2019-08-13T12:27:46-05:00 2018-09-30 990 2017-10-01 010285286 Penobscot Bay Medical Center PENO 2073389378 PO Box 287 Belfast ME 04915 Linda Drinkwater CFO 2073389378 2019-08-12 63.247.60.254 2019-08-13 13:25:30 ED P B45CD6F9D1811B9916B2A423673B63195B36551F 829AE4A393A3EE33A28B50D291306587A51708D5 2017 2019-02-21 02:37:17Z Mark Fourre MD PO BOX 287 Belfast ME 04915 130922336 0 X www.penbayhealthcare.org X 1969 ME Penobscot Bay Medical Center (PBMC) is an acute care hospital that offers inpatient and outpatient care, diagnostic, therapeutic and rehabilitative services, patient and community education, and a full range of specialty services through the emergency department, special care unit, surgical services department, obstetrics and gynecology department, and the psychiatric addiction & recovery center. 20 14 1332 89 728533 -134104 141033 383260 115025681 119727190 507196 67263 924185 10340190 116598095 130517903 0 0 0 0 65733932 61143790 0 0 0 56020543 67943803 121754475 129087593 -5156380 1430310 121309094 120617755 80353043 77329816 40956051 43287939 X See Schedule O 0 0 106733528 103606664 Inpatient & Outpatient Hospital Care: Penobscot Bay Medical Center (PBMC) provides quality medical care regardless of race, creed, sex, national origin, handicap or ability to pay. Although reimbursement for services rendered is critical to the operation and stability of PBMC, not all individuals possess the ability to purchase essential medical services. Our mission is to serve the community by providing health care services and health care education. In keeping with this hospital's commitment to serve all members of its community, we provide free care and subsidized care to persons covered by governmental programs below cost, and health activities and programs for the community. (Continued at Schedule O)(Continued from Part III, Line 4a)PBMC served 3,595 inpatients, including newborns and 181,157 outpatients including ER visits, during FY 18. Twenty-four-hour medical emergency service is provided in the Emergency Room, staffed by full-time attending physicians. Patients are seen regardless of ability to pay. There were 20,203 visits to the Emergency Room during FY 18. Recognizing its mission to the community, services are provided to both Medicare & MaineCare patients. To the extent reimbursement is below cost, PBMC recognizes these amounts as contractual adjustments. For FY 18, the amount of unreimbursed costs reported as contractual adjustments totaled $144,432,371. During FY 18, approximately 65% of services were to patients covered by these governmental programs. Additionally, PBMC provided $6,267,988 in free care to patients not covered by governmental programs. PBMC provides free conference room and meeting space for a variety of health related groups including Alcoholics Anonymous, Al Anon, Midcoast Cancer Support Group, Heart to Heart, Cardiac Spouse Support Group, Crohn's Disease Support Group, Visually Impaired and Blind Support Group, Pediatric Asthma Support Group, Ostomy Group, Midcoast Mastectomy Support Group, Northeast Health Consortium for Integrated Care, Breast Cancer Intervention Project, Mid-Coast Coalition for Domestic Abuse, Teen parenting, Women's and Children's Community Care Project. Assistance is provided to educators through our work with medical students, student nurses, physical therapy interns, emergency medical technicians, medical records and social service students.Through an arrangement with the University of Maine - Orono, our Education and Training department offers nurses with certificate degrees the opportunity to work toward a baccalaureate degree in the local area. The hospital maintains a research library which is open twenty-four-hours a day and available to the general public. During FY 18, the community contributed approximately 6,132 hours toward the common purpose of servicing the health care needs of the community. The value of this contribution is given back to the community through lower costs in both patient services and other wellness programs such as those described above. 