2020-07-13T14:46:47-05:00 2019-06-30 205991824 SC&H TAX & ADVISORY SERVICES LLC 910 RIDGEBROOK ROAD SPARKS MD 21152 990 2018-07-01 521452024 CARROLL HOSPITAL CENTER INC CARR 4108716859 200 MEMORIAL AVENUE WESTMINSTER MD 21157 MICHAEL MYERS CFO 4108716859 2020-07-07 1 LORI S BURGHAUSER P00370694 4104031500 2020-07-06 68.33.106.243 2020-07-07 00:23:05 ED P DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 D598169B7B70477E3779F4FD99F3BFF6A447919F 2018 2020-11-19 02:30:22Z LESLIE SIMMONS 200 MEMORIAL AVENUE WESTMINSTER MD 21157 271517156 0 X WWW. CARROLLHOSPITALCENTER.ORG X 1957 MD OUR COMMUNITIES EXPECT AND DESERVE SUPERIOR MEDICAL TREATMENT, COMPASSIONATE CARE, AND EXPERT GUIDANCE IN MAINTAINING THEIR HEALTH AND WELL-BEING. AT CARROLL HOSPITAL CENTER, WE OFFER AN UNCOMPROMISING COMMITMENT TO THE HIGHEST QUALITY HEALTH CARE EXPERIENCE FOR PEOPLE IN ALL STAGES OF LIFE. WE ARE THE HEART OF HEALTH CARE IN OUR COMMUNITIES. 16 12 2099 369 94897 0 2782569 4456946 238042613 232417498 4801738 6012410 3183693 2905065 248810613 245791919 511000 1485000 0 0 114239390 118162209 0 0 32254 99653323 101699213 214403713 221346422 34406900 24445497 318476790 331607890 196167209 192918945 122309581 138688945 X OUR COMMUNITIES EXPECT AND DESERVE SUPERIOR MEDICAL TREATMENT, COMPASSIONATE CARE, AND EXPERT GUIDANCE IN MAINTAINING THEIR HEALTH AND WELL-BEING. AT CARROLL HOSPITAL CENTER, WE OFFER AN UNCOMPROMISING COMMITMENT TO THE HIGHEST QUALITY HEALTH CARE EXPERIENCE FOR PEOPLE IN ALL STAGES OF LIFE. WE ARE THE HEART OF HEALTH CARE IN OUR COMMUNITIES. 0 0 183818153 1485000 230662778 CARROLL HOSPITAL CENTER (CHC) A 143 LICENSED BED ACUTE CARE FACILITY LOCATED IN WESTMINSTER, MARYLAND OFFERS THE LATEST IN MEDICAL TECHNOLOGY AND SERVICES, COMBINED WITH A STATE-OF-THE-ART FACILITY AND TOP-NOTCH SKILLED MEDICAL PROFESSIONALS, CARING FOR PATIENTS WITH COMPASSION. CURRENTLY, THERE ARE MORE THAN 2,000 INDIVIDUALS EMPLOYED BY THE HOSPITAL - MAKING CHC THE SECOND LARGEST EMPLOYER IN CARROLL COUNTY. THE ORGANIZATION OPERATES AN ACUTE CARE HOSPITAL SERVING THE COMMUNITIES LOCATED IN CARROLL AND SURROUNDING COUNTIES AS WELL AS PARTS OF PENNSYLVANIA. IN ACCORDANCE WITH OUR TAX-EXEMPT FUNCTION, THE ORGANIZATION OPERATES AN EMERGENCY ROOM OPEN TO ALL PERSONS REGARDLESS OF THEIR ABILITY TO PAY AND HAD 46,802 PATIENT VISITS LAST YEAR. AS THE ONLY HOSPITAL IN CARROLL COUNTY, WE OFFER OUR COMMUNITY A FULL ARRAY OF SERVICES INCLUDING, EMERGENCY SERVICES, COMPREHENSIVE CANCER CARE, PEDIATRICS, MATERNITY, GERIATRICS, THE LATEST MINIMALLY INVASIVE SURGICAL PROCEDURES AND ADVANCED TOTAL AND PARTIAL JOINT REPLACEMENT PROCEDURES. IN THE YEAR ENDING JUNE 2019, CARROLL HOSPITAL CENTER RECORDED 13,633 INPATIENT ADMISSIONS AND OBSERVATION STAY CASES, 1,036 BIRTHS AND 6,246 SURGICAL PROCEDURES, ALL CONTRIBUTING TO A TOTAL OF 114,748 PATIENT ENCOUNTERS FOR THE PERIOD. IN LINE WITH OUR MISSION "OUR COMMUNITIES EXPECT AND DESERVE SUPERIOR MEDICAL TREATMENT, COMPASSIONATE CARE, AND EXPERT GUIDANCE IN MAINTAINING THEIR HEALTH AND WELL-BEING. AT CARROLL HOSPITAL CENTER, WE OFFER AN UNCOMPROMISING COMMITMENT TO THE HIGHEST QUALITY HEALTH CARE EXPERIENCE FOR PEOPLE IN ALL STAGES OF LIFE. WE ARE THE HEART OF HEALTHCARE IN OUR COMMUNITIES." THE HOSPITAL ALSO PROVIDES PLANNED COMMUNITY BENEFIT ACTIVITIES TO IMPROVE ACCESS TO HEALTH CARE AND IMPROVE THE OVERALL HEALTH OF OUR COMMUNITY. OUR MISSION IS PURSUED IN COLLABORATION WITH OUR RELATED ORGANIZATIONS: CARROLL COUNTY HEALTH SERVICES, CARROLL HOSPICE, THE PARTNERSHIP FOR A HEALTHIER CARROLL COUNTY (OUR COMMUNITY ADVOCACY ARM), AND THE CARROLL HOSPITAL CENTER FOUNDATION, FOR MORE INFORMATION ON THESE SUBSIDIARIES, PLEASE SEE THEIR INDIVIDUAL FORMS 990, AS WELL AS LIFEBRIDGE HEALTH AND ITS OTHER COMPONENTS. 183818153 1 1 0 1 0 0 0 0 0 1 1 1 1 1 1 0 0 1 0 0 1 0 0 0 0 0 1 1 1 0 1 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 1 1 1 1 0 0 1 186 0 2099 1 1 1 0 0 0 0 0 0 0 0 0 0 0 X 16 12 0 0 0 0 1 1 1 1 1 0 1 1 1 1 1 1 1 1 0 0 1 1 CA MD X AMY ENGLE 4108717114 200 MEMORIAL AVE WESTMINSTER MD 21157 JEFFREY A WOTHERS ESQ CHAIR 1.00 1.00 X X 0 0 0 MARTIN KP HILL INTERIM VICE CHAIR 1.00 1.00 X X 0 0 0 HELEN W WHITEHEAD SECRETARY 1.00 1.00 X X 0 0 0 DAVID S BOLLINGER BOARD MEMBER 1.00 1.00 X 0 0 0 AMBER DAHLGREEN CURTIS ESQ BOARD MEMBER/FOUNDATION CHAIR 1.00 1.00 X 0 0 0 KIMBERLY A JOHNSTON-DELTUVAMD BOARD MEMBER 1.00 40.00 X 0 309433 6792 TODD HERRING BOARD MEMBER 1.00 0.00 X 0 0 0 SARAH LENTZ MD BOARD MEMBER 1.00 40.00 X 0 511449 22247 BARRY LEVIN ESQUIRE BOARD MEMBER/CHAIRMAN OF LBH 1.00 1.00 X 0 0 0 NEIL M MELTZER BOARD MEMBER/LBH PRESIDENT 1.00 40.00 X X 0 1977342 435316 MARCUS L PRIMM BOARD MEMBER 1.00 1.00 X 0 0 0 LESLIE R SIMMONS BOARD MEMBER/PRESIDENT 20.00 20.00 X X 0 918190 164127 JOHN A STEERS MD BOARD MEMBER (PART YEAR) 1.00 1.00 X 51520 0 0 H STANLEY TEVIS III BOARD MEMBER 1.00 0.00 X 0 0 0 THOMAS D WELLIVER BOARD MEMBER 1.00 0.00 X 0 0 0 ALEC YEO BOARD MEMBER 1.00 0.00 X 0 0 0 THOMAS ZIRPOLI BOARD MEMBER 1.00 0.00 X 0 0 0 KEVIN K KELBLY TREASURER/SENIOR VP FINANCE/CFO 20.00 20.00 X 0 450031 36035 MARK D OLSZYK VP OF MEDICAL STAFF 35.00 5.00 X 0 531316 74309 JED S ROSEN MD CHIEF OF SURGERY 40.00 0.00 X 410032 0 27455 HOLLY PHIPPS-ADAMS VP HUMAN RESOURCES 40.00 0.00 X 150883 188868 69640 M ELLEN FINNERTY MYERS CHIEF DEVELOPMENT OFFICER 20.00 20.00 X 0 320639 51499 STEPHANIE J REID CNO/VP QUALITY 40.00 0.00 X 275776 0 46397 DWAYNE RICHARDSON SR VP OPERATION 40.00 0.00 X 248836 0 35650 CRIS W COLEMAN ASSISTANT VP OF FINANCE 40.00 0.00 X 0 244421 32091 SHARON L MCCLERNAN VP OF CLINICAL INTEGRATION 40.00 0.00 X 236982 0 66448 FLAVIO W KRUTER PHYSICIAN 40.00 0.00 X 1202740 0 42194 DARLENE GABEAU PHYSICIAN 40.00 0.00 X 690174 0 31379 QIWEI GAI PHYSICIAN 40.00 0.00 X 630466 0 29764 LINDA BRUCHEY NURSE 40.00 0.00 X 230025 0 9811 RONALD MCDADE DIRECTOR OF HEALTHCARE REDESIGN 40.00 0.00 X 190419 0 21580 JOHN M SERNULKA FORMER PRESIDENT 0.00 0.00 X 125907 0 0 4443760 5451689 1202734 168 1 1 0 MARYLAND INPATIENT CARE SERVICES (MDICS) 7250 PARKWAY DRIVE SUITE 500 HANOVER MD 210761343 PHYSICIAN SERVICES 3070039 MD SPORTSCARE & REHABILITATION LLC 501 FAIRMOUNT AVE SUITE 302 TOWSON MD 21286 REHABILITATION SERVICES 2266114 CARROLL COUNTY ANESTHESIA ASSOCIATES PA PO BOX 75193 BALTIMORE MD 21275 ANESTHESIA SERVICES 1800000 CARROLL COUNTY RADIOLOGY LLC 1510 COTNER AVE LOS ANGELES CA 90025 RADIATION SERVICES 985348 PEDIATRIX OF MARYLAND PA PO BOX 281034 ATLANTA GA 303841034 PEDIATRICIAN SERVICES 706681 21 4348078 108868 4456946 NET PATIENT SERVICE REVENUE 621300 223260735 223260735 CANCER CENTER LEASE TO SINAI HOSP 621300 6079140 6079140 NONPATIENT LAB 621500 3077623 3077623 232417498 4375095 -17978 4393073 538951 0 538951 538951 22875 516076 27358952 3600 24071667 1653570 3287285 -1649970 1637315 1637315 CAFETERIA/VENDING 722210 953211 953211 OTHER OPERATING REVENUE 900099 861303 861303 LAB CONTRACT REVENUE - CANCER CEN 900099 461600 461600 90000 90000 2366114 245791919 230662778 94897 10577298 X 1485000 1485000 1253997 952295 269448 32254 326455 326455 97069520 85027165 12042355 1261922 1110492 151430 11683928 9541367 2142561 6566387 5778421 787966 5453 5453 80192 80192 237151 237151 51125189 38178519 12946670 693619 693331 288 2862526 1547601 1314925 95009 89611 5398 4152338 3608884 543454 225509 154291 71218 4642397 4642397 11772014 6748295 5023719 803298 803298 UBI TAX EXPENSE 26560 26560 MEDICAL SUPPLIES 17167574 17143528 24046 OTHER GENERAL SUPPLIES 2910669 2386749 523920 DIETARY SUPPLIES 1483822 1446592 37230 3415893 2957160 458733 221346422 183818153 37496015 32254 X 2826 2828 36759688 39612154 17100038 19632647 3256873 3518984 3151730 1219956 334001912 215881295 115434940 118120617 1663239 1156860 101334806 94039799 16961832 20621473 10840093 10169657 11970725 23512915 318476790 331607890 25631781 22726407 54576000 52873056 115959428 117319482 196167209 192918945 X 65321920 80765927 55814897 56750255 1172764 1172763 122309581 138688945 318476790 331607890 X 24445497 -109129 -7957004 X X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 1 18618 0 1 61574 80192 0 PART II-B, LINE 1: ATTORNEY FEES RELATED TO LOBBYING ACTIVITIES. LOBBYING ALSO INCLUDES A PORTION OF THE MARYLAND HOSPITAL ASSOCIATION DUES RELATED TO LOBBYING ACTIVITIES DURING THE YEAR ENDED JUNE 2019 AND OTHER LOBBYING ACTIVITIES PERFORMED ON BEHALF OF THE HOSPITAL REGARDING COMMUNITY STABILIZATION AND DEVELOPMENT, HEALTH CARE MALPRACTICE, HEALTH CARE FACILITIES AND BUDGETS. 