2018-08-03T12:09:52-07:00 2017-09-30 990 2016-09-25 010372148 EASTERN MAINE HEALTHCARE SYSTEMS TAMC THE AROOSTOOK MEDICAL CENTER TAMC EAST 2079739081 PO BOX 151 PRESQUE ISLE ME 04769 John J Doyle EMHS VP of Finance 2018-08-03 false 2016 2022-09-23 18:48:47Z John J Doyle 323198522 false false 5247 X WWW.TAMC.ORG X 1981 ME THE MISSION OF THE AROOSTOOK MEDICAL CENTER IS TO RESTORE, MAINTAIN, AND IMPROVE THE HEALTH OF OUR FRIENDS AND NEIGHBORS IN A COMPASSIONATE AND PROFESSIONAL ENVIRONMENT. 15 10 1181 104 0 1109211 508237 276898703 305102148 84125 -333008 178204 5874375 278270243 311151752 17500 33500 0 77242898 82654695 0 0 212115300 226766667 289375698 309454862 -11105455 1696890 80435491 77839817 59359370 55444923 21076121 22394894 X THE MISSION OF THE AROOSTOOK MEDICAL CENTER IS TO RESTORE, MAINTAIN, AND IMPROVE THE HEALTH OF OUR FRIENDS AND NEIGHBORS IN A COMPASSIONATE AND PROFESSIONAL ENVIRONMENT. false false 273802752 33500 310926001 PROVISION OF ACUTE & SUBACUTE HOSPITAL CARE RELATED TO OUTPATIENT CLINICS AND HEALTH CARE SERVICES. SERVED 30,897 PATIENT DAYS OF ROUTINE SERVICES AND 80,119 OUTPATIENTS. PROVIDED SERVICES REGARDLESS OF ABILITY TO PAY AS WELL AS EDUCATION AND PROMOTION OF HEALTH. PROVIDED OTHER UNCOMPENSATED CARE (AT COST) OF $2,537,022. 13516692 MEDICARE SHORTFALLS (AT COST). 78,165 PERSONS SERVED 2597407 MEDICAID SHORTFALLS (AT COST). 25,425 PERSONS SERVED 1239350 291156201 true true false true false false false false false true true false false true true true false true false false false false false false false false true true true false true false false false false false false false false false true false false false false false false true true true true false true 148 0 true 1181 true false false false false false false false false 0 false false false false false false false false false false X 15 10 false false true false true true true true true false false true true true true true true true false true true ME X X X John J Doyle 2079739081 43 Whiting Hill Road Brewer ME 04412 RICHARD DUNCAN Trustee 1.00 0.00 X 0 0 0 CAROL BELL Trustee/ViceChr 1.00 0.00 X X 0 0 0 DAVID WEED MD VP Med Staff 50.00 0.00 X 543567 0 25869 M MICHELLE HOOD President EMHS 1.00 50.00 X X 0 885839 271712 HOLLY JOHNSON Trustee 1.00 0.00 X 0 0 0 JOSEPH LALLANDE Trustee 1.00 0.00 X 0 0 0 ALAN LANDEEN Trustee 1.00 0.00 X 0 0 0 LYNN LOMBARD Trustee 1.00 0.00 X 0 0 0 GENE LYNCH Trustee 1.00 0.00 X 0 0 0 PETER ST JOHN Trustee 1.00 0.00 X 0 0 0 JANE TOWLE Trustee 1.00 0.00 X 0 0 0 BARRY MCCRUM Trustee 1.00 0.00 X 0 0 0 SERGIO LEMA-GUTIERREZ MD Pres. Med Staff 50.00 0.00 X 254522 0 32467 SCOTT VIOLETTE Trustee 1.00 0.00 X 0 0 0 STEVE ST PIERRE Trustee/Chair 1.00 0.00 X X 0 0 0 GLENDA DWYER Interim Preside 50.00 0.00 X X 240039 0 23286 MAURA KELLY VP of Finance 50.00 0.00 X 220738 0 17797 ANTHONY FILER Sr VP/CFO/Treas 1.00 50.00 X 0 177611 2703 GREGORY LAFRANCOIS SVP, President 50.00 0.00 X 34708 0 198 GLENN MARTIN VP/Gen Csl/Sec 1.00 50.00 X 0 368621 90480 JAY REYNOLDS MD CMO/CCO 50.00 0.00 X 257070 0 40352 ROGER PELLI DO CMIO 50.00 0.00 X 275806 0 31259 ROLAND JOY VP Pat Care Svc 50.00 0.00 X 203062 0 24748 YOOSUF SIDDIQUI VP HR/NW 1.00 50.00 X 0 126727 32816 JOY BARRESI SAUCIER VP Strategy/Com 50.00 0.00 X 141797 0 11269 NARAYANA PRASANNA Otolaryngologist 40.00 0.00 X 670290 0 4259 NATHAN UEBELHOER Physician 40.00 0.00 X 571001 0 929 ARJUN SOOD Oncologist 40.00 0.00 X 560023 0 13768 RICHARD LEIDINGER Urology 40.00 0.00 X 544836 0 29217 MARK A BILLINGTON Surgeon 40.00 0.00 X 542226 0 17476 SYLVIA S GETMAN Sr VP & President 40.00 0.00 X 180719 0 29188 JAMES E MCKENNEY VP Support Services 40.00 0.00 X 123063 0 22635 C BRUCE SANDSTROM VP of Finance 0.00 40.00 X 54177 250119 18135 5417644 1808917 740563 119 true true false COMPHEALTH INC PO BOX 972651 DALLAS TX 753972651 PHYSCN FEES-LOCUMS 1511855 AMERICAN MOBILE NURSE DBA 2735 COLLECTION CENTER DRIVE CHICAGO IL 60693 TEMP STAFF 1364518 HUDSON STAFFING PLLC 4625 NADINE LN FRANKLIN TN 37064 TEMP STAFF 1105625 AROOSTOOK MRI LLC PO BOX 6600 NEWPORT BEACH CA 92658 CONTRACTED SERVICES 558459 FRESH AIR LLC 43 HIGH STREET CARIBOU ME 04736 AIR AMBULANCE 492176 20 307619 200618 20558 508237 Cafeteria 722210 419789 419789 LiveSafe Revenue 624200 227774 227774 Program Service 621990 304454585 304454585 305102148 252367 252367 0 0 25037 69695 -44658 -44658 -44658 11281370 2148 11868893 -587523 2148 -585375 -585375 0 0 158704 108182 50522 50522 340B Revenue 621990 5574514 5574514 Meaningful Use 621990 289000 289000 Misc Revenue 900099 4997 4997 5868511 311151752 310506212 137303 33500 33500 0 0 0 2378554 1688722 689832 0 66242432 59270691 6971741 1819210 1628381 190829 8298023 7442292 855731 3916476 3505651 410825 0 33970 33970 25154 25154 0 0 0 14560482 9613789 4946693 115241 82 115159 2513749 1671433 842316 2945773 2624140 321633 0 2743531 2061349 682182 527063 391792 135271 0 32951 13292 19659 825111 825111 0 3903877 3117704 786173 1763814 1725755 38059 CONTRACTUAL ALLOWANCES 166349292 166349292 MEDICAL SUPPLIES EXPENSE 15624561 15624561 PROVISION FOR BAD DEBTS 6323279 6323279 Charity Care 5020903 5020903 3457916 3049593 408323 309454862 291156201 18298661 0 3715 3740 1882787 100 0 20576569 25218635 0 0 640432 649349 2084926 2198408 1337376 1405780 92546263 57755497 37772988 34790766 0 0 0 0 16136698 13573039 80435491 77839817 33152188 28952892 50905 6695 26156277 26485336 59359370 55444923 X 14051974 15158148 4299974 4512573 2724173 2724173 21076121 22394894 80435491 77839817 X 1696890 430210 -808327 X false true X true false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false false false true 18347 18347 false false Part II-B, Line 1i - Other Activities Description Non-deductible portion of dues. 3203458 365752 609560 17950 2941700 2948531 265032 4859 5246 3203458 3058725 5000 -75498 19939 19757 2948531 1909135 1169884 20294 3058725 1709599 -28551 244429 16342 1909135 0.61000 0.39000 false true true 227598 227598 43244717 26619063 16625654 3253264 1876873 1376391 42570614 27276621 15293993 3250070 1982940 1267130 34790766 Assets whose use is limited 73576 Board Designated Other 5796355 Investments in County Physical Therapy 378932 Other Assets 87430 Permanently Donor Restricted Funds 2724173 Temporarily Donor Restricted Funds 4512573 13573039 Amounts due to Related Org 20437379 Reserve for Asset Disposal Costs 256602 Reserve for Retiree Health Benefits 5791355 26485336 X Part V, Line 4: Intended uses of the endowment fund. Endowment Funds are designated for purposes that align within this organization's exempt purpose. Part X : FIN48 Footnote EMHS, its hospitals, and certain other affiliates have been determined by the Internal Revenue Service to be tax-exempt charitable organizations as described in Section 501(c)(3) or 501(c)(2) of the Internal Revenue Code (the