2016-08-12T09:22:03-05:00 2015-09-30 990 2014-10-01 010285286 PENOBSCOT BAY MEDICAL CENTER PENO 2079216747 4 WHITE STREET ROCKLAND ME 048412953 LINDA DRINKWATER REGIONAL CHIEF FIN. OFFICER 2079216747 2016-08-03 2014 2016-09-27 15:27:22Z MARK BISCONE 4 WHITE ST ROCKLAND ME 048412953 106735666 false X WWW.PENBAYHEALTHCARE.ORG X 1969 ME PENOBSCOT BAY MEDICAL CENTER IS AN ACUTE CARE HOSPITAL THAT OFFERS INPATIENT AND OUTPATIENT CARE, DIAGNOSTIC, THERAPEUTIC AND REHABILITATIVE SERVICES, PATIENT AND COMMUNITY EDUCATION, AND A FULL RANGE OF SPECIALTY SERVICES THROUGH THE EMERGENCY DEPARTMENT, SPECIAL CARE UNIT, SURGICAL SERVICES DEPARTMENT, OBSTETRICS AND GYNECOLOGY DEPARTMENT, AND THE PSYCHIATRIC ADDICTION & RECOVERY CENTER. 19 15 1291 181 648621 -63210 2483902 379770 108289336 105314280 468777 890640 789490 150976 112031505 106735666 0 0 56800626 59874510 0 0 53763310 51052124 110563936 110926634 1467569 -4190968 130043933 123916551 70090666 69070631 59953267 54845920 X PENOBSCOT BAY MEDICAL CENTER IS AN ACUTE CARE HOSPITAL THAT OFFERS INPATIENT AND OUTPATIENT CARE, DIAGNOSTIC, THERAPEUTIC AND REHABILITATIVE SERVICES, PATIENT AND COMMUNITY EDUCATION, AND A FULL RANGE OF SPECIALTY SERVICES THROUGH THE EMERGENCY DEPARTMENT, SPECIAL CARE UNIT, SURGICAL SERVICES DEPARTMENT, OBSTETRICS AND GYNECOLOGY DEPARTMENT, AND THE PSYCHIATRIC ADDICTION & RECOVERY CENTER. false true 86549649 88697951 INPATIENT & OUTPATIENT HOSPITAL CARE: PENOBSCOT BAY MEDICAL CENTER PROVIDES QUALITY MEDICAL CARE REGARDLESS OF RACE, CREED, SEX, NATIONAL ORIGIN, HANDICAP OR ABILITY TO PAY. ALTHOUGH REIMBURSEMENT FOR SERVICES RENDERED IS CRITICAL TO THE OPERATION AND STABILITY OF PENOBSCOT BAY MEDICAL CENTER, NOT ALL INDIVIDUALS POSSESS THE ABILITY TO PURCHASE ESSENTIAL MEDICAL SERVICES. OUR MISSION IS TO SERVE THE COMMUNITY BY PROVIDING HEALTH CARE SERVICES AND HEALTH CARE EDUCATION. IN KEEPING WITH THIS HOSPITAL'S COMMITMENT TO SERVE ALL MEMBERS OF ITS COMMUNITY, WE PROVIDE FREE CARE AND SUBSIDIZED CARE TO PERSONS COVERED BY GOVERNMENTAL PROGRAMS BELOW COST, AND HEALTH ACTIVITIES AND PROGRAMS FOR THE COMMUNITY. (CONTINUED AT SCHEDULE O) (CONTINUED FROM PART III, LINE 4A) PENOBSCOT BAY MEDICAL CENTER SERVED 3,920 INPATIENTS, INCLUDING NEWBORNS AND 125,138 OUTPATIENTS INCLUDING ER VISITS, DURING FY 15. TWENTY FOUR HOUR MEDICAL EMERGENCY SERVICE IS PROVIDED IN THE EMERGENCY ROOM, STAFFED BY FULL-TIME ATTENDING PHYSICIANS. PATIENTS ARE SEEN REGARDLESS OF ABILITY TO PAY. THERE WERE 21,634 VISITS TO THE EMERGENCY ROOM DURING FY 15. RECOGNIZING ITS MISSION TO THE COMMUNITY, SERVICES ARE PROVIDED TO BOTH MEDICARE & MAINECARE PATIENTS. TO THE EXTENT REIMBURSEMENT IS BELOW COST, PENOBSCOT BAY MEDICAL CENTER RECOGNIZES THESE AMOUNTS AS CONTRACTUAL ADJUSTMENTS. THE UNREIMBURSED COST OF PROVIDING CARE TO THESE PATIENTS WAS 103,918,452. DURING FY 15, APPROXIMATELY 64% OF SERVICES WERE TO PATIENTS COVERED BY THESE GOVERNMENTAL PROGRAMS. ADDITIONALLY, PENOBSCOT BAY MEDICAL CENTER PROVIDED 4,717,075 IN FREE CARE TO PATIENTS NOT COVERED BY GOVERNMENTAL PROGRAMS. PBMC PROVIDES FREE CONFERENCE ROOM AND MEETING SPACE FOR A VARIETY OF HEALTH RELATED GROUPS INCLUDING ALCOHOLICS ANONYMOUS, AL ANON, MIDCOAST CANCER SUPPORT GROUP, HEART TO HEART, CARDIAC SPOUSE SUPPORT GROUP, CROHN'S DISEASE SUPPORT GROUP, VISUALLY IMPAIRED AND BLIND SUPPORT GROUP, PEDIATRIC ASTHMA SUPPORT GROUP, OSTOMY GROUP, MIDCOAST MASTECTOMY SUPPORT GROUP, NORTHEAST HEALTH CONSORTIUM FOR INTEGRATED CARE, BREAST CANCER INTERVENTION PROJECT, MID-COAST COALITION FOR DOMESTIC ABUSE, TEEN