2024-05-07T07:25:23-05:00 2023-06-30 135565207 KPMG LLP 8350 BROAD STREET SUITE 900 MCLEAN VA 22102 990 2022-07-01 520591607 THE GOOD SAMARITAN HOSPITAL OF MARYLAND INC GOOD 4107726721 5601 LOCH RAVEN BLVD BALTIMORE MD 21239 JOEL BRYAN VP/TREASURER/CIO 4107726721 2024-05-02 1 JOEL BRYAN 999009999 0 SHAWN HUTCHINSON P01048557 7032868000 2024-04-26 2 AAL1 IAL1 2022 2023-04-26 12:10:37Z MEDSTAR GOOD SAMARITAN HOSPITAL BRADLEY CHAMBERS 5601 LOCH RAVEN BLVD BALTIMORE MD 21239 288020735 0 X WWW.GOODSAM-MD.ORG X 1920 MD SEE SCHEDULE OWE ARE GOOD SAMARITANS, GUIDED BY CATHOLIC TRADITION AND TRUSTED TO DELIVER IDEAL HEALTHCARE EXPERIENCES FOR THE PATIENTS WE SERVE. 24 16 1740 45 0 0 5880302 12604961 262933987 272565390 84664 86786 2974322 2763598 271873275 288020735 63427 110126 0 0 153901593 154037923 0 0 0 130851582 132544717 284816602 286692766 -12943327 1327969 188457945 190521931 55777602 33595541 132680343 156926390 X SEE SCHEDULE O 0 0 210437465 110126 261629860 SEE SCHEDULE OMEDSTAR GOOD SAMARITAN'S LARGEST PROGRAM IS ACCESS TO AND THE PROVISION OF ACUTE HOSPITAL SERVICES TO THE COMMUNITIES OF NORTHEASTERN BALTIMORE CITY, MARYLAND AND THE SURROUNDING AREAS. IN ADDITION TO THE PROGRAM SERVICE EXPENSES LISTED ABOVE, MEDSTAR GOOD SAMARITAN INCURRED $49.6M OF MANAGEMENT AND GENERAL EXPENSES IN PROVIDING SERVICES TO ITS COMMUNITIES. MEDSTAR GOOD SAMARITAN IS A JOINT COMMISSION ACCREDITED ACUTE CARE COMMUNITY HOSPITAL LOCATED IN THE NORTHEAST SECTION OF BALTIMORE CITY, MARYLAND. THE HOSPITAL OFFERS THE LATEST IN CLINICAL SERVICES IN CANCER CARE, WOUND HEALING AND HYPERBARIC MEDICINE, GERIATRICS AND COLLABORATIVE CARE PROGRAM WITH FOOD RX FOR THE MANAGEMENT OF CHRONIC ILLNESSES. MEDSTAR GOOD SAMARITAN HOSPITAL IS ACCREDITED BY THE JOINT COMMISSION (TJC) AND HAS ALSO RECEIVED ADVANCED CERTIFICATION IN INPATIENT REHABILITATION FOR AMPUTATION AND STROKE AND IS DESIGNATED AS A PRIMARY STROKE CENTER. THE AMERICAN HEART ASSOCIATION AND AMERICAN STROKE ASSOCIATION HONORED MEDSTAR GOOD SAMARITAN HOSPITAL WITH THE 2022 GET WITH THE GUIDELINES - STROKE GOLD PLUS; TARGET STROKE HONOR ROLL; TARGET TYPE 2 DIABETES HONOR ROLL AWARDS FOR HIGH-QUALITY CARE. MEDSTAR GOOD SAMARITAN RECEIVED A 4-STAR RATING FROM THE CENTER FOR MEDICARE AND MEDICAID SERVICES (CMS). MEDSTAR GOOD SAMARITAN AND MEDSTAR UNION MEMORIAL HOSPITAL WERE THE ONLY MEDSTAR HEALTH HOSPITALS TO EARN 4 STARS FOR QUALITY AND SAFETY. 18669793 10935530 MEDSTAR GOOD SAMARITAN PROVIDED $18.7M IN SUBSIDIZED (MISSION DRIVEN) HEALTH SERVICES IN FISCAL YEAR 2023. THESE CRITICAL SERVICES, WHICH ARE DRIVEN BY COMMUNITY NEEDS, OPERATE AT A LOSS. THEY ADDRESS PRIORITIES PRIMARILY THROUGH DISEASE PREVENTION AND IMPROVEMENT OF HEALTH STATUS. SERVICE INCLUDES EMERGENCY MEDICINE, PRIMARY CARE, WOMEN'S AND CHILDREN'S CARE, PALLIATIVE CARE AND BEHAVIORAL HEALTH. 8002476 MEDSTAR GOOD SAMARITAN PROVIDED $8M IN CHARITY CARE SERVICES IN FISCAL YEAR 2023. CHARITY CARE IS PROVIDED PURSUANT TO MEDSTAR HEALTH'S FINANCIAL ASSISTANCE POLICY TO MEMBERS OF THE COMMUNITY WHOSE INCOME IS BELOW CERTAIN THRESHOLDS AND FOR WHICH THE HOSPITAL IS NOT COMPENSATED. UNDER MARYLAND'S UNIQUE PAYER SYSTEM, THE AMOUNT REPORTED REPRESENTS MEDSTAR GOOD SAMARITAN'S CHARITY CARE EXPENSE AND REVENUES REPRESENT DIRECT PAYMENTS FROM THE STATE'S CHARITY CARE POOL. OTHER CHARITY CARE EXPENSES ARE INDIRECTLY REIMBURSED VIA THE STATE OF MARYLAND'S PAYMENT SYSTEM. 237109734 1 1 0 0 0 0 0 0 0 0 1 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 0 1 0 0 1740 1 0 0 0 0 0 0 0 0 0 0 1 0 X 24 16 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 MD X JOEL BRYAN 4107726721 10980 GRANTCHESTER WAY COLUMBIA MD 21044 BRADLEY CHAMBERS PRESIDENT/DIRECTOR 20.00 20.00 X X 815018 815018 57000 ELIAS K SHAYA MD DIRECTOR 20.00 20.00 X 232242 232242 10735 SHAMS T QUAZI MD DIRECTOR 20.00 20.00 X 267589 267589 29627 DANIEL P CAHILL CHAIR 1.00 0.00 X X 0 0 0 BISHOP DENIS J MADDEN DIRECTOR 1.00 0.00 X 0 0 0 PAUL CONNELLY DIRECTOR (AS OF 9/2022) 1.00 0.00 X 0 0 0 KATHLEEN DYER DIRECTOR 1.00 0.00 X 0 0 0 SAMER S NAJJAR MD DIRECTOR (AS OF 3/2023) 1.00 0.00 X 0 694323 29593 ANTHONY READ DIRECTOR 1.00 0.00 X 0 0 0 LEO E GALLAGHER JR DIRECTOR 1.00 0.00 X 0 0 0 VERONICA COOL DIRECTOR 1.00 0.00 X 0 0 0 KIM D SYDNOR PHD DIRECTOR 1.00 0.00 X 0 0 0 HOLLY TILFORD DIRECTOR 1.00 0.00 X 0 0 0 MAHSA MOHEBTASH MD DIRECTOR (AS OF 4/2023) 39.00 1.00 X 700091 0 10038 DAWN M MOTOVIDLAK VICE CHAIR 1.00 0.00 X X 0 0 0 MESFIN A LEMMA MD DIRECTOR (UNTIL 3/2023) 1.00 39.00 X 0 905971 10803 REBECCA E PEARCE DIRECTOR 1.00 0.00 X 0 0 0 JEFFREY R ELKIN DIRECTOR 1.00 0.00 X 0 0 0 PAUL SACK MD DIRECTOR (AS OF 7/2022) 1.00 39.00 X 0 320518 33311 JUDITH A FEUSTLE DIRECTOR 1.00 0.00 X 0 0 0 ZEENA DORAI MD DIRECTOR 1.00 39.00 X 0 1370476 18778 DAVID ZACHARY MARTIN MD DIRECTOR 39.00 1.00 X 1550974 0 29932 KENNETH A SAMET DIRECTOR 1.00 39.00 X 0 5361626 97941 MICHAEL RANDOLPH MD DIRECTOR 1.00 0.00 X 0 0 0 DAVID NORRIS WILLIS DIRECTOR 1.00 0.00 X 0 0 0 DEANA STOUT TREASURER/CFO 39.00 1.00 X 535082 0 51916 YOLANDA BROOKS ASSISTANT SECRETARY 1.00 39.00 X 0 82606 8876 MICHAEL JACOBS MD PHYSICIAN 40.00 0.00 X 831274 0 36488 DIWAKAR PRADHAN MD PHYSICIAN 40.00 0.00 X 357879 0 18438 BERNARD