2012-11-08T07:33:20-06:00 2011-12-31 010391345 Berry Dunn McNeil & Parker LLC PO Box 1100 Portland ME 041041100 990 2011-01-01 010263198 Down East Community Hospital DOWN 2072553356 11 Hospital Drive Machias ME 04654 Lynnette Parr 2072553356 2012-11-07 1 Barbara J McGuan CPA P00219457 2077752387 2012-11-07 2011 2016-02-24 21:20:13Z Douglas Jones 11 Hospital Drive Machias ME 04654 39313418 0 X www.dech.org X 1963 ME Acute Care Critical Access Hospital 13 11 335 34 0 0 31642 1073878 35417067 37290660 239218 179149 -131017 0 35556910 38543687 330342 376910 0 0 19887757 19889297 0 0 0 16152196 18032363 36370295 38298570 -813385 245117 25898642 25532361 12512846 13457640 13385796 12074721 X Provide access to quality healthcare and promote community wellness through the delivery of primary, emergency and ancillary inpatient and outpatient healthcare. The Hospital strives to improve the overall health of the communities we serve while exceeding customer expectations. 0 0 5232245 5868642 Surgical services to inpatients and outpatients, totaling 2,131 surgeries 3107061 3484972 Care for medical/surgical unit patients. Unit provided care to 999 admissions for 2,959 patient days. 6997846 7848993 Imaging Services to inpatients and outpatients. 16,169 radiological exams were provided to inpatients and outpatients. 17909701 376910 20088053 Various other medical services supplied to patients. 17909701 376910 20088053 33246853 1 1 0 1 0 0 0 0 0 1 1 0 0 0 1 0 0 1 0 0 0 0 0 0 0 0 1 1 1 0 1 1 0 0 0 0 0 0 0 1 1 1 0 0 0 0 0 1 0 0 0 0 1 50 0 1 335 1 0 0 0 0 0 0 0 0 0 0 X 13 11 0 1 0 0 1 1 0 1 1 0 0 1 1 1 1 1 1 1 0 0 ME X X Lynnette Parr 2072553356 11 Hospital Drive Machias ME 04654 Eric Burke MD 2.00 X X 0 0 0 Douglas Jones 40.00 X X 323539 2708 1788 Kara Dwight DO 2.00 X 365750 0 18266 Greg Campbell Ph D 2.00 X X 0 0 0 John Church 2.00 X X 0 0 0 Nora Dickinson 2.00 X 0 0 0 Dona Emerson 2.00 X 0 0 0 Cynthia Huggins 2.00 X X 0 0 0 Mortimer Lockett 2.00 X 0 0 0 Elizabeth Neptune 2.00 X 0 0 0 David Whitney 2.00 X 0 0 0 Thomas Potter 2.00 X 0 0 0 Rebecca Irving 2.00 X 0 0 0 Katherine Land 2.00 X 0 0 0 Debbie Getchell 2.00 X 0 0 0 Paul Weston 2.00 X 0 0 0 Lynnette Parr 40.00 X 134086 1122 14061 Dhanvant Rathod 40.00 X 500000 0 18266 Leonid Brodsky 40.00 X 409128 0 18266 Karen Miller 40.00 X 442791 0 18266 Rita Ten 40.00 X 405692 0 16746 Stephen Madigan 40.00 X 404093 0 14541 Aziz Massaad MD 0.00 X 253229 0 0 3238308 3830 120200 26 1 1 1 Coastal Maine General Contracting Inc PO Box 272 Machias ME 04654 Construction Services 872446 Barton & Associates Inc 10 Dearborn Rd Peabody MA 01960 Physician Staffing Services 761070 Weatherby Locums Inc PO Box 972633 Dallas TX 75397 Physician Staffing Services 604677 Physician Services Inc 126 Osborne Rd Farmington ME 04398 Physician Staffing Services 513760 Eastern Maine Healthcare Systems 43 Whiting Hill Road Brewer ME 04412 Management Services 480578 21 54999 1018879 1073878 Patient Revenue 621400 58954959 58954959 Electronic Health Reco 621400 495225 495225 Other Revenue 621400 298488 234431 64057 Contractual/Char. Adj. 621400 -22458012 -22458012 37290660 149901 149901 789629 9350 760191 9540 29438 -190 29248 29248 38543687 37226603 0 243206 376910 376910 857358 857358 15501571 14334597 1166974 566875 511239 55636 1917557 1700129 217428 1045936 918415 127521 173264 173264 93364 93364 5155082 5155082 178387 83397 94990 1266315 660121 606194 968228 964721 3507 32319 19847 12472 233499 233499 1563986 1563986 950415 247425 702990 Supplies 2897781 2854876 42905 Bad Debt Expense 1939992 1939992 Temporary Personnel 1618225 1618225 Service Provider Tax 769738 769738 191768 64392 127376 38298570 33246853 5051717 0 3148 4993 6424945 4574061 3651589 4443416 174957 139966 492416 436757 355085 295406 27767109 14693827 13049475 13073282 1602946 2479254 51843 0 92238 85226 25898642 25532361 2515375 2793010 5960150 5396208 607424 451460 3429897 4816962 12512846 13457640 X 12982742 10672567 60719 58919 342335 1343235 13385796 12074721 25898642 25532361 X 245117 -1556192 X X 0 1 1 X 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 8701 8701 0 Explanation of Lobbying Activities: Part II-B, Line 1: The Organization pays dues to local associations, a portion of which are attributable to lobbying activities. 1653523 1000900 -32851 26829 2594743 1463886 208434 18797 1653523 1153005 326009 15128 1463886 1635051 -463672 18374 1153005 0.43000 0.57000 0.00000 0 0 257946 257946 14156342 5914747 8241595 11608998 8327881 3281117 1743823 451199 1292624 13073282 Unfunded Pension Liability 2367035 Estimated Third Party Payor Settlements 2449927 4816962 Description of Intended Use of Endowment Funds: Part V, Line 4: Growth of investment to provide earnings that will support operations. 1 1 1 X 0 1 1 1 0 1 1 1 494 1396000 1396000 0.03840 1 494 1396000 1396000 0.03840 74086 74086 0.00200 390398 390398 0.01070 464484 464484 0.01270 1 494 1860484 1860484 0.05110 1183395 1 0 1 1 Down East Community Hospital

