 11411503 0.02310 11411503 11411503 0.02310 34698 1674297 129174 1545123 0.00310 290 1652829 42225 1610604 0.00330 266491 104657378 55896290 48761088 0.09850 0 7028 7028 0.00000 4574 441464 441464 0.00090 306053 108432996 56067689 52365307 0.10580 306053 119844499 56067689 63776810 0.12890 12734 12734 0.00000 104930 6600 98330 0.00020 237086 237086 0.00050 2773463 911000 1862463 0.00380 1962 1962 0.00000 30457 30457 0.00010 3160632 917600 2243032 0.00460 1 6278309 296149082 192321048 103828034 X 1 1 1 1 PENINSULA REGIONAL MEDICAL CENTER 100 E CARROLL STREET SALISBURY MD 21801 WWW.TIDALHEALTH.ORG 210019 X X X PENINSULA REGIONAL MEDICAL CENTER 1 0 0 1 X X X X X X 19 1 0 1 1 X SEE SUPPLEMENTAL INFORMATION X X 1 19 1 SEE SUPPLEMENTAL INFORMATION 0 1 X 200.000000000000 300.000000000000 X X X X 1 1 X X X X 1 X SEE SUPPLEMENTAL INFORMATION X SEE SUPPLEMENTAL INFORMATION X SEE SUPPLEMENTAL INFO X X X X X X 1 X 0 X X X X 1 X 0 0 PENINSULA REGIONAL MEDICAL CENTER PART V, SECTION B, LINE 5: CONSULTING REPRESENTATIVES OF THE COMMUNITY SERVED BY THE HOSPITALCONDUENT HEALTHY COMMUNITIES INSTITUTE (HCI), A XEROX COMPANY, WAS RETAINED BY PENINSULA REGIONAL MEDICAL CENTER TO CONDUCT THE 2019 COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA). IN 2021, PENINSULA REGIONAL HEALTH SYSTEM IS PREPARING TO CONDUCT A NEW COMMUNITY HEALTH NEEDS ASSESSMENT THAT WILL COVER THE MD CBSA OF SOMERSET, WICOMICO AND WORCESTER COUNTIES AND A NEW AREA OF SUSSEX COUNTY, DELAWARE. EFFECTIVE JANUARY 1, 2020, NANTICOKE MEMORIAL HOSPITAL (NMH) AND MID-SUSSEX MEDICAL CENTER, DBA NANTICOKE PHYSICIAN NETWORK, (NPN), LOCATED IN SEAFORD, DELAWARE, JOINED PENINSULA REGIONAL HEALTH SYSTEM. NANTICOKE HAS 139 LICENSED ACUTE CARE BEDS ( 99 CURRENTLY OPERATED ) AND PRIMARILY SERVES THE WESTERN SUSSEX COUNTY, DELAWARE PORTION OF THE HEALTH SYSTEM'S PRIMARY SERVICE AREA. NANTICOKE PHYSICIAN NETWORK PROVIDES OUTPATIENT MEDICAL SERVICES IN WESTERN SUSSEX COUNTY AND FEDERALSBURG, MD. EFFECTIVE MARCH 1, 2020, MCCREADY FOUNDATION, WHICH CONSISTED OF A THREE BED HOSPITAL, ALICE BYRD TAWES NURSING HOME, A 76-LICENSED BED SKLLED NURSING HOME AND CHESAPEAKE COVE ASSISSTED LIVING CENTER IN CRISFIELD, MD, BECAME PART OF PENINSULA REGIONAL HEALTH SYSTEM. THE MCCREADY HOSPITAL DIVISION WAS MERGED IN PENINSULA REGIONAL MEDICAL CENTER AND LIMITED ITS FUNCTIONS TO THOSE CONSISTANT WITH STATUS AS A FREE-STANDING MEDICAL CENTER. HCI AND PRHS HAVE COLLABORATED SINCE 2012 TO DEVELOP THE PRHS CREATING HEALTHY COMMUNITIES PLATFORM. HCI CONSULTANTS CONDUCTED KEY INFORMANT INTERVIEWS IN ORDER TO COLLECT COMMUNITY INPUT. KEY INFORMANT INTERVIEWS WERE CONDUCTED BETWEEN 07/26/2018 AND 08/30/2018. INTERVIEWEES WHO WERE ASKED TO PARTICIPATE WERE RECOGNIZED AS HAVING EXPERTISE IN PUBLIC HEALTH, SPECIAL KNOWLEDGE OF COMMUNITY HEALTH NEEDS AND/OR REPRESENTED THE BROAD INTEREST OF THE COMMUNITY SERVED BY THE HEALTH SYSTEM, AND/OR COULD SPEAK TO THE NEEDS OF THE MEDICALLY UNDERSERVED OR VULNERABLE POPULATIONS.THE FOLLOWING ORGANIZATIONS ARE REPRESENTATIVE OF THE INDIVIDUALS WHO PARTICIPATED IN THE INTERVIEWS:CHESAPEAKE HEALTH CENTER, CORELIFE, DEER'S HEAD HOSPITAL CENTER, HOPE, INC. (HEALTH AND OUTREACH POINT OF ENTRY), LOWER SHORE CLINIC, LOWER SHORE ENTERPRISES, MAC, INC. (MAINTAINING ACTIVE CITIZENS), SALISBURY REHABILITATION AND SKILLED NURSING CENTER - GENESIS HEALTHCARE, SALISBURY UNIVERSITY, TGM GROUP LLC, WICOMICO COUNTY EXECUTIVE, WICOMICO COUNTY HEALTH DEPARTMENT, PENINSULA REGIONAL MEDICAL CENTER, AND THE SOMERSET COUNTY HEALTH DEPARTMENT.THERE WERE ALSO THREE FOCUS GROUPS THAT WERE ORGANIZED AND FACILITATED BY PENINSULA REGIONAL MEDICAL CENTER, WICOMICO COUNTY HEALTH DEPARTMENT, AND SOMERSET COUNTY HEALTH DEPARTMENT. THE FOCUS GROUPS CONVENED ON 08/23/2018, 08/29/2018, AND 09/14/2018. THE AUGUST 23RD FOCUS GROUP CONSISTED OF PROFESSIONALS AND PROVIDERS FROM VARIOUS DISCIPLINES IN THE TRI-COUNTY AREA AND WAS HELD AT PRMC. THE AUGUST 29TH FOCUS GROUP WAS HELD IN SALISBURY AT THE SALVATION ARMY AND INCLUDED MEMBERS OF THE GREATER SALISBURY COMMUNITY. THE SEPTEMBER 14TH FOCUS GROUP WAS HELD IN POCOMOKE CITY IN WORCESTER COUNTY AT THE POCOMOKE LIBRARY AND INCLUDED MEMBERS OF THE GREATER POCOMOKE AREA.A COMMUNITY SURVEY WAS AVAILABLE USING SURVEY MONKEY, AN ONLINE SURVEY TOOL, AND A PAPER VERSION OF THE SURVEY. THE SURVEY WAS DISTRIBUTED ACROSS PRMC'S ENTIRE SERVICE AREA FROM 07/23/2018 TO 09/10/2018. A TOTAL OF 584 RESPONSES WERE COLLECTED AND A REPORT WAS CREATED. PENINSULA REGIONAL MEDICAL CENTER PART V, SECTION B, LINE 6B: CHNA CONDUCTED WITH ONE OR MORE ORGANIZATIONS OTHER THAN HOSPITAL FACILITIESTHE HOSPITAL FACILITY'S CHNA IS CONDUCTED WITH ONE OR MORE ORGANIZATIONS OTHER THAN THE HOSPITAL. THESE ORGANIZATIONS WE PARTNERED WITH INCLUDE THE WICOMICO COUNTY HEALTH DEPARTMENT (WICHD) AND THE SOMERSET COUNTY HEALTH DEPARTMENT (SCHD).A PARTNERSHIP WAS FORMED BETWEEN PRMC, WICHD, AND SCHD TO COLLABORATE FOR THE BENEFIT OF THE COMMUNITY. THESE ORGANIZATIONS HAVE BEEN PARTNERING TOGETHER ON LOCAL ASSESSMENT EFFORTS SINCE 1995. TWO OF THE ORGANIZATIONS ARE REQUIRED TO COMPLETE A CHNA; PRMC IS A NON-PROFIT HOSPITAL AND WICHD AS AN ACCREDITED HEALTH DEPARTMENT. SCHD IS IN THE EARLY PHASE OF PUBLIC HEALTH ACCREDITATION. IN DECEMBER 2018, PRMC, SCHD, AND WICHD PUBLISHED THEIR 2019 CHNA. THE CHNA REPORT PROVIDES AN OVERVIEW OF SIGNIFICANT HEALTH NEEDS IN THE TRI-COUNTY SERVICE AREA. THIS CHNA REPORT WAS DEVELOPED TO PROVIDE AN OVERVIEW OF THE HEALTH NEEDS IN THE TRI-COUNTY SERVICE AREA, INCLUDING SOMERSET, WICOMICO, AND WORCESTER COUNTIES IN MARYLAND. PRMC, SCHD, AND WICHD PARTNERED WITH CONDUENT HEALTHY COMMUNITIES INSTITUTE (HCI) TO CONDUCT THE CHNA. THE GOAL OF THIS REPORT IS TO OFFER A MEANINGFUL UNDERSTANDING OF THE GREATEST HEALTH NEEDS ACROSS THE TRI-COUNTY SERVICE AREA, AS WELL AS TO GUIDE PLANNING EFFORTS TO ADDRESS THOSE NEEDS. SPECIAL ATTENTION HAS BEEN GIVEN TO IDENTIFY HEALTH DISPARITIES, NEEDS OF THE VULNERABLE POPULATIONS, UNMET HEALTH NEEDS OR GAPS IN SERVICES, AND INPUT FROM THE COMMUNITY.CHNA ON HOSPITAL FACILITY'S WEBSITESCHEDULE H, PART V, LINE 7AHTTPS://WWW.TIDALHEALTH.ORG/PUBLICATIONS/COMMUNITY-HEALTH-NEEDS-ASSESSMENT-2019 PENINSULA REGIONAL MEDICAL CENTER PART V, SECTION B, LINE 7D: OTHER WAYS THE HOSPITAL MAKES ITS CHNA REPORT AVAILABLE TO THE PUBLICPENINSULA REGIONAL'S COMPREHENSIVE CHNA REPORT IS MADE AVAILABLE TO THE PUBLIC ONLINE AT HTTPS://WWW.TIDALHEALTH.ORG/PUBLICATIONS/COMMUNITY-HEALTH-NEEDS-ASSESSMENT-2019 AND A PAPER COPY IS MADE AVAILABLE TO THE PUBLIC AT SEVERAL LOCATIONS WITHIN THE HOSPITAL FOR PUBLIC INSPECTION. IN ADDITION, THE REPORT HAS BEEN TRANSLATED INTO SPANISH AND THE HOSPITAL IS LOOKING INTO A FURTHER TRANSLATION TO CREOLE. WE PARTNER WITH CONDUENT HEALTHY COMMUNITIES INSTITUTE TO DISCOVER WHAT THE MOST PRESSING HEALTH CHALLENGES ARE IN SOMERSET, WORCESTER AND WICOMICO COUNTIES. THE PUBLIC CAN VIEW THE RESULTS OF OUR COMMUNITY HEALTH NEEDS ASSESSMENT ONLINE, AS WELL AS OUR ACTION PLAN OF STEPS WE PLAN TO TAKE BASED ON THE INFORMATION GATHERED IN THE ASSESSMENT. IN ADDITION, A COMMUNITY HEALTH DATA AND RESOURCES SECTION CAN BE ACCESSED BY THE PUBLIC. AS PART OF THIS CREATING HEALTHY COMMUNITIES, A MODULE IS AVAILABLE TO THE PUBLIC IN WHICH THEY CAN EXPLORE MULTIPLE DASHBOARDS THAT PROVIDE A GAUGE TO THE HEALTH OF THE COMMUNITIES SERVED, SOCIO-DEMOGRAPHICS AND PROMISING PRACTICES. THE DASHBOARDS INCLUDE FEATURES SUCH AS A CHNA GUIDE, HEALTH DATA, DEMOGRAPHIC DATA, HEALTH DISPARITIES, SOCIO NEEDS INDEXES, FINDING GRANTS, INDICATOR COMPARISONS, AND PROGRESS TRACKING.IMPLEMENTATION STRATEGY ON HOSPITAL FACILITY'S WEBSITESCHEDULE H, PART V, LINE 10AHTTPS://WWW.TIDALHEALTH.ORG/PUBLICATIONS/IMPLEMENTATION-STRATEGY-COMMUNITY-BENEFIT-2019 PENINSULA REGIONAL MEDICAL CENTER PART V, SECTION B, LINE 11: HOW NEEDS IDENTIFIED IN THE CHNA ARE ADDRESSEDPENINSULA REGIONAL MEDICAL CENTER HAS A FIXED VALUE OF RESOURCES AVAILABLE, AND THE HOSPITAL FOCUSES THOSE RESOURCES TO THE AREAS WITH THE GREATEST IMPACT, THEREFORE NOT ALL NEEDS, TO DATE, IDENTIFIED IN THE CHNA WERE ABLE TO BE ADDRESSED. NON-PRIORITIZED NEEDS INCLUDED ACCESS TO HEALTH SERVICES, OLDER ADULTS & AGING, AND ORAL HEALTH. THESE NEEDS WERE NOT SELECTED BECAUSE THEY DID NOT MEET THE PRIORITIZATION CRITERIA AS STRONGLY AS THE SELECTED TOPICS. EVEN THOUGH NOT ALL IDENTIFIED NEEDS ARE ADDRESSED SPECIFICALLY IN THE "IMPLEMENTATION STRATEGY COMMUNITY BENEFITS" PLAN, THERE ARE POPULATION HEALTH INITIATIVES ADOPTED THROUGH THE HEALTH SYSTEM'S 2020 STRATEGIC PLAN THAT PROMOTE HEALTH AND WELL-BEING WITHIN THE COMMUNITY, AND ADDRESS NEEDS WITHIN THE CHNA.BASED ON THE SIGNIFICANT NEEDS IDENTIFIED IN THE COMMUNITY HEALTH NEEDS ASSESSMENT, THE FOLLOWING IMPLEMENTATION INITIATIVES WERE DEVELOPED AND OUTLINED IN OUR 2019-2021 IMPLEMENTATION STRATEGY PLAN FOR PENINSULA REGIONAL MEDICAL CENTER, AND ALSO IN THE COMMUNITY HEALTH IMPROVEMENT PLAN FOR SOMERSET COUNTY HEALTH DEPARTMENT AND WICOMICO COUNTY HEALTH DEPARTMENT. THIS BOOKLET CAN BE FOUND AT HTTPS://WWW.TIDALHEALTH.ORG/PUBLICATIONS/IMPLEMENTATION-STRATEGY-COMMUNITY-BENEFIT-2019 IN ADDITION TO WHERE THE COMMUNITY HEALTH NEEDS ASSESSMENT CAN ALSO BE FOUND. AFTER A THOROUGH REVIEW OF THE HEALTH STATUS IN OUR COMMUNITY THROUGH THE CHNA, WE IDENTIFIED AREAS THAT WE COULD ADDRESS USING OUR RESOURCES, EXPERTISE AND COMMUNITY PARTNERS. THE FOLLOWING ARE THE PRIORITIZED HEALTH NEEDS THAT WILL BE ADDRESSED:- BEHAVIORAL HEALTH (MENTAL HEALTH AND MENTAL DISORDERS AS WELL AS SUBSTANCE ABUSE) - DIABETES - CANCER (FOCUS AREAS: BREAST, COLORECTAL, CERVICAL, LUNG, SKIN)PRIORITY AREAS IDENTIFIEDBEHAVIORAL HEALTHGOALS:- ADDRESS BEHAVIORAL ISSUES IN THE TRI-COUNTY SERVICE AREA BY REDUCING THE INSTANCES OF OPIOID RELATED DEATHS.