2015-03-14T07:00:08-07:00 2014-04-30 990 2013-05-01 010211797 MOUNT DESERT ISLAND HOSPITAL MOUN 2072885081 PO Box 8 10 Wayman Lane Bar Harbor ME 046090008 Christina Harding CFO 2072885082 2015-03-13 2013 2016-02-25 16:41:14Z ARTHUR BLANK 10 WAYMAN LANE PO BOX 8 BAR HARBOR ME 046090008 56372674 0 X www.mdihospital.org X 1897 ME Mount Desert Island Hospitals mission is to provide compassionate care and strengthen the health of our community by embracing tomorrow's methods and respecting time honored values. 18 14 529 244 0 0 2254053 1735208 47520943 45127799 424924 72733 2333173 3058207 52533093 49993947 0 0 0 0 32850936 31466270 0 0 155569 22267919 21346329 55118855 52812599 -2585762 -2818652 52443534 49537121 31102021 28955798 21341513 20581323 X Mount Desert Island Hospitals mission is to provide compassionate care and strengthen the health of our community by embracing tomorrows methods and respecting time honored values. 1 0 39585686 0 48156006 Mount Desert Island hospitals mission statement is described in Part II, Line 1 above. In Fiscal year 2014, MDI Hospital provided 3,326,742 in services for which no compensation was expected or received. Policies exist to provide relief for those who cannot pay for medical care. MDI Hospital provides care to persons covered by governmental programs including Medicare, Medicaid and champus. The unreimbursed value for providing care to these patients approximates 1,244,181. The Hospital provides a number of health services and preventative health programs to the community. Available programs include cardiac pulmonary rehabilitation, wellness programs, diabetes education, nutrition counseling, parenting, pregnancy and sibling classes and physical and occupational therapy programs, as well as speech therapy, as well as our newly adopted oral health program adopted in Fiscal year 2014. Thoughout the years, staff from the hospital make presentations to area school children regarding smoking cessation and health nutrition, and now oral health, including a Give Kids a Smile day in which free or reduced cost screenings are available. Additionally, community groups such as Alcoholics Anonymous use the hospitals conference rooms for their meetings. Many hospital staff members serve other nonprofits in capacities such as volunteer hours, and Board of Directors memberships, as well as memberships in service organization such as the local Rotary, and Lioness clubs. 0 0 0 39585686 1 1 0 1 0 0 0 0 0 1 1 0 0 1 1 1 1 1 0 0 0 0 0 0 0 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 56 0 1 529 1 0 0 0 0 0 0 X 18 14 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 ME X X X Arthur Blank 2072885081 PO Box 8 10 Wayman Lane Bar Harbor ME 046090008 Arthur J Blank President and CEO 40 0 X X X X 314555 0 34783 John Benson MD Boardmember 1 0 X 0 0 0 Michael Bonsey Chairman 5 0 X X 0 0 0 Stewart Brecher Board Member 1 0 X 0 0 0 David Einhorn Esq Board Member 1 0 X 0 0 0 Kathleen Field Board Member 1 0 X 0 0 0 Julius Krevans MD Board Member 1 0 X 0 0 0 Julian Kuffler MD 2nd Vice Chair & Family Physician 40.00 0 X 222993 0 25173 Dean Read Board Member 1 0 X 0 0 0 Patricia Hand PhD Board Member 1 0 X 0 0 0 Elsie Flemings Board Member 1 0 X 0 0 0 Noelle Wolf Board Member 1 0 X 0 0 0 Vince Messer 1st Vice Chair 3 0 X X 0 0 0 James Bright Board member 1 0 X 0 0 0 Christina M Harding CFO/VP of Finance 40 0 X X 164345 0 12970 Terry Musson Board Member 1 0 X 0 0 0 Stuart Davidson Physician 40 0 X 480974 0 37120 Michael Heniser Physician 40 0 X 382683 0 27638 Michelle Kinbrook Physician 40 0 X 282577 0 27876 Kendra Blount General Surgeon 40 0 X 288257 0 37120 Tanya Hanke Physician 40 0 X 251959 0 16774 Bev Paigen Board Member 1 0 X 0 0 0 David Painter MD 40 1 X 183062 0 34313 Audrey Leavitt Secretary 40 0 X 45568 0 18721 2616973 0 272488 40 0 1 0 Bay View Physical Therapy 125 Oak Street Ellsworth ME 04605 Physical Therapy 522273 Rao Surapememi P Ramanadha MD 50 358 Broad st suite 207 Bangor ME 04401 Urologist 336000 Dahl Chase Diagnostic Services 417 State Street Suite 441 Bangor ME 04401 pathology services 388859 3 0 0 0 0 116921 1618287 655264 1735208 Patient Service Revenue 900099 19489185 19489185 0 0 Medicare/Medicaid payments 900099 25638614 25638614 0 0 45127799 -39557 -39557 0 0 57742 57742 0 0 0 0 0 0 30000 0 0 0 30000 0 30000 30000 0 0 6433275 0 6378727 0 54548 0 54548 54548 0 0 0 Cafeteria sales 900099 194338 194338 0 0 Misc Income - Other 900099 2643850 2643850 0 0 Misc Income - HC Admin 900099 190019 190019 0 0 0 0 0 0 3028207 49993947 48258739 0 0 0 0 0 0 0 0 0 0 727284 0 727284 0 0 0 0 0 22990330 16945459 5942572 102299 492461 350713 139607 2141 5669829 4051452 1594681 23696 1586366 1133407 446117 6842 0 0 0 0 125961 0 125961 0 117305 0 117305 0 0 0 0 0 0 0 -39557 0 -39557 0 0 0 0 0 79239 0 79239 0 4276452 4045497 230955 0 0 0 0 0 0 0 0 0 744747 569346 175401 0 136569 113323 23246 0 0 0 0 0 210982 99791 111191 0 694276 567469 126807 0 0 0 0 0 1771190 1395822 375368 0 597688 486715 110973 0 Purchased Services 6564728 4686566 1878162 0 Bad Debt expense 2592434 2592434 0 0 Physician Fees 833184 828184 5000 0 Hospital taxes 1125762 1125762 0 0 1515369 593746 901032 20591 52812599 39585686 13071344 155569 0 0 41553 76474 2379184 1786054 6056753 6139447 0 0 0 0 0 0 523227 590932 214932 271435 48507798 25337958 22720683 23169840 13366094 12401361 0 0 0 0 0 0 7141108 5101578 52443534 49537121 12545489 11237965 0 0 11693 9154 4175016 3640969 0 0 0 0 9199906 7980576 0 0 5169917 6087134 31102021 28955798 X 14265803 14865588 5141021 3674156 1934689 2041579 21341513 20581323 52443534 49537121 X -2818652 352042 0 0 0 1706420 X 1 X 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 1 0 0 1 6704 6704 0 Schedule C, Part II-B, Line 1 The CEO, for part of the fiscal year, was an officer of the Maine Hospital Association. As such, he met directly with legislators and other government officials as part of his advocacy efforts within that organization. Some of these meetings were with the intent to influence public opinion on matters relevant to the organization. 