2012-11-15T15:03:07-06:00 2011-12-31 GRANT THORNTON LLP 2001 MARKET STREET SUITE 3100 PHILADELPHIA PA 19103 990 2011-01-01 521253920 UPPER CHESAPEAKE MEDICAL CENTER % JOSEPH E HOFFMAN III UPPE 4108773700 500 UPPER CHESAPEAKE DRIVE BEL AIR MD 21014 JOSEPH E HOFFMAN III 4436433340 2012-11-13 true 2155614200 2011 2016-02-24 21:20:13Z LYLE E SHELDON 520 UPPER CHESAPEAKE DR STE BEL AIR MD 21014 241216767 false X WWW.UCHS.ORG X 1997 MD ACUTE HOSPITAL CARE 16 12 2242 704 0 0 27538437 7361725 201719717 229956458 102580 579927 169420 275563 229530154 238173673 11364025 8141614 0 0 89163616 95049836 0 0 0 101925468 116218745 202453109 219410195 27077045 18763478 300806783 321262781 213904536 234530464 86902247 86732317 X ACUTE HOSPITAL CARE false false 160339944 8080501 229956458 SEE SCHEDULE O 160339944 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 false true true false false false false false false false false false false false false false false false true false false false false true 8 0 true 2242 true false true false false false false false false false false false X 16 12 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 27083 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 ROBERT F HOOFNAGLE JR MD 1.0 X 65792 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 X X 0 802498 90419 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 151250 0 0 JOYCE FOX 20.0 X 0 223146 44446 JOSEPH E HOFFMAN III 5.0 X 0 396292 81484 KENNETH D KOZEL 5.0 X 0 394262 63239 DEAN C KASTER 5.0 X 0 276903 58880 MARGARET M VAUGHAN 5.0 X 0 376634 77548 E SCOTT CONOVER 5.0 X 0 354257 52953 TONI M SHIVERY 5.0 X 0 200181 64160 ROY PHILLIPS 40.0 X 255803 0 46478 OLUFUNMILAYO ONOBRAKPEYA 40.0 X 223702 0 20775 TAMARA L CALLIGARO 40.0 X 149094 0 31596 BERTHA SIMON 40.0 X 138784 0 41450 ANGELA M KAITIS 40.0 X 131484 0 45627 1142992 3024173 719055 78 false true false NORTHERN CHESAPEAKE ANESTHESIA ASSO PO BOX 89 BEL AIR MD 21014 PHYSICIAN FEES 2507122 VISION CONSULTING LLC 3325 ASPEN GROVE DRIVE SUITE 204 FRANKLIN TN 37067 SOFTWARE CONSULTING 1637782 MEDQUIST TRANSCRIPTIONS LTD PO BOX 102467 ATLANTA GA 30368 TRANSCRIPTION 698014 NCO FINANCIAL SYSTEMS INC PO BOX 931053 CLEVELAND OH 44193 COLLECTIONS 479627 BRAIN AND SPINE SPECIALISTS PA 520 UPPER CHESAPEAKE DR SUITE 211 BEL AIR MD 21014 PHYSICIAN FEES 443720 26 7361725 7361725 NET PATIENT SERVICE REVENUE 621110 229797797 229797797 SPINE CENTER/ENDOCRINOLOGY 621110 158661 158661 229956458 163688 163688 0 0 1410089 3043094 -1633005 -1633005 -1633005 516669 -100430 0 516669 -100430 416239 416239 0 0 0 CAFETERIA SALES 900099 1093279 1093279 PARKING GARAGE 900099 202776 202776 LOSS ON EARLY RETIREMENT OF DEBT 900099 -111896 -111896 724409 0 724409 1908568 238173673 229956458 0 855490 X 8141614 8141614 0 0 0 0 0 77302959 57044270 20258689 4673489 3448714 1224775 6351206 4670738 1680468 6722182 4960508 1761674 0 0 22310 22310 0 0 0 6835233 4219507 2615726 836475 816 835659 51100242 46834132 4266110 0 0 2767510 2767510 27197 14513 12684 0 108449 7262 101187 2968185 1877154 1091031 0 8957545 6456381 2501164 2793535 2061437 732098 PROVISION FOR BAD DEBT 13889579 13889579 0 MANAGEMENT FEES - UCHS 7345781 7345781 0 PURCHASED SERVICES 4437627 2239476 2198151 0 MAINTENANCE CONTRACT 2626122 