2018-08-03T11:37:25-07:00 2017-09-30 990 2016-09-25 010217211 EASTERN MAINE HEALTHCARE SYSTEMS IH INLAND HOSPITAL IH EAST 2079739081 200 KENNEDY MEMORIAL DRIVE WATERVILLE ME 04901 John J Doyle EMHS VP OF Finance 2018-08-03 false 2016 2022-09-23 18:48:47Z John J Doyle 161254018 false false 5247 X www.inlandhospital.org X 1945 ME Inland Hospital operates a 48-bed non-profit hospital and outlying clinics in the Waterville area, that provides medical, surgical, and acute care to all, regardless of ability to pay. 16 12 696 262 112257 -168361 336078 130740 142865157 154081133 257726 668894 143336 306316 143602297 155187083 42362 36345 0 45507978 47778004 0 0 98213740 105806464 143764080 153620813 -161783 1566270 50196750 41251738 29016326 27882503 21180424 13369235 X To care for and serve our community by providing Healthcare Services. false false 132724159 36345 154364800 Provided healthcare services regardless of ability to pay as well as education and promotion of health. Provided $2,976,974 other uncompensated care (at cost).Inland Hospital is a 48-bed facility that provides medical-surgical, and acute care. Inland is a non-profit hospital, serving all who need care, regardless of ability to pay. Inland Hospital also has outlying clinics in the region, allowing easier access for patients.Additional Statistics:Total Admissions 1,564Percent Occupancy of Available Beds 26%Emergency Room Visits 13,014Surgery Cases 1,596Services provided to those who could not pay $7,819,806.13 5254122 Medicare shortfalls (at cost). 24,234 persons served. 3664330 Medicaid shortfalls (at cost). 10,970 persons served. 781507 142424118 true true false true false false false false false true true false false true true true false true false false false false false false false false true true false false true true false false false false false false false false true false false false false false false true true true false false true 123 0 true 696 true true true false false false false false false 0 false false false false false false false false false false X 16 12 true false true false true true true true true false false true true true true true true true true false ME X X X John Doyle 2079739081 43 WHITING HILL ROAD BREWER ME 04412 BETH GIBBS Board Member 0.50 0.00 X 0 0 0 MARY M HOOD EMHS CEO Ex-officio 0.50 50.00 X X 0 885839 271712 THOMAS DAVIS Vice Chair 0.50 0.00 X X 0 0 0 BRYAN WARD ESQ Board Member 0.50 0.00 X 0 0 0 CHRISTOPHER L GAUNCE Board Member 0.50 0.00 X 0 0 0 BRIAN GILLIS DO Board Member 0.50 0.00 X 0 0 0 CATHERINE KIMBALL DO CHF OF STAFF/EX 40.00 0.00 X 274370 0 21100 DONALD PLOURDE Vice Chair 0.50 0.00 X X 0 0 0 MICHAEL F PHILLIPS JR ESQ Chair 0.50 0.00 X X 0 0 0 SUZANNE UHL-MELANSON Board Member 0.50 0.00 X 0 0 0 ROSEMARY WINSLOW Board Member 0.50 0.00 X 0 0 0 WILLIAM BRADFIELD MD Board Member 40.00 0.00 X 333249 0 46409 JOHN DALTON Pres/Ex-Officio 40.00 0.00 X X 759102 0 38569 C PATRICK MICHAUD Board Member 0.50 0.00 X 0 0 0 P JAMES NICHOLSON Board Member 0.50 0.00 X 0 0 0 ALLAN L RANCOURT Board Member 0.50 0.00 X 0 0 0 GLENN MARTIN VP GEN COUNSEL Secretary 0.50 50.00 X 0 368621 90480 PAUL BOLIN VP and CHRO 0.50 50.00 X 0 197240 42346 TONY FILER SENIOR VPCFO Treasurer 0.50 50.00 X 0 177610 2704 WALTER RICK BARRY VP OF PT CARE 40.00 0.00 X 232655 0 22863 CHRIS FRAUENHOFER VP, FINANCE 50.00 50.00 X 107937 107937 33030 DEAN BITHER VP, Finance 40.00 0.00 X 246064 0 43475 DANIEL J BOOTH VP of Operation 40.00 0.00 X 233971 0 21364 GAVIN DUCKER DO VP-Med Affairs 40.00 0.00 X 293075 0 44211 ANGELA GIBBS VP Quality 40.00 0.00 X 5130 0 103 DEEP ACHARYA Physician 40.00 0.00 X 346149 0 28049 GLORIA SIMMS Physician 40.00 0.00 X 301771 0 36719 EUGENE CHARLEBOIS DO Physician 40.00 0.00 X 318488 0 34051 RICHARD T SAMSON MD PHYSICIAN 40.00 0.00 X 311269 0 30438 SIMON GIBBS MD Physician 40.00 0.00 X 382835 0 41650 MICHAEL PALUMBO DO Former VP Med Affairs/CMO 40.00 0.00 X 184587 0 16817 CONSTANCE BARRETT Former VP/CNO 40.00 0.00 X 105043 0 8896 THEODORE HELBERG III Former VP HR South Region 0.00 50.00 X 0 173037 24799 4435695 1910284 899785 64 true true false WEATHERBY LOCUMS INC PO BOX 972633 DALLAS TX 753972633 Physician Services 995811 AMERICAN MOBILE NURSE 2735 COLLECTION CENTER DRIVE CHICAGO IL 60693 Md-Lv Temp Staff Svc 670913 VISTA STAFFING SOLUTIONS FILE 50834 LOS ANGELES CA 900740834 Physician Services 581901 COMPHEALTH INC PO BOX 972651 DALLAS TX 753972651 Physician Services 522059 NURSE ANESTHESIA OF MAINE 141 N MAIN STREET STE 205 BREWER ME 04412 Professional CRNA's 442093 20 103700 27040 3240 130740 CAFETERIA 722210 183268 183268 EDUCATION REVENUE 611710 9555 9555 PATIENT SERVICE REVENUE 621990 153888310 153776015 112295 154081133 57092 -38 57130 0 0 3615 3615 3615 3615 6529825 137009 6034000 21032 495825 115977 611802 611802 0 0 30899 11903 18996 18996 MEANINGFUL USE 621990 283180 283180 Misc Revenue 621990 525 525 283705 155187083 154252543 112257 691543 36345 36345 0 0 0 2740162 1528500 1211662 0 37642528 34032236 3610292 743183 670185 72998 4517066 3978480 538586 2135065 1862152 272913 0 7885 7885 34420 34420 0 0 20781 16299 4482 8636596 6257106 2379490 294480 3458 291022 1496097 912214 583883 2528415 2271285 257130 0 2158771 1693143 465628 97608 68419 29189 0 177011 142107 34904 516034 404730 111304 0 1966841 1542611 424230 1053350 826152 227198 Contractual Allowances 68490956 68490956 Medical Supplies 7437521 7437521 Provision for uncollectible ac 6226849 6193821 33028 Charity Care 1625986 1625986 3036863 2430412 606451 153620813 142424118 11196695 0 4513 4600 30660 0 0 15778857 16758827 28268 0 0 0 671246 609062 533355 598450 45684617 28937399 18348124 16747218 0 0 0 45795 45795 14755932 6487786 50196750 41251738 13881159 12817200 291 3338127 3208875 685517 482593 11111232 11373835 29016326 27882503 X 18446438 10421431 505376 689863 2228610 2257941 21180424 13369235 50196750 41251738 X 1566270 -563736 -8813723 X false true X true false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false false false true 11470 11470 false false Part II-B, Line 1i - Other Activities Description Non-deductible portion of dues 313844 1491112 162332 14966 1952322 300947 27062 14165 313844 316625 -3010 12668 300947 303162 5000 19358 10895 316625 273459 5000 31241 6538 303162 0.04000 0.96000 false true true 83162 83162 18465634 11332101 7133533 1427896 608936 818960 24288615 16209278 8079337 1419310 787084 632226 16747218 Assets Held Under Trust Indenture 99107 Beneficial Interest in Perpetual Trusts 572219 Board Designated Other 3440875 Interest in net assets held at EMHSF 2142895 Permanently Donor Restricted Funds 5000 Temporarily Donor Restricted Funds 227690 6487786 Amounts due to Related Org 7728484 Deferred Compensation 3223770 Liability Under Cap Lease Obligation 193334 Reserve for Asset Disposal Costs 228247 11373835 X Part V, Line 4: Intended uses of the endowment fund. Endowment funds are designated for purposes that align within the organization's exempt purpose. Part X : FIN48 Footnote EMHS, its hospitals, and certain other affiliates have been determined by the Internal Revenue Service to be tax-exempt charitable organizations as described in Section 501(c)(3) or 501(c)(2) of the Internal Revenue Code (the Code) and, accordingly, are exempt from federal income taxes on related income pursuant to Section 501(a) of the Code. Accordingly, no provision for federal income taxes has been recorded in the accompanying consolidated financial statements for these organizations.Tax-exempt charitable 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 (FASB), 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. Estimated interest and penalties, if applicable, related to uncertain tax positions are included as a component of income tax expense. The System has evaluated its tax position taken or expected to be taken on income tax returns and concluded the impact to be not material.Certain of the System's affiliates are taxable entities. Deferred taxes related to these entities are based on the difference between the financial statement and tax basis of assets and liabilities using enacted tax rates in effect in the years the differences are expected to reverse. The deferred tax assets and liabilities for these entities are not material. true true true X true X true true false false true true 581 781507 781507 0.01010 10970 11345159 7680829 3664330 0.04740 190944 190944 0.00250 11551 12317610 7680829 4636781 0.06000 12 40834 328677 328677 0.00430 3 50 117531 117531 0.00150 3 9143 106902 106902 0.00140 18 50027 553110 553110 0.00720 18 61578 12870720 7680829 5189891 0.06720 1 5000 5000 1 5000 5000 true 2976974 20349402 25603524 -5254122 X true true 1 1 Inland Hospital 200 Kennedy Memorial Drive Waterville ME 04901 www.inlandhospital.org State lic #38139 X X X Inland Hospital 1 false false true X X X X X X X X X 16 true true true true X http://www.inlandhospital.org/ X www.emhs.org/Community-Benefit/CHNA.aspx X true 16 true http://www.emhs.org/Community-Benefit/CHNA/ false false true X 150.0000 250.0000 false true X X X true X See Part V, Line 16i-j for URL X See Part V, Line 16i-j for URL X See Part V, Line 16i-j for URL X X X X X X X true X false X X X X true X false false Part V, Line 5 - Account Input from Persons Who Represent the Community The Maine Shared CHNA research team conducted a statewide survey among stakeholders to identify and prioritize significant health issues in communities across the state. The survey, coordinated with the Maine CDC, engaged public health expertise throughout the process. The survey was administered using a snowball approach where stakeholder agencies agreed to send the surveys to their members and stakeholders for participation. 