2025-03-05T14:22:45-06:00 2024-04-30 010494526 Baker Newman & Noyes PO Box 507 Portland ME 04112 990 2023-05-01 010211797 Mount Desert Island Hospital MOUN 2072885081 PO Box 8 10 Wayman Lane Bar Harbor ME 046090008 Michelle Smith Treasurer/CFO 2072885081 2025-03-04 1 0 Connor Smart P02285543 2078792100 2025-03-04 2023 2025-03-06 01:10:19Z Christina Maguire PO Box 8 10 Wayman Lane Bar Harbor ME 046090008 119999417 0 X www.mdihospital.org X 1897 ME Critical access hospital, providing medical & healthcare services located in Bar Harbor, ME. 19 16 583 51 0 0 3895822 27415834 81771454 86998119 -169739 359193 -22785 -103591 85474752 114669555 19000 37500 0 0 50706849 51760350 0 0 812225 37713376 39406720 88439225 91204570 -2964473 23464985 80033646 106023085 30469070 33702543 49564576 72320542 X Mount Desert Island Hospital's mission is to provide compassionate care and strengthen the health of our community by embracing tomorrow's methods and respecting time-honored values. 0 0 66951382 37500 86998119 In fiscal year 2024, Mount Desert Island (MDI) Hospital provided $12,743,863 in services for which no compensation was expected or received. Financial assistance policies exist to provide relief for those who cannot pay for medical care. MDI Hospital provides care to persons covered by governmental programs including Medicare, Medicaid, VA, and CHAMPUS. The unreimbursed value for providing care to these patients approximates $5,264,813. The Hospital continues to provide a number of health services and preventative health programs to the community. Available programs include cardiac pulmonary rehabilitation, care coordination, wellness programs, diabetes education, annual wellness exams, nutrition counseling, parenting, pregnancy and sibling classes, physical and occupational therapy programs, speech therapy, medication therapy management, health coaching, care management, coagulation management, financial and insurance workshops, and our oral health program which included education and outreach to the community, schools, and service providers. The Hospital provides volunteers as Certified Application Counselors to help enroll and educate members of our community into the Health Insurance Exchange options. Throughout the year, staff from the Hospital make presentations to area school children regarding smoking cessation, wellness, health, activity, nutrition, and oral health. Additionally, community groups such as the YMCA, Alcoholics Anonymous, Cancer Support, and Palliative Care use the Hospital's conference rooms for their meetings. Many hospital staff members serve other nonprofits in capacities such as volunteer hours and board of directors' memberships, as well as memberships in service organizations such as the local Healthy Acadia, Rotary, Chamber of Commerce, and Lions/Lioness clubs. 66951382 1 1 0 1 0 0 0 0 0 1 1 0 0 0 1 1 0 1 0 0 0 0 0 0 1 0 1 1 0 1 1 1 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1 1 1 0 0 1 127 0 1 583 1 0 0 0 0 0 0 0 0 0 0 0 0 X 19 16 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 X X Michelle Smith CFO 2072885081 PO Box 8 10 Wayman Lane Bar Harbor ME 046090008 X Peter Witham MD Trustee/Physician 41.00 0.00 X 226958 0 41081 Julian Kuffler MD Trustee/Physician 41.00 0.00 X 173993 0 41099 Christina Maguire President & CEO 41.00 1.00 X X 385636 0 26301 Enoch Albert Trustee 1.00 1.00 X 0 0 0 Edward Benz MD Trustee 1.00 0.00 X 0 0 0 Stewart Brecher Trustee 1.00 0.00 X 0 0 0 James R Bright Trustee (end 8/2023) 1.00 0.00 X 0 0 0 Sarah Fina Trustee 1.00 0.00 X 0 0 0 Elsie Flemings Trustee 1.00 0.00 X 0 0 0 Kathryn Lucchesi PhD RPh Trustee 1.00 0.00 X 0 0 0 Charles Manee Hutchins Trustee 1.00 0.00 X 0 0 0 Arthur Martinez Trustee 1.00 0.00 X 0 0 0 Vince Messer PhD Trustee 1.00 0.00 X 0 0 0 Dean S Read Trustee 1.00 0.00 X 0 0 0 Ed Samek Trustee 1.00 0.00 X 0 0 0 Louise Soucy CPA Trustee 1.00 0.00 X 0 0 0 Noelle Wolf Trustee 1.00 0.00 X 0 0 0 Patricia Hand PhD Chair (end 9/2023); Trustee 1.00 0.00 X X 0 0 0 Martha Wagner PhD Trustee; Chair (start 9/2023) 1.00 0.00 X X 0 0 0 Madeleine Braun PhD MBA 1st Vice Chair 1.00 0.00 X X 0 0 0 Michelle Smith Vice President/Treasurer & CFO 41.00 1.00 X 184885 0 45768 Morgan Mackenzie Clerk/Secretary 41.00 0.00 X 70506 0 16653 Stuart Davidson MD Physician 40.00 0.00 X 615924 0 42621 Charles Hendricks MD Physician 40.00 0.00 X 577208 0 24087 Joseph Dougherty MD Physician 40.00 0.00 X 421435 0 33930 Katherine Gassman MD Physician 40.00 0.00 X 374368 0 14686 David Sugerman MD Physician 40.00 0.00 X 345365 0 49328 3376278 0 335554 101 0 1 0 Cardinal Health 7000 Cardinal Place Dublin OH 43017 Healthcare services 4201550 Cerner Corporation (aka Oracle) 2300 Oracle Way Austin TX 78741 Healthcare IT solutions 1834194 Medefis Inc 2121 North 117th Avenue Omaha NE 68164 Locums staffing 1638397 R1 RCM Inc 433 W Ascension Way Suite 200 Murray UT 84123 Management consulting 1562673 EL Shea Inc 23 Church Street Ellsworth ME 04605 Construction services 1355784 41 456300 5000000 21959534 79622 27415834 Patient services 621990 85694817 85694817 Pharmacy 621400 895565 895565 Cafeteria 722514 214849 214849 Healthcare administration 621400 192888 192888 86998119 580207 580207 14289 7767 6522 6522 6522 4957788 4955981 222821 1807 -222821 -221014 -221014 33180 456300 143293 -110113 -110113 114669555 86998119 0 255602 X 37500 37500 1212880 952289 260591 38120549 29536561 8082599 501389 680059 533946 146113 9104749 7148564 1956185 2642113 2074446 567667 223663 223663 132940 132940 8380 8380 54026 54026 14221868 8562369 5495625 163874 123438 75183 48255 1579939 872790 560187 146962 2113641 1287365 826276 250745 152722 98023 520860 317243 203617 409774 290723 119051 2820796 2001276 819520 1166370 710407 455963 Medical supplies 7383983 4497398 2886585 Provision for bad debt 5881991 5881991 Hospital provider tax 1246296 1246296 Equipment rent./maint. 846880 515813 331067 421130 256500 164630 91204570 66951382 23440963 812225 2650 2650 11549974 12528572 2595320 19443030 15904494 15086067 530674 627030 656444 928730 74123056 40383671 26698856 33739385 16555222 19110178 1860117 1944756 14922 -6707 513586 387238 3151387 2232156 80033646 106023085 11528555 13550267 3620 33750 6604626 14709239 2288586 594020 10043683 4815267 30469070 33702543 X 39806734 43106563 9757842 29213979 49564576 72320542 80033646 106023085 X 23464985 934765 -1643784 X X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 1 8380 0 0 0 8380 0 Part II-B, Line 1: Mount Desert Island Hospital was a member of the American Hospital Association and the Maine Hospital Association in the fiscal year ended April 30, 2024. A portion of the dues paid to these organizations were available for lobbying expenditures on behalf of Mount Desert Island Hospital and the other member organizations in furtherance of their exempt purposes. The total dues paid by the Hospital to these organizations, and the portion that was estimated to