4A (Expenses $ 11831987 including grants of $ 0) (Revenue $ 10851324)
MCCREADY MEMORIAL HOSPITAL

4B (Expenses $ 6882787 including grants of $ 0) (Revenue $ 6449160)
ALICE BYRD TAWES NURSING AND REHABILITATION CENTER

4C (Expenses $ 1274126 including grants of $ 0) (Revenue $ 885320)
CHESAPEAKE COVE ASSISTED LIVING

EDWARD W MCCREADY MEMORIAL HOSPITAL
PART V, SECTION B, LINE 2: ACQUISITIONEFFECTIVE MARCH 1, 2020, MCCREADY FOUNDATION, WHICH CONSISTED OF A THREE BED HOSPITAL, ALICE BYRD TAWES NURSING HOME, A 76-LICENSED BED SKILLED NURSING HOME AND CHESAPEAKE COVE ASSISSTED LIVING CENTER IN CRISFIELD, MD, BECAME PART OF PENINSULA REGIONAL HEALTH SYSTEM. THE MCCREADY HOSPITAL DIVISION WAS MERGED IN PENINSULA REGIONAL MEDICAL CENTER AND LIMITED ITS FUNCTIONS TO THOSE CONSISTANT WITH STATUS AS A FREE-STANDING MEDICAL CENTER.

EDWARD W MCCREADY MEMORIAL HOSPITAL
PART V, SECTION B, LINE 3J: PRIOR TO MARCH 1, 2020, MCCREADY'S HOSPITAL STAFF MEMBERS MET WITH LOCAL SCHOOLS AND HEALTH DEPARTMENTS REGULARLY TO DISCUSS HEALTH NEEDS IN THE LOCAL COMMUNITY. BEGINNING IN 2005, THE MCCREADY FOUNDATION WAS INVOLVED WITH A CONSORTIUM OF AREA HEALTH CARE PROVIDERS WHICH INCLUDED ALL THREE AREA HOSPITALS (MCCREADY, PENINSULA REGIONAL MEDICAL CENTER, AND ATLANTIC GENERAL HOSPITAL) LOCAL HEALTH DEPARTMENTS, AS WELL AS AREA SCHOOLS AND OTHER AGENCIES. THE TEAM DEVELOPED THE TRI-COUNTY SURVEY THAT WAS SENT TO LOWER SHORE RESIDENTS. THE RESULTS OF THE SURVEY WERE USED TO IDENTIFY HEALTH CARE NEEDS IN THE TRI-COUNTY AREA (WICOMICO, WORCESTER, AND SOMERSET) AND PROGRAMS WERE DEVELOPED IN RESPONSE TO THAT SURVEY. THE STUDY IDENTIFIED THE FOLLOWING MEDICAL CONDITIONS TO BE THE MOST PREVALENT IN THE COMMUNITY: DIABETES, HEART AND LUNG DISEASE, CANCER, OBESITY AND METABOLIC SYNDROME.A 2009 SURVEY WAS CONDUCTED BY THE SAME STAKEHOLDERS PARTICIPATING IN THE 2005 STUDY TO ADDRESS ANT POTENTIALLY NEW AREAS OF CONCERN IN THE COMMUNITY. AS THE NEW FINDINGS DEVELOPED, MCCREADY'S MEDICAL AND NURSING STAFFS WORKED WITH THE FOUNDATION'S LEADERSHIP TO DETERMINE WHICH COMMUNTY NEEDS MCCREADY COULD HELP ADDRESS. THE MCCREADY FOUNDATION CONTINUED ITS WORK WITH THE SOMERSET COUNTY HEALTH DEPARTMENT TO IDENTIFY MEDICALLY INDEGENT WOMEN IN THE COMMUNITY AND PROVIDE THEM WITH FREE PREVENTIVE WOMEN'S HEALTH SERVICES. THE PROGRAM PROVIDES FREE MAMMOGRAMS, SCREENING SURGERY, IF NECESSARY.IN 2017 THE SOMERSET COUNTY HEALTH DEPARTMENT AND MCCREADY FOUNDATION PARTNERED WITH THE BUSINESS ECONOMIC AND COMMUNITY OUTREACH NETWORK (BEACON) TO SPONSOR A HEALTH NEEDS ASSESSMENT IN SOMERSET COUNTY, MARYLAND. THE GOAL OF THIS NEEDS ASSESSMENT WAS TO IDENTIFY THE HEALTH CONCERNS OF RESIDENTS AND BARRIERS THEY ENCOUNTER IN ACCESSING HEALTH CARE. INFORMANT INTERVIEWS WERE CONDUCTED WITH FOCUS GROUPS ACCESSING OVER 102 OPINION LEADERS. SECONDARY DATA AND INFORMATION FROM PUBLIC SOURCES WAS ASSESSED TO PROVIDE THE BACKGROUND AND CONTEXT FOR THE IN-DEPTH INTERVIEWS. IT WAS IDENTIFIED THAT POVERTY, LOW HEALTH LITERACY, TRANSPORTATION BARRIERS, FINANCIAL CONSTRAINTS, AND LACK OF INSURANCE APPEARED AS THE LARGEST BARRIERS. OBESITY AND DIABETES WERE IDENTIFIED AS MAJOR PUBLIC HEALTH CONCERNS.MARCH 1, 2020 THE HOSPITAL CHANGED ITS DESIGNATION TO A FREE STANDING MEDICAL FACILITY AND DISCONTINUED INPATIENT SERVICES AT THAT TIME.

