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      <ActivityOrMissionDescription>Meritus Medical Center, Inc. (MMC) is an acute care hospital located in Hagerstown, Maryland and serves the residents of western Maryland, southern Pennsylvania and the panhandle of West Virginia.</ActivityOrMissionDescription>
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      <MissionDescription>MissionMMC exists to improve the health status of our region by providing comprehensive health services to patients and families.The mission emphasizes three core activities of MMC:1. Providing patient and family centered care by bringing patient and family perspectives into the planning, delivery, and evaluation of care to improve healthcare quality and safety at MMC.2. Improving the health status of our region by responding to national healthcare reform and total patient revenue economic structures that incentivize value by expanding the focus of MMC to include improving the health staus of our region.3. Functioning as a regional health system by meeting the healthcare needs of the communities beyond MMC's traditional service area of Washington County.VisionMMC will relentlessly pursue excellence in quality, service, and performance.ValuesThe culture of MMC is driven by the values of teamwork, stewardship, accountability, integrity, advocacy, and innovation.</MissionDescription>
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      <Description>The mission, vision and values of the Meritus Medical Center (MMC) are summarized in MMC's pledge: Responsiveness to need. Excellence in Caring. Respect for All. The pledge says that MMC strives to meet the healthcare needs of the citizens of the tri-state region, is dedicated to providing quality patient care in a safe and caring environment and that MMC esteems the personal diginity of patients and staff.Every day, the hospital's employees live out MMC's values by treating others as they would like to be treated. MMC participates in a variety of activities that focus on the well-being of the patients, including committees and teams that evaluate the progress in the areas of quality patient care, patient safety and professional development. Many staff members provide outreach to the community through educational offerings which have been identified by a survey of community health education needs.MMC is a vibrant healthcare facility, where dedicated staff engages patients and their families in their care, promoting a partnership that leads to improved patient outcomes. At the same time, employees work together to plan a future that focuses on the well-being of the citizens of the tri-state region.As a tax exempt hospital, MMC contributes funds to help many people who might not be able to afford their healthcare. These dollars are used to provide free, reduced-cost or subsidized services to many individuals in the community. It's a collaborative effort involving numerous areas of the health system in activities such as health education and outreach, screenings, programs and events, as well as helping individuals obtain prescription medications, access to needed services, and even transportation to healthcare appointments.MMC is governed by a local board of directors made up entirely of volunteers. In addition to attending quarterly meetings to determine the direction that MMC will take, the board members, who are community and business leaders as well as physicians, serve on various committees, including quality, finance and capital, audit and business integrity, compensation, and governance.The board and its committees ensure that MMC complies with state and federal requirements, while keeping the organization's mission of providing quality care front and center. By working together toward this goal, the board members create policies and procedures that help deliver results.Meritus Health - the largest healthcare provider in Western Maryland - is located at the crossroads of Western Maryland, southern Pennsylvania, and the Eastern Panhandle of West Virginia. As the largest employer in Washington County, it has a deep understanding of the needs of the community. Its programs span the continuum of healthcare, ranging from impatient care to occupational health services to physician practices and outpatient care. The system delivers patient care through two primary components, MMC and MEI. Located in Hagerstown, MMC, an acute care hospital has 265 single-patient rooms, along with the most advanced technologies available. Services include a special care nursery, a level III trauma program, a primary stroke center, a wound center, as well as a cardiac diagnostic laboratory. Other hospital services that address outpatient needs continue to be available, such as the John R. Marsh Cancer Center, Total Rehab Care, the Center for Clinical Research, and the Center for Bariatric Surgery.State-of-the-art medical technologies at MMC include new technologies such as advanced 3T magnetic resonance imaging, single-photo-emission computed tomography (SPECT) scanners, and cardiac interventions. Patients will benefit from the convenient location of MMC, which is adjacent to the Robinwood Professional Center, operated by MEI. With this proximity, patients can take advantage of an array of both inpatient and outpatient services. The medical mall houses a pharmacy, medical laboratory, an urgent care clinic, surgery centers,and diagnostic imaging services. In addition, there are numerous physician practices, offering a wide variety of medical specialties.MEI, an affiliate of MH, is a leading provider in ambulatory health care services in the tri-state region. Its mission is to engage in ambulatory health activities that complement the goals and objectives of MH. MEI vigorously recruits physicians and other healthcare providers to the region, to assure an adequate supply of physicians in many medical specialties. MEI has a very successful record of joint-venture relationships with physicians that has greatly benefited the wellbeing of tri-state area residents. MEI includes a number of businesses and medical practices. It maintains two urgent care clinics in Hagerstown. The urgent care clinics work closely with primary care physicians, caring for patients with minor illnesses or injuries. Because numerous patients can be seen at these clinics, local physicians have more time to spend with regularly-scheduled patients in their offices. Tri-State Health Partners (THP) is a physician hospital organization (PHO) owned by more than 200 physicians and MMC. This partnership enhances the ability of its physician owners and the medical center to focus on technology and initiatives to improve quality and patient care outcomes in the community.THP's mission is to be the region's most comprehensive healthcare solutions company, fostering collaboration with community practitioners and providers to create a fully-integrated medical care delivery system.Clinical integration engages THP physicians in a cooperative effort to improve the quality of healthcare and the cost-effectiveness of healthcare services. MHF is a private, not-for-profit, tax-exempt organization managed by a volunteer board of community leaders whose mission is to support hospital programs and services, scientific research, equipment, technology, medical training and community education. The foundation is an integral part of the overall health system organization, and contributions have a direct impact on the quality of care MH is able to provide. The Foundation Board of Directors works closely with the MH boards and leadership to match resources with MH needs, enabling caregivers to provide the very best care possible every single day.MMC offers a variety of specialized services to meet the healthcare needs of the tri-state region.The Cardiac Catheterization Lab has focused on bringing the very best in cardiac services to the community. Services in cardiac screening, diagnosis, intervention, and rehabilitation are offered. MMC has invested in the most up-to-date technologies to assist physicians in diagnosing and treating heart disease. The board certified cardiologists and interventional cardiologists offer patients a highly specialized experience in structual heart disease and electrical heart malfunctions. They are supported by a team of highly-trained nurses and technicians.The Center for Clinical Research is a growing program that manages from fifteen to twenty active research studies at any given time. The researchers are certified by the Association of Clinical Research Professionals. Physicians serve as the principal investigators for the research studies performed by the center.The Center for Joint Replacement offers a comprehensive program that includes pre- and postoperative therapy as well as the actual surgery. The program has clearly demonstrated a decreased length of hospital stay and improved recovery rates.The Family Birthing Center is a special place where single-room maternity care provides privacy and family bonding. The room is equipped for labor, delivery, postpartum, and newborn care. The special care nursery allows babies born as early as 32 weeks gestation to be treated at MMC.The Home Health Care Services cover the full spectrum of care, ranging from skilled nursing to assistance with the activities of daily living. They also can help with medication management issues.The John R. Marsh Cancer Center offers chemotherapy, intensity modulated radiation therapy, and image guided radiation therapy. The center also offers MammoSite whichdelivers partial irradiation treatment for breast cancer patients in just five days.Total Rehab Care is a comprehensive service providing a full range of rehabiliation programs, including pediatric services, traumatic brain injury rehab, outpatient therapies, inpatient joint replacement, occupational rehabiliation, and support groups. Skilled physicians, nurses, and therapists develop individualized treatment plans for every patient.As a level III trauma service, MMC offers twenty four hour a day, seven days a week access to trauma surgeons, neurosurgeons, and orthopedic surgeons, as well as a specialized trauma team and consulting physicians.The Weight Loss Clinic offers bariatric surgery which includes the most common procedures of gastric bypass and adjustable gastric banding. 