RAVITZ MD PHYSICIAN 40.00 0.00 X 289005 0 9981 BRIAN CAWLEY SENIOR VP, OPERATIONS 1.00 39.00 X 0 369601 29845 LEILA IGNACIO-MACALE CLINICAL DOCUMENTATION SPECIALIST 40.00 0.00 X 279005 0 14153 GEORGE HENNAWI MD FORMER DIRECTOR 39.00 1.00 X 384577 0 33325 ESKANDAR YAZAJI MD FORMER DIR., AND VP, MED. AFFAIRS 20.00 20.00 X 193945 193945 29738 STUART BELL MD FORMER VP, MEDICAL AFFAIRS 1.00 39.00 X 0 324036 36345 6436681 10937951 596863 228 1 1 0 AMN HEALTHCARE INC 2735 COLLECTION CENTER DR CHICAGO IL 60693 STAFFING SERVICES 10844355 AYA HEALTHCARE INC PO BOX 123519 DEPT 3519 DALLAS TX 753123519 STAFFING SERVICES 7662254 MEDICAL SOLUTIONS LLC PO BOX 850737 MINNEAPOLIS MN 554850737 STAFFING SERVICES 2077987 DVA RENAL HEALTHCARE INC PO BOX 781607 PHILADELPHIA PA 191781607 MEDICAL SERVICES 1738544 CROTHALL SVCS GROUP 13028 COLLECTIONS CENTER DRIVE CHICAGO IL 60693 FACILITIES SERVICES 908349 21 7533518 5071443 2522 12604961 NET PATIENT SERVICE RE 621400 262607132 262607132 PHARMACY INCOME 900099 9958258 9958258 272565390 57380 57380 543707 0 543707 543707 543707 24290 5116 0 0 24290 5116 29406 29406 REBATE INCOME 900099 384505 384505 CHILD DAY CARE 900099 47890 47890 1787496 1787496 2219891 288020735 272565390 0 2850384 X 107626 107626 2500 2500 4261744 3921677 340067 641585 641585 123643059 113708659 9934400 1745252 1605632 139620 15711192 14524057 1187135 8035091 7317796 717295 27280717 17200 27263517 38988 38988 42694708 38388177 4306531 196489 6400 190089 2082310 1408991 673319 614661 75775 538886 81546 71283 10263 28612 26901 1711 1844610 1844610 11888156 11888156 1998745 1512050 486695 MED/SURG SUPPLIES 23707000 23720181 -13181 MAINTENANCE 5714310 5375721 338589 UTILITIES 3361910 3078954 282956 FOOD SERVICES/SUPPLIES 2670372 2530033 140339 8341583 5335770 3005813 286692766 237109734 49583032 0 4001 12531 35077556 31932873 2891168 2515050 398763 375381 303700648 236927443 68506301 66773205 1727026 2387728 79853130 86525163 188457945 190521931 17496594 17006735 1668083 959913 36612925 15628893 55777602 33595541 X 62564335 77826033 70116008 79100357 132680343 156926390 188457945 190521931 X 1327969 164536 22753092 X X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 107504119 72396781 35107338 1207989 767220 440769 184654114 160460747 24193367 10334426 3302695 7031731 66773205 OPERATING LEASE ROU ASSET 1562673 INTERCOMPANY RECEIVABLES 9185178 OTHER ASSETS 75777312 86525163 ADVANCES FROM 3RD PARTY PAYORS 5198433 ASBESTOS ABATEMENT LIABILITY 3049315 OPERATING LEASE LIABILITY 1900234 WORKERS COMPENSATION 2760296 CREDIT BALANCE PATIENT A/R 1585958 OTHER LIABILITIES 1134657 15628893 X PART X, LINE 2: FIN 48 FOOTNOTE 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 THE 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, 2023. 1 1 X 1 X 1 X 1 1 1 0 1 1 8002476 8002476 0.02790 8002476 8002476 0.02790 2117451 182523 1934928 0.00670 5452116 5452116 0.01900 18669793 10935530 7734263 0.02700 128577 128577 0.00040 26367937 11118053 15249884 0.05310 34370413 11118053 23252360 0.08100 55626 55626 0.00020 18302 18302 0.00010 33176 33176 0.00010 78518 78518 0.00030 185622 185622 0.00070 1 4316647 X 1 1 1 1 GOOD SAMARITAN HOSPITAL OF MARYLAND 5601 LOCH RAVEN BLVD BALTIMORE MD 21239 X X X X GOOD SAMARITAN HOSPITAL OF MARYLAND 1 0 0 1 X X X X X X X X X 20 1 0 0 1 X WWW.GOODSAM-MD.ORG X 1 20 1 WWW.GOODSAM-MD.ORG 0 1 X 200.000000000000 400.000000000000 X X X X X X 1 1 X X X X 1 X WWW.GOODSAM-MD.ORG X WWW.GOODSAM-MD.ORG X WWW.GOODSAM-MD.ORG X X X X X X 1 X 0 X X X 1 X 0 0 GOOD SAMARITAN HOSPITAL OF MARYLAND PART V, SECTION B, LINE 5: CHNA INPUTHOSPITAL LEADROLE DESCRIPTIONTHE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) HOSPITAL LEAD SERVES AS THE COORDINATOR OF ALL ASPECTS OF THE COMMUNITY HEALTH ASSESSMENT PROCESS. HE/SHE HELPS ESTABLISH AND COORDINATE THE ACTIVITIES OF THE ADVISORY TASK FORCE. THE LEAD ALSO HELPS PRODUCE THE HOSPITAL'S COMMUNITY HEALTH NEEDS ASSESSMENT AND IMPLEMENTATION STRATEGY. HE/SHE WORKS COLLABORATIVELY WITH REPRESENTATIVES FROM THE CORPORATE COMMUNITY HEALTH DEPARTMENT AND GEORGETOWN UNIVERSITY. THE LEAD ALSO WORKS CLOSELY WITH THE WRITER. HE/SHE REVIEWS ALL NARRATIVES PRIOR TO PUBLICATION.NAME OF HOSPITAL LEAD: TRICIA ISENNOCK, RNEXECUTIVE SPONSORROLE DESCRIPTIONTHE EXECUTIVE SPONSOR SERVES AS THE CONDUIT BETWEEN THE ADVISORY TASK FORCE AND THE SENIOR MANAGEMENT TEAM. THE SPONSOR IS AN ACTIVE PARTICIPANT OF THE ADVISORY TASK FORCE AND HE/SHE COMMUNICATES THE HOSPITAL'S CLINICAL STRENGTHS AND PROGRAM PRIORITIES TO DIVERSE AUDIENCES.NAME OF EXECUTIVE SPONSOR: BRAD CHAMBERSADVISORY TASK FORCEROLE DESCRIPTIONTHE ADVISORY TASK FORCE (ATF) REVIEWS PRIMARY/SECONDARY DATA AND LOCAL/STATE/FEDERAL COMMUNITY HEALTH GOALS. BASED ON FINDINGS, THE ATF PROVIDES INPUT INTO THE HOSPITAL'S THREE-YEAR IMPLEMENTATION STRATEGY. AS AMBASSADORS FOR THE CHNA PROCESS, THE ATF MEMBERS SUPPORT EFFORTS TO OPTIMIZE COMMUNITY PARTICIPATION. NOTE: THE ATF SHOULD BE A COMBINATION OF COMMUNITY REPRESENTATIVES AND STAFF. COMMUNITY REPRESENTATIVES SHOULD MAKEUP AT LEAST 50% OF TOTAL PARTICIPANTS.NAME : BRAD CHAMBERS TITLE/AFFILIATION WITH HOSPITAL : PRESIDENT, MGSH AND MUMHNAME OF ORGANIZATION : MEDSTAR HEALTHNAME : DAWN MOTOVIDLAK