2013-11-15T11:45:57-06:00 2012-12-31 GRANT THORNTON LLP 2001 MARKET STREET SUITE 3100 PHILADELPHIA PA 19103 990 2012-01-01 521253920 UPPER CHESAPEAKE MEDICAL CENTER % JOSEPH E HOFFMAN III UPPE 4108773700 500 UPPER CHESAPEAKE DRIVE Suite BEL AIR MD 21014 Joseph E Hoffman III 4108773700 2013-11-14 true 2155614200 2012 2016-02-25 16:41:14Z LYLE E SHELDON 520 UPPER CHESAPEAKE DR STE BEL AIR MD 21014 262312239 false X WWW.UCHS.ORG X 1997 MD ACUTE HOSPITAL CARE 16 9 2173 794 0 0 7361725 4770282 229956458 249739514 579927 488058 275563 4287758 238173673 259285612 8141614 13953770 0 0 95049836 104662896 0 0 0 116218745 130208523 219410195 248825189 18763478 10460423 321262781 353410774 234530464 260959745 86732317 92451029 X ACUTE HOSPITAL CARE false false 187606056 253306496 SEE SCHEDULE O 187606056 true true false true false false false false false false true false false true true true false true false false false false false false false false true true true true true true false false false false false false false false false true false false false false false true false false false true 6 0 true 2173 true false true false false false false false false false false false X 16 9 true false false false true false false true true false false true true true true true true true true true false MD X JOSEPH E HOFFMAN III 4436433340 520 UPPER CHESAPEAKE DRIVE BEL AIR MD 21014 X H WILLIAM ACKER 5.0 X X 0 0 0 STEVEN M BENTMAN MD 1.0 X 22917 0 0 JOHN H CAIN 1.0 X 0 0 0 MELINDA L CRAIG 1.0 X 0 0 0 DIANE K FORD 1.0 X 0 0 0 JASON M BIRNBAUM MD 40.0 X 0 0 0 M SCOT KAUFMAN 5.0 X X 0 0 0 ANDREW KLEIN 1.0 X 0 0 0 JAMES LAMBDIN 1.0 X 0 0 0 ANTHONY J MEOLI 5.0 X X 0 0 0 ROGER E SCHNEIDER MD 5.0 X X 0 0 0 LYLE E SHELDON 5.0 50.0 X X 0 2674235 79823 RICHARD P STREETT JR VMD 1.0 X 0 0 0 ADELE A WILZACK RN MS 1.0 X 0 0 0 ALBERT J A YOUNG 1.0 X 0 0 0 FAHEEM YOUNUS MD 1.0 X 165000 0 0 JOYCE FOX 20.0 20.0 X 0 245318 47696 JOSEPH E HOFFMAN III 5.0 46.0 X 0 724598 77334 JAMES J HURSEY 5.0 49.0 X 0 276141 56414 DEAN C KASTER 5.0 45.0 X 0 499354 63620 MARGARET M VAUGHAN 5.0 46.0 X 0 828477 28762 E SCOTT CONOVER 5.0 46.0 X 0 456107 43977 TONI M SHIVERY 5.0 45.0 X 0 214360 64712 ROY PHILLIPS 40.0 X 271922 0 47081 OLUFUNMILAYO ONOBRAKPEYA 40.0 X 240703 0 36602 ANGELA M KAITIS 40.0 X 136274 0 46004 DENISE C DEEL 40.0 X 138088 0 33523 SAYHIENG SEANG 40.0 X 139972 0 23575 1114876 5918590 649123 88 false true false NORTHERN CHESAPEAKE ANESTHESIA ASSO PO BOX 89 BEL AIR MD 21014 PHYSICIAN FEES 3266667 VISION CONSULTING LLC 3325 ASPEN GROVE DRIVE SUITE 204 FRANKLIN TN 37067 SOFTWARE CONSULTING 718945 BRAIN AND SPINE SPECIALISTS PA 520 UPPER CHESAPEAKE DR SUITE 211 BEL AIR MD 21014 PHYSICIAN FEES 574936 CHESAPEAKE MEDICAL STAFFING 2401 YORK ROAD TIMONIUM MD 21093 MED STAFFING FEES 429213 KPMG LLP 111 SOUTH CALVERT ST BALTIMORE MD 21202 AUDIT FEES 395462 28 X 4770282 4770282 NET PATIENT SERVICE REVENUE 621110 249532571 249532571 SPINE CENTER/ENDOCRINOLOGY 621110 199697 199697 POST REHAB FITNESS 621110 7246 7246 249739514 35914 35914 0 0 1510170 3026627 -1516457 0 -1516457 -1516457 448794 3350 448794 3350 452144 452144 0 0 0 INCENTIVE PMTS-ELECTRONIC HLTH RECORDS 900099 3566982 3566982 CAFETERIA/VENDING 900099 1189802 1189802 PARKING GARAGE 900099 207346 207346 840085 840085 5804215 259285612 253306496 1208834 X 13916322 13916322 37448 37448 0 0 0 0 84042528 62999697 21042831 7217302 5410211 1807091 6083742 4551099 1532643 7319324 5486689 1832635 1322835 1322835 0 24183 24183 0 0 0 15444959 9697195 5747764 962831 2350 960481 61006739 57137996 3868743 0 0 4445052 730760 3714292 24095 15033 9062 0 90354 28651 61703 2819200 1827569 991631 5464893 585311 4879582 9971997 7326281 2645716 3431648 2572421 859227 MANAGEMENT FEES - UCHS 9730142 9730142 REPAIRS & MAINTENANCE 3646561 769060 2877501 BAD DEBT 12081735 12081735 DUES 438296 33903 404393 -696997 2396325 -3093322 248825189 187606056 61219133 0 18019127 18587894 0 0 0 0 26206766 27904096 0 0 0 0 0 0 5693980 5804000 1214175 1191840 263266168 86782917 155785998 176483251 41080170 41528964 0 0 0 0 383343 223518 72879222 81687211 321262781 353410774 24574005 30580356 0 0 0 0 146396066 162519495 0 0 0 0 0 0 0 0 63560393 67859894 234530464 260959745 X 79725317 81060106 7007000 11390923 0 0 86732317 92451029 321262781 353410774 X 10460423 -17433 -4724278 X false true X true false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false true 10106 10106 false false LOBBYING ACTIVITIES SCHEDULE C, PART II-B, LINE 1I LOBBYING EXPENSES IN THE AMOUNT OF $10,106 FOR 12/31/12 REPRESENT A PORTION OF THE DUES PAID TO MARYLAND HOSPITAL ASSOCIATION. THESE ASSOCIATIONS ALLOCATE A PORTION OF MEMBER DUES TO LOBBYING ACTIVITY. 