2018-08-10T09:19:09-04:00 2017-09-30 990 2016-10-01 010211503 FRANKLIN MEMORIAL HOSPITAL FRAN 2077792500 111 FRANKLIN HEALTH COMMONS FARMINGTON ME 04938 JOHN COX REGIONAL CFO 2077792500 2018-08-01 2016 2022-09-23 18:48:47Z TIMOTHY CHURCHILL 111 FRANKLIN HEALTH COMMONS FARMINGTON ME 04938 77519804 false X WWW.FCHN.ORG X 1926 ME COMMUNITY HOSPITAL 17 9 817 122 0 252360 1657842 75719828 75704281 51395 3353 47150 63001 76070733 77428477 0 0 46486808 49479534 0 0 34526402 31669413 81013210 81148947 -4942477 -3720470 46022229 45668255 29494297 27805114 16527932 17863141 X TO PROVIDE HIGH-QUALITY, COST-EFFECTIVE, PATIENT-CENTERED HEALTHCARE TO OUR WEST CENTRAL MAINE COMMUNITY. WE WORK WITH OUR COMMUNITY AND OTHER HEALTHCARE PROVIDERS TO INTEGRATE SERVICES AND ENSURE THE HEALTH OF OUR COMMUNITY. false false 42528056 57181607 ROUTINE INPATIENT AND ANCILLARY OUTPATIENT SERVICES FRANKLIN MEMORIAL HOSPITAL IS A NON-FOR-PROFIT COMMUNITY HOSPITAL WHICH PROVIDES HIGH-QUALITY, COST-EFFECTIVE, PATIENT-CENTERED INPATIENT AND OUTPATIENT HEALTHCARE SERVICES TO THE WEST CENTRAL MAINE COMMUNITY. THE 65-BED HOSPITAL IS FULLY QUALIFIED AND ACCREDITED TO HANDLE A BROAD RANGE OF MEDICAL, SURGICAL, PEDIATRIC, WOMEN'S CARE AND DIAGNOSTIC SERVICES. FRANKLIN MEMORIAL HOSPITAL OFFERS TOP QUALITY SPECIALTY CARE INCLUDING ROUTINE ADULT, PEDIATRIC AND INTENSIVE CARE INPATIENT SERVICES AS WELL AS A VARIETY OF OUTPATIENT SERVICES INCLUDING ONCOLOGY, HEMATOLOGY, CARDIOLOGY, OTOLARYNGOLOGY, ORTHOPEDICS, BEHAVIORAL SERVICES, OCCUPATIONAL HEALTH, (CONTINUED AT SCHEDULE O) (CONTINUED FROM PART III, LINE 4A) DERMATOLOGY, PULMONOLOGY, PAIN MANAGEMENT, PEDIATRIC ENDOCRINOLOGY, PHYSICAL REHABILITATION, SPORTS MEDICINE AND WOUND CARE. DURING THE TWELVE MONTHS ENDING SEPTEMBER 30, 2017 THERE WERE 1,946 INPATIENT DISCHARGES, 1,734 OUTPATIENT SURGERIES, 234,442 OUTPATIENT LAB TESTS AND 40,862 OUTPATIENT IMAGING PROCEDURES. 20096521 10827516 FRANKLIN HEALTH PHYSICIAN PRACTICES FRANKLIN MEMORIAL HOSPITAL IDENTIFIED ACCESS TO PRIMARY CARE AS A CENTRAL COMMUNITY NEED AND IS COMMITTED TO PROVIDING HIGH QUALITY PHYSICIAN SERVICES OF FAMILY PRACTICE, INTERNAL MEDICINE, PEDIATRICS AND WOMEN'S CARE. IN ADDITION, FRANKLIN MEMORIAL HOSPITAL OFFERS A VARIETY OF SPECIALTY CARE SERVICES INCLUDING DERMATOLOGY, SURGERY, ORTHOPEDICS, UROLOGY AND BEHAVIORAL HEALTH SERVICES. DURING THE TWELVE MONTHS ENDING SEPTEMBER 30, 2017 FRANKLIN MEMORIAL HOSPITAL PROVIDED 50,645 PRIMARY CARE VISITS AND 19,346 SPECIALTY CARE VISITS IN THE FRANKLIN HEALTH PHYSICIAN PRACTICES. 5638058 7695158 EMERGENCY ROOM FRANKLIN MEMORIAL HOSPITAL OPERATES AN EMERGENCY DEPARTMENT WHICH OPERATES 24 HOURS A DAY SEVEN DAYS A WEEK. THE EMERGENCY DEPARTMENT SERVES AS THE PRIMARY CARE PHYSICIAN FOR A NUMBER OF LOW INCOME AND INDIGENT RESIDENTS OF THE WEST CENTRAL MAINE COMMUNITY. GIVEN FRANKLIN MEMORIAL HOSPITAL'S COMMITMENT TO ACCESS TO CARE REGARDLESS OF THE ABILITY TO PAY, THE EMERGENCY DEPARTMENT SERVES A VITAL ROLE IN THE COMMUNITY'S HEALTH CARE NETWORK. DURING TWELVE MONTHS ENDING SEPTEMBER 30, 2017 FRANKLIN MEMORIAL HOSPITAL HAD 15,664 EMERGENCY ROOM VISITS. 68262635 true true false true false false false false false true true false false true true true false true false false false false false false false false true true false false true true false false false false false false false false true false false false false false false true false false false true X 137 0 true 817 true false false false false false false false false false false X 17 9 false false false false true true true true true false false true true true true true true true true false ME X JOHN COX REGIONAL CFO 2077792265 111 FRANKLIN HEALTH COMMONS FARMINGTON ME 04938 CHRISTINE TROPEANO DIRECTOR 1.00 0.00 X 0 0 0 CONNIE COGGINS DIRECTOR 1.00 0.00 X 0 0 0 DARRYL WOOD DIRECTOR 1.00 0.00 X 0 0 0 DAVID DIXON MD DIRECTOR 1.00 0.00 X 0 0 0 EVERETT O'NEILL DIRECTOR 1.00 0.00 X 0 0 0 HEIDI DECKER MD FRMR MED STA 50.00 0.00 X 237518 0 18217 JACK PECK DIRECTOR 1.00 0.00 X 0 0 0 KATHERINE HEER DMD DIRECTOR 1.00 0.00 X 0 0 0 MICHAEL CORMIER DIRECTOR 1.00 0.00 