TY 2017 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)
(1) RAYMOND HAMM...................................................................... CHAIRMAN	0.50 ................. 0.60	X	X	0	0	0
(2) DWIGHT THOMEY...................................................................... VICE CHAIRMAN/TREASURER	0.50 ................. 0.50	X	X	0	0	0
(3) DAVID FERGUSON PHD...................................................................... SECRETARY	0.50 ................. 0.60	X	X	0	0	0
(4) RICHARD C SZUMEL MD...................................................................... PRESIDENT & CEO	28.00 ................. 12.00	X	X	0	596,750	114,300
(5) RONALD GRAYBEAL...................................................................... DIRECTOR	0.50 ................. 0.50	X		0	0	0
(6) KELLY ALBANESE BEDDER...................................................................... DIRECTOR	0.50 ................. 1.50	X		0	0	0
(7) MARY BOLT PHD...................................................................... DIRECTOR	0.50 ................. 0.50	X		0	0	0
(8) CHRISTY DRYER DNP...................................................................... DIRECTOR	0.50 ................. 0.50	X		0	0	0
(9) STEPHANIE GARRITY...................................................................... DIRECTOR	0.50 ................. 0.50	X		0	0	0
(10) RYAN GERACIMOS MD...................................................................... DIRECTOR	0.50 ................. 0.50	X		0	0	0
(11) MARTIN J HEALY...................................................................... DIRECTOR	0.50 ................. 0.50	X		0	0	0
(12) JOSE MA MD...................................................................... DIRECTOR	39.50 ................. 0.50	X		310,100	0	24,706
(13) MORGAN MILLER MLIS...................................................................... DIRECTOR	0.50 ................. 0.50	X		0	0	0
(14) CARL ROBERTS PHD...................................................................... DIRECTOR	0.50 ................. 0.50	X		0	0	0
(15) SHEELMOHAN SACHDEV MD...................................................................... DIRECTOR	0.50 ................. 0.50	X		0	0	0
(16) JAMES G RAAB START 1017...................................................................... SENIOR VP/CHIEF FINANCIAL OFFICER	29.00 ................. 11.00		X	98,171	65,981	24,958
(17) LAURIE R BEYER CPA...................................................................... SENIOR VP/CFO (UNTIL 10/17)	29.00 ................. 11.00		X	0	374,688	78,355

(A) Name and business address	(B) Description of services	(C) Compensation
UNION RADIOLOGISTS LLC 106 BOW STREET EKLTON,MD21921	RADIOLOGY SERVICES	3,091,323
WHITING-TURNER CONTRACTING CO PO BOX 17596 BALTIMORE,MD21297	CONTRACTOR	2,545,225
CLEARPATH SOLUTIONS 2465 CENTREVILLE RD SUITE J17-722 HERNDON,VA20171	IT HARDWARE AND SOFTWARE	2,522,178
MDICS AT UNION CECIL COUNTY LLC 7250 PARKWAY DR STE 500 HANOVER,MD21076	PROFESSIONAL STAFFING	2,397,220
THE NEMOURS FOUNDATION 1600 ROCKLAND RD WILMINGTON,DE19803	PROFESSIONAL STAFFING	1,219,416
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 117

- 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.
right arrow

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

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2019

Open to Public
Inspection

Name of the organization

UNION HOSPITAL OF CECIL COUNTY INC

Employer identification number

52-0607945

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 12, 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 (Form 990 or 990-EZ).)

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 agricultural research organization described in 170(b)(1)(A)(ix) operated in conjunction with a land-grant college or university or a non-land grant college of agriculture. See instructions. Enter the name, city, and state of the college or university:

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 in lines 12a through 12d that describes the type of supporting organization and complete lines 12e, 12f, and 12g.

Type I. A supporting organization operated, supervised, or controlled by its supported organization(s), typically by giving the supported organization(s) the power to regularly appoint or elect a majority of the directors or trustees of the supporting organization. You must complete Part IV, Sections A and B.

Type II. A supporting organization supervised or controlled in connection with its supported organization(s), by having control or management of the supporting organization vested in the same persons that control or manage the supported organization(s). You must complete Part IV, Sections A and C.

Type III functionally integrated. A supporting organization operated in connection with, and functionally integrated with, its supported organization(s) (see instructions). You must complete Part IV, Sections A, D, and E.

Type III non-functionally integrated. A supporting organization operated in connection with its supported organization(s) that is not functionally integrated. The organization generally must satisfy a distribution requirement and an attentiveness requirement (see instructions). You must complete Part IV, Sections A and D, and Part V.

Check this box if the organization received a written determination from the IRS that it is a Type I, Type II, Type III functionally integrated, or Type III non-functionally integrated supporting organization.

Enter the number of supported organizations ...............................

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

(i) Name of supported organization	(ii) EIN	(iv) Is the organization listed in your governing document?		(v) Amount of monetary support (see instructions)	(vi) Amount of other support (see instructions)
(i) Name of supported organization	(ii) EIN	Yes	No	(v) Amount of monetary support (see instructions)	(vi) Amount of other support (see instructions)


Total

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

Cat. No. 11285F

Schedule A (Form 990 or 990-EZ) 2019

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 failed to qualify under the tests listed below, please complete Part III.)

Section A. Public Support

Calendar year (or fiscal year beginning in)		(a) 2015	(b) 2016	(c) 2017	(d) 2018	(e) 2019	(f) Total
1	Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grant.") ..
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) 2015	(b) 2016	(c) 2017	(d) 2018	(e) 2019	(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 VI.)..
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 section 501(c)(3) organization, check this box and stop here........................................ right arrow

Section C. Computation of Public Support Percentage

Public support percentage for 2019 (line 6, column (f) divided by line 11, column (f)) .........

Public support percentage for 2018 Schedule A, Part II, line 14 ...............

16a

33 1/3% support test—2019. 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—2018. 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—2019. 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 VI how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly supported
organization ..................................................... right arrow

10%-facts-and-circumstances test—2018. 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 VI 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) 2019

Page 3

Part III

Support Schedule for Organizations Described in Section 509(a)(2)
(Complete only if you checked the box on line 10 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) 2015	(b) 2016	(c) 2017	(d) 2018	(e) 2019	(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) 2015	(b) 2016	(c) 2017	(d) 2018	(e) 2019	(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 VI.) ..
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 section 501(c)(3) organization,
check this box and stop here............................................. right arrow

Section C. Computation of Public Support Percentage

Public support percentage for 2019 (line 8, column (f) divided by line 13, column (f)) .........

Public support percentage from 2018 Schedule A, Part III, line 15 ...............

Section D. Computation of Investment Income Percentage

Investment income percentage for 2019 (line 10c, column (f) divided by line 13, column (f)) ......

Investment income percentage from 2018 Schedule A, Part III, line 17 .............

19a

331/3% support tests—2019. 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—2018. 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) 2019

Page 4

Part IV

Supporting Organizations

(Complete only if you checked a box on line 12 of Part I. If you checked 12a of Part I, complete Sections A and B. If you checked 12b of Part I, complete Sections A and C. If you checked 12c of Part I, complete Sections A, D, and E. If you checked 12d of Part I, complete Sections A and D, and complete Part V.)

Section A. All Supporting Organizations

Yes

Are all of the organization’s supported organizations listed by name in the organization’s governing documents?
If "No," describe in Part VI how the supported organizations are designated. If designated by class or purpose,
describe the designation. If historic and continuing relationship, explain.

Did the organization have any supported organization that does not have an IRS determination of status under section 509(a)(1) or (2)? If "Yes," explain in Part VI how the organization determined that the supported organization was described in section 509(a)(1) or (2).

Did the organization have a supported organization described in section 501(c)(4), (5), or (6)? If "Yes," answer (b) and (c) below.

Did the organization confirm that each supported organization qualified under section 501(c)(4), (5), or (6) and satisfied the public support tests under section 509(a)(2)? If "Yes," describe in Part VI when and how the organization made the determination.

Did the organization ensure that all support to such organizations was used exclusively for section 170(c)(2)(B) purposes? If "Yes," explain in Part VI what controls the organization put in place to ensure such use.

Was any supported organization not organized in the United States ("foreign supported organization")? If “Yes” and if you checked 12a or 12b in Part I, answer (b) and (c) below.

Did the organization have ultimate control and discretion in deciding whether to make grants to the foreign supported organization? If “Yes,” describe in Part VI how the organization had such control and discretion despite being controlled or supervised by or in connection with its supported organizations.

Did the organization support any foreign supported organization that does not have an IRS determination under sections 501(c)(3) and 509(a)(1) or (2)? If “Yes,” explain in Part VI what controls the organization used to ensure that all support to the foreign supported organization was used exclusively for section 170(c)(2)(B) purposes.

Did the organization add, substitute, or remove any supported organizations during the tax year? If “Yes,” answer (b) and (c) below (if applicable). Also, provide detail in Part VI, including (i) the names and EIN numbers of the supported organizations added, substituted, or removed; (ii) the reasons for each such action; (iii) the authority under the organization's organizing document authorizing such action; and (iv) how the action was accomplished (such as by amendment to the organizing document).

Type I or Type II only. Was any added or substituted supported organization part of a class already designated in the organization's organizing document?

Substitutions only. Was the substitution the result of an event beyond the organization's control?

Did the organization provide support (whether in the form of grants or the provision of services or facilities) to anyone other than (i) its supported organizations, (ii) individuals that are part of the charitable class benefited by one or more of its supported organizations, or (iii) other supporting organizations that also support or benefit one or more of the filing organization’s supported organizations? If “Yes,” provide detail in Part VI.

Did the organization provide a grant, loan, compensation, or other similar payment to a substantial contributor (defined in section 4958(c)(3)(C)), a family member of a substantial contributor, or a 35% controlled entity with regard to a substantial contributor? If “Yes,” complete Part I of Schedule L (Form 990 or 990-EZ) .

Did the organization make a loan to a disqualified person (as defined in section 4958) not described in line 7? If “Yes,” complete Part I of Schedule L (Form 990 or 990-EZ).

Was the organization controlled directly or indirectly at any time during the tax year by one or more disqualified persons as defined in section 4946 (other than foundation managers and organizations described in section 509(a)(1) or (2))? If “Yes,” provide detail in Part VI.

Did one or more disqualified persons (as defined in line 9a) hold a controlling interest in any entity in which the supporting organization had an interest? If “Yes,” provide detail in Part VI.

Did a disqualified person (as defined in line 9a) have an ownership interest in, or derive any personal benefit from, assets in which the supporting organization also had an interest? If “Yes,” provide detail in Part VI.

10a

Was the organization subject to the excess business holdings rules of section 4943 because of section 4943(f) (regarding certain Type II supporting organizations, and all Type III non-functionally integrated supporting organizations)? If “Yes,” answer line 10b below.

10a

Did the organization have any excess business holdings in the tax year? (Use Schedule C, Form 4720, to determine whether the organization had excess business holdings).

10b

Schedule A (Form 990 or 990-EZ) 2019

Page 5

Part IV

Supporting Organizations (continued)

Yes

Has the organization accepted a gift or contribution from any of the following persons?

A person who directly or indirectly controls, either alone or together with persons described in (b) and (c) below, the governing body of a supported organization?

11a

A family member of a person described in (a) above?

11b

A 35% controlled entity of a person described in (a) or (b) above? If “Yes” to a, b, or c, provide detail in Part VI.

11c

Section B. Type I Supporting Organizations

Yes

Did the directors, trustees, or membership of one or more supported organizations have the power to regularly appoint or elect at least a majority of the organization’s directors or trustees at all times during the tax year? If “No,” describe in Part VI how the supported organization(s) effectively operated, supervised, or controlled the organization’s activities. If the organization had more than one supported organization, describe how the powers to appoint and/or remove directors or trustees were allocated among the supported organizations and what conditions or restrictions, if any, applied to such powers during the tax year.

Did the organization operate for the benefit of any supported organization other than the supported organization(s) that operated, supervised, or controlled the supporting organization? If “Yes,” explain in Part VI how providing such benefit carried out the purposes of the supported organization(s) that operated, supervised or controlled the supporting organization.

Section C. Type II Supporting Organizations

Yes

Were a majority of the organization’s directors or trustees during the tax year also a majority of the directors or trustees of each of the organization’s supported organization(s)? If “No,” describe in Part VI how control or management of the supporting organization was vested in the same persons that controlled or managed the supported organization(s).

Section D. All Type III Supporting Organizations

Yes

Did the organization provide to each of its supported organizations, by the last day of the fifth month of the organization’s tax year, (i) a written notice describing the type and amount of support provided during the prior tax year, (ii) a copy of the Form 990 that was most recently filed as of the date of notification, and (iii) copies of the organization’s governing documents in effect on the date of notification, to the extent not previously provided?

Were any of the organization’s officers, directors, or trustees either (i) appointed or elected by the supported organization(s) or (ii) serving on the governing body of a supported organization? If "No," explain in Part VI how the organization maintained a close and continuous working relationship with the supported organization(s).

By reason of the relationship described in (2), did the organization’s supported organizations have a significant voice in the organization’s investment policies and in directing the use of the organization’s income or assets at all times during the tax year? If "Yes," describe in Part VI the role the organization’s supported organizations played in this regard.

Section E. Type III Functionally-Integrated Supporting Organizations

Check the box next to the method that the organization used to satisfy the Integral Part Test during the year (see instructions):

The organization satisfied the Activities Test. Complete line 2 below.

The organization is the parent of each of its supported organizations. Complete line 3 below.

The organization supported a governmental entity. Describe in Part VI how you supported a government entity (see instructions)

Activities Test. Answer (a) and (b) below.

Yes

Did substantially all of the organization’s activities during the tax year directly further the exempt purposes of the supported organization(s) to which the organization was responsive? If "Yes," then in Part VI identify those supported organizations and explain how these activities directly furthered their exempt purposes, how the organization was responsive to those supported organizations, and how the organization determined that these activities constituted substantially all of its activities.

Did the activities described in (a) constitute activities that, but for the organization’s involvement, one or more of the organization’s supported organization(s) would have been engaged in? If "Yes," explain in Part VI the reasons for the organization’s position that its supported organization(s) would have engaged in these activities but for the organization’s involvement.

Parent of Supported Organizations. Answer (a) and (b) below.

Did the organization have the power to regularly appoint or elect a majority of the officers, directors, or trustees of each of the supported organizations? Provide details in Part VI.

Did the organization exercise a substantial degree of direction over the policies, programs and activities of each of its supported organizations? If "Yes," describe in Part VI. the role played by the organization in this regard.

Schedule A (Form 990 or 990-EZ) 2019

Page 6

Part V

Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations

Check here if the organization satisfied the Integral Part Test as a qualifying trust on Nov. 20, 1970 (explain in Part VI). See instructions. All other Type III non-functionally integrated supporting organizations must complete Sections A through E.

	Section A - Adjusted Net Income		(A) Prior Year	(B) Current Year (optional)
1	Net short-term capital gain	1
2	Recoveries of prior-year distributions	2
3	Other gross income (see instructions)	3
4	Add lines 1 through 3	4
5	Depreciation and depletion	5
6	Portion of operating expenses paid or incurred for production or collection of gross income or for management, conservation, or maintenance of property held for production of income (see instructions)	6
7	Other expenses (see instructions)	7
8	Adjusted Net Income (subtract lines 5, 6 and 7 from line 4)	8

	Section B - Minimum Asset Amount		(A) Prior Year	(B) Current Year (optional)
1	Aggregate fair market value of all non-exempt-use assets (see instructions for short tax year or assets held for part of year):	1
a	Average monthly value of securities	1a
b	Average monthly cash balances	1b
c	Fair market value of other non-exempt-use assets	1c
d	Total (add lines 1a, 1b, and 1c)	1d
e	Discount claimed for blockage or other factors (explain in detail in Part VI):
2	Acquisition indebtedness applicable to non-exempt use assets	2
3	Subtract line 2 from line 1d	3
4	Cash deemed held for exempt use. Enter 1-1/2% of line 3 (for greater amount, see instructions).	4
5	Net value of non-exempt-use assets (subtract line 4 from line 3)	5
6	Multiply line 5 by .035	6
7	Recoveries of prior-year distributions	7
8	Minimum Asset Amount (add line 7 to line 6)	8

	Section C - Distributable Amount		Current Year
1	Adjusted net income for prior year (from Section A, line 8, Column A)	1
2	Enter 85% of line 1	2
3	Minimum asset amount for prior year (from Section B, line 8, Column A)	3
4	Enter greater of line 2 or line 3	4
5	Income tax imposed in prior year	5
6	Distributable Amount. Subtract line 5 from line 4, unless subject to emergency temporary reduction (see instructions)	6

Check here if the current year is the organization's first as a non-functionally-integrated Type III supporting organization (see instructions)

Schedule A (Form 990 or 990-EZ) 2019

Page 7

Part V

Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations(continued)

Section D - Distributions		Current Year
1 Amounts paid to supported organizations to accomplish exempt purposes
2 Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in excess of income from activity
3 Administrative expenses paid to accomplish exempt purposes of supported organizations
4 Amounts paid to acquire exempt-use assets
5 Qualified set-aside amounts (prior IRS approval required)
6 Other distributions (describe in Part VI). See instructions
7Total annual distributions. Add lines 1 through 6.
8 Distributions to attentive supported organizations to which the organization is responsive (provide details in Part VI). See instructions
9 Distributable amount for 2019 from Section C, line 6
10 Line 8 amount divided by Line 9 amount

Section E - Distribution Allocations (see instructions)		(i) Excess Distributions	(ii) Underdistributions Pre-2019	(iii) Distributable Amount for 2019
1 Distributable amount for 2019 from Section C, line 6
2 Underdistributions, if any, for years prior to 2019 (reasonable cause required-- explain in Part VI). See instructions.
3 Excess distributions carryover, if any, to 2019:
a From 2014.......
b From 2015.......
c From 2016.......
d From 2017.......
e From 2018.......
fTotal of lines 3a through e
g Applied to underdistributions of prior years
h Applied to 2019 distributable amount
i Carryover from 2014 not applied (see instructions)
j Remainder. Subtract lines 3g, 3h, and 3i from 3f.
4Distributions for 2019 from Section D, line 7:
$
a Applied to underdistributions of prior years
b Applied to 2019 distributable amount
c Remainder. Subtract lines 4a and 4b from 4.
5 Remaining underdistributions for years prior to 2019, if any. Subtract lines 3g and 4a from line 2. If the amount is greater than zero, explain in Part VI. See instructions.
6 Remaining underdistributions for 2019. Subtract lines 3h and 4b from line 1. If the amount is greater than zero, explain in Part VI. See instructions.
7 Excess distributions carryover to 2020. Add lines 3j and 4c.
8 Breakdown of line 7:
a Excess from 2015.....
b Excess from 2016.....
c Excess from 2017.....
d Excess from 2018.....
e Excess from 2019.....

Schedule A (Form 990 or 990-EZ) (2019)

Schedule A (Form 990 or 990-EZ) 2019

Page 8

Part VI

Supplemental Information. Provide the explanations required by Part II, line 10; Part II, line 17a or 17b; Part III, line 12; Part IV, Section A, lines 1, 2, 3b, 3c, 4b, 4c, 5a, 6, 9a, 9b, 9c, 11a, 11b, and 11c; Part IV, Section B, lines 1 and 2; Part IV, Section C, line 1; Part IV, Section D, lines 2 and 3; Part IV, Section E, lines 1c, 2a, 2b, 3a and 3b; Part V, line 1; Part V, Section B, line 1e; Part V Section D, lines 5, 6, and 8; and Part V, Section E, lines 2, 5, and 6. Also complete this part for any additional information. (See instructions).

