2020-11-09T09:28:44-06:00 2019-12-31 010494526 BAKER NEWMAN & NOYES LLC 650 ELM STREET SUITE 302 MANCHESTER NH 03101 990 2019-01-01 010211551 St Mary's Regional Medical Center STMA 2077778100 93 Campus Avenue PO Box 7291 Lewiston ME 042430291 Jeffrey Hundman CFO 2077778100 2020-11-06 1 Nicholas E Porto P01310283 8002447444 2020-11-06 208.105.168.164 2020-11-06 13:08:44 ES P 38659DA796957EF4727498C6F5EA77981E0D27E4 DA1D1F22D002DE74304CAE64996AD19EA354FE22 2019 2021-01-29 14:40:06Z Steven Jorgensen 93 Campus Avenue PO Box 7291 Lewiston ME 042430291 235134979 0 X www.stmarysmaine.com X 1967 ME We are a Catholic health ministry, providing healing and care for the whole person, in service to all in our communities. 10 8 1837 174 0 0 1469384 1754611 206534258 232586738 492949 793630 -1076 -10626 208495515 235124353 0 1832 0 0 108053214 110763218 0 0 0 124815760 124157441 232868974 234922491 -24373459 201862 148573306 147144163 79197702 70529104 69375604 76615059 X St. Mary's Regional Medical Center is comprised of a 233-bed acute care facility, a primary care provider network, urgent care and emergency department, behavioral and mental health services, and outpatient specialty practices that combine talented and compassionate caregivers with state of the art medical technology to meet the healthcare needs in the Androscoggin County area and beyond. 0 0 33308740 0 41350104 Surgical Care: The Medical Center provides all surgical services and related care (except open heart procedures) to patients who need surgical intervention. Patients range from infants to geriatrics. Total Patient days = 9,360 9659128 0 11991027 Behavioral Health: St. Mary's Regional Medical Center offers the most advanced behavioral healthcare diagnostic and treatment services available to children, adolescents and adults in both inpatient and outpatient programs. Inpatient and outpatient treatments include comprehensive psychiatric assessments and evaluations, education, individual and group therapy, individualized bio-psychosocial treatment plans, and discharge and aftercare planning.Total patient days = 14,140 10673341 0 13250088 Emergency Care: St. Mary's Regional Medical Center offers a 24-hour per day Level II Emergency Care facility. Services provided include both medical and behavioral care services. Total patient days = 139Total patient visits = 29,026 119321496 1832 165995519 The Medical Center provides a vast array of medical care and community health services, which includes, but is not limited to, the following programs and facilities: physician services; orthopedics; chemical dependency services; OB/GYN women's health services; nursery and youth services; ICU; PACU; infusion therapy; urgent care; family practice services; endoscopy; neurology; lab services; diagnostic radiology; MRI; mammography; ultrasound; nuclear medicine; CT scans; physical therapy; occupational therapy; speech therapy; respiratory therapy; pulmonary rehabilitation; diagnostic cardiology; cath labs; pharmacy; ambulance services; physiatry services; urology; sleep lab; diabetes center services; wound and hyperbaric center services; gastroenterology; rheumatology; weight management services; and skilled nursing facilities and nursing home services. 119321496 1832 165995519 172962705 1 1 0 1 0 0 0 0 0 1 1 1 0 1 1 1 0 1 0 0 0 0 0 0 1 0 1 1 0 0 1 1 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1 0 0 0 1 108 0 1 1837 1 0 0 0 0 0 0 0 0 0 0 0 0 X 10 8 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 ME X X Michael Hendrix Treasurer & CFO 2077778100 93 Campus Avenue PO Box 7291 Lewiston ME 042430291 Michael Newman Physician 40.00 0.00 X 915884 0 34260 Joseph Strauss Physician 40.00 0.00 X 825534 0 34488 Gregory Pomeroy Physician 40.00 0.00 X 772571 0 22796 Jeffery Davila MD Director 40.10 0.20 X 726411 0 1882 Michael Kelley MD Director (end 5/19) 40.10 0.20 X 602415 0 26873 Sacha Matthews Physician 40.00 0.00 X 555592 0 29398 Scott Treworgy Physician 40.00 0.00 X 492518 0 23308 Steve Jorgensen President & CEO 0.10 40.30 X 0 434308 33342 Christopher T Bowe Chief Medical Officer 40.00 0.00 X 405049 0 29579 Michael Hendrix Treasurer & CFO 0.10 40.80 X 0 266839 35419 Philip Hickey CEO Post Acute Care 40.00 0.00 X 222316 0 9305 Anne Brown MD Director 40.10 0.20 X 172811 0 17152 Joan Daigneault Secretary 40.10 0.20 X 61133 0 1057 Judy Andrucki Esq Director (end 5/19) 0.10 0.20 X 0 0 0 John Chapman Director (end 5/19) 0.10 0.20 X 0 0 0 Donald Fournier Director (end 8/19) 0.10 0.20 X 0 0 0 David Geiger Esq Director 0.10 0.20 X 0 0 0 Ralph Harder MD Director 0.10 0.20 X 0 0 0 Lena Hartley Director 0.10 0.20 X 0 0 0 John Isaacson Director (end 5/19) 0.10 3.20 X 0 0 0 Jack Keith MD Director (end 5/19) 0.10 0.20 X 0 0 0 Carolyn Lepage Director (end 5/19) 0.10 0.20 X 0 0 0 Kathy McManus Director 0.10 0.20 X 0 0 0 John Murphy MD Director 0.10 0.20 X 0 0 0 Steve Ouellette Director 0.10 0.20 X 0 0 0 Anne Schuettinger Director (end 5/19) 0.10 0.20 X 0 0 0 Mark Anthoine Chair 0.10 0.20 X X 0 0 0 James Place MD Vice Chair 0.10 0.20 X X 0 0 0 5752234 701147 298859 137 0 1 0 Covenant Health Inc 100 Ames Pond Drive Suite 102 Tewksbury MA 01876 Management services 26124115 Metz Culinary Management Two Woodland Drive Dallas PA 18612 Meal services and cafeteria management 4488972 Medefis Inc PO Box 5068 New York NY 100875068 Locum nursing services 3312282 United Ambulance Service 192 Russell Street Lewiston ME 04240 Ambulance services 2323980 Health Carousel LLC PO Box 714216 Cincinnati OH 452714216 Locum nursing services 2084723 45 78272 1676339 698404 1754611 Patient and healthcare services 621300 226409210 226409210 Pharmaceutical sales 446110 3512456 3512456 Dining and cafeterias 722514 1330761 1330761 Tuition and education services 611600 1138408 1138408 Rental income 532000 195903 195903 232586738 339097 339097 311992 142541 0 0 311992 142541 454533 454533 0 78272 10626 -10626 -10626 235124353 232586738 0 783004 X 1832 1832 2275983 1445249 830734 90725286 69485147 21240139 745769 552612 193157 11129535 8244127 2885408 5886645 4356117 1530528 26124115 26124115 69512 69512 88200 88200 30890495 28763373 2127122 43388 43388 4797707 3550303 1247404 485132 358998 126134 6275189 4643640 1631549 308909 228593 80316 437331 323625 113706 1875028 1387521 487507 5657419 4186490 1470929 4397476 3254132 1143344 Drugs/medical supplies 24194876 24194876 Provision for bad debts 11260395 11260395 ME provider tax 5226906 5226906 Food/dietary costs 2025363 1498769 526594 234922491 172962705 61959786 0 11788673 8831443 3787257 1495311 247192 27200907 30478723 1633052 1734572 3095222 814661 161554815 99318640 58820855 62236175 13841758 42247340 27464328 148573306 147144163 24018165 27233718 731394 334444 40833947 37209015 318632 4529121 13295564 1222806 79197702 70529104 X 61569936 67545180 7805668 9069879 69375604 76615059 148573306 147144163 X 201862 305636 6731957 X X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 1 17386 0 0 0 17386 0 Part II-B, Line 1: The Medical Center partners with the Maine Hospital Association, a like-minded health care association which supports public policies and initiatives that focus on improving health outcomes and the experience of health care, while also aiming to reduce the overall cost of receiving that care. To maintain this partnership, the Center pays membership dues to the Association. A portion of the dues paid to the Association have been designated as available for lobbying expenditures. Any lobbying expenditures paid by the Association are incurred in order to help track and discuss legislation affecting health care policy. In 2019, the Center paid the Association total dues of $69,543, of which 25%, or $17,386, is estimated to be available for lobbying expenditures. 7805668 1747954 4051 487794 9069879 29998051 1608019 23800402 7805668 5847103 26243632 2092684 29998051 2035795 4917990 389 1107071 5847103 2006226 1100997 345 1071773 2035795 0.00000 0.07920 0.92080 0 0 826146 826146 91902806 50872480 41030326 1045129 592302 452827 57589236 47849893 9739343 10191498 3965 10187533 62236175 Providentia Prima Trust, class B shares 11295274 F Investment in joint venture - United Ambulance 2546484 F 13841758 Due from affiliates 23391252 Funds held by Trustee - debt service reserves 4073076 27464328 Deferred fixed asset expenditures (FIN 47) 25123 Medicaid obligations 1197683 1222806 X Part V, Line 4: St. Mary's Regional Medical Center's endowmenet funds, in conjunction with any revenues generated from the the funds, are used to further the Medical Center's exempt mission and operations, which includes the following uses: to offer patients the best medical technology available; preventive services; and a "whole person approach" to meeting the needs of the Androscoggin county area. Part X, Line 2: Covenant and its member organizations are considered not-for-profit corporations as described in Section 501(c)(3) of the Internal Revenue Code and are exempt from federal income taxes on related income pursuant to Section 501(a) of the Code, except as noted below. Tax-exempt organizations could be required to record an obligation for income taxes as the result of a tax position they have historically taken on various tax exposure items including unrelated business income or tax status. Under guidance issued by the Financial Accounting Standards Board, assets and liabilities are established for uncertain tax positions taken or positions expected to be taken in income tax returns when such positions are judged to not meet the "more-likely-than-not" threshold, based upon the technical merits of the position. Estimated interest and penalties, if applicable, related to uncertain tax positions are included as a component of income tax expense. The System has evaluated the position taken on its filed tax returns. The System has concluded no uncertain income tax positions exist at December 31, 2019. Commit to Get Fit 78272 78272 0 0 0 450 0 10176 78272 78272 450 10176 10626 -10626 Schedule G, Part II, Fundraising Events In accordance with the IRS instructions for the reporting of income on Schedule G, event revenue deemed to be charitable contributions has been reported on line 2, thus reducing the total gross event income on line 3. This presentation gives the appearance on Schedule G of a loss from the respective event. However, when the charitable contributions are considered and added back, the event had a profit of $67,646. 