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        <OtherCostOrOtherBasis>176246652</OtherCostOrOtherBasis>
        <Depreciation>17777547</Depreciation>
        <BookValue>158469105</BookValue>
      </Buildings>
      <LeaseholdImprovements>
        <OtherCostOrOtherBasis>13597663</OtherCostOrOtherBasis>
        <Depreciation>1044075</Depreciation>
        <BookValue>12553588</BookValue>
      </LeaseholdImprovements>
      <Equipment>
        <OtherCostOrOtherBasis>167607125</OtherCostOrOtherBasis>
        <Depreciation>82005057</Depreciation>
        <BookValue>85602068</BookValue>
      </Equipment>
      <OtherLandBuildings>
        <OtherCostOrOtherBasis>584426</OtherCostOrOtherBasis>
        <BookValue>584426</BookValue>
      </OtherLandBuildings>
      <TotalOfBookValueLandBuildings>259198787</TotalOfBookValueLandBuildings>
      <OtherAssets>
        <Description>Net assets held by MHF</Description>
        <BookValue>3846164</BookValue>
      </OtherAssets>
      <OtherAssets>
        <Description>Assets held by trustee-debt &amp; construct.</Description>
        <BookValue>29170115</BookValue>
      </OtherAssets>
      <TotalBookValueOtherAssets>51462887</TotalBookValueOtherAssets>
      <OtherLiabilities>
        <Description>Accrued retirement benefits</Description>
        <Amount>1064856</Amount>
      </OtherLiabilities>
      <TotalOfAmounts>1064856</TotalOfAmounts>
      <Form990ScheduleDPartXIV>
        <Identifier>Part X</Identifier>
        <ReturnReference>Part X : FIN48 Footnote</ReturnReference>
        <Explanation>MMC follows the accounting guidance for uncertainties in income tax positions which requires that a tax position be recognized or derecognized based on a "more likely than not" threshold. This applies to positons taken or expected to be taken in a tax return. MMC does not believe its consolidated financial statements include any material uncertain tax positions.</Explanation>
      </Form990ScheduleDPartXIV>
      <Form990ScheduleDPartXIV>
        <Identifier>Part XI, Line 8</Identifier>
        <ReturnReference>Part XI, Line 8: Other Changes in Net Assets or Fund Balances</ReturnReference>
        <Explanation>Acquisition of assets of LLC $5678766 Net assets held by Meritus Healthcare Foundation $ -1361746 Change in retirement benefit obligation $ -88260</Explanation>
      </Form990ScheduleDPartXIV>
      <Form990ScheduleDPartXIV>
        <Identifier>Part V, Line 4</Identifier>
        <ReturnReference>Part V, Line 4: Intended uses of the endowment fund.</ReturnReference>
        <Explanation>Charity care</Explanation>
      </Form990ScheduleDPartXIV>
    </IRS990ScheduleD>
    <IRS990ScheduleH documentId="IRS990ScheduleH" softwareId="11000144" softwareVersion="2011v1.5">
      <CharityCarePolicy>true</CharityCarePolicy>
      <WrittenPolicy>true</WrittenPolicy>
      <FPGReferenceFreeCare>true</FPGReferenceFreeCare>
      <Pcent150>X</Pcent150>
      <FPGReferenceDiscountedCare>true</FPGReferenceDiscountedCare>
      <Pcent300>X</Pcent300>
      <FreeDiscCareMedicallyIndigent>true</FreeDiscCareMedicallyIndigent>
      <AmountsBudgetedForCharityCare>true</AmountsBudgetedForCharityCare>
      <ExpensesExceededBudget>false</ExpensesExceededBudget>
      <UnableToProvideCare>false</UnableToProvideCare>
      <AnnualCommunityBenefitReport>true</AnnualCommunityBenefitReport>
      <ReportPublicallyAvailable>true</ReportPublicallyAvailable>
      <CharityCareAtCost>
        <PersonsServed>3271</PersonsServed>
        <TotalCommunityBenefitExpense>10803681</TotalCommunityBenefitExpense>
        <NetCommunityBenefitExpense>10803681</NetCommunityBenefitExpense>
        <PercentOfTotalExpense>0.03440</PercentOfTotalExpense>
      </CharityCareAtCost>
      <UnreimbursedMedicaid>
        <TotalCommunityBenefitExpense>1104817</TotalCommunityBenefitExpense>
        <NetCommunityBenefitExpense>1104817</NetCommunityBenefitExpense>
        <PercentOfTotalExpense>0.00350</PercentOfTotalExpense>
      </UnreimbursedMedicaid>
      <TotalCharityCare>
        <PersonsServed>3271</PersonsServed>
        <TotalCommunityBenefitExpense>11908498</TotalCommunityBenefitExpense>
        <NetCommunityBenefitExpense>11908498</NetCommunityBenefitExpense>
        <PercentOfTotalExpense>0.03790</PercentOfTotalExpense>
      </TotalCharityCare>
      <CommunityHealthServices>
        <PersonsServed>168015</PersonsServed>
        <TotalCommunityBenefitExpense>1345782</TotalCommunityBenefitExpense>
        <NetCommunityBenefitExpense>1345782</NetCommunityBenefitExpense>
        <PercentOfTotalExpense>0.00430</PercentOfTotalExpense>
      </CommunityHealthServices>
      <HealthProfessionsEducation>
        <PersonsServed>5510</PersonsServed>
        <TotalCommunityBenefitExpense>249050</TotalCommunityBenefitExpense>
        <NetCommunityBenefitExpense>249050</NetCommunityBenefitExpense>
        <PercentOfTotalExpense>0.00080</PercentOfTotalExpense>
      </HealthProfessionsEducation>
      <SubsidizedHealthServices>
        <PersonsServed>34055</PersonsServed>
        <TotalCommunityBenefitExpense>13636101</TotalCommunityBenefitExpense>
        <DirectOffsettingRevenue>2683746</DirectOffsettingRevenue>
        <NetCommunityBenefitExpense>10952355</NetCommunityBenefitExpense>
        <PercentOfTotalExpense>0.03490</PercentOfTotalExpense>
      </SubsidizedHealthServices>
      <Research>
        <PersonsServed>996</PersonsServed>
        <TotalCommunityBenefitExpense>518671</TotalCommunityBenefitExpense>
        <DirectOffsettingRevenue>340626</DirectOffsettingRevenue>
        <NetCommunityBenefitExpense>178045</NetCommunityBenefitExpense>
        <PercentOfTotalExpense>0.00060</PercentOfTotalExpense>
      </Research>
      <CashAndInKindContributions>
        <PersonsServed>3420</PersonsServed>
        <TotalCommunityBenefitExpense>615321</TotalCommunityBenefitExpense>
        <DirectOffsettingRevenue>435253</DirectOffsettingRevenue>
        <NetCommunityBenefitExpense>180068</NetCommunityBenefitExpense>
        <PercentOfTotalExpense>0.00060</PercentOfTotalExpense>
      </CashAndInKindContributions>
      <TotalOtherBenefits>
        <PersonsServed>211996</PersonsServed>
        <TotalCommunityBenefitExpense>16364925</TotalCommunityBenefitExpense>
        <DirectOffsettingRevenue>3459625</DirectOffsettingRevenue>
        <NetCommunityBenefitExpense>12905300</NetCommunityBenefitExpense>
        <PercentOfTotalExpense>0.04120</PercentOfTotalExpense>
      </TotalOtherBenefits>
      <TotalCommunityBenefits>
        <PersonsServed>215267</PersonsServed>
        <TotalCommunityBenefitExpense>28273423</TotalCommunityBenefitExpense>
        <DirectOffsettingRevenue>3459625</DirectOffsettingRevenue>
        <NetCommunityBenefitExpense>24813798</NetCommunityBenefitExpense>
        <PercentOfTotalExpense>0.07910</PercentOfTotalExpense>
      </TotalCommunityBenefits>
      <CommunitySupport>
        <PersonsServed>166</PersonsServed>
        <TotalCommunityBuildingExpense>6624</TotalCommunityBuildingExpense>
        <NetCommunityBuildingExpense>6624</NetCommunityBuildingExpense>
      </CommunitySupport>
      <HealthImprovementAdvocacy>
        <PersonsServed>23</PersonsServed>
        <TotalCommunityBuildingExpense>97</TotalCommunityBuildingExpense>
        <NetCommunityBuildingExpense>97</NetCommunityBuildingExpense>
      </HealthImprovementAdvocacy>
      <Other>
        <PersonsServed>468</PersonsServed>
        <TotalCommunityBuildingExpense>6757</TotalCommunityBuildingExpense>
        <NetCommunityBuildingExpense>6757</NetCommunityBuildingExpense>
      </Other>
      <Total>
        <PersonsServed>657</PersonsServed>
