2024-05-15T07:24:32-05:00 2023-06-30 440160260 FORVIS LLP 1410 SPRING HILL ROAD SUITE 500 TYSONS VA 221023056 990 2022-07-01 521656507 ATLANTIC GENERAL HOSPITAL ATLA 4106411100 9733 HEALTHWAY DRIVE BERLIN MD 21811 JAMES KANUCH VP FINANCE 4106411100 2024-05-15 1 JAMES KANUCH 999009999 1 AMY BIBBY P00445891 7039700400 2024-05-14 2 AAL1 IAL1 2022 2023-04-26 12:10:37Z DON OWREY 9733 HEALTHWAY DR BERLIN MD 21811 164885745 0 X WWW.ATLANTICGENERAL.ORG X 1989 MD TO CREATE A COORDINATED CARE DELIVERY SYSTEM THAT WILL PROVIDE ACCESS TO QUALITY CARE, PERSONALIZED SERVICE, AND EDUCATION TO IMPROVE INDIVIDUAL AND COMMUNITY HEALTH. WE ACCOMPLISH OUR MISSION THROUGH OUR SET OF VALUES, WHICH ARE HONORED IN ALL OUR INTERACTIONS. 22 20 1192 111 669742 0 4652206 1822118 153933454 160803357 1006166 -33285 705252 1228427 160297078 163820617 0 0 0 0 80462375 87838992 0 0 98572 78157998 84160104 158620373 171999096 1676705 -8178479 130679107 124802496 68903898 67033634 61775209 57768862 TO CREATE A COORDINATED CARE DELIVERY SYSTEM THAT WILL PROVIDE ACCESS TO QUALITY CARE, PERSONALIZED SERVICE, AND EDUCATION TO IMPROVE INDIVIDUAL AND COMMUNITY HEALTH. WE ACCOMPLISH OUR MISSION THROUGH OUR SET OF VALUES, WHICH ARE HONORED IN ALL OUR INTERACTIONS. 0 0 138476373 160624360 ATLANTIC GENERAL HOSPITAL IS A NON PROFIT HEALTHCARE PROVIDER FOCUSING ON INPATIENT AND OUTPATIENT SERVICES FOR OUR LOCAL COMMUNITY. WE ALSO OPERATE MULTIPLE PHYSICIAN OFFICES THROUGHOUT THE REGION THAT PROVIDES FAMILY, INTERNAL AND SPECIALTY MEDICINE TO OUR LOCAL RESIDENTS. WE HAD THE FOLLOWING KEY STATISTICS DURING THE 2021 TAX YEAR: ADMISSIONS: 2,745, PATIENT DAYS: 11,651, ED VISITS: 33,070, SURGERIES: 6,581, OTHER OUTPATIENT VISITS: 53,642, TOTAL VISITS TO OUR PHYSICIAN PRACTICES WERE 123,987. 138476373 1 1 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 0 0 0 1 0 0 0 1 0 1 1 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 175 0 1 1192 1 1 1 0 0 0 1 1 1 1 0 0 0 0 0 0 X 22 20 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 MD X X JAMES KANUCH 4106411100 9733 HEALTHWAY DRIVE BERLIN MD 21811 CHARLOTTE CATHELL BOARD CHAIR 2.00 X X 0 0 0 DOUG COOK VICE CHAIR 2.00 X X 0 0 0 CHRIS WOODLEY SECRETARY 2.00 X X 0 0 0 AARON FINNEY TREASURER 2.00 X X 0 0 0 JON ANDES BOARD MEMBER 2.00 X 0 0 0 CORY CARPENTER CHIEF OF STAFF EX-OFFICIO VOTING MEMBER 2.00 X 0 0 0 VONNIE BROWN BOARD MEMBER 2.00 X 0 0 0 WILLIAM ESHAM BOARD MEMBER 2.00 X 0 0 0 TODD FERRANTE BOARD MEMBER 2.00 X 0 0 0 JSTEVEN GREEN FOUNDATION BOARD CHAIR 2.00 X 0 0 0 REBECCA JONES BOARD MEMBER 2.00 X 0 0 0 JAY KNERR BOARD MEMBER 2.00 X 0 0 0 TOM MEARS BOARD MEMBER 2.00 X 0 0 0 LEVOMG YERS BOARD MEMBER 2.00 X 0 0 0 DONALD OWREY PRESIDENT & CEO 40.00 X X 348411 0 9901 GREG SHOCKLEY BOARD MEMBER 2.00 X 0 0 0 JDALE SMACK BOARD MEMBER 2.00 X 0 0 0 PHILLIP SPINUZZA DO VICE CHIEF OF STAFF EX-OFFICIO VOTING MEMBER 2.00 X 0 0 0 STEVEN SWEIGERT BOARD MEMBER 2.00 X 0 0 0 ANNETTE WALLANCE BOARD MEMBER 2.00 X 0 0 0 CHERYL NOTTINGHAM VICE PRESIDENT OF FINANCE 40.00 X 267933 0 19118 JONATHAN BAUER VICE PRESIDENT OF INFORMATION SERVICES 40.00 X 231578 0 25927 KIM JUSTICE VICE PRESIDENT PLANNING AND OPERATIONS 40.00 X 297193 0 22427 RABINDRA N PAUL PHYSICIAN 40.00 X 1389622 0 28073 ALAE ZARIF PHYSICIAN 40.00 X 1078600 0 28073 MICHAEL SHOOKER PHYSICIAN 40.00 X 1015311 0 28092 MARK STRONG PHYSICIAN 40.00 X 570264 0 27844 DANIELLE ORR PHYSICIAN 40.00 X 554252 0 7625 5753164 0 197080 117 0 1 0 ALLSCRIPTS 24630 NETWORK PLACE CHICAGO IL 60673 IT SERVICES 2802397 QUALIVIS INC PO BOX 123847 DALLAS TX 75312 MEDICAL SERVICE 1827543 INTERMED GROUP INC 13301 US HIGHWAY 441 ALACHUA FL 32615 MEDICAL SERVICE 995801 TIDAL HEALTH PO BOX 826880 PHILADELPHIA PA 13182 MEDICAL SERVICE 975517 PHARMACY HEALTHCARE 24042 NETWORK PL CHICAGO IL 60673 MEDICAL SERVICE 911489 33 243857 77000 1501261 2500 1822118 NET PATIENT REVENUE 621110 151852688 151852688 PHARMACY 621110 6457742 5796376 661366 OTHER OPERATING 621110 2492927 2484551 8376 160803357 616847 616847 419266 29042 390224 390224 390224 650132 -650132 -650132 -650132 306751 243857 128445 178306 178306 426661 257509 169152 169152 MISCELLANEOUS 621110 291248 291248 CAFETERIA 621110 199497 199497 490745 163820617 160624360 669742 704397 1271409 1271409 72991324 66881233 6110091 958454 958454 7911454 3555500 4315699 40255 4706351 4201745 504606 186539 65962 120577 12801163 10739709 2059064 2390 833618 824873 1129 7616 5132721 3884721 1218417 29583 5889125 6046 5883079 1050429 1012710 37290 429 108509 80261 27934 314 37638 20320 17318 1561724 422895 1138829 7998458 1028272 6970186 2015118 413738 1601380 MEDICAL SUPPLIES 35470648 35470648 BAD DEBT EXPENSE 5605301 5605301 REPAIRS & MAINTENANCE 3202944 3049684 138902 14358 MISC 520084 190694 325930 3460 1746085 1022061 723857 167 171999096 138476373 33424151 98572 27708805 16799216 2756071 852724 13456659 12715215 3174764 3332560 3972289 3961212 160949691 106628220 55933972 54321471 14746985 19387532 684405 2306036 1559511 1332675 6685646 9793855 130679107 124802496 16368003 17272151 35020000 34092000 1093474 896033 16422421 14773450 68903898 67033634 X 58675028 56572028 3100181 1196834 61775209 57768862 130679107 124802496 X -8178479 2550501 1621631 X X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 6167783 765448 195069 35055 6703107 7502260 -1169741 123888 40848 6167783 