2019-05-10T09:48:34-05:00 2018-06-30 BKD LLP 910 E ST LOUIS 200/PO BOX 1190 SPRINGFIELD MO 658062523 990 2017-07-01 010211494 CENTRAL MAINE MEDICAL CENTER % DAVID THOMPSON CENT 2077952813 PO BOX 4500 LEWISTON ME 042434500 DAVID THOMPSON TREASURER 2019-03-13 true Brian D Todd P00422601 4178658701 167.68.126.162 43032920191305000004 2019-05-10 P 353840E92A19E57AE3D09FB5FB5D869273682438 AECC51588B8B05B8A6088E029F5570AF8FA04FA6 2017 2019-02-21 02:37:17Z DAVID TUPPONCE 300 MAIN STREET LEWISTON ME 04240 401867743 false X WWW.CMMC.ORG X 1888 ME CMMC STRIVES TO PROVIDE EXCEPTIONAL HEALTHCARE SERVICES. THE HOSPITAL DEPENDS ON THE EXPERTISE OF ITS CAREGIVERS IN ADDITION TO THE COMMITMENT AND COMPASSION THEY PROVIDE. 9 8 2628 1400 42181 3355317 2930789 397227190 395738250 412297 1389274 844271 -155967 401839075 399902346 25100 0 0 0 187971200 177775276 0 0 44612 223673465 232152287 411669765 409927563 -9830690 -10025217 263850078 268852897 197979806 216707609 65870272 52145288 TO PROVIDE EXCEPTIONAL HEALTHCARE SERVICES IN A SAFE AND TRUSTFUL ENVIRONMENT THROUGH THE EXPERTISE, COMMITMENT AND COMPASSION OF OUR FAMILY OF CAREGIVERS. false false 332032124 395738250 CENTRAL MAINE MEDICAL CENTER IS A 250-BED, NOT-FOR-PROFIT HOSPITAL LOCATED IN LEWISTON, MAINE OFFERING COMPREHENSIVE HEALTHCARE SERVICES TO THE RESIDENTS OF THE CENTRAL AND WESTERN MAINE REGION WITH AN ACTIVE MEDICAL STAFF OF MORE THAN 300 PHYSICIANS REPRESENTING SOME 30 SPECIALTIES OVER 2,000 HIGHLY SKILLED EMPLOYEES AND WITH THE SUPPORT OF THE LATEST TECHNOLOGIES, CMMC IS WELL POSITIONED TO MEET THE REGION'S HEALTHCARE NEEDS WITH THE UTMOST COMPASSION, KINDNESS, AND UNDERSTANDING. 332032124 true true false true false false false false false true true false false true false false false true false false false false false false true false true true false false true true false false false false false true false false true false false false false false false true true true false false true 152 0 true 2628 true true true false false false false true true false false false false X 9 8 true false true false true true true true true false false true true true true true true false false false ME X DAVID THOMPSON 2077952813 300 MAIN STREET LEWISTON ME 04240 X MARK A ADAMS CHAIRMAN; VICE CHAIR BEG 01/18 1.0 5.0 X X 0 0 0 RONALD PEYSER TRUSTEE END 01/18 1.0 0.0 X 0 0 0 CANDACE SANBORN TRUSTEE END 01/18 1.0 0.0 X 0 0 0 AUSTIN ALBERT TRUSTEE END 01/18; DIRECTOR 1.0 3.0 X 0 0 0 CHRISTINE BOSSE TRUSTEE END 01/18 1.0 0.0 X 0 0 0 ADAM DUNBAR TRUSTEE END 01/18 1.0 0.0 X 0 0 0 STEVE WALLACE TRUSTEE END 01/18 1.0 0.0 X 0 0 0 MICHAEL GENDREAU TRUSTEE END 01/18 1.0 0.0 X 0 0 0 JEFFREY GOSSELIN TRUSTEE END 01/18 1.0 0.0 X 0 0 0 JEFF BRICKMAN TRUSTEE END 01/18; PRESIDENT 1.0 61.0 X X 0 866848 114974 NICHOLETTE ERICKSON MD PHYSICIAN; TRUSTEE END 01/18 55.0 0.0 X 555435 0 26070 DEBORAH DUNLAP AVASTHI CHAIRPERSON/DIRECTOR BEG 01/18 1.0 3.0 X X 0 0 0 DOUGLAS M BOYD DIRECTOR BEG 01/18 1.0 3.0 X 0 0 0 JANET HALL DIRECTOR BEG 01/18 1.0 3.0 X 0 0 0 JOLAN IPPOLITO DIRECTOR BEG 01/18 1.0 3.0 X 0 0 0 WILLIAM LEE MD PHYSICIAN; DIRECTOR BEG 01/18 55.0 3.0 X 324839 0 45326 PHIL LIBBY DIRECTOR BEG 01/18 1.0 3.0 X 0 0 0 CRAIG TRIBUNO DIRECTOR BEG 01/18 1.0 3.0 X 0 0 0 RICHARD GOLDSTEIN PHYS PRACT EXEC END 12/17 55.0 1.0 X 0 536892 102579 DAVID THOMPSON TREASURER 1.0 61.0 X 0 497762 58116 HOLLI BOCCELLI SECRETARY BEG 01/18 1.0 57.0 X 0 130845 0 DAVID TUPPONCE PRESIDENT BEG 10/17 55.0 0.0 X 0 119791 1930 JAMES LOGGINS MD PHYS DIVISION CHIEF END 06/18 55.0 0.0 X 582395 0 50914 DAVID LAUVER MD PHYS DIVISION CHIEF END 09/17 55.0 0.0 X 297165 0 15079 MICHAEL STADNICKI PHYSICIAN DIVISION CHIEF 55.0 0.0 X 292407 0 28393 BETHANY PICKER PHYSICIAN DIVISION CHIEF 55.0 0.0 X 203168 0 29401 ANDREW EISENHAUER PHYS DIVISION CHIEF BEG 09/17 55.0 0.0 X 625159 0 46427 PAUL WELDNER MD PHYSICIAN 55.0 0.0 X 930358 0 24625 OSWALDO BISBAL MD PHYSICIAN 55.0 0.0 X 862690 0 46122 DANIEL LACERTE MD PHYSICIAN 55.0 0.0 X 855161 0 27246 CARMINE FRUMIENTO MD PHYSICIAN 55.0 0.0 X 806527 0 25806 TAREK RADWAN MD PHYSICIAN 55.0 0.0 X 960140 0 33032 TINA-MARIE LEGERE FORMER PRESIDENT CMMC END 1/17 0.0 0.0 X 0 484593 23725 PHILIPPE MORISSETTE FORMER TREASURER/VICE. PRESI 0.0 55.0 X 0 229117 51773 7295444 2865848 751538 282 true true false SODEXO INC 525 WILLIAM PENN PL PITTSBURGH PA 15251 FOOD SERVICES 5277104 UNITED AMBULANCE SERVICES 192 RUSSELL STREET LEWISTON ME 04240 MEDICAL TRANSIT 3313420 WEATHERBY LOCUMS INC 200 1020 SOUTHHILL DR CARY NC 27513 MEDICAL STAFFING 2588493 ANESTHESIA ASSOCIATES 300 MAIN STREET LEWISTON ME 04240 MEDICAL SERVICES 1684403 SODEXO CLINICAL TECHNOLOGY MANAGEME 7100 COMMERCE WAY 280 NASHVILLE TN 37421 EQUIPMENT SERVICING 1586177 45 1704255 885452 5000 336082 2930789 NET PATIENT SERVICE REVENUE 900099 375091032 375091032 PHARMACY REVENUE 446110 14351312 14351312 OTHER REVENUE 900099 5379676 5379676 CAFETERIA REVENUE 722514 916230 916230 395738250 857768 857768 0 0 1069 1069 0 1069 1069 878540 1023001 802544 567491 75996 455510 531506 531506 100304 1704255 468599 -368295 -368295 0 0 0 168944 126763 42181 42181 EQUITY INVESTMENT 900099 348367 348367 LOSS