2021-05-14T08:02:15-05:00 2020-06-30 PricewaterhouseCoopers LLP 2001 MARKET ST SUITE 1800 PHILADELPHIA PA 19103 990 2019-07-01 520607945 UNION HOSPITAL OF CECIL COUNTY INC % DERON G BROWN UNIO 4103984000 106 BOW STREET ELKTON MD 219215596 ROBERT MCMURRAY CFO 4103984000 2021-05-11 true ANTONIO C RUSSO P00858539 2673303000 2021-05-10 2019 2022-09-23 18:48:47Z RICHARD C SZUMEL MD 106 BOW STREET ELKTON MD 219215596 158667623 false X WWW.UHCC.COM X 1903 MD TO PROVIDE CHARITABLE HEALTHCARE SERVICES TO THE RESIDENTS OF CECIL COUNTY, MD AND THE SURROUNDING AREA. 15 11 1354 199 1746410 0 10510084 4700573 160923585 149294107 1953831 1610173 2627581 2819298 176015081 158424151 799694 0 0 0 87612271 84341366 0 0 0 81859106 78654327 170271071 162995693 5744010 -4571542 163925550 160653669 81586351 108476881 82339199 52176788 X UNION HOSPITAL OF CECIL COUNTY, INC.'S MISSION IS TO PROVIDE CHARITABLE HEALTHCARE SERVICES TO THE RESIDENTS OF CECIL COUNTY, MARYLAND, WESTERN NEW CASTLE COUNTY, DELAWARE, AND SOUTHERN CHESTER COUNTY, PENNSYLVANIA. false true 158808328 0 149294107 UNION HOSPITAL OF CECIL COUNTY'S MISSION IS TO PROVIDE QUALITY HEALTH CARE SERVICES TO THE RESIDENTS OF CECIL COUNTY, MARYLAND AND NEIGHBORING COMMUNITIES. SERVICES ARE PROVIDED WITH MODERN TECHNOLOGY AND COMPASSIONATE CARE FROM HEALTH CARE PROFESSIONALS. SERVICES ARE PROVIDED REGARDLESS OF RACE, GENDER, ETHNICITY, AGE, DISABILITY, RELIGION, OR ABILITY TO PAY. ALTHOUGH REIMBURSEMENT FOR SERVICES RENDERED IS VITALLY IMPORTANT TO THE OPERATION, STABILITY, AND VIABILITY OF UNION HOSPITAL OF CECIL COUNTY, IT IS RECOGNIZED THAT NOT ALL MEMBERS OF THE COMMUNITY ARE IN THE FINANCIAL POSITION TO PURCHASE HEALTH CARE SERVICES. FOR ELIGIBLE INDIVIDUALS, UNION HOSPITAL OF CECIL COUNTY OFFERS FREE AND/OR SUBSIDIZED CARE, AS WELL AS ACCESS TO COMMUNITY FINANCIAL ASSISTANCE. DURING THE YEAR, UNION HOSPITAL OF CECIL COUNTY PROVIDED $9,807,394 IN UNCOMPENSATED CARE (CHARITY CARE). IN ADDITION, COMMUNITY BENEFIT ACTIVITIES ARE PROVIDED TO SERVE VULNERABLE POPULATIONS (I.E. MEDICALLY UNDERSERVED, WORKING POOR, HOMELESS). ACTIVITIES ARE CREATED BASED ON COMMUNITY NEED AND ARE PROVIDED IN AN EFFORT TO IMPROVE THE HEALTH OF THE COMMUNITY. COMMUNITY BENEFITS INCLUDE: A) COMMUNITY SUPPORT GROUPS FOR CANCER, DIABETES, STROKE, ALZHEIMER'S,AND BREASTFEEDING B) HEALTH EDUCATION FOR DIABETES AND NUTRITION, CANCER PREVENTION, STROKE RISK, AND HOW TO CARE FOR SUBSTANCE-EFFECTED NEWBORNS C) FREE SCREENINGS IN THE COMMUNITY FOR PROSTATE CANCER, HEAD AND NECK CANCER, SKIN CANCER, AND DIABETES (EYES AND FEET) D) PROVIDING MEETING FACILITIES FOR LOCAL NONPROFITS AND AGENCIES E) ENHANCING FOOD SECURITY WITH MEALS ON WHEELS AND FOOD DONATIONS TO HOMELESS SERVING PROVIDERS IN THE COMMUNITY F) HOSPITAL STAFF PARTICIPATION ON COMMUNITY BOARDS AND COALITIONS, LIKE THE DENTAL HEALTH ADVISORY BOARD, UNITED WAY, VOICES OF HOPE, CECIL COUNTY DRUG-FREE COMMUNITIES COALITION, CORE SERVICE AGENCY MENTAL HEALTH ADVISORY BOARD, DEPARTMENT OF SOCIAL SERVICES BOARD, AND CECIL COUNTY COMMUNITY HEALTH ADVISORY COALITION. UNION HOSPITAL OF CECIL COUNTY SERVICED 4,419 DISCHARGES PROVIDING 18,523 PATIENT DAYS TO INPATIENTS IN FISCAL YEAR 2020 OF WHICH: 1) PATIENTS COVERED UNDER THE MEDICARE PROGRAM WERE 1,960 DISCHARGES AND 9,206 PATIENT DAYS 2) PATIENTS COVERED UNDER THE MEDICAID PROGRAM WERE 137 DISCHARGES AND 587 PATIENT DAYS 3) PATIENTS COVERED UNDER THE MEDICAID HMO PROGRAM WERE 1,203 DISCHARGES AND 4,242 PATIENT DAYS 4) PATIENTS COVERED UNDER THE MEDICARE HMO PROGRAM WERE 166 DISCHARGES AND 764 PATIENT DAYS 158808328 true true false false false false false false false false true true false true true true true true false false true false false false false false true true false false true true false false false false false false false false false false false false false false false true false false false true 184 0 1354 true true true false false false false false false false false false false false X 15 11 false false false false true true true true true false false true true true true true true true true false MD X DERON G BROWN 4103984000 106 BOW STREET ELKTON MD 219215596 X FAHD RAHMAN PHYSICIAN 40.0 0.0 X 690364 0 30866 JUSTIN SAUSVILLE MD DIRECTOR, PHYSICIAN 40.0 0.0 X 548284 0 30922 RICHARD C SZUMEL MD PRESIDENT & CEO 28.0 12.0 X X 0 482681 85791 ROGER D WU PHYSICIAN 40.0 0.0 X 510574 0 26736 NAVEED HASAN PHYSICIAN 40.0 0.0 X 486224 0 26467 HANHAN LI PHYSICIAN 40.0 0.0 X 472539 0 12630 EUGENIA M GRAY PHYSICIAN 40.0 0.0 X 409824 0 19353 CRAIG M BABBITT IN-HOUSE LEGAL COUNSEL 40.0 0.0 X 336181 0 11280 JAMES G RAAB SENIOR VP/CFO THRU 10/2020 29.0 11.0 X 0 299349 25456 DR RYAN GERACIMOS CHIEF MEDICAL OFFICER 30.0 10.0 X 0 302901 3052 JOSE MA MD DIRECTOR 39.5 0.5 X 270651 0 29621 AARON Z ROYSTON THRU 1019 VP OF PROVIDER ENTERPRISE 30.0 10.0 X 242445 0 4172 MARIE VASBINDER SR. VP/CHIEF NURSE OFFICER 39.0 1.0 X 0 217446 2394 JOAN PIRRUNG VP OF NURSING 40.0 0.0 X 0 159909 40282 AMY MARSTON CAMPUS OPERATIONS OFFICER 40.0 0.0 X 0 159954 27668 MICHELLE TWUM-DANSO ASSOCIATE VP HUMAN RESOURCES 40.0 0.0 X 180320 0 3611 DERON BROWN EXEC DIRECTOR OF FINANCE 40.0 0.0 X 151471 0 4150 CYDNEY TEAL FORMER VP MEDICAL AFFAIRS 0.0 0.0 X 0 102263 7159 RAYMOND HAMM CHAIRMAN 0.5 0.6 X X 0 0 0 DWIGHT THOMEY VICE CHAIRMAN/TREASURER 0.5 0.5 X X 0 0 0 DAVID FERGUSON PHD SECRETARY 0.5 0.6 X X 0 0 0 KELLY ALBANESE BEDDER DIRECTOR 0.5 1.5 X 0 0 0 MARY BOLT PHD DIRECTOR 0.5 0.5 X 0 0 0 REVEREND KEVIN BROWN DIRECTOR 0.5 0.5 X 0 0 0 CHRISTY DRYER DNP DIRECTOR 0.5 0.5 X 0 0 0 MORGAN MILLER MLIS DIRECTOR 0.5 0.5 X 0 0 0 ROBERT PALSGROVE DIRECTOR 0.5 0.5 X 0 0 0 CARL ROBERTS PHD DIRECTOR 0.5 0.5 X 0 0 0 DAVID TROLIO DIRECTOR 0.5 0.5 X 0 0 0 JACQUES RENE DIRECTOR 0.5 0.5 X 0 0 0 4298877 1724503 391610 11 true true false UNION RADIOLOGISTS LLC 106 BOW STREET ELKTON MD 21921 RADIOLOGY SERVICES 3472625 USACS INTEGRATED ACUTE CARE SRVCS O 4535 DRESSLER RD NW CANTON OH 44718 ACUTE CARE SERVICES 2437932 CHG COMPANIES INC PO BOX 972651 DALLAS TX 75397 PROF. STAFFING 2227364 CLEARPATH SOLUTIONS GROUP LLC 2465 CENTREVILLE RD SUITE J17-722 HERNDON VA 20171 IT SERVICES 1155886 FLYNN MID ATLANTIC LP 5200 RAYNOR AVENUE LITHICUM MD 21090 CONTRACTOR SERVICES 1010184 105 156049 4182127 362397 4700573 NET PATIENT SERVICE REVENUE 621990 148076991 148076991 OTHER OPERATING REVENUE 621990 1035242 1035242 ADULT DAY CARE 623990 181874 181874 149294107 1148394 -101800 1250194 0 0 79768 7988 71780 0 71780 71780 456024 241239 235484 456024 5755 461779 461779 0 0 0 0 0 0 0 0 0 LABORATORY REVENUE 621500 1848210 1848210 CAFETERIA/FOOD SERVICE REVENUE 722210 737871 737871 PARKING REVENUE 900009 34645 34645 126792 126792 2747518 158424151 149294107 1746410 2683061 X 0 0 0 0 3660804 3595392 65412 0 67717527 66507545 1209982 820306 820306 0 7427905 7323234 104671 4714824 4650980 63844 983609 491805 491804 858780 858780 256500 256500 0 0 72154 72154 28142493 27148628 993865 0 324812 324812 1996714 1992612 4102 200668 200668 0 3962675 3962675 111383 103190 8193 0 70636 44340 26296 1898836 1898836 3888934 3888934 0 0 9028578 9028578 2557266 2534833 22433 MEDICAL SUPPLIES 19708713 19706222 2491 REPAIRS & MAINTENANCE 3446139 3445586 553 DIETARY 808062 801777 6285 OTHER EXPENSES 337375 337375 162995693 158808328 4187365 0 6198168 37308503 0 0 0 0 14069712 14177794 0 0 0 0 0 0 2307404 2523066 2940202 3244897 175592597 125361996 82932993 50230601 32337168 30670970 13788136 13031319 0 0 0 0 9351767 9466519 163925550 160653669 10375169 11559155 0 0 3485157 31554344 56179987 53628217 0 0 0 0 0 0 0 0 11546038 11735165 81586351 108476881 X 79490139 49027095 2849060 3149693 82339199 52176788 163925550 160653669 X -4571542 915320 -26506189 X false true X true false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 1134905 1134905 45935356 27146330 18789026 956373 356466 599907 