2014-05-15T11:17:07-05:00 2013-06-30 010523282 Berry Dunn McNeil & Parker LLC PO Box 1100 Portland ME 041041100 990 2012-07-01 010211503 Franklin Memorial Hospital FRAN 2077792500 111 Franklin Health Commons Farmington ME 04938 Wayne Bennett 2077792500 2014-05-05 1 Barbara J McGuan CPA P00219457 2077752387 2014-05-05 2012 2015-11-30 17:44:51Z Rebecca Arsenault 111 Franklin Health Commons Farmington ME 04938 78141644 0 X www.fchn.org X 1926 ME Community Hospital 18 13 1025 164 0 0 761215 1794711 89240432 76263965 -17445 -24953 3244 28298 89987446 78062021 20000 10000 0 0 56453831 52994819 0 0 0 33510034 31169437 89983865 84174256 3581 -6112235 76169004 68577137 34936190 33177419 41232814 35399718 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. 0 0 40029439 10000 59761828 Routine Inpatient and Ancillary Outpatient ServicesFranklin Memorial Hospital is a non-for-profit community hospital which provides high-quality, cost-effective, patient-centered inpatient and outpatient healthcare services to west central Maine communities. 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, orthopaedics, behavioral services, occupational health, dermatology, pulmonology, pain management, pediatric endocrinology, physical rehabilitation, sports medicine and wound care. During the fiscal year 2013 there were 2,680 inpatient discharges, 1,940 outpatient surgeries, 214,000 outpatient lab tests and 34,750 outpatient imaging procedures. 24534153 9393744 Franklin Health Physician PracticesFranklin 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, orthopaedics, ENT and behavioral health services. During the year Franklin Memorial Hospital provided 57,600 primary care visits and 27,000 specialty care visits in the Franklin Health physician practices. 5681698 7108393 Emergency RoomFranklin 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 communities. Given Franklin Memorial Hospital's commitment to access to care regardless of ability to pay, the Emergency Department serves a vital role in the community's health care network. During FY13 Franklin Memorial Hospital had 14,700 emergency room visits. 70245290 1 1 0 1 0 0 0 0 0 1 1 0 0 1 1 0 0 1 0 0 0 0 0 0 0 0 1 1 1 0 1 1 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 1 0 0 0 1 170 0 1 1025 1 0 0 0 0 0 0 0 0 0 0 X 18 13 0 0 0 0 1 1 0 1 1 0 1 1 1 1 1 1 1 1 1 1 0 ME X Wayne Bennett 2077792613 111 Franklin Health Commons Farmington ME 04938 Rebecca Arsenault 33.00 7.00 X X 362433 0 32836 Carol Timberlake 0.80 0.20 X 0 0 0 Doug Walrath 0.80 0.20 X 0 0 0 Jef Howell 1.80 0.20 X X 0 0 0 Joseph Bujold 2.80 0.20 X X 0 0 0 Gilly Hitchcock 0.80 0.20 X X 0 0 0 Meredith Tipton 0.80 0.20 X 0 0 0 Tim Wallace 0.80 0.20 X 0 0 0 Waine Whittier 1.80 0.20 X 0 0 0 Dr Wil Eastman 0.80 0.20 X 0 0 0 Peter Judkins 0.80 0.20 X 0 0 0 Sheena Bunnell 0.80 0.20 X 0 0 0 Ronald Aseltine 0.80 0.20 X 1115 0 0 Dr Connie Adler 39.80 0.20 X X 214067 0 19078 Paul Soucie 0.80 0.20 X 0 0 0 Clint Boothby 0.80 0.20 X 0 0 0 Les Gatchell 0.80 0.20 X 0 0 0 Dr David Dixon 0.80 0.20 X 0 0 0 Dr Michael Fraley 39.80 0.20 X 340641 0 21844 Gerald Cayer 39.00 1.00 X 218495 0 23710 Wayne Bennett 36.00 4.00 X 250421 0 19093 Nancy Cummings 40.00 0.00 X 447300 0 27584 Joshua D Sparling 32.00 0.00 X 535588 0 22305 Heather DeCarolis 40.00 0.00 X 343242 0 25742 James C Lancaster 40.00 0.00 X 334848 0 0 Stephen P Zanella 39.70 0.30 X 333871 0 29816 Dr