2014-08-11T14:33:32-07:00 2013-09-28 990 2012-09-30 043341666 Eastern Maine Healthcare SystemsCADean Charles A Dean Memorial HospitalCADean EAST 2076955200 Pritham Avenue PO Box 1129 Greenville ME 04441 Eugene Murray Jr 2014-08-11 false 2012 2015-11-30 17:44:51Z Eugene Murray Jr PO Box 1129 Greenville ME 044411129 19047895 false false 5247 X www.cadean.org X 1996 ME The mission of Charles A. Dean Memorial Hospital is to provide a continuum of high quality holistic healthcare services. 13 9 178 130 0 325613 277300 18325462 18428936 38885 18550 292825 172543 18982785 18897329 500 0 9183382 9845072 0 99236 9248198 8419760 18431580 18265332 551205 631997 10725889 10905607 6649166 6142136 4076723 4763471 X The mission of Charles A. Dean Memorial Hospital is to provide a continuum of high quality holistic healthcare services. false false 15354672 500 18600938 Provided emergency, ambulance, inpatient acute care, outpatient surgery, specialty physician clinics and nursing home services to patients regardless of ability to pay. The Charles A. Dean Memorial Hospital is a 25 bed Critical Access Hospital in rural northwestern Maine providing emergency, ambulance, inpatient acute care, outpatient surgery, specialty physician clinics and nursing home services to patients regardless of ability to pay.Additional Statistics:Northwoods Healthcare Clinic visits 10,333Hospital diagnostic and rehabilitation visits 15,453Emergency room visits 2,481 Hospital admissions 365Surgery cases 319Ambulance runs 451 376499 Provided charity care (at cost). 185 persons served. 316363 Experienced Medicaid shortfall (at cost). 4,487 persons served. 109326 16156860 true true false true false false false false false true true false false true true true false true false false false false false false true false true true false false true false false false false false false false false false true true false false false false false true true true false false true 56 0 true 178 true false false false false false false false false 0 false false false false false false false false false false X 13 9 false false true false true true true true true false false true true true true true true true false false ME X X X Jeffrey A Sanford 2079737894 43 Whiting Hill Road Brewer ME 044121006 Laureen J Muzzy 0.50 0.00 X 0 0 0 Ronald Pelletier 0.50 0.00 X 0 0 0 Eugene Murray Jr 40.00 0.00 X X 174771 0 46413 Mary M Hood President CEO 1.00 50.00 X X 0 844254 248039 Stuart C Watt 0.50 0.00 X 0 0 0 David S Richards 0.50 0.00 X X 0 0 0 Steve M Pound 0.50 0.00 X X 0 0 0 Sharon Hastings 0.50 0.00 X 0 0 0 Faye E Booker 0.50 0.00 X 0 0 0 Diane K Bartley 0.50 0.00 X 0 0 0 Geraldine H Godson 2.00 0.00 X X 0 0 0 Linda D Gilbert 2.00 0.00 X X 0 0 0 Ruth E McLaughlin 2.00 0.00 X X 0 0 0 Dwight Foote 0.50 0.00 X 0 0 0 Darin M Peck MD 40.00 0.00 X 314530 0 38549 EE comp is for admin svcs 0.00 0.00 X 0 0 0 Tracy Bonney-Corson 40.00 0.00 X 90131 0 28277 Jennifer Goodrich 40.00 0.00 X 97682 0 19483 Dennis Welsh 40.00 0.00 X 116694 0 30959 Paul Potvin 40.00 0.00 X 251593 0 52737 John L Toothaker 40.00 0.00 X 220880 0 34425 Lawrence DuBien 40.00 0.00 X 220880 0 32866 David T Rideout 40.00 0.00 X 323485 0 41956 Mario Turi 40.00 0.00 X 240288 0 19326 Gregg Christensen 40.00 0.00 X 137412 0 17706 Edward Olivier 0.00 50.00 X 0 158083 20372 2188346 1002337 631108 12 true true false Nurse Anesthesia of Maine 141 Main Street Suite 205 Brewer ME 04412 Anesthesia Services 124658 Dahl-Chase Diagnostic Services 471 State Street Suite 441 Bangor ME 04401 Lab Testing Services 104807 2 1000 23828 483 15464 236525 3339 277300 Patient Care Services 621990 18418020 18418020 Cafeteria 722210 10916 10916 18428936 15108 15108 0 0 7140 6814 326 326 326 140283 136841 3442 3442 3442 6911 23829 6911 0 0 0 Recovery of Abandoned Pro 900099 215 215 Meaningful Use Incentive 621990 172002 172002 172217 18897329 18590022 30007 0 500 500 0 0 957489 619140 338349 0 6856395 6558567 297828 384394 360341 24053 1140133 1103368 36765 506661 474957 31704 0 10688 10688 2714 2714 0 0 0 1570239 740414 822831 6994 79999 236 3751 76012 483587 388600 88739 6248 123836 79561 44275 0 244316 175908 68408 82960 57349 25611 0 28109 17450 10659 14332 14332 0 515556 381596 133960 53756 42625 11131 Bad Debt Expense 488729 488729 Charity Care 524468 524468 Medical Supplies Expenses 699106 699106 Contractual Allowances 2942160 2942160 555205 487453 57770 9982 18265332 16156860 2009236 99236 784 776 1137382 484602 0 3538159 2965099 0 0 0 236304 272783 216363 232365 10006285 6267595 3636658 3738690 0 0 0 0 1960239 3211292 10725889 10905607 4768633 4491196 339593 308289 1540940 1342651 6649166 6142136 X 3236119 4056966 487252 346652 353352 359853 4076723 4763471 10725889 10905607 X 631997 19727 35024 X false true X true false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false false false true 4027 4027 false false Part II-B, Line 1i Part II-B, Line 1i - Other Activities Description Non-deductible portion of dues. 866148 9001 20820 855 3482 891632 823036 10000 37367 832 3423 866148 516370 296827 13517 324 3354 823036 491863 27707 3200 516370 460745 5000 29108 2990 491863 0.59000 0.41000 false true true 160146 160146 4149308 2627115 1522193 5327184 3640480 1686704 369647 369647 3738690 Temporarily Donor Restricted Funds 346652 Self-Insurance Funds Held by Trustee 12337 Permanently Donor Restricted Funds 359853 Estimated Prof. Liab. Claims Receivable 42768 Due from Restricted Funds 233856 Board Designated Investments 2215826 3211292 Reserve for Prof. Liab. Self Ins. 42768 Capital Lease Obligation 35266 Accrual for Post Retirement Benefit 1264617 1342651 X Part X Part X : FIN48 Footnote EMHS, its hospitals, and certain other affiliates have been determined by the Internal Revenue Service to be tax-exempt charitable organizations as described in Section 