2017-08-14T13:57:19-05:00 2016-09-30 010494526 BAKER NEWMAN & NOYES BOX 507 PORTLAND ME 04112 990 2015-10-01 010215911 Mid Coast Hospital MIDC 2077290181 123 Medical Center Drive Brunswick ME 04011 Robert McCue Vice President of Finance/CFO 2077290181 2017-08-14 1 Nicholas E Porto P01310283 2078792100 2017-08-14 2015 2021-01-29 14:40:06Z Lois N Skillings 123 Medical Center Drive Brunswick ME 04011 195744075 0 X www.midcoasthealth.com X 1991 ME Acute and specialty care hospital 24 22 1291 450 0 0 2400981 2818960 160955960 185579368 3553242 2238681 878 22702 166911061 190659711 15820 12000 0 0 85017633 99012275 0 0 372215 74666985 87747305 159700438 186771580 7210623 3888131 177579240 184424765 59419267 60103637 118159973 124321128 X To provide quality health care and health-related services directed toward continually improving the health and wellbeing of the patients and communities we serve. We will provide compassionate, humanistic, accessible, personal, professional, efficient, cost-effective and quality services. 0 0 156017403 12000 185579368 Acute and specialty health care services were provided to residents of the Mid-Coast Maine area. Charity care was provided to those patients who did not have the ability to pay for medical services. 156017403 1 1 0 1 0 0 0 0 0 1 1 0 0 1 1 1 1 1 0 0 0 0 0 0 1 0 1 1 0 0 1 1 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0 1 0 0 0 1 176 0 1 1291 1 0 0 0 0 0 1 1 0 0 0 0 X 24 22 1 0 0 0 1 1 1 1 1 0 0 0 1 1 1 1 1 1 1 0 X Michael Perry 2077290181 123 Medical Center Drive Brunswick ME 04011 X Lenora Burke Director 0.30 0.60 X 0 0 0 Sherrie Bergman Director 0.30 0.60 X 0 0 0 Pamela Bowerman Director 0.30 0.60 X 0 0 0 Robert Cundiff Director 0.30 0.60 X 0 0 0 John Farnham Director 0.30 0.60 X 0 0 0 Rollin Fessenden Director 0.30 0.60 X 0 0 0 Jill Haer Director (part-year) 0.30 0.60 X 0 0 0 Patrice Hennin Director (part-year) 0.30 0.60 X 0 0 0 Ted Huskins Director 0.30 0.60 X 0 0 0 Connie Jones Director 0.30 0.60 X 0 0 0 John Moncure Director 0.30 0.60 X 0 0 0 John G Morse IV Director 0.30 0.60 X 0 0 0 Lloyd Van Lunen MD Director 0.30 0.60 X 0 0 0 Daniel Morgenstern MD Director 0.30 0.60 X 0 0 0 Douglas Niven Director (part-year) 0.30 0.60 X 0 0 0 Steve Obrin Director (part-year) 0.30 0.60 X 0 0 0 Matthew Orlando Director 0.30 0.60 X 0 0 0 Dean Patterson Director 0.30 0.60 X 0 0 0 Dugan Shipway Director 0.30 0.60 X 0 0 0 Sandra Morrell Rooney Director 0.30 0.60 X 0 0 0 Ellen Hutchinson Director/Aux. President (part-year) 0.30 0.60 X 0 0 0 Cyndy Bush Director/Aux. President 0.30 0.60 X 0 0 0 Katarina Sawtelle MD Medical Staff VP 0.30 0.60 X X 0 1000 0 Patrick Keaney MD President Medical Staff 41.80 0.60 X X 319322 0 37121 Barbara Reinertsen Chairperson 0.30 0.60 X X 0 0 0 Bob Davis Vice Chairperson 0.30 0.60 X X 0 0 0 Glenn L Hutchinson Treasurer 0.30 0.60 X X 0 0 0 Charles Bridge Secretary 0.30 0.60 X X 0 0 0 Lois N Skillings President/CEO 30.50 11.00 X X 0 429594 78432 Robert McCue CFO 30.50 11.00 X 0 286129 62700 Miguel Arguedas MD Physician 41.50 0.00 X 588826 0 35898 Calin Stoicov MD Physician 41.50 0.00 X 580702 0 38813 Craig Hawkins MD Physician 41.50 0.00 X 541732 0 37826 Peter Hutchinson MD Physician 41.50 0.00 X 482527 0 25852 Michael Samson MD Physician 41.50 0.00 X 462499 0 29420 2975608 716723 346062 120 0 1 0 Bluewater Emergency Partners PO Box 415778 Boston ME 022417479 ER Facility & Physcian Coverage 1885944 Langford & Low Inc PO Box 662 Portland ME 04104 Building Contractors 885495 Midcoast Pediatrics 121 Medical Center Drive Suite 260 Brunswick ME 04011 Physician Coverage 869059 Synernet Inc 110 Free Street Freeport ME 04101 Transciption Sevices 666978 Locumtenenscom Inc PO Box 405547 Atlanta GA 303845547 Physician Coverage 597829 30 43920 1894318 880722 29267 2818960 Net Patient Service Revenue 621400 182040996 182040996 Miscellaneous Revenue 621400 3325275 3325275 Electronic Health Records Revenue 621400 213097 213097 185579368 2272744 2272744 17520 0 17520 17520 17520 5007279 30051 5037561 33832 -30282 -3781 -34063 -34063 18153 43920 12971 5182 5182 190659711 185579368 0 2261383 X 12000 12000 356443 342185 14258 81109844 72092693 9017151 1277167 727988 549179 12591806 7177355 5414451 3677015 2095906 