6947954 6947954 138763159 34314260 104448899 8707362 1215319 7492043 50370450 37056519 13313931 58477243 14196819 44280424 176483251 OTHER ACCTS RECEIVABLE 1604000 DEFERRED FINANCING COSTS 1038729 DUE FROM AFFILIATES 62105310 FUNDS HELD BY TRUSTEE 3397830 ECON INT FOUNDATION NET ASSETS 11390000 CURRENT PORTION OF ASSETS LTD 2151342 81687211 0 ADVANCES FROM THIRD PARTIES 5794049 ACCRUED PENSION LIABILITY 6792123 BOND INTEREST RATE SWAP 53817599 DUE TO AFFILIATES 1456123 67859894 X 231572471 -17433 -30722335 -30739768 262312239 -3026627 -3026627 259285612 225853759 3026627 3026627 222827132 25998057 25998057 248825189 INCOME TAXES (FIN 48) PART X, QUESTION 2 Upper Chesapeake Medical Center accounts for tax provisions in accordance with FASB Interpretation No. 48 (FIN 48), Accounting for Uncertainty in Income Taxes, included in ASC Subtopic 740-10, Income Taxes - Overall, which clarifies the accounting for uncertainty in tax provisions. FIN 48 requires that Upper Chesapeake Medical Center recognize the effect of income tax positions only if those positions are more likely than not of being sustained. Recognized income tax positions are measured at the largest amount that is greater than 50% likely of being realized. Changes in recognition or measurement are reflected in the period in which the change in judgment occurs. RECONCILIATION OF REVENUE SCHEDULE D, PART XI LINE 2D - OTHER REVENUE ON BOOKS NOT ON RETURN BAD DEBT $ (12,081,735) UNREALIZED GAIN/(LOSS) ON SWAP (4,055,948) MINIMUM PENSION LIABILITY (668,330) GRANT TO AFFILIATE - UC MEDICAL SERVICES (13,510,844) GRANT TO AFFILIATE - UC PROPERTIES (405,478) ------------- TOTAL $ (18,640,600) ============= LINE 4B - OTHER REVENUE ON RETURN NOT ON BOOKS RECLASS - RENTAL EXPENSES $ (3,026,627) RECONCILIATION OF EXPENSES SCHEDULE D, PART XII LINE 2D - OTHER EXPENSES INCLUDED ON BOOKS NOT ON RETURN RECLASS - RENTAL EXPENSES $ 3,026,627 LINE 4B - OTHER EXPENSES INCLUDED ON RETURN NOT ON BOOKS BAD DEBT $ 12,081,735 GRANT TO AFFILIATE - UC MEDICAL SERVICES 13,510,844 GRANT TO AFFILIATE - UC PROPERTIES 405,478 ------------ TOTAL $ 25,998,057 ============ true true X true X true X true true false true true 17330668 17330668 0.08000 17330668 17330668 0.08000 1951645 97456 1854189 0.01000 524683 0 524683 0.00000 3928502 3928502 0.02000 22033 0 22033 0.00000 204408 0 204408 0.00000 6631271 97456 6533815 0.03000 23961939 97456 23864483 0.11000 221773 221773 28 32 3281 3281 176 14528 14528 85 5720 5720 289 32 245302 245302 true 12081735 1873154 98050993 93262192 4788801 X true true 1 1 UPPER CHESAPEAKE MEDICAL CENTER INC

500 UPPER CHESAPEAKE DRIVE BEL AIR MD 21014

WWW.UCHS.ORG X X X 1 UPPER CHESAPEAKE MEDICAL CENTER INC 1 true true 200. true 300. true X X X X true true X X X X X X true X X true X X X X X true X false true 1 UC HEALTH LINK CLINIC

2027 PULASKI HWY SUITE 206 HAVRE DE GRACE MD 21078

PRIMARY CARE CLINIC FOR MEDICALLY INDIGENT PART III, SECTION A, LINE 4 BAD DEBT EXPENSE The Hospital grants credit to patients, substantially all of whom are local residents. The Hospital generally does not require collateral or other security in extending credit; however, the Hospital routinely obtains assignment of (or are otherwsie entitled to receive) patients' benefits receivable under their health insurance programs, plans or policies. PART III, SECTION B, LINE 8 COMMUNITY BENEFIT AND SHORTFALL The Hospital did not have a Medicare shortfall. PART III, SECTION C, LINE 9B COLLECTION PRACTICES IT IS THE POLICY OF UPPER CHESAPEAKE MEDICAL CENTER ("UCMC") TO ATTEMPT TO COLLECT PAYMENT FOR ALL SERVICES RENDERED TO PATIENTS IN THE MOST EFFICIENT AND PATIENT FRIENDLY MANNER. UCMC WILL FIRST ATTEMPT TO COLLECT PAYMENT FROM THE PATIENT'S INSURANCE COMPANY. IN THE EVENT THE PATIENT HAS NO INSURANCE OR LIMITED INSURANCE COVERAGE, UCMC WILL ATTEMPT TO QUALIFY THE PATIENT FOR THE MARYLAND MEDICAL ASSISTANCE PROGRAM AND/OR UCMC'S FINANCIAL ASSISTANCE POLICY. PART V, LINES 15E/16E/19D/21 Billing and Collections: Line 15E PATIENTS WHO ARE LEFT WITH A BALANCE AFTER ALL INSURANCES HAVE BEEN PURSUED AND FINANCIAL ASSISTANCE HAS BEEN OFFERED WILL BE FORWARDED TO A COLLECTION AGENCY AS A LAST RESORT TO OBTAIN PAYMENT FROM THE PATIENT. Line 16E TWO AGENCIES ARE EMPLOYED BY UCMC; EACH RECEIVING APPROXIMATELY FIFTY PERCENT OF THE ACCOUNT (BASED ON THE FIRST LETTER OF THE LAST NAME OF EACH PATIENT). ACCOUNTS PLACED WITH ONE OF THE COLLECTION AGENCIES ARE CLASSIFIED AS BAD DEBTS AND REMOVED FROM ACCOUNTS RECEIVABLE. Charges for Medical Care: Lines 19D & 21 THE STATE OF MARYLAND HEALTH SERVICES COST REVIEW COMMISSION SETS RATES FOR ALL HOSPITALS IN THE STATE. THOSE RATES ARE APPLIED UNIFORMLY TO ALL PATIENTS. GROSS CHARGES MAY NOT BE DISCOUNTED OUTSIDE OF STATE-ACCEPTED DISCOUNTS FOR PROMPT PAYMENT AND ADVANCE FUNDING. IF A PATIENT