2019-11-12T14:30:32-06:00 2019-01-01 990 2018-10-01 010524834 MAINE BEHAVIORAL HEALTHCARE MAIN 2078427700 78 ATLANTIC PLACE SOUTH PORTLAND ME 04106 William Chrisemer CFO 2078427700 2019-11-06 63.247.60.254 2019-11-12 15:28:06 ES P 829AE4A393A3EE33A28B50D291306587A51708D5 829AE4A393A3EE33A28B50D291306587A51708D5 2018 2020-03-31 21:24:44Z X Stephen Merz 78 Atlantic Place South Portland ME 04092 22937669 0 X mainehealth.org/maine-behavioral-healthcare X 1999 ME Maine Behavioral Healthcare provides a seamless and compassionate continuum of care through a community of providers collaborating to promote recovery and the overall mental and physical well-being of those we are privileged to serve. X 18 16 0 68 0 12082 4577206 604571 87045873 21716591 784808 82805 1224424 363709 93632311 22767676 0 0 0 0 68689518 17689119 0 0 89204 22016914 5286395 90706432 22975514 2925879 -207838 56680377 0 35519109 0 21161268 0 X See Schedule O 0 0 8575711 10892599 Spring Harbor HospitalLocated in Westbrook, Maine, Spring Harbor Hospital is southern Maine's only nonprofit, private psychiatric hospital providing comprehensive inpatient services for individuals who experience acute mental illness or dual disorders issues. Our facility, licensed for 100 beds, is set on 50 private acres in greater Portland and offers children, adolescents, and adults a comfortable and pleasant environment for psychiatric treatment. We provide 24-hour information and referral, voluntary and involuntary hospitalization and comprehensive discharge planning. (Continued at Schedule O)(Continued from Part III, Line 4a)As part of the Maine Healthcare system (EIN:01-0431680), and a division of Maine Behavioral Healthcare, Spring Harbor is clinically integrated with mental health providers, hospitals and primary care sites to ensure easy and timely access to treatment and safe and effective transitions between services. Through a unique collaboration with MaineHealth (EIN:01-0238552), Spring Harbor is able to offer the most complete array of psychiatric treatment, physician- training, and medical-research programs north of Boston. Inpatient ServicesOur inpatient programs for children, adolescents, adults, and older adults provide hope for those who suffer from a variety of mental illnesses or co-occurring disorders. Many of our hospital patients experience serious depression and/or anxiety and may exhibit suicidal tendencies or aggression toward peers, family members, coworkers, or school personnel. That is why our services are provided on secure treatment units by multidisciplinary treatment teams who specialize in psychiatric and co-occurring disorders. Developmental Disorders Program produces the highest quality treatment outcomes through a combination of expert programming, specially trained caregivers, and the individual potential of each patient. The Developmental Disorders Program is the only hospital program in Maine where children with a developmental disorder, such as autism or mental retardation, can receive intensive treatment for aggression, self-injury, impairment in functioning, and mental health challenges. Children in the program receive educational services from Spring Harbor Academy, a private, special-purpose school located at the hospital. Each student receives developmentally appropriate educational programming. The child's current Individual Education Plan (IEP) is followed, and ongoing educational needs are assessed through the IEP team process. Spring Harbor Academy also works with the child's home school to ensure the student's successful transition after leaving the hospital. 1576924 958943 Outpatient Mental Health and Substance Abuse TherapyOur outpatient counseling services provide individuals, couples and families struggling with a wide variety of personal and family issues with high-quality, innovative therapeutic treatment by licensed clinicians. We also provide specialized treatment for those with co-occurring mental health and substance abuse issues. Our therapists, in collaboration with case managers, physicians and nurse practitioners, have helped thousands of people recover from mild, short-term emotional and psychological difficulties, as well as to successfully manage severe and chronic mental illness. (Continued at Schedule O)(Continued from Part III, Line 4b)Maine Behavioral Healthcare provides a full range of substance abuse treatment services for adults, adolescents and families. Our licensed professionals focus on helping people examine their relationships with alcohol and drugs and develop healthy, fulfilling lives. 1577391 984714 PsychiatryMaine Behavioral Healthcare is the leading provider of psychiatric care in Maine. Our comprehensive system of care reaches across the state at convenient community treatment centers, at Spring Harbor Hospital, and at our partner hospitals: Maine Medical Center Department of Psychiatry, Southern Maine Health Care Behavioral Health Services and at Pen Bay Medical Center's PARC Unit. Trained, board-certified physicians and nurse practitioners, provide assessments, medication management, and treatment for both children, adolescents and adults. (Continued at Schedule O)(Continued from Part III, Line 4c) Our psychiatry professionals work collaboratively with counselors and case managers to provide coordinated care through such areas as child psychiatry, depression counseling, and geriatric psychiatry, as well as a variety of other mental health services. 