2017-08-09T11:14:14-04:00 2016-09-30 990 2015-10-01 010219904 STEPHENS MEMORIAL HOSPITAL ASSOC STEP 2077435933 181 MAIN STREET NORWAY ME 04268 JOHN COX SR VP-FISCAL 2077435933 2017-08-03 2015 2021-01-29 14:40:06Z TIMOTHY CHURCHILL 181 MAIN STREET NORWAY ME 04268 64065918 false X WWW.WMHCC.ORG X 1956 ME TO ENSURE A HIGH QUALITY, ACCESSIBLE, AFFORDABLE AND APPROPRIATE INTEGRATED HEALTH CARE SYSTEM TO IMPROVE THE HEALTH AND WELL BEING OF THE COMMUNITY. 18 14 642 69 0 20000 0 60493446 63657039 38673 84225 -133034 -219410 60419085 63521854 0 0 31029476 32382594 7028 9863 80667 25394252 27989830 56430756 60382287 3988329 3139567 66898421 63914826 25968318 21119566 40930103 42795260 TO ENSURE A HIGH QUALITY, ACCESSIBLE, AFFORDABLE AND APPROPRIATE INTEGRATED HEALTH CARE SYSTEM TO IMPROVE THE HEALTH AND WELL BEING OF THE COMMUNITY. false false 45544869 49142061 OUTPATIENT SERVICES: STEPHENS MEMORIAL HOSPITAL ASSOCIATION PROVIDED CARE DURING THE COURSE OF 102,944 OUTPATIENT VISITS DURING 2016. SERVICES PROVIDED INCLUDE EMERGENCY SERVICES; DIAGNOSTIC IMAGING AND LAB TESTS; AMBULATORY SURGERY; AND PHYSICAL REHABILITATION. 12196258 13159535 INPATIENT SERVICES: IN 2016 THE HOSPITAL PROVIDED INPATIENT NURSING SERVICES TO 1,504 ADULTS/PEDIATRICS, SPECIAL CARE, AND NURSERY PATIENTS WITH A TOTAL OF 4,935 PATIENT DAYS. 94 INPATIENTS (6%) WERE UNINSURED, 841 (56%) WERE COVERED BY MEDICARE AND 239 (16%) WERE COVERED BY MEDICAID. 1352992 OTHER REVENUE CONSISTS PRIMARILY OF MEANINGFUL USE PAYMENTS, 340B CONTRACT PHARMACY REVENUE, PHYSICIAN INCENTIVE PAYMENTS, VHA-PURCHASE REBATES AND OTHER OPERATING REVENUE. 57741127 true false false true false false false false false false true false false true true true true true false false false false false false false false true true false false true true false false false false false false false false false false false false false false false true false false false true 19 0 true 642 true false false false false false false false false false false X 18 14 false false false false true true true true true false false true true true true true true true false false ME X SENIOR VP - FISCAL 2077435933 181 MAIN STREET NORWAY ME 04268 GREGORY J HARDY MD TRUSTEE 50.00 0.00 X 347719 0 29709 TIMOTHY CHURCHILL PRESID & CEO 1.00 50.00 X X 0 337730 50207 WILLIAM L MEDD MD TRUSTEE 1.00 50.00 X 0 265914 33069 BRIAN M NOLAN MD MED STAFF PR 1.00 50.00 X 0 249494 23994 KATHLEEN A HERLIHY MD TRUSTEE 50.00 0.00 X 187625 0 28891 LISA W MILLER MD TRUSTEE 50.00 0.00 X 177095 0 18303 C BRADLEY CUMMINGS TRUSTEE 1.00 0.00 X 0 0 0 TOM MORTON SECRETARY/TR 1.00 0.00 X X 0 0 0 DAVID HOISINGTON PA TRUSTEE 1.00 0.00 X 0 0 0 LYNN HAMPER TRUSTEE 1.00 0.00 X 0 0 0 DAVID J PREBLE CHAIR 1.00 0.00 X X 0 0 0 TED MOCCIA TRUSTEE 1.00 0.00 X 0 0 0 ROBIN J ZINCHUK TRUSTEE 1.00 0.00 X 0 0 0 PAT WEIGEL VICE CHAIR 1.00 0.00 X X 0 0 0 ALLEN CONNORS TRUSTEE 1.00 0.00 X 0 0 0 KEVIN CARLETON TRUSTEE 1.00 0.00 X 0 0 0 TODD GAUGER DVM TRUSTEE 1.00 0.00 X 0 0 0 HOLLY BANCROFT BROWN TRUSTEE 1.00 0.00 X 0 0 0 SAWIN MILLETT TRUSTEE 1.00 0.00 X 0 0 0 LANCE BEAN TRUSTEE 1.00 0.00 X 0 0 0 GENE BENNER TRUSTEE 1.00 0.00 X 0 0 0 JOHN COX SR VP-FISCAL 0.00 50.00 X 0 218377 26328 MARGARET M BURNS SR VP-CLINIC 0.00 50.00 X 0 73956 436 BRADY C MULLIN MD PHYSICIAN 50.00 0.00 X 342190 0 15629 ALYSSA A PAETAU MD PHYSICIAN 50.00 0.00 X 296634 0 11471 JANNETTE L ANDREWS MD PHYSICIAN 50.00 0.00 X 286664 0 15488 CAROLYN P COSTANZI MD PHYSICIAN 50.00 0.00 X 278004 0 27075 MICHAEL M MOHSENI MD PHYSICIAN 50.00 