Community Benefit Insight - Tax-exempt hospital

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Montgomery General Hospital Inc

Medstar Montgomery Medical Center

18101 Prince Philip Drive
Olney, MD 20832

Bed count	165	Medicare provider number	210018	Member of the Council of Teaching Hospitals	NO	Children's hospital	NO

EIN: 520646893

Display data for year:

Community Benefit Spending- 2021
(as % of functional expenses, which all tax-exempt organizations report on Form 990 Schedule H)

5.01%

Spending by Community Benefit Category- 2021
(as % of total functional expenses)

* = CBI denoted preventative categories

Community Benefit Spending Compared to Functional Expenses, 2010-2021

Additional data

Community Benefit Expenditures: 2021

All tax-exempt organizations file a Form 990 with the IRS for every tax year. If the tax-exempt organization operates one or more hospital facilities during the tax year, the organization must attach a Schedule H to Form 990. On Part I of Schedule H, the organization records the expenditures it made during the tax year for various types of community benefits; 9 types are shown on this web tool. By default, this web tool presents community benefit expenditures as a percentage of the organization’s functional expenses, which it reports on Form 990, Part IX, Line 25, Column A. (The more commonly heard term, ‘total operating expenses’, which organizations report to CMS, is generally about 90% of the ‘functional expenses’). The user may change the default to see the dollar expenditures.
Amount spent in the following IRS community benefit categories:

Financial Assistance at cost as % of operating expenses	$ 4,696,963 2.28 %
Medicaid as % of operating expenses	$ 0 0 %
Costs of other means-tested government programs as % of operating expenses	$ 0 0 %
Health professions education as % of operating expenses	$ 166,696 0.08 %
Subsidized health services as % of operating expenses	$ 4,061,497 1.97 %
Research as % of operating expenses	$ 0 0 %
Community health improvement services and community benefit operations* as % of operating expenses Note: these two community benefit categories are reported together on the Schedule H, part I, line 7e.	$ 1,194,808 0.58 %
Cash and in-kind contributions for community benefit* as % of operating expenses	$ 192,018 0.09 %
Community building* as % of operating expenses	$ 42,005 0.02 %

* = CBI denoted preventative categories

Community building activities details:

Did tax-exempt hospital report community building activities?	YES
Number of activities or programs (optional)	0
Physical improvements and housing	0
Economic development	0
Community support	0
Environmental improvements	0
Leadership development and training for community members	0
Coalition building	0
Community health improvement advocacy	0
Workforce development	0
Other	0
Persons served (optional)	0
Physical improvements and housing	0
Economic development	0
Community support	0
Environmental improvements	0
Leadership development and training for community members	0
Coalition building	0
Community health improvement advocacy	0
Workforce development	0
Other	0
Community building expense as % of operating expenses	$ 42,005 0.02 %
Physical improvements and housing as % of community building expenses	$ 0 0 %
Economic development as % of community building expenses	$ 0 0 %
Community support as % of community building expenses	$ 0 0 %
Environmental improvements as % of community building expenses	$ 0 0 %
Leadership development and training for community members as % of community building expenses	$ 0 0 %
Coalition building as % of community building expenses	$ 8,124 19.34 %
Community health improvement advocacy as % of community building expenses	$ 33,881 80.66 %
Workforce development as % of community building expenses	$ 0 0 %
Other as % of community building expenses	$ 0 0 %
Direct offsetting revenue	$ 0
Physical improvements and housing	$ 0
Economic development	$ 0
Community support	$ 0
Environmental improvements	$ 0
Leadership development and training for community members	$ 0
Coalition building	$ 0
Community health improvement advocacy	$ 0
Workforce development	$ 0
Other	$ 0

Other Useful Tax-exempt Hospital Information: 2021

In addition to community benefit and community building expenditures, the Schedule H worksheet includes sections on what percentage of bad debt can be attributable to patients eligible for financial assistance, and questions on the tax-exempt hospital's debt collection policy. When searching a specific tax-exempt hospital in this web tool, Section II provides information about bad debt and the financial assistance policy, and whether the state in which the tax-exempt hospital resides has expanded Medicaid coverage under the federal ACA.