        <TotalCommunityBuildingExpense>13478</TotalCommunityBuildingExpense>
        <NetCommunityBuildingExpense>13478</NetCommunityBuildingExpense>
      </Total>
      <BadDebtExpenseReported>true</BadDebtExpenseReported>
      <BadDebtExpenseAmount>9491853</BadDebtExpenseAmount>
      <AmountAttributableTo>1479250</AmountAttributableTo>
      <AmountReimbursedByMedicare>283953366</AmountReimbursedByMedicare>
      <CostOfCareReimbursedByMedicare>261276432</CostOfCareReimbursedByMedicare>
      <MedicareSurplusOrShortfall>22676934</MedicareSurplusOrShortfall>
      <CostingMethodologyUsed>
        <CostToChargeRatio>X</CostToChargeRatio>
      </CostingMethodologyUsed>
      <WrittenDebtCollectionPolicy>true</WrittenDebtCollectionPolicy>
      <ProvisionForCharityCare>true</ProvisionForCharityCare>
      <Form990ScheduleHPartIV>
        <NameOfEntity>
          <BusinessNameLine1>Tri-State Health Part Inc</BusinessNameLine1>
        </NameOfEntity>
        <DescriptionEntPrimaryActivity>PHO</DescriptionEntPrimaryActivity>
        <OrganizationProfitOrOwnership>0.50000</OrganizationProfitOrOwnership>
        <PhysicansProfitOrOwnership>0.50000</PhysicansProfitOrOwnership>
      </Form990ScheduleHPartIV>
      <Form990ScheduleHPartIV>
        <NameOfEntity>
          <BusinessNameLine1>Maryland Care Inc</BusinessNameLine1>
        </NameOfEntity>
        <DescriptionEntPrimaryActivity>healthcare</DescriptionEntPrimaryActivity>
        <OrganizationProfitOrOwnership>0.25000</OrganizationProfitOrOwnership>
      </Form990ScheduleHPartIV>
      <NumberOfHospitalFacilities>1</NumberOfHospitalFacilities>
      <Form990ScheduleHPartVSectionA>
        <FacilityNumber>0</FacilityNumber>
        <Name>
          <BusinessNameLine1>Meritus Medical Center Inc</BusinessNameLine1>
        </Name>
        <Address>
          <AddressLine1>11116 Medical Campus Road</AddressLine1>
          <City>Hagerstown</City>
          <State>MD</State>
          <ZIPCode>21742</ZIPCode>
        </Address>
        <LicensedHospital>X</LicensedHospital>
        <GeneralMedicalAndSurgical>X</GeneralMedicalAndSurgical>
        <CriticalAccessHospital>X</CriticalAccessHospital>
        <Er24Hours>X</Er24Hours>
      </Form990ScheduleHPartVSectionA>
      <Form990ScheduleHPartVSectionB>
        <HospitalFacilityName>
          <BusinessNameLine1>Meritus Medical Center Inc</BusinessNameLine1>
        </HospitalFacilityName>
        <HospitalFacilityNumber>1</HospitalFacilityNumber>
        <CHNAConducted>false</CHNAConducted>
        <EligibilityCriteriaExplained>true</EligibilityCriteriaExplained>
        <UsesFPGFree>true</UsesFPGFree>
        <FPGFreePercent>150.0000</FPGFreePercent>
        <UsesFPGDiscounted>true</UsesFPGDiscounted>
        <FPGDiscountPercent>300.0000</FPGDiscountPercent>
        <ExplainsBasis>true</ExplainsBasis>
        <IncomeLevel>X</IncomeLevel>
        <AssetLevel>X</AssetLevel>
        <ExplainsApplicationMethod>true</ExplainsApplicationMethod>
        <IncludesPublicityMeasures>true</IncludesPublicityMeasures>
        <PostedOnWebsite>X</PostedOnWebsite>
        <AttachedToInvoices>X</AttachedToInvoices>
        <PostedInEmergencyRoom>X</PostedInEmergencyRoom>
        <PostedInAdmissionOffice>X</PostedInAdmissionOffice>
        <ProvidedOnAdmission>X</ProvidedOnAdmission>
        <AvailableOnRequest>X</AvailableOnRequest>
        <ActionsOnNonpayment>true</ActionsOnNonpayment>
        <PermitReportToCreditAgency>X</PermitReportToCreditAgency>
        <PermitLawsuit>X</PermitLawsuit>
        <CollectionActivities>true</CollectionActivities>
        <ReportToCreditAgency>X</ReportToCreditAgency>
        <Lawsuit>X</Lawsuit>
        <NotifyUponAdmission>X</NotifyUponAdmission>
        <NotifyBeforeDischarge>X</NotifyBeforeDischarge>
        <NotifiedAllPatients>X</NotifiedAllPatients>
        <DocumentedDetermination>X</DocumentedDetermination>
        <NondiscrimEmergencyCarePolicy>true</NondiscrimEmergencyCarePolicy>
        <MedicareRate>X</MedicareRate>
        <AmountsGenerallyBilled>false</AmountsGenerallyBilled>
        <GrossCharges>false</GrossCharges>
      </Form990ScheduleHPartVSectionB>
      <Form990ScheduleHPartVI>
        <ReturnReference>Part VI - Additional Information</ReturnReference>
        <Explanation>Maryland Healthcare Regulatory SystemLines 7a &amp; 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 directed offsetting revenue related to Uncompensated Care. Community benefit expenses are equal to Medicaid revenues in Maryland, as such, the net effect is zero. The exception to this is the impact on the hospital of its share of the Medicaid assessment. In recent years, the state of Maryland has closed fiscal gaps in the state Medicaid budget by assessing hospitals through the rate-setting system.</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <ReturnReference>Part VI - States Where Community Benefit Report Filed</ReturnReference>
        <Explanation>MD</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <ReturnReference>Part VI - Affilated Health Care System Roles and Promotion</ReturnReference>
        <Explanation>Meritus Healthcare Foundation - 501(c)(3) - provides fund development, financial &amp; other assistance to MMC. MHF is operated exclusively for the charitable &amp; educational purpose of supporting quality health care &amp; related services of MMC.Meritus Medical Center Endowment Fund - 501(c)(3) - dedicated to supporting the charitable purposes of MMC by owning, managing, investing &amp; leasing property using the net income for programs which benefit the charitable purposes.Meritus Enterprises - C corp - provider of ambulatory health care services. MEI insures an adequate supply of physicians in many medical specialities are available in this region.</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <ReturnReference>Part VI - Explanation Of How Organization Furthers Its Exempt Purpose</ReturnReference>
        <Explanation>See Schedule O for explanation under Program Service Accomplishments.</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <ReturnReference>Part VI - Community Building Activities</ReturnReference>
        <Explanation>MMC participates in several community building activities. MMC nutrition center staff are used for the coordination and support of the weekly Farmer's Market held at the medical center. The Care Managment staff spend time attending the outreach social planning meeting. Lastly, MMC staff spend time in coordinating and distributing materials for the annual United Way campaign.</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <ReturnReference>Part VI - Community Information</ReturnReference>
        <Explanation>MMC is the largest healthcare provider in Western MD, located at the crossroads of western MD, southern PA, and the eastern panhandle of WV. MMC is an acute care hospital with 265 single-patient rooms providing services including a soecial care nursery, a designated trauma center, a primary stroke center, a wound center, and a designated cardiac interventional center. As the leading provider of health care services in the tri-state region, MMC's primary service area is Washington County, MD including primary service area zip codes 21740, 21742, 21795, 21713 and 21783 - with residents of that county making up the majority of the hospital's customers - while also serving residents of Frederick County, MD; Franklin County, PA; Fulton County, PA; Morgan County, WV; Jefferson County, WV; and Berkeley County, WV.Within MMC's community service benefit area; the total population is 147,430 with 74,877 male residents and 72,553 female residents; median age is 39.7; median household income is $52,857; percentage of households with incomes below the federal poverty guidelines is 11.2%; the percentage of uninsured people by county is 18.5%; percentage of Medicaid recipients by County is 21%; and the life expectancy by county is 78.4.</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <ReturnReference>Part VI - Patient Education of Eligibility for Assistance</ReturnReference>
        <Explanation>Meritus Medical Center informs patients and/or their families of the hospital's financial assistance policy by providing a copy of the policy and contact information as part of the intake process. The financial assistance policy and contact information is posted in the admitting area, emergency room and other areas throughout the facility where eligible patients are likely to present. When applicable, a representative of the hospital discusses the availability of financial assistance as well as Medicaid and other governmental benefits with patients or their families. The hospital makes every effort to inform patients of this policy throughout their visit.MMC follows the Maryland Hospital Association's Standards for Financial Assistance for Maryland. MMC will provide 100 percent free hospital care for patients below 150 percent of Federal Poverty levels and who have less than $10,000 in net assets. When a patient's income and/or net assets does not qualify them for 100 percent financial assistance, they may be eligible to qualify for financial assistance based on a sliding scale. MMC will consider the size of a patient's bill relative to their ability to pay in determining financial assistance options, which could include payment plans. MMC will grant financial assistance for services determined to be medically necessary.</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <ReturnReference>Part VI - Needs Assessment</ReturnReference>
