2018-03-12T14:39:00-05:00 2017-04-30 010494526 Baker Newman & Noyes PO Box 507 Portland ME 04112 990 2016-05-01 010211797 Mount Desert Island Hospital MOUN 2072885081 PO Box 8 10 Wayman Lane Bar Harbor ME 046090008 Christina Maguire-Harding VP of Finance & CFO 2072885081 2018-03-11 Nicholas E Porto P01310283 2078792100 2018-03-11 208.105.168.164 2018-03-11 14:44:31 ED P AE7C1EA16D8AAA5622960641DD82C01E60BE7149 2CC4C4610C7CE537855CCDE76D04A8640C960E3E 2016 2021-01-29 14:40:06Z Arthur J Blank PO Box 8 10 Wayman Lane Bar Harbor ME 046090008 67459631 0 X www.mdihospital.org X 1897 ME Critical access hospital, providing medical & healthcare services located in Bar Harbor, ME. 19 15 510 138 0 0 1413911 3552887 53807800 59995690 210657 253972 -14038 13200 55418330 63815749 0 0 0 0 31843846 33557946 0 2757 148169 23447485 25698945 55291331 59259648 126999 4556101 48075250 51969386 27536900 26186036 20538350 25783350 X Mount Desert Island Hospital's mission is to provide compassionate care and strengthen the health of our community by embracing tomorrow's methods and respecting time-honored values. 0 0 47486844 0 60008890 In fiscal year 2017, Mount Desert Island (MDI) Hospital provided $5,753,830 in services for which no compensation was expected or received. Financial assistance policies exist to provide relief for those who cannot pay for medical care. MDI Hospital provides care to persons covered by governmental programs including Medicare, Medicaid, VA, and CHAMPUS. The unreimbursed value for providing care to these patients approximates $1,374,708. The Hospital continues to provide a number of health services and preventative health programs to the community. Available programs include cardiac pulmonary rehabilitation, care coordination, wellness programs, diabetes education, annual wellness exams, nutrition counseling, parenting, pregnancy and sibling classes, physical and occupational therapy programs, speech therapy, medication therapy management, health coaching, care management, coagulation management, and our oral health program which included education and outreach to the community, schools, and service providers. Throughout the year, staff from the Hospital make presentations to area school children regarding smoking cessation, wellness, health, activity, nutrition, and oral health, including a Give Kids a Smile Day in which free or reduced cost screenings are available. Additionally, community groups such as the YMCA, Alcoholics Anonymous, Cancer Support, and Palliative Care use the Hospital's conference rooms for their meetings. Many hospital staff members serve other nonprofits in capacities such as volunteer hours, and board of directors' memberships, as well as memberships in service organizations such as the local Healthy Acadia, Rotary, Chamber of Commerce and Lions/Lioness clubs. 47486844 1 1 0 1 0 0 0 0 0 1 1 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 1 1 0 0 1 1 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0 1 1 1 0 0 1 96 0 1 510 1 0 0 0 0 0 0 0 0 0 0 X 19 15 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 0 0 X X Arthur J Blank 2072885081 PO Box 8 10 Wayman Lane Bar Harbor ME 046090008 X John Benson MD Trustee 1.00 1.00 X 0 0 0 Reverend Robert Benson Trustee 1.00 0.00 X 0 0 0 Stewart Brecher Trustee 1.00 0.00 X 0 0 0 Stuart Davidson MD Trustee/Medical Staff Pres 36.00 0.00 X 485697 0 27368 David Einhorn Esq Trustee 1.00 0.00 X 0 0 0 Sarah Fina Trustee 1.00 0.00 X 0 0 0 Elsie Flemings Trustee 1.00 0.00 X 0 0 0 Patricia Hand PhD Trustee 1.00 0.00 X 0 0 0 Charles Manee Hutchins Trustee 1.00 0.00 X 0 0 0 Lawrence Legutko Trustee 1.00 0.00 X 0 0 0 Beverly Paigen PhD Trustee 1.00 0.00 X 0 0 0 Dean Read Trustee 1.00 1.00 X 0 0 0 William Rudolf Trustee 1.00 0.00 X 0 0 0 Martha Wagner PhD Trustee 1.00 0.00 X 0 0 0 Noelle Wolf Trustee 1.00 0.00 X 0 0 0 Vince Messer PhD Board Chair 5.00 0.00 X X 0 0 0 James R Bright 1st Vice Chair 3.00 0.00 X X 0 0 0 Julian Kuffler MD 2nd Vice Chair/Physician 40.00 0.00 X X 256743 0 30696 Arthur J Blank President & CEO 40.00 2.00 X X 335546 0 29691 Christina Maguire-Harding VP Finance/Treasurer/Clerk 40.00 1.00 X 182561 0 23959 Holly Thulin Secretary (part year) 40.00 0.00 X 29385 0 6212 Erin Levy Secretary 40.00 0.00 X 0 0 0 Mark Kandutsch MD Physician 40.00 0.00 X 282614 0 34356 Nathan Donaldson DO MHA FACEP Physician 40.00 0.00 X 322916 0 30361 Edward Gilmore MD MACP Chief Medical Officer 40.00 0.00 X 282497 0 15767 Diehl Snyder MD Physician 40.00 0.00 X 240117 0 23943 Tanya Hanke DO Physician 40.00 0.00 X 261340 0 17715 2679416 0 240068 35 0 1 0 Therapy Partners LLC 7 Hillview Drive Bangor ME 04401 Physical Therapy Services 565130 Vista Staffing Solutions Inc 275 East 200 South Salt Lake City UT 84111 Locum Agency 462776 Barton Associates Inc 300 Jubilee Drive Peabody MA 01960 Locum Agency 435039 Comprehensive Pharmacy Services Inc PO Box 638316 Cincinnati OH 452638316 Pharmacy Management Services 424466 Hancock Community Health LLC PO Box 8 Bar Harbor ME 04609 Dental Services 342735 16 3552887 65430 3552887 Patient Services 621990 56154556 56154556 Pharmacy 621400 1409340 1409340 Other Operating 621400 1269830 1269830 Meaningful Use 621400 743037 743037 Healthcare Administration 621400 220795 220795 198132 198132 59995690 251048 251048 13200 0 13200 13200 13200 3646056 750 3643882 0 2174 750 2924 2924 63815749 60008890 0 253972 X 1709626 1102271 607355 22401743 18116035 4185976 99732 522802 376222 146580 7286072 5193742 2092330 1637703 1162769 474934 87305 87305 101829 101829 2757 2757 33163 33163 9617626 7396122 2221504 82794 82794 5070440 4941094 83666 45680 875065 726186 148879 56368 31351 25017 336590 147847 188743 525578 420462 105116 1624208 1299366 324842 541718 411644 130074 Bad Debt Expense 