2011-05-11T13:31:24-04:00 2010-06-30 KPMG LLP 1676 International Drive McLean VA 22102 990 2009-07-01 520882914 University Specialty Hospital UNIV 4105478500 611 South Charles Street Baltimore MD 21230 KEITH PERSINGER 2011-05-09 7032868000 2009 2016-02-24 21:20:13Z James Warner 611 South Charles Street Baltimore MD 21230 56397294 false X www.specialtyhospital.org X 1968 MD The hospital provides specialized care services to patients who are critically ill, have multiple complications and/or failures that require continued hospitalization beyond the acute care setting. 8 0 589 6 -43395 -43395 0 0 55545156 54088180 13070 1759628 439579 197388 55997805 56045196 0 0 0 0 30880447 28482181 0 0 0 30618384 28980156 61498831 57462337 -5501026 -1417141 40848049 40410879 31038613 32005836 9809436 8405043 THE HOSPITAL PROVIDES SPECIALIZED CARE SERVICES TO PATIENTS WHO ARE CRITICALLY ILL, HAVE MULTIPLE COMPLICATIONS AND/OR FAILURES THAT REQUIRE CONTINUED HOSPITALIZATION BEYOND THE ACUTE CARE SETTING. false false 49799197 54088180 THE HOSPITAL PROVIDES REHABILITATIVE AND CHRONIC MEDICAL AND NURSING SERVICES ON AN INPATIENT AND OUTPATIENT BASIS, TOGETHER WITH THE APPROPRIATE ANCILLIARY SERVICES. THESE SERVICES INCLUDE CARE WHICH MANY FACILITIES PREFER NOT TO PROVIDE. THE MISSION OF THE HOSPITAL IS TO PROVIDE THE BEST QUALITY OF CARE FOR THOSE MEDICALLY COMPLEX LONGER STAY PATIENTS. THE MISSION HAS PROVIDED THE FACILITY A DISPROPORTIONATE SHARE OF MEDICAID PATIENTS WHO ARE THE INDIGENT CITIZENS OF THE STATE OF MARYLAND. ALSO, FOR ANY NON-MEDICAID/MEDICARE PATIENT THE HOSPITAL IS COMMITTED TO PROVIDE CARE WHERE POSSIBLE. 49799197 true false false true false false false false false true false true false false false false false false false false true false false true false false false false false false false false false false false false false true false false false true 55 0 true 589 true true true false false false false false false false false 8 0 false false false false true true true true true false false true true true true true true true true false MD X MICHELLE LEE 4103281376 110 S PACA STREET Baltimore MD 21201 JEFFREY A RIVEST 2.0 X 0 1028442 28123 ALISON G BROWN 2.0 X 0 443425 27605 LISA ROWEN 2.0 X 0 447025 61642 REVEREND JOHN SABATELLI 40.0 X 52938 0 1154 INGRID CONNERNEY 2.0 X 0 168983 17670 KEITH PERSINGER 10.0 X X 0 550080 16480 JONATHAN GOTTLIEB 2.0 X 0 278951 38567 SEBLU ZERA YOHANNES 40.0 X X 180944 0 8725 JAMES WARNER 40.0 X 233457 0 13704 JOYCE A SMITH 40.0 X 182586 0 9038 CARLA JONES 40.0 X 113935 0 5774 ERDA YOUNG 40.0 X 111372 0 18144 AISHA F MUHAMMAD 40.0 X 102681 0 0 KIMBERLY KIDD-WATKINS 40.0 X 107343 0 21160 1085256 2916906 267786 5 false true false ARAMARK SERVICES INC PO Box 651009 CHARLOTTE NC 28265 FOOD SERVICES 656918 SLEEP SERVICES OF AMERICA INC 890 Airport Road GLEN BURNIE MD 21061 SLEEP STUDIES 1083248 TRANSCARE PO BOX 785491 PHILADELPHIA PA 19178 AMBULANCE SERVICES 803633 INDEPENDANT DIALYSIS FOUNDATION 840 HOLLINS STREET BALTIMORE MD 21201 MEDICAL 630900 Medline Industries PO BOX 382075 PITTSBURGH PA 152518075 Laundry/Linen Svcs 498776 8 0 PATIENT SERVICES REVENUE 900099 54088180 54088180 54088180 2054408 2054408 0 0 33059 57318 -24259 -24259 -43395 19136 294780 -294780 -294780 -294780 0 0 0 CAFE & VENDING 722210 217330 217330 OTHER MISC. 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THE ORGANIZATION PAYS MEMBERSHIP DUES TO THE MARYLAND HOSPITAL ASSOCIATION (MHA) AND THE AMERICAN HOSPITAL ASSOCIATION (AHA). MHA AND AHA ENGAGE IN MANY SUPPORT ACTIVITIES INCLUDING LOBBYING AND ADVOCATING FOR THEIR MEMBER HOSPITALS. THE MHA AND AHA REPORTED THAT 8.73% AND 23.76% OF MEMBER DUES WERE USED FOR LOBBYING PURPOSES AND AS SUCH, THE ORGANIZATION HAS REPORTED THIS AMOUNT ON SCHEDULE C PART IV AS LOBBYING ACTIVITIES. 915184 915184 24693969 11531655 13162314 221051 221051 10269359 5380085 4889274 54936 47666 7270 18974042 ALTERNATIVE INVESTMENTS 5094000 F 5094000 0 3RD PARTY ADVANCES 4293827 OTHER CURRENT LIABILITIES 3860998 DUE TO AFFILIATES 17411051 CAPITAL LEASE LIABILITY 583254 26149130 SCHEDULE D, PART X FIN 48 FOOTNOTE PER AUDIT REPORT THE ORGANIZATION IS A SUBSIDIARY OF THE UNIVERSITY OF MARYLAND MEDICAL SYSTEM CORPORATION (THE CORPORATION). THE CORPORATION ADOPTED THE PROVISIONS OF FASB INTERPRETATION NO. 48, ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES (FIN 48) ON JULY 1, 2007. FIN 48 PRESCRIBES A THRESHOLD OF MORE-LIKELY-THAN-NOT FOR RECOGNITION AND DERECOGNITION OF TAX POSITIONS TAKEN OR EXPECTED TO BE TAKEN IN A TAX RETURN. FIN 48 ALSO RECOGNIZES RELATED GUIDANCE ON MEASUREMENT, CLASSIFICATION, INTEREST AND PENALTIES, AND DISCLOSURE. THE IMPLEMENTATION OF FIN 48 DID NOT HAVE A SIGNIFICANT IMPACT ON THE CORPORATION'S BALANCE SHEET OR STATEMENT OF OPERATIONS. MANAGEMENT DOES NOT BELIEVE THAT THERE ARE ANY UNRECOGNIZED TAX BENEFITS THAT SHOULD BE RECOGNIZED. true true true X true X 500. true true false true true 1894186 1894186 0.03300 1894186 1894186 0.03300 68469 68469 0.00120 66359 66359 0.00120 2199 2199 24700 24700 0.00040 161727 161727 0.00280 2055913 2055913 0.03580 129592 129592 0.00230 129592 129592 0.00230 true 4930988 10206768 9998808 207960 true true UNIVERSITY SPECIALTY HOSPITAL