741092 1885030 0 11502955 3732751 7770204 219410195 160339944 59070251 0 20493286 18019127 0 0 0 0 21238343 26206766 0 0 0 0 0 0 4325056 5693980 444953 1214175 232547673 76761675 146439423 155785998 53944023 41080170 0 0 0 0 543168 383343 53378531 72879222 300806783 321262781 21364795 24574005 0 0 0 0 147235698 146396066 0 0 0 0 0 0 0 0 45304043 63560393 213904536 234530464 X 86902247 79725317 0 7007000 0 0 86902247 86732317 300806783 321262781 X 18763478 -18933408 X false true true X false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false true 22524 22524 false false LOBBYING ACTIVITIES SCHEDULE C, PART II-B, LINE 1I LOBBYING EXPENSES IN THE AMOUNT OF $22,524 FOR 12/31/11 REPRESENT A PORTION OF THE DUES PAID TO AMERICAN HOSPITAL ASSOCIATION AND MARYLAND HOSPITAL ASSOCIATION. THESE ASSOCIATIONS ALLOCATE A PORTION OF MEMBER DUES TO LOBBYING ACTIVITY. 6947954 6947954 137856821 30486620 107370201 5150473 759076 4391397 46625416 33790390 12835026 35967009 11725589 24241420 155785998 OTHER ACCTS RECEIVABLE 42255 DEFERRED FINANCING COSTS 1128390 DUE FROM AFFILIATES 58890413 FUNDS HELD BY TRUSTEE 3419077 ECON INT FOUNDATION NET ASSETS 7007000 CURRENT PORTION OF ASSETS LTD 2392087 72879222 0 ADVANCES FROM THIRD PARTIES 5064661 ACCRUED PENSION LIABILITY 7140060 BOND INTEREST RATE SWAP 51355672 63560393 238173673 219410195 18763478 68902 -19003599 -18934697 -171219 212474569 68902 -28811100 -28742198 241216767 -3043094 -3043094 238173673 212645788 3043094 3043094 209602694 9807501 9807501 219410195 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 CHANGE IN NET ASSETS SCHEDULE D, PART XI, LINE 8 UNREALIZED GAIN/(LOSS) ON SWAP (12,174,354) MINIMUM PENSION LIABILITY (6,829,245) ------------ TOTAL (19,003,599) ============ RECONCILIATION OF REVENUE SCHEDULE D, PART XII LINE 2D - OTHER REVENUE ON BOOKS NOT ON RETURN UNREALIZED GAIN/(LOSS) ON SWAP $(12,174,354) MINIMUM PENSION LIABILITY (6,829,245) RECLASS - TRANSFER TO/FROM AFFILIATES (9,807,501) ------------- TOTAL $(28,811,100) ============= LINE 4B - OTHER REVENUE ON RETURN NOT ON BOOKS RECLASS - RENTAL EXPENSES $ (3,043,094) RECONCILIATION OF EXPENSES SCHEDULE D, PART XIII LINE 2D - OTHER EXPENSES INCLUDED ON BOOKS NOT ON RETURN RECLASS - RENTAL EXPENSES $3,043,094 LINE 4B - OTHER EXPENSES INCLUDED ON RETURN NOT ON BOOKS RECLASS - TRANSFER TO/FROM AFFILIATES $9,807,501 true true X true X true X true true false true true 12895119 12895119 0.06000 12895119 12895119 0.06000 1784910 73345 1711565 0.01000 81571 81571 0.00040 3441825 3441825 0.02000 73133 73133 0.00030 5381439 73345 5308094 0.03070 18276558 73345 18203213 0.09070 true 13889579 2816183 86780002 80302780 6477222 X true true 1 1 UPPER CHESAPEAKE MEDICAL CENTER INC

500 UPPER CHESAPEAKE DRIVE BEL AIR MD 21014

X X X 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 TEH 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 UPPER CHESAPEAKE MEDICAL CENTER DID NOT HAVE COMMUNITY BUILDING ACTIVITIES DURING THE CALENDAR YEAR ENDED DECEMBER 31, 2011. 