6591431 25000 625391 0 225000 29284 6987538 6300481 0 588719 0 270000 27769 6591431 8117020 0 -421691 0 1366000 28848 6300481 6997367 17162 1180156 0 46000 31665 8117020 3938882 1801964 1284232 0 7570 20141 6997367 0.9486 0.0514 0 1 0 0 3829845 3829845 0 24979203 12702261 12276942 0 235558 149701 85857 0 15039507 12225897 2813610 0 4423685 260099 4163586 23169840 Due from affiliates 4681817 Deferred financing costs 66193 Estimated third party payor settlements 249273 Aetna deposit 98000 Other receivables 6295 5101578 0 Deferred compensation 2154482 Estimated third party payor settlements 3622845 Due to affiliate 309807 6087134 X 49197901 0 0 0 0 0 49197901 0 796046 796046 49993947 50393478 0 0 0 -2419121 -2419121 52812599 0 0 0 52812599 Schedule D, Part V, Line 4 Endowment amounts restricted by the Board of Directors are released by the Board as needed for Special Projects supplying benefit to the community at large. These funds are intended solely for the use of expanding services, and not for sustaining current operations. Schedule D, Part X, Line 2 No note Schedule D, Part XI, Line 4b Gifts and bequests, temporarily restricted contributions, changes in pledges receivable, net assets released. Schedule D, Part XII, Line 2d Fundraising expenses, investment mgmt fees Schedule D, Part XII, Line 4b Fundraising expenses, investment management fees Schedule D, Part XII, Line 5 The IRS software has a formula error and it won't let you override it. The sum of 50,393,478 and 2,419,121 is 52,812,599, not 47,974,357 as the software states and returns an error on. It is necessary to put this number in as negative in order to calculate correctly. 1 1 X 1 X 1 X 1 1 1 0 1 1 0 0 498854 0 498854 0.01 0 0 4684774 3939447 745327 0.0141 0 0 0 0 0 0 0 0 5183628 3939447 1244181 0.0241 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10726657 7399915 3326742 0.064 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10726657 7399915 3326742 0.0640 0 0 15910285 11339362 4570923 0.0881 1 2592434 1697175 14407909 19137103 -4729194 X 1 1 13 1 Mount Desert Island Hospital 10 Wayman Lane PO Box 8 Bar Harbor ME 046090008 www.mdihospital.org X X X X 2 Cadillac Family Practice and Behavioral Health Center 322 Main Street Bar Harbor ME 04609 Outpatient clinic 3 Cooper Gilmore Health Center 17 Hancock Road Bar Harbor ME 04609 Outpatient clinic 4 Trenton Health Center 394 Bar Harbor Road Trenton ME 04605 Outpatient clinic 5 Community Health Center 16 Community Lane Southwest Harbor ME 04679 Outpatient clinic 6 Family Health Center 9 Hancock Road Bar Harbor ME 04609 Outpatient Clinic 7 Women's Health Center 8 Wayman Lane Bar Harbor ME 04609 Outpatient clinic 8 Northeast Harbor Clinic Kimball Road Northeast Harbor ME 04679 Outpatient clinic 9 MDI Orthopedic clinic 10 Wayman Lane Bar Harbor ME 04609 Outpatient Clinic 10 MDI Dermatology Clinic 322 Main Street Bar Harbor ME 04609 Outpatient Clinic 11 MDI Urology Clinic 322 Main Street Bar Harbor ME 04609 Outpatient Clinic 12 MDI General Surgery Clinic 17 Hancock Road Bar Harbor ME 04609 Outpatient clinic 13 Community Dental Clinic 16 Community Lane Southwest Harbor ME 04679 www.mdihospital.org X Outpatient Clinic Mount Desert Island Hospital 1 1 X X X X X X X X 11 1 0 1 X www.mdihospital.org X X X X X X X X X 1 0 1 1 150 1 250 1 X X X X X X X 1 1 X X X X X 1 X X 0 X X 1 X 0 0 Cadillac Family Practice and Behavioral Health Center 2 1 X X X X X X X X 11 1 0 1 X www.mdihospital.org X X X X X X X X X 1 0 1 1 150 1 250 1 X X X X X X X 1 1 X X X X X 1 X X 0 X X 1 X 0 0 Cooper Gilmore Health Center 3 1 X X X X X X X X 11 1 0 1 X www.mdihospita.org X X X X X X X X X 1 0 1 1 150 1 250 1 X X X X X X X 1 1 X X X X X 1 X X 0 X X 1 X 0 0 Trenton Health Center 4 1 X X X X X X X X 11 1 0 1 X www.mdihospital.org X X X X X X X X X 1 0 1 1 150 1 250 1 X X X X X X X 1 1 X X X X X 1 X X 0 X X 1 X 0 0 Community Health Center 5 1 X X X X X X X X 11 1 0 1 X www.mdihospital.org X X X X X X X X X 1 0 1 1 150 1 250 1 X X X X X X X 1 1 X X X X X 1 X X 0 X X 1 X 0 0 Family Health Center 6 1 X X X X X X X X 11 1 0 1 X www.mdihospital.org X X X X X X X X X 1 0 1 1 150 1 250 1 X X X X X X X 1 1 X X X X X 1 X X 0 X X 1 X 0 0 Women's Health Center 7 1 X X X X X X X X 11 1 0 1 X www.mdihospital.org X X X X X X X X X 1 0 1 1 150 1 250 1 X X X X X X X 1 1 X X X X X 1 X X 0 X X 1 X 0 0 Northeast Harbor Clinic 8 1 X X X X X X X X 11 1 0 1 X www.mdihospital.org X X X X X X X X X 1 0 1 1 150 1 250 1 X X X X X X X 1 1 X X X X X 1 X X 0 X X 1 X 0 0 MDI Orthopedic clinic 9 1 X X X X X X X X 11 1 0 1 X www.mdihospital.org X X X X X X X X X 1 0 1 1 150 1 250 1 X X X X X X X 1 1 X X X X X 1 X X 0 X X 1 X 0 0 MDI Dermatology Clinic 10 1 X X X X X X X X 11 1 0 1 X www.mdihospital.org X X X X X X X X X 1 0 1 1 150 1 250 1 X X X X X X X 1 1 X X X X X 1 X X 0 X X 1 X 0 0 MDI Urology Clinic 11 1 X X X X X X X X 11 1 0 1 X www.mdihospital.org X X X X X X X X X 1 0 1 1 150 1 250 1 X X X X X X X 1 1 X X X X X 1 X X 0 X X 1 X 0 0 MDI General Surgery Clinic 12 1 X X X X X X X X 11 1 0 1 X www.mdihospital.org X X X X X X X X 1 0 1 1 150 1 250 1 X X X X X X X 1 1 X X X X 1 X X 0 X X 1 X 0 0 Community Dental Clinic 13 1 X X X X X X X X 11 1 0 1 X www.mdihospital.org X X X X X X X X X 1 0 1 1 150 1 175 1 X X X X X X X 1 1 X X X X 1 X X 0 X X 1 X 0 0 Schedule H, Part V, Section B, Line 3-Mount Desert Island Hospital The Hospital Partnered with Healthy Acadia to perform a comprehensive community needs assessment, focused on the overall health of the community. The participants were a multifaceted representation of the community, including