PARENTING, WOMEN'S AND CHILDREN'S COMMUNITY CARE PROJECT. ASSISTANCE IS PROVIDED TO EDUCATORS THROUGH OUR WORK WITH MEDICAL STUDENTS, STUDENT NURSES, PHYSICAL THERAPY INTERNS, EMERGENCY MEDICAL TECHNICIANS, MEDICAL RECORDS AND SOCIAL SERVICE STUDENTS. THROUGH AN ARRANGEMENT WITH THE UNIVERSITY OF MAINE - ORONO, OUR EDUCATION AND TRAINING DEPARTMENT OFFERS NURSES WITH CERTIFICATE DEGREES THE OPPORTUNITY TO WORK TOWARD A BACCALAUREATE DEGREE IN THE LOCAL AREA. THE HOSPITAL MAINTAINS A RESEARCH LIBRARY WHICH IS OPEN 24 HOURS A DAY AND AVAILABLE TO THE GENERAL PUBLIC. DURING FY 15, THE COMMUNITY CONTRIBUTED APPROXIMATELY 11,570 HOURS TOWARD THE COMMON PURPOSE OF SERVICING THE HEALTH CARE NEEDS OF THE COMMUNITY. THE VALUE OF THIS CONTRIBUTION IS GIVEN BACK TO THE COMMUNITY THROUGH LOWER COSTS IN BOTH PATIENT SERVICES AND OTHER WELLNESS PROGRAMS SUCH AS THOSE DESCRIBED ABOVE. 9382839 9615736 PHYSICIAN PRACTICES: PEN BAY PHYSICIAN AND ASSOCIATES, A GROUP OF DEPARTMENTS OF PENOBSCOT BAY MEDICAL CENTER, IS COMPOSED OF 18 PRACTICES COVERING MANY SPECIALITIES. 6831036 7000593 THE KNOX CENTER FOR LONG TERM CARE IS AN 84-BED LONG-TERM NURSING CARE AND SKILLED REHABILITATION CENTER. SINCE 1975, THE KNOX CENTER FOR LONG TERM CARE HAS BEEN CARING FOR MEMBERS OF MID-COAST FAMILIES AND PROVIDING THEM WITH A LOVING HOME WHERE THEY RECEIVE BOTH THE SOPHISTICATED TECHNICAL CARE THEY REQUIRE AND THE DIGNITY AND RESPECT THEY DESERVE. 102763524 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 true false false false false false false false false false false false false false false false true true true false false true 74 0 true 1291 true true true false false false false false false false false false X 19 15 false false false false true true true true true false false true true true true true true true true true true ME X LINDA DRINKWATER 2079216747 4 WHITE STREET ROCKLAND ME 048412953 WILLIAM L CARON JR TRUSTEE, PRE 1.00 50.00 X X 0 921196 133628 MARK BISCONE PRESIDENT & 16.00 34.00 X X 0 469771 31050 ROBERT STEIN MD MEDICAL STAF 50.00 1.00 X 0 370657 27498 JENNIFER C MCKENNA MD MEDICAL STAF 1.00 50.00 X 0 299886 21060 CORNELIUS YETMAN DO MEDICAL STAF 1.00 50.00 X 0 272086 20737 LEE WEBB TREASURER 1.00 6.00 X X 0 0 0 GREGORY A DUFOUR SECRETARY 1.00 5.00 X X 0 0 0 DAVID R WILLIAMS CPA CHAIRMAN 1.00 7.00 X X 0 0 0 JACOB GERRITSEN MD TRUSTEE 1.00 1.00 X 0 0 0 EVERETT L SPEAR III IMMEDIATE PA 1.00 1.00 X 0 0 0 JOANNE BILLINGTON TRUSTEE 1.00 2.00 X 0 0 0 CAROLE BRAND TRUSTEE 1.00 2.00 X 0 0 0 STEPHEN W HANSCOM ESQ TRUSTEE 1.00 1.00 X 0 0 0 TAMMY KOLMOSKY TRUSTEE 1.00 6.00 X 0 0 0 WILLIAM LAMBIE MD MEDICAL STAF 1.00 1.00 X 0 0 0 CORNELIUS J RUSSELL TRUSTEE 1.00 1.00 X 0 0 0 MELISSA SCHENK TRUSTEE 1.00 1.00 X 0 0 0 LANCE AHEARN TRUSTEE 1.00 X 0 0 0 PAUL KLAINER MD TRUSTEE 1.00 2.00 X 0 0 0 LINDA DRINKWATER REGIONAL CFO 1.00 49.00 X 0 221285 9081 MAURA KELLY CPA MST VP FISCAL SE 50.00 X 217904 0 16879 ERIK FREDERICK COO 50.00 X 191014 0 14241 PAULA DELAHANTY VP NURSING S 50.00 X 172653 0 17902 REGINALD ALBERT VP PHYSICIAN 50.00 X 166103 0 5624 DAVID BACHMAN MD VP OF MED. A 50.00 X 318156 0 11226 NADIA RAMDIN MD PHYSICIAN 50.00 X 297089 0 14515 CHRISTOPHER MICHALAKES MD ER MEDICAL D 50.00 X 273250 0 14416 FREDERICK GOGGANS MD PHYSICIAN 50.00 X 248642 0 26413 RICHARD CHANDLER MD ER PHYSICIAN 50.00 X 238106 0 17895 WADE JOHNSON PRESIDENT & 50.00 X 0 137355 7725 2122917 2692236 389890 41 true true false PENBAY ANESTHESIA LLC PO BOX 63 WEST ROCKPORT ME 04865 ANESTHESIA SVCS 729812 PEN BAY PATHOLOGY ASSOC PO BOX 1849 LEWISTON ME 04241 PATHOLOGY SVCS. 180167 AHSA LLC PO BOX 945 TRAVERSE CITY MI 49685 INT. STAFFING 143928 JK KALLOCH PO BOX 774 ROCKLAND ME 04841 GROUNDS MAINT. 