Code) and, accordingly, are exempt from federal income taxes on related income pursuant to Section 501(a) of the Code. Accordingly, no provision for federal income taxes has been recorded in the accompanying consolidated financial statements for these organizations.Tax-exempt charitable organizations could be required to record an obligation 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 System has evaluated its tax position taken or expected to be taken on income tax returns and concluded the impact to be not material.Certain of the System's affiliates are taxable entities. Deferred taxes related to these entities are based on the difference between the financial statement and tax basis of assets and liabilities using enacted tax rates in effect in the years the differences are expected to reverse. The deferred tax assets and liabilities for these entities are not material. true true true X true X true true true false true true 608 1239350 1239350 0.00900 25425 14837411 12240004 2597407 0.02000 149139 149139 0.00100 26033 16225900 12240004 3985896 0.03000 6 220 75934 755 75179 0.00100 4 100 1026196 1026196 0.00800 12 150 42223 42223 0.00010 22 470 1144353 755 1143598 0.00910 22 26503 17370253 12240759 5129494 0.03910 true 2537022 45134145 58650837 -13516692 X true true COUNTY PHYSICAL THERAPY OUTPATIENT PHYSICAL THERAPY 0.50000 1 1 The Aroostook Medical Center 140 Academy Street Presque Isle ME 04769 www.tamc.org 37937 X X X The Aroostook Medical Center 1 false false true X X X X X X X X X 16 true true true true X http://tamc.org/ X www.EMHS.org/Community-Benefit/CHNA.aspx X true 16 true http://www.emhs.org/Community-Benefit/CHNA/ false false true X 150.0000 250.0000 true true X X X true X See Part V, Line 16i-j for URL X See Part V, Line 16i-j for URL X See Part V, Line 16i-j for URL X X X X X X X true X false X X X X true X false false Part V, Line 5 - Account Input from Persons Who Represent the Community The Maine Shared CHNA research team conducted a statewide survey among stakeholders to identify and prioritize significant health issues in communities across the state. The survey, coordinated with the Maine CDC, engaged public health expertise throughout the process. The survey was administered using a snowball approach where stakeholder agencies agreed to send the surveys to their members and stakeholders for participation. 1,639 people, representing more than 80 organizations and businesses in Maine, completed the survey. Respondents represented health care agencies, public health agencies, law enforcement, municipalities, schools, local businesses, social service agencies, and nongovernmental organizations. In addition to the stakeholder survey, each county conducted a number of community engagement opportunities (forums) to ensure broad interests of the local community were represented; Obtain stakeholder input on identifying significant health needs based on review of shared CHNA data; Solicit stakeholder feedback on prioritizing significant health needs, and; Identify local assets and resources that potentially may address local health priorities. The local forums were conducted in collaboration with the Maine CDC to solicit input from individuals representing populations with health disparities. The following organizations were in attendance at the January 11, 2016 Presque Isle Chapter of Rotary International Shared CHNA Community Engagement Forum and provided valuable feedback on the Shared CHNA.Details about organizations: Representatives from The Aroostook Medical Center (serves low income patients on MaineCare and medically underserved patients through low cost/free care), Presque Isle city government (city council, city manager, fire chief), UMPI, NMCC, and various local businesses were present. The Rotary Club acts as a funding agency to the United Way and other local charities. Part V, Line 6a - List Other Hospital Facilities that Jointly Conducted Needs Assessment The Shared CHNA was conducted through the Maine Shared Health Needs Assessment Planning Process (SHNAPP) a collaborative effort among Maines four largest health-care systems Central Maine Healthcare, Eastern Maine Healthcare Systems (EMHS), MaineGeneral Health, MaineHealth and the Maine Center for Disease Control and Prevention, an office of the Maine Department of Health and Human Services (DHHS). EMHS member organizations participating in the Shared CHNA included Acadia Hospital, Blue Hill Memorial Hospital, Charles A. Dean Memorial Hospital, Eastern Maine Medical Center, Inland Hospital, Maine Coast Memorial Hospital, Mercy Hospital, Sebasticook Valley Health, and TAMC. Part V, Line 11 - Explanation of Needs Not Addressed and Reasons Why Priorities of Focus - Based on the Aroostook County needs identified during the Community Health Needs Assessment, TAMC has selected the following areas for which we can make a positive impact within our region. Going forward, these priorities will be a focus of our community outreach and operational resources.1. Decrease youth obesity.2. Decrease number of adults age 20-60 with cardiovascular disease risk factors. 3. Improve health status of adults over 65 with 3 or more chronic conditions.4. Decrease inappropriate emergency department utilization by the Medicaid population.5. Improve access to behavioral health services.6. Increase early identification of domestic violence and link victims with appropriate resources.Secondary Focus - For the following community needs, TAMC will play a collaborative role by partnering with and supporting the organizations in the community that are already focused on these areas.1. Oral Health2. Transportation3. Affordable Housing4. Economic Development5. Educational Attainment Part V, Line 13b - Criteria For Providing Discounted Care If Not FPG Due to software glitch, this is in reference to Part V, Line 14 Explain Method for Applying for Financial Assistance - See Part VI, Additional Information for explanation. Part V, Line 16i - Other Means Hospital Facility Publicized the Policy Response for 16a, 16b, 16c (list url) is http://tamc.org/Patients-Visitors/Billing-Help.aspx under Financial Assistance Program. AROOSTOOK GENERAL & VASCULAR SURGERY CTR 146 ACADEMY STREET STE 1A PRESQUE ISLE ME 04769 OUTPATIENT PHYSICIAN CLINIC FAMILY PRACTICE & INTERNAL MEDICINE 23 NORTH STREET STE 4 PRESQUE ISLE ME 04769 OUTPATIENT PHYSICIAN CLINIC OBGYN MIDWIFERY 140 ACADEMY STREET STE 4 PRESQUE ISLE ME 04769 OUTPATIENT PHYSICIAN CLINIC AROOSTOOK PEDIATRICS 23 NORTH STREET STE 1 PRESQUE ISLE ME 04769 OUTPATIENT PHYSICIAN CLINIC SLEEP MEDICINE SERVICES 140 ACADEMY STREET STE 3 PRESQUE ISLE ME 04769 OUTPATIENT PHYSICIAN CLINIC AROOSTOOK CANCER CARE 140 ACADEMY STREET PRESQUE ISLE ME 04769 OUTPATIENT PHYSICIAN CLINIC COUNTY DIALYSIS CENTER 23 NORTH STREET SUITE 5 