82495552 16413 3600365 9500 1304006 84798824 75148952 204650 7353450 11500 200000 82495552 66816320 65467 9146165 9000 870000 75148952 64806460 259012 2084848 9000 325000 66816320 13894871 50512667 410422 11500 64806460 0.16360 0.01380 0.82260 0 1 1 1983973 1983973 154524479 58936054 95588425 146139999 142861005 3278994 31353461 14084236 17269225 118120617 LONG TERM INVESTMENTS IN EXECUTIVE OPTION PLAN 238177 F INVESTMENT IN FOUNDATION 89088238 F INVESTMENT IN PREMIER 3980847 F INVESTMENT IN MT. AIRY HEALTH SERVICE 726988 F INVESTMENT IN CMOA -96855 F PENSION ASSET 102404 C 94039799 INVESTMENT IN HOSPICE 14873427 F INVESTMENT IN CARROLL COUNTY RADIOLOGY 5748046 F 20621473 TRUSTEE BOND INTEREST FUNDS 2012A 1741693 TRUSTEE BOND CONSTRUCTION FUND 2015 3 TRUSTEE FUNDS PRINCIPAL 2012A 1214936 OTHER RECEIVABLES 2587094 OTHER MISCELLANEOUS RECEIVABLE 200 DUE FROM RELATED PARTIES 17610398 OTHER ASSET #10 DEBT SRV FUND 2015 & ACCRUED INTEREST 358591 23512915 ADVANCES FROM THIRD PARTIES 4340069 ACCRUED PENSION 642644 MEDICAL OFFICE BUILDING DEBT 17192397 DEFERRED COMPENSATION 45950 DUE TO AFFILIATES 93195369 OTHER LIABILITIES 1903053 117319482 PART V, LINE 4: THE CARROLL HOSPITAL CENTER ENDOWMENT FUNDS ARE USED TO PROVIDE INCOME ON AN ONGOING BASIS TO MEET THE PURPOSES OF SUPPORTING THE MISSION OF CARROLL HOSPITAL AND OTHER CHARITABLE CARROLL AFFILIATES. THE FUNDS ARE USED TO FURTHER ADVANCE THE CHARITABLE PURPOSES OF THE ORGANIZATIONS. CENTRAL AMERICA AND THE CARIBBEAN - ANTIGUA & BARBUDA, ARUBA, BAHAMAS, 0 0 INVESTMENTS 79329 0 0 0 0 0 0 79329 0 79329 0 0 1 0 0 0 1 1 1 X 300.000000000000 1 X 500.000000000000 1 1 0 1 1 1146780 1146780 0.00520 1146780 1146780 0.00520 3752691 213610 3539081 0.01600 467511 467511 0.00210 10773016 10773016 0.04870 226704 226704 0.00100 369953 369953 0.00170 15589875 213610 15376265 0.06950 16736655 213610 16523045 0.07470 584523 584523 0.00260 584523 584523 0.00260 0 5224670 365730 97139098 76230576 20908522 X 1 1 1 1 CARROLL HOSPITAL CENTER INC 200 MEMORIAL AVENUE WESTMINSTER MD 21157 CARROLLHOSPITALCENTER.ORG 06-002 X X X CARROLL HOSPITAL CENTER INC 1 0 0 1 X X X X X X X X 17 1 0 0 1 X SEE PART V, SECTION C X SEE PART V, SECTION C X 1 17 1 SEE PART V, SECTION C 0 1 X 300.000000000000 500.000000000000 X X 1 1 X X X X 1 X SEE PART V, SECTION C X SEE PART V, SECTION C X SEE PART V, SECTION C X X X X X X 1 X 0 X X X X 1 X 0 0 CARROLL HOSPITAL CENTER, INC. PART V, SECTION B, LINE 5: THE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) TOOK INTO ACCOUNT INPUT FROM REPRESENTATIVES OF THE COMMUNITY SERVED BY THE HOSPITAL FACILITY, INCLUDING PERSONS WITH SPECIAL KNOWLEDGE OF OR EXPERTISE IN PUBLIC HEALTH, AS WELL AS LEADERS AND REPRESENTATIVES OF MEDICALLY UNDERSERVED, LOW-INCOME, AND MINORITY POPULATIONS. THE CHNA WRITTEN REPORT INCORPORATED EXPERTISE AND PARTICIPATION FROM SUCH COMMUNITY LEADERS AND REPRESENTATIVES, AS WELL AS LEADERS IN PUBLIC HEALTH, INCLUDING REPRESENTATIVES FROM THE CARROLL COUNTY HEALTH DEPARTMENT. AS PART OF THE CHNA, A KEY INFORMANT SURVEY OF 78 COMMUNITY LEADERS FROM A BROAD RANGE OF SECTORS, INCLUDING PUBLIC HEALTH AND MEDICAL SERVICES, NON-PROFIT AND SOCIAL ORGANIZATIONS, CHILDREN AND YOUTH AGENCIES, AND THE BUSINESS COMMUNITY WAS UNDERTAKEN. AMONG THE INDIVIDUALS WHO COMPLETED THE KEY INFORMANT SURVEY WERE REPRESENTATIVES FROM SUCH COMMUNITY ORGANIZATIONS AS (ASL INTERPRETER CORPS, RAPE CRISIS SERVICES, CARROLL COUNTY ARTS COUNCIL, CARROLL COUNTY RECREATION AND PARKS, WESTMINSTER FIRE AND ENGINE, GIRL SCOUTS OF CENTRAL MARYLAND, AND ELECTED OFFICIALS) AS WELL AS PUBLIC HEALTH EXPERTS INCLUDING A WIDE RANGE OF PHYSICIANS AND NUMEROUS MEMBERS OF THE CARROLL COUNTY HEALTH DEPARTMENT. IN ADDITION, THE CHNA INCLUDES FINDINGS FROM THE MARYLAND STATE HEALTH IMPROVEMENT PROCESS (SHIP), CARROLL COUNTY SHIP PROFILE AND CARROLL COUNTY LOCAL HEALTH IMPROVEMENT PLAN. FUTHERMORE, LEADERS FROM THE CARROLL COUNTY HEALTH DEPARTMENT AND THE PARTNERSHIP FOR A HEALTHIER CARROLL COUNTY ARE MEMBERS OF A COMMITTEE THAT HELPS OVERSEE THE DEVELOPMENT AND EXECUTION OF THE CHNA PLAN. CARROLL HOSPITAL CENTER, INC.:PART V, SECTION B, LINE 7A AND 7B:HTTPS://HEALTHYCARROLL.ORG/WP-CONTENT/UPLOADS/2019/01/CONSOLIDATED-REPORT-2018-CHNA.PDFCARROLL HOSPITAL CENTER, INC.:PART V, SECTION B, LINE 10A:HTTPS://HEALTHYCARROLL.ORG/WP-CONTENT/UPLOADS/2019/01/COMMUNITY-BENEFIT-PLAN-2019-2021.PDF CARROLL HOSPITAL CENTER, INC. PART V, SECTION B, LINE 11: PURSUANT TO THE CHNA UNDERTAKEN BY CARROLL HOSPITAL, 20 COMMUNITY HEALTH NEEDS WERE IDENTIFIED. THEN, WORKING COLLABORATIVELY, HOSPITAL AND COMMUNITY PUBLIC HEALTH LEADERS, AS WELL AS THE HOSPITAL'S COMMUNITY BENEFIT PLANNING COMMITTEE, BEGAN PRIORITIZING THE FOCUS FOR ACTION IN THE NEXT THREE YEARS. IN PARTICULAR, A JOINT STRATEGIES MEETING WAS CONVENED TO HELP DETERMINE THE PRIORITIZATION OF THE IDENTIFIED COMMUNITY HEALTH NEEDS. DURING THE JOINT STRATEGY MEETING, EACH OF THE 20 IDENTIFIED COMMUNITY HEALTH NEEDS WAS ADDRESSED. THE 20 IDENTIFIED NEEDS WERE PRIORITIZED BY HOSPITAL AND COMMUNITY PUBLIC HEALTH LEADERS ON THE FOLLOWING CRITERIA: SERIOUSNESS AND ABILITY TO IMPACT. FINAL CRITERIA SELECTION WAS DETERMINED BY THE EXECUTIVE COUNCIL MEMBERS OF CARROLL HOSPITAL, IN COLLABORATION WITH THE PARTNERSHIP FOR A HEALTHIER CARROLL COUNTY BOARD. PURSUANT TO THIS PRIORITIZATION PROCESS, IT WAS DETERMINED THAT THE NEEDS CARROLL HOSPITAL WOULD ATTEMPT TO ADDRESS WOULD BE NARROWED DOWN TO FOUR (4) KEY COMMUNITY BENEFIT ISSUES, SO AS TO MAXIMIZE THE HOSPITAL'S RESOURCES TO ADDRESS NEEDS THE HOSPITAL FELT IT WAS IN THE BEST POSITION TO ATTEMPT TO MEET. THE NEEDS IN PRIORITY ORDER ARE: BEHAVIORAL HEALTH, DIABETES, HEART HEALTH, AND CANCER. BEHAVIORAL HEALTH INCLUDES MENTAL HEALTH AND SUBSTANCE ABUSE. AMONG THOSE NEEDS THAT THE HOSPITAL FACILITY DETERMINED IT WOULD NOT SPECIFICALLY FOCUS UPON ADDRESSING WERE: IMMUNIZATION/VACCINATION AND DENTAL HEALTH. IDENTIFIED NEEDS NOT SPECIFICALLY ADDRESSED:IT WAS DETERMINED THAT CARROLL COUNTY'S PRIMARY IMMUNIZATION CONCERN IS THE INFLUENZA IMMUNIZATION, WHICH CURRENTLY IS BEING MANAGED THROUGH A COLLABORATIVE AND COOPERATIVE PROCESS. ADDITIONALLY, CARROLL HOSPITAL OFFERS FLU RESOURCE INFORMATION TO EVERYONE WHO USES SERVICES AT THE HOSPITAL, AS WELL AS IN OUTPATIENT SETTINGS TO ENCOURAGE INDIVIDUALS TO GET THEIR VACCINE. THE RESOURCES LIST LOCATIONS THROUGHOUT THE COUNTY WHERE FLU VACCINES ARE OFFERED. THIS INFORMATION IS ALSO LISTED ON THE HOSPITAL'S WEBSITE AND PROMOTED VIA SOCIAL MEDIA. FLU CLINICS ARE HELD EVERY FALL AT SENIOR CENTERS AS A COLLABORATIVE INITIATIVE LED BY THE PARTNERSHIP'S HEALTHY AGING LEADERSHIP TEAM WITH SENIOR CENTERS AND A PRIVATE PHARMACY.ACCESS CARROLL EXPANDED ON ITS PRIMARY CARE MEDICAL SERVICES TO ADD DENTAL CARE IN FISCAL YEAR 2014. IN ADDITION, ORAL HEALTH SCREENINGS ARE OFFERED AS PART OF THE HOSPITAL'S ANNUAL HEALTH FAIR EACH YEAR AND THROUGHOUT THE COUNTY AT COMMUNITY EVENTS. ADDITIONALLY, THE PARTNERSHIP'S HEALTHY AGING LEADERSHIP TEAM WILL EVALUATE POSSIBLE ROLES FOR IMPROVING ORAL HEALTH. THE CARROLL COUNTY HEALTH DEPARTMENT HAS A DENTAL CLINIC FOR CHILDREN AND PREGNANT WOMEN WHO HAVE MEDICAL ASSISTANCE. CARROLL HOSPITAL CENTER, INC.: PART V, SECTION B, LINE 7A AND 7B, COMMUNITY HEALTH NEEDS ASSESSMENT:HTTPS://HEALTHYCARROLL.ORG/WP-CONTENT/UPLOADS/2019/01/CONSOLIDATED-REPORT-2018-CHNA.PDFCARROLL HOSPITAL CENTER, INC.:PART V, SECTION B, LINE 16A, FAP:HTTP://WWW.CARROLLHOSPITALCENTER.ORG/FINANCIAL-ASSISTANCE CARROLL HOSPITAL CENTER, INC.: PART V, SECTION B, LINE 16B, FAP APPLICATION:HTTP://WWW.CARROLLHOSPITALCENTER.ORG/UPLOAD/DOCS/PATIENTS%20VISITORS/FINANCIAL%20ASSISTANCE%20APPLICATION.PDF CARROLL HOSPITAL CENTER, INC.: PART V, SECTION B, LINE 16C, FAP PLAIN LANGUAGE SUMMARY:HTTP://WWW.CARROLLHOSPITALCENTER.ORG/UPLOAD/DOCS/PATIENTS%20VISITORS/FINANCIAL%20ASSISTANCE%20POLICY%20PLAIN%20LANGUAGE%20SUMMARY.PDFCARROLL HOSPITAL CENTER, INC.:PART V, SECTION B, LINE 20E:THE HOSPITAL FACILITY OR AN AUTHORIZED THIRD PARTY DID NOT UNDERTAKE ANY OF THE COLLECTION ACTIONS NOTED IN PART V, SECTION B, LINE 18 BEFORE MAKING REASONABLE EFFORTS TO DETERMINE ANY PATIENTS' ELIGIBILITY UNDER THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY. IN ORDER TO HELP DETERMINE PATIENTS' ELIGIBILITY UNDER THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY, THE HOSPITAL UNDERTAKES A NUMBER OF ACTIONS, INCLUDING NOTIFYING PATIENTS OF THE FINANCIAL ASSISTANCE POLICY ON ADMISSION, NOTIFYING PATIENTS OF THE FINANCIAL ASSISTANCE POLICY PRIOR TO DISCHARGE, NOTIFYING PATIENTS OF THE FINANCIAL ASSISTANCE POLICY IN COMMUNICATIONS WITH THE PATIENT'S BILLS, AND DOCUMENTING ITS DETERMINATION OF WHETHER PATIENTS WERE ELIGIBLE FOR FINANCIAL ASSISTANCE UNDER THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY. CARROLL HOSPITAL CENTER, INC.: PART V, SECTION B, LINE 22D: CHARGES FOR ALL HOSPITAL PATIENTS ARE STATE REGULATED. SERVICES ARE CHARGED TO ALL HOSPITAL PATIENTS AT THE SAME RATE. CHARGES FOR INDIVIDUALS FOUND ELIGIBLE FOR FAP BASED ON 300% OR LESS OF THE FEDERAL POVERTY LEVEL (FPL) ARE WRITTEN-OFF IN FULL TO FAP (THERE IS NO PATIENT LIABILITY). CHARGES FOR INDIVIDUALS FOUND ELIGIBLE FOR FAP BASED ON THE HSCRC'S FINANCIAL HARDSHIP CRITERIA OF 301%-500% OF FPL ARE CAPPED AT 25% OF THE ANNUAL HOUSEHOLD INCOME PER THE HSCRC'S FINANCIAL HARDSHIP CRITERIA. THE DIFFERENCE BETWEEN THE TOTAL CHARGES AND THE CALCULATED 25% OF THE ANNUAL HOUSEHOLD INCOME IS WRITTEN OFF AS CHARITY CARE. CARROLL HOSPITAL CENTER, INC.: PART V, SECTION B, LINE 24: THE HOSPITAL FACILITY DOES NOT CHARGE ANY INDIVIDUALS THAT IT KNOWS ARE ELIGIBLE FOR FINANCIAL ASSISTANCE AN AMOUNT EQUAL TO THE GROSS CHARGE FOR ANY SERVICE. THE HOSPITAL USES THE CHARGE MASTER RATES FOR A SERVICE AS A STARTING POINT AGAINST WHICH THE DISCOUNTS MANDATED IN THE HOSPITAL FACILITY'S FINANCIAL ASSISTANCE POLICY ARE APPLIED TO DETERMINE THE AMOUNT ACTUALLY BILLED TO PATIENTS ELIGIBLE UNDER THE FINANCIAL ASSISTANCE POLICY. THE HOSPITAL FACILITY WILL NOT COLLECT PAYMENT FROM ANY PATIENT ELIGIBLE UNDER THE FINANCIAL ASSISTANCE POLICY IN EXCESS OF THE REDUCED AMOUNT THAT IS ACTUALLY BILLED TO SUCH FINANCIAL ASSISTANCE PATIENT. IN ADDITION, IF THE HOSPITAL CHARGED AN INDIVIDUAL THAT HAD NOT YET BEEN DETERMINED TO BE ELIGIBLE FOR FINANCIAL ASSISTANCE AT THE TIME OF THE CHARGE AN AMOUNT EQUAL TO GROSS CHARGES, THEN UPON DETERMINING THE INDIVIDUAL WAS ELIGIBLE FOR FINANCIAL ASSISTANCE UNDER THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY, THE HOSPITAL PROMPTLY CORRECTS THE BILL. 5 1 - CARROLL COUNTY RADIOLOGY 7253 AMBASSADOR ROAD BALTIMORE MD 21244 IMAGING CENTER 2 - CARROLL COUNTY RADIOLOGY 1430 PROGRESS WAY SUITE 108 ELDERSBURG MD 21784 IMAGING CENTER 3 - CARROLL COUNTY RADIOLOGY 193 STONER AVENUE SUITE 200 WESTMINSTER MD 21157 IMAGING CENTER 4 - CARROLL COUNTY RADIOLOGY 1011 BALTIMORE BLVD WESTMINSTER MD 21157 IMAGING CENTER 5 - CARROLL COUNTY RADIOLOGY 844 WASHINGTON ROAD SUITE 102 WESTMINSTER MD 21157 IMAGING CENTER PART I, LINE 3C: FOR PATIENTS THAT EXPERIENCE A MEDICAL HARDSHIP (MEDICAL DEBT THAT EXCEEDS 25% OF HOUSEHOLD INCOME OR WHOSE INCOME IS BELOW SPECIFIED LEVELS), CARROLL HOSPITAL CENTER PROVIDES FREE OR DISCOUNTED CARE. IF A PATIENT HAS RECEIVED REDUCED COSTS, UNDER THIS POLICY, THE PATIENT OR ANY IMMEDIATE FAMILY MEMBER OF THE PATIENT LIVING IN THE SAME HOUSEHOLD SHALL REMAIN ELIGIBLE TO RECEIVE REDUCED COSTS FOR ANY MEDICALLY NECESSARY CARE WHEN SEEKING SUBSEQUENT CARE DURING THE 12 MONTH PERIOD BEGINNING ON THE DATE ON WHICH THE REDUCED COST CARE WAS INITIALLY RECEIVED. IN ADDITION, SOME PATIENTS ARE PRESUMED TO BE ELIGIBLE FOR FINANCIAL ASSISTANCE DISCOUNTS ON THE BASIS OF LIFE CIRCUMSTANCES. THESE PATIENTS THAT THE HOSPITAL HAS DETERMINED PRESUMPTIVELY QUALIFY FOR FINANCIAL ASSISTANCE ARE NOT REQUIRED TO COMPLETE ADDITIONAL FORMS OR PROVIDE ADDITIONAL INFORMATION AND ARE GRANTED 100% FINANCIAL ASSISTANCE DISCOUNTS. THE HOSPITAL INTERNALLY DOCUMENTS ANY AND ALL RECOMMENDATIONS TO PROVIDE PRESUMPTIVE FINANCIAL ASSISTANCE DISCOUNTS FROM PATIENTS AND OTHER SOURCES, SUCH AS PHYSICIANS, COMMUNITY OR RELIGIOUS GROUPS, INTERNAL OR EXTERNAL SOCIAL SERVICES OR FINANCIAL COUNSELING PERSONNEL. THE FOLLOWING ARE EXAMPLES OF PATIENT SITUATIONS THAT MAY REASONABLY ASSIST IN THE DETERMINATION OF PRESUMPTIVE ELIGIBILITY FOR FINANCIAL ASSISTANCE: (1) PATIENT HAS RECEIVED CARE FROM AND/OR HAS PARTICIPATED IN WOMEN'S, INFANTS AND CHILDREN (WIC) PROGRAMS, (2) PATIENT IS HOMELESS AND/OR HAS RECEIVED CARE FROM A HOMELESS CLINIC, (3) PATIENT'S FAMILY IS ELIGIBLE FOR AND IS RECEIVING FOOD STAMPS, (4) PATIENT'S FAMILY IS ELIGIBLE FOR AND IS PARTICIPATING IN SUBSIDIZED SCHOOL LUNCH PROGRAMS, (5) PATIENT QUALIFIES FOR OTHER STATE OR LOCAL ASSISTANCE PROGRAMS THAT ARE UNFUNDED OR THE PATIENT'S ELIGIBILITY HAS BEEN DISMISSED DUE TO A TECHNICALITY (E.G. MEDICAID SPEND-DOWN), (6) FAMILY OR FRIENDS OF A PATIENT HAVE PROVIDED INFORMATION ESTABLISHING THE PATIENT'S INABILITY TO PAY, (7) THE PATIENT'S STREET ADDRESS AND DOCUMENTATION EVIDENCE STATUS IN AN AFFORDABLE OR SUBSIDIZED HOUSING DEVELOPMENT, (8) PATIENT/GUARANTOR'S WAGES ARE INSUFFICIENT FOR GARNISHMENT, AS DEFINED BY STATE LAW, OR (9) PATIENT IS DECEASED, WITH NO KNOWN ESTATE. PART I, LINE 7: 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 BREAK-OUT ANY OFFSETTING REVENUE RELATED TO UNCOMPENSATED CARE. THE COST OF RENDERING SERVICES FOR MEDICAL ASSISTANCE PATIENTS IS APPROXIMATELY EQUAL TO MEDICAID REVENUES IN MARYLAND. THUS, THE NET EFFECT IS APPROXIMATELY ZERO. THE EXCEPTION TO THIS IS THE IMPACT ON THE HOSPITAL OF ITS SHARE OF THE MEDICAID ASSESSMENT. IN RECENT YEARS, THE STATE OF MARYLAND HAS CLOSED FISCAL GAPS IN THE STATE MEDICAID BUDGET BY ASSESSING HOSPITALS THROUGH THE RATE-SETTING SYSTEM. PART I, LINE 7A - I:THE FOLLOWING COSTING METHODOLOGY WAS USED TO CALCULATE LINES 7A THROUGH 7I ON THE COMMUNITY BENEFIT REPORT.COST TO CHARGE RATIO - COST TO CHARGE RATIO WAS USED IN REPORTING FINANCIAL ASSISTANCE AT COST. THE COST TO CHARGE RATIO WAS DERIVED FROM CALCULATIONS SIMILAR TO WORKSHEET 2. PART I, LINE 7G: CARROLL HOSPITAL CENTER INCURRED $4.6 MILLION OF NET COMMUNITY BENEFIT EXPENSE AS A RESULT OF UNDERTAKING SUBSIDIZED HEALTH SERVICES.A SHORTAGE OF PRIMARY OR SPECIALTY PROVIDERS HAS PERHAPS POSED THE MOST SIGNIFICANT CHALLENGES IN INPATIENT CARE DELIVERY. SUBSTANTIAL PHYSICIAN SUBSIDIES HAVE BECOME NECESSARY TO ENSURE THAT ALL PATIENTS REQUIRING ANESTHESIA, PEDIATRIC, PSYCHIATRIC, OBSTETRICAL, CRITICAL AND GENERAL MEDICAL CARE HAVE THE ACCESS THEY NEED ONCE ADMITTED TO THE HOSPITAL, INCLUDING 24/7 COVERAGE. CARROLL HOSPITAL CENTER HAS HOSPITALIST PROGRAMS IN EACH OF THESE AREAS AND ALLOCATES A SIGNIFICANT AMOUNT OF RESOURCES SUSTAINING THE PROGRAMS. IN FY19, APPROXIMATELY $10.7 MILLION WAS SPENT IN ENSURING CARE FOR ALL PATIENTS AND RECRUITING AND RETAINING PHYSICIANS. EQUALLY IMPORTANT IS ACCESS TO PHYSICIANS ON AN OUTPATIENT BASIS, NOT JUST FOR THE UNINSURED, BUT ALSO FOR ALL PATIENTS IN OUR GROWING COMMUNITY. TO ENSURE OUR COMMUNITY HAS ACCESS TO QUALITY PHYSICIANS, CARROLL HOSPITAL CENTER CONTINUALLY MONITORS STATISTICALLY CALCULATED NEED BY DEVELOPING A COMPREHENSIVE MEDICAL STAFF DEVELOPMENT PLAN BASED ON THE HEALTH CARE NEEDS OF OUR MEDICAL SERVICE AREA. THE REPORT INCLUDES AN ANALYSIS OF APPROPRIATE STAFFING LEVELS IN A VARIETY OF MEDICAL SPECIALTIES. THE PHYSICIAN NEEDS ASSESSMENT METHODOLOGY USED IS BASED ON A QUALITATIVE STANDARD ESTABLISHED BY THE INTERNAL REVENUE SERVICES (IRS). THE REPORT GUIDES THE HOSPITAL'S RECRUITING STRATEGY, HELPS US TO PRIORITIZE RECRUITING EFFORTS AND ALLOWS THE HOSPITAL TO PLACE CONTINGENCIES ON RECRUITED PHYSICIANS TO ENSURE THEY SEE MEDICALLY UNDERSERVED, UNINSURED, MEDICARE AND MEDICAID PATIENTS. WHILE CARROLL HOSPITAL CENTER CARES FOR PATIENTS WITH NO MEANS TO PAY THEIR MEDICAL EXPENSES THROUGHOUT THE HOSPITAL, IT IS SEEN MOST ACUTELY IN THE EMERGENCY DEPARTMENT (ED), WHERE MANY UNINSURED PATIENTS OFTEN COME FOR PRIMARY AND EMERGENT CARE. SINCE ALL PATIENTS PRESENTING TO THE ED ARE TREATED FOR ANY MEDICAL CONDITION REGARDLESS OF THEIR ABILITY TO PAY FOR CARE, THE UNINSURED POPULATION POSES A SIGNIFICANT CHALLENGE NOT ONLY TO THE HOSPITAL, BUT ALSO TO PHYSICIANS PROVIDING CARE IN THE HOSPITAL AND IN THE ED. DUE IN PART TO LACK OF, OR MINIMAL REIMBURSEMENT, IT HAS BECOME INCREASINGLY DIFFICULT TO FIND SPECIALISTS TO PROVIDE ON-CALL SERVICES FOR THE ED AROUND-THE-CLOCK. THE MORE SERIOUS ISSUE IS THAT THIS TREND EFFECTS NOT ONLY OUR UNINSURED PATIENTS, BUT ALL PATIENTS SEEKING TREATMENT IN OUR ED.THE LIKELIHOOD THAT PATIENTS PRESENT MORE ACUTELY IN THE UNINSURED POPULATION AND THE ACCOMPANYING INCREASED POTENTIAL FOR MALPRACTICE CLAIMS ALSO HAS CONTRIBUTED TO SPECIALISTS CHOOSING NOT TO COVER NONPAYING PATIENTS IN THE ED. THAT GAP IS MOST SIGNIFICANT IN SURGICAL SPECIALTIES INCLUDING, ORTHOPEDICS, OTOLARYNGOLOGY (ENT), GENERAL SURGERY AND PLASTIC SURGERY. THERE ALSO HAS BEEN INCREASING RELUCTANCE FROM OTHER SPECIALTIES WITH SIGNIFICANT ED VOLUMES, INCLUDING VASCULAR SURGERY, NEUROSURGERY AND NEUROLOGY. TO HELP EASE THE EFFECTS OF UNCOMPENSATED CARE ON PHYSICIANS AND ADDRESS THE GAP IN CARE FOR OUR PATIENTS, CARROLL HOSPITAL CENTER HAS CONTINUED TWO MAJOR, COSTLY INITIATIVES TO ADDRESS THE GAP PROACTIVELY. FIRST, THE HOSPITAL CONTRACTS WITH 10 MEDICAL SPECIALTIES TO ENSURE 24/7 COVERAGE IN THE ED. IMPLEMENTED IN 2006, THOSE SPECIALTIES INCLUDE NEUROSURGERY, GENERAL, PLASTIC, VASCULAR, ORAL SURGERY, ORTHOPEDICS, UROLOGY, PODIATRY, OPHTHALMOLOGY AND ENT. ADDITIONALLY, THE GROWING VOLUMES OF UNINSURED PATIENTS HAS CAUSED THE HOSPITAL TO RECENTLY INSTITUTE AN ADDITIONAL POLICY WHICH ALLOWS PHYSICIANS WHO SEE PATIENTS WITHOUT A PAYMENT SOURCE IN THE ED TO BE REIMBURSED FOR PHYSICIAN SERVICES BY THE HOSPITAL AT CURRENT MEDICARE RATES. WHILE PAYMENT FOR ED CALL MAY HELP WITH THE GAPS IN COVERAGE FOR THE UNINSURED, IT BEARS A SIGNIFICANT FINANCIAL TOLL ON THE HOSPITAL. THE EXPENSE TO PAY PHYSICIANS FOR ED CALL HAS COST THE HOSPITAL $1,454,336 IN FY19.ALL THE INITIATIVES AND SUPPORT LISTED ABOVE WOULD NOT BE PROVIDED IF CARROLL HOSPITAL CENTER DID NOT PROVIDE THEM. AS THE ONLY HOSPITAL IN THE COUNTY, IT IS OUR PRIMARY RESPONSIBILITY TO PROVIDE THESE SERVICES FOR THE UNINSURED AND UNDERINSURED, AS WELL AS ALL COMMUNITY MEMBERS. NO OTHER ORGANIZATION OR INDIVIDUAL IN THE COUNTY WOULD BE ABLE TO PROVIDE ALL OF THESE COMPREHENSIVE SERVICES IN THE AREAS THAT THE HOSPITAL DOES. AS PART OF THE MISSION DRIVEN HEALTH SERVICES, CARROLL HOSPITAL PROVIDES MEDICAL SERVICES TO ACCESS CARROLL PATIENTS. FOUNDED IN 2005, ACCESS CARROLL IS A JOINT VENTURE BETWEEN CARROLL HOSPITAL, THE CARROLL COUNTY HEALTH DEPARTMENT AND THE PARTNERSHIP FOR A HEALTHIER CARROLL COUNTY THAT PROVIDES FREE HEALTH CARE TO UNINSURED, LOW-INCOME CARROLL COUNTY RESIDENTS WHO MEET CERTAIN ELIGIBILITY REQUIREMENTS. ACCESS CARROLL CONSISTS OF A HEALTH CARE TEAM INVOLVING VOLUNTEER PHYSICIANS, NURSES AND OTHER MEDICAL PROFESSIONALS WHO WORK TOGETHER TO PROVIDE PATIENTS WITH PRIMARY MEDICAL CARE. MEDICATION ASSISTANCE, SPECIALTY CARE, DIAGNOSTIC AND LABORATORY TESTING, AND PATIENT EDUCATION ARE ALSO AVAILABLE ONSITE. CARROLL HOSPITAL INCURRED $1,256,101 IN COST TREATING ACCESS CARROLL PATIENTS IN FISCAL YEAR 2019.ALSO INCLUDED IN THESE EXPENSES ARE DIRECT AND INDIRECT COSTS ATTRIBUTABLE TO HOSPITAL BASED PHYSICIANS TOTALING $9,331,415.PART II: COALITION BUILDINGTHE PARTNERSHIP FOR A HEALTHIER CARROLL COUNTY, INC., AN AFFILIATE OF CARROLL HOSPITAL AND THE CARROLL COUNTY HEALTH DEPARTMENT, IS A PRIVATE NONPROFIT ORGANIZATION WORKING TO IMPROVE HEALTH BY CONNECTING PEOPLE, INSPIRING ACTION, AND STRENGTHENING COMMUNITY. THE PARTNERSHIP IS A RELATED SECTION 501(C)(3) TAX-EXEMPT ORGANIZATION OF THE HOSPITAL, WHICH RECEIVES A MAJORITY OF ITS OPERATING FUNDS FROM CONTRIBUTIONS MADE DIRECTLY BY THE HOSPITAL.THE HOSPITAL ALSO OFFERS