2018-08-03T12:58:43-07:00 2017-09-30 990 2016-10-01 010198331 Maine Coast Regional Health Facilities DBA Maine Coast Memorial Hospital MAIN 2079739081 50 Union Street Ellsworth ME 04605 John J Doyle EMHS VP of Finance 2018-08-03 false 2016 2022-09-23 18:48:47Z John J Doyle 195248981 false false X www.mcmhospital.org X 1964 ME The Hospital is a not-for-profit entity established to provide health care services through its acute care facility and physician practices. 19 13 776 81 0 773010 1511261 170836146 178940395 -792533 1360804 1875107 563513 172691730 182375973 0 0 48816322 56421035 0 0 130918987 130436627 179735309 186857662 -7043579 -4481689 71512053 58914249 35590321 42129626 35921732 16784623 X The Hospital is a not-for-profit entity established to provide health care services through its acute care facility and physician practices. false false 159565029 179496912 Provided healthcare services regardless of ability to pay as well as education and promotion of health. Provided $4,314,784 of other uncompensated care (at cost).Admissions 2,508Patient Days 7,610Average Stay 3.5 daysClinic Visits:Eleanor Widener Dixon Memorial Clinic 9,798S.W. Harbor Medical Center 4,425Emergency Room Visits 14,129Surgical Cases - Inpatient 615Surgical Cases - Outpatient 3,220Laboratory Tests: 283,675Radiology Exams:Diagnostic Radiology 18,740Ultrasound 5,756CT Scan 5,567Mammography 3,469Nuclear Medicine 2,328MRI 1,910Physical Therapy 80,029Births 260 10907133 Experienced Medicare shortfall (at cost). 54,719 persons served. 4415683 Experienced Medicaid shortfall (at cost). 12,316 persons served. 1084248 175972093 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 false false true false false false false false false false false false false false true false false false false true true true false false true 104 0 true 776 true false false false false false false false false 0 false false false false false false false false false false X 19 13 true false true false true true true true true false false true true true true true true true false false ME X X X John Doyle 2079739081 43 Whiting Hill Road Brewer ME 04412 Robert Beekman MD Trustee 50.00 0.00 X 71819 0 836 Edith Dixon Trustee 1.00 0.00 X 0 0 0 Jeffrey Dow Trustee 1.00 0.00 X 0 0 0 Debra Ehrlenbach Trustee/Chair 10.00 0.00 X X 0 0 0 Alan Goldstein Trustee 1.00 0.00 X 0 0 0 Scott Hammond Trustee/Vice Ch 1.00 0.00 X X 0 0 0 Mary M Hood Ex-Officio 1.00 50.00 X X 0 885839 271712 Sally Hutchins Trustee 1.00 0.00 X 0 0 0 Scott Kimball Trustee 1.00 0.00 X 0 0 0 Sean Maloney MD Trustee 50.00 0.00 X 240200 0 30470 Alan Nauss MD Trustee 1.00 0.00 X 0 0 0 Peter Witham MD Trustee 50.00 0.00 X 197472 0 22595 Curtis Simard Trustee 1.00 0.00 X 0 0 0 Karen Stanley Trustee 1.00 0.00 X 0 0 0 Kevin Tesseo Trustee 1.00 0.00 X 0 0 0 Charles Therrien SVP, President 50.00 50.00 X X 48202 337413 59469 Adin Tooker Trustee 1.00 0.00 X 0 0 0 Nicholas Vachon DPM Trustee 50.00 0.00 X 14145 0 1764 Robert Williams Trustee 1.00 0.00 X 0 0 0 John Ronan SVP, President 25.00 25.00 X X 132031 132033 51928 D Chris Frauenhofer VP, Finance 50.00 50.00 X 107937 107937 33030 Anthony Filer Treasurer 1.00 50.00 X 0 177610 2704 Ardelle Bigos CNO & VP 25.00 25.00 X 114399 114399 27354 Paul Bolin VP, CHRO 1.00 50.00 X 0 197240 42346 Glenn Martin Secretary 1.00 50.00 X 0 368621 90480 Wendy Jones VP, Finance 25.00 25.00 X 75812 75811 29256 Sheena Whittaker VP, CMO 50.00 0.00 X 306669 0 30750 Mark Hankinson VP Operations 25.00 25.00 X 71809 71809 16825 Bruce Hamilton-Dick Physician 50.00 0.00 X 791500 0 37854 Davor G Sklizovic Physician 50.00 0.00 X 514335 0 34939 Elaine Mau Physician 50.00 0.00 X 592785 0 15965 Daniel Reinke Physician 50.00 0.00 X 471501 0 34327 Arthur Manning Physician 50.00 0.00 X 450249 0 34680 4200865 2468712 869284 82 false true false On Assigment Inc PO Box 3256 Boston MA 022413256 Contract Labor 702104 CHG Companies Inc PO Box 972651 Dallas TX 753972651 Contract Labor 680501 AMN Healthcare Inc 12400 High Bluff Drive San Diego CA 92130 Contract Labor 674250 Quest Diagnostics Nichols Institute Inc 14225 Newbrook Drive Chantilly VA 201512228 Lab Services 618348 Nuance Communications 1 Wayside