RUMFORD HOSPITAL: Form 990, tax year 2018

View the entire original 990 at ProPublica ↗

Organization: RUMFORD HOSPITAL (EIN 01-0215227)
Tax period: 2018-07-01 to 2019-06-30
Filed: 2020-07-15
IRS object ID: 202011979349301766
Schema version: 2018v3.3
Source: Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header
Form 990
Schedule A
Schedule B
Schedule C
Schedule D
Schedule H
Schedule J
Schedule O
Schedule R

Return header ReturnHeader

Field	Value	IRS element (for citing)
Return	2020-07-15T08:41:42-05:00	ReturnTs
Tax Period End	2019-06-30	TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

Preparer Firm Name PreparerFirmName

Field	Value	IRS element (for citing)
Business Name Line1	BKD LLP	BusinessNameLine1Txt

Preparer US Address PreparerUSAddress

Field	Value	IRS element (for citing)
Address Line1	910 E ST LOUIS 200/PO BOX 1190	AddressLine1Txt
City	SPRINGFIELD	CityNm
State Abbreviation	MO	StateAbbreviationCd
ZIP	658062523	ZIPCd

Field	Value	IRS element (for citing)
Return Type	990	ReturnTypeCd
Tax Period Begin	2018-07-01	TaxPeriodBeginDt

Filer Filer

Field	Value	IRS element (for citing)
EIN	010215227	EIN

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	RUMFORD HOSPITAL	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
In Care Of	% JOHN WHITLOCK	InCareOfNm
Business Name Control	RUMF	BusinessNameControlTxt
Phone	2077952813	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	420 FRANKLIN STREET	AddressLine1Txt
City	RUMFORD	CityNm
State Abbreviation	ME	StateAbbreviationCd
ZIP	04276	ZIPCd

Business Officer BusinessOfficerGrp

Field	Value	IRS element (for citing)
Person	JOHN WHITLOCK	PersonNm
Person Title	TREASURER	PersonTitleTxt
Phone	2077952972	PhoneNum
Signature	2020-03-12	SignatureDt
Discuss With Paid Preparer	Yes (true)	DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

Field	Value	IRS element (for citing)
Preparer Person	Brian D Todd	PreparerPersonNm
PTIN	P00422601	PTIN
Phone	4178658701	PhoneNum

Filing Security Information FilingSecurityInformation

IP Address IPAddress

Field	Value	IRS element (for citing)
I Pv4 Address	167.68.126.162	IPv4AddressTxt

Field	Value	IRS element (for citing)
Federal Original Submission Id	43032920201975000022	FederalOriginalSubmissionId
Federal Original Submission Id	2020-07-15	FederalOriginalSubmissionIdDt
Filing License Type	P	FilingLicenseTypeCd
At Submission Creation Device Id	74C51B083D6172D3D43AC87F1A33B4712A418457	AtSubmissionCreationDeviceId
At Submission Filing Device Id	39CBA67CBDC84C24964593991C1F330368A3BFFE	AtSubmissionFilingDeviceId

Field	Value	IRS element (for citing)
Tax	2018	TaxYr
Build TS	2021-01-29 14:40:06Z	BuildTS

Form 990 IRS990

Field	Value	IRS element (for citing)
Principal Officer	PETER WRIGHT	PrincipalOfficerNm

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	420 FRANKLIN STREET	AddressLine1Txt
City	RUMFORD	CityNm
State Abbreviation	ME	StateAbbreviationCd
ZIP	04276	ZIPCd

Field	Value	IRS element (for citing)
Gross Receipts	$44,563,220	GrossReceiptsAmt
Group Return For Affiliates	false	GroupReturnForAffiliatesInd
Organization501c3	Yes (X)	Organization501c3Ind
Website Address	WWW.RUMFORDHOSPITAL.ORG	WebsiteAddressTxt
Type Of Organization Corp	Yes (X)	TypeOfOrganizationCorpInd
Formation	1974	FormationYr
Legal Domicile State	ME	LegalDomicileStateCd
Activity Or Mission	RUMFORD HOSPITAL STRIVES TO PROVIDE EXCEPTIONAL HEALTHCARE SERVICES. THE HOSPITAL DEPENDS ON THE EXPERTISE COMMITMENT AND COMPASSION OF ITS CAREGIVERS TO FULFILL ITS MISSION.	ActivityOrMissionDesc
Voting Members Governing Body	12	VotingMembersGoverningBodyCnt
Voting Members Independent	8	VotingMembersIndependentCnt
Total Employee	343	TotalEmployeeCnt
Total Volunteers	50	TotalVolunteersCnt
Total Gross UBI	$0	TotalGrossUBIAmt
PY Contributions Grants	$59,811	PYContributionsGrantsAmt
CY Contributions Grants	$53,320	CYContributionsGrantsAmt
PY Program Service Revenue	$43,013,513	PYProgramServiceRevenueAmt
CY Program Service Revenue	$42,815,304	CYProgramServiceRevenueAmt
PY Investment Income	$253,740	PYInvestmentIncomeAmt
CY Investment Income	$203,899	CYInvestmentIncomeAmt
PY Other Revenue	-$15,151	PYOtherRevenueAmt
CY Other Revenue	-$22,333	CYOtherRevenueAmt
PY Total Revenue	$43,311,913	PYTotalRevenueAmt
CY Total Revenue	$43,050,190	CYTotalRevenueAmt
PY Grants And Similar Paid	$480	PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid	$0	CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members	$0	PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members	$0	CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid	$19,481	PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid	$24,810,321	CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns	$0	PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns	$0	CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense	$0	CYTotalFundraisingExpenseAmt
PY Other Expenses	$25,171,593	PYOtherExpensesAmt
CY Other Expenses	$19,041,509	CYOtherExpensesAmt
PY Total Expenses	$25,191,554	PYTotalExpensesAmt
CY Total Expenses	$43,851,830	CYTotalExpensesAmt
PY Revenues Less Expenses	$18,120,359	PYRevenuesLessExpensesAmt
CY Revenues Less Expenses	-$801,640	CYRevenuesLessExpensesAmt
Total Assets BOY	$26,983,973	TotalAssetsBOYAmt
Total Assets EOY	$26,792,019	TotalAssetsEOYAmt
Total Liabilities BOY	$10,009,144	TotalLiabilitiesBOYAmt
Total Liabilities EOY	$10,539,527	TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY	$16,974,829	NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY	$16,252,492	NetAssetsOrFundBalancesEOYAmt
Mission	TO PROVIDE EXCEPTIONAL HEALTHCARE SERVICES IN A SAFE AND TRUSTFUL ENVIRONMENT THROUGH THE EXPERTISE, COMMITMENT AND COMPASSION OF OUR FAMILY OF CAREGIVERS.	MissionDesc
Significant New Program Srvc	false	SignificantNewProgramSrvcInd
Significant Change	false	SignificantChangeInd
Expense	$32,882,903	ExpenseAmt
Revenue	$42,815,304	RevenueAmt
Desc	RUMFORD HOSPITAL IS A CRITICAL ACCESS HOSPITAL, PROVIDING COMPREHENSIVE PRIMARY CARE AND SOPHISTICATED DIAGNOSTIC SERVICES, INCLUDING CT SCANNING, ULTRASOUND AND NUCLEAR MEDICINE. THE HOSPITAL OFFERS MEDICAL SURGICAL NURSING SERVICES, A BIRTHING CENTER, WOMEN'S HEALTH SERVICES AND AMBULATORY SURGERY. THE SWING BED PROGRAM PROVIDES CARE FOR PATIENTS WHO NEED SKILLED NURSING SERVICES. RUMFORD HOSPITAL ALSO MAINTAINS A 24 HOUR EMERGENCY DEPARTMENT AND STAFFS AN INTENSIVE CARE UNIT.	Desc
Total Program Service Expenses	$32,882,903	TotalProgramServiceExpensesAmt
Described In Section501c3	Yes (true)	DescribedInSection501c3Ind
Schedule B Required	Yes (true)	ScheduleBRequiredInd
Political Campaign Acty	false	PoliticalCampaignActyInd
Lobbying Activities	Yes (true)	LobbyingActivitiesInd
Subject To Proxy Tax	false	SubjectToProxyTaxInd
Donor Advised Fund	false	DonorAdvisedFundInd
Conservation Easements	false	ConservationEasementsInd
Collections Of Art	false	CollectionsOfArtInd
Credit Counseling	false	CreditCounselingInd
Temp Or Permanent Endowments	Yes (true)	TempOrPermanentEndowmentsInd
Report Land Building Equipment	Yes (true)	ReportLandBuildingEquipmentInd
Report Investments Other Sec	false	ReportInvestmentsOtherSecInd
Report Program Related Invst	false	ReportProgramRelatedInvstInd
Report Other Assets	Yes (true)	ReportOtherAssetsInd
Report Other Liabilities	Yes (true)	ReportOtherLiabilitiesInd
Include FIN48 Footnote	false	IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt	false	IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt	Yes (true)	ConsolidatedAuditFinclStmtInd
School Operating	false	SchoolOperatingInd
Foreign Office	false	ForeignOfficeInd
Foreign Activities	false	ForeignActivitiesInd
More Than5000 K To Org	false	MoreThan5000KToOrgInd
More Than5000 K To Individuals	false	MoreThan5000KToIndividualsInd
Professional Fundraising	false	ProfessionalFundraisingInd
Fundraising Activities	false	FundraisingActivitiesInd
Gaming Activities	false	GamingActivitiesInd
Operate Hospital	Yes (true)	OperateHospitalInd
Audited Financial Stmt Att	Yes (true)	AuditedFinancialStmtAttInd
Grants To Organizations	false	GrantsToOrganizationsInd
Grants To Individuals	false	GrantsToIndividualsInd
Schedule J Required	Yes (true)	ScheduleJRequiredInd
Tax Exempt Bonds	false	TaxExemptBondsInd
Engaged In Excess Benefit Trans	false	EngagedInExcessBenefitTransInd
PY Excess Benefit Trans	false	PYExcessBenefitTransInd
Loan Outstanding	false	LoanOutstandingInd
Grant To Related Person	false	GrantToRelatedPersonInd
Business Rln With Org Mem	false	BusinessRlnWithOrgMemInd
Business Rln With Fam Mem	false	BusinessRlnWithFamMemInd
Business Rln With Officer Ent	false	BusinessRlnWithOfficerEntInd
Deductible Non Cash Contri	false	DeductibleNonCashContriInd
Deductible Art Contribution	false	DeductibleArtContributionInd
Terminate Operations	false	TerminateOperationsInd
Partial Liquidation	false	PartialLiquidationInd
Disregarded Entity	false	DisregardedEntityInd
Related Entity	Yes (true)	RelatedEntityInd
Related Organization Ctrl Ent	false	RelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org	false	TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp	false	ActivitiesConductedPrtshpInd
Schedule O Required	Yes (true)	ScheduleORequiredInd
Info In Schedule O Part V	Yes (X)	InfoInScheduleOPartVInd
IRP Document	29	IRPDocumentCnt
IRP Document W2 G	0	IRPDocumentW2GCnt
Backup Wthld Compliance	Yes (true)	BackupWthldComplianceInd
Employee	343	EmployeeCnt
Employment Tax Returns Filed	Yes (true)	EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit	false	UnrelatedBusIncmOverLimitInd
Foreign Financial Account	false	ForeignFinancialAccountInd
Prohibited Tax Shelter Trans	false	ProhibitedTaxShelterTransInd
Taxable Party Notification	false	TaxablePartyNotificationInd
Nondeductible Contributions	false	NondeductibleContributionsInd
Quid Pro Quo Contributions	false	QuidProQuoContributionsInd
Form8282 Property Disposed Of	false	Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct	false	RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct	false	PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services	false	IndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht Pymt	false	SubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst Inc	false	SubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VI	Yes (X)	InfoInScheduleOPartVIInd
Governing Body Voting Members	12	GoverningBodyVotingMembersCnt
Independent Voting Member	8	IndependentVotingMemberCnt
Family Or Business Rln	Yes (true)	FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties	false	DelegationOfMgmtDutiesInd
Change To Org Documents	false	ChangeToOrgDocumentsInd
Material Diversion Or Misuse	false	MaterialDiversionOrMisuseInd
Members Or Stockholders	Yes (true)	MembersOrStockholdersInd
Election Of Board Members	Yes (true)	ElectionOfBoardMembersInd
Decisions Subject To Approva	Yes (true)	DecisionsSubjectToApprovaInd
Minutes Of Governing Body	Yes (true)	MinutesOfGoverningBodyInd
Minutes Of Committees	Yes (true)	MinutesOfCommitteesInd
Officer Mailing Address	false	OfficerMailingAddressInd
Local Chapters	false	LocalChaptersInd
Form990 Provided To Gvrn Body	Yes (true)	Form990ProvidedToGvrnBodyInd
Conflict Of Interest Policy	Yes (true)	ConflictOfInterestPolicyInd
Annual Disclosure Covered Prsn	Yes (true)	AnnualDisclosureCoveredPrsnInd
Regular Monitoring Enfrc	Yes (true)	RegularMonitoringEnfrcInd
Whistleblower Policy	Yes (true)	WhistleblowerPolicyInd
Document Retention Policy	Yes (true)	DocumentRetentionPolicyInd
Compensation Process CEO	false	CompensationProcessCEOInd
Compensation Process Other	false	CompensationProcessOtherInd
Investment In Joint Venture	false	InvestmentInJointVentureInd
States Where Copy Of Return Is Fld	ME	StatesWhereCopyOfReturnIsFldCd
Upon Request	Yes (X)	UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Field	Value	IRS element (for citing)
Person	JOHN WHITLOCK	PersonNm
Phone	2077952813	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	300 MAIN STREET	AddressLine1Txt
City	LEWISTON	CityNm
State Abbreviation	ME	StateAbbreviationCd
ZIP	04240	ZIPCd