1,639 people, representing more than 80 organizations and businesses in Maine, completed the survey. Respondents represented health care agencies, public health agencies, law enforcement, municipalities, schools, local businesses, social service agencies, and nongovernmental organizations. In addition to the stakeholder survey, each county conducted a number of community engagement opportunities (forums) to ensure broad interests of the local community were represented; Obtain stakeholder input on identifying significant health needs based on review of shared CHNA data; Solicit stakeholder feedback on prioritizing significant health needs, and; Identify local assets and resources that potentially may address local health priorities. The local forums were conducted in collaboration with the Maine CDC to solicit input from individuals representing populations with health disparities. The following organizations were in attendance at the December 10, 2015 DCC SHNAPP Waterville Shared CHNA Community Engagement Input Forum and provided valuable feedback on the Shared CHNA.Details about organizations: Sample of organizations KVCAP, Waterville Main Street, Kennebec Messalonskee Trails, Maine Children's Home, NAMI Maine, American Lung Assn., Healthy Northern Kennebec, Somerset Public Health, Healthy Sebasticook Valley, MaineGeneral (MG), Inland Hospital, Redington Fairview General Hospital, EMHS, HealthReach Community Health Centers, Kennebec Behavioral Health, MG Community Care, Assistance Plus, MSAD 59, Waterville/Vassalboro Before/After School Programs, MG Board of Directors, Maine CDC. Hospitals (MaineGeneral, Inland, EMHS, Redington Fairview), health care providers (HealthReach Community Health Centers), and behavioral health care providers (Kennebec Behavioral Health, MG Community Care) serve low income patients through Medicare/MaineCare and provide low-cost/no-cost services to medically underserved residents. Many public health programs and services (Healthy Northern Kennebec, Somerset Public Health, Healthy Sebasticook Valley), non-profit agencies (KVCAP, Maine Children's Home, NAMI Maine), and local/state government agencies (Maine CDC) specifically serve low-income and medically under-served residents. Part V, Line 6a - List Other Hospital Facilities that Jointly Conducted Needs Assessment The Shared CHNA was conducted through the Maine Shared Health Needs Assessment Planning Process (SHNAPP) a collaborative effort among Maine's four largest health-care systems Central Maine Healthcare, Eastern Maine Healthcare Systems (EMHS), MaineGeneral Health, MaineHealth and the Maine Center for Disease Control and Prevention, an office of the Maine Department of Health and Human Services (DHHS). EMHS member organizations participating in the Shared CHNA included Acadia Hospital, Blue Hill Memorial Hospital, Charles A. Dean Memorial Hospital, Eastern Maine Medical Center, Inland Hospital, Maine Coast Memorial Hospital, Mercy Hospital, Sebasticook Valley Health, and TAMC. Part V, Line 11 - Explanation of Needs Not Addressed and Reasons Why Inland Hospital non-selected priorities-Immunizations are provided in our medical practices and through a variety of community settings and programs.Behavioral/mental health and substance abuse - As a small hospital, we are unable to commit the financial resources to address the gaps at this time. Services are available by other organizations in the community and we work with our local Healthy Maine Partnership and local service providers to help address the needs. Part V, Line 13b - Criteria For Providing Discounted Care If Not FPG Due to software glitch, this is in reference to Part V, Line 14 Explain Method for Applying for Financial Assistance - See Part VI, Additional Information for explanation. Part V, Line 16i - Other Means Hospital Facility Publicized the Policy Response for 16a, 16b, 16c (list url) is http://inlandhospital.org/Patients-Visitors/Billing-Financial-Services.aspx under "Financial Assistance Program" Heart First Diagnostics 244 Kennedy Memorial Drive Waterville ME 04901 Medical Office Building - Physician Service Inland Family Care RHC 80 Main Street Unity ME 04988 Medical Office Building - Physician Service Inland Family Care 74 Water Street Oakland ME 04963 Medical Office Building - Physician Service New Horizons Health Care RHC 344 Lakewood Drive Madison ME 04950 Medical Office Building - Physician Service Inland Neurology 246 Kennedy Memorial Drive Suite 20 Waterville ME 04901 Medical Office Building - Physician Service Inland Womens Healthcare 180 Kennedy Memorial Drive Suite 10 Waterville ME 04901 Medical Office Building - Physician Service Heart First Cardiology Assoc 244 Kennedy Memorial Drive 1st Floo Waterville ME 04901 Medical Office Building - Physician Service Inland Family Care 16 Concourse West Waterville ME 04901 Medical Office Building - Physician Service Inland Family Care RHC 167 Main Street North Anson ME 04958 Medical Office Building - Physician Service Inland Medical Associates - Internists 174 Kennedy Memorial Drive Waterville ME 04901 Medical Office Building - Physician Service Inland Diabetes & Nutrition Wellness 180 Kennedy Memorial Drive Waterville ME 04901 Medical Office Building - Physician Service Inland Rheumatology 325-D Kennedy Memorial Drive Waterville ME 04901 Medical Office Building - Physician Service Inland Family Care 10 Washington Street Waterville ME 04901 Medical Office Building - Physician Service Inland Orthopedics & Inland Wound Care 25 First Park Drive Suite C Oakland ME 04963 Medical Office Building - Physician Service Inland Surgical Associates 180 Kennedy Memorial Drive Suite 20 Waterville ME 04901 Medical Office Building - Physician Service Inland Family Care Three Rivers 180 Kennedy Memorial Drive Suite 30 Waterville ME 04901 Medical Office Building - Physician Service Inland Family Care Three Rivers 77 Sewall Street Augusta ME 04330 Medical Office Building - Physician Service Inland Foot & Ankle 25 First Park Drive Suite D Oakland ME 04963 Medical Office Building - Physician Service Inland Outpatient Imaging Services 25 First Park Drive Oakland ME 04963 Medical Office Building - Physician Service Inland Outpatient Imaging Services 244 Kennedy Memorial Drive Waterville ME 04901 Medical Office Building - Physician Service Inland Outpatient Imaging Services 167 Main Street North Anson ME 04958 Medical Office Building - Physician Service Inland Outpatient Imaging Services 180 Kennedy Memorial Drive Waterville ME 04901 Medical Office Building - Physician Service Inland Osteopathic Manipulative Medicine 16 Concourse West Waterville ME 04901 Medical Office Building - Physician Service Inland Rehab Works Outpatient Services 366 Lakewood Road Madison ME 04950 Medical Office Building - Physician Service Inland Rehab Works Outpatient Services 180 Kennedy Memorial Drive Waterville ME 04901 Medical Office Building - Physician Service Inland Rehab Works Outpatient Services 80 Main Street Unity ME 04988 Medical Office Building - Physician Service Inland Rehab Works Outpatient Services 30 Elm Plaza Waterville ME 04901 Medical Office Building - Physician Service Mardens Cardiac Rehab Center 244 Kennedy Memorial Drive Waterville ME 04901 Medical Office Building - Physician Service Sleep Diagnostic Center of Inland Hospital 180 Kennedy Memorial Drive Suite 20 Waterville ME 