TITLE/AFFILIATION WITH HOSPITAL : PRESIDENT, CEO (MGSH AND MUMH BOARD MEMBER, VICE CHAIR)NAME OF ORGANIZATION : BHSNAME : DAN CAHILLTITLE/AFFILIATION WITH HOSPITAL : SENIOR VP SALES (MGSH AND MUMH BOARD MEMBER, CHAIR)NAME OF ORGANIZATION : WEBB MASONNAME : VERONICA COOLTITLE/AFFILIATION WITH HOSPITAL : MANAGING DIRECTOR (MGSH AND MUMH BOARD MEMBER)NAME OF ORGANIZATION : COOL ASSOCIATES, LLCNAME : KIM SYDNOR, PHD TITLE/AFFILIATION WITH HOSPITAL : DEAN (MGSH AND MUMH BOARD MEMBER)NAME OF ORGANIZATION : MORGAN STATE UNIVERSITYNAME : TRICIA ISENNOCK TITLE/AFFILIATION WITH HOSPITAL : RN REGIONAL DIRECTOR POPULATION AND COMMUNITY HEALTHNAME OF ORGANIZATION : MEDSTAR HEALTHNAME : RITU PRASAD, M.D. TITLE/AFFILIATION WITH HOSPITAL : PHYSICIAN ADVISOR, MUMHNAME OF ORGANIZATION : MEDSTAR HEALTHNAME : DANA FRANK, M.D.TITLE/AFFILIATION WITH HOSPITAL : CHAIRMAN, MEDICINE, MGSH/MUMHNAME OF ORGANIZATION : MEDSTAR HEALTHNAME : KEN WALSCH TITLE/AFFILIATION WITH HOSPITAL : ASSISTANT VICE PRESIDENT, QUALITY, SAFETY, RISK MANAGEMENT NAME OF ORGANIZATION : MEDSTAR HEALTHNAME : JOAN CARLSON TITLE/AFFILIATION WITH HOSPITAL : AVP, MISSION INTEGRATION, MGSHNAME OF ORGANIZATION : MEDSTAR HEALTHNAME : DEBORAH BANGLEDORF TITLE/AFFILIATION WITH HOSPITAL : DIRECTOR, MARKETING AND COMMUNICATIONS NAME OF ORGANIZATION : MEDSTAR HEALTHNAME : APRIL BESSLING TITLE/AFFILIATION WITH HOSPITAL : DIRECTOR, CASE MANAGEMENT NAME OF ORGANIZATION : MEDSTAR HEALTHNAME : DIANE MCELVERSONTITLE/AFFILIATION WITH HOSPITAL : J VAN STORY BRANCH COMMUNITY HOUSING PARTNERSNAME OF ORGANIZATION : J VAN STORY BRANCH/ COMMUNITY HOUSING PARTNERSNAME : ELISE BOWMANTITLE/AFFILIATION WITH HOSPITAL : DIRECTOR, ACCOUNTABLE HEALTH COMMUNITIESNAME OF ORGANIZATION : BALTIMORE CITY HEALTH DEPARTMENTNAME : PEGGY THOMAS TITLE/AFFILIATION WITH HOSPITAL : COMMUNITY RESIDENTNAME OF ORGANIZATION : COMMUNITY RESIDENTNAME : SHEILA WILLIAMS TITLE/AFFILIATION WITH HOSPITAL : PARISHIONER, HUBER MEMORIAL CHURCHNAME OF ORGANIZATION : COMMUNITY RESIDENTNAME : EVANGELINE WAIHENYA TITLE/AFFILIATION WITH HOSPITAL : PARISHIONER, ST. MATTHEW'S CHURCHNAME OF ORGANIZATION : COMMUNITY RESIDENTNAME : ASHLEY WILKESTITLE/AFFILIATION WITH HOSPITAL : EXECUTIVE DIRECTORNAME OF ORGANIZATION : HAMPDEN FAMILY CENTERNAME : SUSAN BENDERTITLE/AFFILIATION WITH HOSPITAL : COONAME OF ORGANIZATION : KESWICK - MARYLANDNAME : NICHOLE BATTLE TITLE/AFFILIATION WITH HOSPITAL : CEO NAME OF ORGANIZATION : GEDCONAME : RANDOLPH ROWEL TITLE/AFFILIATION WITH HOSPITAL : ASSOCIATE PROFESSOR, CHAIR OF DEPARTMENT OF BEHAVIORAL HEALTH SCIENCES NAME OF ORGANIZATION : MORGAN STATE UNIVERSITYNAME : SONIA FIERRO-LUPERINI TITLE/AFFILIATION WITH HOSPITAL : COMMUNITY RESIDENTNAME OF ORGANIZATION : SPANISH SPEAKING HEALTH LEADERS OF MARYLANDNAME : ISHAAN PATHAKTITLE/AFFILIATION WITH HOSPITAL : COMMUNITY PROGRAM MANAGERNAME OF ORGANIZATION : CENTRAL BALTIMORE PARTNERSHIPNAME : MARK FLETCHERTITLE/AFFILIATION WITH HOSPITAL : BALTIMORE CITY EMSNAME OF ORGANIZATION : BALTIMORE CITY NAME : MELVIN WILSON TITLE/AFFILIATION WITH HOSPITAL : EXECUTIVE DIRECTOR NAME OF ORGANIZATION : TURNAROUND TUESDAYNAME : ELLEN RAPPAPORTTITLE/AFFILIATION WITH HOSPITAL : POPULATION HEALTH DIRECTORNAME OF ORGANIZATION : HCAMNAME : ADONGO MATTHEWSTITLE/AFFILIATION WITH HOSPITAL : EXECUTIVE DIRECTORNAME OF ORGANIZATION : SHEPHERD'S CLINICNAME : MATT SMITHTITLE/AFFILIATION WITH HOSPITAL : EXECUTIVE DIRECTORNAME OF ORGANIZATION : WAVERLY MAIN STREETNAME : LISA JONESTITLE/AFFILIATION WITH HOSPITAL : COMMUNITY MEDIATION DIRECTORNAME OF ORGANIZATION : WOODBOURNE MCCABE SAFE STREETSNAME : PAT JONESTITLE/AFFILIATION WITH HOSPITAL : DIRECTOR, IMMIGRATION OUTREACH SERVICE CENTERNAME OF ORGANIZATION : ST. MATTHEW'S CHURCHNAME : HEATHER WILSONTITLE/AFFILIATION WITH HOSPITAL : VICE PRESIDENT, OPERATIONSNAME OF ORGANIZATION : Y OF CENTRAL MDNAME : JENNIFER SIEGELTITLE/AFFILIATION WITH HOSPITAL : HOSPITAL COUNSELNAME OF ORGANIZATION : MEDSTAR HEALTHNAME : LUCAS CARLSON, M.D.TITLE/AFFILIATION WITH HOSPITAL : MEDICAL DIRECTOR, COMMUNITY AND POPULATION HEALTH - BALTIMORENAME OF ORGANIZATION : MEDSTAR HEALTHNAME : ASHLEY FUNKTITLE/AFFILIATION WITH HOSPITAL : SR. EXEC. DIRECTORNAME OF ORGANIZATION : THE Y IN CENTRAL MDNAME : MILLER J ROBERTSTITLE/AFFILIATION WITH HOSPITAL : REVITALIZATION DIRECTORNAME OF ORGANIZATION : GREENMOUNT CORRIDORNAME : JEFFREY GRIFFINTITLE/AFFILIATION WITH HOSPITAL : EXEC. DIRECTORNAME OF ORGANIZATION : FRANCISCAN CENTERNAME : KIMBERLY LYLESTITLE/AFFILIATION WITH HOSPITAL : SENIOR DIRECTORNAME OF ORGANIZATION : HCAMNAME : LYNAIA JORDANTITLE/AFFILIATION WITH HOSPITAL : DIRECTORNAME OF ORGANIZATION : GEDCONAME : HARVEY MILESTITLE/AFFILIATION WITH HOSPITAL : COMMUNITY SCHOOL COORDINATORNAME OF ORGANIZATION : GARDENVILLE ELEMENTARY SCHOOLNAME : MARCHELLE ADAMSTITLE/AFFILIATION WITH HOSPITAL : CASE MANAGERNAME OF ORGANIZATION : HAMPDEN FAMILY CENTERNAME : ANGIE WINDERSTITLE/AFFILIATION WITH HOSPITAL : PRESIDENTNAME OF ORGANIZATION : NECONAME : DIANA QUINNTITLE/AFFILIATION WITH HOSPITAL : COMMUNITY HEALTH SYSTEM MGR.NAME OF ORGANIZATION : MEDSTAR HEALTHNAME : KRIS COWPERTHWAITETITLE/AFFILIATION WITH HOSPITAL : PHYSICIAN ADVISORNAME OF ORGANIZATION : MEDSTAR HEALTHNAME : STUART