TY 2023 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)
(1) STEVEN LEONARD...................................................................... PRESIDENT/CEO	50.00 ................. 2.00	X	X	1,182,770	97,448
(2) MEMO DIRIKER...................................................................... BOARD MEMBER THRU 12/23	1.00 ................. 7.00	X		7,500	0
(3) DAVID SECHLER MD...................................................................... BOARD MEMBER/PHYSICIAN	40.00 ................. 0.00	X		406,235	55,020
(4) JAMES HARTSTEIN...................................................................... CHAIRPERSON	5.00 ................. 3.00	X	X	0	0
(5) JULIUS ZANT MD...................................................................... IMMED. PAST CHAIRPERSON THRU 12/23	2.00 ................. 1.00	X	X	0	0
(6) SUSAN WILGUS-MURPHY...................................................................... SECRETARY	1.00 ................. 1.00	X	X	0	0
(7) ANTHONY ADRIGNOLO III MD...................................................................... BOARD MEMBER THRU 12/23	1.00 ................. 0.00	X		0	0
(8) RONDALL ALLEN PHARMD...................................................................... BOARD MEMBER	1.00 ................. 0.00	X		0	0
(9) MARY DIBARTOLO...................................................................... BOARD MEMBER	1.00 ................. 0.00	X		0	0
(10) KATHLEEN HARRISON...................................................................... BOARD MEMBER BEG 01/24	1.00 ................. 0.00	X		0	0
(11) PERCY J PURNELL...................................................................... BOARD MEMBER	1.00 ................. 0.00	X		0	0
(12) ERICA JOSPEH...................................................................... BOARD MEMBER BEG 01/24	1.00 ................. 0.00	X		0	0
(13) JASON MORRIS...................................................................... BOARD MEMBER	1.00 ................. 0.00	X		0	0
(14) MICHAEL MURPHY MD...................................................................... BOARD MEMBER BEG 01/24	1.00 ................. 0.00	X		0	0
(15) NICHOLAS OGBURN MD...................................................................... BOARD MEMBER BEG 01/24	1.00 ................. 0.00	X		0	0
(16) DIANE TURNER...................................................................... BOARD MEMBER	1.00 ................. 0.00	X		0	0
(17) LURA LUNSFORD...................................................................... V.P. OPERATIONS	50.00 ................. 1.00		X	817,408	75,715

- 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

2023

Open to Public
Inspection

Name of the organization

TIDALHEALTH PENINSULA REGIONAL INC

Employer identification number

52-0591628

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) 2023

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) 2019	(b) 2020	(c) 2021	(d) 2022	(e) 2023	(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) 2019	(b) 2020	(c) 2021	(d) 2022	(e) 2023	(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 2023 (line 6, column (f) divided by line 11, column (f)) .........

Public support percentage for 2022 Schedule A, Part II, line 14 ...............

16a

33 1/3% support test—2023. 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—2022. 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—2023. 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—2022. 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) 2023

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) 2019	(b) 2020	(c) 2021	(d) 2022	(e) 2023	(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) 2019	(b) 2020	(c) 2021	(d) 2022	(e) 2023	(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 2023 (line 8, column (f) divided by line 13, column (f)) .........

Public support percentage from 2022 Schedule A, Part III, line 15 ...............

Section D. Computation of Investment Income Percentage

Investment income percentage for 2023 (line 10c, column (f) divided by line 13, column (f)) ......

Investment income percentage from 2022 Schedule A, Part III, line 17 .............

19a

33 1/3% support tests-2023. 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—2022. 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) 2023

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) 2023

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) 2023

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) 2023

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 2023 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-2023	(iii) Distributable Amount for 2023
1 Distributable amount for 2023 from Section C, line 6
2 Underdistributions, if any, for years prior to 2023 (reasonable cause required-- explain in Part VI). See instructions.
3 Excess distributions carryover, if any, to 2023:
a From 2018.......
b From 2019.......
c From 2020.......
d From 2021.......
e From 2022.......
fTotal of lines 3a through e
g Applied to underdistributions of prior years
h Applied to 2023 distributable amount
i Carryover from 2018 not applied (see instructions)
j Remainder. Subtract lines 3g, 3h, and 3i from line 3f.
4Distributions for 2023 from Section D, line 7:
$
a Applied to underdistributions of prior years
b Applied to 2023 distributable amount
c Remainder. Subtract lines 4a and 4b from line 4.
5 Remaining underdistributions for years prior to 2023, 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 2023. 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 2024. Add lines 3j and 4c.
8 Breakdown of line 7:
a Excess from 2019.....
b Excess from 2020.....
c Excess from 2021.....
d Excess from 2022.....
e Excess from 2023.....

Schedule A (Form 990) (2023)

Schedule A (Form 990) 2023

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) 2023

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

2023

Name of the organization

TIDALHEALTH PENINSULA REGIONAL INC

Employer identification number

52-0591628

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) (2023)

Schedule B (Form 990) (2023) Page 2

Name of organization TIDALHEALTH PENINSULA REGIONAL 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) (2023)

Schedule B (Form 990) (2023)

Page 3

Name of organization TIDALHEALTH PENINSULA REGIONAL INC		Employer identification number 52-0591628

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) (2023)

Schedule B (Form 990) (2023)

Page 4


Name of organization TIDALHEALTH PENINSULA REGIONAL INC			Employer identification number 52-0591628
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) (2023)

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE C
(Form 990)

Department of the Treasury
Internal Revenue Service

Political Campaign and Lobbying Activities

For Organizations Exempt From Income Tax Under section 501(c) and section 527

right arrow

Complete if the organization is described below. 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

If the organization answered "Yes" on Form 990, Part IV, Line 3, or Form 990-EZ, Part V, line 46 (Political Campaign Activities), then
Round Bullet

Section 501(c)(3) organizations: Complete Parts I-A and B. Do not complete Part I-C.
Round Bullet

Section 501(c) (other than section 501(c)(3)) organizations: Complete Parts I-A and C below. Do not complete Part I-B.
Round Bullet

Section 527 organizations: Complete Part I-A only.
If the organization answered "Yes" on Form 990, Part IV, Line 4, or Form 990-EZ, Part VI, line 47 (Lobbying Activities), then
Round Bullet

Section 501(c)(3) organizations that have filed Form 5768 (election under section 501(h)): Complete Part II-A. Do not complete Part II-B.
Round Bullet

Section 501(c)(3) organizations that have NOT filed Form 5768 (election under section 501(h)): Complete Part II-B. Do not complete Part II-A.
If the organization answered "Yes" on Form 990, Part IV, Line 5 (Proxy Tax) (see separate instructions) or Form 990-EZ, Part V, line 35c (Proxy Tax) (see separate instructions), then
Round Bullet

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

Name of the organization

TIDALHEALTH PENINSULA REGIONAL INC

Employer identification number

52-0591628

Part I-A

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

Provide a description of the organization’s direct and indirect political campaign activities in Part IV. See instructions for definition of “political campaign activities."

Political campaign activity expenditures. See instructions .................................................................... right arrow

Volunteer hours for political campaign activities. See instructions ..................................................................

Part I-B

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

Enter the amount of any excise tax incurred by the organization under section 4955 ................................ right arrow

Enter the amount of any excise tax incurred by organization managers under section 4955 ....................... right arrow

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

Yes No

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

Yes No

If "Yes," describe in Part IV.

Part I-C

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

Enter the amount directly expended by the filing organization for section 527 exempt function activities ..... right arrow

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

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

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

Yes No

Enter the names, addresses and employer identification number (EIN) of all section 527 political organizations to which the filing
organization made payments. For each organization listed, enter the amount paid from the filing organization’s funds. Also enter the amount of political contributions received that were promptly and directly delivered to a separate political organization, such as a separate segregated fund or a political action committee (PAC). If additional space is needed, provide information in Part IV.

(a) Name	(b) Address	(c) EIN	(d) Amount paid from filing organization's funds. If none, enter -0-.	(e) Amount of political contributions received and promptly and directly delivered to a separate political organization. If none, enter -0-.
1
2
3
4
5
6

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

Cat. No. 50084S

Schedule C (Form 990) 2022

Page 2

Part II-A

Complete if the organization is exempt under section 501(c)(3) and filed Form 5768 (election under section 501(h)).

A Check right arrow

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

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

Limits on Lobbying Expenditures (The term "expenditures" means amounts paid or incurred.)		(b) Affiliated group totals
1a	Total lobbying expenditures to influence public opinion (grass roots lobbying) ......................
b	Total lobbying expenditures to influence a legislative body (direct lobbying) ........................
c	Total lobbying expenditures (add lines 1a and 1b) ............................................................
d	Other exempt purpose expenditures ...............................................................................
e	Total exempt purpose expenditures (add lines 1c and 1d) ..................................................
f	Lobbying nontaxable amount. Enter the amount from the following table in both columns.
	If the amount on line 1e, column (a) or (b) is:The lobbying nontaxable amount is:
	Not over $500,00020% of the amount on line 1e.
	Over $500,000 but not over $1,000,000$100,000 plus 15% of the excess over $500,000.
	Over $1,000,000 but not over $1,500,000$175,000 plus 10% of the excess over $1,000,000.
	Over $1,500,000 but not over $17,000,000$225,000 plus 5% of the excess over $1,500,000.
	Over $17,000,000$1,000,000.

g	Grassroots nontaxable amount (enter 25% of line 1f) .................................................
h	Subtract line 1g from line 1a. If zero or less, enter -0-. ................................................
i	Subtract line 1f from line 1c. If zero or less, enter -0-. ................................................
j	If there is an amount other than zero on either line 1h or line 1i, did the organization file Form 4720 reporting section 4911 tax for this year? ...................................................................................................................	Yes No

4-Year Averaging Period Under Section 501(h) (Some organizations that made a section 501(h) election do not have to complete all of the five columns below. See the separate instructions for lines 2a through 2f.)
Lobbying Expenditures During 4-Year Averaging Period
	Calendar year (or fiscal year beginning in)	(a) 2019	(b) 2020	(c) 2021	(d) 2022	(e) Total

2a	Lobbying nontaxable amount

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

c	Total lobbying expenditures

d	Grassroots nontaxable amount

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

f	Grassroots lobbying expenditures

Schedule C (Form 990) 2022

Page 3

Part II-B

Complete if the organization is exempt under section 501(c)(3) and has NOT filed Form 5768 (election under section 501(h)).

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

(a)

Yes|No

(b)

Amount

During the year, did the filing organization attempt to influence foreign, national, state or local legislation, including any attempt to influence public opinion on a legislative matter or referendum, through the use of:

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

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

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

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

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

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

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

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

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

Yes

23,781

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

23,781

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

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

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

If the filing organization incurred a section 4912 tax, did it file Form 4720 for this year? ........................

Part III-A

Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6).

Yes

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

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

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

Part III-B

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

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

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

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

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

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

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

If notices were sent and the amount on line 2c exceeds the amount on line 3, what portion of the excess does the organization agree to carryover to the reasonable estimate of nondeductible lobbying and political expenditure next year? ......................................................................................................................

Taxable amount of lobbying and political expenditures. See Instructions .........................................

Part IV

Supplemental Information

Provide the descriptions required for Part l-A, line 1; Part l-B, line 4; Part l-C, line 5; Part II-A (affiliated group list); Part II-A, lines 1 and 2 (see instructions), and Part ll-B, line 1. Also, complete this part for any additional information.

Return Reference	Explanation
PART II-B, LINE 1:	OTHER ACTIVITIES: TIDALHEALTH PENINSULA REGIONAL DOES NOT ENGAGE IN ANY DIRECT LOBBYING ACTIVITIES. THE ORGANIZATION PAYS MEMBERSHIP DUES TO MARYLAND HOSPITAL ASSOCIATION (MHA). MHA ENGAGES IN MANY SUPPORT ACTIVITIES INCLUDING LOBBYING AND ADVOCATING FOR ITS MEMBER HOSPITALS. THE MHA REPORTED THAT A PERCENTAGE OF MEMBER DUES WERE USED FOR LOBBYING PURPOSES AND SUCH, THE ORGANIZATION HAS REPORTED THIS AMOUNT ON SCHEDULE C PART IV AS LOBBYING ACTIVITIES.

Return Reference

Explanation

PART II-B, LINE 1:

OTHER ACTIVITIES: TIDALHEALTH PENINSULA REGIONAL DOES NOT ENGAGE IN ANY DIRECT LOBBYING ACTIVITIES. THE ORGANIZATION PAYS MEMBERSHIP DUES TO MARYLAND HOSPITAL ASSOCIATION (MHA). MHA ENGAGES IN MANY SUPPORT ACTIVITIES INCLUDING LOBBYING AND ADVOCATING FOR ITS MEMBER HOSPITALS. THE MHA REPORTED THAT A PERCENTAGE OF MEMBER DUES WERE USED FOR LOBBYING PURPOSES AND SUCH, THE ORGANIZATION HAS REPORTED THIS AMOUNT ON SCHEDULE C PART IV AS LOBBYING ACTIVITIES.

Schedule C (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.
right arrow

Attach to Form 990.
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

TIDALHEALTH PENINSULA REGIONAL INC

Employer identification number

52-0591628

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 July 25, 2006, 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 right arrow

Number of states where property subject to conservation easement is located right arrow

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
right arrow

Amount of expenses incurred in monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
right arrow

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 ......................... right arrow

(ii)

Assets included in Form 990, Part X ............................... right arrow

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 .......................... right arrow

Assets included in Form 990, Part X ............................... right arrow

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

Cat. No. 52283D

Schedule D (Form 990) 2022

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 ....	87,652,533	87,537,245	102,246,212	79,165,301	71,424,439
b	Contributions ...
c	Net investment earnings, gains, and losses	11,952,711	10,561,995	-14,214,441	23,584,799	8,133,343
d	Grants or scholarships ...	19,029	54,474	8,774	92,960	5,217
e	Other expenditures for facilities and programs ...		10,000,000
f	Administrative expenses ....	341,932	392,233	485,752	410,928	387,264
g	End of year balance ......	99,244,283	87,652,533	87,537,245	102,246,212	79,165,301

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

Board designated or quasi-endowment right arrow

39.380 %

Permanent endowment right arrow

8.720 %

Term endowment right arrow

51.900 %

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)

Yes

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

Yes

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 .....	13,542,854		13,542,854
b	Buildings ....	281,346,239	175,883,142	105,463,097
c	Leasehold improvements
d	Equipment ....	350,912,057	309,658,278	41,253,779
e	Other .....	12,102,506	9,772,841	2,329,665
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..				162,589,395

Schedule D (Form 990) 2022

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........
(3)Other
(A)
(B)
(C)
(D)
(E)
(F)
(G)
(H)
Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)

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)DONOR RESTRICTED FUND				60,159,064
(2)BOARD DESIGNATED INVESTMENTS				39,087,246
(3)RIGHT OF USE ASSETS				2,165,856
(4)INTERCOMPANY RECEIVABLES				1,529,281
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........				102,941,447

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
DUE TO AFFILIATES	43,728,263
EMPLOYEE COMP RELATED PAYROLL TAXES	21,332,049
ADVANCES FROM THIRD PARTY PAYORS	20,835,978
LONG-TERM LEASE LIABILITY	1,552,931
ACCRUED SELF INSURANCE LIABILITY	53,413




Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)	87,502,634
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) 2022

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
PART V, LINE 4:	INTENDED USE OF ENDOWMENT FUNDS THE ORGANIZATION'S ENDOWMENT FUNDS ARE USED FOR CAPITAL, PATIENT SERVICES OR EDUCATIONAL PURPOSES. TIDALHEALTH, INC. ADMINISTERS THE ENDOWMENT FOR THE BENEFIT OF TIDALHEALTH PENINSULA REGIONAL. INC. AND TIDALHEALTH FOUNDATION.
PART X, LINE 2:	LIABILITY FOR UNCERTAIN TAX POSITION (ASC 740) THE ORGANIZATION IS INCLUDED IN THE CONSOLIDATED FINANCIAL STATEMENTS OF TIDALHEALTH, INC. THE RELEVANT TEXT OF THE INCOME TAX FOOTNOTE FROM THOSE FINANCIALS IS: THE HEALTH SYSTEM HAS DETERMINED THERE ARE NO MATERIAL UNCERTAIN TAX POSITIONS THAT REQUIRE RECOGNITION OR DISCLOSURE IN THE CONSOLIDATED FINANCIAL STATEMENTS AT JUNE 30, 2024 AND 2023.

Schedule D (Form 990) 2022

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.
Medium right arrow

Attach to Form 990.
Medium right arrow

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

OMB No. 1545-0047

2023

Open to Public Inspection

Name of the organization

TIDALHEALTH PENINSULA REGIONAL INC

Employer identification number

52-0591628

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) . . .	13,242,100	11,275,210	1,966,890	0.400 %
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 . . . . .	13,242,100	11,275,210	1,966,890	0.400 %
Other Benefits
e	Community health improvement services and community benefit operations (from Worksheet 4).	4,529,519	165,077	4,364,442	0.900 %
f	Health professions education (from Worksheet 5) . . .	20,580,276	2,440,000	18,140,276	3.730 %
g	Subsidized health services (from Worksheet 6) . . . .	74,153,143	30,350,465	43,802,678	9.020 %
h	Research (from Worksheet 7) .	2,130,404	923,534	1,206,870	0.250 %
i	Cash and in-kind contributions for community benefit (from Worksheet 8) . . . .	141,607		141,607	0.030 %
j	Total. Other Benefits . .	101,534,949	33,879,076	67,655,873	13.930 %
k	Total. Add lines 7d and 7j .	114,777,049	45,154,286	69,622,763	14.330 %

For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2023

Schedule H (Form 990) 2023

Page

Part II

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

		(a) Number of activities or programs (optional)	(b) Persons served (optional)	(c) Total community building expense	(d) Direct offsetting revenue	(e) Net community building expense	(f) Percent of total expense
1	Physical improvements and housing			8,021		8,021	0 %
2	Economic development			4,627		4,627	0 %
3	Community support			21,583		21,583	0 %
4	Environmental improvements			430,019		430,019	0.090 %
5	Leadership development and training for community members			6,747		6,747	0 %
6	Coalition building			2,585,819	2,344,006	241,813	0.050 %
7	Community health improvement advocacy
8	Workforce development			8,504		8,504	0 %
9	Other
10	Total			3,065,320	2,344,006	721,314	0.140 %

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. ......

17,427,678

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

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

Section B. Medicare

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

222,629,551

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

143,774,261

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

78,855,290

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) 2023

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	TIDALHEALTH PENINSULA REGIONAL 100 E CARROLL STREET SALISBURY,MD21801 WWW.TIDALHEALTH.ORG 210019	X	X	X

Schedule H (Form 990) 2023

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)

	TIDALHEALTH PENINSULA REGIONAL
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 22

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 SUPPLEMENTAL INFORMATION

Other website (list url): HTTP://HEALTHYDELMARVA.ORG

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?.........

Yes

If "Yes" (list url): SEE SUPPLEMENTAL INFORMATION

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) 2023

Page 5

Part VFacility Information (continued)

Financial Assistance Policy (FAP)

	TIDALHEALTH PENINSULA REGIONAL
Name of hospital facility or letter of facility reporting group

Yes

Did the hospital facility have in place during the tax year a written financial assistance policy that:

Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care?

