TY 2019 Form 990

(A) Name and title	(B) Average hours per week (list any hours for related organizations below dotted line)	(C) Position (do not check more than one box, unless person is both an officer and a director/trustee)	(E) Reportable compensation from related organizations (W-2/1099-MISC)	(F) Estimated amount of other compensation from the organization and related organizations
(1) FAHD RAHMAN...................................................................... PHYSICIAN	40.0 ................. 0.0				X	690,364	0	30,866
(2) JUSTIN SAUSVILLE MD...................................................................... DIRECTOR, PHYSICIAN	40.0 ................. 0.0	X				548,284	0	30,922
(3) RICHARD C SZUMEL MD...................................................................... PRESIDENT & CEO	28.0 ................. 12.0	X	X			0	482,681	85,791
(4) ROGER D WU...................................................................... PHYSICIAN	40.0 ................. 0.0				X	510,574	0	26,736
(5) NAVEED HASAN...................................................................... PHYSICIAN	40.0 ................. 0.0				X	486,224	0	26,467
(6) HANHAN LI...................................................................... PHYSICIAN	40.0 ................. 0.0				X	472,539	0	12,630
(7) EUGENIA M GRAY...................................................................... PHYSICIAN	40.0 ................. 0.0				X	409,824	0	19,353
(8) CRAIG M BABBITT...................................................................... IN-HOUSE LEGAL COUNSEL	40.0 ................. 0.0			X		336,181	0	11,280
(9) JAMES G RAAB...................................................................... SENIOR VP/CFO THRU 10/2020	29.0 ................. 11.0		X			0	299,349	25,456
(10) DR RYAN GERACIMOS...................................................................... CHIEF MEDICAL OFFICER	30.0 ................. 10.0			X		0	302,901	3,052
(11) JOSE MA MD...................................................................... DIRECTOR	39.5 ................. 0.5	X				270,651	0	29,621
(12) AARON Z ROYSTON THRU 1019...................................................................... VP OF PROVIDER ENTERPRISE	30.0 ................. 10.0			X		242,445	0	4,172
(13) MARIE VASBINDER...................................................................... SR. VP/CHIEF NURSE OFFICER	39.0 ................. 1.0			X		0	217,446	2,394
(14) JOAN PIRRUNG...................................................................... VP OF NURSING	40.0 ................. 0.0			X		0	159,909	40,282
(15) AMY MARSTON...................................................................... CAMPUS OPERATIONS OFFICER	40.0 ................. 0.0			X		0	159,954	27,668
(16) MICHELLE TWUM-DANSO...................................................................... ASSOCIATE VP HUMAN RESOURCES	40.0 ................. 0.0			X		180,320	0	3,611
(17) DERON BROWN...................................................................... EXEC DIRECTOR OF FINANCE	40.0 ................. 0.0			X		151,471	0	4,150

(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)
(18) CYDNEY TEAL........................................................................ FORMER VP MEDICAL AFFAIRS	0.0 .......................0.0			X	102,263	7,159
(19) RAYMOND HAMM........................................................................ CHAIRMAN	0.5 .......................0.6	X	X		0	0
(20) DWIGHT THOMEY........................................................................ VICE CHAIRMAN/TREASURER	0.5 .......................0.5	X	X		0	0
(21) DAVID FERGUSON PHD........................................................................ SECRETARY	0.5 .......................0.6	X	X		0	0
(22) KELLY ALBANESE BEDDER........................................................................ DIRECTOR	0.5 .......................1.5	X			0	0
(23) MARY BOLT PHD........................................................................ DIRECTOR	0.5 .......................0.5	X			0	0
(24) REVEREND KEVIN BROWN........................................................................ DIRECTOR	0.5 .......................0.5	X			0	0
(25) CHRISTY DRYER DNP........................................................................ DIRECTOR	0.5 .......................0.5	X			0	0
(26) MORGAN MILLER MLIS........................................................................ DIRECTOR	0.5 .......................0.5	X			0	0
(27) ROBERT PALSGROVE........................................................................ DIRECTOR	0.5 .......................0.5	X			0	0
(28) CARL ROBERTS PHD........................................................................ DIRECTOR	0.5 .......................0.5	X			0	0
(29) DAVID TROLIO........................................................................ DIRECTOR	0.5 .......................0.5	X			0	0
(30) JACQUES RENE........................................................................ DIRECTOR	0.5 .......................0.5	X			0	0

(A) Name and business address	(B) Description of services	(C) Compensation
UNION RADIOLOGISTS LLC, 106 BOW STREET ELKTON,MD21921	RADIOLOGY SERVICES	3,472,625
USACS INTEGRATED ACUTE CARE SRVCS O, 4535 DRESSLER RD NW CANTON,OH44718	ACUTE CARE SERVICES	2,437,932
CHG COMPANIES INC, PO BOX 972651 DALLAS,TX75397	PROF. STAFFING	2,227,364
CLEARPATH SOLUTIONS GROUP LLC, 2465 CENTREVILLE RD SUITE J17-722 HERNDON,VA20171	IT SERVICES	1,155,886
FLYNN MID ATLANTIC LP, 5200 RAYNOR AVENUE LITHICUM,MD21090	CONTRACTOR SERVICES	1,010,184
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 105

- 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.
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Attach to Form 990 or Form 990-EZ.
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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
RESTRICTED	,	$ RESTRICTED	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 ....	45,935,356	27,146,330	18,789,026
c	Leasehold improvements	956,373	356,466	599,907
d	Equipment ....	124,309,567	96,441,751	27,867,816
e	Other .....	3,256,396	1,417,449	1,838,947
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..				50,230,601

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........	5,243,103	C
(3) Other (A) MANAGED HEDGE FUNDS	7,788,216	F
(C)
(D)
(E)
(F)
(G)
(H)
(I)
Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)	13,031,319

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				1,436,326
(2)INSURANCE CLAIMS RECOVERABLE				7,699,683
(3)DUE FROM AFFILIATES				330,510
(4)
(5)
(6)
(7)
(8)
(9)
(10)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........				9,466,519

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	0
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)	11,735,165
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	158,926,606
2	Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a	Net unrealized gains (losses) on investments ....	2a	915,320
b	Donated services and use of facilities .........	2b
c	Recoveries of prior year grants ...........	2c
d	Other (Describe in Part XIII.) ............	2d	-412,865
e	Add lines 2a through 2d .....................			2e	502,455
3	Subtract line 2e from line 1..................			3	158,424,151
4	Amounts included on Form 990, Part VIII, line 12, but not on line 1:
a	Investment expenses not included on Form 990, Part VIII, line 7b .	4a
b	Other (Describe in Part XIII.) ...........	4b
c	Add lines 4a and 4b....................			4c
5	Total revenue. Add lines 3 and 4c. (This must equal Form 990, Part I, line 12.) ......			5	158,424,151

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	163,197,186
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	201,493
e	Add lines 2a through 2d....................			2e	201,493
3	Subtract line 2e from line 1...................			3	162,995,693
4	Amounts included on Form 990, Part IX, line 25, but not on line 1:
a	Investment expenses not included on Form 990, Part VIII, line 7b ..	4a
b	Other (Describe in Part XIII.) ............	4b
c	Add lines 4a and 4b.....................			4c
5	Total expenses. Add lines 3 and 4c. (This must equal Form 990, Part I, line 18.) ......			5	162,995,693

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
FORM 990, SCHEDULE D, PART X, LINE 2	TEXT OF FIN 48 (ASC 740) FOOTNOTE THE HOSPITAL IS A NOT-FOR-PROFIT CORPORATION AS DESCRIBED IN SECTION 501 (C)(3) OF THE IRC AND IS EXEMPT FROM FEDERAL INCOME TAXES ON THEIR EXEMPT INCOME UNDER SECTION 501 (A) OF THE IRC. 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 FOR THE PERIOD JANUARY 1, 2020 THROUGH JUNE 30, 2020 (SUCCESSOR) AND PERIOD JULY 1, 2019 THROUGH DECEMBER 31, 2019 AND THE YEAR ENDED JUNE 30, 2019 (PREDECESSOR). THE HOSPITAL'S POLICY IS TO RECOGNIZE INTEREST RELATED TO UNRECOGNIZED TAX BENEFITS IN INTEREST EXPENSE AND PENALTIES IN OPERATING EXPENSES. ---------------
FORM 990, SCHEDULE D, PART XI, LINE 2D	DETAIL OF OTHER ITEMS BANK FEES $ (72,154) OTHER ADJUSTMENTS (340,711) ---------- TOTAL TO SCHEDULE D, PART XI, LINE 2D $(412,865) ---------------
FORM 990, SCHEDULE D, PART XII, LINE 4B	DETAIL OF OTHER ITEMS BANK FEES $ 72,154 OTHER ADJUSTMENTS 129,339 -------- TOTAL TO SCHEDULE D, PART XII, LINE 4D $201,493

Schedule D (Form 990) 2019

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE F(Form 990)

Department of the Treasury
Internal Revenue Service

Statement of Activities Outside the United States

Complete if the organization answered "Yes" to Form 990, Part IV, line 14b, 15, or 16. Right pointing arrow large image

Attach to Form 990. Right pointing arrow large image

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

General Information on Activities Outside the United States. Complete if the organization answered "Yes" on Form 990, Part IV, line 14b.

For grantmakers. Does the organization maintain records to substantiate the amount of its grants and

other assistance, the grantees’ eligibility for the grants or assistance, and the selection criteria used

to award the grants or assistance? . . . . . . . . . . . . . . . . . . . . . . . . .

Yes

For grantmakers. Describe in Part V the organization’s procedures for monitoring the use of its grants and other assistance outside the United States.

Activites per Region. (The following Part I, line 3 table can be duplicated if additional space is needed.)

(a) Region		(d) Activities conducted in region (by type) (such as, fundraising, program services, investments, grants to recipients located in the region)	(f) Total expenditures for and investments in the region
	Central America and the Caribbean	Investments	20,000
















3a	Sub-total ....		20,000
b	Total from continuation sheets to Part I ...
c	Totals (add lines 3a and 3b)		20,000

For Paperwork Reduction Act Notice, see the Instructions for Form 990.Cat. No. 50082W Schedule F (Form 990) 2019

Schedule F (Form 990) 2019

Page 2

Part II

Grants and Other Assistance to Organizations or Entities Outside the United States. Complete if the organization answered "Yes" on Form 990, Part IV, line 15, for any recipient who received more than $5,000. Part II can be duplicated if additional space is needed.

1 (a) Name of organization		(b) IRS code section and EIN (if applicable)	(c) Region	(d) Purpose of grant	(e) Amount of cash grant	(f) Manner of cash disbursement	(g) Amount of noncash assistance	(h) Description of noncash assistance	(i) Method of valuation (book, FMV, appraisal, other)

2	Enter total number of recipient organizations listed above that are recognized as charities by the foreign country, recognized as tax-exempt by the IRS, or for which the grantee or counsel has provided a section 501(c)(3) equivalency letter .......
3	Enter total number of other organizations or entities .......................

Schedule F (Form 990) 2019

Schedule F (Form 990) 2019Page 3

Part III

Grants and Other Assistance to Individuals Outside the United States. Complete if the organization answered "Yes" on Form 990, Part IV, line 16.

Part III can be duplicated if additional space is needed.

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

Schedule F (Form 990) 2019

Page 4

Part IV

Foreign Forms

Schedule F (Form 990) 2019

Page 5

Part V

Supplemental Information
Provide the information required by Part I, line 2 (monitoring of funds); Part I, line 3, column (f) (accounting method; amounts of investments vs. expenditures per region); Part II, line 1 (accounting method); Part III (accounting method); and Part III, column (c) (estimated number of recipients), as applicable. Also complete this part to provide any additional information. See instructions.

ReturnReference	Explanation

Schedule F (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) . . .		1,432,600		1,432,600	0.870 %
b	Medicaid (from Worksheet 3, column a) . . . . .
c	Costs of other means-tested government programs (from Worksheet 3, column b) . .
d	Total Financial Assistance and Means-Tested Government Programs . . . . .		1,432,600		1,432,600	0.870 %
Other Benefits
e	Community health improvement services and community benefit operations (from Worksheet 4).	2,389	82,687	0	82,687	0.050 %
f	Health professions education (from Worksheet 5) . . .	185	115,183	0	115,183	0.070 %
g	Subsidized health services (from Worksheet 6) . . . .	37	15,697,981	6,887,031	8,810,950	5.410 %
h	Research (from Worksheet 7) .	0	14,205	0	14,205	0.010 %
i	Cash and in-kind contributions for community benefit (from Worksheet 8) . . . .	24,298	279,842	172,024	107,818	0.070 %
j	Total. Other Benefits . .	26,909	16,189,898	7,059,055	9,130,843	5.610 %
k	Total. Add lines 7d and 7j .	26,909	17,622,498	7,059,055	10,563,443	6.480 %

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.

