2023-05-05T13:10:55-05:00 2022-06-30 381357951 PLANTE & MORAN PLLC 250 S HIGH ST SUITE 100 COLUMBUS OH 43215 990 2021-07-01 010130427 BRIDGTON HOSPITAL BRID 2077952813 10 HOSPITAL DRIVE BRIDGTON ME 04009 DAVID PAULOSKY CHIEF FINANCIAL OFFICER 2077952813 2023-05-03 1 DAVID PAULOSKY 999009999 AMY CIMINELLO P00796388 6148493000 2023-05-03 3 AAL1 IAL1 2021 2023-04-26 12:10:37Z DAVID PAULOSKY 10 HOSPITAL DRIVE BRIDGTON ME 04009 67712954 0 X WWW.CMHC.ORG X 1917 ME BRIDGTON HOSPITAL STRIVES TO PROVIDE EXCEPTIONAL HEALTHCARE SERVICES AND DEPENDS ON CAREGIVER EXPERTISE AND THE COMMITMENT AND COMPASSION THEY PROVIDE TO FULFILL ITS MISSION. X 14 11 341 30 0 0 890887 2496172 52584956 63547365 1679109 80786 51174 33394 55206126 66157717 0 0 0 0 21822856 21865870 0 0 0 26623174 34598688 48446030 56464558 6760096 9693159 42315863 30748124 18799123 15191968 23516740 15556156 TO PROVIDE EXCEPTIONAL HEALTHCARE SERVICES IN A SAFE AND TRUSTFULENVIRONMENT THROUGH THE EXPERTISE, COMMITMENT, AND COMPASSION OFOUR FAMILY OF CAREGIVERS. 0 0 46327981 0 63580759 BRIDGTON HOSPITAL IS A CRITICAL ACCESS HOSPITAL SERVING 20 SURROUNDING COMMUNITIES PLUS THE MOUNT WASHINGTON VALLEY COMMUNITIES OF NEW HAMPSHIRE. THE HOSPITAL HAS A MEDICAL/SURGICAL UNIT, CRITICAL CARE UNIT. OUR TWO OPERATING ROOMS HANDLE GENERAL, ORTHOPEDIC, AND AMBULATORY SURGERY. THE HOSPITAL HAS A 24 HOUR EMERGENCY DEPARTMENT AND NUMEROUS PROFESSIONAL SERVICES INCLUDING CT SCANNING, MRI, NUCLEAR MEDICINE SPECT SCANNING, TREADMILL INCLUDING THALLIUM ONCOLOGY CLINIC, INPATIENT AND OUTPATIENT PHYSICAL THERAPY AND MEDICAL SCIENCES LIBRARY. 46327981 1 1 0 1 0 0 0 0 0 1 1 0 0 1 1 0 0 1 0 0 0 0 0 0 0 0 1 1 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 1 22 0 1 341 1 0 0 0 0 0 1 1 0 0 0 0 0 0 X 14 11 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 0 0 0 ME X KRISTEN ST PETER 2077957124 29 LOWELL ST BOX A LEWISTON ME 04240 X ANN CONNELLY DIRECTOR 3.00 1.00 X 0 0 0 AUSTIN ALBERT VICE CHAIR 3.00 1.00 X X 0 0 0 DEVORE CULVER CHAIR PERSON/ DIRECTOR 3.00 1.00 X X 0 0 0 GEOFFREY SWIFT DIRECTOR 3.00 1.00 X 0 0 0 JANET HALL KOSKI DIRECTOR 3.00 1.00 X 0 0 0 JOHN MCANUFF DIRECTOR 3.00 1.00 X 0 0 0 JOLAN IPPOLITO DIRECTOR 3.00 1.00 X 0 0 0 LOUIS SILVERMAN DIRECTOR 3.00 1.00 X 0 0 0 MARNEY CHALMERS DIRECTOR 3.00 1.00 X 0 0 0 SHANNON GAUVIN DIRECTOR (BEG 01/2022) 3.00 1.00 X 0 0 0 SHERWOOD MOODY DIRECTOR 3.00 1.00 X 0 0 0 WILLIAM CLIFFORD DIRECTOR (END 12/2021) 3.00 1.00 X 0 0 0 JEFFREY BRICKMAN PRESIDENT/DIRECTOR (END 07/2021) 3.00 60.00 X X 0 1410525 189495 STEVE LITTLESON PRESIDENT/DIRECTOR (BEGIN 07/2021) 3.00 60.00 X X 0 729062 30591 DAVID SALKO PHYSICIAN/DIRECTOR 3.00 55.00 X 0 360886 25322 HECTOR TARRAZA PHYSICIAN/DIRECTOR 3.00 55.00 X 0 367681 0 JENNIFER WEINER-SMITH PHYSICIAN/DIRECTOR (END 12/21) 3.00 55.00 X 0 337629 27688 DAVID PAULOSKY TREASURER (BEG 06/2022) 3.00 60.00 X 0 0 0 CORY BAGBY SECRETARY (END 03/2022) 3.00 55.00 X 0 371046 7015 ELIZABETH SHEW SECRETARY (BEGIN 03/2022) 3.00 55.00 X 0 134438 12560 PETER WRIGHT PRESIDENT BRIDGTON HOSPITAL 55.00 3.00 X 0 510441 10560 JOSEPH BELL PHYSICIAN 55.00 0.00 X 346594 0 22903 LISA BOSINGER PHYSICIAN 55.00 0.00 X 259081 0 8671 DARIUS PIERKO PHYSICIAN 55.00 0.00 X 275364 0 22129 KATRINA SINK PHYSICIAN 55.00 0.00 X 240089 0 19792 MARY WOOD PHYSICIAN 55.00 0.00 X 252267 0 18800 1373395 4221708 395526 26 0 1 0 AYA HEALTHCARE INC 5930 CORNERSTONE CT W SUITE 300 SAN DIEGO CA 92121 MEDICAL STAFFING 2971544 SODEXO INC 9801 WASHINGTONIAN BLVD GAITHERSBURG MD 20878 SUPPORT SERVICES 2456228 QUEST DIAGNOSTICS 500 PLAZA DRIVE SECAUCUS NJ 07094 LAB SERVICES 1904412 CPS SOLUTIONS LLC 655 METRO PL S SUITE 450 DUBLIN OH 43017 MEDICAL STAFFING 540606 MAINE IMAGING SERVICES LLC 700 CONGRESS ST- SUITE 204 QUINCY MA 02169 MEDICAL STAFFING 537807 12 2463766 32406 2496172 NET PATIENT SERVICE REVENUE 621990 63547365 63547365 63547365 195686 195686 33394 0 33394 33394 33394 1440337 1555237 -114900 -114900 -114900 66157717 63580759 0 80786 19190386 16503732 2686654 1622237 1395124 227113 1053247 905792 147455 16920 16920 836 627 