Facts And Circumstances Test

Return Reference	Explanation

Schedule A (Form 990 or 990-EZ) 2019

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.

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2019

Name of the organization

UNION HOSPITAL OF CECIL COUNTY INC

Employer identification number

52-0607945

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, contributions totaling $5,000 or more (in money or other property) from any one contributor. Complete Parts I and II. See instructions for determining a contributor's total contributions.

Special Rules

For an organization described in section 501(c)(3) 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), that checked Schedule A (Form 990 or 990-EZ), Part II, line 13, 16a, or 16b, and that received from any one contributor, during the year, total contributions 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 an organization described in section 501(c)(7), (8), or (10) filing Form 990 or 990-EZ that received from any one contributor,
during the year, total contributions of more than $1,000 exclusively for religious, charitable, scientific, literary, or educational purposes, or for the prevention of cruelty to children or animals. Complete Parts I, II, and III.

For an organization described in section 501(c)(7), (8), or (10) filing Form 990 or 990-EZ that received from any one contributor,
during the year, contributions exclusively for religious, charitable, etc., purposes, but no such contributions totaled 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. Don't complete any of the parts unless the General Rule applies to this organization because it received nonexclusively religious, charitable, etc., contributions totaling $5,000 or more during the year ......... Arrow Bullet

Caution: An organization that isn't covered by the General Rule and/or the Special Rules doesn't 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 its Form 990PF, Part I, line 2, to certify that it doesn't 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) (2019)

Schedule B (Form 990, 990-EZ, or 990-PF) (2019) Page 2

Name of organization UNION HOSPITAL OF CECIL COUNTY INC

Part I Contributors	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
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
Schedule B (Form 990, 990-EZ, or 990-PF) (2019)

Schedule B (Form 990, 990-EZ, or 990-PF) (2019)

Page 3

Name of organization UNION HOSPITAL OF CECIL COUNTY INC		Employer identification number 52-0607945

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) (2019)

Schedule B (Form 990, 990-EZ, or 990-PF) (2019)

Page 4


Name of organization UNION HOSPITAL OF CECIL COUNTY INC			Employer identification number 52-0607945
Part III Exclusively religious, charitable, etc., contributions to organizations described in section 501(c)(7), (8), or (10) that total more than $1,000 for the year from any one contributor. 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.) $ 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) (2019)

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," on 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

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2019

Open to Public Inspection

Name of the organization

UNION HOSPITAL OF CECIL COUNTY INC

Employer identification number

52-0607945

Part I

Organizations Maintaining Donor Advised Funds or Other Similar Funds or Accounts. Complete if the organization answered "Yes" on Form 990, Part IV, line 6.

		(a) Donor advised funds	(b) Funds and other accounts
1	Total number at end of year .........
2	Aggregate value of contributions to (during year)
3	Aggregate value of 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" on 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 7/25/06, 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, handling of violations, and enforcing conservation easements during the year
SchDMd Bullet

Amount of expenses incurred in monitoring, inspecting, handling of violations, 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" on Form 990, Part IV, line 8.

If the organization elected, as permitted under FASB 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 FASB 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)

Revenue included on 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 FASB ASC 958 relating to these items:

Revenue included on 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) 2019

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" on 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


b	If "Yes," explain the arrangement in Part XIII and complete the following table:		Amount
c	Beginning balance .............................	1c
d	Additions during the year ............................	1d
e	Distributions during the year ..........................	1e
f	Ending balance ................................	1f

Did the organization include an amount on Form 990, Part X, line 21, for escrow or custodial account liability? ...

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" on Form 990, Part IV, line 10.

		(a) Current year	(b) Prior year	(c) Two years back	(d) Three years back	(e) Four years back

1a	Beginning of year balance ....
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

Term endowment SchDMd Bullet

The percentages on 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" on 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.
Complete if the organization answered "Yes" on Form 990, Part IV, line 11a. See Form 990, Part X, line 10.

Description of property		(a) Cost or other basis (investment)	(b) Cost or other basis (other)	(c) Accumulated depreciation	(d) Book value

1a	Land .....	1,134,905		1,134,905
b	Buildings ....	83,950,443	38,950,148	45,000,295
c	Leasehold improvements	2,384,742	461,579	1,923,163
d	Equipment ....	126,515,264	90,873,030	35,642,234
e	Other .....	6,296,537	1,858,838	4,437,699
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..				88,138,296

Schedule D (Form 990) 2019

Page 3

Part VII

InvestmentsOther Securities.
Complete if the organization answered "Yes" on Form 990, Part IV, line 11b. 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........	5,609,265	C
(3) Other (A) MANAGED HEDGE FUNDS	4,820,001	C
(B) MANAGED HEDGE FUNDS	3,444,116	F
(C)
(D)
(E)
(F)
(G)
(H)
(I)
Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)	13,873,382

Part VIII

InvestmentsProgram Related. Complete if the organization answered 'Yes' on Form 990, Part IV, line 11c. See Form 990, Part X, line 13.

(a) Description of investment	(b) Book value	(c) Method of valuation: Cost or end-of-year market value

(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
(10)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 13.)

Part IX

Other Assets.
Complete if the organization answered 'Yes' on Form 990, Part IV, line 11d. See Form 990, Part X, line 15.

(a) Description				(b) Book value
(1)OTHER ASSETS				596,370
(2)LOAN ISSUANCE COSTS				451,542
(3)INSURANCE CLAIMS RECEIVABLE				6,692,333
(4)DUE FROM AFFILIATES				698,177
(5)
(6)
(7)
(8)
(9)
(10)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........				8,438,422

Part X

Other Liabilities.
Complete if the organization answered 'Yes' on Form 990, Part IV, line 11e or 11f. See Form 990, Part X, line 25.

1.(a) Description of liability	(b) Book value
(1) Federal income taxes
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)	15,205,144
2. Liability for uncertain tax positions. 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) 2019

Page 4

Part XI Reconciliation of Revenue per Audited Financial Statements With Revenue per Return. Complete if the organization answered 'Yes' on Form 990, Part IV, line 12a.
1	Total revenue, gains, and other support per audited financial statements .......			1	155,878,722
2	Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a	Net unrealized gains (losses) on investments ....	2a	745,063
b	Donated services and use of facilities .........	2b
c	Recoveries of prior year grants ...........	2c
d	Other (Describe in Part XIII.) ............	2d	-12,103,279
e	Add lines 2a through 2d .....................			2e	-11,358,216
3	Subtract line 2e from line 1..................			3	167,236,938
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	0
5	Total revenue. Add lines 3 and 4c. (This must equal Form 990, Part I, line 12.) ......			5	167,236,938

Part XII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return. Complete if the organization answered 'Yes' on Form 990, Part IV, line 12a.
1	Total expenses and losses per audited financial statements ...........			1	164,624,444
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	569,956
e	Add lines 2a through 2d....................			2e	569,956
3	Subtract line 2e from line 1...................			3	164,054,488
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	11,983,381
c	Add lines 4a and 4b.....................			4c	11,983,381
5	Total expenses. Add lines 3 and 4c. (This must equal Form 990, Part I, line 18.) ......			5	176,037,869

Part XIII

Supplemental Information

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.

Return Reference	Explanation
PART X, LINE 2:	THE HOSPITAL ACCOUNTS FOR UNCERTAINTY IN INCOME TAXES BY PRESCRIBING A RECOGNITION THRESHOLD OF MORE-LIKELY-THAN-NOT TO BE SUSTAINED UPON EXAMINATION BY THE APPROPRIATE TAXING AUTHORITY. MEASUREMENT OF THE TAX UNCERTAINTY OCCURS IF THE RECOGNITION THRESHOLD HAS BEEN MET. THERE WERE NO TAX UNCERTAINTIES THAT MET THE RECOGNITION THRESHOLD IN 2018 AND 2017.
PART XI, LINE 2D - OTHER ADJUSTMENTS:	PROVISION FOR BAD DEBTS NETTED AGAINST REVENUE ON F/S -8,807,407. BANK FEES NETTED AGAINST REVENUE ON F/S -59,449. CHANGE IN NET ASSETS OF AFFILIATES -119,898. TRANSFER TO AFFILIATES NETTED AGAINST REVENUE ON F/S -3,116,525.
PART XII, LINE 2D - OTHER ADJUSTMENTS:	IMPAIRMENT LOSS 569,956.
PART XII, LINE 4B - OTHER ADJUSTMENTS:	PROVISION FOR BAD DEBTS NETTED AGAINST REVENUE ON F/S 8,807,407. BANK FEES NETTED AGAINST REVENUE ON F/S 59,449. TRANSFER TO AFFILIATES NETTED AGAINST REVENUE ON F/S 3,116,525.

Schedule D (Form 990) 2019

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" on Form 990, Part IV, question 20.
MediumBullet

Attach to Form 990.
MediumBullet

Go to www.irs.gov/Form990EZ for instructions and the latest information.

OMB No. 1545-0047

2019

Open to Public Inspection

Name of the organization

UNION HOSPITAL OF CECIL COUNTY INC

Employer identification number

52-0607945

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 %

If the organization used factors other than FPG in determining eligibility, describe in Part VI the criteria used 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? . . . . . .

Yes

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		(b) Persons served (optional)	(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) . . .		1,822,394	0	1,822,394	1.090 %
b	Medicaid (from Worksheet 3, column a) . . . . .		0	0
c	Costs of other means-tested government programs (from Worksheet 3, column b) . .		0	0
d	Total Financial Assistance and Means-Tested Government Programs . . . . .		1,822,394		1,822,394	1.090 %
Other Benefits
e	Community health improvement services and community benefit operations (from Worksheet 4).	3,860	522,199	0	522,199	0.310 %
f	Health professions education (from Worksheet 5) . . .	259	295,641	0	295,641	0.180 %
g	Subsidized health services (from Worksheet 6) . . . .	124	10,914,203	5,659,706	5,254,497	3.140 %
h	Research (from Worksheet 7) .	0	7,568	0	7,568	0 %
i	Cash and in-kind contributions for community benefit (from Worksheet 8) . . . .	28,628	348,071	162,403	185,668	0.110 %
j	Total. Other Benefits . .	32,871	12,087,682	5,822,109	6,265,573	3.740 %
k	Total. Add lines 7d and 7j .	32,871	13,910,076	5,822,109	8,087,967	4.830 %

For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2019

Schedule H (Form 990) 2019

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.

		(a) Number of activities or programs (optional)	(c) Total community building expense	(d) Direct offsetting revenue	(e) Net community building expense	(f) Percent of total expense
1	Physical improvements and housing	0	0	0
2	Economic development	0	14,634	0	14,634	0.010 %
3	Community support	73	10,850	0	10,850	0.010 %
4	Environmental improvements	0	0	0
5	Leadership development and training for community members	20	1,998	0	1,998	0 %
6	Coalition building	0	0	0
7	Community health improvement advocacy	0	0	0
8	Workforce development	157	26,202	0	26,202	0.020 %
9	Other	0	0	0
10	Total	250	53,684		53,684	0.040 %

Part III

Bad Debt, Medicare, & Collection Practices

Section A. Bad Debt Expense

Yes

Did the organization report bad debt expense in accordance with Healthcare 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. ......

7,248,496

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. ......

198,884

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).....

59,050,100

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

59,050,100

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

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) 2019

Page

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?1Name, address, primary website address, and state license number (and if a group return, the name and EIN of the subordinate hospital organization that operates the hospital facility)
1	UNION HOSPITAL OF CECIL COUNTY INC 106 BOW STREET ELKTON,MD21921 WWW.UHCC.COM 07-005	X	X	X

Schedule H (Form 990) 2019

Page 4

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)

	UNION HOSPITAL OF CECIL COUNTY INC
Name of hospital facility or letter of facility reporting group

Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A):

Yes

Community Health Needs Assessment

Was the hospital facility first licensed, registered, or similarly recognized by a state as a hospital facility in the current tax year or the immediately preceding tax year?........................

Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C...............

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 12......................

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 significant 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

The impact of any actions taken to address the significant health needs identified in the hospital facility's prior CHNA(s)

Other (describe in Section C)

Indicate the tax year the hospital facility last conducted a CHNA: 20 15

In conducting its most recent CHNA, did the hospital facility 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? If "Yes," describe in Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted .................

Yes

6 a

Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C..................................

Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................

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 (list url): HTTPS://WWW.UHCC.COM/ABOUT-US/COMMUNITY-BENEFIT/REPORTS/

Other website (list url): HTTP://CECILCOUNTYHEALTH.ORG/ABOUT/COMMUNITY-HEALTH-ADVISORY-COMMITTEE/

Made a paper copy available for public inspection without charge at the hospital facility

Other (describe in Section C)

Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. ..............

Yes

Indicate the tax year the hospital facility last adopted an implementation strategy: 20 16

Is the hospital facility's most recently adopted implementation strategy posted on a website?.........

Yes

If "Yes" (list url): HTTPS://WWW.UHCC.COM/ABOUT-US/COMMUNITY-BENEFIT/REPORTS/

If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ......

10b

Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.

12a

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)?...............................

12a

If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........

12b

If "Yes" on line 12b, 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) 2019

Page 5

Part VFacility Information (continued)

Financial Assistance Policy (FAP)

	UNION HOSPITAL OF CECIL COUNTY INC
Name of hospital facility or letter of facility reporting group

Yes

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 included free or discounted care?

Yes

If “Yes,” indicate the eligibility criteria explained in the FAP:

Federal poverty guidelines (FPG), with FPG family income limit for eligibility for free care of 200.000000000000%
and FPG family income limit for eligibility for discounted care of 300.000000000000%

Income level other than FPG (describe in Section C)

Asset level

Medical indigency

Insurance status

Underinsurance discount

Residency

Other (describe in Section C)

Explained the basis for calculating amounts charged to patients?.................

Yes

Explained the method for applying for financial assistance?...................

Yes

If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):

Described the information the hospital facility may require an individual to provide as part of his or her application

Described the supporting documentation the hospital facility may require an individual to submit as part of his or
her application

Provided the contact information of hospital facility staff who can provide an individual with information about the
FAP and FAP application process

Provided the contact information of nonprofit organizations or government agencies that may be sources of
assistance with FAP applications

Other (describe in Section C)

Was widely publicized within the community served by the hospital facility?........

Yes

If "Yes," indicate how the hospital facility publicized the policy (check all that apply):

The FAP was widely available on a website (list url):

HTTPS://WWW.UHCC.COM/PATIENT-FINANCIAL-SERVICES/FINANCIAL-ASSISTANCE/

The FAP application form was widely available on a website (list url):

HTTPS://WWW.UHCC.COM/PATIENT-FINANCIAL-SERVICES/FINANCIAL-ASSISTANCE/

A plain language summary of the FAP was widely available on a website (list url):
HTTPS://WWW.UHCC.COM/PATIENT-FINANCIAL-SERVICES/FINANCIAL-ASSISTANCE/

The FAP was available upon request and without charge (in public locations in the hospital facility and by mail)

The FAP application form was available upon request and without charge (in public locations in the hospital facility
and by mail)

A plain language summary of the FAP was available upon request and without charge (in public locations in the
hospital facility and by mail)

Individuals were notified about the FAP by being offered a paper copy of the plain language summary of the FAP, by
receiving a conspicuous written notice about the FAP on their billing statements, and via conspicuous public displays or
other measures reasonably calculated to attract patients' attention

Notified members of the community who are most likely to require financial assistance about availability of the FAP

The FAP, FAP application form, and plain language summary of the FAP were translated into the primary language(s)
spoken by LEP populations

Other (describe in Section C)

Schedule H (Form 990) 2019

Page 6

Part VFacility Information (continued)

Billing and Collections

	UNION HOSPITAL OF CECIL COUNTY INC
Name of hospital facility or letter of facility reporting group

Yes

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 all of the actions the hospital facility or other authorized party may take upon nonpayment?..................................

Yes

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 individual’s eligibility under the facility’s FAP:

Reporting to credit agency(ies)

Selling an individual’s debt to another party

Deferring, denying, or requiring a payment before providing medically necessary care due to nonpayment of a previous
bill for care covered under the hospital facility's FAP

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

None of these actions or other similar actions were permitted

Did the hospital facility or other authorized party perform any of the following actions during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP?............

If "Yes," check all actions in which the hospital facility or a third party engaged:

Reporting to credit agency(ies)

Selling an individual’s debt to another party

Deferring , denying, or requiring a payment before providing medically necessary care due to nonpayment of a previous
bill for care covered under the hospital facility's FAP

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 19. (check all that apply):

Provided a written notice about upcoming ECAs (Extraordinary Collection Action) and a plain language summary of the
FAP at least 30 days before initiating those ECAs (if not, describe in Section C)

Made a reasonable effort to orally notify individuals about the FAP and FAP application process (if not, describe in
Section C)

Processed incomplete and complete FAP applications (if not, describe in Section C)

Made presumptive eligibility determinations (if not, describe in Section C)

Other (describe in Section C)

None of these efforts were made

Policy Relating to Emergency Medical Care

Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required 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 Section C)

Other (describe in Section C)

Schedule H (Form 990) 2019

Page 7

Part VFacility Information (continued)

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

	UNION HOSPITAL OF CECIL COUNTY INC
Name of hospital facility or letter of facility reporting group

Yes

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 a look-back method based on claims allowed by Medicare fee-for-service during a prior 12-month period

The hospital facility used a look-back method based on claims allowed by Medicare fee-for-service and all private health insurers that pay claims to the hospital facility during a prior 12-month period

The hospital facility used a look-back method based on claims allowed by Medicaid, either alone or in combination with
Medicare fee-for-service and all private health insurers that pay claims to the hospital facility during a prior 12-month
period

The hospital facility used a prospective Medicare or Medicaid method

During the tax year, did the hospital facility charge any FAP-eligible individual 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 Section C.

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

If "Yes," explain in Section C.