business, public health, community health and healthcare providers. Healthy Acadia is dedicated to building vibrant communities and making it easier for people to make healthy choices for themselves and their families. They create lasting improvements to the health of our communities by connecting individuals with health supports, building partnerships, coordinating education and prevention services, and improving policies and environments. Healthy Acadia is a 501c3 non profit with more than 100 partners. They address critical locally defined health priorities across Hancock County. They serve as the Healthy Maine Partnership for Hancock County. Schedule H, Part V, Section B, Line 3-Cadillac Family Practice and Behavioral Health Center The Hospital Partnered with Healthy Acadia to perform a comprehensive community needs assessment, focused on the overall health of the community. The participants were a multifaceted representation of the community, including business, public health, community health and healthcare providers. Healthy Acadia is dedicated to building vibrant communities and making it easier for people to make healthy choices for themselves and their families. They create lasting improvements to the health of our communities by connecting individuals with health supports, building partnerships, coordinating education and prevention services, and improving policies and environments. Healthy Acadia is a 501c3 non profit with more than 100 partners. They address critical locally defined health priorities across Hancock County. They serve as the Healthy Maine Partnership for Hancock County. Schedule H, Part V, Section B, Line 3-Cooper Gilmore Health Center The Hospital Partnered with Healthy Acadia to perform a comprehensive community needs assessment, focused on the overall health of the community. The participants were a multifaceted representation of the community, including business, public health, community health and healthcare providers. Healthy Acadia is dedicated to building vibrant communities and making it easier for people to make healthy choices for themselves and their families. They create lasting improvements to the health of our communities by connecting individuals with health supports, building partnerships, coordinating education and prevention services, and improving policies and environments. Healthy Acadia is a 501c3 non profit with more than 100 partners. They address critical locally defined health priorities across Hancock County. They serve as the Healthy Maine Partnership for Hancock County. Schedule H, Part V, Section B, Line 3-Trenton Health Center The Hospital Partnered with Healthy Acadia to perform a comprehensive community needs assessment, focused on the overall health of the community. The participants were a multifaceted representation of the community, including business, public health, community health and healthcare providers. Healthy Acadia is dedicated to building vibrant communities and making it easier for people to make healthy choices for themselves and their families. They create lasting improvements to the health of our communities by connecting individuals with health supports, building partnerships, coordinating education and prevention services, and improving policies and environments. Healthy Acadia is a 501c3 non profit with more than 100 partners. They address critical locally defined health priorities across Hancock County. They serve as the Healthy Maine Partnership for Hancock County. Schedule H, Part V, Section B, Line 3-Community Health Center The Hospital Partnered with Healthy Acadia to perform a comprehensive community needs assessment, focused on the overall health of the community. The participants were a multifaceted representation of the community, including business, public health, community health and healthcare providers. Healthy Acadia is dedicated to building vibrant communities and making it easier for people to make healthy choices for themselves and their families. They create lasting improvements to the health of our communities by connecting individuals with health supports, building partnerships, coordinating education and prevention services, and improving policies and environments. Healthy Acadia is a 501c3 non profit with more than 100 partners. They address critical locally defined health priorities across Hancock County. They serve as the Healthy Maine Partnership for Hancock County. Schedule H, Part V, Section B, Line 3-Family Health Center The Hospital Partnered with Healthy Acadia to perform a comprehensive community needs assessment, focused on the overall health of the community. The participants were a multifaceted representation of the community, including business, public health, community health and healthcare providers. Healthy Acadia is dedicated to building vibrant communities and making it easier for people to make healthy choices for themselves and their families. They create lasting improvements to the health of our communities by connecting individuals with health supports, building partnerships, coordinating education and prevention services, and improving policies and environments. Healthy Acadia is a 501c3 non profit with more than 100 partners. They address critical locally defined health priorities across Hancock County. They serve as the Healthy Maine Partnership for Hancock County. Schedule H, Part V, Section B, Line 3-Women's Health Center The Hospital Partnered with Healthy Acadia to perform a comprehensive community needs assessment, focused on the overall health of the community. The participants were a multifaceted representation of the community, including business, public health, community health and healthcare providers. Healthy Acadia is dedicated to building vibrant communities and making it easier for