BELL, M.D.TITLE/AFFILIATION WITH HOSPITAL : FORMER VP MEDICAL AFFAIRSNAME OF ORGANIZATION : MEDSTAR GOOD SAMARITAN/UNION MEMORIAL HOSPITALSNAME : KIMBERLY FLOYDTITLE/AFFILIATION WITH HOSPITAL : RN PROGRAM MANAGERNAME OF ORGANIZATION : MEDSTAR GOOD SAMARITAN/UNION MEMORIAL HOSPITALSNAME : PHYLLIS GRAYTITLE/AFFILIATION WITH HOSPITAL : AVP CARE TRANSFORMATIONNAME OF ORGANIZATION : MEDSTAR HEALTH - BALTIMORE GOOD SAMARITAN HOSPITAL OF MARYLAND PART V, SECTION B, LINE 11: IMPLEMENTATION STRATEGYTHE IMPLEMENTATION STRATEGIES SERVE AS A ROADMAP FOR HOW COMMUNITY BENEFIT RESOURCES WILL BE ALLOCATED AND DEPLOYED. MEDSTAR'S HOSPITALS WILL BE ABLE TO MEASURE OUR CONTRIBUTION TO IMPROVING THE HEALTH OF UNDERSERVED AND VULNERABLE POPULATIONS IN THE REGIONS WE SERVE. THREE-YEAR IMPLEMENTATION STRATEGIES WITH MEASURABLE OBJECTIVES WERE DEVELOPED FOR EACH HOSPITAL'S COMMUNITY BENEFIT SERVICE AREA - A SPECIFIC COMMUNITY OR TARGET POPULATION OF FOCUS. PRIORITIES WERE BASED ON COMMUNITY NEED AS DETERMINED BY QUANTITATIVE DATA AND COMMUNITY INPUT, AS WELL AS ON HOSPITAL EXPERTISE, RESOURCES, STRENGTHS OF EXISTING PROGRAMMING AND PARTNERSHIPS, AND ALIGNMENT WITH NATIONAL, STATE, AND LOCAL HEALTH GOALS. THE MEDSTAR HEALTH CORPORATE COMMUNITY HEALTH DEPARTMENT WILL PROVIDE SYSTEM-WIDE COORDINATION AND OVERSIGHT OF COMMUNITY BENEFIT PROGRAMMING.HOSPITAL ADVISORY TASK FORCES CONVENE AT LEAST ANNUALLY TO MONITOR PROGRESS OF STRATEGY EXECUTION AND TO PROVIDE ONGOING RECOMMENDATIONS RELATED TO OUTCOMES ACHIEVEMENT, PROGRAM DEVELOPMENT, PARTNERSHIP APPROACHES, AND OVERALL IMPLEMENTATION IMPROVEMENT. FOR SIGNIFICANT NEEDS IDENTIFIED IN THE CHNA THAT THE HOSPITAL HAS NOT PRIORITIZED AS FOCUS AREAS THROUGH ITS IMPLEMENTATION STRATEGY, THESE NEEDS WILL BE ADDRESSED BY COLLABORATING WITH OTHER LEADING ORGANIZATIONS, AND BY TAKING A SUPPORTER ROLE ON IDENTIFIED NEEDS THAT ARE BEYOND THE SCOPE OF THE HOSPITAL'S STRENGTHS. CHARITY CARE AT COST PART I, LINE 7AMARYLAND'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. UNREIMBURSED MEDICAID PART I, LINE 7BMARYLAND'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. BAD DEBT PART III, LINES 2 & 4MEDSTAR HEALTH AND ITS AFFILIATED ORGANIZATIONS REPORT BAD DEBT EXPENSE IN ACCORDANCE WITH ASU 2011-07, WHICH REQUIRES CERTAIN HEALTHCARE ENTITIES TO CHANGE THE PRESENTATION OF THEIR STATEMENT OF OPERATIONS BY RECLASSIFYING THE PROVISION FOR BAD DEBTS ASSOCIATED WITH PATIENT SERVICE REVENUE FROM AN OPERATING EXPENSE TO A DEDUCTION FROM PATIENT SERVICE REVENUE (NET OF CONTRACTUAL ALLOWANCES AND DISCOUNTS). 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. MEDICARE PART III, LINE 8MARYLAND'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. NEEDS ASSESSMENT PART VI, LINE 2IN FY21, MEDSTAR GOOD SAMARITAN HOSPITAL (MGSH) CONDUCTED A COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) IN ACCORDANCE WITH THE GUIDELINES ESTABLISHED BY THE PATIENT PROTECTION AND AFFORDABLE CARE ACT AND THE INTERNAL REVENUE SERVICE. THE HOSPITAL'S CHNA AND THREE-YEAR IMPLEMENTATION STRATEGIES WERE ENDORSED BY MGSH'S BOARD OF DIRECTORS AND APPROVED BY THE MEDSTAR HEALTH BOARD OF DIRECTORS. THE DOCUMENT BECAME AVAILABLE ON THE HOSPITAL'S WEBSITE ON JUNE 30, 2021 AND WILL GUIDE PROGRAMMING PRIORITIES IN FISCAL YEARS 2022-2024.THE CATEGORIES HEALTH AND WELLNESS, ACCESS TO CARE AND SOCIAL DETERMINANTS OF HEALTH WERE USED TO DETERMINE WHAT PROGRAMMING TO PRIORITIZE FOR THE CHNA. TWO TO THREE STRATEGIES IN EACH CATEGORY WERE SELECTED AS PRIORITIES DUE TO THE SIZE AND SCALE OF IMPACT AND MEASURABLE OUTCOMES. ALL OTHER PROGRAMMING WAS INTEGRATED AS PART OF THE HOSPITAL'S OVERALL COMMUNITY HEALTH PORTFOLIO. THESE ADDITIONAL PROGRAMS WERE CAPTURED IN THE INVENTORY FOR THE WHOLE PICTURE OF CONTRIBUTING TO THE HEALTH OF THE COMMUNITIES SERVED AS WELL AS SORTED FOR WHAT COUNTS AS COMMUNITY BENEFIT FOR REGULATORY REPORTING.THE HOSPITAL'S COMMUNITY BENEFIT SERVICE AREA (CBSA) IS BASED ON THE ADVISORY TASK FORCE (ATF) RECOMMENDATION. THE HOSPITAL IDENTIFIED ZIP CODES 21206 AND 21239 AS ITS CBSA. THE HOSPITAL SELECTED THIS GEOGRAPHIC AREA BASED ON HOSPITAL UTILIZATION DATA AND SECONDARY PUBLIC HEALTH DATA AS WELL AS ITS PROXIMITY TO THE HOSPITAL. THE ATF INCLUDED A DIVERSE GROUP OF INDIVIDUALS, INCLUDING HOSPITAL LEADERS, GRASSROOTS ACTIVISTS, COMMUNITY RESIDENTS, FAITH-BASED LEADERS, HOSPITAL REPRESENTATIVES, PUBLIC HEALTH LEADERS AND OTHER STAKEHOLDER ORGANIZATIONS, SUCH AS REPRESENTATIVES FROM LOCAL HEALTH DEPARTMENTS.HEALTH PRIORITIES FOR THE CBSA INCLUDE HEALTH AND WELLNESS (CHRONIC DISEASE PREVENTION AND MANAGEMENT, BEHAVIORAL HEALTH AND AGING AND OLDER ADULT HEALTH), ACCESS TO HEALTH CARE SERVICES (TRANSPORTATION AND ACCESS TO AFFORDABLE HEALTH CARE AND INSURANCE) AND SOCIAL DETERMINANTS OF HEALTH (EMPLOYMENT, FOOD INSECURITY AND NEIGHBORHOOD SAFETY AND COMMUNITY VIOLENCE). AS A PROUD MEMBER OF MEDSTAR HEALTH, REPRESENTATIVES FROM THE HOSPITAL ROUTINELY PARTICIPATE IN THE MEDSTAR HEALTH COMMUNITY HEALTH WORKGROUP. THE WORKGROUP IS COMPRISED OF COMMUNITY HEALTH PROFESSIONALS WHO REPRESENT ALL TEN 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. PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE PART VI, LINE 3AS ONE OF THE REGION'S LEADING NOT-FOR-PROFIT HEALTHCARE SYSTEMS, MEDSTAR HEALTH IS COMMITTED TO ENSURING THAT UNINSURED AND UNDERINSURED PATIENTS MEETING ELIGIBILITY CRITERIA, AND PATIENTS DETERMINED ELIGIBLE FOR PRESUMPTIVE ELIGIBILITY WITHIN THE COMMUNITIES WE SERVE WHO LACK FINANCIAL RESOURCES HAVE ACCESS TO MEDICALLY NECESSARY HOSPITAL SERVICES. MEDSTAR HEALTH HOSPITALS AND HOSPITAL BASED-PHYSICIAN PRACTICES WILL:- TREAT ALL PATIENTS EQUITABLY, WITH DIGNITY, RESPECT, AND COMPASSION.