2016-05-16T14:37:39-05:00 2015-06-30 ERNST & YOUNG US LLP 201 NORTH FRANKLIN STREET STE 2400 TAMPA FL 33602 990 2014-07-01 520591612 Frederick Memorial Hospital Inc % MICHELLE K MAHAN FRED 2405663000 400 WEST SEVENTH STREET FREDERICK MD 21701 MICHELLE K MAHAN CFO 8132254800 2016-05-13 true MELANIE A MCPEAK P01346034 8132254800 2014 2016-08-17 19:52:53Z THOMAS KLEINHANZL 400 WEST SEVENTH STREET FREDERICK MD 21701 445718107 false X WWW.FMH.ORG X 1897 MD TO CONTRIBUTE TO THE HEALTH AND WELL-BEING OF AREA RESIDENTS BY PROVIDING QUALITY HEALTHCARE IN A CARING, COST EFFICIENT, SAFE AND CONVENIENT MANNER. 20 16 2799 668 11965 3113985 4529757 319339606 330710595 5486185 7037579 -705559 -484627 327234217 341793304 100000 100000 0 0 160554877 134637638 48000 48000 815130 158991207 188814109 319694084 323599747 7540133 18193557 459957008 468398859 258708711 254689875 201248297 213708984 X THE MISSION OF FREDERICK MEMORIAL HOSPITAL, INC. IS TO CONTRIBUTE TO THE HEALTH AND WELL-BEING OF AREA RESIDENTS BY PROVIDING QUALITY HEALTH CARE IN A CARING, COST EFFICIENT, SAFE AND CONVENIENT MANNER THROUGH A COORDINATED PROGRAM OF PREVENTION, DIAGNOSIS AND TREATMENT, REHABILITATION, AND SUPPORT. false false 36983188 100000 57981206 INPATIENT SERVICES IN FY2015, FREDERICK MEMORIAL HOSPITAL'S INPATIENT MEDICAL-SURGICAL DEPARTMENTS PROVIDED QUALITY, PATIENT-CENTERED CARE, REGARDLESS OF ABILITY TO PAY, TO APPROXIMATELY 24,262 IN PATIENTS AND OBSERVATION PATIENTS. MAJOR MEDICAL AND SURGICAL SERVICES INCLUDE CARDIOLOGY, CONGESTIVE HEART FAILURE, POST-CARDIAC CATHETERIZATION, CENTER FOR CHEST PAIN, HEMODIALYSIS, PERITONEAL DIALYSIS, NEUROLOGY, NEUROSURGERY, PULMONOLOGY, ONCOLOGY, ORTHOPEDICS, GENERAL MEDICINE AND SURGICAL CARE. INPATIENT CARE IS SUPPORTED BY A TEAM OF BOARD-CERTIFIED PHYSICIAN HOSPITALISTS. IN ADDITION, FMH IS DESIGNATED AS A PRIMARY STROKE CENTER BY THE MARYLAND INSTITUTE OF EMERGENCY MEDICAL SERVICE SYSTEMS (MIEMSS) AND IS RECOGNIZED WITH THE STROKE CENTER GOLD PERFORMANCE AWARD BY THE AMERICAN HEART ASSOCIATION. OUR BARIATRIC SURGICAL PROGRAM IS ACCREDITED BY THE AMERICAN SOCIETY FOR METABOLIC AND BARIATRIC SURGERY AS A BARIATRIC SURGERY CENTER OF EXCELLENCE. IN ADDITION TO THE PROGRAM SERVICES EXPENSE LISTED HERE, FMH INCURRED $39.9 MILLION OF GENERAL AND ADMINISTRATIVE EXPENSES IN MEETING THE HEALTH NEEDS OF OUR PRIMARY SERVICE AREA. 35564920 0 55174939 PERIOPERATIVE SERVICES FREDERICK MEMORIAL HOSPITAL'S PERIOPERATIVE SERVICES PROVIDED HIGH QUALITY CARE TO 12,121 SURGICAL AND ENDOSCOPY PATIENTS IN FISCAL YEAR 2015. PROCEDURES WERE PERFORMED IN OUR STATE OF THE ART FACILITY WHICH INCLUDES A DEDICATED IMAGING ROOM FOR VASCULAR AND OTHER PROCEDURES. WE HAVE PARTICIPATED IN THE SCIP QUALITY IMPROVEMENT PROJECT FOR CONTINUAL IMPROVEMENTS IN CARE FOLLOWING EVIDENCE BASED MEDICINE. WE TRACKED OUR PATIENT SATISFACTION THROUGH PRESS GANEY TO BENCHMARK OUR RESULTS TO THE NATIONAL DATA BASE. IN ADDITION TO THE PROGRAM SERVICES EXPENSE LISTED HERE, FMH INCURRED $39.9 MILLION OF GENERAL AND ADMINISTRATIVE EXPENSES IN MEETING THE HEALTH NEEDS OF OUR PRIMARY SERVICE AREA. 24004896 0 34652997 ONCOLOGY FMH'S ONCOLOGY PROGRAM PROVIDES INTEGRATED, MULTIDISCIPLINARY, PATIENT CENTERED CANCER CARE FOR PATIENTS WITH MALIGNANCIES, REGARDLESS OF ABILITY TO PAY. SERVICES INCLUDE MEDICAL ONCOLOGY CONSULTATIONS, CHEMOTHERAPY, RADIATION ONCOLOGY CONSULTATIONS AND TREATMENT AND SURGICAL ONCOLOGY CONSULTATIONS AND TREATMENT. WE OFFER COORDINATED MULTIDISCIPLINARY CLINICS FOR PATIENTS WITH CANCERS OF THE LUNG, BREAST AND PROSTATE. INTEGRATED PALLIATIVE CARE AND HOSPICE SERVICES, BOTH INPATIENT AND OUTPATIENT ARE AVAILABLE FOR PATIENTS WITH ADVANCED MALIGNANCIES. SUPPORT SERVICES INCLUDE NUTRITION, PATIENT NAVIGATION AND SOCIAL WORK, AS WELL AS OTHER FORMS OF PSYCHOSOCIAL SUPPORT. FOR THOSE WITH ADDITIONAL FINANCIAL NEED, FINANCIAL COUNSELORS AND A PATIENT ASSISTANCE FUND IS AVAILABLE. THE PROGRAM TREATS APPROXIMATELY 800 NEWLY DIAGNOSED CANCERS PER YEAR AND ALSO HAS A COMMUNITY OUTREACH PROGRAM THAT INCLUDES EDUCATION AND SCREENING. THE PROGRAM IS ACCREDITED BY THE AMERICAN COLLEGE OF SURGEONS COMMISSION ON CANCER. IN ADDITION TO THE PROGRAM SERVICES EXPENSE LISTED HERE, FMH INCURRED $39.9 MILLION OF GENERAL AND ADMINISTRATIVE EXPENSES IN MEETING THE HEALTH NEEDS OF OUR PRIMARY SERVICE AREA. 186395171 0 184385366 282948175 true true false true false false false false false true true false true false true false false true false false true false false true false false true true true false true true false false false false false false false false false false false false false false true true true true false false true 455 0 true 2799 true true true false false false false false false false false false X 20 16 false false false false true true true true true false true true true true true true true true true true true true MD X MICHELLE K MAHAN 2405663350 400 WEST SEVENTH STREET FREDERICK MD 21701 Gregory P Dormitzer Director 2.0 0.0 X 0 0 0 Bernard Gouin Director (ended 09/30/14) 2.0 2.0 X 0 0 0 Theodore Luck Director 2.0 0.0 X 0 0 0 J Frederick Manning SECRETARY/TREASURER 4.0 2.0 X X 0 0 0 P Gregory Rausch MD Chair, FMH Development Council 4.0 0.0 X 0 408 0 E James Reinsch Chairman 4.0 4.0 X X 0 0 0 Anne Herbert Rollins DIRECTOR 2.0 0.0 X 0 0 0 Neil Waravdekar MD DIRECTOR 2.0 0.0 X 20371 1822 0 Rev Roger W Wilmer Jr Director 2.0 0.0 X 1500 0 0 Gerald Winnan MD VICE CHAIRMAN 2.0 3.0 X X 0 0 0 Shawn Wolf Director 2.0 0.0 X X 0 0 0 Ravi Yalamanchili Vice Chief Of Staff 10.0 0.0 X 113608 0 0 Cornelius Fay Director 2.0 0.0 X 0 0 0 Terrence McPherson Director 2.0 0.0 X 0 0 0 Laura Melia Director 2.0 0.0 X 0 0 0 Gerrit SchipperMD VICE CHIEF OF STAFF 10.0 0.0 X 29834 0 0 Thomas A Kleinhanzl President and CEO 30.0 10.0 X X 793936 0 196036 R CARL BENNA DIRECTOR (STARTED 10/1/14) 2.0 0.0 X 0 0 0 ALLEN D MAWDSLEY DIRECTOR (STARTED 10/1/14) 2.0 0.0 X 0 0 0 ELLEN NOLAND DIRECTOR (STARTED 10/1/14) 2.0 0.0 X 0 0 0 ELIZABETH PAKENAS DIRECTOR (STARTED 10/1/14) 2.0 0.0 X 0 0 0 Adrian Wodey Director (ENDED 9/30/14) 2.0 5.0 X 0 0 0 Donna Tisdale Director (ENDED 9/30/14) 2.0 0.0 X 0 0 0 Michelle K Mahan Sr VP and CFO 32.0 8.0 X 444215 0 63817 John R Verbus Sr VP and COO 30.0 10.0 X 427380 0 62940 Manuel A Casiano VP Medical Staff 40.0 0.0 X 396516 0 64227 Cheryl L Cioffi VP Chief Nursing Officer 40.0 0.0 X 252485 0 51927 Kenneth R Coffey II VP Chief Development Officer 40.0 0.0 X 203346 0 26703 Hannah R Jacobs VP Finance 40.0 0.0 X 190098 0 11653 Rachel I Mandel AVP Medical Affairs 20.0 0.0 X 167607 0 8766 Mary B Mann AVP Patient Care Services 40.0 0.0 X 172062 0 24328 Terry P O'Malley VP Human Resources 40.0 0.0 X 217497 0 40815 David J Quirke VP Chief Information Officer 40.0 0.0 X 189948 0 29523 Craig F Rosendale VP Ancillary Services 40.0 0.0 X 197348 0 23411 Donald R Schilling VP Ambulatory Services 40.0 0.0 X 216339 0 18243 Jennifer G Teeter AVP Payor Contracting 20.0 20.0 X 188550 0 22659 Jim R Williams VP Business Development 20.0 20.0 X 223266 0 24904 Mark S Soberman Physician 40.0 0.0 X 497833 0 27587 MARY BRIDGET CASTRO CHARGE NURSE 40.0 0.0 X 168608 0 20634 DUSTIN M SIMONSON ONCOLOGY MEDICAL PHYSICIST 40.0 0.0 X 188515 0 26067 JAMES BLAKE TRUMBLE MEDICAL DIRECTOR 40.0 0.0 X 237253 0 20819 YU XIA ONCOLOGY MEDICAL PHYSICIST 40.0 0.0 X 170224 0 10114 5708339 2230 775173 84 false true false TXTEAM REHAB INC 4625 E STOP 11 ROAD INDIANAPOLIS IN 46237 Rehab Services 6160045 ALLIANCE RADIOSURGERY LLC PO BOX 6600 NEWPORT BEACH CA 92658 Radiology Services 1836903 QUEST DIAGNOSTICS PO BOX 740709 