4A (Expenses $ 60580917 including grants of $ 23500) (Revenue $ 71709329)
Provided healthcare services regardless of ability to pay as well as education and promotion of health. Provided $1,301,871 other uncompensated care (at cost).Northern Light Inland Hospital is a 48-bed facility that provides medical-surgical, and acute care. Northern Light Inland Hospital is a non-profit hospital, serving all who need care, regardless of ability to pay. Northern Light Inland Hospital also has outlying clinics in the region, allowing easier access for patients.Additional Statistics:Total Admissions 1,306Percent Occupancy of Available Beds 29%Emergency Room Visits 9,426Surgery Cases 2,120Services provided to those who could not pay $3,241,491

4B (Expenses $ 8112277 including grants of $ 0) (Revenue $ 0)
Medicaid shortfalls (at cost). 24,884 persons served.

4C (Expenses $ 4448733 including grants of $ 0) (Revenue $ 0)
Medicare shortfalls (at cost). 21,096 persons served.

Facility: Northern Light Inland Hospital - Part V, Section B, Line 5
The Maine Shared CHNA research team conducted a statewide qualitative assessment among stakeholders to identify and prioritize significant health issues in communities across the state. The assessment, coordinated with the Maine CDC, engaged public health expertise throughout the process. Community outreach was conducted between September 2021 and January 2022. All forms of engagement included public forums, community sponsored events, and oral surveys. The purpose of these outreach efforts was to gather feedback on data and to identify health priorities, community assets, and gaps in resources to be used in health improvement planning. Virtual community forums with residents and service providers were held in the county in partnership with the Maine CDC to solicit input from individuals representing populations with health disparities including medically underserved, low-income, or minority populations. The following organizations attended the November 2, 2021, Kennebec County Shared CHNA Community Engagement Forum and provided valuable feedback on the Maine Shared CHNA.Persons representing broad interests of the community who were consulted during the engagement process (the following list was extracted from the Kennebec County CHNA report, page 20): Central Public Health District, City of Gardiner, Friends of Quarry Road, Good Shepherd Food Bank, HealthReach Community Health Centers, Healthy Communities of the Capital Area, Healthy Northern Kennebec, Kennebec Behavioral Health, Maine Center for Disease Control and Prevention, MaineGeneral Health, MaineGeneral Medical Center, Northern Light Health, Northern Light Health Inland Hospital, Northern Light Inland Hospital Continuing Care, Lakewood, Northern Light Sebasticook Valley Hospital, The Maine Children's Home for Little Wanderers. New this cycle was an expanded effort to reach those who may experience systemic disadvantages and therefore experience a greater rate of health disparities. Two types of outreach were piloted in this effort.One effort included nine community sponsored events hosted by organizations having statewide reach representing the following communities: Black or African Americans; people who are homeless or formerly homeless; older adults; people who are deaf or hard of hearing; people who define themselves or identify as lesbian, gay, bisexual, transgender, and queer and/or questioning (LGBTQ+); people with a disability; people with a mental health diagnosis; people with low income; and youth.Another effort included conducting oral surveys in collaboration with eight ethnic-based community organizations community health workers in order to better reach Maines immigrant population that included: 1,000 surveys were conducted in either English (32%), Somali, (24%), Arabic (23%), French (8%), Spanish (5%), Lingala (3%), and other languages including Swahili, Maay Maay, Portuguese, Oromo, Eretria, Kirundi, and Amara. When asked for their countries of origin, respondents most commonly cited the United States (212), Iraq (205), Somalia (157), The Democratic Republic of Congo (81), Djibouti (70), Kenya (30), and Mexico (29). Other countries of origin mentioned included Rwanda, Ethiopia, Angola, Syria, Guatemala, South Africa, Palestine, Puerto Rico, Morocco, Afghanistan, El Salvador, Nigeria, Canada, Burundi, Eritrea, France, Honduras, Uganda, Jamaica, Mali, Gabon, Sudan, Nicaragua, Peru, and Brazil.