be available for lobbying, are detailed below: American Hospital Association - total dues: $14,663 American Hospital Association - amount available for lobbying: $4,632 Maine Hospital Association - total dues: $27,359 Maine Hospital Association - amount available for lobbying: $3,748 12551589 250000 995464 1850000 22344 11924709 12364900 206804 20115 12551589 9847696 3675585 -1133936 24445 12364900 6958392 1000000 1904005 14701 9847696 6896922 78892 17422 6958392 0.94030 0.05970 0.00000 1 0 4007948 4007948 31424941 20359878 11065063 44545 28860 15685 30861659 19994933 10866726 7783963 7783963 33739385 Deferred compensation 3362352 Malpractice insurance obligations 663961 Lease obligations 788954 4815267 X 107211681 934765 92406 1027171 106184510 54026 8431019 8485045 114669555 84455715 7767 7767 84447948 54026 6702596 6756622 91204570 Part V, Line 4: Endowment amounts restricted by the Board of Directors are released by the Board as needed for special projects supplying benefit to the community at large. These funds are intended solely for the use of expanding services, and not for sustaining current operations. Part X, Line 2: The Hospital and BBRV are exempt from federal income taxes under Section 501(c)(3) of the Internal Revenue Code (Code). MDMC is a for-profit entity and is, therefore, subject to income taxes. Income taxes are recorded based upon the asset and liability method as prescribed by Financial Accounting Standards Board (FASB) ASC 740, Income Taxes. At April 30, 2024, and 2023, MDMC has certain net operating loss carryforwards which have been reduced by a valuation allowance of an equal amount as it is not presently considered likely that the deferred tax assets will be realized. Tax-exempt organizations could be required to record an obligation for income taxes as the result of a tax position they have historically taken on various tax exposure items including unrelated business income or tax status. Under guidance issued by the FASB, assets and liabilities are established for uncertain tax positions taken or positions expected to be taken in income tax returns when such positions are judged to not meet the "more-likely-than-not" threshold, based upon the technical merits of the position. The Organization has evaluated the positions taken on its filed tax returns. The Organization has concluded no uncertain income tax positions exist at April 30, 2024. Part XI, Line 2d - Other Adjustments: Rental property expenses 7,767. Change in value of beneficial interest in trust 84,639. Part XI, Line 4b - Other Adjustments: Provision for bad debts 5,881,991. Fundraising expenses, net against revenues 820,605. Pledge discount adjustment 1,728,423. Part XII, Line 2d - Other Adjustments: Rental property expenses 7,767. Part XII, Line 4b - Other Adjustments: Provision for bad debts 5,881,991. Fundraising expenses, net against revenues 820,605. Isleford Dock Benefit 414533 388433 26100 20776 45991 30442 Showhouse 74947 67867 7080 16839 25000 4245 489480 456300 33180 37615 70991 34687 143293 -110113 1 1 1 X 1 X 1 1 1 0 1 1 460926 460926 0.00540 9876106 8869353 1006753 0.01180 18470992 14236989 4234003 0.04960 28808024 23106342 5701682 0.06680 2316216 171074 2145142 0.02510 555524 555524 0.00650 12877180 8818905 4058275 0.04760 38000 38000 0.00040 15786920 8989979 6796941 0.07960 44594944 32096321 12498623 0.14640 1 3511867 0 14236989 18470992 -4234003 X 1 1 1 1 Mount Desert Island Hospital 10 Wayman Lane PO Box 8 Bar Harbor ME 045090008 www.mdihospital.org 37457 X X X X Mount Desert Island Hospital 0 0 1 X X X X X X X X 23 1 1 1 1 X see Part V, Section C X see Part V, Section C X 1 23 1 see Part V, Section C 0 1 X 150.000000000000 250.000000000000 X X X X X 1 1 X X X X 1 X see Part V, Section C X see Part V, Section C X see Part V, Section C X X X X X X X 1 X 0 X X X 1 X 0 0 Mount Desert Island Hospital Part V, Section B, Line 5: The 2023 Community Health Needs Assessment (CHNA), covering the fiscal years ending 2024-2026, was conducted by Mount Desert Island Hospital in coordination with Healthy Acadia. In keeping with previous versions, our 2023-2024 CHNA process relied on the nationally-vetted Mobilizing for Action through Planning and Partnerships (MAPP) process and tools developed and published by the National Association of County and City Health Officers (NACCHO). In gathering information to complete this CHNA, the organizations conducted surveys, public discussion forums, and focus groups with community members, institutions, and partners. The organizations also used data analytic tools and census reports to ensure that the CHNA reached a large and representative portion of the community. For additional information, please refer to the supplemental information disclosed on this Form 990, Schedule H, Part VI, Line 2, as well as the full CHNA. Mount Desert Island Hospital Part V, Section B, Line 6a: The 2023 Community Health Needs Assessment (CHNA), covering the fiscal years ending 2024-2026, was conducted by Mount Desert Island Hospital in coordination with Healthy Acadia, a 501(c)(3) non-profit organization dedicated to building healthy communities. However, many other individuals and organizations contributed to the 2024-2026 needs assessment, a full list of which can be found on the Hospital's complete CHNA, beginning on page 7. Mount Desert Island Hospital Part V, Section B, Line 6b: The 2023 Community Health Needs Assessment (CHNA), covering the fiscal years ending 2024-2026, was conducted by Mount Desert Island Hospital in coordination with Healthy Acadia, a 501(c)(3) non-profit organization dedicated to building healthy communities. However, many other individuals and organizations contributed to the 2024-2026 needs assessment, a full list of which can be found on the Hospital's complete CHNA, beginning on page 7. Mount Desert Island Hospital Part V, Section B, Line 11: The Hospital's 2023 CHNA Action Plan identified a series of core health needs, labeled as "Themes", and a variety of strategies to address each of these needs in a way that would be most efficient and effective for the community served by the Hospital. These themes were then later explored and discussed in the Hospital's Initial Implementation Plan which was approved by the Hospital's Board by August 2, 2024.The primary "Theme Areas" identified in the CHNA and its Action Plan were: 1. Access to Care 2. Aging in Place 3. Basic Needs 4. Community Connected 5. Housing 6. Mental and Behavioral HealthThrough the CHNA and its Action plan, across these six themes, multiple goals and strategies arose that are relevant in all areas and to addressing the significant needs identified in the CHNA.Goal 1: Improve knowledge of and communication about existing resources and services.Goal 1 Strategies: - Connect with local websites and social media platforms such as the local Facebook group Bar Harbor Barter & Swap. - Conduct public talks and/or