2025-10-29T15:44:40-05:00 2024-12-31 010523282 Berry Dunn McNeil & Parker LLC 2211 Congress St Portland ME 04102 990 2024-01-01 010545327 Penobscot Valley Hospital PENO 2077943321 PO Box 368 Lincoln ME 04457 Melissa Pelkey CEO 2077943321 2025-10-29 1 1 Melissa Magoon CPA P01712842 2077752387 2025-10-29 2024 2025-03-06 01:10:19Z Melissa Pelkey PO Box 368 Lincoln ME 04457 25211052 0 X www.pvhme.org X 1973 ME Critical Access Hospital 8 8 259 8 0 0 495663 678730 23108754 24574111 12256 7098 23503 -48887 23640176 25211052 0 0 0 0 14096857 14568572 0 0 0 11335641 11063773 25432498 25632345 -1792322 -421293 7718433 8657464 6271417 7554765 1447016 1102699 To be our community's trusted healthcare partner, committed to the health and well-being of those we serve with compassion, quality, and excellence. 0 0 21775119 24574111 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 2024, some of the largest being Emergency Room Services, Laboratory Services, Pharmacy Services, Rehabilitation Services, Surgical Services & Radiology Services. Please refer to Schedule H for a more comprehensive list of services provided. 21775119 1 1 0 1 0 0 0 0 0 0 1 0 0 0 1 0 0 1 0 0 0 0 0 0 0 0 1 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 1 36 0 1 259 1 0 0 0 0 0 0 0 0 0 0 0 0 X 8 8 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 ME X Elisa Blethen 2077943321 PO Box 368 Lincoln ME 04457 Phillip Dawson Jr President 1.50 0.00 X X 0 0 0 Beatrice Szantyr MD Vice President 1.50 0.00 X X 0 0 0 H Joseph Thibodeau DDS Treasurer 1.50 0.00 X X 0 0 0 Christine Hanson Board Member 1.50 0.00 X 0 0 0 Patricia Nobel MD Board Member 1.50 0.00 X 0 0 0 Ryan Reed Board Member 1.50 0.00 X 0 0 0 Kristen Sciolino DDS Board Member 1.50 0.00 X 0 0 0 Richard Stone Board Member 1.50 0.00 X 0 0 0 Jesse McNally Past Board Member 1.50 0.00 X 0 0 0 Amy Theriault Past COO 0.00 0.00 X 695 0 0 Crystal Landry RN Past CEO 20.00 0.00 X 192786 0 26739 Melissa Pelkey CEO 40.00 0.00 X 188900 0 31225 Elisa Blethen CFO 40.00 0.00 X 170078 0 28100 Lisa Veillette CNO 40.00 0.00 X 87201 0 143 Todd Tritch MD ED Physician and Medical Director 40.00 0.00 X 670035 0 20532 Christopher M Fallon MD Physician 40.00 0.00 X 443824 0 9635 Dr Glenn Deyo Surgeon 40.00 0.00 X 339465 0 21556 Dr Stratton J Shannon Physician 40.00 0.00 X 338250 0 1158 Dr Carl Alessi Physician 40.00 0.00 X 186998 0 1024 2618232 0 140112 24 0 1 0 SJ Rollins Technologies Inc 931 Union St Bangor ME 04412 IT Services 855055 Lotus Medical & Aesthetics PO Box 382 Mount Desert ME 04660 ED Physician 476269 True North Anesthesia 455 Harlow Street Bangor ME 04401 Anethesiologist Staffing 354495 Emcare Inc 7032 Collection Center Drive Chicago IL 60693 ED Physician 329563 NL Acadia Hospital Corporation 43 Whiting Hill Road Brewer ME 04412 Behavioral Health Physician 325948 16 440187 238543 678730 Patient Revenue 621400 24374283 24374283 Cafeteria & Other 900099 199828 174869 24959 24574111 7098 7098 Loss from Subsidiary 900099 -48887 -48887 -48887 25211052 24549152 0 -16830 X 725172 87344 637828 11840106 10768470 1071636 1133234 975552 157682 870060 744118 125942 105457 105457 75000 75000 6473891 5618060 855831 146186 89830 56356 654381 406034 248347 43780 40343 3437 89123 89123 524333 288383 235950 320794 311144 9650 Medical Supplies 1699110 1664783 34327 Repair & Maintenance 534621 418000 116621 Service Provider Tax 200181 200181 Miscellaneous Expenses 196916 73754 123162 25632345 21775119 3857226 0 X 1140 888 1414430 1175636 2028265 3313869 436718 443918 132489 188027 16059047 12622768 3532544 3436279 147734 98847 25113 0 7718433 8657464 1949827 2248694 4132876 3918025 188714 1388046 6271417 7554765 X 1211661 671247 235355 431452 1447016 1102699 7718433 8657464 X -421293 76976 X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 4712 4712 0 Part II-B, Line 1: The Organization pays dues to the Maine Hospital Association (MHA) and American Hospital Association (AHA). A portion of dues paid to the MHA and AHA are attributable to lobbying expenses. 