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        <Explanation>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 TH 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, 2011.</Explanation>
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      <FPGReferenceDiscountedCare>true</FPGReferenceDiscountedCare>
      <Pcent400>X</Pcent400>
      <FreeDiscCareMedicallyIndigent>true</FreeDiscCareMedicallyIndigent>
      <AmountsBudgetedForCharityCare>true</AmountsBudgetedForCharityCare>
      <ExpensesExceededBudget>true</ExpensesExceededBudget>
      <UnableToProvideCare>false</UnableToProvideCare>
      <AnnualCommunityBenefitReport>true</AnnualCommunityBenefitReport>
      <ReportPublicallyAvailable>true</ReportPublicallyAvailable>
      <CharityCareAtCost>
        <TotalCommunityBenefitExpense>8367249</TotalCommunityBenefitExpense>
        <DirectOffsettingRevenue>0</DirectOffsettingRevenue>
        <NetCommunityBenefitExpense>8367249</NetCommunityBenefitExpense>
        <PercentOfTotalExpense>0.02010</PercentOfTotalExpense>
      </CharityCareAtCost>
      <UnreimbursedMedicaid>
        <TotalCommunityBenefitExpense>0</TotalCommunityBenefitExpense>
        <DirectOffsettingRevenue>0</DirectOffsettingRevenue>
        <NetCommunityBenefitExpense>0</NetCommunityBenefitExpense>
        <PercentOfTotalExpense>0.00000</PercentOfTotalExpense>
      </UnreimbursedMedicaid>
      <UnreimbursedCosts>
        <TotalCommunityBenefitExpense>0</TotalCommunityBenefitExpense>
        <DirectOffsettingRevenue>0</DirectOffsettingRevenue>
        <NetCommunityBenefitExpense>0</NetCommunityBenefitExpense>
        <PercentOfTotalExpense>0.00000</PercentOfTotalExpense>
      </UnreimbursedCosts>
      <TotalCharityCare>
        <TotalCommunityBenefitExpense>8367249</TotalCommunityBenefitExpense>
        <DirectOffsettingRevenue>0</DirectOffsettingRevenue>
        <NetCommunityBenefitExpense>8367249</NetCommunityBenefitExpense>
        <PercentOfTotalExpense>0.02010</PercentOfTotalExpense>
      </TotalCharityCare>
      <CommunityHealthServices>
        <TotalCommunityBenefitExpense>2125443</TotalCommunityBenefitExpense>
        <DirectOffsettingRevenue>46931</DirectOffsettingRevenue>
        <NetCommunityBenefitExpense>2078512</NetCommunityBenefitExpense>
        <PercentOfTotalExpense>0.00500</PercentOfTotalExpense>
      </CommunityHealthServices>
      <HealthProfessionsEducation>
        <TotalCommunityBenefitExpense>15143864</TotalCommunityBenefitExpense>
        <DirectOffsettingRevenue>0</DirectOffsettingRevenue>
        <NetCommunityBenefitExpense>15143864</NetCommunityBenefitExpense>
        <PercentOfTotalExpense>0.03630</PercentOfTotalExpense>
      </HealthProfessionsEducation>
      <SubsidizedHealthServices>
        <TotalCommunityBenefitExpense>17499067</TotalCommunityBenefitExpense>
        <DirectOffsettingRevenue>12997752</DirectOffsettingRevenue>
        <NetCommunityBenefitExpense>4501315</NetCommunityBenefitExpense>
        <PercentOfTotalExpense>0.01080</PercentOfTotalExpense>
      </SubsidizedHealthServices>
      <Research>
        <TotalCommunityBenefitExpense>1434</TotalCommunityBenefitExpense>
        <DirectOffsettingRevenue>0</DirectOffsettingRevenue>
        <NetCommunityBenefitExpense>1434</NetCommunityBenefitExpense>