- ADDRESS BEHAVIORAL ISSUES IN THE TRI-COUNTY SERVICE AREA BY TARGETING SENIORS SUFFERING WITH MINOR TO MAJOR DEPRESSION.STRATEGIES:- COLLABORATIVELY ADDRESS THE OPIOID CRISIS IN THE TRI-COUNTY SERVICE AREA WITH AN EMPHASIS ON PREVENTION, TREATMENT, RESOURCES AND ENFORCEMENT. - PROVIDE PEER SUPPORT FOR PEOPLE WHO HAVE OVERDOSED OR SOUGHT HELP FOR OPIOID ADDICTION ISSUES.- ADDRESS DEPRESSION IN ADULTS 50 YEARS OR OLDER THROUGH SKILL BUILDING, PROBLEM SOLVING AND SOCIALIZATION ACTIVITIES.OBJECTIVES AND ANTICIPATED IMPACT:- WORK COLLABORATIVELY TO ADDRESS POLICY, DEVELOP EDUCATION AND RAISE COMMUNITY AWARENESS IN THE FIGHT AGAINST OPIOID USE, AND CONTINUE TO REDUCE INSTANCES OF HEROIN OVERDOSE EACH YEAR.- UTILIZING THE COMMUNITY OUTREACH ADDICTIONS TEAM (COAT), CONTACT AND PROVIDE LINKAGE TO TREATMENT AND OTHER SUPPORT SERVICES TO COMMUNITY MEMBERS DEALING WITH SUBSTANCE ABUSE ISSUES.- REDUCE THE INSTANCES OF DEPRESSION IN OLDER ADULTS THROUGH OUTREACH AND ACCESS TO AN EVIDENCE-BASED INTERVENTION PROGRAM. INCREASE PERCENT OF PROGRAM PARTICIPANTS WITH A SIGNIFICANT REDUCTION OF DEPRESSION ABOVE THE 2018 BASELINE OF 50%.1. PENINSULA REGIONAL TO COLLABORATE WITH WICOMICO COUNTY OPIOID INTERVENTION TEAM AND SOMERSET COUNTY OPIOID UNITED TEAM ACTIVITIES:- BRING AWARENESS, EDUCATION AND RESOURCES TO THE COMMUNITY TO WORK TOWARD ELIMINATING OPIOID ABUSE. - TARGET AWARENESS ACTIVITIES AND CAMPAIGNS TO THE COMMUNITY AND SCHOOLS. - PARTICIPATION IN DRUG AWARENESS COALITIONS.- NARCAN TRAINING FOR COMMUNITY MEMBERS.- DEVELOP AND IMPLEMENT AN OPIOID INTERVENTION TEAM EDUCATIONAL TRAILER FOR PARENTS, GUARDIANS AND ADULTS. THIS IS A MOCK TEENAGE BEDROOM SET UP TO SHOW POSSIBLE RED FLAGS FOR UNHEALTHY BEHAVIOR AND/OR SUBSTANCE USE.- COORDINATE AND HOST FIRST RESPONDER DINNER TO HELP ADDRESS COMPASSION FATIGUE.- WORK WITH COMMUNITY PARTNERS TO COORDINATE THE GO PURPLE AWARENESS CAMPAIGN PROGRAM. 2. PROGRAM TO ENCOURAGE ACTIVE AND REWARDING LIVES (PEARLS)ACTIVITIES:- RAISE AWARENESS OF THIS FREE PROGRAM THROUGH TARGETED OUTREACH TO CLINICIANS CARING FOR OLDER ADULTS, AS WELL AS SENIOR CENTERS AND OTHER LOCAL ORGANIZATIONS SERVING OLDER COMMUNITY MEMBERS.- PROVIDE ENGAGING AND IMPACTFUL CURRICULUM IN AN EASY-TO-LEARN APPROACH THROUGH FLEXIBLE ONE-ON-ONE VISITS AT LOCATIONS CONVENIENT FOR THE COMMUNITY MEMBER BEING SERVED. 3. ER UTILIZATION REDUCTION AND ACCESS IMPROVEMENT ACTIVITIES:- SWIFT, A MOBILE INTEGRATED HEALTH TEAM, MAKES HOME-BASED VISITS TO INDIVIDUALS UTILIZING 911 AT LEAST FIVE TIMES OVER A SIX-MONTH PERIOD FOR NON-LIFE-THREATENING MEDICAL REASONS. THE TEAM PROVIDES PHYSICAL, MENTAL AND SAFETY ASSESSMENTS AND SCREENS FOR SOCIAL DETERMINANTS OF HEALTH. BASED ON THEIR ASSESSMENT, PATIENTS ARE REFERRED, AS NECESSARY, FOR APPROPRIATE CARE INTERVENTIONS SUCH AS PRIMARY CARE PROVIDERS, MEDICAL SPECIALISTS, IN HOME PROVIDERS, FINANCIAL AND SOCIAL RESOURCES, AS WELL AS OTHER COMMUNITY RESOURCES. ALIGNMENT OPPORTUNITIES: - PRMC, AS PART OF A REGIONAL PARTNERSHIP WITH ATLANTIC GENERAL HOSPITAL IN WORCESTER COUNTY, SCHD AND WICHD, IS COLLABORATING WITH THE MARYLAND HEALTH SERVICE COST REVIEW COMMISSION TO DEVELOP A REGIONAL APPROACH TO BEHAVIORAL HEALTH FOR FY 2021. WORK IN THESE THREE AREAS WILL BE INCORPORATED INTO THIS TRI-COUNTY REGIONAL PARTNERSHIP AND UPDATED IN THIS DOCUMENT IN 2021.- WICHD STRATEGIC PLAN 2017-2022, PRIORITY #1: IMPROVE COMMUNITY HEALTH AND WELLNESS BY FOCUSING ON PRIORITY AREAS IDENTIFIED IN COLLABORATION WITH THE LOCAL HEALTH IMPROVEMENT COALITION: CHRONIC DISEASE AND BEHAVIORAL HEALTH. PRMC AND WICHD WILL BUILD OFF THE SUCCESSFUL EFFORTS THAT WERE INCLUDED FOR THIS PROGRAM IN THEIR 2016 IMPLEMENTATION STRATEGY PLAN.COLLABORATIVE ACTIVITIES:- TRAIN PEER SUPPORT SPECIALISTS.- PROVIDE PHONE AND IN-PERSON SUPPORT FOR PEOPLE WHO HAVE OVERDOSED OR WHO STRUGGLE WITH OPIOID ADDICTION, AS WELL AS OTHER SUBSTANCE ABUSE ISSUES.- PROVIDE CONNECTIONS TO RESOURCES INCLUDING TREATMENT OPTIONS.- PROVIDE PEER OUTREACH TO HIGH-RISK AREAS OF THE COMMUNITY.- MAINTAIN ONGOING COMMUNICATIONS ABOUT METRICS BETWEEN PRMC AND COAT TEAM. - EVALUATE EXPANSION TO SOMERSET COUNTY. DIABETESGOAL: IMPROVE HEALTH OF PEOPLE WITH DIABETES OR PRE-DIABETES IN THE TRI-COUNTY SERVICE AREA.STRATEGIES:- OFFER EVIDENCE-BASED CHRONIC DISEASE SELF-MANAGEMENT CLASSES (CDSM) THROUGHOUT THE TRI-COUNTY SERVICE AREA.- EXPAND ACCESS TO DIABETES SCREENING, EDUCATION AND RESOURCES THROUGHOUT THE TRI-COUNTY SERVICE AREA WITH THE WAGNER WELLNESS VAN MOBILE CLINIC SERVICES.- PROVIDE A FREE EVIDENCE-BASED WEIGHT LOSS, NUTRITION AND PHYSICAL ACTIVITY PROGRAM FOR WOMEN AND CHILDREN IN WICOMICO AND SOMERSET COUNTIES.OBJECTIVES AND ANTICIPATED IMPACT:- BY DECEMBER 2020, INCREASE THE NUMBER OF SIX-WEEK EDUCATIONAL CLASSES WITH IDENTIFIED DIABETES PATIENTS AND THEIR SUPPORTING CAREGIVERS FROM 26 TO 52 PER YEAR.- BY PARTNERING WITH OTHER COMMUNITY STAKEHOLDERS, THE COMMUNITY WELLNESS PROGRAM WILL INCREASE ACCESS TO DIABETES SCREENING, EDUCATION AND CONNECTION TO COMMUNITY RESOURCES. THIS PROGRAM, WHICH INCLUDES THE WAGNER WELLNESS VAN OUTREACH, PROVIDES HEALTH OUTREACH EVENTS THAT ARE BOTH LARGE-SCALE AND SMALL-SCALE, AND CAN BE AIMED TOWARD THE PUBLIC OR A TARGETED POPULATION OR GEOGRAPHIC AREA.- STARTING IN SEPTEMBER 2019 AND ENDING IN JUNE 2021, SCALE'S EXPECTED OUTCOMES INCLUDE: 80% OF ADULT PARTICIPANTS WILL REPORT WEIGHT LOSS OF AT LEAST 5% OF THEIR TOTAL BODY WEIGHT FROM BASELINE; 20% OF ADULT PARTICIPANTS WILL REPORT A DROP-IN HEMOGLOBIN A1C BY 0.2 POINTS OR MORE; 20% OF ADULT PARTICIPANTS WILL REPORT A DECREASE IN BLOOD PRESSURE (DIASTOLIC AND SYSTOLIC) BY 5 POINTS OR MORE; DEMONSTRATED BEHAVIOR CHANGE AND IMPROVED HEALTH STATUS.1. CHRONIC DISEASE SELF-MANAGEMENT (CDSM) CLASSES PRMC WILL BUILD OFF THE SUCCESSFUL EFFORTS THAT WERE INCLUDED FOR THIS PROGRAM IN ITS 2016 IMPLEMENTATION STRATEGY PLAN ACTIVITIES.ACTIVITIES:- TARGET AND IDENTIFY PATIENTS WHO HAVE DIABETES AND THEIR CAREGIVERS THROUGH SELF-REFERRAL OR PROVIDER REFERRAL.- TRAIN COMMUNITY PEER TRAINERS AND PRMC COMMUNITY HEALTH WORKERS TO CONDUCT CLASSES.- OFFER CLASSES IN ENGLISH, SPANISH AND AMERICAN SIGN LANGUAGE.- EXPLORE THE POSSIBILITY TO OFFER CLASSES IN HAITIAN-CREOLE, KOREAN AND MANDARIN LANGUAGES, BASED ON AVAILABILITY OF PEER TRAINERS IN THESE LANGUAGES. - OFFER SIX-WEEK CLASSES AT LEAST ONCE WEEKLY.- EDUCATE PARTICIPANTS ON DIABETES SELF-MANAGEMENT AND HAVE THEM SET AND TRACK WEEKLY PERSONAL GOALS AND SHARE THOSE WITH THEIR PROVIDERS.- PARTNER WITH MAC, INC. TO COLLECT DATA ON PRE AND POST A1C VALUES.- CONNECT WITH THE STATEWIDE HEALTH INFORMATION EXCHANGE TO MAKE REFERRALS BETWEEN PROVIDER OFFICES AND MAC, INC. FOR ALL CDSM CLASSES.2. WAGNER WELLNESS VAN EXPANSIONPRMC AND WICHD WILL BUILD OFF THE SUCCESSFUL EFFORTS THAT WERE INCLUDED FOR THIS PROGRAM IN ITS 2016 IMPLEMENTATION STRATEGY PLAN.