2016-05-25T12:51:49-05:00 2015-12-31 010242373 MACPAGE LLC 30 LONG CREEK DRIVE SOUTH PORTLAND ME 04106 990 2015-01-01 205150062 HEALTHINFONET HEAL 2075419250 125 PRESUMPSCOT STREET BOX 8 PORTLAND ME 04103 DEVORE CULVER CEO 2075419250 2016-05-25 1 PETER MONTANO P01200943 2077745701 2016-05-25 2015 2016-09-27 15:27:22Z 125 PRESUMPSCOT STREET BOX 8 PORTLAND ME 04103 6200893 0 1 X WWW.HINFONET.ORG X 2008 ME TO OVERSEE THE IMPLEMENTATION AND OPERATION OF A STATEWIDE HEALTH INFORMATION TECHNOLOGY NETWORK. 19 19 29 0 0 0 41764 0 6666193 6198691 935 2202 0 0 6708892 6200893 0 0 0 0 2726963 2781367 0 0 0 3818074 2474111 6545037 5255478 163855 945415 3311187 4061740 879409 684548 2431778 3377192 TO OVERSEE THE IMPLEMENTATION AND OPERATION OF A STATEWIDE HEALTH INFORMATION TECHNOLOGY NETWORK. 0 0 4349250 6198691 CONTINUED TO MOVE TOWARD FULL IMPLEMENTATION OF THE PROJECT AS SCHEDULED. 4349250 1 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 1 16 0 1 29 1 0 0 0 0 0 0 0 0 X 19 19 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 X KIM BUSTAMANTE 2075419250 125 PRESUMPSCOT STREET BOX 8 PORTLAND ME 04103 ARTHUR BLANK CHAIR 1.00 X X 0 0 0 ANDY CROWDER DIRECTOR 1.00 X 0 0 0 KYLE JOHNSON DIRECTOR 1.00 X 0 0 0 KEVIN LEWIS DIRECTOR 1.00 X X 0 0 0 MARY MAYHEW DIRECTOR 1.00 X 0 0 0 PETER MILLS TREASURER 1.00 X 0 0 0 RICHARD MARSTON DIRECTOR 1.00 X 0 0 0 RICHARD WHITE VICE CHAIRPERSON 1.00 X X 0 0 0 RODERICK PRIOR DIRECTOR 1.00 X 0 0 0 STEPHEN SEARS DIRECTOR 1.00 X 0 0 0 KEN MCCALL DIRECTOR 1.00 X 0 0 0 MICHELLE PROBERT DIRECTOR 1.00 X 0 0 0 PAUL STEIN DIRECTOR 1.00 X 0 0 0 CAROL TIMBERLAKE DIRECTOR 1.00 X 0 0 0 JAY YOE DIRECTOR 1.00 X 0 0 0 ANN SULLIVAN SECRETARY 1.00 X 0 0 0 KAREN BELL DIRECTOR 1.00 X 0 0 0 LYNN DUBY DIRECTOR 1.00 X 0 0 0 DONALD KRAUSE DIRECTOR 1.00 X 0 0 0 DEVORE CULVER CEO 40.00 X 314457 0 29157 PETER PIKE CFO 4.00 X 15454 0 0 SHAUN ALFREDS COO 40.00 X 223273 0 27907 PHILIP PROFENNO DIRECTOR OF INFORMATION SERVICES 40.00 X 122455 0 9164 KIM BUSTAMANTE DIRECTOR OF FINANCE AND AD 40.00 X 115916 0 21491 KATIE SENDZE DIRECTOR OF CLIENT SERVICES 40.00 X 106608 0 13852 898163 0 101571 5 0 1 0 ORION HEALTH INC PO BOX 2927 BUFFALO NY 142402927 SOFTWARE 366895 SYSTEMS ENGINEERING INC 120 EXCHANGE STREET PORTLAND ME 04101 LICENSING & SUPPORT 236142 HBI SOLUTIONS INC 530 LYTTON AVENUE SECOND FLOOR PALO ALTO CA 