ATLANTA GA 30374 LABORATORY SERVICES 1428449 INTEGRATED MEDICAL SYSTEM INT'L 1823 27TH AVENUE SOUTH BIRMINGHAM AL 36209 SURGICAL SERVICES 1314145 EAGLE HOSPITAL PHYSICIANS 16000 DALLAS PKWY SUITE 450 DALLAS TX 75248 PHSYSICIAN SERVICES 1306351 56 0 4529757 0 4529757 INPATIENT REVENUE 624110 163143497 163143497 0 0 OUTPATIENT REVENUE 621410 163973535 163973535 0 0 TRANSCRIPTION REVENUE 561110 3188 3188 0 0 GROUP PURCHASING-PREMIER 525990 -33553 -45518 11965 0 HITECH AND MEDICAL HOME 621610 609766 609766 0 0 3014162 3014162 0 330710595 3196726 0 3196726 0 0 461627 461627 0 461627 461627 107653382 112274 103924803 3728579 112274 3840853 3840853 0 0 0 CAFETERIA REVENUE 722511 1131444 1131444 0 0 MT. AIRY LLC MGMT FEE 541610 364087 364087 0 0 LOSSES ON INT RATE SWAP 900099 -2442132 0 0 -2442132 347 347 0 -946254 341793304 332194508 11965 5057074 100000 100000 0 0 0 0 0 0 5053975 0 5053975 0 98002907 93541431 4134411 327065 0 0 0 0 8055874 7299441 736518 19915 16066616 15382055 634500 50061 7458266 6907425 521829 29012 14192131 12773760 1418371 0 479423 0 479423 0 319973 0 319973 0 22308 0 22308 0 48000 48000 325164 0 325164 0 64432741 48154270 16179210 99261 881099 18352 713206 149541 6208090 5811217 337239 59634 4456390 4456390 0 0 0 0 0 0 3950610 3194155 756455 0 103584 57130 45208 1246 0 0 0 0 143046 78895 62431 1720 4522726 4237795 275886 9045 0 0 0 0 23216745 16252054 6952211 12480 267229 14306 252923 0 SUPPLIES AND COGS 65292850 64669499 615201 8150 323599747 282948175 39836442 815130 0 -1993 0 22569583 24923467 4157674 4573065 46287447 47079421 0 0 0 0 0 0 4404908 6006311 3587161 2290779 455662433 259441916 193926778 196220517 125355049 128157562 0 0 53191184 51139776 0 0 6479217 8007961 459957008 468398859 37913916 37615091 0 0 0 0 168029382 164229787 0 0 0 0 61797 0 0 0 52703616 52844997 258708711 254689875 X 193375608 203281498 6896512 9451309 976177 976177 201248297 213708984 459957008 468398859 X 18193557 -4048991 -1683879 X false true X true false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false 0 false 0 false 0 false 0 false 0 false 0 true 22308 22308 false SCHEDULE C, PART II-B, LINE 1I EXPENSE IS A PORTION OF DUES PAID TO THE AMERICAN HOSPITAL ASSOCIATION and MARYLAND HOSPITAL ASSOCIATION. 976177 976177 976177 976177 976177 976177 976177 976177 976177 976177 1.00000 false false 2421745 2421745 206787823 78047635 128740188 22945585 18000000 4945585 210265532 163394281 46871251 13241748 0 13241748 196220517 ASSETS LIMITED AS TO USE 11882313 F INVESTMENTS IN SUBSIDIARIES 19596463 F INTERCOMPANY RECEIVEABLES 19661000 F 51139776 0 ADVANCES FROM THIRD PARTIES 9813244 INTEREST RATE SWAP CONTRACT 11277237 PENSION LIABILITY 18867941 MALPRACTICE INSURANCE LIABILITY 2781000 CAPITAL LEASE OBLIGATIONS 1884248 OTHER LIABILITIES 6565973 INTER COMPANY LIABILITIES 1655354 52844997 Intended use of endowment funds SCHEDULE D, PART V, LINE 4 ENDOWMENT FUNDS ARE USED FOR HEALTH CARE SERVICES. Central America and the Caribbean 1 Prgm-Related Invstmnts 13026597 Central America and the Caribbean 1 Program Services SELF INSURANCE 2692965 2 2 15719562 15719562 true false true false false false X X X X X X X true PRIDE PHILANTHROPY DEV CNSL SRVCS false 48000 48000 MD true true true X true X true true true false true true 8136217 0 8136217 0.02510 38202856 38787381 -584525 0 0 0 46339073 38787381 7551692 0.02330 1866761 350058 1516703 0.00470 52500 0 52500 0.00020 14431090 630801 13800289 0.04260 16350351 980859 15369492 0.04720 62689424 39768240 22921184 0.07050 false 1899820 143000 122190442 111764262 10426180 X true true 1 1 FREDERICK MEMORIAL HOSPITAL 400 WEST SEVENTH STREET FREDERICK MD 21701 WWW.FMH.ORG X X X Frederick Memorial Hospital false false true X X X X X X X X 12 true false true true X SEE PART V, SECTION C X true 12 true SEE PART V, SECTION C false false true X 200. 300. X X X true true X X true X SEE PART V, SECTION C X SEE PART V, SECTION C X SEE PART V, SECTION C X X X X X true X false X X X X X true X false false INPUT FROM COMMUNITY REPRESENTATIVES SCHEDULE H, PART V, SECTION B, LINE 5 The qualitative element of the human needs assessment was conducted using five methods designed to gather the input of a diverse group of service providers, elected officials, service end-users, and the general public. Components of the research process included: - Seven focus groups; Thirty eight (38) representatives from government agencies, area Nonprofits and professional service providers gathered to provide their assessments of Frederick County's human needs, relative to available services, and gaps in service provision. Individuals who were invited to attend but were unable to do so were interviewed by phone. - Eight key informant interviews; Interviews were conducted with current and former elected officials, civic leaders, and representatives from United Way of Frederick County, Frederick County judiciary, and Frederick County Public Schools. - A service provider survey; A survey was conducted polling 111 service providers to collect information about available services. The survey included an open-response question: "In your professional opinion, what are the top three unmet needs in all of Frederick County?" Responses to the survey were received from 167 programs, which represented the majority of the largest providers of human needs services. The responses to the question were used as part of the human needs assessment portion of the analysis. - A focus group of service recipients; A focus group comprised of 15 individuals who were recipients of Frederick County human services programs including services for people who are homeless, free clinic patients, and consumers of soup kitchens and food programs, was conducted. Participants were asked about their daily needs, programs that have helped them and why, their unmet needs, and the needs of community youth. Community Foundation leaders who participated in United Way of Frederick County's strategic planning process contributed their notes, which also were used in gauging community human needs. - A survey of the general public; a survey of the general public was conducted asking respondents to rank unmet needs in the Community Foundation's three core strategic areas: health, youth, and basic human needs. One hundred and fourteen responses were received, with the survey's availability reported in local print media, on the Community Foundation's website, through email blasts, and social media. On October 4, 2011, the Frederick County Health Care Coalition in partnership with the Frederick County Health Department and Frederick Memorial Hospital hosted a Health Needs Priority Setting Summit. The purpose of the Summit was to establish the priorities for health improvement in Frederick County and to develop goals and action plans to achieve improvement in those priority areas through community engagement. Facilitators for the day long Priority Setting Summit were: - Barbara Brookmyer, MD, MPH, Frederick County Health Officer - Josh Pedersen Chief Executive Officer, United Way of Frederick County Data presenters included: - Madeleine A. Shea, PhD, Director Office of Population Health Improvement, Maryland Department of Health and Mental Hygiene - Barbara Brookmyer, MD, MPH, Frederick County Health Officer - Jacqueline Doug, MD, MPH, FAAP, Deputy Health Officer - Andrea Walker, MA, CPRP, Director, Behavioral Health Services SCHEDULE H, PART V, SECTION B, LINE 6B The Frederick County Health Department, The Maryland Hospital Association, Johns Hopkins Health Care, the American Cancer