130416 ATTORNEY CARL TRYNOR PO BOX 4290 PORTLAND ME 04101 COLLECTION SVCS 125147 6 379770 379770 INPATIENT & OUTPATIENT CARE 624100 88697951 88697951 PEN BAY PHYSICIANS & ASSOC. 621110 9615736 9615736 KNOX CENTER FOR LT CARE 623000 7000593 7000593 105314280 877293 877293 13347 13347 13347 13347 HEALTH CONNECTIONS 624100 498579 498579 CHILD CARE 624410 177196 177196 CHILD CARE 624410 150042 150042 -674841 -674841 150976 106735666 104829982 648621 877293 X 859684 830255 29429 46147837 44568084 1579753 1693776 1635794 57982 8051011 7775405 275606 3122202 3015321 106881 12309 12309 24230 24230 14452 14452 11467242 11074689 392553 30311 29273 1038 421050 406636 14414 27124 26195 929 4740775 4578487 162288 440173 425105 15068 1283405 1239471 43934 5608447 5416456 191991 1716745 1657977 58768 MEDICAL SUPPLIES 13338857 13338857 MEMBER FEES 5035616 5035616 HEALTH CARE PROVIDER TAX 2614190 2614190 NONMEDICAL SUPPLIES 2146434 2072956 73478 2130764 2058373 72391 110926634 102763524 8163110 0 138807 15503 2270612 2246261 20139455 16280591 1659414 1717792 3388696 3025990 150799449 94656316 53932072 56143133 18132973 18443858 30381904 26043423 130043933 123916551 10415398 10643476 29048116 26101833 14193 6609 30612959 32318713 70090666 69070631 X 50900876 46287565 3029435 2574754 6022956 5983601 59953267 54845920 130043933 123916551 X -4190968 -1952279 1035900 X false true X true false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false true 14452 14452 false SCHEDULE C, PART II-B, LINE 1 A PORTION OF THE MEMBERSHIP DUES PAID TO THE MAINE HOSPITAL ASSOCIATION (MHA)REPRESENT LOBBYING ACTIVITIES. 6022956 160000 -199356 5983600 5400541 500000 122415 6022956 5217795 182746 5400541 4898550 319245 5217795 5320145 -421596 4898550 1.00000 false true true 951091 951091 65515039 32979483 32535556 1747732 1361633 386099 78626958 60315200 18311758 3958629 3958629 56143133 PREPAID CAPITAL COSTS 14845077 ESTIMATED AMOUNTS FROM THIRD PARTY 6217345 INVESTMENT IN PINETREE INSURANCE CO. 2429929 DUE FROM AFFILIATES 1335795 TRUSTEE HELD FUNDS 639818 OTHER 567132 RESIDENT ACCOUNT DEPOSITS 8327 BOND ISSUANCE COSTS 26043423 DUE TO MAINEHEALTH AND MEMBERS 31485077 ESTIMATED AMOUNTS DUE TO THIRD PARTY 546092 DUE TO AFFILIATES 279217 RESIDENT ACCOUNTS & DEPOSITS 8327 32318713 X SCHEDULE D, PAGE 2, PART V, LINE 4 TO BE INVESTED IN PERPETUITY TO PROVIDE A PERMANENT SOURCE OF INCOME. SCHEDULE D, PAGE 3, PART X PENOBSCOT BAY MEDICAL CENTER IS ECEMPT FROM INCOME TAXES UNDER SECTION 501 (C)(3) OF THE INTERNAL REVENUE CODE. true true true X 1.750000000000 true X 2.250000000000 true true false true true 2218285 2218285 0.02000 18163365 15265929 2897436 0.02610 20381650 15265929 5115721 0.04610 4840956 4840956 0.04360 4840956 4840956 0.04360 25222606 15265929 9956677 0.08980 false 4644609 27981088 38972326 -10991238 X true true 1 1 PENOBSCOT BAY MEDICAL CENTER 6 GLEN COVE DRIVE ROCKPORT ME 04856 X X X PENOBSCOT BAY MEDICAL CENTER 1 true false true X X X X X X X X 13 true true false true X WWW.PENBAYHEALTHCARE.ORG X true 13 true PENBAYHEALTHCARE.ORG/HEALTH-WELLNESS false false true X 175.000000000000 225.000000000000 true true X X X true X WWWPENBAYHEALTHCAREORG X WWWPENBAYHEALTHCAREORG X X X X true X true true X false true FACILITY 1, PENOBSCOT BAY MEDICAL CENTER - PART V, LINE 5 THE HOSPITAL CONVENED A PLANNING GROUP MADE UP OF PEOPLE REPRESENTING THE BROAD INTERESTS OF THE COMMUNITY SERVED PRIOR TO HOLDING