501(c)(3) or 501(c)(2) of the Internal Revenue Code ("Code") and, accordingly, are exempt from federal income taxes on related income pursuant to Section 501(a) of the Code. Accordingly, no provision for federal income taxes has been recorded in the accompanying consolidated financial statements for these organizations.Tax-exempt charitable organizations could be required to record an obligation for income taxes as the result of a tax position they have historically taken on various tax exposure items including unrelated business income or tax status. Under guidance issued by the Financial Accounting Standards Board (FASB), assets and liabilities are established for uncertain tax positions taken or positions expected to be taken in income tax returns when such positions are judged to not meet the "more-likely-than-not" threshold, based upon the technical merits of the position. Estimated interest and penalties, if applicable, related to uncertain tax positions are included as a component of income tax expense. The System has evaluated its tax position taken or expected to be taken on income tax returns and concluded the impact to be not material.Certain of the System's affiliates are taxable entities. Deferred taxes related to these entities are based on the difference between the financial statement and tax basis of assets and liabilities using enacted tax rates in effect in the years the differences are expected to reverse. The deferred tax assets and liabilities for these entities are not material. Part V, Line 4 Part V, Line 4: Intended uses of the endowment fund. Endowment Funds are designated for purposes that align within this organization's exempt purpose. false Golf Tournament 11030 9250 1780 1000 780 Bike 'n Boat 10625 5604 5021 5021 1 9085 8975 110 110 30740 23829 6911 1000 5911 6911 true true true X true X true true true false true true 185 377999 1500 376499 0.02630 4487 1964804 1648441 316363 0.02210 113164 113164 0.00790 4672 2455967 1649941 806026 0.05630 4 63 117208 117208 0.00820 4 63 117208 117208 0.00820 4 4735 2573175 1649941 923234 0.06450 true 366205 7101966 7211292 -109326 X true true 1 1 CA Dean Memorial Hospital

364 Pritham Ave PO Box 1129 Greenville ME 04441

X X X X true X X X X X X X X X 11 true true true X X X X X X X true false false true true 200.0000 true 300.0000 false X true true X X true false true X false false 3 Northwoods Healthcare

22 Haley Court Rd Sangerville ME 04479

Outpatient clinic Northwoods Healthcare

7 Greenville Road Monson ME 04464

Outpatient clinic Northwoods Healthcare

364 Pritham Avenue Greenville ME 04441

Outpatient clinic Part V - Explanation of Number of Facility Type N/A Part VI - States Where Community Benefit Report Filed ME Part VI - Affilated Health Care System Roles and Promotion CA Dean is a member of EMHS. EMHS serves the northern two-thirds (most rural areas) of Maine. Together, EMHS member organizations identify and meet the health priorities of the state. By working together, our members are able to share resources and information, as well as control costs and better serve our Maine communities. EMHS is addressing the changes and mandates of the new health care reform. Focus groups consisting of staff from each member organization have been formed and are actively collecting data and striving to meet or define best practices as we implement these mandated changes. The roll out and use of electronic medical records across our system is one of these initiatives that is being developed and will enhance the efficiencies of each individual member organization. We have initiated plans for an ACO medical home model and have been certified as a patient centered medical home model level 3. Part VI - Explanation Of How Organization Furthers Its Exempt Purpose We have an Elderwell program that allows the elderly in our community to use our exercise equipment (at a very minimal fee) to promote physical activity in this population. Our 'loan closet' program provides medical equipment supplies for our community at no cost. We author educational healthcare articles for publication in our local newspapers. We offer the use of our buildings, tele-med and office equipment to civic and community groups for meetings and publications. We developed 'walk-in clinic hours' to create greater access to healthcare for our patients. Participate in a bone builders program. Support Community health initiatives around diet and exercise both at the adult and the school level age. CA Dean sponsors several healhy lifestyle events annually such as a triathalon and Bike and Boat. CA Dean serves an elderly population with a high chronic disease burden. Lack of adequate transportation has been attributed to the inability of some patients to access health care. CA Dean implemented a free transportation program for the eligible population (no other means of transportation). This program provides limited transportation to and from medical appointments and procedures at no cost for this eleigble. Part VI - Community Building Activities In keeping with our mission statement, CA Dean actively participates by fulfilling the needs of our civic, community and faith based organizations. We offer flu clinics and blood pressure clinics just to name a few. CA Dean works in collaboration with the school on a number of projects including; nutritious food 'back pack program', activities that promote health and wellness, and general health education. CA Dean sponsors a number of healthy lifestyle activities such as a an annual triathalon and Bike and Boat. Part VI - Community Information Located in Greenville, CA Dean is the only healthcare provider within a 35 mile radius serving the Moosehead Lake region of Maine. This area has a HPSA rating and is one of the poorest counties in the state. We have a heavy