ON RESTRUCTURING 900099 -179289 -179289 169078 399902346 395738250 42181 1191126 X 0 0 0 0 3122178 3122178 145826 145826 145079576 109002443 36077133 1742959 1293423 449536 18624424 14053816 4570608 9060313 6853311 2207002 0 153631 153631 84743 84743 0 0 1950 1950 64169359 48538345 15631014 507590 383946 123644 22734935 17183589 5506734 44612 6487402 4907136 1580266 0 6199141 4689531 1509610 526431 398198 128233 0 536312 405672 130640 4922201 3723202 1198999 0 20250005 15317306 4932699 8659418 6550070 2109348 MEDICAL SUPPLIES & DRUGS 64142995 64142995 BAD DEBT 26802871 26802871 REPAIRS & MAINTENANCE 4848623 3667547 1181076 LICENSES, DUES, SUBSCRIPTIONS 834240 631027 203213 290440 219692 70748 409927563 332032124 77850827 44612 121911 132342 14093218 17440765 59809 4080 42469270 42324208 54122 10028 0 0 3110426 3210504 4932848 6374629 1721926 983915 409905211 277502716 133985766 132402495 11180123 19756370 3611992 3960359 0 0 5047334 4044101 43461333 38209101 263850078 268852897 89026685 104076840 0 0 624112 710818 103249696 102955317 0 0 0 0 2970638 8964634 0 0 2108675 0 197979806 216707609 X 46114238 35844468 7928626 4647554 11827408 11653266 65870272 52145288 263850078 268852897 X -10025217 -244543 -3455224 X false true X true true true X false false false false false false false false true 29239 29239 false SCHEDULE C, PART II-B, LINE 1(I) OTHER LOBBYING ACTIVITIES: PORTION OF DUES FOR PROFESSIONAL ASSOCIATIONS ATTRIBUTED TO LOBBYING EXPENSES - $29,239. 20450606 -3394898 17055708 20239234 211372 20450606 19465393 773841 20239234 19253603 578486 -37780 328916 19465393 16922085 47094 2342008 57584 19253603 0.76340 0.23660 false true true 2318022 2318022 161523706 79950178 81573528 4945143 4520993 424150 231691452 186088449 45603003 9426888 6943096 2483792 132402495 OTHER RECEIVABLES 7991472 DEPOSITS 5900 EST AMT DUE FROM 3RD PARTY 13910909 INTEREST IN RELATED PARTY 16300820 38209101 SCHEDULE D, PART V, LINE 4 INTENDED USE OF ENDOWMENT FUNDS: ENDOWMENT FUNDS ARE USED TO SUPPORT THE ORGANIZATION IN A VARIETY OF WAYS, DEPENDING UPON THE STATED PURPOSE OF EACH FUND. MANY OF THESE FUNDS HELP TO COVER COSTS OF CAPITAL EQUIPMENT PURCHASES, CONTINUING MEDICAL EDUCATION, OR FREE CARE. OTHERS ARE DESIGNATED TO SUPPORT SPECIFIC DEPARTMENTS OF THE HOSPITAL. SCHEDULE D, PART X, LINE 2 UNCERTAIN TAX POSITIONS: MANAGEMENT HAS EVALUATED THEIR INCOME TAX POSITIONS UNDER THE GUIDANCE INCLUDED IN ASC 740. BASED ON THEIR REVIEW, MANAGEMENT HAS NOT IDENTIFIED ANY MATERIAL UNCERTAIN TAX POSITIONS TO BE RECORDED OR DISCLOSED IN THE FINANCIAL STATEMENTS. DEMPSEY CHALLEN 1711559 1633655 77904 12220 95196 36805 17313 287202 FALL GOLF CLASS 93000 70600 22400 2869 5070 4695 7229 0 1804559 1704255 100304 15089 100266 41500 17313 294431 468599 -368295 SCHEDULE G, PART II, COLUMN A FUNDRAISING ACTIVITIES: DEMPSEY CHALLENGE - THIS EVENT OCCURS ANNUALLY IN OCTOBER AND OCCUPIES A YEAR-LONG PLANNING AND EXPENSE CYCLE. DUE TO THE OVERLAPPING YEAR CYCLE OF THIS EVENT, EACH REPORTED TAX YEAR WILL HAVE A PORTION OF REVENUE AND EXPENSES ATTRIBUTABLE TO THE EVENT OCCURRING WITHIN THE REPORTABLE TAX YEAR, AS WELL AS SOME EXPENSES, SPONSORSHIPS, REGISTRATIONS AND DONATIONS ASSOCIATED WITH THE FOLLOWING YEAR'S EVENT. AS SUCH, THE AMOUNT REPORTED WITH THIS RETURN IS NOT REPRESENTATIVE OF A SINGLE EVENT'S PROCEEDS; RATHER IT IS A REPORT OF ACTIVITY ENCOMPASSING OVERLAPPING PERIODS FOR AN EVENT THAT CROSSES A REPORTABLE TAX PERIOD. true true X true X false true true false false 7829234 7829234 0.02040 59113862 40549023 18564839 0.04850 66943096 40549023 26394073 0.06890 946830 946830 0.00250 2711651 1019126 1692525 0.00440 3658481 1019126 2639355 0.00690 70601577 41568149 29033428 0.07580 false 26802871 3784077 82897008 93032956 -10135948 X true true 1 1 CENTRAL MAINE MEDICAL CENTER 300 MAIN STREET LEWISTON ME 04240 WWW.CMMC.ORG 38819 X X X X CENTRAL MAINE MEDICAL CENTER 1 false false true X X X X X X X X X 15 true true true true X SEE PART V, SECTION C X WWW.MAINE.GOV/SHNAPP X true 15 true SEE PART V, SECTION C false true X 200. 0. X X X true true X X X true X SEE PART V, SECTION C X SEE PART V, SECTION C X SEE PART V, SECTION C X X X X X true X false X X X true X false false SCHEDULE H, PART V, SECTION B, LINE 5 COMMUNITY INPUT: COMMUNITY ENGAGEMENT USING SHARED CHNA REPORTS FOR LOCAL AND REGIONAL PLANNING IS A CRITICAL PART OF THE NEEDS ASSESSMENT AND HEALTH IMPROVEMENT PLANNING PROCESS. THE PROCESS, CO-LED BY MAINE CDC DISTRICT LIAISONS AND REPRESENTATIVES FROM MAINE SHNAPP NOT-FOR-PROFIT HOSPITALS, ACHIEVED THE FOLLOWING: -ENSURED BROAD INTERESTS OF THE LOCAL COMMUNITY WERE REPRESENTED; -OBTAINED STAKEHOLDER INPUT ON IDENTIFYING SIGNIFICANT HEALTH NEEDS BASED ON REVIEW OF DATA; -SOLICITED STAKEHOLDER FEEDBACK ON PRIORITIZING SIGNIFICANT HEALTH NEEDS; AND -IDENTIFIED LOCAL ASSETS AND RESOURCES THAT COULD ADDRESS LOCAL HEALTH PRIORITIES. PREPARING FOR COMMUNITY ENGAGEMENT SEPTEMBER 2014-SEPTEMBER 2015 THE SHNAPP COMMUNITY ENGAGEMENT PLANNING PROCESS INCLUDED THE DISTRICT LIAISON FROM THE MAINE CDC AND REPRESENTATIVES FROM PARTICIPATING MAINE SHNAPP HOSPITALS IN THE REGION (ST. MARY'S REGIONAL