611 S CHARLES STREET BALTIMORE MD 21230

X USH is not required to file a community benefit report with the State of Maryland's Health Services Cost Review Commission. That requirement only applies to acute care hospitals. USH does, however, prepare such a report for internal use and review. Schedule H, Line 7a, Column (d) 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. Schedule H, Line 7b, Columns (c) through (f) Maryland's regulatory system creates a unique process for hospital payment that differs from the rest of the nation. The Health Services Cost Review Commission, (HSCRC) determines payment through a rate setting process and all payors, including governmental payors, pay the same amount for the same services delivered at the same hospital. Maryland's unique all payor system includes a method for referencing Uncompensated Care in each payors' rates, which does not enable Maryland hospitals to breakout any offsetting revenue related to Uncompensated Care. Community benefit expenses are equal to Medicaid revenues in Maryland, as such, the net effect is zero. Additionally, net revenues for Medicaid should reflect the full impact on the hospital of its share of the Medicaid assessment. Schedule H, Line 7f Column (c) 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. Schedule H, Line 7f Column (d) 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. PART III, LINE 3: The organization does not code charity care and bad debt expense into the same general ledger account. Charity Care is booked to a separate account and is classified as a "Deduction from Revenue." As such it is netted against Total Patient Revenue in arriving at Net Patient Revenue on the entity's income statements. Bad Debt Expense is booked to a separate account on the general ledger and does not include any other uncompensated care amounts. Part III, Line 4: The provision for bad debts is based upon management's assessment of historical and expected net collections considering historical business and economic conditions, trends in health care coverage, and other collection indicators. Periodically throughout the year, management assesses the adequacy of the allowance for uncollectible accounts based upon historical write off experience by payor category. The results of this review are then used to make modifications to the provision for bad debts and to establish an allowance for uncollectible receivables. After collection of amounts due from insurers, the Corporation follows internal guidelines for placing certain past due balances with collection agencies. In Maryland, The Health Services Cost Review Commission (HSCRC) started setting hospital rates in 1974. At that time, the HSCRC approved rates applied only to commercial insurers. In 1977, the HSCRC negotiated a waiver from Medicare hospital payment rules for Maryland hospitals to bring the federal Medicare payments under HSCRC control. Medicare reimburses Maryland hospitals according to rates established by the HSCRC as long as the State continues to meet a two-part test. This two-part waiver test allows Medicare to participate in the Maryland system as long as two conditions are met. - all other payers participating in the system pay HSCRC set rates and - the rate of growth in Medicare payments to Maryland hospitals from 1981 to the present is not greater than the rate of growth in Medicare payments to hospitals nationally over the same time frame. The organization expects payment at the time the service is provided. Our policy is to comply with all state and federal law and third party regulations and to perform all credit and collection functions in a dignified and respectful manner. Emergency services will be provided to all patients regardless of ability to pay. Financial assistance is available for patients based on financial need as defined in the Financial Assistance Policy. The organization does not discriminate on the basis of age, race, creed, sex or ability to pay. Patients who are unable to pay may request a Financial Assistance application at any time prior to service or during the billing and collection process. The organization may request the patient to apply for Medical Assistance prior to applying for financial assistance. The account will not be forwarded for collection during the Medical Assistance application process or the Financial Assistance application process. University Specialty Hospital (USH) licensed bed Post-Acute facility with 941 inpatient admissions in FY10. USH is a private, non-profit acute care hospital and is affiliated with and collaborates with the University of Maryland Medical Center. The University of Maryland Medical Center (UMMC) and USH serve Baltimore City and the greater metropolitan region, including