X 0 0 0 MICHELE MCCORMICK MD DIRECTOR 1.00 0.00 X 0 0 0 PETER JUDKINS DIRECTOR 1.00 0.00 X 0 0 0 RONALD ASELTINE ESQ DIRECTOR 1.00 0.00 X 0 0 0 SHEENA BUNNELL DIRECTOR 1.00 0.00 X 0 0 0 STEPHEN GOSS DO MEDICAL STAF 50.00 0.00 X 245317 0 18405 WILLIAM L CARON JR MH CEO 1.00 50.00 X 0 1174972 160862 CLINT BOOTHBY CHAIRMAN 1.00 0.00 X X 0 0 0 GILLY HITCHCOCK VICE CHAIR 1.00 0.00 X X 0 0 0 JOHN BOGAR TREASURER 1.00 0.00 X X 0 0 0 CONNIE ADLER MD SECRETARY 1.00 0.00 X X 14788 0 5262 TIMOTHY CHURCHILL PRESIDENT/CE 1.00 50.00 X X 0 421945 51756 JOHN COX REGIONAL CFO 1.00 50.00 X 0 228890 29783 JAY NALIBOFF MD VP MED. AFFA 50.00 0.00 X 237683 0 20665 WAYNE BENNETT FORMER CFO 50.00 0.00 X 224595 0 20027 GERALD CAYER FRMR VP PHYS 50.00 0.00 X 163585 0 17084 JOSHUA D SPARLING MD DERMATOLOGIS 50.00 0.00 X 592368 0 21752 ERIC GUNTHER MD GENERAL SURG 50.00 0.00 X 367243 0 20122 JAY NEIL MD ANESTHESIOLO 50.00 0.00 X 364940 0 13857 JAMES LANCASTER MD ANESTHESIOLO 50.00 0.00 X 364673 0 19949 HEATHER DECAROLIS MD ANESTHESIOLO 50.00 0.00 X 358827 0 19950 REBECCA ARSENAULT FRMR PRES/CE 50.00 0.00 X 409937 0 4152 3581474 1825807 441843 65 true true false NORDX INC 301A US ROUTE ONE SCARBOROUGH ME 04074 LAB SERVICES 3215857 WEATHERBY LOCUMS INC 6440 SOUTH MILLROCK DR SUITE 175 SALT LAKE CITY UT 84121 PHYS. STAFFING 1616018 LOCUMTENENSCOM LLC 3655 NOTHWINDS PARKWAY ALPHARETTA GA 30009 PHYS. STAFFING 496729 MAINEGENERAL MEDICAL CENTER 10 WATER ST SUITE 213 WATERVILLE ME 04901 PHYS. STAFFING 482778 COMPHEALTH 6440 SOUTH MILLROCK DR SUITE 175 SALT LAKE CITY UT 841215027 PHYS. STAFFING 473823 11 185471 1472371 1657842 PATIENT SERVICES 621990 73391700 73391700 OTHER 621990 1341601 1341601 AMBULANCE SUBSIDIES 621910 825070 825070 CAFETERIA 722514 145910 145910 75704281 108881 45880 63001 63001 63001 48800 45447 3353 3353 3353 77428477 75707634 63001 1098238 518053 580185 39044511 34899029 4145482 430840 385788 45052 6516083 5797478 718605 2389862 2111272 278590 10633 10633 104856 104856 11604 11604 4963733 3530381 1433352 130162 130162 838930 571872 267058 208094 208094 1809645 1806540 3105 109241 99704 9537 364696 311819 52877 799853 706613 93240 3674003 3245718 428285 876489 853088 23401 AFFILIATE SERVICES 7769940 3666023 4103917 MEDICAL SUPPLIES 7266913 7266913 HOSPITAL TAX 1939192 1939192 OTHER 791429 553152 238277 81148947 68262635 12886312 0 3480 3755 371796 2011980 7901603 8070663 1574206 1735839 1174715 803060 90865490 64508711 28764907 26356779 6231522 6686179 46022229 45668255 4641164 5546777 270937 152058 17990655 17180941 6591541 4925338 29494297 27805114 X 13608548 14555198 1679687 2149809 1239697 1158134 16527932 17863141 46022229 45668255 X -3720470 5055679 X false true X true true true X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false true 11604 11604 false SCHEDULE C, PART II-B, LINE 1 DUES PAID TO THE MAINE HOSPITAL ASSOCIATION OF 39,173 AND THE AMERICAN HOSPITAL ASSOCATION OF 19,431. THE MAINE HOSPITAL ASSOCIATION AND THE AMERICAN HOSPITAL ASSOCIATION USED 20% AND 20% RESPECTIVELY OF THEIR DUES REVENUE FOR LOBBYING ACTIVITY. 2826394 200531 350340 -166693 3210572 2691932 112614 182291 -160443 2826394 2799451 408226 -187776 -327969 2691932 2874474 53718 -71709 -57032 2799451 2604155 11967 316743 58391 2874474 0.36000 0.64000 false true true 1252337 1252337 50503585 30158153 20345432 33571435 30533874 3037561 5538133 3816684 1721449 26356779 INTEREST IN NET ASSETS OF FCHN 2908822 EST. THIRD PARTY PAYOR SETTLEMENTS 1348338 PREPAID SEHR 785399 PREPAID SHARED IS CAPITAL 535754 DUE FROM AFFILIATES 486289 OTHER ASSETS 319826 BENEFICIAL INT. IN PERPETUAL TRUST 301751 6686179 DUE TO RELATED PARTIES 4025338 MEDICAL MALPRACTICE TAIL LIAB. 600000 INSURANCE CLAIM LIABILITY 300000 4925338 X SCHEDULE D, PAGE 2, PART V, LINE 4 THE ORGANIZATION'S ENDOWMENT FUNDS ARE HELD BY THE FRANKLIN COMMUNITY HEALTH NETWORK AND ARE INTENDED TO SUPPORT VARIOUS PROGRAMS OFFERED BY THE ORGANIZATION, SUCH AS THE CHARITY PROGRAM, COMMUNITY OUTREACH, EDUCATION, MEDICAL LIBRARY, MARTHA B. WEBBER BREAST CARE CENTER AND OTHERS. SCHEDULE D, PAGE 3, PART X