04901 Medical Office Building - Physician Service Part I, Line 6a - Related Organization Community Benefit Report The Inland Hospital community benefit report is contained in an annual community benefit report prepared by Eastern Maine Healthcare Systems which is the parent organization of all related organizations. Part I, Line 7 - Explanation of Costing Methodology Ratio of Patient Care Cost-to-Charges is used in calculations. Part I, Line 7, Column F - Explanation of Bad Debt Expense $6,226,849 of bad debt expense, $1,625,986 of charity care, $68,490,956 of contractual allowances is included on Form 990, Part IX, line 25, column (A). Part III, Line 2 - Methodology Used To Estimate Bad Debt Expense The costing methology used to determine the amount is cost to charge ratio. Part III, Line 4 - Bad Debt Expense Patient and trade accounts receivable are stated at the amount management expects to collect from outstanding balances. Management provides for probable uncollectible amounts through a charge to earnings and a valuation allowance based on its assessment of the current status of individual accounts. Balances that are still outstanding after management has used reasonable collection efforts are written off through a charge to the valuation allowance and the applicable patient accounts receivable. Credit is extended without collateral. Part III, Line 8 - Explanation Of Shortfall As Community Benefit Medicare losses should be treated as a community benefit because the losses are incurred in performing an important public service, and Maine hospitals experience one of the lowest Medicare reimbursement rates in the country. Part III, Line 9b - Provisions On Collection Practices For Qualified Patients All account guarantors who express an inability to pay inpatient and outpatient services will be screened for eligibility for charity care using an application and guidelines established by Inland Hospital. An account may be reconsidered for charity care at any time when new information is available about a patient's inability to pay. Part VI - Patient Education of Eligibility for Assistance At Inland Hospital, Patient Account Representatives are available to assist and answer any questions our patients may have regarding Financial Assistance. Additional interactive strategies are in places that include billing statements that have contact information added for the patient's convenience, providing all uninsured patients with financial assistance packets at point of registration. When a patient states that they are under-insured Financial Assistance Packet information is provided. For any other patient requests we receive (via emails and phone calls) packets are mailed. All patient accessible areas, such as hospital waiting areas, contain information to direct patients on how to receive financial assistance. Additionally, Inland Hospital provides online resources and tools to assist our patients with the necessary information regarding charity/financial assistance via www.inlandhospital.org. Inland Financial Counselors are Certified Application Counselors for the Federal Market Place and will assist customers with the Healthcare Market Place as requested. It is the policy of Inland Hospital to treat all patients requiring care without regard for ability to pay and to assist patients in arranging for settlement of their financial obligation. Under this program, medically necessary services will be provided to Maine residents at no cost. If a patient does not qualify for free hospital care, he or she is entitled to ask for a fair hearing. Part VI - Community Information Inland Hospital is a not-for-profit, community hospital located in Waterville, Maine with a mission to care for and serve our community. We serve residents in parts of Kennebec, Somerset, and Waldo Counties (mostly Kennebec). We are a 48-bed medical-surgical facility, with Lakewood, our 105-bed continuing care facility on the hospital campus, along with 13 primary and specialty care physician practices in Waterville and our surrounding communities of Unity, Oakland, and Madison. We also offer our primary care patients a Weekend Care service to help them avoid unnecessary, costly emergency room visits.Inland has two rural health centers in Unity and Madison serving medically underserved populations.Inland is the only inpatient hospital serving Waterville. The next nearest inpatient hospital is located 15 miles south of Waterville in Augusta. The nearest tertiary hospital is located 60 miles north of Waterville.2016 data from US Census ME.gov shows that Kennebec County has 122,151 residents. Median household income is $48,470. Somerset County has 52,228 residents with a $40,484 median income. Part VI - Community Building Activities Inland Hospital gets involved and gives back to our community to improve quality of life in Greater Waterville it's how we help fulfill our community service mission to care for and serve our community. Whether it's sponsoring scholarships to the local colleges, supporting physical activity and nutrition initiatives in our local schools, funding local public transportation, or supporting a cultural or economic development effort, Inland is proud to support and collaborate with groups that foster health and well-being. Our Community Benefit program contributed $60,000 total in 2017 towards health and community organizations and initiatives. $5,000 was granted to the Central Maine Growth Council for economic and workforce development efforts in our community. In addition, we offered free health screenings and education to the public through our health events, and contribute to health improvement through numerous community collaborations and public events. Part VI - Explanation Of How Organization Furthers Its Exempt Purpose At Inland we strive to live up to our non-profit mission every day by caring for community members who otherwise would have limited access to quality healthcare. Besides providing charity care and financial assistance, we believe we can also affect the health of the communities we serve beyond care inside our hospital. We agree with the World Health Organization which states, Health is a state of complete physical, mental, and social well-being, and not merely the absence of disease or infirmity. We have a vision to be a responsible corporate citizen whose actions can impact our community's overall well-being through commitments to priority issues. A hospital task force considered priority issues from the 2016 Community Health Needs Assessment and other data, and identified areas of significant needs to be addressed, as well as areas of need unable to be addressed by the hospital. An Implementation Strategy was developed and consisted of actions the hospital took to address the health need. Programs/resources the hospital committed to address the health need were identified along with planned collaborations with other area organizations. Inland Hospital focused on four key areas:1-Obesity - Goal: Obesity weight classification among Inland Family Care pediatric patients ages 2-18 will stop upward trend by Sept. 30, 2017. We achieved our stabilization goal with the rate of 29.3% as of September 30,2017.2-Mental health- Goal: Increase access to outpatient mental health services. We added a tele-mental health service at our downtown primary care practice in partnership with our system's mental health facility, Acadia Hospital, and we continue to recruit for additional mental health professionals.3-Substance abuse- Goal: Reduce prescription drug abuse and misuse in Inlands service area. We produced educational materials for patients and the public about pain control options and started to distribute them to our medical practices.4-Economic Opportunity/Poverty - Goal: Enhance public transportation in the community. We contributed funds to KVCAP, the local community action program for its public bus system.In addition to efforts led by Inland and our collaborating partners on the issues above, resources such as in-kind staff time and community benefit funding were dedicated to the following secondary issues:-Domestic Violence-Homelessness-Economic development-Education-Cultural SupportInland's 2017 Community Wellness initiatives included:a)The "World of Women's Wellness", the hospital's health fair for women. 