1581109 205668 205668 59247 59247 19768 19768 18741015 14659994 4081021 235351 184101 51250 11357086 8899444 2085427 372215 7542299 5899897 1642402 45015 35213 9802 1553364 1215105 338259 5907246 4620891 1286355 2004486 1567991 436495 Pharmacy Expenses 12941934 10123714 2818220 Provision for Bad Debts 12592376 12592376 Patient and Non Patient 10103749 9714216 389533 Revenue Tax 2682782 2682782 1755919 1373552 382367 186771580 156017403 30381962 372215 6731103 6995769 9290918 11466797 25030337 24605411 2974822 2990867 2844351 3375786 125746343 69115045 57892977 56631298 57695415 59979747 275565 258368 14843752 18120722 177579240 184424765 18418901 19590499 28235775 26947907 452584 269179 12312007 13296052 59419267 60103637 X 100031294 105089953 10036160 11076041 8092519 8155134 118159973 124321128 177579240 184424765 3888131 2273024 0 X X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 1 19768 0 0 0 19768 0 Part II-B, Line 1: Mid Coast Hospital paid dues to Maine Hospital Association totaling $46,628, of which 22% ($10,258) was available for lobbying; dues to American Hospital Association totaling $25,446 of which 22.1% ($5,629) was available for lobbying; dues to Maine Medical Association of $25,876, 15% ($3,881) of which was available for lobbying. 26168215 62616 1469499 218621 27481709 23753372 54278 2729525 368960 26168215 22293184 259115 1470185 269112 23753372 21128741 176735 1220014 232306 22293184 20613770 71499 611529 168057 21128741 0.46000 0.29630 0.24370 0 0 329281 329281 63498252 21461568 42036684 5942481 2924737 3017744 55976329 44728740 11247589 56631298 Construction in Progress 2604575 L-T Asset (Deferred Comp Plan) 10163125 Due from Affiliates 2464123 Other Assets 2888899 18120722 Deferred Compensation Plan 10163125 Estimated Third-Party Payor Settlements 3132927 13296052 X 192945706 2273024 12971 2285995 190659711 0 190659711 186784551 12971 12971 186771580 0 186771580 Part V, Line 4: Endowment funds are invested and used in a manner that provides predictable streams of funding to the programs supported by the endowed funds, all while seeking to maintain the purchasing power of the endowment assets. Part X, Line 2: The Hospital is a not-for-profit corporation and is tax-exempt under Section 501(c)(3) of the Internal Revenue Code. Tax-exempt organizations could be required to record an obligation for income taxes as the result of a tax position they have historically taken on various tax exposure items including unrelated business income or tax status. Under guidance issued by the Financial Accounting Standards Board, assets and liabilities are established for uncertain tax positions taken or positions expected to be taken in income tax returns when such positions are judged to not meet the "more-likely-than-not" threshold, based upon the technical merits of the position. Estimated interest and penalties, if applicable, related to uncertain tax positions are included as a component of income tax expense. The Hospital has evaluated the position taken on its filed tax returns. The Hospital has concluded no uncertain income tax positions exist at September 30, 2016. The Hospital's tax years from 2013 through 2016 are open and subject to examination. Part XI, Line 2d - Other Adjustments: Fundraiser Expenses 12,971. Part XII, Line 2d - Other Adjustments: Fundraiser Expenses 12,971. Golf Tournament 62073 43920 18153 1328 7210 3461 972 62073 43920 18153 1328 7210 3461 972 12971 5182 1 1 1 X 1 X 1 1 0 0 5460803 166198 5294605 0.03040 11174640 9812255 1362385 0.00780 16635443 9978453 6656990 0.03820 1045541 21001 1024540 0.00590 36767141 28542137 8225004 0.04720 37812682 28563138 9249544 0.05310 54448125 38541591 15906534 0.09130 1 6052511 0 35176204 37373169 -2196965 X 1 1 1 1 Mid Coast Hospital 123 Medical Center Drive Brunswick ME 04011 www.midcoasthealth.com 38168 X X X Mid Coast Hospital 1 0 0 1 X X X X X X X X X 13 1 0 0 1 X see Part V, Section C X 1 13 1 see Part V, Section C 1 0 1 X 200.000000000000 300.000000000000 X X 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 Mid Coast Hospital Part V, Section B, Line 5: Mid Coast Hospital engaged in an assessment of the health needs of the mid coast community and this was the most comprehensive