209 1350314 1012736 337578 115460 86595 28865 1086491 814868 271623 75 56 19 63375 47531 15844 185215 29634 155581 1877482 1652184 225298 1551271 1163453 387818 LEASED EMPLOYEE EXPENSE 12484834 9363626 3121208 MEDICAL SUPPLIES 10023528 7517646 2505882 BAD DEBT EXPENSE 5808845 5808845 LEASE EXPENSE 33110 24833 8277 932 699 233 56464558 46327981 10136577 0 5390051 26956 2061778 1354945 6879540 6540085 630954 634328 207342 130227 43757982 32658413 12584978 11099569 12551026 8873901 64985 43987 1945209 2044126 42315863 30748124 3136917 7259208 263376 5454756 5347287 3394686 -340000 6812764 2662097 18799123 15191968 X 20418808 12403543 3097932 3152613 23516740 15556156 42315863 30748124 X 9693159 -1449802 141994 -16345935 X X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 3894 3894 0 PART II-B, LINE 1: PORTION OF DUES FOR PROFESSIONAL ASSOCIATIONS ATTRIBUTED TO LOBBYING $3894. 3097932 395678 -335397 5600 3152613 3273300 11634 521949 708951 3097932 3864503 28890 -10731 609362 3273300 4605710 508441 178303 1427951 3864503 4421122 75559 139533 30504 4605710 0.00000 0.84159 0.15841 0 1 1 737725 737725 20458246 11910165 8548081 6767 6767 0 22540534 20741481 1799053 14710 14710 11099569 INTEREST IN BENEFICIAL TRUSTS 566633 BONDS 1397313 ROU ASSETS 80180 2044126 MEDICARE CONTRACT LIABILITIES 1436918 LEASE LIABILITIES- OPERATING 31068 LEASE LIABILITIES- FINANCE 362321 ASSET RETIREMENT OBLIGATIONS 805305 LONG TERM CHOICE TIME 26485 2662097 PART V, LINE 4: ENDOWMENT FUNDS ARE USED TO SUPPORT THE ORGANIZATION IN A VARIETY OF WAYS, DEPENDING UPON THE STATED PURPOSE OF EACH FUND. MANY OF THESE FUNDS HELP TO COVER COSTS OF CAPITAL EQUIPMENT PURCHASES, CONTINUING EDUCATION, OR FREE CARE. OTHERS ARE DESIGNATED TO SUPPORT SPECIFIC DEPARTMENTS OF THE HOSPITAL. 1 1 X 1 X 0 1 1 0 0 1145462 453632 691830 0.01370 11771338 10292457 1478881 0.02920 12916800 10746089 2170711 0.04290 81202 58316 22886 0.00050 81202 58316 22886 0.00050 12998002 10804405 2193597 0.04340 0 5808845 1080803 12125186 12040569 84617 X 1 1 1 1 BRIDGTON HOSPITAL 10 HOSPITAL DRIVE BRIDGTON ME 04009 WWW.CMHC.ORG 38658 X X X X OUTPATIENT PHYSICIAN CLINICS BRIDGTON HOSPITAL 1 0 0 1 X X X X X X X X X 21 1 1 1 1 X SEE PART V, PAGE 8 X SEE PART V, PAGE 8 X 1 21 1 SEE PART V, PAGE 8 0 1 X 200.000000000000 0.000000000000 X X X 1 1 X X X 1 X SEE PART V, PAGE 8 X SEE PART V, PAGE 8 X SEE PART V, PAGE 8 X X X X X X 1 X 0 X X X X 1 X 0 0 BRIDGTON HOSPITAL PART V, SECTION B, LINE 5: THE MAINE SHARED CHNA STEERING COMMITTEE, COMMUNITY ENGAGEMENT COMMITTEE, AND LOCAL PLANNING GROUPS CO-ORGANIZED COMMUNITY FORUMS INCLUDING RECRUITING VOLUNTEER SCRIBES AND FACILITATORS, MARKETING THE FORUMS, AND IDENTIFYING HEALTH INDICATOR DATA TO BE PRESENTED TO FORUM PARTICIPANTS.DUE TO THE ONGOING COVID-19 PANDEMIC, MOST OF THE LOCAL FORUMS WERE HELD VIRTUALLY ON ZOOM. IN ADDITION TO ZOOM, THERE WERE SEVERAL OTHER ONLINE PLATFORMS UTILIZED FOR DATA COLLECTION INCLUDING IDEABOARDZ, MENTIMETER, AND SURVEY MONKEY. JOHN SNOW, INC., A CONTRACTED ORGANIZATION FOR THE CHNA PROCESS, PROVIDED TECHNICAL SUPPORT AND DATA COLLECTION THAT WAS UTILIZED AND INCLUDED IN THE COUNTY FORUMS, LOCALLY-SPONSORED EVENTS, AND THE COMMUNITY-SPONSORED FORUMS. THERE WERE FOUR DIFFERENT TYPES OF EVENTS FOR DATA COLLECTION THAT TOOK PLACE DURING THE 2021 CHNA:-COUNTY FORUMS: EACH COUNTY ACROSS THE STATE HELD A COUNTY-WIDE COMMUNITY FORUM HOWEVER, WITH THE VAST DIFFERENCES BETWEEN URBAN AND RURAL CUMBERLAND COUNTY, THERE WERE TWO SEPARATE REGIONAL FORUMS TO ADDRESS THE DIFFERENT NEEDS, SERVICE AREAS AND POPULATIONS WITHIN THE GEOGRAPHICALLY DIVERSE CUMBERLAND COUNTY. THESE FORUMS WERE FOR GREATER PORTLAND, AN URBAN COMMUNITY SERVED BY MAINEHEALTH, AND LAKES REGION, A MORE RURAL POPULATION MAINLY SERVED BY CMHC'S BRIDGTON HOSPITAL -LOCALLY-SPONSORED EVENTS: IN ADDITION TO THE COUNTY FORUMS, COUNTY/REGION PLANNING GROUPS WERE ABLE TO HOLD LOCALLY-SPONSORED FORUMS WITH EXISTING COMMUNITY GROUPS -COMMUNITY-SPONSORED EVENTS: WERE HOSTED BY AND FOR THOSE WHOSE VOICES MAY NOT HAVE BEEN PRESENT AT COUNTY