28897 28897 7879887 6189843 1690044 16080 15080 1000 7750478 6106822 1643656 383705 311023 72682 3436279 Estimated Third-Party Payor Settlements 1388046 1388046 1 1 1 X 1 X 225.000000000000 1 1 0 1 1 89971 89971 0.00350 4496665 4130589 366076 0.01430 4586636 4130589 456047 0.01780 205 18717 750 17967 0.00070 37 45502 45502 0.00180 18172 18172 0.00070 242 82391 750 81641 0.00320 242 4669027 4131339 537688 0.02100 1 5184952 5184952 X 1 1 1 1 Penobscot Valley Hospital PO Box 368 Lincoln ME 04457 www.pvhme.org 39815 X X X X Penobscot Valley Hospital 1 0 0 1 X X X X X X X X X 22 1 1 1 1 X pvhme.org/community-health-needs-assessment/ X 1 22 1 pvhme.org/community-health-needs-assessment/ 0 1 X 150.000000000000 225.000000000000 X 1 1 X X X 1 X https://pvhme.org/patient-resources/billing-help/ X https://pvhme.org/patient-resources/billing-help/ X https://pvhme.org/patient-resources/billing-help/ X 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: Per the Maine Shared CHNA charter, the effort was governed by the Steering Committee. The Metrics Committee and Community Engagement Committee provide input. The Maine CDC and its epidemiology contractor, University of Southern Maine, provided a significant amount of data analysis. The 2021-2022 Maine Shared CHNA process was rolled out in three stages:Data Analysis:220 indicators were selected for the State of Maine, the 16 counties, Public Health districts, cities which were selected and in some cases selected demographics. Outreach and Engagement:Community outreach was conducted in 2021. Community forums were conducted with residents and service providers in all 16 counties. The purpose of this outreach was to gather feedback on data and to identify health priorities, community assets, and gaps in resources to be used in health improvement planning.Final Reports:Reports for the state, each county, and districts were developed in the spring of 2022. These reports included information from the health data profiles, summaries of qualitative information gathered from engagement activities, and a presentation of community health needs. Health priorities for the county, public health district, and the state were developed through community participation and voting at community forums.The Penobscot County Community Forum was an opportunity for review of the Penobscot County Health Profile, discussion of community needs, and prioritization in small break-out sessions followed by a forum session vote. Ten priorities arose from the break-out sessions. The top four became the areas to work on.1. Mental Health 59% 2. Substance and Alcohol Abuse 46% 3. Access to Care 42% 4. Social Determinants of Health 40% Penobscot Valley Hospital Part V, Section B, Line 6a: - Central Maine Healthcare (CMHC)- Maine General Health (MGH)- Maine-Health (MH)- Northern Light Health (NLH) Penobscot Valley Hospital Part V, Section B, Line 6b: Maine Center for Disease Control and Prevention (Maine CDC) Penobscot Valley Hospital Part V, Section B, Line 11: In 2024, PVH offered access to mental health services with telepsych services for both ED patients and inpatients as well as outpatient Behavioral Health counseling through telepsych services. In 2024, PVH the Outpatient Telehealth program in the ED expanded in volume.PVH has addressed substance use disorder through 2024 by building community partnerships with Save A Life Recovery Resource Center, among others. Penobscot Valley Hospital treats substance use disorder patients through emergency services, primary care practices and specialty. Patients with a need to substance use disorder detox are being referred to services in Bangor, ME when appropriate. The Penobscot Valley Hospital staff works to assist substance use disorder patients who are in need of shelter, medication assisted treatment, food, or any other need. In 2024, Behavioral Health staff trained in project ECHO to use technology to leverage scarce resources, trained in best practices to reduce disparity and care learning to master complexity and trained to use data to monitor outcomes to increase impact. Access to care has been identified as another need in Penobscot County. PVH has continued to recruit for primary care providers throughout 2023 to increase access to care for patients in Penobscot County. In 2024, PVH added a primary care provider and continued telehealth services in primary care. PVH continues to forge partnerships around the