2015-05-12T09:16:58-05:00 2014-06-30 GRANT THORNTON LLP 2001 MARKET STREET SUITE 700 PHILADELPHIA PA 19103 990 2013-07-01 520591639 James Lawrence Kernan Hospital Inc % S MICHELLE LEE JAME 4104482500 2200 Kernan Drive Suite Baltimore MD 21207 W W AUGUSTIN III CFO 4104482500 2014-05-05 true FRANK GIARDINI P00532355 4104482500 2013 2016-03-07 17:11:31Z Michael Jablonover 2200 Kernan Drive Baltimore MD 21207 120819482 false X N/A X 1895 MD JAMES L KERNAN HOSPITAL DELIVERS INNOVATIVE, HIGH-QUALITY, AND COST EFFECTIVE REHABILITATION AND SURGICAL SERVICES TO THE COMMUNITY AND REGION. 11 8 773 109 0 0 4513000 1800644 102473566 108350196 1022379 373292 1871380 2037760 109880325 112561892 0 0 0 0 51763733 49302278 0 0 0 54469316 62311795 106233049 111614073 3647276 947819 136743723 150398467 41481656 49366007 95262067 101032460 JAMES L KERNAN HOSPITAL DELIVERS INNOVATIVE, HIGH-QUALITY, AND COST EFFECTIVE REHABILITATION AND SURGICAL SERVICES TO THE COMMUNITY AND REGION. false false 96793982 110387956 THE ORGANIZATION OWNS AND OPERATES A MEDICAL SURGICAL AND REHABILIATION HOSPITAL WITH 132 LICENSED BEDS. THE HOSPITAL PROVIDES CHARITY CARE TO PATIENTS WHO ARE UNABLE TO PAY. SUCH PATIENTS ARE IDENTIFIED BASED ON INFORMATION OBTAINED FROM THE PATIENTS AND SUBSEQUENT ANALYSIS. BECAUSE THE HOSPITAL DOES NOT EXPECT COLLECTION OF AMOUNTS DETERMINED AS CHARITY CARE, THEY ARE NOT REPORTED AS REVENUE BASED ON ESTABLISHED RATES. THE HOSPITAL ESTIMATES THAT $2,626,776 OF CHARITY CARE AT COST WAS PROVIDED IN 2014. OVERALL, THE HOSPITAL DELIVERS INNOVATIVE HIGH QUALITY, COST EFFECTIVE SURGICAL AND REHABILITATION SERVICES TO ITS COMMUNITY. 96793982 true true false true false false false false false false true false false true true true false true false false false false false false false false true true false false true false false false false false false false false false false false false true true true true false false true 80 0 true 773 true false true false false false false false false false false false X 11 8 false false false false true true true true true false false true true true true true true true true false MD X S MICHELLE LEE 4103281376 250 W PRATT STREET 14TH FLOOR Baltimore MD 21201 DAVIS VR SHERMAN CHAIRMAN 1.0 X X 0 0 0 ANTHONY F LEHMAN DIRECTOR 1.0 X 0 0 0 LISA A GLADDEN DIRECTOR 1.0 X 0 0 0 JOHN T CHAY DIRECTOR 1.0 X 0 0 0 ROBERT A CHRENCIK Treasurer 1.0 49.0 X X 0 1735933 246647 HEMA PATEL MD HOSPITALIST 40.0 X 226320 0 26239 ANTHONY T HAWKINS DIRECTOR 1.0 X 0 0 0 WILLIAM PECK DIRECTOR 1.0 X 0 0 0 ANDREW POLLAK DIRECTOR 1.0 X 0 0 0 KAREN E DOYLE DIRECTOR 1.0 X 0 277697 22243 OLIVER STRAVERS JR DIRECTOR 1.0 X 0 0 0 MICHAEL R JABLONOVER CEO 40.0 X 406334 0 23876 W W AUGUSTIN III CFO 40.0 X 259386 0 18834 JUANITA D ROBBINS COO 40.0 X 193779 0 22437 JOHN STRAUMANIS SVP-CMO 40.0 X 262500 0 44964 CHERYL D LEE VP - CNO 40.0 X 203095 0 30262 LORI PATRIA MANAGER- AMBULATORY 40.0 X 141579 0 20974 LOBNA ZADA DENTAL CLINICAL CHIEF 40.0 X 201055 0 15903 THOMAS MERKLE HOSPITALIST 40.0 X 172770 0 19141 NORBERT ROBINSON DIR-PHARMACY 40.0 X 163490 0 22039 MARGARET BEATTY RN - STAFFING & RESOURCE 40.0 X 145764 0 10222 2376072 2013630 523781 63 false true false TURNER CONSTRUCTION 1500 SPRING GARDEN STREET PHILADELPHIA PA 19130 construction mgmt 1372693 ARAMARK HEALTHCARE FOOD LOCKBOX 25271 NETWORK PLACE CHICAGO IL 606731252 FOOD SERVICES 1312843 ARAMARK CORPORATION PO BOX 651009 CHAROLETTE NC 28265 ENVIRONMENTAL SRVC 1025267 MEDI-PHYSICS INC DBA GE HEALTHCARE PO BOX 640200 PITTSBURGH PA 152643458 MEDICAL SERVICES 1004761 BALTIMORE ULTRASOUND 3814 EAST JOPPA ROAD BALTIMORE MD 21236 MEDICAL SERVICES 227345 28 1345147 443437 12060 1800644 PATIENT SERVICE REVENUE 900099 108350196 108350196 108350196 147192 147192 0 0 0 0 0 8483690 8257590 226100 226100 226100 0 0 0 CAF/VENDING 722210 411599 411599 OUTPATIENT PHARMACY 446110 1459213 1459213 MISC 900099 166948 166948 2037760 112561892 110387956 373292 0 0 0 0 2439039 2073183 365856 0 0 37716965 32059420 5657545 1720398 1462338 258060 4588295 3900051 688244 2837581 2411944 425637 0 118042 118042 713558 713558 5378 5378 0 0 10661819 9062546 1599273 264511 224834 39677 604516 513839 90677 2493172 2119196 373976 0 2997360 2547756 449604 58502 49727 8775 0 0 780155 663132 117023 0 4617037 3924481 692556 2108765 1792450 316315 MEDICAL SUPPLIES 15780308 13413262 2367046 BAD DEBT 8877661 8877661 PHYSICAN FEE 8648209 8648209 PURCHASED SERVICES 2452547 2089236 363311 1130255 960717 169538 111614073 96793982 14820091 0 6887050 25635911 0 0 0 0 14670958 16192464 0 0 0 0 0 0 1054308 1188192 0 10000 99144336 53710664 45131779 45433672 6740290 8482652 5297710 5217140 0 0 0 0 56961628 48238436 136743723 150398467 13312096 10740403 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28169560 38625604 41481656 49366007 X 64638067 66896460 30624000 34136000 0 0 95262067 101032460 136743723 150398467 X 947819 4822574 X false true X true X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false true 5378 5378 false Other Activities Schedule C, Part II-B, Line 1i THE ORGANIZATION DOES NOT ENGAGE IN ANY DIRECT LOBBYING ACTIVITIES. THE ORGANIZATION PAYS MEMBERSHIP DUES TO THE 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 6.22% AND 23.65% OF MEMBER DUES WERE USED FOR LOBBYING PURPOSES AND AS SUCH, THE ORGANIZATION HAS REPORTED THIS AMOUNT ON SCHEDULE C PART IV AS LOBBYING ACTIVITIES. 697964 697964 58509630 26631914 31877716 35465835 26580248 8885587 4470907 498502 3972405 45433672 KERNAN ENDOWMENT 31808657 ECONOMIC INT IN UMMS FND 2194160 OTHER A/R 1681365 ASSETS WHOSE USE IS LIMITED 12554254 48238436 0 DUE TO THIRD PARTY 3880283 PATIENT A/R CEDIT BALANCES 981614 FIN 47 ACCRUAL 415068 DUE TO AFFILIATES 22466688 OTHER LIABILITIES 10881951 38625604 X SCHEDULE D, Part X, Line 2 FIN 48 Footnote per Audit Report THE ORGANIZATION IS A SUBSIDIARY OF THE UNIVERSITY OF MARYLAND MEDICAL SYSTEM CORPORATION (THE CORPORATION). THE CORPORATION ADOPTED THE PROVISIONS OF ASC 740, ACCOUNTING FOR UNCERTAINTY IN THE INCOME TAXES (FIN 48) ON JULY 1, 2007. THE FOOTNOTE RELATED TO ASC 740 IN THE CORPORATION'S AUDITED FINANCIAL STATEMENTS IS AS FOLLOWS: THE CORPORATION FOLLOWS A THRESHOLD OF MORE-LIKELY-THAN-NOT FOR RECOGNITION AND DERECOGNITION OF TAX POSITIONS TAKEN OR EXPECTED TO BE TAKEN IN A TAX RETURN. MANAGEMENT DOES NOT BELIEVE THAT THERE ARE ANY UNRECOGNIZED TAX BENEFITS THAT SHOULD BE RECOGNIZED. true true true X true X 500. true true false true true 626776 626776 0.00560 626776 626776 0.00560 162825 162825 0.00150 9183777 9183777 0.08230 381649 116468 265181 0.00240 367970 367970 0.00330 114787 114787 0.00100 10211008 116468 10094540 0.09050 10837784 116468 10721316 0.09610 true 6532335 32363285 31185638 1177647 X true true 1 1 James Lawrence Kernan Hospital 2200 Kernan Drive Baltimore MD 21207 X X Rehabiliation A james lawrence kernan hospital 1 true X X X X X X X X X 12 true true true X http://www.umrehabortho.org/ X X X X X X X X false false true true 200. true 500. true X X X X X X X true true X X X X X X true false X X X X false X X false false James Lawrence Kernan Hospital Schedule H, Part V, Section B Line 20D - All patients are charge state regulated rates regardless of their ability to pay. Line 22 - The State of Maryland is a unique State in regard to the provision of health care services and their related charges by hospitals. All hospital charges processed to all Payors, including Governmental Payors, are set through Maryland's Health Services Cost Commission. Accordingly, all Hospital charges are NOT gross charges as defined by the IRS under Internal Revenue Code section 501(r )(5)(B). Related Organization Report Schedule H, Part I, Line 6a AN ANNUAL COMMUNITY BENEFIT REPORT IS PREPARED FOR EACH FISCAL YEAR ENDING JUNE 30. THIS REPORT IS SUBMITTED TO THE HEALTH SERVICES COST REVIEW COMMISSION (HSCRC), A STATE REGULATORY AGENCY, BY DECEMBER 15 OF EACH