EDWARD W MCCREADY MEMORIAL HOSPITAL
PART V, SECTION B, LINE 5: CONSULTING REPRESENTATIVES OF THE COMMUNITY SERVED BY THE ORGANIZATIONTHIS STUDY COMBINES QUANTITATIVE AND QUALITATIVE APPROACHES. IN ADDITION TO A THOROUGH REVIEW OF THE MOST RECENT FEDERAL, STATE, AND LOCAL DATA SETS PERTAINING TO SOMERSET COUNTY'S HEALTH NEEDS AND HEALTH OUTCOMES, THE BEACON TEAM HAS CONDUCTED A SERIES OF OPINION LEADER AND KEY STAKEHOLDER INTERVIEWS AS WELL AS FOCUS GROUPS WITH KEY HEALTH CARE PROFESSIONALS, ELECTED AND APPOINTED OFFICIALS, BUSINESS AND ECONOMIC DEVELOPMENT DECISION MAKERS, EMERGING COMMUNITY LEADERS, AND OTHER KEY INFORMANTS. THE PROCESS INCLUDED DATA COLLECTION FROM 102 UNIQUE INDIVIDUALS OVER A THREE-MONTH PERIOD IN THE FALL OF 2017. SUCH COMMUNITY-BASED RECRUITING OF KEY INFORMANTS IS MOST SUCCESSFUL WHEN THERE IS A PARTNERSHIP BETWEEN THE RESEARCHERS AND LOCAL COMMUNITY-BASED ORGANIZATIONS SUCH AS HEALTH DEPARTMENTS OR HOSPITALS. THE BEACON TEAM ALSO ACCESSED SECONDARY DATA AND INFORMATION FROM PUBLIC SOURCES TO PROVIDE THE BACKGROUND AND CONTEXT FOR THE IN-DEPTH INTERVIEWS. THE INTERVIEWS AND FOCUS GROUPS WERE CONDUCTED USING QUESTIONS INVOLVING THE IDENTIFICATION, DISCUSSION, AND/OR EXPLANATION OF HEALTH CONCERNS, HEALTH TRENDS, AND POTENTIAL METHODS OF PREVENTION OR IMPROVEMENT OF HEALTH CONCERNS IN SOMERSET COUNTY.

