2014-03-14T10:45:36-07:00 2013-04-30 990 2012-05-01 010211797 MOUNT DESERT ISLAND HOSPITAL MOUN 2072885081 PO Box 8 10 Wayman Lane Bar Harbor ME 046090008 Christina Harding 2072885082 2014-03-14 2012 2015-11-30 17:44:51Z Arthur Blank 10 Wayman Lane PO Box 8 Bar Harbor ME 046090008 52533093 0 X www.mdihospital.org X 1897 ME Mount Desert Island Hospital's mission is to provide compassionate care and strengthen the health of our community by embracing tomorrow's methods and respecting time-honored values. 18 14 516 244 0 0 2017517 2254053 50482649 47520943 591026 424924 926297 2333173 54017489 52533093 0 0 0 0 32391277 32850936 0 0 138705 22644074 22267919 55035351 55118855 -1017862 -2585762 52560561 52443534 31815380 31102021 20745181 21341513 Mount Desert Island Hospital's mission is to provide compassionate care and strengthen the health of our community by embracing tomorrow's methods and respecting time-honored values. 0 0 42455732 49821716 Patient Care: Mount Desert Island hospital's mission statement is described in Part II, Line 1 above. In Fiscal year 2013, MDI Hospital provided $4,534,153 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 $1,351,201. The Hospital provides a number of health services and preventative halth 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. Thoughout the years, staff from the hospital make presentations to area school children regarding smoking cessation and health nutrition. Additionally, community groups such as Alcoholics Anonymous use the hospital's 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 42455732 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 63 0 1 516 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 10 Wayman Lane Bar Harbor ME 046090008 Arthur J Blank 40 0 X X X 298491 0 33957 John Adams MD 1 0 X 0 0 0 John Benson MD 1 0 X 0 0 0 Michael Bonsey 5 0 X X 0 0 0 Stewart Brecher 1 0 X 0 0 0 David Einhorn Esq 1 0 X 0 0 0 Kathleen Field 1 0 X 0 0 0 Julius Krevans MD 1 0 X 0 0 0 Julian Kuffler MD 40 0 X 222601 0 23623 Dean Read 1 0 X 0 0 0 Mickey Shattow 1 0 X 0 0 0 Patricia Hand PhD 1 0 X 0 0 0 Elsie Flemings 1 0 X 0 0 0 Noelle Wolf 1 0 X 0 0 0 Vince Messer 3 0 X X 0 0 0 James Bright 1 0 X 0 0 0 Christina M Harding 40 0 X X X 142721 0 16738 Terry Musson 1 0 X 0 0 0 Mark Kandutsch 40 0 X 218708 0 23717 Stuart Davidson 40 0 X 477638 0 35566 Michael Heniser 40 0 X 342967 0 9551 Ronald Prokopius 40 0 X 260718 0 22963 Edward Gilmore 40 0 X 223967 0 37971 2187811 0 204086 32 0 1 0 Bay View Physical Therapy 125 Oak Street Ellsworth ME 04605 Physical Therapy 611773 NEHE MRI LLC PO Box 415220 Boston MA 022415220 medical testing MRI 253480 J&D Imaging PO Box 213 Bar Harbor ME 04609 Imaging test reading 377932 Rao Surapememi P Ramanadha MD 50 358 Broad st suite 207 Bangor ME 04401 Urologist 399000 Dahl Chase Diagnostic Services 417 State Street Suite 441 Bangor ME 04401 pathology services 263746 6 0 0 0 0 129414 2124639 655264 2254053 Other Patient Service Revenue 900099 24220629 24220629 0 0 Medicare/Medicaid payments 900099 23300314 23300314 0 0 0 0 0 0 47520943 191322 0 0 191322 0 0 0 0 0 0 0 0 32400 0 0 0 32400 0 32400 0 0 32400 233602 0 0 0 233602 0 233602 0 0 233602 0 Cafeteria sales 900099 195202 195202 0 0 Miscellaneous Income - Eden 900099 69550 69550 0 0 Misc income - HC Admin 900099 180282 180282 0 0 1855739 1855739 0 0 2300773 52533093 49821716 0 457324 X 0 0 0 0 0 0 0 0 884991 0 884991 0 0 0 0 0 23532877 17938977 5509807 84093 818952 600931 215191 2830 6027412 4428451 1578632 20329 1586704 1165698 415542 5464 0 0 0 0 69085 0 69085 0 98361 0 98361 0 0 0 0 0 0 0 -42280 0 -42280 0 0 0 0 0 68166 0 68166 0 4481100 4385930 95170 0 0 0 0 0 0 0 0 0 727366 555066 172300 0 83485 73222 10263 0 0 0 0 0 264166 124756 139410 0 644021 534179 109842 0 0 0 0 0 1970300 1557452 412848 0 878273 781023 97250 0 Purchased services 6264868 4656416 1608452 0 Bad debt expense and space rentals 4803598 3721221 1056388 25989 Physician fees 1194729 1169729 25000 0 Tax & Match 762681 762681 0 0 0 0 0 0 55118855 42455732 12524418 138705 0 0 45798 41553 2768971 2379184 5020765 6056753 0 0 0 0 0 0 533456 523227 172391 214932 46192585 23471902 