Schedule H (Form 990) 2019

Page 8

Part V

Facility Information (continued)

Section C. Supplemental Information for Part V, Section B. Provide descriptions required for Part V, Section B, lines 2, 3j, 5, 6a, 6b, 7d, 11, 13b, 13h, 15e, 16j, 18e, 19e, 20a, 20b, 20c, 20d, 20e, 21c, 21d, 23, and 24. If applicable, provide separate descriptions for each hospital facility in a facility reporting group, designated by facility reporting group letter and hospital facility line number from Part V, Section A (“A, 1,” “A, 4,” “B, 2,” “B, 3,” etc.) and name of hospital facility.
Form and Line Reference	Explanation
UNION HOSPITAL OF CECIL COUNTY, INC.	PART V, SECTION B, LINE 5: PLANNING THE CHNA OCCURRED FROM FEBRUARY 2015 - JUNE 2015. THE CHNA/CHIP WAS APPROVED BY BOTH THE UNION HOSPITAL BOARD (FEBRUARY 2015) AND THE COMMUNITY HEALTH ADVISORY COMMITTEE (CHAC) (JULY 2015). PRIMARY DATA COLLECTION OCCURRED FROM JULY 2015 - SEPTEMBER 2015 VIA THREE FOCUS GROUPS AND ADMINISTRATION OF AN ONLINE COMMUNITY SURVEY. SECONDARY DATA WAS TAKEN FROM A VARIETY OF RELIABLE NATIONAL AND LOCAL DATA SOURCES. ANALYSIS OF PRIMARY AND SECONDARY DATA COLLECTED OCCURRED FROM NOVEMBER 2015 THROUGH MID-JANUARY 2016. A) FOCUS GROUPS:THE THREE FOCUS GROUPS WERE CONDUCTED WITH ADULT POPULATIONS WITHOUT ACCESS TO THE INTERNET TO TAKE THE ONLINE SURVEY (HOMELESS, SENIORS, AND SPANISH-SPEAKING MIGRANT WORKERS). EACH FOCUS GROUP SESSION INCLUDED A DESCRIPTION OF THE CHNA, THE PURPOSE OF THE FOCUS GROUP, AN INTRODUCTION OF THE FACILITATORS, AND THE RULES OF ENGAGEMENT. ALL MATERIALS WERE TRANSLATED INTO SPANISH FOR THE FOCUS GROUP WITH MIGRANT, SPANISH-SPEAKING WORKERS, AND A SPANISH INTERPRETER WAS PROVIDED BY THE MARYLAND DEPARTMENT OF HEALTH AND MENTAL HYGIENE. PARTICIPANTS WERE ASKED TO RESPOND TO THE FOLLOWING QUESTIONS:1) WHAT ARE THE GREATEST STRENGTHS OF OUR COMMUNITY?2) WHAT DO YOU THINK ARE THE MOST IMPORTANT HEALTH ISSUES IN CECIL COUNTY?3) WHAT WOULD MOST IMPROVE THE QUALITY OF LIFE IN CECIL COUNTY?4) WHAT ARE THE MOST SIGNIFICANT BARRIERS TO ACCESSING HEALTH CARE IN CECIL COUNTY?5) RELATED TO HEALTH AND QUALITY OF LIFE, WHAT RESOURCES OR SERVICES DO YOU THINK ARE MISSING IN CECIL COUNTY?B) ONLINE COMMUNITY SURVEY:THE ONLINE COMMUNITY SURVEY WAS DEVELOPED BY THE HEALTH POLICY ANALYST (CECIL COUNTY HEALTH DEPARTMENT) WITH INPUT FROM CHAC MEMBER ORGANIZATIONS. THE SURVEY WAS CREATED USING SURVEY MONKEY AND CONSISTED OF TWENTY QUESTIONS - MULTIPLE CHOICE, LIKERT SCALE SELECTIONS, AND FREE TEXT ENTRY. THE SURVEY WAS DIVIDED INTO FOUR SECTIONS: 1) DEMOGRAPHICS, 2) COMMUNITY HEALTH, 3) QUALITY OF LIFE, AND 4) ACCESS TO HEALTH CARE. THE SURVEY TOOK APPROXIMATELY 15 TO 20 MINUTES TO COMPLETE AND 506 PEOPLE COMPLETED THE SURVEY. C) CHAC MEETINGS:INPUT FROM COMMUNITY PARTNERS ENGAGED IN CECIL COUNTY'S CHAC MEETINGS, ALSO KNOWN AS THE LOCAL HEALTH IMPROVEMENT COALITION, WAS INTEGRAL TO THE PROCESS OF SELECTING THE HEALTH PRIORITIES FOR THE COUNTY AND CREATING THE CHIP. CHAC MEMBER ORGANIZATIONS THAT PARTICIPATED IN THE PRIORITIZATION AND STRATEGIC PLANNING PROCESSES INCLUDED: AFFILIATED SANTE GROUP (MOBILE CRISIS), AMERICAN CANCER SOCIETY, CECIL COUNTY DEPT OF EMERGENCY SERVICES, CECIL COUNTY DEPT OF JUVENILE SERVICES, CECIL COUNTY DEPT OF SOCIAL SERVICES, CECIL COUNTY DIRECTOR OF ADMINISTRATION, CECIL COUNTY EXECUTIVE OFFICE, CECIL COUNTY HEALTH DEPT., CECIL COUNTY LIQUOR BOARD, CECIL COUNTY PUBLIC SCHOOLS, CECIL COUNTY SHERIFF'S OFFICE, COUNTY COUNCIL MEMBERS, DHMH - OFFICE OF POPULATION HEALTH IMPROVEMENT, CECIL COLLEGE, CECIL COUNTY DEPT OF COMMUNITY SERVICES, CECIL COUNTY DEPT OF CORRECTIONS, CECIL COUNTY HOUSING, DEEP ROOTS, ELKTON COMMUNITY KITCHEN, ELKTON POLICE DEPARTMENT, ELKTON PRESBYTERIAN CHURCH, ELKTON HOUSING AUTHORITY, MARYLAND STATE DELEGATES, MARYLAND STATE SENATORS, MEADOW WOOD BEHAVIORAL HEALTH SYSTEM, PRIVATE CITIZENS, PRIVATE EDUCATION ORGANIZATIONS, PRIVATE HEALTH CARE PROFESSIONALS, SEVENTH DAY ADVENTIST CHURCH, UNION HOSPITAL OF CECIL COUNTY, UPPER BAY COUNSELING & SUPPORT SERVICES, WEST CECIL HEALTH CENTER, YOUTH EMPOWERMENT SOURCE, IMMACULATE CONCEPTION MEETING GROUND, ON OUR OWN OF CECIL COUNTY, PARIS FOUNDATION, SERENITY HEALTH, STONE RUN FAMILY MEDICINE, WIN FAMILY SERVICES, & YMCA.UNION HOSPITAL COLLABORATED WITH THE CECIL COUNTY HEALTH DEPARTMENT TO CONDUCT THE NEWEST COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) WHOSE COMMUNITY HEALTH IMPLEMENTATION PLAN (CHIP) COVERS FISCAL YEARS 2017 - 2019. THE CHNA PLANNING TEAM INCLUDED STAFF FROM UNION HOSPITAL: THE COMMUNITY BENEFITS COORDINATOR, THE DIRECTOR OF MARKETING, AND A PHYSICIAN FROM OCCUPATIONAL HEALTH (MASTER OF PUBLIC HEALTH (MPH) INTERN), AS WELL AS STAFF FROM THE CECIL COUNTY HEALTH DEPARTMENT: THE HEALTH POLICY ANALYST, THE HEALTH OFFICER, THE DEPUTY HEALTH OFFICER, AND THE PUBLIC AFFAIRS OFFICER. THE CHNA PLANNING TEAM WAS RESPONSIBLE TO FACILITATE ALL COMPONENT PARTS OF THE CHNA PROCESS, INCLUDING WRITING AND SUBMITTING THE REPORTS TO THE INTERNAL REVENUE SERVICE (IRS). ULTIMATELY, THE CHNA/CHIP PROCESS REFLECTED COLLABORATION OF COMMUNITY PARTNERS WORKING TOGETHER TO ACHIEVE THE SAME HEALTH IMPROVEMENT GOALS FOR CECIL COUNTY.
UNION HOSPITAL OF CECIL COUNTY, INC.	PART V, SECTION B, LINE 6B: UNION HOSPITAL COLLABORATED WITH THE CECIL COUNTY HEALTH DEPARTMENT TO CONDUCT THE NEWEST COMMUNITY HEALTH NEEDS ASSESSMENT.
UNION HOSPITAL OF CECIL COUNTY, INC.	PART V, SECTION B, LINE 11: IN 2016, CECIL COUNTY HEALTH DEPARTMENT, UNION HOSPITAL OF CECIL COUNTY, AND PARTNER ORGANIZATIONS IN CHAC BEGAN A COMMUNITY HEALTH IMPROVEMENT PROCESS TO IDENTIFY HEALTH PRIORITIES FOR CECIL COUNTY. THE FOLLOWING THREE HEALTH PRIORITIES WERE SELECTED FOR CECIL COUNTY:1. BEHAVIORAL HEALTH2. CHRONIC DISEASE3. DETERMINANTS OF HEALTHBEHAVIORAL HEALTHGOAL: REDUCE THE PREVALENCE OF SUBSTANCE USE DISORDERS IN CECIL COUNTYOBJECTIVE: BY JUNE 30, 2019, REDUCE THE DRUG-INDUCED DEATH RATE BY 5%STRATEGIES: 1) CONTINUE TO PROVIDE NARCAN TRAINING TO LAW ENFORCEMENT OFFICERS AND THE PUBLIC2) PROVIDE EDUCATION AT PHARMACIES AND PHYSICIANS' OFFICES ON PRESCRIPTION DRUG ABUSE AND NARCAN TRAINING3) ADVOCATE FOR THE DEVELOPMENT OF MORE TREATMENT OPTIONS FOR ADULTS AND ADOLESCENTS IN THE COUNTY4) PARTNER WITH PROVIDERS TO INCREASE THE UTILIZATION OF EXISTING SERVICES5) WORK WITH THE SCHOOL SYSTEM TO REACH AT-RISK ADOLESCENTS6) INCREASE PARTICIPATION IN PREVENTION AND EDUCATION PROGRAMS SUCH AS "MY FAMILY MATTERS AND "STRENGTHENING FAMILIES"7) PROVIDE INCENTIVES FOR ATTENDING PROGRAMS8) PROMOTE THE CREATION OF EDUCATIONAL MESSAGES FOCUSING ON PREVENTION9) IMPLEMENT RECOMMENDATIONS OF CECIL COUNTY'S LOCAL OVERDOSE FATALITY REVIEW TEAM (LOFRT)OBJECTIVE: BY JUNE 30, 2019 REDUCE THE PERCENTAGE OF YOUTH IN GRADES 9-12 REPORTING THE USE OF ALCOHOL ON ONE OR MORE OF THE PAST 30 DAYS TO NO MORE THAN 33.8%STRATEGIES:1) PARTNER WITH MARYLAND STRATEGIC PREVENTION FRAMEWORK 2 (MSPF2) TO IMPLEMENT STRATEGIES IDENTIFIED THROUGH A NEEDS ASSESSMENT2) CONTINUE TO SUPPORT AND EXPAND LIFE SKILLS TRAINING IN CECIL COUNTY PUBLIC SCHOOLSGOAL: IMPROVE THE MENTAL HEALTH AND WELL-BEING OF CECIL COUNTY RESIDENTSOBJECTIVE: BY JUNE 30, 2019, REDUCE THE PERCENTAGE OF YOUTH IN GRADES 9-12 WHO FELT SAD OR HOPELESS ALMOST EVERY DAY FOR TWO WEEKS OR MORE DURING THE PAST 12 MONTHS TO NO MORE THAN 24.8%STRATEGIES:1) PROMOTE DEPRESSION SCREENING DURING WELLNESS CHECKUPS2) RESEARCH PROGRAMMING TO PROMOTE THE HEALTH AND WELL-BEING OF YOUTH3) PROMOTE BEHAVIORAL HEALTH INTEGRATION IN PEDIATRIC PRIMARY CAREOBJECTIVE: BY JUNE 30, 2019, DECREASE THE SUICIDE RATE IN CECIL COUNTY BY 5%.STRATEGIES:1) PROMOTE THE AVAILABILITY OF CRISIS AND SUICIDE HOTLINES2) CONTINUE TO SUPPORT, PROMOTE THE UTILIZATION OF, AND EXPAND MOBILE CRISIS SERVICES IN CECIL COUNTY3) PROMOTE REGULAR SCREENING FOR DEPRESSION DURING PRIMARY CARE PROVIDER VISITS4) PROMOTE MENTAL HEALTH FIRST AID (MHFA) TRAININGGOAL: IMPROVE ACCESS TO BEHAVIORAL HEALTH SERVICES IN CECIL COUNTYOBJECTIVE: BY JUNE 30, 2019, DECREASE THE RATE OF EMERGENCY DEPARTMENT VISITS RELATED TO MENTAL HEALTH CONDITIONS BY 10% AND EMERGENCY DEPARTMENT VISITS RELATED TO SUBSTANCE USE DISORDERS BY 5%STRATEGIES:1) PROVIDE EDUCATION TO REDUCE THE STIGMA SURROUNDING BEHAVIORAL HEALTH DISORDERS2) INCREASE AWARENESS OF BEHAVIORAL HEALTH RESOURCES AND SERVICES IN THE COMMUNITY3) CONTINUE TO SUPPORT OUTREACH EFFORTS TO ENROLL UNINSURED RESIDENTS IN HEALTH INSURANCE/MEDICAL ASSISTANCE4) REDUCE THE HEALTH IMPACT OF VIOLENCE AND TRAUMA BY INTEGRATING TRAUMA-INFORMED CARE THROUGHOUT THE HEALTH CARE AND BEHAVIORAL HEALTH SYSTEMS5) EXPAND OPTIONS FOR INPATIENT AND OUTPATIENT BEHAVIORAL HEALTH TREATMENT FOR CECIL COUNTY RESIDENTS6) PARTNER IN THE DEVELOPMENT OF A REGIONAL CRISIS CENTER7) PROMOTE A SYSTEM OF CARE THAT INTEGRATES SOMATIC AND BEHAVIORAL HEALTH CARE8) CONTINUE TO HOLD MONTHLY ER DIVERSION MEETINGSCHRONIC DISEASEGOAL: REDUCE THE MORBIDITY OF DIABETES IN CECIL COUNTYOBJECTIVE: BY JUNE 30, 2019, INCREASE PHYSICIAN PRACTICE SITES MAKING REFERRALS TO CHRONIC DISEASE SELF-MANAGEMENT PROGRAMS BY 2 SITESSTRATEGIES:1) ENGAGE 2 PHYSICIAN PRACTICE SITES TO PARTICIPATE2) TRACK THE NUMBER OF REFERRALS MADEOBJECTIVE: BY JUNE 30, 2019, INCREASE THE NUMBER OF SITES HOSTING CHRONIC DISEASE SELF-MANAGEMENT PROGRAMS BY 5 SITESSTRATEGIES:1) ENGAGE 5 ADDITIONAL SITES TO HOST CHRONIC DISEASE SELF-MANAGEMENT PROGRAMSOBJECTIVE: BY JUNE 30, 2019, CREATE 1 COUNTY-WIDE WALKING PROGRAMSTRATEGIES:1) USING THE DELAWARE WALKING PROGRAM AS A MODEL, CREATE AND IMPLEMENT A WALKING PROGRAM THAT TRACKS THE NUMBER OF PARTICIPATING INDIVIDUALS, TESTIMONIALS RECEIVED, AND TOTAL MILES WALKED2) IF SUCCESSFUL, CREATE A PLAN FOR FUTURE WALKING PROGRAMS (IF NOT SUCCESSFUL, INDICATE IN ANNUAL REPORTING AND PROVIDE LESSONS LEARNED)GOAL: REDUCE MORTALITY FROM LUNG CANCER IN CECIL COUNTYOBJECTIVE: BY JUNE 30, 2017, INCREASE THE NUMBER OF INDIVIDUALS RECEIVING LOW-DOSE LUNG CT SCREENINGS BY 5% IN ORDER TO INCREASE AWARENESS FOR LUNG CANCER PREVENTIONSTRATEGIES:1) ADVERTISE AND PROMOTE THE LOW-DOSE LUNG CT SCREENING PROGRAM IN THE COMMUNITY2) SUPPORT RECOMMENDATIONS OF THE UNION HOSPITAL CANCER PROGRAM'S COMMUNITY OUTREACH PLAN FOR LOW-DOSE LUNCH CT SCREENINGOBJECTIVE: BY JUNE 30, 2019, REDUCE THE PREVALENCE OF TOBACCO USE AMOUNG ADOLESCENTS BY 5% AND CIGARETTE SMOKING AMONG ADULTS BY 5%STRATEGIES: 1) PROMOTE COMMUNITY SMOKING CESSATION2) EDUCATE ADULTS ABOUT COMMUNITY-BASED AND STATE-BASED SMOKING CESSATION AND PREVENTION RESOURCES3) SUPPORT RECOMMENDATIONS OF THE CECIL COUNTY TOBACCO TASK FORCEGOAL: REDUCE MORBIDITY AND MORTALITY OF HEART DISEASE AND STROKE IN CECIL COUNTYOBJECTIVE: BY JUNE 30, 2019, REDUCE HIGH BLOOD PRESSURE AMONG ADULTS BY 5%, IN ORDER TO REDUCE THE INCIDENCE OF STROKE IN CECIL COUNTYSTRATEGIES:1) EDUCATE AND SUPPORT HEALTH CARE PROVIDERS ON HOW TO WRITE PRESCRIPTIONS FOR PHYSICAL ACTIVITY2) PROVIDE A COMMUNITY-WIDE CAMPAIGN TO TARGET REDUCING SODIUM INTAKE (ALSO SUPPORTS HEALTHY EATING FOR YOUTH)3) SUPPORT RECOMMENDATIONS FROM THE UNION HOSPITAL STROKE PROGRAM FOR STROKE PREVENTION IN THE COMMUNITY.OBJECTIVE: BY JUNE 30, 2019, INCREASE THE PERCENTAGE OF STUDENTS WHO EAT VEGETABLES ONE OR MORE TIMES PER DAY BY 5%, IN ORDER TO REDUCE THE INCIDENCE OF HEART DISEASE IN CECIL COUNTYSTRATEGIES:1) PARTNER WITH SCHOOLS, DAY CARES, AND THE "HEAD START" PROGRAM TO PROVIDE EDUCATION TO STAFF AND COMMUNITY MEMBERS ON NUTRITION FOR YOUTH2) SUPPORT THE TRANSITION FROM THE SCHOOL YEAR TO THE SUMMER BY WORKING WITH SUMMER FOOD PROGRAM PROVIDERS TO INCREASE ACCESS TO AND AWARENESS OF SUMMER FOOD PROGRAMS IN THE COMMUNITY3) ADVOCATE FOR THE INCORPORATION OF HEALTHY FOODS INTO SCHOOL LESSONS4) UTILIZE A LOCAL NEWSPAPER TO PROVIDE HELPFUL TIPS, RECIPES, AND/OR NEWS STORIES ON HEALTHY LIFESTYLE CHOICES AS THEY PERTAIN TO THE "CHIP" OBJECTIVESOBJECTIVE: BY JUNE 30, 2019, IMPLEMENT A WELLNESS PROGRAM FOR ONE LOCAL SMALL BUSINESSSTRATEGIES:1) IMPLEMENT A WELLNESS PROGRAM THAT PROVIDES WELLNESS CHALLENGES FOR EMPLOYEES TO PARTICIPATE IN2) REQUIRE THE PARTNERING SMALL BUSINESS TO PROVIDE PRIZES/AWARDS FOR ITS STAFF THAT WINS THE CHALLENGESDETERMINANTS OF HEALTHGOAL: REDUCE THE BURDEN OF POVERTY IN CECIL COUNTY TO IMPROVE THE OVERALL HEALTH OF CECIL COUNTY RESIDENTSOBJECTIVE: BY OCTOBER 30, 2016, RESEARCH EXISTING AND NEW OR INNOVATIVE ANTI- POVERTY PROGRAMS/INITIATIVES FOR IMPLEMENTATION IN CECIL COUNTYSTRATEGIES:1) GET INFORMATION ON THE ANTI-POVERTY PROGRAM RECENTLY PRESENTED AT THE BHA CHILD/ADOLESCENT CONFERENCE2) IDENTIFY & RESEARCH EXISTING ANTI-POVERTY PROGRAMS IN THE COUNTY3) COLLECT INFORMATION FROM FAITH-BASED ANTI-POVERTY INITIATIVES4) INVESTIGATE CARROLL COUNTY'S PROGRAM MODEL5) REVIEW ALL OPTIONS AS A GROUPGOAL: REDUCE THE PREVALENCE OF HOMELESSNESS IN CECIL COUNTY TO IMPROVE THE OVERALL HEALTH OF THE COMMUNITY AND ITS RESIDENTSOBJECTIVE: BY JUNE 2018, EXPAND SERVICES AND INTERVENTIONS FOR HOMELESS INDIVIDUALS/FAMILIES TO DECREASE PREVALENCE OF HOMELESSNESS IN CECIL COUNTY BY 10%. SERVICES/INTERVENTIONS WILL BE BASED ON THREE TIERS, INCLUDING 1) EMERGENCY/IMMEDIATE ASSISTANCE, 2) INTERMEDIATE/SHORT-TERM ASSISTANCE, 3) LONGER-TERM ASSISTANCE GEARED TOWARD THOSE EXPERIENCING CHRONIC HOMELESSNESS.STRATEGIES:1) IMPLEMENT A COUNTY-WIDE COORDINATED ASSESSMENT SYSTEM FOR EFFICIENT LINKAGE TO SERVICES AND HOUSING OPTIONS FOR ALL.2) PARTICIPATE IN TECHNICAL ASSISTANCE FROM HUD TO DEVELOP A BY-NAME LIST TO END VETERAN'S HOMELESSNESS.3) SEEK FUNDING FOR OR DEVELOP CASE MANAGEMENT/HOUSING SEARCH SERVICES WHOSE SOLE ELIGIBILITY CRITERIA IS THAT OF BEING HOMELESS.4) EXPLORE THE POSSIBILITY OF A MULTIDISCIPLINARY MEETING TO REVIEW THOSE AT RISK OF HOMELESSNESS OR THOSE WITH COMPLEX HOUSING NEEDS.5) CREATE THE AVAILABILITY OF 24-HOUR RESOURCE ASSISTANCE TO PEOPLE EXPERIENCING HOMELESSNESS, INCLUING EMERGENCY SHELTER DURING EXTREME WEATHER EVENTS.6) ESTABLISH LIASIONS BETWEEN LAW ENFORCEMENT AND PROVIDER AGENCIES7) ESTABLISH A COMMUNITY FURNITURE BANK TO ASSIST THOSE TRANSITIONING FROM HOMELESSNESS BACK INTO STABLE HOUSING.SOME HEALTH NEEDS WERE IDENTIFIED BUT NOT PRIORITIZED BY UHCC AS THERE ARE OTHERS IN THE AREA THAT ARE MORE SUITED TO MEET THEM SUCH AS DENTAL HEALTH, PROBLEM GAMBLING, & INFECTIOUS DISEASE.
UNION HOSPITAL OF CECIL COUNTY, INC.	PART V, SECTION B, LINE 13B: PATIENTS WITH A HOUSEHOLD INCOME UP TO 500% OF FPL AND WITH A FINANCIAL HARDSHIP (MEDICAL DEBT, INCURRED BY A FAMILY OVER A 12-MONTH PERIOD THAT EXCEEDS 25 PERCENT OF THE FAMILY INCOME) WILL RECEIVE A 25% ADJUSTMENT.
UNION HOSPITAL OF CECIL COUNTY, INC.	PART V, SECTION B, LINE 16J: UNION HOSPITAL PLACES AN ADVERTISEMENT ONCE A YEAR IN THE LOCAL NEWSPAPERS OUTLINING THE FAP AND HOW TO APPLY. FAP IS PUBLICIZED ON ALL BILLING STATEMENTS, INVOICES, AND FINANCIAL CONSENT FORMS.FAP IS COMMUNICATED TO PATIENTS UPON DISCHARGE FROM INPATIENT, OBSERVATION, OR SURGICAL SERVICES.