94301 SOFTWARE 151116 CLINICAL ARCHITECTURE LLC 11611 N MERIDIAN STREET CARMEL IN 46032 LICENSE, LABOR, MAPPING 132500 SURESCRIPTS LLC 2800 CRYSTAL DRIVE ARLINGTON VA 22202 MED. HISTORY HOSTING 120161 5 CONTRACTED SERVICES 3643542 3643542 PARTICIPATION REVENUE 2487701 2487701 GRANT REVENUE 50000 50000 COMMISSION 17448 17448 6198691 2202 2202 6200893 6198691 0 2202 610247 297425 312822 1696813 1536322 160491 110777 99058 11719 206660 173549 33111 156870 126088 30782 20805 16153 4652 132977 110967 22010 15419 12867 2552 22954 1521 21433 594232 404524 189708 47379 32953 14426 VENDORS 1071203 1071203 SUBCONTRACTS 256615 256615 MISC AND OTHER EXPENSES 94429 94429 CONTRACTUAL SERVICES 70899 70899 147199 44677 102522 5255478 4349250 906228 0 1549041 2750225 367567 493581 245625 217354 1077205 678250 542805 398955 606149 201625 3311187 4061740 271389 206279 608020 478269 879409 684548 X 2431778 3377192 2431778 3377192 3311187 4061740 X 945415 -1 X 0 1 X 1 0 X 41764 41764 6076313 5318880 6425303 6666193 6198691 30685380 6076313 5318880 6425303 6707957 6198691 30727144 0 3562106 2360270 1530923 919779 8373078 3562106 2360270 1530923 919779 8373078 22354066 983 851 396 935 2202 5367 983 851 396 935 2202 5367 6077296 5319731 6425699 6708892 6200893 30732511 0.72740 0.56320 0.00020 0.00020 X 1077205 678250 398955 398955 X 6200893 0 6200893 0 6200893 5255479 0 5255479 -1 -1 5255478 PART X, LINE 2: MANAGEMENT EVALUATED THE ORGANIZATION'S TAX POSITIONS AND CONCLUDED THAT THE ORGANIZATION HAD TAKEN NO UNCERTAIN TAX POSITIONS THAT REQUIRED ADJUSTMENT TO THE FINANCIAL STATEMENTS. AS A RESULT, THERE WAS NO CUMULATIVE EFFECT AND NO INTEREST OR PENALTIES RELATED TO UNCERTAIN TAX POSITIONS. WHEN NECESSARY, THE ORGANIZATION ACCOUNTS FOR INTEREST AND PENALTIES RELATED TO UNCERTAIN TAX POSITIONS AS PART OF ITS PROVISION FOR FEDERAL AND STATE INCOME TAXES. THE ORGANIZATION DOES NOT EXPECT THAT ANY UNRECOGNIZED TAX BENEFITS OR LIABILITIES ARISING FROM TAX POSITIONS WILL CHANGE SIGNIFICANTLY WITHIN THE NEXT TWELVE MONTHS. THE ORGANIZATION IS CURRENTLY OPEN TO AUDIT UNDER THE STATUTE OF LIMITATIONS BY THE INTERNAL REVENUE SERVICE AND STATE TAXING AUTHORITIES FOR THE YEARS ENDING DECEMBER 31, 2011 THROUGH 2014. PART XII, LINE 4B - OTHER ADJUSTMENTS: ROUNDING X 1 0 X X X 0 0 0 0 0 0 0 1 0 DEVORE CULVER CEO 298077 0 0 0 16380 0 0 0 29157 0 