0.00 X 273477 0 11641 M PATRICIA COOK FORMER SR VP 0.00 0.00 X 0 109329 29033 2189408 1254800 321274 38 true true false NORDX 102 CAMPUS DRIVE SCARBOROUGH ME 04074 LAB PROCESSING 2828048 MAINE MEDICAL PARTNERS 301C US ROUTE 1 SCARBOROUGH ME 04074 MED BILL & MGT 1355386 LANDRYFRENCH CONSTRUCTION CO 160 PLEASANT HILL RD SCARBOROUGH ME 04074 CONSTRUCT. SVCS 793120 SPECTRUM MEDICAL GROUP PA 300 PROFESSIONAL DRIVE SCARBOROUGH ME 04074 ANESTHESIA SVCS 559674 MAINE ORTHOPAEDIC CENTER 1601 CONGRESS STREET PORTLAND ME 04102 PHYSICIAN SVCS 370100 12 NET PATIENT SERVICE REVENUE 623000 62301596 62301596 OTHER REVENUE 621990 1355443 1355443 63657039 86676 86676 320911 540321 -219410 -219410 -219410 1292 3743 -2451 -2451 -2451 63521854 63654588 -132734 X 875923 839660 36263 24566354 23549223 967984 49147 911023 873304 37719 4336879 4157318 171034 8527 1692415 1622343 66312 3760 128583 128583 9863 9863 9841268 9787996 53272 62060 59490 2570 1478331 1417123 51963 9245 1017331 975210 42121 1025295 980873 44422 124512 118483 6029 158314 151233 7081 205112 196619 8493 2224199 2132110 92089 589081 401139 187942 MEDICAL SUPPLIES 6517058 6516511 547 PROVIDER TAX 1279252 1279252 AFFILIATE CHARGES 1213105 1162878 50227 MAINTENANCE CONTRACTS 830967 830038 929 1295362 690324 604913 125 60382287 57741127 2560493 80667 34079 373743 24318214 17402671 6038657 6417310 1189093 1253915 511540 525311 54459392 34253280 15285363 20206112 2699924 2840483 1176560 1170331 15644991 13724950 66898421 63914826 5123367 5018747 5862804 5561967 61067 14921080 10538852 25968318 21119566 X 39625276 41462693 746416 774156 558411 558411 40930103 42795260 66898421 63914826 X 3139567 243036 -1517446 X false true X true false X false false false false false false false false true 9252 9252 false SCHEDULE C, PART II-B, LINE 1 DUES PAID TO THE AMERICAN HOSPITAL ASSOCIATION OF 16,646 AND TO THE MAINE HOSPITAL ASSOCIATION OF 31,258. THE AMERICAN HOSPITAL ASSOCIATION AND MAINE HOSPITAL ASSOCIATION USED 21.78% AND 18.00% RESPECTIVELY OF THEIR DUES REVENUE FOR LOBBYING ACTIVITY. 1230517 1230517 26875336 14821261 12054075 22659815 17968027 4691788 3693724 1463992 2229732 20206112 PREPAID CAPITAL COSTS 6677944 INTEREST IN NET ASSETS OF SCHC FOUND 6448788 DUE FROM AFFILIATES 341902 INSURANCE RECEIVABLE 211300 OTHER RECEIVABLES 24755 CSV-LIFE INSURANCE 20261 13724950 AP UNDER REIMBURSEMENT REGULATIONS 5511455 DUE TO AFFILIATES 3986381 PROFESSIONAL LIABILITY CLAIM ACCRUAL 953418 ACCRUED ASSET OBLIGATION 76080 OTHER DEFERRED LIABILITY 11518 10538852 X 62247444 243036 -1517446 -1274410 63521854 63521854 60382287 60382287 60382287 SCHEDULE D, PAGE 3, PART X THE CORPORATION AND ITS SUBSIDIARIES ARE NOT-FOR-PROFIT CORPORATIONS AND HAVE BEEN RECOGNIZED AS TAX-EXEMPT PURSUANT TO 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 (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 CORPORATION HAS EVALUATED THE POSITION TAKEN ON ITS FILED TAX RETURNS. THE CORPORATION HAS CONCLUDED NO UNCERTAIN INCOME TAX POSITIONS EXIST AT SEPTEMBER 30, 2016. THE CORPORATION'S TAX YEARS FROM 2013 THROUGH 2016 MAY BE SUBJECT TO EXAMINATION. SCHEDULE D, PAGE 4, PART XI, LINE 2D EQUITY TRANSFERS TO AFFILIATES -1,868,718 CHANGE IN INTEREST-STEPHENS COMMUNITY HEALTHCARE FOUND 351,272 true true true X 1.750000000000 true X 2.250000000000 true true false true true 1229375 1229375 0.02040 9169617 8071113 1098504 0.01820 10398992 8071113 2327879 0.03860 3569 3219 350 90019 45000 45019 0.00070 10710442 9025540 1684902 0.02790 10804030 9073759 