patients with in-state and out-of-state referrals for tertiary and quaternary care. UMMC/USH uses a variety of credible sources to identify community needs. Local, state, and federal assessments and reports are utilized to address and prioritize community needs. The primary source of information for identifying the health needs of Baltimore city is the 2008 Baltimore City Health Status Report, which is produced by the Baltimore City Health Department. This report outlines Baltimore's prevalence on eight major health categories as well as mortality and leading causes of death. While the focus of this report is on city-wide indicators, there are also numerous comparisons to state-wide and national prevalence rates as well. The national leading health indicators from Healthy People 2010 were also incorporated as a framework into community health programming for this year. The Baltimore City's Health Disparities Report Card was released in May 2010 and was also reviewed at the close of FY2010. This report will be used heavily for FY2011 outreach programming based on its release date late within this reporting period. Additional reports, data, alerts, and public health trends are followed as well from the Centers for Disease Control (as in the H1N1 Fall '09 season), US Dept of Health and Human Services, and locally with B'more Healthy Babies to name a few. In 2008, the Maryland Hospital Association conducted a Maryland Public Opinion Survey on attitudes toward hospitals and health care. The public rated their top health care concerns as quality of care, cost and access, more nursing staff, and reducing infections as their top priorities. This type of survey gives an initial insight into top-of-mind health concerns of the public, although they differ from the identified health needs. In addition to these formal reports, UMMC/USH has a long standing relationship with the Baltimore City Health Department. This promotes ongoing and real-time communication on a variety of health issues for the city. UMMC staff participates in a variety of city-wide coalitions with the health department as the lead agency, such as the Tobacco Coalition, Cancer Coalition, and Flu Coalitions. This participation promotes a broader understanding of community needs with other community leaders, providers, and community organizations. UMMC sponsored a community stakeholder meeting in September 2009 and invited over 100 community and faith-based organizations to address the H1N1 epidemic. Speakers included experts from DHMH, Dr. Anne Bailowitz from the Baltimore City Health Department, and epidemiologists from UMMC and were part of an expert panel to address community concerns. This is a specific example of how UMMC responded to an urgent public health need in FY'10 in addition to our regular health promotion and outreach programming. UMMC commissioned the Jackson Organization to conduct a telephone market research survey of consumers living in its service area. Interviews were conducted with the household's main healthcare decision maker from June 10 through July 1, 2005. These interviews were conducted with residents in a number of zip codes. The survey was conducted to develop a profile of the health status, concerns, and needs of the community served by UMMC. Major identified health needs in Baltimore (as identified in the 2008 Baltimore City Health Status Report) include the following leading causes of death (in ranked order) heart disease, cancer, cerebrovascular disease, HIV/AIDS, homicide, chronic lower respiratory disease, and diabetes. Maryland's health needs are similar with less emphasis on violence, HIV infection, and substance abuse. Childhood and adult obesity and smoking contribute substantially to the prevalence of chronic diseases such as diabetes, cardiovascular disease, cancer, and asthma and are significant chronic disease risk factors. Therefore, much current UMMC community outreach programming is targeted to obesity and tobacco-related prevention and intervention. In the aforementioned survey commissioned with the Jackson Organization, the issues identified that correlated most highly to consumers' health status were stroke, diabetes, high blood pressure and incontinence. These were considered services of importance in terms of increasing community awareness and access to care. The Financial Assistance Policy is posted on a sign at the entrance of Patient Accounting on 1st floor and at the 611 entrance. Also, tents are placed at the numerous nursing stations. If a patient inquires about financial assistance during the registration process, the staff provides the PFS contact information to the patient. In addition, the Maryland Hospital Patient Information Sheet is provided with each hospital bills (Maryland Summary Bills & patient statements). This sheet includes the following statements : (1)The facility provides healthcare services to those in need regardless of an individual's ability to pay, (2) The facility will