2020-07-10T19:29:30-05:00 2019-06-30 KPMG LLP 8350 Broad Street Suite 900 McLean VA 22102 990 2018-07-01 520591607 The Good Samaritan Hospital of Maryland Inc % JOEL BRYAN GOOD 4107726721 5601 LOCH RAVEN BLVD Baltimore MD 21239 JOEL BRYAN VP/Treasurer 4107726721 2020-07-10 true JG WHITE P01498698 7032868000 2020-06-15 199.206.0.5 54028020201925000038 2020-07-10 P F4A606E80CAA15027AB020C83C7B277129705CD7 EB2737A96B8F377BD085BED9F3BA68158C374A96 2018 2021-01-29 14:40:06Z BRADLEY CHAMBERS 5601 LOCH RAVEN BLVD BALTIMORE MD 21239 252640482 false X www.goodsam-md.org X 1920 MD WE ARE GOOD SAMARITANS, GUIDED BY CATHOLIC TRADITION AND TRUSTED TO TRADITION AND TRUSTED TO DELIVER IDEAL HEALTHCARE EXPERIENCES FOR THE PATIENTS WE SERVE. 20 12 1989 80 147054 0 4207562 3971980 271059633 245602394 187320 133154 5043838 2932954 280498353 252640482 0 20500 0 0 138876874 141766758 0 0 0 123285544 120565289 262162418 262352547 18335935 -9712065 168684419 181866248 35137835 31824783 133546584 150041465 X As a proud member of MedStar Health, MedStar Good Samaritan Hospitals (MedStar Good Samaritan) mission is to be Good Samaritans, guided by catholic tradition and trusted to deliver ideal health experiences. MedStar Good Samaritan, located in northeast Baltimore City, Maryland, is known for its specialties in nephrology and physical medicine and rehabilitation programs. In addition to General Adult Acute care services, Medstar Good Samaritan has a comprehensive impatient rehabilitation unit. Through MGSHs Center for Successful Aging, integrated care is provided to patients who experience age-related health conditions. In fiscal year 2019, MedStar Good Samaritan had 8,418 inpatient admissions and 226,687 outpatient visits including 46,717 emergency visits. false false 185369810 20500 245601994 MedStar Good Samaritans largest program is access to and the provision of acute hospital services to the communities of northeastern Baltimore City, Maryland and the surrounding areas. In addition to the program service expenses listed above, MedStar Good Samaritan incurred $61.2M of management and general expenses in providing services to its communities. MedStar Good Samaritan is a Joint Commission accredited acute care community hospital located in the northeast section of Baltimore City, Maryland. The hospital offers clinical services in general medicine and surgery and has specialty services in cancer care through the MedStar Health Cancer Network, diabetes care, and emergency medicine. MedStar Good Samaritan is also nationally known for geriatrics through the Center for Successful Aging, a model of care that helps patients with complex medical and socialconcerns as well as their caregivers. The hospital provides community-based health and wellness services through the Good Health Center, and wound care through the Center for Wound Healing, Hyperbaric Medicine, and Limb Salvage in partnership with MedStar Georgetown University Hospital. MedStar Good Samaritan is known for its high-quality Inpatient Rehabilitation program. Today, the program has moved into a new, $17.5 million, state-of-the-art Inpatient Rehabilitation Center, offering 60,000 square feet of medical care and therapy. The Inpatient Rehabilitation program, which is accredited by the Commission on Accreditation of Rehabilitation Facilities, serves patients from within Central Maryland. The Stroke Program has received accreditation as a Primary Stroke Center from the State of Maryland and received the American Heart Association/American Stroke Associations Get With The Guidelines Stroke Gold Plus Quality Achievement Award. MedStar Good Samaritan has been awarded the 5 Star rating, the highest possible, by CMS. 10343039 0 400 MedStar Good Samaritan provided $10.3M in health professions education in fiscal year 2019. This category includes training in graduate medical education, and education for physicians, medical students, nurses, and other health professions. 5479139 0 0 MedStar Good Samaritan provided $5.5M in charity care services in fiscal year 2019. Charity care is provided pursuant to MedStar Healths Financial Assistance Policy to members of the community whose income is below certain thresholds and for which the hospital is not compensated. Under Marylands unique payer system, the amount reported represents MedStar Good Samaritans charity care expense and revenues represent direct payments from the states charity care pool. Other charity care expenses are indirectly reimbursed via the state of Marylands payment system. 201191988 true true false false false false false false false false true false false true true true false true false false false false false false false false true true true false true false false false false false false false true false false false false true true true true false false true 0 0 true 1989 true true true false false false false false false false false false false false X 20 12 false false false false true true true true true false false true true true true true true true true false MD X JOEL BRYAN 4107726721 10980 GRANTCHESTER WAY COLUMBIA MD 21044 X DANIEL P CAHILL VICE CHAIR 1.0 0.0 X 0 0 0 MOIRA P LARSEN MD BOARD MEMBER 20.0 20.0 X 234823 234823 25427 KENNETH A SAMET BOARD MEMBER 1.0 39.0 X 0 6910499 87839 HOWARD S FREELAND MD BOARD MEMBER 1.0 39.0 X 1750 249578 24578 LUIS GIMENEZ MD BOARD MEMBER 1.0 0.0 X 0 0 0 KAY G BEE BOARD MEMBER 1.0 0.0 X 0 0 0 SONYA H GRAY BOARD MEMBER 1.0 0.0 X 0 0 0 Bishop Denis J Madden BOARD MEMBER (until 10/18) 1.0 0.0 X 0 0 0 JOHN C SMYTH CHAIR 1.0 0.0 X 0 0 0 KATHLEEN