EDWARD W MCCREADY MEMORIAL HOSPITAL
PART V, SECTION B, LINE 6B: CHNA CONDUCTED WITH ONE OR MORE NON-HOSPITAL ORGANIZATIONSMCCREADY FOUNDATION PARTNERED WITH THE SOMERSET COUNTY HEALTH DEPARTMENT AND THE BUSINESS ECONOMIC COMMUNITY OUTREACH NETWORK TO CONDUCT ITS CHNA.

EDWARD W MCCREADY MEMORIAL HOSPITAL
PART V, SECTION B, LINE 11: THE HOSPITAL IDENTIFIED AND FOCUSED ITS EFFORTS ON THE MOST SIGNIFICANT NEEDS IDENTIFIED IN THE CHNA. HOWEVER, DUE TO LIMITED FINANCIAL OR OTHER RESOURCES, MCCREADY FOUNDATION IS NOT ABLE TO ADDRESS ALL IDENTIFIED NEEDS AT THIS TIME.

PART I, LINE 3C:
MCCREADY HEALTH WILL PROVIDE REDUCED-COST MEDICALLY NECESSARY CARE TO LOW-INCOME PATIENTS WITH FAMILY INCOME BETWEEN 301% AND 500% OF THE FEDERAL POVERTY LEVEL WHO HAVE A MEDICAL HARDSHIP AS DEFINED BY MARYLAND LAW. MEDICAL HARDSHIP IS MEDICAL DEBT, INCURRED BY A FAMILY OVER A 12-MONTH PERIOD THAT EXCEEDS 25% OF THE FAMILY INCOME.

PART I, LINE 7:
THE COSTING METHOD TO CALCULATE THE AMOUNTS REPORTED WAS THE MEDICARE OPERATING COST-TO-CHARGE RATIO FOR BOTH OUTPATIENT AND INPATIENT REVENUE.

PART III, LINE 2 & 3:
METHODOLOGY USED TO ESTIMATE BAD DEBT EXPENSESEE RESPONSE BELOW TO LINE 4 REGARDING THE METHODOLOGY USED BY THE ORGANIZATION REGARDING BAD DEBT.

PART III, LINE 4:
BAD DEBT FOOTNOTE IN THE AUDITED FINANCIAL STATEMENTSUNDER THE PROVISIONS OF ASU 2014-09, WHEN THERE IS AN UNCONDITIONAL RIGHT TO PAYMENT, SUBJECT ONLY TO THE PASSAGE OF TIME, THE RIGHT IS TREATED AS A RECEIVABLE. PATIENT ACCOUNTS RECEIVABLE, INCLUDING BILLED ACCOUNTS AND UNBILLED ACCOUNTS, WHICH HAVE THE UNCONDITIONAL RIGHT TO PAYMENT, AND ESTIMATED AMOUNTS DUE FROM THIRD-PARTY PAYERS FOR RETROACTIVE ADJUSTMENTS, ARE RECORDED AS RECEIVABLES SINCE THE RIGHT TO CONSIDERATION IS UNCONDITIONAL AND ONLY THE PASSAGE OF TIME IS REQUIRED BEFORE PAYMENT OF THAT CONSIDERATION IS DUE. THE ESTIMATED UNCOLLECTIBLE AMOUNTS ARE GENERALLY CONSIDERED IMPLICIT PRICE CONCESSIONS THAT ARE RECORDED AS A DIRECT REDUCTION TO PATIENT ACCOUNTS RECEIVABLE RATHER THAN AN ALLOWANCE FOR DOUBTFUL ACCOUNTS.DISCOUNTS RANGING FROM 2% TO 6% OF CHARGES ARE GIVEN TO MEDICARE, MEDICAID, AND CERTAIN APPROVED COMMERCIAL HEALTH INSURANCE AND HEALTH MAINTENANCE ORGANIZATION PROGRAMS FOR REGULATED SERVICES. DISCOUNTS IN VARYING PERCENTAGES ARE GIVEN FOR CERTAIN UNREGULATED SERVICES.

