Form990
Click to see attachment
Department of the Treasury
Internal Revenue Service
Return of Organization Exempt From Income Tax
Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code (except black lung benefit trust or private foundation)

MediumBullet The organization may have to use a copy of this return to satisfy state reporting requirements.
OMB No. 1545-0047
2010
Open to Public Inspection
A For the calendar year, or tax year beginning 07-01-2010 and ending 06-30-2011
BCheck if applicable:
CName of organization
Frederick Memorial Hospital Inc
 
Doing Business As
 
 
Number and street (or P.O. box if mail is not delivered to street address)
400 WEST 7TH STREET
 
Room/suite
City or town, state or country, and ZIP + 4
FREDERICK, MD21701
D Employer identification number

52-0591612
E Telephone number

G Gross receipts $ 366,759,785
F Name and address of principal officer:
THOMAS A KLEINHANZL
400 WEST 7TH STREET
FREDERICK,MD21701
I
Tax-exempt status: (   ) LeftBullet (insert no.) or
J
Website:MediumBullet
WWW.FMH.ORG
H(a)
Is this a group return for
affiliates?
H(b)
Are all affiliates included?
If "No," attach a list. (see instructions)
H(c)
Group exemption number MediumBullet  
K Form of organization:
 
L Year of formation: 1897
M State of legal domicile: MD
Part I
Summary
Activities  & Governance 1 Briefly describe the organization’s mission or most significant activities: TO CONTRIBUTE TO THE HEALTH AND WELL-BEING OF AREA RESIDENTS BY PROVIDING QUALITY HEALTHCARE IN A CARING, COST EFFICIENT, SAFE AND CONVENIENT MANNER.
2 Check this box MediumBullet
3 Number of voting members of the governing body (Part VI, line 1a) .... 3 18
4 Number of independent voting members of the governing body (Part VI, line 1b) .... 4 15
5 Total number of individuals employed in calendar year 2010 (Part V, line 2a) ... 5 3,105
6 Total number of volunteers (estimate if necessary) .... 6 790
7a Total unrelated business revenue from Part VIII, column (C), line 12 .. 7a 1,184
b Net unrelated business taxable income from Form 990-T, line 34 .. 7b 0
Revenues; Prior Year Current Year
8 Contributions and grants (Part VIII, line 1h) ......... 3,600,853 1,975,386
9 Program service revenue (Part VIII, line 2g) ......... 303,546,203 340,072,234
10 Investment income (Part VIII, column (A), lines 3, 4, and 7d ) .... -1,304,105 7,459,520
11 Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e) 1,438,862 -876,778
12 Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)................... 307,281,813 348,630,362
Expenses; 13 Grants and similar amounts paid (Part IX, column (A), lines 1–3 )... 100,000 100,000
14 Benefits paid to or for members (Part IX, column (A), line 4) .... 0 0
15 Salaries, other compensation, employee benefits (Part IX, column (A), lines 5–10) 153,752,164 167,577,086
16a Professional fundraising fees (Part IX, column (A), line 11e).... 0 0
b Total fundraising expenses (Part IX, column (D), line 25) MediumBullet752,576    
17 Other expenses (Part IX, column (A), lines 11a–11d, 11f–24f).... 149,886,646 164,986,730
18 Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25) 303,738,810 332,663,816
19 Revenue less expenses. Subtract line 18 from line 12...... 3,543,003 15,966,546
Net Assets or Fund Balances; Beginning of Current Year End of Year
20 Total assets (Part X, line 16)............ 371,155,162 406,175,936
21 Total liabilities (Part X, line 26)............ 226,506,128 228,526,672
22 Net assets or fund balances. Subtract line 21 from line 20 ..... 144,649,034 177,649,264
Part II
Signature Block
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct, and complete. Declaration of preparer (other than officer) is based on all information of which preparer has any knowledge.
Sign Here
JumboBullet
Signature of officer Date
JumboBullet
Type or print name and title.
Paid Preparer's Use Only Preparer's
signature
Big Right Arrow
Date
right pointing bullet image Preparer’s taxpayer identification number
(see instructions)
Firm’s name (or yours
if self-employed),
address, and ZIP + 4
Big Right Arrow




EIN right pointing bullet image
Phone no. right pointing bullet image
May the IRS discuss this return with the preparer shown above? (see instructions) .........
For Privacy Act and Paperwork Reduction Act Notice, see the separate instructions.
Cat. No. 11282Y
Form 990 (2010)
Form 990 (2010)
Page 2
Part III
Statement of Program Service Accomplishments
Check if Schedule O contains a response to any question in this Part III . . . . . . . . . .
1
Briefly describe the organization’s mission: SEE SCHEDULE O.
2
Did the organization undertake any significant program services during the year which were not listed on
the prior Form 990 or 990-EZ? ....................
If “Yes,” describe these new services on Schedule O.
3
Did the organization cease conducting, or make significant changes in how it conducts, any program services? ..........................
If “Yes,” describe these changes on Schedule O.
4
Describe the exempt purpose achievements for each of the organization’s three largest program services by expenses.
Section 501(c)(3) and 501(c)(4) organizations and section 4947(a)(1) trusts 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 (Code:   ) (Expenses $ 297,121,151 including grants of $ 100,000 ) (Revenue $ 340,072,234 )
SEE SCHEDULE O.
4b (Code:   ) (Expenses $   including grants of $   ) (Revenue $   )
4c (Code:   ) (Expenses $   including grants of $   ) (Revenue $   )
4d Other program services. (Describe in Schedule O.)
(Expenses $   including grants of $   ) (Revenue $   )
4e Total program service expensesMediumBullet$ 297,121,151
Form 990 (2010)
Form 990 (2010)
Page 3
Part IV
Checklist of Required Schedules
Yes
No
1
Is the organization described in section 501(c)(3) or 4947(a)(1) (other than a private foundation)? If “Yes,” complete Schedule AClick to see attachment.....................
1
Yes
 
2
Is the organization required to complete Schedule B, Schedule of Contributors? Click to see attachment........
2
Yes
 
3
Did the organization engage in direct or indirect political campaign activities on behalf of or in opposition to candidates for public office? If “Yes,” complete Schedule C, Part IClick to see attachment..........
3
 
No
4
Section 501(c)(3) organizations. Did the organization engage in lobbying activities? If “Yes,” complete Schedule C,
Part II
Click to see attachment.........................
4
Yes
 
5
Is the organization a section 501(c)(4), 501(c)(5), or 501(c)(6) organization that receives membership dues, assessments, or similar amounts as defined in Revenue Procedure 98-19? If “Yes,” complete Schedule C, Part III........................
5
 
 
6
Did the organization maintain any donor advised funds or any similar funds or accounts where donors have the right to provide advice on the distribution or investment of amounts in such funds or accounts? If “Yes,” complete
Schedule D, Part I
Click to see attachment
.......................
6
 
No
7
Did the organization receive or hold a conservation easement, including easements to preserve open space,
the environment, historic land areas or historic structures? If “Yes,” complete Schedule D, Part IIClick to see attachment
...
7
 
No
8
Did the organization maintain collections of works of art, historical treasures, or other similar assets? If “Yes,” complete Schedule D, Part III Click to see attachment....................
8
 
No
9
Did the organization report an amount in Part X, line 21; serve as a custodian for amounts not listed in Part X; or provide credit counseling, debt management, credit repair, or debt negotiation services? If “Yes,”
complete Schedule D, Part IV
Click to see attachment
...................
9
 
No
10
Did the organization, directly or through a related organization, hold assets in term, permanent,or quasi-endowments? If “Yes,” complete Schedule D, Part VClick to see attachment
10
Yes
 
11
If the organization’s answer to any of the following questions is ‘Yes,’ then complete Schedule D, Parts VI, VII, VIII, IX, or X as applicable:
a
Did the organization report an amount for land, buildings, and equipment in Part X, line10? If “Yes,” complete Schedule D, Part VI.Click to see attachment
11a
Yes
 
b
Did the organization report an amount for investments—other securities in Part X, line 12 that is 5% or more of its total assets reported in Part X, line 16? If “Yes,” complete Schedule D, Part VII.Click to see attachment
11b
 
No
c
Did the organization report an amount for investments—program related in Part X, line 13 that is 5% or more of its total assets reported in Part X, line 16? If “Yes,” complete Schedule D, Part VIII.Click to see attachment
11c
Yes
 
d
Did the organization report an amount for other assets in Part X, line 15 that is 5% or more of its total assets reported in Part X, line 16? If “Yes,” complete Schedule D, Part IX.Click to see attachment
11d
 
No
e
Did the organization report an amount for other liabilities in Part X, line 25? If “Yes,” complete Schedule D, Part X.Click to see attachment
11e
Yes
 
f
Did the organization’s separate or consolidated financial statements for the tax year include a footnote that addresses the organization’s liability for uncertain tax positions under FIN 48 (ASC 740)? If “Yes,” complete Schedule D, Part X.Click to see attachment
11f
 
No
12a
Did the organization obtain separate, independent audited financial statements for the tax year? If “Yes,” complete Schedule D, Parts XI, XII, and XIII Click to see attachment
12a
 
No
b
Was the organization included in consolidated, independent audited financial statements for the tax year? If “Yes,” and if the organization answered ‘No’ to line 12a, then completing Schedule D, Parts XI, XII, and XIII is optional Click to see attachment
12b
Yes
 
13
Is the organization a school described in section 170(b)(1)(A)(ii)? If “Yes,” complete Schedule E
13
 
No
14a
Did the organization maintain an office, employees, or agents outside of the United States?....
14a
 
No
b
Did the organization have aggregate revenues or expenses of more than $10,000 from grantmaking, fundraising, business, and program service activities outside the United States? If “Yes,” complete Schedule F, Part I.........
14b
 
No
15
Did the organization report on Part IX, column (A), line 3, more than $5,000 of grants or assistance to any organization or entity located outside the U.S.? If “Yes,” complete Schedule F, Part II..
15
 
No
16
Did the organization report on Part IX, column (A), line 3, more than $5,000 of aggregate grants or assistance to individuals located outside the U.S.? If “Yes,” complete Schedule F, Part III..
16
 
No
17
Did the organization report a total of more than $15,000, of expenses for professional fundraising services on Part IX, column (A), lines 6 and 11e? If “Yes,” complete Schedule G, Part I
17
 
No
18
Did the organization report more than $15,000 total of fundraising event gross income and contributions on Part VIII, lines 1c and 8a? If “Yes,” complete Schedule G, Part II..........
18
 
No
19
Did the organization report more than $15,000 of gross income from gaming activities on Part VIII, line 9a? If “Yes,” complete Schedule G, Part III...................
19
 
No
Form 990 (2010)
Form 990 (2010)
Page 4
Part IV
Checklist of Required Schedules (continued)
20a
Did the organization operate one or more hospitals? If “Yes,” complete Schedule H..... Click to see attachment
20a
Yes
 
b
Did the organization attach its audited financial statement to this return? Note: All Form 990 filers that operate one or more hospitals must attach audited financial statements. ..... Click to see list of attachments
20b
Yes
 
21
Did the organization report more than $5,000 of grants and other assistance to governments and organizations in the United States on Part IX, column (A), line 1? If “Yes,” complete Schedule I, Parts I and II.. Click to see attachment
21
Yes
 
22
Did the organization report more than $5,000 of grants and other assistance to individuals in the United States on Part IX, column (A), line 2? If “Yes,” complete Schedule I, Parts I and III..... Click to see attachment
22
 
No
23
Did the organization answer “Yes” to Part VII, Section A, questions 3, 4, or 5, about compensation of the organization’s current and former officers, directors, trustees, key employees, and highest compensated employees? If “Yes,” complete Schedule J................ Click to see attachment
23
Yes
 
24a
Did the organization have a tax-exempt bond issue with an outstanding principal amount of more than $100,000 as of the last day of the year, that was issued after December 31, 2002? If “Yes,” answer questions 24b–24d and complete Schedule K. If “No,” go to line 25................ Click to see attachment
24a
Yes
 
b
Did the organization invest any proceeds of tax-exempt bonds beyond a temporary period exception?...
24b
 
No
c
Did the organization maintain an escrow account other than a refunding escrow at any time during the year
to defease any tax-exempt bonds?
......................
24c
 
No
d
Did the organization act as an “on behalf of” issuer for bonds outstanding at any time during the year?...
24d
 
No
25a
Section 501(c)(3) and 501(c)(4) organizations. Did the organization engage in an excess benefit transaction with a disqualified person during the year? If “Yes,” complete Schedule L, Part I...... Click to see attachment
25a
 
No
b
Is the organization aware that it engaged in an excess benefit transaction with a disqualified person in a prior year, and that the transaction has not been reported on any of the organization’s prior Forms 990 or 990-EZ? If “Yes,” complete Schedule L, Part I................ Click to see attachment
25b
 
No
26
Was a loan to or by a current or former officer, director, trustee, key employee, highly compensated employee, or disqualified person outstanding as of the end of the organization’s tax year? If “Yes,” complete Schedule L,
Part II
........................... Click to see attachment
26
Yes
 
27
Did the organization provide a grant or other assistance to an officer, director, trustee, key employee, substantial contributor, or a grant selection committee member, or to a person related to such an individual? If “Yes,” complete Schedule L, Part III............... Click to see attachment
27
 
No
28
Was the organization a party to a business transaction with one of the following parties? (see Schedule L, Part IV instructions for applicable filing thresholds, conditions, and exceptions):
a
A current or former officer, director, trustee, or key employee? If “Yes,” complete Schedule L, Part IV ......................... Click to see attachment
28a
 
No
b
A family member of a current or former officer, director, trustee, or key employee? If “Yes,”
complete Schedule L, Part IV
................... Click to see attachment
28b
 
No
c
An entity of which a current or former officer, director, trustee, or key employee (or a family member thereof) was an officer, director, trustee, or owner? If “Yes,” complete Schedule L, Part IV.. Click to see attachment
28c
 
No
29
Did the organization receive more than $25,000 in non-cash contributions? If “Yes,” complete Schedule MClick to see attachment
29
Yes
 
30
Did the organization receive contributions of art, historical treasures, or other similar assets, or qualified conservation contributions? If “Yes,” complete Schedule M............ Click to see attachment
30
 
No
31
Did the organization liquidate, terminate, or dissolve and cease operations? If “Yes,” complete Schedule N,
Part I
........................... Click to see attachment
31
 
No
32
Did the organization sell, exchange, dispose of, or transfer more than 25% of its net assets? If “Yes,” complete Schedule N, Part II.......................
32
 
No
33
Did the organization own 100% of an entity disregarded as separate from the organization under Regulations sections 301.7701-2 and 301.7701-3? If “Yes,” complete Schedule R, Part I........ Click to see attachment
33
Yes
 
34
Was the organization related to any tax-exempt or taxable entity? If “Yes,” complete Schedule R, Parts II, III, IV, and V, line 1..................... Click to see attachment
34
Yes
 
35
Is any related organization a controlled entity within the meaning of section 512(b)(13)? .....
35
Yes
 
a
Did the organization receive any payment from or engage in any transaction with a controlled entity within the meaning of section 512(b)(13)? If “Yes,” complete Schedule R, Part V, line 2... Click to see attachment
36
Section 501(c)(3) organizations. Did the organization make any transfers to an exempt non-charitable related organization? If “Yes,” complete Schedule R, Part V, line 2........... Click to see attachment
36
 
No
37
Did the organization conduct more than 5% of its activities through an entity that is not a related organization and that is treated as a partnership for federal income tax purposes? If “Yes,” complete Schedule R, Part VIClick to see attachment
37
 
No
38
Did the organization complete Schedule O and provide explanations in Schedule O for Part VI, lines 11 and 19? Note. All Form 990 filers are required to complete Schedule O. ............
38
Yes
 
Form 990 (2010)
Form 990 (2010)
Page 5
Part V
Statements Regarding Other IRS Filings and Tax Compliance
Check if Schedule O contains a response to any question in this Part V . . . . . . . . . .
Yes
No
1a
Enter the number reported in Box 3 of Form 1096. Enter -0- if not applicable. .......
1a
307
b
Enter the number of Forms W-2G included in line 1a. Enter -0- if not applicable.
1b
0
c
Did the organization comply with backup withholding rules for reportable payments to vendors and reportable gaming (gambling) winnings to prize winners? ..................
1c
Yes
 
2a
Enter the number of employees reported on Form W-3, Transmittal of Wage and Tax Statements filed for the calendar year ending with or within the year covered by this return .....................
2a
3,105
b
If at least one is reported on line 2a, did the organization file all required federal employment tax returns?

Note. If the sum of lines 1a and 2a is greater than 250, you may be required to e-file. (see instructions)
2b
Yes
 
3a
Did the organization have unrelated business gross income of $1,000 or more during the year?.............................
3a
Yes
 
b
If “Yes,” has it filed a Form 990-T for this year? If “No,” provide an explanation in Schedule O.....
3b
Yes
 
4a
At any time during the calendar year, did the organization have an interest in, or a signature or other authority over, a financial account in a foreign country (such as a bank account or securities account)?.......................
4a
 
No
b
If "Yes," enter the name of the foreign country: MediumBullet
See instructions for filing requirements for Form TD F 90-22.1, Report of Foreign Bank and Financial Accounts.
5a
Was the organization a party to a prohibited tax shelter transaction at any time during the tax year?..
5a
 
No
b
Did any taxable party notify the organization that it was or is a party to a prohibited tax shelter transaction?
5b
 
No
c
If “Yes” to line 5a or 5b, did the organization file Form 8886-T? ........
5c
 
 
6a
Does the organization have annual gross receipts that are normally greater than $100,000, and did the organization solicit any contributions that were not tax deductible?..........
6a
 
No
b
If “Yes,” did the organization include with every solicitation an express statement that such contributions or gifts were not tax deductible?........................
6b
 
 
7
Organizations that may receive deductible contributions under section 170(c).
a
Did the organization receive a payment in excess of $75 made partly as a contribution and partly for goods and services provided to the payor?....................
7a
 
No
b
If “Yes,” did the organization notify the donor of the value of the goods or services provided?.....
7b
 
 
c
Did the organization sell, exchange, or otherwise dispose of tangible personal property for which it was required to file Form 8282?...........................
7c
 
No
d
If “Yes,” indicate the number of Forms 8282 filed during the year ....
7d
 
e
Did the organization receive any funds, directly or indirectly, to pay premiums on a personal benefit contract?..........................
7e
 
No
f
Did the organization, during the year, pay premiums, directly or indirectly, on a personal benefit contract?..
7f
 
No
g
If the organization received a contribution of qualified intellectual property, did the organization file Form 8899 as required?...................
7g
 
 
h
If the organization received a contribution of cars, boats, airplanes, or other vehicles, did the organization file a Form 1098-C?...............
7h
 
 
8
Sponsoring organizations maintaining donor advised funds and section 509(a)(3) supporting organizations. Did the supporting organization, or a donor advised fund maintained by a sponsoring organization, have excess business holdings at any time during the year?................
8
 
 
9
Sponsoring organizations maintaining donor advised funds.
a
Did the organization make any taxable distributions under section 4966?.........
9a
 
 
b
Did the organization make a distribution to a donor, donor advisor, or related person?......
9b
 
 
10
Section 501(c)(7) organizations. Enter:
a
Initiation fees and capital contributions included on Part VIII, line 12 ...
10a
 
b
Gross receipts, included on Form 990, Part VIII, line 12, for public use of club facilities
10b
 
11
Section 501(c)(12) organizations. Enter:
a
Gross income from members or shareholders .........
11a
 
b
Gross income from other sources (Do not net amounts due or paid to other sources against amounts due or received from them.) ........
11b
 
12a
Section 4947(a)(1) non-exempt charitable trusts. Is the organization filing Form 990 in lieu of Form 1041?
12a
 
 
b
If “Yes,” enter the amount of tax-exempt interest received or accrued during the year.
12b
 
13
Section 501(c)(29) qualified nonprofit health insurance issuers.
a
Is the organization licensed to issue qualified health plans in more than one state?
Note.
All 501(c)(29) organizations must list in Schedule O each state in which they are licensed to issue qualified health plans, the amount of reserves required by each state, and the amount of reserves the organization allocated to each state.
13a
 
 
b
Enter the aggregate amount of reserves the organization is required to maintain by the states in which the organization is licensed to issue qualified health plans.
13b
 
c
Enter the aggregate amount of reserves on hand.
13c
 
14a
Did the organization receive any payments for indoor tanning services during the tax year?.....
14a
 
 
b
If "Yes," has it filed a Form 720 to report these payments? If “No,” provide an explanation in Schedule O..
14b
 
 
Form 990 (2010)
Form 990 (2010)
Page 6
Part VI
Governance, Management, and Disclosure For each “Yes” response to lines 2 through 7b below, and for a “No” response to lines 8a, 8b, or 10b below, describe the circumstances, processes, or changes in Schedule O. See instructions.
Check if Schedule O contains a response to any question in this Part VI . . . . . . . . . .
Section A. Governing Body and Management
Yes
No
1a
Enter the number of voting members of the governing body at the end of the tax year ..............
1a
18
b
Enter the number of voting members included in line 1a, above, who are independent .................
1b
15
2
Did any officer, director, trustee, or key employee have a family relationship or a business relationship with any other officer, director, trustee, or key employee? .................
2
Yes
 
3
Did the organization delegate control over management duties customarily performed by or under the direct supervision of officers, directors or trustees, or key employees to a management company or other person? ..
3
 
No
4
Did the organization make any significant changes to its governing documents since the prior Form 990 was filed?
4
Yes
 
5
Did the organization become aware during the year of a significant diversion of the organization’s assets? .
5
 
No
6
Does the organization have members or stockholders? ................
6
Yes
 
7a
Does the organization have members, stockholders, or other persons who may elect one or more members of the governing body? .........................
7a
Yes
 
b
Are any decisions of the governing body subject to approval by members, stockholders, or other persons? ..
7b
Yes
 
8
Did the organization contemporaneously document the meetings held or written actions undertaken during the year by the following:
a
The governing body? .........................
8a
Yes
 
b
Each committee with authority to act on behalf of the governing body? ............
8b
Yes
 
9
Is there any officer, director, trustee, or key employee listed in Part VII, Section A, who cannot be reached at the organization’s mailing address? If “Yes,” provide the names and addresses in Schedule O .....
9
 
No
Section B. Policies (This Section B requests information about policies not required by the Internal
Revenue Code.)
Yes
No
10a
Does the organization have local chapters, branches, or affiliates? ............
10a
 
No
b
If “Yes,” does the organization have written policies and procedures governing the activities of such chapters, affiliates, and branches to ensure their operations are consistent with those of the organization? ....
10b
 
 
11a
Has the organization provided a copy of this Form 990 to all members of its governing body before filing the form?
11a
Yes
 
b
Describe in Schedule O the process, if any, used by the organization to review the Form 990. .....
12a
Does the organization have a written conflict of interest policy? If “No,” go to line 13.......
12a
Yes
 
b
Are officers, directors or trustees, and key employees required to disclose annually interests that could give rise to conflicts? ...........................
12b
Yes
 
c
Does the organization regularly and consistently monitor and enforce compliance with the policy? If “Yes,” describe in Schedule O how this is done ....................
12c
Yes
 
13
Does the organization have a written whistleblower policy? ...............
13
Yes
 
14
Does the organization have a written document retention and destruction policy? .........
14
Yes
 
15
Did the process for determining compensation of the following persons include a review and approval by independent persons, comparability data, and contemporaneous substantiation of the deliberation and decision?
a
The organization’s CEO, Executive Director, or top management official ...........
15a
Yes
 
b
Other officers or key employees of the organization ................
15b
Yes
 
If "Yes" to line a or b, describe the process in Schedule O. (See instructions.)
16a
Did the organization invest in, contribute assets to, or participate in a joint venture or similar arrangement with a taxable entity during the year? ......................
16a
Yes
 
b
If “Yes,” has the organization adopted a written policy or procedure requiring the organization to evaluate its participation in joint venture arrangements under applicable federal tax law, and taken steps to safeguard the organization’s exempt status with respect to such arrangements? ............
16b
 
No
Section C. Disclosure
17
List the States with which a copy of this Form 990 is required to be filedMediumBullet
MD
18
Section 6104 requires an organization to make its Form 1023 (or 1024 if applicable), 990, and 990-T (501(c)(3)s only) available for public inspection. Indicate how you make these available. Check all that apply.
19
Describe in Schedule O whether (and if so, how), the organization makes its governing documents, conflict of interest policy, and financial statements available to the public.
20
State the name, physical address, and telephone number of the person who possesses the books and records of the organization: MediumBullet
MICHELLE MAHAN
400 WEST 7TH STREET
FREDERICK,MD21701
(240) 566-3300
Form 990 (2010)
Form 990 (2010)
Page 7
Part VII
Compensation of Officers, Directors,Trustees, Key Employees, Highest Compensated Employees, and Independent Contractors
Check if Schedule O contains a response to any question in this Part VII . . . . . . . . . .
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees
1a Complete this table for all persons required to be listed. Report compensation for the calendar year ending with or within the organization’s tax year.
RoundBullet List all of the organization’s current officers, directors, trustees (whether individuals or organizations), regardless of amount
of compensation, and current key employees. Enter -0- in columns (D), (E), and (F) if no compensation was paid.

RoundBullet List all of the organization’s current key employees, if any. See instructions for definition of "key employee."
RoundBullet List the organization’s five current highest compensated employees (other than an officer, director, trustee or key employee)
who received reportable compensation (Box 5 of Form W-2 and/or Box 7 of Form 1099-MISC) of more than $100,000 from the
organization and any related organizations.

RoundBullet List all of the organization’s former officers, key employees, or highest compensated employees who received more than $100,000
of reportable compensation from the organization and any related organizations.

RoundBullet List all of the organization’s former directors or trustees that received, in the capacity as a former director or trustee of the
organization, more than $10,000 of reportable compensation from the organization and any related organizations.