500+ women attended the 20th annual event on April 1, 2017 and received more than 200 blood pressure screenings. More than 50 exhibitors linked attendees to local resources and services to improve health; 30+ of the exhibitors focused on priorities in our Community Health Improvement Plan.b)In an effort to combat the childhood obesity epidemic, in 2017 we continued our year-long program to reach families with children to encourage active lifestyles and healthier eating. Our "Let's Go! Family Fun Series" offers activities each month to engage families with children to be physically active and eat healthier through free and low cost resources and activities such as hiking, swimming, and cross-country skiing. We also provided $8,250 in funding for Let's Go! in 14 local schools, out-of-school and daycare sites through our Community Benefit program. Let's Go! is a nationally recognized childhood obesity prevention program that focuses on healthy habits and changing environments where children and families live, learn work and play.c)We utilized the Let's Go! program in the healthcare sectorspecifically our family practices. Three of Inland's family practices were recognized as Let's Go! Sites of Distinction in 2017 for their efforts to curb childhood obesity in our patient populations. Components of the program include displaying posters with the 5,210 healthy habits messages, tracking weight classification for patients ages 2-18, and using the Healthy Habits survey at all well-child visits to inspire respectful conversations around weight status and lifestyle behaviors. d)We added a full-time Community Health Program Coordinator to our Community Wellness staff to provide Let's Go! technical support to local schools, after-schools, and childcare sites.e)We continue to maintain and improve the Inland Woods Trail on the hospital campus (created in 2010) with support from several local organizations. The trails were developed to create a lasting way to impact health, and give residents an easy, free resource for regular activity. The trails are used regularly by residents, hospital staff, and local schools for walking, biking, and snowshoeing. We enhanced the trail and trailhead by adding a family-friendly Little Let's Go! Loop, and also a Little Free Library.f)We provided ongoing support for the Quarry Road Recreation Area, investing $42,500+ since 2013 in annual support, event and youth program sponsorships and in-kind contributions of staff volunteer hours and board participation.g)Inland provided the following Community Benefit funding in 2017: $4,250 to the Greater Waterville Area Food Bank for a new industrial refrigerator; $3,000 to Kennebec Behavioral Health to support outreach to homeless youth; $1,395 to Unity Barn Raisers for a local park expansion; $5,000 to Maine Farmland Trust for its Veggies for All community garden and food bank program. h)In addition, we employ a Community Health Navigator to help patients connect to local resources that help them overcome barriers to good health, such as housing, medication support, transportation, food support, and health care access.In addition, a majority of Inland Hospital's board of trustees is comprised of people who reside in our primary service area who are neither employees nor independent contractors of the organization, nor family members thereof. Inland extends medical staff privileges to qualified physicians in its community for some or all of its departments or specialties.The Inland Hospital Foundation helps by raising funds for everything from capital expansion projects to residential activities to help offset normal operating expenses.Inland Hospital utilizes surplus funds to support a medical simulation center on the hospital campus that is used for training of clinical staff. Examples of training include Advanced Cardiac Life Support, Neonatal Resuscitation Program, and Pediatric Advanced Life Support. Training is not limited to employees at Inland Hospital - we also offer courses to local Emergency Medical Technicians and to clinicians at other hospitals in our region. Inland Hospital invites men, women, and young adults to volunteer their time to further the hospital's mission. In 2017, volunteers from our community donated 10,367 hours of their time to Inland and Lakewood, our continuing care center. Some volunteers work in areas with direct contact with patients and families; others are involved in our community events and "behind the scenes" activities which enhance the care provided by the hospital.In 2017, more than 100 Inland and Lakewood employees engaged in our community by volunteering on local boards, committees and projects that helped contribute to a vital community. Part VI - Affilated Health Care System Roles and Promotion The 2016 Shared Community Health Needs Assessment conducted by EMHS (Eastern Maine Healthcare Systems) in collaboration with several member/affiliated hospitals and the many public health and community organizations across the state. The Shared Community Health Needs Assessment informs initiatives to promote community health across the system as well as within each member hospital's local service area. Each member hospital adopted a local implementation strategy and community health improvement plan, tailored to meet local needs.Inland Hospital has been part of EMHS (Eastern Maine Healthcare Systems) since 1998. As part of EMHS, we conducted the 2016 Shared Community Health Needs Assessment in collaboration with several member/affiliated hospitals and many public health and community organizations across eight Maine counties. Part VI - States Where Community Benefit Report Filed N/A Part VI - Additional Information Disclosure in accordance with Revenue Procedure 2015-21:Part V Facility Information, Section B Facility Policies and PracticesIn accordance with Revenue Procedure 2015-21, Inland is disclosing the following information with respect to Section 501(r) issues that were discovered during the 2017 tax year and how these have been corrected to satisfy 501(r) requirements.For all items:A good-faith effort was made to implement the requirements of the Section 501(r) regulations. Inland obtained information about the requirements and sought to implement them accordingly, but later identified some compliance gaps due to the detailed nature of the regulations.The issues were discovered in fiscal year 2017 during an internal audit of Inlands compliance with Sections 501(r)(3-4). The correction of these issues did not result in any changes to our overall processes and, therefore, Inland has not identified any persons directly affected by these issues. All individuals would have been in the same position had these issues not occurred.To ensure full compliance with Section 501(r) regulations, EMHS Community Health and Revenue Cycle Departments perform routine reviews to assure Inland is in compliance with Section 501(r). In addition, EMHS continues to engage EMHS Internal Audit to review Inlands compliance with Section 501(r).Specific issues and corrections:1. Approval of the Community Health Needs Assessment (CHNA) and Implementation Strategy a. Requirement: The CHNA must be documented in a written report that is adopted for the hospital facility by an authorized body of the hospital facility. An authorized body of the hospital facility also must adopt an implementation strategy to meet the community health needs identified through the CHNA on or before the 15th day of the fifth month after the end of such taxable year. b. Condition: While the Board minutes and related meeting materials retained for Inland demonstrated the Board's intent to approve both the CHNA and implementation strategy, the Board vote(s) as documented in the minutes did not clearly demonstrate that the Board approved both items. c. Corrective Action: A resolution was passed by Inlands Board to clarify the Board's intent to approve the CHNA and implementation strategy. d. Date Corrected: Inland: May 25, 20172.Information in the FAP regarding Amounts Generally Billed (AGB) a.Requirement: The FAP must include the method the hospital facility uses to determine the amounts generally billed to individuals who have insurance covering emergency or other medically necessary care and must state the AGB percentages or explain how members of the public may readily obtain such percentages.b.Condition: While the Plain Language Summary (PLS) indicated that AGB will be calculated using the look-back method, based on actual past claims paid to the hospital by Medicare and by other private insurers, the FAP did not adequately explain the method used to determine AGB, state the AGB percentages or explain how members of the public may readily obtain the