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 HARFORD COMMUNITY COLLEGE 401 THOMAS RUN ROAD BEL AIR MD 21015 521635738 51258 GENERAL SUPPORT UPPER CHESAPEAKE MEDICAL SERVICES 520 UPPER CHESAPEAKE DRIVE BEL AIR MD 21014 521501734 501(C)(3) 8080501 PHY PRACTICE SUPPRT CECIL COMMUNITY COLLEGE ONE SEAHAWK DRIVE NORTH EAST MD 21901 237345298 5481 GENERAL SUPPORT 3 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 X X X X X false true false false false false false false false LYLE E SHELDON 0 508341 0 243424 0 50733 0 53200 0 37219 0 892917 FAHEEM YOUNUS MD 0 0 0 0 151250 0 0 0 0 0 151250 0 JOYCE FOX 0 168021 0 44381 0 10744 0 42814 0 1632 0 267592 JOSEPH E HOFFMAN III 0 259860 0 109199 0 27233 0 50750 0 30734 0 477776 KENNETH D KOZEL 0 259655 0 97090 0 37517 0 49116 0 14123 0 457501 DEAN C KASTER 0 202337 0 72031 0 2535 0 31674 0 27206 0 335783 MARGARET M VAUGHAN 0 269500 0 84773 0 22361 0 52601 0 24947 0 454182 E SCOTT CONOVER 0 246940 0 89544 0 17773 0 51503 0 1450 0 407210 TONI M SHIVERY 0 150490 0 40019 0 9672 0 36583 0 27577 0 264341 ROY PHILLIPS 202869 0 52000 0 934 0 29149 0 17329 0 302281 0 OLUFUNMILAYO ONOBRAKPEYA 191423 0 32000 0 279 0 19869 0 906 0 244477 0 TAMARA L CALLIGARO 107977 0 11626 0 29491 0 10135 0 21461 0 180690 0 BERTHA SIMON 126687 0 11760 0 337 0 26288 0 15162 0 180234 0 ANGELA M KAITIS 117700 0 13007 0 777 0 27454 0 18173 0 177111 0 SCHEDULE J, COMPENSATION INFORMATION, 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: KENNETH D. KOZEL $13,531 E. SCOTT CONOVER $11,169 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 $109,924 Margaret M. Vaughan $ 31,362 Joseph E. Hoffman III $ 30,462 Dean C. Kaster $ 22,999 MARYLAND HEALTH & HIGHER ED FACILITIES AUTHORITY 520936091 5742172P9 2008-08-08 46473000 REFINANCE EXISTING DEBT false false false 45465000 0 49220640 3340680 0 35384358 414720 0 0 0 0 0 2008 true false true true false false false false false false 0.00000 0.00000 0.00000 true false false false 0 false false false 0 false 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 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................. $ 260,106,771 LESS: ALLOWANCES & CHARITY POLICIES... (30,308,973) -------------- NET PATIENT REVENUE................ $ 229,797,798 PART VII, SECTION A, PART I AVERAGE HOURS PER WEEK The following chart details the filing organization's board of directors members and officers who are also board of directors members and officers of related exempt organizations and the hours spent per week on duties for those related exempt organizations. The chart does not reflect hours spent per week on duties for any related for-profit entities. The hours reflected in Part VII, Section A, Column B are only the average hours per week for this filing organization. UCF HMH UCMS UCP UCHC UCHS HH UCRHH LYLE E. SHELDON 1 5 1 1 .50 40 1 .50 PRES/CEO JOSEPH E. HOFFMAN III 1 1 1 1 1 40 - 1 SR VP/CFO JOYCE FOX - 20 - - - - - - VP PATIENT SERVICES/CNO MARGARET M. VAUGHAN - 5 1 - - 40 - - SR VP/CMO KENNETH D. KOZEL 1 5 1 1 1 40 - - SR VP/COO DEAN C. KASTER - 5 - - - 40 - - SR VP/CORP STRTGY/PLNING TONI M. SHIVERY - 5 - - - 40 - - VP/HUMAN RESOURCES E. SCOTT CONVOER - 5 1 - - 40 - - SR VP/GENERAL COUNSEL UCF - UPPER CHESAPEAKE HEALTH FOUNDATION HMH - HARFORD MEMORIAL HOSPITAL UCMS - UPPER CHESAPEAKE MEDICAL SERVICES UCP - UPPER CHESAPEAKE PROPERTIES UCHC - UPPER CHESAPEAKE/ST. JOE'S HOME CARE UCHS - UPPER CHESAPEAKE HEALTH SYSTEM HH - HEALTHY HARFORD UCRHH - UPPER CHESAPEAKE RESIDENTIAL