5560962 2166682 187533 37851 7502260 5813047 -10220 209845 32020 5560962 5638785 372458 164495 33701 5813047 0.67000 0.33000 0 0 5841074 5841074 54348787 37361654 16987133 2250366 1546997 703369 93530641 64296916 29233725 4978823 3422653 1556170 54321471 DONOR RESTRICTED CASH 344110 BOARD DESIGNATED RESTRICTED CASH 112379 DEFERRED FINANCING COSTS 486353 INSURANCE RECOVERABLE 5771988 ROU ASSET 3079025 9793855 ADVANCES FROM THIRD PARTIES 2623732 CAPITAL LEASE 1798705 INSURANCE UNPAID LOSS 5771988 INSURANCE IBNR FOR CAPTIVE 1500000 LEASE LIABILITY 3079025 14773450 X 162416490 2550501 1650673 4201174 158215316 5605301 5605301 163820617 166422837 29042 29042 166393795 5605301 5605301 171999096 PART V, LINE 4: THE COMMUNITY FOUNDATION OF THE EASTERN SHORE HOLDS, AND ACCOUNTS FOR IN ITS FINANCIAL STATEMENTS, A PERMANENT ENDOWMENT FUND (THE "FUND") ESTABLISHED IN THE HOSPITAL'S NAME. THE HOSPITAL IS THE SOLE BENEFICIARY OF THE FUND AND IS ENTITLED TO INVESTMENT INCOME EARNED BY THE FUND. THE 2022 TAX YEAR ENDING BALANCE FOR THE FUND WAS $2,178,628. PART X, LINE 2: THE CORPORATION IS EXEMPT FROM FEDERAL INCOME TAX UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE AS A PUBLIC CHARITY. FEDERAL TAX LAW REQUIRES THAT THE CORPORATION BE OPERATED IN A MANNER CONSISTENT WITH ITS INITIAL EXEMPTION APPLICATION IN ORDER TO MAINTAIN ITS EXEMPT STATUS. MANAGEMENT HAS ANALYZED THE OPERATIONS OF THE CORPORATION AND CONCLUDED THAT IT REMAINS IN COMPLIANCE WITH THE REQUIREMENTS FOR EXEMPTION. THE STATE IN WHICH THE CORPORATION OPERATES ALSO PROVIDES GENERAL EXEMPTION FROM STATE INCOME TAXATION FOR ORGANIZATIONS THAT ARE EXEMPT FROM FEDERAL INCOME TAXATION. HOWEVER, THE CORPORATION IS SUBJECT TO BOTH FEDERAL AND STATE INCOME TAXATION AT CORPORATE TAX RATES ON ITS UNRELATED BUSINESS INCOME. EXEMPTION FROM OTHER STATE TAXES, SUCH AS REAL AND PERSONAL PROPERTY TAXES, IS SEPARATELY DETERMINED. CURRENT ACCOUNTING STANDARDS DEFINE THE THRESHOLD FOR RECOGNIZING UNCERTAIN INCOME TAX RETURN POSITIONS IN THE FINANCIAL STATEMENTS AS "MORE LIKELY THAN NOT" THAT THE POSITION IS SUSTAINABLE, BASED ON TECHNICAL MERITS, AND ALSO PROVIDE GUIDANCE ON THE MEASUREMENT, CLASSIFICATION, AND DISCLOSURE OF TAX RETURN POSITIONS IN THE FINANCIAL STATEMENTS. MANAGEMENT BELIEVES THERE IS NO IMPACT ON THE CORPORATION'S ACCOMPANYING FINANCIAL STATEMENTS RELATED TO UNCERTAIN INCOME TAX PROVISIONS. PART XI, LINE 2D - OTHER ADJUSTMENTS: CHANGES IN INTEREST RATE SWAP 1,621,631. RENTAL EXPENSE 29,042. PART XI, LINE 4B - OTHER ADJUSTMENTS: BAD DEBT EXPENSE 5,605,301. PART XII, LINE 2D - OTHER ADJUSTMENTS: RENTAL EXPENSE 29,042. PART XII, LINE 4B - OTHER ADJUSTMENTS: BAD DEBT EXPENSE 5,605,301. CENTRAL AMERICA AND THE CARIBBEAN - ANTIGUA & BARBUDA, ARUBA, BAHAMAS, 0 0 INVESTMENTS PREMIUMS FOR GENERAL LIABILITY INSURANCE 1764000 0 0 0 0 0 0 1764000 0 1764000 1 0 1 0 0 0 PART III ACCOUNTING METHOD: 30TH ANNIVERSARY CELEBRATION - 5/18 282430 282430 23256 47870 7200 8049 29TH ANNUAL FALL GOLF CLASSIC - 9/2 151600 127279 24321 2500 13145 9033 1369 1460 1 116578 116578 10306 4257 550608 243857 306751 2500 23451 32289 49239 7200 13766 128445 178306 1 1 1 X 300.000000000000 1 X 1 1 1 0 1 1 1009984 1498182 0 0.00000 10887034 16667168 0 0.00000 11897018 18165350 0 0.00000 437504 437504 0.00260 501655 501655 0.00300 939159 939159 0.00560 12836177 18165350 939159 0.00560 6640 6640 0.00000 16132 16132 0.00010 80871 80871 0.00050 13225 13225 0.00010 6673 6673 0.00000 123541 123541 0.00070 5605298 100895 27554202 24880532 2673670 X 1 1 1 1 ATLANTIC GENERAL HOSPITAL 9733 HEALTHWAY DRIVE BERLIN MD 21811 X X X ATLANTIC GENERAL HOSPITAL 1 0 0 1 X X X X X X X X X 21 1 0 0 1 X WWW.ATLANTICGENERAL.ORG X 1 21 1 WWW.ATLANTICGENERAL.ORG 0 1 X 300.000000000000 300.000000000000 X X 1 1 X X X 1 X WWW.ATLANTICGENERAL.ORG X WWW.ATLANTICGENERAL.ORG X WWW.ATLANTICGENERAL.ORG X X X X X X 1 X 0 X X X 1 0 0 ATLANTIC GENERAL HOSPITAL PART V, SECTION B, LINE 3J: THIS 2022-2024 CHNA COMBINES POPULATION HEALTH STATISTICS, IN ADDITION TO FEEDBACK GATHERED FROM THE COMMUNITY IN THE FORM OF SURVEYS AND FOCUS GROUPS. AGH USES HEALTHY COMMUNITIES INSTITUTE TO PROVIDE HEALTH INDICATOR AND RANKING DATA TO SUPPLEMENT COMMUNITY DATA PROVIDED BY PARTNERS OF THE COLLABORATION. WHEN COMBINED, FINDINGS FROM THE DATA AND COMMUNITY FEEDBACK ARE PARTICULARLY USEFUL IN IDENTIFYING PRIORITY HEALTH NEEDS AND DEVELOPING ACTION PLANS TO MEET THOSE NEEDS. THIS ASSESSMENT INCORPORATES DATA FROM BOTH QUANTITATIVE AND QUALITATIVE SOURCES. QUANTITATIVE DATA INPUT INCLUDES PRIMARY RESEARCH (SURVEYS) AND SECONDARY RESEARCH (VITAL STATISTICS AND OTHER EXISTING HEALTH-RELATED DATA); THESE QUANTITATIVE COMPONENTS ALLOW FOR COMPARISON TO BENCHMARK DATA AT THE STATE AND NATIONAL LEVELS. QUALITATIVE DATA INPUT INCLUDES INFORMATION GATHERED THROUGH ONGOING KEY COMMUNITY GROUPS.SECONDARY DATA COLLECTION AGH PARTNERS WITH SURROUNDING HOSPITALS, HEALTH DEPARTMENTS AND STATE AGENCIES TO BRING TO TOGETHER A MULTITUDE OF INFORMATION. THIS COMMUNITY HEALTH NEEDS ASSESSMENT, A FOLLOW-UP TO A SIMILAR STUDY CONDUCTED IN 2012, 2015, AND 2018 , IS A SYSTEMATIC, DATA-DRIVEN APPROACH TO DETERMINING THE HEALTH STATUS, BEHAVIORS AND NEEDS OF RESIDENTS IN THE PRIMARY SERVICE AREA OF ATLANTIC GENERAL HOSPITAL. SUBSEQUENTLY, THIS INFORMATION MAY BE USED TO INFORM DECISIONS AND GUIDE EORTS TO