QUALIFIES FOR FINANCIAL ASSISTANCE, A PERCENTAGE OF THE GROSS CHARGES ARE THEN WRITTEN-OFF TO CHARITY CARE. PART VI, SUPPLEMENTAL INFORMATION NEEDS ASSESSMENT Every three years a Community Health Assessment Survey/Plan is performed. PART VI, SUPPLEMENTAL INFORMATION PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE The Hospital displays signs at every registration point informing the patients about the availability of the various financial and medical assistance programs. The Hospital offers every self-pay patient or any patient who inquires the financial assistance informational packet and application. The cover sheet for the financial assistance packet also includes information on obtaining Medical Assistance. In addition, the Hospital has a financial counselor that visits the self-pay patient in the emergency department or in the patient's room to discuss what is available to them. The Hospital also employs a medical assistance advocacy company to assist the hospital's patients get medical assistance. The Hospital also provides information about the programs in each billing statement. PART VI, SUPPLEMENTAL INFORMATION COMMUNITY INFORMATION The service area of the Upper Chesapeake Health System, which includes Upper Chesapeake Medical Center, consists of the northeast part of Maryland, including Harford County, western Cecil County and portion of Baltimore County. This service area is located at the apex of the Chesapeake Bay and is spread across 536 square miles. It contains, among others, the cities and towns of Havre de Grace, Aberdeen, Bel Air, Fallston, and Edgewood. The service area enjoys a diverse economic base, ranging from concentrations in service, manufacturing, distribution, and retail, to Federal government employment. Harford Community College provides a local venue for advanced education and Harford County's proximity to Baltimore gives it access to nationally recognized universities which help provide a skilled workforce. The Service Area is served by Interstate 95, Amtrak and freight rail lines along the busy east-coast transportation corridor between New York and Washington, DC. In 2007, the Service Area had a total population of 276,500 people with historical annual growth rates of approximately 1.8% per year. This growth has been characterized by an influx of young families seeking suburban environment in which to live and is complemented by a growth in businesses and other services that follow young, middle class families. In 2007, the Service Area had an estimated 101,930 households with a median family income of $67,300 and an average household income of $81,000. 87% of the service area's adults over the age of 25 are high school graduates or higher; 27% achieved bachelor's degrees or higher. The service area's growth and geographic location explain its ability to attract major east-coast distribution center and industry, which have provided additional employment opportunities in the service area. In December 2007, the service area had a work force of approximately 142,829. Please see Schedule O for more information. PART VI, SUPPLEMENTAL INFORMATION PROMOTION OF COMMUNITY HEALTH Monies spent for hospital and community preparedness for hazardous accidents, natural disasters, and coalition building in the community. PART VI, SUPPLEMENTAL INFORMATION AFFILIATED HEALTH CARE SYSTEM Upper Chesapeake Medical Center, Inc. (UCMC) is one hospital in an "Affiliated Health Care System" that includes a second hospital, Harford Memorial Hospital, Inc. (HMH), a physician services organization (Upper Chesapeake Medical Services, Inc.), a property holding company (Upper Chesapeake Properties, Inc.), a hospice residence (Upper Chesapeake Residential Hospice House, Inc. & Hospice of Harford County LLC) and a for-profit venture with investments in private imaging services (Upper Chesapeake Health Ventures, Inc.). The "System" provides a broad range of community health care services, including preventive, ambulatory, acute and hospice services, through an integrated health care delivery system in Harford County and parts of Baltimore and Cecil Counties, in northeast Maryland. UCMC and HMH are the only hospitals in Harford County, Maryland. UCMC offers acute care services, including intensive care, emergency and other outpatient services, and has the only acute care maternity services in Harford County. PART VI, SUPPLEMENTAL INFORMATION STATE FILING OF COMMUNITY BENEFIT REPORT The Health Services Cost Review Commission, the State agency that regulates hospital rates in Maryland, requires a Community Benefit Report to be filed annually. SUPPLEMENTAL INFORMATION UPPER CHESAPEAKE MEDICAL CENTER EXPECTS ITS COMMUNITY HEALTH NEEDS ASSESSMENT AND IMPLEMENTATION PLAN TO BE