FORUMS. THESE EVENTS FOCUSED ON UNDER-REPRESENTED GROUPS AND WERE HOSTED BY ORGANIZATIONS THAT WORKED WITH THESE COMMUNITIES -ORAL SURVEYS: WERE UTILIZED TO INCLUDE IMMIGRANT, REFUGEE, AND NEW MAINER VOICES BRIDGTON HOSPITAL PART V, SECTION B, LINE 6A: THE CHNA IS CONDUCTED THROUGH A MAINE SHARED CHNA COLLABORATION INCLUDING REPRESENTATION FROM MAINEGENERAL HEALTH, MAINEHEALTH, AND NORTHERN LIGHT HEALTH. BRIDGTON HOSPITAL PART V, SECTION B, LINE 6B: ADDITIONAL NON-HOSPITAL FACILITIES INVOLVED IN THE MAINE SHARED CHNA ARE THE MAINE CENTER FOR DISEASE CONTROL AND PREVENTION, MAINE DEPARTMENT OF HEALTH AND HUMAN SERVICES; THE UNIVERSITY OF SOUTHERN MAINE'S MUSKIE SCHOOL OF PUBLIC SERVICE AND JOHN SNOW, INC WHO BOTH PROVIDED DATA ORGANIZATION, ANALYSIS, METHODOLOGY, AND DESIGN SUPPORT; AND NUMEROUS COMMUNITY PARTNERS AND STAKEHOLDER GROUPS INCLUDING THE STEERING COMMITTEE, METRICS COMMITTEE, DATA ANALYSIS WORKGROUP, COMMUNITY ENGAGEMENT COMMITTEE, AND LOCAL PLANNING COMMITTEE. BRIDGTON HOSPITAL PART V, SECTION B, LINE 11: HEALTH PRIORITIES FOR EACH COUNTY WERE IDENTIFIED THROUGH COMMUNITY PARTICIPATION AND VOTING AT THE FORUMS DURING THE FALL OF 2021. THE FORUMS WERE AN OPPORTUNITY FOR COMMUNITY MEMBERS TO REVIEW THE COUNTY HEALTH PROFILES, DISCUSS COMMUNITY NEEDS, AND PRIORITIZE PERCEIVED COMMUNITY NEEDS IN SMALL BREAK-OUT SESSIONS FOLLOWED WITH A VOTE BY PARTICIPANTS.THE RESPECTIVE COMMUNITY HEALTH COMMITTEE THEN VOTED TO IDENTIFY TWO PRIORITIES TO FOCUS ON, AND THE HEALTH PROMOTION COORDINATOR WORKED WITH HOSPITAL LEADERSHIP, STAFF, AND COMMUNITY PARTNERS TO CREATE TANGIBLE AND REALISTIC GOALS, STRATEGIES, AND ACTIVITIES TO ADDRESS EACH PRIORITY. DURING THE 2019-2022 CYCLE, A THIRD PRIORITY WAS ADDED AROUND CAPACITY BUILDING FOR CREATING SUSTAINABILITY FOR THE WORK WITHIN THE HOSPITAL. FOR THE 2022-2025 PLANS, SUSTAINABILITY IS WEAVED INTO EACH PRIORITY AND DIVERSITY, EQUITY, INCLUSION AND BELONGING WAS IDENTIFIED AS A SYSTEM-WIDE PRIORITY.THE HEALTH PRIORITIES CHOSEN BY THE HOSPITAL COMMUNITY HEALTH COMMITTEES IS MENTAL HEALTH AND SUBSTANCE/ALCOHOL USEFOR MORE INFORMATION ON THE ACTIVITIES IDENTIFIED AND PRIORITIES NOT SELECTED BY THE COMMUNITY HEALTH COMMITTEE FOR BRIDGTON HOSPITAL, PLEASE GO TO COMMUNITY BENEFITS | BRIDGTON HOSPITAL | BRIDGTON, ME (CMHC.ORG) BRIDGTON HOSPITAL PART V, SECTION B, LINE 13H: FAP ELIGIBILITY CRITERIA:PATIENTS MUST APPLY FOR MAINE FREE CARE IN ORDER TO BE CONSIDERED FOR THEHOSPITAL'S FREE CARE PROGRAM. AS PART OF THE APPLICATION, PATIENTS MUSTSUBMIT A COPY OF CURRENT MAINECARE DECISION LETTERS. PATIENTS WILL BEASKED IF THEY HAVE INSURANCE OF ANY KIND TO HELP PAY FOR CARE AND AREALSO ASKED TO SHOW THAT INSURANCE OR A GOVERNMENT PROGRAM WILL NOT PAYFOR YOUR CARE. IF PATIENTS DO NOT QUALIFY FOR FREE HOSPITAL CARE, THEYARE ALLOWED TO ASK FOR A FAIR HEARING OR APPEAL. PART V, SECTION B, LINE 7A HTTPS://WWW.CMHC.ORG/BRIDGTON-HOSPITAL/ABOUT-BRIDGTON-HOSPITAL/COMMUNITY-BENEFITS/ PART V, SECTION B, LINE 7B HTTPS://WWW.MAINE.GOV/DHHS/MECDC/PHDATA/MAINECHNA/ABOUT-MAINE-CHNA.SHTML PART V, SECTION B, LINE 10A HTTPS://WWW.CMHC.ORG/BRIDGTON-HOSPITAL/ABOUT-BRIDGTON-HOSPITAL/COMMUNITY-BENEFITS/ PART V, SECTION B, LINE 16A, FAP WEBSITE: HTTPS://WWW.CMHC.ORG/PATIENTS-VISITORS/BILLING-FINANCIAL-INFORMATION/FINANCIAL-ASSISTANCE/ PART V, SECTION B, LINE 16B, FAP APPLICATION WEBSITE: HTTPS://WWW.CMHC.ORG/PATIENTS-VISITORS/BILLING-FINANCIAL-INFORMATION/FINANCIAL-ASSISTANCE/ PART V, SECTION B, LINE 16C, FAP PLAIN LANGUAGE SUMMARY WEBSITE: HTTPS://WWW.CMHC.ORG/PATIENTS-VISITORS/BILLING-FINANCIAL-INFORMATION/FINANCIAL-ASSISTANCE/ 6 1 - BRIDGTON GENERAL SURGERY 25 HOSPITAL DRIVE BRIDGTON ME 04009 OUTPATIENT PHYSICIAN CLINIC 2 - BRIDTON GASTROENTEROLOGY 15 HOSPITAL DRIVE BRIDGTON ME 04009 OUTPATIENT PHYSICIAN CLINIC 3 - NAPLES FAMILY PRACTICE 410 ROOSEVELT TRAIL NAPLES ME 04055 OUTPATIENT PHYSICIAN CLINIC 4 - BRIDGTON PEDIATRICS 25 HOSPITAL DRIVE BRIDGTON ME 04009 OUTPATIENT PHYSICIAN CLINIC 5 - NORTH BRIDGTON FAMILY PRACTICE 14 WYONEGONIC ROAD BRIDGTON ME 04009 OUTPATIENT PHYSICIAN CLINIC 