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 010211494 CENTRAL MAINE MEDICAL CENTER % JOHN WHITLOCK CENT 2077952813 PO BOX 4500 LEWISTON ME 042434500 JOHN WHITLOCK TREASURER 2020-03-13 true Brian D Todd P00422601 4178658701 167.68.126.162 43032920201975000014 2020-07-15 P 74C51B083D6172D3D43AC87F1A33B4712A418457 39CBA67CBDC84C24964593991C1F330368A3BFFE 2018 2021-01-29 14:40:06Z DAVID TUPPONCE 300 MAIN STREET LEWISTON ME 04240 394363319 false X WWW.CMMC.ORG X 1888 ME CMMC STRIVES TO PROVIDE EXCEPTIONAL HEALTHCARE SERVICES. THE HOSPITAL DEPENDS ON THE EXPERTISE OF ITS CAREGIVERS IN ADDITION TO THE COMMITMENT AND COMPASSION THEY PROVIDE. 12 8 2439 1400 43595 -13865 2930789 1217546 395738250 391026862 1389274 1020265 -155967 -100761 399902346 393163912 0 0 0 0 177775276 219487890 0 0 27523 232152287 192983964 409927563 412471854 -10025217 -19307942 268852897 262579641 216707609 229338373 52145288 33241268 TO PROVIDE EXCEPTIONAL HEALTHCARE SERVICES IN A SAFE AND TRUSTFUL ENVIRONMENT THROUGH THE EXPERTISE, COMMITMENT AND COMPASSION OF OUR FAMILY OF CAREGIVERS. false false 324855862 391026862 CENTRAL MAINE MEDICAL CENTER IS A 250-BED, NOT-FOR-PROFIT HOSPITAL LOCATED IN LEWISTON, MAINE OFFERING COMPREHENSIVE HEALTHCARE SERVICES TO THE RESIDENTS OF THE CENTRAL AND WESTERN MAINE REGION WITH AN ACTIVE MEDICAL STAFF OF MORE THAN 300 PHYSICIANS REPRESENTING SOME 30 SPECIALTIES OVER 2,000 HIGHLY SKILLED EMPLOYEES AND WITH THE SUPPORT OF THE LATEST TECHNOLOGIES, CMMC IS WELL POSITIONED TO MEET THE REGION'S HEALTHCARE NEEDS WITH THE UTMOST COMPASSION, KINDNESS, AND UNDERSTANDING. 324855862 true true false true false false false false false true true false false true false false false true false false false false false false true false true true false false true true false false false false false true false false true false false false false false false true true true false false true 117 0 true 2439 true true true false false false false true true 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 MARK A 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 JEFF BRICKMAN PRESIDENT/DIRECTOR 1.0 61.0 X X 0 717577 99794 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 JANET HALL KOSKI DIRECTOR 1.0 3.0 X 0 0 0 JOLAN IPPOLITO DIRECTOR 1.0 3.0 X 0 0 0 WILLIAM LEE MD PHYSICIAN; DIRECTOR 55.0 3.0 X 299925 0 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 55.0 3.0 X 456513 0 7375 GEOFFREY SWIFT DIRECTOR BEG 07/18 1.0 3.0 X 0 0 0 JENNIFER WEINER-SMITH MD PHYSICIAN; DIRECTOR BEG 10/18 55.0 3.0 X 432983 0 36509 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 DAVID TUPPONCE PRESIDENT OF CMMC 55.0 1.0 X 0 566043 60817 JOHN WHITLOCK TREASURER BEG 06/19 1.0 60.0 X 0 157528 11649 MICHAEL STADNICKI PHYSICIAN DIVISION CHIEF 55.0 0.0 X 355182 0 30909 BETHANY PICKER PHYSICIAN DIVISION CHIEF 55.0 0.0 X 224948 0 24927 ANDREW EISENHAUER PHYSICIAN DIVISION CHIEF 55.0 0.0 X 746062 0 24524 SCOTT JOHNSON PHYSICIAN DIVISION CHIEF 55.0 0.0 X 483223 0 28038 MICHAEL BLAKE PHYSICIAN DIVISION CHIEF 55.0 