2015-11-13T14:35:24-06:00 2014-12-31 010523282 Berry Dunn McNeil & Parker LLC PO Box 1100 Portland ME 041041100 990 2014-01-01 010545327 Penobscot Valley Hospital PENO 2077943321 7 Transalpine Road Box 368 Lincoln ME 04457 Gary Poquette CEO 2077943321 2015-11-13 1 Barbara J McGuan CPA P00219457 2077752387 2015-11-13 2014 2016-02-25 16:41:14Z Gary Poquette 7 Transalpine Road Box 368 Lincoln ME 04457 25436941 0 X www.pvhme.org X 1973 ME Critical Access Hospital 11 10 263 34 0 0 46876 86814 26157943 24973107 75588 68618 -5836 16692 26274571 25145231 0 0 0 0 14140242 14981895 0 0 0 12544831 11011866 26685073 25993761 -410502 -848530 14908408 13378530 10694537 9998207 4213871 3380323 X Penobscot Valley Hospital exists to provide quality healthcare and to serve as an educational and referral resource that meets our customer's needs by providing appropriate services, providing health related information, and making arrangements for additional health services. PVH provides vital services to the community which are not accessible in any other way to many of our patients due to geographical or transportation issues. See Schedule H for additional details. 0 0 21529673 24973107 Penobscot Valley Hospital is a 25 bed critical access hospital in Lincoln, ME. The Hospital provided a wide range of medical services to its patients in 2014, some of the largest being Emergency Room Services, Laboratory Services, Pharmacy Services, & Radiology Services. Please refer to Schedule H for a more comprehensive list of services provided. 21529673 1 1 0 1 0 0 0 0 0 0 1 0 0 0 1 0 0 1 0 0 0 0 0 0 1 0 1 1 0 0 1 1 0 0 0 0 0 1 0 0 1 0 0 0 0 0 0 1 1 0 0 0 1 37 0 1 263 1 0 0 0 0 0 1 1 0 0 0 0 X 11 10 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 ME X Ann Marie Rush 2077943321 7 Transalpine Road Box 368 Lincoln ME 04457 Richard Wyman Board Member 1.50 X 0 0 0 Phillip Dawson Jr Vice President 1.50 X X 0 0 0 Pam Hoxie Board Member 1.50 X 0 0 0 Michael McFalls Board Member 1.50 X 0 0 0 Hervey Clay Board Member 1.50 X 0 0 0 H Joseph Thibodeau DMD Board Member 1.50 X 0 0 0 Gilberte Mayo Treasurer 1.50 X X 0 0 0 Frederick Woodman Jr President 1.50 X X 0 0 0 Ed Woolley Board Member 1.50 X 0 0 0 Annette Haynes Board Member 1.50 X 0 0 0 Amanda Dunn Board Member 1.50 X 0 0 0 David Shannon Past CEO 50.00 X 86536 0 6305 Ann Marie Rush CFO 50.00 X 162627 0 17817 Lynn Beasley Past CEO 50.00 X 107428 0 11561 Gary Poquette CEO 50.00 X 66154 0 7534 Samer Sbayi Surgeon 40.00 X 356703 0 26322 Michael Lescord ED Physician 40.00 X 434492 0 23549 Glenn Deyo Surgeon 40.00 X 353717 0 24373 David L Ettinger ED Physician 40.00 X 326925 0 30406 David H Dumont Hospitalist 40.00 X 279159 0 16614 2173741 0 164481 15 0 1 1 Nurse Anesthesia of Maine LLC 141 North Main Street Suite 205 Brewer ME 04412 Nursing Services 638341 Emcare Inc 7032 Collection Center Drive Chicago IL 60693 ER Physician Services 400899 NEHE MRI LLC PO Box 6600 Newport Beach CA 92658 MRI Services 351866 Quorum Health Resources LLC 105 Continental Place Brentwood TN 37027 Hospital Management Svcs. 330605 Comprehensive Pharmacy Services LLC PO Box 638316 Cincinnati OH 452638316 Pharmacy 322105 7 14116 6148 66550 86814 Patient Revenue 621400 36695215 36695215 Cafeteria & Other 722210 167731 65020 102711 Meaningful Use Revenue 621400 35974 35974 Provision for Bad Debts 621400 -1766554 -1766554 Contractual/Char. Adj. 621400 -10159259 -10159259 24973107 24183 24183 329416 284939 42 44477 -42 44435 44435 7842 14116 6729 1113 1113 Earnings from Subsidiary 900099 12781 12781 Earnings from Investment 900099 2798 2798 15579 25145231 24870396 0 188021 X 465961 465961 11642704 10766549 876155 91222 81402 9820 2012321 1897652 114669 769687 686827 82860 98156 71851 26305 54000 54000 6561 6561 5075034 4018722 1056312 25056 25056 890001 371240 518761 770007 723910 46097 99349 64043 35306 274603 4653 269950 864609 864609 282187 19072 263115 Medical Supplies 1959143 1959143 Service Provider Tax 612242 612242 Physician Events 918 918 25993761 21529673 4464088 0 X 3153912 1711046 722862 747883 22681 2662957 2693406 91985 44976 675089 746891 215231 210920 18728347 12535098 6508900 6193249 756469 833352 20844 36423 21050 18574 79109 119129 14908408 13378530 2755851 2516841 882073 786296 6071162 5292284 985451 1402786 10694537 9998207 X 3967287 3138413 170035 165361 76549 76549 4213871 3380323 14908408 13378530 -848530 14982 0 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 5276 5276 0 Part II-B, Line 1: The Organization pays dues to the Maine Hospital Association and the American Hospital Association. A portion of dues paid to the Maine Hospital Association ($4,700) and American Hospital Association ($576) were attributable to lobbying expenses. 