2013-05-10T11:12:35-05:00 2012-06-30 KPMG LLP 440 Monticello Ave Suite 1900 Norfolk VA 235102674 990 2011-07-01 520591607 The Good Samaritan Hospital of Maryland Inc % MARC BERGER GOOD 4107726719 5601 LOCH RAVEN BLVD Baltimore MD 21239 Marc R Berger 4107726719 2013-05-08 true 7576167000 2011 2016-02-24 21:20:13Z MEDSTAR GOOD SAMARITAN HOSPITAL Jeffrey Matton 5601 LOCH RAVEN BLVD BALTIMORE MD 21239 329621026 false X www.goodsam-md.org X 1920 MD WE ARE GOOD SAMARITANS, GUIDED BY CATHOLIC TRADITION AND TRUSTED TO DELIVER IDEAL HEALTH EXPERIENCES. 22 17 2843 14 139774 183784 134139 322067211 323439152 5927773 1924278 3736785 4123457 331915553 329621026 0 0 0 0 151644605 155820858 0 150000 150000 166224197 161899628 317868802 317870486 14046751 11750540 173434761 171926666 57296176 57290961 116138585 114635705 X AS A PROUD MEMBER OF MEDSTAR HEALTH, MEDSTAR GOOD SAMARITAN HOSPITAL'S MISSION IS TO BE GOOD SAMARITANS, GUIDED BY CATHOLIC TRADITION AND TRUSTED TO DELIVER IDEAL HEALTH EXPERIENCES. MEDSTAR GOOD SAMARITAN HOSPITAL (MEDSTAR GOOD SAMARITAN), LOCATED IN NORTHEAST BALTIMORE CITY, MARYLAND, IS A SPECIALTY FACILITY AND COMPREHENSIVE CARE COMMUNITY HOSPITAL. IT PROVIDES SENIOR LIVING SERVICES THROUGH THE GOOD SAMARITAN NURSING CENTER AND TWO SENIOR HOUSING COMPLEXES LOCATED ON ITS 43-ACRE CAMPUS. IN FISCAL YEAR 2012, MEDSTAR GOOD SAMARITAN HAD 14,948 INPATIENT ADMISSIONS, 327,930 OUTPATIENT VISITS, AND 61,879 EMERGENCY VISITS. false false 253312821 0 306360499 MedStar Good Samaritan Hospital's largest program is access to and the provision of acute hospital services to the communities of northeastern Baltimore City, Maryland and the surrounding areas. In addition to the program service expenses listed above, MedStar Good Samaritan incurred $33.1M of management and general expenses in providing services to its communities. MedStar Good Samaritan is known for excellence in orthopedics, rheumatology, nephrology, physical and rehabilitation medicine, and burn reconstruction. In addition to general adult acute care services, MedStar Good Samaritan has a comprehensive inpatient rehabilitation unit and a sub-acute care unit. It offers community-based health services through the Good Health Center. MedStar Good Samaritan is recognized by the Joint Commission as an Advanced Primary Stroke Center. US News and World Report recognized MedStar Good Samaritan as a high performing hospital in cancer, diabetes/endocrinology, gastroenterology, geriatrics, nephrology/neurosurgery, orthopedics, pulmonology, and urology. The hospital is a four-time recipient of the Delmarva Foundation for Medical Care's Excellence Award for Quality Improvement in Hospitals. MedStar Good Samaritan was also recognized for the seventh consecutive year by HealthGrades as a distinguished hospital for clinical excellence, and was recognized by HealthGrades as one of the nation's 50 best hospitals in 2011. 22705751 0 17078653 MEDSTAR GOOD SAMARITAN HOSPITAL PROVIDED $22.7M IN SUBSIDIZED (MISSION DRIVEN) HEALTH SERVICES IN FISCAL 2012. THESE CRITICAL SERVICES, WHICH ARE DRIVEN BY COMMUNITY NEEDS, OPERATE AT A LOSS. THEY ADDRESS PRIORITIES PRIMARILY THROUGH DISEASE PREVENTION AND IMPROVEMENT OF HEALTH STATUS. SERVICES PROVIDED INCLUDE WOMEN'S HEALTH SERVICES, HOSPITALISTS, PSYCHIATRY, UROLOGY, EMERGENCY DEPARTMENT COVERAGE, OUTPATIENT RENAL CARE, AND CERTAIN SUB-ACUTE PROGRAM SUBSIDIES. 8761836 0 0 MEDSTAR GOOD SAMARITAN HOSPITAL PROVIDED $8.8M IN HEALTH PROFESSIONS EDUCATION IN FISCAL YEAR 2012. THIS CATEGORY INCLUDES TRAINING IN GRADUATE MEDICAL EDUCATION, AND EDUCATION FOR PHYSICIANS, MEDICAL STUDENTS, NURSES, AND OTHER HEALTH PROFESSIONS. 284780408 true false false false false false false false false false true false false true true true false true false false false false false false false false true true false false true false false false false false true false false false false false false true true true true false false true 0 0 true 2843 true true true false false false false false false false false false X 22 17 false false true false true true true true true false false true true true true true true true true false MD X MARC BERGER 4107726719 5565 STERRETT PL 5TH FLR COLUMBIA MD 21044 X DANIEL P CAHILL 1.0 X 0 0 0 MOIRA P LARSEN MD 40.0 X 0 0 0 JEFFREY A MATTON 40.0 X X 589039 0 30286 KENNETH A SAMET 1.0 X 0 6126151 183379 WILMOT C BALL JR MD 1.0 X 0 0 0 HOWARD S FREELAND MD 1.0 X X 13750 255096 15100 SHELDON M GLUSMAN MD 1.0 X 0 0 0 DAVIS M HAHN MD 1.0 X X 0 103031 379 JEREMY P WEINER MD 40.0 X X 50004 0 0 ANTHONY READ 1.0 X 0 0 0 CHARLES L BAUERMANN 1.0 X 0 0 0 KAY G BEE 40.0 X 0 0 0 JEFFREY R DONNELLY 1.0 X 0 0 0 SONYA H GRAY 1.0 X 0 0 0 DENIS J MADDEN 1.0 X 0 0 0 ALLAN NOONAN MD 1.0 X 0 0 0 T EDGIE RUSSELL III 1.0 X 0 0 0 PM SMITH 1.0 X 0 0 0 JOHN C