Of the tax-exempt hospital’s overall operating expenses, amount reported as bad debt as % of operating expenses	$ 4,257,554 2.07 %
Is the tax-exempt hospital considered a "sole community hospital" under the Medicare program?	NO

Information about the tax-exempt hospital's Financial Assistance Policy and Debt Collection Policy
The Financial Assistance Policy section of Schedule H has changed over the years. The questions listed below reflect the questions on the 2009-2011 Schedule H forms and the answers tax-exempt hospitals provided for those years. The Financial Assistance Policy requirements were changed under the ACA. In the future, as the Community Benefit Insight web site is populated with 2021 data and subsequent years, the web tool will also be updated to reflect the new wording and requirements. In the meantime, if you have any questions about this section, we encourage you to contact your tax-exempt hospital directly.

Does the organization have a written financial assistance (charity care) policy?	YES
Did the tax-exempt hospital rely upon Federal Poverty Guidelines (FPG) to determine when to provide free or discounted care for patients?	YES
Amount of the tax-exempt hospital’s bad debt (at cost) attributed to patients eligible under the organization’s financial assistance (charity care) policy as % of operating expenses	$ 0 0 %

Did the tax-exempt hospital, or an authorized third party, take any of the following collection activities before determining whether the patient was eligible for financial assistance:
Under the ACA, states have the choice to expand Medicaid eligibility for their residents up to 138% of the federal poverty guidelines. The Medicaid expansion provision of the ACA did not go into effect until January 2014, so data in this web tool will not reflect each state's current Medicaid eligibility threshold. For up to date information, please visit the Terms and Glossary under the Resources tab.
The federal poverty guidelines (FPG) are set by the government and used to determine eligibility for many federal financial assistance programs. Tax-exempt hospitals often use FPG guidelines in their Financial Assistance policies to determine which patients will qualify for free or discounted care.
In addition to the federal requirements, some states have laws stipulating community benefit requirements as a result of tax-exemption. The laws vary from state to state and may require the tax-exempt hospitals to submit community benefit reports. Data on this web tool captures whether or not a state had a mandatory community benefit reporting law as of 2011. For more information, please see Community Benefit State Law Profiles Comparison at The Hilltop Institute.

Community Health Needs Assessment Activities: 2021

The ACA requires all 501(c)(3) tax-exempt hospitals to conduct a Community Health Needs Assessment (CHNA) every three years, starting with the hospital's tax year beginning after March 23, 2012. The 2011 Schedule H included an optional section of questions on the CHNA process. This web tool includes responses for those hospitals voluntary reporting this information. The web tool will be updated to reflect changes in these questions on the 2012 and subsequent Schedule H forms.

Did the tax-exempt hospital report that they had conducted a CHNA?	YES
Did the CHNA define the community served by the tax-exempt hospital?	YES
Did the CHNA consider input from individuals that represent the broad interests of the community served by the tax-exempt hospital?	YES
Did the tax-exempt hospital make the CHNA widely available (i.e. post online)?	YES
Did the tax-exempt hospital adopt an implementation strategy to address the community needs identified by the CHNA?	YES

Supplemental Information: 2021

This section presents qualitative information submitted by the hospital, verbatim from the 990H record.

Statement of Program Service Accomplishments
Description of the organization's program service accomplishments for each of its three largest program services, as measured by expenses. Section 501(c)(3) and 501(c)(4) organizations are required to report the amount of grants and allocations to others, the total expenses, and revenue, if any, for each program service reported.