J WHITING BOARD MEMBER (Until 10/18) 1.0 0.0 X 0 0 0 DAVID WEISMAN DO BOARD MEMBER 40.0 0.0 X 218063 0 31261 ELIAS SHAYA MD BOARD MEMBER 40.0 0.0 X 429170 0 9956 BRADLEY CHAMBERS President/BOARD MEMBER 20.0 20.0 X X 594727 594727 53584 ANTHONY READ BOARD MEMBER 1.0 0.0 X 0 0 0 Anthony DAgostino BOARD MEMBER 1.0 0.0 X 0 0 0 Kevin E Wesner BOARD MEMBER (Until 9/18) 1.0 0.0 X 0 0 0 Holly A Tilford BOARD MEMBER 1.0 0.0 X 0 0 0 David Zachary Martin MD board member (As of 4/19) 40.0 0.0 X 435836 0 20578 Herbert R Hansen Jr board member 1.0 0.0 X 0 0 0 Kim D Sydnor PhD board member 1.0 0.0 X 0 0 0 George Hennawi MD Board Member (As of 2/19) 40.0 0.0 X 257295 0 17581 Sylvia Hickey BOARD MEMBER (As of 9/18) 1.0 0.0 X 0 0 0 Leo E Gallagher Jr Board Member 1.0 0.0 X 0 0 0 Rev PM Smith Board Member (Until 10/18) 1.0 0.0 X 0 0 0 DEANA STOUT CHIEF FINANCIAL OFFICER 20.0 20.0 X 231137 231137 47914 LINDA HEATH SECRETARY 1.0 39.0 X 0 91552 30556 Neil MacDonald VP, Operations 20.0 20.0 X 194849 194849 57568 Stuart Bell VP, Medical Affairs 20.0 20.0 X 402510 402510 28189 MICHAEL JACOBS MD PHYSICIAN 40.0 0.0 X 830301 0 25263 Margie Banzuelo-Rio PHYSICIAN 40.0 0.0 X 484149 0 26663 MARTIN BINSTOCK VP MEDICAL AFFAIRS 40.0 0.0 X 605903 0 20578 Shams Quazi Physician 40.0 0.0 X 425130 0 26056 CARMEN PICHARD-ENCINA PHYSICIAN 40.0 0.0 X 495249 0 23675 Jeffrey Matton Former President 0.0 40.0 X 0 1117691 53751 Thomas Senker Former Secretary 0.0 40.0 X 0 695907 39764 5840892 10723273 650781 299 true true false MORRISON HEALTHCARE FOOD SERVICES PO BOX 20284 TOWSON MD 21284 Food services 3332138 HUNT VALLEY ANES ASSOC PA PO BOX 20284 TOWSON MD 21284 Medical services 3199210 AMN HEALTHCARE INC 4721 MORRISON DRIVE MOBILE AL 36609 Staffing services 2124150 ROLYN COMPANIES INC 1500 Liberty Ridge DriveSTE 210 WAYNE PA 19087 Facilities services 846821 HEALOGICS WOUND CARE HYPERBARIC S 1700 New York Ave NW 100 WASHINGTON DC 20006 Medical services 802784 31 2385000 182599 1404381 3642 3971980 NET PATIENT SERVICE REVENUE 621400 237740127 237740127 PHARMACY INCOME 900099 7852909 7852909 MEANINGFUL USE INCOME 900099 9358 9358 245602394 54703 54703 0 0 588405 588405 0 588405 588405 40279 38172 40279 38172 78451 78451 0 0 0 0 0 0 0 0 0 REBATE INCOME 900099 476261 476261 CHILD DAY CARE 900099 565212 565212 REFERRAL LAB INCOME 900099 147054 147054 1156022 1156022 2344549 252640482 245602394 147054 2919054 20500 20500 0 0 0 3174230 2938555 235675 0 113952221 105238605 8713616 1565728 1447495 118233 15600830 15039725 561105 7473749 6846786 626963 33670927 143 33670784 12408 12408 7000 7000 0 0 0 23162648 19059049 4103599 401793 11610 390183 2100172 1370259 729913 0 0 1286272 1143633 142639 171350 151169 20181 0 90570 87106 3464 2128539 2128539 0 12112170 7676442 4435728 2791937 2721051 70886 MED/SURG SUPPLIES 22900344 22980141 -79797 MAINTENANCE 5515889 5091318 424571 UTILITIES 3428014 3195635 232379 FOOD SERVICES/SUPPLIES 2401273 2277368 123905 8383983 3895398 4488585 262352547 201191988 61160559 0 4180 19766 0 0 0 0 30854036 28321583 0 0 0 0 0 0 3179786 2813347 383644 322264 267908678 189560490 65769460 78348188 0 0 4229820 4654465 0 0 0 0 64263493 67386635 168684419 181866248 17853739 16912544 0 0 1323311 1913623 0 0 0 0 0 0 0 0 0 0 15960785 12998616 35137835 31824783 X 63282953 76580789 70263631 73460676 0 0 133546584 150041465 168684419 181866248 X -9712065 50304 26156642 X X false true X true false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 81333369 53915601 27417768 1406447 825660 580787 165457684 131986356 33471328 19711178 2832873 16878305 78348188 INTERCOMPANY RECEIVABLES 1716189 OPTION IT ASSET 700922 OTHER ASSETS 64969524 67386635 0 ADVANCES FROM 3RD PARTY PAYORS 5969442 ASBESTOS ABATEMENT LIABILITY 2769370 WORKERS COMPENSATION 1941172 CREDIT BALANCE PATIENT A/R 859771 STOCK OPTION PLAN 637730 DEFERRED TIA 448593 OTHER LIABILITIES 372538 12998616 X FIN 48 FOOTNOTE PART X, LINE 2 INCOME TAXES ARE ACCOUNTED FOR UNDER THE ASSET AND LIABILITY METHOD. DEFERRED TAX ASSETS AND LIABILITIES ARE RECOGNIZED FOR THE FUTURE TAX CONSEQUENCES ATTRIBUTABLE TO DIFFERENCES BETWEEN THE FINANCIAL STATEMENT CARRYING AMOUNTS OF EXISTING ASSETS AND LIABILITIES AND THEIR RESPECTIVE TAX BASES AND OPERATING LOSS AND TAX CREDIT CARRYFORWARDS. DEFERRED TAX ASSETS AND LIABILITIES ARE MEASURED USING ENACTED TAX RATES EXPECTED TO APPLY TO TAXABLE INCOME IN THE YEARS IN WHICH THOSE TEMPORARY DIFFERENCES ARE EXPECTED TO BE RECOVERED OR SETTLED. THE EFFECT ON DEFERRED TAX ASSETS AND LIABILITIES OF A CHANGE IN TAX RATES IS RECOGNIZED IN THE PERIOD THAT INCLUDES THE ENACTMENT DATE. ANY CHANGES TO THE VALUATION ALLOWANCE ON THE DEFERRED TAX ASSET ARE REFLECTED IN THE YEAR OF CHANGE. THE CORPORATION ACCOUNTS FOR UNCERTAIN TAX POSITIONS IN ACCORDANCE WITH THE FASB ACCOUNTING STANDARDS CODIFICATION (ASC) TOPIC 740, INCOME TAXES. THERE WAS NO LIABILITY RECORDED FOR UNCERTAIN TAX POSITIONS AS OF JUNE 30, 2019. true true X true X true X true true true false true true 5479139 5479139 0.02090 5479139 5479139 0.02090 2094071 324242 1769829 0.00680 10343039 400 10342639 0.03940 4622764 2837593 1785171 0.00680 33451 33451 0.00010 17093325 3162235 13931090 0.05310 22572464 3162235 19410229 0.07400 8100 8100 947230 590098 357132 0.00140 26386 26386 0.00010 13359 13359 0.00010 995075 590098 404977 0.00160 true 5954634 true true 1 1 GOOD SAMARITAN HOSPITAL OF MARYLAND 5601 LOCH RAVEN BLVD BALTIMORE MD 21239 X X X X GOOD SAMARITAN HOSPITAL OF MARYLAND 1 false false true X X X X X X X X X 17 true false false true X WWW.MEDSTARGOODSAM.ORG X true 17 true WWW.MEDSTARGOODSAM.ORG false true X 200. 