SMYTH 1.0 X 0 0 0 KATHLEEN J WHITING 1.0 X 0 0 0 JAYNE H MCGEEHAN 1.0 X 0 0 0 CHRISTOPHER T HELMRATH 1.0 X 0 0 0 LAWRENCE M JOHNSON 1.0 X 0 0 0 DEANA STOUT 40.0 X 293469 0 38029 MARTIN BINSTOCK MD 40.0 X 436352 0 37082 SHIRLEY ROTH 40.0 X 216992 0 23916 THOMAS SENKER 40.0 X 219046 0 16619 JENNIFER WILKERSON 40.0 X 188417 0 23492 DALE BUCHBINDER MD 40.0 X 647659 0 12373 DAVID COLL MD 40.0 X 593625 0 15424 MICHAEL JACOBS MD 40.0 X 796527 0 15553 ELIAS SHAYA MD 40.0 X 351398 0 1507 ROBERT BRESLIN MD 40.0 X 447232 0 12264 4843510 6484278 425403 156 false true false MORRISON MANAGEMENT SPECIALIST 4721 MORRISON DRIVE MOBILE AL 36609 FOOD SVC PROVIDER 3425378 UNIVERSITY OF MARYLAND 22 S GREENE STREET BALTIMORE MD 21201 MEDICAL SERVICES 2930353 DRS HAHN PADGETT 5601 LOCH RAVEN BOULEVARD BALTIMORE MD 21239 MEDICAL SERVICES 1600002 HUNT VALLEY ANESTHESIA ASSOC PA PO BOX 20284 TOWSON MD 21284 MEDICAL SERVICES 8144449 GS SURGICAL SERVICES LLC 2400 VELVET RIDGE DRIVE OWINGS MILLS MD 21117 MEDICAL SERVICES 902000 30 134139 134139 NET PATIENT SERVICE REVENUE 621400 323360419 323360419 LAB REVENUE 621500 78733 78733 323439152 1247231 1247231 0 0 511000 511000 511000 511000 676779 268 676779 268 677047 677047 0 0 0 REBATE INCOME 900099 910350 910350 CHILD DAY CARE 900099 310756 310756 MEALS ON WHEELS 900099 140799 140799 2250552 61041 2189511 3612457 329621026 323360419 139774 5986694 0 0 0 0 0 143591620 128393162 15198458 0 2984223 2668358 315865 0 9245015 8266476 978539 20117226 17987918 2129308 2712 2425 287 0 0 150000 150000 0 43936123 39938489 3997634 1360175 1216207 143968 8821497 7887786 933711 198962 177903 21059 0 2038813 1823015 215798 309827 277033 32794 0 49891 44610 5281 2996473 2679311 317162 0 12090030 10810361 1279669 3052645 2729538 323107 MEDICAL/SURGICAL SUPPLIES 16595001 14838503 1756498 DRUGS/PHARMACEUTICALS 16173435 14461557 1711878 IMPLANTS/ PROSTHESES 10142547 9069009 1073538 BAD DEBT 12395841 11120037 1275804 11618430 10388710 1229720 317870486 284780408 32940078 150000 3600 3900 0 0 0 0 41031218 44592743 0 0 0 0 0 0 2841010 2657563 874518 556686 220915628 149168778 75720100 71746850 0 0 126795 141258 0 0 0 0 52837520 52227666 173434761 171926666 30675592 28823499 0 0 103476 976865 0 0 0 0 0 0 0 0 0 0 26517108 27490597 57296176 57290961 X 66847243 66037172 49291342 48598533 0 0 116138585 114635705 173434761 171926666 X 11750540 -13253420 X X false true true X false X 61194529 32450201 28744328 1203152 308683 894469 131806420 98934181 32872239 26711527 17475714 9235814 71746850 CATHOLIC HEALTH CARE FUND 48457275 OPTION IT ASSET 3119882 INTERCOMPANY RECEIVABLES 175 OTHER ASSETS 650334 52227666 0 ADVANCES FROM 3RD PARTY PAYORS 6751656 ASBESTOS ABATEMENT LIABILITY 2628587 STOCK OPTION PLAN 2634095 WORKERS COMP 2435586 CREDIT BALANCE PATIENT A/R 2222124 DEFERRED COMPENSATION LIABILIT 573225 OTHER LIABILITIES 10245324 27490597 FIN 48 FOOTNOTE SCHEDULE D, PART X INCOME TAXES ARE ACCOUNTED FOR UNDER THE ASSET AND LIABILITY METHOD. DEFERRED TAX ASSETS AND LIABILITIES ARE RECOGNIZED FOR THE FUTURE TAX CONSEQUENCES ATTRIBUTABLE TO DIFFERENCES BETWEEN THE FINANCIAL STATEMENT CARRYING AMOUNTS OF EXISTING ASSETS AND LIABILITIES AND THEIR RESPECTIVE TAX BASES AND OPERATING LOSS AND TAX CREDIT CARRYFORWARDS. DEFERRED TAX ASSETS AND LIABILITIES ARE MEASURED USING ENACTED TAX RATES EXPECTED TO APPLY TO TAXABLE INCOME IN THE YEARS IN WHICH THOSE TEMPORARY DIFFERENCES ARE EXPECTED TO BE RECOVERED OR SETTLED. THE EFFECT ON DEFERRED TAX ASSETS AND LIABILITIES OF A CHANGE IN TAX RATES IS RECOGNIZED IN THE PERIOD THAT INCLUDES THE ENACTMENT DATE. ANY CHANGES TO THE VALUATION ALLOWANCE ON THE DEFERRED TAX ASSET ARE REFLECTED IN THE YEAR OF CHANGE. THE CORPORATION ACCOUNTS FOR UNCERTAIN TAX POSITIONS IN ACCORDANCE WITH THE FASB ACCOUNTING STANDARDS CODIFICATION (ASC) TOPIC 740, INCOME TAXES. THERE WAS NO LIABILITY RECORDED FOR UNCERTAIN TAX POSITIONS AS OF JUNE 30, 2012. true true X true X true X true true true false true true 0 5634248 0 5634248 0.01770 0 0 0 0 0.00000 0 0 0 0 0.00000 0 5634248 0 5634248 0.01770 60 112752 1587650 64780 1522870 0.00480 14 675 8761836 0 8761836 0.02760 8 6534 22705751 17078653 5627098 0.01770 1 75 1212 0 1212 3 1000 36280 0 36280 0.00010 86 121036 33092729 17143433 15949296 0.05020 86 121036 38726977 17143433 21583544 0.06790 0 0 0 0 0.00000 0 0 0 0 0.00000 1 0 44628 0 44628 0.00010 0 0 0 0 0.00000 0 0 0 0 0.00000 0 0 0 0 0.00000 1 0 45441 0 45441 0.00010 1 1 6929 0 6929 0 0 0 0 0.00000 3 1 96998 0 96998 0.00020 true 12395841 0 0 0 0 X true true 1 1 Main Hospital Building

5601 Loch Raven Blvd Baltimore MD 21239

X X X Main Hospital Building 1 true X X X X X X X X X 12 true false true X X X X X X X X X X true true 200. true 400. true X X X X X X true true X X X X true false true X false false 1 Transitional Care at Good Samaritan