(CONTINUED IN SUPPLEMENTAL INFORMATION) PENINSULA REGIONAL MEDICAL CENTER PART V, SECTION B, LINE 13B: ELIGIBILITY CRITERIA FOR FINANCIAL ASSISTANCEPENINSULA REGIONAL MEDICAL CENTER OFFERS FINANCIAL ASSISTANCE TO PATIENTS WHOSE INCOME IS AT OR BELOW 200% OF THE FEDERAL POVERTY GUIDELINES. PRMC ALSO PROVIDES FINANCIAL ASSISTANCE BASED UPON SEVERAL SPECIAL SITUATIONS:1) FINANCIAL ASSISTANCE WILL BE CONSIDERED IF PATIENT IS OVER INCOME CRITERION, BUT HAS A FINANCIAL HARDSHIP. A FINANCIAL HARDSHIP EXISTS WHEN THE AMOUNT OF MEDICAL DEBT AT PENINSULA REGIONAL MEDICAL CENTER EXCEEDS 25% OF THE FAMILY'S INCOME IN A YEAR. 2) A PATIENT THAT HAS QUALIFIED FOR MARYLAND MEDICAL ASSISTANCE IS DEEMED TO AUTOMATICALLY QUALIFY FOR PRMC'S FINANCIAL ASSISTANCE PROGRAM. THE AMOUNT DUE FROM A PATIENT ON THESE ACCOUNTS MAY BE WRITTEN OFF TO FINANCIAL ASSISTANCE WITH VERIFICATION OF MEDICAID ELIGIBILITY. NORMAL DOCUMENTATION REQUIREMENTS ARE WAIVED FOR FINANCIAL ASSISTANCE GRANTED UPON THE BASIS OF MARYLAND MEDICAL ASSISTANCE ELIGIBILITY.3) PATIENTS WHO ARE BENEFICIARIES/RECIPIENTS OF CERTAIN MEANS-TESTED SOCIAL SERVICES PROGRAMS ADMINISTERED BY THE STATE OF MARYLAND ARE DEEMED TO HAVE PRESUMPTIVE ELIGIBILITY FOR PRMC'S FINANCIAL ASSISTANCE PROGRAM. THE AMOUNT DUE FROM A PATIENT ON THESE ACCOUNTS MAY BE WRITTEN OFF TO FINANCIAL ASSISTANCE WITH VERIFICATION OF ELIGIBILITY FOR ONE OF THESE PROGRAMS. NORMAL DOCUMENTATION REQUIREMENTS ARE WAIVED FOR FINANCIAL ASSISTANCE GRANTED UPON THE BASIS OF PRESUMPTIVE ELIGIBILITY. IT IS THE RESPONSIBILITY OF PATIENTS TO NOTIFY THE HOSPITAL THEY ARE IN A MEANS TESTED PROGRAM AND PROVIDE THE DOCUMENTATION, BUT PRMC STAFF DOES INQUIRE AS TO THIS STATUS DURING THE INTAKE PROCESS AND AT OTHER POINTS DURING THE FINANCIAL ASSISTANCE DETERMINATION PROCESS. PENINSULA REGIONAL MEDICAL CENTER PART V, SECTION B, LINE 13H: SEE DISCLOSURE FOR SCHEDULE H, PART V, LINE 13B PENINSULA REGIONAL MEDICAL CENTER PART V, SECTION B, LINE 15E: PUBLICIZING THE FINANCIAL ASSISTANCE POLICYIF A PATIENT IS UNABLE TO PAY DUE TO FINANCIAL RESOURCES, ALL EFFORTS WILL BE MADE TO HELP THE PATIENT OBTAIN ASSISTANCE THROUGH APPROPRIATE AGENCIES. IN THE EVENT THAT THE PATIENT HAS APPLIED FOR AND KEPT ALL NECESSARY APPOINTMENTS AND THIRD PARTY ASSISTANCE IS NOT AVAILABLE, PENINSULA REGIONAL MEDICAL CENTER WILL PROVIDE CARE AT REDUCED OR ZERO COST.WHEN NO THIRD PARTY ASSISTANCE IS AVAILABLE TO COVER THE TOTAL BILL AND THE PATIENT INDICATES THAT THEY HAVE INSUFFICIENT FUNDS, THE FOLLOWING PROCEDURE WILL OCCUR:1) THE MARYLAND STATE UNIFORM FINANCIAL ASSISTANCE APPLICATION SHOULD BE REVIEWED BY STAFF, IN CONSULTATION WITH THE PATIENT, TO MAKE INITIAL ASSESSMENT OF ELIGIBILITY.2) COMPARE PATIENT'S INCOME TO CURRENT FEDERAL POVERTY GUIDELINES. 3) IF PRELIMINARILY ELIGIBLE PER GUIDELINES, SEND MARYLAND STATE UNIFORM FINANCIAL ASSISTANCE APPLICATION TO PATIENT/GUARANTOR FOR COMPLETION AND SIGNATURE. PATIENT SHOULD ATTACH APPROPRIATE DOCUMENTATION AND RETURN TO REPRESENTATIVE WITHIN 10 DAYS.UPON RECEIPT OF THE FINANCIAL ASSISTANCE REQUEST, THE REPRESENTATIVE WILL REVIEW INCOME AND ALL DOCUMENTATION. THE PATIENT MUST BE NOTIFIED WITHIN TWO BUSINESS DAYS OF THEIR PROBABLE ELIGIBILITY AND INFORMED THAT THE FINAL DETERMINATION WILL BE MADE ONCE THE COMPLETED FORM AND ALL SUPPORTING DOCUMENTS ARE RECEIVED, REVIEWED, AND THE INFORMATION VERIFIED. INCOME INFORMATION WILL BE VERIFIED USING THE DOCUMENTATION PROVIDED BY THE PATIENT AND EXTERNAL RESOURCES WHEN AVAILABLE. A FINANCIAL ASSISTANCE DISCOUNT WILL BE APPLIED TO THE PATIENT'S RESPONSIBILITY ACCORDINGLY. 4) IF INELIGIBLE, THE REPRESENTATIVE WILL NOTIFY THE PATIENT AND RESUME NORMAL DUNNING PROCESS AND FILE DENIAL WITH THE ACCOUNT. THE DENIALS WILL BE KEPT ON FILE IN THE COLLECTION OFFICE. ALL DENIALS WILL BE REVIEWED BY THE COLLECTION COORDINATOR LEVEL OR ABOVE.THE PATIENT MAY REQUEST RECONSIDERATION BY SUBMITTING A LETTER TO THE DIRECTOR OF PATIENT FINANCIAL SERVICES INDICATING THE REASON FOR THE REQUEST.ONLY INCOME AND FAMILY SIZE WILL BE CONSIDERED IN APPROVING APPLICATIONS FOR FINANCIAL ASSISTANCE UNLESS ONE OF THE FOLLOWING THREE SCENARIOS OCCURS: - THE AMOUNT REQUESTED IS GREATER THAN $50,000.- THE TAX RETURN SHOWS A SIGNIFICANT AMOUNT OF INTEREST INCOME, OR THE PATIENT STATES THEY HAVE BEEN LIVING OFF OF THEIR SAVINGS ACCOUNTS.- DOCUMENTATION INDICATES SIGNIFICANT WEALTH.IF ONE OF THE ABOVE THREE SCENARIOS ARE APPLICABLE IN THE APPLICATION, LIQUID ASSETS MAY BE CONSIDERED INCLUDING: CHECKING AND SAVINGS ACCOUNTS, STOCKS, BONDS, CERTIFICATES OF DEPOSIT, MONEY MARKET OR ANY OTHER ACCOUNTS FOR THE PAST THREE MONTHS ALONG WITH THE PAST YEAR'S TAX RETURN, AND A CREDIT REPORT MAY BE REVIEWED. THE FOLLOWING ASSETS ARE EXCLUDED:- THE FIRST $10,000 OF MONETARY ASSETS.- UP TO $150,000 IN A PRIMARY RESIDENCE.CERTAIN RETIREMENT BENEFITS (SUCH AS A 401-K WHERE THE IRS HAS GRANTED PREFERENTIAL TAX TREATMENT AS A RETIREMENT ACCOUNT INCLUDING BUT NOT LIMITED TO DEFERRED-COMPENSATION PLANS QUALIFIED UNDER THE INTERNAL REVENUE CODE, OR NONQUALIFIED DEFERRED-COMPENSATION PLANS) WHERE THE PATIENT POTENTIALLY COULD PAY TAXES AND/OR PENALTIES BY CASHING IN THE BENEFIT.IF THE BALANCE DUE IS SUFFICIENT TO WARRANT IT AND THE ASSETS ARE SUITABLE, A LIEN WILL BE PLACED ON THE ASSETS FOR THE AMOUNT OF THE BILL. COLLECTION EFFORTS WILL CONSIST OF PLACEMENT OF THE LIEN WHICH WILL RESULT IN PAYMENT TO THE HOSPITAL UPON SALE OR TRANSFER OF THE ASSET. 5) COLLECTION COORDINATOR WILL REVIEW DOCUMENTATION.IF ELIGIBLE, THE ACCOUNT WILL BE WRITTEN OFF TO FINANCIAL ASSISTANCE AND THE "REQUEST FOR FINANCIAL ASSISTANCE" FORM FINALIZED. A COPY IS RETAINED IN THE PATIENT'S FILE. THE REPRESENTATIVE WILL CALL THE PATIENT AND NOTIFY HIM/HER OF THE FINAL DETERMINATION OF ELIGIBILITY.6) PENINSULA REGIONAL MEDICAL CENTER WILL REVIEW ONLY THOSE ACCOUNTS WHERE THE PATIENT OR GUARANTOR INQUIRE ABOUT FINANCIAL ASSISTANCE, MAILS IN AN APPLICATION, OR IN THE NORMAL WORKING OF THE ACCOUNT THERE IS INDICATION THAT THE PATIENT MAY BE ELIGIBLE. ANY PATIENT/CUSTOMER SERVICE REPRESENTATIVE, FINANCIAL COUNSELOR, OR COLLECTION REPRESENTATIVE MAY BEGIN THE REQUEST PROCESS.PRE-PLANNED SERVICE MAY ONLY BE CONSIDERED FOR FINANCIAL ASSISTANCE WHEN THE SERVICE IS MEDICALLY NECESSARY. FOR EXAMPLE, NO COSMETIC SURGERY WILL BE ELIGIBLE. INPATIENT, OUTPATIENT, EMERGENCY, AND PENINSULA REGIONAL MEDICAL GROUP PHYSICIAN CHARGES ARE ALL ELIGIBLE.FINANCIAL ASSISTANCE POLICY, APPLICATION FORM, PLAIN LANGUAGE SUMMARY AVAILABLE ON THE HOSPITAL'S WEBSITESCHEDULE H, PART V, LINES 16A, 16B & 16CHTTPS://WWW.TIDALHEALTH.ORG/MEDICAL-CARE/FINANCIAL-ADMIN-SERVICES/BILLING/TIDALHEALTH-NANTICOKE-FINANCIAL-ASSISTANCEMAXIMUM CHARGE AMOUNTS FOR FAP-ELIGIBLE INDIVIDUALSSCHEDULE H, PART V, LINE 22DPENINSULA REGIONAL MEDICAL CENTER IS A MARYLAND HOSPITAL. AS SUCH PATIENTS AND ALL INSURANCE COMPANIES, INCLUDING MEDICARE & MEDICAID, PAY THE SAME RATE. THIS RATE IS DETERMINED BY THE STATE AGENCY, THE MARYLAND HEALTH SERVICES COST REVIEW COMMISSION. CONTINUED FROM SCHEDULE H, PART V, LINE 11 ACTIVITIES:- OUTREACH TO COMMUNITIES UTILIZING A NURSE PRACTITIONER (NP) TO PROVIDE PRIMARY CARE SERVICES. - PROVIDE SCREENINGS FOR DIABETES (OTHER SCREENINGS PROVIDED AS WELL).- IDENTIFY NEED FOR AND MAKE REFERRALS TO COMMUNITY RESOURCES FOR HEALTH EDUCATION PROGRAMS. - ENSURE THOSE PEOPLE IDENTIFIED AS DIABETIC OR PRE-DIABETIC ARE REFERRED FOR PRIMARY CARE FOLLOW UP. - TRACK RATE OF SUCCESSFUL PCP FOLLOW UP FOR ALL REFERRALS.- IDENTIFY BARRIERS TO ACCESSING PCP FOLLOW UP AND WORK TOWARDS FUTURE SOLUTIONS.3. SUSTAINABLE CHANGE AND LIFESTYLE ENHANCEMENT (SCALE)ACTIVITIES:- TARGET OUTREACH TO OVERWEIGHT WOMEN OF CHILD-BEARING AGE (UP TO AGE 55) AND OVERWEIGHT CHILDREN AGES 7 17. - OFFER EDUCATION AND ACTIVITIES TO ENCOURAGE HEALTHIER EATING AND PHYSICAL ACTIVITY. - PROVIDE SUPPORT THROUGH COOKING DEMONSTRATIONS, GROCERY STORE TOURS, WALKS AND BETTER ACCESS TO FRESH, HEALTHY FOOD. CANCERGOAL: - IMPROVE CANCER PREVENTION, EARLY DETECTION AND INTERVENTION/TREATMENT OF CANCER TO PROVIDE THE BEST POSSIBLE OUTCOMES IN THE TRI-COUNTY AREA FOR COLORECTAL, BREAST, CERVICAL, LUNG AND SKIN CANCERS.STRATEGIES:- PARTNER WITH WICHD AND SCHD TO EXPAND CANCER SCREENING.- UTILIZE CANCER RATE DATA TO IDENTIFY NEIGHBORHOODS WITH HIGH CANCER INCIDENCE RATES FOR TARGETED EDUCATION AND SCREENING ACTIVITIES.- COLLABORATE WITH LOCAL SCHOOL DISTRICT(S) AND COLLEGES/UNIVERSITIES TO INTEGRATE SKIN CANCER PREVENTION EDUCATION WITHIN STUDENT HEALTH CURRICULA.OBJECTIVES AND ANTICIPATED IMPACT:- WORKING IN PARTNERSHIP WITH THE WICHD AND SCHD, OFFER ADDITIONAL CANCER PREVENTION PROGRAMS AND SCREENING OPTIONS FOR LOW-INCOME COMMUNITY MEMBERS, AND CONNECT THOSE WHO NEED TREATMENT.