		(c) Total community building expense	(e) Net community building expense	(f) Percent of total expense
1	Physical improvements and housing
2	Economic development	12,798	12,798	0.010 %
3	Community support	7,110	7,110	0 %
4	Environmental improvements
5	Leadership development and training for community members
6	Coalition building
7	Community health improvement advocacy
8	Workforce development
9	Other
10	Total	19,908	19,908	0.010 %

Part III

Bad Debt, Medicare, & Collection Practices

Section A. Bad Debt Expense

Yes

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

7,168,709

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. ......

70,906

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).....

67,859,200

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

67,859,200

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 LICENSE# 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 19

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

Yes

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): SEE PART V, SECTION C

Other website (list url): SEE PART V, SECTION C

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 19

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

Yes

If "Yes" (list url): SEE PART V, SECTION C

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.%
and FPG family income limit for eligibility for discounted care of 400.%

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):

SEE PART V, PAGE 8

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

SEE PART V, PAGE 8

A plain language summary of the FAP was widely available on a website (list url):
SEE PART V, PAGE 8

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
PART V, SECTION B, LINES 5, 6A & 6B (INPUT FROM COMMUNITY; JOINT CHNA)	UNION HOSPITAL AND THE CECIL COUNTY HEALTH DEPARTMENT (CHNA PLANNING TEAM) HAVE COLLABORATED SINCE 2013 TO DEVELOP THE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) AND IMPLEMENTATION PLAN. TO ENSURE THE 2019 CHNA WOULD REFLECT COMMUNITY NEEDS AND PRIORITIES, THE CHNA PLANNING TEAM DEVELOPED A COMMUNITY SURVEY, HELD FOCUS GROUPS, AND CONDUCTED INTERVIEWS WITH LOCAL LEADERS. THE SURVEY WAS DEVELOPED BY THE CHNA PLANNING TEAM AND CONSISTED OF 20 QUESTIONS DIVIDED INTO 4 SECTIONS PERTAINING TO DEMOGRAPHICS, COMMUNITY HEALTH, QUALITY OF LIFE, AND ACCESS TO HEALTH CARE. 1,403 INDIVIDUALS COMPLETED THE SURVEY WHICH WAS AVAILABLE FROM JULY 2018 TO SEPTEMBER 2018 ONLINE AND IN PAPER FORM AT COMMUNITY LOCATIONS SUCH AS THE COUNTY PUBLIC LIBRARIES AND UNION HOSPITAL'S MULTI-SPECIALTY PRACTICES. THE CHNA PLANNING TEAM ALSO HOSTED 4 FOCUS GROUPS FOR VULNERABLE POPULATIONS: HOMELESS, VETERANS, OLDER ADULTS, AND LOW-INCOME OR ASSET LIMITED INCOME CONSTRAINED EMPLOYED (ALICE) ADULTS. A 5TH FOCUS GROUP WITH AFRICAN AMERICANS WAS ALSO HELD TO DISCUSS HEALTH DISPARITIES IN CECIL COUNTY. EACH FOCUS GROUP SESSION LASTED 1 TO 1.5 HOURS AND ALWAYS BEGAN WITH A DESCRIPTION OF THE CHNA, THE PURPOSE OF THE FOCUS GROUP, THE RULES OF ENGAGEMENT, AND A REFERENCE WORKSHEET WITH SESSION QUESTIONS. PARTICIPATION WAS ANONYMOUS WITH A HEAD COUNT PROVIDING THE NUMBER OF PARTICIPANTS. THE AVERAGE FOR EACH SESSION WAS 10 PARTICIPANTS. AT EACH SESSION, THE FOLLOWING QUESTIONS WERE ASKED: 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? FINALLY, INTERVIEWS WERE CONDUCTED TO UNDERSTAND THE COMMUNITY LEADERSHIP PERSPECTIVE OF THE HEALTH AND QUALITY OF LIFE IN CECIL COUNTY. TWELVE 1-2 HOUR INTERVIEWS WITH 2-5 COMMUNITY LEADERS WERE CONDUCTED BY UNION HOSPITAL. TO ENSURE PARTICIPANTS FELT FREE TO SHARE THEIR THOUGHTS, PARTICIPATION WAS KEPT CONFIDENTIAL. THE SURVEY TOOK APPROXIMATELY 15 TO 20 MINUTES TO COMPLETE AND 506 PEOPLE COMPLETED THE SURVEY. ---------------
SCHEDULE H, PART V, SECTION B, LINE 7A & B (CHNA AVAILABILITY)	UNION HOSPITAL OF CECIL COUNTY, INC.'S CHNA IS AVAILABLE ON ITS WEBSITE AT: HTTPS://WWW.UHCC.COM/ABOUT-US/COMMUNITY-BENEFIT/REPORTS/ UNION HOSPITAL OF CECIL COUNTY, INC.'S CHNA IS ALSO AVAILABLE AT: HTTPS://CECILCOUNTYHEALTH.ORG/RESOURCES/HEALTH-ADVISORY-COMMITTEE/ --------------- SCHEDULE H, PART V, SECTION B, LINE 10 (IMP. STRATEGY PUBLIC AVAILABILITY) UNION HOSPITAL OF CECIL COUNTY, INC.'S CHIP IS AVAILABLE ON ITS WEBSITE AT: HTTP://WWW.UHCC.COM/ABOUT-US/COMMUNITY-BENEFIT/REPORTS/ ---------------
SCHEDULE H, PART V, SECTION B, LINE 11 (ADDRESSING NEEDS FROM THE CHNA)	UNION HOSPITAL'S MOST RECENT CHNA, COMPLETED IN COLLABORATION WITH THE CECIL COUNTY PUBLIC HEALTH DEPARTMENT PRIORITIZED THE FOLLOWING HEALTH NEEDS: - CANCER - BEHAVIORAL HEALTH (COMPRISED OF MENTAL HEALTH AND SUBSTANCE USE) - CHILDHOOD TRAUMA WHILE CANCER INCIDENCE RATES HAVE STEADILY DECLINED IN CECIL COUNTY OVER THE LAST SEVERAL YEARS, THE INCIDENCE RATE REMAINS HIGH IN COMPARISON TO THE STATE AND NATION. UNFORTUNATELY, MANY MEMBERS OF OUR COMMUNITY HAVE BEEN IMPACTED BY CANCER. FOR THE LAST 10 YEARS, BEHAVIORAL HEALTH HAS BEEN PRIORITIZED AS AN AREA OF NEED. IN THE 2013 AND 2016 CHNAS, SUBSTANCE USE WAS IDENTIFIED AS THE NUMBER ONE HEALTH PRIORITY FOLLOWED BY MENTAL HEALTH. AS ILLICIT DRUG USE HAS BEEN INCREASING IN CECIL COUNTY IN RECENT YEARS, WITH OPIOID USE HAVING A SIGNIFICANT IMPACT IN OUR COMMUNITY, IT IS NOT SURPRISING THAT THIS REMAINS AN AREA OF NEED. FINALLY, CHILDHOOD TRAUMA WAS IDENTIFIED AS AN AREA OF NEED BECAUSE OF THE LIKELIHOOD THAT MEMBERS IN OUR COMMUNITY SUFFERED A TRAUMA IN CHILDHOOD AND THE DAMAGING IMPACT IT HAS THROUGHOUT LIFE. ADVERSE CHILDHOOD EXPERIENCES (ACE) IS THE TERM COMMONLY USED TO DESCRIBE ALL TYPES OF ABUSE, NEGLECT, AND OTHER POTENTIALLY TRAUMATIC EXPERIENCES THAT OCCUR TO PEOPLE UNDER THE AGE OF 18. ACES HAVE BEEN LINKED TO RISKY BEHAVIORS, CHRONIC HEALTH CONDITIONS, LOW LIFE POTENTIAL AND PREMATURE DEATH. NEARLY TWO-THIRDS OF ADULTS IN CECIL COUNTY REPORTED EXPERIENCING AT LEAST ONE ACE DURING THEIR CHILDHOOD (2019 CHNA, PAGE 26). CANCER UNION HOSPITAL'S COMPREHENSIVE CANCER SERVICES INCLUDE PREVENTION, DETECTION, INPATIENT AND OUTPATIENT TREATMENT, FOLLOW-UP CARE, AND ONGOING SUPPORT THROUGH A DEDICATED SOCIAL WORKER AND THE CANCER RESOURCE CENTER WHICH IS A VOLUNTEER RUN ORGANIZATION. THE UNION HOSPITAL CANCER PROGRAM IS CERTIFIED BY THE COMMISSION ON CANCER OF THE AMERICAN COLLEGE OF SURGEONS AND IS A RECIPIENT OF ITS PRESTIGIOUS OUTSTANDING ACHIEVEMENT AWARD. TREATMENT OPTIONS INCLUDE RADIATION THERAPY IN COLLABORATION WITH UNIVERSITY OF MARYLAND RADIATION ONCOLOGY, AN ADVANCED INFUSION CENTER, AND PARTICIPATION IN CLINICAL TRIALS. INPATIENT AND OUTPATIENT SERVICES ARE OFFERED AT UNION HOSPITAL, AT CHRISTIANACARE'S HELEN F. GRAHAM CANCER CENTER & RESEARCH INSTITUTE AND RADIATION ONCOLOGISTS, PA. IN FY 20, UNION HOSPITAL CONTINUED TO PROVIDE SCREENINGS FOR LUNG, BREAST, COLORECTAL, AND PROSTATE CANCERS WHICH ARE CANCERS THAT WERE THE FOCUS OF OUR 2019 CHNA, AND TO PROVIDE INFORMATION TO ELIGIBLE PATIENTS FOR SCREENINGS PROVIDED BY THE CECIL COUNTY HEALTH DEPARTMENT. IN SEPTEMBER 2019, UNION HOSPITAL PROVIDED ITS ANNUAL FREE PROSTATE SCREENING AND EDUCATION EVENTS AND SUCCESSFULLY SCREENED 27 INDIVIDUALS. FOR THE PAST SEVERAL YEARS, FREE SCREENINGS FOR HEAD AND NECK CANCERS HAVE BEEN OFFERED IN THE SPRING. UNFORTUNATELY, DUE TO THE CORONAVIRUS PANDEMIC, THESE SCREENINGS WERE NOT HELD IN THE SPRING OF 2020. UNION HOSPITAL CONTINUES TO PROVIDE LOW-DOSE LUNG CT (LDCT) SCREENINGS WHICH DETECT MALIGNANT TUMORS BEFORE SYMPTOMS APPEAR. THIS SCREENING IS SIGNIFICANT BECAUSE THE EARLIER LUNG CANCER CAN BE DETECTED, THE BETTER THE CHANCE OF SURVIVAL. LDCT SCANS ARE RECOMMENDED FOR THOSE: - BETWEEN THE AGES OF 55 AND 74 YEARS OLD - CURRENT SMOKER OR HAVE QUIT IN THE PAST 15 YEARS - HAVE NO SYMPTOMS OF LUNG CANCER - HAVE A 30 PACK YEAR SMOKING HISTORY (PACK YEAR = NUMBER OF PACKS OF CIGARETTES SMOKED PER DAY MULTIPLIED BY NUMBER OF YEARS AS A SMOKER) IN THE 2020-2022 IMPLEMENTATION PLAN, THE STATED OBJECTIVE WAS TO INCREASE THE NUMBER OF INDIVIDUALS RECEIVING LDCT SCANS BY 5% WAS SET. IN CALENDAR YEARS 2016, 2017, AND 2018, 556 PEOPLE WERE SCREENED. THE GOAL FOR CALENDAR YEARS 2019, 2020, AND 2021 IS TO SCAN 584 INDIVIDUALS. IN FISCAL YEAR 2020, UNION HOSPITAL 241 PATIENTS RECEIVED THE LDCT SCAN. WHILE WE EXPECT DECREASED NUMBERS IN FISCAL YEAR 2021 DUE TO THE CORONAVIRUS PANDEMIC, WE BELIEVE THE HIGH NUMBER SCREENED IN FISCAL YEAR 2020 WILL HELP US TO MEET THAT GOAL. BECAUSE SMOKING IN ADULTS IN CECIL COUNTY DOUBLED FROM 2014 TO 2017 (2019 CHNA, PAGE 14) THIS PARTICULAR SCREENING IS A CRITICALLY IMPORTANT OFFERING FOR THE COMMUNITY. DUE TO THE INCREASE IN SMOKING IN CECIL COUNTY, AND COMMUNITY CONCERN WITH RESPIRATORY DISEASES INCLUDING LUNG CANCER, UNION HOSPITAL ALSO IMPLEMENTED THE ABILITY TO REFER PATIENTS THROUGH THEIR ELECTRONIC HEALTH RECORD TO CECIL COUNTY HEALTH DEPARTMENT TOBACCO CESSATION PROGRAMS. IN FY 2020, 44 INDIVIDUALS WERE REFERRED TO COUNTY TOBACCO CESSATION PROGRAMS. ANOTHER IMPORTANT ASPECT OF THE 2020 - 2022 IMPLEMENTATION PLAN IS TO SUPPORT THE WORK OF CECIL COUNTY CANCER TASK FORCE WHICH IS COMPRISED OF LEADERS IN CANCER CARE, COMMUNITY HEALTH, SOCIAL SUPPORTS, PUBLIC HEALTH, AND THE FAITH-BASED