people to make healthy choices for themselves and their families. They create lasting improvements to the health of our communities by connecting individuals with health supports, building partnerships, coordinating education and prevention services, and improving policies and environments. Healthy Acadia is a 501c3 non profit with more than 100 partners. They address critical locally defined health priorities across Hancock County. They serve as the Healthy Maine Partnership for Hancock County. Schedule H, Part V, Section B, Line 3-Northeast Harbor Clinic The Hospital Partnered with Healthy Acadia to perform a comprehensive community needs assessment, focused on the overall health of the community. The participants were a multifaceted representation of the community, including business, public health, community health and healthcare providers. Healthy Acadia is dedicated to building vibrant communities and making it easier for people to make healthy choices for themselves and their families. They create lasting improvements to the health of our communities by connecting individuals with health supports, building partnerships, coordinating education and prevention services, and improving policies and environments. Healthy Acadia is a 501c3 non profit with more than 100 partners. They address critical locally defined health priorities across Hancock County. They serve as the Healthy Maine Partnership for Hancock County. Schedule H, Part V, Section B, Line 3-MDI Orthopedic clinic The Hospital Partnered with Healthy Acadia to perform a comprehensive community needs assessment, focused on the overall health of the community. The participants were a multifaceted representation of the community, including business, public health, community health and healthcare providers. Healthy Acadia is dedicated to building vibrant communities and making it easier for people to make healthy choices for themselves and their families. They create lasting improvements to the health of our communities by connecting individuals with health supports, building partnerships, coordinating education and prevention services, and improving policies and environments. Healthy Acadia is a 501c3 non profit with more than 100 partners. They address critical locally defined health priorities across Hancock County. They serve as the Healthy Maine Partnership for Hancock County. Schedule H, Part V, Section B, Line 3-MDI Dermatology Clinic The Hospital Partnered with Healthy Acadia to perform a comprehensive community needs assessment, focused on the overall health of the community. The participants were a multifaceted representation of the community, including business, public health, community health and healthcare providers. Healthy Acadia is dedicated to building vibrant communities and making it easier for people to make healthy choices for themselves and their families. They create lasting improvements to the health of our communities by connecting individuals with health supports, building partnerships, coordinating education and prevention services, and improving policies and environments. Healthy Acadia is a 501c3 non profit with more than 100 partners. They address critical locally defined health priorities across Hancock County. They serve as the Healthy Maine Partnership for Hancock County. Schedule H, Part V, Section B, Line 3-MDI Urology Clinic The Hospital Partnered with Healthy Acadia to perform a comprehensive community needs assessment, focused on the overall health of the community. The participants were a multifaceted representation of the community, including business, public health, community health and healthcare providers. Healthy Acadia is dedicated to building vibrant communities and making it easier for people to make healthy choices for themselves and their families. They create lasting improvements to the health of our communities by connecting individuals with health supports, building partnerships, coordinating education and prevention services, and improving policies and environments. Healthy Acadia is a 501c3 non profit with more than 100 partners. They address critical locally defined health priorities across Hancock County. They serve as the Healthy Maine Partnership for Hancock County. Schedule H, Part V, Section B, Line 3-MDI General Surgery Clinic The Hospital Partnered with Healthy Acadia to perform a comprehensive community needs assessment, focused on the overall health of the community. The participants were a multifaceted representation of the community, including business, public health, community health and healthcare providers. Healthy Acadia is dedicated to building vibrant communities and making it easier for people to make healthy choices for themselves and their families. They create lasting improvements to the health of our communities by connecting individuals with health supports, building partnerships, coordinating education and prevention services, and improving policies and environments. Healthy Acadia is a 501c3 non profit with more than 100 partners. They address critical locally defined health priorities across Hancock County. They serve as the Healthy Maine Partnership for Hancock County. Schedule H, Part V, Section B, Line 3-Community Dental Clinic The Hospital Partnered with Healthy Acadia to perform a comprehensive community needs assessment, focused on the overall health of the community. The participants were a multifaceted representation of the community, including business, public health, community health and healthcare providers. Healthy Acadia is dedicated to building vibrant communities and making it easier for people to make healthy choices for themselves and their families. They create lasting improvements to the health of our communities by connecting individuals with health supports, building