28897 28897 8066187 4984786 3081401 433876 433876 0 9765204 6750185 3015019 434183 366251 67932 6193249 Estimated Third-Party Payor Settlements 1283657 Deferred Compensation 119129 1402786 Golf Tournament 12005 8310 3695 3062 1352 Holiday Extravaganza 9953 5806 4147 477 1073 350 415 21958 14116 7842 3539 1073 350 1767 6729 1113 1 1 1 X 1 X 225.000000000000 1 1 1 0 1 1 1013955 1013955 0.03900 4681487 4390310 291177 0.01120 13066895 13446259 -379364 0.00000 18762337 17836569 925768 0.05020 30521 244 30277 0.00120 30521 244 30277 0.00120 18792858 17836813 956045 0.05140 1 1257956 9864301 9864301 X 1 1 1 1 Penobscot Valley Hospital 7 Transalpine Road Lincoln ME 04457 www.pvhme.org 38340 X X X X Penobscot Valley Hospital 1 0 0 1 X X X X X X X X X 13 1 0 0 1 X www.pvhme.org/About-Us/Newsletters-Publications.aspx X 1 14 0 1 0 1 X 150.000000000000 225.000000000000 X 1 1 1 X X X X X X 1 X 0 X X X X 1 X 0 0 Penobscot Valley Hospital Part V, Section B, Line 5: Local Expert Advisors included the Community Health Educator and Nutritian Education Coordinator from Partnership for Healthy Northern Penobscot, the owner of Select Designs, the Manager of Clinical Operations from Community Health & Counseling Services, CEO and Penquis District Public Health Liaison of the PV Hospital, Director of Community Services from Eastern Area Agency on Aging, the school nurse from the local school district SAU31, clinician from Clinical Consultation & Counseling PA, FNP and CEO from Health Access Network, and Town Manager of Lincoln.When the analysis was complete, the information and summary conclusions were put before a local group of experts, who were asked to agree or disagree with the summary conclusions. They were free to augment potential conclusions with additional statements of need, and new needs did emerge from this exchange. Consultation with local experts occurred again via an internet-based survey during the period beginning October 4, 2013, and ending October 10, 2013.With the prior steps identifying potential community needs, the local experts participated in a structured communication technique called a Delphi method, originally developed as a systematic, interactive forecasting method that relies on a panel of experts. Experts answer questionnaires in a series of rounds. We contemplated and implemented one round as referenced during the above dates. After each round, we provided an anonymous summary of the experts' forecasts from the previous round, as well as reasons provided for their judgments. The process encouraged experts to revise their earlier answers in light of the replies of other members of their panel. Typically, this process decreases the range of answers and moves the expert opinions toward a consensus "correct" answer. The process stops when we identify the most pressing, highest priority, community needs. In the PVH process, each local expert allocated 100 points among all identified needs, having the opportunity to introduce needs previously unidentified and challenge conclusions developed from the data analysis. A rank order of priorities emerged, with some needs receiving none or virtually no support, and other needs receiving identical point allocations. Penobscot Valley Hospital Part V, Section B, Line 11: Smoking was identified as a significant need in our 2013 CNHA. PVH provides some services to respond to this need - including Pulmonary Function testing, providing smoking cessation educational packets to patients, providing smoking cessation tools to our employees free of charge, and providing a 100% smoke free campus to our patients and community. However, PVH does not intend to develop an implementation plan to address this need because we have a local organization that was developed to address this topic. Sprint for Life (River Coalition), as part of the Healthy Maine Partnership, are working to address this problem. Physician practices in the community also work towards addressing this problem. Penobscot Valley Hospital Part V, Section B, Line 13h: State Regulation Penobscot Valley