TY 2023 Form 990

(A) Name and title	(B) Average hours per week (list any hours for related organizations below dotted line)	(C) Position (do not check more than one box, unless person is both an officer and a director/trustee)	(E) Reportable compensation from related organizations (W-2/1099-MISC/1099-NEC)
(1) Peter Witham MD...................................................................... Trustee/Physician	41.00 ................. 0.00	X		226,958	41,081
(2) Julian Kuffler MD...................................................................... Trustee/Physician	41.00 ................. 0.00	X		173,993	41,099
(3) Christina Maguire...................................................................... President & CEO	41.00 ................. 1.00	X	X	385,636	26,301
(4) Enoch Albert...................................................................... Trustee	1.00 ................. 1.00	X		0	0
(5) Edward Benz MD...................................................................... Trustee	1.00 ................. 0.00	X		0	0
(6) Stewart Brecher...................................................................... Trustee	1.00 ................. 0.00	X		0	0
(7) James R Bright...................................................................... Trustee (end 8/2023)	1.00 ................. 0.00	X		0	0
(8) Sarah Fina...................................................................... Trustee	1.00 ................. 0.00	X		0	0
(9) Elsie Flemings...................................................................... Trustee	1.00 ................. 0.00	X		0	0
(10) Kathryn Lucchesi PhD RPh...................................................................... Trustee	1.00 ................. 0.00	X		0	0
(11) Charles Manee Hutchins...................................................................... Trustee	1.00 ................. 0.00	X		0	0
(12) Arthur Martinez...................................................................... Trustee	1.00 ................. 0.00	X		0	0
(13) Vince Messer PhD...................................................................... Trustee	1.00 ................. 0.00	X		0	0
(14) Dean S Read...................................................................... Trustee	1.00 ................. 0.00	X		0	0
(15) Ed Samek...................................................................... Trustee	1.00 ................. 0.00	X		0	0
(16) Louise Soucy CPA...................................................................... Trustee	1.00 ................. 0.00	X		0	0
(17) Noelle Wolf...................................................................... Trustee	1.00 ................. 0.00	X		0	0

(A) Name and business address	(B) Description of services	(C) Compensation
Cardinal Health 7000 Cardinal Place Dublin,OH43017	Healthcare services	4,201,550
Cerner Corporation (aka Oracle) 2300 Oracle Way Austin,TX78741	Healthcare IT solutions	1,834,194
Medefis Inc 2121 North 117th Avenue Omaha,NE68164	Locums staffing	1,638,397
R1 RCM Inc 433 W Ascension Way Suite 200 Murray,UT84123	Management consulting	1,562,673
EL Shea Inc 23 Church Street Ellsworth,ME04605	Construction services	1,355,784
2 Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 of compensation from the organization 41

- TIN:

SCHEDULE A
(Form 990)

Department of the Treasury
Internal Revenue Service

Public Charity Status and Public Support

Complete if the organization is a section 501(c)(3) organization or a section 4947(a)(1) nonexempt charitable trust.
right arrow

Attach to Form 990 or Form 990-EZ.
right arrow

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2023

Open to Public
Inspection

Name of the organization

Mount Desert Island Hospital

Employer identification number

01-0211797

Part I

Reason for Public Charity Status (All organizations must complete this part.) See instructions.

The organization is not a private foundation because it is: (For lines 1 through 12, check only one box.)

A church, convention of churches, or association of churches described in section 170(b)(1)(A)(i).

A school described in section 170(b)(1)(A)(ii). (Attach Schedule E (Form 990).)

A hospital or a cooperative hospital service organization described in section 170(b)(1)(A)(iii).

A medical research organization operated in conjunction with a hospital described in section 170(b)(1)(A)(iii). Enter the hospital's name, city, and state:

An organization operated for the benefit of a college or university owned or operated by a governmental unit described in section 170(b)(1)(A)(iv). (Complete Part II.)

A federal, state, or local government or governmental unit described in section 170(b)(1)(A)(v).

An organization that normally receives a substantial part of its support from a governmental unit or from the general public described in section 170(b)(1)(A)(vi). (Complete Part II.)

A community trust described in section 170(b)(1)(A)(vi). (Complete Part II.)

An agricultural research organization described in 170(b)(1)(A)(ix) operated in conjunction with a land-grant college or university or a non-land grant college of agriculture. See instructions. Enter the name, city, and state of the college or university:

An organization that normally receives: (1) more than 33 1/3% of its support from contributions, membership fees, and gross receipts from activities related to its exempt functions—subject to certain exceptions, and (2) no more than 33 1/3% of its support from gross investment income and unrelated business taxable income (less section 511 tax) from businesses acquired by the organization after June 30, 1975. See section 509(a)(2). (Complete Part III.)

An organization organized and operated exclusively to test for public safety. See section 509(a)(4).

An organization organized and operated exclusively for the benefit of, to perform the functions of, or to carry out the purposes of one or more publicly supported organizations described in section 509(a)(1) or section 509(a)(2). See section 509(a)(3). Check the box on lines 12a through 12d that describes the type of supporting organization and complete lines 12e, 12f, and 12g.

Type I. A supporting organization operated, supervised, or controlled by its supported organization(s), typically by giving the supported organization(s) the power to regularly appoint or elect a majority of the directors or trustees of the supporting organization. You must complete Part IV, Sections A and B.

Type II. A supporting organization supervised or controlled in connection with its supported organization(s), by having control or management of the supporting organization vested in the same persons that control or manage the supported organization(s). You must complete Part IV, Sections A and C.

Type III functionally integrated. A supporting organization operated in connection with, and functionally integrated with, its supported organization(s) (see instructions). You must complete Part IV, Sections A, D, and E.

Type III non-functionally integrated. A supporting organization operated in connection with its supported organization(s) that is not functionally integrated. The organization generally must satisfy a distribution requirement and an attentiveness requirement (see instructions). You must complete Part IV, Sections A and D, and Part V.

Check this box if the organization received a written determination from the IRS that it is a Type I, Type II, Type III functionally integrated, or Type III non-functionally integrated supporting organization.

Enter the number of supported organizations ...............................

Provide the following information about the supported organization(s).

(i) Name of supported organization	(ii) EIN	(iv) Is the organization listed in your governing document?		(v) Amount of monetary support (see instructions)	(vi) Amount of other support (see instructions)
(i) Name of supported organization	(ii) EIN	Yes	No	(v) Amount of monetary support (see instructions)	(vi) Amount of other support (see instructions)


Total

For Paperwork Reduction Act Notice, see the Instructions for
Form 990 or 990-EZ.

Cat. No. 11285F

Schedule A (Form 990) 2023

Page 2

Part II

Support Schedule for Organizations Described in Sections 170(b)(1)(A)(iv) and 170(b)(1)(A)(vi)
(Complete only if you checked the box on line 5, 7, or 8 of Part I or if the organization failed to qualify under Part III. If the organization failed to qualify under the tests listed below, please complete Part III.)

Section A. Public Support

Calendar year (or fiscal year beginning in)		(a) 2019	(b) 2020	(c) 2021	(d) 2022	(e) 2023	(f) Total
1	Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grant.") ..
2	Tax revenues levied for the organization's benefit and either paid to or expended on its behalf ....
3	The value of services or facilities furnished by a governmental unit to the organization without charge..
4	Total. Add lines 1 through 3
5	The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included on line 1 that exceeds 2% of the amount shown on line 11, column (f) ..
6	Public support. Subtract line 5 from line 4.

Section B. Total Support

Calendar year (or fiscal year beginning in)		(a) 2019	(b) 2020	(c) 2021	(d) 2022	(e) 2023	(f) Total
7	Amounts from line 4..
8	Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources...
9	Net income from unrelated business activities, whether or not the business is regularly carried on..
10	Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.)..
11	Total support. Add lines 7 through 10

Gross receipts from related activities, etc. (see instructions) ..................

First 5 years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a section 501(c)(3) organization, check this box and stop here ........................................ right arrow

Section C. Computation of Public Support Percentage

Public support percentage for 2023 (line 6, column (f) divided by line 11, column (f)) .........

Public support percentage for 2022 Schedule A, Part II, line 14 ...............

16a

33 1/3% support test—2023. If the organization did not check the box on line 13, and line 14 is 33 1/3% or more, check this box
and stop here. The organization qualifies as a publicly supported organization ....................... right arrow

33 1/3% support test—2022. If the organization did not check a box on line 13 or 16a, and line 15 is 33 1/3% or more, check this
box and stop here. The organization qualifies as a publicly supported organization ..................... right arrow

17a

10%-facts-and-circumstances test—2023. If the organization did not check a box on line 13, 16a, or 16b, and line 14 is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here. Explain in Part VI how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly supported organization ............ right arrow

10%-facts-and-circumstances test—2022. If the organization did not check a box on line 13, 16a, 16b, or 17a, and line 15 is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here. Explain in Part VI how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly supported organization ............ right arrow

Private foundation. If the organization did not check a box on line 13, 16a, 16b, 17a, or 17b, check this box and see
instructions ..................................................... right arrow

Schedule A (Form 990) 2023

Page 3

Part III

Support Schedule for Organizations Described in Section 509(a)(2)
(Complete only if you checked the box on line 10 of Part I or if the organization failed to qualify under Part II. If the organization fails to qualify under the tests listed below, please complete Part II.)

Section A. Public Support

Calendar year (or fiscal year beginning in)		(a) 2019	(b) 2020	(c) 2021	(d) 2022	(e) 2023	(f) Total
1	Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") .
2	Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose
3	Gross receipts from activities that are not an unrelated trade or business under section 513 .....
4	Tax revenues levied for the organization's benefit and either paid to or expended on its behalf...
5	The value of services or facilities furnished by a governmental unit to the organization without charge
6	Total. Add lines 1 through 5
7a	Amounts included on lines 1, 2, and 3 received from disqualified persons
b	Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year.
c	Add lines 7a and 7b..
8	Public support. (Subtract line 7c from line 6.)

Section B. Total Support

Calendar year (or fiscal year beginning in)		(a) 2019	(b) 2020	(c) 2021	(d) 2022	(e) 2023	(f) Total
9	Amounts from line 6...
10a	Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..
b	Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975.
c	Add lines 10a and 10b.
11	Net income from unrelated business activities not included on line 10b, whether or not the business is regularly carried on.
12	Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.) ..
13	Total support. (Add lines 9, 10c, 11, and 12.)..

First 5 years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a section 501(c)(3) organization, check this box and stop here................................................. right arrow

Section C. Computation of Public Support Percentage

Public support percentage for 2023 (line 8, column (f) divided by line 13, column (f)) .........

Public support percentage from 2022 Schedule A, Part III, line 15 ...............

Section D. Computation of Investment Income Percentage

Investment income percentage for 2023 (line 10c, column (f) divided by line 13, column (f)) ......

Investment income percentage from 2022 Schedule A, Part III, line 17 .............

19a

33 1/3% support tests-2023. If the organization did not check the box on line 14, and line 15 is more than 33 1/3%, and line 17 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization ....... right arrow

33 1/3 % support tests—2022. If the organization did not check a box on line 14 or line 19a, and line 16 is more than 33 1/3% and line 18 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization ..... right arrow

Private foundation. If the organization did not check a box on line 14, 19a, or 19b, check this box and see instructions .... right arrow

Schedule A (Form 990) 2023

Page 4

Part IV

Supporting Organizations

(Complete only if you checked a box on line 12 of Part I. If you checked box 12a, of Part I, complete Sections A and B. If you checked box 12b, of Part I, complete Sections A and C. If you checked box 12c, of Part I, complete Sections A, D, and E. If you checked box12d, of Part I, complete Sections A and D, and complete Part V.)

Section A. All Supporting Organizations

Yes

Are all of the organization’s supported organizations listed by name in the organization’s governing documents?
If "No," describe in Part VI how the supported organizations are designated. If designated by class or purpose,
describe the designation. If historic and continuing relationship, explain.

Did the organization have any supported organization that does not have an IRS determination of status under section 509(a)(1) or (2)? If "Yes," explain in Part VI how the organization determined that the supported organization was described in section 509(a)(1) or (2).

Did the organization have a supported organization described in section 501(c)(4), (5), or (6)? If "Yes," answer lines 3b and 3c below.

Did the organization confirm that each supported organization qualified under section 501(c)(4), (5), or (6) and satisfied the public support tests under section 509(a)(2)? If "Yes," describe in Part VI when and how the organization made the determination.

Did the organization ensure that all support to such organizations was used exclusively for section 170(c)(2)(B) purposes? If "Yes," explain in Part VI what controls the organization put in place to ensure such use.

Was any supported organization not organized in the United States ("foreign supported organization")? If “Yes” and if you checked box 12a or 12b in Part I, answer lines 4b and 4c below.

Did the organization have ultimate control and discretion in deciding whether to make grants to the foreign supported organization? If “Yes,” describe in Part VI how the organization had such control and discretion despite being controlled or supervised by or in connection with its supported organizations.

Did the organization support any foreign supported organization that does not have an IRS determination under sections 501(c)(3) and 509(a)(1) or (2)? If “Yes,” explain in Part VI what controls the organization used to ensure that all support to the foreign supported organization was used exclusively for section 170(c)(2)(B) purposes.

Did the organization add, substitute, or remove any supported organizations during the tax year? If “Yes,” answer lines 5b and 5c below (if applicable). Also, provide detail in Part VI, including (i) the names and EIN numbers of the supported organizations added, substituted, or removed; (ii) the reasons for each such action; (iii) the authority under the organization's organizing document authorizing such action; and (iv) how the action was accomplished (such as by amendment to the organizing document).

Type I or Type II only. Was any added or substituted supported organization part of a class already designated in the organization's organizing document?

Substitutions only. Was the substitution the result of an event beyond the organization's control?

Did the organization provide support (whether in the form of grants or the provision of services or facilities) to anyone other than (i) its supported organizations, (ii) individuals that are part of the charitable class benefited by one or more of its supported organizations, or (iii) other supporting organizations that also support or benefit one or more of the filing organization’s supported organizations? If “Yes,” provide detail in Part VI.

Did the organization provide a grant, loan, compensation, or other similar payment to a substantial contributor (defined in section 4958(c)(3)(C)), a family member of a substantial contributor, or a 35% controlled entity with regard to a substantial contributor? If “Yes,” complete Part I of Schedule L (Form 990) .

Did the organization make a loan to a disqualified person (as defined in section 4958) not described on line 7? If “Yes,” complete Part I of Schedule L (Form 990).

Was the organization controlled directly or indirectly at any time during the tax year by one or more disqualified persons, as defined in section 4946 (other than foundation managers and organizations described in section 509(a)(1) or (2))? If “Yes,” provide detail in Part VI.

Did one or more disqualified persons (as defined on line 9a) hold a controlling interest in any entity in which the supporting organization had an interest? If “Yes,” provide detail in Part VI.

Did a disqualified person (as defined on line 9a) have an ownership interest in, or derive any personal benefit from, assets in which the supporting organization also had an interest? If “Yes,” provide detail in Part VI.

10a

Was the organization subject to the excess business holdings rules of section 4943 because of section 4943(f) (regarding certain Type II supporting organizations, and all Type III non-functionally integrated supporting organizations)? If “Yes,” answer line 10b below.

10a

Did the organization have any excess business holdings in the tax year? (Use Schedule C, Form 4720, to determine whether the organization had excess business holdings).

10b

Schedule A (Form 990) 2023

Page 5

Part IV

Supporting Organizations (continued)

Yes

Has the organization accepted a gift or contribution from any of the following persons?

A person who directly or indirectly controls, either alone or together with persons described on lines 11b and 11c below, the governing body of a supported organization?

11a

A family member of a person described on 11a above?

11b

A 35% controlled entity of a person described on line 11a or 11b above? If “Yes” to 11a, 11b, or 11c, provide detail in Part VI.

11c

Section B. Type I Supporting Organizations

Yes

Did the officers, directors, trustees, or membership of one or more supported organizations have the power to regularly appoint or elect at least a majority of the organization’s directors or trustees at all times during the tax year? If “No,” describe in Part VI how the supported organization(s) effectively operated, supervised, or controlled the organization’s activities. If the organization had more than one supported organization, describe how the powers to appoint and/or remove directors or trustees were allocated among the supported organizations and what conditions or restrictions, if any, applied to such powers during the tax year.

Did the organization operate for the benefit of any supported organization other than the supported organization(s) that operated, supervised, or controlled the supporting organization? If “Yes,” explain in Part VI how providing such benefit carried out the purposes of the supported organization(s) that operated, supervised or controlled the supporting organization.

Section C. Type II Supporting Organizations

Yes

Were a majority of the organization’s directors or trustees during the tax year also a majority of the directors or trustees of each of the organization’s supported organization(s)? If “No,” describe in Part VI how control or management of the supporting organization was vested in the same persons that controlled or managed the supported organization(s).

Section D. All Type III Supporting Organizations

Yes

Did the organization provide to each of its supported organizations, by the last day of the fifth month of the organization’s tax year, (i) a written notice describing the type and amount of support provided during the prior tax year, (ii) a copy of the Form 990 that was most recently filed as of the date of notification, and (iii) copies of the organization’s governing documents in effect on the date of notification, to the extent not previously provided?