Medicare/MaineCare population. We also are the eldest populated County in Maine. Piscataquis has a population rate of 16.4%/1000 of residents 65 and older. State average is 12.4%/1000. Part VI - Patient Education of Eligibility for Assistance CA Dean offers free care and sliding scale assistance programs. We have posters and pamphlets at all patient intake areas. Patient bills and our web site also list information on the availability of these programs and the application process. C A Dean has put forth a designated position financial councilor within the organization to assist with these programs Part VI - Needs Assessment In the past, CA Dean participated in the regional comprehensive health care needs assessment with the help of One Maine Health Collaboration. In 2011, One Maine Health will conduct the first state-wide health assessment in Maine. Focus groups have been organized to review the report findings. The work groups have carried forth work on ACOs, obesity and substance abuse. Also working with the local school on dietary, exercise and health awareness issues. Also collaborating with Mayo Regional Hospital, Piscataquis County Health District, town officials, civic groups and school leadership to follow through on these needs. Number of Hospital Faciltiy - 1 Part V, Line 20d - Other Billing Determination of Individuals Without Insurance Hospital charges are discounted at 100% for patients who qualify for free care with income at or below 200% FPL. The hospital also offers a partial discount for patients who fall within the 201% to 300% FPL. Number of Hospital Faciltiy - 1 Part V, Line 14g - Other Means Hospital Facility Publicized the Policy Posted signs and individual notices containing information on the availability of free care are located in key public areas in the hospital. Signs and notices inform the patient of the availability of free care and include eligibility criteria, instructions on how to applyand how to obtain additional information or assistance.The "Billing Help" section of the hospital web pages provides a link to the free care application form, instructions and eligibility criteria. Number of Hospital Faciltiy - 1 Part V, Line 6i - Describe Other Needs Identified 6aAs part of CA Deans strategic operations plan, several major initiatives have been adopted by the board of directors and CA Deans leadership team and are in active development. Efforts include; working with the school to promote healthy lifestyles, working with the community and law enforcement to reduce substance abuse, developing a transportation service, and participation in multiple local, county, and state initiatives to identify and address public health concerns.6b CA Dean and its local health partners are actively involved in implementation of strategic elements to address public health needs.6g Breakout #1 Access, Quality and Effectiveness. CA Dean Breakout #2 Chronic Disease - CA Dean is involved in the Maine Quality Counts effort which is funded through the Robert Wood Johnson Foundation and is a participant of the Quality Improvement Roundtable. Clinicians, Primary Care Teams, public health-practitioners, social workers, and hospital leadership have gathered to discuss emerging models of patient-centered healthcare and how to prepare for changes in healthcare delivery in our county. Breakout #3 Mental Health and Substance Abuse. Rx drug abuse is identified as a major public health issue in the CHNA. CA Dean is working with the Penquis District Coordinating Council and the Piscataquis Public Health Council to develop and implement solutions. Solutions include provider education, public education, effective law enforcement programs, and other methods to reduce the Rx drug abuse in the region. CA Dean has worked with local, county, and federal law enforcement officials to offer Rx drug take back programs which have been largely successful. Recently, CA Dean purchased a Rx Drug Collection center for local law enforcement so that the community can safely dispose of unused or older Rx medications.Breakout #4 Prevention, Obesity: CA Dean has partnered with local school district to address childhood obesity and unhealthy lifestyles. Obesity and its related illnesses has been identified as a major public health concern in the CHNA as well as nationally. A team including a provider, nurse, educators, and other professionals from the school and hospital are collaborating on a number of efforts to promote health lifestyles. Response is favorable. Number of Hospital Faciltiy - 1 Part V, Line 5c - Description of Making Needs Assessment Widely Available In conjunction with EMHS, C. A. Dean Memorial Hospital hosted a community forum to present an overview of local assessment results and recommendations. Invitees included: Other area hospitals, Physician leaders, Federally Qualified Health Centers, Healthy Maine Partnerships, District Liaisons linked to Maine CDC, Home Health and Long Term Care leaders, Social Service Agencies, Leaders of the tribal communities, Business leaders, Legislative leaders, Representatives of the State administrationAttendees were provided an executive summary of the assessment as well as a summary table of data reflective of the service area. A presentation was made by EMHS staff who were members of the assessment development steering committee providing selected data results, trends over time and the priorities and recommendations as suggested by the research consultants.In addition to the community forums, the entire statewide assessment (both narrative and data sets) were posted to the EMHS website. After the forums, Power Point presentations used at the Forum as well as input collected in the breakout sessions were also posted on the website. Forum participants were encouraged to go to the website to