IMPROVE COMMUNITY HEALTH AND WELLNESS. THE INFORMATION AS WELL AS OTHER SURVEYS, RESEARCH AND COMMUNITY DATA ARE USED TO IDENTIFY ISSUES OF GREATEST CONCERN AND GUIDE RESOURCE ALLOCATION TO THOSE AREAS, THEREBY MAKING THE GREATEST POSSIBLE IMPACT ON COMMUNITY HEALTH STATUS. THE NEEDS ASSESSMENT IS A PRIMARY TOOL USED BY THE HOSPITAL TO DETERMINE ITS COMMUNITY BENEFIT PRIORITIES, WHICH OUTLINES HOW THE HOSPITAL WILL GIVE BACK TO THE COMMUNITY IN THE FORM OF HEALTH CARE AND OTHER COMMUNITY SERVICES TO ADDRESS UNMET COMMUNITY HEALTH NEEDS. THIS ASSESSMENT INCORPORATES COMPONENTS OF PRIMARY DATA COLLECTION AND SECONDARY DATA ANALYSIS THAT FOCUSES ON THE HEALTH AND SOCIAL NEEDS OF OUR SERVICE AREA. A SAMPLING OF RESOURCES UTILIZED TO COMPLETE THE ASSESSMENT IS LISTED BELOW. A COMPREHENSIVE LIST IS FOUND UNDER CHNA FY22-24 REFERENCES.-COMMUNITY MEETINGS WITH PERSONS REPRESENTING THE BROAD INTERESTS OF THE COMMUNITY-AGH COMMUNITY NEEDS SURVEY-MARYLAND STATE HEALTH IMPROVEMENT PROCESS (SHIP) WWW.DHMH.MARYLAND.GOV/SHIP-TRI-COUNTY HEALTH IMPROVEMENT PLAN (T-CHIP)-HEALTHY PEOPLE 2020 - 2030-WORCESTER COUNTY COMMUNITY HEALTH IMPROVEMENT PLAN (CHIP) LHIC LOCAL HEALTH IMPROVEMENT COALITIONHEALTH IMPROVEMENT COALITION -MEDICAL STAFF DEVELOPMENT PLAN-HEALTH FAIRS-COMMUNITY EDUCATION EVENTS-2020/2021 COUNTY HEALTH OUTCOMES & ROADMAPS-WWW.DHSS.DELAWARE.GOV/DHSS/DPH/FLES/SHASHIP.PDF-DELAWARE HEALTH AND SOCIAL SERVICES THROUGH THE DELAWARE HEALTH TRACKER WWW.DELAWAREHEALTHTRACKER.COM-BEEBE MEDICAL CENTER COMMUNITY HEALTH NEEDS ASSESSMENT -US CENSUS BUREAUTHE COMMUNITY HEALTH NEEDS ASSESSMENT SURVEY WAS DISTRIBUTED BY COMMUNITY OUTREACH PERSONNEL AND THE ATLANTIC GENERAL HOSPITAL WEBSITE. STAKEHOLDER INTERVIEWS AND FOCUS GROUPS WERE CONDUCTED BY COMMUNITY OUTREACH PERSONNEL. COMMUNITY SURVEYS REPRESENT INFORMATION THAT IS SELF-REPORTED. RESULTS FROM THE PAPER SURVEYS AND ELECTRONIC VERSIONS ARE FOUND IN CHNA FY22-24. ATLANTIC GENERAL HOSPITAL PART V, SECTION B, LINE 5: THE HOSPITAL FACILITY TOOK INTO ACCOUNT INPUT FROM REPRESENTATIVES OF THE COMMUNITY SERVED BY THE HOSPITAL FACILITY, INCLUDING THOSE WITH SPECIAL EXPERTISE IN PUBLIC HEALTH AND REPRESENTATIVES FROM UNDERSERVED, UNINSURED OR MINIORITY GROUPS. IN PARTICULAR, INFORMATION WAS GATHERED FROM PARTICIPANTS IN OUR FREE CLINICS AND SCREENINGS, CHURCH GROUPS (VARIOUS CONGREGATIONS TO WHOM WE PROVIDE SERVICES AND THROUGH THOSE REPRESENTED IN OUR FAITH BASED PARTNERSHIP), LOCAL BUSINESSES AND THROUGH OUR COMMUNITY HEALTH FAIRS. THIS PRIMARY DATA WAS COLLECTED THROUGH THE USE OF PAPER QUESTIONNAIRES PROVIDED DIRECTLY TO THE PARTICIPANTS, AS WELL AS QUESTIONNAIRES THAT COULD BE ACCESSED ON THE HOSPITAL FACILITY'S WEBSITE.WE ALSO CONSULTED WITH NUMEROUS AGENCIES IN THE COMMUNITY WHO ARE KNOWLEDGEABLE ABOUT HEALTH NEEDS OF THE COMMUNITY, INCLUDING:WORCESTER COUNTY HEALTH DEPARTMENTWORCESTER COUNTY PREVENTION OFFICEWORCESTER COUNTY MENTAL/BEHAVIOR HEALTH SERVICESMAC, INC. (MAINTAINING ACTIVE CITIZENS-YOUR AREA AGENCY OF AGING)CAREGIVERS RESOURCE CENTERLOCAL PARKS AND RECREATION DEPARTMENTSTRI-COUNTY DIABETES ALLIANCETRI-COUNTY COMMUNITY HEALTH BOARDCOASTAL HOSPICEWORCESTER COUNTY BOARD OF EDUCATIONWORCESTER YOUTH AND FAMILY SERVICES ATLANTIC GENERAL HOSPITAL PART V, SECTION B, LINE 11: THE HOSPITAL IS ADDRESSING SIGNIFICANT NEEDS BASED ON THE SIZE AND SEVERITY OF THE PROBLEM DETERMINED BY WHAT PERCENTAGE OF THE POPULATION IS AFFECTED BY THE RISKS, THE HEATH SYSTEM'S ABILITY TO IMPACT THE NEED AND THE AVAILABILITY OF RESOURCES. THE AREAS NOT ADDRESSED IN THE CHNA ARE STILL BEING ADDRESSED BY THE HEALTH SYSTEM; DENTAL HEALTH - AGHS/AHG HAS NO RESOURCES TO MEET THIS NEED BY THE WORCESTER COUNTY HEALTH DEPARTMENT HAS A DENTAL PROGRAM AS WELL AS NEIGHBORING COUNTIES HAVE PROGRAMS. COMMUNICABLE DISEASE - WE DO PROVIDE FREE FLU AND COVID VACCINE CLINICS TO THE COMMUNITY AND KEEP ABREAST OF ANY COMMUNICABLE DISEASE INFORMATION. WE HAVE CREATED AND MADE AVAILABLE A MONKEYPOX PLAYBOOK. CANCER IS ADDRESSED THROUGH THE REGIONAL CANCER CENTER. HEART DISEASE IS BEING ADDRESSED THROUGH OUR REACH GRANT COLLABORATIVE FOR UNDERSERVED PATIENTS AND COMMUNITIES, AS WELL AS DRIVING INCREASED ACCESS TO PRIMARY CARE PROVIDERS IN THE AREA. ATLANTIC GENERAL HOSPITAL PART V, SECTION B, LINE 18E: THE HOSPITAL FACILITY OR AN AUTHORIZED THIRD PARTY DID NOT UNDERTAKE ANY OF THE COLLECTION ACTIONS NOTED IN PART V, SECTION B, LINE 16 BEFORE MAKING REASONABLE EFFORTS TO DETERMINE ANY PATIENT'S ELIGIBILITY UNDER THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY. IN ORDER TO HELP DETERMINE PATIENTS' ELIGIBILITY UNDER THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY, THE HOSPITAL UNDERTAKES A NUMBER OF ACTIONS, INCLUDING NOTIFYING PATIENTS OF THE FINANCIAL ASSISTANCE POLICY ON ADMISSION, NOTIFYING PATIENTS OF THE FINANCIAL ASSISTANCE POLICY PRIOR TO DISCHARGE, NOTIFYING PATIENTS OF THE FINANCIAL ASSISTANCE POLICY IN COMMUNICATIONS WITH THE PATIENTS' BILLS, AND DOCUMENTING ITS DETERMINATION OF WHETHER PATIENTS WERE ELIGIBLE FOR FINANCIAL ASSISTANCE UNDER THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY. ATLANTIC GENERAL HOSPITAL PART V, SECTION B, LINE 20E: THE HOSPITAL FACILITY DOES NOT CHARGE ANY INDIVIDUALS THAT IT KNOWS ARE ELIGIBLE FOR FINANCIAL ASSISTANCE AN AMOUNT EQUAL TO THE GROSS CHARGE FOR ANY SERVICE. THE HOSPITAL USES THE