Were any of the organization’s officers, directors, or trustees either (i) appointed or elected by the supported organization(s) or (ii) serving on the governing body of a supported organization? If "No," explain in Part VI how the organization maintained a close and continuous working relationship with the supported organization(s).

By reason of the relationship described in line 2 above, did the organization’s supported organizations have a significant voice in the organization’s investment policies and in directing the use of the organization’s income or assets at all times during the tax year? If "Yes," describe in Part VI the role the organization’s supported organizations played in this regard.

Section E. Type III Functionally-Integrated Supporting Organizations

Check the box next to the method that the organization used to satisfy the Integral Part Test during the year (see instructions):

The organization satisfied the Activities Test. Complete line 2 below.

The organization is the parent of each of its supported organizations. Complete line 3 below.

The organization supported a governmental entity. Describe in Part VI how you supported a government entity (see instructions)

Activities Test. Answer lines 2a and 2b below.

Yes

Did substantially all of the organization’s activities during the tax year directly further the exempt purposes of the supported organization(s) to which the organization was responsive? If "Yes," then in Part VI identify those supported organizations and explain how these activities directly furthered their exempt purposes, how the organization was responsive to those supported organizations, and how the organization determined that these activities constituted substantially all of its activities.

Did the activities described on line 2a, above constitute activities that, but for the organization’s involvement, one or more of the organization’s supported organization(s) would have been engaged in? If "Yes," explain in Part VI the reasons for the organization’s position that its supported organization(s) would have engaged in these activities but for the organization’s involvement.

Parent of Supported Organizations. Answer lines 3a and 3b below.

Did the organization have the power to regularly appoint or elect a majority of the officers, directors, or trustees of each of the supported organizations?If "Yes" or "No", provide details in Part VI.

Did the organization exercise a substantial degree of direction over the policies, programs and activities of each of its supported organizations? If "Yes," describe in Part VI. the role played by the organization in this regard.

Schedule A (Form 990) 2023

Page 6

Part V

Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations

Check here if the organization satisfied the Integral Part Test as a qualifying trust on Nov. 20, 1970 (explain in Part VI). See instructions. All other Type III non-functionally integrated supporting organizations must complete Sections A through E.

	Section A - Adjusted Net Income		(A) Prior Year	(B) Current Year (optional)
1	Net short-term capital gain	1
2	Recoveries of prior-year distributions	2
3	Other gross income (see instructions)	3
4	Add lines 1 through 3	4
5	Depreciation and depletion	5
6	Portion of operating expenses paid or incurred for production or collection of gross income or for management, conservation, or maintenance of property held for production of income (see instructions)	6
7	Other expenses (see instructions)	7
8	Adjusted Net Income (subtract lines 5, 6 and 7 from line 4)	8

	Section B - Minimum Asset Amount		(A) Prior Year	(B) Current Year (optional)
1	Aggregate fair market value of all non-exempt-use assets (see instructions for short tax year or assets held for part of year):	1
a	Average monthly value of securities	1a
b	Average monthly cash balances	1b
c	Fair market value of other non-exempt-use assets	1c
d	Total (add lines 1a, 1b, and 1c)	1d
e	Discount claimed for blockage or other factors (explain in detail in Part VI):
2	Acquisition indebtedness applicable to non-exempt use assets	2
3	Subtract line 2 from line 1d	3
4	Cash deemed held for exempt use. Enter 0.015 of line 3 (for greater amount, see instructions).	4
5	Net value of non-exempt-use assets (subtract line 4 from line 3)	5
6	Multiply line 5 by 0.035	6
7	Recoveries of prior-year distributions	7
8	Minimum Asset Amount (add line 7 to line 6)	8

	Section C - Distributable Amount		Current Year
1	Adjusted net income for prior year (from Section A, line 8, Column A)	1
2	Enter 85% of line 1	2
3	Minimum asset amount for prior year (from Section B, line 8, Column A)	3
4	Enter greater of line 2 or line 3	4
5	Income tax imposed in prior year	5
6	Distributable Amount. Subtract line 5 from line 4, unless subject to emergency temporary reduction (see instructions)	6

Check here if the current year is the organization's first as a non-functionally-integrated Type III supporting organization (see instructions)

Schedule A (Form 990) 2023

Page 7

Part V

Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations(continued)

Section D - Distributions		Current Year
1 Amounts paid to supported organizations to accomplish exempt purposes	1
2 Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in excess of income from activity	2
3 Administrative expenses paid to accomplish exempt purposes of supported organizations	3
4 Amounts paid to acquire exempt-use assets	4
5 Qualified set-aside amounts (prior IRS approval required - provide details in Part VI)	5
6 Other distributions (describe in Part VI). See instructions	6
7Total annual distributions. Add lines 1 through 6.	7
8 Distributions to attentive supported organizations to which the organization is responsive (provide details in Part VI). See instructions	8
9 Distributable amount for 2023 from Section C, line 6	9
10 Line 8 amount divided by Line 9 amount	10

Section E - Distribution Allocations (see instructions)		(i) Excess Distributions	(ii) Underdistributions Pre-2023	(iii) Distributable Amount for 2023
1 Distributable amount for 2023 from Section C, line 6
2 Underdistributions, if any, for years prior to 2023 (reasonable cause required-- explain in Part VI). See instructions.
3 Excess distributions carryover, if any, to 2023:
a From 2018.......
b From 2019.......
c From 2020.......
d From 2021.......
e From 2022.......
fTotal of lines 3a through e
g Applied to underdistributions of prior years
h Applied to 2023 distributable amount
i Carryover from 2018 not applied (see instructions)
j Remainder. Subtract lines 3g, 3h, and 3i from line 3f.
4Distributions for 2023 from Section D, line 7:
$
a Applied to underdistributions of prior years
b Applied to 2023 distributable amount
c Remainder. Subtract lines 4a and 4b from line 4.
5 Remaining underdistributions for years prior to 2023, if any. Subtract lines 3g and 4a from line 2. If the amount is greater than zero, explain in Part VI. See instructions.
6 Remaining underdistributions for 2023. Subtract lines 3h and 4b from line 1. If the amount is greater than zero, explain in Part VI. See instructions.
7 Excess distributions carryover to 2024. Add lines 3j and 4c.
8 Breakdown of line 7:
a Excess from 2019.....
b Excess from 2020.....
c Excess from 2021.....
d Excess from 2022.....
e Excess from 2023.....

Schedule A (Form 990) (2023)

Schedule A (Form 990) 2023

Page 8

Part VI

Supplemental Information. Provide the explanations required by Part II, line 10; Part II, line 17a or 17b; Part III, line 12; Part IV, Section A, lines 1, 2, 3b, 3c, 4b, 4c, 5a, 6, 9a, 9b, 9c, 11a, 11b, and 11c; Part IV, Section B, lines 1 and 2; Part IV, Section C, line 1; Part IV, Section D, lines 2 and 3; Part IV, Section E, lines 1c, 2a, 2b, 3a and 3b; Part V, line 1; Part V, Section B, line 1e; Part V Section D, lines 5, 6, and 8; and Part V, Section E, lines 2, 5, and 6. Also complete this part for any additional information. (See instructions).

Facts And Circumstances Test

Return Reference	Explanation

Schedule A (Form 990) 2023

Additional Data

Software ID:
Software Version:

- TIN:

Schedule B
(Form 990)

Department of the Treasury
Internal Revenue Service

Schedule of Contributors

Attach to Form 990, 990-EZ, or 990-PF.

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2023

Name of the organization

Mount Desert Island Hospital

Employer identification number

01-0211797

Organization type (check one):

Filers of:

Section:

Form 990 or 990-EZ

501(c)( ) (enter number) organization

4947(a)(1) nonexempt charitable trust not treated as a private foundation

527 political organization

Form 990-PF

501(c)(3) exempt private foundation

4947(a)(1) nonexempt charitable trust treated as a private foundation

501(c)(3) taxable private foundation

Check if your organization is covered by the General Rule or a Special Rule.
Note: Only a section 501(c)(7), (8), or (10) organization can check boxes for both the General Rule and a Special Rule. See instructions.

General Rule

For an organization filing Form 990, 990-EZ, or 990-PF that received, during the year, contributions totaling $5,000 or more (in money or other property) from any one contributor. Complete Parts I and II. See instructions for determining a contributor's total contributions.

Special Rules

For an organization described in section 501(c)(3) filing Form 990 or 990-EZ that met the 33¹/3% support test of the regulations
under sections 509(a)(1) and 170(b)(1)(A)(vi), that checked Schedule A (Form 990 or 990-EZ), Part II, line 13, 16a, or 16b, and that received from any one contributor, during the year, total contributions of the greater of (1) $5,000 or (2) 2% of the amount on (i) Form 990, Part VIII, line 1h, or (ii) Form 990-EZ, line 1. Complete Parts I and II.

For an organization described in section 501(c)(7), (8), or (10) filing Form 990 or 990-EZ that received from any one contributor,
during the year, total contributions of more than $1,000 exclusively for religious, charitable, scientific, literary, or educational purposes, or for the prevention of cruelty to children or animals. Complete Parts I, II, and III.

For an organization described in section 501(c)(7), (8), or (10) filing Form 990 or 990-EZ that received from any one contributor,
during the year, contributions exclusively for religious, charitable, etc., purposes, but no such contributions totaled more than $1,000. If this box is checked, enter here the total contributions that were received during the year for an exclusively religious, charitable, etc., purpose. Don't complete any of the parts unless the General Rule applies to this organization because it received nonexclusively religious, charitable, etc., contributions totaling $5,000 or more during the year ......... Arrow Bullet

Caution: An organization that isn't covered by the General Rule and/or the Special Rules doesn't file Schedule B (Form 990,
990-EZ, or 990-PF), but it must answer “No” on Part IV, line 2, of its Form 990; or check the box on line H of its Form 990-EZ
or on its Form 990PF, Part I, line 2, to certify that it doesn't meet the filing requirements of Schedule B (Form 990,
990-EZ, or 990-PF).

For Paperwork Reduction Act Notice, see the Instructions
for Form 990, 990-EZ, or 990-PF.

Cat. No. 30613XSchedule B (Form 990) (2023)

Schedule B (Form 990) (2023) Page 2

Name of organization Mount Desert Island Hospital

Part I Contributors	Contributors (see instructions). Use duplicate copies of Part I if additional space is needed.
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
RESTRICTED	,	$ RESTRICTED	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
Schedule B (Form 990) (2023)

Schedule B (Form 990) (2023)

Page 3

Name of organization Mount Desert Island Hospital		Employer identification number 01-0211797

Part II	Noncash Property (see instructions). Use duplicate copies of Part II if additional space is needed.
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
Schedule B (Form 990) (2023)

Schedule B (Form 990) (2023)

Page 4


Name of organization Mount Desert Island Hospital			Employer identification number 01-0211797
Part III Exclusively religious, charitable, etc., contributions to organizations described in section 501(c)(7), (8), or (10) that total more than $1,000 for the year from any one contributor. Complete columns (a) through (e) and the following line entry. For organizations completing Part III, enter the total of exclusively religious, charitable, etc., contributions of $1,000 or less for the year. (Enter this information once. See instructions.) $ Use duplicate copies of Part III if additional space is needed.

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

Schedule B (Form 990) (2023)

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE C
(Form 990)

Department of the Treasury
Internal Revenue Service

Political Campaign and Lobbying Activities

For Organizations Exempt From Income Tax Under section 501(c) and section 527

right arrow

Complete if the organization is described below. right arrow

Attach to Form 990 or Form 990-EZ.
right arrow

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2022

Open to Public
Inspection

If the organization answered "Yes" on Form 990, Part IV, Line 3, or Form 990-EZ, Part V, line 46 (Political Campaign Activities), then
Round Bullet

Section 501(c)(3) organizations: Complete Parts I-A and B. Do not complete Part I-C.
Round Bullet

Section 501(c) (other than section 501(c)(3)) organizations: Complete Parts I-A and C below. Do not complete Part I-B.
Round Bullet

Section 527 organizations: Complete Part I-A only.
If the organization answered "Yes" on Form 990, Part IV, Line 4, or Form 990-EZ, Part VI, line 47 (Lobbying Activities), then
Round Bullet

Section 501(c)(3) organizations that have filed Form 5768 (election under section 501(h)): Complete Part II-A. Do not complete Part II-B.
Round Bullet

Section 501(c)(3) organizations that have NOT filed Form 5768 (election under section 501(h)): Complete Part II-B. Do not complete Part II-A.
If the organization answered "Yes" on Form 990, Part IV, Line 5 (Proxy Tax) (see separate instructions) or Form 990-EZ, Part V, line 35c (Proxy Tax) (see separate instructions), then
Round Bullet

Section 501(c)(4), (5), or (6) organizations: Complete Part III.

Name of the organization

Mount Desert Island Hospital

Employer identification number

01-0211797

Part I-A

Complete if the organization is exempt under section 501(c) or is a section 527 organization.

Provide a description of the organization’s direct and indirect political campaign activities in Part IV. See instructions for definition of “political campaign activities."

Political campaign activity expenditures. See instructions .................................................................... right arrow

Volunteer hours for political campaign activities. See instructions ..................................................................

Part I-B

Complete if the organization is exempt under section 501(c)(3).

Enter the amount of any excise tax incurred by the organization under section 4955 ................................ right arrow

Enter the amount of any excise tax incurred by organization managers under section 4955 ....................... right arrow

If the organization incurred a section 4955 tax, did it file Form 4720 for this year? .........................................

Yes No

Was a correction made? ......................................................................................................................

Yes No

If "Yes," describe in Part IV.

Part I-C

Complete if the organization is exempt under section 501(c), except section 501(c)(3).

Enter the amount directly expended by the filing organization for section 527 exempt function activities ..... right arrow

Enter the amount of the filing organization's funds contributed to other organizations for section 527 exempt function activities ............................................................................................................................ right arrow

Total exempt function expenditures. Add lines 1 and 2. Enter here and on Form 1120-POL, line 17b........... right arrow

Did the filing organization file Form 1120-POL for this year? ...................................................................

Yes No

Enter the names, addresses and employer identification number (EIN) of all section 527 political organizations to which the filing
organization made payments. For each organization listed, enter the amount paid from the filing organization’s funds. Also enter the amount of political contributions received that were promptly and directly delivered to a separate political organization, such as a separate segregated fund or a political action committee (PAC). If additional space is needed, provide information in Part IV.

(a) Name	(b) Address	(c) EIN	(d) Amount paid from filing organization's funds. If none, enter -0-.	(e) Amount of political contributions received and promptly and directly delivered to a separate political organization. If none, enter -0-.
1
2
3
4
5
6

For Paperwork Reduction Act Notice, see the instructions for Form 990.

Cat. No. 50084S

Schedule C (Form 990) 2022

Page 2

Part II-A

Complete if the organization is exempt under section 501(c)(3) and filed Form 5768 (election under section 501(h)).

A Check right arrow

if the filing organization belongs to an affiliated group (and list in Part IV each affiliated group member's name, address, EIN, expenses, and share of excess lobbying expenditures).
B Check right arrow

if the filing organization checked box A and "limited control" provisions apply.

Limits on Lobbying Expenditures (The term "expenditures" means amounts paid or incurred.)		(b) Affiliated group totals
1a	Total lobbying expenditures to influence public opinion (grass roots lobbying) ......................
b	Total lobbying expenditures to influence a legislative body (direct lobbying) ........................
c	Total lobbying expenditures (add lines 1a and 1b) ............................................................
d	Other exempt purpose expenditures ...............................................................................
e	Total exempt purpose expenditures (add lines 1c and 1d) ..................................................
f	Lobbying nontaxable amount. Enter the amount from the following table in both columns.
	If the amount on line 1e, column (a) or (b) is:The lobbying nontaxable amount is:
	Not over $500,00020% of the amount on line 1e.
	Over $500,000 but not over $1,000,000$100,000 plus 15% of the excess over $500,000.
	Over $1,000,000 but not over $1,500,000$175,000 plus 10% of the excess over $1,000,000.
	Over $1,500,000 but not over $17,000,000$225,000 plus 5% of the excess over $1,500,000.
	Over $17,000,000$1,000,000.

g	Grassroots nontaxable amount (enter 25% of line 1f) .................................................
h	Subtract line 1g from line 1a. If zero or less, enter -0-. ................................................
i	Subtract line 1f from line 1c. If zero or less, enter -0-. ................................................
j	If there is an amount other than zero on either line 1h or line 1i, did the organization file Form 4720 reporting section 4911 tax for this year? ...................................................................................................................	Yes No

4-Year Averaging Period Under Section 501(h) (Some organizations that made a section 501(h) election do not have to complete all of the five columns below. See the separate instructions for lines 2a through 2f.)
Lobbying Expenditures During 4-Year Averaging Period
	Calendar year (or fiscal year beginning in)	(a) 2019	(b) 2020	(c) 2021	(d) 2022	(e) Total

2a	Lobbying nontaxable amount

b	Lobbying ceiling amount (150% of line 2a, column(e))

c	Total lobbying expenditures

d	Grassroots nontaxable amount

e	Grassroots ceiling amount (150% of line 2d, column (e))

f	Grassroots lobbying expenditures

Schedule C (Form 990) 2022

Page 3

Part II-B

Complete if the organization is exempt under section 501(c)(3) and has NOT filed Form 5768 (election under section 501(h)).