AGB percentages (and these AGB percentages also were not otherwise readily available). c.Corrective Action: The FAP was updated to explain the method used to determine AGB. The FAP was also updated to state To request a free written description of how EMHS calculates the AGB or to find out the actual AGB for a particular EMHS hospital, please contact (207) 973-6473 or (207) 973-4483 or on the Web at http://emhs.org/Billing-help.aspx. Inlands AGB percentage was added to this Web site. d.Date Corrected: These revisions to the FAP were approved by EMHS Leadership in Fiscal Year 2017 and the EMHS Board of Directors at its October 4, 2017 meeting. The updated FAP was widely publicized upon approval by the EMHS Board of Directors. The AGB percentages were added to the EMHS Web site in January 2018.3. Presumptive eligibilitya. Requirement: The FAP must include whether and under what circumstances prior FAP-eligibility determinations are used for presumptive eligibility.b. Condition: The FAP explained that approved applications from one EMHS Member Organization will be honored at another EMHS Member Organization, but did not fully describe the circumstances under which prior FAP-eligibility determinations are used for presumptive eligibility.c. Corrective Action: The FAP has been updated to fully describe whether and under what circumstances prior-FAP eligibility determinations are used for presumptive eligibility. d. Date Corrected: These revisions to the FAP were approved by EMHS Leadership on May 1, 2018 and the revised FAP has been widely publicized. 4. Emergency Medical Care Language in the FAPa. Requirement: A written policy must be established to require that care will be provided, without discrimination, for emergency medical conditions to individuals regardless of whether they are FAP-eligible.b. Condition: It was and is Inlands practice to provide care for emergency conditions to individuals regardless of whether they are FAP-eligible; however, upon review of Inlands FAP it was determined that this practice was not explicitly stated.c. Corrective Action: The FAP was updated to explicitly state that EMHS Hospitals will provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility for assistance under the FAP and as required under the EMHS Emergency Medical Care Policy. d. Date Corrected: These revisions to the FAP were approved by EMHS Leadership in Fiscal Year 2017 and the EMHS Board of Directors at its October 4, 2017 meeting. The updated FAP was widely publicized upon approval by the EMHS Board of Directors. 5. Billing and Collection Practicesa. Requirement: The FAP (or separate billing and collection policy) must include information on the actions the hospital will take to collect outstanding balances, including the reasonable efforts made to determine FAP eligibility. This information must be widely publicized along with the FAP.b. Condition: The billing and collection practices were adequately described in the Billing and Collections Policy which was referenced in the widely publicized FAP. However, the Billing and Collections Policy itself was not widely publicized.c. Corrective Action: The required billing and collection practices were added to the FAP. d. Date Corrected: These revisions to the FAP were approved by EMHS Leadership in Fiscal Year 2017 and the EMHS Board of Directors at its October 4, 2017 meeting. The updated FAP was widely publicized upon approval by the EMHS Board of Directors.6. Widely Publicized a. Requirement: In order to ensure the FAP is widely publicized , a hospital must take several actions, one of which is to include a conspicuous written notice on billing statements that notifies and informs recipients about the availability of financial assistance under the hospital facility's FAP and includes the telephone number of the hospital facility office or department that can provide information about the FAP and FAP application process and the direct Web site address (or URL) where copies of the FAP, FAP application form and plain language summary of the FAP may be obtained.b. Condition: While Inlands billing statements included a conspicuous written notice to notify recipients about the availability of financial assistance, telephone numbers to the department that can provide more information about financial assistance, and the EMHS billing help Web site address, the billing statements did not clearly state the FAP documents could be obtained from the Web site address provided.c. Corrective Action: Billing statements were updated in Fiscal Year 2017 to clarify that certain FAP-related documents may be obtained from the Web site address provided on the statement. In Fiscal Year 2018, Inland made additional revisions to further clarify the language included on the billing statements.d. Date Corrected: June 15, 2017 with additional revisions made in Fiscal Year 2018.7. PLSa. Requirement: The PLS must include certain information, including a statement of the availability of translations of the FAP, FAP application form and PLS in other languages, and a statement that a FAP-eligible individual will not be charged more than AGB for emergency or other medically necessary care.b. Condition: While the PLS met most of the requirements of the regulation, it did not include a statement of the availability of translations of the FAP, FAP application form and PLS in other languages, and also did not clearly state that a FAP-eligible individual will not be charged more than AGB for emergency or other medically necessary care.c. Corrective Action: The PLS was updated to include a statement of the availability of translations of the FAP, FAP application form and PLS in other languages, and to clearly state that a FAP-eligible individual will not be charged more than AGB for emergency or other medically necessary care. d Date Corrected: After the revisions to the FAP were a X true true false true false false false false false false false false CATHERINE KIMBALL DO CHF OF STAFF/EX 203304 67215 3851 9792 11308 295470 CHRIS FRAUENHOFER VP, FINANCE 101177 101177 6760 6760 1819 1819 14696 14696 124452 124452 CONSTANCE BARRETT Former VP/CNO 86173 11934 6936 2106 6790 113939 DANIEL J BOOTH VP of Operation 209560 18625 5786 8966 12398 255335 DEAN BITHER VP, Finance 220156 19476 6432 14393 29082 289539 DEEP ACHARYA Physician 320769 50 25330 2234 25815 374198 EUGENE CHARLEBOIS DO Physician 262788 20150 35550 4770 29281 352539 GAVIN DUCKER DO VP-Med Affairs 255929 33940 3206 15459 28752 337286 GLENN MARTIN VP GEN COUNSEL Secretary 362009 6612 69889 20591 459101 GLORIA SIMMS Physician 299554 2217 11570 25149 338490 JOHN DALTON Pres/Ex-Officio 280230 14979 463893 21200 17369 797671 450000 MARY M HOOD EMHS CEO Ex-officio 870512 15327 250857 20855 1157551 MICHAEL PALUMBO DO Former VP Med Affairs/CMO 125933 14514 44140 10227 6590 201404 PAUL BOLIN VP and CHRO 192976 4264 13113 29233 239586 RICHARD T SAMSON MD PHYSICIAN 271708 36818 2743 5740 24698 341707 SIMON GIBBS MD Physician 374691 4221 3923 13645 28005 424485 THEODORE HELBERG III Former VP HR South Region 141244 31793 16230 8569 197836 TONY FILER SENIOR VPCFO Treasurer 57283 120327 2704 180314 WALTER RICK BARRY VP OF PT CARE 212865 17888 1902 13222 9641 255518 WILLIAM BRADFIELD MD Board Member 331949 1300 18400 28009 379658 Part I, Line 1a: Relevant information in regards to selections on 1a. The following received a wellness program incentive:Deep Acharya, highest compensated employee $407.00Walter Barry, officer 47.00Daniel Booth, officer 247.00William Bradfield, board member 72.00Eugene Charlebois, highest compensated employee 322.00Catherine Kimball, board member 357.00Gloria Simms, highest compensated employee 357.00The benefit is available for all employees. A Maine Health and Higher Educational Facilities Authority 010314384 560425V80 2007-11-01 3263464 ED Expansion & Purchase Prac false false true B Maine Health and Higher E 010314384 5604273W4 2015-07-14 1169738 To refund the 2006A Bond false false true A 630000 3263464 206349 62525 4557 2990033 2008 false false true true B 105000 1169738 92638 890000 25336 282 161482 2015 false true true true A false false false false false true B false false false false 0.00200 0.00200 true false true A false true false NA true FSA 29.0000 true false false B false true false NA false false false A true B true Part VI Part IV Line 2C, Column A - 12/4/17 - Date of Rebate Computation.Part IV, line 7 - The issuer (MHHEFA) has established written procedures to monitor the requirements of Section 148. The