- INCREASE KNOWLEDGE OF AT-RISK ACTIVITIES FOR CANCER, IMPORTANCE OF HEALTHY BEHAVIORS IN PREVENTION OF CANCER AND IMPORTANCE OF SCREENING ACTIVITIES.1. WAGNER WELLNESS VAN EXPANSION ACTIVITIES:- CLINICAL BREAST EXAMS - SKIN CANCER SCREENING - EDUCATION - REFERRAL FOR CANCER SCREENINGS PART I, LINE 3C: OTHER METHOD USED IN DETERMINING ELIGIBILITY FOR FINANCIAL ASSISTANCEN/A - PENINSULA REGIONAL MEDICAL CENTER USES THE FPG IN DETERMINING ELIGIBILITY FOR FINANCIAL ASSISTANCE. FINANCIAL ASSISTANCE IS ALSO CONSIDERED IF A PATIENT IS OVER INCOME CRITERION BUT HAS FINANCIAL HARDSHIP BASED ON MEDICAL DEBT. PATIENTS WHO ARE BENEFICIARIES/RECIPIENTS OF CERTAIN MEANS-TESTED SOCIAL SERVICES PROGRAM ADMINISTERED BY THE STATE OF THE PATIENT'S RESIDENCE ARE DEEMED TO HAVE PRESUMPTIVE ELIGIBILITY FOR PRMC'S FA PROGRAM. PART I, LINE 6A: COMMUNITY BENEFIT REPORTPENINSULA REGIONAL MEDICAL CENTER FILES ANNUALLY A COMMUNITY BENEFIT REPORT WITH THE STATE OF MARYLAND. THE REPORT IS FILED WITH THE HSCRC (HEALTH SERVICES COST REVIEW COMMISSION). SCHEDULE H, PART I, LINE 7, COLUMN (F) FINANCIAL ASSISTANCE AND CERTAIN OTHER COMMUNITY BENEFITS AT COSTTHE AMOUNT OF BAD DEBT EXPENSE EXCLUDED FROM THE DENOMINATOR IN THE COLUMN (F) PERCENTAGES IS $6,278,309. LINE 7B COLUMN (C) & (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 DIRECTED OFFSETTING REVENUE RELATED TO UNCOMPENSATED CARE. COMMUNITY BENEFIT EXPENSES ARE EQUAL TOMEDICAID REVENUES IN MARYLAND, AS SUCH, THE NET EFFECT IS ZERO. THEEXCEPTION TO THIS IS THE IMPACT ON THE HOSPITAL OF ITS SHARE OF THEMEDICAID ASSESSMENT. IN RECENT YEARS, THE STATE OF MARYLAND HAS CLOSED FISCAL GAPS IN THE STATE MEDICAID BUDGET BY ASSESSING HOSPITALS THROUGH THE RATE-SETTING SYSTEM. THE COST METHODOLOGY FOR CHARITY CARE AND CERTAIN OTHER COMMUNITY BENEFITS IS THE COST-TO-CHARGE RATIO USED FOR THE CHARITY CARE PROGRAMS AND DIRECT COST METHOD FOR THE OTHER BENEFITS/PROGRAMS. PART II, COMMUNITY BUILDING ACTIVITIES: COMMUNITY BUILDING ACTIVITIESPENINSULA REGIONAL FUNDS A VARIETY OF PROGRAMS THAT WORK TO PROMOTE THE HEALTH AND SAFETY OF OUR COMMUNITY. THESE PROGRAMS INCLUDE ACTIVITIES IN THE AREAS OF HOUSING, ECONOMIC DEVELOPMENT, COMMUNITY SUPPORT, ENVIRONMENTAL IMPROVEMENTS, COALITION BUILDING, AND WORKFORCE DEVELOPMENT.THE NUMBER OF PERSONS SERVED BY THE COMMUNITY BUILDING ACTIVITIES WERE NOT TRACKED FOR ALL PROGRAMS THROUGHOUT THE COURSE OF THE YEAR. COALITION BUILDINGHISTORICALLY PENINSULA REGIONAL HAS FACILITATED INVOLVEMENT WITH HEALTH IMPROVEMENT ORGANIZATIONS TO IDENTIFY, ASSESS, AND CREATE AGGREGATE ACTION PLANS TO ADDRESS LOCAL EMERGING AND CHRONIC COMMUNITY BENEFIT SERVICE AREA HEALTHCARE ISSUES. KATHRYN FIDDLER (EXECUTIVE DIRECTOR OF POPULATION HEALTH) AND STEPHANIE ELLIOT (DIRECTOR OF COMMUNITY SERVICES HEALTH) ATTEND THE FOLLOWING LOCAL HEALTH IMPROVEMENT COALITION'S INCLUDING SOME OF THE FRONT-LINE CARE MANAGEMENT COORDINATORS AND PHYSICIANS.- WICOMICO COUNTY LHIC- WORCESTER COUNTY HRSA- HEALTHY SOMERSET COALITION- WORCESTER COUNTY LHIC- TRI COUNTY HEALTH IMPROVEMENT PLANNING- TRI COUNTY ALLIANCE FOR THE HOMELESS- PROJECT LIVING WELL ADVISORY COMMITTEE MAC (MAINTAINING ACTIVE CITIZENS)PHYSICIAN RECRUITING PENINSULA REGIONAL FEELS IT IS IMPORTANT TO CONTINUALLY MONITOR SPECIALTIES WHERE A SIGNIFICANT AMOUNT OF PATIENT CARE WITHIN THE SERVICE AREA IS PROVIDED BY OLDER PHYSICIANS, AS A SUDDEN OR UNEXPECTED LOSS OF COVERAGE COULD HAVE AN ADVERSE EFFECT ON THE PROVISION OF MEDICAL SERVICES TO THE COMMUNITY. SUCCESSION PLANNING AND RECRUITMENT GO HAND-IN-HAND, AS DOES SOCIO-DEMOGRAPHICS AND GOVERNMENTAL INITIATIVES ALL OF WHICH MUST BE CONSIDERED TO ASSESS APPROPRIATE PHYSICIAN RECRUITMENT. KEY FINDINGS, ACCORDING TO THE MOST RECENT MEDICAL STAFF DEVELOPMENT PLAN, INDICATE AN IMMEDIATE NEED FOR RECRUITMENT OF PRIMARY CARE PHYSICIANS TO ENGAGE IN CHRONIC DISEASE MANAGEMENT AS PART OF OUR POPULATION HEALTH INITIATIVES. SUCCESSION PLANNING IS A KEY OBJECTIVE AS TEN PRIMARY CARE PHYSICIANS ARE ABOVE THE AGE OF 55 WHICH WILL LEAVE A VOID IN AN ALREADY UNDERSERVED AREA. DEMOGRAPHICS ALSO PLAY A KEY ROLE AS THE MEDICARE POPULATION IS GROWING AT A FASTER RATE THAN THE STATE OF MARYLAND AND THE NATION. AS A GROWING RETIREMENT COMMUNITY, THERE IS AN INCREASED NEED FOR ADDITIONAL PRIMARY CARE PHYSICIANS AND CERTAIN SPECIALTIES. THERE WILL BE A 22.7% GROWTH OF THOSE BETWEEN THE AGES OF 65 TO 74 OVER THE NEXT 5 YEARS. DEFICIENCIES AND SURPLUSES IN THE CURRENT SUPPLY OF PHYSICIANS WERE DETERMINED BY REVIEWING PHYSICIAN TO-POPULATION RATIOS, PHYSICIAN PATIENT VOLUMES, POPULATION DATA, AND OTHER DATA. MANAGEMENT CONSULTANTS RECOMMEND EVALUATING POTENTIAL RECRUITMENT OF PRIMARY CARE FAMILY MEDICINE, PRIMARY CARE INTERNAL MEDICINE AND PRIMARY CARE PEDIATRICS OVER THE NEXT SEVERAL YEARS. MEDICAL SPECIALTY NEEDS ARE DRIVEN BY THE OVERALL MARKET SUPPLY, WAIT TIMES FOR NEW PATIENT APPOINTMENTS, AND CALL COVERAGE AND INPATIENT CONSULTATION NEEDS. CURRENT MEDICAL SPECIALTY RECOMMENDATIONS INCLUDE RECRUITMENT OF THE FOLLOWING PHYSICIAN SPECIALTIES DUE TO COMMUNITY NEEDS ASSESSMENT, MARKET DEMAND AND RETIREMENT: ALLERGY/IMMUNOLOGY, DERMATOLOGY, ENDOCRINOLOGY, INFECTIOUS DISEASE, NEUROLOGY, OB/GYN, PAIN MANAGEMENT, PSYCHIATRY AND RHEUMATOLOGY. OF THE MEDICAL STAFF, 32% IS EITHER AT OR ABOVE THE AGE OF 55, WHICH POSES SUCCESSION RISK. PENINSULA REGIONAL A RURAL HOSPITAL, AND OTHER LIKE-KIND RURAL COMMUNITIES ARE TYPICALLY CHALLENGED IN BOTH RECRUITMENT AND RETENTION OF PHYSICIANS DUE TO NUMEROUS FACTORS. SOME OF THESE CHALLENGES ARE DUE TO THE LOCATION AND GEOGRAPHY OF THE AREA AND AVAILABILITY OF HEALTHCARE RESOURCES. RETAINING AND RECRUITING RESOURCES IN SUB-SPECIALTIES CAN BE HARD FOR REGIONAL RURAL HOSPITALS AND PENINSULA REGIONAL MEDICAL CENTER IS NO EXCEPTION. TO ADDRESS SPECIFIC COMMUNITY HEALTHCARE NEEDS THE MEDICAL CENTER HAS HAD TO RECRUIT, RETAIN, EMPLOY AND SUBSIDIZE SOME OF THE FOLLOWING SUBSPECIALTIES; PULMONARY, NEURO-HOSPITALIST, NEUROSURGERY, MEDICAL ONCOLOGY & HEMATOLOGY, GASTROENTEROLOGY, PEDIATRIC SPECIALTIES, ENDOCRINOLOGY, CARDIOLOGY, CARDIOVASCULAR SURGERY, AND PAIN MANAGEMENT. RURAL COMMUNITIES LACK THE CULTURAL AND EDUCATIONAL RESOURCES THAT LARGER URBAN CENTERS PROVIDE MAKING IT HARDER TO RETAIN AND RECRUIT THESE PHYSICIANS. LOW POPULATION PATTERNS BY GEOGRAPHY MAKE IT MORE COSTLY AND HARDER FOR COMMUNITIES AND BUSINESSES TO PROVIDE VARIOUS TYPES OF SERVICES ESPECIALLY SPECIALTY PHYSICIAN SERVICES. OVERALL, OUR LOCAL ECONOMY IS NOT AS ROBUST AS THE URBAN CENTERS AS INDICATED BY OUR LOW AVERAGE HOUSEHOLD INCOME IN THE TRI-COUNTY AREA.DISASTER READINESSPENINSULA REGIONAL MEDICAL CENTER IS A MEMBER OF DRHMAG (DELMARVA REGIONAL HEALTH MUTUAL AID GROUP) WHICH IS A COALITION OF LOCAL HEALTH DEPARTMENTS, HOSPITALS AND NURSING HOMES. THEY MEET QUARTERLY TO DISCUSS ISSUES OF DISASTER PREPAREDNESS IN THE DELMARVA REGION. PRMC HAS AN INTERNAL EMERGENCY MANAGEMENT COMMITTEE THAT MEETS MONTHLY WHOSE MEMBERS INCLUDE THE SAFETY COORDINATOR, CHIEF OF SECURITY, EMERGENCY DEPARTMENT RN, RISK MANAGEMENT, INFECTION PREVENTION, EXECUTIVE TEAM REPRESENTATIVE, PHARMACIST, EMERGENCY MANAGEMENT COORDINATOR, FIREFIGHTER, AND A COUNTY HEALTH DEPARTMENT REPRESENTATIVE. PRMC ALSO MEETS QUARTERLY WITH OUR LOCAL PARTNERS THAT INCLUDE FIRE, POLICE, EMERGENCY MEDICAL SERVICES, AND WICOMICO COUNTY EMERGENCY MANAGEMENT TO FACILITATE DISASTER PLANNING AND MOCK DRILLS WITHIN THE COMMUNITY. SCHEDULE H, PART III, LINES 2 AND 3 SEE RESPONSE BELOW TO LINE 4 REGARDING THE METHODOLOGY USED BY THE ORGANIZATION REGARDING BAD DEBT.SCHEDULE H, PART III, LINE 4BAD DEBT FOOTNOTE IN THE AUDITED FINANCIAL STATEMENTSUNDER THE PROVISIONS OF ASU 2014-09, WHEN THERE IS AN UNCONDITIONAL RIGHT TO PAYMENT, SUBJECT ONLY TO THE PASSAGE OF TIME, THE RIGHT IS TREATED AS A RECEIVABLE. PATIENT ACCOUNTS RECEIVABLE, INCLUDING BILLED ACCOUNTS AND UNBILLED ACCOUNTS, WHICH HAVE THE UNCONDITIONAL RIGHT TO PAYMENT, AND ESTIMATED AMOUNTS DUE FROM THIRD-PARTY PAYERS FOR RETROACTIVE ADJUSTMENTS, ARE RECORDED AS RECEIVABLES SINCE THE RIGHT TO CONSIDERATION IS UNCONDITIONAL AND ONLY THE PASSAGE OF TIME IS REQUIRED BEFORE PAYMENT OF THAT CONSIDERATION IS DUE. THE ESTIMATED UNCOLLECTIBLE AMOUNTS ARE GENERALLY CONSIDERED IMPLICIT PRICE CONCESSIONS THAT ARE RECORDED AS A DIRECT REDUCTION TO PATIENT ACCOUNTS RECEIVABLE RATHER THAN AN ALLOWANCE FOR DOUBTFUL ACCOUNTS. DISCOUNTS RANGING FROM 2% TO 6% OF CHARGES ARE GIVEN TO MEDICARE, MEDICAID, AND CERTAIN APPROVED COMMERCIAL HEALTH INSURANCE AND HEALTH MAINTENANCE ORGANIZATION PROGRAMS FOR REGULATED SERVICES. DISCOUNTS IN VARYING PERCENTAGES ARE GIVEN FOR CERTAIN UNREGULATED SERVICES. SCHEDULE H, PART III, LINE 8 MEDICARE COSTING METHODOLOGYMEDICARE ALLOWABLE COSTS WERE CALCULATED USING A COST TO CHARGE RATIO. PENINSULA REGIONAL MEDICAL CENTER PROVIDES QUALITY MEDICAL SERVICES TO ALL PATIENTS REGARDLESS OF WHAT INSURANCE THEY HAVE. APPROXIMATELY, 49.4% OF THE MEDICAL CENTER'S REVENUE IS ATTRIBUTABLE TO MEDICARE PATIENTS DURING THE YEAR ENDED JUNE 30, 2019.SCHEDULE H, PART III, LINE 9BCOLLECTION POLICYTHE PENINSULA REGIONAL MEDICAL CENTER COLLECTION POLICY INCLUDES INFORMATION ABOUT OUR FINANCIAL ASSISTANCE POLICY (FAP) AND HOW TO FIND THE FAP. THE DEBT COLLECTION