For each "Yes" response on lines 1a through 1i below, provide in Part IV a detailed description of the lobbying activity.

(a)

Yes|No

(b)

Amount

During the year, did the filing organization attempt to influence foreign, national, state or local legislation, including any attempt to influence public opinion on a legislative matter or referendum, through the use of:

Volunteers? ...........................................................................................................

Paid staff or management (include compensation in expenses reported on lines 1c through 1i)? ........

Media advertisements? ...................................................................................................

Mailings to members, legislators, or the public? .............................................................................

Publications, or published or broadcast statements? ...........................................................

Grants to other organizations for lobbying purposes? ..........................................................

Yes

8,380

Direct contact with legislators, their staffs, government officials, or a legislative body? .......................

Rallies, demonstrations, seminars, conventions, speeches, lectures, or any similar means? ..................

Other activities? ...................................................................................................................

Total. Add lines 1c through 1i ....................................................................................................

8,380

Did the activities in line 1 cause the organization to be not described in section 501(c)(3)? .....

If "Yes," enter the amount of any tax incurred under section 4912 ...........................................

If "Yes," enter the amount of any tax incurred by organization managers under section 4912 ...................

If the filing organization incurred a section 4912 tax, did it file Form 4720 for this year? ........................

Part III-A

Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6).

Yes

Were substantially all (90% or more) dues received nondeductible by members? ...............................................

Did the organization make only in-house lobbying expenditures of $2,000 or less? ............................................

Did the organization agree to carry over lobbying and political expenditures from the prior year? .................................

Part III-B

Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6) and if either (a) BOTH Part III-A, lines 1 and 2, are answered "No" OR (b) Part III-A, line 3, is answered “Yes."

Dues, assessments and similar amounts from members ......................................................................

Section 162(e) nondeductible lobbying and political expenditures (do not include amounts of political expenses for which the section 527(f) tax was paid).

Current year .............................................................................................................................

Carryover from last year ............................................................................................................

Total ...........................................................................................................................................

Aggregate amount reported in section 6033(e)(1)(A) notices of nondeductible section 162(e) dues .

If notices were sent and the amount on line 2c exceeds the amount on line 3, what portion of the excess does the organization agree to carryover to the reasonable estimate of nondeductible lobbying and political expenditure next year? ......................................................................................................................

Taxable amount of lobbying and political expenditures. See Instructions .........................................

Part IV

Supplemental Information

Provide the descriptions required for Part l-A, line 1; Part l-B, line 4; Part l-C, line 5; Part II-A (affiliated group list); Part II-A, lines 1 and 2 (see instructions), and Part ll-B, line 1. Also, complete this part for any additional information.

Return Reference	Explanation
Part II-B, Line 1:	Mount Desert Island Hospital was a member of the American Hospital Association and the Maine Hospital Association in the fiscal year ended April 30, 2024. A portion of the dues paid to these organizations were available for lobbying expenditures on behalf of Mount Desert Island Hospital and the other member organizations in furtherance of their exempt purposes. The total dues paid by the Hospital to these organizations, and the portion that was estimated to be available for lobbying, are detailed below: American Hospital Association - total dues: $14,663 American Hospital Association - amount available for lobbying: $4,632 Maine Hospital Association - total dues: $27,359 Maine Hospital Association - amount available for lobbying: $3,748

Return Reference

Explanation

Part II-B, Line 1:

Mount Desert Island Hospital was a member of the American Hospital Association and the Maine Hospital Association in the fiscal year ended April 30, 2024. A portion of the dues paid to these organizations were available for lobbying expenditures on behalf of Mount Desert Island Hospital and the other member organizations in furtherance of their exempt purposes. The total dues paid by the Hospital to these organizations, and the portion that was estimated to be available for lobbying, are detailed below: American Hospital Association - total dues: $14,663 American Hospital Association - amount available for lobbying: $4,632 Maine Hospital Association - total dues: $27,359 Maine Hospital Association - amount available for lobbying: $3,748

Schedule C (Form 990) 2022

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE D
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Financial Statements

Complete if the organization answered "Yes," on Form 990,
Part IV, line 6, 7, 8, 9, 10, 11a, 11b, 11c, 11d, 11e, 11f, 12a, or 12b.
right arrow

Attach to Form 990.
right arrow

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2022

Open to Public Inspection

Name of the organization

Mount Desert Island Hospital

Employer identification number

01-0211797

Part I

Organizations Maintaining Donor Advised Funds or Other Similar Funds or Accounts. Complete if the organization answered "Yes" on Form 990, Part IV, line 6.

		(a) Donor advised funds	(b) Funds and other accounts
1	Total number at end of year .........
2	Aggregate value of contributions to (during year)
3	Aggregate value of grants from (during year)
4	Aggregate value at end of year ........

Did the organization inform all donors and donor advisors in writing that the assets held in donor advised funds are the organization’s property, subject to the organization’s exclusive legal control? ............

Yes No

Did the organization inform all grantees, donors, and donor advisors in writing that grant funds can be used only for charitable purposes and not for the benefit of the donor or donor advisor, or for any other purpose conferring impermissible private benefit? ...................................

Yes No

Part II

Conservation Easements.
Complete if the organization answered "Yes" on Form 990, Part IV, line 7.

Purpose(s) of conservation easements held by the organization (check all that apply).

Preservation of land for public use (e.g., recreation or education) Preservation of an historically important land area

Protection of natural habitat Preservation of a certified historic structure

Preservation of open space

Complete lines 2a through 2d if the organization held a qualified conservation contribution in the form of a conservation easement on the last day of the tax year.


a	Total number of conservation easements ......................	2a
b	Total acreage restricted by conservation easements ....................	2b
c	Number of conservation easements on a certified historic structure included in (a) .....	2c
d	Number of conservation easements included in (c) acquired after July 25, 2006, and not on a historic structure listed in the National Register ...	2d

Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during the
tax year right arrow

Number of states where property subject to conservation easement is located right arrow

Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and enforcement of the conservation easements it holds? ............

Yes No

Staff and volunteer hours devoted to monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
right arrow

Amount of expenses incurred in monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
right arrow

Does each conservation easement reported on line 2(d) above satisfy the requirements of section 170(h)(4)(B)(i) and section 170(h)(4)(B)(ii)? .............................

Yes No

In Part XIII, describe how the organization reports conservation easements in its revenue and expense statement, and
balance sheet, and include, if applicable, the text of the footnote to the organization’s financial statements that describes
the organization’s accounting for conservation easements.

Part III

Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets.
Complete if the organization answered "Yes" on Form 990, Part IV, line 8.

If the organization elected, as permitted under FASB ASC 958, not to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide, in Part XIII, the text of the footnote to its financial statements that describes these items.

If the organization elected, as permitted under FASB ASC 958, to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide the following amounts relating to these items:

(i)

Revenue included on Form 990, Part VIII, line 1 ......................... right arrow

(ii)

Assets included in Form 990, Part X ............................... right arrow

If the organization received or held works of art, historical treasures, or other similar assets for financial gain, provide the
following amounts required to be reported under FASB ASC 958 relating to these items:

Revenue included on Form 990, Part VIII, line 1 .......................... right arrow

Assets included in Form 990, Part X ............................... right arrow

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 52283D

Schedule D (Form 990) 2022

Page 2

Part III

Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)

Using the organization’s acquisition, accession, and other records, check any of the following that are a significant use of its collection items (check all that apply):

Public exhibition

Loan or exchange programs

Scholarly research

Other

Preservation for future generations

Provide a description of the organization’s collections and explain how they further the organization’s exempt purpose in
Part XIII.

During the year, did the organization solicit or receive donations of art, historical treasures or other similar
assets to be sold to raise funds rather than to be maintained as part of the organization’s collection?...

Yes No

Part IV

Escrow and Custodial Arrangements. Complete if the organization answered "Yes" on Form 990, Part IV, line 9, or reported an amount on Form 990, Part X, line 21.

Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not
included on Form 990, Part X? ....................................

Yes No


b	If "Yes," explain the arrangement in Part XIII and complete the following table:		Amount
c	Beginning balance .............................	1c
d	Additions during the year ............................	1d
e	Distributions during the year ..........................	1e
f	Ending balance ................................	1f

Did the organization include an amount on Form 990, Part X, line 21, for escrow or custodial account liability? ...

Yes No

If "Yes," explain the arrangement in Part XIII. Check here if the explanation has been provided in Part XIII ....

Part V

Endowment Funds.
Complete if the organization answered "Yes" on Form 990, Part IV, line 10.

		(a) Current year	(b) Prior year	(c) Two years back	(d) Three years back	(e) Four years back

1a	Beginning of year balance ....	12,551,589	12,364,900	9,847,696	6,958,392	6,896,922
b	Contributions ...	250,000		3,675,585	1,000,000
c	Net investment earnings, gains, and losses	995,464	206,804	-1,133,936	1,904,005	78,892
d	Grants or scholarships ...
e	Other expenditures for facilities and programs ...	1,850,000
f	Administrative expenses ....	22,344	20,115	24,445	14,701	17,422
g	End of year balance ......	11,924,709	12,551,589	12,364,900	9,847,696	6,958,392

Provide the estimated percentage of the current year end balance (line 1g, column (a)) held as:

Board designated or quasi-endowment right arrow

94.030 %

Permanent endowment right arrow

5.970 %

Term endowment right arrow

0 %

The percentages on lines 2a, 2b, and 2c should equal 100%.

Are there endowment funds not in the possession of the organization that are held and administered for the
organization by:

Yes

(i) Unrelated organizations .................

3a(i)

Yes

(ii) Related organizations .................

3a(ii)

If "Yes" on 3a(ii), are the related organizations listed as required on Schedule R? .........

Describe in Part XIII the intended uses of the organization's endowment funds.

Part VI

Land, Buildings, and Equipment.
Complete if the organization answered "Yes" on Form 990, Part IV, line 11a. See Form 990, Part X, line 10.

Description of property		(a) Cost or other basis (investment)	(b) Cost or other basis (other)	(c) Accumulated depreciation	(d) Book value

1a	Land .....	4,007,948		4,007,948
b	Buildings ....	31,424,941	20,359,878	11,065,063
c	Leasehold improvements	44,545	28,860	15,685
d	Equipment ....	30,861,659	19,994,933	10,866,726
e	Other .....	7,783,963		7,783,963
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..				33,739,385

Schedule D (Form 990) 2022

Page 3

Part VII

Investments - Other Securities.
Complete if the organization answered "Yes" on Form 990, Part IV, line 11b. See Form 990, Part X, line 12.

(a) Description of security or category (including name of security)	(b) Book value	(c) Method of valuation: Cost or end-of-year market value
(1) Financial derivatives.........
(2) Closely-held equity interests........
(3)Other
(A)
(B)
(C)
(D)
(E)
(F)
(G)
(H)
Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)

Part VIII

Investments - Program Related. Complete if the organization answered 'Yes' on Form 990, Part IV, line 11c. See Form 990, Part X, line 13.

(a) Description of investment	(b) Book value	(c) Method of valuation: Cost or end-of-year market value

(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 13.)

Part IX

Other Assets.
Complete if the organization answered 'Yes' on Form 990, Part IV, line 11d. See Form 990, Part X, line 15.

(a) Description				(b) Book value

(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........

Part X

Other Liabilities.
Complete if the organization answered 'Yes' on Form 990, Part IV, line 11e or 11f. See Form 990, Part X, line 25.

1.(a) Description of liability	(b) Book value
(1) Federal income taxes
Deferred compensation	3,362,352
Malpractice insurance obligations	663,961
Lease obligations	788,954






Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)	4,815,267
2. Liability for uncertain tax positions. In Part XIII, provide the text of the footnote to the organization's financial statements that reports the organization's liability for uncertain tax positions under FIN 48 (ASC 740). Check here if the text of the footnote has been provided in Part XIII

Schedule D (Form 990) 2022

Page 4

Part XI Reconciliation of Revenue per Audited Financial Statements With Revenue per Return. Complete if the organization answered 'Yes' on Form 990, Part IV, line 12a.
1	Total revenue, gains, and other support per audited financial statements .......			1	107,211,681
2	Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a	Net unrealized gains (losses) on investments ....	2a	934,765
b	Donated services and use of facilities .........	2b
c	Recoveries of prior year grants ...........	2c
d	Other (Describe in Part XIII.) ...........	2d	92,406
e	Add lines 2a through 2d .....................			2e	1,027,171
3	Subtract line 2e from line 1..................			3	106,184,510
4	Amounts included on Form 990, Part VIII, line 12, but not on line 1:
a	Investment expenses not included on Form 990, Part VIII, line 7b .	4a	54,026
b	Other (Describe in Part XIII.) ...........	4b	8,431,019
c	Add lines 4a and 4b....................			4c	8,485,045
5	Total revenue. Add lines 3 and 4c. (This must equal Form 990, Part I, line 12.) ......			5	114,669,555

Part XII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return. Complete if the organization answered 'Yes' on Form 990, Part IV, line 12a.
1	Total expenses and losses per audited financial statements ...........			1	84,455,715
2	Amounts included on line 1 but not on Form 990, Part IX, line 25:
a	Donated services and use of facilities .........	2a
b	Prior year adjustments ............	2b
c	Other losses ................	2c
d	Other (Describe in Part XIII.) ...........	2d	7,767
e	Add lines 2a through 2d....................			2e	7,767
3	Subtract line 2e from line 1...................			3	84,447,948
4	Amounts included on Form 990, Part IX, line 25, but not on line 1:
a	Investment expenses not included on Form 990, Part VIII, line 7b ..	4a	54,026
b	Other (Describe in Part XIII.) ...........	4b	6,702,596
c	Add lines 4a and 4b.....................			4c	6,756,622
5	Total expenses. Add lines 3 and 4c. (This must equal Form 990, Part I, line 18.) ......			5	91,204,570

Part XIII

Supplemental Information

Provide the descriptions required for Part II, lines 3, 5, and 9; Part III, lines 1a and 4; Part lV, lines 1b and 2b; Part V, line 4; Part X, line 2; Part XI, lines 2d and 4b; and Part XII, lines 2d and 4b. Also complete this part to provide any additional information.

Return Reference	Explanation
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.
Part X, Line 2:	The Hospital and BBRV are exempt from federal income taxes under Section 501(c)(3) of the Internal Revenue Code (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) ASC 740, Income Taxes. At April 30, 2024, and 2023, 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. Tax-exempt organizations could be required to record an obligation for income taxes as the result of a tax position they have historically taken on various tax exposure items including unrelated business income or tax status. Under guidance issued by the 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. The Organization has evaluated the positions taken on its filed tax returns. The Organization has concluded no uncertain income tax positions exist at April 30, 2024.
Part XI, Line 2d - Other Adjustments:	Rental property expenses 7,767. Change in value of beneficial interest in trust 84,639.
Part XI, Line 4b - Other Adjustments:	Provision for bad debts 5,881,991. Fundraising expenses, net against revenues 820,605. Pledge discount adjustment 1,728,423.
Part XII, Line 2d - Other Adjustments:	Rental property expenses 7,767.
Part XII, Line 4b - Other Adjustments:	Provision for bad debts 5,881,991. Fundraising expenses, net against revenues 820,605.

Schedule D (Form 990) 2022

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE G (Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Information Regarding
Fundraising or Gaming Activities

Complete if the organization answered "Yes" on Form 990, Part IV, lines 17, 18, or 19, or if the organization entered more than $15,000 on Form 990-EZ, line 6a. right arrow

Attach to Form 990 or Form 990-EZ.
right arrow

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2023

Open to Public Inspection

Name of the organization
Mount Desert Island Hospital

Employer identification number

01-0211797

Part I

Fundraising Activities.Complete if the organization answered "Yes" on Form 990, Part IV, line 17.

Form 990-EZ filers are not required to complete this part.

Indicate whether the organization raised funds through any of the following activities. Check all that apply.

a	Mail solicitations	e	Solicitation of non-government grants
b	Internet and email solicitations	f	Solicitation of government grants
c	Phone solicitations	g	Special fundraising events
d	In-person solicitations

Did the organization have a written or oral agreement with any individual (including officers, directors, trustees

or key employees listed in Form 990, Part VII) or entity in connection with professional fundraising services?

YesNo

If "Yes," list the 10 highest paid individuals or entities (fundraisers) pursuant to agreements under which the fundraiser is
to be compensated at least $5,000 by the organization.

(i) Name and address of individual or entity (fundraiser)	(iii) Did fundraiser have custody or control of contributions?
	Yes	No










Total . . . . . . . . . . . . . . . . . . . .

List all states in which the organization is registered or licensed to solicit contributions or has been notified it is exempt from registration or licensing.

For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.

Cat. No. 50083H

Schedule G (Form 990) 2023

Page 2

Part II

Fundraising Events. Complete if the organization answered "Yes" on Form 990, Part IV, line 18, or reported more than $15,000 of fundraising event contributions and gross income on Form 990-EZ, lines 1 and 6b. List events with gross receipts greater than $5,000.