Facility: Northern Light Inland Hospital - Part V, Section B, Line 6a
The Maine Shared CHNA was conducted through a collaborative effort among Maines four largest health-care systems Central Maine Healthcare, Northern Light Health (legal name Eastern Maine Healthcare Systems), MaineGeneral Health, MaineHealth and the Maine Center for Disease Control and Prevention, an office of the Maine Department of Health and Human Services (DHHS). Northern Light Health member organizations participating in the Shared CHNA included Acadia Hospital, AR Gould Hospital, Blue Hill Hospital, CA Dean Hospital, Eastern Maine Medical Center, Inland Hospital, Maine Coast Hospital, Mayo Hospital, Mercy Hospital, and Sebasticook Valley Hospital. See Line 5s response for a comprehensive list of participating organizations, included other non-Northern Light Health hospitals who were consulted during the engagement process.

Facility: Northern Light Inland Hospital - Part V, Section B, Line 11
Northern Light Health recently conducted their 2022 Shared Community Health Needs Assessment that will inform priority work for implementation in FY23 FY25. In FY22, Northern Light Inland Hospital developed our plan to address significant needs identified in our 2022 Community Health Strategy (aka, implementation strategy). Though priority work from the 2022 Shared CHNA wont begin until FY23, Inland Hospital will be prepared to implement priority work from our 2022 strategy with no gap in implementation efforts between the two CHNA cycles. While conducting the 2022 Shared CHNA research and outreach, Inland Hospital continued to implement priority work from the final year, FY22, of the three-year 2019 Community Health Strategy (implementation years FY20, FY21, and FY22). Below reflect these efforts related to the 2019 Community Health Strategy.The data gathered from the 2019 Shared Community Health Needs Assessment (Shared CHNA) informed Inland Hospitals Community Health Strategy (Implementation Strategy) developed with input from community stakeholders including those who serve priority populations, the local Public Health District Liaison, local business leaders, and community advocates. Priorities were selected after weighing the severity of each priority area, availability of known and effective interventions, determination that the priority area was un-addressed or under-addressed, and community collaborations underway with Inland Hospital. A hospital task force considered the data and identified areas of significant need including priority concerns, intended actions to address the need, programs and resource allocation, planned collaborations, and population of focus. The implementation strategy was presented and adopted by the hospitals governing board. Northern Light Inland Hospital identified four priority areas of focus addressing the significant needs identified in its 2019 CHNA as follows:Physical activity, nutrition, weightActions taken by Inland Hospital to address this priority in FY22: Northern Light Inland Hospital was able to maintain the number of evidence-based programs focused on increasing access to and availability of physical activity at one by maintaining the Lets Go! 5-2-1-0 program for the northern Kennebec County region. Inlands Community Health coordinator served as the local county coordinator for Lets Go! and brought programming and activities to schools and childcare centers across northern Kennebec County. The FY22 school year still posed challenges due to local schools and centers being short-staffed and not always allowing visitors inside their buildings because of the COVID-19 pandemic. However, throughout the year our coordinator was able to disseminate information to registered sites to distribute to families, spreading the word about healthy living, physical activity, and healthy choices. Our coordinator was also able to offer professional development trainings to center/school staff, along with activities promoting healthy choices and increasing physical activity, such as Story Walks, sugary beverage displays, policy reviews, and healthy eating games. In addition, we planned community activities to increase physical activity, including family fun outdoor events on local trail systems, and maintained our own trail system at the hospital to bring more free physical activity opportunities to the community.Mental healthActions taken by Inland Hospital to address this priority in FY22: Northern Light Inland Hospital provided interested local schools with Acadia CARES (Child Adolescent Resource and Education Series) toolkits to increase awareness of suicide prevention and mental health resources in the community. We also promoted other educational programs to raise awareness, readiness, and access to mental health services, including promoting Healthy Life Resources from Northern Light Acadia Hospital, mental health first aid training from National Alliance of Mental Illness Maine, and trauma-informed practice and adverse childhood experiences (ACES) training from Maine Resilience Build Network. Stress less suggestions were provided to partnered schools and childcare sites, as well as suggestions and assistance with promoting staff mental health and wellbeing.Substance useActions taken by Inland Hospital to address this priority in FY22: Northern Light Inland Hospital aimed to train and certify providers in Medication-Assisted Treatment options to provide increased access to treatments and resources for individuals in the community with substance use disorder.Social determinants of heathActions taken by Inland Hospital to address this priority in FY22: Northern Light Inland Hospital screened patients at their appointments for food insecurity and related challenges at 18 different sites. Key to our success was reaching out to all primary care and specialty sites to ensure that we had many sites using our screening question to identify needs. Food bags were given to patients if they had a positive response to the screening, along with additional resources on food access in the area.Additional information related to actions taken by Northern Light Inland Hospital on the above priorities can be found in their FY22 Progress Report to Our Community at https://northernlighthealth.org/2019-Community-Health-Strategy. Northern Light Inland Hospital considered all priorities identified in the Shared CHNA, as well as other sources, through an extensive review process. While the full spectrum of needs is important, Inland Hospital is currently poised to focus only on the highest priorities at this time. A number of priorities not selected, due to a variety of reasons are listed below:Access to Care - This identified health need is not being addressed directly as a strategy born out of our community health needs assessment as our hospital has current initiatives focused on improving access to care such as provider recruitment, the establishment of walk-in care (bridging the gap between primary care and emergency room visits), community health navigators (to link vulnerable populations with needed resources) and other efforts that are ongoing and part of our continual mission to improve access to care. Older Adult Health/Healthy Aging - We decided not to focus on this priority because it is already a focus of another health system in our community, as well as several local agencies, such as Spectrum Generations.