Field	Value	IRS element (for citing)
Info In Schedule O Part VII	Yes (X)	InfoInScheduleOPartVIIInd

Form990 Part VII Section A Form990PartVIISectionAGrp (27 entries)

TitleTitleTxt	Average Hours Per WeekAverageHoursPerWeekRt	Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt	Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd	Reportable Comp From OrgReportableCompFromOrgAmt	Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt	Other CompensationOtherCompensationAmt	OfficerOfficerInd	Key EmployeeKeyEmployeeInd	Highest Compensated EmployeeHighestCompensatedEmployeeInd	Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd
JOLAN IPPOLITO
DIRECTOR	1.0	3.0	Yes (X)	$0	$0	$0
JANET HALL KOSKI
DIRECTOR	1.0	3.0	Yes (X)	$0	$0	$0
JEFF BRICKMAN
PRESIDENT/DIRECTOR	1.0	61.0	Yes (X)	$0	$717,577	$99,794	Yes (X)
MARK ADAMS
VICE CHAIR; DIRECTOR END 07/18	1.0	5.0	Yes (X)	$0	$0	$0	Yes (X)
AUSTIN ALBERT
DIRECTOR	1.0	3.0	Yes (X)	$0	$0	$0
DEBORAH DUNLAP AVASTHI
CHAIRPERSON/DIRECTOR	1.0	3.0	Yes (X)	$0	$0	$0	Yes (X)
DOUGLAS M BOYD
DIRECTOR END 12/18	1.0	3.0	Yes (X)	$0	$0	$0
WILLIAM LEE MD
PHYSICIAN; DIRECTOR	1.0	57.0	Yes (X)	$0	$299,925	$24,938
PHIL LIBBY
DIRECTOR END 04/19	1.0	3.0	Yes (X)	$0	$0	$0
CRAIG TRIBUNO
DIRECTOR	1.0	3.0	Yes (X)	$0	$0	$0
WILLIAM CLIFFORD
DIRECTOR BEG 08/18	1.0	3.0	Yes (X)	$0	$0	$0
DEVORE CULVER
DIRECTOR BEG 08/18	1.0	3.0	Yes (X)	$0	$0	$0
MICHAEL RICCI MD
PHYSICIAN; DIRECTOR BEG 10/18	1.0	57.0	Yes (X)	$0	$456,513	$7,375
GEOFFREY SWIFT
DIRECTOR BEG 07/18	1.0	3.0	Yes (X)	$0	$0	$0
JENNIFER WEINER-SMITH MD
PHYSICIAN; DIRECTOR BEG 10/18	1.0	57.0	Yes (X)	$0	$432,983	$36,509
R DAVID FRUM
PRESIDENT END 09/18	27.5	29.5		$0	$418,825	$29,801	Yes (X)
DAVID THOMPSON
TREASURER END 06/19	1.0	61.0		$0	$485,419	$46,547	Yes (X)
HOLLI BOCCELLI
SECRETARY	1.0	57.0		$0	$196,682	$615	Yes (X)
JOHN WHITLOCK
TREASURER BEG 06/19	1.0	60.0		$0	$157,528	$11,649	Yes (X)
PETER WRIGHT
PRESIDENT BEG 03/19	27.5	29.5		$0	$0	$0	Yes (X)
DIETER KRECKEL
PHYSICIAN CHIEF END 06/19	45.0	0.0		$254,499	$0	$7,716		Yes (X)
LISA TORGERSEN
PHYSICIAN	45.0	0.0		$369,554	$0	$24,093			Yes (X)
JACOB LEDESMA
PHYSICIAN	45.0	0.0		$477,663	$0	$26,518			Yes (X)
JEFFREY LYNDS
PHYSICIAN	45.0	0.0		$366,076	$0	$18,541			Yes (X)
STEPHANIE SINCLAIR
PHYSICIAN	45.0	0.0		$366,133	$0	$27,673			Yes (X)
SAID DAOUD
PHYSICIAN	45.0	0.0		$371,874	$0	$34,129			Yes (X)
PHILIPPE MORISSETTE
FORMER TREASURER/VICE PRES.	1.0	55.0		$0	$126,647	$1,684				Yes (X)

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	$2,205,799	TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org	$3,292,099	TotReportableCompRltdOrgAmt
Total Other Compensation	$397,582	TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K	17	IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed	Yes (true)	FormerOfcrEmployeesListedInd
Total Comp Greater Than150 K	Yes (true)	TotalCompGreaterThan150KInd
Compensation From Other Srcs	false	CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1Txt	CityContractorAddress/USAddress/CityNm	State AbbreviationContractorAddress/USAddress/StateAbbreviationCd	ZIPContractorAddress/USAddress/ZIPCd	ServicesServicesDesc	CompensationCompensationAmt
SODEXO CLINICAL TECHNOLOGY
7100 COMMERCE WAY 280	NASHVILLE	TN	37241	MAINTENANCE	$241,979
SODEXO INC
525 WILLIAM PENN PL	PITTSBURGH	PA	152516170	SUPPORT SERVICES	$1,320,586
CHG COMPANIES INC
5003 SOUTH MIAMI BLVD SUITE 400	DURHAM	NC	27703	MEDICAL STAFFING	$248,597
QUEST DIAGNOSTICS
PO BOX 844226	BOSTON	MA	022844226	MEDICAL SERVICES	$694,556
MAINE IMAGING SERVICES LLC
55 CHRISTYS DR	BROCKTON	MA	02301	MEDICAL IMAGING	$338,520

Field	Value	IRS element (for citing)
Cntrct Rcvd Greater Than100 K	8	CntrctRcvdGreaterThan100KCnt
Related Organizations	$5,000	RelatedOrganizationsAmt
All Other Contributions	$48,320	AllOtherContributionsAmt
Total Contributions	$53,320	TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (3 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
NET PATIENT SERVICE REVENUE	900099	$40,466,856	$40,466,856
CAFETERIA REVENUE	722514	$76,083	$76,083
OTHER REVENUE	900099	$2,272,365	$2,272,365

Field	Value	IRS element (for citing)
Total Program Service Revenue	$42,815,304	TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$129,370	TotalRevenueColumnAmt
Exclusion	$129,370	ExclusionAmt

Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt

Royalties Revenue RoyaltiesRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt

Gross Rents GrossRentsGrp

Field	Value	IRS element (for citing)
Real	$10,561	RealAmt

Less Rental Expenses LessRentalExpensesGrp

Field	Value	IRS element (for citing)
Real	$32,894	RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Real	-$22,333	RealAmt
Personal	$0	PersonalAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Total Revenue Column	-$22,333	TotalRevenueColumnAmt
Exclusion	-$22,333	ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

Field	Value	IRS element (for citing)
Securities	$1,545,665	SecuritiesAmt
Other	$9,000	OtherAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

Field	Value	IRS element (for citing)
Securities	$1,480,136	SecuritiesAmt

Gain Or Loss GainOrLossGrp

Field	Value	IRS element (for citing)
Securities	$65,529	SecuritiesAmt
Other	$9,000	OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$74,529	TotalRevenueColumnAmt
Exclusion	$74,529	ExclusionAmt

Field	Value	IRS element (for citing)
Fundraising Gross Income	$0	FundraisingGrossIncomeAmt
Fundraising Direct Expenses	$0	FundraisingDirectExpensesAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt

Field	Value	IRS element (for citing)
Gaming Gross Income	$0	GamingGrossIncomeAmt
Gaming Direct Expenses	$0	GamingDirectExpensesAmt

Net Income From Gaming NetIncomeFromGamingGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt

Field	Value	IRS element (for citing)
Gross Sales Of Inventory	$0	GrossSalesOfInventoryAmt
Cost Of Goods Sold	$0	CostOfGoodsSoldAmt

Net Income Or Loss NetIncomeOrLossGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt

Field	Value	IRS element (for citing)
Other Revenue Total	$0	OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$43,050,190	TotalRevenueColumnAmt
Related Or Exempt Func Income	$42,815,304	RelatedOrExemptFuncIncomeAmt
Exclusion	$181,566	ExclusionAmt

Field	Value	IRS element (for citing)
Info In Schedule O Part IX	Yes (X)	InfoInScheduleOPartIXInd

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Foreign Grants ForeignGrantsGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Benefits To Members BenefitsToMembersGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

Field	Value	IRS element (for citing)
Total	$262,215	TotalAmt
Program Services	$262,215	ProgramServicesAmt

Comp Disqual Persons CompDisqualPersonsGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

Field	Value	IRS element (for citing)
Total	$21,251,356	TotalAmt
Program Services	$18,654,612	ProgramServicesAmt
Management And General	$2,596,744	ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

Field	Value	IRS element (for citing)
Total	$291,662	TotalAmt
Program Services	$283,283	ProgramServicesAmt
Management And General	$8,379	ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

Field	Value	IRS element (for citing)
Total	$2,015,917	TotalAmt
Program Services	$1,486,494	ProgramServicesAmt
Management And General	$529,423	ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

Field	Value	IRS element (for citing)
Total	$989,171	TotalAmt
Program Services	$960,477	ProgramServicesAmt
Management And General	$28,694	ManagementAndGeneralAmt

Fees For Services Management FeesForServicesManagementGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Fees For Services Legal FeesForServicesLegalGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Fees For Services Accounting FeesForServicesAccountingGrp

Field	Value	IRS element (for citing)
Total	$18,165	TotalAmt
Management And General	$18,165	ManagementAndGeneralAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Fees For Services Prof Fundraising FeesForServicesProfFundraising

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

Field	Value	IRS element (for citing)
Total	$9,846	TotalAmt
Management And General	$9,846	ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

Field	Value	IRS element (for citing)
Total	$6,706,234	TotalAmt
Program Services	$2,441,637	ProgramServicesAmt
Management And General	$4,264,597	ManagementAndGeneralAmt

Advertising AdvertisingGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Office Expenses OfficeExpensesGrp

Field	Value	IRS element (for citing)
Total	$1,225,387	TotalAmt
Program Services	$882,674	ProgramServicesAmt
Management And General	$342,713	ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

Field	Value	IRS element (for citing)
Total	$382,239	TotalAmt
Program Services	$202,125	ProgramServicesAmt
Management And General	$180,114	ManagementAndGeneralAmt

Royalties RoyaltiesGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Occupancy OccupancyGrp

Field	Value	IRS element (for citing)
Total	$895,434	TotalAmt
Program Services	$131,080	ProgramServicesAmt
Management And General	$764,354	ManagementAndGeneralAmt

Travel TravelGrp

Field	Value	IRS element (for citing)
Total	$81,644	TotalAmt
Program Services	$47,901	ProgramServicesAmt
Management And General	$33,743	ManagementAndGeneralAmt

Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Conferences Meetings ConferencesMeetingsGrp

Field	Value	IRS element (for citing)
Total	$23,011	TotalAmt
Program Services	$23,011	ProgramServicesAmt

Interest InterestGrp

Field	Value	IRS element (for citing)
Total	$62,072	TotalAmt
Program Services	$7,854	ProgramServicesAmt
Management And General	$54,218	ManagementAndGeneralAmt

Payments To Affiliates PaymentsToAffiliatesGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Depreciation Depletion DepreciationDepletionGrp

Field	Value	IRS element (for citing)
Total	$1,884,884	TotalAmt
Program Services	$882,368	ProgramServicesAmt
Management And General	$1,002,516	ManagementAndGeneralAmt

Insurance InsuranceGrp

Field	Value	IRS element (for citing)
Total	$1,351,957	TotalAmt
Program Services	$285,313	ProgramServicesAmt
Management And General	$1,066,644	ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDesc	TotalTotalAmt	Program ServicesProgramServicesAmt	Management And GeneralManagementAndGeneralAmt
MEDICAL SUPPLIES & DRUGS	$5,469,124	$5,463,973	$5,151
PROVIDER TAX	$834,662	$834,662
LICENSES, DUES, SUBSCRIPTIONS	$78,578	$23,251	$55,327
All other expenses	$18,272	$9,973	$8,299

Total Functional Expenses TotalFunctionalExpensesGrp

Field	Value	IRS element (for citing)
Total	$43,851,830	TotalAmt
Program Services	$32,882,903	ProgramServicesAmt
Management And General	$10,968,927	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

Field	Value	IRS element (for citing)
BOY	$26,547	BOYAmt
EOY	$27,791	EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

Field	Value	IRS element (for citing)
BOY	$2,280,964	BOYAmt
EOY	$3,272,812	EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Accounts Receivable AccountsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$3,846,115	BOYAmt
EOY	$3,811,038	EOYAmt

Receivables From Officers Etc ReceivablesFromOfficersEtcGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

Field	Value	IRS element (for citing)
BOY	$559,047	BOYAmt
EOY	$448,409	EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

Field	Value	IRS element (for citing)
BOY	$49,181	BOYAmt
EOY	$28,506	EOYAmt

Field	Value	IRS element (for citing)
Land Bldg Equip Cost Or Other Bss	$38,063,150	LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec	$25,795,471	LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

Field	Value	IRS element (for citing)
BOY	$12,213,764	BOYAmt
EOY	$12,267,679	EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

Field	Value	IRS element (for citing)
BOY	$4,169,100	BOYAmt
EOY	$3,899,447	EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Intangible Assets IntangibleAssetsGrp

Field	Value	IRS element (for citing)
BOY	$394,546	BOYAmt
EOY	$285,074	EOYAmt

Other Assets Total OtherAssetsTotalGrp

Field	Value	IRS element (for citing)
BOY	$3,444,709	BOYAmt
EOY	$2,751,263	EOYAmt

Total Assets TotalAssetsGrp

Field	Value	IRS element (for citing)
BOY	$26,983,973	BOYAmt
EOY	$26,792,019	EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

Field	Value	IRS element (for citing)
BOY	$8,234,228	BOYAmt
EOY	$8,908,662	EOYAmt

Grants Payable GrantsPayableGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Deferred Revenue DeferredRevenueGrp

Field	Value	IRS element (for citing)
BOY	$33,926	BOYAmt
EOY	$34,123	EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Escrow Account Liability EscrowAccountLiabilityGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Loans From Officers Directors LoansFromOfficersDirectorsGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

Field	Value	IRS element (for citing)
BOY	$884,735	BOYAmt
EOY	$935,932	EOYAmt

Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Other Liabilities OtherLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$856,255	BOYAmt
EOY	$660,810	EOYAmt

Total Liabilities TotalLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$10,009,144	BOYAmt
EOY	$10,539,527	EOYAmt

Field	Value	IRS element (for citing)
Organization Follows SFAS117	Yes (X)	OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$16,388,636	BOYAmt
EOY	$15,660,934	EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$331,071	BOYAmt
EOY	$337,317	EOYAmt

Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$255,122	BOYAmt
EOY	$254,241	EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$16,974,829	BOYAmt
EOY	$16,252,492	EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$26,983,973	BOYAmt
EOY	$26,792,019	EOYAmt

Field	Value	IRS element (for citing)
Info In Schedule O Part XI	Yes (X)	InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss	-$801,640	ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst	$90,177	NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets	-$10,874	OtherChangesInNetAssetsAmt
Method Of Accounting Accrual	Yes (X)	MethodOfAccountingAccrualInd
Accountant Compile Or Review	false	AccountantCompileOrReviewInd
FS Audited	Yes (true)	FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

Field	Value	IRS element (for citing)
Consolidated Basis Fincl Stmt	Yes (X)	ConsolidatedBasisFinclStmtInd

Field	Value	IRS element (for citing)
Audit Committee	Yes (true)	AuditCommitteeInd
Federal Grant Audit Required	false	FederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

Field	Value	IRS element (for citing)
Hospital	Yes (X)	HospitalInd

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

Field	Value	IRS element (for citing)
Contributor	RESTRICTED	ContributorNum

Contributor Business Name ContributorBusinessName

Field	Value	IRS element (for citing)
Business Name Line1	RESTRICTED	BusinessNameLine1

Contributor US Address ContributorUSAddress

Field	Value	IRS element (for citing)
Address Line1	RESTRICTED	AddressLine1
Address Line2	RESTRICTED	AddressLine2
City	RESTRICTED	City
State	RESTRICTED	State
ZIP Code	RESTRICTED	ZIPCode

Field	Value	IRS element (for citing)
Total Contributions	RESTRICTED	TotalContributionsAmt