PRESQUE ISLE ME 04769 OUTPATIENT PHYSICIAN CLINIC AROOSTOOK HEALTH CENTER 15 HIGHLAND AVENUE PO BOX 40 MARS HILL ME 04758 NURSING HOME, OUTPATIENT CLINIC FORT FAIRFIELD HEALTH CENTER 23 HIGH STREET FORT FAIRFIELD ME 04742 OUTPATIENT PHYSICIAN CLINIC OUTPATIENT SPECIALTY CLINICS 19 NORTH STREET PRESQUE ISLE ME 04769 OUTPATIENT PHYSICIAN CLINICS WALK IN CARE 23 NORTH STREET STE 2 PRESQUE ISLE ME 04769 OUTPATIENT PHYSICIAN CLINIC AROOSTOOK HEART & LUNG CENTER 146 ACADEMY STREET STE 1B PRESQUE ISLE ME 04769 OUTPATIENT PHYSICIAN CLINIC TAMC UROLOGY SERVICES 140 ACADEMY STREET STE 5 PRESQUE ISLE ME 04769 OUTPATIENT PHYSICIAN CLINIC NEPHROLOGY SERVICES 19 NORTH STREET PRESQUE ISLE ME 04769 OUTPATIENT PHYSICIAN CLINIC CARIBOU HEALTH CENTER 118 BENNETT DRIVE STE 130 CARIBOU ME 04736 OUTPATIENT PHYSICIAN CLINIC CENTRAL AROOSTOOK HEALTH CENTER 106 MAIN STREET MARS HILL ME 04758 OUTPATIENT PHYSICIAN CLINIC WOMENS HEALTH CENTER 140 ACADEMY STREET STE 6 PRESQUE ISLE ME 04769 OUTPATIENT PHYSICIAN CLINIC TAMC EYE SERVICES 146 ACADEMY STREET SUITE D PRESQUE ISLE ME 04769 OUTPATIENT PHYSICIAN CLINIC CROWN AMBULANCE 140 ACADEMY STREET PRESQUE ISLE ME 04769 AMBULANCE SERVICE TAMC ORTHOPEDIC SERVICES 140 ACADEMY STREET SUITE 10 PRESQUE ISLE ME 04769 OUTPATIENT PHYSICIAN CLINICS SLEEP DISORDERS CENTER 140 ACADEMY STREET SUITE 2 PRESQUE ISLE ME 04769 OUTPATIENT PHYSICIAN CLINICS TAMC EARS NOSE and THROAT 140 ACADEMY STREET SUITE 12 PRESQUE ISLE ME 04769 OUTPATIENT PHYSICIAN CLINIC CROWN AMBULANCE AROOSTOOK HEALTH CENTER 18 HIGHLAND AVENUE MARS HILL ME 04769 AMBULANCE SERVICE CROWN AMBULANCE COMMUNITY GENERAL HOSPITAL 23 GREEN STREET FORT FAIRFIELD ME 04742 AMBULANCE SERVICE Part I, Line 6a - Related Organization Community Benefit Report The TAMC community benefit report is contained in an annual community benefit report prepared by Eastern Maine Healthcare Systems which is the parent organization of all related organizations. Part I, Line 7 - Explanation of Costing Methodology Ratio of Patient Care Cost-to-Charges is used in calculations. Part I, Line 7, Column F - Explanation of Bad Debt Expense $6,323,279 of bad debt expense, $5,020,903 of charity care, $166,349,292 of contractual allowances is included on Form 990, Part IX, line 24, column (A). Part III, Line 2 - Methodology Used To Estimate Bad Debt Expense The costing methology used to determine the amount is cost to charge ratio. Part III, Line 4 - Bad Debt Expense Patient and trade accounts receivable are stated at the amount management expects to collect from outstanding balances. Management provides for probable uncollectible amounts through a charge to earnings and a valuation allowance based on its assessment of the current status of individual accounts. Balances that are still outstanding after management has used reasonable collection efforts are written off through a charge to the valuation allowance and the applicable patient accounts receivable. Credit is extended without collateral. Part III, Line 8 - Explanation Of Shortfall As Community Benefit Medicare losses should be treated as a community benefit because the losses are incurred in performing an important public service, and Maine hospitals experience one of the lowest Medicare reimbursement rates in the country. Part III, Line 9b - Provisions On Collection Practices For Qualified Patients All account guarantors who express an inability to pay inpatient and outpatient services will be screened for eligibility for charity care using an application and guidelines established by The Aroostook Medical Center. An account may be reconsidered for charity care at any time when new information is available about a patient's inability to pay. Part VI - Patient Education of Eligibility for Assistance Financial assistance or free care is available only for medically necessary services. Posters are displayed in patient care areas, information and forms are available online on the hospital website, and patient billing representatives are also available to take calls and to answer questions. Part VI - Community Information The Aroostook Medical Center (TAMC) is the largest, most comprehensive healthcare organization in Aroostook County, Maine. Governed by a volunteer board of trustees, our active medical staff consists of over 60 physicians and 48 allied health professionals. As a member of EMHS, we are able to provide care not commonly found in rural areas, including outpatient hemodialysis, diagnostic heart catheterization, acute inpatient rehabilitation, and comprehensive cancer care. A.R. Gould Memorial Hospital serves as the heart of TAMCs care delivery network, which includes Crown Emergency Care ambulance service, Crown Critical Care Transport ground and fixed-wing air transport service. TAMC also has several primary care centers, a broad scope of specialty services, and a 72 bed long-term skilled nursing and rehabilitation center. TAMC serves as EMHSs most northern member serving all of Aroostook County, Maine. As such, TAMC acts as a leader in the region to improve overall community wellness. TAMC leadership serves on the boards and subcommittees of the Aroostook District Public Health Council and several other health and economic development organizations.Aroostook County is home to 68,628 people, living in a region encompassing 6,671 square miles, with a population density of 10.1 people per square mile. Aroostook has 21.9% of the population over 65 years of age, which is higher than the Maine rate of 18.8%. Aroostook is predominately white (95.4%), with a small Afican American (0.9%), American Indian (1.9%) and Hispanic (1.2%) population. Aroostook trails Maine in education status with only 86.3% of adults having a high school diploma and less than 17% having a bachelors degree. The median household income in Aroostook is $37,378 and over 20% of people live below the poverty level. Major industries include agriculture and forestry.Of Maines 16 counties, Aroostook County ranks fifteenth in health outcomes and sixteenth for quality of life. Top health issues include obesity, drug and alcohol abuse, cardiovascular disease, diabetes, and respiratory diseases. Factors influencing health in Aroostook include access to behavioral and mental health care, poverty, employment, health insurance, and transportation. Aroostook County, like much of the State of Maine has also been challenged with an increasing incidence of opioid abuse and overdoses. Part VI - Explanation Of How Organization Furthers Its Exempt Purpose Collaboration is imperative in Aroostook County as TAMC works with numerous local and regional organizations to improve community health and engage people of all ages in healthy behaviors. Over the past year, TAMC has partnered with each of the Countys hospitals, the higher education institutions, the local