0.0 X 415122 0 12019 CLAUDIA GEYER PHYSICIAN DIVISION CHIEF 55.0 0.0 X 351753 0 31873 PAUL WELDNER MD PHYSICIAN 55.0 0.0 X 945407 0 6875 CARMINE FRUMIENTO MD PHYSICIAN 55.0 0.0 X 802825 0 24230 TAREK RADWAN MD PHYSICIAN 55.0 0.0 X 1077487 0 23660 PETER HIGGINS PHYSICIAN 55.0 0.0 X 784158 0 31349 ARUN THUKKANI PHYSICIAN 55.0 0.0 X 763558 0 17753 RICHARD GOLDSTEIN FORMER PHYS PRACT EXEC 55.0 1.0 X 0 508304 11762 PHILIPPE MORISSETTE FORMER TREASURER/VICE. PRES 55.0 1.0 X 0 126647 1684 JAMES LOGGINS MD FORMER PHYS DIVISION CHIEF 0.0 0.0 X 304631 0 18309 8443777 2758200 576156 273 true true false SODEXO INC 525 WILLIAM PENN PL PITTSBURGH PA 15251 FOOD & OP. PLNT SVCS 14729987 QUEST DIAGNOSTICS PO BOX 844226 BOSTON MA 022844226 MEDICAL SERVICES 4586634 WEATHERBY LOCUMS INC 200 1020 SOUTHHILL DR CARY NC 27513 MEDICAL STAFFING 4386811 COMPREHENSIVE PHARMACY SERVICES PO BOX 638316 CINCINNATI OH 452638316 MEDICAL SERVICES 4027598 AUTUMN ENTERPRISE 2851 S PARKER RD SUITE 1100 AURORA CO 80014 MEDICAL STAFFING 3624487 53 91450 415226 710870 1217546 NET PATIENT SERVICE REVENUE 900099 360156100 360156100 PHARMACY REVENUE 446110 22234621 22234621 OTHER REVENUE 900099 7574336 7574336 CAFETERIA REVENUE 722514 1061805 1061805 391026862 912071 912071 0 0 0 0 0 1071278 146000 1096118 12966 -24840 133034 108194 108194 6940 91450 19423 -12483 -12483 0 0 0 114495 70900 43595 43595 EQUITY INVESTMENT 900099 210957 210957 LOSS ON RESTRUCTURING 900099 -342830 -342830 -131873 393163912 391026862 43595 875909 X 0 0 0 0 3986823 3986823 357526 357526 188819941 166012659 22807282 2886177 2769891 116286 14641833 10318868 4322965 8795590 8403555 392035 0 302689 302689 108896 108896 0 0 0 58569695 25392709 33176986 103464 1207 102257 9151223 7804660 1319040 27523 4269815 2186494 2083321 0 5885716 1785382 4100334 603743 541658 62085 0 509650 509650 5233108 74826 5158282 0 20701363 14484811 6216552 9222636 2535318 6687318 MEDICAL SUPPLIES & DRUGS 69645060 69531622 113438 PROVIDER TAX 7630374 7630374 LICENSES, DUES, SUBSCRIPTIONS 835847 423608 412239 MISCELLANEOUS 210685 104221 106464 412471854 324855862 87588469 27523 132342 1847010 17440765 15768183 4080 4080 42324208 47422342 10028 15834 0 0 3210504 3278106 6374629 6746482 983915 763417 426379773 294175174 132402495 132204599 19756370 7223218 3960359 4171316 0 0 4044101 2922013 38209101 40213041 268852897 262579641 104076840 116965400 0 0 710818 688905 102955317 98731680 0 0 0 0 8964634 12952388 0 0 0 0 216707609 229338373 X 35844468 16715946 4647554 3416706 11653266 13108616 52145288 33241268 268852897 262579641 X -19307942 268243 135679 X false true X true true true X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false true 30506 30506 false SCHEDULE C, PART II-B, LINE 1(I) OTHER LOBBYING ACTIVITIES: PORTION OF DUES FOR PROFESSIONAL ASSOCIATIONS ATTRIBUTED TO LOBBYING EXPENSES - $30,506. 