		(a) Event #1 Isleford Dock Benefit (event type)	(b) Event #2 Showhouse (event type)	(c) Other events (total number)	(d) Total events (add col. (a) through col. (c))
1	Gross receipts . . . . .	414,533	74,947		489,480
2	Less: Contributions . . . .	388,433	67,867		456,300
3	Gross income (line 1 minus line 2) . . . . . .	26,100	7,080		33,180

4	Cash prizes . . . . .
5	Noncash prizes . . . .
6	Rent/facility costs . . . .	20,776	16,839	37,615
7	Food and beverages . . .	45,991	25,000	70,991
8	Entertainment . . . .
9	Other direct expenses . . .	30,442	4,245	34,687
10	Direct expense summary. Add lines 4 through 9 in column (d) . . . . . . . . . .			143,293
11	Net income summary. Subtract line 10 from line 3, column (d). . . . . . . . . .			-110,113

Part III

Gaming. Complete if the organization answered "Yes" on Form 990, Part IV, line 19, or reported more than $15,000 on Form 990-EZ, line 6a.

		(a) Bingo	(b) Pull tabs/Instant bingo/progressive bingo	(c) Other gaming	(d) Total gaming (add col.(a) through col.(c))
1	Gross revenue . . . . .

2	Cash prizes . . . . .
3	Noncash prizes . . . .
4	Rent/facility costs . . . .
5	Other direct expenses . . .

Volunteer labor . . . .

	Yes %
	No

	Yes %
	No

	Yes %
	No

Direct expense summary. Add lines 2 through 5 in column (d) . . . . . . . . . . right arrow

Net gaming income summary. Subtract line 7 from line 1, column (d). . . . . . . . . right arrow

Enter the state(s) in which the organization conducts gaming activities:

Is the organization licensed to conduct gaming activities in each of these states? . . . . . . . .

YesNo

If "No," explain:

10a

Were any of the organization's gaming licenses revoked, suspended or terminated during the tax year? . . .

YesNo

If "Yes," explain:

Schedule G (Form 990) 2023

Page 3

Does the organization conduct gaming activities with nonmembers? . . . . . . . . . . .

YesNo

Is the organization a grantor, beneficiary or trustee of a trust or a member of a partnership or other entity

formed to administer charitable gaming? . . . . . . . . . . . . . . . . .

YesNo

Indicate the percentage of gaming activity conducted in:

The organization's facility . . . . . . . . . . . . . . . . . .

13a

An outside facility . . . . . . . . . . . . . . . . . . . .

13b

Enter the name and address of the person who prepares the organization's gaming/special events books and records:

Name

Address

15a

Does the organization have a contract with a third party from whom the organization receives gaming

revenue? . . . . . . . . . . . . . . . . . . . . . . . .

YesNo

If "Yes," enter the amount of gaming revenue received by the organization right arrow

$ and the

amount of gaming revenue retained by the third party right arrow

$ .

If "Yes," enter name and address of the third party:

Name

Address

Gaming manager information:

Name

Gaming manager compensation right arrow

Description of services provided right arrow

Director/officer Employee Independent contractor

Mandatory distributions:

Is the organization required under state law to make charitable distributions from the gaming proceeds to

retain the state gaming license? . . . . . . . . . . . . . . . . . . .

YesNo

Enter the amount of distributions required under state law distributed to other exempt organizations or spent

in the organization's own exempt activities during the tax year right arrow

Part IV

Supplemental Information. Provide the explanations required by Part I, line 2b, columns (iii) and (v); and Part III, lines 9, 9b, 10b, 15b, 15c, 16, and 17b, as applicable. Also provide any additional information. See instructions.

Return Reference	Explanation

Schedule G (Form 990) 2023

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE H
(Form 990)

Department of the Treasury
Internal Revenue Service

Hospitals

Complete if the organization answered "Yes" on Form 990, Part IV, question 20a.
Medium right arrow

Attach to Form 990.
Medium right arrow

Go to www.irs.gov/Form990EZ for instructions and the latest information.

OMB No. 1545-0047

2023

Open to Public Inspection

Name of the organization

Mount Desert Island Hospital

Employer identification number

01-0211797

Part I

Financial Assistance and Certain Other Community Benefits at Cost

Yes

Did the organization have a financial assistance policy during the tax year? If "No," skip to question 6a . . . .

Yes

If "Yes," was it a written policy? ......................

Yes

If the organization had multiple hospital facilities, indicate which of the following best describes application of the financial assistance policy to its various hospital facilities during the tax year.

Applied uniformly to all hospital facilities Applied uniformly to most hospital facilities Generally tailored to individual hospital facilities

Answer the following based on the financial assistance eligibility criteria that applied to the largest number of the organization's patients during the tax year.

Did the organization use Federal Poverty Guidelines (FPG) as a factor in determining eligibility for providing free care?

If "Yes," indicate which of the following was the FPG family income limit for eligibility for free care:

Yes

100% 150% 200% Other %

Did the organization use FPG as a factor in determining eligibility for providing discounted care? If "Yes," indicate

which of the following was the family income limit for eligibility for discounted care: . . . . . . . .

Yes

200% 250% 300% 350% 400% Other %

If the organization used factors other than FPG in determining eligibility, describe in Part VI the criteria used for determining eligibility for free or discounted care. Include in the description whether the organization used an asset test or other threshold, regardless of income, as a factor in determining eligibility for free or discounted care.

Did the organization's financial assistance policy that applied to the largest number of its patients during the tax year provide for free or discounted care to the "medically indigent"? . . . . . . . . . . . . .

Yes

Did the organization budget amounts for free or discounted care provided under its financial assistance policy during
the tax year? . . . . . . . . . . . . . . . . . . . . . . .

Yes

If "Yes," did the organization's financial assistance expenses exceed the budgeted amount? . . . . . .

Yes

If "Yes" to line 5b, as a result of budget considerations, was the organization unable to provide free or discountedcare to a patient who was eligibile for free or discounted care? . . . . . . . . . . . . .

Did the organization prepare a community benefit report during the tax year? . . . . . . . . .

Yes

If "Yes," did the organization make it available to the public? . . . . . . . . . . . . .

Yes

Complete the following table using the worksheets provided in the Schedule H instructions. Do not submit these worksheets with the Schedule H.

Financial Assistance and Certain Other Community Benefits at Cost

Financial Assistance and Means-Tested Government Programs		(c) Total community benefit expense	(d) Direct offsetting revenue	(e) Net community benefit expense	(f) Percent of total expense
a	Financial Assistance at cost (from Worksheet 1) . . .	460,926		460,926	0.540 %
b	Medicaid (from Worksheet 3, column a) . . . . .	9,876,106	8,869,353	1,006,753	1.180 %
c	Costs of other means-tested government programs (from Worksheet 3, column b) . .	18,470,992	14,236,989	4,234,003	4.960 %
d	Total Financial Assistance and Means-Tested Government Programs . . . . .	28,808,024	23,106,342	5,701,682	6.680 %
Other Benefits
e	Community health improvement services and community benefit operations (from Worksheet 4).	2,316,216	171,074	2,145,142	2.510 %
f	Health professions education (from Worksheet 5) . . .	555,524		555,524	0.650 %
g	Subsidized health services (from Worksheet 6) . . . .	12,877,180	8,818,905	4,058,275	4.760 %
h	Research (from Worksheet 7) .
i	Cash and in-kind contributions for community benefit (from Worksheet 8) . . . .	38,000		38,000	0.040 %
j	Total. Other Benefits . .	15,786,920	8,989,979	6,796,941	7.960 %
k	Total. Add lines 7d and 7j .	44,594,944	32,096,321	12,498,623	14.640 %

For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2023

Schedule H (Form 990) 2023

Page

Part II

Community Building Activities Complete this table if the organization conducted any community building activities during the tax year, and describe in Part VI how its community building activities promoted the health of the communities it serves.

		(a) Number of activities or programs (optional)	(b) Persons served (optional)	(c) Total community building expense	(d) Direct offsetting revenue	(e) Net community building expense	(f) Percent of total expense
1	Physical improvements and housing
2	Economic development
3	Community support
4	Environmental improvements
5	Leadership development and training for community members
6	Coalition building
7	Community health improvement advocacy
8	Workforce development
9	Other
10	Total

Part III

Bad Debt, Medicare, & Collection Practices

Section A. Bad Debt Expense

Yes

Did the organization report bad debt expense in accordance with Healthcare Financial Management Association Statement No. 15? ..........................

Yes

Enter the amount of the organization's bad debt expense. Explain in Part VI the methodology used by the organization to estimate this amount. ......

3,511,867

Enter the estimated amount of the organization's bad debt expense attributable to patients eligible under the organization's financial assistance policy. Explain in Part VI the methodology used by the organization to estimate this amount and the rationale, if any, for including this portion of bad debt as community benefit. ......

Provide in Part VI the text of the footnote to the organization’s financial statements that describes bad debt expense or the page number on which this footnote is contained in the attached financial statements.

Section B. Medicare

Enter total revenue received from Medicare (including DSH and IME).....

14,236,989

Enter Medicare allowable costs of care relating to payments on line 5.....

18,470,992

Subtract line 6 from line 5. This is the surplus (or shortfall)........

-4,234,003

Describe in Part VI the extent to which any shortfall reported in line 7 should be treated as community benefit.Also describe in Part VI the costing methodology or source used to determine the amount reported on line 6.Check the box that describes the method used:

Cost accounting system Cost to charge ratio Other

Section C. Collection Practices

Did the organization have a written debt collection policy during the tax year? ..........

Yes

If "Yes," did the organization’s collection policy that applied to the largest number of its patients during the tax year
contain provisions on the collection practices to be followed for patients who are known to qualify for financial assistance? Describe in Part VI .........................

Yes

Part IV

Management Companies and Joint Ventures(owned 10% or more by officers, directors, trustees, key employees, and physicians—see instructions)

(a) Name of entity	(b) Description of primary activity of entity	(c) Organization's profit % or stock ownership %	(d) Officers, directors, trustees, or key employees' profit % or stock ownership %	(e) Physicians' profit % or stock ownership %
1
2
3
4
5
6
7
8
9
10
11
12
13

Schedule H (Form 990) 2023

Page

Part VFacility Information

Section A. Hospital Facilities (list in order of size from largest to smallest—see instructions)How many hospital facilities did the organization operate during the tax year?1Name, address, primary website address, and state license number (and if a group return, the name and EIN of the subordinate hospital organization that operates the hospital facility)
1	Mount Desert Island Hospital 10 Wayman Lane PO Box 8 Bar Harbor,ME045090008 www.mdihospital.org 37457	X	X	X	X

Schedule H (Form 990) 2023

Page 4

Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)

	Mount Desert Island Hospital
Name of hospital facility or letter of facility reporting group

Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A):

Yes

Community Health Needs Assessment

Was the hospital facility first licensed, registered, or similarly recognized by a state as a hospital facility in the current tax year or the immediately preceding tax year?........................

Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C...............

During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 12......................

Yes

If "Yes," indicate what the CHNA report describes (check all that apply):

A definition of the community served by the hospital facility

Demographics of the community

Existing health care facilities and resources within the community that are available to respond to the health needs of the community

How data was obtained

The significant health needs of the community

Primary and chronic disease needs and other health issues of uninsured persons, low-income persons, and minority groups

The process for identifying and prioritizing community health needs and services to meet the community health needs

The process for consulting with persons representing the community’s interests

The impact of any actions taken to address the significant health needs identified in the hospital facility's prior CHNA(s)

Other (describe in Section C)

Indicate the tax year the hospital facility last conducted a CHNA: 20 23

In conducting its most recent CHNA, did the hospital facility take into account input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge of or expertise in public health? If "Yes," describe in Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted .................

Yes

6 a

Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C..................................

Yes

Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................

Yes

Did the hospital facility make its CHNA report widely available to the public?..............

Yes

If "Yes," indicate how the CHNA report was made widely available (check all that apply):

Hospital facility’s website (list url): see Part V, Section C

Other website (list url): see Part V, Section C

Made a paper copy available for public inspection without charge at the hospital facility

Other (describe in Section C)

Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. ..............

Yes

Indicate the tax year the hospital facility last adopted an implementation strategy: 20 23

Is the hospital facility's most recently adopted implementation strategy posted on a website?.........

Yes

If "Yes" (list url): see Part V, Section C

If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ......

10b

Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.

12a

Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)?...............................

12a

If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........

12b

If "Yes" on line 12b, what is the total amount of section 4959 excise tax the organization reported on Form 4720 for all of its hospital facilities? $

Schedule H (Form 990) 2023

Page 5

Part VFacility Information (continued)

Financial Assistance Policy (FAP)

	Mount Desert Island Hospital
Name of hospital facility or letter of facility reporting group

Yes

Did the hospital facility have in place during the tax year a written financial assistance policy that:

Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care?

Yes

If “Yes,” indicate the eligibility criteria explained in the FAP:

Federal poverty guidelines (FPG), with FPG family income limit for eligibility for free care of 150.000000000000%
and FPG family income limit for eligibility for discounted care of 250.000000000000%

Income level other than FPG (describe in Section C)

Asset level

Medical indigency

Insurance status

Underinsurance discount

Residency

Other (describe in Section C)

Explained the basis for calculating amounts charged to patients?.................

Yes

Explained the method for applying for financial assistance?...................

Yes

If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):

Described the information the hospital facility may require an individual to provide as part of his or her application

Described the supporting documentation the hospital facility may require an individual to submit as part of his or
her application

Provided the contact information of hospital facility staff who can provide an individual with information about the
FAP and FAP application process

Provided the contact information of nonprofit organizations or government agencies that may be sources of
assistance with FAP applications

Other (describe in Section C)

Was widely publicized within the community served by the hospital facility?........

Yes

If "Yes," indicate how the hospital facility publicized the policy (check all that apply):

The FAP was widely available on a website (list url):

see Part V, Section C

The FAP application form was widely available on a website (list url):

see Part V, Section C

A plain language summary of the FAP was widely available on a website (list url):
see Part V, Section C

The FAP was available upon request and without charge (in public locations in the hospital facility and by mail)

The FAP application form was available upon request and without charge (in public locations in the hospital facility
and by mail)

A plain language summary of the FAP was available upon request and without charge (in public locations in the
hospital facility and by mail)

Individuals were notified about the FAP by being offered a paper copy of the plain language summary of the FAP, by
receiving a conspicuous written notice about the FAP on their billing statements, and via conspicuous public displays or
other measures reasonably calculated to attract patients' attention

Notified members of the community who are most likely to require financial assistance about availability of the FAP

The FAP, FAP application form, and plain language summary of the FAP were translated into the primary language(s)
spoken by LEP populations

Other (describe in Section C)

Schedule H (Form 990) 2023

Page 6

Part VFacility Information (continued)

Billing and Collections

	Mount Desert Island Hospital
Name of hospital facility or letter of facility reporting group

Yes

Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained all of the actions the hospital facility or other authorized party may take upon nonpayment?..................................

Yes

Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP:

Reporting to credit agency(ies)

Selling an individual’s debt to another party

Deferring, denying, or requiring a payment before providing medically necessary care due to nonpayment of a previous
bill for care covered under the hospital facility's FAP

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

None of these actions or other similar actions were permitted

Did the hospital facility or other authorized party perform any of the following actions during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP?............

If "Yes," check all actions in which the hospital facility or a third party engaged:

Reporting to credit agency(ies)

Selling an individual’s debt to another party

Deferring , denying, or requiring a payment before providing medically necessary care due to nonpayment of a previous
bill for care covered under the hospital facility's FAP

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 19. (check all that apply):

Provided a written notice about upcoming ECAs (Extraordinary Collection Action) and a plain language summary of the
FAP at least 30 days before initiating those ECAs (if not, describe in Section C)

Made a reasonable effort to orally notify individuals about the FAP and FAP application process (if not, describe in
Section C)

Processed incomplete and complete FAP applications (if not, describe in Section C)

Made presumptive eligibility determinations (if not, describe in Section C)

Other (describe in Section C)

None of these efforts were made

Policy Relating to Emergency Medical Care

Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?..................

Yes

If "No," indicate why:

The hospital facility did not provide care for any emergency medical conditions

The hospital facility’s policy was not in writing

The hospital facility limited who was eligible to receive care for emergency medical conditions (describe in Section C)

Other (describe in Section C)

Schedule H (Form 990) 2023

Page 7

Part VFacility Information (continued)

Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)

	Mount Desert Island Hospital
Name of hospital facility or letter of facility reporting group

Yes

Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.

The hospital facility used a look-back method based on claims allowed by Medicare fee-for-service during a prior 12-month period

The hospital facility used a look-back method based on claims allowed by Medicare fee-for-service and all private health insurers that pay claims to the hospital facility during a prior 12-month period

The hospital facility used a look-back method based on claims allowed by Medicaid, either alone or in combination with
Medicare fee-for-service and all private health insurers that pay claims to the hospital facility during a prior 12-month
period

The hospital facility used a prospective Medicare or Medicaid method

During the tax year, did the hospital facility charge any FAP-eligible individual to whom the hospital facility provided emergency or other medically necessary services more than the amounts generally billed to individuals who had insurance covering such care? ...............................

If "Yes," explain in Section C.

During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? ...........................

If "Yes," explain in Section C.