EMERGENCY PREPAREDNESS TRAINING AND SUPPORT AS NEEDED TO COMMUNITY ORGANIZATIONS. PART III, LINE 2: CARROLL HOSPITAL CENTER INCURRED $5,224,670 IN BAD DEBT EXPENSE DURING THE FISCAL YEAR 2019. THIS REFLECTS THE AMOUNT OF GROSS PATIENT CHARGES UNCOLLECTED FROM PATIENTS THAT DID NOT QUALIFY FOR FINANCIAL ASSISTANCE. PATIENT ACCOUNTS RECEIVABLE ARE REDUCED BY PROVISION FOR BAD DEBTS. IN EVALUATING THE COLLECTABILITY OF ACCOUNTS RECEIVABLE, THE HEALTH SYSTEM ANALYZES HISTORICAL COLLECTIONS AND WRITE-OFFS AND IDENTIFIES TRENDS FOR EACH OF ITS MAJOR PAYOR SOURCES OF REVENUE TO ESTIMATE THE APPROPRIATE PROVISION FOR BAD DEBTS AND PROVISION FOR UNCOLLECTIBLE ACCOUNTS. MANAGEMENT REGULARLY REVIEWS ITS ESTIMATE AND EVALUATES THE SUFFICIENCY OF THE ALLOWANCE FOR BAD DEBTS. THE HEALTH SYSTEM ANALYZES CONTRACTUAL AMOUNTS DUE FROM PATIENTS WHO HAVE THIRD PARTY COVERAGE AND PROVIDES AN ALLOWANCE FOR DOUBTFUL ACCOUNTS AND A PROVISION FOR BAD DEBTS. FOR PATIENT ACCOUNTS RECEIVABLE ASSOCIATED WITH SELF-PAY PATIENTS, WHICH INCLUDES THOSE PATIENTS WITHOUT INSURANCE COVERAGE FOR A PORTION OF THE BILL, THE HEALTH SYSTEM RECORDS A SIGNIFICANT PROVISION FOR BAD DEBTS FOR PATIENTS THAT ARE UNABLE OR UNWILLING TO PAY FOR THE PORTION OF THE BILL REPRESENTING THEIR FINANCIAL RESPONSIBILITY. ACCOUNT BALANCES ARE CHARGED OFF AGAINST THE ALLOWANCE FOR BAD DEBTS AFTER ALL MEANS OF COLLECTION HAS BEEN EXHAUSTED. BAD DEBT EXPENSE REPORTED ON LINE 2 REFLECTS ACTUAL PATIENT CHARGES THAT HAVE BEEN DETERMINED TO BE UNCOLLECTIBLE FOR PATIENTS THAT HAVE NOT QUALIFIED FOR CHARITY CARE. BAD DEBT EXPENSE MAY ALSO INCLUDE ADDITIONAL "BAD DEBT PROVISIONS" FOR DOUBTFUL ACCOUNTS BASED ON MANAGEMENT'S ESTIMATES OF FUTURE ACCOUNT COLLECTIONS BASED ON CHANGES IN SERVICE MIX AND PAYOR MIX. PART III, LINE 3: CARROLL HOSPITAL CENTER, INC. DETERMINES ELIGIBILITY FOR FINANCIAL ASSISTANCE THROUGH OTHER VARIOUS MEANS (CREDIT REPORTS, DEBT AND ASSET REVIEWS, AND REFERRALS FROM THE HOSPITAL'S BILLING AGENTS) WHEN THE PATIENT HAS NOT COMPLETED THE FINANCIAL ASSISTANCE APPLICATION. IF A DETERMINATION IS MADE REGARDING THE PATIENT'S INABILITY TO PAY, THE ACCOUNT CAN BE APPROVED FOR FINANCIAL ASSISTANCE ON A PRESUMPTIVE BASIS RATHER THAN BE REFLECTED AS BAD DEBT EXPENSE. OF THE REMAINING BAD DEBT EXPENSE, IT IS ESTIMATED THAT $365,730 IN COST MAY BE ATTRIBUTABLE TO PATIENTS ELIGIBLE FOR FINANCIAL ASSISTANCE/CHARITY CARE. PART III, LINE 4: ALL PATIENT ACCOUNTS ARE HANDLED CONSISTENTLY AND APPROPRIATELY TO MAXIMIZE CASH FLOW AND TO IDENTIFY BAD DEBT ACCOUNTS TIMELY. ACTIVE ACCOUNTS ARE CONSIDERED BAD DEBT ACCOUNTS WHEN THEY MEET SPECIFIC COLLECTION ACTIVITY GUIDELINES AND/OR ARE REVIEWED BY THE APPROPRIATE MANAGEMENT AND DEEMED TO BE UNCOLLECTIBLE. EVERY EFFORT IS MADE TO IDENTIFY AND PURSUE ALL ACCOUNT BALANCE LIQUIDATION OPTIONS INCLUDING, BUT NOT LIMITED TO THIRD PARTY PAYOR REIMBURSEMENT, PATIENT PAYMENT ARRANGEMENTS, MEDICAID ELIGIBILITY AND FINANCIAL ASSISTANCE. THIRD PARTY RECEIVABLE MANAGEMENT AGENCIES PROVIDE EXTENDED BUSINESS OFFICE SERVICES AND INSURANCE OUTSOURCE SERVICES TO ENSURE MAXIMUM EFFORT IS TAKEN TO RECOVER INSURANCE AND SELF-PAY DOLLARS BEFORE TRANSFER TO BAD DEBT. CONTRACTUAL ARRANGEMENTS WITH THIRD PARTY COLLECTION AGENCIES ARE USED TO ASSIST IN THE RECOVERY OF BAD DEBT DOLLARS AFTER ALL INTERNAL COLLECTION EFFORTS HAVE BEEN EXHAUSTED. IN SO DOING, THE COLLECTION AGENCIES MUST OPERATE CONSISTENTLY WITH CARROLL HOSPITAL CENTER'S GOAL OF MAXIMUM BAD DEBT RECOVERY AND STRICT ADHERENCE WITH FAIR DEBT COLLECTIONS PRACTICES ACT (FDCPA) RULES AND REGULATIONS, WHILE MAINTAINING POSITIVE PATIENT RELATIONS. SEE AUDITED FINANCIAL STATEMENTS PAGE 15 PART III, LINE 8: CARROLL HOSPITAL CENTER'S TAX YEAR 2018 (FISCAL YEAR 2019) MEDICARE COST REPORT SUBMISSION WAS UTILIZED AS THE SOURCE DOCUMENT TO REPORT MEDICARE TOTAL REVENUE AND ALLOWABLE COSTS. PART III, LINE 9B: FOR THOSE PATIENTS THAT DO NOT INITIALLY APPLY OR QUALIFY FOR FINANCIAL ASSISTANCE, THE ORGANIZATION CONTINUES TO MONITOR WHETHER THE PATIENT MAY QUALIFY FOR FINANCIAL ASSISTANCE. IF THE PATIENT IS FOUND TO BE ELIGIBLE FOR FINANCIAL ASSISTANCE AT ANY POINT (INCLUDING ONCE COLLECTION EFFORTS HAVE BEGUN), THE ORGANIZATION WILL APPROVE THE PATIENT FOR FINANCIAL ASSISTANCE. COLLECTION EFFORTS WILL BE STOPPED IMMEDIATELY ONCE THE PATIENT IS FOUND TO QUALIFY FOR FINANCIAL ASSISTANCE UNDER THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY. PATIENTS DETERMINED TO BE ELIGIBLE FOR FINANCIAL ASSISTANCE SUBSEQUENT TO THE DATE OF SERVICE MAY BE ELIGIBLE FOR A REFUND OF PAYMENTS MADE IF IT IS DETERMINED THAT THE PATIENT WAS ELIGIBLE FOR FINANCIAL ASSISTANCE AT THE TIME OF SERVICE. PART VI, LINE 2: MONITORING THE HEALTH STATUS OF THE COMMUNITY IS AN ONGOING AND INTERACTIVE PROCESS ENGAGED IN BY THE HOSPITAL, WITH SUBSTANTIAL INVOLVEMENT FROM OUR COMMUNITY VIA THE PARTNERSHIP FOR A HEALTHIER CARROLL COUNTY, INC. ("THE PARTNERSHIP"), AN ENTITY ESTABLISHED BY THE HOSPITAL AND THE CARROLL COUNTY HEALTH DEPARTMENT SPECIFICALLY TO ASSESS UNMET HEALTH NEEDS IN THE COMMUNITY, EXPAND THE CAPACITY FOR HEALTH AND QUALITY OF LIFE IMPROVEMENT IN THE COMMUNITY, SERVE AS A COLLABORATIVE VEHICLE FOR INTERACTION WITH THE COMMUNITY, AND WITH OUR COMMUNITY, TO DRIVE THE EFFORT TO CREATE A HEALTHIER CARROLL COUNTY. THE PARTNERSHIP IS A RELATED SECTION 501(C)(3) TAX-EXEMPT ORGANIZATION OF THE HOSPITAL, WHICH RECEIVES A MAJORITY OF ITS OPERATING FUNDS FROM CONTRIBUTIONS MADE DIRECTLY BY THE HOSPITAL.IMPROVEMENT IN THE COMMUNITY HEALTH IMPROVEMENT AREAS (CHIA) IS ONE OF THE HOSPITAL'S GOALS. THE CHIA ARE THE NEED AREAS REQUIRING INDIVIDUAL AND ORGANIZATIONAL ACTION TO ACHIEVE TARGETED IMPROVED STATUS USING THE U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES' HEALTHY PEOPLE 2020 TARGETS AS THE BENCHMARK. THE HOSPITAL PARTICIPATES ACTIVELY IN MANY OF THE CHIA LEADERSHIP TEAMS COMPRISED OF DIVERSE INDIVIDUALS AND ORGANIZATIONS FROM THROUGHOUT THE HOSPITAL'S SERVICE AREA, WHO SHARE EXPERTISE AND INTEREST IN THE CHIA. WITH SUPPORT AND GUIDANCE FROM THE PARTNERSHIP, THOSE LEADERSHIP TEAMS DEVELOP AND IMPLEMENT ACTION PLANS SPECIFICALLY INTENDED TO ACCOMPLISH TARGETED RESULTS. "HEALTHY CARROLL VITAL SIGNS" (DESCRIBED BELOW) ARE THEN AFFIRMED, ARE SPECIFIC TO EACH CHIA LEADERSHIP TEAM AND SERVE AS ONE OF THE PRIMARY TOOLS FOR MEASURING AND REPORTING RESULTS TO THE HOSPITAL LEADERSHIP AND TO THE COMMUNITY.RECENTLY THE HOSPITAL HAS COLLABORATED WITH THE PARTNERSHIP WITH RESPECT TO AN ASSESSMENT OF HEALTH NEEDS VIA MARYLAND'S STATE HEALTH IMPROVEMENT PROCESS (S.H.I.P.), WHICH WAS ORGANIZED TO PRODUCE A LOCAL HEALTH IMPROVEMENT PLAN (L.H.I.P.). THE PARTNERSHIP ORGANIZATION ENTHUSIASTICALLY AGREED TO SERVE AS THE LOCAL COALITION REQUIRED IN THE S.H.I.P. PROCESS. THIS PROVIDED CARROLL HOSPITAL CENTER YET ANOTHER OPPORTUNITY FOR LINKAGE TO IMPORTANT, VALIDATED INFORMATION ABOUT HEALTH NEEDS IN OUR COMMUNITY AND ONGOING OPPORTUNITIES TO COLLABORATE WITH OUR LOCAL AND STATE HEALTH DEPARTMENT REGARDING IMPLEMENTATION STRATEGIES FOR TARGETED RESULTS.PURSUANT TO THE S.H.I.P. ASSESSMENT, THIRTY-NINE "HIGH IMPACT OBJECTIVES" WERE IDENTIFIED BY THE STAFF AT MARYLAND'S DEPARTMENT OF HEALTH AND MENTAL HYGIENE. A CARROLL COUNTY SPECIFIC DATA PROFILE SERVED AS THE BASELINE DOCUMENT. AFTER THOROUGH ANALYSIS, A LEADERSHIP TEAM, WHICH INCLUDED THE HOSPITAL, PRODUCED A LOCAL HEALTH IMPROVEMENT PLAN (L.H.I.P.) ADDRESSING FIVE PRIORITY NEED AREAS. THE S.H.I.P. AND L.H.I.P. PROVIDE ANOTHER IMPORTANT SET OF VERY USEFUL INFORMATION AND IS BEING FULLY INTEGRATED WITHIN THE HOSPITAL'S THIRD IRS COMPLIANT COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) AND COMMUNITY BENEFIT PLANNING PROCESSES. THE HOSPITAL AND THE PARTNERSHIP HAVE CONDUCTED MULTIPLE PREVIOUS NEEDS ASSESSMENTS, HAVE MADE REAL PROGRESS TOWARD COMMUNITY ENGAGEMENT IN THESE PROCESSES AND HAVE INTEGRATED ANNUAL MEASUREMENT SYSTEMS INTO THE HEALTH IMPROVEMENT WORK KNOWN AS "HEALTHY CARROLL VITAL SIGNS (HCVS)." THE COMMUNITY BENEFIT & HEALTH IMPROVEMENT PLAN FY2019 TO FY2021, WAS THE PLAN BY THE HOSPITAL AND THE PARTNERSHIP TO ADDRESS THE 2018 COMMUNITY HEALTH NEEDS ASSESSMENT.DURING THE 2018 FISCAL YEAR, THE HOSPITAL CONDUCTED ITS THIRD COMMUNITY HEALTH NEEDS ASSESSMENT IN COMPLIANCE WITH IRS REQUIREMENTS ("CHNA"). SHORTLY THEREAFTER, THE HOSPITAL BEGAN TO UNDERTAKE CERTAIN INITIATIVES IDENTIFIED IN THE CHNA IMPLEMENTATION STRATEGY TO BEGIN TO ATTEMPT TO MEET IDENTIFIED COMMUNITY HEALTH NEEDS. PART VI, LINE 3: CARROLL HOSPITAL CENTER, INC. (CHC) HAS A NUMBER OF PROGRAMS TO ASSIST PATIENTS WITH THEIR PAYMENT OBLIGATIONS. FIRST, WE PROVIDE A MEDICAID ENROLLMENT SERVICE TO PATIENTS WHO QUALIFY FOR MEDICAL ASSISTANCE. THIS SERVICE ASSISTS PATIENTS WITH PAPERWORK AND WILL EVEN PROVIDE TRANSPORTATION IF NEEDED. THIS PAST YEAR, CHC ASSISTED OVER 200 PATIENTS IN APPLYING FOR THE STATE'S MEDICAL ASSISTANCE PROGRAM.FOR PATIENTS WHO DO NOT QUALIFY FOR MEDICAID COVERAGE, CHC HAS AN IN-HOUSE FINANCIAL ASSISTANCE PROGRAM. OUR ELIGIBILITY STANDARDS ARE MORE LENIENT THAN EVEN THOSE PROPOSED BY THE MARYLAND HOSPITAL ASSOCIATION GUIDELINES. WE WRITE OFF 100% OF THE BILL FOR PATIENTS WHOSE INCOME IS BELOW 300% OF THE FEDERAL POVERTY GUIDELINES (FPG) AND WRITE OFF A PORTION OF THE BILL FOR PATIENTS WHOSE INCOME IS BETWEEN 301%-500% OF THE FPG. WHEN PATIENTS EXPRESS THEIR INABILITY TO PAY FOR SERVICES, OUR STAFF WORKS TO FIND THE BEST POSSIBLE OPTION FOR THEM BY DISCUSSING IN DETAIL THEIR