Society, Health Services Cost Review Commission, Frederick City Government, United Way of Frederick County, Community Foundation of Frederick County, the Department of Health and Mental Hygiene, Community Action Council, the Religious Coalition of Frederick County, the Diversity Leadership Institute, Inc., the Family Services Foundation, Community Living Inc. of Frederick County, Care Net of Frederick, Mission of Mercy and Frederick Memorial Hospital. SCHEDULE H, PART V, SECTION B, LINE 7A http://www.fmh.org/workfiles/Community%20Health%20Assessment%20PDF.pdf SCHEDULE H, PART V, SECTION B, LINE 10A http://www.fmh.org/workfiles/Community%20Health%20Assessment%20PDF.pdf SCHEDULE H, PART V, SECTION B, LINE 11 Finding 1 - Access to affordable health care need: The Frederick Regional Health System will continue to fund operations of the FMH Prenatal Center through the generosity of the FMH Auxiliary. Between 2008 and 2009, Maryland's infant mortality rate dipped nearly 10% - from 8 deaths per 1,000 live births to 7.2 deaths per 1,000 live births. Frederick County is one of only two counties state-wide to see a statistically significant decline in its infant mortality rate - dropping from 8.4 deaths per 1,000 live births to just 3.8 deaths per 1,000 live births. In raw numbers, 25 babies less than one year old died in 2008; compared to 11 in 2009. Targeting efforts: The cohort of patients frequenting the FMH Prenatal Center is self-regulating, so "targeting" the service per se has no value. The women for whom the Center was created are using the services appropriately. While there is still work to be done, FMH is proud to be providing prenatal care to local residents who are uninsured or under-insured, and is so doing, positively impacting newborn mortality rates in the County. The goal of hospital's efforts to address access to care will focus upon increasing the number of babies born in the FMH Family Center whose mothers had first trimester neonatal care. FMH Support of Community Partners Free Provision of Diagnostic Services Frederick Regional Health System will continue to provide free laboratory and radiology services to: - Mission of Mercy, - Frederick County Community Action Agency, and - Frederick County Health Care Coalition's Access to Care Program. These three partner providers have been instrumental in addressing access to care needs in Frederick County. The provision of these important services to these organizations will allow them to continue the important health care work they do in Frederick County. As these two organizations and one program provide services that are not geographically defined, the targeting of FMH efforts to provide the free laboratory and imaging services is unnecessary. By the very nature of their missions the patient populations seeking services are those in Frederick County who are either underinsured or uninsured. By default FMH is providing access to laboratory tests and imaging diagnostics to those in our community who are most in need of assistance. FMH has developed a strategic physician manpower plan that provides for the recruitment of primary care physicians, and those physicians practicing in specialty and subspecialty care for which there will be increased need moving forward. The physician manpower plan calls for the incremental increase of 5 to 6 adult primary care practitioners plus 4 extenders (Physician Assistants, Nurse Practitioners) within a 2 year time frame. The placement of the physicians has been researched and analyzed to ensure the equitable geographic distribution of primary care within Frederick County. As the capabilities of Frederick Regional Health System expand in response to demand and more educated consumer needs/wants, Frederick County will require an influx of specialty and sub-specialty practices to provide advanced modality care. The physician manpower plan has mapped out supply and demand to the year 2016, and provided a recruitment road map for specialty physician practices. Finding 2 - Access to affordable dental care need: Frederick Memorial Hospital will continue to work closely with the Frederick County Health Department, the Frederick County Dental Society, the University of Maryland Dental School and other partner organization to establish a dental clinic in Frederick. Significant progress has already been made in this regard. In late December of 2012, Christian S. Stohler, DMD, Dean of University of Maryland Dental School and Marcelena Holmes, Assistant Dean of Institutional Advancement, confirmed their plans to work with the hospital to start a dental clinic in Frederick. FMH will work with the University to help identify a location for the clinic and will engage with the Frederick Dental Society to recruit area Dentists to participate in the development of the facility, the curriculum and provide oversight as necessary. As the Dental Clinic will be in a fixed location and the mission will be to provide care to a well-defined socioeconomic patient population it will not be necessary to geographically target marketing efforts or service provision. As there will be a limited number of appointment availabilities and a patient population that is anticipated to overwhelm capacities, there is the distinct possibility of creating an expectation that the clinic will be unable to fulfill. To create a free dental clinic in Frederick County Finding 3 - Access to mental health care need: Addressing Frederick County's behavioral health needs is an important and urgently needed facet of care that is presently being address by service providers that find themselves stretched to the limit relative to funding, resources and capacity. The Frederick County Health Department and The Mental Health Association have taken the lead in providing outpatient services to Frederick County residents. Frederick County's rate of emergency department visits related to behavioral health is a significant and growing problem in the county. There are days when the FMH Purple Zone, the area in the Emergency Department specially constructed to provide emergency treatment for patients with behavioral health issues is at full capacity. Patients are often housed in the Emergency Department for days at a time waiting for a bed to become available in our 24-bed Behavioral Health Unit. Because of facility constraints and the lack of the infrastructure necessary to sustain the kinds of programs that would make an impact in this area, FMH will not be able to respond in a truly meaningful way to this care provision crisis in the near term. We will continue to support those organizations and agencies in the community who are better positioned to provide the kind of care that is so desperately needed: the Mental Health Association and The Frederick County Health Department. Mental illness is an equal opportunity affliction that does not confine its disruptive symptoms to a particular gender, race or socioeconomic cohort of patients. As the hospital does not have in place community outreach efforts focused upon mental health, there is only a limited amount of targeted education that FMH can accomplish. We will continue to provide emergent care to all citizens seeking care for mental illness and behavioral health issues and provide to the best of our ability a safe and caring environment in which those emergency services are offered. The goal is to reduce the number of patients coming to the FMH Emergency Department with mental illness as a primary diagnosis. Finding 4 - Access to a Medical Home Model for