PART III, LINE 8:
THE COSTING METHOD USED TO DETERMINE ALLOWABLE COSTS ARE THE COSTS IN ACCORDANCE WITH MEDICARE REQUIREMENTS AND REGULATIONS. ONLY COSTS THAT ARE CONSISTENT WITH EFFICIENT, COST-EFFECTIVE MANAGEMENT AND OPERATIONS ARE ALLOWED. ONLY OPERATING COSTS THAT ARE DIRECTLY RELATED TO THE DELIVERY OF HEALTH CARE SERVICES TO MEDICARE AND MEDICAID PATIENTS WERE ALLOWED.

PART III, LINE 9B:
THE COLLECTION POLICY PERTAINS TO ALL PATIENTS WITH A SELF PAY BALANCE. IF A PATIENT APPLIES FOR EITHER CHARITY CARE OR ANY OTHER ASSISTANCE PROGRAM SUCH AS MEDICARE AND MEDICAID, ALL COLLECTION ACTIVITY IS PUT ON HOLD UNTIL A DETERMINATION OF ELIGIBILITY IS MADE.

PART VI, LINE 2:
NOT APPLICABLE

PART VI, LINE 3:
THE MARYLAND STATE UNIFORM FINANCIAL ASSISTANCE APPLICATION, FINANCIAL ASSISTANCE POLICY, PATIENT COLLECTION PRACTICE POLICY, AND PLAIN LANGUAGE SUMMARY, CAN BE OBTAINED BY ONE OF THE FOLLOWING WAYS: A. AVAILABLE FREE OF CHARGE AND UPON REQUEST BY CALLING (410) 968-1200 X3471 B. ARE LOCATED IN THE REGISTRATION AREAS. C. DOWNLOADED FROM THE HOSPITAL WEBSITE: HTTPS://WWW.TIDALHEALTH.ORG/MEDICAL-CARE/FINANCIAL-ADMIN-SERVICES/BILLING/TIDALHEALTH-NANTICOKE-FINANCIAL-ASSISTANCE AND HTTPS://WWW.TIDALHEALTH.ORG/MEDICAL-CARE/FINANCIAL-ADMIN-SERVICES/BILLINGD. THE PLAIN LANGUAGE SUMMARY IS INSERTED IN THE ADMISSION PACKET AND WITH ALL PATIENT STATEMENTS. E. THROUGH SIGNS POSTED IN THE MAIN REGISTRATION AREAS. F. ANNUAL NOTIFICATION IN THE LOCAL NEWSPAPER. G. THE APPLICATION IS AVAILABLE IN ENGLISH AND SPANISH. NO OTHER LANGUAGE CONSTITUTES A GROUP THAT IS 5% OR MORE, OR MORE THAN 1,000 RESIDENTS (WHICHEVER IS LESS) OF THE POPULATION IN OUR PRIMARY SERVICE AREA (WORCESTER, WICOMICO AND SOMERSET COUNTIES) BASED ON U.S. CENSUS DATA. H. FOR PATIENTS WHO HAVE DIFFICULTY IN FILLING OUT AN APPLICATION, THE INFORMATION CAN BE TAKEN ORALLY BY CALLING (410) 912-6957 OR IN PERSON AT THE FINANCIAL COUNSELOR'S OFFICE LOCATED IN THE EDWARD MEMORIAL HOSPITAL.