17055708 260217 17315925 20450606 -3394898 17055708 20239234 211372 20450606 19465393 773841 20239234 19253603 578486 -37780 328916 19465393 0.75700 0.24300 false true true 2318022 2318022 160751206 83992652 76758554 4945143 4603963 341180 247245117 198409155 48835962 11120285 7169404 3950881 132204599 OTHER RECEIVABLES 8392311 DEPOSITS 5900 EST AMT DUE FROM 3RD PARTY 15289508 INTEREST IN RELATED PARTY 16525322 40213041 SCHEDULE D, PART V, LINE 4 INTENDED USE OF 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 MEDICAL EDUCATION, OR FREE CARE. OTHERS ARE DESIGNATED TO SUPPORT SPECIFIC DEPARTMENTS OF THE HOSPITAL. SCHEDULE D, PART X, LINE 2 UNCERTAIN TAX POSITIONS: 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. FALL GOLF CLASS 98390 91450 6940 1200 5592 5119 7512 0 98390 91450 6940 1200 5592 5119 7512 19423 -12483 true true X true X false true true false false 3845106 3845106 0.00930 63823864 36959990 26863874 0.06510 67668970 36959990 30708980 0.07440 774498 774498 0.00190 2441543 1298526 1143017 0.00280 3216041 1298526 1917515 0.00470 70885011 38258516 32626495 0.07910 false 31205659 3120619 79224155 89281063 -10056908 X true true 1 1 CENTRAL MAINE MEDICAL CENTER 300 MAIN STREET LEWISTON ME 04240 WWW.CMMC.ORG 38819 X X X X CENTRAL MAINE MEDICAL CENTER 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 Maines 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 countys 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 forums 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 facilitatiors guided these discussions using key questions and worksheets 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 Androscoggin County. The County Health Rankings Health Action Forum was held on June 27, 2018. The purpose of this event was to solicit community information from immigrants, refugees and asylum seekers on health issues specific to this population. A further goal was to build and strengthen connections between small immigrant-led organizations working in public health in Maine and the district and state-level public health organizations. Finally, this event hoped to generate takeaway action steps and suggestions for interventions aimed at improving health equity in Maine. There were only two County Health Rankings Health Action Forums held in Maine. The other was held in Portland on June 25, 2018. 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 Maines 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/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/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, LINE 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). 33 CENTRAL MAINE GASTROENTEROLOGY ASSOCIATE 77 BATES STREET SUITE 202 LEWISTON ME 04240 OUTPATIENT PHYSICIAN CLINIC CENTRAL MAINE SURGICAL ASSOCIATES 12 HIGH STREET SUITE 401 LEWISTON ME 04240 OUTPATIENT PHYSICIAN CLINIC CENTRAL MAINE BARIATRIC SURGERY 10 HIGH STREET SUITE 105 LEWISTON ME 04240 OUTPATIENT PHYSICIAN CLINIC CENTRAL MAINE ENDOCRINOLOGY AND DIABETES 287 MAIN STREET SUITE 301 LEWISTON ME 04240 OUTPATIENT PHYSICIAN CLINIC CENTRAL MAINE FAMILY HEALTH CARE ASSOC 190 STETSON ROAD AUBURN ME 04210 OUTPATIENT PHYSICIAN CLINIC CENTRAL MAINE FAMILY HEALTH RESIDENCY 