9529175 9250008 Physician Practices: Pen Bay Physician and Associates, a group of departments of PBMC, is composed of 18 practices covering many specialities. 7077871 6870518 The Knox Center for Long Term Care is an 84-bed long-term nursing care and skilled rehabilitation center. Since 1975, The Knox Center for Long Term Care has been caring for members of mid-coast families and providing them with a loving home where they receive both the sophisticated technical care they require and the dignity and respect they deserve. 123340574 1 1 0 1 0 0 0 0 0 1 1 0 0 1 1 1 0 1 0 0 0 0 0 0 1 0 1 1 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 1 X 67 0 1 1332 1 1 1 0 0 0 0 0 0 0 0 0 X 20 14 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 ME X Dorcas Riley 2073389378 PO Box 287 Belfast ME 04915 Ann Hooper Trustee 1.00 50.00 X 0 139832 20070 Benjamin Mailloux MD Frmr Medical Staff President - WCGH 1.00 50.00 X 0 289181 36751 Catherine Reynolds Trustee 1.00 0.00 X 0 0 0 Cornelius Yetman DO Trustee 1.00 50.00 X 0 357047 38880 Dale Kuhnert Trustee 1.00 0.00 X 0 0 0 Deborah Peabody MD Trustee 1.00 50.00 X 0 188074 27394 Elizabeth Connelly DO Medical Staff President - WCGH 1.00 50.00 X 0 443350 31840 Gregory Dufour Trustee 1.00 0.00 X 0 0 0 James C Delehanty MD Trustee 1.00 0.00 X 0 0 0 JB Turner Trustee 1.00 0.00 X 0 0 0 Jennifer McKenna MD Trustee 1.00 50.00 X 0 316339 29454 Joanne Billington Trustee 1.00 0.00 X 0 0 0 Lee Webb Trustee 1.00 0.00 X 0 0 0 Paul Klainer MD Trustee 1.00 0.00 X 0 0 0 Stephanie Lash MD Medical Staff President - PBMC 1.00 50.00 X 0 287088 25910 Syrena Gatewood Trustee 1.00 0.00 X 0 0 0 William Lambie MD Trustee 1.00 0.00 X 0 0 0 Lee Woodward Jr President 1.00 0.00 X X 0 0 0 Carole Brand Vice President 1.00 0.00 X X 0 0 0 Stephen Hanscom Secretary 1.00 0.00 X X 0 0 0 David Flanagan Treasurer 1.00 0.00 X X 0 0 0 Mark Fourre MD CEO 50.00 0.00 X 429171 0 30594 Linda Drinkwater CFO 0.00 50.00 X 0 312958 35179 Christopher Michalakes MD ED Medical Director 50.00 0.00 X 307563 0 43407 Erik Frederick Regional COO 50.00 0.00 X 294413 0 31125 John Nicolet MD ED Physician 50.00 0.00 X 273637 0 36023 Mark McAllister MD ED Physician 50.00 0.00 X 240544 0 34971 James Curtis MD ED Physician 50.00 0.00 X 241673 0 38617 Mark Biscone Former CEO 0.00 0.00 X 0 242078 2928 1787001 2575947 463143 38 1 1 0 JK KALLOCH PO BOX 774 ROCKLAND ME 04841 GROUNDS MAINT. 265729 JF SCOTT CONSTRUCTION 20 ROYAL ST WINTHROP ME 04364 CONSTRUCTION 244212 MICHAEL W SPROWL 2029 APPLETON RIDGE ROAD APPLETON ME 04862 HOUSEKEEPING 133373 PENOBSCOT BAY PATHOLOGY ASSOCIATES PO BOX 1849 LEWISTON ME 042411849 PATHOLOGY 121784 AHSA LLC 10126 E CHERRY BEND ROAD TRAVERSE CITY MI 49684 STAFFING 110318 5 383260 383260 Inpatient & Outpatient Care 624100 103606664 103606664 Pen Bay Physicians & Assoc. 621110 9250008 9250008 Knox Center for LT Care 623000 6870518 6870518 119727190 83737 83737 195210 0 195210 195210 195210 324431 56284 321563 75626 2868 -19342 -16474 -16474 50204 7244 42960 42960 Pharmacy 446110 4762772 4762772 Affiliate revenue 900099 3505448 3505448 Other revenue 900099 1105267 1105267 728533 728533 10102020 130517903 129279413 728533 126697 X 468600 443436 25164 44856441 42447650 2408791 1671446 1581689 89757 10046931 9507411 539520 4100372 3880182 220190 53501 53501 35281 35281 13174 13174 13082669 12613680 468989 7214 6827 387 1940939 1836711 104228 4353403 4119625 233778 346098 327513 18585 1049548 993187 56361 7750944 7334718 416226 1540063 1457362 82701 Affiliate services 17384131 16450603 933528 Medical supplies 16666978 16666978 Hospital tax 2847264 2847264 Other 872596 825738 46858 129087593 123340574 5747019 0 1407791 8722711 6650063 6788095 18238476 16649718 1658861 1876247 930276 430033 143967882 93651303 52491280 50316579 8613367 8893793 31318980 26940579 121309094 120617755 9577794 9872836 42627 20474080 17998415 50301169 49415938 80353043 77329816 X 31231174 32895786 3319462 3840330 6405415 6551823 40956051 43287939 121309094 120617755 X 1430310 403288 498290 X 0 1 X 1 0 X 0 0 0 0 0 0 0 0 1 13174 13174 0 Part II-B, Line 1: Dues paid to the Maine Hospital Association of $53,030 and to the Maine Health Care Association of $6,951. The Maine Hospital Association and Maine Health Care Association used 20.30% and 34.66% respectively of their dues revenue for lobbying activity. 