TY 2022 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/1099-NEC)	(F) Estimated amount of other compensation from the organization and related organizations
(1) SHARON T KURFUERST...................................................................... PRESIDENT- THRU 1/23	1.0 ................. 44.0	X	X				0	967,304	84,880
(2) ROBERT MCMURRAY...................................................................... TREASURER (EX-OFFICIO)	1.0 ................. 44.0		X				0	857,940	86,827
(3) FAHD RAHMAN MD...................................................................... PHYSICIAN	45.0 ................. 0.0				X		842,008	0	20,501
(4) JENNIFER L SCHWARTZ ESQ...................................................................... SECRETARY (EX-OFFICIO)	1.0 ................. 44.0		X				0	745,416	78,435
(5) JUSTIN SAUSVILLE MD...................................................................... DIRECTOR	44.0 ................. 1.0	X					779,955	0	20,501
(6) ROGER D WU MD...................................................................... PHYSICIAN	45.0 ................. 0.0				X		612,074	0	20,839
(7) OLUMIDE OMOBO...................................................................... PHYSICIAN	45.0 ................. 0.0				X		566,412	0	7,085
(8) RYAN GERACIMOS MD...................................................................... CHIEF MEDICAL OFFICER	44.0 ................. 1.0			X			544,531	0	876
(9) CLAIRE YI ZHANG...................................................................... PHYSICIAN	45.0 ................. 0.0				X		507,250	0	0
(10) RICHARD C SZUMEL...................................................................... FORMER OFFICER	0.0 ................. 0.0					X	0	465,941	0
(11) BALTEJ SINGH MD...................................................................... PHYSICIAN	45.0 ................. 0.0				X		426,855	0	20,501
(12) JOSE MA MD...................................................................... DIRECTOR	44.0 ................. 1.0	X					339,085	0	12,272
(13) AMY MARSTON...................................................................... INT. PRESIDENT- AS OF 2/23	44.0 ................. 1.0			X			156,609	95,719	20,670
(14) JOAN PIRRUNG MSN APRN ACNS-BC...................................................................... VP PAT. CARE SERVIVES-NURSING	44.0 ................. 1.0			X			238,113	0	20,501
(15) DONNA MALONEY...................................................................... DIRECTOR OF FINANCE	1.0 ................. 44.0			X			0	221,911	20,501
(16) MICHELLE TWUM-DANSO...................................................................... DIRECTOR OF HR - CECIL CAMPUS	44.0 ................. 1.0			X			0	226,513	8,956
(17) ROBERT ASANTE...................................................................... DIRECTOR	1.0 ................. 44.0	X					0	211,209	20,501

(A) Name and business address	(B) Description of services	(C) Compensation
GENERAL HEALTHCARE RESOURCES LLC, 2250 HICKORY RD STE 240 PLYMOUTH MEETING,PA19460	PROF. STAFFING SRVCS	9,468,613
UNION RADIOLOGISTS LLC, 106 BOW STREET RADIOLOGY OFFICE ELKTON,MD21921	RADIOLOGY SERVICES	3,323,000
SP CONSULTANTS INC, 15 BRAINTREE HILL OFFICE PARK STE BRAINTREE,MD02184	CONSULTING SERVICES	2,355,238
NORTH AMERICAN PARTNERS IN ANESTESI, PO BOX 936947 ATLANTA,GA311936947	HEALTHCARE SERVICES	1,792,329
HOSPITAL RESCUE SERVICES LLC, 5234 HARVEY LANE ELLICOTT CITY,MD21043	HEALTHCARE SERVICES	1,298,657
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 64

- TIN:

SCHEDULE A
(Form 990)

Department of the Treasury
Internal Revenue Service

Public Charity Status and Public Support

Complete if the organization is a section 501(c)(3) organization or a section 4947(a)(1) nonexempt charitable trust.
right arrow

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

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

OMB No. 1545-0047

2022

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).)

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 33 1/3% 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 33 1/3% 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 on 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) 2022

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) 2018	(b) 2019	(c) 2020	(d) 2021	(e) 2022	(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) 2018	(b) 2019	(c) 2020	(d) 2021	(e) 2022	(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 5 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 2022 (line 6, column (f) divided by line 11, column (f)) .........

Public support percentage for 2020 Schedule A, Part II, line 14 ...............

16a

33 1/3% support test—2022. 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—2021. 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—2022. 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—2021. 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) 2022

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) 2018	(b) 2019	(c) 2020	(d) 2021	(e) 2022	(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) 2018	(b) 2019	(c) 2020	(d) 2021	(e) 2022	(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 on 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 5 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 2022 (line 8, column (f) divided by line 13, column (f)) .........

Public support percentage from 2021 Schedule A, Part III, line 15 ...............

Section D. Computation of Investment Income Percentage

Investment income percentage for 2022 (line 10c, column (f) divided by line 13, column (f)) ......

Investment income percentage from 2021 Schedule A, Part III, line 17 .............

19a

33 1/3% support tests-2022. 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—2021. 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) 2022

Page 4

Part IV

Supporting Organizations

(Complete only if you checked a box on line 12 of Part I. If you checked box 12a, of Part I, complete Sections A and B. If you checked box 12b, of Part I, complete Sections A and C. If you checked box 12c, of Part I, complete Sections A, D, and E. If you checked box12d, 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 lines 3b and 3c 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 box 12a or 12b in Part I, answer lines 4b and 4c 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 lines 5b and 5c 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) .

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

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 on 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 on 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) 2022

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 on lines 11b and 11c below, the governing body of a supported organization?

11a

A family member of a person described on 11a above?

11b

A 35% controlled entity of a person described on line 11a or 11b above? If “Yes” to 11a, 11b, or 11c, provide detail in Part VI.

11c

Section B. Type I Supporting Organizations

Yes

Did the officers, 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 line 2 above, 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 lines 2a and 2b 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 on line 2a, above 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 lines 3a and 3b 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?If "Yes" or "No", 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) 2022

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 0.015 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 0.035	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) 2022

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	1
2 Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in excess of income from activity	2
3 Administrative expenses paid to accomplish exempt purposes of supported organizations	3
4 Amounts paid to acquire exempt-use assets	4
5 Qualified set-aside amounts (prior IRS approval required - provide details in Part VI)	5
6 Other distributions (describe in Part VI). See instructions	6
7Total annual distributions. Add lines 1 through 6.	7
8 Distributions to attentive supported organizations to which the organization is responsive (provide details in Part VI). See instructions	8
9 Distributable amount for 2022 from Section C, line 6	9
10 Line 8 amount divided by Line 9 amount	10

Section E - Distribution Allocations (see instructions)		(i) Excess Distributions	(ii) Underdistributions Pre-2022	(iii) Distributable Amount for 2022
1 Distributable amount for 2022 from Section C, line 6
2 Underdistributions, if any, for years prior to 2022 (reasonable cause required-- explain in Part VI). See instructions.
3 Excess distributions carryover, if any, to 2022:
a From 2017.......
b From 2018.......
c From 2019.......
d From 2020.......
e From 2021.......
fTotal of lines 3a through e
g Applied to underdistributions of prior years
h Applied to 2022 distributable amount
i Carryover from 2017 not applied (see instructions)
j Remainder. Subtract lines 3g, 3h, and 3i from line 3f.
4Distributions for 2022 from Section D, line 7:
$
a Applied to underdistributions of prior years
b Applied to 2022 distributable amount
c Remainder. Subtract lines 4a and 4b from line 4.
5 Remaining underdistributions for years prior to 2022, 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 2022. 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 2023. Add lines 3j and 4c.
8 Breakdown of line 7:
a Excess from 2018.....
b Excess from 2019.....
c Excess from 2020.....
d Excess from 2021.....
e Excess from 2022.....

Schedule A (Form 990) (2022)

Schedule A (Form 990) 2022

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) 2022

Additional Data

Software ID:
Software Version:

- TIN:

Schedule B
(Form 990)

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

2022

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) (2022)

Schedule B (Form 990) (2022) 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) (2022)

Schedule B (Form 990) (2022)

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) (2022)

Schedule B (Form 990) (2022)

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) (2022)

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

2021

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) 2021

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 ....	55,330,454	34,925,580	20,404,874
c	Leasehold improvements	1,813,611	545,549	1,268,062
d	Equipment ....	106,432,167	84,302,608	22,129,559
e	Other .....	33,556,077	19,206,751	14,349,326
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..				59,286,726

Schedule D (Form 990) 2021

Page 3

Part VII

Investments - Other 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........	5,495,491
(3) Other (A) MANAGED HEDGE FUNDS	2,927,305	F
(B) INVESTMENTS	43,314,217	F
(B)
(C)
(D)
(E)
(F)
(G)
(H)
Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)	51,737,013

Part VIII

Investments - Program 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

(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
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)DUE FROM AFFILIATES				13,377,108
(2)INSURANCE CLAIMS RECOVERABLE				7,699,683
(3)IN HOUSE LEASES				1,501,211
(4)ROU LEASES				1,225,909
(5)OTHER ASSETS				65,609
(6)SECURITY DEPOSITS				25,618
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........				23,895,138

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
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)	78,011,313
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) 2021

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
2	Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a	Net unrealized gains (losses) on investments ....	2a
b	Donated services and use of facilities .........	2b
c	Recoveries of prior year grants ...........	2c
d	Other (Describe in Part XIII.) ............	2d
e	Add lines 2a through 2d .....................		2e
3	Subtract line 2e from line 1..................		3
4	Amounts included on Form 990, Part VIII, line 12, but not on line 1:
a	Investment expenses not included on Form 990, Part VIII, line 7b .	4a
b	Other (Describe in Part XIII.) ...........	4b
c	Add lines 4a and 4b....................		4c
5	Total revenue. Add lines 3 and 4c. (This must equal Form 990, Part I, line 12.) ......		5

Part XII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return. Complete if the organization answered 'Yes' on Form 990, Part IV, line 12a.
1	Total expenses and losses per audited financial statements ...........		1
2	Amounts included on line 1 but not on Form 990, Part IX, line 25:
a	Donated services and use of facilities .........	2a
b	Prior year adjustments ............	2b
c	Other losses ................	2c
d	Other (Describe in Part XIII.) ............	2d
e	Add lines 2a through 2d....................		2e
3	Subtract line 2e from line 1...................		3
4	Amounts included on Form 990, Part IX, line 25, but not on line 1:
a	Investment expenses not included on Form 990, Part VIII, line 7b ..	4a
b	Other (Describe in Part XIII.) ............	4b
c	Add lines 4a and 4b.....................		4c
5	Total expenses. Add lines 3 and 4c. (This must equal Form 990, Part I, line 18.) ......		5

Part XIII

Supplemental Information

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

Schedule D (Form 990) 2021

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 20a.
MediumBullet

Attach to Form 990.
MediumBullet

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

OMB No. 1545-0047

2022

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		(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) . . .	1,274,789	0	1,274,789	0.660 %
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 . . . . .	1,274,789	0	1,274,789	0.660 %
Other Benefits
e	Community health improvement services and community benefit operations (from Worksheet 4).	127,404	0	127,404	0.070 %
f	Health professions education (from Worksheet 5) . . .	180,111	0	180,111	0.090 %
g	Subsidized health services (from Worksheet 6) . . . .	22,482,803	10,753,067	11,729,736	6.100 %
h	Research (from Worksheet 7) .
i	Cash and in-kind contributions for community benefit (from Worksheet 8) . . . .	165,209	0	165,209	0.090 %
j	Total. Other Benefits . .	22,955,527	10,753,067	12,202,460	6.350 %
k	Total. Add lines 7d and 7j .	24,230,316	10,753,067	13,477,249	7.010 %

For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2022

Schedule H (Form 990) 2022

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
1	Physical improvements and housing
2	Economic development	193	193
3	Community support
4	Environmental improvements
5	Leadership development and training for community members
6	Coalition building
7	Community health improvement advocacy
8	Workforce development	1,540	1,540
9	Other
10	Total	1,733	1,733

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. ......