FORUMS. THE ORGANIZATIONS, INDIVIDUAL EXPERTS AND INDIVIDUAL LEADERS/REPRESENTATIVES INVOLVED IN THE PLANNING GROUP FOR PEN BAY INCLUDE: PENQUIS CAP-PINNY BEEBE CENTER, REGIONAL MANAGER, KNOX COUNTY COMMUNITY HEALTH COALITION, HMP SPECIALIST AND THE DIRECTOR, SPECTRUM GENERATION'S COMMUNICATIONS COORDINATOR AND PEN BAY MEDICAL CENTER'S TWO CO-DIRECTORS OF PICKLER FAMILY RESOURCE CENTER, VP OF COMMUNITY HEALTH, LET'S GO COORDINATOR, DIABETES AND NUTRITIONAL CENTER STAFF, EMPLOYEE HEALTH MANAGER AND ADMINISTRATIVE ASSISTANT AND MEDIA SPECIALIST FROM THE PICKER FAMILY RESOURCE CENTER. FACILITY 1, PENOBSCOT BAY MEDICAL CENTER - PART V, LINE 6A THE ONEMAINE HEALTH COLLABORATION (ONEMAINE) A PARTNERSHIP BETWEEN MAINEHEALTH, EASTERN MAINE HEALTHCARE SYSTEM AND MAINE GENERAL HEALTH. FACILITY 1, PENOBSCOT BAY MEDICAL CENTER - PART V, LINE 11 PENOBSCOT BAY MEDICAL CENTER DID THE FOLLOWING TO IDENTIFY THE ADDRESSED NEEDS IN ITS MOST RECENT CHNA: 1. ADOPTION OF AN IMPLEMENTATION STRATEGY THAT ADDRESSED EACH OF THE COMMUNITY HEALTH NEEDS IDENTIFIED THROUGH THE CHNA 2. EXECUTION OF THE IMPLEMENTATION STRATEGY 3. PARTICIPATION IN THE DEVELOPMENT OF A COMMUNITY-WIDE PLAN 4. PARTICIPATION IN THE EXECUTION OF A COMMUNITY-WIDE PLAN 5. INCLUSION OF A COMMUNITY BENEFIT SECTION IN OPERATIONAL PLANS 6. ADOPTION OF A BUDGET FOR PROVISION OF SERVICES THAT ADDRESS THE NEEDS IDENTIFIED IN THE CHNA 7. PRIORITIZATION OF HEALTH NEEDS IN ITS COMMUNITY 8. PRIORITIZATION OF SERVICES THAT THE HOSPITAL FACILITY WILL UNDERTAKE TO MEET HEALTH NEEDS IN ITS COMMUNITY FACILITY 1, PENOBSCOT BAY MEDICAL CENTER - PART V, LINE 22D GROSS CHARGES ARE USED IN ALL SITUATIONS. FACILITY 1, PENOBSCOT BAY MEDICAL CENTER - PART V, LINE 24 THIS HOSPITAL CHARGES AT GROSS FOR ALL PAYORS. PRIVATE PAY PATIENTS HAVE ALWAYS BEEN BILLED AT GROSS CHARGES AND ARE OFFERED A 5% DISCOUNT WHEN PAYMENT IS MADE PROMPTLY. 7 PEN BAY PHYSICIANS & ASSOCIATES 4 GLEN COVE DRIVE ROCKPORT ME 04856 PHYSICIAN PRACTICES THE KNOX CENTER FOR LONG TERM CARE 6 WHITE STREET ROCKLAND ME 04841 LONG TERM CARE PEN BAY SLEEP CENTER 7 MADELYN LANE ROCKPORT ME 04856 SLEEP CENTER PEN BAY PHYSICAL THERAPY 4 GLEN COVE DRIVE ROCKPORT ME 04856 PHYSICAL THERAPY PEN BAY OCCUPATIONAL THERAPY 4 GLEN COVE DRIVE ROCKPORT ME 04856 OCCUPATIONAL THERAPY PEN BAY PHYSICAL THERAPY 116 UNION STREET ROCKPORT ME 04856 PHYSICAL THERAPY PEN BAY PHYSICAL THERAPY 40 WASHINGTON ROAD WALDOBORO ME 04572 PHYSICAL THERAPY PART I, LINE 7 - COSTING METHODOLOGY EXPLANATION RATIO OF PATIENT CARE COSTS TO CHARGES PER WORKSHEET 2 OF THE INSTRUCTIONS. PART II - COMMUNITY BUILDING ACTIVITIES COMMUNITY HEALTH IMPROVEMENT ADVOCACY PICKER FAMILY RESOURCE CENTER - THE PICKER FAMILY RESOURCE CENTER PROMOTES BUILDING COMMUNITY BY PROVIDING HEALTH RESOURCES AND SUPPORT THAT SERVE THE NEEDS FOR WOMEN AND THEIR FAMILIES THROUGHOUT THEIR LIVES. THE RESOURCE CENTER SERVES PATIENTS WHO WANT TO LEARN ABOUT A DISEASE, CONDITION OR TREATMENT, COMMUNITY MEMBERS WHO NEED HEALTHY LIVING TIPS AND RESOURCES, AND HEALTHCARE PROVIDERS LOOKING FOR HEALTH EDUCATION MATERIALS AND RESOURCES. PART III, LINE 2 - BAD DEBT EXPENSE METHODOLOGY PEN BAY HEALTHCARE (PBHC) (PARENT COMPANY OF PENOBSCOT BAY MEDICAL CENTER), ACCEPTS ALL PATIENTS REGARDLESS OF THEIR ABILITY TO PAY. A PATIENT IS CLASSIFIED AS A FREE CARE PATIENT BY REFERENCE TO CERTAIN ESTABLISHED POLICIES OF PBHC. THESE POLICIES DEFINE FREE CARE SERVICES AS THOSE SERVICES FOR WHICH NO PAYMENT IS ANTICIPATED. IN ASSESSING A PATIENT'S ELIGIBILITY FOR FREE CARE, PBHC UTILIZES FEDERALLY ESTABLISHED POVERTY