2021-11-05T10:54:30-05:00 2020-12-31 010523282 Berry Dunn McNeil & Parker LLC PO Box 1100 Portland ME 041041100 990 2020-01-01 010545327 Penobscot Valley Hospital PENO 2077943321 7 Transalpine Road Box 368 Lincoln ME 04457 Crystal Landry CEO 2077943321 2021-11-04 1 Crystal Landry 999009999 Joseph R Byrne P01289281 2077752387 2021-11-04 2 AAL1 IAL1 2020 2022-09-23 18:48:47Z Crystal Landry 7 Transalpine Road Box 368 Lincoln ME 04457 19679787 0 X www.pvhme.org X 1973 ME Critical Access Hospital 10 10 213 10 0 0 26537 2099744 17784323 17519780 10900 13518 52904 46745 17874664 19679787 0 0 0 0 8355522 8638423 0 0 0 10189680 9918065 18545202 18556488 -670538 1123299 8906899 10887412 12687336 13544550 -3780437 -2657138 X Penobscot Valley Hospital Mission Statement:To be our community's first choice in healthcare, known for a culture of compassion, quality, and safety. To be an excellent community partner, working together every day to improve the health and well-being of those we serve. Penobscot Valley Hospital Vision Statement:To be recognized by the community, employees, and the medical staff as:* The best place to receive care* The best place to work* The best place to practice medicine. 0 0 14719095 17519780 Penobscot Valley Hospital is a 25 bed critical access hospital in Lincoln, ME. The Hospital provided a wide range of medical services to its patients in 2020, some of the largest being Emergency Room Services, Laboratory Services, Pharmacy Services, & Radiology Services. Please refer to Schedule H for a more comprehensive list of services provided. 14719095 1 1 0 1 0 0 0 0 0 0 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 0 0 0 0 0 0 1 1 0 0 0 1 34 0 1 213 1 0 0 0 0 0 0 0 0 0 0 0 0 X 10 10 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 ME X Crystal Landry 2077943321 7 Transalpine Road Box 368 Lincoln ME 04457 Phillip Dawson Jr President 1.50 0.00 X X 0 0 0 Richard Wyman Vice President 1.50 0.00 X X 0 0 0 Bea Szantyr Treasurer 1.50 0.00 X X 0 0 0 Judith Doore Board Member 1.50 0.00 X 0 0 0 Robert Genest Board Member 1.50 0.00 X 0 0 0 Bonnie Gray Board Member 1.50 0.00 X 0 0 0 Annette Haynes Board Member 1.50 0.00 X 0 0 0 Patricia Nobel MD Board Member 1.50 0.00 X 0 0 0 H Joseph Thibodeau DMD Board Member 1.50 0.00 X 0 0 0 Whitney Souers Board Member 1.50 0.00 X 0 0 0 Crystal Landry CEO 40.00 0.00 X 187941 0 35698 Glenn Deyo Surgeon 40.00 0.00 X 320480 0 33110 Carl Alessi Physician 40.00 0.00 X 173362 0 37162 Paul Turnquist ER Physician 36.00 0.00 X 122945 0 5978 Amy Theriault Sr. Director HR/Comp/SS 40.00 0.00 X 111906 0 3544 Matthew Leland Dir. of Plant & Electrical Operator 40.00 0.00 X 104986 0 3544 1021620 0 119036 8 0 1 0 Emcare Inc 7032 Collection Center Drive Chicago IL 60693 ER Physician Services 2446638 Nurse Anesthesia of Maine LLC 141 North Main Street Suite 205 Brewer ME 04412 Nurse Anesthesia Services 343607 Northern Light Eastern Maine 43 Whiting Hill Road Brewer ME 04412 Pharmacy 278480 Murray Plumb & Murray PA 75 Pearl Street Portland ME 04101 Legal Services 241045 NEHE MRI LLC PO Box 19532 Irvine CA 92623 MRI Services 187141 10 2072264 27480 2099744 Patient Revenue 622000 30603065 30603065 Cafeteria & Other 900099 379155 363625 15530 Contractual/Char. Adj. 622000 -13462440 -13462440 17519780 13518 13518 Earnings from Subsidiary 900099 27644 27644 Gain(loss) Affiliate Investment 900099 19101 19101 46745 19679787 17504250 0 75793 X 223639 223639 7180811 5880412 1300399 665302 546780 118522 568671 423909 144762 1075 1075 40000 40000 6107725 5298550 809175 580 580 733707 537175 196532 689786 600044 89742 28825 24859 3966 31982 26449 5533 399237 259504 139733 255784 54204 201580 Medical Supplies 1096313 1066042 30271 Service Provider Tax 489201 489201 Miscellaneous Expenses 43850 1167 42683 18556488 14719095 3837393 0 X 1343239 3794010 699644 727569 2485295 2036815 356709 431144 223268 210662 18568386 15084737 3642968 3483649 125724 172469 6191 3714 23861 27380 8906899 10887412 3630053 3426456 294979 208816 4665344 4519119 4096960 5390159 12687336 13544550 X -3974011 -2878236 193574 221098 -3780437 -2657138 8906899 10887412 1123299 0 X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 3262 3262 0 Part II-B, Line 1: The Organization pays dues to the Maine Hospital Association (MHA) and American Hospital Association (AHA). A portion of dues paid to the MHA and AHA are attributable to lobbying expenses. 