Hospital Part V, Section B, Line 16i: The FAP application is sent with all first time statements. A notice of the FAP and a copy of the FAP application is also posted in the FAQ section of the Organization's website. Notices are also posted at all entrances to the Hospital and at various locations within the building. Penobscot Valley Hospital Part V, Section B, Line 22d: The Hospital applied the determined discount to the gross charge amount for self pay patients. The Hospital applied the determined discount to the remaining balance after insurance payment, if applicable. Part V, Section B, Line 16 Financial Assistance Policy Website Availability Penobscot Valley Hospital Part V, Section B, line 16b website: www.pvhme.org/billing.aspx Part II, Community Building Activities: Many families rely on us for a comprehensive range of services. Without access to these services including primary and preventative care, chronic diseases may go untreated. Often this results in poor health with high emergent or inpatient costs. At PVH, we strive to meet the health needs of all people, and take pride in providing for those who may not be able to afford care. Throughout 2014, we partnered with many other organizations to reach people within our communities to educate, train and inform, including: Bangor Savings Bank, Colonial Healthcare, Eastern Maine Community College, Golden Key Senior Center, Health Access Network, Husson University, Katahdin Shared Services, Katahdin Valley Community College, Lincoln Lakes Region Chamber of Commerce, LifeFlight, Lincoln Police & Fire Departments, Maine Breast & Cervical Health Program, Maine Centers for Disease Control and Prevention, Maine Department of Transportation, Maine Medical Partner's Women's Health Division of Maternal Fetal Medicine, Mayo Regional Hospital, Millinocket Regional Hospital, New England Organ Bank, Northern Penobscot Tech Region III, Quorum Health Resources, Raising Readers Program, RSU #67, SAD #30, SAD #31, PVH Auxiliary, PVH Cancer Support Group, SPRINT for Life, the University of Maine, University of New England, University of Vermont, WomenHeart, Yale University, and more. By employing over 210 people in the community, PVH is a leader in creating good paying jobs and attributing to a positive economy in the region. With the "ripple effect" (jobs the hospital helped create and dollars spent in the area), the U.S. Department of Commerce's Bureau of Economic Analysis determined the multiplier for employment in Maine to be 2.1174, meaning for every employed person in a hospital in Maine, there is another 1.1174 jobs created in supporting industries. PVH does not turn away people who need vital care, regardless of their ability to pay. Each person we treat receives the same high-quality care with utmost compassion from our staff. Our hospital is providing more Free Care, which includes charity care and bad debts, than ever before.Other direct impacts that PVH provided to the communities that we serve:Education/Scholarships:1. Auxiliary provided scholarships to non-traditional students pursuing a degree in healthcare.2. Cancer Support Group meetings twice a month for survivors and caregivers. Hosted physician education on hyperbaric oxygen therapy with Marian Benner, MD from St. Joseph Hospital in May 2014.3. Promoted National Donor Month in May to commemorate those who have given the gift of life and to raise awareness about registering as a donor.4. Published educational articles weekly in the Lincoln News on topics such as hand hygiene, disease prevention, and nutritional advice.5. The Quality Improvement department conducted two lectures to the University of Maine nursing students on quality and service issues. 6. Our Pharmacist provided seniors with education on medication safety and the Physical Therapy department demonstrated safe stretching and exercise techniques at the Golden Key Senior Center.7. Staff created educational displays in our lobby which have included health and nutrition pieces created by students at Hichborn Middle School to promote healthy choices among our staff and community. 8. In February, WomenHeart hosted a display to educate staff and community members about heart disease in women. 9. PVH offered educational tours where students learn age-specific healthcare information like proper hand hygiene, x-ray processing, laboratory testing, and facility tours.10. Our Falls Team provided education on falls risks and measures that can be taken at home to decrease a patient's risk of falls and injury. 