2016-05-10T13:23:26-05:00 2015-06-30 Grant Thornton LLP 2010 CORPORATE RIDGE SUITE 400 MCLEAN VA 22102 990 2014-07-01 520591628 Peninsula Regional Medical Center % JIM GREGORY PENI 4105466400 100 East Carroll Street Salisbury MD 21801 BRUCE RITCHIE CFO 4105466400 2016-05-09 true mary torretta P00847851 7038477500 2014 2016-08-17 19:52:53Z Margaret Naleppa CEO 100 East Carroll Street Salisbury MD 21801 553526452 false X www.peninsula.org X 1897 MD Improve the health of the communities we serve. 16 13 3332 319 4916384 476043 639051 389447738 403960086 22081011 18313873 729289 774562 412734081 423687572 0 0 0 0 190652104 187534771 0 0 421936 193374899 210226154 384027003 397760925 28707078 25926647 585875889 641573965 182269635 212476437 403606254 429097528 X IMPROVE THE HEALTH OF THE COMMUNITIES WE SERVE. false false 340928826 403525988 see schedule o 340928826 true true false true false false false false false true true false false true true false false true false true true false false false false false true true false false true true false false false false false false false false false true false false false false false true true true false false true 218 0 true 3332 true true true true CJ false false false false false false false false X 16 13 true false false false true true true true true false false true true true true true true true true true true CA MD NC X JIM GREGORY 4109124979 100 EAST CARROLL STREET Salisbury MD 21801 X Margaret Naleppa President/CEO 40.0 1.0 X X 937492 0 131496 William R McCain Chairman 1.0 2.0 X X 31204 0 0 Monty Sayler Vice Chairman 1.0 1.0 X X 0 0 0 Deborah Abbott Secretary 1.0 1.0 X X 0 0 0 Herbert J Geary III Treasurer 1.0 1.0 X X 0 0 0 Timothy Benning MD Board Member 1.0 1.0 X 0 0 0 Thomas Coates Board Member 1.0 1.0 X 0 0 0 Mark Higdon Board Member 1.0 1.0 X 0 0 0 Murray K Hoy Board Member 1.0 1.0 X 0 0 0 Christjon J Huddleston MD Board Member -Term ended 10/14 1.0 1.0 X 0 0 51320 Marion Keenan Board Member 1.0 1.0 X 0 0 0 Ryan McLaughlin Board Member 1.0 1.0 X 0 0 0 Vel Natesan MD Board Member 1.0 1.0 X 0 0 15125 Martin Neat Board Member 10.0 1.0 X 0 0 0 Thomas Riccio MD Board Member 1.0 1.0 X 0 0 0 David Rommel Board Member 1.0 2.0 X 0 0 0 William Todd MD Board Member 1.0 2.0 X 0 0 0 Lura Lunsford VP of Operations 40.0 1.0 X 460307 0 92050 Bruce I Ritchie CFO 40.0 0.0 X 534496 0 115052 Charles Silvia Jr MD VP - Chief Medical Officer 40.0 0.0 X 449007 0 58224 Mary Beth D'Amico VP Patient Care Services 40.0 0.0 X 224442 0 38576 Sara Scott VP People & Organization Dev. 40.0 0.0 X 208286 0 51749 Steven Leonard VP Operation Optimization & In 40.0 0.0 X 252167 0 84514 Karen Poisker VP Population Health 40.0 0.0 X 284211 0 113907 Daniel Mulvanny VP - General Counsel 40.0 0.0 X 367931 0 55583 Andy Pierre MD Physician 40.0 0.0 X 768859 0 34241 Jacek Malik MD Physician 40.0 0.0 X 783013 0 33644 Halim Charbel MD Physician 40.0 0.0 X 789206 0 14389 James Todd MD Physician 40.0 0.0 X 756090 0 90582 Kurt Wehberg MD Physician 40.0 0.0 X 754691 0 87034 7601402 0 1067486 219 false true false HORIZON CSA LLC 265 PIT RD MOORESVLLE NC 28115 BIOMEDICAL SERVICES 5281313 SHERIDAN ANESTHESIA OF MD PO BOX 452197 SUNRISE FL 333232197 ANESTHESIA SERVICES 3385917 SLEEP WAVES INC 873 E BALTIMORE PIKE STE 345 KENNETT SQUARE PA 19348 SLEEP LAB SERVICES 2564000 FOCUSONE SOLUTIONS LLC PO BOX 3037 OMAHA NE 681030037 CONTRACTED SERVICES 1769179 MAYO COLLABORATIVE SERVICES PO BOX 9146 MINNEAPOLIS MN 554809146 MEDICAL SERVICES 1443327 91 334585 304466 639051 NET PATIENT SERVICES 621500 399347426 398643139 704287 AMBULATORY PHARMACY 900099 3996644 3996644 INVESTMENT IN PREMIER 900099 616016 600722 15294 403960086 5991069 5991069 0 0 219421 386519 -167098 0 -167098 -167098 141761145 14020 129452361 12308784 14020 12322804 12322804 0 0 0 CAFETERIA 722514 741397 741397 PARTNERSHIP INCOME 900099 159 159 MANAGEMENT FEES 561000 200000 200000 104 104 941660 423687572 399243861 4916384 18888276 0 0 0 0 4151133 3752458 390767 7908 0 151939462 137347167 14302839 289456 4213743 3809055 396661 8027 17095590 15443768 1619144 32678 10134843 9266645 852231 15967 0 1179544 1202 1178342 208482 208482 0 0 1428570 1428570 42591245 29578994 12996993 15258 527635 476961 49669 1005 106980467 102647601 4292501 40365 893308 866756 26059 493 0 4294921 4286828 8093 395945 288849 96964 10132 0 26375 26375 6048606 6048606 0 22250844 22204178 46666 4797328 16482 4780846 BAD DEBTS 10729288 10729288 DUES 564668 212594 351427 647 BOND REFINANCING 7308928 7308928 397760925 340928826 56410163 421936 1991438 1605466 25272529 44566906 0 0 38407998 38694139 0 0 0 0 0 0 9208496 10189320 5234547 4921805 488817735 286484419 203336346 202333316 209601997 232783197 0 0 0 0 0 0 92822538 106479816 585875889 641573965 16261817 17577598 0 0 0 0 124686859 146651280 0 0 0 0 0 0 15000 0 41305959 48247559 182269635 212476437 X 375152248 397331967 20361044 23519520 8092962 8246041 403606254 429097528 585875889 641573965 X 25926647 189641 -625014 X false true X true false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false false true 23205 23205 false OTHER ACTIVITIES PENINSULA REGIONAL MEDICAL CENTER DOES NOT ENGAGE IN ANY DIRECT LOBBYING ACTIVITIES. THE ORGANIZATION DOES NOT ENGAGE IN ANY DIRECT LOBBYING ACTIVITIES. THE ORGANIZATION PAYS MEMBERSHIP DUES TO MARYLAND HOSPITAL ASSOCIATION (MHA) AND THE AMERICAN HOSPITAL ASSOCIATION (AHA). MHA AND AHA ENGAGE IN MANY SUPPORT ACTIVITIES INCLUDING LOBBYING AND ADVOCATING FOR THEIR MEMBER HOSPITALS. THE MHA AND AHA REPORTED THAT 4.80% AND 22.80% OF MEMBER DUES WERE USED FOR LOBBYING PURPOSES AND SUCH, THE ORGANIZATION HAS REPORTED THIS AMOUNT ON SCHEDULE C PART IV AS LOBBYING ACTIVITIES. 45972891 647931 3765292 341503 50044611 39054428 500000 6781222 41210 321549 45972891 34734107 6448 4624939 311066 39054428 34191392 12685 801060 271030 34734107 28295999 105500 6047698 257805 34191392 0.50723 0.00153 0.49124 false false 10636389 10636389 232038282 83336401 148701881 232285782 195904660 36381122 13857282 7243358 6613924 202333316 INVESTMENT IN PARTNERSHIPS 2898942 UNAMORTIZED FINANCING COSTS 1355560 OTHER ASSETS 7989237 CONSTRUCTION FUND 18863488 DONOR RESTRICTED FUND 31921944 SELF INSURANCE FUND 19292994 BOARD DESIGNATED INVESTMENTS 23962536 INTERCOMPANY RECEIVABLES 195115 106479816 0 ADVANCES FROM THIRD PARTY PAYORS 9845839 ACCRUED SELF INSURANCE LIABILITY 14995754 OTHER LIABILITIES 4640176 EMPLOYEE COMPENSATION RELATED PAYROLL TAXES 18765790 48247559 409704908 189641 -10116249 -9926608 419631516 1428570 2627486 4056056 423687572 385636919 386519 386519 385250400 1428570 11081955 12510525 397760925 INTENDED USE OF ENDOWMENT FUNDS Schedule D, Part V, Line 4 The organization's endowment funds are used for capital, patient services or educational purposes. Reconciliation of Revenue and Expenses to Audited Financial Statements Schedule D, Part XI, Line 2d Bad Debt Expenses ($10,729,288) Rent Expenses $386,519 Partnership K-1 Income - Tax Differences $226,520 ------------ ($10,116,249) Schedule D, Part XI, Line 4b Management Fees Reclassed from Expenses $200,000 Foundation Contributions $334,585 Partnership K-1 Income $627,387 Temporary