SITUATION. THE FAMILY IS INVOLVED IN THOSE CONVERSATIONS TO THE EXTENT THE PATIENT FEELS COMFORTABLE.THE HOSPITAL ALSO HAS A PROCESS IN PLACE FOR PATIENTS TO HAVE FINANCIAL ASSISTANCE DECISIONS RECONSIDERED AND THAT PROCESS IS CLEARLY OUTLINED IN OUR FINANCIAL ASSISTANCE POLICY AND IN INFORMATION PROVIDED TO OUR PATIENTS. IN ADDITION, FOR PATIENTS WITH INCOME BELOW 500% OF THE FPG AND WHOSE MEDICAL DEBT AT CHC IS IN EXCESS OF 25% OF THEIR HOUSEHOLD INCOME, THE HOSPITAL HAS A MEDICAL HARDSHIP PLAN THAT PROVIDES FOR REDUCED-COST CARE.IN ADDITION TO THE SIGNAGE AND PRINT COMMUNICATION, CARROLL HOSPITAL ALSO PROVIDES SERVICES AND INFORMATION DURING THE IN-TAKE AND DISCHARGE PROCESS. OUR POLICY IS OFFERED TO ANY PATIENT AT ALL ACCESS POINTS WHO IS EITHER UNINSURED OR UNDER-INSURED. PATIENTS ARE PRE-SCREENED FOR SCHEDULED SERVICES AND DO NOT NEED TO EXPRESS A HARDSHIP; RATHER, WE REACH OUT TO THEM PRIOR TO SERVICE TO DETERMINE IF THEY MAY BE ELIGIBLE FOR ANY PROGRAM OFFERED. OUR ADMITTED PATIENTS WHO ARE UNINSURED ARE VISITED BY FINANCIAL COUNSELORS AT BEDSIDE FOR CONSIDERATION OF ANY AND ALL PROGRAMS OF ASSISTANCE. APPLICATIONS FOR MEDICAID AND FINANCIAL ASSISTANCE ARE STARTED AT THAT POINT.IN ORDER TO ENSURE THERE ARE NO LANGUAGE BARRIERS, INTERPRETERS ARE USED IN THE APPLICATION PROCESS FOR EVERY PATIENT THAT NEEDS ONE. FAMILY MEMBERS ARE INVOLVED, AS THE PATIENT ALLOWS.CARROLL HOSPITAL HAS IMPLEMENTED A DISCHARGE PROCESS IN THE EMERGENCY DEPARTMENT TO ASSIST UNINSURED PATIENTS WITH MEDICAL ASSISTANCE APPLICATIONS ONLINE, IF THEIR HEALTH CONDITION ALLOWS. PATIENTS ARE PROVIDED A COPY OF THE FINANCIAL ASSISTANCE APPLICATION ALONG WITH CONTACT INFORMATION AND ENCOURAGED TO COMPLETE IT AT THE TIME OF SERVICE. FOLLOW-UP-CALLS ARE MADE BY THE FINANCIAL COUNSELING OFFICE FOR RESOLUTION. PART VI, LINE 4: AS THE ONLY HOSPITAL IN THE COUNTY, CHC'S PRIMARY SERVICE AREA IS THE ENTIRE COUNTY. THE HOSPITAL DOES, HOWEVER, ALSO SERVE PORTIONS OF BALTIMORE, FREDERICK AND MONTGOMERY COUNTIES, AS WELL AS, AREAS IN SOUTHERN PENNSYLVANIA. THE GENERAL DEMOGRAPHICS FOR OUR PRIMARY COMMUNITY (CARROLL COUNTY) ARE LISTED BELOW:POPULATIONTOTAL POPULATION 2018: 168,429POPULATION PERCENTAGE CHANGE FROM 2010 TO 2017: 0.4%PERSONS UNDER 5 YEARS OLD, PERCENTAGE IN 2017: 5.5%PERSONS UNDER 18 YEARS OLD, PERCENTAGE IN 2017: 21.7%PERSONS 65 YEARS OLD AND OVER, PERCENTAGE IN 2017: 16.8%FEMALE PERSONS, PERCENTAGE IN 2018: 50.5%PERSONS OF WHITE RACE, PERCENTAGE IN 2018: 91.9%PERSONS OF BLACK RACE, PERCENTAGE IN 2018: 3.7%PERSONS OF HISPANIC OR LATINO ORIGIN, PERCENTAGE IN 2018: 3.7%SOURCE: US CENSUS BUREAU: STATE AND COUNTY QUICKFACTS.FAMILYTOTAL NUMBER OF HOUSEHOLDS (2013-2017): 60,432AVERAGE HOUSEHOLD SIZE (2013-2017): 2.71 PERSONSSOURCE: US CENSUS BUREAU: STATE AND COUNTY QUICKFACTS.ECONOMICSMEDIAN HOUSEHOLD INCOME: $90,510PERCENTAGE OF PERSONS BELOW POVERTY LEVEL: 5.0%SOURCES: CARROLL COUNTY DEPARTMENT OF ECONOMIC DEVELOPMENT AND US CENSUS BUREAU: STATE AND COUNTY QUICKFACTS.OTHER SIGNIFICANT DEMOGRAPHIC CHARACTERISTICSACCORDING TO THE AMERICAN COMMUNITY SURVEY THE PERCENTAGE OF UNINSURED PATIENTS IN CARROLL COUNTY IS 3.7%. IN FY 2019, OF THE CARROLL COUNTY RESIDENTS THAT WERE HOSPITALIZED (EITHER AT CHC OR OTHER HOSPITALS) 10.8% WERE ENROLLED IN MEDICAL ASSISTANCE PROGRAMS IN CARROLL COUNTY, WHICH INCLUDES MCHIP, PAC, AND MEDICAL ASSISTANCE. THE AVERAGE LIFE EXPECTANCY WITHIN CARROLL COUNTY WAS 79.0 YEARS. PART VI, LINE 5: CARROLL HOSPITAL CENTER, FOUNDED IN 1961, IS THE SOLE HOSPITAL SERVING THE JURISDICTION OF CARROLL COUNTY, MARYLAND WITH A FY 2017 POPULATION ESTIMATED AT 168,000 PERSONS. CARROLL HOSPITAL CENTER IS THE SECOND LARGEST EMPLOYER IN CARROLL COUNTY WITH OVER 2,000 ASSOCIATES IN FY 2019. CARROLL HOSPITAL CENTER IS ACCREDITED BY THE JOINT COMMISSION.OUR GOVERNING BODY IS COMPRISED PREDOMINANTLY OF INDEPENDENT LEADERS REPRESENTATIVE OF OUR COMMUNITY WHO ASSURE THAT ALL FINANCIAL SURPLUSES THE HOSPITAL GENERATES ARE USED EXCLUSIVELY TO FURTHER THE CHARITABLE PURPOSES OF THE ORGANIZATION.WE ARE A NOT-FOR-PROFIT ORGANIZATION WITH DIVERSE SERVICE LINES INCLUDING COMPREHENSIVE ACUTE CARE SUCH AS MEDICAL, SURGICAL, PERI-NATAL, PEDIATRICS, PSYCHIATRY, MEDICAL AND RADIATION ONCOLOGY, ADULT INTENSIVE CARE AND CARDIOVASCULAR SERVICES, INCLUDING EMERGENCY PERCUTANEOUS INTERVENTIONAL CARDIOLOGY. BOTH HOME-BASED AND INPATIENT HOSPICE CARE IS PROVIDED THROUGH OUR AFFILIATED AGENCY, CARROLL HOSPICE, INC. DIVERSE DIAGNOSTIC SERVICES ARE PROVIDED AT MULTIPLE LOCATIONS AND INCLUDE BOTH LABORATORY AND RADIOLOGIC CAPABILITIES. WE PARTICIPATE IN MEDICARE AND MEDICAID PROGRAMS.THERE ARE APPROXIMATELY 450 PHYSICIANS REPRESENTING 38 SPECIALTIES ON OUR MEDICAL STAFF WHOSE MEMBERSHIP IS OPEN TO ALL QUALIFIED AREA PHYSICIANS. WE OPERATE AN EMERGENCY DEPARTMENT (ED) SERVING ALL PERSONS REGARDLESS OF ABILITY TO PAY.AN EXTENSIVE NETWORK OF HOSPITAL AFFILIATED PHYSICIAN PRACTICES ASSURES ADEQUATE AVAILABILITY OF BOTH PRIMARY AND SPECIALTY CARE PHYSICIANS THROUGHOUT THE SERVICE AREA MEETING THE CARROLL HOSPITAL CENTER STANDARDS OF EXCELLENCE AND INCORPORATING THE SAME VALUES AND PRINCIPLES. BUILDING ON OUR LONG TRADITION OF COLLABORATION WITH OUR LOCAL RESIDENTS, THE HOSPITAL, IN JOINT EFFORT WITH THE CARROLL COUNTY HEALTH DEPARTMENT, ESTABLISHED THE PARTNERSHIP FOR A HEALTHIER CARROLL COUNTY, INC. (THE PARTNERSHIP) IN 1999 TO LINK HOSPITAL STRENGTHS, ALONGSIDE THOSE OF OTHER WELL-ESTABLISHED COMMUNITY PARTNERS TO ACHIEVE AN IMPROVED HEALTH STATUS. THE PARTNERSHIP IS A RELATED SECTION 501(C)(3) TAX-EXEMPT ORGANIZATION OF CARROLL HOSPITAL CENTER, WHICH RECEIVES A MAJORITY OF ITS OPERATING FUNDS FROM CONTRIBUTIONS MADE DIRECTLY BY THE HOSPITAL. THE PARTNERSHIP WAS ESTABLISHED TO:-ASSESS UNMET HEALTH NEEDS IN OUR COMMUNITY-EXPAND THE CAPACITY FOR HEALTH AND QUALITY OF LIFE IMPROVEMENT IN OUR COMMUNITY-SERVE AS OUR COLLABORATIVE VEHICLE FOR INTERACTION WITH THE COMMUNITY-DRIVE THE EFFORT TO CREATE A HEALTHIER CARROLL COUNTY COMMUNITYTHIS STRATEGY HAS ALLOWED CARROLL HOSPITAL CENTER TO REMAIN CONTINUALLY WELL-CONNECTED TO THE COMMUNITY, TO LEVERAGE OUR RESOURCES IN ACTION ALONGSIDE THOSE OF OTHER KEY ORGANIZATIONS AND AGENCIES (PARTICULARLY, THE CARROLL COUNTY HEALTH DEPARTMENT) AND TO ASSURE MEASURABLE RESULTS. MONITORING THE HEALTH STATUS OF THE COMMUNITY IS AN ONGOING AND INTERACTIVE PROCESS ENGAGED IN BY CARROLL HOSPITAL CENTER AND THE PARTNERSHIP. CARROLL HOSPITAL CENTER AND THE PARTNERSHIP PURSUE IMPROVEMENT IN THE COMMUNITY HEALTH IMPROVEMENT AREAS (CHIAS) VIA LEADERSHIP TEAMS COMPRISED OF DIVERSE INDIVIDUALS AND ORGANIZATIONS WHO SHARE EXPERTISE AND INTEREST IN THE CHIA. THOSE LEADERS DEVELOP AND IMPLEMENT ACTION PLANS SPECIFICALLY INTENDED TO ACCOMPLISH TARGETED RESULTS. "HEALTHY CARROLL VITAL SIGNS" ARE THEN AFFIRMED, ARE SPECIFIC TO EACH CHIA LEADERSHIP TEAM AND SERVE AS ONE OF THE PRIMARY TOOLS FOR RESULTS REPORTING. WWW.HEATLHYCARROLL.ORG IS THE PARTNERSHIP'S WEBSITE WHERE CURRENT SECONDARY DATA, NATIONAL BENCHMARKS, IMPROVEMENT TARGETS AND BEST PRACTICE REFERENCES ARE EASILY AVAILABLE, ARE AS CURRENT AS AVAILABLE, AND ARE AVAILABLE TO ANYONE AT NO COST. CARROLL HOSPITAL CENTER HAS LONG RECOGNIZED THAT PROMOTING THE HEALTH OF ITS COMMUNITY IS ONE OF ITS ESSENTIAL RESPONSIBILITIES. EXTENSIVE COMMUNITY OUTREACH AND LEARNING PROGRAMS ARE OFFERED BY THE HOSPITAL WITH AN EMPHASIS ON DISEASE PREVENTION, EARLY INTERVENTION AND WELLNESS.IN FY 2012 WE EXPANDED ON AN INTEGRATED APPROACH TO POPULATION HEALTH; SEEKING TO ASSURE ACCESS TO EXCELLENT HEALTH CARE AND DISEASE MANAGEMENT ASSISTANCE. OUR INTEGRATED APPROACH RECOGNIZES AND STRIVES TO ELIMINATE BARRIERS SUCH AS TRANSPORTATION CHALLENGES OR LIMITED ABILITIES TO PURCHASE ESSENTIAL PRESCRIPTION PRODUCTS; IT ALSO INCLUDES MORE IN-COMMUNITY CARE COORDINATION AND ASSISTANCE WITH NAVIGATING THE OFTEN COMPLEX WORLD OF HEALTH CARE ASSOCIATED SERVICES.CHC IS ONE OF THE FOUNDING AND FUNDING PARTNERS IN A UNIQUE AND HIGHLY SUCCESSFUL INTEGRATED PRIMARY CARE CENTER KNOWN AS ACCESS CARROLL, INC. AT ACCESS CARROLL, INC. THE BARRIERS OF LOW INCOME AND INELIGIBILITY FOR STATE, FEDERAL OR OTHER INSURANCE ASSISTANCE ARE BEING ELIMINATED FOR SIGNIFICANT NUMBERS OF CARROLL COUNTY RESIDENTS WHO ARE RECEIVING THE SAME STELLAR INTEGRATED PRIMARY AND SPECIALTY CARE SERVICES NEEDED TO MANAGE THEIR ACUTE AND/OR CHRONIC DISEASE ISSUES AS THEIR HIGHER INCOME AND INSURED NEIGHBORS. IN ADDITION TO THE PRIMARY AND SPECIALTY MEDICAL CARE AND CARE MANAGEMENT NAVIGATION ASSISTANCE, THE ACCESS CARROLL PATIENTS RECEIVE DIAGNOSTIC LABORATORY AND RADIOLOGY SERVICES, DENTAL SERVICES, PRESCRIPTION ASSISTANCE AND MORE. CARROLL HOSPITAL CENTER CONTRIBUTED $1,256,101 TO ACCESS CARROLL IN FY19 TO COVER SALARY AND BENEFIT EXPENSES FOR THE EXECUTIVE DIRECTOR, MANAGER, ONE FULL TIME RN CASE MANAGER AND TWO PART-TIME POSITIONS (AIDE AND DEVELOPMENT SPECIALIST), AS WELL AS OPERATIONAL EXPENSES. THE HOSPITAL ALSO PROVIDES LABORATORY AND DIAGNOSTIC IMAGING SERVICES TO ACCESS CARROLL, CAPTURED UNDER CHARITY CARE, WHICH TOTALED $100,682 IN FY19.THESE HEALTH PROMOTION EFFORTS ARE IN ADDITION TO PROGRAMS AND SERVICES THAT SEEK TO HELP PEOPLE CHANGE THEIR LIFESTYLES TO MOVE TOWARD A STATE OF OPTIMAL HEALTH IN MIND, BODY AND SPIRIT. CARROLL HOSPITAL CENTER DEMONSTRATES ITS COMMITMENT TO IMPROVING THE HEALTH AND WELLNESS OF THE COMMUNITIES IT SERVES BY PROVIDING SERVICES AND PROGRAMS THAT ADDRESS CRITICAL NEEDS, INCLUDING HEALTH CARE TO