COMMUNITY. REPRESENTATIVES FROM UNION HOSPITAL PARTICIPATE ON THIS COMMITTEE AND A UNION HOSPITAL CAREGIVER CHAIRED THE COMMITTEE IN FISCAL YEAR 2020. THROUGH PARTICIPATION IN THIS COMMITTEE, UNION HOSPITAL WORKS WITH ITS COMMUNITY PARTNERS TO PROMOTE EDUCATION AND AWARENESS OF CANCER PREVENTION AND SCREENINGS, AND COLLABORATES TO MEET OBJECTIVES SET BY COMMUNITY PARTNERS. FINALLY, UNION HOSPITAL CONTINUED TO RUN AN ACTIVE BREAST CANCER SURVIVORS SUPPORT GROUP IN FY 2020. DESPITE THE CORONAVIRUS PANDEMIC MAKING COMMUNITY EVENTS IN THE SPRING OF 2020 IMPOSSIBLE, OUR CAREGIVERS ADAPTED AND WERE ABLE TO PROVIDE VIRTUAL SESSIONS FOR THE FINAL FEW MONTHS OF FISCAL YEAR. IN TOTAL, 12 SESSIONS, INCLUDING A FULL DAY RETREAT AND 2 VIRTUAL SESSIONS, WERE HELD IN FY 2020. BEHAVIORAL HEALTH UNION HOSPITAL WORKS TO ADDRESS BEHAVIORAL HEALTH ISSUES WITHIN ITS COMMUNITY THROUGH DIRECT PROGRAMMING AND COLLABORATION WITH COMMUNITY PARTNERS. UNION HOSPITAL HAS A 12-BED INPATIENT UNIT, AN OUTPATIENT PRACTICE, AND AN INTENSIVE OUTPATIENT PROGRAM FOR ADULTS STRUGGLING TO MANAGE MENTAL HEALTH DISORDERS. ALL OF THESE OFFERINGS SEEK TO ADDRESS THE PATIENTS' NEEDS HOLISTICALLY WITH A PERSON-CENTERED APPROACH THAT RELIES ON MULTI-DISCIPLINARY TEAMS. IN FY 2020, UNION HOSPITAL CAREGIVERS PARTICIPATED IN THE FOLLOWING COMMUNITY GROUPS FOCUSED ON BEHAVIORAL HEALTH: LOCAL OVERDOSE FATALITY REVIEW TEAM: A COUNTY LEVEL MEETING THAT REVIEWS CONFIRMED OVERDOSE DEATHS IN CECIL COUNTY AND LOOKS FOR OPPORTUNITIES TO CLOSE GAPS IN TREATMENT. CIT ADVISORY COMMITTEE: THIS COMMITTEE MEETS QUARTERLY TO ADVISE AFFILIATED SANTE GROUP ON THEIR GRANT FUNDED INITIATIVE TO BRING CRISIS INTERVENTION TREATMENT TRAINING TO FIRST RESPONDERS IN THE COUNTY. CIT COMMITTEE: THIS COMMITTEE MEETS QUARTERLY TO REVIEW CRISIS INTERVENTION TRAINING PROGRESS AND OPPORTUNITIES FOR CECIL COUNTY. CECIL COUNTY DRUG AND ALCOHOL COUNCIL: THIS COUNCIL IDENTIFIES PRIORITIES AND STRATEGIES FOR MEETING THE EVALUATION, PREVENTION, AND TREATMENT NEEDS OF THE PUBLIC AND THE JUSTICE SYSTEM. COUNCIL MEETINGS ARE OPEN TO THE PUBLIC AND INCLUDE REPRESENTATIVES FROM LOCAL/REGIONAL PREVENTION AND TREATMENT PROVIDERS, HEALTH DEPARTMENT, SOCIAL SERVICES, CRIMINAL JUSTICE ORGANIZATIONS, FAITH COMMUNITY, MEMBERS OF THE RECOVERY COMMUNITY, AND CONCERNED CITIZENS. CECIL COUNTY CORE SERVICES AGENCY: ORGANIZED BY THE CECIL COUNTY HEALTH DEPARTMENT, THESE MEETINGS ARE DESIGNED TO KEEP COMMUNITY PARTNERS AWARE OF NEW AND ONGOING MENTAL HEALTH AND SUBSTANCE USE DISORDER PROGRAMS TO ENSURE THEY CAN DIRECT CECIL COUNTY RESIDENTS AND THEIR FAMILIES TO THESE RESOURCES. UNION HOSPITAL CONTINUED THE PEER RECOVERY ADVOCATES PROGRAM IN COLLABORATION WITH THE CECIL COUNTY HEALTH DEPARTMENT IN FY 2020. UNION HOSPITAL CAREGIVERS IDENTIFY INDIVIDUALS IN THE EMERGENCY DEPARTMENT AND THE PSYCHIATRIC UNIT WHO MAY SUFFER FROM A SUBSTANCE USE DISORDER AND THEN COORDINATE WITH THE PEER PROGRAM TO ENSURE THOSE INDIVIDUALS CONNECT WITH A PEER. THE PEER THEN WORKS TO IDENTIFY THE INDIVIDUAL'S NEEDS, GET THEM INTO TREATMENT, AND GET CONNECTED WITH THE APPROPRIATE COMMUNITY RESOURCES. IMPORTANTLY, THE PEERS REMAIN IN COMMUNICATION WITH THESE INDIVIDUALS TO ENSURE CONTINUED SUCCESS. 285 INDIVIDUALS WERE REFERRED TO THE PEER PROGRAM IN FISCAL YEAR 2020. THE PROGRAM HAS BEEN HALTED SINCE MARCH 2020 DUE TO THE PANDEMIC, BUT WE EXPECT TO RESUME THIS MUCH NEEDED PROGRAM IN THE NEAR FUTURE. UNION HOSPITAL CONTINUED ITS PARTNERSHIP WITH TWO COMMUNITY TREATMENT CENTERS, SERENITY HEALTH AND ELKTON TREATMENT CENTER, TO ALLOW CAREGIVERS TO VISIT THE SITES AND PROVIDE EXPECTANT AND NEW MOTHERS WITH EDUCATION PERTAINING TO CARING FOR INFANTS GENERALLY, BUT ALSO INFANTS WHO EXPERIENCE NEONATAL ABSTINENCE SYNDROME (NAS). IN FY 20, 43 MOTHERS WERE PROVIDED EDUCATION. PRIOR TO FY 20, UNION HOSPITAL CAREGIVERS WOULD PROVIDE THIS EDUCATION AS VOLUNTEERS ON THEIR OWN TIME. IN RECOGNITION OF THE IMPORTANCE OF THIS COMMUNITY NEED, UNION HOSPITAL MADE THE DECISION TO BEGIN PAYING CAREGIVERS FOR THEIR TIME PROVIDING EDUCATION AT THESE TWO TREATMENT LOCATIONS. THE EDUCATION WAS SUSPENDED DUE TO THE PANDEMIC, BUT WE HOPE TO RESUME IT ONCE IT IS SAFE TO DO SO. CHILDHOOD TRAUMA SOME EFFORTS TO ADDRESS CHILDHOOD TRAUMA HAV
SCHEDULE H, PART V, SECTION B, LINE 11 (ADDRESSING NEEDS FROM THE CHNA)	HEALTH NEEDS IDENTIFIED BUT NOT PRIORITIZED: - ACCESS TO CARE: ONGOING EFFORTS THROUGH HEALTH SERVICES TO BRING MORE PROVIDERS INTO THE COMMUNITY COVERING A RANGE OF SPECIALTIES, INCLUDING PRIMARY CARE AND GERIATRIC SERVICES. - HOMELESSNESS: CHAC DOES NOT HAVE ENOUGH RESOURCES TO MANAGE THIS PROBLEM. HOMELESS PROVIDERS IN THE AREA MEET THROUGH THE CECIL COUNTY INTERAGENCY COUNCIL ON HOMELESSNESS TO WORK THROUGH ISSUES AND FIND ADDITIONAL SUPPORTS. - CHRONIC DISEASE: CHRONIC DISEASES IDENTIFIED: ARTHRITIS, ASTHMA, COPD, HEART DISEASE, HYPERTENSION, OBESITY, STROKE, AND DIABETES. WHILE RESOURCE CONSTRAINTS LIMIT THE ABILITY TO IMPLEMENT TARGETED PROGRAMS, THERE ARE ONGOING EFFORTS THROUGH HEALTH SERVICES TO BRING MORE PROVIDERS INTO THE COMMUNITY COVERING A RANGE OF SPECIALTIES, INCLUDING PRIMARY CARE AND GERIATRIC SERVICES. - DENTAL HEALTH: WITH THE DENTAL CLINIC CLOSURE, STARTING A NEW EFFORT TO MANAGE DENTAL HEALTH NEEDS IN VULNERABLE COMMUNITIES WAS NOT FEASIBLE. THE DENTAL ADVISORY COMMITTEE IS CURRENTLY WORKING ON STRATEGIES TO INCREASE AWARENESS AROUND DENTAL HEALTH IN VULNERABLE AND UNDERSERVED NEIGHBORHOODS, PRIMARILY WORKING THROUGH NEIGHBORHOOD COMMUNITY CENTERS AND LOCAL LIBRARIES. - TOBACCO USE: TOBACCO USE IS A RISK FACTOR THAT IS ADDRESSED THROUGH PROGRAMS AT THE CECIL COUNTY HEALTH DEPARTMENT AND THROUGH THE MARYLAND QUITLINE. - INFECTIOUS & COMMUNICABLE DISEASES: THERE ARE PROGRAMS IN PLACE THROUGH THE CECIL COUNTY HEALTH DEPARTMENT TO ADDRESS INFECTIOUS AND COMMUNICABLE DISEASE. - VACCINATION: ADDRESSED BY THE SCHOOLS, CECIL COUNTY HEALTH DEPARTMENT, UNION HOSPITAL, AND PHYSICIAN PRACTICES. - ENVIRONMENTAL HEALTH: ADDRESSED BY DEPT OF NATURAL RESOURCES AND CECIL COUNTY HEATH DEPT. LACK OF AVAILABLE RESOURCES; TOO BROAD. - INJURIES MOTOR VEHICLE/PEDESTRIAN: ADDRESSED BY LAW ENFORCEMENT AND THE DEPT OF TRANSPORTATION. - CHILD ABUSE AND NEGLECT: HANDLED THROUGH REPORTS TO CPS AND MEDICAL EXAMS FROM THE CECIL COUNTY CHILD ADVOCACY CENTER - DOMESTIC VIOLENCE: ADDRESSED BY THE DOMESTIC VIOLENCE SHELTER, A PART OF THE DEPARTMENT OF SOCIAL SERVICES, AND LOCAL LAW ENFORCEMENT - VIOLENT CRIME: ADDRESSED BY LOCAL AND STATE LAW ENFORCEMENT IN CECIL COUNTY. AGENCIES AND HEALTH CARE SERVICES ALSO PARTNER WITH LAW ENFORCEMENT TO SUPPORT THEIR EFFORTS. - SUICIDE: ADDRESSED THROUGH INPATIENT AND OUTPATIENT PROGRAMS IN THE COMMUNITY, MEDIATION SERVICES LIKE EASTERN SHORE MOBILE CRISIS, UPPER BAY COUNSELING SERVICES, AND HOT- AND WARM-LINES PROVIDING REAL-TIME INTERVENTIONS TO THOSE AT-RISK FOR SUICIDE. BARRIERS TO CARE IDENTIFIED BUT NOT PRIORITIZED: - INCOME & POVERTY: MAY BE ADDRESSED AS PART OF EACH OF THE HEALTH PRIORITY AREAS. REQUIRES STRONGER GOVERNMENT/PUBLIC PROGRAMS AND AND FUNDING TO SUPPORT OVERCOMING THESE BARRIERS. - EMPLOYMENT: MAY BE ADDRESSED AS PART OF THE BEHAVIORAL HEALTH PRIORITY. OTHERWISE ADDRESSED BY SUSQUEHANNA WORKFORCE NETWORK, CECIL COLLEGE, AND OTHER LOCAL NON-PROFITS, LIKE THOSE THAT ASSIST VETERANS. - HEALTH INSURANCE AVAILABILITY AND COST: ADDRESSED THROUGH THE MARYLAND HEALTH CONNECTION AND SEEDCO. - TRANSPORTATION: ADDRESSED THROUGH VOUCHER PROGRAMS AT DEPT OF COMMUNITY SERVICES AND THROUGH LOCAL PARTNERSHIPS. - HEALTH CARE COSTS: ADDRESSED THROUGH PROGRAMS LIKE: UNION HOSPITAL COMMUNITY ASSISTED MEDICATION PROGRAM (CAMP), THE UNION HOSPITAL CANCER PROGRAM COMMUNITY OUTREACH SUPPORT, MANY OUTREACH PROGRAMS AT THE CECIL COUNTY HEALTH DEPARTMENT, LOCAL PHARMACY ASSISTANCE PROGRAMS, AND THE DEPARTMENT OF COMMUNITY SERVICES ASSISTANCE PROGRAMS THROUGH MAPP, OPTIONS COUNSELING, AND COMMUNITY FIRST CHOICE. - HOME HEALTH ELIGIBILITY: ADDRESSED THROUGH PROGRAMS THAT ASSIST PERSONS WITH THE APPLICATION PROCESS (EX. THE COUNTY DEPARTMENT OF COMMUNITY SERVICES). - LACK OF KNOWLEDGE (INCL. LOW HEALTH LITERACY, LACK OF ACCESS TO HEALTH INFORMATION): OPPORTUNITIES TO ADDRESS HEALTH LITERACY ARE BEING EXPLORED FOR ALL PRIORITY AREAS. - PUBLIC ASSISTANCE QUALIFICATIONS: ADDRESSED THROUGH CECIL COUNTY HEALTH DEPARTMENT, THE DEPARTMENT OF COMMUNITY SERVICES, THE DEPARTMENT OF SOCIAL SERVICES, AND THE CERTIFIED HEALTH INSURANCE NAVIGATORS THROUGH SEEDCO AND THE MARYLAND HEALTH CONNECTION. - NEED FOR MORE MEDICAL AND SOCIAL SUPPORTS: ADDRESSED BY DEPT OF SOCIAL SERVICES, DEPT OF COMMUNITY SERVICES, CECIL COUNTY HEALTH DEPARTMENT, AND OTHER SOCIAL SERVICES. - EDUCATIONAL ATTAINMENT: ADDRESSED BY LOCAL NON-PROFITS WORK WITH SPECIAL AND VULNERABLE POPULATIONS WHO EXPERIENCE BARRIERS TO GETTING A GED; LOCAL FEDERAL CREDIT UNIONS PROVIDE EDUCATION ON HOW TO AFFORDABLY FINANCE EDUCATION; CECIL COLLEGE OFFERS SCHOLARSHIPS TO ELIGIBLE INDIVIDUALS; AND WORKPLACES PROVIDE TUITION REIMBURSEMENT FOR APPLICABLE EDUCATIONAL ATTAINMENT (E.G.. WORKPLACE CERTIFICATIONS OR DEGREES). - AFFORDABLE HOUSING: AFFORDABLE HOUSING IS A LARGE BARRIER IN CECIL COUNTY, ESPECIALLY AMONG THE POOR AND LOW-INCOME. WHILE WAIT LISTS ARE LONG FOR MOST HOUSING PROGRAMS, THERE ARE AGENCIES IN THE COMMUNITY THAT MANAGE THIS ISSUE. ALSO, WHILE NEW DEVELOPMENT IS COSTLY, THERE ARE SOME RESOURCES AVAILABLE TO PURCHASE AND/OR REHAB EXISTING OR NEW PROPERTIES FOR TRANSITIONAL HOUSING. SOME COMMUNITY WORK HAS BEEN DONE TO STRIKE COMPROMISES WITH LANDLORDS TO HOUSE HOMELESS AND OTHER TENANTS WHO CAN DEMONSTRATE THE ABILITY TO SUSTAIN HOUSING. - LANGUAGE BARRIERS: LANGUAGE BARRIERS CAN BE ADDRESSED THROUGH THE USE OF INTERPRETERS. MOST PROGRAMS IN THE COUNTY HAVE ACCESS TO MEDICAL AND SOCIAL INTERPRETERS OR CONTRACTED INTERPRETER SERVICES. IF ACCESS IS A PROBLEM THEN THERE IS OPPORTUNITY TO PARTNER WITH ORGANIZATIONS THAT HAVE THESE RESOURCES. FOR PATIENTS OR CLIENTS WITH LANGUAGE BARRIERS THERE IS OPPORTUNITY FOR ORGANIZATIONS TO PROVIDE MATERIALS IN OTHER LANGUAGES AND HIRE OR ACCESS PROFESSIONALS THAT CAN SPEAK OTHER LANGUAGES. - TIME LIMITATIONS: IN ALL THE FOCUS GROUPS IT WAS VOICED THAT THERE ARE NOT ENOUGH DOCTORS' OFFICES OPEN IN THE EVENING HOURS. UNION HOSPITAL AND MANY OTHER PROVIDERS IN THE COMMUNITY HAVE ADDED EVENING AND WEEKEND HOURS FOR FREQUENTLY USED SERVICES, LIKE PRIMARY CARE AND URGENT CARE. ---------------
