STRATEGY STUDIO / NONPROFIT PEOPLE SEARCH

RUMFORD HOSPITAL: Form 990, tax year 2017

View the entire original 990 at ProPublica ↗

Organization
RUMFORD HOSPITAL (EIN 01-0215227)
Tax period
2017-07-01 to 2018-06-30
Filed
2019-05-14
IRS object ID
201921349349304637
Schema version
2017v2.3
Source
Download XML · Original 990 at ProPublica

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

Return header ReturnHeader

FieldValueIRS element (for citing)
Return2019-05-14T12:02:19-05:00ReturnTs
Tax Period End2018-06-30TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1BKD LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1910 E ST LOUIS 200/PO BOX 1190AddressLine1Txt
CitySPRINGFIELDCityNm
State AbbreviationMOStateAbbreviationCd
ZIP658062523ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2017-07-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN010215227EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1RUMFORD HOSPITALBusinessNameLine1Txt
FieldValueIRS element (for citing)
In Care Of% DAVID THOMPSONInCareOfNm
Business Name ControlRUMFBusinessNameControlTxt
Phone2077952813PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1420 FRANKLIN STREETAddressLine1Txt
CityRUMFORDCityNm
State AbbreviationMEStateAbbreviationCd
ZIP04276ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonDAVID THOMPSONPersonNm
Person TitleTREASURERPersonTitleTxt
Phone2077952972PhoneNum
Signature2019-03-07SignatureDt
Discuss With Paid PreparerYes (true)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonBrian D ToddPreparerPersonNm
PTINP00422601PTIN
Phone4178658701PhoneNum

Filing Security Information FilingSecurityInformation

IP Address IPAddress

FieldValueIRS element (for citing)
I Pv4 Address167.68.126.162IPv4AddressTxt
FieldValueIRS element (for citing)
Federal Original Submission Id43032920191345000014FederalOriginalSubmissionId
Federal Original Submission Id2019-05-14FederalOriginalSubmissionIdDt
Filing License TypePFilingLicenseTypeCd
At Submission Creation Device Id353840E92A19E57AE3D09FB5FB5D869273682438AtSubmissionCreationDeviceId
At Submission Filing Device Id39CBA67CBDC84C24964593991C1F330368A3BFFEAtSubmissionFilingDeviceId
FieldValueIRS element (for citing)
Tax2017TaxYr
Build TS2019-02-21 02:37:17ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerPETER WRIGHTPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1420 FRANKLIN STREETAddressLine1Txt
CityRUMFORDCityNm
State AbbreviationMEStateAbbreviationCd
ZIP04276ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$45,356,583GrossReceiptsAmt
Group Return For AffiliatesfalseGroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.RUMFORDHOSPITAL.ORGWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1974FormationYr
Legal Domicile StateMELegalDomicileStateCd
Activity Or MissionRUMFORD HOSPITAL STRIVES TO PROVIDE EXCEPTIONAL HEALTHCARE SERVICES. THE HOSPITAL DEPENDS ON THE EXPERTISE COMMITMENT AND COMPASSION OF ITS CAREGIVERS TO FULFILL ITS MISSION.ActivityOrMissionDesc
Voting Members Governing Body9VotingMembersGoverningBodyCnt
Voting Members Independent8VotingMembersIndependentCnt
Total Employee362TotalEmployeeCnt
Total Volunteers50TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$19,410NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$105,414PYContributionsGrantsAmt
CY Contributions Grants$59,811CYContributionsGrantsAmt
PY Program Service Revenue$44,674,220PYProgramServiceRevenueAmt
CY Program Service Revenue$43,013,513CYProgramServiceRevenueAmt
PY Investment Income$133,419PYInvestmentIncomeAmt
CY Investment Income$253,740CYInvestmentIncomeAmt
PY Other Revenue-$25,201PYOtherRevenueAmt
CY Other Revenue-$15,151CYOtherRevenueAmt
PY Total Revenue$44,887,852PYTotalRevenueAmt
CY Total Revenue$43,311,913CYTotalRevenueAmt
PY Grants And Similar Paid$18,250PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$480CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$20,015,348PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$19,481,483CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$24,746,154PYOtherExpensesAmt
CY Other Expenses$25,171,593CYOtherExpensesAmt
PY Total Expenses$44,779,752PYTotalExpensesAmt
CY Total Expenses$44,653,556CYTotalExpensesAmt
PY Revenues Less Expenses$108,100PYRevenuesLessExpensesAmt
CY Revenues Less Expenses-$1,341,643CYRevenuesLessExpensesAmt
Total Assets BOY$28,508,468TotalAssetsBOYAmt
Total Assets EOY$26,983,973TotalAssetsEOYAmt
Total Liabilities BOY$10,206,701TotalLiabilitiesBOYAmt
Total Liabilities EOY$10,009,144TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$18,301,767NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$16,974,829NetAssetsOrFundBalancesEOYAmt
MissionTO PROVIDE EXCEPTIONAL HEALTHCARE SERVICES IN A SAFE AND TRUSTFUL ENVIRONMENT THROUGH THE EXPERTISE, COMMITMENT AND COMPASSION OF OUR FAMILY OF CAREGIVERS.MissionDesc
Significant New Program SrvcfalseSignificantNewProgramSrvcInd
Significant ChangefalseSignificantChangeInd
Expense$36,257,061ExpenseAmt
Grant$480GrantAmt
Revenue$43,013,513RevenueAmt
DescRUMFORD HOSPITAL IS A CRITICAL ACCESS HOSPITAL, PROVIDING COMPREHENSIVE PRIMARY CARE AND SOPHISTICATED DIAGNOSTIC SERVICES, INCLUDING CT SCANNING, ULTRASOUND AND NUCLEAR MEDICINE. THE HOSPITAL OFFERS MEDICAL SURGICAL NURSING SERVICES, A BIRTHING CENTER, WOMEN'S HEALTH SERVICES AND AMBULATORY SURGERY. THE SWING BED PROGRAM PROVIDES CARE FOR PATIENTS WHO NEED SKILLED NURSING SERVICES. RUMFORD HOSPITAL ALSO MAINTAINS A 24 HOUR EMERGENCY DEPARTMENT AND STAFFS AN INTENSIVE CARE UNIT.Desc
Total Program Service Expenses$36,257,061TotalProgramServiceExpensesAmt
Described In Section501c3Yes (true)DescribedInSection501c3Ind
Schedule B RequiredYes (true)ScheduleBRequiredInd
Political Campaign ActyfalsePoliticalCampaignActyInd
Lobbying ActivitiesYes (true)LobbyingActivitiesInd
Subject To Proxy TaxfalseSubjectToProxyTaxInd
Donor Advised FundfalseDonorAdvisedFundInd
Conservation EasementsfalseConservationEasementsInd
Collections Of ArtfalseCollectionsOfArtInd
Credit CounselingfalseCreditCounselingInd
Temp Or Permanent EndowmentsYes (true)TempOrPermanentEndowmentsInd
Report Land Building EquipmentYes (true)ReportLandBuildingEquipmentInd
Report Investments Other SecfalseReportInvestmentsOtherSecInd
Report Program Related InvstfalseReportProgramRelatedInvstInd
Report Other AssetsYes (true)ReportOtherAssetsInd
Report Other LiabilitiesYes (true)ReportOtherLiabilitiesInd
Include FIN48 FootnotefalseIncludeFIN48FootnoteInd
Independent Audit Fincl StmtfalseIndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (true)ConsolidatedAuditFinclStmtInd
School OperatingfalseSchoolOperatingInd
Foreign OfficefalseForeignOfficeInd
Foreign ActivitiesfalseForeignActivitiesInd
More Than5000 K To OrgfalseMoreThan5000KToOrgInd
More Than5000 K To IndividualsfalseMoreThan5000KToIndividualsInd
Professional FundraisingfalseProfessionalFundraisingInd
Fundraising ActivitiesfalseFundraisingActivitiesInd
Gaming ActivitiesfalseGamingActivitiesInd
Operate HospitalYes (true)OperateHospitalInd
Audited Financial Stmt AttYes (true)AuditedFinancialStmtAttInd
Grants To OrganizationsfalseGrantsToOrganizationsInd
Grants To IndividualsfalseGrantsToIndividualsInd
Schedule J RequiredYes (true)ScheduleJRequiredInd
Tax Exempt BondsfalseTaxExemptBondsInd
Engaged In Excess Benefit TransfalseEngagedInExcessBenefitTransInd
PY Excess Benefit TransfalsePYExcessBenefitTransInd
Loan OutstandingfalseLoanOutstandingInd
Grant To Related PersonfalseGrantToRelatedPersonInd
Business Rln With Org MemfalseBusinessRlnWithOrgMemInd
Business Rln With Fam MemfalseBusinessRlnWithFamMemInd
Business Rln With Officer EntfalseBusinessRlnWithOfficerEntInd
Deductible Non Cash ContrifalseDeductibleNonCashContriInd
Deductible Art ContributionfalseDeductibleArtContributionInd
Terminate OperationsfalseTerminateOperationsInd
Partial LiquidationfalsePartialLiquidationInd
Disregarded EntityfalseDisregardedEntityInd
Related EntityYes (true)RelatedEntityInd
Related Organization Ctrl EntfalseRelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd OrgfalseTrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted PrtshpfalseActivitiesConductedPrtshpInd
Schedule O RequiredYes (true)ScheduleORequiredInd
Info In Schedule O Part VYes (X)InfoInScheduleOPartVInd
IRP Document29IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (true)BackupWthldComplianceInd
Employee362EmployeeCnt
Employment Tax Returns FiledYes (true)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over LimitfalseUnrelatedBusIncmOverLimitInd
Foreign Financial AccountfalseForeignFinancialAccountInd
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTransInd
Taxable Party NotificationfalseTaxablePartyNotificationInd
Nondeductible ContributionsfalseNondeductibleContributionsInd
Quid Pro Quo ContributionsfalseQuidProQuoContributionsInd
Form8282 Property Disposed OffalseForm8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft CntrctfalseRcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft CntrctfalsePayPremiumsPrsnlBnftCntrctInd
Indoor Tanning ServicesfalseIndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members9GoverningBodyVotingMembersCnt
Independent Voting Member8IndependentVotingMemberCnt
Family Or Business RlnYes (true)FamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesfalseDelegationOfMgmtDutiesInd
Change To Org DocumentsYes (true)ChangeToOrgDocumentsInd
Material Diversion Or MisusefalseMaterialDiversionOrMisuseInd
Members Or StockholdersYes (true)MembersOrStockholdersInd
Election Of Board MembersYes (true)ElectionOfBoardMembersInd
Decisions Subject To ApprovaYes (true)DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (true)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (true)MinutesOfCommitteesInd
Officer Mailing AddressfalseOfficerMailingAddressInd
Local ChaptersfalseLocalChaptersInd
Form990 Provided To Gvrn BodyYes (true)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (true)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (true)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (true)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (true)WhistleblowerPolicyInd
Document Retention PolicyYes (true)DocumentRetentionPolicyInd
Compensation Process CEOfalseCompensationProcessCEOInd
Compensation Process OtherfalseCompensationProcessOtherInd
Investment In Joint VenturefalseInvestmentInJointVentureInd
States Where Copy Of Return Is FldMEStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