8346990 9229624 In addition to our three largest programs, Maine Behavioral Healthcare offers many other programs to provide a full spectrum of care. Here is a brief description of some of these important services: Case Management ServicesCase management for adults, also called Community Integration, is a MaineCare funded support service designed to improve the quality of life for individuals who have behavioral health or special developmental needs. Case managers determine the person's strength and needs and then help identify and access resources and services to promote independence and integration in the community.We work with our clients to develop treatment plans that meet the goals they identify, and then develop action steps with them to assist in achieving their goals. Our full range of services are tailored to each individual's needs and include mobile outreach, client advocacy, maintenance of basic living needs, assessment of benefits, and linking and monitoring services. We can help adults thrive at home, at work and in their communities by:-Connecting with natural supports and community resources-Helping navigate the systems of behavioral and medical care-Coordinating services and streamlining communication between multiple providers-Developing and monitoring individualized service plansTargeted case management for children and adolescents (up to age 20) is a MaineCare funded service to support mental or behavioral health needs. Working closely with families, the case manager determines the child's strengths and needs and then helps identify and access resources and services in the community. The goal is to help the child or adolescent thrive in the home, school and community. Targeted Case Management is grounded in the Wraparound process, a highly individualized planning process aimed at helping people meet their unmet needs both within and outside of the formal social service system. Wraparound is a holistic process that meets needs across a wide range of life domains.Behavioral Health Homes are a MaineCare service designed to help people with chronic conditions, such as diabetes, heart disease and lung disease manage their mental and physical health needs together. This specialty service helps people address all of their health needs by collaborating with their doctor and arranging services. Case managers work with the individual, a nurse, a clinical team leader and a peer support specialist to provide a whole person integrated approach. The Behavioral Health Home team and primary care providers work together to improve health. Developmental Disorders Program for ChildrenChildren in the developmental disorders program at Spring Harbor Hospital receive educational services from Spring Harbor Academy, a private, special-purpose school located at the hospital. Each student receives developmentally appropriate educational programming. The child's current Individual Education Plan (IEP) is followed, and ongoing educational needs are assessed through the IEP team process. Spring Harbor Academy also works with the child's home school to ensure the student's successful transition after leaving the hospital. An extension of the developmental disorders program at Spring Harbor is our Center for Autism and Developmental Disorders (CADD), an outpatient clinic, offering Maine children, adolescents and their families a comprehensive, coordinated day treatment program with primary care consultation. Each child receives an assessment to identify target behaviors, mental health needs and developmental challenges. The evaluation explores psychiatric, speech, occupational, medical, family and environmental factors that may be contributing to the problems.Crisis ServicesWe serve individuals experiencing an acute behavioral health emergency, along with support for their families. These include a 24/7 Crisis Hotline, Mobile Response Services, Crisis Response Services and a Crisis Stabilization Unit, a short-term alternative to hospitalization.Assertive Community Treatment (ACT)Adult ACT is an intensive community based (outpatient) treatment program with a multi-disciplinary team of providers that supports MaineCare eligible adults who may have a major mental illness diagnosis and often co-occurring disorders. The goal of the ACT Program is to improve the client's functioning in the least restrictive setting, while strengthening family, work, school and community ties. The client has access to support 24/7 for crisis needs. The ACT Program is based on national standards and is intended to prevent psychiatric hospitalization and criminal justice involvement.ResidentialMaine Behavioral Healthcare provides a variety of residential treatment options for adults with mental illness, ranging from the least intensive community rehabilitation apartment programs to the most intensive group home setting. Research shows that community and supported living can be an important step in the recovery process. Our residences are located in York and Knox Counties and staffed by trained 24/7 residential care professionals.Outpatient ServicesOur licensed clinicians provide compassionate, high-quality care including case management, outpatient therapy, substance abuse, and a range of community and home-based treatment services for adults and families who may be experiencing life stresses, transitions, or other behavioral health issues. Clinicians work closely with our psychiatry staff and nurse practitioners to provide integrated treatment.Behavioral Health IntegrationBehavioral health is an important component of overall comprehensive care. In partnership with Maine Healthcare (EIN:01-0431680) and its hospital members, Maine Behavioral Healthcare has integrated over 40 clinicians in more than 50 primary care and specialty medical care practices, from Waldo County to York County, with the overall aim of improving the mind-body connection. 