Schedule H (Form 990) 2019

Page 9

Part VFacility Information (continued)

Section D. 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) 2019

Page 10

Part VI

Supplemental Information

Provide the following information.

1	Required descriptions. Provide the descriptions required for Part I, lines 3c, 6a, and 7; Part II and Part III, lines 2, 3, 4, 8 and 9b.
2	Needs assessment. Describe how the organization assesses the health care needs of the communities it serves, in addition to any CHNAs 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.

Form and Line Reference	Explanation
PART I, LINE 7:	ALL INFORMATION IS BASED ON ACTUAL COST PLUS OVERHEAD. OVERHEAD IS A HOSPITAL AVERAGE PERCENTAGE OF OVERHEAD TO DIRECT COSTS. DIRECT COSTS EXCLUDE BAD DEBT EXPENSE.
PART I, LN 7 COL(F):	THE AMOUNT OF BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25 BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $8,807,407.
PART II, COMMUNITY BUILDING ACTIVITIES:	A) ECONOMIC DEVELOPMENT (F2):-IN FISCAL YEAR 2018, UNION HOSPITAL SUPPORTED THE FOLLOWING ECONOMIC DEVELOPMENT ORGANIZATIONS IN CECIL COUNTY THROUGH BOARD SERVICE BY EXECUTIVE MANAGEMENT STAFF:1) ECONOMIC DEVELOPMENT COMMISSION FOR CECIL COUNTY. THIS COMMISSION PROMOTES ECONOMIC DEVELOPMENT IN CECIL COUNTY, FOCUSING ON BUSINESS AND INDUSTRY DEVELOPMENT, BY BUILDING RELATIONSHIPS WITH LOCAL PARTNERS. UNION HOSPITAL COLLABORATES WITH THIS COMMISSION TO PROMOTE STABILITY WITHIN THE HOSPITAL'S WORKFORCE AND TO BRING MUCH NEEDED PRACTITIONERS TO THE AREA, ESPECIALLY WHERE THERE ARE TOO FEW PROVIDERS OR IDENTIFIED SERVICE GAPS. 2) ELKTON ALLIANCE. ELKTON ALLIANCE WORKS TOGETHER WITH THE LOCAL GOVERNMENT AND BUSINESS COMMUNITIES TO RESTORE, PROMOTE, AND MAINTAIN THE DIVERSE HISTORIC DOWNTOWN ELKTON AREA, WHILE ATTRACTING NEW ENTERPRISES FOR THE BENEFIT OF COMMUNITY RESIDENTS, BUSINESSES, AND VISITORS. IN COLLABORATING WITH ELKTON ALLIANCE, UNION HOSPITAL SEEKS TO MAINTAIN A POSITIVE PRESENCE IN THE COMMUNITY BY HELPING TO ADDRESS COMMUNITY DEVELOPMENT ISSUES.3) CECIL COUNTY SCHOOL EMPLOYEES FEDERAL CREDIT UNION BOARD. THE CREDIT UNION'S BOARD PROMOTES FINANCIAL LITERACY AND EDUCATION FOR ITS MEMBERS AND FOR LOCAL ELEMENTARY SCHOOL STUDENTS, WHICH CONTRIBUTES TO REDUCING FINANCIAL BARRIERS THAT CAN BE EXACERBATED BY SOCIAL DETERMINANTS OF HEALTH. REDUCING THE BARRIERS EXACERBATED BY THE SOCIAL DETERMINANTS OF HEALTH IS ALSO A PART OF HEALTH LITERACY WHICH UNION HOSPITAL SUPPORTS AND PROMOTES INSIDE AND OUTSIDE ITS FOUR WALLS.B) COMMUNITY SUPPORT (F3):-IN FISCAL YEAR 2018, UNION HOSPITAL SUPPORTED THE FOLLOWING COMMUNITY ORGANIZATIONS THROUGH BOARD SERVICE AND CAMPAIGN PLANNING IN CECIL COUNTY:1) UNITED WAY OF CECIL COUNTY. THE UNITED WAY OF CECIL COUNTY BRINGS TOGETHER VOLUNTEERS FROM GOVERNMENT, BUSINESSES, FAITH GROUPS, NONPROFITS, AND CITIZENS IN ORDER TO IMPROVE PEOPLE'S LIVES. WITH AN ANNUAL CAMPAIGN EACH FALL, UNITED WAY OF CECIL COUNTY IS ABLE TO FUND PROGRAMS THAT ADDRESS CRITICAL NEEDS IN THE COMMUNITY SURROUNDING CHILDREN AND FAMILIES, HEALTH AND WELLNESS, AND INDEPENDENT LIVING. UNION HOSPITAL SUPPORTS THE UNITED WAY BY PLANNING AND FACILITATING A HOSPITAL-WIDE ANNUAL GIVING CAMPAIGN. 2) LOCAL MANAGEMENT BOARD OF CECIL COUNTY. THE CORE FUNCTION OF LOCAL MANAGEMENT BOARDS (LMBS) IS TO IDENTIFY PRIORITIES AND TARGET RESOURCES FOR THEIR COMMUNITIES, AS WELL AS SERVE AS THE COORDINATOR OF COLLABORATION FOR CHILD AND FAMILY SERVICES. LMBS BRING TOGETHER LOCAL CHILD-SERVING AGENCIES, LOCAL CHILD PROVIDERS, CLIENTS OF SERVICES, FAMILIES, AND OTHER COMMUNITY REPRESENTATIVES TO EMPOWER LOCAL STAKEHOLDERS TO ADDRESS THE NEEDS OF AND SET PRIORITIES FOR THEIR COMMUNITIES. THERE IS A LOCAL MANAGEMENT BOARD IN EACH COUNTY IN MARYLAND, INCLUDING BALTIMORE CITY. UNION HOSPITAL'S EXECUTIVE MANAGEMENT STAFF SERVES ON CECIL COUNTY'S LOCAL MANAGEMENT BOARD TO PROVIDE INSIGHT ON THE CONNECTION BETWEEN HOSPITAL SERVICES/POPULATION HEALTH INITIATIVES AND SUPPORT FOR COMMUNITY DIRECTIVES/STRATEGIC PRIORITIES. 3) RELAY FOR LIFE PLANNING. HOSPITAL STAFF PARTICIPATES WITH LOCAL CHAPTERS OF RELAY FOR LIFE TO HELP PLAN EVENTS TO SUPPORT CANCER SURVIVORS AND ACCESS TO CANCER TREATMENT, AS WELL AS CREATE AWARENESS AROUND CANCER AND ITS PREVENTION. 4) BEREAVEMENT SUPPORT. UNION HOSPITAL ESTABLISHED BEREAVEMENT SUPPORTS FOR PEOPLE, ACROSS THE AGE CONTINUUM, IN THE COMMUNITY AFFECTED BY GRIEF AND LOSS. AN EXAMPLE INCLUDES: THE BEREAVEMENT MEMORIAL SERVICE WHICH OCCURS ANNUALLY AND IS OPEN TO PATIENTS, THEIR FAMILIES, AND THE COMMUNITY AFFECTED BY GRIEF AND LOSS OF INFANTS. MATERNAL AND INFANT CENTER NURSING STAFF ARE AVAILABLE AT THE MEMORIAL TO ANSWER QUESTIONS AND TALK THROUGH ISSUES/CONCERNS. THE SERVICE INCLUDES A TREE LIGHTING AND A BALLOON AIR LIFT AS A MEMORIAL TO LOST LOVED ONES. C) LEADERSHIP DEVELOPMENT AND TRAINING FOR COMMUNITY MEMBERS (F5):-IN FISCAL YEAR 2018, UNION HOSPITAL SUPPORTED THE FOLLOWING LEADERSHIP DEVELOPMENT AND TRAINING EFFORT IN CECIL COUNTY:1) CECIL LEADERSHIP INSTITUTE. THE CECIL LEADERSHIP INSTITUTE (CLI) IS HOSTED BY CECIL COLLEGE AND PROVIDES A FRAMEWORK WHERE EXISTING AND EMERGING LEADERS IN BUSINESS, GOVERNMENT, AND TOURISM ENGAGE, COLLABORATE, AND COMMIT TO CECIL COUNTY'S ONGOING DEVELOPMENT. UNION HOSPITAL PARTNERS WITH CECIL COLLEGE TO PROVIDE A LEARNING ENVIRONMENT AT THE HOSPITAL FOR CLI PARTICIPANTS. PARTICIPANTS ENGAGE WITH HEALTH CARE PROFESSIONALS THROUGH QUESTION AND ANSWER SESSIONS, PRESENTATIONS BY HOSPITAL LEADERSHIP STAFF, AND TOURS OF THE DIFFERENT HOSPITAL SERVICE LINES, PROGRAMS, AND MODALITIES.D) WORKFORCE DEVELOPMENT (F8):-IN FISCAL YEAR 2018, UNION HOSPITAL SUPPORTED THE FOLLOWING WORKFORCE DEVELOPMENT PROGRAMS/ENTITIES IN CECIL COUNTY:1) BUSINESS AND EDUCATION PARTNERSHIP ADVISORY COUNCIL (BEPAC). BEPAC IDENTIFIES STRENGTHS, NEEDS, AND TRENDS IN JOB READINESS & STUDENT SUCCESS UPON HIGH SCHOOL GRADUATION. BEPAC MEMBERS DEVELOP AND SUSTAIN PARTNERSHIPS WITH AREA PUBLIC SCHOOLS. UNION HOSPITAL'S AFFINITY HEALTH INSTITUTE (THE CLINICAL EDUCATION DEPARTMENT) STAFF IS A MEMBER OF BEPAC AND THE HOSPITAL'S PARTNER IN EDUCATION IS GILPIN MANOR ELEMENTARY SCHOOL (GMES). WORK DONE WITH GMES IS REPORTED IN CATEGORY A4.2) SUSQUEHANNA WORKFORCE BOARD. SUSQUEHANNA WORKFORCE IS A NON-PROFIT ORGANIZATION THAT PLANS WORKFORCE DEVELOPMENT PROGRAMS AND SERVICES FOR INDIVIDUALS AND BUSINESSES IN CECIL AND HARFORD COUNTIES. UNION HOSPITAL'S EXECUTIVE MANAGEMENT STAFF ATTENDS BOARD MEETINGS TO SUPPORT WORKFORCE DEVELOPMENT IN CECIL COUNTY.3) HIGH SCHOOL WORK ENRICHMENT PROGRAM. UNION HOSPITAL FOOD SERVICES STAFF MENTORED 97 DEVELOPMENTALLY DISABLED HIGH SCHOOL STUDENTS FROM ELKTON HIGH SCHOOL AND PERRYVILLE HIGH SCHOOL AS PART OF THE HIGH SCHOOL WORK ENRICHMENT PROGRAM, A PARTNERSHIP PROGRAM BETWEEN UNION HOSPITAL FOOD SERVICES DEPARTMENT AND CECIL COUNTY PUBLIC HIGH SCHOOLS. THIS PROGRAM PROVIDES FOOD SERVICES WORK ASSIGNMENTS AND TRAINING FOR DEVELOPMENTALLY-DISABLED STUDENTS, LIKE DEVELOPING SKILLS FOR FOOD PREPARATION AND FOOD SANITATION. THE PROGRAM PROVIDES DIRECTION AND IMPORTANT LIFE SKILLS, ALLOWING STUDENTS TO FEEL NEEDED, USEFUL, AND CAPABLE WITHIN A BUSY WORK ENVIRONMENT. STUDENTS LEARN THE VALUE OF PRODUCTIVITY AND TASK COMPLETION AND WORK INDIVIDUALLY AND AS PART OF A TEAM.
PART III, LINE 2:	THE COSTING METHODOLOGY USED IN DETERMINING BAD DEBT EXPENSE AT COST IS BAD DEBT EXPENSE TIMES THE COST TO CHARGE RATIO.
PART III, LINE 3:	THE METHODOLOGY ASSUMES THAT THE PERCENTAGE OF CHARITY CARE TO TOTAL REVENUE CAN BE APPLIED TO THE AMOUNT OF BAD DEBT EXPENSE (AT COST) FOR THE YEAR. UNION HOSPITAL OF CECIL COUNTY PROVIDES CARE TO ALL PATIENTS WHO NEED IT, REGARDLESS OF THEIR ABILITY TO PAY. THIS IS PART OF THE HOSPITAL'S MISSION.
PART III, LINE 4:	PATIENT ACCOUNTS RECEIVABLE ARE REPORTED AT NET REALIZABLE VALUE. ACCOUNTS ARE WRITTEN OFF WHEN THEY ARE DETERMINED TO BE UNCOLLECTIBLE BASED UPON MANAGEMENT'S ASSESSMENT OF INDIVIDUAL ACCOUNTS. IN EVALUATING THE COLLECTABILITY OF PATIENT ACCOUNTS RECEIVABLE, THE HOSPITAL ANALYZES ITS PAST HISTORY AND IDENTIFIES TRENDS FOR EACH OF ITS MAJOR PAYOR SOURCES OF REVENUE TO ESTIMATE THE APPROPRIATE ALLOWANCE FOR DOUBTFUL ACCOUNTS AND PROVISION FOR BAD DEBTS. FOR RECEIVABLES ASSOCIATED WITH SERVICES PROVIDED TO PATIENTS WHO HAVE THIRD-PARTY COVERAGE (WHICH INCLUDES PATIENTS WITH DEDUCTIBLE AND COPAYMENT BALANCES DUE FOR WHICH THIRD-PARTY COVERAGE EXISTS FOR PART OF THE BILL), THE HOSPITAL ANALYZES CONTRACTUALLY DUE AMOUNTS AND PROVIDES AN ALLOWANCE FOR DOUBTFUL ACCOUNTS AND A PROVISION FOR BAD DEBTS, IF NECESSARY. FOR RECEIVABLES ASSOCIATED WITH SELF-PAY PATIENTS, THE HOSPITAL RECORDS A SIGNIFICANT PROVISION FOR BAD DEBTS IN THE PERIOD OF SERVICE ON THE BASIS OF ITS PAST EXPERIENCE, WHICH INDICATES THAT MANY PATIENTS ARE UNABLE TO PAY THE PORTION OF THEIR BILL FOR WHICH THEY ARE FINANCIALLY RESPONSIBLE. THE DIFFERENCE BETWEEN THE BILLED RATES AND THE AMOUNTS ACTUALLY COLLECTED AFTER ALL REASONABLE COLLECTION EFFORTS HAVE BEEN EXHAUSTED IS CHARGED OFF AGAINST THE ALLOWANCE FOR DOUBTFUL ACCOUNTS.THE HOSPITAL'S SELF-PAY ACCOUNT WRITEOFFS (NET OF RECOVERIES) INCREASED FROM APPROXIMATELY $5,423,000 IN 2017 TO APPROXIMATELY $6,100,000 IN 2018. THE INCREASE WAS THE RESULT OF THE AVAILABILITY OF HIGHER DEDUCTIBLE INSURANCE PLANS THROUGH MARYLAND'S HEALTHCARE EXCHANGE EFFECTIVE JANUARY 1, 2014 OFFSET BY A CHANGE IN THE CHARITY CARE POLICY IN JUNE 2016 WHICH RESULTED IN AN INCREASE IN PATIENTS QUALIFYING FOR CHARITY CARE. THE HOSPITAL HAS NOT CHANGED THEIR FINANCIAL ASSISTANCE POLICY IN 2018.
PART III, LINE 8:	COSTING METHODOLOGY USED TO DETERMINE AMOUNT OF MEDICARE ALLOWABLE COSTS: MEDICARE ALLOWABLE COSTS EQUAL MEDICARE REVENUE ADJUSTED FOR THE HOSPITAL TOTAL RATIO OF PATIENT CARE COSTS TO CHARGES DUE TO THE FACT THAT MEDICARE PAYS FULL CHARGES IN MARYLAND.EXTENT TO WHICH MEDICARE SHORTFALL SHOULD BE TREATED AS COMMUNITY BENEFIT: IN THE STATE OF MARYLAND, MEDICARE PAYS FULL CHARGES. THERE IS NO SHORTFALL THAT SHOULD BE TREATED AS A COMMUNITY BENEFIT.
PART III, LINE 9B:	THE POLICY'S SECTION LABELED, "INTERNAL COLLECTION EFFORTS," STATES THAT A "PATIENT MAY ALSO APPLY FOR FINANCIAL ASSISTANCE AT ANY TIME DURING THIS PROCESS (COLLECTIONS) AND THEN THE FINANCIAL ASSISTANCE POLICY (F-415) IS REFERENCED FOR MORE INFORMATION. THE SECTION IN F-415 THAT DESCRIBES THE COLLECTION PROCESS IS CALLED "ACTION IN THE EVENT OF NON-PAYMENT": "A.) UNION HOSPITAL MAY CONTRACT WITH OUTSIDE COLLECTION SERVICES TO PURSUE COLLECTION OF DELINQUENT ACCOUNTS. ALL UNPAID ACCOUNTS WITHOUT EXCEPTION OR PAYMENT ARRANGEMENTS ARE PLACED IN OUTSIDE COLLECTION AFTER A MINIMUM OF 90 DAYS FROM THE INITIAL BILLING STATEMENT AND DELIVERY OF ALL SCHEDULED PATIENT ACCOUNT STATEMENTS TO THE PATIENT/GUARANTOR. B.) UNION HOSPITAL DOES NOT CONDUCT, OR PERMIT COLLECTION AGENCIES TO CONDUCT ON THEIR BEHALF, EXTRAORDINARY COLLECTIONS EFFORTS AGAINST INDIVIDUALS."IN ADDITION, THE POLICY F-416 UNDER THE SECTION, "EXTERNAL COLLECTION (BAD DEBT WRITE-OFF)," EXPLAINS THAT "PATIENTS WITH BALANCES BEING COLLECTED BY AN ASSIGNED COLLECTION AGENCY WILL HAVE THEIR BALANCES WRITTEN OFF IF THEY ARE DETERMINED TO BE INDIGENT".
PART VI, LINE 2:	THE CHNA REFLECTS THE CURRENT STATUS OF THE MEDICAL AND SOCIAL DETERMINANTS OF HEALTH FOR CECIL COUNTY AND PROVIDES QUALITATIVE FEEDBACK ON KEY HEALTH ISSUES. THE CHNA IS COMPRISED OF AN ANALYSIS OF BOTH PRIMARY AND SECONDARY DATA. PRIMARY DATA WAS TAKEN FROM RESULTS FROM AN ONLINE COMMUNITY SURVEY CONDUCTED WITH ADULT (AGED 18 YEARS OR OLDER) CECIL COUNTY RESIDENTS AND THREE FOCUS GROUPS CONDUCTED WITH COMMUNITY RESIDENTS. SECONDARY DATA WAS TAKEN FROM A VARIETY OF RELIABLE NATIONAL AND LOCAL DATA SOURCES (LOCAL DATA WAS COMPARED, WHEN POSSIBLE, AGAINST STATE AND NATIONAL TRENDS). IN ADDITION, TWO COMMUNITY HEALTH ADVISORY COMMITTEE (CHAC) MEETINGS WERE HELD TO HELP SELECT THE HEALTH PRIORITIES FOR CECIL COUNTY AND BEGIN FORMATION OF STRATEGIES TO ADDRESS THEM. THE CHNA WAS CONDUCTED FROM QUARTER 3 OF FISCAL YEAR 2015 THROUGH QUARTER 3 OF FISCAL YEAR 2016. THE CHNA PROCESS REFLECTS COLLABORATION OF COMMUNITY PARTNERS WORKING TOGETHER TO ACHIEVE THE SAME HEALTH IMPROVEMENT GOALS FOR CECIL COUNTY.SEE ADDITIONAL DETAIL REGARDING THE NEEDS ASSESSMENT IN OUR RESPONSE TO PART V, SECTION B, LINE 3.