4A (Expenses $ 142125521 including grants of $ 46000) (Revenue $ 180217160)
SEE SCHEDULE OMEDSTAR MONTGOMERY'S LARGEST PROGRAM IS ACCESS TO AND THE PROVISION OF ACUTE HOSPITAL SERVICES TO THE COMMUNITIES OF NORTHEASTERN MONTGOMERY COUNTY, MARYLAND AND THE SURROUNDING AREAS. IN ADDITION TO THE PROGRAM SERVICE EXPENSES LISTED ABOVE, MEDSTAR MONTGOMERY INCURRED $44.8M OF MANAGEMENT AND GENERAL EXPENSES IN PROVIDING SERVICES TO ITS COMMUNITIES. THE ACUTE CARE HOSPITAL OFFERS A CARDIAC AND VASCULAR PROGRAM, GENERAL SURGERY, ORTHOPEDICS, CANCER CARE, AND OBSTETRICS. WITH THE ADDITION OF SPECIALISTS FROM MEDSTAR GEORGETOWN UNIVERSITY HOSPITAL AND MEDSTAR WASHINGTON HOSPITAL CENTER, MEDSTAR MONTGOMERY BRINGS SPECIALTY CARE CLOSER TO ITS PATIENTS. MEDSTAR MONTGOMERY DELIVERS SPECIALIZED CARE FOR SENIORS AND IS NATIONALLY RECOGNIZED FOR ITS COMMITMENT TO PROVIDING HIGH QUALITY STROKE CARE, AS WELL AS OFFERING INPATIENT AND OUTPATIENT MENTAL HEALTH SERVICES. MEDSTAR MONTGOMERY INCLUDES AN EMERGENCY DEPARTMENT WITH A DEDICATED PEDIATRIC CENTER, A FAST-TRACK UNIT AND A SEPARATE UNIT FOR CRISIS EVALUATION. MEDSTAR MONTGOMERY IS A BABY-FRIENDLY DESIGNATED HOSPITAL, HAS ACHIEVED NICHE EXEMPLAR STATUS, AND HAS BEEN NOTED AS ONE OF BLUE DISTINCTION CENTERS FOR BARIATRIC SURGERY.SINCE MARCH 2020, MEDSTAR HEALTH HAS CARED FOR 1 IN 4 COVID-19 PATIENTS IN THE REGION. OPERATING AS ONE MEDSTAR AND ALIGNING WITH GUIDANCE FROM THE CENTERS FOR DISEASE CONTROL AND PREVENTION (CDC) AND LOCAL DEPARTMENTS OF HEALTH, MEDSTAR HEALTH COVID-19 PREPARATIONS AND RESPONSE CONTINUE TO BE GUIDED BY THREE CRITICAL DRIVERS: PROVIDE A SAFE CARE ENVIRONMENT FOR PATIENTS AND ASSOCIATES; MITIGATE COMMUNITY SPREAD OF COVID-19; AND ENSURE OPERATIONAL CONTINUITY TO FULFILL OUR CORE MISSION OF CARING FOR OUR COMMUNITIES.THESE EFFORTS HAVE EVOLVED AND TRANSITIONED IN MULTIPLE WAYS THROUGHOUT THE DURATION OF THE COVID-19 PANDEMIC, LEADING TO A NUMBER OF INTEGRATED CARE APPROACHES IN PLACE TODAY: UTILIZATION OF MEDSTAR HEALTH URGENT CARE, MEDSTAR EVISIT AND OUR DIGITAL CAPABILITIES TO CREATE ACCESS, TESTING SITES, AND TELEHEALTH FOR PRIMARY CARE AND FOLLOW-UP VISITS; EXPANDED MANAGEMENT OF CARE CONTINUUM NEEDS FOR PATIENTS THROUGH MEDSTAR HEALTH HOME CARE; EXECUTION OF INNOVATIVE LABORATORY APPROACHES INTEGRATED WITH OCCUPATIONAL HEALTH TO BETTER SUPPORT ASSOCIATES MANAGING THROUGH COVID-19 EXPOSURES; DEPLOYMENT OF COMMUNITY MOBILE UNITS AND CLINICS FOR COVID-19 VACCINATIONS/BOOSTERS; INCREASED MANAGEMENT OF SUPPLY AND ACQUISITION OF PERSONAL PROTECTIVE EQUIPMENT (PPE), N95 RESPIRATORS, COVID-19 VACCINES AND BOOSTERS; REINFORCEMENT OF A MANDATORY COVID-19 VACCINATION POLICY RESULTING IN COMPLIANCE OF 99% OF ASSOCIATES AND PHYSICIANS; AND ADMINISTRATION OF MORE THAN 36,800 COVID-19 VACCINATIONS/BOOSTERS TO MEDSTAR HEALTH ASSOCIATES AND PHYSICIANS AND MORE THAN 74,500 TO PATIENTS ACROSS THE REGION IN FY 2022.