Road Burlington MA 01803 Transcription 547316 17 850527 52295 608439 76454 1511261 Cafeteria/Vending Revenue 722210 228501 228501 Patient Service Revenue 621990 178711894 178711894 178940395 138248 138248 0 0 6996 6996 6996 6996 14094213 1351 12845871 27137 1248342 -25786 1222556 1222556 0 0 0 340b Pharmacy Benefits 621990 281401 281401 Meaningful Use 621990 275116 275116 556517 182375973 179268411 1596301 0 0 0 0 1553540 1125017 428523 0 44438055 41187602 3250453 953972 881113 72859 6603657 6090819 512838 2871811 2652478 219333 0 3001 3001 33750 33750 0 0 0 7685200 5230885 2454315 108679 108679 3142877 2270818 872059 842530 778182 64348 0 1459127 1088666 370461 242080 190424 51656 0 11565 11565 445430 305640 139790 0 2522125 1730178 791947 956615 883554 73061 Contractual Allowances 85459593 85459593 Medical Supplies Expense 11053567 11053567 Provision for uncollectible ac 8998736 8998736 Charity Care 2700140 2700140 4771612 3224437 1547175 186857662 175972093 10885569 0 4300 4060 3044444 1460763 21000 0 16775983 19827298 0 0 0 755534 632833 1155514 1122737 30943120 5919061 26447735 25024059 0 0 0 300000 300000 23007543 10542499 71512053 58914249 22098951 28427135 17236 68839 13474134 13633652 35590321 42129626 X 32206392 12384232 1094082 1623505 2621258 2776886 35921732 16784623 71512053 58914249 X -4481689 -1593061 -13062359 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 8278 8278 false false Part II-B, Line 1i - Other Activities Description Non-deductible portion of dues 18854258 494050 1815384 15099312 6064380 15420092 5298162 2019330 3883326 18854258 17840050 -1115765 1304193 15420092 21537888 -98438 3599400 17840050 12887926 10000000 1829422 3179460 21537888 0.75300 0.24700 false true true 308479 308479 14147238 1642412 12504826 1480695 418350 1062345 11937984 3595195 8342789 3068724 263104 2805620 25024059 Assets whose use is limited 45205 Benefits Trust Assets 1552363 Board Designated Other 6096904 Permanently Donor Restricted Funds 1224523 Temporarily Donor Restricted Funds 1623504 10542499 Amounts due to Related Org 11786294 Liability Under Cap Lease Obligation 298017 Reserve for Asset Disposal Costs 14788 Reserve for Retiree Health Benefits 1534553 13633652 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 343 1084248 1084248 0.01200 12316 11095094 6679411 4415683 0.04900 109207 109207 0.00100 12659 12288549 6679411 5609138 0.06200 5 1042 326938 326938 0.00400 5 1042 326938 326938 0.00400 5 13701 12615487 6679411 5936076 0.06600 true 4314784 28518120 39425253 -10907133 X true true 1 1 Maine Coast Memorial Hospital 50 Union St Ellsworth ME 04605 www.mcmhospital.org 38528 X X X Maine Coast Memorial Hospital 1 false false true X X X X X X X X X 16 true true true true X https://mcmhospital.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 false 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 November 10, 2015 Hancock County Shared CHNA Community Engagement Input Forum and provided valuable feedback on the Shared CHNA.Details about organizations: State Government - representation from DHHS (low income, medically under served); Non-profit hospitals (Maine Coast Memorial Hospital, Blue Hill Memorial Hospital, Mount Desert Island Hospital providing services to MaineCare populations (medically under served); Healthy Acadia and Healthy Peninsula provide individuals with health supports and coordination of education and prevention services. Non-profit agency- SAGE and GLSEN: provide advocacy and services for LGBT community. Beth Wright provides resources and care for individuals and families with cancer in both counties. Birch Bay and Hancock County Hospice/Home Care provide services for seniors and aging population (low income). Hancock County EMA provides emergency management to all of Hancock County towns. 