8346990 9229624 20077016 1 1 0 1 0 0 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 1 0 0 0 0 0 0 0 0 0 0 1 0 0 1 0 0 0 1 X 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 X 18 16 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 ME X William Chrisemer CFO 2076616603 78 Atlantic Place South Portland ME 04106 CHERYL LEE RUST TRUSTEE 1.00 0.00 X 0 0 0 CREIGHTON TAYLOR TRUSTEE 1.00 0.00 X 0 0 0 DAVID M RICCIO TRUSTEE 1.00 0.00 X 0 0 0 FRANK BRANCELY JR TRUSTEE 1.00 0.00 X 0 0 0 JAMES ALEXANDER TRUSTEE 1.00 0.00 X 0 0 0 JAMES GEORGITIS MD TRUSTEE 1.00 0.00 X 0 0 0 JANINE ROBERTS TRUSTEE 1.00 0.00 X 0 0 0 KAREN A EVANS TRUSTEE 1.00 0.00 X 0 0 0 KAREN E SIMONE TRUSTEE 1.00 50.00 X 0 146166 61775 KATHLEEN KILBRIDE TRUSTEE 1.00 0.00 X 0 0 0 LAWRENCE GROSS TRUSTEE 1.00 0.00 X 0 0 0 LUCY TUCKER TRUSTEE 1.00 0.00 X 0 0 0 NORTON LAMB TRUSTEE 1.00 0.00 X 0 0 0 ROBERT LEVINE TRUSTEE 1.00 0.00 X 0 0 0 WILLIAM BRENNAN MD MEDICAL STAFF PRESIDENT 50.00 0.00 X 229661 0 24616 NANCY HASENFUS MD CHAIR 1.00 0.00 X X 0 0 0 GEOFFREY GREEN VICE CHAIR 1.00 0.00 X X 0 0 0 DAVID SMITH SECRETARY 1.00 0.00 X X 0 0 0 TRACY HAWKINS TREASURER 1.00 0.00 X X 0 0 0 STEPHEN MERZ CEO 50.00 0.00 X 406073 0 20910 MICHAEL ABBATIELLO SVP OPERATIONS & FINANCE 50.00 0.00 X 222565 0 31446 MARY JANE KREBS PRESIDENT SHH 50.00 0.00 X 227532 0 32306 MATTHEW M SIEGEL MD VP MED AFFAIRS - AUTISM/DD 50.00 0.00 X 356161 0 37397 ROBERT V MCCARLEY MD VP MED AFFAIRS - INST SVCS 50.00 0.00 X 326207 0 40654 THEODORE P LOGAN MD PSYCHIATRIST 50.00 0.00 X 323583 0 33424 HAROLD AMSEL MD MEDICAL DIRECTOR 50.00 0.00 X 308502 0 28567 ANDREW G HINKENS MD PHYSICIAN 15.00 35.00 X 83188 209211 92793 2483472 355377 403888 69 0 1 0 LocumTenenscom LLC 2655 Northwinds Parkway Alpharetta GA 30009 Locum Tenens 427580 MaineHealth ACO 110 Free Street Portland ME 04101 Nurse Staffing 294117 GBM Healthcare Mgmt Resources 45 Starboard Court Pawley Island SC 29585 Consulting 250358 Vantage Point LLC 9 Washington Ave Hamden CT 06518 Accredication & License consulting 132912 Casco Bay Electric 322 Presumpscot St Portland ME 04103 Electrical contractor 120917 7 52222 300774 251575 604571 Inpatient Revenue 624100 13124545 13124545 Outpatient Revenue 621400 3788646 3788646 Contract Revenue 623000 3023927 3023927 Residential Income 611600 1280671 1280671 Spring Harbor Academy 624100 428064 428064 70738 70738 21716591 95481 95481 2466 0 2466 2466 2466 157317 169993 -12676 -12676 -12676 1744 0 1744 1744 Misc income 900099 358552 358552 Change in FV Int. Rate Swap 900099 947 947 359499 22767676 22065880 0 97225 353546 353546 13717261 13188049 464480 64732 303027 287663 13952 1412 2398818 2295772 92405 10641 916467 859968 52278 4221 3890 3890 69532 69532 3434 3434 1098925 695292 403021 612 34570 34570 335543 273850 58896 2797 856590 856590 753467 672379 81088 129407 118104 10251 1052 164597 164505 92 596714 444140 152574 108261 108242 19 Other 350463 305633 41832 2998 Hospital Tax 331982 331982 Food Services 185373 181400 3234 739 Pharmaceuticals 146147 146147 117500 117500 22975514 20077016 2809294 89204 2562649 0 2988738 0 0 5107060 0 0 0 635588 0 124090 0 252083 0 0 25841482 0 13775883 0 0 0 0 5392804 0 56680377 0 5073094 131363 15743645 150584 2258733 12161690 0 35519109 0 X 17870621 0 2613132 0 677515 0 21161268 0 56680377 0 X -207838 -297441 -20655989 X 0 0 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 3434 3434 0 Schedule C, Part II-B, Line 1 A portion of membership dues paid represents lobbying activities Lobbying portion of Maine Hospital Associaiton Dues: 1,544 Lobbying portion of American Hospital Association Dues: 1,023 Lobbying portion of Alliance for Addiction & Mental Health Services, Maine: 867 Total dues paid representing lobbying activities: 3,434 X 1 0 1.00 0 0 2733785 304786 -81042 2957529 2471475 922085 67129 726904 2733785 2147681 1085285 96640 858131 2471475 2032165 710681 53644 648809 2147681 1596380 741341 -240 305317 2032164 1 1 1 0 Part II, Line 9: In 2002 Spring Harbor Hospital acquired a 54-acre parcel of land designated as a conservation easment which was conveyed as part of a land purpose upon which the hospital was built. Due to the merger with MaineHealth (EIN: 01-0238552) on 1/1/19 the conservation easement is now the responsibility of MaineHealth and therefore Maine Behavioral Healthcare had no amounts to be reported as "Held at the End of the Tax Year." Part V, Line 4: The endowment funds are used to support programming and special initiatives at MBH. Schedule D, Part V, Line 1e As Maine Behavioral Healthcare merged into MaineHealth(EIN: 01-0238552) on 1/1/2019, at the close of the period covered by this return the endowment balance was transferred to MaineHealth. Of the amount reported on line 1e 305,562 is actual expenditures and 2,651,968 is a transfer to MaineHealth. 