SCHEDULE H, PART V, SECTION B, LINE 13B (DETAIL OF INCOME LEVEL)	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. ---------------
SCHEDULE H, PART V, SECTION B, LINE 16A (FAP AVAILABILITY)	FAP WEBSITE: HTTPS://WWW.UHCC.COM/PATIENT-FINANCIAL-SERVICES/FINANCIAL-ASSISTANCE/ ---------------
SCHEDULE H, PART V, SECTION B, LINE 16B (FAP APPLICATION AVAILABILITY)	FAP APPLICATION WEBSITE: HTTPS://WWW.UHCC.COM/PATIENT-FINANCIAL-SERVICES/FINANCIAL-ASSISTANCE/ ---------------
SCHEDULE H, PART V, SECTION B, LINE 16C (FAP PLS AVAILABILITY)	FAP PLAIN LANGUAGE SUMMARY WEBSITE: HTTPS://WWW.UHCC.COM/PATIENT-FINANCIAL-SERVICES/FINANCIAL-ASSISTANCE/ ---------------
SCHEDULE H, PART V, SECTION B, LINE 16J (FAP OTHER AVAILABILITY)	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, AND 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 (BAD DEBT EXPENSE, COSTING METHODOLOGY USED)	IMPLICIT PRICE CONCESSIONS ARE TREATED AS A CONTRA-REVENUE ITEM ON THE STATEMENT OF REVENUE. AS A RESULT, THERE ARE NO BAD DEBT EXPENSES INCLUDED ON FORM 990, PART IX THAT NEED TO BE SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGES LISTED. THE COSTING METHODOLOGY USED IN CALCULATING THE AMOUNTS REPORTED ON THE LINE 7 TABLE ARE BASED ON ACTUAL COST PLUS OVERHEAD. OVERHEAD IS A HOSPITAL AVERAGE PERCENTAGE OF OVERHEAD TO DIRECT COSTS. DIRECT COSTS EXCLUDE BAD DEBT EXPENSE. ---------------
PART II (DETAIL OF COMMUNITY BUILDING ACTIVITIES)	IN FISCAL YEAR 2020, UNION HOSPITAL PARTICIPATED IN ECONOMIC DEVELOPMENT COMMUNITY BUILDING ACTIVITIES THROUGH THE PARTICIPATION OF ITS PRESIDENT, RICH SZUMEL, ON THE BOARDS OF THE ECONOMIC DEVELOPMENT COMMISSION FOR CECIL COUNTY AND THE ELKTON ALLIANCE. THE ECONOMIC DEVELOPMENT COMMISSION FOCUSES ON BUSINESS AND INDUSTRY DEVELOPMENT BY BUILDING RELATIONSHIPS WITH LOCAL PARTNERS IN CECIL COUNTY. 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. THE ELKTON ALLIANCE COLLABORATES WITH 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 THE ELKTON ALLIANCE, UNION HOSPITAL SEEKS TO MAINTAIN A POSITIVE PRESENCE IN THE COMMUNITY BY HELPING TO ADDRESS COMMUNITY DEVELOPMENT ISSUES. IN FY 2020, DR. RICH SZUMEL ALSO PARTICIPATED IN COMMUNITY SUPPORT COMMUNITY BUILDING ACTIVITIES THROUGH HIS PARTICIPATION ON THE LOCAL MANAGEMENT BOARD OF CECIL COUNTY. THE CORE FUNCTION OF LOCAL MANAGEMENT BOARDS (LMBS) IS TO IDENTIFY COMMUNITY DRIVEN PRIORITIES AND TARGET RESOURCES FOR THEIR COMMUNITIES, AS WELL AS SERVE AS THE COORDINATOR OF COLLABORATION FOR CHILD AND FAMILY SERVICES. THERE IS A LOCAL MANAGEMENT BOARD IN EACH COUNTY IN MARYLAND, INCLUDING BALTIMORE CITY. ON THIS BOARD, DR. SZUMEL PROVIDED INSIGHT ON THE CONNECTION BETWEEN HOSPITAL SERVICES/POPULATION HEALTH INITIATIVES AND SUPPORT FOR COMMUNITY DIRECTIVES/STRATEGIC PRIORITIES. ---------------
PART III, SECTION A, LINE 2 (IMPLICIT PRICE CONCESSIONS/BAD DEBT EXPENSE)	THE COSTING METHODOLOGY USED IN DETERMINING THE AMOUNTS REPORTED ON LINES 2 AND 3 ARE BASED ON ACTUAL CHARGES WRITTEN OFF (AMOUNTS THAT ARE DEEMED TO BE UNCOLLECTIBLE AND RECORDED AS IMPLICIT PRICE CONCESSIONS UNDER ACCOUNTING PRONOUNCEMENT ASC 606)TIMES THE COST TO CHARGE RATIO. ---------------
PART III, SECTION A, LINE 3 (IMPLICIT PRICE CONCESSION METHODOLOGY)	THE IMPLICIT PRICE CONCESSION METHODOLOGY ASSUMES THAT THE PERCENTAGE OF CHARITY CARE TO TOTAL REVENUE CAN BE APPLIED TO THE AMOUNT OF IMPLICIT PRICE CONCESSIONS FOR THE YEAR. OTHER IMPLICIT PRICE CONCESSION AMOUNTS ARE NOT INCLUDED IN COMMUNITY BENEFITS. ---------------
PART III, SECTION A, LINE 4 (IMPLICIT PRICE CONCESSION FOOTNOTE)	THE TEXT OF THE IMPLICIT PRICE CONCESSION (BAD DEBT EXPENSE) FOOTNOTE CAN BE FOUND ON PAGE 13 OF THE ELECTRONICALLY ATTACHED AUDITED FINANCIAL STATEMENTS. ---------------
PART III, SECTION B, LINE 8 (COSTING METHODOLOGY, MEDICARE SHORTFALL)	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, SECTION B, LINE 9B (COLLECTION PRACTICES)	UNION HOSPITAL'S F-416 CREDIT AND COLLECTION POLICY AND PROCEDURE HAS A SECTION CALLED, "INTERNAL COLLECTION EFFORTS" WHICH STATES: "UPON DISCHARGE, PATIENTS RECEIVE AN ITEMIZED BILL FOR INPATIENT ADMISSIONS IN ACCORDANCE WITH THE MARYLAND HOSPITAL COST REVIEW COMMISSION REQUIREMENTS. WHEN INSURANCE PAYMENTS ARE RECEIVED LEAVING A SELF-PAY BALANCE, OR THE ACCOUNT IS STRICTLY SELF-PAY, IT IS OUTSOURCED FOR FOLLOW-UP BUT REMAINS ON THE HOSPITAL'S ACTIVE ACCOUNTS RECEIVABLE. AGENTS WORK THE ACCOUNTS IN THE HOSPITAL'S NAME AND REPRESENTATIVES ARE DIRECTED TO ACCEPT MONTHLY PAYMENTS UNTIL THE ACCOUNT IS PAID IN FULL. COLLECTION EFFORTS CONSIST OF PHONE CALLS AND MONTHLY STATEMENTS. THE PATIENT MAY ALSO APPLY FOR FINANCIAL ASSISTANCE AT ANY TIME DURING THIS PROCESS (SEE POLICY F-415, FINANCIAL ASSISTANCE)." IN THE F-415 FINANCIAL ASSISTANCE POLICY AND PROCEDURE, UNDER SECTION, "ACTION IN THE EVENT OF NON-PAYMENT," IT IS EXPLAINED THAT: "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, IN THE F-416 POLICY, UNDER THE SECTION, "EXTERNAL COLLECTION (BAD DEBT WRITE-OFF)," IT EXPLAINS THAT PATIENTS WITH BALANCES BEING COLLECTED BY AN ASSIGNED COLLECTION AGENCY WILL HAVE THEIR BALANCES WIRTTEN OFF IF THEY ARE DETERMINED TO BE INDIGENT. ---------------
PART VI, LINE 2 (NEEDS ASSESSMENT)	UNION HOSPITAL ASSESSES THE HEALTH CARE NEEDS OF THE COMMUNITIES IT SERVES THROUGH ITS ROBUST COMMUNITY PARTNERSHIPS. PERHAPS ITS MOST SIGNIFICANT PARTNERSHIPS ARE WITH THE CECIL COUNTY HEALTH DEPARTMENT (CCHD) AND THE COMMUNITY HEALTH ADVISORY COMMITTEE (CHAC). UNION HOSPITAL HAS PARTNERED WITH THE CCHD TO CONDUCT AND COMPLETE ITS NEEDS ASSESSMENT (CHNA) SINCE 2013. THE CHAC ALSO PLAYS A SIGNIFICANT ROLE IN THIS PROCESS AS IT PROVIDES SUBSTANTIAL INPUT ON THE SELECTION OF THE PRIORITIZED NEEDS AND IT GOVERNS THE HEALTH TASK FORCES THAT WORK ON AND MONITOR PROGRESS MADE ON THE COMMUNITY HEALTH IMPROVEMENT PLAN (CHIP) STRATEGIES THAT ADDRESS THE HEALTH PRIORITIES IDENTIFIED IN THE CHNA. THE CCHD IS INVOLVED IN MANY HEALTH INITIATIVES THROUGHOUT CECIL COUNTY AND THE CHAC IS COMPRISED OF A NUMBER OF LOCAL GOVERNMENT AND COMMUNITY ORGANIZATIONS. THESE PARTNERSHIPS PROVIDE UNION HOSPITAL WITH RICH INSIGHT INTO THE HEALTH OF OUR COMMUNITY. UNION HOSPITAL CAREGIVERS ALSO PARTICIPATE IN A NUMBER OF DIFFERENT COMMUNITY BOARDS AND COMMITTEES THAT FOCUS ON DIFFERENT AREAS OF COMMUNITY NEED AND INTEREST. BESIDES THE MANY ALREADY MENTIONED IN PRIOR SECTIONS: - CECIL COUNTY DRUG AND ALCOHOL COUNCIL - CECIL COUNTY CORE SERVICES AGENCY - CHILD ADVOCACY CENTER - CIT ADVISORY COMMITTEE - CIT COMMITTEE - ECONOMIC DEVELOPMENT COMMISSION - ELKTON ALLIANCE - LOCAL MANAGEMENT BOARD OF CECIL COUNTY - LOCAL OVERDOSE FATALITY REVIEW TEAM IN FY 2020, UNION HOSPITAL ALSO PARTICIPATED IN THESE ADDITIONAL GROUPS: - CECIL COUNTY DEPARTMENT OF SOCIAL SERVICES BOARD - ELKTON ROTARY - MARYLAND STRATEGIC PREVENTION FRAMEWORK IN JANUARY 2020, UNION HOSPITAL BECAME A PART OF CHRISTIANACARE. CHRISTIANACARE IS ONE OF THE COUNTRY'S MOST DYNAMIC HEALTH CARE ORGANIZATIONS, CENTERED ON IMPROVING HEALTH OUTCOMES, MAKING HIGH-QUALITY CARE MORE ACCESSIBLE AND LOWERING HEALTH CARE COSTS. CHRISTIANACARE ALSO ABIDES BY THE CHRISTIANACARE WAY: WE SERVE OUR NEIGHBORS AS RESPECTFUL, EXPERT, CARING PARTNERS IN THEIR HEALTH. WE DO THIS BY CREATING INNOVATIVE, EFFECTIVE, AFFORDABLE SYSTEMS OF CARE THAT OUR NEIGHBORS VALUE. CHRISTIANACARE IS GUIDED BY ITS COMMITMENT TO PARTNERING WITH OUR NEIGHBORS TO BETTER UNDERSTAND THEIR NEEDS AND GOALS FOR HEALTH. UNION HOSPITAL WAS ALREADY UNDERTAKING THE CHRISTIANACARE WAY IN SPIRIT, AND WE EXPECT OUR COMMUNITY PARTNERSHIPS TO CONTINUE TO STRENGTHEN. ---------------