CAP agency, the local agency on aging, the Aroostook Autism Support Group, United Way of Aroostook, and several other organizations to bring a variety of programs to the community. From promoting physical activity, identifying those with food insecurity challenges, providing education about chronic disease management, working on cutting smoking rates, to provide education about opioid abuse, TAMC has helped positively affect the lives of thousands of residents in northern Maine across the age spectrum. In the fall of 2017, TAMC provided free influenza vaccinations to 1,057 County residents. Part VI - Affilated Health Care System Roles and Promotion The 2016 Shared Community Health Needs Assessment conducted by EMHS (Eastern Maine Healthcare Systems) in collaboration with several member/affiliated hospitals and the many public health and community organizations across the state. The Shared Community Health Needs Assessment informs initiatives to promote community health across the system as well as within each member hospitals local service area. Each member hospital adopted a local implementation strategy and community health improvement plan, tailored to meet local needs.TAMC is a member of EMHS. EMHS (Eastern Maine Healthcare System) includes nine hospitals, numerous physician practices, long-term care facilities, home health and hospice, and ground and air emergency transport. EMHS has a proven record of quality outcomes, cost reduction, and highly engaged patients. The EMHS statewide network of care is tailored to the needs of communities and individuals, working to ensure that the people of Maine have the care they need close to home. Promotion of health is a major priority for EMHS. EMHS leadership participates on the Maine CDC Public Health Statewide Coordinate Council and the Maine Public Health Association. EMHS coordinates several state-wide wellness initiatives. All hospitals are engaged around specific initiatives related to combating opioid abuse and food insecurity.TAMC (The Aroostook Medical Center) serves as EMHSs most northern member serving all of Aroostook County, Maine. As such, TAMC acts as a leader in the region to improve overall community wellness. TAMC leadership serves on the board of the Maine CDC Aroostook District Public Health Council. Over the past year, TAMC has engaged with several community organizations to introduce a significant number of health promotion and wellness activities, including a women's health conference, year round family physical activity series, kids safety fair, community health fair, wellness presentations for seniors, health screenings, chronic disease management classes, provided outreach to the local housing authority and local native American tribe focused on wellness activities, provider speakers for various community health events, and collaborated with a local CAP agency to provide food insecurity screening and referral program for primary care patients. Part VI - States Where Community Benefit Report Filed N/A Part VI - Additional Information Disclosure in accordance with Revenue Procedure 2015-21:Part V Facility Information, Section B Facility Policies and PracticesIn accordance with Revenue Procedure 2015-21, TAMC is disclosing the following information with respect to Section 501(r) issues that were discovered during the 2017 tax year and how these have been corrected to satisfy 501(r) requirements.For all items:A good-faith effort was made to implement the requirements of the Section 501(r) regulations. TAMC obtained information about the requirements and sought to implement them accordingly, but later identified some compliance gaps due to the detailed nature of the regulations.The issues were discovered in fiscal year 2017 during an internal audit of TAMCs compliance with Sections 501(r)(3-4). The correction of these issues did not result in any changes to our overall processes and, therefore, TAMC has not identified any persons directly affected by these issues. All individuals would have been in the same position had these issues not occurred.To ensure full compliance with Section 501(r) regulations, EMHS Community Health and Revenue Cycle Departments perform routine reviews to assure TAMC is in compliance with Section 501(r). In addition, EMHS continues to engage EMHS Internal Audit to review TAMCs compliance with Section 501(r).Specific issues and corrections:1. Approval of the Community Health Needs Assessment (CHNA) and Implementation Strategy a. Requirement: The CHNA must be documented in a written report that is adopted for the hospital facility by an authorized body of the hospital facility. An authorized body of the hospital facility also must adopt an implementation strategy to meet the community health needs identified through the CHNA on or before the 15th day of the fifth month after the end of such taxable year. b. Condition: While the Board minutes and related meeting materials retained for TAMC demonstrated the Boards intent to approve both the CHNA and implementation strategy, the Board vote(s) as documented in the minutes did not clearly demonstrate that the Board approved both items. c. Corrective Action: A resolution was passed by TAMCs Board to clarify the Boards intent to approve the CHNA and implementation strategy. d. Date Corrected: TAMC: May 4, 20172. Information in the FAP regarding Amounts Generally Billed (AGB) a. Requirement: The FAP must include the method the hospital facility uses to determine the amounts generally billed to individuals who have insurance covering emergency or other medically necessary care and must state the AGB percentages or explain how members of the public may readily obtain such percentages.b. Condition: While the Plain Language Summary (PLS) indicated that AGB will be calculated using the look-back method, based on actual past claims paid to the hospital by Medicare and by other private insurers, the FAP did not adequately explain the method used to determine AGB, state the AGB percentages or explain how members of the public may readily obtain the AGB percentages (and these AGB percentages also were not otherwise readily available). c. Corrective Action: The FAP was updated to explain the method used to determine AGB. The FAP was also updated to state To request a free written description of how EMHS calculates the AGB or to find out the actual AGB for a particular EMHS hospital, please contact (207) 973-6473 or (207) 973-4483 or on the Web at http://emhs.org/Billing-help.aspx. TAMCs AGB percentage was added to this Web site. d. Date Corrected: These revisions to the FAP were approved by EMHS Leadership in Fiscal Year 2017 and the EMHS Board of Directors at its October 4, 2017 meeting. The updated FAP was widely publicized upon approval by the EMHS Board of Directors. The AGB percentages were added to the EMHS Web site in January 2018.3. Presumptive eligibilitya. Requirement: The FAP must include whether and under what circumstances prior FAP-eligibility determinations are used for presumptive eligibility.b. Condition: The FAP explained that approved applications from one EMHS Member Organization will be honored at another EMHS Member Organization, but did not fully describe the circumstances under which prior FAP-eligibility determinations are used for presumptive eligibility.c. Corrective Action: The FAP has been updated to fully describe whether and under what circumstances prior-FAP eligibility determinations are used for presumptive eligibility. d. Date Corrected: These revisions to the FAP were approved by EMHS Leadership on May 1, 2018 and the revised FAP has been widely publicized. 