- SERVE THE EMERGENCY HEALTH CARE NEEDS OF EVERYONE WHO PRESENTS TO OUR MEDSTAR HEALTH HOSPITALS AND HOSPITAL-BASED PHYSICIAN PRACTICES REGARDLESS OF A PATIENT'S ABILITY TO PAY FOR CARE.- ASSIST THOSE PATIENTS WHO ARE ADMITTED THROUGH OUR ADMISSION PROCESS FOR NON-URGENT, MEDICALLY NECESSARY CARE WHO CANNOT PAY FOR 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 HOSPITALS AND HOSPITAL-BASED PHYSICIAN PRACTICES WILL WORK WITH THEIR PATIENTS SEEKING EMERGENCY AND MEDICALLY NECESSARY CARE TO GAIN AN UNDERSTANDING OF EACH PATIENT'S FINANCIAL RESOURCES. BASED ON THIS INFORMATION, MEDSTAR HEALTH HOSPITALS AND HOSPITAL-BASED PHYSICIAN PRACTICES WILL MAKE ELIGIBILITY DETERMINATIONS FOR FINANCIAL ASSISTANCE FOR PATIENTS WHO RESIDE WITHIN THE COMMUNITIES THAT WE SERVE. IN DETERMINING ELIGIBILITY FOR FINANCIAL ASSISTANCE, MEDSTAR HEALTH HOSPITALS AND HOSPITAL-BASED PHYSICIAN PRACTICES WILL: - DETERMINE WHETHER THE PATIENT HAS HEALTH INSURANCE. - DETERMINE WHETHER THE PATIENT IS PRESUMPTIVELY ELIGIBLE FOR FREE OR REDUCED-COST CARE. - DETERMINE WHETHER UNINSURED PATIENTS ARE ELIGIBLE FOR PUBLIC OR PRIVATE HEALTH INSURANCE. - TO THE EXTENT POSSIBLE, OFFER ASSISTANCE TO UNINSURED PATIENTS IF THE PATIENT CHOOSES TO APPLY FOR PUBLIC OR PRIVATE HEALTH INSURANCE. - USE INFORMATION IN THE POSSESSION OF THE HOSPITAL, IF AVAILABLE, TO DETERMINE WHETHER THE PATIENT IS QUALIFIED FOR FREE OR REDUCED-COST CARE UNDER THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY.- TO THE EXTENT PRACTICABLE, DETERMINE WHETHER THE PATIENT IS ELIGIBLE FOR OTHER PUBLIC PROGRAMS THAT MAY ASSIST WITH HEALTH CARE COSTS.MEDSTAR HEALTH WILL WIDELY PUBLICIZE THE MEDSTAR FINANCIAL ASSISTANCE POLICY BY:- PROVIDING ACCESS TO THE MEDSTAR FINANCIAL ASSISTANCE POLICY, FINANCIAL ASSISTANCE APPLICATIONS, AND MEDSTAR PATIENT INFORMATION SHEET ON ALL HOSPITAL WEBSITES AND PATIENT PORTALS.- PROVIDING HARD COPIES OF THE MEDSTAR FINANCIAL ASSISTANCE POLICY, MEDSTAR UNIFORM FINANCIAL ASSISTANCE APPLICATION, AND MEDSTAR PATIENT INFORMATION SHEET TO PATIENTS UPON REQUEST.- PROVIDING HARD COPIES OF THE MEDSTAR FINANCIAL ASSISTANCE POLICY, MEDSTAR UNIFORM FINANCIAL ASSISTANCE APPLICATION, AND MEDSTAR PATIENT INFORMATION SHEET TO PATIENTS UPON REQUEST BY MAIL AND WITHOUT CHARGE.- PROVIDING NOTIFICATION AND INFORMATION ABOUT THE MEDSTAR FINANCIAL ASSISTANCE POLICY BY: . OFFERING COPIES AS PART OF ALL REGISTRATION OR DISCHARGES PROCESSES, AND ANSWERING QUESTIONS ON HOW TO APPLY FOR ASSISTANCE. . PROVIDING WRITTEN NOTICES ON BILLING STATEMENTS. . DISPLAYING MEDSTAR FINANCIAL ASSISTANCE POLICY INFORMATION AT ALL HOSPITAL REGISTRATION POINTS, INCLUDING THE BUSINESS OFFICE, INFORMING PATIENTS OF THEIR RIGHTS TO APPLY FOR FINANCIAL ASSISTANCE AND WHO TO CONTACT AT THE HOSPITAL FOR ADDITIONAL INFORMATION. . TRANSLATING THE MEDSTAR FINANCIAL ASSISTANCE POLICY, MEDSTAR UNIFORM FINANCIAL ASSISTANCE APPLICATION, AND THE MEDSTAR PATIENT INFORMATION SHEET INTO PRIMARY LANGUAGES THAT CONSTITUTE THE LESSER OF 1000 INDIVIDUALS OR 5% OF THE OVERALL POPULATION WITHIN THE CITY OR COUNTY IN WHICH THE HOSPITAL IS LOCATED AS MEASURED BY THE MOST RECENT CENSUS.- MEDSTAR HEALTH WILL PROVIDE PUBLIC NOTICES YEARLY IN LOCAL NEWSPAPERS SERVING ALL HOSPITAL TARGET POPULATIONS.THE MEDSTAR HEALTH PATIENT INFORMATION SHEET SHALL BE PROVIDED TO THE PATIENT, THE PATIENT'S FAMILY, OR THE PATIENT'S AUTHORIZED REPRESENTATIVE: - BEFORE DISCHARGE;- WITH THE HOSPITAL BILL; - ON REQUEST; AND - IN EACH WRITTEN COMMUNICATION TO THE PATIENT REGARDING COLLECTION OF THE HOSPITAL BILL.MEDSTAR HEALTH WILL PROVIDE A FINANCIAL ASSISTANCE PROBABLE AND LIKELY ELIGIBILITY DETERMINATION TO THE PATIENT WITHIN TWO BUSINESS DAYS FROM RECEIPT OF THE INITIAL MEDSTAR HEALTH UNIFORM FINANCIAL ASSISTANCE APPLICATION. FINAL ELIGIBILITY DETERMINATIONS ARE MADE AND COMMUNICATED TO THE PATIENT BASED ON RECEIPT AND REVIEW OF A COMPLETED APPLICATION. MEDSTAR HEALTH BELIEVES THAT ITS PATIENTS HAVE PERSONAL RESPONSIBILITIES RELATED TO THE FINANCIAL ASPECTS OF THEIR HEALTHCARE NEEDS. 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: - COMPLY WITH PROVIDING THE NECESSARY FINANCIAL DISCLOSURE FORMS 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 MEDSTAR HOSPITAL PATIENT ADVOCATES AND PATIENT FINANCIAL SERVICES STAFF TO ENSURE THERE IS A COMPLETE UNDERSTANDING OF THE PATIENT'S FINANCIAL SITUATION AND CONSTRAINTS. - 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 MEDSTAR HOSPITAL PATIENT ADVOCATES OR CUSTOMER SERVICE REPRESENTATIVES ON A TIMELY BASIS AS THE PATIENT'S FINANCIAL CIRCUMSTANCES MAY CHANGE. - IT IS A PATIENT'S RESPONSIBILITY, DURING THEIR 12-MONTH ELIGIBILITY PERIOD, TO NOTIFY MEDSTAR HEALTH OF THEIR EXISTING HOUSEHOLD ELIGIBILITY FOR FREE CARE, REDUCED COST-CARE, AND/OR ELIGIBILITY UNDER FINANCIAL HARDSHIP PROVISIONS FOR MEDICAL NECESSARY CARE RECEIVED DURING THE 12-MONTH ELIGIBILITY PERIOD.