6,751,225

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. ......

64,860

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).....

2,861,445

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

2,572,460

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

288,985

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) 2022

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) 2022

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 21

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 22

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

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) 2022

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) 2022

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) 2022

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) 2022

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)	AT CHRISTIANACARE, WE ARE GUIDED BY THE CHRISTIANACARE WAY: WE SERVE OUR NEIGHBORS AS RESPECTFUL, EXPERT, CARING PARTNERS IN THEIR HEALTH. WE DO THIS BY CREATING INNOVATIVE, EFFECTIVE, AFFORDABLE AND EQUITABLE SYSTEMS OF CARE THAT OUR NEIGHBORS VALUE. TO EFFECTIVELY PARTNER WITH OUR NEIGHBORS, WE MUST LEARN FROM THEM DIRECTLY ABOUT THEIR CHALLENGES. COMPLETING THE CHNA PROVIDES THAT OPPORTUNITY. THE 2022 CHNA WAS ALSO THE FOURTH CHNA UNION HOSPITAL HAS UNDERTAKEN IN COLLABORATION WITH THE CECIL COUNTY HEALTH DEPARTMENT (CCHD). WE ARE GRATEFUL FOR THEIR EXPERTISE AND CONTINUED PARTNERSHIP AS WE WORK TOGETHER TO SERVE CECIL COUNTY. DUE TO THE SIGNIFICANT RATE OF COMMUNITY TRANSMISSION OF COVID-19 THAT WAS OCCURRING AS WE WERE COMPLETING THE CHNA, WE OPTED TO HOST VIRTUAL COMMUNITY MEETINGS TO RECEIVE COMMUNITY INPUT INSTEAD OF OUR PREFERRED FORMAT OF IN-PERSON MEETINGS AT ACCESSIBLE COMMUNITY LOCATIONS. WE HOSTED FOUR VIRTUAL MEETINGS WITH THE PARTICIPATION OF 43 COMMUNITY STAKEHOLDERS WHO REPRESENTED THE CCHD AND OTHER GOVERNMENT AGENCIES, NON-PROFIT ORGANIZATIONS, LOCAL BUSINESSES, HEALTH CARE PROVIDERS, AND THE SCHOOL SYSTEM. WE WERE ALSO ABLE TO MEET WITH FOUR TEENAGERS PARTICIPATING IN THE CECIL COUNTY PUBLIC LIBRARY'S YOUTH ADVISORY COUNCIL. IT WAS IMPORTANT TO US TO INCLUDE THE VOICES OF YOUTH AS THEY ARE ALSO PART OF THE COMMUNITY WE SERVE AND MAY HAVE DIFFERENT PERSPECTIVES THAN THOSE OF THE ADULTS. WE ALSO HELD A VIRTUAL MEETING WITH THE PARTICIPATION OF 16 UNION CAREGIVERS REPRESENTING ADMINISTRATION, NURSING, CASE MANAGEMENT, SOCIAL SERVICES, AND PROJECT MANAGEMENT. THE INTENT OF THE MEETING WAS TO GAIN THE CAREGIVERS' PERSPECTIVE ON THE COMMUNITY'S MOST SIGNIFICANT CHALLENGES AS WELL AS PROVIDE THEM WITH MORE INSIGHT INTO THE COMMUNITY. AT EACH MEETING, THE CHNA PROCESS AND THE PURPOSE OF THE MEETING WAS EXPLAINED AND SECONDARY DATA WERE PRESENTED INCLUDING A SUMMARY OF UNFAVORABLE COMMUNITY HEALTH INDICATORS. WE ASKED MEETING PARTICIPANTS FOR THEIR REACTIONS TO THE SECONDARY DATA ANALYSIS AND TO IDENTIFY COMMUNITY HEALTH ISSUES THAT MAY NOT HAVE BEEN INCLUDED IN THE DATA. EACH MEETING CONCLUDED WITH PARTICIPANTS BEING ASKED TO IDENTIFY THREE TO FIVE COMMUNITY HEALTH ISSUES THEY CONSIDER TO BE MOST SIGNIFICANT. AN ONLINE COMMUNITY HEALTH SURVEY WAS ALSO CONDUCTED IN FEBRUARY AND MARCH 2022. THE SURVEY HAD TWENTY QUESTIONS ON THE FOLLOWING TOPICS: DEMOGRAPHICS, COMMUNITY HEALTH, QUALITY OF LIFE, AND ACCESS TO HEALTH CARE SERVICES. 544 PARTICIPANTS COMPLETED THE SURVEY. MOST SURVEY RESPONDENTS WERE FEMALE (87%) AND 64% OF THE SURVEY RESPONDENTS WERE FROM THE TOWNS OF NORTH EAST AND ELKTON. FINALLY, SEVEN KEY STAKEHOLDERS WERE INTERVIEWED TO LEARN ABOUT COMMUNITY HEALTH ISSUES. THE STAKEHOLDERS WERE HEALTH OFFICERS FROM THE CCHD AND ADMINISTRATIVE AND CLINICAL STAFF FROM WEST CECIL HEALTH CENTER, A FEDERALLY QUALIFIED HEALTH CENTER. THE PARTICIPANTS WERE ASKED TO IDENTIFY AND DISCUSS COMMUNITY HEALTH ISSUES PRIOR TO THE COVID-19 PANDEMIC, AND THEN DESCRIBE THE PANDEMIC'S IMPACTS ON THE COMMUNITY AND WHAT HAS BEEN LEARNED ABOUT THE COMMUNITY'S HEALTH GIVEN THOSE IMPACTS. THE STAKEHOLDERS WERE ALSO ASKED TO DESCRIBE THE TYPES OF INITIATIVES, PROGRAMS, AND INVESTMENTS THAT SHOULD BE IMPLEMENTED TO ADDRESS THE COMMUNITY'S HEALTH ISSUES AND TO BE BETTER PREPARED FOR FUTURE RISKS. CHRISTIANACARE CONTRACTED WITH VERIT HEALTHCARE CONSULTING, LLC (VERIT) TO COMPLETE ITS 2022 CHNA. IN COOPERATION WITH CHRISTIANACARE'S OFFICE OF HEALTH EQUITY AND THE CCHD, VERIT CONDUCTED THE RESEARCH, PRIMARY AND SECONDARY DATA COLLECTION, REVIEW, AND ANALYSIS, TO DEVELOP THE CHNA. ---------------
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'S 2022 CHNA IDENTIFIED THE FOLLOWING AS SIGNIFICANT AREAS OF NEED IN CECIL COUNTY: . ACCESS TO HEALTH SERVICES . CANCER . CHILDHOOD TRAUMA/ADVERSE CHILDHOOD EXPERIENCES (ACE) . LGBTQIA+ HEALTH DISPARITIES . MENTAL HEALTH . NUTRITION, OBESITY, AND PHYSICAL INACTIVITY . SMOKING, TOBACCO, AND VAPE PRODUCT USE . SUBSTANCE USE DISORDERS OF THESE SIGNIFICANT NEEDS, UNION PRIORITIZED: . ACCESS TO HEALTH SERVICES . CANCER . LGBTQIA+ HEALTH DISPARITIES . SUBSTANCE USE DISORDERS SELECTION FOR PRIORITIZATION WAS BASED ON RESOURCE AVAILABILITY AND PROGRAMMING UNDERWAY OR PLANNED. UNION DOES ADDRESS ALL THE SIGNIFICANT AREAS OF NEED, BUT DID NOT PRIORITIZE THE FOLLOWING AREAS OF NEED: . CHILDHOOD TRAUMA/ADVERSE CHILDHOOD EXPERIENCES (ACE) . MENTAL HEALTH . NUTRITION, OBESITY, AND PHYSICAL INACTIVITY . SMOKING, TOBACCO, AND VAPE PRODUCT USE THESE AREAS WERE NOT PRIORITIZED BECAUSE WE WERE UNABLE TO CREATE NEW OR EXPANDED COMMUNITY BENEFIT PROGRAMMING IN THESE AREAS. IF OPPORTUNITIES TO ADDRESS THESE AREAS OF NEED ARISE, PARTICULARLY THROUGH COMMUNITY PARTNERSHIPS, THEIR IDENTIFICATION AS SIGNIFICANT AREAS OF NEED WILL BE CONSIDERED. A SIGNIFICANT ACTIVITY WE UNDERTOOK IN FY2023 TO ADDRESS OUR PRIORITIZED AREAS OF NEED WAS THE CREATION AND HIRING OF A MANAGER OF COMMUNITY ENGAGEMENT POSITION. THIS POSITION WAS FILLED IN JANUARY 2023 AND HAS ALREADY MADE A CONSIDERABLE IMPACT IN UNION'S COMMUNITY ENGAGEMENT AND OUTREACH. MUCH OF THE PROGRESS THAT WILL BE DESCRIBED IN THIS SECTION HAS BEEN AS A RESULT OF THE COMMUNITY ENGAGEMENT MANAGER'S EFFORTS. ACCESS TO HEALTH SERVICES CECIL COUNTY HAS A LOW PER-CAPITA SUPPLY OF PRIMARY CARE, DENTAL HEALTH, AND MENTAL HEALTH PROFESSIONALS COMPARED TO NATIONAL AVERAGES, WHICH CREATES SIGNIFICANT BARRIERS TO CARE. LIKE RURAL HOSPITALS ACROSS THE COUNTRY, UNION HAS ALSO EXPERIENCED CHALLENGES RECRUITING AND RETAINING PROVIDERS. CHRISTIANACARE CONTINUES TO RESPOND TO THIS CHALLENGE WITH A DIVERSITY OF ONGOING RECRUITMENT EFFORTS. SIMPLY ADDING MORE PROVIDERS IN THE COMMUNITY, HOWEVER, WILL NOT OVERCOME ALL BARRIERS TO CARE. LACK OF TRANSPORTATION PRESENTS AN ISSUE FOR MANY IN CECIL COUNTY. IN FY22, CHRISTIANACARE BEGAN TO ADDRESS THIS ISSUE ON A SMALL SCALE THROUGH UNION'S CARE TRANSFORMATION INITIATIVE (CTI) WHICH LAUNCHED ON JULY 1, 2021. UNION'S CTI, TRANSITIONS OF CARE, CHRONIC DISEASE NAVIGATION PROGRAM SERVES ADULT MEDICARE FFS BENEFICIARIES WHO WERE ADMITTED TO UNION AS AN INPATIENT OR FOR OBSERVATION WITH A PRIMARY OR SECONDARY DIAGNOSIS OF HEART FAILURE, CHRONIC OBSTRUCTIVE PULMONARY DISEASE (COPD), DIABETES, OR RESPIRATORY FAILURE.. TO PREVENT READMISSION, THESE PATIENTS RECEIVE A CARE TEAM APPROACH AND INTERACTIVE PATIENT TOOLS FOR 180 DAYS POST DISCHARGE. HOWEVER, SOME PATIENTS HAD DIFFICULTY PARTICIPATING DUE TO LACK OF TRANSPORTATION AND LACK OF