PART VI, LINE 3 (PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE)	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 ADHERES TO THE ESTABLISHED MARYLAND STATE FINANCIAL ASSISTANCE GUIDELINES. THE FAP CLEARLY DEFINES PATIENT EXPECTATIONS, OFFERS A STEP-BY-STEP PROCESS FOR PATIENT APPLICATION, DOCUMENT REVIEW, AND REQUEST FOR MORE INFORMATION. INDIVIDUALS WHO PRESENT TO UNION HOSPITAL IN PERSON TO DISCUSS A BILL ARE 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 (COMMUNITY INFORMATION)	UNION HOSPITAL IS THE ONLY HOSPITAL IN CECIL COUNTY AND SERVES THE ENTIRE COUNTY. CECIL COUNTY IS LOCATED IN THE UPPER NORTHEASTERN CORNER OF THE CHESAPEAKE BAY IN MARYLAND AND BORDERS PENNSYLVANIA AND DELAWARE. THE COUNTY SEAT IS ELKTON, MARYLAND, AND THERE ARE EIGHT TOWNS AND SEVEN UNINCORPORATED COMMUNITIES IN THE COUNTY. PRIMARY SERVICE AREA 21921 - ELKTON 21922 - ELKTON 21901 - NORTH EAST 21916 - CHILDS 21920 - ELK MILLS 21915 - CHESAPEAKE CITY 21914 - CHARLESTOWN 21911 - RISING SUN 21912 - WARWICK 21913 - CECILTON 21919 - EARLEVILLE SECONDARY SERVICE AREA 21902 - PERRYPOINT 21903 - PERRYVILLE 21904 - PORT DEPOSIT 21917 - COLORA 21918 - CONOWINGO 21930 - GEORGETOWN THE LARGEST POPULATION CENTERS IN CECIL COUNTY ARE ELKTON (21921), NORTH EAST, AND RISING SUN. HOSPITAL UTILIZATION SHOWS THAT 60% OF THE HOSPITAL'S PATIENTS COME FROM ELKTON AND NORTH EAST. ACCORDING TO THE CENSUS BUREAU, IN 2019 THE CECIL COUNTY POPULATION WAS ESTIMATED TO BE 102,855 WITH 22.5% UNDER THE AGE OF 18 AND 16.2% AGED 65 AND OLDER. 50.5% OF THE POPULATION IS FEMALE. CECIL COUNTY IS LESS RACIALLY DIVERSE THAN MARYLAND WITH 84.6% WHITE (NOT IDENTIFYING AS HISPANIC OR LATINO), 7.3% BLACK OR AFRICAN AMERICAN, 4.7% HISPANIC OR LATINO, AND 1.4% ASIAN. THE MEDIAN INCOME IS $76,887 IN THE COUNTY ($84,805 IN MARYLAND) AND THERE IS A 10.3% POVERTY RATE. 89.5% OF CECIL COUNTY RESIDENTS ARE HIGH SCHOOL GRADUATES OR HIGHER AND 23.9% HAVE A BACHELOR'S DEGREE OR HIGHER (40.2% MARYLANDERS HAVE A BACHELOR'S DEGREE OR HIGHER). CECIL COUNTY IS A LARGELY RURAL AREA AND ACCESSING SERVICES CAN BE CHALLENGING, ESPECIALLY IF INDIVIDUALS ALSO FACE A LACK OF TRANSPORTATION AND OTHER BARRIERS. (CENSUS BUREAU, QUICKFACTS, HTTPS://WWW.CENSUS.GOV/QUICKFACTS/CECILCOUNTYMARYLAND) ---------------
PART VI, LINE 5 (INFORMATION REGARDING PROMOTION OF COMMUNITY HEALTH)	FISCAL YEAR 2020 BROUGHT A LOT OF CHANGES TO UNION HOSPITAL. IT JOINED CHRISTIANACARE IN JANUARY 2020, UNION HOSPITAL'S COMMUNITY BENEFIT MANAGER WHO HAS LED MOST COMMUNITY BENEFIT ACTIVITIES FOR YEARS LEFT IN THE EARLY MONTHS OF THE FISCAL YEAR, AND THE PANDEMIC BROUGHT TO A HALT MANY COMMUNITY ACTIVITIES THAT WOULD TYPICALLY OCCUR IN THE SPRING. WHILE IT HAS BEEN CHALLENGING TO PROVIDE THE SAME COMMUNITY BENEFIT SERVICES AMIDST THE PANDEMIC, LIKE OUR ON-SITE YOUTH PROGRAMMING CAMP SCRUBS AND THE EXPLORERS POST, ALL OF THESE CHANGES PROVIDE EXCELLENT OPPORTUNITIES TO STRENGTHEN OUR COMMUNITY BENEFIT EFFORTS AND CONSIDER OUR COMMUNITY CHALLENGES WITH A NEW PERSPECTIVE. GUIDED BY THE CHRISTIANACARE WAY AND OUR VALUES OF LOVE AND EXCELLENCE, CHRISTIANACARE INCLUDES AN EXTENSIVE NETWORK OF OUTPATIENT SERVICES, HOME HEALTH CARE, URGENT CARE CENTERS, THREE HOSPITALS (1,299 BEDS), A LEVEL I TRAUMA CENTER AND A LEVEL III NEONATAL INTENSIVE CARE UNIT, A COMPREHENSIVE STROKE CENTER AND REGIONAL CENTERS OF EXCELLENCE IN HEART AND VASCULAR CARE, CANCER CARE AND WOMEN'S HEALTH. IT ALSO INCLUDES THE PIONEERING GENE EDITING INSTITUTE AND WAS RATED BY IDG COMPUTERWORLD AS ONE OF THE NATION'S BEST PLACES TO WORK IN IT. CHRISTIANACARE IS A NONPROFIT TEACHING HEALTH SYSTEM WITH MORE THAN 281 RESIDENTS AND FELLOWS. CHRISTIANACARE IS CONTINUALLY RANKED BY US NEWS & WORLD REPORT AS A BEST HOSPITAL. WITH OUR UNIQUE, DATA-POWERED CARE COORDINATION SERVICE CAREVIO AND A FOCUS ON POPULATION HEALTH AND VALUE-BASED CARE, CHRISTIANACARE IS SHAPING THE FUTURE OF HEALTH CARE. UNION HOSPITAL, NOW KNOWN AS CHRISTIANACARE, UNION HOSPITAL, WILL BENEFIT FROM ALL THE EXPERTISE AND INNOVATION OF CHRISTIANACARE AND WE FULLY EXPECT TO ALSO LEARN FROM UNION HOSPITAL, PARTICULARLY AS WE STRIVE TO SERVE A LESS DIVERSE AND MORE RURAL POPULATION IN CECIL COUNTY WITH ITS OWN SET OF UNIQUE CHALLENGES AND STRENGTHS. CHRISTIANACARE SYSTEM LEVEL COMMUNITY HEALTH AND POPULATION HEALTH TEAMS ARE WORKING ON INTEGRATION AND WE LOOK FORWARD TO CONTINUED LEARNING FROM OUR UNION HOSPITAL CAREGIVERS AND CECIL COUNTY NEIGHBORS AND STRENGTHENED POSITIVE IMPACT ON THE COMMUNITY. EACH FISCAL YEAR, UNION HOSPITAL SERVES THE CECIL COUNTY COMMUNITY BY PROVIDING ACTIVITIES, PROGRAMS, AND INITIATIVES THAT SEEK TO IMPROVE COMMUNITY HEALTH, ESPECIALLY SERVING UNDERSERVED AREAS AND VULNERABLE POPULATIONS. WHILE MANY OF THESE ACTIVITIES WERE HALTED IN MARCH 2020 AND SOME WERE UNABLE TO BE COMPLETED AS THE RECENTLY DEPARTED COMMUNITY BENEFIT MANAGER WAS LEADING THEM, NEVERTHELESS, WE PROVIDED SERVICES TO THE COMMUNITY IN FY 2020. THE FOLLOWING IS A SUMMARY OF THE COMMUNITY BENEFIT ACTIVITIES, PROGRAMS, AND INITIATIVES THAT UNION HOSPITAL PROVIDED IN CECIL COUNTY DURING FY 2020 THAT HAVE NOT BEEN MENTIONED PREVIOUSLY IN THIS NARRATIVE: A1: COMMUNITY HEALTH EDUCATION UNION HOSPITAL PROVIDED: - A VARIETY OF HEALTH EDUCATION PRESENTATIONS IN THE COMMUNITY ON TOPICS SUCH AS DIABETES, BREAST CANCER, AND NUTRITION - EXPLORER POST AT UNION HOSPITAL AND CAMP SCRUBS FOR STUDENTS SEEKING EXPOSURE TO MEDICAL OR HEALTH SCIENCE EXPERIENCES - SUPPORT GROUPS FOR NEW MOMS, BREAST CANCER SURVIVORS, AND DIABETES - TARGETED EDUCATION AT TREATMENT CLINICS FOR NEW MOMS WHOSE BABIES MAY BE DELIVERED WITH NEONATAL ABSTINENCE SYNDROME A2: COMMUNITY-BASED CLINICAL SERVICES UNION HOSPITAL PROVIDED: - FREE FOOT AND EYE SCREENINGS FOR DIABETICS - TYPICALLY, UNION HOSPITAL ALSO PROVIDES FREE HEAD AND NECK CANCER SCREENINGS, BUT THESE WERE CANCELLED DUE TO THE PANDEMIC. - UNION HOSPITAL ALSO PROVIDES A FREE SPORTS PHYSICALS CLINIC FOR COUNTY PUBLIC AND PRIVATE MIDDLE SCHOOL AND HIGH SCHOOL STUDENTS - THIS EVENT WAS POSTPONED DUE TO THE PANDEMIC. WHILE IT DID NOT HAPPEN IN FY 20, IT HAPPENED IN EARLY FY 21. A4: SOCIAL AND ENVIRONMENTAL IMPROVEMENTS UNION HOSPITAL: - PARTICIPATED IN BOARD SERVICE WITH ORGANIZATIONS SUPPORTING SOCIAL AND ENVIRONMENTAL HEALTH - PROVIDED TRANSPORTATION DONATIONS FOR ELIGIBLE (NEEDS-BASED) PATIENTS AND THEIR FAMILIES B1-B3: HEALTH PROFESSIONS EDUCATION UNION HOSPITAL STAFF PRECEPTED POST-SECONDARY STUDENTS THROUGH STUDENT EXPERIENCES FOR NURSING AND MEDICAL RESIDENCY CLINICAL ROTATIONS, GRADUATE STUDENT INTERNSHIPS, AND ALLIED HEALTH OBSERVATIONS AND INTERNSHIPS. C: MISSION DRIVEN HEALTH SERVICES UNION HOSPITAL PROVIDED THESE SERVICES TO MEET IDENTIFIED NEEDS IN THE COMMUNITY, EVEN THOUGH THEY OPERATE AT A LOSS: - EMPLOYED PHYSICIAN PRACTICE SUBSIDIES (C3) - ADULT DAY SERVICES FOR OLDER ADULT CLIENTS WITH DEMENTIA AND OTHER NEUROLOGICAL DISORDERS (C7) - HOSPICE CARE (C9) D1: CLINICAL RESEARCH UNION HOSPITAL MAINTAINED A CANCER REGISTRY THROUGH THE CANCER PROGRAM THAT WAS AVAILABLE TO HEALTH SERVICE PROVIDERS AND RESEARCHERS. E3: IN-KIND CONTRIBUTIONS UNION HOSPITAL PROVIDED DONATIONS OF TIME AND MATERIALS FOR THE CECIL COUNTY COMMUNITY BY: - PROVIDING FREE AMBULANCE TRANSPORTS AND FREE SUPPLIES FOR AMBULANCE STOCK-UPS - GIVING BLOOD AT BLOOD DRIVES HELD AT THE HOSPITAL AND OTHER LOCAL DONOR LOCATIONS - ATTENDING MEETINGS FOR COMMUNITY HEALTH IMPROVEMENT (LOCAL HEALTH IMPROVEMENT COALITION, COMMUNITY BOARDS, COALITIONS, ETC.) - PROVIDING FOOD FOR THE HOME DELIVERED MEALS PROGRAM (MEALS ON WHEELS) 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 DIVISIONS - PROVIDING FREE NOTARY SERVICES FOR THE COMMUNITY ONLY 3 MONTHS OF FY 2020 WERE AFFECTED BY THE PANDEMIC, BUT UNFORTUNATELY, PROGRAMMING LIKE BLOOD DRIVES, SPORTS PHYSICALS, HEALTH FAIRS AND PRESENTATIONS, AND STUDENT INITIATIVES TYPICALLY OCCUR IN THE SPRING MONTHS. IN PERSON PROGRAMS SUCH AS THE PEER RECOVERY ADVOCATES PROGRAM AND THE NAS PARENTING EDUCATION WERE ALSO HALTED AND SO DESPITE ONLY AFFECTING A QUARTER OF THE YEAR, WE CERTAINLY FELT THE BURDEN OF THE PANDEMIC ON OUR COMMUNITY WORK IN FY 2020. UNION HOSPITAL ADAPTED WITH STRENGTH AND PERSEVERANCE AND LIKE THE REST OF THE NATION AND WORLD, WAS REMINDED THROUGH THE EXPERIENCE OF THE PANDEMIC HOW TRULY VITAL HEALTH IS TO OUR LIVES AND COMMUNITIES. WE ARE EAGER TO GET BACK INTO OUR COMMUNITIES AND NOT JUST VIRTUALLY! WITH THE SHARED LEARNING AND INTEGRATION BETWEEN UNION HOSPITAL AND CHRISTIANACARE, WE ARE EXCITED ABOUT THE NEW PROGRAMMING AND INITIATIVES TO BE INTRODUCED INTO CECIL COUNTY AS THE PANDEMIC SUBSIDES. OF COURSE, EVERY INITIATIVE WILL BE SUBJECT TO OUR PARTNER AND COMMUNITY'S APPROVAL AS WE STRIVE TO TRULY PARTNER WITH OUR COMMUNITIES. ---------------
PART VI, LINE 6 (AFFILIATED HEALTHCARE SYSTEM INFORMATION)	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 SERVICE 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. ON JANUARY 1, 2020, AHA BECAME A MEMBER OF CHRISTIANA CARE HEALTH SYSTEM. CHRISTIANA CARE IS A MAJOR TEACHING HEALTH SYSTEM WITH MORE THAN 1,600 MEDICAL-STAFF MEMBERS AND 260 MEDICAL-DENTAL RESIDENTS AND FELLOWS AND INCLUDES A NUMBER OF ENTITIES INCLUDING CHRISTIANA CARE HEALTH SERVICES, INC. ---------------
PART VI, LINE 7 (STATES FILING OF COMMUNITY BENEFIT REPORT)	LIST OF STATES RECEIVING COMMUNITY BENEFIT REPORT: MD