PART VI, LINE 3:	UNION HOSPITAL OF CECIL COUNTY UTILIZES A FINANCIAL ASSISTANCE POLICY (FAP) TO ENSURE THAT THE HOSPITAL'S STAFF FOLLOWS A CONSISTENT AND EQUITABLE PROCESS IN GRANTING FINANCIAL ASSISTANCE TO PATIENTS, WHILE RESPECTING THE INDIVIDUAL'S DIGNITY. THE POLICY IS IN AGREEMENT WITH THE ESTABLISHED MARYLAND STATE FINANCIAL ASSISTANCE GUIDELINES. IN FACT, IN FISCAL YEAR 2015, UNION HOSPITAL'S FINANCE DEPARTMENT DIVISIONS OF MANAGED CARE, REVENUE CYCLE, AND BILLING BEGAN WORKING ON CHANGES TO THE FAP TO REFLECT THE ACA'S HEALTH CARE COVERAGE EXPANSION OPTION EFFECTIVE JANUARY 1, 2014. THE RESULTING REVISED FAP IS MORE COMPREHENSIVE IN THAT IT INCLUDES MORE DESCRIPTIONS, PATIENT EXPECTATIONS, AND CONTENT THAT IS EASY TO FOLLOW AND DIGEST. NEW SECTIONS THAT GIVE THE FAP MORE DEPTH INCLUDE: DEFINITIONS, SCOPE, PRESUMPTIVE ELIGIBILITY, ELIGIBILITY PERIOD, RECONSIDERATION OF DENIAL OF FREE OR REDUCED-COST CARE, MEDICAL DEBT DETERMINATION (LIMIT ON CHARGES), ACTION IN THE EVENT OF NON-PAYMENT, ENSURING COMPLIANCE , PLAIN LANGUAGE SUMMARY, AND REFERENCES.THE FAP CLEARLY DEFINES PATIENT EXPECTATIONS, OFFERS A STEP-BY-STEP PROCESS FOR PATIENT APPLICATION, DOCUMENT REVIEW, AND REQUEST FOR MORE INFORMATION. ANY INDIVIDUAL WHO PRESENTS TO UNION HOSPITAL IN PERSON TO DISCUSS HIS/HER BILL IS PROVIDED WITH A FINANCIAL ASSISTANCE APPLICATION. ALL INPATIENT, SELF-PAY PATIENTS ARE VISITED BY FINANCIAL ASSISTANCE NAVIGATORS AND ARE SCREENED FOR THE FINANCIAL ASSISTANCE PROGRAM, AS WELL AS FOR MEDICAID AND OTHER STATE AND COUNTY PROGRAMS. FOLLOWING DISCHARGE FROM THE HOSPITAL, EACH PATIENT RECEIVES A SUMMARY OF CHARGES WHICH INCLUDES NOTICE OF THE FINANCIAL ASSISTANCE PROGRAM AND A DESIGNATED CONTACT TELEPHONE NUMBER AND EMAIL. PATIENT BILLING ALSO INCLUDES INFORMATION ON HOW TO APPLY FOR FINANCIAL ASSISTANCE.THE FINANCIAL ASSISTANCE APPLICATION IS AVAILABLE TO ALL UNDERINSURED AND UNINSURED PATIENTS OF UNION HOSPITAL. ALL FINANCIAL ASSISTANCE APPLICATIONS RECEIVED ARE PROCESSED FOR ELIGIBILITY. PATIENTS WHO ARE NOT ELIGIBLE FOR FINANCIAL ASSISTANCE ARE REFERRED TO THE CECIL COUNTY HEALTH DEPARTMENT, OTHER STATE PROGRAMS, THE MARYLAND HEALTH CONNECTION, AND MEDICAID TO DETERMINE IF OTHER ASSISTANCE IS AVAILABLE. FINANCIAL ASSISTANCE APPLICATIONS AND FAP SIGNAGE ARE LOCATED THROUGHOUT THE HOSPITAL, EMERGENCY ROOM, AND OUTPATIENT AREAS. THE FINANCIAL ASSISTANCE APPLICATION AND BROCHURE (ENGLISH AND SPANISH) ARE AVAILABLE ON THE HOSPITAL'S WEBSITE: HTTPS://WWW.UHCC.COM/PATIENT-FINANCIAL-SERVICES/FINANCIAL-ASSISTANCE/. IN ADDITION, UNION HOSPITAL PLACES AN ADVERTISEMENT ONCE A YEAR IN THE LOCAL NEWSPAPERS OUTLINING THE FAP, HOW TO ACCESS FINANCIAL ASSISTANCE MATERIALS, AND HOW TO APPLY FOR FINANCIAL ASSISTANCE.
PART VI, LINE 4:	UNION HOSPITAL IS THE ONLY HOSPITAL IN CECIL COUNTY AND SERVES THE ENTIRE COUNTY. THEREFORE, THE HOSPITAL'S COMMUNITY BENEFIT SERVICE AREA (CBSA) IS INCLUSIVE OF THE HOSPITAL'S PRIMARY AND SECONDARY SERVICE AREAS. THE PRIMARY SERVICE AREAS INCLUDE ELKTON, NORTH EAST, CHILDS, ELK MILLS, CHESAPEAKE CITY, CHARLESTOWN, RISING SUN, WARWICK, CECILTON, & EARLEVILLE. THE SECONDARY SERVICE AREAS INCLUDE PERRYPOINT, PERRYVILLE, PORT DEPOSIT, COLORA, CONOWINGO, & GEORGETOWN.A MAJORITY OF UNION HOSPITAL'S COMMUNITY BENEFIT RESOURCES ARE FOCUSED WITHIN ELKTON (21921) AND NORTH EAST (21901) HOSPITAL UTILIZATION SHOWS THAT 60% OF THE HOSPITAL'S PATIENTS COME FROM ELKTON AND NORTH EAST.GEOGRAPHY PLAYS A SIGNIFICANT ROLE IN VULNERABILITY AND POVERTY IN CECIL COUNTY. THERE IS POVERTY IN THE RURAL AREAS, LIKE CONOWINGO, EARLEVILLE, AND CECILTON, BUT ALSO IN ELKTON WHICH IS URBAN-RURAL. IN ADDITION, PEOPLE THAT RESIDE IN THE AREAS BELOW THE C&D CANAL (WARWICK, CHESAPEAKE CITY, CECILTON, EARLEVILLE, AND GEORGETOWN) AND WEST OF THE TOWN OF NORTH EAST (PERRY POINT, PERRYVILLE, PORT DEPOSIT, CHARLESTOWN, COLORA, AND CONOWINGO) OFTEN HAVE THE DIFFICULTY ACCESSING SERVICES BECAUSE OF THE DISTANCE TO THE NEAREST SERVICE PROVIDER, LACK OF RELIABLE TRANSPORTATION, AND THE IMPACT OF OTHER SOCIAL DETERMINANTS OF HEALTH.THE ESTIMATED TOTAL POPULATION OF CECIL COUNTY IN 2017 WAS 102,175 PEOPLE. OF THE TOTAL COUNTY POPULATION, 50.5% WAS FEMALE AND 49.5% WAS MALE. THE MEDIAN AGE WAS 40.2 YEARS, AND THE MEDIAN HOUSEHOLD INCOME WAS $67,938.THE ETHNIC MAKE-UP OF THE COUNTY WAS 4% HISPANIC/LATINO AND 96% NON-HISPANIC/LATINO. THE RACIAL MAKE-UP OF THE COUNTY WAS:- WHITE: 88.6%- AFRICAN AMERICAN: 6.7% - AMERICAN INDIAN/ALASKAN NATIVE: 0.2%- ASIAN: 1.3%- NATIVE HAWAIIAN/OTHER PACIFIC ISLANDER: 0%- SOME OTHER RACE: 0.9%- TWO OR MORE RACES: 2.1%ADDITIONAL CECIL COUNTY DEMOGRAPHIC ESTIMATES FOR 2017 INCLUDED: - 6.6% UNEMPLOYMENT - 7.3% OF FAMILIES LIVED BELOW THE POVERTY LEVEL - OF THE CIVILIAN, NON-INSTITUTIONALIZED POPULATION, 7% WAS UNINSURED AND 93% HAD INSURANCE COVERAGE- OF THOSE WITH HEALTH INSURANCE COVERAGE, 32.4% HAD PUBLIC COVERAGE (EX. MEDICAID) AND 72.5% WERE PRIVATELY INSURED
PART VI, LINE 5:	EACH FISCAL YEAR, UNION HOSPITAL SERVES THE CECIL COUNTY COMMUNITY BY PROVIDING ACTIVITIES, PROGRAMS, AND INITIATIVES THAT AIM TO IMPROVE COMMUNITY HEALTH, ESPECIALLY SERVING UNDERSERVED AREAS AND VULNERABLE POPULATIONS. THE FOLLOWING IS A SUMMARY OF THE COMMUNITY BENEFIT ACTIVITIES, PROGRAMS, AND INITIATIVES THAT UNION HOSPITAL PROVIDED IN CECIL COUNTY DURING FISCAL YEAR 2018:A1: COMMUNITY HEALTH EDUCATIONUNION HOSPITAL PROVIDED:- A VARIETY OF HEALTH EDUCATION PRESENTATIONS AND ACTIVITIES IN THE COMMUNITY- FREE BASIC LIFE SUPPORT INSTRUCTION IN THE COMMUNITY- EXPLORER POST AT UNION HOSPITAL AND CAMP SCRUBS FOR HIGH SCHOOL STUDENTS SEEKING EXPOSURE TO MEDICAL OR HEALTH SCIENCE EXPERIENCES- SUPPORT GROUPS FOR VARIOUS HEALTH NEEDS- HEALTH FAIRS IN THE COMMUNITY- HEALTH LITERACY ACTIVITIES IN PARTNERSHIP WITH CECIL COUNTY PUBLIC LIBRARIES AND THE CECIL COUNTY HEALTH DEPARTMENTA2: COMMUNITY-BASED CLINICAL SERVICESUNION HOSPITAL PROVIDED:- A FREE DIABETES CLINIC IN PARTNERSHIP WITH CECIL COUNTY PUBLIC LIBRARIES IN ORDER TO CONNECT CLIENTS WITH EDUCATION AND SUPPORT FOR PREVENTION AND MANAGEMENT OF PRE-DIABETES AND DIABETES, AS WELL AS NUTRITION COUNSELING - FREE SCREENINGS IN THE COMMUNITY FOR PROSTATE AND HEAD AND NECK CANCERS- FREE SPORTS PHYSICALS CLINIC FOR COUNTY PUBLIC AND PRIVATE HIGH SCHOOL STUDENTSA3: HEALTH CARE SUPPORT SERVICESUNION HOSPITAL PROVIDED:- MEDICAL EXAMINATIONS FOR ABUSED CHILDREN IN CONJUNCTION WITH DEPARTMENT OF SOCIAL SERVICES AND THE CECIL COUNTY CHILD ADVOCACY CENTER- RENTAL RELIEF AND OPERATIONAL EXPENSE RELIEF FOR THE PERRYVILLE DENTAL CLINIC (SERVES UNDERSERVED DENTAL NEEDS IN CECIL COUNTY)- A PARTNERSHIP EFFORT WITH THE CECIL COUNTY HEALTH DEPARTMENT TO PROVIDE INTERVENTIONAL SUPPORT TO REDUCE FALLS INSIDE AND OUTSIDE THE HOSPITAL VIA PATIENT CONNECTION TO COMMUNITY HEALTH RESOURCES- INTERPRETING SERVICES BEYOND THE STANDARD OF CARE (FACILITATED THROUGH THE HOSPITAL'S QUALIFIED BILINGUAL STAFF PROGRAM)- SUPPORT FOR THE PEER RECOVERY ADVOCATE PROGRAM, A PARTNERSHIP BETWEEN THE ALCOHOL AND DRUG RECOVERY CENTER AT THE CECIL COUNTY HEALTH DEPARTMENT AND UNION HOSPITAL'S EMERGENCY DEPARTMENT AND PSYCH UNIT AND CRISIS INTERVENTION SERVICES NURSING STAFF- SUPPORT FOR TOBACCO CESSATION EFFORTS PROVIDED BY THE CECIL COUNTY HEALTH DEPARTMENTA4: SOCIAL AND ENVIRONMENTAL IMPROVEMENTSUNION HOSPITAL:- SUPPORTED THE HOSPITAL'S PARTNER IN EDUCATION, GILPIN MANOR ELEMENTARY SCHOOL, THROUGH DONATIONS AND COMMUNITY HEALTH EDUCATION OPPORTUNITIES FOR FAMILIES- PROVIDED TRANSPORTATION DONATIONS FOR ELIGIBLE PATIENTS AND THEIR FAMILIES- SUPPORTED CECIL CARES' COUNTY-WIDE "DAY OF CARING" VIA PLANNING MEETINGS- SUPPORTED A CHRISTMAS IN APRIL EVENT TO PROVIDE HOUSING IMPROVEMENTS FOR A VULNERABLE CECIL COUNTY RESIDENT- SUPPORTED HABITAT-FOR-HUMANITY SUSQUEHANNA THROUGH BUILD DAYS AND OTHER VOLUNTEER SUPPORT- PARTICIPATED IN BOARD SERVICE WITH ORGANIZATIONS SUPPORTING SOCIAL AND ENVIRONMENTAL HEALTH- PROVIDED TRANSPORTATION DONATIONS FOR ELIGIBLE PATIENTS AND THEIR FAMILIESB: HEALTH PROFESSIONS EDUCATIONUNION HOSPITAL STAFF PRECEPTED AND MENTORED STUDENTS THROUGH A VARIETY OF STUDENT EXPERIENCES FROM NURSING AND OTHER MEDICAL RESIDENCY AND CLINICAL ROTATIONS TO GRADUATE STUDENT INTERNSHIPS, ALLIED HEALTH STUDENT EXPERIENCES, AND HIGH SCHOOL TECHNOLOGY AND APPLIED SCIENCES PROGRAMS.C: MISSION DRIVEN HEALTH SERVICESUNION HOSPITAL PROVIDED THESE SERVICES TO MEET IDENTIFIED NEEDS IN THE COMMUNITY, EVEN THOUGH THEY OPERATE AT A LOSS:- A FREE OSTOMY CLINIC (C3)- EMPLOYED PHYSICIAN PRACTICE SUBSIDIES (C3)- ADULT DAY SERVICES FOR OLDER ADULT CLIENTS WITH DEMENTIA AND OTHER NEUROLOGICAL DISORDERS (C7)- FREE HOSPICE SUPPORT (C9)D1: CLINICAL RESEARCHUNION HOSPITAL MAINTAINED A CANCER REGISTRY THROUGH THE CANCER PROGRAM THAT WAS AVAILABLE TO HEALTH SERVICE PROVIDERS AND RESEARCHERS.E1-3: FINANCIAL/IN-KIND CONTRIBUTIONS UNION HOSPITAL PROVIDED DONATIONS OF TIME (STAFF HOURS) AND MONEY (EQUIPMENT/SUPPLIES DONATIONS) FOR THE CECIL COUNTY COMMUNITY BY:- PROVIDING FREE AMBULANCE TRANSPORTS AND FREE SUPPLIES FOR AMBULANCE STOCK-UPS- GIVING BLOOD AT HOSPITAL BLOOD DRIVES AND OTHER LOCAL DONOR LOCATIONS- PROVIDING VOLUNTEER MEDICAL DIRECTORSHIP FOR THE CECIL COUNTY PREGNANCY CENTER- COORDINATING EDUCATIONAL LECTURES AT THE HOSPITAL OPEN TO EMERGENCY SERVICES PERSONNEL AND HOSPITAL EMERGENCY DEPARTMENT STAFF FOCUSED ON IMPROVING EMERGENCY RESPONSE IN THE COMMUNITY - ATTENDING MEETINGS FOR COMMUNITY HEALTH IMPROVEMENT (LOCAL HEALTH IMPROVEMENT COALITION, COMMUNITY BOARDS, ETC.)- SERVING AND EDUCATING THE HOMELESS- PROVIDING FOOD FOR MINISTRIES IN PARTNERSHIP WITH LOCAL COMMUNITY AGENCIES, CHURCHES, AND OTHER LOW-INCOME AND POOR SERVING MINISTRIES- PROVIDING FOOD FOR THE HOME DELIVERED MEALS (MEALS ON WHEELS) PROGRAM IN A PARTNERSHIP BETWEEN UNION HOSPITAL'S FOOD SERVICE DEPARTMENT AND THE CECIL COUNTY DEPARTMENT OF COMMUNITY SERVICES' AGING AND DISABILITY RESOURCE CENTER AND COMMUNITY WELLNESS DIVISION- PROVIDING FREE NOTARY SERVICES FOR THE COMMUNITYJ: FOUNDATION FUNDED COMMUNITY BENEFITTHE UNION HOSPITAL FOUNDATION PROVIDED FUNDING FOR THE COMMUNITY ASSISTED MEDICATIONS PROGRAM (CAMP) WHICH PROVIDES REDUCED-COST MEDICATIONS TO PATIENTS THAT QUALIFY FOR HOSPITAL FINANCIAL ASSISTANCE.
PART VI, LINE 6:	UNION HOSPITAL OF CECIL COUNTY, INC. IS PART OF AN AFFILIATED HEALTH CARE SYSTEM IN WHICH AFFINITY HEALTH ALLIANCE, INC. (AHA) IS THE PARENT ENTITY. AHA'S PURPOSE IS TO SUPPORT THE UNION HOSPITAL OF CECIL COUNTY IN PROVIDING HEALTH CARE AND HEALTH CARE RELATED SERVICES THROUGH THE EFFECTIVE MANAGEMENT OF ALL AFFILIATED CORPORATIONS. SPECIFICALLY, THIS INVOLVES COORDINATING SYSTEM WIDE POLICIES, FUNDRAISING AND STRATEGIC PLANNING PROGRAMS TO PROVIDE HEALTH CARE SERVICES IN RESPONSE TO THE MEDICAL, HUMAN AND RELATED SERVICE NEEDS OF THE COMMUNITY.OTHER TAX-EXEMPT ORGANIZATIONS IN THE GROUP INCLUDE THE UNION HOSPITAL OF CECIL COUNTY FOUNDATION, INC., UNION HOSPITAL OF CECIL COUNTY HEALTH SERVICES, INC., AND UNION HOSPITAL OF CECIL COUNTY ONCOLOGY, INC.THE FOUNDATION CONDUCTS AND SUPERVISES FUNDRAISING ACTIVITIES ON BEHALF OF ITS TAX-EXEMPT AFFILIATES. THE FOUNDATION ENGAGES IN CORPORATE FUNDRAISING, CAPITAL CAMPAIGNS, SPECIAL EVENTS, ACTIVITIES, AND A MULTI-FACETED COMMUNICATION PROGRAM THAT APPEALS TO PRIVATE AND CORPORATE CONTRIBUTORS.UNION HOSPITAL OF CECIL COUNTY HEALTH SERVICES, INC.'S MISSION IS TO OWN, MANAGE AND MAINTAIN PROPERTIES FOR HEALTH RELATED VENTURES TO SERVE CECIL COUNTY AND THE SURROUNDING AREAS. THE ACTIVITIES OF THIS CORPORATION COMPLEMENT AND AUGMENT THE HEALTH CARE ACTIVITIES OF THE HOSPITAL.UNION HOSPITAL OF CECIL COUNTY ONCOLOGY, INC'S (THE "CORPORATION") DUTY AND MISSION IS TO PROVIDE HIGH QUALITY, ADVANCED RADIATION ONCOLOGY SERVICES TO THE CECIL COUNTY AREA IN ORDER TO FOSTER THE BEST CANCER TREATMENT PROCESS CLOSE TO HOME. CANCER-RELATED DEATHS ARE AMONG THE HIGHEST CAUSES OF MORTALITY IN CECIL COUNTY, SO IT IS THE CORPORATION'S MISSION TO BRING SOME OF THE MOST ADVANCED RADIATION THERAPIES TO CECIL COUNTY TO PROVIDE THE MOST COMPREHENSIVE CANCER CARE POSSIBLE TO THE PEOPLE LIVING WITH CANCER HERE AND IN NEIGHBORING COMMUNITIES. BY OFFERING THESE ADVANCED CANCER TREATMENT OPTIONS, THE CORPORATION FURTHERS ITS CHARITABLE PURPOSE OF PROVIDING MEDICAL SERVICES TO PROMOTE THE HEALTH AND WELFARE OF THE RESIDENTS OF CECIL COUNTY AND NEIGHBORING COMMUNITIES.UNION HOSPITAL OF CECIL COUNTY VENTURES, INC. IS A FOR-PROFIT STOCK CORPORATION. ITS PURPOSE IS TO ENGAGE IN ANY BUSINESS OR TRANSACTION WHICH WILL BENEFIT THE ACTIVITIES AND GOALS OF ITS AFFILIATES. OPERATIONS CONSIST PRIMARILY OF PROVIDING MANAGEMENT SUPPORT SERVICES FOR PHYSICIAN PRACTICES AND PROVIDING IMAGING SERVICES TO PHYSICIANS AND HEALTH CENTERS THROUGH ITS WHOLLY OWNED SUBSIDIARIES, TRIANGLE ALLIANCE LLC AND OPEN MRI AND IMAGING CENTER OF ELKTON LLC.
PART VI, LINE 7, REPORTS FILED WITH STATES	MD