        <Explanation>Meritus Medical Center completed a commmunity health needs assessment in the Spring of 2009. It was sent to major community agencies to determine what they knew and perceived to be the most important healthcare needs of Washington County residents. Twenty agencies were surveyed, including the healthcare organizations, the United Way, and the Department of Social Services. Internal healthcare providers were also surveyed; some of them included the healthcare management department, medical director of internal medicine, and the community health education and outreach department.Respondents completed a survey which asked them to identify: the three most important health needs they have encountered; which ones they have designated as current fiscal year priorities; and to name any other agencies that should be included in the survey.Respondents listed the following as the most important health needs: mental health services, services for the elderly, dental services, and obesity.They identified three that are fiscal year priorities: mental health, dental services, and substance abuse.In response to the community needs assessment completed in 2009, MMC responded to the identified needs during fiscal year 2012. The first need identified was to improve access to adolescent mental health and social functioning. MMC provided clinical oversight and board membership to Potomac Case Management in order to help advocate and ensure that adequate mental health services are being provided in Washington County. Secondly MMC increased awareness of senior services. Seniors living in the Washington County region were identified as having a lack of awareness of health issues unique to an aging population. Through community health fairs, screenings, and educational events, MMC provides the information necessary to heighten awareness of senior issues and assist seniors in identifying where help can be obtained.A third identified area was the need to decrease adult obesity. MMC provided BMI screenings and nutritional information at community educational events and health fairs to increase awareness and knowledge of elevated body mass index and potential health risks. Participants were able to identify the need to make lifestyle changes and where such assistance could be obtained. 610 persons completed obesity screening and education for fiscal year 2012.In compliance with IRC Section 501R, MMC is in the process of finalizing, applying and implementing its 2012 Community Health Needs Assessment and related report for Washington County, MD. This report includes a comprehensive review and analysis of the data regarding health issues and needs of Washington County overall. More importantly, the implementation plan developed by MMC will address how the Medical Center continues providing top quality care to all individuals in its service area. This study was conducted to identify the health needs and issues of the region and to provide useful information to health care providers, policy makers, collaborative groups, social service agencies, community groups and organizations, churches, businesses, and consumers who are interested in improving the health status of the community and region. The results enable the health system and other providers to more strategically establish priorities, develop interventions and commit resources to improve the health status of the region.Improving the health of the community is foundational to the mission of Meritus Medical Center and should be an important focus for everyone in the county, individually and collectively. In addition to the education, patient care and program interventions provided through the health system, we hope the information in this study will encourage additional activities and collaborative efforts to improve the health status of the community. The Top Priorities Identified in the study include: 1. Obesity and physical inactivity 2. Diabetes 3. Heart disease and smoking cessation 4. Cancer 5. Behavioral health 6. Teen pregnancyThe Top Initiatives for Meritus Medical Center include: * Reducing obesity and physical inactivity * Improving the management of diabetes illness with better access to care and education * Reducing heart disease and smoking * Improving access to cancer treatment and research * Improving behavioral health access to care and reducing ED visits * Reducing incidence of teen pregnancyThe Top Initiatives for the Washington County Health Improvement Coalition include: * Reducing diabetes mortality through community case management and improved access to care * Decreasing behavioral health Emergency Department visits through better care coordination and community education * Decrease heart disease and address lifestyle behaviors such as physical inactivity and smoking cessation</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <ReturnReference>Part III, Line 9b - Provisions On Collection Practices For Qualified Patients</ReturnReference>
        <Explanation>Meritus Medical Center is committed to providing quality health care for all patients regardless of their inability to meet the associated financial obligation and without discrimination on the grounds of race, color, national origin or creed. Financial assistance can be offered during, or after services are rendered. The financial assistance procedures are designed to assist individuals who qualify for less than full coverage under available federal, state and local medical assistance programs, but whom residual "self-pay" balances exceed their own ability to pay.Meritus Medical Center informs patients and/or their families of the hospital's financial assistance policy by providing a copy of the policy and contact information as part of the intake process. The financial assistance policy and contact information is posted in the admitting area, emergency room and other areas throughout the facility where eligible patients are likely to present. When applicable, a representative of the hospital discusses the availability of financial assistance as well as Medicaid and other governmental benefits with patients or their families. The hospital makes every effort to inform patients of this policy throughout their visit.A financial application that has been approved for financial assistance will remain eligible for a period of six months. Patients or guarantors incurring accounts after the six month period will be required to reapply, so that any changes in their financial status can be reassessed. Accounts receivable accounts approved for financial assistance will be reconciled by the Finance Department at fiscal year endand reported annually to the Health Services Cost Review Commission of the State of Maryland. If financial assistance is denied, a payment arrangement will be obtained on any balance due by the patient or the guarantor by a Patient Financial Services Representative.</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <ReturnReference>Part III, Line 4 - Bad Debt Expense</ReturnReference>
        <Explanation>Meritus Medical Center (MMC) provides an allowance for doubtful accounts for estimated losses resulting from the unwillingness or inability of patients to make payments for services. The allowance is determined by analyzing specific accounts and historical data and trends. Patient accounts receivable are charged off against the allowance for doubtful accounts when management detemines that recovery is unlikely and MMC ceases collection efforts. Losses have been consistant with management's expectations.</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <ReturnReference>Part I, Line 7g - Costs Associated With Physicans Clinics</ReturnReference>
        <Explanation>Subsidized health services for Meritus Medical Center include the following: (1) Hospital owned endocrinology and diabetes program (2) The Medication Assistance Center (3) Hospital owned psychiatric practice (4) Level III trauma program (5) On-call fees for emergency specialist call (6) Hospice of Washington County allowed a voluntary contractual allowance</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <ReturnReference>Part I, Line 7, Column F - Explanation of Bad Debt Expense</ReturnReference>