GUIDELINES. FREE CARE PROVIDED IS NOT INCLUDED IN NET PATIENT SERVICE REVENUE AND IS MEASURED BASED ON PBHC'S CHARGES. COSTS AND EXPENSES INCURRED IN PROVIDING THESE SERVICES ARE INCLUDED IN OPERATING EXPENSES. SERVICES RENDERED TO INDIVIDUALS FROM WHOM PAYMENT IS EXPECTED AND ULTIMATELY NOT RECEIVED IS WRITTEN OFF AND INCLUDED AS PART OF THE PROVISION FOR BAD DEBTS. BY PROVIDING NECESSARY HEALTHCARE SERVICES TO THOSE INDIVIDUALS EITHER WHO FAIL TO APPLY FOR FINANCIAL ASSISTANCE OR WHO ARE EXPERIENCING DIFFICULT PERSONAL OR ECONOMIC CIRCUMSTANCES, PMBC BELIEVES THAT BAD DEBT EXPENSE SHOULD BE INCLUDED AS A COMMUNITY BENEFIT. PART III, LINE 8 - MEDICARE EXPLANATION COST REPORT INFORMATION. PBMC BELIEVES THAT THE MEDICARE SHORTFALL SHOULD BE INCLUDED AS A COMMUNITY BENEFIT BECAUSE THE HOSPITAL HAS A CLEAR MISSION COMMITMENT TO SERVING ELDERLY PATIENTS AND ADULTS WITH DISABILITIES THROUGH THE PROVISION OF SPECIFIC SUBSIDIZED PROGRAMS DEVELOPED TO HELP IMPROVE THE HEALTH STATUS OF THESE PATIENTS. IF THESE CRITICAL SUBSIDIZED PROGRAMS WERE NOT PROVIDED BY THE HOSPITAL, THEY WOULD BECOME THE OBLIGATION OF THE FEDERAL GOVERNMENT. PART III, LINE 9B - COLLECTION PRACTICES EXPLANATION PATIENTS ARE NOTIFIED OF ASSISTANCE OPPORTUNITIES VIA: 1. PATIENT ADVOCATE 2. HOSPITAL FINANCIAL COUNSELOR 3. HOSPITAL POSTINGS IN VARIOUS LOCATIONS 4. ON THE BACK OF EVERY BILL 5. COMMUNICATION WHEN CALLING OUR OFFICES PART VI, LINE 2 - NEEDS ASSESSMENT PEN BAY MEDICAL CENTER IS A MEMBER OF MAINEHEALTH, WHICH CONDUCTS A THOROUGH COMMUNITY NEEDS ASSESSMENT AND DIRECTS ITS MEMBER ORGANIZATIONS TO RESPOND TO THE NEEDS IDENTIFIED. MAINEHEALTH MEMBERS ALSO PARTICIPATE IN VARIOUS INITIATIVES TO KEEP THOSE ASSESSMENTS UP TO DATE. SOME OF THESE INITIATIVES INCLUDE: - CLINICAL STRATEGIC PLANNING - FINANCIAL STRATEGIC PLANNING - FACILITY PLANNING - HUMAN RESOURCE PLANNING - STAFF DEVELOPMENT PLANNING - PHYSICIAN RECRUITMENT STRATEGIC PLANNING - EMERGENCY PREPAREDNESS PLANNING IN ADDITION TO THESE INTERNAL ASSESSMENTS, MAINEHEALTH MEMBER ORGANIZATIONS ALSO REVIEW AND ACT ON MANY OF THE RECOMMENDATIONS PROVIDED BY EXTERNAL GROUPS AND STATE HEALTH PLANNING INITIATIVES, SUCH AS: THE MAINE DEPARTMENT OF HEALTH AND HUMAN SERVICES' HEALTHY MAINE 2010 AND AUTISM SPECTRUM DISORDERS REPORT, THE MAINE CENTER FOR DISEASE CONTROL AND PREVENTION AND THE "STATE HEALTH PLAN" CREATED BY THE ADVISORY COMMITTEE FOR HEALTH SYSTEMS DEVELOPMENT. PART VI, LINE 3 - PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE SEE PART III, LINE 9B - COLLECTION OF PRACTICES EXPLANATION FOR METHODS BY WHICH PATIENTS ARE NOTIFIED OF ASSISTANCE OPPORTUNITIES. PART VI, LINE 4 - COMMUNITY INFORMATION PENOBSCOT BAY MEDICAL CENTER IS A FULL SERVICE, 99 BED COMMUNITY HOSPITAL SERVING THE PEOPLE OF MID-COAST MAINE. PART VI, LINE 5 - PROMOTION OF COMMUNITY HEALTH SEE PROGRAM SERVICE ACCOMPLISHMENTS. PART VI, LINE 6 - AFFILIATED HEALTH CARE SYSTEM PENOBSCOT BAY MEDICAL CENTER IS AN ACUTE CARE HOSPITAL PROVIDING IN-PATIENT AND OUT-PATIENT HOSPITAL SERVICES, AS WELL AS EMERGENCY ROOM SERVICES, PHYSICIANS' PRACTICES AND LONG TERM CARE. QUARRY HILL PROVIDES LONG TERM CARE SERVICES. KNO-WAL-LIN HOME HEALTH CARE PROVIDES IN-HOME HEALTH CARE AND HOSPICE SERVICES. KNO-WAL-LIN HELP AT HOME PROVIDES HOMEMAKER SERVICES. PART VI, LINE 7 - STATE FILING OF COMMUNITY BENEFIT REPORT MAINE ADDITIONAL INFORMATION PART I, LINE 3B PENOBSCOT BAY MEDICAL CENTER USES FEDERAL POVERTY GUIDELINES (FPG) FOR PROVIDING DISCOUNTED CARE TO LOW INCOME INDIVIDUALS. THE FAMILY INCOME FOR ELIGIBILITY FOR DISCOUNTED