Schedule H (Form 990) 2019

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Schedule I
(Form 990)

Department of the Treasury
Internal Revenue Service

Grants and Other Assistance to Organizations,
Governments and Individuals in the United States

Complete if the organization answered "Yes," on Form 990, Part IV, line 21 or 22.
lBullet

Attach to Form 990.
lBullet

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2019

Open to Public
Inspection

Name of the organization
UNION HOSPITAL OF CECIL COUNTY INC

Employer identification number
52-0607945

Part I

General Information on Grants and Assistance

Does the organization maintain records to substantiate the amount of the grants or assistance, the grantees' eligibility for the grants or assistance, and
the selection criteria used to award the grants or assistance? ........................

Yes No

Describe in Part IV the organization's procedures for monitoring the use of grant funds in the United States.

Part II

Grants and Other Assistance to Domestic Organizations and Domestic Governments. Complete if the organization answered "Yes" on Form 990, Part IV, line 21, for any recipient

that received more than $5,000. Part II can be duplicated if additional space is needed.

(a) Name and address of organization or government	(b) EIN	(c) IRC section (if applicable)	(d) Amount of cash grant	(f) Method of valuation (book, FMV, appraisal, other)	(g) Description of noncash assistance	(h) Purpose of grant or assistance
(1) UNION HOSPITAL OF CECIL COUNTY HEALTH SERVICES INC 106 BOW STREET ELKTON,MD21921	52-1794553	501(C)(3)	2,094,180	N/A	N/A	CHARITABLE ACTIVITIES
(2) UNION HOSPITAL OF CECIL COUNTY ONCOLOGY INC 106 BOW STREET ELKTON,MD21921	81-2662359	501(C)(3)	931,648	N/A	N/A	CHARITABLE ACTIVITIES
(3) UNION HOSPITAL OF CECIL COUNTY FOUNDATION INC 106 BOW STREET ELKTON,MD21921	52-1794552	501(C)(3)	90,697	N/A	N/A	CHARITABLE ACTIVITIES

Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ................. Bullet Image

Enter total number of other organizations listed in the line 1 table ........................ . Bullet Image

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

Cat. No. 50055P

Schedule I (Form 990) 2019

Page 2

Part III

Grants and Other Assistance to Domestic Individuals. Complete if the organization answered "Yes" on Form 990, Part IV, line 22.
Part III can be duplicated if additional space is needed.

(a) Type of grant or assistance	(b) Number of recipients	(c) Amount of cash grant	(d) Amount of noncash assistance	(e) Method of valuation (book, FMV, appraisal, other)	(f) Description of noncash assistance

(1)
(2)
(3)
(4)
(5)
(6)
(7)

Part IV

Supplemental Information. Provide the information required in Part I, line 2; Part III, column (b); and any other additional information.

Return Reference	Explanation
PART I, LINE 2:	THE ORGANIZATION ONLY PROVIDES ASSISTANCE TO ITS AFFILIATED ENTITIES. IT DOES NOT PROVIDE GRANTS TO OTHER ORGANIZATIONS. USE OF FUNDS IS MONITORED BY MANAGEMENT.

Schedule I (Form 990) 2019

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Schedule J
(Form 990)

Department of the Treasury
Internal Revenue Service

Compensation Information

For certain Officers, Directors, Trustees, Key Employees, and Highest
Compensated Employees
SchJMediumBullet

Complete if the organization answered "Yes" on Form 990, Part IV, line 23.
SchJMediumBullet

Attach to Form 990.
SchJMediumBullet

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2019

Open to Public Inspection

Name of the organization

UNION HOSPITAL OF CECIL COUNTY INC

Employer identification number

52-0607945

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 on 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 on 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 .........

Did the organization require substantiation prior to reimbursing or allowing expenses incurred by all
directors, trustees, officers, including the CEO/Executive Director, regarding the items checked on Line 1a? ..

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 on 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), 501(c)(4), and 501(c)(29) organizations must complete lines 5-9.

For persons listed on 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," on line 5a or 5b, describe in Part III.

For persons listed on 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," on line 6a or 6b, describe in Part III.

For persons listed on Form 990, Part VII, Section A, line 1a, did the organization provide any nonfixed
payments not described in lines 5 and 6? If "Yes," describe in Part III ............

Yes

Were any amounts reported on 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" on 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) 2019

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 on 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 in column (B) reported as deferred on 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)
1RICHARD C SZUMEL MD PRESIDENT & CEO	(i) (ii)	0 ------------- 456,750	0 ------------- 0	0 ------------- 140,000	0 ------------- 86,783	0 ------------- 27,517	0 ------------- 711,050	0 ------------- 0
2JOSE MA MD DIRECTOR	(i) (ii)	310,100 ------------- 0	0 ------------- 0	0 ------------- 0	3,618 ------------- 0	21,088 ------------- 0	334,806 ------------- 0	0 ------------- 0
3JAMES G RAAB START 1017 SENIOR VP/CHIEF FINANCIAL OFFICER	(i) (ii)	91,691 ------------- 50,568	5,291 ------------- 0	1,189 ------------- 15,413	1,536 ------------- 779	17,920 ------------- 4,723	117,627 ------------- 71,483	0 ------------- 0
4LAURIE R BEYER CPA SENIOR VP/CFO (UNTIL 10/17)	(i) (ii)	0 ------------- 246,387	0 ------------- 75,991	0 ------------- 52,310	0 ------------- 52,960	0 ------------- 25,395	0 ------------- 453,043	0 ------------- 0
5CYDNEY TEAL MD VP MEDICAL AFFAIRS	(i) (ii)	0 ------------- 316,333	0 ------------- 62,656	0 ------------- 29,623	0 ------------- 4,050	0 ------------- 19,246	0 ------------- 431,908	0 ------------- 0
6ANNE LARA SR. VP/CHIEF INNOVATION OFFICER	(i) (ii)	0 ------------- 189,032	0 ------------- 30,289	0 ------------- 19,105	0 ------------- 2,032	0 ------------- 16,050	0 ------------- 256,508	0 ------------- 0
7AARON Z ROYSTON VP OF PROVIDER ENTERPRISE	(i) (ii)	188,125 ------------- 0	31,500 ------------- 0	17,351 ------------- 0	3,294 ------------- 0	1,086 ------------- 0	241,356 ------------- 0	0 ------------- 0
8KHADIJATU BOSTON UNTIL 0118 SR. VP/CHIEF NURSING OFFICER	(i) (ii)	0 ------------- 202,258	0 ------------- 34,488	0 ------------- 16,858	0 ------------- 3,591	0 ------------- 10,998	0 ------------- 268,193	0 ------------- 0
9TERRANCE LOVELL UNTIL 0118 VP HUMAN RESOURCES	(i) (ii)	209,538 ------------- 0	36,723 ------------- 0	19,980 ------------- 0	50,121 ------------- 0	28,170 ------------- 0	344,532 ------------- 0	0 ------------- 0
10FAHD RAHMAN PHYSICIAN	(i) (ii)	342,869 ------------- 0	193,500 ------------- 0	60,540 ------------- 0	4,050 ------------- 0	29,288 ------------- 0	630,247 ------------- 0	0 ------------- 0
11JUSTIN SAUSVILLE PHYSICIAN	(i) (ii)	368,448 ------------- 0	142,127 ------------- 0	31,922 ------------- 0	4,050 ------------- 0	29,331 ------------- 0	575,878 ------------- 0	0 ------------- 0
12ROGER WU PHYSICIAN	(i) (ii)	435,755 ------------- 0	45,220 ------------- 0	13,075 ------------- 0	4,050 ------------- 0	19,935 ------------- 0	518,035 ------------- 0	0 ------------- 0
13TARIQ MAHMOOD PHYSICIAN	(i) (ii)	258,939 ------------- 0	148,160 ------------- 0	5,472 ------------- 0	2,790 ------------- 0	28,322 ------------- 0	443,683 ------------- 0	0 ------------- 0
14DANIELLE PRESS PHYSICIAN	(i) (ii)	365,439 ------------- 0	25,750 ------------- 0	15,947 ------------- 0	3,338 ------------- 0	8,981 ------------- 0	419,455 ------------- 0	0 ------------- 0

Schedule J (Form 990) 2019

Page 3

Part III

Supplemental Information

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.

Return Reference

Explanation

PART I, LINES 4A-B

TERRENCE LOVELL, VP HUMAN RESOURCES, AND KHADIJATU BOSTON, SENIOR VP / CHIEF NURSING OFFICER RECEIVED SEVERANCE PAYMENTS DURING CALENDAR YEAR 2018. THE FOLLOWING PEOPLE PARTICIPATE IN A SUPPLEMENTAL, NON-QUALIFIED RETIREMENT PLAN UNDER SECTION 457(F) OF THE INTERNAL REVENUE CODE: LAURIE BEYER, SENIOR VP/CFO TERRENCE LOVELL, VP HUMAN RESOURCES THE FOLLOWING PAYMENTS HAVE BEEN CONTRIBUTED TO THE PLAN EACH CALENDAR YEAR SINCE 2011: 12/31/2011 - $51,431 (LAURIE BEYER) 12/31/2012 - $54,576 (LAURIE BEYER) 12/31/2013 - $59,861 (LAURIE BEYER) 12/31/2014 - $62,999 (LAURIE BEYER) 12/31/2015 - $56,574 (LAURIE BEYER) 12/31/2016 - $65,921 (LAURIE BEYER) 12/31/2017 - $48,910 (LAURIE BEYER) 12/31/2014 - $38,993 (TERRANCE LOVELL) 12/31/2015 - $38,731 (TERRANCE LOVELL) 12/31/2016 - $45,317 (TERRANCE LOVELL) 12/31/2017 - $46,281 (TERRANCE LOVELL) NO ONE RECEIVED A PAYMENT FROM THE PLAN IN CALENDAR YEAR 2017. THE RIGHT TO RECEIVE PAYMENTS UNDER THE PLAN SHALL BE FORFEITED IN THE EVENT THAT EMPLOYMENT WITH THE HOSPITAL TERMINATES PRIOR TO THE VESTING DATE FOR ANY REASON OTHER THAN INVOLUNTARY TERMINATION WITHOUT CAUSE, DEATH, OR DISABILITY.

PART I, LINE 7

A PORTION OF THE BONUSES AND MERIT INCREASE ARE TIED TO THE ORGANIZATIONAL GOALS, SUCH AS PATIENT SATISFACTION, QUALITY, EMPLOYEE TURNOVER, ETC. A PORTION OF THE BONUSES AND MERIT INCREASE ARE ALSO TIED TO EXPENSES PER EQUIVALENT INPATIENT DAYS OF UNION HOSPITAL OF CECIL COUNTY.