Yes

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

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

Income level other than FPG (describe in Section C)

Asset level

Medical indigency

Insurance status

Underinsurance discount

Residency

Other (describe in Section C)

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

Yes

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

Yes

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

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

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

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

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

Other (describe in Section C)

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

Yes

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

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

SEE SUPPLEMENTAL INFORMATION

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

SEE SUPPLEMENTAL INFORMATION

A plain language summary of the FAP was widely available on a website (list url):
SEE SUPPLEMENTAL INFO

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) 2023

Page 6

Part VFacility Information (continued)

Billing and Collections

	TIDALHEALTH PENINSULA REGIONAL
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) 2023

Page 7

Part VFacility Information (continued)

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

	TIDALHEALTH PENINSULA REGIONAL
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) 2023

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
TIDALHEALTH PENINSULA REGIONAL:	PART V, SECTION B, LINE 5: CONSULTING REPRESENTATIVES OF THE COMMUNITY SERVED BY THE HOSPITALIN 2021, TIDALHEALTH RETAINED CONDUENT HEALTH COMMUNITIES INSTITUTE A XEROX COMPANY TO PREPARE AND CONDUCT A NEW COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) THAT WILL COVER THE MARYLAND COMMUNITY BENEFITS SERVICE AREA OF SOMERSET, WICOMICO AND WORCESTER COUNTIES AND A NEWLY ADDED AREA WHICH INCLUDES SUSSEX COUNTY, DELAWARE. THE CHNA WAS COMPLETED BY CONDUENT IN MAY 2022 AND PLACED ON TIDALHEALTH'S WEBSITE ALONG WITH THE PREVIOUS VERSION FOR PUBLIC ACCESS. SYSTEM DESCRIPTIONTIDALHEALTH IS ANCHORED BY TWO HOSPITALS, TIDALHEALTH PENINSULA REGIONAL AND TIDALHEALTH NANTICOKE. IN ADDITION, TIDALHEALTH INCLUDES A LARGE PHYSICIAN NEWORK OF 300 PLUS PROVIDERS WITH OVER 32 LOCATIONS. TIDALHEALTH WAS FORMED WHEN THE FORMER PENINSULA REGIONAL MEDICAL CENTER, NANTICOKE MEMORIAL HOSPITAL IN SEAFORD, DE AND MCCREADY MEMORIAL HOSPITAL IN CRISFIELD, MD, UNITED TO IMPROVE THE HEALTH OF THE COMMUNITIES WE SERVE.EFFECTIVE JANUARY 1, 2020, TIDALHEALTH NANTICOKE AND TIDALHEALTH PHYSICIAN NETWORK, INC. LOCATED IN SEAFORD, DELAWARE, JOINED TIDALHEALTH. TIDALHEALTH NANTICOKE HAS 139 LICENSED ACUTE CARE BEDS (99 CURRENTLY OPERATED) AND PRIMARILY SERVES THE WESTERN SUSSEX COUNTY, DELAWARE PORTION OF THE HEALTH SYSTEM'S PRIMARY SERVICE AREA. TIDALHEALTH NANTICOKE PHYSICIAN NETWORK PROVIDES OUTPATIENT MEDICAL SERVICES IN WESTERN SUSSEX COUNTY AND FEDERALSBURG, MD. EFFECTIVE MARCH 2020, MCCREADY FOUNDATION, INC., WHICH CONSISTED OF A THREE BED HOSPITAL, ALICE BYRD TAWES NURSING HOME, A 76-LICENSED BED SKILLED NURSING HOME AND CHESAPEAKE COVE ASSISTED LIVING CENTER IN CRISFIELD, MD, BECAME PART OF TIDALHEALTH. THE MCCREADY HOSPITAL DIVISION WAS MERGED INTO TIDALHEALTH PENINSULA REGIONAL AND LIMITED ITS FUNCTIONS TO THOSE CONSISTENT WITH STATUS AS A FREE-STANDING MEDICAL CENTER. HEALTHY COMMUNITIES INSTITUTE AND TIDALHEALTH PENINSULA REGIONAL HAVE COLLABORATED SINCE 2012 TO DEVELOP THE TIDALHEALTH CREATING HEALTHY COMMUNITIES' PLATFORM. CHNA PARTNERSHIPTHE LOCAL CHNA PARTNERSHIP COMBINED PRIMARY AND SECONDARY DATA TO INFORM ITS COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA). THE CHNA PROVIDES AN UNDERSTANDING OF THE HEALTH STATUS, QUALITY OF LIFE, AND RISK FACTORS OF OUR COMMUNITY THROUGH FINDINGS FROM QUALITATIVE AND SECONDARY DATA ANALYSIS. THE THEMES AND STRENGTHS PROVIDE INSIGHTS ABOUT WHAT TOPICS AND ISSUES COMMUNITY MEMBERS FEEL ARE IMPORTANT, HOW THEY PERCEIVE THEIR QUALITY OF LIFE, AND WHAT ASSETS THEY BELIEVE CAN BE USED TO IMPROVE HEALTH. FINDINGS FROM BOTH PRIMARY AND SECONDARY DATA HELPED TO INFORM THE TOP COMMUNITY HEALTH NEEDS. EACH TYPE OF DATA WAS ANALYZED USING A DEFINED METHODOLOGY. PRIMARY DATA WAS OBTAINED THROUGH A COMMUNITY SURVEY, FOCUS GROUPS, AND KEY INFORMANT INTERVIEWS. SECONDARY DATA ARE HEALTH INDICATOR DATA THAT HAVE BEEN COLLECTED BY OTHER SOURCES, SUCH AS NATIONAL AND STATE LEVEL GOVERNMENT ENTITIES, AND MADE AVAILABLE FOR ANALYSIS.PRIMARY DATA COLLECTIONTO ENSURE THE PERSPECTIVES OF COMMUNITY MEMBERS WERE CONSIDERED, INPUT WAS COLLECTED FROM ALL THREE COUNTIES IN THE TRI-COUNTY REGION AND SUSSEX COUNTY, DE. PRIMARY DATA USED IN THIS ASSESSMENT CONSISTED OF AN ONLINE COMMUNITY SURVEY, FOCUS GROUPS, AND KEY INFORMANT INTERVIEWS. THE FINDINGS FROM THIS DATA EXPANDED UPON INFORMATION GATHERED FROM THE SECONDARY DATA ANALYSIS TO INFORM THIS COMMUNITY HEALTH NEEDS ASSESSMENT. AS THE ASSESSMENT WAS CONDUCTED DURING THE COVID-19 PANDEMIC, PRIMARY DATA COLLECTION METHODS WERE MANAGED IN A WAY TO MAINTAIN SOCIAL DISTANCING AND PROTECT THE SAFETY OF PARTICIPANTS BY ELIMINATING IN-PERSON DATA COLLECTION.TO HELP INFORM AN ASSESSMENT OF COMMUNITY ASSETS, COMMUNITY MEMBERS WERE ASKED TO LIST AND DESCRIBE RESOURCES AVAILABLE IN THE COMMUNITY. ALTHOUGH NOT REFLECTIVE OF EVERY RESOURCE AVAILABLE IN THE COMMUNITY, THE LIST CAN HELP THE PARTNERSHIP TO EXPAND AND SUPPORT EXISTING PROGRAMS AND RESOURCES. THE FOLLOWING ORGANIZATIONS ARE REPRESENTATIVE OF LOCAL PARTICIPANTS, RESOURCES, PARTNERS, AND THOSE ORGANIZATIONS WE INCLUDE IN UNDERSTANDING TOP COMMUNITY HEALTH NEEDS:- CHRISTIAN SHELTER - SALISBURY, MD- DIAKONIA - OCEAN CITY, MD- LA RED HEALTH CENTER - SUSSEX, DE- LOWER SHORE VULNERABLE POPULATIONS TASK FORCE - SALISBURY, MD - SALISBURY URBAN MINISTRIES - SALISBURY, MD - CHESAPEAKE HEALTHCARE - DEER'S HEAD HOSPITAL CENTER - HOPE, INC. - MAC, INC. - REBIRTH, INC. - RECOVERY RESOURCE CENTER - SALISBURY UNIVERSITY - SOMERSET COUNTY SCHOOLS - SUSSEX COUNTY COALITION - UNIVERSITY OF MARYLAND EASTERN SHORE (UMES) - WICOMICO COUNTY COUNCILFOCUS GROUPSTHE PROJECT TEAM DEVELOPED A FOCUS GROUP GUIDE MADE UP OF A SERIES OF QUESTIONS AND PROMPTS ABOUT THE HEALTH AND WELL-BEING OF RESIDENTS IN THE TRI-COUNTY REGION AND SUSSEX COUNTY, DE. ALL PARTICIPANTS VOLUNTEERED. ADVERTISEMENT WAS DONE VIA SOCIAL MEDIA, PRESS RELEASES AND POSTERS WITH QR CODES. PARTICIPANTS COULD SIGN UP THROUGH AN ONLINE REGISTRATION FORM OR BY PHONE. COMMUNITY MEMBERS WERE ASKED TO SPEAK ABOUT BARRIERS AND ASSETS TO THEIR HEALTH AND ACCESS TO HEALTHCARE. FOUR VIRTUAL FOCUS GROUPS WERE HOSTED IN THE FOLLOWING COUNTIES: SOMERSET, WICOMICO, WORCESTER, MD, AND SUSSEX, DE, DURING OCTOBER AND NOVEMBER 2021. A TOTAL OF 26 PARTICIPANTS TOOK PART IN THE FOUR FOCUS GROUPS, WHICH EACH LASTED APPROXIMATELY 30 - 45 MINUTES. FACILITATORS IMPLEMENTED TECHNIQUES TO ENSURE THAT EVERYONE WAS ABLE TO PARTICIPATE IN THE DISCUSSIONS.KEY INFORMANT INTERVIEWSHCI CONSULTANTS CONDUCTED KEY INFORMANT INTERVIEWS TO COLLECT COMMUNITY INPUT. INTERVIEWEES WHO WERE ASKED TO PARTICIPATE WERE RECOGNIZED AS HAVING EXPERTISE IN PUBLIC HEALTH, SPECIAL KNOWLEDGE OF COMMUNITY HEALTH NEEDS, AND/OR REPRESENTED THE BROAD INTEREST OF THE COMMUNITY SERVED BY THE HOSPITALS AND HEALTH DEPARTMENTS, AND/OR COULD SPEAK TO THE NEEDS OF MEDICALLY UNDERSERVED OR VULNERABLE POPULATIONS. A TOTAL OF 14 KEY INFORMANT INTERVIEWS WERE CONDUCTED DURING AUGUST 2021-OCTOBER 2021. YOU CAN SEE THE KEY INFORMANT ORGANIZATIONS REPRESENTED IN THE TABLE BELOW. THESE ORGANIZATIONS ARE ALSO CURRENT OR POTENTIAL COMMUNITY PARTNERS FOR THE HOSPITALS AND HEALTH DEPARTMENTS LEADING THIS ASSESSMENT. EACH INTERVIEW INCLUDED AN INTERVIEWER AND NOTETAKER AND LASTED APPROXIMATELY 30 - 60 MINUTES. DURING THE INTERVIEWS, QUESTIONS WERE ASKED TO LEARN ABOUT THE INTERVIEWEE'S BACKGROUND AND ORGANIZATION, BIGGEST HEALTH NEEDS AND BARRIERS OF CONCERN IN THE COMMUNITY, AS WELL AS THE IMPACT OF HEALTH ISSUES ON VULNERABLE POPULATIONS.KEY INFORMANT ORGANIZATION : POPULATION SERVEDCHESAPEAKE HEALTHCARE : TRI-COUNTY REGIONDEER'S HEAD HOSPITAL CENTER : TRI-COUNTY REGIONHOPE, INC. : TRI-COUNTY REGIONMAC, INC. : TRI-COUNTY REGIONREBIRTH, INC. : WICOMICO COUNTY AND SURROUNDING REGIONRECOVERY RESOURCE CENTER : WICOMICO COUNTYSALISBURY UNIVERSITY : WICOMICO COUNTYSOMERSET COUNTY DEPARTMENT OF SOCIAL SERVICES : SOMERSET COUNTYSOMERSET COUNTY HEALTH DEPARTMENT : SOMERSET COUNTYSOMERSET COUNTY SCHOOLS : SOMERSET COUNTYSUSSEX COUNTY COALITION : SUSSEX, DEUNIVERSITY OF MARYLAND EASTERN SHORE (UMES) : TRI-COUNTY REGION AND SUSSEX, DEWICOMICO COUNTY COUNCIL : WICOMICO COUNTYWICOMICO COUNTY HEALTH DEPARTMENT : WICOMICO COUNTYCOMMUNITY SURVEYCOMMUNITY INPUT WAS COLLECTED VIA AN ONLINE COMMUNITY SURVEY AVAILABLE IN ENGLISH AND SPANISH, AS WELL AS PAPER COPIES AVAILABLE IN ARABIC, CREOLE, KOREAN, AND PORTUGUESE, FROM AUGUST 2021 THROUGH NOVEMBER 2021. THE SURVEY CONSISTED OF 45 QUESTIONS RELATED TO TOP HEALTH NEEDS IN THE COMMUNITY, INDIVIDUALS' PERCEPTION OF THEIR OVERALL HEALTH, INDIVIDUALS' ACCESS TO HEALTHCARE SERVICES, AS WELL AS SOCIAL AND ECONOMIC DETERMINANTS OF HEALTH. THE SURVEY WAS SHARED VIA HEALTH DEPARTMENTS' WEBSITES, SOCIAL MEDIA, EMAIL DISTRIBUTION, AND OTHER LOCAL COMMUNITY PARTNERS. PAPER COPIES WERE ALSO DISTRIBUTED AT SEVERAL COMMUNITY OUTREACH EVENTS, LOCAL LIBRARIES, AND DIRECTLY TO PATIENTS AT TIDALHEALTH VIA COMMUNITY HEALTH WORKERS OR CARE COORDINATION SPECIALISTS. A TOTAL OF 774 RESPONSES WERE COLLECTED.TIDALHEALTH PENINSULA REGIONAL:PART V, SECTION B, LINE 6A:THE ORGANIZATION'S CHNA WAS CONDUCTED AS PART OF TIDALHEALTH'S CHNA OF THE GREATER AREA WHICH INCLUDED TIDALHEALTH NANTICOKE.
TIDALHEALTH PENINSULA REGIONAL:	PART V, SECTION B, LINE 6B: CHNA CONDUCTED WITH ONE OR MORE ORGANIZATIONS OTHER THAN HOSPITAL FACILITIESA PARTNERSHIP WAS FORMED BETWEEN TIDALHEALTH, SOMERSET COUNTY HEALTH DEPARTMENT (SCHD), AND WICOMICO COUNTY HEALTH DEPARTMENT (WICHD) FOR THE BENEFIT OF THE COMMUNITY. THESE ORGANIZATIONS HAVE BEEN PARTNERING TOGETHER ON LOCAL HEALTH ASSESSMENT EFFORTS SINCE 1995. TWO OF THE ORGANIZATIONS ARE REQUIRED TO COMPLETE A CHNA; TIDALHEALTH PENINSULA REGIONAL IS A NON-PROFIT HOSPITAL AND WICHD AS AN ACCREDITED HEALTH DEPARTMENT. SCHD IS IN THE EARLY PHASE OF PUBLIC HEALTH ACCREDITATION. IN MAY OF 2022, TIDALHEALTH, SCHD, AND WICHD PUBLISHED THEIR 2022 CHNA. THE CHNA REPORT PROVIDES AN OVERVIEW OF SIGNIFICANT HEALTH NEEDS IN THE TRI-COUNTY SERVICE AREA. THIS CHNA REPORT WAS DEVELOPED TO PROVIDE AN OVERVIEW OF THE HEALTH NEEDS IN THE TRI-COUNTY SERVICE AREA, INCLUDING SOMERSET, WICOMICO, AND WORCESTER COUNTIES IN MARYLAND AND SUSSEX COUNTY, DELAWARE. TIDALHEALTH, SCHD, AND WICHD PARTNERED WITH CONDUENT HEALTHY COMMUNITIES INSTITUTE TO CONDUCT THE CHNA. THE GOAL OF THIS REPORT IS TO OFFER A MEANINGFUL UNDERSTANDING OF THE GREATEST HEALTH NEEDS ACROSS THE FOUR COUNTY SERVICE AREA, AS WELL AS TO GUIDE PLANNING EFFORTS TO ADDRESS THOSE NEEDS. SPECIAL ATTENTION HAS BEEN GIVEN TO IDENTIFY HEALTH DISPARITIES, NEEDS OF VULNERABLE POPULATIONS, UNMET HEALTH NEEDS OR GAPS IN SERVICES, AND INPUT FROM THE COMMUNITY.
PART V, LINE 7A: CHNA ON HOSPITAL FACILITY'S WEBSITE	HTTPS://WWW.TIDALHEALTH.ORG/COMMUNITY-OUTREACH-PARTNERS/COMMUNITY-HEALTH-RESEARCH-DATA
TIDALHEALTH PENINSULA REGIONAL:	PART V, SECTION B, LINE 7D: PUBLIC AVAILABILITY OF TIDALHEALTH CHNAA PAPER COPY IS MADE AVAILABLE TO THE PUBLIC AT SEVERAL LOCATIONS WITHIN THE HOSPITAL FOR PUBLIC INSPECTION. IN ADDITION, THE REPORT IS BEING EVALUATED FOR TRANSLATION INTO SPANISH AND POSSIBLE FURTHER TRANSLATION TO HAITIAN CREOLE. WE PARTNER WITH CONDUENT HEALTHY COMMUNITIES INSTITUTE TO DISCOVER WHAT THE MOST PRESSING HEALTH CHALLENGES ARE IN SOMERSET, WORCESTER, WICOMICO COUNTIES, MD AND SUSSEX COUNTY, DE. THE PUBLIC CAN VIEW THE RESULTS OF OUR COMMUNITY HEALTH NEEDS ASSESSMENT ONLINE, AS WELL AS OUR ACTION PLAN OF STEPS WE PLAN TO TAKE BASED ON THE INFORMATION GATHERED IN THE ASSESSMENT. IN ADDITION, A COMMUNITY HEALTH DATA AND RESOURCES SECTION CAN BE ACCESSED BY THE PUBLIC. AS PART OF THIS CREATING HEALTHY COMMUNITIES, A MODULE IS AVAILABLE TO THE PUBLIC IN WHICH THEY CAN EXPLORE MULTIPLE DASHBOARDS THAT PROVIDE A GAUGE TO THE HEALTH OF THE COMMUNITIES SERVED, SOCIO-DEMOGRAPHICS AND PROMISING PRACTICES. THE DASHBOARDS INCLUDE FEATURES SUCH AS A CHNA GUIDE, HEALTH DATA, DEMOGRAPHIC DATA, HEALTH DISPARITIES, SOCIO NEEDS INDEXES, FINDING GRANTS, INDICATOR COMPARISONS, AND PROGRESS TRACKING.
TIDALHEALTH PENINSULA REGIONAL:	PART V, LINE 10A: IMPLEMENTATION STRATEGY ON HOSPITAL FACILITY'S WEBSITEHTTPS://WWW.TIDALHEALTH.ORG/COMMUNITY-OUTREACH-PARTNERS/COMMUNITY-HEALTH-RESEARCH-DATATIDALHEALTH PENINSULA REGIONAL HAS FINALIZED ITS 2023-2025 COMMUNITY HEALTH IMPROVEMENT PLAN, WHICH IS NOW PUBLISHED ON THE HOSPITAL'S WEBSITE. SOME NEW INITIATIVES HAVE BEEN INCLUDED IN THE UPDATED IMPLEMENTATION PLAN. SUCCESSFUL PROGRAMS AND INITIATIVES HAVE BEEN CARRIED OVER FROM THE PREVIOUS PLAN AS THEY HAVE PROVEN TO SUBSTANTIALLY IMPROVE THE HEALTH OF OUR COMMUNITIES. LOCAL HEALTH PARTNERSHIPS WILL ALSO REMAIN INTACT.
TIDALHEALTH PENINSULA REGIONAL:	PART V, SECTION B, LINE 11: HOW NEEDS IDENTIFIED IN THE CHNA ARE ADDRESSEDTIDALHEALTH PENINSULA REGIONAL HAS A FIXED VALUE OF RESOURCES AVAILABLE, AND THE HOSPITAL FOCUSES THOSE RESOURCES TO THE AREAS WITH THE GREATEST IMPACT AND THOSE WHERE TIDALHEALTH HAS SPECIFIC EXPERTISE. THEREFORE, NOT ALL NEEDS, TO DATE, IDENTIFIED IN THE CHNA WERE ABLE TO BE ADDRESSED. NON-PRIORITIZED NEEDS INCLUDED CRIME AND CRIME PREVENTION, HOMELESSNESS AND UNSTABLE HOUSING, ORAL HEALTH, PREVENTION AND SAFETY. THESE NEEDS WERE NOT SELECTED BECAUSE THEY DID NOT MEET THE PRIORITIZATION CRITERIA AS STRONGLY AS THE SELECTED TOPICS. OTHER NEEDS WERE SELECTED BECAUSE OF GREATER IMPACT AND CAPACITY TO ADDRESS. EVEN THOUGH NOT ALL IDENTIFIED NEEDS ARE ADDRESSED SPECIFICALLY IN THE "IMPLEMENTATION STRATEGY COMMUNITY BENEFITS" PLAN, THERE ARE POPULATION HEALTH INITIATIVES ADOPTED THROUGH THE HEALTH SYSTEM'S STRATEGIC PLAN THAT PROMOTE HEALTH AND WELL-BEING WITHIN THE COMMUNITY, AND ADDRESS NEEDS WITHIN THE CHNA.BASED ON THE SIGNIFICANT NEEDS IDENTIFIED IN THE COMMUNITY HEALTH NEEDS ASSESSMENT, THE FOLLOWING IMPLEMENTATION INITIATIVES WERE DEVELOPED AND OUTLINED IN OUR 2023-2025 IMPLEMENTATION STRATEGY PLAN FOR TIDALHEALTH PENINSULA REGIONAL, AND ALSO IN THE COMMUNITY HEALTH IMPROVEMENT PLAN FOR SOMERSET COUNTY HEALTH DEPARTMENT AND WICOMICO COUNTY HEALTH DEPARTMENT. THIS REPORT WAS PRESENTED AND APPROVED BY THE HOSPITAL'S BOARD OF DIRECTORS AND LOCAL HEALTH IMPROVEMENT COALITIONS AND WAS PUBLISHED IN SPRING OF 2023.AFTER A THOROUGH REVIEW OF THE HEALTH STATUS IN OUR COMMUNITY THROUGH THE CHNA, WE IDENTIFIED AREAS THAT WE COULD ADDRESS USING OUR RESOURCES, EXPERTISE AND COMMUNITY PARTNERS. THE FOLLOWING ARE THE PRIORITIZED HEALTH NEEDS THAT WILL BE ADDRESSED:- ACCESS AND HEALTH EQUITY - BEHAVIORAL HEALTH (PREVENTION AND TREATMENT FOR MENTAL HEALTH AND MENTAL DISORDERS AS WELL AS SUBSTANCE ABUSE DISORDERS) - CHRONIC DISEASE AND WELLNESS
TIDALHEALTH PENINSULA REGIONAL:	PART V, SECTION B, LINE 13B: ELIGIBILITY CRITERIA FOR FINANCIAL ASSISTANCEFINANCIAL ASSISTANCE POLICY: IN ACCORDANCE WITH STATE AND FEDERAL GUIDELINES, TIDALHEALTH WILL PROVIDE EMERGENCY AND MEDICALLY NECESSARY FREE AND/OR REDUCED-COST CARE TO PATIENTS WHO LACK HEALTH CARE COVERAGE OR WHOSE HEALTH CARE COVERAGE DOES NOT PAY THE FULL COST OF THEIR MEDICAL BILL. A PATIENT'S PAYMENT SHALL NOT EXCEED THE AMOUNT GENERALLY BILLED (AGB). ALL HOSPITAL REGULATED SERVICES (WHICH INCLUDES EMERGENCY AND MEDICALLY NECESSARY CARE) AT TIDALHEALTH PENINSULA REGIONAL WILL BE CHARGED CONSISTENTLY AS ESTABLISHED BY THE HEALTH SERVICES COST REVIEW COMMISSION (HSCRC) WHICH EQUATES TO THE AMOUNTS GENERALLY BILLED (AGB) METHOD. ALL PATIENTS SEEN BY A TIDALHEALTH PROVIDER OR IN AN UNREGULATED AREA AT TIDALHEALTH PENINSULA REGIONAL OR ALL SERVICES AT TIDALHEALTH NANTICOKE HOSPITAL WILL BE CHARGED THE FEE SCHEDULE PLUS THE STANDARD MARK-UP WHICH IS THE AGB FOR TIDALHEALTH. SELF-PAY PATIENTS, FOR ALL SERVICES NOT REGULATED BY THE HSCRC, WILL RECEIVE A DISCOUNT TO REDUCE CHARGES TO THE AMOUNT TIDALHEALTH WOULD BE REIMBURSED BY MEDICARE WHICH IS THE PROSPECTIVE METHOD. FOR SELF-PAY PATIENTS, THE AMOUNT BILLED WILL NOT EXCEED THE MEDICARE FEE SCHEDULE FOR ALL UNREGULATED SERVICES.TIDALHEALTH WILL PROVIDE FREE MEDICALLY NECESSARY CARE TO PATIENTS WITH FAMILY INCOME AT OR BELOW 200% OF THE FEDERAL POVERTY LEVEL. PATIENTS QUALIFYING FOR FINANCIAL ASSISTANCE BASED ON INCOME AT OR BELOW 200% OF THE FEDERAL POVERTY LEVEL HAVE NO COST FOR THEIR CARE AND THEREFORE PAY LESS THAN AGB.TIDALHEALTH WILL PROVIDE REDUCED-COST MEDICALLY NECESSARY CARE TO LOW-INCOME PATIENTS WITH FAMILY INCOME BETWEEN 200% AND 300% OF THE FEDERAL POVERTY LEVEL. TIDALHEALTH WILL PROVIDE REDUCED-COST MEDICALLY NECESSARY CARE TO LOW-INCOME PATIENTS WITH FAMILY INCOME BETWEEN 301% AND 500% OF THE FEDERAL POVERTY LEVEL WHO HAVE A MEDICAL HARDSHIP AS DEFINED BY MARYLAND LAW. MEDICAL HARDSHIP IS MEDICAL DEBT, INCURRED BY A FAMILY OVER A 12-MONTH PERIOD THAT EXCEEDS 25% OF THE FAMILY INCOME.PROCEDURE:IF A PATIENT IS UNABLE TO PAY DUE TO FINANCIAL RESOURCES, ALL EFFORTS WILL BE MADE TO HELP THE PATIENT OBTAIN ASSISTANCE THROUGH APPROPRIATE AGENCIES. IN THE EVENT THAT THE PATIENT HAS APPLIED FOR AND KEPT ALL NECESSARY APPOINTMENTS AND THIRD-PARTY ASSISTANCE IS NOT AVAILABLE, TIDALHEALTH WILL PROVIDE CARE AT REDUCED OR ZERO COST. WHEN NO THIRD-PARTY ASSISTANCE IS AVAILABLE TO COVER THE TOTAL BILL AND THE PATIENT INDICATES THAT THEY HAVE INSUFFICIENT FUNDS, FINANCIAL ASSISTANCE (FA) WILL BE OFFERED. THE UNIFORM FINANCIAL ASSISTANCE APPLICATION, FINANCIAL ASSISTANCE POLICY, PATIENT COLLECTION PRACTICE POLICY, AND PLAIN LANGUAGE SUMMARY, CAN BE OBTAINED BY ONE OF THE FOLLOWING WAYS:A. AVAILABLE FREE OF CHARGE AND UPON REQUEST BY CALLING (410) 543-7436 OR (877) 729-7762.B. ARE LOCATED IN THE REGISTRATION AREAS.C. DOWNLOADED FROM THE TIDALHEALTH WEBSITE: HTTPS://WWW.TIDALHEALTH.ORG/MEDICAL-CARE/FINANCIAL-ADMIN-SERVICES/PATIENT-FORMSHTTPS://WWW.TIDALHEALTH.ORG/MEDICAL-CARE/FINANCIAL-ADMIN-SERVICES/BILLINGD. THE PLAIN LANGUAGE SUMMARY IS INSERTED IN THE ADMISSION PACKET AND WITH ALL PATIENT STATEMENTS.E. ANNUAL NOTIFICATION IN THE LOCAL NEWSPAPER.F. THE APPLICATION IS AVAILABLE IN ENGLISH, SPANISH, AND CREOLE. NO OTHER LANGUAGE CONSTITUTES A GROUP THAT IS 5% OR MORE, OR MORE THAN 1,000 RESIDENTS (WHICHEVER IS LESS) OF THE POPULATION IN OUR PRIMARY SERVICE AREA (WORCESTER, WICOMICO AND SOMERSET COUNTIES) FOR MARYLAND BASED ON U.S. CENSUS DATA. FOR DELAWARE, THE HOSPITAL POPULATION CONSIDERED WAS 5%.G. FOR PATIENTS WHO HAVE DIFFICULTY IN FILLING OUT AN APPLICATION, THE INFORMATION CAN BE TAKEN ORALLY BY CALLING (410) 912-6957 OR IN PERSON AT THE FINANCIAL COUNSELOR'S OFFICE LOCATED IN THE FRANK B. HANNA OUTPATIENT CENTER.
PART V, LINES 16A, 16B & 16C: FINANCIAL ASSISTANCE POLICY,	APPLICATION FORM, PLAIN LANGUAGE SUMMARY AVAILABLE ON THE HOSPITAL'S WEBSITEWWW.TIDALHEALTH.ORG/MEDICAL-CARE/FINANCIAL-ADMIN-SERVICES/BILLING/TIDALHEALTH-FINANCIAL-ASSISTANCE
SCHEDULE H, PART V, LINE 22D: MAXIMUM CHARGE AMOUNTS FOR FAP-ELIGIBLE	INDIVIDUALSTIDALHEALTH PENINSULA REGIONAL IS A MARYLAND HOSPITAL. AS SUCH PATIENTS AND ALL INSURANCE COMPANIES, INCLUDING MEDICARE & MEDICAID, PAY THE SAME RATE. THIS RATE IS DETERMINED BY THE STATE AGENCY, THE MARYLAND HEALTH SERVICES COST REVIEW COMMISSION.

