2013-11-14T14:52:16-06:00 2012-12-31 010523282 Berry Dunn McNeil & Parker LLC PO Box 1100 Portland ME 041041100 990 2012-01-01 010545327 Penobscot Valley Hospital PENO 2077943321 7 Transalpine Road Box 368 Lincoln ME 04457 David Shannon 2077943321 2013-11-14 1 Barbara J McGuan CPA P00219457 2077752387 2013-11-14 2012 2016-02-24 21:20:13Z David Shannon 7 Transalpine Road Box 368 Lincoln ME 04457 26860037 0 X www.pvhme.org X 1973 ME Critical Access Hospital 11 11 277 34 0 0 100430 53589 25044297 26448876 72409 52151 -3102 -14678 25214034 26539938 14229 9935 0 0 14172619 13470965 0 0 0 10497163 13094211 24684011 26575111 530023 -35173 16723968 15970607 12132873 11406094 4591095 4564513 X Penobscot Valley Hospital exists to provide quality healthcare and to serve as an educational and referral resource that meets our customer's needs by providing appropriate services, providing health related information, and making arrangements for additional health services. PVH provides vital services to the community which are not accessible in any other way to many of our patients due to geographical or transportation issues. See Schedule H for additional details. 0 0 22312386 9935 26448876 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 2012, some of the largest being Emergency Room Services, Laboratory Services, Pharmacy Services, & Radiology Services. Please refer to Schedule H for a more comprehensive list of services provided. 22312386 1 1 0 1 0 0 0 0 0 0 1 0 0 1 1 0 0 1 0 0 0 0 0 0 1 0 1 1 1 0 1 1 0 0 0 0 0 1 0 0 1 0 0 0 0 0 0 1 1 0 0 0 1 33 0 1 277 1 0 0 0 0 0 1 1 0 0 0 0 X 11 11 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 ME X Ann Marie Rush 2077943321 7 Transalpine Road Box 368 Lincoln ME 04457 Frederick Woodman Jr 1.50 X X 0 0 0 Gilberte Mayo 1.50 X X 0 0 0 Lynn Sanderson 1.50 X 0 0 0 Carl Alessi MD 1.50 X 169805 0 29352 Hervey Clay 1.50 X 0 0 0 Phillip Dawson Jr 1.50 X X 0 0 0 Victor Jipson 1.50 X X 0 0 0 Michael McFalls 1.50 X 0 0 0 Ed Woolley 1.50 X 0 0 0 Richard Wyman 1.50 X 0 0 0 Annette Haynes 1.50 X 0 0 0 H Joseph Thibodeau 1.50 X 0 0 0 Amanda Dunn 1.50 X 0 0 0 Pam Hoxie 1.50 X 0 0 0 David Shannon 50.00 X 220360 0 24211 Ann Marie Rush 50.00 X 148734 0 16788 David L Ettinger 40.00 X 284643 0 25352 David H Dumont 40.00 X 272907 0 14299 Samer Sbayi 40.00 X 334209 0 26357 Phillip Scaglione 40.00 X 301484 0 12499 Paul E Turnquist 40.00 X 276358 0 23763 2008500 0 172621 9 0 1 1 Emcare Inc 7032 Collection Center Drive Chicago IL 60693 ED Physician Services 1009089 Nurse Anesthesia of Maine LLC 141 North Main Street Suite 205 Brewer ME 04412 Nursing Services 629701 CompHealth PO Box 972651 Dallas TX 753972651 Physician Services 466360 NEHE MRI PO Box 6600 Newport Beach CA 92658 MRI Services 366968 Quorum Health Resources LLC 105 Continental Place Brentwood TN 370271018 Hospital Management Svcs. 344688 17 17993 13000 22596 6407 53589 Patient Revenue 621400 37597006 37597006 Meaningful Use Revenue 621400 426779 426779 Cafeteria & Other 722210 208689 90972 117717 Provision for Bad Debts 621400 -1641335 -1641335 Contractual/Char. Adj. 621400 -10142263 -10142263 26448876 23878 23878 338319 500 301170 9376 37149 -8876 28273 28273 4430 17993 9553 -5123 -5123 Earnings from Subsidiary 900099 21523 21523 Earnings from Investment 900099 -4532 -4532 Loss on Early Extinguishment of D 900099 -26546 -26546 -9555 26539938 26331159 0 155190 X 9935 9935 608250 198157 410093 10210819 9483657 727162 72538 65141 7397 1860943 1750715 110228 718415 645151 73264 55087 7972 47115 66416 66416 5460 5460 6749072 5722460 1026612 23720 23720 1607551 476733 1130818 755775 706061 49714 128510 82070 46440 302029 302029 1061163 1061163 299996 64906 235090 Medical Supplies 2038265 2038265 Physician Events 1167 0 1167 26575111 22312386 4262725 0 3158145 1410836 768291 661768 2819117 3382218 51394 479893 607544 215373 228030 17661042 10936605 6818159 6724437 556665 644090 6588 23579 13334 23527 1888403 2213184 16723968 15970607 2838986 2821343 1024908 982850 5060075 5182020 3208904 2419881 12132873 11406094 X 4361605 4352302 152941 135662 76549 76549 4591095 4564513 16723968 15970607 -35173 8591 0 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 4330 4330 0 Explanation of Lobbying Activities: Part II-B, Line 1: The Organization pays dues to the Maine Hospital Association and the American Hospital Association. A portion of dues paid to the Maine Hospital Association ($3,738) and American Hospital Association ($592) were attributable to lobbying expenses. 