6 - FRYEBURG FAMILY MEDICINE 253 BRIDGTON ROAD FRYEBURG ME 04037 OUTPATIENT PHYSICIAN CLINIC PART I, LINE 3C: PATIENTS MUST APPLY FOR MAINE FREE CARE IN ORDER TO BE CONSIDERED FOR THEHOSPITAL'S FREE CARE PROGRAM. AS PART OF THE APPLICATION, PATIENTS MUSTSUBMIT A COPY OF CURRENT MAINECARE DECISION LETTERS. PATIENTS WILL BEASKED IF THEY HAVE INSURANCE OF ANY KIND TO HELP PAY FOR CARE AND AREALSO ASKED TO SHOW THAT INSURANCE OR A GOVERNMENT PROGRAM WILL NOT PAYFOR YOUR CARE. IF PATIENTS DO NOT QUALIFY FOR FREE HOSPITAL CARE, THEYARE ALLOWED TO ASK FOR A FAIR HEARING OR APPEAL.ELIGIBILITY FOR 100% FINANCIAL ASSISTANCE AS STATED IN THE FINANCIAL ASSISTANCE POLICY: A. FINANCIAL ASSISTANCE FOR MEDICALLY NECESSARY CARE IS AVAILABLE TO MAINE RESIDENTS WHO: HAVE NO HEALTH INSURANCE COVERAGE OR HAVE COVERAGE THAT PAYS ONLY PART OF THE BILL; AND MEET THE INCOME CRITERIA SET FORTH BELOW. B. FINANCIAL ASSISTANCE FOR EMERGENCY CARE IS AVAILABLE TO MAINE RESIDENTS AND NON-MAINE RESIDENTS WHO: HAVE NO HEALTH INSURANCE COVERAGE OR HAVE COVERAGE THAT PAYS ONLY PART OF THE BILL; AND MEET THE INCOME CRITERIA SET FORTH BELOW. C. CMH HOSPITALS PROVIDE 100% FINANCIAL ASSISTANCE BASED ON CRITERIA AS DEFINED BELOW: GROSS INCOME IS BELOW 200% OF THE FPL, SUBJECT TO APPROVAL PATIENT IS A RESIDENT OF MAINE NON-MAINE RESIDENT SEEKING EMERGENCY CARE FOR SERVICES OR SUPPLIES THAT ARE A MEDICAL NECESSITY ALL THIRD-PARTY PAYER SOURCES HAVE BEEN EXHAUSTED D. NO INDIVIDUAL ELIGIBLE FOR FINANCIAL ASSISTANCE WILL BE CHARGED MORE FOR EMERGENCY OR OTHERWISE MEDICALLY NECESSARY CARE THAN THE CALCULATED AGB. PART I, LINE 7: COSTING METHODOLOGY:THE COST TO CHARGE RATIO CALCULATED ON IRS WORKSHEET 2 WAS USED TO CALCULATE AMOUNTS ON IRS WORKSHEETS 1 AND 3. ALL OTHER WORKSHEETS USED THE ORGANIZATION'S COST ACCOUNTING SYSTEM. PART I, LN 7 COL(F): THE PERCENT OF TOTAL EXPENSE ON SCHEDULE H, PART I, LINE 7, COLUMN (F),WAS CALCULATED USING TOTAL EXPENSES ON FORM 990, PART IX, LINE 25,COLUMN(A). PART III, LINE 2: BAD DEBT EXPENSE:THE HOSPITAL HAS ADOPTED THE NEW REVENUE RECOGNITION STANDARD ASU2014-09. UNDER ASU 2014-09, THE ESTIMATED AMOUNTS DUE FROM PATIENTS FORWHICH THE HEALTH SYSTEMS DOES NOT EXPECT TO BE ENTITLED OR COLLECT FROMTHE PATIENTS ARE CONSIDERED IMPLICIT PRICE CONCESSIONS AND EXCLUDED FROMTHE HEALTH SYSTEM'S ESTIMATION OF THE TRANSACTION PRICE OR REVENUERECORDED. BAD DEBT EXPENSE WAS NOT SIGNIFICANT TO THE AUDITED FINANCIALSTATEMENTS FOR THE YEAR. HOWEVER, THE HOSPITALINTERNALLY TRACKS BAD DEBT EXPENSE CONSISTENT WITH HISTORICAL PRACTICESAND THAT AMOUNT HAS BEEN REPORTED ON SCHEDULE H, PART III, SECTION A,LINE 2. PART III, LINE 3: BAD DEBT EXPENSE ATTRIBUTABLE TO CHARITY CARE:BAD DEBT ATTRIBUTABLE TO PATIENTS UNDER THE ORGANIZATION'S CHARITY CAREPOLICY FOR LINE 3 WAS DETERMINED USING A COMPARISON OF EXPERIENCEDCHARITY CARE COVERAGE AND US CENSUS BUREAU DATA FOR THE MOST RECENT YEARAVAILABLE WHEN CHARITY CARE CONVERGE EXCEEDS THE CENSUS DATA, A MINIMALAMOUNT OF BAD DEBT IS ASSUMED TO BE ELIGIBLE FOR CHARITY CARE TO ACCOUNTFOR THOSE PATIENTS WHO REFUSE TO PROVIDE INFORMATION DOCUMENTINGELIGIBILITY FOR THE PROGRAM. THESE ESTIMATES ARE BASED ON STATE-WIDE DATAAND DO NOT ACCOUNT FOR DIFFERENCES IN GEOGRAPHIC LOCATIONS WITHIN THESTATE. AS THIS AMOUNT IS RELATED TO PATIENTS ELIGIBLE UNDER THE FINANCIALASSISTANCE POLICY, IT IS INCLUDED AS A COMMUNITY BENEFIT. PART III, LINE 4: BAD DEBT EXPENSE FOOTNOTE:THE AUDITED FINANCIAL STATEMENTS DO NOT CONTAIN A FOOTNOTE THAT DESCRIBESBAD DEBT EXPENSE. THEY DO, HOWEVER, CONTAIN A FOOTNOTE THAT DESCRIBESPATIENTS ACCOUNTS RECEIVABLE:ACCOUNTS RECEIVABLE FOR PATIENTS, INSURANCE COMPANIES, AND GOVERNMENTAL AGENCIES ARE BASED ON GROSS CHARGES, REDUCED BY EXPLICIT PRICE CONCESSIONS PROVIDED TO THIRD-PARTY PAYORS, DISCOUNTS PROVIDED TO QUALIFYING INDIVIDUALS AS PART OF THE CORPORATION'S FINANCIAL ASSISTANCE POLICY, AND IMPLICIT PRICE CONCESSIONS PROVIDED PRIMARILY TO SELF-PAY PATIENTS. ESTIMATES FOR EXPLICIT PRICE CONCESSIONS ARE BASED ON PROVIDER CONTRACTS, PAYMENT TERMS FOR RELEVANT PROSPECTIVE