Schedule H (Form 990) 2023

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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) 2023

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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 3C:	OTHER METHOD USED IN DETERMINING ELIGIBILITY FOR FINANCIAL ASSISTANCEN/A - TIDALHEALTH PENINSULA REGIONAL USES THE FPG IN DETERMINING ELIGIBILITY FOR FINANCIAL ASSISTANCE. FINANCIAL ASSISTANCE IS ALSO CONSIDERED IF A PATIENT IS OVER INCOME CRITERION BUT HAS FINANCIAL HARDSHIP BASED ON MEDICAL DEBT. PATIENTS WHO ARE BENEFICIARIES/RECIPIENTS OF CERTAIN MEANS-TESTED SOCIAL SERVICES PROGRAM ADMINISTERED BY THE STATE OF THE PATIENT'S RESIDENCE ARE DEEMED TO HAVE PRESUMPTIVE ELIGIBILITY FOR THPR'S FA PROGRAM.
PART I, LINE 7, COLUMN (F)	FINANCIAL ASSISTANCE AND CERTAIN OTHER COMMUNITY BENEFITS AT COSTTHE AMOUNT OF BAD DEBT EXPENSE EXCLUDED FROM THE DENOMINATOR IN THE COLUMN (F) PERCENTAGES IS $17,427,678.LINE 7B, COLUMN (C) & (F):MARYLAND'S REGULATORY SYSTEM CREATES A UNIQUE PROCESS FOR HOSPITAL PAYMENT THAT DIFFERS FROM THE REST OF THE NATION. THE HEALTH SERVICES COST REVIEW COMMISSION (HSCRC) DETERMINES PAYMENT THROUGH A RATE-SETTING PROCESS AND ALL PAYORS, INCLUDING GOVERNMENTAL PAYORS, PAY THE SAME AMOUNT FOR THE SAME SERVICES DELIVERED AT THE SAME HOSPITAL. MARYLAND'S UNIQUE ALL-PAYOR SYSTEM INCLUDES A METHOD FOR REFERENCING UNCOMPENSATED CARE IN EACH PAYORS' RATES, WHICH DOES NOT ENABLE MARYLAND HOSPITALS TO BREAKOUT ANY DIRECTED OFFSETTING REVENUE RELATED TO UNCOMPENSATED CARE. COMMUNITY BENEFIT EXPENSES ARE EQUAL TO MEDICAID REVENUES IN MARYLAND, AS SUCH, THE NET EFFECT IS ZERO. THE EXCEPTION TO THIS IS THE IMPACT ON THE HOSPITAL OF ITS SHARE OF THE MEDICAID ASSESSMENT. IN RECENT YEARS, THE STATE OF MARYLAND HAS CLOSED FISCAL GAPS IN THE STATE MEDICAID BUDGET BY ASSESSING HOSPITALS THROUGH THE RATE-SETTING SYSTEM.THE COST METHODOLOGY FOR CHARITY CARE AND CERTAIN OTHER COMMUNITY BENEFITS IS THE COST-TO-CHARGE RATIO USED FOR THE CHARITY CARE PROGRAMS AND DIRECT COST METHOD FOR THE OTHER BENEFITS/PROGRAMS.
PART II, COMMUNITY BUILDING ACTIVITIES:	COMMUNITY BUILDING ACTIVITIESTIDALHEALTH PENINSULA REGIONAL FUNDS A VARIETY OF PROGRAMS THAT WORK TO PROMOTE THE HEALTH AND SAFETY OF OUR COMMUNITY. THESE PROGRAMS INCLUDE ACTIVITIES IN THE AREAS OF HOUSING, ECONOMIC DEVELOPMENT, COMMUNITY SUPPORT, ENVIRONMENTAL IMPROVEMENTS, COALITION BUILDING, AND WORKFORCE DEVELOPMENT.THE NUMBER OF PERSONS SERVED BY THE COMMUNITY BUILDING ACTIVITIES WERE NOT TRACKED FOR ALL PROGRAMS THROUGHOUT THE COURSE OF THE YEAR. COALITION BUILDINGHISTORICALLY TIDALHEALTH PENINSULA REGIONAL HAS FACILITATED INVOLVEMENT WITH HEALTH IMPROVEMENT ORGANIZATIONS TO IDENTIFY, ASSESS, AND CREATE AGGREGATE ACTION PLANS TO ADDRESS LOCAL EMERGING AND CHRONIC COMMUNITY BENEFIT SERVICE AREA HEALTHCARE ISSUES. KATHRYN FIDDLER (VICE PRESIDENT OF POPULATION HEALTH) AND KATHERINE RODGERS (COMMUNITY HEALTH INITIATIVES DIRECTOR) ATTEND THE FOLLOWING LOCAL HEALTH IMPROVEMENT COALITIONS AND ADVISORY BOARDS FOCUSED ON IMPROVING POPULATION HEALTH. - EASTERN SHORE AREA HEALTH EDUCATION CENTER BOARD- LOWER SHORE VULNERABLE POPULATIONS TASK FORCE- LOWER SHORE HEALTH INSURANCE ASSISTANCE PROGRAM STEERING COMMITTEE- SWIFT ADVISORY COUNCIL- SALISBURY UNIVERSITY PUBLIC HEALTH ADVISORY COUNCIL- HEALTHCARE COUNCIL POPULATION HEALTH COMMITTEE- SOMERSET COUNTY LHIC- SOMERSET COUNTY LMB- REACH COALITION FOR PATHWAYS TO HEALTH EQUITY- WICOMICO COUNTY LHIC- WORCESTER COUNTY LHIC- TRI COUNTY ALLIANCE FOR THE HOMELESS- PROJECT LIVING WELL ADVISORY COMMITTEE MAC (MAINTAINING ACTIVE CITIZENS)ADDITIONALLY, TIDALHEALTH PARTICIPATES IN THE INSTITITE FOR HEALTHCARE IMPROVEMENT'S INTERNATIONAL PURSUING EQUITY LEARNING COLLABORATIVE. PHYSICIAN RECRUITING TIDALHEALTH PENINSULA REGIONAL FEELS IT IS IMPORTANT TO CONTINUALLY MONITOR SPECIALTIES WHERE A SIGNIFICANT AMOUNT OF PATIENT CARE WITHIN THE SERVICE AREA IS PROVIDED BY OLDER PHYSICIANS, AS A SUDDEN OR UNEXPECTED LOSS OF COVERAGE COULD HAVE AN ADVERSE EFFECT ON THE PROVISION OF MEDICAL SERVICES TO THE COMMUNITY. SUCCESSION PLANNING AND RECRUITMENT GO HAND-IN-HAND, AS DOES SOCIO-DEMOGRAPHICS AND GOVERNMENTAL INITIATIVES ALL OF WHICH MUST BE CONSIDERED TO ASSESS APPROPRIATE PHYSICIAN RECRUITMENT. ACCORDING TO TIDALHEALTH'S MOST RECENT MEDICAL STAFF DEVELOPMENT PLAN (2021), THE CONSULTING ENGAGEMENT RECOMMEDED TIDALHEALTH EVALUATE RECRUITING 6-9 ADULT PRIMARY CARE PHYSICIANS IN OUR PRIMARY SERVICE AREA AND ALSO LOOK AT OPPORTUNITIES TO ALIGN WITH INDEPENDENT PHYSICIANS. TIDALHEALTH HAS RECENTLY ENGAGED WHITECAP, A HEALTHCARE CONSULTING FIRM, TO CONDUCT AN ANALYSIS OF PHYSICIAN REQUIREMENTS, ENCOMPASSING BOTH PRIMARY AND SPECIALTY CARE, THROUGHOUT OUR ENTIRE SERVICE AREA. WHITECAP OFFERS AN EXTENSIVE RANGE OF SERVICES THAT SUPPORT STRATEGIC DECISION-MAKING, FOCUSING ON THE OPTIMAL GEOGRAPHIC PLACEMENT OF PROVIDERS AND THE ENGAGEMENT OF PATIENTS WITHIN THEIR OWN COMMUNITIES. COMMUNITY NEEDS PLACES EMPHASIS ON PRIMARY AND FAMILY PRACTICE PROVIDERS TO ENGAGE IN CHRONIC DISEASE MANAGEMENT AS PART OF OUR POPULATION HEALTH INITIATIVES. SUCCESSION PLANNING IS A KEY OBJECTIVE AS A SUBSTANIAL NUMBER OF PRIMARY CARE PHYSICIANS ARE ABOVE THE AGE OF 55 WHICH WILL LEAVE A VOID IN AN ALREADY UNDERSERVED AREA. DEMOGRAPHICS PLAYS A KEY ROLE AS THE MEDICARE POPULATION IS GROWING AT A FASTER RATE THAN THE STATE OF MARYLAND AND THE NATION. AS A GROWING RETIREMENT COMMUNITY, THERE IS AN INCREASED NEED FOR ADDITIONAL PRIMARY CARE PHYSICIANS AND CERTAIN SPECIALTIES. THERE WILL BE A 20%-28% GROWTH OF SENIORS 65+ OVER THE NEXT 5 YEARS WITHIN OUR TOTAL SERVICE AREA. TIDALHEALTH PHYSICIAN NETWORK OPTIMIZATION WAS DETERMINED BY CALCULATING USING THE CURRENT SUPPLY OF PHYSICIANS AND APPLYING PHYSICIAN TO-POPULATION RATIO BENCHMARKS, PHYSICIAN PATIENT VOLUMES, POPULATION DATA, AND OTHER DATA. MANAGEMENT CONSULTANTS RECOMMENDED EVALUATING POTENTIAL RECRUITMENT OF PRIMARY CARE FAMILY MEDICINE, PRIMARY CARE INTERNAL MEDICINE AND PRIMARY CARE PEDIATRICS OVER THE NEXT FIVE YEARS. MEDICAL SPECIALTY NEEDS ARE DRIVEN BY THE OVERALL MARKET SUPPLY, WAIT TIMES FOR NEW PATIENT APPOINTMENTS, AND CALL COVERAGE AND INPATIENT CONSULTATION NEEDS. CURRENT MEDICAL SPECIALTY RECOMMENDATIONS INCLUDE RECRUITMENT OF THE FOLLOWING PHYSICIAN SPECIALTIES DUE TO COMMUNITY NEEDS ASSESSMENT, MARKET DEMAND AND RETIREMENT: ALLERGY/IMMUNOLOGY, DERMATOLOGY, ENDOCRINOLOGY, HEMATOLOGY/ONCOLOGY, INFECTIOUS DISEASE, INTERVENTIONAL RADIOLOGY, NEUROLOGY, OB/GYN, GENERAL SURGERY, ORTHOPAEDICS, OTOLARYNGOLOGY, PAIN MANAGEMENT, PSYCHIATRY AND RHEUMATOLOGY. OF THE MEDICAL STAFF, 30%+ IS EITHER AT OR ABOVE THE AGE OF 55, WHICH POSES SUCCESSION RISK. TIDALHEALTH PENINSULA REGIONAL, A RURAL HOSPITAL, AND OTHER LIKE-KIND RURAL COMMUNITIES ARE TYPICALLY CHALLENGED IN BOTH RECRUITMENT AND RETENTION OF PHYSICIANS DUE TO NUMEROUS FACTORS. SOME OF THESE CHALLENGES ARE DUE TO THE LOCATION AND GEOGRAPHY OF THE AREA AND AVAILABILITY OF HEALTHCARE RESOURCES. RETAINING AND RECRUITING RESOURCES IN SUB-SPECIALTIES CAN BE HARD FOR REGIONAL RURAL HOSPITALS AND TIDALHEALTH PENINSULA REGIONAL IS NO EXCEPTION. TO ADDRESS SPECIFIC COMMUNITY HEALTHCARE NEEDS THE MEDICAL CENTER HAS HAD TO RECRUIT, RETAIN, EMPLOY AND SUBSIDIZE SOME OF THE FOLLOWING SUB-SPECIALTIES; NEONATOLOGY, PULMONARY, NEURO-HOSPITALIST, NEUROSURGERY, MEDICAL ONCOLOGY & HEMATOLOGY, RADIATION ONCOLOGY, GASTROENTEROLOGY, PEDIATRIC SPECIALTIES, ENDOCRINOLOGY, CARDIOLOGY, CARDIOVASCULAR SURGERY, ANESTHESIOLOGY AND PAIN MANAGEMENT. RURAL COMMUNITIES LACK THE CULTURAL AND EDUCATIONAL RESOURCES THAT LARGER URBAN CENTERS PROVIDE MAKING IT HARDER TO RETAIN AND RECRUIT THESE PHYSICIANS. LOW POPULATION PATTERNS BY GEOGRAPHY MAKE IT MORE COSTLY AND HARDER FOR COMMUNITIES AND BUSINESSES TO PROVIDE VARIOUS TYPES OF SERVICES ESPECIALLY SPECIALTY PHYSICIAN SERVICES. OVERALL, OUR LOCAL ECONOMY IS NOT AS ROBUST AS THE URBAN CENTERS AS INDICATED BY OUR LOW AVERAGE HOUSEHOLD INCOME IN THE TRI-COUNTY AREA.DISASTER READINESSTIDALHEALTH PENINSULA REGIONAL IS A MEMBER OF DRHMAG (DELMARVA REGIONAL HEALTH MUTUAL AID GROUP) WHICH IS A COALITION OF LOCAL HEALTH DEPARTMENTS, HOSPITALS AND NURSING HOMES. THEY MEET QUARTERLY TO DISCUSS ISSUES OF DISASTER PREPAREDNESS IN THE DELMARVA REGION. TIDALHEALTH PENINSULA REGIONAL HAS AN INTERNAL EMERGENCY MANAGEMENT COMMITTEE THAT MEETS MONTHLY WHOSE MEMBERS INCLUDE THE SAFETY COORDINATOR, DIRECTOR OF PUBLIC SAFETY, EMERGENCY DEPARTMENT RN, RISK MANAGEMENT, INFECTION PREVENTION, EXECUTIVE TEAM REPRESENTATIVE, PHARMACIST, EMERGENCY MANAGEMENT COORDINATOR, FIREFIGHTER, AND A COUNTY HEALTH DEPARTMENT REPRESENTATIVE. THPR ALSO MEETS QUARTERLY WITH OUR LOCAL PARTNERS THAT INCLUDE FIRE, POLICE, EMERGENCY MEDICAL SERVICES, AND WICOMICO COUNTY EMERGENCY MANAGEMENT TO FACILITATE DISASTER PLANNING AND MOCK DRILLS WITHIN THE COMMUNITY.
PART III, LINES 2 AND 3:	SEE RESPONSE BELOW TO LINE 4 REGARDING THE METHODOLOGY USED BY THE ORGANIZATION REGARDING BAD DEBT.
PART III, LINE 4:	BAD DEBT FOOTNOTE IN THE AUDITED FINANCIAL STATEMENTSA RECEIVABLE IS RECOGNIZED WHEN THERE IS AN UNCONDITIONAL RIGHT TO PAYMENT, SUBJECT ONLY TO THE PASSAGE OF TIME. PATIENT ACCOUNTS RECEIVABLE, INCLUDING BILLED ACCOUNTS AND UNBILLED ACCOUNTS, WHICH HAVE THE UNCONDITIONAL RIGHT TO PAYMENT, AND ESTIMATED AMOUNTS DUE FROM THIRD-PARTY PAYORS FOR RETROACTIVE ADJUSTMENTS, ARE RECORDED AS RECEIVABLES SINCE THE RIGHT TO CONSIDERATION IS UNCONDITIONAL AND ONLY THE PASSAGE OF TIME IS REQUIRED BEFORE PAYMENT OF THAT CONSIDERATION IS DUE. THE ESTIMATED UNCOLLECTIBLE AMOUNTS ARE GENERALLY CONSIDERED IMPLICIT PRICE CONCESSIONS THAT ARE RECORDED AS A DIRECT REDUCTION TO PATIENT ACCOUNTS RECEIVABLE.DISCOUNTS RANGING FROM 2.0% TO 7.7% OF CHARGES ARE GIVEN TO MEDICARE, MEDICAID, AND CERTAIN APPROVED COMMERCIAL HEALTH INSURANCE AND HEALTH MAINTENANCE ORGANIZATION PROGRAMS FOR REGULATED SERVICES. DISCOUNTS IN VARYING PERCENTAGES ARE GIVEN FOR CERTAIN UNREGULATED SERVICES.
PART III, LINE 8:	MEDICARE COSTING METHODOLOGYMEDICARE ALLOWABLE COSTS WERE CALCULATED USING A COST TO CHARGE RATIO. TIDALHEALTH PENINSULA REGIONAL PROVIDES QUALITY MEDICAL SERVICES TO ALL PATIENTS REGARDLESS OF WHAT INSURANCE THEY HAVE. APPROXIMATELY, 53.84% OF THE MEDICAL CENTER'S REVENUE IS ATTRIBUTABLE TO MEDICARE PATIENTS DURING THE YEAR ENDED JUNE 30, 2024.
PART III, LINE 9B:	COLLECTION POLICYTHE TIDALHEALTH PENINSULA REGIONAL COLLECTION POLICY INCLUDES INFORMATION ABOUT OUR FINANCIAL ASSISTANCE POLICY (FAP) AND HOW TO FIND THE FAP. THE DEBT COLLECTION POLICY APPLIES TO ALL PATIENTS. ADDITIONALLY, OUR COLLECTION POLICY INSTRUCTS THAT EXTRAORDINARY COLLECTION ACTIONS (ECA) WILL BE SUSPENDED WHEN A PATIENT REQUESTS INFORMATION ON OUR FAP OR SUBMITS A FINANCIAL ASSISTANCE APPLICATION WITHIN 240 DAYS OF THE FIRST POST-DISCHARGE BILLING STATEMENT. OUR POLICY DESCRIBES WHAT TO DO IF THE FINANCIAL ASSISTANCE APPLICATION IS INCOMPLETE AND WHAT IS REQUIRED TO BE REFUNDED (AMOUNTS OVER $5) IF THE PATIENT QUALIFIES FOR FINANCIAL ASSISTANCE AFTER MAKING A PAYMENT. WE INCLUDE CLARIFICATION OF WHAT DATES OF SERVICES ARE INCLUDED IN THE FINANCIAL ASSISTANCE SO THAT WE UNDERSTAND WHEN NORMAL COLLECTION EFFORTS ARE APPROPRIATE.WITHIN OUR COLLECTION POLICY WE DESCRIBE THAT A PATIENT DENIED FINANCIAL ASSISTANCE MAY REQUEST A RECONSIDERATION. FOR DATES OF SERVICES APPROVED FOR FINANCIAL ASSISTANCE COLLECTIONS PROCESSES ARE HALTED AS THE ACCOUNT IS ADJUSTED TO ZERO DUE FROM PATIENT. THE POLICY STATES HOW TO PROCESS THE PATIENT BALANCE WHEN ONLY A PORTION OF THE CHARGE QUALIFIED FOR FINANCIAL ASSISTANCE; COLLECTIONS WILL ONLY BE PURSUED ON THE AMOUNT THAT DID NOT QUALIFY FOR FINANCIAL ASSISTANCE.