COMPLETED BY THE END OF TAX YEAR 2013 IN ACCORDANCE WITH THE AFFORDABLE CARE ACT. IMPLEMENTATION PLAN TO BE COMPLETED BY THE END OF TAX YEAR 2013 IN ACCORDANCE WITH THE AFFORDABLE CARE ACT. true UPPER CHESAPEAKE PROPERTIES 520 UPPER CHESAPEAKE DRIVE BEL AIR MD 21014 521907237 501(C)(2) 405478 GENERAL SUPPORT UPPER CHESAPEAKE MEDICAL SERVICES 520 UPPER CHESAPEAKE DRIVE BEL AIR MD 21014 521501734 501(C)(3) 13510844 PHYSICIAN PRACTICE SUPPORT 1 1 SCHOLARSHIPS TO STUDY IN THE MEDICAL FIELD SCHOLARSHIPS 20 37448 SCHEDULE I - GRANTS & OTHER ASSISTANCE PART I, QUESTION 2 - GENERAL INFORMATION ON GRANTS AND ASSISTANCE ALTHOUGH THE FILING ORGANIZATION DOES NOT HAVE FORMALIZED INTERNAL PROCEDYRES FOR MONITORING THE USE OF GRANT FUNDS IN THE UNITED STATES, THE FILING ORGANIZATION DOES HAVE A WRITTEN AND APPROVED CHARITABLE GIVING POLICY AND PROCEDURE. THERE IS WRITTEN CRITERIA REGARDING THE RECOMMENDATIONS FOR CONSIDERATION WHEN EVALUATING CONTRIBUTION REQUESTS SUCH AS FOLLOWS: (1) THAT CONTRIBUTIONS WILL BE MADE ONLY TO ORGANIZATIONS FOR PURPOSES CONSISTENT WITH UPPER CHESAPEAKE HEALTH SYSTEM'S (PARENT ENTITY) VISION AND MISSION. (2) CONTRIBUTIONS WILL BE MADE ONLY TO NOT-FOR-PROFIT ORGANIZATIONS. (3) CONTRIBUTIONS WILL PREFERABLY BE MADE TO ORGANIZATIONS WHICH DIRECTLY SERVE THE CITIZENS OF HARFORD AND CECIL COUNTIES. (4) CONTRIBUTIONS WILL NOT BE GIVEN TO INDIVIDUALS (EXLUDING SCHOLARSHIPS). (5) CONTRIBUTIONS WILL NOT BE MADE FOR RELIGIOUS PURPOSES; HOWEVER, THERE MAY BE CONTRIBUTIONS GIVEN FOR A SPECIFIC EFFORT OR PROGRAM WITHIN A CHURCH OR RELIGIOUS FACILITY WHICH PROVIDES HEALTH-RELATED SERVICES TO THE BROADER COMMUNITY. (6) CONTRIBUTIONS WILL NOT BE MADE IN SUPPORT OF POLITICAL ADVOCACY. (7) UPPER CHESAPEAKE HEALTH SYSTEM WILL STRIVE TO DONATE TO ORGANIZATIONS WHERE THE MAJORITY OF THE FUNDS RECEIVED ARE APPLIED DIRECTLY TO THE NEED THE ORGANIZATION IS DESIGNED TO MEET. *** REQUESTS FOR $5,000 AND UNDER ARE REFERRED TO THE PRESIDENT/CEO FOR REVIEW AND APPROVAL *** REQUESTS FOR GREATER THAN $5,000 ARE REFERRED TO THE COMMUNITY DEVELOPMENT COMMITTEE FOR DISCUSSION AND APPROVAL false true false false false false false false false LYLE E SHELDON 0 506583 0 249752 0 1917900 0 54500 0 25323 0 2754058 0 1194080 FAHEEM YOUNUS MD 165000 0 0 0 0 0 0 0 0 0 165000 0 0 0 JOYCE FOX 0 189669 0 48561 0 7088 0 44119 0 3577 0 293014 0 0 JOSEPH E HOFFMAN III 0 296238 0 119391 0 308969 0 51500 0 25834 0 801932 0 224402 JAMES J HURSEY 0 269587 0 0 0 6554 0 46037 0 10377 0 332555 0 0 DEAN C KASTER 0 223452 0 89174 0 186728 0 32438 0 31182 0 562974 0 148505 MARGARET M VAUGHAN 0 308514 0 125000 0 394963 0 0 0 28762 0 857239 0 270754 E SCOTT CONOVER 0 308389 0 102030 0 45688 0 41500 0 2477 0 500084 0 0 TONI M SHIVERY 0 169792 0 44298 0 270 0 37747 0 26965 0 279072 0 0 ROY PHILLIPS 214397 0 56000 0 1525 0 29412 0 17669 0 319003 0 0 0 OLUFUNMILAYO ONOBRAKPEYA 198906 0 36000 0 5797 0 24072 0 12530 0 277305 0 0 0 ANGELA M KAITIS 122456 0 13012 0 806 0 29989 0 16015 0 182278 0 0 0 DENISE C DEEL 123836 0 13773 0 479 0 12191 0 21332 0 171611 0 0 0 SAYHIENG SEANG 100087 0 39830 0 55 0 1459 0 22116 0 163547 0 0 0 SCHEDULE J, PART I, QUESTION 3 THIS ORGANIZATION DOES NOT HAVE A PAID CEO/EXECUTIVE DIRECTOR. ALL COMPENSATION TO THE CEO/EXECUTIVE DIRECTOR REPORTED ON PART VII OF THE FORM 990 WAS PAID BY A RELATED ORGANIZATION, UPPER CHESAPEAKE HEALTH SYSTEM. UPPER CHESAPEAKE HEALTH SYSTEM UNDERTAKES A THOROUGH PROCESS TO ENSURE THAT THE EXECUTIVE COMPENSATION IT PAYS TO ITS TOP MANAGEMENT OFFICIALS IS REASONABLE GIVEN THE MARKET IN WHICH THE ORGANIZATION OPERATES. UPPER CHESAPEAKE HEALTH SYSTEM CHECKS THE FOLLOWING BOXES FOR SCHEDULE J, PART I, QUESTION 3 ON ITS FORM 990: COMPENSATION COMMITTEE WRITTEN EMPLOYMENT CONTRACT INDEPENDENT COMPENSATION CONSULTANT COMPENSATION SURVEY OR STUDY APPROVAL BY THE BOARD OF COMPENSATION COMMITTEE SCHEDULE J, PART I, QUESTION 4B AN ORGANIZATION RELATED TO THIS FILING ORGANIZATION MADE INTERNAL REVENUE CODE SECTION 457F PLAN CONTRIBUTIONS TO THE FOLLOWING MEMBERS OF SENIOR LEADERSHIP WHO ARE LISTED ON THIS FILING ORGANIZATION'S FORM 990, PART VII, SECTION A, LINE 1A: JOSEPH E. HOFFMAN III $24,501 JAMES J. HURSEY $ 5,369 DEAN C. KASTER $18,438 JOHN K. LYNCH $ 7,605 LYLE E. SHELDON $81,116 E. SCOTT CONOVER $44,658 * *AMOUNT FOR E. SCOTT CONOVER REPRESENTS "PAYOUT OF PRIOR YEAR 457F CONTRIBUTIONS" An organization related to this filing organization made split dollar life insurance plan contributions to the following members of senior leadership who are listed on this filing organization's Form 990, Part VII, Section A, Line 1A: Lyle E. Sheldon $ 29,885 Margaret M. Vaughan $ 8,562 Joseph E. Hoffman III $ 8,481 Dean C. Kaster $ 6,489 SCHEDULE J, SUPPLEMENTAL INFORMATION Effective in calendar