1730271 0.02870 21203022 17144872 4058150 0.06720 27507 27507 0.00050 27507 27507 0.00050 false 2783684 17542057 17368373 173684 X true true 1 1 STEPHENS MEMORIAL HOSPITAL ASSOC 181 MAIN STREET NORWAY ME 04268 WWW.WMHCC.ORG 38607 X X X STEPHENS MEMORIAL HOSPITAL ASSOC 1 false false true X X X X X X X X X X 16 true true false true X SEE PART V, SECTION C X true 16 true SEE PART V, SECTION C false true X 175.000000000000 225.000000000000 false true X X X X true X SEE PART V SECTION C X SEE PART V SECTION C X SEE PART V SECTION C X X X X true X true X X true X false false FACILITY 1, STEPHENS MEMORIAL HOSPITAL ASSOC. - PART V, LINE 3J ALSO INCLUDED IN THE CHNA WAS A PRIORITIZED LIST OF HEALTH NEEDS IDENTIFIED, AS WELL AS THE IMPLEMENTATION PLANS RELATED TO THESE NEEDS. FACILITY 1, STEPHENS MEMORIAL HOSPITAL ASSOC. - PART V, LINE 5 COMMUNITY INPUT WAS TAKEN INTO ACCOUNT WHEN CONDUCTING THE CHNA, INCLUDING THOSE WITH SPECIAL KNOWLEDGE OR EXPERTISE IN PUBLIC HEALTH. THIS INCLUDED INDIVIDUALS FROM THE FOLLOWING ORGANIZATIONS: STEPHENS MEMORIAL HOSPITAL, HEALTHY OXFORD HILLS, WESTERN MAINE PUBLIC HEALTH DISTRICT, BESSEY MOTORS, OXFORD HILLS SCHOOL DISTRICT AND MAINEHEALTH. FACILITY 1, STEPHENS MEMORIAL HOSPITAL ASSOC. - PART V, LINE 6A THE CHNA WAS CONDUCTED THROUGH A PARTNERSHIP BETWEEN MAINEHEALTH, EASTERN MAINE HEALTHCARE SYSTEMS AND MAINEGENERAL HEALTH. FACILITY 1, STEPHENS MEMORIAL HOSPITAL ASSOC. - PART V, LINE 7D THE CHNA, WHICH INCLUDES THE IMPLEMENTATION PLAN, IS AVAILABLE AT THE FOLLOWING WEBSITE: HTTPS://MAINEHEALTH.ORG/WESTERN-MAINE-HEALTH/HEALTHY-COMMUNITIES FACILITY 1, STEPHENS MEMORIAL HOSPITAL ASSOC. - PART V, LINE 11 THE ORGANIZATION HAS COMPLETED ITS WORK ON ADDRESSING THE SIGNIFICANT NEEDS IDENTIFIED IN ITS 2013-2015 CHNA AND IMPLEMENTATION PLAN. FOR THE 2016-2018 CHNA, THE ORGANIZATION HAS IDENTIFIED PRIORITIES AND DEVELOPED STRATEGIES TO ADDRESS THE SIGNIFICANT NEEDS IDENTIFIED IN ITS MOST RECENTLY CONDUCTED CHNA AND PROVIDED REASONS IF IDENTIFIED NEEDS ARE NOT BEING ADDRESSED. SEE HTTPS://MAINEHEALTH.ORG/ABOUT/HEALTH-INDEX-INITIATIVE/COMMUNITY- HEALTH-NEEDS-ASSESSMENT FOR DETAILS. FACILITY 1, STEPHENS MEMORIAL HOSPITAL ASSOC. - PART V, LINE 16I THE FAP IS AVAILABLE ON THE FOLLOWING WEBSITE: HTTPS://MAINEHEALTH.ORG/PATIENTS-VISITORS/BILLING-INSURANCE/FINANCIAL- ASSISTANCE/FREE-CARE THE FAP APPLICATION FORM IS AVAILABLE ON THE FOLLOWING WEBSITE: HTTPS://MAINEHEALTH.ORG/PATIENTS-VISITORS/BILLING-INSURANCE/FINANCIAL- ASSISTANCE/FREE-MEDICAL-CARE-APPLICATION THE PLAIN LANGUAGE SUMMARY IS AVAILABLE ON THE FOLLOWING WEBSITE: HTTPS://MAINEHEALTH.ORG/PATIENTS-VISITORS/BILLING-INSURANCE/FINANCIAL- ASSISTANCE/FREE-CARE PART I, LINE 7G - SUBSIDIZED HEALTH SERVICES EXPLANATION SUBSIDIZED HEALTH SERVICES INCLUDE THE NET OPERATING LOSS OF PACE PARAMEDIC SERVICE, A DEPARTMENT OF STEPHENS MEMORIAL HOSPITAL, AND DIRECT SUBSIDIES AND SUPPORT OF LOCAL SCHOOL-BASED HEALTH CLINICS AND OTHER CLINICAL PROGRAMS THAT ARE NOT REVENUE-PRODUCING. IF THESE SERVICES WERE NOT PROVIDED OR SUBSIDIZED BY THE HOSPITAL, THEY WOULD NOT BE AVAILABLE IN THE COMMUNITY. PART II - COMMUNITY BUILDING ACTIVITIES IN ADDITION TO THE SUBSIDIZED HEALTH SERVICES AND COMMUNITY HEALTH SERVICES DESCRIBED ABOVE, WESTERN MAINE HEALTH CARE SPONSORS OR PARTICIPATES IN A VARIETY OF OTHER COMMUNITY ACTIVITIES AND PROGRAMS. THESE COMMUNITY BUILDING ACTIVITIES INCLUDE: -WE ARE THE LEAD AGENCY FOR HEALTHY OXFORD HILLS, A COMMUNITY COALITION TO PROMOTE PARTNERSHIPS, POLICIES AND PROGRAMS TO PROTECT