2023-11-14T10:34:30-06:00 2022-12-31 010494526 Baker Newman & Noyes PO Box 507 Portland ME 04112 990 2022-01-01 010212444 York Hospital YORK 2073634321 15 Hospital Drive York ME 03909 Robin LaBonte CFO 2073634321 2023-11-09 1 Robin LaBonte 999009999 0 Connor Smart P02285543 2078792100 2023-11-09 3 AAL1 IAL1 2022 2023-04-26 12:10:37Z Patrick Taylor MD 15 Hospital Drive York ME 03909 213320709 0 X www.yorkhospital.com X 1904 ME Community Hospital 26 20 1394 130 1892643 65802 5325099 1521260 210090396 207476822 5945144 2293021 91551 76039 221452190 211367142 134569 401050 0 0 107243227 106351664 0 0 364159 101401299 105580410 208779095 212333124 12673095 -965982 137570951 120333185 66426372 54445372 71144579 65887813 Community Hospital 0 0 191943385 401050 205670683 York Hospital is a not-for-profit health care center established to provide health care services to the York county area. It offers both inpatient and outpatient acute services and has 79 licensed acute beds. The Hospital has outpatient satellite services in Wells, Kittery, Berwick, South Berwick, Sanford, and Newington, NH.York Hospital is committed to enhancing the health and wellness of the communities we serve. Our vision is to be the community's trusted health partner dedicated to clinical excellence and service, empowering people to live their best possible lives. 191943385 1 1 0 1 0 0 0 0 0 1 1 1 0 1 1 1 1 0 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 0 0 0 1 55 0 1 1394 1 1 1 0 0 0 0 1 1 0 0 0 0 0 0 X 26 20 0 0 1 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 1 1 X X Robin LaBonte CFO 2073634321 15 Hospital Drive York ME 03909 Jennifer Cutts MD CMO/Trustee/Radiologist (end 6/2022) 40.00 0.00 X X 282438 0 25960 Marilyn McLaughlin MD Trustee/Oncologist 40.00 0.00 X 404073 0 68516 Erich Fogg PA-C Trustee/Physician Assistant 40.00 0.00 X 245768 0 40503 Meghan Ceberek RN Trustee/RN 10.00 0.00 X 40394 0 1120 Patrick A Taylor MD CEO/President 40.00 0.00 X X 575671 0 66373 Kathryn Ford Trustee/Volunteer Coordinator 40.00 0.00 X 73333 0 1907 Frank Green DO Trustee/Physician 40.00 0.00 X 359745 0 42421 Lorraine Boston Trustee 1.00 0.00 X 0 0 0 Amy Bush Trustee 1.00 0.00 X 0 0 0 Gretchen Dunkelberger Trustee 1.00 0.00 X 0 0 0 Mark Eves Trustee 1.00 0.00 X 0 0 0 Ken Fellows MD Trustee 1.00 0.00 X 0 0 0 Eugene Gaudette Trustee 1.00 0.00 X 0 0 0 John Houlihan Trustee 1.00 0.00 X 0 0 0 Judith McAllister Trustee 1.00 0.00 X 0 0 0 Deborah Pease Trustee 1.00 0.00 X 0 0 0 Suzi Raeside Trustee 1.00 0.00 X 0 0 0 Ala Reid Trustee 1.00 0.00 X 0 0 0 Dianne Smallidge EdD RDH Trustee 1.00 0.00 X 0 0 0 David Speert MD Trustee 1.00 0.00 X 0 0 0 Robert Sullivan Trustee 1.00 0.00 X 0 0 0 Mark Wladis Trustee 1.00 0.00 X 0 0 0 Wendy Cote Trustee/Co-Chair 1.00 0.00 X X 0 0 0 Daniel Morrison Trustee/Co-Chair 1.00 0.00 X X 0 0 0 Ann Hussey Trustee/Vice Chair 1.00 0.00 X X 0 0 0 Douglas Bracy Trustee/Treasurer 1.00 0.00 X X 0 0 0 Gary Samia Trustee/Vice Treasurer 1.00 0.00 X X 0 0 0 Robin LaBonte CFO/Leader 40.00 0.00 X 356045 0 68841 Jeffrey Colness MD Cardiologist 40.00 0.00 X 776083 0 26330 Peter Dourdoufis MD Cardiologist 40.00 0.00 X 772053 0 51740 Daneille Leighton Radilogist 40.00 0.00 X 633061 0 41503 Alex Gold Cardiologist 40.00 0.00 X 563161 0 45845 Richard Gray Radilogist 40.00 0.00 X 552430 0 48890 Jud Knox Former CEO/President 0.00 0.00 X 236500 0 0 5870755 0 529949 180 1 1 0 Medifis PO Box 5068 New York NY 10087 Locum staffing 7216872 Weatherby Locums Inc PO Box 972633 Dallas TX 753972633 Locum tenums services 1402153 Seacoast Pathology Inc PO Box 100519 Atlanta GA 30384 Contract pathology services 1326294 Quest Diagnostics Inc 12436 Collection Center Drive Chicago IL 60693 Contract laboratory services 1088899 ECG Management Consultants PO Box 847950 Boston MA 022847950 Consulting services 922314 32 19000 46937 922619 532704 55994 1521260 Patient services 621400 148756298 148756298 Diagnostic and reference labs 621500 50740134 50390027 350107 Pharmacies and drug stores 456110 5626079 4087799 1538280 Miscellaneous program services 621400 1828303 1824047 4256 Cafeteria and dietary 722210 492286 492286 33722 33722 207476822 415544 415544 86504 0 86504 86504 86504 3349078 456074 1566775 360900 1782303 95174 1877477 1877477 15427 46937 25892 -10465 -10465 211367142 205670683 1892643 2282556 X 401050 401050 2653108 2439722 213386 83598926 76563107 6897301 138518 1301602 1196723 102617 2262 13368352 12240872 1105587 21893 5429676 4973362 447562 8752 482503 482503 114666 114666 162476 162476 10353 10353 53435 53435 26650684 24107499 2480972 62213 244749 115032 129717 3324136 351112 2849861 123163 79591 37408 42183 7804884 5931712 1873172 184337 86638 97699 130956 61549 69407 432465 432465 4194208 3219893 966957 7358 3694783 2201522 1493261 Medical supplies/fees 38710683 38710683 Provision for bad debt 7976915 7976915 Pharmacy supplies 7286928 7286928 Healthcare provider tax 4041658 4041658 212333124 191943385 20025580 364159 3424800 2640081 4817040 2230181 645523 448718 20604286 22807663 5506554 5048204 2682719 2519297 136936095 94671456 42504982 42264639 40763723 23486313 2497718 11966626 14123606 6921463 137570951 120333185 35556929 22463792 8436752 7398245 5538492 6676283 16894199 17907052 66426372 54445372 X 50360406 50306080 20784173 15581733 71144579 65887813 137570951 120333185 X -965982 -9319680 5028896 X X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 1 10353 0 0 0 10353 0 Part II-B, Line 1: Part II-B, Line 1f: York Hospital partners with various like-minded trade associations which support public policies and initiatives that focus on improving health outcomes and the experience of health care, while also aiming to reduce the overall cost of receiving that care. To maintain these partnerships, the Hospital is required to pay membership dues back to these various trade associations. A portion of the dues paid to these associations has been designated as available for lobbying expenditures. Any lobbying expenditures paid by the associations are incurred in order to help track and discuss legislation affecting health care policy. The specific dues paid by York Hospital to the trade associations in 2022, as well as the portion of the dues that were available for lobbying expenditures, are detailed below: Maine Hospital Association - Total 2022 dues: $57,140 - Portion of dues available for lobbying: $7,885 American Hospital Association - Total 2022 dues: $17,885 - Portion of dues available for lobbying: $2,468 20784173 195141 -2762106 2635475 15581733 18572340 739411 1964538 492116 20784173 16116712 641121 2261257 446750 18572340 12558375 1507759 2583038 532460 16116712 13337701 247972 -474485 552813 12558375 0.00000 0.27830 0.72170 0 0 3904522 3904522 73818080 44295696 29522384 3116115 2880173 235942 54813214 47495587 7317627 1284164 1284164 42264639 Alternative investments 1949786 F Other investments 518804 F Corporate bonds 9498036 F 11966626 Medical malpractice insurance recoveries receivable 844459 Miscellaneous receivables 871278 Right-of-use assets 5205726 6921463 Pension obligation 7114670 Estimated third-party payor settlements 3967441 Other liabilities 1615061 Lease liabilities 5209880 17907052 X 194043004 -9319680 25892 -9293788 203336792 53435 7976915 8030350 211367142 204328666 25892 25892 204302774 53435 7976915 8030350 212333124 Part V, Line 4: Temporarily Restricted Funds are classified and sorted by the following groups and purposes: Capital Campaign Funds are to be used for the Cardiac Cath Lab Campaign. The current Cardiac Cath Lab equipment is fast approaching the end of its life. Also an addition to the current facility will both enhance functionality and improve overall service. The hospital is facing an equipment replacement and renovation cost of over $7 million. Providing a state-of-the-art Cardiovascular Catheterization Lab which fully supports the needs of our communities is a collaborative effort. Healthcare technology and patient's needs and expectations have greatly changed since the present center was established several decades ago. Biewend (12/82) - Funds from which the original principal and any incurred income are to be restricted for the purchase of new equipment (at Board discretion which must be approved by a family member). Biewend Funds can also be used for the acquisition of land and buildings other than an addition to the present hospital buildings. Page (1945) - Funds that are to be used for support and maintenance of district visiting nurses. Diana Baldwin-Dunnan Fund for Nursing Excellence to be used for financial support of Newly Licensed Nurse Residency Program to defray costs of orientation, preceptors, and classroom instruction for current year graduate nurses orienting to hospital required nursing skills. Rose F. Voignier Education Fund - Funds that are to be used for education for all with exception of physicians. Rose Voignier Education Fund - Funds to be used for staff education. Breast Cancer Living Well Fund - Funds to be used for breast cancer patients. Cancer Living Well Fund - Funds are to be used for cancer patients. Hancock Healthy Aging Fund - Funds are to be used to support programs and services that promote and benefit the physical, emotional, spiritual, and overall health and well-being of our community as they age. Women's Heart Health Fund - Funds are to be used for the support of the York Hospital Cardiology Center program "Heart Care for Women", an initiative specializing in women's heart care and diagnostics where the approach is to treat a health of women as a whole, minimizing the risk of heart disease and keeping the heart healthy. Permanently Restricted Funds are classified and sorted by the following groups and purposes: Elizabeth B. Perkins - The Perkins' Funds Principal is to remain restricted in perpetuity. The income generated from the Funds are restricted for the care of patients who are unable to pay for proper treatment. Gerrity - Principal Gerrity Funds are to be maintained in perpetuity. 80% of income generated by the funds are considered unrestricted, to be used on general operations, while 20% is to be reinvested as Principal. Cowey - and gains generated by the Funds are to be used for pediatrics (Corpus only to be kept intact). Forristall - Income and gains generated by the Funds are to be used for SNF (Corpus only to be kept intact). Mason - Income and gains generated by the Funds are to be used to provide free care to patients who cannot afford to pay (Corpus only to be kept intact). Brewster - Income and gains generated by the Funds are to be used for any form of diabetes research and care (Corpus only to be kept intact). Rose F. Voignier Education Fund - Income and gains generated by the Funds are to be used for education for all with the exception of physicians (Corpus only to be kept intact). Palmer/Perkins Endowment - Income and gains generated by the Funds are to be used for education for nursing education for the staff (Corpus only to be kept intact). Sidelinger - (6/88) Income and gains generated by the Funds are to be used for general support, upkeep and maintenance of the Hospital as determined by the Board (principal only to be kept intact). Oncology Fund - Income and gains generated by the funds are to be used for support programs for patients, their families, and their caregivers. Part X, Line 2: The Hospital is a not-for-profit corporation and is tax-exempt under Section 501(c)(3) of the Internal Revenue Code. 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 Financial Accounting Standards Board, 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 Hospital has evaluated the positions taken on its filed tax returns. The Hospital has concluded no uncertain income tax positions exist at December 31, 2022. Part XI, Line 2d - Other Adjustments: Fundraising event expenses 25,892. Part XI, Line 4b - Other Adjustments: Provision for bad debts 7,976,915. Part XII, Line 2d - Other Adjustments: Fundraising event expenses 25,892. Part XII, Line 4b - Other Adjustments: Provision for bad debts 7,976,915. Cruise 41635 29635 12000 600 2500 7786 1750 2737 Road Race 20729 17302 3427 950 3440 2260 350 3519 62364 46937 15427 950 4040 4760 7786 2100 6256 25892 -10465 1 1 1 X 0 1 1 0 0 1 161 138862 138862 0.00070 1 7790 20652558 18193645 2458913 0.01200 2 7951 20791420 18193645 2597775 0.01270 522713 16212 506501 0.00250 65656249 31189566 34466683 0.16870 1370 1370 0.00000 66180332 31205778 34974554 0.17120 2 7951 86971752 49399423 37572329 0.18390 1 3136702 0 27273782 38367453 -11093671 X 1 1 1 1 York Hospital 15 Hospital Drive York ME 03909 www.yorkhospital.com 38066 X X X York Hospital 1 0 0 1 X X X X X X X X X X 21 1 0 1 1 X Please see Part V X 1 21 1 Please see Part V 0 1 X 200.000000000000 X X X X 1 1 X X X X 1 X Please see Part V X Please