5601 Loch Raven Blvd Baltimore MD 21239

Comprehensive Care Facility CHARITY CARE AT COST PART I, LINE 7A MARYLAND'S REGULATORY SYSTEM CREATES A UNIQUE PROCESS FOR HOSPITAL PAYMENT THAT DIFFERS FROM THE REST OF THE NATION. THE HEALTH SERVICES COST REVIEW COMMISSION (HSCRC), DETERMINES PAYMENT THROUGH A RATE-SETTING PROCESS AND ALL PAYORS, INCLUDING GOVERNMENTAL PAYORS, PAY THE SAME AMOUNT FOR THE SAME SERVICES DELIVERED AT THE SAME HOSPITAL. MARYLAND'S UNIQUE ALL-PAYOR SYSTEM INCLUDES A METHOD FOR REFERENCING UNCOMPENSATED CARE IN EACH PAYORS' RATES, WHICH DOES NOT ENABLE MARYLAND HOSPITALS TO BREAKOUT ANY OFFSETTING REVENUE RELATED TO UNCOMPENSATED CARE. UNREIMBURSED MEDICAID PART I, LINE 7B MARYLAND'S REGULATORY SYSTEM CREATES A UNIQUE PROCESS FOR HOSPITAL PAYMENT THAT DIFFERS FROM THE REST OF THE NATION. THE HEALTH SERVICES COST REVIEW COMMISSION (HSCRC), DETERMINES PAYMENT THROUGH A RATE-SETTING PROCESS AND ALL PAYORS, INCLUDING GOVERNMENTAL PAYORS, PAY THE SAME AMOUNT FOR THE SAME SERVICES DELIVERED AT THE SAME HOSPITAL. MARYLAND'S UNIQUE ALL-PAYOR SYSTEM INCLUDES A METHOD FOR REFERENCING UNCOMPENSATED CARE IN EACH PAYORS' RATES, WHICH DOES NOT ENABLE MARYLAND HOSPITALS TO BREAKOUT ANY OFFSETTING REVENUE RELATED TO UNCOMPENSATED CARE. COMMUNITY BENEFIT EXPENSES ARE EQUAL TO MEDICAID REVENUES IN MARYLAND, AS SUCH, THE NET EFFECT IS ZERO. THE EXCEPTION TO THIS IS THE IMPACT ON THE HOSPITAL OF ITS SHARE OF THE MEDICAID ASSESSMENT. IN RECENT YEARS, THE STATE OF MARYLAND HAS CLOSED FISCAL GAPS IN THE STATE MEDICAID BUDGET BY ASSESSING HOSPITALS THROUGH THE RATE-SETTING SYSTEM. HEALTH PROFESSIONS EDUCATION PART I, LINE 7F 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. PERCENT OF TOTAL EXPENSE PART I, LINE 7, COLUMN(F) BAD DEBT EXPENSE OF $12,395,841 HAS BEEN REMOVED FROM TOTAL EXPENSE TO CALCULATE THE PERCENTAGES IN COLUMN (F). BAD DEBT PART III, LINE 4 MEDSTAR HEALTH AND ITS AFFILIATED ORGANIZATIONS REPORT BAD DEBT EXPENSE IN ACCORDANCE WITH GENERALLY ACCEPTED ACCOUNTING PRINCIPLES (GAAP) AND HFMA 15. AMOUNTS THAT ARE NOT EXPECTED TO BE COLLECTED, FOR PATIENTS QUALIFYING UNDER MEDSTAR HEALTH'S FINANCIAL ASSISTANCE POLICY, ARE WRITTEN OFF TO CHARITY CARE AND REPORTED AS A REDUCTION TO REVENUE. BAD DEBT EXPENSE RESULTS FROM MANAGEMENT'S INABILITY TO COLLECT REVENUES THAT MEET THE GAAP CRITERIA FOR REVENUE RECOGNITION. BAD DEBT REPRESENTS AN OPERATING EXPENSE AND IS REFLECTED AS A SEPARATE LINE ITEM ON THE ORGANIZATION'S STATEMENT OF OPERATIONS. HOWEVER, MEDSTAR AND ITS AFFILIATED ENTITIES DO NOT MAKE A DETERMINATION AS TO WHETHER SELF PAY AMOUNTS ARE COLLECTIBLE IN DETERMINING REVENUE RECOGNITION. RESERVE MODELS, WHICH HAVE BEEN DEVELOPED BASED ON HISTORICAL COLLECTION RESULTS AND WHICH ARE ADJUSTED PERIODICALLY BASED ON ACTUAL COLLECTIONS EXPERIENCE, ARE USED TO ESTIMATE UNCOLLECTIBLE AMOUNTS ACROSS ALL PAYORS INCLUDING SELF PAY. BAD DEBT DETERMINATIONS ARE MADE ONLY AFTER SUFFICIENT EVIDENCE IS OBTAINED TO SUPPORT THAT AN AMOUNT IS NOT COLLECTIBLE. MEDICARE PART III, LINE 8 MARYLAND'S REGULATORY SYSTEM CREATES A UNIQUE PROCESS FOR HOSPITAL PAYMENT THAT DIFFERS FROM THE REST OF THE NATION. THE HEALTH SERVICES COST REVIEW COMMISSION (HSCRC) DETERMINES PAYMENT THROUGH A RATE-SETTING PROCESS AND ALL PAYORS, INCLUDING GOVERNMENTAL PAYORS, PAY THE SAME AMOUNT FOR THE SAME SERVICES DELIVERED AT THE SAME HOSPITAL. MARYLAND'S UNIQUE ALL-PAYOR SYSTEM INCLUDES A METHOD FOR REFERENCING UNCOMPENSATED CARE IN EACH PAYORS' RATES, WHICH DOES NOT ENABLE MARYLAND HOSPITALS TO BREAKOUT ANY OFFSETTING REVENUE RELATED TO UNCOMPENSATED CARE. AS SUCH, THE NET EFFECT FOR MEDICARE EXPENSES AND REVENUES IN MARYLAND IS ZERO. NEEDS ASSESSMENT Part V, Section B, Line 7 The implementation strategies serve as a roadmap for how community benefit resources will be allocated and deployed. MedStar's hospitals will be able to measure our contribution to improving the health of underserved and vulnerable populations in the regions we serve. Three-year implementation strategies with measurable objectives were developed for each hospital's community benefit service area - a specific community or target population of focus. Priorities were based on community need as determined by quantitative data and community input, as well as on hospital expertise, resources, strengths of existing programming and partnerships, and alignment with national, state, and local health goals. The MedStar Health Corporate Community Health Department will provide system-wide coordination and oversight of community benefit programming. PART VI, LINE 2 IN FY12, MEDSTAR GOOD SAMARITAN HOSPITAL CONDUCTED A COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) IN ACCORDANCE WITH THE GUIDELINES ESTABLISHED BY THE PATIENT PROTECTION AND AFFORDABLE