28897 28897 8062598 6351583 1711015 436056 436056 9611270 8361536 1249734 429565 371618 57947 3483649 Estimated Third-Party Payor Settlements 3773555 Deferred Compensation 27380 CARES Act Funding 1589224 5390159 1 1 1 X 1 X 225.000000000000 1 1 0 1 1 115948 115948 0.00620 5749258 5359576 389682 0.02100 5865206 5359576 505630 0.02720 1950 1950 0.00010 1950 1950 0.00010 5867156 5359576 507580 0.02730 1 5103259 5103259 X 1 1 1 1 Penobscot Valley Hospital 7 Transalpine Road Lincoln ME 04457 www.pvhme.org 39134 X X X X Penobscot Valley Hospital 1 0 0 1 X X X X X X X X X 19 1 1 1 1 X https://www.pvhme.org/Resources.aspx X 1 19 1 https://www.pvhme.org/Resources.aspx 0 1 X 150.000000000000 225.000000000000 X 1 1 X X X 1 X www.pvhme.org/billing.aspx X www.pvhme.org/billing.aspx X www.pvhme.org/billing.aspx X X X X X X X 1 X 0 X X X X 1 X 0 0 Penobscot Valley Hospital Part V, Section B, Line 5: Per the Maine Shared CHNA charter, the effort was conducted by the Steering Committee, Metrics Committee, and Community Engagement Committee. These committees worked in partnership with the Maine CDC and contracted vendor, JSI. Maine CDC and its epidemiology contractor, University of Southern Maine, provided a significant amount of data analyses, technical support, and website development. The Maine Shared CHNA process was rolled out in three stages:Data Analysis:- County Health Profiles were released in September 2018. Two Hundred indicators were selected.- District Health Profiles were released in November 2018.- City Health Profiles for Lewiston/Auburn, Bangor, and Portland were released in January 2019.Outreach and Engagement:- Community outreach was conducted between September 2018 and January 2019. Community forums were conducted with residents and service providers in all 16 counties. The pur ose of this outreach was to gather feedback on data and to identify health priorities, community assets, and gaps in resources to be used in health improvement planning.Final Reports:- Reports for the state, each county, and districts were released in the spring of 2019. These reports included information from the health data profiles, summaries of qualitative information gathered from engagement activities, and a presentation of community health needs. Health priorities for the county, public health district, and the state were developed through community participation and voting at community forums. The Penobscot County Community Forum was an opportunity for review of the Penobscot County Health Profile, discussion of community needs, and prioritization in small break-out sessions followed by a forum session vote. Ten priorities arose from the break-out sessions. The top five became the areas to work on.1. Mental Health 19%2. Social Determinants of Health 18%3. Substance Abuse 15%4. Access to Care 14%5. Physical Activity, Nutrition, and Weight 12%Penobscot Valley then searched to define how they can respond to these needs within the community it resides in. Penobscot Valley Hospital Part V, Section B, Line 6a: - Central Maine Healthcare (CMHC)- Maine General Health (MGH)- Maine-Health (MH)- Northern Light Health (NLH) Penobscot Valley Hospital Part V, Section B, Line 6b: Maine Center for Disease Control and Prevention (Maine CDC) Penobscot Valley Hospital Part V, Section B, Line 11: The top five health issues identified in the 2019 CHNA were:1. Mental Health2. Social Determinants of Health3. Substance Abuse4. Access to Care5. Physical Activity, Nutrition, and Weight.Mental Health has been identified as depression, anxiety, and stress with depression being higher than the overall state average in Penobscot County. Also the percentage of high school students reported they had been sad/hopeless for more than two weeks.Resources available to Penobscot Valley Hospital is Tele-Psych in the PVH Emergency Department used for treatment and referrals, and Health Access Network has a team of mental health providers who can serve patients in our area. The strategy is to involve care providers in speaking to area schools about mental health. Encourage primary care providers to understand the importance of early screening, intervention, and treatment of mental illness. Increase beds for those in need of inpatient treatment.Social