23342117 22720683 12789380 13366094 0 0 0 0 0 0 7887683 7141108 52560561 52443534 13236501 12545489 0 0 38837 11693 4784067 4175016 0 0 0 0 9806150 9199906 0 0 3949825 5169917 31815380 31102021 X 13622451 14265803 5222565 5141021 1900165 1934689 20745181 21341513 52560561 52443534 X -2585762 400181 0 0 0 2781913 X 1 X 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 8060 8060 0 SchC_P2B_S00_L01 Schedule C, Part II-B, Line 1 this amount represents a portion of dues determined expended for specific lobbying purposes. These expenditures are defined as direct communications with certian members of federal, state or local government to influcence legislation. These dues support the organizations advocacy and representation in its broadest sense, activities that are well beyond the scope of defined lobbying activities. For the American Hospital Association, total dues are $16,820, of which 23.98% are lobbying expenses, or $4,033. For the Maine Hospital Association, total dues are $24,293, of which 15.5% are lobbying expenses or $3,644. Total lobbying expenses included in dues is $7,677. 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 5077190 -974551 0 150000 13757 3938882 0.9466 0.0534 0 1 0 0 3802848 3802848 0 24722070 11765343 12956727 0 235558 139834 95724 0 14709312 11332631 3376681 0 2722797 234094 2488703 22720683 0 F 0 F 0 Due from Affilliates 4801787 Deferred financing costs 76975 Estimated 3rd party payor settlements 2161435 Deposits 98000 Other 2911 7141108 0 Deferred Compensation 1732901 Estimated 3rd party payor settlements 3127209 Due to affilliate 309807 5169917 X 50458344 0 0 0 0 0 50458344 0 2074749 2074749 52533093 55022429 0 0 0 0 0 55022429 0 96426 96426 55118855 SchD_P05_S00_L04 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. SchD_P10_S00_L02 Schedule D, Part X, Line 2 The Hospital and BBRV are exempt from federal income taxes under Section 501(c)(3) of the Internal Revenue Code. MDMC is a for-profit entity and is, therefore, subject to income taxes. Income taxes are recorded based upon the asset and liability method as prescribed by Financial Accounting Standards Board (FASB) Accounting Standards Codification (ASC) 740, Income Taxes. At April 30, 2013 and 2012, MDMC has certain net operating loss carryforwards which have been reduced by a valuation allowance of an equal amount as it is not presently considered likely that the deferred tax assets will be realized. SchD_P11_S00_L04b Schedule D, Part XI, Line 4b Gifts and bequests, temporarily restricted contributions, changes in pledges receivable SchD_P12_S00_L04b Schedule D, Part XII, Line 4b Fundraising expenses, investment management fees 1 1 X 1 X 1 X 1 1 1 0 1 1 0 0 822772 0 822772 0.0148 0 0 5077961 4549532 528429 0.0096 0 0 0 0 0 0 0 5900733 4549532 1351201 0.0244 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11811862 7277709 4534153 0.0824 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11811862 7277709 4534153 0.0824 0 0 17712595 11827241 5885354 0.1068 1 3156954 2254733 14858106 19156438 -4298332 X 1 1 12 1 Mount Desert Island Hospital

10 Wayman Lane PO Box 8 Bar Harbor ME 046090008

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 Mount Desert Island Hospital 1 1 X X X X X X X X 11 1 0 1 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 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 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 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 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 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 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 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 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 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 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 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 SchH_P01_S00_L06a Schedule H, Part I, Line 6a The Hospital prepares a Community Benefit Report and does not use a related organization. SchH_P01_S00_L07 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. SchH_P01_S00_L072f 