AND ENHANCE THE HEALTH OF RESIDENTS OF OXFORD HILLS -OUR VIAL OF LIFE PROGRAM ALLOWS INDIVIDUALS IN THE COMMUNITY TO RECORD AND SAFELY STORE THEIR CURRENT HEALTH INFORMATION AT HOME, IN CASE THAT INFORMATION NEEDS TO BE RETRIEVED IN AN EMERGENCY SITUATION -SAFE SITTER COURSES, A MEDICALLY-ACCURATE INSTRUCTIONAL PROGRAM DESIGNED FOR YOUNG ADOLESCENTS 11 TO 13 YEARS OF AGE -COMMUNITY-WIDE EMERGENCY PREPAREDNESS PLANNING -REGIONAL HEALTH PLANNING AND PANDEMIC PLANNING -WE PROVIDE A CLINICAL SITE FOR LOCAL REGISTERED NURSES AND CERTIFIED NURSES AIDE PROGRAMS -ANNUAL CONFERENCE - ALCOHOLISM AND DRUG ADDICTION: DISEASE, TREATMENT AND RECOVERY -FREE COMMUNITY BLOOD PRESSURE SCREENINGS AND CLINICS -BLOOD DRIVES -SIBLING CLASSES FOR CHILDREN EXPECTING NEW FAMILY MEMBERS -NUTRITION OPEN HOUSES FOR THE GENERAL PUBLIC -"RELAY FOR LIFE" TO SUPPORT THE AMERICAN CANCER SOCIETY -"BOWL FOR KIDS SAKE" TO BENEFIT THE LOCAL BIG BROTHERS/BIG SISTERS PROGRAM -WE PROVIDE COMMUNITY OUTREACH SERVICES TO EDUCATE FAMILIES ABOUT THE ALFOND SCHOLARSHIP FOR BABIES, AND ASSIST FAMILIES IN PREPARING THE GRANT APPLICATION -WE PROVIDE MEETING SPACE AT NO CHARGE FOR LOCAL NON-PROFIT SUPPORT GROUPS INCLUDING ALCOHOLICS ANONYMOUS, SMOKING CESSATION, GEAR PARENT NETWORK SUPPORT GROUP, TAKE OFF POUNDS SENSIBLY (TOPS), THE SHRINERS ANNUAL HEALTH SCREENING DAY AND SUPPORT GROUPS FOR THOSE AFFECTED BY DEPRESSION/BIPOLAR CONDITIONS, DIABETES, GRIEF, AND PARKINSON'S DISEASE PART III, LINE 2 - BAD DEBT EXPENSE METHODOLOGY THE HOSPITAL ACCEPTS ALL PATIENTS REGARDLESS OF THEIR ABILITY TO PAY. A PATIENT QUALIFIES FOR FREE CARE BASED UPON CERTAIN ESTABLISHED POLICIES OF THE HOSPITAL. THESE POLICIES DEFINE FREE CARE AS THOSE SERVICES FOR WHICH NO PAYMENT IS ANTICIPATED. FREE CARE PROVIDED IS NOT INCLUDED IN NET PATIENT SERVICE REVENUE AND IS MEASURED BASED ON THE HOSPITAL'S CHARGES. COSTS AND EXPENSES INCURRED IN PROVIDING THESE SERVICES ARE INCLUDED IN OPERATING EXPENSES. CHARGES FOR SERVICES RENDERED TO INDIVIDUALS FROM WHOM PAYMENT IS EXPECTED AND ULTIMATELY NOT RECEIVED ARE WRITTEN OFF. BAD DEBT EXPENSE REPRESENTS HEALTHCARE SERVICES THAT THE HOSPITAL HAS PROVIDED WITHOUT COMPENSATION. AS A TAX-EXEMPT HOSPITAL, THE HOSPITAL PROVIDES NECESSARY PATIENT CARE REGARDLESS OF THE PATIENTS ABILITY TO PAY FOR THE SERVICES. A PORTION OF THE HOSPITAL'S BAD DEBT EXPENSE IS ATTRIBUTABLE TO PATIENTS ELIGIBLE FOR FINANCIAL ASSISTANCE THAT, FOR A VARIETY OF REASONS, DO NOT COMPLETE THE FINANCIAL ASSISTANCE APPLICATION PROCESS. THE HOSPITAL CANNOT DETERMINE THE AMOUNT OF BAD DEBT EXPENSE THAT COULD BE REASONABLY ATTRIBUTABLE TO PATIENTS WHO LIKELY WOULD QUALIFY FOR FINANCIAL ASSISTANCE UNDER THE HOSPITAL FREE CARE POLICY. IN ADDITION, BAD DEBT EXPENSE ALSO INCLUDES AMOUNTS FOR SERVICES PROVIDED TO INDIVIDUALS EXPERIENCING DIFFICULT PERSONAL OR ECONOMIC CIRCUMSTANCES RELATED TO A PORTION OF OUR COMMUNITY BASED PATIENT POPULATION. THEIR MEDICAL BILLS OFTEN PLACE THESE INDIVIDUALS IN UNTENABLE POSITIONS WHERE THEY ARE NOT ABLE TO HANDLE THEIR PERSONAL DEBT AND THEN THEIR NEW MEDICAL DEBT. HOWEVER, BECAUSE OF THEIR INCOME LEVEL, THEY DO NOT QUALIFY FOR FREE CARE. BY PROVIDING NECESSARY HEALTHCARE SERVICES TO THOSE INDIVIDUALS EITHER WHO FAIL TO APPLY FOR FINANCIAL ASSISTANCE OR WHO ARE EXPERIENCING DIFFICULT PERSONAL OR ECONOMIC CIRCUMSTANCES, THE HOSPITAL BELIEVES THAT BAD DEBT EXPENSE SHOULD BE INCLUDED AS A COMMUNITY BENEFIT. THE RESERVE FOR UNCOLLECTIBLE ACCOUNTS IS PROVIDED BASED ON AN ANALYSIS BY MANAGEMENT