CHARGE MASTER RATES FOR A SERVICE AS A STARTING POINT AGAINST WHICH THE DISCOUNTS MANDATED IN THE HOSPITAL FACILITY'S FINANCIAL ASSISTANCE POLICY ARE APPLIED TO DETERMINE THE AMOUNT ACTUALLY BILLED TO PATIENTS ELIGIBLE UNDER THE FINANCIAL ASSISTANCE POLICY. THE HOSPITAL FACILITY WILL NOT COLLECT PAYMENT FROM ANY PATIENT ELIGIBLE UNDER THE FINANCIAL ASSISTANCE POLICY IN EXCESS OF THE REDUCED AMOUNT THAT IS ACTUALLY BILLED TO SUCH FINANCIAL ASSISTANCE PATIENT. IN ADDITION, IF THE HOSPITAL CHARGED AN INDIVIDUAL THAT HAD NOT YET BEEN DETERMINED TO BE ELIGIBLE FOR FINANCIAL ASSISTANCE AT THE TIME OF CHARGE AN AMOUNT EQUAL TO GROSS CHARGES, THEN UPON DETERMINING THE INDIVIDUAL WAS ELIGIBLE FOR FINANCIAL ASSISTANCE UNDER THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY, THE HOSPITAL PROMPTLY CORRECTS THE BILL. ATLANTIC GENERAL HOSPITAL PART V, SECTION B, LINE 23: THE HOSPITAL FACILITY DOES NOT CHARGE ANY INDIVIDUALS THAT IT KNOWS ARE ELIGIBLE FOR FINANCIAL ASSISTANCE AN AMOUNT EQUAL TO THE GROSS CHARGE FOR ANY SERVICE. THE HOSPITAL USES THE CHARGE MASTER RATES FOR A SERVICE AS A STARTING POINT AGAINST WHICH THE DISCOUNTS MANDATED IN THE HOSPITAL FACILITY'S FINANCIAL ASSISTANCE POLICY ARE APPLIED TO DETERMINE THE AMOUNT ACTUALLY BILLED TO PATIENTS ELIGIBLE UNDER THE FINANCIAL ASSISTANCE POLICY. THE HOSPITAL FACILITY WILL NOT COLLECT PAYMENT FROM ANY PATIENT ELIGIBLE UNDER THE FINANCIAL ASSISTANCE POLICY IN EXCESS OF THE REDUCED AMOUNT THAT IS ACTUALLY BILLED TO SUCH FINANCIAL ASSISTANCE PATIENT. IN ADDITION, IF THE HOSPITAL CHARGED AN INDIVIDUAL THAT HAD NOT YET BEEN DETERMINED TO BE ELIGIBLE FOR FINANCIAL ASSISTANCE AT THE TIME OF CHARGE AN AMOUNT EQUAL TO GROSS CHARGES, THEN UPON DETERMINING THE INDIVIDUAL WAS ELIGIBLE FOR FINANCIAL ASSISTANCE UNDER THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY, THE HOSPITAL PROMPTLY CORRECTS THE BILL. PART V, SECTION, LINE 22 MARYLAND WAIVER MEDICARE EXEMPT 29 1 - ACE BUSINESS CENTER (PA) 10026 OLD OCEAN CITY BLVD BLD 3 BERLIN MD 21811 PHYSICAN PRACTICE 2 - ACE BUSINESS CENTER (PBO) 10026 OLD OCEAN CITY BLVD BLD 1 POCOMOKE MD 21851 PHYSICAN PRACTICE 3 - AG GASTROENTEROLOGY 314 FRANKLIN AVE STE 304 BERLIN MD 21811 PHYSICAN PRACTICE 4 - AG INTERNAL MEDICINE - CASTANEDA 10324 OLD OCEAN CITY BLVD BERLIN MD 21811 PHYSICAN PRACTICE 5 - AG PRIMARY CARE & ENDOCRINOLOGY 11107 RACETRACK ROAD OCEAN CITY MD 21842 PHYSICAN PRACTICE 6 - AG PRIMARY CARE OCEAN VIEW 96 ATLANTIC AVE STE 2 OCEAN VIEW DE 19970 PHYSICAN PRACTICE 7 - AG PRIMARY CARE OCEAN VIEW 96 ATLANTIC AVE STE 1 OCEAN CITY MD 21842 PHYSICAN PRACTICE 8 - ATLANTIC ENDOSCOPY CENTER (AES) 10231 OLD OCEAN CITY BLVD UNIT 205 BERLIN MD 21811 PHYSICAN PRACTICE 9 - ATLANTIC GENERAL PRIMARY CARE SELBYVILLE 15 N WILLIAM STREET SELBYVILLE DE 19975 PHYSICAN PRACTICE 10 - ATLANTIC GENERAL WOMEN'S HEALTH 38394 DUPONT HIGHWAY SUITE H OCEAN VIEW DE 19970 PHYSICAN PRACTICE 11 - ATLANTIC HEALTH CENTER 9714 HEALTHWAY DRIVE BERLIN MD 21811 PHYSICAN PRACTICE 12 - ATLANTIC IMMEDICARE 1001 PHILADELPHIA AVE BERLIN MD 21811 PHYSICAN PRACTICE 13 - ATLANTIC SURGICAL ASSOCIATES BARIATRIC 10231 OLD OCEAN CITY BLVD UNIT 207 BERLIN MD 21811 PHYSICAN PRACTICE 14 - BERLIN PRIMARY CARE 10344 OLD OCEAN CITY SUITE A BERLIN MD 21811 PHYSICAN PRACTICE 15 - NEUROLOGY 314 FRANKLIN AVE STE 104 BERLIN MD 21811 PHYSICAN PRACTICE 16 - ORTHOPEDICS 314 FRANKLIN AVE SUITE 201 BERLIN MD 21811 PHYSICAN PRACTICE 17 - OUTPATINET LAB 10231 OLD OCEAN CITY BLVD UNIT 103 BERLIN MD 21811 OUTPATIENT LAB 18 - POCOMOKE MEDICAL OFFICE 500 MARKET STREET SUITE 101 BERLIN MD 21811 PHYSICAN PRACTICE 19 - REGIONAL CANCER CARE CENTER 9707 HEALTHWAY DRIVE BERLIN MD 21811 REGIONAL CANCER CENTER 20 - RHEUMATOLOGY 10231 OLD OCEAN CITY BLVD UNIT 210 BERLIN MD 21811 PHYSICAN PRACTICE 21 - UROLOGY 10231 OLD OCEAN CITY BLVD UNIT 206 BERLIN MD 21811 PHYSICAN PRACTICE 22 - UROLOGY - 208 10231 OLD OCEAN CITY BLVD UNIT 208 BERLIN MD 21811 PHYSICAN PRACTICE 23 - WEST FENWICK 2 VILLAGE SQUARE STE 219/37464 LION DR U SELBYVILLE DE 19975 PHYSICAN PRACTICE 24 - WOC PCMH 12308 OCEAN GATEWAY APT 34 UPSTAIRS 4 OCEAN CITY MD 21842 PHYSICAN PRACTICE 25 - WOC PEDIATRICS 12308 OCEAN GATEWAY APT 3 OCEAN CITY MD 21842 PHYSICAN PRACTICE 26 - WOC PRIMARY CARE 12308 OCEAN GATEWAY APT 1 OCEAN CITY MD 21842 PHYSICAN PRACTICE 27 - WOC WOMEN'S HEALTH CENTER 12308 OCEAN GATEWAY APT 8 OCEAN CITY MD 21842 PHYSICAN PRACTICE 28 - WOC WOMEN'S IMAGING 12308 OCEAN GATEWAY APT 5 OCEAN CITY MD 21842 IMAGING FACILITY 29 - WOUND CARE CENTER 10231 OLD OCEAN CITY BLVD UNIT 104 BERLIN MD 21811 PHYSICAN PRACTICE PART I, LINE 3C: IN ADDITION TO QUALIFYING FOR FINANCIAL ASSISTANCE BECAUSE THE PATIENT'S FAMILY INCOME FALLS BELOW THE FEDERAL POVERTY GUIDELINES THRESHOLDS (FREE CARE FOR FAMILY INCOME LESS THAN 200% OF THE FEDERAL POVERTY GUIDELINES, AND DISCOUNTED CARE FOR FAMILY INCOME LESS THAN 300% OF THE FEDERAL POVERTY GUIDELINES), A PATIENT MAY QUALIFY FOR FINANCIAL ASSISTANCE IF THAT PATIENT INCURS A FINANCIAL HARDSHIP AND HAS FAMILY INCOME UNDER 500% OF THE FEDERAL POVERTY GUIDELINES. A FINANCIAL HARDSHIP MEANS MEDICAL DEBT INCURRED BY A FAMILY OVER A TWELVE MONTH PERIOD THAT EXCEEDS 25% OF THE FAMILY'S INCOME. ONLY INCOME AND FAMILY SIZE WILL BE CONSIDERED IN APPROVING APPLICATIONS FOR FINANCIAL ASSISTANCE, UNLESS THE AMOUNT OWED IS GREATER THAN $20,000, THE