124309567 96441751 27867816 3256396 1417449 1838947 50230601 5243103 C MANAGED HEDGE FUNDS 7788216 F 13031319 OTHER ASSETS 1436326 INSURANCE CLAIMS RECOVERABLE 7699683 DUE FROM AFFILIATES 330510 9466519 0 CAPITAL LEASE OBLIGATIONS 1384942 DUE TO AFFILIATES 461343 EST. MEDICAL MALPRACTICE LIABILITY 8895187 OTHER LIABILITIES 993693 11735165 X 158926606 915320 -412865 502455 158424151 158424151 163197186 201493 201493 162995693 162995693 FORM 990, SCHEDULE D, PART X, LINE 2 TEXT OF FIN 48 (ASC 740) FOOTNOTE THE HOSPITAL IS A NOT-FOR-PROFIT CORPORATION AS DESCRIBED IN SECTION 501 (C)(3) OF THE IRC AND IS EXEMPT FROM FEDERAL INCOME TAXES ON THEIR EXEMPT INCOME UNDER SECTION 501 (A) OF THE IRC. THE HOSPITAL ACCOUNTS FOR UNCERTAINTY IN INCOME TAXES BY PRESCRIBING A RECOGNITION THRESHOLD OF MORE-LIKELY-THAN-NOT TO BE SUSTAINED UPON EXAMINATION BY THE APPROPRIATE TAXING AUTHORITY. MEASUREMENT OF THE TAX UNCERTAINTY OCCURS IF THE RECOGNITION THRESHOLD HAS BEEN MET. THERE WERE NO TAX UNCERTAINTIES THAT MET THE RECOGNITION THRESHOLD FOR THE PERIOD JANUARY 1, 2020 THROUGH JUNE 30, 2020 (SUCCESSOR) AND PERIOD JULY 1, 2019 THROUGH DECEMBER 31, 2019 AND THE YEAR ENDED JUNE 30, 2019 (PREDECESSOR). THE HOSPITAL'S POLICY IS TO RECOGNIZE INTEREST RELATED TO UNRECOGNIZED TAX BENEFITS IN INTEREST EXPENSE AND PENALTIES IN OPERATING EXPENSES. --------------- FORM 990, SCHEDULE D, PART XI, LINE 2D DETAIL OF OTHER ITEMS BANK FEES $ (72,154) OTHER ADJUSTMENTS (340,711) ---------- TOTAL TO SCHEDULE D, PART XI, LINE 2D $(412,865) --------------- FORM 990, SCHEDULE D, PART XII, LINE 4B DETAIL OF OTHER ITEMS BANK FEES $ 72,154 OTHER ADJUSTMENTS 129,339 -------- TOTAL TO SCHEDULE D, PART XII, LINE 4D $201,493 Central America and the Caribbean Investments 20000 20000 20000 true false true false false false true true X true X true X true true true false true true 1432600 1432600 0.00870 1432600 1432600 0.00870 2389 82687 0 82687 0.00050 185 115183 0 115183 0.00070 37 15697981 6887031 8810950 0.05410 0 14205 0 14205 0.00010 24298 279842 172024 107818 0.00070 26909 16189898 7059055 9130843 0.05610 26909 17622498 7059055 10563443 0.06480 12798 12798 0.00010 7110 7110 0.00000 19908 19908 0.00010 true 7168709 70906 67859200 67859200 X true true 1 1 UNION HOSPITAL OF CECIL COUNTY INC 106 BOW STREET ELKTON MD 21921 WWW.UHCC.COM LICENSE# 07-005 X X X UNION HOSPITAL OF CECIL COUNTY INC 1 false false true X X X X X X X X X 19 true true true true X SEE PART V, SECTION C X SEE PART V, SECTION C X true 19 true SEE PART V, SECTION C false true X 200. 400. X X X X X X true true X X X X true X SEE PART V, PAGE 8 X SEE PART V, PAGE 8 X SEE PART V, PAGE 8 X X X X X X X true X false X X X true X false false PART V, SECTION B, LINES 5, 6A & 6B (INPUT FROM COMMUNITY; JOINT CHNA) UNION HOSPITAL AND THE CECIL COUNTY HEALTH DEPARTMENT (CHNA PLANNING TEAM) HAVE COLLABORATED SINCE 2013 TO DEVELOP THE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) AND IMPLEMENTATION PLAN. TO ENSURE THE 2019 CHNA WOULD REFLECT COMMUNITY NEEDS AND PRIORITIES, THE CHNA PLANNING TEAM DEVELOPED A COMMUNITY SURVEY, HELD FOCUS GROUPS, AND CONDUCTED INTERVIEWS WITH LOCAL LEADERS. THE SURVEY WAS DEVELOPED BY THE CHNA PLANNING TEAM AND CONSISTED OF 20 QUESTIONS DIVIDED INTO 4 SECTIONS PERTAINING TO DEMOGRAPHICS, COMMUNITY HEALTH, QUALITY OF LIFE, AND ACCESS TO HEALTH CARE. 1,403 INDIVIDUALS COMPLETED THE SURVEY WHICH WAS AVAILABLE FROM JULY 2018 TO SEPTEMBER 2018 ONLINE AND IN PAPER FORM AT COMMUNITY LOCATIONS SUCH AS THE COUNTY PUBLIC LIBRARIES AND UNION HOSPITAL'S MULTI-SPECIALTY PRACTICES. THE CHNA PLANNING TEAM ALSO HOSTED 4 FOCUS GROUPS FOR VULNERABLE POPULATIONS: HOMELESS, VETERANS, OLDER ADULTS, AND LOW-INCOME OR ASSET LIMITED INCOME CONSTRAINED EMPLOYED (ALICE) ADULTS. A 5TH FOCUS GROUP WITH AFRICAN AMERICANS WAS ALSO HELD TO DISCUSS HEALTH DISPARITIES IN CECIL COUNTY. EACH FOCUS GROUP SESSION LASTED 1 TO 1.5 HOURS AND ALWAYS BEGAN WITH A DESCRIPTION OF THE CHNA, THE PURPOSE OF THE FOCUS GROUP, THE RULES OF ENGAGEMENT, AND A REFERENCE WORKSHEET WITH SESSION QUESTIONS. PARTICIPATION WAS ANONYMOUS WITH A HEAD COUNT PROVIDING THE NUMBER OF PARTICIPANTS. THE AVERAGE FOR EACH SESSION WAS 10 PARTICIPANTS. AT EACH SESSION, THE FOLLOWING QUESTIONS WERE ASKED: 1) WHAT ARE THE GREATEST STRENGTHS OF OUR COMMUNITY? 2) WHAT DO YOU THINK ARE THE MOST IMPORTANT HEALTH ISSUES IN CECIL COUNTY? 3) WHAT WOULD MOST IMPROVE THE QUALITY OF LIFE IN CECIL COUNTY? 4) WHAT ARE THE MOST SIGNIFICANT BARRIERS TO ACCESSING HEALTH CARE IN CECIL COUNTY? 5) RELATED TO HEALTH AND QUALITY OF LIFE, WHAT RESOURCES OR SERVICES DO YOU THINK ARE MISSING IN CECIL COUNTY? FINALLY, INTERVIEWS WERE CONDUCTED TO UNDERSTAND THE COMMUNITY LEADERSHIP PERSPECTIVE OF THE HEALTH AND QUALITY OF LIFE IN CECIL COUNTY. TWELVE 1-2 HOUR INTERVIEWS WITH 2-5 COMMUNITY LEADERS WERE CONDUCTED BY UNION HOSPITAL. TO ENSURE PARTICIPANTS FELT FREE TO SHARE THEIR THOUGHTS, PARTICIPATION WAS KEPT CONFIDENTIAL. THE SURVEY TOOK APPROXIMATELY 15 TO 20 MINUTES TO COMPLETE AND 506 PEOPLE COMPLETED THE SURVEY. --------------- SCHEDULE H, PART V, SECTION B, LINE 7A & B (CHNA AVAILABILITY) UNION HOSPITAL OF CECIL COUNTY, INC.'S CHNA IS AVAILABLE ON ITS WEBSITE AT: HTTPS://WWW.UHCC.COM/ABOUT-US/COMMUNITY-BENEFIT/REPORTS/ UNION HOSPITAL OF CECIL COUNTY, INC.'S CHNA IS ALSO AVAILABLE AT: HTTPS://CECILCOUNTYHEALTH.ORG/RESOURCES/HEALTH-ADVISORY-COMMITTEE/ --------------- SCHEDULE H, PART V, SECTION B, LINE 10 (IMP. STRATEGY PUBLIC AVAILABILITY) UNION HOSPITAL OF CECIL COUNTY, INC.'S CHIP IS AVAILABLE ON ITS WEBSITE AT: HTTP://WWW.UHCC.COM/ABOUT-US/COMMUNITY-BENEFIT/REPORTS/ --------------- SCHEDULE H, PART V, SECTION B, LINE 11 (ADDRESSING NEEDS FROM THE CHNA) UNION HOSPITAL'S MOST RECENT CHNA, COMPLETED IN COLLABORATION WITH THE CECIL COUNTY PUBLIC HEALTH DEPARTMENT PRIORITIZED THE FOLLOWING HEALTH NEEDS: - CANCER - BEHAVIORAL HEALTH (COMPRISED OF MENTAL HEALTH AND SUBSTANCE USE) - CHILDHOOD TRAUMA WHILE CANCER INCIDENCE RATES HAVE STEADILY DECLINED IN CECIL COUNTY OVER THE LAST SEVERAL YEARS, THE INCIDENCE RATE REMAINS HIGH IN COMPARISON TO THE STATE AND NATION. UNFORTUNATELY, MANY MEMBERS OF OUR COMMUNITY HAVE BEEN IMPACTED BY CANCER. FOR THE LAST 10 YEARS, BEHAVIORAL HEALTH HAS BEEN PRIORITIZED AS AN AREA OF NEED. IN THE 2013 AND 2016 CHNAS, SUBSTANCE USE WAS IDENTIFIED AS THE NUMBER ONE HEALTH PRIORITY FOLLOWED BY MENTAL HEALTH. AS ILLICIT DRUG USE HAS BEEN INCREASING IN CECIL COUNTY IN RECENT YEARS, WITH OPIOID USE HAVING A SIGNIFICANT IMPACT IN OUR COMMUNITY, IT IS NOT SURPRISING THAT THIS REMAINS AN AREA OF NEED. FINALLY, CHILDHOOD TRAUMA WAS IDENTIFIED AS AN AREA OF NEED BECAUSE OF THE LIKELIHOOD THAT MEMBERS IN OUR COMMUNITY SUFFERED A TRAUMA IN CHILDHOOD AND THE DAMAGING IMPACT IT HAS THROUGHOUT LIFE. ADVERSE CHILDHOOD EXPERIENCES (ACE) IS THE TERM COMMONLY USED TO DESCRIBE ALL TYPES OF ABUSE, NEGLECT, AND OTHER POTENTIALLY TRAUMATIC EXPERIENCES THAT OCCUR TO PEOPLE UNDER THE AGE OF 18. ACES HAVE BEEN LINKED TO RISKY BEHAVIORS, CHRONIC HEALTH CONDITIONS, LOW LIFE POTENTIAL AND PREMATURE DEATH. NEARLY TWO-THIRDS OF ADULTS IN CECIL COUNTY REPORTED EXPERIENCING AT LEAST ONE ACE DURING THEIR CHILDHOOD (2019 CHNA, PAGE 26). CANCER UNION HOSPITAL'S COMPREHENSIVE CANCER SERVICES INCLUDE PREVENTION, DETECTION, INPATIENT AND OUTPATIENT TREATMENT, FOLLOW-UP CARE, AND ONGOING SUPPORT THROUGH A DEDICATED SOCIAL WORKER AND THE CANCER RESOURCE CENTER WHICH IS A VOLUNTEER RUN ORGANIZATION. THE UNION HOSPITAL CANCER PROGRAM IS CERTIFIED BY THE COMMISSION ON CANCER OF THE AMERICAN COLLEGE OF SURGEONS AND IS A RECIPIENT OF ITS PRESTIGIOUS OUTSTANDING ACHIEVEMENT AWARD. TREATMENT OPTIONS INCLUDE RADIATION THERAPY IN COLLABORATION WITH UNIVERSITY OF MARYLAND RADIATION ONCOLOGY, AN ADVANCED INFUSION CENTER, AND PARTICIPATION IN CLINICAL TRIALS. INPATIENT AND OUTPATIENT