OF THE COLLECTABILITY OF OUTSTANDING BALANCES. MANAGEMENT CONSIDERS THE AGE OF OUTSTANDING BALANCES AND PAST COLLECTION EFFORTS IN DETERMINING THE RESERVE FOR UNCOLLECTIBLE ACCOUNTS. ACCOUNTS DEEMED UNCOLLECTIBLE ARE CHARGED OFF AGAINST THE ESTABLISHED RESERVE. THE 2,783,684 OF BAD DEBT EXPENSE (AT COST) WAS CALCULATED USING THE HOSPITAL'S COST TO CHARGE RATIO. BAD DEBT EXPENSE FOOTNOTE TO FINANCIAL STATEMENTS STEPHENS MEMORIAL HOSPITAL ASSOCATION DOES NOT HAVE A SPECIFIC FOOTNOTE IN THE FINANCIAL STATEMENTS THAT DESCRIBES "BAD DEBT EXPENSE." SEE PART III, LINE 2 - BAD DEBT EXPENSE METHODOLOGY PART III, LINE 8 - MEDICARE EXPLANATION MEDICARE ALLOWABLE COSTS WERE TAKEN FROM THE HOSPITAL'S AS-FILED 2016 MEDICARE COST REPORTS. THE COST REPORT UTILIZES A SOPHISTICATED, DETAILED STEP-DOWN COST ALLOCATION APPROACH. THE COST REPORT EXCLUDES REVENUE, EXPENSES AND REIMBURSEMENT FOR PROFESSIONAL FEES SUCH AS EMERGENCY DEPARTMENT PHYSICIANS. IF THE COST TO PROVIDE THESE SERVICES AND PAYMENTS FOR THE SERVICES WERE INCLUDED IN THE PART III SECTION B ANALYSIS, THERE WOULD BE A MEDICARE SHORTFALL FOR THESE SERVICES. PART III, LINE 9B - COLLECTION PRACTICES EXPLANATION PATIENTS WHO APPLY FOR AND QUALIFY FOR CHARITY CARE/ FINANCIAL ASSISTANCE BASED ON THE STATE OF MAINE FREE HOSPITAL CARE GUIDELINES WILL HAVE THE SELF PAY PORTION OF THEIR ACCOUNT BALANCE ADJUSTED AT TIME OF APPROVAL. FUTURE SELF PAY BALANCES WILL BE ADJUSTED DURING THEIR ELIGIBILITY PERIOD AT THE POINT OF BILLING, PRIOR TO SENDING BILLS TO PATIENTS. FOR THOSE WHO APPLY FOR ASSISTANCE BUT WHOSE INCOME EXCEEDS THE LIMIT FOR 100% ASSISTANCE, A 50% REDUCTION WILL BE APPLIED IF THEIR INCOME IS BETWEEN 176% AND 200% OF THE FEDERAL POVERTY LIMITS. PATIENTS WHOSE FAMILY INCOME RANGES FROM 201% TO 225% OF THE FEDERAL POVERTY LIMITS QUALIFY FOR A 25% REDUCTION. IF REQUESTED, A MONTHLY PAYMENT PLAN WILL BE SET UP FOR THE REMAINDER OF THE PATIENT'S BALANCE. PART VI, LINE 2 - NEEDS ASSESSMENT STEPHENS MEMORIAL HOSPITAL'S BOARD OF TRUSTEES IS MADE UP OF A DIVERSE SET OF COMMUNITY MEMBERS. THE BOARD REQUIRES A THOROUGH COMMUNITY NEEDS ASSESSMENT ON BEHALF OF THE ORGANIZATION, AND DIRECTS THE ORGANIZATION TO ANALYZE AND RESPOND TO THE CURRENT NEEDS ASSESSMENT. STEPHENS MEMORIAL HOSPITAL AND ITS PARENT WESTERN MAINE HEALTH CARE ALSO PARTICIPATE IN VARIOUS INITIATIVES TO HELP SUPPORT AND PROVIDE UPDATES TO COMMUNITY NEEDS ASSESSMENT PLANNING. SOME OF THESE INITIATIVES INCLUDE: - CLINICAL STRATEGIC PLANNING - FINANCIAL STRATEGIC PLANNING - FACILITY PLANNING - MANPOWER PLANNING - PHYSICIAN RECRUITMENT STRATEGIC PLANNING - EMERGENCY PREPAREDNESS PLANNING ALONG WITH THE INTERNAL ASSESSMENTS, MOST MEMBER ORGANIZATIONS ALSO REVIEW AND ACT ON MANY OF THE RECOMMENDATIONS PROVIDED BY EXTERNAL GROUPS SUCH AS THE MAINE CENTER FOR DISEASE CONTROL AND PREVENTION AND THE "STATE HEALTH PLAN" CREATED BY THE ADVISORY COMMITTEE FOR HEALTH SYSTEMS DEVELOPMENT. IN ADDITION, MAINEHEALTH AND ITS PARTNERS IN THE ONEMAINE HEALTH COLLABORATIVE, EASTERN MAINE HEALTH SYSTEM AND MAINEGENERAL HEALTH, RELEASED THE ONEMAINE HEALTH COMMUNITY HEALTH NEEDS ASSESSMENT REPORT IN MARCH 2011. THE REPORT WAS A COMPREHENSIVE COMPILATION AND ANALYSIS CONTAINING PRIMARY AND SECONDARY HEALTH DATA SOURCES. THE REPORT CONTAINED A HEALTH STATUS PROFILE FOR THE STATE AS A WHOLE AND FOR EACH OF MAINE'S SIXTEEN COUNTIES. THE PRIMARY DATA SOURCE WAS A RANDOMIZED TELEPHONE SURVEY; THE SAMPLING METHODOLOGY WAS DESIGNED TO PERMIT COMPARISONS AT THE COUNTY LEVEL. SECONDARY