2021-11-15T12:30:47-06:00 2020-12-31 010494526 BAKER NEWMAN & NOYES LLC 650 ELM STREET SUITE 302 MANCHESTER NH 03101 990 2020-01-01 010211551 St Mary's Regional Medical Center STMA 2077778100 93 Campus Avenue PO Box 7291 Lewiston ME 042430291 Steven Jorgensen President & CEO 2077778100 2021-11-12 1 Steven Jorgensen 999009999 Nicholas E Porto P01310283 8002447444 2021-11-11 2 AAL1 IAL1 2020 2022-09-23 18:48:47Z Steven Jorgensen 93 Campus Avenue PO Box 7291 Lewiston ME 042430291 220142588 0 X www.stmarysmaine.com X 1967 ME We are a Catholic health ministry, providing healing and care for the whole person, in service to all in our communities. 11 8 1700 94 0 0 1754611 18339069 232586738 199523933 793630 367594 -10626 -3130 235124353 218227466 1832 31907 0 0 110763218 107699111 0 0 0 124157441 122509249 234922491 230240267 201862 -12012801 147144163 134146748 70529104 72241628 76615059 61905120 X St. Mary's Regional Medical Center is comprised of a 233-bed acute care facility, a primary care provider network, urgent care and emergency department, behavioral and mental health services, and outpatient specialty practices that combine talented and compassionate caregivers with state of the art medical technology to meet the healthcare needs in the Androscoggin County area and beyond. 0 0 117941937 31907 142398827 The Medical Center provides a vast array of medical care and community health services, which includes, but is not limited to, the following programs and facilities: physician services; orthopedics; chemical dependency services; OB/GYN women's health services; nursery and youth services; ICU; PACU; infusion therapy; urgent care; family practice services; endoscopy; neurology; lab services; diagnostic radiology; MRI; mammography; ultrasound; nuclear medicine; CT scans; physical therapy; occupational therapy; speech therapy; respiratory therapy; pulmonary rehabilitation; diagnostic cardiology; cath labs; pharmacy; ambulance services; physiatry services; urology; sleep lab; diabetes center services; wound and hyperbaric center services; gastroenterology; rheumatology; weight management services; and skilled nursing facilities and nursing home services. 32923635 0 35472080 Surgical Care: The Medical Center provides all surgical services and related care (except open heart procedures) to patients who need surgical intervention. Patients range from infants to geriatrics. Total Patient days = 8,282 10549939 0 11366554 Emergency Care: St. Mary's Regional Medical Center offers a 24-hour per day Level II Emergency Care facility. Services provided include both medical and behavioral care services. Total patient days = 165Total patient visits:- Emergency Department = 18,831- Emergency Psychological Services = 4,291- Emergency Urgent Care = 21,895 9547452 0 10286472 Behavioral Health: St. Mary's Regional Medical Center offers the most advanced behavioral healthcare diagnostic and treatment services available to children, adolescents and adults in both inpatient and outpatient programs. Inpatient and outpatient treatments include comprehensive psychiatric assessments and evaluations, education, individual and group therapy, individualized bio-psychosocial treatment plans, and discharge and aftercare planning.Total patient days = 14,685 9547452 0 10286472 170962963 1 1 0 1 0 0 0 0 0 1 1 1 0 1 1 1 0 1 0 0 0 0 0 0 1 0 1 1 0 1 1 1 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1 0 0 0 1 83 0 1 1700 1 0 0 0 0 0 0 0 0 0 0 0 0 X 11 8 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 ME X X Michael Hendrix Interim CFO 2077778100 93 Campus Avenue PO Box 7291 Lewiston ME 042430291 Jeffery Davila MD Director 40.10 0.20 X 852146 0 1498 Anne Brown MD Director 40.10 0.20 X 162323 0 28588 David Geiger Esq Director 0.10 0.20 X 0 0 0 Ralph Harder MD Director 0.10 0.20 X 0 0 0 Lena Hartley Director 0.10 0.20 X 0 0 0 Kathy McManus Director 0.10 0.20 X 0 0 0 John Murphy MD Director 0.10 0.20 X 0 0 0 Steve Ouellette Director 0.10 0.20 X 0 0 0 Mark Anthoine Chair 0.10 0.20 X X 0 0 0 James Place MD Vice Chair 0.10 0.20 X X 0 0 0 Steve Jorgensen President & CEO 0.10 40.30 X X 0 471002 35764 Michael Hendrix Treasurer & CFO (end 8/2020) 0.10 40.90 X 0 268752 31395 Jeffrey Hundman Treasurer & VP Finance 0.10 40.30 X 0 123104 11280 Joan Daigneault Secretary 40.10 0.20 X 62497 0 8127 Christopher T Bowe Chief Medical Officer (end 4/2020) 40.00 0.00 X 165712 0 11879 Douglas Smith MD Chief Medical Officer 40.00 0.00 X 427316 0 31715 Michael Newman MD Physician 40.00 0.00 X 919234 0 38643 Joseph Strauss MD Physician 40.00 0.00 X 841130 0 34172 Gregory Pomeroy MD Physician 40.00 0.00 X 595222 0 24269 Sacha Matthews MD Physician 40.00 0.00 X 568488 0 33504 Michael Parker MD Physician 40.00 0.00 X 616240 0 19261 5210308 862858 310095 168 0 1 0 Covenant Health Inc 100 Ames Pond Drive Suite 102 Tewksbury MA 01876 Management services 25008193 Metz Culinary Management Two Woodland Drive Dallas PA 18612 Meal services and cafeteria management 5755478 Medefis Inc PO Box 5068 New York NY 100875068 Locum nursing services 3613722 Herbert Construction LLC 9 Gould Road Lewiston ME 04240 Construction services 2430312 United Ambulance Service 192 Russell Street Lewiston ME 04240 Ambulance services 2230617 42 15049 69702 10000 16757777 1486541 515881 18339069 Patient and healthcare services 621300 192560956 192560956 Pharmaceutical sales 446110 4722951 4722951 Dining and cafeterias 722514 1120837 1120837 Tuition and education services 611600 982272 982272 Rental income 532000 136917 136917 199523933 276936 276936 2000000 2650 1911992 0 88008 2650 90658 90658 0 69702 3130 -3130 -3130 218227466 199523933 0 364464 X 4200 4200 27707 27707 1751800 1112393 639407 88373659 67624852 20748807 1083359 802925 280434 10908841 8079893 2828948 5581452 4130274 1451178 25008193 25008193 457369 457369 216667 216667 32364666 30644763 1719903 166754 166754 3327886 2434929 892957 916561 678255 238306 5844508 4324936 1519572 51007 37745 13262 452704 335001 117703 1753655 1297705 455950 5192463 3842423 1350040 2302563 1703897 598666 Drugs/medical supplies 23552484 23552484 Provision for bad debts 13713669 13713669 ME provider tax 4983532 4983532 Food/dietary costs 1972076 1459336 512740 232492 172044 60448 230240267 170962963 59277304 0 8831443 10243999 1495311 1068323 247192 1236705 30478723 22687199 1734572 2168503 814661 1125119 165286455 104712288 62236175 60574167 13841758 13982688 27464328 21060045 147144163 134146748 27233718 17928133 334444 5240992 37209015 32194116 4529121 4296041 1222806 12582346 70529104 72241628 X 67545180 52493180 9069879 9411940 76615059 61905120 147144163 134146748 X -12012801 -28247 -2668891 X X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 1 18512 0 0 0 18512 0 Part II-B, Line 1: Part II-B, Line 1f: St. Mary's Regional Medical Center (SMRMC) partners with various like-minded professional associations which support public policies and initiatives that focus on improving health outcomes and the experience of health care, while also aiming to reduce the overall cost of receiving that care. To maintain these partnerships, SMRMC pays membership dues back to these various associations. A portion of the dues paid to these associations have been designated as available for lobbying expenditures. Any lobbying expenditures paid by the associations are incurred in order to help track and discuss legislation affecting health care policy. The specific dues paid by SMRMC to the trade associations in 2020, as well as the portion of those dues that were estimated to be available for lobbying expenditures, are detailed below: American Hospital Association - Total 2020 dues: $34,045 - Portion of dues available for lobbying: $8,701 Maine Hospital Association - Total 2020 dues: $70,581 - Portion of dues available for lobbying: $9,811 In order to take advantage of group rates and terms, Covenant Health Inc., the parent-organization of SMRMC, arranges for membership and dues with the American Hospital Association on behalf of SMRMC. While SMRMC is ultimately the member of the Association, SMRMC pays its AHA dues by reimbursing Covenant Health for the cost of the membership. 