2021-11-15T15:59:40-06:00 2020-12-31 010523282 Berry Dunn McNeil & Parker LLC PO Box 1100 Portland ME 041041100 990 2020-01-01 010263198 Down East Community Hospital DOWN 2072553356 11 Hospital Drive Machias ME 04654 Lynnette Parr CFO 2072553356 2021-11-15 1 Lynnette Parr 999009999 Joseph R Byrne P01289281 2077752387 2021-11-15 2 AAL1 IAL1 2020 2022-09-23 18:48:47Z Steven Lail 11 Hospital Drive Machias ME 04654 52082622 0 X www.dech.org X 1960 ME Acute Care Critical Access Hospital 15 12 388 16 0 0 79937 1593761 49909984 48818554 242645 378944 0 0 50232566 50791259 10102 4986 0 0 25975925 26869934 0 0 0 22108592 20933362 48094619 47808282 2137947 2982977 34835177 50175979 20103486 32758624 14731691 17417355 X Provide access to quality healthcare and promote community wellness through the delivery of primary, emergency and ancillary inpatient and outpatient healthcare. The Hospital strives to improve the overall health of the communities we serve while exceeding customer expectations. 0 0 2369006 6442025 Surgical services to inpatients and outpatients, totaling 2,391 surgeries. 2925456 2838744 Care for medical/surgical unit patients. Unit provided care to 805 admissions for 2,637 patient days & 32 swing bed admissions for 219 swing bed days. 2056387 8660069 Imaging Services to inpatients and outpatients. 17,370 radiological exams were provided to inpatients and outpatients. 35614695 4986 30877716 Various other medical services supplied to patients. 35614695 4986 30877716 42965544 1 1 0 1 0 0 0 0 0 1 1 0 0 0 1 0 0 1 0 0 0 0 0 0 0 0 1 1 0 0 1 1 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 1 1 1 0 0 1 70 0 1 388 1 0 0 0 0 0 0 0 0 0 0 0 0 X 15 12 1 0 0 0 1 1 0 1 1 0 0 1 1 1 1 1 1 1 0 0 ME X X Lynnette Parr 2072553356 11 Hospital Drive Machias ME 04654 Kathryn Land Chair 1.75 0.25 X X 0 0 0 Lisa Carlisle Vice Chair 1.75 0.25 X X 0 0 0 Michael Hennessey Treasurer 1.75 0.25 X X 0 0 0 Nate Martel Secretary 1.75 0.25 X X 0 0 0 Betty Marshall Trustee 1.75 0.25 X 0 0 0 Christian Inegbenijie MD Trustee 39.75 0.25 X 389188 0 34467 Corey Schwinn Trustee 1.75 0.25 X 0 0 0 Eric Burke MD Trustee 1.75 0.25 X 0 0 0 Jacqueline O'Clair Trustee 1.75 0.25 X 0 0 0 Jack Corrigan Trustee 1.75 0.25 X 0 0 0 Karen Eldridge Trustee 1.75 0.25 X 0 0 0 Rita Ten MD Trustee 39.75 0.25 X 492111 0 39447 Rose St Louis Trustee 1.75 0.25 X 0 0 0 Wayne Peters Trustee 1.75 0.25 X 0 0 0 Steven Lail CEO 39.75 0.25 X X 280316 0 27485 Lynnette Parr CFO 39.75 0.25 X 195754 0 28474 Stephen Madigan Physician 40.00 0.00 X 456610 0 29397 Kara Dwight Physician 40.00 0.00 X 425984 0 29887 Thomas Crowe Physician 40.00 0.00 X 334351 0 25599 Leonid Brodksy Physician 40.00 0.00 X 325288 0 33323 Elaine Mau Physician 40.00 0.00 X 311739 0 11963 Aziz Massaad Former Trustee 60.00 0.00 X 1033996 0 0 4245337 0 260042 40 1 1 0 Emcare Physician Services 7032 Collection Center Drive Chicago IL 60693 Physician Services 1562885 Down East Medical Associates PO Box 317 Machias ME 04654 Physician Services 1033996 Bluewater Emergency Partners PO Box 270 South Freeport ME 04078 Physician Services 700910 Machias Primary Care Associates PO Box 398 Machias ME 04654 Physician Services 402306 Dahl-Chase Diagnostic Services 417 State Street Bangor ME 04401 Lab Diagnostic Services 356749 15 1566141 27620 1593761 Patient Revenue 621400 100687908 100687908 Other Revenue 621400 1895005 1806137 88868 Contractual/Char. Adj. 621400 -53764359 -53764359 48818554 205355 205355 1464952 1291363 173589 173589 173589 50791259 48729686 0 467812 X 4986 4986 1487242 955213 532029 19608289 17861322 1746967 917160 834548 82612 3534928 3170141 364787 1322315 1176860 145455 65468 65468 76187 76187 8222222 7545572 676650 61523 61523 1616760 994904 621856 901264 741487 159777 7817 3884 3933 316804 316804 1505649 1505649 913706 822335 91371 Supplies 6122434 6044271 78163 Service Provider Tax 933450 933450 Miscellaneous 190078 54118 135960 47808282 42965544 4842738 0 X 1587 1587 10898484 25411623 151808 20625 5145765 3873084 662779 673521 404652 411979 38728657 23469590 14534564 15259067 3035538 3334544 0 1189949 34835177 50175979 4346207 4789221 7103491 10648535 4997815 2058731 3655973 15262137 20103486 32758624 X 13025704 15837874 1705987 1579481 14731691 17417355 34835177 50175979 X 2982977 -49054 -248259 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 9138 9138 0 Part II-B, Line 1: The Organization pays dues to local associations, a portion of which are attributable to lobbying activities. 