DATA SOURCES INCLUDE NUMEROUS STATE AND FEDERAL SOURCES. THIS REPORT PROVIDES BASELINE DATA ON HUNDREDS OF HEALTH INDICATORS THAT ARE RELEVANT TO HOSPITALS AND COMMUNITIES TO INFORM PLANNING AND EVALUATION ACTIVITIES. MAINEHEALTH HOLDS COMMUNITY FORUMS IN PARTNERSHIP WITH EACH MEMBER AND AFFILIATE HOSPITAL IN ORDER TO INCREASE UNDERSTANDING AND USE OF THE COMMUNITY NEEDS HEALTH ASSESSMENT AND TO FORM IDENTIFICATION AND ACTION ON LOCAL, COMMUNITY-BASED HEALTH PRIORITIES. PART VI, LINE 3 - PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE STEPHENS MEMORIAL HOSPITAL'S POLICY OF CHARITY CARE AND FINANCIAL ASSISTANCE IS EASILY UNDERSTOOD, PROMINENTLY POSTED, AND PUBLICLY AVAILABLE. FOR PATIENTS WHOSE FAMILY INCOME IS AT OR BELOW 175% OF THE FEDERAL POVERTY LEVEL, CHARITY CARE IS 100% OF THEIR BILLED AMOUNTS. PATIENTS WHOSE FAMILY INCOME RANGES FROM 176% TO 200% OF THE FEDERAL POVERTY LEVEL QUALIFY FOR A 50% CHARITY CARE DISCOUNT. PATIENTS WHOSE FAMILY INCOME RANGES FROM 201% TO 225% OF THE FEDERAL POVERTY LEVEL QUALIFY FOR A 25% CHARITY CARE DISCOUNT. A PROCESS EXISTS FOR OFFERING CHARITY CARE OR FINANCIAL ASSISTANCE TO PATIENTS WHO ARE UNABLE TO PAY AFTER THEY HAVE ALREADY BEEN BILLED. IN ADDITION TO MONITORING COLLECTION PRACTICES, COPIES OF THE CHARITY CARE POLICY ARE MADE AVAILABLE TO PATIENTS AT ALL ENTRY POINTS (REGISTRATION, ED, ETC.) AND WITH BILL/COLLECTION NOTICES. THE ORGANIZATION USES SIMPLE APPLICATION PROCEDURES FOR CHARITY CARE OR FINANCIAL ASSISTANCE THAT DO NOT INTIMIDATE OR CONFUSE APPLICANTS. STEPHENS MEMORIAL HOSPITAL'S EMPLOYEES WHO WORK IN ADMISSIONS, BILLING, ACCOUNTS RECEIVABLE, OR PATIENT FINANCIAL SERVICES ARE FULLY INFORMED AND EDUCATED ABOUT ALL FINANCIAL ASSISTANCE POLICIES. THESE STAFF MEMBERS IDENTIFY UNPAID BILLS WHERE PERSONS ARE UNABLE TO PAY, AND SEPARATES THESE POTENTIAL "CHARITY CARE" BILLS FROM OTHER BAD DEBT ACCOUNTS. PART VI, LINE 4 - COMMUNITY INFORMATION STEPHENS MEMORIAL HOSPITAL PRIMARILY SERVES SOUTHERN OXFORD COUNTY IN WESTERN MAINE. TRADITIONALLY, THE DEMOGRAPHICS OF THIS REGION REFLECT A POPULATION THAT IS OLDER AND POORER THAN THE STATE OF MAINE AVERAGE. RECENT INDEPENDENT STUDIES FOUND OXFORD COUNTY TO BE THE SECOND LEAST HEALTHY COUNTY IN THE STATE. PART VI, LINE 5 - PROMOTION OF COMMUNITY HEALTH IN ORDER TO ENSURE ACCESS TO PRIMARY CARE AND CERTAIN SPECIALTY PHYSICIAN SERVICES, WESTERN MAINE HEALTH CARE OWNS AND OPERATES ITS SUBSIDIARIES STEPHENS MEMORIAL HOSPITAL ASSOCIATION AND WESTERN MAINE MULTI-MEDICAL SPECIALISTS (WMMMS)INCLUDING PHYSICIAN PRACTICES PROVIDING CARDIOLOGY, FAMILY MEDICINE, GENERAL SURGERY, INTERNAL MEDICINE, ONCOLOGY, PEDIATRIC, AND OBSTETRIC AND GYNECOLOGY SERVICES. WMMMS ALSO HAS PARTNERED WITH PHYSICIAN GROUPS TO PROVIDE UROLOGY SERVICES TO THE COMMUNITY. DUE TO THE DEMOGRAPHICS OF THE POPULATION IN OXFORD COUNTY, MOST OF THESE SERVICES WOULD NOT BE AVAILABLE IF THEY WERE NOT PROVIDED BY A SYSTEM SUCH AS OURS. MOST LOCAL PRIVATE PHYSICIANS HAVE CLOSED TO, OR SIGNIFICANTLY LIMITED ACCESS FOR, NEW MEDICAID PATIENTS. OUR PRACTICES CONTINUE TO ACCEPT PATIENTS REGARDLESS OF THEIR INSURANCE COVERAGE OR LACK THEREOF. IN THE AGGREGATE, 21% OF PATIENTS SERVED BY WESTERN MAINE HEALTH CARE'S PHYSICIANS WERE COVERED BY THE STATE OF MAINE MEDICAID PROGRAM. PART VI, LINE 7 - STATE FILING OF COMMUNITY BENEFIT REPORT MAINE false false false false false false false false false GREGORY J HARDY MD TRUSTEE 279307 68412 14042 15667 377428 TIMOTHY CHURCHILL PRESID & CEO 272901 45000 19829 