Restricted Income $1,439,630 Permanently Restricted Income $23,410 Misc. Income $2,474 ------------- $2,627,486 Schedule D, Part XII, line 2d Rent Expenses $386,519 Schedule D, Part XII, line 4b Reclass of Bad Debt Expenses $10,729,288 Management Fees Reclassed from Expenses $200,000 Foundation Contributions $152,667 ------------ $11,081,955 Central America and the Caribbean 1 1 Investments Captive Insurance Co. 1151487 1 1 1 1 1151487 1151487 true false true false false false ACTIVITIES PER REGION SCHEDULE F, PART IV THE AMOUNTS IN COLUMN F WERE DETERMINED USING AN ACCRUAL METHOD OF ACCOUNTING. THE ENTIRE $1,151,487 REPRESENTS A CAPTIVE INSURANCE INVESTMENT. true true true X true X true true true false true true 10195082 10195082 0.02680 10195082 10195082 0.02680 46517 2005862 279108 1726754 0.00450 584 653908 38755 615153 0.00160 85185 40663870 18033378 22630492 0.05960 535 535 2106 100489 100489 0.00030 134392 43424664 18351241 25073423 0.06600 134392 53619746 18351241 35268505 0.09280 25260 25260 0.00010 34976 34976 0.00010 115415 115415 0.00030 294938 350 294588 0.00080 1020 1020 0.00120 471609 350 471259 0.00250 true 10729288 238652107 225032100 13620007 X true true 1 1 Peninsula Regional Medical Center 100 E Carroll Street Salisbury MD 21801 www.peninsula.org X X X Peninsula Regional Medical Center 1 false false true X X X X X X 13 true false false true X WWW.PENINSULA.ORG X X true 13 true www.peninsula.org false false true X 200. 300. X X X X true true X X X true X www.peninsula.org X www.peninsula.org X www.peninsula.org X X X X true X false X X X true X false false Consulting a representative of the community served by the Hospital Schedule H, Part V, Line 5 Peninsula Regional Medical Center conducted a Community Needs Assessment Survey of 335 individuals. These individuals were Board Members, the Executive Team, Peninsula Partners (a community senior group), churches, the Lions and Rotary clubs and community wellness and screening events. In addition the survey was posted on our website, Facebook and blog. Other ways the Hospital makes its CHNA report available the public Schedule H, Part V, Line 7d Peninsula Regionals CHNA plan is available to the Public, through our website under Quick Links - Creating Health Communities at (www.peninsula.org/chc). Available to the public is the current and comprehensive Community Health Needs Assessment and the Implementation Strategy. In addition, there is a Community Health Data and Resources section than can be accessed by the public, collaboration between Peninsula Regional Medical Center, Wicomico County; Atlantic General, Worcester County; and Edward McCready Memorial Hospital, Somerset County. As part of this Creating Healthy Communities Module available to the public is Disparity Dashboard, Demographics, Healthy People 2020 Tracker, Maryland SHIP Tracker and Promising. Needs not addressed by the most recent CHNA Schedule H, Part V, Line 11 Based on the significant needs identified in the Community Health Needs Assessment, the following implementation initiatives were developed and outlined below: 1) Reduce diabetes complications: a. Provide awareness, education and diabetes management to the community. i. Continue to create general public awareness around the high prevalence of diabetes in this region. ii. Create and continue a "Diabetes Support Group for Teens and Kids" that meets the medical, educational and social needs of this group. iii. "Educating the Educators." Work with multiple educators to promote adolescent and adult diabetes awareness. iv. Support and partner with the Tri-County Diabetes Alliance to create awareness, education and management of the diabetes population in the lower three counties. v. Disease Self- Management Program. Partner with Maintaining Active Citizens in the statewide license for chronic disease self-management education. The primary objective is to deliver chronic disease self-management services to community residents. The program will promote increased patient competence and coping through treatment plans that include education and referrals to necessary resources, provide comprehensive assessments and help the patient utilize the health system appropriately. Healthy Living with Diabetes. A diabetes self-management education program at MAC. Healthy Living with Diabetes is a 6-8 week workshop developed at Stanford University, based on self-management. vi. Partner with local health departments under the 1422 grant to prevent obesity and diabetes. 2) Reduce obesity: a. Reduce the number of child and adolescents in Wicomico, Worcester and Somerset counties who are considered overweight. b. Develop educational modules and increase educational awareness around childhood and adolescent obesity to reduce the total number of children who are overweight. c. The primary objective is to educate our children on how to make better healthy lifestyle choices at a young age, and to involve the parents in healthy lifestyle activities so they will start to commit to a healthier lifestyle and reinforce this with their children. d. Create diabetes community awareness and provide education regarding healthy lifestyles within the tri-county region (Wicomico, Worcester & Somerset). e. Provide screenings and education for underserved and uninsured members of the community through HealthFest, an annual health expo. f. Provide pediatric obesity screenings and education for under and uninsured community members. Increase breast feeding rates to help lower pediatric obesity. Promote physical activity. g. Provide healthy heart screenings to residents of Delmarva using a mobile van to reach communities that have limited access to healthcare. The two healthy heart initiatives include: - CCC- Coastal Cardiac Checks - Women's Heart Screenings Obesity Component An integral component of these heart screenings includes an educational session that highlights reducing obesity, exercising and healthy food choices -all of which contribute to a healthy heart. - Obesity Screening Component Includes: - Height - Weight - BMI - Body Fat % - Educational Session on Nutrition and Healthy Lifestyles - Resources Available - Potential Referral if Needed Needs Not Addressed by the Most Recent CHNA Schedule H, Part V, Line 11 Peninsula Regional Medical Center has a fixed value of resources available and the hospital focuses those resources to the areas with the greatest impact, therfore not all needs identified in the CHNA were able to be addressed to date. Eligibility Criteria for Financial Assistance Schedule H, Part V, Line 13 Peninsula Regional Medical Center offers financial assistance to patients whose income is at or below 200% of the Federal Poverty Guidelines. PRMC also provides financial assistance based upon several special exceptions: 1) Financial assistance will be considered if patient is over income criterion, but have a financial hardship. A financial hardship exists when the amount of medical debt at Peninsula Regional Medical Center exceeds 25% of the family's income in a year. 2) A patient that has qualified for Maryland Medical Assistance is deemed to automatically qualify for PRMC's Financial Assistance program. The amount due from a patient on these accounts may be written off to Financial Assistance with verification of Medicaid eligibility. Normal documentation requirements are waived for financial assistance granted upon the basis of Maryland Medical Assistance eligibility. 