Schedule C IRS990ScheduleC

Field	Value	IRS element (for citing)
Total Grassroots Lobbying		TotalGrassrootsLobbyingGrp
Total Direct Lobbying		TotalDirectLobbyingGrp
Total Lobbying Expend		TotalLobbyingExpendGrp
Other Exempt Purpose Expend		OtherExemptPurposeExpendGrp
Total Exempt Purpose Expend		TotalExemptPurposeExpendGrp
Lobbying Nontaxable Amount		LobbyingNontaxableAmountGrp
Grassroots Nontaxable		GrassrootsNontaxableGrp
Tot Lbbyng Grassroot Mns Non Tx		TotLbbyngGrassrootMnsNonTxGrp
Tot Lbby Expend Mns Lbbyng Non Tx		TotLbbyExpendMnsLbbyngNonTxGrp
Volunteers	false	VolunteersInd
Paid Staff Or Management	false	PaidStaffOrManagementInd
Media Advertisements	false	MediaAdvertisementsInd
Mailings Members	false	MailingsMembersInd
Publications Or Broadcast	false	PublicationsOrBroadcastInd
Grants Other Organizations	false	GrantsOtherOrganizationsInd
Direct Contact Legislators	false	DirectContactLegislatorsInd
Rallies Demonstrations	false	RalliesDemonstrationsInd
Other Activities	Yes (true)	OtherActivitiesInd
Other Activities	$8,549	OtherActivitiesAmt
Total Lobbying Expenditures	$8,549	TotalLobbyingExpendituresAmt
Not Described Section501c3	false	NotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	SCHEDULE C, PART II-B, LINE 1I	FormAndLineReferenceDesc
Explanation	LOBBYING EXPENSES: PORTION OF DUES FOR PROFESSIONAL ASSOCIATIONS ATTRIBUTED TO LOBBYING EXPENSES - $8,549.	ExplanationTxt

Schedule D IRS990ScheduleD

Field	Value	IRS element (for citing)
Art Public Exhibition Amounts		ArtPublicExhibitionAmountsGrp
Held Works Art		HeldWorksArtGrp

CY Endwmt Fund CYEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$586,193	BeginningYearBalanceAmt
Contributions	$16,246	ContributionsAmt
Investment Earnings Or Losses	-$881	InvestmentEarningsOrLossesAmt
Other Expenditures	$10,000	OtherExpendituresAmt
End Year Balance	$591,558	EndYearBalanceAmt

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$575,743	BeginningYearBalanceAmt
Contributions	$9,356	ContributionsAmt
Investment Earnings Or Losses	$1,094	InvestmentEarningsOrLossesAmt
End Year Balance	$586,193	EndYearBalanceAmt

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$504,309	BeginningYearBalanceAmt
Contributions	$70,344	ContributionsAmt
Investment Earnings Or Losses	$1,090	InvestmentEarningsOrLossesAmt
End Year Balance	$575,743	EndYearBalanceAmt

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$508,032	BeginningYearBalanceAmt
Contributions	$11,339	ContributionsAmt
Investment Earnings Or Losses	-$3,803	InvestmentEarningsOrLossesAmt
Other Expenditures	$11,259	OtherExpendituresAmt
End Year Balance	$504,309	EndYearBalanceAmt

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$504,227	BeginningYearBalanceAmt
Contributions	$4,434	ContributionsAmt
Investment Earnings Or Losses	-$629	InvestmentEarningsOrLossesAmt
End Year Balance	$508,032	EndYearBalanceAmt

Field	Value	IRS element (for citing)
Prmnnt Endowment Balance EOY	0.42980	PrmnntEndowmentBalanceEOYPct
Term Endowment Balance EOY	0.57020	TermEndowmentBalanceEOYPct
Endowments Held Unrelated Org	false	EndowmentsHeldUnrelatedOrgInd
Endowments Held Related Org	Yes (true)	EndowmentsHeldRelatedOrgInd
Related Org List Sch R	Yes (true)	RelatedOrgListSchRInd

Land LandGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$89,148	OtherCostOrOtherBasisAmt
Book Value	$89,148	BookValueAmt

Buildings BuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$15,084,970	OtherCostOrOtherBasisAmt
Depreciation	$8,362,146	DepreciationAmt
Book Value	$6,722,824	BookValueAmt

Field	Value	IRS element (for citing)
Leasehold Improvements		LeaseholdImprovementsGrp

Equipment EquipmentGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$22,287,569	OtherCostOrOtherBasisAmt
Depreciation	$17,111,696	DepreciationAmt
Book Value	$5,175,873	BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$601,463	OtherCostOrOtherBasisAmt
Depreciation	$321,629	DepreciationAmt
Book Value	$279,834	BookValueAmt

Field	Value	IRS element (for citing)
Total Book Value Land Buildings	$12,267,679	TotalBookValueLandBuildingsAmt

Other Assets Org OtherAssetsOrgGrp (4 entries)

DescDesc	Book ValueBookValueAmt
EST AMT DUE FROM THIRD PARTIES	$2,217,260
INVESTMENT IN CHARITABLE TRUST	$64,793
OTHER RECEIVABLES	$468,310
DEPOSITS	$900

Field	Value	IRS element (for citing)
Total Book Value Other Assets	$2,751,263	TotalBookValueOtherAssetsAmt
Federal Income Tax Liability	$0	FederalIncomeTaxLiabilityAmt

Other Liabilities Org OtherLiabilitiesOrgGrp

Field	Value	IRS element (for citing)
Desc	EST AMT DUE TO THIRD PARTIES	Desc
Amt	$660,810	Amt

Field	Value	IRS element (for citing)
Total Liability	$660,810	TotalLiabilityAmt

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
SCHEDULE D, PART V, LINE 4	ENDOWMENT FUNDS: 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. OTHER ARE DESIGNATED TO SUPPORT SPECIFIC DEPARTMENTS OF THE HOSPITAL.
SCHEDULE D, PART X, LINE 2	UNCERTAIN TAX POSITION: MANAGEMENT HAS EVALUATED THEIR INCOME TAX POSITIONS UNDER THE GUIDANCE INCLUDED IN ASC 740. BASED ON THEIR REVIEW, MANAGEMENT HAS NOT IDENTIFIED ANY MATERIAL UNCERTAIN TAX POSITIONS TO BE RECORDED OR DISCLOSED IN THE FINANCIAL STATEMENTS.

Schedule H IRS990ScheduleH

Field	Value	IRS element (for citing)
Financial Assistance Policy	Yes (true)	FinancialAssistancePolicyInd
Written Policy	Yes (true)	WrittenPolicyInd
All Hospitals Policy	Yes (X)	AllHospitalsPolicyInd
FPG Reference Free Care	Yes (true)	FPGReferenceFreeCareInd
Percent200	Yes (X)	Percent200Ind
FPG Reference Discounted Care	false	FPGReferenceDiscountedCareInd
Free Care Medically Indigent	Yes (true)	FreeCareMedicallyIndigentInd
Financial Assistance Budget	Yes (true)	FinancialAssistanceBudgetInd
Expenses Exceed Budget	false	ExpensesExceedBudgetInd
Annual Community Bnft Report	false	AnnualCommunityBnftReportInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$375,745	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$375,745	NetCommunityBenefitExpnsAmt
Total Expense	0.00860	TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$9,629,965	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$6,292,006	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$3,337,959	NetCommunityBenefitExpnsAmt
Total Expense	0.07610	TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$10,005,710	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$6,292,006	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$3,713,704	NetCommunityBenefitExpnsAmt
Total Expense	0.08470	TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$10,005,710	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$6,292,006	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$3,713,704	NetCommunityBenefitExpnsAmt
Total Expense	0.08470	TotalExpensePct

Field	Value	IRS element (for citing)
Bad Debt Expense Reported	false	BadDebtExpenseReportedInd
Bad Debt Expense	$4,282,739	BadDebtExpenseAmt
Bad Debt Expense Attributable	$843,071	BadDebtExpenseAttributableAmt
Reimbursed By Medicare	$12,929,704	ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr	$13,267,155	CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall	-$337,451	MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

Field	Value	IRS element (for citing)
Cost To Charge Ratio	Yes (X)	CostToChargeRatioInd

Field	Value	IRS element (for citing)
Written Debt Collection Policy	Yes (true)	WrittenDebtCollectionPolicyInd
Financial Assistance Prvsn	Yes (true)	FinancialAssistancePrvsnInd
Hospital Facilities	1	HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp

Field	Value	IRS element (for citing)
Facility	1	FacilityNum

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	RUMFORD HOSPITAL	BusinessNameLine1Txt

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	420 FRANKLIN STREET	AddressLine1Txt
City	RUMFORD	CityNm
State Abbreviation	ME	StateAbbreviationCd
ZIP	04276	ZIPCd

Field	Value	IRS element (for citing)
Website Address	WWW.RUMFORDHOSPITAL.ORG	WebsiteAddressTxt
State License	38727	StateLicenseNum
Licensed Hospital	Yes (X)	LicensedHospitalInd
General Medical And Surgical	Yes (X)	GeneralMedicalAndSurgicalInd
Critical Access Hospital	Yes (X)	CriticalAccessHospitalInd
Emergency Room24 Hrs	Yes (X)	EmergencyRoom24HrsInd
Other	OUTPATIENT PHYSICIAN CLINICS	OtherDesc
Facility Reporting Group	1	FacilityReportingGroupCd