review the assessment in detail, and access the data for local planning. Media releases were also sent to local news outlets in combination with the forums, encouraging new articles on the forum and inviting all members of the public to view the report on the website.Instructions on the website assist viewers to download and /or print sections of the report. Individuals without computer or printer access were provided a phone number where they can request a printed assessment. Number of Hospital Faciltiy - 1 Part V, Line 4 - List Other Hospital Facilities that Jointly Conducted Needs Assessment The needs assessment was developed as a statewide collaborative between the states three largest health systems: EMHS (in central, eastern and northern Maine), MaineGeneral (in central Maine) and MaineHealth (in southern Maine). Multiple collaborators were involved in the dissemination of the assessment findings and establishment of priorities (see Section 5). Number of Hospital Faciltiy - 1 Part V, Line 3 - Account Input from Person Who Represent the Community On a statewide basis, the research consultants developed an advisory committee that met two times during the assessment research and drafting of the publication. These individuals represented a broad spectrum of backgrounds, and they are named: Carol Bell, Healthy Maine Partnership Director; Kelly Bentley, Healthy Maine Partnership Director; Gail Dana-Sacco, Wabanaki Center (serving tribal populations); Patricia Hart, Maine Development Foundation; Barbara Leonard, MPH, Maine Health Access Foundation (philanthropic foundation focused on access to care in Maine); Becca Matusovich, Maine Center for Disease Control; Lisa Miller, Bingham Foundation (philanthropic foundation); Dora Ann Mills, MD, Maine Center for Disease Control; Elizabeth Mitchell, Maine Health Management Coalition (representing the states major employers, insurers and providers); Trish Riley, Governors Office of Health Policy and Finance (GOHPF); Brian Rines, Advisory Committee for Health System Development (overseen by GOHPF); Rachel Talbot-Ross, Maine Chapter, NAACP; Ted Trainer, Public Health Coordinating Council Shawn Yardley, City of Bangor, Department of Health and Welfare. Number of Hospital Faciltiy - 1 Part V, Line 1j - Description of Other Needs Assessment 1a CA Dean is a rural critical access hospital with health clinics in Greenville, Monson, and Sangerville. CA Dean Hospital primarily serves those communities north Monson, Maine; Greenville, east to Lily Bay and Beaver Cove, and west towards Rockwood. CA Dean also serves the unorganized territories in this region and has patients from as far North as Jackman on the Canadian Border and as far south and east as Sangerville and Dexter. The majority of CA Dean patients are from Piscataquis County but we also see patients from Somerset and Penobscot Counties. The primary service area maintains a population of less than 2,500 and covers an area larger than 1,000 square miles. Population varies depending on season due to the regions status as a vacation destination and may swell to six times its normal volume in peak season. The 24-7 ER and acute care units serve the local population and the needs of travelers and second home owners. The clinics are a vital role in the delivery of health care and disease prevention and control for the region. Diagnostic and therapeutic services support the clinics, ER, and inpatient units. Primary industries are tourism in logging- with employees and their families healthcare needs being supported by CA Dean. Population is aged with15% of residents being 65 years or elder. The population has a high chronic disease burden with a high population of residents having 3 or more chronic conditions.1b C. A. Dean Memorial Hospital and its related physician practices utilize extensive electronic medical records, including disease registries, which provide a vast amount of data relative to patients in care. The needs assessment provides a much broader picture of the community as a whole, including the health status of individuals not in care, as well as functional health status and social-demographics (such as employment, income and education levels). The local units of the states public health infrastructure (known as Healthy Maine Partnerships) are also integrated into the process so that their data relative to health, environmental and social measures are part of the community dissemination process. CA Dean is HiMSS Meaningful Use Stage 6 certified and is actively applying for level 7.1c C. A. Dean Memorial Hospital engaged multiple health resource leaders in the community forum invitation list (as described in Section 1g). Additional resources and leaders needed were identified in the breakout sessions (see question for breakout participants, Section 1g). CA Dean Hospital, Mayo Regional Hospital, Penquis District Coordinating Council, Piscataquis Public Health Council, Healthy Maine Partnerships, and other agencies are available and work actively at meeting the public health needs of the community.1d-1e-1f EMHS, the parent company of C. A. Dean Memorial Hospital, routinely conducts a community health needs assessment (Hereafter needs assessment) across the service area of all of its member hospitals. The most recent assessment, published in 2011, was conducted under a contract with the University of New England Center for Health Planning, Policy and Research (CHPPR) and the University of Southern Maines Muskie School for Public Health. Using a methodology developed by CHPPR over decades of work, the assessment integrates primary data from a telephone survey to heads of households with secondary data retrieved from state databases (ED usage, Mortality, Cancer Registry, etc.). That data is reviewed in the context of multiple health