3) Patients who are beneficiaries/recipients of certain means-tested social services programs administered by the State of Maryland are deemed to have presumptive eligibility for PRMC's Financial Assistance program. The amount due from a patient on these accounts may be written off to Financial Assistance with verification of eligibility for one of these programs. Normal documentation requirements are waived for financial assistance granted upon the basis of presumptive eligibility. It is the responsibility of patients to notify the hospital they are in a means tested program and provide the documentation. PUBLICIZING THE FINANCIAL ASSISTANCE POLICY SCHEDULE H, PART V, LINE 15 If a patient is unable to pay due to financial resources, all efforts will be made to help the patient obtain assistance through appropriate agencies. In the event that the patient has applied for and kept all necessary appointments and third party assistance is not available, Peninsula Regional Medical Center will provide care at reduced or zero cost. When no third party assistance is available to cover the total bill and the patient indicates that they have insufficient funds, the following procedure will occur: 1) The Maryland State Uniform Financial Assistance Application should be reviewed by staff, in consultation with the patient, to make initial assessment of eligibility. 2) Compare patient's income to current Federal Poverty Guidelines. 3) If preliminarily eligible per Guidelines, send Maryland State Uniform Financial Assistance Application to patient/guarantor for completion and signature. Patient should attach appropriate documentation and return to representative within 10 days. Upon receipt of the financial assistance request, the Representative will review income and all documentation. The patient must be notified within two business days of their probable eligibility and informed that the final determination will be made once the completed form and all supporting documents are received, reviewed, and the information verified. Income information will be verified using the documentation provided by the patient and external resources when available. A financial assistance discount will be applied to the patient's responsibility in accordingly. 4) If ineligible, the Representative will notify the patient and resume normal dunning process and file denial with the account. The denials will be kept on file in the collection office. All denials will be reviewed by the Collection Coordinator level or above. The patient may request reconsideration by submitting a letter to the Director of Patient Financial Services indicating the reason for the request. Only income and family size will be considered in approving applications for Financial Assistance unless one of the following three scenarios occurs: - The amount requested is greater than $50,000. - The tax return shows a significant amount of interest income, or the patient states they have been living off of their savings accounts. - Documentation indicates significant wealth. If one of the above three scenarios are applicable in the application, liquid assets may be considered including: checking and savings accounts, stocks, bonds, CD's, money market or any other accounts for the past three months along with the past year's tax return, and a credit report may be reviewed. The following assets are excluded: - The first $10,000 of monetary assets. - Up to $150,000 in a primary residence. Certain retirement benefits (such as a 401-K where the IRS has granted preferential tax treatment as a retirement account including but not limited to deferred-compensation plans qualified under the Internal Revenue Code, or nonqualified deferred-compensation plans) where the patient potentially could pay taxes and/or penalties by cashing in the benefit. If the balance due is sufficient to warrant it and the assets are suitable, a lien will be placed on the assets for the amount of the bill. Collection efforts will consist of placement of the lien which will result in payment to the hospital upon sale or transfer of the asset. Refer account to Collection Coordinator for filing a lien. 5) Collection Coordinator will review documentation. If eligible, the account will be written off to financial assistance and the "Request for Financial Assistance" form finalized. A copy is retained in the patient's file. The Representative will call the patient and notify him/her of the final determination of eligibility. 6) Peninsula Regional Medical Center will review only those accounts where the patient or guarantor inquire about financial assistance, mails in an application, or in the normal working of the account there is indication that the patient may be eligible. Any patient/customer service representative, financial counselor, or collection representative may begin the request process. Pre-planned service may only be considered for financial assistance when the service is medically necessary. For example, no cosmetic surgery will be eligible. Inpatient, outpatient, emergency, and Peninsula Regional Medical Group physician charges are all eligible. Maximum Charge Amounts for FAP-Eligible Individuals Schedule H, Part V, Line 22E PENINSULA REGIONAL MEDICAL CENTER IS A MARYLAND HOSPITAL. AS SUCH PATIENTS AND ALL INSURANCE COMPANIES, INCLUDING MEDICARE & MEDICAID, PAY THE SAME RATE. THIS RATE IS DETERMINED BY THE STATE AGENCY, THE MARYLAND HEALTH SERVICES COST REVIEW COMMISSION. Other Method used in determining eligibility for financial assistance Schedule H, Part I, Line 3c N/A - Peninsula Regional Medical Center uses the FPG in determining eligibility for financial assistance. Financial assistance is also considered if a patient is over income criterion but has financial hardship based on medical debt. Patients who are beneficiaries/recipients of certain means-tested social services program administered by the state of Maryland are deemed to have presumptive elegibility for PRMC's FA program. Community Benefit Report Schedule H, Part I, Line 6a Peninsula Regional Medical Center functions as the primary hospital provider for the rural southernmost three counties of the Eastern Shore of Maryland, which includes Wicomico, Worcester and Somerset. In FY 2015, approximately 77% of the patients discharged from the Medical Center were residents of the primary service area, which had an estimated population of approximately 179,605 in 2015 and is expected to increase to 183,893 in 2020, or by 2.4%. The primary service area population has grown by an estimated 10% since 2000. The secondary service area, accounting for 20.6% of Peninsula Regional's FY 2015 discharges, consists of the southern portion of Sussex County, Delaware and the northern portion of Accomack County, Virginia and parts of Dorchester County, Maryland. These