        <PercentOfTotalExpense>0.00000</PercentOfTotalExpense>
      </Research>
      <CashAndInKindContributions>
        <TotalCommunityBenefitExpense>261638</TotalCommunityBenefitExpense>
        <DirectOffsettingRevenue>0</DirectOffsettingRevenue>
        <NetCommunityBenefitExpense>261638</NetCommunityBenefitExpense>
        <PercentOfTotalExpense>0.00060</PercentOfTotalExpense>
      </CashAndInKindContributions>
      <TotalOtherBenefits>
        <TotalCommunityBenefitExpense>35031446</TotalCommunityBenefitExpense>
        <DirectOffsettingRevenue>13044683</DirectOffsettingRevenue>
        <NetCommunityBenefitExpense>21986763</NetCommunityBenefitExpense>
        <PercentOfTotalExpense>0.05270</PercentOfTotalExpense>
      </TotalOtherBenefits>
      <TotalCommunityBenefits>
        <TotalCommunityBenefitExpense>43398695</TotalCommunityBenefitExpense>
        <DirectOffsettingRevenue>13044683</DirectOffsettingRevenue>
        <NetCommunityBenefitExpense>30354012</NetCommunityBenefitExpense>
        <PercentOfTotalExpense>0.07280</PercentOfTotalExpense>
      </TotalCommunityBenefits>
      <CommunitySupport>
        <TotalCommunityBuildingExpense>114216</TotalCommunityBuildingExpense>
        <DirectOffsettingRevenue>0</DirectOffsettingRevenue>
        <NetCommunityBuildingExpense>114216</NetCommunityBuildingExpense>
        <PercentOfTotalExpense>0.00030</PercentOfTotalExpense>
      </CommunitySupport>
      <LeadershipDevelopment>
        <TotalCommunityBuildingExpense>2221</TotalCommunityBuildingExpense>
        <DirectOffsettingRevenue>0</DirectOffsettingRevenue>
        <NetCommunityBuildingExpense>2221</NetCommunityBuildingExpense>
      </LeadershipDevelopment>
      <HealthImprovementAdvocacy>
        <TotalCommunityBuildingExpense>47834</TotalCommunityBuildingExpense>
        <DirectOffsettingRevenue>0</DirectOffsettingRevenue>
        <NetCommunityBuildingExpense>47834</NetCommunityBuildingExpense>
        <PercentOfTotalExpense>0.00010</PercentOfTotalExpense>
      </HealthImprovementAdvocacy>
      <Total>
        <TotalCommunityBuildingExpense>164271</TotalCommunityBuildingExpense>
        <DirectOffsettingRevenue>0</DirectOffsettingRevenue>
        <NetCommunityBuildingExpense>164271</NetCommunityBuildingExpense>
        <PercentOfTotalExpense>0.00040</PercentOfTotalExpense>
      </Total>
      <BadDebtExpenseReported>true</BadDebtExpenseReported>
      <BadDebtExpenseAmount>11791844</BadDebtExpenseAmount>
      <AmountAttributableTo>0</AmountAttributableTo>
      <AmountReimbursedByMedicare>0</AmountReimbursedByMedicare>
      <CostOfCareReimbursedByMedicare>0</CostOfCareReimbursedByMedicare>
      <MedicareSurplusOrShortfall>0</MedicareSurplusOrShortfall>
      <CostingMethodologyUsed>
        <CostToChargeRatio>X</CostToChargeRatio>
      </CostingMethodologyUsed>
      <WrittenDebtCollectionPolicy>true</WrittenDebtCollectionPolicy>
      <ProvisionForCharityCare>true</ProvisionForCharityCare>
      <NumberOfHospitalFacilities>1</NumberOfHospitalFacilities>
      <Form990ScheduleHPartVSectionA>
        <FacilityNumber>1</FacilityNumber>
        <Name>
          <BusinessNameLine1>FRANKLIN SQUARE HOSPITAL CENTER</BusinessNameLine1>
        </Name>