RESOURCES TO BE ABLE TO PARTICIPATE IN VIRTUAL VISITS THAT WOULD HAVE RESOLVED THE TRANSPORTATION BARRIER. TO ADDRESS THIS BARRIER, THE CARE TEAM BEGAN USING ROUNDTRIP. ROUNDTRIP IS A COMPANY THAT PROVIDES A DIGITAL TRANSPORTATION MARKETPLACE TO CONNECT PATIENTS FACING TRANSPORTATION BARRIERS WITH NON-EMERGENCY MEDICAL TRANSPORTATION. CHRISTIANACARE HAS BEEN PARTNERED WITH ROUNDTRIP SINCE 2019 TO PROVIDE FREE TRANSPORTATION TO ELIGIBLE PATIENTS IN DELAWARE WITH TRANSPORTATION BARRIERS TO RECEIVE MEDICAL SERVICES. THE CTI IS THE FIRST UNION PROGRAM TO UTILIZE ROUNDTRIP. IN FY23, TWELVE RIDES THROUGH ROUNDTRIP WERE PROVIDED TO HELP CTI PATIENT PARTICIPANTS RECEIVE MEDICAL SERVICES. THROUGHOUT THE LATTER PART OF FY23, WE ALSO WORKED WITH ROUNDTRIP TO PREPARE FOR EXPANDED USE THROUGHOUT UNION IN EARLY FY24. THIS INVOLVED PROVIDING INFORMATION ABOUT LOCAL TRANSPORTATION AND EXPECTED TYPES OF VEHICLES THAT WILL NEED TO BE UTILIZED (TAXI, WHEELCHAIR VANS, ETC.). UNION ALSO PROVIDES TAXI VOUCHERS TO INPATIENTS AT DISCHARGE WHO HAVE NO TRANSPORTATION HOME. IN FY23, UNION PAID $3,841 TO TRANSPORT PATIENTS HOME IN TAXIS. IN FY23, UNION ALSO BEGAN PARTICIPATING IN THE MARYLAND PRIMARY CARE PROGRAM (MDPCP). MDPCP PROVIDES FUNDING AND SUPPORT FOR THE DELIVERY OF ADVANCED PRIMARY CARE THROUGHOUT MARYLAND IN SUPPORT OF THE OVERALL HEALTH CARE TRANSFORMATION PROCESS. THE GOALS ARE TO ENABLE PRIMARY CARE PROVIDERS TO PLAY AN INCREASED ROLE IN PREVENTION, MANAGEMENT OF CHRONIC DISEASE, AND PREVENTING UNNECESSARY HOSPITAL UTILIZATION. THROUGH THIS PROGRAM, UNION RECEIVES FUNDING TO ADDRESS THE SOCIAL NEED OF MEDICARE PATIENTS. HEALTH EQUITY ADVANCEMENT RESOURCE AND TRANSFORMATION (HEART) PAYMENTS ARE ALSO USED TO PROVIDE PARTICIPATING PATIENTS WITH HYPERTENSION AND DIABETES WITH MEDICALLY TAILORED FOODS, SELF-MONITORING EQUIPMENT, AND TRANSPORTATION THROUGH ROUNDTRIP TO THEIR MEDICAL APPOINTMENTS AND SERVICES. UNION'S CHILDBIRTH AND EARLY EDUCATION TEAM AND PEDIATRIC NURSES CONTINUE TO RESPOND TO OUR COMMUNITY NEEDS BY PROVIDING CHILDBIRTH AND INFANT CARE EDUCATION IN THE COMMUNITY. IN FY23, MONTHLY EDUCATION CONTINUED TO BE PROVIDED ON-SITE AT THE COMMUNITY TREATMENT PROVIDER, SERENITY HEALTH, IN ELKTON. THOSE WHO ARE PREGNANT AND RECEIVING TREATMENT ATTEND THESE CLASSES TO LEARN ABOUT CHILDBIRTH AND INFANT CARE. THEY ARE ALSO PROVIDED INFORMATION ABOUT THE PROGRAM EAT, SLEEP, CONSOLE WHICH IS AN APPROACH TO CARING FOR BABIES BORN WITH NEONATAL ABSTINENCE SYNDROME (NAS) THAT CAN REDUCE THE NEED FOR MEDICAL INTERVENTION. AT THE REQUEST OF HERITAGE PREGNANCY CENTER IN ELKTON, UNION CAREGIVERS ALSO PROVIDED AN ON-SITE BI-WEEKLY BREASTFEEDING EDUCATION SUPPORT GROUP. THE CCHD WILL ALSO OCCASIONALLY REQUEST OUR CAREGIVERS PROVIDE PRENATAL EDUCATION IN THE COMMUNITY. IN FY23, OUR CAREGIVERS PROVIDED A PRENATAL EDUCATION CLASS AT THE HERITAGE PREGNANCY CENTER IN OCTOBER 2022 AT THE REQUEST OF THE CCHD. FINALLY, UNION HAS HELD A FREE SPORTS PHYSICAL EVENT FOR CECIL COUNTY STUDENTS FOR OVER 15 YEARS. EACH YEAR THESE PHYSICALS ARE REQUESTED BY CECIL COUNTY PUBLIC SCHOOL ATHLETIC ADMINISTRATION. GIVEN THE PROVIDER SHORTAGE IN CECIL COUNTY, THIS EVENT IS SIGNIFICANT IN PROVIDING RELIEF TO CECIL COUNTY PRACTICES AND IN ENSURING STUDENTS ARE ABLE TO RECEIVE A PHYSICAL AND PARTICIPATE IN SPORTS. PHYSICAL INACTIVITY WAS ALSO A SIGNIFICANT AREA OF NEED IDENTIFIED IN CECIL COUNTY AND SO HELPING TO MAKE PARTICIPATION IN SPORTS EASIER FOR FAMILIES IS AN ADDITIONAL BENEFIT OF THIS OFFERING. ON JUNE 7, 2023, IN PARTNERSHIP WITH ATI PHYSICAL THERAPY AND THE CECIL COUNTY PUBLIC SCHOOLS, 623 STUDENTS WERE ABLE TO COMPLETE THEIR PHYSICALS, AN INCREASE OF NEARLY 100 STUDENTS FROM THE PRIOR YEAR. AT THE EVENT, ATTENDEES WERE ALSO ENCOURAGED TO ENROLL WITH A PRIMARY CARE PROVIDER IF THEY HAD NONE. CANCER CANCER RATES IN CECIL COUNTY REMAIN ABOVE THE MARYLAND AND UNITED STATES AVERAGES. THE MORTALITY RATE FOR LUNG AND BRONCHUS CANCER IN CECIL COUNTY HAS BEEN CONSIDERABLY ABOVE THE UNITED STATES AVERAGE AT 87.1 PER 100,000 IN COMPARISON TO 57.3 PER 100,000. IN RESPONSE, UNION HAS PARTNERED CLOSELY WITH THE CECIL COUNTY CANCER TASK FORCE TO CRAFT AND IMPLEMENT PUBLIC OUTREACH TO PROMOTE CANCER SCREENINGS, WITH A FOCUS ON LOW DOSE COMPUTED TOMOGRAPHY (LDCT) SCREENING, AND OTHER PREVENTION ACTIVITIES. IN FY23, UNION CAREGIVERS, LED BY NURSE MANAGER SHEELAGH STEWART, WHO ALSO SERVES AS THE CHAIR OF THE CECIL COUNTY CANCER TASK FORCE, UNDERTOOK A RESEARCH PROJECT TO GAIN AN UNDERSTANDING OF THE BARRIERS TO LDCT SCREENING. A REVIEW OF 55 LUNG CANCER PATIENTS DIAGNOSED IN 2020 AND 2021 AT UNION REVEALED THAT ONLY 1 OF THOSE PATIENTS WAS REFERRED TO LDCT SERVICES BEFORE DIAGNOSIS. BASED ON THIS, THE TEAM RECOGNIZED THAT BOTH PATIENTS AND PROVIDERS WOULD BENEFIT FROM INFORMATION ABOUT LDCT SCREENING. IN PARTNERSHIP WITH THE CECIL COUNTY CANCER TASK FORCE, A 19-QUESTION VALIDATED SURVEY WAS SELECTED AND SENT OUT TO 38 CECIL COUNTY PROVIDERS IN OCTOBER 2022 TO GAUGE THEIR UNDERSTANDING OF THE LDCT SCREEN AND BARRIERS TO SUCCESSFUL REFERRALS FOR LDCT SCREENING. THE SURVEY RESPONSE RATE WAS 26.32% WITH 10 PROVIDERS COMPLETING THE SURVEY. OVERALL, THE SURVEY DEMONSTRATED PROVIDER FAMILIARITY WITH THE SCREEN, BUT REVEALED SOME OPPORTUNITIES FOR MORE EDUCATION. FOR EXAMPLE, NEARLY HALF OF THE PROVIDERS WERE NOT SURE WHICH PATIENTS QUALIFY FOR THE SCREENING. THE SURVEY ALSO DEMONSTRATED MORE PATIENT EDUCATION IS NEEDED. SEVEN OUT OF THE 10 PROVIDERS SURVEYED SAID THEY WERE NEVER ASKED ABOUT THE LCDT SCREENING BY PATIENTS AND 6 OUT OF THE 10 PROVIDERS SURVEYED SAID PATIENTS REFUSED THE LCDT SCREENING EVEN AFTER IT WAS OFFERED TO THEM.
SCHEDULE H, PART V, SECTION B, LINE 11 (ADDRESSING NEEDS FROM THE CHNA)	IN RESPONSE TO THE SCREENING, THE COMMUNITY ENGAGEMENT MANGER HAS WORKED TO ENSURE THAT EVERY OPPORTUNITY UNION HAS TO PROVIDE EDUCATION IN THE COMMUNITY INCLUDES SHARING INFORMATION ABOUT CANCER SCREENING AND PREVENTION, PARTICULARLY LDCT SCANS. IN PARTNERSHIP WITH THE CANCER TASK FORCE, THE COMMUNITY ENGAGEMENT MANAGER WILL ALSO UNDERTAKE OUTREACH TO BOTH UNION AND NON-UNION PROVIDERS TO PROVIDE EDUCATION ON LDCT SCANS IN GENERAL, AND HOW TO ORDER THEM. THESE CONTINUED EFFORTS HAVE SHOWN SOME SUCCESS. IN CALENDAR YEAR 2023, THERE HAS BEEN A 20% INCREASE IN LDCT SCANS IN COMPARISON TO CALENDAR YEAR 2022. THE ACTIVITIES IN THIS AREA DEMONSTRATE A FOCUS OF THE COMMUNITY ENGAGEMENT MANAGER WHICH HAS BEEN TO PROMOTE EXISTING RESOURCES TO INTERNAL AND EXTERNAL PARTNERS. THE CHALLENGE IS SOMETIMES THAT RESOURCES EXIST BUT ARE NOT KNOWN. ENSURING OUR PROVIDERS ARE AWARE OF COMMUNITY RESOURCES AND THAT OUR COMMUNITY PARTNERS ARE AWARE OF UNION'S PROGRAMS WAS AN IMMEDIATE NEED OUR COMMUNITY ENGAGEMENT MANAGER RECOGNIZED AND HAS BEEN WORKING TO ADDRESS. LGBTQIA+ HEALTH DISPARITIES THE DATA IN THE 2022 CHNA WAS VERY CLEAR THAT LESBIAN, GAY, TRANSGENDER, QUEER/QUESTIONING, INTERSEX AND ASEXUAL, ETC. (LGBTQIA+) COMMUNITY FACE SIGNIFICANT CHALLENGES. LGBTQIA+ YOUTH ARE MORE THAN TWICE AS LIKELY TO BE BULLIED AND THREATENED WITH A WEAPON ON SCHOOL PROPERTY COMPARED TO YOUTH WHO IDENTIFY AS STRAIGHT. LGBTQIA+ YOUTH ARE ALSO MORE LIKELY TO ENGAGE IN HIGH-RISK BEHAVIORS SUCH AS TOBACCO, ALCOHOL, AND OTHER DRUG USE AND TO REPORT SIGNIFICANTLY LOWER RATES OF PHYSICAL ACTIVITY. THE STAKEHOLDERS INTERVIEWED IN THE 2022 CHNA ALSO IDENTIFIED AS SIGNIFICANT