MEDICAL CENTER AND CENTRAL MAINE MEDICAL CENTER IN LEWISTON.) IT WAS DECIDED THAT THE EXISTING COMMUNITY HEALTH STAKEHOLDER COALITION WOULD BE THE LOCAL GROUP TO COORDINATE COMMUNITY ENGAGEMENT SESSIONS IN ANDROSCOGGIN COUNTY. IN 2012, REPRESENTATIVES FROM THE TWO LOCAL HOSPITAL SYSTEMS CAME TOGETHER TO ESTABLISH THE COMMUNITY HEALTH STAKEHOLDER COALITION, A GROUP OF COMMUNITY HEALTH AGENCIES, THE PUBLIC HEALTH SECTOR 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 -DEVELOPING STRATEGIES TO ADDRESS PRIORITIZED NEEDS -SHARING RELEVANT RESOURCES THROUGH NETWORKING ADDITIONALLY THE STAKEHOLDER GROUP CONTINUES TO ASSESS METHODS TO INCREASE THE COMMUNITIES' KNOWLEDGE OF, AND ACCESS TO, RESOURCES IN OUR AREA SUCH AS 2-1-1 MAINE AND TO EXPLORE OPTIONS FOR DIRECT REFERRAL TO RESOURCES FROM WITHIN THE HEALTHCARE SYSTEMS. FOR THE MOST RECENT CHNA, COALITION MEMBERS INCLUDED: JAMIE PAUL, WESTERN MAINE DISTRICT COORDINATING COUNCIL OF THE MAINE CENTER FOR DISEASE CONTROL AND PREVENTION, CYNTHIA RICE, DIRECTOR OF COMMUNITY HEALTH, WELLNESS AND CARDIOPULMONARY REHAB, CENTRAL MAINE MEDICAL CENTER, ELIZABETH KEENE, VP OF MISSION INTEGRATION, ST. MARY'S HEALTH SYSTEM, ERIN GUAY, EXECUTIVE DIRECTOR, HEALTHY ANDROSCOGGIN, CATHERINE RYDER, EXECUTIVE DIRECTOR, TRI-COUNTY MENTAL HEALTH SERVICES, GINNY ANDREWS, NUTRITION SERVICES PROGRAM MANAGER, WESTERN MAINE COMMUNITY ACTION, STEVE JOHNDRO, EXECUTIVE DIRECTOR, WESTERN MAINE COMMUNITY ACTION, BRENDA CZADO, DIRECTOR HOME CARE, ANDROSCOGGIN HOME CARE AND HOSPICE, REBECCA AUSTIN, DIRECTOR OF OUTREACH SERVICES, SAFE VOICES, SAM BOSS, HARWOOD CENTER AT BATES COLLEGE, JOAN CHURCHILL, EXECUTIVE DIRECTOR, COMMUNITY CLINICAL SERVICES, SHAWN YARDLEY, EXECUTIVE DIRECTOR, COMMUNITY CONCEPTS, LARRY MARCOUX, UNITED WAY AND QUINN GORMLEY, HEALTH EQUITY ALLIANCE. THESE MEMBERS REPRESENTED COMMUNITY HEALTH, PUBLIC HEALTH, HOSPITALS, MINORITY POPULATIONS, LOCAL COLLEGES, COMMUNITY ACTION AGENCIES AND THE LOCAL FEDERALLY QUALIFIED HEALTH CENTER (FQHC). OBTAINING LOCAL COMMUNITY ENGAGEMENT INPUT OCTOBER 2015-MARCH 2016 IN ORDER TO OBTAIN LOCAL COMMUNITY INPUT, THE COMMUNITY HEALTH STAKEHOLDER COALITION REVIEWED THE DATA IN THE ANDROSCOGGIN COUNTY SHNAPP CHNA REPORT AND THEN DEVELOPED AN APPROACH TO COMMUNITY ENGAGEMENT TO MAXIMIZE PARTICIPATION OF A CROSS SECTION OF THE COMMUNITY. THE COMMUNITY HEALTH STAKEHOLDER COALITION COORDINATED TWO COMMUNITY FORUMS HELD IN MARCH 2016 AND 13 OTHER GROUP PRESENTATION/KEY INFORMANT INTERVIEWS WITH EXISTING COMMUNITY GROUPS. THE OBJECTIVES OF THE FORUM INCLUDED: -PROVIDE AWARENESS AMONG COMMUNITY STAKEHOLDERS OF THE DATA/RESULTS FROM THE MAINE SHNAPP OR SUBSEQUENT RESEARCH BUILT ON THAT RESOURCE; -INVITE LOCAL INPUT ON WHAT THE DATA MEANS TO EACH LOCAL COMMUNITY/REGION; -SOLICIT LOCAL INPUT ON WHAT ISSUES SHOULD BE PRIORITIZED LOCALLY; -SOLICIT LOCAL IDEAS ON EXISTING RESOURCES, ASSETS, OR NEW INITIATIVES THAT SHOULD BE ALIGNED/DEVELOPED TO ADDRESS THE PRIORITIZED ISSUES; AND -CAPTURE AND SHARE INPUT FROM THE FORUM USING THE MODEL LOCAL SHNAPP COMMITTEE REPORTING FORM. THE COALITION ALSO DECIDED TO APPROACH EXISTING COMMUNITY GROUPS SUCH AS THE CHAMBER OF COMMERCE AND SENIORS PLUS AND INDIVIDUAL COMMUNITY MEMBERS TO OFFER GROUP PRESENTATIONS, KEY INFORMANT INTERVIEWS AND EVEN WRITTEN SURVEYS OFFERING THE ABOVE ELEMENTS. IN ALL, 520 PEOPLE PARTICIPATED IN EITHER THE COMMUNITY FORUMS, GROUP PRESENTATIONS, INTERVIEWS AND WRITTEN SURVEYS IN ANDROSCOGGIN COUNTY. THE SECTORS REPRESENTED INCLUDED: PUBLIC HEALTH, MEDICALLY UNDERSERVED, COMMUNITY HEALTH COALITION, NON PROFIT AGENCIES, LOW INCOME, RACIAL/ETHNIC MINORITIES, BUSINESS AND EDUCATION. THE CONVERSATIONS LARGELY INFORMED BOTH THE IMPLEMENTATION STRATEGIES AND STRATEGIC PLANS FOR THE HOSPITALS. SCHEDULE H, PART V, SECTION B, LINE 6A HOSPITAL FACILITIES: THE CHNA WAS CONDUCTED WITH ST. MARY'S REGIONAL MEDICAL CENTER. IN ADDITION, CMMC USED DATA FROM THE MAINE SHARED CHNA FOR ANDROSCOGGIN COUNTY, WHICH WAS PREPARED IN CONJUNCTION WITH EASTERN MAINE HEALTHCARE SYSTEM AND MAINEGENERAL HEALTH. SCHEDULE H, PART V, SECTION B, LINE 6B NON-HOSPITAL FACILITIES: THE CHNA WAS ALSO CONDUCTED WITH HEALTHY ANDROSCOGGIN AND OTHER COMMUNITY HEALTH AGENCIES. IN ADDITION, CMMC USED DATA FROM THE MAINE SHARED CHNA FOR ANDROSCOGGIN COUNTY, WHICH WAS PREPARED IN CONJUNCTION WITH MAINEHEALTH AND MAINE CENTER FOR DISEASE CONTROL AND PREVENTION. SCHEDULE H, PART V, SECTION B, LINE 7A HOSPITAL FACILITIY'S WEBSITE: WWW.CMHC.ORG/CMMC/ABOUT-CMMC/CENTRAL-MAINE-COMMUNITY-BENEFITS SCHEDULE H, PART V, SECTION B, LINE 10A IMPLEMENTATION STRATEGY WEBSITE: HTTPS://WWW.CMHC.ORG/CMMC/ABOUT-CMMC/CENTRAL-MAINE-COMMUNITY-BENEFITS SCHEDULE H, PART V, SECTION B, LINE 11 ADDRESSING IDENTIFIED NEEDS: THE COMMITMENT FROM CENTRAL MAINE MEDICAL CENTER AND ITS COMMUNITY PARTNERS WAS TO PRODUCE A DOCUMENT THAT REFLECTS THE VOICE OF OUR COMMUNITY. THE PRIORITIES THAT HAVE EMERGED INCLUDE: -MENTAL HEALTH -HEALTH CARE ACCESS -CHRONIC DISEASE (CARDIOVASCULAR DISEASE/HTN, DIABETES, RESPIRATORY DISEASE, DIABETES, CANCER) -PHYSICAL ACTIVITY, NUTRITION, OBESITY AND RELATED ISSUES -ENVIRONMENTAL HEALTH