1 1 1 X 1 X 0 1 0 1 1 3892797 3892797 0.01740 40541687 34702536 5839151 0.02610 44434484 34702536 9731948 0.04350 3 11128 483044 19500 463544 0.00210 4 795 1142511 0 1142511 0.00510 1 7882 0 7882 0.00000 2 20392 405188 52000 353188 0.00160 10 32315 2038625 71500 1967125 0.00880 10 32315 46473109 34774036 11699073 0.05230 12158 192467 97818 94649 0.00040 3217 133099 48500 84599 0.00040 87 64757 16500 48257 0.00020 1254 26356 9500 16856 0.00010 18 10957 0 10957 0.00000 16734 427636 172318 255318 0.00110 1 11260395 225208 62269006 75350913 -13081907 X 1 1 1 1 St Mary's Regional Medical Center 93 Campus Avenue Lewiston ME 042430291 38244 X X X St Mary's Regional Medical Center 1 0 0 1 X X X X X X X X X 19 1 1 1 1 X See Schedule H, Part V, Section C X See Schedule H, Part V, Section C X 1 19 1 See Schedule H, Part V, Section C 1 0 1 X 200.000000000000 200.000000000000 X X X X 1 1 X X X X 1 X See Schedule H, Part V, Section C X See Schedule H, Part V, Section C X See Schedule H, Part V, Section C X X X X X X 1 X 0 X X X X 1 X 0 0 St. Mary's Regional Medical Center Part V, Section B, Line 5: Understanding the health needs of a community allows public health and health care organizations to design and implement cost-effective strategies that improve the health status of the populations they serve. A comprehensive data driven assessment process can identify, with a high degree of accuracy, priority health needs and issues related to prevention, diagnosis and treatment. Assessment tools also may assist in pinpointing access to care barriers, utilization of evidence based guidelines, and utilization of health services. In Maine, healthcare leaders and public health leaders collaborated to conduct the assessment and analyze the data for this latest CHNA in a collaboration designated as The Maine Shared Health Needs Assessment (Maine Shared CHNA.)Maine Shared Community Health Needs Assessment Charter: Vision: The Maine Shared Community Health Needs Assessment helps to turn data into action so that Maine will become the healthiest state in the US. Mission: The Maine Shared Community Health Needs Assessment is a dynamic public private partnership that creates Shared Community Health Needs Assessment reports, engages and activates communities, and supports data-driven health improvements for Maine people.Steering Committee Statement of Purpose: The Steering Committee provides leadership for the creation of an efficient, integrated, and sustainable process to conduct triennial Maine Shared Community Health Needs Assessments (Maine Shared CHNAs) and subsequent public health improvement plans/hospital implementation strategies. In addition, this group provides stewardship of the resources made available through Central Maine Healthcare (CMHC), Maine Center for Disease Control and Prevention (Maine CDC), MaineGeneral Health (MGH), MaineHealth (MH), and Northern Light Health (NLH) to: [a] strengthen Maine's state and community health improvement efforts; [b] meet Treasury Department/Internal Revenue Service (IRS) community benefit reporting requirements for hospitals; and [c] meet public health agencies' Public Health Accreditation Board (PHAB) requirements. St. Mary's Regional Medical Center is an affiliate of MaineHealth.Data Analysis: Over 200 health indicators from over 30 sources were used for the Maine Shared CHNA. These indicators were arranged under 24 health topics and analyzed by demographic characteristics and geographic stratification. Community Input: Community outreach and engagement for the Maine Shared CHNA occurred at the statewide, public health district, county and local levels. The statewide community engagement committee met monthly from March 2018-January 2019 to review and oversee the engagement process.In addition, local community engagement planning committees met in each of Maine's 16 counties. St. Mary's facilitated and hosted the Androscoggin local community engagement planning committee through the Community Health Stakeholder Coalition (established for the first cycle of the Maine Shared CHNA 7 years ago.) In Androscoggin County, representatives from the two local hospital systems came together in 2012 to establish the Community Health Stakeholder Coalition, a group of community health agencies, public health and hospitals. They developed this purpose statement:Improve the health of Androscoggin County by convening community health stakeholders to collaborate on:- Conducting community health needs assessments- Educating members and constituents on findings of community health needs assessments- Develop strategies to address prioritized needs- Sharing relevant resources through networkingFor the most recent CHNA, members included: Jamie Paul, Western Maine District Coordinating Council of the Maine Center for Disease Control and Prevention; Elizabeth Keene, VP of Mission Integration, St. Mary's Health System; Holly Lasagna and Corrie Brown, Healthy Androscoggin; Catherine Ryder, Executive Director, Tri-County Mental Health Services; Angela Richards, Androscoggin Home Healthcare + Hospice; Sam Boss and Kristen Cloutier, Harwood Center at Bates College; Joan Churchill, Executive Director, Community Clinical Services; Nate Miller, Seniors Plus; Shawn Yardley, Executive Director, Community Concepts; Barry Schmieks, Auburn Police Department; Joe Philippon, Lewiston Police Department; Jennifer McCarthy and Ann Marie Day of Healthcentric Advisors; Katherine Lary of Western Maine Community Action; Ruby Bean of Community Concepts; and Melanie Gagnon, YWCA. This group began meeting monthly in the spring of 2012 and continues to meet to assess and address community health needs. These members represent community health, public health, hospitals, minority populations, local colleges, community action agencies and the local Federally Qualified Health Center (FQHC.)Three community engagement sessions were held in Androscoggin County in 2018. Two sessions were hosted by the local community engagement planning team (October 3, 2018 and October 11, 2018). One session was held in June and was a County Health Rankings Health Action Forum (to solicit community information from immigrants, refugees and asylum seekers). One session in each county was facilitated by JSI, the vendor hired by the Maine Shared CHNA to oversee the data collection, analysis and community sessions. The other session was facilitated by employees from St. Mary's Regional Medical Center and Central Maine Medical Center who serve on the Community Health Stakeholder Coalition.Other methods for obtaining feedback from organizations and groups included, but were not limited to key informant interviews (focused conversations) and focus groups. In addition to the two community forums held in Androscoggin County, a forum was held with refugees and immigrants to specifically address health issues in their communities. Key informants were also interviewed to speak to the needs of this population. Mental health was identified as one of the leading health concerns for this population, specifically trauma and stress around immigration status in the current political climate, separation from families, and experiences in their home country. Oral health was another clinical concern identified across several community engagement activities. Community members also identified a need for health services that are linguistically and culturally appropriate and increased efforts to improve health literacy around chronic disease management, substance use, and life skills (e.g., how to keep a healthy home, how to dress appropriately for cold weather). Many health needs for this population fall into the category of social determinants of health: accessible and comprehensive health insurance, safer and more affordable housing, better access to transportation, and more opportunities to bolster community relations and social cohesion.Youth were identified as a priority population in community forums. Specific issues of concern were youth mental health issues (specifically stress, depression, and anxiety); substance use (specifically opioids, marijuana, and vaping/Juuling), lack of education and promotion around nutrition and physical activity, and unsupervised youth. In addition to the data collected and analyzed for the County Health Profiles, the Maine CDC created Health Equity Data Summaries (available at www.mainechna.org) which provides selected data analyzed by sex, race, ethnicity, sexual orientation, education, and income. These data are at the state level, as much of the county level data would be suppressed due to small numbers and privacy concerns, and the previous analyses have shown that health disparities found at the state level are generally similar in individual counties.These forums, essential components of the Maine Shared CHNA, allowed for community members to review the data and vote for community health priorities. Participants at the community forums met in small groups to discuss opportunities for collaboration and specific issues for each priority. The conversations largely informed both the implementation strategies and strategic plans for the hospitals. Health data results were also presented to the hospital's board of trustees' strategy committee. The State of Maine is fortunate to have many sources of data to help assess health needs of communities. The 