counties had a population of approximately 285,978 in 2015 and are projected to grow to 301,015 in 2020, a growth rate of 5.3%. The primary and secondary service areas combined accounted for 98% of Peninsula Regional's total patients. In the past Peninsula Regional's approach to rural population health and community benefits was generalized and consisted of touching our three primary counties: Wicomico, Worcester and Somerset. However, there are examples where Peninsula Regional has participated with our neighbors in Delaware and Virginia on urgent community healthcare needs. Many of the social determinants of rural health in our three county area spill over state lines creating similar issues in our neighboring states and allowing us to work together. Until now, most of PRMC's initiatives have been "reactive," activated by patients presenting in the emergency room or as inpatients. PRMC now seeks to deploy resources and embed care management functions within primary care practices to address some of the determinants (or root causes) of high utilization. By moving care back out into the community with PCPs and care managers embedded within those PCPs, the right care will delivered, reducing the need for inpatient hospital admissions and readmissions. Over the next several years, Peninsula Regional will be in a transitional period where specified "Super Utilizers" within our CBSA will be identified, categorized and targeted for population health management. o Demographics (block groups, zip codes) o Race/Ethnicity o Age-Cohorts o Chronic Conditions The target population includes patients that have chronic conditions who have demonstrated to have been high utilizers at PRMC, or are identified as being at risk of high utilization based on his/her chronic conditions and patterns of care. PENINSULA REGIONAL MEDICAL CENTER FILES ANNUALLY A COMMUNITY BENEFIT REPORT WITH THE STATE OF MARYLAND. THE REPORT IS FILED WITH THE HSCRC (HEALTH SERVICES COST REVIEW COMMISSION). Financial Assistance and Certain Other Community Benefits at Cost Schedule H, Part I, Line 7 THE AMOUNT OF BAD DEBT EXPENSE EXCLUDED FROM THE DENOMINATOR IN THE COLUMN (F) PERCENTAGES IS $10,729,228. LINE 7B COLUMN (C) & (F)- MARYLAND'S REGULATORY SYSTEM CREATES A UNIQUE PROCESS FOR HOSPITAL PAYMENT THAT DIFFERS FROM THE REST OF THE NATION. THE HEALTH SERVICES COST REVIEW COMMISSION, (HSCRC) DETERMINES PAYMENT THROUGH A RATE-SETTING PROCESS AND ALL PAYORS, INCLUDING GOVERNMENTAL PAYORS, PAY THE SAME AMOUNT FOR THE SAME SERVICES DELIVERED AT THE SAME HOSPITAL. MARYLAND'S UNIQUE ALL-PAYOR SYSTEM INCLUDES A METHOD FOR REFERENCING UNCOMPENSATED CARE IN EACH PAYORS' RATES, WHICH DOES NOT ENABLE MARYLAND HOSPITALS TO BREAKOUT ANY DIRECTED OFFSETTING REVENUE RELATED TO UNCOMPENSATED CARE. COMMUNITY BENEFIT EXPENSES ARE EQUAL 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. THE COST METHODOLOGY FOR CHARITY CARE AND CERTAIN OTHER COMMUNITY BENEFITS IS THE COST-TO-CHARGE RATIO USED FOR THE CHARITY CARE PROGRAMS AND DIRECT COST METHOD FOR THE OTHER BENEFITS/PROGRAMS. Methodology Used to esimated Bad Debt expense Schedule H, Part III, Lines 2 and 3 See response below to Line 4 regarding the methodology used by the organization regarding bad debt. Bad Debt Footnote in the Audited Financial Statements Schedule H, Part III, Line 4 The Hospital provides services to patients in the Eastern Shore area of Maryland, Delaware and Virginia, the majority of whom are covered by third-party health insurance. The Hospital bills the insurer directly for services provided. Insurance coverage and financial information is obtained from patients upon admission when available. The Hospital's policy is to perform in-house collection procedures for approximately 85 days. A determination is made at that time as to what additional collection efforts to pursue. A provision for uncollectible accounts is recorded for amounts not yet written off, which are expected to become uncollectible. Discounts ranging from 2% to 6% of charges are given to Medicare, Medicaid and certain approved commercial health insurance and health maintenance organization programs for regulated services. Discounts in varying percentages are given for certain unregulated services. These major payors routinely review patient billings and deny payment for certain charges as medically unnecessary or as performed without appropriate preauthorization. Discounts and denials are recorded as reductions of net patient service revenue. Accounts receivable from these third-party payors have been adjusted to reflect the difference between charges and the estimated reimbursable amounts. Approximately 38% and 39%, respectively, of accounts receivable were due from the Medicare program as of June 30, 2015 and 2014, respectively. The Medicare and Medicaid reimbursement programs represent a substantial portion of the Hospital's revenues. The Hospital's operations are subject to numerous laws and regulations of federal, state and local governments. These laws and regulations include, but are not necessarily limited to, matters such as licensure, accreditation, government health care program participation requirements, reimbursement for patient services and Medicare and Medicaid fraud and abuse. Medicare Costing Methodology Schedule H, Part III, Line 8 MEDICARE ALLOWABLE COSTS WERE CALCULATED USING A COST TO CHARGE RATIO. PENINSULA REGIONAL MEDICAL CENTER PROVIDES QUALITY MEDICAL SERVICES TO ALL PATIENTS REGARDLESS OF WHAT INSURANCE THEY HAVE. APPROXIMATELY, 49% OF THE MEDICAL CENTER'S NET PATIENT REVENUE REVENUE IS ATTRIBUTABLE TO MEDICARE PATIENTS DURING THE YEAR ENDED JUNE 30, 2015. Collection Policy Schedule H, Part III, Line 9B COLLECTION POLICIES ARE THE SAME FOR ALL PATIENTS. IF A PATIENT NOTIFIES THE MEDICAL CENTER ABOUT THEIR INABILITY TO PAY, THE MEDICAL CENTER WILL SEND THEM THE CHARITY CARE AND FINANCIAL ASSISTANCE FORMS TO FILL OUT. ONCE THE FORMS ARE COMPLETE AND RETURNED TO THE MEDICAL CENTER AND THE PATIENT QUALIFIES FOR FINANCIAL ASSISTANCE, THEN THE PATIENT'S ACCOUNT WILL BE REMOVED FROM COLLECTIONS AND THE ACCOUNT WILL BE WRITTEN OFF. Needs Assessment - Promotion of Community Health Schedule H, Part VI, Line 2 PENINSULA REGIONAL MEDICAL CENTER IN COOPERATION WITH THE WICOMICO, WORCESTER AND SOMERSET COUNTIES, HEALTH DEPARTMENTS, THE ATLANTIC GENERAL HOSPITAL AND THE EDWARD W. MCCREADY MEMORIAL HOSPITAL, HAS BEEN CONDUCTING COMMUNITY HEALTH SURVEYS OF THE TRI-COUNTY AREA SINCE 1995. THESE SURVEYS, ADMINISTERED BY PROFESSIONAL RESEARCH CONSULTANTS (PRC) OF OMAHA, NEBRASKA WERE ADMINISTERED IN 1995, 2000, 2004,2009 AND 2013. IN ADDITION TO THESE ADULT SURVEYS, A SEPARATE ADOLESCENT SURVEY WAS CONDUCTED IN 2000, 2005, AND 2010. RESULTS OF THESE SURVEYS ARE USED BY THE PARTICIPANTS TO ASSESS COMMUNITY HEALTH NEEDS AND PLAN FUTURE SERVICES. OF PARTICULAR NOTE WAS THE DEVELOPMENT OF THE TRI-COUNTY DIABETES ALLIANCE, WHICH IS A COOPERATIVE VENTURE BETWEEN ALL THE PARTNERS AND COMMUNITY AGENCIES TO REDUCE THE INCIDENCES OF DIABETES IN THE TRI-COUNTY AREA. OTHER OUTCOMES RESULTING FROM THE SURVEY FINDINGS INCLUDE SMOKING CESSATION