CARE ACT AND THE INTERNAL REVENUE SERVICE. THE HOSPITAL'S CHNA WAS LED BY 11 ADVISORY TASK FORCE (ATF) MEMBERS, WHICH WAS COMPRISED OF A DIVERSE GROUP OF INDIVIDUALS, INCLUDING GRASSROOTS ACTIVISTS, COMMUNITY RESIDENTS, FAITH-BASED LEADERS, HOSPITAL REPRESENTATIVES, PUBLIC HEALTH LEADERS, AND OTHER STAKEHOLDER ORGANIZATIONS, SUCH AS REPRESENTATIVES FROM LOCAL HEALTH DEPARTMENTS. THE ATF REVIEWED QUANTITATIVE AND QUALITATIVE COMMUNITY HEALTH DATA, AS WELL AS LOCAL, REGIONAL AND NATIONAL HEALTH GOALS. BASED ON THEIR FINDINGS, THE ATF DESIGNED A SURVEY TO IDENTIFY TRENDS IN HOW PARTICIPANTS PERCEIVED THE SEVERITY OF KEY HEALTH ISSUES IN THE FOLLOWING CATEGORIES: WELLNESS AND PREVENTION, ACCESS TO CARE, QUALITY OF LIFE, AND ENVIRONMENT. COMMUNITY MEMBERS RESPONDED TO THE SURVEY BY ATTENDING A COMMUNITY INPUT SESSION OR COMPLETING IT ONLINE OR VIA HARDCOPY. BASED ON THE ATF'S RECOMMENDATION, THE HOSPITAL IDENTIFIED GOVANS AS ITS COMMUNITY BENEFIT SERVICE AREA (CBSA) - GEOGRAPHY WITH A HIGH DENSITY OF LOW-INCOME OR VULNERABLE RESIDENTS WITHIN CLOSE PROXIMITY OF THE HOSPITAL. HEALTH PRIORITIES FOR THE CBSA INCLUDE HEART DISEASE AND DIABETES. THE HOSPITAL'S FY12 CHNA AND 3-YEAR IMPLEMENTATION STRATEGIES WERE ENDORSED BY MEDSTAR GOOD SAMARITAN'S BOARD OF DIRECTORS AND APPROVED BY THE MEDSTAR HEALTH BOARD OF DIRECTORS. THE DOCUMENT WAS PUBLISHED ON THE HOSPITAL'S WEBSITE ON JUNE 30, 2012. AS A PROUD MEMBER OF MEDSTAR HEALTH, REPRESENTATIVES FROM MEDSTAR GOOD SAMARITAN ROUTINELY PARTICIPATE IN THE MEDSTAR HEALTH COMMUNITY BENEFIT WORKGROUP. THE WORKGROUP IS COMPRISED OF COMMUNITY HEALTH PROFESSIONALS WHO REPRESENT ALL NINE MEDSTAR HOSPITALS. THE TEAM ANALYZES LOCAL AND REGIONAL COMMUNITY HEALTH DATA, ESTABLISHES SYSTEM-WIDE COMMUNITY HEALTH PROGRAMMING PERFORMANCE AND EVALUATION MEASURES AND SHARES BEST PRACTICES. PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE PART VI, LINE 3 AS ONE OF THE REGION'S LEADING NOT-FOR-PROFIT HEALTHCARE SYSTEMS, MEDSTAR HEALTH IS COMMITTED TO ENSURING THAT UNINSURED PATIENTS WITHIN THE COMMUNITIES WE SERVE WHO LACK FINANCIAL RESOURCES HAVE ACCESS TO NECESSARY HOSPITAL SERVICES. MEDSTAR HEALTH AND ITS HEALTHCARE FACILITIES WILL: " TREAT ALL PATIENTS EQUITABLY, WITH DIGNITY, WITH RESPECT AND WITH COMPASSION. " SERVE THE EMERGENCY HEALTH CARE NEEDS OF EVERYONE WHO PRESENTS AT OUR FACILITIES REGARDLESS OF A PATIENT'S ABILITY TO PAY FOR CARE. " ASSIST THOSE PATIENTS WHO ARE ADMITTED THROUGH OUR ADMISSIONS PROCESS FOR NON-URGENT, MEDICALLY NECESSARY CARE WHO CANNOT PAY FOR PART OF ALL OF THE CARE THEY RECEIVE. " BALANCE NEEDED FINANCIAL ASSISTANCE FOR SOME PATIENTS WITH BROADER FISCAL RESPONSIBILITIES IN ORDER TO KEEP ITS HOSPITALS' DOORS OPEN FOR ALL WHO MAY NEED CARE IN THE COMMUNITY. IN MEETING ITS COMMITMENTS, MEDSTAR HEALTH'S FACILITIES WILL WORK WITH THEIR UNINSURED PATIENTS TO GAIN AN UNDERSTANDING OF EACH PATIENT'S FINANCIAL RESOURCES PRIOR TO ADMISSION (FOR SCHEDULED SERVICES) OR PRIOR TO BILLING (FOR EMERGENCY SERVICES). BASED ON THIS INFORMATION AND PATIENT ELIGIBILITY, MEDSTAR HEALTH'S FACILITIES WILL ASSIST UNINSURED PATIENTS WHO RESIDE WITHIN THE COMMUNITIES WE SERVE IN ONE OR MORE OF THE FOLLOWING WAYS: " ASSIST WITH ENROLLMENT IN PUBLICLY-FUNDED ENTITLEMENT PROGRAMS (E.G., MEDICAID). " ASSIST WITH CONSIDERATION OF FUNDING THAT MAY BE AVAILABLE FROM OTHER CHARITABLE ORGANIZATIONS. " PROVIDE CHARITY CARE AND FINANCIAL ASSISTANCE ACCORDING TO APPLICABLE GUIDELINES. " PROVIDE FINANCIAL ASSISTANCE FOR PAYMENT OF FACILITY CHARGES USING A SLIDING SCALE BASED ON PATIENT FAMILY INCOME AND FINANCIAL RESOURCES. " OFFER PERIODIC PAYMENT PLANS TO ASSIST PATIENTS WITH FINANCING THEIR HEALTHCARE SERVICES. EACH FACILITY WILL POST THE POLICY, INCLUDING A DESCRIPTION OF THE APPLICABLE COMMUNITIES IT SERVES, IN EACH MAJOR PATIENT REGISTRATION AREA AND IN ANY OTHER AREAS REQUIRED BY APPLICABLE REGULATIONS, WILL COMMUNICATE THE INFORMATION TO PATIENTS AS REQUIRED BY THIS POLICY AND APPLICABLE REGULATIONS AND WILL MAKE A COPY OF THE POLICY AVAILABLE TO ALL PATIENTS. ADDITIONALLY, THE MARYLAND PATIENT INFORMATION SHEET/MEDSTAR'S PATIENT INFORMATION SHEET WILL BE PROVIDED TO INPATIENTS ON ADMISSION AND AT TIME OF FINAL ACCOUNT BILLING. MEDSTAR HEALTH BELIEVES THAT ITS PATIENTS HAVE PERSONAL RESPONSIBILITIES RELATED TO THE FINANCIAL ASPECTS OF THEIR HEALTHCARE NEEDS. THE CHARITY CARE, FINANCIAL ASSISTANCE, AND PERIODIC PAYMENT PLANS AVAILABLE UNDER THIS POLICY WILL NOT BE AVAILABLE TO THOSE PATIENTS WHO FAIL TO FULFILL THEIR RESPONSIBILITIES. FOR PURPOSES OF THIS POLICY, PATIENT RESPONSIBILITIES INCLUDE: " COMPLETING FINANCIAL DISCLOSURE FORMS NECESSARY TO EVALUATE THEIR ELIGIBILITY FOR PUBLICLY-FUNDED HEALTHCARE PROGRAMS, CHARITY CARE PROGRAMS, AND OTHER FORMS OF FINANCIAL ASSISTANCE. THESE DISCLOSURE FORMS