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

Field	Value	IRS element (for citing)
Business Name Line1	RUMFORD HOSPITAL	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Facility	1	FacilityNum
First Licensed CY Or PY	false	FirstLicensedCYOrPYInd
Tax Exempt Hospital CY Or PY	false	TaxExemptHospitalCYOrPYInd
CHNA Conducted	Yes (true)	CHNAConductedInd
Community Definition	Yes (X)	CommunityDefinitionInd
Community Demographics	Yes (X)	CommunityDemographicsInd
Existing Resources	Yes (X)	ExistingResourcesInd
How Data Obtained	Yes (X)	HowDataObtainedInd
Community Health Needs	Yes (X)	CommunityHealthNeedsInd
Other Health Issues	Yes (X)	OtherHealthIssuesInd
Community Hlth Needs Id Process	Yes (X)	CommunityHlthNeedsIdProcessInd
Consulting Process	Yes (X)	ConsultingProcessInd
Prior CHNA Impact	Yes (X)	PriorCHNAImpactInd
CHNA Conducted	18	CHNAConductedYr
Take Into Account Others Input	Yes (true)	TakeIntoAccountOthersInputInd
CHNA Conducted With Other Fclts	Yes (true)	CHNAConductedWithOtherFcltsInd
CHNA Conducted With Non Fclts	Yes (true)	CHNAConductedWithNonFcltsInd
CHNA Report Widely Available	Yes (true)	CHNAReportWidelyAvailableInd
Rpt Available On Own Website	Yes (X)	RptAvailableOnOwnWebsiteInd
Own Website URL	SEE PART V, SECTION C	OwnWebsiteURLTxt
Other Website	Yes (X)	OtherWebsiteInd
Other Website URL	SEE PART V, SECTION C	OtherWebsiteURLTxt
Paper Copy Public Inspection	Yes (X)	PaperCopyPublicInspectionInd
Implementation Strategy Adopt	Yes (true)	ImplementationStrategyAdoptInd
Implementation Strategy Adpt	18	ImplementationStrategyAdptYr
Strategy Posted Website	Yes (true)	StrategyPostedWebsiteInd
Strategy Website URL	SEE PART V, SECTION C	StrategyWebsiteURLTxt
Organization Incur Excise Tax	false	OrganizationIncurExciseTaxInd
Elig Criteria Explained	Yes (true)	EligCriteriaExplainedInd
FPG Family Incm Lmt Free Dscnt	Yes (X)	FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care	200.	FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care	0.	FPGFamilyIncmLmtDscntCarePct
Medical Indigency Criteria	Yes (X)	MedicalIndigencyCriteriaInd
Insurance Status Criteria	Yes (X)	InsuranceStatusCriteriaInd
Other Criteria	Yes (X)	OtherCriteriaInd
Explained Basis	Yes (true)	ExplainedBasisInd
App Financial Asst Expln	Yes (true)	AppFinancialAsstExplnInd
Described Info	Yes (X)	DescribedInfoInd
Described Suprt Doc	Yes (X)	DescribedSuprtDocInd
Provided Hospital Contact	Yes (X)	ProvidedHospitalContactInd
Includes Publicity Measures	Yes (true)	IncludesPublicityMeasuresInd
FAP Available On Website	Yes (X)	FAPAvailableOnWebsiteInd
FAP Available On Website URL	SEE PART V, SECTION C	FAPAvailableOnWebsiteURLTxt
FAP App Available On Website	Yes (X)	FAPAppAvailableOnWebsiteInd
FAP App Available On Website URL	SEE PART V, SECTION C	FAPAppAvailableOnWebsiteURLTxt
FAP Summary On Website	Yes (X)	FAPSummaryOnWebsiteInd
FAP Summary On Website URL	SEE PART V, SECTION C	FAPSummaryOnWebsiteURLTxt
FAP Avlbl On Request No Charge	Yes (X)	FAPAvlblOnRequestNoChargeInd
FAP App Avlbl On Request No Chrg	Yes (X)	FAPAppAvlblOnRequestNoChrgInd
FAP Sum Avlbl On Request No Chrg	Yes (X)	FAPSumAvlblOnRequestNoChrgInd
Notified FAP Copy Bill Display	Yes (X)	NotifiedFAPCopyBillDisplayInd
Communtity Notified FAP	Yes (X)	CommuntityNotifiedFAPInd
FAP Actions On Nonpayment	Yes (true)	FAPActionsOnNonpaymentInd
Permit No Actions	Yes (X)	PermitNoActionsInd
Collection Activities	false	CollectionActivitiesInd
Provided Written Notice	Yes (X)	ProvidedWrittenNoticeInd
Made Effort Orally Notify	Yes (X)	MadeEffortOrallyNotifyInd
Processed FAP Application	Yes (X)	ProcessedFAPApplicationInd
Nondis Emergency Care Policy	Yes (true)	NondisEmergencyCarePolicyInd
Look Back Medicare	Yes (X)	LookBackMedicareInd
Amounts Generally Billed	false	AmountsGenerallyBilledInd
Gross Charges	false	GrossChargesInd

Supplemental Information SupplementalInformationGrp (10 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
SCHEDULE H, PART V, SECTION B, LINE 5	COMMUNITY INPUT: COMMUNITY OUTREACH AND ENGAGEMENT FOR THE MAINE SHARED CHNA INCLUDED COORDINATION AT BOTH THE STATEWIDE, PUBLIC HEALTH DISTRICT, AND COUNTY LEVEL. THE STATEWIDE COMMUNITY ENGAGEMENT COMMITTEE MET MONTHLY FROM MARCH 2018 THROUGH JANUARY 2019 TO REVIEW AND PROVIDE INPUT ON EVERY ASPECT OF ENGAGEMENT PROCESS. IN ADDITION TO THE STATE-LEVEL COMMUNITY ENGAGEMENT COMMITTEE, A LOCAL COMMUNITY ENGAGEMENT PLANNING COMMITTEE IN EACH OF MAINE'S 16 COUNTIES PLANNED AND IMPLEMENTED THE LOGISTICS OF COMMUNITY FORUMS AND EVENTS WITHIN EACH DISTRICT. THESE COMMITTEES WERE COMPRISED OF HOSPITALS, PUBLIC HEALTH DISTRICT LIAISONS, AND A VARIETY OF ADDITIONAL PARTNERS. THE 2018 COMMUNITY ENGAGEMENT TOOLKIT WAS DESIGNED TO ASSIST THE LOCAL COMMUNITY ENGAGEMENT PLANNING COMMITTEES IN THIS EFFORT. CRITERIA FOR VISUALIZING DATA INCLUDED AREAS IDENTIFIED AS A HEALTH PRIORITY IN THE LAST CHNA, SIGNIFICANT CHANGES IN THE DATA OVER TIME, OR WHERE A COUNTY'S DATA WAS NOTABLY BETTER OR WORSE THAN THE STATE OR THE NATION. FORUM AGENDA ITEMS INCLUDED REMARKS FROM HEALTH LEADERS; A REVIEW OF PREVIOUS HEALTH IMPROVEMENT EFFORTS; A REVIEW OF COUNTY-LEVEL DATA, DISCUSSION, AND PRIORITIZATION IN SMALL GROUPS; AND AN OVERALL FORUMWIDE VOTING PROCESS. THE COMMUNITY ENGAGEMENT AND STEERING COMMITTEES CREATED AND APPROVED A RUBRIC TO GUIDE THE SELECTION CRITERIA FOR THE SUBSET OF DATA TO BE PRESENTED IN EACH FORUM'S POWERPOINT PRESENTATIONS. SMALL GROUPS HAD 35-45 MINUTES TO DISCUSS THE DATA IN THE PRESENTATION AND THE FULL COUNTY PROFILE, AND TO SHARE THEIR OWN EXPERIENCES IN ORDER TO IDENTIFY THEIR TOP COUNTY HEALTH PRIORITIES. TABLE FACILITATORS GUIDED THESE DISCUSSIONS USING KEY QUESTIONS AND WORKSHEETS FOR REPORTING PURPOSES. HEALTH PRIORITIES IDENTIFIED DURING THESE SMALL GROUPS WERE COLLATED AND PRESENTED TO THE LARGER PLENARY SESSION, WHERE EACH ATTENDEE VOTED FOR THEIR TOP FOUR PRIORITIES. VOTES WERE TALLIED AND A HIERARCHY EMERGED. THE SUMMARY VOTES FOR EACH FORUM WERE USED TO DEVELOP THE COUNTY LEVEL PRIORITIES. IF MULTIPLE FORUMS WERE HELD IN A COUNTY, THE FORUM RESULTS FOR FORUMS HELD WITH THE GENERAL COMMUNITY WERE INCLUDED IN THE TOTAL VOTES FOR THE COUNTY. IN CASES WHERE A FORUM WAS HELD WITH A SPECIFIC POPULATION, FOR EXAMPLE, LGBTQ YOUTH OR OLDER ADULTS, THEN THE RESULTS OF THEIR VOTING AND DISCUSSION WERE INCLUDED IN THE SECTION DESCRIBING THE NEEDS OF THAT PARTICULAR POPULATION. TO ARRIVE AT THE TOP COUNTYWIDE COMMUNITY HEALTH ISSUES, VOTES FROM THE BROAD COMMUNITY FORUMS WERE COMBINED FOR EACH OF THE PRIORITY AREAS TO IDENTIFY PRIORITY AREAS WHICH FELL WITHIN 70% OF THE COMBINED VOTING TOTAL. THE COMMUNITY FORUM PARTICIPANTS ALSO SHARED KNOWLEDGE ON GAPS AND ASSETS AVAILABLE IN THEIR COMMUNITIES TO ADDRESS EACH OF THE TOP FOUR PRIORITIES IDENTIFIED. THE INFORMATION GATHERED IN THIS REPORT IS A START FOR FURTHER ASSET AND GAP MAPPING FOR EACH PRIORITY SELECTED BY THE COUNTY. THREE COMMUNITY ENGAGEMENT ACTIVITIES WERE HELD IN OXFORD COUNTY. THE KEY INFORMANT INTERVIEW GUIDE WAS DEVELOPED WITH INPUT FROM THE COMMUNITY ENGAGEMENT AND STEERING COMMITTEE MEMBERS AND CONSISTED OF FIVE QUESTIONS. THIRTY-ONE INTERVIEWS WERE CONDUCTED BY JSI AND 11 BY MEMBERS OF LOCAL COMMUNITY ENGAGEMENT PLANNING COMMITTEES. INFORMATION GATHERED FROM THE KEY INFORMANT INTERVIEWS IS INCLUDED IN DISCUSSIONS WHERE APPLICABLE IN THE COUNTY LEVEL REPORT WITHIN EACH OF THE COUNTY PRIORITIES. FOR EXAMPLE, WHEN DISCUSSING SUBSTANCE USE, A DISCUSSION OF THE NEEDS OF VULNERABLE POPULATIONS WITHIN THIS PRIORITY WAS ALSO INCLUDED. THE STATE LEVEL REPORT PROVIDES A SUMMARY OF KEY FINDINGS FROM THESE INTERVIEWS FOR EACH OF THE TEN VULNERABLE POPULATIONS. ALL OUTCOMES FROM THESE EFFORTS WERE COLLECTED VIA THE COMMUNITY OUTREACH REPORTING TOOL OR THE KEY INFORMANT REPORTING TOOL. BOTH OF THESE COLLECTION TOOLS WERE ONLINE SURVEYS WITHIN SURVEY MONKEY. OTHER DATA COLLECTION TOOLS INCLUDED TABLE FACILITATORS NOTES, FORUM REGISTRATIONS, AND SIGN-INS.
SCHEDULE H, PART V, SECTION B, LINE 6A	HOSPITAL FACILITIES: OTHER HOSPITAL FACILITIES PROVIDING FUNDING FOR THE MAINE SHARED CHNA ARE CENTRAL MAINE HEALTHCARE (INCLUDING CENTRAL MAINE MEDICAL CENTER, BRIDGTON HOSPITAL, AND RUMFORD HOSPITAL), MAINEGENERAL HEALTH, MAINEHEALTH, AND NORTHERN LIGHT HEALTH.
SCHEDULE H, PART V, SECTION B, LINE 6B	NON-HOSPITAL FACILITIES: OTHER NON-HOSPITAL FACILITIES INVOLVED IN THE MAINE SHARED CHNA ARE 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, MAINE HEALTH DATA ORGANIZATION FOR WORKING WITH US TO ACCESS THEIR DATA. 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.
SCHEDULE H, PART V, SECTION B, LINE 7A	HOSPITAL FACILITY'S WEBSITE: HTTPS://WWW.CMHC.ORG/RUMFORD-HOSPITAL/ABOUT-US/COMMUNITY-BENEFITS
SCHEDULE H, PART V, SECTION B, LINE 7B	OTHER WEBSITE: HTTPS://WWW.MAINE.GOV/DHHS/MECDC/PHDATA/MAINECHNA/
SCHEDULE H, PART V, SECTION B, LINE 10A	IMPLEMENTATION STRATEGY WEBSITE: https://www.cmhc.org/rumford-hospital/about-us/community-benefits
SCHEDULE H, PART V, SECTION B, LINE 11	ADDRESSING IDENTIFIED NEEDS: THE COMMITMENT FROM CENTRAL MAINE MEDICAL CENTER AND ITS COMMUNITY PARTNERS WAS TO PRODUCE A DOCUMENT THAT REFLECTS THE VOICE OF OUR COMMUNITY. THE PRIORITIES THAT HAVE EMERGED INCLUDE: - SOCIAL DETERMINANTS OF HEALTH - MENTAL HEALTH - SUBSTANCE USE - ACCESS TO CARE - TOBACCO USE THE NEXT STEP IN THIS PROCESS WAS TO DEVELOP AN IMPLEMENTATION STRATEGY THAT INCLUDED LONG-RANGE PLANS FOR THE PRIORITIZED NEEDS AND TIED THE SPECIFIC IMPLEMENTATION PLANS TO THE STRATEGIC PLAN FOR CENTRAL MAINE MEDICAL CENTER. THIS PROCESS WAS FACILITATED BY THE CMMC LEADERSHIP TEAM, THE COMMUNITY PILLAR STEERING COMMITTEE, AND INCLUDED PARTICIPATION FROM THE COMMUNITY STAKEHOLDER GROUP AND OTHER COMMUNITY MEMBERS. THE STRATEGIES, ACTIVITIES, ACTIONS TAKEN, PROGRAMS AND RESOURCES COMMITTED, COLLABORATION WITH OTHER ORGANIZATIONS, AND OUTCOMES CAN BE VIEWED AT WWW.CMMC.ORG/ABOUT-COMMUNITY-BENEFITS.
SCHEDULE H, PART V, SECTION B, LINES 13H	FAP ELIGIBILITY CRITERIA: PATIENTS MUST APPLY FOR MAINE FREE CARE IN ORDER TO BE CONSIDERED FOR THE HOSPITAL'S FREE CARE PROGRAM. AS PART OF THE APPLICATION, PATIENTS MUST SUBMIT A COPY OF CURRENT MAINECARE DECISION LETTERS. PATIENTS WILL BE ASKED IF THEY HAVE INSURANCE OF ANY KIND TO HELP PAY FOR CARE AND ARE ALSO ASKED TO SHOW THAT INSURANCE OR A GOVERNMENT PROGRAM WILL NOT PAY FOR YOUR CARE. IF PATIENTS DO NOT QUALIFY FOR FREE HOSPITAL CARE, THEY ARE ALLOWED TO ASK FOR A FAIR HEARING OR APPEAL.
SCHEDULE H, PART V, SECTION B, LINES 16A, 16B, & 16C	MEASURES TO PUBLICIZE THE POLICY: HTTPS://WWW.CMHC.ORG/BILLING-AND-FINANCIAL-INFORMATION/
SCHEDULE H, PART V, LINE 16I	LEP TRANSLATIONS: THERE ARE NO GROUPS WITH LIMITED ENGLISH PROFICIENCY THAT RISE TO THE THRESHOLD REQUIRED UNDER THE IRC SECTION 501(R).