THE DISCRIMINATION IN HEALTHCARE FACED BY THE LGBTQIA+ COMMUNITY, WHICH LEADS TO AVOIDING HEALTH CARE SERVICES. TO BEGIN TO ADDRESS THOSE DISPARITIES, UNION CAREGIVERS ARE PARTICIPATING IN THE PRIDE AMBASSADORS PROGRAM. CREATED BY CHRISTIANACARE'S OFFICE OF HEALTH EQUITY, THE PRIDE AMBASSADORS PROGRAM OFFERS SIX HOURS OF INSTRUCTION INCLUDING EXPLORATION OF LGBTQIA+ HEALTH TOPICS AS THEY RELATE TO CREATING MORE EQUITABLE HEALTHCARE FOR OUR LGBTQIA+ PATIENTS AND FAMILIES. THE FIRST COHORT OF UNION CAREGIVERS BECAME PRIDE AMBASSADORS IN JULY 2021. IN MAY 2023, AN ADDITIONAL 15 UNION CAREGIVERS COMPLETED THE PRIDE AMBASSADORS PROGRAM. ALL THESE CAREGIVERS WILL USE THAT KNOWLEDGE TO BETTER SERVE THEIR PATIENTS AND ACT AS AMBASSADORS FOR THEIR COLLEAGUES BY SHARING WHAT THEY LEARNED. IN LATE FY23, OUR COMMUNITY ENGAGEMENT MANAGER ALSO ACCEPTED AN INVITATION FROM THE CCHD TO SERVE ON A COMMITTEE THEY CREATED TO ENSURE CECIL COUNTY BECOMES MORE INCLUSIVE FOR THIS POPULATION. THE FIRST MEETING WAS HELD IN JUNE 2023. THIS PARTICIPATION WILL ALSO PROVIDE THE OPPORTUNITY FOR THE COMMUNITY ENGAGEMENT MANAGER TO WORK WITH PARTNERS TO ORGANIZE A PRIDE AMBASSADORS TRAINING FOR COMMUNITY PROVIDERS AND THE HEALTH DEPARTMENT. SUBSTANCE USE DISORDERS THERE HAS BEEN CONSIDERABLE SUFFERING AMONG CECIL COUNTY RESIDENTS BECAUSE OF SUBSTANCE USE DISORDERS AND THE OPIOID EPIDEMIC IN PARTICULAR. TO ADDRESS THIS INTRACTABLE COMMUNITY ISSUE, UNION HAS LONG PARTNERED WITH CCHD'S ALCOHOL & DRUG RECOVERY CENTER TO MAKE AVAILABLE A DESIGNATED PEER RECOVERY SPECIALIST FOR REFERRALS ON BEHALF OF UNION PATIENTS. CAREGIVERS CONTACT THE PEER RECOVERY SPECIALIST ON BEHALF OF THE PATIENT IF THEY EXPRESS AN INTEREST IN SPEAKING WITH THEM OR TREATMENT. IF AVAILABLE, THE PEER RECOVERY SPECIALIST CAN COME TO THE HOSPITAL TO MEET WITH THE PATIENT OR FOLLOW UP WITH THEM IN THE COMMUNITY. WHEN A PATIENT EXPRESSES AN INTEREST IN RECOVERY OUTSIDE OF REGULAR BUSINESS HOURS, THE CAREGIVER ENCOURAGES THEM TO CALL CATCH (CECIL ADDICTION TREATMENT COORDINATION HOTLINE) WHICH IS AVAILABLE 24 HOURS-A-DAY, 7 DAYS-A-WEEK. IN FY23, 284 PATIENTS WERE REFERRED TO THE PEER RECOVERY SPECIALIST WHO COMPLETED 1,187 BEDSIDE ENCOUNTERS. MUCH OF FY23 WAS ALSO SPENT WORKING WITH THE CCHD TO BUILD UPON THIS PROGRAM. THE CCHD SUCCESSFULLY APPLIED FOR A NATIONAL ASSOCIATION OF COUNTY & CITY HEALTH OFFICIALS (NACCHO) SUSTAINING PEERS IN EMERGENCY DEPARTMENTS GRANT THAT WILL ALLOW OUR PATIENTS A SIGNIFICANT INCREASE IN ACCESS TO RESOURCES TO ADDRESS THEIR SUBSTANCE USE DISORDER. THROUGH THIS GRANT, THE CCHD ASKED THAT WE CONTINUE TO PARTNER WITH THEM ON THIS INITIATIVE AS WELL AS INCLUDE VOICES OF HOPE, A COMMUNITY ORGANIZATION MADE OF PEOPLE IN RECOVERY, FAMILY MEMBERS, AND ALLIES WHO SUPPORT INDIVIDUALS IN RECOVERY. WE WORKED WITH CCHD AND VOICES OF HOPE TO DESIGN THE GRANT PROGRAM WHICH WILL ALLOW 5 PEERS, FROM BOTH CCHD AND VOICES OF HOPE, TO BE PRESENT IN THE EMERGENCY DEPARTMENT (ED), AS WELL AS AVAILABLE ON ANY FLOOR IN THE HOSPITAL SHOULD A PATIENT REQUEST A CONSULT, FROM 8:00 A.M. TO 1:00 A.M. EVERY DAY OF THE WEEK. THIS INITIATIVE BEGAN IN AUGUST 2023, AND WE LOOK FORWARD TO SHARING MORE ABOUT ITS SUCCESS NEXT YEAR. LAST FISCAL YEAR, WE SHARED THAT UNION ALSO BEGAN PROVIDING MEDICATION ASSISTED TREATMENT (MAT) INDUCTIONS WITHIN THE ED IN AUGUST 2022. WHILE THESE INDUCTIONS ARE NOT YET ROUTINE IN EDS THROUGHOUT THE COUNTRY, GIVEN OUR COMMUNITY'S HIGH RATE OF OVERDOSE DEATHS, WE THOUGHT IT NECESSARY TO PROVIDE A CONVENIENT ACCESS POINT TO TREATMENT. FOR THIS REASON, WE ALSO PARTNERED WITH CCHD LAST FISCAL YEAR TO PROVIDE NALOXONE TO PATIENTS AND VISITORS IN OUR HOSPITAL. NEITHER INITIATIVE HAS SERVED A CONSIDERABLE NUMBER OF PATIENTS, BUT WE EXPECT THAT THE EXPANDED PEER SERVICES NOW AVAILABLE IN THE HOSPITAL WILL SERVE TO PROMOTE THESE RESOURCES AND INCREASE USAGE. AS PREVIOUSLY DESCRIBED, UNION CAREGIVERS ALSO PROVIDE CHILDBIRTH AND INFANT EDUCATION TO PREGNANT WOMEN RECEIVING SUBSTANCE USE DISORDER TREATMENT AT SERENITY HEALTH ELKTON. A REGISTERED NURSE GOES TO SERENITY HEALTH TO PROVIDE MONTHLY EDUCATIONAL SESSIONS ON TOPICS SUCH AS BREASTFEEDING, NEONATAL ABSTINENCE SYNDROME (NAS), AND SAFE SLEEP, AMONG OTHERS. UNION SOCIAL WORKERS ALSO ATTEND SOME OF THE SESSIONS WITH THE REGISTERED NURSES TO PROVIDE INFORMATION ON TOPICS LIKE CHILD PROTECTIVE SERVICES AND ANSWER QUESTIONS ON ASSESSING SOCIAL SERVICES. IN FY23, ELEVEN EDUCATION SESSIONS WERE HELD AT SERENITY HEALTH ELKTON WITH 1 TO 3 PREGNANT PARTICIPANTS IN EACH COURSE. IN FY23, CAREGIVERS ALSO WORKED TO DEVELOP PARTNERSHIPS WITH OTHER TREATMENT PROVIDERS IN CECIL COUNTY TO PROVIDE THE SAME EDUCATION. PROVIDING THIS EDUCATION IS IMPORTANT TO EMPOWER THESE MOTHERS TO TAKE THE BEST CARE OF THEIR BABY INSTEAD OF FEELING ISOLATED AND ASHAMED. ON BEHALF OF UNION, REGISTERED NURSES ALSO CONTINUE TO ATTEND MONTHLY LOCAL OVERDOSE FATALITY REVIEW TEAMS (LORFT) MEETINGS TO DISCUSS AND CASE REVIEW ALL UNINTENTIONAL OVERDOSE DEATHS RELATED TO STREET DRUGS AND ALCOHOL IN CECIL COUNTY. MEMBERS ARE STAKEHOLDERS FROM LAW ENFORCEMENT, THE COMMUNITY, GOVERNMENT AGENCIES, AND PROVIDERS. SOCIAL DETERMINANTS OF HEALTH (SDOH) WERE NOT IDENTIFIED AS A SIGNIFICANT AREA OF NEED IN OUR 2022 CHNA, BUT SDOH CAUSE AND/OR EXACERBATE ALL THE SIGNIFICANT AREAS OF NEED. IN FY23 UNION COMPLETED THE PROCESS OF INTEGRATION WITH CHRISTIANACARE'S ELECTRONIC HEALTH RECORD. AMONG THE MANY BENEFITS OF THIS INTEGRATION IS THAT UNION NOW HAS ACCESS TO CHRISTIANACARE'S SOCIAL DETERMINANTS OF HEALTH SCREENING TOOL. THIS SCREENING WILL PROVIDE US WITH MORE INSIGHT INTO THE CHALLENGES OUR PATIENTS FACE. AS UNION HAS NOT PREVIOUSLY HAD A UNIFORM SDOH SCREENING, THE ADOPTION AND IMPLEMENTATION OF THIS TOOL WILL TAKE TIME. WE EXPECT THAT THE PATIENT CARE COORDINATORS, HIRED THROUGH THE PREVIOUSLY DESCRIBED MDPCP, WILL PILOT THE SDOH SCREENING AT UNION. IMPORTANTLY, WE DO NOT WANT TO SIMPLY COLLECTION INFORMATION ABOUT OUR PATIENTS' BARRIERS TO GOOD HEALTH. WE WANT TO HELP PATIENTS ADDRESS THESE BARRIERS. IN DECEMBER 2021, UNION BEGAN USING UNITE MARYLAND, AN ELECTRONIC CARE COORDINATION NETWORK LAUNCHED BY UNITE US. THE UNITE US NETWORKS CONNECT SOCIAL SERVICES AND CLINICAL CARE PROVIDERS. BY PARTICIPATING IN THESE NETWORKS, HEALTHCARE PROVIDERS AND SOCIAL SERVICE ORGANIZATIONS CAN HELP INDIVIDUALS ADDRESS THEIR DIVERSE NEEDS BY SENDING AN ELECTRONIC REFERRAL ON THEIR BEHALF TO THE APPROPRIATE ORGANIZATION. THE SENDER OF THAT REFERRAL WILL BE ABLE TO TRACK WHETHER THAT NEED WAS MET OR NOT AND TAKE ADDITIONAL ACTION IF NEEDED TO HELP THE PATIENT MEET THEIR NEED. UNION'S USE OF UNITE MARYLAND EXPANDED IN FEBRUARY 2023 WITH THE ONBOARDING OF 5 ADDITIONAL PROGRAMS/DEPARTMENTS INCLUDING SOCIAL WORK, CASE MANAGEMENT, AND INSURANCE NAVIGATION. OUR SUPPORT OF UNITE MARYLAND ALSO BENEFITS THE BROADER COMMUNITY AS COMMUNITY ORGANIZATIONS ARE ABLE TO PARTICIPATE ON THE NETWORK FOR FREE. AS OF JUNE 30, 2023, THE UNITE MARYLAND NETWORK HAD 57 LOCAL ORGANIZATIONS WITH 66 PROGRAMS OPEN TO RECEIVE REFERRALS SERVING THE CECIL COUNTY COMMUNITY. CHRISTIANACARE ALSO ESTABLISHED THE COMMUNITY INVESTMENT FUND IN DECEMBER 2019 TO ADDRESS SDOH BY GIVING FUNDING TO COMMUNITY ORGANIZATIONS THAT PROVIDE VITAL SERVICES IN OUR COMMUNITIES. THAT YEAR, CHRISTIANACARE AWARDED NEARLY $2
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) 2022

