2022-11-14T07:23:34-06:00 2021-12-31 010523282 Berry Dunn McNeil & Parker LLC 2211 Congress St Portland ME 04102 990 2021-03-03 862728785 Calais Community Hospital CALA 2074547521 24 Hospital Lane Calais ME 04619 Lynnette Parr CFO 2074547521 2022-11-11 1 Lynnette Parr 999009999 Joseph R Byrne P01289281 2077752387 2022-11-11 0 AAL1 IAL1 2021 2022-09-23 18:48:47Z X Steven Lail 24 Hospital Lane Calais ME 04619 11332836 0 X www.calaishospital.org X 2021 ME Critical Access Hospital 16 13 201 21 0 0 509612 10821581 1643 0 11332836 0 0 5543339 0 0 5153561 10696900 635936 13954869 11209454 2745415 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 217801 1608785 Emergency Services - Total visits July to Dec 2021 = 4,012 120682 1529742 Laboratory services- performed 37,070 laboratory tests to inpatients and outpatients from July-December 2021 118259 3187656 Imaging Services to inpatients and outpatients. 5,378 radiological exams were provided to inpatients and outpatients from July to December 2021. 8169315 4495668 Various other medical services supplied to patients. 8169315 4495668 8626057 1 1 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 1 0 0 0 0 0 0 0 0 1 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 31 0 1 201 1 0 0 0 0 0 0 0 0 0 0 0 0 X 16 13 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 0 0 ME X Lynnette Parr 2072550269 24 Hospital Lane Calais ME 04619 X Kathryn Land Chair 1.25 1.75 X X 0 0 0 Lisa Carlisle Vice Chair 1.25 1.75 X X 0 0 0 Michael Hennessey Treasurer 1.25 1.75 X X 0 0 0 Nate Martel Secretary 1.25 1.75 X X 0 0 0 Betty Marshall Trustee 1.25 1.75 X 0 0 0 Christian Inegbenijie MD Trustee 1.25 38.75 X 0 406310 31067 Corey Schwinn Trustee 1.25 1.75 X 0 0 0 Gwendolyn Jones Trustee 1.25 1.75 X 0 0 0 Ian Pratt Trustee 1.25 1.75 X 0 0 0 Jacqueline O'Clair Trustee 1.25 1.75 X 0 0 0 Jack Corrigan Trustee 1.25 1.75 X 0 0 0 Judd Bragg Trustee 1.25 1.75 X 0 0 0 Karen Eldridge Trustee 1.25 1.75 X 0 0 0 Rita Ten MD Trustee 1.25 38.75 X 0 514986 36797 Rose St Louis Trustee 1.25 1.75 X 0 0 0 Eric Burke MD Past Trustee 1.25 1.75 X 0 0 0 Wayne Peters Past Trustee 1.25 1.75 X 0 0 0 Steven Lail CEO 1.25 38.75 X X 0 350299 24787 Lynnette Parr CFO 1.25 38.75 X 0 251902 27393 Peter Wilkinson DO Physician 40.00 0.00 X 170772 0 88 Luis Santiagoo-Rosado Physician 40.00 0.00 X 159008 0 5657 Nima Moghaddas DPM Physician 40.00 0.00 X 117941 0 6607 Elizabeth Eliacin MD Physician 40.00 0.00 X 117519 0 5028 565240 1523497 137424 4 0 1 0 Emcare Physician Services 7032 Collection Center Drive Chicago IL 60693 Physician Services 511252 Medefis Consolidated PO Box 5068 New York NY 100875068 Locum Staffing Services 426171 Cody Davis DO LLC 7322 Manatee Ave West 220 Bradenton FL 34209 Physician Services 218400 Evident PO Box 11407 Birmingham AL 35246 EMR Software & Support 217745 Weatherby Locums Inc 3400 Red Lion Rd Philadelphia PA 19114 Physician Locum Staffing 104894 6 506785 2827 509612 Patient Services 622100 18312402 18312402 Other Revenue 622100 358847 355230 3617 Contractual/Char. Adj. 622100 -7849668 -7849668 10821581 1643 1643 11332836 10817964 0 5260 X 4606497 3799984 806513 598633 490888 107745 338209 277331 60878 16832 16832 2783079 2282847 500232 355 355 22149 8974 13175 676937 431496 245441 198 148 50 31075 31075 127658 127658 260747 229873 30874 Supplies 599512 585136 14376 Miscellaneous Expense 328092 53720 274372 Service Provider Tax 306927 306927 10696900 8626057 2070843 0 X 658166 5614190 1669576 366124 166856 5607615 127658 0 5479957 0 13954869 2439147 7537527 0 1232780 0 11209454 X 2745415 0 2745415 0 13954869 X 635936 2109479 X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 205517 205517 4194483 98242 4096241 1191115 29416 1161699 16500 16500 5479957 Estimated Third-Party Payor Settlements 62687 CARES Act Funding 1170093 1232780 1 1 1 X 1 X 1 1 0 1 1 5010 5010 0.00050 2469081 2137858 331223 0.03100 3378730 3370890 7840 0.00070 5852821 5508748 344073 0.03220 4598 4598 0.00040 36467 36467 0.00340 324794 324794 0.03040 365859 365859 0.03420 6218680 5508748 709932 0.06640 1 0 0 3370890 3378727 -7837 X 1 1 1 1 Calais Community