11 Hospital Drive Machias ME 04654

X X X X Down East Community Hospital 1 1 1 200.000000000000 0 1 X X 1 1 X X X X X X 0 0 1 X 0 0 Part I, Line 6a: The senior leadership team, with approval by the board of trustees, manages the community benefit activities of the Hospital. An expense budget is identified annually for community benefit activities. Community benefit activities are reported each year in the Hospital's annual report. 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 $ 1939992. Part III, Line 4: Bad debt expense represents actual and estimated write-offs as identified by the Hospital. Actual write-offs represent accounts that have exceeded 90 days in Accounts Receivable with no payment plans established. Estimated write-offs represent bad debts that are expected based on payment percentage assumptions as determined by the age and payor type of the receivable. Down East Community Hospital Part V, Section B, Line 19d: The Organization offers only free care, so no amount was billed to eligible individuals. Schedule H, Part V, Section B, Line 14: A procedure did exist during 2011, but was not documented in policy format. During 2012, a formal policy was developed and implemented. Part VI, Line 2: DECH participates with Eastern Maine Health System's community health needs assessment process. Community meetings are held in the hospital's service area and information is collected and reported in a formalized report that the hospital then uses to evaluate and respond to the health needs of its service area. Part VI, Line 3: Each private pay patient that receives a bill from the Hospital will receive a copy of the Hospital's free care guidelines and application with their bill. The free care guidelines are posted throughout the hospital in patient waiting areas and the application is also available on the Hospital's website. At every opportunity, billing personnel will communicate to patients the free care policy and encourage patients to apply.The Hospital also contracts with a collection organization who will review certain private pay patients' eligibility for MaineCare (Medicaid) insurance coverage. The Organization will contact the patients and help take them through the MaineCare application process, if applicable. Part VI, Line 4: Down East Community Hospital provides services to rural communities of Washington County, with 81% of its admissions coming from its service area covering 24 towns from Harrington to Lubec (14% come from the HSA for Calais Regional Hospital and 1% come from the HSA for Maine Coast Memorial Hospital). The population of 32,175 for the Hospital Service Area (HSA) has an average household income of $26,081, compared to $46,933 for the State of Maine. Of the HSA population, approximately 18% fall below the poverty line and the average age is 40.2 years. Part VI, Line 5: The Hospital furthers its exempt purpose by promoting the health of the community. The board consists of volunteer community members that are elected by the Corporators of the Hospital. The Hospital has an open medical staff where all applicants have the opportunity to obtain membership as long as the guidelines as determined by the medical staff bylaws are met. 1 Sunrise Nursing Care Facility 11 Hospital Drive Machias ME 04654 222582949 501(c)(3) 359879 Support to affiliate for operations and capital acquisitions. Women's Health Resource Library PO Box 463 Milbridge ME 04658 550880014 501(c)(3) 11031 To support the Womens' Health Resource Library. Machias Memorial High School 109 Court Street Machias ME 04654 016000249 N/A 6000 To provide funding for after school programs. 3 Procedure for Monitoring Grants in the U.S.: Part I, Line 2: Schedule I, Part I, Line 2: The Organization only awards grants to qualifying public charities exempt under 501(c)(3) or municipalities. Additional monitoring is not deemed necessary. X X 0 0 0 0 0 0 0 0 0 Douglas Jones 319302 2708 0 0 4237 0 0 0 1773 15 325312 2723 0 0 Kara Dwight DO 365750 0 0 0 0 0 9800 0 8466 0 384016 0 0 0 Dhanvant Rathod 500000 0 0 0 0 0 9800 0 8466 0 518266 0 0 0 Leonid Brodsky 409128 0 0 0 0 0 9800 0 8466 0 427394 0 0 0 Karen Miller 442791 0 0 0 0 0 9800 0 8466 0 461057 0 0 0 Rita Ten 405692 0 0 0 0 0 8280 0 8466 0 422438 0 0 0 Stephen Madigan 404093 0 0 0 0 0 6075 0 8466 0 418634 0 0 0 Aziz Massaad MD 253229 0 0 0 0 0 0 0 0 0 253229 0 0 0 Supplemental Information Part III From January-October 2011, Douglas Jones, the Organization's CEO, received compensation from Eastern Maine Health Systems, an unrelated organization, for services as interim CEO of Down East Community Hospital and affiliates. Eastern Maine Health Systems is paid by Down East Community Hospital for these services. Compensation related to all affiliates included: Wages: $261,280 Non-taxable Benefits: $0 After October 2011, Mr. Jones' compensation was paid directly by Down East Community Hospital. Maine Health and Higher Educational Facilities Authority 010314384 560425V80 2007-11-01 1035000 Finance new Construction and Equipment 0 0 1 Maine Health and Higher Educational Facilities Authority 010314384 560427JA5 2010-06-24 5480000 Refinance 1998 Bond 0 0 1 304451 1040241 47144 28516 964581 2010 0 0 1 1 1205503 5865921 341527 56710 5467684 2010 1 0 1 1 0 0 0 0 1 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 Downeast Medical Associates Entity more than 35% owned by Aziz Massaad, former director 253229 Dr. Aziz Massaad provided on-call physician services through his medical practice Downeast Medical Associates, to the Organization. 