Armand Auger 40.00 0.00 X 193523 0 21912 3575544 0 243920 73 1 1 0 Hebert Construction LLC 9 Gould Road Lewiston ME 04240 Construction 1073803 Weatherby Locums 6440 South Millrock Dr Suite 175 Salt Lake City UT 84121 Physician Contract Staffing 556745 Quest Diagnostics 415 Massachusetts Avenue Cambridge MA 02139 Lab Diagnostic Services 554383 CHG Companies Inc 6440 South Millrock Dr Suite 175 Salt Lake City UT 84121 Physician Contract Staffing 424367 Staff Care Inc 12400 High Bluff Drive San Diego CA 92130 Physician Contract Staffing 291576 18 1579980 214731 1794711 Patient Services 621990 166927201 166927201 Other 621990 1086991 1086991 Ambulance Subsidies 621910 890652 890652 Meaningful Use Revenue 621990 42500 42500 Contract/Char./Bad Dbt. 621990 -92683379 -92683379 76263965 77943 49645 28298 28298 28298 5025 29978 -24953 -24953 -24953 78062021 76263965 0 3345 10000 10000 1719166 811063 908103 40875478 35267672 5607806 864075 773963 90112 6671670 5784577 887093 2864430 2471452 392978 92363 92363 67657 67657 20986 20986 7694637 6153592 1541045 143892 143892 1430748 986090 444658 2445690 2222152 223538 2050020 1761962 288058 124872 121029 3843 460190 340877 119313 1180951 1018933 162018 4512293 3893241 619052 1408186 1331153 77033 Medical Supplies 6820681 6820681 0 Hospital Tax and Match 2031209 0 2031209 Other 685062 476853 208209 84174256 70245290 13928966 0 3580 3635 5553570 3827383 10470970 10333479 1219194 1212571 2459056 932802 85787883 50538491 38621125 35249392 2497648 2771509 306316 292145 15037545 13954221 76169004 68577137 6293976 7120921 56111 21905514 21108267 3763867 3657629 2972833 1234491 34936190 33177419 X 38723155 32562079 1077560 1387990 1432099 1449649 41232814 35399718 76169004 68577137 X -6112235 279139 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 1 0 0 0 0 1 10159 0 1 10827 20986 0 Explanation of Lobbying Activities: Part II-B, Line 1: Rebecca Arsenault, President/CEO of the Organization, spent time meeting with members of the congressional delegation. A proportional amount of her time spent engaging in these activities has been calculated to arrive at the total lobbying expense amount. In addition, The Organization pays dues to various associations, a portion of which is attributable to lobbying expenses. 2325015 126671 166297 13828 2604155 2341310 216215 -63416 169094 2325015 2007058 12117 335279 13144 2341310 1903822 60144 135979 93491 2007058 1895540 120033 -66109 45642 1903822 0.00000 0.56000 0.44000 0 1 1 1268949 1268949 48045614 21840762 26204852 10517 10517 0 31498291 25958372 5539919 4964512 2728840 2235672 35249392 Estimated Settlements from MaineCare 12608331 Deferred Compensation Asset 1234491 Due from Related Parties 111399 13954221 Deferred Compensation 1234491 1234491 Description of Intended Use of Endowment Funds: 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. 1 1 1 X 1 X 0 1 1 0 1 1 3132948 0 3132948 0.03720 16358549 14088868 2269681 0.02700 19491497 14088868 5402629 0.06420 436169 58063 378106 0.00450 272242 0 272242 0.00320 11013473 6131922 4881551 0.05800 37900 0 37900 0.00050 11759784 6189985 5569799 0.06620 31251281 20278853 10972428 0.13040 2000 2000 0.00000 2000 2000 1 2516848 0 19636116 22693211 -3057095 X 1 1 1 Western Maine PHO Physician Hospital Organization 0.50000 0.00000 0.00000 2 Scorekeeper LLC Wellness Software 0.40000 0.00000 0.00000 1 1 Franklin Memorial Hospital