List persons in the following order: individual trustees or directors; institutional trustees; officers; key employees; highest
compensated employees; and former such persons.
Check this box if neither the organization nor any related organizations compensated any current or former officer, director, or trustee.
(A)
Name and Title
(B)
Average hours per week (describe hours for related organizations in Schedule O)
(C)
Position (check all that apply)
(D)
Reportable compensation from the organization (W- 2/1099-MISC)
(E)
Reportable compensation from related organizations (W- 2/1099-MISC)
(F)
Estimated amount of other compensation from the organization and related organizations
Individual Trustee or Director; Institutional Trustee; Officer; Key Employee; Highest compensated employee; Former;
(1) Thomas A Kleinhanzl
President and CEO
40.0 X   X       726,891 0 130,262
(2) Marvin Ausherman
Director
2.0 X           0 0 0
(3) James R Dixon
Director
2.0 X           0 0 0
(4) Carol W Eaton PhD
Director
2.0 X           0 0 0
(5) Bernard Gouin
Director
2.0 X           0 0 0
(6) Phil Hammond
Director (THROUGH 10/1/10)
2.0 X           0 0 0
(7) Theodore Luck
Director
2.0 X           0 0 0
(8) J Frederick Manning
Director
2.0 X           0 0 0
(9) John Molesworth DO
Chief Of Staff
10.0 X   X       52,996 0 0
(10) Greg Powell PhD
Chairman Of The Board
8.0 X           0 0 0
(11) Joann Ramsburg
Director
2.0 X           0 0 0
(12) E James Reinsch
Director
2.0 X           0 0 0
(13) Adriana Roa BSN
Director
2.0 X           0 0 0
(14) Anne Herbert Rollins
Secretary And Treasurer
6.0 X           0 0 0
(15) Neil Waravdekar MD
Vice Chief Of Staff
10.0 X   X       34,411 0 0
(16) Reverend Roger W Wilmer Jr
Director
2.0 X           1,200 0 0
(17) Gerald Winnan MD
Director
2.0 X           0 0 0
Form 990 (2010)
Form 990 (2010)
Page 8
Part VII
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees (continued)
(A)
Name and Title
(B)
Average hours per week (describe hours for related organizations in Schedule O)
(C)
Position (check all that apply)
(D)
Reportable compensation from the organization (W- 2/1099-MISC)
(E)
Reportable compensation from related organizations (W- 2/1099-MISC)
(F)
Estimated amount of other compensation from the organization and related organizations
Individual Trustee or Director; Institutional Trustee; Officer; Key Employee; Highest compensated employee; Former;
(18) Adriane Wodey
Vice Chairman
6.0 X           0 0 0
(19) Saeed Zaidi Md
Former Chief Of Staff
2.0 X           1,000 0 0
(20) Manuel A Casiano
VP Medical Staff
40.0     X       319,416 0 29,804
(21) Kenneth R Coffey II
VP Chief Development Officer
40.0     X       180,481 0 28,975
(22) Rose A Labriola
Sr VP Patient Care
40.0     X       272,788 0 43,004
(23) Michelle K Mahan
Sr VP and CFO
40.0     X       357,699 0 41,585
(24) Terry P O'Malley
VP Human Resources
40.0     X       203,041 0 30,796
(25) David Quirke
VP Chief Information Officer
40.0     X       243,991 0 18,672
(26) Craig F Rosendale
VP Ancillary Services
40.0     X       187,002 0 27,334
(27) Donald R Schilling
VP Ambulatory Services
40.0     X       190,335 0 12,352
(28) Lucy A Shamash
VP Srvc Line Dev & Ops
40.0     X       107,286 0 5,622
(29) Jennifer G Teeter
AVP Payor Contracting
40.0     X       152,212 0 24,753
(30) John R Verbus
Sr VP and COO
40.0     X       375,888 0 35,648
(31) Jim R Williams
VP Bus Dev and Prof Svcs
40.0     X       189,105 0 26,557
(32) Susan Bahl
Physician
40.0         X   278,966 0 7,235
(33) Paul N Chomiak
Physician
40.0         X   331,058 0 27,721
(34) Elhamy D Eskander
Physician
40.0         X   265,255 0 35,421
(35) Dung-Thu Nguyen
Physician
40.0         X   264,723 0 29,889
(36) Brian M O'Connor
Physician
40.0         X   357,412 0 36,201
(37) Michael W Gaskins
VP Finance
40.0           X 211,328 0 23,385
1b Sub-Total................MediumBullet
c Total from continuation sheets to Part VII, Section A....MediumBullet
d Total (add lines 1b and 1c)............MediumBullet 5,304,484 0 615,216
2
Total number of individuals (including but not limited to those listed above) who received more than $100,000 in reportable compensation from the organizationMediumBullet124
Yes
No
3
Did the organization list any former officer, director or trustee, key employee, or highest compensated employee on line 1a? If “Yes,” complete Schedule J for such individual .............
3
Yes
 
4
For any individual listed on line 1a, is the sum of reportable compensation and other compensation from the organization and related organizations greater than $150,000? If “Yes,” complete Schedule J for such individual...........................
4
Yes
 
5
Did any person listed on line 1a receive or accrue compensation from any unrelated organization or individual for services rendered to the organization? If “Yes,” complete Schedule J for such person .....
5
 
No
Section B. Independent Contractors
1
Complete this table for your five highest compensated independent contractors that received more than $100,000 of compensation from the organization.
(A)
Name and business address
(B)
Description of services
(C)
Compensation
TX Team Rehab Inc
4625 East Stop 11 Road
INDIANAPOLIS,IN46237
REHABILITATION SRVCS 6,823,735
PRIME DOC OF FREDERICK PA
PO BOX 7568
ASHEVILLE,NC28802
PHYSICIAN SERVICES 1,799,850
SLEEPMEDDIGITRACE CARE SERVICES
200 CORPORATE PLACE
PEABODY,MA01960
MEDICAL SERVICES 1,276,430
CARDIOVASCULAR CONSULTANTS PA
7901 MAPLE AVENUE
TAKOMA PARK,MD20912
PHYSICIAN SERVICES 1,097,545
FIRST COLONIES ANESTHESIA ASSOCIATE
7490 NEW TECHNOLOGY WAY
FREDERICK,MD21703
PHYSICIAN SERVICES 1,051,483
2
Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 in compensation from the organization MediumBullet24
Form 990 (2010)
Form 990 (2010)
Page 9
Part VIII
Statement of Revenue
(A)
Total revenue
(B)
Related or
exempt
function
revenue
(C)
Unrelated
business
revenue
(D)
Revenue
excluded from
tax under sections
512, 513, or 514
Contributions, gifts, grants and other similar amounts 1a Federated campaigns..1a  
b Membership dues....1b  
c Fundraising events....1c  
d Related organizations...1d  
e Government grants (contributions)1e  
f All other contributions, gifts, grants, and
similar amounts not included above
1f
1,975,386
g Noncash contributions included in lines 1a-1f:$ 53,354
h Total. Add lines 1a-1f.......MediumBullet 1,975,386
 Program Service Revenue Business Code
2a Inpatient Revenue 900,099 178,267,833 178,267,833    
b Outpatient Revenue 621,400 159,270,399 159,270,399    
c Transcription Services 561,000 546,395 546,395    
d Group Purchasing (Premier) 900,099 722,676 721,492 1,184  
e All other program service revenue 900,099 1,264,931 1,264,931    
f All other program service revenue .        
g Total. Add lines 2a–2f........MediumBullet 340,072,234
 Other Revenue 3 Investment income (including dividends, interest
and other similar amounts).....MediumBullet 2,865,401     2,865,401
4 Income from investment of tax-exempt bond proceeds..MediumBullet 0      
5 Royalties............MediumBullet 0      
(i) Real (ii) Personal
6a Gross Rents 201,446  
b Less: rental expenses    
c Rental income or (loss) 201,446  
d Net rental income or (loss).......MediumBullet 201,446     201,446
(i) Securities (ii) Other
7a Gross amount from sales of assets other than inventory 18,723,542 4,000,000
b Less: cost or other basis and sales expenses 17,429,423 700,000
c Gain or (loss) 1,294,119 3,300,000
d Net gain or (loss)..........MediumBullet 4,594,119     4,594,119
8a Gross income from fundraising events (not including
$  
of contributions reported on line 1c). See Part IV, line 18 ...
a  
b Less: direct expenses ...b  
c Net income or (loss) from fundraising events..MediumBullet 0    
9a Gross income from gaming activities.
See Part IV, line 19 ...
a  
b Less: direct expenses ...b  
c Net income or (loss) from gaming activities...MediumBullet 0      
10a Gross sales of inventory, less
returns and allowances .
a  
b Less: cost of goods sold ..b  
c Net income or (loss) from sales of inventory..MediumBullet 0      
Miscellaneous Revenue Business Code
11a Cafeteria and Coffee Shop 722,210 1,237,159     1,237,159
b Mt. Airy Joint Venture management fee 541,610 304,203     304,203
c Realized losses on interest rate swap 900,099 -2,619,586     -2,619,586
d All other revenue ....        
e Total. Add lines 11a–11d ......MediumBullet -1,078,224
12 Total revenue. See Instructions....MediumBullet 348,630,362 340,071,050 1,184 6,582,742
Form 990 (2010)
Form 990 (2010)
Page 10
Part IX
Statement of Functional Expenses
Section 501(c)(3) and 501(c)(4) organizations must complete all columns. All other organizations must complete column (A) but are not required to complete columns (B), (C), and (D).
Do not include amounts reported on lines 6b,
7b, 8b, 9b, and 10b of Part VIII.
(A)
Total expenses
(B)
Program service expenses
(C)
Management and general expenses
(D)
Fundraising expenses
1 Grants and other assistance to governments and organizations in the U.S. See Part IV, line 21 100,000 100,000
2 Grants and other assistance to individuals in the U.S. See Part IV, line 22 0  
3 Grants and other assistance to governments, organizations, and individuals outside the U.S. See Part IV, lines 15 and 16 0  
4 Benefits paid to or for members 0  
5 Compensation of current officers, directors, trustees, and key employees .... 4,945,503   4,945,503  
6 Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) .... 0      
7 Other salaries and wages 129,192,747 119,341,335 9,562,344 289,068
8 Pension plan contributions (include section 401(k) and section 403(b) employer contributions) .... 2,662,246 2,462,633 197,321 2,292
9 Other employee benefits ....... 21,218,312 19,585,079 1,564,955 68,278
10 Payroll taxes ........... 9,558,278 8,841,606 708,443 8,229
11 Fees for services (non-employees):        
a Management ...... 1,968,955 650,390 1,270,565 48,000
b Legal ......... 809,792   809,792  
c Accounting ........... 278,190   278,190  
d Lobbying ........... 0      
e Professional fundraising. See Part IV, line 17.. 0  
f Investment management fees ...... 244,762   244,762  
g Other .......... 37,156,094 34,409,364 2,697,754 48,976
12 Advertising and promotion .... 980,356 13,124 834,784 132,448
13 Office expenses ....... 7,409,538 6,623,220 676,948 109,370
14 Information technology ...... 2,573,687 2,573,687    
15 Royalties .. 0      
16 Occupancy ........... 4,437,238 4,003,642 433,596  
17 Travel ............ 132,114 84,834 42,845 4,435
18 Payments of travel or entertainment expenses for any federal, state, or local public officials ...... 0      
19 Conferences, conventions, and meetings .... 308,230 197,930 99,960 10,340
20 Interest ........... 4,666,552 4,372,559 284,660 9,333
21 Payments to affiliates ....... 0      
22 Depreciation, depletion, and amortization ..... 18,840,219 14,953,943 3,875,245 11,031
23 Insurance .............. 4,623,911 249,723 4,374,188  
24 Other expenses. Itemize expenses not covered above. (Expenses grouped together and labeled miscellaneous may not exceed 5% of total expenses shown on line 25 below.)
a SUPPLIES AND COGS 59,276,301 58,946,394 320,971 8,936
b Bad debt expense 13,784,680 13,784,680    
c All other expenses 7,496,111 5,927,008 1,567,263 1,840
d
e
f All other expenses        
25 Total functional expenses. Add lines 1 through 24f 332,663,816 297,121,151 34,790,089 752,576
26 Joint costs. Check here MediumBullet if following
SOP 98-2 (ASC 958-720). Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation
       
Form 990 (2010)
Form 990 (2010)
Page 11
Part X Balance Sheet
(A)
Beginning of year
(B)
End of year
Assets 1 Cash—non-interest-bearing .......... 1,713,322 1 0
2 Savings and temporary cash investments ....... 32,461,636 2 25,713,868
3 Pledges and grants receivable, net ......... 3,112,781 3 3,277,527
4 Accounts receivable, net ......... 43,739,800 4 45,891,896
5 Receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of
Schedule L .......... 189,443 5 135,316
6 Receivables from other disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B). Complete Part II of
Schedule L ..........   6  
7 Notes and loans receivable, net .............   7  
8 Inventories for sale or use .............. 4,155,677 8 4,355,878
9 Prepaid expenses and deferred charges ............ 2,181,733 9 2,357,935
10a Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D 10a 359,545,624
b Less: accumulated depreciation. ..... 10b 184,811,378 175,285,453 10c 174,734,246
11 Investments—publicly traded securities .......... 69,011,624 11 107,206,670
12 Investments—other securities. See Part IV, line 11 ......   12  
13 Investments—program-related. See Part IV, line 11 .. 33,813,787 13 36,930,641
14 Intangible assets .........   14  
15 Other assets. See Part IV, line 11 ........... 5,489,906 15 5,571,959
16 Total assets. Add lines 1 through 15 (must equal line 34)... 371,155,162 16 406,175,936
Liabilities 17 Accounts payable and accrued expenses . 33,272,469 17 35,316,086
18 Grants payable ..........   18  
19 Deferred revenue ..........   19  
20 Tax-exempt bond liabilities .......... 139,767,920 20 138,926,650
21 Escrow or custodial account liability. Complete Part IV of Schedule D..   21  
22 Payables to current and former officers, directors, trustees, key
employees, highest compensated employees, and disqualified
persons. Complete Part II of Schedule L..........   22  
23 Secured mortgages and notes payable to unrelated third parties .. 461,278 23 372,575
24 Unsecured notes and loans payable to unrelated third parties ....   24  
25 Other liabilities. Complete Part X of Schedule D..... 53,004,461 25 53,911,361
26 Total liabilities. Add lines 17 through 25..... 226,506,128 26 228,526,672
Net Assets or Fund Balance Organizations that follow SFAS 117, check here MediumBullet and complete lines 27 through 29, and lines 33 and 34.
27 Unrestricted net assets ..... 138,989,704 27 171,475,327
28 Temporarily restricted net assets ..... 4,683,153 28 5,197,760
29 Permanently restricted net assets ..... 976,177 29 976,177
Organizations that do not follow SFAS 117, check here MediumBullet and complete lines 30 through 34.
30 Capital stock or trust principal, or current funds .....   30  
31 Paid-in or capital surplus, or land, building or equipment fund .....   31  
32 Retained earnings, endowment, accumulated income, or other funds   32  
33 Total net assets or fund balances ..... 144,649,034 33 177,649,264
34 Total liabilities and net assets/fund balances ..... 371,155,162 34 406,175,936
Form 990 (2010)
Form 990 (2010)
Page 12
Part XI
Reconcilliation of Net Assets
Check if Schedule O contains a response to any question in this Part XI . . . . . . . . . .
1
Total revenue (must equal Part VIII, column (A), line 12) . . .
1
348,630,362
2
Total expenses (must equal Part IX, column (A), line 25) . . . . .
2
332,663,816
3
Revenue less expenses. Subtract line 2 from line 1 . . . .
3
15,966,546
4
Net assets or fund balances at beginning of year (must equal Part X, line 33, column (A)) . .
4
144,649,034
5
Other changes in net assets or fund balances (explain in Schedule O) . . . .
5
17,033,684
6
Net assets or fund balances at end of year. Combine lines 3, 4, and 5 (must equal Part X, line 33, column (B)) . . . . . .
6
177,649,264
Part XII
Financial Statements and Reporting
Check if Schedule O contains a response to any question in this Part XII . . . . . . . . . .
Yes
No
1
Accounting method used to prepare the Form 990:  
If the organization changed its method of accounting from a prior year or checked "Other," explain in
Schedule O.
2a
Were the organization’s financial statements compiled or reviewed by an independent accountant?..
2a
 
No
b
Were the organization’s financial statements audited by an independent accountant?........
2b
Yes
 
c
If “Yes,” to 2a or 2b, does the organization have a committee that assumes responsibility for oversight of the audit, review, or compilation of its financial statements and selection of an independent accountant?
If the organization changed either its oversight process or selection process during the tax year, explain in Schedule O.
...........................
2c
Yes
 
d
If “Yes” to line 2a or 2b, check a box below to indicate whether the financial statements for the year were issued on a separate basis, consolidated basis, or both:
3a
As a result of a federal award, was the organization required to undergo an audit or audits as set forth in the Single Audit Act and OMB Circular A-133? ................
3a
 
No
b
If “Yes,” did the organization undergo the required audit or audits? If the organization did not undergo the required audit or audits, explain why in Schedule O and describe any steps taken to undergo such audits. ..
3b
 
 
Form 990 (2010)
Additional Data


Software ID:  
Software Version:  
Form 990, Special Condition Description:
Special Condition Description
SCHEDULE A
(Form 990 or 990EZ)

Department of the Treasury
Internal Revenue Service
Public Charity Status and Public Support

Complete if the organization is a section 501(c)(3) organization or a section
4947(a)(1) nonexempt charitable trust.
right arrow Attach to Form 990 or Form 990-EZ. right arrow See separate instructions.
OMB No. 1545-0047
2010
Open to Public
Inspection
Name of the organization
Frederick Memorial Hospital Inc
 
Employer identification number

52-0591612
Part I
Reason for Public Charity Status (All organizations must complete this part.) See instructions
The organization is not a private foundation because it is: (For lines 1 through 11, check only one box.)
1
2
3
4
5
section 170(b)(1)(A)(iv). (Complete Part II.)
6
7
8
9
receipts from activities related to its exempt functions—subject to certain exceptions, and (2) no more than 331/3% of
its support from gross investment income and unrelated business taxable income (less section 511 tax) from businesses
acquired by the organization after June 30, 1975. See section 509(a)(2). (Complete Part III.)
10
11
e
f
g
(i) a person who directly or indirectly controls, either alone or together with persons described in (ii)
Yes
No
and (iii) below, the governing body of the the supported organization? ................
11g(i)
 
 
(ii) a family member of a person described in (i) above? ......................
11g(ii)
 
 
(iii) a 35% controlled entity of a person described in (i) or (ii) above? ................
11g(iii)
 
 
h
(i)
Name of supported organization
(ii)
EIN
(iii)
Type of organization (described on lines 1- 9 above or IRC section (see instructions))
(iv)
Is the organization in col. (i) listed in your governing document?
(v)
Did you notify the organization in col. (i) of your support?
(vi)
Is the organization in col. (i) organized in the U.S.?
(vii)
Amount of support?
Yes No Yes No Yes No
Total                  

For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 11285F
Schedule A (Form 990 or 990-EZ) 2010
Schedule A (Form 990 or 990-EZ) 2010
Page 2
Part II
Support Schedule for Organizations Described in IRC 170(b)(1)(A)(iv) and 170(b)(1)(A)(vi)
(Complete only if you checked the box on line 5, 7, or 8 of Part I or if the organization failed to qualify under Part III. If the organization fails to qualify under the tests listed below, please complete Part III.)
Section A. Public Support
Calendar year(or fiscal year beginning in) (a) 2006 (b) 2007 (c) 2008 (d) 2009 (e) 2010 (f) Total
1 Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") ....            
2 Tax revenues levied for the organization's benefit and either paid to or expended on its behalf.......            
3 The value of services or facilities furnished by a governmental unit to the organization without charge..            
4 Total. Add lines 1 through 3..            
5 The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included on line 1 that exceeds 2% of the amount shown on line 11, column (f)..            
6 Public Support. Subtract line 5 from line 4.            
Section B. Total Support
Calendar year(or fiscal year beginning in) (a) 2006 (b) 2007 (c) 2008 (d) 2009 (e) 2010 (f) Total
7 Amounts from line 4..            
8 Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..            
9 Net income from unrelated business activities, whether or not the business is regularly carried on..            
10 Other income. (Explain in Part IV.) Do not include gain or loss from the sale of capital assets..            
11 Total support (Add lines 7 through 10).            
12
12
 
13
Section C. Computation of Public Support Percentage
14
14
 
15
15
 
16a
b
17a
b
18
Schedule A (Form 990 or 990-EZ) 2010
Schedule A (Form 990 or 990-EZ) 2010
Page 3
Part III
Support Schedule for Organizations Described in IRC 509(a)(2)
(Complete only if you checked the box on line 9 of Part I or if the organization failed to qualify under Part II. If the organization fails to qualify under the tests listed below, please complete Part II.)
Section A. Public Support
Calendar year(or fiscal year beginning in) (a) 2006 (b) 2007 (c) 2008 (d) 2009 (e) 2010 (f) Total
1 Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") .            
2 Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose......            
3 Gross receipts from activities that are not an unrelated trade or business under section 513..            
4 Tax revenues levied for the organization's benefit and either paid to or expended on its behalf...            
5 The value of services or facilities furnished by a governmental unit to the organization without charge..            
6 Total. Add lines 1 through 5.            
7a Amounts included on lines 1, 2, and 3 received from disqualified persons...            
b Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year.            
c Add lines 7a and 7b..            
8 Public Support (Subtract line 7c from line 6.)            
Section B. Total Support
Calendar year (or fiscal year beginning in) (a) 2006 (b) 2007 (c) 2008 (d) 2009 (e) 2010 (f) Total
9 Amounts from line 6...            
10a Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..            
b Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975.            
c Add lines 10a and 10b.            
11 Net income from unrelated business activities not included in line 10b, whether or not the business is regularly carried on.            
12 Other income. Do not include gain or loss from the sale of capital assets (Explain in Part IV.)            
13 Total support (Add lines 9, 10c, 11 and 12.).            
14
Section C. Computation of Public Support Percentage
15
15
 
16
16
 
Section D. Computation of Investment Income Percentage
17
17
 
18
18
 
19a
b
20
Schedule A (Form 990 or 990-EZ) 2010
Schedule A (Form 990 or 990-EZ) 2010
Page 4
Part IV
Supplemental Information. Supplemental Information. Complete this part to provide the explanation required by Part II, line 10; Part II, line 17a or 17b; or Part III, line 12. Also complete this part for any additional information. (See instructions).
Facts And Circumstances Test
 
Explanation
 
 
 
 
Schedule A (Form 990 or 990-EZ) 2010

Additional Data


Software ID:  
Software Version:  
Schedule B
(Form 990, 990-EZ,
or 990-PF)
Department of the Treasury
Internal Revenue Service
Schedule of Contributors
Arrow Bullet Attach to Form 990, 990-EZ, or 990-PF.
OMB No. 1545-0047
2010
Name of organization
Frederick Memorial Hospital Inc
 
Employer identification number

52-0591612
Organization type (check one):
Filers of:
Section:
Form 990 or 990-EZ





Form 990-PF




Check if your organization is covered by the General Rule or a Special Rule.  
Note. Only a section 501(c)(7), (8), or (10) organization can check boxes for both the General Rule and a Special Rule. See instructions.
General Rule—
Special Rules
......................... Arrow Bullet   $    
Caution. An Organization that is not covered by the General Rule and/or the Special Rules does not file Schedule B (Form 990,
990-EZ, or 990-PF), but it must answer “No” on Part IV, line 2 of its Form 990, or check the box in the heading of its
Form 990-EZ, or on line 2 of its Form 990-PF, to certify that it does not meet the filing requirements of Schedule B (Form 990,
990-EZ, or 990-PF).
For Paperwork Reduction Act Notice, see the Instructions
for Form 990, 990-EZ, or 990-PF.
Cat. No. 30613XSchedule B (Form 990, 990-EZ, or 990-PF) (2010)

Schedule B (Form 990, 990-EZ, or 990-PF) (2010)
Page 1 of 1 of Part I
Name of organization
Frederick Memorial Hospital Inc
 
Employer identification number

52-0591612
Part I
Contributors (see Instructions)
     
(a)
No.
(b)
Name, address, and ZIP + 4
(c)
Aggregate contributions
(d)
Type of contribution
RESTRICTED
RESTRICTED
 

     
RESTRICTED
RESTRICTED  
RESTRICTED, RESTRICTED   RESTRICTED

$RESTRICTED




(Complete Part II if there is
a noncash contribution.)
(a)
No.
(b)
Name, address, and ZIP + 4
(c)
Aggregate contributions
(d)
Type of contribution
 
 
 

     
 
   

$  




(Complete Part II if there is
a noncash contribution.)
(a)
No.
(b)
Name, address, and ZIP + 4
(c)
Aggregate contributions
(d)
Type of contribution
 
 
 

     
 
   

$  




(Complete Part II if there is
a noncash contribution.)
(a)
No.
(b)
Name, address, and ZIP + 4
(c)
Aggregate contributions
(d)
Type of contribution
 
 
 

     
 
   

$  




(Complete Part II if there is
a noncash contribution.)
(a)
No.
(b)
Name, address, and ZIP + 4
(c)
Aggregate contributions
(d)
Type of contribution
 
 
 

     
 
   

$  




(Complete Part II if there is
a noncash contribution.)
(a)
No.
(b)
Name, address, and ZIP + 4
(c)
Aggregate contributions
(d)
Type of contribution
 
 
 

     
 
   

$  




(Complete Part II if there is
a noncash contribution.)
Schedule B (Form 990, 990-EZ, or 990-PF) (2010)

Schedule B (Form 990, 990-EZ, or 990-PF) (2010)
Page 1 of 1 of Part II
Name of organization
Frederick Memorial Hospital Inc
 
Employer identification number

52-0591612
Part II
Noncash Property (see Instructions)
     
(a) No.
from
Part I
(b)
Description of noncash property given
(c)
FMV (or estimate)
(see instructions)
(d)
Date received
 
$    
(a) No.
from
Part I
(b)
Description of noncash property given
(c)
FMV (or estimate)
(see instructions)
(d)
Date received
 
$    
(a) No.
from
Part I
(b)
Description of noncash property given
(c)
FMV (or estimate)
(see instructions)
(d)
Date received
 
$    
(a) No.
from
Part I
(b)
Description of noncash property given
(c)
FMV (or estimate)
(see instructions)
(d)
Date received
 
$    
(a) No.
from
Part I
(b)
Description of noncash property given
(c)
FMV (or estimate)
(see instructions)
(d)
Date received
 
$    
(a) No.
from
Part I
(b)
Description of noncash property given
(c)
FMV (or estimate)
(see instructions)
(d)
Date received
 
$    
Schedule B (Form 990, 990-EZ, or 990-PF) (2010)

Schedule B (Form 990, 990-EZ, or 990-PF) (2010)
Page 1 of 1 of Part III
Name of organization
Frederick Memorial Hospital Inc
 
Employer identification number

52-0591612
Part III
Exclusively religious, charitable, etc., individual contributions to section 501(c)(7), (8), or (10) organizations
aggregating more than $1,000 for the year. (Complete columns (a) through (e) and the following line entry.)
For organizations completing Part III, enter the total of exclusively religious, charitable, etc.,
contributions of $1,000 or less for the year. (Enter this information once. See instructions.) Arrow Bullet $  
(a) No.
from
Part I
(b)
Purpose of gift
(c)
Use of gift
(d)
Description of how gift is held
 
(e)
Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
       
 
(a) No.
from
Part I
(b)
Purpose of gift
(c)
Use of gift
(d)
Description of how gift is held
 
(e)
Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
       
 
(a) No.
from
Part I
(b)
Purpose of gift
(c)
Use of gift
(d)
Description of how gift is held
 
(e)
Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
       
 
(a) No.
from
Part I
(b)
Purpose of gift
(c)
Use of gift
(d)
Description of how gift is held
 
(e)
Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
       
 
Schedule B (Form 990, 990-EZ, or 990-PF) (2010)

Additional Data


Software ID:  
Software Version:  
SCHEDULE C
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service
Political Campaign and Lobbying Activities

For Organizations Exempt From Income Tax Under section 501(c) and section 527
SchCMd Bullet Complete if the organization is described below.
SchCMd Bullet Attach to Form 990 or Form 990-EZ. SchCMd Bullet See separate instructions.
OMB No. 1545-0047
2010
Open to Public
Inspection
If the organization answered “Yes,” to Form 990, Part IV, Line 3, or Form 990-EZ, Part V, line 46 (Political Campaign Activities), then
Round Bullet Section 501(c)(3) organizations: Complete Parts I-A and B. Do not complete Part I-C.
Round Bullet Section 501(c) (other than section 501(c)(3)) organizations: Complete Parts I-A and C below. Do not complete Part I-B.
Round Bullet Section 527 organizations: Complete Part I-A only.
If the organization answered “Yes,” to Form 990, Part IV, Line 4, or Form 990-EZ, Part VI, line 47 (Lobbying Activities), then
Round Bullet Section 501(c)(3) organizations that have filed Form 5768 (election under section 501(h)) Complete Part II-A. Do not complete Part II-B.
Round Bullet Section 501(c)(3) organizations that have NOT filed Form 5768 (election under section 501(h)): Complete Part II-B. Do not complete Part II-A.
If the organization answered “Yes,” to Form 990, Part IV, Line 5 (Proxy Tax) or Form 990-EZ, Part V, line 35a (Proxy Tax), then
Round Bullet Section 501(c)(4), (5), or (6) organizations: Complete Part III.
Name of the organization
Frederick Memorial Hospital Inc
 
Employer identification number

52-0591612
Part I-A
Complete if the organization is exempt under section 501(c) or is a section 527 organization.

1
Provide a description of the organization's direct and indirect political campaign activities on behalf of or in opposition to candidates for public office in Part IV.
2
Political expenditures ....................................SchCMd Bullet
$  
3
Volunteer hours ........................................
 