year 2012, Upper Chesapeake Health System, Inc., terminated their Secured Executive Benefit Plan (SERP). As a result of the SERP's termination, the plan participants: Lyle Sheldon, Joseph Hoffman, Dean Caster and Margaret Vaughan recognized additional taxable compensation (subject to employment tax withholding) in tax year 2012. This additional compensation is reflected in Schedule J - Part II - Column B(iii). A MARYLAND HEALTH & HIGHER ED FACILITIES AUTHORITY 520936091 5742172P9 2008-08-08 46473000 REFI EXISTING DEBT-SERIES 2008C false false false B MARYLAND HEALTH & HIGHER ED FACILITIES AUTHORITY 520936091 2011-10-01 42000000 CAPITAL PROJECTS-SERIES 2011A false false false C MARYLAND HEALTH & HIGHER ED FACILITIES AUTHORITY 520936091 2011-12-01 49749000 REFI EXISTING DEBT-SERIES 2011B false false false D MARYLAND HEALTH & HIGHER ED FACILITIES AUTHORITY 520936091 2011-12-01 49749000 REFI EXISTING DEBT-SERIES 2011C false false false A 45465000 0 49220640 3340680 0 35384358 414720 0 0 0 0 0 2008 true false true true B 0 0 42000000 0 290227 0 953 0 0 0 0 0 2013 false false true true C 0 0 49749000 0 0 0 0 0 0 0 0 0 2000 true false true true D 0 0 49749000 0 0 0 0 0 0 0 0 0 2000 true false true true A false false false true false true 0 false false false true B false false false true false true 0 false false false true C false false false true false true 0 false false false true D false false false true false true 0 false false false true A false false false 0 false 0 false false B false false false 0 false 0 false false C false false false 0 false 0 false false D false false false 0 false 0 false false A false B false C false D false THE OBLIGATED GROUP ON THE BOND ISSUES IDENTIFIED IN SCHEDULE K INCLUDE 0 BOTH UPPER CHESAPEAKE MEDICAL CENTER, INC. (52-1253920) AND HARFORD 0 MEMORIAL HOSPITAL, INC. (52-0591484). THE ALLOCATION IS AS FOLLOWS: 0 UPPER CHESAPEAKE MEDICAL CENTER 84%; HARFORD MEMORIAL HOSPITAL 16%. 0 JOHN H CAIN BB&T OFFICER 1734120 INTEREST ON O/S DEBT false ROGER E SCHNEIDER MD VASC SURG ASSOC PARTNER 435044 PHYSICIAN FEES PAID TO VSA LLC false RICHARD P STREETT JR ROCK GLENN COMM PARTNER 569547 LEASE PAYMENTS false JASON M BIRNBAUM MD PULMONARY CCA PARTNER 919589 PHYSICIAN FEES PAID TO PCCA false PART VI, SECTION A, GOVERNING BODY & MANAGEMENT, QUESTION 2 FAMILY OR BUSINESS RELATIONSHIP LYLE E SHELDON AND JOSEPH E HOFFMAN III ARE OFFICERS IN THE SAME BUSINESS ENTITIES. THE SAME BUSINESS ENTITIES ARE THE FOR-PROFT CORPORATIONS OR PARTNERSHIPS THAT ARE RELATED TO THIS FILING ENTITY. PLEASE SEE FORM 990, SCHEDULE R. PART VI, SECTION A, GOVERNING BODY & MANAGEMENT, QUESTION 6 EXISTENCE OF MEMBERS UPPER CHESAPEAKE HEALTH SYSTEM AND UNIVERSITY OF MARYLAND MEDICAL SYSTEM ARE PARTNERS IN A MARYLAND LIMITED LIABILITY COMPANY NAMED UCHS/UMMS VENTURE LLC ("VENTURE"). THE VENTURE WAS ORGANIZED FOR CHARITABLE PURPOSES TO COORDINATE ACTIVITIES OF HEALTHCARE FACILITIES AND OTHER CORPORATE BODIES WHOSE PURPOSES INCLUDE THE PROVISION OF HEALTHCARE SERVICES OR FINANCIAL ASSISTANCE TO HEALTHCARE FACILITIES IN HARFORD COUNTY, MARYLAND. VENTURE IS THE SOLE MEMBER OF THIS FILING ORGANIZATION. PART VI, SECTION B, POLICIES, QUESTION 11B ORGANIZATIONAL REVIEW OF FORM 990 THE BOARD OF UPPER CHESAPEAKE HEALTH SYSTEM, INC. ("HEALTH SYSTEM") HAS ASSIGNED THE EXECUTIVE COMMITTEE OF THE HEALTH SYSTEM'S BOARD TO REVIEW AND APPROVE ALL CONTENTS OF FORM 990 ON BEHALF OF THE BOARDS OF ALL HEALTH SYSTEM'S TAX-EXEMPT AFFILIATES. IN TURN, ONCE THE FORM 990 HAS BEEN APPROVED BY HEALTH SYSTEM'S EXECUTIVE COMMITTEE, A FINAL VERSION OF THE FORM 990 WILL BE MADE AVAILABLE TO ALL BOARD MEMBERS OF THE RESPECTIVE HEALTH SYSTEM'S TAX-EXEMPT AFFILIATES. FORMAL NOTIFICATION OF THE FINAL AND APPROVED FORM 990 FOR EACH OF THE HEALTH SYSTEM'S AFFILIATES AS WELL AS ITS AVAILABILITY WILL BE COMMUNICATED TO THE APPLICABLE BOARD MEMBERS ON OR BEFORE THE FILING OF THE FORM 990. PART VI, SECTION B, POLICIES, QUESTION 12C CONFLICT OF INTEREST POLICY The organization's written conflict of interest policy covers the following individuals: Directors, Principal Officers, and Senior Management. Furthermore, the policy extends to the family members (per Internal Revenue Service definition) of such Directors, Principal Officers, and Senior Management. The Board of Directors and any committee considering a contract, transaction or arrangement to which a known or potential conflict of interest relates, determines whether a conflict exists. Actual conflicts are reviewed by the Chairman of the Board. An individual with a known or potential conflict of interest must refrain from participating in, or acting on, the decision on any matter in which a conflict of interest, or even the appearance of such a conflict of interest, is