9069879 1409962 5605 1073506 9411940 7805668 1747954 4051 487794 9069879 29998051 1608019 23800402 7805668 5847103 26243632 2092684 29998051 2035795 4917990 389 1107071 5847103 0.00000 0.20200 0.79800 0 0 826146 826146 91963907 53847389 38116518 1045129 663669 381460 59620433 50187750 9432683 11830840 13480 11817360 60574167 Investment in Covenant Health Investment Trust 11516776 F Investment in United Ambulance 2465912 F 13982688 Due from affiliates 21060037 Funds held by Trustee - debt service reserves 8 21060045 Deferred fixed asset expenditures (FIN 47) 25123 Medicaid obligations 9695680 Due to affiliates 2861543 12582346 X Part V, Line 4: St. Mary's Regional Medical Center's endowmenet funds, in conjunction with any revenues generated from the the funds, are used to further the Medical Center's exempt mission and operations, which includes the following uses: to offer patients the best medical technology available; preventive services; and a "whole person approach" to meeting the needs of the Androscoggin county area. Part X, Line 2: Covenant and its member organizations are considered not-for-profit corporations as described in Section 501(c)(3) of the Internal Revenue Code and are exempt from federal income taxes on related income pursuant to Section 501(a) of the Code. 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 Financial Accounting Standards Board, assets and liabilities are established for uncertain tax positions taken or positions expected to be taken in income tax returns when such positions are judged to not meet the "more-likely-than-not" threshold, based upon the technical merits of the position. Estimated interest and penalties, if applicable, related to uncertain tax positions are included as a component of income tax expense. The System has evaluated the position taken on its filed tax returns. The System has concluded no uncertain income tax positions exist at December 31, 2020. Commit to Get Fit 69702 69702 3130 69702 69702 3130 3130 -3130 Schedule G, Part II, Fundraising Events In accordance with the IRS instructions for the reporting of income on Schedule G, event revenue deemed to be charitable contributions has been reported on line 2, thus reducing the total gross event income on line 3. This presentation gives the appearance on Schedule G of a loss from the respective event. However, when the charitable contributions are considered and added back, the event had a profit of $66,572. 1 1 1 X 1 X 0 1 0 1 1 1316569 1316569 0.00610 49284136 43956600 5327536 0.02460 50600705 43956600 6644105 0.03070 11 5822 1501166 13000 1488166 0.00690 3 219 353595 353595 0.00160 1 140 23010 21000 2010 0.00000 9 21082 434884 70063 364821 0.00170 24 27263 2312655 104063 2208592 0.01020 24 27263 52913360 44060663 8852697 0.04090 1 6454 214409 119767 94642 0.00040 1 58 63049 38190 24859 0.00010 1 44 30292 5000 25292 0.00010 2 160 40484 33667 6817 0.00000 2 10 6611 6611 0.00000 7 6726 354845 196624 158221 0.00060 1 13713669 274000 72663135 95593010 -22929875 X 1 1 1 1 St Mary's Regional Medical Center 93 Campus Avenue Lewiston ME 042430291 38244 X X X St Mary's Regional Medical Center 1 0 0 1 X X X X X X X X X 19 1 1 1 1 X See Schedule H, Part V, Section C X See Schedule H, Part V, Section C X 1 19 1 See Schedule H, Part V, Section C 1 0 1 X 200.000000000000 200.000000000000 X X X X 1 1 X X X X 1 X See Schedule H, Part V, Section C X See Schedule H, Part V, Section C X See Schedule H, Part V, Section C X X X X X X 1 X 0 X X X X 1 X 0 0 St. Mary's Regional Medical Center Part V, Section B, Line 5: Understanding the health needs of a community allows public health and health care organizations to design and implement cost-effective strategies that improve the health status of the populations they serve. A comprehensive data driven assessment process can identify, with a high degree of accuracy, priority health needs and issues related to prevention, diagnosis and treatment. Assessment tools also may assist in pinpointing access to care barriers, utilization of evidence based guidelines, and utilization of health services. In Maine, healthcare leaders and public health leaders collaborated to conduct the assessment and analyze the data for this latest CHNA in a collaboration designated as The Maine Shared Health Needs Assessment (Maine Shared CHNA.)Maine Shared Community Health Needs Assessment Charter: Vision: The Maine Shared Community Health Needs Assessment helps to turn data into action so that Maine will become the healthiest state in the US. Mission: The Maine Shared Community Health Needs Assessment is a dynamic public private partnership that creates Shared Community Health Needs Assessment reports, engages and activates communities, and supports data-driven health improvements for Maine people.Steering Committee Statement of Purpose: The Steering Committee provides leadership for the creation of an efficient, integrated, and sustainable process to conduct triennial Maine Shared Community Health Needs Assessments (Maine Shared CHNAs) and subsequent public health improvement plans/hospital implementation strategies. In addition, this group provides stewardship of the resources made available through Central Maine Healthcare (CMHC), Maine Center for Disease Control and Prevention (Maine CDC), MaineGeneral Health (MGH), MaineHealth (MH), and Northern Light Health (NLH) to: [a] strengthen Maine's state and community health improvement efforts; [b] meet Treasury Department/Internal Revenue Service (IRS) community benefit reporting requirements for hospitals; and [c] meet public health agencies' Public Health Accreditation Board (PHAB) requirements. St. Mary's Regional Medical Center is an affiliate of MaineHealth.Data Analysis: Over 200 health indicators from over 30 sources were used for the Maine Shared CHNA. These indicators were arranged under 24 health topics and analyzed by demographic characteristics and geographic stratification. Community Input: Community outreach and engagement for the Maine Shared CHNA occurred at the statewide, public health district, county and local levels. The statewide community engagement committee met monthly from March 2018-January 2019 to review and oversee the engagement process.In addition, local community engagement planning committees met in each of Maine's 16 counties. St. Mary's facilitated and hosted the Androscoggin local community engagement planning committee through the Community Health Stakeholder Coalition (established for the first cycle of the Maine Shared CHNA 7 years ago.) In Androscoggin County, representatives from the two local hospital systems came together in 2012 to establish the Community Health Stakeholder Coalition, a group of community health agencies, public health and hospitals. They developed this purpose statement:Improve the health of Androscoggin County by convening community health stakeholders to collaborate on:- Conducting community health needs assessments- Educating members and constituents on findings of community health needs assessments- Develop strategies to address prioritized needs- Sharing relevant resources through networkingFor the most recent CHNA, members included: Jamie Paul, Western Maine District Coordinating Council of the Maine Center for Disease Control and Prevention; Elizabeth Keene, VP of Mission Integration, St. Mary's Health System; Holly Lasagna and Corrie Brown, Healthy Androscoggin; Catherine Ryder, Executive Director, Tri-County Mental Health Services; Angela Richards, Androscoggin Home Healthcare + Hospice; Sam Boss and Kristen Cloutier, Harwood Center at Bates College; Joan Churchill, Executive Director, Community Clinical Services; Nate Miller, Seniors Plus; Shawn Yardley, Executive Director, Community Concepts; Barry Schmieks, Auburn Police Department; Joe Philippon, Lewiston Police Department; Jennifer McCarthy and Ann Marie Day of Healthcentric Advisors; Katherine Lary of Western Maine Community Action; Ruby Bean of Community Concepts; and Melanie Gagnon, YWCA. This group began meeting monthly in the spring of 2012 and continues to meet to assess and address community health needs. These members represent community health, public health, hospitals, minority populations, local colleges, community action agencies and the local Federally Qualified Health Center (FQHC.)Three community engagement sessions were held in Androscoggin County in 2018. Two sessions were hosted by the local community engagement planning team (October 3, 2018 and October 11, 2018). One session was held in June and was a County Health Rankings Health Action Forum (to