31749 18458 387937 WILLIAM L MEDD MD TRUSTEE 230118 11475 24321 29790 3279 298983 BRIAN M NOLAN MD MED STAFF PRESIDENT 223675 11475 14344 8557 15437 273488 KATHLEEN A HERLIHY MD TRUSTEE 172618 15007 12903 15988 216516 LISA W MILLER MD TRUSTEE 149990 7308 19797 2521 15782 195398 JOHN COX SR VP-FISCAL 188940 29437 10118 16210 244705 BRADY C MULLIN MD PHYSICIAN 313289 28901 15629 357819 ALYSSA A PAETAU MD PHYSICIAN 294024 2610 2532 8939 308105 JANNETTE L ANDREWS MD PHYSICIAN 271480 15184 15488 302152 CAROLYN P COSTANZI MD PHYSICIAN 271982 6022 10994 16081 305079 MICHAEL M MOHSENI MD PHYSICIAN 272186 1291 2747 8894 285118 M PATRICIA COOK FORMER SR VP-CLINIC. 79149 30180 19259 9774 138362 SCHEDULE J, PAGE 1, PART I, LINE 3 TOP MANAGEMENT OFFICIALS ARE COMPENSATED BY THIS OR OTHER RELATED ORGANIZATIONS. THESE ORGANIZATIONS USED ONE OR MORE OF THE METHODS SHOWN AT PART 1, LINE 3 TO ESTABLISH THE COMPENSATION OF TOP MANAGEMENT. FOR ADDITIONAL INFORMATION SEE SCHEDULE O - FORM 990, PART VI, LINE 15A - COMPENSATION FOR TOP OFFICIAL A MAINEHEALTH & HIGHER ED FACILITIES 010314384 560427Y75 2015-01-07 6079722 SEE PART VI false false false A 430000 6079683 130548 78890 6000793 2016 true false false true A false false false false false false false A false true false false false false false false false A false SCHEDULE K - ADDITIONAL INFORMATION MAINEHEALTH & HIGHER ED. FACILITIES PART I (F) DESCRIPTION OF PURPOSE - CONSTRUCTION, RENOVATION, AND EQUIPPING OF MEDICAL OFFICE BUILDING. WITH RESPECT TO PART I COLUMNS (E) AND (F), PART II LINES 1-12, AND PART III, THE INSTITUTION IS REPORTING ITS ALLOCABLE PORTION OF THIS BOND ISSUE, THE REMAINDER OF WHICH IS ALLOCABLE TO AFFILIATED ENTITIES. FOR PURPOSES OF PART I COLUMN (I), THE INSTITUTION HAS ASSUMED THAT THIS ARRANGEMENT DOES NOT CONSTITUTE A "POOLED FINANCING." PART II LINE 14 HAS BEEN ANSWERED WITH RESPECT TO THE ISSUE AS A WHOLE, RATHER THAN THE INSTITUTION'S ALLOCABLE PORTION; THE INSTITUTION'S ALLOCABLE PORTION OF THE BONDS DID NOT INCLUDE ANY REFUNDING COMPONENT. THE DIFFERENCE BETWEEN THE ISSUE PRICE (PART I) AND TOTAL PROCEEDS (PART II, LINE 3) IN COLUMN A IS DUE TO INVESTMENT EARNINGS (INCREASE IN PROCEEDS) AND A SMALL PORTION OF WHAT WOULD HAVE BEEN INVESTMENT PROCEEDS THAT WAS USED TO RETIRE PRINCIPAL OF THE BONDS (REDUCTION IN PROCEEDS). PART II, LINE 4 - THE AMOUNT SHOWN HERE CONSISTS OF DEBT SERVICE FUND DEPOSITS. PART III, LINE 2 - THE INSTITUTION LEASES CERTAIN SPACE IN THE FINANCED SPACE TO AN AFFILIATED 501(C)(3) ORGANIZATION. FOR PURPOSES OF THIS LINE, THE INSTITUTION HAS ASSUMED THAT THIS DOES NOT CONSTITUTE A LEASE THAT MAY RESULT IN PRIVATE BUSINESS USE. PART III, LINE 3A - THE INSTITUTION HAS ENTERED INTO A MANAGEMENT CONTRACT WITH AN AFFILIATED 501(C)(3) ORGANIZATION. FOR PURPOSES OF THIS LINE, THE INSTITUTION HAS ASSUMED THAT THIS DOES NOT CONSTITUTE A MANAGEMENT OR SERVICE CONTRACT THAT MAY RESULT IN PRIVATE BUSINESS USE. FORM 990, PAGE 6, PART VI, LINE 6 WESTERN MAINE HEALTH CARE, CORP. (EIN 01-0411788) IS THE SOLE MEMBER OF THE ORGANIZATION. FORM 990, PAGE 6, PART VI, LINE 7A THE SOLE MEMBER HAS THE RESPONSIBILITY FOR THE ELECTION OF THE MEMBERS OF THE GOVERNING BODY. FORM 990, PAGE 6, PART VI, LINE 7B ALL DECISIONS BY THE STEPHENS MEMORIAL HOSPITAL ASSOCIATION'S GOVERNING BODY ARE APPROVED BY DEFAULT BY THE MEMBER ORGANIZATION'S GOVERNING BODY SINCE THESE TWO ORGANIZATIONS SHARE A COMMON GOVERNING BODY. FORM 990, PAGE 6, PART VI, LINE 11B THE 990 WAS REVIEWED IN DETAIL BY A COMMITTEE OF THE