Determinants of Health is identified as poverty tends to be root of the issue; lack of stable employment causes many people to struggle to afford nutritious foods, maintain safe and affordable housing, reliable transportation. The unemployment rate is higher in Penobscot County then the state overall.Resources available to respond to this need are food drives for local food cupboards, and school backpack program, Penquis Lynx Transportation and Lincoln shuttle for transportation issues. Screen patients who are at risk of homelessness and provide them with assistance from PVH care coordination. The strategy to increase help is to encourage other businesses in our community to contribute to local food cupboards and schools. Collaborate with Northern Penobscot Tech Region III to provide resources for job education and training. Advertise community free suppers that are open for the public.Substance Abuse is identified as the need for more comprehensive, accessible, and affordable services to help those in need, Overdose emergency medical service response per 10,000 population were higher that the state overall.Resources available to respond to these needs include treatment and referrals from emergency department patients. Penobscot Valley Primary Care closely monitors patients per state standards. The hospital offers alternative pain management services. PVH staff members have volunteered to participate in the "Every 15 Minutes" program with local high school. Care Coordination nurse is active member of Save-A-Life Task Force. The hospital provides space for AA at no cost. PVH will work with other local organizations to promote national and statewide Prescription Drug Take Back events. The strategy to respond to the community needs are to establish an after-care program for patients after being discharged from treatment. Create efforts to provide and education the community on substance abuse use: focusing on area schools. Work with Health Access Network through their substance abuse grant. Continue to educate patients on alternative pain therapies that are available.Access to Care is defined as barriers to accessing care including vailability and affordability of care. The percentage of population who reported an inability to access healthcare due to cost was slightly higher in Penobscot county than the state overall.Resources available are the hospital provides Charity Care and a Sliding Fee Scale to low-income patients. The Patient Financial Services helps patients set up a payment plan. PVH Primary care providers are offering same day care to patients. The strategy to respond to the need is to encourage patients to seek their primary care provider regularly to prevent costly ER visits. Offer the sliding fee/charity care application to patients struggling to pay. Offer discounts to patients who pay their bill in advance or on time. Find ways to encourage primary care providers to work in the area. Offer patient's assistance from PVH care coordination to apply for health care benefits from MaineCare/Medicare.Physical Activity, Nutrition, and Weight. In Penobscot County 16.2% of households lack enough food to maintain healthy, active lifestyles for all household members. The percentage of adults who are obese (35.1%) was higher than the state overall. The percentage was significantly higher than the national average.Resources available to respond to these needs are PVH offers the committee the use of the Independent gym for a small monthly fee. PVH provides healthy meals to patients and staff in their cafeteria. PVH sponsors a Run/Walk for Wellness during homecoming each year. PVH has a registered dietician on staff. The strategy to respond to these needs are to implement workplace wellness initiatives, and encourage other businesses to do so as well. Continue to encourage the community to become members of the Community Fitness Center and Independent Gym. Ensure primary care providers are educating parents and patients at well child visits the importance of healthy eating and exercise. Penobscot Valley Hospital Part V, Section B, Line 13h: State Regulation Penobscot Valley Hospital Part V, Section B, Line 16j: The FAP application is sent with all first time statements. A notice of the FAP and a copy of the FAP application is also posted in the Billing Help section