HOSPICE HOUSE PART XI, LINE 5 RECONCILIATION OF NET ASSETS UNREALIZED GAIN/(LOSS) ON SWAP $(12,174,354) MINIMUM PENSION LIABILITY (6,829,245) UNREALIZED GAIN/(LOSS) ON SECURITIES 68,902 ROUNDING 1,289 ------------- Total $(18,933,408) 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 HEALTH CARE. ITS TWO HOSPITALS, HARFORD MEMORIAL HOSPITAL AND UPPER CHESAPEAKE MEDICAL CENTER OFFER SOME OF THE AREAS 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 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 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 CLINICS A NUMERICAL SUMMARY OF COMMUNITY ACTIVITIES FOR UPPER CHESAPEAKE MEDICAL CENTER IS AS FOLLOWS: # OF STAFF HOURS # OF ENCOUNTERS COMMUNITY HEALTH SERVICES 3,292 17,605 HEALTH PROFESSIONS EDUCATION 6,594 - RESEARCH - 20 FINANCIAL CONTRIBUTIONS 33 221 COMMUNITY BENEFIT OPERATIONS 7 - --------- --------- TOTAL HOSPITAL COMMUNITY BENEFIT 9,925 17,846 DIRECT COST ($) INDIRECT COST ($) COMMUNITY HEALTH SERVICES 1,159,869 624,590 HEALTH PROFESSIONS EDUCATION 206,922 111,428 MISSION DRIVEN HEALTHCARE SVCS 3,132,501 1,686,852 RESEARCH 1,443 777 FINANCIAL CONTRIBUTIONS 70,921 38,191 COMMUNITY BENEFIT OPERATIONS 294 158 FOUNDATION FUNDED COMM. BENEFIT 109,567 59,002 MEDICAID ASSESSMENTS 5,643,166 - --------- --------- TOTAL HOSPITAL COMMUNITY BENEFIT 10,324,683 2,520,997 OFFSETTING NET COMMUNITY REVENUE ($) BENEFIT ($) COMMUNITY HEALTH SERVICES 73,345 1,711,114 HEALTH PROFESSIONS EDUCATION 2,600 315,750 MISSION DRIVEN HEALTH CARE SVCS - 4,819,352 RESEARCH - 2,220 FINANCIAL CONTRIBUTIONS 2,470 106,642 COMMUNITY BENEFIT OPERATIONS - 452 CHARITY CARE - 3,679,633 FOUNDATION FUNDED COMM. BENEFIT - 168,569 MEDICAID ASSESSMENTS 4,687,103 956,063 ------- --------- TOTAL HOSPITAL COMMUNITY BENEFIT 4,765,518 11,759,795 COMMUNITY OUTREACH In 2011, HealthLink had approximately 23,060 community-wide contacts through their screening and educational programs, flu vaccination clinics, support groups and HealthLink Primary Care Clinic visits. Approximately 7,400 of these contacts were for health screenings (blood pressure, body fat, cholesterol, osteoporosis, stroke, sleep, diabetes risk assessments, foot and eye screenings, and cancer screenings). This also includes 3,575 contacts that were realized through the HealthLink Primary Care Clinic. Over 2,570 influenza vaccinations were administered countywide. Community Outreach also provided local businesses with employee health screenings and vaccinations totaling 456 encounters. And more than 3,150 Harford County children received health education from Upper Chesapeake Community Outreach. Senior Center Programs - In addition to Community Health holding monthly blood pressure screenings at all six senior centers, a Jeopardy Health Fair was held at each center. A Jeopardy game was played on a large screen for groups of seniors. The focus was on general health and wellbeing. Health screenings including osteoporosis, blood pressures and stroke risk assessments were provided. There were also educational tables as well as tetanus vaccinations available that were provided by Community Outreach. Approximately 250 seniors participated in these events. Children's Programs - A total of 710 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 1,130 children were exposed to our "KATU" (Kids Against Tobacco Use) program and new Smoking Out the Truth. 