VULNERABLE OR UNDERSERVED PEOPLE, PUBLIC HEALTH PROGRAMS, AND HEALTH EDUCATION, SCREENING AND PREVENTION SERVICES. THESE PROGRAMS AND ACTIVITIES INCLUDED HOSPICE SERVICES, PHYSICIAN SUPPORT, CHARITY/UNCOMPENSATED CARE, EDUCATION PROGRAMS, HEALTH SCREENINGS, SUPPORT GROUPS, HEALTH PROFESSIONS EDUCATION AND COMMUNITY CONTRIBUTIONS.CARROLL HOSPITAL CENTER OFFERS THESE PROGRAMS AND SERVICES NOT ONLY TO ADDRESS THE NEEDS OF PEOPLE WITH CHRONIC OR ACUTE MEDICAL ISSUES, BUT ALSO TO ADDRESS PREVENTION AND EDUCATION TO KEEP OUR POPULATION WELL. PART VI, LINE 6: CARROLL HOSPITAL, A LIFEBRIDGE HEALTH CENTER, IS PART OF AN AFFILIATED HEATH CARE SYSTEM THAT PROVIDES AN ARRAY OF HEALTH CARE SERVICES TO ITS COMMUNITY. THE HOSPITAL, AS A SOLE COMMUNITY PROVIDER, PROVIDES BOTH INPATIENT AND OUTPATIENT CARE, INCLUDING ESSENTIAL HEALTH CARE SERVICES SUCH AS OBSTETRICS, EMERGENCY SERVICES, PEDIATRIC, AND CRITICAL CARE, WHICH WOULD LIKELY OTHERWISE NOT BE PROVIDED WITHIN CARROLL COUNTY DUE TO THEIR UNPROFITABLE NATURE (HIGH COST SERVICES WITH RELATIVELY LOW REIMBURSEMENT). ADDITIONALLY, THE HOSPITAL IS RELATED TO A GROUP PHYSICIAN PRACTICE (CARROLL HEALTH GROUP), WHICH PROVIDES PRIMARY AND SPECIALTY CARE SERVICES TO THE COMMUNITY. THE PROVISION OF THE PHYSICIAN SERVICE HELPS MEET AN IDENTIFIED COMMUNITY HEALTH NEED FOR ADDITIONAL PRIMARY AND SPECIALTY CARE PHYSICIANS AND PROVIDERS IN THE COMMUNITY. CARROLL HOSPICE, AN AFFILIATE OF CARROLL HOSPITAL, PROVIDES INPATIENT HOSPICE CARE, AS WELL AS RESIDENTIAL HOSPICE AND PALLIATIVE CARE, TO PATIENTS NEARING THE END OF LIFE. CARROLL HOSPICE PROVIDES PAIN MANAGEMENT AND SYMPTOM CONTROL AND HELPS COORDINATE HOME AND INPATIENT SERVICES. IN ORDER TO PROVIDE COMPREHENSIVE AND COMPASSIONATE CARE, CARROLL HOSPICE UTILIZES AN INTERDISCIPLINARY TEAM, INCLUDING PHYSICIANS, NURSES, SOCIAL WORKERS, CLERGY, PHARMACISTS, AND HOME HEALTH AIDES. FURTHER, CARROLL HOSPICE PROVIDES BEREAVEMENT CARE FOR FAMILY MEMBERS FOR UP TO THIRTEEN MONTHS, AS WELL AS, FOR THE BROADER COMMUNITY AS NEEDED. PART VI, LINE 7, REPORTS FILED WITH STATES MD 1 PARTNERSHIP FOR A HEALTHIER CARROLL COUNTY 535 OLD WESTMINSTER PIKE SUITE 102 WESTMINSTER MD 211575799 522156892 501(C)(3) 191000 TO SUPPORT THE OPERATIONS OF PARTNERSHIP. ACCESS CARROLL 10 DISTILLERY DRIVE SUITE 200 WESTMINSTER MD 211575799 202146701 501(C)(3) 1294000 TO SUPPORT THE OPERATIONS OF ACCESS CARROLL. 2 0 PART I, LINE 2: THE FIRST GRANT PROVIDED IS TO THE PARTNERSHIP FOR A HEALTHIER CARROLL COUNTY, A RELATED ORGANIZATION THAT IS CONTROLLED BY THE ORGANIZATION AND IS A JOINT VENTURE WITH THE CARROLL COUNTY HEALTH DEPARTMENT. THE PARTNERSHIP FOR A HEALTHIER CARROLL COUNTY IS A 501(C)(3) TAX EXEMPT ORGANIZATION THAT IS DEDICATED TO IMPROVING THE HEALTH AND QUALITY OF LIFE OF INDIVIDUALS LIVING IN CARROLL COUNTY, MARYLAND. THE SECOND GRANT PROVIDED IS TO ACCESS CARROLL, A RELATED ORGANIZATION THAT IS A JOINT VENTURE BETWEEN CARROLL HOSPITAL, THE CARROLL COUNTY HEALTH DEPARTMENT AND THE PARTNERSHIP FOR A HEALTHIER CARROLL COUNTY. ACCESS CARROLL IS A 501 (C)(3) TAX EXEMPT ORGANIZATION THAT PROVIDES FREE HEALTH CARE TO UNINSURED, LOW-INCOME CARROLL COUNTY RESIDENTS WHO MEET CERTAIN ELIGIBILITY REQUIREMENTS. 0 1 0 0 0 0 0 0 0 KIMBERLY A JOHNSTON-DELTUVAMD BOARD MEMBER 0 291163 0 18000 0 270 0 5950 0 842 0 316225 0 0 SARAH LENTZ MD BOARD MEMBER 0 400784 0 110395 0 270 0 0 0 22247 0 533696 0 0 NEIL M MELTZER BOARD MEMBER/LBH PRESIDENT 0 954219 0 584642 0 438481 0 412001 0 23315 0 2412658 0 332995 LESLIE R SIMMONS BOARD MEMBER/PRESIDENT 0 627046 0 217500 0 73644 0 142564 0 21563 0 1082317 0 57800 KEVIN K KELBLY TREASURER/SENIOR VP FINANCE/CFO 0 363877 0 85380 0 774 0 12021 0 24014 0 486066 0 0 MARK D OLSZYK VP OF MEDICAL STAFF 0 424025 0 105901 0 1390 0 72540 0 1769 0 605625 0 0 JED S ROSEN MD CHIEF OF SURGERY 398844 0 10000 0 1188 0 5850 0 21605 0 437487 0 0 0 HOLLY PHIPPS-ADAMS VP HUMAN RESOURCES 125316 156864 25061 31370 506 634 20029 25071 10898 13642 181810 227581 0 0 M ELLEN FINNERTY MYERS CHIEF DEVELOPMENT OFFICER 0 256863 0 63362 0 414 0 48868 0 2631 0 372138 0 0 STEPHANIE J REID CNO/VP QUALITY 225780 0 48808 0 1188 0 43973 0 2424 0 322173 0 0 0 DWAYNE RICHARDSON SR VP OPERATION 190618 0 21751 0 36467 0 21986 0 13664 0 284486 0 0 0 CRIS W COLEMAN ASSISTANT VP OF FINANCE 0 204713 0 39294 0 414 0 6830 0 25261 0 276512 0 0 SHARON L MCCLERNAN VP OF CLINICAL INTEGRATION 191773 0 44798 0 411 0 39907 0 26541 0 303430 0 0 0 FLAVIO W KRUTER PHYSICIAN 987828 0 212650 0 2262 0 17150 0 25044 0 1244934 0 0 0 DARLENE GABEAU PHYSICIAN 561369 0 128535 0 270 0 2663 0 28716 0 721553 0 0 0 QIWEI GAI PHYSICIAN 524081 0 105611 0 774 0 2373 0 27391 0 660230 0 0 0 LINDA BRUCHEY NURSE 229530 0 0 0 495 0 0 0 9811 0 239836 0 0 0 RONALD MCDADE DIRECTOR OF HEALTHCARE REDESIGN 165369 0 24431 0 619 0 955 0 20625 0 211999 0 0 0 JOHN M SERNULKA FORMER PRESIDENT 125907 0 0 0 0 0 0 0 0 0 125907 0 0 0 PART I, LINE 3 ITHE COMPENSATION OF CARROLL HOSPITAL CENTER, INC.'S CEO/EXECUTIVE DIRECTOR IS DETERMINED AT THE PARENT LEVEL BY LIFEBRIDGE HEALTH, INC. THE METHODS USED AT LIFEBRIDGE HEALTH, INC. INCLUDE A COMPENSATION COMMITTEE, INDEPENDENT COMPENSATION CONSULTANT, WRITTEN EMPLOYMENT CONTRACT, COMPENSATION SURVEY OR STUDY AND APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE. PART I, LINE 4B THE FOLLOWING DIRECTORS AND OFFICERS PARTICIPATED IN A LIFEBRIDGE HEALTH SPONSORED SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN DURING THE YEAR: NEIL MELTZER $ 378,851 LESLIE SIMMONS $ 118,553 ELLEN FINNERTY MYERS $ 43,009 SHARON MCCLERNAN $ 33,406 MARK OLSZYK $ 70,601 STEPHANIE REID $ 37,698 HOLLY PHIPPS-ADAMS $ 42,560 DWAYNE RICHARDSON $ 21,000 THE FOLLOWING DIRECTORS AND OFFICERS RECEIVED PAYMENTS AS PART OF THEIR PARTICIPATION IN A LIFEBRIDGE HEALTH SPONSORED SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN DURING THE YEAR: NEIL MELTZER $ 410,275 LESLIE SIMMONS $ 63,270 COMPENSATION PROVIDED BY RELATED ORGANIZATIONS: MR. MELTZER RECEIVED COMPENSATION AS PRESIDENT OF LIFEBRIDGE HEALTH, INC., NOT AS A DIRECTOR. MS. SIMMONS RECEIVED COMPENSATION AS PRESIDENT OF CARROLL HOSPITAL CENTER, INC. AND EXECUTIVE VICE PRESIDENT OF LIFEBRIDGE HEALTH, INC., NOT AS A DIRECTOR. DR. JOHNSON-DELTUVA RECEIVED COMPENSATION AS PHYSICIAN OF A SINGLE MEMBER LLC OWNED BY LIFEBRIDGE COMMUNITY PHYSICIANS, INC., NOT AS A DIRECTOR. DR. LENTZ RECEIVED COMPENSATION AS A PHYSICIAN OF CARROLL HEALTH GROUP, LLC, NOT AS A DIRECTOR. A MARYLAND HEALTH AND HIGHER EDUCATION FAC AUTHORITY 520936091 574218HJ5 2012-05-31 93596537 REFUND 2002 BONDS, FAC ACQ, RENOVATION 1 0 0 A 39290000 26543750 93596537 100764 14899236 78596537 2012 1 0 1 1 A 0 0 1 1 1 1 0.01000 0.01000 0.02000 0 0 1 A 0 0 0 1 1 0 0 0 1 A 1 DATE REBATE COMPUTATION PERFORMED ISSUER NAME: MARYLAND HEALTH AND HIGHER EDUCATION FAC AUTHORITY DATE THE REBATE COMPUTATION WAS PERFORMED: 07/01/2015 HEATHER GREEN FAMILY RELATIONSHIP TO AN OFFICER, LESLIE SIMMONS 87081 EMPLOYEE OF HOSPITAL - DIRECTOR OF CARDIAC VASCULAR LAB 0 CHELSEA BEAUVAIS FAMILY RELATIONSHIP TO AN OFFICER, LESLIE SIMMONS 41348 REGISTERED NURSE 0 ROBERT J BEAUVAIS FAMILY RELATIONSHIP TO AN OFFICER, LESLIE SIMMONS 82816 IT SYSTEM ENGINEER 0 RANDY C GREEN JR FAMILY RELATIONSHIP TO AN OFFICER, LESLIE SIMMONS 41337 REGISTERD NURSE 0 SOMMER DORSEY FAMILY RELATIONSHIP TO A KEY EMPLOYEE, SHARON MCCLERNAN 36903 COLLECTIONS REG SPECIALIST 0 FORM 990, PART VI, SECTION A, LINE 6 THE CORPORATION SHALL HAVE ONE MEMBER: CARROLL COUNTY HEALTH SERVICES CORPORATION (THE "MEMBER") A MARYLAND NONSTOCK CORPORATION. MEMBERSHIP IN THE CORPORATION SHALL NOT BE TRANSFERABLE. FORM 990, PART VI, SECTION A, LINE 7A THE MEMBER SHALL HAVE THE EXCLUSIVE POWER AND AUTHORITY TO TAKE THE FOLLOWING ACTIONS: (1) THE BOARD OF DIRECTORS SHALL AT ALL TIME BE IDENTICAL TO THE BOARD OF DIRECTORS OF THE MEMBER. NONVOTING MEMBERS OF THE BOARD OF DIRECTORS OF THE MEMBERS, AS PROVIDED FOR UNDER THE BYLAWS OF THE MEMBER, SHALL BE NONVOTING DIRECTORS OF THE CORPORATION. (2) THE MEMBER MAY REMOVE ANY DIRECTOR AT ANY TIME, WITH OR WITHOUT CAUSE. REMOVAL FROM THE BOARD OF DIRECTORS OF THE MEMBER CONSTITUTES REMOVAL FROM THE BOARD OF DIRECTORS OF THE CORPORATION. (3) THE INDIVIDUAL SERVING AS PRESIDENT OF THE MEMBER WILL SERVE AS THE PRESIDENT OF THE CORPORATION. REMOVAL OR RESIGNATION OF THE PRESIDENT OF THE MEMBER WILL CONSTITUTE REMOVAL OR RESIGNATION AS THE PRESIDENT OF THE CORPORATION, AND APPOINTMENT AS THE PRESIDENT OF THE MEMBER WILL CONSTITUTE APPOINTMENT AS PRESIDENT OF THE CORPORATION. FORM 990, PART VI, SECTION A, LINE 7B THE MEMBER HAS POWER TO APPOINT AND/OR REMOVE MEMBERS OF THE GOVERNING BODY. FORM 990, PART VI, SECTION B, LINE 10A: THE POLICIES DESCRIBED IN PART VI, SECTION B, LINES 10A-16B APPLY TO CARROLL HOSPITAL CENTER, INC. AND ITS AFFILIATES AS LISTED BELOW: CARROLL HOSPITAL CENTER MOB INVESTMENT, LLC CARROLL REGIONAL CANCER CENTER PHYSICIANS FORM 990, PART VI, SECTION B, LINE 11B THE LIFEBRIDGE EXEMPT ENTITIES 990'S ARE INITIALLY REVIEWED BY THE ASSISTANT VICE PRESIDENT OF FINANCIAL REPORTING. IN ADDITION, AN INDEPENDENT ACCOUNTING FIRM ALSO REVIEWS ALL THE 990 RETURNS. A FORMAL MEETING IS THEN SCHEDULED WITH THE CHIEF FINANCIAL OFFICER, VICE PRESIDENT OF FINANCE, GENERAL COUNSEL, AND ASSISTANT VICE PRESIDENT OF FINANCIAL REPORTING TO REVIEW IN THEIR ENTIRETY ALL THE LIFEBRIDGE EXEMPT ENTITIES 990'S. MANAGEMENT THEN PROVIDES A COPY OF THE 990'S TO THE AUDIT AND COMPLIANCE COMMITTEE OF THE