community forums. - Use traditional and social media, including newspapers, newsletters, flyers, television, radio, podcasts, Facebook, Twitter, and Instagram to increase awareness. - Leverage or create community bulletin boards at locations frequented by many people in regular travels, such as food shops, banks and restaurants, post offices, libraries, schools, banks, laundromats, and gyms. - Coordinate with 211 to maximize the effectiveness of that tool for finding services in the LSA. - Promote use of 211 as a resource. - Explore the "Bundle" smart phone app that Heart of Maine United Way developed for Piscataquis County as a model.Goal 2: Offer free support to access and enroll in existing services and programs.Goal 2 Strategies: - Expand and better coordinate navigator programs. - Design programs and recruit volunteers to help people understand and apply for existing programs. - Coordinate to promote and publicize existing programs and services. - Engage those outside the health and social services sectors, such as the business community, schools, faith-based organizations, libraries, and first-responders, to help publicize options and where to find help in accessing services. - Expand online and social media avenues for learning about and accessing services.Goal 3: Improve coordination of existing services.Goal 3 Strategies: - Hold monthly breakfasts or informal meetings for non-profit staff and other interested parties to network, share information, and plan ways of coordinating activities and improving ability to refer people to other options. - Create systems for a "warm hand-off" between services, both clinical and social. - Leverage town office staff and connect with town select boards and comprehensive planning efforts to promote LSA-wide ongoing communication and joint planning. - Explore Washington County's "The Connection Initiative" sponsored by the Community Caring CollaborativeGoal 4: Improve wireless and telecommunication services and expand broadband capacity in ways that will support telehealth, help attract and retain employees, and foster overall economic growth and remote work opportunities in the LSA.Goal 4 Strategies: - Investigate opportunities through Connectivity Maine. - Engage the business community in solutions. - Research state, federal, and philanthropic grant opportunities. - Leverage the services offered by libraries and schools. - Design systems and options for affordable access for low and limited income residents. - Collaborate with libraries and other community centers to offer computer literacy programs and trainings.Goal 5: Improve transportation options.Goal 5 Strategies: - Focus on connectivity and coordination with services and social/community engagement opportunities. - Promote and publicize existing public transportation services, such as Island Connections, the Island Explorer, and transportation resources through MDIH and insurance designed to access health care. - Encourage existing transportation resources to collaborate to promote easy access, such as publicity and coordinating their trip schedules. - Prioritize needs of people without access to a motor vehicle, including older residents, low-income residents, and children. - Explore creating a "water taxi" program to the unbridged islands as a lower cost alternative to the ferries; perhaps identify someone willing to donate a used lobster boat that can be retrofitted for passenger seating as the vehicle. - Improve pedestrian and bicycle lanes for transportation and physical activity options. - Encourage car-pooling and other alternative modes of transportation. - Leverage the opening of the new Acadia Gateway Center for proactive work that will increase public transportation, rideshare, and parking options.Additional information regarding the health need themes, goals, and strategies can be found in the full CHNA and Action Plan. Mount Desert Island Hospital Part V, Section B, Line 16j: The policy was provided, in writing, to patients on admission to the Hospital facility.The Hospital works with community service organizations to post the Plain Language Summary in public libraries, local municipality facilities, the local YMCA/YWCA, and the Healthy Acadia website.Additionally, a qualified interpreter is made available to patients who need assistance translating the FAP, application, and related documents to another language, and translated copies of our Financial Assistance Policy and Application are available in French and Spanish. Part V, Section B, Lines 7a, 7b, and 10, Publication of Reports: The Hospital makes its annual reports and other various resources and publications publicly available on its website. The home page for the Hospital's various reports can be found online at:https://www.mdihospital.org/about-us/reports-resources/Prior year Community Health Needs Assessments, Implementation Plans, and other benefits reports may also be found on the Hospital's website at the link provided above.The Hospital's 2020 Implemenation Plan can be downloaded directly from the previous link as a Word Document. The Action Plan proposed with the 2024-2026 CHNA can be found within the full 2024-2026 CHNA document. The 2024-2026 Initial Implementation Plan may be found at the following website:https://www.mdihospital.org/wp-content/uploads/2025/02/MDIH-Community-Health-Needs-Assessment-2024-2026-PC-BOT-Approved-8.2.2024.pdfThe Hospital's 2024-2026 Community Health Needs Assessment (CHNA) is freely available online on the Hospital's website at:https://www.mdihospital.org/wp-content/uploads/\2025/02/2024-MDI-Region-CHNA-Action-Plan-FINAL-REPORT-5.1.2024.pdfThe Hospital's 2024-2026 CHNA can also be found online at:https://static1.squarespace.com/static/5d5fec1f2b3df90001522875/t/663ae39d3e53895271fe7e17/1715135395937/2024+MDI+Region+CHNA+Action+Plan+(2).pdfThe Hospital's Community Benefits Report for the year ending April 2023 is available online at:https://www.mdihospital.org/wp-content/uploads/2023/12/Community-Benefits-Report-FY23-web.pdfLastly, the Hospital's Impact Report for the year ending April 2024 is available online at:https://www.mdihospital.org/wp-content/uploads/2024/10/MDI-Hospital-Impact-Report-2024-webupdateOct2.pdf Schedule H, Part V, Section B, Line 16a-16c: The Hospital's Financial Assistance Program and related information can be found online at:https://www.mdihospital.org/insurance-and-billing/financialassistance/The Hospital's free care/reduced cost application is available online at:https://www.mdihospital.org/wp-content/uploads/2021/07/MDIH-FA-FORM-2019-1.pdfThe Hospital also provides checklist and guides to accompany its financial assistance application process, available online at:https://www.mdihospital.org/insurance-and-billing-faqs/financial-assistance-application-checklist/The Hospital's Financial Assistance Plain Language Summary is available online