MUST BE COMPLETED ACCURATELY, TRUTHFULLY, AND TIMELY TO ALLOW MEDSTAR HEALTH'S FACILITIES TO PROPERLY COUNSEL PATIENTS CONCERNING THE AVAILABILITY OF FINANCIAL ASSISTANCE. " WORKING WITH THE FACILITY'S FINANCIAL COUNSELORS AND OTHER FINANCIAL SERVICES STAFF TO ENSURE THERE IS A COMPLETE UNDERSTANDING OF THE PATIENT'S FINANCIAL SITUATION AND CONSTRAINTS. " COMPLETING APPROPRIATE APPLICATIONS FOR PUBLICLY-FUNDED HEALTHCARE PROGRAMS. THIS RESPONSIBILITY INCLUDES RESPONDING IN A TIMELY FASHION TO REQUESTS FOR DOCUMENTATION TO SUPPORT ELIGIBILITY. " MAKING APPLICABLE PAYMENTS FOR SERVICES IN A TIMELY FASHION, INCLUDING ANY PAYMENTS MADE PURSUANT TO DEFERRED AND PERIODIC PAYMENT SCHEDULES. " PROVIDING UPDATED FINANCIAL INFORMATION TO THE FACILITY'S FINANCIAL COUNSELORS ON A TIMELY BASIS AS THE PATIENT'S CIRCUMSTANCES MAY CHANGE. " IT IS THE RESPONSIBILITY OF THE PATIENT TO INFORM THE MEDSTAR HOSPITAL OF THEIR EXISTING ELIGIBILITY UNDER A MEDICAL HARDSHIP DURING THE 12 MONTH PERIOD. UNINSURED PATIENTS OF MEDSTAR HEALTH'S FACILITIES MAY BE ELIGIBLE FOR CHARITY CARE OR SLIDING-SCALE FINANCIAL ASSISTANCE UNDER THIS POLICY. THE FINANCIAL COUNSELORS AND FINANCIAL SERVICES STAFF WILL DETERMINE ELIGIBILITY FOR CHARITY CARE AND SLIDING-SCALE FINANCIAL ASSISTANCE BASED ON REVIEW OF INCOME FOR THE PATIENT AND THEIR FAMILY (HOUSEHOLD), OTHER FINANCIAL RESOURCES AVAILABLE TO THE PATIENT'S FAMILY, FAMILY SIZE, AND THE EXTENT OF THE MEDICAL COSTS TO BE INCURRED BY THE PATIENT. COMMUNITY INFORMATION PART VI, LINE 4 GEOGRAPHIC: MEDSTAR GOOD SAMARITAN IS LOCATED IN THE NORTHEAST SECTION OF BALTIMORE CITY AND SERVES THE FOLLOWING COMMUNITIES: CHINQUAPIN PARK/BELVEDERE, GOVANS, HAMILTON, HARFORD/ECHODALE, LAURAVILLE, LOCH RAVEN VILLAGE, AND NORTHWOOD. MOST OF THESE COMMUNITIES ARE COMPRISED OF MODERATELY PRICED TOWNHOMES AND SOME SMALL SINGLE FAMILY HOMES WHICH ARE CONVENIENTLY LOCATED NEAR GROCERY STORES, SHOPPING CENTERS, COLLEGES, SCHOOLS AND CHURCHES AND HAVE EASY ACCESS TO PUBLIC TRANSPORTATION. PRIMARY SERVICE AREA ZIP CODES INCLUDE 21234, 21239, 21214, 21212 AND 21206. DEMOGRAPHICS: THE BASE POPULATION OF THE COMMUNITY BENEFIT SERVICE AREA (CBSA) IS APPROXIMATELY 619,413. THE FOLLOWING DEMOGRAPHICS REFLECT THE AVERAGE NUMBERS FOR ALL CBSA'S NOTED ABOVE. THE COMMUNITIES SERVED ARE RACIALLY/ETHNICALLY DIVERSE, WITH 78.7% AFRICAN AMERICAN, 17.4% WHITE 1.8% HISPANIC/LATINOS, 0.8% ASIAN, 2.0% TWO OR MORE RACES AND 0.9% OTHER RACE. AGE DISTRIBUTION IS; 0-17 - 24.4%, 18-24 - 10.1%, 25-44 - 25.6%, 45-64 - 27%, 65+ - 12.8%. MALES REPRESENT 45.2% OF THE POPULATION, FEMALES 54.8%. PROMOTION OF COMMUNITY HEALTH PART VI, LINE 5 AS A COMMUNITY PARTNER, MEDSTAR GOOD SAMARITAN ENGAGES IN A NUMBER OF COMMUNITY BENEFIT ACTIVITIES TO IMPROVE AND PROMOTE THE HEALTH AND WELL-BEING OF THE COMMUNITY. BLOOD PRESSURE SCREENING PROGRAM MEDSTAR GOOD SAMARITAN'S COMMUNITY OUTREACH AND PARISH NURSE PROGRAM PARTNER WITH MANY CHURCHES AND COMMUNITY ORGANIZATIONS, SUCH AS SENIOR CENTERS AND SENIOR HOUSING, TO OFFER FREE BLOOD PRESSURE SCREENINGS ON A MONTHLY BASIS. THE PROGRAM RAISES AWARENESS, EDUCATES PARTICIPANTS ABOUT THE DANGERS OF HYPERTENSION, AND IDENTIFIES THOSE WITH HIGH BLOOD PRESSURE. IN FY12 APPROXIMATELY 1,000 PEOPLE WERE SCREENED FOR HYPERTENSION AND APPROXIMATELY 50% OF THOSE SCREENED HAD BLOOD PRESSURE READINGS OVER THE NORMAL RANGE. PARTICIPANTS WERE ADVISED TO TAKE URGENT ACTION IF NEEDED, REFERRED TO A PHYSICIAN AND WERE GIVEN EDUCATIONAL LITERATURE ON HYPERTENSION AND STROKE. PARTICIPANTS WHO DID NOT HAVE A PRIMARY CARE PHYSICIAN WERE PROVIDED THE NAMES AND PHONE NUMBERS OF PHYSICIANS, AS WELL AS INFORMATION FOR MEDSTAR GOOD SAMARITAN'S PRIMARY CARE CENTER, WHICH PROVIDES CARE TO UNINSURED AND UNDERINSURED INDIVIDUALS. BALTIMORE CITY HEAD START AND PAROCHIAL SCHOOL VISION AND HEARING SCREENING PROGRAM IN RESPONSE TO A REQUEST FROM THE BALTIMORE CITY PAROCHIAL SCHOOLS AND SOME LOCAL HEAD START PROGRAMS, MEDSTAR GOOD SAMARITAN WORKS WITH LOYOLA COLLEGE TO CONDUCT VISION AND HEARING SCREENINGS FOR GRADE SCHOOL CHILDREN. MEDSTAR GOOD SAMARITAN AND LOYOLA COLLEGE'S SPEECH AND HEARING DEPARTMENT SCREEN CHILDREN IN GRADES PRE-K THROUGH 8 AT SIX LOCAL PAROCHIAL SCHOOLS, 2 HEAD START PROGRAMS AND ONE SPECIAL NEEDS SCHOOL ON A YEARLY BASIS. UNIDENTIFIED, UNTREATED PROBLEMS WITH VISION AND HEARING IN CHILDREN CAN LEAD TO LOSS OF VISION AND HEARING, LEARNING DIFFICULTIES AND DELAYED SENSORY, MOTOR, COGNITIVE, AND SOCIAL-EMOTIONAL DEVELOPMENT. IN FY12, SCREENINGS WERE CONDUCTED AT 9 SCHOOLS WITH A TOTAL OF 808 CHILDREN SCREENED, GIVING 66 REFERRALS FOR VISION FOLLOW UP AND 62 REFERRALS FOR HEARING FOLLOW UP TO THE PARENTS OF CHILDREN WHO DID NOT PASS THE SCREENING. APPROXIMATELY 10% OF THE CHILDREN WERE FOUND TO HAVE EITHER A VISION OR HEARING PROBLEM WHEN