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) 2022

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 FY2023, UNION HOSPITAL REPORTED EXPENDITURES IN THE COMMUNITY BUILDING CATEGORIES OF ECONOMIC DEVELOPMENT AND WORKFORCE DEVELOPMENT. THIS COST REPRESENTS TIME SPENT BY THE DIRECTOR OF HUMAN RESOURCES PARTICIPATING ON TWO COMMUNITY BOARDS: THE BOARD OF THE ECONOMIC DEVELOPMENT COMMISSION FOR CECIL COUNTY AND THE SUSQUEHANNA WORKFORCE NETWORK. THE ECONOMIC DEVELOPMENT COMMISSION FOCUSES ON BUSINESS AND INDUSTRY DEVELOPMENT BY BUILDING RELATIONSHIPS WITH LOCAL PARTNERS IN 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. THE SUSQUEHANNA WORKFORCE NETWORK OVERSEES, COORDINATES, AND PLANS WORKFORCE DEVELOPMENT PROGRAMS AND SERVICES FOR BUSINESSES AND INDIVIDUALS IN CECIL AND HARFORD COUNTIES. IT IDENTIFIES NEEDS AND DEVELOPS SOLUTIONS THAT MAXIMIZE REGIONAL ECONOMIC SUCCESS AND WORKER POTENTIAL. THEY REPRESENT AN AFFILIATION OF OVER 50 LOCAL AGENCIES, BUSINESSES, AND ORGANIZATIONS THAT WORK COLLABORATIVELY TO EXECUTE A SYSTEM OF EDUCATION, TRAINING, EMPLOYMENT, AND OUTREACH PROGRAMS AND SERVICES THAT ARE RESPONSIVE TO LOCAL ECONOMIC CHALLENGES AND MEET THE NEEDS OF BUSINESSES, WORKERS, AND YOUTH. ---------------
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 STARTING 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 WRITTEN OFF IF THEY ARE DETERMINED TO BE INDIGENT. ---------------
PART VI, LINE 2 (NEEDS ASSESSMENT)	AS MENTIONED IN THE PRIOR SECTION, CAREGIVERS AT UNION WILL UTILIZE THE SDOH SCREENING INSTRUMENT TO LEARN ABOUT AND ADDRESS OUR PATIENTS' NEEDS. AS DEMONSTRATED BY OUR YEARS OF PRODUCING JOINT CHNAS AND THE DIFFERENT INITIATIVES WE HAVE UNDERTAKEN TOGETHER, UNION ALSO HAS A STRONG RELATIONSHIP WITH THE CECIL COUNTY HEALTH DEPARTMENT. THIS ALLOWS US TO COORDINATE EFFORTS WHEN POSSIBLE AND TO LEARN FROM THEIR INSIGHT ABOUT OUR COMMUNITY AS WELL. OUR NEW COMMUNITY ENGAGEMENT MANAGER IS ALSO FOCUSED ON ENGAGING WITH OUR COMMUNITY AND DEVISING STRATEGIES TO RESPOND TO THEIR NEEDS. UNION CAREGIVERS PARTICIPATE IN CECIL COUNTY'S COMMUNITY HEALTH ADVISORY COMMITTEE (CHAC) AND ITS TASK FORCES CREATED TO ADDRESS PROMINENT ISSUES IN THE COUNTY SUCH AS THE HEALTHY LIFESTYLES AND TOBACCO TASK FORCES. FOR SEVERAL YEARS, A UNION CAREGIVER HAS CHAIRED THE CANCER TASK FORCE. UNION CAREGIVERS ALSO PARTICIPATE IN DIFFERENT COMMUNITY BOARDS AND COMMITTEES THAT FOCUS ON DIFFERENT AREAS OF COMMUNITY NEED. ALONG WITH THE CHAC TASK FORCES. UNION CAREGIVERS ALSO PARTICIPATED IN THESE ADDITIONAL COMMUNITY GROUPS: . CECIL COUNTY BEHAVIORAL HEALTH PROVIDERS . CECIL COUNTY BEHAVIORAL HEALTH ADVISORY BOARD . CECIL COUNTY HEALTH DEPARTMENT ADVISORY COMMITTEE . CECIL COUNTY CHILD ADVOCACY CENTER . CECIL COUNTY ECONOMIC DEVELOPMENT COMMISSION . LOCAL MANAGEMENT BOARD . LOCAL OVERDOSE FATALITY REVIEW TEAM . CHILD FATALITY REVIEW BOARD ---------------
PART VI, LINE 3 (PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE)	UNION'S FINANCIAL ASSISTANCE POLICY (FAP) ENSURES A UNIFORM AND EQUITABLE PROCESS IN GRANTING FINANCIAL ASSISTANCE TO APPROPRIATE PATIENTS WHILE RESPECTING THE INDIVIDUAL'S DIGNITY. THE FAP ALIGNS WITH FEDERAL AND STATE REGULATIONS. INDIVIDUALS WHO NEED EMERGENCY OR MEDICALLY NECESSARY TREATMENT AND HAVE A HOUSEHOLD INCOME BELOW 400% OF THE FEDERAL POVERTY LEVEL (FPL) ARE ELIGIBLE FOR FREE OR DISCOUNTED CARE. UNION DOES NOT PURSUE EXTRAORDINARY COLLECTION ACTIONS AGAINST ANY INDIVIDUAL. A PLAIN LANGUAGE SUMMARY OF THE FAP, THE FULL POLICY, THE FINANCIAL ASSISTANCE APPLICATION IN ENGLISH AND SPANISH, AND THE MOST RECENT FINANCIAL ASSISTANCE SCALE ARE ALL AVAILABLE ON UNION'S WEBSITE AT: https://www.uhcc.com/about-us/patient-financial-services/financial-assista nce/ UNION'S WEBSITE ALSO PROVIDES PATIENTS WITH DETAILED DESCRIPTIONS OF HOW THEY CAN OBTAIN THE FAP AND APPLICATION IN PERSON AND GET HELP IN THE APPLICATION PROCESS. UNION FINANCIAL COUNSELORS ARE AVAILABLE MONDAY THROUGH FRIDAY, FROM 8 A.M. TO 4:30 P.M. TO DISCUSS THE APPLICATION PROCESS BY PHONE OR AT THE HOSPITAL. THE WEBSITE ALSO PROVIDES A MAILING ADDRESS, TELEPHONE NUMBER, EMAIL ADDRESS, AND IN-PERSON LOCATIONS WHERE INDIVIDUALS CAN RECEIVE OR REQUEST THE FAP AND APPLICATION. INFORMATION ABOUT THE FAP IS INCLUDED ON THE FINANCIAL CONSENT FORM, ON BILLING STATEMENTS/INVOICES, UPON DISCHARGE FROM INPATIENT, OBSERVATION, OR SURGICAL SERVICES, AND ON ELECTRONIC AND PAPER SIGNS AT REGISTRATION LOCATIONS IN THE HOSPITAL. PATIENTS RECEIVE FINANCIAL COUNSELING, REFERRALS, AND ASSISTANCE TO IDENTIFY PUBLIC OR PRIVATE HEALTHCARE PROGRAMS TO ASSIST WITH LONG TERM NEEDS. IF THE PATIENT IS UNINSURED, THEY WILL BE ASSISTED TO DETERMINE MARYLAND MEDICAID OR QUALIFIED HEALTH PLAN ELIGIBILITY THROUGH THE APPROPRIATE MARYLAND HEALTH CONNECTION CONNECTOR ENTITY OR OTHER QUALIFIED HEALTH INSURANCE MARKETPLACE. UNION'S INSURANCE PROGRAM NAVIGATORS ALSO ATTEND COMMUNITY EVENTS TO PROVIDE INFORMATION ABOUT MARYLAND HEALTH CONNECTION. ---------------
PART VI, LINE 4 (COMMUNITY INFORMATION)	UNION PRIMARILY SERVES CECIL COUNTY, MARYLAND. IN FY22, CECIL COUNTY RESIDENTS ACCOUNTED FOR APPROXIMATELY 85% OF THE HOSPITAL'S TOTAL INPATIENT VOLUMES AND 84% OF TOTAL EMERGENCY DEPARTMENT VISITS. UNION HOSPITAL IS THE ONLY HOSPITAL IN THE COUNTY AND IS LOCATED IN ELKTON, THE MOST POPULOUS TOWN IN CECIL COUNTY. CECIL COUNTY IS RURAL AND BORDERS DELAWARE AND PENNSYLVANIA. IN 2021, THE TOTAL POPULATION OF CECIL COUNTY WAS APPROXIMATELY 102,722 PERSONS. BETWEEN 2020 AND 2030, THE CECIL COUNTY POPULATION IS EXPECTED TO GROW BY 8.5% WITH THE POPULATION OF THOSE 65 YEARS AND OLDER PROJECTED TO GROW AT A MORE RAPID RATE OF 43.1%. FROM 2016 TO 2020, THE POVERTY RATE IN CECIL COUNTY (9.5%) WAS SLIGHTLY ABOVE THE MARYLAND POVERTY RATE (9%), BUT BELOW THE UNITED STATES AVERAGE (12.8%). SIGNIFICANT DISPARITIES EXIST IN CECIL COUNTY WITH THE POVERTY RATES FOR BLACK (15.8%) AND HISPANIC (18.1%) PEOPLE SIGNIFICANTLY HIGHER THAN THOSE FOR WHITE (8.5%) RESIDENTS. LOW-INCOME CENSUS TRACTS ARE MOST PREVALENT IN ELKTON, NORTH EAST, AND PORT DEPOSIT. MOST OF THESE CENSUS TRACTS ARE WHERE MORE THAN ONE-HALF OF HOUSEHOLDS ARE "RENT BURDENED," ARE CATEGORIZED AS "HIGH NEED" BY THE DIGNITY HEALTH COMMUNITY NEED INDEXT (CNI) AND ARE IN THE TOP QUARTILE NATIONALLY FOR "SOCIAL VULNERABILITY" ACCORDING TO THE CENTERS FOR DISEASE CONTROL SOCIAL VULNERABILITY INDEX. THERE ARE CONSIDERABLE SUBSTANCE USE DISORDER ISSUES IN CECIL COUNTY. ADULT SMOKING RATES ARE HIGHER IN CECIL COUNTY THAN IN MARYLAND AND THE UNITED STATES. YOUTH TOBACCO AND NICOTINE USE ALSO COMPARES UNFAVORABLY IN COMPARISON TO NATIONAL AVERAGES. THE PERCENT OF CECIL COUNTY YOUTH THAT CURRENTLY USE SMOKELESS TOBACCO IS MORE THAN 50% ABOVE THE UNITED STATES AVERAGE. THE DRUG OVERDOSE DEATH RATE IS ALSO CONSIDERABLY HIGHER IN CECIL COUNTY THAN THE RATE IN MARYLAND AND THE UNITED STATES. BETWEEN 2016 AND 2020, THE DRUG OVERDOSE DEATH RATE MORE THAN DOUBLED. ---------------
PART VI, LINE 5 (INFORMATION REGARDING PROMOTION OF COMMUNITY HEALTH)	CHRISTIANACARE IS CENTERED ON IMPROVING HEALTH OUTCOMES, MAKING HIGH-QUALITY CARE MORE ACCESSIBLE, AND LOWERING HEALTH CARE COSTS. GUIDED BY OUR VALUES, LOVE AND EXCELLENCE, UNION CONTINUES TO SERVE OUR CECIL COUNTY NEIGHBORS AS THEIR COMMUNITY HOSPITAL. EACH FISCAL YEAR, UNION SERVES CECIL COUNTY BY PROVIDING ACTIVITIES, PROGRAMS, AND INITIATIVES THAT SEEK TO IMPROVE COMMUNITY HEALTH. THE FOLLOWING IS A SUMMARY OF THE COMMUNITY BENEFIT ACTIVITIES, PROGRAMS, AND INITIATIVES THAT UNION HOSPITAL PROVIDED IN CECIL COUNTY DURING FY23: . A1: COMMUNITY HEALTH EDUCATION - UNION HOSPITAL PROVIDED: HEALTH EDUCATION PRESENTATIONS IN THE COMMUNITY ON TOPICS SUCH AS DIABETES AND NUTRITION, CANCER PREVENTION AND SCREENING, CHILDBIRTH AND INFANT EDUCATION INCLUDING NEONATAL ABSTINENCE SYNDROME AND LACTATION SUPPORT, AND INFORMATION ON MARYLAND HEALTH CONNECTION. . A2: COMMUNITY-BASED CLINICAL SERVICES - TWO FREE EYE SCREENINGS FOR DIABETICS - A FREE SPORTS PHYSICALS CLINIC FOR COUNTY PUBLIC AND PRIVATE MIDDLE SCHOOL AND HIGH SCHOOL STUDENTS . A3: HEALTH CARE SUPPORT SERVICES - PARTICIPATION ON CHILD ADVOCACY CENTER INVESTIGATIONS/MEETINGS - PARTNERSHIP WITH CCHD TO SUPPORT THE PEER RECOVERY ADVOCATES PROGRAM AND IMPLEMENT A NEW GRANT INITIATIVE THAT WILL PROVIDE MORE CONNECTIONS TO PEERS IN THE COMMUNITY . A4: SOCIAL AND ENVIRONMENTAL IMPROVEMENTS - TRANSPORTATION DONATIONS FOR ELIGIBLE PATIENTS . B1-B3: HEALTH PROFESSIONS EDUCATION - UNION CAREGIVERS OFFERED TRADITIONAL CLINICAL ROTATIONS TO 64 UNDERGRADUATE NURSING STUDENTS. . C: MISSION DRIVEN HEALTH SERVICES - UNION PROVIDED SUBSIDIZED OUTPATIENT SERVICES TO MEET IDENTIFIED NEEDS IN THE COMMUNITY, EVEN THOUGH THEY OPERATE AT A LOSS. THESE INCLUDE PRIMARY CARE, PSYCH-OUTPATIENT AND ENDOCRINOLOGY, AMONG OTHERS. . E3: IN-KIND CONTRIBUTIONS - PROVIDED FREE AMBULANCE TRANSPORTS AND FREE SUPPLIES FOR AMBULANCE STOCK-UPS - PARTICIPATION IN COMMUNITY BOARDS/COMMITTEES/TASK FORCES AND OTHER GROUPS ---------------
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 (ONCOLOGY") 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 UNION ONCOLOGY'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, UNION ONCOLOGY 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 265 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) 2022