see Part V X Please see Part V X X X X X X X 1 X 0 X X X X 1 0 0 York Hospital Part V, Section B, Line 3j: A shared vision of a healthy Southern York County; socio-economic characteristics by town, and a community themes and strengths assessment. York Hospital Part V, Section B, Line 5: The current local Community Health Needs Assessment process completed in December 2021 helped York Hospital, its partners, and its community members identify three health issues of concern in the local service area: Mental Health; Substance Misuse; and Access to Care. York Hospital has a long tradition of asking community members for feedback formally and informally to determine concerns and needs. The Hospital's 2021-2024 continues to listen to the communities it serves in order to help improve the health of those living in Southern York County Maine. The 2021-2024 CHNA compiles local, county, and state health data gathered through community member input about health issues and the needs and assets community members care about most.Transportation was the biggest barrier to healthcare for many in two prior consecutive community surveys which led the hospital to establish its now extensive transportation service. The formality of the CHNA requirement helps to ensure community participation, collaboration and follow up. York Hospital is the fiscal agent of and partners with the Choose to Be Healthy Coalition (CTBH) a federal and state funded youth substance use prevention coalition housed at the hospital whose staff make up its Community Health Team. CTBH assisted in engaging the community in the health assessment process. CTBH has a membership and Advisory Board purposefully comprised of individuals who represent or have backgrounds from all of the diverse demographics and community groups that are served by the coalition. This includes individuals from law enforcement, behavioral health care, social service agencies, municipalities, business, faith, parents and youth. The involvement of these perspectives is necessary to implement successful health improvement initiatives. Guiding the process was the perspective that much of what influences health outcomes happens outside of the health care system. These social factors include poverty, level of education, behavioral health status, age, and social connectedness, among others. Members of CTBH represent populations in the hospital service area with disparate health outcomes including those with low-incomes, the elderly, youth and those with substance use and mental health disorders. Elements of the National Association of City and County Health Officials (NACCHO) community health planning process were used in 2015 and 2018 to help community stakeholders identify a Vision for a Healthy Community and a list of Community Values. A Community Themes & Strengths Survey (available online and printed) was also implemented in 2015, 2018 and 2021. In addition, a York County Community Health Forum was held on September 27, 2021, with over sixty public health professionals, community members, and decision makers who reviewed the most current county and state data, discussed local health concerns and helped prioritize health issues going forward as a county and as collaborating agencies, coalitions and hospitals.The Community Health Team provided guidance for the CHNA process through monthly meetings with help from members of the York Hospital Patient Advisory Committee and York Hospital Board. York Hospital Part V, Section B, Line 6b: York Hospital's CHNA was conducted with Choose To Be Healthy (CTBH), a community health coalition with a membership purposefully comprised of those representing diverse community sectors, such as education, health care, business, municipalities, law enforcement, and other similar community and public-service based institutions.Additionally, the current assessment includes the Southern York County Maine towns of Berwick, Eliot, Kittery, Lebanon, North Berwick, Ogunquit, South Berwick, Wells, Sanford and York. York Hospital Part V, Section B, Line 11: The York Hospital Community Health Needs Assessment 2021-2024 Implementation Plan Progress Report (for the 2021-2024 CHNA) identified three priority health issues: Mental Health, Substance Abuse and Misuse, and Access to Care. The Report outlines the Hospital's strategies, activities, progress, and status on each of these core issues.The Hospital actively worked to address each of the priority health issues through improved access to care and health-related resources, community engagement and education initiatives, improved staff capacity and skillsets, increased service-infrastructure, and through additional community, Hospital, clinic, and facility-based programs available to vulnerable populations and the public at-large.Please see the Community Health Needs Assessment 2021-2024 Progress Report on our website for additional and specific details on how York Hospital is addressing the significant needs identified in the 2021-2024 CHNA. The full report can be found at the following web address:https://www.yorkhospital.com/wp-content/uploads/2023/09/YorkHospitalCommunityHealthNeedsAssessmentImplementationPlan2021-2024ProgressReport.pdf York Hospital Part V, Section B, Line 13b: In addition to providing free care to patients with household income at or below 200% of the FPG, during 2022 York Hospital also offered a 33% discount to uninsured patients and a HELP Financial Assistance Program, which provides prompt payment discounts based on balances-due and patient income. Any reduction of these patients' hospital bills was based on the applicable patients' household income and the amount owed the Hospital. York Hospital Part V, Section B, Line 16j: All patient billing statements list the Hospital's financial assistance program's applicable phone number and website-address, which the patient may then use to acquire more information or receive additional assistance. York Hospital Part V, Section B, Line 20e: The collection agency working for York Hospital is aware of the Hospital's financial assistance policy. Therefore, in the unlikely event that a patient eligible for financial assistance is not identified before their account is sent to outside collections, the collection agency itself has the ability to identify these patients who will be unable to pay their hospital bills, and who may also qualify for the