3474337 206918 24535 3656720 2956004 8934 535912 26513 3474337 3151396 -167263 28129 2956004 2680421 495180 24205 3151396 3540908 164375 1000533 24329 2680421 0.20000 0.80000 0.00000 0 0 257946 257946 21494142 10778876 10715266 15202792 11894245 3308547 1773777 796469 977308 15259067 Unfunded Pension Liability 2896114 Medicare Accelerated Payments 5500000 CARES Act Funding 6866023 15262137 Part V, Line 4: Growth of investment to provide earnings that will support operations. 1 1 1 X 1 X 1 1 0 1 1 403000 403000 0.00840 18685567 17877414 808153 0.01690 19088567 17877414 1211153 0.02530 29521 29521 0.00060 74456 74456 0.00160 1342679 1342679 0.02810 1446656 1446656 0.03030 20535223 17877414 2657809 0.05560 1 0 0 17877414 18686207 -808793 X 1 1 1 1 Down East Community Hospital 11 Hospital Drive Machias ME 04654 www.dech.org 39153 X X X X Down East Community Hospital 1 0 0 1 X X X X X X X X 19 1 1 1 1 X http://www.dech.org X http://www.mainechna.org X 1 19 1 http://www.dech.org 0 1 X 150.000000000000 200.000000000000 X 1 1 X X X X 1 X http://www.dech.org X http://www.dech.org X http://www.dech.org X X X X X 1 X 0 X X X X 1 X 0 0 Down East Community Hospital Part V, Section B, Line 5: The 2019 Maine Shared Community Health Needs Assessment was born out of a unique public-private partnership. The partnership began as the OneMaine Health Collaborative in 2007, involving Northern Light Health (formerly Eastern Maine Healthcare Systems), MaineGeneral Health, and MaineHealth. After conversations with the Statewide Coordinating Council for Public Health, the Maine Center for Disease Control and Prevention, an office of the Department of Health and Human Services joined in 2012. In 2013, Central Maine Healthcare joined the group and in 2014 a charter was drafted by all five partners to guide a statewide assessment process. The shared CHNA includes a large set of statistics on health status and risk factors from existing surveillance and health data sets.This 2019 CHNA includes input from a broad set of stakeholders from across the state as facilitated by the Steering Committee, Metrics Committee & Community Engagement Committee. Community outreach and engagement for the Maine Shared CHNA included coordination at the statewide, public health district & county level. In addition to the state-level Community Engagement Committee, a local community engagement planning committee for Washington County planned and implemented the logistics of community forums within the county. The committee was compromised of hospitals, public health district liaisons and a variety of additional partners. Down East Community Hospital Part V, Section B, Line 6a: The Hospital participated in the statewide community health needs assessment along with the following Maine hospitals: Northern Light Health Member Organizations: Acadia Hospital; Blue Hill Memorial Hospital; Charles A Dean Memorial Hospital; Eastern Maine Medical Center, Inland Hospital, Mercy Hospital; Sebasticook Valley Hospital, Maine Coast Hospital, AR Gould Hospital; Maine Health Affiliated: Southern Maine Healthcare, Maine Medical Center, Spring Harbor, Stephens Memorial Hospital, Franklin Memorial Hospital, Lincoln Health, Waldo County General Hospital, Pen Bay Medical Center; CMHC Affiliated: Bridgton Hospital, Central Maine Medical Center, Rumford Hospital; York Hospital; NE Rehabilitation; St. Mary's Regional Medical Center; Mid Coast Hospital; Maine General Health; Reddington-Fairview General Hospital; Millinocket Regional Hospital; Penobscot Valley Hospital; St. Joseph Hospital; Mayo Regional Hospital; Calais Regional Hospital; Mt. Desert Island Hospital; Cary Medical Center; Houlton Regional Hospital and Northern Maine Medical CenterThe Maine Shared Health Needs Assessment and Planning Process (SHNAPP) Project is a collaborative effort among Maine's four largest healthcare systems - Central Maine HealthCare, Northern Light Health, Maine General Health, and Maine Health - as well as the Maine Center for Disease Control and Prevention (Maine CDC), an office of the Maine Department of Health and Human Services (Maine DHHS). Down East Community Hospital was an active participant in the process. Down East Community Hospital Part V, Section B, Line 6b: The Hospital's CHNA was conducted with the following community non-hospital organizations:Aroostook Mental Health Center; Calais Regional Medical Services; City of Calais; City of Eastport; Community Health & Counseling Services; County of Washington; Downeast Hospice; Downeast Public Health District; Eastern