3735577 3735577 Hospital Provider Tax 1125762 1125762 Equipment Rental/Mainte 947700 867253 80447 Food and Nutrition 201636 201636 735586 231505 504081 59259648 47486844 11624635 148169 2290 2289 1772351 2277866 154775 1307832 7700678 6579530 711591 719180 452808 907193 51319179 29823846 21569633 21495333 8335471 9502285 1801125 1931881 80000 100000 44629 35473 5449899 7110524 48075250 51969386 9158634 7769563 2622786 2041638 6120738 6201117 2200892 2822154 7433850 7351564 27536900 26186036 X 16702491 20110961 1831059 3485084 2004800 2187305 20538350 25783350 48075250 51969386 X 4556101 706195 -17296 X X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 1 7239 0 0 0 7239 0 Part II-B, Line 1: A portion of dues paid to the Maine Hospital Association and the American Hospital Association are available for lobbying. For the filing period, the amount paid to MHA available for lobbying was $2,867 and for AHA the amount was $4,372. 5390259 35000 735670 25100 6135829 6133933 479781 -340076 860000 23379 5390259 6987538 250000 372871 1450000 26476 6133933 6591431 25000 625391 225000 29284 6987538 6300481 588719 270000 27769 6591431 0.86340 0.13660 0.00000 1 0 4258948 4258948 28456094 15665836 12790258 235558 166904 68654 18163408 13991106 4172302 205171 205171 21495333 Due from Affiliates 4405406 Aetna Deposit 98000 Other Receivables 893896 Estimated Third Party Settlements 1713222 7110524 Deferred Compensation 2873043 Estimated Third Party Settlements 4078714 Due to Affiliate 399807 7351564 X 64340612 706195 706195 63634417 33163 148169 181332 63815749 59078316 0 59078316 33163 148169 181332 59259648 Part V, Line 4: Endowment amounts restricted by the Board of Directors are released by the Board as needed for special projects supplying benefit to the community at large. These funds are intended solely for the use of expanding services, and not for sustaining current operations. Part X, Line 2: The Hospital and BBRV are exempt from federal income taxes under Section 501(c)(3) of the Internal Revenue Code (Code). MDMC is a for-profit entity and is, therefore, subject to income taxes. Income taxes are recorded based upon the asset and liability method as prescribed by Financial Accounting Standards Board (FASB) Accounting Standards Coalition (ASC) 740, Income Taxes. At April 30, 2017 and 2016, MDMC has certain net operating loss carryforwards which have been reduced by a valuation allowance of an equal amount as it is not presently considered likely that the deferred tax assets will be realized. Part XI, Line 4b - Other Adjustments: Fundraising Expenses Netted with Revenue on AFS 148,169. Part XII, Line 4b - Other Adjustments: Fundraising Expenses Netted with Revenue on AFS 148,169. 1 1 1 X 1 X 1 1 1 0 1 1 530343 530343 0.00960 5223487 4379122 844365 0.01520 5753830 4379122 1374708 0.02480 100496 100496 0.00180 12971084 7072623 5898461 0.10620 13071580 7072623 5998957 0.10800 18825410 11451745 7373665 0.13280 1 2261571 0 14168648 17757533 -3588885 X 1 1 1 1 Mount Desert Island Hospital 10 Wayman Lane PO Box 8 Bar Harbor ME 045090008 www.mdihospital.org 37457 X X X X X Mount Desert Island Hospital 0 0 1 X X X X X X X X 15 1 1 1 1 X see Part V, Section C X see Part V, Section C X 1 15 1 see Part V, Section C 0 1 X 150.000000000000 250.000000000000 X X X X X 1 1 X X X X 1 X see Part V, Section C X see Part V, Section C X see Part V, Section C X X X X X X 1 X 0 1 X 0 0 Mount Desert Island Hospital Part V, Section B, Line 5: Mount Desert Island Hospital participated in the Maine State Statewide Community Health Needs Assessment that focused on individual counties within the State, and during fiscal year 2016 also collaborated with Healthy Acadia to perform a service area CHNA. The CHNA for Hancock County provided an avenue to look at State of Maine surveillance data and validate our implementation plan and evaluation plan. MDIH felt that our community and service area would best be served by a more focused and representative CHNA. MDIH collaborated with Healthy Acadia to perform a focused CHNA for our services area commencing in September 2015. Additionally, Mount Desert Island Hospital partnered with a number of other medical and community organizations to prepare a county-wide CHNA that was completed in February 2016. The CHNA presents the combined findings of three separate studies and surveys, which together consider the responses from a broad cross-section of the community, including health care professionals from a variety of backgrounds and people who work at other types of nonprofits, the private sector, education, and social services. Mount Desert Island Hospital Part V, Section B, Line 6a: Additional hospitals participating in the supplemental countywide CHNA were Eastern Maine Health System, MaineHealth, and MaineGeneral Health. Mount Desert Island Hospital Part V, Section B, Line 6b: The Hospital's primary CHNA published during tax year 2015 was conducted in partnership with Healthy Acadia, a 501(c)(3) non-profit organization dedicated to empowering people and organizations to build healthy communities and making it possible for all people to lead healthier lives.Multiple non-hospital community health organization participated in the supplemental countywide CHNA, as well, including Maine Center for Disease Control and Prevention and the University of Southern Maine. Mount Desert Island Hospital Part V, Section B, Line 11: The Hospital, working with our community and our implementation plan, continues to move strategies forward for a healthy community. While there were two strategies that were outside of the main purview of the Hospital, the organization committed to providing feedback and support to help start a Farmers' Market and created walking maps of the community to