LIFEBRIDGE BOARD AND TO EACH INDIVIDUAL BOARD DIRECTOR PRIOR TO THE FILING DATE FOR REVIEW. FORM 990, PART VI, SECTION B, LINE 12C ALL DIRECTORS, OFFICERS, EMPLOYEES, MEDICAL STAFF MEMBERS, AND VOLUNTEERS ARE EXPECTED TO RECOGNIZE AND DISCLOSE AT THE EARLIEST POSSIBLE TIME ACTUAL AND POTENTIAL CONFLICTS OF INTEREST. AN INDIVIDUAL IS CONSIDERED TO HAVE A CONFLICT OF INTEREST WITH REGARD TO A MATTER OR TRANSACTION IF THE INDIVIDUAL OR A FAMILY MEMBER OF THE INDIVIDUAL HAS A PERSONAL OR FINANCIAL INTEREST THAT HAS THE POTENTIAL TO INFLUENCE THE ACTION TAKEN BY THE INDIVIDUAL ON BEHALF OF LIFEBRIDGE HEALTH. ADDITIONAL INFORMATION REGARDING WHAT CONSTITUTES A CONFLICT OF INTEREST AND HOW TO DISCLOSE A CONFLICT IS OUTLINED BELOW. LIFEBRIDGE AND ALL OF ITS SUBSIDIARIES SHALL REQUIRE ALL EMPLOYEES, MEDICAL STAFF, AND MEMBERS OF THE BOARD TO DISCLOSE ANY ACTIVITIES THAT COULD RESULT IN A POSSIBLE CONFLICT OF INTEREST. IF A CONFLICT IS IDENTIFIED, THE PERSON INVOLVED WOULD RECUSE HIM/HERSELF FROM DELIBERATIONS REGARDING THE TRANSACTIONS. AN INDIVIDUAL IS CONSIDERED TO HAVE A CONFLICT OF INTEREST WITH REGARD TO A MATTER OR TRANSACTION IF THE INDIVIDUAL HAS A PERSONAL OR FINANCIAL INTEREST THAT HAS THE POTENTIAL TO INFLUENCE THE ACTION TAKEN BY THE INDIVIDUAL ON BEHALF OF LIFEBRIDGE OR ANY OF ITS SUBSIDIARIES. AN INDIVIDUAL IS CONSIDERED TO HAVE A "PERSONAL INTEREST" IN A MATTER IF IT IS LIKELY TO HAVE A DIRECT AND MATERIAL IMPACT ON THE INDIVIDUAL'S RELATIONSHIP WITH LIFEBRIDGE OR ANY OF ITS SUBSIDIARIES (E.G., THE INDIVIDUAL'S CONTINUED MEMBERSHIP ON A SUBSIDIARY HOSPITAL'S MEDICAL STAFF), OR ON THE INDIVIDUAL'S OWN HEALTH CARE, OR THE INDIVIDUAL IS PERSONALLY INVOLVED IN A SUBSTANTIAL WAY (E.G., SERVES AS AN OFFICER, DIRECTOR, TRUSTEE, OR KEY EMPLOYEE) WITH ANOTHER ORGANIZATION THAT HAS A SIGNIFICANT INTEREST IN THE MATTER. AN INDIVIDUAL IS CONSIDERED TO HAVE A "FINANCIAL INTEREST" IN A TRANSACTION IF THE INDIVIDUAL, OR THEIR FAMILY MEMBER, (I) IS A PARTY TO THE TRANSACTION, (II) WILL BENEFIT PERSONALLY FROM THE TRANSACTION, OR (III) HAS, DIRECTLY OR INDIRECTLY, A CURRENT OR ANTICIPATED OWNERSHIP OR INVESTMENT IN, OR COMPENSATION ARRANGEMENT WITH, A PARTY TO THE TRANSACTION. AN OWNERSHIP INTEREST OF LESS THAN 5% IN AN ENTITY WILL NOT, IN AND OF ITSELF, GENERALLY BE CONSIDERED A FINANCIAL INTEREST; HOWEVER, TO THE EXTENT THE INDIVIDUAL'S COMPENSATION FROM THE ENTITY IS DIRECTLY LINKED TO THE ENTITY'S BUSINESS WITH LIFEBRIDGE HEALTH, SUCH COMPENSATION WILL CONSTITUTE A FINANCIAL INTEREST. FOR THE PURPOSES OF THIS POLICY, A "FAMILY MEMBER" INCLUDES SPOUSE OR DOMESTIC PARTNER, PARENTS, BROTHERS AND SISTERS, CHILDREN (WHETHER NATURAL OR ADOPTED), GRANDPARENTS, GRANDCHILDREN, GREAT-GRANDCHILDREN, AND IN-LAWS, SPOUSES OF BROTHERS, SISTERS, CHILDREN, GRANDCHILDREN, AND GREAT-GRANDCHILDREN, AND ANY OTHER MEMBER OF A HOUSEHOLD OF THE INDIVIDUAL. CONFLICTS OF INTEREST ARE TO BE REPORTED BY EMPLOYEES TO THEIR SUPERVISOR, WHO WILL BE RESPONSIBLE FOR DETERMINING WHETHER FURTHER DISSEMINATION IS NECESSARY. MEMBERS OF THE MEDICAL STAFF SHOULD REPORT CONFLICTS TO THE CHIEF OF THEIR DEPARTMENT, AND MEMBERS OF THE BOARD SHOULD REPORT THEM TO THE CHIEF COMPLIANCE OFFICER. QUESTIONNAIRES ARE SENT OUT TO MEMBERS OF THE BOARD ON AN ANNUAL BASIS. IF QUESTIONS ARISE OR FURTHER GUIDANCE IS SOUGHT, INDIVIDUALS CAN CONTACT THE CHIEF COMPLIANCE OFFICER (410-601-4832) OR CONFIDENTIAL COMPLIANCE HOTLINE (1-844-732-6233). NOTHING IN THIS DEFINITION IS INTENDED TO RELIEVE ANY PERSON OF ANY ADDITIONAL OBLIGATIONS THAT MAY BE IMPOSED BY STATE OR FEDERAL LAW. FORM 990, PART VI, SECTION C, LINE 19 IT IS THE POLICY OF LIFEBRIDGE HEALTH INC. AND ITS SUBSIDIARIES TO MAKE AVAILABLE UPON REQUEST THE AUDITED FINANCIAL STATEMENTS TO THE GENERAL PUBLIC. THE LIFEBRIDGE HEALTH INC. AND SUBSIDIARY GOVERNING DOCUMENTS ARE NOT MADE AVAILABLE TO THE GENERAL PUBLIC UPON REQUEST OR VIA A WEBSITE. THE CONFLICT OF INTEREST POLICY IS INCLUDED ON SCHEDULE O. FORM 990, PART IX, LINE 11G PHYSICIAN FEES: PROGRAM SERVICE EXPENSES 11,441,365. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 11,441,365. CONTRACTED SERVICES: PROGRAM SERVICE EXPENSES 5,045,876. MANAGEMENT AND GENERAL EXPENSES 52,459. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 5,098,335. OTHER FEES: PROGRAM SERVICE EXPENSES 5,385,765. MANAGEMENT AND GENERAL EXPENSES 12,583,540. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 17,969,305. PURCHASED SERVICES, AGENCY, PATIENT RELATED SERVICES: PROGRAM SERVICE EXPENSES 15,198,191. MANAGEMENT AND GENERAL EXPENSES 310,167. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 15,508,358. LAB OUTREACH: PROGRAM SERVICE EXPENSES 654,298. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 654,298. CANCER CENTER: PROGRAM SERVICE EXPENSES 300,000. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 300,000. FOOD SERVICES: PROGRAM SERVICE EXPENSES 93,300. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 93,300. CONSULTING: PROGRAM SERVICE EXPENSES 59,724. MANAGEMENT AND GENERAL EXPENSES 504. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 60,228. DUE TO AFFILIATES - BONDS ON MAY 1, 2015, A SINGLE OBLIGATED GROUP (THE OBLIGATED GROUP) WAS FORMED, CONSISTING OF LIFEBRIDGE HEALTH INC., SINAI HOSPITAL OF BALTIMORE INC., NORTHWEST HOSPITAL CENTER INC., LEVINDALE HEBREW GERIATRIC CENTER & HOSPITAL INC., THE BALTIMORE JEWISH HEALTH FOUNDATION INC., CHILDREN'S HOSPITAL AT SINAI FOUNDATION INC., CARROLL COUNTY HEALTH SERVICES CORPORATION, CARROLL HOSPITAL CENTER INC., CARROLL COUNTY MED SERVICES INC., CARROLL HEALTH GROUP LLC, CARROLL HOSPICE INC., AND CARROLL REGIONAL CANCER CENTER PHYSICIANS LLC. MEMBERS OF THE OBLIGATED GROUP ARE JOINTLY AND SEVERALLY LIABLE FOR ALL OF THE OUTSTANDING BONDS. THE BONDS INCLUDE THE ONES DETAILED ABOVE AS WELL AS THE BONDS ISSUED ON BEHALF OF CARROLL HOSPITAL CENTER, INC. AND ITS RELATED SUBSIDIARIES. THESE BONDS WERE ISSUED BY THE MARYLAND HEALTH AND HIGH EDUCATION FACILITIES (MHHEFA) AUTHORITY ON BEHALF OF LIFEBRIDGE HEALTH INC. AND CARROLL HOSPITAL CENTER, INC. AND THEIR RESPECTIVE AFFILIATES, TOGETHER WITH THE OTHER OBLIGATIONS ON PARITY WITH SUCH BONDS. ALL THE BONDS ARE REPORTED ON SCHEDULE K OF THE LIFEBRIDGE HEALTH INC. FORM 990. ON JULY 30, 2015, LIFEBRIDGE HEALTH, INC., TOGETHER WITH ITS AFFILIATES SINAI HOSPITAL OF BALTIMORE INC., NORTHWEST HOSPITAL CENTER INC., LEVINDALE HEBREW GERIATRIC CENTER & HOSPITAL INC., THE BALTIMORE JEWISH HEALTH FOUNDATION INC., CHILDREN'S HOSPITAL AT SINAI FOUNDATION INC., CARROLL COUNTY HEALTH SERVICES CORPORATION, CARROLL HOSPITAL CENTER INC., CARROLL COUNTY MED SERVICES INC., CARROLL HEALTH GROUP LLC, CARROLL HOSPICE INC., AND CARROLL REGIONAL CANCER CENTER PHYSICIANS LLC (COLLECTIVELY, THE OBLIGATED GROUP) BORROWED $159,685,000 FROM THE MARYLAND HEALTH AND HIGHER EDUCATIONAL FACILITIES AUTHORITY (THE AUTHORITY) TO FINANCE AND REFINANCE THE COST OF CONSTRUCTION, RENOVATION, AND EQUIPPING OF CERTAIN ADDITIONAL FACILITIES FOR THE OBLIGATED GROUP, TO REFUND A PORTION OF THE SERIES 2008 BONDS AND THE AUTHORITY'S CARROLL ISSUE, SERIES 2006 BONDS, AND REFINANCE A PORTION OF AN OUTSTANDING LINE OF CREDIT. THE AUTHORITY OBTAINED THE FUNDS FOR THIS FINANCING THROUGH THE ISSUANCE OF BONDS UNDER THE MARYLAND HEALTH AND HIGHER EDUCATIONAL FACILITIES AUTHORITY (MHHEFA) REVENUE BONDS, LIFEBRIDGE HEALTH ISSUE, SERIES 2015, COLLATERALIZED BY ALL RECEIPTS OF THE OBLIGATED GROUP. THE BONDS WERE ISSUED AT A PREMIUM OF $7,389,102, OF WHICH CARROLL HOSPITAL'S PORTION IS $2,387,741, WHICH IS BEING AMORTIZED OVER THE LIFE OF THE BOND ISSUE. THE MEMBERS OF THE OBLIGATED GROUP ARE JOINTLY AND SEVERALLY LIABLE FOR REPAYMENT OF THE PRINCIPAL AND LOAN AND INTEREST THEREON. AS OF JUNE 30, 2019, $165,411,955 OF THE TOTAL AMOUNT BORROWED, OF WHICH CARROLL HOSPITAL'S PORTION IS $76,152,000, APPEARS AS DUE TO LIFEBRIDGE HEALTH. ALL THE BONDS WERE ISSUED IN THE NAME OF LIFEBRIDGE AND ARE REPORTED ON SCHEDULE K OF ITS FORM 990. ON OCTOBER 25, 2016, LIFEBRIDGE HEALTH, INC., TOGETHER WITH ITS AFFILIATES SINAI HOSPITAL OF BALTIMORE INC., NORTHWEST HOSPITAL CENTER INC., LEVINDALE HEBREW GERIATRIC CENTER & HOSPITAL INC., THE BALTIMORE JEWISH HEALTH FOUNDATION INC., CHILDREN'S HOSPITAL AT SINAI FOUNDATION INC., CARROLL COUNTY HEALTH SERVICES CORPORATION, CARROLL HOSPITAL CENTER INC., CARROLL COUNTY MED SERVICES INC., CARROLL HEALTH GROUP LLC, CARROLL HOSPICE INC., AND CARROLL REGIONAL CANCER CENTER PHYSICIANS LLC (COLLECTIVELY, THE OBLIGATED GROUP) BORROWED $120,695,000 FROM THE MARYLAND HEALTH AND HIGHER EDUCATIONAL FACILITIES AUTHORITY (THE AUTHORITY) TO REFINANCE THE SERIES 2008 BONDS. THE AUTHORITY OBTAINED THE FUNDS FOR THIS FINANCING THROUGH THE ISSUANCE OF BONDS UNDER THE MARYLAND HEALTH AND HIGHER EDUCATIONAL FACILITIES AUTHORITY (MHHEFA) REVENUE BONDS, LIFEBRIDGE HEALTH ISSUE, SERIES 2016, COLLATERALIZED BY ALL RECEIPTS OF THE OBLIGATED GROUP. THE BONDS WERE ISSUED AT A PREMIUM OF $11,192,819, WHICH IS BEING AMORTIZED OVER THE LIFE OF THE BOND ISSUE. THE MEMBERS OF THE OBLIGATED GROUP ARE JOINTLY AND SEVERALLY LIABLE FOR REPAYMENT OF THE PRINCIPAL AND LOAN AND INTEREST THEREON. AS OF JUNE 30, 2019, $129,530,458 OF THE TOTAL AMOUNT BORROWED APPEARS AS DUE TO LIFEBRIDGE HEALTH. ALL THE BONDS WERE ISSUED IN THE NAME OF LIFEBRIDGE AND ARE REPORTED ON SCHEDULE K OF ITS FORM 990. ON OCTOBER 31, 2017, LIFEBRIDGE HEALTH, INC. TOGETHER WITH ITS AFFILIATES SINAI HOSPITAL OF BALTIMORE, NORTHWEST