Hospital 24 Hospital Lane Calais ME 04619 www.calaishospital.org 39454 X X X X Calais Community Hospital 1 0 1 1 X X X X X X X X X 19 1 1 1 1 X calaishospital.org/community-health-needs-assessment/ X http://www.mainechna.org X 1 19 1 calaishospital.org/community-health-needs-assessment/ 0 1 X 150.000000000000 200.000000000000 X 1 1 X X X 1 X calaishospital.org/financial-assistance/ X calaishospital.org/financial-assistance/ X calaishospital.org/financial-assistance/ X X X X X X 1 X 0 X X X X 1 X 0 0 Calais Community Hospital Part V, Section B, Line 2: On February 19, 2021, Down East Community Hospital (DECH) filed a motion with the United States Bankruptcy Court District of Maine, together with the creditors' committee, to allow DECH to purchase substantially all of the assets of Calais Regional Hospital (CRH) a not-for-profit acute care hospital in Calais, Maine. A formal plan was filed on February 24, 2021 and at a hearing on March 24, 2021, the plan was approved. The purpose of the acquisition is to maintain and improve access to quality health care services in Washington County. A Plan Officer was appointed and authorized to take all actions necessary to implement the approved plan. In anticipation of the purchase, DECH formed Calais Community Hospital (CCH), a wholly owned subsidiary, to hold the purchased assets. On March 25, 2021, DECH took over management at CRH. Calais Community Hospital began services effective July 1, 2021. Closing of the transaction was subject to various approvals, including the receipt of an approved Emergency Certificate of Need from the State of Maine Department of Health and Human Services. The closing occurred on June 30, 2021. Calais Community Hospital Part V, Section B, Line 5: The 2019 Maine Shared Community Health Needs Assessment was born out of a unique public-private partnership. The partnership began as the OneMaine Health Collaborative in 2007, involving Northern Light Health (formerly Eastern Maine Healthcare Systems), MaineGeneral Health, and MaineHealth. After conversations with the Statewide Coordinating Council for Public Health, the Maine Center for Disease Control and Prevention, an office of the Department of Health and Human Services joined in 2012. In 2013, Central Maine Healthcare joined the group and in 2014 a charter was drafted by all five partners to guide a statewide assessment process. The shared CHNA includes a large set of statistics on health status and risk factors from existing surveillance and health data sets.This 2019 CHNA includes input from a broad set of stakeholders from across the state as facilitated by the Steering Committee, Metrics Committee & Community Engagement Committee. Community outreach and engagement for the Maine Shared CHNA included coordination at the statewide, public health district & county level. In addition to the state-level Community Engagement Committee, a local community engagement planning committee for Washington County planned and implemented the logistics of community forums within the county. The committee was compromised of hospitals, public health district liaisons and a variety of additional partners. Calais Community Hospital Part V, Section B, Line 6a: The Hospital participated in the statewide community health needs assessment along with the following Maine hospitals: Northern Light Health Member Organizations: Acadia Hospital; Blue Hill Memorial Hospital; Charles A Dean Memorial Hospital; Eastern Maine Medical Center, Inland Hospital, Mercy Hospital; Sebasticook Valley Hospital, Maine Coast Hospital, AR Gould Hospital; Maine Health Affiliated: Southern Maine Healthcare, Maine Medical Center, Spring Harbor, Stephens Memorial Hospital, Franklin Memorial Hospital, Lincoln Health, Waldo County General Hospital, Pen Bay Medical Center; CMHC Affiliated: Bridgton Hospital, Central Maine Medical Center, Rumford Hospital; York Hospital; NE Rehabilitation; St. Mary's Regional Medical Center; Mid Coast Hospital; Maine General Health; Reddington-Fairview General Hospital; Millinocket Regional Hospital; Penobscot Valley Hospital; St. Joseph Hospital; Mayo