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

2022

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) 2022

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, 1099-MISC compensation, and/or 1099-NEC			(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)
1JENNIFER L SCHWARTZ ESQ SECRETARY (EX-OFFICIO)	(i) (ii)	0 ------------- 543,248	0 ------------- 197,288	0 ------------- 4,880	0 ------------- 57,934	0 ------------- 20,501	0 ------------- 823,851	0 ------------- 0
2JOSE MA MD DIRECTOR	(i) (ii)	243,710 ------------- 0	92,946 ------------- 0	2,429 ------------- 0	0 ------------- 0	12,272 ------------- 0	351,357 ------------- 0	0 ------------- 0
3JUSTIN SAUSVILLE MD DIRECTOR	(i) (ii)	583,596 ------------- 0	174,158 ------------- 0	22,201 ------------- 0	0 ------------- 0	20,501 ------------- 0	800,456 ------------- 0	0 ------------- 0
4ROBERT ASANTE DIRECTOR	(i) (ii)	0 ------------- 179,571	0 ------------- 30,620	0 ------------- 1,018	0 ------------- 0	0 ------------- 20,501	0 ------------- 231,710	0 ------------- 0
5SHARON T KURFUERST PRESIDENT- THRU 1/23	(i) (ii)	0 ------------- 691,616	0 ------------- 248,907	0 ------------- 26,781	0 ------------- 71,217	0 ------------- 13,663	0 ------------- 1,052,184	0 ------------- 0
6ROBERT MCMURRAY TREASURER (EX-OFFICIO)	(i) (ii)	0 ------------- 624,494	0 ------------- 226,794	0 ------------- 6,652	0 ------------- 66,326	0 ------------- 20,501	0 ------------- 944,767	0 ------------- 0
7RYAN GERACIMOS MD CHIEF MEDICAL OFFICER	(i) (ii)	444,002 ------------- 0	96,743 ------------- 0	3,786 ------------- 0	0 ------------- 0	876 ------------- 0	545,407 ------------- 0	0 ------------- 0
8JOAN PIRRUNG MSN APRN ACNS-BC VP PAT. CARE SERVIVES-NURSING	(i) (ii)	186,068 ------------- 0	40,659 ------------- 0	11,386 ------------- 0	0 ------------- 0	20,501 ------------- 0	258,614 ------------- 0	0 ------------- 0
9AMY MARSTON INT. PRESIDENT- AS OF 2/23	(i) (ii)	120,502 ------------- 73,650	26,178 ------------- 16,000	9,929 ------------- 6,069	0 ------------- 0	12,829 ------------- 7,841	169,438 ------------- 103,560	0 ------------- 0
10MICHELLE TWUM-DANSO DIRECTOR OF HR - CECIL CAMPUS	(i) (ii)	0 ------------- 191,842	0 ------------- 33,506	0 ------------- 1,165	0 ------------- 0	0 ------------- 8,956	0 ------------- 235,469	0 ------------- 0
11DERON G BROWN FORMER FINANCE DIRECTOR	(i) (ii)	71,339 ------------- 86,442	12,440 ------------- 15,073	417 ------------- 506	0 ------------- 0	0 ------------- 0	84,196 ------------- 102,021	0 ------------- 0
12RICHARD C SZUMEL FORMER OFFICER	(i) (ii)	0 ------------- 0	0 ------------- 0	0 ------------- 465,941	0 ------------- 0	0 ------------- 0	0 ------------- 465,941	0 ------------- 0
13ROGER D WU MD PHYSICIAN	(i) (ii)	556,611 ------------- 0	52,865 ------------- 0	2,598 ------------- 0	0 ------------- 0	20,839 ------------- 0	632,913 ------------- 0	0 ------------- 0
14FAHD RAHMAN MD PHYSICIAN	(i) (ii)	491,660 ------------- 0	347,973 ------------- 0	2,375 ------------- 0	0 ------------- 0	20,501 ------------- 0	862,509 ------------- 0	0 ------------- 0
15DONNA MALONEY DIRECTOR OF FINANCE	(i) (ii)	0 ------------- 175,811	0 ------------- 32,590	0 ------------- 13,510	0 ------------- 0	0 ------------- 20,501	0 ------------- 242,412	0 ------------- 0
16OLUMIDE OMOBO PHYSICIAN	(i) (ii)	529,550 ------------- 0	35,702 ------------- 0	1,160 ------------- 0	0 ------------- 0	7,085 ------------- 0	573,497 ------------- 0	0 ------------- 0
17CLAIRE YI ZHANG PHYSICIAN	(i) (ii)	445,423 ------------- 0	59,663 ------------- 0	2,164 ------------- 0	0 ------------- 0	0 ------------- 0	507,250 ------------- 0	0 ------------- 0
18BALTEJ SINGH MD PHYSICIAN	(i) (ii)	393,595 ------------- 0	32,102 ------------- 0	1,158 ------------- 0	0 ------------- 0	20,501 ------------- 0	447,356 ------------- 0	0 ------------- 0

Schedule J (Form 990) 2022

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 3	TOP MANAGEMENT COMPENSATION AS PROVIDED IN THE FORM 990, SCHEDULE J INSTRUCTIONS, SINCE THE ORGANIZATION RELIES ON A RELATED ORGANIZATION WHICH USES ONE OR MORE OF THE METHOD DESCRIBED IN LINE 3 TO ESTABLISH THE TOP MANAGEMENT OFFICIALS' COMPENSATION, THIS QUESTION HAS BEEN LEFT UNANSWERED. REFER TO SCHEDULE O FOR A DESCRIPTION OF THE COMPENSATION REVIEW AND APPROVAL PROCESS. ---------------
FORM 990, SCHEDULE J, PART I, LINE 4A	DETAIL OF SEVERANCE PAYMENTS SHARON KURFUERST (PRESIDENT) RECEIVED A SEVERANCE PAYMENT OF $168,230 DURING THE YEAR. KENNETH SILVERSTEIN (MEMBER) RECEIVED A SEVERANCE PAYMENT OF $173,170 DURING THE YEAR. RICHARD SZUMEL (FORMER OFFICER) RECEIVED A SEVERANCE PAYMENT OF $465,941 DURING THE YEAR. ---------------
FORM 990, SCHEDULE J, PART I, LINE 4B	SUPP. NONQUALIFIED PLAN PARTICIPATION THIS ORGANIZATION IS AN AFFILIATE OF CHRISTIANA CARE HEALTH SERVICES, INC. ("CCHS"). CCHS MAINTAINS AN IRC SECTION 457(F) DEFERRED COMPENSATION PLAN. THE FOLLOWING INDIVIDUALS LISTED ON FORM 990, PART VII, SECTION A, LINE 1A PARTICIPATED AND/OR RECEIVED DISTRIBUTIONS FROM THE 457(F) PLAN DURING THE YEAR: SHARON T. KURFUERST- $21,575 ROBERT MCMURRAY- NO DISTRIBUTION JENNIFER L. SCHWARTZ, ESQ.- NO DISTRIBUTION ---------------
FORM 990, SCHEDULE J, PART I, LINE 7	NONFIXED PAYMENTS THIS ORGANIZATION IS AN AFFILIATE OF CHRISTIANA CARE HEALTH SYSTEM, INC. ("SYSTEM") AND CHRISTIANA CARE HEALTH SERVICES, INC. ("CCHS"). ALL OFFICER/TRUSTEE COMPENSATION ARRANGEMENTS, INCLUDING THE PAYMENT OF DISCRETIONARY BONUS AND/OR INCENTIVE COMPENSATION PAYMENTS TO ELIGIBLE EMPLOYEES, ARE DETERMINED BY THE SYSTEM BOARD AND PAID EITHER THROUGH CCHS OR THIS ORGANIZATION. PAYMENTS MADE TO ANY DISQUALIFIED PERSON ARE APPROVED BY THE COMPENSATION COMMITTEE OF SYSTEM THROUGH THE PROCESS DESCRIBED IN FORM 990, PART VI, SECTION B, LINE 15. ---------------