solicit community information from immigrants, refugees and asylum seekers). One session in each county was facilitated by JSI, the vendor hired by the Maine Shared CHNA to oversee the data collection, analysis and community sessions. The other session was facilitated by employees from St. Mary's Regional Medical Center and Central Maine Medical Center who serve on the Community Health Stakeholder Coalition.Other methods for obtaining feedback from organizations and groups included, but were not limited to key informant interviews (focused conversations) and focus groups. In addition to the two community forums held in Androscoggin County, a forum was held with refugees and immigrants to specifically address health issues in their communities. Key informants were also interviewed to speak to the needs of this population. Mental health was identified as one of the leading health concerns for this population, specifically trauma and stress around immigration status in the current political climate, separation from families, and experiences in their home country. Oral health was another clinical concern identified across several community engagement activities. Community members also identified a need for health services that are linguistically and culturally appropriate and increased efforts to improve health literacy around chronic disease management, substance use, and life skills (e.g., how to keep a healthy home, how to dress appropriately for cold weather). Many health needs for this population fall into the category of social determinants of health: accessible and comprehensive health insurance, safer and more affordable housing, better access to transportation, and more opportunities to bolster community relations and social cohesion.Youth were identified as a priority population in community forums. Specific issues of concern were youth mental health issues (specifically stress, depression, and anxiety); substance use (specifically opioids, marijuana, and vaping/Juuling), lack of education and promotion around nutrition and physical activity, and unsupervised youth. In addition to the data collected and analyzed for the County Health Profiles, the Maine CDC created Health Equity Data Summaries (available at www.mainechna.org) which provides selected data analyzed by sex, race, ethnicity, sexual orientation, education, and income. These data are at the state level, as much of the county level data would be suppressed due to small numbers and privacy concerns, and the previous analyses have shown that health disparities found at the state level are generally similar in individual counties.These forums, essential components of the Maine Shared CHNA, allowed for community members to review the data and vote for community health priorities. Participants at the community forums met in small groups to discuss opportunities for collaboration and specific issues for each priority. The conversations largely informed both the implementation strategies and strategic plans for the hospitals. Health data results were also presented to the hospital's board of trustees' strategy committee. The State of Maine is fortunate to have many sources of data to help assess health needs of communities. The 2016 Maine Shared Community Health Needs Assessment, County Rankings results, the state health plan, the Community Health Needs Index (CHNI), and community engagement results provide a comprehensive picture of all major health indicators in the community.A copy of the 2019 Androscoggin County CHNA can be found at this link:https://www.stmarysmaine.com/media/file/Androscoggin_Report_2019.pdf St. Mary's Regional Medical Center Part V, Section B, Line 6a: Central Maine Medical Center St. Mary's Regional Medical Center Part V, Section B, Line 6b: The Maine Shared CHNA began as the OneMaine Health Collaborative in 2007 as a partnership between MaineGeneral Health (MGH), MaineHealth (MH), and Northern Light Health (NLH, formerly known as Eastern Maine Healthcare System or EMHS). After conversations with the Statewide Coordinating Council for Public Health, the Maine Center for Disease Control (Maine CDC) joined the collaborative in 2012. The effort was then named the Maine Shared Health Needs Assessment and Planning Process (SHNAPP). Central Maine Healthcare (CMHC) joined the group in 2013. In 2014, CMHC, Maine CDC, MGH, MH and NLH signed a formal Memorandum of Understanding and drafted the Maine Shared CHNA Charter (PDF) to guide the collaborative. In 2017, the name was changed to the Maine Shared Community Health Needs Assessment or Maine Shared CHNA. Funding for the Maine Shared CHNA is provided by the partnering healthcare systems with generous in-kind support from the Maine CDC. Governance is provided by the Steering Committee. Countless community partners and stakeholders provide additional support by participating in either the Metrics Committee, Community Engagement Committee, Local Planning Committees, or the Data Analysis Workgroup. Funding for the Maine Shared CHNA is provided by Central Maine Healthcare, MaineGeneral Health, MaineHealth, and Northern Light Health, with generous in-kind support from the Maine Center for Disease Control and Prevention, an office of the Department of Health and Human Services and countless community partners and stakeholder groups. These stakeholder groups include the Metrics Committee, Data Analysis Workgroup, Community Engagement Committee, Local Planning Committees, and the Steering Committee. Special thanks to the Maine Health Data Organization for working with us to access their data. For a listing of committee members please visit www.mainechna.org and click on "About Maine CHNA." Significant analysis was conducted by epidemiologists at the Maine CDC and the University of Southern Maine's Muskie School of Public Service. John Snow, Inc. provided analysis, methodology, and design support. In addition, the Steering Committee gratefully acknowledges the countless community volunteers who gave their time and passionately committed to hosting, facilitating, attending, and engaging in this effort. From Aroostook to York, Oxford to Washington County, over 2,000 Mainers gave their time and talent to this effort. St. Mary's Regional Medical Center Part V, Section B, Line 11: The following descriptions are the prioritized community health needs identified by the data, community engagement and key informant interviews.Prioritized Significant Community Health Needs: Social Determinants of Health (25%); Mental Health (19%); Substance Use (14%); Access to Care (12%); and Tobacco Use (9%).Social Determinants of Health: A key theme from the community engagement sessions and key interviews in Androscoggin County (as well as the entire state of Maine) was the impact that social determinants of health (specifically housing, transportation, poverty, employment, cultural barriers, and Adverse Childhood Experiences or ACEs) have on county residents. The number of people living in poverty is higher than the state (14.8% vs. 13.5%). The percentage of households that are food insecure is higher than the state (16% vs. 15.1%). Slightly over 1/4 of high school students have experienced at least 3 adverse childhood experiences, and the number of children with confirmed elevated blood levels for lead is significantly higher than the state (3.4% vs. 2.2%).St. Mary's is addressing this priority by focusing on cultivating equitable access to food and land by increasing access to urban spaces for food production, creating more equitable access to healthy, local food through community engagement and creating community food champions to support outreach and education. New community gardens will be established, two new pilot food access programs will be created and 5-10 community members will be trained as community food champions.Access to Health Care and Primary Care: While Androscoggin County has a relatively low percentage of uninsured residents, access to care is an issue. The percentage of individuals unable to obtain healthcare due to cost was significantly higher than the state (14.5% vs 10.3%).St. Mary's did not select this as a priority. We already offer financial assistance, help connect people to resources and assist patients in applying for MaineCare. In addition, Community Clinical Services, the local Federally Qualified Health