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 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 https://mcmhospital.org/Patients-Visitors/Billing-Financial-Services.aspx under Financial Assistance Program. Coastal Health Center 37 Commerce Park Ellsworth ME 04605 Physician Practice Ellsworth Family Practice 32 Resort Way Ellsworth ME 04605 Physician Practice Gouldsboro Rehabilitation Services 37 Clinic Road Gouldsboro ME 04607 Clinic Maine Coast Rehabilitation Services 65 Church Street Ellsworth ME 04605 Clinic Somesville Rehabilitation Services Route 102 Mount Desert ME 04660 Clinic Eleanor Widener Dixon Memorial Clinic 37 Clinic Road Gouldsboro ME 04607 Physician Practice Ellsworth Internal Medicine 32 Resort Way Ellsworth ME 04605 Physician Practice Maine Coast Pediatrics 32 Resort Way Ellsworth ME 04605 Physician Practice Southwest Harbor Medical Center 45 Herrick Road Southwest Harbor ME 04679 Physician Practice Downeast Dermatology 50 Union Street Ellsworth ME 04605 Physician Practice Frenchman Bay Orthopedics 50 Union Street Ellsworth ME 04605 Physician Practice Maine Coast General Surgery 50 Union Street Ellsworth ME 04605 Physician Practice Maine Coast Otolaryngology 50 Union Street Ellsworth ME 04605 Physician Practice Maine Coast Urology 50 Union Street Ellsworth ME 04605 Physician Practice Maine Coast Women Care 50 Union Street Ellsworth ME 04605 Physician Practice Neurology Services 50 Union Street Ellsworth ME 04605 Physician Practice Maine Coast Rheumatology 50 Union Street Ellsworth ME 04605 Physician Practice Cardiology 50 Union Street Ellsworth ME 04605 Physician Practice Oncology 50 Union Street Ellsworth ME 04605 Clinic Osteoporosis Clinic 50 Union Street Ellsworth ME 04605 Clinic Wound Center 50 Union Street Ellsworth ME 04605 Clinic Maine Coast Specialty Clinic 306 Main Street Ellsworth ME 04605 Physician Practice Part I, Line 6a - Related Organization Community Benefit Report Maine Coast Memorial Hospital 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 $8,998,736 of bad debt expense, $2,700,140 of charity care, $85,459,593 of contractual allowances is included on Form 990, Part IX, line 25, column (A). Part III, Line 2 - Methodology Used To Estimate Bad Debt Expense The costing methodology 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 collection from outstanding balances. Management provides for probably 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 are screened for eligibility for charity care using an application and guidelines established by Maine Coast Memorial Hospital. 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 We notify patients and customers about access to Assistance in various ways. The simplest way is the signage, pamphlets and educational material located around the Organization and in the offices. In every Patient Access/Patient Financial Services area, is a sign explaining the availability of Free/Discounted care and the Federal Poverty guidelines. There are also pamphlets located in the outpatient areas explaining Free Care/Discounted Care and providing information on MaineCare. For inpatients, there is a book in the room which provides all the information on all programs available.All information related to our financial assistance policy (FAP)can be found at the following URL: http://www.mcmhospital.org/Patients-Visitors/Billing-Financial-Services.aspx Part VI - Community Information Located in Ellsworth, Maine, Maine Coast Memorial Hospital is a member of EMHS. The 64-bed, full-service hospital serves Hancock and western Washington Counties. Opened in 1956, our comprehensive healthcare facility provides emergency, primary and specialty care, acute inpatient, diagnostic, and surgical services. Maine Coast Memorial Hospital is accredited by The Joint Commission, reflecting our commitment to meeting the highest performance standards for patient safety and quality, and has received both national and state recognition for patient safety, outcomes, and patient satisfaction levels. Maine Coast Memorial Hospital strives to provide access to healthcare and improve the quality of health in the communities it serves. It does this through robust partnerships with other health care facilities and public service organizations. 2013 data shows Hancock County with a population of 54,845, 14 percent of whom live in poverty (21.5 percent of children in the county live in poverty.) 