6405415 4600 141808 6551823 6141089 264326 6405415 5983600 25727 131762 6141089 6022956 160000 -199356 5983600 5400541 500000 122415 6022956 1.00000 1 1 1 1021020 1021020 68518414 39003434 29514980 2902370 2005490 896880 69445461 52642379 16803082 2080617 2080617 50316579 Due from Affiliates 1606985 Resident Account Deposits 7477 Estimated Amounts from Third Party 4111730 Other 3106667 Prepaid Capital Costs 18107720 26940579 Amounts Due to Affiliates 47640477 Insurance Claim Liability 667984 Medical Malpractice Tail Liab. 1100000 Resident Accounts & Deposits 7477 49415938 X Part V, Line 4: To be invested in perpetuity to provide a permanent source of income. Part X, Line 2: The Corporation and its subsidiaries are not-for-profit corporations and have been recognized as tax-exempt pursuant to Section 501(c)(3) of the Internal Reveue Code. Tax-exempt organizations could be required to record an obligations for income taxes as the result of a tax position they have historically taken on various tax exposure items including unrelated business income or tax status. Under guidance issued by the Financial Accounting Standards Board (FASB), assets and liabilities are established for uncertain tax positions taken or positions expected to be taken in income tax returns when such positions are judged to not meet the "more-likely-than-not" threshold, based upon the technical merits of the position. Estimated interest and penalties, if applicable, related to uncertain tax positions are included as a component of income tax expense. The Corporation has evaluated the position taken on its filed tax returns. The Corporation has concluded no uncertian income tax positions exist at September 30, 2018. The Corporation's tax years from 2015 through 2018 may be subject to examination. Golf Tournament 50204 50204 4995 2160 89 50204 50204 4995 2160 89 7244 42960 1 1 1 X 175.000000000000 0 1 1 0 1 1 2547200 2547200 0.01970 18554984 12957075 5597909 0.04340 21102184 12957075 8145109 0.06310 5279796 5279796 0.04090 5279796 5279796 0.04090 26381980 12957075 13424905 0.10400 0 5877827 29655636 41738403 -12082767 X 1 1 1 1 Penobscot Bay Medical Center 6 Glen Cove Drive Rockport ME 04856 www.penbayhealthcare.org 38936 X X X Penobscot Bay Medical Center 1 0 0 1 X X X X X X X X X 16 1 1 0 1 X See Part V, Section C 1 16 1 See Part V, Section C 0 1 X 175.000000000000 X X 1 1 X X X 1 X See Part V, Section C X See Part V, Section C X See Part V, Section C X X X X X 1 X 0 X X X X 1 X 0 0 Penobscot Bay Medical Center Part V, Section B, Line 5: The hospital convened a group of people who represented the broad interests of the community served prior to holding forums. Members of the planning committee and engaged organizations were:- Rep. Pinny Beebe-Center, MA; House of Representative; State of Maine- Celine Bourke-Kuhn, MS; Program Manager, Community Health Improvement;MaineHealth- Al May, MPH; Midcoast District Public Health Liaison; Maine Center forDisease Control- Rachael McCormick, Manager, Community Health & Wellness; Pen Bay MedicalCenter- Joy Osterhout, MS, MCHES; Regional Director, Community Health & Wellness; Pen Bay Medical Center & Waldo County General Hospital- Connie Putnam; Director; Knox County Community Health Coalition Penobscot Bay Medical Center Part V, Section B, Line 6a: The CHNA was conducted through a partnership between MaineHealth, Central Maine Healthcare, Eastern Maine Healthcare Systems, MaineGeneral Health and the Maine Department of Health and Human Services. Penobscot Bay Medical Center Part V, Section B, Line 11: For the 2016-2018 CHNA, the organization has identified priorities and developed strategies to address the significant needs identified in its most recently conducted CHNA and provided reasons if identified needs are not being addressed. Please see the 2016-2018 Community Health Needs Assessment and Annual Implementation Plan Update FY18 at https://mainehealth.org/healthy-communities/community-health-needs-assessment for details of the activities