at:https://www.mdihospital.org/wp-content/uploads/2019/05/Plain-Language-Summary-of-Financial-Assistance-Program-1557-revised-02-2020.pdfLastly, the Hospital's complete Financial Assistance Policy is available online at:https://www.mdihospital.org/wp-content/uploads/2019/10/MDIH-Finance-Assistance-and-Free-Care-Policy-Approved-FC-2-24-2020.pdf Schedule H, Part V, Section B, Line 20d: MDI Hospital does not assume or engage in presumptive eligibility in assessing financial assistance or government assistance. However, any individual residing in the State of Maine who indicates the financial inability to pay a bill for a medically necessary service shall be evaluated for Financial Assistance. The patient's potential eligibility for governmental or other coverage will be assessed. This may include Medicaid and participation in Health Insurance Exchange coverage and subsidies. Additionally, a Financial Assistance Application/Disclosure Form is used to document each patient's overall financial situation. Credit reports may be used to verify the individual's financial circumstances. If an engaged collection agency suspects or gains knowledge that someone may need to apply for one of our programs, the agency sends out a financial assistance application to the patient or guarantor and proceeds to notify MDIH of the outreach. Accordingly, each collection agency engaged is aware of the policy on Financial Assistance. This allows the agency to report amounts that they have determined to be uncollectible due to the inability to pay in accordance with the Financial Assistance eligibility guidelines. 10 1 - Cadillac Family Practice 322 Main Street Bar Harbor ME 04609 Outpatient Clinic 2 - Community Health Center 16 Community Lane Southwest Harbor ME 04679 Outpatient Clinic 3 - Trenton Health Center 394 Bar Harbor Road Trenton ME 04605 Outpatient Clinic 4 - Cooper Gilmore Health Center 17 Hancock Street Bar Harbor ME 04609 Outpatient Clinic 5 - MDI Behavioral Health Center 322 Main Street Bar Harbor ME 04609 Outpatient Clinic 6 - MDI General Surgery 17 Hancock Street Bar Harbor ME 04609 Outpatient Clinic 7 - Lisa Stewart Women's Health Center 330 Main Street Bar Harbor ME 04609 Outpatient Clinic 8 - MDI Orthopedics 10 Wayman Lane Bar Harbor ME 04609 Outpatient Clinic 9 - MDI Urology 10 Wayman Lane Bar Harbor ME 04609 Outpatient Clinic 10 - Northeast Harbor Health Center Kimball Road Northeast Harbor ME 04679 Outpatient Clinic Part I, Line 7: The costing methodology utilized for this table was derived from Worksheet 2, ratio of patient care cost to charges with data from filed cost reports for the fiscal year. Part I, Line 7g: The Hospital provides to the community several provider-based physician and specialty practices to serve this rural island population. These practices are listed on Part V of this schedule. The facility subsidizes their operating costs to maintain access and coordination of care to our population. Part I, Line 7, Column (f): The Bad Debt expense included on Form 990, Part IX, Line 25, Column (A), but subtracted for purposes of calculating the percentage in this column is $ 5,881,991. Part II, Community Building Activities: Beyond being a hub of health and care services in the Downeast Region of Maine, Mount Desert Island Hospital engages in multiple community building activities that promote the overall health and wellbeing of the communities it serves.Volunteerism:In a time of social isolation and a loneliness epidemic, the Hospital fosters multiple programs and initiatives that promote collaboration, connection, citizenship, philanthropy, and the common good of the community. The volunteers who donate their time to MDI Hospital, our Health Centers, and Birch Bay Retirement Village play an important role in the experience of our patients, families, and residents. They work alongside healthcare professionals, help in clinical and non-clinical areas, and support our mission to care for our community. Volunteer opportunities through the Hospital include nutrition services; emergency department; nursing department; materials management, and medical and administrative services. MDI Hospital Auxiliary:Beyond directly volunteering to facilitate hospital services, the MDI Hospital Auxiliary Program has for decades provided an opportunity for the Hospital and the community to meet, collaborate, and improve the health of the region together. This volunteer group is comprised of community members, Hospital employees and retirees. Auxiliary members devote many hours each year to various fundraising efforts including their annual auction and raffle, bakes sales, and jewelry sales. The MDI Hospital Auxiliary acts as a liaison between MDI Hospital and the local. Community members organize events and volunteer their time and skills to raise financial support for a variety of needs around MDI Hospital. Members support our annual fundraising efforts through volunteering at various events, baking delicious treats and serving as ambassadors for the Hospital. These efforts help to provide important philanthropic support for needed programs and services.Community Health Education:Mount Desert Island Hospital dedicates significant time and resources to providing a wide array of community engagement and health education programs, designed to improve the general health literacy and day-to-day wellbeing of persons living and working in the community served by the Hospital. Classes and resources offered by the Hospital for community health programs cover the following topics: childbirth and child support; diabetes education; general wellness, fitness, and healthy living; tobacco, drug, and alcohol avoidance programs; nutritional education; affordable care act and patient rights education; and "Serv Safe" courses for restaurant and food establishments.Social Services:The Hospital understands that health resources available at home is just as important as the health care received at a hospital. To that end, Social Services at MDI Hospital serve many important roles in delivery and management of care in our organization and beyond. Our goal is to provide compassionate, professional, confidential support for people suffering from mental health and substance abuse issues. As a liaison between the Hospital and MDI Behavioral Health Center, Clinical Social Work professionals facilitate scheduling of therapy, substance abuse services, outpatient psychiatric consultations, and prescription of medications as needed. We also help coordinate psychiatric admissions, gather information for psychiatric consultations, and provide counseling support. As part of the Care Management Team, our staff meets with Hospital patients to address mental health needs and provide patients with information about available resources. In addition, we offer guidance for families of Hospital patients regarding coping with the health of loved ones, discharge planning, and accessing services like prescription