Part I-B
Complete if the organization is exempt under section 501(c)(3).
1
Enter the amount of any excise tax incurred by the organization under section 4955 .........SchCMd Bullet
$  
2
Enter the amount of any excise tax incurred by organization managers under section 4955 ......SchCMd Bullet
$  
3
If the organization incurred a section 4955 tax, did it file Form 4720 for this year? ..............
4a
Was a correction made? .........................................
b
If "Yes," describe in Part IV.
Part I-C
Complete if the organization is exempt under section 501(c) except section 501(c)(3).
1
Enter the amount directly expended by the filing organization for section 527 exempt function activities SchCMd Bullet
$  
2
Enter the amount of the filing organization's funds contributed to other organizations for section 527 exempt funtion activities ....................................SchCMd Bullet

$  
3
Total exempt function expenditures. Add lines 1 and 2. Enter here and on Form 1120-POL, line 17b..SchCMd Bullet

$  
4
Did the filing organization file Form 1120-POL for this year? ..........................
5
Enter the names, addresses and employer identification number (EIN) of all section 527 political organizations to which the filing
organization made payments. For each organization listed, enter the amount paid from the filing organization’s funds. Also enter the amount of political contributions received that were promptly and directly delivered to a separate political organization, such as a separate segregated fund or a political action committee (PAC). If additional space is needed, provide information in Part IV.
(a) Name (b) Address (c) EIN (d) Amount paid from filing organization's funds. If none, enter -0-. (e) Amount of political contributions received and promptly and directly delivered to a separate political organization. If none, enter -0-.










For Privacy Act and Paperwork Reduction Act Notice, see the instructions for Form 990.
Cat. No. 50084S
Schedule C (Form 990 or 990-EZ) 2010

Schedule C (Form 990 or 990-EZ) 2010
Page 2
Part II-A
Complete if the organization is exempt under section 501(c)(3) and filed Form 5768 (election under section 501(h)).
A Check
B Check
Limits on Lobbying Expenditures
(The term "expenditures" means amounts paid or incurred.)
(a) Filing
Organization's
Totals
(b) Affiliated Group
Totals
1a Total lobbying expenditures to influence public opinion (grass roots lobbying) ......    
b Total lobbying expenditures to influence a legislative body (direct lobbying) .......    
c Total lobbying expenditures (add lines 1a and 1b) ...................    
d Other exempt purpose expenditures ........................    
e Total exempt purpose expenditures (add lines 1c and 1d) ...............    
f Lobbying nontaxable amount. Enter the amount from the following table in both
columns.
   
  If the amount on line 1e, column (a) or (b) is:The lobbying nontaxable amount is:    
  Not over $500,00020% of the amount on line 1e.    
  Over $500,000 but not over $1,000,000$100,000 plus 15% of the excess over $500,000.    
  Over $1,000,000 but not over $1,500,000$175,000 plus 10% of the excess over $1,000,000.    
  Over $1,500,000 but not over $17,000,000$225,000 plus 5% of the excess over $1,500,000.    
  Over $17,000,000$1,000,000.    
       
g Grassroots nontaxable amount (enter 25% of line 1f) .................    
h Subtract line 1g from line 1a. If zero or less, enter -0-. ................    
i Subtract line 1f from line 1c. If zero or less, enter -0-. ................    
j If there is an amount other than zero on either line 1h or line 1i, did the organization file Form 4720 reporting
section 4911 tax for this year? ......................................

4-Year Averaging Period Under Section 501(h)
(Some organizations that made a section 501(h) election do not have to complete all of the five
columns below. See the instructions for lines 2a through 2f on page 4.)
Lobbying Expenditures During 4-Year Averaging Period
  Calendar year (or fiscal year
beginning in)
(a) 2007 (b) 2008 (c) 2009 (d) 2010 (e) Total
             
2a Lobbying non-taxable amount          
             
b Lobbying ceiling amount
(150% of line 2a, column(e))
         
             
c Total lobbying expenditures          
             
d Grassroots non-taxable amount          
             
e Grassroots ceiling amount
(150% of line 2d, column (e))
         
             
f Grassroots lobbying expenditures          
Schedule C (Form 990 or 990-EZ) 2010


Schedule C (Form 990 or 990-EZ) 2010
Page 3
Part II-B
Complete if the organization is exempt under section 501(c)(3) and has NOT filed Form 5768 (election under section 501(h)).
(a)
Yes
No
(b)
Amount
1
During the year, did the filing organization attempt to influence foreign, national, state or local legislation, including any attempt to influence public opinion on a legislative matter or referendum, through the use of:
a
Volunteers? .........................................
 
No
b
Paid staff or management (include compensation in expenses reported on lines 1c through 1i)? ....
 
No
c
Media advertisements? ....................................
 
No
 
d
Mailings to members, legislators, or the public? .........................
 
No
 
e
Publications, or published or broadcast statements? .......................
 
No
 
f
Grants to other organizations for lobbying purposes? .......................
 
No
 
g
Direct contact with legislators, their staffs, government officials, or a legislative body? ........
 
No
 
h
Rallies, demonstrations, seminars, conventions, speeches, lectures, or any similar means? ......
 
No
 
i
Other activities? If "Yes," describe in Part IV ..........................
Yes
 
27,249
j
Total. lines 1c through 1i ...................................
27,249
2a
Did the activities in line 1 cause the organization to be not described in section 501(c)(3)? .....
 
No
b
If "Yes," enter the amount of any tax incurred under section 4912 .................
 
c
If "Yes," enter the amount of any tax incurred by organization managers under section 4912 .....
 
d
If the filing organization incurred a section 4912 tax, did it file Form 4720 for this year? .......
 
 
Part III-A
Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6).
Yes
No
1
Were substantially all (90% or more) dues received nondeductible by members? ................
1
 
 
2
Did the organization make only in-house lobbying expenditures of $2,000 or less? ................
2
 
 
3
Did the organization agree to carryover lobbying and political expenditures from the prior year? ..........
3
 
 
Part III-B
Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6) if BOTH Part III-A, lines 1 and 2 are answered “No” OR if Part III-A, line 3 is answered “Yes”.
1
Dues, assessments and similar amounts from members .....................
1
 
2
Section 162(e) non-deductible lobbying and political expenditures (do not include amounts of political
expenses for which the section 527(f) tax was paid).
a
Current year .........................................
2a
 
b
Carryover from last year ....................................
2b
 
c
Total ...........................................
2c
 
3
Aggregate amount reported in section 6033(e)(1)(A) notices of nondeductible section 162(e) dues .
3
 
4
If notices were sent and the amount on line 2c exceeds the amount on line 3, what portion of the excess does the organization agree to carryover to the reasonable estimate of nondeductible lobbying and political expenditure next year? ................................
4
 
5
Taxable amount of lobbying and political expenditures (see instructions) ..............
5
 
Part IV
Supplemental Information
Complete this part to provide the descriptions required for Part l-A, line 1; Part l-B, line 4; Part l-C, line 5; and Part ll-B, line 1i.
Also, complete this part for any additional information.
Identifier Return Reference Explanation
Description of lobbying activities Schedule C Part II-B line 1i The expense of $27,249 is a portion of dues paid to the American Hospital Association, Maryland Hospital Association, National Association for Home Care and National Hospice and Palliative Care Organization.
Schedule C (Form 990 or 990EZ) 2010

Additional Data


Software ID:  
Software Version:  

SCHEDULE D
(Form 990)
Department of the Treasury
Internal Revenue Service
Supplemental Financial Statements
SchDMd Bullet Complete if the organization answered "Yes," to Form 990,
Part IV, line 6, 7, 8, 9, 10, 11, or 12.
SchDMd Bullet Attach to Form 990. SchDMd Bullet See separate instructions.
OMB No. 1545-0047
2010
Open to Public Inspection
Name of the organization
Frederick Memorial Hospital Inc
 
Employer identification number

52-0591612
Part I
Organizations Maintaining Donor Advised Funds or Other Similar Funds or Accounts. Complete if the organization answered "Yes" to Form 990, Part IV, line 6.
(a) Donor advised funds (b) Funds and other accounts
1 Total number at end of year .......    
2 Aggregate contributions to (during year) ...    
3 Aggregate grants from (during year) ...    
4 Aggregate value at end of year .......    
5
Did the organization inform all donors and donor advisors in writing that the assets held in donor advised
funds are the organization's property, subject to the organization's exclusive legal control? ............
6
Did the organization inform all grantees, donors, and donor advisors in writing that grant funds may be
used only for charitable purposes and not for the benefit of the donor or donor advisor, or for any other purpose conferring impermissible private benefit. ...................................
Part II
Conservation Easements. Complete if the organization answered "Yes" to Form 990, Part IV, line 7.
1
Purpose(s) of conservation easements held by the organization (check all that apply).
2
Complete lines 2a–2d if the organization held a qualified conservation contribution in the form of a conservation easement on the last day of the tax year.
Held at the End of the Year
a Total number of conservation easements ....................... 2a  
b Total acreage restricted by conservation easements .................. 2b  
c Number of conservation easements on a certified historic structure included in (a) ..... 2c  
d Number of conservation easements included in (c) acquired after 8/17/06 ........ 2d  
3
Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during
the taxable year SchDMd Bullet  
4
Number of states where property subject to conservation easement is located SchDMd Bullet  
5
Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and
enforcement of the conservation easements it holds? .............................
6
Staff and volunteer hours devoted to monitoring, inspecting and enforcing conservation easements during the year SchDMd Bullet  
7
Amount of expenses incurred in monitoring, inspecting, and enforcing conservation easements during the year SchDMd Bullet $  
8
Does each conservation easement reported on line 2(d) above satisfy the requirements of section
170(h)(4)(B)(i) and 170(h)(4)(B)(ii)? ....................................
9
In Part XIV, describe how the organization reports conservation easements in its revenue and expense statement, and
balance sheet, and include, if applicable, the text of the footnote to the organization’s financial statements that describes
the organization’s accounting for conservation easements.
Part III
Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets.
Complete if the organization answered "Yes" to Form 990, Part IV, line 8.
1a
If the organization elected, as permitted under SFAS 116, not to report in its revenue statement and balance sheet works of
art, historical treasures, or other similar assets held for public exhibition, education or research in furtherance of public service,
provide, in Part XIV, the text of the footnote to its financial statements that describes these items.
b
If the organization elected, as permitted under SFAS 116, to report in its revenue statement and balance sheet works of art,
historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service,
provide the following amounts relating to these items:
(i)
Revenues included in Form 990, Part VIII, line 1 ........................SchDMd Bullet $  
(ii)
Assets included in Form 990, Part X ..............................SchDMd Bullet $  
2
If the organization received or held works of art, historical treasures, or other similar assets for financial gain, provide the
following amounts required to be reported under SFAS 116 relating to these items:
a
Revenues included in Form 990, Part VIII, line 1 ..........................SchDMd Bullet $  
b
Assets included in Form 990, Part X ...............................SchDMd Bullet $  
For Privacy Act and Paperwork Reduction Act Notice, see the Intructions for Form 990
Cat. No. 52283D
Schedule D (Form 990) 2010

Schedule D (Form 990) 2010
Page 2
Part III
Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)
3
Using the organization’s accession and other records, check any of the following that are a significant use of its collection
items (check all that apply):
a
d
b
e
 
c
4
Provide a description of the organization’s collections and explain how they further the organization’s exempt purpose in
Part XIV.
5
During the year, did the organization solicit or receive donations of art, historical treasures or other similar
assets to be sold to raise funds rather than to be maintained as part of the organization’s collection?........
Part IV
Escrow and Custodial Arrangements. Complete if the organization answered "Yes" to Form 990,
Part IV, line 9, or reported an amount on Form 990, Part X, line 21.
1a
Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not
included on Form 990, Part X? ....................................
b
If "Yes," explain the arrangement in Part XIV and complete the following table:
Amount
c Beginning balance ................................. 1c  
d Additions during the year .............................. 1d  
e Distributions during the year ............................. 1e  
f Ending balance ................................... 1f  
2a
Did the organization include an amount on Form 990, Part X, line 21? .....................
b
If “Yes,” explain the arrangement in Part XIV.
Part V
Endowment Funds. Complete if the organization answered "Yes" to Form 990, Part IV, line 10.
(a)Current Year (b)Prior Year (c)Two Years Back (d)Three Years Back (e)Four Years Back
1a Beginning of year balance .... 976,177 976,177 976,177
b Contributions ........      
c Investment earnings or losses ...      
d Grants or scholarships .....      
e Other expenditures for facilities
and programs ........
     
f Administrative expenses ....      
g End of year balance ...... 976,177 976,177 976,177
2
Provide the estimated percentage of the year end balance held as:
a
Board designated or quasi-endowment: SchDMd Bullet  
b
Permanent endowment: SchDMd Bullet100.000 %
c
Term endowment: SchDMd Bullet  
3a
Are there endowment funds not in the possession of the organization that are held and administered for the
organization by:

Yes
No
(i) unrelated organizations ........................
3a(i)
 
No
(ii) related organizations ........................
3a(ii)
 
No
b
If "Yes" to 3a(ii), are the related organizations listed as required on Schedule R? .........
3b
 
 
4
Describe in Part XIV the intended uses of the organization's endowment funds.
Part VI
Investments—Land, Buildings, and Equipment. See Form 990, Part X, line 10.
Description of investment (a) Cost or other basis (investment) (b)Cost or other basis (other) (c) Accumulated depreciation (d) Book value
1a Land .................   2,421,745 2,421,745
b Buildings ................   173,259,873 51,135,804 122,124,069
c Leasehold improvements ............   17,651,268 11,631,294 6,019,974
d Equipment ................   164,106,294 122,044,280 42,062,014
e Other .................   2,106,444   2,106,444
Total. Add lines 1a-1e. (Column (d) should equal Form 990, Part X, column (B), line 10(c).)........SchDMdBullet 174,734,246
Schedule D (Form 990) 2010

Schedule D (Form 990) 2010
Page 3
Part VII
Investments—Other Securities. See Form 990, Part X, line 12.
(a) Description of security or category
(including name of security)
(b)Book value (c) Method of valuation:
Cost or end-of-year market value
(1)Financial derivatives    
(2)Closely-held equity interests    
Other








Total. (Column (b) should equal Form 990, Part X, col.(B) line 12.)Small Bullet  
Part VIII
Investments—Program Related. See Form 990, Part X, line 13.
(a) Description of investment type (b) Book value (c) Method of valuation:
Cost or end-of-year market value
(1) Life insurance policy 687,699 F
(2) Investment in subsidiaries 18,537,645 F
(3) Assets limited as to use 17,705,297 F






Total. (Column (b) should equal Form 990, Part X, col.(B) line 13.)Small Bullet 36,930,641
Part IX
Other Assets. See Form 990, Part X, line 15.
(a) Description (b) Book value








Total. (Column (b) should equal Form 990, Part X, col.(B) line 15.)...........Small Bullet  
Part X
Other Liabilities. See Form 990, Part X, line 25.
1.(a) Description of Liability (b) Amount
Federal Income Taxes 0
Advances from third parties 8,178,429
Interest rate swap contract 9,714,769
Pension liability 16,475,649
Malpractice insurance liability 6,733,000
Capital lease obligations 6,999,735
Other liabilities 5,809,779



Total. (Column (b) should equal Form 990, Part X, col.(B) line 25.)Small Bullet 53,911,361
2. Fin 48 (ASC 740) Footnote. In Part XIV, provide the text of the footnote to the organization's financial statements that reports the organization's liability for uncertain tax positions under FIN 48 (ASC740).
Schedule D (Form 990) 2010

Schedule D (Form 990) 2010
Page 4
Part XI Reconciliation of Change in Net Assets from Form 990 to Financial Statements
1 Total revenue (Form 990, Part VIII, column (A), line 12) .................... 1  
2 Total expenses (Form 990, Part IX, column (A), line 25) ..................... 2  
3 Excess or (deficit) for the year. Subtract line 2 from line 1 ............. 3  
4 Net unrealized gains (losses) on investments .......................... 4  
5 Donated services and use of facilities ............................. 5  
6 Investment expenses ................................... 6  
7 Prior period adjustments .................................. 7  
8 Other (Describe in Part XIV) ................................. 8  
9 Total adjustments (net). Add lines 4 - 8 ............................. 9  
10 Excess or (deficit) for the year per financial statements. Combine lines 3 and 9 ......... 10  
Part XII Reconciliation of Revenue per Audited Financial Statements With Revenue per Return
1 Total revenue, gains, and other support per audited financial statements ....... 1  
2 Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a Net unrealized gains on investments .......... 2a  
b Donated services and use of facilities ......... 2b  
c Recoveries of prior year grants ........... 2c  
d Other (Describe in Part XIV): ............ 2d  
e Add lines 2a through 2d ..................... 2e  
3 Subtract line 2e from line 1..................... 3  
4 Amounts included on Form 990, Part VIII, line 12, but not on line 1:
a Investment expenses not included on Form 990, Part VIII, line 7b . 4a  
b Other (Describe in Part XIV): ........... 4b  
c Add lines 4a and 4b....................... 4c  
5 Total Revenue. Add lines 3 and 4c. (This should equal Form 990, Part I, line 12.) ...... 5  
Part XIII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return
1 Total expenses and losses per audited financial statements ............. 1  
2 Amounts included on line 1 but not on Form 990, Part IX, line 25:
a Donated services and use of facilities .......... 2a  
b Prior year adjustments .............. 2b  
c Other losses ................ 2c  
d Other (Describe in Part XIV): ............ 2d  
e Add lines 2a through 2d...................... 2e  
3 Subtract line 2e from line 1..................... 3  
4 Amounts included on Form 990, Part IX, line 25, but not on line 1:
a Investment expenses not included on Form 990, Part VIII, line 7b .. 4a  
b Other (Describe in Part XIV): ............ 4b  
c Add lines 4a and 4b....................... 4c  
5 Total expenses. Add lines 3 and 4c. (This should equal Form 990, Part I, line 18.) ...... 5  
Part XIV
Supplemental Information
Complete this part to provide the descriptions required for Part II, lines 3, 5, and 9; Part III, lines 1a and 4; Part lV, lines 1b and 2b;
Part V, line 4; Part X; Part XI, line 8; Part XII, lines 2d and 4b; and Part XIII, lines 2d and 4b. Also complete this part to provide any additional information.
Identifier Return Reference Explanation
INTENDED USE OF ENDOWMENT FUNDS FORM 990, SCHEDULE D, PART V, LINE 4 ENDOWMENT FUNDS ARE USED FOR HEALTH CARE SERVICES. ASC 740 FOOTNOTE DISCLOSURE FORM 990, SCHEDULE D, PART X, LINE 2 THERE WAS NO ASC 740 FOOTNOTE IN THE AUDITED FINANCIAL STATEMENTS BECAUSE THERE WERE NO MATERIAL UNCERTAIN TAX POSITIONS AS OF JUNE 30, 2011.
Schedule D (Form 990) 2010

Additional Data


Software ID:  
Software Version:  




SCHEDULE H
(Form 990)
Department of the Treasury
Internal Revenue Service
Hospitals
MediumBullet Complete if the organization answered "Yes" to Form 990, Part IV, question 20.
MediumBullet Attach to Form 990. MediumBullet See separate instructions.
OMB No. 1545-0047
2010
Open to Public Inspection
Name of the organization
Frederick Memorial Hospital Inc
 
Employer identification number

52-0591612
Part I
Charity Care and Certain Other Community Benefits at Cost
Yes
No
1a
Does the organization have a charity care policy? If "No," skip to question 6a...........
1a
Yes
 
b
If "Yes," is it a written policy? .......................
1b
Yes
 
2
If the organization has multiple hospitals, indicate which of the following best describes application of the charity care policy to the various hospitals.
3
Answer the following based on the charity care eligibility criteria that applies to the largest number of the organization's patients.
a
Does the organization use Federal Poverty Guidelines (FPG) to determine eligibility for providing free care to low
income individuals? If "Yes," indicate which of the following is the FPG family income limit for eligibility for free care:
3a
Yes
 
b
Does the organization use FPG to determine eligibility for providing discounted care to low income individuals? If
"Yes," indicate which of the following is the family income limit for eligibility for discounted care: .....
3b
Yes
 
c
If the organization does not use FPG to determine eligibility, describe in Part VI the income based criteria for determining eligibility for free or discounted care. Include in the description whether the organization uses an asset test or other threshold, regardless of income, to determine eligibility for free or discounted care.
4
Does the organization's policy provide free or discounted care to the "medically indigent"? ......
4
Yes
 
5a
Does the organization budget amounts for free or discounted care provided under its charity care policy? ...
5a
Yes
 
b
If "Yes," did the organization's charity care expenses exceed the budgeted amount?.........
5b
Yes
 
c
If "Yes" to line 5b, as a result of budget considerations, was the organization unable to provide free or discounted
care to a patient who was eligibile for free or discounted care?...............
5c
 
No
6a
Does the organization prepare an annual community benefit report?.............
6a
Yes
 
6b
If "Yes," does the organization make it available to the public? ..............
6b
Yes
 
Complete the following table using the worksheets provided in the Schedule H instructions. Do not submit these worksheets with the Schedule H.
7
Charity Care and Certain Other Community Benefits at Cost
Charity Care and
Means-Tested Government Programs
(a) Number of activities or programs (optional) (b) Persons served (optional) (c) Total community benefit expense (d) Direct offsetting revenue (e) Net community benefit expense (f) Percent of total expense
a Charity care at cost (from
Worksheets 1 and 2) ..
    5,847,015 0 5,847,015 1.830 %
b Unreimbursed Medicaid (from
Worksheet 3, column a) .
           
c Unreimbursed costs—other means-tested government programs (from Worksheet 3, column b) ....            
dTotal Charity Care and
Means-Tested Government Programs .....
    5,847,015 0 5,847,015 1.830 %
Other Benefits
e Community health improvement
services and community
benefit operations (from
(Worksheet 4) ....
    2,219,962 951,274 1,268,688 0.400 %
f Health professions education
(from Worksheet 5) ..
    212,500 0 212,500 0.070 %
g Subsidized health services
(from Worksheet 6) ..
    11,577,094 516,738 11,060,356 3.470 %
h Research (from Worksheet 7)            
i Cash and in-kind contributions
to community groups
(from Worksheet 8) ..
    70,410 0 70,410 0.020 %
jTotal Other Benefits ...     14,079,966 1,468,012 12,611,954 3.960 %
kTotal. Add lines 7d and 7j. ..     19,926,981 1,468,012 18,458,969 5.790 %
For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2010
Schedule H (Form 990) 2010
Page 2
Part II
Community Building Activities Complete this table if the organization conducted any community building activities.
(a) Number of activities or programs (optional) (b) Persons served (optional) (c) Total community building expense (d) Direct offsetting
revenue
(e) Net community building expense (f) Percent of total expense
1 Physical improvements and housing            
2 Economic development            
3 Community support            
4 Environmental improvements            
5 Leadership development and training for community members            
6 Coalition building            
7 Community health improvement advocacy            
8 Workforce development            
9 Other            
10 Total            
Part III
Bad Debt, Medicare, & Collection Practices
Section A. Bad Debt Expense
Yes
No
1
Does the organization report bad debt expense in accordance with Heathcare Financial Management Association Statement No. 15? ..........................
1
 
No
2
Enter the amount of the organization's bad debt expense (at cost).....
2
11,634,710
3
Enter the estimated amount of the organization's bad debt expense (at cost) attributable to patients eligible under the organization's charity care policy ..
3
1,745,206
4
Provide in Part VI the text of the footnote to the organization's financial statements that describes bad debt expense. In addition, describe the costing methodology used in determining the amounts reported on lines 2 and 3, and rationale for including a portion of bad debt amounts as community benefit.
Section B. Medicare
5
Enter total revenue received from Medicare (including DSH and IME).....
5
122,597,797
6
Enter Medicare allowable costs of care relating to payments on line 5.....
6
112,621,198
7
Subtract line 6 from line 5. This is the surplus or (shortfall)........
7
9,976,599
8
Describe in Part VI the extent to which any shortfall reported in line 7 should be treated as community benefit.
Also describe in Part VI the costing methodology or source used to determine the amount reported on line 6.
Check the box that describes the method used:
Section C. Collection Practices
9a
Does the organization have a written debt collection policy? ...............
9a
Yes
 
b
If "Yes," does the organization's collection policy contain provisions on the collection practices to be followed for patients who are known to qualify for charity care or financial assistance? Describe in Part VI......
9b
Yes
 
Part IV
Management Companies and Joint Ventures
(a) Name of entity (b) Description of primary
activity of entity
(c) Organization's
profit % or stock
ownership %
(d) Officers, directors,
trustees, or key
employees' profit %
or stock ownership%
(e) Physicians'
profit % or stock
ownership %
1
2
3
4
5
6
7
8
9
10
11
12
13
Schedule H (Form 990) 2010
Schedule H (Form 990) 2010
Page 3
Part VFacility Information
Section A. Hospital Facilities
(list in order of size, measured by total revenue per facility, from largest to smallest)
How many hospital facilities did the organization operate during the tax year?1
Name and address
Licensed Hospital General-Medical-Surgical Children's Hospital Teaching Hospital Critical Hospital Research Facility ER-24Hours ER-Other Other (Describe)
1 FREDERICK MEMORIAL HOSPITAL
400 WEST SEVENTH STREET
FREDERICK,MD21701
X X         X    
Schedule H (Form 990) 2010
Schedule H (Form 990) 2010
Page 4
Part VFacility Information (continued)

Section B. Facility Policies and Practices.