POLICY APPLIES TO ALL PATIENTS. ADDITIONALLY, OUR COLLECTION POLICY INSTRUCTS THAT EXTRAORDINARY COLLECTION ACTIONS (ECA) WILL BE SUSPENDED WHEN A PATIENT REQUESTS INFORMATION ON OUR FAP OR SUBMITS A FINANCIAL ASSISTANCE APPLICATION WITHIN 240 DAYS OF THE FIRST POST-DISCHARGE BILLING STATEMENT. OUR POLICY DESCRIBES WHAT TO DO IF THE FINANCIAL ASSISTANCE APPLICATION IS INCOMPLETE AND WHAT IS REQUIRED TO BE REFUNDED (AMOUNTS OVER $5) IF THE PATIENT QUALIFIES FOR FINANCIAL ASSISTANCE AFTER MAKING A PAYMENT. WE INCLUDE CLARIFICATION OF WHAT DATES OF SERVICES ARE INCLUDED IN THE FINANCIAL ASSISTANCE SO THAT WE UNDERSTAND WHEN NORMAL COLLECTION EFFORTS ARE APPROPRIATE.WITHIN OUR COLLECTION POLICY WE DESCRIBE THAT A PATIENT DENIED FINANCIAL ASSISTANCE MAY REQUEST A RECONSIDERATION. FOR DATES OF SERVICES APPROVED FOR FINANCIAL ASSISTANCE COLLECTIONS PROCESSES ARE HALTED AS THE ACCOUNT IS ADJUSTED TO ZERO DUE FROM PATIENT. THE POLICY STATES HOW TO PROCESS THE PATIENT BALANCE WHEN ONLY A PORTION OF THE CHARGE QUALIFIED FOR FINANCIAL ASSISTANCE; COLLECTIONS WILL ONLY BE PURSUED ON THE AMOUNT THAT DID NOT QUALIFY FOR FINANCIAL ASSISTANCE. PART VI, LINE 2: NEEDS ASSESSMENTPENINSULA REGIONAL ASSESSES COMMUNITY HEALTH NEEDS IN PARTNERSHIP WITH THE LOCAL COUNTY HEALTH DEPARTMENTS (WICOMICO, WORCESTER, SOMERSET). WE MEET ON A REGULAR BASIS TO DISCUSS AND FORMULATE STRATEGIES AND ACTION PLANS IN WHICH WE COLLABORATE WITH EACH OTHER AND LOCAL ENTITIES TO ADDRESS RESIDENTS' MOST UNDERSERVED AND CRITICAL HEALTHCARE AND SOCIAL NEEDS. DEVELOPING RELATIONSHIPS WITH COMMUNITY PARTNERS IS CRITICAL TO CONTINUED IDENTIFICATION OF UNDERSERVED NEEDS AND POPULATION HEALTH MANAGEMENT SUCCESS; A CORNERSTONE OF PENINSULA REGIONAL STRATEGY. THE FOLLOWING LOCAL RELATIONSHIPS, PARTNERSHIPS AND MEMBERSHIPS HAS CREATED SYNERGY PRODUCING LOCAL HEALTHCARE DIVIDENDS, EXAMPLES OF THESE RELATIONSHIPS INCLUDE THE FOLLOWING: TRI-COUNTY DIABETES ALLIANCE, SWIFT (SALISBURY WICOMICO INTEGRATED FIRSTCARE TEAM), FEDERALLY QUALIFIED HEALTH CENTERS, YMCA, PATIENT CARE ADVISORY COUNCIL, LOCAL SNFS, FAITH BASED ENTITIES, MAC (MAINTAINING ACTIVE CITIZENS), SHELTERS (HALO, HOPE), LOCAL COLLEGES & HIGH SCHOOLS. WORKING TOGETHER WITH DIVERSE AND DISPARATE LOCAL ENTITIES FOR THE UNITED BUT COMMON GOAL OF MEETING RESIDENTS' UNDERSERVED NEEDS- PLANNING TOGETHER, APPLYING RESOURCES OUR GOAL IS A HEALTHIER COMMUNITY.IN ADDITION TO THE CHNA, PENINSULA REGIONAL HAS EMBARKED ON IDENTIFYING AND TARGETING "SUPER UTILIZERS" WITHIN OUR CBSA (COMMUNITY BENEFIT SERVICE AREA); THESE RESIDENTS WILL BE IDENTIFIED, AND TARGETED FOR POPULATION HEALTH MANAGEMENT. - DEMOGRAPHICS (BLOCK GROUPS, ZIP CODES)- RACE/ETHNICITY- AGE-COHORTS- CHRONIC CONDITIONSTHE TARGET POPULATION INCLUDES PATIENTS THAT HAVE CHRONIC CONDITIONS WHO HAVE DEMONSTRATED TO HAVE BEEN HIGH UTILIZERS AT PRMC, OR ARE IDENTIFIED AS BEING AT RISK OF HIGH UTILIZATION BASED ON HIS/HER CHRONIC CONDITIONS AND PATTERNS OF CARE. CURRENT DATA INDICATES AN "OVERRELIANCE" BY LOCAL RESIDENTS ON PENINSULA REGIONAL'S EMERGENCY ROOM FOR PRIMARY AND CHRONIC CONDITION NEEDS. IN RESPONSE, PRMC HAS INTRODUCED INTERVENTIONS, CARE MANAGEMENT PROGRAMS, EDUCATION, AND FOLLOW-UP WITH MEASUREMENT AND OUTCOMES. BASED UPON A CURRENT ASSESSMENT THERE ARE APPROXIMATELY 1,000+ RESIDENTS THAT MEET THE CRITERIA OF "SUPER UTILIZERS" STRATIFIED BY SOCIO-DEMOGRAPHICS AND CHRONIC DISEASE.PENINSULA REGIONAL IS TARGETING CBSA ZIP CODES BASED UPON SOCIAL AND ECONOMIC DETERMINANTS OF HEALTH TO INCLUDE THE UNINSURED, INDIGENT POPULATION, RESIDENTS WHO LACK TRANSPORTATION, LACK OF EDUCATION AND AVAILABILITY OF HEALTHY FOODS. TARGETING THIS BY CLUSTER AND BLOCK GROUPS, WE SEEK TO IMPACT THE HEALTH BY PROVIDING PRIMARY HEALTH SERVICES, EDUCATION, ACCESS AND MORE IMPORTANTLY BY FOSTERING RELATIONSHIPS WITHIN THE COMMUNITY WE SERVE. FOR EXAMPLE, OUR WAGNER WELLNESS VAN TRAVELS LOCALLY TO BLOCK GROUPS WHERE THERE WAS AN IDENTIFIED NEED FOR BASIC HEALTH SERVICES, IN ADDITION TO PROVIDING HEALTH SERVICES AND EDUCATION TO LOCAL ETHNIC CHURCHES AND CIVIC ORGANIZATIONS. PART VI, LINE 3: PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCEPENINSULA REGIONAL MEDICAL CENTER MAKES AVAILABLE TO ALL PATIENTS THE HIGHEST QUALITY OF MEDICAL CARE POSSIBLE WITHIN THE RESOURCES AVAILABLE.IF A PATIENT IS UNABLE TO PAY DUE TO FINANCIAL RESOURCES, ALL EFFORTS WILL BE MADE TO HELP THE PATIENT OBTAIN ASSISTANCE THROUGH APPROPRIATE AGENCIES, OR, IF HELP IS NOT AVAILABLE, TO PROVIDE CARE AT REDUCED OR ZERO COST. ONE OF PENINSULA REGIONAL'S OVERALL GUIDING PRINCIPLES IS THAT CONCERN OVER A HOSPITAL BILL SHOULD NEVER PREVENT ANY INDIVIDUAL FROM RECEIVING EMERGENCY HEALTH SERVICES. THE MEDICAL CENTER WILL COMMUNICATE THIS MESSAGE CLEARLY TO PROSPECTIVE PATIENTS AND TO LOCAL COMMUNITY SERVICE AGENCIES AND MAKE IT CLEAR THAT EMERGENCY SERVICES WILL BE PROVIDED WITHOUT REGARD TO ABILITY TO PAY. THE MEDICAL CENTER WILL ENSURE THAT AN EMERGENCY ADMISSION OR TREATMENT IS NOT DELAYED OR DENIED PENDING DETERMINATION OF COVERAGE OR REQUIREMENT FOR PREPAYMENT OR DEPOSIT. THE MEDICAL CENTER WILL POST ADEQUATE NOTICE OF THE AVAILABILITY OF MEDICAL SERVICES, AND THE GENERAL OBLIGATION OF THE HOSPITAL TO PROVIDE CHARITY CARE. PENINSULA REGIONAL'S "FINANCIAL ASSISTANCE POLICY" INCLUDES THE REQUIRED LANGUAGE OF DETERMINATION OF PROBABLE ELIGIBILITY WITHIN TWO BUSINESS DAYS. ON PAGE 2, THE "FINANCIAL ASSISTANCE POLICY" STATES THAT UPON RECEIPT OF THE FINANCIAL ASSISTANCE REQUEST, THE REPRESENTATIVE WILL REVIEW INCOME AND ALL DOCUMENTATION. THE PATIENT MUST BE NOTIFIED WITHIN TWO BUSINESS DAYS OF THEIR PROBABLE ELIGIBILITY. IN ACCORDANCE WITH SECTION 1, 2 AND 3, PENINSULA REGIONAL PROVIDES PUBLIC NOTICE AND INFORMATION REGARDING ITS CHARITY CARE POLICY IN DELMARVA'S LARGEST PAPER "THE DAILY TIMES", POSTED SIGNS IN THE ADMISSION, BUSINESS OFFICE EMERGENCY ROOM AND OTHER MAJOR SERVICE AREAS OF THE MEDICAL CENTER; ADDITIONALLY INDIVIDUAL NOTICE IS PROVIDED TO EACH SELF-PAY ACCOUNT WHO SEEKS SERVICES IN THE MEDICAL CENTER AT THE TIME OF PRE-ADMISSION, ADMISSION, OR UPON REQUEST.A COPY OF THE FINANCIAL ASSISTANCE POLICY IS PROVIDED DURING INTAKE AND DISCHARGE PROCESS UPON REQUEST, AND A FINANCIAL ASSISTANCE INFORMATION BROCHURE IS PROVIDED TO ALL SELFPAY PATIENTS DURING INTAKE. THE AVAILABILITY OF FINANCIAL ASSISTANCE IS PRINTED ON BILLING STATEMENTS SENT TO PATIENTS. PRMC NOTIFIES THE PATIENT OR POTENTIAL PATIENT OF GOVERNMENT PROGRAMS, INCLUDING PROVIDING THEM WITH INITIAL ASSISTANCE TO APPLY FOR SUCH PROGRAMS. PART VI, LINE 4: COMMUNITY INFORMATIONPENINSULA REGIONAL MEDICAL CENTER AT 266 LICENSED BEDS FUNCTIONS AS THE PRIMARY HOSPITAL PROVIDER FOR THE RURAL SOUTHERNMOST THREE COUNTIES OF THE EASTERN SHORE OF MARYLAND, WHICH INCLUDES WICOMICO, WORCESTER AND SOMERSET COUNTIES. APPROXIMATELY 78% OF THE PATIENTS DISCHARGED FROM THE MEDICAL CENTER ARE RESIDENTS OF THE PRIMARY SERVICE AREA, WHICH HAS AN ESTIMATED POPULATION OF APPROXIMATELY 181,350 IN 2019, AND IS EXPECTED TO INCREASE TO 185,357 OR BY 2.2% BY 2024. THE MEDICAL CENTER ALSO SERVICES DORCHESTER COUNTY, MARYLAND, THE SOUTHERN PORTION OF SUSSEX COUNTY, DELAWARE AND THE NORTHERN PORTION OF ACCOMACK COUNTY, VIRGINIA.PENINSULA REGIONAL'S CBSA (COMMUNITY BENEFITS SERVICE AREA) CONSISTS OF THOSE ZIP CODES WITHIN OUR PRIMARY SERVICE AREA. MOST OF THE POPULATION RESIDES IN WICOMICO COUNTY (105,103) WITH SALISBURY SERVING AS THE CAPITAL OF THE EASTERN SHORE. SALISBURY IS LOCATED ON THE HEADWATERS OF THE WICOMICO RIVER AND IT IS LOCATED AT THE CROSSROADS OF THE BAY AND THE OCEAN. THE REGION IS UNIQUE; THE CITY OF SALISBURY HAS SIMILAR SOCIO-ECONOMIC AND DEMOGRAPHIC CHARACTERISTICS OF A LARGE CITY, HOWEVER, THE AREA SURROUNDING SALISBURY IS RURAL AND HAS LIKE-KIND CHARACTERISTICS OF SMALL-TOWN AMERICA. DUE TO THIS DICHOTOMY, SERVING BOTH SOMETIMES PRESENTS A CHALLENGE IN DELIVERING HEALTHCARE. THE TWO OTHER COUNTIES IN PENINSULA REGIONAL'S CBSA INCLUDE WORCESTER COUNTY, WITH A POPULATION OF 52,030 AND SOMERSET COUNTY WITH A POPULATION OF 24,217. THE GREATER "METROPOLITAN" SALISBURY AREA (ZIP CODES 21801, 21804) HAS A HIGHER POPULATION DENSITY THAN THE SURROUNDING RURAL AREAS. THIS AREA HAS A VULNERABLE POPULATION THAT INCLUDES THE INDIGENT AND A HIGHER MEDICAID MIX. MOVING EAST TOWARDS THE BEACH, LOCATED IN WORCESTER COUNTY ARE SEVERAL LARGER TOWNS, LIKE BERLIN (21811) AND OCEAN CITY (21842) THAT HAVE A HIGH POPULATION DENSITY. SOUTH OF SALISBURY, LOCATED IN SOMERSET COUNTY, ARE THE LARGER TOWNS OF PRINCESS ANNE (21853) AND CRISFIELD (21817). EXCLUDING THE GREATER SALISBURY AREA, THE LANDSCAPE AND ENVIRONMENT IS CONSIDERED