assistance. Our staff also coordinates with providers and services outside MDI Hospital's system to ensure a smooth transition for our patients. Our Social Services staff is also involved in facilitation of a free support group for cancer survivors and employee wellness programs for local employees of MDI Hospital and other local employers.Community Partnerships:Mount Desert Island Hospital understands that its community is composed of a wide variety or stakeholders, individuals, businesses, and cultural groups. To facilitate the wellbeing of this broad collection of personalities and backgrounds, the Hospital routinely collaborates with community partners, government agencies, or other charitable organizations to bolster and improve the health of its community. For example, the Hospital coordinates services and resources with food and clothing banks to address food insecurity. The Hospital also collaborates with local businesses to secure fundraising and grant opportunities, and to help spread health education and healthy lifestyle literature throughout the local service area. Part III, Line 2: The estimated cost of bad debt expense as reported is derived from the accounting systems and software the organization uses to calculate the cost-to-charge ratio from the as-filed Medicare Cost Reports.Mount Desert Island Hospital (MDI Hospital) estimates the cost of bad debt expense using accounting systems and software from our organization to calculate the cost of care from the as filed Medicare Cost Reports. This estimate best represents the value of providing care for those services that will be considered or deemed uncollectible. The value of these services at cost is estimated to be $3,511,867. This is the amount the Hospital must forgive as a benefit to the community for providing services. Part III, Line 3: The Hospital's financial assistance policy provides administrative and accounting guidelines for the identification, classification, and reporting of patients receiving financial assistance as distinguished from bad debts. Accordingly, the Hospital has estimated that no amount of bad debt expense at cost is attributable to patients eligible under the organization's financial assistance policy. Part III, Line 4: See Footnote 2 of the attached audited financial statements. Part III, Line 8: The IRS Form 990, Schedule H instructions and guidance provide a template in Worksheet 2 as a way to determine the overall cost to charge ratio that could be applied throughout Schedule H in order to convert charges to cost. Where applicable, we have utilized the Worksheet 2 template calculation. The only area where we did not utilize this template calculation was in Schedule H, Part III, Section B, Line 6, Medicare allowable costs and payments related to the subsidized health services. Instead, the Hospital utilized the Medicare Cost Report estimated cost and payment for these services. The Hospital believes that provider-based clinics listed in the Cost Report should be considered a community benefit due to the fact that without the Hospital subsidizing and offering the services that these clinics offer, the community-at-large would have to travel 45 minutes or more to the nearest similar hospital. As such, Mount Desert Island Hospital believes that by offering and subsidizing these clinics within its community, thus enabling community members to have easy access and an easier commute for these services, the entire community at large benefits.Additionally, the Hospital has elected to treat its Medicare Shortfall as Costs of Other Means Tested Government Programs, as reported on this Form 990, Schedule H, Part I, Line 7c. Mount Desert Island Hospital has determined that, in accordance with publications issued by the American Hospital Association and other industry associations, that this Medicare Shortfall should represent a net community benefit. The Hospital considers such net Medicare benefits to be substantially equivalent to a government health program for which eligibility depends on the recipient's income or assets. Additionally, given the shortfall reported on this Schedule H, Part I and III (Medicare revenues are only 77% of Medicare costs), it seems to the Hospital that Medicare reimbursement rates and other related revenues do not represent the true cost to the Hospital of treating Medicare patients. Furthermore, by treating patients eligible for Medicare at a net shortfall, the Hospital alleviates the Federal government's burden to directly provide medical or other care services. As the Hospital provides patient services to those eligible for Medicare benefits, this is also an indication of increased services to promote the overall health of the Hospital's surrounding community; as the Hospital operates in a rural region of its State, and as the State of Maine as a whole has a rapidly aging median age and has one of the oldest average ages in the United States, treating Medicare-eligible patients is critical to providing care to the Hospital's community. Part III, Line 9b: The Hospital would not initiate collection efforts against a patient that qualified for a sliding fee scale unless that patient failed to meet his or her obligation under a mutually agreed upon payment arrangement. After it was determined that the patient did not qualify for a readjustment to his or her payment terms, the Hospital would follow normal notification practices dictated by our collection policy, which follows the 501(r) regulations. Upon the qualifying defaults a patient's account may result in collection efforts. If the collection agency suspects or gains knowledge that someone may need to apply for one of the programs, the agency sends out a financial assistance application to the patient or guarantor and proceeds to notify MDIH of the outreach. Information about our free and sliding scale programs is on our website, on our account statements, and posted in public areas and at our provider clinics. Our Plain Language Summary is posted within our community as well. We also make available a Patient Financial Counselor to help advocate, assist and navigate the process. Part VI, Line 2: The 2023 Community Health Needs Assessment (CHNA), covering the fiscal years ending 2024-2026, was conducted by Mount Desert Island Hospital in coordination with Healthy Acadia. In keeping with previous versions, our 2023-2024 CHNA process relied on the nationally-vetted Mobilizing for Action through Planning and Partnerships (MAPP) process and tools developed and published by the National Association of County and City Health Officers (NACCHO). MAPP outlines a four-step assessment process intended to take two years. We modified the process in accordance with the characteristics and small population size of our rural region and our six-month timeline.To start, we convened a Steering Committee to help guide and advise the project. The Steering Committee was