4. Emergency Medical Care Language in the FAPa. Requirement: A written policy must be established to require that care will be provided, without discrimination, for emergency medical conditions to individuals regardless of whether they are FAP-eligible.b. Condition: It was and is TAMCs practice to provide care for emergency conditions to individuals regardless of whether they are FAP-eligible; however, upon review of TAMCs FAP it was determined that this practice was not explicitly stated.c. Corrective Action: The FAP was updated to explicitly state that EMHS Hospitals will provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility for assistance under the FAP and as required under the EMHS Emergency Medical Care Policy. d. Date Corrected: These revisions to the FAP were approved by EMHS Leadership in Fiscal Year 2017 and the EMHS Board of Directors at its October 4, 2017 meeting. The updated FAP was widely publicized upon approval by the EMHS Board of Directors. 5. Billing and Collection Practicesa. Requirement: The FAP (or separate billing and collection policy) must include information on the actions the hospital will take to collect outstanding balances, including the reasonable efforts made to determine FAP eligibility. This information must be widely publicized along with the FAP.b. Condition: The billing and collection practices were adequately described in the Billing and Collections Policy which was referenced in the widely publicized FAP. However, the Billing and Collections Policy itself was not widely publicized.c. Corrective Action: The required billing and collection practices were added to the FAP. d. Date Corrected: These revisions to the FAP were approved by EMHS Leadership in Fiscal Year 2017 and the EMHS Board of Directors at its October 4, 2017 meeting. The updated FAP was widely publicized upon approval by the EMHS Board of Directors.6. Widely Publicized a. Requirement: In order to ensure the FAP is widely publicized , a hospital must take several actions, one of which is to include a conspicuous written notice on billing statements that notifies and informs recipients about the availability of financial assistance under the hospital facilitys FAP and includes the telephone number of the hospital facility office or department that can provide information about the FAP and FAP application process and the direct Web site address (or URL) where copies of the FAP, FAP application form and plain language summary of the FAP may be obtained.b. Condition: While TAMCs billing statements included a conspicuous written notice to notify recipients about the availability of financial assistance and a telephone number to the department that can provide more information about financial assistance, the billing statement did not provide a direct Web site address (or URL) for the EMHS billing help Web site where a copy of the FAP documents could be obtained.c. Corrective Action: Billing statements were updated in Fiscal Year 2017 to clarify that certain FAP-related documents may also be obtained from the Web site address provided on the statement. In Fiscal Year 2018, TAMC made additional revisions to further clarify the language included on the billing statements.d. Date Corrected: TAMC: June 15, 2017 with additional revisions made in Fiscal Year 2018.7. PLSa. Requirement: The PLS must include certain information, including a statement of the availability of translations of the FAP, FAP application form and PLS in other languages, and a statement that a FAP-eligible individual will not be charged more than AGB for emergency or other medically necessary care.b. Condition: While the PLS met most of the requirements of the regulation, it did not include a statement of the availability of translations of the FAP, FAP application form and PLS in other languages, and also did not clearly state that a FAP-eligible individual will not be charged more than AGB for emergency or other medically necessary care.c. Corrective Action: The PLS was updated to include a statement of the availability of translations of the FAP, FAP application form and PLS in other languages, and to clearly state that a FAP-eligible individual will not be charged more than AGB for emergency or other medically necessary care. d. Date Corrected: After the revisions to the FAP were approved by true Aroostook Mental Health Cente 43 Hatch Drive Caribou ME 04736 010276859 501(c)(3) 10000 0 To support their mission LifeFlight Foundation PO Box 899 Camden ME 04843 522377085 501(c)(3) 10000 0 Aircraft-helicopters 2 0 Grantmaker's Description of How Grants are Used The Organization makes payments only to other not-for-profit organizations. Therefore, additional monitoring was not deemed necessary. X true true false true false false false false false false false false ANTHONY FILER Sr VP/CFO/Treas 57284 120327 2703 180314 ARJUN SOOD Oncologist 553897 6126 10531 3237 573791 C BRUCE SANDSTROM VP of Finance 8580 221852 45320 25398 277 2869 2970 3824 787 10554 57934 264497 DAVID WEED MD VP Med Staff 539457 4110 14575 11294 569436 GLENDA DWYER Interim Preside 216014 7596 16429 11870 11416 263325 GLENN MARTIN VP/Gen Csl/Sec 362009 6612 69889 20591 459101 JAMES E MCKENNEY VP Support Services 98531 12682 11850 6954 15681 145698 JAY REYNOLDS MD CMO/CCO 244129 9243 3698 14003 26349 297422 JOY BARRESI SAUCIER VP Strategy/Com 134072 5378 2347 7894 3375 153066 M MICHELLE HOOD President EMHS 870512 15327 250857 20855 1157551 MARK A BILLINGTON Surgeon 534135 8091 7950 9526 559702 MAURA KELLY VP of Finance 216940 3798 17797 238535 NARAYANA PRASANNA Otolaryngologist 584822 80000 5468 4259 674549 NATHAN UEBELHOER Physician 568263 2738 929 571930 RICHARD LEIDINGER Urology 488104 50200 6532 4469 24748 574053 ROGER PELLI DO CMIO 252806 14359 8641 11963 19296 307065 ROLAND JOY VP Pat Care Svc 186933 9415 6714 5933 18815 227810 SERGIO LEMA-GUTIERREZ MD Pres. Med Staff 251227 2900 395 7856 24611 286989 SYLVIA S GETMAN Sr VP & President 140668 14941 