1 1 1 X 175.000000000000 0 1 1 0 0 1299000 1299000 0.05650 1299000 1299000 0.05650 179214 179214 0.00780 242097 242097 0.01050 91451 91451 0.00400 512762 512762 0.02230 1811762 1811762 0.07880 0 1071175 1099771 1590229 -490458 X 1 1 1 1 Spring Harbor Hospital 123 Andover Road Westbrook ME 04092 See Part V Section C 38919 X Spring Harbor Hospital 1 0 0 1 X X X X X X X X X 16 1 1 0 1 X See Part V, Section C 1 16 1 See Part V, Section C 0 1 X 175.000000000000 X X 1 1 X X X 1 X See Part V, Section C X See Part V, Section C X See Part V, Section C X X X X X 1 X 0 X X X X 1 X 0 0 Part V, Section A: Facility Information - Website Address:mainehealth.org/maine-behavioral-healthcare Spring Harbor Hospital Part V, Section B, Line 5: Community EngagementCommunity engagement using shared CHNA reports for local and regionalplanning is a critical part of the needs assessment and health improvementplanning process. For some, working with a community means engagingcommunity partners at the organizational or agency level, and for others it entails working with individual community members or working with community leaders who represent specific populations. Both types of engagement satisfy the IRS and Public Health Accreditation Board. Community feedback was used to collaboratively create 3-year implementation strategies, also called implementation plans.The process, co-led by Maine CDC District Liasons and representatives fromMaine Shared Health Needs Assessment & Planning Process (SHNAPP) not-for-profit hospitals, achieved the following:- Ensured broad interests of the local community were represented- Obtained stakeholder input on identifying significant health needs based on review of data- Solicited stakeholder feedback on prioritizing significant health needs- Identified local assets and resources that could address local health prioritesThe planning process included the District Liaison from the Maine CDC andrepresentatives from participating Maine SHNAPP hospitals in the region.The leaders reached out to community benefit leadership among other localnot-for-profit hospitals, local public health departments, and otherorganizations and community sectors whose work impacts the health of thecommunities in the district and/or county. The committees established forthis purpose or a current body may carry out the commitments. This outreach resulted in the formation of committees which reflected the populations that need to be engaged, and included individuals with diverse expertise or community roles, including representatives from the following sectors:- Public health- Community health coalitions- Healthcare providers, including oral and behavioral health care providers- Minority populations (e.g. Maine NAACP members, Latino student club, immigrant services)- Business and civic leadership (e.g. local employers, civic organizations, community leaders)- Funding agencies (e.g. local philanthropic organizations, bank and credit union services)- Local and state government non-profit organizations, including hospitals- Collegs and Universities- Low-income and/or medically underserved peopleThe SHNAPP Committee collected input as resources allowed through the bestmethods determined locally. Suggestions for obtaining feedback fromorganizations and groups included, but were not limited to:- Additional Community Forums- Key Informant Interviews: Interviews are focused conversations. They are used to learn about assumptions and perceptions in our communities about health issues, resources, and actions.- Focus Groups: Focus groups are discussions led by a trained facilitator among a small group of people. Members of the group share opinions about the topic at hand and offer suggestions.- Written or Electronic Surveys: Surveys provide a consistent and structured method for asking questions among a selected group of people. People responding to surveys share their experience or feedback at their convenience without the potential influence of responding to a person.- Group Presentations with Structured Feedback: Instead of a forum focus group, a presentation of an issue using prepared slides or handouts can be planned during a regularly scheduled meeting of a group such as a Rotary Club, school booster club, public health nursing staff meeting, or patient advisory board, etc. with the goal of gaining input through nominal group process or a variation to obtain individual votes and recommendations. Spring Harbor Hospital Part V, Section B, Line 6a: The CHNA was conducted through a partnership between Maine Healthcare, Central Maine Healthcare, Northern Light Health, MaineGeneral Health and the Maine Department of Health and Human Services. Spring Harbor Hospital Part V, Section B, Line 11: For the 2016-2018 CHNA, the organization has identified priorities and developed strategies to address the significant needs identified in its most recently conducted CHNA and provided reasons if identified needs are not being addressed. Please see the 2016-2018 Community Health Needs Assessment and Annual Implementation Plan Update FY18 at https://mainehealth.org/healthy-communities/community-health-needs-assessment for details of the activities undertaken by the organization. Part V, Section B, Lines 7a & 10a: The CHNA and implementation strategy are posted on the following website: https://mainehealth.org/healthy-communities/community-health-needs-assessment Part V, Section B, Lines 16a, 16b, 16c: The Financial Assistance Policy (Free Care Policy and Billing Collection Policy), free care application and the plain language summary are available on the following website: https://mainehealth.org/patients-visitors/billing-insurance/financial-assistance/free-care 31 1 - Portland Office 