PART VI, LINE 4:
SOMERSET COUNTY IS LOCATED ON THE EASTERN SHORE OF MARYLAND, SURROUNDED BY WICOMICO COUNTY, MD TO THE NORTH; WORCESTER COUNTY, MD TO THE EAST; ACCOMACK COUNTY, VA TO THE SOUTH, AND THE CHESAPEAKE BAY TO THE WEST. IT IS ONE OF 24 MARYLAND COUNTIES/JURISDICTIONS. THE COUNTY HAS A RURAL DESIGNATION, AS DEFINED BY THE UNITED STATES CENSUS BUREAU, HOSTING A POPULATION OF LESS THAN 50,000 RESIDENTS. SOMERSET COUNTY HAS ONE HOSPITAL, THREE HEALTH CARE AND SOCIAL ASSISTANCE CLINICS, AND THREE NURSING AND RESIDENTIAL CARE FACILITIES. SOMERSET COUNTY IS HOME TO 26,000 RESIDENTS. RACIALLY, THE COUNTY IS MAJORITY WHITE (54%); 43% BLACK; 0.9% ASIAN, AND LESS THAN 1% EACH OF NATIVE AMERICAN AND HAWAIIAN BACKGROUNDS. 3.6% OF THE RESIDENTS IDENTIFY THEMSELVES AS HISPANIC/LATINO. THE MEDIAN AGE OF THE COUNTY IS 37 YEARS OLD. IN 2016, THE SOMERSET COUNTY MEDIAN HOUSEHOLD INCOME WAS JUST UNDER $36,000 WITH 24.3% OF THE POPULATION LIVING IN POVERTY. HOUSING PROBLEMS ARE AN ISSUE, WITH AROUND 24% OF ALL HOUSEHOLDS (HIGHEST IN MARYLAND) EXPERIENCING ONE OR MORE OF THE FOLLOWING CHALLENGES: OVERCROWDING, HIGH HOUSING COSTS, OR LACK OF KITCHEN OR PLUMBING FACILITIES.

PART VI, LINE 6:
MCCREADY FOUNDATION IS PART OF THE PENINSULA REGIONAL HEALTH SYSTEM. IN ADDITION TO THE COMMUNITY BENEFITS PROVIDED BY THE RELATED MEDICAL CENTER, THE HEALTH SYSTEM EVALUATES THE NEEDS OF THE COMMUNITY AND WILL PARTICIPATE IN COMMUNITY BENEFIT PROGRAMS AS NEEDED.

PART VI, LINE 7:
COMMUNITY BENEFIT REPORT STATE FILINGSSTATE(S) WITH WHICH THE ORGANIZATION FILES A COMMUNITY BENEFIT REPORT: MARYLAND

PART VI, LINE 5:
A MAJORITY OF MCCREADY FOUNDATION'S BOARD MEMBERS ARE INDEPENDENT COMMUNITY MEMBERS, MOST LIVING AND/OR WORKING IN THE HOSPITAL'S PRIMARY SERVICE AREA AND ARE VERY INVOLVED IN BETTERING THE HEALTH OF ITS COMMUNITY. BOARD MEMBERS PARTICIPATE IN THE OVERSIGHT OF COMMUNITY HEALTH PROGRAMS AND OFTEN GO INTO THE COMMUNITY ALONGSIDE STAFF MEMBERS TO HELP PROVIDE CONNECTION OF THE BOARD WITH COMMUNITY NEEDS. THE ORGANIZATION IS COMMITTED TO THE EDUCATION OF THE COMMUNITY RANGING FROM GENERAL AWARENESS TO PATIENT OR CONDITION SPECIFIC INFORMATION TO CLINICAL SCHOLARSHIPS FOR LOCAL HIGH SCHOOL STUDENTS AND FOR STAFF WANTING TO EXPAND SKILLS AND EXPERTISE. THE ORGANIZATION INVESTS IN MEDICAL EQUIPMENT AND TRAINING TO ENSURE THE BEST POSSIBLE CARE FOR ITS PATIENTS. IT USES PLANNED FUNDS, CONTINGENCY OR EXTRA FUNDS AND GRANT FUNDING TO AID IN ONGOING INVESTMENTS. PRIOR TO COMING ON STAFF TO CARE FOR PATIENTS, EACH PROVIDER PREPARES AN APPLICATION FOR MEMBERSHIP AND PRIVILEGES WHICH IS VERIFIED AND PRIMARY SOURCED, REVIEWED BY THE CREDENTIALS AND MEDICAL EXECUTIVE COMMITTEE BEFORE BEING RECOMMENDED TO THE BOARD OF DIRECTORS FOR THEIR APPROVAL. IN ADDITION, EVERY TWO YEARS, PROVIDER PERFORMANCE IS REVIEWED AND EVALUATED.