PART VI, LINE 2:	NEEDS ASSESSMENTTIDALHEALTH PENINSULA REGIONAL ASSESSES COMMUNITY HEALTH NEEDS IN PARTNERSHIP WITH THE LOCAL COUNTY HEALTH DEPARTMENTS (WICOMICO, WORCESTER, SOMERSET). WE MEET ON A REGULAR BASIS TO DISCUSS AND FORMULATE STRATEGIES AND ACTION PLANS IN WHICH WE COLLABORATE WITH EACH OTHER AND LOCAL ENTITIES TO ADDRESS RESIDENTS' MOST UNDERSERVED AND CRITICAL HEALTHCARE AND SOCIAL NEEDS. DEVELOPING RELATIONSHIPS WITH COMMUNITY PARTNERS IS CRITICAL TO CONTINUED IDENTIFICATION OF UNDERSERVED NEEDS AND POPULATION HEALTH MANAGEMENT SUCCESS; A CORNERSTONE OF TIDALHEALTH PENINSULA REGIONAL STRATEGY. THE FOLLOWING LOCAL RELATIONSHIPS, PARTNERSHIPS AND MEMBERSHIPS HAS CREATED SYNERGY PRODUCING LOCAL HEALTHCARE DIVIDENDS, EXAMPLES OF THESE RELATIONSHIPS INCLUDE THE FOLLOWING: TRI-COUNTY DIABETES ALLIANCE, SWIFT (SALISBURY WICOMICO INTEGRATED FIRSTCARE TEAM), FEDERALLY QUALIFIED HEALTH CENTERS, YMCA, PATIENT CARE ADVISORY COUNCIL, LOCAL SNFS, FAITH BASED ENTITIES, MAC (MAINTAINING ACTIVE CITIZENS), SHELTERS (HALO, HOPE), LOCAL COLLEGES & HIGH SCHOOLS. WE ARE WORKING WITH DIVERSE AND DISPARATE LOCAL ENTITIES FOR THE UNITED BUT COMMON GOAL OF MEETING RESIDENTS' UNDERSERVED NEEDS. OUR GOAL IS A HEALTHIER COMMUNITY.IN ADDITION TO THE CHNA (DISCUSSED IN PREVIOUS SECTION), TIDALHEALTH PENINSULA REGIONAL HAS EMBARKED ON IDENTIFYING AND TARGETING "SUPER UTILIZERS" WITHIN OUR CBSA (COMMUNITY BENEFIT SERVICE AREA); THESE RESIDENTS WILL BE IDENTIFIED, AND TARGETED FOR POPULATION HEALTH MANAGEMENT. - DEMOGRAPHICS (CENSUS TRACK, ZIP CODES)- DISPARITIES AND HEALTH EQUITY, USING A DEPRIVATION INDEX - RACE/ETHNICITY- AGE-COHORTS- CHRONIC CONDITIONSTHE TARGET POPULATION INCLUDES PATIENTS THAT HAVE CHRONIC CONDITIONS WHO HAVE DEMONSTRATED TO HAVE BEEN HIGH UTILIZERS AT TIDALHEALTH PENINSULA REGIONAL OR ARE IDENTIFIED AS BEING AT RISK OF HIGH UTILIZATION BASED ON HIS/HER CHRONIC CONDITIONS AND PATTERNS OF CARE. CURRENT DATA INDICATES AN "OVERRELIANCE" BY LOCAL RESIDENTS ON TIDALHEALTH PENINSULA REGIONAL'S EMERGENCY ROOM FOR PRIMARY AND CHRONIC CONDITION NEEDS. IN RESPONSE, TIDALHEALTH PENINSULA REGIONAL HAS INTRODUCED INTERVENTIONS, CARE MANAGEMENT PROGRAMS, EDUCATION, AND FOLLOW-UP WITH MEASUREMENT AND OUTCOMES. BASED UPON A CURRENT ASSESSMENT THERE ARE MANY RESIDENTS THAT MEET THE CRITERIA OF "SUPER UTILIZERS" STRATIFIED BY SOCIO-DEMOGRAPHICS AND CHRONIC DISEASE. TIDALHEALTH PENINSULA REGIONAL IS TARGETING CBSA ZIP CODES BASED UPON SOCIAL AND ECONOMIC DETERMINANTS OF HEALTH TO INCLUDE THE UNINSURED, INDIGENT POPULATION, RESIDENTS WHO LACK TRANSPORTATION, LACK OF EDUCATION AND AVAILABILITY OF HEALTHY FOODS. TARGETING THIS BY CLUSTER AND CENSUS TRACK, WE SEEK TO IMPACT HEALTH BY PROVIDING PRIMARY HEALTH SERVICES, EDUCATION, ACCESS AND MORE IMPORTANTLY BY FOSTERING RELATIONSHIPS WITHIN THE COMMUNITY WE SERVE. FOR EXAMPLE, OUR WAGNER WELLNESS VAN TRAVELS LOCALLY TO CENSUS TRACK WHERE THERE WAS AN IDENTIFIED NEED FOR BASIC HEALTH SERVICES, IN ADDITION TO PROVIDING HEALTH SERVICES AND EDUCATION TO LOCAL ETHNIC CHURCHES AND CIVIC ORGANIZATIONS.WHILE IDENTIFYING WHICH BARRIERS AND DISPARITIES ARE CRITICAL COMPONENTS IN ASSESSING THE NEEDS OF A COMMUNITY, IT IS ALSO IMPORTANT TO UNDERSTAND THE SOCIAL DETERMINANTS OF HEALTH AND OTHER UPSTREAM FACTORS THAT INFLUENCE A COMMUNITY'S HEALTH AS WELL. THE CHALLENGES AND BARRIERS FACED BY A COMMUNITY MUST BE BALANCED BY IDENTIFYING PRACTICAL, COMMUNITY-DRIVEN SOLUTIONS. TOGETHER, THESE FACTORS COME TOGETHER TO INFORM AND FOCUS STRATEGIES TO POSITIVELY IMPACT A COMMUNITY'S HEALTH. TIDALHEALTH AND PARTNERS ARE OUTLINING OPPORTUNITIES FOR ON-GOING WORK AS WELL AS POTENTIAL FOR FUTURE IMPACT.
PART VI, LINE 3:	PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCEIF A PATIENT IS UNABLE TO PAY DUE TO FINANCIAL RESOURCES, ALL EFFORTS WILL BE MADE TO HELP THE PATIENT OBTAIN ASSISTANCE THROUGH APPROPRIATE AGENCIES. IN THE EVENT THAT THE PATIENT HAS APPLIED FOR AND KEPT ALL NECESSARY APPOINTMENTS AND THIRD-PARTY ASSISTANCE IS NOT AVAILABLE, TIDALHEALTH WILL PROVIDE CARE AT REDUCED OR ZERO COST. WHEN NO THIRD-PARTY ASSISTANCE IS AVAILABLE TO COVER THE TOTAL BILL AND THE PATIENT INDICATES THAT THEY HAVE INSUFFICIENT FUNDS, FINANCIAL ASSISTANCE (FA) WILL BE OFFERED. THE UNIFORM FINANCIAL ASSISTANCE APPLICATION, FINANCIAL ASSISTANCE POLICY, PATIENT COLLECTION PRACTICE POLICY, AND PLAIN LANGUAGE SUMMARY, CAN BE OBTAINED BY ONE OF THE FOLLOWING WAYS:A. AVAILABLE FREE OF CHARGE AND UPON REQUEST BY CALLING (410) 543-7436 OR (877) 729-7762.B. ARE LOCATED IN THE REGISTRATION AREAS.C. DOWNLOADED FROM THE TIDALHEALTH WEBSITE:HTTPS://WWW.TIDALHEALTH.ORG/MEDICAL-CARE/FINANCIAL-ADMIN-SERVICES/PATIENT-FORMSHTTPS://WWW.TIDALHEALTH.ORG/MEDICAL-CARE/FINANCIAL-ADMIN-SERVICES/BILLINGD. THE PLAIN LANGUAGE SUMMARY IS INSERTED IN THE ADMISSION PACKET AND WITH ALL PATIENT STATEMENTS.E. ANNUAL NOTIFICATION IN THE LOCAL NEWSPAPER.F. THE APPLICATION IS AVAILABLE IN ENGLISH, SPANISH, AND CREOLE. NO OTHER LANGUAGE CONSTITUTES A GROUP THAT IS 5% OR MORE, OR MORE THAN 1,000 RESIDENTS (WHICHEVER IS LESS) OF THE POPULATION IN OUR PRIMARY SERVICE AREA (WORCESTER, WICOMICO AND SOMERSET COUNTIES) FOR MARYLAND BASED ON U.S. CENSUS DATA. FOR DELAWARE, THE HOSPITAL POPULATION CONSIDERED WAS 5%.G. FOR PATIENTS WHO HAVE DIFFICULTY IN FILLING OUT AN APPLICATION, THE INFORMATION CAN BE TAKEN ORALLY BY CALLING (410) 912-6957 OR IN PERSON AT THE FINANCIAL COUNSELOR'S OFFICE LOCATED IN THE FRANK B. HANNA OUTPATIENT CENTER.SIGNS WILL BE POSTED IN VARIOUS LOCATIONS THROUGHOUT TIDALHEALTH TO INFORM PATIENTS WHERE TO CALL OR APPLY FOR FINANCIAL ASSISTANCE.THE PATIENT'S INCOME WILL BE COMPARED TO CURRENT FEDERAL POVERTY GUIDELINES (ON FILE WITH THE COLLECTION COORDINATOR). THE COLLECTION COORDINATOR REPRESENTATIVE WILL CONSULT WITH THE PATIENT AS NEEDED TO MAKE ASSESSMENT OF ELIGIBILITY.IT IS THE INTENTION OF TIDALHEALTH TO MAKE AVAILABLE TO ALL PATIENTS THE HIGHEST QUALITY OF MEDICAL CARE POSSIBLE WITHIN THE RESOURCES AVAILABLE. IF A PATIENT IS UNABLE TO PAY DUE TO FINANCIAL RESOURCES, ALL EFFORTS WILL BE MADE TO HELP THE PATIENT OBTAIN ASSISTANCE THROUGH APPROPRIATE AGENCIES, OR, IF NO HELP IS AVAILABLE, TO RENDER CARE AT A REDUCED OR ZERO COST FOR EMERGENCY AND MEDICALLY NECESSARY CARE.
PART VI, LINE 4:	COMMUNITY INFORMATIONTIDALHEALTH PENINSULA REGIONAL, AT 283 LICENSED BEDS, FUNCTIONS AS THE PRIMARY ACUTE TERTIARY CARE HOSPITAL PROVIDER FOR THE RURAL SOUTHERNMOST THREE COUNTIES OF THE EASTERN SHORE OF MARYLAND, WHICH INCLUDES WICOMICO, WORCESTER AND SOMERSET COUNTIES. APPROXIMATELY 77% OF THE PATIENTS DISCHARGED FROM THE MEDICAL CENTER ARE RESIDENTS OF THE PRIMARY SERVICE AREA, WHICH HAS AN ESTIMATED POPULATION OF APPROXIMATELY 183,321 IN 2024 AND IS EXPECTED TO DECREASE TO 182,983 (-0.7%) BY 2029. THE MEDICAL CENTER ALSO HAS A SECONDARY SERVICE AREA INCLUDING, DORCHESTER COUNTY, MARYLAND, SUSSEX COUNTY, DELAWARE AND ACCOMACK COUNTY, VIRGINIA. WITH THE SECONDARY SERVICE AREA HAVING AN ESTIMATED POPULATION OF APPROXIMATELY 329,555 IN 2024 AND IS EXPECTED TO INCREASE TO 351,020 OR BY 6.5% BY 2029.TIDALHEALTH PENINSULA REGIONAL'S COMMUNITY BENEFITS SERVICE AREA CONSISTS OF THOSE ZIP CODES WITHIN OUR PRIMARY SERVICE AREA. MOST OF THE POPULATION RESIDES IN WICOMICO COUNTY (105,394) WITH SALISBURY SERVING AS THE CAPITAL OF THE EASTERN SHORE. SALISBURY IS LOCATED ON THE HEADWATERS OF THE WICOMICO RIVER AND IT IS LOCATED AT THE CROSSROADS OF THE BAY AND THE OCEAN. THE REGION IS UNIQUE; THE CITY OF SALISBURY HAS SIMILAR SOCIO-ECONOMIC AND DEMOGRAPHIC CHARACTERISTICS OF A LARGE CITY, HOWEVER, THE AREA SURROUNDING SALISBURY IS RURAL AND HAS LIKE-KIND CHARACTERISTICS OF SMALL-TOWN AMERICA. DUE TO THIS DICHOTOMY, SERVING BOTH SOMETIMES PRESENTS A CHALLENGE IN DELIVERING HEALTHCARE. THE TWO OTHER COUNTIES IN TIDALHEALTH PENINSULA REGIONAL'S CBSA INCLUDE WORCESTER COUNTY, WITH A POPULATION OF 53,531 AND SOMERSET COUNTY WITH A POPULATION OF 24,396.THE GREATER "METROPOLITAN" SALISBURY AREA (ZIP CODES 21801, 21804) HAS A HIGHER POPULATION DENSITY THAN THE SURROUNDING RURAL AREAS. THIS AREA HAS A VULNERABLE POPULATION THAT INCLUDES THE INDIGENT AND A HIGHER MEDICAID MIX. MOVING EAST TOWARDS THE BEACH, LOCATED IN WORCESTER COUNTY ARE SEVERAL LARGER TOWNS, LIKE BERLIN (21811) AND OCEAN CITY (21842) THAT HAVE A HIGH POPULATION DENSITY. SOUTH OF SALISBURY, LOCATED IN SOMERSET COUNTY, ARE THE LARGER TOWNS OF PRINCESS ANNE (21853) AND CRISFIELD (21817). EXCLUDING THE GREATER SALISBURY AREA, THE LANDSCAPE AND ENVIRONMENT IS CONSIDERED RURAL, MADE UP OF SMALL BUSINESSES AND AGRICULTURE.ALL THREE COUNTIES CAN BE CLASSIFIED AS RURAL WITH HISTORIC ECONOMIC FOUNDATION IN AGRICULTURE, POULTRY AND TOURISM. WATERMEN AND FARMERS HAVE ALWAYS COMPRISED A LARGE PERCENTAGE OF THE PENINSULA POPULATION, HOWEVER, THEIR NUMBERS HAVE BEEN DECLINING WITH A GROWTH IN THE POPULATION AND EXPANSION OF OTHER SMALL TO MIDSIZE BUSINESSES. OCEAN CITY, MD LOCATED IN WORCESTER COUNTY, IS A MAJOR TOURIST DESTINATION. DURING THE SUMMER WEEKENDS, THE CITY HOSTS BETWEEN 320,000 AND 345,000 VACATIONERS, AND UP TO 8 MILLION VISITORS ANNUALLY.THE THREE COUNTIES HAVE A DIVERSIFIED ECONOMIC BASE; HOWEVER, IT IS PREDOMINATELY MADE UP OF SMALL EMPLOYERS (COMPANIES WITH LESS THAN 50 EMPLOYEES). MAJOR EMPLOYERS INCLUDE LOCAL HOSPITALS, THE POULTRY INDUSTRY, LOCAL COLLEGES AND TEACHING INSTITUTIONS. THE MEDIAN HOUSEHOLD INCOME OF $65,197 IN OUR COMMUNITY BENEFITS SERVICE AREA IS CONSIDERABLY LESS THAN MARYLAND'S MEDIAN INCOME OF $91,431. IN ADDITION, 2024 UNEMPLOYMENT RATES WERE HIGHER FOR MARYLAND'S MOST EASTERN SHORE COUNTIES. THE UNEMPLOYMENT RATE IN MARYLAND WAS 3.1%, THE NATION 4.1% COMPARED TO WICOMICO 4.0% WORCESTER 4.9% AND SOMERSET 4.9% (US BUREAU OF LABOR STATISTICS). RESEARCH INDICATES LOWER MEDIAN INCOMES AND HIGHER UNEMPLOYMENT RATES CONTRIBUTE TO A DISPARITY IN ACCESS TO MEDICAL CARE AND A PREVALENCE OF UNTREATED CHRONIC DISEASE.THE BABY BOOMER POPULATION (THOSE AGED 55+) REPRESENT A GREATER PORTION OF THE TOTAL POPULATION IN TIDALHEALTH PENINSULA REGIONAL'S CBSA AS COMPARED TO THE NATION. THE EASTERN SHORE OF MARYLAND IS BECOMING A POPULAR RETIREMENT DESTINATION AND THE TREND IS LIKELY TO CONTINUE. THE CHRONIC CONDITIONS OF THIS AGE GROUPING CONSUME HEALTHCARE RESOURCES AT MUCH HIGHER RATES THAN SOME OF THE OTHER YOUNGER AGE-COHORTS.TIDALHEALTH PENINSULA REGIONAL'S PRIMARY SERVICE AREA (WICOMICO, WORCESTER, SOMERSET) REPRESENT SOME OF THE NEEDIEST COUNTIES IN THE STATE OF MARYLAND (HTTPS://WWW.COUNTYHEALTHRANKINGS.ORG/HEALTH-DATA/MARYLAND?YEAR=2023), BASED UPON A SOCIONEEDS INDEX INCOME, POVERTY, UNEMPLOYMENT, OCCUPATION, EDUCATIONAL ATTAINMENT AND LINGUISTIC BARRIERS THAT ARE ASSOCIATED WITH POOR HEALTH OUTCOMES, INCLUDING PREVENTABLE HOSPITALIZATIONS AND PREMATURE DEATH. PENINSULA REGIONAL HAS ZIP CODES IN EACH OF ITS PRIMARY SERVICE AREA COUNTIES WITH HIGH SOCIONEEDS INDEX LEVELS. DEPLOYMENT OF RESOURCES IS KEY IN THESE COMMUNITIES WITH HIGH SOCIOECONOMIC NEEDS AS WE FOCUS AND TARGET PREVENTION AND OUTREACH SERVICES. TO MEET ITS MISSION OF IMPROVING THE HEALTH OF THE COMMUNITIES IT SERVES, TIDALHEALTH PENINSULA REGIONAL HAS DEVELOPED A POPULATION HEALTH DIVISION AND HAS ENGAGED IN POPULATION HEALTH STRATEGIES TO SUPPORT THE MARYLAND TOTAL COST OF CARE MODEL, WHICH AIMS TO IMPROVE OUTCOMES, IMPROVE THE PATIENT EXPERIENCE AND REDUCE THE TOTAL COST OF CARE. THE HOSPITAL IS COORDINATING CARE, INCLUDING MENTAL HEALTH AND POST-ACUTE CARE, ACROSS HOSPITAL AND NON-HOSPITAL SETTINGS. THE POPULATION HEALTH DIVISION INCORPORATES A MULTIDISCIPLINARY TEAM OF NURSES, SOCIAL WORKERS AND COMMUNITY HEALTH WORKERS SUPPORTING THE COMMUNITY WITH A BROAD RANGE OF PRIMARY CARE SERVICES. THE DIVISION ALSO FOSTERS COMMUNITY PARTNERSHIPS WITH LOCAL HOSPITALS, IN ADDITION TO COMMUNITY-BASED ORGANIZATIONS INCLUDING LOCAL HEALTH DEPARTMENTS, FIRE DEPARTMENTS, THE MARYLAND STATE AREA AGENCY ON AGING AND OTHER AGENCIES TO PROVIDE PATIENT SUPPORT ALIGNED WITH SOCIAL DETERMINANTS OF HEALTH.