composed of leaders from organizations across the MDI region who reflect various perspectives and sectors.As part of the four-step MAPP process, we developed and fielded two surveys: 1. Community Partner Survey 2. Community Health SurveyThrough these surveys, available in both English and Spanish, thousands of community members were invited to answer questions and share their personal perceptions about the health of the community. Dozens of community partners, including Steering Committee members helped publicize and disseminate the survey widely in the region through various modalities, including social media sites, organization's electronic and print newsletters, and posters with a QR code and phone number to request a paper survey at locations including town offices, libraries, gyms, community centers and faith organizations.Additionally, starting in September 2023, community interviews and group discussions were regularly conducted to gather insight, data, and information from the community regarding their health priorities and concerns. These topics were then further scrutinized in themed working groups, and the committees leading the health assessments solicited feedback on their reports to ensure the documents accurately summarized the perspectives and experiences of the community. The CHNA generated responses from community members living, working, playing, and/or receiving services in the local service area ("LSA"). The resulting data were analyzed, organized, and used to identify and frame our six themes further explored and discussed in the full CHNA.Through the survey process, significant efforts were made to ensure that respondents matched the LSA population and recognized data collection norms. This was fulfilled through a diverse survey dissemination effort and frequent evaluation of respondent demographics. Data on town, gender, age, race and ethnicity, household income, and healthcare payment methods were collected. In response to recommendations in the 2020 CHNA report, special considerations and strategic outreach was focused to ensure participation among community members who are traditionally underrepresented in these types of surveys, including people who have low incomes, identify as Black, Indigenous, and people of color (BIPOC), identify as lesbian, gay, bisexual, pansexual, transgender, genderqueer, queer, intersexed, agender, asexual (LGBTQIA+), disabled or having disabilities, essential workers, unemployed and underemployed individuals, and seasonal residents. In response to recommendations in the 2020 CHNA Report, we added features to the demographic data collection: (1) income data; (2) actual name of the town rather than zip code for greater specificity; and (3) expansion of the question "How do you pay for healthcare?" to clarify data on employer-provided, personally purchased, and various types of government-sponsored insurance. A high number of survey responses is always desirable, of course. CHNA Coordinators and Steering Committee Members are pleased that with a population of 15,000 in our LSA, we heard from a large and representative group of community members with varied interests and opinions regarding the health of their communities, where strengths and challenges exist, and what priorities they would like addressed.We also conducted a review of relevant literature and existing data, such as those published by the U.S. Census Bureau and the Maine Center for Disease Control and Prevention, and as framed within the context of 2023 U.S. Census Bureau data. The combined process led to identifying six major themes and a working group was convened to address each of these themes. People with expertise in these areas as well as members of the general public were invited to join a working group to be sure the compositions included myriad perspectives and passions. The six themes are 1) Access to Care; 2) Aging in Place; 3) Basic Needs; 4) Community Connectedness; 5) Housing; and 6) Mental and Behavioral Health, including Substance Use. The working groups helped delineate strengths, challenges, goals and strategies within each theme. Part VI, Line 3: The Financial Assistance Policy (FAP) information is sent with all account statements and is printed on the back of the statement. A notice of the FAP in plain language is also available on our Hospital website, posted in public areas, and available within the departments and provider clinics of our organization. The Hospital provides a Patient Financial Counselor to help navigate the process to ensure that our patients have access to the care and services they need. MDI Hospital is committed to providing access to quality healthcare services with compassion, dignity, and respect for those we serve, particularly the poor, indigent, and underserved in our communities, regardless of their ability to pay. We assist our patients who cannot afford to pay for part or all of the services received by working with our community to identify those in need and find the financial resources that may be made available to them. MDI Hospital has adopted guiding principles when handling billing, collections, and financial support functions for our patients. We provide effective communications with patients regarding hospital bills and make affirmative efforts to help patients apply for public and private financial support programs, including providing resources to perform the application process on behalf of the patient. We have implemented policies and procedures for assisting low-income patients in a consistent manner that is in compliance with the State of Maine Chapter 150 Guidelines for Free and Reduced Care. These policies are reviewed by the Finance Committee of the Board of Trustees at a minimum annually, or as deemed necessary. The adjustment for Amounts Generally Billed is made annually after the acceptance of MDI Hospital's Medicare Cost Report by the regional Fiscal Intermediary (MAC). A Patient Financial Counselor is also available to assist with triaging patient needs and working with our patients to align resources. This representative is available to explain and review patient payment obligations. We also have a Patient Advocate to facilitate issues that arise during this process. Information about Hospital-based financial support polices and external support programs that provide coverage for services is made available to patients during the pre-registration and registration processes and/or through communications with patients seeking financial assistance. Support is available to uninsured and underinsured patients who do not qualify for public programs or other means of assistance. Notification about financial assistance programs at MDI Hospital, including contact information, is available through messaging included on patient bills, at provider clinics, in public areas, through care management and billing support staff, in registration