11. Laboratory staff made weekly visits to four area nursing homes to collect specimens from residents and technologists offered free educational sessions to nursing home staff members on specimen collection. 12. Participated in the March Lincoln Expo with surgical equipment to entertain the crowd. We also provided information from our imaging department on breast cancer prevention, preventative care with Penobscot Valley Primary Care, swing beds and hand hygiene.13. PVH is a clinical site for Northern Penobscot Tech Region III and several colleges and universities. During 2014, PVH had over 30 students conducting clinical rotations here for certifications with Medical Assistant, Certified Nursing Assistant and Phlebotomy. Husson University sent students to the PVH pharmacy and nursing departments for their rotations. PVH has also worked with the University of Maine School of Nursing and Kennebec Valley Community College Radiology Program. PVH provided emergency medicine training of family medicine residents from Eastern Maine Medical Center. We serve as a rotation site for physician assistants and medical students from University of New England, University of Vermont, and Yale University. Time spent with the students varies from a couple of hours to the entire semester of hands-on education. The demand for students to utilize PVH as a clinical site has increased over the last several years. 14. Professionals at PVH often visit local schools to share information on health-related topics with young people. These range from our infection prevention officer teaching students the importance of good hand washing to staff teaching children about their career field. 15. At the end of each school year, PVH awards scholarships to three graduating seniors from Lee Academy, Mattanawcook Academy and Penobscot Valley High School. Each recipient is selected by the schools and must be pursuing a healthcare-related degree. They are awarded $500 each with the hospital giving a total of $1,500 annually. Community Contributions:1. Auxiliary volunteers organized fundraisers and blood drives, visited patients, provided activity packs for children and special gifts for patients on the holidays.2. Hosted a Red Cross Blood Drive3. Organized disaster preparedness drill in May 2014 to prepare for an incident involving hazardous materials that could affect our communities. The drill was effective in determining shared resources with local agencies and implementing methods to protect the community. 4. Donated to the Lincoln Regional Food Cupboard, which supplies food, clothing, and other necessities to people in need. 5. LifeFlight relies on private donations to help fund advanced medical equipment on board each helicopter and they are currently fundraising to purchase another helicopter and airplane to their fleet. In 2014, PVH donated $3,000 toward this worthy cause. 6. PVH is a member and proud supporter of the Lincoln Lakes Region Chamber of Commerce. We understand the importance of supporting our local business community and make it a point to buy locally whenever possible.7. Members of the PVH senior leadership team serve in the Lincoln Economic Development Council which is working to rebrand the town, revitalize Main Street, enhance recreational offerings, and entice a younger generation to relocate to our town. 8. In the summer, PVH employees held a school supply drive in collaboration with Penquis CAP. Collection sites were set up throughout our facilities during the month of August. Penquis CAP then distributed the items to area K-12 students in need. 9. Each month, PVH hosted a networking lunch time meeting for social workers and others who do similar work in the community. PVH provided education for the participants and facilitated discussions about social work-related issues. Part III, Line 4: Patient accounts receivable are stated at the amount management expects to collect from outstanding balances. In evaluating the collectibility of accounts receivable, the Hospital analyzes past results and identifies trends for each of its major payor sources of revenue to estimate the appropriate allowance for doubtful accounts and provision for bad debts. Management regularly reviews data