343614 0 0 0 SHAUN ALFREDS COO 223273 0 0 0 0 0 0 0 27907 0 251180 0 0 0 PART I, LINE 1A CEO RECEIVES A HOUSING ALLOWANCE OF $16,380 ANNUALLY; IT IS INCLUDED IN HIS W-2 WAGES BUT IS NOT PART OF HIS BASE SALARY. PART I, LINE 3 THE EXECUTIVE COMMITTEE PERFORMS INDEPENDENT THIRD-PARTY COMPENSATION REVIEWS EVERY THREE YEARS FOR THE OFFICERS. THE EXECUTIVE COMMITTEE DETERMINES AMOUNT OF COMPENSATION AND ANNUAL BONUS FOR THE CEO. THE CEO HAS THE AUTHORITY TO DETERMINE AMOUNT OF COMPENSATION AND ANNUAL BONUS AMOUNTS FOR OTHER OFFICERS BASED UPON GUIDELINES DETERMINED BY THE EXECUTIVE COMMITTEE. BONUSES ARE BASED ON ORGANIZATIONAL AND EMPLOYEE PERFORMANCE. PART I, LINE 7 EMPLOYEES INCLUDING THE CEO ARE ELIGIBLE TO RECEIVE MERIT BONUSES FROM THE ORGANIZATION AT THEIR ANNUAL REVIEWS. THIS IS INCLUDED ON THE W-2S. KYLE JOHNSON CHIEF INFORMATION OFFICER AT EASTERN MAINE MEDICAL BOD MEMBER 733881 SCHEDULE O - HIN REVENUE 0 PAUL STEIN COO AT MAINEGENERAL MEDICAL CENTER BOD MEMBER 150000 SCHEDULE O - HIN REVENUE 0 ANDY CROWDER SENIOR VP AND CIO MAINEHEALTH BOD MEMBER 543333 SCHEDULE O - HIN REVENUE 0 ARTHUR BLANK CEO MDI HOSPITAL BOD OFFICER 42360 SCHEDULE O - HIN REVENUE 0 MARY MAYHEW COMMISSIONER (DHHS) AND JAY YOE DIR OF QUALITY IMPR MAINE CD BOD MEMBER 824875 SCHEDULE O - HIN REVENUE 0 DONALD KRAUSE ST JOSEPH HEALTHCARE BOD MEMBER 238782 SCHEDULE O - HIN REVENUE 0 FORM 990, PART VI, SECTION B, LINE 11 LINE 11A EXPLANATION - THE IRS 990 REPORT IS AN INFORMATIONAL TAX FILING FOR ORGANIZATIONS EXEMPT FROM FEDERAL INCOME TAX. THESE REPORTS ARE DUE TO THE IRS BY MAY FOLLOWING THE CLOSED FISCAL YEAR. THE INDEPENDENT AUDIT FIRM REQUIRES VARIOUS INTERNAL DOCUMENTS TO COMPLETE THE 990 REPORT INCLUDING INCOME, EXPENSES, GRANT AWARDS, PAYROLL, EQUIPMENT INVENTORY, ETC. THE 990 TAX RETURN IS SUBMITTED TO THE DIRECTOR OF ADMINISTRATION & FINANCE TO REVIEW PRIOR TO SIGNING BY THE CEO. THE BOARD OF DIRECTORS REVIEWS AND APPROVES THE 990 PRIOR TO FILING WITH THE IRS. COPIES OF EACH YEAR'S 990 REPORTS ARE MAINTAINED IN ACTIVE FINANCE OFFICE FILES WITH ORIGINALS MAILED TO THE IRS. FORM 990, PART VI, SECTION B, LINE 12C THE BOARD MEMBERS SIGN A CONFLICT OF INTEREST STATEMENT ANNUALLY AND DISCLOSE ANY CONFLICT OF INTEREST ISSUES AT MEETINGS WHEN APPLICABLE. FORM 990, PART VI, SECTION B, LINE 15 THE EXECUTIVE COMMITTEE PERFORMS INDEPENDENT