work with the uninsured to gain an understanding of each patient's financial resources, (3) The facility provides assistance with enrollment for publicly funded entitlement programs. In addition, patients are informed that they may qualify for free or reduced cost of medically necessary care. Lastly, the Self Pay team at Patient Financial Services provides financial counseling and clearance while patients are screened for their services. In addition, the Customer Service team advises and coordinates efforts with Self Pay team, for any patient/guarantor calling in, stating financial hardship. According to 2010 population estimates by Claritas - Nielsen Company, Baltimore City's population was at 634,206. Forty-one percent of UMMC's patients reside in Baltimore City. While UMMC serves all of Baltimore City, many of the patients reside in West Baltimore City. According to the 2010 population estimate again from Claritas - Nielsen Company, African Americans or Blacks make up 63% of Baltimore City's population. Caucasions comprise 32.6% of the population followed by Hispanic or Latino representing 2.8%. The remaining racial makeup is comprised of Asian, American Indian, Native Hawaiian/Pacific Islanders and other races. Forty-six percent of Baltimore City households reported an income of less than $35,000 in 2010 according to the Nielsen Company. Statewide, 20% of households reported an income in this range. The 2010 median household income in Baltimore City for all races was $39,366; approximately half of the statewide median income which is $70,825. Three times as many families living in Baltimore City had an income that was below the poverty level compared to Maryland families in 2007. More than three-quarters of Baltimore City residents of all races were above the poverty level, however, African American residents of Baltimore City were almost two times more likely than Caucasian residents to have a median income below the poverty level. In FY2010, University of Maryland Medical Center had over 38,000 discharges. Approximately 20% of the hospital's discharges had Medicaid as a financial payor. Ten percent of the patients are considered uninsured. In 2006, heart disease, cancer and cerebrovascular disease were the top three leading causes of death in Baltimore City and nationwide. There were 7,017 deaths among Baltimore City residents, resulting in an all-cause mortality rate of 1083.4 per 100,000. There were 3,554 deaths from the top three causes of death which accounted for 51% of all deaths in Baltimore city. Among race/ethnic groups, African Americans had the highest mortality rate both in Baltimore and statewide. Source: 2008 Baltimore City Health Status Report USH provides workforce assistance to seniors through the Maryland Dept. of Aging and Maryland Dept. of Aging Family and Children's Services. USH offers placements for senior citizens to spend time with USH patients. It provides socialization for both the seniors and the patients. They receive a small stipend. The University of Maryland Medical System (UMMS), the health care system in which both UMMC and USH are a part, created the University of Maryland Community Outreach and Advocacy team that meets bi-monthly to address the health care needs of the West Baltimore community. The group is comprised of community outreach management and staff, social workers, directors, vice presidents, and physicians from UMMS system hospitals. The group determines what needs are addressed as well as community involvement and activities each year. UMMC/USH participate in this Advocacy Team and representatives communicate priorities to the medical center. In addition to the identified UMMS priorities, UMMC senior leaders and community outreach staff meet to determine annual goals and activities. UMMC was a major participant and sponsor in the three annual UMMS outreach activities described below: Fall Back To Good Health Fall Back into Good Health is an annual event focused on improving health in the West Baltimore community. This year's event was held on the west side of Baltimore City at the University Park across from the UMMC in September 2009. We choose this particular location because of the convenient accessibility to all forms of public transportation and local businesses. From community resources, to on-site screening for vascular disease and glaucoma, to prevention and wellness information, and testing for cholesterol, HIV, and diabetes, this event had it all! Free prostate screenings and flu shots were also offered to participants. The attendees could feel free to ask questions about specific heath concerns, and how to access care. The event was attended by over 1,000 people, over 110 men received prostrate screening which identified 10% of men who needed to return for follow-up, and over 150 vaccinated. From the HeartAn Afternoon of Heart Health and Education for the Entire Family The UMMS Community Outreach and Advocacy team, hosted "From the Heart, An