28897 28897 7762559 4469845 3292714 433876 406628 27248 8752334 5573835 3178499 683376 486297 197079 6724437 Estimated Third-Party Payor Settlements 2175613 Deferred Compensation 37571 2213184 Estimated Third-Party Payor Settlements 2382310 Deferred Compensation 37571 2419881 Golf Tournament 15960 12030 3930 3920 1987 Fashion Show 6463 5963 500 569 2070 1008 22423 17993 4430 4489 2070 2995 9554 -5124 1 1 1 X 1 X 275.000000000000 1 1 1 0 0 1061696 1061696 0.04000 5754455 5461387 293068 0.01100 6816151 5461387 1354764 0.05100 6541 666 5875 0.00020 6541 666 5875 0.00020 6822692 5462053 1360639 0.05120 1 1141169 10584905 10584905 X 1 1 1 1 Penobscot Valley Hospital

7 Transalpine Road Lincoln ME 04457

X X X X Penobscot Valley Hospital 1 0 1 1 200.000000000000 1 275.000000000000 1 X X 1 1 X X 1 0 1 X 0 0 Part III, Line 4: Patient accounts receivable are stated at the amount management expects to collect from outstanding balances. Management provides for probable uncollectible amounts through a charge to earnings and a credit to a valuation allowance based on its assessment of the current status of individual accounts. Balances that are outstanding after management has used reasonable collection efforts are written off through a charge to the valuation allowance and a credit to patient accounts receivable. 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. Penobscot Valley Hospital Part V, Section B, Line 14g: The FAP application is sent with all first time statements. A notice of the FAP is also posted in the FAQ section of the Organization's website. Notices are also posted at all entrances to the Hospital and at various locations within the building. Penobscot Valley Hospital Part V, Section B, Line 20d: The Hospital applied the determined discount to the gross charge amount for self pay patients. The Hospital applied the determined discount to the remaining balance after insurance payment, if applicable. Part VI, Line 2: In 2010, PVH joined three other healthcare organizations in performing a joint community needs assessment for all of our service areas in northern Penobscot County. This group retained professional help to do the research, community focus groups, surveys, data manipulation, and report writing. We looked to identify gaps in services for the entire area, and also to try and identify opportunities for collaboration in providing those services to our communities. In addition to this assessment, the three largest hospitals in the state conducted a state-wide needs assessment that was broken down by county and service area. This too has provided us with information to use in our hospital planning sessions. We continually ask our patients if there are things that we could do better, or if there are services that they need that are not currently being offered locally. If something is identified that we have the capability to do, then we try to meet the needs of our community. One example would be expanding the hours available for walk-in services at our laboratory and x-ray departments. This was done in response to feedback from a survey done by the staff. Part VI, Line 3: Notices regarding PVH's charity care policy are posted around the hospital. We also have information in each patient room, and our employees know to refer patients to the registration or billing offices of the hospital if they have questions. Part VI, Line 4: Lincoln is a rural community of approximately 5,700 people located in north central Maine. Our service area consists of many small towns that use Lincoln as a hub. The hospital, school system, logging companies, and paper mill are the major employers in town. Life and industry primarily revolve around the woods of central Maine. It is an area rich with history for making paper. Maine is one of the oldest states in the nation according to the latest US Census report, and Lincoln reflects that demographic. The median resident age in 2008 was 