HOSPITAL CENTER, LEVINDALE HEBREW AND GERIATRIC CENTER, CHILDREN'S HOSPITAL AT SINAI FOUNDATION, THE BALTIMORE JEWISH HEALTH FOUNDATION, CARROLL COUNTY HEALTH SERVICES CORPORATION, CARROLL HOSPITAL CETNER, INC., CARROLL COUNTY MED SERVICES, INC., CARROLL HEALTH GROUP LLC, CARROLL HOSPICE INC. AND CARROLL REGIONAL CANCER CENTER PHYSICIANS LLC (COLLECTIVELY, THE OBLIGATED GROUP) BORROWED $118,120,000 FROM THE MARYLAND HEALTH AND HIGHER EDUCATIONAL FACILITIES AUTHORITY (THE AUTHORITY) WHICH WAS USED TO REFUND THE SERIES 2008 BONDS. THE BONDS WERE ISSUED AT A PREMIUM OF $12,517,982, WHICH IS BEING AMORTIZED OVER THE LIFE OF THE BOND ISSUE. THE MEMBERS OF THE OBLIGATED GROUP ARE JOINTLY AND SEVERALLY LIABLE FOR REPAYMENT OF THE PRINCIPAL AND LOAN AND INTEREST THEREON. AS OF JUNE 30, 2019, $126,282,092 OF THE TOTAL AMOUNT BORROWED APPEARS AS DUE TO LIFEBRIDGE HEALTH. ALL THE BONDS WERE ISSUED IN THE NAME OF LIFEBRIDGE AND ARE REPORTED ON SCHEDULE K OF ITS FORM 990. FORM 990, PART XI, LINE 9: MANAGEMENT REVENUE FROM RELATED ORGS -90,000. TRANSFER TO CARROLL COUNTY HEALTH SERVICES CORPORATION -1,500,000. CHANGE IN MINIMUM PENSION LIABILITY -11,159,921. CARROLL COUNTY RADIOLOGY, LLC -2,033,712. CHANGE IN INVESTMENT IN HOSPICE UNRESTRICTED 2,833,028. CHANGE IN INVESTMENT IN FOUNDATION UNRESTRICTED 1,622,316. CHANGE IN TEMPORARY RESTRICTED ASSETS (FOUNDATION & HOSPICE) 935,358. TRANSFERS TO AFFLIATES -539,840. GRANTS 191,000. TRANSFER FROM UNRESTRICTED 40,000. NON-UNION PENSION NON- SERVICE INCOME 1,744,767. FORM 990, PART XII, LINE 2C: THIS PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. CARROLL HOSPITAL CENTER MOB INVESTMENT LLC 200 MEMORIAL AVENUE WESTMINSTER MD 21157 271528335 INVESTMENTS MD 284393 0 CARROLL HOSPITAL CENTER INC CARROLL REGIONAL CANCER CENTER PHYSICIANS 200 MEMORIAL AVENUE WESTMINSTER MD 21157 422463175 HEALTHCARE MD 1767784 125404 CARROLL HOSPITAL CENTER INC CARROLL COUNTY HEALTH SERVICES CORPORATION 200 MEMORIAL AVENUE WESTMINSTER MD 21157 520691413 CHARITY SUPPORT FOR CARROLL HOSPITAL CENTER, INC. MD 501(C)(3) LINE 12B, II LIFEBRIDGE HEALTH INC 0 CARROLL HOSPITAL CENTER FOUNDATION INC 200 MEMORIAL AVENUE WESTMINSTER MD 21157 521115038 CHARITY SUPPORT FOR CARROLL HOSPITAL CENTER, INC. & CARROLL HOSPICE MD 501(C)(3) LINE 12A, I CARROLL HOSPITAL CENTER INC 1 CARROLL HOSPICE INC 200 MEMORIAL AVENUE WESTMINSTER MD 21157 521565870 HOSPICE MD 501(C)(3) LINE 7 CARROLL HOSPITAL CENTER INC 1 PARTNERSHIP FOR A HEALTHIER CARROLL COUNTY 535 OLD WESTMINSTER PIKE SUITE 102 WESTMINSTER MD 21157 522156892 HEALTH SERVICE MD 501(C)(3) LINE 7 CARROLL HOSPITAL CENTER INC 1 LEVINDALE HEBREW GERIATRIC CENTER AND HOSPITAL INC 2434 WEST BELVEDERE AVENUE BALTIMORE MD 21215 520607913 GERIATRIC HOSPITAL DEICATED TO PROVIDING SERVICE TO THE AGED MD 501(C)(3) LINE 3 LIFEBRIDGE HEALTH INC 0 SINAI HOSPITAL OF BALTIMORE INC 2401 WEST BELVEDERE AVENUE BALTIMORE MD 21215 520486540 PROVIDE MEDICAL CARE, EDUCATE STUDENTS, PERFORM MEDICAL RESEARCH MD 501(C)(3) LINE 3 LIFEBRIDGE HEALTH INC 0 COURTLAND GARDENS NURSING AND REHABILITATION CENTER 2434 WEST BELVEDERE AVENUE BALTIMORE MD 21215 520607907 SKILLED NURSING CARE FOR THE ELDERLY MD 501(C)(3) LINE 10 LIFEBRIDGE HEALTH INC 0 NORTHWEST HOSPITAL CENTER INC 5401 OLD COURT ROAD RANDALLSTOWN MD 21133 521372665 A HOSPITAL ASPIRING TO IMPROVE THE WELLBEING OF THE COMMUNITY IT SERVES MD 501(C)(3) LINE 3 LIFEBRIDGE HEALTH INC 0 CHILDREN'S HOSPITAL OF BALTIMORE CITY 2401 WEST BELVEDERE AVENUE BALTIMORE MD 21215 520591592 CHARITY SUPPORT FOR SINAI HOSPITAL OF BALTIMORE, INC. MD 501(C)(3) LINE 12B, II LIFEBRIDGE HEALTH INC 0 THE BALTIMORE JEWISH HEALTH FOUNDATION INC 2401 WEST BELVEDERE AVENUE BALTIMORE MD 21215 522111541 CHARITY SUPPORT FOR SINAI HOSPITAL OF BALTIMORE, INC. MD 501(C)(3) LINE 12B, II LIFEBRIDGE HEALTH INC 0 CHILDREN'S HOSPITAL AT SINAI FOUNDATION 2401 WEST BELVEDERE AVENUE BALTIMORE MD 21215 522167587 CHARITY SUPPORT FOR SINAI HOSPITAL OF BALTIMORE, INC. MD 501(C)(3) LINE 12B, II LIFEBRIDGE HEALTH INC 0 THE BALTIMORE JEWISH ELDERCARE FOUNDATION INC 2401 WEST BELVEDERE AVENUE BALTIMORE MD 21215 522337669 CHARITY SUPPORT FOR LEVINDALE HEBREW GERIATRIC CENTER HOSPITAL MD 501(C)(3) LINE 12B, II LIFEBRIDGE HEALTH INC 0 LIFEBRIDGE HEALTH INC 2401 WEST BELVEDERE AVENUE BALTIMORE MD 21215 521402373 TO SUPPORT THE CHARITABLE MISSIONS OF ITS SUBSIDIARIES. MD 501(C)(3) LINE 12C, III-FI N/A 0 THE BALTIMORE CHILD ABUSE CENTER INC 2300 NORTH CHARLES STREET BALTIMORE MD 21218 521681279 CHILD ABUSE SUPPORT, TREATMENT, AND PREVENTION MD 501(C)(3) LINE 7 LIFEBRIDGE HEALTH INC 0 CARROLL COUNTY RADIOLOGY LLC 7253 AMBASSADOR ROAD BALTIMORE MD 21244 522190849 RADIOLOGY MD CARROLL HOSPITAL CENTER INC RELATED 3535828 6764525 0 0 0.60000 CARROLL OCCUPATIONAL HEALTH LLC 7001 CORPORATE CENTER COURT WESTMINSTER MD 21157 202769332 OCCUPATIONAL MD N/A CARDIOVASCULAR ASSOCIATES OF MARYLAND LLC 2401 WEST BELVEDERE AVENUE BALTIMORE MD 21215 462935110 MEDICAL SERVICES MD N/A HOMECARE MARLYAND LLC 8028 RITCHIE HIGHWAY SUITE 210B PASADENA MD 21122 261378175 MEDICAL SERVICES MD N/A LIFEBRIDGE CARDIOLOGY PARKVILLE LLC 2401 WEST BELVEDERE AVENUE BALTIMORE MD 21215 463742313 MEDICAL SERVICES MD N/A LIFEBRIDGE COMMUNITY GASTROENTEROLOGY LLC 2401 WEST BELVEDERE AVENUE BALTIMORE MD 21215 462863298 MEDICAL SERVICES MD N/A LIFEBRIDGE COMMUNITY PEDIATRICS LLC 2401 WEST BELVEDERE AVENUE BALTIMORE MD 21215 462842468 MEDICAL SERVICES MD N/A LIFEBRIDGE COMMUNITY PULMONOLOGY LLC 2401 WEST BELVEDERE AVENUE BALTIMORE MD 21215 461401312 MEDICAL SERVICES MD N/A LIFEBRIDGE GYNECOLOGY OF PIKESVILLE LLC 2401 WEST BELVEDERE AVENUE BALTIMORE MD 21215 462949092 MEDICAL SERVICES MD N/A LIFEBRIDGE MEDICAL ASSOCIATES LLC 2401 WEST BELVEDERE AVENUE BALTIMORE MD 21215 462941505 MEDICAL SERVICES MD N/A LIFEBRIDGE NEUROSCIENCES LLC (FORMALLY ORTHOPEDIC SPECIALISTS LLC) 2401 WEST BELVEDERE AVENUE BALTIMORE MD 21215 450719598 MEDICAL SERVICES MD N/A LIFEBRIDGE PRIMARY CARE OF ELDERSBURG LLC 2401 WEST BELVEDERE AVENUE BALTIMORE MD 21215 383897702 MEDICAL SERVICES MD N/A LIFEBRIDGE PRIMARY CARE OF NORTH CARROLL LLC 2401 WEST BELVEDERE AVENUE BALTIMORE MD 21215 800883321 MEDICAL SERVICES MD N/A LIFEBRIDGE REHABILITATON SERVICES LLC 2401 WEST BELVEDERE AVENUE BALTIMORE MD 21215 811504380 MEDICAL SERVICES MD N/A ELLICOTT CITY ASC MANAGEMENT LLC 2401 WEST BELVEDERE AVENUE BALTIMORE MD 21215 522331663 MEDICAL SERVICES MD N/A SURGICENTER OF BALTIMORE LLC 2401 WEST BELVEDERE AVENUE BALTIMORE MD 21215 521658841 MEDICAL SERVICES MD N/A MOUNT AIRY MED-SERVICES LLC 200 MEMORIAL AVENUE WESTMINSTER MD 21157 465632176 MEDICAL SERVICES MD RELATED 254390 932364 0 0 0.50000 SPRINGWELL PARTNERS LLC 2200 PINE HILL FARMS LANE HUNT VALLEY MD 21030 271971171 ASSISTED LIVING MD N/A LIFEBRIDGE SUBURBAN PHYSICIAN GROUP II LLC 5401 OLD COURT ROAD RANDALLSTOWN MD 21133 814209029 MEDICAL SERVICES MD N/A LIFEBRIDGE LAB MANAGEMENT LLC 2401 WEST BELVEDERE AVENUE BALTIMORE MD 21215 821113874 LABORATORY SERVICES MD N/A LIFEBRIDGE METROPOLITAN PHYSICIAN GROUP II LLC 2401 WEST BELVEDERE AVENUE BALTIMORE MD 21215 814223537 MEDICAL SERVICES MD N/A LIFEBRIDGE MULTI-SPECIALTY LLC 41 MAGNA WAY SUITE 100 WESTMINSTER MD 21157 463753120 MEDICAL SERVICES MD N/A BRINTON WOODS HEALTH CARE CENTER LLC 9515 DEERECO ROAD SUITE 407 TIMONIUM MD 21093 260107427 REHABILITATION CENTER MD N/A BRINTON WOODS SENIOR LIVING LLC 9515 DEERECO ROAD SUITE 407 TIMONIUM MD 21093 743137876 ASSISTED LIVING MD N/A ELLICOTT CITY AMBULATORY SURGERY CENTER LLLP 2850 NORTH RIDGE ROAD ELLICOTT CITY MD 21043 MEDICAL SERVICES MD N/A OAK FARM SOLUTIONS LLC 1122 KENILWORTH DRIVE SUITE 307 TOWSON MD 21204 474944865 HOME HEALTH SERVICES MD N/A CARROLL COUNTY MED-SERVICES INC 200 MEMORIAL AVENUE WESTMINSTER MD 21157 521891102 MEDICAL SERVICE MD N/A C 0 LIFEBRIDGE INVESTMENTS INC 2401 WEST BELVEDERE AVENUE BALTIMORE MD 21215 521483166 INVESTMENTS MD N/A C 0 HEALTHSTAR MEDICAL SERVICES INC 2401 WEST BELVEDERE AVENUE BALTIMORE MD 21215 521829098 HEALTHCARE MD N/A C 0 PRACTICE DYNAMICS INC 124 BUSINESS CENTER DRIVE REISTERSTOWN MD 21136 521960319 MANAGEMENT MD N/A C 0 LIFEBRIDGE INSURANCE COMPANY LTD PO BOX 1109 KY1-1102 GRAND CAYMAN GRAND CAYMAN CJ 980415396 INSURANCE CJ N/A C 0 LIFEBRIDGE COMMUNITY PHYSICIANS INC 2401 WEST BELVEDERE AVENUE BALTIMORE MD 21215 800719005 HEALTHCARE MD N/A C 0 CARROLL COUNTY GENERAL HOSPITAL SOUTH CARROLL MEDICAL CENTER CONDOMINIUM 200 MEMORIAL AVENUE WESTMINSTER MD 21157 REAL ESTATE MD N/A C 0 MED-SERVICES HOLDINGS INC 200 MEMORIAL AVENUE WESTMINSTER MD 21157 MEDICAL SERVICES MD N/A C 0 CARROLL BILLING SERVICES INC 200 MEMORIAL AVENUE WESTMINSTER MD 21157 300026598 HEALTHCARE MD CARROLL HOSPITAL CENTER INC C 1.00000 1 CARROLL HEALTH GROUP LLC 200 MEMORIAL AVENUE WESTMINSTER MD 21157 271956453 HEALTHCARE MD N/A C 0 CARROLL URGENT CARE LLC 200 MEMORIAL AVENUE WESTMINSTER MD 21157 465739154 HEALTHCARE MD N/A C 0 LIFEBRIDGE HEALTH ISRAEL LTD 16 ABBA HILLEL ROAD RAMAT GAN IS 5250608 515804516 HEALTHCARE CALL CENTER IS N/A C 0 0 1 1 1 1 0 0 0 0 1 1 1 1 0 1 1 1 1 1 CARROLL HOSPITAL CENTER FOUNDATION INC C 4348078 CASH CARROLL HOSPICE INC L 385000 FMV PARTNERSHIP FOR A HEALTHIER CARROLL COUNTY INC B 191000 FMV PARTNERSHIP FOR A HEALTHIER CARROLL COUNTY INC O 104605 FMV CARROLL HOSPICE INC Q 6234490 CASH CARROLL COUNTY RADIOLOGY LLC M 985348 FMV LIFEBRIDGE HEALTH INC P 37060024 CASH LIFEBRIDGE HEALTH INC R 539840 CASH CARROLL COUNTY HEALTH SERVICES CORPORATION R 1500000 CASH