assistance program. York Hospital will not impose extraordinary collection actions, such as wage garnishments, liens on residences, or other legal action, on any patient without first making reasonable efforts to determine whether that patient is eligible for financial assistance under the Hospital's policy. Schedule H, Part V, Section B, Line 7a York Hospital's 2021-2024 Community Health Needs Assessment can be found on its website at the following web address:https://www.yorkhospital.com/wp-content/uploads/2021/12/YH-CHNA-Report-2021-2024-1.pdfAdditionally, the past two mostly recently published Community Health Needs Assessments prior to the 2021-2024 Report can be found on the following web page:https://www.yorkhospital.com/990-chna/The CHNA Report 2018 is available at the following address:https://www.yorkhospital.com/wp-content/uploads/2023/10/York_Hospital_CHNA_Report_2018-1.pdfThe CHNA Report 2015 is available at the following address:https://www.yorkhospital.com/wp-content/uploads/2023/10/York_Hospital_CHNA_Report_2015-2.pdf Schedule H, Part V, Section B, Line 16a: York Hospital's Financial Assistance Policy is available on their website at the following web address: https://www.yorkhospital.com/financial-assistance-program/financial-assistance-policy/ Schedule H, Part V, Section B, Line 16b: Information for York Hospital's FAP Application Process is available on their website at the following web address:https://www.yorkhospital.com/financial-assistance-program/Additionally, the actual Financial Assistance Application Form can be found at the following web address:https://www.yorkhospital.com/wp-content/uploads/2023/01/FAP-2023_CoverandApplication-1.pdf Schedule H, Part V, Section B, Line 16c: York Hospital's FAP Plain Language Summary is available on their website at the following web address:https://www.yorkhospital.com/financial-assistance-program/ Schedule H, Part V, Section B, Line 10: York Hospital's Community Health Needs Assessment (CHNA) 2021-2024 Implementation Plan Progress Report can be found at the following web address:https://www.yorkhospital.com/wp-content/uploads/2023/09/YorkHospitalCommunityHealthNeedsAssessmentImplementationPlan2021-2024ProgressReport.pdf Schedule H, Part V, Section B, Line 16i: 501(r) Regulations require that hospitals translate their financial assistance policy (FAP) into primary languages spoken by limited English proficient (LEP) populations in their hospital service area. Should a LEP population demographic exceed 5% of the community residents or 1,000 individuals, whichever is less, a hospital must make available translated copies of its FAP. The York Hospital website allows its users to automatically translate the language of the Hospital FAP into English, French, or Spanish, as is preferred and applicable to the user. The Hospital website allows this functionality through a Select Language drop-down box, located in the upper left-hand corner of the Hospital home-page (https://www.yorkhospital.com/); at the user's selection, the Hospital website will automatically translate into the desired language of choice. Schedule H, Part V, Section B, Line 22: Individuals who qualify under the Hospital's financial assistance policy receive a 100% write off of charges. Accordingly, no box has been checked to indicate how the Hospital determines the maximum amount that may be charged to FAP-eligible patients. 14 1 - York Hospital Long Sands 127 Long Sands York ME 03909 See Description in Part VI 2 - York Hospital in Wells 112-114 Sanford Road Wells ME 04090 See Description in Part VI 3 - York Hospital 16 Hospital Drive 16 Hospital Drive York ME 03909 See Description in Part VI 4 - Cardiovascular Care in Newington 2064 Woodbury Avenue Suite 103 Newington NH 03801 See Description in Part VI 5 - York Hospital in Kittery 35 Walker Street Kittery ME 03909 See Description in Part VI 6 - York Hospital Kittery Medical Services 75 US Route 1 Kittery ME 03909 See Description in Part VI 7 - York Hospital 12 Hospital Drive 12 Hospital Drive York ME 03909 See Description in Part VI 8 - York Hospital in South Berwick 57 Portland Street South Berwick ME 03908 See Description in Part VI 9 - York Hospital Neurology Associates 223 York Street York ME 03909 See Description in Part VI 10 - York Hospital in Sanford 1474 Main Street Sanford ME 04073 See Description in Part VI 11 - York Hospital Route 1 York 343 US Route 1 York ME 03909 See Description in Part VI 12 - Webhannett Internal Medicine 277 Post Road Moody ME 04054 See Description in Part VI 13 - York Hospital in Berwick 4 Dana Drive Berwick ME 03901 See Description in Part VI 14 - Psychiatric Associates of York Hospital 32 York Street York ME 03909 See Description in Part VI Part I, Line 3c: In addition to providing free care to patients with household income at or below 200% of the FPG, during 2022 York Hospital also offered a 33% discount to uninsured patients and a HELP Financial Assistance Program, which provides prompt payment discounts based on balances-due and patient income. Any reduction of these patients' hospital bills was based on the applicable patients' household income and the amount owed the Hospital. Part I, Line 7: York Hospital has several hospital clinical services and hospital-owned physician practices. Per instructions for IRS Form 990, Schedule H, Worksheet 6, organizations may include any applicable physician practice that the Hospital subsidizes (i.e., operates at a loss) in the completing of Schedule H. Therefore, the Hospital has included the following hospital clinical services and hospital-owned physician practices that operate at a loss (i.e., are subsidized by the Hospital) and the associated costs of these practices:a. Endocrinology Practiceb. Adult House Callc. Kittery Family Practice d. Emergency Room e. Home Health Agencyf. OB/GYN Practice g. Wells Walk-Inh. Rheumatology Practicei. Neurology Practicej. Psychiatry Practicek. Urology Practicel. Berwick Walk-Inm. Pulmonary Practicen. Great Works Family Practiceo. Family Medicine in Wellsp. York Family Practiceq. Webhannet Internal Medicine Practicer. Pediatric Practices. York Walk-Int. Surgical Associatesu. Sanford Family Practicev. Kittery Walk-Inw. Sanford Walk-Inx. Wells Primary Carey. Center for Older Adultsz. York Hospital Recovery Centeraa. Sanford Family PracticeThe above-listed hospital clinical services and hospital-owned physician