PAYMENT SYSTEMS, AND HISTORICAL EXPERIENCE ADJUSTED FOR ECONOMIC CONDITIONS AND OTHER TRENDS AFFECTING THE CORPORATION'S ABILITY TO COLLECT OUTSTANDING AMOUNTS.FOR RECEIVABLES ASSOCIATED WITH SELF-PAY PATIENTS, WHICH INCLUDES BOTH PATIENTS WITHOUT INSURANCE AND PATIENTS WITH DEDUCTIBLE AND COPAYMENT BALANCES DUE FOR WHICH THIRD-PARTY COVERAGE EXISTS FOR PART OF THE BILL, THE CORPORATION RECORDS SIGNIFICANT IMPLICIT PRICE CONCESSIONS IN THE PERIOD OF SERVICE ON THE BASIS OF ITS PAST EXPERIENCE, WHICH INDICATES THAT MANY PATIENTS ARE UNABLE OR UNWILLING TO PAY THE PORTION OF THEIR BILL FOR WHICH THEY ARE FINANCIALLY RESPONSIBLE. PART III, LINE 8: COMMUNITY BENEFIT:THE COSTING METHODOLOGY USED FOR LINE 6 IS INFORMATION PULLED FROM THEMEDICARE COST REPORT FILING. IF THE PATIENTS FALLING UNDER200% FPG LEVEL WERE NOT COVERED BY MEDICARE THEY WOULD QUALIFY UNDERBRIDGTON HOSPITAL'S FREE CARE POLICY. UNDER THAT CIRCUMSTANCE, THESEPATIENTS WOULD THEN APPEAR AS PART OF THE STATISTICS ON PART I, LINE 7A. PART III, LINE 9B: COLLECTION POLICY:COLLECTION PRACTICES FOR PATIENTS KNOWN TO BE ELIGIBLE FOR CHARITY CAREARE LIMITED TO COLLECTING FROM ANY AVAILABLE PAYMENT SOURCES SUCH ASMEDICARE OR MEDICAID. IF A PATIENT IS ELIGIBLE, BUT HAS NOT APPLIED FORMEDICAID COVERAGE, THE PATIENT IS REQUESTED TO APPLY. ASSISTANCE IS AVAILABLE TO HELP THE PATIENT WITH THE MEDICAID APPLICATION PROCESS. PART VI, LINE 2: NEEDS ASSESSMENT:AS A CRITICAL ACCESS HOSPITAL, BRIDGTON HOSPITAL ATTEMPTS TO PROVIDE ANYNEEDED HEALTH CARE SERVICES NECESSARY TO TREAT THE POPULATION OF THISRURAL AREA OF MAINE. ADDITIONALLY, BRIDGTON HOSPITAL FOCUSES ONSTATE-WIDE INITIATIVES, SUCH AS HEART DISEASE AND DIABETES, AS WELL ASORGANIZATIONAL INITIATIVES BASED ON NEEDS OBSERVED WITHIN ITS PATIENTPOPULATION. MANY FORMS OF EDUCATION, PREVENTION AND EARLY DETECTION AREALSO, PART OF ITS COMMUNITY HEALTH CARE PLAN. PART VI, LINE 3: PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE:BRIDGTON HOSPITAL PROVIDES NOTICES ABOUT ITS FREE CARE POLICY IN ALLCLINICAL DEPARTMENTS AND MAJOR PATIENT AREAS. AN INPATIENT FINANCIALCOUNSELOR VISITS WITH ALL UNINSURED PATIENTS TO DISCUSS OPTIONS,INCLUDING GOVERNMENTAL PROGRAM ELIGIBILITY AND FREE CARE ASSISTANCE IS AVAILABLE TO HELP PATIENTS WITH COMPLETION OF MEDICAID APPLICATIONS. ALLPATIENT FINANCIAL SERVICES STAFF ARE TRAINED TO OFFER FREE CARE AS ANOPTION TO PATIENTS WHO INDICATE AN INABILITY OR DIFFICULTY IN PAYING FORSERVICES. INFORMATION ABOUT FINANCIAL ASSISTANCE AVAILABILITY IS INCLUDEDON THE BACK OF EVERY PATIENT STATEMENT. ADDITIONALLY, UNINSURED PATIENTSRECEIVE A SEPARATE INFORMATION SHEET WITH THEIR STATEMENTS, FURTHERINFORMING THEM ABOUT THE AVAILABLE OPTIONS. PART VI, LINE 4: COMMUNITY INFORMATION:BRIDGTON HOSPITAL, LOCATED IN BRIDGTON, MAINE, SERVES 21 TOWNS IN THE"LAKES REGION" OF WESTERN MAINE, AS WELL AS THE WESTERN MOUNTAINS OFMAINE AND THE MOUNT WASHINGTON VALLEY REGION OF NEW HAMPSHIRE. THE REGIONIS RURAL IN NATURE AND IS PRIMARILY MADE UP OF WESTERN CUMBERLAND ANDSOUTHERN OXFORD COUNTIES IN MAINE, AS WELL AS CARROLL COUNTY IN NEWHAMPSHIRE. THE REGION IS PRIMARILY MADE UP OF CAUCASIAN PERSONS AND HAS AVARIABLE POPULATION. THE REGION IS A SUMMER TOURIST DESTINATION AND THEPOPULATION SWELLS DRAMATICALLY DURING THAT SEASON, MAKING DEMOGRAPHICS SOMEWHAT FLUID. APPROXIMATELY 14% OF THE YEAR-ROUND POPULATION IS BELOWTHE POVERTY LEVEL. PART VI, LINE 5: PROMOTION OF COMMUNITY HEALTH:BRIDGTON HOSPITAL HAS AN OPEN MEDICAL STAFF, ALLOWING ANY NON-EMPLOYED ORAFFILIATED PHYSICIANS TO HAVE ADMITTING PRIVILEGES TO THE HOSPITAL. THEBOARD OF DIRECTORS IS MADE UP OF A MAJORITY OF LOCAL COMMUNITY MEMBERSALONG WITH SOME REPRESENTATION BY DIRECTORS FROM CENTRAL MAINEHEALTHCARE, THE PARENT OF THE HEALTHCARE SYSTEM WHICH BRIDGTON HOSPITALBELONGS TO, HELPING TO BRING TOGETHER THE VISIONS OF THE LOCAL COMMUNITYWITH THE CAPABILITIES AND VISION OF THE SYSTEM AS A WHOLE FOR THE BENEFITOF BRIDGTON AND SURROUNDING COMMUNITIES. PART VI, LINE 6: AFFILIATED HEALTH CARE SYSTEM:AS A MEMBER OF THE CENTRAL MAINE HEALTHCARE