PROGRAMS, OTHER EARLY DETECTION AND SCREENING PROGRAMS FOR HEART AND CANCER, AS WELL AS HEALTH PROMOTION AND EDUCATION WITH A FOCUS ON PREVENTION. THE PRC COMMUNITY HEALTH ASSESSMENT IS A SYSTEMATIC, DATA-DRIVEN APPROACH TO DETERMINING THE HEALTH STATUS, BEHAVIORS AND NEEDS OF OUR COMMUNITY RESIDENTS. SURVEY RESULTS ARE SHARED WITH THE COMMUNITY AND ARE POSTED TO THE PARTICIPANTS WEBSITES. THIS COMMUNITY HEALTH ASSESSMENT SERVES AS A TOOL TOWARDS REACHING THE FOLLOWING THREE GOALS: 1. TO IMPROVE RESIDENTS' HEALTH STATUS, INCREASE THEIR LIFE SPANS, AND ELEVATE THEIR OVERALL QUALITY OF LIFE. 2. REDUCE THE HEALTH DISPARITIES AMONG RESIDENTS BY GATHERING DEMOGRAPHIC INFORMATION ALONG WITH HEALTH STATUS AND BEHAVIOR DATA. 3. TO INCREASE ACCESSIBILITY TO PREVENTIVE SERVICES FOR ALL COMMUNITY RESIDENTS. Patient Education of Eligibility for Assistance Schedule H, Part VI, Line 3 PENINSULA REGIONAL MEDICAL CENTER MAKES AVAILABLE TO ALL PATIENTS THE HIGHEST QUALITY OF MEDICAL CARE POSSIBLE WITHIN THE RESOURCES AVAILABLE. IF A PATIENT IS UNABLE TO PAY DUE TO FINANCIAL RESOURCES, ALL EFFORTS WILL BE MADE TO HELP THE PATIENT OBTAIN ASSISTANCE THROUGH APPROPRIATE AGENCIES, OR, IF HELP IS NOT AVAILABLE, TO PROVIDE CARE AT REDUCED OR ZERO COST. ONE OF PENINSULA REGIONAL'S OVERALL GUIDING PRINCIPLES IS THAT CONCERN OVER A HOSPITAL BILL SHOULD NEVER PREVENT ANY INDIVIDUAL FROM RECEIVING EMERGENCY HEALTH SERVICES. THE MEDICAL CENTER WILL COMMUNICATE THIS MESSAGE CLEARLY TO PROSPECTIVE PATIENTS AND TO LOCAL COMMUNITY SERVICE AGENCIES AND MAKE IT CLEAR THAT EMERGENCY SERVICES WILL BE PROVIDED WITHOUT REGARD TO ABILITY TO PAY. THE MEDICAL CENTER WILL ENSURE THAT AN EMERGENCY ADMISSION OR TREATMENT IS NOT DELAYED OR DENIED PENDING DETERMINATION OF COVERAGE OR REQUIREMENT FOR PREPAYMENT OR DEPOSIT. THE MEDICAL CENTER WILL POST ADEQUATE NOTICE OF THE AVAILABILITY OF MEDICAL SERVICES, AND THE GENERAL OBLIGATION OF THE HOSPITAL TO PROVIDE CHARITY CARE. PENINSULA REGIONAL'S "FINANCIAL ASSISTANCE POLICY" INCLUDES THE REQUIRED LANGUAGE OF DETERMINATION OF PROBABLE ELIGIBILITY WITHIN TWO BUSINESS DAYS. ON PAGE 2, THE "FINANCIAL ASSISTANCE POLICY" STATES THAT UPON RECEIPT OF THE FINANCIAL ASSISTANCE REQUEST, THE REPRESENTATIVE WILL REVIEW INCOME AND ALL DOCUMENTATION. THE PATIENT MUST BE NOTIFIED WITHIN TWO BUSINESS DAYS OF THEIR PROBABLE ELIGIBILITY. IN ACCORDANCE WITH SECTION 1, 2 AND 3, PENINSULA REGIONAL PROVIDES PUBLIC NOTICE AND INFORMATION REGARDING ITS CHARITY CARE POLICY IN DELMARVA'S LARGEST PAPER "THE DAILY TIMES", POSTED SIGNS IN THE ADMISSION, BUSINESS OFFICE EMERGENCY ROOM AND OTHER MAJOR SERVICE AREAS OF THE MEDICAL CENTER; ADDITIONALLY, INDIVIDUAL NOTICE IS PROVIDED TO EACH PERSON WHO SEEKS SERVICES IN THE MEDICAL CENTER AT THE TIME OF PRE-ADMISSION OR ADMISSION. Community Information Schedule H, PART VI, LINE 4 PENINSULA REGIONAL IS LOCATED IN SALISBURY, MARYLAND . THE HOSPITAL'S SERVICE AREA IS PREDOMINATELY RURAL AND COVERS 6 COUNTIES LOCATED IN THREE DIFFERENT STATES: MARYLAND, DELAWARE AND VIRGINIA. SOME OF THE UNIQUE HEALTHCARE CHARACTERISTICS OF THESE COUNTIES INCLUDE A HIGH PREVALENCE OF DIABETES WHICH IS APPROXIMATELY TWICE THAT OF THE STATE OF MARYLAND. THERE IS A HIGHER INCIDENCE OF SKIN CANCER AND THE INCIDENCE RATE FOR HEART DISEASE IS STATISTICALLY SIGNIFICANTLY HIGHER THAN MARYLAND. IN ADDITION, THE MEDIAN INCOME IS LOWER THAN THAT OF MARYLAND AND EDUCATIONAL ATTAINMENT LAGS BEHIND THE STATES AVERAGE. THE MEDICAL CENTER'S PRIMARY SERVICE AREA IS COMPRISED OF THE MAJORITY OF ZIP CODES IN WICOMICO, WORCESTER, AND SOMERSET COUNTIES. AS OF JUNE 30, 2015 THESE COUNTIES CONTRIBUTED APPROXIMATELY 75 PERCENT OF PENINSULA REGIONAL'S TOTAL DISCHARGES. THE MEDICAL CENTER ALSO SERVICES DORCHESTER COUNTY, MARYLAND, THE SOUTHERN PORTION OF SUSSEX COUNTY, DELAWARE AND THE NORTHERN PORTION OF ACCOMACK COUNTY, VIRGINIA. THESE COUNTIES COMPRISED AN ADDITIONAL 21 PERCENT OF THE MEDICAL CENTER'S TOTAL DISCHARGES DURING THE SAME TIME PERIOD. PATIENTS DISCHARGED FROM THE FOLLOWING GEOGRAPHICAL AREAS: AREA 2015 DISCHARGES % --------------------------------------------------------- WICOMICO 9,746 50.0% WORCESTER 3,261 16.7% SOMERSET 1,999 10.3% DORCHESTER, TALBOT,CAROLINE 691 3.6% DELAWARE 2,186 11.2% VIRGINIA 1,120 5.8% ALL OTHERS 474 2.4% ------ ------ TOTAL 19,477 100.0% SOURCE: PENINSULA REGIONAL MEDICAL CENTER, FINANCIAL AND STATISTICAL REPORT, JUNE 30, 2015. BETWEEN 2009 AND 2014, THE MEDICAL CENTER'S PRIMARY SERVICE AREA (WICOMICO, WORCESTER AND SOMERSET COUNTIES, MARYLAND) HAD AN ESTIMATEDPOPULATION OF 179,605 IN 2013 AND IS EXPECTED TO INCREASE TO 183,893 IN 2020, OR BY 2.4%. IN THE MEDICAL CENTER'S SECONDARY SERVICE AREA (DORCHESTER COUNTY, MARYLAND, SUSSEX COUNTY, DELAWARE, AND ACCOMACK COUNTY, VIRGINIA) THE POPULATION WAS ESTIMATED AT 177,422 IN 2013, AND IS EXPECTED TO INCREASE TO 179,814 IN 2017. Promotion of Community Health Schedule H, Part VI, Line 5 PENINSULA REGIONAL MEDICAL CENTER IS COMMITTED TO THE HEALTH OF THE RURAL COMMUNITIES IT SERVES. IN FY 2015, THE HOSPITAL'S CHARITY CARE WAS $9,408,499; COMBINED CHARITY AND BAD DEBT FOR FY 2015 WAS $20,137,787. AS PART OF PENINSULA REGIONAL'S ONGOING COMMITMENT AND MISSION STATEMENT "TO IMPROVE THE HEALTH OF THE COMMUNITIES WE SERVE, WE CONTINUE TO ASSESS THE HEALTH NEEDS OF THE COMMUNITY. WE ATTEND TRI-COUNTY COMMUNITY HEALTH IMPROVEMENT (T-CHIP)PROCESS MEETINGS. THESE MEETINGS ARE MADE UP OF WICOMICO, WORCESTER AND SOMERSET'S HEALTH DEPARTMENT, LOCAL HOSPITALS, LOCAL AND NATIONAL COMMUNITY HEALTH ORGANIZATIONS AND OTHER LOCAL HEALTHY LIFESTYLE PROGRAMS. WE SYNERGIZE AS A GROUP WORKING TOWARD OUR IDENTIFIED SHIP (STATE HEALTH IMPROVEMENT PROCESS INITIATIVES) IN ADDTION TO SHARING WITH EACH OTHER OUR PROGRAM SUCCESSES AND SOMETIMES FAILURES. THE DIVERSITY OF THE PARTICIPANTS AND THE DYNAMICS OF THIS PARTICULAR GROUP ALLOW US TO KEEP A BETTER PULSE PN THE NEEDS OF THE COMMUNITY WITH CONTRIBUTES TO PLANNING AND FORMULATION OF TACTICS TO MEET LOCAL HEALTH OBJECTIVES. PENINSULA REGIONAL CLINICIANS AND EXECUTIVES ATTEND VARIOUS PUBLIC MEETINS AS REQUESTED BY EITHER ENTITY AS WE EXCHANGE COMMUNITY HEALTH IDEAS, DATA OR BRING RESOURCES TO BARE THAT BOTH PARTIES CAN BENEFIT FROM. Community Benefits is woven throughout Peninsula Regional's Strategic Plan and is an integral part of each one of our Strategic Tenets which encompasses the following themes: patient centered care, population health management and expanding access through growth of an ambulatory presence. The Strategic Plan is a living document that interfaces with Community Benefit Initiatives, the Strategic Transformation Plan, Local County Health Departments, and dovetails the State Health Improvement Plan (SHIP) goals. In addition, collaboration and partnerships with local civic organizations, faith based institutions and community providers like the YMCA and MAC, etc., are now the norm instead of the exception. As part of the preceding Strategic Tenet, Peninsula Regional continues to build the future care infrastructure for ongoing community health benefits by investing in patient- centered care, provider/care team innovations, health