areas, and at the reception areas in the Hospital and at our provider clinics. Patient brochures describing the financial counseling services, our financial assistance policies, financial assistance application, and the applicable services which are available in these areas as well as on our public website, www.mdihospital.org. The annual review of these policies is done through the Board Appointed Finance Committee. Part VI, Line 4: Mount Desert Island Hospital serves the Mount Desert Island region local service area, which includes the towns of Bar Harbor, Cranberry Isles, Frenchboro, Hancock, Lamoine, Mount Desert, Southwest Harbor, Swan's Island, Tremont, and Trenton, all of which are located in the Downeast and Acadia Region of the State of Maine, specifically Hancock County.In 2020, the population of Hancock County totaled 55,478, an increase of 2 percent or 1,060 since 2010, according to U.S. Census Bureau data. The population for the ten towns in the LSA was approximately 15,000 in 2023. The LSA includes three municipalities on unbridged islands: Cranberry Isles, Frenchboro, and Swans Island.Census Bureau 2020 data related to health status show Hancock County with demographics that suggest complex and high-usage health-related needs. For example, Maine has the oldest population in the United States and Hancock County has a greater than average number of older adults compared to the overall population in Maine. The County's median age is 48.9 years compared to 45.1 years for Maine. In other words, Maine has the oldest population in the nation and Hancock County is the third oldest county in Maine. The percentage of Hancock County adults over age 65 is 25.7% compared to 22.6% in Maine.Adults in Hancock County without health coverage total 10.2% compared to the statewide average of 6.6%. Hancock County's poverty rate of 10.9% is slightly higher than for all of Maine at 10.8%. Household income parallels those comparisons with a median of $64,149 in Hancock County and $69,543 statewide. Regarding access to services, 2020 Census data reveal limitations on access compared to other areas in Maine. For example, Hancock County has one primary care provider per 950 residents, while Maine overall has one provider per 930 residents. The results for dentists are more dramatic with one dentist per 2030 residents in Hancock County and one for every 1401 residents statewide. According to the Maine Department of Labor, Hancock County unemployment levels are higher than the statewide average, 6% unemployment in Hancock County, compared to 4.5% statewide. Hancock County has the third highest unemployment rate in the State, just below Washington and Piscatquis counties. Seasonal fluctuations in employment are significant and complicate the County and local data because two of the most substantial portions of the economy are highly seasonal - tourism and the fishing industries. Part VI, Line 5: Mount Desert Island Hospital serves a close-knit island and surrounding communities through a 25-bed critical access facility in Bar Harbor and a network of area health centers-all designed to provide comprehensive healthcare for residents and visitors. Since it was established in 1897, the nonprofit hospital has grown into a premier rural healthcare organization with a retirement community and six primary care health centers, as well as a full-service behavioral health center and a dental clinic.Today, MDI Hospital employs more than 500 people and is the second-largest employer on Mount Desert Island. Our active medical staff includes hospitalists, primary care physicians and practitioners, highly skilled nurses, orthopedic surgeons, general surgeons, psychiatrists, care managers, a board-certified emergency physician, an oncologist, an ophthalmologist, a pathologist, a radiologist, and a urologist.MDI Hospital's groundbreaking teaching partnership with Penn Medicine, established in 2011, has evolved into a model for future urban-rural partnerships across the nation and has established MDI Hospital as a premier rural hospital for emergency medicine and critical care. The hospital's Emergency Department, a critical link in Downeast Maine's trauma delivery system, serves the Mount Desert Island community 24 hours a day, 365 days a year.MDI Hospital received a five-star rating, the highest awarded, from the Centers for Medicare and Medicaid Services in 2020. In addition, the organization's inpatient, outpatient, emergency and surgical care services have been consistently recognized by Avatar International, the Leapfrog Group, the National Rural Health Association, Harvard Pilgrim and Healthgrades.At MDI Hospital and Health Centers, we are dedicated to providing compassionate, high-quality healthcare to every patient who walks through our doors. As an independent, nonprofit critical access health system, we serve our community with respect, dignity, and care-welcoming all individuals, regardless of background, circumstances, or ability to pay.MDI Hospital also serves as a critical education center for the future of the State's healthcare profession, providing technical and professional educational opportunities in a rural health care setting. The Hospital offers multiple programs and incentives to ensure that its community continues to attract and retain health service professionals, which in turn helps protect the viability and future wellbeing of the community. As a Hospital and Health Center serving a rural part of the State, the Hospital ensures it can provide a comprehensive line of services that, were it not for Mount Desert Island Hospital, would not be available in the Downeast Region. Such services include: Adult Day Programs; Anticoagulation Clinics; Behavioral Health services; Breast Health services; Cancer Patient Navigator programs; Cardiac Rehabilitation services; Cardiology services; Cardiopulmonary services; Care Management; Critical Care/ICU access; Dental/Oral Health services; Diabetes Education; Elder Care; Emergency Department access; Family Medicine; Health Coaching; Laboratory services; Medical Imaging; Music Therapy; Nursing; Nutrition Counseling; Obstetrics; Occupational Medicine; Oncology & Hematology services ; Ophthalmology services; Orthopedics services; Palliative Care; Platelet-Rich Plasma Therapy; Pediatric services; Pharmacy access; Physical Medicine; Physical Therapy; Prescription Assistance; Primary Care services; Pulmonology services; Short Term Rehab; Speech Therapy; Sports Medicine; Surgery and Surgical Centers; Urogynecology services; Urology services; Weekend Care Clinic access; and Women's Health.The Hospital openly and directly shares information with its patients regarding pricing, care options, and health logistics to assist patients in navigating what health and care options fits their needs and lifestyle most appropriately. The Hospital also routinely gathers information about its community's needs