partnerships, coordinating education and prevention services, and improving policies and environments. Healthy Acadia is a 501c3 non profit with more than 100 partners. They address critical locally defined health priorities across Hancock County. They serve as the Healthy Maine Partnership for Hancock County. Schedule H, Part V, Section B, Line 5-Mount Desert Island Hospital The Community Health Needs Assessment is available to our community members through our public website and the ongoing implementation and workplan is documented by our Planning and Board Committees. Schedule H, Part V, Section B, Line 5-Cadillac Family Practice and Behavioral Health Center The Community Health Needs Assessment is available to our community members through our public website and the ongoing implementation and workplan is documented by our Planning and Board Committees. Schedule H, Part V, Section B, Line 5-Cooper Gilmore Health Center The Community Health Needs Assessment is available to our community members through our public website and the ongoing implementation and workplan is documented by our Planning and Board Committees. Schedule H, Part V, Section B, Line 5-Trenton Health Center The Community Health Needs Assessment is available to our community members through our public website and the ongoing implementation and workplan is documented by our Planning and Board Committees. Schedule H, Part V, Section B, Line 5-Community Health Center The Community Health Needs Assessment is available to our community members through our public website and the ongoing implementation and workplan is documented by our Planning and Board Committees. Schedule H, Part V, Section B, Line 5-Family Health Center The Community Health Needs Assessment is available to our community members through our public website and the ongoing implementation and workplan is documented by our Planning and Board Committees. Schedule H, Part V, Section B, Line 5-Women's Health Center The Community Health Needs Assessment is available to our community members through our public website and the ongoing implementation and workplan is documented by our Planning and Board Committees. Schedule H, Part V, Section B, Line 5-Northeast Harbor Clinic The Community Health Needs Assessment is available to our community members through our public website and the ongoing implementation and workplan is documented by our Planning and Board Committees. Schedule H, Part V, Section B, Line 5-MDI Orthopedic clinic The Community Health Needs Assessment is available to our community members through our public website and the ongoing implementation and workplan is documented by our Planning and Board Committees. Schedule H, Part V, Section B, Line 5-MDI Dermatology Clinic The Community Health Needs Assessment is available to our community members through our public website and the ongoing implementation and workplan is documented by our Planning and Board Committees. Schedule H, Part V, Section B, Line 5-MDI Urology Clinic The Community Health Needs Assessment is available to our community members through our public website and the ongoing implementation and workplan is documented by our Planning and Board Committees. Schedule H, Part V, Section B, Line 5-Community Dental Clinic The Community Health Needs Assessment is available to our community members through our public website and the ongoing implementation and workplan is documented by our Planning and Board Committees. Schedule H, Part I, Line 7 The costing methodology utilized for this table were derived from Worksheet 2, Ratio of patient care cost to charges with data from filed cost reports for the filing fiscal year. 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 puposes of caculating the percentage in this column is 2,952,434 Schedule H, Part I, Line 7g The Hospital provides to the community several provider based physician and specialty practices to serve this rural island population. These practices are listed on Part V of this schedule. The facility subsidizes their operating costs to maintain access and coordination of care to our population. Schedule H, Part III, Section A, Line 4 Patient accounts receivable are stated at the amount that management expects to collect from outstanding balances. Management provides for probable uncollectible amounts through a charge to operations and a credit to a valuation allowance based on its assessment to individual accounts and historical adjustments. Balances that are still outstanding, after management has used reasonable collection efforts are written off through a charge to the valuation allowance and a credit to the patient accounts receivable. The Hospital follows the Medicare guidelines for allowable bad debts. It uses the following criteria. A. Establishing that reasonable collection efforts were made B. Establishing that the accounts were uncollectible C. Establishing that there is no likelihood of recovery at anytime in the future. Schedule H, Part III, Section B, Line 8 The IRS 990H instructions and guidance provide a template in worksheet 2 template as a way to determine the overall cost to charge ratio that could be applied throughout the IRS 990H form in order to convert charges to cost. Where applicable, we have utilized the worksheet 2 template calculation. The only area where we did not utilize this template calculation was in form 990H worksheet B, Line 2 and 6 Medicare allowable costs and payments related to the subsidized health services we utilized the Medicare cost report estimated cost and payment for these services. The Hospital believes that provider based clinics listed in 1C above should be and are considered a community benefit due to the fact that without the Hospital subsidizing and offering the services that these clinics offer, the community at large would have