40.7 years. Lincoln is located in a modest area of the State, where the median resident income in 2008 was $32,229. Maine's average income for that same time period was $46,581. Part VI, Line 5: Penobscot Valley Hospital in Lincoln, Maine provides a substantial range of free or low-cost services, care, and educational opportunities to the Lincoln Lakes Region in northern Maine. PVH is one of the largest employers in the area and provides careers for more than 225 people in a region in which people struggle to find full-time, good paying employment. PVH is also the only rural health center with emergency care in the region for many of our patients and clients. The nearest Critical Access Hospital is 30 minutes away, and the nearest full service hospital is more than 45 minutes away from PVH. Sustaining PVH's longevity not only means vital services remain nearby for our patients but also that the economic vitality of the region is better secured. During 2012, PVH partnered with many agencies to reach a broad range of people. Some of those agencies included Colonial Healthcare, Eastern Maine Community College, Golden Key Senior Center, Health Access Network, Husson University, Katahdin Shared Services, Katahdin Valley Community College, Lincoln Lakes Region Chamber of Commerce, LifeFlight, the Lincoln Police Department, the Lincoln Fire Department, Maine Centers for Disease Control and Prevention, Maine Department of Transportation, Millinocket Regional Hospital, R.S.U. #67, SAD #30, SAD #31, PVH Auxiliary, PVH Cancer Support Group, SPRINT for Life, the University of Maine, WomenHeart and more. These partnerships allowed PVH to provide education, services, training and informational materials to people in our region.AuxiliaryThe PVH Auxiliary is a group of men and women who work as a team to volunteer for hospital-related events, greet patients and their families, and supply certain items to patients as needed. One of their biggest focuses is "baby bags" - a goody bag that each new mother receives with helpful items for her and the new baby. They also provide scholarships to non-traditional students pursuing a degree in the healthcare industry.Blood DrivesPVH held two American Red Cross blood drives in 2012 - one in June and another in December, both at the Lincoln Knights of Columbus Hall. The blood drives resulted in over 100 units of blood being collected for those in need.Cancer Support GroupThis group meets twice a month at PVH with two survivors leading the group. All area cancer survivors and their caregivers are invited to attend for help in dealing with cancer. Discussion topics include finances, transportation, cancer centers, and occasional guest speakers. The group helps to fund education, transportation and other care costs for area cancer patients that are in need. Childbirth Education and Obstetric CareEach quarter, PVH provides education at low or no cost to expectant mothers and families. These classes are typically held on the weekends and teach breastfeeding, comfort during pregnancy, relaxation techniques, pain control, baby care, and much more. For those families delivering at PVH, they are showered with gifts from the PVH Auxiliary, enjoy the baby's first birthday cake made special by our Food Services Staff, and receive books through the Raising Readers program.Disaster PreparednessPVH participates in a regional disaster preparedness committee with several other agencies including doctors' groups, other hospitals, local police and fire departments, schools, and other organizations. The goal of these monthly meetings is to prepare for pandemic flu, natural disasters, or other incidents that could affect our communities as well as to find ways to work together to share resources and protect the community. Economic ImpactPVH is one of the largest employers in the Lincoln Lakes Region. By employing more than 240 people in the community, PVH is a critical leader in creating and maintaining jobs and livelihoods in the region.EducationEach week, the PVH staff places articles and ads in the local paper, the Lincoln News, the PVH website, PVH Facebook page, and other nearby publications covering topics that are helpful to the general public. These