Area Agency on Aging; Eastern Maine Development Corp.; Eastport Healthcare; Healthways Regional Medical Center Lubec; Healthy Acadia; I Care; Maine CDC; Public Health Nursing; Maine Seacoast Mission; Maine State Legislature; Maine Veterans Homes; Marshall Healthcare Facility; National Alliance of Mental Illness (NAMI); Next Step Domestic Violence Project; Northern Light Health; Office of Aging & Disability Services, DHHS; St. Croix Regional Family Health Center; Sunrise County Economic Council; Sunrise Opportunities; Sunrise Senior College; The Quoddy Tides; Town of Baileyville, Town of Machias; United Way of Eastern Maine, Washington County Emergency Management. Down East Community Hospital Part V, Section B, Line 11: DECH addressed the needs in its most recent CHNA by preparing and adopting an implementation strategy. DECH plans to address all priorities identified through the management and budget of community benefit activities. In addition, DECH also takes advantage of partnering with other community plans by participating, supporting or promoting programs which support community health needs. No needs are not addressed. DECH's detailed implementation strategy can be found on the hospital website, www.dech.org. Part I, Line 6a: The senior leadership team, with approval by the board of trustees, manages the community benefit activities of the Hospital. An expense budget is identified annually for community benefit activities. Community benefit activities are reported each year in the Hospital's annual report. Part III, Line 4: See Pages 11-12 of audited financial statements for footnote disclosure. Patient service revenue is reported at the amount that reflects the consideration to which the Hospital expects to be entitled in exchange for providing patient care. These amounts are due from patients, third-party payors (including health insurers and government programs), and others and includes variable consideration for retroactive revenue adjustments due to settlement of audits, reviews, and investigations. Generally, the Hospital bills the patients and third-party payors several days after the services are performed or the patient is discharged. Revenue is recognized as performance obligations are satisfied.Patient accounts receivable are stated at the amount management expects to collect from outstanding balances.The Hospital has elected the practical expedient allowed under FASB ASC 606-10-32-18 and does not adjust the promised amount of consideration from patients and third-party payors for the effects of a significant financing component due to the Hospital's expectation that the period between the time the service is provided to a patient and the time that the patient or a third- party payor pays for that service will be one year or less. However, the Hospital does, in certain instances, enter into payment agreements with patients that allow payments in excess of one year. For those cases, the financing component is not deemed to be significant to the contract.Performance obligations are determined based on the nature of the services provided by the Hospital. Revenue for performance obligations satisfied over time is recognized based on actual charges incurred in relation to total expected (or actual) charges. The Hospital believes that this method provides a faithful depiction of the transfer of services over the term of the performance obligation based on the inputs needed to satisfy the obligation. Generally, performance obligations satisfied over time relate to patients in hospitals receiving inpatient acute care services or patients receiving services in outpatient centers or in their homes. The Hospital measures the performance obligation from admission into the hospital or the commencement of an outpatient service, to the point when it is no longer required to provide services to that patient, which is generally at the time of discharge or completion of the outpatient services.Because all of its performance obligations relate to contracts with a duration of less than one year, the Hospital has elected to apply the optional exemption provided in FASB ASC 606-10-50-14 (a) and, therefore, is not required to disclose the aggregate amount of the transaction price allocated to performance obligations that are unsatisfied or partially unsatisfied at the end of the reporting period. The unsatisfied or partially unsatisfied performance obligations referred to above are primarily related to inpatient acute care services at the end of