AN IN-DEPTH FOLLOW UP WAS COMPLETED BY OPHTHALMOLOGIST OR AUDIOLOGIST. "MEDSTAR GOOD SAMARITAN HOSPITAL KNOW STROKE PROGRAM" THE KNOW STROKE PROGRAM IS A ONE HOUR LECTURE ON STROKE PREVENTION PRESENTED BY SPEECH PATHOLOGIST FROM THE MEDSTAR GOOD SAMARITAN REHABILITATION DEPARTMENT. PROGRAMS ARE PRESENTED IN SENIOR CENTERS AND LIBRARIES. RISK FACTORS, SIGNS AND SYMPTOMS, TREATMENTS AND LIFESTYLE CHOICES RELATED TO PREVENTION ARE TOPICS PRESENTED. IN FY12 EIGHT LECTURES WERE GIVEN AT VARIOUS LOCATIONS WITH A TOTAL 128 PARTICIPANTS. POST TESTS WERE GIVEN TO PARTICIPANTS AFTER THE LECTURES, 75% OF PARTICIPANTS SCORED 100 AND, 25% OF PARTICIPANT SCORED 80 ON THE TEST. MEDSTAR GOOD SAMARITAN'S COMMITMENT TO THE COMMUNITY IS ALSO DEMONSTRATED THROUGH A VARIETY OF SUBSIDIZED HEALTH SERVICES. THESE INCLUDE, BUT ARE NOT LIMITED TO: A) PRIMARY CARE SUBSIDIES, INCLUDING DIABETES - THE CENTER FOR PRIMARY CARE PROVIDES PRIMARY HEALTH CARE SERVICES. MOST OF THE PATIENTS ARE FROM THE LOCAL COMMUNITY AND ARE LOW-INCOME FAMILIES. THIS SERVICE GENERATES A NEGATIVE MARGIN; HOWEVER, THE PRACTICE ADDRESSES A COMMUNITY NEED AND SUPPORTS THE HOSPITAL'S MISSION OF COMMITMENT TO PATIENTS, COMMUNITIES, PHYSICIANS AND EMPLOYEES. PROVIDING THIS SERVICE ALLOWS THE LOCAL COMMUNITY ACCESS TO HEALTH CARE SERVICES AND, THEREFORE, MORE PREVENTIVE MEASURES AND AN IMPROVEMENT OF THE PATIENTS' HEALTH STATUS ARE ACHIEVED. B) OBSTETRIC AND PEDIATRIC SUBSIDIES - THESE REPRESENT PHYSICIAN PRACTICES PROVIDING HEALTH CARE SERVICES FOR GYNECOLOGY, AND PEDIATRICS WHERE A NEGATIVE MARGIN IS GENERATED. A LARGE NUMBER OF OUR PATIENTS RECEIVING THESE SERVICES ARE FROM MINORITY AND LOW-INCOME FAMILIES. GYN AND PEDIATRIC COVERAGE IS PROVIDED 24 HOURS/DAY. PREVENTIVE MEASURES AND IMPROVEMENT OF THE PATIENT'S HEALTH STATUS ARE ACHIEVED. THE SERVICES ADDRESS A COMMUNITY NEED FOR WOMEN'S HEALTH AND CHILDREN'S SERVICES FOR LOWER INCOME AND MINORITY FAMILIES. C) PSYCHIATRIC/BEHAVIORAL HEALTH SUBSIDIES - THE OVERALL COST OF 24/7 PSYCHIATRY PHYSICIAN COVERAGE IS DISPROPORTIONATE TO THE TOTAL COLLECTIONS FROM THE PATIENTS SEEN BY THESE PHYSICIANS DURING OFF HOURS. MANY OF THESE PATIENTS ARE UNINSURED. OUR HOSPITAL ABSORBS THE COST OF PROVIDING PSYCHIATRIC SUPERVISION FOR THE EMERGENCY DEPARTMENT ON A 24/7 BASIS. IF THESE SERVICES WERE NOT PROVIDED, THE PATIENT WOULD BE TRANSPORTED TO ANOTHER FACILITY TO RECEIVE THESE SERVICES. THE COMMUNITY NEEDS ARE BEING MET AND COMMITMENT TO PATIENTS IS EXHIBITED BY PROVIDING THESE SERVICES. AFFILIATED HEALTH CARE SYSTEM PART VI, LINE 6 AS A PROUD MEMBER OF MEDSTAR HEALTH, MEDSTAR GOOD SAMARITAN IS ABLE TO EXPAND ITS CAPACITY TO MEET THE NEEDS OF THE COMMUNITY BY PARTNERING WITH OTHER MEDSTAR HOSPITALS AND ASSOCIATED ENTITIES. MEDSTAR HEALTH RESOURCES ASSIST THE HOSPITAL IN COMMUNITY HEALTH PLANNING TO MEET THE NEEDS OF THE UNINSURED AND OTHER VULNERABLE POPULATIONS. THROUGH ITS COMMUNITY HEALTH FUNCTION, MEDSTAR HEALTH PROVIDES MEDSTAR GOOD SAMARITAN WITH TECHNICAL SUPPORT TO ENHANCE COMMUNITY HEALTH PROGRAMMING AND EVALUATION. MEDSTAR'S CORPORATE PHILANTHROPY DEPARTMENT IDENTIFIES AND SEEKS PUBLIC AND PRIVATE FUNDING SOURCES TO ENSURE THE AVAILABILITY OF HIGH QUALITY HEALTH SERVICES, REGARDLESS OF ABILITY TO PAY. STATE FILING OF COMMUNITY BENEFIT REPORT PART VI, LINE 7 THE COMMUNITY BENEFIT REPORT FOR MEDSTAR GOOD SAMARITAN HOSPITAL IS ONLY FILED IN THE STATE OF MARYLAND. X X X X X X false true false false false false false false false JEFFREY A MATTON 384573 0 204466 0 0 0 14501 0 15785 0 619325 0 0 0 KENNETH A SAMET 0 1166887 0 1481670 0 3477594 0 163987 0 19392 0 6309530 0 0 HOWARD S FREELAND MD 13750 229455 0 25641 0 0 0 0 0 15100 13750 270196 0 0 DALE BUCHBINDER MD 617659 0 30000 0 0 0 0 0 12373 0 660032 0 0 0 DAVID COLL MD 593625 0 0 0 0 0 0 0 15424 0 609049 0 0 0 DEANA STOUT 203496 0 89973 0 0 0 20051 0 17978 0 331498 0 0 0 MARTIN BINSTOCK MD 308393 0 127959 0 0 0 16441 0 20641 0 473434 0 0 0 MICHAEL JACOBS MD 796527 0 0 0 0 0 0 0 15553 0 812080 0 0 0 ELIAS SHAYA MD 351398 0 0 0 0 0 412 0 1095 0 352905 0 0 0 ROBERT BRESLIN MD 399332 0 47900 0 0 0 0 0 12264 0 459496 0 0 0 SHIRLEY ROTH 180199 0 36793 0 0 0 6232 0 17684 0 240908 0 0 0 THOMAS SENKER 180646 0 38400 0 0 0 0 0 16619 0 235665 0 0 0 JENNIFER WILKERSON 154032 0 34385 0 0 0 7199 0 16293 0 211909 0 0 0 OTHER REPORTABLE COMPENSATION FORM 990, SCHEDULE J, PART I, LINE 4B KENNETH SAMET MR. SAMET'S OTHER REPORTABLE COMPENSATION IN PART II, COLUMN (B) (III) INCLUDES $3,465,504 REPRESENTING HIS ACCRUED BENEFIT IN A SUPPLEMENTAL RETIREMENT PLAN, WHICH WAS EARNED DURING THE PAST 23 YEARS OF SERVICE. THIS AMOUNT WAS NOT ACTUALLY PAID DURING THIS REPORTING PERIOD, BUT WAS REPORTED AS COMPENSATION UNDER FICA TAX-REPORTING RULES. DRS HAHN PADGETT PC DIRECTOR 1428345 MEDICAL SERVICES false