related domains to develop a composite view of health status, behavioral risks, and barriers to access and care. Results are compared to national and state benchmarks to produce priorities and recommendations as prepared by the consultants.Members of the CA Dean staff serve active roles on several public health initiative groups including the Piscatiquis Public Health Council and the recently developed TiP (Thriving in Place) Steering Committee. CA Dean has actively partnered with a non-profit organization that provides social and mental health services (Charlotte White Center) that serves the need of our extended community. Through this partnership, CA Dean was able to add 1.0FTE of social/mental health services to the Greenville area to increase access to local residents.1g See question #31h On a statewide basis, the research consultants developed an advisory committee that met two times during the assessment research and drafting of the publication. These individuals represented a broad spectrum of backgrounds, and they are named: Carol Bell, Healthy Maine Partnership Director; Kelly Bentley, Healthy Maine Partnership Director; Gail Dana-Sacco, Wabanaki Center (serving tribal populations); Patricia Hart, Maine Development Foundation; Barbara Leonard, MPH, Maine Health Access Foundation (philanthropic foundation focused on access to care in Maine); Becca Matusovich, Maine Center for Disease Control; Lisa Miller, Bingham Foundation (philanthropic foundation); Dora Ann Mills, MD, Maine Center for Disease Control; Elizabeth Mitchell, Maine Health Management Coalition (representing the states major employers, insurers and providers); Trish Riley, Governors Office of Health Policy and Finance (GOHPF); Brian Rines, Advisory Committee for Health System Development (overseen by GOHPF); Rachel Talbot-Ross, Maine Chapter, NAACP; Ted Trainer, Public Health Coordinating Council Shawn Yardley, City of Bangor, Department of Health and Welfare. In the local area served by the assessment, multiple parties were engaged in dissemination of the assessment findings and establishment of priorities (see Section 5).1j In the past, CA Dean participated in the regional comprehensive health care needs assessment with the help of One Maine Health Collaboration. In 2011, One Maine Health will conduct the first state-wide health assessment in Maine. Focus groups have been organized to review the report findings. The work groups have carried forth work on ACOs, obesity and substance abuse. Also working with the local school on dietary, exercise and health awareness issues. Also collaborating with Mayo Regional Hospital, Piscataquis County Health District, town officials, civic groups and school leadership to follow through on these needs. Part III, Line 9b - Provisions On Collection Practices For Qualified Patients All account guarantors who express an inability to pay inpatient and outpatient services are screened for eligibility for charity care using an application and guidelines established by CA Dean. An account may be reconsidered for charity care at any time when new information is available about a patient's ability to pay. Part III, Line 8 - Explanation Of Shortfall As Community Benefit Medicare losses should be treated as a community benefit because the losses are incurred in performing an important public service, and Maine hospitals experience one of the lowest Medicare reimbursement rates in the country. Part III, Line 4 - Bad Debt Expense Patient and trade accounts receivable are stated at the amount management expects to collect from outstanding balances. Management provides for probable uncollectible amounts through a charge to earnings and a valuation allowance based on its assessment of the current status of individual accounts. Balances that are still outstanding after management has used reasonable collection efforts are written off through a charge to the valuation allowance and the applicable patient accounts receivable. Credit is extended without collateral. The costing methodology used to determine the amount reported on line 2 is cost to charge ratio. Part I, Line 7, Column F - Explanation of Bad Debt Expense $488,729 of bad debt expense, $524,468 of charity care and $2,942,160 of contractual allowances is included on Form 990, Part IX, line 25, column (A) Part I, Line 7 - Explanation of Costing Methodology Ratio of Patient Care Cost-to-Charges is used in calculations. Part I, Line 6a - Related Organization Community Benefit Report The Charles A Dean Memorial Hospital community benefit report is contained in an annual community benefit report prepared by Eastern Maine Healthcare Systems which is the parent organization of all related organizations. X true true X X X X X false true false false false false false false false false Paul Potvin 249885 100 1608 19600 33137 304330 Mary M Hood President CEO 691048 140786 12420 225828 22211 1092293 Mario Turi 239230 100 958 16930 2396 259614 Lawrence DuBien 218838 100 1942 15936 16930 253746 John L Toothaker 218838 100 1942 17495 16930 255305 Gregg Christensen 91455 43691 2266 8490 9216 155118 Eugene Murray Jr 146078 10000 18693 17412 29001 221184 Edward Olivier 143378 13311 1394 10644 9728 178455 David T Rideout 322234 100 1151 16054 25902 365441 Darin M Peck MD 254637 58637 1256 14352 24197 353079 Sch J, Part I, Line 1a Part I, Line 1a: Relevant information in regards to selections on 1a. Dennis Welsh, officer received a gift certificate for $50 with a $27.71 gross-up payment. David Rideout, highest compensated employee received a gift certificate for $25 with a $13.84 gross-up payment. Eugene Murray, Jr, officer/board member received a gift certificate for $150 with a $83.10 gross-up payment. Donna Welsh fam of offic 18523 compensation false Ann Murray fam of offic 15517 compensation