61.7 percent of the population is over age 18, and 20.7 percent of the population is over age 65. Statistically, residents of Hancock County are more likely to be uninsured than the rest of the state (14.7 percent versus 10.4 percent) and MaineCare enrollment is 23.6 percent, with 40.4 percent of children relying on MaineCare for access to healthcare. Residents of Hancock County are more prone to acute myocardial infarction (AMI) and higher rates of mortality related to AMI and coronary heart disease than the rest of the state of Maine. Statistically aligned with the rest of the state, Hancock County reports that 21.1 percent of adult residents have a history of depression, 15.7 percent have suffered from anxiety, and currently 14.9 percent of the population is receiving outpatient mental health treatment. Substance and alcohol misuse data shows that the county population aligns with the majority of the state in regards to substance abuse with an alcohol induced mortality rate of 8.7 per 100,000 and a drug induced mortality rate of 11.6 per 100,000. Per 100,000: emergency medical service overdose response in 2014 was 301.7. Emergency department visits and opiate poisoning per 100,000 population between 2009 and 2011 were 21.5 and 11.6, respectively. Overall substance misuse hospital admissions per 100,000 population were 184.4. Part VI - Explanation Of How Organization Furthers Its Exempt Purpose Maine Coast Regional Health Facilities is a local not for profit hospital that serves its local communities and people regardless of their ability to pay. Maine Coast provides financial assistance and sliding scale discounts to self-pay and low income patients. Also the Hospital participates in government sponsored health care programs including Medicare, Medicaid, Champus and Tricare. The volunteer Board of Trustees sets the strategic direction for the Hospital and is comprised of community members from the Hospital's service area. This group is made up of local business owners, professionals and retirees. Maine Coast's non-profit status allows the Hospital to reinvest any excess of revenues over expense back into the Hospital to continuously improve the medical care it delivers. The Hospital allows access to healthcare that would otherwise be difficult. The Hospital is the main employer for the local physicians, including specialty physicians that would otherwise have to be accessed out of the area. 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.The Maine Coast Memorial Hospital implementation strategy can be accessed online at http://www.emhs.org/Document-library/Reports/CHNA/2015-Shared-CHNA/2016-Community-Health-Strategy/Maine-Coast-Community-Health-Strategy_Web-Document.aspx Maine Coast Memorial Hospital identified four priorities of focus addressing the significant needs identified in its most recently conducted CHNA as follows:Drug and Alcohol Abuse Develop a hub and spoke model for treatment in Hancock and Washington counties, and develop and/or distribute of resource guides for prevention, education, and treatment. MCMH will also foster support group meetings (AA, NA, etc) by providing space when possible and disseminating information about meetings to the community, as well as continued work with our PT/Rehab Pain Control Program, the introduction of substance misuse screening in the primary care setting for use in regular check-ups, and education around medication free pain control alternatives.Obesity, Physical Activity, Nutrition Support the development and implementation of education programs around nutrition and obesity, as well as support activities to encourage healthy and safe physical activity in our community in order to reduce the rate of obesity in our service area and increase physical fitness in our patientsMental Health Implementing new delivery methods and bolstering existing services and screenings through provider and patient education. The intent of these services and education is to remove stigma around the treatment of mental health, increase awareness of mental health needs, and provide care for patients who may otherwise go without treatment.Health Literacy - Hosting and/or staffing free Know Your Numbers health fairs, hosting free community health education forums in a variety of settings, providing