practices have a community benefit (i.e. aggregate loss or subsidy from the Hospital) of approximately $34.47 million. In addition, the community benefit does not take into account bad debts, charity care, or contractual adjustments. Thus, this community benefit of approximately $34.47 million is a conservative figure that reconciles to the community benefit information reported on IRS Form 990, Schedule H, Part I, Line 7g, Column e.Form 990, Schedule H instructions/guidance contains a template (Worksheet 2) that may be used to determine the overall cost to charge ratio that could be applied throughout Schedule H in order to convert charges to cost. Where applicable, the Hospital has utilized Worksheet 2 for various calculations. The only areas where Worksheet 2 was not utilized for Part 1, Line 7 were the following:a. Schedule H Worksheet 6, Subsidized Health Services (the supporting worksheet for Part I, Line 7g), the Hospital did not utilize Worksheet 2 when calculating the percentage used when determining the profit/loss of each hospital clinical service and hospital-owned physician practice. Instead, when compiling the subsidized hospital clinical services and hospital-owned physician practices listed in 1c above, the Hospital utilized the actual estimated costs on the modified Medicare cost report instead of applying the Worksheet 2 cost to charge percentage. b. Schedule H Worksheet 3, Unreimbursed Medicaid and Other Means Tested Government Programs (the supporting schedule for Part I, Lines 7b and 7c), and Worksheet 6, Medicaid Allowable Costs for Subsidized Health Services, listed in line 1c above (which is part of the line 7g costs). The Hospital did not utilize the Worksheet 2 percentage when calculating the Medicaid allowable cost. Instead, the Hospital utilized the actual Medicaid filed cost report for the allowable costs. 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 $ 7,976,915. Part II, Community Building Activities: While the Hospital does not explicitly report cost and revenue reports related to Community Building Activities on its Schedule H, Part II, the Hospital does engage in various activities that improve the community's health and safety. For example, the Hospital offers numerous scholarships and financial assistance programs to staff to lessen the burden of higher education and to increase the total number of trained and qualified professional health care providers in the area. The Hospital also offers transportation services within its operating area to help patients get to and from their medical appointments or to deliver prescription medications; without the Hospital's intervention, many of these patients would not be able to access health care services. Additionally, York Hospital collaborates with many local social service agencies to design and deliver year-round programs to meet the basic needs of the Hospital's community, and to promote stronger physical, emotional, spiritual, and financial health. These are just a few of the many ways in which the Hospital is engaging with its community to promote health, safety, and general well-being. Part III, Line 2: The Hospital utilized Worksheet 2 from the IRS Schedule H instructions/guidance to determine the ratio of patient care cost to charge (39.32% for fiscal year 2022) and multiplied this ratio by the Hospital's total bad debt expense of $7,976,915 to determine the Part II, Line 2 bad debt expense of $3,136,702. Part III, Line 3: Patients who qualify for financial assistance have 100% of their liability written off, so no portion of it is included in the Hospital's bad debt expense. Part III, Line 4: See Footnote 2 on page 11 of the attached audited financial statements. Part III, Line 8: Form 990, Schedule H instructions/guidance contains a template (Worksheet 2) that may be used to determine the overall cost to charge ratio that could be applied throughout Schedule H in order to convert charges to cost. Where applicable, the Hospital has utilized Worksheet 2 for various calculations. The only areas where Worksheet 2 was not utilized for Part III, Line 8 was Schedule H, Worksheet B, Line 2 & 6, Medicare Allowable Costs and Payments Related to Subsidized Health Services. The Hospital utilized the Medicare cost report estimated cost and payment for these services. The Hospital believes that its hospital clinical services, hospital-owned physician practices, emergency room, and home health agency listed above should be considered a community benefit, as community members benefit by having easy access to these services, facilities, and programs which are both offered and subsidized. These facilities and programs are offered and thus subsidized through the Hospital. Part III, Line 9b: Accounts with self-pay balances that show no evidence of patient payments or eligibility for financial assistance that have completed a patient dunning cycle (120 days approximately) may be transferred to a collection agency. Any patient account that has applied for any of York Hospital's financial assistance programs and supplied all required documentation will be held in a pending status until a determination is made. Part VI, Line 2: York Hospital has focused on three goals identified in its Community Health Needs Assessment: 1. Mental Health2. Substance Use and Misuse3. Access to CareYork Hospital has posted the most current CHNA, Implementation Plan, and Implementation Plan Progress Report for the following CHNA goals at the following address: https://www.yorkhospital.com/990-chnaThe Hospital's most recent CHNA identifies a number of core objectives as part of its overall community assistance goals, which are detailed below.MentalHealth:- Increase access to mental health services and improve collaboration between service providers, especially in helping youth and young adults.- Build capacity of York Hospital staff to understand mental health and increase ability to provide support for each other and patients.- Build capacity of families and professionals to understand mental health and increase ability to provide support and access services.- Advocate for mental health services and options for inpatient treatment.Substance Use and Misuse:- Increase capacity to provide medication assisted treatment through the YH Recovery Center.