- IN THE EVENT PATIENT FAILS TO MEET THESE RESPONSIBILITIES, MEDSTAR RESERVES THE RIGHT TO PURSUE ADDITIONAL BILLING AND COLLECTION EFFORTS. IN THE EVENT OF NON-PAYMENT BILLING, AND COLLECTION EFFORTS ARE DEFINED IN THE MEDSTAR BILLING AND COLLECTION POLICY. A FREE COPY IS AVAILABLE ON ALL HOSPITAL WEBSITES AND PATIENT PORTALS VIA THE FOLLOWING URL: WWW.MEDSTARHEALTH.ORG/FINANCIALASSISTANCE , OR BY CALLING CUSTOMER SERVICE AT 1-800-280-9006.PATIENTS OF MEDSTAR HEALTH'S HOSPITALS AND HOSPITAL-BASED PHYSICIAN PRACTICES MAY BE ELIGIBLE FOR FULL FINANCIAL ASSISTANCE OR PARTIAL SLIDING-SCALE FINANCIAL ASSISTANCE AS SET FORTH UNDER THIS POLICY. THE PATIENT ADVOCATE AND PATIENT FINANCIAL SERVICES STAFF WILL DETERMINE ELIGIBILITY FOR FULL FINANCIAL ASSISTANCE AND PARTIAL SLIDING-SCALE FINANCIAL ASSISTANCE BASED ON REVIEW OF INCOME FOR THE PATIENT AND THEIR FAMILY (HOUSEHOLD), OTHER FINANCIAL RESOURCES AVAILABLE TO THE PATIENT'S FAMILY, FAMILY SIZE, AND THE EXTENT OF THE MEDICAL COSTS TO BE INCURRED BY THE PATIENT. COMMUNITY INFORMATION PART VI, LINE 4GEOGRAPHIC AND DEMOGRAPHIC:THE COMMUNITIES THE ORGANIZATION SERVES INCLUDES ZIP CODES 21239 AND 21206, BOTH URBAN GEOGRAPHIC SERVICE AREAS. THERE ARE 17 HOSPITALS SERVING BALTIMORE CITY, AND 15 FEDERALLY DESIGNATED MEDICALLY UNDERSERVED AREAS PRESENT IN THE COMMUNITY. THERE ARE 28,793 PEOPLE IN 21239 (LOCH RAVEN VILLAGE/NORTHWOOD) AND THE AVERAGE INCOME IS $51,331. THERE ARE 50,846 PEOPLE IN 21206 (CEDONIA/FRANKFORD AREA) AND THE AVERAGE INCOME IS $48,428. BALTIMORE CITY INCLUDES RESIDENTS WITH INCOMES BELOW THE FEDERAL POVERTY GUIDELINE (15.3%), UNINSURED (5.9%) AND MEDICAID RECIPIENTS (49.8%). PROMOTION OF COMMUNITY HEALTH PART VI, LINE 5AS A COMMUNITY PARTNER, MEDSTAR GOOD SAMARITAN HOSPITAL ENGAGES IN SEVERAL COMMUNITY BENEFIT ACTIVITIES TO IMPROVE AND PROMOTE THE HEALTH AND WELLBEING OF THE COMMUNITY. PRIORITY AREAS, AS DETERMINED BY THE CHNA, FALL UNDER THREE AREAS OF FOCUS INCLUDING HEALTH AND WELLNESS, ACCESS TO CARE, AND SOCIAL DETERMINANTS OF HEALTH. PROGRAMS INCLUDE (BUT ARE NOT LIMITED TO):HEALTH AND WELLNESS:MEDSTAR GOOD SAMARITAN HOSPITAL ADDRESSES HEALTH AND WELLNESS BY OFFERING A VARIETY OF PROGRAMS AND RESOURCES THAT SEEK TO ADDRESS CHRONIC DISEASE PREVENTION AND MANAGEMENT. MEDSTAR GOOD SAMARITAN HOSPITAL SERVES AS A HUB TO SCREEN INDIVIDUALS FOR BREAST, CERVICAL, AND COLON CANCER. A UNIQUE ASPECT OF THIS PROGRAM IS THAT IT PROVIDES SCREENING TO INDIVIDUALS WITHOUT INSURANCE AND/OR DOCUMENTATION. AS A RESULT, MORE THAN 50% OF PEOPLE SERVED ARE HISPANIC/LATINO. MEDSTAR GOOD SAMARITAN HOSPITAL'S COMMUNITY-BASED EDUCATION COURSES ARE OFFERED TO SUPPORT HEALTHY LIFESTYLE CHANGES FOR COMMUNITY MEMBERS. PROGRAMS INCLUDE CENTERS FOR DISEASE CONTROL DIABETES PREVENTION, DIABETES SELF-MANAGEMENT EDUCATION, FLU VACCINATION CLINICS, YOGA SERVICES, SENIOR PHYSICAL FITNESS, AND SMOKING CESSATION. ACCESS TO CARE:THE PRIORITY AREA IS ADDRESSING ACCESS TO BEHAVIORAL HEALTH SERVICES, INCLUDING MENTAL HEALTH AND SUBSTANCE USE. MEDSTAR GOOD SAMARITAN OFFERS A SCREENING, BRIEF INTERVENTION, AND REFERRAL TO TREATMENT (SBIRT) PROGRAM TO SUPPORT THOSE EXPERIENCING SUBSTANCE USE DISORDER. AN ENHANCEMENT OF SBIRT INCLUDES THE OPIOID OVERDOSE SURVIVOR OUTREACH PROGRAM (OSOP). OSOP LINKS COMMUNITY MEMBERS WITH A HISTORY OF SUBSTANCE ABUSE TREATMENT WITH THE RESOURCES THEY NEED TO PREVENT A FUTURE OVERDOSE. MEDSTAR GOOD SAMARITAN HOSPITAL ALSO ADDRESSES ACCESS TO CARE BY HELPING TO REDUCE THE FINANCIAL BURDEN FOR PATIENTS AND THEIR FAMILIES. PATIENT FINANCIAL SERVICES PROVIDES FINANCIAL ASSISTANCE TO UNINSURED PATIENTS WHO RESIDE WITHIN THE COMMUNITY BY ASSISTING WITH ENROLLMENT IN PUBLICLY FUNDED ENTITLEMENT PROGRAMS, REFERRING PATIENTS TO STATE OR FEDERAL INSURANCE EXCHANGE NAVIGATOR RESOURCES AND ASSISTING WITH CONSIDERATION OF FUNDING THAT MAY BE AVAILABLE FROM OTHER CHARITABLE ORGANIZATIONS.THE HOSPITAL SUBSIDIZES HEALTH SERVICES TO ENSURE RESIDENTS HAVE ACCESS TO THE CLINICAL CARE THEY NEED.SOCIAL DETERMINANTS OF HEALTH:MEDSTAR GOOD SAMARITAN HOSPITAL'S OTHER PRIORITY IS ADDRESSING THE SOCIAL DETERMINANTS OF HEALTH OF THE COMMUNITY. INITIATED BY THE BALTIMORE POPULATION HEALTH WORKFORCE COLLABORATIVE PROGRAM AND CONTINUED WITH HOSPITAL RESOURCES, COMMUNITY RESIDENTS ARE HIRED AND TRAINED AS COMMUNITY HEALTH ADVOCATES OR PEER RECOVERY COACHES. THESE POSITIONS SERVE TO EMPOWER INDIVIDUALS AND THEIR FAMILIES INTO BETTER ECONOMIC CONDITIONS.MEDSTAR GOOD SAMARITAN HOSPITAL ALSO PROVIDES PATHWAYS FOR HEALTHCARE CAREERS FOR THE YOUTH IN ITS SURROUNDING COMMUNITY. THIS ALLOWS STUDENTS TO DEMONSTRATE SKILL DEVELOPMENT AND EXPERIENCE WORKING IN THE MEDICAL FIELD, INCLUDING THE HOSPITAL'S PARTNERSHIP WITH MERCY HIGH SCHOOL. AS PART OF THEIR RESPONSIBILITIES, THE COMMUNITY HEALTH ADVOCATE ROLES CONDUCT SOCIAL NEEDS SCREENINGS. SOCIAL NEEDS SCREENINGS ARE PROVIDED TO SCREEN FOR FOOD AND HOUSING INSECURITY, AND BARRIERS RELATED TO TRANSPORTATION, EMPLOYMENT, AND UTILITIES. IDENTIFIED NEEDS ARE ADDRESSED BY CONNECTING THE PARTICIPANT TO SOCIAL SERVICES