2015-08-17T09:29:11-05:00 2014-09-30 MAINEHEALTH 110 FREE ST PORTLAND ME 041013908 990 2013-10-01 010285286 PENOBSCOT BAY MEDICAL CENTER PENO 2079216747 4 WHITE STREET ROCKLAND ME 048412953 MAURA KELLY VP OF FISCAL SERVICES 2079216747 2015-08-12 2015-08-17 2013 2016-04-25 22:37:26Z MAURA KELLY 4 WHITE ST ROCKLAND ME 048412953 112031505 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. 18 13 1234 170 596985 108286 2343152 2483902 102174907 108289336 465783 468777 2481188 789490 107465030 112031505 0 0 51936784 56800626 0 0 53945054 53763310 105881838 110563936 1583192 1467569 109961182 130043933 54949272 70090666 55011910 59953267 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 false 84767183 88116148 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 3,617 INPATIENTS, INCLUDING NEWBORNS AND 139,347 OUTPATIENTS INCLUDING ER VISITS, DURING FY 14. 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 21,870 VISITS TO THE EMERGENCY ROOM DURING FY 14. 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 90,736,204. DURING FY 14, APPROXIMATELY 64% OF SERVICES WERE TO PATIENTS COVERED BY THESE GOVERNMENTAL PROGRAMS. ADDITIONALLY, PENOBSCOT BAY MEDICAL CENTER PROVIDED 6,077,345 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 14, THE COMMUNITY CONTRIBUTED APPROXIMATELY 9,290 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. 10970769 11404200 PHYSICIAN PRACTICES: PEN BAY PHYSICIAN AND ASSOCIATES, A GROUP OF DEPARTMENTS OF PENOBSCOT BAY MEDICAL CENTER, IS COMPOSED OF 18 PRACTICES COVERING MANY SPECIALITIES. 6968605 7243919 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. 1652295 1717574 PEN BAY BEHAVIORAL HEALTH PHYSICIANS. 1652295 1717574 104358852 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 67 0 true 1234 true true true false false false false false false false false false X 18 13 false false false false true true true true true false false true true true true true true true true true true X LYNN SOUCY 2079216747 4 WHITE STREET ROCKLAND ME 048412953 WILLIAM L CARON JR TRUSTEE, PRE 1.00 50.00 X X 0 1034119 79809 ROBERT STEIN MD MEDICAL STAF 1.00 X 0 379708 26846 WADE JOHNSON PRESIDENT & 40.00 X X 0 320084 16453 JENNIFER C MCKENNA MD MEDICAL STAF 1.00 X 0 274065 20950 CORNELIUS YETMAN DO MEDICAL STAF 1.00 X 0 244178 20861 LEE WEBB TREASURER 1.00 5.00 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 X 0 0 0 EVERETT L SPEAR III CHAIRMAN 1.00 5.00 X X 0 0 0 DOUGLAS COLE MD MEDICAL STAF 1.00 X X 0 0 0 JOANNE BILLINGTON TRUSTEE 1.00 X 0 0 0 CAROLE BRAND TRUSTEE 1.00 X 0 0 0 STEPHEN W HANSCOM ESQ TRUSTEE 1.00 X 0 0 0 MICHAEL F JONES TRUSTEE 1.00 X 0 0 0 TAMMY KOLMOSKY TRUSTEE 1.00 X 0 0 0 WILLIAM LAMBIE MD MEDICAL STAF 1.00 X 0 0 0 CORNELIUS J RUSSELL TRUSTEE 1.00 X 0 0 0 MELISSA SCHENK TRUSTEE 1.00 X 0 0 0 DANA GOLDSMITH MD VP & CHIEF M 1.00 40.00 X 0 281114 12509 MAURA KELLY CPA MST VP FISCAL SE 40.00 X 252623 0 16175 REGINALD ALBERT VP PRACTICE 40.00 X 173463 0 5402 PAULA DELAHANTY VP NURSING S 40.00 X 172295 0 16177 ERIC WATERS VICE PRESIDE 40.00 X 141561 0 4534 ERIK FREDERICK VICE PRESIDE 40.00 X 40472 0 3130 JULIE WHITE PHYSICIAN 10.00 40.00 X 132351 360624 22705 NADIA RAMDIN MD PHYSICIAN 40.00 X 325200 0 15050 CHRISTOPHER MICHALAKES MD ER MEDICAL D 40.00 X 282120 0 11795 FREDERICK GOGGANS MD PHYSICIAN 40.00 X 263083 0 25496 MCKENZIE ABENDROTH MD ER PHYSICIAN 40.00 X 250317 0 11868 2033485 2893892 309760 10 false true false JK KALLOCH PO BOX 774 ROCKLAND ME 04841 GROUNDS MAINT. 298658 THE PENOBSCOT COMPANY 519 WEST STREET ROCKPORT ME 04856 CONSTRUCTION 285875 HENDRICKSON ROOFING 250 VIOLET LANE WALDOBORO ME 04572 ROOFING 175765 PEN BAY PATHOLOGY ASSOC PO BOX 1849 LEWISTON ME 04241 PATHOLOGY SVCS. 174814 ATTORNEY CARL TRYNOR PO BOX 4290 PORTLAND ME 04101 COLLECTION SVCS 126498 6 1778078 705824 2483902 INPATIENT & OUTPATIENT CARE 624100 88116148 88116148 PEN BAY PHYSICIANS & ASSOC. 