Center, offers access and financial assistance.Mental Health: Androscoggin County residents receive outpatient mental health treatment at a higher rate than Maine residents (21% vs. 17%). The percentage of middle school students who reported having seriously considered suicide increased significantly between 2011 and 2017 (from 14.5% to 18.8%). A theme for mental health was the need for increased education and resources around the mental (and physical) health effects of Adverse Childhood Experiences (ACEs). St. Mary's will address mental health by improving integration and treatment of mental health in the community. The strategies will include improving the physical environment for people with psychiatric illness, exploring new treatment options for people who cannot tolerate medication as treatment for mental illness, implementing depress/suicide screening, expanding a pediatric behavioral health home, expanding partnership with schools serving at-risk youth and creating a plan to address Adverse Childhood Experiences (ACEs).Substance and Alcohol Use: Opioid use was the leading substance use issue discussed in the community forums. In Androscoggin County, substance use hospitalizations were higher than the state in 2016 (39 vs 18 per 10,000 population). The rate of overdose deaths increased from 12.5 to 18.4 per 100,000 (2007-2011 and 2012-2016 data).St. Mary's will address this by working to prevent and treat substance use disorder. Strategies will include developing protocols for rapid access to suboxone in the Emergency Department, increasing timely access to treatment after Emergency Department visits for substance use disorder, providing integrative therapies for pain management, providing greater access to polypharmacy guidance for opioid tapers, decreasing access to prescription drugs in the community and facilitating access to 12 step and other recovery programs.Tobacco Use: Tobacco use is one of the leading causes of preventable illnesses and death. Maine has made progress in reducing tobacco use. The percentage of Maine adults who smoked cigarettes in 2017 was significantly lower than in 2011. However, the emergence of electronic products is of grave concern. (Data from a 2018 national youth survey indicate up to a 78% increase in the use of electronic devices since 2017.)St. Mary's did not select this as a priority because the local public health agency, Healthy Androscoggin, addresses this key issue in the community. St. Mary's does participate by hosting tobacco cessation programs. St. Mary's is partnering with the other local hospital, Central Maine Medical Center, to address youth tobacco and vaping use.Potentially available health care facilities and resources available to meet the health needs identified: The assessment identified a number of strong community assets, including the two local hospitals (including behavioral services at SMRMC) and their community benefit programs, an Urgent Care Center by SMRMC, primary care physicians at accredited patient-centered medical homes, dentists, school-based health centers, federally qualified health centers through Community Clinical Services, a free clinic, community health agencies for mental health services and substance abuse, a local home care and hospice agency, social service agencies for outreach to the rural poor, the elderly, victims of domestic violence and children, St. Mary's Nutrition Center (emergency food pantry, community gardens, farmers' markets, cooking classes and outreach for Somali Nutrition programs), public school systems and Catholic school systems with active home and school associations, numerous religious communities and community coalitions to support downtown Lewiston. St. Mary's Regional Medical Center Part V, Section B, Line 13h: Household size St. Mary's Regional Medical Center Part V, Section B, Line 15e: St. Mary's website provides access to the free care application as well as contact information for assistance in answering any questions or in completing the application. Schedule H, Part V, Section B, Line 10a: The Center's most recently adopted implementation strategy is available at the following web address:https://www.stmarysmaine.com/community-health/community-health Schedule H, Part V, Section B, Line 7: The Center's CHNA report was made available at the Center's own website at the following web address:https://www.stmarysmaine.com/community-health/community-healthIn addition, the Center's CHNA report was made available on the website of MaineHealth, at the following web address:https://mainehealth.org/healthy-communities/community-health-needs-assessment Schedule H, Part V, Section B, Line 16a-c: The Medical Center's Financial Assistance Policy, Application for Financial Assistance and Free Care, and Plain Language Summary can be found online through the following webpage:https://www.stmarysmaine.com/patient-and-visitor-information/billing-and-insurance 1 1 - St Mary's D'Youville Pavilion 102 Campus Avenue Lewiston ME 04240 Nursing home and restorative facility Part I, Ln 7 Col(f): The Center has estimated that 2% of its total annual bad debts, or approximately $274,000, may potentially be due to free care accounts and services. However, this estimated amount has not been included in Part I or Part II. Part II, Community Building Activities: St. Mary's Regional Medical Center is very active in programs that address the root causes of health problems, such as poverty, homelessness and environmental concerns. Leadership is involved in local coalition building and economic development to address these issues. One of the Center's leading ways to engage and build its community is through its efforts to improve nutrition and food security. For example, St. Mary's Nutrition Center (NC) places value in strengthening community connections, addressing root causes, nurturing a sense of place, and facilitating a deeper commitment to equity across our community. The NC was founded by St. Mary's Health System in Lewiston, Maine in 2006 to promote community health through organizing, advocacy and education. Although the NC was formed in 2006, it houses the Lots to Gardens program, which has provided gardening and food access programming in Lewiston since 1999.The NC believes that everyone deserves access to healthy food, as a fundamental right. Failing to address this basic need has far reaching impacts, for the individual and the community. The NC intentionally uses food as a tool for community building, leadership and youth development, and neighborhood revitalization. Through our work, we've realized that equity in our food system is deeply tied to inequity within our community, and that a whole-person, and whole-community, approach is critical to creating long-term change. By weaving together direct support with education and community change strategies, the NC builds resiliency at an individual, family, and community level. The St Mary's Nutrition Center in Lewiston, Maine provides training opportunities for diverse crews of teenagers throughout the year. Their unique and powerful voices are heard within their community as they learn to grow, harvest and cook healthy food; learn about nutrition, food systems and hunger; and teach others their newfound knowledge. Youth receive stipends for participation in most programs. For younger members of the community, the St. Mary's Nutrition Center provides children with a safe and fun environment to explore the wonders of growing and cooking healthy food. School-based and neighborhood gardening and cooking programs give children the chance to get their hands dirty, work as a team, and try fresh, delicious vegetables - sometimes right from the ground! Our programs give children leadership opportunities in a safe environment and allow kids to build their confidence. At the St. Mary's Nutrition Center in Lewiston, Maine, we offer a full range of cooking centered healthy eating classes and programs for kids, youth, adults, and seniors. The cooking education programs empower families and individuals with the skills, knowledge, and confidence to make healthy eating choices and provide opportunities to learn to love good food. As one of the largest emergency food pantries in Maine, the St. Mary's Food Pantry has been providing food assistance for residents of the greater Lewiston-Auburn area for over 20 years. The