Schedule H (Form 990) 2019

Additional Data

Software ID:
Software Version:

- TIN:

Schedule J
(Form 990)

Department of the Treasury
Internal Revenue Service

Compensation Information

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

Complete if the organization answered "Yes" 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 ------------- 461,034	0 ------------- 0	0 ------------- 21,647	0 ------------- 77,504	0 ------------- 8,287	0 ------------- 568,472	0 ------------- 0
2JOSE MA MD DIRECTOR	(i) (ii)	113,761 ------------- 0	132,654 ------------- 0	24,236 ------------- 0	3,458 ------------- 0	26,163 ------------- 0	300,272 ------------- 0	0 ------------- 0
3JAMES G RAAB SENIOR VP/CFO THRU 10/2020	(i) (ii)	0 ------------- 265,004	0 ------------- 0	0 ------------- 34,345	0 ------------- 3,784	0 ------------- 21,672	0 ------------- 324,805	0 ------------- 0
4AARON Z ROYSTON THRU 1019 VP OF PROVIDER ENTERPRISE	(i) (ii)	177,655 ------------- 0	0 ------------- 0	64,790 ------------- 0	2,790 ------------- 0	1,382 ------------- 0	246,617 ------------- 0	0 ------------- 0
5CRAIG M BABBITT IN-HOUSE LEGAL COUNSEL	(i) (ii)	284,148 ------------- 0	0 ------------- 0	52,033 ------------- 0	4,200 ------------- 0	7,080 ------------- 0	347,461 ------------- 0	0 ------------- 0
6FAHD RAHMAN PHYSICIAN	(i) (ii)	378,996 ------------- 0	180,294 ------------- 0	131,074 ------------- 0	4,200 ------------- 0	26,666 ------------- 0	721,230 ------------- 0	0 ------------- 0
7JUSTIN SAUSVILLE MD DIRECTOR, PHYSICIAN	(i) (ii)	398,786 ------------- 0	29,694 ------------- 0	119,804 ------------- 0	4,200 ------------- 0	26,722 ------------- 0	579,206 ------------- 0	0 ------------- 0
8ROGER D WU PHYSICIAN	(i) (ii)	445,628 ------------- 0	26,510 ------------- 0	38,436 ------------- 0	4,200 ------------- 0	22,536 ------------- 0	537,310 ------------- 0	0 ------------- 0
9NAVEED HASAN PHYSICIAN	(i) (ii)	332,313 ------------- 0	27,500 ------------- 0	126,411 ------------- 0	4,200 ------------- 0	22,267 ------------- 0	512,691 ------------- 0	0 ------------- 0
10HANHAN LI PHYSICIAN	(i) (ii)	391,867 ------------- 0	17,500 ------------- 0	63,172 ------------- 0	4,200 ------------- 0	8,430 ------------- 0	485,169 ------------- 0	0 ------------- 0
11MICHELLE TWUM-DANSO ASSOCIATE VP HUMAN RESOURCES	(i) (ii)	168,143 ------------- 0	0 ------------- 0	12,177 ------------- 0	1,993 ------------- 0	1,618 ------------- 0	183,931 ------------- 0	0 ------------- 0
12DR RYAN GERACIMOS CHIEF MEDICAL OFFICER	(i) (ii)	0 ------------- 288,101	0 ------------- 0	0 ------------- 14,800	0 ------------- 1,511	0 ------------- 1,541	0 ------------- 305,953	0 ------------- 0
13MARIE VASBINDER SR. VP/CHIEF NURSE OFFICER	(i) (ii)	0 ------------- 97,550	0 ------------- 0	0 ------------- 119,896	0 ------------- 1,613	0 ------------- 781	0 ------------- 219,840	0 ------------- 0
14DERON BROWN EXEC DIRECTOR OF FINANCE	(i) (ii)	144,989 ------------- 0	0 ------------- 0	6,482 ------------- 0	2,180 ------------- 0	1,970 ------------- 0	155,621 ------------- 0	0 ------------- 0
15EUGENIA M GRAY PHYSICIAN	(i) (ii)	396,682 ------------- 0	11,250 ------------- 0	1,892 ------------- 0	4,200 ------------- 0	15,153 ------------- 0	429,177 ------------- 0	0 ------------- 0
16CYDNEY TEAL FORMER VP MEDICAL AFFAIRS	(i) (ii)	0 ------------- 54,628	0 ------------- 0	0 ------------- 47,635	0 ------------- 3,759	0 ------------- 3,400	0 ------------- 109,422	0 ------------- 0
17JOAN PIRRUNG VP OF NURSING	(i) (ii)	0 ------------- 119,904	0 ------------- 22,911	0 ------------- 17,094	0 ------------- 18,369	0 ------------- 21,913	0 ------------- 200,191	------------- 0
18AMY MARSTON CAMPUS OPERATIONS OFFICER	(i) (ii)	0 ------------- 131,676	0 ------------- 14,994	0 ------------- 13,284	0 ------------- 4,935	0 ------------- 22,733	0 ------------- 187,622	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
FORM 990, SCHEDULE J, PART I, LINE 4A	DEATAIL OF SEVERANCE PAYMENTS THE FOLLOWING INDIVIDUALS RECEIVED SEVERANCE PAYMENTS DURING THE CALENDAR YEAR 2019: - AARON Z. ROYSTON $33,408 - CRAIG M. BABBITT $29,376 - MARIE VASBINDER $103,846 ---------------
FORM 990, SCHEDULE J, PART I, LINE 4B	SUPPLEMENTAL NONQUALIFIED PLAN PARTICIPATION DR. RICHARD C. SZUMEL (PRESIDENT & CEO) PARTICIPATES IN A SUPPLEMENTAL, NON-QUALIFIED RETIREMENT PLAN UNDER SECTION 457(F) OF THE INTERNAL REVENUE CODE WITH CONTRIBUTION AMOUNT OF $73,304 DURING THE CALENDAR YEAR 2019. ---------------
FORM 990, SCHEDULE J, PART I, LINE 7	PROVISION OF NON-FIXED PAYMENTS 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