2016 Maine Shared Community Health Needs Assessment, County Rankings results, the state health plan, the Community Health Needs Index (CHNI), and community engagement results provide a comprehensive picture of all major health indicators in the community.A copy of the 2019 Androscoggin County CHNA can be found at this link:https://www.stmarysmaine.com/media/file/Androscoggin_Report_2019.pdf St. Mary's Regional Medical Center Part V, Section B, Line 6a: Central Maine Medical Center St. Mary's Regional Medical Center Part V, Section B, Line 6b: The Maine Shared CHNA began as the OneMaine Health Collaborative in 2007 as a partnership between MaineGeneral Health (MGH), MaineHealth (MH), and Northern Light Health (NLH, formerly known as Eastern Maine Healthcare System or EMHS). After conversations with the Statewide Coordinating Council for Public Health, the Maine Center for Disease Control (Maine CDC) joined the collaborative in 2012. The effort was then named the Maine Shared Health Needs Assessment and Planning Process (SHNAPP). Central Maine Healthcare (CMHC) joined the group in 2013. In 2014, CMHC, Maine CDC, MGH, MH and NLH signed a formal Memorandum of Understanding and drafted the Maine Shared CHNA Charter (PDF) to guide the collaborative. In 2017, the name was changed to the Maine Shared Community Health Needs Assessment or Maine Shared CHNA. Funding for the Maine Shared CHNA is provided by the partnering healthcare systems with generous in-kind support from the Maine CDC. Governance is provided by the Steering Committee. Countless community partners and stakeholders provide additional support by participating in either the Metrics Committee, Community Engagement Committee, Local Planning Committees, or the Data Analysis Workgroup. Funding for the Maine Shared CHNA is provided by Central Maine Healthcare, MaineGeneral Health, MaineHealth, and Northern Light Health, with generous in-kind support from the Maine Center for Disease Control and Prevention, an office of the Department of Health and Human Services and countless community partners and stakeholder groups. These stakeholder groups include the Metrics Committee, Data Analysis Workgroup, Community Engagement Committee, Local Planning Committees, and the Steering Committee. Special thanks to the Maine Health Data Organization for working with us to access their data. For a listing of committee members please visit www.mainechna.org and click on "About Maine CHNA." Significant analysis was conducted by epidemiologists at the Maine CDC and the University of Southern Maine's Muskie School of Public Service. John Snow, Inc. provided analysis, methodology, and design support. In addition, the Steering Committee gratefully acknowledges the countless community volunteers who gave their time and passionately committed to hosting, facilitating, attending, and engaging in this effort. From Aroostook to York, Oxford to Washington County, over 2,000 Mainers gave their time and talent to this effort. St. Mary's Regional Medical Center Part V, Section B, Line 11: The following descriptions are the prioritized community health needs identified by the data, community engagement and key informant interviews.Prioritized Significant Community Health Needs: Social Determinants of Health (25%); Mental Health (19%); Substance Use (14%); Access to Care (12%); and Tobacco Use (9%).Social Determinants of Health: A key theme from the community engagement sessions and key interviews in Androscoggin County (as well as the entire state of Maine) was the impact that social determinants of health (specifically housing, transportation, poverty, employment, cultural barriers and Adverse Childhood Experiences or ACEs) have on county residents. The number of people living in poverty is higher than the state (14.8% vs. 13.5%). The percentage of households that are food insecure is higher than the state (16% vs. 15.1%). Slightly over 1/4 of high school students have experienced at least 3 adverse childhood experiences, and the number of children with confirmed elevated blood levels for lead is significantly higher than the state (3.4% vs. 2.2%).St. Mary's is addressing this priority by focusing on cultivating equitable access to food and land by increasing access to urban spaces for food production, creating more equitable access to healthy, local food through community engagement and creating community food champions to support outreach and education. New community gardens will be established, two new pilot food access programs will be created and 5-10 community members will be trained as community food champions.Access to Health Care and Primary Care: While Androscoggin County has a relatively low percentage of uninsured residents, access to care is an issue. The percentage of individuals unable to obtain healthcare due to cost was significantly higher than the state (14.5% vs 10.3%).St. Mary's did not select this as a priority. We already offer financial assistance, help connect people to resources and assist patients in applying for MaineCare. In addition, Community Clinical Services, the local Federally Qualified Health Center, offers access and financial assistance.Mental Health: Androscoggin County residents receive outpatient mental health treatment at a higher rate than Maine residents (21% vs. 17%). The percentage of middle school students who reported having seriously considered suicide increased significantly between 2011 and 2017 (from 14.5% to 18.8%). A theme for mental health was the need for increased education and resources around the mental (and physical) health effects of Adverse Childhood Experiences (ACEs). St. Mary's will address mental health by improving integration and treatment of mental health in the community. The strategies will include improving the physical environment for people with psychiatric illness, exploring new treatment options for people who cannot tolerate medication as treatment for mental illness, implementing depress/suicide screening, expanding a pediatric behavioral health home, expanding partnership with schools serving at-risk youth and creating a plan to address Adverse Childhood Experiences (ACEs).Substance and Alcohol Use: Opioid use was the leading substance use issue discussed in the community forums. In Androscoggin County, substance use hospitalizations were higher than the state in 2016 (39 vs 18 per 10,000 population). The rate of overdose deaths increased from 12.5 to 18.4 per 100,000 (2007-2011 and 2012-2016 data).St. Mary's will address this by working to prevent and treat substance use disorder. Strategies will include developing protocols for rapid access to suboxone in the Emergency Department, increasing timely access to treatment after Emergency Department visits for substance use disorder, providing integrative therapies for pain management, providing greater access to polypharmacy guidance for opioid tapers, decreasing access to prescription drugs in the community and facilitating access to 12 step and other recovery programs.Tobacco Use: Tobacco use is one of the leading causes of preventable illnesses and death. Maine has made progress in reducing tobacco use. The percentage of Maine adults who smoked cigarettes in 2017 was significantly lower than in 2011. However, the emergence of electronic products is of grave concern. (Data from a 2018 national youth survey indicate up to a 78% increase in the use of electronic devices since 2017.)St. Mary's did not select this as a priority because the local public health agency, Healthy Androscoggin, addresses this key issue in the community. St. Mary's does participate by hosting tobacco cessation programs. St. Mary's is partnering with the other local hospital, Central Maine Medical Center, to address youth tobacco and vaping use.Potentially available health care facilities and resources available to meet the health needs identified: The assessment identified a number of strong community assets, including the two local hospitals (including behavioral services at SMRMC) and their community benefit programs, an Urgent Care Center by SMRMC, primary care physicians at accredited patient-centered medical homes, dentists, school-based health centers, federally qualified health centers through Community Clinical Services, a free clinic, community health agencies for mental health services and substance abuse, a local home care and hospice agency, social service agencies for outreach to the rural poor, the elderly, victims of domestic violence and children, St. Mary's Nutrition Center (emergency food pantry, community gardens, farmers' markets, cooking classes and outreach for Somali Nutrition programs), public school systems and Catholic school systems with active home and school associations, numerous religious communities and community coalitions to support downtown Lewiston. St. Mary's Regional Medical Center Part V, Section B, Line 13h: Household size St. Mary's Regional Medical Center Part V, Section B, Line 15e: St. Mary's website provides access to the free care application as well as contact information for assistance in answering any questions or in completing the application. Schedule H, Part V, Section B, Line 10a: The Center's most recently adopted implementation strategy is available at the following web address:https://www.stmarysmaine.com/community-health/community-health Schedule H, Part V, Section B, Line 7a and 7 b: The Center's CHNA report was made available at the Center's own website at the following web address:https://www.stmarysmaine.com/community-health/community-healthIn addition, the Center's CHNA report was made available on the website of Maine Health, at the following web address:https://mainehealth.org/healthy-communities/community-health-needs-assessment Schedule H, Part V, Section B, Lines 16a, 16b, and 16c: The Center's Financial Assistance Policy is available at the following