Field	Value	IRS element (for citing)
Facility	4	FacilityNum

Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp

Oth Hlth Care Fclts OthHlthCareFcltsGrp (4 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	FacilityFacilityTxt
ELSEMORE DIXFIELD FAMILY MEDICINE
146 WELD STREET	DIXFIELD	ME	04224	OUTPATIENT PHYSICIAN CLINIC
SWIFT RIVER FAMILY MEDICINE
430 FRANKLIN STREET	RUMFORD	ME	04276	OUTPATIENT PHYSICIAN CLINIC
RUMFORD SPECIALTY SERVICES CLINIC
431 FRANKLIN STREET	RUMFORD	ME	04276	OUTPATIENT PHYSICIAN CLINIC
RUMFORD SURGICAL SPECIALISTS
431 FRANKLIN STREET	RUMFORD	ME	04276	OUTPATIENT PHYSICIAN CLINIC

Supplemental Information Detail SupplementalInformationDetail (13 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
SCHEDULE H, PART I, LINE 1C	FAP ELIGIBILITY CRITERIA: PATIENTS MUST APPLY FOR MAINE FREE CARE IN ORDER TO BE CONSIDERED FOR THE HOSPITAL'S FREE CARE PROGRAM. AS PART OF THE APPLICATION, PATIENTS MUST SUBMIT A COPY OF CURRENT MAINECARE DECISION LETTERS. PATIENTS WILL BE ASKED IF THEY HAVE INSURANCE OF ANY KIND TO HELP PAY FOR CARE AND ARE ALSO ASKED TO SHOW THAT INSURANCE OR A GOVERNMENT PROGRAM WILL NOT PAY FOR YOUR CARE. IF PATIENTS DO NOT QUALIFY FOR FREE HOSPITAL CARE, THEY ARE ALLOWED TO ASK FOR A FAIR HEARING OR APPEAL.
SCHEDULE H, PART I, LINE 7, COLUMN F	PERCENT OF TOTAL EXPENSE: 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).
SCHEDULE H, 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.
SCHEDULE H, PART III, SECTION A, LINE 2	BAD DEBT EXPENSE: THE HOSPITAL HAS ADOPTED THE NEW REVENUE RECOGNITION STANDARD ASU 2014-09. UNDER ASU 2014-09, THE ESTIMATED AMOUNTS DUE FROM PATIENTS FOR WHICH THE HEALTH SYSTEMS DOES NOT EXPECT TO BE ENTITLED OR COLLECT FROM THE PATIENTS ARE CONSIDERED IMPLICIT PRICE CONCESSIONS AND EXCLUDED FROM THE HEALTH SYSTEM'S ESTIMATION OF THE TRANSACTION PRICE OR REVENUE RECORDED. BAD DEBT EXPENSE WAS NOT SIGNIFICANT TO THE AUDITED FINANCIAL STATEMENTS FOR THE YEAR ENDED JUNE 30, 2019. HOWEVER, THE HOSPITAL INTERNALLY TRACKS BAD DEBT EXPENSE CONSISTENT WITH HISTORICAL PRACTICES AND THAT AMOUNT HAS BEEN REPORTED ON SCHEDULE H, PART III, SECTION A, LINE 2.
SCHEDULE H, PART III, SECTION A, LINE 3	BAD DEBT EXPENSE ATTRIBUTABLE TO CHARITY CARE: BAD DEBT ATTRIBUTABLE TO PATIENTS UNDER THE ORGANIZATION'S CHARITY CARE POLICY FOR LINE 3 WAS DETERMINED USING A COMPARISON OF EXPERIENCED CHARITY CARE COVERAGE AND US CENSUS BUREAU DATA FOR THE MOST RECENT YEAR AVAILABLE WHEN CHARITY CARE COVERAGE EXCEEDS THE CENSUS DATA, A MINIMAL AMOUNT OF BAD DEBT IS ASSUMED TO BE ELIGIBLE FOR CHARITY CARE TO ACCOUNT FOR THOSE PATIENTS WHO REFUSE TO PROVIDE INFORMATION DOCUMENTING ELIGIBILITY FOR THE PROGRAM. THESE ESTIMATES ARE BASED ON STATE-WIDE DATA AND DO NOT ACCOUNT FOR DIFFERENCES IN GEOGRAPHIC LOCATIONS WITHIN THE STATE. AS THIS AMOUNT IS RELATED TO PATIENTS ELIGIBLE UNDER THE FINANCIAL ASSISTANCE POLICY, IT SHOULD BE INCLUDED AS A COMMUNITY BENEFIT.
SCHEDULE H, PART III, SECTION A, LINE 4	BAD DEBT EXPENSE FOOTNOTE: THE AUDITED FINANCIAL STATEMENTS DO NOT CONTAIN A FOOTNOTE THAT DESCRIBES BAD DEBT EXPENSE. THEY DO, HOWEVER, CONTAIN A FOOTNOTE THAT DESCRIBES PATIENTS ACCOUNTS RECEIVABLE, THAT NOTE CAN BE FOUND ON PAGE 10 OF THE ATTACHED AUDITED FINANCIAL STATEMENTS.
SCHEDULE H, PART III, SECTION B, LINE 8	COMMUNITY BENEFIT: THE COSTING METHODOLOGY USED FOR LINE 6 IS INFORMATION PULLED FROM THE MEDICARE COST REPORT FILING. ANY SHORTFALL REPORTED ON LINE 7 COULD BE CONSIDERED COMMUNITY BENEFIT TO A LEVEL PROPORTIONAL TO THE POVERTY LEVELS INDICATED BY CENSUS BUREAU DATA. IF THE PATIENTS FALLING UNDER 200% FPG LEVEL WERE NOT COVERED BY MEDICARE THEY WOULD QUALIFY UNDER RUMFORD HOSPITAL'S FREE CARE POLICY. UNDER THAT CIRCUMSTANCE, THESE PATIENTS WOULD THEN APPEAR AS PART OF THE STATISTICS ON PART I, LINE 7A.
SCHEDULE H, PART III, SECTION C, LINE 9B	COLLECTION POLICY: COLLECTION PRACTICES FOR PATIENTS KNOWN TO BE ELIGIBLE FOR CHARITY CARE ARE LIMITED TO COLLECTING FROM ANY AVAILABLE PAYMENT SOURCES SUCH AS MEDICARE OR MEDICAID. IF A PATIENT IS ELIGIBLE, BUT HAS NOT APPLIED FOR MEDICAID COVERAGE, THE PATIENT IS REQUESTED TO APPLY. ASSISTANCE IS AVAILABLE TO HELP THE PATIENT WITH THE MEDICAID APPLICATION PROCESS.
SCHEDULE H, PART VI, LINE 2	NEEDS ASSESSMENT: AS A CRITICAL ACCESS HOSPITAL, RUMFORD HOSPITAL ATTEMPTS TO PROVIDE ANY NEEDED HEALTH CARE SERVICES NECESSARY TO TREAT THE POPULATION OF THIS RURAL AREA OF MAINE, ADDITIONALLY, RUMFORD HOSPITAL FOCUSES ON STATE-WIDE INITIATIVES, SUCH AS HEART DISEASE AND DIABETES, AS WELL AS ORGANIZATIONAL INITIATIVES BASED ON NEEDS OBSERVED WITHIN ITS PATIENT POPULATION. MANY FORMS OF EDUCATION, PREVENTION AND EARLY DETECTION ARE ALSO PART OF ITS COMMUNITY HEALTH CARE PLAN.
SCHEDULE H, PART VI, LINE 3	PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE: RUMFORD HOSPITAL PROVIDES NOTICES ABOUT ITS FREE CARE POLICY IN ALL CLINICAL DEPARTMENTS AND MAJOR PATIENT AREAS. AN INPATIENT FINANCIAL COUNSELOR 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. ALL PATIENT FINANCIAL SERVICES STAFF ARE TRAINED TO OFFER FREE CARE AS AN OPTION TO PATIENTS WHO INDICATE AN INABILITY OR DIFFICULTY IN PAYING FOR SERVICES. INFORMATION ABOUT FINANCIAL ASSISTANCE AVAILABILITY IS INCLUDED ON THE BACK OF EVERY PATIENT STATEMENT. ADDITIONALLY, UNINSURED PATIENTS RECEIVE A SEPARATE INFORMATION SHEET WITH THEIR STATEMENTS, FURTHER INFORMING THEM ABOUT THE AVAILABLE OPTIONS.
SCHEDULE H, PART VI, LINE 4	COMMUNITY INFORMATION: RUMFORD HOSPITAL, LOCATED IN RUMFORD, MAINE, SERVES CENTRAL OXFORD COUNTY ALONG THE WESTERN BORDER OF MAINE. A LIGHTLY POPULATED, RURAL AREA AGED 65 OR OVER AND 14% OF THE POPULATION BELOW THE POVERTY LEVEL.