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	TOWN OF ELKTON - SERIES 2012A	52-6000790		05-18-2012	10,000,000	REFUND PORTION OF SERIES 2009 BOND		X		X		X
B	TOWN OF ELKTON - SERIES 2012B1B2	52-6000790		05-18-2012	8,662,336	REFUND SERIES 2009 & 2000 BONDS		X		X		X
C	TOWN OF ELKTON - SERIES 2012C	52-6000790		05-18-2012	9,000,000	REFUND ESCROW TO REPAY 2002 BoND		X		X		X
D	MD HEALTH & HIGHER EDUCATION FACILITIES AUTHORITY	52-0936091		07-18-2012	9,924,000	REFUND PORTION OF SERIES 2002 BOND		X		X		X
	MD HEALTH & HIGHER EDUCATION FACILITIES AUTHORITY	52-0936091		07-18-2012	4,007,000	FINANCE ACQUISITION OF EQUIPMENT		X		X		X
	MD HEALTH & HIGHER EDUCATION FACILITIES AUTHORITY	52-0936091		12-01-2014	30,778,000	REFINANCE THE 2005 BOND		X		X		X

Part Ⅱ

Proceeds

	A		B		C		D
	1 Amount of bonds retired ..................	2,667,702		4,378,636		0		7,698,735
2 Amount of bonds legally defeased ..............	0		0		0		0
3 Total proceeds of issue ..................	10,000,000		8,662,336		9,000,000		9,924,000
4 Gross proceeds in reserve funds .............	0		0		0		0
5 Capitalized interest from proceeds .............	0		0		0		0
6 Proceeds in refunding escrows ...............	0		0		0		0
7 Issuance costs from proceeds ...............	0		0		0		0
8 Credit enhancement from proceeds .............	0		0		0		0
9 Working capital expenditures from proceeds .............	0		0		0		0
10 Capital expenditures from proceeds .............	0		0		0		0
11 Other spent proceeds .............	10,000,000		8,662,336		9,000,000		9,924,000
12 Other unspent proceeds .............	0		0		0		0
13 Year of substantial completion .............	2012		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)? ........	X		X		X		X
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)? ........		X		X		X		X
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. ..			0 %				0 %
c If "Yes" to line 8a, was any remedial action taken pursuant to Regulations sections 1.141-12 and 1.145-2? .............		X		X		X		X
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 ..........	0		0		0		0
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 ..........	0		0		0		0
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

Schedule K (Form 990) 2019

Additional Data

Software ID:
Software Version:

- TIN:

Note: To capture the full content of this document, please select landscape mode (11" x 8.5") when printing.

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	TOWN OF ELKTON - SERIES 2012A	52-6000790		05-18-2012	10,000,000	REFUND PORTION OF SERIES 2009 BOND		X		X		X
B	TOWN OF ELKTON - SERIES 2012B1B2	52-6000790		05-18-2012	8,662,336	REFUND SERIES 2009 & 2000 BONDS		X		X		X
C	TOWN OF ELKTON - SERIES 2012C	52-6000790		05-18-2012	9,000,000	REFUND ESCROW TO REPAY 2002 BoND		X		X		X
D	MD HEALTH & HIGHER EDUCATION FACILITIES AUTHORITY	52-0936091		07-18-2012	9,924,000	REFUND PORTION OF SERIES 2002 BOND		X		X		X
	MD HEALTH & HIGHER EDUCATION FACILITIES AUTHORITY	52-0936091		07-18-2012	4,007,000	FINANCE ACQUISITION OF EQUIPMENT		X		X		X
	MD HEALTH & HIGHER EDUCATION FACILITIES AUTHORITY	52-0936091		12-01-2014	30,778,000	REFINANCE THE 2005 BOND		X		X		X

Part Ⅱ

Proceeds

	A		B		C		D
	1 Amount of bonds retired ..................	2,667,702		4,378,636		0		7,698,735
2 Amount of bonds legally defeased ..............	0		0		0		0
3 Total proceeds of issue ..................	10,000,000		8,662,336		9,000,000		9,924,000
4 Gross proceeds in reserve funds .............	0		0		0		0
5 Capitalized interest from proceeds .............	0		0		0		0
6 Proceeds in refunding escrows ...............	0		0		0		0
7 Issuance costs from proceeds ...............	0		0		0		0
8 Credit enhancement from proceeds .............	0		0		0		0
9 Working capital expenditures from proceeds .............	0		0		0		0
10 Capital expenditures from proceeds .............	0		0		0		0
11 Other spent proceeds .............	10,000,000		8,662,336		9,000,000		9,924,000
12 Other unspent proceeds .............	0		0		0		0
13 Year of substantial completion .............	2012		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)? ........	X		X		X		X
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)? ........		X		X		X		X
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. ..			0 %				0 %
c If "Yes" to line 8a, was any remedial action taken pursuant to Regulations sections 1.141-12 and 1.145-2? .............		X		X		X		X
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 ..........	0		0		0		0
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 ..........	0		0		0		0
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

Schedule K (Form 990) 2019

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE O
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Supplemental Information to Form 990 or 990-EZ

Complete to provide information for responses to specific questions on
Form 990 or 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 III, LINE 3	DETAIL OF CHANGES IN ACTIVITIES THE ORGANIZATION'S ADULT DAYCARE PROGRAM WAS CEASED IN NOVEMBER 2019. --------------- FORM 990, PART VI, SECTION A, LINE 6 DETAIL OF MEMBERS AND STOCKHOLDERS CHRISTIANA CARE HEALTH SERVICES, INC. IS THE SOLE MEMBER OF AFFINITY HEALTH ALLIANCE ("AFFINITY"), BOTH TAX-EXEMPT ORGANIZATIONS. AFFINITY IS THE SOLE MEMBER OF THE UNION HOSPITAL OF CECIL COUNTY, INC. ---------------
FORM 990, PART VI, SECTION A, LINE 7A	GOVERNING BODY AND MANAGEMENT THE BYLAWS OF THE HOSPITAL PROVIDE THAT ITS DIRECTORS ARE APPOINTED BY ITS SOLE MEMBER, AFFINITY. ---------------
FORM 990, PART VI, SECTION A, LINE 7B	GOVERNING BODY AND MANAGEMENT THE BYLAWS OF THE HOSPITAL PROVIDE THAT ITS SOLE MEMBER (AFFINITY) MAY AMEND ITS BYLAWS. ---------------
FORM 990, PART VI, SECTION B, LINE 11B	FORM 990 REVIEW PROCESS INFORMATION RELATED TO THE UNION HOSPITAL OF CECIL COUNTY, INC. FORM 990 IS GATHERED BY FINANCE STAFF AND PROVIDED TO PRICEWATERHOUSECOOPERS LLP FOR REVIEW. THE FINAL 2019 FORM 990 FOR THE FISCAL YEAR ENDING JUNE 30, 2020 WAS REVIEWED AND APPROVED BY VARIOUS SENIOR MANAGEMENT OFFICIALS. THE ORGANIZATION'S GOVERNING BOARD WAS ALSO PROVIDED ACCESS TO THE APPROVED 2019 FORM 990 VIA ITS BOARD OF DIRECTORS PORTAL. ---------------
FORM 990, PART VI, SECTION B, LINE 12C	CONFLICT OF INTEREST POLICY 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	COMPENSATION REVIEW AND APPROVAL PROCESS 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 OR SURVEYS, TO SET COMPENSATION. DURING FISCAL YEAR 2020, 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	GOVERNANCE, MANAGEMENT & DISCLOSURE THE ORGANIZATION MAKEs ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. ---------------
FORM 990, PART XI, LINE 9	DETAIL OF OTHER CHANGES IN NET ASSETS INVESTMENT IN CCHS & SUBSIDIARIES $ (26,601,805) CHANGE IN NET ASSETS OF FOUNDATION 95,616 ______________ TOTAL $ (26,506,189) --------------- ---------------
FORM 990 PART IX LINE 11G	DESCRIPTION:CONTRACTED SERVICES TOTAL FEES:9437392
FORM 990 PART IX LINE 11G	DESCRIPTION:PHYSICIAN SERVICES TOTAL FEES:11380354
FORM 990 PART IX LINE 11G	DESCRIPTION:PURCHASED SERVICES & FEES TOTAL FEES:1737637
FORM 990 PART IX LINE 11G	DESCRIPTION:AGENCY EMPLOYEES TOTAL FEES:2683491
FORM 990 PART IX LINE 11G	DESCRIPTION:TRANSCRIPTION SERVICES TOTAL FEES:185785
FORM 990 PART IX LINE 11G	DESCRIPTION:CLEANING SERVICES TOTAL FEES:170985
FORM 990 PART IX LINE 11G	DESCRIPTION:BILLING & COLLECTIONS SERVICES TOTAL FEES:2367149
FORM 990 PART IX LINE 11G	DESCRIPTION:ADMINISTRATIVE SERVICES TOTAL FEES:179700

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

Software ID:
Software Version:

- TIN:

SCHEDULE R
(Form 990)

Department of the Treasury
Internal Revenue Service

Related Organizations and Unrelated Partnerships

Complete if the organization answered "Yes" 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 FDN INC 106 BOW STREET ELKTON,MD21921 52-1794552	FUNDRAISING	MD	501(C)(3)	7	AFFINITY		No
(2)UNION HOSPITAL OF CECIL COUNTY HLTH SVCS 106 BOW STREET ELKTON,MD21921 52-1794553	PROPERTY MGMT	MD	501(C)(3)	10	AFFINITY		No
(3)AFFINITY HEALTH ALLIANCE INC 106 BOW STREET ELKTON,MD21921 52-1794697	MANAGEMENT	MD	501(C)(3)	12B,II	CCH SERVICES		No
(4)UNION HOSPITAL OF CECIL COUNTY ONCOLOGY 106 BOW STREET ELKTON,MD21921 81-2662359	HEALTHCARE	MD	501(C)(3)	3	AFFINITY		No
(5)CHRISTIANA CARE HEALTH SYSTEM INC 501 WEST 14TH STREET WILMINGTON,DE19801 52-1479538	FUNDRAISING	DE	501(C)(3)	7	NA		No
(6)CHRISTIANA CARE HLTH INITIATIVES INC 200 HYGEIA DRIVE SUITE 2300 NEWARK,DE19713 51-0295186	OUTPATIENT SV	DE	501(C)(3)	10	CCH SYSTEM		No
(7)CHRISTIANA CARE HOME HEALTH & COM SRVCS 4000 NEXUS DRIVE STE W2 WILMINGTON,DE19803 51-0064334	HOME HLTHCARE	DE	501(C)(3)	7	CCH SYSTEM		No
(8)CHRISTIANA CARE HEALTH SERVICES INC PO BOX 2653 WILMINGTON,DE19805 51-0103684	HOSPITAL	DE	501(C)(3)	3	CCH SYSTEM		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
(1) CHRISTIANACARE GOHEALTH URGENT CARE LLC 5555 GLENRIDGE CONNECTOR STE 700 ATLANTA,GA30342 84-4061485	URGENT CARE SRVCS	DE	CCH SERVICES
(2) CHRISTIANACARE VALUE HEALTH JV LLC 11221 ROE AVENUE LEAWOOD,KS66211 85-1100149	AMBULATORY SRVCS	DE	CCH SERVICES

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 106 BOW STREET ELKTON,MD21921 52-1793691	MEDICAL SERVICES	MD	AFFINITY	C CORP				No
(2) THE DE CTR FOR MAT FETAL MED OF CC INC 4000 NEXUS DR STE NW3-100 WILMINGTON,DE19803 20-5891272	HEALTHCARE	DE	CC HEALTH SRVCS	C CORP				No
(3) CHRISTIANA CARE HEALTH PLANS 4000 NEXUS DR STE NW3-100 WILMINGTON,DE19803 51-0352728	INSURANCE	DE	CCH SYSTEM	C CORP				No
(4) CHRISTIANA CARE DEFERRED COMP PLAN 4755 OGLETOWN STANTON RD NEWARK,DE19718 81-6359549	DEF COMP PLAN	DE	CC HEALTH SRVCS	TRUST				No
(5) CHRISTIANA CARE EXEC DEFERRED COMP PLAN 4755 OGLETOWN STANTON RD NEWARK,DE19718 35-7048822	DEF COMP PLAN	DE	CC HEALTH SRVCS	TRUST				No
(6) CARE ASSOCIATES DEFERRED COMP PLAN 4755 OGLETOWN STANTON RD NEWARK,DE19718 35-7048714	DEF COMP PLAN	DE	CC HEALTH SRVCS	TRUST				No
(7) CHRISTIANA CARE INSURANCE CO LTD PO BOX 1159 878 W BAY RD GRAND CAYMAN KY1-1102 CJ 98-1489490	SELF-INSURANCE	CJ	CC HEALTH SRVCS	C CORP				No
(8) CHRISTIANA CARE STRATEGIC INVESTMENTS 4000 NEXUS DR STE NW3-100 WILMINGTON,DE19803 85-3348300	STRATEGY	DE	CCH SYSTEM	C CORP				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) .......................