Afternoon of Heart Heath Education for the Entire Family," The event was held at the Reginald F. Lewis Museum of Maryland African American History and Culture in recognition of National Heart Month in February 2010 and drew hundreds of Baltimore City community members. We emphasized the importance of living a heart healthy lifestyle by offering heart-related health screenings and information, stroke and diabetes prevention, and fun heart-related activities for children. The main attraction of the day was the heart-healthy cooking demonstrations, by one well known Baltimore chef; while the chefs prepared healthy dishes, Yvette Rooks, M.D. presented mini- health seminars on the importance of maintaining a healthy lifestyle with food choices, portion control, and preparation. Spring into Good Health The spring event was very similar to the Fall Back event with free screenings, health and wellness information, exercise demonstrations, and more. This event was held at Mondawmin Mall in April 2010 and was well attended. In addition to UMMC's participation and leadership with the above UMMS events, we led several large community events and a wide variety of smaller community and faith-based health fairs. H1N1 Community Stakeholders Forum This forum was in response to the emerging H1N1 epidemic last fall and was held in September 2009 and included over 100 community and faith-based organizations. UMMC sponsored an expert panel with physicians from DHMH, Baltimore City Health Dept and UMMC to answer questions of community and faith leaders so that they could be prepared for the new H1N1 epidemic. Topics included: immunizations, limiting the spread of the flu, symptoms and care, and employee health issues. Participants were surveyed at the conclusion of the event and expressed satisfaction and gratitude for the information presented. Community vaccines were given at USH. Helping Haiti The University of Maryland Medical Center, with its Shock Trauma Center, is known world-wide as the premier resource for trauma care. It provides care and resources throughout Maryland and beyond. We felt compelled to share this expertise to help the survivors of Haiti's horrific earthquake. The people of Haiti had no way to recover on their own and we had the expertise and capacity to help neighbors that are even closer to Baltimore than Denver, Colorado. The Haiti relief program not only provided immediate help to people of Haiti, it also led to new knowledge. Providing expert care for the most severe and complex traumatic injury and illness resulting from this disaster will also help us improve care for the citizens of Maryland, including preparing for future mass casualty disasters at home. Our partners in this endeavor, the University of Maryland School of Medicine and its Institute of Human Virology, have run an established HIV/AIDS program in Haiti along with Catholic Relief Services, for many years. The staff of both institutions are intimately familiar with the people and agencies in Haiti. Their clinic was located in the largest hospital in Port-au-Prince, which was 70 percent destroyed by the earthquake. Our teams worked in what remains of that hospital, the St. Francois de Sales Hospital, along with Haitian doctors and nurses who survived the disaster. Staff volunteered their time, and many donations helped to sustain this project, and therefore, this project is not counted in our FY'10 financials. However, this relief mission was a source of extreme pride to our employees and touched many local, Baltimore citizens who had families in Haiti, many of them who were helped by our teams. In addition to these large community outreach events, the UMMC coordinated a wide variety of wellness and outreach events like: employee health fairs, blood pressure screenings, smoking cessation classes, car safety seat checks, violence and trauma prevention, breast and prostrate screenings, physician-led health and wellness talks for local businesses, churches, senior & community centers, and many community events and fairs each year. A community health newsletter is also produced quarterly. Cancer, diabetes, and heart disease prevention along with chronic disease risk factor minimization are the main focus of these events. At each of our larger UMMS Community Outreach events, we currently ask each participant for their demographic information and the following: do they currently see a UMMS or other physician, have health insurance, and if they would like to receive information on our up-coming events or other health related information. This information is then put into a database and we are in the process of developing a tracking system when participants go to a UMMS hospital either as inpatient or outpatient care. Our team also completes "on the spot" evaluations by asking various attendees their thoughts about the events, what they liked, disliked, was the location satisfactory, what would they also like to see, etc. Our team then compiles