111 Franklin Health Commons Farmington ME 04938

X X X Franklin Memorial Hospital 1 1 X X X X X X X X 12 1 0 1 X X X X X X X X X 0 0 1 1 200.000000000000 1 300.000000000000 1 X 1 1 X 1 0 1 X 0 0 19 Franklin Hlth Livermore Falls Fam Pract

21 Main Street Livermore Falls ME 04254

Family Practice Franklin Health Wilton Family Practice

75 Allen Street Wilton ME 04294

Family Practice Franklin Hlth Farmington Family Practice

111 Franklin Health Commons Farmington ME 04938

Family Practice Franklin Health Internal Medicine

131 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 Rangeley Region Physical Rehabilitation

25 Dallas Hill Road Rangeley ME 04970

Outpatient Physical Therapy Outpatient Services 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 Child Developmental Prog

131 Franklin Health Commons Farmington ME 04938

Child Developmental Program 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 Ear Nose & Throat

111 Franklin Health Commons Farmington ME 04938

ENT Part I, Line 7: 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. The cost to charge ratio was calculated using internal cost accounting data for the subsidized health services included in the community benefit. Part I, Line 7g: The Organization has included costs associated with primary care (Family practice, Pediatrics, Internal Medicine and Women's Care), Behavioral Services, Child & Adolescent Developmental Pediatrics and physical therapy services provided in Rangeley, ME as subsidized health services. Part II: See 990, Schedule H, Part VI, line 5. Part III, Line 4: Franklin Memorial Hospital used the RCC calculated from Worksheet 2 and multiplied it by the bad debts expense per the financials. Bad debts include 100% of the charges written off due to no payment. If a payment is made on a bad debt account, then that payment reduces the bad debt expense in the year received.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. Part III, Line 8: The Medicare Principles of Reimbursement were used to determine the Medicare inpatient and outpatient costs based on the Organization's cost report. Part III, Line 9b: Patient balances are screened for eligibility for financial assistance by outside collection agency and are transferred back to Franklin Memorial Hospital for follow up with a counselor as needed. Balances that are owed to the Hospital after applying any financial assistance are collected in the same manner as any other self pay balances. Franklin Memorial Hospital Part V, Section B, Line 3: The working group for developing the community health needs assessment consisted of persons who are considered public health experts, such as Meredith Tipton, PhD MPH ,Associate Dean for Community Programs, University of New England, FCHN Board Member; Sarah Martin, PhD Epidemiology, Healthy Community Coalition, Husson College School of Pharmacy; and Michael Rowland, MD MPH, Vice President Medical Affairs, Franklin Memorial Hospital. The working group took input from various community groups interested in promoting wellbeing of the population in our community, including:-FCHN Board, representing communities in Franklin county-Healthy Community Coalition Board, representing diverse groups involved with health improvement -Franklin Health Collaborative, representing health-related organizations and initiatives county-wide (Long-term care, home health, public health nursing, mental health agencies, school districts, domestic violence victim advocacy, emergency response services, University of Maine at Farmington, Franklin County Children's Task Force, Western Mountains Alliance)-FMH Primary Care service, representing primary care providers in Franklin county-Western Maine Public Health District, coordinating regional health improvement work with Maine CDCIn addition to numerous face-to-face meetings with the community groups identified above, direct input from community members was obtained via community survey, conducted by Healthy Community Coalition in 2013, meetings with Franklin Health Patient Advisory group and Community Visioning public meetings conducted every 2 years. Franklin Memorial Hospital Part V, Section B, Line 7: CHNA identified several community needs for which other agencies are taking a leading role with Franklin Memorial Hospital taking a supporting role. Domestic violence - 3 organizations are actively working in this area; Children's Task Force, Sexual Assault Victims Emergency Services, and Safe Voices. FCHN coordinates with these organizations through the primary care practices, and mutual inclusion of leadership at the board level. Dental Care access - Community Dental is the lead agency for providing dental care to low income residents. FCHN has provided support through provision of low-cost dental office space. High rate of Motor Vehicle Fatalities - Our research indicated that poor winter road conditions and large wildlife were the root cause in most cases. Only 6% of highway fatalities involved intoxication. The lead agency to address these issues is the Maine Highway administration. Franklin Memorial Hospital Part V, Section B, Line 14g: Franklin Memorial Hospital takes a number of steps to publicize the availability of the financial assistance to patients: 1. Notices of the availability of financial assistance are posted in locations within the hospital at which members of the public generally transact business with the Hospital or present themselves to receive or request hospital services, including admitting areas, waiting rooms, business offices and outpatient reception areas. 2. With respect with inpatient admissions, individual written notice of the availability of financial assistance is presented to each patient upon admission or in the case of emergency admission before discharge. In addition, all uninsured inpatients are visited by an Advanced Patient Advocacy representative to discuss availability of financial assistance and government coverage options. 