primary care need: The best way to maintain wellness and to prevent the onset of chronic disease is to establish a relationship with a primary care physician. This "medical home" model of care is a major component of the health care reform act and the federal and state governments will be turning to hospitals to create the structure and resources necessary to support this model of care. The infrastructure will include the integration of Information Technology such that access to medical information is available to all providers of care to an individual patient. Frederick Memorial Hospital has been designate as the regional resource to establish the IT "cloud" into which providers will enter patient information and through which they will be able to access that information as necessary and appropriate. As the sole provider of health care in Frederick County, it is the responsibility of Frederick Regional Health System to ensure that there are adequate primary care physicians to provide a medical home model of care for the citizens of the County. To that end, the physician manpower plan calls for the addition of 5 to 6 primary care physicians and 4 extenders within the next two years. FMH will continue to support all of the programs, screening, seminars and outreach efforts described in the body of this document, and will work in close association with our community partners, especially with the Frederick County Health Department's Medical Director, Dr. Barbara Brookmyer to provide the access to care, programs and services necessary to maintain and improve Frederick County's health profile. As FMH provides care to all the citizens of Frederick County regardless of their ability to pay, there is no geographic target for our continuing efforts to ensure adequate provision of services and care. Frederick Memorial Hospital's certified Asthma Educators (AE-C) are dedicated to educating the community about this chronic disease. The Educators will continue to work with the State Asthma Coalition to increase awareness of the fact that asthma is a significant health problem. Their goal is to reduce the number of SCHEDULE H, PART V, SECTION B, LINE 13H STATE REGULATIONS SCHEDULE H, PART V, SECTION B, LINE 16A, 16B, and 16C http://www.fmh.org/financialinformation SCHEDULE H, PART V, SECTION B, LINE 20E PATIENTS WITH BALANCES GREATER THAN $10,000 RECEIVE A SPECIAL LETTER STATING THEY MAY QUALIFY FOR CHARITY AND REQUESTS THAT THEY CONTACT THE HOSPITAL. SCHEDULE H, PART V, SECTION B, LINE 22D MARYLAND'S HEALTH SERVICES COST REVIEW COMMISSION DETERMINES AMOUNTS CHARGED TO PATIENTS. 16 FMH KLINE HOSPICE HOUSE 7000 KIMMEL ROAD MT AIRY MD 21771 INPATIENT HOSPICE PATIENT FACILITY MT AIRY HEALTH SERVICES 1502 SOUTH MAIN STREET MT AIRY MD 21771 OUTPATIENT HEALTH SERVICE FACILITY PARKVIEW MEDICAL GROUP MT AIRY 1502 SOUTH MAIN STREET MT AIRY MD 21771 PHYSICIAN PRACTICE PARKVIEW MEDICAL GROUP MYERSVILLE 3000-D VENTRIE COURT MYERSVILLE MD 21773 PHYSICIAN PRACTICE PARKVIEW MEDICAL GROUP FREDERICK 1564 OPPOSSUMTOWN PIKE FREDERICK MD 21702 PHYSICIAN PRACTICE FMH REGIONAL CANCER CARE THERAPY CTR 501 WEST SEVENTH STREET FREDERICK MD 21701 OUTPATIENT CANCER TREATMENT CENTER FMH ROSEHILL 1562 OPPOSSUMTOWN PIKE FREDERICK MD 21701 OUTPATIENT HEALTH SERVICE FACILITY UNION BRIDGE FAMILY PRACTICE 104 NORTH MAIN STREET UNION BRIDGE MD 21701 PHYSICIAN PRACTICE FMH HOME HEALTH SERVICES 605 EAST CHURCH STREET FREDERICK MD 21701 HOME HEALTH NURSING ORGANIZATION HOSPICE OF FREDERICK COUNTY 516 TRAIL AVENUE FREDERICK MD 21702 HOSPICE CARE ORGANIZATION FMH ROSE HILL REHAB SERVICES 1562 OPPOSSUMTOWN PIKE FREDERICK MD 21702 PHYSICAL REHABILITATION CLINIC FMH CRESTWOOD 7211 BANK COURT FREDERICK MD 21703 OUTPATIENT HEALTH SERVICE FACILITY FMH WELLNESS CENTER 5500 BUCKEYSTOWN PIKE FREDERICK MD 21702 HEALTH SERVICES CENTER FMH ECHO AND VASCULAR LAB 1560 OPPOSSUMTOWN PIKE FREDERICK MD 21702 HEALTH SERVICES CENTER FMH URBANA 3430 WORTHINGTON BLVD FREDERICK MD 21704 OUTPATIENT HEALTH SERVICE FACILITY FMH IMMEDIATE CARE 850 OAK STREET FREDERICK MD 21702 WALK-IN CLINIC SUPPLEMENTAL INFORMATION SCHEDULE H, PART I FOR THE LAST 30 YEARS, MARYLAND HOSPITALS HAVE MET THEIR COMMUNITY BENEFIT OBLIGATIONS IN A UNIQUE MANNER THAT BUILDS THE COSTS OF UNCOMPENSATED CARE (CHARITY CARE AND PATIENT BAD DEBT) AND GRADUATE MEDICAL EDUCATION INTO THE RATES THAT HOSPITALS ARE REIMBURSED BY ALL PAYORS. THE SYSTEM IS BASED IN FEDERAL AND STATE LAW AND BENEFITS ALL MARYLAND RESIDENTS, INCLUDING THOSE IN NEED OF FINANCIAL ASSISTANCE TO PAY THEIR HOSPITAL BILLS. MARYLAND IS THE ONLY STATE IN WHICH ALL PAYORS (GOVERNMENTALLY-INSURED, COMMERCIALLY-INSURED, OR SELF-PAY) ARE CHARGED THE SAME PRICE FOR SERVICES AT ANY GIVEN HOSPITAL. UNDER THIS SYSTEM, MARYLAND HOSPITALS ARE REGULATED BY A STATE AGENCY, KNOWN AS THE HEALTH SERVICES COST REVIEW COMMISSION (HSCRC), THAT IS REQUIRED TO: -PUBLICLY DISCLOSE INFORMATION ON THE COST AND FINANCIAL POSITION OF HOSPITALS; -REVIEW AND APPROVE HOSPITAL RATES; -COLLECT INFORMATION DETAILING TRANSACTIONS BETWEEN HOSPITALS AND FIRMS WITH WHICH THEIR TRUSTEES HAVE A FINANCIAL INTEREST; AND, -MAINTAIN THE SOLVENCY OF EFFICIENT AND EFFECTIVE HOSPITALS. SINCE 2000, THE RATE SETTING COMMISSION HAS HAD ITS OWN FRAMEWORK FOR REPORTING HOSPITALS' COMMUNITY BENEFITS AND ISSUING A REPORT ANNUALLY REGARDING HOSPITALS' COMMUNITY BENEFIT TOTALS. THAT REPORT IS AVAILABLE ON TTP://WWW.HSCRC.STATE.MD.US/ BECAUSE OF THIS UNIQUE STRUCTURE MARYLAND HOSPITALS' COMMUNITY BENEFITS NUMBERS WILL NOT COMPARE WITH THE REST OF THE NATION'S HOSPITALS. HOWEVER, MARYLAND HOSPITALS MEET OR EXCEED THE COMMUNITY BENEFIT STANDARD ESTABLISHED BY THE IRS IN 1969. ADDITIONAL DETAIL ILLUSTRATING THIS CAN BE FOUND WITHIN THIS SCHEDULE H REPORT. CRITERIA FOR DETERMINING ELIGIBILITY FOR FREE OR DISCOUNTED CARE Form 990, Schedule H, Part I, Line 3c IN ADDITION TO USING FPG TO DETERMINE FREE AND DISCOUNTED CASE, PATIENTS MAY RECEIVE ADDITIONAL FINANCIAL ASSISTANCE IF THEIR BILL IS 25% OR MORE OF THEIR ANNUAL INCOME. EVERY INPATIENT OR OUTPATIENT WHO ACCUMULATES $10,000 OR MORE IN CHARGES RECEIVES A VISIT FROM A FINANCIAL COUNSELOR ALONG WITH A FINANCIAL ASSISTANCE APPLICATION. WE ALSO MAIL THESE PATIENTS ANOTHER FINANCIAL ASSISTANCE APPLICATION WITH A COVER LETTER STATING THAT DUE TO THE BALANCE OF THEIR BILL, THEY MAY QUALIFY FOR FINANCIAL ASSISTANCE. Text of bad debt expense footnote Form 990, schedule H, part III, line 4 BAD DEBT VALUATION WAS CALCULATED USING THE COST-TO-CHARGE RATIO DERIVED FROM WORKSHEET 2. WE ESTIMATE APPROXIMATELY 7.5% OF BAD DEBT EXPENSE IS ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER OUR FINANCIAL ASSISTANCE POLICY. WE CONTINUE OUR EFFORTS TO QUALIFY PATIENTS FOR FREE OR REDUCED CARE. Medicare Costing Methodology Form 990, schedule H, part III, line 8 MEDICARE PS&R REPORTS USED AS SOURCE OF COSTS AND PAYMENTS. Application of Collection Practices to those Qualifying for Financial Assistance Form 990, schedule H, part III, line 9b PATIENTS WHO QUALIFY FOR CHARITY CARE OR FINANCIAL ASSISTANCE ARE SPECIFICALLY EXCLUDED FROM THE COLLECTION PROCESS. NEEDS ASSESSMENT SCHEDULE H, PART VI, LINE 2 THE 2013 FREDERICK COUNTY HEALTH ASSESSMENT IS A DATA DRIVEN APPROACH TO DETERMINING THE HEALTH STATUS OF FREDERICK COMMUNITY RESIDENTS BY CAPTURING AND COMPARING STATISTICAL INFORMATION FROM THREE INDEPENDENT COMMUNITY-BASED HEALTH FOCUSED AND HUMAN NEEDS DRIVEN ORGANIZATION: - THE FREDERICK COMMUNITY FOUNDATION'S HUMAN NEEDS ASSESSMENT CONDUCTED IN AUGUST OF 2011, - THE LOCAL HEALTH IMPROVEMENT PLAN (L-HIP) PRIORITIES SUMMIT CONDUCTED IN OCTOBER OF 2011, AND - FREDERICK MEMORIAL HOSPITAL'S UTILIZATION DATA FOR THE EMERGENCY ROOM, INPATIENT ADMISSIONS AND OUTPATIENT SERVICE PROVISION. THE FMH DATA SERVED AS AN EVIDENCE-BASED CONFIRMATION OF THE OTHER TWO STUDIES' FINDINGS. THE COMPARATIVE ASSESSMENT FINDINGS WERE ADDITIONALLY VERIFIED USING THE CURRENT DATA FROM THE STATE HEALTH IMPROVEMENT PLAN. IN ADDITION, THE ASSESSMENT USES THE MOST CURRENT STATISTICAL INFORMATION AVAILABLE FROM A VARIETY OF RESOURCES INCLUDING THE MARYLAND HEALTH SERVICES COST REVIEW COMMISSION, THE MARYLAND BEHAVIORAL RISK FACTOR SURVEILLANCE SYSTEM, THE MARYLAND DEPARTMENT OF HEALTH AND MENTAL HYGIENE, THE US CENSUS AND OTHER STATE AND FEDERAL AGENCIES. THE 2013 COMMUNITY HEALTH ASSESSMENT PROVIDES THE INFORMATION THAT THE FREDERICK COUNTY HEALTH DEPARTMENT, FREDERICK REGIONAL HEALTH SYSTEM, THE FREDERICK COUNTY HEALTH CARE COALITION AND PARTNER GRASS-ROOTS AGENCIES AND ORGANIZATIONS NEED TO IDENTIFY ISSUES OF GREATEST CONCERN. DECISIONS TO COMMIT RESOURCES TO THOSE AREAS IDENTIFIED IN THIS COMPARATIVE STUDY WILL ENSURE THAT OUR COLLECTIVE EFFORTS HAVE THE GREATEST IMPACT ON OUR COMMUNITY'S HEALTH STATUS. PROJECT GOALS THE 2013 FREDERICK COUNTY HEALTH ASSESSMENT WILL SERVE AS A RESOURCE AND TOOL FOR REACHING THREE GOALS: - TO IMPROVE THE HEALTH STATUS OF FREDERICK COUNTY RESIDENTS, ELEVATE THEIR OVERALL QUALITY OF LIFE, AND INCREASE THEIR LIFE SPANS. QUALITY OF LIFE ISSUES REMAIN AN IMPORTANT COMPONENT OF THE PLAN AS ALL AGREE THAT THE MEASURE OF OUR COMMUNITY'S HEALTH GOES BEYOND ADDRESSING PHYSICAL, DENTAL, MENTAL AND BEHAVIORAL HEALTH NEEDS. - TO IDENTIFY THE SOCIO-ECONOMIC FACTORS WHICH HAVE HISTORICALLY HAD A NEGATIVE IMPACT ON OUR RESIDENTS' HEALTH. BY IDENTIFYING POPULATION SEGMENTS THAT ARE MOST AT-RISK FOR VARIOUS DISEASES AND INJURIES WE WILL, AS A COMMUNITY, BE BETTER POSITIONED TO ADDRESS HEALTH DISPARITIES. - TO PROVIDE MORE ACCESSIBLE PREVENTIVE SERVICES TO ASSIST COMMUNITY PARTNERS IN IMPROVING THE HEALTH STATUS OF FREDERICK COUNTY RESIDENTS, AND TO HELP US AS A COMMUNITY KEEP THE COSTS OF PROVIDING CARE FOR LATE-STAGE DISEASE IN CHECK. LATE-STAGE DISEASE IN CHECK. PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE SCHEDULE H, PART VI, LINE 3 FREDERICK MEMORIAL HOSPITAL POSTS ITS CHARITY CARE POLICY AND FINANCIAL ASSISTANCE CONTACT INFORMATION IN ADMISSION AREAS, THE FMH EMERGENCY DEPARTMENT, AND IN ALL OF OUR SATELLITE FACILITIES IN AREAS WHERE ELIGIBLE PATIENTS ARE LIKELY TO PRESENT. FMH PROVIDES A SUMMARY OF THE CHARITY CARE POLICY AND FINANCIAL ASSISTANCE CONTACT INFORMATION TO ALL PATIENTS AT THE TIME OF ADMISSION TO THE HOSPITAL. FMH ADMISSIONS PERSONNEL DISCUSS THE AVAILABILITY OF VARIOUS GOVERNMENT BENEFITS SUCH AS MEDICAID OR STATE PROGRAMS WITH PATIENTS AND/OR THEIR FAMILY MEMBERS, AND THEY ASSIST PATIENTS WITH QUALIFICATION FOR THE PROGRAMS. FREDERICK MEMORIAL HOSPITAL INCREASED ITS EFFORTS TO PROVIDE FINANCIAL ASSISTANCE TO ITS PATIENTS THROUGH A VARIETY OF INITIATIVES. FMH INCREASED ITS FINANCIAL ASSISTANCE FOR CATASTROPHIC SITUATIONS. IN OUR PROGRAM, PATIENTS MAY RECEIVE FINANCIAL ASSISTANCE IF THEIR BILL IS 25% OR MORE OF THEIR ANNUAL INCOME. A FINANCIAL COUNSELOR MEETS WITH PATIENTS WHO HAVE NO INSURANCE THE DAY AFTER ADMISSION TO EXPLAIN OUR FINANCIAL ASSISTANCE PROGRAM AND THE STATE'S MEDICAL ASSISTANCE PROGRAM. EVERY INPATIENT OR OUTPATIENT WHO ACCUMULATES $10,000 OR MORE IN CHARGES WILL RECEIVE A SECOND VISIT FROM A FINANCIAL COUNSELOR ALONG WITH A FINANCIAL ASSISTANCE APPLICATION. ALSO, WE MAIL THESE PATIENTS ANOTHER FINANCIAL ASSISTANCE APPLICATION WITH A COVER LETTER STATING THAT DUE TO THE BALANCE OF THEIR BILL, THEY MAY QUALIFY FOR FINANCIAL ASSISTANCE. COMMUNITY INFORMATION SCHEDULE H, PART VI, LINE 4 IN THE YEAR ENDED JUNE 30, 2015, FREDERICK MEMORIAL HOSPITAL ADMITTED 18,309 PATIENTS. THE FMH EMERGENCY DEPARTMENT TREATED 76,363 PATIENTS. THE HOSPITAL IS THE ONLY HOSPITAL LOCATED IN ITS PRIMARY SERVICE AREA AND THE ONLY HOSPITAL WITHIN A 25-MILE RADIUS OF THE CITY OF FREDERICK. APPROX. 2% OF ALL COUNTY RESIDENTS LACK HEALTH INSURANCE AND 19% ARE MEDICAID RECIPIENTS. FMH DEFINES ITS PRIMARY SERVICE AREA AS FREDERICK COUNTY, MARYLAND, WHICH ACCOUNTED FOR APPROXIMATELY 60% OF FMH'S DISCHARGES IN FISCAL YEAR 2015. THE HOSPITAL IS THE ONLY HOSPITAL LOCATED IN ITS PRIMARY SERVICE AREA AND THE ONLY HOSPITAL WITHIN A 25-MILE RADIUS OF THE CITY OF FREDERICK. MT. AIRY THE MOUNT AIRY AREA IS PREDOMINANTLY WHITE (92.1%), WITH SMALLER HISPANIC OR LATINO (4.7%), AFRICAN AMERICAN (2.4%) AND ASIAN (2.2%) POPULATIONS. THE MEDIAN AGE IS 36, WITH APPROXIMATELY 20% OF THE POPULATION IN EACH OF TWO RANGES: 5-14 AND 40-49 YEARS OF AGE. ABOUT 10% OF ALL RESIDENTS ARE AGE 62 OR OLDER. THE POPULATION IS 51.5% FEMALE AND 48.5% MALE. 79% OF MOUNT AIRY RESIDENTS LIVE IN FAMILY HOUSEHOLDS (A HOUSEHOLDER AND ONE OR MORE OTHER PEOPLE RELATED BY BIRTH, MARRIAGE, OR ADOPTION). 86.9% OF THE HOUSING UNITS ARE OWNER-OCCUPIED. THE POVERTY LEVEL IN MOUNT AIRY IS 5.3%, WELL BELOW THE STATE-WIDE RATE OF 12.0%. LIFE EXPECTANCY IS ABOVE THE STATE AVERAGE AT 80.1%. CANCER AND HEART DISEASE (INCLUDING STROKE) RATE HIGHEST IN TERMS OF CAUSES OF DEATH AND YEARS OF POTENTIAL LIFE LOST. ABOUT 5.0% OF THE RESIDENTS IN THIS AREA LIVE WITH CHRONIC HEART DISEASE, JUST 1.3% HAVE HAD A STROKE, AND 28.5% HAVE BEEN TOLD THEY HAVE HIGH BLOOD PRESSURE. 6.1% HAVE BEEN DIAGNOSED WITH SKIN CANCER AND ANOTHER 6.8% HAVE BEEN DIAGNOSED WITH ANOTHER FORM OF CANCER. THURMONT THURMONT'S POPULATION IS FAIRLY EVENLY DISTRIBUTED IN TERMS OF AGE, WITH THE LARGEST COHORT (18%) IN THE 40-49 AGE BRACKET. RESIDENTS ARE 95.8% WHITE, 2.4% HISPANIC OR LATINO, AND 1% AFRICAN AMERICAN. NEARLY 16% OF THURMONT'S POPULATION IS AGE 62 OR OLDER. SIMILARLY TO MOUNT AIRY, THE POPULATION IS 48.4% MALE AND 51.6% FEMALE. 72% OF THURMONT RESIDENTS LIVE IN FAMILY HOUSEHOLDS, WITH 74.7% OF HOUSING UNITS OCCUPIED BY THE PROPERTY OWNER. 7.2% OF RESIDENTS IN THE AREA EARN INCOME BELOW THE POVERTY LEVEL. AGAIN, CANCER AND HEART DISEASE (INCLUDING STROKE) RATE HIGHEST IN TERMS OF CAUSES OF DEATH AND YEARS OF POTENTIAL LIFE LOST. ABOUT 4.6% OF RESIDENTS IN THIS AREA SUFFER FROM CHRONIC HEART DISEASE, 4.1% HAVE HAD A STROKE, AND 24.7% HAVE BEEN TOLD THEY HAVE HIGH BLOOD PRESSURE. 6.8% HAVE BEEN DIAGNOSED WITH SKIN CANCER AND ANOTHER 8.1% HAVE BEEN DIAGNOSED WITH ANOTHER FORM OF CANCER. FREDERICK CITY AND SUBURBS FREDERICK CITY AND ITS IMMEDIATE SUBURBS ARE MORE RACIALLY DIVERSE THAN EITHER THURMONT OR MT. AIRY, WITH WHITE (63.9%), AFRICAN AMERICAN (18.6%), HISPANIC OR LATINO (14.4%) AND ASIAN (5.8%) GROUPS ACCOUNTING FOR THE LARGEST PERCENTAGES. RESIDENTS ARE EVENLY DISTRIBUTED IN TERMS OF AGE, WITH THE LARGEST GROUP (17%) APPEARING IN THE 25-34 AGE BRACKET. THE POPULATION IS 48.2% MALE AND 51.8% FEMALE. JUST 60.5% OF THIS AREA'S RESIDENTS LIVE IN FAMILY HOUSEHOLDS, WITH A RELATIVELY EVEN SPLIT BETWEEN OWNER-OCCUPIED (57.6%) AND RENTER-OCCUPIED (42.4%) HOUSING. 12.1% OF RESIDENTS IN THIS AREA LIVE BELOW THE POVERTY LEVEL, WHICH IS JUST ABOVE THE STATE AVERAGE OF 12.0%. AS IN THE OTHER TWO AREAS DESCRIBED, CANCER AND HEART DISEASE (INCLUDING STROKE) RATE HIGHEST IN TERMS OF CAUSES OF DEATH AND YEARS OF POTENTIAL LIFE LOST. 6.5% OF THE RESIDENTS IN THIS AREA LIVE WITH CHRONIC HEART DISEASE, 3.1% HAVE SUFFERED A STROKE, AND 30.2% HAVE BEEN TOLD THEY HAVE HIGH BLOOD PRESSURE. 