SYSTEM, BRIDGTON HOSPITALPROVIDES HIGH QUALITY HEALTH CARE IN A RURAL SETTING WITH LIMITED HEALTH CARE OPTIONS. ITS AFFILIATION WITH CENTRAL MAINE MEDICAL CENTER PROVIDESACCESS TO A MUCH LARGER, TERTIARY CARE HOSPITAL, INCLUDING TRAUMA CARE,NEONATAL INTENSIVE CARE, AND A SPECIALIZED CARDIAC CARE UNIT.ADDITIONALLY, CENTRAL MAINE MEDICAL CENTER PROVIDES ACCESS TO SPECIALISTPHYSICIANS FOR OUTPATIENT CARE IN THE BRIDGTON AREA ON A REGULARSCHEDULE. THE SYSTEM PARENT, CENTRAL MAINE HEALTHCARE, PROVIDESSTREAMLINED ADMINISTRATIVE FUNCTIONS AND BACK OFFICE SERVICES, ALLOWINGBRIDGTON HOSPITAL TO PERFORM AT A COST-EFFICIENT LEVEL WHICH WOULDNORMALLY BE UNACHIEVABLE IN A SMALL, RURAL HOSPITAL, ALLOWING FOR BROADERRANGE OF SERVICES AVAILABLE. 0 1 0 0 0 0 0 0 0 JEFFREY BRICKMAN PRESIDENT/DIRECTOR (END 07/2021) 0 489351 0 347838 0 573336 0 165360 0 24135 0 1600020 0 562418 STEVE LITTLESON PRESIDENT/DIRECTOR (BEGIN 07/2021) 0 592242 0 71875 0 64945 0 0 0 30591 0 759653 0 0 PETER WRIGHT PRESIDENT BRIDGTON HOSPITAL 0 370405 0 94729 0 45307 0 0 0 10560 0 521001 0 0 DAVID SALKO PHYSICIAN/DIRECTOR 0 273491 0 84570 0 2825 0 0 0 25322 0 386208 0 0 CORY BAGBY SECRETARY (END 03/2022) 0 321452 0 15825 0 33769 0 0 0 7015 0 378061 0 0 JOSEPH BELL PHYSICIAN 336310 0 0 0 10284 0 0 0 22903 0 369497 0 0 0 HECTOR TARRAZA PHYSICIAN/DIRECTOR 0 359651 0 0 0 8030 0 0 0 0 0 367681 0 0 JENNIFER WEINER-SMITH PHYSICIAN/DIRECTOR (END 12/21) 0 307351 0 26214 0 4064 0 0 0 27688 0 365317 0 0 DARIUS PIERKO PHYSICIAN 236435 0 0 0 38929 0 0 0 22129 0 297493 0 0 0 MARY WOOD PHYSICIAN 228855 0 0 0 23412 0 0 0 18800 0 271067 0 0 0 LISA BOSINGER PHYSICIAN 256031 0 0 0 3050 0 0 0 8671 0 267752 0 0 0 KATRINA SINK PHYSICIAN 190253 0 27942 0 21894 0 0 0 19792 0 259881 0 0 0 PART I, LINE 3 CEO COMPENSATION: THE COMPENSATION OF THE ORGANIZATION'S PRESIDENT IS DETERMINED BY THE PARENT CORPORATION'S BOARD OF DIRECTORS' EXECUTIVE COMPENSATION COMMITTEE USING THE FOLLOWING: -COMPENSATION COMMITTEE -INDEPENDENT COMPENSATION CONSULTANT -COMPENSATION SURVEY OR STUDY -APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE PART I, LINE 4B SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN: A PARTICIPANT'S ENTITLEMENT TO BENEFITS WILL VEST ON THE PARTICIPANT'S VESTING DATE PROVIDED THE PARTICIPANT HAS REMAINED IN CONTINUOUS EMPLOYMENT IN THE SAME POSITION WHILE PARTICIPATING IN THIS PLAN. A PARTICIPANT WILL HAVE ONLY ONE VESTING DATE FOR ALL ELECTIVE DEFERRALS AND OTHER PLAN CONTRIBUTIONS MADE ON THE PARTICIPANT'S BEHALF DURING ALL PLAN YEARS. A PARTICIPANT'S ENTITLEMENT TO BENEFITS WILL ALSO VEST ( A) IF THE PARTICIPANT DIES WHILE STILL EMPLOYED BY THE EMPLOYER, ( B) IF THE PARTICIPANT'S EMPLOYMENT TERMINATES DUE TO TOTAL DISABILITY, OR ( C) IF THE EMPLOYER TERMINATES THE PARTICIPANTS EMPLOYMENT FOR ANY REASON OTHER THAN FOR CAUSE ANY PORTION OF THE PARTICIPANT'S ENTITLEMENT BENEFITS THAT IS NOT VESTED WHEN THE PARTICIPANT'S EMPLOYMENT WITH THE EMPLOYER TERMINATES, INCLUDING ELECTIVE DEFERRALS, WILL BE FORFEITED. THE EMPLOYER WILL DISTRIBUTE A PARTICIPANT'S BENEFITS UNDER THE PLAN AS SOON AS PRACTICABLE AFTER THE PARTICIPANT'S ENTITLEMENT BECOMES VESTED. A MAINE HEALTH AND HIGHER EDUCATIONAL FACILITIES 010314384 56042RLG5 2001-06-27 6150311 REFUND BOND SERIES 2001A 0 0 1 A 1235000 6150311 68878 6083433 2017 1 0 1 1 A 0 0 0 0 0.00000 0.00000 0.00000 0 0 0 A 0 1 0 0 0 0 0 0 0 A 0 EQUITY TRANSFER TO AFFILIATE 2022-06-30 16692426 ACCRUAL 010386913 CENTRAL MAINE HEALTHCARE CORPORATION PO BOX 4500 LEWISTON ME 04243 501(C)(3) 0 0 0 0 PART II, LINE 2E: EXPLANATION OF INVOLVEMENT: NET ASSETS OF THE ORGANIZATION WERE TRANSFERRED TO CENTRAL MAINE HEALTHCARE CORPORATION, THE SOLE MEMBER OF BRIDGTON HOSPITAL. THE BOARD OF DIRECTORS OF CENTRAL MAINE HEALTHCARE CORPORATION CONSIST OF THE SAME INDIVIDUALS SERVING AS MEMBERS OF BRIDGTON HOSPITAL'S BOARD OF DIRECTORS. FORM 990, PART VI, SECTION A, LINE 6 THE SOLE MEMBER OF THE CORPORATION SHALL BE CENTRAL MAINE HEALTHCARE CORPORATION ACTING THROUGH THE MEMBER'S BOARD OF DIRECTORS. THE BOARD OF DIRECTORS OF THE