- Support the Choose To Be Healthy Coalition (CTBH) in preventing youth substance use disorders with evidence based strategies. - Provide regular community education.Increase and Improve Access to Care:- Increase proportion of patients with a usual primary care provider- Increase proportion of patients with online access to electronic medical records and appointment information.- Increase proportion of patients that receive eveidence based preventive care.These priorities were chosen through a process that examined data from state and county sources as well as local data including the York Hospital Community Themes and Strengths Survey results, local forums, discussion groups and one-on-one key informant interviews. In choosing its community's significant health needs and priorities, the Hospital used the following criteria:- Data showing significant problem(s) compared to past and/or to the state numbers- Gaps in existing services and efforts- Concern for issue demonstrated by community members and collaborating partners- Capacity at York Hospital and among partners to implement actions resulting in measurable outcomesThe quantitative data for the CHNA comes primarily from the 2021 York County Maine Shared Community Health Needs Assessment process and includes multiple secondary sources including the US Census, the Maine Behavioral Risk Factor Surveillance System, the Maine Integrated Youth Health Survey, and several State of Maine departments. The complete reports and data sources for this information can be found at:https://www.maine.gov/dhhs/mecdc/phdata/MaineCHNA/final-CHNA-reports.shtmlYork County and local area data used in the 2021-2022 CHNA include:- Demographic and socio-economic factors;- Health care access;- Health status;- Disease incidence and prevalence; and- Health behaviors and risk factors.Qualitative data was compiled from:- Group discussions with hospital staff and community members;- Key informant interviews with stakeholders and patients;The total amount of information that can be compiled from these data-sets allows the Hospital to assess the health care needs of the community it serves. Part VI, Line 3: York Hospital is a non-profit healthcare provider. York Hospital is committed to providing financial assistance to every person in need of medically necessary treatment even if that person is uninsured, under insured or ineligible for government programs, or unable to pay based on their financial situation. The patients' billing statement lists the phone number and website address to use for more information regarding the Financial Assistance Program. York Hospital will accept a variety of payment methods and will offer resources to assist in resolving outstanding balances. The Hospital will assist patients in applying for known programs of financial assistance that may be applicable. York Hospital will treat all patients with loving-kindness, respect and compassion.The Hospital offers free care to patients whose income is twice the federal poverty income level. For example, an uninsured family of 4 whose total annual income is $51,500 or lower qualify for free care at York Hospital. Based on this program alone, York Hospital provides free care to patients who utilize our services every year and FAP-eligible individuals can't be charged more than the amounts generally billed (AGB) for an emergency or other medically-necessary care. Additionally, York Hospital's Prescription Assistance Program (PAP) helps qualifying patients without prescription drug coverage get the medicines they need through the program that is right for them. Many can get their medications free or nearly free.Financial assistance is available for any resident of the State of Maine indicating the inability to pay a medically necessary bill. The Hospital will evaluate a patient's ability to pay, their available insurance and health coverage, and their financial status when determining if a patient if eligible for free care or financial assistance. The evaluation process may require a patient to provide verification of their income.Lastly, The Notice of York Hospitals Financial Assistance Policy shall be distributed by means of posting notices in prominent, well-traveled patient locations while also being placed in the information section of patient statements. The Financial Assistance Policy will also be made readily available on the York Hospital website and on brochures in common patient locations. These notices will be posted in the language most commonly spoken by the surrounding community. Part VI, Line 4: York Hospital's primary service area includes the following communities in Southern York County Maine: Berwick, Eliot, Kittery, North Berwick, Ogunquit, South Berwick, Wells, Sanford, and York. Additionally, the Hospital's secondary service area includes the following communities: Lebanon and Kennebunk, Maine, and Portsmouth and Newington, New Hampshire.Approximately 7.39% of York Hospital patients utilize Medicaid and approximately 51.61% of York Hospital patients utilize Medicare. According to the United States Census Bureau, as of the July 1, 2022 census data, 8.3% of York County Residents lived in poverty (http://www.census.gov/).The 2021-2024 CHNA reports that the Hospital's immediate service area of ten towns had a population of approximately 90,000 people. York County continues to be one of the healthiest parts of Maine. Across economic measures, York County ranks more positively than the Maine state-average on median household income, unemployment, and poverty.According to the United States Census Bureau, the overwhelming majority of the County's population is white (white alone)(94.9%), with Hispanic (2.2%), Asian (1.5%), or two or more races (1.9%) making up the difference.Despite the County's relative economic success and good-health, the region still struggles with health and social issues that are somewhat more hidden in the County's small towns. The Hospital's priority communities see affordable housing and food security as two priorities to improve to make the communities healthier. An aging population and more families living together due to economics and behavioral health issues are factors in some of Hospital's challenges to providing care. Part VI, Line 5: York Hospital is a not-for-profit 79 bed hospital that has been serving the needs of our community, patients and visitors for over 110 years. The Hospital maintains a dual purpose to provide high quality health care services to care