RURAL, MADE UP OF SMALL BUSINESSES AND AGRICULTURE. ALL THREE COUNTIES CAN BE CLASSIFIED AS RURAL WITH A HISTORIC ECONOMIC FOUNDATION IN AGRICULTURE, POULTRY AND TOURISM. WATERMEN AND FARMERS HAVE ALWAYS COMPRISED A LARGE PERCENTAGE OF THE PENINSULA POPULATION, HOWEVER, THEIR NUMBERS HAVE BEEN DECLINING WITH A GROWTH IN THE POPULATION AND EXPANSION OF OTHER SMALL BUSINESSES. OCEAN CITY, MD LOCATED IN WORCESTER COUNTY, IS A MAJOR TOURIST DESTINATION. DURING THE SUMMER WEEKENDS, THE CITY HOSTS BETWEEN 320,000 AND 345,000 VACATIONERS, AND UP TO 8 MILLION VISITORS ANNUALLY.THE THREE COUNTIES HAVE A DIVERSIFIED ECONOMIC BASE; HOWEVER, IT IS PREDOMINATELY MADE UP OF SMALL EMPLOYERS (COMPANIES WITH LESS THAN 50 EMPLOYEES). MAJOR EMPLOYERS INCLUDE LOCAL HOSPITALS, THE POULTRY INDUSTRY, LOCAL COLLEGES AND TEACHING INSTITUTIONS. THE MEDIAN INCOME OF $55,681 IN OUR COMMUNITY BENEFITS SERVICE AREA IS CONSIDERABLY LESS THAN MARYLAND'S MEDIAN INCOME OF $85,459. IN ADDITION, SEPTEMBER 2019 UNEMPLOYMENT RATES WERE HIGHER FOR MARYLAND'S MOST EASTERN SHORE COUNTIES. THE UNEMPLOYMENT RATE IN MARYLAND WAS 3.7%, THE NATION 3.6% COMPARED TO WICOMICO 4.1%; WORCESTER 4.7% AND SOMERSET 5.4%. RESEARCH INDICATES LOWER MEDIAN INCOMES AND HIGHER UNEMPLOYMENT RATES CONTRIBUTE TO A DISPARITY IN ACCESS TO MEDICAL CARE AND A PREVALENCE OF UNTREATED CHRONIC DISEASE.THE BABY BOOMER POPULATION (THOSE AGED 55+) REPRESENT A GREATER PORTION OF THE TOTAL POPULATION IN PENINSULA REGIONAL'S CBSA AS COMPARED TO THE NATION. THE EASTERN SHORE OF MARYLAND IS BECOMING A POPULAR RETIREMENT DESTINATION AND THE TREND IS LIKELY TO CONTINUE. THE CHRONIC CONDITIONS OF THIS AGE GROUPING CONSUME HEALTHCARE RESOURCES AT MUCH HIGHER RATES THAN SOME OF THE OTHER YOUNGER AGE-COHORTS. MEDICARE POPULATION %-----------------------------WICOMICO 16.1%WORCESTER 27.8%SOMERSET 16.9%-----------------------------MARYLAND 15.7%UNITED STATES 16.2%SOURCE: TRUVEN HEALTH ANALYTICS/IBM 2019PENINSULA REGIONAL'S PRIMARY SERVICE AREA (WICOMICO, WORCESTER, SOMERSET) REPRESENT SOME OF THE NEEDIEST COUNTIES IN THE STATE OF MARYLAND (WWW.COUNTYHEALTHRANKINGS.ORG/MARYLAND), BASED UPON A SOCIONEEDS INDEX INCOME, POVERTY, UNEMPLOYMENT, OCCUPATION, EDUCATIONAL ATTAINMENT AND LINGUISTIC BARRIERS THAT ARE ASSOCIATED WITH POOR HEALTH OUTCOMES, INCLUDING PREVENTABLE HOSPITALIZATIONS AND PREMATURE DEATH. PENINSULA REGIONAL HAS ZIP CODES IN EACH OF ITS PRIMARY SERVICE AREA COUNTIES WITH HIGH SOCIONEEDS INDEX LEVELS. DEPLOYMENT OF RESOURCES IS KEY IN THESE COMMUNITIES WITH HIGH SOCIOECONOMIC NEEDS AS WE FOCUS AND TARGET PREVENTION AND OUTREACH SERVICES. TO MEET ITS MISSION OF IMPROVING THE HEALTH OF THE COMMUNITIES IT SERVES, PENINSULA REGIONAL HAS DEVELOPED A POPULATION HEALTH DIVISION AND HAS ENGAGED IN POPULATION HEALTH STRATEGIES TO SUPPORT THE MARYLAND TOTAL COST OF CARE MODEL, WHICH AIMS TO IMPROVE OUTCOMES, IMPROVE THE PATIENT EXPERIENCE AND REDUCE THE TOTAL COST OF CARE. THE HOSPITAL IS COORDINATING CARE, INCLUDING MENTAL HEALTH AND POST-ACUTE CARE, ACROSS HOSPITAL AND NON-HOSPITAL SETTINGS. THE POPULATION HEALTH DIVISION INCORPORATES A MULTIDISCIPLINARY TEAM OF NURSES, SOCIAL WORKERS AND COMMUNITY HEALTH WORKERS SUPPORTING THE COMMUNITY WITH A BROAD RANGE OF PRIMARY CARE SERVICES. THE DIVISION ALSO FOSTERS COMMUNITY PARTNERSHIPS WITH LOCAL HOSPITALS ATLANTIC GENERAL AND MCCREADY HEALTH IN ADDITION TO COMMUNITY-BASED ORGANIZATIONS INCLUDING LOCAL HEALTH DEPARTMENTS, FIRE DEPARTMENTS, THE MARYLAND STATE AREA AGENCY ON AGING AND OTHER AGENCIES TO PROVIDE PATIENT SUPPORT ALIGNED WITH SOCIAL DETERMINANTS OF HEALTH. PART VI, LINE 5: PROMOTION OF COMMUNITY HEALTHPENINSULA REGIONAL MEDICAL CENTER IS COMMITTED TO THE HEALTH OF THE RURAL COMMUNITIES IT SERVES. IN FY 2019, THE HOSPITAL'S CHARITY CARE WAS $8,454,930; COMBINED CHARITY AND BAD DEBT FOR FY 2019 WAS $16,429,970. AS PART OF PENINSULA REGIONAL'S ONGOING COMMITMENT AND MISSION STATEMENT "TO IMPROVE THE HEALTH OF THE COMMUNITIES WE SERVE," WE CONTINUE TO ASSESS THE HEALTH NEEDS OF THE COMMUNITY THROUGH BUILDING RELATIONSHIPS AND COLLABORATIONS WITH ORGANIZATIONS THAT ARE ADDRESSING UNMET HEALTH NEEDS.THE WAGNER WELLNESS VAN IS A MOBILE CLINIC THAT VISITS LOCAL SHELTERS, CHURCHES AND OTHER AREAS IN PRMC'S COMMUNITY BENEFITS SERVICE AREA WHERE UNDERSERVED RESIDENTS CAN RECEIVE NON-EMERGENCY MEDICAL CARE, CHRONIC CARE MANAGEMENT AND HEALTHY LIFESTYLES EDUCATION. THE VAN VISITS AREAS WHERE THE SOCIAL DETERMINANTS OF HEALTH INDICATE THE GREATEST AMOUNT OF NEED. IT PROVIDES CARE IN AREAS WITH A HIGHER PREVALENCE OF ER VISITS, LOWER MEDIAN INCOMES, INDIGENT POPULATION, ACCESS ISSUES, COMMUNICATION BARRIERS AND OVERALL POOR HEALTH OUTCOMES. THERE HAS BEEN IMPROVED CONTROL OF DIABETES AND HYPERTENSION. THE WAGNER WELLNESS VAN STRIVES TO EDUCATE PATIENTS BY PROVIDING NUTRITIONAL AND HEALTHY LIFESTYLE COUNSELING, IN ADDITION TO MEDICATION COMPLIANCE TO CONTROL DIABETES AND HYPERTENSION. HEALTH SCREENINGS ARE PERFORMED ON RESIDENTS TO HELP DETERMINE APPROPRIATE EDUCATION, SELF-MANAGEMENT CLASS INFORMATION OR REFERRALS TO COMMUNITY RESOURCES AND SERVICES. THESE SCREENINGS INCLUDE PRE-DIABETES, HYPERTENSION AND OBESITY. WHEN WARRANTED, DRUG AND ALCOHOL MISUSE SCREENINGS ARE ALSO CONDUCTED, AND COUNSELING IS AVAILABLE. IF A RESIDENT IS AT RISK FOR DIABETES, AN A1C SCREENING IS PERFORMED TO FURTHER ASSIST WITH DIAGNOSIS AND TREATMENT.SMITH ISLAND TELEHEALTH- SMITH ISLAND IS KNOWN FOR ITS WATERMEN, SMITH ISLAND CAKE, EXCEPTIONAL SEAFOOD AND BEING ISOLATED WITH LIMITED CONTACT FROM MAINLAND VISITORS. FOR THIS REASON, PENINSULA REGIONAL MEDICAL CENTER CREATED A PARTNERSHIP WITH MCCREADY HEALTH, MAC AREA AGENCY ON AGING, SOMERSET COUNTY HEALTH DEPARTMENT AND THE CRISFIELD CLINIC. THE GOAL OF THE PARTNERSHIP IS TO IMPROVE THE HEALTH OF SMITH ISLAND RESIDENTS, WITH THE TARGET OF EFFECTIVELY REDUCING POTENTIALLY AVOIDABLE ED UTILIZATION. THE PROGRAM WAS LED BY THE SMITH ISLAND COMMUNITY HEALTH STAFF, WHICH PROVIDES CHRONIC DISEASE EDUCATION, MANAGEMENT AND CONNECTS 250 RESIDENTS OF SMITH ISLAND VIA TELEHEALTH FOR PRIMARY CARE PHYSICIAN VISITS. COMMUNITY HEALTH WORKERS PLAY AN INTEGRAL ROLE IN CHANGING ISLAND RESIDENTS' HEALTH BEHAVIORS AND ACTIONS; THESE EMBEDDED HEALTH FACILITATORS ARE ABLE TO EFFECTIVELY BRIDGE RELATIONSHIPS WITH THE RESIDENTS OF SMITH ISLAND. THESE FACILITATORS ARE ESSENTIALLY A PERSONAL HEALTH COACH THAT ASSISTS RESIDENTS WITH MEDICATION MANAGEMENT, TIMELY COMPLIANCE AND ULTIMATELY HELPING GUIDE RESIDENTS THROUGH PRESCRIBED HEALTHCARE PLANS. FLU SHOTS WERE ADMINISTERED ENSURING THE RESIDENTS OF SMITH ISLAND WERE PROTECTED DURING THE FLU SEASON, EFFECTIVELY REDUCING ED VISITS. SINCE INCEPTION, THE PARTNERSHIP HAS HAD GREAT SUCCESSES. FOR EXAMPLE, THERE HAS BEEN SUBSTANTIAL REDUCTIONS IN A1C LEVELS IN RESIDENTS DIAGNOSED WITH DIABETES; A PRIME EXAMPLE OF THE "TRIPLE AIM" IMPROVING HEALTH, PROVIDING ACCESS, CHRONIC DISEASE EDUCATION, AND REDUCING THE PROBABILITY OF A FUTURE EMERGENCY DEPARTMENT VISIT. RESIDENTS ARE LEARNING HOW TO SELF-MANAGE THEIR CHRONIC DISEASES AND ARE BEING EXPOSED TO THE PRINCIPLES OF LEADING HEALTHY LIFESTYLES. TO EXPAND OUR "HEALTHY LIVING" MESSAGE, PENINSULA REGIONAL SPONSORS AND PARTICIPATES IN MANY COMMUNITY-BASED HEALTH FAIRS PROVIDING NUTRITION EDUCATION, WEIGHT LOSS, DIABETES ASSESSMENT, MULTIPLE SCREENINGS AND HEALTH LITERACY. PARTICIPATION IN HEALTH FAIRS INCLUDE UNDERSERVED AREAS LIKE SMITH ISLAND, AN ISLAND ON THE CHESAPEAKE BAY WITH A POPULATION OF ONLY 250, A HAITIAN CREOLE HEALTH FAIR, HEALTHFEST AND SCREENINGS AT THE GOVERNOR'S BASKETBALL CHALLENGE AT THE CIVIC CENTER IN WICOMICO COUNTY. TRANSFORMING THE CULTURE THROUGH PARTICIPATION AND SPONSORSHIP OF HEALTHY LIFESTYLES AND SCREENINGS, MEETING RESIDENTS AT COMMUNITY EVENTS LOCATED THROUGHOUT THE TRI-COUNTY AREA. HEALTH ASSESSMENTS- CHOLESTEROL, HDL, TRIGLYCERIDES - RESTING 12-LEAD EKG - BODY FAT / MASS INDEX - BLOOD PRESSURE TESTING - PULSE OXIMETRY TESTING - 10-YEAR RISK ANALYSIS - REVIEW CURRENT MEDICATIONS - FOLLOW-UP CARE PLAN - EXERCISE/NUTRITION WALKWICOMICO PROMOTES WALKING TRAILS, PERSONAL CHALLENGES, AND AVENUES TO ENJOY THE OUTDOORS- THE PRIMARY OBJECTIVE IS TO INCREASE AWARENESS OF AND ENGAGEMENT IN HEALTHY LIFESTYLE BEHAVIORS PROMOTING EXERCISE TO HELP WITH WEIGHT LOSS, INCREASE ENERGY, REDUCE RISK OF CHRONIC DISEASE AND MAKE PEOPLE FEEL HAPPIER. WALKWICOMICO IS PRIMARILY TARGETING THOSE THAT RESIDE IN THE COUNTY (POP. 100,000+); HOWEVER, IT WOULD ALSO BE AN ATTRACTION FOR ADJACENT COUNTIES INCLUDING VISITORS. PENINSULA REGIONAL, AS A PARTICIPANT, HAS A COMMON GOAL TO TRANSFORM THE COMMUNITY'S CULTURE