2020-07-15T08:41:42-05:00 2019-06-30 BKD LLP 910 E ST LOUIS 200/PO BOX 1190 SPRINGFIELD MO 658062523 990 2018-07-01 010215227 RUMFORD HOSPITAL % JOHN WHITLOCK RUMF 2077952813 420 FRANKLIN STREET RUMFORD ME 04276 JOHN WHITLOCK TREASURER 2077952972 2020-03-12 true Brian D Todd P00422601 4178658701 167.68.126.162 43032920201975000022 2020-07-15 P 74C51B083D6172D3D43AC87F1A33B4712A418457 39CBA67CBDC84C24964593991C1F330368A3BFFE 2018 2021-01-29 14:40:06Z PETER WRIGHT 420 FRANKLIN STREET RUMFORD ME 04276 44563220 false X WWW.RUMFORDHOSPITAL.ORG X 1974 ME RUMFORD HOSPITAL STRIVES TO PROVIDE EXCEPTIONAL HEALTHCARE SERVICES. THE HOSPITAL DEPENDS ON THE EXPERTISE COMMITMENT AND COMPASSION OF ITS CAREGIVERS TO FULFILL ITS MISSION. 12 8 343 50 0 59811 53320 43013513 42815304 253740 203899 -15151 -22333 43311913 43050190 480 0 0 0 19481 24810321 0 0 0 25171593 19041509 25191554 43851830 18120359 -801640 26983973 26792019 10009144 10539527 16974829 16252492 TO PROVIDE EXCEPTIONAL HEALTHCARE SERVICES IN A SAFE AND TRUSTFUL ENVIRONMENT THROUGH THE EXPERTISE, COMMITMENT AND COMPASSION OF OUR FAMILY OF CAREGIVERS. false false 32882903 42815304 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. 32882903 true true false true false false false false false true true false false true true false false true false false false false false false false false true true false false true false false false false false false false false false false false false false true false false false true X 29 0 true 343 true false false false false false false false false false false false false X 12 8 true false false false true true true true true false false true true true true true true false false false ME X JOHN WHITLOCK 2077952813 300 MAIN STREET LEWISTON ME 04240 X JOLAN IPPOLITO DIRECTOR 1.0 3.0 X 0 0 0 JANET HALL KOSKI DIRECTOR 1.0 3.0 X 0 0 0 JEFF BRICKMAN PRESIDENT/DIRECTOR 1.0 61.0 X X 0 717577 99794 MARK ADAMS VICE CHAIR; DIRECTOR END 07/18 1.0 5.0 X X 0 0 0 AUSTIN ALBERT DIRECTOR 1.0 3.0 X 0 0 0 DEBORAH DUNLAP AVASTHI CHAIRPERSON/DIRECTOR 1.0 3.0 X X 0 0 0 DOUGLAS M BOYD DIRECTOR END 12/18 1.0 3.0 X 0 0 0 WILLIAM LEE MD PHYSICIAN; DIRECTOR 1.0 57.0 X 0 299925 24938 PHIL LIBBY DIRECTOR END 04/19 1.0 3.0 X 0 0 0 CRAIG TRIBUNO DIRECTOR 1.0 3.0 X 0 0 0 WILLIAM CLIFFORD DIRECTOR BEG 08/18 1.0 3.0 X 0 0 0 DEVORE CULVER DIRECTOR BEG 08/18 1.0 3.0 X 0 0 0 MICHAEL RICCI MD PHYSICIAN; DIRECTOR BEG 10/18 1.0 57.0 X 0 456513 7375 GEOFFREY SWIFT DIRECTOR BEG 07/18 1.0 3.0 X 0 0 0 JENNIFER WEINER-SMITH MD PHYSICIAN; DIRECTOR BEG 10/18 1.0 57.0 X 0 432983 36509 R DAVID FRUM PRESIDENT END 09/18 27.5 29.5 X 0 418825 29801 DAVID THOMPSON TREASURER END 06/19 1.0 61.0 X 0 485419 46547 HOLLI BOCCELLI SECRETARY 1.0 57.0 X 0 196682 615 JOHN WHITLOCK TREASURER BEG 06/19 1.0 60.0 X 0 157528 11649 