health needs assessment ever performed in our community. All told, over 1,000 community members attended one of many focus groups to discuss the current and future health needs in our region. In the process of developing priorities and a plan for how to operate over the next decade, Mid Coast Parkview Health listened and learned from the community - patients and families, faith community, municipal leaders, legislators, experts in public health, local businesses, employees, medical staff, hospital volunteers, auxiliary, Board members, and Corporators for guidance. Mid Coast Hospital Part V, Section B, Line 11: Please see attached CHNA and Implementation Strategy for information on how the Hospital is addressing the significant needs identified in its most recently conducted CHNA. The Hospital is addressing each significant need identified in its most recent CHNA. Mid Coast Hospital Part V, Section B, Line 22d: The Hospital currently starts with gross charges for all patient billing. Federal poverty guidelines are utilized in the determination of charity care eligibility. Patients who are unable to pay and have exhausted all sources of payment may qualify for charity care. Those patients that qualify and have income levels below 200% of the federal poverty guidelines can receive 100% charity care. A sliding scale is used for patients with income levels between 200% and 300% of the federal poverty guidelines. The amount considered for charity will be based upon the evaluation of the patients' ability to pay. Patients who qualify for partial financial assistance are responsible for any remaining balance after the charity care adjustment and third party payments. Once an account has been processed through an internal routine collection process, it may be assigned to an attorney/agency for collection. Schedule H, Part V, Section B, line 7a & 10a: The CHNA & Implementation Strategy are available at the Hospital facility's website:http://www.midcoasthealth.com/about/community-health/The Hospital was required to conduct a new CHNA and Implementation strategy for the tax year ending September 30, 2017 (the 2016 tax year). In anticipation of this deadline, the Hospital began working on a new CHNA during the fiscal year ended September 30, 2016. This new CHNA and Implementation Strategy was finished and made widely available to the public shortly after the September 30, 2016 yearend. In accordance with IRS instructions, the Hospital's 2015 Schedule H filing corresponding to the September 30, 2016 fiscal yearend has been completed based on the previous CHNA which was done for the 2013 tax year as this was the document that was in effect during the 2015 tax year. The URL above is for the Hospital's current (tax year 2016) CHNA and Implementation Strategy as well as archived versions from previous periods. The Hospital has attached to this return the version that corresponds with this tax year filing. Schedule H, Part V, Section B, Line 16a, 16b, & 16c: The Hospital's Financial Assistance Policy, Financial Assistance Applications, and Plain Language Summary can be found at: Policy:https://www.midcoasthealth.com/patient-accounts/pdf/Mid-Coast-Hospital-Charity-Care-Policy.pdf Applications:https://www.midcoasthealth.com/patient-accounts/pdf/Financial-Assistance-Application-ENGLISH.pdfhttps://www.midcoasthealth.com/patient-accounts/pdf/Financial-Assistance-Application-SPANISH.pdfPlain Language Summary:https://www.midcoasthealth.com/patient-accounts/financial-assistance/ 17 1 - Mid Coast Hospital 121 Medical Center Drive Brunswick ME 04011 General Medical & Surgical 2 - Mid Coast Hospital 81 Medical Center Drive Brunswick ME 04011 General Medical & Surgical 3 - Mid Coast Hospital 11 Medical Center Drive Brunswick ME 04011 General Medical & Surgical 4 - Mid Coast Hospital 310 Bath Road Brunswick ME 04011 General Medical & Surgical 5 - Mid Coast Hospital 430 Bath Road Brunswick ME 04011 General Medical & Surgical 6 - Mid Coast Hospital 66 Baribeau Drive Brunswick ME 04011 General Medical & Surgical 7 - Mid Coast Hospital 30 So Bristol Road Damariscotta ME 04543 General Medical & Surgical 8 - Mid Coast Hospital 108 Center Street Bath ME 04530 General Medical & Surgical 9 - Mid Coast