        <Address>
          <AddressLine1>9000 FRANKLIN SQUARE DRIVE</AddressLine1>
          <City>BALTIMORE</City>
          <State>MD</State>
          <ZIPCode>212373901</ZIPCode>
        </Address>
        <LicensedHospital>X</LicensedHospital>
        <GeneralMedicalAndSurgical>X</GeneralMedicalAndSurgical>
        <TeachingHospital>X</TeachingHospital>
        <ResearchFacility>X</ResearchFacility>
        <Er24Hours>X</Er24Hours>
        <ErOther>X</ErOther>
        <Other>FAST TRACK ER</Other>
      </Form990ScheduleHPartVSectionA>
      <Form990ScheduleHPartVSectionB>
        <HospitalFacilityName>
          <BusinessNameLine1>FRANKLIN SQUARE HOSPITAL CENTER</BusinessNameLine1>
        </HospitalFacilityName>
        <HospitalFacilityNumber>1</HospitalFacilityNumber>
      </Form990ScheduleHPartVSectionB>
      <Form990ScheduleHPartVI>
        <Identifier>CHARITY CARE AT COST</Identifier>
        <ReturnReference>PART I, LINE 7A</ReturnReference>
        <Explanation>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.</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <Identifier>UNREIMBURSED MEDICAID</Identifier>
        <ReturnReference>PART I, LINE 7B</ReturnReference>
        <Explanation>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.</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <Identifier>HEALTH PROFESSIONS EDUCATION</Identifier>
        <ReturnReference>PART I, LINE 7F</ReturnReference>
        <Explanation>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 $18,153,399 HAS BEEN REMOVED FROM TOTAL EXPENSE TO CALCULATE THE PERCENTAGES IN COLUMN (F).</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <Identifier>BAD DEBT</Identifier>
        <ReturnReference>PART III, LINE 4</ReturnReference>
        <Explanation>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.</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <Identifier>MEDICARE</Identifier>
        <ReturnReference>PART III, LINE 8</ReturnReference>
        <Explanation>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.</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <Identifier>NEEDS ASSESSMENT</Identifier>
        <ReturnReference>PART VI, LINE 2</ReturnReference>
        <Explanation>AS A COMMUNITY PARTNER, MEDSTAR FRANKLIN SQUARE MEDICAL CENTER (MFSMC) WORKS COLLABORATIVELY WITH LOCAL PARTNERS TO IDENTIFY KEY HEALTH NEEDS. PARTNERS INCLUDE, BUT ARE NOT LIMITED TO: THE BALTIMORE COUNTY DEPARTMENT OF HEALTH, NOT-FOR-PROFIT AND SOCIAL SERVICE AGENCIES, SCHOOLS AND UNIVERSITIES, FAITH BASED ORGANIZATIONS AND COMMUNITY BASED COALITIONS. LOCAL, STATE AND NATIONAL HEALTH GOALS ARE ALSO USED TO ASSESS THE NEEDS OF THE COMMUNITY. IN ADDITION, HOSPITAL SERVICE UTILIZATION PATTERNS, SUCH AS THE CAUSES OF EMERGENCY ROOM VISITS AND INPATIENT ADMISSIONS HELP DETERMINE THE HEALTH NEEDS OF THE COMMUNITY. THE HOSPITAL'S MOST RECENT COMMUNITY HEALTH ASSESSMENT WAS CONDUCTED IN 2007-2008. MFSMC LED AND FINANCIALLY SUPPORTED THE ASSESSMENT, WHICH FOCUSED ON THE SOUTHEASTERN PORTION OF BALTIMORE COUNTY. THE PURPOSE OF THE PROJECT WAS THREEFOLD: (1) TO ASSESS THE CURRENT HEALTH AND WELL-BEING OF SOUTHEAST BALTIMORE RESIDENTS; (2) TO IDENTIFY DISCREPANCIES IN SERVICE NEEDS AND OUTCOMES AMONG AREA RESIDENTS; AND (3) TO DEVISE