CARE IS 176% - 225%. false true false false false false false false false WILLIAM L CARON JR TRUSTEE, PRES-MH 699679 128000 93517 114986 18642 1054824 MARK BISCONE PRESIDENT & CEO 359595 93000 17176 7800 23250 500821 ROBERT STEIN MD MEDICAL STAFF PRES 359042 11615 13000 14498 398155 JENNIFER C MCKENNA MD MEDICAL STAFF REP 242304 57582 7800 13260 320946 CORNELIUS YETMAN DO MEDICAL STAFF REP 187488 36185 48413 6378 14359 292823 LINDA DRINKWATER REGIONAL CFO 216285 5000 6664 2417 230366 MAURA KELLY CPA MST VP FISCAL SERVICES 217904 7800 9079 234783 ERIK FREDERICK COO 191014 14241 205255 PAULA DELAHANTY VP NURSING SVCS. 172653 8337 9565 190555 REGINALD ALBERT VP PHYSICIAN'S PRAC. 166103 4726 898 171727 DAVID BACHMAN MD VP OF MED. AFFAIRS 318156 4022 7204 329382 NADIA RAMDIN MD PHYSICIAN 297089 7800 6715 311604 CHRISTOPHER MICHALAKES MD ER MEDICAL DIRECTOR 265847 7403 13000 1416 287666 FREDERICK GOGGANS MD PHYSICIAN 208122 40520 12670 13743 275055 RICHARD CHANDLER MD ER PHYSICIAN 228871 9235 11232 6663 256001 WADE JOHNSON PRESIDENT & CEO 137355 2630 5095 145080 SCHEDULE J, PAGE 1, PART I, LINE 3 TOP MANAGEMENT OFFICIALS ARE COMPENSATED BY RELATED ORGANIZATIONS. THESE ORGANIZATIONS USE ONE OR MORE OF THE METHODS SHOWN ABOVE TO ESTABLISH THE COMPENSATION OF TOP MANAGEMENT. SCHEDULE J, PAGE 1, PART I, LINE 4 WILLIAM L. CARON, JR. 0 70,976 0 A MHHEFA SERIES 2006F 010314384 560425G20 2006-09-07 2135000 BUILDINGS & FACILITIES false false true B MHHEFA SERIES 2007B 010314384 560425V80 2007-11-01 6220000 BUILDINGS & FACILITIES false false true C MHHEFA SERIES 2008C 010314384 560525Z78 2008-06-19 6450000 BUILDINGS & FACILITIES false false true D MHHEFA SERIES 2012A 010314384 560427EU4 2012-06-28 4025000 REFUNDING false false true A 740000 2135000 25002 23714 2135000 2007 false false true true B 1855000 6220000 71259 105591 6220000 2007 false false true true C 895000 6450000 36253 163357 6450000 2008 false false true true D 1930000 4025000 55893 63386 4025000 2012 true false true true A false false false false false false false B false false false false false false false C false false false false false false false D false false false false false false false A true false false true FSA 29.800000000000 true false false B false false false true false false true FSA 29.700000000000 true false false C false false false true false false true FSA 30.000000000000 true false false D false true false false false false false false false A false B false C false D false SCHEDULE K - DATE REBATE COMPUTATION PERFORMED MHHEFA SERIES 2007B 11/01/12 MHHEFA SERIES 2008C 06/19/13 SCHEDULE K - ADDITIONAL INFORMATION MHHEFA SERIES 2006F MHHEFA SERIES 2006F AND MHHEFA SERIES 2007B, 2008C, 2012A AND 2014A BONDS - POOLED FINANCING - WITH RESPECT TO PART I, COLUMNS (E) AND (I), AND PART II, LINES 1-12, THE INSTITUTION IS REPORTING ITS PAR AMOUNT OF EACH BOND ISSUE, WITH THE REMAINING PROCEEDS ISSUED TO UNAFFILIATED ENTITIES. THE FOLLOWING IS APPLICABLE TO ALL BOND ISSUES LISTED IN PART I - PART IV, LINE 7 & PART V - THE ISSUER HAS ESTABLISHED WRITTEN PROCEDURES TO MONITOR THESE REQUIREMENTS. THE ORGANIZATION HAS ENTERED INTO A TAX REGULATORY AGREEMENT WITH THE ISSUER THAT REQUIRES THE ISSUER TO MONITOR THE REQUIREMENTS OF SECTION 148. THE ORGANIZATION IS WORKING TO ESTABLISH ITS OWN WRITTEN PROCEDURES TO MONITOR THESE REQUIREMENTS AND UNDERTAKE CORRECTIVE ACTION WHEN APPROPRIATE. FORM 990 - ORGANIZATION'S MISSION PENOBSCOT BAY MEDICAL CENTER IS AN ACUTE CARE HOSPITAL THAT OFFERS INPATIENT AND OUTPATIENT CARE, DIAGNOSTIC, THERAPEUTIC AND