this information in a written summary and shares it with the team at committee meetings. We also ask our vendors to rate the event by the following; location, time, attendance, how many people they saw, etc. The response from vendors has been overwhelmingly positive, and feels that our events are a true benefit to the community. Both types of evaluations, from participants and vendors, provide valuable information to help determine successful events and services as well as less successful services. Future events and outreach is then adjusted as needed based on these evaluations. X true true X X X X false true false false false false false false false JEFFREY A RIVEST 0 515774 0 218427 0 294241 0 8199 0 19924 0 1056565 0 272708 ALISON G BROWN 0 291691 0 111406 0 40328 0 9195 0 18410 0 471030 0 0 LISA ROWEN 0 306291 0 124800 0 15934 0 43200 0 18442 0 508667 0 0 INGRID CONNERNEY 0 147218 0 21308 0 457 0 6056 0 11614 0 186653 0 0 KEITH PERSINGER 0 366474 0 136500 0 47106 0 8793 0 7687 0 566560 0 0 JONATHAN GOTTLIEB 0 227153 0 50000 0 1798 0 31024 0 7543 0 317518 0 0 SEBLU ZERA YOHANNES 180580 0 0 0 364 0 6975 0 1750 0 189669 0 0 0 JAMES WARNER 172327 0 47412 0 13718 0 6689 0 7015 0 247161 0 0 0 JOYCE A SMITH 145202 0 25616 0 11768 0 2269 0 6769 0 191624 0 0 0 SCHEDULE J, PART I, LINE 1A HEALTH OR SOCIAL CLUB DUES OR INITIATION FEES UMMS EXECUTIVES RECEIVE A BENEFIT PACKAGE WHICH MAY BE USED TOWARDS HEALTH CLUB DUES OR OTHER HEALTH MAINTENANCE PROGRAMS. SUCH BENEFITS ARE CAPPED AT $7,000, $5,000 OR $3,000 DEPENDING ON JOB TITLE AS DESCRIBED IN THE PROGRAM DOCUMENTS. SCHEDULE J, PART I, LINE 4B Supplemental, Nonqualifed Retirement Plan The following individuals participate in a section 457(f) supplemental, nonqualified retirement plan ("the Plan") sponsored by the filing organization or a related organization: JOYCE A SMITH JAMES WARNER ALISON BROWN KEITH PERSINGER LISA ROWEN JEFFREY RIVEST JONATHAN GOTTLIEB In addition, the following individuals became vested in or received payments from the plan that have been reported on Schedule J, Part II, column B(iii): JOYCE A SMITH $10,254 JAMES WARNER $12,206 ALISON BROWN $31,759 KEITH PERSINGER $41,337 JEFFREY RIVEST $281,052 Tax Exempt Bond Issue Form 990, Part IV, Line 24A PURSUANT TO A MASTER LOAN AGREEMENT DATED JUNE 20, 1991 (THE "MASTER LOAN AGREEMENT"), AS AMENDED, THE UNIVERSITY OF MARYLAND MEDICAL SYSTEM CORPORATION (THE "CORPORATION") AND SEVERAL OF ITS SUBSIDIARIES HAVE ISSUED DEBT THROUGH THE MARYLAND HEALTH AND HIGHER EDUCATION FACILITY AUTHORITY (THE "AUTHORITY"). AS SECURITY FOR THE PERFORMANCE OF THE BOND OBLIGATION UNDER THE MASTER LOAN AGREEMENT, THE AUTHORITY MAINTAINS A SECURITY INTEREST IN THE REVENUE OF THE OBLIGORS. THE MASTER LOAN AGREEMENT CONTAINS CERTAIN RESTRICTIVE COVENANTS. THESE COVENANTS REQUIRE THAT RATES AND CHARGES BE SET AT CERTAIN LEVELS, LIMIT INCURRENCE OF ADDITIONAL DEBT, REQUIRE COMPLIANCE WITH CERTAIN OPERATING RATIOS AND RESTRICT THE DISPOSITION OF ASSETS. THE OBLIGATED GROUP UNDER THE MASTER LOAN AGREEMENT INCLUDES THE CORPORATION, UNIVERSITY SPECIALTY HOSPITAL, INC., THE JAMES LAWRENCE KERNAN HOSPITAL, INC., MARYLAND GENERAL HOSPITAL, INC., BALTIMORE WASHINGTON MEDICAL CENTER, INC., SHORE HEALTH SYSTEM, INC., CHESTER RIVER HEALTH SYSTEM, INC. AND THE UNIVERSITY OF MARYLAND MEDICAL SYSTEM FOUNDATION, INC. EACH MEMBER OF THE OBLIGATED GROUP IS JOINTLY AND SEVERALLY LIABLE FOR THE REPAYMENT OF THE OBLIGATIONS UNDER THE MASTER LOAN AGREEMENT OF THE CORPORATION'S $1,013,920,000 OF OUTSTANDING AUTHORITY BONDS ON JUNE 30, 2010. ALL OF THE BONDS WERE ISSUED IN THE NAME OF THE UNIVERSITY OF MARYLAND MEDICAL SYSTEM CORPORATION AND ARE REPORTED ON SCHEDULE K OF ITS FORM 990. Members and Stockholders FORM 990, PART VI, SECTION A, LINES 6, 7A AND 7B UNIVERSITY OF MARYLAND MEDICAL SYSTEM CORPORATION (UMMS) IS THE SOLE MEMBER OF UNIVERSITY SPECIALITY HOSPITAL (USH). UMMS MAY ELECT ONE OR MORE BOARD MEMBERS OF THE GOVERNING BODY AND ALL DECISIONS OF THE GOVERNING BODY MUST BE APPROVED BY UMMS. Form 990 Preparation and Review Process Part VI, Section A, Line 11 THE IRS FORM 990 IS PREPARED AND REVIEWED BY THE ACCOUNTING FIRM OF KPMG. ACCOUNTING PERSONNEL IN FINANCE SHARED SERVICES AT THE UNIVERSITY OF MARYLAND MEDICAL SYSTEM GATHER THE INFORMATION NEEDED TO COMPLETE THE RETURN AND INPUT THE DATA INTO THE KPMG TAX ORGANIZER, WHICH IS A WEB-BASED SYSTEM. WHEN ALL DATA HAS BEEN ENTERED, THE INFORMATION IS SUBMITTED TO KPMG FOR IMPORTATION INTO THEIR TAX SOFTWARE. AT THIS POINT, KPMG STAFF MEMBERS REVIEW THE DATA, ASK FOR ADDITIONAL INFORMATION IF NEEDED AND PREPARE THE TAX RETURN. EACH RETURN IS REVIEWED AT SEVERAL LEVELS AT KPMG INCLUDING THE TAX PARTNER. AFTER THEIR REVIEW PROCESS, A DRAFT RETURN IS SENT TO THE ACCOUNTING STAFF AT UMMS FOR AN IN-HOUSE REVIEW. UPON COMPLETION OF THE IN-HOUSE REVIEW, KPMG IS INSTRUCTED TO MAKE ANY NECESSARY CHANGES AND TO PREPARE THE FINAL TAX RETURN. THE FINAL RETURN UNDERGOES ANOTHER REVIEW BY THE ACCOUNTING