76 HIGH STREET SUITE 100 LEWISTON ME 04240 OUTPATIENT PHYSICIAN CLINIC CENTRAL MAINE FAMILY PRACTICE 12 HIGH STREET SUITE 302 LEWISTON ME 04240 OUTPATIENT PHYSICIAN CLINIC CENTRAL MAINE GYNECOLOGY & UROGYNECOLOGY 287 MAIN STREET SUITE 201 LEWISTON ME 04240 OUTPATIENT PHYSICIAN CLINIC CENTRAL MAINE CARDIOLOGY 2 GREAT FALLS PLAZA AUBURN ME 04210 OUTPATIENT PHYSICIAN CLINIC CENTRAL MAINE HEMATOLOGY ONCOLOGY 12 HIGH STREET SUITE 205 LEWISTON ME 04240 OUTPATIENT PHYSICIAN CLINIC CENTRAL MAINE INTERNAL MEDICINE 10 HIGH STREET SUITE 400 LEWISTON ME 04240 OUTPATIENT PHYSICIAN CLINIC CENTRAL MAINE NEUROLOGY 10 MINOT AVENUE AUBURN ME 04210 OUTPATIENT PHYSICIAN CLINIC CENTRAL MAINE OBGYN 12 HIGH STREET SUITE 200 LEWISTON ME 04240 OUTPATIENT PHYSICIAN CLINIC CENTRAL MAINE PAIN AND HEADACHE CENTER 77 BATES STREET LEWISTON ME 04240 OUTPATIENT PHYSICIAN CLINIC CENTRAL MAINE PEDIATRICS 12 HIGH STREET SUITE 301 LEWISTON ME 04240 OUTPATIENT PHYSICIAN CLINIC CENTRAL MAINE PLASTIC SURGERY 287 MAIN STREET SUITE 302 LEWISTON ME 04240 OUTPATIENT PHYSICIAN CLINIC CENTRAL MAINE SPORTS MEDICINE 77 BATES STREET SUITE 101 LEWISTON ME 04240 OUTPATIENT PHYSICIAN CLINIC CENTRAL MAINE THERAPY SERVICES 77 BATES STREET SUITE 201 LEWISTON ME 04240 OUTPATIENT PHYSICIAN CLINIC CENTRAL MAINE UROLOGY 287 MAIN STREET SUITE 404 LEWISTON ME 04240 OUTPATIENT PHYSICIAN CLINIC GRAY FAMILY CLINIC 126 SHAKER ROAD GRAY ME 04039 OUTPATIENT PHYSICIAN CLINIC INFECTIOUS DISEASE ASSOCIATES 76 HIGH STREET SUITE 200 LEWISTON ME 04240 OUTPATIENT PHYSICIAN CLINIC LISBON FAMILY PRACTICE 2 BISBEE ROAD LISBON ME 04250 OUTPATIENT PHYSICIAN CLINIC MINOT AVENUE FAMILY MEDICINE 789 MINOT AVENUE AUBURN ME 04210 OUTPATIENT PHYSICIAN CLINIC POLAND COMMUNITY HEALTH CENTER 364 MAIN STREET POLAND ME 04274 OUTPATIENT PHYSICIAN CLINIC PULMONARY AND SLEEP MEDICINE 76 HIGH STREET SUITE 300 LEWISTON ME 04240 OUTPATIENT PHYSICIAN CLINIC TOPSHAM FAMILY MEDICINE 4 HORTON PLACE TOPSHAM ME 04086 OUTPATIENT PHYSICIAN CLINIC CENTRAL MAINE HEARING CENTER 12 HIGH STREET SUITE 102 LEWISTON ME 04240 OUTPATIENT PHYSICIAN CLINIC CENTRAL MAINE MEDICATION MANAGEMENT 10 HIGH STREET SUITE 103 LEWISTON ME 04240 OUTPATIENT PHYSICIAN CLINIC CENTRAL MAINE EAR NOSE AND THROAT 12 HIGH STREET SUITE 102 LEWISTON ME 04240 OUTPATIENT PHYSICIAN CLINIC CENTRAL MAINE PODIATRY 287 MAIN STREET LEWISTON ME 04240 OUTPATIENT PHYSICIAN CLINIC CENTRAL MAINE MENTAL HEALTH 10 HIGH STREET SUITE 301 LEWISTON ME 04240 OUTPATIENT PHYSICIAN CLINIC TOPSHAM CARE CENTER 105 TOPSHAM FAIR MALL ROAD TOPSHAM ME 04086 OUTPATIENT PHYSICIAN CLINIC CENTRAL MAINE RHEUMATOLOGY 77 BATES STREET SUITE 201 LEWISTON ME 04240 OUTPATIENT PHYSICIAN CLINIC SCHEDULE H, PART I, LINE 3C FAP ELIGIBILITY CRITERIA: PATIENTS MUST APPLY FOR MAINE FREE CARE IN ORDER TO BEING 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 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 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 ENTITILED 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 EXPENSES 