Food Pantry is located in the heart of downtown Lewiston across from Kennedy Park on the corner of Bates and Walnut Street and serves over 1,000 people weekly.The center also strives to connect community markets, farms and transportation systems in and around healthy nutrition and food security. One of St. Mary's many programs on this front is the Good Food Bus: The Good Food Bus is a mobile food market, creating easier access to good food. We are a market on wheels with stops across Lewiston-Auburn and surrounding areas. Our goal is to bring food that is local, convenient, and affordable to the people of Maine.Additionally, at St. Mary's Health System, we believe in living life to the fullest. That means giving seniors the care and attention they need with quality nursing care, on-site rehabilitation services, independent living, long-term care, short-term post-hospital recovery care, social activities, nutrition services, and more. St. Mary's d'Youville Pavilion offers short-term rehabilitation, long-term care, independent living, memory care and restorative nursing program. And St. Mary's Residences offers 128 private apartments reserved exclusively for seniors and/or handicapped individuals. Our residents have the independence of living on their own, with some extra help when needed. Part III, Line 2: This amount represents accounts sent to the collection agency minus payments that have been collected plus a factor estimating the self-pay amounts in accounts receivable that will be uncollectible. Part III, Line 3: 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 System records an allowance for doubtful accounts 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. The difference between the standard rates (or the discounted rates if negotiated) and the amounts actually collected after all reasonable collection efforts have been exhausted is charged off against the allowance for doubtful accounts. Part III, Line 4: Accounts are written off when all reasonable internal and external collection efforts have been performed. The estimates for implicit price concessions are based upon management's assessment of historical write-offs and expected net collections, business and economic conditions, trends in federal, state and private employer health care coverage and other collection indicators. Management relies on the results of detailed reviews of historical write-offs and collections at facilities that represent a majority of the systems revenues and accounts receivable as a primary source of information in estimating the collectability of accounts receivable. Part III, Line 8: None were reported but it is important to note that approximately 30% of Medicare patients also qualify for Medicaid. Costing on line 6 is based on ratio of cost to charge from worksheet 2. Part III, Line 9b: St. Mary's Regional Medical Center will make a reasonable effort to determine whether an individual qualifies for financial assistance prior to initiating any collection activity. Part VI, Line 2: In addition to the official Community Health Needs Assessment reported in Part V, Section B, St. Mary's assesses the needs of our community in an on-going basis through several key methods. Leaders are active on community health boards; these monthly meetings allow for continued assessment and sharing of information. Patient or resident advisory panels also help us assess needs of patients and the community. We also work closely with Community Clinical Services (an FQHC look-alike) to share information about some of the health disparities experienced by community members. St. Mary's works with the local ethnic community based organizations for information as well. Part VI, Line 3: St. Mary's Regional Medical Center provides financial education at the point of registration by having brochures available. These brochures provide information about the hospital bill and various options on financial assistance. On the backside of the monthly patient statements also provides education of the financial assistance availability and options to those who need it.Additionally, the Center operates in conformity with the Financial Assistance Policy as defined and mandated within the Covenant Health System. Consistent with its mission to provide high quality health and wellness services for the community, it is the Center's policy that an individual meeting qualified income guidelines may receive financial assistance in paying medically necessary self-pay bills, without discrimination due to race, gender, age, sexual orientation, religious affiliation, social or immigrant status, or health insurance status. In accordance with the Affordable Care Act (ACA), any patient eligible for financial assistance will not be charged more for emergency or medically necessary care than the amount generally billed (AGB) to insured patients. Covenant Health follows all EMTALA regulations, and no patient will be denied emergency services.The Medical Center operates in accordance with 22 M.R.S.A. Section 1716 and the State of Maine Department of Human Services and Bureau of Medical Services Chapter 150, Agency 10-144. Accordingly, this hospital is required to provide Free Care to residents of Maine, whose income fall below the following income guidelines. Before providing Free Care, the Center will ask a patient for information about their income and also ask the patient to show that insurance and a government medical assistance program will not pay for their care. Services that are not medically necessary are not provided as free care. If a patient does not qualify for Free Care, they are allowed to ask for a fair hearing. Part VI, Line 4: During 2018-2019, a community health needs assessment (CHNA) was conducted by St. Mary's Regional Medical Center, Central Maine Medical Center, Healthy Androscoggin and other community health agencies as part of a statewide initiative through the Maine Shared CHNA.St. Mary's Regional Medical Center (SMRMC) is a 233-bed acute care hospital, a primary care provider network, urgent care and emergency department, behavioral and mental health services, and outpatient specialty practices that combine talented and compassionate caregivers with state-of-the-art medical technology to meet the healthcare needs in the Androscoggin County area and beyond. St. Mary's draws most of its inpatient and outpatient population from Androscoggin County, therefore the needs of this geographic area are the focus of the assessment. Androscoggin County is located in south central Maine and is one of three counties that comprise the Western Public Health District. It contains roughly 8% (107,376) of Maine's 1.27 million residents. Androscoggin County contains Maine's second and fifth largest cities: Lewiston (population 36,592 in the 2010 census) and Auburn (population 23,055 in the 2010 census) respectively. Located across from each other on the Androscoggin River, the twin cities of Lewiston and Auburn are the central hub of the region. The county is working to transform the downtown area from vacant textile mills and abandoned shoe factories to a region known for progressive health care, tourism, high-precision manufacturing, telemarketing and financial services. Over the past 20 years, Lewiston has become home to a large African immigrant population (approximately 11% of the population of Lewiston). The "New Mainers" come from Somalia, Djbouti, Angola, Sudan, Ethiopia, and the Democratic Republic of the Congo, among others. Androscoggin County is one of the few counties in Maine experiencing a growth in population because of this emigration. This population growth has enhanced cultural and economic aspects of Lewiston and Auburn while also presenting unique healthcare opportunities and challenges. The rest of the county is comprised of small rural towns with an average population of 222 persons per square mile.The county is primarily white (92.8%) with black (3.8%) and two or more races at 2.1%. Androscoggin County's population reflects two interesting trends: the highest number of people is in the under 18 years category (22%) and the second highest concentration of the population is over age 65 (17%.) The unemployment rate was 3.3% as of April 2019. Slightly over 10% of the primary languages spoken in the home are categorized as "other than English" so interpretation services