FieldValueIRS element (for citing)
PersonDAVID THOMPSONPersonNm
Phone2077952813PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1300 MAIN STREETAddressLine1Txt
CityLEWISTONCityNm
State AbbreviationMEStateAbbreviationCd
ZIP04240ZIPCd
FieldValueIRS element (for citing)
Info In Schedule O Part VIIYes (X)InfoInScheduleOPartVIIInd

Form990 Part VII Section A Form990PartVIISectionAGrp (26 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtKey EmployeeKeyEmployeeIndHighest Compensated EmployeeHighestCompensatedEmployeeIndFormer Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd
JOLAN IPPOLITO
CHAIR END 01/18; DIRECTOR1.03.0Yes (X)Yes (X)$0$0$0
ROGER ARSENAULT
DIRECTOR END 01/181.00.0Yes (X)$0$0$0
RICHARD LOVEJOY
SECRETARY END 01/181.01.0Yes (X)Yes (X)$0$0$0
LINDA CAMERON OD
VICE CHAIR/DIRECTOR END 01/181.00.0Yes (X)Yes (X)$0$0$0
DAVID DUGUAY
DIRECTOR END 01/181.00.0Yes (X)$0$0$0
JANET HALL
DIRECTOR1.03.0Yes (X)$0$0$0
JERROLD COHEN
DIRECTOR END 01/181.00.0Yes (X)$0$0$0
THOMAS PUIIA
DIRECTOR END 01/181.00.0Yes (X)$0$0$0
JEFF BRICKMAN
DIRECTOR END 01/18; PRESIDENT1.061.0Yes (X)Yes (X)$0$866,848$114,974
MARK ADAMS
DIRECTOR/VICE CHAIR BEG 01/181.05.0Yes (X)Yes (X)$0$0$0
AUSTIN ALBERT
DIRECTOR BEG 01/181.03.0Yes (X)$0$0$0
DEBORAH DUNLAP AVASTHI
DIRECTOR/CHAIRPERSON BEG 01/181.03.0Yes (X)Yes (X)$0$0$0
DOUGLAS M BOYD
DIRECTOR BEG 01/181.03.0Yes (X)$0$0$0
WILLIAM LEE MD
DIRECTOR BEG 01/18; PHYSICIAN1.057.0Yes (X)$0$324,839$45,326
PHILLIP LIBBY
DIRECTOR BEG 01/181.03.0Yes (X)$0$0$0
CRAIG TRIBUNO
DIRECTOR BEG 01/181.03.0Yes (X)$0$0$0
R DAVID FRUM
PRESIDENT27.529.5Yes (X)$0$434,019$72,252
DAVID THOMPSON
TREASURER1.061.0Yes (X)$0$497,762$58,116
HOLLI BOCCELLI
SECRETARY BEG 01/181.057.0Yes (X)$0$130,845$0
DIETER KRECKEL
PHYSICIAN CHIEF45.00.0$246,783$0$9,946Yes (X)
THOMAS DELUCA
PHYSICIAN45.00.0$340,226$0$46,122Yes (X)
JACOB LEDESMA
PHYSICIAN45.00.0$458,738$0$30,122Yes (X)
JEFFREY LYNDS
PHYSICIAN45.00.0$378,235$0$21,497Yes (X)
STEPHANIE SINCLAIR
PHYSICIAN45.00.0$338,462$0$26,046Yes (X)
SAID DAOUD
PHYSICIAN45.00.0$353,511$0$26,886Yes (X)
PHILIPPE MORISSETTE
FORMER TREASURER/VICE PRES.0.055.0$0$229,117$51,773Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$2,115,955TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$2,483,430TotReportableCompRltdOrgAmt
Total Other Compensation$503,060TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K20IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedYes (true)FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (true)TotalCompGreaterThan150KInd
Compensation From Other SrcsfalseCompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
SODEXO CLINICAL TECHNOLOGY
7100 COMMERCE WAY 280NASHVILLETN37241MAINTENANCE$275,639
SODEXO INC
525 WILLIAM PENN PLPITTSBURGHPA152516170SUPPORT SERVICES$179,362
CHG COMPANIES INC
5003 SOUTH MIAMI BLVD SUITE 400DURHAMNC27703MEDICAL STAFFING$134,770
INSIGHT HEALTH CORP
26250 ENTERPRISE COURT SUITE 100LAKE FORESTCA92630MEDICAL IMAGING$277,977
X RAY PROFESSIONAL ASSOCIATION
300 MAIN STREETLEWISTONME04240MEDICAL IMAGING$121,290
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K6CntrctRcvdGreaterThan100KCnt
Related Organizations$6,789RelatedOrganizationsAmt
Government Grants$13,795GovernmentGrantsAmt
All Other Contributions$39,227AllOtherContributionsAmt
Total Contributions$59,811TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (3 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
NET PATIENT SERVICE REVENUE900099$41,041,186$41,041,186
CAFETERIA REVENUE722514$77,402$77,402
OTHER REVENUE900099$1,894,925$1,894,925
FieldValueIRS element (for citing)
Total Program Service Revenue$43,013,513TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$118,652TotalRevenueColumnAmt
Exclusion$118,652ExclusionAmt

Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Royalties Revenue RoyaltiesRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Gross Rents GrossRentsGrp

FieldValueIRS element (for citing)
Real$11,086RealAmt

Less Rental Expenses LessRentalExpensesGrp

FieldValueIRS element (for citing)
Real$26,237RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real-$15,151RealAmt
Personal$0PersonalAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column-$15,151TotalRevenueColumnAmt
Exclusion-$15,151ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Securities$2,153,521SecuritiesAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Securities$1,967,231SecuritiesAmt
Other$51,202OtherAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities$186,290SecuritiesAmt
Other-$51,202OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$135,088TotalRevenueColumnAmt
Exclusion$135,088ExclusionAmt
FieldValueIRS element (for citing)
Fundraising Gross Income$0FundraisingGrossIncomeAmt
Fundraising Direct Expenses$0FundraisingDirectExpensesAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt
FieldValueIRS element (for citing)
Gaming Gross Income$0GamingGrossIncomeAmt
Gaming Direct Expenses$0GamingDirectExpensesAmt

Net Income From Gaming NetIncomeFromGamingGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt
FieldValueIRS element (for citing)
Gross Sales Of Inventory$0GrossSalesOfInventoryAmt
Cost Of Goods Sold$0CostOfGoodsSoldAmt

Net Income Or Loss NetIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt
FieldValueIRS element (for citing)
Other Revenue Total$0OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$43,311,913TotalRevenueColumnAmt
Related Or Exempt Func Income$43,013,513RelatedOrExemptFuncIncomeAmt
Exclusion$238,589ExclusionAmt
FieldValueIRS element (for citing)
Info In Schedule O Part IXYes (X)InfoInScheduleOPartIXInd

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$480TotalAmt
Program Services$480ProgramServicesAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Foreign Grants ForeignGrantsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Benefits To Members BenefitsToMembersGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$256,729TotalAmt
Program Services$256,729ProgramServicesAmt

Comp Disqual Persons CompDisqualPersonsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$15,668,574TotalAmt
Program Services$11,955,362ProgramServicesAmt
Management And General$3,713,212ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$343,081TotalAmt
Program Services$263,037ProgramServicesAmt
Management And General$80,044ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$2,187,331TotalAmt
Program Services$1,674,684ProgramServicesAmt
Management And General$512,647ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$1,025,768TotalAmt
Program Services$786,446ProgramServicesAmt
Management And General$239,322ManagementAndGeneralAmt

Fees For Services Management FeesForServicesManagementGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$1,005TotalAmt
Management And General$1,005ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$14,438TotalAmt
Management And General$14,438ManagementAndGeneralAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

FieldValueIRS element (for citing)
Total$9,364TotalAmt
Management And General$9,364ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$8,727,478TotalAmt
Program Services$6,691,270ProgramServicesAmt
Management And General$2,036,208ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$3,012TotalAmt
Program Services$2,309ProgramServicesAmt
Management And General$703ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$2,484,711TotalAmt
Program Services$1,905,890ProgramServicesAmt
Management And General$578,821ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$596,485TotalAmt
Program Services$457,319ProgramServicesAmt
Management And General$139,166ManagementAndGeneralAmt

Royalties RoyaltiesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$925,556TotalAmt
Program Services$709,615ProgramServicesAmt
Management And General$215,941ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$108,825TotalAmt
Program Services$83,435ProgramServicesAmt
Management And General$25,390ManagementAndGeneralAmt

Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$17,658TotalAmt
Program Services$13,538ProgramServicesAmt
Management And General$4,120ManagementAndGeneralAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$42,127TotalAmt
Program Services$32,298ProgramServicesAmt
Management And General$9,829ManagementAndGeneralAmt

Payments To Affiliates PaymentsToAffiliatesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$1,753,502TotalAmt
Program Services$1,344,392ProgramServicesAmt
Management And General$409,110ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$1,247,723TotalAmt
Program Services$956,617ProgramServicesAmt
Management And General$291,106ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
MEDICAL SUPPLIES & DRUGS$4,676,119$4,676,119
BAD DEBT$4,066,104$4,066,104
REPAIRS & MAINTENANCE$396,433$303,941$92,492
LICENSES, DUES, SUBSCRIPTIONS$78,846$60,450$18,396

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$22,207TotalAmt
Program Services$17,026ProgramServicesAmt
Management And General$5,181ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$44,653,556TotalAmt
Program Services$36,257,061ProgramServicesAmt
Management And General$8,396,495ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$25,619BOYAmt
EOY$26,547EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$2,259,310BOYAmt
EOY$2,280,964EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$4,157,450BOYAmt
EOY$3,846,115EOYAmt

Receivables From Officers Etc ReceivablesFromOfficersEtcGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$434,404BOYAmt
EOY$559,047EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$76,280BOYAmt
EOY$49,181EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$36,502,190LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$24,288,426LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$12,412,713BOYAmt
EOY$12,213,764EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$6,076,045BOYAmt
EOY$4,169,100EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Intangible Assets IntangibleAssetsGrp

FieldValueIRS element (for citing)
BOY$492,423BOYAmt
EOY$394,546EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$2,574,224BOYAmt
EOY$3,444,709EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$28,508,468BOYAmt
EOY$26,983,973EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$9,227,462BOYAmt
EOY$8,234,228EOYAmt

Grants Payable GrantsPayableGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
BOY$32,667BOYAmt
EOY$33,926EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Escrow Account Liability EscrowAccountLiabilityGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Loans From Officers Directors LoansFromOfficersDirectorsGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$946,572BOYAmt
EOY$884,735EOYAmt

Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$856,255EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$10,206,701BOYAmt
EOY$10,009,144EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$17,726,024BOYAmt
EOY$16,388,636EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$321,715BOYAmt
EOY$331,071EOYAmt

Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$254,028BOYAmt
EOY$255,122EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$18,301,767BOYAmt
EOY$16,974,829EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$28,508,468BOYAmt
EOY$26,983,973EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss-$1,341,643ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst$13,605NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets$1,100OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or ReviewfalseAccountantCompileOrReviewInd
FS AuditedYes (true)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Consolidated Basis Fincl StmtYes (X)ConsolidatedBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (true)AuditCommitteeInd
Federal Grant Audit RequiredfalseFederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
HospitalYes (X)HospitalInd

Schedule B IRS990ScheduleB

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Total Grassroots LobbyingTotalGrassrootsLobbyingGrp
Total Direct LobbyingTotalDirectLobbyingGrp
Total Lobbying ExpendTotalLobbyingExpendGrp
Other Exempt Purpose ExpendOtherExemptPurposeExpendGrp
Total Exempt Purpose ExpendTotalExemptPurposeExpendGrp
Lobbying Nontaxable AmountLobbyingNontaxableAmountGrp
Grassroots NontaxableGrassrootsNontaxableGrp
Tot Lbbyng Grassroot Mns Non TxTotLbbyngGrassrootMnsNonTxGrp
Tot Lbby Expend Mns Lbbyng Non TxTotLbbyExpendMnsLbbyngNonTxGrp
VolunteersfalseVolunteersInd
Paid Staff Or ManagementfalsePaidStaffOrManagementInd
Media AdvertisementsfalseMediaAdvertisementsInd
Mailings MembersfalseMailingsMembersInd
Publications Or BroadcastfalsePublicationsOrBroadcastInd
Grants Other OrganizationsfalseGrantsOtherOrganizationsInd
Direct Contact LegislatorsfalseDirectContactLegislatorsInd
Rallies DemonstrationsfalseRalliesDemonstrationsInd
Other ActivitiesYes (true)OtherActivitiesInd
Other Activities$8,451OtherActivitiesAmt
Total Lobbying Expenditures$8,451TotalLobbyingExpendituresAmt
Not Described Section501c3falseNotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceSCHEDULE C, PART II-B, LINE 1IFormAndLineReferenceDesc
ExplanationLOBBYING EXPENSES: PORTION OF DUES FOR PROFESSIONAL ASSOCIATIONS ATTRIBUTED TO LOBBYING EXPENSES - $8,451.ExplanationTxt

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Art Public Exhibition AmountsArtPublicExhibitionAmountsGrp
Held Works ArtHeldWorksArtGrp

CY Endwmt Fund CYEndwmtFundGrp

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

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

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

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

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

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

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

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$491,674BeginningYearBalanceAmt
Contributions$9,235ContributionsAmt
Investment Earnings Or Losses$3,518InvestmentEarningsOrLossesAmt
Other Expenditures$200OtherExpendituresAmt
End Year Balance$504,227EndYearBalanceAmt
FieldValueIRS element (for citing)
Prmnnt Endowment Balance EOY0.43520PrmnntEndowmentBalanceEOYPct
Term Endowment Balance EOY0.56480TermEndowmentBalanceEOYPct
Endowments Held Unrelated OrgfalseEndowmentsHeldUnrelatedOrgInd
Endowments Held Related OrgYes (true)EndowmentsHeldRelatedOrgInd
Related Org List Sch RYes (true)RelatedOrgListSchRInd

Land LandGrp

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

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$15,018,411OtherCostOrOtherBasisAmt
Depreciation$7,985,772DepreciationAmt
Book Value$7,032,639BookValueAmt
FieldValueIRS element (for citing)
Leasehold ImprovementsLeaseholdImprovementsGrp

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$20,977,656OtherCostOrOtherBasisAmt
Depreciation$15,994,952DepreciationAmt
Book Value$4,982,704BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$416,975OtherCostOrOtherBasisAmt
Depreciation$307,702DepreciationAmt
Book Value$109,273BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$12,213,764TotalBookValueLandBuildingsAmt

Other Assets Org OtherAssetsOrgGrp (4 entries)

DescDescBook ValueBookValueAmt
EST AMT DUE FROM THIRD PARTIES$2,883,631
INVESTMENT IN CHARITABLE TRUST$65,674
OTHER RECEIVABLES$494,504
DEPOSITS$900
FieldValueIRS element (for citing)
Total Book Value Other Assets$3,444,709TotalBookValueOtherAssetsAmt
Federal Income Tax Liability$0FederalIncomeTaxLiabilityAmt

Other Liabilities Org OtherLiabilitiesOrgGrp

FieldValueIRS element (for citing)
DescDUE TO AFFILIATESDesc
Amt$856,255Amt
FieldValueIRS element (for citing)
Total Liability$856,255TotalLiabilityAmt

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
SCHEDULE D, PART V, LINE 4ENDOWMENT FUNDS: ENDOWMENT FUNDS ARE USED TO SUPPORT THE ORGANIZATION IN A VARIETY OF WAYS, DEPENDING UPON THE STATED PURPOSE OF EACH FUND. MANY OF THESE FUNDS HELP TO COVER COSTS OF CAPITAL EQUIPMENT PURCHASES, CONTINUING EDUCATION, OR FREE CARE. OTHER ARE DESIGNATED TO SUPPORT SPECIFIC DEPARTMENTS OF THE HOSPITAL.
SCHEDULE D, PART X, LINE 2UNCERTAIN TAX POSITION: MANAGEMENT HAS EVALUATED THEIR INCOME TAX POSITIONS UNDER THE GUIDANCE INCLUDED IN ASC 740. BASED ON THEIR REVIEW, MANAGEMENT HAS NOT IDENTIFIED ANY MATERIAL UNCERTAIN TAX POSITIONS TO BE RECORDED OR DISCLOSED IN THE FINANCIAL STATEMENTS.

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Financial Assistance PolicyYes (true)FinancialAssistancePolicyInd
Written PolicyYes (true)WrittenPolicyInd
All Hospitals PolicyYes (X)AllHospitalsPolicyInd
FPG Reference Free CareYes (true)FPGReferenceFreeCareInd
Percent200Yes (X)Percent200Ind
FPG Reference Discounted CarefalseFPGReferenceDiscountedCareInd
Free Care Medically IndigentYes (true)FreeCareMedicallyIndigentInd
Financial Assistance BudgetYes (true)FinancialAssistanceBudgetInd
Expenses Exceed BudgetfalseExpensesExceedBudgetInd
Annual Community Bnft ReportfalseAnnualCommunityBnftReportInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$504,315TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$504,315NetCommunityBenefitExpnsAmt
Total Expense0.01240TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$10,172,999TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$7,848,329DirectOffsettingRevenueAmt
Net Community Benefit Expns$2,324,670NetCommunityBenefitExpnsAmt
Total Expense0.05730TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$10,677,314TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$7,848,329DirectOffsettingRevenueAmt
Net Community Benefit Expns$2,828,985NetCommunityBenefitExpnsAmt
Total Expense0.06970TotalExpensePct

Cash And In Kind Contributions CashAndInKindContributionsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$695TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$695NetCommunityBenefitExpnsAmt

Total Other Benefits TotalOtherBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$695TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$695NetCommunityBenefitExpnsAmt

Total Community Benefits TotalCommunityBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$10,678,009TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$7,848,329DirectOffsettingRevenueAmt
Net Community Benefit Expns$2,829,680NetCommunityBenefitExpnsAmt
Total Expense0.06970TotalExpensePct
FieldValueIRS element (for citing)
Bad Debt Expense ReportedfalseBadDebtExpenseReportedInd
Bad Debt Expense$4,066,104BadDebtExpenseAmt
Bad Debt Expense Attributable$628,765BadDebtExpenseAttributableAmt
Reimbursed By Medicare$13,192,813ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr$12,809,655CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall$383,158MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