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 CONVERGE 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 IS INCLUDED AS A COMMUNITY BENEFIT. SCHEDULE H, PART III, SECTION A, LINE 4 BAD DEBT EXPENSE FOOTNOTE: THE AUDITED FINANCIAL STATEMENTS DO NOT OCNTAIN 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. THE SHORTFALL REPORTED ON LINE 7 COULD BE CONSIDERED COMMUNITY BENEFIT TO A LEVEL PROPORTIONAL TO THE POVERTY LEVELS INDICATED BY CENSUS BUREAU DATA. IF MAINE RESIDENTS, AGE 65 OR OLDER, BELOW THE 200% FPG LEVEL WERE NOT COVERED BY MEDICARE, THEY WOULD QUALIFY UNDER CMMC'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: CENTRAL MAINE MEDICAL CENTER PROVIDES A FULL RANGE OF SERVICES TO ITS PRIMARY SERVICES AREA, AS WELL AS THE EXTENDED AREA OF THE ENTIRE CENTRAL MAINE HEALTHCARE SYSTEM. IT ASSESSES THE NEEDS OF ITS VARIOUS COMMUNITIES FROM VARIOUS THIRD-PARTY SURVEYS AND REPORTS, OBSERVATIONS IN ITS PATIENT POPULATION AND THE POPULATIONS OF ITS AFFILIATED SYSTEM HOSPITALS, AS WELL AS ASSISTING WITH STATE-WIDE INITIATES IN PREVENTATIVE MEDICINE AND EDUCATION. SCHEDULE H, PART VI, LINE 3 PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE: CENTRAL MAINE MEDICAL CENTER PROVIDES NOTICES ABOUT ITS FREE CARE POLICY IN ALL CLINICAL DEPARTMENTS AND MAJOR PATIENTS 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 PATIENTS 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 RECEIVED A SEPARATE INFORMATION SHEET WITH THEIR STATEMENTS, FURTHER INFORMING THEM ABOUT THE AVAILABLE OPTIONS. SCHEDULE H, PART VI, LINE 4 COMMUNITY INFORMATION: CENTRAL MAINE MEDICAL CENTER, LOCATED IN LEWISTON, MAINE SERVES A PRIMARY AREA OF ANDROSCOGGIN COUNTY IN CENTRAL MAINE. ADDITIONALLY, IT SERVES PORTIONS OF CUMBERLAND, FRANKLIN, KENNEBEC, OXFORD, AND SAGADAHOC COUNTIES. THE LEWISTON-AUBURN AREA IS URBAN, FOR MAINE STANDARDS, BUT QUICKLY BECOMES SUBURBAN TO ALMOST-RURAL QUICKLY OUTSIDE THE CITY LIMITS. ANDROSCOGGIN COUNTY HAS A POPULATION OF JUST UNDER 108,000 PERSONS, WHICH MAKES UP APPROXIMATELY 8% OF THE OVERALL MAINE POPULATION. WHILE ALMOST 93% OF THE POPULATION IS MADE UP OF CAUCASIAN PERSONS, MORE THAN 16% SPEAK A LANGUAGE OTHER THAN ENGLISH AT HOME. THIRTEEN PERCENT OF THE POPULATION IS BELOW THE POVERTY LEVEL, SPECIFICALLY IN LEWISTON, THE SECOND LARGEST CITY IN MAINE, WITH A POPULATION OF APPROXIMATELY 36,600 PERSONS, SIMILAR RACIAL DISTRIBUTIONS ARE OBSERVED, BUT MORE THAN 28% CLAIM A LANGUAGE OTHER THAN ENGLISH AS THEIR PRIMARY. FIFTEEN PERCENT ARE BELOW THE POVERTY LEVEL. SCHEDULE H, PART VI, LINE 5 PROMOTION OF COMMUNITY HEALTH: CENTRAL MAINE MEDICAL CENTER 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 CENTRAL MAINE MEDICAL CENTER 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 LEWISTON AND SURROUNDING COMMUNITIES. SCHEDULE H, PART VI, LINE 6 AFFILIATED HEALTH CARE SYSTEM: CENTRAL MAINE MEDICAL CENTER (CMMC) IS A TERTIARY CARE HOSPITAL IN THE CENTRAL MAINE HEALTHCARE SYSTEM. TWO RURAL, CRITICAL ACCESS HOSPITALS ARE ALSO MEMBERS OF THIS SYSTEM. CMMC PROVIDES A WIDE RANGE OF