Facility: Northern Light Inland Hospital - Part V, Section B, Line 13h
Income Level

Facility: Northern Light Inland Hospital - Part V, Section B, Line 16j
"Response for 7a (list URL) is https://northernlighthealth.org/Inland-HospitalResponse for 7b (list URL) is https://northernlighthealth.org/Community-Health-Needs-Assessment/2022-Shared-CHNA-ReportsResponse for 10a (list URL) is https://northernlighthealth.org/Community-Health-Needs-Assessment/2022-Community-Health-StrategyResponse for 16a, 16b, 16c (list url) is https://northernlighthealth.org/Inland-Hospital under ""Pay My Bill""."

Part I, Line 6a - Related Organization Community Benefit Report
The Northern Light Inland Hospital community benefit report is contained in an annual community benefit report prepared by Northern Light Health which is the parent organization of all related organizations.

Part I, Line 7 - Explanation of Costing Methodology
Ratio of Patient Care Cost-to-Charges is used in calculations.

Part III, Line 2 - Methodology Used To Estimate Bad Debt Expense
The costing methodology used to determine the amount is cost to charge ratio.

Part III, Line 4 - Bad Debt Expense
Patient and trade accounts receivable are stated at the amount management expects to collect from outstanding balances. See Footnote 2 of the attached financial statements, page 16 to 19 - Patient Service Revenue and Accounts Receivable section.

Part III, Line 8 - Explanation Of Shortfall As Community Benefit
Medicare losses should be treated as a community benefit because the losses are incurred in performing an important public service, and Maine hospitals experience one of the lowest Medicare reimbursement rates in the country.

Part III, Line 9b - Provisions On Collection Practices For Qualified Patients
All account guarantors who express an inability to pay inpatient and outpatient services will be screened for eligibility for charity care using an application and guidelines established by Northern Light Inland Hospital. An account may be reconsidered for charity care at any time when new information is available about a patient's inability to pay.