25110 16890 12298 209907 YOOSUF SIDDIQUI VP HR/NW 124953 1774 7957 24859 159543 Part I, Line 1a: Relevant information in regards to selections on 1a. The following received a wellness program incentive:Joy Barresi Saucier, officer $322Glenda Dwyer, officer/trustee 357Sylvia Getman, former officer/trustee 157Maura Kelly, officer 62Gregory LaFrancois, officer/trustee 15James McKenney, former officer 267Narayana Prasanna, highest compensated employee 15David Weed, officer/trustee 307The benefit is available for all employees.The following received a giftcard for $30 with a $9.06 gross up payment:Joy Barresi Saucier, officer Mark Billington, highest compensated employeeGlenda Dwyer, officer/trustee Roland Joy, officer Richard Leidinger, highest compensated employee Sergio Lema-Gutierrez, officer/trustee James McKenney, former officer Roger Pelli, officer Arjun Sood, highest compensated employee Nathan Uebelhoer, highest compensated employee David Weed, officer/trustee The following received a giftcard for $15 with a $9.06 gross up payment:Jay Reynolds, officer Bruce Sandstrom, former officer Tina Weed fam mem=officer 52512 compensation false Beverly McCrum fam mem=brd mem 27653 compensation false Schedule L, Part V Supplemental Information Tina Weed is a family member of an officer and is an employee of TAMC.Beverly McCrum is a family member of a board member and is an employee of TAMC. Form 990, Part III, Line 4d: Other Program Services Description OTHER PROGRAM SERVICES 4: CHARITY CARE PROVIDED (AT COST). 608 PERSONS SERVED OTHER PROGRAM SERVICES 5: Please see the following excerpt from the EMHS Annual Report to the Community for details of community benefit projects at EMHS members: OTHER PROGRAM SERVICES 6: Coming together is a beginning; keeping together is progress; working together is success. The man who spoke these words understood the value of teamwork. He embraced technology in a way that nobody else had before him. His vision, passion, and innovation revolutionized the world. He made it possible for families to feel more connected despite living long distances apart. In many ways, EMHS shares the same goals championed 100 years ago by industrialist and automaker, Henry Ford.Like Ford, we know that we are succeeding by working together. Our new integrated, systemwide electronic health record (EHR) will allow all our hospitals, primary care practices, and other members within the EMHS family to share information seamlessly. Using this system, we can collaborate more effectively and improve patient care. OTHER PROGRAM SERVICES 7: By mass-producing the automobile, Ford helped rural Americans feel connected. We are connecting people through technology, too. People who live in rural communities can talk one-on-one through a computer screen with doctors who may be several states away, thanks to our investments in telemedicine. Patients have access to specialists that would have been out of reach without this technology.Ford was an innovator. We too are embracing innovation in the way we deliver care. Our partnership with Dana-Farber Cancer Institute affords opportunities for cancer patients to access clinical trials closer to home at our Lafayette Family Cancer Center in Brewer. We are using paramedics to make routine house calls in our rural communities to perform wellness checks. This service is helping patients avoid trips to the hospital or doctors office while getting compassionate care in the comfort of their own homes. OTHER PROGRAM SERVICES 8: Of course, all of these initiatives require dedicated people who are committed to teamwork. Its the very reason why we take extraordinary measures to recruit and retain our employees. We have added a new nurse residency program, which is already showing signs of success in addressing a critical statewide nursing shortage and providing our nurses the tools they need to thrive. By working together, we can continue to do great things.To borrow another line from Henry Ford, If everyone is moving forward together, then success takes care of itself. In the pages that follow are numerous testaments to the innovative spirit underscoring many successes this past year throughout our system. While the hard work will continue, we are pleased to share with you the progress we are making towards achieving our vision to be a nationally recognized model of excellence in healthcare. OTHER PROGRAM SERVICES 9: M. Michelle Hood, FACHEEMHS President and CEOBarry McCrumEMHS Board Chair OTHER PROGRAM SERVICES 10: CONNECTING WORLD CLASS CARETerry White longs for the day that she can return to the sandy shores of Myrtle Beach to feel the warm Carolina sunshine on her face and the ocean waves splashing upon her feet. She has plans to go back to visit family and wont let cancer slow her down. My journey is not over just because I have this disease, Terry said. It doesnt mean life doesnt go on. I definitely have a lot of life to live.Terry was diagnosed with breast cancer a decade ago. I was 38 when I found a lump in my breast in the shower one morning and immediately called my primary care physician. Unfortunately, the cancer became metastatic, meaning it spread to other parts of her body. I went from being a survivor to a lifer because I live with cancer every day, and Ill live with it every day until the end, she said. Terry has gone through several treatments of radiation and chemotherapy over the years. OTHER PROGRAM SERVICES 11: During a recent visit to EMMC Cancer Care at the Lafayette Family Cancer Center in Brewer, she was comfortably dressed in jeans and a maroon blouse, and wore a hat on her head. Because the cancer spread to the bone marrow in her leg, she wore a knee brace to alleviate pain. Whats remarkable about Terry is how she projects a positive attitude. A powerful storm that day was toppling trees and knocking down power lines outsideit wasnt enough to stop her from making the 30-minute ride to the treatment center from her home in Pittsfield or to diminish her optimism. Research today has given us treatments that are light years ahead of what we used to have, she said. OTHER PROGRAM SERVICES 12: Terry is hopeful because she is taking part in a clinical trial thanks to a collaborative partnership between Dana-Farber Cancer Institute in Boston and EMMC Cancer Care. She is taking an experimental drug under the coordinated care of her medical team in Brewer and the Dana-Farber specialists in Boston. The treatment I come for is administered by a syringe. I dont have to sit there for four hours waiting for this to be over and waiting for the side effects, she said.Eric Winer, MD, is chief clinical strategy officer at Dana-Farber and director of the Breast Oncology Center. He and other members of the Dana-Farber team visited EMMC Cancer Care last fall for a