FieldValueIRS element (for citing)
Cost To Charge RatioYes (X)CostToChargeRatioInd
FieldValueIRS element (for citing)
Written Debt Collection PolicyYes (true)WrittenDebtCollectionPolicyInd
Financial Assistance PrvsnYes (true)FinancialAssistancePrvsnInd
Hospital Facilities1HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp

FieldValueIRS element (for citing)
Facility1FacilityNum

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1RUMFORD HOSPITALBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1420 FRANKLIN STREETAddressLine1Txt
CityRUMFORDCityNm
State AbbreviationMEStateAbbreviationCd
ZIP04276ZIPCd
FieldValueIRS element (for citing)
Website AddressWWW.RUMFORDHOSPITAL.ORGWebsiteAddressTxt
State License38727StateLicenseNum
Licensed HospitalYes (X)LicensedHospitalInd
General Medical And SurgicalYes (X)GeneralMedicalAndSurgicalInd
Critical Access HospitalYes (X)CriticalAccessHospitalInd
Emergency Room24 HrsYes (X)EmergencyRoom24HrsInd
OtherOUTPATIENT PHYSICIAN CLINICSOtherDesc
Facility Reporting Group1FacilityReportingGroupCd

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1RUMFORD HOSPITALBusinessNameLine1Txt
FieldValueIRS element (for citing)
Facility1FacilityNum
First Licensed CY Or PYfalseFirstLicensedCYOrPYInd
Tax Exempt Hospital CY Or PYfalseTaxExemptHospitalCYOrPYInd
CHNA ConductedYes (true)CHNAConductedInd
Community DefinitionYes (X)CommunityDefinitionInd
Community DemographicsYes (X)CommunityDemographicsInd
Existing ResourcesYes (X)ExistingResourcesInd
How Data ObtainedYes (X)HowDataObtainedInd
Community Health NeedsYes (X)CommunityHealthNeedsInd
Other Health IssuesYes (X)OtherHealthIssuesInd
Community Hlth Needs Id ProcessYes (X)CommunityHlthNeedsIdProcessInd
Consulting ProcessYes (X)ConsultingProcessInd
Prior CHNA ImpactYes (X)PriorCHNAImpactInd
CHNA Conducted15CHNAConductedYr
Take Into Account Others InputYes (true)TakeIntoAccountOthersInputInd
CHNA Conducted With Other FcltsYes (true)CHNAConductedWithOtherFcltsInd
CHNA Conducted With Non FcltsYes (true)CHNAConductedWithNonFcltsInd
CHNA Report Widely AvailableYes (true)CHNAReportWidelyAvailableInd
Rpt Available On Own WebsiteYes (X)RptAvailableOnOwnWebsiteInd
Own Website URLSEE PART V, SECTION COwnWebsiteURLTxt
Other WebsiteYes (X)OtherWebsiteInd
Other Website URLWWW.MAINE.GOV/SHNAPP/OtherWebsiteURLTxt
Paper Copy Public InspectionYes (X)PaperCopyPublicInspectionInd
Implementation Strategy AdoptYes (true)ImplementationStrategyAdoptInd
Implementation Strategy Adpt15ImplementationStrategyAdptYr
Strategy Posted WebsiteYes (true)StrategyPostedWebsiteInd
Strategy Website URLSEE PART V, SECTION CStrategyWebsiteURLTxt
Organization Incur Excise TaxfalseOrganizationIncurExciseTaxInd
Elig Criteria ExplainedYes (true)EligCriteriaExplainedInd
FPG Family Incm Lmt Free DscntYes (X)FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care200.FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care0.FPGFamilyIncmLmtDscntCarePct
Medical Indigency CriteriaYes (X)MedicalIndigencyCriteriaInd
Insurance Status CriteriaYes (X)InsuranceStatusCriteriaInd
Other CriteriaYes (X)OtherCriteriaInd
Explained BasisYes (true)ExplainedBasisInd
App Financial Asst ExplnYes (true)AppFinancialAsstExplnInd
Described InfoYes (X)DescribedInfoInd
Described Suprt DocYes (X)DescribedSuprtDocInd
Provided Hospital ContactYes (X)ProvidedHospitalContactInd
Includes Publicity MeasuresYes (true)IncludesPublicityMeasuresInd
FAP Available On WebsiteYes (X)FAPAvailableOnWebsiteInd
FAP Available On Website URLSEE PART V, SECTION CFAPAvailableOnWebsiteURLTxt
FAP App Available On WebsiteYes (X)FAPAppAvailableOnWebsiteInd
FAP App Available On Website URLSEE PART V, SECTION CFAPAppAvailableOnWebsiteURLTxt
FAP Summary On WebsiteYes (X)FAPSummaryOnWebsiteInd
FAP Summary On Website URLSEE PART V, SECTION CFAPSummaryOnWebsiteURLTxt
FAP Avlbl On Request No ChargeYes (X)FAPAvlblOnRequestNoChargeInd
FAP App Avlbl On Request No ChrgYes (X)FAPAppAvlblOnRequestNoChrgInd
FAP Sum Avlbl On Request No ChrgYes (X)FAPSumAvlblOnRequestNoChrgInd
Notified FAP Copy Bill DisplayYes (X)NotifiedFAPCopyBillDisplayInd
Communtity Notified FAPYes (X)CommuntityNotifiedFAPInd
FAP Actions On NonpaymentYes (true)FAPActionsOnNonpaymentInd
Permit No ActionsYes (X)PermitNoActionsInd
Collection ActivitiesfalseCollectionActivitiesInd
Provided Written NoticeYes (X)ProvidedWrittenNoticeInd
Made Effort Orally NotifyYes (X)MadeEffortOrallyNotifyInd
Processed FAP ApplicationYes (X)ProcessedFAPApplicationInd
Nondis Emergency Care PolicyYes (true)NondisEmergencyCarePolicyInd
Look Back MedicareYes (X)LookBackMedicareInd
Amounts Generally BilledfalseAmountsGenerallyBilledInd
Gross ChargesfalseGrossChargesInd