web address:https://www.stmarysmaine.com/media/file/Financial%20Assistance%20Policy%20from%20policy%20stat%20012319.pdfThe Center's Financial Assisance Application and Plain Language Summary is available at the following web address:https://www.stmarysmaine.com/media/file/Financial%20Application%20St%20Marys%20and%20CCS.pdf 1 1 - St Mary's D'Youville Pavilion 102 Campus Avenue Lewiston ME 04240 Nursing home and restorative facility Part I, Ln 7 Col(f): The Center has estimated that 2% of its total annual bad debts, or approximately $225,208, may potentially be due to free care accounts and services. However, this estimated amount has not been included in Part I or Part II. Part II, Community Building Activities: St. Mary's is very active in programs that address the root causes of health problems, such as poverty, homelessness and environmental concerns. Leadership is involved in local coalition building and economic development to address these issues. Physical Improvements:St. Mary's Nutrition Center Gardens and Food Access: The 2019 season saw positive growth for Community Gardens on both sides of the Androscoggin River. St. Mary's Nutrition Center staff supported nine community gardens across the Twin Cities - two in Auburn and seven in Lewiston and helped 132 households (561 individuals) grow food for themselves and their families. In addition to offering weekly times for gardeners to access resources and ask questions, staff focused their energy on creating cohesive programming, improving infrastructure, and building community across gardens through gatherings, workshops, and field trips to area farms. In addition to facilitating learning opportunities and stronger connections among gardeners, Nutrition Center staff spent the season hard at work strengthening garden infrastructure and increasing accessibility. Pathways in the Nutrition Center garden were built to be accessible for wheelchairs and other mobility devices thanks to the efforts of Limb-It Tree and Landscaping and volunteer groups. Blake Street Garden's decaying wooden raised beds were replaced with sturdy new beds made of concrete blocks, with the help of volunteers from Wolf Pack Fitness and John F. Murphy homes. Finally, both the Knox Street and the Nutrition Center Gardens received new raised beds thanks in part to a past Healthy Neighborhood mini-grant. It takes a team effort to maintain and improve so many Community Gardens. Much of the weekly and seasonal tasks such as removing invasive plants, cleaning up trash or building raised beds is supported by dedicated community gardeners, Nutrition Center staff, Fellows and volunteers. Thanks to a mini-grant from Healthy Neighborhoods the Nutrition Center, in partnership with the Root Cellar and Goodwill's Take 2, created a neighborhood lawn-care service called the Lew Crew. The Lew Crew is a small business opportunity that provided area youth with a paid, skills-building work while helping to maintain and beautify neighborhood green spaces.Growing Our Tree Streets: Lewiston recently became the first city in Maine to be awarded a Choice Neighborhoods Planning Grant through the U.S. Department of Housing and Urban Development - a program that aims to provide a comprehensive approach to revitalization projects.The main purpose of the grant is to plan and execute major housing improvements in a 12-block section where nearly half of the residents live below the federal poverty level and the childhood lead-poisoning rate is three times that of the entire state.The focus area of the Choice Neighborhood is census tracts 201, 203 and 204, which include the neighborhoods surrounding Bates College and St. Mary's Regional Medical Center. The Tree Streets neighborhood, a 30-block area within the zone, has experienced some of the highest rates of poverty in Maine for decades and one third of the residents in the neighborhood are under age 18. St. Mary's leadership serve on the planning committee for this improvement plan. Here is a link to the transformation plan which was finalized in 2019 and approved by the Lewiston City Council:https://www.lewistonmaine.gov/DocumentCenter/View/10530/GrowingOurTreeStreets_FINAL_091119_lowresforweb The Good Food Bus: The Good Food Bus is a mobile food market, creating easier access to good food across Maine. Sponsored by St. Mary's Nutrition Center, it is a market on wheels providing direct and convenient access to fresh vegetables, fruit, and other grocery items. Our goal is to provide food that is local, convenient, and affordable and help to make the better choice the easier one. We strive to help all Maine people put good food on their tables with an emphasis on those who are at a greater risk for food insecurity.After a pilot in 2018, the Good Food Bus unveiled a new and improved Membership Program aimed at connecting customers more closely with the project while helping to reduce the cost of the food sold. The Membership is free to sign up and in addition to getting discounts at Neighborhood (lower income) market stops, members can opt into receiving weekly e-newsletters and day-of text message reminders. In 2018, members at Neighborhood Market stops received 25% off their purchases. After much consideration about the impact, the discount was increased to 50% for the 2019 season. Tremendous results were seen thanks to massive community involvement and a large increase in Member sign-ups and participation. Membership program highlights: - Membership program grew from 700 to 1800 members from 2018 to 2019- Neighborhood Membership and discount offered at 8 out of 12 market stops- 820 transactions using Neighborhood discount- $5,100 in discounts given through Membership ProgramThe Good Food Bus has also been continuing its focus on supporting Maine farmers and creating a new marketplace for their products. This season, $25,000 of Maine produce and goods were purchased and sold at our markets. This not only allowed us to connect more people than ever with fresh, healthy food, but also put money back into Maine's economy.Statistics from 2019:- 12 distinct market stops- Over 50% of revenue from communities at risk for food insecurity- 3,060 total transactions- 44% from Neighborhood Market locations- 311 SNAP/EBT transactionsCommunity Support:St. Mary's Nutrition Center Children's Programs: Children's programming at the Nutrition Center (NC) experienced a great deal of exciting growth and change during 2019. During the 2018-2019 school year NC staff offered over 850 gardening and cooking sessions with over 1400 kids in 94 classrooms, afterschool programs, and summer school sites in local schools. The inaugural class of School Garden Coaches was piloted in four Lewiston-Auburn schools, partnered with Lewiston and Auburn School Nutrition Departments to offer staff training days at Whiting Farm, and participated in a district-wide teacher workshop day. One exciting project has been a partnership with Connors Elementary School which opened in August 2019 and consolidated Longley and Martel, two previous partner schools. In advance of the consolidation, NC staff and FoodCorps service members worked with champion teachers from Longley and Martel to form a Connors Farm to School team. The team, consisting of one kindergarten teacher, one STEM teacher, one ELL teacher, one FoodCorps member, and one cafeteria manager then applied and was accepted into this year's Northeast Farm to School Institute at Shelburne Farms in Shelburne, VT. They attended a three-day retreat in June and developed a year-long farm to school work plan with the help of a coach, the Development Director of Maine School Garden Network. The team now meets monthly with a larger farm to school committee to discuss projects such as building a new school garden, conducting cafeteria taste tests, and forming a new student Green Team. Outside of the classroom, the Knox Street and Hillview Kids Gardens allow kids to explore and help grow their own food, often right outside their front door. Teens in the summer and fall gardener job training programs designed and led hands-on and interactive activities as part of these fun and educational garden and cooking times. This opportunity not only paired younger kids with older mentors but allowed teens to build valuable leadership and teaching skills. Some of the in-school programming this year was supported in part through a collaborative agreement with the Auburn and Lewiston school districts and Maine Farm and Sea Cooperative as part of Auburn's USDA Farm to School implementation grant that wraps up in June 2020. Part III, Line 2: This amount represents accounts sent to the collection agency minus payments that have been collected plus a factor estimating the self-pay amounts in accounts receivable that will be uncollectible. Part III, Line 3: For receivables associated with self-pay patients (which includes both patients without insurance and patients with deductible and copayment balances due for which third-party coverage exists for part of the bill), the System records an allowance for doubtful accounts in the period of service on the basis of its past experience, which indicates that many patients are unable or unwilling to pay the portion of their bill for which they are financially responsible. The difference between the standard rates (or the discounted rates if negotiated) and the amounts actually collected after all reasonable collection efforts have been exhausted is charged off against the allowance for doubtful accounts. Part III, Line 4: Accounts are written off when all reasonable internal and external collection efforts have been performed. The estimates for implicit price concessions are based upon management's assessment of historical write-offs and expected net collections, business and economic conditions, trends in federal, state and private employer health care coverage and