are available as well as cultural brokers hired by the local hospitals to assist new Mainers in navigating the health systems. Lewiston/Auburn qualifies as a Medically Underserved Area, defined as having too few primary care providers, with high infant mortality, high poverty rates and/or high elderly populations. The poverty rate in Maine is 14.8% and the median income is $48,728 annually. Lewiston's poverty rate is even higher-21% (2017 American Community Survey) and the rate of childhood poverty in Lewiston is 43% (according to the 2013-2017 American Community Survey). Additionally, the Community Needs Index (CNI) identifies the severity of community health needs for a specific geography by analyzing the degree to which the following health care access barriers exist in the community: a. income barriers; b. education/literacy barriers, c. culture/language barriers, d. insurance barriers, and e. housing barriers. The score is a weighted average; the current (July 2019) score for Androscoggin County is 3.1; the score for the city of Lewiston is 4.2 (based on scale of 1-5 with 5 being the highest need). While the county scored improved from 3.2 to 3.1 since the 2016 CHNA, Lewiston's rating remains at 4.2 which is in the category of "highest need".Androscoggin County currently ranks 12 (out of 16 counties in Maine) for health. This score includes including health behaviors, clinical care, physical environment, and social and environmental factors. These physical, social and environmental factors can contribute to, or detract from, overall health. The BroadStreet Network measures social vulnerability through its "Area Deprivation Index" (ADI.) The ADI is calculated by combining 17 indicators of income, education, employment, and housing quality. The ADI has been used for 20 years by the Health Resources & Services Administration (HRSA). The ADI and percentile scores are calculated by using Census Block Group level data. While Androscoggin County has a deprivation score of 100.6, Lewiston's score is even higher at 108.1 (the higher the score, the greater the vulnerability).Understanding the health needs of a community allows public health and health care organizations to design and implement cost-effective strategies that improve the health status of the populations they serve. A comprehensive data driven assessment process can identify, with a high degree of accuracy, priority health needs and issues related to prevention, diagnosis and treatment. Assessment tools also may assist in pinpointing access to care barriers, utilization of evidence based guidelines, and utilization of health services. Part VI, Line 5: St. Mary's provided many community health improvement services to address the public health needs identified in Androscoggin County in the most recent Community Health Needs Assessment. The most significant public health issues continue to be chronic diseases, mental health, substance use, obesity and tobacco use. Community health education and improvement services focused on chronic diseases and substance use. Initiatives included health screenings for cancer, cooking classes (embedded within food access strategies), and self-help programs for smoking cessation and weight loss. St. Mary's also focused on access to care for underserved populations. Mental and Behavioral Health:As one of New England's most comprehensive behavioral healthcare facilities, St Mary's Regional Medical Center offers a place where lives are turned around and put on a path to hope, happiness and good mental health. St. Mary's provides compassionate patient centered care to children, adolescents, and adults. We offer multiple programs, both in the hospital setting or through outpatient services.Women, Children, and Family Health:St. Mary's also offers highly professional and compassionate resources for women's and family health. For example, the Women's Health Pavilion features private birthing rooms that are designed with a warm, comfortable, home-like environment. Mothers enjoy the convenience of staying in one room throughout labor, delivery and post-partum. Hot tubs in every room help women relax during labor, and birthing tubs offer women the option of a water birth. Private bathrooms and showers, recessed lighting and oversized windows help make this birthing experience like none other. Additionally, The Breast Health Program provides comprehensive education and treatment services for breast health care. The program offers a clinical, educational, psychosocial, and personal resource for learning more about breast health and treating and living with breast cancer.Cancer Care:St. Mary's Health System is a proud partner of the MaineHealth Cancer Care Network, a coordinated system of care with the support of the Harold Alfond Foundation. Our cancer program is accredited by the American College of Surgeons, Commission on Cancer. We at CCBD understand that fighting cancer requires a team effort. Our program is led by specially trained medical oncologist/hematologist physicians and surgeons and supported by oncology trained Registered Nurses, pharmacists, physical therapists, nutritionists, and dedicated oncology social workers. Surgeons and are supported by an oncology trained nurse navigator. We recognize that every person has special needs and we strive to provide individualized state-of-the-art cancer care for our patients and their family members.Spiritual Care:St. Mary's also believes that providing spiritual care is paramount to promoting physical wellbeing; the Center recognizes that to be hospitalized or admitted to a nursing home can be extremely challenging. Many people find that talking with a chaplain can help during this period. Chaplains provide spiritual support to patients, family members, friends, and staff members at St. Mary's Regional Medical Center, d'Youville Pavilion, and St. Mary's Residences. An integral part of our health care team, chaplains are available around-the-clock to be a caring presence, offer spiritual and emotional support, and listen with openness and understanding. Patients and families are encouraged to call a chaplain when experiencing feelings of fear, anger, loneliness, helplessness, anxiety, grief, or loss, or when they just need someone to talk to. The priest chaplain is available to celebrate the Sacrament of the Sick and Dying. Chaplains are available to support all our patients regardless of their beliefs and religious affiliation. Patients do not need to be affiliated with a congregation or faith community to call a chaplain. However, if you do belong to a community, we can notify your home faith community to make a visit. Your minister, rabbi, or other spiritual advisor may visit you or your family member at any time.Emergency Care:The Cecile J. Coulombe Emergency Center offers a full spectrum of emergency care. We have built strong relationships with tertiary hospitals to ensure the best possible care for patients. Quick diagnosis and appropriate treatments provide optimal care.Multi-Language Services:The Center also believes that diverse languages and culture should not create barriers to care or community health. Interpreter services are available if English is not your primary language. All persons, regardless of their ability to communicate, be it disability or language, will be provided with equal access to health care offered by St. Mary's Health System. Under the Americans with Disabilities Act (ADA), hospitals must provide effective means of communication for patients, family members, and hospital visitors. The primary role of the interpreter is to communicate informed consent between a patient and a medical provider prior to St. Mary's administering medical care for the patient. These services are to be provided at no cost to the patient or individuals needing assistance. COVID-19 Response:One of the major challenges to community health that St. Mary's has faced during the past year has been the COVID-19 Pandemic. St. Mary's Healthcare is effectively responding to the COVID-19 pandemic, which is having a significant impact on our community. Our team is not only selflessly caring for our patients, we're also collaborating with other community leaders and striving to meet all the needs for care and support. Our full commitment to providing the best care possible on the frontlines demands resources, including