materials for patients to write down their questions and answers, and facilitating access to evidence based online health education resources. In addition to these actions MCMH will invest in provider communication training to simplify communication with 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, MCMH 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. MCMH 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 MCMHs compliance with Sections 501(r)(3-4). The correction of these issues did not result in any changes to our overall processes and, therefore, MCMH 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 MCMH is in compliance with Section 501(r). In addition, EMHS continues to engage EMHS Internal Audit to review MCMHs 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 MCMH 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 MCMHs Board to clarify the Boards intent to approve the CHNA and implementation strategy. d. Date Corrected: MCMH: May 23, 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. MCMHs 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 MCMHs practice to provide care for emergency conditions to individuals regardless of whether they are FAP-eligible; however, upon review of MCMHs 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 MCMHs 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, MCMH made additional revisions to further clarify the language included on the billing statements.d. Date Corrected: MCMH: June 20, 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 b X true true false true false false false false false false false false Anthony Filer Treasurer 57283 120327 2704 180314 Ardelle Bigos CNO & VP 102411 102410 5000 5000 6988 6989 1722 1723 11955 11954 128076 128076 Arthur Manning Physician 442701 7548 5922 28758 484929 Bruce Hamilton-Dick Physician 759614 31886 8892 28962 829354 Charles Therrien SVP, President 41274 288916 6458 45208 470 3289 6088 42612 1346 9423 55636 389448 D Chris Frauenhofer VP, Finance 101177 101178 6760 6759 1819 1820 14696 14695 124452 124452 Daniel Reinke Physician 457133 14368 6239 28088 505828 Davor G Sklizovic Physician 492059 18562 3714 6770 28169 549274 Elaine Mau Physician 564291 15074 13420 5673 10292 608750 Glenn Martin Secretary 362009 6612 69889 20591 459101 John Ronan SVP, President 120061 120062 6018 6019 5952 5952 20827 20827 5137 5137 157995 157997 Mark Hankinson VP Operations 66521 66520 3842 3843 1446 1446 3861 3862 4551 4551 80221 80222 Mary M Hood Ex-Officio 870512 15327 250857 20855 1157551 Paul Bolin VP, CHRO 192976 4264 13113 29233 239586 Peter Witham MD Trustee 184656 11305 1511 2646 19949 220067 Sean Maloney MD Trustee 225853 12988 1359 3674 26796 270670 Sheena Whittaker VP, CMO 270078 33085 3506 4445 26305 337419 Wendy Jones VP, Finance 69754 69753 4639 4639 1419 1419 5410 5409 9218 9219 90440 90439 Part I, Line 1a: Relevant information in regards to selections on 1a. The following received a wellness program incentive:Mark Hankinson, officer $407John Ronan, director/officer 275Peter Witham, director 232The benefit is available for all employees. X 120 FMV X 9549 FMV X 1 15229 FMV X 28 3559 FMV X Medical Equipment 1 35337 FMV X Gift Certificat 43 8235 FMV X Computer Equip 1 425 FMV X Exercise Equip 1 4000 FMV false false false Form 990, Part III, Line 4d: Other Program Services Description OTHER PROGRAM SERVICES 4: Experienced Medicare shortfall (at cost). 54,719 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: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.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.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.M. Michelle Hood, FACHEEMHS President and CEOBarry McCrumEMHS Board ChairCONNECTING 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.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.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.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.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.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.