4.0% REPORT BEING DIAGNOSED WITH SKIN CANCER AND ANOTHER 4.5% HAVE BEEN DIAGNOSED WITH ANOTHER FORM OF CANCER. PROMOTION OF COMMUNITY HEALTH SCHEDULE H, PART VI, LINE 5 THE COMMUNITY HEALTH ASSESSMENT IDENTIFIED BREAST CANCER AS A FOCUS NEED: FMH DATA SHOWS THAT CANCER STRIKES WHITE WOMEN, 65+ YEARS OF AGE. THAT COHORT ACCOUNTS FOR 55% (329) OF THE 596 PATIENTS ADMITTED TO FMH IN FY2012 WITH A CANCER DIAGNOSIS. CAUCASIANS ARE IMPACTED BY A GREATER DEGREE AS MEASURED BY PERCENTAGE OF THAT RACE'S POPULATION IN FREDERICK. IN FY2012, THE TOTAL NUMBER OF CASES (INPATIENT AND OUTPATIENT) WITH THE DIAGNOSIS OF NEOPLASM EQUALED 14,761. EIGHT PERCENT OF THE FREDERICK COUNTY POPULATION IS CURRENTLY LISTED IN THE FMH CANCER REGISTRY. BREAST CANCER IS THE MOST PREVALENT SITE OF CANCER DIAGNOSED AND TREATED AT FMH. IN 2012, THE TOTAL NUMBER OF BREAST CANCER PATIENTS AT FMH WAS 211, OR 25.5% OF THE TOTAL NUMBER OF CANCER PATIENTS DIAGNOSED AND TREATED AT FMH. THIS REPRESENTS AN 18% INCREASE IN VOLUMES FROM THE TOTAL SEEN IN 2011. The increase in volume is evidence that the hospital's awareness and educational programs are working well, especially given the fact that analysis of Stage at Diagnosis shows the largest proportion - 41% - are diagnosed at Stage I. 102 women attended the 10th annual breast cancer symposium, the theme for this free and open to the public event was Celebrating Life and Embracing Challenges: Moving Forward in Frederick. Dr. Susan Bahl, Medical Director of the Center for Breast Care discussed the advantages of the FMH Multidisciplinary Breast Cancer Clinic and the FMH Survivorship Clinic; Dr. Mark Goldstein provided education about fitness and nutrition for survivors. Dr. Lawrence Wickerham discussed the high risk clinic. The purpose of these outreach efforts is to influence a woman's decision to practice monthly breast self examinations, be examined yearly by a health care provider, have a yearly mammogram as indicated by screening protocols. The overarching goal is to decrease the incidence of late-stage breast cancer diagnosis in Frederick County. Over the past 5 years, the FMH cancer registry has recorded an increase in the number of breast cancers diagnosed in Stage I and Stage II. Given the favorable outcomes as measured by the number of breast cancer patients presenting in the early stages of the disease, FMH plans to continue hosting the Breast Cancer Symposium for many years to come. THE COMMUNITY NEEDS HEALTH ASSESSMENT IDENTIFIED HEART DISEASE AS FOCUS NEED. STROKE WORKSHOPS WERE PROVIDED TO THOSE COMMUNITIES IN OUR SERVICE AREA WHERE THE INCIDENCE OF HEART AND VASCULAR DISEASE ARE MORE PREVALENT WITH THE GOAL OF INCREASING AWARENESS ABOUT THE SIGNS AND SYMPTOMS OF STROKE. -FMH DATA SHOWS THAT THE PREPONDERANCE OF HEART DISEASE STRIKES WHITE MEN, 65 + YEARS OF AGE. THE COHORT ACCOUNTS FOR 49% (1,628) OF THE 3,206 HEART PATIENTS ADMITTED TO FMH IN FY 2012. -THE AFRICAN AMERICAN COMMUNITY IS IMPACTED BY A GREATER DEGREE AS MEASURED BY PERCENTAGE OF THAT RACE'S POPULATION IN FREDERICK. -IN FY 2012, THE TOTAL NUMBER OF CASES (INPATIENT AND OUTPATIENT) WITH THE DIAGNOSIS OF HEART DISEASE OR A DISEASE OF THE CIRCULATORY SYSTEM EQUALED 28, 467. -SIX PERCENT OF THE FREDERICK COUNTY POPULATION SUFFERS FROM CHRONIC HEART DISEASE. STROKE WORKSHOPS STROKE WORKSHOPS WERE PROVIDED TO THOSE COMMUNITIES IN OUR SERVICE AREA WHERE THE INCIDENCE OF HEART AND VASCULAR DISEASE ARE MORE PREVALENT WITH THE GOAL OF INCREASING AWARENESS ABOUT THE SIGNS AND SYMPTOMS OF STROKE. THE DIRECTOR OF THE FMH STROKE PROGRAM ATTENDED A NUMBER OF COMMUNITY MEETINGS AND EVENT TO EDUCATED ATTENDEES ABOUT THE RISK FACTORS ASSOCIATED WITH CARDIOVASCULAR DISEASE. ATTENDEES ARE GIVEN INFORMATION ON RISK FACTORS AND STEPS THEY CAN TAKE RIGHT AWAY TO CHANGE THEIR OWN RISK FOR STROKE. BECAUSE THE ONSET OF CORONARY ARTERY DISEASE, VASCULAR DISEASE AND THE PREDILECTION TO ATHEROSCLEROSIS ALL HAVE A GENETIC COMPONENT, IT IS DIFFICULT TO ASCERTAIN WHAT IMPACT, IF ANY, A FOCUSED AWARENESS CAMPAIGN ABOUT THE SIGNS AND SYMPTOMS OF STROKE MAY HAVE ON A GIVEN POPULATION. AN IMMEDIATE EVALUATION TOOL WAS USED TO ASSESS WHETHER THE ATTENDEES LEARNED AND RETAINED SOME OF THE PERTINENT INFORMATION PRESENTED IN THE WORKSHOPS. AT THE CONCLUSION OF THE WORKSHOPS, APPROXIMATELY 100% OF THE ATTENDEES ARE ABLE TO NAME AND IDENTIFY STROKE SIGNS AND SYMPTOMS AND KNOW WHAT TO DO IN CASE THEY, OR SOMEONE THEY KNOW, ARE HAVING A STROKE. FMH WILL CONTINUE TO OFFER FREE STROKE WORKSHOPS TO THE CITIZENS OF FREDERICK COUNTY TO INCREASE AWARENESS AND PROVIDE DETAILS ON STROKE CARE AND PREVENTION. EFFORTS WILL FOCUS EVEN MORE SPECIFICALLY IN THOSE UNDERSERVED COMMUNITIES IN WHICH THE INCIDENCE OF CARDIOVASCULAR DISEASE IS HIGHEST IN FREDERICK COUNTY. THE COMMUNITY NEEDS HEALTH ASSESSMENT IDENTIFIED ACCESS TO PRENATAL CARE AS FOCUS NEED: THE FMH PRENATAL CENTER PROVIDES PRENATAL CARE FOR FREDERICK COUNTY RESIDENTS WHO ARE UNDERINSURED OR UNINSURED AND WHO MAY BE UNABLE TO OBTAIN PRENATAL CARE FROM PRIVATE OBSTETRICIANS. MANY OF THE WOMEN IN THE PRENATAL CENTER'S PROGRAMS ARE HIGH-RISK MATERNITY PATIENTS, WHO PRESENT WITH MEDICAL CONDITIONS THAT MAY POSE SIGNIFICANT MATERNAL AND INFANT RISK. FMH PRENATAL CENTER PRACTITIONERS ARE CERTIFIED NURSE MIDWIVES, UNDER THE SUPERVISION OF DR. EDWIN CHEN, MEDICAL DIRECTOR FOR THE PRENATAL CENTER, AND DR. WAYNE KRAMER, A MATERNAL FETAL MEDICINE SPECIALIST WITH MID MARYLAND PERINATOLOGY ASSOCIATES, WHO ARE ABLE TO DIAGNOSE AND TREAT NORMAL PREGNANCIES AS WELL AS HIGH RISK PREGNANCIES. PNC MEDICAL ASSISTANTS, AND A CERTIFIED SPANISH INTERPRETER COMPLETE THE STAFF MEMBERS IN THE PRENATAL CENTER WHICH IS UNDER THE UMBRELLA OF WOMEN'S AND CHILDREN'S SERVICES SUPERVISED BY A MASTERS PREPARED NURSING DIRECTOR. ACCESS TO THE FMH PRENATAL CENTER IS PRIMARILY FROM SELF-REFERRALS, AS WELL AS REFERRALS FROM FREDERICK COUNTY HEALTH DEPARTMENT (FCHD), AND MISSION OF MERCY. THIS INITIATIVE WAS IMPLEMENTED AFTER THE FIRST FCHD HEALTH NEEDS ASSESSMENT DEMONSTRATED THAT THERE WERE SIGNIFICANT UNMET NEEDS FOR PRENATAL CARE. THE FMH AUXILIARY CONTRIBUTED SIGNIFICANT FUNDS FOR THE FIRST FOUR YEARS OF THE PNC. FMH LEADERSHIP IS COMMITTED TO THE CONTINUATION OF THE PNC DUE TO THE SIGNIFICANT IMPROVEMENT IN ACCESS TO PRENATAL CARE AND IMPROVEMENTS IN INFANT MORTALITY STATISTICS FOR FREDERICK COUNTY. THE GOAL OF THE PRENATAL CENTER IS TO HAVE HEALTHY MOTHERS AND HEALTHY NEWBORNS. OUR SUCCESS IS ASSESSED BY THE NUMBER AND PERCENTAGE OF WOMEN WHO HAVE HAD EIGHT OR MORE PRENATAL VISITS AND DELIVERED A NEWBORN WHO WEIGHS AT LEAST 2,500 GRAMS. THERE WERE 475 NEW MATERNITY PATIENTS WHO HAD 2,748 OUTPATIENT PRENATAL VISITS IN 2015. THE PNC ALSO MEASURES PATIENT SATISFACTION AND REGULARLY ACHIEVES AVERAGE SCORES BETWEEN 91-98%. THERE WERE 176 MATERNITY PATIENTS WHO RECEIVED AT LEAST 8 PRENATAL CARE VISITS AND WHO DELIVERED BABIES OF HEALTHY BIRTH WEIGHT (2,500 GRAMS OR ABOVE). OF THOSE WOMEN WHO HAD AT LEAST 8 PRENATAL CARE VISITS 96% DELIVERED BABIES OF HEALTHY BIRTH WEIGHT. IN MARYLAND, FREDERICK COUNTY HAD THE 5TH LOWEST PERCENTAGE OF BABIES BORN WEIGHING LESS THAN 2,500 GRAMS IN 2012 AND THE 4TH LOWEST INFANT MORTALITY RATE PER 1,000 LIVE BIRTHS IN 2012 (DHMH MOST RECENT STATE WIDE STATISTICS ARE FROM 2012). THE FREDERICK REGIONAL HEALTH SYSTEM WILL CONTINUE TO FUND OPERATIONS OF THE FMH PRENATAL CENTER THROUGH OUR COMMITMENT TO SERVING OUR COMMUNITY AND OUR POPULATION HEALTH INITIATIVES. TOTAL DIRECT OPERATING EXPENSES FOR PNC STAFF, SUPPLIES, PROVIDERS AND HIGH RISK CONSULTANTS EXCEED $335,000 ANNUALLY. THE COMMUNITY NEEDS HEALTH ASSESSMENT IDENTIFIED ACCESS TO CARE MANAGEMENT AS A FOCUS NEED: ONE OF THE MAIN REASONS FOR