LEAD POISONING -SUBSTANCE AND ALCOHOL USE -TOBACCO USE THE NEXT STEP IN THIS PROCESS WAS TO DEVELOP AN IMPLEMENTATION STRATEGY THAT INCLUDED LONG-RANGE PLANS FOR THE PRIORITIZED NEEDS AND TIED THE SPECIFIC IMPLEMENTATION PLANS TO THE STRATEGIC PLAN FOR CENTRAL MAINE MEDICAL CENTER. THIS PROCESS WAS FACILITATED BY THE CMMC LEADERSHIP TEAM, THE COMMUNITY PILLAR STEERING COMMITTEE, AND INCLUDED PARTICIPATION FROM THE COMMUNITY STAKEHOLDER GROUP AND OTHER COMMUNITY MEMBERS. IT WAS COMPLETED IN QUARTER ONE OF FISCAL YEAR 17 USING EVIDENCE FROM USPTF AND HEALTH PEOPLE 2020 EVIDENCE-BASED RESOURCES. THE STRATEGIES, ACTIVITIES, ACTIONS TAKEN, PROGRAMS AND RESOURCES COMMITTED, COLLABORATION WITH OTHER ORGANIZATIONS, AND OUTCOMES CAN BE VIEWED AT WWW.CMMC.ORG/ABOUT-COMMUNITY-BENEFITS. SCHEDULE H, PART V, SECTION B, LINE 13H FAP ELIGIBILITY CRITERIA: PATIENTS MUST APPLY FOR MAINE FREE CARE IN ORDER TO 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, & 16C MEASURES TO PUBLICIZE THE POLICY: HTTPS://WWW.CMHC.ORG/BILLING-AND-FINANCIAL-INFORMATION/ SCHEDULE H, PART V, LINE 16I LEP TRANSLATIONS: THERE ARE NO GROUPS WITH LIMITED ENGLISH PROFICIENCY THAT RISE TO THE THRESHOLD REQUIRED UNDER THE IRC SECTION 501(R). 34 CENTRAL MAINE GASTROENTEROLOGY ASSOCIATE 77 BATES STREET SUITE 202 LEWISTON ME 04240 OUTPATIENT PHYSICIAN CLINIC CENTRAL MAINE SURGICAL ASSOCIATES 12 HIGH STREET SUITE 401 LEWISTON ME 04240 OUTPATIENT PHYSICIAN CLINIC CENTRAL MAINE BARIATRIC SURGERY 10 HIGH STREET SUITE 105 LEWISTON ME 04240 OUTPATIENT PHYSICIAN CLINIC CENTRAL MAINE ENDOCRINOLOGY AND DIABETES 287 MAIN STREET SUITE 301 LEWISTON ME 04240 OUTPATIENT PHYSICIAN CLINIC CENTRAL MAINE FAMILY HEALTH CARE ASSOC 190 STETSON ROAD AUBURN ME 04210 OUTPATIENT PHYSICIAN CLINIC CENTRAL MAINE FAMILY HEALTH RESIDENCY 76 HIGH STREET SUITE 100 LEWISTON ME 04240 OUTPATIENT PHYSICIAN CLINIC CENTRAL MAINE FAMILY PRACTICE 12 HIGH STREET SUITE 302 LEWISTON ME 04240 OUTPATIENT PHYSICIAN CLINIC CENTRAL MAINE GYNECOLOGY & UROGYNECOLOGY 287 MAIN STREET SUITE 201 LEWISTON ME 04240 OUTPATIENT PHYSICIAN CLINIC CENTRAL MAINE CARDIOLOGY 2 GREAT FALLS PLAZA AUBURN ME 04210 OUTPATIENT PHYSICIAN CLINIC CENTRAL MAINE HEMATOLOGY ONCOLOGY 12 HIGH STREET SUITE 205 LEWISTON ME 04240 OUTPATIENT PHYSICIAN CLINIC CENTRAL MAINE INTERNAL MEDICINE 10 HIGH STREET SUITE 400 LEWISTON ME 04240 OUTPATIENT PHYSICIAN CLINIC CENTRAL MAINE NEUROLOGY 10 MINOT AVENUE AUBURN ME 04210 OUTPATIENT PHYSICIAN CLINIC CENTRAL MAINE OBGYN 12 HIGH STREET SUITE 200 LEWISTON ME 04240 OUTPATIENT PHYSICIAN CLINIC CENTRAL MAINE PAIN AND HEADACHE CENTER 77 BATES STREET LEWISTON ME 04240 OUTPATIENT PHYSICIAN CLINIC CENTRAL MAINE PEDIATRICS 12 HIGH STREET SUITE 301 LEWISTON ME 04240 OUTPATIENT PHYSICIAN CLINIC CENTRAL MAINE PLASTIC SURGERY 287 MAIN STREET SUITE 302 LEWISTON ME 04240 OUTPATIENT PHYSICIAN CLINIC CENTRAL MAINE RADIOLOGY - OP 77 BATES STREET SUITE 201 LEWISTON ME 04240 OUTPATIENT PHYSICIAN CLINIC CENTRAL MAINE SPORTS MEDICINE 77 BATES STREET SUITE 101 LEWISTON ME 04240 OUTPATIENT PHYSICIAN CLINIC CENTRAL MAINE THERAPY SERVICES 77 BATES STREET SUITE 201 LEWISTON ME 04240 OUTPATIENT PHYSICIAN CLINIC CENTRAL MAINE UROLOGY 287 MAIN STREET SUITE 404 LEWISTON ME 04240 OUTPATIENT PHYSICIAN CLINIC GRAY FAMILY CLINIC 116 SHAKER ROAD GRAY ME 04039 OUTPATIENT PHYSICIAN CLINIC INFECTIOUS DISEASE ASSOCIATES 76 HIGH STREET SUITE 200 LEWISTON ME 04240 OUTPATIENT PHYSICIAN CLINIC LISBON FAMILY PRACTICE 2 BISBEE ROAD LISBON ME 04250 OUTPATIENT PHYSICIAN CLINIC MECHANIC FALLS FAMILY PRACTICE 22 PLEASANT STREET MECHANIC FALLS ME 04256 OUTPATIENT PHYSICIAN CLINIC MINOT AVENUE FAMILY MEDICINE 789 MINOT AVENUE AUBURN ME 04210 OUTPATIENT PHYSICIAN CLINIC POLAND COMMUNITY HEALTH CENTER 364 MAIN STREET POLAND ME 04274 OUTPATIENT PHYSICIAN CLINIC PULMONARY AND SLEEP MEDICINE 76 HIGH STREET SUITE 300 LEWISTON ME 04240 OUTPATIENT PHYSICIAN CLINIC TOPSHAM FAMILY MEDICINE 4 HORTON PLACE TOPSHAM ME 04086 OUTPATIENT PHYSICIAN CLINIC CENTRAL MAINE HEARING CENTER 12 HIGH STREET SUITE 102 LEWISTON ME 04240 OUTPATIENT PHYSICIAN CLINIC CENTRAL MAINE MEDICATION MANAGEMENT 10 HIGH STREET SUITE 103 LEWISTON ME 04240 OUTPATIENT PHYSICIAN CLINIC CENTRAL MAINE EAR NOSE AND THROAT 12 HIGH STREET SUITE 102 LEWISTON ME 04240 OUTPATIENT PHYSICIAN CLINIC SPRUCE MOUNTAIN HEALTH CENTER 38 UNION STREET LIVERMORE FALLS ME 04254 OUTPATIENT PHYSICIAN CLINIC CENTRAL MAINE PODIATRY 287 MAIN STREET LEWISTON ME 04240 OUTPATIENT PHYSICIAN CLINIC CENTRAL MAINE MENTAL HEALTH 10 HIGH STREET SUITE 301 LEWISTON ME 04240 OUTPATIENT PHYSICIAN CLINIC SCHEDULE H, PART I, LINE 3C FAP ELIGIBILITY CRITERIA: PATIENTS MUST APPLY FOR MAINE FREE CARE IN ORDER TO BEING CONSIDERED FOR THE HOSPITAL'S FREE CARE PROGRAM. AS PART OF THE APPLICATION, PATIENTS MUST SUBMIT A COPY OF CURRENT MAINECARE DECISION LETTERS. PATIENTS WILL BE ASKED IF THEY HAVE INSURANCE OF ANY KIND TO HELP PAY FOR CARE AND ARE ALSO ASKED TO SHOW THAT INSURANCE OR A GOVERNMENT PROGRAM WILL NOT PAY FOR YOUR CARE. IF PATIENTS DO NOT QUALIFY FOR FREE HOSPITAL CARE, THEY ARE ALLOWED TO ASK FOR A FAIR HEARING OR APPEAL. SCHEDULE H, PART I, LINE 7, COLUMN F