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 emergency department. Inland does, too, but also offers the service through its primary care practices. Our goal has been to deliver the care on site, in a place theyre familiar with, comfortable with, and would feel more relaxed, and hopefully in a more timely manner. Telemedicine has allowed u Form 990, Part VI, Line 2: Description of Business or Family Relationship of Officers, Directors, Et Mary M. Hood, board member/officer and Charles Therrien, board member/officer are board members of Maine Hospital Association. 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 Maine Coast Memorial Hospital (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 Corporations operating budget and capital expenditures;V. the Corporations 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 Corporations role in the EMHS Strategic Plan;XII. action concerning the Corporations 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, Finance of Maine Coast Memorial Hospital. 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 Maine Coast Memorial Hospital and the system President/CEO (President) who serves on the board ex-officio are employed by 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 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 utilizes external market research to establish compensation ranges for specific positions. The compensation of officers and key employees are reviewed by the MCMH President and the VP of Human Resources.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 Maine Coast Memorial Hospital 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 = $1755360 Other Changes In Net Assets Or Fund Balances - Other Increases Transfer from exempt subsidiary-EMHSF = $206000 Other Changes In Net Assets Or Fund Balances - Other Decreases Transfer to exempt parent-Eastern Maine Healthcare Systems = -$13608691 Other Changes In Net Assets Or Fund Balances - Other Decreases Transfer to exempt subsidiary - EMHSF = -$1094474 Other Changes In Net Assets Or Fund Balances - Other Decreases Transfer to exempt subsidiary - MCHC = -$320554 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 MCMH, 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. Eastern Maine Healthcare Systems EMHS 43 Whiting Hill Rd Brewer ME 04412 010527066 Supporting org for healthcare affiliates ME 501(c)(3) 12 Type II N/A true WorkHealth LLC 43 Whiting Hill Rd Brewer ME 04412 474315094 Provide healthcare services ME 501(c)(3) 12 Type II EMHS true Eastern Maine Healthcare Real Estate 43 Whiting Hill Rd Brewer ME 04412 010391036 Leases real estate ME 501(c)(2) EMHS true Acadia Hospital CorpAHC 43 Whiting Hill Rd Brewer ME 04412 010459837 Provide healthcare services ME 501(c)(3) 3 EMHS true Acadia Healthcare Inc AHI 43 Whiting Hill Rd Brewer ME 04412 223183888 Provide healthcare services ME 501(c)(3) 10 AHC true Meadow Wood LLC 43 Whiting Hill Rd Brewer ME 04412 272935243 Provide patient care ME 501(c)(3) 10 AHI true Restoration Health LLC 43 Whiting Hill Rd Brewer ME 04412 352449986 Provide mental & behavioral hlth srvs ME 501(c)(3) 10 AHI true Eastern Maine Medical Center EMMC PO Box 404 489 State Street Bangor ME 044020404 010211501 Provide healthcare services ME 501(c)(3) 3 EMHS true Eastern Maine Medical Center Auxiliary 43 Whiting Hill Rd Brewer ME 04412 010377901 Fund raising for exempt EMMC ME 501(c)(3) 10 EMMC true Norumbega Medical Specialists LTD 43 Whiting Hill Rd Suite 400 Brewer ME 04412 010465231 Provide patient care and education ME 501(c)(3) 10 EMMC true EMHS Foundation 43 Whiting Hill Rd Suite 400 Brewer ME 04412 222514163 Raise and manage funds for exempt orgs ME 501(c)(3) 12 Type II EMHS true Rosscare 43 Whiting Hill Rd Suite 400 Brewer ME 04412 010391038 Provide services to elderly ME 501(c)(3) PF EMHS true Rosscare Nursing Homes Inc 43 Whiting Hill Rd Suite 400 Brewer ME 04412 010430751 Operation of nursing homes ME 501(c)(3) 10 Rosscare true Inland Hospital 200 Kennedy Memorial Drive Waterville ME 04901 010217211 Provide healthcare services ME 501(c)(3) 3 EMHS true Lakewood 220 Kennedy Memorial Drive Waterville ME 04901 010421234 Provide skilled and LT nursing care ME 501(c)(3) 3 Inland Hospital true CA Dean 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