A STRATEGIC PLAN FOR CORRECTING IDENTIFIED DISCREPANCIES. IN APRIL 2008, MFSMC PUBLISHED AN ACTION PLAN FOR DEVELOPING COORDINATED AND COLLABORATIVE EFFORTS AND INVESTING IN ECONOMIC AND SOCIAL RESOURCES IN WAYS THAT IMPROVE THE HEALTH AND WELL-BEING FOR ALL OF SOUTHEASTERN BALTIMORE COUNTY'S RESIDENTS. RESOURCES WHICH ARE CURRENTLY AVAILABLE TO MEET THE ACTION PLAN WERE IDENTIFIED IN FY2009 THROUGH A COLLABORATIVE EFFORT AMONG PROFESSIONAL NETWORKS, COUNTY AGENCIES AND COMMUNITY ORGANIZATIONS. IN FY2010, BEST PRACTICES AND FUNDING SOURCES FOR ACTION ITEMS WERE ASSESSED. IN FY2011 THE HOSPITAL AND ITS NETWORK PARTNERS COMPLETED SOME INITIATIVES AND CONTINUE TO DEVELOP OTHER PROGRAMS. AS A PROUD MEMBER OF MEDSTAR HEALTH, REPRESENTATIVES FROM MFSMC ALSO 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.</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <Identifier>PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE</Identifier>
        <ReturnReference>PART VI, LINE 3</ReturnReference>
        <Explanation>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 OR 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 ENROLLMENT IN PUBLICLY-FUNDED PROGRAMS FOR THE UNINSURED (E.G., D.C. HEALTHCARE ALLIANCE). " 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 MEDSTAR HEALTH FACILITY (IN COOPERATION AND CONSULTATION WITH THE FINANCE DIVISION OF MEDSTAR HEALTH) WILL SPECIFY THE COMMUNITIES IT SERVES BASED ON THE GEOGRAPHIC AREAS IT HAS SERVED HISTORICALLY FOR THE PURPOSE OF IMPLEMENTING THIS POLICY. 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. 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.</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <Identifier>COMMUNITY INFORMATION</Identifier>
        <ReturnReference>PART VI, LINE 4</ReturnReference>
        <Explanation>GEOGRAPHIC: LOCATED IN THE ROSEDALE SECTION OF EASTERN BALTIMORE COUNTY, MARYLAND, MEDSTAR FRANKLIN SQUARE MEDICAL CENTER'S SERVICE AREA INCLUDES NEIGHBORHOODS IN EASTERN BALTIMORE CITY, SOUTHEASTERN BALTIMORE COUNTY AND EXTENDING UP TO SOUTHERN HARFORD COUNTY, ADJACENT TO THE CHESAPEAKE BAY. SIGNIFICANT DEMOGRAPHIC CHARACTERISTICS RELEVANT TO THE NEEDS THE HOSPITAL SEEKS TO MEET: THIS AREA HAS A LARGE BASE POPULATION OF APPROXIMATELY 503,072, AND IS PROJECTED TO GROW BY 3.7% IN THE NEXT FIVE YEARS, TO ABOUT 521,728. THE SERVICE AREA HAS BECOME A MUCH MORE DIVERSE COMMUNITY OVER THE PAST FEW DECADES. THE AREA, PARTICULARLY EASTERN BALTIMORE CITY AND EASTERN BALTIMORE COUNTY, CAN BE DESCRIBED AS BLUE-COLLAR, HIGH SCHOOL EDUCATED, AND ECONOMICALLY DEPRESSED, WITH A DIVERSE POPULATION CONSISTING OF CAUCASIANS (71.2%), AFRICAN-AMERICANS (20.5%), ASIAN/PACIFIC ISLANDERS (2.6%), HISPANICS/LATINOS (3.2%), AND OTHERS (2.4%). FORTY-TWO PERCENT OF THE POPULATION IS EITHER VERY YOUNG OR ELDERLY, WITH 24% OF RESIDENTS UNDER THE AGE OF EIGHTEEN AND 18% OVER 65 YEARS OF AGE. POVERTY IS A SIGNIFICANT PROBLEM IN EASTERN BALTIMORE COUNTY. STATISTICS SHOW THAT 46% OF THE RESIDENTS ABOVE 24 YEARS OF AGE HAVE A HIGH SCHOOL OR LOWER LEVEL OF EDUCATION. STATISTICS ALSO SHOW THAT THE MEDIAN HOUSEHOLD INCOME IN THE ESSEX/MIDDLE RIVER/DUNDALK AREA OF APPROXIMATELY $49,200 IS MUCH LOWER THAN THE OVERALL COUNTY MEDIAN OF $74,750. BASED ON HOSPITAL