YEAR. IN ADDITION, THE ANNUAL COMMUNITY BENEFIT REPORT IS AVAILABLE UPON REQUEST AT THE ENTITY'S CORPORATE OFFICES. Costing Methodology Schedule H, Part I, Line 7A, COLUMN (D) MARYLAND'S REGULATORY SYSTEM CREATES A UNIQUE PROCESS FOR HOSPITAL PAYMENT THAT DIFFERS FROM THE REST OF THE NATION. THE HEALTH SERVICES COST REVIEW COMMISSION, (HSCRC) DETERMINES PAYMENT THROUGH A RATE SETTING PROCESS AND ALL PAYORS, INCLUDING GOVERNMENTAL PAYORS, PAY THE SAME AMOUNT FOR THE SAME SERVICES DELIVERED AT THE SAME HOSPITAL. MARYLAND'S UNIQUE ALL PAYOR SYSTEM INCLUDES A METHOD FOR REFERENCING UNCOMPENSATED CARE IN EACH PAYORS' RATES, WHICH DOES NOT ENABLE MARYLAND HOSPITALS TO BREAKOUT ANY OFFSETTING REVENUE RELATED TO UNCOMPENSATED CARE. SCHEDULE H, LINE 7B, COLUMNS (C) THROUGH (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 OFFSETTING REVENUE RELATED TO UNCOMPENSATED CARE. COMMUNITY BENEFIT EXPENSES ARE EQUAL TO MEDICAID REVENUES IN MARYLAND, AS SUCH, THE NET EFFECT IS ZERO. ADDITIONALLY, NET REVENUES FOR MEDICAID SHOULD REFLECT THE FULL IMPACT ON THE HOSPITAL OF ITS SHARE OF THE MEDICAID ASSESSMENT. SCHEDULE H, LINE 7F COLUMN (C) MARYLAND'S REGULATORY SYSTEM CREATES A UNIQUE PROCESS FOR HOSPITAL PAYMENT THAT DIFFERS FROM THE REST OF THE NATION. THE HEALTH SERVICES COST REVIEW COMMISSION, (HSCRC) DETERMINES PAYMENT THROUGH A RATE SETTING PROCESS AND ALL PAYORS, INCLUDING GOVERNMENTAL PAYORS, PAY THE SAME AMOUNT FOR THE SAME SERVICES DELIVERED AT THE SAME HOSPITAL. MARYLAND'S UNIQUE ALL PAYOR SYSTEM INCLUDES A METHOD FOR REFERENCING UNCOMPENSATED CARE IN EACH PAYORS' RATES, WHICH DOES NOT ENABLE MARYLAND HOSPITALS TO BREAKOUT ANY OFFSETTING REVENUE RELATED TO UNCOMPENSATED CARE. SCHEDULE H, LINE 7F COLUMN (D) MARYLAND'S REGULATORY SYSTEM CREATES A UNIQUE PROCESS FOR HOSPITAL PAYMENT THAT DIFFERS FROM THE REST OF THE NATION. THE HEALTH SERVICES COST REVIEW COMMISSION, (HSCRC) DETERMINES PAYMENT THROUGH A RATE SETTING PROCESS AND ALL PAYORS, INCLUDING GOVERNMENTAL PAYORS, PAY THE SAME AMOUNT FOR THE SAME SERVICES DELIVERED AT THE SAME HOSPITAL. MARYLAND'S UNIQUE ALL PAYOR SYSTEM INCLUDES A METHOD FOR REFERENCING UNCOMPENSATED CARE IN EACH PAYORS' RATES, WHICH DOES NOT ENABLE MARYLAND HOSPITALS TO BREAKOUT ANY OFFSETTING REVENUE RELATED TO UNCOMPENSATED CARE. Community Building Activities Schedule H, Part II The James Lawrence Kernan Hospital provides health information and screenings/events as part of its community health outreach and advocacy work. The hospital has a staff person who is responsible for coordinating and implementing events and participation with the University of Maryland Medical System team events. The following are the initiatives Kernan has undertaken to meet the major health needs pertinent to Kernans specialty patient population and identified in Healthy Baltimore 2015, Marylands State Health Improvement Plan (SHIP) and in the UMMS market research survey. These initiatives have also been identified in Kernans 2012 Community Health Needs Assessment and help to promote the health of the community that it serves. Kernan staff coordinated and participated in the following initiatives that help promote the health of its community: - Chronic Disease: Heart Disease Reduce deaths from heart disease. Initiative 1 Adapted Sports Festival was created to help disabled adults fight obesity and heart disease, diabetes - Chronic Disease: Obesity Reduce the proportion of children and adolescents who are considered obese Initiative 2 Promoting Physical Activity in High Schools through Sports - Healthcare Access Reduce the proportion of individuals who are unable to afford to see a doctor Initiative 3 Support Groups/Patient Education - Chronic Disease Reduce deaths from heart disease. Initiative 4 Take a Loved One to the Doctor Day Targets obesity, diabetes, high blood pressure and cardiac issues. - Healthcare Access - Increase the proportion of children and adolescents who receive dental care Initiative 5 Dental Care for those in Need Bad Debt Expense Schedule H, Part III, Lines 2, 3, and 4 PART III, LINES 2 AND 3: The organization does not code charity care and bad debt expense into the same general ledger account. Charity Care is booked to a separate account and is classified as a "Deduction from Revenue." As such it is netted against Total Patient Revenue in arriving at Net Patient Revenue on the entity's income statements. Bad Debt Expense is booked to a separate account on the general ledger and does not include any other uncompensated care amounts. Part III, Line 4: The provision for bad debts is based upon management's assessment of historical and expected net collections considering historical business and economic conditions, trends in health care coverage, and other collection indicators. Periodically throughout the year, management assesses the adequacy of the allowance for uncollectible accounts based upon historical write off experience by payor category. The results of this review are then used to make modifications to the provision for bad debts and to establish an allowance for uncollectible receivables. After collection of amounts due from insurers, the Corporation follows internal guidelines for placing certain past due balances with collection agencies. Medicare Cost Report Schedule H, Part III, Line 8 In Maryland, The Health Services Cost Review Commission (HSCRC) started setting hospital rates in 1974. At that time, the HSCRC approved rates applied only to commercial insurers. In 1977, the HSCRC negotiated a waiver from Medicare hospital payment rules for Maryland hospitals to bring the federal Medicare payments under HSCRC control. Medicare reimburses Maryland hospitals according to rates established by the HSCRC as long as the State continues to meet a two-part test. This two-part waiver test allows Medicare to participate in the Maryland system as long as two conditions are met. - all other payers participating in the system pay HSCRC set rates and - the rate of growth in Medicare payments to Maryland hospitals from 1981 to the present is not greater than the rate of growth in Medicare payments to hospitals nationally over the same time frame. Collection Practices Schedule H, Part III, Line 9b The organization expects payment at the time the service is provided. Our policy is to comply with all state and federal law and third party regulations and to perform all credit and collection functions in a dignified and respectful manner. Financial assistance is available for patients based on financial need as defined in the Financial Assistance Policy. The organization does not discriminate on the basis of age, race, creed, sex or ability to pay. Patients who are unable to pay may request a Financial Assistance application at any time prior to service or during the billing and collection process. The organization may request the patient to apply for Medical Assistance prior to applying for financial assistance. The account will not be forwarded for collection during the Medical Assistance application process or the Financial Assistance application process. Community Health Care Needs Assessment Schedule H, Part VI, Line 2 According to the Patient Protection and Affordable Care Act (ACA), hospitals must perform a Community Health Needs Assessment (CHNA) either fiscal year 2011, 2012, or 2013, adopt an implementation strategy to meet the community health needs identified, and perform an assessment at least every three years. The needs assessment must take into account input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge of or expertise in public health, and must be made widely available to the public. Community Benefits is a part of our hospitals strategic plan. In addition, stakeholders in the hospital are involved in your hospital community benefit process/structure to implement and deliver community benefit activities which includes the CEO, CFO