of the Organization's website. Notices are also posted at all patient entrances to the Hospital and at various locations within the building. Part II, Community Building Activities: Many families rely on Penobscot Valley Hospital (PVH) for a comprehensive range of services. Without access to these services including primary and preventative care, chronic dieses may go untreated. Often this results in poor health with high emergent or inpatient costs. At PVH, we strive to be out Community's first choice in healthcare, known for a culture of compassion, quality, and safety: to be an excellent community partner, working together every day to improve the health and well-being of those we serve.Throughout 2020, the hospital partnered with many other organizations to reach people within our communities to educate, train, and inform, including Colonial Healthcare, Cummings Nursing Home, Eastern Maine Community College, Lincoln Economic Development Committee, Lincoln Lakes Region Chamber of Commerce, LifeFlight, Lincoln Police & Fire Departments, Maine Breast & Cervical Health Program, Maine Centers for Disease Control and Prevention, Maine Department of Transportation, Mayo Regional Hospital, Millinocket Regional Hospital, New England Organ Bank, Northern Penobscot Tech Region III, Raising Readers Program, Red Cross, RSU #67, SAD #30, SAD #31, PVH Auxiliary, PVH Cancer Support Group, Save-A-Life Substance Abuse Task Force, the University of Maine, University of New England, University of Vermont, Husson University, and more.By employing about 180 people in the community, PVH is a leader in creating good paying jobs, and attributing to a positive economy in the region. With the "ripple effect" (jobs the hospital helped create, and dollars spent in the area), the U.S. Department of Commerce's Bureau of Economic Analysis determined the multiplier for employment in Maine to be 2.1174, meaning for every employed person in a hospital in Maine, there is another 1.174 jobs created in supporting industries.PVH does not turn away people who need vital care, regardless of their ability to pay. Each person the hospital treats receives the same high-quality care with the utmost compassion from our staff. Our hospital is providing more Free Care, which includes charity care and bad debts, than ever before. Other direct impacts that PVH provides to the community that are served:Education/Scholarships:1. Published educational articles on social media on topics such as hand hygiene, disease prevention, Covid-19, and nutritional advice.2. Staff create educational displays in our lobby.3. Laboratory staff made weekly visits to area nursing homes to collect specimens from residents.4. Trained RN's from Community Health and Counseling to draw blood.5. Trained incoming CNA's and RN's to draw blood, do some CLIA-waived testing.6. Taught students from Region III to draw blood.7. PVH is a clinical site for Northern Penobscot Tech Region III, and several colleges and universities. During 2020, PVH had students conducting clinical rotations here for certifications with Medical Assistant, Certified Nursing Assistant and Phlebotomy. Husson University sent students to the PVH pharmacy and nursing departments for their rotations. PVH has also worded with the University of Maine School of Nursing and Kennebec Valley Community College Radiology Program. PVH has also provided emergency medicine training of family medicine residents from Eastern Maine Medical Center. The hospital serves as a rotation site for physician assistants, and medical students from the University of New England, University of Vermont, and Yale University. Time spent with students varies from a couple of hours to the entire semester of hands-on education. The demand to utilize PVH as a clinical site has increased over the last several years.Promote Organ Donation from October to April. PVH provides information regarding organ donation with social media posts, and the Lincoln News. For National donor month in April, PVH flies the organ donor flag for the month, plus have a display with information for the public. PVH has won HRSA awards for the work that the employees do for organ donation.Penobscot Valley Hospital volunteers, staff, and providers are committed to providing quality healthcare services to the people in our community. In 