undertaken by the organization. Part V, Section B, Lines 7a & 10a: The CHNA and implementation strategy are posted on the following website: https://mainehealth.org/healthy-communities/community-health-needs-assessment Part V, Section B, Lines 16a, 16b, 16c: The Financial Assistance Policy (Free Care Policy and Billing and Collection Policy), free care application and the plain language summary are available on the following website: https://mainehealth.org/patients-visitors/billing-insurance/financial-assistance/free-care 6 1 - Pen Bay Physicians & Associates 4 Glen Cove Drive Rockport ME 04856 Physician Practices 2 - The Knox Center for Long Term Care 6 White Street Rockland ME 04841 Long Term Care 4 - Pen Bay Physical Therapy 4 Glen Cove Drive Rockport ME 04856 Physical Therapy 5 - Pen Bay Occupational Therapy 4 Glen Cove Drive Rockport ME 04856 Occupational Therapy 6 - Pen Bay Physical Therapy 116 Union Street Rockport ME 04856 Physical Therapy 7 - Pen Bay Physical Therapy 40 Washington Road Waldoboro ME 04572 Physical Therapy Part I, Line 7: Ratio of patient care costs to charges per Worksheet 2 of the instructions. Part III, Line 2: See Part III, Line 4 - Bad Debt Expense Footnote to Financial Statements Part III, Line 4: Penobscot Bay Medical Center (PBMC) does not have a specific footnote inthe financial statements that describes "bad debt expense." However,reference is made within the footnotes to a bad debt policy in a couple ofinstances. Within the footnote describing "Net Patient Service Revenue",the following explains the Provision for Bad Debts:"For receivables associated with self-pay patients (which includes bothpatients without insurance and patients with deductible and copaymentbalances due for which third-party coverage exists for part of the bill),the Corporation records a provision for bad debts in the period of servicebased on past experience, which indicates that many patients are unable orunwilling to pay amounts for which they are financially responsible. The difference between the standard rates (or the discounted rates if negotiated or eligible) and the amounts actually collected after all reasonable collection efforts have been exhausted is charged against the allowance for doubtful accounts."The amount of expense associated with the provision of services, ultimately written off as bad debt at PBMC, has been calculated at $5,877,827 for the current fiscal year. This amount was calculated using a cost to charge ratio. Bad debt expense represents healthcare services PBMC has provided without compensation. As a tax-exempt organization, PBMC provides necessary patient care regardless of the patient's ability to pay for the services. PBMC cannot determine the amount of bad debt expense that could be reasonably attributable to patients who likely would qualify for financial assistance under the Hospital free care policy. In addition, bad debt expense also includes amounts for services provided to individuals experiencing difficult personal or economic circumstances related to a portion of our community based patient population. Their medical bills often place these individuals in untenable positions where they are not able to handle their personal debt and then their new medical debt; however, because of their income level, they do not qualify for free care. By providing necessary healthcare services to those individuals either who fail to apply for financial assistance or who are experiencing difficult personal or economic circumstances, PMBC believes that bad debt expense should be included as a community benefit. Part III, Line 8: Cost Report Information:PBMC believes that the Medicare shortfall should be included as a Community Benefit because the hospital has a clear mission commitment to serving elderly patients and adults with disabilities through the provision of specific subsidized programs developed to help improve the health status of these patients. If these critical subsidized programs were not provided by the hospital, they would become the obligation of the Federal Government. Part III, Line 9b: Patients who qualify for free care have