SERVICES ARE OFFERED AT UNION HOSPITAL, AT CHRISTIANACARE'S HELEN F. GRAHAM CANCER CENTER & RESEARCH INSTITUTE AND RADIATION ONCOLOGISTS, PA. IN FY 20, UNION HOSPITAL CONTINUED TO PROVIDE SCREENINGS FOR LUNG, BREAST, COLORECTAL, AND PROSTATE CANCERS WHICH ARE CANCERS THAT WERE THE FOCUS OF OUR 2019 CHNA, AND TO PROVIDE INFORMATION TO ELIGIBLE PATIENTS FOR SCREENINGS PROVIDED BY THE CECIL COUNTY HEALTH DEPARTMENT. IN SEPTEMBER 2019, UNION HOSPITAL PROVIDED ITS ANNUAL FREE PROSTATE SCREENING AND EDUCATION EVENTS AND SUCCESSFULLY SCREENED 27 INDIVIDUALS. FOR THE PAST SEVERAL YEARS, FREE SCREENINGS FOR HEAD AND NECK CANCERS HAVE BEEN OFFERED IN THE SPRING. UNFORTUNATELY, DUE TO THE CORONAVIRUS PANDEMIC, THESE SCREENINGS WERE NOT HELD IN THE SPRING OF 2020. UNION HOSPITAL CONTINUES TO PROVIDE LOW-DOSE LUNG CT (LDCT) SCREENINGS WHICH DETECT MALIGNANT TUMORS BEFORE SYMPTOMS APPEAR. THIS SCREENING IS SIGNIFICANT BECAUSE THE EARLIER LUNG CANCER CAN BE DETECTED, THE BETTER THE CHANCE OF SURVIVAL. LDCT SCANS ARE RECOMMENDED FOR THOSE: - BETWEEN THE AGES OF 55 AND 74 YEARS OLD - CURRENT SMOKER OR HAVE QUIT IN THE PAST 15 YEARS - HAVE NO SYMPTOMS OF LUNG CANCER - HAVE A 30 PACK YEAR SMOKING HISTORY (PACK YEAR = NUMBER OF PACKS OF CIGARETTES SMOKED PER DAY MULTIPLIED BY NUMBER OF YEARS AS A SMOKER) IN THE 2020-2022 IMPLEMENTATION PLAN, THE STATED OBJECTIVE WAS TO INCREASE THE NUMBER OF INDIVIDUALS RECEIVING LDCT SCANS BY 5% WAS SET. IN CALENDAR YEARS 2016, 2017, AND 2018, 556 PEOPLE WERE SCREENED. THE GOAL FOR CALENDAR YEARS 2019, 2020, AND 2021 IS TO SCAN 584 INDIVIDUALS. IN FISCAL YEAR 2020, UNION HOSPITAL 241 PATIENTS RECEIVED THE LDCT SCAN. WHILE WE EXPECT DECREASED NUMBERS IN FISCAL YEAR 2021 DUE TO THE CORONAVIRUS PANDEMIC, WE BELIEVE THE HIGH NUMBER SCREENED IN FISCAL YEAR 2020 WILL HELP US TO MEET THAT GOAL. BECAUSE SMOKING IN ADULTS IN CECIL COUNTY DOUBLED FROM 2014 TO 2017 (2019 CHNA, PAGE 14) THIS PARTICULAR SCREENING IS A CRITICALLY IMPORTANT OFFERING FOR THE COMMUNITY. DUE TO THE INCREASE IN SMOKING IN CECIL COUNTY, AND COMMUNITY CONCERN WITH RESPIRATORY DISEASES INCLUDING LUNG CANCER, UNION HOSPITAL ALSO IMPLEMENTED THE ABILITY TO REFER PATIENTS THROUGH THEIR ELECTRONIC HEALTH RECORD TO CECIL COUNTY HEALTH DEPARTMENT TOBACCO CESSATION PROGRAMS. IN FY 2020, 44 INDIVIDUALS WERE REFERRED TO COUNTY TOBACCO CESSATION PROGRAMS. ANOTHER IMPORTANT ASPECT OF THE 2020 - 2022 IMPLEMENTATION PLAN IS TO SUPPORT THE WORK OF CECIL COUNTY CANCER TASK FORCE WHICH IS COMPRISED OF LEADERS IN CANCER CARE, COMMUNITY HEALTH, SOCIAL SUPPORTS, PUBLIC HEALTH, AND THE FAITH-BASED COMMUNITY. REPRESENTATIVES FROM UNION HOSPITAL PARTICIPATE ON THIS COMMITTEE AND A UNION HOSPITAL CAREGIVER CHAIRED THE COMMITTEE IN FISCAL YEAR 2020. THROUGH PARTICIPATION IN THIS COMMITTEE, UNION HOSPITAL WORKS WITH ITS COMMUNITY PARTNERS TO PROMOTE EDUCATION AND AWARENESS OF CANCER PREVENTION AND SCREENINGS, AND COLLABORATES TO MEET OBJECTIVES SET BY COMMUNITY PARTNERS. FINALLY, UNION HOSPITAL CONTINUED TO RUN AN ACTIVE BREAST CANCER SURVIVORS SUPPORT GROUP IN FY 2020. DESPITE THE CORONAVIRUS PANDEMIC MAKING COMMUNITY EVENTS IN THE SPRING OF 2020 IMPOSSIBLE, OUR CAREGIVERS ADAPTED AND WERE ABLE TO PROVIDE VIRTUAL SESSIONS FOR THE FINAL FEW MONTHS OF FISCAL YEAR. IN TOTAL, 12 SESSIONS, INCLUDING A FULL DAY RETREAT AND 2 VIRTUAL SESSIONS, WERE HELD IN FY 2020. BEHAVIORAL HEALTH UNION HOSPITAL WORKS TO ADDRESS BEHAVIORAL HEALTH ISSUES WITHIN ITS COMMUNITY THROUGH DIRECT PROGRAMMING AND COLLABORATION WITH COMMUNITY PARTNERS. UNION HOSPITAL HAS A 12-BED INPATIENT UNIT, AN OUTPATIENT PRACTICE, AND AN INTENSIVE OUTPATIENT PROGRAM FOR ADULTS STRUGGLING TO MANAGE MENTAL HEALTH DISORDERS. ALL OF THESE OFFERINGS SEEK TO ADDRESS THE PATIENTS' NEEDS HOLISTICALLY WITH A PERSON-CENTERED APPROACH THAT RELIES ON MULTI-DISCIPLINARY TEAMS. IN FY 2020, UNION HOSPITAL CAREGIVERS PARTICIPATED IN THE FOLLOWING COMMUNITY GROUPS FOCUSED ON BEHAVIORAL HEALTH: LOCAL OVERDOSE FATALITY REVIEW TEAM: A COUNTY LEVEL MEETING THAT REVIEWS CONFIRMED OVERDOSE DEATHS IN CECIL COUNTY AND LOOKS FOR OPPORTUNITIES TO CLOSE GAPS IN TREATMENT. CIT ADVISORY COMMITTEE: THIS COMMITTEE MEETS QUARTERLY TO ADVISE AFFILIATED SANTE GROUP ON THEIR GRANT FUNDED INITIATIVE TO BRING CRISIS INTERVENTION TREATMENT TRAINING TO FIRST RESPONDERS IN THE COUNTY. CIT COMMITTEE: THIS COMMITTEE MEETS QUARTERLY TO REVIEW CRISIS INTERVENTION TRAINING PROGRESS AND OPPORTUNITIES FOR CECIL COUNTY. CECIL COUNTY DRUG AND ALCOHOL COUNCIL: THIS COUNCIL IDENTIFIES PRIORITIES AND STRATEGIES FOR MEETING THE EVALUATION, PREVENTION, AND TREATMENT NEEDS OF THE PUBLIC AND THE JUSTICE SYSTEM. COUNCIL MEETINGS ARE OPEN TO THE PUBLIC AND INCLUDE REPRESENTATIVES FROM LOCAL/REGIONAL PREVENTION AND TREATMENT PROVIDERS, HEALTH DEPARTMENT, SOCIAL SERVICES, CRIMINAL JUSTICE ORGANIZATIONS, FAITH COMMUNITY, MEMBERS OF THE RECOVERY COMMUNITY, AND CONCERNED CITIZENS. CECIL COUNTY CORE SERVICES AGENCY: ORGANIZED BY THE CECIL COUNTY HEALTH DEPARTMENT, THESE MEETINGS ARE DESIGNED TO KEEP COMMUNITY PARTNERS AWARE OF NEW AND ONGOING MENTAL HEALTH AND SUBSTANCE USE DISORDER PROGRAMS TO ENSURE THEY CAN DIRECT CECIL COUNTY RESIDENTS AND THEIR FAMILIES TO THESE RESOURCES. UNION HOSPITAL CONTINUED THE PEER RECOVERY ADVOCATES PROGRAM IN COLLABORATION WITH THE CECIL COUNTY HEALTH DEPARTMENT IN FY 2020. UNION HOSPITAL CAREGIVERS IDENTIFY INDIVIDUALS IN THE EMERGENCY DEPARTMENT AND THE PSYCHIATRIC UNIT WHO MAY SUFFER FROM A SUBSTANCE USE DISORDER AND THEN COORDINATE WITH THE PEER PROGRAM TO ENSURE THOSE INDIVIDUALS CONNECT WITH A PEER. THE PEER THEN WORKS TO IDENTIFY THE INDIVIDUAL'S NEEDS, GET THEM INTO TREATMENT, AND GET CONNECTED WITH THE APPROPRIATE COMMUNITY RESOURCES. IMPORTANTLY, THE PEERS REMAIN IN COMMUNICATION WITH THESE INDIVIDUALS TO ENSURE CONTINUED SUCCESS. 285 INDIVIDUALS WERE REFERRED TO THE PEER PROGRAM IN FISCAL YEAR 2020. THE PROGRAM HAS BEEN HALTED SINCE MARCH 2020 DUE TO THE PANDEMIC, BUT WE EXPECT TO RESUME THIS MUCH NEEDED PROGRAM IN THE NEAR FUTURE. UNION HOSPITAL CONTINUED ITS PARTNERSHIP WITH TWO COMMUNITY TREATMENT CENTERS, SERENITY HEALTH AND ELKTON TREATMENT CENTER, TO ALLOW CAREGIVERS TO VISIT THE SITES AND PROVIDE EXPECTANT AND NEW MOTHERS WITH EDUCATION PERTAINING TO CARING FOR INFANTS GENERALLY, BUT ALSO INFANTS WHO EXPERIENCE NEONATAL ABSTINENCE SYNDROME (NAS). IN FY 20, 43 MOTHERS WERE PROVIDED EDUCATION. PRIOR TO FY 20, UNION HOSPITAL CAREGIVERS WOULD PROVIDE THIS EDUCATION AS VOLUNTEERS ON THEIR OWN TIME. IN RECOGNITION OF THE IMPORTANCE OF THIS COMMUNITY NEED, UNION HOSPITAL MADE THE DECISION TO BEGIN PAYING CAREGIVERS FOR THEIR TIME PROVIDING EDUCATION AT THESE TWO TREATMENT LOCATIONS. THE EDUCATION WAS SUSPENDED DUE TO THE PANDEMIC, BUT WE HOPE TO RESUME IT ONCE IT IS SAFE TO DO SO. CHILDHOOD TRAUMA SOME EFFORTS TO ADDRESS CHILDHOOD TRAUMA HAV SCHEDULE H, PART V, SECTION B, LINE 11 (ADDRESSING NEEDS FROM THE CHNA) HEALTH NEEDS IDENTIFIED BUT NOT PRIORITIZED: - ACCESS TO CARE: ONGOING EFFORTS THROUGH HEALTH SERVICES TO BRING MORE PROVIDERS INTO THE COMMUNITY COVERING A RANGE OF SPECIALTIES, INCLUDING PRIMARY CARE AND GERIATRIC SERVICES. - HOMELESSNESS: CHAC DOES NOT HAVE ENOUGH RESOURCES TO MANAGE THIS PROBLEM. HOMELESS PROVIDERS IN THE AREA MEET THROUGH THE CECIL COUNTY INTERAGENCY COUNCIL ON HOMELESSNESS TO WORK THROUGH ISSUES AND FIND ADDITIONAL SUPPORTS. - CHRONIC DISEASE: CHRONIC DISEASES IDENTIFIED: ARTHRITIS, ASTHMA, COPD, HEART DISEASE, HYPERTENSION, OBESITY, STROKE, AND DIABETES. WHILE RESOURCE CONSTRAINTS LIMIT THE ABILITY TO IMPLEMENT TARGETED PROGRAMS, THERE ARE ONGOING EFFORTS THROUGH HEALTH SERVICES TO BRING MORE PROVIDERS INTO THE COMMUNITY COVERING A RANGE OF SPECIALTIES, INCLUDING PRIMARY CARE AND GERIATRIC SERVICES. - DENTAL HEALTH: WITH THE DENTAL CLINIC CLOSURE, STARTING A NEW EFFORT TO MANAGE