via volunteer programs, community assessments, and patient surveys. The Hospital is also managed by an Independent Board of Directors made up of members of the community with a vested interest in seeing the health and wellbeing of the Downeast Region improve and prosper. Part VI, Line 6: Mount Desert Island Hospital is not part of an affiliated health care system. Part VI, Line 7, Reports Filed With States ME 1 Scholarships for students pursuing a degree in medical or healthcare-related fields 14 37500 Part I, Line 2: All high school seniors who are graduates of MDI High School and who are committed to pursuing a degree and career in medical and healthcare services are considered eligible. Potential applicants must work with their school's guidance office to prepare and submit an application to the Hospital on behalf of the Auxiliary Scholarship Committee (the "ASC"). After determining the number of eligible applications and the amount of funds available from available funds, the ASC will determine the amount of scholarships that can be awarded in a given year. A chosen scholarship-recipient may be awarded a grant for multiple years so long as the recipient continues to meet predefined criteria. Separate and unique books and records are maintained to substantiate and track all scholarships awarded and to ensure they are used for their intended purpose. 1 X X 0 0 0 0 0 0 0 1 0 Stuart Davidson MD Physician 526649 0 46875 0 42400 0 0 0 42621 0 658545 0 0 0 Charles Hendricks MD Physician 525680 0 27518 0 24010 0 0 0 24087 0 601295 0 0 0 Joseph Dougherty MD Physician 365766 0 25000 0 30669 0 0 0 33930 0 455365 0 0 0 Christina Maguire President & CEO 333286 0 15375 0 36975 0 0 0 26301 0 411937 0 0 0 David Sugerman MD Physician 335663 0 7500 0 2202 0 0 0 49328 0 394693 0 0 0 Katherine Gassman MD Physician 346721 0 27500 0 147 0 0 0 14686 0 389054 0 0 0 Peter Witham MD Trustee/Physician 216270 0 10000 0 688 0 0 0 41081 0 268039 0 0 0 Michelle Smith Vice President/Treasurer & CFO 176819 0 7841 0 225 0 0 0 45768 0 230653 0 0 0 Julian Kuffler MD Trustee/Physician 169291 0 0 0 4702 0 0 0 41099 0 215092 0 0 0 Part I, Line 7 Performance-based variable compensation which is subject to review annually by a board compensation committee. A MHHEFA Series 2020B 010314384 2020-11-01 6596038 Financing MRI Equipment, Construction, EMR System. 0 0 1 B MHHEFA Series 2023B 010314384 2023-12-05 8236713 Refinance Cadillac building mortgage; central utility plant upgrades. 0 0 1 A 624962 6516000 6516000 0 0 1 1 B 698288 9361915 698288 2388217 140296 31 6135083 2025 0 0 0 1 A 0 0 0 0 0.00000 0.00000 0.00000 0 0 1 B 0 0 0 0 0.00000 0.00000 0.00000 0 0 1 A 0 1 0 0 0 0 0 0 1 B 0 1 0 0 0 0 0 0 1 A 1 B 1 X 5 79622 Stock exchange value 0 1 1 Part I, Line 32b: The Hospital gift acceptance policy stipulates that stock donations are sold by their third-party investment advisors as soon as administratively possible. Form 990, Part VI, Section B, line 11b The Form 990 is prepared by an outside independent accounting firm with input and assistance from Finance Department staff. The Trustees are provided with an electronic copy of the full Form 990 and all supporting schedules. Once the Finance Committee has completed its review, all Board of Trustees members are provided with a copy of the Form 990. Trustees are given the opportunity to comment and review the Form 990 before it is filed with the IRS. The President & CEO and the VP of Finance & CFO are available to answer any inquiries from members of the Board of Trustees. Form 990, Part VI, Section B, line 12c Mount Desert Island Hospital monitors and enforces compliance with the conflict of interest policy by requiring all trustees, officers, and committee members to annually sign a statement affirming that each person has received, read, and understands the conflict of interest policy and that no such conflict exists. Additionally, interested persons have a duty to disclose any actual or possible conflicts of interest at the time they arise. After disclosing a potential conflict of interest and answering any questions that might be asked concerning such interest, the affected person shall withdraw from any meetings, deliberations, votes, or other matters concerning the conflict. To ensure that the Hospital does not engage in activities that could jeopardize its tax exempt status, the Board of Trustees or a committee appointed by the Board of Trustees periodically reviews compensation and similar arrangements to ensure they are reasonable and are the result of arms-length bargaining. In conducting these reviews the Board of Trustees may use outside advisors. Form 990, Part VI, Section B, line 15 The process used by Mount Desert Island Hospital for determining the President & CEO's compensation includes a review and approval by the governing body of the Organization, specifically the Compensation Committee of the Board of Trustees. The governing body and this committee use market data from an independent source to compare compensation models of similarly sized organizations within like demographic and geographic areas to align compensation packages. The compensation of other officers and key employees is reviewed by the Human Resources Department using the same market data guidelines to compare and establish compensation for these positions. Form 990, Part VI, Section C, line 19 The annual report and Form 990 are available to the public on the Hospital's website. Governing documents, the conflict of interest policy, and the financial statements are available upon request. Form 990, Part VII, Section A, Line 1: Dr. Peter Witham and Dr. Julius Kuffler are employees affiliated with Mount Desert Island Hospital. Compensation paid to them is for their services in these roles, and not for their services as members of the Board of Trustees. Form 990, Part IX, line 11g Purchased services: Program service expenses 3,918,267. Management and general expenses 5,495,625. Fundraising expenses 0. Total expenses 9,413,892. Contract labor: Program service expenses 4,638,901. Management and general expenses 0. Fundraising expenses 0. Total expenses 4,638,901. Consulting fees: Program service expenses 5,201. Management and general expenses 0. Fundraising expenses 163,874. Total expenses 169,075. Form 990, Part XI, line 9: Change in value of beneficial interest in trust 84,639. Pledge discount adjustment -1,728,423. Form 990, Part XII, Line 2c: The audit process has not changed from the prior year. Birch Bay Retirement Village PO Box 8 10 Wayman Lane Bar Harbor ME 046090008 010481696 Retirement Community ME 501(c)(3) Line 12a, I Mount Desert Island Hospital 1 Mount Desert Management Company PO Box 8 10 Wayman Lane Bar Harbor ME 04609 010538776 Real Estate Development ME N/A C 0 0 0 0 1 0 0 0 0 0 0 0 1 0 1 1 0 0 0 0 Birch Bay Retirement Village L 192888 Actual per Books Birch Bay Retirement Village D 1268498 Actual per Books