AND OTHER RESOURCES IN THE COMMUNITY. MEDSTAR GOOD SAMARITAN HOSPITAL HAS A PARTNERSHIP WITH UBER TO ADDRESS TRANSPORTATION BARRIERS TO ACCESS MEDICAL SERVICES. THROUGH THIS PARTNERSHIP, RIDES ARE PROVIDED TO PATIENTS AND/OR FAMILIES WITH FINANCIAL NEED. THE TRANSPORTATION ASSISTANCE ENABLES PATIENTS TO ATTEND NECESSARY APPOINTMENTS WITH THEIR HEALTH CARE PROVIDERS. FURTHER, MEDSTAR GOOD SAMARITAN HOSPITAL ADDRESSES FOOD INSECURITY BY ENROLLING PATIENTS INTO A FOOD PRESCRIPTION DELIVERY PROGRAM THROUGH ITS PARTNER HUNGRY HARVEST. THIS TEMPORARY SOURCE OF FOOD ASSISTANCE ALLOWS COMMUNITY HEALTH ADVOCATES TO ADDRESS A LONG-TERM STRATEGY FOR FOOD ACCESS (E.G. MEALS ON WHEELS, ETC.) AFFILIATED HEALTH CARE SYSTEM PART VI, LINE 6AS A PROUD MEMBER OF MEDSTAR HEALTH, MEDSTAR GOOD SAMARITAN HOSPITAL 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 MEDSTAR GOOD SAMARITAN HOSPITAL TECHNICAL SUPPORT TO ENHANCE COMMUNITY HEALTH PROGRAMMING AND EVALUATION. MEDSTAR'S CORPORATE PHILANTHROPY DEPARTMENT IDENTIFIES AND SEEKS PUBLIC AND PRIVATE FUNDING SOURCES TO ENSURE THE AVAILABILITY OF HIGH-QUALITY HEALTH SERVICES, REGARDLESS OF ABILITY TO PAY. STATE FILING OF COMMUNITY BENEFIT REPORT PART VI, LINE 7THE COMMUNITY BENEFIT REPORT FOR MEDSTAR GOOD SAMARITAN HOSPITAL IS FILED IN THE STATE OF MARYLAND. 1 AMERICAN HEART ASSOCIATION NATIONAL CENTER 7272 GREENVILLE AVENUE DALLAS TX 75231 135613797 501(C)(3) 40000 0 SPONSORSHIP: HEART WALK 2022 CRISTO REY JESUIT HIGH SCHOOL 420 SOUTH CHESTER STREET BALTIMORE MD 21231 205300491 501(C)(3) 22000 0 CORPORATE INTERNSHIP PROGRAM BALTIMORE CIVIC FUND 1 N CHARLES ST STE 1600 BALTIMORE MD 21201 521212473 501(C)(3) 45626 0 SUPPORTIVE HOUSING INVESTMENT 3 0 SCHEDULE I, PART I, LINE 2 OUR GRANT MONITORING PROCEDURE BRINGS TOGETHER ALL KEY PERSONNEL INVOLVED IN THE GRANT AT THE ONSET OF THE AWARD TO DISCUSS MANAGEMENT, RESPONSIBILITIES, BUDGETS, AND REPORTING. THIS INITIAL MEETING IS DOCUMENTED AND DISBURSED TO ALL INVOLVED. THE ACTUAL GRANT MONITORING IS DONE BY THE HOSPITAL DEPARTMENT IMPLEMENTING THE GRANT. MEDSTAR CORPORATE'S GRANTS AND PHILANTHROPY DEPARTMENT ENSURES THAT EACH GRANT HAS A COST CENTER AND/OR GRANT ACCOUNT SET UP BASED ON THE TERMS OF THE GRANT AWARD. MEDSTAR CORPORATE'S GRANTS AND PHILANTHROPY DEPARTMENT ALSO TRACKS AND REMINDS HOSPITAL DEPARTMENTS WHEN PROGRESS REPORTS ARE DUE THROUGHOUT THE LIFE OF THE GRANT. X 1 1 X X X X X X 0 0 0 0 0 0 0 0 0 KENNETH A SAMET DIRECTOR 0 2106059 0 3176567 0 79000 0 62059 0 35882 0 5459567 0 0 BRADLEY CHAMBERS PRESIDENT/DIRECTOR 427823 427823 387195 387195 0 0 11922 11922 16578 16578 843518 843518 0 0 DAVID ZACHARY MARTIN MD DIRECTOR 1403911 0 147063 0 0 0 8700 0 21232 0 1580906 0 0 0 ZEENA DORAI MD DIRECTOR 0 1206461 0 89015 0 75000 0 8700 0 10078 0 1389254 0 0 MESFIN A LEMMA MD DIRECTOR (UNTIL 3/2023) 0 715168 0 190803 0 0 0 8700 0 2103 0 916774 0 0 MICHAEL JACOBS MD PHYSICIAN 831274 0 0 0 0 0 19592 0 16896 0 867762 0 0 0 SAMER S NAJJAR MD DIRECTOR (AS OF 3/2023) 0 694323 0 0 0 0 0 8700 0 20893 0 723916 0 0 MAHSA MOHEBTASH MD DIRECTOR (AS OF 4/2023) 463781 0 236310 0 0 0 8700 0 1338 0 710129 0 0 0 DEANA STOUT TREASURER/CFO 359678 0 175404 0 0 0 30423 0 21493 0 586998 0 0 0 SHAMS T QUAZI MD DIRECTOR 212776 212776 54813 54813 0 0 8700 0 20927 0 297216 267589 0 0 ELIAS K SHAYA MD DIRECTOR 220992 220992 11250 11250 0 0 9405 0 1330 0 242977 232242 0 0 GEORGE HENNAWI MD FORMER DIRECTOR 349844 0 34733 0 0 0 8700 0 24625 0 417902 0 0 0 ESKANDAR YAZAJI MD FORMER DIR., AND VP, MED. AFFAIRS 186179 186179 7766 7766 0 0 8700 0 21038 0 223683 193945 0 0 BRIAN CAWLEY SENIOR VP, OPERATIONS 0 298861 0 70740 0 0 0 8700 0 21145 0 399446 0 0 DIWAKAR PRADHAN MD PHYSICIAN 332879 0 25000 0 0 0 8700 0 9738 0 376317 0 0 0 STUART BELL MD FORMER VP, MEDICAL AFFAIRS 0 29688 0 272809 0 21539 0 17184 0 19161 0 360381 0 0 PAUL SACK MD DIRECTOR (AS OF 7/2022) 0 296854 0 23664 0 0 0 8700 0 24611 0 353829 0 0 BERNARD RAVITZ MD PHYSICIAN 263005 0 26000 0 0 0 8699 0 1282 0 298986 0 0 0 LEILA IGNACIO-MACALE CLINICAL DOCUMENTATION SPECIALIST 278772 0 233 0 0 0 13076 0 1077 0 293158 0 0 0 PART I, LINE 1A HEALTH OR SOCIAL CLUB DUES: THE ORGANIZATION PAID BUSINESS CLUB DUES FOR TWO ASSOCIATES IN SENIOR MANAGEMENT THIS YEAR. PARTICIPATION IN THESE ACTIVITIES WAS FOR BUSINESS PURPOSES, AND HELPED THE ORGANIZATION FURTHER ITS EXEMPT PURPOSE. SCHEDULE J, PART III DETAILED BELOW ARE SEVERAL ONE-TIME PAYMENTS TO CERTAIN EXECUTIVES RELATED TO VARIOUS RETIREMENT, RETENTION AND LONG-TERM INCENTIVE PLANS. THESE PLANS AND PAYMENTS ARE NOT A ROUTINE PART OF THE TYPICAL MEDSTAR EXECUTIVE COMPENSATION PROGRAM, AND SUPPORTED IMPORTANT OBJECTIVES OF OUR ORGANIZATION. MR. SAMET'S OTHER REPORTABLE COMPENSATION IN PART II, COLUMN (B)(III) INCLUDES A CASH LUMP-SUM PAYMENT OF $79,000, WHICH REPRESENTS THE ANNUAL PREMIUM FOR A SPLIT DOLLAR LIFE INSURANCE POLICY. DR. DORAI'S OTHER REPORTABLE COMPENSATION IN PART II, COLUMN (B)(III) INCLUDES $75,000 REPRESENTING A LONG-TERM RETENTION ARRANGEMENT. BRADLEY CHAMBERS' COMPENSATION IS FOR SERVICES PROVIDED AS PRESIDENT TO BOTH MEDSTAR GOOD SAMARITAN HOSPITAL AND MEDSTAR UNION MEMORIAL HOSPITAL. DEANA STOUT'S COMPENSATION IS FOR SERVICES PROVIDED AS CFO AT MEDSTAR