4B (Expenses $ 14016359 including grants of $ 0) (Revenue $ 9954862)
MEDSTAR MONTGOMERY PROVIDED $14.0M IN SUBSIDIZED (MISSION DRIVEN) HEALTH SERVICES IN FISCAL YEAR 2022. 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. SERVICES PROVIDED INCLUDE HOSPITALISTS, WOMEN'S AND CHILDREN'S CARE, AND HOSPICE AND CONTINUING CARE.

4C (Expenses $ 4696963 including grants of $ 0) (Revenue $ 0)
MEDSTAR MONTGOMERY PROVIDED $4.7M IN CHARITY CARE SERVICES IN FISCAL YEAR 2022. 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 MONTGOMERY'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.

Facility Information

Schedule H (Form 990) Section C. Supplemental Information for Part V, Section B.

MONTGOMERY GENERAL HOSPITAL
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: DIANA SALADINI AND ANDREA MOCCA/DAIRY MARROQUINEXECUTIVE 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: NGOZI WEXLER, MD ADVISORY 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 : DIANA SALADINITITLE/AFFILIATION WITH HOSPITAL : DIRECTOR, POPULATION HEALTH (LEAD)NAME OF ORGANIZATION : MEDSTAR MONTGOMERY MEDICAL CENTERNAME : ANDREA MOCCATITLE/AFFILIATION WITH HOSPITAL : COMMUNITY OUTREACH COORDINATOR (LEAD)NAME OF ORGANIZATION : MEDSTAR MONTGOMERY MEDICAL CENTERNAME : DAIRY MARROQUINTITLE/AFFILIATION WITH HOSPITAL : COMMUNITY OUTREACH COORDINATOR (LEAD)NAME OF ORGANIZATION : MEDSTAR MONTGOMERY MEDICAL CENTERNAME : NGOZI WEXLER, MDTITLE/AFFILIATION WITH HOSPITAL : VP, MEDICAL AFFAIRS (EXECUTIVE SPONSOR)NAME OF ORGANIZATION : MEDSTAR MONTGOMERY MEDICAL CENTERNAME : DEANA CHOTITLE/AFFILIATION WITH HOSPITAL : SOCIAL WORKER, CENTER FOR SUCCESSFUL AGING NAME OF ORGANIZATION : MEDSTAR MONTGOMERY MEDICAL CENTERNAME : DEBBIE OTANITITLE/AFFILIATION WITH HOSPITAL : CANCER NURSE NAVIGATORNAME OF ORGANIZATION : MEDSTAR MONTGOMERY MEDICAL CENTERNAME : LISA KINGTITLE/AFFILIATION WITH HOSPITAL : PATIENT FAMILY ADVISORY COUNCIL MEMBERNAME OF ORGANIZATION : MEDSTAR MONTGOMERY MEDICAL CENTERNAME : LYNDA SUHTITLE/AFFILIATION WITH HOSPITAL : DIRECTOR, QUALITY AND RISKNAME OF ORGANIZATION : MEDSTAR MONTGOMERY MEDICAL CENTERNAME : AUDREY PARTINGTON TITLE/AFFILIATION WITH HOSPITAL : CHAIR, OUTREACH NAME OF ORGANIZATION : OLNEY HOME FOR LIFENAME : DANIELLE DENNISTITLE/AFFILIATION WITH HOSPITAL : READMISSIONS REDUCTION CASE MANAGERNAME OF ORGANIZATION : MINDOULANAME : DEBBIE ELLINGHAUSTITLE/AFFILIATION WITH HOSPITAL : COMMUNITY REPRESENTATIVENAME OF ORGANIZATION : OLNEY THEATER NAME : EDITH WILLIAMSTITLE/AFFILIATION WITH HOSPITAL : COMMUNITY REPRESENTATIVENAME OF ORGANIZATION : MILLIAN UNITED METHODIST CHURCH NAME : FELICIA HUGEETITLE/AFFILIATION WITH HOSPITAL : PLANNING SPECIALISTNAME OF ORGANIZATION : HEALTHY MONTGOMERY/ DHHS OFFICE NAME : JACQUELINE WILLIAMS-HUBBARDTITLE/AFFILIATION WITH HOSPITAL : CENTER ADMINISTRATORNAME OF ORGANIZATION : HOLY CROSS HEALTH CENTER-ASPEN HILLNAME : MARSHA BATISTATITLE/AFFILIATION WITH HOSPITAL : RESIDENT COUNSELOR IIINAME OF ORGANIZATION : HOUSING OPPORTUNITIES COMMISSION NAME : MARY JANE JOSEPHTITLE/AFFILIATION WITH HOSPITAL : PROJECT MANAGERNAME OF ORGANIZATION : PRIMARY CARE COALITIONNAME : PAOLA FERNAN-ZAGARRATITLE/AFFILIATION WITH HOSPITAL : PLANNING AND QUALITY ASSURANCE MANAGER NAME OF ORGANIZATION : LATINO HEALTH INITIATIVE NAME : REINA GUERREROTITLE/AFFILIATION WITH HOSPITAL : COMMUNITY SCHOOL COORDINATOR NAME OF ORGANIZATION : EVERYMIND-LINKAGES TO LEARNING NAME : SANJANA QUSEMTITLE/AFFILIATION WITH HOSPITAL : PROGRAM MANAGERNAME OF ORGANIZATION : ASIAN AMERICAN HEALTH INITIATIVENAME : SUSAN MONTGOMERYTITLE/AFFILIATION WITH HOSPITAL : DIRECTOR OF SOCIAL SERVICESNAME OF ORGANIZATION : LEISURE WORLD OF MARYLAND CORPORATION