encourage healthy activities. The Hospital is continuing with the implementation strategies that were first adopted in 2016 with its current CHNA as they are again recognized as ongoing initiatives in the Hancock County CHNA. The Hospital is using the strategies from the 2014 countywide CHNA survey, as well. The Hospital completed its CHNA in partnership with Healthy Acadia; the results were approved by the Planning Committee of the Board of Trustees in March of 2016. The Hospital's Planning Committee oversees the work and the implementation of the CHNA including revisions and ongoing implementation evaluations. Mount Desert Island Hospital Part V, Section B, Line 16j: The policy was provided, in writing, to patients on admission to the Hospital facility.The Hospital works with community service organizations to post the Plain Language Summary in public libraries, local municipality facilities, local YMCA/YWCA, and the Healthy Acadia website.Additionally, a qualified interpreter is made available to patients who need assistance translating the FAP, application, and related documents to another language. Part V, Line 7a, Hospital's website: https://www.mdihospital.org/wp-content/uploads/2016/01/Final-MDIH_HA-2016-CHNA-and-Action-Plan.pdf Part V, Line 7b, Other website: https://healthyacadia.org/resources/documents/Final-MDIH_HA-2016-CHNA-and-Action-Plan.pdf Part V, Line 10a, Implementation Plan: CHNA Implementation Guide: https://www.mdihospital.org/wp-content/uploads/2016/01/CHNA-Mount-Desert-Island-Hospital-Organization-Implementation-Guide.pdfCHNA Implementation Plan: https://www.mdihospital.org/wp-content/uploads/2016/01/CHNA-Strategic-Planning-Public-Presentation-Copy.pdf Schedule H, Part V, Section B, Line 16a-16c: Financial Assistance Policy URL:https://www.mdihospital.org/wp-content/uploads/2017/01/MDIHO-Financial-Assistance-Policy-FC-Approved-01-2017.pdfFinancial Assistance Policy Application URL:https://www.mdihospital.org/wp-content/uploads/2014/08/FAPApplication.pdfFinancial Assistance Plain Languange Summary URL:https://www.mdihospital.org/wp-content/uploads/2017/01/Plain-Language-Summary-of-Financial-Assistance-Program-1557-01-2017.pdf 13 1 - Community Health Center 16 Community Lane Southwest Harbor ME 04679 Outpatient Clinic 2 - Trenton Health Center 394 Bar Harbor Road Trenton ME 04605 Outpatient Clinic 3 - Behavioral Health Center 322 Main Street Bar Harbor ME 04609 Outpatient Clinic 4 - Cooper Gilmore Health Center 17 Hancock Road Bar Harbor ME 04609 Outpatient Clinic 5 - Cadillac Family Practice 322 Main Street Bar Harbor ME 04609 Outpatient Clinic 6 - Family Health Center 9 Hancock Road Bar Harbor ME 04609 Outpatient Clinic 7 - Lisa Stewart Women's Health Center 8 Wayman Lane Bar Harbor ME 04609 Outpatient Clinic 8 - MDI Orthopedics 10 Wayman Lane Bar Harbor ME 04609 Outpatient Clinic 9 - MDI Dermatology Health Center 322 Main Street Bar Harbor ME 04609 Outpatient Clinic 10 - MDI Urology 322 Main Street Bar Harbor ME 04609 Outpatient Clinic 11 - MDI General Surgery 17 Hancock Road Bar Harbor ME 04609 Outpatient Clinic 12 - Northeast Harbor Health Center Kimball Road Northeast Harbor ME 04679 Outpatient Clinic 13 - MDI Podiatry 10 Wayman Lane Bar Harbor ME 04609 Outpatient Clinic Part I, Line 7: The costing methodology utilized for this table was derived from Worksheet 2, Ratio of patient care cost to charges with data from filed cost reports for the fiscal year. Part I, Line 7g: The Hospital provides to the community several provider based physician and specialty practices to serve this rural island population. These practices are listed on Part V of this schedule. The facility subsidizes their operating costs to maintain access and coordination of care to our population. Part I, Line 7, Column (f): The Bad Debt expense included on Form 990, Part IX, Line 25, Column (A), but subtracted for purposes of calculating the percentage in this column is $ 3,735,577. Part III, Line 2: The estimated cost of bad debt expense as reported is derived from the accounting systems and software the organization uses to calculate the cost-to-charge ratio from the as-filed Medicare Cost Reports.Mount Desert Island Hospital (MDIH) estimates the cost of bad debt expense using accounting systems and software from our organization to calculate the cost of care from the as filed Medicare Cost Reports. This estimate best represents the value of providing care for those services that will be considered or deemed uncollectible. The value of these services at cost are estimated to be $2,261,571. This is the amount the hospital must forgive as a benefit to the community for providing services. Part III, Line 3: The Hospital's financial assistance policy provides administrative and accounting guidelines for the identification, classification, and reporting of patients receiving financial assistance as distinguished from bad debts. Accordingly, the Hospital has estimated that no amount of bad debt expense at cost is attributable to patients eligible under the organization's financial assistance policy. Part III, Line 4: See Footnote 2 on Page 8 of the attached audited financial statements. Part III, Line 8: The IRS Form 990, Schedule H instructions and guidance provide a template in Worksheet 2 as a way to determine the overall cost to charge ratio that could be applied throughout Schedule H in order to convert charges to cost. Where applicable, we have utilized the Worksheet 2 template calculation. The only area where we did not utilize this template calculation was in Schedule H, Part III, Section B, Line 6, Medicare allowable costs and payments related to the subsidized health services. Instead, the Hospital utilized the Medicare cost report estimated cost and payment for these