165 Lancaster St Portland ME 04101 Outpatient counseling offices 2 - Sherry Sabo Center 2 Springbrook Drive Biddeford ME 04005 Outpatient counseling offices 3 - Rockland Office 12 Union Street Rockland ME 04841 Outpatient office & peer recovery center 4 - Administration 77-79 Atlantic Place South Portland ME 04106 Administration offices 5 - Springvale Office 474 Main Street Springvale ME 04083 Outpatient counseling offices 6 - CADD 236 Gannett Drive South Portland ME 04106 Center of Autism & Developmental Disorders 7 - Alfred St Apartments 20 Alfred Street Biddeford ME 04005 Apartments with supported housing services 8 - High Street Residence 5 High Street Sanford ME 04073 Sing. room supp. housing & file storage 9 - Belfast Office 15 Midcoast Drive Belfast ME 04915 Outpatient office 10 - Beach Street Offices & CSU 31 Beach Street Saco ME 04072 Res. Crisis Stabilization Unit & Admin 11 - The Elms 1-8 Sherry Lane North Berwick ME 03906 Apartments with supp. housing services 12 - Main Street Biddeford 235 Main Street Biddeford ME 04005 Substance use outpatient counseling office 13 - Warren Street Apartments 28 Warren Street Rockland ME 04841 Apartments, office & Common area for staff 14 - Bacon Street Apartments 72 Bacon Street Biddeford ME 04005 Sing. room supp. housing 15 - Belfast Apartments 31 Midcoast Drive Belfast ME 04915 Apartments, 1 office and common area 16 - Crescent Place 15 Crescent Street Biddeford ME 04005 6 bed group home 17 - Owls Head 38 West Keag Road Owls Head ME 04854 7 bed single room occupancy 18 - Woodbridge 19 Woodbridge Road York ME 03909 7 bed group home 19 - Brunswick Office 11 Medical Center Drive Brunswick ME 04011 Outpatient counseling offices 20 - Damariscotta Miles Campus LincolnHealth 35 Miles Street Damariscotta ME 04543 Outpatient counseling offices 21 - Pleasant Street 407 Pleasant Street Rockland ME 04841 3 bed single room occupancy 22 - Grace Street 47 Grace Street Rockland ME 04841 3 bed single room occupancy 23 - Cedar Street 125 Cedar Street Rockland ME 04841 3 bed single room occupancy 24 - Sanford Recovery Center 19 Washington Street Sanford ME 04073 Peer recovery center 25 - Biddeford Recovery Center 15 York Street Biddeford ME 04005 Peer recovery center 26 - ACT 106 Gilman Street Portland ME 04101 Assertive Community Treatment team 27 - ACT 576 St John Street Portland ME 04101 Assertive Community Treatment team 28 - Core 66 Baribeau Drive Brunswick ME 04086 Assertive Community Treatment team offices 29 - Norway Office 193 Main Street Norway ME 04268 Outpatient counseling offices 30 - Core 18 Beluedere Road Damariscotta ME 04543 Assertive Community Treatment team 31 - Bangor Office 268 State Street Bangor ME 04474 Outpatient counseling offices Part I, Line 7: Charity care cost data presented in this section has been calculated by assigning the various program level ratios of cost to charges to the actual gross amount of charity care charges recorded by MBH programs during the period.Other benefit cost data has been calculated through the use of a combination of actual general ledger specific cost data, and the use of employee time studies. Part III, Line 2: See Part III, Line 4 - Bad Debt Expense Footnote to the FinancialStatements. Part III, Line 4: As outlined in the "Bad Debts," section of the MBH audited financialstatements:"MBH recognizes a provision for bad debts in establishing an allowance for services provided which may ultimately be uncollectible. The amount of the allowance for bad debts is based on historical trends and current market conditions."The amount of expense associated with the provision of services, ultimately written off as bad debt at MBH, has been calculated at $1,071,175 for the current fiscal period. This amount was calculated by assigning the various program level ratios of cost to charges to the gross amount of MBH program level charges written off as bad debt during the fiscal period. Bad debt expense represents healthcare services MBH has provided without compensation. As a tax-exempt organization, MBH provides necessary patient care regardless of the patient's ability to pay for the services. MBH cannot determine the amount of bad debt expense that could be reasonably attributable to patients who likely would qualify for financial assistance under the Hospital free care policy. In addition, bad debt expense also includes amounts for services provided to individuals experiencing difficult personal or economic circumstances related to a portion of our community based patient population. Their medical bills often place these individuals in untenable positions where they are not able to handle their personal debt and then their new medical debt. However, because of their income level, they do not qualify for free care. By providing necessary healthcare services to those individuals either who fail to apply for financial assistance or who are experiencing difficult personal or economic circumstances, MBH believes that bad debt expense should be included as a community benefit. Part III, Line 8: MBH's hospital, Spring Harbor Hospital is currently reimbursed by MedicarePart A (for inpatient services) through a Prospective Payment System (PPS)day rate methodology, while Medicare Part B reimburses the hospital forprofessional services rendered through a fee schedule for each serviceprovided. In both cases (Part A and Part B), the reimbursement provideddoes not fully cover the hospital's costs to provide services to