MONTGOMERY GENERAL HOSPITAL
PART V, SECTION B, LINE 11: IMPLEMENTATION STRATEGIESTHE 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.

Supplemental Information

Schedule H (Form 990) Part VI

PART I, LINE 7:
CHARITY CARE AT COSTMARYLAND'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 MEDICAIDPART 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.

PART III, LINE 4:
MEDSTAR 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.

PART III, LINE 8:
MEDICAREMARYLAND'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.

PART III, LINE 9B:
IF IT IS DETERMINED THAT A PATIENT MAY POTENTIALLY QUALIFY FOR A CHARITABLE/FINANCIAL PROGRAM, A HOLD IS PLACED ON THE ACCOUNT TO PREVENT IT FROM BEING REPORTED AS BAD DEBT UNTIL PROGRAM APPROVALS HAVE BEEN OBTAINED. IF IT IS APPROVED, THE ACCOUNT IS DOCUMENTED AND THE NECESSARY ADJUSTMENTS ARE MADE TO CLOSE THE ACCOUNT.

PART VI, LINE 2
IN FY21, MEDSTAR MONTGOMERY MEDICAL CENTER (MMMC) 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 MMMC'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 ITS CBISA AS ALL RESIDENTS LIVING IN ZIP CODE 20906. 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 (ACCESS TO AFFORDABLE HEALTH CARE AND INSURANCE) AND SOCIAL DETERMINANTS OF HEALTH (FOOD INSECURITY). 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.

Operating expenses	$ 205,678,733
Total amount spent on community benefits as % of operating expenses	$ 10,311,982 5.01 %