DENTAL HEALTH NEEDS IN VULNERABLE COMMUNITIES WAS NOT FEASIBLE. THE DENTAL ADVISORY COMMITTEE IS CURRENTLY WORKING ON STRATEGIES TO INCREASE AWARENESS AROUND DENTAL HEALTH IN VULNERABLE AND UNDERSERVED NEIGHBORHOODS, PRIMARILY WORKING THROUGH NEIGHBORHOOD COMMUNITY CENTERS AND LOCAL LIBRARIES. - TOBACCO USE: TOBACCO USE IS A RISK FACTOR THAT IS ADDRESSED THROUGH PROGRAMS AT THE CECIL COUNTY HEALTH DEPARTMENT AND THROUGH THE MARYLAND QUITLINE. - INFECTIOUS & COMMUNICABLE DISEASES: THERE ARE PROGRAMS IN PLACE THROUGH THE CECIL COUNTY HEALTH DEPARTMENT TO ADDRESS INFECTIOUS AND COMMUNICABLE DISEASE. - VACCINATION: ADDRESSED BY THE SCHOOLS, CECIL COUNTY HEALTH DEPARTMENT, UNION HOSPITAL, AND PHYSICIAN PRACTICES. - ENVIRONMENTAL HEALTH: ADDRESSED BY DEPT OF NATURAL RESOURCES AND CECIL COUNTY HEATH DEPT. LACK OF AVAILABLE RESOURCES; TOO BROAD. - INJURIES MOTOR VEHICLE/PEDESTRIAN: ADDRESSED BY LAW ENFORCEMENT AND THE DEPT OF TRANSPORTATION. - CHILD ABUSE AND NEGLECT: HANDLED THROUGH REPORTS TO CPS AND MEDICAL EXAMS FROM THE CECIL COUNTY CHILD ADVOCACY CENTER - DOMESTIC VIOLENCE: ADDRESSED BY THE DOMESTIC VIOLENCE SHELTER, A PART OF THE DEPARTMENT OF SOCIAL SERVICES, AND LOCAL LAW ENFORCEMENT - VIOLENT CRIME: ADDRESSED BY LOCAL AND STATE LAW ENFORCEMENT IN CECIL COUNTY. AGENCIES AND HEALTH CARE SERVICES ALSO PARTNER WITH LAW ENFORCEMENT TO SUPPORT THEIR EFFORTS. - SUICIDE: ADDRESSED THROUGH INPATIENT AND OUTPATIENT PROGRAMS IN THE COMMUNITY, MEDIATION SERVICES LIKE EASTERN SHORE MOBILE CRISIS, UPPER BAY COUNSELING SERVICES, AND HOT- AND WARM-LINES PROVIDING REAL-TIME INTERVENTIONS TO THOSE AT-RISK FOR SUICIDE. BARRIERS TO CARE IDENTIFIED BUT NOT PRIORITIZED: - INCOME & POVERTY: MAY BE ADDRESSED AS PART OF EACH OF THE HEALTH PRIORITY AREAS. REQUIRES STRONGER GOVERNMENT/PUBLIC PROGRAMS AND AND FUNDING TO SUPPORT OVERCOMING THESE BARRIERS. - EMPLOYMENT: MAY BE ADDRESSED AS PART OF THE BEHAVIORAL HEALTH PRIORITY. OTHERWISE ADDRESSED BY SUSQUEHANNA WORKFORCE NETWORK, CECIL COLLEGE, AND OTHER LOCAL NON-PROFITS, LIKE THOSE THAT ASSIST VETERANS. - HEALTH INSURANCE AVAILABILITY AND COST: ADDRESSED THROUGH THE MARYLAND HEALTH CONNECTION AND SEEDCO. - TRANSPORTATION: ADDRESSED THROUGH VOUCHER PROGRAMS AT DEPT OF COMMUNITY SERVICES AND THROUGH LOCAL PARTNERSHIPS. - HEALTH CARE COSTS: ADDRESSED THROUGH PROGRAMS LIKE: UNION HOSPITAL COMMUNITY ASSISTED MEDICATION PROGRAM (CAMP), THE UNION HOSPITAL CANCER PROGRAM COMMUNITY OUTREACH SUPPORT, MANY OUTREACH PROGRAMS AT THE CECIL COUNTY HEALTH DEPARTMENT, LOCAL PHARMACY ASSISTANCE PROGRAMS, AND THE DEPARTMENT OF COMMUNITY SERVICES ASSISTANCE PROGRAMS THROUGH MAPP, OPTIONS COUNSELING, AND COMMUNITY FIRST CHOICE. - HOME HEALTH ELIGIBILITY: ADDRESSED THROUGH PROGRAMS THAT ASSIST PERSONS WITH THE APPLICATION PROCESS (EX. THE COUNTY DEPARTMENT OF COMMUNITY SERVICES). - LACK OF KNOWLEDGE (INCL. LOW HEALTH LITERACY, LACK OF ACCESS TO HEALTH INFORMATION): OPPORTUNITIES TO ADDRESS HEALTH LITERACY ARE BEING EXPLORED FOR ALL PRIORITY AREAS. - PUBLIC ASSISTANCE QUALIFICATIONS: ADDRESSED THROUGH CECIL COUNTY HEALTH DEPARTMENT, THE DEPARTMENT OF COMMUNITY SERVICES, THE DEPARTMENT OF SOCIAL SERVICES, AND THE CERTIFIED HEALTH INSURANCE NAVIGATORS THROUGH SEEDCO AND THE MARYLAND HEALTH CONNECTION. - NEED FOR MORE MEDICAL AND SOCIAL SUPPORTS: ADDRESSED BY DEPT OF SOCIAL SERVICES, DEPT OF COMMUNITY SERVICES, CECIL COUNTY HEALTH DEPARTMENT, AND OTHER SOCIAL SERVICES. - EDUCATIONAL ATTAINMENT: ADDRESSED BY LOCAL NON-PROFITS WORK WITH SPECIAL AND VULNERABLE POPULATIONS WHO EXPERIENCE BARRIERS TO GETTING A GED; LOCAL FEDERAL CREDIT UNIONS PROVIDE EDUCATION ON HOW TO AFFORDABLY FINANCE EDUCATION; CECIL COLLEGE OFFERS SCHOLARSHIPS TO ELIGIBLE INDIVIDUALS; AND WORKPLACES PROVIDE TUITION REIMBURSEMENT FOR APPLICABLE EDUCATIONAL ATTAINMENT (E.G.. WORKPLACE CERTIFICATIONS OR DEGREES). - AFFORDABLE HOUSING: AFFORDABLE HOUSING IS A LARGE BARRIER IN CECIL COUNTY, ESPECIALLY AMONG THE POOR AND LOW-INCOME. WHILE WAIT LISTS ARE LONG FOR MOST HOUSING PROGRAMS, THERE ARE AGENCIES IN THE COMMUNITY THAT MANAGE THIS ISSUE. ALSO, WHILE NEW DEVELOPMENT IS COSTLY, THERE ARE SOME RESOURCES AVAILABLE TO PURCHASE AND/OR REHAB EXISTING OR NEW PROPERTIES FOR TRANSITIONAL HOUSING. SOME COMMUNITY WORK HAS BEEN DONE TO STRIKE COMPROMISES WITH LANDLORDS TO HOUSE HOMELESS AND OTHER TENANTS WHO CAN DEMONSTRATE THE ABILITY TO SUSTAIN HOUSING. - LANGUAGE BARRIERS: LANGUAGE BARRIERS CAN BE ADDRESSED THROUGH THE USE OF INTERPRETERS. MOST PROGRAMS IN THE COUNTY HAVE ACCESS TO MEDICAL AND SOCIAL INTERPRETERS OR CONTRACTED INTERPRETER SERVICES. IF ACCESS IS A PROBLEM THEN THERE IS OPPORTUNITY TO PARTNER WITH ORGANIZATIONS THAT HAVE THESE RESOURCES. FOR PATIENTS OR CLIENTS WITH LANGUAGE BARRIERS THERE IS OPPORTUNITY FOR ORGANIZATIONS TO PROVIDE MATERIALS IN OTHER LANGUAGES AND HIRE OR ACCESS PROFESSIONALS THAT CAN SPEAK OTHER LANGUAGES. - TIME LIMITATIONS: IN ALL THE FOCUS GROUPS IT WAS VOICED THAT THERE ARE NOT ENOUGH DOCTORS' OFFICES OPEN IN THE EVENING HOURS. UNION HOSPITAL AND MANY OTHER PROVIDERS IN THE COMMUNITY HAVE ADDED EVENING AND WEEKEND HOURS FOR FREQUENTLY USED SERVICES, LIKE PRIMARY CARE AND URGENT CARE. --------------- SCHEDULE H, PART V, SECTION B, LINE 13B (DETAIL OF INCOME LEVEL) PATIENTS WITH A HOUSEHOLD INCOME UP TO 500% OF FPL AND WITH A FINANCIAL HARDSHIP (MEDICAL DEBT, INCURRED BY A FAMILY OVER A 12-MONTH PERIOD THAT EXCEEDS 25 PERCENT OF THE FAMILY INCOME) WILL RECEIVE A 25% ADJUSTMENT. --------------- SCHEDULE H, PART V, SECTION B, LINE 16A (FAP AVAILABILITY) FAP WEBSITE: HTTPS://WWW.UHCC.COM/PATIENT-FINANCIAL-SERVICES/FINANCIAL-ASSISTANCE/ --------------- SCHEDULE H, PART V, SECTION B, LINE 16B (FAP APPLICATION AVAILABILITY) FAP APPLICATION WEBSITE: HTTPS://WWW.UHCC.COM/PATIENT-FINANCIAL-SERVICES/FINANCIAL-ASSISTANCE/ --------------- SCHEDULE H, PART V, SECTION B, LINE 16C (FAP PLS AVAILABILITY) FAP PLAIN LANGUAGE SUMMARY WEBSITE: HTTPS://WWW.UHCC.COM/PATIENT-FINANCIAL-SERVICES/FINANCIAL-ASSISTANCE/ --------------- SCHEDULE H, PART V, SECTION B, LINE 16J (FAP OTHER AVAILABILITY) UNION HOSPITAL PLACES AN ADVERTISEMENT ONCE A YEAR IN THE LOCAL NEWSPAPERS OUTLINING THE FAP AND HOW TO APPLY. FAP IS PUBLICIZED ON ALL BILLING STATEMENTS, INVOICES, AND FINANCIAL CONSENT FORMS. FAP IS COMMUNICATED TO PATIENTS UPON DISCHARGE FROM INPATIENT, OBSERVATION, AND SURGICAL SERVICES. PART I, LINE 7 (BAD DEBT EXPENSE, COSTING METHODOLOGY USED) IMPLICIT PRICE CONCESSIONS ARE TREATED AS A CONTRA-REVENUE ITEM ON THE STATEMENT OF REVENUE. AS A RESULT, THERE ARE NO BAD DEBT EXPENSES INCLUDED ON FORM 990, PART IX THAT NEED TO BE SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGES LISTED. THE COSTING METHODOLOGY USED IN CALCULATING THE AMOUNTS REPORTED ON THE LINE 7 TABLE ARE BASED ON ACTUAL COST PLUS OVERHEAD. OVERHEAD IS A HOSPITAL AVERAGE PERCENTAGE OF OVERHEAD TO DIRECT COSTS. DIRECT COSTS EXCLUDE BAD DEBT EXPENSE. --------------- PART II (DETAIL OF COMMUNITY BUILDING ACTIVITIES) IN FISCAL YEAR 2020, UNION HOSPITAL PARTICIPATED IN ECONOMIC DEVELOPMENT COMMUNITY BUILDING ACTIVITIES THROUGH THE PARTICIPATION OF ITS PRESIDENT, RICH SZUMEL, ON THE BOARDS OF THE ECONOMIC DEVELOPMENT COMMISSION FOR CECIL COUNTY AND THE ELKTON ALLIANCE. THE ECONOMIC DEVELOPMENT COMMISSION FOCUSES ON BUSINESS AND INDUSTRY DEVELOPMENT BY BUILDING RELATIONSHIPS WITH LOCAL PARTNERS IN CECIL COUNTY. UNION HOSPITAL COLLABORATES WITH THIS COMMISSION TO PROMOTE STABILITY WITHIN THE HOSPITAL'S WORKFORCE AND TO BRING MUCH NEEDED PRACTITIONERS TO THE AREA, ESPECIALLY WHERE THERE ARE TOO FEW PROVIDERS OR IDENTIFIED SERVICE GAPS. THE ELKTON ALLIANCE COLLABORATES WITH LOCAL GOVERNMENT AND BUSINESS COMMUNITIES TO RESTORE, PROMOTE, AND MAINTAIN THE DIVERSE HISTORIC DOWNTOWN ELKTON AREA, WHILE ATTRACTING NEW ENTERPRISES FOR THE BENEFIT OF COMMUNITY RESIDENTS, BUSINESSES, AND