400. X X X X X X true true X X X X true X WWW.MEDSTARGOODSAM.ORG X WWW.MEDSTARGOODSAM.ORG X WWW.MEDSTARGOODSAM.ORG X X X X X X true X false X X X X true X false false CHNA INPUT PART V, SECTION B, LINE 5 HOSPITAL LEAD ROLE DESCRIPTION The Community Health Needs Assessment (CHNA) Hospital Lead serves as the coordinator of all aspects of the community health assessment process. He/she helps establish and coordinate the activities of the Advisory Task Force. The Lead also helps produce the hospital's Community Health Needs Assessment and Implementation Strategy. He/she works collaboratively with representatives from the Corporate Community Health Department on all Schedule Hs. The Lead also works closely with the writer. He/she reviews all narratives prior to publication. Name of Hospital Lead: Deborah Bena Executive Sponsor Role Description The Executive Sponsor serves as the conduit between the Advisory Task Force and the Senior Management Team. The sponsor is an active participant of the Advisory Task Force and he/she communicates the hospital's clinical strengths and program priorities to diverse audiences. Name of Executive Sponsor: Bradley Chambers AND MARTIN BINSTOCK, MD Advisory Task Force Role Description The Advisory Task Force (ATF) reviews primary/secondary data and local/state/federal community health goals. Based on findings, the ATF provides input into the hospital's three-year implementation strategy. As ambassadors for the CHNA process, the ATF members support efforts to optimize community participation. Note: The ATF should be a combination of community representatives and staff. Community representatives should makeup at least 50% of total participants. Name: Title/Affiliation with Hospital: Name of Organization Aaron Kaufman Community Leader Central Baltimore Partnership Allan Noonan, MD Board Member MGSH Bernie Ravitz,MD Physician Advisor MGSH Brad Chambers Executive Sponsor MGSH, MUMH President Carmel Roques CEO Keswick - Maryland Dana Frank, MD Chairman, Medicine MGSH, MUMH Dawn Motovidlak Board Member MUMH Deborah Director, Marketing and MGSH Bangledorf Communications Deborah Bena Community Health and MGSH, MUMH Ministry Coordinator Emilie Gilde Former Director, Tobacco Baltimore City Health Use/CVD/Diabetes/Cancer Department Prevention Evangeline Community Representative St. Matthew's Church Waihenya George Farley AVP, Mission Integration MGSH Ken Walsch Assistant Vice President, MGSH Quality, Safety, Risk Management Kerry Martinez Director Shepherd's Joy Wellness Kim Sydnor, PhD Dean Morgan State University Kimberly Mays Sr. Director, Multicultural American Heart Affairs Association Lisa Ghinger Executive Director Hampden Family Center Mark Fletcher Community Leader Baltimore City EMS Martin Binstock, Executive Sponsor MGSH MD Vice President, Medical Affairs Melvin Wilson Executive Director Turnaround Tuesday Nichole Battle CEO GEDCO Nilesh Chief Health Officer Healthcare for Homeless Kalyanaraman Pat Jones Director, Immigration St. Matthew's Church Outreach Service Center Peggy Thomas Community Representative Community Resident Randolph Rowel Associate Professor, Chair of Morgan State University Department of Behavioral Health Sciences Ritu Prasad, MD Physician Advisor MUMH Ryan Moran Director, Community Health MGSH, MHH, MUMH Savas Karas Board Member MUMH Sheila Williams Community Representative Huber Memorial Church Shely Choo Senior Medical Advisor Baltimore City Health Department Sonia Fierro- Community Leader Spanish Speaking Health Luperini Leaders of Maryland Sonya Gray Board Member MGSH Stu Bell, MD Vice President, Medical MUMH Affairs Tracy Holcomb RN, CDE Shepherd's Clinic IMPLEMENTATION STRATEGY PART V, SECTION B, LINE 11 THE IMPLEMENTATION STRATEGIES SERVE AS A ROADMAP FOR HOW COMMUNITY BENEFIT RESOURCES WILL BE ALLOCATED AND DEPLOYED. MEDSTAR'S HOSPITALS WILL BE ABLE TO MEASURE OUR CONTRIBUTION TO IMPROVING THE HEALTH OF UNDERSERVED AND VULNERABLE POPULATIONS IN THE REGIONS WE SERVE. THREE-YEAR IMPLEMENTATION STRATEGIES WITH MEASURABLE OBJECTIVES WERE DEVELOPED FOR EACH HOSPITAL'S COMMUNITY BENEFIT SERVICE AREA - A SPECIFIC COMMUNITY OR TARGET POPULATION OF FOCUS. PRIORITIES WERE BASED ON COMMUNITY NEED AS DETERMINED BY QUANTITATIVE DATA AND COMMUNITY INPUT, AS WELL AS ON HOSPITAL EXPERTISE, RESOURCES, STRENGTHS OF EXISTING PROGRAMMING AND PARTNERSHIPS, AND ALIGNMENT WITH NATIONAL, STATE, AND LOCAL HEALTH GOALS. THE MEDSTAR HEALTH CORPORATE COMMUNITY HEALTH DEPARTMENT WILL PROVIDE SYSTEM-WIDE COORDINATION AND OVERSIGHT OF COMMUNITY BENEFIT PROGRAMMING. HOSPITAL ADVISORY TASK FORCES CONVENE AT LEAST ANNUALLY TO MONITOR PROGRESS OF STRATEGY EXECUTION AND TO PROVIDE ONGOING RECOMMENDATIONS RELATED TO OUTCOMES ACHIEVEMENT, PROGRAM DEVELOPMENT, PARTNERSHIP APPROACHES, AND OVERALL IMPLEMENTATION IMPROVEMENT. FOR SIGNIFICANT NEEDS IDENTIFIED IN THE CHNA THAT THE HOSPITAL HAS NOT PRIORITIZED AS FOCUS AREAS THROUGH ITS IMPLEMENTATION STRATEGY, THESE NEEDS WILL BE ADDRESSED BY COLLABORATING WITH OTHER LEADING ORGANIZATIONS, AND BY TAKING A SUPPORTER ROLE ON IDENTIFIED NEEDS THAT ARE BEYOND THE SCOPE OF THE HOSPITALS STRENGTHS. CHARITY CARE AT COST PART I, LINE 7A MARYLAND'S REGULATORY SYSTEM CREATES A UNIQUE PROCESS FOR HOSPITAL PAYMENT THAT DIFFERS FROM THE REST OF THE NATION. THE HEALTH SERVICES COST REVIEW COMMISSION (HSCRC), DETERMINES PAYMENT THROUGH A RATE-SETTING PROCESS AND ALL PAYORS, INCLUDING GOVERNMENTAL PAYORS, PAY THE SAME AMOUNT FOR THE SAME SERVICES DELIVERED AT THE SAME HOSPITAL. MARYLAND'S