PERCENT OF TOTAL EXPENSE: TO ARRIVE AT THE PERCENT OF TOTAL EXPENSES, THE DENOMINATOR WHICH EQUALS TOTAL OPERATING EXPENSES PER PART IX, LINE 25, OF THE FORM 990 WAS REDUCED BY BAD DEBT OF $26,802,871. SCHEDULE H, PART I, LINE 7 COSTING METHODOLOGY: THE COST TO CHARGE RATIO CALCULATED ON IRS WORKSHEET 2 WAS USED TO CALCULATE AMOUNTS ON IRS WORKSHEETS 1 AND 3. ALL OTHER WORKSHEETS USED THE ORGANIZATION'S COST ACCOUNTING SYSTEM. SCHEDULE H, PART III, SECTION A, LINE 2 BAD DEBT EXPENSE: LINE 2 REPORTS BAD DEBT EXPENSE FROM THE ORGANIZATION'S AUDITED FINANCIAL STATEMENTS. SCHEDULE H, PART III, SECTION B, LINE 3 BAD DEBT EXPENSES ATTRIBUTABLE TO CHARITY CARE: BAD DEBT ATTRIBUTABLE TO PATIENTS UNDER THE ORGANIZATION'S CHARITY CARE POLICY FOR LINE 3 WAS DETERMINED USING A COMPARISON OF EXPERIENCED CHARITY CARE COVERAGE AND US CENSUS BUREAU DATA FOR THE MOST RECENT YEAR AVAILABLE WHEN CHARITY CARE CONVERGE EXCEEDS THE CENSUS DATA, A MINIMAL AMOUNT OF BAD DEBT IS ASSUMED TO BE ELIGIBLE FOR CHARITY CARE TO ACCOUNT FOR THOSE PATIENTS WHO REFUSE TO PROVIDE INFORMATION DOCUMENTING ELIGIBILITY FOR THE PROGRAM. THESE ESTIMATES ARE BASED ON STATE-WIDE DATA AND DO NOT ACCOUNT FOR DIFFERENCES IN GEOGRAPHIC LOCATIONS WITHIN THE STATE. AS THIS AMOUNT IS RELATED TO PATIENTS ELIGIBLE UNDER THE FINANCIAL ASSISTANCE POLICY, IT IS INCLUDED AS A COMMUNITY BENEFIT. SCHEDULE H, PART III, SECTION A, LINE 4 BAD DEBT EXPENSE FOOTNOTE: THE AUDITED FINANCIAL STATEMENTS DO NOT 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 THE 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 8 COMMUNITY BENEFIT: THE COSTING METHODOLOGY USED FOR LINE 6 IS INFORMATION PULLED FROM THE MEDICARE COST REPORT FILING. THE SHORTFALL REPORTED ON LINE 7 COULD BE CONSIDERED COMMUNITY BENEFIT TO A LEVEL PROPORTIONAL TO THE POVERTY LEVELS INDICATED BY CENSUS BUREAU DATA. IF MAINE RESIDENTS, AGE 65 OR OLDER, BELOW THE 200% FPG LEVEL WERE NOT COVERED BY MEDICARE, THEY WOULD QUALIFY UNDER CMMC'S FREE CARE POLICY. UNDER THAT CIRCUMSTANCE, THESE PATIENTS WOULD THEN APPEAR AS PART OF THE STATISTICS ON PART I, LINE 7A. SCHEDULE H, PART III, SECTION C, LINE 9B COLLECTION POLICY: COLLECTION PRACTICES FOR PATIENTS KNOWN TO BE ELIGIBLE FOR CHARITY CARE ARE LIMITED TO COLLECTING FROM ANY AVAILABLE PAYMENT SOURCES SUCH AS MEDICARE OR MEDICAID. IF A PATIENT IS ELIGIBLE, BUT HAS NOT APPLIED FOR MEDICAID COVERAGE, THE PATIENT IS REQUESTED TO APPLY. ASSISTANCE IS AVAILABLE TO HELP THE PATIENT WITH THE MEDICAID APPLICATION PROCESS. SCHEDULE H, PART VI, LINE 2 NEEDS ASSESSMENT: CENTRAL MAINE MEDICAL CENTER PROVIDES A FULL RANGE OF SERVICES TO ITS PRIMARY SERVICES AREA, AS WELL AS THE EXTENDED AREA OF THE ENTIRE CENTRAL MAINE HEALTHCARE SYSTEM. IT ASSESSES THE NEEDS OF ITS VARIOUS COMMUNITIES FROM VARIOUS THIRD-PARTY SURVEYS AND REPORTS, OBSERVATIONS IN ITS PATIENT POPULATION AND THE POPULATIONS OF ITS AFFILIATED SYSTEM HOSPITALS, AS WELL AS ASSISTING WITH STATE-WIDE INITIATES IN PREVENTATIVE MEDICINE AND EDUCATION. SCHEDULE H, PART VI, LINE 3 PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE: CENTRAL MAINE MEDICAL CENTER PROVIDES NOTICES ABOUT ITS FREE CARE POLICY IN ALL CLINICAL DEPARTMENTS AND MAJOR PATIENTS AREAS. AN INPATIENT FINANCIAL COUNSELOR VISITS WITH ALL UNINSURED PATIENTS TO DISCUSS OPTIONS, INCLUDING GOVERNMENTAL PROGRAM ELIGIBILITY AND FREE CARE ASSISTANCE IS AVAILABLE TO HELP PATIENTS WITH COMPLETION OF MEDICAID APPLICATIONS. ALL PATIENTS FINANCIAL SERVICES STAFF ARE TRAINED TO OFFER FREE CARE AS AN OPTION TO PATIENTS WHO INDICATE AN INABILITY OR DIFFICULTY IN PAYING FOR SERVICES. INFORMATION ABOUT FINANCIAL ASSISTANCE AVAILABILITY IS INCLUDED ON THE BACK OF EVERY PATIENT STATEMENT. ADDITIONALLY, UNINSURED PATIENTS RECEIVED A SEPARATE INFORMATION SHEET WITH THEIR STATEMENTS, FURTHER INFORMING THEM ABOUT THE AVAILABLE OPTIONS. SCHEDULE H, PART VI, LINE 4 COMMUNITY INFORMATION: CENTRAL MAINE MEDICAL CENTER, LOCATED IN LEWISTON, MAINE SERVES A PRIMARY AREA OF ANDROSCOGGIN COUNTY IN CENTRAL MAINE. ADDITIONALLY, IT SERVES PORTIONS OF CUMBERLAND, FRANKLIN, KENNEBEC, OXFORD, AND SAGADAHOC COUNTIES. THE LEWISTON-AUBURN AREA IS URBAN, FOR MAINE STANDARDS, BUT QUICKLY BECOMES SUBURBAN TO ALMOST-RURAL QUICKLY OUTSIDE THE CITY LIMITS. ANDROSCOGGIN COUNTY HAS A POPULATION OF JUST UNDER 108,000 PERSONS, WHICH MAKES UP APPROXIMATELY 8% OF THE OVERALL MAINE POPULATION. WHILE ALMOST 93% OF THE POPULATION IS MADE UP OF CAUCASIAN PERSONS, MORE THAN 16% SPEAK A LANGUAGE OTHER THAN ENGLISH AT HOME. THIRTEEN PERCENT OF THE POPULATION IS BELOW THE POVERTY LEVEL, SPECIFICALLY IN LEWISTON, THE SECOND LARGEST CITY IN MAINE, WITH A POPULATION OF APPROXIMATELY 36,600 PERSONS, SIMILAR RACIAL DISTRIBUTIONS ARE OBSERVED, BUT MORE THAN 28% CLAIM A LANGUAGE OTHER THAN ENGLISH AS THEIR PRIMARY. FIFTEEN PERCENT ARE BELOW THE POVERTY LEVEL. SCHEDULE H, PART VI, LINE 5 PROMOTION OF COMMUNITY HEALTH: CENTRAL MAINE MEDICAL CENTER HAS AN OPEN MEDICAL STAFF, ALLOWING ANY NON-EMPLOYED OR AFFILIATED PHYSICIANS TO HAVE ADMITTING PRIVILEGES TO THE HOSPITAL. THE BOARD OF DIRECTORS IS MADE UP OF A MAJORITY OF LOCAL COMMUNITY MEMBERS ALONG WITH SOME