other collection indicators. Management relies on the results of detailed reviews of historical write-offs and collections at facilities that represent a majority of the systems revenues and accounts receivable as a primary source of information in estimating the collectability of accounts receivable. Part III, Line 8: None were reported but it is important to note that approximately 30% of medicare patients also qualify for medicaid. Costing on line 6 is based on ratio of cost to charge from worksheet 2. Part III, Line 9b: St. Mary's Regional Medical Center will make a reasonable effort to determine whether an individual qualifies for financial assistance prior to initiating any collection activity. Part VI, Line 2: In addition to the official Community Health Needs Assessment reported in Part V, Section B, St. Mary's assesses the needs of our community in an on-going basis through several key methods. Leaders are active on community health boards; these monthly meetings allow for continued assessment and sharing of information. Patient or resident advisory panels also help us assess needs of patients and the community. We also work closely with Community Clinical Services (an FQHC look-alike) to share information about some of the health disparities experienced by community members. St. Mary's works with the local ethnic community based organizations for information as well. Part VI, Line 3: St. Mary's Regional Medical Center provides financial education at the point of registration by having brochures available. These brochures provide information about the hospital bill and various options on financial assistance. On the backside of the monthly patient statements also provides education of the financial assistance availability and options to those who need it. Part VI, Line 4: During 2018-2019, a community health needs assessment (CHNA) was conducted by St. Mary's Regional Medical Center, Central Maine Medical Center, Healthy Androscoggin and other community health agencies as part of a statewide initiative through the Maine Shared CHNA.St. Mary's Regional Medical Center (SMRMC) is a 233-bed acute care hospital, a primary care provider network, urgent care and emergency department, behavioral and mental health services, and outpatient specialty practices that combine talented and compassionate caregivers with state-of-the-art medical technology to meet the healthcare needs in the Androscoggin County area and beyond. St. Mary's draws most of its inpatient and outpatient population from Androscoggin County, therefore the needs of this geographic area are the focus of the assessment. Androscoggin County is located in south central Maine and is one of three counties that comprise the Western Public Health District. It contains roughly 8% (107,376) of Maine's 1.27 million residents. Androscoggin County contains Maine's second and fifth largest cities: Lewiston (population 36,592 in the 2010 census) and Auburn (population 23,055 in the 2010 census) respectively. Located across from each other on the Androscoggin River, the twin cities of Lewiston and Auburn are the central hub of the region. The county is working to transform the downtown area from vacant textile mills and abandoned shoe factories to a region known for progressive health care, tourism, high-precision manufacturing, telemarketing and financial services. Over the past 20 years, Lewiston has become home to a large African immigrant population (approximately 11% of the population of Lewiston). The "New Mainers" come from Somalia, Djbouti, Angola, Sudan, Ethiopia, and the Democratic Republic of the Congo, among others. Androscoggin County is one of the few counties in Maine experiencing a growth in population because of this emigration. This population growth has enhanced cultural and economic aspects of Lewiston and Auburn while also presenting unique healthcare opportunities and challenges. The rest of the county is comprised of small rural towns with an average population of 222 persons per square mile.The county is primarily white (92.8%) with black (3.8%) and two or more races at 2.1%. Androscoggin County's population reflects two interesting trends: the highest number of people is in the under 18 years category (22%) and the second highest concentration of the population is over age 65 (17%.) The unemployment rate was 3.3% as of April 2019. Slightly over 10% of the primary languages spoken in the home are categorized as "other than English" so interpretation services are available as well as cultural brokers hired by the local hospitals to assist new Mainers in navigating the health systems. Lewiston/Auburn qualifies as a Medically Underserved Area, defined as having too few primary care providers, with high infant mortality, high poverty rates and/or high elderly populations. The poverty rate in Maine is 14.8% and the median income is $48,728 annually. Lewiston's poverty rate is even higher-21% (2017 American Community Survey) and the rate of childhood poverty in Lewiston is 43% (according to the 2013-2017 American Community Survey). Additionally, the Community Needs Index (CNI) identifies the severity of community health needs for a specific geography by analyzing the degree to which the following health care access barriers exist in the community: a. income barriers; b. education/literacy barriers, c. culture/language barriers, d. insurance barriers, and e. housing barriers. The score is a weighted average; the current (July 2019) score for Androscoggin County is 3.1; the score for the city of Lewiston is 4.2 (based on scale of 1-5 with 5 being the highest need). While the county scored improved from 3.2 to 3.1 since the 2016 CHNA, Lewiston's rating remains at 4.2 which is in the category of "highest need".Androscoggin County currently ranks 12 (out of 16 counties in Maine) for health. This score includes including health behaviors, clinical care, physical environment, and social and environmental factors. These physical, social and environmental factors can contribute to, or detract from, overall health. The BroadStreet Network measures social vulnerability through its "Area Deprivation Index" (ADI.) The ADI is calculated by combining 17 indicators of income, education, employment, and housing quality. The ADI has been used for 20 years by the Health Resources & Services Administration (HRSA). The ADI and percentile scores are calculated by using Census Block Group level data. While Androscoggin County has a deprivation score of 100.6, Lewiston's score is even higher at 108.1 (the higher the score, the greater the vulnerability).Understanding the health needs of a community allows public health and health care organizations to design and implement cost-effective strategies that improve the health status of the populations they serve. A comprehensive data driven assessment process can identify, with a high degree of accuracy, priority health needs and issues related to prevention, diagnosis and treatment. Assessment tools also may assist in pinpointing access to care barriers, utilization of evidence based guidelines, and utilization of health services. Part VI, Line 5: St. Mary's provided many community health improvement services to address the public health needs identified in Androscoggin County in the most recent Community Health Needs Assessment. The most significant public health issues continue to be chronic diseases, mental health, substance use, obesity and tobacco use. Community health education and improvement services focused on chronic diseases and substance use. Initiatives included health screenings for cancer, cooking classes (embedded within food access strategies), and self-help programs for smoking cessation and weight loss. St. Mary's also focused on access to care for underserved populations. Community Education and Health Improvement Efforts:St. Mary's offered community education and health screenings to address the prioritized health needs in Androscoggin County. St. Mary's also hosted and/or facilitated community support groups for health services as well as exercise programs targeted for wellness and prevention. - Since Maine has an excessively high rate of cancer incidence, several initiatives were related to cancer prevention and screening. Staff offered special mammography screenings on a Saturday for those who work on weekdays. Two educational sessions were held at the local Area on Aging that focused on risk and prevention of breast cancer. Six employees also participated in the annual Survivorship Day at the local cancer support center and offered a cooking class that focused on the importance of nutrition. About 100 people attended the program. The medical director of our occupational medicine program (WorkMed) attended a conference that reported on the increased risk of cancer for firefighters and then developed and offered a special workshop for fire chiefs in the state of Maine about cancer screening and prevention for firefighters. Over 50 fire chiefs from around the state (as well as other town/city officials) attended the fall 2018 program where they received education on the types of cancer for which their firefighters are at greatest risk.- Maine is facing an opiate crisis. In 2017, Maine's fatal opioid overdose rate was 29.9 per 100,000 people (the sixth highest in the country). St. Mary's is a partner in a major community grant for the Community in Recovery program. Its goal is to create a community response and safe pathway to recovery that provides full access, reduces stigma and encourages the possibility of successful overall well-being and participation. In 2018 St. Mary's leadership continued to serve on the steering committee and also offered medication assisted therapy (MAT) training for providers in order to increase access to MAT in our community. Providers from both local hospitals and the local mental health social service agency participated in the training.St. Mary's also hosted a session to educate community health agencies about statistics related to substance use in Androscoggin County in the summer of 2018 following the release of the county level data for the Maine Shared Community Health Needs Assessment.