UNIQUE ALL-PAYOR SYSTEM INCLUDES A METHOD FOR REFERENCING UNCOMPENSATED CARE IN EACH PAYORS' RATES, WHICH DOES NOT ENABLE MARYLAND HOSPITALS TO BREAKOUT ANY OFFSETTING REVENUE RELATED TO UNCOMPENSATED CARE. UNREIMBURSED MEDICAID PART I, LINE 7B MARYLAND'S REGULATORY SYSTEM CREATES A UNIQUE PROCESS FOR HOSPITAL PAYMENT THAT DIFFERS FROM THE REST OF THE NATION. THE HEALTH SERVICES COST REVIEW COMMISSION (HSCRC), DETERMINES PAYMENT THROUGH A RATE-SETTING PROCESS AND ALL PAYORS, INCLUDING GOVERNMENTAL PAYORS, PAY THE SAME AMOUNT FOR THE SAME SERVICES DELIVERED AT THE SAME HOSPITAL. MARYLAND'S UNIQUE ALL-PAYOR SYSTEM INCLUDES A METHOD FOR REFERENCING UNCOMPENSATED CARE IN EACH PAYORS' RATES, WHICH DOES NOT ENABLE MARYLAND HOSPITALS TO BREAKOUT ANY OFFSETTING REVENUE RELATED TO UNCOMPENSATED CARE. COMMUNITY BENEFIT EXPENSES ARE EQUAL TO MEDICAID REVENUES IN MARYLAND, AS SUCH, THE NET EFFECT IS ZERO. THE EXCEPTION TO THIS IS THE IMPACT ON THE HOSPITAL OF ITS SHARE OF THE MEDICAID ASSESSMENT. IN RECENT YEARS, THE STATE OF MARYLAND HAS CLOSED FISCAL GAPS IN THE STATE MEDICAID BUDGET BY ASSESSING HOSPITALS THROUGH THE RATE-SETTING SYSTEM. BAD DEBT PART III, LINES 2 & 4 MEDSTAR HEALTH AND ITS AFFILIATED ORGANIZATIONS REPORT BAD DEBT EXPENSE IN ACCORDANCE WITH ASU 2011-07, WHICH REQUIRES CERTAIN HEALTHCARE ENTITIES TO CHANGE THE PRESENTATION OF THEIR STATEMENT OF OPERATIONS BY RECLASSIFYING THE PROVISION FOR BAD DEBTS ASSOCIATED WITH PATIENT SERVICE REVENUE FROM AN OPERATING EXPENSE TO A DEDUCTION FROM PATIENT SERVICE REVENUE (NET OF CONTRACTUAL ALLOWANCES AND DISCOUNTS). HOWEVER, MEDSTAR AND ITS AFFILIATED ENTITIES DO NOT MAKE A DETERMINATION AS TO WHETHER SELF PAY AMOUNTS ARE COLLECTIBLE IN DETERMINING REVENUE RECOGNITION. RESERVE MODELS, WHICH HAVE BEEN DEVELOPED BASED ON HISTORICAL COLLECTION RESULTS AND WHICH ARE ADJUSTED PERIODICALLY BASED ON ACTUAL COLLECTIONS EXPERIENCE, ARE USED TO ESTIMATE UNCOLLECTIBLE AMOUNTS ACROSS ALL PAYORS INCLUDING SELF PAY. BAD DEBT DETERMINATIONS ARE MADE ONLY AFTER SUFFICIENT EVIDENCE IS OBTAINED TO SUPPORT THAT AN AMOUNT IS NOT COLLECTIBLE. MEDICARE PART III, LINE 8 MARYLAND'S REGULATORY SYSTEM CREATES A UNIQUE PROCESS FOR HOSPITAL PAYMENT THAT DIFFERS FROM THE REST OF THE NATION. THE HEALTH SERVICES COST REVIEW COMMISSION (HSCRC) DETERMINES PAYMENT THROUGH A RATE-SETTING PROCESS AND ALL PAYORS, INCLUDING GOVERNMENTAL PAYORS, PAY THE SAME AMOUNT FOR THE SAME SERVICES DELIVERED AT THE SAME HOSPITAL. MARYLAND'S UNIQUE ALL-PAYOR SYSTEM INCLUDES A METHOD FOR REFERENCING UNCOMPENSATED CARE IN EACH PAYORS' RATES, WHICH DOES NOT ENABLE MARYLAND HOSPITALS TO BREAKOUT ANY OFFSETTING REVENUE RELATED TO UNCOMPENSATED CARE. AS SUCH, THE NET EFFECT FOR MEDICARE EXPENSES AND REVENUES IN MARYLAND IS ZERO. PART III, LINE 9B IF IT IS DETERMINED THAT A PATIENT MAY POTENTIALLY QUALIFY FOR A CHARITABLE/FINANCIAL PROGRAM, A HOLD IS PLACED ON THE ACCOUNT TO PREVENT IT FROM BEING REPORTED AS BAD DEBT UNTIL PROGRAM APPROVALS HAVE BEEN OBTAINED. IF IT IS APPROVED, THE ACCOUNT IS DOCUMENTED AND THE NECESSARY ADJUSTMENTS ARE MADE TO CLOSE THE ACCOUNT. NEEDS ASSESSMENT PART VI, LINE 2 In FY18, MedStar Good Samaritan Hospital (MGSH) conducted a Community Health Needs Assessment (CHNA) in accordance with the guidelines established by the Patient Protection and Affordable Care Act and the Internal Revenue Service. The hospitals FY18 CHNA and three-year Implementation Strategies were endorsed by MGSHs Board of Directors and approved by the MedStar Health Board of Directors. The document became available on the hospitals website on June 30, 2018. During FY19, key revisions were made across MedStar Health to more effectively impact the communities served throughout Maryland and Washington, DC. Several internal meetings were convened with leadership from each MedStar Health Hospital to review current practices and strategies. As a result of these meetings, the approach to the current CHNA for the remainder of the three-year cycle (FY19-FY21) was revised. A key revision to the CHNA is a greater focus on hospital area strategies that are most appropriate for the local communities served. The number of strategies each hospital is accountable for executing was reduced to encourage more meaningful reach within key areas contrasted with broader reach with reduced impact. Using the standard categories, Health and Wellness, Access to Care and Social Determinants of Health to determine what to prioritize for the CHNA IRS requirements, each hospital agreed to select two to three strategies as priorities that have size and scale impact and measurable outcomes. All other programming was integrated as part of the hospitals overall community health portfolio. These additional programs were captured in the inventory for the whole picture of contributing to the health of the communities served as well as sorted for what counts as community benefit for regulatory reporting. The hospitals Community Benefit Service Area (CBSA) remains the same, based on the Advisory Task Force (ATF) recommendation. The hospital identified Govans as its CBSA, which includes all residents living in ZIP codes 21206 and 21239. The hospital selected this geographic area based on hospital utilization data and secondary public health data as well as its proximity to the hospital. The ATF included a diverse group of individuals, including hospital leaders, grassroots activists, community residents, faith-based leaders, hospital representatives, public health leaders and other stakeholder organizations, such as