2020, staff and volunteers provided:1. Free educational programs to seniors.2. The Auxiliary provides Kids Activity Packs and blankets for children visiting the hospital.3. Books for pediatric patients at well child checkups for through Raising Readers.4. Vaccinations through the Maine Impact Program.5. Substance Abuse prevention education.6. Free meeting space for area non-profits.7. Leadership to Lincoln Economic Development Community & Lincoln Lakes Region Chamber of Commerce.8. Holiday gifts for area nursing home residents.9. Christmas Tree Lighting Ceremony with free snacks, beverages, and cookie decorating for the community. Part III, Line 4: In 2019, the Hospital adopted FASB Accounting Standards Update (ASU) No. 2014-09, Revenue from Contracts with Customers (Topic 606), and related guidance, which supersedes accounting standards that previously existed under GAAP and provides a single revenue model to address revenue recognition to be applied by all companies. Under the new standard, companies recognize revenue when a customer obtains control of promised goods or services in an amount that reflects the consideration to which the company expects to be entitled in exchange for those goods and services. Topic 606 also requires companies to disclose additional information, including the nature, amount, timing, and uncertainty of revenue and cash flows arising from contracts with customers. The Hospital adopted this ASU for the year ended December 31, 2019 and elected the modified retrospective method; therefore, the financial statements and related notes have been presented accordingly. Under the modified retrospective method, the cumulative effect of applying the standard was recognized at the date of initial application and resulted in a decrease in net assets without donor restrictions of $755,000, recording a decrease in patient accounts receivable in the same amount.The effect of adopting Topic 606 changed the timing of when the Hospital recognizes uncollectible patient accounts receivable in full upon the recognition of patient service revenue. Previously, these uncollectible patient accounts receivable were recognized through an estimation process that occurred over a period of months.As a result of the adoption of the rules described above, the Hospital is recording $0 of bad debt expense for 2020. Part III, Line 8: The Organization uses its Medicare Cost Report to obtain the amounts reported above. Part III, Line 9b: The Hospital would not initiate collection efforts against a patient that qualified for a sliding fee scale unless that patient failed to meet their obligation under payment arrangement agreed to by both parties. After it was determined that the patient did not qualify for a readjustment to their payment terms, the Hospital would follow normal notification practices dictated by our collection policy until the account eventually ended up in collections. Part VI, Line 2: The Organization took a comprehensive approach to assess community health needs. Several independent data analyses were performed based on secondary source data, augmented with local survey data, and any data inconsistency or discrepancies are resolved from the combined opinions formed from local experts. PVH relies on secondary source data, and most secondary sources use the county as the smallest unit of analysis. We asked our local expert area residents to note if they perceived the problems or needs identified by secondary sources to exist in their portion of the county. Most data used in the analysis is available from public internet sources. Critical data needed to address specific regulations or developed by the individuals cooperating with us in this study is displayed in the report of the appendix. Part VI, Line 3: Notices regarding PVH's charity care policy are posted at Registration and Emergency Room. Our employees also know to refer patients to the registration or billing offices of the hospital if they have questions. Part VI, Line 4: Lincoln is a rural community of approximately 5,700 people located in north central Maine. Our service area consists of many small towns that use Lincoln as a hub. The hospital, school system, and logging companies, are the major employers in town. Life and industry primarily revolve around the woods of central Maine. It