Yes

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

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

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

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

Yes

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

Yes

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

Yes

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: TO PROVIDE CHARITABLE 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	11
5	Total number of individuals employed in calendar year 2019 (Part V, line 2a) ......	5	1,354
6	Total number of volunteers (estimate if necessary) .............	6	199
7a	Total unrelated business revenue from Part VIII, column (C), line 12 ........	7a	1,746,410
b	Net unrelated business taxable income from Form 990-T, line 39 .........	7b	0

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........	10,510,084	4,700,573
9	Program service revenue (Part VIII, line 2g) .........	160,923,585	149,294,107
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	1,953,831	1,610,173
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	2,627,581	2,819,298
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)	176,015,081	158,424,151
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...	799,694	0
14	Benefits paid to or for members (Part IX, column (A), line 4).....	0	0
15	Salaries, other compensation, employee benefits (Part IX, column (A), lines 5–10)	87,612,271	84,341,366
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)....	81,859,106	78,654,327
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	170,271,071	162,995,693
19	Revenue less expenses. Subtract line 18 from line 12.......	5,744,010	-4,571,542
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	163,925,550	160,653,669
21	Total liabilities (Part X, line 26).............	81,586,351	108,476,881
22	Net assets or fund balances. Subtract line 21 from line 20.....	82,339,199	52,176,788

Sign Here

	Signature of officer	Date

	Type or print name and title


4a	(Code: ) (Expenses $ 158,808,328 including grants of $ 0 ) (Revenue $ 149,294,107 )
	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. DURING THE YEAR, UNION HOSPITAL OF CECIL COUNTY PROVIDED $9,807,394 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) COMMUNITY SUPPORT GROUPS FOR CANCER, DIABETES, STROKE, ALZHEIMER'S,AND BREASTFEEDING B) HEALTH EDUCATION FOR DIABETES AND NUTRITION, CANCER PREVENTION, STROKE RISK, AND HOW TO CARE FOR SUBSTANCE-EFFECTED NEWBORNS C) FREE SCREENINGS IN THE COMMUNITY FOR PROSTATE CANCER, HEAD AND NECK CANCER, SKIN CANCER, AND DIABETES (EYES AND FEET) D) PROVIDING MEETING FACILITIES FOR LOCAL NONPROFITS AND AGENCIES E) ENHANCING FOOD SECURITY WITH MEALS ON WHEELS AND FOOD DONATIONS TO HOMELESS SERVING PROVIDERS IN THE COMMUNITY F) 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, DEPARTMENT OF SOCIAL SERVICES BOARD, AND CECIL COUNTY COMMUNITY HEALTH ADVISORY COALITION. UNION HOSPITAL OF CECIL COUNTY SERVICED 4,419 DISCHARGES PROVIDING 18,523 PATIENT DAYS TO INPATIENTS IN FISCAL YEAR 2020 OF WHICH: 1) PATIENTS COVERED UNDER THE MEDICARE PROGRAM WERE 1,960 DISCHARGES AND 9,206 PATIENT DAYS 2) PATIENTS COVERED UNDER THE MEDICAID PROGRAM WERE 137 DISCHARGES AND 587 PATIENT DAYS 3) PATIENTS COVERED UNDER THE MEDICAID HMO PROGRAM WERE 1,203 DISCHARGES AND 4,242 PATIENT DAYS 4) PATIENTS COVERED UNDER THE MEDICARE HMO PROGRAM WERE 166 DISCHARGES AND 764 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 expenses158,808,328

1b	Sub-Total................
c	Total from continuation sheets to Part VII, Section A....
d	Total (add lines 1b and 1c)...........	4,298,877	1,724,503	391,610

1a	Federated campaigns..		1a
b	Membership dues..		1b
c	Fundraising events..		1c
d	Related organizations		1d	156,049
e	Government grants (contributions)		1e	4,182,127

f	All other contributions, gifts, grants, and similar amounts not included above		1f	362,397

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

h Total. Add lines 1a-1f.......		4,700,573

		Business Code
2a	NET PATIENT SERVICE REVENUE	621990	148,076,991	148,076,991
b	OTHER OPERATING REVENUE	621990	1,035,242	1,035,242
c	ADULT DAY CARE	623990	181,874	181,874
d
e
f	All other program service revenue.
g	Total. Add lines 2a–2f .....		149,294,107

3 Investment income (including dividends, interest, and othersimilar amounts) ......			1,148,394		-101,800	1,250,194
4 Income from investment of tax-exempt bond proceeds			0
5 Royalties...........			0
		(ii) Personal	(i) Real
6a	Gross rents		79,768	6a
b	Less: rental expenses		7,988	6b
c	Rental income or (loss)	0	71,780	6c
d	Net rental income or (loss).......			71,780			71,780
		(ii) Other	(i) Securities
7a	Gross amount from sales of assets other than inventory	241,239	456,024	7a
b	Less: cost or other basis and sales expenses	235,484		7b
c	Gain or (loss)	5,755	456,024	7c
d	Net gain or (loss).........			461,779			461,779
8a	Gross income from fundraising events (not including $ of contributions reported on line 1c). See Part IV, line 18 ....
			8a	0
b	Less: direct expenses ...		8b	0
c	Net income or (loss) from fundraising events..			0
9a	Gross income from gaming activities. See Part IV, line 19 ...
			9a	0
b	Less: direct expenses ...		9b	0
c	Net income or (loss) from gaming activities..			0
10a	Gross sales of inventory, less returns and allowances ..
			10a	0
b	Less: cost of goods sold ..		10b	0
c	Net income or (loss) from sales of inventory..			0
Business Code			Miscellaneous Revenue
11a	LABORATORY REVENUE		621500	1,848,210		1,848,210
b	CAFETERIA/FOOD SERVICE REVENUE		722210	737,871			737,871
c	PARKING REVENUE		900009	34,645			34,645
d	All other revenue ....			126,792			126,792
e	Total. Add lines 11a–11d ......			2,747,518
12	Total revenue. See instructions.....			158,424,151	149,294,107	1,746,410	2,683,061

1	Grants and other assistance to domestic organizations and domestic governments. See Part IV, line 21 ....	0
2	Grants and other assistance to domestic individuals. See Part IV, line 22 ...........	0
3	Grants and other assistance to foreign organizations, foreign governments, and foreign individuals. See Part IV, lines 15 and 16. .............	0
4	Benefits paid to or for members .......	0
5	Compensation of current officers, directors, trustees, and key employees ...........	3,660,804	3,595,392	65,412
6	Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) .........	0
7	Other salaries and wages........	67,717,527	66,507,545	1,209,982
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....	820,306	820,306	0
9	Other employee benefits .......	7,427,905	7,323,234	104,671
10	Payroll taxes ...........	4,714,824	4,650,980	63,844
11	Fees for services (non-employees):
a	Management ......	983,609	491,805	491,804
b	Legal .........	858,780		858,780
c	Accounting ...........	256,500		256,500
d	Lobbying ...........	0
e	Professional fundraising services. See Part IV, line 17	0
f	Investment management fees ......	72,154		72,154
g	Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O)	28,142,493	27,148,628	993,865	0
12	Advertising and promotion ....	324,812	324,812
13	Office expenses .......	1,996,714	1,992,612	4,102
14	Information technology ......	200,668	200,668
15	Royalties ..	0
16	Occupancy ...........	3,962,675	3,962,675
17	Travel ............	111,383	103,190	8,193
18	Payments of travel or entertainment expenses for any federal, state, or local public officials .	0
19	Conferences, conventions, and meetings ....	70,636	44,340	26,296
20	Interest ...........	1,898,836	1,898,836
21	Payments to affiliates .......	3,888,934	3,888,934	0	0
22	Depreciation, depletion, and amortization ..	9,028,578	9,028,578
23	Insurance ...	2,557,266	2,534,833	22,433
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	19,708,713	19,706,222	2,491
b	REPAIRS & MAINTENANCE	3,446,139	3,445,586	553
c	DIETARY	808,062	801,777	6,285
d	OTHER EXPENSES	337,375	337,375
e	All other expenses
25	Total functional expenses. Add lines 1 through 24e	162,995,693	158,808,328	4,187,365	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 ........			6,198,168	1	37,308,503
2	Savings and temporary cash investments .........			0	2	0
3	Pledges and grants receivable, net ......			0	3	0
4	Accounts receivable, net .............			14,069,712	4	14,177,794
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 .......
				0	5	0
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) ...
				0	6	0
7	Notes and loans receivable, net ...........			0	7	0
8	Inventories for sale or use ............			2,307,404	8	2,523,066
9	Prepaid expenses and deferred charges ......			2,940,202	9	3,244,897
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	175,592,597
b	Less: accumulated depreciation	10b	125,361,996	82,932,993	10c	50,230,601
11	Investments—publicly traded securities .			32,337,168	11	30,670,970
12	Investments—other securities. See Part IV, line 11 .....			13,788,136	12	13,031,319
13	Investments—program-related. See Part IV, line 11 ..			0	13	0
14	Intangible assets ...............			0	14	0
15	Other assets. See Part IV, line 11 ...........			9,351,767	15	9,466,519
16	Total assets. Add lines 1 through 15 (must equal line 33)...			163,925,550	16	160,653,669

17	Accounts payable and accrued expenses .....	10,375,169	17	11,559,155
18	Grants payable ...	0	18	0
19	Deferred revenue .........	3,485,157	19	31,554,344
20	Tax-exempt bond liabilities .........	56,179,987	20	53,628,217
21	Escrow or custodial account liability. Complete Part IV of Schedule D	0	21	0
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 .........
		0	22	0
23	Secured mortgages and notes payable to unrelated third parties ..	0	23	0
24	Unsecured notes and loans payable to unrelated third parties ..	0	24	0
25	Other liabilities (including federal income tax, payables to related third parties, and other liabilities not included on lines 17 - 24). Complete Part X of Schedule D	11,546,038	25	11,735,165
26	Total liabilities. Add lines 17 through 25..	81,586,351	26	108,476,881

	Organizations that follow FASB ASC 958, check here and complete lines 27, 28, 32, and 33.
27	Net assets without donor restrictions ..........	79,490,139	27	49,027,095
28	Net assets with donor restrictions ...........	2,849,060	28	3,149,693
	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 ...........	82,339,199	32	52,176,788
33	Total liabilities and net assets/fund balances ........	163,925,550	33	160,653,669

1	Was the organization a U.S. transferor of property to a foreign corporation during the tax year? If "Yes," the organization may be required to file Form 926, Return by a U.S. Transferor of Property to a Foreign Corporation (see Instructions for Form 926). . . . . . . . . . . . . . . . . . . . . . . . . . . . . .	Yes	No
2	Did the organization have an interest in a foreign trust during the tax year? If "Yes," the organization may be required to separately file Form 3520, Annual Return to Report Transactions with Foreign Trusts and Receipt of Certain Foreign Gifts, and/or Form 3520-A, Annual Information Return of Foreign Trust With a U.S. Owner (see Instructions for Forms 3520 and 3520-A; don't file with Form 990). . . . . . . . . . . . . . . . . . . . . . . .	Yes	No
3	Did the organization have an ownership interest in a foreign corporation during the tax year? If "Yes," the organization may be required to file Form 5471, Information Return of U.S. Persons with Respect to Certain Foreign Corporations. (see Instructions for Form 5471). . . . . . . . . . . . . . . . . . . . . . . . . . . .	Yes	No
4	Was the organization a direct or indirect shareholder of a passive foreign investment company or a qualified electing fund during the tax year? If “Yes,” the organization may be required to file Form 8621, Information Return by a Shareholder of a Passive Foreign Investment Company or Qualified Electing Fund. (see Instructions for Form 8621) .	Yes	No
5	Did the organization have an ownership interest in a foreign partnership during the tax year? If "Yes," the organization may be required to file Form 8865, Return of U.S. Persons with Respect to Certain Foreign Partnerships (see Instructions for Form 8865). . . . . . . . . . . . . . . . . . . . . . . . . . . . . .	Yes	No
6	Did the organization have any operations in or related to any boycotting countries during the tax year? If "Yes," the organization may be required to separately file Form 5713, International Boycott Report (see Instructions for Form 5713; don't file with Form 990).. . . . . . . . . . . . . . . . . . . . . . . . . . . .	Yes	No