representatives from local health departments. MGSHs health priorities for the CBSA include health and wellness (chronic disease prevention and management, behavioral health) and social determinants of health (social needs screenings, Baltimore JOBS). As a proud member of MedStar Health, representatives from MGSH routinely participate in the MedStar Health community health workgroup. The workgroup is comprised of community health professionals who represent all ten MedStar hospitals. The team analyzes local and regional community health data, establishes system-wide community health programming performance and evaluation measures and shares best practices. PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE PART VI, LINE 3 As one of the regions leading not-for-profit healthcare systems, MedStar Health is committed to ensuring that uninsured patients and underinsured patients meeting medical hardship criteria within the communities we serve who lack financial resources have access to emergency and medically necessary hospital services. MedStar Health and its healthcare facilities will: . Treat all patients equitably, with dignity, respect, and compassion; . Serve the emergency health care needs of everyone who presents to our facilities regardless of a patient's ability to pay for care; . Assist those patients who are admitted through our admission process for non-urgent, medically necessary care who cannot pay for the care they receive; . Balance needed financial assistance for some patients with broader fiscal responsibilities in order to keep its hospitals' doors open for all who may need care in the community. In meeting its commitments, MedStar Healths facilities will work with their uninsured patients seeking emergency and medically necessary care to gain an understanding of each patients financial resources. Based on this information and eligibility determination, MedStar Health facilities will provide financial assistance to uninsured patients who reside within the communities we serve in one or more of the following ways: . Assist with enrollment in publicly-funded entitlement programs (e.g., Medicaid); . Refer patients to State or Federal Insurance Exchange Navigator resources; . Assist with consideration of funding that may be available from other charitable organizations; . Provide financial assistance according to applicable policy guidelines; . Provide financial assistance for payment of facility charges using a sliding-scale based on the patients household income and financial resources; . Offer periodic payment plans to assist patients with financing their healthcare services. Each facility publicizes the MedStar Financial Assistance Policy by: . Providing access to the MedStar Financial Assistance Policy, Financial Assistance Applications, and MedStar Patient Information Sheet on all hospital websites and patient portals; . Providing hard copies of the MedStar Financial Assistance Policy, MedStar Uniform Financial Assistance Application, and MedStar Patient Information Sheet to patients upon request; . Providing notification and information about the MedStar Financial Assistance Policy by offering copies as part of all registration or discharges processes, and answering questions on how to apply for assistance; . Providing written notices on billing statements; . Displaying MedStar Financial Assistance Policy information at all hospital registration points; . Translating the MedStar Financial Assistance Policy, MedStar Uniform Financial Assistance Application, and the MedStar Patient Information Sheet into primary languages of all significant populations with Limited English Proficiency. MedStar Health provides a financial assistance probable and likely eligibility determination to the patient within two business days from receipt of the initial financial assistance application. Final eligibility determinations are made and communicated to the patient based on receipt and review of a completed application. MedStar Health believes that its patients have personal responsibilities related to the financial aspects of their healthcare needs. Financial assistance and periodic payment plans available under this policy will not be available to those patients who fail to fulfill their responsibilities. For purposes of this policy, patient responsibilities include: . Complying with providing the necessary financial disclosure forms to evaluate their eligibility for publicly-funded healthcare programs, charity care programs, and other forms of financial assistance (these disclosure forms must be completed accurately, truthfully, and timely to allow MedStar Healths facilities to properly counsel patients concerning the availability of financial assistance); . Working with the facilitys Patient Advocates and Patient Financial Services staff to ensure there is a complete understanding of the patients financial situation and constraints; . Making applicable payments for services in a timely fashion, including any payments made pursuant to deferred and periodic payment schedules; . Providing updated financial information to the facilitys Patient Advocates or Customer Service Representatives on a timely basis as the patients financial circumstances may change. . It is the responsibility of the patient to inform the MedStar hospital of their existing eligibility under a medical hardship during the 12-month period. . In the event a patient fails to meet these responsibilities, MedStar reserves the right to pursue additional billing and collection efforts. In the event of