REHABILITATIVE SERVICES, PATIENT AND COMMUNITY EDUCATION, AND A FULL RANGE OF SPECIALTY SERVICES THROUGH THE EMERGENCY DEPARTMENT, SPECIAL CARE UNIT, SURGICAL SERVICES DEPARTMENT, OBSTETRICS AND GYNECOLOGY DEPARTMENT, AND THE PSYCHIATRIC ADDICTION & RECOVERY CENTER. FORM 990, PAGE 2, PART III, LINE 3 THE BEHAVIORAL HEALTH SERVICES PROGRAM (PEN BAY BEHAVIORAL HEALTH) WAS DISCONTINUED AS OF DECEMBER 31, 2014. IN PREVIOUS YEARS, THIS PROGRAM WAS PRESENTED IN THE "OTHER" SECTION AT LINE 4D. BEHAVIORAL HEALTH SERVICES ARE STILL PROVIDED AT PBMC BY PHYSICIANS EMPLOYED BY A RELATED ORGANIZATION, MAINE BEHAVIORAL HEALTHCARE (EIN 01-0524834). FORM 990, PAGE 2, PART III, LINE 4A (CONTINUED FROM PART III, LINE 4A) PENOBSCOT BAY MEDICAL CENTER SERVED 3,920 INPATIENTS, INCLUDING NEWBORNS AND 125,138 OUTPATIENTS INCLUDING ER VISITS, DURING FY 15. TWENTY FOUR HOUR MEDICAL EMERGENCY SERVICE IS PROVIDED IN THE EMERGENCY ROOM, STAFFED BY FULL-TIME ATTENDING PHYSICIANS. PATIENTS ARE SEEN REGARDLESS OF ABILITY TO PAY. THERE WERE 21,634 VISITS TO THE EMERGENCY ROOM DURING FY 15. RECOGNIZING ITS MISSION TO THE COMMUNITY, SERVICES ARE PROVIDED TO BOTH MEDICARE & MAINECARE PATIENTS. TO THE EXTENT REIMBURSEMENT IS BELOW COST, PENOBSCOT BAY MEDICAL CENTER RECOGNIZES THESE AMOUNTS AS CONTRACTUAL ADJUSTMENTS. THE UNREIMBURSED COST OF PROVIDING CARE TO THESE PATIENTS WAS 103,918,452. DURING FY 15, APPROXIMATELY 64% OF SERVICES WERE TO PATIENTS COVERED BY THESE GOVERNMENTAL PROGRAMS. ADDITIONALLY, PENOBSCOT BAY MEDICAL CENTER PROVIDED 4,717,075 IN FREE CARE TO PATIENTS NOT COVERED BY GOVERNMENTAL PROGRAMS. PBMC PROVIDES FREE CONFERENCE ROOM AND MEETING SPACE FOR A VARIETY OF HEALTH RELATED GROUPS INCLUDING ALCOHOLICS ANONYMOUS, AL ANON, MIDCOAST CANCER SUPPORT GROUP, HEART TO HEART, CARDIAC SPOUSE SUPPORT GROUP, CROHN'S DISEASE SUPPORT GROUP, VISUALLY IMPAIRED AND BLIND SUPPORT GROUP, PEDIATRIC ASTHMA SUPPORT GROUP, OSTOMY GROUP, MIDCOAST MASTECTOMY SUPPORT GROUP, NORTHEAST HEALTH CONSORTIUM FOR INTEGRATED CARE, BREAST CANCER INTERVENTION PROJECT, MID-COAST COALITION FOR DOMESTIC ABUSE, TEEN PARENTING, WOMEN'S AND CHILDREN'S COMMUNITY CARE PROJECT. ASSISTANCE IS PROVIDED TO EDUCATORS THROUGH OUR WORK WITH MEDICAL STUDENTS, STUDENT NURSES, PHYSICAL THERAPY INTERNS, EMERGENCY MEDICAL TECHNICIANS, MEDICAL RECORDS AND SOCIAL SERVICE STUDENTS. THROUGH AN ARRANGEMENT WITH THE UNIVERSITY OF MAINE - ORONO, OUR EDUCATION AND TRAINING DEPARTMENT OFFERS NURSES WITH CERTIFICATE DEGREES THE OPPORTUNITY TO WORK TOWARD A BACCALAUREATE DEGREE IN THE LOCAL AREA. THE HOSPITAL MAINTAINS A RESEARCH LIBRARY WHICH IS OPEN 24 HOURS A DAY AND AVAILABLE TO THE GENERAL PUBLIC. DURING FY 15, THE COMMUNITY CONTRIBUTED APPROXIMATELY 11,570 HOURS TOWARD THE COMMON PURPOSE OF SERVICING THE HEALTH CARE NEEDS OF THE COMMUNITY. THE VALUE OF THIS CONTRIBUTION IS GIVEN BACK TO THE COMMUNITY THROUGH LOWER COSTS IN BOTH PATIENT SERVICES AND OTHER WELLNESS PROGRAMS SUCH AS THOSE DESCRIBED ABOVE. FORM 990, PAGE 6, PART VI, LINE 6 PEN BAY HEALTHCARE (PBHC) (EIN 22-2494475) IS THE SOLE MEMBER OF PEN BAY MEDICAL CENTER. MAINEHEALTH (EIN 01-0431680), AS THE SOLE MEMBER OF PBHC, HAS THE RIGHT TO APPROVE SIGNIFICANT DECISIONS OF THE GOVERNING BODY OF PBHC AND ITS SUBSIDIARIES. FORM 990, PAGE 6, PART VI, LINE 7A THE SOLE MEMBER, PEN BAY HEALTHCARE MAY ELECT THE BOARD OF DIRECTORS FROM A SLATE OF NOMINEES SUBMITTED BY THE CORPORATION. THE OFFICERS ARE ELECTED BY THE BOARD OF TRUSTEES. FORM 990, PAGE 6, PART VI, LINE 7B DECISIONS OF THE GOVERNING BODY SUCH AS BUDGETS, BUSINESS