services. The Hospital believes that provider based clinics listed in above should be considered a community benefit due to the fact that without the Hospital subsidizing and offering the services that these clinics offer, the community-at-large would have to travel 45 minutes or more to the nearest like-hospital. As such, Mount Desert Island Hospital believes that by offering and subsidizing these clinics within its community, thus enabling community members to have easy access and an easier commute for these services, this benefits the entire community at large. Part III, Line 9b: The Hospital would not initiate collection efforts against a patient that qualified for a sliding fee scale unless that patient failed to meet his or her obligation under a mutually agreed upon payment arrangement. After it was determined that the patient did not qualify for a readjustment to his or her payment terms, the Hospital would follow normal notification practices dictated by our collection policy, which is in compliance with the 501(r) regulations. Upon the qualifying defaults a patient's account may result in collection efforts. If the collection agency suspects or gains knowledge that someone may need to apply for one of the programs, the agency sends out a financial assistance application to the patient or guarantor and proceeds to notify MDIH of the outreach. Information about our free and sliding scale programs are on our website, on our account statements, and posted in public areas and at our provider clinics. We also make available a Patient Financial Counselor to help navigate the process. Part VI, Line 2: Mount Desert Island Hospital assesses the health needs of the community through the use of a collaborative Community Health Needs Assessment. As a key participant in the CHNA process, our institution is able to further address and identify those areas of most concern and need in our community. A community needs assessment is a point-in-time effort to measure the health and wellbeing of the community. It serves as a constructive tool to and basis for Mount Desert Island Hospital's strategic and subsequent action planning to develop health policy advocacy, allocate resources, improve or expand existing services, implement new programs and collaborate with other community health care providers. A community health needs assessment also serves as a benchmark for future assessment of measured progress toward established community health objectives. Mount Desert Island Hospital's Community Health Needs Assessment provides an opportunity to gain insight into the needs and assets that are served. It also provides a measure to identify and address the needs of the vulnerable populations within our community. The Mount Desert Island Hospital process was a partnership with Healthy Acadia, a comprehensive community health coalition that was formed in 2001 with public health funding provided by the Maine Center for Disease Control and Prevention. The Community Health Improvement Plan and Health Needs Assessment were performed using the Mobilizing for Action through Planning and Partnerships process, which utilized a broad cross-section of our demographic and service area. This process delivered the basis for the assessment which demonstrated the strengths and opportunities for our plan. This process involved the gathering of quantitative data such as demographics, health indicators, and local statistical information as well as qualitative data from public surveys, focus groups, and community stakeholders. The data helps support short-term and long-term decisions about allocation of community human and capital resources. Participants included members of the Hospital's medical staff, nursing staff, board of trustees and administration. Focus groups were used to gain feedback from diverse and remote populations, as we are an institution that serves the rural and coastal community of Mount Desert Island and the other islands off the coast of Hancock County. This assessment, in conjunction with the Maine Shared Health Needs Assessment and Planning Process, which provides detailed surveillance data about the chronic health conditions or improved health of the population we serve, allows for a comparative measurement to determine priorities of focus. This collaborative effort developed several themes for strategic initiatives and goals. The organization reviewed the overarching needs and validated those to the health needs of the community. This process was reviewed and prioritized through the Board Designated Planning Committee of the organization, which develops and maintains oversight of the Hospital's official Community Health Needs Assessment and Implementation and Evaluation Plans. The Implementation Plan is reviewed periodically and updated as strategies and initiatives are completed or modified. Those items that were not achievable are reviewed and documented as to the barrier for successful implementation and/or alternatives. MDI Hospital is currently implementing the results of the 2016 plan as there are several broad reaching programs that will continue to be a focus for our organization, using supplemental data from the Maine Shared Health Needs and Planning Process (Maine SHNAPP). They are outlined on our adopted implementation plan under the evaluation process. The revised plan continued on the foundation from the 2011 CHNA addressing the newly identified opportunities and has been approved by the Hospital's CHNA planning committee who has been authorized by the Hospital's board of directors to oversee the CHNA process on the board's behalf. The supplemental plan was approved as well while the Hospital engaged in a comprehensive update to its' CHNA in partnership again with