non-payment billing, and collection efforts are defined in the MedStar Billing and Collection Policy. A free copy is available on all hospital websites and patient portals or by calling customer service at 1-800-280-9006. Uninsured patients of MedStar Healths facilities may be eligible for full financial assistance or partial sliding-scale financial assistance under this policy. The Patient Advocate and Patient Financial Services staff will determine eligibility for full financial assistance and partial sliding-scale financial assistance based on review of income for the patient and their family (household), other financial resources available to the patients family, family size, and the extent of the medical costs to be incurred by the patient. COMMUNITY INFORMATION PART VI, LINE 4 Geographic: MGSHs CBSA includes residents in the ZIP codes of 21239 and 21206. Both areas are primarily located in the northeast section of Baltimore City with some portions in Baltimore County, just over the city line, and can be classified as middle class to lower income areas compared to others in Maryland. This geographic area was selected based on hospital utilization and secondary data, as well as its proximity to the hospital and opportunities to build on pre-existing programs, services and partnerships. Demographics: 21239 consists of several small neighborhoods including Loch Raven Village and Northwood. The total population is 27,099 with 90% of its residents African American and a median age of 36. The median household income is 47,058, poverty rate is 11.9%, uninsured over the age of 18 is 9%, and single parent households are 65%. According the 2017 Baltimore City Neighborhood Health Profile Report, the life expectancy is 75.7, higher than the average of Baltimore Citys 73.6, with heart disease and cancer being the leading causes of death. A large portion of 21206 is in the Baltimore City neighborhood of Cedonia/Frankford which is a predominantly middle class to lower income residential area. The total population is 23,701 with 76.3% of its residents African American and a median age of 35. According the 2017 Baltimore City Neighborhood Health Profile Report, the median household income is 39,306, poverty rate is 23.7%, uninsured over the age of 18 is 12.5%, single parent households are 61.5%., the life expectancy is 72.4, compared to 73.6 in Baltimore City with heart disease and cancer being the leading causes of death. PROMOTION OF COMMUNITY HEALTH PART VI, LINE 5 As a community partner, MGSH engages in several community benefit activities to improve and promote the health and wellbeing of the community. Priority areas of focus, as determined by the 2018 CHNA, are Health and Wellness (Chronic Disease Prevention and Management, Behavioral Health) and Social Determinants of Health. To address health and wellness, MGSH provided a variety of programs in partnership with local community centers and churches, serving a total of 971 people. Programs conducted in FY19 include Diabetes Prevention Program), Living Well Chronic Disease Self-Management Program Fitness Programs, Community Free Flu Shot Clinics, and Smoking Cessation Program. Support Groups through the hospital also include diabetes, stroke, aphasia, and caregivers are provided as safe havens for continued support and wellbeing. To address behavioral health, MGSH screened 42,264 patients for substance use in the emergency department through MedStars SBIRT program (Screening, Brief Intervention and Referral to Treatment).. Peer Recovery Coaches are integral to hospital care teams to assist with improving access to substance use treatment and social service linkage and support community education efforts. Through the Opioid Overdose Survivors Outreach Program (OSOP), MGSH sends peer recovery coaches in the field to see recent overdose survivors and link them to treatment services, naloxone trainings and provide a consistent point of contact should someone wish to enter care. Additionally, in partnership with community organizations such as the Baltimore City Health Department and Mosaic Community Services, the hospital offers no cost education courses on mental health awareness and naloxone administration. MGSH addresses the social determinants of health of the community with the Baltimore JOBS Program. MGSH hires and trains Community Health Advocates and Peer Recovery Coaches from the CBSA as part of the Population Health Workforce Development program. These positions serve to empower individuals and their families into better economic conditions. As part of the community health advocates responsibilities, social needs screenings and support linkages to social need services are done as part of care delivery and chronic disease self-management programming. 