STRATEGIES, SIGNIFICANT FINANCIAL COMMITMENTS, AMENDMENTS TO THE ARTICLES OF INCORPORATION, AND ELECTION OF THE PRESIDENT/CEO AMONG OTHER DECISIONS, ARE SUBJECT TO APPROVAL BY PEN BAY HEALTHCARE & MAINEHEALTH. FORM 990, PAGE 6, PART VI, LINE 11B THE FORM 990 IS REVIEWED IN DETAIL WITH THE FINANCE COMMITTEE. IT IS THEN MADE AVAILABLE TO THE FULL BOARD. A FINAL DETAILED REVIEW OF THE FORM 990 IS PERFORMED BY THE REGIONAL CHIEF FINANCIAL OFFICER BEFORE SIGNING AND PRIOR TO FILING. FORM 990, PAGE 6, PART VI, LINE 12C AT THE BEGINNING OF BOARD SERVICE, BOARD MEMBERS ARE REQUIRED TO DOCUMENT ANY CONFLICT OF INTEREST THAT MAY EXIST, AND THEY ARE REQUIRED TO REPORT ANY ADDITIONAL CONFLICTS AS THEY ARISE. BOARD MEMBER CONFLICT OF INTEREST FORMS ARE UPDATED AND REVIEWED ANNUALLY. FORM 990, PAGE 6, PART VI, LINE 15A PEN BAY MEDICAL CENTER BOARD OF DIRECTORS ARE RESPONSIBLE FOR AN ANNUAL EVALUATION OF THE PRESIDENT/CEO AND THE OTHER KEY ADMINISTRATIVE EMPLOYEES OF THE ORGANIZATION. FOR THOSE KEY ADMINISTRATIVE EMPLOYEES THAT ARE SHARED WITH PBHC, COMPENSATION IS EVALUATED BY THE PBHC GOVERNANCE COMMITTEE AND APPROVED BY THE ORGANIZATION'S BOARD OF DIRECTORS. FOR THE CURRENT YEAR, PBMC SHARES A PRESIDENT & CEO AND A REGIONAL CFO WITH WALDO COUNTY HEALTHCARE, INC. MARK BISCONE IS THE PRESIDENT & CEO AND LINDA DRINKWATER IS THE REGIONAL CHIEF FINANCIAL OFFICER OF BOTH PEN BAY HEALTHCARE (PBHC) AND SUBSIDIARIES AND WALDO COUNTY HEALTHCARE, INC. (WCHC) AND SUBSIDIARIES. THEY ARE PAID BY WCHC. PBHC REIMBURSES WCHC THEIR PORTION OF THEIR COMPENSATION AS CONTRACTOR SERVICES. FORM 990, PAGE 6, PART VI, LINE 15B SEE EXPLANATION ABOVE FOR PART VI, LINE 15A THAT INCLUDES EXPLANATION OF COMPENSATION FOR OFFICERS AND OTHER KEY ADMINISTRATIVE EMPLOYEES. FORM 990, PAGE 6, PART VI, LINE 19 DOCUMENTS THAT ARE REQUIRED TO BE OPEN FOR THE PUBLIC INSPECTION ARE MADE AVAILABLE UPON REQUEST. FORM 990, PART IX, LINE 11G LABORATORY PURCH. SVCS. 3,966,857 140,609 0 MED STAFF PURCH. SVCS. 1,283,283 45,487 0 OPER. & MAINT. PURCH. SVCS. 307,114 10,886 0 ADMIN. PURCH. SVCS. 1,140,517 40,427 0 COLLECTION SERVICES 206,499 7,320 0 RADIOLOGY 178,322 6,321 0 CONSULTING 24,273 860 0 SAFETY & SECURITY 40,028 1,419 0 PHARMACY SERVICES 77,190 2,736 0 OTHER FEES 3,850,606 136,488 0 FORM 990, PART XI, LINE 9 INCOME EARNED ON TRNA 1,123,610 TRANSFER FROM AFFILIATE 983,603 GAIN ON INVESTMENT IN PINE TREE INSURANCE 5,687 PY RESTATEMENT OF EST. 3RD PARTY SETTLEMEN -1,077,000 QUARRY HILL 4 WHITE STREET ROCKLAND ME 04841 010213976 LT CARE ME 501C3 9 PEN BAY HC false PEN BAY HEALTHCARE 4 WHITE STREET ROCKLAND ME 04841 222494475 ADMIN. ME 501C3 11B MAINEHLTH false PEN BAY BEHAVIORAL HEALTH 4 WHITE STREET ROCKLAND ME 04841 010277794 BHV HLTH ME 501C3 9 PEN BAY HC false KNO-WAL-LIN HOMECARE & HOSPICE INC 4 WHITE STREET ROCKLAND ME 04841 010340947 HOME HC ME 501C3 9 PEN BAY HC false KNO-WAL-LIN HELP AT HOME INC 4 WHITE STREET ROCKLAND ME 04841 222968726 HM MKR SVC ME 501C3 9 PEN BAY HC false PEN BAY HEALTHCARE FOUNDATION 4 WHITE STREET ROCKLAND ME 04841 222482325 FNDRAISING ME 501C3 7 PEN BAY HC false PENOBSCOT BAY PHYSICIANS & ASSOC 4 WHITE STREET ROCKLAND ME 04841 010530517 PHYS. SVCS ME 501C3 11C PB MED CNT true MAINEHEALTH 110 FREE STREET PORTLAND ME 04101 010431680 HEALTHCARE ME 501C3 11C NA false PBH MANAGEMENT COMPANY 4 WHITE STREET ROCKLAND ME 04841 010537278 MANAGEMENT ME PEN BAY HC C CORP false true false false true false false false false false true true true true true true true true true true PEN BAY PHYSICIANS & ASSOCIATES M 15844413 FAIR MARKET VALUE