SPECIALIST PHYSICIANS AND SERVICES TO ITS COMMUNITY, AS WELL AS THE SYSTEM. CMMC PROVIDES PHYSICIANS TO STAFF SPECIALTY CLINICS IN THE RURAL COMMUNITIES SERVED BY THE CRITICAL ACCESS HOSPITALS ON A LIMITED, BUT REGULAR, BASIS. THESE SERVICES WOULD NOT NORMALLY BE SUPPORTED BY THE LIMITED POPULATIONS AND PATIENTS WOULD INSTEAD NEED TO TRAVEL MUCH LONGER DISTANCES TO CONSULT OR VISIT WITH A SPECIALIST. CMMC ALSO PROVIDES ACCESS TO TRAUMA CARE, NEONATAL INTENSIVE CARE, AND SPECIALIZED CARDIAC CARE. THE SYSTEM PARENT, CENTRAL MAINE HEALTHCARE, PROVIDES STREAMLINED ADMINISTRATIVE FUNCTIONS AND BACKROOM SERVICES FOR THE ENTIRE SYSTEM, PROVIDING COST EFFICIENCY AND OTHER BENEFITS TO ALL MEMBERS. THIS ALSO ALLOWS FOR EASY ADMINISTRATIVE HANDLING OF TRANSFERS OF PATIENTS BETWEEN HOSPITALS, AS WELL AS A SINGLE POINT OF CONTACT FOR PATIENTS TO ADDRESS BILLS AND INSURANCE ISSUES. true true false false false false false false false RICHARD GOLDSTEIN FORMER PHYS PRACT EXEC 0 0 0 0 0 508304 0 0 0 11762 0 520066 0 0 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 253540 0 18135 0 28250 0 6875 0 18063 0 324863 0 0 0 HOLLI BOCCELLI SECRETARY 0 195952 0 0 0 730 0 615 0 0 0 197297 0 0 DAVID TUPPONCE PRESIDENT OF CMMC 0 502222 0 0 0 63821 0 50875 0 9942 0 626860 0 0 MICHAEL RICCI MD PHYSICIAN; DIRECTOR BEG 10/18 449508 0 786 0 6219 0 6875 0 500 0 463888 0 0 0 JENNIFER WEINER-SMITH MD PHYSICIAN; DIRECTOR BEG 10/18 284487 0 126507 0 21989 0 6875 0 29634 0 469492 0 0 0 JOHN WHITLOCK TREASURER BEG 06/19 0 105073 0 19000 0 33455 0 3368 0 8281 0 169177 0 0 PAUL WELDNER MD PHYSICIAN 900427 0 10500 0 34480 0 6875 0 0 0 952282 0 0 0 CARMINE FRUMIENTO MD PHYSICIAN 760118 0 38000 0 4707 0 6875 0 17355 0 827055 0 0 0 TAREK RADWAN MD PHYSICIAN 809551 0 221750 0 46186 0 6875 0 16785 0 1101147 0 0 0 PETER HIGGINS PHYSICIAN 574088 0 182747 0 27323 0 6875 0 24474 0 815507 0 0 0 ARUN THUKKANI PHYSICIAN 584468 0 132114 0 46976 0 6875 0 10878 0 781311 0 0 0 MICHAEL STADNICKI PHYSICIAN DIVISION CHIEF 351687 0 0 0 3495 0 6875 0 24034 0 386091 0 0 0 BETHANY PICKER PHYSICIAN DIVISION CHIEF 207143 0 15574 0 2231 0 5672 0 19255 0 249875 0 0 0 ANDREW EISENHAUER PHYSICIAN DIVISION CHIEF 467329 0 250705 0 28028 0 6875 0 17649 0 770586 0 0 0 SCOTT JOHNSON PHYSICIAN DIVISION CHIEF 440892 0 13594 0 28737 0 6875 0 21163 0 511261 0 0 0 MICHAEL BLAKE PHYSICIAN DIVISION CHIEF 219506 0 153342 0 42274 0 6875 0 5144 0 427141 0 0 0 CLAUDIA GEYER PHYSICIAN DIVISION CHIEF 275382 0 55507 0 20864 0 5367 0 26506 0 383626 0 0 0 PHILIPPE MORISSETTE FORMER TREASURER/VICE. PRES 0 11693 0 0 0 114954 0 728 0 956 0 128331 0 0 JAMES LOGGINS MD FORMER PHYS DIVISION CHIEF 232810 0 35384 0 36437 0 6796 0 11513 0 322940 0 0 0 SCHEDULE J, PART I, LINE 3 CEO COMPENSATION: THE COMPENSATION OF THE ORGANIZATION'S PRESIDENT IS DETERMINED BY THE PARENT CORPORATION'S BOARD OF DIRECTORS' EXECUTIVE COMPENSATION COMMITTEE USING THE FOLLOWING: -COMPENSATION COMMITTEE -INDEPENDENT COMPENSATION CONSULTANT -COMPENSATION SURVEY OR STUDY -APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE SCHEDULE J, PART I, LINE 4A SEVERANCE PAYMENTS: THE FOLLOWING INDIVIDUALS RECEIVED SEVERANCE PAYMENTS FROM CENTRAL MAINE HEALTHCARE CORPORATION: RICHARD GOLDSTEIN: $510,000 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 PARTICIPANTS ENTITLEMENT TO 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. $68,250 JEFF BRICKMAN (DEFERRAL) 44,000 DAVID TUPPONCE (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. A MAINE HEALTH & HIGHER EDUCATIONAL FACILITIES AUTH 010314384 56042RTR3 2009-12-10 56033554 FACILITY EXPANSION/CONSTRUCTION false false true B MAINE HEALTH & HIGHER EUDCATIONAL FACILITIES AUTH 010314384 560427WV4 2013-05-23 41071242 REFUND SERIES 2003A BOND false false true C MAINE HEALTH & HIGHER EDUCATIONAL FACILITIES AUTH 010314384 56042RLG5 2017-06-27 12279914 REFUND SERIES 2005B BOND false false true A 2585000 0 56033554 6631632 1923331 0 639410 0 1675000 45161181 0 0 2011 false false true true B 7075000 0 41071242 2957944 0 0 302888 0 0 0 42862476 0 2013 true false true true C 1715000 0 12279914 0 0 0 138533 0 0 0 12141381 0 2017 true false true true A false false false false 0 false false false true B false false false false 0 false false false true C false false false false 0 false false false true A false false false true false false 0 false 0 false false B false false false true false false 0 false 0 false false C false true false false false false 0 false 0 false false A false B false C false SCHEDULE K, PART IV, LINE 2C, COLUMN A DATE OF REBATE COMPUTATION: THE REBATE COMPUTATION WAS PERFORMED 12/10/2014. SCHEDULE K, PART IV, LINE 2C, COLUMN B DATE OF REBATE COMPUTATION: THE REBATE COMPUTATION WAS PERFORMED 06/25/2018. ARUN THUKKANI EMPLOYEE SALARY ADV X 40000 15834 false false true 15834 TIFFANY EISENHAUER REALTIVE OF A. EISENHAUER 34586 SALARY AND WAGES false FORM 990, PART V, LINE 1A & 2A COMMON PAYMASTER: CENTRAL MAINE MEDICAL CENTER 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, RICHARD GOLDSTEIN, DAVID THOMPSON, HOLLI BOCCELLI, PHILIPPE MORISSETTE, AND DAVID TUPPONCE HAVE A BUSINESS RELATIONSHIP THROUGH THEIR EMPLOYMENT WITH A RELATED ORGANIZATION. FORM 990, PART VI, SECTION A, LINE 6, 7A, AND 7B MEMBERS OF THE ORGANIZATION: THE SOLE MEMBER OF CENTRAL MAINE MEDICAL CENTER IS CENTRAL MAINE HEALTHCARE CORPORATION (CMHC). THE BOARD SHALL CONSIST OF THE SAME INDIVIDUALS SERVING AS MEMBERS OF THE BOARD OF DIRECTORS OF CMHC. 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 A PUBLIC ACCOUNTING FIRM IN COOPERATION WITH THE FINANCE DEPARTMENT. THE COMPLETED RETURNS ARE REVIEWED WITH THE VICE PRESIDENT OF FINANCE, THEN 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, LINE 15A & 15B EXECUTIVE COMPENSATION REVIEW: 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, AND PRESIDENT OF RUMFORD AND BRIDGTON HOSPITALS. THE PROCESS GUIDELINES AND AUTHORITY OF THE ECC ARE SET OUR IN THE EXECUTIVE COMPENSATION PHILOSOPHY AND RESPONSIBILITIES CHARTER WHICH 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 ATTORNEYS. FACTORS USED