BOARD OF TRUSTEES. THE PRESIDENT AND SENIOR VICE PRESIDENT - FISCAL LED THE DISCUSSION. SUBSEQUENT TO THAT REVIEW, A COPY OF THE ORGANIZATION'S 990 WAS DISTRIBUTED TO ALL TRUSTEES. THE 990 WAS REVIEWED IN SUMMARY AT A BOARD MEETING PRIOR TO FILING. FORM 990, PAGE 6, PART VI, LINE 12C CONFLICT OF INTEREST STATEMENTS ARE OBTAINED ANNUALLY. THE PRESIDENT'S OFFICE COLLECTS AND REVIEWS THE RESPONSES. WHERE ANY REAL OR PERCEIVED CONFLICTS EXIST, OFFICERS AND TRUSTEES ARE EXPECTED TO RECUSE THEMSELVES (1) FROM MEETINGS DURING TIMES WHEN THE TOPICS OF POTENTIAL CONFLICT ARE DISCUSSED AND (2) FROM VOTING ON SUCH MATTERS. KEY EMPLOYEES MAY NOT USE THEIR POSITIONS TO PROFIT PERSONALLY OR TO ASSIST OTHERS IN PROFITING IN ANY WAY AT THE EXPENSE OF STEPHENS MEMORIAL HOSPITAL ASSOCIATION. FORM 990, PAGE 6, PART VI, LINE 15A THE PARENT COMPANY OF STEPHENS MEMORIAL HOSPITAL ASSOCIATION IS WESTERN MAINE HEALTH CARE, CORP. (EIN 01-0411788)WHO THROUGH ITS PARENT COMPANY MAINEHEALTH, HAS A FORMAL WRITTEN COMPENSATION POLICY IN PLACE. IN CONSULTATION WITH SULLIVAN COTTER, THE MAINEHEALTH BOARD COMPENSATION COMMITTEE ESTABLISHES APPROPRIATE COMPENSATION PARAMETERS FOR EACH ORGANIZATION'S CEO AND CERTAIN MEMBERS OF THEIR SENIOR MANAGEMENT TEAM. WORKING WITHIN THESE PARAMETERS, THE WESTERN MAINE HEALTH CARE BOARD DETERMINES THE LEVEL OF COMPENSATION FOR ITS CEO. THE FINDINGS OF THE COMPENSATION COMMITTEE ARE MADE TRANSPARENT TO, AND VOTED ON BY, THE FULL GOVERNING BOARD. THE "TOTAL EXECUTIVE COMPENSATION" IS FILED PUBLICLY BY THE ORGANIZATION, AND INCLUDES "TOTAL CASH COMPENSATION- AND "TOTAL VALUE OF ALL BENEFITS AND PERQUISITES" ASSOCIATED WITH THE POSITION. THE BOARD TAKES NECESSARY ACTION TO PREVENT THE CEO FROM VOTING OR DIRECTLY PARTICIPATING IN THE FINAL COMMITTEE DETERMINATION OF HIS OWN COMPENSATION. THE ORGANIZATION'S EXECUTIVE COMPENSATION PROCEDURES RELY UPON APPROPRIATE DATA FOR COMPARABILITY (E.G. COMPENSATION LEVELS PAID BY BOTH TAXABLE AND TAX-EXEMPT SIMILARLY SITUATED ORGANIZATIONS AND INDEPENDENT SURVEYS BY NATIONALLY RECOGNIZED INDEPENDENT FIRMS). FINALLY, THE ORGANIZATION REFRAINS FROM ALLOWING EXECUTIVE COMPENSATION TO EVER BE BASED SOLELY ON WESTERN MAINE HEALTH CARE, CORP.'S REVENUES OR OTHER SIMILAR PROFIT-SHARING STRATEGIES. FORM 990, PAGE 6, PART VI, LINE 19 DOCUMENTS THAT ARE REQUIRED TO BE OPEN FOR PUBLIC INSPECTION ARE MADE AVAILABLE UPON REQUEST. FORM 990, PART IX, LINE 11G LAB/PATHOLOGY SERVICES 2,951,936 0 0 OTHER 2,844,918 53,272 0 PHYSICIAN SERVICES 2,362,796 0 0 NURSING SERVICES 717,233 0 0 ANESTHESIA SERVICES 534,999 0 0 IMAGING 376,114 0 0 FORM 990, PART XI, LINE 9 EQUITY TRANSFERS TO AFFILIATES -1,868,718 CHANGE IN INTEREST-STEPHENS COMM. HEALTHCARE FOUND 351,272 TOTAL -1,517,446 WESTERN MAINE HEALTH CARE CORP 181 MAIN STREET NORWAY ME 04268 010411788 HEALTHCARE ME 501C3 11B 01-0431680 false MAINEHEALTH 110 FREE STREET PORTLAND ME 04101 010431680 HEALTHCARE ME 501C3 11C NA false WESTERN MAINE MULTI-MEDICAL SPECIAL 181 MAIN STREET NORWAY ME 04268 010489824 PHYS PRACT ME 501C3 9 01-0411788 false WESTERN MAINE NURSING HOME INC 181 MAIN STREET NORWAY ME 04268 222842655 NURSING HO ME 501C3 9 01-0411788 false STEPHENS COMMUNITY HEALTHCARE FOUND 181 MAIN STREET NORWAY ME 04268 311644144 HEALTHCARE ME 501C3 11A 01-0411788 false CHAPEL VALLEY BOARDING HOME CORP 181 MAIN STREET NORWAY ME 04268 010433206 HEALTHCARE ME 501C3 7 01-0411788 false false false false false false false false false false true false true true false false true true true true