        <Explanation>Meritus Medical Center (MMC) is committed to providing quality health care for all patients regardless of their ability to meet the associated financial obligation and without discrimination on the grounds of race, color, national origin or creed. It shall be the policy of MMC to ensure that all appropriate and reasonable efforts have been made prior to referring an account to bad debt, a collection agency or outside attorney. In addition, a satisfactory level of control is maintained over bad debts and levels of management are involved in the decision making process prior to write-off and/or assignment of bad debt.</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <ReturnReference>Part I, Line 7 - Explanation of Costing Methodology</ReturnReference>
        <Explanation>The direct cost was calculated by using the expense categories for salaries and wages, benefits, expendable suppiles, purchased services, repairs and maintenance and depreciation. The indirect cost was calculated using the approved methodology on the community benefit report.</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <ReturnReference>Part I, Line 6a - Related Organization Community Benefit Report</ReturnReference>
        <Explanation>MMC prepares a community benefits report through the Maryland Health Services Cost Review Commission (HSCRC), and it is available via their website.</Explanation>
      </Form990ScheduleHPartVI>
    </IRS990ScheduleH>
    <IRS990ScheduleI documentId="IRS990ScheduleI" softwareId="11000144" softwareVersion="2011v1.5">
      <RecordsMaintained>true</RecordsMaintained>
      <NoGrantMoreThan5000>X</NoGrantMoreThan5000>
      <TotalNbrOf501C3AndGovtGrants>0</TotalNbrOf501C3AndGovtGrants>
      <TotalNbrOfOtherOrganizations>0</TotalNbrOfOtherOrganizations>
      <Form990ScheduleIPartIII>
        <TypeOfGrant>HSCRC Nursing Grant</TypeOfGrant>
        <NumberOfRecipients>13</NumberOfRecipients>
        <AmountOfCashGrant>104281</AmountOfCashGrant>
        <MethodOfValuation>N/A</MethodOfValuation>
        <DescriptionOfNonCashAssistance>N/A</DescriptionOfNonCashAssistance>
      </Form990ScheduleIPartIII>
      <Form990ScheduleIPartIV>
        <Identifier>Grantmaker's Description of How Grants are Used</Identifier>
        <Explanation>The HSCRC grant provides money to employees of the Hospital who are enrolled in the Hagerstown Community College nursing program. The grant program pays for all of the student's tuition, books, and fees with an agreement that upon graduation the student will work for the Hospital as a registered nurse. The grant also provides monies for registered nurses who are working on their MSN in education. Each award recipient will be required to sign a Service Card Agreement with the Meritus Medical Center. The length of payback will be one year of service (equivalent to 2,080 hours of service) for each year of the grant you receive. The program is five semesters long and most recipients will owe 4,160 hours.</Explanation>
      </Form990ScheduleIPartIV>
    </IRS990ScheduleI>
    <IRS990ScheduleJ documentId="IRS990ScheduleJ" softwareId="11000144" softwareVersion="2011v1.5">
      <CompensationCommittee>X</CompensationCommittee>
      <IndependentConsultant>X</IndependentConsultant>
      <WrittenEmploymentContract>X</WrittenEmploymentContract>
      <CompensationSurvey>X</CompensationSurvey>
      <BoardOrCommitteeApproval>X</BoardOrCommitteeApproval>
      <SeverancePayment>true</SeverancePayment>
      <SupplementalNonqualRetirePlan>true</SupplementalNonqualRetirePlan>
      <EquityBasedCompArrangement>false</EquityBasedCompArrangement>
      <CompBasedOnRevenueOfFilingOrg>false</CompBasedOnRevenueOfFilingOrg>
      <CompBasedOnRevenueRelatedOrgs>false</CompBasedOnRevenueRelatedOrgs>
      <CompBasedNetEarningsFilingOrg>false</CompBasedNetEarningsFilingOrg>
      <CompBasedNetEarningsRelateOrgs>false</CompBasedNetEarningsRelateOrgs>
      <AnyNonFixedPayments>true</AnyNonFixedPayments>
      <InitialContractException>false</InitialContractException>
      <RebuttablePresumptionProcedure>false</RebuttablePresumptionProcedure>
      <Form990ScheduleJPartII>
        <NamePerson>Thomas Gilbert MD</NamePerson>
        <BaseCompensationFilingOrg>464892</BaseCompensationFilingOrg>
        <BonusFilingOrg>316679</BonusFilingOrg>
        <OtherCompensationFilingOrg>42099</OtherCompensationFilingOrg>
        <DeferredCompFilingOrg>7350</DeferredCompFilingOrg>
        <NontaxableBenefitsFilingOrg>21850</NontaxableBenefitsFilingOrg>
        <TotalCompensationFilingOrg>852870</TotalCompensationFilingOrg>
      </Form990ScheduleJPartII>
      <Form990ScheduleJPartII>
        <NamePerson>T Michael White</NamePerson>
        <BaseCompensationFilingOrg>203684</BaseCompensationFilingOrg>
        <BonusFilingOrg>25000</BonusFilingOrg>
        <OtherCompensationFilingOrg>179800</OtherCompensationFilingOrg>
        <DeferredCompFilingOrg>9949</DeferredCompFilingOrg>
        <NontaxableBenefitsFilingOrg>15566</NontaxableBenefitsFilingOrg>
        <TotalCompensationFilingOrg>433999</TotalCompensationFilingOrg>
      </Form990ScheduleJPartII>
      <Form990ScheduleJPartII>
        <NamePerson>Raymond Grahe</NamePerson>
        <BaseCompensationFilingOrg>316795</BaseCompensationFilingOrg>
        <BonusFilingOrg>73304</BonusFilingOrg>
        <OtherCompensationFilingOrg>13225</OtherCompensationFilingOrg>
        <DeferredCompFilingOrg>13461</DeferredCompFilingOrg>
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        <TotalCompensationFilingOrg>432944</TotalCompensationFilingOrg>
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      <Form990ScheduleJPartII>
        <NamePerson>Michael Zampelli</NamePerson>
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        <TotalCompensationRelatedOrgs>419002</TotalCompensationRelatedOrgs>
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      <Form990ScheduleJPartII>
        <NamePerson>Matthew Wagner MD</NamePerson>
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        <BonusFilingOrg>30001</BonusFilingOrg>
        <OtherCompensationFilingOrg>1242</OtherCompensationFilingOrg>
        <DeferredCompFilingOrg>11586</DeferredCompFilingOrg>
        <NontaxableBenefitsFilingOrg>20674</NontaxableBenefitsFilingOrg>
        <TotalCompensationFilingOrg>330869</TotalCompensationFilingOrg>
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      <Form990ScheduleJPartII>
        <NamePerson>Kelly Corbi</NamePerson>
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        <BonusFilingOrg>50720</BonusFilingOrg>
        <OtherCompensationFilingOrg>400</OtherCompensationFilingOrg>
        <DeferredCompFilingOrg>12818</DeferredCompFilingOrg>
        <NontaxableBenefitsFilingOrg>23325</NontaxableBenefitsFilingOrg>
        <TotalCompensationFilingOrg>289528</TotalCompensationFilingOrg>
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      <Form990ScheduleJPartII>
        <NamePerson>Joseph Ross</NamePerson>
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        <DeferredCompFilingOrg>37476</DeferredCompFilingOrg>
        <NontaxableBenefitsFilingOrg>18883</NontaxableBenefitsFilingOrg>
        <TotalCompensationFilingOrg>428778</TotalCompensationFilingOrg>
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      <Form990ScheduleJPartII>
        <NamePerson>Jayantilal Kadiwar MD</NamePerson>
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        <BonusFilingOrg>131950</BonusFilingOrg>
        <OtherCompensationFilingOrg>16561</OtherCompensationFilingOrg>
        <DeferredCompFilingOrg>4477</DeferredCompFilingOrg>
        <NontaxableBenefitsFilingOrg>14641</NontaxableBenefitsFilingOrg>
        <TotalCompensationFilingOrg>454320</TotalCompensationFilingOrg>
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      <Form990ScheduleJPartII>
        <NamePerson>James Hamill</NamePerson>
        <BaseCompensationFilingOrg>137934</BaseCompensationFilingOrg>
        <BonusFilingOrg>236787</BonusFilingOrg>
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        <DeferredCompFilingOrg>1331</DeferredCompFilingOrg>
        <NontaxableBenefitsFilingOrg>8852</NontaxableBenefitsFilingOrg>
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      <Form990ScheduleJPartII>
        <NamePerson>Heather Lorenzo</NamePerson>
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        <NamePerson>Garry Seligman MD</NamePerson>
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        <OtherCompensationFilingOrg>2792</OtherCompensationFilingOrg>
        <DeferredCompFilingOrg>8134</DeferredCompFilingOrg>
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      <Form990ScheduleJPartII>
        <NamePerson>Frank Slabinski</NamePerson>
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        <OtherCompensationFilingOrg>4473</OtherCompensationFilingOrg>
        <DeferredCompFilingOrg>1397</DeferredCompFilingOrg>
        <NontaxableBenefitsFilingOrg>1297</NontaxableBenefitsFilingOrg>
        <TotalCompensationFilingOrg>217246</TotalCompensationFilingOrg>
      </Form990ScheduleJPartII>
      <Form990ScheduleJPartII>
        <NamePerson>Deborah Addo-Samuels</NamePerson>
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        <BonusFilingOrg>51916</BonusFilingOrg>