STAFF AT FINANCE SHARED SERVICES AND IS ALSO REVIEWED BY THE ACCOUNTING MANAGER, THE DIRECTOR OF FINANCIAL REPORTING, THE VICE PRESIDENT OF FINANCE AND THE CFO, WHO SIGNS THE RETURN. PRIOR TO FILING THE IRS FORM 990, THE ORGANIZATION'S BOARD CHAIRMAN, TREASURER, AUDIT COMMITTEE CHAIRMAN, EXECUTIVE COMMITTEE CHAIRMAN OR OTHER MEMBER OF THE BOARD WITH SIMILAR AUTHORITY WILL REVIEW THE IRS FORM 990. AT THE DISCRETION OF THE REVIEWING BOARD MEMBER, SUCH MEMBER WILL BRING ANY ISSUES OR QUESTIONS RELATED TO THE COMPLETED IRS FORM 990 TO THE ATTENTION OF THE BOARD. NOTWITHSTANDING THE ABOVE, A BOARD RESOLUTION IS NOT REQUIRED FOR THE FILING OF THE ORGANIZATION'S IRS FORM 990. EACH BOARD MEMBER IS PROVIDED WITH A COPY OF THE FINAL IRS FORM 990 BEFORE FILING. Conflict of Interest Policy Form 990, Part VI, Section B, Line 12c THE ORGANIZATION'S OFFICERS, DIRECTORS, EMPLOYEES AND MEDICAL STAFF MEMBERS, AS APPLICABLE, SHALL DISCLOSE CONFLICTS OF INTEREST OR POTENTIAL CONFLICTS OF INTEREST BETWEEN THEIR PERSONAL INTERESTS AND THE INTERESTS OF THE ORGANIZATION, OR ANY ENTITY CONTROLLED BY OR OWNED IN SUBSTANTIAL PART BY THE ORGANIZATION. A QUESTIONNAIRE WHICH DISCLOSES POTENTIAL CONFLICTS OF INTEREST IS DISTRIBUTED ANNUALLY TO ALL OFFICERS, DIRECTORS AND KEY EMPLOYEES. THE GENERAL COUNSEL OF THE UNIVERSITY OF MARYLAND MEDICAL SYSTEM CORPORATION (UMMSC) REVIEWS THE RESPONSES FOR UMMSC, UNIVERSITY SPECIALTY HOSPITAL AND JAMES LAWRENCE KERNAN HOSPITAL. THE CEO OR CFO OF EACH OF THE OTHER ENTITIES IN THE UNIVERSITY OF MARYLAND MEDICAL SYSTEM REVIEWS THE RESPONSES FOR THOSE ENTITIES. THE GENERAL COUNSEL, IN CONSULTATION WITH THE AUDIT COMMITTEE, IF NECESSARY, WOULD DETERMINE IF A CONFLICT OF INTEREST EXISTED FOR UMMSC, UNIVERSITY SPECIALTY HOSPITAL AND JAMES LAWRENCE KERNAN HOSPITAL. WITH RESPECT TO THE OTHER ENTITIES IN THE UNIVERSITY OF MARYLAND MEDICAL SYSTEM, THE GENERAL COUNSEL MAY BE CALLED FOR CONSULT. IF SO, THE GENERAL COUNSEL MAY CONSULT THE AUDIT COMMITTEE, IF NECESSARY. WHENEVER A CONFLICT OR POTENTIAL CONFLICT OF INTEREST EXISTS, THE NATURE OF THE CONFLICT OR POTENTIAL CONFLICT OF INTEREST MUST BE DISCLOSED IN WRITING TO THE ORGANIZATION'S BOARD, BOARD COMMITTEE, AN OFFICER OF THE ORGANIZATION OR OTHER APPROPRIATE EXECUTIVE. SUCH INDIVIDUAL HAVING A POTENTIAL CONFLICT OF INTEREST SHALL PLAY NO ROLE ON BEHALF OF THE ORGANIZATION, OR ANY ORGANIZATION CONTROLLED OR SUBSTANTIALLY OWNED, IN ANY TRANSACTION IN WHICH A CONFLICT EXISTS. ALL INVITATIONS FOR BIDS, PROPOSALS OR SOLICITATIONS FOR OFFERS INCLUDE THE FOLLOWING PROVISION: ANY VENDOR, SUPPLIER OR CONTRACTOR MUST DISCLOSE ANY ACTUAL OR POTENTIAL TRANSACTION WITH ANY ORGANIZATION OFFICER, DIRECTOR, EMPLOYEE OR MEMBER OF THE MEDICAL STAFF, INCLUDING FAMILY MEMBERS WITHIN FIVE DAYS OF THE TRANSACTION. FAILURE TO COMPLY WITH THIS PROVISION IS A MATERIAL BREACH OF AGREEMENT. IN ADDITION, A BOARD DISCLOSURE REPORT IS FILED WITH THE MARYLAND HEALTH SERVICES COST REVIEW COMMISSION ON AN ANNUAL BASIS SHOWING ANY BUSINESS TRANSACTIONS BETWEEN THE BOARD MEMBERS AND THE ORGANIZATION. Executive Compensation Form 990, Part VI, Section B, Line 15 THE ORGANIZATION DETERMINES THE EXECUTIVE COMPENSATION PAID TO ITS EXECUTIVES IN THE FOLLOWING MANNER PRESCRIBED IN THE IRS REGULATIONS: EXECUTIVE COMPENSATION PACKAGES ARE DETERMINED BY A COMMITTEE OF THE BOARD THAT IS COMPOSED ENTIRELY OF BOARD MEMBERS WHO HAVE NO CONFLICT OF INTEREST. THE COMMITTEE ACQUIRES CREDIBLE COMPARABILITY MARKET DATA CONCERNING THE COMPENSATION PACKAGES OF SIMILARLY SITUATED EXECUTIVES. THE COMMITTEE CAREFULLY REVIEWS THAT DATA, THE EXECUTIVE'S PERFORMANCE AND THE PROPOSED COMPENSATION PACKAGES DURING THE DECISION MAKING PROCESS. THE COMMITTEE MEMORIALIZES ITS DELIBERATIONS IN DETAILED MINUTES REVIEWED AND ADOPTED AT THE NEXT-FOLLOWING MEETING. THE COMMITTEE SEEKS AN OPINION OF COUNSEL THAT IT HAS MET THE REQUIREMENTS OF THE IRS INTERMEDIATE SANCTIONS REGULATIONS. THIS PROCESS IS USED TO DETERMINE THE COMPENSATION PACKAGES FOR ALL MANAGEMENT EMPLOYEES FROM THE VICE PRESIDENT LEVEL AND UP. Public Disclosure Form 990, Part VI, Section C, Line 19 IN GENERAL, FINANCIAL AND TAX INFORMATION RELATING TO THE ORGANIZATION IS DEEMED PROPRIETARY AND NOT SUBJECT TO DISCLOSURE UPON REQUEST. HOWEVER, SPECIFIC PROVISIONS OF FEDERAL AND STATE LAW REQUIRE THE ORGANIZATION TO DISCLOSE CERTAIN LIMITED FINANCIAL AND TAX DATA UPON A SPECIFIC REQUEST FOR THAT INFORMATION. REQUESTS FOR FORM 990 AND FORM 1023: A REQUESTOR SEEKING TO REVIEW AND/OR OBTAIN A COPY OF THE ORGANIZATION'S IRS FORM 990 OR FORM 1023 AS FILED WITH THE INTERNAL REVENUE SERVICE, INCLUDING ALL SCHEDULES AND ATTACHMENTS, MAY APPEAR IN PERSON OR SUBMIT A WRITTEN REQUEST. THE MOST RECENT THREE YEARS OF IRS FORM 990 MAY BE REQUESTED. IF THE REQUESTER APPEARS IN PERSON, THE INDIVIDUAL IS DIRECTED TO THE OFFICE OF THE CHIEF FINANCIAL OFFICER FOR THE ORGANIZATION AND THE FORM 990 AND/OR FORM 1023 ARE MADE AVAILABLE FOR INSPECTION. THE INDIVIDUAL IS PERMITTED TO