REPRESENTATION BY DIRECTORS FROM CENTRAL MAINE HEALTHCARE, THE PARENT OF THE HEALTHCARE SYSTEM WHICH CENTRAL MAINE MEDICAL CENTER BELONGS TO, HELPING TO BRING TOGETHER THE VISIONS OF THE LOCAL COMMUNITY WITH THE CAPABILITIES AND VISION OF THE SYSTEM AS A WHOLE FOR THE BENEFIT OF LEWISTON AND SURROUNDING COMMUNITIES. SCHEDULE H, PART VI, LINE 6 AFFILIATED HEALTH CARE SYSTEM: CENTRAL MAINE MEDICAL CENTER (CMMC) IS A TERTIARY CARE HOSPITAL IN THE CENTRAL MAINE HEALTHCARE SYSTEM. TWO RURAL, CRITICAL ACCESS HOSPITALS ARE ALSO MEMBERS OF THIS SYSTEM. CMMC PROVIDES A WIDE RANGE OF SPECIALIST PHYSICIANS AND SERVICES TO ITS COMMUNITY, AS WELL AS THE SYSTEM. CMMC PROVIDES PHYSICIANS TO STAFF SPECIALTY CLINICS IN THE RURAL COMMUNITIES SERVED BY THE CRITICAL ACCESS HOSPITALS ON A LIMITED, BUT REGULAR, BASIS. THESE SERVICES WOULD NOT NORMALLY BE SUPPORTED BY THE LIMITED POPULATIONS AND PATIENTS WOULD INSTEAD NEED TO TRAVEL MUCH LONGER DISTANCES TO CONSULT OR VISIT WITH A SPECIALIST. CMMC ALSO PROVIDES ACCESS TO TRAUMA CARE, NEONATAL INTENSIVE CARE, AND SPECIALIZED CARDIAC CARE. THE SYSTEM PARENT, CENTRAL MAINE HEALTHCARE, PROVIDES STREAMLINED ADMINISTRATIVE FUNCTIONS AND BACKROOM SERVICES FOR THE ENTIRE SYSTEM, PROVIDING COST EFFICIENCY AND OTHER BENEFITS TO ALL MEMBERS. THIS ALSO ALLOWS FOR EASY ADMINISTRATIVE HANDLING OF TRANSFERS OF PATIENTS BETWEEN HOSPITALS, AS WELL AS A SINGLE POINT OF CONTACT FOR PATIENTS TO ADDRESS BILLS AND INSURANCE ISSUES. true true false false false false false false false RICHARD GOLDSTEIN PHYS PRACT EXEC END 12/17 0 468400 0 0 0 68492 0 75625 0 26954 0 639471 0 0 JEFF BRICKMAN TRUSTEE END 01/18; PRESIDENT 0 659404 0 195000 0 12444 0 94125 0 20849 0 981822 0 0 NICHOLETTE ERICKSON MD PHYSICIAN; TRUSTEE END 01/18 540982 0 8842 0 5611 0 6625 0 19445 0 581505 0 0 0 DAVID THOMPSON TREASURER 0 379692 0 92500 0 25570 0 45125 0 12991 0 555878 0 0 WILLIAM LEE MD PHYSICIAN; DIRECTOR BEG 01/18 299378 0 18317 0 7144 0 24625 0 20701 0 370165 0 0 0 PAUL WELDNER MD PHYSICIAN 899995 0 13500 0 16863 0 24625 0 0 0 954983 0 0 0 OSWALDO BISBAL MD PHYSICIAN 772706 0 84597 0 5387 0 24625 0 21497 0 908812 0 0 0 DANIEL LACERTE MD PHYSICIAN 686244 0 164327 0 4590 0 6625 0 20621 0 882407 0 0 0 CARMINE FRUMIENTO MD PHYSICIAN 756776 0 45620 0 4131 0 6625 0 19181 0 832333 0 0 0 TAREK RADWAN MD PHYSICIAN 821871 0 99000 0 39269 0 24625 0 8407 0 993172 0 0 0 JAMES LOGGINS MD PHYS DIVISION CHIEF END 06/18 470016 0 99676 0 12703 0 24625 0 26289 0 633309 0 0 0 DAVID LAUVER MD PHYS DIVISION CHIEF END 09/17 163818 0 131815 0 1532 0 10067 0 5012 0 312244 0 0 0 MICHAEL STADNICKI PHYSICIAN DIVISION CHIEF 289263 0 0 0 3144 0 6625 0 21768 0 320800 0 0 0 BETHANY PICKER PHYSICIAN DIVISION CHIEF 183192 0 17500 0 2476 0 5312 0 24089 0 232569 0 0 0 ANDREW EISENHAUER PHYS DIVISION CHIEF BEG 09/17 470700 0 127375 0 27084 0 24625 0 21802 0 671586 0 0 0 TINA-MARIE LEGERE FORMER PRESIDENT CMMC END 1/17 0 15039 0 0 0 469554 0 21591 0 2134 0 508318 0 0 PHILIPPE MORISSETTE FORMER TREASURER/VICE. PRESI 0 226974 0 0 0 2143 0 43774 0 7999 0 280890 0 0 SCHEDULE J, PART I, LINE 3 CEO COMPENSATION: THE COMPENSATION OF THE ORGANIZATION'S PRESIDENT IS DETERMINED BY THE PARENT CORPORATION'S BOARD OF DIRECTORS' EXECUTIVE COMPENSATION COMMITTEE USING THE FOLLOWING: -COMPENSATION COMMITTEE -INDEPENDENT COMPENSATION CONSULTANT -COMPENSATION SURVEY OR STUDY -APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE SCHEDULE J, PART I, LINE 4A SEVERANCE PAYMENTS: THE FOLLOWING INDIVIDUALS RECEIVED SEVERANCE PAYMENTS FROM CENTRAL MAINE HEALTHCARE CORPORATION: RICHARD GOLDSTEIN: $ 29,423 TINA-MARIE LEGERE: $430,560 SCHEDULE J, PART I, LINE 4B SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN: A PARTICIPANT'S ENTITLEMENT TO BENEFITS WILL VEST ON THE PARTICIPANT'S VESTING DATE PROVIDED THE PARTICIPANT HAS REMAINED IN CONTINUOUS EMPLOYMENT IN THE SAME POSITION WHILE PARTICIPATING IN THIS PLAN. A PARTICIPANT WILL HAVE ONLY ONE VESTING DATE FOR ALL ELECTIVE DEFERRALS AND OTHER PLAN CONTRIBUTIONS MADE ON THE PARTICIPANT'S BEHALF. DURING ALL PLAN YEARS, A PARTICIPANT'S ENTITLEMENT TO BENEFITS WILL ALSO VEST (A) IF THE PARTICIPANT DIES WHILE STILL EMPLOYED BY THE EMPLOYER, (B) IF THE PARTICIPANT'S EMPLOYMENT TERMINATES DUE TO TOTAL DISABILITY; OR (C) IF THE EMPLOYER TERMINATES THE PARTICIPANT'S EMPLOYMENT FOR ANY REASON OTHER THAN FOR "CAUSE". ANY PORTION OF THE PARTICIPANTS ENTITLEMENT TO BENEFITS THAT IS NOT VESTED WHEN THE PARTICIPANT'S EMPLOYMENT WITH THE EMPLOYER TERMINATES, INCLUDING ELECTIVE DEFERRALS, WILL BE FORFEITED. THE EMPLOYER WILL DISTRIBUTE A PARTICIPANT'S BENEFITS UNDER THE PLAN AS SOON AS PRACTICABLE AFTER THE PARTICIPANT'S ENTITLEMENT BECOMES VESTED. THE FOLLOWING INDIVIDUALS PARTICIPATED IN A SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN THROUGH CENTRAL MAINE HEALTHCARE CORPORATION, A RELATED ENTITY. $51,000 RICHARD GOLDSTEIN (DEFERRAL) 69,500 JEFF BRICKMAN (DEFERRAL) 20,500 DAVID THOMPSON (DEFERRAL) 38,000 PHILIPPE MORISSETTE (DEFERRAL) SCHEDULE J, PART II, COLUMN F COMPENSATION REPORTED IN PRIOR FORM 990: COMPENSATION IS REPORTED ON THE FORM 990 IN THE YEAR THAT THE