- St. Mary's hosted a four-part film conversation series in November 2018 entitled "It's About How You Live" in order to educate the community about the importance of advance care planning and the resources and support available through palliative care. The series was well-received by the community members who attended.HIV Case Management Program:The HIV/AIDS Case Management Program started in 1998 when St. Mary's was awarded the Ryan White grant/contract under the Maine CDC and is now the second largest AIDS Service organization in the state of Maine. The program serves 95 clients between Portland and Ellsworth, Maine. Services provided include: medical, dental and eye care linkages; ongoing monitoring of client health status including treatment and care, lab results and helping to ensure ongoing treatment adherence on all levels; access to vital medications, linkages to health care, substance abuse and mental health services; and access to food and financial assistance as well as housing and transportation assistance. The program also offers client support groups, holiday luncheons and much needed personal care supplies. In 2018 the number of clients who are asylum seekers doubled (from 5 to 10 clients). Since most asylum seekers are not eligible for any assistance, they are very grateful for the support provided through the HIV case management program, in terms of both tangible support and being treated respectfully. One client remarked, "Wherever I go here at St. Mary's, people attend to me, rather than ignoring me." Health Initiatives/Collaboration with Other Health Entities:St. Mary's is an affiliate member of MaineHealth, one of the major health systems in Maine. MaineHealth has created The Center for Health Improvement which supports and serves MaineHealth organizations and others with integrated clinical, community and policy approaches. One of St. Mary's senior leaders has been appointed to serve on this council. In 2018, the council developed a charter which outlines areas for which input and recommendations will be provided: - Development of population health priorities within MaineHealth Strategic Plans (system, service lines, member organizations, etc.)- Development and dissemination of aligned strategies in clinical, community and policy domains- Implementation of appropriate measurement, evaluation, and achievement of outcomes- Coordination of population health-related initiatives among system members and affiliates- Creation and maintenance of partnerships with public and private sectors- Advocacy regarding funding and resource allocations- Effective implementation of the Community Health Needs Assessment process- Effective implementation of the Health Index Commit to Get Fit Challenge:Since lack of physical activity and obesity are significant health challenges in our country, St. Mary's decided to create a community event to encourage physical activity. The health and wellbeing of our employees and community members are of the utmost importance to St. Mary's. The Commit to Get Fit Challenge is focused on encouraging individuals of all levels of physical activity to engage in our event. We welcome and support the person who is committed to running their first 5K with as much enthusiasm as the person who is putting all their effort into walking our 3K. Our success can be seen on the faces of the walkers and runners as they cross the finish line. On May 5th, 2018, St. Mary's Health System held our 5th annual Commit to Get Fit Challenge. Close to 400 hundred individuals participated in our 3K walk, 5K, 10K and 15K run with 60 plus volunteers helping to make our event run smoothly. Thanks to our many generous sponsors, donations from employees and community members and the fees from registrations we were able to raise close to $70,000. The proceeds from this event help to support three important areas of our healthcare system, the Marguerite d'Youville Fund for the Needy, the Nutrition Center and the Resident Activity Fund at St. Mary's d'Youville Pavilion. St. Mary's Nutrition Center: Cooking Classes:Poverty and poor nutrition are significant public health issues in the area we serve. St. Mary's subsidizes the St. Mary's Nutrition Center to address these needs. The long-term goal of the Nutrition Center is to build a viable, just food system, while supporting local leaders, strengthening community ties, and engaging youth as agents of change. The Nutrition Center operates on the belief that equity in our food system is deeply tied to inequity within our community, and that a whole-person, and whole-community, approach is critical to creating long-term change in order to improve the overall health of the community. Located in a previously vacant, but beautiful, historic school building in the midst of downtown Lewiston, Maine's most economically challenged neighborhoods, the Nutrition Center serves families, youth, adults, elders and refugees across the city's many diverse communities with a focus on those who have limited incomes and an increased risk for food insecurity. In 2018 community cooking classes featured the theme "Eat the World." Each cooking class featured a different country and a chef native to that country led the class. Ten sessions were held in 2018 with attendance ranging from 12-45 people at each session. Cuisine included food from Sudan, Iraq, Morocco, Senegal, Nigeria, Angola, and Yemen. Part VI, Line 6: St. Mary's Health System, a member of Covenant Health, includes St. Mary's Regional Medical Center, a 233-licensed bed acute care facility; Community Clinical Services, with primary care and behavioral physicians, and nurse practitioners; St. Mary's d'Youville Pavilion, one of the largest nursing homes north of Boston, with 210 beds dedicated to long-term care, a secure Alzheimer's unit, a rehab speciality care suite, and a state of the art Rehab Center; St. Mary's Residences, an independent living center.Our Mission is to continue the healing ministry of the Catholic Church in the Spirit of St. Marguerite d'Youville by providing preventive, curative, restorative, and supportive services with compassion and respect for everyone. We take seriously the "preventive" aspect of the mission statement by offering Prevention and Wellness programs for the community, offer health screenings and working to provide access to healthy food through the Nutrition Center. The nursing home offers education to the community about fall prevention, grief support and caregiver support. Health system leadership participate in various community groups to conduct health care needs assessments and to develop community interventions to improve health. Part VI, Line 7, Reports Filed With States ME Schedule H, Part II, Community Building Activities (continued): St. Mary's Nutrition Center Youth Programs:2019 was a busy year for our youth programs with approximately 60 young people participating in 5 different training programs and monthly community dinners. In addition to improving leadership opportunities for youth, time was spent cooking and sharing good food with the wider community and helping youth lead positive change in their school system.One example of this change included a project aimed at increasing student voice in school wide decision-making process. The youth Campaign Crew (YCC), spent the 2018-2019 winter interviewing and surveying middle school students about different school issues. The Crew presented their findings and recommendations to the Middle School principal and members of the Department of Education at the statehouse in Augusta through the Young People's Caucus. These recommendations, including starting up a Student Advisory Council, are now largely being carried out at the middle school due to the persistence and care with which this group handled this project. This set the tone for a year of young people rising to the challenge, caring for their community, and getting work done. Another highlight of our programming this year were our interns. These four high-schoolers- graduates of other youth programs, dove headfirst into planning and leading programs for other youth. They were dedicated, kind, considerate, and always willing to learn and challenge themselves. They brought a spirit of fun while also prioritizing equity, agency, and truthfulness. Because of the interns, this year's summer programs included a series of workshops addressing systems of oppression and youth voice, which were one of the most highly praised elements of the program. More than 20 youth participated in our Summer Youth Gardeners (SYG) program. The SYGs (youth gardeners) cared for, and harvested from two Youth Production Gardens, providing fresh veggies for Nutrition Center-sponsored meals, their families, pantry guests and other community members. They cooked for each other and guests twice a week, learning skills and new ways to eat healthy, fresh produce that they themselves grew. Projects that were new to the SYG program this year included: - Bringing beauty and food to downtown with the Edible Lisbon Street garden boxes; - Planting and running two Garden Carnivals for kids at Hillview Apartments; - Preparing and served meals at Trinity Soup Kitchen. Eight former SYGs then returned for the Fall Gardener program, where they increased their leadership skills, took on specific projects, and connected with each other and their community. Interns continue to lead Nutrition Center programs, and over the winter they are serving as an Advisory Council as Youth Programs Expectations and Goals are examined.The Nutrition Center continues to