Schedule J (Form 990) 2022

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

2021

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 ..................	3,804,760		5,041,900		911,370		9,924,000
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 2020, 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 2020, 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

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

Cat. No. 50193E

Schedule K (Form 990) 2021

Page 2

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
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 %		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

Schedule K (Form 990) 2021

Page 3

Part Ⅳ

Arbitrage (Continued)

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
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? ........
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) 2021

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

2021

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 ..................	3,804,760		5,041,900		911,370		9,924,000
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 2020, 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 2020, 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

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

Cat. No. 50193E

Schedule K (Form 990) 2021

Page 2

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
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 %		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

Schedule K (Form 990) 2021

Page 3

Part Ⅳ

Arbitrage (Continued)

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
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? ........
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) 2021

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE O
(Form 990)

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

2021

Open to Public
Inspection

Name of the organization

UNION HOSPITAL OF CECIL COUNTY INC

Employer identification number

52-0607945

Return Reference	Explanation
FORM 990, PART VI, SECTION A, LINES 6 & 7A,7B	GOVERNING BODY AND MANAGEMENT CHRISTIANA CARE HEALTH SERVICES, INC. ("CCHS") IS THE SOLE MEMBER OF AFFINITY HEALTH ALLIANCE, INC. ("AHA"), THE SOLE MEMBER OF THE UNION HOSPITAL OF CECIL COUNTY, INC. ("UHCC"). CCHS AND AHA ARE BOTH TAX-EXEMPT ORGANIZATIONS. THE BOARD OF DIRECTORS OF CCHS ELECTS THE DIRECTORS OF UHCC AT ITS ANNUAL MEETING. THE ANNUAL OPERATING BUDGET OF UHCC IS APPROVED BY THE UHCC BOARD, THE FINANCE COMMITTEE OF THE CCHS BOARD, THE CCHS BOARD, THE FINANCE COMMITTEE OF THE BOARD OF CHRISTIANA CARE HEALTH SYSTEM, INC. ("SYSTEM"), THE SOLE MEMBER OF CCHS, AND THE SYSTEM BOARD. ---------------
FORM 990, PART VI, SECTION B, LINE 11B	FORM 990 REVIEW PROCESS INFORMATION RELATED TO THE UHCC FORM 990 IS GATHERED BY FINANCE STAFF AND PROVIDED TO PWC US TAX LLP FOR REVIEW. THE FINAL 2022 FORM 990 FOR THE FISCAL YEAR ENDING JUNE 30, 2023 WAS REVIEWED AND APPROVED BY VARIOUS SENIOR MANAGEMENT OFFICIALS. THE ORGANIZATION'S GOVERNING BOARD WAS ALSO PROVIDED ACCESS TO THE APPROVED 2022 FORM 990 VIA ITS BOARD OF DIRECTORS PORTAL. ---------------
FORM 990, PART VI, SECTION B, LINE 12C	CONFLICT OF INTEREST POLICY OUR CONFLICT OF INTEREST ("COI") POLICY IS LOCATED IN THE CAREGIVER RESOURCE CENTER ON THE EMPLOYEE PORTAL. THERE IS AN ANNUAL MANDATORY EDUCATION FOR REQUIRED INDIVIDUALS, WHICH INCLUDES AN ELECTRONIC SIGN OFF ACKNOWLEDGING COMPLETION OF THE EDUCATION, REPORTING OF A REAL OR PERCEIVED CONFLICT OR THAT NO CONFLICTS OF INTEREST EXIST. THE HR/EMPLOYEE RELATIONS TEAM FOLLOWS UP WITH ANYONE WHO HAS A CONFLICT OR PERCEIVED CONFLICT OR DOES NOT COMPLETE THE EDUCATION IN ORDER TO RESOLVE. THE EMPLOYEE HANDBOOK SETS EXPECTATIONS FOR EMPLOYEE CONFLICTS OF INTEREST AND EXPECTATIONS. SEVERAL REPORTING MECHANISMS ALSO EXIST FOR EMPLOYEES TO REPORT CONCERNS. THE BOARD OF DIRECTORS HAS THEIR OWN COI POLICY. COI IS A STANDING AGENDA ITEM ON EACH BOARD OR BOARD COMMITTEE MEETING. BOARD MEMBERS EXPECTATIONS FOR COI ARE CLEARLY COMMUNICATED. ---------------
FORM 990, PART VI, SECTION B, LINE 15	COMPENSATION REVIEW AND APPROVAL PROCESS THE BOARD OF DIRECTORS OF CHRISTIANA CARE HEALTH SYSTEM, INC. ("SYSTEM"), THE SOLE MEMBER OF CHRISTIANA CARE HEALTH SERVICES, INC. ("CCHS"), THE SOLE MEMBER OF UNION HOSPITAL OF CECIL COUNTY, INC. ("UHCC"), ESTABLISHES UHCC'S COMPETITIVE TOTAL COMPENSATION POLICY AND PRACTICE. THE EXECUTIVE COMPENSATION COMMITTEE ("ECC") OF THE SYSTEM BOARD ENGAGES AN INDEPENDENT THIRD PARTY ANNUALLY WHO ASSESSES DATA FROM SEVERAL MAJOR SURVEYS TO ENSURE TOTAL REMUNERATION IS MARKET COMPETITIVE AND QUALIFIES FOR THE "REBUTTABLE PRESUMPTION OF REASONABLENESS" UNDER THE INTERMEDIATE SANCTIONS RULE, SECTION 4958 OF THE INTERNAL REVENUE CODE. AFTER DELIBERATION, THE ECC DOCUMENTS THEIR DECISIONS IN MEETING MINUTES. ---------------
FORM 990, PART VI, SECTION C, LINE 19	GOVERNANCE, MANAGEMENT & DISCLOSURE THE GOVERNING DOCUMENTS, AUDITED FINANCIAL STATEMENTS, AND CONFLICT OF INTEREST POLICY ARE AVAILABLE TO THE PUBLIC UPON REQUEST. ---------------
FORM 990, PART XI, LINE 9	OTHER CHANGES IN NET ASSETS OR FUND BALANCES CHANGE IN NET ASSETS OF FOUNDATION $285,664 OTHER CHANGES (5,325) -------- TOTAL $280,339 ---------------
FORM 990, SCHEDULE C	DETAIL OF LOBBYING ACTIVITIES UHCC IS A MEMBER OF THE MARYLAND HOSPITAL ASSOCIATION ("MHA"). A PORTION OF THE MEMBERSHIP DUES PAID BY UHCC MAY BE USED BY MHA FOR LOBBYING PURPOSES. ---------------
FORM 990 PART IX LINE 11G	DESCRIPTION:ADMINISTRATION FEES TOTAL FEES:4185
FORM 990 PART IX LINE 11G	DESCRIPTION:AMBULANCE TOTAL FEES:290
FORM 990 PART IX LINE 11G	DESCRIPTION:AMBULANCE TRANSPORT SRVS TOTAL FEES:99186
FORM 990 PART IX LINE 11G	DESCRIPTION:BILLING FEES TOTAL FEES:-196019
FORM 990 PART IX LINE 11G	DESCRIPTION:COLLECTION FEES TOTAL FEES:491544
FORM 990 PART IX LINE 11G	DESCRIPTION:CONSULTING FEES TOTAL FEES:-450
FORM 990 PART IX LINE 11G	DESCRIPTION:FLEX ADMINISTRATION TOTAL FEES:17104
FORM 990 PART IX LINE 11G	DESCRIPTION:PHYSICIAN FEES TOTAL FEES:9618602
FORM 990 PART IX LINE 11G	DESCRIPTION:PURCHASED ANCILLARY SRVS TOTAL FEES:223365
FORM 990 PART IX LINE 11G	DESCRIPTION:PURCHASED LABOR TOTAL FEES:3325419
FORM 990 PART IX LINE 11G	DESCRIPTION:PURCHASED SERVICES TOTAL FEES:7467969
FORM 990 PART IX LINE 11G	DESCRIPTION:SNOW REMOVAL TOTAL FEES:1694
FORM 990 PART IX LINE 11G	DESCRIPTION:TYPING & SUBSCRIPTION TOTAL FEES:120078

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

Cat. No. 51056K

Schedule O (Form 990) 2021

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

2021

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 4000 NEXUS DR NW3-100 WILMINGTON,DE19803 52-1794552	FUNDRAISING	MD	501(C)(3)	7	AFFINITY		No
(2)UNION HOSPITAL OF CECIL COUNTY HLTH SVCS 4000 NEXUS DR NW3-100 WILMINGTON,DE19803 52-1794553	PROPERTY MGMT	MD	501(C)(3)	10	AFFINITY		No
(3)AFFINITY HEALTH ALLIANCE INC 4000 NEXUS DR NW3-100 WILMINGTON,DE19803 52-1794697	MANAGEMENT	MD	501(C)(3)	12B,II	CCH SERVICES		No
(4)UNION HOSPITAL OF CECIL COUNTY ONCOLOGY 4000 NEXUS DR NW3-100 WILMINGTON,DE19803 81-2662359	HEALTHCARE	MD	501(C)(3)	3	AFFINITY		No
(5)CHRISTIANA CARE HEALTH SYSTEM INC 4000 NEXUS DR NW3-100 WILMINGTON,DE19803 52-1479538	FUNDRAISING	DE	501(C)(3)	7	NA		No
(6)CHRISTIANA CARE HLTH INITIATIVES INC 4000 NEXUS DR NW3-100 WILMINGTON,DE19803 51-0295186	OUTPATIENT SV	DE	501(C)(3)	10	CCH SYSTEM		No
(7)CHRISTIANA CARE HOME HEALTH & COM SRVCS 4000 NEXUS DR NW3-100 WILMINGTON,DE19803 51-0064334	HOME HLTHCARE	DE	501(C)(3)	7	CCH SYSTEM		No
(8)CHRISTIANA CARE HEALTH SERVICES INC 4000 NEXUS DR NW3-100 WILMINGTON,DE19803 51-0103684	HOSPITAL	DE	501(C)(3)	3	CCH SYSTEM		No
(9)CHRISTIANA CARE WEST GROVE INC 4000 NEXUS DR NW3-100 WILMINGTON,DE19803 51-0275944	HEALTHCARE	PA	501(C)(3)	PENDING	CCH SERVICES		No
(10)CHRISTIANA CARE GENE EDITING INSTITUTE 4000 NEXUS DR NW3-100 WILMINGTON,DE19803 88-3110655	HEALTHCARE	DE	501(C)(3)	PENDING	CCH SYSTEM		No