tour. Dana-Farber only partners with cancer centers that already deliver excellent care, Dr. Winer said. The goal of the collaborative for Dana-Farber is to extend its reach and bring clinical trials to people living in rural areas. When people participate in clinical trials, the hope is that they will do better than they might with standard care, but no matter what, they are contributing to the future of cancer care, he said. OTHER PROGRAM SERVICES 13: The staff at EMMC Cancer Care also benefits by being in the collaborative. They have more educational opportunities and access to medical specialists at Dana-Farber for rapid consultation on complex cases. Dana-Farber clinical care is provided in Boston and this collaborative brings their expertise to the heart of Maine, explained Thomas Openshaw, MD, medical director, Oncology Research at EMMC Cancer Care. The staff at EMMC and Dana-Farber have a firm resolve to help not only current patients, but also future patients to live better lives. Our whole goal is to try to cure whatever patients can be cured, and thats a large proportion of patients, and for the others to give them the best and the longest life that they can have, Dr. Winer said.That seems to be working for Terry White, whos already making travel plans to Myrtle Beach. It gives you a reason to go through what youre going through. Weve got to learn from it for the future, she said, adding, I want to be healthy for my family, I want to participate in life with my family and my friends, and continue to enjoy life. OTHER PROGRAM SERVICES 14: CONNECTING WITH TECHNOLOGYCharles A. Dean Memorial Hospital (CA Dean) in Greenville sits along the scenic shores of Moosehead Lake, one of Maines most treasured natural resources. Its a peaceful, idyllic spot that draws tourists from far and away who are eager to get away from the hustle and bustle of their daily grind. But beneath the hum of motorboats cruising along Moosehead Lake in the summer, or the snowmobiles skirting across its icy surface in winter; beneath the laughter of kids splashing in the water on a hot August day or pulling a trophy trout through the ice on a frigid February morning, there is a rural health problem that those visitors do not see. To be fair, it affects communities throughout Maine but has been more problematic in those towns and hamlets tucked far away from urban centers. OTHER PROGRAM SERVICES 15: There is very little rural mental health period, explains Joseph Babbitt, MD, an emergency room physician and hospitalist at CA Dean. Historically people in rural communities have had to travel hours to access psychiatric services. If they showed up at any rural hospital emergency room with a mental health crisis, they had to wait hours for an evaluation. Youve got an emotionally unstable patient who is in a very disruptive emergency waiting room environment, waiting 18 hours to have a mental health professional come assess them. That doesnt help anyone, Dr. Babbitt said. OTHER PROGRAM SERVICES 16: But technology is bridging the gap and allowing those who live in rural communities to have the same access to psychiatric services as their urban counterparts. Telemedicine is a medium that connects a patient with a practitioner via a screen, explained Gavin Ducker, MD, chief medical officer at Inland Hospital in Waterville.Inland Hospital and CA Dean use telemedicine to provide psychiatric services to patients through Acadia Hospital, which offers telepsychiatry services to 15 rural emergency departments and 12 rural primary care practices across the state. CA Dean uses telemedicine for behavioral health in its emer Form 990, Part VI, Line 4: Description of Significant Changes to Organizational Documents Amended Article IV (Officers), Section 5 (President) - to remove President as the chief executive officer of the Corporation.Amended Article IV (Officers), Section 7 (Treasurer & Assistant Treasurer) - to change the title of Chief Financial Officer to VP of Finance.Amended Article V (Committees), Section 7 (Governance Committee) to change the title President/CEO to President.Amended Article V (Committees), Section 10 (Finance Committee) to change the title of Chief Financial Officer to Assistant Treasurer.Amended Article VIII (Fiduciary Duty; Prohibited Transactions; Divided Loyalty; Independence), Section 5 (Independent Trustees), Subsection (a) and Subsection (b) to change the reference to interim chief executive officer to President. Form 990, Part VI, Line 6: Explanation of Classes of Members or Shareholder The Aroostook Medical Center (the "Corporation") is a Maine nonprofit corporation. Eastern Maine Healthcare Systems ("EMHS"), also a Maine nonprofit corporation, is the sole voting corporate member of the Corporation. Form 990, Part VI, Line 7a: How Members or Shareholders Elect Governing Body Each year at their annual meeting, the directors elect replacements for those directors whose terms are expiring. Election of directors is subject to ratification by the EMHS Board of Directors. Form 990, Part VI, Line 7b: Describe Decisions of Governing Body Approval by Members or Shareholders The EMHS President has authority to appoint and remove the SVP, President of the Corporation. EMHS also has joint and superior authority to approve, disapprove or initiate action with respect to the following matters:I. amendments to the corporations Articles of Incorporation or Bylaws; II. changes in legal form of organization of the Corporation;III. election of the Directors/Trustees of the Corporation;IV. action concerning the Corporation's operating budget and capital expenditures;V. the Corporation's acquisition of assets or assumption of liabilities of an unaffiliated third party;VI. transfer of 5% or more of the assets of the Corporation;VII. financing transactions concerning the Corporation; VIII. merger, consolidation, sale, lease, mortgage, pledge or other disposition of all or substantially all assets of the Corporation;IX. add or revise a health care service of the Corporation;X. discontinue or close a health care service of the Corporation;XI. action concerning the Corporation's role in the EMHS Strategic Plan;XII. action concerning the Corporation's participation in key strategic affiliations with third parties not affiliated with EMHS; andXIII. dissolution of the Corporation Form 990, Part VI, Line 11b: Form 990 Review Process Form 990 is reviewed by the VP of Finance. It is also provided to each board member either electronically or in hard copy with an opportunity to ask questions prior to filing with the IRS. Form 990, Part VI, Line 12c: Explanation of Monitoring and Enforcement of Conflicts The organization requests updates of potential conflicts and relationships from the officers and Board members on an annual basis. The request requires