and Clinical Leaders in Therapy. The Community Benefit Department Committee is comprised of the Sr. Director of Development and Marketing, Director of Service Excellence and Volunteer Services and Director of Outreach. An internal audit (i.e., an internal review) of the Community Benefit report is conducted at the hospital and then by the approved by Hospitals Board. The completed Community Benefit Report is submitted to the HSCRC The Community Health Needs Assessment for the UM Rehab & Ortho was conducted through meetings with health care leaders, faith-based leaders, discussions with area health care stakeholders, and surveys with community residents, hospital visitors and community health fair attendees. Secondary data was used in conjunction with other University of Maryland Medical System (UMMS) Baltimore City hospitals including UMMC, UM Midtown Campus and Mt. Washington Pediatric hospitals. This information was reviewed and compared with statistics available through the State of Marylands Health Improvement Plan, State of Maryland Department of Health and Mental Hygiene data, Baltimore City Health Department Healthy Baltimore 2015, Healthy People 2020 and American Community Survey data. UM Rehab & Ortho has worked with a variety of groups to gather information in order to compile the hospitals Community Health Needs Assessment (CHNA). Information on area health needs was obtained through community meetings with the Baltimore City Health Department Neighborhood Health Initiative, The University of Maryland Medical System Community Health Outreach and Advocacy, UMMS Community Needs Survey, and a meeting with Baltimore City community group stakeholders. UMMS created the University of Maryland Community Health Outreach and Advocacy team that meets bi-monthly to address the health care needs of the West Baltimore community. The group is comprised of community outreach management and staff, social workers, directors, vice presidents, and physicians from UMMS system hospitals. UM Rehab & Ortho, in partnership with UMMS, is a major participant and sponsor in major annual outreach efforts, and sees firsthand the needs of its patient community. In addition to UM Rehab & Orthos participation in UMMS events, additional community outreach initiatives, involving partnerships with both local education and community groups, as well as organizations with specific ties to the disabled community, and the disabilities treated at UM Rehab & Ortho. Stakeholders expressed through roundtable discussion, areas that they felt are important to the community, and needed to be addressed. UMMS outreach team members took note of those items and a discussion followed to address what could occur within the scope of healthcare. Additionally community leaders from the surrounding Baltimore City neighborhoods to UM Rehab & Ortho Hospital attended meetings conducted by the Baltimore City Health Department as a part of its Healthy Baltimore 2015 study. These community members discussed their ideas of what were issues within the community. A survey was also taken to gain input as to what needs the community felt were important. Additionally data was obtained from Healthy People 2020, the Maryland DHMHs State Health Improvement Plan (SHIP), Baltimore City Health Departments 2011 Neighborhood Profiles and Healthy Baltimore 2015 and included to provide national and local context, data, as well as direction for the assessment. UM Rehab & Ortho serves a diverse community, both in terms of diagnosis, as well as location. As a rehabilitation specialty hospital, adult patients are treated for a variety of musculoskeletal issues such as total joint replacement and sports medicine, and rehabilitation issues such as brain injury, spinal cord injury, stroke, and pain management. These patients primarily come from the previously described areas of Anne Arundel, Baltimore and Howard counties, and Baltimore City. Health needs identified through the assessment process include chronic disease such as obesity and access to health care provisions. There are existing health care facilities and resources within the community available to meet the community health needs. They include but are limited to: American Heart Association, American Red Cross, Brain Injury Association of Maryland and US against MS. Our hospital conducted a Community Health Needs Assessment that conforms to the IRS definition in June of 2012, http://www.umrehabortho.org/about/community-health-needs-assessment.htm Our hospital adopted an implementation strategy that conforms to the IRS definitions and may be found at http://www.umrehabortho.org/about/community-health-needs-assessment.htm Eligibility Education Schedule H, Part VI, Line 3 Financial Assistance Policy (FAP) of The University of Maryland Rehabilitation & Orthopaedic Institute. University of Maryland Rehabilitation & Orthopaedic Institute, as a part of the University of Maryland Medical System, provides healthcare services to those in need regardless of an individual's ability to pay. Care may be provided without charge, or at a reduced charge, to those who do not have insurance, Medicare/Medical Assistance coverage, and are without the means to pay. An individual's eligibility to receive care without charge, at a reduced charge, or to pay for their care over time is determined on a case by case basis. Within two days following a patient's request for financial assistance services, application for medical assistance, or both, the hospital makes a determination of probable eligibility. A large percentage of the UM Rehab & Ortho patients are transferred from the Shock Trauma Center or the University of Maryland Hospital. Those who do not have the ability to pay are never turned away and are helped to find resources to cover the costs of their hospital stay and medications with the assistance of UM Rehab & Ortho's Institute case managers. For patients who require financial assistance, UM Rehab & Ortho Institute has endowment funds available to assist people without resources who may need medical supplies or medications. This assistance is available upon request and is reviewed on a case-by-case basis. Information regarding the Financial Assistance Policy at UM Rehab & Ortho Institute is posted within the hospital in clinic areas and business areas where eligible patients are likely to be present. Patients also receive individualized help in obtaining services and care should they not have the ability to pay. Information regarding UM Rehab & Ortho Institute financial assistance policy is provided at the time of preadmission or admission to each person who seeks services at the hospital, including the Patient Handbook. UM Rehab & Ortho Institute makes every effort to ensure that information is provided in languages that is understood by the target population of patients utilizing hospital services. UM Rehab & Ortho Institute makes every effort to make financial assistance information available to our patients including, but not limited to: - Signage in main admitting areas of the hospital are posted in English and Spanish. - Information sheets explaining financial assistance are made available in all patient care areas in English and Spanish. - Information sheets are provided to all patients at the time of admission, explaining the process for payment. If payment cannot be made, options are explained to the patient. - A description of the Financial Assistance Policy is included in the Patient Handbook which is given to all patients admitted to the hospital. POLICY This policy applies to The University of Maryland Medical System (UMMS) following entities: - University of Maryland Medical Center (UMMC) - University of Maryland Rehabilitation & Orthopaedic Institute - University Specialty Hospital (USH) - University of Maryland St. Joseph Medical Center (UMSJMC) UMMS is committed to providing