(Complete a separate Section B for each of the hospital facilities listed in Part V, Section A)
Name of Hospital Facility:FREDERICK MEMORIAL HOSPITAL
Line Number of Hospital Facility (from Schedule H, Part V, Section A):1

Yes No
Community Health Needs Assessment (Lines 1 through 7 are optional for 2010)
1 During the tax year or any prior tax year, did the hospital facility conduct a community health needs assessment (“Needs Assessment”)? If “No,” skip to question 8. ..................... 1    
If “Yes,” indicate what the Needs Assessment describes (check all that apply):
a A definition of the community served by the hospital facility
b Demographics of the community
c Existing health care facilities and resources within the community that are available to respond to the health needs of the community
d How data was obtained
e The health needs of the community
f Primary and chronic disease needs and other health issues of uninsured persons, low-income persons, and minority groups
g The process for identifying and prioritizing community health needs and services to meet those needs
h The process for consulting with persons representing the community’s interests
i Information gaps that limit the hospital facility’s ability to assess all of the community’s health needs
j Other (describe in Part VI)
2 Indicate the tax year the hospital facility last conducted a Needs Assessment: 20  
3 In conducting its most recent Needs Assessment, did the hospital facility take into account input from persons who represent the community served by the hospital facility? If “Yes,” describe in Part VI how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted. 3    
4 Was the hospital facility’s Needs Assessment conducted with one or more other hospital facilities? If “Yes,” list the other hospital facilities in Part VI............................ 4    
5 Did the hospital facility make its Needs Assessment widely available to the public? ........... 5    
If “Yes,” indicate how the Needs Assessment was made widely available (check all that apply):
a Hospital facility’s website
b Available upon request from the hospital facility
c Other (describe in Part VI)
6 If the hospital facility addressed needs identified in its most recently conducted Needs Assessment, indicate how (check all that apply):
a Adoption of an implementation strategy to address the health needs of the hospital facility’s community
b Execution of the implementation strategy
c Development of a community benefit plan for the facility
d Participation in community-wide community benefit plan
e Inclusion of a community benefit section in operational plans
f Adoption of a budget for provision of services that address the needs identified in the CHNA
g Prioritization of health needs in the community
h Prioritization of services that the hospital facility will undertake to meet health needs in its community
i Other (describe in Part VI)
7 Did the hospital facility address all of the needs identified in its most recently conducted Needs Assessment? If “No,” explain in Part VI which needs it has not addressed together with the reasons why it has not addressed such needs. 7    
Financial Assistance Policy
Did the hospital facility have in place during the tax year a written financial assistance policy that:
8 Explains eligibility criteria for financial assistance, and whether such assistance includes free or discounted care? 8    
9 Used federal poverty guidelines (FPG) to determine eligibility for providing free care to low incomeindividuals?.. 9    
If “Yes,” indicate the FPG family income limit for eligibility for free care:   %
Schedule H (Form 990) 2010
Schedule H (Form 990) 2010
Page 5
Part VFacility Information (continued)

Yes No
10 Used FPG to determine eligibility for providing discounted care to low income individuals?......... 10    
If “Yes,” indicate the FPG family income limit for eligibility for discounted care:   %
11 Explained the basis for calculating amounts charged to patients?................. 11    
If “Yes,” indicate the factors used in determining such amounts (check all that apply):
a Income level
b Asset level
c Medical indigency
d Insurance status
e Uninsured discount
f Medicaid/Medicare
g State regulation
h Other (describe in Part VI)
12 Explained the method for applying for financial assistance?................... 12    
13 Included measures to publicize the policy within the community served by the hospital facility?....... 13    
If “Yes,” indicate how the hospital facility publicized the policy (check all that apply):
a The policy was posted at all times on the hospital facility’s web site
b The policy was attached to all billing invoices
c The policy was posted in the hospital facility’s emergency rooms or waiting rooms
d The policy was posted in the hospital facility’s admissions offices
e The policy was provided, in writing, to patients upon admission to the hospital facility
f The policy was available upon request
g Other (describe in Part VI)
Billing and Collections
14 Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy that explained actions the hospital facility may take upon non-payment?........ 14    
15 Check all of the following collection actions against a patient that were permitted under the hospital facility's policies at any time during the tax year:
a Reporting to credit agency
b Lawsuits
c Liens on residences
d Body attachments or arrests
e Other (describe in Part VI)
16 Did the hospital facility engage in or authorize a third party to engage in any of the following collection actions during the tax year?................................... 16    
If “Yes,” check all collection actions in which the hospital facility or a third party engaged (check all that apply):
a Reporting to credit agency
b Lawsuits
c Liens on residences
d Body attachments
e Other (describe in Part VI)
17 Indicate which actions the hospital facility took before initiating any of the collection actions checked in question 16 (check all that apply):
a Notified patients of the financial assistance policy upon admission
b Notified patients of the financial assistance policy prior to discharge
c Notified patients of the financial assistance policy in communications with the patients regarding the patients’ bills
d Documented its determination of whether a patient who applied for financial assistance under the financial assistance policy qualified for financial assistance
e Other (describe in Part VI)
Schedule H (Form 990) 2010
Schedule H (Form 990) 2010
Page 6
Part VFacility Information (continued)

Policy Relating to Emergency Medical Care
Yes No
18 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that requires the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?.......... 18    
If “No,” indicate the reasons why (check all that apply):
a The hospital facility did not provide care for any emergency medical conditions
b The hospital facility did not have a policy relating to emergency medical care
c The hospital facility limited who was eligible to receive care for emergency medical conditions (describe in Part VI)
d Other (describe in Part VI)
Charges for Medical Care
19 Indicate how the hospital facility determined the amounts generally billed to individuals who had insurance covering emergency or other medically necessary care (check all that apply):
a The hospital facility used the lowest negotiated commercial insurance rate for those services at the hospital facility
b The hospital facility used the average of the three lowest negotiated commercial insurance rates for those services at the hospital facility
c The hospital facility used the Medicare rate for those services
d Other (describe in Part VI)
20 Did the hospital facility charge any of its patients who were eligible for assistance under the hospital facility’s financial assistance policy, and to whom the hospital facility provided emergency or other medically necessary services, more than the amounts generally billed to individuals who had insurance covering such care?......... 20    
If “Yes,” explain in Part VI.
21 Did the hospital facility charge any of its patients an amount equal to the gross charge for services provided to that patient?................................... 21    
If “Yes,” explain in Part VI.
Schedule H (Form 990) 2010
Schedule H (Form 990) 2010
Page 7
Part VFacility Information (continued)

Section C. Other Facilities That Are Not Licensed, Registered, or Similarly Recognized as a Hospital Facility
(list in order of size, measured by total revenue per facility, from largest to smallest)
How many non-hospital facilities did the organization operate during the tax year?17
Name and address Type of Facility (Describe)
1 FMH KLINE HOSPICE HOUSE
7000 KIMMEL ROAD
mt airy,MD21771
INPATIENT HOSPICE PATIENT FACILITY
2 FMH KLINE HOSPICE HOUSE
7000 KIMMEL ROAD
mt airy,MD21771
INPATIENT HOSPICE PATIENT FACILITY
3 FMH KLINE HOSPICE HOUSE
7000 KIMMEL ROAD
mt airy,MD21771
INPATIENT HOSPICE PATIENT FACILITY
4 FMH KLINE HOSPICE HOUSE
7000 KIMMEL ROAD
mt airy,MD21771
INPATIENT HOSPICE PATIENT FACILITY
5 FMH KLINE HOSPICE HOUSE
7000 KIMMEL ROAD
mt airy,MD21771
INPATIENT HOSPICE PATIENT FACILITY
6 FMH KLINE HOSPICE HOUSE
7000 KIMMEL ROAD
mt airy,MD21771
INPATIENT HOSPICE PATIENT FACILITY
7 FMH KLINE HOSPICE HOUSE
7000 KIMMEL ROAD
mt airy,MD21771
INPATIENT HOSPICE PATIENT FACILITY
8 FMH KLINE HOSPICE HOUSE
7000 KIMMEL ROAD
mt airy,MD21771
INPATIENT HOSPICE PATIENT FACILITY
9 FMH KLINE HOSPICE HOUSE
7000 KIMMEL ROAD
mt airy,MD21771
INPATIENT HOSPICE PATIENT FACILITY
10 FMH KLINE HOSPICE HOUSE
7000 KIMMEL ROAD
mt airy,MD21771
INPATIENT HOSPICE PATIENT FACILITY
11 FMH KLINE HOSPICE HOUSE
7000 KIMMEL ROAD
mt airy,MD21771
INPATIENT HOSPICE PATIENT FACILITY
12 FMH KLINE HOSPICE HOUSE
7000 KIMMEL ROAD
mt airy,MD21771
INPATIENT HOSPICE PATIENT FACILITY
13 FMH KLINE HOSPICE HOUSE
7000 KIMMEL ROAD
mt airy,MD21771
INPATIENT HOSPICE PATIENT FACILITY
14 FMH KLINE HOSPICE HOUSE
7000 KIMMEL ROAD
mt airy,MD21771
INPATIENT HOSPICE PATIENT FACILITY
15 FMH KLINE HOSPICE HOUSE
7000 KIMMEL ROAD
mt airy,MD21771
INPATIENT HOSPICE PATIENT FACILITY
16 FMH KLINE HOSPICE HOUSE
7000 KIMMEL ROAD
mt airy,MD21771
INPATIENT HOSPICE PATIENT FACILITY
17 FMH KLINE HOSPICE HOUSE
7000 KIMMEL ROAD
mt airy,MD21771
INPATIENT HOSPICE PATIENT FACILITY
Schedule H (Form 990) 2010
Schedule H (Form 990) 2010
Page 8
Part VI
Supplemental Information
Complete this part to provide the following information.
1 Required descriptions. Provide the description required for Part I, lines 3c, 6a, and 7; Part II; Part III, lines 4, 8, and 9b; and Part V, Section B, lines 1j, 2, 4c, 6i, 7, 11i, 13i, 17l, 18l, 19e, 21d, 25, and 26.
2 Community health needs assessment. Describe how the organization assesses the health care needs of the communities it serves, in addition to any community health needs assessments reported in Part V, Section B.
3 Patient education of eligibility for assistance. Describe how the organization informs and educates patients and persons who may be billed for patient care about their eligibility for assistance under federal, state, or local government programs or under the organization’s financial assistance policy.
4 Community information. Describe the community the organization serves, taking into account the geographic area and demographic constituents it serves.
5 Promotion of community health. Provide any other information important to describing how the organization’s hospital facilities or other health care facilities further its exempt purpose by promoting the health of the community (e.g., open medical staff, community board, use of surplus funds, etc.).
6 Affiliated health care system. If the organization is part of an affiliated health care system, describe the respective roles of the organization and its affiliates in promoting the health of the communities served.
7 State filing of community benefit report. If applicable, identify all states with which the organization, or a related organization, files a community benefit report.
Identifier ReturnReference Explanation
SUPPLEMENTAL INFORMATION   PART I, LINE 7B For the last 30 years, Maryland hospitals have met their community benefit obligations in a unique manner that builds the costs of uncompensated care-charity care and patient bad debt-and graduate medical education into the rates that hospitals are reimbursed by all payors. The system is based in federal and state law and benefits all Maryland residents, including those in need of financial assistance to pay their hospital bills. Maryland is the only state in which all payors-governmentally-insured, commercially-insured, or self-pay-are charged the same price for services at any given hospital. Under this system, Maryland hospitals are regulated by a state agency -the Health Services Cost Review Commission (HSCRC)-that is required to: -Publicly disclose information on the cost and financial position of hospitals; -Review and approve hospital rates; -Collect information detailing transactions between hospitals and firms with which their trustees have a financial interest; and, -Maintain the solvency of efficient and effective hospitals. Since 2000, the rate setting commission has had its own framework for reporting hospitals' community benefits and issuing a report annually regarding hospitals' community benefit totals. That report is available on http://www.hscrc.state.md.us/ Because of this unique structure Maryland hospitals' community benefits numbers will not compare with the rest of the nation's hospitals. However, Maryland hospitals meet or exceed the community benefit standard established by the IRS in 1969. Additional detail illustrating this can be found within this Schedule H report. PART I, LINE 7G N/A PART I, LINE 7, COLUMN (F) Our total expense from Form 990, Part IX, Line 25, Column (A) is $332,663,816. The bad debt expense included in this amount is $13,784,680. This left a total expense of $318,879,136 for purposes of calculating Line 7, Column (F). PART I, LINE 7 Medicare allowable costs were calculated using a cost-to-charge ratio. PART III, LINE 3 Frederick Memorial Hospital attempts to identify and notify all patients eligible for financial assistance. All patients are notified at the time of registration of our financial assistance policy. Despite our efforts, we estimate as much as 15% of our bad debt expense could be the result of a lack of information on patients that would otherwise qualify for assistance if this information was available to us. Frederick Memorial Hospital continues to look for ways to improve our charity care process to ensure that all patients eligible for charity do receive charity. PART III, LINE 4 The Hospital's policy is to write off all patient accounts that have been identified as uncollectible. An allowance for doubtful accounts is recorded for accounts not yet written off that are anticipated to become uncollectible in future periods. Insurance coverage and credit information are obtained from patients when available. No collateral is obtained for accounts receivable. Accounts receivable from third-party payors have been adjusted to reflect the difference between charges and the estimated reimbursable amounts. Recoveries of previously written off patient receivables are recorded when received. PART III, LINE 8 Medicare allowable costs were calculated using a cost-to-charge ratio. PART III, LINE 9B Patients who qualify for charity care or financial assistance are specifically excluded from the collection process. NEEDS ASSESSMENT IN 2011, THE COMMUNITY FOUNDATION OF FREDERICK COUNTY COMMISSIONED A FREDERICK COUNTY HUMAN NEEDS ASSESSMENT. ONE OF THE PRIORITY AREAS COVERED IN THE ASSESSMENT WAS THE COUNTY'S HEALTH NEEDS. THREE AREAS WERE IDENTIFIED IN THE ASSESSMENT AS REQUIRING SPECIAL ATTENTION: 1. AFFORDABLE HEALTH CARE 2. A "MEDICAL HOME" FOR LOW-INCOME FAMILIES AND INDIVIDUALS 3. THE NEED FOR AFFORDABLE MENTAL HEALTH SERVICES LOCAL HEALTH IMPROVEMENT PRIORITY SETTING SUMMIT FREDERICK MEMORIAL HOSPITAL PARTNERED WITH THE FREDERICK COUNTY HEALTH DEPARTMENT AND THE FREDERICK COUNTY HEALTH CARE COALITION TO SPONSOR AND PARTICIPATE IN THE LOCAL HEALTH IMPROVEMENT PRIORITY (LHIP) SETTING SUMMIT. THE PURPOSE OF THE DAY-LONG SUMMIT WAS TO ESTABLISH THE PRIORITIES FOR HEALTH IMPROVEMENT IN FREDERICK COUNTY AND TO DEVELOP GOALS AND ACTION PLANS TO ACHIEVE IMPROVEMENT IN THOSE PRIORITY AREAS THROUGH COMMUNITY ENGAGEMENT. FREDERICK COUNTY LOCAL HEALTH IMPROVEMENT PLAN (LHIP) THE FREDERICK HEALTH IMPROVEMENT PLAN SETS FREDERICK-SPECIFIC OBJECTIVES FOR IMPROVING THE HEALTH OF FREDERICK COUNTY RESIDENTS. IN ADDITION, THE LHIP PRESENTS ACTION STEPS FOR HOW TO ACHIEVE THESE OBJECTIVES. THE PRIORITY AREAS INCLUDED IN THE DOCUMENT WERE CHOSEN BY THE OCTOBER 2011 SUMMIT ATTENDEES. ATTENDEES THEN MET IN WORKGROUPS TO CLARIFY AND DEFINE THE TOP 5 PRIORITIES FOR LOCAL HEALTH IMPROVEMENT. THOSE AREAS ARE: 1. MENTAL HEALTH 2. AFFORDABLE DENTAL CARE 3. WELLNESS & PREVENTION 4. HEALTH INEQUITIES AWARENESS 5. ACCESS TO CARE WHAT IS THE RELATIONSHIP OF THE LHIP TO HEALTHY PEOPLE 2020? HEALTHY PEOPLE 2020 PROVIDES SCIENCE-BASED, 10-YEAR NATIONAL OBJECTIVES FOR IMPROVING THE HEALTH OF ALL AMERICANS. FOR THREE DECADES, HEALTHY PEOPLE HAS ESTABLISHED BENCHMARKS AND MONITORED PROGRESS OVER TIME IN ORDER TO ENCOURAGE COLLABORATIONS ACROSS SECTORS; GUIDE INDIVIDUALS TOWARD MAKING INFORMED HEALTH DECISIONS; AND MEASURE THE IMPACT OF PREVENTION ACTIVITIES. THE FREDERICK COUNTY LOCAL HEALTH IMPROVEMENT PLAN FOCUSES ON A SMALL SUBSET OF THE CDC'S HEALTHY PEOPLE 2020 OBJECTIVES SO THAT (1) WE CAN FOCUS ON FACTORS THAT ARE MOST CRITICAL TO HEALTH EQUITY AND IMPROVING THE HEALTH OF ALL FREDERICK COUNTY RESIDENTS, (2) AND WE CAN MEASURE OUR SUCCESS AND IMPROVE OUR LEADERSHIP IF OUR PLANS AREN'T MEETING OUR GOALS. FREDERICK REGIONAL HEALTH SYSTEM'S COMMUNITY BENEFITS PROGRAM THE FINDINGS OF THE SURVEY TOOLS DESCRIBED ABOVE COINCIDE REMARKABLY WELL WITH THE HEALTH SYSTEM'S INTERNAL DATA THAT CLEARLY INDICATES THAT RESOURCES NEED TO FOCUS UPON THE SAME 5 AREAS OF NEED IDENTIFIED BY THE LOCAL HEALTH IMPROVEMENT PLAN AND THE HUMAN NEEDS ASSESSMENT. THESE DOCUMENTS AND OUR CLOSE WORKING RELATIONSHIP WITH THE FREDERICK COUNTY HEALTH DEPARTMENT AND THE FREDERICK COUNTY HEALTH CARE COALITION WILL HELP TO FOCUS THE HEALTH SYSTEM'S COMMUNITY BENEFITS PROGRAM MOVING FORWARD. FMH WILL ALLOCATE RESOURCES TO ADDRESS MORE SPECIFICALLY THOSE IDENTIFIED COMMUNITY NEEDS, WHILE CONTINUING TO PROVIDE EDUCATIONAL AND SUPPORT PROGRAMS, EARLY DETECTION SCREENINGS AND WELLNESS CLASSES, COUNSELING AND DEMONSTRATIONS TO A BROADER AUDIENCE IN OUR COMMUNITY. PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE Frederick Memorial Hospital posts its charity care policy and financial assistance contact information in admission areas, the FMH Emergency Department, and in all of our satellite facilities in areas where eligible patients are likely to present. FMH provides a summary of the Charity Care Policy and financial assistance contact information to all patients at the time of admission to the hospital. FMH admissions personnel discuss the availability of various government benefits such as Medicaid or state programs with patients and/or their family members, and they assist patients with qualification for the programs. COMMUNITY INFORMATION Frederick Memorial Hospital's patients are primarily from Frederick County, Maryland. Referrals for primary care coming from outside the county include Washington County and Carroll Counties. Regional areas from which patients come for specialty services such as cancer care, CyberKnife Radiosurgery, Interventional Cardiology procedures and Neonatal Intensive Care, include Southern Pennsylvania, Eastern West Virginia and Northern Virginia. Frederick Memorial Hospital is located in the south central portion of Frederick County, Maryland with a 2010 population of 233,600 and a projected 2020 population of 287,900. PROMOTION OF COMMUNITY HEALTH Please refer to the program service accomplishments section (schedule O for Part III, line 4) AFFILIATED HEALTH CARE SYSTEM On June 28, 2011 Frederick Memorial Hospital, Inc. (FMH) Board of Directors approved a corporate restructuring which included the creation of a non-profit parent corporation to be known as Frederick Regional Health System (FRHS). Additionally two new entities were organized, Monocacy Insurance, LTD and Monocacy Health Partners, LLC, both of which are 100% controlled by FRHS. Monocacy Insurance, LTD is a Cayman Islands domiciled single parent captive organized to provide a flexible risk financing structure to meet the needs of FRHS. Monocacy Health Partners, LLC will serve as a non-profit physician enterprise, providing governance, management and support functions for employed physicians. Completion of this restructuring will occur during fiscal year 2012. FRHS is the sole member of FMH. As sole Member, FRHS shall exercise all powers conferred on FMH by the FMH Articles of Incorporation, Bylaws, and the laws of the State of Maryland. FRHS sha
Schedule H (Form 990) 2010
Additional Data


Software ID:  
Software Version:  
Schedule I
(Form 990)
Department of the Treasury
Internal Revenue Service
Grants and Other Assistance to Organizations,
Governments and Individuals in the United States
Complete if the organization answered "Yes," to Form 990, Part IV, line 21 or 22.
lBullet Attach to Form 990
OMB No. 1545-0047
2010
Open to Public
Inspection
Name of the organization
Frederick Memorial Hospital Inc
 
Employer identification number
52-0591612
Part I
General Information on Grants and Assistance
1
Does the organization maintain records to substantiate the amount of the grants or assistance, the grantees' eligibility for the grants or assistance, and
the selection criteria used to award the grants or assistance? ....................................
2
Describe in Part IV the organization's procedures for monitoring the use of grant funds in the United States.
Part II
Grants and Other Assistance to Governments and Organizations in the United States. Complete if the organization answered "Yes" to
Form 990, Part IV, line 21 for any recipient that received more than $5,000. Check this box if no one recipient received more than $5,000. Use
Part IV and Schedule I-1 (Form 990) if additional space is needed
......................... lBullet
(a) Name and address of organization
or government
(b) EIN (c) IRC Code section
if applicable
(d) Amount of cash grant (e) Amount of non-cash
assistance
(f) Method of valuation
(book, FMV, appraisal,
other)
(g) Description of
non-cash assistance
(h) Purpose of grant
or assistance
(1) Frederick Community College7932 Opossumtown pike
Frederick,MD21702
52-0743590 501(c)(3) 100,000 0 CASH N/A Support of Allied Health Education Program






















2
Enter total number of section 501(c)(3) and government organizations ......................... Bullet Image
1
3
Enter total number of other organizations ................................ . Bullet Image
0
For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50055P
Schedule I (Form 990) 2010

Schedule I (Form 990) 2010
Page 2
Part III
Grants and Other Assistance to Individuals in the United States. Complete if the organization answered "Yes" to Form 990, Part IV, line 22.
Use Schedule I-1 (Form 990) if additional space is needed.
(a)Type of grant or assistance (b)Number of
recipients
(c)Amount of
cash grant
(d)Amount of
non-cash assistance
(e)Method of valuation (book,
FMV, appraisal, other)
(f)Description of non-cash assistance













Part IV
Supplemental Information. Complete this part to provide the information required in Part I, line 2, and any other additional information.
Identifier Return Reference Explanation
Form 990, Schedule I Description of Organization's Procedures for Monitoring the Use of Grants THE HOSPITAL PROVIDES FUNDING TO A LOCAL COMMUNITY COLLEGE (501(C)(3)) IN AN EFFORT TO ENHANCE ITS ALLIED HEALTH PROGRAM. THROUGH THIS PROGRAM, A FORMAL EDUCATION FORUM IS ESTABLISHED RESULTING IN FULLY ACCREDITED PROGRAMS THAT MEET THE HOSPITAL'S NEEDS.
Schedule I (Form 990) 2010


Additional Data


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Schedule J
(Form 990)
Department of the Treasury
Internal Revenue Service
Compensation Information
For certain Officers, Directors, Trustees, Key Employees, and Highest
Compensated Employees
SchJMediumBullet Complete if the organization answered "Yes" to Form 990,
Part IV, question 23.
SchJMediumBullet Attach to Form 990. SchJMediumBullet See separate instructions.
OMB No. 1545-0047
2010
Open to Public Inspection
Name of the organization
Frederick Memorial Hospital Inc
 
Employer identification number

52-0591612
Part I
Questions Regarding Compensation
Yes
No
1a
Check the appropiate box(es) if the organization provided any of the following to or for a person listed in Form
990, Part VII, Section A, line 1a. Complete Part III to provide any relevant information regarding these items.
b
If any of the boxes in line 1a are checked, did the organization follow a written policy regarding payment or reimbursement orprovision of all the expenses described above? If "No," complete Part III to explain....
1b
Yes
 
2
Did the organization require substantiation prior to reimbursing or allowing expenses incurred by all
officers, directors, trustees, and the CEO/Executive Director, regarding the items checked in line 1a? ....
2
Yes
 
3
Indicate which, if any, of the following the organization uses to establish the compensation of the
organization's CEO/Executive Director. Check all that apply.
4
During the year, did any person listed in Form 990, Part VII, Section A, line 1a with respect to the filing organization or a related organization:
a
Receive a severance payment or change-of-control payment? ...............
4a
 
No
b
Participate in, or receive payment from, a supplemental nonqualified retirement plan? ........
4b
Yes
 
c
Participate in, or receive payment from, an equity-based compensation arrangement? ........
4c
 
No
If "Yes" to any of lines 4a-c, list the persons and provide the applicable amounts for each item in Part III.
Only 501(c)(3) and 501(c)(4) organizations only must complete lines 5-9.
5
For persons listed in form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the revenues of:
a
The organization? ...........................
5a
 
No
b
Any related organization? .........................
5b
 
No
If "Yes," to line 5a or 5b, describe in Part III.
6
For persons listed in form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the net earnings of:
a
The organization? ...........................
6a
Yes
 
b
Any related organization? .........................
6b
 
No
If "Yes," to line 6a or 6b, describe in Part III.
7
For persons listed in Form 990, Part VII, Section A, line 1a, did the organization provide any non-fixed
payments not described in lines 5 and 6? If "Yes," describe in Part III ............
7
 
No
8
Were any amounts reported in Form 990, Part VII, paid or accured pursuant to a contract that was
subject to the initial contract exception described in Regs. section 53.4958-4(a)(3)? If "Yes," describe
in Part III .............................
8
 
No
9
If "Yes" to line 8, did the organization also follow the rebuttable presumption procedure described in Regulations section 53.4958-6(c)? .........................
9
 
 
For Privacy Act and Paperwork Reduction Act Notice, see the Intructions for Form 990
Cat. No. 50053T
Schedule J (Form 990) 2010

Schedule J (Form 990) 2010
Page 2
Part II
Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees. Use Schedule J-1 if additional space needed.
For each individual whose compensation must be reported in Schedule J, report compensation from the organization on row (i) and from related organizations, described in the
instructions on row (ii). Do not list any individuals that are not listed on Form 990, Part VII.

Note. The sum of columns (B)(i)-(iii) must equal the applicable column (D) or column (E) amounts on Form 990, Part VII, line 1a.
(A) Name (B) Breakdown of W-2 and/or 1099-MISC compensation (C) Retirement and other deferred compensation (D) Nontaxable
benefits
(E) Total of columns
(B)(i)-(D)
(F) Compensation
reported in prior
Form 990 or
Form 990-EZ
(i) Base compensation (ii) Bonus & incentive compensation (iii) Other reportable compensation
(1) Susan Bahl (i)
(ii)
278,750
0
0
0
216
0
0
0
7,235
0
286,201
0
0
0
(2) Paul N Chomiak (i)
(ii)
330,698
0
0
0
360
0
12,378
0
15,343
0
358,779
0
0
0
(3) Manuel A Casiano (i)
(ii)
287,238
0
30,936
0
1,242
0
17,108
0
12,696
0
349,220
0
0
0
(4) Kenneth R Coffey II (i)
(ii)
157,916
0
20,243
0
2,322
0
13,421
0
15,554
0
209,456
0
0
0
(5) Elhamy D Eskander (i)
(ii)
264,223
0
0
0
1,032
0
20,078
0
15,343
0
300,676
0
0
0
(6) Michael W Gaskins (i)
(ii)
190,036
0
20,752
0
540
0
7,712
0
15,673
0
234,713
0
0
0
(7) Thomas A Kleinhanzl (i)
(ii)
586,446
0
136,535
0
3,910
0
113,875
0
16,387
0
857,153
0
0
0
(8) Rose A Labriola (i)
(ii)
247,955
0
22,511
0
2,322
0
30,142
0
12,862
0
315,792
0
0
0
(9) Michelle K Mahan (i)
(ii)
296,302
0
59,075
0
2,322
0
28,665
0
12,920
0
399,284
0
0
0
(10) Dung-Thu Nguyen (i)
(ii)
264,483
0
0
0
240
0
14,546
0
15,343
0
294,612
0
0
0
(11) Brian M O'Connor (i)
(ii)
356,380
0
0
0
1,032
0
20,858
0
15,343
0
393,613
0
0
0
(12) Terry P O'Malley (i)
(ii)
180,102
0
19,375
0
3,564
0
18,138
0
12,658
0
233,837
0
0
0
(13) David Quirke (i)
(ii)
217,430
0
26,021
0
540
0
11,053
0
7,619
0
262,663
0
0
0
(14) Craig F Rosendale (i)
(ii)
165,639
0
19,041
0
2,322
0
14,962
0
12,372
0
214,336
0
0
0
(15) Donald R Schilling (i)
(ii)
171,573
0
17,520
0
1,242
0
4,585
0
7,767
0
202,687
0
0
0
(16) Jennifer G Teeter (i)
(ii)
134,570
0
16,832
0
810
0
12,386
0
12,367
0
176,965
0
0
0
(17) John R Verbus (i)
(ii)
315,829
0
57,737
0
2,322
0
32,987
0
2,661
0
411,536
0
0
0
(18) Jim R Williams (i)
(ii)
167,104
0
19,679
0
2,322
0
13,965
0
12,592
0
215,662
0
0
0
Schedule J (Form 990) 2010

Schedule J (Form 990) 2010
Page 3
Part III
Supplemental Information
Complete this part to provide the information, explanation, or descriptions required for Part I, lines 1a, 1b, 4c, 5a, 5b, 6a, 6b, 7, and 8. Also complete this part for any additional information.
Identifier Return Reference Explanation
Supplemental Compensation Information SCHEDULE J, PART I, LINE 1 FREDERICK MEMORIAL HOSPITAL HOLDS TWO CORPORATE MEMBERSHIPS TO A LOCAL GOLF/COUNTRY CLUB THAT ARE USED BY THE CHIEF EXECUTIVE OFFICER AND THE CHIEF FUND DEVELOPMENT OFFICER OF THE HOSPITAL. WHILE THE MAJORITY OF THE FEES ASSOCIATED WITH THE CLUB DUES, ETC. ARE BUSINESS RELATED, GENERAL PERSONAL USE EXPENSES ARE REIMBURSED BACK TO THE HOSPITAL BY THESE INDIVIDUALS AS NEEDED. SCHEDULE J, PART I, LINE 4B Frederick Memorial Hospital has one 457(f) non-qualified deferred compensation plan for certain members of senior management. Under the plan, they may contribute amounts from their compensation to the plan and may receive a discretionary employer contribution. Employees are fully vested in all employee contributions to the plan. Vesting in employer contributions occurs in accordance with the underlying plan documents. All assets of the plan are held in a separate trust. Total Hospital contributions to this plan were $174,025 and there were no payments from the Plan during the year. SCHEDULE J, PART I, LINE 6A THE EXECUTIVE COMPENSATION PROGRAM IS DESIGNED TO CARRY OUT THE HEALTH SYSTEM MISSION, TO ACHIEVE THE CHARITABLE PURPOSE, TO ATTRACT, RETAIN, MOTIVATE AND REQARD EXECUTIVE MANAGEMENT, AND TO MAINTAIN A COMPETITIVE POSITION WITH PEER ORGANIZATIONS IN THE REGION. OVERSIGHT OF THE EXECUTIVE COMPENSATION PROGRAM IS PROVIDED BY THE EXECUTIVE COMPENSATION COMMITTEE OF THE BOARD, COMPOSED OF THE BOARD CHAIR, VICE CHAIR, IMMEDIATE PRECEDING CHAIR, CHAIR OF THE FINANCE COMMITTEE AND CHAIR OF THE GOVERNANCE COMMITTEE. ANNUALLY, THE COMMITTEE REVIEWS AND RECOMMENDS TO THE BOARD VARIABLE PAY GOALS FOR THE COMING YEAR, AND PAYMENT LEVELS BASED ON PERFORMANCE FOR THE CURRENT YEAR. THE EXECUTIVE COMPENSATION PHILOSOPHY OF THE BOARD PROVIDES FOR BASE COMPENSATION AT THE 50TH TO 60TH PERCENTILE WITH VARIABLE PAY DESIGNED TO PROVIDE A TARGET OPPORTUNITY FOR TOTAL COMPENSATION TO REACH THE 75TH PERCENTILE. VARIABLE PAY CRITERIA ARE; CLINICAL QUALITY (33%), CUSTOMER SERVICE (11%), PEOPLE (11%), FINANCIAL VIABILITY (28%), AND GROWTH (17%). GOALS USING THE VARIABLE PAY CRITERIA ARE ESTABLISHED AT BOTH THE CORPORATE AND INDIVIDUAL LEVEL. INDIVIDUAL PAYMENTS ARE BASED ON PERFORMANCE AGAINST CORPORATE GOALS, INDIVIDUALS GOALS, AND DISCRETION OF THE BOARD.
Schedule J (Form 990) 2010

Additional Data


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Schedule K
(Form 990)
Department of the Treasury
Internal Revenue Service
Supplemental Information on Tax Exempt Bonds
SchKMediumBullet Complete if the organization answered "Yes" to Form 990, Part IV, line 24a. Provide descriptions,
explanations, and any additional information in Schedule O (Form 990).
SchKMediumBullet Attach to Form 990. SchKMediumBullet See separate instructions.