Schedule H (Form 990) 2023

Page 8

Part V

Facility Information (continued)

Section C. Supplemental Information for Part V, Section B. Provide descriptions required for Part V, Section B, lines 2, 3j, 5, 6a, 6b, 7d, 11, 13b, 13h, 15e, 16j, 18e, 19e, 20a, 20b, 20c, 20d, 20e, 21c, 21d, 23, and 24. If applicable, provide separate descriptions for each hospital facility in a facility reporting group, designated by facility reporting group letter and hospital facility line number from Part V, Section A (“A, 1,” “A, 4,” “B, 2,” “B, 3,” etc.) and name of hospital facility.
Form and Line Reference	Explanation
Mount Desert Island Hospital	Part V, Section B, Line 5: The 2023 Community Health Needs Assessment (CHNA), covering the fiscal years ending 2024-2026, was conducted by Mount Desert Island Hospital in coordination with Healthy Acadia. In keeping with previous versions, our 2023-2024 CHNA process relied on the nationally-vetted Mobilizing for Action through Planning and Partnerships (MAPP) process and tools developed and published by the National Association of County and City Health Officers (NACCHO). In gathering information to complete this CHNA, the organizations conducted surveys, public discussion forums, and focus groups with community members, institutions, and partners. The organizations also used data analytic tools and census reports to ensure that the CHNA reached a large and representative portion of the community. For additional information, please refer to the supplemental information disclosed on this Form 990, Schedule H, Part VI, Line 2, as well as the full CHNA.
Mount Desert Island Hospital	Part V, Section B, Line 6a: The 2023 Community Health Needs Assessment (CHNA), covering the fiscal years ending 2024-2026, was conducted by Mount Desert Island Hospital in coordination with Healthy Acadia, a 501(c)(3) non-profit organization dedicated to building healthy communities. However, many other individuals and organizations contributed to the 2024-2026 needs assessment, a full list of which can be found on the Hospital's complete CHNA, beginning on page 7.
Mount Desert Island Hospital	Part V, Section B, Line 6b: The 2023 Community Health Needs Assessment (CHNA), covering the fiscal years ending 2024-2026, was conducted by Mount Desert Island Hospital in coordination with Healthy Acadia, a 501(c)(3) non-profit organization dedicated to building healthy communities. However, many other individuals and organizations contributed to the 2024-2026 needs assessment, a full list of which can be found on the Hospital's complete CHNA, beginning on page 7.
Mount Desert Island Hospital	Part V, Section B, Line 11: The Hospital's 2023 CHNA Action Plan identified a series of core health needs, labeled as "Themes", and a variety of strategies to address each of these needs in a way that would be most efficient and effective for the community served by the Hospital. These themes were then later explored and discussed in the Hospital's Initial Implementation Plan which was approved by the Hospital's Board by August 2, 2024.The primary "Theme Areas" identified in the CHNA and its Action Plan were: 1. Access to Care 2. Aging in Place 3. Basic Needs 4. Community Connected 5. Housing 6. Mental and Behavioral HealthThrough the CHNA and its Action plan, across these six themes, multiple goals and strategies arose that are relevant in all areas and to addressing the significant needs identified in the CHNA.Goal 1: Improve knowledge of and communication about existing resources and services.Goal 1 Strategies: - Connect with local websites and social media platforms such as the local Facebook group Bar Harbor Barter & Swap. - Conduct public talks and/or community forums. - Use traditional and social media, including newspapers, newsletters, flyers, television, radio, podcasts, Facebook, Twitter, and Instagram to increase awareness. - Leverage or create community bulletin boards at locations frequented by many people in regular travels, such as food shops, banks and restaurants, post offices, libraries, schools, banks, laundromats, and gyms. - Coordinate with 211 to maximize the effectiveness of that tool for finding services in the LSA. - Promote use of 211 as a resource. - Explore the "Bundle" smart phone app that Heart of Maine United Way developed for Piscataquis County as a model.Goal 2: Offer free support to access and enroll in existing services and programs.Goal 2 Strategies: - Expand and better coordinate navigator programs. - Design programs and recruit volunteers to help people understand and apply for existing programs. - Coordinate to promote and publicize existing programs and services. - Engage those outside the health and social services sectors, such as the business community, schools, faith-based organizations, libraries, and first-responders, to help publicize options and where to find help in accessing services. - Expand online and social media avenues for learning about and accessing services.Goal 3: Improve coordination of existing services.Goal 3 Strategies: - Hold monthly breakfasts or informal meetings for non-profit staff and other interested parties to network, share information, and plan ways of coordinating activities and improving ability to refer people to other options. - Create systems for a "warm hand-off" between services, both clinical and social. - Leverage town office staff and connect with town select boards and comprehensive planning efforts to promote LSA-wide ongoing communication and joint planning. - Explore Washington County's "The Connection Initiative" sponsored by the Community Caring CollaborativeGoal 4: Improve wireless and telecommunication services and expand broadband capacity in ways that will support telehealth, help attract and retain employees, and foster overall economic growth and remote work opportunities in the LSA.Goal 4 Strategies: - Investigate opportunities through Connectivity Maine. - Engage the business community in solutions. - Research state, federal, and philanthropic grant opportunities. - Leverage the services offered by libraries and schools. - Design systems and options for affordable access for low and limited income residents. - Collaborate with libraries and other community centers to offer computer literacy programs and trainings.Goal 5: Improve transportation options.Goal 5 Strategies: - Focus on connectivity and coordination with services and social/community engagement opportunities. - Promote and publicize existing public transportation services, such as Island Connections, the Island Explorer, and transportation resources through MDIH and insurance designed to access health care. - Encourage existing transportation resources to collaborate to promote easy access, such as publicity and coordinating their trip schedules. - Prioritize needs of people without access to a motor vehicle, including older residents, low-income residents, and children. - Explore creating a "water taxi" program to the unbridged islands as a lower cost alternative to the ferries; perhaps identify someone willing to donate a used lobster boat that can be retrofitted for passenger seating as the vehicle. - Improve pedestrian and bicycle lanes for transportation and physical activity options. - Encourage car-pooling and other alternative modes of transportation. - Leverage the opening of the new Acadia Gateway Center for proactive work that will increase public transportation, rideshare, and parking options.Additional information regarding the health need themes, goals, and strategies can be found in the full CHNA and Action Plan.
Mount Desert Island Hospital	Part V, Section B, Line 16j: The policy was provided, in writing, to patients on admission to the Hospital facility.The Hospital works with community service organizations to post the Plain Language Summary in public libraries, local municipality facilities, the local YMCA/YWCA, and the Healthy Acadia website.Additionally, a qualified interpreter is made available to patients who need assistance translating the FAP, application, and related documents to another language, and translated copies of our Financial Assistance Policy and Application are available in French and Spanish.
Part V, Section B, Lines 7a, 7b, and 10, Publication of Reports:	The Hospital makes its annual reports and other various resources and publications publicly available on its website. The home page for the Hospital's various reports can be found online at:https://www.mdihospital.org/about-us/reports-resources/Prior year Community Health Needs Assessments, Implementation Plans, and other benefits reports may also be found on the Hospital's website at the link provided above.The Hospital's 2020 Implemenation Plan can be downloaded directly from the previous link as a Word Document. The Action Plan proposed with the 2024-2026 CHNA can be found within the full 2024-2026 CHNA document. The 2024-2026 Initial Implementation Plan may be found at the following website:https://www.mdihospital.org/wp-content/uploads/2025/02/MDIH-Community-Health-Needs-Assessment-2024-2026-PC-BOT-Approved-8.2.2024.pdfThe Hospital's 2024-2026 Community Health Needs Assessment (CHNA) is freely available online on the Hospital's website at:https://www.mdihospital.org/wp-content/uploads/\2025/02/2024-MDI-Region-CHNA-Action-Plan-FINAL-REPORT-5.1.2024.pdfThe Hospital's 2024-2026 CHNA can also be found online at:https://static1.squarespace.com/static/5d5fec1f2b3df90001522875/t/663ae39d3e53895271fe7e17/1715135395937/2024+MDI+Region+CHNA+Action+Plan+(2).pdfThe Hospital's Community Benefits Report for the year ending April 2023 is available online at:https://www.mdihospital.org/wp-content/uploads/2023/12/Community-Benefits-Report-FY23-web.pdfLastly, the Hospital's Impact Report for the year ending April 2024 is available online at:https://www.mdihospital.org/wp-content/uploads/2024/10/MDI-Hospital-Impact-Report-2024-webupdateOct2.pdf
Schedule H, Part V, Section B, Line 16a-16c:	The Hospital's Financial Assistance Program and related information can be found online at:https://www.mdihospital.org/insurance-and-billing/financialassistance/The Hospital's free care/reduced cost application is available online at:https://www.mdihospital.org/wp-content/uploads/2021/07/MDIH-FA-FORM-2019-1.pdfThe Hospital also provides checklist and guides to accompany its financial assistance application process, available online at:https://www.mdihospital.org/insurance-and-billing-faqs/financial-assistance-application-checklist/The Hospital's Financial Assistance Plain Language Summary is available online at:https://www.mdihospital.org/wp-content/uploads/2019/05/Plain-Language-Summary-of-Financial-Assistance-Program-1557-revised-02-2020.pdfLastly, the Hospital's complete Financial Assistance Policy is available online at:https://www.mdihospital.org/wp-content/uploads/2019/10/MDIH-Finance-Assistance-and-Free-Care-Policy-Approved-FC-2-24-2020.pdf
Schedule H, Part V, Section B, Line 20d:	MDI Hospital does not assume or engage in presumptive eligibility in assessing financial assistance or government assistance. However, any individual residing in the State of Maine who indicates the financial inability to pay a bill for a medically necessary service shall be evaluated for Financial Assistance. The patient's potential eligibility for governmental or other coverage will be assessed. This may include Medicaid and participation in Health Insurance Exchange coverage and subsidies. Additionally, a Financial Assistance Application/Disclosure Form is used to document each patient's overall financial situation. Credit reports may be used to verify the individual's financial circumstances. If an engaged collection agency suspects or gains knowledge that someone may need to apply for one of our programs, the agency sends out a financial assistance application to the patient or guarantor and proceeds to notify MDIH of the outreach. Accordingly, each collection agency engaged is aware of the policy on Financial Assistance. This allows the agency to report amounts that they have determined to be uncollectible due to the inability to pay in accordance with the Financial Assistance eligibility guidelines.

Schedule H (Form 990) 2023

Page 9

Part VFacility Information (continued)

Section D. Other Health Care Facilities That Are Not Licensed, Registered, or Similarly Recognized as a Hospital Facility (list in order of size, from largest to smallest) How many non-hospital health care facilities did the organization operate during the tax year?10
Name and address		Type of Facility (describe)
1	1 - Cadillac Family Practice 322 Main Street Bar Harbor,ME04609	Outpatient Clinic
2	2 - Community Health Center 16 Community Lane Southwest Harbor,ME04679	Outpatient Clinic
3	3 - Trenton Health Center 394 Bar Harbor Road Trenton,ME04605	Outpatient Clinic
4	4 - Cooper Gilmore Health Center 17 Hancock Street Bar Harbor,ME04609	Outpatient Clinic
5	5 - MDI Behavioral Health Center 322 Main Street Bar Harbor,ME04609	Outpatient Clinic
6	6 - MDI General Surgery 17 Hancock Street Bar Harbor,ME04609	Outpatient Clinic
7	7 - Lisa Stewart Women's Health Center 330 Main Street Bar Harbor,ME04609	Outpatient Clinic
8	8 - MDI Orthopedics 10 Wayman Lane Bar Harbor,ME04609	Outpatient Clinic
9	9 - MDI Urology 10 Wayman Lane Bar Harbor,ME04609	Outpatient Clinic
10	10 - Northeast Harbor Health Center Kimball Road Northeast Harbor,ME04679	Outpatient Clinic

Schedule H (Form 990) 2023

Page 10

Part VI

Supplemental Information

Provide the following information.

1	Required descriptions. Provide the descriptions required for Part I, lines 3c, 6a, and 7; Part II and Part III, lines 2, 3, 4, 8 and 9b.
2	Needs assessment. Describe how the organization assesses the health care needs of the communities it serves, in addition to any CHNAs reported in Part V, Section B.
3	Patient education of eligibility for assistance. Describe how the organization informs and educates patients and persons who may be billed for patient care about their eligibility for assistance under federal, state, or local government programs or under the organization’s financial assistance policy.
4	Community information. Describe the community the organization serves, taking into account the geographic area and demographic constituents it serves.
5	Promotion of community health. Provide any other information important to describing how the organization’s hospital facilities or other health care facilities further its exempt purpose by promoting the health of the community (e.g., open medical staff, community board, use of surplus funds, etc.).
6	Affiliated health care system. If the organization is part of an affiliated health care system, describe the respective roles of the organization and its affiliates in promoting the health of the communities served.
7	State filing of community benefit report. If applicable, identify all states with which the organization, or a related organization, files a community benefit report.