present with respect to such individual and will remove himself or herself from any meeting or deliberations on the matter. PART VI, SECTION B, POLICIES, QUESTION 15 PROCESS FOR DETERMINING COMPENSATION The executive compensation committee of the board of directors approves compensation for the Chief Executive Officer, Chief Operating Officer, Chief Financial Officer, and all key employees. The executive compensation committee utilizes but is not limited to the following resources in evaluating and establishing reasonable compensation: independent compensation consultants, compensation surveys and compensation studies. This organization and its tax-exempt affiliates strive to maintain an arm's length relationship between itself and its employees. It is the goal of the executive compensation committee to ensure that total compensation (compensation and benefits) paid to its employees is fair and reasonable. Finally, the process of setting and approving such compensation is performed annually by the board's executive compensation committee. PART VI, SECTION C, DISCLOSURE, QUESTION 19 DOCUMENTS AVAILABLE TO THE PUBLIC THE ORGANIZATION WILL MAKE THE FOLLOWING DOCUMENTS AVAILABLE TO THE PUBLIC UPON REQUEST: ARTICLES OF INCORPORATION, BYLAWS, CONFLICT OF INTEREST POLICY, AND AUDITED FINANCIAL STATEMENTS (HARFORD MEMORIAL HOSPITAL, INC. AND UPPER CHESAPEAKE MEDICAL CENTER, INC.). PART VIII STATEMENT OF REVENUE LINE 2A - PROGRAM SERVICE REVENUE GROSS PATIENT REVENUE................. $ 284,980,428 LESS: ALLOWANCES & CHARITY POLICIES... (35,447,857) -------------- NET PATIENT REVENUE................ $ 249,532,571 RECONCILIATION OF NET ASSETS PART XI, LINE 8, OTHER CHANGES IN NET ASSETS UNREALIZED GAIN/(LOSS) ON SWAP $ (4,055,948) MINIMUM PENSION LIABILITY (668,330) ------------- TOTAL $ (4,724,278) ============= PART III, PROGRAM SERVICE ACCOMPLISHMENTS TO PROVIDE HEALTHCARE SERVICES TO PATIENTS REGARDLESS OF THEIR ABILITY TO PAY FOR SUCH SERVICES. FOR MORE THAN 90 YEARS, UPPER CHESAPEAKE HEALTH HAS BEEN PROVIDING COMPREHENSIVE, HIGH QUALITY HEALTHCARE. ITS TWO HOSPITALS, HARFORD MEMORIAL HOSPITAL AND UPPER CHESAPEAKE MEDICAL CENTER OFFER SOME OF THE AREA'S MOST ADVANCED INPATIENT AND OUTPATIENT SERVICES SO THAT PATIENTS CAN ENJOY THE SUPERIOR WELLNESS RESOURCES A HEALTHY LIFESTYLE NEEDS, WITHOUT LEAVING THEIR NEIGHBORHOOD. UPPER CHESAPEAKE HEALTH SYSTEM IS A COMMUNITY-BASED, NON-PROFIT HEALTH SYSTEM LOCATED IN HARFORD COUNTY, MARYLAND. OUR VISION IS BASED ON CREATING THE HEALTHIEST COMMUNITY IN MARYLAND. BUILDING ON THAT VISION, WE HAVE A STRONG COMMITMENT TO SERVICE EXCELLENCE. SO MUCH SO THAT IT HAS BECOME PART OF THE FABRIC OF THE HEALTHCARE EXPERIENCE AT UPPER CHESAPEAKE HEALTH. UPPER CHESAPEAKE HEALTH SYSTEM HAS OVER 2,500 PHYSICIANS AND HEALTHCARE PROFESSIONALS WHO ARE DELIVERING CARE FOR THE MIND, BODY, AND SPIRIT IN SETTINGS FROM OFFICES, TO OUTPATIENT CENTERS, TO HOSPITALS, TO SHOPPING CENTERS, TO BUSINESSES, AND TO HOMES. UPPER CHESAPEAKE MEDICAL CENTER IS A MEMBER OF THE UPPER CHESAPEAKE HEALTH SYSTEM. UPPER CHESAPEAKE MEDICAL CENTER IS AN ACUTE CARE, NON-PROFIT FACILITY OFFERING A FULL COMPLEMENT OF MEDICAL, DIAGNOSTIC AND EMERGENCY CARE SERVICES. THE HOSPITAL IS FULLY ACCREDITED BY THE JOINT COMMISSION ON THE ACCREDITATION OF HEALTHCARE ORGANIZATIONS (JCAHO). THIS PREMIER HEALTH CARE FACILITY INCORPORATES SEVERAL TRENDS THAT REFLECT HOW HEALTH CARE IS CHANGING, INCLUDING REORIENTATION TOWARDS OUTPATIENT CARE, MORE ACUTELY ILL PATIENTS IN THE HOSPITAL AND FLEXIBILITY FOR GROWTH AND CHANGE TO MEET OUR COMMUNITY'S FUTURE HEALTH CARE NEEDS. LOCATED ON THE MEDICAL CAMPUS IS THE UPPER CHESAPEAKE MEDICAL CENTER WITH 194 ACUTE CARE BEDS. ADJACENT TO THE MEDICAL CENTER IS THE AMBULATORY CARE CENTER OF HARFORD COUNTY, CONTAINING PHYSICIAN OFFICES, OUTPATIENT IMAGING AND LABORATORY PROCEDURES, OUTPATIENT PRE-ASSESSMENT TESTING AND ASSESSMENT, UPPER CHESAPEAKE CARDIOVASCULAR INSTITUTE, AND THE ADMINISTRATIVE OFFICES OF UPPER CHESAPEAKE HEALTH. ALSO LOCATED NEXT TO THE MEDICAL CENTER, IS A PRE-EXISTING MEDICAL OFFICE BUILDING WITH PHYSICIAN OFFICES AND OTHER HEALTHCARE RELATED SERVICES, A PARKING GARAGE AND A SECOND MEDICAL OFFICE BUILDING WHICH INCLUDES OUTPATIENT SERVICES AND PHYSICIAN OFFICES. HARFORD MEMORIAL HOSPITAL AND UPPER CHESAPEAKE MEDICAL CENTER MAINTAIN CHARITY CARE PROGRAMS AND, IN ADDITION, CONDUCT MANY COMMUNITY OUTREACH AND COMMUNITY BUILDING ACTIVITIES INCLUDING: - COMMUNITY HEALTH EDUCATION PROGRAMS WHICH INCLUDE NEWBORN BABY CARE, SITTER SAFETY PROGRAM, INFANT CPR, INFANT SAFETY, STOP SMOKING CLASS, KIDS SAFETY CLASS, AND PRENATAL BREAST FEEDING CLASS - SUPPORT GROUPS INCLUDING BREAST FEEDING SUPPORT, BREAST CANCER AWARENESS GROUPS, PERINATAL BEREAVEMENT, ASTHMA SUPPORT