to travel at least 45 to 65 minutes to the nearest like hospital and that hospital's service offerings. As such, Mount Desert Island Hospital believes that by offering and subsidizing these clinics within its community and thus enabling community members to have easy access and an easier commute for these services, that this benefits the whole community at large. Schedule H, Part III, Section C, Line 9b The Hospital would not initiate collection efforts against a patient that qualified for a sliding fee scale unless that patient failed to meet their obligation under a mutually agreed upon payment arrangement. After it was determined that the patient did not qualify for a readjustment to their payment terms, the Hospital would follow normal notification practices dictated by our collection policy which may result in the account sent to collections. When a patient is referred out to collections but then applies for free or discounted care, we pull the account back from collections when it is determined they qualify for one of the programs. If the collection agency suspects that someone may need to apply for one of the programs, they send out an application and notify us. We make every effort to screen as many people as possible before we send them to collections. Information about our free and sliding scale programs are on our website, on our account statements, posted in public areas and at our provider clinics. We also make available a Patient Financial Counselor to help navigate the process Schedule H, Part VI, Line 2 Mount Desert Island Hospital assesses the health needs of the community through the use of a collaborative Community Health Needs Assessment. As a key participant in the CHNA process our institution is able to further address and identify those areas of most concern and need in our community. A community needs assessment is a point in time effort to measure the health and well being of the community. It serves as a constructive tool to and basis for Mount Desert Island Hospital's strategic and subsequent action planning to develop Health Policy Advocacy, allocate resources, improve or expand existing services, implement new programs and collaborate with other community health care providers. A community health needs assessment also serves as a benchmark for future assessment of measured progress toward established community health objectives. The Mount Desert Island Hospital's Community Health Needs Assessment provides an opportunity to gain insight into the needs and assets that are served, it also provides a measure to identify and address the needs of the vulnerable populations with our community. The Mount Desert Island Hospital process was a partnership with Healthy Acadia, a comprehensive community health coalition that was formed in 2001 with the public health funding provided by the Maine Center for Disease Control and Prevention. The Community Health Improvement Plan and Health Needs Assessment were performed using the Mobilizing for Action through Planning and Partnerships process utilizing a broad cross section of our demographic and service area. This process delivered the basis for the assessment which demonstrated the strengths and opportunities for our plan. This process involved gather of two types of data, quantitative demographics, health indicators, local statistics, etc. and qualitative Public Surveys, Focus Groups and Community Stakeholders. The data helps support short-term and long-term decisions about allocation of community human and capital resources. Participants included members of the Hospitals medical staff, nursing staff, board of trustees and administration. Focus groups were used to gain feedback from diverse and remote populations, as an institution that serves the rural and coastal community of Mount Desert Island and the other islands off the Coast of Hancock County, this feedback was essential to continue to develop strategies to meet the needs of our residents. This collaborative effort developed the eight themes for strategic initiatives and goals. The organization reviewed the overarching needs and validated those to the health needs of the community. This process was reviewed and prioritized through the Board Designated Planning Committee of the organization, which developed and maintains oversight of the Hospitals official Community Health Needs Assessment and Implementation Plan. The implementation plan is reviewed periodically. Those items that were not achievable are reviewed and documented as to the barrier for successful implementation and or alternatives. Schedule H, Part VI, Line 3 The Financial Assistance Policy application is sent with all account statements, it is printed on the back of the statement. A notice of the FAP is also available on our Hospital website, posted in public areas and available within the departments and clinics of our organization. The hospital provides a Patient Financial Representative to help navigate the process to ensure that our patients have access to care and services they need. MDIH is committed to Providing access to quality healthcare services with compassion, dignity and respect for those we serve, particularly the poor, indigent, and underserved in our communities. Caring for all members of our communities or persons needed care, regardless of their ability to pay for services. Assisting our patients who cannot afford to pay for part or all of the services received by working with our community to address those in need and aid in finding the financial resources available. MDIH has adopted guiding principles when handling the billing, collections and financial support functions for our patients. Provide effective communications with patients regarding hospital bills Make affirmative efforts to help patients apply for public and