Supplemental Information SupplementalInformationGrp (9 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
SCHEDULE H, PART V, SECTION B, LINE 5COMMUNITY INPUT: QUALITATIVE DATA WERE COLLECTED THROUGH A STATEWIDE STAKEHOLDER SURVEY CONDUCTED IN MAY AND JUNE 2015 WITH 1,639 PEOPLE REPRESENTING MORE THAN 80 ORGANIZATIONS AND BUSINESSES IN MAINE. THE SURVEY WAS DEVELOPED USING A COLLABORATIVE PROCESS THAT INCLUDED MAINE SHNAPP PARTNERS, MARKET DECISIONS RESEARCH AND HART CONSULTING, AND A NUMBER OF OTHER STAKEHOLDERS AND HEALTH EXPERTS. IN OXFORD COUNTY, A TOTAL OF 61 STAKEHOLDERS RESPONDED TO THE SURVEY. THE OBJECTIVE OF THE SURVEY WAS TO PRODUCE QUALITATIVE DATA OF THE OPINIONS OF HEALTH PROFESSIONALS AND COMMUNITY STAKEHOLDERS ON THE HEALTH ISSUES AND NEEDS OF COMMUNITIES ACROSS THE STATE. GIVEN THIS PURPOSE, THE SURVEY USED A SNOWBALL SAMPLING APPROACH BY INVITING LEADERS OF MEMBER ORGANIZATIONS AND AGENCIES TO INVITE THEIR MEMBERS AND EMPLOYEES TO PARTICIPATE. A CONCERTED EFFORT WAS MADE TO RECRUIT PARTICIPANTS FROM A NUMBER OF DIFFERENT INDUSTRIES AND BACKGROUNDS ACROSS ALL COMMUNITIES IN THE STATE. SURVEY RESPONDENTS REPRESENTED PUBLIC HEALTH AND HEALTH CARE ORGANIZATIONS AS WELL AS BEHAVIORAL HEALTH, BUSINESS, MUNICIPALITIES, EDUCATION, PUBLIC SAFETY, AND NONGOVERNMENTAL ORGANIZATIONS. MORE THAN 80 ORGANIZATIONS AGREED TO SEND THE SURVEY TO THEIR MEMBERS OR STAKEHOLDERS. THE ONLINE SURVEY WAS APPROXIMATELY 25 MINUTES IN LENGTH AND CONTAINED A NUMBER OF QUESTIONS ABOUT IMPORTANT HEALTH ISSUES AND DETERMINANTS IN THE STATE, INCLUDING A RATING OF MOST CRITICAL ISSUES, THE ABILITY OF MAINE'S HEALTH SYSTEM (INCLUDING PUBLIC HEALTH) TO RESPOND TO ISSUES, AVAILABILITY OF RESOURCES AND ASSETS TO ADDRESS SPECIFIC HEALTH ISSUES, IMPACT ON DISPARATE POPULATIONS, AND IDENTIFICATION OF THE ENTITIES PRIMARILY RESPONSIBLE FOR ADDRESSING ISSUES AND DETERMINANTS. THE SURVEY ASKED ALL RESPONDENTS A BASIC SET OF QUESTIONS TO RATE THE IMPORTANCE OF HEALTH ISSUES AND IMPACT OF HEALTH FACTORS. IT THEN ALLOWED RESPONDENTS TO PROVIDE ANSWERS TO PROBING QUESTIONS ON THE THREE ISSUES AND FACTORS THAT THEY WERE MOST INTERESTED IN OR HAD THE MOST KNOWLEDGE ABOUT. RESPONDENTS PROVIDED OVER 12,000 OPEN-ENDED COMMENTS TO THESE IN-DEPTH PROBING QUESTIONS IN THE SURVEY. THE MARKET DECISIONS RESEARCH/HART CONSULTING TEAM REVIEWED, CODED, AND CLEANED ALL OPEN-ENDED COMMENTS FOR SIMILAR AND RECURRENT THEMES. NOT ALL RESPONDENTS SHARED COMMENTS FOR THE PROBING QUESTIONS.
SCHEDULE H, PART V, SECTION B, LINE 6AHOSPITAL FACILITIES: THE CHNA WAS CONDUCTED WITH EASTERN MAINE HEALTHCARE SYSTEMS AND MAINE GENERAL MEDICAL CENTER.
SCHEDULE H, PART V, SECTION B, LINE 6BNON-HOSPITAL FACILITIES: THE CHNA WAS ALSO CONDUCTED WITH MAINE HEALTH AND MAINE CENTER FOR DISEASE CONTROL AND PREVENTION.
SCHEDULE H, PART V, SECTION B, LINE 7AHOSPITAL FACILITY'S WEBSITE: https://www.cmhc.org/rumford-hospital/about-us/community-benefits
SCHEDULE H, PART V, SECTION B, LINE 10AIMPLEMENTATION STRATEGY WEBSITE: https://www.cmhc.org/rumford-hospital/about-us/community-benefits
SCHEDULE H, PART V, SECTION B, LINE 11ADDRESSING IDENTIFIED NEEDS: IN SUPPORT OF THE 2015 MAINE SHARED HEALTH NEEDS ASSESSMENT AND PLANNING PROCESS PROJECT, RUMFORD HOSPITAL ENGAGED IN AN ASSESSMENT OF THE HEALTH NEEDS OF OXFORD COUNTY. RUMFORD HOSPITAL'S GOAL IS TO RESPOND TO IDENTIFIED COMMUNITY HEALTH NEEDS, PROVIDE ACCESS AND IMPROVE HEALTH STATUS FOR ALL CITIZENS; ESPECIALLY THE VULNERABLE AND UNDERSERVED, AND BE A LEADING INSTITUTION OF IMPROVED HEALTH FOR THE COMMUNITIES WE SERVE. COMMUNITY FORUMS WERE HELD WITH CITIZENS OF OXFORD COUNTY ATTENDING A VARIETY OF FOCUS GROUPS TO DISCUSS THE CURRENT AND FUTURE HEALTH NEEDS IN OUR REGION. INPUT PROVIDED DURING THE DISCUSSION GROUPS WAS SUMMARIZED INTO THREE COMMUNITY HEALTH CONCERNS THAT HAVE BECOME RUMFORD HOSPITAL'S IMPLEMENTATION STRATEGY. - SUBSTANCE ABUSE: COMMUNITY OUTREACH, EDUCATIONAL SESSIONS, AND LOCAL DRUG/ALCOHOL COALITION INVOLVEMENT - MENTAL HEALTH: (FREE) EDUCATIONAL SESSIONS AND MENTAL HEALTH AWARENESS - HUNGER: EDUCATION ON HEALTHY EATING; WORKING WITH AGENCIES PRODUCING FOOD AVAILABILITY INCREASING HEALTH TO THE COMMUNITY WE SERVE. A LOCAL COMMUNITY STAKEHOLDER GROUP WORKED TOGETHER TO ANALYZE THE RESULTS FROM THE ONEMAINE CHNA FOR THE OXFORD COUNTY COMMUNITY WITH THE HEALTH CARE INDICATORS OF CONCERN BRIDGED WITH HEALTH 2020, SUPPORTING THE DEVELOPMENT OF THE RUMFORD HOSPITAL'S COMMUNITY BENEFIT IMPLEMENTATION PLAN. THE IMPLEMENTATION STRATEGY HAS BEEN ADJUSTED FOR FISCAL YEAR 6/30/2018. ADDRESSING FOOD INSECURITY THROUGH THE HUNGER VITAL SIGNS PROGRAM: TO ADDRESS FOOD INSECURITY, IDENTIFIED AS A TOP COMMUNITY HEALTH NEED IN THE PREVIOUS COMMUNITY HEALTH NEEDS ASSESSMENT, RUMFORD HOSPITAL LAUNCHED A PILOT PROGRAM WITH MAINES LEADING FOOD INSECURITY ORGANIZATION, GOOD SHEPHERD FOOD BANK. THE PILOT PROGRAM, CALLED HUNGER VITAL SIGNS, UTILIZES A TWO QUESTION INPATIENT SCREENING TO IDENTIFY PATIENTS WITHOUT ADEQUATE FOOD. PATIENTS NEEDING FOOD ASSISTANCE ARE PROVIDED REFERRALS TO LOCAL FOOD PANTRIES AND A BAG OF SHELF STABLE HEALTHY FOODS UPON HOSPITAL DISCHARGE. DURING THE PILOT PROGRAM, 696 FOOD INSECURITY SCREENINGS WERE CONDUCTED, 58 OR 8% OF PATIENTS IDENTIFIED AS FOOD INSECURE. 47 PATIENTS WERE PROVIDED A COMMUNITY FOOD RESOURCE HANDOUT AND A BAG OF FOOD. IN TOTAL, 750 POUNDS OF HEALTHY FOOD ITEMS WERE DISTRIBUTED. THE PILOT WAS SO SUCCESSFUL THAT IT CONTINUES INTO FY19. COMMUNITY HEALTH NEEDS ASSESSMENT PLANNING: DURING FY2018, RUMFORD HOSPITAL STAFF PARTICIPATED IN PLANNING FOR THE COMMUNITY HEALTH NEEDS ASSESSMENT PROCESS. RUMFORD HOSPITAL PARTICIPATES IN A COMMUNITY HEALTH NEEDS ASSESSMENT COLLABORATIVE CALLED THE MAINE SHARED CHNA WITH ALL OTHER MAINE HOSPITAL SYSTEMS AND THE STATE HEALTH DEPARTMENT. PLANNING INCLUDED HIRING A STATEWIDE CHNA COORDINATOR, IDENTIFYING WHICH QUANTITATIVE INDICATORS WOULD BE REPORTED AND PLANNING FOR QUALITATIVE DATA COLLECTION ACROSS THE STATE. OTHER COMMUNITY BENEFIT SUPPORT SERVICES: IN FY18, RUMFORD HOSPITAL PROVIDED A NUMBER OF SUPPORT SERVICES FOR THE COMMUNITY SUCH AS ADVANCE CARE PLANNING EDUCATION AND OPPORTUNITIES TO WALK WITH A DOC.
SCHEDULE H, PART V, SECTION B, LINE 13HFAP 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 V, SECTION B, LINES 16A, 16B, & 16CMEASURES TO PUBLICIZE THE POLICY: https://www.cmhc.org/billing-and-financial-information/
SCHEDULE H, PART V, LINE 16ILEP TRANSLATIONS: THERE ARE NO GROUPS WITH LIMITED ENGLISH PROFICIENCY THAT RISE TO THE THRESHOLD REQUIRED UNDER THE IRC SECTION 501(R).
FieldValueIRS element (for citing)
Facility5FacilityNum

Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp

Oth Hlth Care Fclts OthHlthCareFcltsGrp (5 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdFacilityFacilityTxt
ELSEMORE DIXFIELD FAMILY MEDICINE
146 WELD STREETDIXFIELDME04224OUTPATIENT PHYSICIAN CLINIC
SWIFT RIVER FAMILY MEDICINE
430 FRANKLIN STREETRUMFORDME04276OUTPATIENT PHYSICIAN CLINIC
RIVER VALLEY INTERNAL MEDICINE
431 FRANKLIN STREETRUMFORDME04276OUTPATIENT PHYSICIAN CLINIC
RUMFORD SPECIALTY SERVICES CLINIC
431 FRANKLIN STREETRUMFORDME04276OUTPATIENT PHYSICIAN CLINIC
RUMFORD SURGICAL SPECIALISTS
431 FRANKLIN STREETRUMFORDME04276OUTPATIENT PHYSICIAN CLINIC