SCHEDULE H, PART VI, LINE 5	PROMOTION OF COMMUNITY HEALTH: RUMFORD HOSPITAL HAS AN OPEN MEDICAL STAFF, ALLOWING ANY NON-EMPLOYED OR AFFILIATED PHYSICIANS TO HAVE ADMITTING PRIVILEGES TO THE HOSPITAL. THE BOARD OF DIRECTORS IS MADE UP OF A MAJORITY OF LOCAL COMMUNITY MEMBERS ALONG WITH SOME REPRESENTATION BY DIRECTORS FROM CENTRAL MAINE HEALTHCARE, THE PARENT OF THE HEALTHCARE SYSTEM WHICH RUMFORD HOSPITAL BELONGS TO, HELPING TO BRING TOGETHER THE VISIONS OF THE LOCAL COMMUNITY WITH THE CAPABILITIES AND VISION OF THE SYSTEM AS A WHOLE FOR THE BENEFIT OF RUMFORD AND SURROUNDING COMMUNITIES.
SCHEDULE H, PART VI, LINE 6	AFFILIATED HEALTH CARE SYSTEM: AS A MEMBER OF THE CENTRAL MAINE HEALTHCARE SYSTEM, RUMFORD HOSPITAL PROVIDES HIGH QUALITY HEALTH CARE IN A RURAL SETTING WITH LIMITED HEALTH CARE OPTIONS. ITS AFFILIATION WITH CENTRAL MAINE MEDICAL CENTER PROVIDES ACCESS 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 SPECIALIST PHYSICIANS FOR OUTPATIENT CARE IN THE RUMFORD AREA ON A REGULAR SCHEDULE. THE SYSTEM PARENT, CENTRAL MAINE HEALTHCARE, PROVIDES STREAMLINED ADMINISTRATIVE FUNCTIONS AND BACKROOM SERVICES, ALLOWING RUMFORD HOSPITAL TO PERFORM AT A COST EFFICIENT LEVEL WHICH WOULD NORMALLY BE UNACHIEVABLE IN A SMALL, RURAL HOSPITAL, ALLOWING FOR BROADER RANGE OF SERVICES AVAILABLE.

Schedule J IRS990ScheduleJ

Field	Value	IRS element (for citing)
Severance Payment	Yes (true)	SeverancePaymentInd
Supplemental Nonqual Rtr Plan	Yes (true)	SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm	false	EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org	false	CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs	false	CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org	false	CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs	false	CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments	false	AnyNonFixedPaymentsInd
Initial Contract Exception	false	InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (15 entries)

TitleTitleTxt	Base Compensation Filing OrgBaseCompensationFilingOrgAmt	Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt	Bonus Filing OrganizationBonusFilingOrganizationAmount	Bonus Related OrganizationsBonusRelatedOrganizationsAmt	Other Compensation Filing OrgOtherCompensationFilingOrgAmt	Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt	Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt	Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt	Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt	Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt	Total Compensation Filing OrgTotalCompensationFilingOrgAmt	Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt	Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt	Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
R DAVID FRUM
PRESIDENT END 09/18	$0	$227,806	$0	$0	$0	$191,019	$0	$16,875	$0	$12,926	$0	$448,626	$0	$38,203
JEFF BRICKMAN
PRESIDENT/DIRECTOR	$0	$686,633	$0	$0	$0	$30,944	$0	$75,125	$0	$24,669	$0	$817,371	$0	$0
DAVID THOMPSON
TREASURER END 06/19	$0	$429,738	$0	$0	$0	$55,681	$0	$31,383	$0	$15,164	$0	$531,966	$0	$0
WILLIAM LEE MD
PHYSICIAN; DIRECTOR	$0	$253,540	$0	$18,135	$0	$28,250	$0	$6,875	$0	$18,063	$0	$324,863	$0	$0
HOLLI BOCCELLI
SECRETARY	$0	$195,952	$0	$0	$0	$730	$0	$615	$0	$0	$0	$197,297	$0	$0
MICHAEL RICCI MD
PHYSICIAN; DIRECTOR BEG 10/18	$0	$449,508	$0	$786	$0	$6,219	$0	$6,875	$0	$500	$0	$463,888	$0	$0
JENNIFER WEINER-SMITH MD
PHYSICIAN; DIRECTOR BEG 10/18	$0	$284,487	$0	$126,507	$0	$21,989	$0	$6,875	$0	$29,634	$0	$469,492	$0	$0
JOHN WHITLOCK
TREASURER BEG 06/19	$0	$105,073	$0	$19,000	$0	$33,455	$0	$3,368	$0	$8,281	$0	$169,177	$0	$0
LISA TORGERSEN
PHYSICIAN	$187,920	$0	$145,402	$0	$36,232	$0	$6,875	$0	$17,218	$0	$393,647	$0	$0	$0
JACOB LEDESMA
PHYSICIAN	$361,952	$0	$111,758	$0	$3,953	$0	$6,875	$0	$19,643	$0	$504,181	$0	$0	$0
JEFFREY LYNDS
PHYSICIAN	$294,743	$0	$68,003	$0	$3,330	$0	$898	$0	$17,643	$0	$384,617	$0	$0	$0
STEPHANIE SINCLAIR
PHYSICIAN	$212,760	$0	$150,590	$0	$2,783	$0	$6,875	$0	$20,798	$0	$393,806	$0	$0	$0
SAID DAOUD
PHYSICIAN	$286,442	$0	$65,400	$0	$20,032	$0	$5,452	$0	$28,677	$0	$406,003	$0	$0	$0
DIETER KRECKEL
PHYSICIAN CHIEF END 06/19	$245,754	$0	$3,235	$0	$5,510	$0	$6,483	$0	$1,233	$0	$262,215	$0	$0	$0
PHILIPPE MORISSETTE
FORMER TREASURER/VICE PRES.	$0	$11,693	$0	$0	$0	$114,954	$0	$728	$0	$956	$0	$128,331	$0	$0

Supplemental Information Detail SupplementalInformationDetail (4 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
SCHEDULE J, PART I, LINE 3	EXECUTIVE 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
SCHEDULE J, PART I, LINE 4A	SEVERANCE PAYMENT: THE FOLLOWING INDIVIDUAL RECEIVED SEVERANCE PAYMENTS FROM CENTRAL MAINE HEALTHCARE CORPORATION: PHILIPPE MORISSETTE: $ 97,920
SCHEDULE J, 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 PARTICIPANT'S 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. THE FOLLOWING INDIVIDUALS PARTICIPATED IN A SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN THROUGH CENTRAL MAINE HEALTHCARE CORPORATION, A RELATED ENTITY. $ 38,203 R. DAVID FRUM (DISTRIBUTION) 10,000 R. DAVID FRUM (DEFERRAL) 68,250 JEFF BRICKMAN (DEFERRAL) 24,508 DAVID THOMPSON (DEFERRAL)
SCHEDULE J, PART II, COLUMN F	COMPENSATION REPORTED IN PRIOR FORM 990: COMPENSATION IS REPORTED ON THE FORM 990 IN THE YEAR THAT THE COMPENSATION IS EARNED BY OR AWARDED TO AN INDIVIDUAL, EVEN IF THE COMPENSATION IS NOT PAID TO THE INDIVIDUAL, IS NOT FULLY VESTED, OR IS SUBJECT TO SUBSTANTIAL RISK OF FORFEITURE. IF COMPENSATION IS EARNED OR AWARDED IN ONE YEAR BUT PAID IN A LATER YEAR, THEN THE COMPENSATION IS REPORTED A SECOND TIME ON THE FORM 990 IN THE YEAR THE COMPENSATION IS VESTED OR PAID TO THE INDIVIDUAL.