621110 11404200 11404200 KNOX CENTER FOR LT CARE 623000 7243919 7243919 OTHER 624100 1218993 1218993 MRI REVENUE 624100 306076 306076 108289336 467313 467313 1464 1464 1464 1464 HEALTH CONNECTIONS 624100 483021 483021 CHILD CARE 624410 178252 178252 CHILD CARE 624410 113964 113964 14253 14253 789490 112031505 108483305 596985 467313 X 853124 837665 15459 42725693 41951503 774190 1611190 1581995 29195 7879911 7737127 142784 3730708 3663108 67600 16357 16357 31116 31116 14502 14502 15128183 14854060 274123 834 819 15 3358555 3297698 60857 24393 23951 442 4246100 4169161 76939 422169 414519 7650 1242682 1220165 22517 5319931 5223534 96397 440014 432041 7973 MEDICAL SUPPLIES 12005720 12005720 MEMBER FEES 4501366 4501366 HEALTH CARE PROVIDER TAX 2605182 2605182 OTHER 2120958 2082526 38432 2285248 2258078 27170 110563936 104358852 6205084 0 114444 138807 10253732 2270612 18135618 20139455 1438200 1659414 2049553 3388696 143065765 89133693 39655323 53932072 17377915 18132973 20936397 30381904 109961182 130043933 11395139 10415398 21239289 29048116 131478 14193 1605102 20578264 30612959 54949272 70090666 X 46233941 50900876 3377428 3029435 5400541 6022956 55011910 59953267 109961182 130043933 X 1467569 509047 2964741 X false true X true false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false true 14502 14502 false SCHEDULE C, PART II-B, LINE 1 A PORTION OF THE MEMBERSHIP DUES PAID TO THE MAINE HOSPITAL ASSOCIATION (MHA)AND THE AMERICAN HOSPITAL ASSOCIATION (AHA) REPRESENT LOBBYING ACTIVITIES. 5400541 500000 122415 6022956 5217795 182746 5400541 4898550 319245 5217795 5320145 -421596 4898550 5120364 199781 5320145 1.00000 false false 951091 951091 59301549 31005124 28296425 1590112 1320279 269833 71557158 56808290 14748868 9665855 9665855 53932072 PREPAID CAPITAL COSTS 13407199 ESTIMATED AMOUNTS FROM THIRD PARTY 8392233 TRUSTEE HELD FUNDS 3232172 INVESTMENT IN PINETREE INSURANCE CO. 2424242 OTHER 1513350 DUE FROM AFFILIATES 1033199 BOND ISSUANCE COSTS 368272 RESIDENT ACCOUNT DEPOSITS 11237 30381904 DUE TO MAINEHEALTH AND MEMBERS 28873300 ESTIMATED AMOUNTS DUE TO THIRD PARTY 1648247 DUE TO AFFILIATES 80174 RESIDENT ACCOUNTS & DEPOSITS 11238 30612959 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 EXEMPT 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 true false true true 2660214 2660214 0.02410 16984811 14004620 2980191 0.02700 19645025 14004620 5640405 0.05100 3394616 3394616 0.03070 3394616 3394616 0.03070 23039641 14004620 9035021 0.08170 false 2499295 27109630 41896703 -14787073 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 X X X X X X X X 13 true true true X WWW.PENBAYHEALTHCARE.ORG X X X X X X X X X true false true true 175.000000000000 true 225.000000000000 true X true true X X X X X X true false true X false true FACILITY 1, PENOBSCOT BAY MEDICAL CENTER - PART V, LINE 3 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 4 THE ONEMAINE HEALTH COLLABORATION (ONEMAINE) A PARTNERSHIP BETWEEN MAINE HEALTH'S FACILITIES COMPRISED OF LINCOLN COUNTY HEALTHCARE, MAINE MEDICAL CENTER, MAINE MENTAL HEALTH PARTNERS, PEN BAY HEALTHCARE, SOUTHERN MAINE HEALTH CARE, WALDO COUNTY HEALTHCARE, WESTERN MAINE HEALTH, HOME HEALTH VISITING NURSES, MAINE PHYSICIAN HOSPITAL ORGANIZATION, NORDX AND SYNERNET. ALSO INCLUDED ARE EASTERN MAINE HEALTHCARE SYSTEM AND MAINE GENERAL HEALTH. FACILITY 1, PENOBSCOT BAY MEDICAL CENTER - PART V, LINE 20D GROSS CHARGES ARE USED IN ALL SITUATIONS. FACILITY 1, PENOBSCOT BAY MEDICAL CENTER - PART V, LINE 22 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 699295 334824 59222 20587 1113928 ROBERT STEIN MD MEDICAL STAFF PRES 379708 10838 16008 406554 WADE JOHNSON PRESIDENT & CEO 276084 44000 951 15502 336537 JENNIFER C MCKENNA MD MEDICAL STAFF REP 254714 19351 6651 14299 295015 CORNELIUS YETMAN DO MEDICAL STAFF REP 236607 7571 5206 15655 265039 DANA GOLDSMITH MD VP & CHIEF MED. OFF. 228968 52146 5201 7308 293623 MAURA KELLY CPA MST VP FISCAL SERVICES 222123 30500 5576 10599 268798 REGINALD ALBERT VP PRACTICE ADMIN. 