Regional Hospital; Calais Regional Hospital; Mt. Desert Island Hospital; Cary Medical Center; Houlton Regional Hospital and Northern Maine Medical CenterThe Maine Shared Health Needs Assessment and Planning Process (SHNAPP) Project is a collaborative effort among Maine's four largest healthcare systems - Central Maine HealthCare, Northern Light Health, Maine General Health, and Maine Health - as well as the Maine Center for Disease Control and Prevention (Maine CDC), an office of the Maine Department of Health and Human Services (Maine DHHS). CCH's Parent company was an active participant representing Washington County. CCH is an active participant in current planning. Calais Community Hospital Part V, Section B, Line 6b: The Hospital's CHNA was conducted with the following community non-hospital organizations:Aroostook Mental Health Center; Calais Regional Medical Services; City of Calais; City of Eastport; Community Health & Counseling Services; County of Washington; Downeast Hospice; Downeast Public Health District; Eastern Area Agency on Aging; Eastern Maine Development Corp.; Eastport Healthcare; Healthways Regional Medical Center Lubec; Healthy Acadia; I Care; Maine CDC; Public Health Nursing; Maine Seacoast Mission; Maine State Legislature; Maine Veterans Homes; Marshall Healthcare Facility; National Alliance of Mental Illness (NAMI); Next Step Domestic Violence Project; Northern Light Health; Office of Aging & Disability Services, DHHS; St. Croix Regional Family Health Center; Sunrise County Economic Council; Sunrise Opportunities; Sunrise Senior College; The Quoddy Tides; Town of Baileyville, Town of Machias; United Way of Eastern Maine, Washington County Emergency Management. Calais Community Hospital Part V, Section B, Line 11: CCH addressed the needs of the most recent CHNA by preparing and adopting an implementation strategy. CCH plans to address all priorities identified through the management and budget of community benefit activities. In addition, CCH also takes advantage of partnering with other community plans by participating, supporting or promoting programs which support community health needs. No needs are not addressed. CCH's detailed implementation strategy can be found on the hospital website. 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 III, Line 4: See Pages 13-14 of the attached audited financial statements for footnote disclosure. In 2019, the Hospital adopted FASB ASU No. 2014-09, Revenue from Contracts with Customers (Topic 606), and related guidance, which supersedes accounting standards that previously existed under GAAP and provides a single revenue model to address revenue recognition to be applied by all companies. Under the new standard, companies recognize revenue when a customer obtains control of promised goods or services in an amount that reflects the consideration to which the company expects to be entitled in exchange for those goods and services. As a result of the adoption, the Hospital is recording $0 of bad debt expense for 2021. In 2021, $575,672 was estimated to be uncollectible from patients at the time services were rendered utilizing the adopted method of revenue recognition. Part III, Line 8: The Organization used the Hospital's as-filed cost reports to obtain Medicare and Medicaid costs and expected reimbursement. Part III, Line 9b: The financial assistance policy that is referred to in the billing & collection policy states that based on the financial assistance level approved, an eligible individual will not be billed for services or any amount not paid by an insurer or medical assistance program if the person has been qualified for financial assistance. Part VI, Line 2: See Schedule H, Part V, Section C. Part VI, Line 3: CCH has a financial assistance policy that outlines all the discounted cost opportunities that the Hospital has to offer. The complete financial assistance policy, plain language summary, and free care application is located on the Hospital's website at www.calaishospital.org. Copies of the plain language summary is also posted in all main waiting areas of the