about these major payor sources in evaluating the sufficiency of the allowance for doubtful accounts. For receivables associated with self-pay patients (which includes both patients without insurance and patients with deductible and copayment balances due for which third-party coverage exists for part of the bill), the Hospital records a provision for bad debts in the period of service based on past experience, which indicates that many patients are unable or unwilling to pay amounts for which they are financially responsible. The difference between the standard rates (or the discounted rates if negotiated or eligible) and the amounts actually collected after all reasonable collection efforts have been exhausted is charged against the allowance for doubtful accounts. Part III, Line 8: The Organization uses its Medicare Cost Report to obtain the amounts reported above. 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 their obligation under payment arrangement agreed to by both parties. After it was determined that the patient did not qualify for a readjustment to their payment terms, the Hospital would follow normal notification practices dictated by our collection policy until the account eventually ended up in collections. Part VI, Line 2: The Organization took a comprehensive approach to assess community health needs. Several independent data analyses were performed based on secondary source data, augmented with local survey data, and any data inconsistency or discrepancies are resolved from the combined opinions formed from local experts. PVH relies on secondary source data, and most secondary sources use the county as the smallest unit of analysis. We asked our local expert area residents to note if they perceived the problems or needs identified by secondary sources to exist in their portion of the county. Most data used in the analysis is available from public internet sources. Critical data needed to address specific regulations or developed by the individuals cooperating with us in this study is displayed in the report of the appendix. Part VI, Line 3: Notices regarding PVH's charity care policy are posted around the hospital. We also have information in each patient room, and our employees know to refer patients to the registration or billing offices of the hospital if they have questions. Part VI, Line 4: Lincoln is a rural community of approximately 5,700 people located in north central Maine. Our service area consists of many small towns that use Lincoln as a hub. The hospital, school system, logging companies, and paper mill are the major employers in town. Life and industry primarily revolve around the woods of central Maine. It is an area rich with history for making paper. Maine is one of the oldest states in the nation according to the latest US Census report, and Lincoln reflects that demographic. The median resident age in 2013 was 43.3 years. Lincoln is located in a modest area of the State, where the median resident income in 2013 was $44,649. Maine's average income for that same time period was $46,288. Part VI, Line 7, Reports Filed With States ME Form 990, Schedule H, Part VI, Line 5: Program OfferingsThrough Penobscot Valley Hospital:1. CPR/AED/First Aid classes - available to the community throughout the year at a low cost2. Internships/Job Shadowing - The hospital works closely with students of all ages from across New England. PVH has hosted many job shadow opportunities with students from area high schools and colleges. 3. Teddy Bear Clinics - designed to familiarize children ages 4-10 with hospital surroundings and equipment. During the Clinics, staff register the bears for treatment of their "boo-boos" and then they proceed through the operating room introducing the children to medical equipment and procedures. The goal is that the children will have an increased level of comfort in the emergency room or during a surgical procedure. PVH hosted one clinic in May 2014 and had around 40 children attend.Through Penobscot Valley Primary Care:1. ImPACT program - PVH has provided Mattanawcook Academy with a software program to help prevent long-term brain injuries in student athletes through the Maine Concussion Management Initiative, a program created by Dr. William Heinz, a Portland orthopedist, and Dr. Paul Berkner, director of health services at Colby College. Family practice physician