THE COMPANY IS EXEMPT FROM FEDERAL INCOME TAXES UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE true true true X 1.750000000000 false true true false true true 1250773 1250773 0.01540 11707842 9625277 2082565 0.02570 12958615 9625277 3333338 0.04110 483885 55413 428472 0.00530 213993 103194 110799 0.00140 10138356 4301834 5836522 0.07190 21276 21276 0.00030 10857510 4460441 6397069 0.07880 23816125 14085718 9730407 0.11990 false 2792035 16533559 19072098 -2538539 X true true 1 1 FRANKLIN MEMORIAL HOSPITAL 111 FRANKLIN HEALTH COMMONS FARMINGTON ME 04938 SEE PART V, SECTION C ME STATE LIC. 38728 X X X FRANKLIN MEMORIAL HOSPITAL 1 false false true X X X X X X X X X 16 true true false true X SEE PART V, SECTION C true 16 true SEE PART V, SECTION C false true X 175.000000000000 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 X true X false false FACILITY 1, FRANKLIN MEMORIAL HOSPITAL - PART V, LINE 5 THE HOSPITAL CONVENED A GROUP OF PEOPLE WHO REPRESENTED THE BROAD INTERESTS OF THE COMMUNITY SERVED PRIOR TO HOLDING FORUMS. MEMBERS OF THE PLANNING COMMITTEE AND ENGAGED ORGANIZATIONS INCLUDE THE FOLLOWING: - JERRY CAYER; MPH; VP OF PHYSICIAN AND COMMUNITY SERVICES; FRANKLIN COMMUNITY HEALTH NETWORK (FCHN) - DAVID DIXON, MD; RETIRED SURGEON; FCHN - JILL GRAY; COMMUNICATIONS, MARKETING & FUND DEVELOPMENT MGR; FCHN - TRACY HARTY, RN, BSN; SENIOR PROGRAM DIRECTOR/NURSE NAVIGATOR; HEALTHY COMMUNITY COALITION (HCC) - CELINE BOURKE-KUHN, MS; PROGRAM MANAGER, COMMUNITY HEALTH IMPROVEMENT; MAINEHEALTH - JENNIFER MCCORMACK, RN, BSN, MBA; EXECUTIVE DIRECTOR; HCC - MICHELE MCCORMICK, MD; PEDIATRIC HOSPITALIST; FCHN - JAMIE PAUL; WESTERN DISTRICT PUBLIC HEALTH LIAISON; MAINE CDC - DOUG SAUNDERS; COMMUNITY COORDINATOR; FRANKLIN COUNTY CHILDREN'S TASK FORCE - JANIS WALKER; PROGRAM MANAGER; HCC FACILITY 1, FRANKLIN MEMORIAL HOSPITAL - PART V, LINE 6A THE CHNA WAS CONDUCTED THROUGH A PARTNERSHIP BETWEEN MAINEHEALTH, CENTRAL MAINE HEALTHCARE, EASTERN MAINE HEALTHCARE SYSTEMS, MAINEGENERAL HEALTH AND THE MAINE DEPARTMENT OF HEALTH AND HUMAN SERVICES. FACILITY 1, FRANKLIN MEMORIAL HOSPITAL - PART V, LINE 7D THE CHNA AND IMPLEMENTATION STRATEGY ARE POSTED ON THE FOLLOWING WEBSITE: HTTPS://MAINEHEALTH.ORG/HEALTHY-COMMUNITIES/COMMUNITY-HEALTH-NEEDS- ASSESSMENT FACILITY 1, FRANKLIN MEMORIAL HOSPITAL - PART V, LINE 11 FOR THE 2016-2018 CHNA, THE ORGANIZATION HAS IDENTIFIED PRIORITIES AND DEVELOPED STRATEGIES TO ADDRESS THE SIGNIFICANT NEEDS IDENTIFIED IN ITS MOST RECENTLY CONDUCTED CHNA AND PROVIDED REASONS IF IDENTIFIED NEEDS ARE NOT BEING ADDRESSED. PLEASE SEE THE 2016-2018 COMMUNITY HEALTH NEEDS ASSESSMENT AND ANNUAL IMPLEMENTATION PLAN UPDATE FY17 AT HTTPS://MAINEHEALTH.ORG/HEALTHY-COMMUNITIES/COMMUNITY-HEALTH-NEEDS- ASSESSMENT FOR DETAILS OF THE ACTIVITIES UNDERTAKEN BY THE ORGANIZATION. FACILITY 1, FRANKLIN MEMORIAL HOSPITAL - PART V, LINE 16J THE FINANCIAL ASSISTANCE POLICY (FAP)/FREE CARE POLICY, FAP/FREE CARE APPLICATION AND THE PLAIN LANGUAGE SUMMARY ARE AVAILABLE ON THE FOLLOWING WEBSITE: HTTPS://MAINEHEALTH.ORG/PATIENTS-VISITORS/BILLING- INSURANCE/FINANCIAL-ASSISTANCE/FREE-CARE FACILITY 1, FRANKLIN MEMORIAL HOSPITAL - PART V, LINE 16I THE FAP, FAP APPLICATION AND PLAIN LANGUAGE SUMMARY WERE TRANSLATED INTO THE PRIMARY LANGUAGES SPOKEN BY LIMITED ENGLISH PROFICIENCY POPULATIONS AND MADE AVAILABLE AS OF JULY, 2018. 17 FRANK HLTH LIVERMORE FALLS FAM PRAC 21 MAIN STREET LIVERMORE FALLS ME 04254 FAMILY PRACTICE FRANKLIN HLTH FARMINGTON FAM PRACT 111 FRANKLIN HEALTH COMMONS FARMINGTON ME 04938 FAMILY PRACTICE FRANKLIN HEALTH INTERNAL MEDICINE 111 FRANKLIN HEALTH COMMONS FARMINGTON ME 04938 INTERNAL MEDICINE PRACTICE FRANKLIN HEALTH PEDIATRICS 111 FRANKLIN HEALTH COMMONS FARMINGTON ME 04938 PEDIATRICIAN PRACTICE FRANKLIN HEALTH ORTHOPAEDICS 111 FRANKLIN HEALTH COMMONS FARMINGTON ME 04938 ORTHOPAEDIC PRACTICE FRANKLIN HEALTH SURGERY 111 FRANKLIN HEALTH COMMONS FARMINGTON ME 04938 GENERAL SURGERY PRACTICE OUTPATIENT SVCS AT LIVERMORE FALLS 21 MAIN STREET LIVERMORE FALLS ME 04254 OUTPATIENT CLINIC NORTHSTAR 15 SCHOOL STREET RANGELEY ME 