UTILIZATION DATA, THE NUMBER OF INDIVIDUALS WHO ARE UNINSURED OR UNDERINSURED IN THE HOSPITAL'S CATCHMENT AREA IS ESTIMATED TO BE 38% AND GROWING. THIS IS A DIRECT RESULT OF THE DECLINE IN MANUFACTURING INDUSTRIES IN THE REGION, WHICH ARE BEING REDUCED OR DECLARING BANKRUPTCY (E.G., GENERAL MOTORS OLDSMOBILE ASSEMBLY PLANT AND BETHLEHEM STEEL CORPORATION, BOTH OF WHOM WERE PREVIOUSLY MAJOR EMPLOYERS IN THE AREA). CURRENTLY, THE LARGEST EMPLOYER IN THE AREA IS THE HOSPITAL. THE INCREASING NUMBER OF FAMILIES AND INDIVIDUALS WITH EITHER NO HEALTH INSURANCE OR SEVERELY CURBED HEALTH INSURANCE REPRESENTS A SERIOUS CONCERN FOR THE HEALTHCARE COMMUNITY AND GOVERNMENT AGENCIES.</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <Identifier>PROMOTION OF COMMUNITY HEALTH</Identifier>
        <ReturnReference>PART VI, LINE 5</ReturnReference>
        <Explanation>AS A COMMUNITY PARTNER, THE HOSPITAL ENGAGES IN A NUMBER OF COMMUNITY BENEFIT ACTIVITIES TO IMPROVE AND PROMOTE THE HEALTH AND WELLBEING OF THE COMMUNITY. FOR EXAMPLE, IN PARTNERSHIP WITH BALTIMORE COUNTY AND HEALTHCARE FOR THE HOMELESS IN BALTIMORE CITY, MFSMC ESTABLISHED A NEW PRIMARY CARE ACCESS POINT FOR HOMELESS PERSONS IN BALTIMORE COUNTY. THE HOSPITAL PROVIDES THE PRIMARY HEALTHCARE STAFF, IN-KIND SUPPORT IN TECHNICAL ASSISTANCE, INFORMATION TECHNOLOGY, FINANCE/BUDGET/BILLING, AND PUBLIC RELATIONS AND MARKETING. MFSMC ALSO PROVIDES WRITE OFFS FOR LABS AND SPECIALTY SERVICES. ADDITIONALLY, MFSMC EVALUATES OVER 300 CHILDREN EACH YEAR WHO ARE SUSPECTED OF BEING ABUSED. CHILDREN IN EASTERN BALTIMORE COUNTY ARE ALMOST 50% MORE LIKELY AS CHILDREN IN THE REST OF THE COUNTY TO BE ABUSE VICTIMS. IN RESPONSE TO THE HIGH INCIDENCE OF ABUSE, THE DEPARTMENT OF PEDIATRICS DEVELOPED A COMPREHENSIVE APPROACH TO DIAGNOSE AND PREVENT CHILD ABUSE. THE FRANKLIN SQUARE HOSPITAL CHILD PROTECTION TEAM (CPT) BEGAN TO FUNCTION IN NOVEMBER, 2000. THE LEADERS OF THE CPT ARE A SOCIAL WORKER COORDINATOR, THE MEDICAL DIRECTOR, AND ON-CALL SOCIAL WORK AND MEDICAL STAFF. THE TEAM PROVIDES 24/7 COVERAGE TO THE HOSPITAL AND EVALUATES ANY CHILD WHO IS SUSPECTED OF BEING PHYSICALLY OR SEXUALLY ABUSED. THIS SERVICE HAS PROVEN TO BE A SIGNIFICANT CONTRIBUTION TO THE COMMUNITY - IMPACTING THOUSANDS OF PARENTS AND CHILDREN.</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <Identifier>AFFILIATED HEALTH CARE SYSTEM</Identifier>
        <ReturnReference>PART VI, LINE 6</ReturnReference>
        <Explanation>AS A PROUD MEMBER OF MEDSTAR HEALTH, MEDSTAR FRANKLIN SQUARE MEDICAL CENTER 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 MFSMC WITH TECHNICAL SUPPORT TO ENHANCE COMMUNITY HEALTH PROGRAMMING AND EVALUATION. MEDSTAR'S CORPORATE PHILANTHROPY DIVISION IDENTIFIES PUBLIC AND PRIVATE FUNDING SOURCES TO ENSURE THE AVAILABILITY OF HIGH QUALITY HEALTH SERVICES, REGARDLESS OF ABILITY TO PAY.</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <Identifier>STATE FILING OF COMMUNITY BENEFIT REPORT</Identifier>
        <ReturnReference>PART VI, LINE 7</ReturnReference>
        <Explanation>THE COMMUNITY BENEFIT REPORT FOR MEDSTAR FRANKLIN SQUARE MEDICAL CENTER IS FILED IN THE STATE OF MARYLAND.</Explanation>
      </Form990ScheduleHPartVI>
    </IRS990ScheduleH>
    <IRS990ScheduleJ documentId="IRS990ScheduleJ">