162542 10921 4080 1322 178865 PAULA DELAHANTY VP NURSING SVCS. 161085 11210 6398 9779 188472 JULIE WHITE PHYSICIAN 132351 360624 1891 4802 16012 134242 381438 NADIA RAMDIN MD PHYSICIAN 325200 6694 8356 340250 CHRISTOPHER MICHALAKES MD ER MEDICAL DIRECTOR 276500 5620 10838 957 293915 FREDERICK GOGGANS MD PHYSICIAN 263083 10612 14884 288579 MCKENZIE ABENDROTH MD ER PHYSICIAN 241450 8867 4524 7344 262185 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. 0 315,764 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 2135000 23755 2135000 2007 false false true true B 6220000 66264 6220000 2007 false false true true C 6450000 33757 6450000 2008 false false false true D 4025000 175198 2012 true false false 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 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 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 4A (CONTINUED FROM PART III, LINE 4A) PENOBSCOT BAY MEDICAL CENTER SERVED 3,617 INPATIENTS, INCLUDING NEWBORNS AND 139,347 OUTPATIENTS INCLUDING ER VISITS, DURING FY 14. 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 21,870 VISITS TO THE EMERGENCY ROOM DURING FY 14. 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 90,736,204. DURING FY 14, APPROXIMATELY 64% OF SERVICES WERE TO PATIENTS COVERED BY THESE GOVERNMENTAL PROGRAMS. ADDITIONALLY, PENOBSCOT BAY MEDICAL CENTER PROVIDED 6,077,345 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 14, THE COMMUNITY CONTRIBUTED APPROXIMATELY 9,290 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 2, PART III, LINE 4D PEN BAY BEHAVIORAL HEALTH PHYSICIANS. FORM 990, PAGE 6, PART VI, LINE 6 PEN BAY HEALTHCARE (PBHC) 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 VP OF FISCAL SERVICES BEFORE SIGNING AND PRIOR TO FILING. FORM 990, PAGE 6, PART VI, LINE 12C AT THE BEGINNING OF BOARD SERVICE, MEMBERS ARE REQUIRED TO DOCUMENT ANY CONFLICT OF INTEREST THAT MAY EXIST, THEY ARE REQUIRED TO REPORT ANY ADDITIONAL CONFLICTS THAT MAY 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 HAS HAD AN INTERIM CEO SINCE MARCH, 2014. THIS PERSON WAS SHARED WITH WALDO COUNTY GENERAL HEALTH AND WAS PAID AS INVOICED. FORM 990, PAGE 6, PART VI, LINE 15B THE MEMBER IS RESPONSIBLE FOR AN ANNUAL EVALUATION OF THE PRESIDENT/CEO AND THE OTHER KEY ADMINISTRATIVE EMPLOYEES OF THE ORGANIZATION. COMPENSATION IS EVALUATED BY THE COMPENSATION COMMITTEE APPOINTED BY THE MEMBER, AND THE ORGANIZATION'S BOARD OF TRUSTEES MUST APPROVE THE COMPENSATION. IN ADDITION, THE ORGANIZATION UTILIZES THE SERVICES OF AN INDEPENDENT COMPENSATION CONSULTING FIRM AND INDUSTRY SURVEY. 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. 4,086,262 75,410 0 MED STAFF PURCH. SVCS. 4,218,442 77,849 0 OPER. & MAINT. PURCH. SVCS. 386,110 7,125 0 ADMIN. PURCH. SVCS. 1,298,900 23,970 0 COLLECTION SERVICES 433,891 8,007 0 RADIOLOGY 308,565 5,694 0 CONSULTING 116,147 2,143 0 OTHER FEES 4,005,743 73,925 0 FORM 990, PART XI, LINE 9 INCOME EARNED ON TRNA 244,113 TRANSFER FROM AFFILIATE 4,632,641 LOSS ON INVESTMENT IN PINE TREE INSURANCE -1,912,013 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 11C 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 HEALTH CARE INC 4 WHITE STREET ROCKLAND ME 04841 010340947 HOME HC ME 501C3 9 PEN BAY HC false KNO-WAL-LIN HELP AT HOME 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 true true false false false false false false true true true true true true true true true PEN BAY PHYSICIANS & ASSOCIATES M 15907092 FAIR MARKET VALUE