private financial support programs. We implement policies and procedures for assisting low income patients in a consistent manner. We implement fair and consistent billing and collection practices for all patients with patient payment obligations. We communicate effectively and timely with our patients regarding patient payment obligation. Noting that a patient financial representative is available to assist with triaging patient needs and working with our patients to align resources. This representative is available to explain and review patient payment obligations as well we have a patient advocate to facilitate issues that arise in the course of this process. Information about hospital based financial support polices and external support programs that provide coverage for services are made available to patients during the pre registration and registration processes and or through communications with patients seeking financial assistance. Support is available to uninsured and underinsured patients who do not qualify for public programs or other means of assistance. Notification about financial assistance programs at MDIH, including contact information, is available through messaging included on patient bills, physician offices, public areas, care management staff, registration areas, billing support staff and reception in the hospital, and clinics. Patient brochures describing the financial counseling and assistance services are available in these areas as well as on our public website, mdihospital.org. Schedule H, Part VI, Line 4 Mount Desert Island Hospital is a 25 Critical Access Hospital located in Bar Harbor, Maine providing acute, swing, obstetrics and nursery services. It is a not-for profit hospital located in Bar Harbor, Maine Hancock County. The Hospital is licensed by the State of Maine. The mission is to provide compassionate care and strengthen the health of our community by embracing tomorrow's methods and respecting time honored values. Its services include acute inpatient, 24 hours emergency center, and diagnostic and surgical services. Along with hospital services, the Hospital employs the majority of primary and specialty care physicians in the area. The Hospital provides the only Behavioral Health Clinic services in Hancock County. Hancock and Washington county is considered rural by the state of Maine and the United States Census Bureau, under guidelines set forth by the office of Management and Budget OMB. The Hospital service area HSA as defined by the Maine Health Data Organization MHDO uses the statistical method where the greatest proportion of residents received their inpatient care. Schedule H, Part VI, Line 5 The volunteer Board of Trustees sets the strategic direction for the Hospital and is comprised of community members from the Hospital service area. Mount Desert Island Hospital non-profit status allows the Hospital to reinvest any excess of revenues over expense back into the Hospital to continuously improve the medical care it delivers. The Hospital provides staff and space to the community for Health Forums, Medical Certification Courses, Physician Education, Nutrition Education, Advocacy, Community Health Forums, Vaccination Clinics, Public Kiosks to access Healthcare.gov, and a Public Website with links to Healthy Choices. The Hospital works with the local YMCA to promote healthy choices and early education about exercise benefits to the youth of the area. The Hospital engages with the school systems to provide Nurses and Health Coaches to promote the health of the community and sponsors and annual Health Fair for the community to educate and engage the members of the community about choosing wisely and healthy options within their lifestyles. Mount Desert Island Hospital Organization was able to maintain and expand its ongoing Affordable Care Act outreach, enrollment and education efforts during the 2015 open enrollment period on the Health Insurance Marketplace. This was achieved through broadening our base of Certified Application Counselors, which now includes public affairs and care management professionals in addition to patient advocacy representatives and finance specialists. MDI Hospital Organization certified 9 CACs in advance of 2015 open enrollment, which allowed for a robust outreach and education schedule. During the 2015 open enrollment period, MDI Hospital Organization CACs provided enrollment counseling through public enrollment sessions, private appointments, telephone, social media and one-on-one support. MDI Hospital Organization application counselors also provided and will continue to offer counseling to those with questions about how best to utilize their new health insurance coverage through one-on-one, telephone, email and social media support. By expanding our public outreach to local eateries, we connected with a demographic that we had not previously reached, such as area retail and restaurant employees as well as local small business owners. By meeting our community in an environment that was comfortable to them, we removed their hesitancy to explore their options. Additionally, we found that the people we met during this outreach were more apt to share their experience with friends, coworkers and family, so our outreach began to spread much more organically through word of mouth. By expanding our social media outreach, we removed another barrier to access for many people, allowing them to connect with us through text and social media messaging. Our Facebook outreach was not only done through our organization's Facebook page, but through specifically targeted Facebook groups formed around sharing public events and employment options. As a result, we received many email, social media and text inquiries and referrals. By certifying application counselors across a wide