information systems reinvestment and employee/ family, "Live Well" initiatives. The synergy created by these incremental health building blocks has provided access to those most in need of health resources and chronic disease management in our community. Patient Centered Care-Sampling o Developed a behavioral health "Partial Hospitalization Program" in partnership with Adventist secondary to a community assessment for gaps in service for the region. o Provision of medication for indigent population to pay for meds to help prevent readmissions and develop a healthier community. o Palliative care whose focus on patient with complex chronic disease states with specialized care revolving around symptom control, counseling, family support and education/assistance with end of life decision making. o RN coordinators to improve access to primary care appointments within 72 hours of discharge. o Additional social worker to connect ED high utilizers with community services, primary care physicians including helping to provide transportation. Provider Care Teams-Sampling o Health Coaches at Peninsula Home Care focus on heart failure and chronic kidney disease patients providing assistance with improving compliance with dietary and medication management etc. o Endocrinology: Implementation of telemedicine/diabetes clinic for pediatric patients with a focus on accurate diagnosis/ treatment using family support and school nurse. o Continued recruitment of primary care physicians that develop care models targeting high risk patients assigning them to specific care plans and care plan coordinators. Health Information Systems Health information technology implemented to support predictive analytic modeling software to determine high risk renal patients and engaging physicians and caregivers in participating in the patient's self-care regimen compliance. Development of processes used to identify high risk patients for care, identification of quality care issues and improvements to prevent complications and readmissions. Employee Family "Live Well" Campaign Building on the externally focused "Live Well" marketing efforts, Peninsula Regional turned that inward to the new "Live Well" campaign that is directed at employees and their families. This campaign encourages/promotes healthy lifestyles through education, financial benefits, health care assessments, chronic disease management and other collective health activities. A specific module associated with the "Live Well" campaign focuses on employees with diabetes as a diagnosis, the primary objective is to improve diabetes control and reduce A1C for individuals over time. Employees participating in the program receive a reduction in cost for their health care benefit and receive free testing and medications for their diabetes care. In addition, PRMC is currently developing a playbook to build ways to engage its employees and their families in a comprehensive "Live Well" lifestyle. Population Health Over the last few years population health activities are based upon community and regional needs. PRMC's overarching goals have been to provide care within the community to improve the overall quality of life, reduce health disparities, work with community organization and county health departments that impact the population on a daily basis, and to increase access to care outside of the acute care setting. The Community Health Benefits Report details efforts around Diabetes, and Obesity however PRMC has been working to further population health efforts. Future Community Benefit Intent: PRMC has determined that there is a great need to focus activities in the community with Care Managers located in primary care offices to assist primary care physicians in caring for patients with multiple admissions/emergency room visits and with multiple chronic conditions. Further, there is a need to access to care for those patients who do not have a primary care physician by assisting patients within a bridge clinic. Action plans are being developed to assist patients by providing a mobile van to address rural disparities in accessing health. Chronic disease management: Heartline, a data collection source, and health coaches who utilize the information to assist patients in better managing chronic disease. We are also developing care managers to assist primary care practitioners, patients and their families to make palliative care and hospital referrals for outpatient symptom control and counseling as well as in-home services. Finally in collaboration with multiple partners such as Atlantic General, McCready Hospital, Crisfield Clinic and multiple SNF's/Rehab, PRMC seeks to prevent avoidable admissions by addressing behavioral/chronic health needs and chronic disease management. Ambulatory Access PRMC is committed to being an integrator of health services, as an integrator we must provide appropriate access to service for the populations we seek to serve across the entire continuum. The range of services that populations require is broad and includes: o Facility-based services such as hospitals, free-standing urgent care centers, clinics and other essential ambulatory networks o Non-facility-based services o New partnerships, relationships, affiliations and pathways to drive integration and innovation. o Health professional services such as physicians, nurse practitioners and physician assistants In the last several years Peninsula Regional has opened several Health Pavilions within the community, one in Millsboro, Delaware and one in Ocean Pines, Maryland. As part of our plan to expand health services outside the hospital walls and into communities the strategy provides ease of access and promotes continuity of primary and population health services. These health pavilions provide primary care physicians, a pharmacy, rehab, medical imaging, and partnerships that provide specialty services such as cardiology and orthopedics. Each pavilion has an educational room that can be utilized by the public and other community health providers to hold health seminars and educational sessions. PRMC continues to develop its ambulatory care presence in addition to affiliations and partnerships as we review the external environment's socio-demographics, gaps in health services and access needs. Affiliated Health Care System Roles Schedule H, Part VI, Line 6 PENINSULA REGIONAL MEDICAL CENTER IS PART OF THE PENINSULA REGIONAL HEALTH SYSTEM. THE SYSTEM INCLUDES A FOUNDATION AND FOR-PROFIT ENTITIES WITH INTERESTS IN VARIOUS HEALTH CARE JOINT VENTURES. IN ADDITION TO THE COMMUNITY BENEFITS PROVIDED BY THE MEDICAL CENTER, THE HEALTH SYSTEM EVALUATES THE NEEDS OF THE COMMUNITY AND WILL PARTICIPATE IN COMMUNITY BENEFIT PROGRAMS AS NEEDED. Community Benefit Report State Filings Schedule H, Part VI, Line 7 State(s) with which the organization files a community benefit report: MARYLAND X true true X X X X X X false true false false false true true true false Margaret Naleppa President/CEO 706910 0 214403 0 16179 0 117641 0 13855 0 1068988 0 0 0 Lura Lunsford VP of Operations 369983 0 81839 0 8485 0 78195 0 13855 0 552357 0 0 0 Bruce I Ritchie CFO 