false Linda D Gilbert VP at Bank VP=Treasurer/dir 308289 unsec note w/bank false Linda D. Gilbert, Charles A. Dean Board Treasurer is a Camden National Bank VP. Camden National Bank is Charles A. Dean's primary bank, holding deposits of $2,144,827 and a note for $308,289.Ann Murray is a family member of an officer and is an employee of Charles A. Dean.Donna Welsh is a family member of an officer and is an employee of Charles A. Dean. Form 990, Part XI, Line 9 Other Changes In Net Assets Or Fund Balances - Other Increases Post Retirement Health Benefit FAS158 = $132073 Form 990, Part XI, Line 9 Other Changes In Net Assets Or Fund Balances - Other Decreases Contribution To Strat Pool Per Affiliation Agreement = -$104340 Form 990, Part XI, Line 9 Other Changes In Net Assets Or Fund Balances - Other Increases Change in net assets held @ EMHS Foundation = $7291 Form 990, Part VI, Line 19 Form 990, Part VI, Line 19: Other Organization Documents Publicly Available The Charles A. Dean Memorial Hospital makes its governing documents, conflict of interest policy and financial statements available to the public upon request. Form 990, Part VI, Line 15a Form 990, Part VI, Line 15a: Compensation Review & Approval Process - CEO, Top Management The CEO of The Charles A. Dean Memorial Hospital (C.A. Dean), who is employed by C.A. Dean, reports directly to the system parent, Eastern Maine Healthcare Systems (EMHS) President/CEO (President) who serves on the board ex-officio. The EMHS Executive Performance Management Committee (the Committee) is responsible to monitor and evaluate the performance of the EMHS President, to set compensation of the EMHS President, and to review recommendations of the EMHS President with respect to compensation of the Chief Executive Officer of the direct subsidiaries, and other direct reports to the President. The Committee is comprised entirely of independent Directors per EMHS bylaws. Process:The Committee meets regularly throughout the fiscal year at the discretion of the Committee chair as well as on call of the Chair of the EMHS board. In carrying out its duties pursuant to the Bylaws, the Committee:-Assures that the executive compensation program is administered in a manner consistent with the EMHS executive compensation philosophy.-Reviews and updates the EMHS executive compensation philosophy which serves as the foundation on which all current and future executive compensation decisions are made.-Assures that value of compensation provided by EMHS does not exceed the value of services provided by the executive.-Reviews annual incentive compensation criteria for eligible executives, as defined by the EMHS President.-Reviews periodic compensation survey information and provides expert input to proposed changes to the executive compensation program.-Assures that a formal and timely performance management system is in place for executives.-Reviews incentive compensation criteria scoring and associated pay schedules for officers and key employees.-Provides any public statements regarding executive compensation practices at EMHS deemed appropriate.-Maintains minutes of the meetings and communicates actions to the EMHS Board of Directors.To accomplish this, the committee uses an external consultant with access to comparative data from independent sources and include national as well as regional data points. The EMHS President reviews all direct report compensation actions with the committee. In addition, the EMHS President ensures that any subsidiary policies and practices governing executive compensation are consistent with the committee's philosophy and practices statement.Form 990, Part VI, Line 15b - Compensation Review & Approval Process for Officers & Key EmployeesCompensation of other officers and key employees of the organization is established by the Human Resources department who utilize external market research to establish compensation ranges for specific positions. On an annual basis, the compensation ranges are compared to the updated survey information. The hiring manager will determine where the employee will fall within the ranges established by the Human Resources department based on experience and credentials. Form 990, Part VI, Line 12c Form 990, Part VI, Line 12c: Explanation of Monitoring and Enforcement of Conflicts The organization requests updates of potential conflicts and relationships from the officers and Board members on an annual basis. The request requires disclosure of all business relationships, board memberships, and family relationships. A database is maintained that is compared to payroll records and the accounts payable vendor list to identify any potential conflicts of interest. Transactions are reviewed for reasonableness as an arm's length transaction. The first agenda item for board meetings and board committee meetings is for members to declare any conflict of interest with upcoming agenda items or deliberations. At any point when consideration is being given to purchase/contract with a party in interest, the member with the conflict is either excused from the discussion and consideration process or abstains from voting on the matter. All transactions identified with parties in interest are disclosed within the Form 990. All are deemed to be arm's length transactions. Form 990, Part VI, Line 11b Form 990, Part VI, Line 11b: Form 990 Review Process Form 990 is reviewed by the CEO and CFO of CA Dean Memorial Hospital. It is provided to each board member either electronically or in hard copy with an opportunity to ask questions prior to filing with the IRS. Form 990, Part VI, Line 7b Form 990, Part VI, Line 7b: Describe Decisions of Governing Body Approval by Members or Shareholders EMHS has authority to appoint and remove the CEO of the Corporation. EMHS also has joint and