Dr. Carl Alessi oversees the program in our rural health center.2. Maine Breast and Cervical Health Program - PVPC helps provide breast and cervical cancer screening and diagnosis services to underserved women, to provide public and professional education, and to support community partnerships to enhance statewide cancer control activities.3. Maine Immpact program - providing a lifetime of good health with vaccines regardless of the patient's ability to pay4. From the First Tooth - we participate in this prevention initiative whose goal is to improve the oral health of Maine children. Children receive fluoride varnish at well child visits with their healthcare provider from approximately 6 months to 42 months. At this time, the healthcare providers will assist the family in transitioning the child to a local dentist. 5. Raising Readers - pediatric patients at PVPC will have a library of over 12 books by the time they enter school thanks to this great program. Raising Readers provides participating hospitals and medical practices with quality, hardcover books. They are selected by Maine people who know about children's literature: doctors, librarians, child development experts, and parents. Our pediatrician, Dr. Patricia Nobel serves on the Raising Readers board and says she is honored to be able to choose quality reading materials for Maine children.Through SPRINT, our Healthy Maine Partnership:Tobacco prevention:1. No BUTS (Blocking Underage Tobacco Sales) program educated area retailers on blocking underage tobacco sales. 35 of the 68 retailers in our area have participated in this training course2. Implemented municipal policies and ordinances to prohibit tobacco use at public events, including: Run/Walk for Wellness, Lincoln Trail System and Springfield Fair GroundsObesity prevention:1. Increased municipal policies and ordinances to promote healthy living, currently working in the Town of Lee to complete the Rural Active Living Assessment2. Increased the number of public access sites for physical activity which currently include Lincoln Trail Systems, Springfield Fairgrounds, Lee/Winn walking club, and the Walking School Bus.Education in schools:1. Implemented comprehensive tobacco policies at Lee Academy and Mattanawcook Academy.2. Established wellness policies at all area school systemsSubstance abuse prevention:1. Local Area Underage Drinking Enforcement Task Forces have been established in Lincoln2. Save-A-Life Task Force was created in Lincoln3. TipSoft was promoted and utilized by police departments4. Party Patrols and/or Compliance Checks conducted by police departments5. Party Smarter; Parents Who Host, Lose the Most; Find out More Do More materials were disseminated via print, social media, radio, lawn signs, and table tents by community partners6. Prescription Monitoring Program information was distributed to all identified providers7. "Lock Your Meds" and "Up and Away" Campaign materials were distributed to seniors throughout the service area. 8. National Take Back Day was promoted on local radio, print and social media, Chamber listserv's, provider offices, pharmacies and the local EAAA. 9. Safe Storage and Disposal of Medication resources were included in patient discharge packets at local hospitals, in provider offices and at funeral homes. X X X X 0 0 0 0 0 0 0 0 0 David Shannon Past CEO 84721 0 0 0 1815 0 0 0 6305 0 92841 0 0 0 Ann Marie Rush CFO 159027 0 0 0 3600 0 0 0 17817 0 180444 0 0 0 Lynn Beasley Past CEO 103867 0 0 0 3561 0 0 0 11561 0 118989 0 0 0 Gary Poquette CEO 63920 0 0 0 2234 0 0 0 7534 0 73688 0 0 0 Samer Sbayi Surgeon 356703 0 0 0 0 0 3900 0 22422 0 383025 0 0 0 Michael Lescord ED Physician 434492 0 0 0 0 0 0 0 23549 0 458041 0 0 0 Glenn Deyo Surgeon 353717 0 0 0 0 0 3900 0 20473 0 378090 0 0 0 David L Ettinger ED Physician 309425 0 0 0 17500 0 3900 0 26506 0 357331 0 0 0 David H Dumont Hospitalist 261659 0 0 0 17500 0 3900 0 12714 0 295773 0 0 0 Part VII Section B Line 5 Dave Shannon, Past CEO, Lynn Beasley, Past CEO, Gary Poquette, CEO, & Ann Marie Rush, CFO, are compensated by Quorum Health Resources, an unrelated organization, for services rendered to the Organization. The amounts listed below are not included in the total reported on Form 990, Part VII, Section B for Quorum Health Resources, LLC. A breakdown of their 2014 compensation is as follows: Dave Shannon, Past CEO: Salary: $84,721 Benefits: $6,305 Automobile Allowance: $1,815 Lynn Beasley, Past CEO: Salary: $103,867 Benefits: $11,561 Automobile Allowance: $3,561 Gary Poquette, CEO: Salary: $63,920 Benefits: $7,534 Automobile Allowance: $2,234 Ann Marie Rush, CFO: Salary: $159,027 Benefits: $17,817 Automobile Allowance: $3,600 A Maine Health and Higher Educational Facilities Authority Revenue Bonds 010314384 560427EU4 2012-06-28 1117769 To refinance Series 2002A bond 0 0 1 A 331473 1117769 132031 24765 2012 0 1 1 1 A 0 0 0 0 0 0 0 A 0 0 1 0 0 0 0 0 0 A 0 Glenn Deyo Employee of the Organization Sign-On Loan X 118054 44976 0 1 1 44976 Debbie Rancourt Family member of Frederick Woodman, Jr., Board President 82143 Employment 0 Form 990, Part VI, Section B, line 11 Once Form 990 is prepared by the certified public accounting firm, a draft copy is e-mailed to the controller. The controller will then review the Form, and also compare it with the previous year's 990. Once the controller is satisfied with the draft copy, it is forwarded to the CFO. The CFO will then review the document. Any questions she has will either be answered by the controller or the accounting firm. Once the CFO approves the draft 990, a copy is provided to the board of directors for their review. Once the board has approved the draft, the accounting firm is notified and the final version is prepared for filing. Form 990, Part VI, Section B, line 12c It is the expectation of Penobscot Valley Hospital that our board of directors, medical staff, regular and contracted employees, and our volunteers avoid activities that may involve, or appear to involve, a conflict of interest. This is a standard of conduct communicated through Administrative Policy 109 "Code of Ethics," our code of conduct and ethics, and our medical by-laws. These documents are drafted and signed off by the president of the board of directors, the chief executive officer, chief of medical staff and the compliance officer as appropriate. Every individual employed by, or otherwise representing the Hospital, is responsible for complying with this standard. It is the responsibility of the compliance officer and the chief executive officer to ensure that this standard is communicated, maintained and enforced within the Organization. Administrative Policy 127 "Compliance Reporting" outlines the expectation for reporting non-compliance, the mechanisms in place to do so, and the investigative process. Such mechanisms include a 24-hour confidential reporting hotline. Education on Penobscot Valley Hospital's code of conduct and ethics is provided during orientation or at the beginning of the business relationship. Reinforcement of this education is provided annually and upon any business contract renewal. Form 990, Part VI, Section B, line 15 CEO & CFO - Quorum Health Resources, an unrelated organization, does an extensive national compensation analysis. Ranges are presented to the finance/personnel committee of the board by QHR, and the wage is set. Other officer's wages are set using a state-wide wage survey conducted annually by the Maine Society for Healthcare Human Resources Administration. Wages are set by evaluating the position in conjunction with the job description listed in the survey. Form 990, Part VI, Section C, line 19 The Organization does not make its governing documents, conflict of interest policy, and financial statements available to the public. Form 990, Part IX, line 11g Physician Fees: Program service expenses 1,475,163. Management and general expenses 0. Fundraising expenses 0. Total expenses 1,475,163. Purchased Services: Program service expenses 2,543,509. Management and general expenses 1,056,312. Fundraising expenses 0. Total expenses 3,599,821. Consulting: Program service expenses 50. Management and general expenses 0. Fundraising expenses 0. Total expenses 50. Form 990, Part X, Line 10: Land, Buildings, and Equipment Section 1.263(a)-3(n) Election: Penobscot Valley Hospital 7 Transalpine Road, Box 368 Lincoln, ME 04457 EIN 01-0545327 Penobscot Valley Hospital is electing to capitalize repair and maintenance costs under Regulation Section 1.263(a)-3(n). Alpine Health Services Inc PO Box 460 West Enfield ME 04493 222533280 Support to provide health services in underserved areas of Maine. ME 501(c)(3) Line 9 Penobscot Valley Hospital 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0