REVIEW THE RETURN, TAKE NOTES AND REQUEST A COPY. IF REQUESTED, A COPY IS PROVIDED ON THE SAME DAY. A NOMINAL FEE IS CHARGED FOR MAKING THE COPIES. THE ORGANIZATION MAY HAVE AN EMPLOYEE PRESENT DURING THE PUBLIC INSPECTION OF THE DOCUMENT. WRITTEN REQUESTS FOR AN ENTITY'S FORM 990 OR FORM 1023 ARE DIRECTED IMMEDIATELY TO THE OFFICE OF THE CHIEF FINANCIAL OFFICER FOR THE ORGANIZATION. THE REQUESTED COPIES ARE MAILED WITHIN 30 DAYS OF THE REQUEST. REPRODUCTION FEES AND MAILING COSTS ARE CHARGED TO THE REQUESTOR. CONFLICT OF INTEREST POLICY AND GOVERNING DOCUMENTS: IF THE GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY OF OUR ORGANIZATION ARE SUBJECT TO THE FEDERAL PUBLIC DISCLOSURE RULES (OR STATE PUBLIC DISCLOSURE RULES), THESE DOCUMENTS WILL BE MADE PUBLICLY AVAILABLE AS APPLICABLE LAW MAY REQUIRE. OTHERWISE, THE GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY WILL BE PROVIDED TO THE PUBLIC AT THE DISCRETION OF MANAGEMENT. Baltimore Washington Emergency Phys Inc 301 Hospital Drive Glen Burnie MD 21061 521756326 Health Care MD 501 (c) (3) 11 BWMS Baltimore Washington Healthcare Services 301 Hospital Drive Glen Burnie MD 21061 521830243 Health Care MD 501 (c) (3) 11 BWMS Baltimore Washington Medical Center Inc 301 Hospital Drive Glen Burnie MD 21061 520689917 Health Care MD 501 (c) (3) 3 BWMS Baltimore Washington Medical System Inc 301 Hospital Drive Glen Burnie MD 21061 521830242 Health Care MD 501 (c) (3) 11 UMMSC BW Medical Center Foundation Inc 301 Hospital Drive Glen Burnie MD 21061 521813656 Fundraising MD 501 (c) (3) 11 BWMS North Arundel Development Corporation 301 Hospital Drive Glen Burnie MD 21061 521318404 Real Estate MD 501 (c) (2) BWMS North County Corporation 301 Hospital Drive Glen Burnie MD 21061 521591355 Real Estate MD 501 (c) (2) BWMS Chester River Health Foundation Inc 100 Brown Street Chestertown MD 21620 521338861 Fundraising MD 501 (c) (3) 11 CRHS Chester River Health System Inc 100 Brown Street Chestertown MD 21620 522046500 Health Care MD 501 (c) (3) 11 UMMSC Chester River Hospital Center Inc 100 Brown Street Chestertown MD 21620 520679694 Health Care MD 501 (c) (3) 3 CRHS Chester River Manor Inc 200 Morgnec Road Chestertown MD 21620 526070333 Health Care MD 501 (c) (3) 11 CRHS Maryland General Clinical Practice Group 827 Linden Avenue Baltimore MD 21201 521566211 Health Care MD 501 (c) (3) 11 MGHS Maryland General Comm Health Foundation 827 Linden Avenue Baltimore MD 21201 522147532 Fundraising MD 501 (c) (3) 11 MGHS Maryland General Health Systems Inc 827 Linden Avenue Baltimore MD 21201 521175337 Health Care MD 501 (c) (3) 11 UMMSC Maryland General Hospital Inc 827 Linden Avenue Baltimore MD 21201 520591667 Health Care MD 501 (c) (3) 3 MGHS Care Health Services Inc 219 South Washington Street Easton MD 21601 521510269 Health Care MD 501 (c) (3) 11 SHS Dorchester General Hospital Foundation 219 South Washington Street Easton MD 21601 521703242 Fundraising MD 501 (c) (3) 11 SHS Memorial Hospital Foundation Inc 219 South Washington Street Easton MD 21601 521282080 Fundraising MD 501 (c) (3) 11 SHS Shore Clinical Foundation Inc 219 South Washington Street Easton MD 21601 521874111 Health Care MD 501 (c) (3) 11 SHS Shore Health System Inc 219 South Washington Street Easton MD 21601 520610538 Health Care MD 501 (c) (3) 3 UMMSC James Lawrence Kernan Hosp Endow Fd 2200 Kernan Drive Baltimore MD 21207 237360743 Fundraising MD 501 (c) (3) 11 UMMSC James Lawrence Kernan Hospital Inc 2200 Kernan Drive Baltimore MD 21207 520591639 Health Care MD 501 (c) (3) 3 UMMSC Shipley s Choice Medical Park Inc 22 South Greene Street Baltimore MD 21201 043643849 Real Estate MD 501 (c) (2) UMMSC UMMS Foundation Inc 22 South Greene Street Baltimore MD 21201 522238893 Fundraising MD 501 (c) (3) 11 UMMSC University of MD Medical System Corp 22 South Greene Street Baltimore MD 21201 521362793 Health Care MD 501 (c) (3) 3 UMMSC Arundel Physicians Associates LLC 301 Hospital Drive Glen Burnie MD 21061 522000762 Health Care MD NA N/A Central Maryland Radiology Oncology 10710 Charter Drive Columbia MD 21044 270879418 Health Care MD NA N/A Central MD Rehabilitation Center LLC 22 South Greene Street Baltimore MD 21201 521939987 Health Care MD NA N/A Helen P Denit Cancer Treatment Center 22 South Greene Street Baltimore MD 21201 522283591 Health Care MD NA N/A Innovative Health LLC 29165 Canvasback Drive Suite 100 Easton MD 21601 521997287 Billing MD NA N/A North Arundel Pet Center LLC 301 Hospital Drive Glen Burnie MD 21061 200806027 Health Care MD NA N/A North Arundel Senior Living LLC 301 Hospital Drive Glen Burnie MD 21061 541810728 Health Care MD NA N/A NAHSunrise of Severna Park LLC 301 Hospital Drive Glen Burnie MD 21061 541810729 Health Care MD NA N/A Shipleys Imaging Center LLC 22 South Greene Street Baltimore MD 21201 522040338 Health Care MD NA N/A Universitycare LLC 521914892 Health Care MD NA N/A Arundel Physicians Associates Inc 301 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