superior authority to approve, disapprove or initiate action with respect to the following matters: I.amendments to the corporations Articles of Incorporation or Bylaws;II.changes in legal form of organization of the Corporation;III.election of the Directors/Trustees of the Corporation;IV.action concerning the Corporations operating budget and capital expenditures;V.the Corporations acquisition of assets or assumption of liabilities of an unaffiliated third party;VI.transfer of 5% or more of the assets of the Corporation;VII.financing transactions concerning the Corporation; VIII.merger, consolidation, sale, lease, mortgage, pledge or other disposition of all or substantially all assets of the Corporation; IX.add or revise a health care service of the Corporation;X.discontinue or close a health care service of the Corporation;XI.action concerning the Corporations role in the EMHS Strategic Plan;XII.action concerning the Corporations participation in key strategic affiliations with third parties not affiliated with EMHS; andXIII.dissolution of the Corporation. Form 990, Part VI, Line 7a Form 990, Part VI, Line 7a: How Members or Shareholders Elect Governing Body Each year at their annual meeting, the directors elect replacements for those directors whose terms are expiring Election of directors is subject to ratification by the EMHS Board of Directors. Form 990, Part VI, Line 6 Form 990, Part VI, Line 6: Explanation of Classes of Members or Shareholder The Charles A. Dean Memorial Hospital (the "Corporation") is a Maine nonprofit corporation. Eastern Maine Healthcare Systems ("EMHS"), also a Maine nonprofit corporation, is the sole corporate member of the Corporation. Form 990, Part VI, Line 4 Form 990, Part VI, Line 4: Description of Significant Changes to Organizational Documents In December 2012 Eastern Maine Healthcare Systems (EMHS), the parent of this corporation, and this corporation together with other direct subsidiaries of EMHS, modernized their governance structure by replacing a traditional reserved powers model for EMHS control over its subsidiaries with a joint initiatory powers model of control. Under the traditional reserved powers model, in addition to the EMHS CEO having exclusive authority to appoint and remove the CEO of the subsidiaries, EMHS exercised control exclusively through approval rights over important subsidiary action. The new joint initiatory powers model gives EMHS authority not only to approve or disapprove important subsidiary action, but also to actually initiate action on behalf of the subsidiaries with respect to the following matters: I.amendments to the corporations Articles of Incorporation or Bylaws;II.changes in legal form of organization of the Corporation;III.election of the Directors/Trustees of the Corporation;IV.action concerning the Corporations operating budget and capital expenditures;V.the Corporations acquisition of assets or assumption of liabilities of an unaffiliated third party;VI.transfer of 5% or more of the assets of the Corporation;VII.financing transactions concerning the Corporation; VIII.merger, consolidation, sale, lease, mortgage, pledge or other disposition of all or substantially all assets of the Corporation; IX.add or revise a health care service of the Corporation;X.discontinue or close a health care service of the Corporation;XI.action concerning the Corporations role in the EMHS Strategic Plan;XII.action concerning the Corporations participation in key strategic affiliations with third parties not affiliated with EMHS; andXIII.dissolution of the Corporation Form 990, Part III, Line 4d Form 990, Part III, Line 4d: Other Program Services Description OTHER PROGRAM SERVICES 4: Provided emergency, ambulance, inpatient acute care, outpatient surgery, specialty physician clinics and nursing home services to patients regardless of ability to pay. The Charles A. Dean Memorial Hospital is a 25 bed Critical Access Hospital in rural northwestern Maine providing emergency, ambulance, inpatient acute care, outpatient surgery, specialty physician clinics and nursing home services to patients regardless of ability to pay.Additional Statistics:Northwoods Healthcare Clinic visits 10,333Hospital diagnostic and rehabilitation visits 15,453Emergency room visits 2,481 Hospital admissions 365Surgery cases 319Ambulance runs 451 OTHER PROGRAM SERVICES 5: Please see the following excerpt from the EMHS Annual Report to the Community for details of community benefit projects by C.A. Dean.Charles A. Dean Memorial HospitalLeadership: Geno Murray, President and CEO; David S. Richards, Board Chair Description: CA Dean is a 25-bed critical access hospital nestled near the shores of Moosehead Lake. Northwoods Healthcare is a division of CA Dean providing family practice and specialty services at clinics in Greenville, Monson, and Sangerville.Employees: 167Location: Greenville, Monson, SangervilleCharles A. Dean Memorial Hospital Highlights-Named a Top 100 Critical Access Hospital in the country by iVantage Health Analytics.-Recognized nationally by the Leapfrog Group as a Top Rural Hospital. -Renovated the Monson Clinic after it was damaged by a neighboring structure fire and dedicated it to an honorary board member, Wayne Huff.-Purchased a state-of-the-art digital mammography machine and bone densitometer and opened the Lyn Cima Imaging Center.