04970 AMBULANCE BASE NORTHSTAR 138C PARK STREET PHILLIPS ME 04966 AMBULANCE BASE NORTHSTAR 119 FEDERAL ROAD LIVERMORE ME 04254 AMBULANCE BASE NORTHSTAR 1001 CARRIAGE ROAD CARRABASSET VALLEY ME 04947 AMBULANCE BASE NORTHSTAR 111 FRANKLIN HEALTH COMMONS FARMINGTON ME 04938 AMBULANCE BASE FRANKLIN HEALTH WOMEN'S CARE 111 FRANKLIN HEALTH COMMONS FARMINGTON ME 04938 OB/GYN FRANKLIN HEALTH BEHAVIORAL SERVICES 131 FRANKLIN HEALTH COMMONS FARMINGTON ME 04938 BEHAVIORAL HEALTH PRACTICE FRANKLIN HEALTH DERMATOLOGY 111 FRANKLIN HEALTH COMMONS FARMINGTON ME 04938 DERMATOLOGY PRACTICE FRANKLIN HEALTH UROLOGY 126 MIDDLE STREET FARMINGTON ME 04938 UROLOGY PRACTICE FRANKLIN HEALTH INTOWN MEDICINE 107 BOX SHOP HILL ROAD FARMINGTON ME 04938 INTERNAL MEDICINE PRACTICE PART I, LINE 7 - COSTING METHODOLOGY EXPLANATION THE COSTING METHODOLOGY FOR THE AMOUNTS REPORTED IN PART I, LINE 7 OF THE SCHEDULE H IS BASED ON A RATIO OF PATIENT CARE COST TO CHARGES. THIS COST TO CHARGE RATIO WAS DERIVED FROM WORKSHEET 2, RATIO OF PATIENT CARE COST- TO-CHARGES PROVIDED IN THE INSTRUCTIONS FOR SCHEDULE H. PART III, LINE 2 - BAD DEBT EXPENSE METHODOLOGY SEE PART III, LINE 4 - BAD DEBT EXPENSE FOOTNOTE TO THE FINANCIAL STATEMENTS. BAD DEBT EXPENSE FOOTNOTE TO FINANCIAL STATEMENTS BAD DEBT EXPENSE REPRESENTS HEALTHCARE SERVICES THAT FRANKLIN MEMORIAL HOSPITAL HAS PROVIDED WITHOUT COMPENSATION. AS A TAX EXEMPT HOSPITAL, FRANKLIN MEMORIAL HOSPITAL PROVIDES NECESSARY PATIENT CARE REGARDLESS OF THE PATIENT'S ABILITY TO PAY FOR THE SERVICES. A PORTION OF FRANKLIN MEMORIAL HOSPITAL'S BAD DEBT EXPENSE IS ATTRIBUTABLE TO PATIENTS ELIGIBLE FOR FINANCIAL ASSISTANCE THAT FOR A VARIETY OF REASONS, DO NOT COMPLETE THE FINANCIAL ASSISTANCE APPLICATION PROCESS. FRANKLIN MEMORIAL HOSPITAL CANNOT DETERMINE THE AMOUNT OF BAD DEBT EXPENSE THAT COULD BE REASONABLY ATTRIBUTABLE TO PATIENTS WHO LIKELY WOULD QUALIFY FOR FINANCIAL ASSISTANCE UNDER THE FRANKLIN MEMORIAL HOSPITAL'S FREE CARE POLICY. WITHIN THE FOOTNOTES DESCRIBING "PATIENT ACCOUNTS RECEIVABLE," THE FOLLOWING EXPLAINS THE PROVISION FOR BAD DEBTS: "FOR RECEIVABLES RELATING TO SELF-PAY PATIENTS, A PROVISION FOR DOUBTFUL ACCOUNTS AND CORRESPONDING ALLOWANCE FOR DOUBTFUL ACCOUNTS IS MADE IN THE PERIOD SERVICES ARE RENDERED BASED ON EXPERIENCE INDICATING THE INABILITY OR UNWILLINGNESS OF PATIENTS TO PAY AMOUNTS FOR WHICH THEY ARE FINANCIALLY RESPONSIBLE. THE HOSPITAL ESTABLISHED A DISCOUNT POLICY FOR UNINSURED PATIENTS." PRIOR TO BILLING, 100% OF THE CHARGE IS APPLIED AS A DISCOUNT FOR QUALIFYING PATIENTS. ACTUAL WRITE-OFFS ARE CHARGED AGAINST THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. PAGES 12-14 OF THE ATTACHED FINANCIAL STATEMENTS ALSO PROVIDE FOOTNOTES RELATED TO BAD DEBT EXPENSE AND BAD DEBT ALLOWANCE. PART III, LINE 8 - MEDICARE EXPLANATION THE MEDICARE PRINCIPLES OF REIMBURSEMENT WERE USED TO DETERMINE THE MEDICARE INPATIENT AND OUTPATIENT COSTS BASED ON THE ORGANIZATION'S COST REPORT. FRANKLIN MEMORIAL HOSPITAL BELIEVES THAT THE MEDICARE SHORTFALL SHOULD BE INCLUDED AS A COMMUNITY BENEFIT BECAUSE THE HOSPITAL HAS A CLEAR MISSION COMMITMENT TO SERVING ELDERLY PATIENTS AND ADULTS WITH DISABILITIES THROUGH THE PROVISION OF SPECIFIC SUBSIDIZED PROGRAMS DEVELOPED TO HELP IMPROVE THE HEALTH STATUS OF THESE PATIENTS. IF THESE CRITICAL SUBSIDIZED PROGRAMS WERE NOT PROVIDED BY THE HOSPITAL, THEY WOULD BECOME THE OBLIGATION OF THE FEDERAL GOVERNMENT. PART III, LINE 9B - COLLECTION PRACTICES EXPLANATION PATIENTS WHO QUALIFY FOR FINANCIAL ASSISTANCE HAVE THEIR ACCOUNT BALANCE ADJUSTED ACCORDINGLY ONCE FINANCIAL ASSISTANCE HAS BEEN APPROVED. MONTHLY PAYMENT ARRANGEMENTS CAN BE ESTABLISHED BY THE RESPONSIBLE PARTY BY CONTACTING THE PATIENT FINANCIAL SERVICES CUSTOMER SERVICE DEPARTMENT. AS A TAX-EXEMPT HOSPITAL, FRANKLIN MEMORIAL HOSPITAL PROVIDES NECESSARY PATIENT CARE REGARDLESS OF THE PATIENT'S ABILITY TO PAY FOR THE SERVICES. PART VI, LINE 2 - NEEDS ASSESSMENT THE FRANKLIN MEMORIAL HOSPITAL NETWORK CONDUCTS A HEALTH VISIONING PROCESS EVERY TWO YEARS THAT IS USED TO IDENTIFY NEEDS AND PERCEIVED PRIORITIES IN