BY PROVIDING EDUCATION, GUIDANCE AND RESOURCES TOWARDS PROMOTING EXERCISE THROUGH WALKABILITY AS AN INTEGRAL PART OF A HEALTHY LIFESTYLE. THE COALITION'S INITIATIVES INCLUDED CREATING A WEBSITE AND PHONE APP SPECIFIC TO WALKING IN WICOMICO COUNTY; COMMUNICATING WITH THE COMMUNITY VIA SOCIAL MEDIA; WORKING WITH CIVIC ORGANIZATIONS, CHURCHES, LOCAL BUSINESSES, TOWNS, COUNTY HEALTH DEPARTMENTS AND OTHER GROUPS TO ENCOURAGE LOCAL WALKABILITY. WALKWICOMICO HAS MARKED WALKING ROUTES, INCREASED THE NUMBER OF WALKING ROUTES, PARTICIPATED IN AND LAUNCHED WALKING EVENTS, AND IS ENGAGED WITH DECISION MAKERS THROUGH INPUT AND FEEDBACK ABOUT MAKING WALKING SAFER EASIER AND MORE ACCESSIBLE. PENINSULA REGIONAL PARTICIPATES WITH MANY PARTNERS THAT MAKE IT POSSIBLE TO CREATE AND DELIVER POPULATION PROGRAMS THAT IMPROVE THE HEALTH OF THE COMMUNITIES WE SERVE. THESE PARTNERS HAVE PROVIDED EXPERTISE AND ALLOCATED RESOURCES TO MEET THOSE URGENT HEALTHCARE NEEDS WITHIN OUR COMMUNITY. SOME OF THESE PARTNERS INCLUDE: WICOMICO COUNTY HEALTH DEPARTMENT, SOMERSET COUNTY HEALTH DEPARTMENT, WORCESTER COUNTY HEALTH DEPARTMENT, WICOMICO COUNTY LOCAL HEALTH IMPROVEMENT COALITION, THE CITY OF SALISBURY, YMCA, CRISFIELD CLINIC, CHESAPEAKE HEALTH CARE, SWIFT, SALISBURY FIRE DEPARTMENT/EMS, ATLANTIC GENERAL HOSPITAL, FAITH BASED ORGANIZATIONS, MCCREADY MEMORIAL HOSPITAL, MAC (MAINTAINING ACTIVE CITIZENS), LOCAL COLLEGES/ AND SCHOOLS, C.O.A.T, NATIONAL KIDNEY FOUNDATION, PENINSULA REGIONAL EMPLOYEES, POST-ACUTE CARE FACILITIES, HALO, WALKWICOMICO (COALITION), LOWER SHORE CLINIC, WICOMICO COUNTY SHERIFF'S OFFICE, RESOURCE AND RECOVERY CENTER AND OTHERS. SHERIFF'S OFFICE, RESOURCE AND RECOVERY CENTER AND OTHERS. PART VI, LINE 6: AFFILIATED HEALTH CARE SYSTEM ROLESPENINSULA REGIONAL MEDICAL CENTER IS PART OF THE PENINSULA REGIONAL HEALTH SYSTEM. THE SYSTEM INCLUDES A FOUNDATION AND FOR-PROFIT ENTITIES WITH INTERESTS IN VARIOUS HEALTH CARE JOINT VENTURES. IN ADDITION TO THE COMMUNITY BENEFITS PROVIDED BY THE MEDICAL CENTER, THE HEALTH SYSTEM EVALUATES THE NEEDS OF THE COMMUNITY AND WILL PARTICIPATE IN COMMUNITY BENEFIT PROGRAMS AS NEEDED. PART VI, LINE 7, REPORTS FILED WITH STATES MD X 1 1 X X X X X 0 1 0 0 0 1 1 1 0 JAMES TODD MD PHYSICIAN 846008 0 181285 0 1218 0 86460 0 14215 0 1129186 0 0 0 ZACHARY BAKER MD PHYSICIAN 804083 0 88285 0 37218 0 14258 0 16304 0 960148 0 0 0 STEVEN LEONARD PRESIDENT/CEO 650174 0 178672 0 15336 0 76054 0 21114 0 941350 0 0 0 FAWAD KHAN MD PHYSICIAN 821356 0 83380 0 1171 0 11186 0 21084 0 938177 0 0 0 DANIEL DANIELS MD PHYSICIAN 513392 0 305972 0 1218 0 19763 0 7646 0 847991 0 0 0 KARIM ARANOUT MD PHYSICIAN 613259 0 195610 0 1218 0 17645 0 19966 0 847698 0 0 0 LURA LUNSFORD VP OF OPERATIONS 523457 0 121084 0 1218 0 52240 0 6648 0 704647 0 0 0 BRUCE I RITCHIE CFO 488399 0 121040 0 1218 0 73274 0 15818 0 699749 0 0 0 CHARLES SILVIA JR MD VP - CHIEF MEDICAL OFFICER 460825 0 63032 0 1218 0 52957 0 11472 0 589504 0 0 0 SIMONA ENG DO BOARD MEMBER THRU 12/31/19 380318 0 95875 0 1218 0 40753 0 11640 0 529804 0 0 0 KARIN DIBARI MD VP PRESIDENT PRMG 415130 0 58650 0 750 0 10732 0 17882 0 503144 0 0 0 SARAH SCOTT VP PEOPLE & ORGANIZATION DEV. 272270 0 32451 0 1218 0 51745 0 0 0 357684 0 0 0 JAMES TRUMBLE VP - CLINICAL INTEGRATION 304952 0 24627 0 1424 0 10766 0 14036 0 355805 0 0 0 KATHRYN FIDDLER VP - POPULATION HEALTH 223255 0 25025 0 982 0 31473 0 2038 0 282773 0 0 0 SARAH ARNETT CHIEF NURSING OFFICER 181341 0 14418 0 281 0 10614 0 3007 0 209661 0 0 0 PART I, LINE 1A TRAVEL FOR COMPANIONS PRMC PROVIDES TRAVEL FOR COMPANIONS OF BOARD MEMBERS AND REPORTS THE VALUE OF THE COMPENSATION PROVIDED AS TAXABLE TO THE RECIPIENT. THIS POLICY HAS BEEN APPROVED BY THE BOARD. PART I, LINE 4B SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN PRMC HAS A NON-QUALIFIED SUPPLEMENTAL RETIREMENT PLAN (UNDER SECTION 457 (F)). THIS PLAN WAS APPROVED BY THE COMPENSATION COMMITTEE OF THE PRMC BOARD OF DIRECTORS TO SUPPLEMENT THE EXECUTIVE'S RETIREMENT INCOME. THE SUPPLEMENTAL RETIREMENT PLAN WAS DEVELOPED BASED ON AN INDEPENDENT CONSULTANT REPORT ON MARKET-BASED PRACTICES FOR SUPPLEMENTAL RETIREMENT PLANS. THE PERCENTAGE OF FINAL AVERAGE PAY, THE REQUIREMENTS FOR VESTING, PARTICIPANTS, AND PAY-OUT PROVISIONS WERE ESTABLISHED, REVIEWED, AND APPROVED BY THE COMPENSATION COMMITTEE. THE CONTRIBUTIONS TO THE SUPPLEMENTAL NON-QUALIFIED RETIREMENT PLAN ARE INCLUDED IN SCHEDULE J, PART II, COLUMN C OR IN SCHEDULE J, PART II, COLUMN B(III) AS PART OF DEFERRED COMPENSATION. THE FOLLOWING INDIVIDUALS PARTICIPATED IN THIS SUPPLEMENTAL NON-QUALIFIED RETIREMENT PLAN: STEVEN LEONARD AND JAMES TODD PRMC PROVIDED THE FOLLOWING FUNDING AMOUNTS DURING 2019: STEVEN LEONARD $25,525 JAMES TODD $50,000 PART I, LINE 6 CONTINGENT COMPENSATION OFFICERS AND KEY EMPLOYEES OF PENINSULA REGIONAL MEDICAL CENTER ARE PAID COMPENSATION DETERMINED BY A NUMBER OF VARIABLES INCLUDING BUT NOT LIMITED TO INDIVIDUAL GOALS AS WELL AS ORGANIZATION OPERATIONAL ACHIEVEMENTS IN SERVICE, QUALITY, SAFETY, EMPLOYEE SATISFACTION, AND COST. THE FINAL DETERMINATION OF THE CONTINGENT COMPENSATION AMOUNT IS DETERMINED AND APPROVED BY THE BOARD AS PART OF THE OVERALL COMPENSATION REVIEW OF OFFICERS AND KEY EMPLOYEES. VARIABLE COMPENSATION PAYMENTS ARE REPORTED IN SCHEDULE J, PART II, COLUMN B(II) AND REFLECT ATTAINMENT OF CERTAIN GOALS. ALSO INCLUDED IN THAT COLUMN ARE PRODUCTIVITY PAYMENTS OF $275,972 (DANIELS) AND $123,099 (ARNAOUT) PART I, LINE 7 NON-FIXED PAYMENTS HIGHEST COMPENSATED EMPLOYEES OF THE ORGANIZATION ARE PAID COMPENSATION DETERMINED BY A NUMBER OF VARIABLES INCLUDING BUT NOT LIMITED TO INDIVIDUAL GOALS AS WELL AS ORGANIZATION OPERATIONAL ACHIEVEMENTS IN SERVICE, QUALITY, SAFETY, EMPLOYEE SATISFACTION, AND COST. VARIABLE COMPENSATION PAYMENTS ARE REPORTED IN SCHEDULE J, PART II, COLUMN B(II) AND REFLECT ATTAINMENT OF CERTAIN GOALS. A MARYLAND HEALTH & HIGHER EDUCATION FACILITY 520936091 574217UF8 2015-05-02 122212727 REFER TO PART VI 1 0 0 B MARYLAND HEALTH & HIGHER EDUCATION FACILITY 520936091 574218UE1 2015-05-02 25222024 REFER TO PART VI 1 0 0 A 9354447 122212727 121024047 1188680 0 1 1 1 B 1930553 25222024 222024 25000000 0 0 0 1 A 0 1 1 1 1 1 0.00920 0.00540 0.01460 0 0 1 B 0 1 1 1 1 1 0.00920 0.00540 0.01460 0 0 1 A 0 0 1 0 0 0 0 0 1 B 0 0 1 0 0 0 0 0 1 A 1 B 1 SCHEDULE K, PART I, COLUMN F DESCRIPTION OF PURPOSE PROCEEDS OF PUBLICLY-OFFERED, FIXED RATE SERIES 2015 BONDS, TOGETHER WITH FUNDS HELD IN AN EXISTING DEBT SERVICE RESERVE FUND ACCOUNT AND THE EXISTING PRINCIPAL AND INTEREST ACCOUNTS, HAVE BEEN USED TO 1) ADVANCE REFUND ALL OF PENINSULA REGIONAL MEDICAL CENTER'S ("PRMC") OUTSTANDING SERIES 2006 BONDS (ISSUED 2/09/06) FOR SAVINGS, 2) FUND VARIOUS CAPITAL EXPENDITURES (INCLUDING EQUIPMENT PURCHASES) (THE "PROJECT"), AND 3) PAY ALL BOND ISSUANCE EXPENSES. SCHEDULE K, PART I, LINE A (F) REFUNDING OF BONDS ISSUED ON 02/09/2006 SCHEDULE K, PART II, LINE 13 A - 2006 PROJECTS - 2009; 1993 PROJECTS - 1998 B - 2015 PROJECTS - 2017 SIMONA ENG DO TRUSTEE 141266 MEDICAL STAFF FEES 0 RONDALL ALLEN PHARMD TRUSTEE 232500 UMES PHARMACY PROGRAM SUPPORT 0 DAVID ROMMEL TRUSTEE 1003317 ELECTRICAL/MECHANICAL SERVICES 0 KIRSTIE SILVIA FAMILY MBR OF OFCR 62047 EMPL COMPN 0 BRIAN RITCHIE FAMILY MBR OF OFCR 53894 EMPL COMPN 0 SCHEDULE L, PART IV DESCRIPTION OF TRANSACTIONS WITH INTERESTED PERSONSEACH OF THE ABOVE-NAMED TRUSTEES ARE OWNERS OF BUSINESSES WHICH PROVIDE SERVICES TO PRMC. THE SERVICES PROVIDED WERE APPROVED BY INDEPENDENT MEMBERS OF THE GOVERNING BODY AND ARE CHARGED AT FAIR MARKET VALUE RATES. CHARLES SILVIA JR. AND BRUCE I. RITCHIE BOTH HAVE FAMILY MEMBERS WHO ARE EMPLOYED BY THE ORGANIZATION. FORM 990, PART III, LINE 4A STATEMENT OF PROGRAM SERVICE ACCOMPLISHMENTS PENINSULA REGIONAL MEDICAL CENTER IS A NOT-FOR-PROFIT 501(C)(3) NON-STOCK CORPORATION FOUNDED IN 1897 TO SERVE THE HEALTH CARE NEEDS OF THE COMMUNITY. THE HOSPITAL'S PRIMARY PURPOSE IS TO PROVIDE THE HIGHEST PRIMARY, SECONDARY, AND SELECTED TERTIARY HEALTH CARE SERVICES TO RESIDENTS OF AND VISITORS TO THE MID-DELMARVA PENINSULA IN A COMPETENT, COMPASSIONATE, AND COST-EFFECTIVE MANNER DESIGNED TO ELICIT A HIGH DEGREE OF CUSTOMER SATISFACTION. THE HOSPITAL'S MISSION IS TO IMPROVE THE HEALTH OF THE COMMUNITIES WE SERVE BY PROVIDING QUALITY MEDICAL CARE REGARDLESS OF RACE, CREED, SEX, NATIONAL ORIGIN, HANDICAP, OR AGE. IF A PATIENT IS UNABLE TO PAY DUE TO FINANCIAL RESOURCES, EFFORTS WILL BE TAKEN TO ASSURE CARE AT AN AFFORDABLE COST, OR OBTAINED ASSISTANCE THROUGH APPROPRIATE AGENCIES ON THE PATIENT'S BEHALF. EMERGENCY SERVICES CARE WILL BE PROVIDED TO EVERYONE REGARDLESS OF