financial assistance to persons who have health care needs and are uninsured, underinsured, ineligible for a government program, or otherwise unable to pay, for medically necessary care based on their individual financial situation. It is the policy of the UMMS Entities to provide Financial Assistance based on indigence or high medical expenses for patients who meet specified financial criteria and request such assistance. The purpose of the following policy statement is to describe how applications for Financial Assistance should be made, the criteria for eligibility, and the steps for processing applications. UMMS Entities will publish the availability of Financial Assistance on a yearly basis in their local newspapers and will post notices of availability at appropriate intake locations as well as the Billing Office. Notice of availability will also be sent to patients to patient with patient bills. Signage in key patient access areas will be made available. A Patient Billing and Financial Assistance Information Sheet will be provided before discharge and will be available to all patients upon request. Financial Assistance may be extended when a review of a patient's individual financial circumstances has been conducted and documented. This should include a review of the patient's existing medical expenses and obligations (including any accounts having gone to bad debt except those accounts that have gone to lawsuit and a judgment has been obtained) and any projected medical expenses. Financial Assistance Applications may be offered to patients whose accounts are with a collection agency and may apply only to those accounts on which a judgment has not been granted. UMMS retains the right in its sole discretion to determine a patient's ability to pay. All patients presenting for emergency services will be treated regardless of their ability to pay. For emergent/urgent services, applications to the Financial Clearance Program will be completed, received, and evaluated retrospectively and will not delay patients from receiving care. University of Maryland St. Joseph Medical Center (UMSJMC) adopted this policy effective June 1, 2013. PROGRAM ELIGIBILITY Consistent with their mission to deliver compassionate and high quality healthcare services and to advocate for those who do not have the means to pay for medically necessary care, UMMC, UMSJMC, JLK, and USH hospitals strive to ensure that the financial capacity of people who need health care services does not prevent them from seeking or receiving care. Specific exclusions to coverage under the Financial Assistance program include the following: 1. Services provided by healthcare providers not affiliated with UMMS hospitals (e.g., durable medical equipment, home health services) 2. Patients whose insurance program or policy denies coverage for services by their insurance company (e.g., HMO, PPO, or Workers Compensation), are not eligible for the Financial Assistance Program. a. Generally, the Financial Assistance Program is not available to cover services that are denied by a patient's insurance company; however, exceptions may be made on a case by case basis considering medical and programmatic implications. 3. Unpaid balances resulting from cosmetic or other non-medically necessary services 4. Patient convenience items 5. Patient meals and lodging Patients may be ineligible for Financial Assistance for the following reasons: 1. Refusal to provide requested documentation or provide incomplete information. 2. Have insurance coverage through an HMO, PPO, Workers Compensation, Medicaid, or other insurance programs that deny access to the Medical Center due to insurance plan restrictions/limits. 3. Failure to pay co-payments as required by the Financial Assistance Program. 4. Failure to keep current on existing payment arrangements with UMMS. 5. Failure to make appropriate arrangements on past payment obligations owed to UMMS (including those patients who were referred to an outside collection agency for a previous debt). 6. Refusal to be screened for other assistance programs prior to submitting an application to the Financial Clearance Program. 7. Refusal to divulge information pertaining to a pending legal liability claim Patients who become ineligible for the program will be required to pay any open balances and may be submitted to a bad debt service if the balance remains unpaid in the agreed upon time periods. Patients who indicate they are unemployed and have no insurance coverage shall be required to submit a Financial Assistance Application unless they meet Presumptive Financial Assistance Eligibility criteria. If the patient qualifies for COBRA coverage, patient's financial ability to pay COBRA insurance premiums shall be reviewed by the Financial Counselor/Coordinator and recommendations shall be made to Senior Leadership. Individuals with the financial capacity to purchase health insurance shall be encouraged to do so, as a means of assuring access to health care services and for their overall personal health. Coverage amounts will be calculated based upon 200-300% of income as defined by federal poverty guidelines and follows the sliding scale included in Attachment A for a Reduced Cost of Care. PRESUMPTIVE FINANCIAL ASSISTANCE Patients may also be considered for Presumptive Financial Assistance Eligibility. There are instances when a patient may appear eligible for financial assistance, but there is no financial assistance form on file. There is adequate information provided by the patient or through other sources, which provide sufficient evidence to provide the patient with financial assistance. In the event there is no evidence to support a patient's eligibility for financial assistance, UMMS reserves the right to use outside age Description of Community Served Schedule H, Part VI, Line 4 The following information details the areas UM Rehab & Ortho serves: Baltimore City, Maryland Baltimore city consists of nine geographical regions: Northern, Northwestern, Northeastern, Western, Central, Eastern, Southern, Southwestern, and Southeastern. The West Baltimore community is nearest to UM Rehab & Ortho Institute, and consists of the Northwestern, Western, and Southwestern districts. The Northwestern district, bounded by the Baltimore County line on its northern and western boundaries, Gwynns Falls Parkway on the south and Pimlico Road on the East, is home to Pimlico Race Course, where the Preakness Stakes takes place each May, and is primarily residential. The Western district, located west of the main commercial district downtown, is the heart of West Baltimore, bounded by Gwynns Falls Parkway, Fremont Avenue, and Baltimore Street. Coppin State University, Mondawmin Mall, and Edmondson Village, all located within this district, have been historic cultural and economic centers of the city's African American community. The Southwestern district is bounded by Baltimore County to the west, Baltimore Street to the north, and the downtown area to the east. Economic and demographic characteristics of Southwestern district vary. Demographics According to the 2010 U.S. Census, the latest data available, there were 621,342 people residing in Baltimore, an increase of .01% since 2010. According to the 2010 U.S. Census, 29.6% of the population was non-Hispanic White, 63.7% non-Hispanic Black or African American, 0.4% non-Hispanic American Indian and Alaska Native, 2.3% non-Hispanic Asian, 0% from some other race (non-Hispanic) and 2.1% of two or more races (non-Hispanic). 