Medicarebeneficiaries. Actual 10/1/18-12/31/18 costs to provide care for Medicare patients has been calculated at $1,590,229, while total actual Medicare reimbursement provided totaled $1,099,771. The cost calculation was determined using standard Medicare Part A cost reporting methodologies (cost to charge ratios), coupled with in-house Spring Harbor analysis of Part B costs. The difference between actual cost and Medicare reimbursement of $490,458 represents the cost of actual unreimbursed care provided to Medicare beneficiaries. MBH believes that the Medicare shortfall should be included as a community benefit because the Hospital has a clear mission commitment to serving elderly patients and adults with disabilities through the provision of specific subsidized programs developed to help improve the health status of these patients. If these critical subsidized programs were not provided by MBH, they would become the obligation of the Federal Government. Part III, Line 9b: Patients who qualify for free care have their account balance adjusted accordingly once free care has been approved. As a tax-exempt hospital, MBH provides necessary patient care regardless of the patient's ability to pay for the services. Part VI, Line 2: MBH is a member of Maine Healthcare, which conducts a thorough community needs assessment and directs its member organizations to respond to the needs identified. Maine Healthcare members also participate in various initiatives to keep those assessments up to date. Some of these initiatives include:- Clinical Strategic Planning- Financial Strategic Planning- Facility Planning- Human Resource Planning- Staff Development Planning- Physician Recruitment Strategic Planning- Emergency Preparedness PlanningIn addition to these internal assessments, Maine Healthcare member organizations also review and act on many of the recommendations provided by external groups and State health planning initiatives, such as: The Maine Department of Health and Human Services' Healthy Maine 2010 and Autism Spectrum Disorders Report, the Maine Center for Disease Control andPrevention and the "State Health Plan created by the Advisory Committeefor Health Systems Development. Part VI, Line 3: Free Care information is provided in the Admitting and Emergency Registration locations in the following manner:- Postings including Free Care and Monthly Payment Plan- Handouts- InterviewsPatients receive Maine Healthcare's Free Care Guidelines and Financial Policies brochure explaining our billing policies and contact information upon request.If the patient is self-pay, underinsured or can't afford to pay theirhospital bill, they may receive a Financial Counseling Packet and/orreferred to financial counseling from the registration staff or The Thomas Agency, an outside vendor who helps manage the self-pay accounts. The packet includes:- Information on Maine Healthcare's financial policies- Information on Maine Healthcare's Free Care Program, Monthly Payment Plan Program, and Care Partners, MedAccess and other community resource needs.- Program applications and instructions for Maine Healthcare's Free CareProgram, and Monthly Payment Plan Application- Contact information for assistance with applications, bills or financialconcernsSelf-pay or underinsured patients registering in person or via a phoneinterview receive financial counseling including information on ourfinancial assistance programs. Registration staff or The Thomas Agencyprovide forms and assist with completing financial assistance applicationsand providing follow up contact information.Maine Healthcare's website includes online Registration and Patient Billing information:- Billing Process- Free Care- Monthly Payment Plan- Patient Statement- Price Information- Contact Us and QuestionsPrimary language, deaf and hard of hearing and interpreter needs are assessed during the registration interview and services are provided asneeded.If a patient does not respond at pre-registration, registration, or whilereceiving care, all of these programs are explained again by the SingleBilling Office staff. The intent of these efforts is to ensure that thepatient is fully informed of and able to take advantage of these assistance programs. Part VI, Line 4: The Community Health Needs Assessment describes the geographic area anddemographic constituents it services. See https://mainehealth.org/healthy-communities/community-health-needs-assessment for the completed CHNA. Part VI, Line 5: The tax exempt purpose of the organization to improve the health of thecommunity is promoted and enhanced in the following ways:- The majority of the governing body is composed of persons living withinthe organization's service area that are neither employed by, nor havecontractual relationships with, the organization or its affiliates.- Solicitation of community input in the strategic planning process,through the community health needs assessment process.- Common governance of the organization's hospital and community basedservices to promote common health care and improvement planning and control costs.- Each year a portion of Retained Earnings are distributed to our parent,MaineHealth, for the specific purpose of health status improvement programs throughout the MaineHealth service area.- MBH employees provide community workshops on suicide and other mentalhealth topics, assist school systems in referral management, and leadtrainings for local law enforcement and police outreach.