facility and satellite locations and full copies of the policy can be obtained per request and without charge. Annually, CCH also advertises its plain language summary in local media outlets. Each patient is given the Hospital's financial assistance policy plain language summary prior to the commencement of each date of service. The summary and contact information to obtain a free care application is also listed on the patient's bill. At every opportunity, the Hospital's billing specialists and financial counselors will communicate our policies to patients after billing and encourage patients to apply for financial assistance. During discussions, if patients are identified to be eligible for other governmental insurances, CCH will assist the patient with the application process if requested by the patient. Part VI, Line 4: Demographics:Washington County is one of two counties in the Downeast Public Health District. The population of Washington County is 31,925 and 21.9% of the population is 65 years of age or older. The population is predominantly white (91.4%); 1.8% are Hispanic, and 2.6% are two or more races. The median household income is $39,469, over $10,000 less than the state average. The high school graduation rate (87.7%) is higher than the state overall, while the percent of the population with an associates' degree or higher (29.1%) is lower.Quantitative Evidence:In Washington County:The percentage of the population that was uninsured was higher than the state overall (12.7% vs. 9.5%) in 2012-2016.The percentage of the population who reported an inability to access healthcare due to cost was higher than the state overall (12.1% vs. 10.3%) from 2014-2016.The percentage of the population with a usual primary care provider was significantly lower than the state overall (81.6% vs. 87.6%) in 2014-2016.The percentage of the population with a primary care visit to any provider in the past year was significantly lower than the state overall (65.8% vs. 71.8%) in 2014-2016. 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. 0 0 0 0 0 0 0 1 1 1 Rita Ten MD Trustee 0 514361 0 625 0 0 0 14500 0 22297 0 551783 0 0 Christian Inegbenijie MD Trustee 0 405685 0 625 0 0 0 14500 0 16567 0 437377 0 0 Steven Lail CEO 0 315657 0 25625 0 9017 0 11600 0 13187 0 375086 0 0 Lynnette Parr CFO 0 241953 0 5625 0 4324 0 15273 0 12120 0 279295 0 0 Peter Wilkinson DO Physician 155879 0 14893 0 0 0 0 0 88 0 170860 0 0 0 Luis Santiagoo-Rosado Physician 67133 0 91875 0 0 0 0 0 5657 0 164665 0 0 0 Part I, Line 3 The Organization's CEO is compensated by Down East Community Hospital, a related organization. The Hospital uses the following to establish the compensation for the CEO: 1. Compensation committee 2. Written employment contract 3. Compensation survey or study 4. Approval by the board or compensation committee Part I, Line 7 Peter Wilkinson & Nima Moghaddas, physicians, received WRVU based incentive bonuses and a retention bonus during 2021. The Organization also paid bonuses to all full-time employees during 2021. Part I, Line 8 Luis Santiago-Rosado, general surgeon, received a sign on bonus during 2021. Form 990, Part VI, Section A, line 6 The sole Member of the Organization is Down East Community Hospital. Form 990, Part VI, Section A, line 7a Down East Community Hospital, the sole member of the Organization, has the sole power to appoint and remove Trustees serving on the Board of Trustees of the Organization. Form 990, Part VI, Section A, line 7b Down East Community Hospital, the sole member of the Organization, has the sole power to take any necessary actions related to the following: 1. Adopting and implementing a system-wide strategic plan for this Corporation and its affiliates, as well as preparing any annual or other reports required to update that plan; 2. Ensuring the financial viability of this Corporation; 3. Overseeing the development of a continuum of integrated health care services; 4. Approving plans with respect to the development of any new programs and/or consolidation of existing programs; 5. Approving plans for clinical initiatives that involve