state to improve the lives of the public in Penobscot County, assisting patients to find shelter, food, and transportation. A screening process for social determinants of health as well as a referral system have been implemented. PVH actively participates with the American Red Cross to assist with blood drives. PVH promotes health related topics on its social media to help educate the public. PVH collects new winter outerwear to donate to area schools and Christmas gifts for area Nursing home resident's that may not have family. Penobscot Valley Hospital offered free vaccinations to those eligible through the Maine IMPACT program. In 2024, PVH increased screening for social determinates of health. A social worker assists in the ED and with inpatients with social needs. Penobscot Valley Hospital Part V, Section B, Line 13h: State Regulation Penobscot Valley Hospital Part V, Section B, Line 16j: 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 Billing Help section of the Organization's website. Notices are also posted at all patient entrances to the Hospital and at various locations within the building. Part II, Community Building Activities: Many families rely on Penobscot Valley Hospital (PVH) 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 be our Community's first choice in healthcare, known for a culture of compassion, quality, and safety: to be an excellent community partner, working together every day to improve the health and well-being of those we serve.Throughout 2024, the Hospital partnered with many other organizations to reach people within our communities to educate, train, and inform, including Colonial Healthcare, Cummings Healthcare, Lakeview Terrace, Care Ridge Estates, Eastern Maine Community College, Husson College, LifeFlight, Lincoln Police & Fire Departments, Maine Breast & Cervical Health Program, Maine Centers for Disease Control and Prevention, Hospice, Maine Department of Transportation, Mayo Regional Hospital, Millinocket Regional Hospital, New England Organ Bank, Northern Penobscot Tech Region III, Raising Readers Program, American Red Cross, RSU #67, SAD #31, Academy of Nutrition and Dietetics, Breathe Easy Maine through MaineHealth, The American Heart Association, Healthcare.gov, the Maine Emergency Management Agency, the National Heart, Lung and Blood Institute, the University of Maine, University of New England, University of Vermont, Husson University, and more.By employing about 200 people in the community, PVH is a leader in creating good paying jobs, and contributing 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 1.174 jobs created in supporting industries.PVH does not turn away people who need vital care, regardless of their ability to pay. Each person the hospital treats receives the same high-quality care with the 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 provides to the community that are served:Education/Scholarships:1. Published educational articles on social media on topics such as hand hygiene, disease prevention, tick prevention, diabetes education, nutritional advice, water safety, hyperthermia prevention, suicide prevention, mental health awareness, fentanyl awareness, and alcohol awareness.2. Staff create educational displays in our lobby.3. Laboratory staff made weekly visits to area nursing homes to collect specimens from residents.4. Trained incoming CNA's and RN's to draw blood, do some CLIA-waived testing.5. PVH is a clinical site for Northern Penobscot Tech Region III, and several colleges and universities. During 2024, PVH had students conducting clinical rotations here for certifications with Medical Assistant, Certified Nursing Assistant and Phlebotomy. Husson University, Eastern Maine Community College and the University of Maine sent students to the PVH nursing departments for their rotations. PVH has also worked with the Eastern Maine Community College Radiology Program. PVH has also provided emergency medicine training of family medicine residents from Eastern Maine Medical Center. Time spent with students varies from a couple of hours to the entire semester of hands-on education. The demand to utilize PVH as a clinical site has increased over the last several years.Promote