4.2% of Baltimore's population was of Hispanic, Latino, or Spanish origin. In the 1990s, the US Census reported that Baltimore ranked as one of the largest population losers alongside Detroit and Washington D.C., losing over 84,000 residents between 1990 and 2000. The same report also estimated these people lived in a total of 294,579 housing units. Age ranges were 22.4% under 18 years old, 11.8% at age 65 or older, and 65.8% from 18 to 64 years old. The city's estimated 2009 population of 637,418 was 53.4% female. A statistical abstract prepared by the U.S. Census Bureau estimated the median income for a household in the city during 2009 at $38,458, with 20.9% of the population below the poverty line. Baltimore County, Maryland A part of the Baltimore-Washington Metropolitan area, Baltimore County is located in the northern part of the state of Maryland. In 2010, the countys population was 805,029. Comprised of approximately 598 square miles, Baltimore County does not have any incorporated cities or towns and is divided into council districts. UM Rehab & Ortho is located on the southwestern border of district 4(Randallstown/Woodlawn/Security) of the county and Baltimore City. Demographics According to the 2010 Census QuickFacts, the latest data available, the population and demographics of Baltimore County were as follows: White persons comprised 64.8 percent of the population, with Black persons accounting for 27 percent of the countys population. American Indian and Alaska Native persons made up .04 percent of the population, Asian population comprised 5.4 percent, with Native Hawaiian and other Pacific Islander at .01 percent. Persons reporting two or more races made up percent of Baltimore Countys population, persons of Hispanic or Latino origin, totaled 4.6 percent. The percent of White persons, not Hispanic was 61.4 percent. There were 315.127 households out of which 30.20% had children under the age of 18 living with them, 49.40% were married couples living together, 12.80% had a female householder with no husband present, and 33.80% were non-families. 27.30% of all households were made up of individuals and 10.10% had someone living alone who was 65 years of age or older. The average household size was and the average family size was 3.00. In the county the population was spread out with 23.60% under the age of 18, 8.50% from 18 to 24, 29.80% from 25 to 44, 23.40% from 45 to 64, and 14.60% who were 65 years of age or older. The median age was 38 years. For every 100 females there were 90.00 males. For every 100 females age 18 and over, there were 86.00 males. The median income for a household in the county was $65,411.00, and the median income for a family was $59,998. Males had a median income of $41,048 versus $31,426 for females. The per capita income for the county was $34,304.0. About 8.2% of the population was below the poverty line, including 7.20% of those under age 18 and 6.50% of those aged 65 or over. Howard County, Maryland Howard County is located in the central part of the Maryland, between Baltimore and Washington, D.C. It is considered part of the Baltimore-Washington Metropolitan Area. According to the 2010 U.S. Census, the latest data available, its population was 299,430. Its county seat is Ellicott City. The center of population of Maryland is located on the county line between Howard County and Anne Arundel County, in the unincorporated town of Jessup. Due to the proximity of Howard County's population centers to Baltimore, the county has traditionally been considered a part of the Baltimore Metropolitan Area. Recent development in the south of the county has led to some realignment towards the Washington, D.C. media and employment markets. The county is also home to Columbia, a major planned community of 100,000 founded by developer James Rouse in 1967. Howard County is frequently cited for its affluence, quality of life, and excellent schools. For 2011, it was ranked the fifth wealthiest county by median household income in the United States by the U.S. Census Bureau. Many of the most affluent communities in the Baltimore-Washington Metropolitan Area, such as Clarksville, Glenelg, Glenwood and West Friendship, are located along the Route 32 corridor in Howard County. The main population center of Columbia/Ellicott City was named 2nd among Money magazine's 2010 survey of "America's Best Places to Live." Howard County's schools frequently rank first in Maryland as measured by standardized test scores and graduation rates. Demographics According to the 2010 U.S. Census, the latest data available, white persons comprised 62.3 percent of the population of Howard County. Black persons made up 18.1 percent. Asian person were 15.7 percent of the population, and American Indian or Alaska Natives were 0.4 percent of the population, persons reporting two or more races comprised 3.6 percent of the countys population, and persons of Hispanic or Latino origin totaled 6.2 percent of the population. There were no reported Native Hawaiian or Pacific Islanders. Median household income was reported at $105,692 and the number of people living below the poverty level was 4.5 percent. Anne Arundel County, Maryland Anne Arundel County is located in the state of Maryland. According to the 2010 U.S. Census, the latest data available its population was 550,488. The county forms part of the Baltimore-Washington metropolitan area. The following information provides demographic data pertaining to Anne Arundel County. Demographics White persons comprised 76.9 percent of the countys population. Black persons totaled 16.1percent. American Indian and Alaska Natives made up 0.4 percent of the countys population, while Asian persons totaled 3.7 percent, native Hawaiian and other Pacific Islanders made up 0.1 percent. Those reporting two or more races totaled 2.8 percent and those reporting Hispanic or Latino origin made up 6.6percent of the population. Median household income of Anne Arundel County residents was reported at $85,690. Persons living below the poverty level were 5.5 percent. Source: US Census Bureau Quick Facts 2010 Significant demographic characteristics and social determinants of the Community Benefit Service Area that are relevant to the needs of the community are as follows: (For purposes of this section, social determinants are factors that contribute to a persons current state of health.) 1. Target Population Baltimore City 621,342: Male 47.1 %; Female 52.9% Anne Arundel County 550,448: Male 49.4%; Female 50.6% Baltimore County 817, 455: Male 47.3%; Female 52.7% Howard County 299, 430: Male 49.1%; Female 50.9% 2. Median Household Income Baltimore City $40,100.00 Anne Arundel County $85,690.00 Baltimore County $65,411.00 Howard County - $105,692.00 Source: US Census 2010 3. Percentage of households with incomes below the federal poverty guidelines Baltimore City 23.4 % Anne Arundel County 5.9% Baltimore County 8.5% Howard County 4.4 % Source: 2012 American Community Survey- US Census 4. Maryland Medical Insurance Statistics Uninsured residents 10 % HMO enrollment 1, 742, 980 Annual employee premium in MD employer-sponsored plan (after employer contribution:) $1115 Average hospital cost per inpatient day (before insura Promoting the Health of the Community Schedule H, Part VI, Line 5 The following information highlights the initiatives UM Rehab & Ortho has undertaken to meet the major health needs pertinent to UM Rehab & Orthos specialty patient population and identified in Healthy Baltimore 2015, Marylands State Health Improvement Plan (SHIP) and in the UMMS market research survey. These initiatives have also been identified in UM Rehab & Orthos 2012 Community Health Needs Assessment and detailed below: Initiative 1 Heart Disease: Reduce deaths from heart disease by encouraging disabled community members to participate in sports and to keep as physically fit as possible, in order to reduce obesity and other health risk factors. Sufficient evidence now exists to recommend that adults with disabilities should also get regular physical activity. The Adapted Sports Festival offers opportunities to participate in hand cycling, bocce ball, wheelchair basketball, a wheelchair slalom course, scuba