THE COMMUNITY. A PHYSICIAN SURVEY IS CONDUCTED PERIODICALLY TO ASSIST IN GATHERING INFORMATION ABOUT CLINICAL CARE NEEDS, REFERRAL PATTERNS, SPECIALIST NEEDS, ETC. THE LONG-RANGE PLANNING COMMITTEE, BOARD OF DIRECTORS AND SENIOR LEADERSHIP USE THIS AND OTHER DATA IN DEVELOPING GOALS AND PRIORITIES, MAKING DECISIONS, AND SETTING LONG-TERM GOALS AND STRATEGIES. THE ORGANIZATION SEEKS TO MEET THE NEEDS OF THE POPULATION WHENEVER FEASIBLE THROUGH DIRECT PROVISION OF SERVICES, CONTRACTUAL RELATIONSHIPS, OR THROUGH REFERRAL. PART VI, LINE 3 - PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE FINANCIAL ASSISTANCE INFORMATION IS PROVIDED IN THE ADMITTING AND EMERGENCY REGISTRATION LOCATIONS IN THE FOLLOWING MANNER: - POSTINGS INCLUDING FREE CARE AND MONTHLY PAYMENT PLAN - HANDOUTS - INTERVIEWS PATIENTS RECEIVE MAINEHEALTH'S FREE CARE GUIDELINES AND FINANCIAL POLICIES BROCHURE EXPLAINING OUR BILLING POLICIES AND CONTACT INFORMATION UPON REQUEST. IF THE PATIENT IS SELF-PAY, UNDER INSURED OR CAN'T AFFORD TO PAY THEIR HOSPITAL BILL, THEY MAY RECEIVE A FINANCIAL COUNSELING PACKET AND/OR REFERRED TO FINANCIAL COUNSELING FROM THE REGISTRATION STAFF OR CHANGE HEALTHCARE, AN OUTSIDE VENDOR WHO HELPS MANAGE THE SELF- PAY ACCOUNTS. THE PACKET INCLUDES: - INFORMATION ON MAINEHEALTH'S FINANCIAL POLICIES - FINANCIAL ASSISTANCE INFORMATION INCLUDING FREE CARE PROGRAM, MONTHLY PAYMENT PLAN PROGRAM, AND CARE PARTNERS, MEDACCESS AND OTHER COMMUNITY RESOURCE NEEDS. - PROGRAM APPLICATIONS AND INSTRUCTIONS FOR MAINEHEALTH'S FREE CARE PROGRAM, AND MONTHLY PAYMENT PLAN APPLICATION - CONTACT INFORMATION FOR ASSISTANCE WITH APPLICATIONS, BILLS OR FINANCIAL CONCERNS SELF-PAY OR UNDERINSURED PATIENTS REGISTERING IN PERSON OR VIA A PHONE INTERVIEW RECEIVE FINANCIAL COUNSELING INCLUDING INFORMATION ON OUR FINANCIAL ASSISTANCE PROGRAMS. REGISTRATION STAFF OR CHANGE HEALTHCARE PROVIDE FORMS AND ASSIST WITH COMPLETING FINANCIAL ASSISTANCE APPLICATIONS AND PROVIDING FOLLOW UP CONTACT INFORMATION. MAINEHEALTH'S WEB SITE INCLUDES ON LINE REGISTRATION AND PATIENT BILLING INFORMATION: - BILLING PROCESS - FREE CARE - MONTHLY PAYMENT PLAN - PATIENT STATEMENT - PRICE INFORMATION - CONTACT US AND QUESTIONS PRIMARY LANGUAGE, DEAF AND HARD OF HEARING AND INTERPRETER NEEDS ARE ASSESSED DURING THE REGISTRATION INTERVIEW AND SERVICES ARE PROVIDED AS NEEDED. IF A PATIENT DOES NOT RESPOND AT PRE-REGISTRATION, REGISTRATION, OR WHILE RECEIVING CARE, ALL OF THESE PROGRAMS ARE EXPLAINED AGAIN BY THE SINGLE BILLING OFFICE STAFF. THE INTENT OF THESE EFFORTS IS TO ENSURE THAT THE PATIENT IS FULLY INFORMED OF AND ABLE TO TAKE ADVANTAGE OF THESE ASSISTANCE PROGRAMS. PART VI, LINE 4 - COMMUNITY INFORMATION THE COMMUNITY HEALTH NEEDS ASSESSMENT DESCRIBES THE GEOGRAPHIC AREA AND DEMOGRAPHIC CONSTITUENTS IT SERVICES. SEE HTTPS://MAINEHEALTH.ORG/HEALTHY-COMMUNITIES/COMMUNITY-HEALTH-NEEDS- ASSESSMENT FOR THE COMPLETED CHNA. PART VI, LINE 5 - PROMOTION OF COMMUNITY HEALTH PROMOTION OF COMMUNITY HEALTH: THE TAX-EXEMPT PURPOSE OF THE ORGANIZATION TO IMPROVE THE HEALTH OF THE COMMUNITY IS PROMOTED AND ENHANCED IN THE FOLLOWING WAYS: 1.THE MAJORITY OF THE GOVERNING BODY IS COMPOSED OF PERSONS LIVING WITHIN THE HOSPITAL SERVICE AREA THAT ARE NEITHER EMPLOYED BY, NOR HAVE CONTRACTUAL RELATIONSHIPS WITH, THE HOSPITAL OR ITS AFFILIATES. 2.MEDICAL STAFF PRIVILEGES ARE AVAILABLE TO ALL QUALIFIED PHYSICIANS IN THE COMMUNITY. 3.SOLICITATION OF COMMUNITY INPUT IN THE STRATEGIC PLANNING PROCESS. 4.COMMON GOVERNANCE OF THE HOSPITAL AND PHYSICIAN SERVICES PROVIDED IN THE COUNTY TO PROMOTE COMMON HEALTH CARE AND IMPROVEMENT PLANNING AND CONTROL COSTS. 