COMPENSATION IS EARNED BY OR AWARDED TO AN INDIVIDUAL, EVEN IF THE COMPENSATION IS NOT PAID TO THE INDIVIDUAL, IS NOT FULLY VESTED, OR IS SUBJECT TO SUBSTANTIAL RISK OF FORFEITURE. IF COMPENSATION IS EARNED OR AWARDED IN ONE YEAR BUT PAID IN A LATER YEAR, THEN THE COMPENSATION IS REPORTED A SECOND TIME ON THE FORM 990 IN THE YEAR THE COMPENSATION IS VESTED OR PAID TO THE INDIVIDUAL. A MAINE HEALTH & HIGHER EDUCATIONAL FACILITIES AUTH 010314384 560427GE0 2009-12-10 56033554 FACILITY EXPANSION/CONSTRUCTION false false true B MAINE HEALTH & HIGHER EUDCATIONAL FACILITIES AUTH 010314384 560427WV4 2013-05-23 41071242 REFUND SERIES 2003A BOND false false true C MAINE HEALTH & HIGHER EDUCATIONAL FACILITIES AUTH 010314384 56042RLG5 2017-06-27 12279914 REFUND SERIES 2005B BOND false false true A 2180000 0 56033554 6631632 1923331 0 639410 0 1675000 45161181 0 0 2011 false false true true B 5530000 0 41071242 2957944 0 0 302888 0 0 0 42862476 0 2013 false true true true C 0 0 12279914 0 0 0 138533 0 0 0 12141381 0 2017 true false true true A false false false false 0 false false false true B false false false false 0 false false false true C false false false false 0 false false false true A false false false true false false 0 false 0 false false B false false false true false false 0 false 0 false false C false true false false false false 0 false 0 false false A false B false C false SCHEDULE K, PART IV, LINE 2C, COLUMN A DATE OF REBATE COMPUTATION: THE REBATE COMPUTATION WAS PERFORMED 12/10/2014. SCHEDULE K, PART IV, LINE 2C, COLUMN B DATE OF REBATE COMPUTATION: THE REBATE COMPUTATION WAS PERFORMED 6/25/2018. PAUL WELDNER EMPLOYEE SALARY ADV X 50000 4333 false false true TAREK RADWAN EMPLOYEE SALARY ADV X 100000 5695 false false true 10028 JULIA LAUVER RELATIVE OF D. LAUVER 52547 SALARY AND WAGES false TIFFANY CHARLESON REALTIVE OF A. EISENHAUER 93279 SALARY AND WAGES false FORM 990, PART V, LINE 1A & 2A COMMON PAYMASTER: CENTRAL MAINE MEDICAL CENTER IS A TAX EXEMPT ORGANIZATION WHICH FILES ITS PAYROLL FORMS AND REPORTS WITH THE IRS AND DOL ON A CONSOLIDATED BASIS UNDER ITS PARENT, CENTRAL MAINE HEALTHCARE CORPORATION, USING THE PARENT'S EIN. THIS INCLUDES FORM 941'S, W-2'S AND OTHER RELATED FILINGS. FORM 990, PART VI, SECTION A, LINE 2 BUSINESS RELATIONSHIP: JEFF BRICKMAN, RICHARD GOLDSTEIN, DAVID THOMPSON, HOLLI BOCCELLI, PHILIPPE MORISSETTE, TINA-MARIE LEGERE, AND DAVID TUPPONCE HAVE A BUSINESS RELATIONSHIP THROUGH THEIR EMPLOYMENT WITH A RELATED ORGANIZATION. FORM 990, PART VI, SECTION A, LINE 4 SIGNIFICANT CHANGES IN GOVERNING DOCUMENTS: 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 SOLE MEMBER OF THE CORPORATION SHALL BE CENTRAL MAINE HEALTHCARE CORPORATION ACTING THROUGH THE MEMBER'S BOARD OF DIRECTORS. -THE BOARD SHALL CONSIST OF THE SAME INDIVIDUALS SERVING AS MEMBERS OF THE BOARD OF DIRECTORS OF CENTRAL MAINE HEALTHCARE CORPORATION (CMHC). -THE OFFICERS OF THE CORPORATION SHALL BE THE CHAIR OF THE BOARD, THE VICE CHAIR OF THE BOARD, THE PRESIDENT, THE TREASURER, AND THE SECRETARY. FORM 990, PART VI, SECTION A, LINE 6, 7A, AND 7B MEMBERS OF THE ORGANIZATION: THE SOLE MEMBER OF CENTRAL MAINE MEDICAL CENTER IS CENTRAL MAINE HEALTHCARE CORPORATION (CMHC). THE BOARD SHALL CONSIST OF THE SAME INDIVIDUALS SERVING AS MEMBERS OF THE BOARD OF DIRECTORS OF CMHC. THE MEMBER MAY MAKE, AMEND OR REPEAL THE BYLAWS IN WHOLE OR IN PART. FORM 990, PART VI, SECTION B, LINE 11B FORM 990 REVIEW PROCESS: ALL AFFILIATED FORM 990'S AND APPLICABLE SCHEDULES ARE PREPARED BY A PUBLIC ACCOUNTING FIRM IN COOPERATION WITH THE FINANCE DEPARTMENT. THE COMPLETED RETURNS ARE REVIEWED WITH THE VICE PRESIDENT OF FINANCE, THEN THE CFO. FOLLOWING THAT REVIEW THEY ARE PRESENTED TO THE FINANCE COMMITTEE OF THE CENTRAL MAINE HEALTHCARE BOARD OF DIRECTORS, WHICH HAS REPRESENTATIVES FROM ALL AFFILIATED BOARDS. ONCE THIS REVIEW IS COMPLETED, ANY NECESSARY CHANGES ARE MADE AND THE FINAL RETURN IS PRESENTED TO ITS RESPECTIVE BOARD 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 12C MONITORING COMPLIANCE WITH CONFLICT OF INTEREST POLICY: OFFICERS AND DIRECTORS COMPLETE AN ANNUAL CONFLICT OF INTEREST STATEMENT WHICH IS REVIEWED BY THE CHAIRMAN OF THE BOARD AND CONFORMS TO THE CONDITIONS CONTAINED WITHIN THE CORPORATION'S BYLAWS, WHICH MEET OR EXCEED THE CURRENT IRS REPORTING THRESHOLDS. IN AREAS OF CONFLICT BY THE CHAIRMAN, THE VICE-CHAIRMAN REVIEWS. ADDITIONALLY, AS PART OF THE ANNUAL FORM 990 PREPARATION PROCESS, A SEPARATE QUESTIONNAIRE IS PROVIDED, WHICH INCLUDES DISTRIBUTION TO KEY EMPLOYEES, COVERING REPORTING AREAS OF LOANS, GRANTS, BUSINESS RELATIONSHIPS, AND OTHER CONFLICTS. THESE QUESTIONNAIRES ARE REVIEWED BY THE FINANCE DEPARTMENT FOR REPORTABLE ITEMS FOR THE FORM 990. IN THE CASE OF A POSSIBLE CONFLICT, THE BOARD WOULD REVIEW THE SITUATION AND TAKE ACTIONS DEEMED APPROPRIATE FOR THE POSSIBLE OR ACTUAL CONFLICTS OF MEMBERS OF THE BOARD OR THE EXECUTIVE OFFICERS. IN THE CASE OF KEY EMPLOYEES, THE REVIEW AND ACTIONS TAKEN WOULD BE PERFORMED BY THEIR DIRECT SUPERVISOR. FORM 990, PART VI, SECTION B, LINE 15A & 15B EXECUTIVE COMPENSATION REVIEW: A STANDING EXECUTIVE COMPENSATION