Healthy Acadia. The results are available upon request and through www.mdihospital.org.The Hospital's county-wide Community Health Needs Assessment, which aligns many state and county partners in Hancock County, was led primarily by Eastern Maine Health Systems and identified several health initiatives that MDI Hospital developed as part of its adopted implementation plan.The implementation and evaluation plans and CHNA are located on the Hospital's public website along with a notice to solicit comments from the community regarding any questions, suggestions or concerns regarding the CHNA and the implementation plan. Part VI, Line 3: The Financial Assistance Policy (FAP) information is sent with all account statements and is printed on the back of the statement. A notice of the FAP in plain language is also available on our Hospital website, posted in public areas, and available within the departments and clinics of our organization. The Hospital provides a patient financial representative to help navigate the process to ensure that our patients have access to the care and services they need. MDIH is committed to providing access to quality healthcare services with compassion, dignity, and respect for those we serve, particularly the poor, indigent, and underserved in our communities, regardless of their ability to pay. We assist our patients who cannot afford to pay for part or all of the services received by working with our community to identify those in need and find the financial resources that may be made available to them. MDIH has adopted guiding principles when handling billing, collections, and financial support functions for our patients. We provide effective communications with patients regarding hospital bills and make affirmative efforts to help patients apply for public and private financial support programs, including providing resources to perform the application process on behalf of the patient. We have implemented policies and procedures for assisting low income patients in a consistent manner that is in compliance with the State of Maine Chapter 150 Guidelines for Free and Reduced Care. A patient financial representative is also available to assist with triaging patient needs and working with our patients to align resources. This representative is available to explain and review patient payment obligations. We also have a patient advocate to facilitate issues that arise during the course of this process. Information about Hospital-based financial support polices and external support programs that provide coverage for services are made available to patients during the pre-registration and registration processes and/or through communications with patients seeking financial assistance. Support is available to uninsured and underinsured patients who do not qualify for public programs or other means of assistance. Notification about financial assistance programs at MDIH, including contact information, is available through messaging included on patient bills, physician offices, public areas, care management staff, registration areas, billing support staff, and reception in the Hospital and at our clinics. Patient brochures describing the financial counseling services, our financial assistance policies, financial assistance application, and the applicable services which are available in these areas as well as this information may be found on our public website, www.mdihospital.org. The annual review of these policies is done through the Board Appointed Finance Committee. Part VI, Line 4: Mount Desert Island Hospital is a 25-bed critical access hospital located in Bar Harbor, Maine and licensed by the State of Maine. The mission is to provide compassionate care and strengthen the health of our community by embracing tomorrow's methods and respecting time-honored values. Its services include acute inpatient, swing bed, 24-hour emergency center, diagnostic services, lab, physical therapy, pharmacy, obstetrics, nursery, and surgical services. Along with hospital services, the Hospital employs the majority of primary and specialty care physicians in the area. The Hospital provides the only behavioral health clinic services in Hancock County, which has been identified as a need in the CHNA for mental and substance use treatment availability and the removal of stigma associated with mental and substance use disorders. Hancock and Washington counties are considered rural by the State of Maine and the United States Census Bureau, under guidelines set forth by the Office of Management and Budget (OMB). The Hospital service area (HSA) as defined by the Maine Health Data Organization (MHDO) uses the statistical method where the greatest proportion of residents received their inpatient care. The Hospital's primary service area is Mount Desert Island and the towns it supports as well as the outer islands off the coast of Bar Harbor, Northeast Harbor, and Southwest Harbor. Also included in our service area are the towns of Trenton and Lamoine, Maine. The Hospital entered into a collaborative to bring dental and oral health services to Mount Desert Island, which is defined as a federally underserved location for dental health and identified as a need in the Hospital's CHNA. MDI Hospital opened a dental center in Southwest Harbor to address the community's needs for oral health, expanding access the past year to our community for outreach and dental health services. Part VI, Line 5: Mount Desert Island Hospital is committed to improving health and quality of life in the MDI region. Through innovation and effort, we strive to meet the evolving needs of our community with a compassionate, patient-centered approach to care. Our dedication to excellence has been recognized