CORPORATION SHALL CONSIST OF THE SAME INDIVIDUALS SERVING AS MEMBERS OF THE MEMBER'S BOARD OF DIRECTORS. THE MEMBER MAY MAKE, AMEND OR REPEAL THE BYLAWS IN A WHOLE OR IN PART. FORM 990, PART VI, SECTION A, LINE 7A THE SOLE MEMBER OF THE CORPORATION SHALL BE CENTRAL MAINE HEALTHCARE CORPORATION ACTING THROUGH THE MEMBER'S BOARD OF DIRECTORS. THE BOARD OF DIRECTORS OF THE CORPORATION SHALL CONSIST OF THE SAME INDIVIDUALS SERVING AS MEMBERS OF THE MEMBER'S BOARD OF DIRECTORS. THE MEMBER MAY MAKE, AMEND OR REPEAL THE BYLAWS IN A WHOLE OR IN PART. FORM 990, PART VI, SECTION A, LINE 7B THE SOLE MEMBER OF THE CORPORATION SHALL BE CENTRAL MAINE HEALTHCARE CORPORATION ACTING THROUGH THE MEMBER'S BOARD OF DIRECTORS. THE BOARD OF DIRECTORS OF THE CORPORATION SHALL CONSIST OF THE SAME INDIVIDUALS SERVING AS MEMBERS OF THE MEMBER'S BOARD OF DIRECTORS. THE MEMBER MAY MAKE, AMEND OR REPEAL THE BYLAWS IN A WHOLE OR IN PART. FORM 990, PART VI, SECTION B, LINE 11B ALL AFFILIATED FORM 990'S AND APPLICABLE SCHEDULES ARE PREPARED BY AN INDEPENDENT PUBLIC ACCOUNTING FIRM IN COOPERATION WITH THE FINANCE DEPARTMENT. THE COMPLETED RETURNS ARE REVIEWED WITH THE VICE PRESIDENT OF FINANCE THEN WITH THE CFO FOLLOWING THAT REVIEW; THEY ARE PRESENTED TO THE FINANCE COMMITTEE OF THE CENTRAL MAINE HEALTHCARE BOARD OF DIRECTORS. ONCE THIS REVIEW IS COMPLETED, ANY NECESSARY CHANGES ARE MADE AND THE FINAL RETURN IS PRESENTED TO ITS RESPECTIVE BOARD. FORM 990, PART VI, SECTION B, LINE 12C OFFICERS AND DIRECTORS COMPLETE AN ANNUAL CONFLICT OF INTEREST STATEMENT WHICH IS REVIEWED BY THE CHAIRMAN OF THE BOARD AND CONFORMS TO THE CONDITIONS CONTAINED WITHIN THE CORPORATION'S BYLAWS, WHICH MEET OR EXCEED THE CURRENT IRS REPORTING THRESHOLDS. IN AREAS OF CONFLICT BY THE CHAIRMAN, THE VICE-CHAIRMAN REVIEWS. ADDITIONALLY, AS PART OF THE ANNUAL FORM 990 PREPARATION PROCESS, A SEPARATE QUESTIONNAIRE IS PROVIDED, WHICH INCLUDES DISTRIBUTION TO KEY EMPLOYEES, COVERING REPORTING AREAS OF LOANS, GRANTS, BUSINESS RELATIONSHIPS, AND OTHER CONFLICTS. THESE QUESTIONNAIRES ARE REVIEWED BY THE FINANCE DEPARTMENT FOR REPORTABLE ITEMS FOR THE FORM 990. IN THE CASE OF A POSSIBLE CONFLICT, THE BOARD WOULD REVIEW THE SITUATION AND TAKE ACTIONS DEEMED APPROPRIATE FOR THE POSSIBLE OR ACTUAL CONFLICTS OF MEMBERS OF THE BOARD OR THE EXECUTIVE OFFICERS. IN THE CASE OF KEY EMPLOYEES, THE REVIEW AND ACTIONS TAKEN WOULD BE PERFORMED BY THEIR DIRECT SUPERVISOR. FORM 990, PART VI, SECTION B, LINE 15 CENTRAL MAINE HEALTHCARE (CMHC) HAS ESTABLISHED AND FOLLOWS A DELIBERATIVE TRANSPARENT PROCESS WHICH MEETS IRS REGULATIONS FOR "REBUTTABLE" PRESUMPTION OF REASONABLENESS. A STANDING EXECUTIVE PHYSICIAN COMPENSATION COMMITTEE (ECC) , COMPRISED OF INDEPENDENT MEMBERS OF BOARD LEADERSHIP, EXISTS TO UNDERTAKE THE PROCESS OF DETERMINING COMPENSATION FOR THE CHIEF EXECUTIVE OFFICER, CHIEF FINANCIAL OFFICER, CHIEF MEDICAL OFFICER, PRESIDENT OF CENTRAL MAINE MEDICAL CENTER, PHYSICIAN PRACTICE EXECUTIVE, PRESIDENT OF RUMFORD HOSPITAL, AND PRESIDENT OF BRIDGTON HOSPITAL. THE PROCESS GUIDELINES AND AUTHORITY OF THE EPCC ARE SET OUT IN THE EXECUTIVE COMPENSATION PHILOSOPHY AND RESPONSIBILITIES CHARTER WHICH WAS APPROVED BY THE CMHC BOARD. THE ENTIRE CHMC BOARD PARTICIPATES IN THE ANNUAL PERFORMANCE EVALUATION OF EACH EXECUTIVE, INCLUDING A REVIEW OF ACCOMPLISHMENTS RELATIVE TO GOALS AND OBJECTIVES DERIVED FROM THE STRATEGIC PLAN. THE EPCC REVIEWS THE RESULTS OF THE ANNUAL PERFORMANCE EVALUATION AND APPROPRIATE COMPARABILITY DATA BASED ON SEVERAL FACTORS RECOMMENDED BY AN INDEPENDENT EXECUTIVE COMPENSATION CONSULTANT, WHO SPECIALIZES IN NOT-FOR-PROFIT HOSPITALS AND HEALTH SYSTEMS, AND OUR ATTORNEY'S FACTORS USED IN DETERMINING COMPARABILITY TO THE ORGANIZATION INCLUDING GEOGRAPHY, ORGANIZATIONAL COMPLEXITY, FACILITY TYPE, OWNERSHIP TYPE, AND ANY OTHER FACTORS DEEMED RELEVANT BY THE COMMITTEE'S CONSULTANTS, OR ITS ATTORNEYS. USING THIS INFORMATION, THE EPCC ANNUALLY REVIEWS THE EXECUTIVES' COMPENSATION TO DETERMINE IF MODIFICATION TO BASE SALARY IS WARRANTED, AND REVIEWS THE