404966 0 128265 0 1265 0 92796 0 22256 0 649548 0 0 0 Charles Silvia Jr MD VP - Chief Medical Officer 391525 0 56217 0 1265 0 34838 0 23386 0 507231 0 0 0 Mary Beth D'Amico VP Patient Care Services 202560 0 20617 0 1265 0 15190 0 23386 0 263018 0 0 0 Sara Scott VP People & Organization Dev. 187187 0 19834 0 1265 0 31443 0 20306 0 260035 0 0 Steven Leonard VP Operation Optimization & In 226267 0 24635 0 1265 0 58628 0 25886 0 336681 0 0 0 Karen Poisker VP Population Health 255045 0 27901 0 1265 0 97552 0 16355 0 398118 0 0 0 Daniel Mulvanny VP - General Counsel 345369 0 22000 0 562 0 37857 0 17726 0 423514 0 0 0 Andy Pierre MD Physician 666344 0 70000 0 32515 0 18522 0 15719 0 803100 0 0 0 Jacek Malik MD Physician 672748 0 109000 0 1265 0 22710 0 10934 0 816657 0 0 0 Halim Charbel MD Physician 482910 0 293853 0 12443 0 14171 0 218 0 803595 0 0 0 James Todd MD Physician 721491 0 33334 0 1265 0 72990 0 17592 0 846672 0 0 0 Kurt Wehberg MD Physician 720092 0 33334 0 1265 0 68402 0 18632 0 841725 0 0 0 Supplemental non-qualified retirement plan Schedule J, Part I, Line 4b PRMC has a non-qualified supplemental retirement plan (under section 457 (f)). This plan wasApproved by the compensation committee of the prmc board of directors to supplement the executive's retirement income. The supplemental retirement plan was developed based on an independent consultant report on market-based practices for supplemental retirement plans. The percentage of final average pay, the requirements for vesting, participants, and pay-out provisions were established, reviewed, and approved by the compensation committee. The contributions to the supplemental non-qualified retirement plan are included in Schedule J, Part ii, Column c or in Schedule J, Part II, Column b(iii) as part of deferred compensation. The following individuals participated in this supplemental non-qualified retirement plan: Margaret Naleppa 76,923 Lura Lunsford 40,000 Bruce I. Ritchie 40,000 Steven Leonard 40,000 James Todd, M.D. 50,000 Kurt Wehberg, M.D. 50,000 CONTINGENT COMPENSATION Schedule J, Part I, Line 6a & 6b OFFICERS AND KEY EMPLOYEES OF PENINSULA REGIONAL MEDICAL CENTER ARE PAID COMPENSATION DETERMINED BY A NUMBER OF VARIABLES INCLUDING BUT NOT LIMITED TO INDIVIDUAL GOALS AS WELL AS ORGANIZATION OPERATIONAL ACHIEVEMENTS IN SERVICE, QUALITY, SAFETY, EMPLOYEE SATISFACTION, AND COST. THE FINAL DETERMINATION OF THE CONTIGENT COMPENSATION AMOUNT IS DETERMINED AND APPROVED BY THE BOARD AS PART OF THE OVERALL COMPENSATION REVIEW OF OFFICERS AND KEY EMPLOYEES. DURING CALENDAR YEAR 2014, THE FOLLOWING BONUSES WERE PAID: Margaret Naleppa 214,403 Lura Lunsford 81,839 Bruce I. Ritchie 128,265 Mary Beth D'Amico 20,617 Sara Scott 19,834 Steven Leonard 24,635 Karen Poisker 27,901 Daniel Mulvanny 22,000 Charles Silvia Jr, M.D. 56,217 Andy Pierre, M.D. 20,000 Jacek Malik, M.D. 59,000 James Todd, M.D. 33,334 Kurt Wehberg, M.D. 33,334 Non Fixed Payments Schedule J, Part I, Line 7 During calendar year 2014, the following productivity bonuses were paid: Andy Pierre, M.D. 50,000 Jacek Malik, M.D. 50,000 Halim Charbel, M.D. 293,853 A Maryland Health & Higher Education Facilites 520936091 574218UF8 2015-02-05 122212727 Refer to part VI true false false B Maryland Health & Higher Education Facilites 520936091 574218UF8 2015-02-05 25222024 Refer to part VI true false false A 0 0 122212727 0 0 121024047 1188680 0 0 0 0 0 false true true true B 0 0 25222024 0 0 0 222024 0 0 6156857 0 18843143 false false false true A false true true false true true 0.00900 0.00440 0.01340 false false true B false true true false true true 0.00900 0.00440 0.01340 false false true A false true false false 0 false 0 false true B false false false false 0 false 0 false true A B Description of Purpose Schedule K, Part I, Column F Proceeds of publicly-offered, fixed rate Series 2015 Bonds, together with funds held in an existing debt service reserve fund account and the existing principal and interest accounts, have been used to 1) advance refund all of Peninsula Regional Medical Center's ("PRMC") outstanding Series 2006 Bonds (Issued 2/09/06) for savings, 2) fund various capital expenditures (including equipment purchases) (the "Project"), and 3) pay all bond issuance expenses. Schedule K, Part I, Line a (f) Refunding of bonds issued on 02/09/2006 William Todd MD Trustee 112254 Medical Staff Fees false William Todd MD Trustee 206562 Emergency Room Services false David Rommel Trustee 697217 Electrical/Mechanical Services false Timothy Benning Trustee 462000 Pathology Services false SCHEDULE L, PART IV DESCRIPTION OF TRANSACTIONS WITH INTERESTED PERSONS Each of the above-named trustees are owners of businesses which provide services to PRMC. The services provided were approved by independent members of the governing body and are charged at fair market value rates. STATEMENT OF PROGRAM SERVICE ACCOMPLISHMENTS Form 990, Part III, Line 4 Peninsula Regional Medical Center is a not-for-profit 501(c)(3) non-stock corporation founded in 1897 to serve the health care needs of the community. The Hospital's primary purpose is to provide the highest primary, secondary, and selected tertiary health care services to residents of and visitors to the Mid-Delmarva Peninsula in a competent, compassionate, and cost-effective manner designed to elicit a high degree of customer satisfaction. The Hospital's mission is to improve the health of the communities we serve by providing quality medical care regardless of race, creed, sex, national origin, handicap, or age. If a patient is unable to pay due to financial resources, efforts will be taken to assure care at an affordable cost, or obtained assistance through appropriate agencies on the patient's behalf. Emergency services care will be provided to everyone regardless of ability to pay. Peninsula Regional Medical Center served over 19,000 inpatients and provided more than 540,000 outpatient services during fiscal 2015. Food service provided more than 400,000 meals to patients and employees. Although reimbursement for services rendered is critical to the operation and stability of Peninsula Regional Medical Center, it is recognized that not all individuals possess the ability to pay for essential medical services. The Hospital, in keeping with the commitment to serve all members of the community, during fiscal 2015 provided: -Charity and other allowances totaling $40,255,085 -Discounts to third party payors including government programs such as -Medicare and Medicaid $53,492,511 -Write-off of uncollectible accounts $10,729,288 -The total unreimbursed value of providing care to these patients is $104,476,884 Also provided are many wellness programs, community education and free programs offered throughout the year based upon activities and services that Peninsula Regional Medical Center believes will serve a bona fide community health need. Some of the programs are as follows: -A variety of brochures are displayed in all hospital waiting areas to educate members of the community regarding programs and services. -Participation in health fairs during FY 2015 in order to foster health education in