OMB No. 1545-0047
2010
Open to Public
Inspection
Name of the organization
Frederick Memorial Hospital Inc
 
Employer identification number
52-0591612
Part I
Bond Issues
(a) Issuer Name (b) Issuer EIN (c) CUSIP # (d) Date Issued (e) Issue Price (f) Description of Purpose (g) Defeased (h) On
Behalf of
Issuer
(i) Pool
financing
Yes No Yes No Yes No
A MARYLAND HEALTH & HIGHER EDUC FACILITIES AUTHORITY
 
52-0936091 574217Y25 07-09-2008 72,160,000 SEE PART V   X   X   X
Part II
Proceeds
A B C D
1 Amount of bonds retired. . . . . 0      
2 Amount of bonds defeased . . . . 0      
3 Total proceeds of issue . . . . 72,160,000      
4 Gross proceeds in reserve funds . . 0      
5 Capitalized interest from proceeds. 0      
6 Proceeds in refunding escrow. . . . . 0      
7 Issuance costs from proceeds . . . 975,844      
8 Credit enhancement from proceeds. 166,621      
9 Working capital expenditures from proceeds . . 0      
10 Capital expenditures from proceeds . . 0      
11 Other spent proceeds . . 0      
12 Other unspent proceeds. . . 0      
13 Year of substantial completion . . . 2008
Yes No Yes No Yes No Yes No
14 Were the bonds issued as part of a current refunding issue? X              
15 Were the bonds issued as part of an advance refunding issue?   X            
16 Has the final allocation of proceeds been made? . . X              
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? . X              
Part III
Private Business Use
A B C D
Yes No Yes No Yes No Yes No
1 Was the organization a partner in a partnership, or a member of an LLC, which owned property financed by tax-exempt bonds? . . .   X            
2 Are there any lease arrangements that may result in private business use of bond-financed property? . . . . . X              
For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50193E
Schedule K (Form 990) 2010
Schedule K (Form 990) 2010
Page 2
Part III
Private Business Use (Continued)
A B C D
Yes No Yes No Yes No Yes No
3a Are there any management or service contracts that may result in private business use?   X            
b Are there any research agreements that may result in private business use of bond-financed property? . .   X            
c Does the organization routinely engage bond counsel or other outside counsel to review any management or service contracts or research agreements relating to the financed property? . X              
4 Enter the percentage of financed property used in a private business use by entities other than a section 501(c)(3) organization or a state or local government . . . . . . . . . . . . . SchKMediumBullet 0.760 %      
5 Enter the percentage of financed property used in a private business use as a result of unrelated trade or business activity carried on by your organization, another section 501(c)(3) organization, or a state or local government . SchKMediumBullet 0 %      
6 Total of lines 4 and 5 . . .. . . . . . 0.760 %      
7 Has the organization adopted management practices and procedures to ensure the post-issuance compliance of its tax-exempt bond liabilities?   X            
Part IV
Arbitrage
A B C D
Yes No Yes No Yes No Yes No
1 Has a Form 8038-T, Arbitrage Rebate, Yield Reduction and Penalty in Lieu of Arbitrage Rebate, been filed with respect to the bond issue? . . .   X            
2 Is the bond issue a variable rate issue? X              
3a Has the organization or the governmental issuer entered into a hedge with respect to the bond issue? X              
b Name of provider . UBS AG STAMFORD
 
 
 
 
 
 
 
c Term of hedge . . 3.8      
d Was the hedge superintegrated? .   X            
e Was a hedge terminated? .   X            
4a Were gross proceeds invested in a GIC? .   X            
b Name of provider .  
 
 
 
 
 
 
 
c Term of GIC . .        
d Was the regulatory safe harbor for establishing the fair market value of the GIC satisfied? .                
5 Were any gross proceeds invested beyond an available temporary period? .   X            
6 Did the bond issue qualify for an exception to rebate? . . . X              
Schedule K (Form 990) 2010

Schedule K (Form 990) 2010
Page 3
Part V
Supplemental Information
Complete this part to provide additional information for responses to questions on Schedule K (see instructions).
Identifier Return Reference Explanation
DESCRIPTION OF TAX-EXEMPT BONDS SCHEDULE K, PART I, COLUMN F THE MHHEFA SERIES 2008 REVENUE BONDS, ISSUED ON JULY 9, 2008 WERE A REFUNDING OF THE SERIES 2006 BONDS, WHICH WERE ISSUED ON MAY 23, 2006. MANAGEMENT PRACTICES AND PROCEDURES SCHEDULE K, PART III, LINE 7 THE ORGANIZATION HAS POLICIES AND PROCEDURES IN PLACE TO ENSURE TAX-EXEMPT BOND POST-ISSUANCE COMPLIANCE, BUT WRITTEN POLICIES ARE BEING CREATED AND EVALUATED AND WILL BE ADOPTED BY THE FMH BOARD PRIOR TO JUNE 30, 2012.
Schedule K (Form 990) 2010

Additional Data


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Schedule L
(Form 990 or 990-EZ)
Department of the Treasury
Internal Revenue Service
Transactions with Interested Persons
MediumBullet Complete if the organization answered
"Yes" on Form 990, Part IV, lines 25a, 25b, 26, 27, 28a, 28b, or 28c,
or Form 990-EZ, Part V lines 38a or 40b.
MediumBullet Attach to Form 990 or Form 990-EZ. MediumBulletSee separate instructions.
OMB No. 1545-0047
2010
Open to Public Inspection
Name of the organization
Frederick Memorial Hospital Inc
 
Employer identification number

52-0591612
Part I
Excess Benefit Transactions (section 501(c)(3) and section 501 (c)(4) organizations only).
Complete if the organization answered "Yes" on Form 990, Part IV, line 25a or 25b, or Form 990-EZ, Part V, line 40b.
1(a) Name of disqualified person (b) Description of transaction (c) Corrected?
Yes No





2
Enter the amount of tax imposed on the organization managers or disqualified persons during the year under section 4958. ......................... Bullet Image$
 
3
Enter the amount of tax, if any, on line 2, above, reimbursed by the organization ....... Bullet Image$
 

Part II
Loans to and/or From Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 26, or Form 990-EZ, Part V, line 38a.
(a) Name of interested person and purpose (b) Loan to or from the organization? (c)Original principal amount (d)Balance due (e) In default? (f) Approved by board or committee? (g)Written agreement?
To From Yes No Yes No Yes No
(1) PAUL CHOMIAK
SEE SCH L, PART V
  X 649,518 135,316   No   No Yes  
Total ...............Small Bullet $ 135,316
Part III
Grants or Assistance Benefitting Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 27.
(a) Name of interested person (b)Relationship between interested person and the organization (c)Amount of grant or type of assistance
For Privacy Act and Paperwork Reduction Act Notice, see the
Instructions for Form 990 or 990-EZ.
Cat. No. 50056A
Schedule L (Form 990 or 990-EZ) 2010
Schedule L (Form 990 or 990-EZ) 2010
Page 2
Part IV
Business Transactions Involving Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 28a, 28b, or 28c.
(a) Name of interested person (b) Relationship between interested person and the organization (c) Amount of transaction (d) Description of transaction (e) Sharing of organization's revenues?
Yes No
Part V
Supplemental Information
Complete this part to provide additional information for responses to questions on Schedule L (see instructions).
Identifier Return Reference Explanation
LOANS TO AND FROM INTERESTED PERSONS SCHEDULE L, PART II PURPOSE OF LOAN: PHYSICIAN RECRUITMENT AND INCOME GUARANTEE AGREEMENT.
Schedule L (Form 990 or 990-EZ) 2010

Additional Data


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SCHEDULE M
(Form 990)


Department of the Treasury
Internal Revenue Service
NonCash Contributions
Right pointing arrow large imageComplete if the organization answered "Yes" on Form 990, Part IV, lines 29 or 30.
Right pointing arrow large image Attach to Form 990.
OMB No. 1545-0047
2010
Open to Public Inspection
Name of the organization
Frederick Memorial Hospital Inc
 
Employer identification number

52-0591612
Part I
Types of Property
(a)
Check if applicable
(b)
Number of Contributions or items contributed
(c)
Contribution amounts reported on
Form 990, Part VIII, line 1g
(d)
Method of determining
contribution amounts
1 Art—Works of art ....        
2 Art—Historical treasures .        
3 Art—Fractional interests ..        
4 Books and publications ..      
5 Clothing and household
goods .......
     
6 Cars and other vehicles ..        
7 Boats and planes ....        
8 Intellectual property ...        
9 Securities—Publicly traded . X 3 48,354 FMV
10 Securities—Closely held stock .        
11 Securities—Partnership, LLC,
or trust interests ....
       
12 Securities—Miscellaneous ..        
13 Qualified conservation
contribution—Historic
structures .....
       
14 Qualified conservation
contribution—Other ...
       
15 Real estate—Residential .        
16 Real estate—Commercial ..        
17 Real estate—Other ...        
18 Collectibles .....        
19 Food inventory ...        
20 Drugs and medical supplies .        
21 Taxidermy ......        
22 Historical artifacts ....        
23 Scientific specimens ..        
24 Archeological artifacts ...        
25 Other Right pointing arrow large image ( )
26 Other Right pointing arrow large image( )
27 Other Right pointing arrow large image( )
28 Other Right pointing arrow large image ( )
29
Number of Forms 8283 received by the organization during the tax year for contributions
for which the organization completed Form 8283, Part IV, Donee Acknowledgement
...
29
0
Yes
No
30a
During the year, did the organization receive by contribution any property reported in Part I, lines 1-28 that it
must hold for at least three years from the date of the initial contribution, and which is not required to be used
for exempt purposes for the entire holding period? ..................
30a
 
No
b
If "Yes," describe the arrangement in Part II.
31
Does the organization have a gift acceptance policy that requires the review of any non-standard contributions?
31
 
No
32a
Does the organization hire or use third parties or related organizations to solicit, process, or sell non-cash
contributions? ............................
32a
 
No
b
If "Yes," describe in Part II.
33
If the organization did not report revenues in column (c) for a type of property for which column (a) is checked,
describe in Part II.
For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 51227J
Schedule M (Form 990) 2010
Schedule M (Form 990) 2010
Page 2
Part II
Supplemental Information. Complete this part to provide the information required by Part I, lines 30b,
32b, and 33. Also complete this part for any additional information.
Identifier Return Reference Explanation
Schedule M (Form 990) 2010
Additional Data


Software ID:  
Software Version:  
SCHEDULE O
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service
Supplemental Information to Form 990 or 990-EZ

Complete to provide information for responses to specific questions on
Form 990 or to provide any additional information.
MediumBullet Attach to Form 990 or 990-EZ.
OMB No. 1545-0047
2010
Open to Public
Inspection
Name of the organization
Frederick Memorial Hospital Inc
 