401 social needs screens were completed in FY19. AFFILIATED HEALTH CARE SYSTEM PART VI, LINE 6 As a proud member of MedStar Health, MGSH is able to expand its capacity to meet the needs of the community by partnering with other MedStar hospitals and associated entities. MedStar Health resources assist the hospital in community health planning to meet the needs of the uninsured and other vulnerable populations. Through its community health function, MedStar Health provides MGSH with technical support to enhance community health programming and evaluation. MedStars corporate philanthropy department identifies and seeks public and private funding sources to ensure the availability of high-quality health services, regardless of ability to pay. STATE FILING OF COMMUNITY BENEFIT REPORT PART VI, LINE 7 The community benefit report for MGSH is filed in the state of Maryland. true CRISTO REY JESUIT HIGH SCHOOL 420 South Chester Street Baltimore MD 21231 205300491 501(C)(3) 20500 Charitable support 1 Schedule I, Part I, Line 2 Our grant monitoring procedure brings together all key personnel involved in the grant at the onset of the award to discuss management, responsibilities, budgets, and reporting. This initial meeting is documented and disbursed to all involved. The actual grant monitoring is done by the hospital department implementing the grant. MedStar Corporate's Grants and Philanthropy Department ensures that each grant has a cost center and/or grant account set up based on the terms of the grant award. MedStar Corporate's Grants and Philanthropy Department also tracks and reminds hospital departments when progress reports are due throughout the life of the grant. X true true X X X X X X true false false false false false false false false MOIRA P LARSEN MD BOARD MEMBER 209777 209778 24230 24230 816 815 4125 4125 8589 8588 247537 247536 0 0 KENNETH A SAMET BOARD MEMBER 0 1887489 0 5002733 0 20277 0 52149 0 35690 0 6998338 0 0 HOWARD S FREELAND MD BOARD MEMBER 1750 238158 0 11420 0 0 0 7675 0 16903 1750 274156 0 0 DAVID WEISMAN DO BOARD MEMBER 193802 0 24261 0 0 0 10112 0 21149 0 249324 0 0 0 ELIAS SHAYA MD BOARD MEMBER 404170 0 25000 0 0 0 8830 0 1126 0 439126 0 0 0 MICHAEL JACOBS MD PHYSICIAN 830301 0 0 0 0 0 8250 0 17013 0 855564 0 0 0 DEANA STOUT CHIEF FINANCIAL OFFICER 151774 151774 70875 70875 8488 8488 13061 13061 10896 10896 255094 255094 0 0 BRADLEY CHAMBERS President/BOARD MEMBER 309102 309102 285625 285625 0 0 10355 10355 16437 16437 621519 621519 0 0 David Zachary Martin MD board member (As of 4/19) 403519 0 0 0 32317 0 0 0 20578 0 456414 0 0 0 George Hennawi MD Board Member (As of 2/19) 233895 0 23400 0 0 0 0 0 17581 0 274876 0 0 0 Margie Banzuelo-Rio PHYSICIAN 473149 0 11000 0 0 0 8250 0 18413 0 510812 0 0 0 MARTIN BINSTOCK VP MEDICAL AFFAIRS 209633 0 149979 0 246291 0 8250 0 12328 0 626481 0 0 0 Shams Quazi Physician 375130 0 50000 0 0 0 8250 0 17806 0 451186 0 0 0 CARMEN PICHARD-ENCINA PHYSICIAN 495249 0 0 0 0 0 8250 0 15425 0 518924 0 0 0 Jeffrey Matton Former President 0 562364 0 555327 0 0 0 18313 0 35438 0 1171442 0 0 Thomas Senker Former Secretary 0 375878 0 320029 0 0 0 8250 0 31514 0 735671 0 0 Neil MacDonald VP, Operations 153431 153431 41418 41418 0 0 19246 19247 9538 9537 223633 223633 0 0 Stuart Bell VP, Medical Affairs 247440 247441 155070 155069 0 0 4125 4125 9969 9970 416604 416605 0 0 SOCIAL CLUB DUES SCHEDULE J, PART I, LINE 1 THE ORGANIZATION PAID BUSINESS CLUB DUES FOR ONE OF ITS OFFICERS DURING THIS YEAR. PARTICIPATION IN THESE ACTIVITIES BY THE OFFICER WAS FOR BUSINESS PURPOSES, AND HELPED THE ORGANIZATION FURTHER ITS EXEMPT PURPOSES. SCHEDULE J, PART III Mr. Samet's compensation in Part II, Column (B) includes $1,950,307 representing benefits received from executive retirement plans that are comprised of target benefits determined annually based on compensation and years of service and long-term retention arrangements. Bradley Chambers compensation is for services provided as President to both MedStar Good Samaritan Hospital and MedStar Union Memorial Hospital. Deana Stouts compensation is for services provided as CFO to both MedStar Good Samaritan Hospital and MedStar Union Memorial Hospital. SCHEDULE J, PART I, LINE 4A Martin Binstocks Other reportable compensation in Part II, Column (B) (iii) includes $187,050 representing severance payments received by Mr. Binstock. WEBBMASON SEE PART V 136039 MARKETING STRATEGIES SERVICES false Whiting-Turner Contracting Company SEE PART V 8594850 MARKETING STRATEGIES SERVICES false BUSINESS TRANSACTIONS INVOLVING INTERESTED PERSONS SCHEDULE L, PART IV The following were substantial contributors (in excess of $5,000) that also provided services to MedStar Good Samaritan valued in excess of $100,000: Whiting-Turner Contracting Company and WebbMason. Per MedStars conflict of interest policy, these transactions are at arms-length for fair market value. ORGANIZATION MEMBERS PART VI, LINE 6 THE ORGANIZATION IS AN AFFILIATE AND SUBSIDIARY OF MEDSTAR HEALTH, INC., A TAX-EXEMPT MARYLAND NON-STOCK CORPORATION. MEDSTAR HEALTH, INC., OR ONE OF ITS AFFILIATES AND SUBSIDIARIES, IS THE SOLE MEMBER OF THE ORGANIZATION. DESCRIPTION OF MEMBERS PART VI, LINE 7A AS AN AFFILIATE AND SUBSIDIARY OF MEDSTAR HEALTH, INC., A TAX-EXEMPT MARYLAND NON-STOCK CORPORATION, THE ORGANIZATION MAY RECOMMEND PERSON(S) FOR MEMBERSHIP ON THE ORGANIZATION'S GOVERNING BODY. ANY SUCH RECOMMENDATION BY THE ORGANIZATION IS SUBJECT TO APPROVAL BY THE GOVERNANCE COMMITTEE OF THE BOARD OF DIRECTORS OF MEDSTAR HEALTH, INC. THE BOARD OF MEDSTAR HEALTH, INC. HAS DELEGATED CERTAIN APPROVAL AUTHORITY TO THE GOVERNANCE COMMITTEE AND THE PRESIDENT & CEO OF MEDSTAR HEALTH, INC. DECISIONS OF GOVERNING BODY PART VI, LINE 7B AS AN AFFILIATE AND SUBSIDIARY OF MEDSTAR HEALTH, INC., A TAX-EXEMPT MARYLAND NON-STOCK CORPORATION, THE BYLAWS OF THE ORGANIZATION ARE SUBJECT TO CERTAIN RESERVED POWERS, WHICH PROVIDE THAT THE SOLE MEMBER OF THE ORGANIZATION MUST APPROVE CERTAIN DECISIONS, INCLUDING BUT NOT LIMITED TO MATTERS CONCERNING THE SALE OR PURCHASE OF REAL OR PERSONAL PROPERTY, CAPITAL BUDGETS, STRATEGIC PLANNING, INVESTMENTS, AND CORPORATE GOVERNANCE. PROCESS FOR REVIEWING FORM 990 PART VI, LINE 11B THE PROCESS FOR REVIEWING THE FORM 990 INCLUDED EDUCATION AND TRANSPARENCY. SENIOR FINANCIAL EXECUTIVES, WORKING WITH INDEPENDENT