the community. -Being called upon to speak before community organizations on a variety of healthcare topics. We provide childbirth preparation classes, exercise classes for prenatal and postpartum women and CPR classes. -We provide assistance to educators through our work with student nurses, radiology, respiratory and laboratory technicians. During FY 2015, Peninsula Regional Medical Center volunteers contributed over 35,000 hours toward the common purpose of servicing the health care of the community. During FY 2015, Peninsula Regional Medical Center performed over 450 community outreach activities. Specific examples of education and outreach programs, support groups, community health screenings, and fitness and wellness activities supported by Peninsula Regional Medical Center are as follows: Community Educational and Outreach Programs: - Labor & Delivery Tours (exclusive of Childbirth Class Tours) - CPR - Childbirth Preparation Classes - Refresher Course - Childbirth - Infant Care Classes - Grandparent Classes - Safe Sitter Program - Women's Health Education Support Groups: - Diabetes Support Groups - Stroke Support Group - Head and Neck Cancer Support Group Events: Community Screenings: - Height/Weight, Blood Pressure - Skin Cancer Screenings - Oral, Head and Neck Cancer Screenings - Hearing Screenings - Flu Clinic - Educational Exhibits to promote Healthy lifestyles Benefits: - United Way - Healthfest Fitness/Exercise Programming: - Cardiac Rehabilitation - Indoor Cycling and Weights Business Relationships Form 990, Part VI, Line 2 Margaret Naleppa, Martin Neat, William McCain and Monty Sayler are members of the board of directors of Peninsula Health Ventures, a wholly-owned taxable subsidiary of Peninsula Regional Health System. Bruce I. Ritchie, PRMC's CFO, also serves as Secretary / Treasurer of Peninsula Health Ventures. Members or Stockholders Form 990, Part VI, Line 6 Peninsula Regional Health System is the sole corporate member of the medical center. Members or Stockholders Who May Elect Form 990, Part VI, Line 7a As the sole corporate member of the medical center, Peninsula Regional Health System has the ability to elect members of the medical center's governing body. Decisions Subject to Approval Form 990, Part VI, Line 7b As the sole corporate member, Peninsula Regional Health System has the ability to approve major expenditures and long term borrowings of the medical center. Form 990 Review Process Form 990, Part VI, Line 11b Oversight of the completion of the organization's Form 990 has been delegated to the Chief Financial Officer of Peninsula Regional Medical Center by the President of the organization. once the Form 990 and all schedules have been prepared by the organization's independent tax services provider, they are reviewed by the President prior to filing. THE RETURN IS presented to the Board of trustees by the organization's independent tax advisors from Grant Thornton LLP and approved for submission. Conflict of Interest Policy Monitoring & Enforcement Form 990, Part VI, Line 12c THE BOARD OF TRUSTEES ARE REQUIRED TO DISCLOSE ANNUALLY, IN WRITING, ANY AND ALL INTEREST WHICH THEY OR ANY IMMEDIATE MEMBER OF THEIR FAMILY MAY HAVE IN ANY BUSINESS ENTITY WHICH HAS OR SEEKS A CONTRACTUAL OR COMPETITIVE RELATIONSHIP WITH THE ORGANIZATION. THE BOARD HAS THE AUTHORITY TO DETERMINE IF A VIOLATION HAS OCCURED AND WHETHER ANY INTEREST WHICH SHOULD BE DISCLOSED SHOULD DISQUALIFY A DIRECTOR FROM PARTICIPATING IN ANY SPECIFIC BOARD DISCUSSION OR BOARD MEMBERSHIP. ALL DISCLOSURES ARE REVIEWED BY THE ORGANIZATION'S CHIEF COMPLIANCE OFFICER. ANY CONFLICTS ARE PRESENTED TO THE BOARD. IF A PERSON IS CONFLICTED, THEY WILL RECUSE THEMSELVES FROM ALL DISCUSSIONS AND DELIBERATIONS TO WHICH THEY WOULD APPEAR TO BE CONFLICTED. Process for Determining Compensation Form 990, Part VI, Line 15a & 15b THE ORGANIZATION USES A COMPENSATION COMMITTEE TO DETERMINE THE COMPENSATION OF THE CEO/EXECUTIVE DIRECTOR AND OTHER KEY EMPLOYEES. THE CEO OF THE ORGANIZATION HAS A WRITTEN EMPLOYMENT CONTRACT. THE COMPENSATION COMMITTEE USES AN INDEPENDENT CONSULTANT, COMPENSATION SURVEYS AND OTHER ORGANIZATION'S FORM 990 IN THE DETERMINATION PROCESS. THE MEMBERS OF THE COMPENSATION COMMITTEE ARE INDEPENDENT AND RELY ON THIS COMPARABILITY DATA WHEN THEY DISCUSS AND DETERMINE THE INDIVIDUAL'S COMPENSATION. CONTEMPORANEOUS MINUTES OF SUCH DISCUSSIONS ARE KEPT AND MAINTAINED IN THE ORGANIZATION'S FILES. How Documents are Made Available to the Public Form 990, Part VI, Line 19 The organization's governing documents, conflict of interest policy and financial statements are available to the public upon request to the public information office of Peninsula Regional Medical Center at 100 East Carroll Street, Salisbury, MD 21801 Other Changes in Net Assets Form 990, Part XI, Line 9 Pension Adjustment - FAS 158 $ (2,713,764) Net assets released from restriction 978,127 Foundation transfer - Capital restricted 48,450 Change in net assets endowment 1,463,040 Partnership K-1 Income not on books (400,867) --------------- Total $ (625,014) FORM 990 PART IX LINE 11G DESCRIPTION:TECHNICAL PROFESSIONAL FEES TOTAL FEES:5372533 FORM 990 PART IX LINE 11G DESCRIPTION:REFERENCE LAB WORK TOTAL FEES:1869201 FORM 990 PART IX LINE 11G DESCRIPTION:MEDICAL STAFF ADMINISTRATION TOTAL FEES:75000 FORM 990 PART IX LINE 11G DESCRIPTION:CONTRACTED SERVICES TOTAL FEES:20230924 FORM 990 PART IX LINE 11G DESCRIPTION:LICENSES TAXES TOTAL FEES:177816 FORM 990 PART IX LINE 11G DESCRIPTION:COLLECTION FEES TOTAL FEES:847782 FORM 990 PART IX LINE 11G DESCRIPTION:TEMPORARY LABOR TOTAL FEES:4016525 FORM 990 PART IX LINE 11G DESCRIPTION:PEST CONTROL TOTAL FEES:35005 FORM 990 PART IX LINE 11G DESCRIPTION:TRASH PICKUP TOTAL FEES:288907 FORM 990 PART IX LINE 11G DESCRIPTION:CANDIDATE EXPENSE TOTAL FEES:180321 FORM 990 PART IX LINE 11G DESCRIPTION:EMPLOYEE MOVING EXPENSE TOTAL FEES:20371 FORM 990 PART IX LINE 11G DESCRIPTION:PHYSICIAN CONTRACTED SERVICES TOTAL FEES:9476860 Peninsula Regional Medical Center Fdn 100 East Carroll Street Salisbury MD 21801 521851935 Fundraising MD 501(c)(3) 11 TYPE I PRHS false Peninsula Regional Health System (PRHS) 100 East Carroll Street Salisbury MD 21801 522132761 Parent MD 501(c)(3) 11-II NA false Peninsula General Hospital INS Trust 100 East Carroll Street Salisbury MD 21801 526321234 Insurance MD 501(c)(3) 11 TYPE III PRHS false Delmarva Surg Ctr 641 S Salisbury Salisbury MD 21801 522251436 Healthcare MD PHV 0 0 Peninsula Health Ventures (PHV) 100 East Carroll Street Salisbury MD 21801 522250012 P'SHIP INV MD PRHS C Corp 0 0 false PRLTC Inc 100 East Carroll Street Salisbury MD 21801 522190588 LT Care MD PHV C Corp 0 0 false Delmarva Peninsula Insurance Company PO Box 1159 Grand Cayman CJ KY1-1102 981110617 Insurance PRMC C Corp 1.00000 true false false true false false false false false false false false true true true true false true true true PENINSULA REGIONAL MEDICAL CENTER FOUNDATION M,S,C 334585 FMV PENINSULA REGIONAL MEDICAL CENTER FOUNDATION N,O,Q 375053 FMV Delmarva Peninsula Insurance Company R 1151487 FMV Peninsula Health Ventures (PHV) L 200000 FMV