the reporting period. The performance obligations for these contracts are generally completed when the patients are discharged, which generally occurs within days or weeks of the end of the reporting period. Part III, Line 9b: The financial assistance policy #1016 that is referred to in the billing & collection policy states that based on the financial assistance level approved, an eligible individual will not be billed for services or any amount not paid by an insurer or medical assistance program if the person has been qualified for financial assistance. Part VI, Line 2: See Schedule H, Part V, Section C. Part VI, Line 3: DECH has a financial assistance policy that outlines all the discounted cost opportunities that the Hospital has to offer. The complete financial assistance policy, plain language summary, and free care application is located on the Hospital's website at www.dech.org. Copies of the plain language summary is also posted in all main waiting areas of the facility and satellite locations and full copies of the policy can be obtained per request and without charge. Annually, DECH also advertises its plain language summary in local media outlets. Each patient is given the Hospital's financial assistance policy plain language summary prior to the commencement of each date of service. The summary and contact information to obtain a free care application is also listed on the patient's bill. At every opportunity, the Hospital's billing specialists and financial counselors will communicate our policies to patients after billing and encourage patients to apply for financial assistance. During discussions, if patients are identified to be eligible for other governmental insurances, DECH will assist the patient with the application process if requested by the patient. Part VI, Line 4: Demographics:Washington County is one of two counties in the Downeast Public Health District. The population of Washington County is 31,925 and 21.9% of the population is 65 years of age or older. The population is predominantly white (91.4%); 1.8% are Hispanic, and 2.6% are two or more races. The median household income is $39,469, over $10,000 less than the state average. The high school graduation rate (87.7%) is higher than the state overall, while the percent of the population with an associates' degree or higher (29.1%) is lower.Quantitative Evidence:In Washington County:The percentage of the population that was uninsured was higher than the state overall (12.7% vs. 9.5%) in 2012-2016.The percentage of the population who reported an inability to access healthcare due to cost was higher than the state overall (12.1% vs. 10.3%) from 2014-2016.The percentage of the population with a usual primary care provider was significantly lower than the state overall (81.6% vs. 87.6%) in 2014-2016.The percentage of the population with a primary care visit to any provider in the past year was significantly lower than the state overall (65.8% vs. 71.8%) in 2014-2016. Part VI, Line 5: The Hospital furthers its exempt purpose by promoting the health of the community. The board consists of volunteer community members that are elected by the Corporators of the Hospital.The Hospital has an open medical staff where all applicants have the opportunity to obtain membership as long as the guidelines as determined by the medical staff bylaws are met. X X X X 0 0 0 0 0 0 0 1 0 Aziz Massaad Former Trustee 1033996 0 0 0 0 0 0 0 0 0 1033996 0 0 0 Rita Ten MD Trustee 472111 0 0 0 20000 0 14250 0 25197 0 531558 0 0 0 Stephen Madigan Physician 456610 0 0 0 0 0 14250 0 15147 0 486007 0 0 0 Kara Dwight Physician 425984 0 0 0 0 0 14250 0 15637 0 455871 0 0 0 Christian Inegbenijie MD Trustee 377938 0 0 0 11250 0 14250 0 20217 0 423655 0 0 0 Thomas Crowe Physician 265946 0 68405 0 0 0 11400 0 14199 0 359950 0 0 0 Leonid Brodksy Physician 325288 0 0 0 0 0 11400 0 21923 0 358611 0 0 0 Elaine Mau Physician 216172 0 95567 0 0 0 0 0 11963 0 323702 0 0 0 Steven Lail CEO 246617 0 25000 0 8699 0 11348 0 16137 0 307801 0 0 0 Lynnette Parr CFO 193947 0 0 0 1807 0 11970 0 16504 0 224228 0 0 0 Part I, Line 7 Dr. Crowe and Dr. Mau received bonus payments for meeting certain productivity goals established by the Organization. The bonus received by Steven Lail was determined by the Board of Trustees based on an annual performance review. A Maine Health and Higher Educational Facilities Authority 010314384 560425V80 2007-11-01 1035000 Finance New Construction and Equipment 0 0 1 B Maine Health and Higher