GS SURGICAL SERVICES LLC DIRECTOR 984000 SURGICAL SERVICES false PATHOLOGY ASSOCIATES LABORATORIES DIRECTOR 675855 LAB SERVICES false BUSINESS TRANSACTIONS INVOLVING INTERESTED PERSONS SCHEDULE L, PART IV DR. JEREMY WEINER, A BOARD MEMBER AT MEDSTAR GOOD SAMARITAN HOSPITAL, OWNS MORE THAN 5% OF GS SURGICAL SERVICES, LLC (GSS), WHICH PROVIDES MEDICAL AND SURGICAL SERVICES TO MEDSTAR GOOD SAMARITAN HOSPITAL. GSS'S GROSS REVENUES RECEIVED FROM THE HOSPITAL FOR THE YEAR WAS $1.0 MILLION. DR. DAVIS HAHN, A BOARD MEMBER AT MEDSTAR GOOD SAMARITAN HOSPITAL, IS AN OFFICER OF DRS. HAHN & PADGETT, P.C. (PC), WHICH PROVIDES ONCOLOGY SERVICES TO MEDSTAR GOOD SAMARITAN HOSPITAL. PC'S GROSS REVENUES RECEIVED FROM THE HOSPITAL FOR THE YEAR WAS $1.4 MILLION. DR. MOIRA LARSEN, A BOARD MEMBER AT GOOD SAMARITAN HOSPITAL, OWNS MORE THAN 5% OF PATHOLOGY ASSOCIATES LABORATORIES, PC (PAL), WHICH PROVIDES LAB SERVICES TO GOOD SAMARITAN HOSPITAL. PAL'S GROSS REVENUES RECEIVED FROM THE HOSPITAL FOR THE YEAR WAS $0.7 MILLION. BYLAWS REVISIONS - 2012, MEDSTAR HEALTH, INC. AND AFFILIATED HOSPITALS PART VI, LINE 4 DURING THE FISCAL YEAR ENDING JUNE 30, 2012, MEDSTAR HEALTH, INC., A MARYLAND NON-STOCK CORPORATION ("MEDSTAR") REVIEWED ITS BYLAWS AND THE BYLAWS OF NINE MEDSTAR-AFFILIATED HOSPITALS, INCLUDING FRANKLIN SQUARE HOSPITAL CENTER, INC., HARBOR HOSPITAL, INC., MEDSTAR-GEORGETOWN MEDICAL CENTER, INC., MONTGOMERY GENERAL HOSPITAL, INC., NATIONAL REHABILITATION HOSPITAL, INC., ST. MARY'S HOSPITAL OF ST. MARY'S COUNTY, INC., THE GOOD SAMARITAN HOSPITAL OF MARYLAND, INC., THE UNION MEMORIAL HOSPITAL AND WASHINGTON HOSPITAL CENTER CORPORATION (COLLECTIVELY THE "HOSPITALS"). THE REVISED BYLAWS OF MEDSTAR AND THE HOSPITALS WERE DEVELOPED USING A COMMON TEMPLATE BASED ON THE EXISTING MEDSTAR BYLAWS. THE BOARD OF DIRECTORS OF MEDSTAR AND THE BOARD OF DIRECTORS OF EACH HOSPITAL VOTED AND APPROVED THE CHANGES TO THEIR BYLAWS. A SUMMARY OF THE CHANGES TO THE BYLAWS OF MEDSTAR AND THE HOSPITALS IS SET FORTH BELOW. THE BYLAWS CHANGES: (A) CONFORM PROVISIONS TO MARYLAND, DELAWARE AND DISTRICT OF COLUMBIA LAW, AS APPLICABLE, IN MANY CASES TO GIVE GREATER FLEXIBILITY TO MEDSTAR AND THE BOARD OF DIRECTORS OF EACH HOSPITAL); (B) CONFORM PROVISIONS TO MAXIMIZE UNIFORMITY AMONG THE HOSPITAL BYLAWS (TO THE EXTENT POSSIBLE); (C) REFLECT RECENT DEVELOPMENTS IN CORPORATE/HOSPITAL GOVERNANCE; (D) CLARIFY CERTAIN CORPORATE PROCEDURES; AND (E) CONFORM LANGUAGE AND STYLE. ORGANIZATION MEMBERS PART VI, LINE 6 THE ORGANIZATION IS AN AFFILIATE AND SUBSIDIARY OF MEDSTAR HEALTH, INC., A TAX-EXEMPT MARYLAND NON-STOCK CORPORATION. MEDSTAR HEALTH, INC., OR ONE OF ITS AFFILIATES AND SUBSIDIARIES, IS THE SOLE MEMBER OF THE ORGANIZATION. DESCRIPTION OF MEMBERS PART VI, LINE 7A AS AN AFFILIATE AND SUBSIDIARY OF MEDSTAR HEALTH, INC., A TAX-EXEMPT MARYLAND NON-STOCK CORPORATION, THE ORGANIZATION MAY RECOMMEND PERSON(S) FOR MEMBERSHIP ON THE ORGANIZATION'S GOVERNING BODY. ANY SUCH RECOMMENDATION BY THE ORGANIZATION IS SUBJECT TO APPROVAL BY THE GOVERNANCE COMMITTEE OF THE BOARD OF DIRECTORS OF MEDSTAR HEALTH, INC. THE BOARD OF MEDSTAR HEALTH, INC. HAS DELEGATED CERTAIN APPROVAL AUTHORITY TO THE GOVERNANCE COMMITTEE AND THE PRESIDENT & CEO OF MEDSTAR HEALTH, INC. DECISIONS OF GOVERNING BODY PART VI, LINE 7B AS AN AFFILIATE AND SUBSIDIARY OF MEDSTAR HEALTH, INC., A TAX-EXEMPT MARYLAND NON-STOCK CORPORATION, THE BYLAWS OF THE ORGANIZATION ARE SUBJECT TO CERTAIN RESERVED POWERS, WHICH PROVIDE THAT THE SOLE MEMBER OF THE ORGANIZATION MUST APPROVE CERTAIN DECISIONS, INCLUDING BUT NOT LIMITED TO MATTERS CONCERNING THE SALE OR PURCHASE OF REAL OR PERSONAL PROPERTY, CAPITAL BUDGETS, STRATEGIC PLANNING, INVESTMENTS, AND CORPORATE GOVERNANCE. PROCESS FOR REVIEWING FORM 990 PART VI, LINE 11A THE PROCESS FOR REVIEWING THE FORM 990 INCLUDED EDUCATION AND TRANSPARENCY. SENIOR FINANCIAL EXECUTIVES, WORKING WITH INDEPENDENT OUTSIDE EXPERTS, THOROUGHLY REVIEWED FORM 990 AND ACCOMPANYING INSTRUCTIONS. IN ADDITION, SENIOR EXECUTIVES REVIEWED THE RELEVANT SECTIONS OF THE FORM 990 WITH THE FOLLOWING COMMITTEES OF THE ORGANIZATION'S GOVERNING BODY: FINANCE, AUDIT, GOVERNANCE, STRATEGIC PLANNING, AND EXECUTIVE COMPENSATION. FOLLOWING THESE MEETINGS, THE GOVERNING BODY WAS PROVIDED A COPY OF THE FORM 990 IN ITS FINAL FORM AND GIVEN AN OPPORTUNITY TO PROVIDE ANY INPUT OR COMMENTS RELATING TO THE FORM 990 PRIOR TO ITS FILING. CONFLICT OF INTEREST POLICY PART VI, LINE 12C APPOINTMENT OF BOARDS OF DIRECTORS MEDSTAR HEALTH (AND ITS SUBSIDIARIES) REQUIRE ALL NOMINATED DIRECTORS, PRIOR TO THEIR APPOINTMENT OR ELECTION, TO DISCLOSE THE EXISTENCE OF (OR POTENTIAL EXISTENCE OF) ANY TRANSACTION WITH MEDSTAR THAT WOULD RESULT IN A CONFLICT OF INTEREST. SUCH DISCLOSURES (IF ANY) ARE REVIEWED BY THE GOVERNANCE COMMITTEE OF