Supplemental Information Detail SupplementalInformationDetail (13 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
SCHEDULE H, PART I, LINE 1CFAP ELIGIBILITY CRITERIA: PATIENTS MUST APPLY FOR MAINE FREE CARE IN ORDER TO BE CONSIDERED FOR THE HOSPITAL'S FREE CARE PROGRAM. AS PART OF THE APPLICATION, PATIENTS MUST SUBMIT A COPY OF CURRENT MAINECARE DECISION LETTERS. PATIENTS WILL BE ASKED IF THEY HAVE INSURANCE OF ANY KIND TO HELP PAY FOR CARE AND ARE ALSO ASKED TO SHOW THAT INSURANCE OR A GOVERNMENT PROGRAM WILL NOT PAY FOR YOUR CARE. IF PATIENTS DO NOT QUALIFY FOR FREE HOSPITAL CARE, THEY ARE ALLOWED TO ASK FOR A FAIR HEARING OR APPEAL.
SCHEDULE H, PART I, LINE 7, COLUMN FPERCENT OF TOTAL EXPENSE: TO ARRIVE AT THE PERCENT OF TOTAL EXPENSES, THE DENOMINATOR WHICH EQUALS TOTAL OPERATING EXPENSES PER PART I LINE 25 OF THE FORM 990, WAS REDUCED BY BAD DEBT OF $4,066,104.
SCHEDULE H, PART I, LINE 7COSTING 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 2BAD DEBT EXPENSE: LINE 2 REPORTS BAD DEBT EXPENSE FROM THE ORGANIZATION'S AUDITED FINANCIAL STATEMENTS.
SCHEDULE H, PART III, SECTION A, LINE 3BAD DEBT EXPENSE ATTRIBUTABLE TO CHARITY CARE: BAD DEBT ATTRIBUTABLE TO PATIENTS UNDER THE ORGANIZATION'S CHARITY CARE POLICY FOR LINE 3 WAS DETERMINED USING A COMPARISON OF EXPERIENCED CHARITY CARE COVERAGE AND US CENSUS BUREAU DATA FOR THE MOST RECENT YEAR AVAILABLE WHEN CHARITY CARE COVERAGE EXCEEDS THE CENSUS DATA, A MINIMAL AMOUNT OF BAD DEBT IS ASSUMED TO BE ELIGIBLE FOR CHARITY CARE TO ACCOUNT FOR THOSE PATIENTS WHO REFUSE TO PROVIDE INFORMATION DOCUMENTING ELIGIBILITY FOR THE PROGRAM. THESE ESTIMATES ARE BASED ON STATE-WIDE DATA AND DO NOT ACCOUNT FOR DIFFERENCES IN GEOGRAPHIC LOCATIONS WITHIN THE STATE. AS THIS AMOUNT IS RELATED TO PATIENTS ELIGIBLE UNDER THE FINANCIAL ASSISTANCE POLICY, IT SHOULD BE INCLUDED AS A COMMUNITY BENEFIT.
SCHEDULE H, PART III, SECTION A, LINE 4BAD DEBT EXPENSE FOOTNOTE: THE AUDITED FINANCIAL STATEMENTS DO NOT CONTAIN A FOOTNOTE THAT DESCRIBES BAD DEBT EXPENSE. THEY DO, HOWEVER, CONTAIN A FOOTNOTE THAT DESCRIBES PATIENT ACCOUNTS RECEIVABLE. THAT FOOTNOTE READS AS FOLLOWS: ACCOUNTS RECEIVABLE ARE REDUCED BY AN ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS. IN EVALUATING THE COLLECTABILITY OF ACCOUNTS RECEIVABLE, THE CORPORATION ANALYZES ITS PAST HISTORY AND IDENTIFIES TRENDS FOR EACH OF ITS MAJOR PAYER SOURCES OF REVENUE TO ESTIMATE THE APPROPRIATE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS AND PROVISION FOR UNCOLLECTIBLE ACCOUNTS. MANAGEMENT REGULARLY REVIEWS DATA ABOUT THESE MAJOR PAYER SOURCES OF REVENUE IN EVALUATING THE SUFFICIENCY OF THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS. FOR RECEIVABLES ASSOCIATED WITH SERVICES PROVIDED TO PATIENTS WHO HAVE THIRD-PARTY COVERAGE, THE CORPORATION ANALYZES CONTRACTUALLY DUE AMOUNTS AND PROVIDES AN ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS AND A PROVISION FOR UNCOLLECTIBLE ACCOUNTS, IF NECESSARY (FOR EXAMPLE, FOR EXPECTED UNCOLLECTIBLE DEDUCTIBLES AND COPAYMENTS ON ACCOUNTS FOR WHICH THE THIRD-PARTY PAYER HAS NOT YET PAID, OR FOR PAYERS WHO ARE KNOWN TO BE HAVING FINANCIAL DIFFICULTIES THAT MAKE THE REALIZATION OF AMOUNTS DUE UNLIKELY). 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 CORPORATION RECORDS A SIGNIFICANT PROVISION FOR UNCOLLECTIBLE 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 OR PROVIDED BY POLICY) AND THE AMOUNTS ACTUALLY COLLECTED AFTER ALL REASONABLE COLLECTION EFFORTS HAVE BEEN EXHAUSTED IS CHARGED OFF AGAINST THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS.
SCHEDULE H, PART III, SECTION B, LINE 8COMMUNITY BENEFIT: THE COSTING METHODOLOGY USED FOR LINE 6 IS INFORMATION PULLED FROM THE MEDICARE COST REPORT FILING. ANY SHORTFALL REPORTED ON LINE 7 COULD BE CONSIDERED COMMUNITY BENEFIT TO A LEVEL PROPORTIONAL TO THE POVERTY LEVELS INDICATED BY CENSUS BUREAU DATA. IF THE PATIENTS FALLING UNDER 200% FPG LEVEL WERE NOT COVERED BY MEDICARE THEY WOULD QUALIFY UNDER RUMFORD HOSPITAL'S FREE CARE POLICY. UNDER THAT CIRCUMSTANCE, THESE PATIENTS WOULD THEN APPEAR AS PART OF THE STATISTICS ON PART I, LINE 7A.
SCHEDULE H, PART III, SECTION C, LINE 9BCOLLECTION 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 2NEEDS ASSESSMENT: AS A CRITICAL ACCESS HOSPITAL, RUMFORD HOSPITAL ATTEMPTS TO PROVIDE ANY NEEDED HEALTH CARE SERVICES NECESSARY TO TREAT THE POPULATION OF THIS RURAL AREA OF MAINE, ADDITIONALLY, RUMFORD HOSPITAL FOCUSES ON STATE-WIDE INITIATIVES, SUCH AS HEART DISEASE AND DIABETES, AS WELL AS ORGANIZATIONAL INITIATIVES BASED ON NEEDS OBSERVED WITHIN ITS PATIENT POPULATION. MANY FORMS OF EDUCATION, PREVENTION AND EARLY DETECTION ARE ALSO PART OF ITS COMMUNITY HEALTH CARE PLAN.
SCHEDULE H, PART VI, LINE 3PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE: RUMFORD HOSPITAL PROVIDES NOTICES ABOUT ITS FREE CARE POLICY IN ALL CLINICAL DEPARTMENTS AND MAJOR PATIENT AREAS. AN INPATIENT FINANCIAL COUNSELOR VISITS WITH ALL UNINSURED PATIENTS TO DISCUSS OPTIONS, INCLUDING GOVERNMENTAL PROGRAM ELIGIBILITY AND FREE CARE ASSISTANCE IS AVAILABLE TO HELP PATIENTS WITH COMPLETION OF MEDICAID APPLICATIONS. ALL PATIENT FINANCIAL SERVICES STAFF ARE TRAINED TO OFFER FREE CARE AS AN OPTION TO PATIENTS WHO INDICATE AN INABILITY OR DIFFICULTY IN PAYING FOR SERVICES. INFORMATION ABOUT FINANCIAL ASSISTANCE AVAILABILITY IS INCLUDED ON THE BACK OF EVERY PATIENT STATEMENT. ADDITIONALLY, UNINSURED PATIENTS RECEIVE A SEPARATE INFORMATION SHEET WITH THEIR STATEMENTS, FURTHER INFORMING THEM ABOUT THE AVAILABLE OPTIONS.
SCHEDULE H, PART VI, LINE 4COMMUNITY INFORMATION: RUMFORD HOSPITAL, LOCATED IN RUMFORD, MAINE, SERVES CENTRAL OXFORD COUNTY ALONG THE WESTERN BORDER OF MAINE. A LIGHTLY POPULATED, RURAL AREA AGED 65 OR OVER AND 14% OF THE POPULATION BELOW THE POVERTY LEVEL.
SCHEDULE H, PART VI, LINE 5PROMOTION OF COMMUNITY HEALTH: RUMFORD HOSPITAL HAS AN OPEN MEDICAL STAFF, ALLOWING ANY NON-EMPLOYED OR AFFILIATED PHYSICIANS TO HAVE ADMITTING PRIVILEGES TO THE HOSPITAL. THE BOARD OF DIRECTORS IS MADE UP OF A MAJORITY OF LOCAL COMMUNITY MEMBERS ALONG WITH SOME REPRESENTATION BY DIRECTORS FROM CENTRAL MAINE HEALTHCARE, THE PARENT OF THE HEALTHCARE SYSTEM WHICH RUMFORD HOSPITAL BELONGS TO, HELPING TO BRING TOGETHER THE VISIONS OF THE LOCAL COMMUNITY WITH THE CAPABILITIES AND VISION OF THE SYSTEM AS A WHOLE FOR THE BENEFIT OF RUMFORD AND SURROUNDING COMMUNITIES.
SCHEDULE H, PART VI, LINE 6AFFILIATED HEALTH CARE SYSTEM: AS A MEMBER OF THE CENTRAL MAINE HEALTHCARE SYSTEM, RUMFORD HOSPITAL PROVIDES HIGH QUALITY HEALTH CARE IN A RURAL SETTING WITH LIMITED HEALTH CARE OPTIONS. ITS AFFILIATION WITH CENTRAL MAINE MEDICAL CENTER PROVIDES ACCESS TO A MUCH LARGER, TERTIARY CARE HOSPITAL, INCLUDING TRAUMA CARE, NEONATAL INTENSIVE CARE, AND A SPECIALIZED CARDIAC CARE UNIT. ADDITIONALLY, CENTRAL MAINE MEDICAL CENTER PROVIDES ACCESS TO SPECIALIST PHYSICIANS FOR OUTPATIENT CARE IN THE RUMFORD AREA ON A REGULAR SCHEDULE. THE SYSTEM PARENT, CENTRAL MAINE HEALTHCARE, PROVIDES STREAMLINED ADMINISTRATIVE FUNCTIONS AND BACKROOM SERVICES, ALLOWING RUMFORD HOSPITAL TO PERFORM AT A COST EFFICIENT LEVEL WHICH WOULD NORMALLY BE UNACHIEVABLE IN A SMALL, RURAL HOSPITAL, ALLOWING FOR BROADER RANGE OF SERVICES AVAILABLE.