Educational Facilities Authority 010314384 56044RUP5 2019-11-04 6515000 Finance Rural Health Clinic and Electronic Medical Records System 0 0 1 C Maine Health and Higher Educational Facilities Authority 010314384 2020-10-22 3910000 Refinancing of USDA Note Payable 0 0 1 A 952995 1040241 97995 11097 33641 897508 2007 0 0 1 1 B 673050 7556996 523050 83200 6950746 2019 0 0 0 1 C 4186343 273100 82411 3830832 2020 0 0 1 1 A 0 0 0 0 0 0 0 B 0 0 0 0 0 0 0 C 0 0 0 0 0 0 0 A 0 0 1 0 0 0 0 0 0 B 0 0 1 0 0 0 0 0 0 C 0 0 1 0 0 0 0 0 0 A 0 B 0 C 0 Part II, Line 3 The total proceeds of issue listed on line 3 differ from the issue prices listed on Part I due to the amount of premiums of each bond. Downeast Medical Associates Entity more than 35% owned by Aziz Massaad, Former Trustee 1033996 Independent Contractor Agreement 0 Form 990, Part VI, Section A, line 2 Aziz Massaad, Former Trustee, and Rita Ten, current Board Trustee, have a family relationship. Form 990, Part VI, Section A, line 6 The members of the Organization, known as "Corporators," shall be those individuals who are Corporators of Down East Community Hospital as of January 1, 2011, and such other individuals as may be elected to membership in this Corporation by a majority vote of (i) those Corporators present at the Annual Meeting of this Corporation; or (ii) the Board of Trustees. A Corporator is elected for life, unless the Corporator voluntarily resigns, or the Corporator fails to attend two successive annual meetings of the Corporation without prior notice. Additionally, those individuals who are appointed as members of the Active Medical Staff of Down East Community Hospital are eligible to serve as Corporators during the period of their appointment to the Active Medical Staff if so desired. Form 990, Part VI, Section A, line 7a The Corporators shall elect the Trustees of this Corporation from a slate of nominees presented by the Nominating Committee in accordance with the provisions of the Bylaws. Form 990, Part VI, Section B, line 11b The 990 is reviewed by the CEO and CFO and a copy is provided to the full board before filing. Form 990, Part VI, Section B, line 12c In order to monitor compliance with the conflict of interest policy for the Organization, each member of the board of trustees is required annually to submit a conflict of interest document and the compliance officer verifies the receipt of these documents. The compliance officer also reviews payments issued to the board of trustees and any contracts in effect with board members. All new employees sign a conflict of interest statement at the time of hire. Form 990, Part VI, Section B, line 15a The Organization has a CEO Search & Compensation committee to recruit and hire the CEO. This committee is responsible for organizing a search, interviewing prospective candidates & evaluating compensation. Committee meetings are documented with minutes. The CEO for the Organization is determined by a vote of the full Board of Trustees and the existence of a legal contract. Form 990, Part VI, Section C, line 19 The financial statements and annual report are made available to the public upon request. The Organization's governing documents and conflict of interest policy are not made available to the public. Form 990, Part IX, line 11g Purchased Services: Program service expenses 1,979,155. Management and general expenses 0. Fundraising expenses 0. Total expenses 1,979,155. Professional Fees: Program service expenses 4,653,176. Management and general expenses 0. Fundraising expenses 0. Total expenses 4,653,176. Collection Fees: Program service expenses 0. Management and general expenses 182,089. Fundraising expenses 0. Total expenses 182,089. Temporary Personnel: Program service expenses 913,241. Management and general expenses 494,561. Fundraising expenses 0. Total expenses 1,407,802. Form 990, Part X, Line 10: Land, Buildings, and Equipment Section 1.263(a)-3(n) Election: Down East Community Hospital 11 Hospital Drive Machias, ME 04654 EIN: 01-0263198 Down East Community Hospital is electing to capitalize repair and maintenance costs under Regulation Section 1.263(a)-3(n). Form 990, Part XI, line 9: Unfunded Pension Liability Adjustment -308,259. Transfer from Affiliate 60,000. Sunrise Healthcare 11 Hospital Drive Machias ME 04645 222582949 Community Healthcare ME 501(c)(3) Line 7 Down East Community Hospital 1 1 0 1 0 0 0 0 0 0 1 0 0 0 0 0 0 1 0 0 Sunrise Healthcare A 8100 Fair Market Value Sunrise Healthcare C 60000 Fair Market Value