5.SURPLUS FUNDS ARE REINVESTED IN CAPITAL EQUIPMENT AND IMPROVEMENTS TO ENSURE HIGH QUALITY CARE. 6.EACH YEAR A PORTION OF RETAINED EARNINGS ARE DISTRIBUTED TO OUR PARENT, MAINEHEALTH, FOR THE SPECIFIC PURPOSE OF HEALTH STATUS IMPROVEMENT PROGRAMS THROUGHOUT THE MAINEHEALTH SERVICE AREA. COMMUNITY BUILDING: PHYSICAL IMPROVEMENTS AND HOUSING: 1.DEVELOPMENT AND MAINTENANCE OF THE RAIL TRAIL WHICH IS ON FMH PROPERTY AND IS AVAILABLE TO THE PUBLIC TO ENCOURAGE HEALTH AND WELLNESS. ECONOMIC DEVELOPMENT: 1.MEMBER OF GREATER FRANKLIN DEVELOPMENT CORPORATION - AN ORGANIZATION COMMITTED TO ECONOMIC DEVELOPMENT. COMMUNITY SUPPORT: 1.PERFORM DISASTER DRILLS WITH THE COMMUNITY 1-2 TIMES A YEAR. 2.COMMUNITY DENTAL (PROVIDE LOW COST RENTAL SPACE). COALITION BUILDING: 1.HEALTHY COMMUNITY COALITION OF GREATER FRANKLIN COUNTY, FOUNDED IN 1989, IS ONE OF THE OLDEST HEALTH COALITIONS IN THE COUNTRY. ITS MISSION IS TO MEASURABLY IMPROVE THE WELL-BEING OF ALL PEOPLE IN GREATER FRANKLIN COUNTY AND NEIGHBORING TOWNS USING A COORDINATED PUBLIC HEALTH APPROACH OF EDUCATION, PROMOTION, AND OUTREACH. WITH ITS QUALIFIED STAFF OF PUBLIC HEALTH PROFESSIONALS, HEALTHY COMMUNITY COALITION OFFERS HEALTH SCREENINGS, HEALTH INFORMATION, AND PROGRAMS AND EVENTS TO SUPPORT HEALTHY LIFESTYLES THAT PREVENT DISEASE AND IMPROVE QUALITY OF LIFE. ITS COMMUNITY OUTREACH EFFORTS APPEAR IN EVERY TOWN AND CORNER OF THE REGION. IN THE PAST YEAR, MORE THAN 2,000 INDIVIDUALS BENEFITED FROM OUTREACH ACTIVITIES PROVIDED THROUGH THE MOBILE HEALTH UNIT WHERE HEALTH RISK APPRAISALS (HRAS) ARE ROUTINELY OFFERED. HRAS INCLUDE A BLOOD PRESSURE AND CHOLESTEROL CHECK AND INDIVIDUALIZED HEALTH EDUCATION. ADDITIONAL OUTREACH EVENTS WERE HELD THROUGHOUT THE REGION SUCH AS: BONE DENSITY SCREENINGS, FLU IMMUNIZATIONS, BODY COMPOSITION ANALYSIS, FREE CLINICAL BREAST EXAMS, EDUCATION ON TOBACCO, NUTRITION, PHYSICAL ACTIVITY AND SUBSTANCE ABUSE, AND EDUCATION ON THE PREVENTION OF BREAST, CERVICAL, COLON, LUNG, PROSTATE, AND SKIN CANCER. 2.AHEC EDUCATION CENTER - ESTABLISHED IN 2004, THE FRANKLIN AHEC PROGRAM WAS DEVELOPED OUT OF GREAT INTEREST FROM EMPLOYEES AND COMMUNITY MEMBERS REQUESTING LOCAL OPPORTUNITIES TO PURSUE CAREERS IN THE HEALTH FIELD AND EDUCATIONAL PROGRAMS FOR RETENTION AND PROFESSIONAL GROWTH. THE FRANKLIN AHEC ALLOWS US TO MEET THE NEEDS OF THE RURAL POPULATION. IT ALSO BRINGS TO THE MAINE AHEC NETWORK THE RESOURCES OF A LARGE INNOVATIVE RURAL HEALTH SYSTEM THAT INCLUDES A COMMUNITY HOSPITAL, MAINE'S OLDEST HEALTHY COMMUNITY COALITION AND THE BEN FRANKLIN CENTER WHICH HOUSES A STATE OF THE ART EDUCATION CENTER, MEDICAL LIBRARY FACILITIES, AND DISTANCE LEARNING OPPORTUNITIES. THE PROGRAM HAS GREATLY EXPANDED TO INCLUDE MANY ASPECTS AND ACTIVITIES FOR RETENTION AND RECRUITMENT FOR HEALTH CAREERS IN OUR VAST RURAL CATCHMENT AREA. BECOMING AN AHEC CENTER ALLOWS US TO PARTNER WITH YOUTH PROGRAMS, PUBLIC SCHOOLS, MULTIPLE COLLEGES, ADULT EDUCATION, A LOCAL CAREER CENTER AND OTHER HEALTH CAREER PROGRAMS TO OFFER COMMUNITY MEMBERS, DISPLACED WORKERS AND CURRENT HEALTHCARE EMPLOYEES THE OPPORTUNITY TO CONTINUE OR PURSUE CAREERS. 3.HEALTHINFONET: FMH, ALONG WITH ALL OTHER MAINE HOSPITALS AND HUNDREDS OF PHYSICIAN PRACTICES IN MAINE NOW HAVE ACCESS TO A NEW, CONSOLIDATED ELECTRONIC HEALTH RECORD MADE POSSIBLE BY HEALTHINFONET THAT CONTAINS CRITICAL INFORMATION DRAWN FROM RECORDS THAT HAVE TRADITIONALLY BEEN SEPARATELY MAINTAINED IN PHYSICIAN PRACTICES, HOSPITALS AND OTHER SETTINGS. ARMED WITH MORE COMPLETE AND TIMELY INFORMATION ABOUT A PATIENT, CLINICIANS CAN PROVIDE BETTER QUALITY CARE AND IMPROVE THE COORDINATION OF CARE, PARTICULARLY FOR THOSE PATIENTS WHO SEE SEVERAL PROVIDERS AND RECEIVE CARE IN MORE THAN ONE COMMUNITY OR SETTING. PART VI, LINE 6 - AFFILIATED HEALTH CARE SYSTEM MAINEHEALTH IS A NOT-FOR-PROFIT FAMILY OF LEADING HIGH-QUALITY PROVIDERS AND OTHER HEALTHCARE ORGANIZATIONS WORKING TOGETHER SO THEIR COMMUNITIES ARE THE HEALTHIEST IN AMERICA. RANKED AMONG THE NATION'S TOP 100 INTEGRATED HEALTHCARE DELIVERY NETWORKS, MAINEHEALTH IS GOVERNED BY A BOARD OF TRUSTEES CONSISTING OF COMMUNITY AND BUSINESS LEADERS FROM ITS SOUTHERN, CENTRAL AND WESTERN MAINE REGIONAL SERVICE AREAS. THE COLLABORATION OF MAINEHEALTH MEMBERS MAKES IT POSSIBLE TO OFFER AN EXTENSIVE RANGE OF CLINICAL INTEGRATION AND COMMUNITY HEALTH PROGRAMS, MANY AIMED AT IMPROVING ACCESS TO PREVENTIVE AND PRIMARY CARE SERVICES. MAINEHEALTH INCLUDES THE FOLLOWING MEMBER ORGANIZATIONS: LINCOLNHEALTH GROUP, MAINE MEDICAL CENTER, MAINE BEHAVIORAL HEALTHCARE (SPRING HARBOR HOSPITAL), COASTAL HEALTHCARE ALLIANCE (PEN BAY MEDICAL CENTER AND WALDO COUNTY GENERAL HOSPITAL), SOUTHERN MAINE HEALTH CARE (SOUTHERN MAINE MEDICAL CENTER AND GOODALL CAMPUSES), WESTERN MAINE HEALTH CARE (STEPHENS MEMORIAL HOSPITAL), THE MEMORIAL HOSPITAL AT NORTH CONWAY, N.H., MAINEHEALTH CARE AT HOME, MAINE PHYSICIAN HOSPITAL ORGANIZATION, NORDX, SYNERNET AND MAINEHEALTH ACCOUNTABLE CARE ORGANIZATION. THE STRATEGIC AFFILIATES OF MAINEHEALTH ARE MAINEGENERAL MEDICAL CENTER, MID COAST HOSPITAL AND ST. MARY'S REGIONAL MEDICAL CENTER. PART VI, LINE 7 - STATE FILING OF COMMUNITY BENEFIT REPORT MAINE ADDITIONAL INFORMATION PART I, LINE 7G: THE ORGANIZATION HAS INCLUDED COSTS ASSOCIATED WITH PRIMARY CARE (FAMILY PRACTICES, PEDIATRICS, INTERNAL MEDICINE, AND WOMEN'S CARE) AND BEHAVIORAL SERVICES. true false false false false false false false false HEIDI DECKER MD FRMR MED STAFF PRES. 202094 34167 1257 2814 15403 255735 STEPHEN GOSS DO MEDICAL STAFF PRES. 211318 30227 3772 2875 15530 263722 WILLIAM L CARON JR MH CEO 841603 228000 105369 141114 19748 1335834 TIMOTHY CHURCHILL PRESIDENT/CEO 279588 98000 44357 33262 18494 473701 JOHN COX REGIONAL CFO 197868 31022 13490 16293 258673 JAY NALIBOFF MD VP MED. AFFAIRS 228663 9020 2523 18142 258348 WAYNE BENNETT FORMER CFO 222224 2371 2482 17545 244622 GERALD CAYER FRMR VP PHYS. & COMM 161449 2136 1820 15264 180669 JOSHUA D SPARLING MD DERMATOLOGIST 450204 141574 590 5300 16452 614120 ERIC GUNTHER MD GENERAL SURGEON 348037 14000 5206 3956 16166 387365 JAY NEIL MD ANESTHESIOLOGIST 363698 1242 3983 9874 378797 JAMES LANCASTER MD ANESTHESIOLOGIST 363431 1242 3983 15966 384622 HEATHER DECAROLIS MD ANESTHESIOLOGIST 357878 949 3984 15966 378777 REBECCA ARSENAULT FRMR PRES/CEO 74593 9000 326344 2203 1949 414089 SCHEDULE J, PAGE 1, PART I, LINE 3 TOP MANAGEMENT OFFICIALS ARE COMPENSATED BY THIS OR RELATED ORGANIZATIONS. THESE ORGANIZATIONS USE ONE OR MORE OF THE METHODS SHOWN ABOVE TO ESTABLISH THE COMPENSATION OF TOP MANAGEMENT. SCHEDULE J, PAGE 1, PART I, LINE 4 REBECCA ARSENAULT 254,177 0 0 A MAINE HEALTH & HIGHER ED FAC AUTH 010314384 560427NM4 2011-11-30 10452958 REF. OF SERIES 2001A false false true B MAINE HEALTH & HIGHER ED FAC AUTH 010314384 56042REW8 2016-06-28 12359721 REF. OF SERIES 2006F false false true A 4054032 10452958 169449 117007 9633963 2002 true false true true B 445173 12359721 222360 58709 12359721 2016 true false true true A false false false false false false false B false false false false false false false A false false false true false false false false false B false true false false false false false false false A false B false SCHEDULE K - DATE REBATE COMPUTATION PERFORMED MAINE HEALTH & HIGHER ED FAC. AUTH. 11/30/16 SCHEDULE K - ADDITIONAL INFORMATION MAINE HEALTH & HIGHER ED FAC. AUTH. A TAX EXEMPT BOND POLICY WAS ENDORSED BY THE MAINEHEALTH FINANCE COUNCIL IN JULY, 2018. THIS POLICY IS EXPECTED TO BE ADOPTED BY ALL INDIVIDUAL MEMBER ORGANIZATIONS BEFORE 9/30/18. STACY HERSHFELD FAMILY MEMBER 238007 EMPLOYMENT false REBECCA WOOD FAMILY MEMBER 133844 EMPLOYMENT false ADAM DIXON FAMILY MEMBER 44710 EMPLOYMENT false SCHEDULE L, PART V REBECCA WOOD WAS EMPLOYEED BY FRANKLIN MEMORIAL HOSPITAL AS CHIEF NURSING OFFICER / VP OF PATIENT CARE SERVICES. HER HUSBAND, DARRYL WOOD, IS A BOARD MEMBER. ADAM DIXON WAS EMPLOYED BY FRANKLIN MEMORIAL HOSPITAL AS A RADIOGRAPHER. HIS FATHER,DAVID DIXON IS A BOARD MEMBER. STACY HERSHFELD,DO WAS EMPLOYED BY FRANKLIN MEMORIAL HOSPITAL AS A PHYSICIAN. HER HUSBAND, STEPHEN GOSS, MD IS A BOARD MEMBER. FORM 990 - ORGANIZATION'S MISSION TO PROVIDE HIGH-QUALITY, COST-EFFECTIVE, PATIENT-CENTERED HEALTHCARE TO OUR WEST CENTRAL MAINE COMMUNITY. WE WORK WITH OUR COMMUNITY AND OTHER HEALTHCARE PROVIDERS TO INTEGRATE SERVICES AND ENSURE THE HEALTH OF OUR COMMUNITY. FORM 990, PAGE 2, PART III, LINE 4A (CONTINUED FROM PART III, LINE 4A) DERMATOLOGY, PULMONOLOGY, PAIN MANAGEMENT, PEDIATRIC ENDOCRINOLOGY, PHYSICAL REHABILITATION, SPORTS MEDICINE AND WOUND CARE. DURING THE TWELVE MONTHS ENDING SEPTEMBER 30, 2017 THERE WERE 1,946 INPATIENT