diving, adapted golf and quad rugby. The Festival was created to help disabled adults fight obesity, heart disease, and diabetes. Approximately 125 community members participated in the adapted sports events. This event marked the fifth year of the initiative. Current and former patients, as well as individuals with disabilities living in the community, attended the event and were encouraged to participate in a range of recreational activities. All activities were supervised by trained staff, taking into account individual needs and abilities. Equipment was adapted as necessary and patients were encouraged to utilize newly developed skills and techniques acquired through rehabilitation. Initiative 2 Chronic Obesity: Reduce the proportion of children and adolescents who are considered obese by providing sports physicals and care to high school students who participate in sports activities. Studies show that regular physical activity reduces risk of depression, diabetes, heart disease, high blood pressure, obesity, stroke, and certain kinds of cancer. Yet, the 2008 Physical Activity Guidelines Advisory Committee notes that data from various national surveillance programs consistently show most adults and youth in the U.S. do not meet current physical activity recommendations, --45% to 50% of adults and 35.8% of high school students say they get the recommended amounts of moderate to vigorous physical activity. Many high school students in the Baltimore and Howard County communities do not have a primary care physician and some do not have the resources to see a doctor to obtain a physical in order to participate in sports. The athletic trainers at UM Rehab & Ortho, as well as many of the sports medicine physicians, donate their time each summer to provide an opportunity for students to see a physician at their school and obtain a free physical in order to participate in athleticsan opportunity for many of these students to remain active in order to reduce obesity. Additionally, the physicians and /or residents in the sports medicine program donate their time to attend athletic contests as team physicians for various schools. Parents and students request that they can bring/arrange for their students to attend these low cost or free physicals; 148 students were screened. Initiative 3 Healthcare Access - Reduce the proportion of individuals who are unable to afford to see a doctor by helping those experiencing a life-changing event, and/or their loved ones to be able to adapt to their new experience with the aid of support groups. UM Rehab & Ortho provides education, serves as an advocate and supports the disability populations within its continuum of care. During FY 2014, UM Rehab & Ortho provided and facilitated monthly support groups for brain injury, stroke, spinal cord injury, amputee, caregivers, total joint replacement, trauma survivors programs and Multiple Sclerosis . In addition to monthly groups UM Rehab & Ortho held an Amputee Walking Clinic. Each group meets monthly or bi-monthly, depending upon needs of the group. Length of meeting varies from 1 2 hours. A total of 1,092 visit to the support groups. A total of 118 attendees came to the Walking Clinic. Initiative 4 Access to Dental Care: To increase the proportion of children and adolescents in need who receive dental care by providing education to children and adults who have limited access to oral health care. Staff visited area schools to instruct students on oral care, as well as participated in community health fairs. The dental clinic staff has formed relationships with dental practices throughout Maryland so that all patients have resources to dental care they need available to them prior to arriving for an appointment. Most area Schools, hospitals, primary care and dental practices throughout the State of Maryland cannot treat special needs children and adults. The UM Rehab & Ortho Dental Clinic saw 9467 patients including disabled and /or low income adults and children in FY 2014. Dental Clinic Staff distributed information on dental care to 323 individuals during school visits and health fairs. Baltimore City community group stakeholders felt access to care, poverty and mental health issues were unaddressed. Other unaddressed needs identified include cancer, mental health issues, HIV/AIDS, STDs, and asthma/lung disease. The members of the UMMS Community Health Outreach and Advocacy team will continue to meet and discuss the items that are currently not being addressed by system hospitals and determine if programs and resources can be allocated to assist in those unaddressed areas. Currently areas are being addressed as resources allow. Many of the health needs mentioned in the first paragraph are met through UMMS community outreach efforts, described in the Community Benefits Implementation Plan section. Available resources to assist in the unaddressed identified needs include: - Baltimore City Health Department - Baltimore City Government - Anne Arundel County Government - Baltimore County Government - Howard County Government - State of Maryland (governmental agencies) - U.S. Health and Human Services Department - Housing Office (HUD) V. PHYSICIANS As required under HG19-303, provide a written description of gaps in the availability of specialist providers, including outpatient specialty care, to serve the uninsured cared for by the hospital. Gap Coverage The UM Rehab & Ortho is a specialty hospital that offers total joint surgery, non-operative management of back pain, the latest minimally invasive techniques for shoulder surgery, integrative medicine, and leadership in sports medicine and pediatric orthopaedics. The hospitals expert staff treats a full range of rehabilitative issues resulting from stroke, spinal cord injuries, traumatic brain injuries and neurological disorders. As an orthopaedic and rehabilitation specialty hospital, UM Rehab & Ortho does not have an emergency department. It is classified as a Level IV emergency service facility. Appropriate referral to an acute care facility capable of providing continued emergency services are made if necessary Visitors and outpatients who suffer cardiopulmonary arrest will have emergent care initiated by the code blue team and then will be transported to an emergency room via 911. All inpatients requiring treatment by the code blue team will be transported, with monitoring, to the Intensive Care Unit at UM Rehab & Ortho at the discretion of the team leader. In consultation, the intensivist and service attending will make the determination regarding patient transport to a tertiary care facility. UM Rehab & Ortho has a rapid response team that will respond to calls regarding visitors/patients who need emergent care or rapid management outside of the critical care setting. The rapid response team consists of a respiratory therapist, registered nurse, intensivist (day shift only) and hospitalist. 