organization has entered into a tax regulatory agreement with the issuer that requires the organization to comply with the requirements of Section 148. The organization is working to establish its own written procedures to monitor such requirements. Susan Palumbo fam mem of officer 43770 compensation false Sara Barry fam mem of officer 100403 compensation false Simon Gibbs spouse of officer 382835 compensation false Schedule L, Part V Supplemental Information Susan Palumbo is a family member of an officer of Inland Hospital.Sara Barry is a family member of a former officer of Inland Hospital.Simon Gibbs is a spouse of an officer of Inland Hospital. Form 990, Part III, Line 4d: Other Program Services Description OTHER PROGRAM SERVICES 4: Provided healthcare services regardless of ability to pay as well as education and promotion of health. Provided $2,976,974 other uncompensated care (at cost).Inland Hospital is a 48-bed facility that provides medical-surgical, and acute care. Inland is a non-profit hospital, serving all who need care, regardless of ability to pay. Inland Hospital also has outlying clinics in the region, allowing easier access for patients.Additional Statistics:Total Admissions 1,564Percent Occupancy of Available Beds 26%Emergency Room Visits 13,014Surgery Cases 1,596Services provided to those who could not pay $7,819,806.13 OTHER PROGRAM SERVICES 5: Please see the following excerpt from the EMHS Annual Report to the Community for details of community benefit projects at EMHS members:Coming together is a beginning; keeping together is progress; working together is success. The man who spoke these words understood the value of teamwork. He embraced technology in a way that nobody else had before him. His vision, passion, and innovation revolutionized the world. He made it possible for families to feel more connected despite living long distances apart. In many ways, EMHS shares the same goals championed 100 years ago by industrialist and automaker, Henry Ford.Like Ford, we know that we are succeeding by working together. Our new integrated, system wide electronic health record (EHR) will allow all our hospitals, primary care practices, and other members within the EMHS family to share information seamlessly. Using this system, we can collaborate more effectively and improve patient care.By mass-producing the automobile, Ford helped rural Americans feel connected. We are connecting people through technology, too. People who live in rural communities can talk one-on-one through a computer screen with doctors who may be several states away, thanks to our investments in telemedicine. Patients have access to specialists that would have been out of reach without this technology.Ford was an innovator. We too are embracing innovation in the way we deliver care. Our partnership with Dana-Farber Cancer Institute affords opportunities for cancer patients to access clinical trials closer to home at our Lafayette Family Cancer Center in Brewer. We are using paramedics to make routine house calls in our rural communities to perform wellness checks. This service is helping patients avoid trips to the hospital or doctor's office while getting compassionate care in the comfort of their own homes.Of course, all of these initiatives require dedicated people who are committed to teamwork. It's the very reason why we take extraordinary measures to recruit and retain our employees. We have added a new nurse residency program, which is already showing signs of success in addressing a critical statewide nursing shortage and providing our nurses the tools they need to thrive. By working together, we can continue to do great things.To borrow another line from Henry Ford, If everyone is moving forward together, then success takes care of itself. In the pages that follow are numerous testaments to the innovative spirit underscoring many successes this past year throughout our system. While the hard work will continue, we are pleased to share with you the progress we are making towards achieving our vision to be a nationally recognized model of excellence in healthcare.M. Michelle Hood, FACHEEMHS President and CEOBarry McCrumEMHS Board ChairCONNECTING WORLD CLASS CARETerry White longs for the day that she can return to the sandy shores of Myrtle Beach to feel the warm Carolina sunshine on her face and the ocean waves splashing upon her feet. She has plans to go back to visit family and won't let cancer slow her down. My journey is not over just because I have this disease, Terry said. It doesn't mean life doesn't go on. I definitely have a lot of life to live.Terry was diagnosed with breast cancer a decade ago. I was 38 when I found a lump in my breast in the shower one morning and immediately called my primary care physician. Unfortunately, the cancer became metastatic, meaning it spread to other parts of her body. I went from being a survivor to a lifer because I live with cancer every day, and I'll live with it every day until the end, she said. Terry has gone through several treatments of radiation and chemotherapy over the years.During a recent visit to EMMC Cancer Care at the Lafayette Family Cancer Center in Brewer, she was comfortably dressed in jeans and a maroon blouse, and wore a hat on her head. Because the cancer spread to the bone marrow in her leg, she wore a knee brace to alleviate pain. What's remarkable about Terry is how she projects a positive attitude. A powerful storm that day was toppling trees and knocking down power lines outsideit wasn't enough to stop her from making the 30-minute ride to the treatment center from her home in Pittsfield or to diminish her optimism. Research today has given us treatments that are light years ahead of what we used to have, she said.Terry is hopeful because she is taking part in a clinical trial thanks to a collaborative partnership between Dana-Farber Cancer Institute in Boston and EMMC Cancer Care. She is taking an experimental drug under the coordinated care of her medical team in Brewer and the Dana-Farber specialists in Boston. The treatment I come for is administered by a syringe. I don't have to sit there for four hours waiting for this to be over and waiting for the side effects, she said.Eric Winer, MD, is chief clinical strategy officer at Dana-Farber and director of the Breast Oncology Center. He and other members of the Dana-Farber team visited EMMC Cancer Care last fall for a tour. Dana-Farber only partners with cancer centers that already deliver excellent care, Dr. Winer said. The goal of the collaborative for Dana-Farber is to extend its reach and bring clinical trials to people living in rural areas. When people participate in clinical trials, the hope is that they will do better than they might with standard care, but no matter what, they are contributing to the future of cancer care, he said.The staff at EMMC Cancer Care also benefits by being in the collaborative. They have more educational opportunities and access to medical specialists at Dana-Farber for rapid consultation on complex cases. Dana-Farber clinical care is provided in Boston and this collaborative brings their expertise to the heart of Maine, explained Thomas Openshaw, MD, medical director, Oncology Research at EMMC Cancer Care. The staff at EMMC and Dana-Farber have a firm resolve to help not only current patients, but also future patients to live better lives. Our whole goal is to try to cure whatever patients can be cured, and that's a large proportion of patients, and for the others to give them the best and the longest life that they can have, Dr. Winer said.That seems to be working for Terry White, who's already making travel plans to Myrtle Beach. It gives you a reason to go through what you're going through. We've got to learn from it for the future, she said, adding, I want to be healthy for my family, I want to participate in life with my family and my friends, and continue to enjoy life.CONNECTING WITH TECHNOLOGYCharles A. Dean Memorial Hospital (CA Dean) in Greenville sits along the scenic shores of Moosehead Lake, one of Maine's most treasured natural resources. It's a peaceful, idyllic spot that draws tourists from far and away who are eager to get away from the hustle and bustle of their daily grind. But beneath the hum of motorboats cruising along Moosehead Lake in the summer, or the snowmobiles skirting across its icy surface in winter; beneath the laughter of kids splashing in the water on a hot August day or pulling a trophy trout through the ice on a frigid