with national awards for patient satisfaction and for the delivery of care in a rural setting. Today, MDI Hospital is a beacon of quality care for residents and visitors and a model of rural care delivery for the nation.As one of the largest employers on MDI, the Hospital provided approximately 530 jobs in fiscal year 2017. Our network of island health centers are our frontline, providing the community with top quality, individualized primary care where they feel most at home. Our Hospital network offers seven primary care facilities in Bar Harbor, Northeast Harbor, Southwest Harbor, and Trenton as well as a new full service dental clinic, a nationally recognized Breast Health Center, and comprehensive behavioral health services. MDI Hospital Organization Services: Breast Health Center at MDI Hospital, Cadillac Family Practice, Cooper Gilmore Health Center, Community Health Center, Community Dental Center, Lisa Stewart Women's Health Center, MDI Behavioral Health Center, Northeast Harbor Clinic (seasonal), Trenton Health Center, 24-7 emergency room, acute care (swing beds), behavioral health services, breast health services, cardiac rehabilitation, dental/oral health services, digital mammography, diabetes education, general surgery, imaging/radiology, infusion center, palliative care, laboratory services, neurology, nutrition education, obstetrical services, occupational therapy, oncology-hematology, orthopedics, pediatrics, physical therapy, podiatry, primary care, pulmonology, skilled rehabilitation, speech therapy, sports medicine, surgical services, urology, and women's health services.In fiscal year 2017, our healthcare professionals offered skilled services to the Downeast Region including free and uncompensated care. MDI Hospital and Health Centers do not turn away those in need of medical care, regardless of their ability to pay. The organization provided $5.7 million in free and uncompensated care during the year. Community PartnershipsDuring fiscal year 2017, MDIH partnered with many area organizations to reach a broad range of community members. These community partnerships included MDI YMCA, Healthy Acadia, Connors Emerson School, AOS 91 School District, Havana Restaurant, Jesup Memorial Library, Southwest Harbor Public Library, Hancock County Emergency Management, MDI Search and Rescue, Acadia National Park, Life Flight of Maine, Eastern Maine Medical Center, Maine Coast Memorial Hospital, EMS personnel throughout Hancock County, Bar Harbor Fire Station, Bar Harbor Chamber of Commerce, MDI Rotary, MDI Lioness Club, MDI YWCA, MDI Marathon, Bar Harbor Food Pantry, and the Southwest Harbor and Tremont Chamber of Commerce. These partnerships allow MDI Hospital and Health Centers to provide education, services, training and informational materials to individuals and organizations throughout Downeast Maine. Dedicated StaffIn fiscal year 2017, MDI Hospital's dedicated staff contributed countless hours of volunteer time and donations to groups such as Hospice Volunteers of Hancock County, Bar Harbor Food Pantry, Bar Harbor Housing Authority, MDI Marathon, Maine Alzheimer's Association, MDI Rotary, Island Connections, MDI YMCA, Island Housing Trust, MDI Lioness Club, Acadia National Park, Beth C. Wright Cancer Center, and American Cancer Society Relay for Life. MDIH staff also hosted a table during Bar Harbor's annual Halloween celebration on Ledgelawn, providing warm drinks and healthy snacks to children. In addition, Hospital staff volunteered at Harbor House's Basketball Shoot-Out, MDI High School sporting events, and Bar Harbor's annual Luminary Walk in honor of breast cancer awareness.Community Health ServicesOral Health Services: In fiscal year 2017, MDI Hospital was proud to partner with the American Dental Association (ADA) to host the Island's fourth annual Give Kids a Smile Day at our Community Dental Center in Southwest Harbor. This event was founded by the ADA to raise awareness of the critical need for access to oral healthcare. Children were provided with oral hygiene instruction, cleanings and fluoride varnish from registered dietitians. MDI Hospital is committed to providing greater access to quality dental health services in our community.Childbirth Education Classes: MDI Hospital's OB department provides low-cost classes for new families on labor and delivery, breastfeeding, newborn care, sibling issues, and infant and child CPR.Flu Shot Clinics: The Hospital conducts low-cost public flu clinics each year at several locations throughout the community. A total of 50 people took advantage of these convenient clinics in fiscal year 2017.Diabetes Education: MDI Hospital's Diabetes Education program provides guidance and support to help people manage their disease.Telemedicine Services: Using two-way telecommunications technology, MDIH is able to connect clinicians in the ICU, ER, and on outer islands with providers' located miles away.Nutrition Education: MDI Hospital dietitians provide a variety of educational and outreach services to the community each year. In fiscal year 2017, these efforts included: health coaching as part of the Jackson Laboratory's Health and Fitness Program; food safety education for the Jackson Laboratory Safety Fair; diabetes education program; nutrition education for the Diabetes Prevention Program classes; participation in the MDI Hospital health fair; individual nutrition counseling to hospital staff; nutrition and exercise education for the Food Revolution Day for elementary school students; nutrition education through grocery store tours as the local Hannaford; and nutrition education presentations and talks for Jackson Lab employees.Palliative Care Team: In fiscal year 2017, MDI Hospital launched a new Palliative Care