Employer identification number

52-0591612
Identifier Return Reference Explanation
ORGANIZATION'S MISSION STATEMENT FORM 990, PART III, LINE 1 ORGANIZATION'S MISSION STATEMENT FORM 990, PART III, LINE 1 THE MISSION OF FREDERICK MEMORIAL HOSPITAL, INC. IS TO CONTRIBUTE TO THE HEALTH AND WELL-BEING OF AREA RESIDENTS BY PROVIDING QUALITY HEALTHCARE IN A CARING, COST EFFICIENT, SAFE AND CONVENIENT MANNER THROUGH A COORDINATED PROGRAM OF PREVENTION, DIAGNOSIS AND TREATMENT, REHABILITATION, AND SUPPORT.
PROGRAM SERVICE ACTIVITIES FORM 990, PART III, LINE 4A The Year in Review Fiscal year 2011 was another year of unprecedented growth for the Frederick Regional Health System. The name change of our parent organization from Frederick Memorial Healthcare System to Frederick Regional Health System was adopted in response to the regional demand for care in FMH facilities. As our reputation for providing safe, compassionate, quality inpatient care and superb customer service in our outpatient settings has grown throughout the region, our patient volumes have grown to reflect market reach well beyond our primary service area. Patients from as far away as the eastern shore have traveled to Frederick County to take advantage of the state-of-the-art cancer care available in the FMH CyberKnife Center. Others have traveled from West Virginia and southern Pennsylvania to avail themselves of the surgical skills of a fellowship trained breast surgeon at the FMH Women's Center. Frederick Memorial Hospital and its affiliated off campus sites have become regional destinations for advanced health care services. A great deal of preparation went into the planning of the facility expansion project that is currently underway. Our intuitive sense that demand for FMH inpatient care was rising as the result of our community's growth, the increased acuity of admitted patients, and our admissions stats indicating reach beyond our county's borders was validated by the data collected by a variety of consultants and agencies. Verification of increased demand when overlaid by demographic and growth trends clearly indicated the need for more inpatient beds at FMH. A Master Facility Plan (MFP) initiative was launched in FY 2011, and construction is currently underway to expand inpatient and parking capacity on the main campus. It is anticipated that MFP construction will be completed in 2015. While a great deal of time and effort has been spent on addressing macro issues and challenges for the Health System in FY 11, attention to the operational details that make FMH an exceptional place to work was never diverted. Quality care, patient and employee safety, superb customer service, and creating a work environment that is inclusive and welcoming have remained top shelf priorities. FMH continues to improve patient, employee and physician satisfaction scores despite FY11 being one of the highest patient volume years in the organization's 110 year history. In the final month of the fiscal year, overall Press Ganey inpatient satisfaction scores were 92%. The FMH Diversity Council has had a tremendous positive impact on the organization's improved satisfaction scores. By creating a work and care environment that embraces diversity as an organizational strength, the Council has led the way in encouraging open dialogue that promotes understanding and acceptance. Frederick Memorial Hospital has created a care environment in which people of all colors, faiths and creeds feel welcome and respected. A series of "Lunch and Learn" in-services have taught FMH employees the importance of greeting, touching, comforting and conveying instructions in culturally acceptable ways. The simple act of saying "Hello" to a patient in their native tongue can do so much to make them feel welcome and safe. You will read about the robust interpreting services department we have created at FMH and the important role they play in caring for our ever more diverse patient population later in this report. One of the reasons that demand for care at Frederick Memorial Hospital reached an all time high in FY11 is that our programs and services continue to receive regional and national recognition by winning awards, and garnering certifications, accreditations and Center of Excellence designations. The Stroke Program, the FMH Joint Works, the Interventional Cardiology Program, the Pulmonary Function Laboratory, and the Regional Cancer Therapy Center are just a few FMH departments and services that continue to receive recognition for excellence. The FMH Wound Care Center is now one of only a few hundred centers nationally accredited for hyperbaric medicine treatment. In addition, HIMSS (the national healthcare information systems society) recognized FMH as a Level 6 provider on the nationwide Electronic Medical Record adoption model ranking scale. RECOGNIZED FOR EXCELLENCE Frederick Memorial Hospital is being recognized throughout the region as the physicians' destination of choice for outstanding patient care, service excellence and quality outcomes. -The Joint Commission's Gold Seal of Approval was awarded to FMH for adhering to strict standards of operational excellence in the provision of patient care, the maintenance of metric standards relative to core measures, and providing a safe environment of care. -The FMH Regional Cancer Therapy Center has been awarded a 3-year accreditation by the Commission on Cancer, the highest degree of accreditation possible. The Commission has recognized the FMH cancer program as a Comprehensive Community Cancer Program, an honor only 22% of hospitals in the nation achieve. -The Intersocietal Commission for the Accreditation of Echocardiography Laboratories has accredited the FMH Echo Laboratory in Adult Transthoracic Echocardiography. -The Intersocietal Commission for the Accreditation of Vascular Laboratories has accredited the FMH Vascular Laboratory in Extracranial Cerebrovascular, Peripheral Arterial and Peripheral Venous Testing. -The Undersea & Hyperbaric Medical Society has accredited the FMH Center for Advanced Wound Care & Hyperbaric Medicine. FMH is the region's only Hyperbaric Oxygen Therapy Center accredited by the UHMS. -The American College of Radiology has accredited the FMH Imaging Services Department in CT, Mammography, MRI, Nuclear Medicine and Ultrasound. -Designated by UnitedHealth as a Premium Interventional Cardiology Specialty Center -The FMH Joint Works program has been designated as a Premium Joint Surgery Specialty Center by UnitedHealth, and has received the Blue Distinction Center of excellence for Hip and Knee surgery by the National BlueCross & BlueShield Association, A designated Aetna Institute of Quality Orthopedic Care Total Joint Replacement. -Designated by the Maryland Institute of Emergency Medical Service Systems (MIEMSS) as a Primary Stroke Center. Awarded a Stroke Center Bronze Performance Award by the American Heart Association In October, FMH received 8 awards from the Medicare Hospital Quality Incentive Demonstration (HQID) project. The Health System received $88,000 in recognition of our continued commitment to meeting exceptional quality standards in high volume diagnoses. Important work continues in the area of reducing patient infections as well. In the final quarter of FY11, employees launched a Health System-wide initiative to improve compliance with the organization's hand hygiene policy. The campaign was an enormous success with our compliance scores reaching into the 80% - 90% range as measured by thousands of observations by secret "shoppers." In the spirit of improving quality, the Medical Executive Committee and the medical staff have decided to restructure the manner in which physician peer review is conducted with the establishment of the Systems Review Oversight Committee (SROC). This new peer review process will provide for greater continuity of physician peer reviewers and improved timeliness of reviews of individual cases while identifying opportunities for education.
As the implementation of federal health care reform begins to take root,   we know we will be called upon to do more with less. We will be required to focus on providing higher value and quality, rather than volume and quantity of service to our patients. Together with our physician partners, we will continue to redefine how we coordinate and deliver community based care for the residents of Frederick County and beyond. By working together, our 110-year legacy of providing for the health and well being of our community will last well into the 21st century. As the regional leader for superb care, we look forward to our continued journey. Service Area Geographic Profile Frederick Regional Health System's patients are primarily from Frederick County, Maryland, that has an estimated population of 234,700 citizens. Referrals for primary care coming from outside the county include: -Washington County -Carroll County Regional areas from which patients come for specialty services such as cancer care, CyberKnife Radiosurgery, Interventional Cardiology procedures and Neonatal Intensive Care, include: -Southern Pennsylvania -Eastern West Virginia -Northern Virginia Frederick Regional Health System is located in the south central portion of Frederick County, Maryland. Population: 2010 - 234,700 2020 - 287,900 Statistical and Service Profile Licensed Bed Capacity: Frederick Memorial Hospital is a 309 licensed bed, acute care facility that has been caring for the citizens of Frederick, Washington and Carroll Counties for more than 109 years. In FY 2011, 22,126 patients were admitted to the hospital for in-patient care. Statistical Profile of Service Area Income Profile of Primary Service Area According to the 2010 American Community Survey, Frederick County had a median household income of $82,133. This is $13,279 more than the median income of Maryland, $68,854. Since 1979, when County residents made only $560 more than the average state resident, Frederick County has continued to increase the gap between the median income of the Maryland and the County. The greatest increase in household income was between 1989 and 1999, when residents went from making $41,382 to $60,276 in 10 years; a 46% increase. This trend ended abruptly with the advent of the economic downturn. In 2010, the unemployment rate in Frederick County was 7.0%. In 2007 the unemployment rate was 2.7%. As of 2010, the majority of households make $75,000 - $99,999 a year. In 1999, the income ranges of households were more evenly distributed than in 2010, taking on a bell shaped curve appearance. Incomes spiked at $50,000 - $74,999 and on both sides of this spike the percentage of households slowly dropped. The 2010 data show the household income spiking at the $75,000 - $99,999 range; however the 2 sides of this spike were not evenly distributed. The income ranges rise at a slow rate until spiking and then remain at constantly higher percentage levels. In essence, the division of poor and rich households in Frederick County has become more extreme within the past 12 years. Poverty Levels In 2006 fewer people and families were below the poverty level than in 1989 and 1999. Since 1989, the poverty level has consistently dropped going from 4.8% of all people to 3.9% in 2006. The most recent American Community Survey (2010) puts the poverty level at 2.6% Community Health Assessment In 2007, the Frederick County Health Department contracted Professional Research Consultants, Inc., to perform a telephone survey of 1,000 Frederick County adults aged 18 and older. This was the first time that a community wide Health Assessment was performed for the Frederick community. The survey instrument used for this study was based largely upon the Centers for Disease Control and Prevention (CDC) Behavioral Risk Factor Surveillance System, as well as other public health surveys. As part of this community health assessment, there were five health related community focus groups. These focus groups included meetings with Physicians, Social Services Providers, Political and Community leaders, and Allied Health Professionals. The data collected by the Community Health Assessment served as a tool for reaching three basic county-wide goals: 1.To improve residents' health status, increase their life spans, and elevate their overall quality of life. FMH ACTION 2009: The FMH Wellness Center created a number of screenings, programs and educational events to increase the community's knowledge about specific disease conditions that were identified in the Community Health Assessment as areas of concern for our community: Cancer, Heart Disease, Nutrition and Weight Management. Armed with the knowledge needed to make the necessary lifestyle and behavioral changes to remain healthy has enhanced our community's health status in many positive ways. FMH ACTION 2010: The Radiology Department in conjunction with Corp OHS, organized block appointment times for screening mammograms for the business community in Frederick County. Over 300 women participated in the program. The FMH Community Outreach Program was launched in FY 2010. This group of FMH volunteer employees organized a number of screening and educational events including: Asthma Awareness Day, COPD Screenings & Seminars, Smoking Cessation & Tobacco Prevention Programs. This same group brought attention to the high incidence of Heart Attack and Stroke in Frederick County by participating in the American Heart Association's Start! Greater Washington Heart Walk. Dozens of FMH employees and their family members participated in the walk, raising more than $7,000 for the cause. The FMH Center for Advanced Wound Care and Hyperbaric Medicine sponsored a free seminar and screening event to assess wounds that would not heal. The educational seminar explained the latest advances in wound care protocols and techniques, and offered a tour of the Hyperbaric Chambers. The FMH Wellness Program sponsored a number of Blood Pressure Screenings and General Wellness Maintenance lectures throughout the community. FMH ACTION 2011: Frederick Memorial Hospital worked in conjunction with the Frederick County Health Department to secure grant funding for the Frederick County Health Care Coalition to continue and expand the important role the Access to Health Care committee plays in obtaining care for the un- and under- insured in Frederick County. The areas in which there is a critical need for service expansion include vision and dental care.
In its second year of operation, the FMH Community Outreach program really   shifted into high gear and nearly tripled its outreach efforts. Classes, educational seminars and screening events were hosted throughout the Frederick Community and in conjunction with a number of organized community events. They reached thousands of citizens with their information about the dangers of tobacco use, smoking cessation, asthma and respiratory disease and cardiac health. All of their presentations and activities are geared toward promoting healthy lifestyles and healthy choices. 2.To reduce the health disparities among residents. The demographic information gathered during the survey process has allowed the Health Department and Frederick Regional Health System to identify population segments that are most at-risk for various diseases and injuries. FMH ACTION 2009: The FMH Regional Cancer Therapy Center hosted prostate cancer screening events, and Vascular Services performed screenings for Peripheral Artery Disease in areas of the county where access to such services is challenging. The African American and Hispanic populations represent high-risk demographics in Frederick County for both of these disease conditions. FMH ACTION 2010: Frederick Memorial Hospital's participation in the Frederick County Health Care Coalition (FCHCC) has increased over the past 12 months. The Chairman of the Executive Committee is an FMH employee as is another member of the Board. The FCHCC has been working behind the scenes with the Community Action Agency to encourage their application for federal funding to expand programs and services as a Community Health Clinic. The establishment of a Free Community Clinic would help to address the identified disparities in accessing care. The Health System continued to offer laboratory diagnostic testing to the Frederick County Mission of Mercy. FMH ACTION 2011: Frederick Memorial Hospital took a lead role in the first ever Frederick County Convoy of Hope. Providing a wide variety of health screenings and information as the draw to attract participants to the event, other organizations and agencies were on hand at the event to help guide many through the process of accessing resources available to them and enrolling in support programs. As the majority of the citizens participating in the event belonged to the demographic most in need of health care services, the outreach was extremely successful in informing them about the resources available to them. As minority populations swell in Frederick County, (Frederick County is ranked 17th nationally, and 5th in the state of Maryland in the number of Hispanics moving into the area), various grass roots organizations are springing to life to celebrate their growing community. FMH is invited to, and participates in, all of the heritage festivals held in the area: The Hispanic Festival, the Indian Festival and the Asian Festival are just three examples of events in which FMH brings information and various health screenings, e.g. blood pressure, blood sugar, percent body fat, etc. 3.To increase accessibility to preventive services for all community residents. FMH ACTION 2009: An area identified by the Community Health Assessment as requiring immediate action relative to access issues was in the prenatal care arena. Many women in Frederick County were receiving no prenatal care. Their babies being delivered at FMH were requiring admission to the Neonatal Care Intensive Care unit in percentages far above the expected admission rate when compared with actual patient admissions. The FMH Auxiliary Prenatal Center was established to provide these underinsured or uninsured women with the prenatal care necessary to ensure a healthy birth weight baby that was full-term gestational age. It worked! FMH ACTION 2010: The Cardiac and Pulmonary Rehabilitation Department organized vascular screenings and one-on-one consultations with cardiovascular physicians and pulmonologists. The FMH Wellness Center sponsored a number of Diet and Nutrition Classes in conjunction with their Healthy Weigh program targeting obesity in children in Frederick County. FMH ACTION 2011: FMH partnered with Leadership Diversity Institute to sponsor the first Frederick County Family Olympics, a day-long family event focused upon the importance of making good decisions relative to behaviors and nutrition choices. The Olympics stressed the importance of including the whole family in a program of good nutrition and weight management, healthy heart activities and spiritual harmony. FMH has been working with the Frederick County Health Department and through the Frederick County Health Care Coalition to map out a strategy relative to access to preventive dental care. Oral health was identified as one of the top three areas in which care was critically lacking. It is our hope to be able to report significant success in moving this initiative forward in the FY12 CBR. Addressing Needs Decision Making Process Decisions relative to addressing the health care needs of our community are driven by the FMH Board of Directors and the Senior Leadership team. The Health System is in constant and close consultation with other community organizations such as the Frederick County Health Department, Mission of Mercy, the Frederick County Mental Health Association, religious coalitions and many others. The FMH Senior Leadership Team is represented in those discussions by the Vice President of Business Development & Planning, Jim Williams, who is the Chair of the Executive Council of the Frederick County Health Care Coalition, the grass-roots community organization that serves as the clearing house for Frederick County health issues. Physician Manpower Plan The Health System has done a great deal of work relative to identifying the specialty and sub-specialty needs of the Frederick Community moving forward. The Physician Steering Committee has embarked on a 3-5 year physician manpower plan to direct recruiting efforts toward those areas research has indicated we may experience physician shortages. While the document is still in draft form, we can share those physician practice specialties the report is indicating there may be need in the next 3 to 5 years: Medical Specialties: -Cardiology -Hematology/Oncology -Gastroenterology Surgical Specialties: -Neurosurgery -Cardiovascular -Thoracic
Working with Our Partners   Other community needs that the Health System has not been able to address on its own, but is working in close consultation with a number of other agencies to craft a lasting and meaningful solution include: -Access to preventive dental care and other issues as they relate to oral health -A subcommittee of the Frederick County Health Improvement Planning Committee is working on this issue. -Access to vision screens and ocular health -Another subcommittee of the Frederick County Health Improvement Planning Committee is investigating this vital community need. -Behavioral health issues relative to partial hospitalization and day programs -Through the Frederick County Health Care Coalition, the Health System is working with the Mental Health Association and Sheppard-Pratt to create a 3 to 5 year plan about to address this pressing need. Community Benefits Department Rather than having a separate department that is dedicated solely to the oversight of the organization's Community Benefits program, an operational structure has been created such that members of diverse departments, services and programs work together to coordinate activities and events. Under the direction of the Vice President of Business Development and Planning and the Director of Marketing, the Community Outreach Program takes the lead in planning, organizing and manning community benefit activities. As indicated above, the Community Outreach Program is in its second year of operations. The program has expanded rapidly over the past 18 months. Cherie Hyssong, Respiratory Therapist and Pulmonary Lab supervisor, has assumed the additional position as Community Outreach Coordinator. She and her pulmonary team have done an outstanding job of coordinating community activities including health fairs, screening events, educational seminars, the Convoy of Hope, the health tent at the Great Frederick Fair, and a whole host of other outreach activities. While this structure may not adhere to the strict definition of a "Department" its operational effectiveness is clearly evidenced in the activities detailed in this report. As the CBR initiative grows and we begin using Lyons Software to more formally track activities, there may be a need moving forward to create a department in the classic sense that is dedicated to our community benefit efforts. FMH Wellness Center The FMH Wellness Center is a division of the Frederick Regional Health System which promotes healthier lifestyles and enhanced levels of wellness by providing health education classes, health screenings and individual services. Because early detection and education are the keys to a highly informed and educated community, the hospital vigorously supports the Wellness Center in a variety of client centered wellness activities. In FY 2011, the FMH Wellness Center touched more than 100,000 members of our community. Corporate Partners and Community Wellness Services - 2011 The health and wellness of the residents of Frederick County and the surrounding areas is the most important contribution of The Frederick Regional Health System Wellness Center. Each year we search for new partnerships and programs that focus on guiding our friends and families towards healthier lifestyles. These organizations and businesses joined us in a collaborative effort to secure a greater level of health for members of our community: -Airline Owners and Pilots Association -American Cancer Society -American Diabetes Association -American Heart Association -BB & T Bank -Bank of America -Bechtel -Boy Scouts of America -Ceresville Mansion -City Of Frederick -Coca Cola Enterprises -Corporate Occupational Health Services -Critical Care Enterprises -Elder Expo -Families Plus -Ferguson Enterprises -First Potomac Realty Investment -FMH Select -Frances Scott Key Mall -Frederick Community College -Frederick County Commission On Women -Frederick County Health Department -Frederick County Head Start -Frederick County Hospice -Frederick County Public School System -Frederick News Post -Ft. Detrick -FSK Mall -Gilbane Building Company -Greater Frederick Fair -Holistic Health Conference Planning Committee -Hughes Network Systems -Jeannie Bussard -Key 103 -Kiwanis Club -KIWI-TEK -Legal and General America -LIFE and Discovery Inc. -M & T Bank -Manpower -Maryland Mental Health Association -Mental Health Association of Frederick County -Pride Philanthropy -Red Devil Organization -SAIC of Fort Detrick -Transit Services of Frederick County -TX Team -Visitation Academy -YMCA
Services/Programs   Either through joint efforts with our collaborative partners or independently, the following services were designed and implemented by the Frederick Regional Health System Wellness Center. -12 blood pressure screenings attended by 35 participants -1 wellness lecture serving 15 members of the Frederick County Community. -General health and wellness information distributed during 6 community events serving more than 600 members of the community. -General health and wellness information, and health screenings provided during 3 community events serving more than 400 participants. -Physician Information and Referral Service for greater than 1,335 individuals and families. Employee Wellness Program - 2011 The Wellness Center in partnership with the FMH Human Resources Department and CorpOHS, continued the Employee Wellness Program in 2011. This program, designed to address the specific health needs of members of the hospital family provided 120 events for more than 2,000 members of the hospital staff and volunteers. Family Focus Program Services - 2011 The Wellness Center's Family Focus Program provides education and support to the core of our community - the family. The program works in conjunction with the FMH BirthPlace to provide expectant parents a preview tour of the birth facility. The Family Focus Program also helps parents prepare for the birth of their child by providing quality Childbirth and Parenting Education classes to thousands of parents every year. Siblings to-be participate in the ever-popular "Small Wonder" program to help them welcome a new baby brother or sister. Family Focus has served over 6,463 community members. Just like the family - this program continues to grow and thrive each year to benefit our community! AHA CPR Training - 2011 FMH Wellness Center is an American Heart Association Basic Life Support Training Site under the Frederick Community College Training Center. Besides training 637 hospital employees in CPR & AED, 351 community members were trained. Many of these individuals are students at local colleges taking CPR training as a requirement prior to participating in their clinical experiences. Safety and Injury Prevention Programs - 2011 FMH continues to support Safe Kids Frederick County, a local coalition affiliated with Safe Kids Worldwide - the only grassroots, long-term effort dedicated solely to preventing unintentional injury - the number one killer of children age 0-14 years. FMH Wellness Center and Frederick County Health Department are the co-lead agencies. The co-lead agencies conduct 10 annual meetings with representatives from the member agencies to discuss, plan, and develop a coordinated program of public awareness, education, legislative action and enforcement to help to prevent these unintentional injuries in Frederick County children. Access to low cost safety products is also offered to Frederick County families. Adopt a Pharmacist This was the second year partnering with the Maryland Poison Center with this program. We recruited 18 local pharmacists who attended training sessions taught by one of the pharmacist/educators from the Maryland Poison Center. Teaching kits were supplied to the pharmacists and they went into 22 Frederick County Public School first grade classrooms to teach the children about poison safety. Safety & Injury Prevention The Injury Prevention Coordinator at FMH Wellness Center participates with the following county/state committees as an injury prevention expert. -Frederick County Interagency Early Childhood Committee -Maryland Mid-Western Region Highway Safety Task Force -Maryland Child Passenger Safety Advisory Board -Maryland Occupant Protection Committee -Safe Kids Maryland We have created unique partnerships with the following organizations and businesses to provide quality safety services to members of our community: -American Cancer Society -American Red Cross -Bikers Against Child Abuse -Brunswick Police Department -Calvary Weekday School -Carroll County Health Department -Centro Hispano -Child Care Choices -Convoy of Hope -Families Plus! -Family Partnership -Fitzgerald Auto Mall -Frederick County Autism Society of America -Frederick County Dept. of Emergency Planning -Frederick County Dept. of Fire & Rescue Services -Frederick County Dept. of Social Services Foster Parent Group -Frederick County Even Start -Frederick County Head Start -Frederick County Health Department -Frederick County Parks & Recreation -Frederick County Pharmacists -Frederick County Public Schools -Frederick County Sheriff's Department -Frederick County Transit -Frederick County Volunteer Fire & Rescue Association -Frederick Memorial Hospital - Pediatrics Dept., Family Center, Neonatal ICU and ED -Frederick Pedalers -Frederick Police Department -Frederick Rescue Mission -Frederick Women's Civic Club -Ft. Detrick -Healthy Families Frederick -Heartly House -Hope Alive -Key 103 -Kinder Care -Kiwanis Club of Suburban Frederick -Life & Discovery (Asian community resource group) -Mark Agency (State Farm Insurance agent) -Marriott International -Maryland Poison Center -Maryland School for the Deaf -Maryland State Police -Mid Western Traffic Safety Coalition -MIEMSS -Parent Power (Mental Health Association) -Priority Partners -Special Education Resource Group -Thurmont Police Department -Up County Family Partnership -Urbana MOPS (Mothers of Preschool Children) -US Fire Administration -Volunteer Frederick! -WIC -YMCA of Frederick County
In FY 2011 the following services were provided:   -1,961 first graders in 22 Frederick County Public Schools (FCPS) were taught poison safety. -488 telephone consultations educating parents and caretakers on child safety issues -103 car seats rented/distributed to low income families or individuals having out of town guests with small children -416 individual car safety seat checks -18 parents/caregivers attended car seat training classes -3 angle tolerance tests performed for infants discharged from FMH NICU in a car bed to determine if the infant can move to a regular infant car seat. -1 Child Passenger Safety Technician was mentored to the Senior Checker level. -23 law enforcement officers, firefighters, EMTs and health educators trained as child passenger safety technicians -1447 community members attended 14 Events/Safety Fairs. Five (5) of these events were held for ESL residents -104 community members attended injury prevention classes about home safety, child passenger safety and poison safety -287 bicycle & multi-sport helmets distributed & fitted properly -153 children participated in 4 bicycle rodeos -15 mature drivers attended a CarFit event to learn how to make adjustments in their vehicles to make them more comfortable and have better control of their vehicle. CarFit was developed through collaboration among the American Society on Aging, AARP, the American Occupational Therapy Association and AAA. FMH Wellness Center provided classroom space for other groups: -8 PALS (Pediatric Advanced Life Support) classes -2 Safe Kids Frederick County meetings -5 Children's Festival/Interagency Early Childhood Committee meetings -1 Safe Routes to School meeting -3 Amputee Support Group sessions -3 Religious Coalition meetings -1 Elder Council meeting -1 Spastic Paraplegic Foundation meeting -IHONL spring conference -2 BHS/Corp OHS Well Cycle Open House sessions Nutrition and Weight Management - 2011 In addition to the provisions described above, the Nutrition and Weight Management Services Division hosted more that 9,395 visits from clients with a variety of health needs. Clients were monitored weekly for changes in weight and blood pressure. Those who participated in the weekly education offerings received information and counseling in all areas of cardiovascular disease and stroke prevention. Healthy lifestyle changes including regular exercise programs, nutrition enhancements and stress management were emphasized with all clients. Diabetes Services FMH Diabetes Services hosted a number of support groups, educational seminars and screening events throughout the County. Support Groups-144 Other events-95 ADA Walk Convoy of Hope Diabetes Center Open House Diabetes Alert Day @ FSK FMH Stroke & Chest Pain Centers The CPC is a dedicated 24/7 observation unit that evaluates low-risk chest pain patients in accordance with the Society of Chest Pain Centers (SCPC), ACC and AHA guidelines. Frederick County residents no longer have to be transported to neighboring facilities to receive acute stroke care, nor to have their low-risk chest pain evaluated. A program with the highest level of preparedness and state recognition is right here at Frederick Memorial Hospital. The FMH Stroke Program provides stroke training to Frederick County Emergency Medical Services to ensure that first-responders are aware of stroke signs and symptoms and also the most current treatments. The cooperation between these two entities enables the patient to have the best care possible at every stage of treatment. The Stroke Program also offers free stroke workshops to the citizens of Frederick County. The stroke workshops increase awareness and provide details on stroke care and prevention. Attendees are given information on risk factors and steps they can take right away to change their own risk for stroke. At the conclusion of the workshop, attendees are able to name and identify stroke signs and symptoms and know what to do in case they, or someone they know, are having a stroke. The Director of the FMH Stroke Center of Excellence has presented information and educational materials about stroke and stroke prevention: -Citizen's Nursing Home - 7/08/10 - 10 attendees -Fred. County Health Dept - 8/16/10 - 20 attendees -Fred. County Health Dept - 8/23/10 - 25 attendees -New Dimensions - 12/12/10 - 20 attendees -Fred. County Health Dept - 1/06/11 - 25 attendees -Johnsville Senior Center - 1/13/11 - 25 attendees -Thurmont Senior Center - 3/15/11 - 25 attendees -New Dimensions - 4/11/11 - attendees -Emmitsburg Senior Center - 4/14/11 - 20 attendees -Frederick County Health Dept - 4/14/11 - 20 attendees -Frederick County Dept of Aging - 4/21/11 - 150+ attendees -Tranquility Nursing Home - 6/02/11 - 35 attendees TOTAL - 395
Community Outreach Program   Smoking Cessation Tobacco continues to be the leading cause of preventable disease and death in the United States. Smoking harms nearly every organ of the body and generally diminishes the health of smokers. Quitting smoking has immediate as well as long term effects. People who stop smoking greatly reduce the risk of dying prematurely and lower their risk of heart disease, stroke, lung disease and other health conditions. Frederick Memorial Hospital's Community Outreach Program promotes a healthier community by offering both intermediate and intensive smoking cessation counseling as a service to the community. Smoking cessation facilitators provided information, resources and tools to treat tobacco use and dependence. FMH's Smoking Cessation Facilitators are active with the Local Tobacco Coalition which strives to reduce tobacco use in Frederick County through education and information. The FMH Smoking Cessation Facilitators support efforts throughout the Frederick County community to prevent chronic lung disease by encouraging teens to not smoke cigarettes and to educate the public about the dangers of exposure to secondhand smoke. We will continue to work with the Frederick County Health Department to monitor the success of our efforts as measured by the reduction of tobacco use within the community. FMH offers the American Lung Association's Freedom from Smoking Program and provides the Association with statistical results of the cessation program. Success is measured by the number of participants entering the program as smokers and those who have kicked the habit at the end of the program. The FMH Community Outreach Program provides a wonderful opportunity to make a difference in the lung health of so many individuals. Asthma Educators Asthma is a chronic lung disease with varying levels of severity and it is characterized by exacerbations. With access to quality healthcare and appropriate medications, combined with an understanding of how to avoid specific environmental triggers, asthma is a controllable disease. The keys to control are knowledge, skill and behavior. The goal of Frederick Memorial Hospital's Community Outreach Program is to increase awareness of the fact that asthma is a significant health problem. FMH has certified asthma educators (AE-C) who are dedicated to educating the community about this chronic disease that strikes so many throughout the state of Maryland, allowing for better disease management. FMH's Certified Asthma Educators are active with the State Asthma Coalition, which involves groups like ours to increase awareness that asthma is a significant health problem. We will remain dedicated to educating the community about this chronic disease that strikes so many. By educating those stricken with the disease about the importance of self-management and trigger avoidance, we can reduce the number of exacerbations and hospital utilization. We will continue to monitor the outcomes of asthmatics and promote best practice in pediatric asthma care. Community Activities and Events National Night Out- August 3, 2010: This is a unique crime and drug prevention event that is held to heighten crime and drug prevention awareness and generate support and participation in local anti crime programs. A staff member attended this event offering tobacco education. This event was attended by an estimated 1,000 participants. In the Streets Festival - September 11, 2010: Staff attended this community block party in the Health and Wellness block offering asthma/tobacco education. Thousands of participants were able to benefit from speaking to an educator. Great Frederick Fair Senior Expo - September 20, 2010: Staff attended this event offering seniors COPD awareness information as well as tobacco education, which is the number one cause of emphysema. This event reached approximately 250 individuals. Taneytown Middle School - October 13-14, 2010: An asthma educator offered "Asthma 101," an educational program to 55 students. This is an education program using a curriculum from the American Lung Association. Thomas Johnson High School - October 18, 2010: A tobacco educator offered tobacco education program to 35 health class students. Mount Airy Middle School - October 22, 2010: "Asthma 101" offered to 40 students. Evangelical Reformed Church - October 24, 2010: Staff offered asthma/COPD/tobacco education to approximately 80 individuals. Mount Airy Middle School- November 4-5, 2010- "Asthma 101" offered to 80 students. Annual American Heart Association Heart Walk - November 6, 2010- 6th: Staff raised $7,000 and donated it to the American Heart Association. Fort Detrick Health Fair - November 10, 2010: Staff offered asthma/COPD awareness and tobacco education to approximately 1000 participants. Managing COPD Seminar - November 22, 2010: A physician speaker along with tobacco educators, asthma educators and respiratory therapists offered participants pulse oximetry, spirometry screenings, carbon monoxide screenings, tobacco education and pulmonary rehabilitation information. This event reached 45 participants. COPD Awareness Seminar - January 12, 2011: This is the second event reaching another 15 participants. Employee Smoking - February 2, 2011: Learn and Lunch offered an hour presentation on tobacco cessation. Tobacco Support Group - February 28, 2011: This 90 minute session is offered to those who have quit and need extra support. This session was attended by one participant. Working Together to Control Your Asthma - March 8, 2011: This free community seminar offered participants information on basic asthma facts, triggers, symptom control, medications, asthma action plans and self management skills. Participants offered spirometry screening and mediation demonstrations. Dr. Robert Wack gave a presentation on "A Team Approach to Controlling Your Asthma." This event reached 24 individuals.
Health and Wellness Fair at Crumland Farms - March 10, 2011: Staff   Health and Wellness Fair at Crumland Farms - March 10, 2011: Staff attended this health fair reaching approximately 200 participants offering asthma/COPD/tobacco education. Staff offered spirometry screenings and carbon monoxide screenings. Toxic Soup Program at Sagner - March 10, 2011: This program offered a presentation on all the items that make up a cigarette to a group of underprivileged children within the community. This event reaches approximately 15 children. Kick Butts Day - March 17, 2011: In recognition of Kick Butts Day, staff worked with local authorities who permitted them and a group of local children to create the important abstinence message using red paper cups in the chain link fence surrounding the Frederick Fair Grounds. Second Hand Smoke Workshop for Latino Moms - May 5, 2011: Staff worked with the Diversity Leadership Institute offering a workshop to Latino women and spouses who are expecting and exposed to secondhand smoke. This event reached 10 Latino families. Each participant received a nice basket of baby supplies for attending. These gifts were funded by the Cigarette Restitution Fund and the Smoking Cessation Program at Frederick County Health Department. Mount Airy Middle School - May 12/17, 2011: "Asthma 101" offered to 100 students. The day-long program offered education on asthma that included: triggers, medications, symptom control, asthma action plans, basic asthma facts, tobacco education, spirometry screening, carbon monoxide screening, pulse oximetry and home delivery devices. This year's event was presented in memory of T.J. Luck who had just passed from an asthma exacerbation. This event reached approximately 400 individuals. Thomas Johnson High School - May 25, 2011: Tobacco education offered to 25 students. Walkersville Elementary School - May 25, 2011: "Asthma 101" offered to 3 different classes reaching 75 students. Frederick County Public Schools Health Fair - June 14, 2011: Staff offered asthma/tobacco education to approximately 100 participants. This also included spirometry screening. Convoy of Hope - June 18, 2011: An international relief organization who partnered with FMH to serve thousands of Frederick residents. Staff offered asthma/tobacco education to estimated 5,000 under/uninsured residents. Frederick Tobacco Coalition Meetings monthly Maryland Asthma Coalition Meetings Freedom From Smoking Program offered 6 sessions (7 weeks in length) reaching approximately 50 participants. The FMH Emergency Department The FMH Emergency Department continues to be one of the busiest emergency departments in the State of Maryland. In fiscal year 2011, over 75,000 patient visits were recorded. The Frederick Regional Health System has been providing emergency care to the citizens of Frederick County ever since a one bed "Accident Room" was set-aside in 1905 on the first floor of the old Frederick City Hospital. Since that day, the doors have remained open 24 hours a day, 7 days a week, 365 days a year for nearly 110 years. Fast Track The FMH 7-bed Fast Track area is staffed by a Physician Assistant, R.N. and an ED Technician. Approximately 40 - 50 patients are treated and released from the Fast Track area every day with an average length of stay of 95 minutes. The George L. Shields Emergency Department is one of the largest emergency departments in the region. With over 24,000 square feet, the ED houses: -50 beds and treatments rooms -14 general-purpose rooms -5 Crisis rooms -1 SAFE Room -15 Acute care beds -CT scanner dedicated to ED patients only -X-ray suite dedicated to ED patients only The FMH Emergency Department has forged strong working relationships with the Frederick County Public School System, the Frederick County Court System, and community law enforcement agencies. Many of the community benefit programs offered by the Emergency Department are the result of collaborative efforts between these agencies and organizations and Frederick Memorial Hospital's ED staff. The Pediatric ED Co-location Located on the second floor of the hospital, the Pediatric Emergency Department began treating patients in October of 2010. The department is designed to meet the urgent and critical medical needs of pediatric patients in an environment that is quiet, calm and secure. The new Pediatric ED is located next to the Pediatric Inpatient Unit. The team of pediatric specialists who care for children in the emergency setting also provide care to our pediatric inpatients. That means that if a child needs to be admitted to the hospital for care, the same team of doctors and nurses will remain with them throughout their stay. A consistent care team ensures coordinated, quality pediatric care, and provides the calming confidence of familiar faces that children find so comforting. Community Benefit Programs The Emergency Department in conjunction with the above mentioned organizations have developed the following programs: 1. SAFE Program 2. Lethality Assessment Program 3. Take a Moment
1. SAFE Program   Since 1997, Frederick Memorial Hospital has provided medical forensic examinations performed by a Forensic Nurse Examiner, to any patient who presents to the Emergency Department with a chief complaint of rape or sexual assault. Our program follows the new Department of Justice mandate that patients have a right to evidence collection and treatment provided whether law enforcement is initially involved or not. FMH employs 10 forensic nurses who, as part of the FMH SAFE Team, provide 24/7 coverage. The SAFE Program treated 72 patients in FY10. An essential component of the SAFE team's charge is to educate members of the Sexual Assault Response Team (SART). We have presented in-services on rape trauma to: -All Officers of the Frederick County Sheriff's department, -Frederick City Police Academy (15), and -Mount Saint Mary's University resident advisors and members of the freshman class of 2010. (100) The SAFE Program team members provided Unit Victim Advocates (UVA) continuing education training at Fort Detrick. (50 Participants) In the community, members of the SAFE staff have served as guest speakers/educators at: -Hood College's Into the Light Program (100) and, -Mount St Mary's Domestic Violence Panel Discussion. (70) SAFE has become an integral part of the community by being a member of: -The Frederick County Domestic Violence Coordinating Council (15) -The Frederick County Domestic Violence Fatality Review Board (20) -The executive board of the Frederick County Child Advocacy Center (15) -The Frederick County SART (20) -The Maryland Board of Nursing RN FNE advisory board (10) -Two of our forensic nurses were part of the training team for the Adult Forensic Nurse Examiner Adult Training hosted by Washington County Hospital. (12 new nurses were trained) Safe Program: Sheriff's Department In-service on Strangulation The Lethality Assessment tool used in our ED to help patients who come to our hospital with injury from an intimate partner assault indicates that over fifty percent have been "choked." The coordinator of the SAFE Program testified in Annapolis on behalf of House Bill 819 Crimes- Definition of Serious Physical Injury Strangulation and Suffocation. Our team recognized that knowledge of what to look for and how to document it could benefit law enforcement. One deputy spoke in the middle of one presentation and exclaimed "I wish I had this class last week because the woman was only whispering on the phone that her husband was trying to kill her. Had I known that strangulation can cause swelling which can change the tone of voice I would have responded differently." Every deputy in Frederick County received this one hour in-service provided by a Forensic Nurse. The classes occurred every Tuesday during the months of March, April, May and June and one additional class at the end of the summer. 2. Lethality Assessment Program Interpersonal violence occurs to approximately 5.3 million people a year (mostly women). Fifteen hundred of those victims are killed each year. Forty seven percent of those killed had previously sought medical attention. At Frederick Regional Health System we see patients who present with injuries or related medical conditions aggravated by domestic violence. We have always treated their wounds but not assisted them in realizing that they could be in lethal danger. Our goal is to connect our patients with domestic violence services that can help them with immediate and/or long term safety plans, shelter and legal expertise. Frederick Regional Health System (FMH) is one of two hospitals in the state of Maryland who are modeling a Lethality Assessment Program (LAP) piloted by first responders in law enforcement since 2005. This lethality assessment tool was implemented by the Maryland Network against Domestic Violence (MNADV) after being researched and developed by Dr. Jackie Campbell from Johns Hopkins University. Since our implementation we have provided four other hospitals with our program model. These include Meritus, Peninsula Regional Medical Center (PGHC), Prince George's Hospital Center and Carroll Hospital Center. Our program received a letter of gratitude for our participation at the Maryland Patient Safety Center (MPSC) 7th Annual Conference: Champions of Change. It stated that our presentation entitled Lethality Assessment Program contributed greatly to the success of the day. The conference was attended by nearly 1,200 participants including nurses, physicians, long term care staff, executive leaders, administrators, quality/safety managers and human resource directors. Conference evaluations revealed 92% of respondents thought the conference met their expectations "well to very well." FMH received a Distinguished Achievement Award in Patient Safety Innovation by MPSC. On June 24th 2011 the SAFE Coordinator presented for the Maryland Health Care Coalition Against Domestic Violence conference-The Health Care Response to Domestic Violence about our LAP program. This was at PGHC to over 100 participants. Youthful Offenders Program The FMH SAFE team is part of the YOP which was initiated by the State's Attorney's Office. Every month one of our Forensic Nurse Examiner's speaks to different at-risk juvenile males who have been to court on criminal charges about the cycle of violence, and positive changes they can make in dealing with anger. Each monthly group has 15 participants (180) 3. The "Take a Moment" Program The Take a Moment program was developed at the request of the Frederick County Court System, and the Frederick County and Frederick City law enforcement agencies that identified the need to present a drunk driving awareness program. This program is now shown at special times. Take a Moment targets offenders convicted of driving while intoxicated, and is designed to show the consequences of driving under the influence of drugs or alcohol.