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 purposed of calculating the percentage in this column in $ 3,156,286 SchH_P01_S00_L07g 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. SchH_P03_S0A_L04 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 uncollectable 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. SchH_P03_S0B_L08 Schedule H, Part III, Section B, Line 8 The IRS 990H instructions/guidance provide a template (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 & 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. SchH_P03_S0C_L09b 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. SchH_P05_S0B_L03 Schedule H, Part V, Section B, Line 3 The Hospital Partnered with Health Acadia to perform an comprehensive community needs assessments, 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 501(c)(3) non-profit with more than 100 partners. They address critical locally defined health priorities across Hancock they serve as the Healthy Maine Partnership for Hancock County. SchH_P05_S0B_L05 Schedule H, Part V, Section B, Line 5 The Community Health Needs Assessment is available to our community members through our problic website and the ongoing implementation and work plan is documented by our Planning and Board committees. SchH_P06_S00_L02 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 Health 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 (MAPP) 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 Hospital's 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. 1.) How can we ensure that all community members have access to affordable high quality health care? 2.) How can we ensure that all community members have access to health affordable food? 3.) How can we increase physical activity and health transportation in our region? 4.) How can we reduce and prevent substance abuse in our community? 5.) How can we ensure that the children and youth in our region have the best opportunities to grow and thrive? 6.) How can we promote healthy aging for all members of our community? 7.) How do we build an environment that is healthy, free from toxins, and protected for current and future generations? 8.) How can we increase economic opportunities and decrease economic disparities in our region? 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 Hospital's 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. SchH_P06_S00_L03 Schedule H, Part VI, Line 3 Patient Education and Eligibility for Assistance- 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. In accordance with the American Hospital Association Recommendations, 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 -Offer financial support to patients with limited means -Implement policies and procedures for assisting low-income patients in a consistent manner -Implement fair and consistent billing and collection practices for all patients with patient payment obligations 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. MDIH offers financial support to patients with limited means. This 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. SchH_P06_S00_L04 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 The following demographics represent the counties served by Mount Desert Island Hospital: - Population: Hancock County 54,578; Washington County 32,637; State of Maine 1,329,000 - Persons < 5 yrs: Hancock County 4.5%; Washington County 5.0%; State of Maine 5.1% - Persons < 18 yrs: Hancock County 17.9%; Washington County 19.6%; State of Maine 20.3% - Persons 65 yrs & over: Hancock County 18.9%; Washington County 19.9%; State of Maine 16.3% - Median Household Income: Hancock County $47,421; Washington County $35,272; State of Maine $47,898 - Persons below poverty level: Hancock County 12.4%; Washington County 20.4%; State of Maine 12.1% SchH_P06_S00_L05 Schedule H, Part VI, Line 5 The Hospital provides assistance and sliding scale discounts to self pay and low income patients. Also the Hospital participates in government sponsored health care programs including Medicare, Medicaid, Champus and Tricare. The volunteer Board of Trustees sets the strategic direction for the Hospital and is comprised of community members from the Hospital's service area. This group is made up of local business owners, professionals and retirees. Mount Desert Island Hospital's 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 allows access to healthcare that would otherwise be difficult. The Hospital is the main employer for the local physicians, including specialty physicians that would otherwise have to be accessed out of the area. 