include topics such as hand hygiene, disease prevention, and nutritional advice. The hospital also produces a variety of brochures and educational materials covering a wide range of health-related topics which are handed out to the public. Our Quality Improvement department conducted two lectures to the University of Maine nursing students on quality and service issues. Our Pharmacist provided members of the Golden Key Senior Center with education on medical safety. Staff have worked to create educational displays in our lobby which have included a "bug" display of artwork created by students at Ella P. Burr elementary school to promote proper hand hygiene and infection prevention among our staff and community. In February, WomenHeart hosted a display to educate staff and community members about heart disease in women. Educational ToursStudents from local schools throughout the region, as well as Boy and Girl Scout troops, were given tours of PVH during 2012. During the tours, students learn age-specific healthcare informationlike proper hand hygiene, ambulance tours, x-ray processing, and laboratory testing.Falls RisksPVH is also providing education on fall risks and measures that can be taken at home to decrease a patient's risk of falls and injury. The hospital provides patients with a handout that teaches ways to make their home safe and other tips to avoid falls. There is an active Falls Team who works on projects to make the hospital and our community a safer place. Food Cupboard SupportThroughout the year, staff and visitors to the PVH Cafeteria place change in a special container by the checkout counter. Periodically, this change is removed and donated to the Lincoln Area Food Cupboard, which supplies food, clothing, and other necessities to people in need. In 2012, PVH collected over $400 for the Lincoln Area Food Cupboard. ImPACT Program at Mattanawcook AcademyPVH has provided MA with software to help prevent long-term brain injuries through the Maine Concussion Management Initiative, a program created by Dr. William Heinz, a Portland orthopedist, and Dr. Paul Berkner, director of health services at Colby College in Waterville. During the month of August, about 160 student-athletes at MA took the ImPACT testing. ImPACT stands for Immediate Post-Concussion Assessment and Cognitive Testing and is a computerized neurocognitive testing program used as a standard tool used in comprehensive clinical management of concussions for athletes of all ages. Dr. Carl Alessi oversees the program at PVH and will monitor any student athlete presenting signs of a concussion or head injury during the sports season.InfluenzaOur clinicians and support staff held multiple influenza vaccination clinics for our community in Penobscot Valley Primary Care and the PVH Specialty Clinic. On October 24, the Maine Center for Disease Control and Prevention stopped by PVH to recognize our extraordinary efforts to vaccinate staff from influenza. During 2011-2012 flu season, over 90% of staff at PVH had received the influenza vaccination. Internships/Job Shadowing/Job SkillsThe hospital works closely with students from across the state. PVH has hosted many job shadow opportunities from local high school and college students. Northern Penobscot Tech Region III had students complete their clinical rotations for Medial Assistant, Certified Nursing Assistant and Phlebotomy at the hospital. Husson University sent students to the PVH Pharmacy for their rotations. PVH has also worked with the University of Maine School of Nursing and Kennebec Valley Community College Radiology Program.PVH also partnered with the University of Maine Business School students in the American Marketing Association to conduct a community awareness and perception study. The students gained valuable, real-life education skills through survey implementation, data collection, analysis, and business presentation. Laboratory ServicesMedical Laboratory Technologists in the PVH Laboratory make weekly visits to four area nursing homes to collect specimens from residents. The technologists have also provided free educational sessions to nursing home staff members on specimen collection. LifeFlight of MaineThe