PART VI, LINE 5:	PROMOTION OF COMMUNITY HEALTHTIDALHEALTH PENINSULA REGIONAL IS COMMITTED TO THE HEALTH OF THE RURAL COMMUNITIES IT SERVES. IN FY2024, AS REPORTED TO MARYLAND HSCRC, THE HOSPITAL'S CHARITY CARE WAS $10,407,353; COMBINED CHARITY AND BAD DEBT FOR FY2024 WAS $27,835,031. AS PART OF TIDALHEALTH PENINSULA REGIONAL'S ONGOING COMMITMENT AND MISSION STATEMENT "TO IMPROVE THE HEALTH OF THE COMMUNITIES WE SERVE," WE CONTINUE TO ASSESS THE HEALTH NEEDS OF THE COMMUNITY THROUGH BUILDING RELATIONSHIPS AND COLLABORATIONS WITH ORGANIZATIONS THAT ARE ADDRESSING UNMET HEALTH NEEDS.TIDALHEALTH USES DATA FROM THE COMMUNITY HEALTH NEEDS ASSESSMENT AND DATA FROM ITS EPIC EHR STRATIFIED BY RACE, ETHNICITY, AGE, LANGUAGE AND GENDER TO IDENTIFY SIGNIFICANT HEALTH DISPARITIES IN THE PATIENT POPULATION. THE POPULATION HEALTH DIVISION IN PARTNERSHIP WITH COMMUNITY-BASED ORGANIZATIONS, MANAGED CARE ORGANIZATIONS, THE LOCAL HEALTH IMPROVEMENT COALITIONS, AND LOCAL HEALTH DEPARTMENTS, HAS INITIATIVES UNDERWAY TO ADDRESS DISPARITIES AND HEALTH ISSUES PRIORITIZED AND INCLUDED IN THE CHNA AND COMMUNITY HEALTH IMPROVEMENT PLAN. TIDALHEALTH WAS AWARDED A TWO-YEAR GRANT THROUGH THE MARYLAND COMMUNITY HEALTH RESOURCES COMMISSION'S NEW PATHWAYS TO HEALTH EQUITY PROGRAM TO ENHANCE AND EXPAND EFFORTS TO ADDRESS HEALTH DISPARITIES AND ADVANCE HEALTH EQUITY. THE PROGRAM, RURAL EQUITY AND ACCESS TO COMMUNITY HEALTH (REACH), LAUNCHED IN MAY 2022 AND IS A COLLABORATIVE, REGIONAL PROJECT TO PREVENT AND REDUCE DISPARITIES PARTICULARLY AMONG BLACK/AFRICAN AMERICAN AND HAITIAN RESIDENTS OF THE LOWER EASTERN SHORE WITH DIABETES AND/OR HYPERTENSION.REACH INVOLVES MULTI-LEVEL, CROSS-SECTOR APPROACHES TO ADDRESS DISPARITIES AND IMPROVE POPULATION HEALTH. AT THE INDIVIDUAL LEVEL, THE PROJECT INCLUDES INCREASED CARE COORDINATION AND FOLLOW-UP FOR HIGH-RISK PATIENTS WITH DIABETES AND/OR HYPERTENSION WHO HAVE BEEN DISCHARGED FROM THE HOSPITAL. COMMUNITY HEALTH WORKERS ARE DEPLOYED TO SCREEN AND ADDRESS SOCIAL DETERMINANTS OF HEALTH (SDOH).AT THE COMMUNITY-LEVEL, TIDALHEALTH WORKS WITH COMMUNITY PARTNERS TO INCREASE ACCESS TO EVIDENCE-BASED CHRONIC DISEASE PREVENTION AND MANAGEMENT OR HEALTHY LIFESTYLE PROGRAMMING IN UNDERSERVED COMMUNITIES. AT THE SYSTEM LEVEL, TIDALHEALTH AND COMMUNITY PARTNERS USE A SOCIAL CARE COORDINATION PLATFORM TO IMPROVE PROCESSES FOR SDOH SCREENING AND REFERRALS. THE POPULATION HEALTH DIVISION INCLUDES THE COMMUNITY WELLNESS DEPARTMENT AND IS FOCUSED ON ADDRESSING DISPARITIES AND SDOH FACTORS THROUGH COMMUNITY-INTEGRATED STRATEGIES. COMMUNITY WELLNESS INCLUDES A NURSE PRACTITIONER, REGISTERED NURSES, COMMUNITY HEALTH WORKERS, AND A SOCIAL WORKER. THE COMMUNITY WELLNESS TEAM THE COMMUNITY WELLNESS TEAM CONDUCTS HOME VISITS OF HIGH-RISK PATIENTS IN THE COMMUNITY. THESE ASSESSMENTS INCLUDE SCREENING FOR SDOH (SOCIAL DETERMINANTS OF HEALTH) AND ADDRESSING GAPS IDENTIFIED BY CONNECTING PATIENTS TO COMMUNITY-BASED RESOURCES AND SUPPORTS AND CHRONIC DISEASE SELF-MANAGEMENT EDUCATION. ADDITIONALLY, THE COMMUNITY WELLNESS TEAM OPERATES A MOBILE CLINIC CALLED THE WAGNER WELLNESS VAN TO VISIT LOCAL SHELTERS, CHURCHES, AND OTHER AREAS IN TIDALHEALTH PENINSULA REGIONAL'S COMMUNITY BENEFITS SERVICE AREA WHERE UNDERSERVED RESIDENTS CAN RECEIVE NON-EMERGENCY MEDICAL CARE, CHRONIC CARE MANAGEMENT AND HEALTHY LIFESTYLES EDUCATION. THE VAN VISITS AREAS WHERE THE SOCIAL DETERMINANTS OF HEALTH INDICATE THE GREATEST AMOUNT OF NEED. IT PROVIDES CARE IN AREAS WITH A HIGHER PREVALENCE OF ER VISITS, LOWER MEDIAN INCOMES, INDIGENT POPULATION, ACCESS ISSUES, COMMUNICATION BARRIERS AND OVERALL POOR HEALTH OUTCOMES. THE COMMUNITY WELLNESS TEAM STRIVES TO EDUCATE PATIENTS BY PROVIDING NUTRITIONAL AND HEALTHY LIFESTYLE COUNSELING, IN ADDITION TO MEDICATION COMPLIANCE TO CONTROL DIABETES AND HYPERTENSION. HEALTH SCREENINGS ARE PERFORMED ON RESIDENTS TO HELP DETERMINE APPROPRIATE EDUCATION, SELF-MANAGEMENT CLASS INFORMATION OR REFERRALS TO COMMUNITY RESOURCES AND SERVICES. THESE SCREENINGS INCLUDE DIABETES RISK ASSESSMENTS, HYPERTENSION, AND OBESITY. WHEN WARRANTED, DRUG AND ALCOHOL MISUSE SCREENINGS ARE ALSO CONDUCTED, AND COUNSELING IS AVAILABLE. NARCAN IS PROVIDED TO RESIDENTS TO SUPPORT EFFORTS TO PREVENT OPIOID MISUSE AND OVERDOSE. FLU SHOTS ARE PROVIDED TO COMMUNITY MEMBERS THROUGH THE COMMUNITY WELLNESS OUTREACH EFFORTS TO UNDERSERVED COMMUNITIES AND HOMEBOUND RESIDENTS. SWIFTSWIFT IS A MOBILE INTEGRATED HEALTH INITIATIVE IN PARTNERSHIP WITH THE CITY OF SALISBURY AND THE WICOMICO COUNTY HEALTH DEPARTMENT. THE PROGRAM REDUCES UNNECESSARY USE OF THE 911 EMS SYSTEM AND HEALTH SYSTEM EMERGENCY DEPARTMENT BY ADDRESSING MEDICAL AND PSYCHOSOCIAL NEEDS OF THOSE IDENTIFIED AS HIGH UTILIZERS OF EMS AND/OR THE ED. AN INTERDISCIPLINARY TEAM INCLUDING A NURSE PRACTITIONER, REGISTERED NURSE, PARAMEDIC, COMMUNITY HEALTH WORKER AND SOCIAL WORKER WORK TOGETHER TO ADDRESS UNDERLYING CONDITIONS OR SOCIAL DETERMINANTS OF HEALTH CONTRIBUTING TO EXCESSIVE CALLS TO 911 AND VISITS TO THE ED. THE TEAM CONNECTS THE PROGRAM PARTICIPANTS TO PRIMARY CARE, BEHAVIORAL HEALTH, CHRONIC DISEASE PREVENTION AND MANAGEMENT, MEDICATION MANAGEMENT, AND SOCIAL DETERMINANTS OF HEALTH NEEDS SUCH AS HOUSING, TRANSPORTATION, FOOD, UTILITY ASSISTANCE AND OTHER SERVICES. THE PROGRAM SAVES LIVES BY TAKING A TEAM APPROACH TO SUPPORT PARTICIPANTS IN ACHIEVING THEIR OWN GOALS FOR BETTER QUALITY OF LIFE. THE TEAM BUILDS TRUST WITH PARTICIPANTS OVER TIME BY SHOWING UP, MEETING THEM WHERE THEY ARE, AND HELPING THEM GET THE SUPPORT THEY NEED TO STAY WELL. SWIFT EXPANDED TWO YEARS AGO TO INCLUDE OPERATING AN EXTENSION OF THE MOBILE INTEGRATED HEALTH PROGRAM, CALLED MINOR DEFINITIVE CARE NOW (MDCN) MODEL, WHICH INCLUDED A PARAMEDIC-NP TEAM RESPONDING TO LOW ACUITY 911 CALLS AND PROVIDING CARE AT HOME. THIS MODEL AVOIDS UNNECESSARY TRANSPORTS AND ED VISITS. THE EXPANSION IS FUNDED THROUGH A GRANT FROM THE RURAL MARYLAND COUNCIL. SMITH ISLAND TELEHEALTH - SMITH ISLAND IS KNOWN FOR ITS WATERMEN, SMITH ISLAND CAKE, EXCEPTIONAL SEAFOOD AND BEING ISOLATED WITH LIMITED CONTACT FROM MAINLAND VISITORS. FOR THIS REASON, TIDALHEALTH PENINSULA REGIONAL'S COMMUNITY WELLNESS NURSE PRACTITIONER COORDINATES WITH A MEDICAL ASSISTANT WHO RESIDES ON THE ISLAND TO PROVIDE PREVENTATIVE HEALTH SCREENING, ACUTE VISITS, AND CONSULT WITH PATIENTS. THE GOAL OF THE PROGRAM IS TO IMPROVE THE HEALTH OF SMITH ISLAND RESIDENTS, WITH THE TARGET OF EFFECTIVELY REDUCING POTENTIALLY AVOIDABLE ED UTILIZATION. THE COMMUNITY WELLNESS TEAM AND PARTNERS SUCH AS A TIDALHEALTH PHARMACIST PROVIDE CHRONIC DISEASE EDUCATION, MANAGEMENT AND CONNECTS APPROXIMATELY 250 RESIDENTS OF SMITH ISLAND VIA TELEHEALTH AND IN-PERSON VISITS. THE MEDICAL ASSISTANT WHO RESIDES ON THE ISLAND IS CROSS TRAINED AS A COMMUNITY HEALTH WORKER. SHE IS ABLE TO EFFECTIVELY BRIDGE RELATIONSHIPS WITH THE RESIDENTS OF SMITH ISLAND. IN HER COMMUNITY HEALTH WORKER ROLE, SHE IS ESSENTIALLY A PERSONAL HEALTH COACH THAT ASSISTS RESIDENTS WITH MEDICATION MANAGEMENT, TIMELY COMPLIANCE AND ULTIMATELY HELPING GUIDE RESIDENTS THROUGH PRESCRIBED HEALTHCARE PLANS. FLU SHOTS WERE ADMINISTERED ENSURING THE RESIDENTS OF SMITH ISLAND WERE PROTECTED DURING THE FLU SEASON, EFFECTIVELY REDUCING ED VISITS. THE TEAM ALSO WORKS WITH THE HEALTH DEPARTMENT TO PROVIDE COVID-19 SCREENING AND VACCINATIONS. SINCE INCEPTION, THE PARTNERSHIP HAS HAD GREAT SUCCESSES. FOR EXAMPLE, THERE HAS BEEN SUBSTANTIAL REDUCTIONS IN A1C LEVELS IN RESIDENTS DIAGNOSED WITH DIABETES; A PRIME EXAMPLE OF THE "TRIPLE AIM" IMPROVING HEALTH, PROVIDING ACCESS, CHRONIC DISEASE EDUCATION, AND REDUCING THE PROBABILITY OF A FUTURE EMERGENCY DEPARTMENT VISIT. RESIDENTS ARE LEARNING HOW TO SELF-MANAGE THEIR CHRONIC DISEASES AND ARE BEING EXPOSED TO THE PRINCIPLES OF LEADING HEALTHY LIFESTYLES. A TEAM OF PROVIDERS INCLUDING A PHYSICIAN, NURSE PRACTITIONER AND PHARMACIST, VISIT THE ISLAND ON AVERAGE EVERY OTHER WEEK FROM APRIL - NOVEMBER. NEW PRIMARY CARE PROVIDER APPOINTMENTS ARE OFFERED TO COMMUNITY MEMBERS WITHOUT A PCP. IN FISCAL 2023 TIDALHEALTH BROUGHT BACK ITS ANNUAL HEALTH FAIR WHICH INCLUDED ACCESS TO A WIDE RANGE OF SCREENINGS, HEALTH PROMOTION INFORMATION, AND COMMUNITY RESOURCES.
PEARLS	PEARLS STANDS FOR PROGRAMS TO ENCOURAGE ACTIVE AND REWARDING LIVES. THIS PROGRAM, RUN BY MAC INC., THE AGENCY ON AGING, IS AN EVIDENCE-BASED PROGRAM THAT HELPS RESIDENTS AGED 60 AND OVER COMBAT DEPRESSION FROM LOSS OR FEELINGS OF ISOLATION. THE PROGRAM PROVIDES ONE-ON-ONE COUNSELING SESSIONS TO PARTICIPANTS WHO MAY FEEL DEPRESSED, FRUSTRATED, RESTLESS, OR ANXIOUS FROM DUE TO EVENTS IN THEIR LIFE. AS ONE AGES, THERE ARE LOSSES SUCH AS LOSS OF HEALTH, LOVED ONES, AND/OR INDEPENDENCE. A GRIEVING WIDOW WHO LOST THEIR SPOUSE OF FORTY YEARS MAY FEEL DEPRESSED AND LONELY NOW THAT THEIR PARTNER IS GONE. ANOTHER OLDER GENTLEMAN MAY FEEL FRUSTRATION AT NOT BEING ABLE TO BE AS INDEPENDENT AS HE ONCE WAS AT A YOUNGER AGE. PEARLS HELPS COUNSEL THE PATIENT AND PROVIDE GUIDANCE ON HOW TO MANAGE THEIR FEELINGS. ESPECIALLY DURING THE COVID-19 EPIDEMIC, MANY OLDER RESIDENTS IN THE TRI-COUNTY AREA ARE FEELING LONELY, DUE TO THE RESTRICTIONS ON NURSING HOMES AND FAMILIES NOT BEING ABLE TO GET TOGETHER WITH OLDER FAMILY MEMBERS. COVID-19 AFFECTS OLDER POPULATIONS WORSE THAN YOUNGER PEOPLE, AND BY THE ADVICE OF HEALTHCARE OFFICIALS, MANY FAMILIES ARE HAVING TO KEEP THEIR DISTANCE. WITH HELP FROM MAC, INC., THESE OLDER ADULTS CAN TALK TO A COUNSELOR AND IMPROVE THEIR QUALITY OF LIFE. TO EXPAND OUR "HEALTHY LIVING" MESSAGE, TIDALHEALTH PENINSULA REGIONAL SPONSORS AND PARTICIPATES IN MANY COMMUNITY-BASED HEALTH FAIRS PROVIDING NUTRITION EDUCATION, WEIGHT LOSS, DIABETES ASSESSMENT, MULTIPLE SCREENINGS AND HEALTH LITERACY. PARTICIPATION IN HEALTH FAIRS INCLUDE UNDERSERVED AREAS LIKE SMITH ISLAND, AN ISLAND ON THE CHESAPEAKE BAY WITH A POPULATION OF ONLY 250, A HAITIAN-CREOLE HEALTH FAIR, HEALTHFEST, DRIVE THRU FLU CLINICS, HEALTH SCREENING AND OUTREACH EVENTS IN LOCAL CHURCHES AND UNDERSERVED NEIGHBORHOODS TRANSFORMING THE CULTURE THROUGH PARTICIPATION AND SPONSORSHIP OF HEALTHY LIFESTYLES AND SCREENINGS, MEETING RESIDENTS AT COMMUNITY EVENTS LOCATED THROUGHOUT THE TRI-COUNTY AREA. THESE ACTIVITIES IMPROVE TRUST AMONG UNDERSERVED RESIDENTS. HEALTH ASSESSMENTS AVAILABLE AT THESE EVENTS INCLUDE, BUT ARE NOT LIMITED TO:- CHOLESTEROL, HDL, TRIGLYCERIDES - RESTING 12-LEAD EKG - BODY FAT / MASS INDEX - BLOOD PRESSURE TESTING - PULSE OXIMETRY TESTING - 10-YEAR RISK ANALYSIS - REVIEW CURRENT MEDICATIONS - FOLLOW-UP CARE PLAN - EXERCISE/NUTRITION WALK WICOMICO PROMOTES WALKING TRAILS, PERSONAL CHALLENGES, AND AVENUES TO ENJOY THE OUTDOORS- THE PRIMARY OBJECTIVE IS TO INCREASE AWARENESS OF AND ENGAGEMENT IN HEALTHY LIFESTYLE BEHAVIORS PROMOTING EXERCISE TO HELP WITH WEIGHT LOSS, INCREASE ENERGY, REDUCE RISK OF CHRONIC DISEASE AND MAKE PEOPLE FEEL HAPPIER. WALKWICOMICO IS PRIMARILY TARGETING THOSE THAT RESIDE IN THE COUNTY (POP. 100,000+); HOWEVER, IT WOULD ALSO BE AN ATTRACTION FOR ADJACENT COUNTIES INCLUDING VISITORS. TIDALHEALTH PENINSULA REGIONAL, AS A PARTICIPANT, HAS A COMMON GOAL TO TRANSFORM THE COMMUNITY'S CULTURE BY PROVIDING EDUCATION, GUIDANCE AND RESOURCES TOWARDS PROMOTING EXERCISE THROUGH WALKABILITY AS AN INTEGRAL PART OF A HEALTHY LIFESTYLE. THE COALITION'S INITIATIVES INCLUDED CREATING A WEBSITE AND PHONE APP SPECIFIC TO WALKING IN WICOMICO COUNTY; COMMUNICATING WITH THE COMMUNITY VIA SOCIAL MEDIA; WORKING WITH CIVIC ORGANIZATIONS, CHURCHES, LOCAL BUSINESSES, TOWNS, COUNTY HEALTH DEPARTMENTS AND OTHER GROUPS TO ENCOURAGE LOCAL WALKABILITY. WALKWICOMICO HAS MARKED WALKING ROUTES, INCREASED THE NUMBER OF WALKING ROUTES, PARTICIPATED IN AND LAUNCHED WALKING EVENTS, AND IS ENGAGED WITH DECISION MAKERS THROUGH INPUT AND FEEDBACK ABOUT MAKING WALKING SAFER EASIER AND MORE ACCESSIBLE. MAC, INC. CHRONIC DISEASE PROGRAMS MAC, INC. THE AREA AGENCY ON AGING OFFERS A PLETHORA OF SERVICES TO HELP MORE ACTIVE SENIORS LIVE THEIR LIVES TO THE FULLEST. THE COLLABORATION BETWEEN TIDALHEALTH PENINSULA REGIONAL AND MAC, INC., HAS BEEN IN PLACE FOR SEVERAL YEARS. MAC, INC. OFFERS A VARIETY OF