THIRD-PARTY COMPENSATION REVIEWS EVERY THREE YEARS FOR THE OFFICERS. THE EXECUTIVE COMMITTEE DETERMINES AMOUNT OF COMPENSATION AND ANNUAL BONUS FOR THE CEO. THE CEO HAS THE AUTHORITY TO DETERMINE AMOUNT OF COMPENSATION AND ANNUAL BONUS AMOUNTS FOR OTHER OFFICERS BASED UPON GUIDELINES DETERMINED BY THE EXECUTIVE COMMITTEE. BONUSES ARE BASED ON ORGANIZATIONAL AND EMPLOYEE PERFORMANCE. FORM 990, PART VI, SECTION C, LINE 19 FINANCIAL STATEMENTS, GOVERNING DOCUMENTS AND POLICIES ARE PROVIDED UPON REQUEST. FORM 990, PART XI, LINE 9: ROUNDING -1. SCHEDULE L, SUPPLEMENTAL INFORMATION HEALTHINFONET RECEIVES REVENUE FROM SEVERAL ENTITIES WHICH HAVE REPRESENTATIVES SERVING ON THE BOARD OF DIRECTORS. IN ADDITION, HEALTHINFONET MAKES PAYMENTS TO SEVERAL OF THESE ENTITIES WHICH PARTICIPATE IN A PROGRAM FUNDED BY A FEDERAL GRANT. PART IV (1) KYLE JOHNSON, MD, CHIEF INFORMATION OFFICER OF EASTERN MAINE HEALTHCARE SYSTEMS. EASTERN MAINE HEALTHCARE SYSTEM MADE GRANTS AND PAYMENTS TO HEALTHINFONET TOTALING REVENUE OF $733,881. HEALTHINFONET HAD ACCOUNTS RECEIVABLE TOTALING $4,250 DUE FROM THE EASTERN MAINE HEALTHCARE SYSTEMS AT DEC. 31, 2015. PART IV (2) PAUL STEIN, CHIEF OPERATING OFFICER, MAINEGENERAL MEDICAL CENTER (MEMBER MAINEGENERAL HEALTH). MAINEGENERAL HEALTH PROVIDED HEALTHINFONET WITH REVENUE TOTALING $150,000 IN 2015. PART IV (3) ANDY CROWDER, SENIOR VIP AND CIO, MAINEHEALTH. MAINEHEALTH AND MAINE MEDICAL CENTER PROVIDED REVENUE TOTALING $543,333 TO HEALTHINFONET IN 2015. PART IV (4) ARTHUR J. BLANK, PRESIDENT & CEO, MT. DESERT ISLAND HOSPITAL. MT. DESERT ISLAND HOSPITAL PROVIDED HEALTHINFONET WITH REVENUE TOTALING $42,360 AND $6,000 DEFERRED REVENUE IN 2015. HEALTHINFONET HAD ACCOUNTS RECEIVABLE TOTALING $6,027 DUE FROM MDI HOSPITAL AT DEC. 31, 2015. PART IV (5) MARY MAYHEW, COMMISSIONER, DEPARTMENT OF HEALTH AND HUMAN SERVICES, JAY YOE, DIRECTOR CONTINUOUS QUALITY IMPROVEMENT, DHHS. THE MAINE CDC MADE GRANTS TO HEALTHINFONET TOTALING $824,875 IN 2015; HEALTHINFONET HAD ACCOUNTS RECEIVABLE TOTALING $375,717 DUE FROM THE MAINE CDC AT DEC. 31, 2015. PART IV (6) DONALD KRAUSE, MD, ST. JOSEPH'S HEALTHCARE. ST. JOSEPH'S HEALTHCARE PROVIDED HEALTHINFONET WITH REVENUE TOTALING $238,782 IN 2015 AND $31,500 DEFERRED REVENUE; HEALTHINFONET HAD ACCOUNTS RECEIVABLE TOTALING $10,002 DUE FROM ST. JOSEPH'S HEALTHCARE AT DEC. 31, 2015.