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. - Approximately 1,040 children attended our Teddy Bear Clinics. This is a program that familiarizes children with the hospital experience. - "Be Smart about Body Art" was also taken out into the community. It educates teens about the potential dangers associated with body piercing and tattooing. This program has been very successful with over 275 teens being educated in 2011. - "How Sweet It Is", a fairly new program was also taken out into the community. The program educates 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 2,500 children and adults were exposed to this program. - A new program was developed this year titled "Sun Sense". This program educates children, teens and adults on the harmful effects of the sun including the dangers of tanning beds. A skin analyzer was purchased by the Community Outreach. This machine allows individuals to examine their own skin and realize the impact that the sun has had on their skin. Over 1,235 adults and children participated in this program. - In addition to the above programs, a nutrition program titled "Mission Nutrition" was developed geared for children, teens and young adults, and seniors. The program includes new information regarding the "MyPlate" approach, portion control, reading labels, etc. Over 215 adults and children participated in a nutrition program. New Screenings - In 2011, equipment was purchased for vision and hearing screenings. This allows Community Health to offer these screenings to Harford County private schools and home schoolers that may not have the opportunity to be screened. Hearing screenings are also being made available to seniors. Approximately 260 people participated in these screenings. VACCINES - Community Outreach administered approximately 2,570 community flu vaccinations throughout the county in 2011. "Dining with Docs" Lectures - In 2011 "Dining with Docs" community lectures were held at both Upper Chesapeake Medical Center and Harford Memorial. A total of 239 community residents attended the lectures. Havre de Grace Health-Tacular - A large health fair was held at the Havre de Grace Activity Center. Free flu vaccinations were offered as well as twenty different health screenings. These included balance, blood pressure, body fat composition, cholesterol, glucose, DEXA scans, carotid ultrasounds, stroke risk assessments, diabetic eye and foot screenings, and hearing screenings. Cancer screenings were also offered including prostate, skin, oral and colorectal cancer screenings. Children were fitted for bike helmets and provided a free helmet. UCH service lines as well as outside vendors were represented. This event would not have been possible without the strong partnership with the HC Office on Aging, Parks and Rec and the Boys and Girls Club. Over 380 people attended this event. HealthLink Community Wellness Center - In 2011, the HealthLink Community Wellness Center, which operates out of the HL Medical Mobile Van, had 130 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 2011, the PCC had approximately 1,315 established patients and