for all, and to improve the health of those living in our expanding service area community. Medical services are offered at the Hospital's main campus in York and at satellite locations throughout the Hospital's service area in Southern York County. York Hospital's service area covers an approximately 250 square mile area, with a combined population of approximately 90,000 residents. The Hospital's Board of Trustees is made up of members from all communities served by York Hospital. All medical staff are eligible to participate with the Board if they meet privileging criteria. All hospital profits are reinvested in the facilities, equipment and services for the communities.York Hospital is committed to providing care for all, including the under- and uninsured within the Hospital's community. York Hospital has been an integral part of the quality of life in southern Maine for over a century. The Hospital's devotion to its values, and its responsiveness to the community it serves, truly sets it apart and is what makes the Hospital one of the most respected and successful organizations in Maine. York Hospital's success in meeting the needs of the community is based on one simple tenet: provide patients and their families with the highest quality, most accessible, sensitive and compassionate medical care. York Hospital responds to community needs for clinically excellent healthcare, close to home, by partnering with tertiary care hospitals in Boston and Portland. To provide patients with easy access to care, York Hospital has community outpatient medical facilities in Berwick, Kittery, Sanford, South Berwick, Wells and York. In addition to providing needed medical/healthcare services, the hospital supports its communities in many meaningful ways such as the York Hospital Transportation Services. The York Hospital Transportation Services provides help patients get to and from medical appointments or to deliver prescription medications to their homes. Volunteer drivers deliver meals to residents and families who lacked access to fresh, nutritious meals due to illness, injury or other physical barriers.The Hospital collaborates with many local social service agencies to design and deliver year-round programs to meet the basic needs of our community in support of stronger physical, emotional, spiritual, and financial health. York Hospital continues a long history of listening to the communities it serves in order to help improve the health of those living in Southern York County Maine. Part VI, Line 6: Not Applicable Schedule H, Part V, Section D: Non-Hospital Facility Services Offered:1. York Hospital in Wells: ER, Walk-In Clinic, Lab, Imaging, Breast Care, Wound Care, Physical Therapy, Oncology, OB/GYN practice, Pediatric Associates, Primary Care.2. York Hospital @ Long Sands: Family Practice, Physical Therapy, Oncology, Home Care, Cardiac Rehab, Cardiovascular Care.3. York Hospital in Kittery: Family Practice, Walk-In Clinic, Lab, Imaging, OB/GYN Practice.4. York Hospital in South Berwick: Family Practice, Lab, Physical Therapy, OB/GYN Practice.5. York Hospital Neurology Associates: Neurology6. York Hospital in Berwick: Walk-In Clinic, Imaging, Lab.7. York Hospital Kittery Medical Services: Oncology, Physical Therapy.8. York Hospital @ Route 1 York: Walk-In Clinic, Lab, Imaging, Pediatric Rehab.9. York Hospital @ 12 Hospital Drive: Internal Medicine, Cardiovascular, Urology, Diabetes, Endocrinology. 10. Psychiatric Associates of York Hospital: Psychiatric Care.11. York Hospital in Sanford: Walk-In Clinic, Lab, Imaging, Family Practice.12. Cardiovascular Care in Newington: Cardiovascular Care.14. York Hospital at 16 Hospital Drive: Surgery Associates, Pediatric Associates, Pulmonary Associates, OB/GYN Practice, Rheumatology Associates. 15. Webhannett Internal Medicine: Internal Medicine. 1 Health Stream Online Learning Library 1000 58892 Continuing Education/Seminars and Workshops 15 8921 New Graduate Nursing Orientation 9 298834 Employee Assistance Program 33 34403 Part I, Line 2: The scholarship funds are monitored by the Education Committee, which manages the funds in accordance with the donor's wishes. The committee does this by determining what the spending policy is at the beginning of the year by fund category. Some funds are restricted to nursing education, others to non-nursing education. The funds can be used for those who want to attend workshops or seminars or to further their education through a post-secondary accredited school. Funds are also used for orientation programs. Requests for funding must be made through a formal process. Each person requesting funds must prepare an application which must be approved by a director or leader. The form is then submitted to the Education Committee for review and approval. All amounts are also tracked and reviewed in accounting to ensure that the monies are used in accordance with the donor's wishes. Annually, staff from the Community Relations Department reports fund activity directly to donors that request it. Lastly, the Hospital operated an Employee Assistance Program during the year. The Employee Assistance Program provides employees and their dependents no-cost short-term confidential counseling services on personal issues, and referrals to local providers, financial resources, tools and legal resources, consultants, and other care referrals. 1 X X X X 1 1 0 0 0 0 0 1 0 Peter Dourdoufis MD Cardiologist 444085 0 323733 0 4235 0 13500 0 38240 0 823793 0 0 0 Jeffrey Colness MD Cardiologist 465411 0 306437 0 4235 0 11607 0 14723 0 802413 0 0 0 Daneille Leighton Radilogist 513673 0 114926 0 4462 0 6113 0 35390 0 674564 0 0 0 Patrick A Taylor MD CEO/President 526762 0 39750 0 9159 0 53000 0 13373 0 642044 0 0 0 Alex Gold Cardiologist 401413 0 158067 0 3681 0 5125 0 40720 0 609006 0 0 0 Richard Gray Radilogist 453020 0 95225 0 4185 0 13500 0 35390 0 601320 0 0 0 Marilyn McLaughlin MD Trustee/Oncologist 400401 0 0 0 3672 0 9592 0 58924 0 472589 0 0 0 Robin LaBonte CFO/Leader 350785 0 0 0 5260 0 12164 0 56677 0 424886 0 0 0 Frank Green DO Trustee/Physician 356824 0 0 0 2921 0 8059 0 34362 0 402166 0 0 0 Jennifer Cutts MD CMO/Trustee/Radiologist (end 6/2022) 260216 0 19519 0 2703 0 9032 0 16928 0 308398 0 0 0 Erich Fogg PA-C Trustee/Physician Assistant 243460 0 0 0 2308 0 7098 0 33405 0 286271 0 0 0 Jud Knox Former CEO/President 0 0 0 0 236500 0 0 0 0 0 