a much-needed additional inventory of medical and safety supplies.This detail only begins to describe the many ways in which the Medical Center promotes the health of its community. More information can be found on the Hospital's website. Part VI, Line 6: St. Mary's Regional Medical Center is a member and related organization to the Covenant Health System.Covenant Health is an innovative, Catholic regional health delivery network and a leader in values-based, not-for-profit health and elder care. Covenant consists of hospitals, skilled nursing and rehabilitation centers, assisted living residences, and community-based health and elder care organizations throughout New England. Through its partnership and membership with Covenant Health, the Medical Center is able to better navigate the increasingly complex and competitive healthcare marketplace while improving its ability to offer high-quality patient service. Access to Covenant Health resources allows the Center to compete on cost and quality of care; to maintain financial strength while fulfilling its care-oriented missions; to enhance the skills of its staff and leadership; and to strengthen the Center's ability to serve its community. Through the Covenant Health System, the Center can access and utilize funds and resources that allow it to better serve its priority communities and their specific health care needs. Part VI, Line 7, Reports Filed With States ME 1 Marguerite d'Youville Fund for the Needy 113 27707 Part I, Line 2: In an effort to provide financial assistance and support to its valuable employees and the communities it serves Covenant Health and its various affiliates created an assistance and relief program during 2020. The Medical Center's Employee Campaign invited donations to the Marguerite d'Youville Fund and the Covenant Hearts United Emergency Assistance Fund. These funds allow the Hospital to provide a helping hand to members of the St. Mary's family and community who might experience unexpected financial hardships for which they are not prepared. Employees and community members who are able to actively demonstrate and document a financial need may be eligible for assistance by the Hospital under either of these funds. The Medical Center established an independent body to review and evaluate any assistance-payments to be offered on behalf of its employees. The Hospital maintains books and records for the funds expensed for employee assistance and the vendors paid. X X X X 0 0 0 0 0 0 0 0 0 Michael Newman MD Physician 898332 0 0 0 20902 0 4956 0 33687 0 957877 0 0 0 Joseph Strauss MD Physician 820228 0 0 0 20902 0 4111 0 30061 0 875302 0 0 0 Jeffery Davila MD Director 848127 0 0 0 4019 0 0 0 1498 0 853644 0 0 0 Michael Parker MD Physician 586469 0 0 0 29771 0 5287 0 13974 0 635501 0 0 0 Gregory Pomeroy MD Physician 590073 0 0 0 5149 0 2850 0 21419 0 619491 0 0 0 Sacha Matthews MD Physician 547586 0 0 0 20902 0 4815 0 28689 0 601992 0 0 0 Steve Jorgensen President & CEO 0 428697 0 18000 0 24305 0 5700 0 30064 0 506766 0 0 Douglas Smith MD Chief Medical Officer 426390 0 0 0 926 0 5556 0 26159 0 459031 0 0 0 Michael Hendrix Treasurer & CFO (end 8/2020) 0 242518 0 7500 0 18734 0 4651 0 26744 0 300147 0 0 Anne Brown MD Director 161884 0 0 0 439 0 3186 0 25402 0 190911 0 0 0 Christopher T Bowe Chief Medical Officer (end 4/2020) 165453 0 0 0 259 0 3057 0 8822 0 177591 0 0 0 Part I, Line 3 Any compensation paid to the trustees, directors, officers or key employees of the Organization is subject to the oversight and decisions of Covenant Health, a related tax-exempt organization. Every two-to-three years the Compensation Committee of the Covenant Health Board of Directors engages an external consultant to provide competitive market data from various survey sources, which is then used to develop recommendations for changes to the compensation program. Since 2003, the Compensation Committee has engaged a human resources consultant to conduct this analysis. Objectives of the analysis are to assess the compositeness of the total cash compensation levels of the senior leadership team, develop market based competitive salary ranges for all executive positions, and ensure that the annual incentive opportunities, if there are any, are competitive and reasonable. A MHHEFA Revenue Bond Series 2007A 010314384 560425v80 2007-11-01 6685000 Funding for construction and capital improvements 0 0 0 B MHHEFA Revenue Bond Series 2014A 010314384 560427W77 2014-07-24 8490000 Refinancing of 2004A bonds 0 0 0 C MHHEFA Revenue Bond Series 2014 010314384 560427U61 2014-07-24 2450000 Refinancing of 2004A bonds 0 0 0 D MHHEFA Revenue Bond Series 2017B 010314384 00056042R 2017-03-21 6000000 Funding for construction and capital improvements 0 0 0 A 6853065 444500 89925 6318640 2007 0 0 1 1 B 9406745 1615380 1560850 52292 2014 0 1 1 1 C 2661384 616000 2993216 19344 2014 1 0 1 1 D 6000000 414069 120000 5465931 2017 0 0 1 1 A 0 0 0 0 0.00000 0.00000 0.00000 0 0 0 B 0 0 0 0 0.00000 0.00000 0.00000 0 0 0 C 0 0 0 0 0.00000 0.00000 0.00000 0 0 0 D 0 0 0 0 0.00000 0.00000 0.00000 0 0 0 A 1 0 0 1 fsa 30.000000000000 1 0 0 B 1 0 0 1 FSA 9.000000000000 1 0 0 C 0 0 0 0 0 0 1 FSA 9.000000000000 1 0 0 D 1 0 0 1 FSA 30.000000000000 0 0 0 A 0 B 0 C 0 D 0 Schedule K, Part III, Line 9; Part IV, Line 7, & Part V While formal, written policies have not been adopted by the Organization, the Center carefully and consistently monitors its tax-exempt bond for potential violations. Additionally, the Organization routinely confers with bond counsel to ensure all relevant compliance requirements have been met. A MHHEFA Revenue Bond Series 2020A 010314384 2020-06-30 4904565 Refinancing of 2010 bonds 0 0 0 A 4904565 1025474 72007 3652 2020 1 0 1 1 A 0 0 0 0 0.00000 0.00000 0.00000 0 0 1 A 0 1 0 0 0 0 0 0 1 A 1 X 4 515881 Gift Date FMV 0 1 1 Part I, Line 32b: The Organization sells gifts of stock as soon as administratively possible through its third party broker, Bar Harbor Bank & Trust. Form 990, Part VI, Section A, line 6 St. Mary's Health System is the sole corporate member of the organization. Form 990, Part VI, Section A, line 7a As the sole corporate member of the Organization, St. Mary's Health System retains the ability to elect and remove the Organization's board of directors with or without cause. Form 990, Part VI, Section A, line 7b As the sole corporate member of the Organization, St. Mary's Heath System has the following powers and rights over the Organization and its subsidiaries as outlined in the Organization's bylaws: 1. To approve any change in the written statements of philosophy and mission; 2. To amend and to repeal the organizing and governing documents; 3. To approve all plans of merger, consolidation, reorganization, dissolution, or the sale, lease assignment, or transfer of substantially all of the assets, or the purchase or acquisition of an interest in any corporation, partnership, joint venture, or other entity; 4. To approve all long-range strategic plans before implementation; 5. To approve the acquisition, sale, or encumberance of any real estate valued in excess of an amount set by the Member in writing; 6. To approve all capital budgets and non-budgeted expeness in excess of an amount set by the Member in writing; 7. To approve all debt in excess of limits set by the Member in writing; 8. To approve the sale, assignment, or transfer of any equity interest or membership interest in any subsidiary; 9. To approve any reclassification or other change of any capital stock or other equity security; 10. To approve the issuance of, or the creation of any obligation to issue, an equity security; and, 11. To evaluate the performance of the Medical Center in preserving, furthering, and promoting the purposes of the Medical Center. Form 990, Part VI, Section B, line 11b The Form 990 is provided to the governing body for their review and approval prior to filing. Form 990, Part VI, Section B, line 12c This process is the responsibility of the Compliance Officer. A conflict of interest disclosure form is submitted to all leadership, board members, board committee members, employed physicians, medical directors and certain employees in key positions annually to be completed. Reminders are sent to all persons of interest to ensure that all conflict of interest disclosure forms are completed and collected. Form 