their account balance adjusted accordingly once free care has been approved. As a tax-exempt hospital, PBMC provides necessary patient care regardless of the patient's ability to pay for the services. Part VI, Line 2: PBMC is a member of MaineHealth, which conducts a thorough community needs assessment and directs its member organizations to respond to the needs identified. MaineHealth members also participate in various initiatives to keep those assessments up to date. Some of these initiatives include:- Clinical Strategic Planning- Financial Strategic Planning- Facility Planning- Human Resource Planning- Staff Development Planning- Physician Recruitment Strategic Planning- Emergency Preparedness PlanningIn addition to these internal assessments, MaineHealth member organizations also review and act on many of the recommendations provided by external groups and State health planning initiatives, such as: The Maine Department of Health and Human Services' Healthy Maine 2010 and Autism Spectrum Disorders Report, the Maine Center for Disease Control andPrevention and the "State Health Plan created by the Advisory Committeefor Health Systems Development. Part VI, Line 3: Financial assistance information is provided in the Admitting and Emergency Registration locations in the following manner:- Postings including Free Care and Monthly Payment Plan- Handouts- InterviewsIf the patient is self-pay, under insured or can't afford to pay theirhospital bill, they may receive a Financial Counseling Packet and/orreferred to financial counseling from the registration staff or ChangeHealthcare, an outside vendor who helps manage the self-pay accounts. Thepacket includes:- Information on MaineHealth's financial policies- Financial assistance information including Free Care Program- Monthly Payment Plan Program, and Care Partners, MedAccess and other community resource needs- Program applications and instructions for MaineHealth's Free CareProgram, and Monthly Payment Plan Application- Contact information for assistance with applications, bills or financialconcernsSelf-pay or underinsured patients registering in person or via a phoneinterview receive financial counseling including information on ourfinancial assistance programs. Registration staff or Change Healthcareprovide forms and assist with completing financial assistance applicationsand providing follow up contact information.MaineHealth's Web site includes on-line Registration and Patient Billinginformation:- Billing Process- Free Care- Monthly Payment Plan- Patient Statement- Price Information- Contact Us and QuestionsPrimary language, deaf and hard of hearing and interpreter needs are assessed during the registration interview and services are provided asneeded.If a patient does not respond at pre-registration, registration, or whilereceiving care, all of these programs are explained again by the SingleBilling Office staff. The intent of these efforts is to ensure that thepatient is fully informed of and able to take advantage of these assistance programs. Part VI, Line 4: The Community Health Needs Assessment describes the geographic area anddemographic constituents it services. See https://mainehealth.org/healthy-communities/community-health-needs-assessment for the completed CHNA. Part VI, Line 5: The tax exempt purpose of the organization to improve the health of thecommunity is promoted and enhanced in the following ways:- The majority of the governing body comprises people living within thehospital's service area that are neither employed by, nor have contractualrelationships with, the hospital or its affiliates- Medical staff privileges are available to all qualified physicians in the community- Solicitation of community input in the strategic planning process- Common governance of the hospital, long-term care, and physician services provided in the county to promote common health care and control costs- Annual investment in capital equipment and building improvements to ensure high quality care- Each year a portion of Net Assets is distributed to our parent,MaineHealth, for the specific purpose of promoting health statusimprovement