VISITORS. IN COLLABORATING WITH THE ELKTON ALLIANCE, UNION HOSPITAL SEEKS TO MAINTAIN A POSITIVE PRESENCE IN THE COMMUNITY BY HELPING TO ADDRESS COMMUNITY DEVELOPMENT ISSUES. IN FY 2020, DR. RICH SZUMEL ALSO PARTICIPATED IN COMMUNITY SUPPORT COMMUNITY BUILDING ACTIVITIES THROUGH HIS PARTICIPATION ON THE LOCAL MANAGEMENT BOARD OF CECIL COUNTY. THE CORE FUNCTION OF LOCAL MANAGEMENT BOARDS (LMBS) IS TO IDENTIFY COMMUNITY DRIVEN PRIORITIES AND TARGET RESOURCES FOR THEIR COMMUNITIES, AS WELL AS SERVE AS THE COORDINATOR OF COLLABORATION FOR CHILD AND FAMILY SERVICES. THERE IS A LOCAL MANAGEMENT BOARD IN EACH COUNTY IN MARYLAND, INCLUDING BALTIMORE CITY. ON THIS BOARD, DR. SZUMEL PROVIDED INSIGHT ON THE CONNECTION BETWEEN HOSPITAL SERVICES/POPULATION HEALTH INITIATIVES AND SUPPORT FOR COMMUNITY DIRECTIVES/STRATEGIC PRIORITIES. --------------- PART III, SECTION A, LINE 2 (IMPLICIT PRICE CONCESSIONS/BAD DEBT EXPENSE) THE COSTING METHODOLOGY USED IN DETERMINING THE AMOUNTS REPORTED ON LINES 2 AND 3 ARE BASED ON ACTUAL CHARGES WRITTEN OFF (AMOUNTS THAT ARE DEEMED TO BE UNCOLLECTIBLE AND RECORDED AS IMPLICIT PRICE CONCESSIONS UNDER ACCOUNTING PRONOUNCEMENT ASC 606)TIMES THE COST TO CHARGE RATIO. --------------- PART III, SECTION A, LINE 3 (IMPLICIT PRICE CONCESSION METHODOLOGY) THE IMPLICIT PRICE CONCESSION METHODOLOGY ASSUMES THAT THE PERCENTAGE OF CHARITY CARE TO TOTAL REVENUE CAN BE APPLIED TO THE AMOUNT OF IMPLICIT PRICE CONCESSIONS FOR THE YEAR. OTHER IMPLICIT PRICE CONCESSION AMOUNTS ARE NOT INCLUDED IN COMMUNITY BENEFITS. --------------- PART III, SECTION A, LINE 4 (IMPLICIT PRICE CONCESSION FOOTNOTE) THE TEXT OF THE IMPLICIT PRICE CONCESSION (BAD DEBT EXPENSE) FOOTNOTE CAN BE FOUND ON PAGE 13 OF THE ELECTRONICALLY ATTACHED AUDITED FINANCIAL STATEMENTS. --------------- PART III, SECTION B, LINE 8 (COSTING METHODOLOGY, MEDICARE SHORTFALL) COSTING METHODOLOGY USED TO DETERMINE AMOUNT OF MEDICARE ALLOWABLE COSTS: MEDICARE ALLOWABLE COSTS EQUAL MEDICARE REVENUE ADJUSTED FOR THE HOSPITAL TOTAL RATIO OF PATIENT CARE COSTS TO CHARGES DUE TO THE FACT THAT MEDICARE PAYS FULL CHARGES IN MARYLAND. EXTENT TO WHICH MEDICARE SHORTFALL SHOULD BE TREATED AS COMMUNITY BENEFIT: IN THE STATE OF MARYLAND, MEDICARE PAYS FULL CHARGES. THERE IS NO SHORTFALL THAT SHOULD BE TREATED AS A COMMUNITY BENEFIT. --------------- PART III, SECTION B, LINE 9B (COLLECTION PRACTICES) UNION HOSPITAL'S F-416 CREDIT AND COLLECTION POLICY AND PROCEDURE HAS A SECTION CALLED, "INTERNAL COLLECTION EFFORTS" WHICH STATES: "UPON DISCHARGE, PATIENTS RECEIVE AN ITEMIZED BILL FOR INPATIENT ADMISSIONS IN ACCORDANCE WITH THE MARYLAND HOSPITAL COST REVIEW COMMISSION REQUIREMENTS. WHEN INSURANCE PAYMENTS ARE RECEIVED LEAVING A SELF-PAY BALANCE, OR THE ACCOUNT IS STRICTLY SELF-PAY, IT IS OUTSOURCED FOR FOLLOW-UP BUT REMAINS ON THE HOSPITAL'S ACTIVE ACCOUNTS RECEIVABLE. AGENTS WORK THE ACCOUNTS IN THE HOSPITAL'S NAME AND REPRESENTATIVES ARE DIRECTED TO ACCEPT MONTHLY PAYMENTS UNTIL THE ACCOUNT IS PAID IN FULL. COLLECTION EFFORTS CONSIST OF PHONE CALLS AND MONTHLY STATEMENTS. THE PATIENT MAY ALSO APPLY FOR FINANCIAL ASSISTANCE AT ANY TIME DURING THIS PROCESS (SEE POLICY F-415, FINANCIAL ASSISTANCE)." IN THE F-415 FINANCIAL ASSISTANCE POLICY AND PROCEDURE, UNDER SECTION, "ACTION IN THE EVENT OF NON-PAYMENT," IT IS EXPLAINED THAT: "A. UNION HOSPITAL MAY CONTRACT WITH OUTSIDE COLLECTION SERVICES TO PURSUE COLLECTION OF DELINQUENT ACCOUNTS. ALL UNPAID ACCOUNTS WITHOUT EXCEPTION OR PAYMENT ARRANGEMENTS ARE PLACED IN OUTSIDE COLLECTION AFTER A MINIMUM OF 90 DAYS FROM THE INITIAL BILLING STATEMENT AND DELIVERY OF ALL SCHEDULED PATIENT ACCOUNT STATEMENTS TO THE PATIENT/GUARANTOR. B. UNION HOSPITAL DOES NOT CONDUCT, OR PERMIT COLLECTION AGENCIES TO CONDUCT ON THEIR BEHALF, EXTRAORDINARY COLLECTIONS EFFORTS AGAINST INDIVIDUALS." IN ADDITION, IN THE F-416 POLICY, UNDER THE SECTION, "EXTERNAL COLLECTION (BAD DEBT WRITE-OFF)," IT EXPLAINS THAT PATIENTS WITH BALANCES BEING COLLECTED BY AN ASSIGNED COLLECTION AGENCY WILL HAVE THEIR BALANCES WIRTTEN OFF IF THEY ARE DETERMINED TO BE INDIGENT. --------------- PART VI, LINE 2 (NEEDS ASSESSMENT) UNION HOSPITAL ASSESSES THE HEALTH CARE NEEDS OF THE COMMUNITIES IT SERVES THROUGH ITS ROBUST COMMUNITY PARTNERSHIPS. PERHAPS ITS MOST SIGNIFICANT PARTNERSHIPS ARE WITH THE CECIL COUNTY HEALTH DEPARTMENT (CCHD) AND THE COMMUNITY HEALTH ADVISORY COMMITTEE (CHAC). UNION HOSPITAL HAS PARTNERED WITH THE CCHD TO CONDUCT AND COMPLETE ITS NEEDS ASSESSMENT (CHNA) SINCE 2013. THE CHAC ALSO PLAYS A SIGNIFICANT ROLE IN THIS PROCESS AS IT PROVIDES SUBSTANTIAL INPUT ON THE SELECTION OF THE PRIORITIZED NEEDS AND IT GOVERNS THE HEALTH TASK FORCES THAT WORK ON AND MONITOR PROGRESS MADE ON THE COMMUNITY HEALTH IMPROVEMENT PLAN (CHIP) STRATEGIES THAT ADDRESS THE HEALTH PRIORITIES IDENTIFIED IN THE CHNA. THE CCHD IS INVOLVED IN MANY HEALTH INITIATIVES THROUGHOUT CECIL COUNTY AND THE CHAC IS COMPRISED OF A NUMBER OF LOCAL GOVERNMENT AND COMMUNITY ORGANIZATIONS. THESE PARTNERSHIPS PROVIDE UNION HOSPITAL WITH RICH INSIGHT INTO THE HEALTH OF OUR COMMUNITY. UNION HOSPITAL CAREGIVERS ALSO PARTICIPATE IN A NUMBER OF DIFFERENT COMMUNITY BOARDS AND COMMITTEES THAT FOCUS ON DIFFERENT AREAS OF COMMUNITY NEED AND INTEREST. BESIDES THE MANY ALREADY MENTIONED IN PRIOR SECTIONS: - CECIL COUNTY DRUG AND ALCOHOL COUNCIL - CECIL COUNTY CORE SERVICES AGENCY - CHILD ADVOCACY CENTER - CIT ADVISORY COMMITTEE - CIT COMMITTEE - ECONOMIC DEVELOPMENT COMMISSION - ELKTON ALLIANCE - LOCAL MANAGEMENT BOARD OF CECIL COUNTY - LOCAL OVERDOSE FATALITY REVIEW TEAM IN FY 2020, UNION HOSPITAL ALSO PARTICIPATED IN THESE ADDITIONAL GROUPS: - CECIL COUNTY DEPARTMENT OF SOCIAL SERVICES BOARD - ELKTON ROTARY - MARYLAND STRATEGIC PREVENTION FRAMEWORK IN JANUARY 2020, UNION HOSPITAL BECAME A PART OF CHRISTIANACARE. CHRISTIANACARE IS ONE OF THE COUNTRY'S MOST DYNAMIC HEALTH CARE ORGANIZATIONS, CENTERED ON IMPROVING HEALTH OUTCOMES, MAKING HIGH-QUALITY CARE MORE ACCESSIBLE AND LOWERING HEALTH CARE COSTS. CHRISTIANACARE ALSO ABIDES BY THE CHRISTIANACARE WAY: WE SERVE OUR NEIGHBORS AS RESPECTFUL, EXPERT, CARING PARTNERS IN THEIR HEALTH. WE DO THIS BY CREATING INNOVATIVE, EFFECTIVE, AFFORDABLE SYSTEMS OF CARE THAT OUR NEIGHBORS VALUE. CHRISTIANACARE IS GUIDED BY ITS COMMITMENT TO PARTNERING WITH OUR NEIGHBORS TO BETTER UNDERSTAND THEIR NEEDS AND GOALS FOR HEALTH. UNION HOSPITAL WAS ALREADY UNDERTAKING THE CHRISTIANACARE WAY IN SPIRIT, AND WE EXPECT OUR COMMUNITY PARTNERSHIPS TO CONTINUE TO STRENGTHEN. --------------- PART VI, LINE 3 (PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE) UNION HOSPITAL OF CECIL COUNTY UTILIZES A FINANCIAL ASSISTANCE POLICY (FAP) TO ENSURE THAT THE HOSPITAL'S STAFF FOLLOWS A CONSISTENT AND EQUITABLE PROCESS IN GRANTING FINANCIAL ASSISTANCE TO PATIENTS, WHILE RESPECTING THE INDIVIDUAL'S DIGNITY. THE POLICY ADHERES TO THE ESTABLISHED MARYLAND STATE FINANCIAL ASSISTANCE GUIDELINES. THE FAP CLEARLY DEFINES PATIENT EXPECTATIONS, OFFERS A STEP-BY-STEP PROCESS FOR PATIENT APPLICATION, DOCUMENT REVIEW, AND REQUEST FOR MORE INFORMATION. INDIVIDUALS WHO PRESENT TO UNION HOSPITAL IN PERSON TO DISCUSS A BILL ARE PROVIDED WITH A FINANCIAL ASSISTANCE APPLICATION. ALL INPATIENT, SELF-PAY PATIENTS ARE VISITED BY FINANCIAL ASSISTANCE NAVIGATORS AND ARE SCREENED FOR THE FINANCIAL ASSISTANCE PROGRAM, AS WELL AS FOR MEDICAID AND OTHER STATE AND COUNTY PROGRAMS.FOLLOWING DISCHARGE FROM THE HOSPITAL, EACH PATIENT RECEIVES A SUMMARY OF CHARGES WHICH INCLUDES NOTICE OF THE FINANCIAL ASSISTANCE PROGRAM AND A DESIGNATED CONTACT TELEPHONE NUMBER AND EMAIL. PATIENT BILLING ALSO INCLUDES INFORMATION ON HOW TO APPLY FOR FINANCIAL ASSISTANCE. THE FINANCIAL ASSISTANCE APPLICATION IS AVAILABLE TO ALL UNDERINSURED AND UNINSURED PATIENTS OF UNION HOSPITAL. ALL FINANCIAL ASSISTANCE APPLICATIONS RECEIVED ARE