PATIENT'S TAX RETURN SHOWS A SIGNIFICANT AMOUNT OF INTEREST INCOME, OR THE PATIENT INDICATES THAT THE PATIENT HAS BEEN LIVING OFF OF THEIR SAVINGS ACCOUNT. IF ONE OF THE SCENARIOS LISTED ABOVE IS APPLICABLE, THEN THE ORGANIZATION MAY CONSIDER THE PATIENT'S LIQUID ASSETS, INCLUDING THE PATIENT'S CHECKING AND SAVINGS ACCOUNTS, STOCKS, BONDS, CD'S, MONEY MARKET OR ANY OTHER ACCOUNTS FOR THE PAST THREE MONTHS. HOWEVER, THE FOLLOWING ASSETS ARE ALWAYS EXCLUDED: THE FIRST $10,000 OF MONETARY ASSETS, UP TO $150,000 IN A PRIMARY RESIDENCE, AND CERTAIN RETIREMENT BENEFITS, SUCH AS 401K PLANS WHERE THE IRS HAS GRANTED PREFERENTIAL TAX TREATMENT. IF THE PATIENT IS ALREADY ENROLLED IN A MEANS-TESTED PROGRAM, THE PATIENT IS DEEMED ELIGIBLE FOR FREE CARE ON A PRESUMPTIVE BASIS, WITHOUT REQUIRING ANY OF THE FINANCIAL DOCUMENTS REQUIRED ON A FULL APPLICATION. PART I, LINE 7, COLUMN (F): THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $ 5,605,298. SCHEDULE H, PART I, LINE 5 IT IS THE ORGANIZATION'S POLICY TO PROVIDE FINANCIAL ASSISTANCE TO ANY INDIVIDUAL THAT QUALIFIES UNDER THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY, REGARDLESS OF THE AMOUNT OF CHARITY CARE BUDGETED FOR BY THE ORGANIZATION DURING THE YEAR. SCHEDULE H, PART I, LINE 6 THE ORGANIZATION FILES A COMMUNITY BENEFIT REPORT WITH THE MARYLAND HEALTH SERVICES COST REVIEW COMMISSION ANNUALLY. THE COMMUNITY BENEFIT REPORT IS AVAILABLE TO THE PUBLIC. SCHEDULE H, PART I, LINE 7A, 7B AND 7F MARYLAND HOSPITAL ASSOCIATION UNIFIED MARYLAND HOSPITAL RESPONSES SCHEDULE H PART I LINE 7A, 7B AND 7F 7A. CHARITY CARE AT COST AND 7F. HEALTH PROFESSIONS EDUCATION ARE EXPLAINED IN THE FOLLOWING: 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. 7B. UNREIMBURSED MEDICAID IS EXPLAINED IN THE FOLLOWING: 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 DIRECTED 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. PART III, LINE 2: WE USE THE AGING REPORT FOR ACCOUNTS OVER 120 DAYS PLUS ACTUAL BAD DEBT WRITE OFFS. PART III, LINE 3: WE LOOKED AT THE PATIENTS WHO WE PROVIDED FINANCIAL ASSISTANCE PAPERWORK SINCE WE FELT THEY WOULD QUALIFY, BUT THE COMPLETED PAPERWORK WAS NOT RETURNED. WE LOOKED AT THOSE ACCOUNTS TO SEE IF THOSE INDIVIDUALS WERE IN BAD DEBT AND INCLUDED ANY IN BAD DEBT AMOUNTS IN THE CALCULATION. PART III, LINE 4: TEXT FROM THE ORGANIZATION'S AFS FOOTNOTE:NET PATIENT SERVICE REVENUE AND PATIENT ACCOUNTS RECEIVABLE PATIENT ACCOUNTS RECEIVABLE ARE REPORTED AT ESTIMATED NET REALIZABLE AMOUNTS FROM PATIENTS, THIRD PARTY PAYORS, AND OTHERS FOR SERVICES RENDERED. PATIENT ACCOUNTS RECEIVABLE INCLUDE HOSPITAL AND PHYSICIAN CHARGES FOR ACCOUNTS DUE FROM MEDICARE, MARYLAND MEDICAL ASSISTANCE (MEDICAID), CAREFIRST, COMMERCIAL AND MANAGED CARE INSURERS, AND SELF-PAYING PATIENTS. DEDUCTED FROM PATIENT ACCOUNTS RECEIVABLE ARE ESTIMATES OF IMPLICIT PRICE CONCESSIONS FOR THE EXCESS OF CHARGES OVER THE PAYMENTS ON PATIENT ACCOUNTS TO BE RECEIVED FROM THIRD PARTY PAYORS AND UNCOLLECTIBLE AMOUNTS RELATED TO SELF-PAYING PATIENTS. THESE ESTIMATES ARE CALCULATED BY MANAGEMENT BASED ON HISTORICAL COLLECTION EXPERIENCE AND AGE OF GROUPS OF ACCOUNTS RECEIVABLE. GENERALLY, PATIENTS WHO ARE COVERED BY THIRD PARTY PAYORS ARE RESPONSIBLE FOR RELATED DEDUCTIBLES AND COINSURANCE, WHICH VARY IN AMOUNT. THE CORPORATION ALSO PROVIDES SERVICES TO UNINSURED PATIENTS, AND OFFERS THOSE UNINSURED OR UNDERINSURED PATIENTS FINANCIAL ASSISTANCE, BY EITHER POLICY OR LAW, FROM STANDARD CHARGES. THE CORPORATION ESTIMATES THE TRANSACTION PRICE FOR PATIENTS WITH DEDUCTIBLES AND COINSURANCE AND FROM THOSE WHO ARE UNINSURED BASED ON HISTORICAL EXPERIENCE AND CURRENT MARKET CONDITIONS. THE INITIAL ESTIMATE OF THE TRANSACTION PRICE IS DETERMINED BY REDUCING THE STANDARD CHARGES BY ANY EXPLICIT PRICE CONCESSION, FINANCIAL ASSISTANCE, AND IMPLICIT PRICE CONCESSIONS. SUBSEQUENT CHANGES TO THE ESTIMATE OF THE TRANSACTION PRICE ARE GENERALLY RECORDED AS ADJUSTMENT TO NET PATIENT SERVICE REVENUE IN THE PERIOD OF THE CHANGE. SUBSEQUENT CHANGES THAT ARE DETERMINED TO BE THE RESULT OF AN ADVERSE CHANGE IN THE PATIENT'S ABILITY TO PAY ARE RECORDED AS BAD DEBT EXPENSE.CONSISTENT WITH THE CORPORATION'S MISSION, CARE IS PROVIDED TO PATIENTS REGARDLESS OF THEIR ABILITY TO PAY. THEREFORE, THE CORPORATION HAS DETERMINED IT HAS PROVIDED IMPLICIT PRICE CONCESSIONS TO UNINSURED PATIENTS AND OTHER PATIENT BALANCES (FOR EXAMPLE, COPAYS AND DEDUCTIBLES). PART III, LINE 8: WE USED THE MEDICARE COST REPORT TO DETERMINE MEDICARE ALLOWABLE COSTS COMPARED TO MEDICARE TOTAL REVENUE. PART III, LINE 9B: IF THE PATIENTS REQUEST FINANCIAL ASSISTANCE WITH 240 DAYS OF THE FIRST POST-DISCHARGE BILLING DATE, ALL ECA ACTIONS WILL BE SUSPENDED. IF THE FA IS APPROVED, OR IF THE PATIENT PAYS THE BILL IN FULL, THE FINANCIAL COUNSELOR WILL NOTIFY THE AGENCY TO REMOVE ANY JUDGEMENTS OR ADVERSE ECA INFORMATION SENT TO A CONSUMER REPORTING AGENCY WITHIN 14 DAYS. PART VI, LINE 2: THE ORGANIZATION ASSESSES THE HEALTH CARE NEEDS OF THE COMMUNITY IT SERVES THROUGH MANY DIFFERENT ACTIVITIES, STUDIES AND COLLABORATIONS WITH LOCAL GOVERNMENT AND NON-GOVERNMENT ORGANIZATIONS. THE HOSPITAL IS CURRENTLY WORKING UNDER THE STRATEGIC INITIATIVES WHICH WERE DEVELOPED FOR PLANNING THROUGH 2020. EACH YEAR, WITHIN THIS FRAMEWORK THE HOSPITAL MAKES PLANS FOR THE UPCOMING YEAR USING THE SWOT/GAP