Organ Donation from October to April. PVH provides information regarding organ donation with social media posts, and the Lincoln News. For national donor month in April, PVH flies the organ donor flag for the month, plus have a display with information for the public. PVH has won HRSA awards for the work that the employees do for organ donation.In 2024, Penobscot Valley Hospital won the Breathe Easy Platinum Award from the MaineHealth Center for Tobacco Independence. Penobscot Valley Hospital volunteers, staff, and providers are committed to providing quality healthcare services to the people in our community. In 2024, staff provided:1. Books for pediatric patients at well child checkups for through Raising Readers.2. Vaccinations through the Maine Impact Program.3. Substance Abuse prevention education.4. Free gym visits to community.5. Collect pet supplies for area animal shelters.6. Holiday gifts for area nursing home residents.7. Donated winter outerwear to area schools over the holidays. Part III, Line 4: Please refer to pages 9-10 and page 13 of the attached audited financial statements. 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 at Registration, Emergency Room and the hospital's website: www.pvhme.org. Our employees also 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 4,900 people located in north central Maine. Our service area consists of many small towns that use Lincoln as a hub. The hospital, school system, and logging companies, 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 2022 was 60.2. Lincoln is located in a modest area of the State, where the median resident income in 2022 was $41,080. Maine's average income for that same time period was $75,740. Part VI, Line 7, Reports Filed With States ME X X X X 0 0 0 0 0 0 0 1 0 Todd Tritch MD ED Physician and Medical Director 641768 0 27000 0 1267 0 0 0 20532 0 690567 0 0 0 Christopher M Fallon MD Physician 434108 0 8168 0 1548 0 0 0 9635 0 453459 0 0 0 Dr Glenn Deyo Surgeon 329996 0 6292 0 3177 0 0 0 21556 0 361021 0 0 0 Dr Stratton J Shannon Physician 335766 0 0 0 2484 0 0 0 1158 0 339408 0 0 0 Melissa Pelkey CEO 184622 0 2887 0 1391 0 0 0 31225 0 220125 0 0 0 Crystal Landry RN Past CEO 181789 0 9518 0 1479 0 0 0 26739 0 219525 0 0 0 Elisa Blethen CFO 169898 0 0 0 180 0 0 0 28100 0 198178 0 0 0 Dr Carl Alessi Physician 173224 0 12687 0 1087 0 0 0 1024 0 188022 0 0 0 Part I, Line 7 Per Diem employees who worked at least 1040 hours during the previous 365 days are paid $500 for every 200 hours worked during one quarter of the year. This bonus is not new and is based on time worked, but not related to the hospital's revenue. Todd Tritch's bonus is holiday pay. Form 990, Part VI, Section B, line 11b Once Form 990 is prepared by the certified public accounting firm, a draft copy is e-mailed to the Financial Reporting Manager. The CFO & Financial Reporting Manager will then review the Form and also compare it with the previous year's 990. Once the CFO & Financial Reporting Manager are satisfied with the draft copy, it is forwarded to the CEO. The CEO will then review the document. Any questions will either be answered by the Financial Reporting Manager or the accounting firm. Once the CEO 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's wages come from the 2022 Northern New England Healthcare Compensation Survey by Gallagher. Ranges are presented to the finance/personnel committee of the board and the wage is set by the board. Other officers wages are also set by utilizing the survey. 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 2,862,199. Management and general expenses 0. Fundraising expenses 0. Total expenses 2,862,199. Purchased Services: Program service expenses 2,755,861. Management and general expenses 855,831. Fundraising expenses 0. Total expenses 3,611,692. Form 990, Part X, Line 10: Land, Buildings, and Equipment Section 1.263(a)-3(n) Election: Penobscot Valley Hospital PO 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). Form 990, Part XI, line 9: Equity Transfer 76,976. 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 10 Penobscot Valley Hospital 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Alpine Health Services Inc S 76976 FMV