LifeFlight helicoptors are known for transporting critical patients to the care they need quickly and safely. Though not talked about as often, the crew and equipment on board are just as important to the patient's survival and recovery as the helicopter itself. LifeFlight relies on private donations to help fund the more than $175,000 of advanced medical equipment on board each helicopter. In 2012, PVH donated $4,500 toward this worthy cause. Reports Filed With States Part VI, Line 7 ME Continuation of Schedule H, Part VI, Line 5 Form 990, Schedule H, Part VI, Line 5: Lincoln Chamber of CommerceIn May, PVH hosted a Business After Hours event with the Lincoln Lakes Region Chamber of Commerce. At the event, business members were introduced to hospital staff and visited stations around the hospital including surgical services, tele-trauma and tele-medicine in the emergency room, orthopedics, urology, and the new patient beds. Lincoln ExpoIn April, staff at PVH volunteered their time to teach the community about services offered at PVH. Attendees at the Lincoln Expo had the opportunity to learn about the ambulance units. The EMS crew was teaching the difference between a heart attack and a stroke. They also had the Seatbelt Enforcer on loan from the Maine Department of Transportation, which demonstrates the impact of a 5mph collision and why it's so important to wear your seatbelt. Other education was provided on hand hygiene and infection, imaging and radiology services, general and orthopedic surgery.Meeting Space for Non-ProfitsPVH offers conference room space to local non-profit organizations. This space is offered when it does not interfere with hospital business, at no cost to the organizations.Nursing Home PresentsEach year, the PVH staff collects presents for local nursing home residents. These gifts are given to local residents of nursing and boarding homes, who may not have received holiday gifts otherwise. The staff and residents truly look forward to each holiday season. Our two dozen presents were distributed to area nursing home residents in time for the holidays. Primary Care Penobscot Valley Primary Care is located in the hospital's Medical Arts Building at 252 Enfield Road and provides primary care services for patients.Public CPR, First Aid, and Babysitting ClassesPVH staff makes several classes available to the community throughout the year at low or no cost to teenagers and adults.School VisitsProfessionals at PVH often visit local schools to share information on health-related topics with young people. These range from our infection prevention officer teaching students the importance of good handwashing, laboratory technicians teaching kids about their career field, to our laparoscopic surgeon explaining surgical procedures to kids on their level. Normally, students are given something to help retain the material, such as coloring books, posters, informational materials for parents, or small promotional items such as hand sanitizer or bandage containers. New this year, our registered dietitian visited students involved in the Carleton Project at Northern Penobscot Tech Region III and taught a session on Cooking Matters to help diversify the students' skills.Social Work NetworkingEach month, PVH hosts a networking luncheon for social workers and others who do similar work in the community. PVH provides education for them and facilitates discussions about social work-related issues.SPRINT for LifePVH also supports a grant-funded community health coalition in collaboration with Millinocket Regional Hospital and the River Coalition in Old Town. SPRINT for Life is part of a statewide system of public health organizations called Healthy Maine Partnerships that bring people and resources together to improve the health of Maine residents. 1. 