disclosure of all business relationships, board memberships, and family relationships. A database is maintained that is compared to payroll records and the accounts payable vendor list to identify any potential conflicts of interest. Transactions are reviewed for reasonableness as an arm's length transaction. The first agenda item for board meetings and board committee meetings is for members to declare any conflict of interest with upcoming agenda items or deliberations. At any point when consideration is being given to purchase/contract with a party in interest, the member with the conflict is either excused from the discussion and consideration process or abstains from voting on the matter. All transactions identified with parties in interest are disclosed within the Form 990. All are deemed to be arm's length transactions. Form 990, Part VI, Line 15a: Compensation Review & Approval Process - CEO, Top Management The SVP, President of TAMC and the system President/CEO (President) who serves on the board ex-officio are employed by the system parent, Eastern Maine Healthcare Systems (EMHS). The EMHS Executive Performance Management Committee (the Committee) is responsible to monitor and evaluate the performance of the EMHS President, to set compensation of the EMHS President, and to review recommendations of the EMHS President with respect to compensation of the SVP, President of the direct subsidiaries, and other direct reports to the EMHS President. The Committee is comprised entirely of independent Directors per EMHS bylaws. Process:The Committee meets regularly throughout the fiscal year at the discretion of the Committee chair as well as on call of the Chair of the EMHS board. In carrying out its duties pursuant to the Bylaws, the Committee:- Assures that the executive compensation program is administered in a manner consistent with the EMHS executive compensation philosophy.- Reviews and updates the EMHS executive compensation philosophy which serves as the foundation on which all current and future executive compensation decisions are made.- Assures that value of compensation provided by EMHS does not exceed the value of services provided by the executive.- Reviews annual incentive compensation criteria for eligible executives, as defined by the EMHS President.- Reviews periodic compensation survey information and provides expert input to proposed changes to the executive compensation program.- Assures that a formal and timely performance management system is in place for executives.- Reviews incentive compensation criteria scoring and associated pay schedules for officers and key employees.- Provides any public statements regarding executive compensation practices at EMHS deemed appropriate.- Maintains minutes of the meetings and communicates actions to the EMHS Board of Directors.To accomplish this, the committee uses an external consultant with access to comparative data from independent sources and include national as well as regional data points. The EMHS President reviews all direct report compensation actions with the committee. In addition, the EMHS President ensures that any subsidiary policies and practices governing executive compensation are consistent with the committee's philosophy and practices statement.Form 990, Part VI, Line 15b - Compensation Review & Approval Process for Officers & Key EmployeesCompensation of other officers and key employees of the organization is established by the Human Resources department who utilize external market research to establish compensation ranges for specific positions. The compensation of officers and key employees are reviewed by the system President/CEO and EMMC Executive & Finance committee. On an annual basis, the compensation ranges are compared to the updated survey information. The hiring manager will determine where the employee will fall within the ranges established by the Human Resources department based on experience and credentials. Form 990, Part VI, Line 19: Other Organization Documents Publicly Available The Aroostook Medical Center makes its governing documents, conflict of interest policy and financial statements available to the public upon request. Other Changes In Net Assets Or Fund Balances - Other Increases Net Change in Funds Held at Affiliates = $55708 Other Changes In Net Assets Or Fund Balances - Other Increases Transfer from exempt subsidiary-EMHSF = $2500 Other Changes In Net Assets Or Fund Balances - Other Decreases Transfer to exempt parent-Eastern Maine Healthcare Systems = -$830322 Other Changes In Net Assets Or Fund Balances - Other Decreases Transfer to exempt subsidiary - EMHSF = -$36213 SCHEDULE H PART VI SUPPLEMENTAL INFORMATION Continuation of Disclosure in accordance with Revenue Procedure 2015-21:Schedule H, Part V Facility Information, Section B Facility Policies and Practices8. PLS Eligibility Requirementsa. Requirement: The PLS must include certain information, including a brief description of the eligibility requirements and assistance offered under the FAP.b. Condition: Although patients from any state could be eligible to receive financial assistance under the FAP, the PLS indicated that financial assistance or free care was only available for medically necessary or emergency care services received by Maine residents. c. Corrective Action: The PLS was updated to indicate that non-Maine residents were eligible to receive financial assistance or free care for emergency care services. d. Date Corrected: After the revisions to the FAP were approved by EMHS Leadership in Fiscal Year 2017 and the EMHS Board of Directors at its October 4, 2017 meeting, the PLS was updated and was widely publicized in October 2017. 9. Translationsa. Requirement: To widely publicize its FAP, a hospital facility must accommodate all significant populations that have limited English proficiency (LEP) by translating its FAP, FAP application form and PLS into the primary language(s) spoken by such populations.b. Condition: While the FAP, FAP application and PLS were translated into the primary languages spoken by the populations served by TAMC, the instructions to the FAP application and the title and one paragraph of the Provider List attached to the FAP (i.e., the list of providers covered by the hospitals FAP) were not translated into these languages.c. Corrective Action: The FAP application instructions and the applicable language on the Provider List were translated into the required languages.d. Date Corrected: After the revisions to the FAP were approved by EMHS Leadership in Fiscal Year 2017 and the EMHS Board of Directors at its October 4, 2017 meeting, the FAP application instructions and Provider List were updated and were widely publicized in October 2017. 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