DISCHARGES, 1,734 OUTPATIENT SURGERIES, 234,442 OUTPATIENT LAB TESTS AND 40,862 OUTPATIENT IMAGING PROCEDURES. FORM 990, PART V 990 PART V, LINE 2A FRANKLIN MEMORIAL HOSPITAL(EIN 01-0211503) FILED FORM W-3, REPORTING 817 EMPLOYEES FOR THE CALENDAR YEAR 2016 ON BEHALF OF THE FOLLOWING ORGANIZATIONS: FRANKLIN MEMORIAL HOSPITAL, FRANKLIN COMMUNITY HEALTH NETWORK, EVERGREEN BEHAVIORAL SERVICES, AND HEALTH COMMUNITY COALITION. FORM 990, PAGE 6, PART VI, LINE 6 MAINEHEALTH (EIN: 01-0431680), IS THE SOLE MEMBER OF FRANKLIN COMMUNITY HEALTH NETWORK (FCHN) (EIN: 22-3209406). FCHN IS THE SOLE MEMBER OF FMH. FORM 990, PAGE 6, PART VI, LINE 7A MAINEHEALTH AND FRANKLIN COMMUNITY HEALTH NETWORK HAVE THE RESPONSIBILITY FOR THE ELECTION OF THE MEMBERS OF THE GOVERNING BODY. FORM 990, PAGE 6, PART VI, LINE 7B DECISIONS OF THE GOVERNING BODY SUCH AS BUDGETS, BUSINESS STRATEGIES, SIGNIFICANT FINANCIAL COMMITMENTS, AMENDMENTS TO THE ARTICLES OF INCORPORATION AND ELECTION OF THE PRESIDENT/CEO AMONG OTHER DECISIONS, ARE SUBJECT TO THE APPROVAL OF THE SOLE MEMBER. FORM 990, PAGE 6, PART VI, LINE 11B A COMPLETE COPY OF THE FORM 990 WAS DISTRIBUTED TO EACH MEMBER OF THE BOARD OF DIRECTORS PRIOR TO FILING WITH IRS. IN ADDITION, KEY COMPONENTS OF THE 990 WERE REVIEWED WITH THE BOARD OF DIRECTORS PRIOR TO FILING THE TAX RETURN IN A FORM OF A PRESENTATION AND A Q&A SESSION TO ADDRESS ANY QUESTIONS OR CONCERNS. FORM 990, PAGE 6, PART VI, LINE 12C ON AN ANNUAL BASIS BOARD MEMBERS AND OFFICERS ARE REQUIRED TO SUBMIT A CONFLICT OF INTEREST STATEMENT WHICH IS THEN REVIEWED BY THE COMPLIANCE COMMITTEE. THE COMPLIANCE COMMITTEE IS RESPONSIBLE FOR REGULARLY AND CONSISTENTLY MONITORING AND ENFORCING COMPLIANCE WITH THE CONFLICT OF INTEREST POLICY. FORM 990, PAGE 6, PART VI, LINE 15A THE PROCESS FOLLOWED FOR DETERMINING COMPENSATION OF THE CEO COMPENSATED BY THIS OR OTHER RELATED ORGANIZATION IS A FORMAL PROCESS PERFORMED ANNUALLY BY THE EXECUTIVE COMMITTEE OF THE BOARD OF DIRECTORS. A RELATED ORGANIZATION USES AN OUTSIDE FIRM, SULLIVAN COTTER, TO PERFORM AN INDEPENDENT BENCHMARK ANALYSIS FOR THE CEO OF FRANKLIN MEMORIAL HOSPITAL, ALONG WITH OTHER EXECUTIVES IN THE MAINEHEALTH SYSTEM. THE FIRM MEETS WITH THE EXECUTIVE COMMITTEE TO REVIEW EACH EXECUTIVE'S BENCHMARK REPORT. THE COMMITTEE THEN DELIBERATES ON MAINEHEALTH'S WRITTEN SALARY AND INCENTIVE PLAN PHILOSOPHY BEFORE MAKING A FINAL DECISION. ALL DECISIONS AND MEETINGS ARE CAPTURED IN MINUTES AND THERE ARE APPROPRIATE APPROVALS AT ALL LEVELS. FORM 990, PAGE 6, PART VI, LINE 15B THE MEMBER IS RESPONSIBLE FOR AN ANNUAL EVALUATION OF THE OTHER KEY ADMINISTRATIVE EMPLOYEES OF THE ORGANIZATION. COMPENSATION IS EVALUATED BY THE COMPENSATION COMMITTEE APPOINTED BY THE MEMBER, AND THE ORGANIZATION'S BOARD OF TRUSTEES MUST APPROVE OF THE COMPENSATION. IN ADDITION, THE ORGANIZATION UTILIZES THE SERVICES OF AN INDEPENDENT COMPENATION CONSULTING FIRM AND INDUSTRY SURVEY. FORM 990, PAGE 6, PART VI, LINE 19 DOCUMENTS THAT ARE REQUIRED TO BE OPEN FOR PUBLIC INSPECTION ARE MADE AVAILABLE UPON REQUEST. FORM 990, PART XI, LINE 9 CHANGE IN INTEREST OF RELATED PARTY NET ASSETS 365,742 CHANGE IN INTEREST IN PERPETUAL TRUST 18,437 NET TRANSFERS FROM AFFILIATES 4,671,500 TOTAL 5,055,679 FRANKLIN COMMUNITY HEALTH NETWORK 111 FRANKLIN HEALTH COMMONS FARMINGTON ME 04938 223209406 HEALTHCARE ME 501C3 12B 01-0431680 false HEALTHY COMMUNITY COALITION INC 105 MT BLUE CIRCLE SUITE 1 FARMINGTON ME 04938 223305743 COMMUNITY ME 501C3 7 22-3209406 false PINE TREE MEDICAL ASSOCIATES 131 FRANKLIN HEALTH COMMONS FARMINGTON ME 04938 010469478 CM HTH AG ME 501C3 10 22-3209406 false EVERGREEN BEHAVIORAL SERVICES 131 FRANKLIN HEALTH COMMONS FARMINGTON ME 04938 010492747 MNTL HLTH ME 501C3 10 22-3209406 false MAINEHEALTH 110 FREE STREET PORTLAND ME 04101 010431680 HEALTHCARE ME 501C3 12C NA false WILLIAM A HOWELL TRUST FUND C/O BANK OF AMERICA NA PO BOX 830269 DALLAS TX 75283 016032170 PERP. TRST ME NA TRUST 23628 301751 1.00000 false false false true false false false false false false true false false false false false false false true true