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

Cat. No. 50135Y

Schedule R (Form 990) 2021

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?		(k) Percentage ownership
(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	(k) Percentage ownership
(1) CHRISTIANACARE GOHEALTH URGENT CARE LLC 5555 GLENRIDGE CONNECTOR STE 700 ATLANTA,GA30342 84-4061485	URGENT CARE S	DE	CCH SERVICES							No
(2) CHRISTIANACARE VALUE HEALTH JV LLC 11221 ROE AVE LEAWOOD,KS66211 85-1100149	AMBULATORY SR	DE	CCH SERVICES							No
(3) CLINERGY LLC 4755 OGLETOWN STANTON RD NEWARK,DE19718 85-2698063	GROUP PURCHAS	DE	CCH SERVICES							No
(4) LEEWARD HEALTH LLC 4000 NEXUS DRIVE STE C3-300 WILMINGTON,DE19803	MED ADV RISK	DE	CCH SYSTEM							No

Part IV

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

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Type of entity (C corp, S corp, or trust)	(f) Share of total income	(g) Share of end-of-year assets	(h) Percentage ownership	(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	(h) Percentage ownership	Yes	No
(1) UNION HOSPITAL OF CECIL COUNTY VENTURES 4000 NEXUS DR NW3-100 WILMINGTON,DE19803 52-1793691	MEDICAL SERVICES	MD	AFFINITY	C CORP					No
(2) THE DE CTR FOR MAT FETAL MED OF CC INC 4000 NEXUS DR NW3-100 WILMINGTON,DE19803 20-5891272	HEALTHCARE	DE	CCH SERVICES	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	CCH SERVICES	TRUST					No
(5) CHRISTIANA CARE EXEC DEFERRED COMP PLAN 4755 OGLETOWN STANTON RD NEWARK,DE19718 35-7048822	DEF COMP PLAN	DE	CCH SERVICES	TRUST					No
(6) CARE ASSOCIATES DEFERRED COMP PLAN 4755 OGLETOWN STANTON RD NEWARK,DE19718 35-7048714	DEF COMP PLAN	DE	CCH SERVICES	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	CCH SERVICES	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) 2021

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

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

Yes

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) 2021

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?		(k) Percentage ownership
(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	(k) Percentage ownership

Schedule R (Form 990) 2021

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) 2021

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	12
4	Number of independent voting members of the governing body (Part VI, line 1b) .....	4	9
5	Total number of individuals employed in calendar year 2021 (Part V, line 2a) ......	5	1,169
6	Total number of volunteers (estimate if necessary) .............	6	100
7a	Total unrelated business revenue from Part VIII, column (C), line 12 ........	7a	2,424,924
b	Net unrelated business taxable income from Form 990-T, Part I, line 11 .........	7b	0

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........	997,954	902,376
9	Program service revenue (Part VIII, line 2g) .........	169,542,293	172,643,201
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	4,746,882	1,580,560
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	2,759,534	2,719,965
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)	178,046,663	177,846,102
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...	0	0
14	Benefits paid to or for members (Part IX, column (A), line 4).....	0	0
15	Salaries, other compensation, employee benefits (Part IX, column (A), lines 5–10)	115,682,360	122,030,806
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)....	86,433,407	70,389,001
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	202,115,767	192,419,807
19	Revenue less expenses. Subtract line 18 from line 12.......	-24,069,104	-14,573,705
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	171,242,854	186,066,867
21	Total liabilities (Part X, line 26).............	130,401,794	156,038,586
22	Net assets or fund balances. Subtract line 21 from line 20.....	40,841,060	30,028,281

Sign Here

	Signature of officer	Date

	Type or print name and title


4a	(Code: ) (Expenses $ 166,707,286 including grants of $ 0 ) (Revenue $ 172,668,589 )
	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 $8,974,331 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 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 5,996 DISCHARGES PROVIDING 27,044 PATIENT DAYS TO INPATIENTS IN FISCAL YEAR 2023 OF WHICH: 1) PATIENTS COVERED UNDER THE MEDICARE PROGRAM WERE 2,396 DISCHARGES AND 11,958 PATIENT DAYS 2) PATIENTS COVERED UNDER THE MEDICAID PROGRAM WERE 175 DISCHARGES AND 794 PATIENT DAYS 3) PATIENTS COVERED UNDER THE MEDICAID HMO PROGRAM WERE 1,540 DISCHARGES AND 5,561 PATIENT DAYS 4) PATIENTS COVERED UNDER THE MEDICARE HMO PROGRAM WERE 710 DISCHARGES AND 3,840 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 expenses166,707,286

(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)			(D) Reportable compensation from the organization (W-2/1099-MISC/1099-NEC)	(E) Reportable compensation from related organizations (W-2/1099-MISC/1099-NEC)	(F) Estimated amount of other compensation from the organization and related organizations
(A) Name and title
(18) DERON G BROWN........................................................................ FORMER FINANCE DIRECTOR	43.0 .......................1.0			X	84,196	102,021	0
(19) CHRISTY DRYER DNP........................................................................ DIRECTOR	1.0 .......................1.0	X			0	0	0
(20) DAVID TROLIO........................................................................ DIRECTOR	1.0 .......................1.0	X			0	0	0
(21) DWIGHT D THOMEY ESQ........................................................................ DIRECTOR, CHAIR	1.0 .......................3.0	X	X		0	0	0
(22) JACQUES RENE........................................................................ DIRECTOR	1.0 .......................1.0	X			0	0	0
(23) LEO NAJERA MD........................................................................ DIRECTOR	1.0 .......................2.0	X			0	0	0
(24) MORGAN MILLER MLIS........................................................................ VICE CHAIR	1.0 .......................1.0	X	X		0	0	0
(25) REVEREND R KEVIN BROWN........................................................................ DIRECTOR	1.0 .......................1.0	X			0	0	0
(26) ROBERT PALSGROVE........................................................................ DIRECTOR	1.0 .......................1.0	X			0	0	0
(27) JOHN NESS........................................................................ DIRECTOR (AS OF 1/1/23)	1.0 .......................1.0	X			0	0	0

1b	Sub-Total................
c	Total from continuation sheets to Part VII, Section A....
d	Total (add lines 1b and 1c)...........	5,097,088	3,893,974	443,846

1a	Federated campaigns..		1a
b	Membership dues..		1b
c	Fundraising events..		1c
d	Related organizations		1d	170,563
e	Government grants (contributions)		1e	731,813

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

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

h Total. Add lines 1a-1f.......		902,376

		Business Code
2a	NET PATIENT SERVICE REVENUE	621990	172,428,070	172,428,070
b	OTHER OPERATING REVENUE	621990	119,731	83,731	36,000
c	ADULT DAY CARE	623990	95,400	95,400
d
e
f	All other program service revenue.
g	Total. Add lines 2a–2f .....		172,643,201

3 Investment income (including dividends, interest, and othersimilar amounts) ......			1,518,575		67,012	1,451,563
4 Income from investment of tax-exempt bond proceeds			0
5 Royalties...........			0
		(ii) Personal	(i) Real
6a	Gross rents		65,755	6a
b	Less: rental expenses		265	6b
c	Rental income or (loss)	0	65,490	6c
d	Net rental income or (loss).......			65,490			65,490
		(ii) Other	(i) Securities
7a	Gross amount from sales of assets other than inventory	400	9,183,646	7a
b	Less: cost or other basis and sales expenses		9,122,061	7b
c	Gain or (loss)	400	61,585	7c
d	Net gain or (loss).........			61,985		47,960	14,025
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	2,299,340	25,388	2,273,952
b	CAFETERIA/FOOD SERVICE REVENUE		722210	348,684			348,684
c	OTHER REVENUE		900009	6,451			6,451
d	All other revenue ....
e	Total. Add lines 11a–11d ......			2,654,475
12	Total revenue. See instructions.....			177,846,102	172,632,589	2,424,924	1,886,213

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 ...........	2,382,878	2,083,147	299,731	0
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........	94,557,510	82,663,555	11,893,955	0
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....	4,551,708	3,868,952	682,756	0
9	Other employee benefits .......	14,155,350	12,643,502	1,511,848	0
10	Payroll taxes ...........	6,383,360	5,437,629	945,731	0
11	Fees for services (non-employees):
a	Management ......	0
b	Legal .........	20,725	1,938	18,787	0
c	Accounting ...........	82,328	0	82,328	0
d	Lobbying ...........	0
e	Professional fundraising services. See Part IV, line 17	0
f	Investment management fees ......	117,567	0	117,567	0
g	Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O)	21,172,967	18,342,795	2,830,172	0
12	Advertising and promotion ....	75,791	16,760	59,031	0
13	Office expenses .......	1,643,636	911,187	732,449	0
14	Information technology ......	2,142,644	415,517	1,727,127	0
15	Royalties ..	0
16	Occupancy ...........	4,047,076	3,483,167	563,909	0
17	Travel ............	241,397	217,873	23,524	0
18	Payments of travel or entertainment expenses for any federal, state, or local public officials .	0
19	Conferences, conventions, and meetings ....	147,823	119,141	28,682	0
20	Interest ...........	2,351,027	1,942,889	408,138	0
21	Payments to affiliates .......	0
22	Depreciation, depletion, and amortization ..	7,226,175	4,378,353	2,847,822	0
23	Insurance ...	2,236,279	2,209,702	26,577	0
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	23,366,531	23,219,179	147,352	0
b	REPAIRS & MAINTENANCE	3,236,059	3,153,885	82,174	0
c	DUES & SUBSCRIPTIONS	874,462	206,714	667,748	0
d	DIETARY	716,431	703,755	12,676	0
e	All other expenses	690,083	687,646	2,437
25	Total functional expenses. Add lines 1 through 24e	192,419,807	166,707,286	25,712,521	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 ........			30,464,963	1	17,608,186
2	Savings and temporary cash investments .........			0	2	0
3	Pledges and grants receivable, net ......			0	3	0
4	Accounts receivable, net .............			14,033,313	4	26,368,053
5	Loans and other receivables from 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 ............			2,934,672	8	3,952,561
9	Prepaid expenses and deferred charges ......			4,305,163	9	3,219,190
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	198,267,214
b	Less: accumulated depreciation	10b	138,980,488	52,680,855	10c	59,286,726
11	Investments—publicly traded securities .			0	11	0
12	Investments—other securities. See Part IV, line 11 .....			47,193,854	12	51,737,013
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 ...........			19,630,034	15	23,895,138
16	Total assets. Add lines 1 through 15 (must equal line 33)...			171,242,854	16	186,066,867

17	Accounts payable and accrued expenses .....	63,932,757	17	28,768,329
18	Grants payable ...	0	18	0
19	Deferred revenue .........	5,627,708	19	2,444,392
20	Tax-exempt bond liabilities .........	49,121,622	20	46,814,552
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	11,719,707	25	78,011,313
26	Total liabilities. Add lines 17 through 25..	130,401,794	26	156,038,586

	Organizations that follow FASB ASC 958, check here and complete lines 27, 28, 32, and 33.
27	Net assets without donor restrictions ..........	37,254,152	27	26,126,386
28	Net assets with donor restrictions ...........	3,586,908	28	3,901,895
	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 ...........	40,841,060	32	30,028,281
33	Total liabilities and net assets/fund balances ........	171,242,854	33	186,066,867