-Welcomed four new family practice providers: Dana Green, PA -C; Karen Leggett, DO; Kathleen Thibault, DO, and Elisa Thompson, MD. -Launched the Northwoods Kids Program, to provide healthcare-related events and games for kids each month. TOTAL COMMUNITY BENEFIT: $1,032,560Community Health Improvement Services: $17,507Community Benefit Operations: $99,701Unrecoverable Interest Cost on funds used to subsidize state MaineCare/Medicaid underpayments of $1.3M $113,164Traditional Charity Care: $376,499Unpaid Cost of Public Programs:Medicaid: $316,363Medicare: $109,326Philanthropy: $483 Restoration Health LLC 43 Whiting Hill Road Brewer ME 04412 352449986 Provide mental & behavioral hlth srvcs ME 501(c)(3) 9 Acadia Healthcare Inc true Sebasticook Valley Work Health LLC 447 North Main Street Pittsfield ME 04967 453359446 Provide patient care ME 501(c)(3) 3 SVH true Sebasticook Valley Family Practice Assoc 447 North Main Street Pittsfield ME 04967 010357854 Provide patient care ME 501(c)(3) 9 SVH true Meadow Wood LLC 43 Whiting Hill Road Brewer ME 04412 272935243 Provide patient care ME 501(c)(3) 9 AHI true Blue Hill Memorial Hospital 57 Water Street Blue Hill ME 046145231 010227195 Provide healthcare services ME 501(c)(3) 3 Eastern Maine Healthcare Systems true Maine Inst for Human Genetics and Health 43 Whiting Hill Road Brewer ME 04412 550894346 Biomedical research and development ME 501(c)(3) 9 Eastern Maine Healthcare Systems true Eastern Maine HomeCare PO Box 688 Caribou ME 04736 010328442 Provide home health and hospice services ME 501(c)(3) 9 Eastern Maine Healthcare Systems true Horizons Health Services PO Box 151 140 Academy Street Presque Isle ME 047690151 010504393 Provide patient care ME 501(c)(3) 3 The Aroostook Medical Center true TAMC Endowments PO Box 151 140 Academy Steet Presque Isle ME 047690151 010389222 Raise funds for exempt organizations ME 501(c)(3) 11, Type I The Aroostook Medical Center true TAMC Title Corp PO Box 151 140 Academy Street Presque Isle ME 047690151 010389226 Real estate holding company ME 501(c)(2) The Aroostook Medical Center true The Aroostook Medical Center TAMC PO Box 151 140 Academy Street Presque Isle ME 047690151 010372148 Provide healthcare services ME 501(c)(3) 3 Eastern Maine Healthcare Systems true Sebasticook Valley Health SVH 447 North Main Street Pittsfield ME 04967 010263628 Critical care hospital ME 501(c)(3) 3 Eastern Maine Healthcare Systems true Lakewood A Continuing Care Center 220 Kennedy Memorial Drive Waterville ME 04901 010421234 Provide skilled and long-term nursing care ME 501(c)(3) 3 Inland Hospital true Inland Hospital 200 Kennedy Memorial Drive Waterville ME 04901 010217211 Provide healthcare services ME 501(c)(3) 3 Eastern Maine Healthcare Systems true Norumbega Medical Specialists LTD 43 Whiting Hill Road Ste 400 Brewer ME 04412 010465231 Provide patient care and education ME 501(c)(3) 9 Eastern Maine Medical Center true EMHS Foundation 43 Whiting Hill Road Ste 400 Brewer ME 04412 222514163 Raise and manage funds for exempt organizations ME 501(c)(3) 11, Type II Eastern Maine Healthcare Systems true Acadia Healthcare Inc AHI 43 Whiting Hill Road Brewer ME 04412 223183888 Provide healthcare services ME 501(c)(3) 9 Acadia Hospital Corp true Eastern Maine Medical Center Auxiliary 43 Whiting Hill Road Brewer ME 04412 010377901 Fund raising for exempt Eastern Maine Medical Center ME 501(c)(3) 9 Eastern Maine Medical Center true Acadia Hospital Corp AHC 43 Whiting Hill Road Brewer ME 04412 010459837 Provide healthcare services ME 501(c)(3) 3 Eastern Maine Healthcare Systems true Rosscare Nursing Homes Inc 43 Whiting Hill Road Ste 400 Brewer ME 04412 010430751 Operation of nursing homes ME 501(c)(3) 9 Rosscare true Rosscare 43 Whiting Hill Road Ste 400 Brewer ME 04412 010391038 Provide services to elderly ME 501(c)(3) PF Eastern Maine Healthcare Systems true Eastern Maine Healthcare Real Estate 43 Whiting Hill Road Brewer ME 04412 010391036 Leases real estate ME 501(c)(2) Eastern Maine Healthcare Systems true Eastern Maine Medical Center EMMC PO Box 404 489 State Street Bangor ME 044020404 010211501 Provide healthcare services ME 501(c)(3) 3 Eastern Maine Healthcare Systems true Eastern Maine Healthcare Systems EMHS 43 Whiting Hill Road Brewer ME 04412 010527066 Supporting organization for healthcare affiliates ME 501(c)(3) 11 Type III Func Int N/A true Beacon Health LLC 43 Whiting Hill Road Brewer ME 04412 452967056 Accountable care organization ME EMHS false false Alliance Health Documentation LLC 9 Central Street Ste 205 Bangor ME 04401 462751855 Transcription ME AHS C true M Drug LLC PO Box 1779 Bangor ME 044021779 272175482 Pharmacy ME AHS C true Dirigo Pines Development Company LLC 9 Alumni Drive Orono ME 04473 010537924 RetirCottag ME AHS C true Dirigo Funding LLC 9 Alumni Drive Orono ME 04473 010599968 Prov Finance ME AHS C true Dirigo Pines Inn LLC 9 Alumni Drive Orono ME 04473 020547749 Contin Care ME Rosscare C true Dirigo Pines Retirement Community LLC 9 Alumni Drive Orono ME 04473 010537924 Holding Co. ME AHS C true Maine Network for Health PO Box 2813 Bangor ME 044022813 010496352 Support srv ME EMHS C true Meridian Mobile Health LLC 931 Union Street PO Box 940 Bangor ME 044020940 010512673 Ambulance ME AHS C true DE Collections DBA ACI PO Box 2759 Bangor ME 044022759 010366209 Collections ME AHS C true Affiliated Pharmacy Services 917 Union St Suite 7 Bangor ME 04401 010587230 Pharmacy ME AHS C true Affiliated Materiel Services PO Box 1300 Bangor ME 044021300 010381189 Purchasing ME AHS C true Affiliated Laboratory Inc PO Box 638 Bangor ME 044020638 010381283 Clinicl lab ME AHS C true Affiliated Healthcare Management PO Box 811 Bangor ME 044020811 010349339 Hlthcr mgmnt ME AHS C true Affiliated Healthcare Systems AHS PO Box 940 Bangor ME 044020940 010385322 Holding Co. ME EMHS C true false false false false false false false false false false false false true false false true false true true Affiliated Materiel Services p 153171 FMV Affiliated Laboratory Inc m 111055 FMV EMHS Foundation m 99000 FMV Eastern Maine Medical Center EMMC m 157984 FMV Eastern Maine Healthcare Systems EMHS r 104339 FMV Eastern Maine Healthcare Systems EMHS p 1383535 FMV Eastern Maine Healthcare Systems EMHS m 707351 FMV