Program offering both inpatient and outpatient consultations for patients suffering from serious illnesses. Our palliative care program focuses on improving quality-of-life for patients with life-limiting illnesses and their families through the prevention and relief of physical, social, and spiritual aspects of suffering.Integrated Care Team: In fiscal year 2017, MDI Hospital began operational implementation of our Integrated Care Model, a way to give our patients better, more personalized care. Under our Integrated Care Model, care is provided by a care team that works together to give each patient with the best care possible, tailored to meet their needs. Care team members work side by side with patients and their families to improve health, wellness, and quality of life both in and out of the clinic setting. Each patient's care team is led by their primary care practitioner, who helps to establish and maintain their care plan. Patients receive regular follow-up calls from their care manager, and additional support is available both at home and in the clinic setting to help improve the quality of their care and their access to care. If a patient needs to be hospitalized, their care team works with their hospital care practitioners to coordinate their care.School Based Nurse Program: MDI Hospital provides nursing services to the following schools: Trenton, Tremont, Pemetic Schools and College of the Atlantic. MDIH also provides Family Nurse Practitioner services to MDI High School one day per week during the school year. Oversight and training to all Island emergency medical servicesMDI Hospital's Emergency Department is led by Nathan Donaldson, DO, MHA, FACEP. Dr. Donaldson is the Medical Director for all Bar Harbor, Northeast Harbor and Southwest Harbor Emergency Medical Services (EMS). Dr. Donaldson is a board-certified emergency physician with a background in sports medicine. As an EMS director, Dr. Donaldson facilitates quarterly education reviews and protocol updates for all Island EMS professionals.Pharmaceutical Support for EMS Crash Boxes: The local EMS services and Mount Desert Island Hospital Pharmacy have an ongoing relationship where the Hospital pharmacy provides the medications for the ambulance services at no cost. This service allows the EMS crews to have the needed lifesaving medications on hand for MDI residents. EMS services and the pharmacy work closely to ensure compliance and ensure that the best medications are available for any emergency.MDI Marathon: MDI Hospital has provided medical support and organizes volunteers for the MDI marathon for the past 14 years.(continued) Part VI, Line 6: N/A Part VI, Line 7, Reports Filed With States ME Schedule H, Part VI, Line 5 (continued) Subsidized Health Services: YES (Your Exercise Solution) class in Bar Harbor, MDI Hospital's free Wellness Program provided two classes per week for 50 weeks to a total of 1664 participants.Free Blood Pressure Clinics: MDI Hospital's Wellness Department provided free blood pressure clinics throughout the island, serving 60 people.Community Walking Program: A total of 352 people participated in the spring and fall walking programs.Free Cancer Support Group: With sponsorship from the MDI Hospital Auxiliary and MDI Behavioral Health Center, and in collaboration with the Beth C. Wright Cancer Resource Center, MDI Hospital provides free monthly support groups for patients, survivors, and their families. Prescription Assistance Program: At no cost to patients, MDI Hospital's Prescription Assistance Program helps those who lack prescription coverage access free or reduced cost medications available through programs sponsored by pharmaceutical companies. Between May 2016 and April 2017, the program helped 103 patients receive free prescriptions valued at $168,400 wholesale. Since inception, the program has saved participants over $2,034,000. Chronic Disease Prevention Programs: MDI Hospital continues to provide support for programs operated by Healthy Acadia for the management of chronic disease. Affordable Care Act Education: During fiscally year 2017, MDI Hospital offered health insurance enrollment counseling to help community members explore their health insurance options on the Health Insurance Marketplace. Other Programs: In fiscal year 2017, 52 people attend MDI Hospital's health fair; 25 people attended MDI Hospital health screenings held at COA; 20 people participated in bone density and cholesterol screenings at MDI High School; 2 pre-diabetes classes were offered free to the community; MDI Hospital hosted 1 blood drive; and 1 smoking cessation group was offered. X 1 1 X X 0 0 0 0 0 0 0 1 0 Stuart Davidson MD Trustee/Medical Staff Pres 460566 0 0 0 25131 0 0 0 27368 0 513065 0 0 0 Julian Kuffler MD 2nd Vice Chair/Physician 241227 0 0 0 15516 0 0 0 30696 0 287439 0 0 0 Arthur J Blank President & CEO 283582 0 14163 0 37801 0 0 0 29691 0 365237 0 0 0 Christina Maguire-Harding VP Finance/Treasurer/Clerk 172181 0 8142 0 2238 0 7088 0 16871 0 206520 0 0 0 Mark Kandutsch MD Physician 253758 0 21844 0 7012 0 0 0 34356 0 316970 0 0 0 Nathan Donaldson DO MHA FACEP Physician 288489 0 0 0 34427 0 0 0 30361 0 353277 0 0 0 Edward Gilmore MD MACP Chief Medical Officer 264877 0 0 0 17620 0 0 0 15767 0 298264 0 0 0 Diehl Snyder MD Physician 230149 0 0 0 9968 0 0 0 23943 0 264060 0 0 0 Tanya Hanke DO Physician 185852 0 44799 0 30689 0 0 0 17715 0 279055 0 0 0 Part I, Line 1a The Hospital provides the President & CEO's fitness membership, which is approximately $399 per year. The Hospital reimburses all other benefitted employees, including other employees listed in Part VII, $100 annually toward a health club membership with appropriate supporting documentation. Part I, Line 7 Performance-based