CLASSES, EVENTS, ACTIVITIES, AND MEALS FOR THE SENIOR POPULATIONS OF THE AREA. THE PROGRAMS RUN BY MAC INCLUDE CHRONIC DISEASE SELF-MANAGEMENT, STEPPING ON FALLS PREVENTION, HEALTHY LIVING WITH HYPERTENSION, AND OTHER EXERCISE AND NUTRITION CLASSES. THE CHRONIC DISEASE SELF-MANAGEMENT EDUCATION PROGRAMS, WHICH INCLUDES CHRONIC CONDITIONS, DIABETES, AND CHRONIC PAIN, WERE DEVELOPED BY STANFORD UNIVERSITY IN 1990 AND HAVE GONE THROUGH RIGOROUS RANDOM CONTROLLED TRIALS TO SHOW EFFICACY AND EVIDENCE OF HEALTH IMPROVEMENT AMONG PARTICIPANTS. PARTICIPANTS LEARN TO COPE WITH THE FATIGUE, FRUSTRATION AND PAIN THAT ACCOMPANY CHRONIC DISEASE, AND EXERCISES FOR IMPROVING STRENGTH AND ENDURANCE, ALL WHICH HAVE BEEN SHOWN TO IMPROVE HEALTH AND DECREASE THE NUMBER OF HOSPITAL STAYS. THE STEPPING ON FALLS PREVENTION PROGRAM BUILDS SKILLS AND EXERCISES TO REDUCE FALLS AND INCREASE SELF-CONFIDENCE AND BEHAVIORAL CHANGE TO REDUCE RISK OF FALLING. STRENGTH AND BALANCE EXERCISES ARE TAUGHT BY PHYSICAL THERAPISTS.OTHER PROGRAMS THAT MAC INC. OFFERS INCLUDE CHRONIC PAIN SELF-MANAGEMENT, DIABETES PREVENTION, DIABETES SELF-MANAGEMENT AND WALKING WITH EASE. THESE PROGRAMS HAVE A SIMILAR FORMAT TO THE CHRONIC DISEASE SELF-MANAGEMENT PROGRAM. MANY PARTICIPANTS ARE ENROLLED IN MULTIPLE EVIDENCE-BASED PROGRAMS THROUGH MAC.A SUBSTANTIAL NUMBER OF PARTICIPANTS IN THESE PROGRAMS HAVE COMORBIDITIES SUCH AS DIABETES, CHRONIC PAIN, HEART DISEASE, STROKE, HYPERTENSION, ETC. THE EVIDENCE-BASED PROGRAMS OFFERED BY MAC, INC. ARE ESSENTIAL TO IMPROVING THE HEALTH OF THE COMMUNITIES WE SERVE AND ARE A GOOD FIRST STEP IN HELPING PEOPLE BECOME MORE EDUCATED ABOUT THEIR HEALTH. THIS COLLABORATION BETWEEN MAC, INC. THE AREA AGENCY ON AGING AND TIDALHEALTH PENINSULA REGIONAL IS A COMMUNITY BENEFIT THAT HAS MULTIPLE TOUCH POINTS THAT AFFECT THE OVERALL HEALTH OF OUR SENIOR AND OLDER ADULT COMMUNITY IN THE TRI-COUNTY AREA. ADULT DIABETES SUPPORT GROUPTHE ADULT DIABETES SUPPORT GROUP IS A PROGRAM GEARED TOWARDS ADULTS WITH DIABETES AND THEIR CAREGIVERS. THE PROGRAM HELPS TO PROVIDE SUPPORT, NETWORKING, EDUCATION, FELLOWSHIP AND TO PROMOTE COMMUNITY UNITY TO THESE ADULTS WITH DIABETES AND THEIR CAREGIVERS. KIDS AND TEENS DIABETES SUPPORT GROUPTHE KIDS AND TEENS DIABETES SUPPORT GROUP IS A PROGRAM GEARED TOWARDS KIDS, TEENS, AND THEIR CAREGIVERS. THE PROGRAM HELPS TO PROVIDE SUPPORT, NETWORKING, EDUCATION, FELLOWSHIP AND TO PROMOTE COMMUNITY UNITY TO THESE KIDS, TEENS, AND THEIR CAREGIVERS. THE PROGRAM STARTED IN FY 2021 WITH THE DIABETES AND NUTRITION TEAM AT TIDALHEALTH PENINSULA REGIONAL AND THEN TRANSITIONED INTO A LOCAL "HOME GROWN" COMMUNITY-BASED SUPPORT GROUP. NUTRITION AND DIABETES EDUCATION COMMUNITY EDUCATION PRESENTATIONSNUTRITION AND DIABETES EDUCATION DEPARTMENT PROVIDES COMMUNITY PRESENTATIONS AND EDUCATIONAL OPPORTUNITIES TO INCREASE AWARENESS AND EFFICACY AMONG PARTICIPANTS TO UNDERSTAND THE RISKS OF DIABETES, PREDIABETES AND HOW TO BETTER MANAGE THE CONDITIONS. A MEMBER OF THE NUTRITION AND DIABETES EDUCATION TEAM WAS THE PRECEPTOR FOR A LOCAL COLLEGE'S DIETETIC INTERNSHIP PROGRAM TO EDUCATE ON THE IMPORTANCE OF DIABETES EDUCATION IN THE TRI-COUNTY AREA.TRIBETRIBE STANDS FOR TRI-COUNTY BEHAVIORAL HEALTH ENGAGEMENT. THIS NEWLY FORMED COLLABORATION IS A REGIONAL PARTNERSHIP BETWEEN TIDALHEALTH PENINSULA REGIONAL, ATLANTIC GENERAL HOSPITAL AND NINE BEHAVIORAL HEALTH COMMUNITY PARTNER AGENCIES IN SOMERSET, WICOMICO, AND WORCESTER COUNTIES. THE IMMEDIATE GOAL IS TO DESIGN BEHAVIORAL HEALTH CRISIS STABILIZATION CENTERS OR BEHAVIORAL HEALTH URGENT CARE CENTERS WITHIN THE TRI-COUNTY AREA. THE PRIMARY OBJECTIVES OF THIS PROGRAM ARE TO REDUCE ED UTILIZATION, HOSPITAL ADMISSIONS TO BOTH TIDALHEALTH PENINSULA REGIONAL AND ATLANTIC GENERAL HOSPITAL AND READMISSIONS FOR INDIVIDUALS EXPERIENCING BEHAVIORAL HEALTH ISSUES IN THE TRI-COUNTY AREA. TRIBE MET THROUGHOUT THE YEAR TO DISCUSS AND IDENTIFY GAPS AND FRAGMENTATION OF SERVICES IN THE AREA WITH THE GOAL OF PROVIDING MORE SEAMLESS AND "REAL TIME" BEHAVIORAL HEALTH URGENT CARE AND BEHAVIORAL HEALTH CARE SERVICES.HEALING SEATED YOGAA PROGRAM THROUGH WHICH CANCER PATIENTS AND THEIR CAREGIVERS PRACTICE YOGA. STUDIES HAVE INDICATED THAT YOGA CAN COMPLEMENT CANCER TREATMENT AND IT IS USEFUL IN HELPING HEAL THE BODY AND SPIRIT. THE GOAL IS TO HELP THE PATIENT AND THEIR CAREGIVERS REDUCE STRESS, LOWER FATIGUE, IMPROVE DAILY LIVING ACTIVITIES AND IMPROVE SLEEP.
WHAT'S COOKING	THE WHAT'S COOKING PROGRAM TEACHES CANCER PATIENTS AND THEIR CAREGIVERS HOW TO MODIFY THEIR DIETS TO HELP BUILD STRENGTH TO WITHSTAND THE EFFECT OF CANCER TREATMENTS. THIS EDUCATIONAL CLASS STRESSES THE IMPORTANCE OF LIMITING SUGAR, ALCOHOL, AND SALT. A REGISTERED DIETICIAN LEADS THE CLASS AND TEACHES CANCER PATIENTS AND THEIR CAREGIVERS HOW TO PREPARE HEALTHY FOOD DISHES USING FRUITS, VEGETABLES, BEANS, AND HEALTHY GRAINS. THE REGISTERED DIETICIAN ALSO HAS TOPICS OF DISCUSSION DURING THESE SESSIONS AND THE PARTICIPANTS CAN TASTE TEST THE DISHES AND ASK QUESTIONS.TAI CHI FOR BETTER BALANCETHE TAI CHI FOR BETTER BALANCE PROGRAM IMPROVES PHYSICAL STRENGTH, BALANCE, CIRCULATION, STRESS LEVELS AND AMBULATION AMONG CANCER PATIENTS. THE PROGRAM IS LED BY AN INSTRUCTOR WHO TEACHES HOUR LONG CLASSES FOR A VARIETY OF PATIENT LEVELS. TAI CHI CLASSES ARE OFFERED IN MANY HOSPITALS AND CANCER CENTERS. THE CLASSES HELP SUPPORT RECOVERY AND AMBULATION, WHICH IS CRITICAL FOR CANCER PATIENTS IN THEIR BATTLE. PROSTATE CANCER SUPPORT GROUPTHIS PROGRAM MEETS BI-MONTHLY FOR PATIENTS AND THEIR CAREGIVERS WHO HAVE BEEN AFFECTED BY PROSTATE CANCER. THE GOAL OF THIS SUPPORT GROUP IS TO PROVIDE EMOTIONAL SUPPORT TO FAMILIES OF PROSTATE CANCER PATIENTS IN ADDITION TO HELPING LOVED ONES ADJUST TO SUPPORTING THEIR FAMILY MEMBER WHO HAS PROSTATE CANCER. IT HAS IMPROVED PSYCHOLOGICAL WELLBEING OF PATIENTS, REDUCED ANXIETY AND DEPRESSION, AND OVERALL IMPROVED THE QUALITY OF LIFE FOR THESE PATIENTS GOING THROUGH PROSTATE CANCER. CANCER THRIVING AND SURVIVINGTHIS CLASS IS FOR CURRENT CANCER PATIENTS AND THEIR CAREGIVERS TO EDUCATE ABOUT THE DIFFICULTIES ASSOCIATED WITH CANCER DIAGNOSIS AND CANCER TREATMENT. CANCER PATIENTS AND THEIR FAMILIES ARE PROVIDED WITH THE TOOLS NEEDED TO LIVE A HEALTHIER LIFE. CANCER SURVIVOR CAREGIVER SUPPORT GROUPTHIS PROGRAM GATHERS SURVIVORS, CURRENT CANCER PATIENTS AND CAREGIVERS FROM PAST AND PRESENT TO OFFER SUPPORT AND CONNECT WITH EACH OTHER. THE WEEKLY SUPPORT GROUP'S FOCUSES ARE TO EDUCATE, NETWORK AND ENJOY FELLOWSHIP WITH PAST AND PRESENT CANCER PATIENTS AND THEIR CAREGIVERS. THIS NETWORK CAN PROVIDE ADVICE ABOUT CURRENT AND FUTURE DIFFICULTIES THAT CURRENT CANCER PATIENTS AND THEIR CAREGIVERS MAY FACE.FOOD DISTRIBUTIONTHIS PROGRAM IS USED TO PROVIDE CLEAN, NUTRITIOUS FOOD TO NOURISH PATIENTS IN THEIR FIGHT AGAINST CANCER. A SHARE OF ORGANIC VEGETABLES IS PROVIDED TO CANCER PATIENTS AND CANCER SURVIVORS. DURING THE MONTHS OF MAY-OCTOBER, VEGETABLES ARE PRIMARILY PROVIDED FROM THE HEALING ROSE GARDEN. DURING THE MONTHS OF DECEMBER-APRIL OR DURING PERIODS OF LOW VEGETABLE PRODUCTION, VEGETABLES ARE PURCHASED BY A LOCAL ORGANIZATION TO PROVIDE FOR CANCER PATIENTS. THIS PROGRAM IS ESPECIALLY VALUABLE FOR CANCER PATIENTS WHO HAVE FOOD INSECURITIES OR COME FROM A POORER QUALITY OF LIFE AND CANNOT AFFORD THESE NUTRITIOUS FOODS. THESE WHOLESOME, CLEAN FOOD HELPS TO OVERCOME FOOD INSECURITY AND GET CANCER PATIENTS HEALTHIER.TIDALHEALTH PENINSULA REGIONAL PARTICIPATES WITH MANY PARTNERS THAT MAKE IT POSSIBLE TO CREATE AND DELIVER POPULATION PROGRAMS THAT IMPROVE THE HEALTH OF THE COMMUNITIES WE SERVE. THESE PARTNERS HAVE PROVIDED EXPERTISE AND ALLOCATED RESOURCES TO MEET THOSE URGENT HEALTHCARE NEEDS WITHIN OUR COMMUNITY. SOME OF THESE PARTNERS INCLUDE: WICOMICO COUNTY HEALTH DEPARTMENT, SOMERSET COUNTY HEALTH DEPARTMENT, WORCESTER COUNTY HEALTH DEPARTMENT, WICOMICO COUNTY LOCAL HEALTH IMPROVEMENT COALITION, THE CITY OF SALISBURY, YMCA, CRISFIELD CLINIC, CHESAPEAKE HEALTH CARE, SWIFT, SALISBURY FIRE DEPARTMENT/EMS, ATLANTIC GENERAL HOSPITAL, FAITH BASED ORGANIZATIONS, MAC (MAINTAINING ACTIVE CITIZENS), LOCAL COLLEGES/ AND SCHOOLS, C.O.A.T., NATIONAL KIDNEY FOUNDATION, PENINSULA REGIONAL EMPLOYEES, POST-ACUTE CARE FACILITIES, HALO, WALK WICOMICO (COALITION), LOWER SHORE CLINIC, WICOMICO COUNTY SHERIFF'S OFFICE, RESOURCE AND RECOVERY CENTER AND OTHERS. SHERIFF'S OFFICE, RESOURCE AND RECOVERY CENTER AND OTHERS.REMOTE PATIENT MONITORING THE REMOTE PATIENT MONITORING PROGRAM AT TIDALHEALTH HELPS MEDICARE PATIENTS WITH CHRONIC CONDITIONS LIKE DIABETES, COPD, CHF, OR RESPIRATORY FAILURE ADHERE TO PROTOCOLS, MEDICATIONS, AND MEDICAL INSTRUCTIONS. EQUIPMENT IS RENTED TO THE PATIENT FREE OF CHARGE AFTER DISCHARGE FROM THE HOSPITAL FOR 60 DAYS. DURING THE 60-DAY PERIOD, HEALTHCARE WORKERS HELP TO EDUCATE THE PATIENT ON MONITORING THEIR VITALS, MEDICATIONS, ETC. TO REDUCE READMISSION RATES TO THE HOSPITAL AND INCREASE PATIENT/CAREGIVER ENGAGEMENT. AFTER THE 60-DAY PERIOD, PATIENTS ARE ENCOURAGED TO PURCHASE THEIR OWN MONITORING EQUIPMENT WHICH THEN CAN BE USED IN THE FUTURE FOR SELF-MONITORING. GRADUATE MEDICAL EDUCATIONTIDALHEALTH LAUNCHED ITS GRADUATE MEDICAL EDUCATION PROGRAM TO HOST RESIDENCY AND FELLOWSHIP TRAINING PROGRAMS IN A SELECT NUMBER OF SPECIALTIES. CURRENTLY, TIDALHEALTH HAS GME PROGRAMS FOR INTERNAL MEDICINE, GENERAL SURGERY, AND ANESTHESIOLOGY, WITH A PLAN TO ADD MORE SPECIALTIES IN THE COMING YEARS. THE GME PROGRAM HAS TWO PRIMARY GOALS: TO TRAIN THE NEXT GENERATION OF PHYSICIANS AND TO ADDRESS THE ISSUE OF DISPARITY AND PHYSICIAN SHORTAGE ON THE EASTERN SHORE. IT IS OUR HOPE THAT THE RESIDENCY AND FELLOWSHIP PROGRAMS ATTRACT AND KEEP OUTSTANDING PHYSICIANS IN OUR COMMUNITY AFTER THE COMPLETION OF THEIR GME PROGRAM TO PROVIDE HIGH-QUALITY CARE AND IMPROVE POPULATION HEALTH AND ACCESS TO CARE.HEALTH FAIRS AND COMMUNITY WELLNESS OUTREACHTIDALHEALTH HOSTS AND ATTENDS NUMEROUS HEALTH FAIRS AND COMMUNITY BASED WELLNESS EVENTS, SUCH AS THE SALISBURY HEALTH FEST, SMITH ISLAND HEALTH FAIR, AND HOSTS DRIVE-THRU FLU CLINICS. THESE INITIATIVES ALLOW HEALTHCARE PROFESSIONALS TO PROVIDE SCREENING SERVICES TO THE GENERAL PUBLIC AND HELP REFER THEM TO THE NECESSARY RESOURCES IF UNFAVORABLE OR ABNORMAL SCREENING RESULTS ARE OBTAINED. THIS OUTREACH ALSO ADDRESSES OVERALL COMMUNITY WELLNESS BY ENCOURAGING INDIVIDUALS TO BE CONSIOUS OF THEIR HEALTH AND TAKE A MORE ACTIVE ROLE IN PREVENTION AND OVERALL WELLBEING. WAGNER WELLNESS VANTHE WAGNER WELLNESS VAN IS A MOBILE MEDICAL UNIT THAT PROVIDES SERVICES SUCH AS BLOOD PRESSURE CHECKS, DIABETES ASSESSMENTS, REFERRALS AND LINKS TO PRIMARY CARE, SEASONAL FLU SHOTS, AND MORE. THE VAN REACHES UNDERSERVED COMMUNITIIES ON THE LOWER EASTERN SHORE. SOME OF THE LOCATIONS THE WELLNESS VAN VISITS INCLUDE COLD WEATHER SHELTERS, HOMELESS SHELTERS, OUTREACH EVENTS TARGETING SPECIFIC COMMUNITIES SUCH AS MIGRANTS, THOSE SUFFERING WITH MENTAL HEALTH CONDITIONS, BACK TO SCHOOL EVENTS, THE LOWER SHORE CLINIC, THE BLIND INDUSTRIES, HEALTH FAIRS, AND CHURCHES WHEN CONDUCTING CHARITY OR HOMELESS OUTREACH.
PART VI, LINE 6:	AFFILIATED HEALTH CARE SYSTEM ROLESTIDALHEALTH IS ANCHORED BY TWO HOSPITALS, TIDALHEALTH PENINSULA REGIONAL AND TIDALHEALTH NANTICOKE. IN ADDITION, TIDALHEALTH INCLUDES AN EXPANSIVE PHYSICIAN NETWORK (TIDALHEALTH PENINSULA MEDICAL GROUP) WITH MORE THAN 300 PROVIDERS IN 24 SPECIALTIES ACROSS 32 LOCATIONS. TIDALHEALTH PENINSULA REGIONAL IS PART OF TIDALHEALTH. THE SYSTEM INCLUDES A FOUNDATION AND ENTITIES WITH INTERESTS IN VARIOUS HEALTH CARE JOINT VENTURES. IN ADDITION TO THE COMMUNITY BENEFITS PROVIDED BY THE MEDICAL CENTER, THE HEALTH SYSTEM EVALUATES THE NEEDS OF THE COMMUNITY AND WILL PARTICIPATE IN COMMUNITY BENEFIT PROGRAMS AS NEEDED AS COLLABORATORS WITH OUR OTHER ENTITIES AND THOSE PARTNERS OUTSIDE OF OUR SYSTEM.PART VI, LINE 7:COMMUNITY BENEFIT REPORT STATE FILINGSSTATE(S) WITH WHICH THE ORGANIZATION FILES A COMMUNITY BENEFIT REPORT:MARYLAND