        <OtherCompensationFilingOrg>15984</OtherCompensationFilingOrg>
        <DeferredCompFilingOrg>3204</DeferredCompFilingOrg>
        <NontaxableBenefitsFilingOrg>13307</NontaxableBenefitsFilingOrg>
        <TotalCompensationFilingOrg>303029</TotalCompensationFilingOrg>
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      <Form990ScheduleJPartII>
        <NamePerson>Carolyn Simonsen</NamePerson>
        <BaseCompensationFilingOrg>186792</BaseCompensationFilingOrg>
        <BonusFilingOrg>37677</BonusFilingOrg>
        <OtherCompensationFilingOrg>6266</OtherCompensationFilingOrg>
        <DeferredCompFilingOrg>11507</DeferredCompFilingOrg>
        <NontaxableBenefitsFilingOrg>11303</NontaxableBenefitsFilingOrg>
        <TotalCompensationFilingOrg>253545</TotalCompensationFilingOrg>
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      <Form990ScheduleJPartII>
        <NamePerson>Carey Leverett</NamePerson>
        <BaseCompensationFilingOrg>100978</BaseCompensationFilingOrg>
        <OtherCompensationFilingOrg>91341</OtherCompensationFilingOrg>
        <DeferredCompFilingOrg>2973</DeferredCompFilingOrg>
        <NontaxableBenefitsFilingOrg>16413</NontaxableBenefitsFilingOrg>
        <TotalCompensationFilingOrg>211705</TotalCompensationFilingOrg>
      </Form990ScheduleJPartII>
      <Form990ScheduleJPartII>
        <NamePerson>Adriana Maldonaldo-Brem</NamePerson>
        <BaseCompensationFilingOrg>188763</BaseCompensationFilingOrg>
        <OtherCompensationFilingOrg>905</OtherCompensationFilingOrg>
        <DeferredCompFilingOrg>7653</DeferredCompFilingOrg>
        <NontaxableBenefitsFilingOrg>24547</NontaxableBenefitsFilingOrg>
        <TotalCompensationFilingOrg>221868</TotalCompensationFilingOrg>
      </Form990ScheduleJPartII>
      <Form990ScheduleJPartIII>
        <Identifier>Sch J, Part III, Additional Information</Identifier>
        <ReturnReference>Part III, Additional Information</ReturnReference>
        <Explanation>Joseph Ross is a participant in a 457F plan. $26,466 has been deferred and is not substantially vested.</Explanation>
      </Form990ScheduleJPartIII>
      <Form990ScheduleJPartIII>
        <Identifier>Sch J, Part I, Line 7</Identifier>
        <ReturnReference>Part I, Line 7: Non-Fixed payments not listed above</ReturnReference>
        <Explanation>Bonuses are determined by the review of individual and corporate goals.</Explanation>
      </Form990ScheduleJPartIII>
    </IRS990ScheduleJ>
    <IRS990ScheduleK documentId="IRS990ScheduleK.1" softwareId="11000144" softwareVersion="2011v1.5">
      <Form990ScheduleKPartI>
        <IssuerName>
          <BusinessNameLine1>MD Hlth &amp; Hig Ed Fac Aut</BusinessNameLine1>
        </IssuerName>
        <IssuerEIN>520936091</IssuerEIN>
        <CUSIPNumber>574217T21</CUSIPNumber>
        <DateIssued>2008-02-12</DateIssued>
        <IssuePrice>264300000</IssuePrice>
        <DescriptionOfPurpose>Construction-new hospital</DescriptionOfPurpose>
        <Defeased>false</Defeased>
        <OnBehalfOfIssuer>false</OnBehalfOfIssuer>
        <PoolFinancing>false</PoolFinancing>
      </Form990ScheduleKPartI>
      <Form990ScheduleKPartII>
        <TotalProceeds>262855181</TotalProceeds>
        <AmountInReserveFund>18344513</AmountInReserveFund>
        <IssuanceCostsFromProceeds>3121975</IssuanceCostsFromProceeds>
        <CapitalExpenditures>235980961</CapitalExpenditures>
        <OtherSpentProceeds>5407732</OtherSpentProceeds>
        <YearOfSubstCompletion>2010</YearOfSubstCompletion>
        <CurrentRefunding>false</CurrentRefunding>
        <AdvanceRefunding>false</AdvanceRefunding>
        <FinalAllocationMade>true</FinalAllocationMade>
        <AdequateBooksAndRecdsMaintaind>true</AdequateBooksAndRecdsMaintaind>
      </Form990ScheduleKPartII>
      <Form990ScheduleKPartIII>
        <OwningBondFinancedProperty>false</OwningBondFinancedProperty>
        <AnyLeaseArrangements>false</AnyLeaseArrangements>
        <MngmentCntrctBondFinancdPrprty>false</MngmentCntrctBondFinancdPrprty>
        <AnyResearchAgreements>false</AnyResearchAgreements>
        <PrcntgePrvtBusinessUseByOthers>0.03000</PrcntgePrvtBusinessUseByOthers>
        <TotalPrivateBusinessUse>0.03000</TotalPrivateBusinessUse>
        <PostIssuanceComplianceProcdrs>true</PostIssuanceComplianceProcdrs>
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      <Form990ScheduleKPartIV>
        <Form8038TFiled>true</Form8038TFiled>
        <VariableRateIssue>false</VariableRateIssue>
        <HedgeIdentifiedInBooksAndRecds>false</HedgeIdentifiedInBooksAndRecds>
        <GrossProceedsInvestedInGIC>false</GrossProceedsInvestedInGIC>
        <GrossProceedsInvested>false</GrossProceedsInvested>
        <ExceptionToRebate>true</ExceptionToRebate>
      </Form990ScheduleKPartIV>
      <FedTaxRequirementsCompliance>X</FedTaxRequirementsCompliance>
    </IRS990ScheduleK>
    <IRS990ScheduleL documentId="IRS990ScheduleL" softwareId="11000144" softwareVersion="2011v1.5">
      <Form990ScheduleLPartIV>
        <NameOfInterestedPerson>
          <NamePerson>Greg Snook</NamePerson>
        </NameOfInterestedPerson>
        <Relationship>Director</Relationship>
        <AmountOfTransaction>3498</AmountOfTransaction>
        <DescriptionOfTransaction>See suppl. info. below</DescriptionOfTransaction>
        <SharingOfRevenues>false</SharingOfRevenues>
      </Form990ScheduleLPartIV>
      <Form990ScheduleLPartIV>
        <NameOfInterestedPerson>
          <NamePerson>Marc Kross MD</NamePerson>
        </NameOfInterestedPerson>
        <Relationship>Former director</Relationship>
        <AmountOfTransaction>566050</AmountOfTransaction>
        <DescriptionOfTransaction>See suppl. info. below</DescriptionOfTransaction>
        <SharingOfRevenues>false</SharingOfRevenues>
      </Form990ScheduleLPartIV>
      <Form990ScheduleLPartIV>
        <NameOfInterestedPerson>
          <NamePerson>William Su MD</NamePerson>
        </NameOfInterestedPerson>
        <Relationship>Director</Relationship>
        <AmountOfTransaction>105171</AmountOfTransaction>
        <DescriptionOfTransaction>See suppl. info. below</DescriptionOfTransaction>
        <SharingOfRevenues>false</SharingOfRevenues>
      </Form990ScheduleLPartIV>
      <Form990ScheduleLPartV>
        <Explanation>Marc Kross, MD has contracts with MMC to serve as Surgeon and Chief of Trauma, to provide emergency room call coverage and to provide trauma call coverage.William Su, MD has a contract directly with MMC to provide emergency room and trauma call coverage.Greg Snook's brother owns a storage company in which MMC leases space.</Explanation>
      </Form990ScheduleLPartV>
    </IRS990ScheduleL>
    <IRS990ScheduleO documentId="IRS990ScheduleO" softwareId="11000144" softwareVersion="2011v1.5">
      <GeneralExplanation>
        <ReturnReference>Part XI, Line 2b</ReturnReference>
        <Explanation>Meritus Medical Center is audited as part of the consolidated audit of the Meritus Health, Inc. entities. The medical center received consolidated audited financial statements prepared in accordance with GAAP from an independent accounting firm.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <ReturnReference>Part VII, Section A, Line 2</ReturnReference>
        <Explanation>The salary &amp; benefits that Dr. Gilbert received are for his services as a physician &amp; not as a director.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <ReturnReference>Part VI, Line 16b</ReturnReference>
        <Explanation>As defined by the Meritus Medical Center bylaws which state the process for joint venture activity, a joint venture arrangement with a taxable entity would first be evaluated by the the Meritus Medical Center Board and the Meritus Health, Inc. Board. After presentation and approval by those two boards, the Finance &amp; Capital Board of Meritus Health, Inc. would evaluate the financial implications of the joint venture. The Audit &amp; Business Integrity Committee of the Meritus Health, Inc. Board would analyze any possible interested party transactions and the limitations and prohibitions associated with the section 501(c)(3) status of the medical center. The Meritus Health, Inc. Board would ultimately need to approve any joint venture resolutions.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <ReturnReference>Part VI, Line 16a</ReturnReference>