programs throughout the MaineHealth service area Part VI, Line 6: MaineHealth is a not-for-profit family of leading high-quality providersand other healthcare organizations working together so their communities are the healthiest in America. Ranked among the nation's top 100 integrated healthcare delivery networks, MaineHealth is governed by a board of trustees consisting of community and business leaders from its southern, central and western Maine regional service areas. The collaboration of MaineHealth members makes it possible to offer an extensive range of clinical integration and community health programs, many aimed at improving access to preventive and primary care services. MaineHealth includes the following member organizations: LincolnHealth Group, Maine Medical Center, Maine Behavioral Healthcare (Spring Harbor Hospital), Coastal Healthcare Alliance (Pen Bay Medical Center and Waldo County General Hospital), Southern Maine Health Care (Southern Maine Medical Center and Goodall campuses), Western Maine Health Care (Stephens Memorial Hospital), The Memorial Hospital at North Conway, N.H., MaineHealth Care at Home, Maine Physician Hospital Organization, NorDx, Synernet and MaineHealth Accountable Care Organization. The strategic affiliates of MaineHealth are MaineGeneral Medical Center, Mid Coast Hospital and St. Marys Regional Medical Center. Part VI, Line 7, Reports Filed With States ME 0 0 0 0 0 0 0 0 0 Ann Hooper Trustee 0 138885 0 0 0 947 0 4331 0 15739 0 159902 0 0 Benjamin Mailloux MD Frmr Medical Staff President - WCGH 0 288990 0 0 0 191 0 8100 0 28651 0 325932 0 0 Cornelius Yetman DO Trustee 0 356500 0 0 0 547 0 8100 0 30780 0 395927 0 0 Deborah Peabody MD Trustee 0 186949 0 0 0 1125 0 5472 0 21922 0 215468 0 0 Elizabeth Connelly DO Medical Staff President - WCGH 0 437346 0 0 0 6004 0 8100 0 23740 0 475190 0 0 Jennifer McKenna MD Trustee 0 315077 0 0 0 1262 0 8100 0 21354 0 345793 0 0 Stephanie Lash MD Medical Staff President - PBMC 0 284623 0 0 0 2465 0 8100 0 17810 0 312998 0 0 Mark Fourre MD CEO 371456 0 54000 0 3715 0 0 0 30594 0 459765 0 0 0 Linda Drinkwater CFO 0 311612 0 0 0 1346 0 8100 0 27079 0 348137 0 0 Christopher Michalakes MD ED Medical Director 305146 0 0 0 2417 0 13500 0 29907 0 350970 0 0 0 Erik Frederick Regional COO 293436 0 0 0 977 0 8100 0 23025 0 325538 0 0 0 John Nicolet MD ED Physician 273085 0 0 0 552 0 7038 0 28985 0 309660 0 0 0 Mark McAllister MD ED Physician 240261 0 0 0 283 0 6830 0 28141 0 275515 0 0 0 James Curtis MD ED Physician 239142 0 0 0 2531 0 10532 0 28085 0 280290 0 0 0 Mark Biscone Former CEO 0 241987 0 0 0 91 0 2928 0 0 0 245006 0 0 Part I, Line 3 Top management officials are compensated by this or other related organizations. These organizations used one or more of the methods shown at Part 1, Line 3 to establish the compensation of top management. For additional information see Schedule O - Form 990, Part VI, Section B, Line 15 - Compensation for Top Official. A Maine Health & Higher Educational Facilities Authority 010314384 560427EU4 2012-06-28 4287472 See Part VI 0 0 1 B Maine Health & Higher Educational Facilities Authority 010314384 560427W77 2014-07-24 7427323 See Part VI 0 0 1 C Maine Health & Higher Educational Facilities Authority 010314384 000000000 2014-03-31 4800000 Buildings & Facilities 0 0 0 D Maine Health & Higher Educational Facilities Authority 010314384 000000000 2014-09-24 3125535 Equipment 0 0 0 A 2953650 4287472 354220 63386 4287472 1 0 1 1 B 3688047 7427323 955230 78140 7427323 1 0 1 1 C 2025078 4800000 53225 4746775 2014 0 0 1 1 D 1343087 3125535 3125535 2015 0 0 1 1 B 0 0 0 0 0.00000 0.00000 0.00000 0 1 0 0 C 0 0 0 0 0.00000 0.00000 0.00000 0 0 0 D 0 0 0 0 0.00000 0.00000 0.00000 0 0 0 A 0 0 0 1 0 0 0 1 0 B 0 1 0 0 0 0 0 0 0 C 0 1 0 0 0 0 0 0 0 D 0 1 0 0 0 0 0 0 0 A 0 B 0 C 0 D 0 Date Rebate Computation Performed Issuer Name: Maine Health & Higher Educational Facilities Authority Date the Rebate Computation was Performed: 06/28/2017 Part I, Column F - Bond issued 6/28/12: Refund bonds issued 5/19/1999 and 8/3/2000 - Bond issued 7/24/14: Refund bonds issued 10/16/2003 and 6/3/2004 - Bond