0 Rita Ten MD Family member of Dr. Aziz Massaad, former board member 422438 Dr. Rita Ten provided physician anesthesia services to the Organization. 0 Form 990, Part VI, Section A, line 3 On July 2, 2009, Eastern Maine Health Systems (EMHS) was appointed Emergency Receiver for the Hospital in response to investigations of clinical practices by the Centers for Medicare and Medicaid Services (CMS) and threatened disqualification from the Medicare program. EMHS appointed an Interim Chief Executive Officer to act as their agent. As Emergency Receiver, EMHS at its discretion was authorized to: terminate or modify contracts, hire, manage, and discharge employees of the Hospital, modify or terminate privileges of medical staff. The Hospital Board of Trustees was divested of governance responsibility and/or management authority. The Emergency Receiver was not required to consult the Board of Trustees with respect to governance and management affairs but kept the Board informed of the activities and operations of the Hospital during the term of receivership. An inspection by CMS in December 2009 found no violations of federal conditions to participate in the Medicare program. As of October 2011, the Hospital is no longer under the Emergency Receivership, and the Board of Trustees has assumed full governance responsibilities. Form 990, Part VI, Section A, line 6 Effective January 1, 2011, Down East Health System undertook a corporate restructuring whereby Down East Health System and Down East Health Trust were merged into Down East Community Hospital, leaving the Hospital as the surviving corporation. As a result of this merger, the members of the Organization, known as "Corporators," shall be those individuals who are Corporators of Down East Community Hospital as of January 1, 2011, and such other individuals as may be elected to membership in this Corporation by a majority vote of (i) those Corporators present at the Annual Meeting of this Corporation; or (ii) the Board of Trustees. A Corporator is elected for life, unless (i) the Corporator voluntarily resigns; or (ii) the Corporator fails to attend two (2) successive Annual Meetings of this Corporation. Additionally, those individuals who are appointed as members of the Active Medical Staff of Down East Community Hospital are eligible to serve as Corporators during the period of their appointment to the Active Medical Staff if so desired. Form 990, Part VI, Section A, line 7a Effective January 1, 2011, the Corporators shall elect the Trustees of this Corporation from a slate of nominees presented by the Nominating Committee in accordance with the provisions of the Bylaws. Form 990, Part VI, Section B, line 11 The 990 is reviewed by the CEO and CFO and a copy is provided to the full board before filing. Form 990, Part VI, Section B, line 12c In order to monitor compliance with the conflict of interest policy for the Organization, each member of the board of trustees is required annually to submit a conflict of interest document and the compliance officer verifies the receipt of these documents. The compliance officer also reviews payments issued to the board of trustees and any contracts in effect with board members. Department managers and key personnel are also required to submit a conflict of interest statement annually and new employees sign a conflict of interest statement at the time of hire. Form 990, Part VI, Section B, line 15a Compensation for the Organization's CEO is set by the Executive Compensation Committee made up of independent board members. Form 990, Part VI, Section C, line 19 The financial Statements and annual report are made available to the public upon request. The Organization's governing documents and conflict of interest policy are not made available to the public. Changes in Net Assets or Fund Balances: Form 990, Part XI, line 5: Net unrealized losses on investments: -132,257. Pension Liability Adjustment -1,424,834. Transfer of Equity 899. Total to Form 990, Part XI, Line 5: -1,556,192. Oversight of Audit Form 990, Part XI, Line 2c: Tha audit process has not changed from the prior year. Sunrise Nursing Care Facility 11 Hospital Drive Machias ME 04645 222582949 Nursing Care Facility ME 501(c)(3) Line 9 Down East Community Hospital 0 0 1 0 0 0 0 0 0 1 0 0 0 0 1 0 1 1 0