is an area rich with history for making paper. Maine is one of the oldest states in the nation according to the latest US Census report, and Lincoln reflects that demographic. The median resident age in 2013 was 43.3 years. Lincoln is located in a modest area of the State, where the median resident income in 2013 was $44,649. Maine's average income for that same time period was $46,288. Part VI, Line 7, Reports Filed With States ME X X X X 0 0 0 0 0 0 0 0 0 Glenn Deyo Surgeon 320480 0 0 0 0 0 0 0 33110 0 353590 0 0 0 Crystal Landry CEO 187941 0 0 0 0 0 0 0 35698 0 223639 0 0 0 Carl Alessi Physician 173362 0 0 0 0 0 0 0 37162 0 210524 0 0 0 A Maine Health and Higher Educational Facilities Authority Revenue Bonds 010314384 560427EU4 2012-06-28 1117769 To refinance Series 2002A bond 0 0 1 A 908953 1117769 132031 24765 960973 2012 0 1 1 1 A 0 0 0 0 0 0 0 A 0 0 1 0 0 0 0 0 0 A 0 Form 990, Part VI, Section B, line 11b Once Form 990 is prepared by the certified public accounting firm, a draft copy is e-mailed to the controller. The controller will then review the Form, and also compare it with the previous year's 990. Once the controller is satisfied with the draft copy, it is forwarded to the CEO. The CEO will then review the document. Any questions will either be answered by the controller or the accounting firm. Once the CEO approves the draft 990, a copy is provided to the board of directors for their review. Once the board has approved the draft, the accounting firm is notified and the final version is prepared for filing. Form 990, Part VI, Section B, line 12c It is the expectation of Penobscot Valley Hospital that our board of directors, medical staff, regular and contracted employees, and our volunteers avoid activities that may involve, or appear to involve, a conflict of interest. This is a standard of conduct communicated through Administrative Policy 109 "Code of Ethics," our code of conduct and ethics, and our medical by-laws. These documents are drafted and signed off by the president of the board of directors, the chief executive officer, chief of medical staff and the compliance officer as appropriate. Every individual employed by, or otherwise representing the Hospital, is responsible for complying with this standard. It is the responsibility of the compliance officer and the chief executive officer to ensure that this standard is communicated, maintained and enforced within the Organization. Administrative Policy 127 "Compliance Reporting" outlines the expectation for reporting non-compliance, the mechanisms in place to do so, and the investigative process. Such mechanisms include a 24-hour confidential reporting hotline. Education on Penobscot Valley Hospital's code of conduct and ethics is provided during orientation or at the beginning of the business relationship. Reinforcement of this education is provided annually and upon any business contract renewal. Form 990, Part VI, Section B, line 15 CEO's wages come from the 2018 Northern New England Healthcare Compensation Survey by Gallagher. Ranges are presented to the finance/personnel committee of the board and the wage is set by the board. Other officers wages are also set by utilizing the survey. Wages are set by evaluating the position in conjunction with the job description listed in the survey. Form 990, Part VI, Section C, line 19 The Organization does not make its governing documents, conflict of interest policy, and financial statements available to the public. Form 990, Part IX, line 11g Physician Fees: Program service expenses 3,411,105. Management and general expenses 0. Fundraising expenses 0. Total expenses 3,411,105. Purchased Services: Program service expenses 1,887,445. Management and general expenses 809,175. Fundraising expenses 0. Total expenses 2,696,620. Form 990, Part X, Line 10: Land, Buildings, and Equipment Section 1.263(a)-3(n) Election: Penobscot Valley Hospital 7 Transalpine Road, Box 368 Lincoln, ME 04457 EIN 01-0545327 Penobscot Valley Hospital is electing to capitalize repair and maintenance costs under Regulation Section 1.263(a)-3(n). Alpine Health Services Inc PO Box 460 West Enfield ME 04493 222533280 Support to provide health services in underserved areas of Maine. ME 501(c)(3) Line 10 Penobscot Valley Hospital 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0