Part VI, Line 3 - Patient Education of Eligibility for Assistance
Northern Light Health Financial Counselors screen patients for federal, state or government programs and brochures are displayed at all Northern Light locations. Financial Assistance is widely publicized within the community by the following methods:Offered by receiving a conspicuous written notice on their billing statementsListed on the Northern Light Health web portal www.northernlighthealth.org/billing Posters are displayed in public locations in each hospital facilityCommunity posters are displayed outside of the organization (Food Cupboards, Libraries, Auditoriums, Churches, Banks)Packets are provided at all check in locations which include an application, instructions, and a Financial Assistance Policy (FAP) Plain Language Summary

Part VI, Line 4 - Community Information
Located in Waterville, Maine, Northern Light Inland Hospital has a service area comprised of both primary and secondary service areas, together referred to as the total service area. Total service areas (TSAs) are developed by the Northern Light Health Planning department based on neighboring zip codes from which a majority of a hospitals inpatient admissions originate. TSAs can sometimes overlap due to hospital locations or because of the specialty services provided by the hospitals.Towns representing Inlands primary service area include, Albion, Belgrade Lakes, Belgrade, Burnham, Clinton, Fairfield, Freedom, Jackman, North Vassalboro, Oakland, Palermo, Smithfield, South China, Thorndike, Troy, Unity, Vassalboro, and Waterville.Towns representing Inlands secondary service area include, Anson, Athens, Augusta, Bingham, Canaan, Caratunk, Coopers Mills, Farmingdale, Gardiner, Hallowell, Harmony, Jefferson, Madison, Manchester, Mount Vernon, New Portland, Norridgewock, North Anson, Randolph, Readfield, Skowhegan, Solon, West Forks, Whitefield, Windsor, and Winthrop.Kennebec Countys race/ethnicity and selected demographics are provided below for Inland Hospital based on the hospitals physical location in Kennebec County.Kennebec County - Race/Ethnicity: American Indian/Alaskan Native 0.5% (661), Asian 0.9% (1,108), Black/African American 0.9% (1,039), Native Hawaiian or Pacific Islander 0.1% (85), White 95.7% (116,530), Some other race 0.2% (224), Two or more races 1.7% (2,106), Hispanic 1.6% (1,900), Non-Hispanic 98.4% (119,853), Total county population 121,753.Kennebec County - Selected Demographics: Median household income $55,365, Unemployment rate 5.0%, Individuals living in poverty 12.8%, Children living in poverty 13.9%, 65+ living alone 31.5%, Veterans 9.9%, Gay, lesbian, and bisexual (high school students) 12.7%, Gay, lesbian, and bisexual (adults) 3.0%, Transgender youth (high school students) 1.4%, Persons with a disability 16.6%.Other hospitals serving the Northern Light Inland Hospital community: Based on the State of Maines definition of hospital service area, Northern Light Inland Hospital is the only hospital in this community per Hospital Service Area (HSA) designation. Additionally, the Health Resources & Services Administration designated Inland Hospitals service area as having a total of 18 medically underserved population/areas.

Part VI, Line 4 - Community Building Activities
Northern Light Inland Hospitals community building activities include Central Maine Growth Council WiFi Sponsorship, Waterville Creates! Sponsorship, Central Maine Growth Council, FY22 Job Shadow - Staff time for job shadow and school tours.