PETER WRIGHT PRESIDENT BEG 03/19 27.5 29.5 X 0 0 0 DIETER KRECKEL PHYSICIAN CHIEF END 06/19 45.0 0.0 X 254499 0 7716 LISA TORGERSEN PHYSICIAN 45.0 0.0 X 369554 0 24093 JACOB LEDESMA PHYSICIAN 45.0 0.0 X 477663 0 26518 JEFFREY LYNDS PHYSICIAN 45.0 0.0 X 366076 0 18541 STEPHANIE SINCLAIR PHYSICIAN 45.0 0.0 X 366133 0 27673 SAID DAOUD PHYSICIAN 45.0 0.0 X 371874 0 34129 PHILIPPE MORISSETTE FORMER TREASURER/VICE PRES. 1.0 55.0 X 0 126647 1684 2205799 3292099 397582 17 true true false SODEXO CLINICAL TECHNOLOGY 7100 COMMERCE WAY 280 NASHVILLE TN 37241 MAINTENANCE 241979 SODEXO INC 525 WILLIAM PENN PL PITTSBURGH PA 152516170 SUPPORT SERVICES 1320586 CHG COMPANIES INC 5003 SOUTH MIAMI BLVD SUITE 400 DURHAM NC 27703 MEDICAL STAFFING 248597 QUEST DIAGNOSTICS PO BOX 844226 BOSTON MA 022844226 MEDICAL SERVICES 694556 MAINE IMAGING SERVICES LLC 55 CHRISTYS DR BROCKTON MA 02301 MEDICAL IMAGING 338520 8 5000 48320 53320 NET PATIENT SERVICE REVENUE 900099 40466856 40466856 CAFETERIA REVENUE 722514 76083 76083 OTHER REVENUE 900099 2272365 2272365 42815304 129370 129370 0 0 10561 32894 -22333 0 -22333 -22333 1545665 9000 1480136 65529 9000 74529 74529 0 0 0 0 0 0 0 0 0 0 43050190 42815304 181566 X 0 0 0 0 262215 262215 0 21251356 18654612 2596744 291662 283283 8379 2015917 1486494 529423 989171 960477 28694 0 0 18165 18165 0 0 9846 9846 6706234 2441637 4264597 0 1225387 882674 342713 382239 202125 180114 0 895434 131080 764354 81644 47901 33743 0 23011 23011 62072 7854 54218 0 1884884 882368 1002516 1351957 285313 1066644 MEDICAL SUPPLIES & DRUGS 5469124 5463973 5151 PROVIDER TAX 834662 834662 LICENSES, DUES, SUBSCRIPTIONS 78578 23251 55327 All other expenses 18272 9973 8299 43851830 32882903 10968927 0 26547 27791 2280964 3272812 0 0 3846115 3811038 0 0 0 0 0 0 559047 448409 49181 28506 38063150 25795471 12213764 12267679 4169100 3899447 0 0 0 0 394546 285074 3444709 2751263 26983973 26792019 8234228 8908662 0 0 33926 34123 0 0 0 0 0 0 884735 935932 0 0 856255 660810 10009144 10539527 X 16388636 15660934 331071 337317 255122 254241 16974829 16252492 26983973 26792019 X -801640 90177 -10874 X false true X true false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false true 8549 8549 false SCHEDULE C, PART II-B, LINE 1I LOBBYING EXPENSES: PORTION OF DUES FOR PROFESSIONAL ASSOCIATIONS ATTRIBUTED TO LOBBYING EXPENSES - $8,549. 586193 16246 -881 10000 591558 575743 9356 1094 586193 504309 70344 1090 575743 508032 11339 -3803 11259 504309 504227 4434 -629 508032 0.42980 0.57020 false true true 89148 89148 15084970 8362146 6722824 22287569 17111696 5175873 601463 321629 279834 12267679 EST AMT DUE FROM THIRD PARTIES 2217260 INVESTMENT IN CHARITABLE TRUST 64793 OTHER RECEIVABLES 468310 DEPOSITS 900 2751263 0 EST AMT DUE TO THIRD PARTIES 660810 660810 