- MBH has a Trauma Intervention Program (TIP) that is comprised of specially trained citizen volunteers who provide support to victims oftraumatic events and their families. Volunteers are available to meet community needs 24x7, 365 days per year. Part VI, Line 6: Maine Healthcare is a not-for-profit family of leading high-quality providers and other healthcare organizations working together so their communities are the healthiest in America. Ranked among the nation's top 100 integrated healthcare delivery networks, Maine Healthcare is governed by a board of trustees consisting of community and business leaders from its southern, central and western Maine regional service areas. The collaboration of Maine Healthcare members makes it possible to offer an extensive range of clinical integration and community health programs, many aimed at improving access to preventive and primary care services. Maine Healthcare includes the following member organizations: LincolnHealth Group, MaineHealth, Maine Behavioral Healthcare (Spring Harbor Hospital), Coastal Healthcare Alliance (Pen Bay Medical Center and Waldo County General Hospital), Southern Maine Health Care (Southern Maine Medical Center and Goodall campuses), Western Maine Health Care (Stephens Memorial Hospital), The Memorial Hospital at North Conway, N.H., MaineHealth Care at Home, NorDx, Synernet and MaineHealth Accountable Care Organization. The strategic affiliates of Maine Healthcare are MaineGeneral Medical Center, Mid Coast Hospital and St. Mary's Regional Medical Center. Part VI, Line 7, Reports Filed With States ME 0 0 0 0 0 0 0 0 0 KAREN E SIMONE TRUSTEE 0 145311 0 0 0 855 0 33991 0 27784 0 207941 0 0 WILLIAM BRENNAN MD MEDICAL STAFF PRESIDENT 216687 0 9928 0 3046 0 8753 0 15863 0 254277 0 0 0 STEPHEN MERZ CEO 319312 0 57000 0 29761 0 11000 0 9910 0 426983 0 0 0 MICHAEL ABBATIELLO SVP OPERATIONS & FINANCE 194888 0 26660 0 1017 0 0 0 31446 0 254011 0 0 0 MARY JANE KREBS PRESIDENT SHH 190599 0 25108 0 11825 0 8337 0 23969 0 259838 0 0 0 MATTHEW M SIEGEL MD VP MED AFFAIRS - AUTISM/DD 314946 0 19025 0 22190 0 9250 0 28147 0 393558 0 0 0 ROBERT V MCCARLEY MD VP MED AFFAIRS - INST SVCS 297926 0 22871 0 5410 0 13717 0 26937 0 366861 0 0 0 THEODORE P LOGAN MD PSYCHIATRIST 278958 0 1581 0 43044 0 0 0 33424 0 357007 0 0 0 HAROLD AMSEL MD MEDICAL DIRECTOR 219809 0 0 0 88693 0 1384 0 27183 0 337069 0 0 0 ANDREW G HINKENS MD PHYSICIAN 82688 205667 500 0 0 3544 0 79878 3628 9287 86816 298376 0 0 Part III - Other Additional Information Top management officials are compensated using one or more of the methods at Part I, Line 3 to establish the compensation of top management. For additional information see Schedule O - Form 990, Part VI, Section B, Line 15 - Compensation for Top Official. Cash & cash equivalents 2019-01-01 3890801 Book value 010238552 MaineHealth 22 Bramhall Street Portland ME 04102 501(c)3 Investments 2019-01-01 13150917 Book value 010238552 MaineHealth 22 Bramhall Street Portland ME 04102 501(c)3 Patient accounts receivable, net 2019-01-01 5082748 Book value 010238552 MaineHealth 22 Bramhall Street Portland ME 04102 501(c)3 Inventory, prepaid, and other current assets 2019-01-01 1764685 Book value 010238552 MaineHealth 22 Bramhall Street Portland ME 04102 501(c)3 Investments whose use is limited 2019-01-01 3704862 Book value 010238552 MaineHealth 22 Bramhall Street Portland ME 04102 501(c)3 Property, plant & equipment, net 2019-01-01 25526768 Book value 010238552 MaineHealth 22 Bramhall Street Portland ME 04102 501(c)3 Other assets 2019-01-01 2551548 Book value 010238552 MaineHealth 22 Bramhall Street Portland ME 04102 501(c)3 AP & other current liabilities 2019-01-01 1255790 Book value 010238552 MaineHealth 22 Bramhall Street Portland ME 04102 501(c)3 Accrued payroll, payroll tax and withholdings 2019-01-01 2587592 Book value 010238552 MaineHealth 22 Bramhall Street Portland ME 04102 501(c)3 Accrued earned time 2019-01-01 2266542 Book value 010238552 MaineHealth 22 Bramhall Street Portland ME 04102 501(c)3 Deferred revenue 2019-01-01 55013 Book value 010238552 MaineHealth 22 Bramhall Street Portland ME 04102 501(c)3 Due to affiliates 2019-01-01 1221011 Book value 010238552 MaineHealth 22 Bramhall Street Portland ME 04102 501(c)3 Payable under reimbursement regulations 2019-01-01 9294331 Book value 010238552 MaineHealth 22 Bramhall Street Portland ME 04102 501(c)3 Long-term debt 2019-01-01 17944162 Book value 010238552 MaineHealth 22 Bramhall Street Portland ME 04102 501(c)3 Other long-term liabilities 2019-01-01 405899 Book value 010238552 MaineHealth 22 Bramhall Street Portland ME 04102 501(c)3 Unrestricted net assets 2019-01-01 17350022 Book value 010238552 MaineHealth 22 Bramhall Street Portland ME 04102 501(c)3 Temporarily restricted net assets 2019-01-01 2628452 Book value 010238552 MaineHealth 22 Bramhall Street Portland ME 04102 501(c)3 Permanently restricted net assts 2019-01-01 663515 Book value 010238552 MaineHealth 22 Bramhall Street Portland ME 04102 501(c)3 1 1 0 0 1 1 1 1 1 0 Part I, Line 2e: Person(s) Involved: Nancy Hasenfus, MD; Karen E. Simone; William Brennan, MD; Stepehn Merz, Michael Abbatiello; Mary Jane Krebs Part I, Line 2e: Explanation of Involvement: Nancy Hasenfus, MD, MBH Board of Trustees Chair, became a member of MaineHealth's (EIN: 01-0238552) Board of Trustees upon MBH's merger with MaineHealth on 1/1/2019.Stephen Merz, CEO of MBH, Michael Abbatiello, SVP Operations & Finance, and Mary Jane Krebs, Key