work to more authentically partner with young people, and to that end, be deliberate with the focus, content, and structure of our programs. We strive to be flexible with our plans and prioritize building real relationships and networks with youth. We are honored to get to work alongside so many young people and be inspired by their resilience, creativity, and spirit. St. Mary's Nutrition Center Food Champion Program:The Community Food Champion Program is a peer to peer promotion and support program of St. Mary's Nutrition Center. Community Food Champions are residents from Lewiston- Auburn who help their neighbors learn about and access more fresh, affordable, local food. The program was piloted in 2018 and in 2019, five community champions participated, speaking a range of languages that included English, French, Somali and Arabic. Champions conducted weekly outreach during St. Mary's food pantry hours, the Good Food Bus stops and at area agencies. They completed more than 600 hours of outreach and signed up 853 people of low income for the Neighborhood Membership Program (a 50% discount at the Good Food Bus stops). $5,100 in discounts were distributed through the membership program. Champions also assisted with translation and outreach at weekly garden times.Under Leadership Development:St. Mary's Nutrition Center Leadership Development programming:The Nutrition Center continued its efforts to engage community members in meaningful volunteer roles as well as provide training and leadership opportunities. Examples of this include:- Nutrition Center management staff conducted a full overhaul of the Volunteer Program - redesigning recruitment, intake process, orientation, and training. After the implementation, we have been intentional in reflecting and assessing the new approach. Additional opportunities for improvement have been identified, particularly the need to provide more interpreting and translation for the very diverse base of community members interested in volunteering.- Seven community members and local college students completed Fellowships at the Nutrition Center - gaining professional and community engagement experience while helping us extend and improve our community impact.- One volunteer for the Food Pantry, a recent asylum seeker from Angola, was selected for a full-time staff position using a competitive hiring process that prioritized community hiring preference and equity in the approach. Workshops around community engagement and outreach were provided for the Community Food Champions as well as other community members playing outreach/advocate roles within partner organizations. Additionally, the NC paid the registration fee for the Community Food Champions to join an Adult Education class teaching basic Microsoft Excel - a skill set they requested.Under Coalition Building:St. Mary's Nutrition Center Local Foods, Local Places:In early 2019 the St. Mary's Nutrition Center applied for, and was awarded, a Technical Assistance (TA) grant sponsored by the U.S. Department of Agriculture (USDA), Environmenal Protection Agency (EPA), and the Northern Border Regional Commission called Local Foods, Local Places. Local Foods, Local Places (LFLP) helps cities and towns across the country protect the environment and human health by engaging with local partners to reinvest in existing neighborhoods as they develop local food systems. LFLP supports locally led, community-driven efforts to protect air and water quality, preserve open space and farmland, boost economic opportunities for local farmers and businesses, improve access to healthy local food, and promote childhood wellness. With support from the TA Team provided through the grant, each Local Foods Local Places participant identifies goals for their city or town, convenes a steering committee of community stakeholders and plans and implements a two-day community-driven conversation and action planning session. The goal of this session, and subsequent steering committee meetings, is to draft and finalize an Action Plan for the City to further the highlighted goals.The goals of Local Foods Local Places Lewiston-Auburn, Maine program were outlined as follows:1. Strengthen access to local food while expanding market opportunities and infrastructure for farm and food businesses.2. Integrate local food and agriculture into city planning and economic development strategies.3. Build food and agriculture as a defining brand identity for Lewiston-Auburn.4. Increase equitable access, ownership, and preservation of land to grow food in Lewiston-Auburn.Close to 80 residents, farmers, and other community stakeholders attended the first public session of the Local Foods, Local Places Lewiston-Auburn workshop on the evening of October 22nd to help establish a Local Food Vision for the region. The following day, approximately 50 community stakeholders took that vision and drafted action steps for each of the four goals. Following the LFLP event, the steering committee along with additional community members and the TA team revised and finalized the Local Foods Local Places Action Plan. The final document provides background and context about Lewiston-Auburn, an overview of the two-day LFLP event and nearly 20 action steps. The document can be found at the following web-address:https://goodfood4la.org/wp-content/uploads/2020/01/LFLP-L-A-Community-Action-Plan-FINAL.pdfA small team from the original steering committee along with key stakeholders are already putting those action steps into place. X X X X 0 0 0 0 0 0 0 0 0 Michael Newman Physician 896034 0 0 0 19850 0 2711 0 31549 0 950144 0 0 0 Joseph Strauss Physician 805684 0 0 0 19850 0 2700 0 31788 0 860022 0 0 0 Gregory Pomeroy Physician 767613 0 0 0 4958 0 2770 0 20026 0 795367 0 0 0 Jeffery Davila MD Director 722541 0 0 0 3870 0 0 0 1882 0 728293 0 0 0 Michael Kelley MD Director (end 5/19) 601318 0 0 0 1097 0 2796 0 24077 0 629288 0 0 0 Sacha Matthews Physician 535242 0 0 0 20350 0 2782 0 26616 0 584990 0 0 0 Scott Treworgy Physician 487982 0 0 0 4536 0 2769 0 20539 0 515826 0 0 0 Steve Jorgensen President & CEO 0 412358 0 0 0 21950 0 2800 0 30542 0 467650 0 0 Christopher T Bowe Chief Medical Officer 404107 0 0 0 942 0 2764 0 26815 0 434628 0 0 0 Michael Hendrix Treasurer & CFO 0 246888 0 0 0 19951 0 2424 0 32995 0 302258 0 0 Philip Hickey CEO Post Acute Care 220845 0 0 0 1471 0 0 0 9305 0 231621 0 0 0 Anne Brown MD Director 172339 0 0 0 472 0 1516 0 15636 0 189963 0 0 0 Part I, Line 3 Any compensation paid to the trustees, directors, officers or key employees of the Organization is subject to the oversight and decisions of Covenant Health, a related tax-exempt organization. Every two-to-three years the Compensation Committee of the Covenant Health Board of Directors engages an external consultant to provide competitive market data from various survey sources, which is then used to develop recommendations for changes to the compensation program. Since 2003, the Compensation Committee has engaged a human resources consultant to conduct this analysis. Objectives of the analysis are to assess the compositeness of the total cash compensation levels of the senior leadership team, develop market based competitive salary ranges for all executive positions, and ensure that the annual incentive opportunities, if there are any, are competitive and reasonable. A MHHEFA Revenue Bond Series 2007A 010314384 560425v80 2007-11-01 6685000 Funding for construction and capital improvements 0 0 0 B MHHEFA Revenue Bond Series 2010B 010314384 560427JA5 2010-06-24 7825000 Refinancing of 1999 and 2001 tax-exempt bonds 0 0 0 C MHHEFA Revenue Bond Series 2014A 010314384 560427W77 2014-07-24 8490000 Refinancing of 2004A bonds 0 0 0 D MHHEFA Revenue Bond Series 2014 010314384 560427U61 2014-07-24 2450000 Refinancing of 2004A bonds 0 0 0 A 6853065 444500 89925 6318640 2007 0 0 1 1 B 9077696 603175 96465 2010 1 0 1 1 C 9406745 1615380 1560850 52292 2014 0 1 1 1 D 2661384 616000 2993216 19344 2014 1 0 1 1 A 0 0 0 0 0.00000 0.00000 0.00000 0 0 0 B 0 0 0 0 0.00000 0.00000 0.00000 0 0 0 C 0 0 0 0 0.00000 0.00000 0.00000 0 0 0 D 0 0 0 0 0.00000 0.00000 0.00000 0 0 0 A 1 0 0 1 fsa 30.000000000000 1 0 0 B 1 0 0 1 fsa 20.000000000000 1 0 0 C 1 0 0 1 FSA 9.000000000000 1 0 0 D 0 0 0 0 0 0 1 FSA 9.000000000000 1 0 0 A 0 B 0 C 0 D 0 Schedule K, Part III, Line 9; Part IV, Line 7, & Part V While formal, written policies have not been adopted by the Organization, the Center carefully and consistently monitors its tax-exempt bond for potential violations. Additionally, the Organization routinely confers with bond counsel to ensure all relevant compliance requirements have been met. A MHHEFA Revenue Bond Series 2017B 010314384 00056042R 2017-03-21 6000000 Funding for construction and capital improvements 0 0 0 A 6000000 414069 120000 5465931 2017 0 0 0 1 A 0 0 0 0 0.00000 0.00000 0.00000 0 0 0 A 1 0 0 1 FSA 30.000000000000 0 0 0 A 0 X 6 696321 Fair Market Value 0 0 1 1 Part I, Line 32b: The Organization sells gifts of stock as soon as administratively possible through its third party broker, Bar Harbor Bank & Trust. Form 990, Part VI, Section A, line 6 St. Mary's Health System is the sole corporate member of the organization. Form 990, Part VI, Section A, line 7a As the sole corporate member of the Organization, St. Mary's Health System retains the ability to elect and remove the Organization's board of directors with or without cause. Form 990, Part VI, Section A, line 7b As the sole corporate member of the Organization, St. Mary's Heath System has the following powers and rights over the Organization and its subsidiaries as outlined in the Organization's bylaws: 1. To approve any change in the written statements of philosophy and mission; 2. To amend and to repeal the organizing and governing documents; 3. To approve all plans of merger, consolidation, reorganization, dissolution, or