        <Explanation>Meritus Medical Center holds a 25% equity interest in Maryland Care, Inc. Maryland Care, Inc. d/b/a Maryland Physicians Care is a managed care organization ("MCO") that was established to serve Maryland's Medicaid population as a result of the State's requirement for Medicaid patients to be a member of an MCO.Meritus Medical Center holds a 50% equity interest in Tri-State Health Partners ("THP"). THP is an innovative physician-hospital organization ("PHO") established to organize, assemble and facilitate the provision of cost effective health care services. The partnership consists of more than 200 local physicians and the Hospital. THP is involved in the medical management of more than 6,000 covered lives through regional self-insured businesses. In April of 2009, THP developed a clinical integration program that was approved by the Federal Trade Commission ("FTC"). THP has one of only three clinical integration programs that have been approved by the FTC to date. Within a clinical integration program, physicians agree to work together with a high degree of cooperation, collaboration and mutual interdependence that focuses on improving the quality of care they collectively provide. Physicians use electronic health record technology to coordinate treatment among the patients' healthcare providers, which can substantially reduce the cost of care.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <ReturnReference>Part I, Line 6 - Volunteers</ReturnReference>
        <Explanation>Meritus Medical Center receives volunteers that are recruited by the Meritus Medical Center Auxiliary, Inc. ("Auxiliary"). The mission of the Auxiliary is to cooperate and assist in the work of the medical center by promoting the medical center's work in the community and supplementing the work of the staff of the medical center.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>Form 990, Part VI, Line 19</Identifier>
        <ReturnReference>Form 990, Part VI, Line 19: Other Organization Documents Publicly Available</ReturnReference>
        <Explanation>Governing documents, conflict of interest policy, and financial statements are available upon request. In addition, the annual audited financial statements are available on the organization's website.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>Form 990, Part VI, Line 15b</Identifier>
        <ReturnReference>Form 990, Part VI, Line 15b: Compensation Review and Approval Process for Officers and Key Employees</ReturnReference>
        <Explanation>Annually in September, the Compensation Committee of the MH Board meets and reviews the following as it relates to compensation of the CEO and other key employees: Market Data - Presented by an independent third party compensation consultant Performance Evaluation - Provided by the CEO Overall Financials- used for Bonus Current Salary Along with Merit GuidelinesThe independent third party compensation consultant then makes recommendations to the compensation committee and the committee deliberates, discusses, and approves the recommendation as is or makes amendments to it before approval. The report and resulting decision is then reported to the MH Board.The positions reviewed in September of 2011 were as follows: President &amp; CEO,Senior VP-Chief Financial Officer, Senior VP-Chief Operating Officer, VP-Chief Information Officer, VP for Financial Services, VP for Support Services, VP-Chief Medical Officer, VP-Chief Compliance Officer, VP-Chief Administrative Officer, and VP-Chief Nursing Officer.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>Form 990, Part VI, Line 12c</Identifier>
        <ReturnReference>Form 990, Part VI, Line 12c: Explanation of Monitoring and Enforcement of Conflicts</ReturnReference>
        <Explanation>An annual disclosure of interest is required for all officers, directors or trustees, and key employees. These disclosures are then reviewed against the accounts payable system to determine the amount, if any, of transactions that have occurred. All disclosures and transactions are reviewed in detail by the following group of individuals: Vice President &amp; Chief Compliance Officer, Executive Director of Internal Audit &amp; Compliance, Chair of the MH Board, Chair of the Audit and Business Integrity Committee, President and CEO of MH, Chair of the Governance Committee and Legal Counsel. A summary of all disclosures are then provided to the full Audit and Business Integrity Committee for review. After this review, a copy of the disclosures, by Board or Committee, listing the type of involvement/transactions the entity has with the named disclosure, if any, are provided to the chair of the Board or Committee. Any director with a determined conflict is prohibited from participating in the Board's decisions and decisions with regards to that transaction.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>Form 990, Part VI, Line 11</Identifier>
        <ReturnReference>Form 990, Part VI, Line 11: Form 990 Review Process</ReturnReference>
        <Explanation>The Form 990 was prepared by the Finance department and reviewed by an independent accounting firm. A copy of the Form 990 was provided to the Audit and Business Integrity Committee of the Board. Acting under the authority of the Board, the Committee reviewed the Form 990 prior to the submission of the Form 990 to the Internal Revenue Service. In addition, the Form 990 will be provided to all Boards before it is filed with the Internal Revenue Service.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>Form 990, Part VI, Line 7b</Identifier>
        <ReturnReference>Form 990, Part VI, Line 7b: Describe Decisions of Governing Body Approval by Members or Shareholders</ReturnReference>
        <Explanation>Along with the election of governing members to the board, the MH Board (Parent) also needs to review and approve the following before becoming effective and before the action is implemented: 1. Any merger, consolidation or dissolution of the corporation. 2. Annual Business Plan. 3. Annual Budget. 4. Contractual obligations that meet any one of the folowing criteria: a. Outside the scope of the Corporation's annual business plan. b. Require approval by external health and/or financial regulatory agency. c. Having the potential of adversely impacting the operation of any subsidiary of the Member. 5. Any joint venture between the corporation and another person or entity that meets with any one of the following criteria: a. Extends beyond the scope of the annual business plan of the Corporation. b. Requires external approval by external health and/or financial regulatory agency. c. Has the potential of adversely impacting the operation of any subsidiary of the Member. 6. Sales or transfers of all or substantially all of the assets of the Corporation or sales or transfers of assets that meet with any one of the following criteria: a. Fall outside the scope of the Corporation's annual business plan. b. Require approval by external health and/or financial regulatory agency. c. Has the potential of adversely impacting the operations of any subsidiary of the Member. 7. Formulation of a subsidiary. 8. Adoption and amendment of the mission and vision statements.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>Form 990, Part VI, Line 7a</Identifier>
        <ReturnReference>Form 990, Part VI, Line 7a: How Members or Shareholders Elect Governing Body</ReturnReference>
        <Explanation>MMC nominates candidates for their board and presents the nominees to the MH Board (Parent) through the board designated Governance Committee. Final election occurs through the MH Board. The MH Board also approves the budget.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>Form 990, Part VI, Line 6</Identifier>
        <ReturnReference>Form 990, Part VI, Line 6: Explanation of Classes of Members or Shareholder</ReturnReference>
        <Explanation>The sole member of the Corporation, MMC, is MH. MH has the right to elect the members of the governing body and approve significant decisions of the governing body.</Explanation>
      </GeneralExplanation>
    </IRS990ScheduleO>
    <IRS990ScheduleR documentId="IRS990ScheduleR" softwareId="11000144" softwareVersion="2011v1.5">
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        <NameOfDisregardedEntity>
          <BusinessNameLine1>Medical Practices of Antietam LLC</BusinessNameLine1>
        </NameOfDisregardedEntity>
        <AddressUS>
          <AddressLine1>11116 Medical Campus Road</AddressLine1>
          <City>Hagerstown</City>
          <State>MD</State>
          <ZIPCode>21742</ZIPCode>
        </AddressUS>
        <EIN>522315129</EIN>
        <PrimaryActivities>Health services</PrimaryActivities>
        <LegalDomicileState>MD</LegalDomicileState>
        <TotalIncome>3529849</TotalIncome>
        <EOYAssets>4713227</EOYAssets>
        <DirectControllingEntityName>
          <BusinessNameLine1>MEI</BusinessNameLine1>
        </DirectControllingEntityName>
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          <BusinessNameLine1>Health Work LLC</BusinessNameLine1>
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          <AddressLine1>11116 Medical Campus Road</AddressLine1>
          <City>Hagerstown</City>
          <State>MD</State>
          <ZIPCode>21742</ZIPCode>
        </AddressUS>
        <EIN>342014438</EIN>
        <PrimaryActivities>Health servies</PrimaryActivities>
        <LegalDomicileState>MD</LegalDomicileState>
        <DirectControllingEntityName>
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        </DirectControllingEntityName>