      <CompensationCommittee>X</CompensationCommittee>
      <IndependentConsultant>X</IndependentConsultant>
      <Form990OfOtherOrganizations>X</Form990OfOtherOrganizations>
      <WrittenEmploymentContract>X</WrittenEmploymentContract>
      <CompensationSurvey>X</CompensationSurvey>
      <BoardOrCommitteeApproval>X</BoardOrCommitteeApproval>
      <SeverancePayment>false</SeverancePayment>
      <SupplementalNonqualRetirePlan>true</SupplementalNonqualRetirePlan>
      <EquityBasedCompArrangement>false</EquityBasedCompArrangement>
      <CompBasedOnRevenueOfFilingOrg>false</CompBasedOnRevenueOfFilingOrg>
      <CompBasedOnRevenueRelatedOrgs>false</CompBasedOnRevenueRelatedOrgs>
      <CompBasedNetEarningsFilingOrg>false</CompBasedNetEarningsFilingOrg>
      <CompBasedNetEarningsRelateOrgs>false</CompBasedNetEarningsRelateOrgs>
      <AnyNonFixedPayments>false</AnyNonFixedPayments>
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        <Identifier>RETIREMENT PLAN</Identifier>
        <ReturnReference>SCHEDULE J, PART I, LINE 4B</ReturnReference>
        <Explanation>KENNETH SAMET KENNETH SAMET'S OTHER REPORTABLE COMPENSATION IN PART II, COLUMN (B) (III) INCLUDES $568,506 REPRESENTING MR. SAMET'S ACCRUED BENEFIT IN A SUPPLEMENTAL RETIREMENT PLAN, WHICH WAS EARNED DURING THE PAST 22 YEARS OF SERVICE. THIS AMOUNT WAS NOT ACTUALLY PAID TO MR. SAMET, BUT WAS REPORTED AS COMPENSATION UNDER FICA TAX-REPORTING RULES.</Explanation>
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        <Relationship>SEE PART V</Relationship>
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        <DescriptionOfTransaction>ORTHOPEDIC SERVICES</DescriptionOfTransaction>
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        <Identifier>BUSINESS TRANSACTIONS INVOLVING INTERESTED PERSONS</Identifier>
        <ReturnReference>SCHEDULE L, PART IV</ReturnReference>
        <Explanation>DR. IRA GUBERNICK, A BOARD MEMBER AT FRANKLIN SQUARE HOSPITAL, OWNS MORE THAN 5% OF ORTHOPEDIC &amp; HAND SURGERY ASSOCIATES, P.A. (OHSA), WHICH PROVIDES MANAGEMENT AND SUPPORT SERVICES TO FRANKLIN SQUARE HOSPITAL'S ORTHODEPIC, SPORTS MEDICINE, AND EMERGENCY DEPARTMENTS. OHSA'S GROSS REVENUES RECEIVED FROM THE HOSPITAL FOR THE YEAR WERE $0.3 MILLION.</Explanation>
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        <Identifier>DESCRIPTION OF EXEMPT PURPOSE ACHIEVEMENTS</Identifier>
        <ReturnReference>PART III, lINE 4A</ReturnReference>
        <Explanation>MFSMC ATTAINED MAGNET RECOGNITION BY THE AMERICAN NURSES CREDENTIALING CENTER (ANCC) IN 2008 AND IS RECOGNIZED BY THE JOINT COMMISSION AS AN ADVANCED PRIMARY STROKE CENTER. US NEWS AND WORLD REPORT RECOGNIZED MFSMC AS A HIGH PERFORMING HOSPITAL IN GASTROENTEROLOGY, PULMONOLOGY, CANCER, DIABETES, ENDOCRINOLOGY, EAR NOSE AND THROAT, GYNECOLOGY, ORTHOPEDICS, NEPHROLOGY, NEUROLOGY AND UROLOGY. THE HOSPITAL WAS ALSO A THIRD-TIME RECIPIENT OF THE DELMARVA FOUNDATION MEDICARE EXCELLENCE AWARD FOR QUALITY IMPROVEMENT. MFSMC WAS ALSO RECOGNIZED BY HEALTHGRADES AS ONE OF THE NATION'S 50 BEST HOSPITALS FOR ITS CLINICAL EXCELLENCE. 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 &amp; CEO OF MEDSTAR HEALTH, INC.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>DECISIONS OF GOVERNING BODY</Identifier>