IN DETERMINING COMPARABILITY TO THE ORGANIZATION INCLUDING SIZE, GEOGRAPHY, ORGANIZATIONAL COMPLEXITY, FACILITY TYPE, OWNERSHIP TYPE, AND ANY OTHER FACTORS DEEMED RELEVANT BY THE COMMITTEE, ITS CONSULTANTS, OR ITS ATTORNEYS. USING THIS INFORMATION, THE ECC ANNUALLY REVIEWS THE EXECUTIVES' COMPENSATION TO DETERMINE IF MODIFICATION TO BASE SALARY IS WARRANTED, AND REVIEWS THE EXECUTIVES' ACCOMPLISHMENTS TO DETERMINE IF ANY VARIABLE PAY IS TO BE AWARDED. THE ENTIRE PROCESS IS THEN DOCUMENTED CONTEMPORANEOUSLY WITH THE DECISION-MAKING PROCESS AND APPROVED THEREAFTER IN ACCORDANCE WITH THE REQUIREMENTS OF THE IRS. 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 BOARD MEMBER COMPENSATION: 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. MICHAEL RICCI, M.D. IS A PHYSICIAN AND HIS COMPENSATED TIME IS SPENT IN THAT CAPACITY. JENNIFER WEINER-SMITH, M.D. IS A PHYSICIAN AND HER COMPENSATED TIME IS SPENT IN THAT CAPACITY. FORM 990, PART XI, LINE 9 OTHER CHANGES IN NET ASSETS: $ 135,679 CHANGE IN INTEREST IN RELATED PARTY FORM 990 PART IX LINE 11G DESCRIPTION:OUTSIDE SERVICES TOTAL FEES:52942054 FORM 990 PART IX LINE 11G DESCRIPTION:PROFESSIONAL FEES TOTAL FEES:3445701 FORM 990 PART IX LINE 11G DESCRIPTION:CONSULTING TOTAL FEES:1586814 FORM 990 PART IX LINE 11G DESCRIPTION:MEDICAL DIRECTOR FEES TOTAL FEES:576530 FORM 990 PART IX LINE 11G DESCRIPTION:PURCHASED LABOR - PHYSICIANS TOTAL FEES:16814 FORM 990 PART IX LINE 11G DESCRIPTION:INTERPRETING SERVICES TOTAL FEES:1782 MAINE COLLEGE OF HEALTH PROFESSIONS PO BOX 4500 LEWISTON ME 04243 010356077 EDUCATION ME 501(C)(3) 2 CMMC true CENTRAL MAINE REAL ESTATE MANAGEMENT COR PO BOX 4500 LEWISTON ME 04243 010387674 REAL ESTATE ME 501(C)(2) CMHC false RUMFORD COMMUNITY HOME CORPORATION 11 JOHN F KENNEDY DRIVE RUMFORD ME 04276 222844951 NURSING HOME ME 501(C)(3) 10 CMHC false RUMFORD COMMUNITY FAMILY HEALTH CENTER 430 FRANKLIN STREET RUMFORD ME 04276 010481000 HEALTHCARE ME 501(C)(3) 3 CMHC false BRIDGTON HOSPITAL 10 HOSPITAL DRIVE BRIDGTON ME 04009 010130427 HEALTHCARE ME 501(C)(3) 3 CMHC false CENTRAL MAINE COMMUNITY HEALTH CORP PO BOX 4500 LEWISTON ME 04243 010386912 PUBLIC ED ME 501(C)(3) 7 CMHC false CENTRAL MAINE HEALTHCARE CORPORATION PO BOX 4500 LEWISTON ME 04243 010386913 HEALTHCARE ME 501(C)(3) 7 NA false RUMFORD HOSPITAL 420 FRANKLIN STREET RUMFORD ME 04276 010215227 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 true CWM INSURANCE LTD GENESIS BUILDING PO BOX 1363 GRAND CAYMAN B.W.I. CJ 980220891 INSURANCE CJ CMHC C CORP false CENTRAL MAINE HEALTH VENTURES INC 300 MAIN STREET LEWISTON ME 04240 010430016 HEALTHCARE ME CMHC C CORP false CENTRAL MAINE ACO 300 MAIN STREET LEWISTON ME 04240 274604314 ACCOUNTABLE C ME CMHC C CORP false true false true false false false false false false true false true false false true true true false false MAINE COLLEGE OF HEALTH PROFESSIONS A 36972 COST MAINE COLLEGE OF HEALTH PROFESSIONS L 176883 COST MAINE COLLEGE OF HEALTH PROFESSIONS O 894650 COST MAINE COLLEGE OF HEALTH PROFESSIONS Q 50550 COST