February morning, there is a rural health problem that those visitors do not see. To be fair, it affects communities throughout Maine but has been more problematic in those towns and hamlets tucked far away from urban centers.There is very little rural mental health period, explains Joseph Babbitt, MD, an emergency room physician and hospitalist at CA Dean. Historically people in rural communities have had to travel hours to access psychiatric services. If they showed up at any rural hospital emergency room with a mental health crisis, they had to wait hours for an evaluation. You've got an emotionally unstable patient who is in a very disruptive emergency waiting room environment, waiting 18 hours to have a mental health professional come assess them. That doesn't help anyone, Dr. Babbitt said.But technology is bridging the gap and allowing those who live in rural communities to have the same access to psychiatric services as their urban counterparts. Telemedicine is a medium that connects a patient with a practitioner via a screen, explained Gavin Ducker, MD, chief medical officer at Inland Hospital in Waterville.Inland Hospital and Form 990, Part VI, Line 2: Description of Business or Family Relationship of Officers, Directors, Et Mary M. Hood, board member/officer is board member of Maine Hospital Association and John Dalton, board member/officer is committee member of Maine Hospital Association Public Policy Committee. Form 990, Part VI, Line 4: Description of Significant Changes to Organizational Documents Amended Article IV (Officers), Section 5 (President) - to remove President as the chief executive officer of the Corporation.Amended Article IV (Officers), Section 7 (Treasurer & Assistant Treasurer) - to change the title of Chief Financial Officer to VP of Finance.Amended Article V (Committees), Section 7 (Governance Committee) to change the title President/CEO to President.Amended Article V (Committees), Section 10 (Finance Committee) to change the title of Chief Financial Officer to Assistant Treasurer.Amended Article VIII (Fiduciary Duty; Prohibited Transactions; Divided Loyalty; Independence), Section 5 (Independent Trustees), Subsection (a) and Subsection (b) to change the reference to interim chief executive officer to President. Form 990, Part VI, Line 6: Explanation of Classes of Members or Shareholder Inland Hospital (the "Corporation") is a Maine nonprofit corporation. Eastern Maine Healthcare Systems ("EMHS"), also a Maine nonprofit corporation, is the sole voting corporate member of the Corporation. Form 990, Part VI, Line 7a: How Members or Shareholders Elect Governing Body Each year at their annual meeting, the directors elect replacements for those directors whose terms are expiring Election of directors is subject to ratification by the EMHS Board of Directors. Form 990, Part VI, Line 7b: Describe Decisions of Governing Body Approval by Members or Shareholders The EMHS President has authority to appoint and remove the SVP, President of the Corporation. EMHS also has joint and superior authority to approve, disapprove or initiate action with respect to the following matters: I. amendments to the corporations Articles of Incorporation or Bylaws;II. changes in legal form of organization of the Corporation;III. election of the Directors/Trustees of the Corporation;IV. action concerning the Corporation's operating budget and capital expenditures;V. the Corporation's acquisition of assets or assumption of liabilities of an unaffiliated third party;VI. transfer of 5% or more of the assets of the Corporation;VII. financing transactions concerning the Corporation; VIII. merger, consolidation, sale, lease, mortgage, pledge or other disposition of all or substantially all assets of the Corporation; IX. add or revise a health care service of the Corporation;X. discontinue or close a health care service of the Corporation;XI. action concerning the Corporation's role in the EMHS Strategic Plan;XII. action concerning the Corporation's participation in key strategic affiliations with third parties not affiliated with EMHS; andXIII. dissolution of the Corporation. Form 990, Part VI, Line 11b: Form 990 Review Process Form 990 is reviewed by the VP of Finance of Inland Hospital. It is provided to each board member either electronically or in hard copy with an opportunity to ask questions prior to filing with the IRS. Form 990, Part VI, Line 12c: Explanation of Monitoring and Enforcement of Conflicts The organization requests updates of potential conflicts and relationships from the officers and Board members on an annual basis. The request requires disclosure of all business relationships, board memberships, and family relationships. A database is maintained that is compared to payroll records and the accounts payable vendor list to identify any potential conflicts of interest. Transactions are reviewed for reasonableness as an arm's length transaction. The first agenda item for board meetings and board committee meetings is for members to declare any conflict of interest with upcoming agenda items or deliberations. At any point when consideration is being given to purchase/contract with a party in interest, the member with the conflict is either excused from the discussion and consideration process or abstains from voting on the matter. All transactions identified with parties in interest are disclosed within the Form 990. All are deemed to be arm's length transactions. Form 990, Part VI, Line 15a: Compensation Review & Approval Process - CEO, Top Management The SVP, President of Inland Hospital(Inland) is employed by the system parent, Eastern Maine Healthcare Systems and reports directly to the EMHS President/CEO (President). The EMHS Executive Performance Management Committee (the Committee) is responsible to monitor and evaluate the performance of the EMHS President, to set compensation of the EMHS President, and to review recommendations of the EMHS President with respect to compensation of the SVP, President of the direct subsidiaries, and other direct reports to the President. The Committee is comprised entirely of independent Directors per EMHS bylaws. Process:The Committee meets regularly throughout the fiscal year at the discretion of the Committee chair as well as on call of the Chair of the EMHS board. In carrying out its duties pursuant to the Bylaws, the Committee:-Assures that the executive compensation program is administered in a manner consistent with the EMHS executive compensation philosophy.-Reviews and updates the EMHS executive compensation philosophy which serves as the foundation on which all current and future executive compensation decisions are made.-Assures that value of compensation provided by EMHS does not exceed the value of services provided by the executive.-Reviews annual incentive compensation criteria for eligible executives, as defined by the EMHS President.-Reviews periodic compensation survey information and provides expert input to proposed changes to the executive compensation program.-Assures that a formal and timely performance management system is in place for executives.-Reviews incentive compensation criteria scoring and associated pay schedules for officers and key employees.-Provides any public statements regarding executive compensation practices at EMHS deemed appropriate.