a total of 3,575 patient encounters. HealthLink Call Center -In 2011, our HealthLink Call Center handled approximately 8,060 calls. This included almost 590 physician referral, 4,635 physicians' related calls, and 2,335 service calls. - The "flu HOTLINE" was reinstated to keep the community better informed about the locations and times that flu clinics were being held throughout the county. As new information became available or changed, the recording on the HOTLINE was updated so that residents could get accurate information. Support Groups - HealthLink RNs facilitate countywide support groups; stroke and diabetes. Both groups meet monthly; the stroke group meets at UCMC and the diabetes group meets at the Aberdeen Senior Center. Two additional diabetes support groups were established in 2011, one at the Edgewood Senior Center and the second at the McFaul Activity Center. The stroke group averages 12 participants per meeting (146 per year) and the diabetes support groups served 66 participants. HealthLink and Community Health Improvement Coalitions and Committees - Harford County School Health Board - Harford County Tobacco Coalition - Harford County Cancer Coalition - Office on Aging Advisory Board - Harford County Homeless Advisory Board - GAIN Committee - Healthy Harford UPPER CHESAPEAKE HEALTH SYSTEMS INC 520 UPPER CHESAPEAKE DRIVE BEL AIR MD 21014 521398513 HLTHCARE SVCS MD 501(c)(3) 11C;III-FI NA false UPPER CHESAPEAKE HEALTH FOUNDATION INC 520 UPPER CHESAPEAKE DRIVE BEL AIR MD 21014 521398507 FIN SUPPORT MD 501(c)(3) 11A UCHS false UPPER CHESAPEAKE MEDICAL SERVICES INC 520 UPPER CHESAPEAKE DRIVE BEL AIR MD 21014 521501734 PHYSICIAN SVC MD 501(c)(3) 9 UCHSUMMS VN false HARFORD MEMORIAL HOSPITAL INC 520 UPPER CHESAPEAKE DRIVE BEL AIR MD 21014 520591484 HOSPITAL CARE MD 501(c)(3) 3 UCHSUMMS VN false UPPER CHESAPEAKE PROPERTIES INC 520 UPPER CHESAPEAKE DRIVE BEL AIR MD 21014 521907237 TITLE HOLDING MD 501(c)(2) N/A UCHSUMMS VN false UPPER CHESAPEAKEST JOE'S HOME CARE INC 520 UPPER CHESAPEAKE DRIVE BEL AIR MD 21014 521229742 HOSPICE CARE MD 501(c)(3) 9 UCHSUMMS VN false UPPER CHESAPKE RESIDENTIAL HOSPICE HOUSE 520 UPPER CHESAPEAKE DRIVE BEL AIR MD 21014 260737028 HOSPICE CARE MD 501(c)(3) 7 UCHSUMMS VN false HEALTHY HARFORD INC 2027 PULASKI HWY SUITE 215 HAVRE DE GRACE MD 21078 521944325 HEALTH INIATV MD 501(c)(3) 7 NA false UCHSUMMS VENT LLC 520 UPPER CHESAPEAKE BEL AIR MD 21014 522178070 MEDICAL SERVI MD NA N/A UCHSUMMS REAL ESTATE TRUST 520 UPPER CHESAPEAKE DRIVE BEL AIR MD 21014 276803540 HOLD LAND MD NA N/A UPPER CHESAPEAKE HEALTH VENTURES INC 520 UPPER CHESAPEAKE DRIVE BEL AIR MD 21014 522031264 MISC. SERVICE MD NA C CORP UPPER CHESAPEAKE MED OFFICE BLDG INC 520 UPPER CHESAPEAKE DRIVE BEL AIR MD 21014 521946829 REAL ESTATE MD NA C CORP UPPER CHESAPEAKE MGMT SVCS ORG INC 520 UPPER CHESAPEAKE DRIVE BEL AIR MD 21014 521946025 MANAGEMENT SV MD NA C CORP UC MEDICAL CENTER LAND CONDOMINIUM INC 520 UPPER CHESAPEAKE DRIVE BEL AIR MD 21014 770674478 REAL ESTATE MD NA C CORP UPPER CHESAPEAKE INSURANCE COMPANY LTD PO BOX 1109 GRAND CAYMAN CAYMAN ISLANDS CJ KY1-1102 980468438 CAPTIVE INSURANCE CJ NA LTD. true false true false false false false false false false false true false false false true false false