variable compensation which is subject to review annually by a board compensation committee. A MHHEFA 2006F Bond 010314384 2005-07-03 707200 Replacement of central chiller 0 0 0 B MHHEFA 2007B Bond 010314384 2007-07-03 4427988 Clinic construction, office and clinic space 0 0 0 C MHHEFA 2010B Bond 010314384 2010-07-01 Reinfinancing of 1998A bond for renovation of outpatient service area 0 0 0 A 707200 707200 2008 0 0 1 1 B 4427988 4427988 2009 0 0 1 1 C 1200000 1200000 1999 1 0 1 1 A 0 0 0 0 0 0 1 B 0 0 0 0 0 0 1 C 0 0 0 0 0 0 1 A 1 0 0 0 0 1 B 0 0 0 1 0 0 0 0 0 C 0 0 0 1 0 0 0 0 0 A 1 B 1 C 1 Date Rebate Computation Performed Issuer Name: MHHEFA 2007B Bond Date the Rebate Computation was Performed: 12/29/2012 Issuer Name: MHHEFA 2010B Bond Date the Rebate Computation was Performed: 08/21/2015 Dr John Benson Trustee 301766 John Benson, MD is the proprietor of J&D Imaging, Inc. which is contracted with MDI Hospital to preform radiology and imaging services. The equipment is under lease from J&D Imaging, Inc. Although Dr. Benson is a member of the Board of Trustees, he abstains from any motion or situation which may be deemed a conflict of interest and duly reports and completes all required disclosure documents. All transactions are at arms-length. 0 X 3 65430 Stock Exchange Value 0 1 1 Part I, Line 32b: The Hospital gift acceptance policy stipulates that stock donations are sold by their third-party investment advisors as soon as administratively possible. Form 990, Part VI, Section B, line 11b The Form 990 is prepared by an outside independent accounting firm with input and assistance from Finance Department staff. The initial review of the Form 990 is performed by the Finance Committee of the Hospital's Board of Directors. Members are provided with an electronic copy of the Form 990 and all supporting schedules (printed versions are also available upon request). Once the Finance Committee has completed its review, all Board of Trustees members are provided with a copy of the Form 990 and supporting schedules. Board Members are given the opportunity to comment and review before the Form 990 is filed with the IRS. The President & CEO and the VP of Finance & CFO are available to answer any inquiries from Board members. Board Members are also provided with a copy of the final Form 990 as it is filed. Form 990, Part VI, Section B, line 12c Mount Desert Island Hospital monitors and enforces compliance with the conflict of interest policy by requiring all trustees, officers, and committee members to annually sign a statement affirming that each person has received, read, and understands the conflict of interest policy and that no such conflict exists. Additionally, interested persons have a duty to disclose any actual or possible conflicts of interest at the time they arise. After disclosing a potential conflict of interest and answering any questions that might be asked concerning such interest, the affected person shall withdraw from any meetings, deliberations, votes, or other matters concerning the conflict. To ensure that the Hospital does not engage in activities that could jeopardize its tax exempt status, the Board or a committee appointed by the Board, periodically reviews compensation and similar arrangements to ensure they are reasonable and are the result of arms-length bargaining. In conducting these reviews the Board may use outside advisors. Form 990, Part VI, Section B, line 15a The process used by Mount Desert Island Hospital for determining the President & CEO's compensation includes a review and approval by the governing body of the Organization. The governing body uses market data from an independent source to compare compensation models of similarly sized organizations within like demographic and geographic areas to align compensation packages. The compensation of other officers and key employees is reviewed by the Human Resources Department using the same market data guidelines to compare and establish compensation for these positions. Form 990, Part VI, Section C, line 19 The annual report and Form 990 are available to the public on the Hospital's website. Governing documents, the conflict of interest policy, and the financial statements are available upon request. Form 990, Part VII, Section A, Line 1: Dr. Stuart Davidson and Dr. Julius Kuffler are employees and/or independent contractors affiliated with Mount Desert Island Hospital. Compensation paid to them is for their services in these roles, and not for their services as Trustees. Form 990, Part IX, line 11g Consulting: Program service expenses 0. Management and general expenses 68,932. Fundraising expenses 0. Total expenses 68,932. Purchased Services: Program service expenses 6,162,960. Management and general expenses 2,085,959. Fundraising expenses 0. Total expenses 8,248,919. Physician Fees: Program service expenses 696,336. Management and general expenses 66,613. Fundraising expenses 0. Total expenses 762,949. Outside Lab Fees: Program service expenses 536,826. Management and general expenses 0. Fundraising expenses 0. Total expenses 536,826. Form 990, Part XI, line 9: Equity Transfer to Affiliate -17,296. Form 990, Part XII, Line 2c: The audit process has not changed from the prior year. Birch Bay Retirement Village PO Box 8 10 Wayman Lane Bar Harbor ME 046090008 010481696 Retirement Community ME 501(c)(3) Line 12a, I Mount Desert Island Hospital 1 Mount Desert Management Company PO Box 8 10 Wayman Lane Bar Harbor ME 04609 010538776 Real Estate Development ME N/A C 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1 1 Birch Bay Retirement Village O 1113479 Actual per Books Birch Bay Retirement Village R 52092 Actual per Books Birch Bay Retirement Village S 1480839 Actual per Books