1. If you list Physician Subsidies in your data in category C of the CB Inventory Sheet, please indicate the category of subsidy, and explain why the services would not otherwise be available to meet patient demand. The categories include: Hospital-based physicians with whom the hospital has an exclusive contract; Non-Resident house staff and hospitalists; Coverage of Emergency Department Call; Physician provision of financial assistance to encourage alignment with the hospital financial assistance policies; and Physician recruitment to meet community need. Affiliated Health Care System Roles Schedule H, Part VI, Line 6 The James Lawrence Kernan Hospital is a part of the University of Maryland Medical System (UMMS) and participates on the UMMS Community Health Outreach and Advocacy team. UMMS created the University of Maryland Community Health Outreach and Advocacy team to address the health care needs of the West Baltimore community. The group is comprised of community outreach management and staff, social workers, directors, vice presidents, and physicians from UMMS system hospitals. The group determines what needs are addressed as well as community involvement and activities each year. UMMC participates in this Advocacy Team and representatives In addition to the identified UMMS priorities, Kernan senior leaders and community outreach staff meet to determine annual goals and activities. Kernan, in partnership with UMMS, was a major participant and sponsor in major annual outreach efforts. state filing of community benefit report Schedule H, part VI, Line 7 Maryland X true true X X X X false true false false false false false true false ROBERT A CHRENCIK Treasurer 0 1173854 0 543595 0 18484 0 236346 0 10301 0 1982580 0 0 HEMA PATEL MD HOSPITALIST 225997 0 0 0 323 0 11556 0 14683 0 252559 0 0 0 KAREN E DOYLE DIRECTOR 0 214168 0 41763 0 21766 0 8567 0 13676 0 299940 0 0 MICHAEL R JABLONOVER CEO 286856 0 67039 0 52439 0 10200 0 13676 0 430210 0 0 0 W W AUGUSTIN III CFO 207868 0 27732 0 23786 0 8533 0 10301 0 278220 0 0 0 JUANITA D ROBBINS COO 162652 0 30330 0 797 0 21207 0 1230 0 216216 0 0 0 JOHN STRAUMANIS SVP-CMO 227797 0 25622 0 9081 0 30281 0 14683 0 307464 0 0 0 LORI PATRIA MANAGER- AMBULATORY 120682 0 20760 0 137 0 6291 0 14683 0 162553 0 0 0 LOBNA ZADA DENTAL CLINICAL CHIEF 185301 0 15049 0 705 0 9406 0 6497 0 216958 0 0 0 THOMAS MERKLE HOSPITALIST 172648 0 0 0 122 0 8840 0 10301 0 191911 0 0 0 NORBERT ROBINSON DIR-PHARMACY 141984 0 21332 0 174 0 7356 0 14683 0 185529 0 0 0 MARGARET BEATTY RN - STAFFING & RESOURCE 145640 0 0 0 124 0 4010 0 6212 0 155986 0 0 0 CHERYL D LEE VP - CNO 183021 0 17267 0 2807 0 24050 0 6212 0 233357 0 0 0 Health or social club dues or initiation fees Schedule J, Part I, Line 1a UMMS executives receive a benefit package wihich may be used towards health club dues or other health maintenance programs. Such benefits are capped at $7,000, $5,000 or $3,000 depending on job title as described in the program documents. Supplemental Nonqualified Retirement Plan Schedule J, Part I, Line 4b During the Fiscal Year ended June 30, 2014, certain officers and key employees participated in the University of Maryland Medical System (UMMS) Supplemental Nonqualified Retirement Plan. The individuals listed below have not vested in the plan therefore the accrued contribution to the plan for the Fiscal Year is reported on Schedule J, Part II, Column C, Retirement and Other Deferred Compensation: Robert A. Chrencik, Juanita D. Robbins, John Straumanis & Cheryl D. Lee. During the Fiscal Year,ended June 30, 2014, certain officers and key employees participated in the University of Maryland Medical System (UMMS) Supplemental Nonqualified Retirement Plan. The individuals listed below have vested in the plan in a prior year, therefore the contributions to the plan for the Fiscal Year are reported as taxable compensation and reported on Schedule J, Part II, Line B(III), Other Reportable Compensation: Michael R. Jablonover,W.W. Augustin III, and karen doyle. Non Fixed Compensation Schedule J, Part I, Line 7 Bonuses paid are based on a number of variables including but not limited to individual goal achievements as well as organization operation achievements. The final determination of the bonus amount is determined and approved by the Board as part of the overall compensation review of the officers and key employees. Members or Stockholders Form 990, Part VI, Line 6, 7a & 7b UNIVERSITY OF MARYLAND MEDICAL SYSTEM CORPORATION (UMMS) IS THE SOLE MEMBER OF JAMES LAWRENCE KERNAN HOSPITAL (JLK). UMMS MAY ELECT ONE OR MORE BOARD MEMBERS OF THE GOVERNING BODY AND ALL DECISIONS OF THE GOVERNING BODY MUST BE APPROVED BY UMMS. Form 990 Review Process Form 990, Part VI, Line 11b THE I.R.S. FORM 990 IS PREPARED AND REVIEWED BY THE ACCOUNTING FIRM OF GRANT THORNTON. ACCOUNTING PERSONNEL IN FINANCE SHARED SERVICES AT THE UNIVERSITY OF MARYLAND MEDICAL SYSTEM GATHER THE INFORMATION NEEDED TO COMPLETE THE RETURN AND INPUT THE DATA INTO THE GRANT THORNTON TAX ORGANIZER. WHEN ALL DATA HAS BEEN ENTERED, THE INFORMATION IS SUBMITTED TO GRANT THORNTON FOR IMPORTATION INTO THEIR TAX SOFTWARE. AT THIS POINT, GRANT THORNTON STAFF MEMBERS REVIEW THE DATA, ASK FOR ADDITIONAL INFORMATION IF NEEDED AND PREPARE THE TAX RETURN. EACH RETURN IS REVIEWED AT SEVERAL LEVELS AT GRANT THORNTON INCLUDING THE TAX PARTNER. AFTER THEIR REVIEW PROCESS, A DRAFT RETURN IS SENT TO THE ACCOUNTING STAFF AT UMMS FOR AN IN-HOUSE REVIEW. UPON COMPLETION OF THE IN-HOUSE REVIEW, GRANT THORNTON IS INSTRUCTED TO MAKE ANY NECESSARY CHANGES AND TO PREPARE THE FINAL TAX RETURN. THE FINAL RETURN UNDERGOES ANOTHER REVIEW BY THE ACCOUNTING STAFF AT FINANCE SHARED SERVICES AND IS ALSO REVIEWED BY THE ACCOUNTING MANAGER, THE DIRECTOR OF FINANCIAL REPORTING, THE VICE PRESIDENT OF FINANCE AND THE CFO, WHO SIGNS THE RETURN. PRIOR TO FILING THE I.R.S. FORM 990, THE ORGANIZATION'S BOARD CHAIRMAN, TREASURER, AUDIT COMMITTEE CHAIRMAN, EXECUTIVE COMMITTEE CHAIRMAN OR OTHER MEMBER OF THE BOARD WITH SIMILAR AUTHORITY WILL REVIEW THE I.R.S. FORM 990. AT THE DISCRETION OF THE REVIEWING BOARD MEMBER, SUCH MEMBER WILL BRING ANY ISSUES OR QUESTIONS RELATED TO THE COMPLETED I.R.S. FORM 990 TO THE ATTENTION OF THE BOARD. NOTWITHSTANDING THE ABOVE, A BOARD RESOLUTION IS NOT REQUIRED FOR THE FILING OF THE ORGANIZATION'S I.R.S. FORM 990. EACH BOARD MEMBER IS PROVIDED WITH A COPY OF THE FINAL I.R.S. FORM 990 BEFORE FILING. Conflict of Interest Policy Monitoring & Enforcement Form 990, Part VI, Line 12c THE ORGANIZATION'S OFFICERS, DIRECTORS, EMPLOYEES AND MEDICAL STAFF MEMBERS, AS APPLICABLE, SHALL DISCLOSE CONFLICTS OF INTEREST OR POTENTIAL CONFLICTS OF INTEREST BETWEEN THEIR PERSONAL INTERESTS AND THE INTERESTS OF THE ORGANIZATION, OR ANY ENTITY CONTROLLED BY OR OWNED IN SUBSTANTIAL PART BY THE ORGANIZATION. A QUESTIONNAIRE WHICH DISCLOSES POTENTIAL CONFLICTS OF INTEREST IS DISTRIBUTED ANNUALLY TO ALL OFFICERS, DIRECTORS AND KEY EMPLOYEES. THE GENERAL COUNSEL OF THE UNIVERSITY OF MARYLAND MEDICAL SYSTEM CORPORATION (UMMSC) REVIEWS THE RESPONSES FOR UMMSC AND JAMES LAWRENCE KERNAN HOSPITAL. THE CEO OR CFO OF EACH OF THE OTHER ENTITIES IN THE UNIVERSITY OF MARYLAND MEDICAL SYSTEM REVIEWS THE RESPONSES FOR THOSE ENTITIES. THE GENERAL COUNSEL, IN CONSULTATION WITH THE AUDIT COMMITTEE, IF NECESSARY, WOULD DETERMINE IF A CONFLICT OF INTEREST EXISTED FOR UMMSC OR JAMES LAWRENCE KERNAN HOSPITAL. WITH RESPECT TO THE OTHER ENTITIES IN THE UNIVERSITY OF MARYLAND MEDICAL SYSTEM, THE GENERAL COUNSEL MAY BE CALLED FOR CONSULT. IF SO, THE GENERAL COUNSEL MAY CONSULT THE AUDIT COMMITTEE, IF NECESSARY. WHENEVER A CONFLICT OR POTENTIAL CONFLICT OF INTEREST EXISTS, THE NATURE OF THE CONFLICT OR POTENTIAL CONFLICT OF INTEREST MUST BE DISCLOSED IN WRITING TO THE ORGANIZATION'S BOARD, BOARD COMMITTEE, AN OFFICER OF THE ORGANIZATION OR OTHER APPROPRIATE EXECUTIVE. SUCH INDIVIDUAL HAVING A POTENTIAL CONFLICT OF INTEREST SHALL PLAY NO ROLE ON BEHALF OF THE ORGANIZATION, OR ANY ORGANIZATION CONTROLLED OR SUBSTANTIALLY OWNED, IN ANY TRANSACTION IN WHICH A CONFLICT EXISTS. ALL INVITATIONS FOR BIDS, PROPOSALS OR SOLICITATIONS FOR OFFERS INCLUDE THE FOLLOWING PROVISION: ANY VENDOR, SUPPLIER OR CONTRACTOR MUST DISCLOSE ANY ACTUAL OR POTENTIAL TRANSACTION WITH ANY ORGANIZATION OFFICER, DIRECTOR, EMPLOYEE OR MEMBER OF THE MEDICAL STAFF, INCLUDING FAMILY MEMBERS WITHIN FIVE DAYS OF THE TRANSACTION. FAILURE TO COMPLY WITH THIS PROVISION IS A MATERIAL BREACH OF AGREEMENT. IN ADDITION, A BOARD DISCLOSURE REPORT IS FILED WITH THE MARYLAND HEALTH SERVICES COST REVIEW COMMISSION ON AN ANNUAL BASIS SHOWING ANY BUSINESS TRANSACTIONS BETWEEN THE BOARD MEMBERS AND THE ORGANIZATION. Process for Determining Compensation Form 990, Part VI, Lines 15a & 15b THE ORGANIZATION DETERMINES THE EXECUTIVE COMPENSATION PAID TO ITS EXECUTIVES IN THE