COMMITTEE (ECC), COMPRISED OF INDEPENDENT MEMBERS OF BOARD LEADERSHIP, EXISTS TO UNDERTAKE THE PROCESS OF DETERMINING COMPENSATION FOR THE CHIEF EXECUTIVE OFFICER, CHIEF FINANCIAL OFFICER, CHIEF MEDICAL OFFICER, PRESIDENT OF CENTRAL MAINE MEDICAL CENTER, PHYSICIAN PRACTICE EXECUTIVE, AND PRESIDENT OF RUMFORD AND BRIDGTON HOSPITALS. THE PROCESS GUIDELINES AND AUTHORITY OF THE ECC ARE SET OUR IN THE EXECUTIVE COMPENSATION PHILOSOPHY AND RESPONSIBILITIES CHARTER WHICH APPROVED BY THE CMHC BOARD. THE ENTIRE CMHC BOARD PARTICIPATES IN THE ANNUAL PERFORMANCE EVALUATION OF EACH EXECUTIVE, INCLUDING A REVIEW OF ACCOMPLISHMENTS RELATIVE TO GOALS AND OBJECTIVES DERIVED FROM THE STRATEGIC PLAN. THE ECC REVIEWS THE RESULTS OF THE ANNUAL PERFORMANCE EVALUATION AND APPROPRIATE COMPARABILITY DATA BASED ON SEVERAL FACTORS RECOMMENDED BY AN INDEPENDENT EXECUTIVE COMPENSATION CONSULTANT, WHO SPECIALIZES IN NOT-FOR-PROFIT HOSPITALS AND HEALTH SYSTEMS, AND OUR ATTORNEYS. FACTORS USED IN DETERMINING COMPARABILITY TO THE ORGANIZATION INCLUDING SIZE, GEOGRAPHY, ORGANIZATIONAL COMPLEXITY, FACILITY TYPE, OWNERSHIP TYPE, AND ANY OTHER FACTORS DEEMED RELEVANT BY THE COMMITTEE, ITS CONSULTANTS, OR ITS ATTORNEYS. USING THIS INFORMATION, THE ECC ANNUALLY REVIEWS THE EXECUTIVES' COMPENSATION TO DETERMINE IF MODIFICATION TO BASE SALARY IS WARRANTED, AND REVIEWS THE EXECUTIVES' ACCOMPLISHMENTS TO DETERMINE IF ANY VARIABLE PAY IS TO BE AWARDED. THE ENTIRE PROCESS IS THEN DOCUMENTED CONTEMPORANEOUSLY WITH THE DECISION-MAKING PROCESS AND APPROVED THEREAFTER IN ACCORDANCE WITH THE REQUIREMENTS OF THE IRS. FORM 990, PART VI, SECTION C, LINE 19 PUBLIC DISCLOSURE: THE ORGANIZATION'S GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY ARE AVAILABLE UPON REQUEST IN THE ORGANIZATION'S ADMINISTRATIVE OFFICES. THE FINANCIAL STATEMENTS OF THE ORGANIZATION ARE INCLUDED IN THE MOST RECENTLY FILED FORM 990 AND PROVIDED, UPON REQUEST, IN THAT FORMAT UNLESS THE SPECIFIC REQUEST DEEMS A DIFFERENT FORMAT MORE APPROPRIATE. FORM 990, PART VII, SECTION A BOARD MEMBER COMPENSATION: NO MEMBERS OF THE BOARD OF DIRECTORS RECEIVED COMPENSATION FOR THEIR DUTIES AS DIRECTORS. JEFF BRICKMAN IS EMPLOYED AS PRESIDENT OF CENTRAL MAINE HEALTHCARE CORPORATION AND HIS COMPENSATED TIME IS SPENT IN THAT CAPACITY. WILLIAM LEE, M.D. IS A PHYSICIAN AND HIS COMPENSATED TIME IS SPENT IN THAT CAPACITY. NICHOLETTE ERICKSON, M.D., IS A PHYSICIAN AND HER COMPENSATED TIME IS SPENT IN THAT CAPACITY. FORM 990, PART XI, LINE 9 OTHER CHANGES IN NET ASSETS: $ (3,455,224) CHANGE IN INTEREST IN RELATED PARTY FORM 990 PART IX LINE 11G DESCRIPTION:LABOR SERVICES TOTAL FEES:23111627 FORM 990 PART IX LINE 11G DESCRIPTION:OUTSIDE PURCHASED SERVICES TOTAL FEES:18876477 FORM 990 PART IX LINE 11G DESCRIPTION:PURCHASED SERVICES TOTAL FEES:11171863 FORM 990 PART IX LINE 11G DESCRIPTION:PHYSICIANS PURCHASED LABOR TOTAL FEES:3833295 FORM 990 PART IX LINE 11G DESCRIPTION:OTHER PURCHASED LABOR TOTAL FEES:3221265 FORM 990 PART IX LINE 11G DESCRIPTION:NURSES PURCHASED LABOR TOTAL FEES:1865206 FORM 990 PART IX LINE 11G DESCRIPTION:PROFESSIONAL FEES TOTAL FEES:1672579 FORM 990 PART IX LINE 11G DESCRIPTION:CONSULTING TOTAL FEES:374464 FORM 990 PART IX LINE 11G DESCRIPTION:MEDICAL DIRECTOR FEES TOTAL FEES:31500 FORM 990 PART IX LINE 11G DESCRIPTION:OUTSIDE PURCHASED SERVICES-IT TOTAL FEES:6200 FORM 990 PART IX LINE 11G DESCRIPTION:INTERPRETING SERVICES TOTAL FEES:4883 MAINE COLLEGE OF HEALTH PROFESSIONS PO BOX 4500 LEWISTON ME 04243 010356077 EDUCATION ME 501(C)(3) 2 CMMC true CENTRAL MAINE REAL ESTATE MANAGEMENT COR PO BOX 4500 LEWISTON ME 04243 010387674 REAL ESTATE ME 501(C)(2) CMHC false RUMFORD COMMUNITY HOME CORPORATION 11 JOHN F KENNEDY DRIVE RUMFORD ME 04276 222844951 NURSING HOME ME 501(C)(3) 10 CMHC false RUMFORD COMMUNITY FAMILY HEALTH CENTER 430 FRANKLIN STREET RUMFORD ME 04276 010481000 HEALTHCARE ME 501(C)(3) 3 CMHC false BRIDGTON HOSPITAL 10 HOSPITAL DRIVE BRIDGTON ME 04009 010130427 HEALTHCARE ME 501(C)(3) 3 CMHC false CENTRAL MAINE COMMUNITY HEALTH CORP PO BOX 4500 LEWISTON ME 04243 010386912 PUBLIC ED ME 501(C)(3) 7 CMHC false CENTRAL MAINE HEALTHCARE CORPORATION PO BOX 4500 LEWISTON ME 04243 010386913 HEALTHCARE ME 501(C)(3) 7 NA false RUMFORD HOSPITAL 420 FRANKLIN STREET RUMFORD ME 04276 010215227 HEALTHCARE ME 501(C)(3) 3 CMHC false BRIDGTON HOSPITAL PHYSICIANS GROUP SOUTH HIGH STREET BRIDGTON ME 04009 010493083 HEALTHCARE ME 501(C)(3) PF CMHC false ELIAS E TUCKER TRUST FUND C/O CMMC 300 MAIN STREET LEWISTON ME 04240 016042343 NURSING ED ME 501(C)(3) 12 A I CMMC true CWM INSURANCE LTD GENESIS BUIDLING PO BOX 1363 GRAND CAYMAN B.W.I. CJ 980220891 INSURANCE CJ CMHC C CORP false CENTRAL MAINE HEALTH VENTURES INC 300 MAIN STREET LEWISTON ME 04240 010430016 HEALTHCARE ME CMHC C CORP false CENTRAL MAINE ACO 300 MAIN STREET LEWISTON ME 04240 274604314 ACCOUNTABLE C ME CMHC C CORP false true false true false false false false false false true false true false false true true true false false MAINE COLLEGE OF HEALTH PROFESSIONS A 147888 COST MAINE COLLEGE OF HEALTH PROFESSIONS L 229929 COST MAINE COLLEGE OF HEALTH PROFESSIONS O 1137082 COST