variety of disciplines, we were able to more fully integrate our outreach efforts and offer support to a broader community base. X 1 1 X X X 0 0 0 0 0 0 0 0 0 Arthur J Blank President and CEO 314555 0 0 0 0 0 17500 0 34783 0 366838 0 0 0 Christina M Harding CFO/VP of Finance 164345 0 0 0 0 0 0 0 12970 0 177315 0 0 0 Stuart Davidson Physician 480974 0 0 0 0 0 17500 0 37120 0 535594 0 0 0 Michael Heniser Physician 382683 0 0 0 0 0 17500 0 27638 0 427821 0 0 0 Michelle Kinbrook Physician 282577 0 0 0 0 0 17500 0 27876 0 327953 0 0 0 Kendra Blount General Surgeon 288257 0 0 0 0 0 17500 0 37120 0 342877 0 0 0 Tanya Hanke Physician 251959 0 0 0 0 0 0 0 16774 0 268733 0 0 0 David Painter MD 183062 0 0 0 0 0 17500 0 34313 0 234875 0 0 0 Schedule J, Part I, Line 1a The Hospital provides the CEO's fitness membership, which is approximately $399 per year. MDI Hospital reimburses all other benefited employees up to $100 per year toward the YMCA or other health club membership with appropriate supporting documentation. Schedule J, Part I, Line 7 Fitness memberships A MHHEFA 2006F Bond 2005-07-03 707200 Replacement of central chiller 0 0 0 B MHHEFA 2007B Bond 2007-07-03 4427988 Clinic construction, office and clinic space 0 0 0 C MHEFFA 2010 Bond 2010-07-01 1200000 Refinancing of 98A Bond for renovation of outpatient service area 0 0 0 A 0 0 707200 0 0 0 0 0 0 707200 0 0 2008 0 0 1 1 B 0 0 4427988 0 0 0 0 0 0 4427988 0 0 2009 0 0 1 1 C 0 0 1200000 0 0 0 0 0 0 0 1200000 0 1999 1 0 1 1 A 0 0 0 0 0 0 0 1 0 1 B 0 0 0 0 0 0 0 1 0 1 C 0 0 0 0 0 0 0 1 0 1 A 0 0 0 0 0 0 0 0 1 B 0 0 0 0 0 0 0 0 1 C 0 0 0 0 0 0 0 0 1 J and D Imaging John Benson MD Board member 379708 Equipment leasing and radiology services 0 Schedule L, Part I, Line 1 John Benson, MD is the propiretor of J&D Imaging Co. J&D Imaging does consulting for MDI Hospital in the form of radiology services performed by Dr. John Benson. MDI Hospital also leases radiology equipment from J&D Imaging. Although Dr. Benson is a member of the Board of Directors of MDI Hospital, he abstains from any situation which may be deemed a conflict of interest, and duly reports and compeltes required disclosures. X 7 515927 Fair Market Value 0 0 1 1 Schedule M, Part I, Line 32b The hospital policy requires that sotck donations are immediately sold by the Advisors Account to which they are received. Form 990, Part III, Line 2 Oral Health Services Reference Part III, Line 4a of 990 Form 990, Part VI, Section B, Line 11b The initial review of the Form 990 is performed by the Finance Sub Committee of the Board of Directors of the Hospital. The members are provided with an electronic copy of the Form 990 and all supporting schedules (printed versions are also available upon request). Once reviewed by the Finance Sub-Committee, all Board of Trustees members are provided with a copy of the Form 990 and supporting schedules for review. Board Members are given the opportunity to comment and review. Both the CEO, President and CFO, Vice President are available to answer any inquiries. Board Members are also given the opportunity to receive the final copy via an electronic format or a printed copy. Form 990, Part VI, Section B, Line 12c Per the conflict of interest policy, the organization monitors and enforces disclosure compliance of interests that could give rise to conflicts by officers, directors, or trustees and key employees. disclosures are completed and submitted to the CEO. Board members will abstain from discussions or approval if there is even an appearance of possible conflict of interest during meetings. Form 990, Part VI, Section B, Line 15 The compensation for the President and CEO of MDI Hospital is reviewed and approved by the governing body of the organization. The governing body uses market data from an independent source to compare compensation models of similar size organizations within like demographiscs and geographical similarities to align compensation packages. Other officers and key employees' compensation is reviewed by the Human Resource Department of the organization using the same market data guidelines to compare compensation for these positions relative to like organizations with like demographic and geographic similarities. Form 990, Part VI, Section C, Line 19 The annual report and Form 990, including financial information is available to the public through our website at mdihospital.org. Additional financial information is available on federal and state governmental websites for required reporting. Governing documents and conflict of interest policy are available upon request, as are audited financial statements. Form 990, Part XI, Line 9 Changes in pledges rec, value of beneficial interest in perpetual trust Birch Bay Village Retirement Community 10 Wayman Lane Bar Harbor ME 04609 010481696 Retirement Community ME 501(c)(3) 170(b)(1)(A)(iii) Mount Desert Island Hospital 0 Mount Desert Management Company PO Box 8 10 Wayman Lane Bar Harbor ME 04609 010538776 Real Estate Development ME Birch Bay Village Retirement Community C 1 0 Hancock County Community Health LLC 4 Community Lane PO Box 731 Southwest Harbor ME 04679 464278107 Lease dental provider services ME C 50 50 0.5 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 Birch Bay Village Retirement Community a-iv 32400 building costs allocated by square footage equal to amount of rent charged Birch Bay Village Retirement Community q 119970 Receivable account - a receivable account is maintained on the general ledger of MDI Hospital, as well as an accounts payable account on the general ledger of Birch Bay Village Retirement Community. Transfers to the Birch Bay Village Retirement Community are recorded as receivables at the time of transfer. A detail of this account in maintained in order to provide this information. no late filing