OUTSIDE EXPERTS, THOROUGHLY REVIEWED FORM 990 AND ACCOMPANYING INSTRUCTIONS. IN ADDITION, SENIOR EXECUTIVES REVIEWED THE RELEVANT SECTIONS OF THE FORM 990 WITH THE FOLLOWING COMMITTEES OF THE ORGANIZATION'S GOVERNING BODY: FINANCE, AUDIT, GOVERNANCE, STRATEGIC PLANNING, AND EXECUTIVE COMPENSATION. FOLLOWING THESE MEETINGS, THE GOVERNING BODY WAS PROVIDED A COPY OF THE FORM 990 IN ITS FINAL FORM AND GIVEN AN OPPORTUNITY TO PROVIDE ANY INPUT OR COMMENTS RELATING TO THE FORM 990 PRIOR TO ITS FILING. CONFLICT OF INTEREST POLICY PART VI, LINE 12C APPOINTMENT OF BOARDS OF DIRECTORS MEDSTAR HEALTH (AND ITS SUBSIDIARIES) REQUIRE ALL NOMINATED DIRECTORS, PRIOR TO THEIR APPOINTMENT OR ELECTION, TO DISCLOSE THE EXISTENCE OF (OR POTENTIAL EXISTENCE OF) ANY TRANSACTION WITH MEDSTAR THAT WOULD RESULT IN A CONFLICT OF INTEREST. SUCH DISCLOSURES (IF ANY) ARE REVIEWED BY THE GOVERNANCE COMMITTEE OF THE MEDSTAR HEALTH BOARD OF DIRECTORS WHICH DETERMINES HOW THE MATTER SHOULD BE RESOLVED. ANNUAL DISCLOSURES - ALL OFFICERS, DIRECTORS, AND SENIOR MANAGERS ALL OFFICERS, DIRECTORS AND SENIOR MANAGERS ARE REQUIRED, NOT LESS THAN ANNUALLY, TO COMPLETE A SURVEY OF QUESTIONS CONCERNING ANY TRANSACTIONS OR RELATIONSHIPS WHICH WOULD OR COULD REPRESENT A CONFLICT OF INTEREST. SUCH DISCLOSURES (IF ANY) RELATED TO DIRECTORS ARE REVIEWED BY THE GOVERNANCE COMMITTEE OF THE MEDSTAR HEALTH BOARD OF DIRECTORS WHICH DETERMINES HOW THE MATTER SHOULD BE RESOLVED. SUCH DISCLOSURES (IF ANY) RELATED TO OFFICERS AND SENIOR MANAGERS ARE REVIEWED BY AN APPROPRIATE EXECUTIVE WHO DETERMINES HOW THE MATTER SHOULD BE RESOLVED IN ADDITION, OFFICERS AND DIRECTORS OF MARYLAND HOSPITALS AND NURSING CENTERS ARE REQUIRED TO ANNUALLY DISCLOSE ADDITIONAL INFORMATION RELATING TO POTENTIAL CONFLICTS OF INTEREST AND SUCH DISCLOSURES ARE REPORTED TO THE MARYLAND HEALTH SERVICES COST REVIEW COMMISSION (HSCRC). DESCRIPTION OF EXECUTIVE COMPENSATION PROCESS PART VI, LINE 15 THE EXECUTIVE COMPENSATION COMMITTEE OF THE BOARD OF DIRECTORS OF MEDSTAR HEALTH, INC. (THE "COMMITTEE") HAS OVERSIGHT OVER THE EXECUTIVE COMPENSATION PROGRAM (THE "PROGRAM") OF MEDSTAR HEALTH, INC. AND ITS AFFILIATES. TOTAL COMPENSATION FOR THE TOP MANAGEMENT OFFICIALS, OFFICERS AND KEY EMPLOYEES OF MEDSTAR HEALTH, INC. AND ITS AFFILIATES ARE REVIEWED AND APPROVED BY THE COMMITTEE WITH ASSISTANCE AND GUIDANCE FROM AN INDEPENDENT THIRD PARTY ADVISOR. THE MEMBERS OF THE COMMITTEE ARE INDEPENDENT FROM ALL OF THE PARTICIPANTS IN THE PROGRAM. THE MAIN OBJECTIVE OF THE PROGRAM IS TO PROVIDE MARKET COMPETITIVE TOTAL COMPENSATION THAT IS INTERNALLY EQUITABLE AND HAS A STRONG PAY-FOR-PERFORMANCE LINKAGE. PERFORMANCE IS EVALUATED AT THE SYSTEM, OPERATING UNIT, AND INDIVIDUAL LEVELS. THE OVERALL TOTAL COMPENSATION PHILOSOPHY IS MANAGED AT THE 75TH PERCENTILE OF THE COMPETITIVE MARKET FOR COMPARABLE SIZE (NET REVENUE) AND TYPE (TAX-EXEMPT HEALTHCARE ORGANIZATIONS). WHERE APPROPRIATE, ADDITIONAL INDUSTRY DATA IS CONSIDERED (GENERAL BUSINESS AND/OR TAXABLE HEALTHCARE) FOR SELECTED POSITIONS THAT CAN BE RECRUITED FROM OR POTENTIALLY LOST TO THESE INDUSTRIES (E.G., INFORMATION TECHNOLOGY, FINANCE, ETC.). THE COMMITTEE HAS ENGAGED ERNST & YOUNG LLP ("E&Y") TO SERVE AS AN ADVISOR ON THE REASONABLENESS AND COMPETITIVENESS OF THE PROGRAM. IN DETERMINING REASONABLENESS AND COMPETITIVENESS, E&Y REVIEWS MARKET PRACTICES AND TRENDS, AND MAKES RECOMMENDATIONS RELATED TO THE PROGRAM. E&Y UTILIZES INFORMATION FROM CUSTOM SURVEYS, NATIONAL COMPENSATION SURVEYS, PROPRIETARY DATABASES, AND CLIENT EXPERIENCES TO DETERMINE ITS FINAL RECOMMENDATIONS. E&Y PRESENTS THEIR FINDINGS AND RECOMMENDATIONS TO THE COMMITTEE. THE COMMITTEE MAKES THE FINAL DECISIONS ON ALL OF THE COMPENSATION DETERMINATIONS OF THE PROGRAM. ALL DECISIONS MADE BY THE COMMITTEE ARE CONTEMPORANEOUSLY DOCUMENTED. FINANCIAL STATEMENT AVAILABILITY PART VI, LINE 19 MEDSTAR HEALTH POSTS ITS ANNUAL FINANCIAL AUDIT AND QUARTERLY FINANCIAL REPORTS TO THE ELECTRONIC MUNICIPAL MARKET ACCESS (EMMA) SYSTEM. THE ORGANIZATION ALSO E-MAILS ITS ANNUAL AND QUARTERLY DISCLOSURES TO HOLDERS OF THE COMPANY'S PUBLICLY TRADED DEBT. THE COMPANY'S GOVERNANCE DOCUMENTS AND CONFLICTS OF INTEREST POLICIES ARE AVAILABLE UPON REQUEST THROUGH ITS CORPORATE (OR AS APPLICABLE ENTITY) PUBLIC INFORMATION OFFICES. FINANCIAL STATEMENTS AND REPORTING PART XII, LINE 2C THE GOOD SAMARITAN HOSPITAL OF MARYLAND, INC. IS AN AFFILIATE OF THE MEDSTAR HEALTH, INC. AUDIT AND SUBJECT TO OVERSIGHT BY THE AUDIT COMMITTEE OF THE MEDSTAR BOARD. OTHER CHANGES IN NET ASSETS PART XI, LINE 9 EQUITY TRANSFERS - NET ASSETS.....................$ 23,639,019 O'NEILL EQUITY....................................$ 2,517,623 ------------- TOTAL OTHER CHANGES IN NET ASSETS.................$ 26,156,642 MEDSTAR HEALTH ANESTHESIA SERVICES A LLC 5601 LOCH RAVEN BLVD BALTIMORE MD 21239 205909017 HEALTHCARE MD 92594 0 Church Home Corporation 10980 GRANTCHESTER WAY Columbia MD 21044 237374724 Medical Fund MD 501(C)(3) PF NA true Franklin Square Hospital Center Inc 9000 Franklin Square Drive Baltimore MD 21237 520608007 Hospital MD 501(C)(3) 3 NA true Harbor Hospital Inc 3001 South Hanover Street Baltimore MD 21225 520491660 Hospital MD 501(C)(3) 3 NA true Medstar Health Inc 10980 GRANTCHESTER WAY Columbia MD 21044 522087445 Medical Svcs MD 501(C)(3) 12C III NA false Montgomery General Hospital 18101 Prince Philip Drive Olney MD 20832 520646893 Hospital MD 501(C)(3) 3 NA true The Union Memorial Hospital 201 East University Parkway Baltimore MD 21218 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