Hospital - Mid Coast Med Group One Wellness Way Topsham ME 04086 General Medical & Surgical 10 - Mid Coast Hospital 22 Maine Street Station Brunswick ME 04011 General Medical & Surgical 11 - Mid Coast Hospital 30 Governors Way Topsham ME 04086 General Medical & Surgical 12 - Mid Coast Hospital 120 Harpswell Road Brunswick ME 04011 General Medical & Surgical 13 - Mid Coast Hospital 331 Maine Street Brunswick ME 04011 General Medical & Surgical 14 - Mid Coast Hospital 130 Center Street Bath ME 04530 General Medical & Surgical 15 - Mid Coast Hospital 8 Mason Street Brunswick ME 04011 General Medical & Surgical 16 - Mid Coast Hospital 44 Elm Street Topsham ME 04086 General Medical & Surgical 17 - Mid Coast Hospital 329 Maine Street Brunswick ME 04011 General Medical & Surgical Part I, Line 7: Based on the IRS Form 990, Schedule H, a worksheet was provided to determine the overall cost to charge ratio that could be used to apply throughout Schedule H of Form 990. Where applicable, the Organization utilized this worksheet to convert charges to costs. The Organization did not use the Worksheet 2 percentage for the IRS Form 990, Schedule H, Worksheet 3, Unreimbursed Medicaid and Other Means Tested Government Programs, or Worksheet 6, Subsidized Health Services, for the Medicaid allowable costs. Instead, the Organization utilized the actual Medicaid filed cost report for the Medicaid allowable costs. Additionally, the Organization used the modified Medicare allowable costs and payments related to these services in regards to the cardiopulmonary community program and psychiatric unit. For our provider based clinics, in this same section we used the actual costs for each clinic. In addition, for its addiction resource center, senior psychiatric services, and access health services, the Organization used the estimated costs calculated based on actual clinic costs estimated from reporting on these centers to the State of Maine. Part I, Line 7g: Mid Coast Hospital has clinical services and hospital-owned physician practices. Mid Coast Hospital has included these practices in this section of the 990, Schedule H of subsidized health services if they are operating at a loss. The Hospital has included the following clinical services and hospital-owned physician practices that operate at a loss and the corresponding costs of these practices: primary care practice, OB/GYN practice, pulmonary practice, urology practice, neurology practice, senior psychiatric services, nephrology practice, orthopedics practice, gastroenterology practice, diabetes & endocrinology practice, general surgery practice, rheumatology practice, cardiopulmonary community program, addiction resource center, access health service, chemical dependency services, breast health clinic, pediatrics clinic, oncology practice, physiatry practice, and an ENT practice. The above listed hospital clinical services and hospital-owned physician practices have a community benefit of approximately $8.2 million. In addition, the community benefit does not take into account bad debts, charity care, and contractual adjustments. Thus, this community benefit of approximately $8.2 million is a conservative number that reconciles to the community benefit on the IRS Form 990, Schedule H. Part I, Line 7, Column (f): The Bad Debt expense included on Form 990, Part IX, Line 25, Column (A), but subtracted for purposes of calculating the percentage in this column is $ 12,592,376. Part II, Community Building Activities: N/A Part III, Line 2: The amount reported on Part III line 2 was derived by applying the cost tocharge ratio against the amount of bad debt expense reported on Form 990, Part IX, line 24, coluinn (A) ($12,592,376). Accounts written off to baddebt include gross charges being written off less any payments receivedagainst those charges. Any cash collected on accounts previously writtenoff is included as an offset to bad debt expense as recoveries of baddebt. The Hospital calculates the ratio in a manner consistent withworksheet 2, patient care charges to patient care expenses, to arrive atthe ratio of costs to charges. Part III, Line 3: The Hospital does not consider any amount of its bad debt at cost to be attributable to