Part VI, Line 7 - States Filing of Community Benefit Report
N/A

Part VI, Line 5 - Promotion of Community Health
Northern Light Inland Hospital furthers its exempt purpose by promoting the health of the community through the following grant activity in FY22:Community Health Education: Lets Go promote healthy habits and childhood obesity prevention tactics for enrolled schools, childcare programs, and other sites; Rural Health Clinic Vaccine Confidence Program to improve vaccine and counter vaccine hesitancy in rural communities where COVID-19 uptake lags in comparison to more populated areas.At Northern Light Inland Hospital, we strive to live up to our non-profit mission every day by caring for community members who otherwise would have limited access to quality healthcare. Besides providing charity care and financial assistance, we believe we can also affect the health of the communities we serve beyond the walls of our hospital and medical practices. We agree with the World Health Organization which states, Health is a state of complete physical, mental, and social well-being, and not merely the absence of disease or infirmity. We have a vision to be a responsible corporate citizen whose actions can impact our communitys overall well-being through commitments to priority issues. A hospital task force considered priority issues from the Community Health Needs Assessment and other data, and identified areas of significant needs to be addressed, as well as areas of need unable to be addressed by the hospital. An Implementation Strategy was developed and consisted of actions the hospital took to address the health need. Programs/resources the hospital committed to address the health need were identified along with planned collaborations with other area organizations. Northern Light Inland Hospital focused on four key areas: Physical Activity, nutrition, weight; Mental health; Substance abuse; Social determinants of health.In addition to efforts led by Northern Light Inland Hospital and our collaborating partners on the issues above through our Community Health Strategy, resources such as in-kind staff time and community benefit funding were dedicated to the following secondary issues:-Domestic Violence-Homelessness-Economic development-Education-Cultural supportNorthern Light Inland Hospital's 2022 Community Wellness initiatives included:a)We continued to dedicate Community Wellness Coordinator staff time to provide Lets Go! technical support to local schools, after-schools, and childcare sites. Lets Go! is an evidence-based childhood obesity prevention program that focuses on promoting good nutrition, physical activity, less screen time and more water consumption/less sugary drinks. b)We also utilized the Lets Go! program in the healthcare sector. Four out of Northern Light Inland Hospitals six Lets Go registered practices were recognized in 2019 for their efforts to curb childhood obesity in our patient populations. Components of the program include displaying posters with the 5210 healthy habits messages, tracking weight classification for patients ages 2-18, and using the Healthy Habits survey at all well-child visits to inspire respectful conversations around weight status and lifestyle behaviors. c)We continued to maintain the Inland Woods Trail on the hospital campus (created in 2010) with support from several local organizations. The trails were developed to create a lasting way to impact health, and give residents an easy, free resource for regular activity. The trails are used regularly by residents, hospital staff, and local schools for walking, biking, and snowshoeing. The trailhead was enhanced by adding a family-friendly Little Free Library in 2017.d)We provided ongoing support for the Quarry Road Recreation Area to support event and youth program sponsorships, and in-kind contributions of staff volunteer hours and board participation. e)We employ a full-time Community Health Navigator to help patients connect to local resources that help them overcome barriers to good health, such as housing, medication support, transportation, food support, and health care access. A majority of Northern Light Inland Hospitals board of trustees is comprised of people who reside in our primary service area who are neither employees nor independent contractors of the organization, nor family members thereof. Northern Light Inland Hospital extends medical staff privileges to qualified physicians in its community for some or all of its departments or specialties.The Northern Light Inland Hospital Foundation helps by raising funds for everything from capital expansion projects to residential activities to help offset normal operating expenses.Northern Light Inland Hospital utilizes surplus funds to support a medical simulation center on the hospital campus that is used for training of clinical staff. Examples of training include Advanced Cardiac Life Support, Neonatal Resuscitation Program, and Pediatric Advanced Life Support. Training is not limited to employees at Northern Light Inland Hospital - we also offer courses to local Emergency Medical Technicians and to clinicians at other hospitals in our region. Northern Light Inland Hospital invites men, women, and young adults to volunteer their time to further the hospital's mission. The pandemic impacted the amount of time volunteers from our community were allowed to volunteer and/or chose to participate. Some volunteers work in areas with direct contact with patients and families; others are involved in behind the scene activities, which enhance the care provided by the hospital.In 2022, Northern Light Inland and Northern Light Continuing Care, Lakewood employees engaged in our community by volunteering on local boards, committees and projects that helped contribute to a vital community.

Part VI, Line 6 - Affilated Health Care System
The 2022 Maine Shared Community Health Needs Assessment (CHNA) was conducted by Northern Light Health in collaboration with several member/affiliated hospitals, non-affiliated hospitals as well as public health and community organizations across the state. The Maine Shared CHNA informs initiatives to promote community health across the system as well as within each member hospitals local service area. Each member hospital adopted a local implementation strategy referred to as a Community Health Strategy and annual community health improvement plans, tailored to meet local needs.Northern Light Inland Hospital has been part of Eastern Maine Healthcare Systems d/b/a Northern Light Health (NLH) since 1998. As part of EMHS, we conduct Shared Community Health Needs Assessment in collaboration with several member/affiliated hospitals and many public health and community organizations across eight Maine counties.