        <ReturnReference>PART VI, LINE 7B</ReturnReference>
        <Explanation>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.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>PROCESS FOR REVIEWING FORM 990</Identifier>
        <ReturnReference>PART VI, LINE 11A</ReturnReference>
        <Explanation>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.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>CONFLICT OF INTEREST POLICY</Identifier>
        <ReturnReference>PART VI, LINE 12C</ReturnReference>
        <Explanation>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) ARE REVIEWED BY THE GOVERNANCE COMMITTEE OF THE MEDSTAR HEALTH BOARD OF DIRECTORS WHICH 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).</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>DESCRIPTION OF EXECUTIVE COMPENSATION</Identifier>
        <ReturnReference>PART VI, LINE 15</ReturnReference>
        <Explanation>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 &amp; YOUNG LLP ("E&amp;Y") TO SERVE AS AN ADVISOR ON THE REASONABLENESS AND COMPETITIVENESS OF THE PROGRAM. IN DETERMINING REASONABLENESS AND COMPETITIVENESS, E&amp;Y REVIEWS MARKET PRACTICES AND TRENDS, AND MAKES RECOMMENDATIONS RELATED TO THE PROGRAM. E&amp;Y UTILIZES INFORMATION FROM CUSTOM SURVEYS, NATIONAL COMPENSATION SURVEYS, PROPRIETARY DATABASES, AND CLIENT EXPERIENCES TO DETERMINE ITS FINAL RECOMMENDATIONS. E&amp;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.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>FINANCIAL STATEMENT AVAILABILITY</Identifier>
        <ReturnReference>PART VI, LINE 19</ReturnReference>
        <Explanation>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.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>OTHER CHANGES IN NET ASSETS</Identifier>
        <ReturnReference>PART XI, LINE 5</ReturnReference>
        <Explanation>EQUITY TRANSFERS ...................................$ 11,927,152 UNREALIZED GAIN ON INVESTMENTS...................... 63,482 ============ TOTAL: $ 11,990,634</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>HOURS DEVOTED FOR RELATED ORGANIZATION</Identifier>
        <ReturnReference>FORM 990 PART VII</ReturnReference>
        <Explanation>NAME:KENNETH A SAMET TITLE:DIRECTOR HOURS:40</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>HOURS DEVOTED FOR RELATED ORGANIZATION</Identifier>
        <ReturnReference>FORM 990 PART VII</ReturnReference>
        <Explanation>NAME:CARL SCHINDELAR TITLE:FORMER OFFICER HOURS:40</Explanation>
      </GeneralExplanation>
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          <State>MD</State>
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          <AddressLine1>5565 Sterrett Place 5th Floor</AddressLine1>
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          <AddressLine1>5565 Sterrett Place 5th Floor</AddressLine1>
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          <AddressLine1>5565 Sterrett Place 5th Floor</AddressLine1>
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        <EIN>522139841</EIN>
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          <State>MD</State>
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</Return>