HOSPITAL RE-ADMISSION IS THE FACT THAT DISCHARGED PATIENTS HAVE HISTORICALLY RECEIVED LITTLE OR NO GUIDANCE RELATIVE TO FOLLOW-UP VISITS WITH PHYSICIANS, FILLING AND TAKING THEIR PRESCRIBED MEDICATIONS, MAKING APPOINTMENTS FOR REHABILITATION, ETC. PATIENTS IDENTIFIED AS HIGH ED UTILIZERS, AND/OR PATIENTS RETURNING TO THE HOSPITAL WITHIN 30 DAYS OF DISCHARGE, MEET WITH EITHER AN RN OR SOCIAL WORK CASE MANAGEMENT IN AN EFFORT TO UNDERSTAND WHY A PATIENT HAS RETURNED AFTER DISCHARGE AND OR HAS FREQUENT VISITS TO THE EMERGENCY ROOM. THE RESULTS OVERWHELMINGLY SUPPORTED THE NEED TO ESTABLISH A PLAN FOR ACCESS TO; MEDICATIONS, FOLLOW UP PHYSICIAN APPOINTMENTS, TRANSPORTATION, AND OTHER MEDICAL/SOCIAL SUPPORT IN THE COMMUNITY. CARE TRANSITIONS IN 2015 WITH 2,994 PATIENTS RECEIVING INTERVENTIONS FROM OUR CARE TRANSITIONS TEAM. THROUGH THE WORK OF OUR CARE TRANSITIONS TEAM PATIENTS RECEIVE MORE FOCUSED DISEASE MANAGEMENT EDUCATION, AND INTENSIVE TRANSITION PLANNING, WHICH OFTEN INCLUDES FINANCIAL SUPPORT FOR MEDICATIONS, FOLLOW UP PHYSICIAN APPOINTMENTS, TRANSPORTATION AND VARIOUS OTHER MEDICAL AND SOCIAL SUPPORT SERVICES IN THE COMMUNITY. AS THE TEAM OF CARE TRANSITIONS NURSES, SOCIAL WORKERS AND PHARMACIST WORKS CLOSELY WITH PATIENTS WHO HAVE BEEN IDENTIFIED AS HIGH RISK FOR READMISSION A GREAT DEAL OF TIME AND ENERGY IS SPENT WORKING WITH PATIENTS AND CAREGIVERS TO ESTABLISH A POST DISCHARGE PLAN. THI AFFILIATED HEALTH CARE SYSTEM SCHEDULE H, PART VI, LINE 6 FREDERICK MEMORIAL HOSPITAL, INC. ("FMH") IS A PRIVATE, NON-STOCK, NOT-FOR-PROFIT 501 (C) (3) MARYLAND CORPORATION ORGANIZED IN 1897. AS OF JULY 1, 2011, FREDERICK REGIONAL HEALTH SYSTEM BECAME THE PARENT CORPORATION UNDER WHICH THE ENTITIES DESCRIBED BELOW EXIST AND OPERATE. FREDERICK REGIONAL HEALTH SYSTEM IS GOVERNED BY A SIXTEEN MEMBER BOARD OF DIRECTORS. THE BOARD MEETS MONTHLY, WITH ELECTION OF OFFICERS AND MEMBERS OCCURRING AT THE SEPTEMBER MEETING. MUCH OF THE BOARD'S WORK IS ACCOMPLISHED THROUGH STANDING COMMITTEES, INCLUDING THE EXECUTIVE, FINANCE, GOVERNANCE, EXECUTIVE COMPENSATION, JOINT CONFERENCE (WITH MEDICAL STAFF), PLANNING, AND HOSPITAL PERFORMANCE REVIEW COMMITTEES. FREDERICK MEMORIAL HOSPITAL IS A 298-BED ACUTE CARE HOSPITAL LOCATED IN FREDERICK, MARYLAND, APPROXIMATELY 50 MILES WEST OF BALTIMORE AND 45 MILES NORTHWEST OF WASHINGTON D. C. THE HOSPITAL OPENED IN 1902 AND IS CURRENTLY THE ONLY ACUTE CARE HOSPITAL IN FREDERICK COUNTY AND THE ONLY ACUTE CARE HOSPITAL WITHIN A 25-MILE RADIUS OF THE CITY OF FREDERICK. THE MAIN CAMPUS OF THE HOSPITAL IS LOCATED ON AN APPROXIMATELY 15.85-ACRE SITE IN FREDERICK, MARYLAND. THE TOTAL SQUARE FOOTAGE OF THE HOSPITAL IS APPROXIMATELY 596,000 SQUARE FEET. FMH'S HOSPITAL-BASED AND OFF-SITE OUTPATIENT SERVICES ACCOUNT FOR OVER 350,000 VISITS ANNUALLY INCLUDING HOME HEALTH SERVICES, WHICH MAKES APPROXIMATELY 35,000 VISITS PER YEAR. IN ADDITION, HOSPITAL-BASED HOSPICE SERVICES HANDLE APPROXIMATELY 15,000 VISITS PER YEAR. FREDERICK REGIONAL HEALTH SYSTEM IS THE PARENT CORPORATION FOR MONOCACY HEALTH PARTNERS, A PHYSICIAN LED ENTERPRISE COMPOSED OF THE FOLLOWING HEALTH SYSTEM OWNED PRACTICES FREDERICK REGIONAL HEALTH SYSTEM PROVIDES A FULL RANGE OF ACUTE CARE SERVICES INCLUDING: MEDICINE, SURGERY, OBSTETRICS, GYNECOLOGY, PEDIATRICS, INTENSIVE CARE, CORONARY CARE, INTERVENTIONAL CARDIOLOGY, PRIMARY STROKE PROGRAM, WOUND CARE, JOINT REPLACEMENT PROGRAM, CYBERKNIFE RADIOSURGERY CENTER, PSYCHIATRIC CARE, MEDICAL FITNESS, WELLNESS PROGRAM/CENTER AND EMERGENCY SERVICES. IN ADDITION, THE HEALTH SYSTEM PROVIDES A COMPREHENSIVE RANGE OF OUTPATIENT SERVICES, INCLUDING: EMERGENCY MEDICINE, OUTPATIENT SURGERY, HOME HEALTH, RADIATION THERAPY, MRI, PET AND CT SCANNING, MEDICAL ONCOLOGY, AND COMPREHENSIVE WOMEN'S SERVICES. THROUGH THE SATELLITE LOCATIONS AND OUTPATIENT CENTERS, THE HEALTH SYSTEM PROVIDES: URGENT CARE, LABORATORY, DIAGNOSTIC RADIOLOGY, AMBULATORY SURGERY, VASCULAR IMAGING, REHABILITATION SERVICES, PAIN AND PALLIATIVE CARE. STATE FILING OF COMMUNITY BENEFIT REPORT SCHEDULE H, PART VI, LINE 7 MARYLAND true FREDERICK COMMUNITY COLLEGE 7932 OPOSSUMTOWN PIKE FREDERICK MD 21702 520743590 501(c)(3) 100000 0 1 PROCEDURES FOR MONITORING THE USE OF GRANTS FORM 990, Schedule I, Part I, Line 2 THE HOSPITAL PROVIDES FUNDING TO A LOCAL COMMUNITY COLLEGE (501(C)(3) IN AN EFFORT TO ENHANCE ITS ALLIED HEALTH PROGRAM. THROUGH THIS PROGRAM A FORMAL EDUCATION FORUM IS ESTABLISHED RESULTING IN FULLY ACCREDITED PROGRAMS THAT MEET THE HOSPITAL'S NEEDS. X true true X X X X false true false false false false false false false Manuel A Casiano VP Medical Staff 340503 0 53691 0 2322 0 16117 0 48110 0 460743 0 0 0 Cheryl L Cioffi VP Chief Nursing Officer 216997 0 34948 0 540 0 36123 0 15804 0 304412 0 0 0 Kenneth R Coffey II VP Chief Development Officer 181502 0 19522 0 2322 0 15691 0 11012 0 230049 0 0 0 Hannah R Jacobs VP Finance 170762 0 18796 0 540 0 2261 0 9392 0 201751 0 0 0 Thomas A Kleinhanzl President and CEO 610432 0 176344 0 7160 0 15804 0 180232 0 989972 0 0 0 Michelle K Mahan Sr VP and CFO 367941 0 73952 0 2322 0 15804 0 48013 0 508032 0 0 0 Rachel I Mandel AVP Medical Affairs 149588 0 17870 0 149 0 1986 0 6780 0 176373 0 0 0 Mary B Mann AVP Patient Care Services 154685 0 16135 0 1242 0 15476 0 8852 0 196390 0 0 0 Terry P O'Malley VP Human Resources 191897 0 19533 0 6067 0 12971 0 27844 0 258312 0 0 0 David J Quirke VP Chief Information Officer 147322 0 42190 0 436 0 6782 0 22741 0 219471 0 0 0 Craig F Rosendale VP Ancillary Services 174812 0 18972 0 3564 0 12835 0 10576 0 220759 0 0 0 Donald R Schilling VP Ambulatory Services 195807 0 18210 0 2322 0 12985 0 5258 0 234582 0 0 0 Mark S Soberman Physician 496655 0 146 0 1032 0 15336 0 12251 0 525420 0 0 0 Jennifer G Teeter AVP Payor Contracting 166074 0 21234 0 1242 0 12608 0 10051 0 211209 0 0 0 John R Verbus Sr VP and COO 359625 0 65433 0 2322 0 14177 0 48763 0 490320 0 0 0 Jim R Williams VP Business Development 198869 0 20833 0 3564 0 12985 0 11919 0 248170 0 0 0 MARY BRIDGET CASTRO CHARGE NURSE 168414 0 146 0 48 0 5410 0 15224 0 189242 0 0 0 DUSTIN M SIMONSON ONCOLOGY MEDICAL PHYSICIST 188249 0 146 0 120 0 10779 0 15228 0 214522 0 0 0 JAMES BLAKE TRUMBLE MEDICAL DIRECTOR 236927 0 146 0 180 0 5170 0 15649 0 258072 0 0 0 YU XIA ONCOLOGY MEDICAL PHYSICIST 169933 0 146 0 145 0 7901 0 2213 0 180338 0 0 0 FOrm 990, schedule j, part I, line 1a FREDERICK MEMORIAL HOSPITAL HOLDS TWO CORPORATE MEMBERSHIPS TO A LOCAL GOLF/COUNTRY CLUB THAT ARE USED BY THE CHIEF EXECUTIVE OFFICER AND THE CHIEF FUND DEVELOPMENT OFFICER OF THE HOSPITAL. WHILE THE MAJORITY OF THE FEES ASSOCIATED WITH THE CLUB DUES, ETC. ARE BUSINESS RELATED, GENERAL PERSONAL USE EXPENSES ARE REIMBURSED BACK TO THE HOSPITAL BY THESE INDIVIDUALS AS NEEDED. form 990, schedule J, part I, line 3 THE EXECUTIVE COMPENSATION PROGRAM IS DESIGNED TO CARRY OUT THE HEALTH SYSTEM MISSION, TO ACHIEVE THE CHARITABLE PURPOSE, TO ATTRACT, RETAIN, MOTIVATE AND REWARD EXECUTIVE MANAGEMENT, AND TO MAINTAIN A COMPETITIVE POSITION WITH PEER ORGANIZATIONS IN THE REGION. OVERSIGHT OF THE EXECUTIVE COMPENSATION PROGRAM IS PROVIDED BY THE EXECUTIVE COMPENSATION COMMITTEE OF THE BOARD, COMPOSED OF THE BOARD CHAIRMAN, VICE CHAIRMAN, IMMEDIATE PRECEDING CHAIRMAN, CHAIRMAN OF THE FINANCE COMMITTEE AND THE CHAIRMAN OF THE GOVERNANCE COMMITTEE. IN ADDITION TO THE BOARD'S COMPENSATION COMMITTEE, WE UTILIZED AN EXTERNAL INDEPENDENT CONSULTANT AND MARKET SURVEYS FOR ALL EXECUTIVE MANAGEMENT COMPENSATION. THE PRESIDENT AND CEO HAVE A WRITTEN EMPLOYMENT CONTRACT. form 990, schedule