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      <Form990ScheduleRPartI>
        <NameOfDisregardedEntity>
          <BusinessNameLine1>Meritus Medical Lab LLC</BusinessNameLine1>
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        <AddressUS>
          <AddressLine1>11116 Medical Campus Road</AddressLine1>
          <City>Hagerstown</City>
          <State>MD</State>
          <ZIPCode>21742</ZIPCode>
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        <PrimaryActivities>Health servies</PrimaryActivities>
        <LegalDomicileState>MD</LegalDomicileState>
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        <NameOfDisregardedEntity>
          <BusinessNameLine1>Meritus Urgent Care LLC</BusinessNameLine1>
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          <AddressLine1>11116 Medical Campus Road</AddressLine1>
          <City>Hagerstown</City>
          <State>MD</State>
          <ZIPCode>21742</ZIPCode>
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        <EIN>711050982</EIN>
        <PrimaryActivities>Health services</PrimaryActivities>
        <LegalDomicileState>MD</LegalDomicileState>
        <DirectControllingEntityName>
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          <City>Hagerstown</City>
          <State>MD</State>
          <ZIPCode>21742</ZIPCode>
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        <EIN>452382196</EIN>
        <PrimaryActivities>Health services</PrimaryActivities>
        <LegalDomicileState>MD</LegalDomicileState>
        <TotalIncome>3248930</TotalIncome>
        <EOYAssets>9387092</EOYAssets>
        <DirectControllingEntityName>
          <BusinessNameLine1>MMC</BusinessNameLine1>
        </DirectControllingEntityName>
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          <BusinessNameLine1>Meritus Medical Cent Endow Devel Co Inc</BusinessNameLine1>
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          <AddressLine1>11116 Medical Campus Road</AddressLine1>
          <City>Hagerstown</City>
          <State>MD</State>
          <ZIPCode>21742</ZIPCode>
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        <PrimaryActivities>Develops rental properties</PrimaryActivities>
        <LegalDomicileState>MD</LegalDomicileState>
        <ExemptCodeSection>501(c)(3)</ExemptCodeSection>
        <PublicCharityStatus>11-III FI</PublicCharityStatus>
        <DirectControllingEntityName>
          <BusinessNameLine1>MH</BusinessNameLine1>
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          <BusinessNameLine1>Meritus Healthcare Foundation Inc</BusinessNameLine1>
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          <AddressLine1>11116 Medical Campus Road</AddressLine1>
          <City>Hagerstown</City>
          <State>MD</State>
          <ZIPCode>21742</ZIPCode>
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        <EIN>010639265</EIN>
        <PrimaryActivities>Fundraising</PrimaryActivities>
        <LegalDomicileState>MD</LegalDomicileState>
        <ExemptCodeSection>501(c)(3)</ExemptCodeSection>
        <PublicCharityStatus>11c</PublicCharityStatus>
        <DirectControllingEntityName>
          <BusinessNameLine1>MH</BusinessNameLine1>
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        <ControlledOrg>false</ControlledOrg>
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        <NameOfDisregardedEntity>
          <BusinessNameLine1>Meritus Health Inc</BusinessNameLine1>
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          <AddressLine1>11116 Medical Campus Road</AddressLine1>
          <City>Hagerstown</City>
          <State>MD</State>
          <ZIPCode>21742</ZIPCode>
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        <EIN>521656378</EIN>
        <PrimaryActivities>Parent corporation</PrimaryActivities>
        <LegalDomicileState>MD</LegalDomicileState>
        <ExemptCodeSection>501(c)(3)</ExemptCodeSection>
        <PublicCharityStatus>11-III FI</PublicCharityStatus>
        <DirectControllingEntityName>
          <BusinessNameLine1>NA</BusinessNameLine1>
        </DirectControllingEntityName>
        <ControlledOrg>false</ControlledOrg>
      </Form990ScheduleRPartII>
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        <NameOfDisregardedEntity>
          <BusinessNameLine1>Meritus Medical Center Endowment Fund</BusinessNameLine1>
        </NameOfDisregardedEntity>
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          <AddressLine1>11116 Medical Campus Road</AddressLine1>
          <City>Hagerstown</City>
          <State>MD</State>
          <ZIPCode>21742</ZIPCode>
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        <EIN>237411960</EIN>
        <PrimaryActivities>Develops rental properties</PrimaryActivities>
        <LegalDomicileState>MD</LegalDomicileState>
        <ExemptCodeSection>501(c)(3)</ExemptCodeSection>
        <PublicCharityStatus>11-III FI</PublicCharityStatus>
        <DirectControllingEntityName>
          <BusinessNameLine1>MH</BusinessNameLine1>
        </DirectControllingEntityName>
        <ControlledOrg>false</ControlledOrg>
      </Form990ScheduleRPartII>
      <Form990ScheduleRPartIII>
        <NameOfRelatedOrg>
          <BusinessNameLine1>Robinwood Surgery Center LLC</BusinessNameLine1>
        </NameOfRelatedOrg>
        <AddressUS>
          <AddressLine1>11116 Medical Campus Road</AddressLine1>
          <City>Hagerstown</City>
          <State>MD</State>
          <ZIPCode>21742</ZIPCode>
        </AddressUS>
        <EIN>521770185</EIN>
        <PrimaryActivity>Health services</PrimaryActivity>
        <LegalDomicileState>MD</LegalDomicileState>
        <DirectControllingEntityNA>N/A</DirectControllingEntityNA>
        <DisproportionateAllocations>false</DisproportionateAllocations>
        <GeneralOrManagingPartner>false</GeneralOrManagingPartner>
      </Form990ScheduleRPartIII>
      <Form990ScheduleRPartIV>
        <NameOfRelatedOrg>
          <BusinessNameLine1>Meritus Insurance Company Ltd</BusinessNameLine1>
        </NameOfRelatedOrg>
        <AddressForeign>
          <AddressLine1>PO Box 1109GT</AddressLine1>
          <City>Grand Cayman</City>
          <Country>CJ</Country>
        </AddressForeign>
        <EIN>980162257</EIN>
        <PrimaryActivity>Captive insurance</PrimaryActivity>
        <LegalDomicileForeignCountry>CJ</LegalDomicileForeignCountry>
        <DirectControllingEntityNA>N/A</DirectControllingEntityNA>
      </Form990ScheduleRPartIV>
      <Form990ScheduleRPartIV>
        <NameOfRelatedOrg>
          <BusinessNameLine1>Meritus Enterprises Inc</BusinessNameLine1>
        </NameOfRelatedOrg>
        <AddressUS>
          <AddressLine1>11116 Medical Campus Road</AddressLine1>
          <City>Hagerstown</City>
          <State>MD</State>
          <ZIPCode>21742</ZIPCode>
        </AddressUS>
        <EIN>521393624</EIN>
        <PrimaryActivity>Health serv</PrimaryActivity>
        <LegalDomicileState>MD</LegalDomicileState>
        <DirectControllingEntityName>
          <BusinessNameLine1>MMC</BusinessNameLine1>
        </DirectControllingEntityName>
        <TypeOfEntity>C corp</TypeOfEntity>
        <ShareOfTotalIncome>-4107866</ShareOfTotalIncome>
        <ShareOfEOYAssets>34786019</ShareOfEOYAssets>
        <PercentageOwnership>1.00000</PercentageOwnership>
      </Form990ScheduleRPartIV>
      <ReceiptOfIntAnnRentsRoyalties>false</ReceiptOfIntAnnRentsRoyalties>
      <GiftGrantOrCapContrToOtherOrg>false</GiftGrantOrCapContrToOtherOrg>
      <GiftGrantOrCapContrFrOtherOrg>true</GiftGrantOrCapContrFrOtherOrg>
      <LoansOrGuaranteesToOtherOrg>false</LoansOrGuaranteesToOtherOrg>
      <LoansOrGuaranteesFromOtherOrg>false</LoansOrGuaranteesFromOtherOrg>
      <SaleOfAssetsToOtherOrg>false</SaleOfAssetsToOtherOrg>
      <PurchaseOfAssetsFromOtherOrg>false</PurchaseOfAssetsFromOtherOrg>
      <ExchangeOfAssets>false</ExchangeOfAssets>
      <RentalOfFacilitiesToOtherOrgs>false</RentalOfFacilitiesToOtherOrgs>
      <RentalOfFacilitiesFrOtherOrgs>false</RentalOfFacilitiesFrOtherOrgs>
      <PerformOfServicesForOtherOrgs>false</PerformOfServicesForOtherOrgs>
      <PerformOfServicesByOtherOrgs>true</PerformOfServicesByOtherOrgs>
      <SharingOfFacilities>true</SharingOfFacilities>
      <SharingOfPaidEmployees>true</SharingOfPaidEmployees>
      <ReimbursementPaidToOtherOrg>false</ReimbursementPaidToOtherOrg>
      <ReimbursementPaidByOtherOrg>true</ReimbursementPaidByOtherOrg>
      <OtherTransferToOtherOrg>false</OtherTransferToOtherOrg>
      <OtherTransferFromOtherOrg>false</OtherTransferFromOtherOrg>
      <TransactionsRelatedOrgsTable>
        <NameOfOtherOrganization>
          <BusinessNameLine1>Meritus Healthcare Foundation Inc</BusinessNameLine1>
        </NameOfOtherOrganization>
        <TransactionType>c</TransactionType>
        <AmountInvolved>2220538</AmountInvolved>
        <MethodOfAmtDetermination>Cash</MethodOfAmtDetermination>
      </TransactionsRelatedOrgsTable>
    </IRS990ScheduleR>
  </ReturnData>
</Return>