EXECUTIVES' ACCOMPLISHMENTS TO DETERMINE IF ANY VARIABLE PAY IS TO BE AWARDED. THE ENTIRE PROCESS IS THEN DOCUMENTED CONTEMPORANEOUSLY WITH THE DECISION MAKING PROCESS AND APPROVED THEREAFTER IN ACCORDANCE WITH THE IRS GUIDANCE. THE COMPENSATION PAID TO KEY EMPLOYEES IS REVIEWED BY THE VICE PRESIDENT OF HUMAN RESOURCES AND ORGANIZATIONAL DEVELOPMENT. DURING THE REVIEW PROCESS, THE CENTRAL MAINE HEALTHCARE COMPENSATION MANAGER PROVIDERS MARKET DATA ON COMPARABLE POSITIONS FROM COMPARATIVE GROUPS OF HEALTHCARE ORGANIZATIONS THAT ARE APPROPRIATELY SIMILAR IN TERMS OF THEIR REVENUE, GEOGRAPHIC LOCATION, NUMBER OF EMPLOYEES, NUMBER OF STAFFED HOSPITAL BEDS, ETC. HUMAN RESOURCES PROVIDES AT A MINIMUM FOUR SETS OF COMPARABILITY DATA FROM THE MOST RECENT NATIONAL HEALTHCARE SPECIFIC COMPENSATION SURVEYS ( E. G. WATSON & WYATT, SULLIVAN & COTTER, THE HAY GROUP, MERCER, ETC) FOR REFERENCE. THESE SURVEYS REPORT PAY RATE DATA THAT IS TYPICALLY AGED LESS THAN 6 MONTHS. CENTRAL MAINE HEALTHCARE AND AFFILIATES STRIVE TO PAY AT THE MARKET AVERAGE OR SLIGHTLY ABOVE IT FOR KEY EMPLOYEES. ONCE THE COMPENSATION MANAGER AND THE VICE PRESIDENT OF HUMAN RESOURCES AND ORGANIZATIONAL DEVELOPMENT HAVE FINALIZED RECOMMENDATIONS BASED ON THIS EMPIRICAL DATA, THEY ARE PRESENTED TO THE PRESIDENTS OF EACH HOSPITAL THAT SUPERVISE THE KEY EMPLOYEES, AND THE CEO OF CENTRAL MAINE HEALTHCARE, FOR REVIEW, EDITS, AND APPROVAL. THIS PROCESS TYPICALLY OCCURS DURING THE LAST MONTH OF THE FISCAL YEAR IN PREPARATION FOR THE NEXT FISCAL YEAR. CENTRAL MAINE HEALTHCARE DOCUMENTS THE BASIS FOR ITS DETERMINATION FOR KEY EMPLOYEES' COMPENSATION AND MAINTAINS THIS CONTEMPORANEOUSLY SUBSTANTIATED MATERIAL IN THE HUMAN RESOURCES DEPARTMENT. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY ARE AVAILABLE UPON REQUEST IN THE ORGANIZATION'S ADMINISTRATIVE OFFICES. THE FINANCIAL STATEMENTS OF THE ORGANIZATION ARE INCLUDED IN THE MOST RECENTLY FILED FORM 990 AND PROVIDED, UPON REQUEST, IN THAT FORMAT UNLESS THE SPECIFIC REQUEST DEEMS A DIFFERENT FORMAT MORE APPROPRIATELY. FORM 990, PART VII, SECTION A BOARD MEMBER COMPENSATION: NO BOARD MEMBERS RECEIVE COMPENSATION FOR THEIR DUTIES AS DIRECTORS. JEFF BRICKMAN WAS EMPLOYED AS PRESIDENT OF CENTRAL MAINE HEALTHCARE CORPORATION AND NOW STEVEN LITTLESON IS IN THAT POSITION. BOTH JEFF BRICKMAN AND STEVEN LITTLESON WERE COMPENSATED BASED ON THEIR ROLE AS PRESIDENT. FORM 990, PART XI, LINE 9: TRANSFER TO AFFILIATE -16,692,426. OTHER CHANGES IN NET ASSETS 346,491. FORM 990, PART XII, LINE 2C: THE ORGANIZATION HAS NOT CHANGED ITS OVERSIGHT PROCESS DURING THE TAX YEAR. CENTRAL MAINE MEDICAL CENTER PO BOX 4500 LEWISTON ME 04243 010211494 HEALTHCARE ME 501(C)(3) LINE 3 CMHC 0 MAINE COLLEGE OF HEALTH PROFESSIONS PO BOX 4500 LEWISTON ME 04243 010356077 EDUCATION ME 501(C)(3) LINE 2 CMMC 0 RUMFORD COMMUNITY FAMILY HEALTH CENTER 430 FRANKLIN STREET RUMFORD ME 04276 010481000 HEALTHCARE ME 501(C)(3) LINE 3 CMHC 0 RUMFORD HOSPITAL 420 FRANKLIN STREET RUMFORD ME 04276 010215227 HEALTHCARE ME 501(C)(3) LINE 3 CMHC 0 CENTRAL MAINE REAL ESTATE MANAGEMENT CO01-0387674 PO BOX 4500 LEWISTON ME 04243 010387674 REAL ESTATE ME 501(C)(2) CMHC 0 RUMFORD COMMUNITY HOME CORPORATION 11 JOHN F KENNEDY LANE RUMFORD ME 04276 222844951 NURSING HOME ME 501(C)(3) LINE 10 CMHC 0 CENTRAL MAINE COMMUNITY HEALTH CORP PO BOX 4500 LEWISTON ME 04243 010386912 PUBLIC EDUCATION ME 501(C)(3) LINE 7 CMHC 0 ELIAS E TUCKER TRUST FUND CO CMMC 300 MAIN STREET LEWISTON ME 04240 016042343 FUNDING ME 501(C)(3) LINE 12A, I CMMC 0 BRIDGTON HOSPITAL PHYSICIANS GROUP SOUTH HIGH STREET BRIDGTON ME 04009 010493083 FUNDING ME 501(C)(3) PF CMHC 0 CENTRAL MAINE HEALTHCARE CORPORATION PO BOX 4500 LEWISTON ME 04243 010386913 HEALTHCARE ME 501(C)(3) LINE 7 N/A 0 CENTRAL MAINE HEALTH VENTURES INC 300 MAIN STREET LEWISTON ME 04240 010430016 HEALTHCARE ME N/A C 0 CWM INSURANCE LTD GENESIS BUILDING PO BOX B.W.I CJ 980220891 INSURANCE CJ N/A C 0 CENTRAL MAINE ACO 300 MAIN STREET LEWISTON ME 04240 274604314 ACCOUNTABLE CARE ME N/A C 0 0 0 0 0 0 0 0 0 0 0 1 0 1 0 1 1 1 1 0