ANALYSIS MODEL. USING THIS MODEL THE LEADERSHIP TEAM MEETS WITH THE MEDICAL STAFF TO LOOK AT STRENGTHS, WEAKNESSES, OPPORTUNITIES AND THREATS TO PLAN FOR THE COMING FISCAL YEAR. THIS INFORMATION THEN GOES TO THE BOARD TO, ALONG WITH SENIOR LEADERSHIP, FINALIZE THE STRATEGIC INITIATIVES FOR THE COMING YEAR. USING THIS INFORMATION THE COMMUNITY BENEFITS COMMITTEE AND THE HEALTHY HAPPENINGS (VISIONS) ADVISORY COMMITTEE DETERMINE THE GOALS FOR THE COMING YEAR. THE DOCUMENTS USED BY THE HOSPITAL TO DETERMINE COMMUNITY NEEDS ARE: THE HEALTH ASSESSMENT PUBLICATION FROM THE HEALTH DEPARTMENT, LOCAL AGENCIES AND HOSPITALS, WORCESTER COUNTY LOCAL HEALTH PLAN, FY2022 LOCAL HEALTH IMPROVEMENT COALITIONS, MARYLAND SHIP, FY2022 TRI-COUNTY HEALTH PLANNING BOARD, STATE OF MARYLAND CANCER REGISTRY LATEST CENSUS UPDATE FEEDBACK FROM AREA PHYSICIANS AND COMMUNITY MEMBERS QUESTIONNAIRES AND EVALUATIONS FROM OUR COMMUNITY EVENTS NCR PICKER PATIENT EVALUATIONS AND FEEDBACK HOSPITAL PERCEPTION SURVEY 2021 IN ADDITION, INFORMATION REGARDING COMMUNITY HEALTH NEEDS IS OBTAINED AS A RESULT OF THE ORGANIZATION'S LEADERSHIP MEMBERS SITTING ON THE BOARDS OF MANY COMMUNITY ORGANIZATIONS, INCLUDING: LHIC, TCHIP, SART, SAFE, PLAY IT SAFE COMMITTEE, OCEAN CITY DRUG AND ALCOHOL ABUSE PREVENTION COMMITTEE, MHA ADVISORY BOARD, FAITH BASED COALITION, UNITED WAY, BLOOD BANK OF DELMARVA, LHIC , CHAMBERS OF COMMERCE OF TOWNS THROUGHOUT THE REGION, MANY HEALTH DEPARTMENT COUNCILS, MHA COMMITTEES, STATE HEALTH DEPARTMENT BOARDS, WE ALSO HAVE A HEALTHY HAPPENINGS (VISIONS) ADVISORY COMMITTEE COMPRISED OF COMMUNITY PROVIDERS OF HEALTH RELATED SERVICES INCLUDING TRADITIONAL AS WELL AS INTEGRATIVE HEALTH SERVICES. THROUGH THIS COMMITTEE WE CAN KEEP OUR FINGER ON THE PULSE OF THE AREA IN WHICH WE SERVE. THIS COMMITTEE GIVES US GREAT FEEDBACK ON SERVICES AND PROGRAMS THAT ARE NEEDED THOSE THAT ARE WORKING AND THOSE THAT AREN'T. IT IS THROUGH THIS COMMITTEE THAT PUTS ON A MAJOR HEALTH CONFERENCE EACH YEAR, WHICH PROVIDES HEALTH EDUCATION AS WELL AS SCREENINGS. WE MET WITH GREAT SUCCESS COMMUNITY HEALTH FAIRS. AND ACCORDING TO THE EVALUATIONS, WERE ABLE TO PROVIDE SERVICES TO PEOPLE WHO OTHERWISE WOULD NOT HAVE GOTTEN THEM. THE ORGANIZATION'S AUXILIARY VOLUNTEERS ARE ANOTHER GREAT RESOURCE FOR DETERMINING COMMUNITY HEALTH NEEDS. THE ORGANIZATION HAS OVER 400 AUXILIANS. THEY ARE ACTIVE ON MANY COMMITTEES WITHIN THE HOSPITAL AND ALSO REPRESENT THE HOSPITAL ON DIFFERENT COMMUNITY BOARDS. IN ADDITION, THE ORGANIZATION WORKS VERY CLOSELY WITH ITS LOCAL HEALTH DEPARTMENT TO PLAN SERVICES TO MEET COMMUNITY NEEDS AND DECREASE THE DUPLICATION OF SERVICES IN THE COMMUNITY. MEMBERS OF THE HOSPITAL STAFF SIT ON MANY COMMITTEES, COMMUNITY BOARDS, COMMUNITY COALITIONS, AND BOARDS OF THE LOCAL HEALTH DEPARTMENT. PART VI, LINE 3: WE INFORM INDIVIDUALS IN THE COMMUNITY ABOUT THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY IN A NUMBER OF WAYS. FIRST, THERE IS SIGNAGE THROUGHOUT THE HOSPITAL, AS WELL AS BROCHURES IN ALL WAITING AREAS, EXPLAINING THAT THE ORGANIZATION PROVIDES FINANCIAL ASSISTANCE. IN ADDITION, ARTICLES ARE PUBLISHED IN NEWSLETTERS THAT ARE DISTRIBUTED TO THE HOMES OF ALL RESIDENTS IN THE COMMUNITY NOTING THE EXISTENCE OF THE ORGANIZATION'S FINANCIAL ASSISTANCE PROGRAM. HOSPITAL STAFF IS EDUCATED TO ANSWER QUESTIONS RELATED TO APPLYING FOR FINANCIAL ASSISTANCE, AND HOSPITAL SUPPORT SERVICES HELPS PATIENTS APPLY FOR MEDICAL ASSISTANCE (SUCH AS MEDICAID). FURTHERMORE, HOSPITAL FINANCIAL COUNSELORS HELP GUIDE PATIENTS TO FINANCIAL AID SERVICES THEY MAY QUALIFY FOR. ALL INPATIENTS ARE PROVIDED WITH A FINANCIAL ASSISTANCE APPLICATION IN THEIR DISCHARGE PACKAGE. IN ADDITION, DURING THE REGISTRATION PROCESS, IF THE PATIENT DOES NOT HAVE INSURANCE THE REGISTRAR OR FINANCIAL COUNSELOR WILL ASK IF THEY ARE INTERESTED IN APPLYING FOR FINANCIAL ASSISTANCE AND HELP WITH FILLING OUT THE APPLICATION. ANY PATIENT WHO SEEKS FINANCIAL OR MEDICAL ASSISTANCE WILL READILY FIND INFORMATION AND HOSPITAL STAFF TO HELP WITH THE PROCESS. PART VI, LINE 4: ATLANTIC GENERAL IS LOCATED IN WORCESTER COUNTY, WHICH IS THE EASTERNMOST COUNTY LOCATED IN THE U.S. STATE OF MARYLAND. WORCESTER COUNTY COMPRISES ATLANTIC GENERAL'S PRIMARY SERVICE AREA. WORCESTER COUNTY CONTAINS THE ENTIRE LENGTH OF THE STATE'S ATLANTIC COAST LINE. IT IS HOME TO THE POPULAR VACATION RESORT AREA OF OCEAN CITY. THE COUNTY IS APPROXIMATELY 60 MILES LONG. ACCORDING TO THE U.S. CENSUS BUREAU, THE COUNTY HAS A TOTAL AREA OF 695 SQUARE MILES OF WHICH, 473 SQUARE MILES OF IT IS LAND AND 221 SQUARE MILES OF IT IS WATER. ATLANTIC GENERAL IS LOCATED IN A NON-URBAN AREA OF WORCESTER COUNTY, 10 MILES FROM THE ATLANTIC OCEAN. THE 2023 CENSUS SHOWED A POPULATION OF THE COUNTY OF 54,171. THE LARGEST CONCENTRATION OF THE POPULATION IS IN THE NORTHERN PART OF THE COUNTY, WHICH IS WHERE THE OCEAN CITY RESORT AREA IS LOCATED, AS WELL AS THE BERLIN/OCEAN PINES AREA. THE AREA IS A MECCA FOR RETIREES WHO LIVE HERE FULL TIME OR DIVIDE THEIR TIME BETWEEN MARYLAND AND FLORIDA. ETHNICITY IS AS FOLLOWS: WHITE 45,124, BLACK/AF AMER 6,771, AM IND/AK NATIVE 216, ASIAN 921, 2+ RACES 1,138MEDIAN HOUSEHOLD INCOME OF RESIDENTS OF WORCESTER COUNTY $76,689. THE PERCENTAGE OF RESIDENTS BELOW THE POVERTY LEVEL IS 8.4%. THE AVERAGE AGE OF THE RESIDENTS IS BROKEN DOWN AS FOLLOWS: 