PROCESSED FOR ELIGIBILITY. PATIENTS WHO ARE NOT ELIGIBLE FOR FINANCIAL ASSISTANCE ARE REFERRED TO THE CECIL COUNTY HEALTH DEPARTMENT, OTHER STATE PROGRAMS, THE MARYLAND HEALTH CONNECTION, AND MEDICAID TO DETERMINE IF OTHER ASSISTANCE IS AVAILABLE. FINANCIAL ASSISTANCE APPLICATIONS AND FAP SIGNAGE ARE LOCATED THROUGHOUT THE HOSPITAL, EMERGENCY ROOM, AND OUTPATIENT AREAS. THE FINANCIAL ASSISTANCE APPLICATION AND BROCHURE (ENGLISH AND SPANISH) ARE AVAILABLE ON THE HOSPITAL'S WEBSITE: HTTPS://WWW.UHCC.COM/PATIENT-FINANCIAL-SERVICES/FINANCIAL-ASSISTANCE/. IN ADDITION, UNION HOSPITAL PLACES AN ADVERTISEMENT ONCE A YEAR IN THE LOCAL NEWSPAPERS OUTLINING THE FAP, HOW TO ACCESS FINANCIAL ASSISTANCE MATERIALS, AND HOW TO APPLY FOR FINANCIAL ASSISTANCE. --------------- PART VI, LINE 4 (COMMUNITY INFORMATION) UNION HOSPITAL IS THE ONLY HOSPITAL IN CECIL COUNTY AND SERVES THE ENTIRE COUNTY. CECIL COUNTY IS LOCATED IN THE UPPER NORTHEASTERN CORNER OF THE CHESAPEAKE BAY IN MARYLAND AND BORDERS PENNSYLVANIA AND DELAWARE. THE COUNTY SEAT IS ELKTON, MARYLAND, AND THERE ARE EIGHT TOWNS AND SEVEN UNINCORPORATED COMMUNITIES IN THE COUNTY. PRIMARY SERVICE AREA 21921 - ELKTON 21922 - ELKTON 21901 - NORTH EAST 21916 - CHILDS 21920 - ELK MILLS 21915 - CHESAPEAKE CITY 21914 - CHARLESTOWN 21911 - RISING SUN 21912 - WARWICK 21913 - CECILTON 21919 - EARLEVILLE SECONDARY SERVICE AREA 21902 - PERRYPOINT 21903 - PERRYVILLE 21904 - PORT DEPOSIT 21917 - COLORA 21918 - CONOWINGO 21930 - GEORGETOWN THE LARGEST POPULATION CENTERS IN CECIL COUNTY ARE ELKTON (21921), NORTH EAST, AND RISING SUN. HOSPITAL UTILIZATION SHOWS THAT 60% OF THE HOSPITAL'S PATIENTS COME FROM ELKTON AND NORTH EAST. ACCORDING TO THE CENSUS BUREAU, IN 2019 THE CECIL COUNTY POPULATION WAS ESTIMATED TO BE 102,855 WITH 22.5% UNDER THE AGE OF 18 AND 16.2% AGED 65 AND OLDER. 50.5% OF THE POPULATION IS FEMALE. CECIL COUNTY IS LESS RACIALLY DIVERSE THAN MARYLAND WITH 84.6% WHITE (NOT IDENTIFYING AS HISPANIC OR LATINO), 7.3% BLACK OR AFRICAN AMERICAN, 4.7% HISPANIC OR LATINO, AND 1.4% ASIAN. THE MEDIAN INCOME IS $76,887 IN THE COUNTY ($84,805 IN MARYLAND) AND THERE IS A 10.3% POVERTY RATE. 89.5% OF CECIL COUNTY RESIDENTS ARE HIGH SCHOOL GRADUATES OR HIGHER AND 23.9% HAVE A BACHELOR'S DEGREE OR HIGHER (40.2% MARYLANDERS HAVE A BACHELOR'S DEGREE OR HIGHER). CECIL COUNTY IS A LARGELY RURAL AREA AND ACCESSING SERVICES CAN BE CHALLENGING, ESPECIALLY IF INDIVIDUALS ALSO FACE A LACK OF TRANSPORTATION AND OTHER BARRIERS. (CENSUS BUREAU, QUICKFACTS, HTTPS://WWW.CENSUS.GOV/QUICKFACTS/CECILCOUNTYMARYLAND) --------------- PART VI, LINE 5 (INFORMATION REGARDING PROMOTION OF COMMUNITY HEALTH) FISCAL YEAR 2020 BROUGHT A LOT OF CHANGES TO UNION HOSPITAL. IT JOINED CHRISTIANACARE IN JANUARY 2020, UNION HOSPITAL'S COMMUNITY BENEFIT MANAGER WHO HAS LED MOST COMMUNITY BENEFIT ACTIVITIES FOR YEARS LEFT IN THE EARLY MONTHS OF THE FISCAL YEAR, AND THE PANDEMIC BROUGHT TO A HALT MANY COMMUNITY ACTIVITIES THAT WOULD TYPICALLY OCCUR IN THE SPRING. WHILE IT HAS BEEN CHALLENGING TO PROVIDE THE SAME COMMUNITY BENEFIT SERVICES AMIDST THE PANDEMIC, LIKE OUR ON-SITE YOUTH PROGRAMMING CAMP SCRUBS AND THE EXPLORERS POST, ALL OF THESE CHANGES PROVIDE EXCELLENT OPPORTUNITIES TO STRENGTHEN OUR COMMUNITY BENEFIT EFFORTS AND CONSIDER OUR COMMUNITY CHALLENGES WITH A NEW PERSPECTIVE. GUIDED BY THE CHRISTIANACARE WAY AND OUR VALUES OF LOVE AND EXCELLENCE, CHRISTIANACARE INCLUDES AN EXTENSIVE NETWORK OF OUTPATIENT SERVICES, HOME HEALTH CARE, URGENT CARE CENTERS, THREE HOSPITALS (1,299 BEDS), A LEVEL I TRAUMA CENTER AND A LEVEL III NEONATAL INTENSIVE CARE UNIT, A COMPREHENSIVE STROKE CENTER AND REGIONAL CENTERS OF EXCELLENCE IN HEART AND VASCULAR CARE, CANCER CARE AND WOMEN'S HEALTH. IT ALSO INCLUDES THE PIONEERING GENE EDITING INSTITUTE AND WAS RATED BY IDG COMPUTERWORLD AS ONE OF THE NATION'S BEST PLACES TO WORK IN IT. CHRISTIANACARE IS A NONPROFIT TEACHING HEALTH SYSTEM WITH MORE THAN 281 RESIDENTS AND FELLOWS. CHRISTIANACARE IS CONTINUALLY RANKED BY US NEWS & WORLD REPORT AS A BEST HOSPITAL. WITH OUR UNIQUE, DATA-POWERED CARE COORDINATION SERVICE CAREVIO AND A FOCUS ON POPULATION HEALTH AND VALUE-BASED CARE, CHRISTIANACARE IS SHAPING THE FUTURE OF HEALTH CARE. UNION HOSPITAL, NOW KNOWN AS CHRISTIANACARE, UNION HOSPITAL, WILL BENEFIT FROM ALL THE EXPERTISE AND INNOVATION OF CHRISTIANACARE AND WE FULLY EXPECT TO ALSO LEARN FROM UNION HOSPITAL, PARTICULARLY AS WE STRIVE TO SERVE A LESS DIVERSE AND MORE RURAL POPULATION IN CECIL COUNTY WITH ITS OWN SET OF UNIQUE CHALLENGES AND STRENGTHS. CHRISTIANACARE SYSTEM LEVEL COMMUNITY HEALTH AND POPULATION HEALTH TEAMS ARE WORKING ON INTEGRATION AND WE LOOK FORWARD TO CONTINUED LEARNING FROM OUR UNION HOSPITAL CAREGIVERS AND CECIL COUNTY NEIGHBORS AND STRENGTHENED POSITIVE IMPACT ON THE COMMUNITY. EACH FISCAL YEAR, UNION HOSPITAL SERVES THE CECIL COUNTY COMMUNITY BY PROVIDING ACTIVITIES, PROGRAMS, AND INITIATIVES THAT SEEK TO IMPROVE COMMUNITY HEALTH, ESPECIALLY SERVING UNDERSERVED AREAS AND VULNERABLE POPULATIONS. WHILE MANY OF THESE ACTIVITIES WERE HALTED IN MARCH 2020 AND SOME WERE UNABLE TO BE COMPLETED AS THE RECENTLY DEPARTED COMMUNITY BENEFIT MANAGER WAS LEADING THEM, NEVERTHELESS, WE PROVIDED SERVICES TO THE COMMUNITY IN FY 2020. THE FOLLOWING IS A SUMMARY OF THE COMMUNITY BENEFIT ACTIVITIES, PROGRAMS, AND INITIATIVES THAT UNION HOSPITAL PROVIDED IN CECIL COUNTY DURING FY 2020 THAT HAVE NOT BEEN MENTIONED PREVIOUSLY IN THIS NARRATIVE: A1: COMMUNITY HEALTH EDUCATION UNION HOSPITAL PROVIDED: - A VARIETY OF HEALTH EDUCATION PRESENTATIONS IN THE COMMUNITY ON TOPICS SUCH AS DIABETES, BREAST CANCER, AND NUTRITION - EXPLORER POST AT UNION HOSPITAL AND CAMP SCRUBS FOR STUDENTS SEEKING EXPOSURE TO MEDICAL OR HEALTH SCIENCE EXPERIENCES - SUPPORT GROUPS FOR NEW MOMS, BREAST CANCER SURVIVORS, AND DIABETES - TARGETED EDUCATION AT TREATMENT CLINICS FOR NEW MOMS WHOSE BABIES MAY BE DELIVERED WITH NEONATAL ABSTINENCE SYNDROME A2: COMMUNITY-BASED CLINICAL SERVICES UNION HOSPITAL PROVIDED: - FREE FOOT AND EYE SCREENINGS FOR DIABETICS - TYPICALLY, UNION HOSPITAL ALSO PROVIDES FREE HEAD AND NECK CANCER SCREENINGS, BUT THESE WERE CANCELLED DUE TO THE PANDEMIC. - UNION HOSPITAL ALSO PROVIDES A FREE SPORTS PHYSICALS CLINIC FOR COUNTY PUBLIC AND PRIVATE MIDDLE SCHOOL AND HIGH SCHOOL STUDENTS - THIS EVENT WAS POSTPONED DUE TO THE PANDEMIC. WHILE IT DID NOT HAPPEN IN FY 20, IT HAPPENED IN EARLY FY 21. A4: SOCIAL AND ENVIRONMENTAL IMPROVEMENTS UNION HOSPITAL: - PARTICIPATED IN BOARD SERVICE WITH ORGANIZATIONS SUPPORTING SOCIAL AND ENVIRONMENTAL HEALTH - PROVIDED TRANSPORTATION DONATIONS FOR ELIGIBLE (NEEDS-BASED) PATIENTS AND THEIR FAMILIES B1-B3: HEALTH PROFESSIONS EDUCATION UNION HOSPITAL STAFF PRECEPTED POST-SECONDARY STUDENTS THROUGH STUDENT EXPERIENCES FOR NURSING AND MEDICAL RESIDENCY CLINICAL ROTATIONS, GRADUATE STUDENT INTERNSHIPS, AND ALLIED HEALTH OBSERVATIONS AND INTERNSHIPS. C: MISSION DRIVEN HEALTH SERVICES UNION HOSPITAL PROVIDED THESE SERVICES TO MEET IDENTIFIED NEEDS IN THE COMMUNITY, EVEN THOUGH THEY OPERATE AT A LOSS: - EMPLOYED PHYSICIAN PRACTICE SUBSIDIES (C3) - ADULT DAY SERVICES FOR OLDER ADULT CLIENTS WITH DEMENTIA AND OTHER NEUROLOGICAL DISORDERS (C7) - HOSPICE CARE (C9) D1: CLINICAL RESEARCH UNION HOSPITAL MAINTAINED A CANCER REGISTRY THROUGH THE CANCER PROGRAM THAT WAS AVAILABLE TO HEALTH SERVICE PROVIDERS AND RESEARCHERS. E3: IN-KIND CONTRIBUTIONS UNION HOSPITAL PROVIDED DONATIONS OF TIME AND MATERIALS FOR THE CECIL COUNTY COMMUNITY BY: - PROVIDING FREE AMBULANCE TRANSPORTS AND FREE SUPPLIES FOR AMBULANCE STOCK-UPS - GIVING BLOOD AT BLOOD DRIVES HELD AT THE HOSPITAL AND OTHER LOCAL DONOR LOCATIONS - ATTENDING MEETINGS FOR COMMUNITY HEALTH IMPROVEMENT (LOCAL HEALTH IMPROVEMENT COALITION, COMMUNITY BOARDS, COALITIONS, ETC.) - PROVIDING FOOD FOR THE HOME DELIVERED MEALS PROGRAM (MEALS ON WHEELS) IN A PARTNERSHIP BETWEEN UNION HOSPITAL'S FOOD SERVICE DEPARTMENT AND THE CECIL COUNTY DEPARTMENT OF COMMUNITY SERVICES' AGING AND DISABILITY RESOURCE CENTER AND COMMUNITY WELLNESS DIVISIONS - PROVIDING FREE NOTARY SERVICES FOR THE COMMUNITY ONLY 3 MONTHS OF FY 2020 WERE AFFECTED BY THE PANDEMIC, BUT UNFORTUNATELY, PROGRAMMING LIKE BLOOD DRIVES, SPORTS PHYSICALS, HEALTH FAIRS AND PRESENTATIONS, AND STUDENT INITIATIVES TYPICALLY OCCUR IN THE SPRING MONTHS. IN PERSON PROGRAMS SUCH AS THE PEER RECOVERY ADVOCATES PROGRAM AND THE NAS PARENTING EDUCATION WERE ALSO HALTED AND SO DESPITE ONLY AFFECTING A QUARTER OF THE YEAR, WE CERTAINLY FELT THE BURDEN OF THE PANDEMIC ON OUR COMMUNITY WORK IN FY 2020. UNION HOSPITAL ADAPTED WITH STRENGTH AND PERSEVERANCE AND LIKE THE REST OF THE NATION AND WORLD, WAS REMINDED THROUGH THE EXPERIENCE OF THE PANDEMIC HOW TRULY VITAL HEALTH IS TO OUR LIVES AND COMMUNITIES. WE ARE EAGER TO GET BACK INTO OUR COMMUNITIES AND NOT JUST VIRTUALLY! WITH THE SHARED LEARNING AND INTEGRATION BETWEEN UNION HOSPITAL AND CHRISTIANACARE, WE ARE EXCITED ABOUT THE NEW PROGRAMMING AND INITIATIVES TO BE INTRODUCED INTO CECIL COUNTY AS THE PANDEMIC SUBSIDES. OF COURSE, EVERY INITIATIVE WILL BE SUBJECT TO OUR PARTNER AND COMMUNITY'S APPROVAL AS WE STRIVE TO TRULY PARTNER WITH OUR COMMUNITIES. --------------- PART VI, LINE 6 (AFFILIATED HEALTHCARE SYSTEM INFORMATION) UNION HOSPITAL OF CECIL COUNTY, INC. IS PART OF AN AFFILIATED HEALTH CARE SYSTEM IN WHICH AFFINITY HEALTH ALLIANCE, INC. (AHA) IS THE PARENT ENTITY. AHA'S PURPOSE IS TO SUPPORT THE UNION HOSPITAL OF CECIL COUNTY IN PROVIDING HEALTH CARE AND HEALTH CARE RELATED SERVICES THROUGH THE EFFECTIVE MANAGEMENT OF ALL AFFILIATED CORPORATIONS. SPECIFICALLY, THIS INVOLVES COORDINATING SYSTEM WIDE POLICIES, FUNDRAISING AND STRATEGIC PLANNING PROGRAMS TO PROVIDE HEALTH CARE SERVICES IN RESPONSE TO THE MEDICAL, HUMAN AND RELATED SERVICE NEEDS OF THE COMMUNITY. OTHER TAX-EXEMPT ORGANIZATIONS IN THE GROUP INCLUDE THE UNION HOSPITAL OF CECIL COUNTY FOUNDATION, INC., UNION HOSPITAL OF CECIL COUNTY HEALTH SERVICES, INC., AND UNION HOSPITAL OF CECIL COUNTY ONCOLOGY, INC. THE FOUNDATION CONDUCTS AND SUPERVISES FUNDRAISING ACTIVITIES ON BEHALF OF ITS TAX-EXEMPT AFFILIATES. THE FOUNDATION ENGAGES IN CORPORATE FUNDRAISING, CAPITAL CAMPAIGNS, SPECIAL EVENTS, ACTIVITIES, AND A MULTI-FACETED COMMUNICATION PROGRAM THAT APPEALS TO PRIVATE AND CORPORATE CONTRIBUTORS. UNION HOSPITAL OF CECIL COUNTY HEALTH SERVICES, INC.'S MISSION IS TO OWN, MANAGE AND MAINTAIN PROPERTIES FOR HEALTH RELATED VENTURES TO SERVICE CECIL COUNTY AND THE SURROUNDING AREAS. THE ACTIVITIES OF THIS CORPORATION COMPLEMENT AND AUGMENT THE HEALTH CARE ACTIVITIES OF THE HOSPITAL. UNION HOSPITAL OF CECIL COUNTY ONCOLOGY, INC'S (THE "CORPORATION") DUTY AND MISSION IS TO PROVIDE HIGH QUALITY, ADVANCED RADIATION ONCOLOGY SERVICES TO THE CECIL COUNTY AREA IN ORDER TO FOSTER THE BEST CANCER TREATMENT PROCESS CLOSE TO HOME. CANCER-RELATED DEATHS ARE AMONG THE HIGHEST CAUSES OF MORTALITY IN CECIL COUNTY, SO IT IS THE CORPORATION'S MISSION TO BRING SOME OF THE MOST ADVANCED RADIATION THERAPIES TO CECIL COUNTY TO PROVIDE THE MOST COMPREHENSIVE CANCER CARE POSSIBLE TO THE PEOPLE LIVING WITH CANCER HERE AND IN NEIGHBORING COMMUNITIES. BY OFFERING THESE ADVANCED CANCER TREATMENT OPTIONS, THE CORPORATION FURTHERS ITS CHARITABLE PURPOSE OF PROVIDING MEDICAL SERVICES TO PROMOTE THE HEALTH AND WELFARE OF THE RESIDENTS OF CECIL COUNTY AND NEIGHBORING COMMUNITIES. UNION HOSPITAL OF CECIL COUNTY VENTURES, INC. IS A FOR-PROFIT STOCK CORPORATION. ITS PURPOSE IS TO ENGAGE IN ANY BUSINESS OR TRANSACTION WHICH WILL BENEFIT THE ACTIVITIES AND GOALS OF ITS AFFILIATES. OPERATIONS CONSIST PRIMARILY OF PROVIDING MANAGEMENT SUPPORT SERVICES FOR PHYSICIAN PRACTICES AND PROVIDING IMAGING SERVICES TO PHYSICIANS AND HEALTH CENTERS THROUGH ITS WHOLLY OWNED SUBSIDIARIES, TRIANGLE ALLIANCE LLC AND OPEN MRI AND IMAGING CENTER OF ELKTON LLC. ON JANUARY 1, 2020, AHA BECAME A MEMBER OF CHRISTIANA CARE HEALTH SYSTEM. CHRISTIANA CARE IS A MAJOR TEACHING HEALTH SYSTEM WITH MORE THAN 1,600 MEDICAL-STAFF MEMBERS AND 260 MEDICAL-DENTAL RESIDENTS AND FELLOWS AND INCLUDES A NUMBER OF ENTITIES INCLUDING CHRISTIANA CARE HEALTH SERVICES, INC. --------------- PART VI, LINE 7 (STATES FILING OF COMMUNITY BENEFIT REPORT) LIST OF STATES RECEIVING COMMUNITY BENEFIT REPORT: MD X X X X true true false false false false false true false RICHARD C SZUMEL MD PRESIDENT & CEO 0 461034 0 0 0 21647 0 77504 0 8287 0 568472 0 0 JOSE MA MD DIRECTOR 113761 0 132654 0 24236 0 3458 0 26163 0 300272 0 0 0 JAMES G RAAB SENIOR VP/CFO THRU 10/2020 0 265004 0 0 0 34345 0 3784 0 21672 0 324805 0 0 AARON Z ROYSTON THRU 1019 VP OF PROVIDER ENTERPRISE 177655 0 0 0 64790 0 2790 0 1382 0 246617 0 0 0 CRAIG M BABBITT IN-HOUSE LEGAL COUNSEL 284148 0 0 0 52033 0 4200 0 7080 0 347461 0 0 0 FAHD RAHMAN PHYSICIAN 378996 0 180294 0 131074 0 4200 0 26666 0 721230 0 0 0 JUSTIN SAUSVILLE MD DIRECTOR, PHYSICIAN 398786 0 29694 0 119804 0 4200 0 26722 0 579206 0 0 0 ROGER D WU PHYSICIAN 445628 0 26510 0 38436 0 4200 0 22536 0 537310 0 0 0 NAVEED HASAN PHYSICIAN 332313 0 27500 0 126411 0 4200 0 22267 0 512691 0 0 0 HANHAN LI PHYSICIAN 391867 0 17500 0 63172 0 4200 0 8430 0 485169 0 0 0 MICHELLE TWUM-DANSO ASSOCIATE VP HUMAN RESOURCES 168143 0 0 0 12177 0 1993 0 1618 0 183931 0 0 0 DR RYAN GERACIMOS CHIEF MEDICAL OFFICER 0 288101 0 0 0 14800 0 1511 0 1541 0 305953 0 0 MARIE VASBINDER SR. VP/CHIEF NURSE OFFICER 0 97550 0 0 0 119896 0 1613 0 781 0 219840 0 0 DERON BROWN EXEC DIRECTOR OF FINANCE 144989 0 0 0 6482 0 2180 0 1970 0 155621 0 0 0 EUGENIA M GRAY PHYSICIAN 396682 0 11250 0 1892 0 4200 0 15153 0 429177 0 0 0 CYDNEY TEAL FORMER VP MEDICAL AFFAIRS 0 54628 0 0 0 47635 0 3759 0 3400 0 109422 0 0 JOAN PIRRUNG VP OF NURSING 0 119904 0 22911 0 17094 0 18369 0 21913 0 200191 0 AMY MARSTON CAMPUS OPERATIONS OFFICER 0 131676 0 14994 0 13284 0 4935 0 22733 0 187622 0 0 FORM 990, SCHEDULE J, PART I, LINE 4A DEATAIL OF SEVERANCE PAYMENTS THE FOLLOWING INDIVIDUALS RECEIVED SEVERANCE PAYMENTS DURING THE CALENDAR YEAR 2019: - AARON Z. ROYSTON $33,408 - CRAIG M. BABBITT $29,376 - MARIE VASBINDER $103,846 --------------- FORM 990, SCHEDULE J, PART I, LINE 4B SUPPLEMENTAL NONQUALIFIED PLAN PARTICIPATION DR. RICHARD C. SZUMEL (PRESIDENT & CEO) PARTICIPATES IN A SUPPLEMENTAL, NON-QUALIFIED RETIREMENT PLAN UNDER SECTION 457(F) OF THE INTERNAL REVENUE CODE WITH CONTRIBUTION AMOUNT OF $73,304 DURING THE CALENDAR YEAR 2019. --------------- FORM 990, SCHEDULE J, PART I, LINE 7 PROVISION OF NON-FIXED PAYMENTS A PORTION OF THE BONUSES AND MERIT INCREASE ARE TIED TO THE ORGANIZATIONAL GOALS, SUCH AS PATIENT SATISFACTION, QUALITY, EMPLOYEE TURNOVER, ETC. A PORTION OF THE BONUSES AND MERIT INCREASE ARE ALSO TIED TO EXPENSES PER EQUIVALENT INPATIENT DAYS OF UNION HOSPITAL OF CECIL COUNTY. A TOWN OF ELKTON - SERIES 2012A 526000790 2012-05-18 10000000 REFUND PORTION OF SERIES 2009 BOND false false false B TOWN OF ELKTON - SERIES 2012B1B2 526000790 2012-05-18 8662336 REFUND SERIES 2009 & 2000 BONDS false false false C TOWN OF ELKTON - SERIES 2012C 526000790 2012-05-18 9000000 REFUND ESCROW TO REPAY 2002 BoND false false false D MD HEALTH & HIGHER EDUCATION FACILITIES AUTHORITY 520936091 2012-07-18 9924000 REFUND PORTION OF SERIES 2002 BOND false false false A 2667702 0 10000000 0 0 0 0 0 0 0 10000000 0 2012 true false true true B 4378636 0 8662336 0 0 0 0 0 0 0 8662336 0 2012 true false true true C 0 0 9000000 0 0 0 0 0 0 0 9000000 0 2012 true false true true D 7698735 0 9924000 0 0 0 0 0 0 0 9924000 0 2012 true false true true A false false true true false 0 false false false true B false false true true false 0.00000 0.00000 0.00000 false false 0.00000 false true C false false true true false 0.00000 0.00000 