Form and Line Reference	Explanation
Part I, Line 7:	The costing methodology utilized for this table was derived from Worksheet 2, ratio of patient care cost to charges with data from filed cost reports for the fiscal year.
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.
Part I, Line 7, Column (f):	The Bad Debt expense included on Form 990, Part IX, Line 25, Column (A), but subtracted for purposes of calculating the percentage in this column is $ 5,881,991.
Part II, Community Building Activities:	Beyond being a hub of health and care services in the Downeast Region of Maine, Mount Desert Island Hospital engages in multiple community building activities that promote the overall health and wellbeing of the communities it serves.Volunteerism:In a time of social isolation and a loneliness epidemic, the Hospital fosters multiple programs and initiatives that promote collaboration, connection, citizenship, philanthropy, and the common good of the community. The volunteers who donate their time to MDI Hospital, our Health Centers, and Birch Bay Retirement Village play an important role in the experience of our patients, families, and residents. They work alongside healthcare professionals, help in clinical and non-clinical areas, and support our mission to care for our community. Volunteer opportunities through the Hospital include nutrition services; emergency department; nursing department; materials management, and medical and administrative services. MDI Hospital Auxiliary:Beyond directly volunteering to facilitate hospital services, the MDI Hospital Auxiliary Program has for decades provided an opportunity for the Hospital and the community to meet, collaborate, and improve the health of the region together. This volunteer group is comprised of community members, Hospital employees and retirees. Auxiliary members devote many hours each year to various fundraising efforts including their annual auction and raffle, bakes sales, and jewelry sales. The MDI Hospital Auxiliary acts as a liaison between MDI Hospital and the local. Community members organize events and volunteer their time and skills to raise financial support for a variety of needs around MDI Hospital. Members support our annual fundraising efforts through volunteering at various events, baking delicious treats and serving as ambassadors for the Hospital. These efforts help to provide important philanthropic support for needed programs and services.Community Health Education:Mount Desert Island Hospital dedicates significant time and resources to providing a wide array of community engagement and health education programs, designed to improve the general health literacy and day-to-day wellbeing of persons living and working in the community served by the Hospital. Classes and resources offered by the Hospital for community health programs cover the following topics: childbirth and child support; diabetes education; general wellness, fitness, and healthy living; tobacco, drug, and alcohol avoidance programs; nutritional education; affordable care act and patient rights education; and "Serv Safe" courses for restaurant and food establishments.Social Services:The Hospital understands that health resources available at home is just as important as the health care received at a hospital. To that end, Social Services at MDI Hospital serve many important roles in delivery and management of care in our organization and beyond. Our goal is to provide compassionate, professional, confidential support for people suffering from mental health and substance abuse issues. As a liaison between the Hospital and MDI Behavioral Health Center, Clinical Social Work professionals facilitate scheduling of therapy, substance abuse services, outpatient psychiatric consultations, and prescription of medications as needed. We also help coordinate psychiatric admissions, gather information for psychiatric consultations, and provide counseling support. As part of the Care Management Team, our staff meets with Hospital patients to address mental health needs and provide patients with information about available resources. In addition, we offer guidance for families of Hospital patients regarding coping with the health of loved ones, discharge planning, and accessing services like prescription assistance. Our staff also coordinates with providers and services outside MDI Hospital's system to ensure a smooth transition for our patients. Our Social Services staff is also involved in facilitation of a free support group for cancer survivors and employee wellness programs for local employees of MDI Hospital and other local employers.Community Partnerships:Mount Desert Island Hospital understands that its community is composed of a wide variety or stakeholders, individuals, businesses, and cultural groups. To facilitate the wellbeing of this broad collection of personalities and backgrounds, the Hospital routinely collaborates with community partners, government agencies, or other charitable organizations to bolster and improve the health of its community. For example, the Hospital coordinates services and resources with food and clothing banks to address food insecurity. The Hospital also collaborates with local businesses to secure fundraising and grant opportunities, and to help spread health education and healthy lifestyle literature throughout the local service area.
Part III, Line 2:	The estimated cost of bad debt expense as reported is derived from the accounting systems and software the organization uses to calculate the cost-to-charge ratio from the as-filed Medicare Cost Reports.Mount Desert Island Hospital (MDI Hospital) estimates the cost of bad debt expense using accounting systems and software from our organization to calculate the cost of care from the as filed Medicare Cost Reports. This estimate best represents the value of providing care for those services that will be considered or deemed uncollectible. The value of these services at cost is estimated to be $3,511,867. This is the amount the Hospital must forgive as a benefit to the community for providing services.
Part III, Line 3:	The Hospital's financial assistance policy provides administrative and accounting guidelines for the identification, classification, and reporting of patients receiving financial assistance as distinguished from bad debts. Accordingly, the Hospital has estimated that no amount of bad debt expense at cost is attributable to patients eligible under the organization's financial assistance policy.
Part III, Line 4:	See Footnote 2 of the attached audited financial statements.
Part III, Line 8:	The IRS Form 990, Schedule H instructions and guidance provide a template in Worksheet 2 as a way to determine the overall cost to charge ratio that could be applied throughout Schedule H 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 Schedule H, Part III, Section B, Line 6, Medicare allowable costs and payments related to the subsidized health services. Instead, the Hospital utilized the Medicare Cost Report estimated cost and payment for these services. The Hospital believes that provider-based clinics listed in the Cost Report should be 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 45 minutes or more to the nearest similar hospital. As such, Mount Desert Island Hospital believes that by offering and subsidizing these clinics within its community, thus enabling community members to have easy access and an easier commute for these services, the entire community at large benefits.Additionally, the Hospital has elected to treat its Medicare Shortfall as Costs of Other Means Tested Government Programs, as reported on this Form 990, Schedule H, Part I, Line 7c. Mount Desert Island Hospital has determined that, in accordance with publications issued by the American Hospital Association and other industry associations, that this Medicare Shortfall should represent a net community benefit. The Hospital considers such net Medicare benefits to be substantially equivalent to a government health program for which eligibility depends on the recipient's income or assets. Additionally, given the shortfall reported on this Schedule H, Part I and III (Medicare revenues are only 77% of Medicare costs), it seems to the Hospital that Medicare reimbursement rates and other related revenues do not represent the true cost to the Hospital of treating Medicare patients. Furthermore, by treating patients eligible for Medicare at a net shortfall, the Hospital alleviates the Federal government's burden to directly provide medical or other care services. As the Hospital provides patient services to those eligible for Medicare benefits, this is also an indication of increased services to promote the overall health of the Hospital's surrounding community; as the Hospital operates in a rural region of its State, and as the State of Maine as a whole has a rapidly aging median age and has one of the oldest average ages in the United States, treating Medicare-eligible patients is critical to providing care to the Hospital's community.
Part III, 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 his or her obligation under a mutually agreed upon payment arrangement. After it was determined that the patient did not qualify for a readjustment to his or her payment terms, the Hospital would follow normal notification practices dictated by our collection policy, which follows the 501(r) regulations. Upon the qualifying defaults a patient's account may result in collection efforts. If the collection agency suspects or gains knowledge that someone may need to apply for one of the programs, the agency sends out a financial assistance application to the patient or guarantor and proceeds to notify MDIH of the outreach. Information about our free and sliding scale programs is on our website, on our account statements, and posted in public areas and at our provider clinics. Our Plain Language Summary is posted within our community as well. We also make available a Patient Financial Counselor to help advocate, assist and navigate the process.
Part VI, Line 2:	The 2023 Community Health Needs Assessment (CHNA), covering the fiscal years ending 2024-2026, was conducted by Mount Desert Island Hospital in coordination with Healthy Acadia. In keeping with previous versions, our 2023-2024 CHNA process relied on the nationally-vetted Mobilizing for Action through Planning and Partnerships (MAPP) process and tools developed and published by the National Association of County and City Health Officers (NACCHO). MAPP outlines a four-step assessment process intended to take two years. We modified the process in accordance with the characteristics and small population size of our rural region and our six-month timeline.To start, we convened a Steering Committee to help guide and advise the project. The Steering Committee was composed of leaders from organizations across the MDI region who reflect various perspectives and sectors.As part of the four-step MAPP process, we developed and fielded two surveys: 1. Community Partner Survey 2. Community Health SurveyThrough these surveys, available in both English and Spanish, thousands of community members were invited to answer questions and share their personal perceptions about the health of the community. Dozens of community partners, including Steering Committee members helped publicize and disseminate the survey widely in the region through various modalities, including social media sites, organization's electronic and print newsletters, and posters with a QR code and phone number to request a paper survey at locations including town offices, libraries, gyms, community centers and faith organizations.Additionally, starting in September 2023, community interviews and group discussions were regularly conducted to gather insight, data, and information from the community regarding their health priorities and concerns. These topics were then further scrutinized in themed working groups, and the committees leading the health assessments solicited feedback on their reports to ensure the documents accurately summarized the perspectives and experiences of the community. The CHNA generated responses from community members living, working, playing, and/or receiving services in the local service area ("LSA"). The resulting data were analyzed, organized, and used to identify and frame our six themes further explored and discussed in the full CHNA.Through the survey process, significant efforts were made to ensure that respondents matched the LSA population and recognized data collection norms. This was fulfilled through a diverse survey dissemination effort and frequent evaluation of respondent demographics. Data on town, gender, age, race and ethnicity, household income, and healthcare payment methods were collected. In response to recommendations in the 2020 CHNA report, special considerations and strategic outreach was focused to ensure participation among community members who are traditionally underrepresented in these types of surveys, including people who have low incomes, identify as Black, Indigenous, and people of color (BIPOC), identify as lesbian, gay, bisexual, pansexual, transgender, genderqueer, queer, intersexed, agender, asexual (LGBTQIA+), disabled or having disabilities, essential workers, unemployed and underemployed individuals, and seasonal residents. In response to recommendations in the 2020 CHNA Report, we added features to the demographic data collection: (1) income data; (2) actual name of the town rather than zip code for greater specificity; and (3) expansion of the question "How do you pay for healthcare?" to clarify data on employer-provided, personally purchased, and various types of government-sponsored insurance. A high number of survey responses is always desirable, of course. CHNA Coordinators and Steering Committee Members are pleased that with a population of 15,000 in our LSA, we heard from a large and representative group of community members with varied interests and opinions regarding the health of their communities, where strengths and challenges exist, and what priorities they would like addressed.We also conducted a review of relevant literature and existing data, such as those published by the U.S. Census Bureau and the Maine Center for Disease Control and Prevention, and as framed within the context of 2023 U.S. Census Bureau data. The combined process led to identifying six major themes and a working group was convened to address each of these themes. People with expertise in these areas as well as members of the general public were invited to join a working group to be sure the compositions included myriad perspectives and passions. The six themes are 1) Access to Care; 2) Aging in Place; 3) Basic Needs; 4) Community Connectedness; 5) Housing; and 6) Mental and Behavioral Health, including Substance Use. The working groups helped delineate strengths, challenges, goals and strategies within each theme.
Part VI, Line 3:	The Financial Assistance Policy (FAP) information is sent with all account statements and is printed on the back of the statement. A notice of the FAP in plain language is also available on our Hospital website, posted in public areas, and available within the departments and provider clinics of our organization. The Hospital provides a Patient Financial Counselor to help navigate the process to ensure that our patients have access to the care and services they need. MDI Hospital 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, regardless of their ability to pay. We assist our patients who cannot afford to pay for part or all of the services received by working with our community to identify those in need and find the financial resources that may be made available to them. MDI Hospital has adopted guiding principles when handling billing, collections, and financial support functions for our patients. We provide effective communications with patients regarding hospital bills and make affirmative efforts to help patients apply for public and private financial support programs, including providing resources to perform the application process on behalf of the patient. We have implemented policies and procedures for assisting low-income patients in a consistent manner that is in compliance with the State of Maine Chapter 150 Guidelines for Free and Reduced Care. These policies are reviewed by the Finance Committee of the Board of Trustees at a minimum annually, or as deemed necessary. The adjustment for Amounts Generally Billed is made annually after the acceptance of MDI Hospital's Medicare Cost Report by the regional Fiscal Intermediary (MAC). A Patient Financial Counselor is also 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. We also have a Patient Advocate to facilitate issues that arise during this process. Information about Hospital-based financial support polices and external support programs that provide coverage for services is 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 MDI Hospital, including contact information, is available through messaging included on patient bills, at provider clinics, in public areas, through care management and billing support staff, in registration areas, and at the reception areas in the Hospital and at our provider clinics. Patient brochures describing the financial counseling services, our financial assistance policies, financial assistance application, and the applicable services which are available in these areas as well as on our public website, www.mdihospital.org. The annual review of these policies is done through the Board Appointed Finance Committee.
Part VI, Line 4:	Mount Desert Island Hospital serves the Mount Desert Island region local service area, which includes the towns of Bar Harbor, Cranberry Isles, Frenchboro, Hancock, Lamoine, Mount Desert, Southwest Harbor, Swan's Island, Tremont, and Trenton, all of which are located in the Downeast and Acadia Region of the State of Maine, specifically Hancock County.In 2020, the population of Hancock County totaled 55,478, an increase of 2 percent or 1,060 since 2010, according to U.S. Census Bureau data. The population for the ten towns in the LSA was approximately 15,000 in 2023. The LSA includes three municipalities on unbridged islands: Cranberry Isles, Frenchboro, and Swans Island.Census Bureau 2020 data related to health status show Hancock County with demographics that suggest complex and high-usage health-related needs. For example, Maine has the oldest population in the United States and Hancock County has a greater than average number of older adults compared to the overall population in Maine. The County's median age is 48.9 years compared to 45.1 years for Maine. In other words, Maine has the oldest population in the nation and Hancock County is the third oldest county in Maine. The percentage of Hancock County adults over age 65 is 25.7% compared to 22.6% in Maine.Adults in Hancock County without health coverage total 10.2% compared to the statewide average of 6.6%. Hancock County's poverty rate of 10.9% is slightly higher than for all of Maine at 10.8%. Household income parallels those comparisons with a median of $64,149 in Hancock County and $69,543 statewide. Regarding access to services, 2020 Census data reveal limitations on access compared to other areas in Maine. For example, Hancock County has one primary care provider per 950 residents, while Maine overall has one provider per 930 residents. The results for dentists are more dramatic with one dentist per 2030 residents in Hancock County and one for every 1401 residents statewide. According to the Maine Department of Labor, Hancock County unemployment levels are higher than the statewide average, 6% unemployment in Hancock County, compared to 4.5% statewide. Hancock County has the third highest unemployment rate in the State, just below Washington and Piscatquis counties. Seasonal fluctuations in employment are significant and complicate the County and local data because two of the most substantial portions of the economy are highly seasonal - tourism and the fishing industries.
Part VI, Line 5:	Mount Desert Island Hospital serves a close-knit island and surrounding communities through a 25-bed critical access facility in Bar Harbor and a network of area health centers-all designed to provide comprehensive healthcare for residents and visitors. Since it was established in 1897, the nonprofit hospital has grown into a premier rural healthcare organization with a retirement community and six primary care health centers, as well as a full-service behavioral health center and a dental clinic.Today, MDI Hospital employs more than 500 people and is the second-largest employer on Mount Desert Island. Our active medical staff includes hospitalists, primary care physicians and practitioners, highly skilled nurses, orthopedic surgeons, general surgeons, psychiatrists, care managers, a board-certified emergency physician, an oncologist, an ophthalmologist, a pathologist, a radiologist, and a urologist.MDI Hospital's groundbreaking teaching partnership with Penn Medicine, established in 2011, has evolved into a model for future urban-rural partnerships across the nation and has established MDI Hospital as a premier rural hospital for emergency medicine and critical care. The hospital's Emergency Department, a critical link in Downeast Maine's trauma delivery system, serves the Mount Desert Island community 24 hours a day, 365 days a year.MDI Hospital received a five-star rating, the highest awarded, from the Centers for Medicare and Medicaid Services in 2020. In addition, the organization's inpatient, outpatient, emergency and surgical care services have been consistently recognized by Avatar International, the Leapfrog Group, the National Rural Health Association, Harvard Pilgrim and Healthgrades.At MDI Hospital and Health Centers, we are dedicated to providing compassionate, high-quality healthcare to every patient who walks through our doors. As an independent, nonprofit critical access health system, we serve our community with respect, dignity, and care-welcoming all individuals, regardless of background, circumstances, or ability to pay.MDI Hospital also serves as a critical education center for the future of the State's healthcare profession, providing technical and professional educational opportunities in a rural health care setting. The Hospital offers multiple programs and incentives to ensure that its community continues to attract and retain health service professionals, which in turn helps protect the viability and future wellbeing of the community. As a Hospital and Health Center serving a rural part of the State, the Hospital ensures it can provide a comprehensive line of services that, were it not for Mount Desert Island Hospital, would not be available in the Downeast Region. Such services include: Adult Day Programs; Anticoagulation Clinics; Behavioral Health services; Breast Health services; Cancer Patient Navigator programs; Cardiac Rehabilitation services; Cardiology services; Cardiopulmonary services; Care Management; Critical Care/ICU access; Dental/Oral Health services; Diabetes Education; Elder Care; Emergency Department access; Family Medicine; Health Coaching; Laboratory services; Medical Imaging; Music Therapy; Nursing; Nutrition Counseling; Obstetrics; Occupational Medicine; Oncology & Hematology services ; Ophthalmology services; Orthopedics services; Palliative Care; Platelet-Rich Plasma Therapy; Pediatric services; Pharmacy access; Physical Medicine; Physical Therapy; Prescription Assistance; Primary Care services; Pulmonology services; Short Term Rehab; Speech Therapy; Sports Medicine; Surgery and Surgical Centers; Urogynecology services; Urology services; Weekend Care Clinic access; and Women's Health.The Hospital openly and directly shares information with its patients regarding pricing, care options, and health logistics to assist patients in navigating what health and care options fits their needs and lifestyle most appropriately. The Hospital also routinely gathers information about its community's needs via volunteer programs, community assessments, and patient surveys. The Hospital is also managed by an Independent Board of Directors made up of members of the community with a vested interest in seeing the health and wellbeing of the Downeast Region improve and prosper.
Part VI, Line 6:	Mount Desert Island Hospital is not part of an affiliated health care system.
Part VI, Line 7, Reports Filed With States	ME

Schedule H (Form 990) 2023

Additional Data

Software ID:
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Note: To capture the full content of this document, please select landscape mode (11" x 8.5") when printing.

Schedule I
(Form 990)

Department of the Treasury
Internal Revenue Service

Grants and Other Assistance to Organizations,
Governments and Individuals in the United States

Complete if the organization answered "Yes," on Form 990, Part IV, line 21 or 22.
lBullet

Attach to Form 990.
lBullet

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2023

Open to Public
Inspection

Name of the organization
Mount Desert Island Hospital

Employer identification number
01-0211797

Part I

General Information on Grants and Assistance

Does the organization maintain records to substantiate the amount of the grants or assistance, the grantees' eligibility for the grants or assistance, and
the selection criteria used to award the grants or assistance? ........................

Yes No

Describe in Part IV the organization's procedures for monitoring the use of grant funds in the United States.

Part II

Grants and Other Assistance to Domestic Organizations and Domestic Governments. Complete if the organization answered "Yes" on Form 990, Part IV, line 21, for any recipient

that received more than $5,000. Part II can be duplicated if additional space is needed.

(a) Name and address of organization or government	(b) EIN	(c) IRC section (if applicable)	(d) Amount of cash grant	(e) Amount of non-cash assistance	(f) Method of valuation (book, FMV, appraisal, other)	(g) Description of noncash assistance	(h) Purpose of grant or assistance
(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
(10)
(11)
(12)

Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ................. Bullet Image

Enter total number of other organizations listed in the line 1 table ........................ . Bullet Image

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50055P

Schedule I (Form 990) 2023

Page 2

Part III

Grants and Other Assistance to Domestic Individuals. Complete if the organization answered "Yes" on Form 990, Part IV, line 22.
Part III can be duplicated if additional space is needed.

(a) Type of grant or assistance	(b) Number of recipients	(c) Amount of cash grant	(d) Amount of noncash assistance	(e) Method of valuation (book, FMV, appraisal, other)	(f) Description of noncash assistance

(1) Scholarships for students pursuing a degree in medical or healthcare-related fields	14	37,500
(1)
(2)
(3)
(4)
(5)
(6)
(7)

Part IV

Supplemental Information. Provide the information required in Part I, line 2; Part III, column (b); and any other additional information.

Return Reference

Explanation

Part I, Line 2:

All high school seniors who are graduates of MDI High School and who are committed to pursuing a degree and career in medical and healthcare services are considered eligible. Potential applicants must work with their school's guidance office to prepare and submit an application to the Hospital on behalf of the Auxiliary Scholarship Committee (the "ASC"). After determining the number of eligible applications and the amount of funds available from available funds, the ASC will determine the amount of scholarships that can be awarded in a given year. A chosen scholarship-recipient may be awarded a grant for multiple years so long as the recipient continues to meet predefined criteria. Separate and unique books and records are maintained to substantiate and track all scholarships awarded and to ensure they are used for their intended purpose.

Schedule I (Form 990) 2023

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Schedule J
(Form 990)

Department of the Treasury
Internal Revenue Service

Compensation Information

For certain Officers, Directors, Trustees, Key Employees, and Highest
Compensated Employees
medium right arrow graphic

Complete if the organization answered "Yes" on Form 990, Part IV, line 23.
medium right arrow graphic

Attach to Form 990.
medium right arrow graphic

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2023

Open to Public Inspection

Name of the organization

Mount Desert Island Hospital

Employer identification number

01-0211797

Part I

Questions Regarding Compensation

Yes

Check the appropiate box(es) if the organization provided any of the following to or for a person listed on Form
990, Part VII, Section A, line 1a. Complete Part III to provide any relevant information regarding these items.