J, part I, line 4b FREDERICK MEMORIAL HOSPITAL HAS ONE 457(F) NON-QUALIFIED DEFERRED COMPENSATION PLAN FOR CERTAIN MEMBERS OF SENIOR MANAGEMENT. UNDER THE PLAN, THEY MAY CONTRIBUTE AMOUNTS FROM THEIR COMPENSATION TO THE PLAN AND MAY RECEIVE A DISCRETIONARY EMPLOYER CONTRIBUTION. EMPLOYEES ARE FULLY VESTED IN ALL EMPLOYEE CONTRIBUTIONS TO THE PLAN. VESTING IN EMPLOYER CONTRIBUTIONS OCCURS IN ACCORDANCE WITH THE UNDERLYING PLAN DOCUMENTS. ALL ASSETS OF THE PLAN ARE HELD IN A SEPARATE TRUST. TOTAL HOSPITAL CONTRIBUTIONS TO THIS PLAN WERE AS FOLLOWS: MANUEL A. CASIANO 34,270 CHERYL L. CIOFFI 25,000 MICHELLE K. MAHAN 18,150 TERRY P. O'MALLEY 17,448 DAVID J. QUIRKE 15,656 THOMAS A. KLEINHANZL 148,519 JOHN R. VERBUS 17,266 A MARYLAND HEALTH & HIGHER EDU FACILITIES AUTH 2012A 520936091 574218LY7 2012-12-05 96240000 SEE PART VI false false false B MARYLAND HEALTH & HIGHER EDU FACILITIES AUTH 2012B 520936091 2012-12-05 70020000 SEE PART VI false false false A 68293488 0 108345805 0 1648756 0 1203561 0 0 14450568 0 22749432 2014 true false false true B 70020000 0 70690852 0 0 320948 349253 0 0 0 0 0 2012 true false true true A false true true true true true 0.00630 0.00630 false false false true B false true true true true true 0.00260 0.00260 false false false true A false true false false 0 false 0 false true B false true true true UBS AG STAMFORD 3.804 false false false 0 false true A true B true DESCRIPTION OF TAX EXEMPT BONDS SCHEDULE K, PART I, COLUMN F MARYLAND HEALTH & HIGHER ED AUTHORITY 2012A: FINANCE 2012 PROJECT AND CURRENT REFUND 2002 BONDS WHICH FUNDED THE 2002 PROJECT. MARYLAND HEALTH & HIGHER ED AUTHORITY 2012B: REFUND THE 2008 SERIES BONDS WHICH WERE USED TO FINANCE THE 2006 AND PRIOR PROJECTS. SCHEDULE K, PART II, LINE 3 Difference Between issue Price and Total Proceeds MARYLAND HEALTH & HIGHER ED AUTHORITY 2012A: ORIGINAL ISSUE PREMIUM OF $3,989,854 AND PREVIOUSLY TRUSTEED HELD FUNDS OF $8,115,951. MARYLAND HEALTH & HIGHER ED AUTHORITY 2012B: PREVIOUSLY TRUSTEED HELD funds of $670,852 MANAGEMENT PRACTICES AND PROCEDURES SCHEDULE K, PART III, LINE 9 THE ORGANIZATION HAS POLICIES AND PROCEDURES IN PLACE TO ENSURE TAX EXEMPT BOND POST ISSUANCE COMPLIANCE, WRITTEN POLICIES WERE CREATED AND ADOPTED DURING THE TAX YEAR. Description of Other Program Services form 990, part III, line 4d OTHER PROGRAM SERVICES INCLUDE BEHAVIORAL HEALTH, CARDIOLOGY, SLEEP, HOSPICE & HOME CARE, IMAGING, WOMEN & CHILDREN AND WOUND CARE. MEMBERS OR STOCKHOLDERS FORM 990, PART VI, LINE 6 THE SOLE MEMBER OF THE ORGANIZATION IS FREDERICK REGIONAL HEALTH SYSTEM. Power to elect or appoint members form 990, part vi, line 7a THE SOLE MEMBER, FREDERICK REGIONAL HEALTH SYSTEM, HAS THE POWER TO APPOINT THE PRESIDENT/CEO AND THE DIRECTORS OF FREDERICK MEMORIAL HOSPITAL. Decisions reserved to members or stockholders form 990, part vi, line 7b THE MEMBER, FREDERICK REGIONAL HEALTH SYSTEM, MUST APPROVE THE INCURRENCE OF DEBT IF SUCH DEBT EXCEEDS A CERTAIN AMOUNT TO BE DESIGNATED BY THE MEMBER, CAPITAL EXPENDITURES EXCEEDING A CERTAIN AMOUNT TO BE DESIGNATED BY THE MEMBER, THE DECISION TO DISSOLVE OR LIQUIDATE, THE CREATION OF A SUBSIDIARY, AND AMENDMENTS TO THE BYLAWS. Process used to review the Form 990 form 990, part vi, line 11b THE 990 IS PREPARED IN CONJUNCTION WITH OUTSIDE TAX ACCOUNTANTS AND REVIEWED BY UPPER MANAGEMENT PRIOR TO PROVIDING A COPY TO THE BOARD. A COPY OF FORM 990 IS PROVIDED TO ALL MEMBERS OF THE BOARD PRIOR TO FILING. Monitoring and enforcement of compliance with conflict of interest policy form 990, part vi, line 12c THE FREDERICK MEMORIAL HOSPITAL, INC. BOARD OF DIRECTORS IS COMMITTED TO MEETING ITS FIDUCIARY RESPONSIBILITIES AND MAINTAINING ITS DUTY OF LOYALTY TO THE HOSPITAL AND THE COMMUNITY IT SERVES. TO THIS END, THE BOARD WILL EXERCISE VIGILANCE IN IDENTIFYING ANY CONFLICTS OF INTEREST. THE BOARD WILL ALSO MAINTAIN TRANSPARENCY AND OBJECTIVITY IN MAKING DECISIONS ABOUT CONFLICTS OF INTEREST SO THAT THE ORGANIZATION'S MISSION IS ALWAYS THE FIRST PRIORITY. THE CHAIRPERSON (OR VICE CHAIRPERSON IF THE CHAIR IS INVOLVED) WILL NOTIFY ALL DIRECTORS OF A REPORTED CONFLICT OF INTEREST AND DECIDE WHETHER TO TAKE THE MATTER TO THE FULL BOARD TO DECIDE WHETHER A CONFLICT EXISTS AND, IF SO, WHAT ACTION TO TAKE, OR WILL REFER THE MATTER TO THE GOVERNANCE COMMITTEE FOR AN IN-DEPTH EXAMINATION, SUMMARY, AND RECOMMENDATION PRIOR TO A FULL BOARD DISCUSSION AND DECISION. IF TIME IS OF THE ESSENCE, THE CHAIRPERSON OR VICE CHAIRPERSON WILL TAKE THE MATTER TO THE EXECUTIVE COMMITTEE FOR DISCUSSION AND A DECISION, AND WILL THEN NOTIFY THE FULL BOARD. WHERE A CONFLICT OF INTEREST HAS BEEN IDENTIFIED, THE BOARD MEMBER SHALL NOT VOTE OR BE PRESENT FOR THE DISCUSSION OR THE VOTE REGARDING THE TRANSACTION AT THE FULL BOARD, EXECUTIVE COMMITTEE, OR GOVERNANCE COMMITTEE MEETINGS, EXCEPT TO ANSWER QUESTIONS THAT MAY BE ASKED OF HIM OR HER. TO PREVENT ACTUAL OR PERCEIVED INFLUENCE ON THE BOARD'S DECISION, THE CONFLICTED MEMBER IS PROHIBITED, AFTER INITIAL DISCLOSURE, FROM DISCUSSING THE CONFLICT OF INTEREST EITHER FORMALLY OR INFORMALLY WITH FELLOW DIRECTORS OR WITH MEMBERS OF THE MANAGEMENT. THERE WILL BE AN ANNUAL REVIEW OF ALL BOARD MEMBERS AND OFFICERS TRANSACTIONS PREPARED BY THE ADMINISTRATION AND REVIEWED BY THE GOVERNANCE COMMITTEE AND THE FULL BOARD OF DIRECTORS. AT THAT TIME, ALL DIRECTORS WILL BE REMINDED OF THE IRS INTERMEDIATE SANCTIONS REGULATION THAT ESTABLISHES EXCISE TAXES AS A SANCTION AGAINST ADMINISTRATORS AND DIRECTORS OF TAX-EXEMPT ORGANIZATIONS WHO PARTICIPATE IN 'EXCESS BENEFIT TRANSACTIONS' (E.G., UNREASONABLY HIGH EMPLOYMENT COMPENSATION OR BUSINESS DEALS). Process for determining compensation form 990, part vi, line 15 THE EXECUTIVE COMPENSATION PROGRAM IS DESIGNED TO CARRY OUT THE HEALTH SYSTEM MISSION, TO ACHIEVE THE CHARITABLE PURPOSE, TO ATTRACT, RETAIN, MOTIVATE AND REWARD EXECUTIVE MANAGEMENT, AND TO MAINTAIN A COMPETITIVE POSITION WITH PEER ORGANIZATIONS IN THE REGION. OVERSIGHT OF THE EXECUTIVE COMPENSATION PROGRAM IS PROVIDED BY THE EXECUTIVE COMPENSATION COMMITTEE OF THE BOARD, COMPOSED OF THE BOARD CHAIRMAN, VICE CHAIRMAN, IMMEDIATE PRECEDING CHAIRMAN, CHAIRMAN OF THE FINANCE COMMITTEE AND THE CHAIRMAN OF THE GOVERNANCE COMMITTEE. IN ADDITION TO THE BOARD'S COMPENSATION COMMITTEE, WE UTILIZED AN EXTERNAL INDEPENDENT CONSULTANT AND MARKET SURVEYS FOR ALL EXECUTIVE MANAGEMENT COMPENSATION. THE PRESIDENT AND CEO HAVE A WRITTEN EMPLOYMENT CONTRACT. PROCESS FOR MAKING DOCUMENTS AVAILABLE TO THE PUBLIC FORM 990, PART VI, LINE 19 GOVERNING DOCUMENTS AND THE CONFLICT OF INTEREST POLICY ARE AVAILABLE UPON REQUEST. FREDERICK MEMORIAL HOSPITAL, INC. CONSOLIDATED ANNUAL AUDITED FINANCIAL STATEMENTS ARE AVAILABLE AT WWW.FMH.ORG. Other changes in net assets or fund balances Form 990, Part XI, Line 9 Unrealized loss on interest rate swap (38,881) Pension adjustment (1,678,621) Other 33,623 ----------- (1,683,879) EMMITSBURG PROPERTIES LLC 400 WEST SEVENTH STREET FREDERICK MD 21701 521910823 HLDG INVSTMNT MD -2000 399430 FMH INC HOSPICE OF FREDERICK COUNTY INC 400 WEST SEVENTH STREET FREDERICK MD 21701 521164513 HOSPICE CARE MD 501(c)(3) 9 FRHS true FREDERICK REGIONAL HEALTH SYSTEM INC 400 WEST SEVENTH STREET FREDERICK MD 21701 454133096 HEALTH SYSTEM MD 501(c)(3) 11b NA false MONOCACY HEALTH PARTNERS 400 WEST SEVENTH STREET FREDERICK MD 21701 453007639 PHYSICIAN ORG MD 501(c)(3) 9 FRHS true FREDERICK HEALTH SERVICES CORPORATION 400 WEST SEVENTH STREET FREDERICK MD 21701 521851661 MANAGEMENT CO. 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