patients eligible to receive financial assistance under the Hospital's financial assistance policy. Part III, Line 4: See Footnote 2 on Page 8 of the attached audited financial statements. Part III, Line 8: The Hospital believes all of the clinical areas included in the Form 990, Schedule H should be and are considered a community benefit. Mid Coast Hospital believes that by offering and thus subsidizing these clinical services within the community, the community benefits by having easy access to these services. If these services were not available from Mid Coast Hospital there would be a greater burden on the community and many, if not all, of these services would not be available with such easy access. Based on the IRS Form 990, Schedule H, a worksheet was provided to assist in determining the overall cost-to-charge ratio that could be used to apply throughout the Schedule H of the Form 990 in order to convert charges to costs. Where applicable, we have utilized this worksheet to convert charges to costs. We did not use this worksheet percentage on the calculation of Medicare costs in this section. We used the Medicare allowable costs and payments related to the subsidized health service and we used the Medicare cost report estimated cost and payment for these services. Part III, Line 9b: The Hospital currently starts with gross charges for all patient billing. Federal poverty guidelines are utilized in the determination of charity care eligibility. Patients who are unable to pay and have exhausted all sources of payment may qualify for charity care. Those patients that qualify and have income levels below 150% of the federal poverty guidelines can receive 100% charity care. A sliding scale is used for patients with income levels between 200% and 300% of the federal poverty guidelines. The amount considered for charity will be based upon the evaluation of the patients' ability to pay. Patients who qualify for partial financial assistance are responsible for any remaining balance after the charity care adjustment and third party payments. Once an account has been processed through an internal routine collection process, it may be assigned to an attorney/agency for collection. Part VI, Line 2: Mid Coast Hospital assesses the health care needs of the community on an ongoing basis. Mid Coast Hospital's strategic plan is a road map as to where and how to deliver services to the surrounding communities. This process of how to provide these services included listening and learning to/from the community - patients and families, faith community, municipal leaders, legislatures and local businesses. Mid Coast also looked inward, calling upon board members, corporators, medical staff, volunteers, auxiliary, and employees since they are all part of the community Mid Coast Hospital serves. Part VI, Line 3: Mid Coast Hospital will notify patients about access to various financial assistance needs in different ways. We have postings in various departments as well has handouts informing patients how to access these programs if financial assistance is required. There are signs and pamphlets in the Hospital settings indicating the poverty guidelines and how to obtain assistance to obtain free or discounted care. All of our patients can speak to one of the Hospital's employees on how to obtain financial assistance; and, if there is assistance needed, the employee will inform our patient financial services department who will then work with the patient to either help them apply for MaineCare or discuss options for free or discounted care. Part VI, Line 4: Mid Coast Hospital's primary service area includes the following communities in the Mid Coast Maine: Arrowsic, Bailey Island, Bath, Bowdoin, Bowdoinham, Brunswick, Dresden, Durham, Freeport, Georgetown, Harpswell, Lisbon, Litchfield, North Yarmouth, Perkins Township, Phippsburg, Pownal, Richmond, Sabattus, Topsham, West Bath, Westport, Wiscasset, Woolwich, Yarmouth. Approximately 10% of Mid Coast Hospital patients utilize Medicaid and 46% of Mid Coast Hospital patients utilize Medicare. The population of the communities supported by Mid Coast Hospital with income under 200% of the poverty guidelines is about 21%. Part VI, Line 5: Mid Coast Hospital is a local, not-for-profit, community hospital that serves the local communities and the people regardless of their ability to pay. The members on the board of directors and corporators are all members of the communities that Mid Coast Hospital serves. All Hospital net income gains are reinvested into the facilities, equipment and services for the community. Part VI, Line 6: Mid Coast Hospital has a clinical affiliation with Maine Health to provide the best patient care to all of the communities that Mid Coast Hospital and Maine Health serves. 