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (14 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
FORM 990, PART V, LINE 1A & 2A	COMMON PAYMASTER: RUMFORD HOSPITAL IS A TAX EXEMPT ORGANIZATION WHICH FILES ITS PAYROLL FORMS AND REPORTS WITH THE IRS AND DOL ON A CONSOLIDATED BASIS UNDER ITS PARENT, CENTRAL MAINE HEALTHCARE CORPORATION, USING THE PARENT'S EIN. THIS INCLUDES FORM 941'S, W-2'S AND OTHER RELATED FILINGS.
FORM 990, PART VI, SECTION A, LINE 2	BUSINESS RELATIONSHIP: JEFF BRICKMAN, R. DAVID FRUM, PETER WRIGHT, WILLIAM LEE, MD, HOLLI BOCCELLI, JOHN WHITLOCK, JENNIFER WEINER-SMITH, MD, MICHAEL RICCI, MD, AND DAVID THOMPSON HAVE A BUSINESS RELATIONSHIP THROUGH THEIR EMPLOYMENT WITH A RELATED ORGANIZATION.
FORM 990, PART VI, SECTION A, LINE 6, 7A, & 7B	MEMBERS OR STOCKHOLDERS: 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 WHOLE OR IN PART.
FORM 990, PART VI, SECTION B, LINE 11B	FORM 990 REVIEW PROCESS: 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, WHICH HAS REPRESENTATIVES FROM ALL AFFILIATED BOARDS. 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	MONITORING COMPLIANCE WITH CONFLICT OF INTEREST POLICY: 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, LINES 15A & 15B	EXECUTIVE COMPENSATION POLICY: CENTRAL MAINE HEALTHCARE (CMHC) HAS ESTABLISHED AND FOLLOWS A DELIBERATIVE TRANSPARENT PROCESS WHICH MEETS IRS REGULATIONS FOR "REBUTTABLE" PRESUMPTION OF REASONABLENESS. A STANDING EXECUTIVE 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 ECC ARE SET OUT IN THE EXECUTIVE COMPENSATION PHILOSOPHY AND RESPONSIBILITIES CHARTER WHICH WAS APPROVED BY THE CMHC BOARD. THE ENTIRE CMHC 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 ECC 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 ATTORNEY'S. USING THIS INFORMATION, THE ECC ANNUALLY REVIEWS THE EXECUTIVE'S 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 A ACCORDANCE WITH THE REQUIREMENTS OF THE IRS. 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 PROVIDES 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 FO THE NEXT FISCAL YEAR. CENTRAL MAINE HEALTHCARE DOCUMENTS THE BASIS FOR ITS DETERMINATION OF KEY EMPLOYEES' COMPENSATION AND MAINTAINS THIS CONTEMPORANEOUSLY SUBSTANTIATED MATERIAL IN THE HUMAN RESOURCES DEPARTMENT.
FORM 990, PART VI, SECTION C, LINE 19	PUBLIC DISCLOSURE: 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 APPROPRIATE.
FORM 990, PART VII, SECTION A	NO MEMBERS OF THE BOARD OF DIRECTORS RECEIVED COMPENSATION FOR THEIR DUTIES AS DIRECTORS. JEFF BRICKMAN IS EMPLOYED AS PRESIDENT OF CENTRAL MAINE HEALTHCARE CORPORATION AND HIS COMPENSATED TIME IS SPENT IN THAT CAPACITY. WILLIAM LEE, M.D. IS A PHYSICIAN AND HIS COMPENSATED TIME IS SPENT IN THAT CAPACITY. JENNIFER WEINER-SMITH IS A PHYSICIAN AND HER COMPENSATED TIME IS SPENT IN THAT CAPACITY. MICHAEL RICCI, M.D. IS A PHYSICIAN AND HIS COMPENSATED TIME IS SPENT IN THAT CAPACITY.
FORM 990, PART XI, LINE 9	OTHER CHANGES IN NET ASSETS: $ (10,000) FUNDS RELEASED FOR TRNA (874) CHANGE IN BENEFICIAL INTEREST IN PERPETUAL TRUST ----------- $ (10,874)
FORM 990 PART IX LINE 11G	DESCRIPTION:OUTSIDE SERVICES PURCHASED TOTAL FEES:4282187
FORM 990 PART IX LINE 11G	DESCRIPTION:IC OTHER TOTAL FEES:1445703
FORM 990 PART IX LINE 11G	DESCRIPTION:PURCHASED SERVICES TOTAL FEES:926227
FORM 990 PART IX LINE 11G	DESCRIPTION:CONSULTING TOTAL FEES:47660
FORM 990 PART IX LINE 11G	DESCRIPTION:PROFESSIONAL FEES TOTAL FEES:4457

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (10 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Exempt Code SectionExemptCodeSectionTxt	Public Charity StatusPublicCharityStatusTxt	Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt	Controlled OrganizationControlledOrganizationInd
CENTRAL MAINE COMMUNITY HEALTH CORP
PO BOX 4500	LEWISTON	ME	04243	010386912	PUBLIC EDU	ME	501(C)(3)	7	CMHC	false
CENTRAL MAINE MEDICAL CENTER
PO BOX 4500	LEWISTON	ME	04243	010211494	HEALTHCARE	ME	501(C)(3)	3	CMHC	false
CENTRAL MAINE HEALTHCARE CORPORATION
PO BOX 4500	LEWISTON	ME	04243	010386913	HEALTHCARE	ME	501(C)(3)	7	NA	false
MAINE COLLEGE OF HEALTH PROFESSIONS
PO BOX 4500	LEWISTON	ME	04243	010356077	EDUCATION	ME	501(C)(3)	2	CMMC	false
CENTRAL MAINE REAL ESTATE MGMT CORP
PO BOX 4500	LEWISTON	ME	04243	010387674	REAL ESTATE	ME	501(C)(2)		CMHC	false
RUMFORD COMMUNITY FAMILY HEALTH CENTER
430 FRANKLIN STREET	RUMFORD	ME	04276	010481000	HEALTHCARE	ME	501(C)(3)	3	CMHC	false
RUMFORD COMMUNITY HOME CORPORATION
11 JOHN F KENNEDY LANE	RUMFORD	ME	04276	222844951	NURSING HOME	ME	501(C)(3)	10	CMHC	false
BRIDGTON HOSPITAL
10 HOSPITAL DRIVE	BRIDGTON	ME	04009	010130427	HEALTHCARE	ME	501(C)(3)	3	CMHC	false
BRIDGTON HOSPITAL PHYSICIANS GROUP
SOUTH HIGH STREET	BRIDGTON	ME	04009	010493083	HEALTHCARE	ME	501(C)(3)	PF	CMHC	false
ELIAS E TUCKER TRUST FUND
C/O CMMC 300 MAIN STREET	LEWISTON	ME	04240	016042343	NURSING ED	ME	501(C)(3)	12 A I	CMMC	false

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (3 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt	Entity TypeEntityTypeTxt	Controlled OrganizationControlledOrganizationInd	Address Line1ForeignAddress/AddressLine1Txt	CityForeignAddress/CityNm	Province Or StateForeignAddress/ProvinceOrStateNm	CountryForeignAddress/CountryCd	Legal Domicile Foreign CountryLegalDomicileForeignCountryCd
CENTRAL MAINE HEALTH VENTURES INC
300 MAIN STREET	LEWISTON	ME	04240	010430016	HEALTHCARE	ME	CMHC	C CORP	false
CWM INSURANCE LTD
				980220891	INSURANCE		CMHC	C CORP	false	GENESIS BUILDING PO BOX 1363	BWI	GRAND CAYMAN	CJ	CJ
CENTRAL MAINE ACO
300 MAIN STREET	LEWISTON	ME	04240	274604314	ACCOUNTABLE CARE	ME	CMHC	C CORP	false

Field	Value	IRS element (for citing)
Receipt Of Int Annts Rnts Rylts	false	ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org	false	GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth Org	false	GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org	false	LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org	false	LoansOrGuaranteesFromOthOrgInd
Div Related Organization	false	DivRelatedOrganizationInd
Asset Sale To Other Org	false	AssetSaleToOtherOrgInd
Asset Purchase From Other Org	false	AssetPurchaseFromOtherOrgInd
Asset Exchange	false	AssetExchangeInd
Rental Of Facilities To Oth Org	false	RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org	Yes (true)	RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org	false	PerformOfServicesForOthOrgInd
Perform Of Services By Other Org	Yes (true)	PerformOfServicesByOtherOrgInd
Sharing Of Facilities	false	SharingOfFacilitiesInd
Paid Employees Sharing	Yes (true)	PaidEmployeesSharingInd
Reimbursement Paid To Other Org	Yes (true)	ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other Org	Yes (true)	ReimbursementPaidByOtherOrgInd
Transfer To Other Org	false	TransferToOtherOrgInd
Transfer From Other Org	false	TransferFromOtherOrgInd