Employee of MBH, are employees of MaineHealth.Karen E. Simone and William Brennan, Trustees of MBH, are employees of MaineHealth. Part I, Line 6c: MaineHealth assumed the liability of MBH's tax-exempt bond upon the merger date. Form 990, Part V, Line 1a: MaineHealth (EIN 01-0238552), acting on behalf of Maine Healthcare (EIN 01-0431680), filed 1,645 Form 1099s for the calendar year 2018 on behalf of the following organizations: Maine Healthcare, MaineHealth, Southern Maine Health Care, Coastal Healthcare Alliance, Pen Bay Medical Center, Waldo County General Hospital, Franklin Memorial Hospital, LincolnHealth Group, Memorial Hospital, Western Maine Health Care, Maine Behavioral Healthcare, NorDx, MaineHealth Care at Home. Form 990, Part V, Line 2a: MaineHealth (EIN 01-0238552) filed Form W-3, reporting 18,322 employees, for the calendar year 2018 on behalf of the following organizations: Maine Healthcare, MaineHealth, MMC Realty, Maine Medical Partners, NorDx, MaineHealth Care at Home and MaineHealth Cardiology, Southern Maine Health Care and Maine Behavioral Healthcare. Form 990, Part VI, Section A, line 6 Maine Healthcare (EIN #01-0431680) is the sole member of the organization. As the sole member, Maine Healthcare has the right to approve significant decisions of the governing body of MBH. Form 990, Part VI, Section A, line 7a The sole member of the organization has the responsibility for the election of the members of the governing body. The officers are elected by the board of trustees, except that the CFO, COO, Chief Medical Officer and Chief Clinical & Nursing officer are appointed by the Board of Trustees based upon a recommendation of the CEO. Form 990, Part VI, Section A, line 7b Decisions of the governing body such as budgets, business strategies, significant financial commitments, amendments to the Articles of Incorporation, and election of the President/CEO among other decisions, are subject to the approval of the sole member. Form 990, Part VI, Section B, line 11b A detailed review of the Form 990 is performed by the Controller and CFO. The Form 990 is made available to the full board prior to filing. Form 990, Part VI, Section B, line 12c Conflict of Interest statements are obtained annually. The organization reviews the responses to these documents and addresses any issues immediately. Form 990, Part VI, Section B, line 15 Compensation for Top Official The process followed for determining compensation of the CEO compensated by this or other related organization is a formal process performed annually by the Executive Committee of the Board of Directors. A related organization uses an outside firm, Sullivan Cotter, to perform an independent benchmark analysis for the CEO of Maine Behavioral Healthcare, along with other executives in the Maine Healthcare system. The firm meets with the Executive Committee to review each executive's benchmark report. The Committee then deliberates on Maine Healthcare's written salary and incentive plan philosophy before making a final decision. All decisions and meetings are captured in minutes and there are appropriate approvals at all levels. Compensation for Officers The member is responsible for an annual evaluation of the other Officers and key administrative employees of the organization. Compensation is evaluated by the compensation committee appointed by the member, and the organization's Board of Trustees must approve of the compensation. In additon, the organization utilizes the services of an independent compensation consulting firm and industry survey. Form 990, Part VI, Section C, line 19 Documents that are required to be open for public inspection are made available upon request. Form 990, Part XI, line 9: Merger of assets into MaineHealth (EIN: 01-0238552) -20,641,989. Change in value of perpetual trust -14,000. Maine Healthcare 110 Free Street Portland ME 04101 010431680 Healthcare ME 501(c)(3) Line 12c, III-FI N/A 0 MaineHealth 22 Bramhall Street Portland ME 04102 010238552 Hospital ME 501(c)(3) Line 3 Maine Healthcare 0 NorDx 301A US Route One Scarborough ME 04074 010511356 Lab ME 501(c)(3) Line 10 Maine Healthcare 0 LincolnHealth Group 6 St Andrews Lane Boothbay Harbor ME 04538 261475629 Healthcare ME 501(c)(3) Line 12b, II Maine Healthcare 0 Western Maine Health Care Corp 181 Main Street Norway ME 04268 010411788 Healthcare ME 501(c)(3) Line 12b, II Maine Healthcare 0 MaineHealth Care at Home 15 Industrial Park Saco ME 04072 222571902 Home health ME 501(c)(3) Line 10 Maine Healthcare 0 Coastal Healthcare Alliance PO Box 287 Belfast ME 04915 222494475 Healthcare ME 501(c)(3) Line 12b, II Maine Healthcare 0 Geriatric Resource Network 110 Free Street Portland ME 04101 010542842 Healthcare ME 501(c)(3) Line 7 Maine Healthcare 0 MaineHealth Cardiology 110 Free Street Portland ME 04101 452525629 Healthcare ME 501(c)(3) Line 10 Maine Healthcare 0 Southern Maine Health Care PO Box 626 Biddeford ME 04005 010179500 Hospital ME 501(c)(3) Line 3 Maine Healthcare 0 The Memorial Hospital 3073 White Mountain Highway North Conway NH 03860 020222156 Hospital NH 501(c)(3) Line 3 Maine Healthcare 0 Franklin Community Health Network 111 Franklin Health Commons Farmington ME 04938 223209406 Healthcare ME 501(c)(3) Line 12b, II Maine Healthcare 0 MaineHealth ACO 110 Free Street Portland ME 04101 452929273 Healthcare ME N/A Synernet Inc 110 Free Street Portland ME 04101 010539789 Administrative services ME N/A C 0 0 0 0 0 1 0 0 1 0 0 1 0 0 0 1 1 0 1 1