0.00000 false false false true D false false true true false 0.00000 0.00000 0.00000 false false 0.00000 false true A false false true false false false 0 false 0 false true B false false true false false false 0 false 0 false true C false false true false false false 0 false 0 false true D false false true false false false 0 false 0 false true A true B true C true D true A MD HEALTH & HIGHER EDUCATION FACILITIES AUTHORITY 520936091 2012-07-18 4007000 FINANCE ACQUISITION OF EQUIPMENT false false false B MD HEALTH & HIGHER EDUCATION FACILITIES AUTHORITY 520936091 2014-12-01 30778000 REFINANCE THE 2005 BOND false false false A 3019674 0 4007000 0 0 0 0 0 0 0 4007000 0 2012 true false true true B 540000 0 30778000 0 0 0 0 0 0 0 30778000 0 2014 true false true true A false false true true false 0.00000 0.00000 0.00000 false false false true B false false true true false 0.00000 0.00000 0.00000 false false 0.00000 false true A false false true false false false 0 false 0 false true B false false true false false false 0 false 0 false true A true B true FORM 990, PART III, LINE 3 DETAIL OF CHANGES IN ACTIVITIES THE ORGANIZATION'S ADULT DAYCARE PROGRAM WAS CEASED IN NOVEMBER 2019. --------------- FORM 990, PART VI, SECTION A, LINE 6 DETAIL OF MEMBERS AND STOCKHOLDERS CHRISTIANA CARE HEALTH SERVICES, INC. IS THE SOLE MEMBER OF AFFINITY HEALTH ALLIANCE ("AFFINITY"), BOTH TAX-EXEMPT ORGANIZATIONS. AFFINITY IS THE SOLE MEMBER OF THE UNION HOSPITAL OF CECIL COUNTY, INC. --------------- FORM 990, PART VI, SECTION A, LINE 7A GOVERNING BODY AND MANAGEMENT THE BYLAWS OF THE HOSPITAL PROVIDE THAT ITS DIRECTORS ARE APPOINTED BY ITS SOLE MEMBER, AFFINITY. --------------- FORM 990, PART VI, SECTION A, LINE 7B GOVERNING BODY AND MANAGEMENT THE BYLAWS OF THE HOSPITAL PROVIDE THAT ITS SOLE MEMBER (AFFINITY) MAY AMEND ITS BYLAWS. --------------- FORM 990, PART VI, SECTION B, LINE 11B FORM 990 REVIEW PROCESS INFORMATION RELATED TO THE UNION HOSPITAL OF CECIL COUNTY, INC. FORM 990 IS GATHERED BY FINANCE STAFF AND PROVIDED TO PRICEWATERHOUSECOOPERS LLP FOR REVIEW. THE FINAL 2019 FORM 990 FOR THE FISCAL YEAR ENDING JUNE 30, 2020 WAS REVIEWED AND APPROVED BY VARIOUS SENIOR MANAGEMENT OFFICIALS. THE ORGANIZATION'S GOVERNING BOARD WAS ALSO PROVIDED ACCESS TO THE APPROVED 2019 FORM 990 VIA ITS BOARD OF DIRECTORS PORTAL. --------------- FORM 990, PART VI, SECTION B, LINE 12C CONFLICT OF INTEREST POLICY BOARD MEMBERS AND OFFICERS ARE REQUIRED TO ANNUALLY DISCLOSE ANY POTENTIAL CONFLICT OF INTEREST. THE ORGANIZATION'S CEO REVIEWS THE SIGNED ANNUAL DISCLOSURES. THE CORPORATE COMPLIANCE OFFICER IS MADE AWARE OF ANY DISCLOSED CONFLICT, INVESTIGATES THE CONFLICT, AND REPORTS BACK TO THE BOARD OF DIRECTORS. THE BOARD CONSIDERS THE FACTS AND MAKES AN APPROPRIATE FINDING. ANY BOARD MEMBER WITH A CONFLICT MUST ABSTAIN FROM BOARD DELIBERATIONS AND VOTING ON THE MATTER. ALL VICE PRESIDENTS ANNUALLY RECEIVE A LIST OF THE INDIVIDUALS UNDER THEIR SUPERVISION WHO MAY HAVE A POTENTIAL CONFLICT OF INTEREST. THE LIST IS COMPRISED OF ALL MANAGERS, CERTAIN PROFESSIONAL STAFF WHO MAY HAVE RESPONSIBILITY NEGOTIATING WITH VENDORS, AND ANY OTHER PERSONS THAT HOSPITAL EXECUTIVES DEEM APPROPRIATE. EACH VICE PRESIDENT REVIEWS THE CONFLICT OF INTEREST POLICY WITH THEIR DESIGNATED EMPLOYEES, AND EACH EMPLOYEE IS REQUIRED TO SIGN A FORM STIPULATING WHETHER OR NOT THEY HAVE A CONFLICT. THE FORMS ARE REVIEWED BY THE VICE PRESIDENT OF HUMAN RESOURCES. IF A CONFLICT IS NOTED, IT IS BROUGHT TO THE ATTENTION OF THE APPROPRIATE VICE PRESIDENT AND THE CEO TO DETERMINE WHETHER OPERATIONAL CHANGES NEED TO OCCUR BECAUSE OF THE POTENTIAL CONFLICT. --------------- FORM 990, PART VI, SECTION B, LINE 15 COMPENSATION REVIEW AND APPROVAL PROCESS THE COMPENSATION COMMITTEE OF THE ORGANIZATION'S BOARD OF DIRECTORS IS RESPONSIBLE FOR SETTING THE OVERALL COMPENSATION PHILOSOPHY OF THE ORGANIZATION, AS WELL AS SETTING, MONITORING AND REVIEWING THE COMPENSATION PACKAGE OF THE ORGANIZATION'S CEO AND OTHER MEMBERS OF THE EXECUTIVE MANAGEMENT TEAM. THE COMMITTEE USES RELEVANT MARKET INFORMATION, INCLUDING THE USE OF AN INDEPENDENT COMPENSATION CONSULTANT AND COMPENSATION OR SURVEYS, TO SET COMPENSATION. DURING FISCAL YEAR 2020, AN INDEPENDENT COMPENSATION CONSULTANT PROVIDED THE FOLLOWING SERVICES: EXECUTIVE COMPENSATION AND PERFORMANCE EVALUATION. COMPENSATION REVIEW AND APPROVAL IS DOCUMENTED VIA BOARD MINUTES. --------------- FORM 990, PART VI, SECTION C, LINE 19 GOVERNANCE, MANAGEMENT & DISCLOSURE THE ORGANIZATION MAKEs ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. --------------- FORM 990, PART XI, LINE 9 DETAIL OF OTHER CHANGES IN NET ASSETS INVESTMENT IN CCHS & SUBSIDIARIES $ (26,601,805) CHANGE IN NET ASSETS OF FOUNDATION 95,616 ______________ TOTAL $ (26,506,189) --------------- --------------- FORM 990 PART IX LINE 11G DESCRIPTION:CONTRACTED SERVICES TOTAL FEES:9437392 FORM 990 PART IX LINE 11G DESCRIPTION:PHYSICIAN SERVICES TOTAL FEES:11380354 FORM 990 PART IX LINE 11G DESCRIPTION:PURCHASED SERVICES & FEES TOTAL FEES:1737637 FORM 990 PART IX LINE 11G DESCRIPTION:AGENCY EMPLOYEES TOTAL FEES:2683491 FORM 990 PART IX LINE 11G DESCRIPTION:TRANSCRIPTION SERVICES TOTAL FEES:185785 FORM 990 PART IX LINE 11G DESCRIPTION:CLEANING SERVICES TOTAL FEES:170985 FORM 990 PART IX LINE 11G DESCRIPTION:BILLING & COLLECTIONS SERVICES TOTAL FEES:2367149 FORM 990 PART IX LINE 11G DESCRIPTION:ADMINISTRATIVE SERVICES TOTAL FEES:179700 UNION HOSPITAL OF CECIL COUNTY FDN INC 106 BOW STREET ELKTON MD 21921 521794552 FUNDRAISING MD 501(C)(3) 7 AFFINITY false UNION HOSPITAL OF CECIL COUNTY HLTH SVCS 106 BOW STREET ELKTON MD 21921 521794553 PROPERTY MGMT MD 501(C)(3) 10 AFFINITY false AFFINITY HEALTH ALLIANCE INC 106 BOW STREET ELKTON MD 21921 521794697 MANAGEMENT MD 501(C)(3) 12B,II CCH SERVICES false UNION HOSPITAL OF CECIL COUNTY ONCOLOGY 106 BOW STREET ELKTON MD 21921 812662359 HEALTHCARE MD 501(C)(3) 3 AFFINITY false CHRISTIANA CARE HEALTH SYSTEM INC 501 WEST 14TH STREET WILMINGTON DE 19801 521479538 FUNDRAISING DE 501(C)(3) 7 NA false CHRISTIANA CARE HLTH INITIATIVES INC 200 HYGEIA DRIVE SUITE 2300 NEWARK DE 19713 510295186 OUTPATIENT SV DE 501(C)(3) 10 CCH SYSTEM false CHRISTIANA CARE HOME HEALTH & COM SRVCS 4000 NEXUS DRIVE STE W2 WILMINGTON DE 19803 510064334 HOME HLTHCARE DE 501(C)(3) 7 CCH SYSTEM false CHRISTIANA CARE HEALTH SERVICES INC PO BOX 2653 WILMINGTON DE 19805 510103684 HOSPITAL DE 501(C)(3) 3 CCH SYSTEM false CHRISTIANACARE GOHEALTH URGENT CARE LLC 5555 GLENRIDGE CONNECTOR STE 700 ATLANTA GA 30342 844061485 URGENT CARE SRVCS DE CCH SERVICES CHRISTIANACARE VALUE HEALTH JV LLC 11221 ROE AVENUE LEAWOOD KS 66211 851100149 AMBULATORY SRVCS DE CCH SERVICES UNION HOSPITAL OF CECIL COUNTY VENTURES 106 BOW STREET ELKTON MD 21921 521793691 MEDICAL SERVICES MD AFFINITY C CORP false THE DE CTR FOR MAT FETAL MED OF CC INC 4000 NEXUS DR STE NW3-100 WILMINGTON DE 19803 205891272 HEALTHCARE DE CC HEALTH SRVCS C CORP false CHRISTIANA CARE HEALTH PLANS 4000 NEXUS DR STE NW3-100 WILMINGTON DE 19803 510352728 INSURANCE DE CCH SYSTEM C CORP false CHRISTIANA CARE DEFERRED COMP PLAN 4755 OGLETOWN STANTON RD NEWARK DE 19718 816359549 DEF COMP PLAN DE CC HEALTH SRVCS TRUST false CHRISTIANA CARE EXEC DEFERRED COMP PLAN 4755 OGLETOWN STANTON RD NEWARK DE 19718 357048822 DEF COMP PLAN DE CC HEALTH SRVCS TRUST false CARE ASSOCIATES DEFERRED COMP PLAN 4755 OGLETOWN STANTON RD NEWARK DE 19718 357048714 DEF COMP PLAN DE CC HEALTH SRVCS TRUST false CHRISTIANA CARE INSURANCE CO LTD PO BOX 1159 878 W BAY RD GRAND CAYMAN CJ KY1-1102 981489490 SELF-INSURANCE CJ CC HEALTH SRVCS C CORP false CHRISTIANA CARE STRATEGIC INVESTMENTS 4000 NEXUS DR STE NW3-100 WILMINGTON DE 19803 853348300 STRATEGY DE CCH SYSTEM C CORP false false true true false false false false false false true false false false true true true true true true