issued 6/28/16: Refund bond issued 9/7/2006 - Bond issued 12/28/17: Refund bonds issued 11/1/2007 and 6/19/2008 Part I, Column I MHHEFA Series 2012A, 2014A, 2016 and 2017B Bonds: Pooled Financing - PBMC's share of pooled financings constitutes less than 100% of each issue. Part I columns (e) and (f), and all of Parts II and III, have been answered with respect to PBMC's share of such pooled financings, not with respect to 100% of each issue. Part II Line 17, Part III Line 9, Part IV Line 7, Part V The following is applicable to all bond issues listed in Part I: During this fiscal year, the institution was in the process of implementing written compliance procedures. Part II, Line 4, column A - Bond issued 6/28/12: The amount shown here consists of $288,650 in debt service reserve fund, plus $65,570 of debt service fund deposits. - Bond issued 7/24/14: The amount shown here consists of $768,700 in debt service reserve fund, plus $186,530 of debt service fund deposits. - Bond issued 6/28/16: The amount shown here consists of $179,600 in debt service reserve fund, plus $44,135 of debt service fund deposits. - Bond issued 12/28/17: The amount shown here consists of $419,888 in debt service reserve fund, plus $195,102 of debt service fund deposits. Part III Part III has not been completed with respect to the refunding bonds issued 6/28/2012, since the bonds being refinanced by such bonds were issued before 2003. Part IV, Line 6, Bond Issued 6/28/12 The "yes" answer here refers to the debt service reserve fund that (in the aggregate for the entire issue, including the institution's portion plus all other participating institutions) exceeds the amount qualifying as a reasonably required reserve or replacement fund. It is our understanding that the Authority appropriately restricts the investment yield on the excess amounts. A Maine Health & Higher Educational Facilities Authority 010314384 56042REW8 2016-06-28 1349217 See Part VI 0 0 1 B Maine Health & Higher Educational Facilities Authority 010314384 56042RQL9 2017-12-28 8909963 See Part VI 0 0 1 A 250000 1349217 223735 25510 1349217 1 0 1 1 B 230000 8909963 614990 94253 8909963 1 0 1 1 A 0 0 0 0 0.00000 0.00000 0.00000 0 0 0 B 0 0 0 0 0.00000 0.00000 0.00000 0 0 0 A 0 1 0 0 0 0 0 0 0 B 0 1 0 0 0 0 0 0 0 A 0 B 0 990 Form, Part V, Line 1a Maine Medical Center (EIN 01-0238552), acting on behalf of MaineHealth (EIN 01-0431680), filed 1,030 Form 1099s for the calendar year 2017 on behalf of the following organizations: MaineHealth, Maine Medical Center, Southern Maine Health Care, Pen Bay Medical Center, Waldo County General Hospital, Franklin Memorial Hospital, LincolnHealth Group, Memorial Hospital, Western Maine Health Care, Maine Behavioral Healthcare, NorDx, MaineHealth Care at Home. Prior to consolidating accounts payable operations with Maine Medical Center (EIN 01-0238552), the entity filed 67 Form 1099s for the calendar year 2017. Form 990, Part VI, Section A, line 6 Coastal Healthcare Alliance (CHA) (EIN# 22-2494475) is the sole member of PBMC. MaineHealth (EIN# 01-0431680), as the sole member of CHA, has the right to approve significant decisions of the governing body of CHA and its subsidiaries. Form 990, Part VI, Section A, line 7a The sole member, CHA (EIN# 22-2494475) may elect the Board of Trustees from a slate of nominees submitted by the Corporation. The officers are elected by the Board of Trustees. Form 990, Part VI, Section A, line 7b Decisions of the governing body such as budgets, business strategies, significant financial commitments, amendments to the Articles of Incorporation, and election of the President/CEO among other decisions, are subject to approval by Coastal Healthcare Alliance (EIN# 22-2494475) and MaineHealth (EIN# 01-0431680). Form 990, Part VI, Section B, line 11b A detailed review of the Form 990 is performed by the Controller. The Form 990 is reviewed in detail with the Finance Committee. It is then made available to the full board prior to filing. Form 990, Part VI, Section B, line 12c At the beginning of service, board members and officers are required to document any conflict of interest that may