-Maintains minutes of the meetings and communicates actions to the EMHS Board of Directors.To accomplish this, the committee uses an external consultant with access to comparative data from independent sources and include national as well as regional data points. The EMHS President reviews all direct report compensation actions with the committee. In addition, the EMHS President ensures that any subsidiary policies and practices governing executive compensation are consistent with the committee's philosophy and practices statement. Form 990, Part VI, Line 15b: Compensation Review and Approval Process for Officers and Key Employees Compensation of other officers and key employees of the organization is established by the Human Resources department who utilize external market research to establish compensation ranges for specific positions. The compensation of officers and key employees are reviewed by the system President/CEO and Inland board of trustees.On an annual basis, the compensation ranges are compared to the updated survey information. The Human Resources department will determine where the employee will fall within the ranges established by the Human Resources department based on experience and credentials. Form 990, Part VI, Line 19: Other Organization Documents Publicly Available Inland Hospital makes its governing documents, conflict of interest policy and financial statements available to the public upon request. Other Changes In Net Assets Or Fund Balances - Other Increases Change in interest in nets assets held @ EMHSF = $1657801 Other Changes In Net Assets Or Fund Balances - Other Decreases Transfer to exempt parent-Eastern Maine Healthcare Systems = -$8980412 Other Changes In Net Assets Or Fund Balances - Other Decreases Transfer to exempt subsidiary - EMHSF = -$1491112 SCHEDULE H PART VI SUPPLEMENTAL INFORMATION Continuation of Disclosure in accordance with Revenue Procedure 2015-21:Schedule H, Part V Facility Information, Section B Facility Policies and Practices8. PLS Eligibility Requirementsa. Requirement: The PLS must include certain information, including a brief description of the eligibility requirements and assistance offered under the FAP.b. Condition: Although patients from any state could be eligible to receive financial assistance under the FAP, the PLS indicated that financial assistance or free care was only available for medically necessary or emergency care services received by Maine residents. c. Corrective Action: The PLS was updated to indicate that non-Maine residents were eligible to receive financial assistance or free care for emergency care services. d. Date Corrected: After the revisions to the FAP were approved by EMHS Leadership in Fiscal Year 2017 and the EMHS Board of Directors at its October 4, 2017 meeting, the PLS was updated and was widely publicized in October 2017. 9. Translationsa. Requirement: To widely publicize its FAP, a hospital facility must accommodate all significant populations that have limited English proficiency (LEP) by translating its FAP, FAP application form and PLS into the primary language(s) spoken by such populations.b. Condition: While the FAP, FAP application and PLS were translated into the primary languages spoken by the populations served by Inland, the instructions to the FAP application and the title and one paragraph of the Provider List attached to the FAP (i.e., the list of providers covered by the hospital's FAP) were not translated into these languages.c. Corrective Action: The FAP application instructions and the applicable language on the Provider List were translated into the required languages.d. Date Corrected: After the revisions to the FAP were approved by EMHS Leadership in Fiscal Year 2017 and the EMHS Board of Directors at its October 4, 2017 meeting, the FAP application instructions and Provider List were updated and were widely publicized in October 2017. Eastern Maine Healthcare Systems EMHS 43 Whiting Hill Road Brewer ME 04412 010527066 Supporting organization for healthcare affiliates ME 501(c)(3) 12 Type II N/A true Eastern Maine Medical Center EMMC PO Box 404 489 State Street Bangor ME 044020404 010211501 Provide healthcare services ME 501(c)(3) 3 EMHS true Eastern Maine Healthcare Real Estate 43 Whiting Hill Road Brewer ME 04412 010391036 Leases real estate ME 501(c)(2) EMHS true Rosscare 43 Whiting Hill Road Ste 400 Brewer ME 04412 010391038 Provide services to elderly ME 501(c)(3) PF EMHS true Rosscare Nursing Homes Inc 43 Whiting Hill Road Ste 400 Brewer ME 04412 010430751 Operation of nursing homes ME 501(c)(3) 10 Rosscare true Acadia Hospital Corp AHC 43 Whiting Hill Road Brewer ME 04412 010459837 Provide healthcare services ME 501(c)(3) 3 EMHS true Eastern Maine Medical Center Auxiliary 43 Whiting Hill Road Brewer ME 04412 010377901 Fund raising for exempt Eastern Maine Medical Center ME 501(c)(3) 10 EMMC true Acadia Healthcare Inc AHI 43 Whiting Hill Road Brewer ME 04412 223183888 Provide healthcare services ME 501(c)(3) 10 AHC true EMHS Foundation 43 Whiting Hill Road Brewer ME 04412 222514163 Raise and manage funds for exempt organizations ME 501(c)(3) 12 Type II EMHS true Norumbega Medical Specialists LTD 43 Whiting Hill Road Brewer ME 04412 010465231 Provide patient care and education ME 501(c)(3) 10 EMMC true Lakewood 220 Kennedy Memorial Drive Waterville ME 04901 010421234 Provide skilled and long-term nursing care ME 501(c)(3) 3 Inland Hospital true CA Dean Memorial Hospital Pritham Avenue PO Box 1129 Greenville ME 044411129 043341666 Provide healthcare services ME 501(c)(3) 3 EMHS true Sebasticook Valley Health SVH 447 North Main Street Pittsfield ME 04967 010263628 Critical care hospital ME 501(c)(3) 3 EMHS true The Aroostook Medical Center TAMC PO Box 151 140 Academy Street Presque Isle ME 047690151 010372148 Provide healthcare services ME 501(c)(3) 3 EMHS true TAMC Title Corp PO Box 151 140 Academy Street Presque Isle ME 047690151 010389226 Real estate holding company ME 501(c)(2) TAMC true Horizons Health Services PO Box 151 140 Academy Street Presque Isle ME 047690151 010504393 Provide patient care ME 501(c)(3) 3 TAMC true Blue Hill Memorial Hospital 57 Water Street Blue Hill ME 046145231 010227195 Provide healthcare services ME 501(c)(3) 3 EMHS true Meadow Wood LLC 43 Whiting Hill Road Brewer ME 04412 272935243 Provide patient care ME 501(c)(3) 10 AHI true Sebasticook Valley Family Practice Assoc 447 North Main Street Pittsfield ME 04967 010357854 Provide patient care ME 501(c)(3) 10 SVH true Restoration Health LLC 43 Whiting Hill Road Brewer ME 04412 352449986 Provide mental & behavioral hlth srvs ME 501(c)(3) 10 AHI true Mercy Hospital 144 State Street Portland ME 04101 010211534 Provide healthcare services ME 501(c)(3) 3 EMHS true Mercy Health System of Maine 144 State Street Portland ME 04101 010484074 Supporting org for healthcare affiliates ME 501(c)(3) 12 Type III Func Int EMHS true VNA Home Health & Hospice 50 Foden Road South Portland ME 04106 010246804 Provide home health and hospice services ME 501(c)(3) 10 EMHS true Work Health LLC 43 Whiting Hill Rd Brewer ME 04412 474315094 Provide healthcare services ME 501(c)(3) 12 Type II EMHS true Maine Coast Healthcare Corporation 50 Union Street Ellsworth ME 04605 223176167 Provide Dental Services ME 501(c)(3) 12 Type II EMHS true Maine Coast Regional Health Facilities 50 Union Street Ellsworth ME 04605 010198331 Provide Healthcare Services ME 501(c)(3) 3 EMHS true Maine Coast Medical Realty 50 Union Street Ellsworth ME 04605 010390918 Lease medical facilities ME 501(c)(3) 12 Type I MCMH true Lifestages Physician Services LLC 50 Foden Road South Portland ME 04106 821043752 Provide home health and hospice services ME 501(c)(3) 10 VNA true Beacon Health LLC 43 Whiting Hill Road Brewer ME 04412 452967056 Accountable care organization ME EMHS false false Beacon Rural Health LLC 43 Whiting Hill Road Brewer ME 04412 474483187 Accountable Care Organization ME EMHS false false Meridian Mobile Health LLC 43 Whiting Hill Road Brewer ME 04412 010512673 Ambulance ME AHS false false M Drug LLC 43 Whiting Hill Road Brewer ME 04412 272175482 Pharmacy ME AHS false false Alliance Health Documentation LLC 43 Whiting Hill Road Brewer ME 04412 462751855 Transcription ME AHS false false Affiliated Healthcare Systems AHS 43 Whiting Hill Road Brewer ME 04412 010385322 Holding co. ME EMHS C true Affiliated Healthcare Management 43 Whiting Hill Road Brewer ME 04412 010349339 Hlthcr mgmt ME AHS C true Affiliated Laboratory Inc 43 Whiting Hill Road Brewer ME 04412 010381283 Clinicl lab ME AHS C true Affiliated Materiel Services 43 Whiting Hill Road Brewer ME 04412 010381189 Purchasing ME AHS C true Beacon Direct 43 Whiting Hill Road Brewer ME 04412 371864965 Healthcare Self-Funded TPA ME EMHS C true Maine Coast Physician Affiliates 50 Union Street Ellsworth ME 04605 010479952 Patient Care ME MCMH C true true false false false false false false false false false false true true false false true false true true Eastern Maine Healthcare Systems EMHS m 5009182 FMV Eastern Maine Healthcare Systems EMHS p 6618642 FMV Eastern Maine Healthcare Systems EMHS r 9359263 FMV Eastern Maine Healthcare Systems EMHS s 378851 FMV Eastern Maine Medical Center EMMC m 3630690 FMV Acadia Hospital Corp AHC m 106602 FMV Acadia Healthcare Inc AHI m 88564 FMV EMHS Foundation m 204000 FMV EMHS Foundation r 1491112 FMV EMHS Foundation s 103700 FMV Lakewood a 9000 FMV Lakewood l 55714 FMV Sebasticook Valley Health SVH l 121828 FMV Beacon Health LLC m 281862 FMV M Drug LLC m 63104 FMV Alliance Health Documentation LLC m 154557 FMV Affiliated Laboratory Inc m 664661 FMV Affiliated Materiel Services m 59192 FMV Affiliated Materiel Services p 1149466 FMV