Schedule H (Form 990) 2023

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Schedule I
(Form 990)

Department of the Treasury
Internal Revenue Service

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

Complete if the organization answered "Yes," on Form 990, Part IV, line 21 or 22.
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Attach to Form 990.
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Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2023

Open to Public
Inspection

Name of the organization
TIDALHEALTH PENINSULA REGIONAL INC

Employer identification number
52-0591628

Part I

General Information on Grants and Assistance

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

Yes No

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

Part II

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

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

(a) Name and address of organization or government	(b) EIN	(c) IRC section (if applicable)	(d) Amount of cash grant	(h) Purpose of grant or assistance
(1) UNIVERSITY OF MARYLAND EASTERN SHORE 11868 ACADEMIC OVAL PRINCESS ANNE,MD21853	52-6002033	GOVERNMENT	25,000	GENERAL DONATION
(2) DELAWARE TECHNICAL AND COMMUNITY COLLEGE 21179 COLLEGE DR GEORGETOWN,DE19947	51-6000279	501(C)(3)	10,000	EVENT SPONSORSHIP
(3) COASTAL HOSPICE INC PO BOX 1733 SALISBURY,MD21802	52-1214775	501(C)(3)	7,000	EVENT SPONSORSHIP

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

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

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

Cat. No. 50055P

Schedule I (Form 990) 2023

Page 2

Part III

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

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

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

Part IV

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

Return Reference	Explanation
PART I, LINE 2:	THE ORGANIZATION CHOOSES TO SUPPORT OTHER PUBLIC CHARITIES WHICH ALSO WORK TO IMPROVE THE COMMUNITY SERVED BY THE HOSPITAL.

Schedule I (Form 990) 2023

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Schedule J
(Form 990)

Department of the Treasury
Internal Revenue Service

Compensation Information

For certain Officers, Directors, Trustees, Key Employees, and Highest
Compensated Employees
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Complete if the organization answered "Yes" on Form 990, Part IV, line 23.
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Attach to Form 990.
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Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2023

Open to Public Inspection

Name of the organization

TIDALHEALTH PENINSULA REGIONAL INC

Employer identification number

52-0591628

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

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) 2023

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)
1STEVEN LEONARD PRESIDENT/CEO	(i) (ii)	0 ------------- 874,064	0 ------------- 236,259	0 ------------- 72,447	0 ------------- 71,005	0 ------------- 26,443	0 ------------- 1,280,218	0 ------------- 0
2LURA LUNSFORD V.P. OPERATIONS	(i) (ii)	0 ------------- 697,278	0 ------------- 113,617	0 ------------- 6,513	0 ------------- 68,007	0 ------------- 7,708	0 ------------- 893,123	0 ------------- 0
3TRUDY HALL MD V.P. CHIEF MEDICAL OFFICER	(i) (ii)	0 ------------- 514,873	0 ------------- 73,625	0 ------------- 13,871	0 ------------- 32,647	0 ------------- 25,882	0 ------------- 660,898	0 ------------- 0
4STEPHANIE GARY V.P. FINANCE/CFO	(i) (ii)	0 ------------- 509,284	0 ------------- 78,505	0 ------------- 1,262	0 ------------- 36,919	0 ------------- 22,733	0 ------------- 648,703	0 ------------- 0
5JAMES TRUMBLE MD V.P. CLINICAL INTEGRATION	(i) (ii)	0 ------------- 399,129	0 ------------- 54,789	0 ------------- 0	0 ------------- 19,863	0 ------------- 17,506	0 ------------- 491,287	0 ------------- 0
6TIMOTHY FEIST V.P CHIEF COMPLIANCE OFF. THRU 01/24	(i) (ii)	0 ------------- 331,413	0 ------------- 45,026	0 ------------- 8,424	0 ------------- 89,355	0 ------------- 16,129	0 ------------- 490,347	0 ------------- 0
7DAVID SECHLER MD BOARD MEMBER/PHYSICIAN	(i) (ii)	0 ------------- 361,048	0 ------------- 43,969	0 ------------- 1,218	0 ------------- 39,384	0 ------------- 15,636	0 ------------- 461,255	0 ------------- 0
8SARAH SCOTT V.P. PEOPLE & ORGANIZATON DEV	(i) (ii)	0 ------------- 340,899	0 ------------- 44,807	0 ------------- 1,218	0 ------------- 69,395	0 ------------- 337	0 ------------- 456,656	0 ------------- 0
9BRUCE RITCHIE FORMER CFO THRU 01/23	(i) (ii)	0 ------------- 167,966	0 ------------- 0	0 ------------- 258,152	0 ------------- 28,600	0 ------------- 1,087	0 ------------- 455,805	0 ------------- 217,958
10KATHRYN FIDDLER V.P. POPULATION HEALTH	(i) (ii)	0 ------------- 335,624	0 ------------- 47,277	0 ------------- 1,218	0 ------------- 43,626	0 ------------- 2,205	0 ------------- 429,950	0 ------------- 0
11KARIN DIBARI FMR. V.P. TH MED. PTNRS. THRU 10/22	(i) (ii)	0 ------------- 0	0 ------------- 0	0 ------------- 407,246	0 ------------- 0	0 ------------- 12,277	0 ------------- 419,523	0 ------------- 0
12ANGELA BRITTINGHAM CHIEF NURSING OFFICER	(i) (ii)	0 ------------- 246,525	0 ------------- 26,690	0 ------------- 422	0 ------------- 34,170	0 ------------- 14,542	0 ------------- 322,349	0 ------------- 0

Schedule J (Form 990) 2023

Page 3

Part III

Supplemental Information

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

Return Reference	Explanation
PART I, LINE 3	PROCESS FOR DETERMINING COMPENSATION A COMPENSATION COMMITTEE OF TIDALHEALTH INC. (THI), THE SOLE CORPORATE MEMBER OF THE FILING ORGANIZATION, DETERMINES THE COMPENSATION OF THE CEO/EXECUTIVE DIRECTOR OF THE ORGANIZATION. THE COMPENSATION COMMITTEE USES AN INDEPENDENT CONSULTANT, COMPENSATION SURVEYS, AND OTHER ORGANIZATION'S FORM 990 IN THE DETERMINATION PROCESS AND KEEPS CONTEMPROANEOUS RECORDS OF DECISIONS MADE.
PART I, LINE 4A-B	SEVERANCE THE FOLLOWING INDIVIDUALS RECEIVED SEVERANCE PAYMENTS DURING 2023. THESE AMOUNTS ARE REPORTED IN SCHEDULE J, PART II, COLUMN (B) (III): KARIN DIBARI $407,155 SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN THI HAS A NON-QUALIFIED SUPPLEMENTAL RETIREMENT PLAN (UNDER SECTION 457 (F)). THIS PLAN WAS APPROVED BY THE COMPENSATION COMMITTEE OF THE THI BOARD OF DIRECTORS TO SUPPLEMENT THE EXECUTIVE'S RETIREMENT INCOME. THE SUPPLEMENTAL RETIREMENT PLAN WAS DEVELOPED BASED ON AN INDEPENDENT CONSULTANT REPORT ON MARKET-BASED PRACTICES FOR SUPPLEMENTAL RETIREMENT PLANS. THE PERCENTAGE OF FINAL AVERAGE PAY, THE REQUIREMENTS FOR VESTING, PARTICIPANTS, AND PAY-OUT PROVISIONS WERE ESTABLISHED, REVIEWED, AND APPROVED BY THE COMPENSATION COMMITTEE. THE CONTRIBUTIONS TO THE SUPPLEMENTAL NON-QUALIFIED RETIREMENT PLAN ARE INCLUDED IN SCHEDULE J, PART II, COLUMN C OR IN SCHEDULE J, PART II, COLUMN B(III) AS PART OF DEFERRED COMPENSATION. THE FOLLOWING INDIVIDUALS PARTICIPATED IN THIS SUPPLEMENTAL NON-QUALIFIED RETIREMENT PLAN: STEVEN LEONARD BRUCE RITCHIE THE FOLLOWING INDIVIDUAL RECEIVED A DISTRIBUTION DURING 2023 BASED ON THEIR PLAN'S VESTING DATE: BRUCE RITCHIE $217,958
PART I, LINE 6A, 6B AND 7:	CONTINGENT COMPENSATION AND NON-FIXED PAYMENTS OFFICERS, KEY EMPLOYEES AND CERTAIN PHYSICIAN DIRECTORS OF THE FILING ORGANIZATION ARE PAID BY THI. THE COMPENSATION IS DETERMINED BY A NUMBER OF VARIABLES INCLUDING BUT NOT LIMITED TO INDIVIDUAL GOALS AS WELL AS ORGANIZATION OPERATIONAL ACHIEVEMENTS IN SERVICE, QUALITY, SAFETY, EMPLOYEE SATISFACTION, AND COST. THE FINAL DETERMINATION OF THE CONTINGENT COMPENSATION AMOUNT IS DETERMINED AND APPROVED BY THE BOARD AS PART OF THE OVERALL COMPENSATION REVIEW OF THOSE EMPLOYEES.

Schedule J (Form 990) 2023

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.
Attach to Form 990 or 990-EZ.
Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2023

Open to Public
Inspection

Name of the organization

TIDALHEALTH PENINSULA REGIONAL INC

Employer identification number

52-0591628

Return Reference	Explanation
FORM 990, PART V, LINES 1A & 2A	THE FILING ORGANIZATION HAS ENTERED "0" IN PART V, LINE 1A AND LINE 2A BECAUSE THE ORGANIZATION'S 1099 AND W-2 RETURNS ARE FILED BY AND UNDER THE NAME AND EIN OF TIDALHEALTH, INC., A RELATED ENTITY, UNDER A SHARED SERVICES AGREEMENT. ACCORDINGLY, THE REQUIRED DISCLOSURES RELATED TO EMPLOYEES AND INDEPENDENT CONTRACTORS ARE INCLUDED ON THE FORM 990 OF TIDALHEALTH, INC.
FORM 990, PART VI, SECTION A, LINE 2	BUSINESS RELATIONSHIPS STEVEN LEONARD AND MEMO DIRIKER ARE MEMBERS OF THE BOARD OF DIRECTORS OF PENINSULA HEALTH VENTURES, A WHOLLY-OWNED TAXABLE SUBSIDIARY OF TIDALHEALTH, INC. STEPHANIE GARY, TPR'S CFO, ALSO SERVES AS SECRETARY/TREASURER OF PENINSULA HEALTH VENTURES.
FORM 990, PART VI, SECTION A, LINE 6	MEMBERS OR STOCKHOLDERS TIDALHEALTH, INC. IS THE SOLE CORPORATE MEMBER OF TIDALHEALTH PENINSULA REGIONAL, INC.
FORM 990, PART VI, SECTION A, LINE 7A	ELECTION OF MEMBERS OF GOVERNING BODY IN ITS CAPACITY AS THE SOLE CORPORATE MEMBER OF THE ORGANIZATION, TIDALHEALTH, INC. HAS THE ABILITY TO ELECT MEMBERS OF THE ORGANIZATION'S GOVERNING BODY.
FORM 990, PART VI, SECTION A, LINE 7B	DECISIONS SUBJECT TO APPROVAL AS THE SOLE CORPORATE MEMBER, TIDALHEALTH, INC. HAS THE ABILITY TO APPROVE MAJOR EXPENDITURES AND LONG-TERM BORROWINGS OF THE ORGANIZATION.
FORM 990, PART VI, SECTION B, LINE 11B	FORM 990 REVIEW PROCESS OVERSIGHT OF THE COMPLETION OF THE ORGANIZATION'S FORM 990 HAS BEEN DELEGATED TO THE CHIEF FINANCIAL OFFICER OF TIDALHEALTH, INC. BY THE PRESIDENT OF THE ORGANIZATION. ONCE THE FORM 990 AND ALL SCHEDULES HAVE BEEN PREPARED BY THE ORGANIZATION'S INDEPENDENT TAX SERVICES PROVIDER, THEY ARE REVIEWED BY THE PRESIDENT PRIOR TO FILING. A COPY OF THE FORM 990 WAS MADE AVAILABLE TO ALL MEMBERS OF THE GOVERNING BODY PRIOR TO THE FILING WITH IRS.
FORM 990, PART VI, SECTION B, LINE 12C	CONFLICT OF INTEREST POLICY MONITORING & ENFORCEMENT THE BOARD OF DIRECTORS ARE REQUIRED TO DISCLOSE ANNUALLY, IN WRITING, ANY AND ALL INTERESTS WHICH THEY OR ANY IMMEDIATE MEMBER OF THEIR FAMILY MAY HAVE IN ANY BUSINESS ENTITY WHICH HAS OR SEEKS A CONTRACTUAL OR COMPETITIVE RELATIONSHIP WITH THE ORGANIZATION. THE BOARD HAS THE AUTHORITY TO DETERMINE IF A VIOLATION HAS OCCURRED AND WHETHER ANY INTEREST WHICH SHOULD BE DISCLOSED SHOULD DISQUALIFY A DIRECTOR FROM PARTICIPATING IN ANY SPECIFIC BOARD DISCUSSION OR BOARD MEMBERSHIP. ALL DISCLOSURES ARE REVIEWED BY THE ORGANIZATION'S CHIEF COMPLIANCE OFFICER. ANY CONFLICTS ARE PRESENTED TO THE BOARD. IF A PERSON IS CONFLICTED, THEY WILL RECUSE THEMSELVES FROM ALL DISCUSSIONS AND DELIBERATIONS TO WHICH THEY WOULD APPEAR TO BE CONFLICTED.
FORM 990, PART VI, SECTION B, LINE 15	PROCESS FOR DETERMINING COMPENSATION A COMPENSATION COMMITTEE OF TIDALHEALTH INC. (THI), THE SOLE CORPORATE MEMBER OF THE FILING ORGANIZATION, DETERMINES THE COMPENSATION OF THE CEO/EXECUTIVE DIRECTOR OF THE ORGANIZATION. THE COMPENSATION COMMITTEE USES AN INDEPENDENT CONSULTANT, COMPENSATION SURVEYS, AND OTHER ORGANIZATION'S FORM 990 IN THE DETERMINATION PROCESS AND KEEPS CONTEMPROANEOUS RECORDS OF DECISIONS MADE.
FORM 990, PART VI, SECTION C, LINE 19	HOW DOCUMENTS ARE MADE AVAILABLE TO THE PUBLIC THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, FINANCIAL STATEMENTS, AND FORM 990 ARE AVAILABLE TO THE PUBLIC UPON REQUEST TO THE PUBLIC INFORMATION OFFICE OF TIDALHEALTH PENINSULA REGIONAL AT 100 EAST CARROLL STREET, SALISBURY, MD 21801.
FORM 990, PART IX, LINE 11G	PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 77,407,003. MANAGEMENT AND GENERAL EXPENSES 9,321,535. FUNDRAISING EXPENSES 226,082. TOTAL EXPENSES 86,954,620.
FORM 990, PART X, LINE 20:	TAX EXEMPT BONDS IN MAY 2020, MHHEFA AUTHORIZED THE ISSUANCE OF $95,995,000 AGGREGATE PRINCIPAL AMOUNT OF REVENUE BONDS (SERIES 2020A REVENUE BONDS) AT A PREMIUM OF $5,944,000. THE OBLIGATED GROUP FOR THE 2020A CONSISTS OF TIDALHEALTH, INC., TPR, AND TN. SUPPLEMENTAL INFORMATION ON TAX-EXEMPT BONDS REPORTED ON SCHEDULE K OF FORM 990 FOR TIDALHEALTH INC., THE PARENT ORGANIZATION.
FORM 990, PART XI, LINE 9:	PENSION ADJUSTMENT 1,511,635. CHANGE IN ENDOWMENT 880,239. INVESTMENT IN SUBSIDIARIES -124,317,759.