GROUP, WIDOW AND WIDOWERS SUPPORT GROUP, GRIEF SUPPORT GROUP, PROSTATE CANCER SUPPORT GROUP, AMPUTEE NETWORK, BRAIN INJURY SUPPORT GROUP, STROKE CLUB, LUPUS SUPPORT GROUP, AND OTHERS - HEALTH SCREENINGS INCLUDING SCREENINGS FOR OSTEOPOROSIS, CARDIAC PROBLEMS, BLOOD PRESSURE, AND OTHER ISSUES - FREE AND MOBILE CLINIC # OF STAFF HOURS # OF ENCOUNTERS COMMUNITY HEALTH SERVICES 1,500 18,792 HEALTH PROFESSIONS EDUCATION 14,822 408 MISSION DRIVEN HEALTHCARE SVCS - - RESEARCH 214 12 FINANCIAL CONTRIBUTIONS 323 18 COMMUNITY BUILDING ACTIVITIES 289 32 FOUNDATION FUNDED COMMUNITY BENEFIT - - MEDICAID ASSESSMENTS - - --------- --------- TOTAL HOSPITAL COMMUNITY BENEFIT 17,148 19,262 DIRECT COST ($) INDIRECT COST ($) COMMUNITY HEALTH SERVICES $ 1,278,175 $ 673,470 HEALTH PROFESSIONS EDUCATION 524,683 - MISSION DRIVEN HEALTHCARE SVCS 3,928,502 - RESEARCH 22,033 - FINANCIAL CONTRIBUTIONS 204,408 - COMMUNITY BUILDING ACTIVITIES 289 32 FOUNDATION FUNDED COMM. BENEFIT 111,256 - MEDICAID ASSESSMENTS 7,382,380 - --------- --------- TOTAL HOSPITAL COMM. BENEFIT $ 13,612,091 $ 758,119 OFFSETTING NET COMMUNITY REVENUE ($) BENEFIT ($) COMMUNITY HEALTH SERVICES $ 97,456 $ 1,854,189 HEALTH PROFESSIONS EDUCATION - 524,683 MISSION DRIVEN HEALTH CARE SVCS - 3,928,502 RESEARCH - 22,033 FINANCIAL CONTRIBUTIONS - 204,408 COMMUNITY BENEFIT OPERATIONS - 245,303 CHARITY CARE - 4,777,100 FOUNDATION FUNDED COMM. BENEFIT - 111,256 MEDICAID ASSESSMENTS 6,312,858 1,069,522 ------- --------- TOTAL HOSPITAL COMM. BENEFIT $ 6,410,314 $ 12,736,996 COMMUNITY OUTREACH Community Outreach - In 2012, HealthLink had over 19,000 community-wide contacts through their screening and educational programs, flu vaccination clinics, support groups and HealthLink Primary Care Clinic visits. Approximately, 4740 of these contacts were for health screenings (blood pressure, body fat, cholesterol, osteoporosis, stroke, diabetes risk assessments, foot and eye screenings, and cancer screenings). This also includes 4,689 contacts that were realized through the HealthLink Primary Care Clinic. Over 2,277 influenza vaccinations were administered countywide. Community Outreach also provided local businesses with employee health screenings and vaccinations. And more than 3000 Harford County children received health education from Upper Chesapeake Community Outreach. Senior Center/Senior Housing/Assisted Living Programs - Community Outreach continued to provide monthly blood pressure screenings at all six senior centers and senior housing centers including Windsor Valley Apartments, Abingdon Senior Housing, Fairbrooke, St. Johns commons, St. Johns Towers, Aberdeen and Perryman Station as well as Brightview and Avondale assisted Living Facilities. Throughout the year, many different health screenings were held during certain months at each senior location. During the month of February, cholesterol screenings were provided to 253 participants at all six senior centers. In March, a screening for body composition was provided to 106 participants at the senior centers. During the month of May, a screening for stroke risk assessment was provided for 249 participants at all of the senior centers and senior housing centers. In September, a hearing and vision screening was provided for the first time at all six senior centers for 137 participants. Then in October, influenza vaccinations were provided at all of the senior centers, senior housing, and assisted living programs. There was also a diabetes risk screening provided in November at a few senior centers that 17 participants engaged in. Children's Programs - A total of 291 children were involved with our Glo Germ Program. This is a program that emphasizes how infection is spread and the importance of good hand washing habits. - Approximately 588 children were exposed to our KATU (Kids Against Tob Approximately 588 children were exposed to our KATU (Kids Against Tobacco Use) program and Smoking Out the Truth programs. These programs teach children, adolescents, and teens about the dangers associated with tobacco use. Toxic Soup is a program that addresses the effects of secondhand smoke which is a program included at times. - There were approximately 1043 children who attended our Teddy Bear Clinics at many of the Harford County elementary public schools. This is an interactive program that familiarizes children with the hospital experience and presents information on child safety. - Another popular program titled How Sweet It Is was taken out into the community and over 2363 children and adults were exposed to this program. The focus of this program is to educate children and adults on the sugar content in many of their favorite drinks including juice boxes, sports drinks, soda, flavored water, and