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. true true X true X false true true false false 375745 375745 0.00860 9629965 6292006 3337959 0.07610 10005710 6292006 3713704 0.08470 10005710 6292006 3713704 0.08470 false 4282739 843071 12929704 13267155 -337451 X true true 1 1 RUMFORD HOSPITAL 420 FRANKLIN STREET RUMFORD ME 04276 WWW.RUMFORDHOSPITAL.ORG 38727 X X X X OUTPATIENT PHYSICIAN CLINICS 1 RUMFORD HOSPITAL 1 false false true X X X X X X X X X 18 true true true true X SEE PART V, SECTION C X SEE PART V, SECTION C X true 18 true SEE PART V, SECTION C false true X 200. 0. X X X true true X X X true X SEE PART V, SECTION C X SEE PART V, SECTION C X SEE PART V, SECTION C X X X X X true X false X X X true X false false 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). 4 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 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. true true false false false false false false false R DAVID FRUM PRESIDENT END 09/18 0 227806 0 0 0 191019 0 16875 0 12926 0 448626 0 38203 JEFF BRICKMAN PRESIDENT/DIRECTOR 0 686633 0 0 0 30944 0 75125 0 24669 0 817371 0 0 DAVID THOMPSON TREASURER END 06/19 0 429738 0 0 0 55681 0 31383 0 15164 0 531966 0 0 WILLIAM LEE MD PHYSICIAN; DIRECTOR 0 253540 0 18135 0 28250 0 6875 0 18063 0 324863 0 0 HOLLI BOCCELLI SECRETARY 0 195952 0 0 0 730 0 615 0 0 0 197297 0 0 MICHAEL RICCI MD PHYSICIAN; DIRECTOR BEG 10/18 0 449508 0 786 0 6219 0 6875 0 500 0 463888 0 0 JENNIFER WEINER-SMITH MD PHYSICIAN; DIRECTOR BEG 10/18 0 284487 0 126507 0 21989 0 6875 0 29634 0 469492 0 0 JOHN WHITLOCK TREASURER BEG 06/19 0 105073 0 19000 0 33455 0 3368 0 8281 0 169177 0 0 LISA TORGERSEN PHYSICIAN 187920 0 145402 0 36232 0 6875 0 17218 0 393647 0 0 0 JACOB LEDESMA PHYSICIAN 361952 0 111758 0 3953 0 6875 0 19643 0 504181 0 0 0 JEFFREY LYNDS PHYSICIAN 294743 0 68003 0 3330 0 898 0 17643 0 384617 0 0 0 STEPHANIE SINCLAIR PHYSICIAN 212760 0 150590 0 2783 0 6875 0 20798 0 393806 0 0 0 SAID DAOUD PHYSICIAN 286442 0 65400 0 20032 0 5452 0 28677 0 406003 0 0 0 DIETER KRECKEL PHYSICIAN CHIEF END 06/19 245754 0 3235 0 5510 0 6483 0 1233 0 262215 0 0 0 PHILIPPE MORISSETTE FORMER TREASURER/VICE PRES. 0 11693 0 0 0 114954 0 728 0 956 0 128331 0 0 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. 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 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 CENTRAL MAINE HEALTH VENTURES INC 300 MAIN STREET LEWISTON ME 04240 010430016 HEALTHCARE ME CMHC C CORP false CWM INSURANCE LTD GENESIS BUILDING PO BOX 1363 BWI GRAND CAYMAN CJ 980220891 INSURANCE CJ CMHC C CORP false CENTRAL MAINE ACO 300 MAIN STREET LEWISTON ME 04240 274604314 ACCOUNTABLE CARE ME CMHC C CORP false false false false false false false false false false false true false true false true true true false false