5K Run/Walk for Wellness: Nearly 80 participants raced in the 5K organized by SPRINT during the Lincoln Homecoming celebration. The walk raises awareness of the importance of living a healthy lifestyle.2. Providing Opportunities to Dispose of Unwanted Medications: Promoted the national and statewide Prescription and Drig Take Back event on September 29 with the Lincoln Police Department. In addition to the events, SPRINT purchased a drug drop box for the Lincoln Public Safety Building so that community members can dispose of medications on an ongoing basis.3. Raising Readers: Staff worked with Health Access Network to develop a process to disseminate 5-2-1-0 Let's Go materials to families. As a result, 5-2-1-0 bookmarks on healthy eating and active lifestyles are being given to all children with the books they receive through the "Raising Readers" program at well child visits.4. Substance Abuse Prevention: Staff worked with SAD #30 to help them host an underage drinking/substance abuse town hall forum in April. Chief Deputy Troy Morton along with staff facilitated a training session for school faculty and staff during their in-service regarding youth signs and symptoms of substance abuse. He also facilitated the evening forum along with staff. There was a great turnout for the evening presentation for this small community with over 40 people attending. "Parents Who Host Lose the Most" table tents were distributed to businesses in the Lincoln area. Approximately 74 table tents were disseminated to 14 businesses such as restaurants and convenience stores. A press release was printed in the 5/17 edition of the Lincoln News talking about "Parents Who Host Lose the Most" and describing the table tent project. 5. Tobacco Cessation: The town of Lincoln's homecoming festival was promoted as smoke free, and portable signage was placed throughout the community to remind attendees not to smoke. Signs were used by many local vendors to promote a smoke-free area around their site.6. Tobacco Prevention: Staff worked with Penobscot Valley Hospital to address compliance with their tobacco free policy. Media outreach materials were created and used to remind the community that PVH is tobacco free, in and around its facilities. Reminders appeared in the local newspaper, the Lincoln News. Staff also consulted with the Maine Tobacco-Free Hospital Network and began the process to implement some strategies to curb tobacco use by patients, visitors, and staff.7. Walking School Bus: Staff and coalition members implemented a Walking School Bus program for elementary school students in Lincoln for the month of October. The walks took place every Wednesday during the month and averaged 60 participants. Vital ServicesPVH provides vital services to the community, of which most are paid for through individuals, insurance companies, MaineCare and Medicare. In 2012, the hospital handled or performed:1. 42,793 patient visits2. 8,089 visits to the emergency room3. 892 operating room cases4. 77 newborns5. 1,530 ambulance runs6. 3,210 EKGs7. 27,539 respiratory therapy treatments8. 82,503 lab tests9. 13,189 physical therapy modalities10. 2,883 speech therapy treatments11. 3,332 occupational therapy treatments12. 430 cases involving nuclear medicine13. 1,530 mammograms14. 1,705 CT scans15. 189 bone density tests16. 760 MRIs17. 4,846 primary care visits18. 1,791 ultrasounds19. 321 vascular exams20. 7,189 X-rays 1 Alpine Health Services PO Box 460 West Enfield ME 04493 222533280 501(c)(3) 9935 To fund operations 1 0 Procedure for Monitoring Grants in the U.S.: Part I, Line 2: Schedule I, Part I, Line 2: Once a month the controller for Alpine prepares a spreadsheet listing cash on hand, expenses for the month, and balance needed. If Alpine is short on cash for that month the spreadsheet is printed and attached to a Check Request for the hospital for the amount that is needed to fund Alpine's expenses for that month. X X X X 0 0 0 0 0 0 0 0 0 Carl Alessi MD 169805 0 0 0 0 0 1000 0 28352 0 199157 0 0 0 David Shannon 207200 0 5900 0 7260 0 0 0 24211 0 244571 0 0 0 Ann Marie Rush 145134 0 0 0 3600 0 0 0 16788 0 165522 0 0 0 David L Ettinger 282043 0 0 0 2600 0 3675 0 21677 0 309995 0 0 0 David H Dumont 255907 0 0 0 17000 0 3675 0 10624 0 287206 0 0 0 Samer Sbayi 334209 0 0 0 0 0 2600 0 23757 0 360566 0 0 0 Phillip Scaglione 301484 0 0 0 0 0 0 0 12499 0 313983 0 0 0 Paul E Turnquist 276358 0 0 0 0 0 0 0 23763 0 300121 0 0 0 Supplemental Information Part III Dave Shannon, CEO & Ann Marie Rush, CFO are compensated by Quorum Health Resources, an unrelated organization, for services rendered to the Organization. The