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

Cat. No. 51056K

Schedule O (Form 990) 2023

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.
Attach to Form 990.
Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2023

Open to Public Inspection

Name of the organization

TIDALHEALTH PENINSULA REGIONAL INC

Employer identification number

52-0591628

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)TIDALHEALTH INC 100 EAST CARROLL STREET SALISBURY,MD21801 52-2132761	PARENT	MD	501(C)(3)	LINE 10	N/A		No
(2)TIDALHEALTH FOUNDATION INC 100 EAST CARROLL STREET SALISBURY,MD21801 52-1851935	FUNDRAISING	MD	501(C)(3)	LINE 7	TIDALHEALTH INC		No
(3)TIDALHEALTH PHYSICIAN NETWORK 801 MIDDLEFORD ROAD SEAFORD,DE19973 51-0224470	HEALTH SERVICES	DE	501(C)(3)	LINE 10	TIDALHEALTH INC		No
(4)TIDALHEALTH NANTICOKE INC 801 MIDDLEFORD ROAD SEAFORD,DE19973 51-0069243	HOSPITAL	DE	501(C)(3)	LINE 3	TIDALHEALTH INC		No
(5)DELMARVA PENINSULA INSURANCE COMPANY PO BOX 1159 GRAND CAYMAN,GRAND CAYMANKY1-1102 CJ 98-1110617	INSURANCE	CJ	501(C)(3)		TIDALHEALTH INC		No
(6)PENINSULA GENERAL HOSPITAL INS TRUST 100 EAST CARROLL STREET SALISBURY,MD21801 52-6321234	INSURANCE	MD	501(C)(3)	LINE 12C, III-FI	TIDALHEALTH INC		No
(7)MCCREADY FOUNDATION INC 201 HALL HIGHWAY CRISFIELD,MD21817 52-0607921	HOSPITAL	MD	501(C)(3)	LINE 10	TIDALHEALTH INC		No

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

Cat. No. 50135Y

Schedule R (Form 990) 2023

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) DELMARVA ENDOSC CTR 11103 CATHAGE ROAD BERLIN,MD21801 83-1509115	HEALTH CARE	MD	N/A				No			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) PENINSULA HEALTH VENTURES (PHV) 100 EAST CARROLL STREET SALISBURY,MD21801 52-2250012	P'SHIP INVESTMENT	MD	N/A	C					No
(2) PRLTC INC 100 EAST CARROLL STREET SALISBURY,MD21801 52-2190588	LONG TERM CARE	MD	N/A	C					No

Schedule R (Form 990) 2023

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

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

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

Yes

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

Yes

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

Yes

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

Yes

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

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

Yes

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

Yes

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

Yes

If the answer to any of the above is "Yes," see the instructions for information on who must complete this line, including covered relationships and transaction thresholds.

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

Schedule R (Form 990) 2023

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) 2023

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) 2023

Additional Data

Software ID:
Software Version:

1	Briefly describe the organization’s mission or most significant activities: IMPROVE THE HEALTH OF THE COMMUNITIES WE SERVE.
2	Check this box
3	Number of voting members of the governing body (Part VI, line 1a) ........	3	13
4	Number of independent voting members of the governing body (Part VI, line 1b) .....	4	10
5	Total number of individuals employed in calendar year 2023 (Part V, line 2a) ......	5	0
6	Total number of volunteers (estimate if necessary) .............	6	100
7a	Total unrelated business revenue from Part VIII, column (C), line 12 ........	7a	8,952,889
b	Net unrelated business taxable income from Form 990-T, Part I, line 11 .........	7b	1,990,851

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........	8,559,039	2,537,218
9	Program service revenue (Part VIII, line 2g) .........	505,004,219	543,698,925
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	13,321,804	26,738,082
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	842,662	2,493,548
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)	527,727,724	575,467,773
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...	53,200	59,625
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)	223,148,225	226,301,489
16a	Professional fundraising fees (Part IX, column (A), line 11e) .....	0	0
b	Total fundraising expenses (Part IX, column (D), line 25) 1,308,010
17	Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e)....	277,795,239	276,779,126
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	500,996,664	503,140,240
19	Revenue less expenses. Subtract line 18 from line 12.......	26,731,060	72,327,533
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	711,052,938	746,869,059
21	Total liabilities (Part X, line 26).............	154,532,721	214,258,711
22	Net assets or fund balances. Subtract line 21 from line 20.....	556,520,217	532,610,348

Sign Here

	Signature of officer	Date

	Type or print name and title


4a	(Code: ) (Expenses $ 447,901,988 including grants of $ 59,625 ) (Revenue $ 534,978,606 )
	SEE SCHEDULE OTIDALHEALTH PENINSULA REGIONAL IS A NOT-FOR-PROFIT 501(C)(3) NON-STOCK CORPORATION FOUNDED IN 1897 TO SERVE THE HEALTH CARE NEEDS OF THE COMMUNITY. THE HOSPITAL'S PRIMARY PURPOSE IS TO PROVIDE THE HIGHEST PRIMARY, SECONDARY, AND SELECTED TERTIARY HEALTH CARE SERVICES TO RESIDENTS OF AND VISITORS TO THE MID-DELMARVA PENINSULA IN A COMPETENT, COMPASSIONATE, AND COST-EFFECTIVE MANNER DESIGNED TO ELICIT A HIGH DEGREE OF CUSTOMER SATISFACTION. THE HOSPITAL'S MISSION IS TO IMPROVE THE HEALTH OF THE COMMUNITIES WE SERVE BY PROVIDING QUALITY MEDICAL CARE REGARDLESS OF RACE, CREED, SEX, NATIONAL ORIGIN, HANDICAP, OR AGE. IF A PATIENT IS UNABLE TO PAY DUE TO FINANCIAL RESOURCES, EFFORTS WILL BE TAKEN TO ASSURE CARE AT AN AFFORDABLE COST, OR OBTAINED ASSISTANCE THROUGH APPROPRIATE AGENCIES ON THE PATIENT'S BEHALF. EMERGENCY SERVICES CARE WILL BE PROVIDED TO EVERYONE REGARDLESS OF ABILITY TO PAY.TIDALHEALTH PENINSULA REGIONAL SERVED OVER 17,000 INPATIENTS AND PROVIDED MORE THAN 402,000 OUTPATIENT SERVICES DURING FISCAL 2024. ALTHOUGH REIMBURSEMENT FOR SERVICES RENDERED IS CRITICAL TO THE OPERATION AND STABILITY OF TIDALHEALTH PENINSULA REGIONAL, IT IS RECOGNIZED THAT NOT ALL INDIVIDUALS POSSESS THE ABILITY TO PAY FOR ESSENTIAL MEDICAL SERVICES. THE HOSPITAL, IN KEEPING WITH THE COMMITMENT TO SERVE ALL MEMBERS OF THE COMMUNITY, DURING FISCAL 2024 PROVIDED:CHARITY AND OTHER ALLOWANCES TOTALING $49,901,008DISCOUNTS TO THIRD PARTY PAYORS INCLUDING GOVERNMENT PROGRAMS SUCH AS MEDICARE AND MEDICAID $58,672,289WRITE-OFF OF UNCOLLECTIBLE ACCOUNTS $17,427,678THE TOTAL UNREIMBURSED VALUE OF PROVIDING CARE TO THESE PATIENTS IS $126,000,974ALSO PROVIDED ARE MANY WELLNESS PROGRAMS, COMMUNITY EDUCATION AND FREE PROGRAMS OFFERED THROUGHOUT THE YEAR BASED UPON ACTIVITIES AND SERVICES THAT TIDALHEALTH PENINSULA REGIONAL BELIEVES WILL SERVE A BONA FIDE COMMUNITY HEALTH NEED. SOME OF THE PROGRAMS ARE AS FOLLOWS: - A VARIETY OF BROCHURES ARE DISPLAYED IN ALL HOSPITAL WAITING AREAS TO EDUCATE MEMBERS OF THE COMMUNITY REGARDING PROGRAMS AND SERVICES.- WE PROVIDE CHILDBIRTH PREPARATION CLASSES, EXERCISE CLASSES FOR PRENATAL AND POSTPARTUM WOMEN AND CPR CLASSES. - WE PROVIDE ASSISTANCE TO EDUCATORS THROUGH OUR WORK WITH STUDENT NURSES, RADIOLOGY, RESPIRATORY AND LABORATORY TECHNICIANS.PROGRAM ACTIVITYDURING FY 2024, TIDALHEALTH PENINSULA REGIONAL PERFORMED COMMUNITY OUTREACH ACTIVITIES ASSOCIATED WITH FLU CLINICS AND WELLNESS ACTIVITIES AND A MOBILE HEALTH INITIATIVE AIMED TO REDUCE UNNECESSARY USE OF THE 911 EMS SYSTEM AND EMERGENCY DEPARTMENT. SPECIFIC EXAMPLES OF EDUCATION AND OUTREACH PROGRAMS, SUPPORT GROUPS, COMMUNITY HEALTH SCREENINGS, AND FITNESS AND WELLNESS ACTIVITIES SUPPORTED BY TIDALHEALTH PENINSULA REGIONAL ARE AS FOLLOWS: CLASSES AND EDUCATIONAL SUPPORT GROUPS: - CHILDBIRTH CLASSES - DIABETES SUPPORT GROUP - CANCER SUPPORT CLASSES AND SUPPORT GROUPS - FAMILY SUPPORT GROUP - PARKINSON'S SUPPORT GROUP - STRESS REDUCTION AND RESILIENCY TRAINING EVENTS: - COMMUNITY SCREENINGS - HEIGHT/WEIGHT, BLOOD PRESSURE - SKIN CANCER SCREENINGS - ORAL, HEAD AND NECK CANCER SCREENINGS - HEARING SCREENINGS - FLU CLINIC - EDUCATIONAL EXHIBITS TO PROMOTE HEALTHY LIFESTYLES FITNESS/EXERCISE PROGRAMMING: - CARDIAC REHABILITATION - EXERCISES FOR STRENGTH AND ENDURANCE - HEALTH AND WELLNESS FOR SENIORS

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 expenses447,901,988

(A) Name and title	(B) Average hours per week (list any hours for related organizations below dotted line)				(D) Reportable compensation from the organization (W-2/1099-MISC/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) TRUDY HALL MD........................................................................ V.P. CHIEF MEDICAL OFFICER	50.00 .......................2.00	X			0	602,369	58,529
(19) STEPHANIE GARY........................................................................ V.P. FINANCE/CFO	50.00 .......................4.00	X			0	589,051	59,652
(20) TIMOTHY FEIST........................................................................ V.P CHIEF COMPLIANCE OFF. THRU 01/24	50.00 .......................0.00		X		0	384,863	105,484
(21) SARAH SCOTT........................................................................ V.P. PEOPLE & ORGANIZATON DEV	50.00 .......................2.00		X		0	386,924	69,732
(22) JAMES TRUMBLE MD........................................................................ V.P. CLINICAL INTEGRATION	50.00 .......................1.00		X		0	453,918	37,369
(23) KATHRYN FIDDLER........................................................................ V.P. POPULATION HEALTH	50.00 .......................2.00		X		0	384,119	45,831
(24) ANGELA BRITTINGHAM........................................................................ CHIEF NURSING OFFICER	50.00 .......................1.00		X		0	273,637	48,712
(25) BRUCE RITCHIE........................................................................ FORMER CFO THRU 01/23	0.00 .......................0.00			X	0	426,118	29,687
(26) KARIN DIBARI........................................................................ FMR. V.P. TH MED. PTNRS. THRU 10/22	0.00 .......................0.00			X	0	407,246	12,277

1b	Sub-Total..............
c	Total from continuation sheets to Part VII, Section A..
d	Total (add lines 1b and 1c).........	0	6,322,158	695,456

(A) Name and business address	(B) Description of services	(C) Compensation





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 0

1a	Federated campaigns..		1a
b	Membership dues..		1b
c	Fundraising events..		1c
d	Related organizations		1d	894,760
e	Government grants (contributions)		1e	1,642,458

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.......		2,537,218

		Business Code
2a	NET PATIENT SERVICES	621500	526,802,384	521,503,366	5,299,018
b	AMBULATORY PHARMACY	456110	16,896,541	13,475,240	3,421,301
c
d
e
f	All other program service revenue.
g	Total. Add lines 2a–2f .....		543,698,925

3 Investment income (including dividends, interest, and othersimilar amounts) ......			8,714,421		-55,630	8,770,051
4 Income from investment of tax-exempt bond proceeds
5 Royalties...........
			(i) Real	(ii) Personal
6a	Gross rents	6a	419,784
b	Less: rental expenses	6b	451,732
c	Rental income or (loss)	6c	-31,948
d	Net rental income or (loss).......			-31,948			-31,948
			(i) Securities	(ii) Other
7a	Gross amount from sales of assets other than inventory	7a	407,402,094
b	Less: cost or other basis and sales expenses	7b	389,378,433
c	Gain or (loss)	7c	18,023,661
d	Net gain or (loss).........			18,023,661			18,023,661
8a	Gross income from fundraising events (not including $ of contributions reported on line 1c). See Part IV, line 18 ....
			8a
b	Less: direct expenses ...		8b
c	Net income or (loss) from fundraising events..
9a	Gross income from gaming activities. See Part IV, line 19 ...
			9a
b	Less: direct expenses ...		9b
c	Net income or (loss) from gaming activities..
10a	Gross sales of inventory, less returns and allowances ..
			10a
b	Less: cost of goods sold ..		10b
c	Net income or (loss) from sales of inventory..

Business Code
11a	CAFETERIA		722514	2,167,430			2,167,430
b	MANAGEMENT FEES		561000	200,000		200,000
c	LIFELINE		532283	88,200		88,200
d	All other revenue ....			69,866			69,866
e	Total. Add lines 11a–11d ......			2,525,496
12	Total revenue. See instructions.....			575,467,773	534,978,606	8,952,889	28,999,060

1	Grants and other assistance to domestic organizations and domestic governments. See Part IV, line 21 ....	59,625	59,625
2	Grants and other assistance to domestic individuals. See Part IV, line 22 ...........
3	Grants and other assistance to foreign organizations, foreign governments, and foreign individuals. See Part IV, lines 15 and 16. .............
4	Benefits paid to or for members .......
5	Compensation of current officers, directors, trustees, and key employees ...........	5,636,027		5,636,027
6	Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) .........	148,604		148,604
7	Other salaries and wages........	181,425,288	166,654,270	14,284,272	486,746
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....	9,474,887	8,434,544	1,015,708	24,635
9	Other employee benefits .......	16,354,776	14,559,022	1,753,232	42,522
10	Payroll taxes ...........	13,261,907	11,805,750	1,421,676	34,481
11	Fees for services (non-employees):
a	Management ......
b	Legal .........	983,225	875,267	105,402	2,556
c	Accounting ...........	700,000	623,140	75,040	1,820
d	Lobbying ...........	23,781	21,170	2,549	62
e	Professional fundraising services. See Part IV, line 17
f	Investment management fees ......	1,490,274	1,326,642	159,757	3,875
g	Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O)	86,954,620	77,407,003	9,321,535	226,082
12	Advertising and promotion ....	579,801	516,139	62,155	1,507
13	Office expenses .......	39,669,440	35,313,735	4,252,564	103,141
14	Information technology ......	1,027,664	914,826	110,166	2,672
15	Royalties ..
16	Occupancy ...........	5,466,830	4,866,572	586,044	14,214
17	Travel ............	640,779	570,421	68,692	1,666
18	Payments of travel or entertainment expenses for any federal, state, or local public officials .
19	Conferences, conventions, and meetings ....	11,119	9,898	1,192	29
20	Interest ...........	4,350,922	3,873,191	466,419	11,312
21	Payments to affiliates .......
22	Depreciation, depletion, and amortization ..	25,349,390	22,566,027	2,717,455	65,908
23	Insurance ...	2,932,088	2,610,145	314,320	7,623
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	52,034,246	46,320,886	5,578,071	135,289
b	DRUG SUPPLIES	35,593,979	31,685,760	3,815,675	92,544
c	BAD DEBT	17,427,678	15,514,119	1,868,247	45,312
d	UBI TAXES	583,500	519,432	62,551	1,517
e	All other expenses	959,790	854,404	102,889	2,497
25	Total functional expenses. Add lines 1 through 24e	503,140,240	447,901,988	53,930,242	1,308,010
26	Joint costs. Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation. Check here if following SOP 98-2 (ASC 958-720).

1	Cash–non-interest-bearing ........			6,612,121	1	9,876,756
2	Savings and temporary cash investments .........			17,003,061	2	23,652,893
3	Pledges and grants receivable, net ......				3
4	Accounts receivable, net .............			59,468,115	4	69,302,232
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 .......
					5
6	Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), and persons described in section 4958(c)(3)(B) ...
					6
7	Notes and loans receivable, net ...........				7
8	Inventories for sale or use ............			11,774,166	8	13,489,176
9	Prepaid expenses and deferred charges ......			9,403,737	9	10,295,735
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	657,903,656
b	Less: accumulated depreciation	10b	495,314,261	181,207,589	10c	162,589,395
11	Investments—publicly traded securities .			334,590,234	11	354,721,425
12	Investments—other securities. See Part IV, line 11 .....				12
13	Investments—program-related. See Part IV, line 11 ..				13
14	Intangible assets ...............				14
15	Other assets. See Part IV, line 11 ...........			90,993,915	15	102,941,447
16	Total assets. Add lines 1 through 15 (must equal line 33)...			711,052,938	16	746,869,059

17	Accounts payable and accrued expenses .....	7,582,833	17	7,898,954
18	Grants payable ...		18
19	Deferred revenue .........	0	19	29,726
20	Tax-exempt bond liabilities .........	3,230,467	20	0
21	Escrow or custodial account liability. Complete Part IV of Schedule D		21
22	Loans and other payables to any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons .........
			22
23	Secured mortgages and notes payable to unrelated third parties ..		23
24	Unsecured notes and loans payable to unrelated third parties ..	119,855,011	24	118,827,397
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	23,864,410	25	87,502,634
26	Total liabilities. Add lines 17 through 25..	154,532,721	26	214,258,711

	Organizations that follow FASB ASC 958, check here and complete lines 27, 28, 32, and 33.
27	Net assets without donor restrictions ..........	499,549,381	27	468,830,863
28	Net assets with donor restrictions ...........	56,970,836	28	63,779,485
	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 ...........	556,520,217	32	532,610,348
33	Total liabilities and net assets/fund balances ........	711,052,938	33	746,869,059