0 1 0 0 0 0 0 0 0 Patrick Keaney MD President Medical Staff 319322 0 0 0 0 0 25950 0 11171 0 356443 0 0 0 Lois N Skillings President/CEO 0 429594 0 0 0 0 0 71659 0 6773 0 508026 0 0 Robert McCue CFO 0 286129 0 0 0 0 0 51529 0 11171 0 348829 0 0 Miguel Arguedas MD Physician 588826 0 0 0 0 0 25950 0 9948 0 624724 0 0 0 Calin Stoicov MD Physician 580702 0 0 0 0 0 25950 0 12863 0 619515 0 0 0 Craig Hawkins MD Physician 541732 0 0 0 0 0 23614 0 14212 0 579558 0 0 0 Peter Hutchinson MD Physician 482527 0 0 0 0 0 18000 0 7852 0 508379 0 0 0 Michael Samson MD Physician 462499 0 0 0 0 0 18000 0 11420 0 491919 0 0 0 Part I, Line 3 Mid Coast Hospital's CEO, Lois Skillings, and CFO, Robert McCue, are compensated by a related organization, Mid Coast Health Management Corp & Sub (MCHMC). MCHMC uses an independent compensation consultant, compensation survey or study, and approval by the board or compensation committee to establish their annual compensation. Part I, Line 4b The Hospital has a deferred compensation arrangement under a nonqualified defined contribution plan to provide supplemental retirement benefits to certain employees. Lois Skillings and Robert McCue, who are officers of the Organization, participated in this plan and received $63,709 and $43,579, respectively. Other physician employees listed on Form 990, Part VII that participated in the nonqualified defined contribution plan are: Dr. Patrick Keaney, Dr. Miguel Arguedas, Dr. Calin Stoicov, Dr. Craig Hawkins, Dr. Peter Hutchinson, and Dr. Michael Samson. Each of these individuals received $18,000 relative to the plan. A Maine Health and Higher Ed Fac Auth (MHHEFA) 010314384 560425L40 2007-07-18 97716087 Refinance Series 1998B Revenue Bond 0 0 0 B Maine Health and Higher Ed Fac Auth (MHHEFA) 010314384 560425362 2008-12-03 41658395 Hospital Facility Expansion Project 0 0 0 A 28930803 1984500 26651099 290758 4446 2002 1 1 1 1 B 12393996 892731 138784 11362143 338 2009 0 0 1 1 A 0 0 0 0 0 0 0 B 0 0 0 0 0 0 0 A 0 0 0 1 0 0 1 Trans America 20.000000000000 1 0 0 B 0 0 0 1 0 0 0 0 0 A 0 B 0 Date Rebate Computation Performed Issuer Name: Maine Health and Higher Ed Fac Auth (MHHEFA) Date the Rebate Computation was Performed: 07/18/2012 Issuer Name: Maine Health and Higher Ed Fac Auth (MHHEFA) Date the Rebate Computation was Performed: 12/03/2013 Schedule K, Part III, Line 9, Part IV, line 7, and Part V: The Hospital does not have written procedures to ensure that violations of federal tax requirements are timely identified and corrected. However, the Hospital does have a policy in place to accomplish these purposes. On an annual basis, the Hospital's controller and CFO review bond documents and bond covenants to ensure the Hospital is in full compliance. Lois Skillings Member of board of directors of Medical Mutual Insurance Company 1639898 The amount paid to Medical Mutual and identified in this section is for malpractice insurance coverage for the Hospital. Ms. Skillings serves on the board of directors for Medical Mutual and is the CEO of Mid Coast Hospital. Ms. Skillings was paid a nominal fee to serve on Medical Mutual's board of directors.The amount included in column c represents the total amount paid to Medical Mutual for insurance services. 