Schedule J (Form 990) 2019

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Schedule K
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Information on Tax-Exempt Bonds

Complete if the organization answered "Yes" to Form 990, Part Ⅵ, line 24a. Provide descriptions,
explanations, and any additional information in Part Ⅵ.
SchKMediumBullet

Attach to Form 990.
SchKMediumBullet

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2019

Open to Public
Inspection

Name of the organization
UNION HOSPITAL OF CECIL COUNTY INC

Employer identification number
52-0607945

Part Ⅰ

Bond Issues

(a) Issuer name		(b) Issuer EIN	(c) CUSIP #	(d) Date issued	(e) Issue price	(f) Description of purpose	(g) Defeased		(h) On behalf of issuer		(i) Pool financing
(a) Issuer name		(b) Issuer EIN	(c) CUSIP #	(d) Date issued	(e) Issue price	(f) Description of purpose	Yes	No	Yes	No	Yes	No
A	MARYLAND HEALTH & HIGHER EDUCATION FACILITIES AUTHORITY	52-0936091		12-01-2014	30,778,000	SEE PART VI		X		X		X
B	TOWN OF ELKTON	52-6000790		05-18-2012	10,000,000	SEE PART VI		X		X		X
C	TOWN OF ELKTON	52-6000790		05-18-2012	8,662,336	SEE PART VI		X		X		X
D	TOWN OF ELKTON	52-6000790		05-18-2012	9,000,000	SEE PART VI		X		X		X
	MARYLAND HEALTH & HIGHER EDUCATION FACILITIES AUTHORITY	52-0936091		07-18-2012	9,924,000	SEE PART VI		X		X		X
	MARYLAND HEALTH & HIGHER EDUCATION FACILITIES AUTHORITY	52-0936091		07-18-2012	4,007,000	SEE PART VI		X		X		X

Part Ⅱ

Proceeds

	A		B		C		D
	1 Amount of bonds retired ..................	420,000		1,922,012		3,216,314
2 Amount of bonds legally defeased ..............
3 Total proceeds of issue ..................	30,778,000		10,000,000		8,662,336		9,000,000
4 Gross proceeds in reserve funds .............
5 Capitalized interest from proceeds .............
6 Proceeds in refunding escrows ...............
7 Issuance costs from proceeds ...............
8 Credit enhancement from proceeds .............
9 Working capital expenditures from proceeds .............
10 Capital expenditures from proceeds .............			4,007,000
11 Other spent proceeds .............	30,778,000		10,000,000		8,662,336		9,000,000
12 Other unspent proceeds .............
13 Year of substantial completion .............	2014		2012		2012		2012
	Yes	No	Yes	No	Yes	No	Yes	No
14 Were the bonds issued as part of a current refunding issue of tax-exempt bonds (or, if issued prior to 2018, a current refunding issue)? ........
15 Were the bonds issued as part of an advance refunding issue of taxable bonds (or, if issued prior to 2018, an advance refunding issue)? ........
16 Has the final allocation of proceeds been made? ..........	X		X		X		X
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? ..................	X		X		X		X

Part Ⅲ

Private Business Use

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
1 Was the organization a partner in a partnership, or a member of an LLC, which owned property financed by tax-exempt bonds? .............		X		X		X		X
2 Are there any lease arrangements that may result in private business use of bond-financed property? ...............		X		X		X		X

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

Cat. No. 50193E

Schedule K (Form 990) 2019

Page 2

Part Ⅲ

Private Business Use (Continued)

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
3a Are there any management or service contracts that may result in private business use of bond-financed property? .............	X		X		X		X
b If "Yes" to line 3a, does the organization routinely engage bond counsel or other outside counsel to review any management or service contracts relating to the financed property?	X		X		X		X
c Are there any research agreements that may result in private business use of bond-financed property? .............		X		X		X		X
d If "Yes" to line 3c, does the organization routinely engage bond counsel or other outside counsel to review any research agreements relating to the financed property?
4 Enter the percentage of financed property used in a private business use by entities other than a section 501(c)(3) organization or a state or local government ....	0 %		0 %		0 %		0 %
5 Enter the percentage of financed property used in a private business use as a result of unrelated trade or business activity carried on by your organization, another section 501(c)(3) organization, or a state or local government .........	0 %		0 %		0 %		0 %
6 Total of lines 4 and 5 .............	0 %		0 %		0 %		0 %
7 Does the bond issue meet the private security or payment test? ...		X		X		X		X
8a Has there been a sale or disposition of any of the bond-financed property to a nongovernmental person other than a 501(c)(3) organization since the bonds were issued?.............		X		X		X		X
b If "Yes" to line 8a, enter the percentage of bond-financed property sold or disposed of. ..
c If "Yes" to line 8a, was any remedial action taken pursuant to Regulations sections 1.141-12 and 1.145-2? .............
9 Has the organization established written procedures to ensure that all nonqualified bonds of the issue are remediated in accordance with the requirements under Regulations sections 1.141-12 and 1.145-2? ........	X		X		X		X

Part Ⅳ

Arbitrage

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
1 Has the issuer filed Form 8038-T, Arbitrage Rebate, Yield Reduction and Penalty in Lieu of Arbitrage Rebate? ...		X		X		X		X
2 If "No" to line 1, did the following apply? ....
a Rebate not due yet? .......		X		X		X		X
b Exception to rebate? ........	X		X		X		X
c No rebate due? .........		X		X		X		X
If "Yes" to line 2c, provide in Part Ⅵ the date the rebate computation was performed ......
3 Is the bond issue a variable rate issue? .....		X		X		X		X
4a Has the organization or the governmental issuer entered into a qualified hedge with respect to the bond issue?		X		X		X		X
b Name of provider ..........
c Term of hedge .........
d Was the hedge superintegrated? ......
e Was the hedge terminated? ........

Schedule K (Form 990) 2019

Page 3

Part Ⅳ

Arbitrage (Continued)

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
5a Were gross proceeds invested in a guaranteed investment contract (GIC)?		X		X		X		X
b Name of provider ..........
c Term of GIC .........
d Was the regulatory safe harbor for establishing the fair market value of the GIC satisfied? ........
6 Were any gross proceeds invested beyond an available temporary period?		X		X		X		X
7 Has the organization established written procedures to monitor the requirements of section 148? ...	X		X		X		X

Part Ⅴ

Procedures To Undertake Corrective Action

---------------------------------------------------------------------------------------------------------------	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
Has the organization established written procedures to ensure that violations of federal tax requirements are timely identified and corrected through the voluntary closing agreement program if self-remediation is not available under applicable regulations?	X		X		X		X

Part Ⅵ

Supplemental Information. Provide additional information for responses to questions on Schedule K. (See instructions).

Return Reference	Explanation
PART I, COLUMN (F)	ISSUE A: TO REFINANCE THE 2005 BONDS. ISSUE B: TO REFUND PORTION OF SERIES 2009 BONDS. ISSUE C: TO REFUND REMAINING PORTION OF SERIES 2009 BONDS AND ALL OF SERIES 2000 BONDS. ISSUE D: TO FUND AN ESCROW WHICH REPAYS A PORTION OF THE SERIES 2002 BONDS AND INTEREST THEREON. ISSUE E: TO REFUND REMAINING PORTION OF SERIES 2002 BONDS. ISSUE F: TO FINANCE ACQUISITION OF EQUIPMENT AND CLOSING COSTS.

Schedule K (Form 990) 2019

Additional Data

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Schedule K
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Information on Tax-Exempt Bonds

Complete if the organization answered "Yes" to Form 990, Part Ⅵ, line 24a. Provide descriptions,
explanations, and any additional information in Part Ⅵ.
SchKMediumBullet

Attach to Form 990.
SchKMediumBullet

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2019

Open to Public
Inspection

Name of the organization
UNION HOSPITAL OF CECIL COUNTY INC

Employer identification number
52-0607945

Part Ⅰ

Bond Issues

(a) Issuer name		(b) Issuer EIN	(c) CUSIP #	(d) Date issued	(e) Issue price	(f) Description of purpose	(g) Defeased		(h) On behalf of issuer		(i) Pool financing
(a) Issuer name		(b) Issuer EIN	(c) CUSIP #	(d) Date issued	(e) Issue price	(f) Description of purpose	Yes	No	Yes	No	Yes	No
A	MARYLAND HEALTH & HIGHER EDUCATION FACILITIES AUTHORITY	52-0936091		12-01-2014	30,778,000	SEE PART VI		X		X		X
B	TOWN OF ELKTON	52-6000790		05-18-2012	10,000,000	SEE PART VI		X		X		X
C	TOWN OF ELKTON	52-6000790		05-18-2012	8,662,336	SEE PART VI		X		X		X
D	TOWN OF ELKTON	52-6000790		05-18-2012	9,000,000	SEE PART VI		X		X		X
	MARYLAND HEALTH & HIGHER EDUCATION FACILITIES AUTHORITY	52-0936091		07-18-2012	9,924,000	SEE PART VI		X		X		X
	MARYLAND HEALTH & HIGHER EDUCATION FACILITIES AUTHORITY	52-0936091		07-18-2012	4,007,000	SEE PART VI		X		X		X

Part Ⅱ

Proceeds

	A		B		C		D
	1 Amount of bonds retired ..................	420,000		1,922,012		3,216,314
2 Amount of bonds legally defeased ..............
3 Total proceeds of issue ..................	30,778,000		10,000,000		8,662,336		9,000,000
4 Gross proceeds in reserve funds .............
5 Capitalized interest from proceeds .............
6 Proceeds in refunding escrows ...............
7 Issuance costs from proceeds ...............
8 Credit enhancement from proceeds .............
9 Working capital expenditures from proceeds .............
10 Capital expenditures from proceeds .............			4,007,000
11 Other spent proceeds .............	30,778,000		10,000,000		8,662,336		9,000,000
12 Other unspent proceeds .............
13 Year of substantial completion .............	2014		2012		2012		2012
	Yes	No	Yes	No	Yes	No	Yes	No
14 Were the bonds issued as part of a current refunding issue of tax-exempt bonds (or, if issued prior to 2018, a current refunding issue)? ........
15 Were the bonds issued as part of an advance refunding issue of taxable bonds (or, if issued prior to 2018, an advance refunding issue)? ........
16 Has the final allocation of proceeds been made? ..........	X		X		X		X
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? ..................	X		X		X		X

Part Ⅲ

Private Business Use

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
1 Was the organization a partner in a partnership, or a member of an LLC, which owned property financed by tax-exempt bonds? .............		X		X		X		X
2 Are there any lease arrangements that may result in private business use of bond-financed property? ...............		X		X		X		X

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

Cat. No. 50193E

Schedule K (Form 990) 2019

Page 2

Part Ⅲ

Private Business Use (Continued)

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
3a Are there any management or service contracts that may result in private business use of bond-financed property? .............	X		X		X		X
b If "Yes" to line 3a, does the organization routinely engage bond counsel or other outside counsel to review any management or service contracts relating to the financed property?	X		X		X		X
c Are there any research agreements that may result in private business use of bond-financed property? .............		X		X		X		X
d If "Yes" to line 3c, does the organization routinely engage bond counsel or other outside counsel to review any research agreements relating to the financed property?
4 Enter the percentage of financed property used in a private business use by entities other than a section 501(c)(3) organization or a state or local government ....	0 %		0 %		0 %		0 %
5 Enter the percentage of financed property used in a private business use as a result of unrelated trade or business activity carried on by your organization, another section 501(c)(3) organization, or a state or local government .........	0 %		0 %		0 %		0 %
6 Total of lines 4 and 5 .............	0 %		0 %		0 %		0 %
7 Does the bond issue meet the private security or payment test? ...		X		X		X		X
8a Has there been a sale or disposition of any of the bond-financed property to a nongovernmental person other than a 501(c)(3) organization since the bonds were issued?.............		X		X		X		X
b If "Yes" to line 8a, enter the percentage of bond-financed property sold or disposed of. ..
c If "Yes" to line 8a, was any remedial action taken pursuant to Regulations sections 1.141-12 and 1.145-2? .............
9 Has the organization established written procedures to ensure that all nonqualified bonds of the issue are remediated in accordance with the requirements under Regulations sections 1.141-12 and 1.145-2? ........	X		X		X		X

Part Ⅳ

Arbitrage

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
1 Has the issuer filed Form 8038-T, Arbitrage Rebate, Yield Reduction and Penalty in Lieu of Arbitrage Rebate? ...		X		X		X		X
2 If "No" to line 1, did the following apply? ....
a Rebate not due yet? .......		X		X		X		X
b Exception to rebate? ........	X		X		X		X
c No rebate due? .........		X		X		X		X
If "Yes" to line 2c, provide in Part Ⅵ the date the rebate computation was performed ......
3 Is the bond issue a variable rate issue? .....		X		X		X		X
4a Has the organization or the governmental issuer entered into a qualified hedge with respect to the bond issue?		X		X		X		X
b Name of provider ..........
c Term of hedge .........
d Was the hedge superintegrated? ......
e Was the hedge terminated? ........

Schedule K (Form 990) 2019

Page 3

Part Ⅳ

Arbitrage (Continued)

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
5a Were gross proceeds invested in a guaranteed investment contract (GIC)?		X		X		X		X
b Name of provider ..........
c Term of GIC .........
d Was the regulatory safe harbor for establishing the fair market value of the GIC satisfied? ........
6 Were any gross proceeds invested beyond an available temporary period?		X		X		X		X
7 Has the organization established written procedures to monitor the requirements of section 148? ...	X		X		X		X

Part Ⅴ

Procedures To Undertake Corrective Action

---------------------------------------------------------------------------------------------------------------	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
Has the organization established written procedures to ensure that violations of federal tax requirements are timely identified and corrected through the voluntary closing agreement program if self-remediation is not available under applicable regulations?	X		X		X		X

Part Ⅵ

Supplemental Information. Provide additional information for responses to questions on Schedule K. (See instructions).

Return Reference	Explanation
PART I, COLUMN (F)	ISSUE A: TO REFINANCE THE 2005 BONDS. ISSUE B: TO REFUND PORTION OF SERIES 2009 BONDS. ISSUE C: TO REFUND REMAINING PORTION OF SERIES 2009 BONDS AND ALL OF SERIES 2000 BONDS. ISSUE D: TO FUND AN ESCROW WHICH REPAYS A PORTION OF THE SERIES 2002 BONDS AND INTEREST THEREON. ISSUE E: TO REFUND REMAINING PORTION OF SERIES 2002 BONDS. ISSUE F: TO FINANCE ACQUISITION OF EQUIPMENT AND CLOSING COSTS.

Schedule K (Form 990) 2019

Additional Data

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Schedule L
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Transactions with Interested Persons

Complete if the organization answered "Yes" on Form 990, Part IV, lines 25a, 25b, 26, 27, 28a, 28b, or 28c, or Form 990-EZ, Part V, line 38a or 40b.
MediumBullet

Attach to Form 990 or Form 990-EZ.
MediumBullet

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2019

Open to Public Inspection

Name of the organization

UNION HOSPITAL OF CECIL COUNTY INC

Employer identification number

52-0607945

Part I

Excess Benefit Transactions (section 501(c)(3), section 501(c)(4), and section 501(c)(29) organizations only).
Complete if the organization answered "Yes" on Form 990, Part IV, line 25a or 25b, or Form 990-EZ, Part V, line 40b.

1(a) Name of disqualified person	(c) Description of transaction	(d) Corrected?
1(a) Name of disqualified person	(c) Description of transaction	Yes	No

Enter the amount of tax incurred by the organization managers or disqualified persons during the year under section 4958. ........................... Bullet Image

Enter the amount of tax, if any, on line 2, above, reimbursed by the organization ........ Bullet Image

Part II

Loans to and/or From Interested Persons.
Complete if the organization answered "Yes" on Form 990-EZ, Part V, line 38a, or Form 990, Part IV, line 26; or if the organization reported an amount on Form 990, Part X, line 5, 6, or 22

(a) Name of interested person	(b) Relationship with organization	(c) Purpose of loan	(d) Loan to or from the organization?		(e) Original principal amount	(f) Balance due	(g) In default?		(h) Approved by board or committee?		(i) Written agreement?
(a) Name of interested person	(b) Relationship with organization	(c) Purpose of loan	To	From	(e) Original principal amount	(f) Balance due	Yes	No	Yes	No	Yes	No






Total ............... $

Part III

Grants or Assistance Benefiting Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 27.

(a) Name of interested person	(b) Relationship between interested person and the organization	(c) Amount of assistance	(d) Type of assistance	(e) Purpose of assistance

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

Cat. No. 50056A

Schedule L (Form 990 or 990-EZ) 2019

Page 2

Part IV

Business Transactions Involving Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 28a, 28b, or 28c.

(a) Name of interested person	(b) Relationship between interested person and the organization	(c) Amount of transaction	(d) Description of transaction	(e) Sharing of organization's revenues?
(a) Name of interested person		(c) Amount of transaction	(d) Description of transaction	Yes	No
(1) RYAN GERACIMOS	BOARD MEMBER	3,091,323	SEE PART V		No

Part V

Supplemental Information
Provide additional information for responses to questions on Schedule L (see instructions).

Return Reference	Explanation
SCHEDULE L, PART IV	DR. RYAN GERACIMOS IS THE PRINCIPAL OF UNION RADIOLOGISTS, LLC AND A BOARD MEMBER OF UNION HOSPITAL OF CECIL COUNTY (UHCC). UHCC CONTRACTS WITH UNION RADIOLOGISTS, LLC FOR RADIOLOGY SERVICES.

Schedule L (Form 990 or 990-EZ) 2019

Additional Data

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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 990-EZ or to provide any additional information.
MediumBullet

Attach to Form 990 or 990-EZ.
MediumBullet

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2019

Open to Public
Inspection

Name of the organization

UNION HOSPITAL OF CECIL COUNTY INC

Employer identification number

52-0607945

Return Reference	Explanation
FORM 990, PART VI, SECTION A, LINE 6	AFFINITY HEALTH ALLIANCE, INC. ("AHA"), A TAX-EXEMPT ORGANIZATION, IS THE SOLE MEMBER OF THE UNION HOSPITAL OF CECIL COUNTY, INC.
FORM 990, PART VI, SECTION A, LINE 7A	THE BYLAWS OF THE HOSPITAL PROVIDE THAT ITS DIRECTORS ARE APPOINTED BY ITS SOLE MEMBER, AHA.
FORM 990, PART VI, SECTION A, LINE 7B	THE BYLAWS OF THE HOSPITAL PROVIDE THAT ITS SOLE MEMBER (AHA) MAY AMEND ITS BYLAWS.
FORM 990, PART VI, SECTION B, LINE 11B	MANAGEMENT OF THE HOSPITAL REVIEWS THE 990 IN DETAIL BEFORE IT IS PRESENTED TO THE BOARD OF DIRECTORS OF THE ORGANIZATION. THE BOARD REVIEWS AND APPROVES THE FORM 990 PRIOR TO FILING WITH THE INTERNAL REVENUE SERVICE.
FORM 990, PART VI, SECTION B, LINE 12C	BOARD MEMBERS AND OFFICERS ARE REQUIRED TO ANNUALLY DISCLOSE ANY POTENTIAL CONFLICT OF INTEREST. THE ORGANIZATION'S CEO REVIEWS THE SIGNED ANNUAL DISCLOSURES. THE CORPORATE COMPLIANCE OFFICER IS MADE AWARE OF ANY DISCLOSED CONFLICT, INVESTIGATES THE CONFLICT, AND REPORTS BACK TO THE BOARD OF DIRECTORS. THE BOARD CONSIDERS THE FACTS AND MAKES AN APPROPRIATE FINDING. ANY BOARD MEMBER WITH A CONFLICT MUST ABSTAIN FROM BOARD DELIBERATIONS AND VOTING ON THE MATTER. ALL VICE PRESIDENTS ANNUALLY RECEIVE A LIST OF THE INDIVIDUALS UNDER THEIR SUPERVISION WHO MAY HAVE A POTENTIAL CONFLICT OF INTEREST. THE LIST IS COMPRISED OF ALL MANAGERS, CERTAIN PROFESSIONAL STAFF WHO MAY HAVE RESPONSIBILITY NEGOTIATING WITH VENDORS, AND ANY OTHER PERSONS THAT HOSPITAL EXECUTIVES DEEM APPROPRIATE. EACH VICE PRESIDENT REVIEWS THE CONFLICT OF INTEREST POLICY WITH THEIR DESIGNATED EMPLOYEES, AND EACH EMPLOYEE IS REQUIRED TO SIGN A FORM STIPULATING WHETHER OR NOT THEY HAVE A CONFLICT. THE FORMS ARE REVIEWED BY THE VICE PRESIDENT OF HUMAN RESOURCES. IF A CONFLICT IS NOTED, IT IS BROUGHT TO THE ATTENTION OF THE APPROPRIATE VICE PRESIDENT AND THE CEO TO DETERMINE WHETHER OPERATIONAL CHANGES NEED TO OCCUR BECAUSE OF THE POTENTIAL CONFLICT.
FORM 990, PART VI, SECTION B, LINE 15	THE COMPENSATION COMMITTEE OF THE ORGANIZATION'S BOARD OF DIRECTORS IS RESPONSIBLE FOR SETTING THE OVERALL COMPENSATION PHILOSOPHY OF THE ORGANIZATION, AS WELL AS SETTING, MONITORING AND REVIEWING THE COMPENSATION PACKAGE OF THE ORGANIZATION'S CEO AND OTHER MEMBERS OF THE EXECUTIVE MANAGEMENT TEAM. THE COMMITTEE USES RELEVANT MARKET INFORMATION, INCLUDING THE USE OF AN INDEPENDENT COMPENSATION CONSULTANT AND COMPENSATION STUDIES OR SURVEYS, TO SET COMPENSATION. DURING 2015, AN INDEPENDENT COMPENSATION CONSULTANT PROVIDED THE FOLLOWING SERVICES: EXECUTIVE COMPENSATION AND PERFORMANCE EVALUATION. COMPENSATION REVIEW AND APPROVAL IS DOCUMENTED VIA BOARD MINUTES.
FORM 990, PART VI, SECTION C, LINE 19	THE ORGANIZATION WILL MAKE ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST.
FORM 990, PART IX, LINE 11G	CONTRACTED SERVICES: PROGRAM SERVICE EXPENSES 8,930,190. MANAGEMENT AND GENERAL EXPENSES 852,757. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 9,782,947. PHYSICIAN SERVICES AND FEES: PROGRAM SERVICE EXPENSES 14,697,098. MANAGEMENT AND GENERAL EXPENSES 150,800. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 14,847,898. PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 1,675,791. MANAGEMENT AND GENERAL EXPENSES 5,185. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,680,976. AGENCY EMPLOYEES: PROGRAM SERVICE EXPENSES 3,888,415. MANAGEMENT AND GENERAL EXPENSES 58,613. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 3,947,028. TRANSCRIPTION: PROGRAM SERVICE EXPENSES 198,027. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 198,027. RECORD FILE STORAGE: PROGRAM SERVICE EXPENSES 147,370. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 147,370. CLEANING SERVICES: PROGRAM SERVICE EXPENSES 67,524. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 67,524. BILLING & COLLECTIONS: PROGRAM SERVICE EXPENSES 847,979. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 847,979.
FORM 990, PART XI, LINE 9:	CHANGE IN INTEREST IN NET ASSETS OF SUBSIDIARIES -119,898. IMPAIRMENT LOSS -569,956.