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Severance PaymentfalseSeverancePaymentInd
Supplemental Nonqual Rtr PlanYes (true)SupplementalNonqualRtrPlanInd
Equity Based Comp ArrngmfalseEquityBasedCompArrngmInd
Comp Based On Revenue Of Flng OrgfalseCompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related OrgsfalseCompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng OrgfalseCompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd OrgsfalseCompBsdNetEarnsRltdOrgsInd
Any Non Fixed PaymentsfalseAnyNonFixedPaymentsInd
Initial Contract ExceptionfalseInitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (11 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
R DAVID FRUM
PRESIDENT$0$316,949$0$80,325$0$36,745$0$50,755$0$21,497$0$506,271$0$27,134
JEFF BRICKMAN
DIRECTOR END 01/18; PRESIDENT$0$659,404$0$195,000$0$12,444$0$94,125$0$20,849$0$981,822$0$0
DAVID THOMPSON
TREASURER$0$379,692$0$92,500$0$25,570$0$45,125$0$12,991$0$555,878$0$0
WILLIAM LEE MD
DIRECTOR BEG 01/18; PHYSICIAN$0$299,378$0$18,317$0$7,144$0$24,625$0$20,701$0$370,165$0$0
THOMAS DELUCA
PHYSICIAN$311,915$0$23,867$0$4,444$0$24,625$0$21,497$0$386,348$0$0$0
JACOB LEDESMA
PHYSICIAN$351,689$0$103,443$0$3,606$0$6,625$0$23,497$0$488,860$0$0$0
JEFFREY LYNDS
PHYSICIAN$284,729$0$90,466$0$3,040$0$0$0$21,497$0$399,732$0$0$0
STEPHANIE SINCLAIR
PHYSICIAN$242,576$0$93,227$0$2,659$0$6,625$0$19,421$0$364,508$0$0$0
SAID DAOUD
PHYSICIAN$296,755$0$51,725$0$5,031$0$5,389$0$21,497$0$380,397$0$0$0
DIETER KRECKEL
PHYSICIAN CHIEF$235,956$0$5,192$0$5,635$0$6,486$0$3,460$0$256,729$0$0$0
PHILIPPE MORISSETTE
FORMER TREASURER/VICE PRES.$0$226,974$0$0$0$2,143$0$43,774$0$7,999$0$280,890$0$0

Supplemental Information Detail SupplementalInformationDetail (3 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
SCHEDULE J, PART I, LINE 3EXECUTIVE 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 4BSUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN: A PARTICIPANT'S ENTITLEMENT TO BENEFITS WILL VEST ON THE PARTICIPANT'S VESTING DATE PROVIDED THE PARTICIPANT HAS REMAINED IN CONTINUOUS EMPLOYMENT IN THE SAME POSITION WHILE PARTICIPATING IN THIS PLAN. A PARTICIPANT WILL HAVE ONLY ONE VESTING DATE FOR ALL ELECTIVE DEFERRALS AND OTHER PLAN CONTRIBUTIONS MADE ON THE PARTICIPANT'S BEHALF DURING ALL PLAN YEARS. A PARTICIPANT'S ENTITLEMENT TO BENEFITS WILL ALSO VEST (A) IF THE PARTICIPANT DIES WHILE STILL EMPLOYED BY THE EMPLOYER, (B) IF THE PARTICIPANT'S EMPLOYMENT TERMINATES DUE TO TOTAL DISABILITY, OR (C) IF THE EMPLOYER TERMINATES THE PARTICIPANT'S EMPLOYMENT FOR ANY REASON OTHER THAN FOR CAUSE ANY PORTION OF THE PARTICIPANT'S ENTITLEMENT BENEFITS THAT IS NOT VESTED WHEN THE PARTICIPANT'S EMPLOYMENT WITH THE EMPLOYER TERMINATES, INCLUDING ELECTIVE DEFERRALS, WILL BE FORFEITED. THE EMPLOYER WILL DISTRIBUTE A PARTICIPANT'S BENEFITS UNDER THE PLAN AS SOON AS PRACTICABLE AFTER THE PARTICIPANT'S ENTITLEMENT BECOMES VESTED. THE FOLLOWING INDIVIDUALS PARTICIPATED IN A SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN THROUGH CENTRAL MAINE HEALTHCARE CORPORATION, A RELATED ENTITY. $ 27,134 R. DAVID FRUM (DISTRIBUTION) 26,130 R. DAVID FRUM (DEFERRAL) 69,500 JEFF BRICKMAN (DEFERRAL) 20,500 DAVID THOMPSON (DEFERRAL) 38,000 PHILIPPE MORISSETTE (DEFERRAL)
SCHEDULE J, PART II, COLUMN FCOMPENSATION REPORTED IN PRIOR FORM 990: COMPENSATION IS REPORTED ON THE FORM 990 IN THE YEAR THAT THE COMPENSATION IS EARNED BY OR AWARDED TO AN INDIVIDUAL, EVEN IF THE COMPENSATION IS NOT PAID TO THE INDIVIDUAL, IS NOT FULLY VESTED, OR IS SUBJECT TO SUBSTANTIAL RISK OF FORFEITURE. IF COMPENSATION IS EARNED OR AWARDED IN ONE YEAR BUT PAID IN A LATER YEAR, THEN THE COMPENSATION IS REPORTED A SECOND TIME ON THE FORM 990 IN THE YEAR THE COMPENSATION IS VESTED OR PAID TO THE INDIVIDUAL.