2023 MALE POPULATION 26,598 2023 FEMALE POPULATION 27,5732023 PERSONS UNDER 5 YEARS 2,1122023 PERSONS UNDER 18 YEARS 9,1552023 PERSONS 65 YEARS AND OLDER 15,709 FY20 50.83% OF THE PATIENTS CARED FOR AT THE HOSPITAL ARE MEDICARE PATIENTS. THE REMAINING PAYOR MIX IS THE FOLLOWING: MEDICAID 12.28%, COMMERCIAL 10.50%, BLUE CROSS 13.71%, MCO 3.78%, SELF PAY 3.48%, DONOR 0.25%, WORKERS COMPT 0.89%, AND OTHER GOVERNMENT PRORGRAMS 4.26%. IN THE WORCESTER COUNTY VITAL STATS 2014, THE AGE-ADJUSTED MORTALITY RATE IS 599/100,000. ACCORDING TO THE WORCESTER COUNTY HEALTH DEPARTMENT 2017 COMMUNITY HEALTH IMPROVEMENT PLAN, PRIORITY AREAS IN THE COUNTY INCLUDE; #1 PROMOTE HEALTHY LIFESTYLES AND PREVENT CHRONIC DISEASE #2 PROMOTE SAFE SCHOOL ENVIRONMENTS AND HEALTHY BEHAVIORS #3 ACCESS TO HEALTH CARE #4 STRENGTHEN BEHAVIORAL HEALTH SERVICES. DURING THE SUMMER MONTHS, THE ORGANIZATION PROVIDES A SIGNIFICANT AMOUNT OF HEALTH CARE SERVICES (PREDOMINANTLY EMERGENCY CARE) TO TOURISTS VISITING THE OCEAN RESORT OF OCEAN CITY, MD. THIS IS RELATED TO THE FACT THAT THE POPULATION OF OCEAN CITY INCREASES BY ABOUT 200,000 EACH YEAR DURING THE TOURIST SEASON. PART VI, LINE 5: THE ORGANIZATION'S GOVERNING BODY IS COMPOSED PRIMARILY OF INDEPENDENT MEMBERS FROM THE ORGANIZATION'S COMMUNITY. IN ADDITION, THE ORGANIZATION'S MEDICAL STAFF IS OPEN TO ALL QUALIFIED PHYSICIANS IN THE COMMUNITY. ALL FINANCIAL SURPLUSES EARNED BY THE ORGANIZATION ARE USED TO ENHANCE THE ORGANIZATION'S PATIENT SERVICES, INCLUDING THROUGH THE UNDERTAKING OF VARIOUS COMMUNITY BENEFIT ACTIVITIES. THE ORGANIZATION UNDERTAKES NUMEROUS ACTIVITIES TO PROMOTE THE HEALTH OF ITS COMMUNITY. IN PARTICULAR, THE ORGANIZATION HAS IDENTIFIED A COMMUNITY NEED FOR ACCESS TO ADDITIONAL PHYSICIANS LOCATED IN THE COMMUNITY. IN ORDER TO MEET THIS IDENTIFIED COMMUNITY NEED, THE ORGANIZATION HAS DIRECTLY EMPLOYED NUMEROUS PHYSICIANS AT A SUBSTANTIAL COST TO THE ORGANIZATION. IN ADDITION, THE ORGANIZATION UNDERTAKES COMMUNITY BUILDING ACTIVITIES TO PROMOTE THE PROGRAMS THE ORGANIZATION OFFERS AND ASSURE THEY ARE REACHING THE TARGETED AUDIENCE. EXAMPLES OF THESE SPECIFIC ACTIVITIES WOULD BE THE SMALL NEIGHBORHOOD-TYPE HEALTH FAIRS IN WHICH WE ARE INVOLVED, AT WHICH EVENTS YOUNG PEOPLE ARE TARGETED AND NEEDS THAT ARE FILLED THROUGH OUR SPEAKERS BUREAU.OTHER INVOLVEMENT IN COMMUNITY BUILDING ACTIVITIES INCLUDE: OUR PARTICIPATION IN THE LOCAL SCHOOL MENTORING PROGRAMS IN WHICH OUR STAFF IS VERY ACTIVE. WE HAVE STUDENTS FROM OUR LOCAL HIGH SCHOOL WHO DO A SHADOWING PROGRAM THROUGHOUT ALL DEPARTMENTS OF OUR HOSPITAL. THIS HELPS THEM IN MAKING A CAREER CHOICE THROUGH EXPOSURE TO DIFFERENT JOBS IN THE HEALTH CARE ARENA.WE HAVE STAFF WHO REPRESENT THE HOSPITAL ON MANY CIVIC BOARDS SUCH AS ALL THE LOCAL AREA CHAMBERS, VARIOUS CIVIC GROUPS, AND THE LOCAL COUNTY SCHOOL BOARD. WE ALSO PARTICIPATE IN THE ACS RELAY FOR LIFE, KOMEN RACE, AND OUT OF THE DARKNESS.WE PROVIDE EMS TRAINING FOR THE LOCAL FIRE COMPANIES, MOST OF WHOM ARE VOLUNTEER STAFFED. WE OFFER AN EXCHANGE PROGRAM OF EQUIPMENT WHICH HELPS THEM WITH TRANSPORTS TO THE EMERGENCY DEPARTMENT.AGH WORKS WITH THE LOCAL FAITH BASED COMMUNITIES BY PROVIDING EDUCATION AND SERVICES TO THEIR CONGREGATIONS. WE HAVE A FAITH BASED MEDICAL HOME GROUP WHICH MEETS WITH CLERGY AND LAY HEALTH AMBASSADORS FROM THEIR HOUSES OF WORSHIP TO FUNNEL THE MESSAGE OF HEALTH AND WELLNESS TO THEIR PEOPLE.ALSO, PART OF OUR COMMUNITY BUILDING PROGRAM INCLUDES OUR PARTICIPATION IN DISASTER PREPAREDNESS. BECAUSE WE ARE GEOGRAPHICALLY LOCATED IN AN AREA OF EXTREME POTENTIAL DISASTER, ONLY 6 MILES FROM THE ATLANTIC OCEAN, WE WOULD BE THE SOURCE OF CARE AND PROTECTION FOR MANY IN THE AREA SHOULD A MAJOR HURRICANE HIT OUR AREA OF COASTLINE. PART OF THE HOSPITAL'S PROVISION FOR THE COMMUNITY IN SUCH A DISASTER WOULD BE TO PROVIDE CLEAN DRINKING WATER FOR THEM; THROUGH THE WATER PURIFICATION SYSTEM WHICH WE PREVIOUSLY PURCHASED AND INSTALLED WE HAVE THE ABILITY TO PROVIDE CLEAN WATER FOR NOT JUST OUR PATIENTS AND STAFF BUT FOR THE COMMUNITY AT LARGE.WE ALSO WORK CLOSELY WITH OUR LOCAL PUBLIC AND PRIVATE SCHOOLS TO OFFER EDUCATION PROGRAMMING. EACH YEAR WE HOST STUDENTS FOR OUR HOSPITAL TOURS. THIS SERVES TO INTRODUCE THEM TO THE SERVICES OF THE HOSPITAL IN HOPES THAT THEIR TRIP FOR SERVICES WILL NOT BE AS FRIGHTENING. MANY OF OUR ASSOCIATES SERVE ON VARIOUS BOARDS OF THE SCHOOL SYSTEM OFFERING OUR EXPERTISE. THROUGH OUR SPEAKER'S BUREAU WE SEND SPEAKERS INTO MANY CLASSROOMS FOR INSTRUCTION. THE INTEGRATED HEALTH LITERACY PROGRAM (IHLP) SERVES APPROXIMATELY 3,500 STUDENTS ACROSS WORCESTER COUNTY. CURRENTLY, THE PROGRAM IS IMPLEMENTED IN GRADES ONE THROUGH EIGHT COUNTY-WIDE. STUDENTS ARE TAUGHT FOUR HEALTH LESSONS THAT ARE INTEGRATED INTO THEIR CORE AREA (MATHEMATICS, SCIENCE, READING LANGUAGE ARTS, AND SOCIAL STUDIES) CURRICULUM. ALL LESSONS IN THE PROGRAM ARE TAUGHT BY CORE AREA CLASSROOM TEACHERS. THE IHLP TEAM EXPANDED THE PROGRAM TO INCLUDE A HIGH SCHOOL SENIOR HEALTH SURVEY. THE SURVEY WILL PROVIDE A BENCHMARK SINCE THOSE STUDENT SURVEYED HAD NOT PARTICIPATED IN THE IHLP. THE SURVEY WILL ENABLE THE IHLP TEAM TO EVALUATE THE IHLP LESSON HEALTH CONCEPTS RETAINED BY STUDENTS AS THEY GRADUATE. THE GOAL OF THE PROGRAM IS TO GRADUATE A HEALTH LITERATE ADULT. SOME ADDITIONAL SERVICES WHICH THE HOSPITAL PROVIDES FOR FREE TO THE