popular coffee drinks. - Over 300 children and adults were involved in our Sun Sense program during the year. This program educates children, teens and adults on the harmful effects of the sun including the dangers of tanning beds. A skin analyzer machine is also utilized with this program to allow individuals to examine their own skin and realize the impact that the sun has had on their skin. - In addition to the above programs, a nutrition program titled My Plate was developed geared to children, teens, adults and seniors. This program focuses on making healthier food choices and building a healthy plate. New Screenings and New Businesses - In 2012, new equipment was obtained to be able to provide HbA1c screenings for Team Members determined at risk for diabetes at the Wellness Works program here at UCH. This screening uses blood from a fingerstick to determine a HbA1c level which is the average blood glucose level in the body over a 2-3month period. The ability to use this screening tool in the community is being evaluated. - A new partnership was formed with the Harford County Sheriff's Office to provide health fairs for their employees. The first health fair was held at the Heat Center in Aberdeen with over 25 participants at this event. Some of the health screenings and programs offered were blood pressures, body composition, Health Wheel, sleep assessment, and How Sweet It Is. In the Fall, two health fairs were coordinated at the northern and southern precincts to capture and improve accessability to more employees. There were approximately 55 participants at these events. Some of the screenings offered in the fall were cholesterol, blood pressure, body composition, CO assessment to screen for smoking, My Plate, Health Wheel, flu shots, and How Sweet It Is. - Community Outreach got involved with a new initiative by the Harford County Public Schools to provide health screenings to their employees at three designated schools during the month of September. Many different health screenings were offered including cholesterol, blood pressures, body composition, osteoporosis, cardiac risk assessment, and stroke risk assessment. VACCINES - Community Outreach administered approximately 2277 community flu vaccinations throughout the county in 2012. "Dining with Docs" Lectures and Community Lectures - In 2012, there were several "Dining with Docs" lectures about cancer and the environment and sleep disorders that were held at the Upper Chesapeake Medical Center. Approximately 68 community residents attended these lectures. - There were many other community lectures provided on topics regarding Healthy Aging, Heart Health, and Nutrition held at several churches in the county. Approximately 546 community residents attended one of these lectures. - A seminar on Heart Disease and Erectile Dysfunction presented by a cardiologist and urologist was coordinated with Chesapeake Urology Associates at the Richlin Ballroom in Edgewood. Over 45 members of the community attended this event. A blood pressure screening was also provided. Havre de Grace Health-Tacular - The Second Annual Health Fair was held at the Havre de Grace Activity Center. HealthLink was involved in the planning of this event with Marketing and other departments on the committee. There were many different screenings and programs offered at this event including cholesterol, blood pressure, body composition, hearing screening, breast health, skin cancer screening, prostate screening, Health Wheel, How Sweet It Is program, and free flu vaccinations. Over 300 people took advantage of these services offered. HealthLink Community Wellness Center - In 2012, the HealthLink Community Wellness Center which operates from the HealthLink Medical Mobile Van had 84 residents participate in one of the available health screenings offered throughout the year. The Wellness Centers are offered monthly at two different locations in the County. Primary Care Clinic - The HealthLink Primary Care Clinic (PCC) provided primary care on a sliding fee scale to low income adults age 19 and above who are uninsured or underinsured and meet specific income criteria. In 2012, the PCC had approximately 4,689 patient encounters. HealthLink Call Center - In 2012, our HealthLink Call Center handled approximately 6,334 calls. This included almost 387 physician referrals, 2,784 physician related calls and 1,884 service calls. Support Groups - HealthLink RNs facilitate countywide support groups for diabetes. The support groups meet at the Aberdeen Senior Center, Edgewood Senior Center, Primary Care Clinic, and the McFaul Activity Center. These groups meet monthly and served approximately 180 participants. 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