ABILITY TO PAY. PENINSULA REGIONAL MEDICAL CENTER SERVED OVER 16,000 INPATIENTS AND PROVIDED MORE THAN 645,000 OUTPATIENT SERVICES DURING FISCAL 2020. FOOD SERVICE PROVIDED MORE THAN 460,000 MEALS TO PATIENTS AND EMPLOYEES. ALTHOUGH REIMBURSEMENT FOR SERVICES RENDERED IS CRITICAL TO THE OPERATION AND STABILITY OF PENINSULA REGIONAL MEDICAL CENTER, IT IS RECOGNIZED THAT NOT ALL INDIVIDUALS POSSESS THE ABILITY TO PAY FOR ESSENTIAL MEDICAL SERVICES. THE HOSPITAL, IN KEEPING WITH THE COMMITMENT TO SERVE ALL MEMBERS OF THE COMMUNITY, DURING FISCAL 2020 PROVIDED: - CHARITY AND OTHER ALLOWANCES TOTALING $50,410,263 - DISCOUNTS TO THIRD PARTY PAYORS INCLUDING GOVERNMENT PROGRAMS SUCH AS MEDICARE AND MEDICAID $88,301,818 - WRITE-OFF OF UNCOLLECTIBLE ACCOUNTS $6,278,309 - THE TOTAL UNREIMBURSED VALUE OF PROVIDING CARE TO THESE PATIENTS IS $144,990,390 ALSO PROVIDED ARE MANY WELLNESS PROGRAMS, COMMUNITY EDUCATION AND FREE PROGRAMS OFFERED THROUGHOUT THE YEAR BASED UPON ACTIVITIES AND SERVICES THAT PENINSULA REGIONAL MEDICAL CENTER BELIEVES WILL SERVE A BONA FIDE COMMUNITY HEALTH NEED. SOME OF THE PROGRAMS ARE AS FOLLOWS: - A VARIETY OF BROCHURES ARE DISPLAYED IN ALL HOSPITAL WAITING AREAS TO EDUCATE MEMBERS OF THE COMMUNITY REGARDING PROGRAMS AND SERVICES. - PARTICIPATION IN HEALTH FAIRS DURING FY 2020 IN ORDER TO FOSTER HEALTH EDUCATION IN THE COMMUNITY. - WE PROVIDE CHILDBIRTH PREPARATION CLASSES, EXERCISE CLASSES FOR PRENATAL AND POSTPARTUM WOMEN AND CPR CLASSES. WE PROVIDE ASSISTANCE TO EDUCATORS THROUGH OUR WORK WITH STUDENT NURSES, RADIOLOGY, RESPIRATORY AND LABORATORY TECHNICIANS. DURING FY 2020, PENINSULA REGIONAL MEDICAL CENTER VOLUNTEERS CONTRIBUTED OVER 17,500 HOURS TOWARD THE COMMON PURPOSE OF SERVICING THE HEALTH CARE OF THE COMMUNITY. PROGRAM ACTIVITY DURING FY 2020, PENINSULA REGIONAL MEDICAL CENTER PERFORMED OVER 650 COMMUNITY OUTREACH ACTIVITIES. SPECIFIC EXAMPLES OF EDUCATION AND OUTREACH PROGRAMS, SUPPORT GROUPS, COMMUNITY HEALTH SCREENINGS, AND FITNESS AND WELLNESS ACTIVITIES SUPPORTED BY PENINSULA REGIONAL MEDICAL CENTER ARE AS FOLLOWS: COMMUNITY EDUCATIONAL AND OUTREACH PROGRAMS: - CPR - CHILDBIRTH PREPARATION CLASSES - REFRESHER COURSE - CHILDBIRTH - INFANT CARE CLASSES - SAFE SITTER PROGRAM - WOMEN'S HEALTH EDUCATION SUPPORT GROUPS - DIABETES SUPPORT GROUP - HEAD AND NECK CANCER SUPPORT GROUP - CAREGIVER SUPPORT GROUP EVENTS: - COMMUNITY SCREENINGS - HEIGHT/WEIGHT, BLOOD PRESSURE - SKIN CANCER SCREENINGS - ORAL, HEAD AND NECK CANCER SCREENINGS - HEARING SCREENINGS - FLU CLINIC - EDUCATIONAL EXHIBITS TO PROMOTE HEALTHY LIFESTYLES BENEFITS: - UNITED WAY FITNESS/EXERCISE PROGRAMMING: - CARDIAC REHABILITATION - INDOOR CYCLING AND WEIGHTS FORM 990, PART VI, SECTION A, LINE 2 BUSINESS RELATIONSHIPS STEVEN LEONARD, DAVID ROMMEL, MEMO DIRIKER, RYAN MCLAUGHLIN AND MONTGOMERY SAYLER ARE MEMBERS OF THE BOARD OF DIRECTORS OF PENINSULA HEALTH VENTURES, A WHOLLY-OWNED TAXABLE SUBSIDIARY OF PENINSULA REGIONAL HEALTH SYSTEM. BRUCE I. RITCHIE, PRMC'S CFO, ALSO SERVES AS SECRETARY/TREASURER OF PENINSULA HEALTH VENTURES. FORM 990, PART VI, SECTION A, LINE 4 CHANGES TO ORGANIZATIONAL DOCUMENTS ON JANUARY 1, 2020, (THE NANTICOKE ACQUISITION DATE), PENINSULA REGIONAL HEALTH SYSTEM ACQUIRED AND BECAME THE SOLE CORPORATE MEMBER OF MID-SUSSEX MEDICAL CENTER, INC. AND NANTICOKE MEMORIAL HOSPITAL. ON MARCH 1, 2020, (THE MCCREADY ACQUISITION DATE), PENINSULA REGIONAL HEALTH SYSTEM ACQUIRED AND BECAME THE SOLE CORPORATE MEMBER OF MCCREADY FOUNDATION, INC. FORM 990, PART VI, SECTION A, LINE 6 MEMBERS OR STOCKHOLDERS PENINSULA REGIONAL HEALTH SYSTEM IS THE SOLE CORPORATE MEMBER OF THE MEDICAL CENTER. FORM 990, PART VI, SECTION A, LINE 7A MEMBERS OR STOCKHOLDERS WHO MAY ELECT IN ITS CAPACITY AS THE SOLE CORPORATE MEMBER OF THE MEDICAL CENTER, PENINSULA REGIONAL HEALTH SYSTEM HAS THE ABILITY TO ELECT MEMBERS OF THE MEDICAL CENTER'S GOVERNING BODY. FORM 990, PART VI, SECTION A, LINE 7B DECISIONS SUBJECT TO APPROVAL AS THE SOLE CORPORATE MEMBER, PENINSULA REGIONAL HEALTH SYSTEM HAS THE ABILITY TO APPROVE MAJOR EXPENDITURES AND LONG TERM BORROWINGS OF THE MEDICAL CENTER. FORM 990, PART VI, SECTION B, LINE 11B FORM 990 REVIEW PROCESS OVERSIGHT OF THE COMPLETION OF THE ORGANIZATION'S FORM 990 HAS BEEN DELEGATED TO THE CHIEF FINANCIAL OFFICER OF PENINSULA REGIONAL MEDICAL CENTER BY THE PRESIDENT OF THE ORGANIZATION. ONCE THE FORM 990 AND ALL SCHEDULES HAVE BEEN PREPARED BY THE ORGANIZATION'S INDEPENDENT TAX SERVICES PROVIDER, THEY ARE REVIEWED BY THE PRESIDENT PRIOR TO FILING. THE RETURN IS PRESENTED TO THE BOARD OF TRUSTEES BY THE ORGANIZATION'S INDEPENDENT TAX ADVISORS FROM GRANT THORNTON LLP AND APPROVED FOR SUBMISSION. A COPY OF THE FORM 990 WAS MADE AVAILABLE TO ALL MEMBERS OF THE GOVERNING BODY PRIOR TO THE FILING WITH IRS. FORM 990, PART VI, SECTION B, LINE 12C CONFLICT OF INTEREST POLICY MONITORING & ENFORCEMENT THE BOARD OF TRUSTEES ARE REQUIRED TO DISCLOSE ANNUALLY, IN WRITING, ANY AND ALL INTEREST WHICH THEY OR ANY IMMEDIATE MEMBER OF THEIR FAMILY MAY HAVE IN ANY BUSINESS ENTITY WHICH HAS OR SEEKS A CONTRACTUAL OR COMPETITIVE RELATIONSHIP WITH THE ORGANIZATION. THE BOARD HAS THE AUTHORITY TO DETERMINE IF A VIOLATION HAS OCCURRED AND WHETHER ANY INTEREST WHICH SHOULD BE DISCLOSED SHOULD DISQUALIFY A DIRECTOR FROM PARTICIPATING IN ANY SPECIFIC BOARD DISCUSSION OR BOARD MEMBERSHIP. ALL DISCLOSURES ARE REVIEWED BY THE ORGANIZATION'S CHIEF COMPLIANCE OFFICER. ANY CONFLICTS ARE PRESENTED TO THE BOARD. IF A PERSON IS CONFLICTED, THEY WILL RECUSE THEMSELVES FROM ALL DISCUSSIONS AND DELIBERATIONS TO WHICH THEY WOULD APPEAR TO BE CONFLICTED. FORM 990, PART VI, SECTION B, LINE 15 PROCESS FOR DETERMINING COMPENSATION THE ORGANIZATION USES A COMPENSATION COMMITTEE TO DETERMINE THE COMPENSATION OF THE CEO/EXECUTIVE DIRECTOR AND OTHER KEY EMPLOYEES. THE CEO OF THE ORGANIZATION HAS A WRITTEN EMPLOYMENT CONTRACT. THE COMPENSATION COMMITTEE USES AN INDEPENDENT CONSULTANT, COMPENSATION SURVEYS AND OTHER ORGANIZATION'S FORM 990 IN THE DETERMINATION PROCESS. THE MEMBERS OF THE COMPENSATION COMMITTEE ARE INDEPENDENT AND RELY ON THIS COMPARABILITY DATA WHEN THEY DISCUSS AND DETERMINE THE INDIVIDUAL'S COMPENSATION. CONTEMPORANEOUS MINUTES OF SUCH DISCUSSIONS ARE KEPT AND MAINTAINED IN THE ORGANIZATION'S FILES. FORM 990, PART VI, SECTION C, LINE 19 HOW DOCUMENTS ARE MADE AVAILABLE TO THE PUBLIC THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, FINANCIAL STATEMENTS, AND FORM 990 ARE AVAILABLE TO THE PUBLIC UPON REQUEST TO THE PUBLIC INFORMATION OFFICE OF PENINSULA REGIONAL MEDICAL CENTER AT 100 EAST CARROLL STREET, SALISBURY, MD 21801. FORM 990, PART IX, LINE 11G PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 35,265,487. MANAGEMENT AND GENERAL EXPENSES 11,842,795. FUNDRAISING EXPENSES 54,849. TOTAL EXPENSES 47,163,131. PHYSICIAN PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 11,981,685. TOTAL EXPENSES 11,981,685. OTHER CONTRACTOR SERVICES: PROGRAM SERVICE EXPENSES -12,375. TOTAL EXPENSES -12,375. FORM 990, PART XI, LINE 9: PENSION ADJUSTMENT -7,547,744. PARTNERSHIP INCOME - TAX ADJUSTMENT -28,644. CONTRIBUTION FROM FOUNDATION -1,656,452. DECREASE IN CAPITAL -17,749,408. PENINSULA REGIONAL MED CENTER FOUNDATION 100 EAST CARROLL STREET SALISBURY MD 21801 521851935 FUNDRAISING MD 501(C)(3) LINE 7 PRHS 0 PENINSULA REGIONAL HEALTH SYSTEM (PRHS) 100 EAST CARROLL STREET SALISBURY MD 21801 522132761 PARENT MD 501(C)(3) LINE 12B, II N/A 0 PENINSULA GENERAL HOSPITAL INS TRUST 100 EAST CARROLL STREET SALISBURY MD 21801 526321234 INSURANCE MD 501(C)(3) LINE 12C, III-FI PRHS 0 DELMARVA PENINSULA INSURANCE COMPANY PO BOX 1159 KY1-1102 GRAND CAYMAN CJ 981110617 INSURANCE CJ 501(C)(3) PRHS 1 MID-SUSSEX MEDICAL CENTER INC 801 MIDDLEFORD ROAD SEAFORD DE 19973 510224470 HEALTH SERVICES DE 501(C)(3) LINE 10 PRHS 0 NANTICOKE MEMORIAL HOSPITAL 801 MIDDLEFORD ROAD SEAFORD DE 19973 510069243 HOSPITAL DE 501(C)(3) LINE 3 PRHS 0 NANTICOKE INSURANCE COMPANY LTD 3RD FLR WILLOW HOUSE 171 ELGIN AVE GEORGETOWN CJ 980446259 INSURANCE CJ 501(C)(3) NMH 0 MCCREADY FOUNDATION INC 201 HALL HIGHWAY CRISFIELD MD 21817 520607921 HOSPITAL MD 501(C)(3) LINE 3 PRHS 0 DELMARVA SURG CTR 641 S SALISBURY SALISBURY MD 21801 522251436 HEALTHCARE MD N/A N/A 0 0 DELMARVA ENDOSC CTR 11103 CATHAGE ROAD BERLIN MD 21801 831509115 HEALTHCARE MD N/A N/A 0 0 PENINSULA HEALTH VENTURES (PHV) 100 EAST CARROLL STREET SALISBURY MD 21801 522250012 P'SHIP INVESTMENT MD N/A C 0 PRLTC INC 100 EAST CARROLL STREET SALISBURY MD 21801 522190588 LONG TERM CARE MD N/A C 0 0 0 1 0 0 0 0 0 0 0 0 1 1 1 1 0 1 1 1 DELMARVA PENINSULA INSURANCE COMPANY R 5314879 CASH