0 X 4 29267 Market Value 0 1 1 Part I, Line 32b: The Organization sells contributions of securities through its investment broker. All gifts of securities are sold as soon as administratively possible. Form 990, Part VI, Section A, line 2 Board of Directors members Glenn Hutchinson and Ellen Hutchinson have a family relationship. Form 990, Part VI, Section A, line 6 Mid Coast-Parkview Health (MCPH) shall be the Organization's sole member with all rights and responsibilities of membership, including all voting rights. Form 990, Part VI, Section A, line 7a At each annual meeting of the sole member, the sole member shall elect directors to hold office until the election and qualification of their respective successors. The directors shall be persons who have demonstrated an interest in the Organization's goals and objectives and, to the extent reasonably feasible, shall represent the Mid-Coast area. To the extent feasible, all directors serving on the Organization's board of directors shall be persons who also serve on the board of directors of MCPH. Form 990, Part VI, Section A, line 7b The business and affairs of the Organization shall be conducted and managed by its board of directors which shall exercise all of the powers of the Organization. The board of directors shall approve an annual operating budget, develop a long-term capital expenditure plan and, through its own committees or the committees of its sole member, monitor the implementation of the plan. Notwithstanding the foregoing, the directors shall not submit any application for a certificate of need to the Maine Department of Health and Human Services, or incur any long-term debt without the approval of MCPH as the sole member. The board of directors may delegate such powers as it sees fit to committees and officers of the Organization. Form 990, Part VI, Section B, line 11 The Form 990 is prepared by an independent public accounting firm with the assistance of information provided by key financial staff. An initial draft is reviewed in detail by key financial staff. Once any changes are incorporated, a draft copy is presented to the Board and copies are provided upon request. Form 990, Part VI, Section B, line 12c The Hospital has a compliance committee that meets on a quarterly basis to review any compliance issues that may arise. Form 990, Part VI, Section B, line 15 An independent consultant prepares a market analysis at the regional level for all officers and key employees of the Organization. Form 990, Part VI, Section C, line 19 The Organization makes its governing documents, conflict of interest policy and audited financial statements available to the public upon request. Form 990, Part VII, Section A: Dr. Patrick Keaney receives compensation for his services to the Organization in his capacity as a physician. The salary and benefit amounts disclosed in Part VII do not reflect payments made to him for his services as a member of the board of directors. Form 990, Part IX, line 11g Physician Fees: Program service expenses 6,419,180. Management and general expenses 0. Fundraising expenses 0. Total expenses 6,419,180. Purchased Staffing: Program service expenses 633,969. Management and general expenses 176,483. Fundraising expenses 0. Total expenses 810,452. Intercompany Management: Program service expenses 0. Management and general expenses 3,082,389. Fundraising expenses 0. Total expenses 3,082,389. Consulting: Program service expenses 214,487. Management and general expenses 59,708. Fundraising expenses 0. Total expenses 274,195. Purchased Medical Services: Program service expenses 7,392,358. Management and general expenses 762,441. Fundraising expenses 0. Total expenses 8,154,799. Form 990, Part XI, Line 2c The audit process has not changed from the prior year. Mid Coast-Parkview Health 123 Medical Center Drive Brunswick ME 04011 010430069 Health Services ME 501(c)(3) Line 11a, I N/A 0 Mid Coast Geriatric Services Corporation 123 Medical Center Drive Brunswick ME 04011 010496221 Geriatric Services ME 501(c)(3) Line 9 Mid Coast-Parkview Health 0 Community Health and Nursing Services 60 Baribeau Drive Brunswick ME 04011 010211546 Hospice Services ME 501(c)(3) Line 9 Mid Coast-Parkview Health 0 Mid Coast Medical Group 123 Medical Center Drive Brunswick ME 04011 010484592 Medical Services ME N/A C 0 Midcoast Health Management Corporation 123 Medical Center Drive Brunswick ME 04011 010429598 Management of Health Services ME N/A C 0 Thornton Oaks Development Corporation 123 Medical Center Drive Brunswick ME 04011 010448411 Management of Health Services ME N/A C 0 0 0 0 0 0 0 0 0 0 1 0 0 1 0 1 1 1 0 0