HARBOR HOSPITAL, MEDSTAR FRANKLIN SQUARE MEDICAL CENTER, MEDSTAR GOOD SAMARITAN HOSPITAL AND MEDSTAR UNION MEMORIAL HOSPITAL STUART BELL'S COMPENSATION IS FOR SERVICES PROVIDED AS VP MEDICAL AFFAIRS RESPECTIVELY, AT BOTH MEDSTAR GOOD SAMARITAN HOSPITAL AND MEDSTAR UNION MEMORIAL HOSPITAL. FORM 990, PART III, LINE 1 AS A PROUD MEMBER OF MEDSTAR HEALTH, MEDSTAR GOOD SAMARITAN HOSPITAL'S (MEDSTAR GOOD SAMARITAN) MISSION IS TO BE GUIDED BY CATHOLIC TEACHINGS TO PROVIDE COMPASSIONATE, INCLUSIVE, AND CONNECTED CARE TO THE COMMUNITY WE ARE ENTRUSTED TO SERVE. MEDSTAR GOOD SAMARITAN, LOCATED IN NORTHEAST BALTIMORE CITY, MARYLAND, IS KNOWN AS A HOSPITAL THAT CARES FOR ITS COMMUNITY. OFFERING THE LATEST TREATMENTS FOR INPATIENT REHABILITATION, IN PARTNERSHIP WITH MEDSTAR NATIONAL REHABILITATION NETWORK; GERIATRICS WITH THE CENTER FOR SUCCESSFUL AGING; WOUND CARE, HYPERBARIC MEDICINE, AND LIMB SAVING, AS PART OF THE MEDSTAR HEALTH WOUND HEALING INSTITUTE; AND CANCER CARE, IN PARTNERSHIP WITH MEDSTAR FRANKLIN SQUARE MEDICINE CENTER AND MEDSTAR GEORGETOWN CANCER INSTITUTE. LOCATED JUST THREE MILES AWAY, MEDSTAR GOOD SAMARITAN EXPERTS WORK IN PARTNERSHIP WITH MEDSTAR UNION MEMORIAL HOSPITAL, OFFERING THE LATEST MEDICAL AND SURGICAL ADVANCES IN HEART CARE, ORTHOPEDICS AND SPINE CARE, AND HAND CARE WITH THE CURTIS NATIONAL HAND CENTER. IN FISCAL YEAR 2023, MEDSTAR GOOD SAMARITAN HAD 7,770 INPATIENT ADMISSIONS AND 197,273 OUTPATIENT VISITS INCLUDING 39,248 EMERGENCY VISITS. FORM 990, PART VI, SECTION A, LINE 6 ORGANIZATION MEMBERS 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. FORM 990, PART VI, SECTION A, LINE 7A DESCRIPTION OF MEMBERS 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 & CEO OF MEDSTAR HEALTH, INC. FORM 990, PART VI, SECTION A, LINE 7B DECISIONS OF GOVERNING BODY 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. FORM 990, PART VI, SECTION B, LINE 11B PROCESS FOR REVIEWING FORM 990 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 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. FORM 990, PART VI, SECTION B, LINE 12C CONFLICT OF INTEREST POLICY 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) RELATED TO DIRECTORS ARE REVIEWED BY THE GOVERNANCE COMMITTEE OF THE MEDSTAR HEALTH BOARD OF DIRECTORS WHICH DETERMINES HOW THE MATTER SHOULD BE RESOLVED. SUCH DISCLOSURES (IF ANY) RELATED TO OFFICERS AND SENIOR MANAGERS ARE REVIEWED BY AN APPROPRIATE EXECUTIVE WHO 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). FORM 990, PART VI, SECTION B, LINE 15 DESCRIPTION OF EXECUTIVE COMPENSATION PROCESS THE EXECUTIVE COMPENSATION COMMITTEE OF THE BOARD OF DIRECTORS OF MEDSTAR HEALTH, INC. (THE "COMMITTEE") HAS OVERSIGHT OF 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 & YOUNG LLP ("E&Y") TO SERVE AS AN ADVISOR ON THE REASONABLENESS AND COMPETITIVENESS OF THE PROGRAM. IN DETERMINING REASONABLENESS AND COMPETITIVENESS, E&Y REVIEWS MARKET PRACTICES AND TRENDS, AND MAKES RECOMMENDATIONS RELATED TO THE PROGRAM. E&Y UTILIZES INFORMATION FROM CUSTOM SURVEYS, NATIONAL COMPENSATION SURVEYS, PROPRIETARY DATABASES, AND CLIENT EXPERIENCES TO DETERMINE ITS FINAL RECOMMENDATIONS. E&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. FORM 990, PART VI, SECTION C, LINE 19 FINANCIAL STATEMENT AVAILABILITY 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. FORM 990, PART IX, LINE 11G PURCHASED PROFESSIONAL SERVICES: PROGRAM SERVICE EXPENSES 3,706,041. MANAGEMENT AND GENERAL EXPENSES 589,820. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 4,295,861. PHYSICIAN SERVICES: PROGRAM SERVICE EXPENSES 23,750. MANAGEMENT AND GENERAL EXPENSES 240,893. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 264,643. TESTING & DIAGNOSTIC SERVICES: PROGRAM SERVICE EXPENSES 66,885. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 66,885. PHARMACY SERVICES: PROGRAM SERVICE EXPENSES 44,899. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 44,899. LAB SERVICES: PROGRAM SERVICE EXPENSES 490,485. MANAGEMENT AND GENERAL EXPENSES 18,640. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 509,125. SUBSIDY EXPENSE - INTERCOMPANY: PROGRAM SERVICE EXPENSES 26,171,087. MANAGEMENT AND GENERAL EXPENSES 2,890,380. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 29,061,467. NON-PHYS INTERCO PURCH SRVS: PROGRAM SERVICE EXPENSES 5,442,679. MANAGEMENT AND GENERAL EXPENSES 50. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 5,442,729. MISC FIXED PURCH SRVCS: PROGRAM SERVICE EXPENSES 163,260. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 163,260. CONSULTING FEES: PROGRAM SERVICE EXPENSES 131,296. MANAGEMENT AND GENERAL EXPENSES 36,379. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 167,675. MISCELLANEOUS: PROGRAM SERVICE EXPENSES 2,147,795. MANAGEMENT AND GENERAL EXPENSES 530,369. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,678,164. FORM 990, PART XI, LINE 9: EQUITY TRANSFERS - NET ASSETS 15,171,866. O'NEILL EQUITY 7,581,226. FINANCIAL STATEMENTS AND REPORTING PART XII, LINE 2C THE GOOD SAMARITAN HOSPITAL OF MARYLAND, INC. IS AN AFFILIATE OF THE MEDSTAR HEALTH, INC. AUDIT AND SUBJECT TO OVERSIGHT BY THE AUDIT COMMITTEE OF THE MEDSTAR BOARD. 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