the sale, lease assignment, or transfer of substantially all of the assets, or the purchase or acquisition of an interest in any corporation, partnership, joint venture, or other entity; 4. To approve all long-range strategic plans before implementation; 5. To approve the acquisition, sale, or encumberance of any real estate valued in excess of an amount set by the Member in writing; 6. To approve all capital budgets and non-budgeted expeness in excess of an amount set by the Member in writing; 7. To approve all debt in excess of limits set by the Member in writing; 8. To approve the sale, assignment, or transfer of any equity interest or membership interest in any subsidiary; 9. To approve any reclassification or other change of any capital stock or other equity security; 10. To approve the issuance of, or the creation of any obligation to issue, an equity security; and, 11. To evaluate the performance of the Medical Center in preserving, furthering, and promoting the purposes of the Medical Center. Form 990, Part VI, Section B, line 11b The Form 990 is provided to the governing body for their review and approval prior to filing. Form 990, Part VI, Section B, line 12c This process is the responsibility of the Compliance Officer. A conflict of interest disclosure form is submitted to all leadership, board members, board committee members, employed physicians, medical directors and certain employees in key positions annually to be completed. Reminders are sent to all persons of interest to ensure that all conflict of interest disclosure forms are completed and collected. Form 990, Part VI, Section B, line 15 Any compensation paid to the trustees, directors, officers or key employees of the Organization is subject to the oversight and decisions of Covenant Health, a related tax-exempt organization. Every two-to-three years the Compensation Committee of the Covenant Health Board of Directors engages an external consultant to provide competitive market data from various survey sources, which is then used to develop recommendations for changes to the compensation program. Since 2003, the Compensation Committee has engaged a human resources consultant to conduct this analysis. Objectives of the analysis are to assess the compositeness of the total cash compensation levels of the senior leadership team, develop market based competitive salary ranges for all executive positions, and ensure that the annual incentive opportunities, if there are any, are competitive and reasonable. Form 990, Part VI, Section C, line 19 The Organization's Form 990, governing documents, conflict of interest policy, and financial statements are made available to the public upon request. The Organization's Form 990 is also made available on the website of its parent organization, Covenant Health, Inc., at the following web address: https://www.covenanthealth.net/financial-information/financial-information Form 990, Part IX, line 11g Contracted support services: Program service expenses 16,700,727. Management and general expenses 2,127,122. Fundraising expenses 0. Total expenses 18,827,849. Nursing agencies: Program service expenses 7,458,355. Management and general expenses 0. Fundraising expenses 0. Total expenses 7,458,355. Physician fees: Program service expenses 4,604,291. Management and general expenses 0. Fundraising expenses 0. Total expenses 4,604,291. Form 990, Part XI, line 9: Net transfers from affiliates 6,731,957. Form 990, Part XI, Line 2c: The Audit Committee of Covenant Health assumes responsibility for oversight of the audit and selection of the independent auditor. This audit process has not changed from the previous year. Youville Lifecare Inc 1575 Cambridge Street Cambridge MA 02138 042103582 Hospital and health care facility MA 501(c)(3) Line 10 Covenant Health Inc 0 St Joseph Manor Health Care 215 Thatcher Street Brockton MA 02302 042565937 Nursing home and restorative facility MA 501(c)(3) Line 10 Covenant Health Inc 0 St Mary's Health System PO Box 7291 Lewiston ME 04243 222504349 Hospital and health care facility ME 501(c)(3) Line 12a, I Covenant Health Inc 0 St Joseph's Hospital of NashuaNH Inc 172 Kinsley Street Nashua NH 03061 020222215 Hospital and health care facility NH 501(c)(3) Line 3 Covenant Health Inc 0 Youville Place 10 Pelham Road Lexington MA 02421 043297834 Assisted living services MA 501(c)(3) Line 10 Covenant Health Inc 0 St Mary's Villa Nursing Home Inc 675 St Marys Villa Road Moscow PA 18444 232057177 Nursing home and restorative facility PA 501(c)(3) Line 10 Covenant Health Inc 0 CHS of Waltham Inc dba Maristhill Nursing & Rehab Center 66 Newton Street Waltham MA 02453 043333609 Nursing home and restorative facility MA 501(c)(3) Line 10 Covenant Health Inc 0 CHS of Worcester Inc dba St Mary Care Center 39 Queen Street Worchester MA 01610 043419625 Nursing home and restorative facility MA 501(c)(3) Line 10 Covenant Health Inc 0 Fanny Allen Holdings Inc 790 College Parkway Colchester VT 05446 030181052 Real estate holding company VT 501(c)(3) Line 12a, I Covenant Health Inc 0 St Andre Health Care 407 Pool Street Biddeford ME 04005 010342399 Nursing home and restorative facility ME 501(c)(3) Line 10 Covenant Health Inc 0 MI Nursing Restorative Center Inc 172 Lawrence Street Lawrence MA 01841 042104851 Nursing home and restorative facility MA 501(c)(3) Line 10 Covenant Health Inc 0 Helping Hands of St Marguerite Inc 799 Concord Avenue Cambridge MA 02138 800199674 Private home-care health services MA 501(c)(3) Line 10 Covenant Health Inc 0 Providentia Prima Trust 420 Bedford Street Lexington MA 02420 046835128 Investment trust MA 501(c)(3) Line 12a, I Covenant Health Inc 0 Fanny Allen Corporation Inc 790 College Parkway Colchester VT 05446 222495808 Charitable foundation VT 501(c)(3) Line 12a, I Covenant Health Inc 0 Youville House Inc 1573 Cambridge Street Cambridge MA 02138 043239593 Assisted living services MA 501(c)(3) Line 10 Youville Lifecare Inc 0 Youville Hospital and Rehabilitation Center Inc 1575 Cambridge Street Cambridge MA 02138 043239563 Hospital and health care facility MA 501(c)(3) Line 10 Youville Lifecare Inc 0 Community Clinical Services PO Box 7291 Lewiston ME 04243 010409788 Physician pratice ME 501(c)(3) Line 10 St Mary's Health System 0 St Mary's D'Youville Pavilion PO Box 7291 Lewiston ME 04243 010211558 Nursing home and restorative facility ME 501(c)(3) Line 10 St Mary's Health System 0 St Mary's Residences PO Box 7291 Lewiston ME 04243 222504356 Low income housing ME 501(c)(3) Line 10 St Mary's Health System 0 Neighborhood Housing Initiative PO Box 7291 Lewiston ME 04243 010539730 Affordable housing services ME 501(c)(3) Line 10 St Mary's Health System 0 Souhegan Nursing Association 24 North River Road Nashua NH 03055 020222795 Home health and hospice NH 501(c)(3) Line 10 St Joseph Hospital of Nashua NH Inc 0 The Surgicenter at St Joseph Hospital Inc 172 Kinsley Street Nashua NH 03061 020222215 Healthcare and surgery center NH 501(c)(3) Line 10 St Joseph Hospital of Nashua NH Inc 0 MI Management Inc 172 Lawrence Street Lawrence MA 01841 042857794 Assisted living services MA 501(c)(3) Line 12a, I Covenant Health Inc 0 MI Adult Day Health Care Center Inc 189 Maple Street Lawrence MA 01841 042921888 Adult day care services MA 501(c)(3) Line 10 Covenant Health Inc 0 MI Residential Community Inc 189 Maple Street Lawrence MA 01841 042647207 HUD low income housing MA 501(c)(3) Line 10 Covenant Health Inc 0 MI Residential Community II Inc 189 Maple Street Lawrence MA 01841 042679954 HUD low income housing MA 501(c)(3) Line 10 Covenant Health Inc 0 MI Residential Community III Inc 189 Maple Street Lawrence MA 01841 042186043 HUD low income housing MA 501(c)(3) Line 10 Covenant Health Inc 0 MI Transportation Inc 189 Maple Street Lawrence MA 01841 042921889 Elderly transportation services MA 501(c)(3) Line 10 Covenant Health Inc 0 Mary Immaculate Guild 172 Lawrence Street Lawrence MA 01841 463073987 Nonprofit funding and support ME 501(c)(3) Line 12a, I Covenant Health Inc 0 St Joseph Healthcare Foundation 360 Broadway Bangor ME 04402 222480149 Healthcare foundation ME 501(c)(3) Line 10 Covenant Health Inc 0 St Joseph Hospital 360 Broadway Bangor ME 04402 010212435 Hospital and health care facility ME 501(c)(3) Line 3 St Joseph Healthcare Foundation 0 M & J Company 360 Broadway Bangor ME 04402 222480150 Lease holding company ME 501(c)(2) St Joseph Healthcare Foundation 0 St Joseph Ambulatory Care Inc 360 Broadway Bangor ME 04402 222480373 Physician pratice ME 501(c)(3) Line 10 St Joseph Healthcare Foundation 0 Alternative Health Services 360 Broadway Bangor ME 04402 010422885 Home health and hospice ME 501(c)(3) Line 10 St Joseph Healthcare Foundation 0 Mount St Rita Health Centre 15 Sumner Brown Road Cumberland RI 02864 050342330 Nursing home RI 501(c)(3) Line 10 Covenant Health Inc 0 Penacook Place Inc 150 Water Street Haverhill MA 01830 237090088 Nursing home MA 501(c)(3) Line 10 Covenant Health Inc 0 Covenant Health Inc 100 Ames Pond Drive Tewksbury MA 01876 222484505 Health care management and resource organization MA 501(c)(3) Line 10 N/A 0 Covenant Health Foundation Inc 100 Ames Pond Drive Tewksbury MA 01876 800199674 Charitable foundation MA 501(c)(3) Line 12a, I Covenant Health Inc 0 Covenant Health Insurance LTD PO Box 69 Grand Cayman CJ KY1-1102 043360127 Self-insurance company CJ N/A C 0 Campus Holding PO Box 7291 Lewiston ME 04240 010406049 Holding company ME N/A C 0 St Joseph Corporate Services Inc 172 Kinsley Street Nashua NH 03060 020405197 Holding company NH N/A C 0 Strauss Incorporated 360 Broadway Bangor ME 04402 010391369 Repairs and transcriptions ME N/A C 0 GNM Corporation 172 Kinsley Street Nashua NH 03060 020400550 Real estate holding company NH N/A C 0 SJ Physicians Services 172 Kinsley Street Nashua NH 03060 020522234 Physician practice NH N/A C 0 0 0 0 0 0 0 1 0 0 1 1 1 1 0 1 1 1 1 0