amounts listed below are not included in the total reported on Form 990, Part VII, Section B for Quorum Health Resources, LLC. A breakdown of their 2012 compensation is as follows: Dave Shannon, CEO: Salary: $207,200 Bonus: $5,900 Benefits: $24,211 Automobile Allowance: $7,260 Ann Marie Rush: Salary: $145,134 Benefits: $16,788 Automobile Allowance: $3,600 A Maine Health and Higher Educational Facilities Authority Revenue Bonds 010314384 560427EU4 2012-06-28 1117769 To refinance Series 2002A bond 0 0 1 A 2888 1117769 132031 24765 960973 2012 0 1 1 1 A 0 0 0 0 0 0 0 A 0 0 0 0 0 0 0 0 0 A 0 Part II, Line 3 Bond Issue Proceeds The total proceeds of issue listed on line 3 differ from the issue price listed on Part I due to the amount of the premium on the bond. Samer Sbayi Employee of the Organization Sign-On Loan X 100000 45561 0 1 1 Phillip Scaglione Employee of the Organization Sign-On Loan X 50000 5833 0 1 1 51394 Amy Woodman Family member of Frederick Woodman, Jr., Board President 40290 Employment 0 Debbie Rancourt Family member of Frederick Woodman, Jr., Board President 74743 Employment 0 Form 990, Part I, Lines 8-18: Prior year numbers have been restated to present revenue net of bad debt expense. Form 990, Part VI, Section B, line 11 Once Form 990 is prepared by the certified public accounting firm, a draft copy is e-mailed to the controller. The controller will then review the Form, and also compare it with the previous year's 990. Once the controller is satisfied with the draft copy, it is forwarded to the CFO. The CFO will then review the document. Any questions she has will either be answered by the controller or the accounting firm. Once the CFO approves the draft 990, a copy is provided to the board of directors for their review. Once the board has approved the draft, the accounting firm is notified and the final version is prepared for filing. Form 990, Part VI, Section B, line 12c It is the expectation of Penobscot Valley Hospital that our board of directors, medical staff, regular and contracted employees, and our volunteers avoid activities that may involve, or appear to involve, a conflict of interest. This is a standard of conduct communicated through Administrative Policy 109 "Code of Ethics," our code of conduct and ethics, and our medical by-laws. These documents are drafted and signed off by the president of the board of directors, the chief executive officer, chief of medical staff and the compliance officer as appropriate. Every individual employed by, or otherwise representing the Hospital, is responsible for complying with this standard. It is the responsibility of the compliance officer and the chief executive officer to ensure that this standard is communicated, maintained and enforced within the Organization. Administrative Policy 127 "Compliance Reporting" outlines the expectation for reporting non-compliance, the mechanisms in place to do so, and the investigative process. Such mechanisms include a 24-hour confidential reporting hotline. Education on Penobscot Valley Hospital's code of conduct and ethics is provided during orientation or at the beginning of the business relationship. Reinforcement of this education is provided annually and upon any business contract renewal. Form 990, Part VI, Section B, line 15 CEO & CFO - Quorum Health Resources, an unrelated organization, does an extensive national compensation analysis. Ranges are presented to the finance/personnel committee of the board by QHR, and the wage is set. Other officer's wages are set using a state-wide wage survey conducted annually by Dix Consulting. 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. Other Fees Form 990, Part IX, line 11g Physician Fees: Program service expenses 2,701,400. Management and general expenses 0. Fundraising expenses 0. Total expenses 2,701,400. Purchased Services: Program service expenses 3,021,060. Management and general expenses 1,026,612. Fundraising expenses 0. Total expenses 4,047,672. Alpine Health Services Inc PO Box 460 West Enfield ME 04493 222533280 Support to provide health services in underserved areas of Maine. ME 501(c)(3) Line 9 Penobscot Valley Hospital 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0