236500 0 0 0 Part I, Lines 4a-b Schedule J, Part I, Line 4a, Severance Payments: Jud Knox served as the Hospital's President from November 1992 until March 2020. Per Mr. Knox's separation agreement, he is to receive severance payments over a five-year period beginning in 2020. Accordingly, Mr. Knox received severance compensation of $142,500 in 2022 pursuant to this separation agreement. These payments have been reported for Mr. Knox on this Form 990, Schedule J, Part II, Column B(iii). Additionally, in accordance with the IRS instructions, Mr. Knox has been listed on this Form 990, Part VII, as a former officer as he did not serve as an officer during the period covered by this return. Schedule J, Part I, Line 4b, Non-Qualified Retirement Plans: Patrick A. Taylor, MD became the President and CEO of the Hospital in 2021, at which time he entered a Supplemental Executive Retirement Plan with the Hospital that was intended to comply with the requirements of Section 457(f) of the Internal Revenue Code. The Plan is intended to be an unfunded plan maintained primarily for the purpose of providing deferred compensation to a select group of management. During the 2022 tax year, Patrick Taylor received tax-deferred contributions of $32,500 under the 457(f) Plan. This amount is included in his deferred income as reported on this Form 990, Schedule J, Part II, Column C. Part I, Line 7 The Hospital may provide performance-based variable compensation as is deemed approrpiate relative to performance metrics and goals. Such variable compensation is subject to review on an annual basis. A MHHEFA 010314384 560427JA5 2010-06-24 113477369 Refinance 1993, 1998, 1999A & 2001D 0 0 0 B MHHEFA 010314384 56042RLG5 2017-06-27 5004813 Refinance 2007A 0 0 0 C MHHEFA 010314384 56042RTR3 2019-07-31 54640000 Refinance 2008C, 2008D, 2009A, 2010A, and 2017A bonds 0 0 0 D MHHEFA 010314384 56042RUP5 2019-11-06 36415000 Imaging and surgical equipment; compounding and cath lab renovation 0 0 0 A 2759250 6081252 607056 5418358 55838 2010 1 1 1 1 B 1500000 5908558 483431 5360081 65045 2017 1 1 1 1 C 940750 3119187 542055 2542023 35110 2019 1 1 1 1 D 335000 4338016 291650 55176 3991190 2022 0 0 0 1 A 0 0 0 0 0.00000 0.00000 0.00000 0 0 0 B 0 0 0 0 0.00000 0.00000 0.00000 0 0 0 C 0 0 0 0 0.00000 0.00000 0.00000 0 0 0 D 0 0 0 0 0.00000 0.00000 0.00000 0 0 0 A 0 1 0 0 0 0 0 0 0 B 0 1 0 0 0 0 0 0 0 C 0 1 0 0 0 0 0 0 0 D 0 1 0 0 0 0 0 0 0 A 0 B 0 C 0 D 0 Form 990, Schedule K, Part III, Line 9, IV, Line 7, and Part V: Although formal, written policies are not in place to ensure that violations are timely identified and corrected, the bonds issuer, Maine Health & Higher Educational Facilities Authority (MHHEFA), monitors Section 148 requirements for York Hospital until funds are spent down enough to ensure none of the Hospital's tax exempt bonds become arbitrage bonds. Bond proceeds are placed in low yield investments and no funds are released to York Hospital until expenses have been incurred and receipts are provided to MHHEFA. Furthermore, the Hospital works closely with MHHEFA to ensure that safeguards are in place to take appropriate and timely remedial action should any violations of federal tax requirements occur. X 2 55994 Gift Date FMV 0 1 1 Part I, Line 32b: The Organization uses qualified investment and brokerage services to process and dispose of gifts of non-cash financial assets as applicable. Potential donors interested in contributing financial securities to the Organization are provided the Organization's investment advisor contact information to faciliate the donation. Form 990, Part VI, Section A, line 4 During the tax year covered by this Form 990, the Hospital made effective the following changes and amendments to its bylaws: 1. The Chief Financial Officer is now required to be a member of the Finance Committee. 2. Initial appointments to the Medical Staff shall now be for no more than 24 months. 3. Hospital administration and/or the medical staff president may ask a prospective medical staff applicant to complete a pre-application when the applicant is unknown to the Hospital and/or its staff. Prior to this amendment, the pre-application interview was a mandatory procedure prior to the issuance of any application form to a prospective physician. Form 990, Part VI, Section B, line 11b The Hospital's Form 990 is prepared with the assistance of an independent public accounting firm and thoroughly reviewed by the Hospital's finance staff before it is filed. The 990 is distributed to the Board of Trustees for their review and approval prior to the tax return's filing with the IRS. Form 990, Part VI, Section B, line 12c Annually the Board of Trustees and the officers sign a conflict of interest form. Form 990, Part VI, Section B, line 15 The executive committee of the Board of Trustees utilizes an outside firm's database of CEO salaries to determine the CEO's compensation. The CEO determines the compensation of other officers or key employees using an outside firm's data to make sure the compensation is market based. Form 990, Part VI, Section C, line 19 The Hospital's governing documents, conflict of interest policy, and financial statements are available upon request. Form 990, Part VI, Section A, Line 16b: While York Hospital does not have a formal joint venture policy that is written, it does have procedures in place to ensure that hospital-related assets are not misappropriated which includes periodic review of any joint venture related activity. Furthermore, the Hospital's joint venture arrangements better enable it to provide health-care related services to the community it serves. Form 990, Part IX, line 11g Contracted labor costs: Program service expenses 24,107,499. Management and general expenses 2,480,972. Fundraising expenses 62,213. Total expenses 26,650,684. Form 990, Part XI, line 9: Adjustment to long-term pension obligations 5,700,277. Net periodic pension cost -671,381. Form 990, Part XII, Line 2c: The audit process has not changed from the prior year. York Health Services 15 Hospital Drive York ME 03909 020469065 Heart health ME 501(c)(3) Line 10 N/A 0 Shields Imaging at York Hospital 700 Congress Street Suite 204 Quincy MA 02169 815066570 Imaging ME York Hospital Related 145610 90864 0 1 0.50000 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 Shields Imaging at York Hospital LLC S 125000 Actual per books