First-class or charter travel Housing allowance or residence for personal use

Travel for companions Payments for business use of personal residence

Tax idemnification and gross-up payments Health or social club dues or initiation fees

Discretionary spending account Personal services (e.g., maid, chauffeur, chef)

If any of the boxes on Line 1a are checked, did the organization follow a written policy regarding payment or reimbursement or provision of all of the expenses described above? If "No," complete Part III to explain .....

Did the organization require substantiation prior to reimbursing or allowing expenses incurred by all
directors, trustees, officers, including the CEO/Executive Director, regarding the items checked on Line 1a? ....

Yes

Indicate which, if any, of the following the filing organization used to establish the compensation of the
organization's CEO/Executive Director. Check all that apply. Do not check any boxes for methods
used by a related organization to establish compensation of the CEO/Executive Director, but explain in Part III.

Compensation committee Written employment contract

Independent compensation consultant Compensation survey or study

Form 990 of other organizations Approval by the board or compensation committee

During the year, did any person listed on Form 990, Part VII, Section A, line 1a, with respect to the filing organization or a related organization:

Receive a severance payment or change-of-control payment? .............

Participate in, or receive payment from, a supplemental nonqualified retirement plan? .........

Participate in, or receive payment from, an equity-based compensation arrangement? .........

If "Yes" to any of lines 4a-c, list the persons and provide the applicable amounts for each item in Part III.

Only 501(c)(3), 501(c)(4), and 501(c)(29) organizations must complete lines 5-9.

For persons listed on Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the revenues of:

The organization? ....................

Any related organization? .......................

If "Yes," on line 5a or 5b, describe in Part III.

For persons listed on Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the net earnings of:

The organization? ..................

Any related organization? ......................

If "Yes," on line 6a or 6b, describe in Part III.

For persons listed on Form 990, Part VII, Section A, line 1a, did the organization provide any nonfixed
payments not described in lines 5 and 6? If "Yes," describe in Part III ............

Yes

Were any amounts reported on Form 990, Part VII, paid or accured pursuant to a contract that was
subject to the initial contract exception described in Regulations section 53.4958-4(a)(3)? If "Yes," describe
in Part III ..........................

If "Yes" on line 8, did the organization also follow the rebuttable presumption procedure described in Regulations section 53.4958-6(c)? .........................

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50053T

Schedule J (Form 990) 2023

Page 2

Part II

Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees. Use duplicate copies if additional space is needed.

For each individual whose compensation must be reported on Schedule J, report compensation from the organization on row (i) and from related organizations, described in the
instructions, on row (ii). Do not list any individuals that are not listed on Form 990, Part VII.
Note. The sum of columns (B)(i)-(iii) for each listed individual must equal the total amount of Form 990, Part VII, Section A, line 1a, applicable column (D) and (E) amounts for that individual.

(A) Name and Title		(B) Breakdown of W-2, 1099-MISC compensation, and/or 1099-NEC			(C) Retirement and other deferred compensation	(D) Nontaxable benefits	(E) Total of columns (B)(i)-(D)	(F) Compensation in column (B) reported as deferred on prior Form 990
(A) Name and Title		(i) Base compensation	(ii) Bonus & incentive compensation	(iii) Other reportable compensation	(C) Retirement and other deferred compensation	(D) Nontaxable benefits	(E) Total of columns (B)(i)-(D)
1Stuart Davidson MD Physician	(i) (ii)	526,649 ------------- 0	46,875 ------------- 0	42,400 ------------- 0	0 ------------- 0	42,621 ------------- 0	658,545 ------------- 0	0 ------------- 0
2Charles Hendricks MD Physician	(i) (ii)	525,680 ------------- 0	27,518 ------------- 0	24,010 ------------- 0	0 ------------- 0	24,087 ------------- 0	601,295 ------------- 0	0 ------------- 0
3Joseph Dougherty MD Physician	(i) (ii)	365,766 ------------- 0	25,000 ------------- 0	30,669 ------------- 0	0 ------------- 0	33,930 ------------- 0	455,365 ------------- 0	0 ------------- 0
4Christina Maguire President & CEO	(i) (ii)	333,286 ------------- 0	15,375 ------------- 0	36,975 ------------- 0	0 ------------- 0	26,301 ------------- 0	411,937 ------------- 0	0 ------------- 0
5David Sugerman MD Physician	(i) (ii)	335,663 ------------- 0	7,500 ------------- 0	2,202 ------------- 0	0 ------------- 0	49,328 ------------- 0	394,693 ------------- 0	0 ------------- 0
6Katherine Gassman MD Physician	(i) (ii)	346,721 ------------- 0	27,500 ------------- 0	147 ------------- 0	0 ------------- 0	14,686 ------------- 0	389,054 ------------- 0	0 ------------- 0
7Peter Witham MD Trustee/Physician	(i) (ii)	216,270 ------------- 0	10,000 ------------- 0	688 ------------- 0	0 ------------- 0	41,081 ------------- 0	268,039 ------------- 0	0 ------------- 0
8Michelle Smith Vice President/Treasurer & CFO	(i) (ii)	176,819 ------------- 0	7,841 ------------- 0	225 ------------- 0	0 ------------- 0	45,768 ------------- 0	230,653 ------------- 0	0 ------------- 0
9Julian Kuffler MD Trustee/Physician	(i) (ii)	169,291 ------------- 0	0 ------------- 0	4,702 ------------- 0	0 ------------- 0	41,099 ------------- 0	215,092 ------------- 0	0 ------------- 0

Schedule J (Form 990) 2023

Page 3

Part III

Supplemental Information

Provide the information, explanation, or descriptions required for Part I, lines 1a, 1b, 3, 4a, 4b, 4c, 5a, 5b, 6a, 6b, 7, and 8, and for Part II. Also complete this part for any additional information.

Return Reference	Explanation
Part I, Line 7	Performance-based variable compensation which is subject to review annually by a board compensation committee.

Schedule J (Form 990) 2023

Additional Data

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Schedule K
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Information on Tax-Exempt Bonds

Complete if the organization answered "Yes" to Form 990, Part Ⅵ, line 24a. Provide descriptions,
explanations, and any additional information in Part Ⅵ.
Attach to Form 990.
Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2023

Open to Public
Inspection

Name of the organization
Mount Desert Island Hospital

Employer identification number
01-0211797

Part Ⅰ

Bond Issues

(a) Issuer name		(b) Issuer EIN	(c) CUSIP #	(d) Date issued	(e) Issue price	(f) Description of purpose	(g) Defeased		(h) On behalf of issuer		(i) Pool financing
(a) Issuer name		(b) Issuer EIN	(c) CUSIP #	(d) Date issued	(e) Issue price	(f) Description of purpose	Yes	No	Yes	No	Yes	No
A	MHHEFA Series 2020B	01-0314384		11-01-2020	6,596,038	Financing MRI Equipment, Construction, EMR System.		X		X	X
B	MHHEFA Series 2023B	01-0314384		12-05-2023	8,236,713	Refinance Cadillac building mortgage; central utility plant upgrades.		X		X	X

Part Ⅱ

Proceeds

	A		B		C		D
	1 Amount of bonds retired ..................	624,962		698,288
2 Amount of bonds legally defeased ..............
3 Total proceeds of issue ..................	6,516,000		9,361,915
4 Gross proceeds in reserve funds .............			698,288
5 Capitalized interest from proceeds .............
6 Proceeds in refunding escrows ...............			2,388,217
7 Issuance costs from proceeds ...............			140,296
8 Credit enhancement from proceeds .............			31
9 Working capital expenditures from proceeds .............			6,135,083
10 Capital expenditures from proceeds .............	6,516,000
11 Other spent proceeds .............
12 Other unspent proceeds .............
13 Year of substantial completion .............			2025
	Yes	No	Yes	No	Yes	No	Yes	No
14 Were the bonds issued as part of a current refunding issue of tax-exempt bonds (or, if issued prior to 2020, a current refunding issue)? ........		X		X
15 Were the bonds issued as part of an advance refunding issue of taxable bonds (or, if issued prior to 2020, an advance refunding issue)? ........		X		X
16 Has the final allocation of proceeds been made? ..........	X			X
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? ..................	X		X

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50193E

Schedule K (Form 990) 2023

Page 2

Part Ⅲ

Private Business Use

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
1 Was the organization a partner in a partnership, or a member of an LLC, which owned property financed by tax-exempt bonds? .............		X		X
2 Are there any lease arrangements that may result in private business use of bond-financed property? ...............		X		X
3a Are there any management or service contracts that may result in private business use of bond-financed property? .............		X		X
b If "Yes" to line 3a, does the organization routinely engage bond counsel or other outside counsel to review any management or service contracts relating to the financed property?
c Are there any research agreements that may result in private business use of bond-financed property? .............		X		X
d If "Yes" to line 3c, does the organization routinely engage bond counsel or other outside counsel to review any research agreements relating to the financed property?
4 Enter the percentage of financed property used in a private business use by entities other than a section 501(c)(3) organization or a state or local government ....	0 %		0 %
5 Enter the percentage of financed property used in a private business use as a result of unrelated trade or business activity carried on by your organization, another section 501(c)(3) organization, or a state or local government .........	0 %		0 %
6 Total of lines 4 and 5 .............	0 %		0 %
7 Does the bond issue meet the private security or payment test? ...		X		X
8a Has there been a sale or disposition of any of the bond-financed property to a nongovernmental person other than a 501(c)(3) organization since the bonds were issued?.............		X		X
b If "Yes" to line 8a, enter the percentage of bond-financed property sold or disposed of. ..
c If "Yes" to line 8a, was any remedial action taken pursuant to Regulations sections 1.141-12 and 1.145-2? .............
9 Has the organization established written procedures to ensure that all nonqualified bonds of the issue are remediated in accordance with the requirements under Regulations sections 1.141-12 and 1.145-2? ........	X		X

Part Ⅳ

Arbitrage

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
1 Has the issuer filed Form 8038-T, Arbitrage Rebate, Yield Reduction and Penalty in Lieu of Arbitrage Rebate? ...		X		X
2 If "No" to line 1, did the following apply? ....
a Rebate not due yet? .......	X		X
b Exception to rebate? ........		X		X
c No rebate due? .........		X		X
If "Yes" to line 2c, provide in Part Ⅵ the date the rebate computation was performed ......
3 Is the bond issue a variable rate issue? .....		X		X

Schedule K (Form 990) 2023

Page 3

Part Ⅳ

Arbitrage (Continued)

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
4a Has the organization or the governmental issuer entered into a qualified hedge with respect to the bond issue?		X		X
b Name of provider ..........
c Term of hedge .........
d Was the hedge superintegrated? ......
e Was the hedge terminated? ........
5a Were gross proceeds invested in a guaranteed investment contract (GIC)?		X		X
b Name of provider ..........
c Term of GIC .........
d Was the regulatory safe harbor for establishing the fair market value of the GIC satisfied? ........
6 Were any gross proceeds invested beyond an available temporary period?		X		X
7 Has the organization established written procedures to monitor the requirements of section 148? ...	X		X

Part Ⅴ

Procedures To Undertake Corrective Action

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
Has the organization established written procedures to ensure that violations of federal tax requirements are timely identified and corrected through the voluntary closing agreement program if self-remediation is not available under applicable regulations?	X		X

Part Ⅵ

Supplemental Information. Provide additional information for responses to questions on Schedule K. (See instructions).

Return Reference	Explanation

Schedule K (Form 990) 2023

Additional Data

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SCHEDULE M
(Form 990)

Department of the Treasury

Internal Revenue Service

Noncash Contributions

Complete if the organizations answered "Yes" on Form 990, Part IV, lines 29 or 30.
Right pointing arrow large image

Attach to Form 990.
Right pointing arrow large image

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2023

Open to Public Inspection

Name of the organization

Mount Desert Island Hospital

Employer identification number

01-0211797

Part I

Types of Property

	(a) Check if applicable	(b) Number of contributions or items contributed	(c) Noncash contribution amounts reported on Form 990, Part VIII, line 1g	(d) Method of determining noncash contribution amounts
1 Art—Works of art ....
2 Art—Historical treasures .
3 Art—Fractional interests ..
4 Books and publications ..
5 Clothing and household goods .......
6 Cars and other vehicles ..
7 Boats and planes ....
8 Intellectual property ...
9 Securities—Publicly traded .	X	5	79,622	Stock exchange value
10 Securities—Closely held stock .
11 Securities—Partnership, LLC, or trust interests ....
12 Securities—Miscellaneous ..
13 Qualified conservation contribution—Historic structures .....
14 Qualified conservation contribution—Other ...
15 Real estate—Residential .
16 Real estate—Commercial ..
17 Real estate—Other ...
18 Collectibles .....
19 Food inventory ...
20 Drugs and medical supplies .
21 Taxidermy ......
22 Historical artifacts ....
23 Scientific specimens ..
24 Archeological artifacts ...
25 Other ( )
26 Other ( )
27 Other ( )
28 Other ( )

Number of Forms 8283 received by the organization during the tax year for contributions
for which the organization completed Form 8283, Part IV, Donee Acknowledgement

Yes

30a

During the year, did the organization receive by contribution any property reported in Part I, lines 1 through 28, that it must hold for at least three years from the date of the initial contribution, and which isn't required to be used for exempt purposes for the entire holding period? ...................

30a

If "Yes," describe the arrangement in Part II.

Does the organization have a gift acceptance policy that requires the review of any nonstandard contributions?

Yes

32a

Does the organization hire or use third parties or related organizations to solicit, process, or sell noncash

contributions? ..........................

32a

Yes

If "Yes," describe in Part II.

If the organization didn't report an amount in column (c) for a type of property for which column (a) is checked,

describe in Part II.

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 51227J

Schedule M (Form 990) (2023)

Page 2

Part IISupplemental Information. Provide the information required by Part I, lines 30b, 32b, and 33, and whether the organization is reporting in Part I, column (b), the number of contributions, the number of items received, or a combination of both. Also complete this part for any additional information.

Return Reference	Explanation
Part I, Line 32b:	The Hospital gift acceptance policy stipulates that stock donations are sold by their third-party investment advisors as soon as administratively possible.

Schedule M (Form 990) (2023)

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SCHEDULE O
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Information to Form 990 or 990-EZ

Complete to provide information for responses to specific questions on
Form 990 or 990-EZ or to provide any additional information.
Attach to Form 990 or 990-EZ.
Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2023

Open to Public
Inspection

Name of the organization

Mount Desert Island Hospital

Employer identification number

01-0211797

Return Reference	Explanation
Form 990, Part VI, Section B, line 11b	The Form 990 is prepared by an outside independent accounting firm with input and assistance from Finance Department staff. The Trustees are provided with an electronic copy of the full Form 990 and all supporting schedules. Once the Finance Committee has completed its review, all Board of Trustees members are provided with a copy of the Form 990. Trustees are given the opportunity to comment and review the Form 990 before it is filed with the IRS. The President & CEO and the VP of Finance & CFO are available to answer any inquiries from members of the Board of Trustees.
Form 990, Part VI, Section B, line 12c	Mount Desert Island Hospital monitors and enforces compliance with the conflict of interest policy by requiring all trustees, officers, and committee members to annually sign a statement affirming that each person has received, read, and understands the conflict of interest policy and that no such conflict exists. Additionally, interested persons have a duty to disclose any actual or possible conflicts of interest at the time they arise. After disclosing a potential conflict of interest and answering any questions that might be asked concerning such interest, the affected person shall withdraw from any meetings, deliberations, votes, or other matters concerning the conflict. To ensure that the Hospital does not engage in activities that could jeopardize its tax exempt status, the Board of Trustees or a committee appointed by the Board of Trustees periodically reviews compensation and similar arrangements to ensure they are reasonable and are the result of arms-length bargaining. In conducting these reviews the Board of Trustees may use outside advisors.
Form 990, Part VI, Section B, line 15	The process used by Mount Desert Island Hospital for determining the President & CEO's compensation includes a review and approval by the governing body of the Organization, specifically the Compensation Committee of the Board of Trustees. The governing body and this committee use market data from an independent source to compare compensation models of similarly sized organizations within like demographic and geographic areas to align compensation packages. The compensation of other officers and key employees is reviewed by the Human Resources Department using the same market data guidelines to compare and establish compensation for these positions.
Form 990, Part VI, Section C, line 19	The annual report and Form 990 are available to the public on the Hospital's website. Governing documents, the conflict of interest policy, and the financial statements are available upon request.
Form 990, Part VII, Section A, Line 1:	Dr. Peter Witham and Dr. Julius Kuffler are employees affiliated with Mount Desert Island Hospital. Compensation paid to them is for their services in these roles, and not for their services as members of the Board of Trustees.
Form 990, Part IX, line 11g	Purchased services: Program service expenses 3,918,267. Management and general expenses 5,495,625. Fundraising expenses 0. Total expenses 9,413,892. Contract labor: Program service expenses 4,638,901. Management and general expenses 0. Fundraising expenses 0. Total expenses 4,638,901. Consulting fees: Program service expenses 5,201. Management and general expenses 0. Fundraising expenses 163,874. Total expenses 169,075.
Form 990, Part XI, line 9:	Change in value of beneficial interest in trust 84,639. Pledge discount adjustment -1,728,423.
Form 990, Part XII, Line 2c:	The audit process has not changed from the prior year.

For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.