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. X 1 1 X X X 0 0 0 0 0 0 0 1 0 Arthur J Blank 298055 0 0 0 0 0 17000 0 33957 0 349012 0 0 0 Julian Kuffler MD 222601 0 0 0 0 0 0 0 23623 0 246224 0 0 0 Michael Heniser 255397 0 87570 0 0 0 0 0 9551 0 352518 0 0 0 Ronald Prokopius 217592 0 43126 0 0 0 0 0 22963 0 283681 0 0 0 Stuart Davidson 477638 0 0 0 0 0 17000 0 35566 0 530204 0 0 0 Edward Gilmore 194781 0 29186 0 0 0 9800 0 37971 0 271738 0 0 0 Mark Kandutsch 208412 0 10296 0 0 0 0 0 23717 0 242425 0 0 0 Christina M Harding 142721 0 0 0 0 0 0 0 16738 0 159459 0 0 0 SchJ_P01_S00_L01a Schedule J, Part I, Line 1a The Hospital provides teh 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. SchJ_P01_S00_L07 Schedule J, Part I, Line 7 The Hospital provides a performance incentive system for Division Directors and Vice Presidents who are employees in good standing during the entire fiscal year. The program is based on the organization maintaining top 12 status in overall patient satisfaction, meeting its financial target, as well as individual financial performance and quality improvement objectives. Medical staff are provided with an RVU based incentive bonus, calculated on relative value units of patient encounters. A MHHEFA 92 Bond 1992-07-01 1300000 Contruction and renovation of hospital departments 0 0 0 B MHHEFA 2006F Bond 2005-07-03 707200 Replacement of central chiller 0 0 0 C MHHEFA 2007B Bond 2007-07-03 4427988 Clinic construction, office and clinic space 0 0 0 D MHEFFA 2010 Bond 2010-07-01 1200000 Refinancing of 98A Bond for renovation of outpatient service area 0 0 0 A 0 0 1300000 0 0 0 0 0 0 1300000 0 0 1993 0 0 1 1 B 0 0 707200 0 0 0 0 0 0 707200 0 0 2008 0 0 1 1 C 0 0 4427988 0 0 0 0 0 0 4427988 0 0 2009 0 0 1 1 D 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 D 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 D 0 0 0 0 0 0 0 0 1 J and D Imaging John Benson MD Board Member 355459 Equipment leasing and radiology services 0 SchL_P04_S00_L00 Schedule L, Part IV John Benson, MD is the proprietor 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 completes required disclosures. X 11 655264 Fair Market Value 0 1 1 SchM_P01_S00_L32b Schedule M, Part I, Line 32b The hopsital policy requires that stock donations are immediately sold by the Advisors Account to which they are received. F990_P06_S0B_L11b 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. F990_P06_S0B_L12c 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 turstees 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. F990_P06_S0B_L15 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 demographics 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 geogrphic similarities. F990_P06_S0C_L19 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, conflict of interest policy are available upon request, as are audited financial statements. F990_P09_S00_L24e Form 990, Part IX, Line 24e Purchased services, Bad debt expense, Physician fees, Tax & match, space rental. F990_P11_S00_L05 Form 990, Part XI, Line 5 This is made up of Gifts and bequests, interest income on investments, realized gain on sale of investements and other miscellaneous expense. F990_P11_S00_L09 Form 990, Part XI, Line 9 Change in value of beneficial interest in perpetual trusts of $34,524, Change n pledges receivable, net of $389,786, net assets released from restrictes $1,566,771, contributions 1,875,013, net assets released for purchase of property and quipment 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 12212 937995 1 0 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 233600 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 is maintained in order to provide this information.