THE MEDSTAR HEALTH BOARD OF DIRECTORS WHICH DETERMINES HOW THE MATTER SHOULD BE RESOLVED. ANNUAL DISCLOSURES - ALL OFFICERS, DIRECTORS, AND SENIOR MANAGERS ALL OFFICERS, DIRECTORS AND SENIOR MANAGERS ARE REQUIRED, NOT LESS THAN ANNUALLY, TO COMPLETE A SURVEY OF QUESTIONS CONCERNING ANY TRANSACTIONS OR RELATIONSHIPS WHICH WOULD OR COULD REPRESENT A CONFLICT OF INTEREST. SUCH DISCLOSURES (IF ANY) RELATED TO DIRECTORS ARE REVIEWED BY THE GOVERNANCE COMMITTEE OF THE MEDSTAR HEALTH BOARD OF DIRECTORS WHICH DETERMINES HOW THE MATTER SHOULD BE RESOLVED. SUCH DISCLOSURES (IF ANY) RELATED TO OFFICERS AND SENIOR MANAGERS ARE REVIEWED BY AN APPROPRIATE EXECUTIVE WHO DETERMINES HOW THE MATTER SHOULD BE RESOLVED IN ADDITION, OFFICERS AND DIRECTORS OF MARYLAND HOSPITALS AND NURSING CENTERS ARE REQUIRED TO ANNUALLY DISCLOSE ADDITIONAL INFORMATION RELATING TO POTENTIAL CONFLICTS OF INTEREST AND SUCH DISCLOSURES ARE REPORTED TO THE MARYLAND HEALTH SERVICES COST REVIEW COMMISSION (HSCRC). DESCRIPTION OF EXECUTIVE COMPENSATION PROCESS PART VI, LINE 15 THE EXECUTIVE COMPENSATION COMMITTEE OF THE BOARD OF DIRECTORS OF MEDSTAR HEALTH, INC. (THE "COMMITTEE") HAS OVERSIGHT OVER THE EXECUTIVE COMPENSATION PROGRAM (THE "PROGRAM") OF MEDSTAR HEALTH, INC. AND ITS AFFILIATES. TOTAL COMPENSATION FOR THE TOP MANAGEMENT OFFICIALS, OFFICERS AND KEY EMPLOYEES OF MEDSTAR HEALTH, INC. AND ITS AFFILIATES ARE REVIEWED AND APPROVED BY THE COMMITTEE WITH ASSISTANCE AND GUIDANCE FROM AN INDEPENDENT THIRD PARTY ADVISOR. THE MEMBERS OF THE COMMITTEE ARE INDEPENDENT FROM ALL OF THE PARTICIPANTS IN THE PROGRAM. THE MAIN OBJECTIVE OF THE PROGRAM IS TO PROVIDE MARKET COMPETITIVE TOTAL COMPENSATION THAT IS INTERNALLY EQUITABLE AND HAS A STRONG PAY-FOR-PERFORMANCE LINKAGE. PERFORMANCE IS EVALUATED AT THE SYSTEM, OPERATING UNIT, AND INDIVIDUAL LEVELS. THE OVERALL TOTAL COMPENSATION PHILOSOPHY IS MANAGED AT THE 75TH PERCENTILE OF THE COMPETITIVE MARKET FOR COMPARABLE SIZE (NET REVENUE) AND TYPE (TAX-EXEMPT HEALTHCARE ORGANIZATIONS). WHERE APPROPRIATE, ADDITIONAL INDUSTRY DATA IS CONSIDERED (GENERAL BUSINESS AND/OR TAXABLE HEALTHCARE) FOR SELECTED POSITIONS THAT CAN BE RECRUITED FROM OR POTENTIALLY LOST TO THESE INDUSTRIES (E.G., INFORMATION TECHNOLOGY, FINANCE, ETC.). THE COMMITTEE HAS ENGAGED ERNST & YOUNG LLP ("E&Y") TO SERVE AS AN ADVISOR ON THE REASONABLENESS AND COMPETITIVENESS OF THE PROGRAM. IN DETERMINING REASONABLENESS AND COMPETITIVENESS, E&Y REVIEWS MARKET PRACTICES AND TRENDS, AND MAKES RECOMMENDATIONS RELATED TO THE PROGRAM. E&Y UTILIZES INFORMATION FROM CUSTOM SURVEYS, NATIONAL COMPENSATION SURVEYS, PROPRIETARY DATABASES, AND CLIENT EXPERIENCES TO DETERMINE ITS FINAL RECOMMENDATIONS. E&Y PRESENTS THEIR FINDINGS AND RECOMMENDATIONS TO THE COMMITTEE. THE COMMITTEE MAKES THE FINAL DECISIONS ON ALL OF THE COMPENSATION DETERMINATIONS OF THE PROGRAM. ALL DECISIONS MADE BY THE COMMITTEE ARE CONTEMPORANEOUSLY DOCUMENTED. FINANCIAL STATEMENT AVAILABILITY PART VI, LINE 19 MEDSTAR HEALTH POSTS ITS ANNUAL FINANCIAL AUDIT AND QUARTERLY FINANCIAL REPORTS TO THE ELECTRONIC MUNICIPAL MARKET ACCESS (EMMA) SYSTEM. THE ORGANIZATION ALSO E-MAILS ITS ANNUAL AND QUARTERLY DISCLOSURES TO HOLDERS OF THE COMPANY'S PUBLICLY TRADED DEBT. THE COMPANY'S GOVERNANCE DOCUMENTS AND CONFLICTS OF INTEREST POLICIES ARE AVAILABLE UPON REQUEST THROUGH ITS CORPORATE (OR AS APPLICABLE ENTITY) PUBLIC INFORMATION OFFICES. FINANCIAL STATEMENTS AND REPORTING PART XII, LINE 2C THE GOOD SAMARITAN HOSPITAL OF MARYLAND, INC. IS AN AFILLIATE OF THE MEDSTAR HEALTH, INC. AUDIT AND SUBJECT TO OVERSIGHT BY THE AUDIT COMMITTEE OF THE MEDSTAR BOARD. OTHER CHANGES IN NET ASSETS PART XI, LINE 5 EQUITY TRANSFERS - NET ASSETS.....................$ (11,476,215) UNREALIZED LOSS ON INVESTMENTS..................... (1,777,205) ============= TOTAL $ (13,253,420) HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:KENNETH A SAMET TITLE:DIRECTOR HOURS:40 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:HOWARD S FREELAND MD TITLE:DIRECTOR HOURS:40 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:DAVIS M HAHN MD TITLE:DIRECTOR HOURS:40 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:JENNIFER WILKERSON TITLE:VICE PRESIDENT HOURS:1 MEDSTAR HEALTH ANESTHESIA SERVICES A LLC 5601 LOCH RAVEN BLVD BALTIMORE MD 21239 205909017 HEALTHCARE MD 8543319 652528 Church Home Corporation 5565 Sterrett Place 5th Floor Columbia MD 21044 237374724 Medical Fund MD 501(C)(3) PF NA true Franklin Square Hospital Center Inc 9000 Franklin Square Drive Baltimore MD 21237 520608007 Hospital MD 501(C)(3) 3 NA true Harbor Hospital Inc 3001 South Hanover Street Baltimore MD 21225 520491660 Hospital MD 501(C)(3) 3 NA true Medstar Health Inc 5565 Sterrett Place 5th Floor Columbia MD 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