Cat. No. 51056K

Schedule O (Form 990) 2023

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SCHEDULE R
(Form 990)

Department of the Treasury
Internal Revenue Service

Related Organizations and Unrelated Partnerships

Complete if the organization answered "Yes" on Form 990, Part IV, line 33, 34, 35b, 36, or 37.
Attach to Form 990.
Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2023

Open to Public Inspection

Name of the organization

Mount Desert Island Hospital

Employer identification number

01-0211797

Part I

Identification of Disregarded Entities. Complete if the organization answered "Yes" on Form 990, Part IV, line 33.

(a) Name, address, and EIN (if applicable) of disregarded entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Total income	(e) End-of-year assets	(f) Direct controlling entity

Part II

Identification of Related Tax-Exempt Organizations. Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related tax-exempt organizations during the tax year.

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Exempt Code section	(e) Public charity status (if section 501(c)(3))	(f) Direct controlling entity	(g) Section 512(b)(13) controlled entity?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Exempt Code section	(e) Public charity status (if section 501(c)(3))	(f) Direct controlling entity	Yes	No
(1)Birch Bay Retirement Village PO Box 8 10 Wayman Lane Bar Harbor,ME046090008 01-0481696	Retirement Community	ME	501(c)(3)	Line 12a, I	Mount Desert Island Hospital	Yes

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50135Y

Schedule R (Form 990) 2023

Page 2

Part III

Identification of Related Organizations Taxable as a Partnership. Complete if the organization answered "Yes" on Form 990, Part IV, line 34, because it had one or more related organizations treated as a partnership during the tax year.

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(f) Share of total income	(g) Share of end-of-year assets	(h) Disproprtionate allocations?		(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	(j) General or managing partner?		(k) Percentage ownership
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No	(k) Percentage ownership

Part IV

Identification of Related Organizations Taxable as a Corporation or Trust. Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a corporation or trust during the tax year.

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Type of entity (C corp, S corp, or trust)	(f) Share of total income	(g) Share of end-of-year assets	(h) Percentage ownership	(i) Section 512(b)(13) controlled entity?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Type of entity (C corp, S corp, or trust)	(f) Share of total income	(g) Share of end-of-year assets	(h) Percentage ownership	Yes	No
(1) Mount Desert Management Company PO Box 8 10 Wayman Lane Bar Harbor,ME04609 01-0538776	Real Estate Development	ME	N/A	C					No

Schedule R (Form 990) 2023

Page 3

Part V

Transactions With Related Organizations. Complete if the organization answered "Yes" on Form 990, Part IV, line 34, 35b, or 36.

Note. Complete line 1 if any entity is listed in Parts II, III, or IV of this schedule.

Yes

1 During the tax year, did the orgranization engage in any of the following transactions with one or more related organizations listed in Parts II-IV?

a Receipt of (i) interest, (ii) annuities, (iii) royalties, or (iv) rent from a controlled entity .....................

b Gift, grant, or capital contribution to related organization(s) ............................

c Gift, grant, or capital contribution from related organization(s) ............................

d Loans or loan guarantees to or for related organization(s) ............................

Yes

e Loans or loan guarantees by related organization(s) ............................

f Dividends from related organization(s) ............................

g Sale of assets to related organization(s) ............................

h Purchase of assets from related organization(s) ............................

i Exchange of assets with related organization(s) ............................

j Lease of facilities, equipment, or other assets to related organization(s) .......................

k Lease of facilities, equipment, or other assets from related organization(s) ......................

l Performance of services or membership or fundraising solicitations for related organization(s) .....................

Yes

m Performance of services or membership or fundraising solicitations by related organization(s) .................

n Sharing of facilities, equipment, mailing lists, or other assets with related organization(s) ...................

Yes

o Sharing of paid employees with related organization(s) ............................

Yes

p Reimbursement paid to related organization(s) for expenses ............................

q Reimbursement paid by related organization(s) for expenses ............................

r Other transfer of cash or property to related organization(s) ............................

s Other transfer of cash or property from related organization(s) ............................

If the answer to any of the above is "Yes," see the instructions for information on who must complete this line, including covered relationships and transaction thresholds.

(a) Name of related organization	(b) Transaction type (a-s)	(c) Amount involved	(d) Method of determining amount involved
(1) Birch Bay Retirement Village	L	192,888	Actual per Books
(2) Birch Bay Retirement Village	D	1,268,498	Actual per Books

Schedule R (Form 990) 2023

Page 4

Part VI

Unrelated Organizations Taxable as a Partnership. Complete if the organization answered "Yes" on Form 990, Part IV, line 37.

Provide the following information for each entity taxed as a partnership through which the organization conducted more than five percent of its activities (measured by total assets or gross revenue) that was not a related organization. See instructions regarding exclusion for certain investment partnerships.

(a) Name, address, and EIN of entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	(e) Are all partners section 501(c)(3) organizations?		(f) Share of total income	(g) Share of end-of-year assets	(h) Disproprtionate allocations?		(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	(j) General or managing partner?		(k) Percentage ownership
(a) Name, address, and EIN of entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	Yes	No	(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No	(k) Percentage ownership

Schedule R (Form 990) 2023

Page 5

Part VII

Supplemental Information

Provide additional information for responses to questions on Schedule R. See instructions.

Return Reference	Explanation

Schedule R (Form 990) 2023

Additional Data

Software ID:
Software Version:

1	Briefly describe the organization’s mission or most significant activities: Critical access hospital, providing medical & healthcare services located in Bar Harbor, ME.
2	Check this box
3	Number of voting members of the governing body (Part VI, line 1a) ........	3	19
4	Number of independent voting members of the governing body (Part VI, line 1b) .....	4	16
5	Total number of individuals employed in calendar year 2023 (Part V, line 2a) ......	5	583
6	Total number of volunteers (estimate if necessary) .............	6	51
7a	Total unrelated business revenue from Part VIII, column (C), line 12 ........	7a	0
b	Net unrelated business taxable income from Form 990-T, Part I, line 11 .........	7b	0

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........	3,895,822	27,415,834
9	Program service revenue (Part VIII, line 2g) .........	81,771,454	86,998,119
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	-169,739	359,193
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	-22,785	-103,591
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)	85,474,752	114,669,555
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...	19,000	37,500
14	Benefits paid to or for members (Part IX, column (A), line 4).....	0	0
15	Salaries, other compensation, employee benefits (Part IX, column (A), lines 5–10)	50,706,849	51,760,350
16a	Professional fundraising fees (Part IX, column (A), line 11e) .....	0	0
b	Total fundraising expenses (Part IX, column (D), line 25) 812,225
17	Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e)....	37,713,376	39,406,720
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	88,439,225	91,204,570
19	Revenue less expenses. Subtract line 18 from line 12.......	-2,964,473	23,464,985
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	80,033,646	106,023,085
21	Total liabilities (Part X, line 26).............	30,469,070	33,702,543
22	Net assets or fund balances. Subtract line 21 from line 20.....	49,564,576	72,320,542

Sign Here

	Signature of officer	Date

	Type or print name and title


4a	(Code: ) (Expenses $ 66,951,382 including grants of $ 37,500 ) (Revenue $ 86,998,119 )
	In fiscal year 2024, Mount Desert Island (MDI) Hospital provided $12,743,863 in services for which no compensation was expected or received. Financial assistance 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, VA, and CHAMPUS. The unreimbursed value for providing care to these patients approximates $5,264,813. The Hospital continues to provide a number of health services and preventative health programs to the community. Available programs include cardiac pulmonary rehabilitation, care coordination, wellness programs, diabetes education, annual wellness exams, nutrition counseling, parenting, pregnancy and sibling classes, physical and occupational therapy programs, speech therapy, medication therapy management, health coaching, care management, coagulation management, financial and insurance workshops, and our oral health program which included education and outreach to the community, schools, and service providers. The Hospital provides volunteers as Certified Application Counselors to help enroll and educate members of our community into the Health Insurance Exchange options. Throughout the year, staff from the Hospital make presentations to area school children regarding smoking cessation, wellness, health, activity, nutrition, and oral health. Additionally, community groups such as the YMCA, Alcoholics Anonymous, Cancer Support, and Palliative Care 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 organizations such as the local Healthy Acadia, Rotary, Chamber of Commerce, and Lions/Lioness clubs.

4b	(Code: ) (Expenses $ including grants of $ ) (Revenue $ )












4c	(Code: ) (Expenses $ including grants of $ ) (Revenue $ )












4d	Other program services (Describe in Schedule O.)
	(Expenses $ including grants of $ ) (Revenue $ )
4e	Total program service expenses66,951,382

(A) Name and title	(B) Average hours per week (list any hours for related organizations below dotted line)	(C) Position (do not check more than one box, unless person is both an officer and a director/trustee)			(D) Reportable compensation from the organization (W-2/1099-MISC/1099-NEC)	(E) Reportable compensation from related organizations (W-2/1099-MISC/1099-NEC)	(F) Estimated amount of other compensation from the organization and related organizations
(A) Name and title
(18) Patricia Hand PhD........................................................................ Chair (end 9/2023); Trustee	1.00 .......................0.00	X	X		0	0	0
(19) Martha Wagner PhD........................................................................ Trustee; Chair (start 9/2023)	1.00 .......................0.00	X	X		0	0	0
(20) Madeleine Braun PhD MBA........................................................................ 1st Vice Chair	1.00 .......................0.00	X	X		0	0	0
(21) Michelle Smith........................................................................ Vice President/Treasurer & CFO	41.00 .......................1.00		X		184,885	0	45,768
(22) Morgan Mackenzie........................................................................ Clerk/Secretary	41.00 .......................0.00		X		70,506	0	16,653
(23) Stuart Davidson MD........................................................................ Physician	40.00 .......................0.00			X	615,924	0	42,621
(24) Charles Hendricks MD........................................................................ Physician	40.00 .......................0.00			X	577,208	0	24,087
(25) Joseph Dougherty MD........................................................................ Physician	40.00 .......................0.00			X	421,435	0	33,930
(26) Katherine Gassman MD........................................................................ Physician	40.00 .......................0.00			X	374,368	0	14,686
(27) David Sugerman MD........................................................................ Physician	40.00 .......................0.00			X	345,365	0	49,328

1b	Sub-Total..............
c	Total from continuation sheets to Part VII, Section A..
d	Total (add lines 1b and 1c).........	3,376,278	0	335,554

1a	Federated campaigns..		1a
b	Membership dues..		1b
c	Fundraising events..		1c	456,300
d	Related organizations		1d
e	Government grants (contributions)		1e	5,000,000

f	All other contributions, gifts, grants, and similar amounts not included above		1f	21,959,534

g	Noncash contributions included in lines 1a - 1f:$		1g	79,622

h Total. Add lines 1a-1f.......		27,415,834

		Business Code
2a	Patient services	621990	85,694,817	85,694,817
b	Pharmacy	621400	895,565	895,565
c	Cafeteria	722514	214,849	214,849
d	Healthcare administration	621400	192,888	192,888
e
f	All other program service revenue.
g	Total. Add lines 2a–2f .....		86,998,119

3 Investment income (including dividends, interest, and othersimilar amounts) ......			580,207			580,207
4 Income from investment of tax-exempt bond proceeds
5 Royalties...........
			(i) Real	(ii) Personal
6a	Gross rents	6a	14,289
b	Less: rental expenses	6b	7,767
c	Rental income or (loss)	6c	6,522
d	Net rental income or (loss).......			6,522			6,522
			(i) Securities	(ii) Other
7a	Gross amount from sales of assets other than inventory	7a	4,957,788
b	Less: cost or other basis and sales expenses	7b	4,955,981	222,821
c	Gain or (loss)	7c	1,807	-222,821
d	Net gain or (loss).........			-221,014			-221,014
8a	Gross income from fundraising events (not including $ 456,300of contributions reported on line 1c). See Part IV, line 18 ....
			8a	33,180
b	Less: direct expenses ...		8b	143,293
c	Net income or (loss) from fundraising events..			-110,113			-110,113
9a	Gross income from gaming activities. See Part IV, line 19 ...
			9a
b	Less: direct expenses ...		9b
c	Net income or (loss) from gaming activities..
10a	Gross sales of inventory, less returns and allowances ..
			10a
b	Less: cost of goods sold ..		10b
c	Net income or (loss) from sales of inventory..

Business Code
11a
b
c
d	All other revenue ....
e	Total. Add lines 11a–11d ......
12	Total revenue. See instructions.....			114,669,555	86,998,119	0	255,602

1	Grants and other assistance to domestic organizations and domestic governments. See Part IV, line 21 ....
2	Grants and other assistance to domestic individuals. See Part IV, line 22 ...........	37,500	37,500
3	Grants and other assistance to foreign organizations, foreign governments, and foreign individuals. See Part IV, lines 15 and 16. .............
4	Benefits paid to or for members .......
5	Compensation of current officers, directors, trustees, and key employees ...........	1,212,880	952,289	260,591
6	Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) .........
7	Other salaries and wages........	38,120,549	29,536,561	8,082,599	501,389
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....	680,059	533,946	146,113
9	Other employee benefits .......	9,104,749	7,148,564	1,956,185
10	Payroll taxes ...........	2,642,113	2,074,446	567,667
11	Fees for services (non-employees):
a	Management ......
b	Legal .........	223,663		223,663
c	Accounting ...........	132,940		132,940
d	Lobbying ...........	8,380		8,380
e	Professional fundraising services. See Part IV, line 17
f	Investment management fees ......	54,026		54,026
g	Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O)	14,221,868	8,562,369	5,495,625	163,874
12	Advertising and promotion ....	123,438	75,183	48,255
13	Office expenses .......	1,579,939	872,790	560,187	146,962
14	Information technology ......
15	Royalties ..
16	Occupancy ...........	2,113,641	1,287,365	826,276
17	Travel ............	250,745	152,722	98,023
18	Payments of travel or entertainment expenses for any federal, state, or local public officials .
19	Conferences, conventions, and meetings ....	520,860	317,243	203,617
20	Interest ...........	409,774	290,723	119,051
21	Payments to affiliates .......
22	Depreciation, depletion, and amortization ..	2,820,796	2,001,276	819,520
23	Insurance ...	1,166,370	710,407	455,963
24	Other expenses. Itemize expenses not covered above (List miscellaneous expenses in line 24e. If line 24e amount exceeds 10% of line 25, column (A) amount, list line 24e expenses on Schedule O.)
a	Medical supplies	7,383,983	4,497,398	2,886,585
b	Provision for bad debt	5,881,991	5,881,991
c	Hospital provider tax	1,246,296	1,246,296
d	Equipment rent./maint.	846,880	515,813	331,067
e	All other expenses	421,130	256,500	164,630
25	Total functional expenses. Add lines 1 through 24e	91,204,570	66,951,382	23,440,963	812,225
26	Joint costs. Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation. Check here if following SOP 98-2 (ASC 958-720).

1	Cash–non-interest-bearing ........			2,650	1	2,650
2	Savings and temporary cash investments .........			11,549,974	2	12,528,572
3	Pledges and grants receivable, net ......			2,595,320	3	19,443,030
4	Accounts receivable, net .............			15,904,494	4	15,086,067
5	Loans and other receivables from any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons .......
					5
6	Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), and persons described in section 4958(c)(3)(B) ...
					6
7	Notes and loans receivable, net ...........				7
8	Inventories for sale or use ............			530,674	8	627,030
9	Prepaid expenses and deferred charges ......			656,444	9	928,730
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	74,123,056
b	Less: accumulated depreciation	10b	40,383,671	26,698,856	10c	33,739,385
11	Investments—publicly traded securities .			16,555,222	11	19,110,178
12	Investments—other securities. See Part IV, line 11 .....			1,860,117	12	1,944,756
13	Investments—program-related. See Part IV, line 11 ..			14,922	13	-6,707
14	Intangible assets ...............			513,586	14	387,238
15	Other assets. See Part IV, line 11 ...........			3,151,387	15	2,232,156
16	Total assets. Add lines 1 through 15 (must equal line 33)...			80,033,646	16	106,023,085

17	Accounts payable and accrued expenses .....	11,528,555	17	13,550,267
18	Grants payable ...		18
19	Deferred revenue .........	3,620	19	33,750
20	Tax-exempt bond liabilities .........	6,604,626	20	14,709,239
21	Escrow or custodial account liability. Complete Part IV of Schedule D		21
22	Loans and other payables to any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons .........
			22
23	Secured mortgages and notes payable to unrelated third parties ..	2,288,586	23	594,020
24	Unsecured notes and loans payable to unrelated third parties ..		24
25	Other liabilities (including federal income tax, payables to related third parties, and other liabilities not included on lines 17 - 24). Complete Part X of Schedule D	10,043,683	25	4,815,267
26	Total liabilities. Add lines 17 through 25..	30,469,070	26	33,702,543

	Organizations that follow FASB ASC 958, check here and complete lines 27, 28, 32, and 33.
27	Net assets without donor restrictions ..........	39,806,734	27	43,106,563
28	Net assets with donor restrictions ...........	9,757,842	28	29,213,979
	Organizations that do not follow FASB ASC 958, check here and complete lines 29 through 33.
29	Capital stock or trust principal, or current funds .....		29
30	Paid-in or capital surplus, or land, building or equipment fund ...		30
31	Retained earnings, endowment, accumulated income, or other funds		31
32	Total net assets or fund balances ...........	49,564,576	32	72,320,542
33	Total liabilities and net assets/fund balances ........	80,033,646	33	106,023,085