990, Part VI, Section B, line 15 Any compensation paid to the trustees, directors, officers or key employees of the Organization is subject to the oversight and decisions of Covenant Health, a related tax-exempt organization. Every two-to-three years the Compensation Committee of the Covenant Health Board of Directors engages an external consultant to provide competitive market data from various survey sources, which is then used to develop recommendations for changes to the compensation program. Since 2003, the Compensation Committee has engaged a human resources consultant to conduct this analysis. Objectives of the analysis are to assess the compositeness of the total cash compensation levels of the senior leadership team, develop market based competitive salary ranges for all executive positions, and ensure that the annual incentive opportunities, if there are any, are competitive and reasonable. Form 990, Part VI, Section C, line 19 The Organization's Form 990, governing documents, conflict of interest policy, and financial statements are made available to the public upon request. The Organization's Form 990 is also made available on the website of its parent organization, Covenant Health, Inc., at the following web address: https://www.covenanthealth.net/financial-information/financial-information Form 990, Part IX, line 11g Medical and health care professionals: Program service expenses 14,535,468. Management and general expenses 0. Fundraising expenses 0. Total expenses 14,535,468. Purchased administrative and manintenance services: Program service expenses 16,109,295. Management and general expenses 1,247,342. Fundraising expenses 0. Total expenses 17,356,637. Consulting and management services: Program service expenses 0. Management and general expenses 472,561. Fundraising expenses 0. Total expenses 472,561. Form 990, Part XI, line 9: Net transfers to affiliates -2,668,891. Form 990, Part XI, Line 2c: The Audit Committee of Covenant Health assumes responsibility for oversight of the audit and selection of the independent auditor. This audit process has not changed from the previous year. Youville Lifecare Inc 1575 Cambridge Street Cambridge MA 02138 042103582 Hospital and health care facility MA 501(c)(3) Line 10 Covenant Health Inc 0 St Joseph Manor Health Care 215 Thatcher Street Brockton MA 02302 042565937 Nursing home and restorative facility MA 501(c)(3) Line 10 Covenant Health Inc 0 St Mary's Health System PO Box 7291 Lewiston ME 04243 222504349 Hospital and health care facility ME 501(c)(3) Line 12a, I Covenant Health Inc 0 St Joseph's Hospital of NashuaNH Inc 172 Kinsley Street Nashua NH 03061 020222215 Hospital and health care facility NH 501(c)(3) Line 3 Covenant Health Inc 0 Youville Place 10 Pelham Road Lexington MA 02421 043297834 Assisted living services MA 501(c)(3) Line 10 Covenant Health Inc 0 St Mary's Villa Nursing Home Inc 675 St Marys Villa Road Moscow PA 18444 232057177 Nursing home and restorative facility PA 501(c)(3) Line 10 Covenant Health Inc 0 CHS of Waltham Inc dba Maristhill Nursing & Rehab Center 66 Newton Street Waltham MA 02453 043333609 Nursing home and restorative facility MA 501(c)(3) Line 10 Covenant Health Inc 0 CHS of Worcester Inc dba St Mary Care Center 39 Queen Street Worchester MA 01610 043419625 Nursing home and restorative facility MA 501(c)(3) Line 10 Covenant Health Inc 0 Fanny Allen Holdings Inc 790 College Parkway Colchester VT 05446 030181052 Real estate holding company VT 501(c)(3) Line 12a, I Covenant Health Inc 0 St Andre Health Care 407 Pool Street Biddeford ME 04005 010342399 Nursing home and restorative facility ME 501(c)(3) Line 10 Covenant Health Inc 0 MI Nursing Restorative Center Inc 172 Lawrence Street Lawrence MA 01841 042104851 Nursing home and restorative facility MA 501(c)(3) Line 10 Covenant Health Inc 0 Helping Hands of St Marguerite Inc 799 Concord Avenue Cambridge MA 02138 800199674 Private home-care health services MA 501(c)(3) Line 10 Covenant Health Inc 0 Covenant Health Investment Trust 420 Bedford Street Lexington MA 02420 046835128 Investment trust MA 501(c)(3) Line 12a, I Covenant Health Inc 0 Fanny Allen Corporation Inc 790 College Parkway Colchester VT 05446 222495808 Charitable foundation VT 501(c)(3) Line 12a, I Covenant Health Inc 0 Youville House Inc 1573 Cambridge Street Cambridge MA 02138 043239593 Assisted living services MA 501(c)(3) Line 10 Youville Lifecare Inc 0 Youville Hospital and Rehabilitation Center Inc 1575 Cambridge Street Cambridge MA 02138 043239563 Hospital and health care facility MA 501(c)(3) Line 10 Youville Lifecare Inc 0 Community Clinical Services PO Box 7291 Lewiston ME 04243 010409788 Physician pratice ME 501(c)(3) Line 10 St Mary's Health System 0 St Mary's D'Youville Pavilion PO Box 7291 Lewiston ME 04243 010211558 Nursing home and restorative facility ME 501(c)(3) Line 10 St Mary's Health System 0 St Mary's Residences PO Box 7291 Lewiston ME 04243 222504356 Low income housing ME 501(c)(3) Line 10 St Mary's Health System 0 Neighborhood Housing Initiative PO Box 7291 Lewiston ME 04243 010539730 Affordable housing services ME 501(c)(3) Line 10 St Mary's Health System 0 Souhegan Nursing Association 24 North River Road Nashua NH 03055 020222795 Home health and hospice NH 501(c)(3) Line 10 St Joseph Hospital of Nashua NH Inc 0 The Surgicenter at St Joseph Hospital Inc 172 Kinsley Street Nashua NH 03061 020222215 Healthcare and surgery center NH 501(c)(3) Line 10 St Joseph Hospital of Nashua NH Inc 0 MI Management Inc 172 Lawrence Street Lawrence MA 01841 042857794 Assisted living services MA 501(c)(3) Line 12a, I Covenant Health Inc 0 MI Adult Day Health Care Center Inc 189 Maple Street Lawrence MA 01841 042921888 Adult day care services MA 501(c)(3) Line 10 Covenant Health Inc 0 MI Residential Community Inc 189 Maple Street Lawrence MA 01841 042647207 HUD low income housing MA 501(c)(3) Line 10 Covenant Health Inc 0 MI Residential Community II Inc 189 Maple Street Lawrence MA 01841 042679954 HUD low income housing MA 501(c)(3) Line 10 Covenant Health Inc 0 MI Residential Community III Inc 189 Maple Street Lawrence MA 01841 042186043 HUD low income housing MA 501(c)(3) Line 10 Covenant Health Inc 0 MI Transportation Inc 189 Maple Street Lawrence MA 01841 042921889 Elderly transportation services MA 501(c)(3) Line 10 Covenant Health Inc 0 Mary Immaculate Guild 172 Lawrence Street Lawrence MA 01841 463073987 Nonprofit funding and support ME 501(c)(3) Line 12a, I Covenant Health Inc 0 St Joseph Healthcare Foundation 360 Broadway Bangor ME 04402 222480149 Healthcare foundation ME 501(c)(3) Line 10 Covenant Health Inc 0 St Joseph Hospital 360 Broadway Bangor ME 04402 010212435 Hospital and health care facility ME 501(c)(3) Line 3 St Joseph Healthcare Foundation 0 M & J Company 360 Broadway Bangor ME 04402 222480150 Lease holding company ME 501(c)(2) St Joseph Healthcare Foundation 0 St Joseph Ambulatory Care Inc 360 Broadway Bangor ME 04402 222480373 Physician pratice ME 501(c)(3) Line 10 St Joseph Healthcare Foundation 0 Alternative Health Services 360 Broadway Bangor ME 04402 010422885 Home health and hospice ME 501(c)(3) Line 10 St Joseph Healthcare Foundation 0 Mount St Rita Health Centre 15 Sumner Brown Road Cumberland RI 02864 050342330 Nursing home RI 501(c)(3) Line 10 Covenant Health Inc 0 Penacook Place Inc 150 Water Street Haverhill MA 01830 237090088 Nursing home MA 501(c)(3) Line 10 Covenant Health Inc 0 Covenant Health Inc 100 Ames Pond Drive Tewksbury MA 01876 222484505 Health care management and resource organization MA 501(c)(3) Line 10 N/A 0 Covenant Health Foundation Inc 100 Ames Pond Drive Tewksbury MA 01876 800199674 Charitable foundation MA 501(c)(3) Line 12a, I Covenant Health Inc 0 Covenant Health Insurance LTD PO Box 69 Grand Cayman CJ KY1-1102 043360127 Self-insurance company CJ N/A C 0 Campus Holding PO Box 7291 Lewiston ME 04240 010406049 Holding company ME N/A C 0 St Joseph Corporate Services Inc 172 Kinsley Street Nashua NH 03060 020405197 Holding company NH N/A C 0 Strauss Incorporated 360 Broadway Bangor ME 04402 010391369 Repairs and transcriptions ME N/A C 0 GNM Corporation 172 Kinsley Street Nashua NH 03060 020400550 Real estate holding company NH N/A C 0 SJ Physicians Services 172 Kinsley Street Nashua NH 03060 020522234 Physician practice NH N/A C 0 0 0 0 0 0 0 1 0 0 1 1 1 1 0 1 1 1 1 1