exist, and they are required to report any additional conflicts as they arise. Board member and officer conflict of interest forms are updated and reviewed annually. Form 990, Part VI, Section B, line 15 Compensation for Top Official The process followed for determining compensation of the CEO compensated by this or other related organization is a formal process performed annually by the Executive Committee of the Board of Directors. A related organization uses an outside firm, Sullivan Cotter, to perform an independent benchmark analysis for the CEO of Penobscot Bay Medical Center, along with other executives in the MaineHealth system. The firm meets with the Executive Committee to review each executive's benchmark report. The Committee then deliberates on MaineHealth's written salary and incentive plan philosophy before making a final decision. All decisions and meetings are captured in minutes and there are appropriate approvals at all levels. Compensation Process for Officers At the time of hire the Compensation department utilizes market data to provide an accurate, competitive and appropriate offer. On an annual basis officers receive a merit increase related to the results of their annual performance appraisal performed by the CEO. At this time it is evaluated if an additional bonus will be provided based upon budget and performance, this is at the discretion of the CEO, CFO and HR Director. Form 990, Part VI, Section C, line 19 Documents that are required to be open for the public inspection are made available upon request. Form 990, Part IX, line 11g Other fees for services: Program service expenses 4,387,709. Management and general expenses 248,991. Fundraising expenses 0. Total expenses 4,636,700. Temp personnel: Program service expenses 1,961,504. Management and general expenses 111,310. Fundraising expenses 0. Total expenses 2,072,814. Locum tenens: Program service expenses 1,915,303. Management and general expenses 108,688. Fundraising expenses 0. Total expenses 2,023,991. Lab services: Program service expenses 4,349,164. Management and general expenses 0. Fundraising expenses 0. Total expenses 4,349,164. Form 990, Part XI, line 9: Transfer from affiliates 203,379. Loss on investment in Pine Tree Insurance -19,310. Transfer of net assets from Kno-Wal-Lin 314,221. Coastal Healthcare Alliance PO Box 287 Belfast ME 04915 222494475 Healthcare ME 501(c)(3) Line 12b, II MaineHealth 0 Quarry Hill PO Box 287 Belfast ME 04915 010213976 Long-term care ME 501(c)(3) Line 10 Coastal Healthcare Alliance 0 Pen Bay Behavioral Health PO Box 287 Belfast ME 04915 010277794 Behavioral health ME 501(c)(3) Line 10 Coastal Healthcare Alliance 0 Kno-Wal-Lin Home Care and Hospice PO Box 287 Belfast ME 04915 010340947 Home health ME 501(c)(3) Line 10 Coastal Healthcare Alliance 0 Kno-Wal-Lin Help at Home Inc PO Box 287 Belfast ME 04915 222968726 Home services ME 501(c)(3) Line 10 Coastal Healthcare Alliance 0 Pen Bay Waldo Healthcare Foundation PO Box 287 Belfast ME 04915 222482325 Fundraising ME 501(c)(3) Line 7 Coastal Healthcare Alliance 0 Penobscot Bay Physicians & Assoc PO Box 287 Belfast ME 04915 010530517 Physician services ME 501(c)(3) Line 12b, II Penobscot Bay Medical Center 1 MaineHealth 110 Free Street Portland ME 04101 010431680 Healthcare ME 501(c)(3) Line 12c, III-FI N/A 0 Waldo County General Hospital 118 Northport Ave Belfast ME 04915 010177170 Hospital ME 501(c)(3) Line 3 Coastal Healthcare Alliance 0 Waldo County Home Healthcare Svcs PO Box 287 Belfast ME 04915 222864960 Hospice ME 501(c)(3) Line 10 Coastal Healthcare Alliance 0 Coastal Medical Care PO Box 287 Belfast ME 04915 010487091 Medical services ME 501(c)(3) Line 10 Coastal Healthcare Alliance 0 Belfast Public Health Nursing PO Box 287 Belfast ME 04915 043359810 Public health ME 501(c)(3) Line 10 Coastal Healthcare Alliance 0 PBH Management Company PO Box 287 Belfast ME 04915 010537278 Management services ME N/A C 0 Waldo County Healthcare Mgmt Co PO Box 287 Belfast ME 04915 010485133 Management services ME N/A C 0 0 1 1 0 1 0 0 0 0 0 1 1 1 1 1 1 1 1 1 Pen Bay Physicians & Associates M 18526974 Fair Market Value