FOLLOWING MANNER PRESCRIBED IN THE I.R.S. REGULATIONS: EXECUTIVE COMPENSATION PACKAGES ARE DETERMINED BY A COMMITTEE OF THE BOARD THAT IS COMPOSED ENTIRELY OF BOARD MEMBERS WHO HAVE NO CONFLICT OF INTEREST. THE COMMITTEE ACQUIRES CREDIBLE COMPARABILITY MARKET DATA CONCERNING THE COMPENSATION PACKAGES OF SIMILARLY SITUATED EXECUTIVES. THE COMMITTEE CAREFULLY REVIEWS THAT DATA, THE EXECUTIVE'S PERFORMANCE AND THE PROPOSED COMPENSATION PACKAGES DURING THE DECISION MAKING PROCESS. THE COMMITTEE MEMORIALIZES ITS DELIBERATIONS IN DETAILED MINUTES REVIEWED AND ADOPTED AT THE NEXT-FOLLOWING MEETING. THE COMMITTEE SEEKS AN OPINION OF COUNSEL THAT IT HAS MET THE REQUIREMENTS OF THE I.R.S. INTERMEDIATE SANCTIONS REGULATIONS. THIS PROCESS IS USED TO DETERMINE THE COMPENSATION PACKAGES FOR ALL MANAGEMENT EMPLOYEES FROM THE VICE PRESIDENT LEVEL AND UP. How Documents are Made Available to the Public Form 990, Part VI, Line 19 IN GENERAL, FINANCIAL AND TAX INFORMATION RELATING TO THE ORGANIZATION IS DEEMED PROPRIETARY AND NOT SUBJECT TO DISCLOSURE UPON REQUEST. HOWEVER, SPECIFIC PROVISIONS OF FEDERAL AND STATE LAW REQUIRE THE ORGANIZATION TO DISCLOSE CERTAIN LIMITED FINANCIAL AND TAX DATA UPON A SPECIFIC REQUEST FOR THAT INFORMATION. REQUESTS FOR FORM 990 AND FORM 1023: A REQUESTOR SEEKING TO REVIEW AND/OR OBTAIN A COPY OF THE ORGANIZATION'S IRS FORM 990 OR FORM 1023 AS FILED WITH THE INTERNAL REVENUE SERVICE, INCLUDING ALL SCHEDULES AND ATTACHMENTS, MAY APPEAR IN PERSON OR SUBMIT A WRITTEN REQUEST. THE MOST RECENT THREE YEARS OF IRS FORM 990 MAY BE REQUESTED. IF THE REQUESTER APPEARS IN PERSON, THE INDIVIDUAL IS DIRECTED TO THE OFFICE OF THE CHIEF FINANCIAL OFFICER FOR THE ORGANIZATION AND THE FORM 990 AND/OR FORM 1023 ARE MADE AVAILABLE FOR INSPECTION. THE INDIVIDUAL IS PERMITTED TO REVIEW THE RETURN, TAKE NOTES AND REQUEST A COPY. IF REQUESTED, A COPY IS PROVIDED ON THE SAME DAY. A NOMINAL FEE IS CHARGED FOR MAKING THE COPIES. THE ORGANIZATION MAY HAVE AN EMPLOYEE PRESENT DURING THE PUBLIC INSPECTION OF THE DOCUMENT. WRITTEN REQUESTS FOR AN ENTITY'S FORM 990 OR FORM 1023 ARE DIRECTED IMMEDIATELY TO THE OFFICE OF THE CHIEF FINANCIAL OFFICER FOR THE ORGANIZATION. THE REQUESTED COPIES ARE MAILED WITHIN 30 DAYS OF THE REQUEST. REPRODUCTION FEES AND MAILING COSTS ARE CHARGED TO THE REQUESTOR. CONFLICT OF INTEREST POLICY AND GOVERNING DOCUMENTS: IF THE GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY OF OUR ORGANIZATION ARE SUBJECT TO THE FEDERAL PUBLIC DISCLOSURE RULES (OR STATE PUBLIC DISCLOSURE RULES), THESE DOCUMENTS WILL BE MADE PUBLICLY AVAILABLE AS APPLICABLE LAW MAY REQUIRE. OTHERWISE, THE GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY WILL BE PROVIDED TO THE PUBLIC AT THE DISCRETION OF MANAGEMENT. Tax Exempt Bond Issue Part IV, Line 24a Pursuant to a Master Loan Agreement dated June 20, 1991 (The "Master Loan Agreement"), as Amended, The University Of Maryland Medical System Corporation (The "Corporation") and several of its subsidiaries have issued debt through the Maryland Health and Higher Education Facility Authority (the "Authority"). As Security for the performance of the bond obligation under the Master Loan Agreement, The Authority maintains a security interest in the revenue of the obligors. The Master Loan Agreement contains certain restrictive covenants. These covenants require that rates and charges be set at certain levels, limit incurrence of additional debt, require compliance with certain operating ratios and restrict the disposition of assets. The obligated group under the Master Loan Agreement includes the Corporation, The James Lawrence Kernan Hospital, Inc., Maryland General Hospital, Inc., Baltimore Washington Medical Center, Inc., Shore Health System, Inc., Chester River Hospital Center, Inc., Civista Medical Center, Inc., University of Maryland St. Joseph Medical Center, LLC, Upper Chesapeake Medical Center, Inc., Harford Memorial Hospital, Inc. and the University of Maryland Medical System Foundation, Inc. Each member of the obligated Group is jointly and severally liable for the repayment of the obligations under the Master Loan Agreement of the Corporation's $1,457,870,000 of outstanding Authority Bonds on June 30, 2014. All of the bonds were issued in the name of the University of Maryland Medical System Corporation and are reported on Schedule K of its Form 990. Hours on Related Entities PART VII, SECTION A, COLUMN (B) THE UNIVERSITY OF MARYLAND MEDICAL SYSTEM (UMMS) IS A MULTI-ENTITY HEALTH CARE SYSTEM THAT INCLUDES 11 ACUTE CARE HOSPITALS, 1 ACUTE CARE HOSPITAL OWNED IN A JOINT VENTURE ARRANGEMENT AND VARIOUS SUPPORTING ENTITIES. A NUMBER OF INDIVIDUALS PROVIDE SERVICES TO VARIOUS ENTITIES WITHIN THE SYSTEM. IN GENERAL, THE OFFICERS AND KEY EMPLOYEES OF UMMS AVERAGE IN EXCESS OF 40 HOURS PER WEEK SERVING THE DIFFERENT ENTITIES THAT COMPRISE UMMS. Reconciliation of Net Assets Form 990, Part XI, Line 9 Unrealized Gain $1,309,994 Change in economic interest of UMMS Foundation $363,722 Change in economic interest of kernan Endowment $3,148,858 --------------- Total Other Changes in Net Assets $4,822,574 Shipley's Physical Therapy Center LLC 2200 Kernan Drive Baltimore MD 21207 522061788 Healthcare MD 612000 3000 JLK UM Rehab Institute of Southern Maryland 2200 Kernan Drive Baltimore MD 20207 Healthcare MD JLK Baltimore Washington Emergency Phys Inc 301 Hospital Drive Glen Burnie MD 21061 521756326 Healthcare MD 501(c)(3) 11A BWMS false Baltimore Washington Healthcare Services 301 Hospital Drive Glen Burnie MD 21061 521830243 Healthcare MD 501(c)(3) 11A BWMS false Baltimore Washington Medical Center Inc 301 Hospital Drive Glen Burnie MD 21061 520689917 Healthcare MD 501(c)(3) 03 BWMS false UM Baltimore Washington Medical System 301 Hospital Drive Glen Burnie MD 21061 521830242 Healthcare MD 501(c)(3) 11A UMMSC false BW Medical Center Foundation Inc 301 Hospital Drive Glen Burnie MD 21061 521813656 Fundraising MD 501(c)(3) 11A BWMS false North Arundel Development Corporation 301 Hospital Drive Glen Burnie MD 21061 521318404 Real Estate MD 501(c)(2) NCC false North County Corporation 301 Hospital Drive Glen Burnie MD 21061 521591355 Real Estate MD 501(c)(2) BWMS false Shipleys Choice Medical Park Inc 22 South Greene Street Baltimore MD 21201 043643849 Real Estate MD 501(c)(2) NCC false Chester River Health Foundation Inc 100 Brown Street Chestertown MD 21620 521338861 Fundraising MD 501(c)(3) 08 CRHS false Univ of MD Shore Regional HealthInc 100 Brown Street Chestertown MD 21620 522046500 Healthcare MD 501(c)(3) 11A UMMSC false Chester River Hospital Center 100 Brown Street Chestertown MD 21620 520679694 Healthcare MD 501(c)(3) 03 CRHS false Chester River Manor Inc 200 Morgnec Road Chestertown MD 21620 526070333 Healthcare MD 501(c)(3) 09 CRHS false Maryland General Clinical Practice Group 827 Linden Avenue Baltimore MD 21201 521566211 Healthcare MD 501(c)(3) 11B MGHS false Maryland General Comm Health Foundation 827 Linden Avenue Baltimore MD 21201 522147532 Fundraising MD 501(c)(3) 11C MGHS false University of Maryland Midtown Health 827 Linden Avenue Baltimore MD 21201 521175337 Healthcare MD 501(c)(3) 11B UMMSC false Maryland General Hospital Inc 827 Linden Avenue Baltimore MD 21201 520591667 Healthcare MD 501(c)(3) 03 MGHS false Care Health Services Inc 219 South Washington Street Easton MD 21601 521510269 Healthcare MD 501(c)(3) 09 SHS false Dorchester General Hospital Foundation 219 South Washington Street Easton MD 21601 521703242 Fundraising MD 501(c)(3) 11D SHS false Memorial Hospital Foundation Inc 219 South Washington Street Easton MD 21601 521282080 Fundraising MD 501(c)(3) 11A SHS false Shore Clinical Foundation Inc 219 South Washington Street Easton MD 21601 521874111 Healthcare MD 501(c)(3) 03 SHS false Shore Health System Inc 219 South Washington Street Easton MD 21601 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