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (16 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART V, LINE 1A & 2ACOMMON PAYMASTER: RUMFORD HOSPITAL IS A TAX EXEMPT ORGANIZATION WHICH FILES ITS PAYROLL FORMS AND REPORTS WITH THE IRS AND DOL ON A CONSOLIDATED BASIS UNDER ITS PARENT, CENTRAL MAINE HEALTHCARE CORPORATION, USING THE PARENT'S EIN. THIS INCLUDES FORM 941'S, W-2'S AND OTHER RELATED FILINGS.
FORM 990, PART VI, SECTION A, LINE 2BUSINESS RELATIONSHIP: JEFF BRICKMAN, R. DAVID FRUM, WILLIAM LEE, MD, HOLLI BOCCELLI, PHILIPPE MORISSETTE, AND DAVID THOMPSON HAVE A BUSINESS RELATIONSHIP THROUGH THEIR EMPLOYMENT WITH A RELATED ORGANIZATION.
FORM 990, PART VI, SECTION A, LINE 4SIGNIFICANT CHANGES TO BYLAWS: THE BYLAWS AND ARTICLES OF INCORPORATION WERE AMENDED DURING THE YEAR AND CONTAINED THE FOLLOWING SIGNIFICANT CHANGES: - THE ARTICLE FOR PURPOSE WAS AMENDED TO STATE: THE CORPORATION IS ORGANIZED AS A PUBLIC BENEFIT CORPORATION FOR THE FOLLOWING PURPOSES: A) TO ESTABLISH AND MAINTAIN A GENERAL HOSPITAL AND MEDICAL CENTER FOR THE CARE OF PERSONS SUFFERING FROM ILLNESSES OR DISABILITIES WHICH REQUIRE THAT THE PATIENTS RECEIVE IN OR OUT PATIENT HOSPITAL CARE. B) TO CARRY ON ANY EDUCATIONAL ACTIVITIES RELATED TO RENDERING CARE TO THE SICK AND INJURED OR THE PROMOTION OF HEALTH WHICH, IN THE OPINION OF THE BOARD OF DIRECTORS MAY BE JUSTIFIED BY THE FACILITIES, PERSONNEL, FUNDS OR OTHER REQUIREMENTS THAT ARE, OR CAN BE MADE, AVAILABLE. C) TO PROMOTE AND CARRY ON SCIENTIFIC RESEARCH RELATED TO THE CARE OF THE SICK AND INJURED INSOFAR AS, IN THE OPINION OF THE BOARD OF DIRECTORS, SUCH RESEARCH CAN BE CARRIED ON IN, OR IN CONNECTION WITH, THE CORPORATION. D) TO PARTICIPATE, SO FAR AS CIRCUMSTANCES MAY WARRANT, IN ANY ACTIVITY DESIGNED AND CARRIED ON TO PROMOTE THE GENERAL HEALTH OF PERSONS IN THE AREAS SERVED BY THE CORPORATION. - THE BOARD SHALL CONSIST OF THE SAME INDIVIDUALS SERVING AS MEMBERS OF THE BOARD OF DIRECTORS OF CENTRAL MAINE HEALTHCARE CORPORATION (CMHC). THE ARTICLES STATE THE NUMBER OF BOARD MEMBERS SHALL BE BETWEEN 9 AND 15.
FORM 990, PART VI, SECTION A, LINE 6, 7A, & 7BMEMBERS OR STOCKHOLDERS: THE SOLE MEMBER OF THE CORPORATION SHALL BE CENTRAL MAINE HEALTHCARE CORPORATION ACTING THROUGH THE MEMBER'S BOARD OF DIRECTORS. THE BOARD OF DIRECTORS OF THE CORPORATION SHALL CONSIST OF THE SAME INDIVIDUALS SERVING AS MEMBERS OF THE MEMBER'S BOARD OF DIRECTORS. THE MEMBER MAY MAKE, AMEND OR REPEAL THE BYLAWS IN WHOLE OR IN PART.
FORM 990, PART VI, SECTION B, LINE 11BFORM 990 REVIEW PROCESS: ALL AFFILIATED FORM 990'S AND APPLICABLE SCHEDULES ARE PREPARED BY AN INDEPENDENT PUBLIC ACCOUNTING FIRM IN COOPERATION WITH THE FINANCE DEPARTMENT. THE COMPLETED RETURNS ARE REVIEWED WITH THE VICE PRESIDENT OF FINANCE THEN WITH THE CFO FOLLOWING THAT REVIEW; THEY ARE PRESENTED TO THE FINANCE COMMITTEE OF THE CENTRAL MAINE HEALTHCARE BOARD OF DIRECTORS, WHICH HAS REPRESENTATIVES FROM ALL AFFILIATED BOARDS. ONCE THIS REVIEW IS COMPLETED, ANY NECESSARY CHANGES ARE MADE AND THE FINAL RETURN IS PRESENTED TO ITS RESPECTIVE BOARD WITH THE FINANCE COMMITTEE MEMBER TAKING AND ANSWERING QUESTIONS. A FINANCE DEPARTMENT REPRESENTATIVE, KNOWLEDGEABLE OF THE RETURN, IS AVAILABLE TO ASSIST DURING PRESENTATIONS, IF REQUESTED BY THE FINANCE COMMITTEE MEMBER. IN THE EVENT THAT THE NEXT BOARD MEETING IS NOT SCHEDULED UNTIL AFTER THE FILING DATE, THE FINAL RETURN IS MAILED TO ALL BOARD MEMBERS AND THE PRESENTATION OCCURS AT THE NEXT SCHEDULED BOARD MEETING.
FORM 990, PART VI, SECTION B, LINE 12CEXECUTIVE COMPENSATION REVIEW: CENTRAL MAINE HEALTHCARE (CMHC), A RELATED ORGANIZATION, HAS ESTABLISHED AND FOLLOWS A DELIBERATIVE TRANSPARENT PROCESS WHICH MEETS IRS REGULATIONS FOR REBUTTABLE PRESUMPTION OF REASONABLENESS. A STANDING EXECUTIVE COMPENSATION COMMITTEE (ECC), COMPRISED OF INDEPENDENT MEMBERS OF BOARD LEADERSHIP, EXISTS TO UNDERTAKE THE PROCESS OF DETERMINING COMPENSATION FOR THE CHIEF EXECUTIVE OFFICER, CHIEF FINANCIAL OFFICER, CHIEF MEDICAL OFFICER, PRESIDENT OF CENTRAL MAINE MEDICAL CENTER, PHYSICIAN PRACTICE EXECUTIVE, AND PRESIDENT OF RUMFORD AND BRIDGTON HOSPITALS. THE PROCESS GUIDELINES AND AUTHORITY OF THE ECC ARE SET OUT IN THE EXECUTIVE COMPENSATION PHILOSOPHY AND RESPONSIBILITIES CHARTER WHICH WAS APPROVED BY THE CMHC BOARD. THE ENTIRE CMHC BOARD PARTICIPATES IN THE ANNUAL PERFORMANCE EVALUATION OF EACH EXECUTIVE, INCLUDING A REVIEW OF ACCOMPLISHMENTS RELATIVE TO GOALS AND OBJECTIVES DERIVED FROM THE STRATEGIC PLAN. THE ECC REVIEWS THE RESULTS OF THE ANNUAL PERFORMANCE EVALUATION AND APPROPRIATE COMPARABILITY DATA BASED ON SEVERAL FACTORS RECOMMENDED BY AN INDEPENDENT EXECUTIVE COMPENSATION CONSULTANT, WHO SPECIALIZES IN NOT-FOR-PROFIT HOSPITALS AND HEALTH SYSTEMS, AND OUR ATTORNEYS. FACTORS USED IN DETERMINING COMPARABILITY TO THE ORGANIZATION INCLUDE 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. THE COMPENSATION PAID TO KEY EMPLOYEES IS REVIEWED BY THE VICE PRESIDENT OF HUMAN RESOURCES AND ORGANIZATIONAL DEVELOPMENT. DURING THE REVIEW PROCESS, THE CENTRAL MAINE HEALTHCARE COMPENSATION MANAGER PROVIDES MARKET DATA ON COMPARABLE POSITIONS FOR COMPARATIVE GROUPS OF HEALTHCARE ORGANIZATIONS THAT ARE APPROPRIATELY SIMILAR IN TERMS OF THEIR REVENUE, GEOGRAPHIC LOCATION, NUMBER OF EMPLOYEES, NUMBER OF STAFFED HOSPITAL BEDS, ETC. HUMAN RESOURCES PROVIDES AT A MINIMUM FOUR SETS OF COMPARABILITY DATA FROM THE MOST RECENT NATIONAL HEALTHCARE SPECIFIC COMPENSATION SURVEYS (E.G. WATSON AND WYATT, SULLIVAN AND COTTER, THE HAY GROUP, MERCER, ETC) FOR REFERENCE. THESE SURVEYS REPORT PAY RATE DATA THAT IS TYPICALLY AGED LESS THAN 6 MONTHS. CENTRAL MAINE HEALTHCARE AND AFFILIATES STRIVE TO PAY AT THE MARKET AVERAGE OR SLIGHTLY ABOVE IT FOR KEY EMPLOYEES. ONCE THE COMPENSATION MANAGER AND THE VICE PRESIDENT OF HUMAN RESOURCES AND ORGANIZATIONAL DEVELOPMENT HAVE FINALIZED RECOMMENDATIONS BASED ON THIS EMPIRICAL DATA, THEY ARE PRESENTED TO THE PRESIDENTS OF EACH HOSPITAL THAT SUPERVISE THE KEY EMPLOYEES, AND THE CEO OF CENTRAL MAINE HEALTHCARE, FOR REVIEW, EDITS, AND APPROVAL. THIS PROCESS TYPICALLY OCCURS DURING THAT LAST MONTH OF FISCAL YEAR IN PREPARATION FOR THE NEXT FISCAL YEAR CENTRAL MAINE HEALTHCARE DOCUMENTS THE BASIS FOR ITS DETERMINATION OF KEY EMPLOYEES' COMPENSATION AND MAINTAINS THIS CONTEMPORANEOUSLY SUBSTANTIATED MATERIAL IN THE HUMAN RESOURCES DEPARTMENT.
FORM 990 PART VI, SECTION B, LINES 15A & 15BMONITORING 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 C, LINE 19PUBLIC 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 ABOARD 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.
FORM 990, PART XI, LINE 9OTHER CHANGES IN NET ASSETS: $ 1,100 CHANGE IN BENEFICIAL INTEREST IN PERPETUAL TRUST
FORM 990 PART IX LINE 11GDESCRIPTION:PURCHASED LABOR TOTAL FEES:3644320
FORM 990 PART IX LINE 11GDESCRIPTION:LABOR SERVICES TOTAL FEES:2502425
FORM 990 PART IX LINE 11GDESCRIPTION:OUTSIDE SERVICES TOTAL FEES:1406543
FORM 990 PART IX LINE 11GDESCRIPTION:PURCHASED SERVICES TOTAL FEES:1162865
FORM 990 PART IX LINE 11GDESCRIPTION:CONSULTING FEES TOTAL FEES:8523
FORM 990 PART IX LINE 11GDESCRIPTION:PROFESSIONAL FEES TOTAL FEES:2802

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (10 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtControlled OrganizationControlledOrganizationInd
CENTRAL MAINE COMMUNITY HEALTH CORP
PO BOX 4500LEWISTONME04243010386912PUBLIC EDUCATME501(C)(3)7CMHCfalse
CENTRAL MAINE MEDICAL CENTER
PO BOX 4500LEWISTONME04243010211494HEALTHCAREME501(C)(3)3CMHCfalse
CENTRAL MAINE HEALTHCARE CORPORATION
PO BOX 4500LEWISTONME04243010386913HEALTHCAREME501(C)(3)7NAfalse
MAINE COLLEGE OF HEALTH PROFESSIONS
PO BOX 4500LEWISTONME04243010356077EDUCATIONME501(C)(3)2CMMCfalse
CENTRAL MAINE REAL ESTATE MGMT CORP
PO BOX 4500LEWISTONME04243010387674REAL ESTATEME501(C)(2)CMHCfalse
RUMFORD COMMUNITY FAMILY HEALTH CENTER
430 FRANKLIN STREETRUMFORDME04276010481000HEALTHCAREME501(C)(3)3CMHCfalse
RUMFORD COMMUNITY HOME CORPORATION
11 JOHN F KENNEDY LANERUMFORDME04276222844951NURSING HOMEME501(C)(3)10CMHCfalse
BRIDGTON HOSPITAL
10 HOSPITAL DRIVEBRIDGTONME04009010130427HEALTHCAREME501(C)(3)3CMHCfalse
BRIDGTON HOSPITAL PHYSICIANS GROUP
SOUTH HIGH STREETBRIDGTONME04009010493083HEALTHCAREME501(C)(3)PFCMHCfalse
ELIAS E TUCKER TRUST FUND
C/O CMMC 300 MAIN STREETLEWISTONME04240010493083NURSING EDME501(C)(3)12 A ICMMCfalse

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (3 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtEntity TypeEntityTypeTxtControlled OrganizationControlledOrganizationIndAddress Line1ForeignAddress/AddressLine1TxtCityForeignAddress/CityNmProvince Or StateForeignAddress/ProvinceOrStateNmCountryForeignAddress/CountryCdLegal Domicile Foreign CountryLegalDomicileForeignCountryCd
CENTRAL MAINE HEALTH VENTURES INC
300 MAIN STREETLEWISTONME04240010430016HEALTHCAREMECMHCC CORPfalse
CWM INSURANCE LTD
980220891INSURANCECMHCC CORPfalseGENESIS BUILDING PO BOX 1363BWIGRAND CAYMANCJCJ
CENTRAL MAINE ACO
300 MAIN STREETLEWISTONME04240274604314ACCOUNTABLE CAREMECMHCC CORPfalse
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts RyltsfalseReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth OrgfalseGiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth OrgfalseGiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other OrgfalseLoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth OrgfalseLoansOrGuaranteesFromOthOrgInd
Div Related OrganizationfalseDivRelatedOrganizationInd
Asset Sale To Other OrgfalseAssetSaleToOtherOrgInd
Asset Purchase From Other OrgfalseAssetPurchaseFromOtherOrgInd
Asset ExchangefalseAssetExchangeInd
Rental Of Facilities To Oth OrgfalseRentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth OrgYes (true)RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth OrgfalsePerformOfServicesForOthOrgInd
Perform Of Services By Other OrgYes (true)PerformOfServicesByOtherOrgInd
Sharing Of FacilitiesfalseSharingOfFacilitiesInd
Paid Employees SharingYes (true)PaidEmployeesSharingInd
Reimbursement Paid To Other OrgYes (true)ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other OrgYes (true)ReimbursementPaidByOtherOrgInd
Transfer To Other OrgfalseTransferToOtherOrgInd
Transfer From Other OrgfalseTransferFromOtherOrgInd