any capital expenditure or the development of any new facility; 6. Amending the Articles of Incorporation or Bylaws of this Corporation; 7. Employing a Chief Executive Officer; 8. Appointing and removing Trustees serving on the Board of Trustees of this Corporation; 9. Approving the operational structure of this Corporation; and 10. Approving the sale of all or substantially all of the assets of this Corporation. The following actions, when taken by the Board of Trustees of this Corporation, shall require the approval of the Member, and any such action shall not be effective until such approval is granted: 1. Adoption of annual operating and capital budgets, or substantial changes thereto, including but not limited to the addition of new health services; 2. Unbudgeted debt instruments, notes, guarantees, mortgages, or pledges in excess of such limits as the Member shall specify from time to time; 3. Authorization or material amendment of contracts for the sale, lease, exchange, or other disposition or acquisition or divestiture of real property or other substantial corporate assets in excess of such amounts as the Member shall specify from time to time; 4. The filing of any petition for voluntary dissolution; 5. The filing of any petition for voluntary bankruptcy; 6. Affiliation, consolidation, or merger with, or acquisition of, any other organization; 7. Establishment, termination, or relocation of any major clinical service; and 8. Selection of any outside auditor or legal counsel. Form 990, Part VI, Section B, line 11b 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. All new employees sign a conflict of interest statement at the time of hire. Form 990, Part VI, Section B, line 15a The Organization has a CEO Search & Compensation committee to recruit and hire the CEO. This committee is responsible for organizing a search, interviewing prospective candidates & evaluating compensation. Committee meetings are documented with minutes. The CEO for the Organization is determined by a vote of the full Board of Trustees and the existence of a legal contract. Form 990, Part VI, Section C, line 19 The financial statements and annual report are made available to the public upon request. The annual report is also available on the hospital website. The Organization's governing documents and conflict of interest policy are not made available to the public. Form 990, Part VII: The compensation reported on Part VII and Schedule J, Part II of the 990 for the Highest Compensated Employees represents July - Decmeber of 2021. This is the total compensation paid to these employees by Calais Community Hospital, after the sale of the Hospital was completed on June 30th, 2021. The Directors and Officers listed on Part VII of the 990 were compensated by Down East Community Hospital, a related organization. The compensation reported for these officers and directors on Part VII and Schedule J, Part II of the 990 represents all of Calendar Year 2021. Form 990, Part IX, line 11g Purchased Services: Program service expenses 479,398. Management and general expenses 500,232. Fundraising expenses 0. Total expenses 979,630. Temporary Personnel: Program service expenses 677,113. Management and general expenses 0. Fundraising expenses 0. Total expenses 677,113. Physician Fees: Program service expenses 1,126,336. Management and general expenses 0. Fundraising expenses 0. Total expenses 1,126,336. Form 990, Part X, Line 10: Land, Buildings, and Equipment Section 1.263(a)-3(n) Election: Calais Community Hospital 24 Hospital Lane Calais, ME 04619 EIN: 86-2728785 Calais Community Hospital is electing to capitalize repair and maintenance costs under Regulation Section 1.263(a)-3(n). Form 990, Part XI, line 9: Net Assets acquired in Purchase of Calais Regional Hospital 2,109,479. Sunrise Healthcare 11 Hospital Drive Machias ME 04645 222582949 Community Healthcare ME 501(c)(3) Line 7 Down East Community Hospital 0 Down East Community Hospital 11 Hospital Drive Machias ME 04645 010263198 Hospital ME 501(c)(3) Line 3 N/A 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 1 1 0 0 0