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

Cat. No. 51056K

Schedule O (Form 990 or 990-EZ) 2019

Additional Data

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SCHEDULE R
(Form 990)

Department of the Treasury
Internal Revenue Service

Related Organizations and Unrelated Partnerships

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

Attach to Form 990.
MediumBullet

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2019

Open to Public Inspection

Name of the organization

UNION HOSPITAL OF CECIL COUNTY INC

Employer identification number

52-0607945

Part I

Identification of Disregarded Entities. Complete if the organization answered "Yes" on 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

Part II

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

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Exempt Code section	(e) Public charity status (if section 501(c)(3))	(f) Direct controlling entity	(g) Section 512(b)(13) controlled 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)UNION HOSPITAL OF CECIL COUNTY FOUNDATION INC 106 BOW STREET ELKTON,MD21921 52-1794552	FUNDRAISING & SUPPORT	MD	501(C)(3)	LINE 7	AFFINITY HEALTH ALLIANCE INC		No
(2)UNION HOSPITAL OF CECIL COUNTY HEALTH SERVICES INC 106 BOW STREET ELKTON,MD21921 52-1794553	HEALTHCARE PROPERTY MANAGEMENT	MD	501(C)(3)	LINE 10	AFFINITY HEALTH ALLIANCE INC		No
(3)AFFINITY HEALTH ALLIANCE INC 106 BOW STREET ELKTON,MD21921 52-1794697	MANAGEMENT & SUPPORT	MD	501(C)(3)	LINE 12B, II	N/A		No
(4)UNION HOSPITAL OF CECIL COUNTY ONCOLOGY INC 106 BOW STREET ELKTON,MD21921 81-2662359	HEALTHCARE	MD	501(C)(3)	LINE 3	AFFINITY HEALTH ALLIANCE INC		No

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

Cat. No. 50135Y

Schedule R (Form 990) 2019

Page 2

Part III

Identification of Related Organizations Taxable as a Partnership. Complete if the organization answered "Yes" on Form 990, Part IV, line 34, because it had one or more related organizations treated as a partnership during the tax year.

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(f) Share of total income	(g) Share of end-of-year assets	(h) Disproprtionate allocations?		(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	(j) General or managing partner?
(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 V-UBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No

Part IV

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

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Type of entity (C corp, S corp, or trust)	(f) Share of total income	(g) Share of end-of-year assets	(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) UNION HOSPITAL OF CECIL COUNTY VENTURES INC 106 BOW STREET ELKTON,MD21921 52-1793691	MEDICAL SERVICES	MD	N/A	C				No

Schedule R (Form 990) 2019

Page 3

Part V

Transactions With Related Organizations. Complete if the organization answered "Yes" on 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) ............................

Yes

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) .................

Yes

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

Yes

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

Yes

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

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

Yes

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

Yes

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

Yes

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 related organization	(b) Transaction type (a-s)	(c) Amount involved	(d) Method of determining amount involved

Schedule R (Form 990) 2019

Page 4

Part VI

Unrelated Organizations Taxable as a Partnership. Complete if the organization answered "Yes" on Form 990, Part IV, line 37.

Provide the following information for each entity taxed as a partnership through which the organization conducted more than five percent of its activities (measured by total assets or gross revenue) that was not a related organization. See instructions regarding exclusion for certain investment partnerships.

(a) Name, address, and EIN of entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	(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 V-UBI 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 V-UBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No

Schedule R (Form 990) 2019

Page 5

Part VII

Supplemental Information

Provide additional information for responses to questions on Schedule R. (see instructions).

Return Reference	Explanation

Schedule R (Form 990) 2019

Additional Data

Software ID:
Software Version:

1	Briefly describe the organization’s mission or most significant activities: PROVIDE HEALTHCARE SERVICES TO THE RESIDENTS OF CECIL COUNTY, MD, AND THE SURROUNDING AREA.
2	Check this box
3	Number of voting members of the governing body (Part VI, line 1a) ........	3	15
4	Number of independent voting members of the governing body (Part VI, line 1b) .....	4	12
5	Total number of individuals employed in calendar year 2019 (Part V, line 2a) ......	5	1,375
6	Total number of volunteers (estimate if necessary) .............	6	318
7a	Total unrelated business revenue from Part VIII, column (C), line 12 ........	7a	1,720,821
b	Net unrelated business taxable income from Form 990-T, line 39 .........	7b	-522,534

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........	760,419	4,635,791
9	Program service revenue (Part VIII, line 2g) .........	160,117,692	157,587,785
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	1,586,989	2,311,445
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	2,691,662	2,701,917
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)	165,156,762	167,236,938
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...	18,197,080	3,116,525
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)	83,471,094	84,855,967
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)....	79,119,434	88,065,377
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	180,787,608	176,037,869
19	Revenue less expenses. Subtract line 18 from line 12.......	-15,630,846	-8,800,931
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	173,889,013	166,082,740
21	Total liabilities (Part X, line 26).............	88,038,568	88,978,017
22	Net assets or fund balances. Subtract line 21 from line 20.....	85,850,445	77,104,723

Sign Here

	Signature of officer	Date

	Type or print name and title


4a	(Code: ) (Expenses $ 171,683,578 including grants of $ 3,116,525 ) (Revenue $ 157,587,785 )
	UNION HOSPITAL OF CECIL COUNTY'S MISSION IS TO PROVIDE QUALITY HEALTH CARE SERVICES TO THE RESIDENTS OF CECIL COUNTY, MARYLAND AND NEIGHBORING COMMUNITIES. SERVICES ARE PROVIDED WITH MODERN TECHNOLOGY AND COMPASSIONATE CARE FROM HEALTH CARE PROFESSIONALS. SERVICES ARE PROVIDED REGARDLESS OF RACE, GENDER, ETHNICITY, AGE, DISABILITY, RELIGION, OR ABILITY TO PAY. ALTHOUGH REIMBURSEMENT FOR SERVICES RENDERED IS VITALLY IMPORTANT TO THE OPERATION, STABILITY, AND VIABILITY OF UNION HOSPITAL OF CECIL COUNTY, IT IS RECOGNIZED THAT NOT ALL MEMBERS OF THE COMMUNITY ARE IN THE FINANCIAL POSITION TO PURCHASE HEALTH CARE SERVICES. FOR ELIGIBLE INDIVIDUALS, UNION HOSPITAL OF CECIL COUNTY OFFERS FREE AND/OR SUBSIDIZED CARE, AS WELL AS ACCESS TO COMMUNITY FINANCIAL ASSISTANCE. CONTINUED ON SCHEDULE "O"DURING THE YEAR, UNION HOSPITAL OF CECIL COUNTY PROVIDED $10,629,804 IN UNCOMPENSATED CARE (CHARITY CARE).IN ADDITION, COMMUNITY BENEFIT ACTIVITIES ARE PROVIDED TO SERVE VULNERABLE POPULATIONS (I.E. MEDICALLY UNDERSERVED, WORKING POOR, HOMELESS). ACTIVITIES ARE CREATED BASED ON COMMUNITY NEED AND ARE PROVIDED IN AN EFFORT TO IMPROVE THE HEALTH OF THE COMMUNITY. COMMUNITY BENEFITS INCLUDE: A) ADULT DAY SERVICES FOR ADULTS WITH DEMENTIAB) COMMUNITY SUPPORT GROUPS FOR CANCER, DIABETES, STROKE, ALZHEIMER'S, AND BREASTFEEDING C) HEALTH EDUCATION FOR DIABETES AND NUTRITION, CANCER PREVENTION, STROKE RISK, AND HOW TO CARE FOR SUBSTANCE-EFFECTED NEWBORNSD) FREE SCREENINGS IN THE COMMUNITY FOR PROSTATE CANCER, HEAD AND NECK CANCER, SKIN CANCER, AND DIABETES (EYES AND FEET)E) PROVIDING MEETING FACILITIES FOR LOCAL NONPROFITS AND AGENCIESF) ENHANCING FOOD SECURITY WITH MEALS ON WHEELS AND FOOD DONATIONS TO HOMELESS SERVING PROVIDERS IN THE COMMUNITY G) HOSPITAL STAFF PARTICIPATION ON COMMUNITY BOARDS AND COALITIONS, LIKE THE DENTAL HEALTH ADVISORY BOARD, UNITED WAY, VOICES OF HOPE, CECIL COUNTY DRUG-FREE COMMUNITIES COALITION, CORE SERVICE AGENCY MENTAL HEALTH ADVISORY BOARD, AND CECIL COUNTY COMMUNITY HEALTH ADVISORY COALITIONUNION HOSPITAL OF CECIL COUNTY SERVICED 5,140 DISCHARGES PROVIDING 18,475 PATIENT DAYS TO INPATIENTS IN FISCAL YEAR 2018 OF WHICH:1) PATIENTS COVERED UNDER THE MEDICARE PROGRAM WERE 2,309 DISCHARGES AND 9,615 PATIENT DAYS2) PATIENTS COVERED UNDER THE MEDICAID PROGRAM WERE 152 DISCHARGES AND 564 PATIENT DAYS3) PATIENTS COVERED UNDER THE MEDICAID HMO PROGRAM WERE 1,308 DISCHARGES AND 3,843 PATIENT DAYS4) PATIENTS COVERED UNDER THE MEDICARE HMO PROGRAM WERE 204 DISCHARGES AND 894 PATIENT DAYS

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 expenses171,683,578

(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) CYDNEY TEAL MD........................................................................ VP MEDICAL AFFAIRS	39.00 .......................1.00	X		0	408,612	23,296
(19) ANNE LARA........................................................................ SR. VP/CHIEF INNOVATION OFFICER	33.00 .......................7.00	X		0	238,426	18,082
(20) AARON Z ROYSTON........................................................................ VP OF PROVIDER ENTERPRISE	40.00 .......................	X		236,976	0	4,380
(21) KHADIJATU BOSTON UNTIL 0118........................................................................ SR. VP/CHIEF NURSING OFFICER	39.00 .......................1.00	X		0	253,604	14,589
(22) TERRANCE LOVELL UNTIL 0118........................................................................ VP HUMAN RESOURCES	40.00 .......................	X		266,241	0	78,291
(23) FAHD RAHMAN........................................................................ PHYSICIAN	40.00 .......................		X	596,909	0	33,338
(24) JUSTIN SAUSVILLE........................................................................ PHYSICIAN	40.00 .......................		X	542,497	0	33,381
(25) ROGER WU........................................................................ PHYSICIAN	40.00 .......................		X	494,050	0	23,985
(26) TARIQ MAHMOOD........................................................................ PHYSICIAN	40.00 .......................		X	412,571	0	31,112
(27) DANIELLE PRESS........................................................................ PHYSICIAN	40.00 .......................		X	407,136	0	12,319

1b	Sub-Total................
c	Total from continuation sheets to Part VII, Section A....
d	Total (add lines 1b and 1c)...........	3,364,651	1,938,061	515,092

1a	Federated campaigns..		1a
b	Membership dues..		1b
c	Fundraising events..		1c
d	Related organizations		1d	4,635,791
e	Government grants (contributions)		1e

f	All other contributions, gifts, grants, and similar amounts not included above		1f

g	Noncash contributions included in lines 1a - 1f:$		1g

h Total. Add lines 1a-1f.......		4,635,791

		Business Code
2a	NET PATIENT SERVICE REVENUE	621990	156,192,399	156,192,399
b	OTHER OPERATING REVENUE	621990	903,740	903,740
c	ADULT DAY CARE	623990	491,646	491,646
d
e
f	All other program service revenue.
g	Total. Add lines 2a–2f .....		157,587,785

3 Investment income (including dividends, interest, and othersimilar amounts) ......			1,674,113		-57,781	1,731,894
4 Income from investment of tax-exempt bond proceeds
5 Royalties...........
		(ii) Personal	(i) Real
6a	Gross rents		24,336	6a
b	Less: rental expenses		8,305	6b
c	Rental income or (loss)		16,031	6c
d	Net rental income or (loss).......			16,031			16,031
		(ii) Other	(i) Securities
7a	Gross amount from sales of assets other than inventory	212,792	6,700,620	7a
b	Less: cost or other basis and sales expenses	291,362	5,984,718	7b
c	Gain or (loss)	-78,570	715,902	7c
d	Net gain or (loss).........			637,332			637,332
8a	Gross income from fundraising events (not including $ of contributions reported on line 1c). See Part IV, line 18 ....
			8a
b	Less: direct expenses ...		8b
c	Net income or (loss) from fundraising events..
9a	Gross income from gaming activities. See Part IV, line 19 ...
			9a
b	Less: direct expenses ...		9b
c	Net income or (loss) from gaming activities..
10a	Gross sales of inventory, less returns and allowances ..
			10a
b	Less: cost of goods sold ..		10b
c	Net income or (loss) from sales of inventory..
Business Code			Miscellaneous Revenue
11a	LABORATORY REVENUE		621500	1,778,602		1,778,602
b	CAFETERIA/FOOD SERVICE		722210	797,210			797,210
c	PURCHASE DISCOUNTS		900099	38,674			38,674
d	All other revenue ....			71,400			71,400
e	Total. Add lines 11a–11d ......			2,685,886
12	Total revenue. See instructions.....			167,236,938	157,587,785	1,720,821	3,292,541

1	Grants and other assistance to domestic organizations and domestic governments. See Part IV, line 21 ....	3,116,525	3,116,525
2	Grants and other assistance to domestic individuals. See Part IV, line 22 ...........
3	Grants and other assistance to foreign organizations, foreign governments, and foreign individuals. See Part IV, lines 15 and 16. .............
4	Benefits paid to or for members .......
5	Compensation of current officers, directors, trustees, and key employees ...........	1,080,398	610,828	469,570
6	Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) .........
7	Other salaries and wages........	70,792,597	70,174,060	618,537
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....	779,432	753,209	26,223
9	Other employee benefits .......	7,401,414	7,360,952	40,462
10	Payroll taxes ...........	4,802,126	4,747,606	54,520
11	Fees for services (non-employees):
a	Management ......	1,574,678	787,339	787,339
b	Legal .........	829,498		829,498
c	Accounting ...........	108,660		108,660
d	Lobbying ...........
e	Professional fundraising services. See Part IV, line 17
f	Investment management fees ......	59,449		59,449
g	Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O)	31,519,749	30,452,394	1,067,355
12	Advertising and promotion ....	461,803	461,803
13	Office expenses .......	872,580	865,417	7,163
14	Information technology ......	48,800	48,800
15	Royalties ..
16	Occupancy ...........	2,992,064	2,992,064
17	Travel ............	262,772	242,251	20,521
18	Payments of travel or entertainment expenses for any federal, state, or local public officials .
19	Conferences, conventions, and meetings ....	142,694	84,766	57,928
20	Interest ...........	2,024,928	2,024,928
21	Payments to affiliates .......
22	Depreciation, depletion, and amortization ..	11,476,003	11,476,003
23	Insurance ...	3,314,387	3,303,570	10,817
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	17,626,763	17,623,460	3,303
b	BAD DEBTS	8,807,407	8,807,407
c	REPAIRS & MAINTENANCE	2,926,951	2,926,653	298
d	DIETARY	977,531	971,571	5,960
e	All other expenses	2,038,660	1,851,972	186,688
25	Total functional expenses. Add lines 1 through 24e	176,037,869	171,683,578	4,354,291	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).

1	Cash–non-interest-bearing ........			5,412,598	1	3,007,119
2	Savings and temporary cash investments .........			440,529	2	162,892
3	Pledges and grants receivable, net ......				3
4	Accounts receivable, net .............			17,732,375	4	16,617,200
5	Loans and other payables to any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons .......
					5
6	Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), and persons described in section 4958(c)(3)(B) ...
					6
7	Notes and loans receivable, net ...........				7
8	Inventories for sale or use ............			2,027,595	8	2,268,203
9	Prepaid expenses and deferred charges ......			3,231,364	9	2,136,306
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	220,281,891
b	Less: accumulated depreciation	10b	132,143,595	89,053,840	10c	88,138,296
11	Investments—publicly traded securities .			33,159,205	11	31,440,920
12	Investments—other securities. See Part IV, line 11 .....			13,259,622	12	13,873,382
13	Investments—program-related. See Part IV, line 11 ..				13
14	Intangible assets ...............				14
15	Other assets. See Part IV, line 11 ...........			9,571,885	15	8,438,422
16	Total assets. Add lines 1 through 15 (must equal line 33)...			173,889,013	16	166,082,740

17	Accounts payable and accrued expenses .....	9,657,225	17	14,591,487
18	Grants payable ...		18
19	Deferred revenue .........		19
20	Tax-exempt bond liabilities .........	61,640,225	20	59,181,386
21	Escrow or custodial account liability. Complete Part IV of Schedule D		21
22	Loans and other payables to any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons .........
			22
23	Secured mortgages and notes payable to unrelated third parties ..		23
24	Unsecured notes and loans payable to unrelated third parties ..		24
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	16,741,118	25	15,205,144
26	Total liabilities. Add lines 17 through 25..	88,038,568	26	88,978,017

	Organizations that follow FASB ASC 958, check here and complete lines 27, 28, 32, and 33.
27	Net assets without donor restrictions ..........		27
28	Net assets with donor restrictions ...........		28
	Organizations that do not follow FASB ASC 958, check here and complete lines 29 through 33.
29	Capital stock or trust principal, or current funds .....		29
30	Paid-in or capital surplus, or land, building or equipment fund ...		30
31	Retained earnings, endowment, accumulated income, or other funds		31
32	Total net assets or fund balances ...........	85,850,445	32	77,104,723
33	Total liabilities and net assets/fund balances ........	173,889,013	33	166,082,740