The program is a two-part presentation:   -A program focusing upon "Choices and Their Consequences" is presented to participants, and they are shown pictures from fatality scenes that graphically depict the results of poor choices. -Participants engage in "role play" scenarios wherein one is a patient and the other a healthcare worker having to deal with an intoxicated patient. The patient is placed in restraints, and the unpleasant procedure known as a gastric lavage (having your stomach pumped) is demonstrated. Program Presentations The Victim Impact Panel presents the "Take A Moment" program every other month to offenders of driving under the influence, who are ordered by the court to attend this program. Take A Moment was provided to: -Frederick Community College (50-75) -St. John's High School (Entire student body) Frederick County Court System's rate of recidivism statistic is used as the gauge by which the program's efficacy is measured. The rate of recidivism has declined since the implementation of this program in Frederick County. Mothers Against Drunk Driving (MADD) supports the Take a Moment Program. Their evaluations provide feedback to the FMH Emergency Department staff and the State Police instructors. Frederick Running Festival The FMH Emergency Department furnished all of the supplies and equipment necessary to create a MASH-like first aid tent for the Frederick Running Festival's marathon held in May 2010. It was a particularly hot, steamy day and many more runners were overcome by the heat and conditions than was anticipated. Fortunately the tent was adequately staffed and fully stocked so that first aid care provided to the more than 200 runners who needed it was up to FMH quality standards. Physicians and nurses tended to minor injuries such as blisters from ill-fitting footwear to the administration of IV fluids for those who became dehydrated. Perioperative Services Open House FMH's Perioperative Services opened its doors again to share the latest technology and surgical procedures with the community. On November 12, 2011 the Operating Room hosted over 120 adults and children from our community through the operating rooms and Pre and Post surgical areas. Many Cub Scouts, Girl scouts, Brownies and Student Nurses attended. The Open House is a wonderful opportunity for children and young adults to explore the many different medical professions and job opportunities for their future. Participants were able to touch the equipment and ask the surgical team members about their jobs, and the surgical procedures. They discovered the many rewards of working in the operating room environment. This year staff, anesthesiologists and surgeons set up rooms to demonstrate the new da Vinci Robotics procedures, Total Joint Replacements and Chest Surgery. Visitors were invited to tour the pre-operative areas where patients are prepared for the operating room and the post-anesthesia care unit where patients recover from the effects of anesthesia. This event marked the fifth year for the program and is run solely by volunteers from Perioperative Services and physicians. The community looks forward to the FMH OR Open House announcement every year. Cardiology Services Preventive Cardiology and Rehabilitation: The Medical Fitness Program The FMH Medical Fitness program is a medically supervised fitness program that helps special populations promote health, improve physical fitness and enhance the quality of their life through exercise, education and service. The Medical Fitness program is recommended for people with health concerns such as high blood pressure, heart disease, diabetes, lung disease, circulatory problems and weight issues. Evidence clearly supports that regular exercise improves quality of life. Many people who live day to day with the challenges associated with a number of conditions and diseases miss out on the healthy benefits of routine exercise because of the fears associated with cardiovascular work outs. The staff at Medical Fitness consists of registered nurses and degreed exercise physiologists trained and certified in BLS and Advanced Cardiac Life Support. The staff prepares an individualized exercise program for each participant and monitors the exercise routine. Included in this program are regular blood pressure readings, glucose measurement (as needed), exercise prescription, one-on-one assistance from our staff (as needed) and regular feedback and communication with physicians. Sign language and foreign language interpreters are also used when needed. The Medical Fitness program was provided free of charge to 15 patients in FY 11. These patients must attend the fitness programs regularly. The gratis participants in the program remain in excellent health. Their energy levels, range of motion, cardiovascular condition and overall health are exponentially better than if they had not had access to a medically supervised exercise program. FMH Vascular Services On May 14th, FMH Vascular Services in conjunction with the Preventive Cardiology and Rehabilitation Department offered a free vascular screening event to the Frederick Community. The screenings took place at two locations: FMH Main Campus, 2nd floor classrooms and Rose Hill Vascular Lab. FMH partnered with community physicians who provided supervision, interpretation of test results and a number of informational talks and demonstrations. Physicians who provided the lectures included Horizon Vascular Surgery, Cardiovascular Specialists of Frederick and Dr. Sahid Rafiq, Medical Director, FMH Stroke Center, and Dr. Ryan Kulkarni, Medical Director, FMH Center for Advanced Wound Care & Hyperbaric Medicine. These physicians volunteer their time to provide a three-hour lecture series that explains how vascular disease is diagnosed and the treatment modalities available to them after the diagnosis has been made. A vascular sonographer screened participants using ultrasound equipment to detect Abdominal Aortic Aneurysm (AAA), Carotid Stenosis (high risk for stroke), and Peripheral Arterial Disease (PAD). Every participant was screened for risk factors that may contribute to vascular disease such as hypertension, family history and smoking. Results of the screens were evaluated at the events. All participants who had abnormal result discovered the screens were immediately permitted to consult with one of the physicians manning the event regarding appropriate follow up and care. The consultations directed the participants to follow up with their PCP or with a vascular surgeon if the patients did not have a PCP and their condition was such that it required immediate treatment. All participants in the Vascular Screening were registered into a sophisticated database that recorded the results of their vascular screen. This database will allow us to track the impact the vascular screening events have on the health of our community over time. The vascular screenings are offered to the community - FREE of charge. The average charge for a vascular screening is between $100 and $150. The FMH vascular screening event equated to $16,000 of free services being offered to our community.
Raising the community's awareness and understanding of vascular disease is   a priority for FMH. Statistically, only three out of four adults have heard of Peripheral Artery Disease, and frequently life-threatening conditions such as Abdominal Aortic Aneurysm and Carotid Stenosis are not discovered in time to save a life. Because symptoms of the disease may be vague or absent all together, patients do not seek care so that the necessary surgical intervention cannot take place in time to avoid unfortunate outcomes. Over 170 participants have been screened this year in Frederick County, and significant vascular disease has been detected and treated. The Vascular Disease Screening Events sponsored by FMH Vascular Services have made a significant difference in the lives of the citizens we serve by preventing probable stroke or ruptured aneurysm. By raising the public's awareness of vascular disease, and actually detecting the presence of the disease in the population, FMH Vascular Services has truly made a difference in the health status of our community. As recent participants commented: -"I am very grateful for this screening and appreciate the work involved," -"This has been a concern of mine for some time and I am very happy to have this chance to attend," and -"Very informative. A GREAT community offering and service." Students: In FY11, the Vascular Lab was a clinical site for 6 students studying Vascular Sonography for 46 weeks, 40 hours a week. Interventional Cardiology & Electrophysiology In the 2007 Community Health Needs Assessment, 5.6% of surveyed Frederick County adults report that they suffer from or have been diagnosed with heart disease, such as coronary heart disease, angina, or heart attack. Viewed by race, heart disease mortality in Frederick County is higher among Whites (239.0/100,000) than among Blacks (216.8 per 100,000). The Frederick County annual average age-adjusted heart disease death rate for 2002-2004 was 235.2 deaths per 100,000 residents. -Similar to the Maryland rate (227.7 deaths per 100,000 residents). -Similar to the U.S. rate (233.1). -Fails to satisfy the adjusted Healthy People 2010 objective of 213.7 per 100,000 or lower. The FMH Interventional Cardiology Department presented four community education events in FY2011. Some of the presentations were at the request of hosting organizations while others were the result of the Department's participation in health fairs and other events in the Frederick community. At each of the events, representatives from the Interventional Cardiology and Electrophysiology Departments presented lectures and handout materials to educate the public about the treatments that are available for heart attacks, stroke and arrhythmias. Presentations: -Mt. Airy Senior Center - May 2, 2011 -The Great Frederick Fair - Sept 13, 2010 -Crumland Farms - March 3, 2011 -Amvets - April 2, 2011 The event at the Mt. Airy Senior Center was followed by tours of the FMH Interventional Cardiology Lab for all interested participants. FMH Auxiliary/Volunteer Services On September 11, 1952, the Women's Auxiliary of Frederick Memorial Hospital was founded. Service to the hospital began immediately with the first volunteers helping out in the Record Room and quickly expanding to other departments. By 1955, the FMH Auxiliary was the largest women's organization in Frederick County. Candy Stripers, now known as Junior Volunteers, joined the organization's ranks in 1967. When men joined the group in the early 1970s, and teenage boys began to volunteer in 1971, the name was officially changed to the Frederick Memorial Hospital Auxiliary. Originally founded to "serve on committees, support fund raising activities and promote good will," the FMH Auxiliary's first fundraiser was the Snow Ball held on December 22, 1952. The event raised $1,131.50, which was used to air-condition the operating room. Since then, the Auxiliary has donated more than $8 million to the hospital for equipment and improvements, and has contributed millions of hours of service to the Frederick community. Today the Auxiliary is composed of men and women who continue the tradition of service and stewardship. Members of the auxiliary provide hundreds of thousands of hours of their time to guide our visitors, transport our patients, and support the family members of those who are ill, injured, or on the mend. Select Seconds Thrift Shop Select Seconds, located at 8 East Patrick Street in downtown Frederick, Maryland has been serving the community for more than 25 years. Manned completely by FMH volunteers, gently used clothing is collected, sorted, inspected and washed, and then put on display in the retail shop. Those in the Frederick community who may need good, clean clothing to go to a job interview, or just to restore some semblance of dignity and self respect are given vouchers by non-profit grass-roots humanitarian agencies and organizations throughout the county to come into Select Seconds and take whatever they need - free of charge. FMH provides these vouchers to organizations such as Dress for Success and the Union Rescue mission. FMH Auxiliary Tours Committee In response to a number of requests from first grade teachers in Frederick County, the FMH Auxiliary created a hospital tours program. Dates and times of the tours are coordinated with the individual classes but occur most frequently in the fall and winter months - weather permitting. Eleven FMH Auxilians provided 150 hours of service providing tours on 14 days. The tours include a general overview of the hospital and hospital operations. In addition to seeing and touring the hospital facility, an important teaching aspect of the visit is for students to appreciate the teamwork necessary to keep a hospital running at maximum efficiency. Doctors, nurses, security and housekeeping staff tell the children what part they each play in helping to take care of our patients. Throughout the course of the tour the Auxilian leading the tour will invite the children to have a seat in one of the hospital's private waiting areas and will lead a discussion about health and hygiene topics. They will discuss proper hand washing techniques, the importance of covering coughs and sneezes appropriately and how to identify medicines versus candies. One of the most important aspects of the hospital tour is explaining to the children what they can expect if they are ever admitted to the hospital for care. The class is escorted into the radiology department where x-ray technicians and radiologists have the opportunity to show the children x-rays, explain to them how the instruments work and allow them to safely touch some of the equipment. The children also visit the rehabilitation department and are permitted to play with some of the various pieces of equipment that are used in physical and occupational therapies. Many of the tools used in the discipline are balls - large and small - exercise bars and stretchy straps. The children learn how they can exercise as they play with very items they use in the playground every day.
The students are escorted to the Pediatric Department on 2nd floor. They   are shown a pediatric inpatient room and they are allowed to visit Dr. Wack in the Pediatric Emergency Department co-located with the inpatient unit. The tour guides discuss with the students some of the reasons why they might be brought to the Pediatric ED, and why they might have to stay overnight for the kind of care that only doctors and nurses can give to make them well. The final stop on the tour is the newborn nursery located in the FMH Family Center. Here they are allowed to look through the glass at some of the newborn infants in our well baby nursery. The questions here can get quite interesting . . . . All students, teachers, and volunteers have their hands cleaned with antiseptic hand sanitizer upon entering and leaving the hospital. A bag of educational material is also provided to teacher(s) for distribution to students when they return to school. Volunteer Services In response to numerous requests from Frederick County Public Schools Success and Challenges Program, the Maryland School for the Deaf (MSD), and Goodwill Industries the FMH Auxiliary created a placement program - mostly for junior volunteers - to provide an opportunity for students to learn job skills. The program currently in place allows students/clients from the above mentioned organizations and agencies to volunteer their time at FMH and, in return, receive training in the area in which they are volunteering, e.g. the FMH cafeteria, sterile processing, materials management and distribution, restocking supplies, etc. Students from Frederick County Public Schools and MSD attend volunteer opportunities throughout the school year. Goodwill clients are at FMH year-round. Training & Organizational Development Department The Training and Organization Development Department supports FMH mission, vision, and strategic goals by helping to develop the skills and competencies of FMH staff. Competent and skilled staff-members contribute to customers choosing FMH as their health care provider of choice. FMH has signed student affiliation agreements with colleges whose programs include amongst others: nursing, imaging and rehabilitation. These collaborative efforts allow students the opportunity to complete a clinical rotation at FMH. Schools throughout Maryland, as far away as the Eastern Shore, have signed affiliation agreements with FMH. Given the shortage of both nursing and allied health professionals, many schools have looked to increase enrollment in these programs. Any increase in enrollment has meant the need for additional clinical placements. During FY11 FMH continued its partnership with the nuclear medicine course at Frederick Community College, helping in an advisory role and clinical rotation site. This course was started based upon the severe shortage of nuclear med technicians throughout the state of Maryland. FMH is proud to provide clinical placements for these students. Community Benefit Services Clinical placements at FMH provide a real-world environment in which the students may observe, learn, and practice their skills under the direct supervision of a licensed practitioner. Structuring a positive student clinical experience has led to many students applying for open positions at FMH. In addition, FMH provides direct financial support to Frederick Community College enabling it to offer associate degree programs in nursing, respiratory therapy and nuclear medicine. Outcomes Assessment Every program is evaluated via regular contact with school faculty, the completion of a student evaluation, as well as feedback from the hospital department staff. Modifications to the clinical rotations have been made when warranted. Presentation Schedule Students are placed at FMH year round, with the busiest periods being in the spring and fall. On average, during a spring or fall semester, about 130 nursing students from a variety of colleges could be completing a clinical rotation at FMH. Imaging and rehabilitation students number from 1 to 5 in any given semester. Support of Frederick Community College (FCC) Monetary support paid to FCC to help fund their allied health and nursing program = $100,000.00. In addition, FMH pledged $40,000.00 to FCC through the Maryland Hospital Association's Partners in Nursing Program. Finally, FMH also provides space and phones at no charge for a training lab valued at $1032.48 monthly and the phone service we provide is valued at $60.40 per month = $13,114.56 The total support to FCC = $153,114. Support of business and educational partnerships through the Frederick County Chamber of Commerce (FCBRE) FMH is a founding member of the Frederick County Business Roundtable for Education. This group supports, amongst other initiatives, educational internships for high school students, career fairs highlighting the math and science jobs within Frederick County, and continuing educational programs for public school teachers. FMH provides committee members who dedicate their time and ideas to this effort, along with an annual monetary pledge of $10,000.00. Community support via FMH's Diversity and Inclusion Program Diversity and inclusion at FMH represent essential values that are embedded in our work culture and enhance our ability to attract, develop and retain a highly talented workforce. In essence, our commitment to diversity and inclusion goes to the very core of who we are as a healthcare provider and an employer. It defines and strengthens our mission to provide superb quality, superb service, all the time. Everyone at FMH recognizes the benefits of diversity and inclusion. Throughout our system, we have programs and resources that reinforce the value of different individual perspectives, increase cultural awareness and education, and ensure that our benefits and rewards meet the needs of an increasingly diverse talent pool. Our history of diversity and inclusion is reflected in programs, initiatives and accomplishments that include: include:
-Inception of a Diversity Advisory Council in 2002   -Diversity education and awareness opportunities -Development and implementation of a language assistance program -Expansion of benefit policies to include members of the LGBT community -Mandatory online diversity awareness training -Tuition assistance program -Award and recognition by Frederick Magazine as one of the Top Five Family Friendly Employers in Frederick County Reaching Beyond Our Halls Furthermore, we recognize that diversity is not just about what we do and who we are within our own environments - it shapes how we care for the greater community. With that in mind, and with an appreciation for the increasing diversity of the growing greater Frederick area, we have completed an assessment of the implications of diversity on our organization and the community we serve. This information will drive our diversity and inclusion efforts going forward - because our commitment continues to grow. FMH prohibits discrimination of all aspects of employment and advancement based on race, color, religion, sex, age, size, national origin, marital status, disability, sexual orientation, or genetic information. FMH provides free health screenings and general health information to members of the community via the support of the following programs: -Annual Latino Festival - 6 FMH employees serving approximately 500 attendees -Frederick 1st Family Olympics - 6 FMH employees serving approximately 20 attendees -North of 4th Street event - 5 FMH employees serving approximately 300 attendees Oncology Services Located directly across the street from the hospital, the 26,000 square foot FMH Regional Cancer Therapy Center houses the latest technology in outpatient cancer therapy, offering the very best in cancer treatment in a pleasant, compassionate atmosphere. Within the modern facility are hospital-affiliated chemotherapy and radiation therapy programs and facilities for community outreach, patient education and support. The cancer program also provides access to a wide variety of clinical cancer trials. All of these services and support are close to home for cancer patients, their families and friends throughout Frederick County and the surrounding region. Frederick Memorial Hospital has a longstanding commitment to provide quality cancer care and to aid efforts to find a cure for the disease. In 1976 the hospital established a cooperative cancer care clinic with Johns Hopkins Hospital. Because there was no oncologist located in Frederick, Maryland at the time, a specialist from Johns Hopkins came one day each month to serve as a consultant. The outpatient chemotherapy clinic was started one year later, and the cancer program has grown steadily ever since. The Regional Cancer Therapy Center opened in 1989. Since that time the cancer program has been ranked as one of the top 100 in the United States by Cancer Magazine. The American College of Surgeons Commission on Cancer has recognized our cancer program as a Comprehensive Community Cancer Program, an honor only 22% of hospitals in the nation achieve. The FMH Regional Cancer Therapy Center has become one of the Health System's most important regional providers of cancer care. With the opening of the FMH CyberKnife Center, the FMH Regional Cancer Therapy Center provides state-of-the-art cancer care for patients who come from as far away as Pennsylvania, West Virginia and the Eastern Shore. Free Annual Prostate Cancer Screening On September 10th, the Regional Cancer Therapy Center offered a free Prostate Cancer Screening event at the FMH Wellness Center located in the Francis Scott Key Mall. All participants were required to have both the PSA blood test and the digital exam portion of the screen. Two urologists volunteered their time to participate in the Prostate Screening event. Forty five men were screened for prostate cancer. Minority communities in Frederick were especially targeted for this Prostate Cancer screening event as research has shown that men in these demographics are much less likely to be screened for prostate cancer. Ads were placed in minority publications and radio stations broadcast PSAs about the event. We also created church bulletin inserts that were distributed by the FMH Pastoral Care department to churches throughout the Frederick community. Annual Prostate Cancer Symposium On September, 27th, the Regional Cancer Therapy Center hosted the 4th Annual Prostate Cancer Symposium in the atrium of the Cancer Center. The theme for this year's presentation was Technological Advances in Prostate Cancer Treatment. Two presentations by physicians highlighted new treatment modalities for the 100 men and women who attended the symposium. Urologist Dr. Jared Berkowitz presented "da Vinci Robotic Surgery in the Treatment of Prostate Cancer," and Radiation Oncologist Dr. Gregory Gagnon presented "CyberKnife Radiosurgery in the Treatment of Prostate Cancer." A free dinner, paid for by vendor donations, was provided to all participants. Annual Breast Cancer Symposium In October, the Regional Cancer Therapy Center partnered with the American Cancer Society and Frederick Community College to host the Annual Breast Cancer Symposium. This year's event was held in the Women's Center at FMH Crestwood. More than 100 women attended this year's symposium, many of the oncology nurses and other professional care providers who gather every year to hear about the latest diagnostic tools and treatment modalities. Man To Man Prostate Cancer Support Group Man To Man is a prostate cancer support group for both patients and family members is co-sponsored by Frederick Memorial Hospital and the American Cancer Society. The group meets on the fourth Wednesday of the month at 6:30 pm at the Regional Cancer Therapy Center. Twenty five men and their spouses attend every monthly meeting. Humanitarian Aid FMH Medical Missionary Trip to Peru In February, four physicians from The Emergency Physicians Association, the contract physician group that provides services in the FMH Emergency Department, along with Ob/Gyn physician Dr. Renee Thomas and five ED nurses went on a medical missionary trip to Iquitos, Peru. The medical team donated their time and expertise to treat the desperately poor people of Peru, many of whom have no access to medical care at all - ever.
More than 1,600 men, women and children lined up outside of the MASH-style   Emergency Room long before sunrise in hopes of being able to be seen by a physician, nurse or technician. Practitioners provided wellness checks, general medical interventions, pelvic exams and wound care. Patients presented with intestinal parasites, wound infections, dysentery, monkey bites, vehicle accidents and malnourishment. In the words of one of the attending nurses, "You name it. We saw it." The following medical supplies were donated to relief efforts: -16 cases of used, clean linens for Dr. Razi's humanitarian trip to Pakistan -8 cases of used, clean linens for Dr. Haque's Pakistani relief efforts -4 cases of used, clean linen for Amvets -11 skids of medical supplies and IV fluids to Dr. Raza's mission to Pakistan -10 skids of medical supplies and IV fluids for Dr. Gough's trip to South America -Medical supplies donated to the Boy Scouts of America The FMH Pharmacy & Care Coordination Department Combined with the emergency disasters around the world, the local economy adversely affected a number of Frederick County residents. Job loss and the loss of medical insurance left a number of our citizens unable to afford the healthcare and medications they needed to keep chronic disease in check. The FMH Pharmacy in conjunction with our Care Coordination team provided $1,500 of medications to the disaster teams mentioned above, including antibiotics, ointments, creams and children's medications. On the local scene, the FMH Pharmacy provided $4,500 worth of medications to indigent patients or to patients who did not have the resources to pay for their medications. The Care Coordination Department was instrumental in coordinating the dispensing of the medications to those unable to pay. They assisted the patients with the paperwork necessary to apply for financial assistance and to access community resources available to help them. FMH Pharmacy Department Health Professional Education A Pharmacist Graduate Residency program was established at Frederick Memorial Hospital, with the first class in session from July 1, 2010 through June 30, 2011. Two registered pharmacists completed this very intense, structured program that incorporated numerous clinical and administrative experiences. The Graduate Program at FMH has clearly enhanced the organization's image as the region's leader in pharmaceutical education and patient care. The Pharmacist Graduate Residency Program and the Pharmacy Department participated in a two-day inspection and certification review conducted by the Residency Accreditation Board of the American Society of Health System Pharmacists. The pharmacy received notification in October that the Pharmacist Residency Program would be awarded full certification in the spring of 2012 Outpatient Anticoagulation Clinic In June, the Pharmacy Department opened a Pharmacist-managed Outpatient Anticoagulation Clinic. Under the supervision of a physician Medical Director, new patients spend about 30 minutes with an FMH Pharmacist reviewing the appropriate use of their medications and individualized dose instructions. Outpatient anticoagulation clinics have been established at numerous hospitals around the state and country, and their value to the community is well documented. Anticoagulation clinics improve patient outcomes by preventing adverse drug interactions, decreasing the incidence of bleeding and preventable embolism, and positively impacting the need for hospital admissions. The clinic operates Monday through Friday from 8:00 am to 4:30 pm. Patients must be referred to the FMH Anticoagulation Clinic, and there are currently more than 425 patients being managed by the clinic. Providing such a service will assist in closing the loop in our patients' continuum of care and treatment and ensures our patients anticoagulation needs are met. FMH Bariatric Program The FMH Bariatric Program has been actively engaged in educating the Frederick community about the dangers of obesity. Bariatric surgeon Dr. Stephen McKenna and nurse Dan Armstrong have contributed many hours hosting and lecturing at community events about the risks associated with obesity. The 2007 Frederick County Health Risk Assessment found that 67.8% of Frederick County adults are overweight with a BMI of greater than 25. Specifically, 28.3% of Frederick County adults are obese with a BMI of greater than 30. Among Frederick County community members, the 2001 assessment found that obese adults are much more likely to report a number of adverse health conditions, including: -High cholesterol -Hypertension (high blood pressure) -Arthritis/rheumatism -Activity limitations -Diabetes Dr. McKenna has been very active in the area of childhood obesity and has provided community education at a number of venues. Dr. McKenna and Dan Armstrong provided information to the community at the following events. -FMH Select! Meeting - November 8, 2011 -Community Education Seminars - The last Monday of every month -Frederick Family Olympics - October 8, 2011 FMH Center for Advanced Wound Care & Hyperbaric Medicine The FMH Center for Advanced Wound Care & Hyperbaric Medicine is a state-of-the-art medical facility that was designed to provide the degree of privacy necessary to make patients feel comfortable. For people living with challenging or chronic, non-healing wounds, burns, or other skin conditions, the center provides many soothing benefits. -Hands-on care, supervised by a team of multi-disciplinary experts. -Innovative skin/wound products and services. -Leading-edge technology.
The FMH Center for Advanced Wound Care & Hyperbaric Medicine features two   corridors lined with spacious treatment rooms in addition to a pair of hyperbaric chambers. Appropriate medical management of wounds is a very important part of nursing care. The quality of care provided to patients and the expertise of the staff who attend patients in the FMH Center for Advanced Wound Care & Hyperbaric Medicine have come to the attention of the regions institutions of higher learning. The Center has been approached by Frederick Community College, Independence University and West Virginia School of Medicine to provide an introduction to wound care to nursing and medical students. The students follow the clinical wound specialists and learn how to evaluate and perform wound care in the inpatient environment. The medical students observe the various providers in the outpatient wound care center. They are educated comprehensively on the diagnosis and treatment of wounds. The following is an overview of the courses and hours of instruction provided: (1) 12 encounters totaling 96 hours with nursing students (2) 6 encounters totaling 22 hours with respiratory students (3) 15 encounters totaling 120 hours with medical students The FMH Auxiliary Prenatal Center The FMH Auxiliary Prenatal Center provides underinsured/uninsured women in Frederick County, Maryland with prenatal care. Since opening in December 2007, the center has provided care to more than 1,500 mothers, approximately 95% of whom had little to no care before entering the Prenatal Center program. Many of these women, in addition to being pregnant, have underlying medical conditions that are either undiagnosed or not treated and many social and cultural issues requiring coordinated care and services to enhance the outcome of the pregnancy. Frederick Memorial Hospital (FMH) is the lone hospital-based healthcare provider in what the Washington-Pew Hispanic Center has identified as the county having the 17th fastest growing Hispanic population in the country. From 2003-2005, Hispanic mothers showed the highest rate of inadequate prenatal care in Maryland (24.8%) compared to other races and ethnicities (PeriStats, 2008). Being a sole provider in such an environment. Outcomes Since opening in December 2007, the FMH Auxiliary Prenatal Center has been a blessing to underinsured/uninsured women in Frederick County. By delivering quality and comprehensive prenatal care to those who need these services the most, FMH has already enhanced the health status of these women and their babies and has reduced their risk of complications during pregnancy and childbirth. In fiscal year 2011, the Prenatal Center handled more than 3,124 clinical visits and delivered 249 infants, 97-98% healthy infants delivered with only 2-3% needing additional care in the NICU (for moms attending at least 8 prenatal visits). These outcome measures have been consistently high since the opening of the program and are highly praised by the neonatologists at the hospital. In the last two years the Maryland Department of Mental Health and Hygiene's Vital Statistics Administration has had good news regarding infant mortality rates for Maryland, and Frederick in particular. Between 2008 and 2009, Maryland infant mortality rate dipped nearly 10% - from 8 deaths to 7.2 deaths per 1,000 live births. Frederick County was one of only 2 counties in Maryland to see a statistically significant decline in its infant mortality rate, dropping from 8.4 to just 3.8 deaths per 1,000 live births. This means that 11 babies younger than one year old died in 2009, compared to 25 in 2008. This trend continued into 2010. The FMH Auxiliary Prenatal Center is a shining example of what a community can do by working together, pooling resources and resolve, to provide healthcare to those who are often overlooked and underserved. The arena in which they vie for services is fraught with challenges, and the playing field is often skewed to their disadvantage. A constituency composed of our most impoverished citizens - frequently unemployed and uninsured and of indeterminate legal status - profiles a demographic that many find easy to dismiss. The Frederick County Healthcare Coalition refused to turn away. Clearly focused upon the health and well-being of the mother and the birth of a healthy baby, the public, private and nonprofit sectors found a way to deliver desperately needed prenatal healthcare services. Thanks to the generous financial support of our community - and the FMH Auxiliary - the underserved pregnant women in the Frederick Community will have a resource for prenatal health care for years - and generations - to come. FMH Interpreting Services FMH Interpreting Services provides on-site language accessibility for all patients so that they can participate fully in their own healthcare and in the healthcare of their loved ones. Onsite interpreting is available for American Sign Language (ASL) and Spanish. In addition, we provide telephonic interpreting for more than 170 spoken languages. Services are available 24 hours a day, 7 days a week, to all patients and their families for appointments, procedures and hospital stays. There is no cost to patients or families for interpretation. In case of the unavailability of an on-site interpreter, telephone interpreting is available for spoken languages, and video remote interpreting is available for American Sign Language. As minority populations continue to grow in Frederick County, demand for the FMH interpreters to lend their skills at events and activities throughout the County grows as well. Our dedicated team is always willing to participate in health fairs and seminars, and provide a "must-have" link to our community. In FY11, the Interpreting team participated in three major community events: 1. Convoy of Hope - June 18th 2. Life & Discovery Asian Fair - October 22nd 3. Life & Discovery Follow up phone calls - November 18th The following piece was written by Maria Shuck of Interpreting Services about the three events in which the interpreting team participated: 1. Convoy of Hope: It was muggy and thankfully the rain held off. The crowds began to pour in at 9:00am as planned. The volunteers in their gray "Hope" T-shirts were in position, anticipating the wave of people soon to come through. I quickly noticed familiar faces in FMH burgundy T-shirts. Harry was handing out FMH t-shirts to staff as we entered into the huge white Health Care tent. I immediately felt at ease being at the Frederick Fairgrounds for the Convoy of Hope event. Other FMH staff were already busy setting up their areas. As I stood at the entrance of our tent I watched and acknowledged patients as they approached. People seeking medical advice came in all shapes and sizes, socioeconomic backgrounds, ethnicities, nationalities and every other diverse representation possible. Some were speaking languages I recognized, and others I did not. languages I recognized, and others I did not.
FMH interpreters, Gloria, Rosario, Elisa, Daniela and I assisted our   Spanish speaking patients. JoAnn, our ASL interpreter, was on the lookout for Deaf patients. We were easy to spot; we wore sashes denoting the languages we served. Elizabeth Chung, Director of Life and Discovery, did an excellent job providing interpreters for various Asian languages. Our tent had a fair amount of Asian patients, including Vietnamese, Burmese, Chinese, and Hindi. Hugs were plentiful for us Spanish interpreters, since many of the Hispanic patients that day have been assisted by FMH interpreters in the past, and for the most part continue to show their appreciation towards us. Many came to check their blood pressure and blood sugar levels. Others came in with ailments like abdominal pain, headaches, high blood pressure and eye sight issues. After consulting with the physicians, most were referred to see specialists in the community in order to receive follow up care. The patients I assisted nodded politely and thanked the doctors upon stepping out from behind the curtain. My immediate thought was that many of these folks were uninsured and would probably not be seen any time soon by anyone. I suspect that most people that took the time to visit our tent probably did not have a primary doctor or the resources to seek further medical attention for their ailment in the first place. 2. Asian Fair: Staff interpreters attended this event, which was organized by Life and Discovery. The Asian Health Fair was founded to serve those less fortunate, providing health services in a professional, caring atmosphere. For many who have attended our Health Fair in the past, this event is their only chance to see a physician, get their blood pressure and sugars checked, and get basic blood work done. Our interpreters provided services to Spanish speaking attendees. 3. Follow up phone calls were made by our staff Spanish interpreters to 9 individuals who attended the Asian Fair mentioned in #2 in order to notify them where they could receive the second installment of the Hepatitis B series which they began at the Asian Health Fair. Community Contributions FMH receives numerous requests for financial support from a wide variety of worthy community organizations. The FMH Department of Marketing and Communications serves as the Health System's clearing house for vetting the many requests. While the hospital helps whenever and wherever it can in providing in-kind contributions of time and talent; cash contributions are used to support those organizations or community initiatives that espouse a cause that is most in keeping with that of the Health System's mission to contribute to the health and well being of area residents. Heartly House is a nationally recognized organization dedicated to combating domestic violence and providing shelter, legal assistance and transitional housing to victims. FMH works closely with Heartly House, as advocates from that organization often accompany women to the FMH SAFE Program described above, and observe the process of forensic examinations. We assisted Heartly House with their lifesaving work by helping them publicize their services and creating print materials for their fundraising events. While some of the assistance FMH provided was in the form of purchasing advertising space in local publications, some in-kind contributions in time and talents proved to be even more valuable to the organization. Total Heartly House contributions = $5,000 Another important cause to which FMH has provided support touches upon a topic that was identified in the 2007 Community Health Assessment as an area of growing concern relative to access to care and adequate number of physician/extender providers. The Mental Health Association's Guide to Mental Health and Community Support Services is a comprehensive referral resource that is used extensively throughout the region by physician office practices, fire and police departments and other community organizations seeking appropriate interventional resources. Frederick County Mental Health Association contribution = $2,500 One of the greatest challenges for the health care industry as it moves into the 21st century is to make sure that there is an adequate supply of well trained and educated Registered Nurses. The Maryland Hospital Association established the Who Will Care? Campaign to help Maryland solve its expected shortage of 10,000 nurses. -Nurse shortages compromise health care-limiting health care access, delaying treatment, escalating costs, and contributing to provider stress. -Over the next ten years more than 40% of the nursing workforce will retire just as retiring baby boomers are increasing the demand. -Problem? There are not enough students to graduate and fill the gap. In fact, Maryland nursing schools are at capacity and have had to turn away thousands of qualified applicants. Who Will Care? will double the number of registered nurse (RN) graduates across Maryland by awarding grants to Maryland associate, baccalaureate, and entry-level master's nursing programs that can achieve a measured increase in the number of first professional degree graduates. FMH is an ardent supporter of the Who Will Care? Campaign and in FY11 contributed $40,000. Other community events to which the Healthcare System contributed: -Asian Lunar New Year Diversity Event - $1,000 -Indian Association of Frederick - $300 -Community Foundation: -Frederick County Business Roundtable for Education - $10,000 -Eshman Randall Memorial Fund Golf Sponsor - $800 -Lt. Rob Seidel Memorial Golf Tournament - $300 -Ross Family Charitable Pass Through Fund - $100 -2nd Annual Run for Shelter - $250 -Frederick County Chamber of Commerce: -Student sponsorship for Media & Tech conference - $250 -Mental Health Association of Frederick - Catoctin Affair - $2,000 -Leadership Montgomery - $300 -Mission of Mercy - $500 -Frederick Marathon (In kind medical support services) - $5,000 -The Great Frederick Fair, Community Tent - $1,000 -YMCA Special Events - $1,000 -YMCA Campaign for Kids Golf Tournament - $600 -YMCA 2011 Healthy Kids Day - $2,500 -American Red Cross Hometown Heroes Nursing Award - $2,500 -The Red Devils Heart and Sole Stroll for Breast Cancer - $500 -The Great Frederick Fair Health Tent Sponsorship - $1,000 -Frederick Community College Foundation - $100 -Frederick Community College Foundation - $100
Total contribution to Community Events = $77,800.00   Mission Driven Health Services The mission of Frederick Regional Health System is to contribute to the health and well-being of area residents by providing quality healthcare in a caring, cost efficient and convenient manner through a coordinated program of prevention, diagnosis and treatment, rehabilitation and support. In order to fulfill our mission, The Health System has entered into a number of exclusive contracts and/or subsidy arrangements with hospital based physicians/physician groups. These arrangements provided for timely patient care in a cost effective manner, and allow for efficient allocation of physician time and resources. The following specialty practice physicians are subsidized to be on-call, 24/7 at FMH: -Hospitalists FMH Hospitalists are specialists trained in the care of hospitalized patients. They provide care to the patients of those physicians with whom they have established a relationship, and assume the medical management of the patient throughout the duration of their hospital stay. The hospitalists also provide care to those patients who do not have a primary care physician and/or are uninsured. -Surgicalists FMH expanded its Hospitalist program by including two new in house programs: Surgicalists and Pediatric Hospitalists (see below). Surgicalists are surgeons who are in-house 24/7 and ensure that Frederick County residents receive around-the-clock quality surgical care. Surgicalists not only provide better access to the highest quality surgical care, but are available to answer patients' questions about their surgical procedure. -Pediatric Hospitalists FMH has expanded its service provision relative to our pediatric populations. A subset of our Hospitalist program is Pediatric Hospitalists, physicians who specialize in the medical management of the hospitalized pediatric patient. In addition, some of our Pediatric Hospitalists have advanced training in pediatric emergency services and provide care in our Pediatric Emergency Department that is co-located with our inpatient pediatric unit on the second floor of the hospital. -Intensivists The FMH Intensivist program was initiated as an adjunct service for the expansion of the FMH Heart Service line. With the advent of the Interventional Cardiology Program, it was necessary to have 24/7 specialty care in the Intensive Care unit. Intensivists are physicians who have special training in critical care medicine. The specialty requires additional fellowship training for physicians who complete their primary residency training in internal medicine, anesthesiology, or surgery. Research has demonstrated that ICU care provided by intensivists produces better outcomes and more cost effective care. -Obstetricians FMH's recent designation as a Neonatal Intensive Care center has increased the number of high-risk pregnancies choosing to delivery in our BirthPlace. An increase in our demographic profile of those individuals less likely to have adequate - or any - prenatal care has also increased the probability that immediate/emergent obstetrical care be available. Our obstetric on-call schedule permits for that need 24/7. -Emergency Physicians FMH's Emergency Department is the third busiest ED in Maryland, registering over 65,000 annual patient visits. Because of the nature of our growing community, and the severity of the emergencies encountered, it is increasing necessary to provide around-the-clock physician specialty care. A variety of specialty and sub-specialty physicians are on call to provide the emergent care 24/7. -Anesthesiologists In addition to the on-site, 24/7, OB anesthesiology coverage, FMH has a "first-call" anesthesiologist available to cover emergency cases should the in house anesthesiologist be occupied with another patient. The availability of an on-call anesthesiologist has decreased the time interval between diagnoses and surgical intervention, resulting in significantly better patient outcomes. -Interventional Cardiologist FMH contracted a group of Interventional Cardiologist to provide 24-hour service for emergency angioplasty services. The Interventionalists are available 7-days a week and serve as the Code Heart Team leaders when responding to an emergency situation. Community Benefits 2011 Community Health Services - $1,715,159 Health Professions Education - $243,647 Mission Driven Health Services - $10,577,161 Financial Contributions - $70,410 Charity Care - $7,810,600 Medicaid Assessments - $706,091 Total - $21,123,068 Charity Care Policy Information to Patients Frederick Regional Health System posts its charity care policy and financial assistance contact information in admission areas, the FMH Emergency Department, and in all of our satellite facilities in areas where eligible patients are likely to present. FMH provides a summary of the Charity Care Policy and financial assistance contact information to all patients at the time of admission to the hospital.
FMH admissions personnel discuss the availability of various government   benefits such as Medicaid or state programs with patients and/or their family members, and they assist patients with qualification for the programs. Description of Mission/Vision/Value Statements While the composition of the individual FMH Mission, Vision and Value statements is not extraordinary - the orchestration of the three to create a harmonious whole - is exceptional. FMH Mission Statement The Mission Statement is quite ambitious, and describes in a single sentence the purpose to which the employees and staff have dedicated their professional lives. In addition to purpose, our Mission Statement characterizes the parameters within which our operations are delivered, and details the programs through which services are rendered. But more than that, the FMH Mission Statement anchors the Frederick Community by solidifying a commitment to care that has never faltered. There is a stability to the words that suggests competency, compassion and confidence. They are comforting words to the citizens of our community, and remain steadfast and true regardless of world condition or personal circumstance. FMH Statement of Values Our Value Statement reflects those qualities of comportment and service delivery in which we believe as an organization. These attributes dovetail with our Mission Statement in that they describe the philosophy that directs our business operations and governs our provision of care. Each statement is powerful as a stand-alone expression of purpose and belief; but together they provide the foundation upon which the Frederick Regional Health System has been built. FMH Vision As powerful as our Mission and Values Statements are, it is our Vision Statement that most directly governs day-to-day operations, provision of care, and the personal comportment of employees and staff. Superb Quality. Superb Service. All the Time. These seven words are the ideals to which we aspire every single day. They guide our business practices, our interactions with our customers and visitors, the care delivered to every patient, and the degree of and visitors, the care delivered to every patient, and the degree of
DESCRIPTION OF RELATIONSHIPS FORM 990, PART VI, QUESTION 2 MARVIN AUSHERMAN, DIRECTOR OF FMH, INC. IS ENGAGED IN AN INDIRECT BUSINESS RELATIONSHIP WITH THOMAS KLEINHANZL, JOHN VERBUS, KENNETH COFFEY, JAMES REINSCH AND ANNE HERBERT ROLLINS. CHANGES IN ORGANIZATIONAL DOCUMENTS FORM 990, PART VI, QUESTION 4 During the tax year, the organization revised its bylaws. The new parent organization and sole member of the organization is Frederick Regional Health System (FRHS). As sole member, FRHS has the power to remove a board member. The president/CEO of the organization is now appointed by the sole member, FRHS. Under the revised bylaws, the assets of the organization, upon dissolution, will be transferred to FRHS. The bylaws also provide that amendments to the bylaws are subject to approval by FRHS. FORM 990, PART VI, QUESTION 6 The sole member of the organization is Frederick Regional Health System. FORM 990, PART VI, QUESTION 7A The sole member, Frederick Regional Health System, has the power to appoint the president/CEO and the directors of Frederick Memorial Hospital. FORM 990, PART VI, QUESTION 7B The member, Frederick Regional Health System, must approve the incurrence of debt if such debt exceeds a certain amount to be designated by the member, capital expenditures exceeding a certain amount to be designated by the member, the decision to dissolve or liquidate, the creation of a subsidiary, and amendments to the bylaws. DESCRIBE THE PROCESS USED BY MANAGEMENT/GOVERNING BODY TO REVIEW 990 FORM 990, PART VI, QUESTION 11B THE 990 IS PREPARED IN CONJUNCTION WITH OUTSIDE TAX ACCOUNTANTS AND REVIEWED BY UPPER MANAGEMENT PRIOR TO PROVIDING A COPY TO THE BOARD. COPY OF FORM 990 WILL BE PROVIDED TO ALL MEMBERS OF THE BOARD PRIOR TO FILING. DESCRIPTION OF PROCESS TO MONITOR TRANSACTIONS FOR CONFLICTS OF INTEREST FORM 990, PART VI, QUESTION 12C THE FREDERICK MEMORIAL HOSPITAL, INC. BOARD OF DIRECTORS IS COMMITTED TO MEETING ITS FIDUCIARY RESPONSIBILITIES AND MAINTAINING ITS DUTY OF LOYALTY TO THE HOSPITAL AND THE COMMUNITY IT SERVES. TO THIS END, THE BOARD WILL EXERCISE VIGILANCE IN IDENTIFYING ANY CONFLICTS OF INTEREST. THE BOARD WILL ALSO MAINTAIN TRANSPARENCY AND OBJECTIVITY IN MAKING DECISIONS ABOUT CONFLICTS OF INTEREST SO THAT THE ORGANIZATION'S MISSION IS ALWAYS THE FIRST PRIORITY. THE CHAIRPERSON (OR VICE CHAIRPERSON IF THE CHAIR IS INVOLVED) WILL NOTIFY ALL DIRECTORS OF A REPORTED CONFLICT OF INTEREST AND DECIDE WHETHER TO TAKE THE MATTER TO THE FULL BOARD TO DECIDE WHETHER A CONFLICT EXISTS AND, IF SO, WHAT ACTION TO TAKE, OR WILL REFER THE MATTER TO THE GOVERNANCE COMMITTEE FOR AN IN-DEPTH EXAMINATION, SUMMARY, AND RECOMMENDATION PRIOR TO A FULL BOARD DISCUSSION AND DECISION. IF TIME IS OF THE ESSENCE, THE CHAIRPERSON OR VICE CHAIRPERSON WILL TAKE THE MATTER TO THE EXECUTIVE COMMITTEE FOR DISCUSSION AND A DECISION, AND WILL THEN NOTIFY THE FULL BOARD. WHERE A CONFLICT OF INTEREST HAS BEEN IDENTIFIED, THE BOARD MEMBER SHALL NOT VOTE OR BE PRESENT FOR THE DISCUSSION OR THE VOTE REGARDING THE TRANSACTION AT EITHER THE FULL BOARD, EXECUTIVE COMMITTEE, OR GOVERNANCE COMMITTEE MEETINGS, EXCEPT TO ANSWER QUESTIONS THAT MAY BE ASKED OF HIM OR HER. TO PREVENT ACTUAL OR PERCEIVED INFLUENCE ON THE BOARD'S DECISION, THE CONFLICTED MEMBER IS PROHIBITED, AFTER INITIAL DISCLOSURE, FROM DISCUSSING THE CONFLICT OF INTEREST EITHER FORMALLY OR INFORMALLY WITH FELLOW DIRECTORS OR WITH MEMBERS OF THE MANAGEMENT. THERE WILL BE AN ANNUAL REVIEW OF ALL BOARD MEMBERS AND OFFICERS TRANSACTIONS PREPARED BY THE ADMINISTRATION AND REVIEWED BY THE GOVERNANCE COMMITTEE AND THE FULL BOARD OF DIRECTORS. AT THAT TIME, ALL DIRECTORS WILL BE REMINDED OF THE IRS INTERMEDIATE SANCTIONS REGULATION THAT ESTABLISHES EXCISE TAXES AS A SANCTION AGAINST ADMINISTRATORS AND DIRECTORS OF TAX-EXEMPT ORGANIZATIONS WHO PARTICIPATE IN "EXCESS BENEFIT TRANSACTIONS" (E.G., UNREASONABLY HIGH EMPLOYMENT COMPENSATION OR BUSINESS DEALS). OFFICES & POSITIONS FOR WHICH PROCESS WAS USED, & YEAR PROCESS WAS BEGUN FORM 990, PART VI, QUESTIONS 15A & 15B THE EXECUTIVE COMPENSATION PROGRAM IS DESIGNED TO CARRY OUT THE HEALTH SYSTEM MISSION, TO ACHIEVE THE CHARITABLE PURPOSE, TO ATTRACT, RETAIN, MOTIVATE AND REWARD EXECUTIVE MANAGEMENT, AND TO MAINTAIN A COMPETITIVE POSITION WITH PEER ORGANIZATIONS IN THE REGION. OVERSIGHT OF THE EXECUTIVE COMPENSATION PROGRAM IS PROVIDED BY THE EXECUTIVE COMPENSATION COMMITTEE OF THE BOARD, COMPOSED OF THE BOARD CHAIRMAN, VICE CHAIRMAN, IMMEDIATE PRECEDING CHAIRMAN, CHAIRMAN OF THE FINANCE COMMITTEE AND THE CHAIRMAN OF THE GOVERNANCE COMMITTEE. THE EXECUTIVE COMPENSATION PHILOSOPHY OF THE BOARD PROVIDES FOR BASE COMPENSATION AT THE 50TH TO 60TH PERCENTILE OF OUR PEER GROUP. IN ADDITION TO THE BOARD'S COMPENSATION COMMITTEE, WE UTILIZED AN EXTERNAL INDEPENDENT CONSULTANT AND MARKET SURVEYS FOR ALL EXECUTIVE MANAGEMENT COMPENSATION. THE PRESIDENT AND CEO HAVE A WRITTEN EMPLOYMENT CONTRACT. WRITTEN POLICIES AND PROCEDURES FOR JOINT VENTURES FORM 990, PART VI, QUESTION 16B FREDERICK MEMORIAL HOSPITAL USES LEGAL COUNSEL WHEN EVALUATING ANY POTENTIAL JOINT VENTURES WITH FOR-PROFIT ENTITIES. IN ADDITION, TAX EXPOSURES RELATED TO THESE ENTITIES ARE CONSIDERED ANNUALLY IN THE PREPARATION OF THE FIN 48 MEMO REQUIRED AS PART OF THE AUDIT OF THE CONSOLIDATED FINANCIAL STATEMENTS. FMH IS IN THE PROCESS OF COMPILING A FORMAL POLICY IN THIS AREA AND WRITTEN POLICIES WILL BE ADOPTED PRIOR TO 6/30/12. AVAIL OF GOV DOCS, CONFL. OF INTEREST POLICY & FIN STMTS TO GEN PUBLIC FORM 990, PART VI, QUESTION 19 GOVERNING DOCUMENTS AND THE CONFLICT OF INTEREST POLICY ARE AVAILABLE UPON REQUEST. FREDERICK MEMORIAL HOSPITAL, INC. CONSOLIDATED ANNUAL AUDITED FINANCIAL STATEMENTS ARE AVAILABLE AT WWW.FMH.ORG. OTHER CHANGES IN NET ASSETS OR FUND BALANCES FORM 990, PART XI, LINE 5 GAIN ON SALE OF ASSETS $5,232 UNREALIZED GAINS ON INVESTMENT SECURITIES AND EBURG $8,203,068 UNREALIZED GAINS ON INTEREST RATE SWAP $1,550,539 PENSION ADJUSTMENT $6,504,235 MISC ($37) CHANGE IN TEMP RESTRICTED NET ASSETS $514,607 RELEASES FROM RESTRICTION $256,040 ----------- TOTAL $17,033,684
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 51056K
Schedule O (Form 990 or 990-EZ) 2010

Additional Data


Software ID:  
Software Version:  
SCHEDULE R
(Form 990)

Department of the Treasury
Internal Revenue Service
Related Organizations and Unrelated Partnerships
MediumBulletComplete if the organization answered "Yes" to Form 990, Part IV, line 33, 34, 35, 36, or 37.
MediumBulletAttach to Form 990. MediumBullet See separate instructions.

OMB No. 1545-0047
2010
Open to Public Inspection
Name of the organization
Frederick Memorial Hospital Inc
 
Employer identification number

52-0591612
Part I
Identification of Disregarded Entities (Complete if the organization answered "Yes" on Form 990, Part IV, line 33.)
(a)
Name, address, and EIN of disregarded entity


(b)
Primary activity


(c)
Legal domicile (state
or foreign country)

(d)
Total income



(e)
End-of-year assets


(f)
Direct controlling
entity









(1) EMMITSBURG PROPERTIES LLC
 
 
52-1910823
Holding Invts MD 430,988 2,671,656 NA
 










Part II
Identification of Related Tax-Exempt Organizations (Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related tax-exempt organizations during the tax year.)
(a)
Name, address, and EIN of related organization


(b)
Primary activity


(c)
Legal domicile (state
or foreign country)

(d)
Exempt Code section



(e)
Public charity status
(if section 501(c)(3))

(f)
Direct controlling
entity

(g)
Section 512(b)(13) controlled organization
Yes No
(1) Hospice of Frederick County Inc

 
 
52-1164513
HOSPICE CARE MD 501(c)(3) 7  
Yes
 
(2) Frederick Regional Health System

400 West 7th Street

Frederick,MD21701
45-4133096
Health System MD 501(c)(3) 11b  
 
No
(3) Monocacy Health Partners LLC

400 West 7th Street

Frederick,MD21701
45-3007639
Physician Org MD 501(c)(3) 7  
 
No








For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50135Y
Schedule R (Form 990) 2010
Schedule R (Form 990) 2010
Page 2
Part III
Identification of Related Organizations Taxable as a Partnership (Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a partnership during the tax year.)
(a)
Name, address, and EIN of
related organization



(b)
Primary activity




(c)
Legal
domicile
(state or foreign
country)


(d)
Direct controlling
entity



(e)
Predominant income(related, unrelated, excluded from tax under sections 512-514)

(f)
Share of total income




(g)
Share of end-of-year
assets



(h)
Disproprtionate allocations?




(i)
Code V—UBI
amount in box 20 of
Schedule K-1
(Form 1065)
(j)
General or
managing
partner?



(k)
Percentage
ownership


Yes No Yes No












Part IV
Identification of Related Organizations Taxable as a Corporation or Trust (Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a corporation or trust during the tax year.)
(a)
Name, address, and EIN of related organization



(b)
Primary activity



(c)
Legal domicile
(state or
foreign
country)
(d)
Direct controlling
entity


(e)
Type of entity
(C corp, S corp,
or trust)

(f)
Share of total income



(g)
Share of
end-of-year
assets

(h)
Percentage
ownership


(1) Frederick Health Services Corporation
 
 
52-1851661
MANAGEMENT CO. MD N/A
C Corp 210,258 11,987,041 100.000 %
(2) Frederick Surgical Services Corporation
 
 
52-1642334
Holding Company MD FHSC
 
C CORP -146,469 2,153,146 100.000 %
(3) Monocacy Insurance Ltd
 
 
98-1011570
Insurance MD NA
 
C Corp      








Schedule R (Form 990) 2010
Schedule R (Form 990) 2010
Page 3
Part V
Transactions With Related Organizations (Complete if the organization answered "Yes" on Form 990, Part IV, line 34, 35, 35A, or 36.)
Note. Complete line 1 if any entity is listed in Parts II, III or IV.
Yes
No
1 During the tax year, did the orgranization engage in any of the following transactions with one or more related organizations listed in Parts II-IV?
a Receipt of (i) interest (ii) annuities (iii) royalties (iv) rent from a controlled entity . . . . . . . . . . . . . . . . . . . . . . .
1a
 
No
b Gift, grant, or capital contribution to other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1b
 
No
c Gift, grant, or capital contribution from other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1c
 
No
d Loans or loan guarantees to or for other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1d
 
No
e Loans or loan guarantees by other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1e
 
No
f Sale of assets to other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1f
 
No
g Purchase of assets from other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1g
 
No
h Exchange of assets . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1h
 
No
i Lease of facilities, equipment, or other assets to other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1i
 
No
j Lease of facilities, equipment, or other assets from other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . .
1j
 
No
k Performance of services or membership or fundraising solicitations for other organization(s) . . . . . . . . . . . . . . . . . . . . . .
1k
 
No
l Performance of services or membership or fundraising solicitations by other organization(s) . . . . . . . . . . . . . . . . . . . . . .
1l
 
No
m Sharing of facilities, equipment, mailing lists, or other assets . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1m
 
No
n Sharing of paid employees . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1n
Yes
 
o Reimbursement paid to other organization for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1o
Yes
 
p Reimbursement paid by other organization for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1p
Yes
 
q Other transfer of cash or property to other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1q
 
No
r Other transfer of cash or property from other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1r
 
No
2
If the answer to any of the above is "Yes," see the instructions for information on who must complete this line, including covered relationships and transaction thresholds.
(a)
Name of other organization
(b)
Transaction
type(a-r)
(c)
Amount involved
(d)
Method of determining amount involved
(1) Hospice of Frederick County Inc

n 655,653  
(2) Frederick Health Services Corporation

n 267,831  
(3)

(4)

(5)

(6)

Schedule R (Form 990) 2010
Schedule R (Form 990) 2010
Page 4
Part VI
Unrelated Organizations Taxable as a Partnership (Complete if the organization answered "Yes" on Form 990, Part IV, line 37.)
Provide the following information for each entity taxed as a partnership through which the organization conducted more than five percent of its activities (measured by total assets or gross revenue) that was not a related organization. See instructions regarding exclusion for certain investment partnerships.
(a)
Name, address, and EIN of entity
(b)
Primary activity
(c)
Legal domicile
(state or foreign
country)
(d)
Are all
partners
section
501(c)(3)
organizations?
(e)
Share of
end-of-year
assets
(f)
Disproprtionate allocations?
(g)
Code V—UBI
amount in box
20 of Schedule K-1
(Form 1065)
(h)
General or
managing
partner?
Yes No Yes No Yes No






























Schedule R (Form 990) 2010
Schedule R (Form 990) 2010
Page 5
Part VII
Supplemental Information
Complete this part to provide additional information for responses to questions on Schedule R (see instructions).
Identifier Return Reference Explanation
Additional Data


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