COMMUNITY, WHICH PROMOTE HEALTH INCLUDE:1. LIVING WELL PROGRAM - THIS CHRONIC DISEASE SELF MANAGEMENT PROGRAM FROM STANFORD UNIVERSITY TEACHES PEOPLE HOW TO LIVE A BETTER LIFE IN THE MIDST OF THE LIMITATIONS CAUSED BY THEIR CHRONIC CONDITIONS.2. HYPERTENSION CLINICS - BLOOD PRESSURE SCREENINGS IN LOCAL PHARMACIES MONTHLY AS WELL AS AT MANY OTHER MEETINGS AND CONVENTIONS IN THE AREA. THESE HELP RESIDENTS MONITOR THEIR BLOOD PRESSURE AND RELIEVE SOME OVERCROWDING IN PHYSICIAN OFFICES. THIS ALLOWS US THE OPPORTUNITY TO PROVIDE ONE-ON-ONE TEACHING TO INDIVIDUALS.3. HEALTHFAIRS -THE HOSPITAL IS INVOLVED IN SEVERAL LARGE AND SMALL HEALTHFAIR EVENTS IN VARIOUS LOCATIONS THROUGHOUT THE YEAR. ONE SUCH EVENT IS A PARTNERSHIP WITH AARP/TOWN OF OCEAN CITY TO OFFER A FAIR WITH MANY SCREENINGS AND HEALTH INFORMATION. WE ALSO SPONSOR AN EDUCATIONAL AND SCREENING CONFERENCES THROUGHOUT THE YEAR LED BY THE HEALTHY HAPPENINGS COMMITTEE. THIS IS HELD IN VARIOUS LOCATIONS WITHIN OUR SERVICE AREA WHICH ALLOWS US TO PROVIDE FREE SERVICES TO THOSE WHO MIGHT NOT OTHERWISE BE ABLE TO ACCESS HEALTH CARE. WE ALSO PARTNER WITH MANY CHURCHES AND COMMUNITY GROUPS TO OFFER SMALL HEALTH FAIRS.4. WE PROVIDE EDUCATION IN WRITTEN FORM THROUGH LOCAL PUBLICATIONS (NEWSPAPERS AND MAGAZINES) AND OUR OWN ON CALL QUARTERLY PUBLICATION. MANY OF OUR PHYSICIANS PROVIDE ARTICLES FOR THESE.5. WE ALSO HAVE A SPEAKER'S BUREAU WHICH PROVIDES EDUCATIONAL PRESENTATIONS FOR AREA CIVIC GROUPS, BUSINESSES, CHURCHES, SCHOOLS AND CONVENTIONS WHICH ARE HELD IN OUR RESORT AREA.6. WE PROVIDE EDUCATION FOR THE LOCAL SCHOOLS THROUGH OUR HOSPITAL TOUR PROGRAM AND IHLP. THESE PROGRAMS ALLOW US TO SPREAD THE HEALTH MESSAGE AGAINST CHILDHOOD OBESITY TO THE YOUNGER GENERATION. INCLUDING A YOUTH SPEAKERS BUREAU FOR SCHOOL AGE AND ADOLESCENT HEALTH TOPICS.7. BEING IN A BEACH RESORT COMMUNITY THERE ARE MANY SPORTING EVENTS WHICH OCCUR LOCALLY. WE PARTICIPATE IN MANY OF THESE BY PROVIDING FIRST AID ON SITE FOR THOSE IN ATTENDANCE AND THOSE PARTICIPATING IN THE ACTIVITY. PART VI, LINE 6: IN ADDITION TO OPERATING AN ACUTE CARE HOSPITAL THAT PROVIDES A 24 HOUR ER, ATLANTIC GENERAL HOSPITAL EMPLOYS A NETWORK OF PRIMARY CARE AND SPECIALIST PHYSICIANS THAT PROVIDE NEEDED HEALTH CARE SERVICES THROUGHOUT ATLANTIC GENERAL'S COMMUNITY, INCLUDING SERVING SOME OF THE HOSPITAL'S MORE RURAL AREAS. BECAUSE OF THE RURAL NATURE OF THE COMMUNITIES THE HOSPITAL SERVES, TRANSPORTATION FOR HEALTHCARE CAN BE CHALLENGING. BY LOCATING THESE EMPLOYED PHYSICIANS' OFFICES THROUGHOUT THE HOSPITAL'S SERVICE REGION, THE HOSPITAL IS ABLE TO HELP IMPROVE ACCESS TO PHYSICIANS' SERVICES FOR MEMBERS OF THE COMMUNITY. PART VI, LINE 7, REPORTS FILED WITH STATES MD X X 0 0 0 0 0 0 0 0 0 RABINDRA N PAUL PHYSICIAN 599999 0 616450 0 173173 0 7625 0 20448 0 1417695 0 0 0 ALAE ZARIF PHYSICIAN 639423 0 297011 0 142166 0 7625 0 20448 0 1106673 0 0 0 MICHAEL SHOOKER PHYSICIAN 650000 0 365173 0 138 0 7625 0 20467 0 1043403 0 0 0 MARK STRONG PHYSICIAN 452373 0 34004 0 83887 0 7625 0 20219 0 598108 0 0 0 DANIELLE ORR PHYSICIAN 276402 0 250961 0 26889 0 7625 0 0 0 561877 0 0 0 DONALD OWREY PRESIDENT & CEO 284616 0 0 0 63795 0 0 0 9901 0 358312 0 0 0 KIM JUSTICE VICE PRESIDENT PLANNING AND OPERATIO 183992 0 97960 0 15241 0 7409 0 15018 0 319620 0 0 0 CHERYL NOTTINGHAM VICE PRESIDENT OF FINANCE 244357 0 22602 0 974 0 6674 0 12444 0 287051 0 0 0 JONATHAN BAUER VICE PRESIDENT OF INFORMATION SERVIC 208992 0 19330 0 3256 0 5708 0 20219 0 257505 0 0 0 A MHHEFA SERIES A 2017-09-01 7501000 0 0 0 B MHHEFA SERIES B 2017-09-01 20013000 0 0 0 C MAYOR AND COUNCIL OF BERLIN MD 2017-09-01 10000000 0 0 0 A 3422000 7501000 0 0 1 1 B 20013000 402264 5340103 0 0 1 1 C 10000000 127253 8500563 0 0 1 1 A 0 0 0 0 0 0 1 B 0 0 0 0 0 0 1 C 0 0 0 0 0 0 1 A 0 1 0 0 0 0 0 0 1 B 0 1 0 0 0 0 0 0 1 C 0 1 0 0 0 0 0 0 1 A 0 B 0 C 0 FORM 990, PART VI, SECTION B, LINE 11B THE DIRECTOR OF FINANCE COMPILES THE NECESSARY INFORMATION FROM THE ORGANIZATION'S ACCOUNTING RECORDS, INFORMATION RECEIVED FROM THE FOUNDATION, AND INFORMATION RECEIVED FROM THE PATIENT BILLING OFFICE. THE COMPILED INFORMATION IS THEN SENT TO THE ORGANIZATION'S OUTSIDE TAX ACCOUNTANTS TO HELP PREPARE THE FORM 990. A DRAFT OF THE FORM 990 IS THEN REVIEWED BY THE DIRECTOR OF FINANCE, THE CFO, AND THE CEO OF THE ORGANIZATION AND ANY COMMENTS ARE REFLECTED IN A FURTHER REVISED DRAFT. PRIOR TO FILING THE FORM 990, THE LATEST VERSION OF THE FORM 990 IS MADE AVAILABLE TO ALL MEMBERS OF THE BOARD FOR THEIR REVIEW AND COMMENTS. FORM 990, PART VI, SECTION B, LINE 12C IT IS THE POLICY OF ATLANTIC GENERAL HOSPITAL/HEALTH SYSTEM THAT MEMBERS OF THE BOARD OF DIRECTORS, THE HOSPITAL PRESIDENT, AND THE SENIOR LEADERSHIP STAFF WILL BE REQUIRED TO SIGN AN ANNUAL CONFLICT OF INTEREST STATEMENT AND TO ADHERE TO THE CONFLICT OF INTEREST POLICY. THIS WILL BE SIGNED ANNUALLY IN OCTOBER. ALL CANDIDATES FOR BOARD MEMBERSHIP MUST BE ADVISED OF THIS POLICY PRIOR TO THEIR ELECTION TO THE BOARD. FORM 990, PART VI, SECTION B, LINE 15 THE ORGANIZATION UTILIZES A COMPENSATION COMMITTEE, A WRITTEN EMPLOYMENT CONTRACT, A COMPENSTION SURVEY OR STUDY AND AN APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART XI, LINE 9: CHANGE IN FAIR VALUE OF SWAP CONTRACTS 1,621,631. FORM 990, PART XII, LINE 2C: THE PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR.