TY 2012 Form 990

(A) Name and Title	(B) Average hours per week (list any hours for related organizations below dotted line)	(C) Position (do not check more than one box, unless person is both an officer and a director/trustee)	(E) Reportable compensation from related organizations (W- 2/1099-MISC)	(F) Estimated amount of other compensation from the organization and related organizations
(1) DAVIS VR SHERMAN........................................................................ CHAIRMAN	1.0 .......................	X	X			0	0	0
(2) ANTHONY F LEHMAN........................................................................ DIRECTOR	1.0 .......................	X				0	0	0
(3) LISA A GLADDEN........................................................................ DIRECTOR	1.0 .......................	X				0	0	0
(4) JOHN T CHAY........................................................................ DIRECTOR	1.0 .......................	X				0	0	0
(5) ROBERT A CHRENCIK........................................................................ TREASURER	1.0 .......................49.0	X	X			0	2,174,568	234,466
(6) HEMA PATEL MD........................................................................ HOSPITALIST	40.0 .......................	X				223,893	0	25,512
(7) ANTHONY T HAWKINS........................................................................ DIRECTOR	1.0 .......................	X				0	0	0
(8) WILLIAM F PECK........................................................................ DIRECTOR	1.0 .......................	X				0	0	0
(9) ANDREW POLLAK........................................................................ DIRECTOR	1.0 .......................	X				0	0	0
(10) THOMAS M SCALEA........................................................................ DIRECTOR	1.0 .......................	X				0	0	0
(11) OLIVER S TRAVERS JR........................................................................ DIRECTOR	1.0 .......................	X				0	0	0
(12) MICHAEL R JABLONOVER........................................................................ CEO	40.0 .......................		X			452,675	0	22,586
(13) W W AUGUSTIN III........................................................................ CFO	40.0 .......................		X			299,395	0	19,028
(14) VALERIE SUMMERLIN........................................................................ VP CNO	40.0 .......................			X		224,618	0	3,841
(15) JUANITA D ROBBINS........................................................................ COO	40.0 .......................			X		345,143	0	27,858
(16) JOHN STRAUMANIS........................................................................ SVP - CMO	40.0 .......................			X		300,283	0	41,890
(17) LORI PATRIA........................................................................ MANAGER - AMBULATORY	40.0 .......................				X	152,650	0	20,334

(A) Name and business address	(B) Description of services	(C) Compensation
Aramark Healthcare Food Lockbox, 25271 Network PlaceCHICAGOIL606731252	FOOD SERVICES	1,258,668
PHYSICIAN MANAGEMENT LTD, 3 BETHESDA METRO SUITE 630BETHESDAMD20814	Physician SERVICES	944,496
Aramark Corporation, PO Box 651009CHAROLETTENC28265	Environmental SRVCS	904,395
Advanced Care Service, 3435 Wilshire Blvd 945LOS ANGELESCA90010	Staffing SERVICES	503,588
Alliant Staffing, 7201 Winconsin Ave 705BETHESDAMD20814	STAFFING SERVICES	470,057
2 Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 of compensation from the organization 26

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 United States. See Part IV, line 21	0
2	Grants and other assistance to individuals in the United States. See Part IV, line 22	0
3	Grants and other assistance to governments, organizations, and individuals outside the United States. 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 ....	1,873,823	552,716	1,321,107
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	40,167,586	32,376,693	7,790,893
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....	1,620,952	1,269,629	351,323
9	Other employee benefits .......	5,119,986	4,010,287	1,109,699
10	Payroll taxes ...........	2,981,386	2,335,204	646,182
11	Fees for services (non-employees):
a	Management ......	0
b	Legal .........	-107,700		-107,700
c	Accounting ...........	685,850		685,850
d	Lobbying ...........	6,264		6,264
e	Professional fundraising services. See Part IV, line 17	0
f	Investment management fees ......	0
g	Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O) ........	9,970,496	7,809,504	2,160,992
12	Advertising and promotion ....	403,731	316,227	87,504
13	Office expenses .......	555,535	435,129	120,406
14	Information technology ......	2,781,806	2,178,881	602,925
15	Royalties ..	0
16	Occupancy ...........	2,917,606	2,285,248	632,358
17	Travel ............	89,499	70,101	19,398
18	Payments of travel or entertainment expenses for any federal, state, or local public officials ......	0
19	Conferences, conventions, and meetings ....	0
20	Interest ...........	712,018	557,696	154,322
21	Payments to affiliates .......	0
22	Depreciation, depletion, and amortization .....	3,861,852	3,024,839	837,013
23	Insurance ..............	1,889,130	1,479,682	409,448
24	Other expenses. Itemize expenses not covered above (List miscellaneous expenses in line 24e. If line 24e amount exceeds 10% of line 25, column (A) amount, list line 24e expenses on Schedule O.)
a	MEDICAL SUPPLIES	14,695,061	11,510,073	3,184,988
b	BAD DEBTS	4,599,081	4,599,081
c	PHYSICIAN FEE	8,067,517	8,067,517
d	PURCHASED SERVICES	2,388,050	1,875,116	512,934
e	All other expenses	953,520	746,856	206,664
25	Total functional expenses. Add lines 1 through 24e	106,233,049	85,500,479	20,732,570	0
26	Joint costs. Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation. Check here if following SOP 98-2 (ASC 958-720).

Part X Balance Sheet Check if Schedule O contains a response to any question in this Part X ...............
	1	Cashnon-interest-bearing .............	5,008,790	1	6,887,050
2	Savings and temporary cash investments .........	0	2	0
3	Pledges and grants receivable, net ...........	0	3	0
4	Accounts receivable, net .............	16,171,837	4	14,670,958
5	Loans and other receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of Schedule L ..................
		0	5	0
6	Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), persons described in section 4958(c)(3)(B), and contributing employers and sponsoring organizations of section 501(c)(9) voluntary employees' beneficiary organizations (see instructions) Complete Part II of Schedule L
		0	6	0
7	Notes and loans receivable, net .............	0	7	0
8	Inventories for sale or use ..............	997,619	8	1,054,308
9	Prepaid expenses and deferred charges ..........	16,184	9	0
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	94,256,235
b	Less: accumulated depreciation .....	10b	49,124,456	42,111,305	10c	45,131,779
11	Investments—publicly traded securities ..........	7,669,231	11	6,740,290
12	Investments—other securities. See Part IV, line 11 .....	5,342,000	12	5,297,710
13	Investments—program-related. See Part IV, line 11 .....	0	13	0
14	Intangible assets ...............	0	14	0
15	Other assets. See Part IV, line 11 ...........	42,601,741	15	56,961,628
16	Total assets. Add lines 1 through 15 (must equal line 34)......	119,918,707	16	136,743,723
	17	Accounts payable and accrued expenses .........	10,583,958	17	13,312,096
18	Grants payable .................	0	18	0
19	Deferred revenue ................	0	19	0
20	Tax-exempt bond liabilities .............	0	20	0
21	Escrow or custodial account liability. Complete Part IV of Schedule D..	0	21	0
22	Loans and other payables to current and former officers, directors, trustees, key employees, highest compensated employees, and disqualified
	persons. Complete Part II of Schedule L..........	0	22	0
23	Secured mortgages and notes payable to unrelated third parties ..	0	23	0
24	Unsecured notes and loans payable to unrelated third parties ....	0	24	0
25	Other liabilities (including federal income tax, payables to related third parties, and other liabilities not included on lines 17-24). Complete Part X of Schedule D....................	17,422,968	25	28,169,560
26	Total liabilities. Add lines 17 through 25.........	28,006,926	26	41,481,656
		Organizations that follow SFAS 117 (ASC 958), check here and complete lines 27 through 29, and lines 33 and 34.
27	Unrestricted net assets ..............	60,991,790	27	64,638,067
28	Temporarily restricted net assets ...........	30,919,991	28	30,624,000
29	Permanently restricted net assets ...........	0	29	0
	Organizations that do not follow SFAS 117 (ASC 958), check here 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 ...........	91,911,781	33	95,262,067
34	Total liabilities and net assets/fund balances ........	119,918,707	34	136,743,723

- TIN:

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.

Attach to Form 990 or Form 990-EZ. right arrow

See separate instructions.

OMB No. 1545-0047

2012

Open to Public
Inspection

Name of the organization

James Lawrence Kernan Hospital Inc

Employer identification number

52-0591639

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.)

A church, convention of churches, or association of churches described in section 170(b)(1)(A)(i).

A school described in section 170(b)(1)(A)(ii). (Attach Schedule E.)

A hospital or a cooperative hospital service organization described in section 170(b)(1)(A)(iii).

A medical research organization operated in conjunction with a hospital described in section 170(b)(1)(A)(iii). Enter the hospital's name, city, and state:

An organization operated for the benefit of a college or university owned or operated by a governmental unit described in

section 170(b)(1)(A)(iv). (Complete Part II.)

A federal, state, or local government or governmental unit described in section 170(b)(1)(A)(v).

An organization that normally receives a substantial part of its support from a governmental unit or from the general public described in section 170(b)(1)(A)(vi). (Complete Part II.)

A community trust described in section 170(b)(1)(A)(vi). (Complete Part II.)

An organization that normally receives: (1) more than 331/3% of its support from contributions, membership fees, and gross

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.)

An organization organized and operated exclusively to test for public safety. See section 509(a)(4).

An organization organized and operated exclusively for the benefit of, to perform the functions of, or to carry out the purposes of one or more publicly supported organizations described in section 509(a)(1) or section 509(a)(2). See section 509(a)(3). Check the box that describes the type of supporting organization and complete lines 11e through 11h.

Type I

Type II

Type III - Functionally integrated

Type III - Non-functionally integrated

By checking this box, I certify that the organization is not controlled directly or indirectly by one or more disqualified persons other than foundation managers and other than one or more publicly supported organizations described in section 509(a)(1) or section 509(a)(2).

If the organization received a written determination from the IRS that it is a Type I, Type II, or Type III supporting organization, check this box ..................................................

Since August 17, 2006, has the organization accepted any gift or contribution from any of the
following persons?

(i) A person who directly or indirectly controls, either alone or together with persons described in (ii)

Yes

and (iii) below, the governing body of 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)

Provide the following information about the supported organization(s).

(i) Name of supported organization	(ii) EIN	(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 monetary support
(i) Name of supported organization	(ii) EIN	Yes	No	Yes	No	Yes	No	(vii) Amount of monetary support


Total

For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990EZ.

Cat. No. 11285F

Schedule A (Form 990 or 990-EZ) 2012

Page 2

Part II

Support Schedule for Organizations Described in Sections 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) 2008	(b) 2009	(c) 2010	(d) 2011	(e) 2012	(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) 2008	(b) 2009	(c) 2010	(d) 2011	(e) 2012	(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. Do not include gain or loss from the sale of capital assets (Explain in Part IV.)..
11	Total support (Add lines 7 through 10).

Gross receipts from related activities, etc. (see instructions) ..................

First five years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a 501(c)(3) organization, check this box and stop here........................................ right arrow

Section C. Computation of Public Support Percentage

Public support percentage for 2012 (line 6, column (f) divided by line 11, column (f)) .........

Public support percentage for 2011 Schedule A, Part II, line 14 ...............

16a

33 1/3% support test—2012. If the organization did not check the box on line 13, and line 14 is 33 1/3% or more, check this box
and stop here. The organization qualifies as a publicly supported organization ....................... right arrow

33 1/3% support test—2011. If the organization did not check a box on line 13 or 16a, and line 15 is 33 1/3% or more, check this
box and stop here. The organization qualifies as a publicly supported organization ..................... right arrow

17a

10%-facts-and-circumstances test—2012. If the organization did not check a box on line 13, 16a, or 16b, and line 14
is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here. Explain
in Part IV how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly supported
organization ..................................................... right arrow

10%-facts-and-circumstances test—2011. If the organization did not check a box on line 13, 16a, 16b, or 17a, and line
15 is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here.
Explain in Part IV how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly
supported organization ................................................ right arrow

Private foundation. If the organization did not check a box on line 13, 16a, 16b, 17a, or 17b, check this box and see
instructions ..................................................... right arrow

Schedule A (Form 990 or 990-EZ) 2012

Page 3

Part III

Support Schedule for Organizations Described in Section 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) 2008	(b) 2009	(c) 2010	(d) 2011	(e) 2012	(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) 2008	(b) 2009	(c) 2010	(d) 2011	(e) 2012	(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.)..

First five years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a 501(c)(3) organization,
check this box and stop here............................................. right arrow

Section C. Computation of Public Support Percentage

Public support percentage for 2012 (line 8, column (f) divided by line 13, column (f)) .........

Public support percentage from 2011 Schedule A, Part III, line 15 ...............

Section D. Computation of Investment Income Percentage

Investment income percentage for 2012 (line 10c, column (f) divided by line 13, column (f)) ......

Investment income percentage from 2011 Schedule A, Part III, line 17 .............

19a

33 1/3% support tests—2012. If the organization did not check the box on line 14, and line 15 is more than 33 1/3%, and line 17 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization ........ right arrow

33 1/3% support tests—2011. If the organization did not check a box on line 14 or line 19a, and line 16 is more than 33 1/3% and line 18 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization ..... right arrow

Private foundation. If the organization did not check a box on line 14, 19a, or 19b, check this box and see instructions ..... right arrow

Schedule A (Form 990 or 990-EZ) 2012

Page 4

Part IV

Supplemental Information. Complete this part to provide the explanations required by Part II, line 10; Part II, line 17a or 17b; and 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) 2012

Additional Data

Software ID:
Software Version:

- TIN:

Schedule B
(Form 990, 990-EZ,
or 990-PF)

Department of the Treasury
Internal Revenue Service

Schedule of Contributors

Attach to Form 990, 990-EZ, or 990-PF.

OMB No. 1545-0047

2012

Name of the organization

James Lawrence Kernan Hospital Inc

Employer identification number

52-0591639

Organization type (check one):

Filers of:

Section:

Form 990 or 990-EZ

501(c)( ) (enter number) organization

4947(a)(1) nonexempt charitable trust not treated as a private foundation

527 political organization

Form 990-PF

501(c)(3) exempt private foundation

4947(a)(1) nonexempt charitable trust treated as a private foundation

501(c)(3) taxable private foundation

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

For an organization filing Form 990, 990-EZ, or 990-PF that received, during the year, $5,000 or more (in money or
property) from any one contributor. Complete Parts I and II.

Special Rules

For a section 501(c)(3) organization filing Form 990 or 990-EZ that met the 33¹/3% support test of the regulations
under sections 509(a)(1) and 170(b)(1)(A)(vi) and received from any one contributor, during the year, a contribution of the
greater of (1) $5,000 or (2) 2% of the amount on (i) Form 990, Part VIII, line 1h, or (ii) Form 990-EZ, line 1. Complete Parts I and II.

For a section 501(c)(7), (8), or (10) organization filing Form 990 or 990-EZ that received from any one contributor,
during the year, total contributions of more than $1,000 for use exclusively for religious, charitable,
scientific, literary, or educational purposes, or the prevention of cruelty to children or animals. Complete Parts I, II, and
III.

For a section 501(c)(7), (8), or (10) organization filing Form 990 or 990-EZ that received from any one contributor,
during the year, contributions for use exclusively for religious, charitable, etc., purposes, but these contributions did
not total to more than $1,000. If this box is checked, enter here the total contributions that were received during
the year for an exclusively religious, charitable, etc., purpose. Do not complete any of the parts unless the General Rule
applies to this organization because it received nonexclusively religious, charitable, etc., contributions of $5,000 or more
during the year ......................... 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 on line H of its
Form 990-EZ or on Part I, 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) (2012)

Schedule B (Form 990, 990-EZ, or 990-PF) (2012)

Page 2

Name of organization James Lawrence Kernan Hospital Inc

Part I	Contributors (see instructions). Use duplicate copies of Part I if additional space is needed.
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
RESTRICTED	RESTRICTED RESTRICTED RESTRICTED RESTRICTED, RESTRICTED RESTRICTED	$RESTRICTED	Person Payroll Noncash (Complete Part II if there is a noncash contribution.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II if there is a noncash contribution.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II if there is a noncash contribution.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II if there is a noncash contribution.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II if there is a noncash contribution.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II if there is a noncash contribution.)
Schedule B (Form 990, 990-EZ, or 990-PF) (2012)

Schedule B (Form 990, 990-EZ, or 990-PF) (2012)

Page 3

Name of organization James Lawrence Kernan Hospital Inc

Part II	Noncash Property (see instructions). Use duplicate copies of Part II if additional space is needed.
(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) (2012)

Schedule B (Form 990, 990-EZ, or 990-PF) (2012)

Page 4

Name of organization
James Lawrence Kernan Hospital Inc

Employer identification number

52-0591639

Part III

Exclusively religious, charitable, etc., individual contributions to section 501(c)(7), (8), or (10) organizations
that total 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

$
Use duplicate copies of Part III if additional space is needed.

(a) No.
from
Part I

(b) Purpose 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

(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

(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

(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) (2012)

Additional Data

Software ID:
Software Version:

- TIN:

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

2012

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 35c (Proxy Tax), then
Round Bullet

Section 501(c)(4), (5), or (6) organizations: Complete Part III.

Name of the organization

James Lawrence Kernan Hospital Inc

Employer identification number

52-0591639

Part I-A

Complete if the organization is exempt under section 501(c) or is a section 527 organization.

Provide a description of the organization’s direct and indirect political campaign activities in Part IV.

Political expenditures .................................... SchCMd Bullet

Volunteer hours ........................................

Part I-B

Complete if the organization is exempt under section 501(c)(3).

Enter the amount of any excise tax incurred by the organization under section 4955 ......... SchCMd Bullet

Enter the amount of any excise tax incurred by organization managers under section 4955 ...... SchCMd Bullet

If the organization incurred a section 4955 tax, did it file Form 4720 for this year? ..............

Yes No

Was a correction made? .........................................

Yes No

If "Yes," describe in Part IV.

Part I-C

Complete if the organization is exempt under section 501(c), except section 501(c)(3).

Enter the amount directly expended by the filing organization for section 527 exempt function activities SchCMd Bullet

Enter the amount of the filing organization's funds contributed to other organizations for section 527 exempt function activities ................................... SchCMd Bullet

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

Did the filing organization file Form 1120-POL for this year? ..........................

Yes No

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 Paperwork Reduction Act Notice, see the instructions for Form 990 or 990-EZ.

Cat. No. 50084S

Schedule C (Form 990 or 990-EZ) 2012

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 SchCMd Bullet

if the filing organization belongs to an affiliated group (and list in Part IV each affiliated group member's name, address, EIN, expenses, and share of excess lobbying expenditures).
B Check SchCMd Bullet

if the filing organization checked box A and "limited control" provisions apply.

Limits on Lobbying Expenditures (The term "expenditures" means amounts paid or incurred.)		(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? ......................................	Yes No

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) 2009	(b) 2010	(c) 2011	(d) 2012	(e) Total

2a	Lobbying nontaxable amount

b	Lobbying ceiling amount (150% of line 2a, column(e))

c	Total lobbying expenditures

d	Grassroots nontaxable amount

e	Grassroots ceiling amount (150% of line 2d, column (e))

f	Grassroots lobbying expenditures

Schedule C (Form 990 or 990-EZ) 2012

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)).

For each “Yes” response to lines 1a through 1i below, provide in Part IV a detailed description of the lobbying activity.

(a)

Yes

(b)

Amount

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:

Volunteers? .........................................

Paid staff or management (include compensation in expenses reported on lines 1c through 1i)? ....

Media advertisements? ....................................

Mailings to members, legislators, or the public? .........................

Publications, or published or broadcast statements? .......................

Grants to other organizations for lobbying purposes? .......................

Direct contact with legislators, their staffs, government officials, or a legislative body? ........

Rallies, demonstrations, seminars, conventions, speeches, lectures, or any similar means? ......

Other activities? ..........................

Yes

6,264

Total. Add lines 1c through 1i ...............................

6,264

Did the activities in line 1 cause the organization to be not described in section 501(c)(3)? .....

If "Yes," enter the amount of any tax incurred under section 4912 .................

If "Yes," enter the amount of any tax incurred by organization managers under section 4912 .....

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

Were substantially all (90% or more) dues received nondeductible by members? ................

Did the organization make only in-house lobbying expenditures of $2,000 or less? ................

Did the organization agree to carry over lobbying and political expenditures from the prior year? ..........

Part III-B

Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6) and if either (a) BOTH Part III-A, lines 1 and 2, are answered “No” OR (b) Part III-A, line 3, is answered “Yes."

Dues, assessments and similar amounts from members .....................

Section 162(e) nondeductible lobbying and political expenditures (do not include amounts of political
expenses for which the section 527(f) tax was paid).

Current year .........................................

Carryover from last year ....................................

Total ............................................

Aggregate amount reported in section 6033(e)(1)(A) notices of nondeductible section 162(e) dues .

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? ................................

Taxable amount of lobbying and political expenditures (see instructions) ..............

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; Part II-A (affiliated group list); Part II-A, line 2; and Part ll-B, line 1. Also, complete this part for any additional information.

Identifier	Return Reference	Explanation
Other Activities	Schedule C, Part II-B, Line 1i	The organization does not engage in any direct lobbying activities. The organization pays membership dues to the Maryland Hospital Association (MHA) and the American Hospital Association (AHA). MHA and AHA engage in many support activities including lobbying and advocating for their member hospitals. The MHA and AHA reported that 7.71% and 23.98% of member dues were used for lobbying purposes and as such, the organization has reported this amount on Schedule C Part IV as lobbying activities.

Schedule C (Form 990 or 990EZ) 2012

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE D
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Financial Statements

Complete if the organization answered "Yes," to Form 990,
Part IV, line 6, 7, 8, 9, 10, 11a, 11b, 11c, 11d, 11e, 11f, 12a, or 12b
SchDMd Bullet

Attach to Form 990. SchDMd Bullet

See separate instructions.

OMB No. 1545-0047

2012

Open to Public Inspection

Name of the organization

James Lawrence Kernan Hospital Inc

Employer identification number

52-0591639

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 ........

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? ............

Yes No

Did the organization inform all grantees, donors, and donor advisors in writing that grant funds can 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? ...................................

Yes No

Part II

Conservation Easements. Complete if the organization answered "Yes" to Form 990, Part IV, line 7.

Purpose(s) of conservation easements held by the organization (check all that apply).

Preservation of land for public use (e.g., recreation or education) Preservation of an historically important land area

Protection of natural habitat Preservation of a certified historic structure

Preservation of open space

Complete lines 2a through 2d if the organization held a qualified conservation contribution in the form of a conservation easement on the last day of the tax 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, and not on a historic structure listed in the National Register ....................	2d

Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during
the tax year SchDMd Bullet

Number of states where property subject to conservation easement is located SchDMd Bullet

Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and
enforcement of the conservation easements it holds? .............................

Yes No

Staff and volunteer hours devoted to monitoring, inspecting, and enforcing conservation easements during the year
SchDMd Bullet

Amount of expenses incurred in monitoring, inspecting, and enforcing conservation easements during the year
SchDMd Bullet

Does each conservation easement reported on line 2(d) above satisfy the requirements of section 170(h)(4)(B)(i) and section 170(h)(4)(B)(ii)? .......................................

Yes No

In Part XIII, 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.

If the organization elected, as permitted under SFAS 116 (ASC 958), 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 XIII, the text of the footnote to its financial statements that describes these items.

If the organization elected, as permitted under SFAS 116 (ASC 958), 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

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 (ASC 958) relating to these items:

Revenues included in Form 990, Part VIII, line 1 .......................... SchDMd Bullet

Assets included in Form 990, Part X ............................... SchDMd Bullet

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 52283D

Schedule D (Form 990) 2012

Page 2

Part III

Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)

Using the organization’s acquisition, accession, and other records, check any of the following that are a significant use of its collection items (check all that apply):

Public exhibition

Loan or exchange programs

Scholarly research

Other

Preservation for future generations

Provide a description of the organization’s collections and explain how they further the organization’s exempt purpose in
Part XIII.

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?........

Yes No

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.

Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not
included on Form 990, Part X? ....................................

Yes No

If "Yes," explain the arrangement in Part XIII and complete the following table:


c	Beginning balance .................................	1c
d	Additions during the year ..............................	1d
e	Distributions during the year .............................	1e
f	Ending balance ...................................	1f

Did the organization include an amount on Form 990, Part X, line 21? .....................

Yes No

If “Yes,” explain the arrangement in Part XIII. Check here if the explanation has been provided in Part XIII ........

Part V

Endowment Funds. Complete if the organization answered "Yes" to Form 990, Part IV, line 10.

		(a)Current year	(b)Prior year	b (c)Two years back	(d)Three years back	(e)Four years back
1a	Beginning of year balance ....
b	Contributions ........
c	Net investment earnings, gains, and losses
d	Grants or scholarships .....
e	Other expenditures for facilities and programs ........
f	Administrative expenses ....
g	End of year balance ......

Provide the estimated percentage of the current year end balance (line 1g, column (a)) held as:

Board designated or quasi-endowment SchDMd Bullet

Permanent endowment SchDMd Bullet

Temporarily restricted endowment SchDMd Bullet

The percentages in lines 2a, 2b, and 2c should equal 100%.

Are there endowment funds not in the possession of the organization that are held and administered for the
organization by:

Yes

(i) unrelated organizations ........................

3a(i)

(ii) related organizations ........................

3a(ii)

If "Yes" to 3a(ii), are the related organizations listed as required on Schedule R? .........

Describe in Part XIII the intended uses of the organization's endowment funds.

Part VI

Land, Buildings, and Equipment. See Form 990, Part X, line 10.

Description of property		(b)Cost or other basis (other)	(c) Accumulated depreciation	(d) Book value
1a	Land .................	697,964		697,964
b	Buildings ................	55,213,829	24,533,575	30,680,254
c	Leasehold improvements ............
d	Equipment ................	32,450,358	24,127,726	8,322,632
e	Other .................	5,894,084	463,155	5,430,929
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).).......				45,131,779

Schedule D (Form 990) 2012

Page 3

Part VII

InvestmentsOther 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) must equal Form 990, Part X, col. (B) line 12.)

Part VIII

InvestmentsProgram 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









Total. (Column (b) must equal Form 990, Part X, col.(B) line 13.)

Part IX

Other Assets. See Form 990, Part X, line 15.

(a) Description				(b) Book value
(1) DUE FROM AFFILIATES				12,455,945
(2) ECONOMIC INT IN KERNAN ENDOW				28,659,786
(3) ECONOMIC INT IN UMMS FDN				1,830,430
(4) OTHER A/R				14,934
(5) ASSETS WHOSE USE IS LIMITED				14,000,533




Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........				56,961,628

Part X

Other Liabilities. See Form 990, Part X, line 25.

1.(a) Description of liability		(b) Book value
Federal income taxes		0
DUE TO THIRD PARTY		3,036,966
PATIENT A/R CEDIT BALANCES		897,721
FIN 47 ACCRUAL		415,068
DUE TO AFFILIATES		22,856,707
OTHER LIABILITIES		963,098




Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)		28,169,560
2. Fin 48 (ASC 740) Footnote. In Part XIII, 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 (ASC 740). Check here if the text of the footnote has been provided in Part XIII .....................................................

Schedule D (Form 990) 2012

Page 4

Part XI 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 XIII.) ............	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 XIII.) ...........	4b
c	Add lines 4a and 4b.......................		4c
5	Total revenue. Add lines 3 and 4c. (This must equal Form 990, Part I, line 12.) ......		5

Part XII 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 XIII.) ............	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 XIII.) ............	4b
c	Add lines 4a and 4b.......................		4c
5	Total expenses. Add lines 3 and 4c. (This must equal Form 990, Part I, line 18.) ......		5

Part XIII

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, line 2; Part XI, lines 2d and 4b; and Part XII, lines 2d and 4b. Also complete this part to provide any additional information.

Identifier	Return Reference	Explanation
SCHEDULE D, Part X, Line 2	FIN 48 Footnote per Audit Report	THE ORGANIZATION IS A SUBSIDIARY OF THE UNIVERSITY OF MARYLAND MEDICAL SYSTEM CORPORATION (THE CORPORATION). THE CORPORATION ADOPTED THE PROVISIONS OF ASC 740, ACCOUNTING FOR UNCERTAINTY IN THE INCOME TAXES (FIN 48) ON JULY 1, 2007. THE FOOTNOTE RELATED TO ASC 740 IN THE CORPORATION'S AUDITED FINANCIAL STATEMENTS IS AS FOLLOWS: THE CORPORATION FOLLOWS A THRESHOLD OF MORE-LIKELY-THAN-NOT FOR RECOGNITION AND DERECOGNITION OF TAX POSITIONS TAKEN OR EXPECTED TO BE TAKEN IN A TAX RETURN. MANAGEMENT DOES NOT BELIEVE THAT THERE ARE ANY UNRECOGNIZED TAX BENEFITS THAT SHOULD BE RECOGNIZED.

Schedule D (Form 990) 2012

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE H (Form 990)

Department of the Treasury
Internal Revenue Service

Hospitals

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

2012

Open to Public Inspection

Name of the organization

James Lawrence Kernan Hospital Inc

Employer identification number

52-0591639

Part I

Financial Assistance and Certain Other Community Benefits at Cost

Yes

Did the organization have a financial assistance policy during the tax year? If "No," skip to question 6a ...

Yes

If "Yes," was it a written policy? .......................

Yes

If the organization had multiple hospital facilities, indicate which of the following best describes application of the financial assistance policy to its various hospital facilities during the tax year.

Applied uniformly to all hospital facilities Applied uniformly to most hospital facilities Generally tailored to individual hospital facilities

Answer the following based on the financial assistance eligibility criteria that applied to the largest number of the organization's patients during the tax year.

Did the organization use Federal Poverty Guidelines (FPG) as a factor in determining eligibility for providing free care?

If "Yes," indicate which of the following was the FPG family income limit for eligibility for free care:

Yes

100% 150% 200% Other %

Did the organization use FPG as a factor in determining eligibility for providing discounted care? If "Yes," indicate

which of the following was the family income limit for eligibility for discounted care: .........

Yes

200% 250% 300% 350% 400% Other 500 %

If the organization used factors other than FPG in determining eligibility, describe in Part VI the income based criteria for determining eligibility for free or discounted care. Include in the description whether the organization used an asset test or other threshold, regardless of income, as a factor in determining eligibility for free or discounted care.

Did the organization's financial assistance policy that applied to the largest number of its patients during the tax year provide for free or discounted care to the "medically indigent"? ..............

Yes

Did the organization budget amounts for free or discounted care provided under its financial assistance policy during the tax year? ............................

Yes

If "Yes," did the organization's financial assistance expenses exceed the budgeted amount? ......

If "Yes" to line 5b, as a result of budget considerations, was the organization unable to provide free or discountedcare to a patient who was eligibile for free or discounted care? ..............

Did the organization prepare a community benefit report during the tax year? ..........

Yes

If "Yes," did the organization make it available to the public? ..............

Yes

Complete the following table using the worksheets provided in the Schedule H instructions. Do not submit these worksheets with the Schedule H.

Financial Assistance and Certain Other Community Benefits at Cost

Financial Assistance and Means-Tested Government Programs		(c) Total community benefit expense	(d) Direct offsetting revenue	(e) Net community benefit expense	(f) Percent of total expense
a	Financial Assistance at cost (from Worksheet 1) ..	2,533,327		2,533,327	2.380 %
b	Medicaid (from Worksheet 3, column a) ....
c	Costs of other means-tested government programs (from Worksheet 3, column b) .
d	Total Financial Assistance and Means-Tested Government Programs .	2,533,327		2,533,327	2.380 %
Other Benefits		160,422		160,422	0.150 %
e	Community health improvement services and community benefit operations (from Worksheet 4) ..	160,422		160,422	0.150 %
f	Health professions education (from Worksheet 5) ..	7,844,391		7,844,391	7.380 %
g	Subsidized health services (from Worksheet 6) ..	349,318	107,975	241,343	0.230 %
h	Research (from Worksheet 7)	505,120		505,120	0.480 %
i	Cash and in-kind contributions for community benefit (from Worksheet 8)	114,502		114,502	0.110 %
j	Total. Other Benefits ..	8,973,753	107,975	8,865,778	8.350 %
k	Total. Add lines 7d and 7j .	11,507,080	107,975	11,399,105	10.730 %

For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2012

Schedule H (Form 990) 2012

Page

Part II

Community Building Activities Complete this table if the organization conducted any community building activities during the tax year, and describe in Part VI how its community building activities promoted the health of the communities it serves.

		(c) Total community building expense	(e) Net community building expense	(f) Percent of total expense
1	Physical improvements and housing
2	Economic development	5,743	5,743	0.010 %
3	Community support
4	Environmental improvements
5	Leadership development and training for community members
6	Coalition building	1,367	1,367
7	Community health improvement advocacy
8	Workforce development
9	Other
10	Total	7,110	7,110	0.010 %

Part III

Bad Debt, Medicare, & Collection Practices

Section A. Bad Debt Expense

Yes

Did the organization report bad debt expense in accordance with Heathcare Financial Management Association Statement No. 15? ..........................

Yes

Enter the amount of the organization's bad debt expense. Explain in Part VI the methodology used by the organization to estimate this amount. ......

3,542,949

Enter the estimated amount of the organization's bad debt expense attributable to patients eligible under the organization's financial assistance policy. Explain in Part VI the methodology used by the organization to estimate this amount and the rationale, if any, for including this portion of bad debt as community benefit. ......

Provide in Part VI the text of the footnote to the organization’s financial statements that describes bad debt expense or the page number on which this footnote is contained in the attached financial statements.

Section B. Medicare

Enter total revenue received from Medicare (including DSH and IME).....

29,936,253

Enter Medicare allowable costs of care relating to payments on line 5.....

31,387,428

Subtract line 6 from line 5. This is the surplus (or shortfall)........

-1,451,175

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:

Cost accounting system Cost to charge ratio Other

Section C. Collection Practices

Did the organization have a written debt collection policy during the tax year? ..........

Yes

If "Yes," did the organization’s collection policy that applied to the largest number of its patients during the tax year contain provisions on the collection practices to be followed for patients who are known to qualify for financial assistance? Describe in Part VI.......................

Yes

Part IV

Management Companies and Joint Ventures(owned 10% or more by officers, directors, trustees, key employees, and physicians—see instructions)

(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) 2012

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Part VFacility Information

Section A. Hospital Facilities (list in order of size from largest to smallest—see instructions) How many hospital facilities did the organization operate during the tax year?1 Name, address, and primary website address				Other (Describe)
1	JAMES LAWRENCE KERNAN HOSPITAL 2200 KERNAN DRIVE BALTIMORE,MD21207	X	X	Rehabilitation

Schedule H (Form 990) 2012

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Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)

	JAMES LAWRENCE KERNAN HOSPITAL
Name of hospital facility or facility reporting group

For single facility filers only: line Number of Hospital Facility (from Schedule H, Part V, Section A)

Yes

Community Health Needs Assessment (Lines 1 through 8c are optional for tax years begining on or before March 23, 2012)

During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 9....................

Yes

If “Yes,” indicate what the CHNA report describes (check all that apply):

A definition of the community served by the hospital facility

Demographics of the community

Existing health care facilities and resources within the community that are available to respond to the health needs of the community

How data was obtained

The health needs of the community

Primary and chronic disease needs and other health issues of uninsured persons, low-income persons, and minority groups

The process for identifying and prioritizing community health needs and services to meet the community health needs

The process for consulting with persons representing the community’s interests

Information gaps that limit the hospital facility’s ability to assess the community’s health needs

Other (describe in Part VI)

Indicate the tax year the hospital facility last conducted a CHNA: 20 12

In conducting its most recent CHNA, did the hospital facility take into account input from representatives of the community served by the hospital facility, including those with special knowledge of or expertise in public health? 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 ....................

Yes

Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If “Yes,” list the other hospital facilities in Part VI................................

Yes

Did the hospital facility make its CHNA report widely available to the public? .............

Yes

If “Yes,” indicate how the CHNA report was made widely available (check all that apply):

Hospital facility’s website

Available upon request from the hospital facility

Other (describe in Part VI)

If the hospital facility addressed needs identified in its most recently conducted CHNA, indicate how (check all that apply to date):

Adoption of an implementation strategy that addresses each of the community health needs identified through the CHNA

Execution of the implementation strategy

Participation in the development of a community-wide plan

Participation in the execution of a community-wide plan

Inclusion of a community benefit section in operational plans

Adoption of a budget for provision of services that address the needs identified in the CHNA

Prioritization of health needs in its community

Prioritization of services that the hospital facility will undertake to meet health needs in its community

Other (describe in Part VI)

Did the hospital facility address all of the needs identified in its most recently conducted CHNA? If “No,” explain in Part VI which needs it has not addressed and the reasons why it has not addressed such needs ........

Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)? ...........................

If "Yes" to line 8a, did the organization file Form 4720 to report the section 4959 excise tax? ......

If "Yes" to line 8b, what is the total amount of section 4959 excise tax the organization reported on Form 4720 for all of its hospital facilities? $

Schedule H (Form 990) 2012

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Part VFacility Information (continued)

Financial Assistance Policy			Yes	No
9	Did the hospital facility have in place during the tax year a written financial assistance policy that:
	Explained eligibility criteria for financial assistance, and whether such assistance includes free or discounted care?	9	Yes
10	Used federal poverty guidelines (FPG) to determine eligibility for providing free care?...........	10	Yes
	If "Yes," indicate the FPG family income limit for eligibility for free care: 200.% If "No," explain in Part VI the criteria the hospital facility used.
11	Used FPG to determine eligibility for providing discounted care?.................	11	Yes
	If “Yes,” indicate the FPG family income limit for eligibility for discounted care: 500.% If "No," explain in Part VI the criteria the hospital facility used.
12	Explained the basis for calculating amounts charged to patients?.................	12	Yes
	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)
13	Explained the method for applying for financial assistance?...................	13	Yes
14	Included measures to publicize the policy within the community served by the hospital facility?.......	14	Yes
	If “Yes,” indicate how the hospital facility publicized the policy (check all that apply):
a	The policy was posted on the hospital facility’s website
b	The policy was attached to 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 on admission to the hospital facility
f	The policy was available upon request
g	Other (describe in Part VI)
Billing and Collections
15	Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained actions the hospital facility may take upon non-payment?.......	15	Yes
16	Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the patient’s eligibility under the facility’s FAP:
a	Reporting to credit agency
b	Lawsuits
c	Liens on residences
d	Body attachments
e	Other similar actions (describe in Part VI)
17	Did the hospital facility or an authorized third party perform any of the following actions during the tax year before making reasonable efforts to determine the patient’s eligibility under the facility’s FAP?..........	17		No
	If “Yes,” check all actions in which the hospital facility or a third party engaged:
a	Reporting to credit agency
b	Lawsuits
c	Liens on residences
d	Body attachments
e	Other similar actions (describe in Part VI)

Schedule H (Form 990) 2012

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Part VFacility Information (continued)

Indicate which efforts the hospital facility made before initiating any of the actions listed in line 17 (check all that apply):

Notified individuals of the financial assistance policy on admission

Notified individuals of the financial assistance policy prior to discharge

Notified individuals of the financial assistance policy in communications with the patients regarding the patients’ bills

Documented its determination of whether patients were eligible for financial assistance under the hospital facility’s financial assistance policy

Other (describe in Part VI)

Policy Relating to Emergency Medical Care

Yes

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?..........

Yes

If “No,” indicate why:

The hospital facility did not provide care for any emergency medical conditions

The hospital facility’s policy was not in writing

The hospital facility limited who was eligible to receive care for emergency medical conditions (describe in Part VI)

Other (describe in Part VI)

Charges to Individuals Eligible for Assistance under the FAP (FAP-Eligible Individuals)

Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.

The hospital facility used its lowest negotiated commercial insurance rate when calculating the maximum amounts that can be charged

The hospital facility used the average of its three lowest negotiated commercial insurance rates when calculating the maximum amounts that can be charged

The hospital facility used the Medicare rates when calculating the maximum amounts that can be charged

Other (describe in Part VI)

During the tax year, did the hospital facility charge any FAP-eligible individuals 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? ............................

If “Yes,” explain in Part VI.

During the tax year, did the hospital facility charge any FAP-eligible individuals an amount equal to the gross charge for any service provided to that individual? .........................

If “Yes,” explain in Part VI.

Schedule H (Form 990) 2012

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Part VFacility Information (continued)

Section C. Other Health Care Facilities That Are Not Licensed, Registered, or Similarly Recognized as a Hospital Facility (list in order of size, from largest to smallest) How many non-hospital health care facilities did the organization operate during the tax year?
Name and address		Type of Facility (describe)
1
2
3
4
5
6
7
8
9
10

Schedule H (Form 990) 2012

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Part VI

Supplemental Information

Complete this part to provide the following information.

1	Required descriptions. Provide the descriptions required for Part I, lines 3c, 6a, and 7; Part II; Part III, lines 4, 8, and 9b; Part V, Section A; and Part V, Section B, lines 1j, 3, 4, 5c, 6i, 7, 10, 11, 12h, 14g, 16e, 17e, 18e, 19c, 19d, 20d, 21, and 22.
2	Needs assessment. Describe how the organization assesses the health care needs of the communities it serves, in addition to any 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.
8	Facility reporting group(s). If applicable, for each hospital facility in a facility reporting group provide the descriptions required for Part V, Section B, lines 1j, 3, 4, 5c, 6i, 7, 10, 11, 12h, 14g, 16e, 17e, 18e, 19c, 19d, 20d, 21, and 22.

Identifier	ReturnReference	Explanation
Related Organization Report	Schedule H, Part I, Line 6a	AN ANNUAL COMMUNITY BENEFIT REPORT IS PREPARED FOR EACH FISCAL YEAR ENDING JUNE 30. THIS REPORT IS SUBMITTED TO THE HEALTH SERVICES COST REVIEW COMMISSION (HSCRC), A STATE REGULATORY AGENCY, BY DECEMBER 15 OF EACH YEAR. IN ADDITION, THE ANNUAL COMMUNITY BENEFIT REPORT IS AVAILABLE UPON REQUEST AT THE ENTITY'S CORPORATE OFFICES.
Costing Methodology	Schedule H, Part I, Line 7	SCHEDULE H, LINE 7A, COLUMN (D) MARYLAND'S REGULATORY SYSTEM CREATES A UNIQUE PROCESS FOR HOSPITAL PAYMENT THAT DIFFERS FROM THE REST OF THE NATION. THE HEALTH SERVICES COST REVIEW COMMISSION, (HSCRC) DETERMINES PAYMENT THROUGH A RATE SETTING PROCESS AND ALL PAYORS, INCLUDING GOVERNMENTAL PAYORS, PAY THE SAME AMOUNT FOR THE SAME SERVICES DELIVERED AT THE SAME HOSPITAL. MARYLAND'S UNIQUE ALL PAYOR SYSTEM INCLUDES A METHOD FOR REFERENCING UNCOMPENSATED CARE IN EACH PAYORS' RATES, WHICH DOES NOT ENABLE MARYLAND HOSPITALS TO BREAKOUT ANY OFFSETTING REVENUE RELATED TO UNCOMPENSATED CARE. SCHEDULE H, LINE 7B, COLUMNS (C) THROUGH (F) MARYLAND'S REGULATORY SYSTEM CREATES A UNIQUE PROCESS FOR HOSPITAL PAYMENT THAT DIFFERS FROM THE REST OF THE NATION. THE HEALTH SERVICES COST REVIEW COMMISSION, (HSCRC) DETERMINES PAYMENT THROUGH A RATE SETTING PROCESS AND ALL PAYORS, INCLUDING GOVERNMENTAL PAYORS, PAY THE SAME AMOUNT FOR THE SAME SERVICES DELIVERED AT THE SAME HOSPITAL. MARYLAND'S UNIQUE ALL PAYOR SYSTEM INCLUDES A METHOD FOR REFERENCING UNCOMPENSATED CARE IN EACH PAYORS' RATES, WHICH DOES NOT ENABLE MARYLAND HOSPITALS TO BREAKOUT ANY OFFSETTING REVENUE RELATED TO UNCOMPENSATED CARE. COMMUNITY BENEFIT EXPENSES ARE EQUAL TO MEDICAID REVENUES IN MARYLAND, AS SUCH, THE NET EFFECT IS ZERO. ADDITIONALLY, NET REVENUES FOR MEDICAID SHOULD REFLECT THE FULL IMPACT ON THE HOSPITAL OF ITS SHARE OF THE MEDICAID ASSESSMENT. SCHEDULE H, LINE 7F COLUMN (C) MARYLAND'S REGULATORY SYSTEM CREATES A UNIQUE PROCESS FOR HOSPITAL PAYMENT THAT DIFFERS FROM THE REST OF THE NATION. THE HEALTH SERVICES COST REVIEW COMMISSION, (HSCRC) DETERMINES PAYMENT THROUGH A RATE SETTING PROCESS AND ALL PAYORS, INCLUDING GOVERNMENTAL PAYORS, PAY THE SAME AMOUNT FOR THE SAME SERVICES DELIVERED AT THE SAME HOSPITAL. MARYLAND'S UNIQUE ALL PAYOR SYSTEM INCLUDES A METHOD FOR REFERENCING UNCOMPENSATED CARE IN EACH PAYORS' RATES, WHICH DOES NOT ENABLE MARYLAND HOSPITALS TO BREAKOUT ANY OFFSETTING REVENUE RELATED TO UNCOMPENSATED CARE. SCHEDULE H, LINE 7F COLUMN (D) MARYLAND'S REGULATORY SYSTEM CREATES A UNIQUE PROCESS FOR HOSPITAL PAYMENT THAT DIFFERS FROM THE REST OF THE NATION. THE HEALTH SERVICES COST REVIEW COMMISSION, (HSCRC) DETERMINES PAYMENT THROUGH A RATE SETTING PROCESS AND ALL PAYORS, INCLUDING GOVERNMENTAL PAYORS, PAY THE SAME AMOUNT FOR THE SAME SERVICES DELIVERED AT THE SAME HOSPITAL. MARYLAND'S UNIQUE ALL PAYOR SYSTEM INCLUDES A METHOD FOR REFERENCING UNCOMPENSATED CARE IN EACH PAYORS' RATES, WHICH DOES NOT ENABLE MARYLAND HOSPITALS TO BREAKOUT ANY OFFSETTING REVENUE RELATED TO UNCOMPENSATED CARE.
Community Building Activities	Schedule H, Part II	The James Lawrence Kernan Hospital provides health information and screenings/events as part of its community health outreach and advocacy work. The hospital has a staff person who is responsible for coordinating and implementing events and participation with the University of Maryland Medical System team events. The following are the initiatives Kernan has undertaken to meet the major health needs pertinent to Kernans specialty patient population and identified in Healthy Baltimore 2015, Marylands State Health Improvement Plan (SHIP) and in the UMMS market research survey. These initiatives have also been identified in Kernans 2012 Community Health Needs Assessment and help to promote the health of the community that it serves. Kernan staff coordinated and participated in the following initiatives that help promote the health of its community: - Chronic Disease: Heart Disease Reduce deaths from heart disease. Initiative 1 Adapted Sports Festival was created to help disabled adults fight obesity and heart disease, diabetes - Chronic Disease: Obesity Reduce the proportion of children and adolescents who are considered obese Initiative 2 Promoting Physical Activity in High Schools through Sports - Healthcare Access Reduce the proportion of individuals who are unable to afford to see a doctor Initiative 3 Support Groups/Patient Education - Chronic Disease Reduce deaths from heart disease. Initiative 4 Take a Loved One to the Doctor Day Targets obesity, diabetes, high blood pressure and cardiac issues. - Healthcare Access - Increase the proportion of children and adolescents who receive dental care Initiative 5 Dental Care for those in Need
Bad Debt Expense	Schedule H, Part III, Line 3 and Line 4	PART III, LINE 3: The organization does not code charity care and bad debt expense into the same general ledger account. Charity Care is booked to a separate account and is classified as a "Deduction from Revenue." As such it is netted against Total Patient Revenue in arriving at Net Patient Revenue on the entity's income statements. Bad Debt Expense is booked to a separate account on the general ledger and does not include any other uncompensated care amounts. Part III, Line 4: The provision for bad debts is based upon management's assessment of historical and expected net collections considering historical business and economic conditions, trends in health care coverage, and other collection indicators. Periodically throughout the year, management assesses the adequacy of the allowance for uncollectible accounts based upon historical write off experience by payor category. The results of this review are then used to make modifications to the provision for bad debts and to establish an allowance for uncollectible receivables. After collection of amounts due from insurers, the Corporation follows internal guidelines for placing certain past due balances with collection agencies.
Medicare Cost Report	Schedule H, Part III, Line 8	In Maryland, The Health Services Cost Review Commission (HSCRC) started setting hospital rates in 1974. At that time, the HSCRC approved rates applied only to commercial insurers. In 1977, the HSCRC negotiated a waiver from Medicare hospital payment rules for Maryland hospitals to bring the federal Medicare payments under HSCRC control. Medicare reimburses Maryland hospitals according to rates established by the HSCRC as long as the State continues to meet a two-part test. This two-part waiver test allows Medicare to participate in the Maryland system as long as two conditions are met. - all other payers participating in the system pay HSCRC set rates and - the rate of growth in Medicare payments to Maryland hospitals from 1981 to the present is not greater than the rate of growth in Medicare payments to hospitals nationally over the same time frame.
Collection Practices	Schedule H, Part III, Line 9b	The organization expects payment at the time the service is provided. Our policy is to comply with all state and federal law and third party regulations and to perform all credit and collection functions in a dignified and respectful manner. Financial assistance is available for patients based on financial need as defined in the Financial Assistance Policy. The organization does not discriminate on the basis of age, race, creed, sex or ability to pay. Patients who are unable to pay may request a Financial Assistance application at any time prior to service or during the billing and collection process. The organization may request the patient to apply for Medical Assistance prior to applying for financial assistance. The account will not be forwarded for collection during the Medical Assistance application process or the Financial Assistance application process. Individuals Eligible For Financial Assistance Schedule H, Part V, Section B Line 20D - All patients are charge state regulated rates regardless of their ability to pay. Line 22 - As previously discussed in an earlier Schedule H narrative, the State of Maryland is a unique State in regard to the provision of health care services and their related charges by hospitals. All hospital charges processed to all Payors, including Governmental Payors, are set through Maryland's Health Services Cost Commission. Accordingly, all Hospital charges are NOT gross charges as defined by the IRS under Internal Revenue Code section 501(r )(5)(B).
Community Health Care Needs Assessment	Schedule H, Part VI, Line 2	According to the Patient Protection and Affordable Care Act (ACA), hospitals must perform a Community Health Needs Assessment (CHNA) either fiscal year 2011, 2012, or 2013, adopt an implementation strategy to meet the community health needs identified, and perform an assessment at least every three years. The needs assessment must take into account input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge of or expertise in public health, and must be made widely available to the public. For the purposes of this report, the IRS defines a CHNA as a: Written document developed for a hospital facility that includes a description of the community served by the hospital facility: the process used to conduct the assessment including how the hospital took into account input from community members and public health experts; identification of any persons with whom the hospital has worked on the assessment; and the health needs identified through the assessment process. Description of the process used to conduct the assessment; The Community Health Needs Assessment for the UM Rehab & Ortho was conducted through meetings with health care leaders, faith-based leaders, discussions with area health care stakeholders, and surveys with community residents, hospital visitors and community health fair attendees. Secondary data was used in conjunction with other University of Maryland Medical System (UMMS) Baltimore City hospitals including UMMC, UM Midtown Campus and Mt. Washington Pediatric hospitals. This information was reviewed and compared with statistics available through the State of Marylands Health Improvement Plan, State of Maryland Department of Health and Mental Hygiene data, Baltimore City Health Department Healthy Baltimore 2015, Healthy People 2020 and American Community Survey data. Description of whom the hospital has worked; UM Rehab & Ortho has worked with a variety of group to gather information in order to compile the hospitals Community Health Needs Assessment (CHNA). Information on area health needs was obtained through community meetings with the Baltimore City Health Department Neighborhood Health Initiative, The University of Maryland Medical System Community Health Outreach and Advocacy, UMMS Community Needs Survey, and a meeting with Baltimore City community group stakeholders. UMMS created the University of Maryland Community Health Outreach and Advocacy team that meets bi-monthly to address the health care needs of the West Baltimore community. The group is comprised of community outreach management and staff, social workers, directors, vice presidents, and physicians from UMMS system hospitals. UM Rehab & Ortho, in partnership with UMMS, is a major participant and sponsor in major annual outreach efforts, and sees firsthand the needs of its patient community. In addition to UM Rehab & Orthos participation in UMMS events, additional community outreach initiatives, involving partnerships with both local education and community groups, as well as organizations with specific ties to the disabled community, and the disabilities treated at UM Rehab & Ortho. These groups include: Community Groups Franklintown Community Association Greater Catonsville Chamber of Commerce Security-Woodlawn Business Association Gwynns Falls Trail Council Dickeyville Community Association Baltimore Metro Red Line Baltimore County Department of Aging Schools Baltimore City Schools Baltimore County Schools Howard County Schools Corporate/Non-Profit Groups Baltimore Municipal Golf Corporation Baltimore City Department of Parks & Rec. Howard County Youth Programs The Brain Injury Association of Maryland Arthritis Foundation of Maryland Baltimore Adaptive Recreation and Sports Multiple Sclerosis Society of Maryland Maryland Amputee Association TKF Foundation Baltimore County Department of Aging American Red Cross American Heart Association United Way of Central Maryland A description of how the hospital took into account input from community members and public health experts; Stakeholders included experts from the following organizations: American Heart Association American Diabetes Association American Asthma Association American Cancer Society American Red Cross Brain Injury Association of Maryland Baltimore Adapted Recreation and Sports Coalition to End Childhood Lead Poisoning BMore Healthy Babies Baltimore Healthy Start, Inc. Baltimore City Head Start Program Sisters Together Reaching (HIV/AIDS) Baltimore City Fire Department Baltimore City Police Department US against MS Donate Life Leaders from the above organizations expressed through roundtable discussion, areas that they felt are important to the community, and needed to be addressed. UMMS outreach team members took note of those items and a discussion followed to address what could occur within the scope of the healthcare. Additionally community leaders from the surrounding Baltimore City neighborhoods to UM Rehab & Ortho Hospital (Beechfield/Ten Hills/West Hills/Edmonson Village/Forest Park/Walbrook) attended meetings conducted by the Baltimore City Health Department as a part of its Healthy Baltimore 2015 study. These community members discussed their ideas of what were issues within the community. A survey was also taken to gain input as to what needs the community felt were important. Additionally data was obtained from Healthy People 2020, the Maryland DHMHs State Health Improvement Plan (SHIP), Baltimore City Health Departments 2011 Neighborhood Profiles and Healthy Baltimore 2015 and included to provide national and local context, data, as well as direction for the assessment. A description of the community served: UM Rehab & Ortho serves a diverse community, both in terms of diagnosis, as well as location. As a rehabilitation specialty hospital, adult patients are treated for a variety of musculoskeletal issues such as total joint replacement and sports medicine, and rehabilitation issues such as brain injury, spinal cord injury, stroke, and pain management. These patients primarily come from the previously described areas of Anne Arundel, Baltimore and Howard counties, and Baltimore City. A description of the health needs identified through the assessment process: Chronic Disease: Obesity Increase the proportion of adults who are at a healthy weight and reduce deaths from heart disease, diabetes, high blood pressure, and other cardiac issues. Chronic Disease: Obesity - Reduce the proportion of children and adolescents who are considered obese. Healthcare Access - Reduce the proportion of individuals who are unable to afford to see a doctor. Healthcare Access Dental - Increase the proportion of children and adolescents who receive dental care. A description of the existing health care facilities and other resources within the community available to meet the community health needs identified: American Heart Association American Diabetes Association American Asthma Association American Cancer Society American Red Cross Brain Injury Association of Maryland Baltimore Adapted Recreation and Sports US against MS Coalition to End Childhood Lead Poisoning Donate Life BMore Healthy Babies Baltimore Healthy Start, Inc. Baltimore City Head Start Program Sisters Together and Reaching (HIV/AIDS) Baltimore City Fire Department Baltimore City Police Department Baltimore City Health Departments 2011 Neighborhood Profiles Healthy People 2020 Maryland DHMHs State Health Improvement Plan (SHIP) Social Determinants of Health (SDoH) Needs A description of the Implementation Strategy: The following information highlights the initiatives UM Rehab & Ortho has undertaken to meet the major health needs pertinent to UM Rehab & Orthos specialty patient population and identified in Healthy Baltimore 2015, Marylands State Health Improvement Plan (SHIP) and in the UMMS market research survey. These initiatives have also been identified in UM Rehab & Orthos 2012 Community Health Needs Assessment. Chronic Disease: Heart Disease Reduce deaths from heart disease. Initiative 1 Adapted Sports Festival was created to help disabled adults fight obesity and heart disease, diabetes Chronic Disease: Obesity Reduce the proportion of children and adolescents who are considered obese Initiative 2 Promoting Physical Activity in High Schools through Sports Healthcare Access Reduce the proportion of individuals who are unable to afford to see a doctor Initiative 3 Support Groups/Patient Education Chronic Disease Reduce deaths from heart disease. Initiative 4 Take a Loved One to the Doctor Day Targets obesity, diabetes, high blood pressure and cardiac issues. Healthcare Access - Increase the proportion of children and adolescents who receive dental care Initiative 5 Dental Care for those in Need 1. Has your hospital conducted a Community Health Needs Assessment that conforms to the IRS definition within the past three fiscal years? Yes Provide da
Eligibility Education	Schedule H, Part VI, Line 3	University of Maryland Rehabilitation & Orthopaedic Institute, as a part of the University of Maryland Medical System, provides healthcare services to those in need regardless of an individuals ability to pay. Care may be provided without charge, or at a reduced charge, to those who do not have insurance, Medicare/Medical Assistance coverage, and are without the means to pay. An individuals eligibility to receive care without charge, at a reduced charge, or to pay for their care over time is determined on a case by case basis. Within two days following a patients request for financial assistance services, application for medical assistance, or both, the hospital makes a determination of probable eligibility. A large percentage of the UM Rehab & Ortho patients are transferred from the Shock Trauma Center or the University of Maryland Hospital. Those who do not have the ability to pay are never turned away and are helped to find resources to cover the costs of their hospital stay and medications with the assistance of UM Rehab & Orthos Institute case managers. For patients who require financial assistance, UM Rehab & Ortho Institute has endowment funds available to assist people without resources who may need medical supplies or medications. This assistance is available upon request and is reviewed on a case-by-case basis. Information regarding the Financial Assistance Policy at UM Rehab & Ortho Institute is posted within the hospital in clinic areas and business areas where eligible patients are likely to be present. Patients also receive individualized help in obtaining services and care should they not have the ability to pay. Information regarding UM Rehab & Ortho Institute financial assistance policy is provided at the time of preadmission or admission to each person who seeks services at the hospital. UM Rehab & Ortho Institute makes every effort to ensure that information is provided in languages that is understood by the target population of patients utilizing hospital services. UM Rehab & Ortho Institute makes every effort to make financial assistance information available to our patients including, but not limited to: - Signage in main admitting areas of the hospital are posted in English and Spanish - Information sheets explaining financial assistance are made available in all patient care areas in English and Spanish. - Information sheets are provided to all patients at the time of admission, explaining the process for payment. If payment cannot be made, options are explained to the patient. A copy of the Financial Assistance Policy for UM Rehab & Ortho Institute, as well as the information provided to those who make the request for the service follow in Appendices II and III.This policy applies to The University of Maryland Medical System (UMMS) following entities: - University of Maryland Medical Center (UMMC) - University of Maryland Rehabilitation & Orthopaedic Institute - University Specialty Hospital (USH) - University of Maryland St. Joseph Medical Center (UMSJMC) UMMS is committed to providing financial assistance to persons who have health care needs and are uninsured, underinsured, ineligible for a government program, or otherwise unable to pay, for medically necessary care based on their individual financial situation. It is the policy of the UMMS Entities to provide Financial Assistance based on indigence or high medical expenses for patients who meet specified financial criteria and request such assistance. The purpose of the following policy statement is to describe how applications for Financial Assistance should be made, the criteria for eligibility, and the steps for processing applications. UMMS Entities will publish the availability of Financial Assistance on a yearly basis in their local newspapers and will post notices of availability at appropriate intake locations as well as the Billing Office. Notice of availability will also be sent to patients to patient with patient bills. Signage in key patient access areas will be made available. A Patient Billing and Financial Assistance Information Sheet will be provided before discharge and will be available to all patients upon request. Financial Assistance may be extended when a review of a patient's individual financial circumstances has been conducted and documented. This should include a review of the patient's existing medical expenses and obligations (including any accounts having gone to bad debt except those accounts that have gone to lawsuit and a judgment has been obtained) and any projected medical expenses. Financial Assistance Applications may be offered to patients whose accounts are with a collection agency and may apply only to those accounts on which a judgment has not been granted. UMMS retains the right in its sole discretion to determine a patients ability to pay. All patients presenting for emergency services will be treated regardless of their ability to pay. For emergent/urgent services, applications to the Financial Clearance Program will be completed, received, and evaluated retrospectively and will not delay patients from receiving care. University of Maryland St. Joseph Medical Center (UMSJMC) adopted this policy effective June 1, 2013. PROGRAM ELIGIBILITY Consistent with their mission to deliver compassionate and high quality healthcare services and to advocate for those who do not have the means to pay for medically necessary care, UMMC, UMSJMC, JLK, and USH hospitals strive to ensure that the financial capacity of people who need health care services does not prevent them from seeking or receiving care. Specific exclusions to coverage under the Financial Assistance program include the following: 1. Services provided by healthcare providers not affiliated with UMMS hospitals (e.g., durable medical equipment, home health services) 2. Patients whose insurance program or policy denies coverage for services by their insurance company (e.g., HMO, PPO, or Workers Compensation), are not eligible for the Financial Assistance Program. a. Generally, the Financial Assistance Program is not available to cover services that are denied by a patients insurance company; however, exceptions may be made on a case by case basis considering medical and programmatic implications. 3. Unpaid balances resulting from cosmetic or other non-medically necessary services 4. Patient convenience items 5. Patient meals and lodging Patients may be ineligible for Financial Assistance for the following reasons: 1. Refusal to provide requested documentation or provide incomplete information. 2. Have insurance coverage through an HMO, PPO, Workers Compensation, Medicaid, or other insurance programs that deny access to the Medical Center due to insurance plan restrictions/limits. 3. Failure to pay co-payments as required by the Financial Assistance Program. 4. Failure to keep current on existing payment arrangements with UMMS. 5. Failure to make appropriate arrangements on past payment obligations owed to UMMS (including those patients who were referred to an outside collection agency for a previous debt). 6. Refusal to be screened for other assistance programs prior to submitting an application to the Financial Clearance Program. 7. Refusal to divulge information pertaining to a pending legal liability claim Patients who become ineligible for the program will be required to pay any open balances and may be submitted to a bad debt service if the balance remains unpaid in the agreed upon time periods. Patients who indicate they are unemployed and have no insurance coverage shall be required to submit a Financial Assistance Application unless they meet Presumptive Financial Assistance Eligibility criteria. If the patient qualifies for COBRA coverage, patient's financial ability to pay COBRA insurance premiums shall be reviewed by the Financial Counselor/Coordinator and recommendations shall be made to Senior Leadership. Individuals with the financial capacity to purchase health insurance shall be encouraged to do so, as a means of assuring access to health care services and for their overall personal health. Coverage amounts will be calculated based upon 200-300% of income as defined by federal poverty guidelines and follows the sliding scale included in Attachment A for a Reduced Cost of Care. Presumptive Financial Assistance Patients may also be considered for Presumptive Financial Assistance Eligibility. There are instances when a patient may appear eligible for financial assistance, but there is no financial assistance form on file. There is adequate information provided by the patient or through other sources, which provide sufficient evidence to provide the patient with financial assistance. In the event there is no evidence to support a patient's eligibility for financial assistance, UMMS reserves the right to use outside agencies or information in determining estimated income amounts for the basis of determining financial assistance eligibility and potenti
Description of Community Served	Schedule H, Part VI, Line 4	For the purposes of this section, primary services area means the Maryland postal ZIP code areas from which the first 60 percent of a hospitals patient discharges originate during the most recent 12 month period available, where the discharges from each ZIP code are ordered from largest to smallest number of discharges. This information will be provided to all hospitals by the HSCRC. Describe in detail the community or communities the organization serves: The University of Maryland Rehabilitation and Orthopaedic Institute (UM Rehab & Ortho) is the largest inpatient rehabilitation specialty hospital located in Maryland. Formerly known also as Kernan Orthopaedics and Rehabilitation, the hospital is Baltimores original orthopaedic and rehabilitation specialty hospital and is a committed provider of a full array of rehabilitation programs and specialty surgery--primarily orthopaedics. A member of the University of Maryland Medical System (UMMS) and affiliated with the University of Maryland School of Medicine, the hospital has been serving patients who are residents of the State of Maryland and the surrounding Baltimore metropolitan area for over 116 years. UM Rehab & Ortho at a Glance (FY 2013) 144 Rehabilitation, Chronic and Acute Care Beds 6 Operating Rooms 3,465 admissions, 2850 orthopaedic surgeries Ambulatory Visits - 76,720 Medical Staff 250 - 237 Physicians representing 44 specialties - 180 University of Maryland School of Medicine Facility - 57 Community physicians - 25 Mid-Level Providers - 29 Dentists 686 Full and Part-Time Staff 44% nursing positions 20% Therapy positions 36% All other positions Located in the Forest Park/Gwynns Falls community in southwest Baltimore City, and the Gwynn Oak/Woodlawn area in western Baltimore County, UM Rehab & Ortho is accessible to patients residing in Baltimore City, Anne Arundel, Baltimore, and Howard counties. Approximately 18 percent of UM Rehab & Ortho patients are admitted to the hospital for elective orthopaedic surgical procedures. Patients requiring rehabilitative care comprise the other 82 percent of admissions and are patients who are transferred to UM Rehab & Ortho from acute care hospitals that are located throughout the state of Maryland. During FY 2013, 33 percent of Baltimore City patients requiring rehabilitative care were treated at UM Rehab & Ortho. Statewide, 28 percent of those needing post-acute rehabilitation were cared for at UM Rehab & Ortho. As the largest provider of acute spinal cord injury rehabilitation in the State of Maryland, UM Rehab & Ortho treated approximately 50 percent of central Maryland's spinal cord injury patients, and 38 percent of spinal cord injury patients statewide. The largest provider of acute traumatic brain injury rehabilitation in the State of Maryland, UM Rehab & Ortho treated 66 percent of those patient in central Maryland, and 61 percent statewide. The following information details the areas UM Rehab & Ortho serves --Baltimore City, Anne Arundel, Baltimore, and Howard counties. For purposes of this report, UM Rehab & Orthos CBSA could be considered the following zip codes, by city and county: Baltimore City Anne Arundel County Howard County Baltimore County 21201 21144 21043 21207 21208 21202 21061 21044 21215 21117 21217 21122 21045 21209 21228 21216 21060 21075 21229 Baltimore city consists of nine geographical regions: Northern, Northwestern, Northeastern, Western, Central, Eastern, Southern, Southwestern, and Southeastern. The West Baltimore community is nearest to UM Rehab & Ortho Institute, and consists of the Northwestern, Western, and Southwestern districts. The Northwestern district, bounded by the Baltimore County line on its northern and western boundaries, Gwynns Falls Parkway on the south and Pimlico Road on the East, is home to Pimlico Race Course, where the Preakness Stakes takes place each May, and is primarily residential. The Western district, located west of the main commercial district downtown, is the heart of West Baltimore, bounded by Gwynns Falls Parkway, Fremont Avenue, and Baltimore Street. Coppin State University, Mondawmin Mall, and Edmondson Village, all located within this district, have been historic cultural and economic centers of the city's African American community The Southwestern district is bounded by Baltimore County to the west, Baltimore Street to the north, and the downtown area to the east. Economic and demographic characteristics of Southwestern district vary. Demographics Baltimore City According to the 2010 U.S. Census, the latest data available, there were 621,342 people residing in Baltimore, an increase of .01% since 2010. According to the 2010 U.S. Census, 29.6% of the population was non-Hispanic White, 63.7% non-Hispanic Black or African American, 0.4% non-Hispanic American Indian and Alaska Native, 2.3% non-Hispanic Asian, 0% from some other race (non-Hispanic) and 2.1% of two or more races (non-Hispanic). 4.2% of Baltimore's population was of Hispanic, Latino, or Spanish origin. In the 1990s, the US Census reported that Baltimore ranked as one of the largest population losers alongside Detroit and Washington D.C., losing over 84,000 residents between 1990 and 2000. The same report also estimated these people lived in a total of 294,579 housing units. Age ranges were 22.4% under 18 years old, 11.8% at age 65 or older, and 65.8% from 18 to 64 years old. The city's estimated 2009 population of 637,418 was 53.4% female. A statistical abstract prepared by the U.S. Census Bureau estimated the median income for a household in the city during 2009 at $38,458, with 20.9% of the population below the poverty line. A part of the Baltimore-Washington Metropolitan area, Baltimore County is located in the northern part of the state of Maryland. In 2010, the countys population was 805,029. Comprised of approximately 598 square miles, Baltimore County does not have any incorporated cities or towns and is divided into council districts. UM Rehab & Ortho is located on the southwestern border of district 4 (Randallstown/Woodlawn/Security) of the county and Baltimore City. Demographics Baltimore County According to the 2010 Census QuickFacts, the latest data available, the population and demographics of Baltimore County were as follows: White persons comprised 64.8 percent of the population, with Black persons accounting for 27 percent of the countys population. American Indian and Alaska Native persons made up .04 percent of the population, Asian population comprised 5.4 percent, with Native Hawaiian and other Pacific Islander at .01 percent. Persons reporting two or more races made up percent of Baltimore Countys population, persons of Hispanic or Latino origin, totaled 4.6 percent. The percent of White persons, not Hispanic was 61.4 percent. There were 315.127 households out of which 30.20% had children under the age of 18 living with them, 49.40% were married couples living together, 12.80% had a female householder with no husband present, and 33.80% were non-families. 27.30% of all households were made up of individuals and 10.10% had someone living alone who was 65 years of age or older. The average household size was and the average family size was 3.00. In the county the population was spread out with 23.60% under the age of 18, 8.50% from 18 to 24, 29.80% from 25 to 44, 23.40% from 45 to 64, and 14.60% who were 65 years of age or older. The median age was 38 years. For every 100 females there were 90.00 males. For every 100 females age 18 and over, there were 86.00 males. The median income for a household in the county was $65,411.00, and the median income for a family was $59,998. Males had a median income of $41,048 versus $31,426 for females. The per capita income for the county was $34,304.0. About 8.2% of the population was below the poverty line, including 7.20% of those under age 18 and 6.50% of those aged 65 or over. Howard County is located in the central part of the Maryland, between Baltimore and Washington, D.C. It is considered part of the Baltimore-Washington Metropolitan Area. According to the 2010 U.S. Census, the latest data available, its population was 299,430. Its county seat is Ellicott City. The center of population of Maryland is located on the county line between Howard County and Anne Arundel County, in the unincorporated town of Jessup. Due to the proximity of Howard County's population centers to Baltimore, the county has traditionally been considered a part of the Baltimore Metropolitan Area. Recent development in the south of the county has led to some realignment towards the Washington, D.C. media and employment markets. The county is also home to Columbia, a major planned community of 100,000 founded by developer James Rouse in 1967. Howard County is frequently cited for its affluence, quality of life, and excellent schools. For 2011, it was ranked the fifth wealthiest county by median household income in the United States by the U.S. Census Bureau. Many of th
Promoting the Health of the Community	Schedule H, Part VI, Line 5	The members of the UMMS Community Health Outreach and Advocacy team will continue to meet and discuss the items that are currently not being addressed by system hospitals and determine if programs and resources can be allocated to assist in those unaddressed areas. Currently areas are being addressed as resources allow. Many of the health needs mentioned in the first paragraph are met through UMMS community outreach efforts, described in the Community Benefits Implementation Plan section. Available resources to assist in the unaddressed identified needs include: - Baltimore City Health Department - Baltimore City Government - Anne Arundel County Government - Baltimore County Government - Howard County Government - State of Maryland (governmental agencies) - U.S. Health and Human Services Department - Housing Office (HUD) Initiative 1 Identified Need - Chronic Disease: Obesity Increase the proportion of adults who are at a healthy weight and reduce death from heart disease. Decrease risk of stroke, diabetes; reduce death from heart disease. Obesity rates among disabled adults are nearly 58 % higher than adults without disabilities. 2012 Behavioral Risk Factor Surveillance System, CDC. The goal was to encourage disabled community members to participate in sports and to keep as physically fit as possible, in order to reduce obesity and other health risk factors. Sufficient evidence now exists to recommend that adults with disabilities should also get regular physical activity. The Adapted Sports Festival helps to meet SHIP Vision Areas 5: - Chronic Disease #25 Reduce deaths from heart disease. Opportunities to participate in hand cycling, bocce ball, wheelchair basketball, a wheelchair slalom course, volley ball and adapted golf and quad rugby. Impact Approximately 90 community members participated in the adapted sports events. Initiative 2 Identified Need - Chronic Disease: Obesity - Reduce the proportion of children and adolescents who are considered obese. Studies show that regular physical activity reduces risk of depression, diabetes, heart disease, high blood pressure, obesity, stroke, and certain kinds of cancer. Yet, the 2008 Physical Activity Guidelines Advisory Committee notes that data from various national surveillance programs consistently show most adults and youth in the U.S. do not meet current physical activity recommendations, --45% to 50% of adults and 35.8% of high school students say they get the recommended amounts of moderate to vigorous physical activity. To provide sports physicals and care to high school students who participate in sports activities. Studies show that keeping active in sports enables many students to ward off obesity and to set a course for a life time of physical fitness. Many high school students in the Baltimore and Howard County communities do not have a primary care physician and some do not have the resources to see a doctor to obtain a physical in order to participate in sports. The athletic trainers at Kernan, as well as many of the sports medicine physicians, donate their time each summer to provide an opportunity for students to see a physician at their school and obtain a free physical in order to participate in athleticsan opportunity for many of these students to remain active in order to reduce obesity. Additionally, the physicians and /or residents in the sports medicine program donate their time to attend athletic contests as team physicians for various schools. Impact 223 students screened. Initiative 3 Identified need -Healthcare Access - Reduce the proportion of individuals who are unable to afford to see a doctor To help those experiencing a life-changing event, and/or their loved ones to be able to adapt to their new experience with the aid of support groups. UM Rehab & Ortho provides education, serves as an advocate and supports the disability populations within its continuum of care. During FY 2013, UM Rehab & Ortho provided and facilitated monthly support groups for brain injury, stroke, spinal cord injury, amputee, caregivers, total joint, and trauma survivors programs. Additionally, clients with multiple sclerosis were served by participating in UM Rehab & Ortho MS (Multiple Sclerosis) Day Program. These groups and classes are free and open to all. Impact: A total of 1518 visits to the support groups. Initiative 4 Identified Need- Chronic Disease - Reduce deaths from heart disease. To provide opportunities for health screening and education to members of the community who do not have access to medical care, health screenings and education. Impact: Attendees average about 750 to the events. Initiative 5 Identified Need -Increase the proportion of children and adolescents in need who receive dental care. To provide education to children and adults who have limited access to oral health care. Staff visits area schools to instruct students on oral care, as well as participate in community health fairs. The dental clinic staff has formed relationships with dental practices throughout Maryland so that all patients have resources to dental care. The hospital plans to revise its dental clinic web page to include forms and resource data to enable patients to have all information that they need available to them prior to arriving for an appointment. Impact: We provided dental health information for 807 children at 4 different venues for FY 2013.
Affiliated Health Care System Roles	Schedule H, Part VI, Line 6	The James Lawrence Kernan Hospital is a part of the University of Maryland Medical System (UMMS) and participates on the UMMS Community Health Outreach and Advocacy team. UMMS created the University of Maryland Community Health Outreach and Advocacy team to address the health care needs of the West Baltimore community. The group is comprised of community outreach management and staff, social workers, directors, vice presidents, and physicians from UMMS system hospitals. The group determines what needs are addressed as well as community involvement and activities each year. UMMC participates in this Advocacy Team and representatives In addition to the identified UMMS priorities, Kernan senior leaders and community outreach staff meet to determine annual goals and activities. Kernan, in partnership with UMMS, was a major participant and sponsor in major annual outreach efforts.
state filing of community benefit report	Schedule H, part VI, Line 7	Maryland

Schedule H (Form 990) 2012

Additional Data

Software ID:
Software Version:

- TIN:

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

2012

Open to Public Inspection

Name of the organization

James Lawrence Kernan Hospital Inc

Employer identification number

52-0591639

Part I

Questions Regarding Compensation

Yes

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.

First-class or charter travel Housing allowance or residence for personal use

Travel for companions Payments for business use of personal residence

Tax idemnification and gross-up payments Health or social club dues or initiation fees

Discretionary spending account Personal services (e.g., maid, chauffeur, chef)

If any of the boxes in line 1a are checked, did the organization follow a written policy regarding payment or reimbursement or provision of all of the expenses described above? If "No," complete Part III to explain....

Yes

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? .......

Yes

Indicate which, if any, of the following the filing organization used to establish the compensation of the
organization's CEO/Executive Director. Check all that apply. Do not check any boxes for methods
used by a related organization to establish compensation of the CEO/Executive Director, but explain in Part III.

Compensation committee Written employment contract

Independent compensation consultant Compensation survey or study

Form 990 of other organizations Approval by the board or compensation committee

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:

Receive a severance payment or change-of-control payment? ................

Yes

Participate in, or receive payment from, a supplemental nonqualified retirement plan? .........

Yes

Participate in, or receive payment from, an equity-based compensation arrangement? .........

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.

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:

The organization? ...........................

Any related organization? .........................

If "Yes," to line 5a or 5b, describe in Part III.

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:

The organization? ...........................

Any related organization? .........................

If "Yes," to line 6a or 6b, describe in Part III.

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 ............

Yes

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 Regulations section 53.4958-4(a)(3)? If "Yes," describe
in Part III .............................

If "Yes" to line 8, did the organization also follow the rebuttable presumption procedure described in Regulations section 53.4958-6(c)? .........................

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50053T

Schedule J (Form 990) 2012

Page 2

Part II

Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees. Use duplicate copies if additional space is 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) for each listed individual must equal the total amount of Form 990, Part VII, Section A, line 1a, applicable column (D) and (E) amounts for that individual.

(A) Name and Title		(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 as deferred in prior Form 990
(A) Name and Title		(i) Base compensation	(ii) Bonus & incentive compensation	(iii) Other reportable compensation	(C) Retirement and other deferred compensation	(D) Nontaxable benefits	(E) Total of columns (B)(i)-(D)	(F) Compensation reported as deferred in prior Form 990
(1)ROBERT A CHRENCIKTREASURER	(i) (ii)	0 1,166,972	0 994,524	0 13,072	0 223,385	0 11,081	0 2,409,034
(2)HEMA PATEL MDHOSPITALIST	(i) (ii)	221,650 0	0 0	2,243 0	11,435 0	14,077 0	249,405 0
(3)MICHAEL R JABLONOVERCEO	(i) (ii)	284,971 0	119,475 0	48,229 0	10,000 0	12,586 0	475,261 0
(4)W W AUGUSTIN IIICFO	(i) (ii)	207,089 0	70,755 0	21,551 0	8,487 0	10,541 0	318,423 0
(5)VALERIE SUMMERLINVP CNO	(i) (ii)	84,154 0	0	140,464 0	3,589 0	252 0	228,459 0
(6)JUANITA D ROBBINSCOO	(i) (ii)	232,066 0	108,935 0	4,142 0	27,858 0	0 0	373,001 0
(7)JOHN STRAUMANISSVP - CMO	(i) (ii)	226,676 0	66,881 0	6,726 0	27,813 0	14,077 0	342,173 0
(8)LORI PATRIAMANAGER - AMBULATORY	(i) (ii)	120,128 0	32,386 0	136 0	6,257 0	14,077 0	172,984 0
(9)LOBNA ZADADENTAL CLINICAL CHIEF	(i) (ii)	176,286 0	12,833 0	335 0	724 0	5,345 0	195,523 0
(10)THOMAS MERKLEHOSPITALIST	(i) (ii)	182,342 0	0	114 0	9,320 0	10,541 0	202,317 0
(11)NORBERT ROBINSONDIR - PHARMACY	(i) (ii)	141,318 0	39,328 0	116 0	7,317 0	14,077 0	202,156 0
(12)MARY RICEDIRECTOR - SURGICAL SERV.	(i) (ii)	120,296 0	36,900 0	386 0	6,266 0	14,077 0	177,925 0

Schedule J (Form 990) 2012

Page 3

Part III

Supplemental Information

Complete this part to provide the information, explanation, or descriptions required for Part I, lines 1a, 1b, 3, 4a, 4b, 4c, 5a, 5b, 6a, 6b, 7, and 8, and for Part II.
Also complete this part for any additional information.

Identifier	Return Reference	Explanation
Health or social club dues or initiation fees	Schedule J, Part I, Line 1a	UMMS executives receive a benefit package wihich may be used towards health club dues or other health maintenance programs. Such benefits are capped at $7,000, $5,000 or $3,000 depending on job title as described in the program documents.
severence or change of control payment	Schedule J, Part I, Line 4a	A severance payment was paid to the following individual in Calendar Year 2012: Valerie M. Summerlin received $120,918
Supplemental nonqualified retirement plan	Schedule J, Part I, Line 4b	During the Fiscal Year ended June 30, 2013, certain officers and key employees participated in the University of Maryland Medical System (UMMS) Supplemental Nonqualified Retirement Plan. The individuals listed below have not vested in the plan therefore the accrued contribution to the plan for the Fiscal Year is reported on Schedule J, Part II, Column C, Retirement and Other Deferred Compensation: Robert A. Chrencik, Juanita D. Robbins, John Straumanis & Cheryl D. Lee. During the Fiscal Year,ended June 30, 2013, certain officers and key employees participated in the University of Maryland Medical System (UMMS) Supplemental Nonqualified Retirement Plan. The individuals listed below have vested in the plan in a prior year, therefore the contributions to the plan for the Fiscal Year are reported as taxable compensation and reported on Schedule J, Part II, Line B(III), Other Reportable Compensation: Michael R. Jablonover, W.W. Augustin III & Valerie M. Summerlin .
Non Fixed Compensation	Schedule J, Part I, Line 7	Bonuses paid are based on a number of variables including but not limited to individual goal achievements as well as organization operation achievements. The final determination of the bonus amount is determined and approved by the Board as part of the overall compensation review of the officers and key employees.

Schedule J (Form 990) 2012

Additional Data

Software ID:
Software Version:

- TIN:

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

2012

Open to Public
Inspection

Name of the organization

James Lawrence Kernan Hospital Inc

Employer identification number

52-0591639

Identifier	Return Reference	Explanation
Members or Stockholders	Form 990, Part VI, Line 6, 7a & 7b	UNIVERSITY OF MARYLAND MEDICAL SYSTEM CORPORATION (UMMS) IS THE SOLE MEMBER OF JAMES LAWRENCE KERNAN HOSPITAL (JLK). UMMS MAY ELECT ONE OR MORE BOARD MEMBERS OF THE GOVERNING BODY AND ALL DECISIONS OF THE GOVERNING BODY MUST BE APPROVED BY UMMS.
Form 990 Review Process	Form 990, Part VI, Line 11b	THE IRS FORM 990 IS PREPARED AND REVIEWED BY THE ACCOUNTING FIRM OF GRANT THORNTON. ACCOUNTING PERSONNEL IN FINANCE SHARED SERVICES AT THE UNIVERSITY OF MARYLAND MEDICAL SYSTEM GATHER THE INFORMATION NEEDED TO COMPLETE THE RETURN AND INPUT THE DATA INTO THE GRANT THORNTON TAX ORGANIZER. WHEN ALL DATA HAS BEEN ENTERED, THE INFORMATION IS SUBMITTED TO GRANT THORNTON FOR IMPORTATION INTO THEIR TAX SOFTWARE. AT THIS POINT, GRANT THORNTON STAFF MEMBERS REVIEW THE DATA, ASK FOR ADDITIONAL INFORMATION IF NEEDED AND PREPARE THE TAX RETURN. EACH RETURN IS REVIEWED AT SEVERAL LEVELS AT GRANT THORNTON INCLUDING THE TAX PARTNER. AFTER THEIR REVIEW PROCESS, A DRAFT RETURN IS SENT TO THE ACCOUNTING STAFF AT UMMS FOR AN IN-HOUSE REVIEW. UPON COMPLETION OF THE IN-HOUSE REVIEW, GRANT THORNTON IS INSTRUCTED TO MAKE ANY NECESSARY CHANGES AND TO PREPARE THE FINAL TAX RETURN. THE FINAL RETURN UNDERGOES ANOTHER REVIEW BY THE ACCOUNTING STAFF AT FINANCE SHARED SERVICES AND IS ALSO REVIEWED BY THE ACCOUNTING MANAGER, THE DIRECTOR OF FINANCIAL REPORTING, THE VICE PRESIDENT OF FINANCE AND THE CFO, WHO SIGNS THE RETURN. PRIOR TO FILING THE IRS FORM 990, THE ORGANIZATION'S BOARD CHAIRMAN, TREASURER, AUDIT COMMITTEE CHAIRMAN, EXECUTIVE COMMITTEE CHAIRMAN OR OTHER MEMBER OF THE BOARD WITH SIMILAR AUTHORITY WILL REVIEW THE IRS FORM 990. AT THE DISCRETION OF THE REVIEWING BOARD MEMBER, SUCH MEMBER WILL BRING ANY ISSUES OR QUESTIONS RELATED TO THE COMPLETED IRS FORM 990 TO THE ATTENTION OF THE BOARD. NOTWITHSTANDING THE ABOVE, A BOARD RESOLUTION IS NOT REQUIRED FOR THE FILING OF THE ORGANIZATION'S IRS FORM 990. EACH BOARD MEMBER IS PROVIDED WITH A COPY OF THE FINAL IRS FORM 990 BEFORE FILING.
Conflict of Interest Policy Monitoring & Enforcement	Form 990, Part VI, Line 12c	THE ORGANIZATION'S OFFICERS, DIRECTORS, EMPLOYEES AND MEDICAL STAFF MEMBERS, AS APPLICABLE, SHALL DISCLOSE CONFLICTS OF INTEREST OR POTENTIAL CONFLICTS OF INTEREST BETWEEN THEIR PERSONAL INTERESTS AND THE INTERESTS OF THE ORGANIZATION, OR ANY ENTITY CONTROLLED BY OR OWNED IN SUBSTANTIAL PART BY THE ORGANIZATION. A QUESTIONNAIRE WHICH DISCLOSES POTENTIAL CONFLICTS OF INTEREST IS DISTRIBUTED ANNUALLY TO ALL OFFICERS, DIRECTORS AND KEY EMPLOYEES. THE GENERAL COUNSEL OF THE UNIVERSITY OF MARYLAND MEDICAL SYSTEM CORPORATION (UMMSC) REVIEWS THE RESPONSES FOR UMMSC, UNIVERSITY SPECIALTY HOSPITAL AND JAMES LAWRENCE KERNAN HOSPITAL. THE CEO OR CFO OF EACH OF THE OTHER ENTITIES IN THE UNIVERSITY OF MARYLAND MEDICAL SYSTEM REVIEWS THE RESPONSES FOR THOSE ENTITIES. THE GENERAL COUNSEL, IN CONSULTATION WITH THE AUDIT COMMITTEE, IF NECESSARY, WOULD DETERMINE IF A CONFLICT OF INTEREST EXISTED FOR UMMSC, UNIVERSITY SPECIALTY HOSPITAL AND JAMES LAWRENCE KERNAN HOSPITAL. WITH RESPECT TO THE OTHER ENTITIES IN THE UNIVERSITY OF MARYLAND MEDICAL SYSTEM, THE GENERAL COUNSEL MAY BE CALLED FOR CONSULT. IF SO, THE GENERAL COUNSEL MAY CONSULT THE AUDIT COMMITTEE, IF NECESSARY. WHENEVER A CONFLICT OR POTENTIAL CONFLICT OF INTEREST EXISTS, THE NATURE OF THE CONFLICT OR POTENTIAL CONFLICT OF INTEREST MUST BE DISCLOSED IN WRITING TO THE ORGANIZATION'S BOARD, BOARD COMMITTEE, AN OFFICER OF THE ORGANIZATION OR OTHER APPROPRIATE EXECUTIVE. SUCH INDIVIDUAL HAVING A POTENTIAL CONFLICT OF INTEREST SHALL PLAY NO ROLE ON BEHALF OF THE ORGANIZATION, OR ANY ORGANIZATION CONTROLLED OR SUBSTANTIALLY OWNED, IN ANY TRANSACTION IN WHICH A CONFLICT EXISTS. ALL INVITATIONS FOR BIDS, PROPOSALS OR SOLICITATIONS FOR OFFERS INCLUDE THE FOLLOWING PROVISION: ANY VENDOR, SUPPLIER OR CONTRACTOR MUST DISCLOSE ANY ACTUAL OR POTENTIAL TRANSACTION WITH ANY ORGANIZATION OFFICER, DIRECTOR, EMPLOYEE OR MEMBER OF THE MEDICAL STAFF, INCLUDING FAMILY MEMBERS WITHIN FIVE DAYS OF THE TRANSACTION. FAILURE TO COMPLY WITH THIS PROVISION IS A MATERIAL BREACH OF AGREEMENT. IN ADDITION, A BOARD DISCLOSURE REPORT IS FILED WITH THE MARYLAND HEALTH SERVICES COST REVIEW COMMISSION ON AN ANNUAL BASIS SHOWING ANY BUSINESS TRANSACTIONS BETWEEN THE BOARD MEMBERS AND THE ORGANIZATION.
Process for Determining Compensation	Form 990, Part VI, Lines 15a & 15b	THE ORGANIZATION DETERMINES THE EXECUTIVE COMPENSATION PAID TO ITS EXECUTIVES IN THE FOLLOWING MANNER PRESCRIBED IN THE IRS REGULATIONS: EXECUTIVE COMPENSATION PACKAGES ARE DETERMINED BY A COMMITTEE OF THE BOARD THAT IS COMPOSED ENTIRELY OF BOARD MEMBERS WHO HAVE NO CONFLICT OF INTEREST. THE COMMITTEE ACQUIRES CREDIBLE COMPARABILITY MARKET DATA CONCERNING THE COMPENSATION PACKAGES OF SIMILARLY SITUATED EXECUTIVES. THE COMMITTEE CAREFULLY REVIEWS THAT DATA, THE EXECUTIVE'S PERFORMANCE AND THE PROPOSED COMPENSATION PACKAGES DURING THE DECISION MAKING PROCESS. THE COMMITTEE MEMORIALIZES ITS DELIBERATIONS IN DETAILED MINUTES REVIEWED AND ADOPTED AT THE NEXT-FOLLOWING MEETING. THE COMMITTEE SEEKS AN OPINION OF COUNSEL THAT IT HAS MET THE REQUIREMENTS OF THE IRS INTERMEDIATE SANCTIONS REGULATIONS. THIS PROCESS IS USED TO DETERMINE THE COMPENSATION PACKAGES FOR ALL MANAGEMENT EMPLOYEES FROM THE VICE PRESIDENT LEVEL AND UP.
How Documents are Made Available to the Public	Form 990, Part VI, Line 19	IN GENERAL, FINANCIAL AND TAX INFORMATION RELATING TO THE ORGANIZATION IS DEEMED PROPRIETARY AND NOT SUBJECT TO DISCLOSURE UPON REQUEST. HOWEVER, SPECIFIC PROVISIONS OF FEDERAL AND STATE LAW REQUIRE THE ORGANIZATION TO DISCLOSE CERTAIN LIMITED FINANCIAL AND TAX DATA UPON A SPECIFIC REQUEST FOR THAT INFORMATION. REQUESTS FOR FORM 990 AND FORM 1023: A REQUESTOR SEEKING TO REVIEW AND/OR OBTAIN A COPY OF THE ORGANIZATION'S IRS FORM 990 OR FORM 1023 AS FILED WITH THE INTERNAL REVENUE SERVICE, INCLUDING ALL SCHEDULES AND ATTACHMENTS, MAY APPEAR IN PERSON OR SUBMIT A WRITTEN REQUEST. THE MOST RECENT THREE YEARS OF IRS FORM 990 MAY BE REQUESTED. IF THE REQUESTER APPEARS IN PERSON, THE INDIVIDUAL IS DIRECTED TO THE OFFICE OF THE CHIEF FINANCIAL OFFICER FOR THE ORGANIZATION AND THE FORM 990 AND/OR FORM 1023 ARE MADE AVAILABLE FOR INSPECTION. THE INDIVIDUAL IS PERMITTED TO REVIEW THE RETURN, TAKE NOTES AND REQUEST A COPY. IF REQUESTED, A COPY IS PROVIDED ON THE SAME DAY. A NOMINAL FEE IS CHARGED FOR MAKING THE COPIES. THE ORGANIZATION MAY HAVE AN EMPLOYEE PRESENT DURING THE PUBLIC INSPECTION OF THE DOCUMENT. WRITTEN REQUESTS FOR AN ENTITY'S FORM 990 OR FORM 1023 ARE DIRECTED IMMEDIATELY TO THE OFFICE OF THE CHIEF FINANCIAL OFFICER FOR THE ORGANIZATION. THE REQUESTED COPIES ARE MAILED WITHIN 30 DAYS OF THE REQUEST. REPRODUCTION FEES AND MAILING COSTS ARE CHARGED TO THE REQUESTOR. CONFLICT OF INTEREST POLICY AND GOVERNING DOCUMENTS: IF THE GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY OF OUR ORGANIZATION ARE SUBJECT TO THE FEDERAL PUBLIC DISCLOSURE RULES (OR STATE PUBLIC DISCLOSURE RULES), THESE DOCUMENTS WILL BE MADE PUBLICLY AVAILABLE AS APPLICABLE LAW MAY REQUIRE. OTHERWISE, THE GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY WILL BE PROVIDED TO THE PUBLIC AT THE DISCRETION OF MANAGEMENT.
Tax Exempt Bond Issue	Part IV, Line 24a	Pursuant to a Master Loan Agreement dated June 20, 1991 (The "Master Loan Agreement"), as Amended, The University Of Maryland Medical System Corporation (The "Corporation") and several of its subsidiaries have issued debt through the Maryland Health and Higher Education Facility Authority (the "Authority"). As Security for the performance of the bond obligation under the Master Loan Agreement, The Authority maintains a security interest in the revenue of the obligors. The Master Loan Agreement contains certain restrictive covenants. These covenants require that rates and charges be set at certain levels, limit incurrence of additional debt, require compliance with certain operating ratios and restrict the disposition of assets. The obligated group under the Master Loan Agreement includes the Corporation, The James Lawrence Kernan Hospital, Inc., Maryland General Hospital, Inc., Baltimore Washington Medical Center, Inc., Shore Health System, Inc., Chester River Hospital Center, Inc., Civista Medical Center, Inc., University of Maryland St. Joseph Medical Center, LLC and the University of Maryland Medical System Foundation, Inc. Each member of the obligated Group is jointly and severally liable for the repayment of the obligations under the Master Loan Agreement of the Corporations $1,267,185,000 of outstanding Authority Bonds on June 30, 2013. All of the bonds were issued in the name of the University of Maryland Medical System Corporation and are reported on Schedule K of its Form 990.
Hours on Related Entities	PART VII, SECTION A, COLUMN (B)	THE UNIVERSITY OF MARYLAND MEDICAL SYSTEM (UMMS) IS A MULTI-ENTITY HEALTH CARE SYSTEM THAT INCLUDES 10 ACUTE CARE HOSPITALS, 3 ACUTE CARE HOSPITALS OWNED IN JOINT VENTURE ARRANGEMENTS AND VARIOUS SUPPORTING ENTITIES. A NUMBER OF INDIVIDUALS PROVIDE SERVICES TO VARIOUS ENTITIES WITHIN THE SYSTEM. IN GENERAL, THE OFFICERS AND KEY EMPLOYEES OF UMMS AVERAGE IN EXCESS OF 40 HOURS PER WEEK SERVING THE DIFFERENT ENTITIES THAT COMPRISE UMMS.
Reconciliation of Net Assets	Form 990, Part XI, Line 9	Change in UMMS Foundation $ 44,810 Change in James L. Kernan Foundation (341,800) ------------- Total Other Changes in Net Assets $(296,990)

For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.

Cat. No. 51056K

Schedule O (Form 990 or 990-EZ) 2012

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE R
(Form 990)

Department of the Treasury
Internal Revenue Service

Related Organizations and Unrelated Partnerships

Complete if the organization answered "Yes" to Form 990, Part IV, line 33, 34, 35, 36, or 37.
MediumBullet

Attach to Form 990. MediumBullet

See separate instructions.

OMB No. 1545-0047

2012

Open to Public Inspection

Name of the organization

James Lawrence Kernan Hospital Inc

Employer identification number

52-0591639

Part I

Identification of Disregarded Entities (Complete if the organization answered "Yes" to Form 990, Part IV, line 33.)

(a) Name, address, and EIN (if applicable) 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) Shipley's Physical Therapy Center LLC 2200 Kernan Drive Baltimore,MD21207 52-2061788	Healthcare	MD	1,077,000	89,000	JLK Hospital

Part II

Identification of Related Tax-Exempt Organizations (Complete if the organization answered "Yes" to 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 entity?
(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	Yes	No
(1) Baltimore Washington Emergency Phys Inc 301 HOSPITAL DRIVE GLEN BURNIE,MD21061 52-1756326	HEALTH CARE	MD	501(c)(3)	11A	BWMS		No
(2) Baltimore Washington Healthcare Services 301 HOSPITAL DRIVE GLEN BURNIE,MD21061 52-1830243	HEALTH CARE	MD	501(c)(3)	11A	BWMS		No
(3) Baltimore Washington Medical Center Inc 301 HOSPITAL DRIVE GLEN BURNIE,MD21061 52-0689917	HEALTH CARE	MD	501(c)(3)	3	BWMS		No
(4) Baltimore Washington Medical System Inc 301 HOSPITAL DRIVE GLEN BURNIE,MD21061 52-1830242	HEALTH CARE	MD	501(c)(3)	11A	UMMSC		No
(5) BW Medical Center Foundation Inc 301 HOSPITAL DRIVE GLEN BURNIE,MD21061 52-1813656	HEALTH CARE	MD	501(c)(3)	11c	BWMS		No
(6) North Arundel Development Corporation 301 HOSPITAL DRIVE GLEN BURNIE,MD21061 52-1318404	REAL ESTATE	MD	501(c)(2)	N/A	NCC		No
(7) North County Corporation 301 HOSPITAL DRIVE GLEN BURNIE,MD21061 52-1591355	REAL ESTATE	MD	501(c)(2)	N/A	BWMS		No
(8) Chester River Health Foundation Inc 100 BROWN STREET CHESTERTOWN,MD21620 52-1338861	FUNDRAISING	MD	501(c)(3)	7	CRHS		No
(9) Univ of MD shore regional health inc 100 BROWN STREET CHESTERTOWN,MD21620 52-2046500	HEALTH CARE	MD	501(c)(3)	11A	UMMSC		No
(10) Chester River Hospital Center Inc 100 BROWN STREET CHESTERTOWN,MD21620 52-0679694	HEALTH CARE	MD	501(c)(3)	3	CRHS		No
(11) Chester River Manor Inc 200 MORGNEC ROAD CHESTERTOWN,MD21620 52-6070333	HEALTH CARE	MD	501(c)(3)	9	CRHS		No
(12) Maryland General Clinical Practice Group 827 LINDEN AVE BALTIMORE,MD21201 52-1566211	HEALTH CARE	MD	501(c)(3)	11B	MGHS		No
(13) Maryland General Comm Health Foundation 827 LINDEN AVE BALTIMORE,MD21201 52-2147532	FUNDRAISING	MD	501(c)(3)	11c	MGHS		No
(14) univ of maryland midtown health inc 827 LINDEN AVE BALTIMORE,MD21201 52-1175337	HEALTH CARE	MD	501(c)(3)	11B	UMMSC		No
(15) Maryland General Hospital Inc 827 LINDEN AVE BALTIMORE,MD21201 52-0591667	HEALTH CARE	MD	501(c)(3)	3	MGHS		No
(16) Care Health Services Inc 219 SOUTH WASHINGTON STREET EASTON,MD21601 52-1510269	HEALTH CARE	MD	501(c)(3)	9	SHS		No
(17) Dorchester General Hospital Foundation 219 SOUTH WASHINGTON STREET EASTON,MD21601 52-1703242	FUNDRAISING	MD	501(c)(3)	11d	SHS		No
(18) Memorial Hospital Foundation Inc 219 SOUTH WASHINGTON STREET EASTON,MD21601 52-1282080	FUNDRAISING	MD	501(c)(3)	11A	SHS		No
(19) Shore Clinical Foundation Inc 219 SOUTH WASHINGTON STREET EASTON,MD21601 52-1874111	HEALTH CARE	MD	501(c)(3)	3	SHS		No
(20) Shore Health System Inc 219 SOUTH WASHINGTON STREET EASTON,MD21601 52-0610538	HEALTH CARE	MD	501(c)(3)	3	UMMSC		No
(21) University Specialty Hospital 611 South Charles Street BALTIMORE,MD21230 52-0882914	HEALTH CARE	MD	501(c)(3)	3	UMMSC		No
(22) James Lawrence Kernan Hosp Endow Fnd 2200 KERNAN DRIVE BALTIMORE,MD21207 23-7360743	FUNDRAISING	MD	501(c)(3)	11B	JLK Hospital	Yes
(23) Shipley's Choice Medical Park Inc 22 SOUTH GREENE STREET BALTIMORE,MD21201 04-3643849	REAL ESTATE	MD	501(c)(2)	N/A	UMMSC		No
(24) UMMS Foundation Inc 22 SOUTH GREENE STREET BALTIMORE,MD21201 52-2238893	FUNDRAISING	MD	501(c)(3)	11A	UMMSC		No
(25) University of MD Medical System Corp 22 SOUTH GREENE STREET BALTIMORE,MD21201 52-1362793	HEALTH CARE	MD	501(c)(3)	3	N/A		No
(26) Civista Health Inc PO Box 1070 La Plata,MD20646 52-2155576	Healthcare	MD	501(c)(3)	11c	UMMSC		No
(27) Civista Medical Center Inc PO Box 1070 La Plata,MD20646 52-0445374	Healthcare	MD	501(c)(3)	3	CIVHS		No
(28) Civista Health Foundation Inc PO Box 1070 La Plata,MD20646 52-1414564	Fundraising	MD	501(c)(3)	11a	CIVHS		No
(29) Civista Health Auxiliary Inc PO Box 1070 La Plata,MD20646 52-1131193	Fundraising	MD	501(c)(3)	11A	CIVHS		No
(30) Univ of MD St Joseph foundation inc 7601 Osler drive towson,MD21204 52-1682964	fundraising	MD	501(c)(3)	11a	ummsc		No

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50135Y

Schedule R (Form 990) 2012

Page 2

Part III

Identification of Related Organizations Taxable as a Partnership (Complete if the organization answered "Yes" to 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 VUBI amount in box 20 of Schedule K-1 (Form 1065)	(j) General or managing partner?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity		(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code VUBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No
(1) Arundel Physicians Associates LLC 301 Hospital Drive GLEN BURNIE,MD21601 52-2000762	HEALTH CARE	MD	na	n/a
(2) Central Maryland Radiology Oncology 10710 Charter Drive COLUMBIA,MD21044 27-0879418	HEALTH CARE	MD	na	n/a
(3) Innovative Health LLC 29165 Canvasback Drive Suite 100 EASTON,MD21601 52-1997287	BILLING	MD	na	n/a
(4) Baltimore Washington Imaging LLC 301 Hospital Drive GLEN BURNIE,MD21061 20-0806027	HEALTH CARE	MD	na	n/a
(5) North Arundel Senior Living LLC 301 Hospital Drive GLEN BURNIE,MD21061 54-1810728	HEALTH CARE	MD	na	n/a
(6) NAHSunrise of Severna Park LLC 301 Hospital Drive GLEN BURNIE,MD21061 54-1810729	HEALTH CARE	MD	na	n/a
(7) Shipley's Imaging Center LLC 22 South Greene Street BALTIMORE,MD21201 52-2040338	HEALTH CARE	MD	na	n/a
(8) Universitycare LLC 22 South Greene Street BALTIMORE,MD21201 52-1914892	HEALTH CARE	MD	na	n/a
(9) O'dea medical arts limited partnership 7601 Osler Drive towson,MD21204 52-1682964	healthcare	MD	NA	N/A

Part IV

Identification of Related Organizations Taxable as a Corporation or Trust (Complete if the organization answered "Yes" to 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	(i) Section 512(b)(13) controlled entity?
(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	Yes	No
(1) Arundel Physicians Associates Inc 301 Hospital Drive GLEN BURNIE,MD21061 52-1992649	HEALTH CARE	MD	na	C Corp
(2) Baltimore Washington Health Enterprises 301 Hospital Drive GLEN BURNIE,MD21061 52-1936656	HEALTH CARE	MD	na	C Corp
(3) BW Professional Services Inc 301 Hospital Drive GLEN BURNIE,MD21061 52-1655640	HEALTH CARE	MD	na	C Corp
(4) Univ Midtown Prof Center a condominium 827 Linden Avenue BALTIMORE,MD21201 52-1891126	REAL ESTATE	MD	na	C Corp
(5) Shore Health Enterprises Inc 219 South Washington Street EASTON,MD21601 52-1363201	REAL ESTATE	MD	na	C Corp
(6) UMMS Self Insurance Trust 22 South Greene Street BALTIMORE,MD21201 52-6315433	INSURANCE	MD	na	Trust
(7) Terrapin Insurance Company PO BOX 1109 GRAND CAYMAN KY1-1102 CJ 98-0129232	INSURANCE	CJ	na	C Corp
(8) NA Executive Building Condo Assn Inc 301 Hospital Drive GLEN BURNIE,MD21061	REAL ESTATE	MD	na	C Corp
(9) Civista Care Partners 701 E Charles Street La Plata,MD20646 52-2176314	Health Care	MD	NA	C Corp

Schedule R (Form 990) 2012

Page 3

Part V

Transactions With Related Organizations (Complete if the organization answered "Yes" to Form 990, Part IV, line 34, 35b, or 36.)

Note. Complete line 1 if any entity is listed in Parts II, III, or IV of this schedule.

Yes

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 or (iv) rent from a controlled entity . . . . . . . . . . . . . . . . . . . . . . .

b Gift, grant, or capital contribution to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

c Gift, grant, or capital contribution from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Yes

d Loans or loan guarantees to or for related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

e Loans or loan guarantees by related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

f Dividends from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

g Sale of assets to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

h Purchase of assets from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

i Exchange of assets with related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

j Lease of facilities, equipment, or other assets to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . .

k Lease of facilities, equipment, or other assets from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . .

l Performance of services or membership or fundraising solicitations for related organization(s) . . . . . . . . . . . . . . . . . . . .

m Performance of services or membership or fundraising solicitations by related organization(s) . . . . . . . . . . . . . . . . . . . .

n Sharing of facilities, equipment, mailing lists, or other assets with related organization(s) . . . . . . . . . . . . . . . . . . . . .

o Sharing of paid employees with related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

p Reimbursement paid to related organization(s) for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

q Reimbursement paid by related organization(s) for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

r Other transfer of cash or property to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

s Other transfer of cash or property from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

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-s)	(c) Amount involved	(d) Method of determining amount involved
(1) James L Kernan Hosp Endowment Fund Inc	c	3,733,000	FMV

Schedule R (Form 990) 2012

Page 4

Part VI

Unrelated Organizations Taxable as a Partnership (Complete if the organization answered "Yes" to 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)	(e) Are all partners section 501(c)(3) organizations?		(f) Share of total income	(g) Share of end-of-year assets	(h) Disproprtionate allocations?		(i) Code VUBI amount in box 20 of Schedule K-1 (Form 1065)	(j) General or managing partner?
(a) Name, address, and EIN of entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	Yes	No	(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code VUBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No

Schedule R (Form 990) 2012

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

Software ID:
Software Version:

1	Briefly describe the organization’s mission or most significant activities: JAMES L KERNAN HOSPITAL DELIVERS INNOVATIVE, HIGH-QUALITY, AND COST EFFECTIVE REHABILITATION AND SURGICAL SERVICES TO THE COMMUNITY AND REGION.
2	Check this box
3	Number of voting members of the governing body (Part VI, line 1a) ........	3	11
4	Number of independent voting members of the governing body (Part VI, line 1b) .....	4	9
5	Total number of individuals employed in calendar year 2011 (Part V, line 2a) ......	5	798
6	Total number of volunteers (estimate if necessary) .............	6	80
7a	Total unrelated business revenue from Part VIII, column (C), line 12 ........	7a	680,554
b	Net unrelated business taxable income from Form 990-T, line 34 .........	7b	0

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........	5,134,000	4,513,000
9	Program service revenue (Part VIII, line 2g) .........	106,262,183	102,473,566
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	425,675	1,022,379
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	2,258,550	1,871,380
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)...................	114,080,408	109,880,325
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...	0	0
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)	50,603,770	51,763,733
16a	Professional fundraising fees (Part IX, column (A), line 11e).....	0	0
b	Total fundraising expenses (Part IX, column (D), line 25) 0
17	Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e)....	53,795,580	54,469,316
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	104,399,350	106,233,049
19	Revenue less expenses. Subtract line 18 from line 12.......	9,681,058	3,647,276
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	119,918,707	136,743,723
21	Total liabilities (Part X, line 26).............	28,006,926	41,481,656
22	Net assets or fund balances. Subtract line 21 from line 20.....	91,911,781	95,262,067

Sign Here

	Signature of officer	Date

	Type or print name and title


4a	(Code: ) (Expenses $ 85,500,479 including grants of $ ) (Revenue $ 101,793,012 )
	THE ORGANIZATION OWNS AND OPERATES A MEDICAL SURGICAL AND REHABILIATION HOSPITAL WITH 132 LICENSED BEDS. THE HOSPITAL PROVIDES CHARITY CARE TO PATIENTS WHO ARE UNABLE TO PAY. SUCH PATIENTS ARE IDENTIFIED BASED ON INFORMATION OBTAINED FROM THE PATIENTS AND SUBSEQUENT ANALYSIS. BECAUSE THE HOSPITAL DOES NOT EXPECT COLLECTION OF AMOUNTS DETERMINED AS CHARITY CARE, THEY ARE NOT REPORTED AS REVENUE BASED ON ESTABLISHED RATES. THE HOSPITAL ESTIMATES THAT $2,533,327 OF CHARITY CARE AT COST WAS PROVIDED IN 2013. OVERALL, THE HOSPITAL DELIVERS INNOVATIVE HIGH QUALITY, COST EFFECTIVE SURGICAL AND REHABILITATION SERVICES TO ITS COMMUNITY.

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 expenses85,500,479

(A) Name and Title	(B) Average hours per week (list any hours for related organizations below dotted line)		(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
(A) Name and Title
(18) LOBNA ZADA........................................................................ DENTAL CLINICAL CHIEF	40.0 .......................	X	189,454	0	6,069
(19) THOMAS MERKLE........................................................................ HOSPITALIST	40.0 .......................	X	182,456	0	19,861
(20) NORBERT ROBINSON........................................................................ DIR - PHARMACY	40.0 .......................	X	180,762	0	21,394
(21) MARY RICE........................................................................ DIRECTOR - SURGICAL SERV.	40.0 .......................	X	157,582	0	20,343

1b	Sub-Total................
c	Total from continuation sheets to Part VII, Section A....
d	Total (add lines 1b and 1c)............	2,708,911	2,174,568	463,182

				(A) Total revenue	(B) Related or exempt function revenue	(C) Unrelated business revenue	(D) Revenue excluded from tax under sections 512, 513, or 514
1a	Federated campaigns..1a
b	Membership dues....1b
c	Fundraising events....1c
d	Related organizations...1d		3,733,000
e	Government grants (contributions)1e		750,000

f	All other contributions, gifts, grants, and similar amounts not included above1f		30,000

g	Noncash contributions included in lines 1a-1f:$
h	Total. Add lines 1a-1f.......			4,513,000
			Business Code
2a	PATIENT SERVICE REVENUE		900099	102,473,566	101,793,012	680,554
b
c
d
e
f	All other program service revenue .
g	Total. Add lines 2a–2f........			102,473,566
3	Investment income (including dividends, interest, and other similar amounts).......			813,015			813,015
4	Income from investment of tax-exempt bond proceeds..			0
5	Royalties...........			0
		(i) Real	(ii) Personal
6a	Gross rents
b	Less: rental expenses
c	Rental income or (loss)	0	0
d	Net rental income or (loss).......			0
		(i) Securities	(ii) Other
7a	Gross amount from sales of assets other than inventory	5,886,447
b	Less: cost or other basis and sales expenses	5,677,083
c	Gain or (loss)	209,364
d	Net gain or (loss)..........			209,364			209,364
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..			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...			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..			0
Miscellaneous Revenue			Business Code
11a	CAFE AND VENDING		722514	374,468	374,468
b	OUTPATIENT PHARMACY		446110	1,435,679	1,435,679
c	SALARY REIMBURSEMENT		900099	101,197	101,197
d	All other revenue ....			-39,964	-39,964
e	Total. Add lines 11a–11d ......			1,871,380
12	Total revenue. See Instructions......			109,880,325	103,664,392	680,554	1,022,379


				(A) Beginning of year		(B) End of year
1	Cashnon-interest-bearing .............			5,008,790	1	6,887,050
2	Savings and temporary cash investments .........			0	2	0
3	Pledges and grants receivable, net ...........			0	3	0
4	Accounts receivable, net .............			16,171,837	4	14,670,958
5	Loans and other receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of Schedule L ..................
				0	5	0
6	Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), persons described in section 4958(c)(3)(B), and contributing employers and sponsoring organizations of section 501(c)(9) voluntary employees' beneficiary organizations (see instructions) Complete Part II of Schedule L
				0	6	0
7	Notes and loans receivable, net .............			0	7	0
8	Inventories for sale or use ..............			997,619	8	1,054,308
9	Prepaid expenses and deferred charges ..........			16,184	9	0
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	94,256,235
b	Less: accumulated depreciation .....	10b	49,124,456	42,111,305	10c	45,131,779
11	Investments—publicly traded securities ..........			7,669,231	11	6,740,290
12	Investments—other securities. See Part IV, line 11 .....			5,342,000	12	5,297,710
13	Investments—program-related. See Part IV, line 11 .....			0	13	0
14	Intangible assets ...............			0	14	0
15	Other assets. See Part IV, line 11 ...........			42,601,741	15	56,961,628
16	Total assets. Add lines 1 through 15 (must equal line 34)......			119,918,707	16	136,743,723
17	Accounts payable and accrued expenses .........			10,583,958	17	13,312,096
18	Grants payable .................			0	18	0
19	Deferred revenue ................			0	19	0
20	Tax-exempt bond liabilities .............			0	20	0
21	Escrow or custodial account liability. Complete Part IV of Schedule D..			0	21	0
22	Loans and other payables to current and former officers, directors, trustees, key employees, highest compensated employees, and disqualified
	persons. Complete Part II of Schedule L..........			0	22	0
23	Secured mortgages and notes payable to unrelated third parties ..			0	23	0
24	Unsecured notes and loans payable to unrelated third parties ....			0	24	0
25	Other liabilities (including federal income tax, payables to related third parties, and other liabilities not included on lines 17-24). Complete Part X of Schedule D....................			17,422,968	25	28,169,560
26	Total liabilities. Add lines 17 through 25.........			28,006,926	26	41,481,656
	Organizations that follow SFAS 117 (ASC 958), check here and complete lines 27 through 29, and lines 33 and 34.
27	Unrestricted net assets ..............			60,991,790	27	64,638,067
28	Temporarily restricted net assets ...........			30,919,991	28	30,624,000
29	Permanently restricted net assets ...........			0	29	0
	Organizations that do not follow SFAS 117 (ASC 958), check here 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 ...........			91,911,781	33	95,262,067
34	Total liabilities and net assets/fund balances ........			119,918,707	34	136,743,723