3. Availability of financial assistance is publicized on the patient invoices supplying patients with a contact number to obtain further information about available options. 4. Financial assistance options are outlined on the hospitals' website and are readily available to the public. 5. Rack cards & Financial Assistance Applications are located throughout the Hospital & physician practices6. Hospital booklets are available in all patient rooms with a section regarding Financial Assistance7. Business office staff and contracted third party collection agency notify all patients with self pay balances about Hospital's financial assistance resources and encourages them to apply for such assistance. Part VI, Line 2: 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: When patients are registered there are brochures available that describe Franklin Memorial Hospital's charity care programs. When a patient is admitted with no insurance, registration sends a financial counselor up to the patient's room to meet the patient. Each bill provided to a patient has the phone number to call if the patient needs financial assistance. The Organization's billers also refer patients to the Organization's financial counselors when a patient is identified as needing assistance. The Organization's pre-collection and collection agencies also educate patients and help to set them up with financial assistance when needed. Part VI, Line 4: Franklin Memorial Hosptial's service area covers 2,200 square miles which extends to the Canadian border. It is one of the most rural and economically challenged regions in Maine, including several areas that have been federally designated as health professional shortage and medically underserved areas. Part VI, Line 5: Community BuildingPhysical Improvements and Housing:1. Development and maintenance of the rail trail which is on FMH property - available to the public to encourage health and wellness. Economic Development:1. Member of Greater Franklin Development Corporation - an organization committed to economic developmentCommunity Support:1. Perform disaster drills with the community 1-2 times a year2. 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 8,000 individuals benefited from the outreach activities of the Coalition with 2,500 seeking services of 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 analyzation, 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 include 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 forhealth 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: Thirty-four out of thirty-eight Maine hospitals, including FMH, 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.4. ScoreHealth Screenings - ScoreHealth is a health risk assessment program that helps individuals evaluate many different areas affecting their health, including but not limited to diabetes, cancer, asthma and osteoporosis. The screenings are offered part of the mobile health outreach program conducted by the Healthy Community Coalition of Greater Franklin County and offer cholesterol, blood pressure, BMI and bone density assessments along with counseling on tobacco use and exposure, benefits of physical activity, healthy nutrition and stress management.5. Health Works! Worksite Wellness Award Program is a new and free aware program offered by Healthy Community Coalition of Greater Franklin County. The award program provides businesses and organizations with the opportunity to be recognized as a community leader in health promotion. The purpose of the Healthy Maine Works (HMW) is to guide and support Maine employers in developing worksite wellness programs that support the health of employees. HWM is a project of Maine's Center for Disease Control, Office of Substance Abuse, and Department of Education and is delivered in collaboration with local Healthy Maine Partnerships across the state. Part VI, Line 6: Franklin Communith Health Network: Supporting OrganizationFranklin Memorial Hospital: Community hospitalHealthy Community Coalition: A subsidiary of FCHN - HCC's mission is to measurably improve the health and well-being of all people in Greater Franklin County using a coordinated approach of education, health promotion, and outreach. HCC offers health screenings, health information, and programs and events to support healthy lifestyles that prevent disease and improve quality of life.Evergreen Behavioral Services: Operates 24/7 emergency mental health response services for the Greater Franklin County area as well as bordering towns of Androscoggin & Oxford counties. 1 LifeFlight Foundation PO Box 940 Bangor ME 044020940 522377085 501(c)(3) 10000 Organizational Support 1 0 Procedure for Monitoring Grants in the U.S.: Part I, Line 2: Schedule I, Part I, Line 2: All assistance is given to either 501(c)(3) public charities or governmental units and their affiliates. Therefore, additional monitoring is not deemed necessary. X X X X X X 0 0 0 0 0 0 0 0 0 Rebecca Arsenault 356109 0 6324 0 0 0 23038 0 9798 0 395269 0 0 0 Dr Connie Adler 213927 0 140 0 0 0 8043 0 11035 0 233145 0 0 0 Dr Michael Fraley 340641 0 0 0 0 0 5939 0 15905 0 362485 0 0 0 Gerald Cayer 218495 0 0 0 0 0 8089 0 15621 0 242205 0 0 0 Wayne Bennett 218421 0 15000 0 17000 0 5308 0 13785 0 269514 0 0 0 Nancy Cummings 435649 0 11651 0 0 0 10340 0 17244 0 474884 0 0 0 Joshua D Sparling 337074 0 182915 0 15599 0 5954 0 16351 0 557893 0 0 0 Heather DeCarolis 343242 0 0 0 0 0 9582 0 16160 0 368984 0 0 0 James C Lancaster 334848 0 0 0 0 0 0 0 0 0 334848 0 0 0 Stephen P Zanella 333871 0 0 0 0 0 13506 0 16310 0 363687 0 0 0 Dr Armand Auger 189263 0 4260 0 0 0 7910 0 14002 0 215435 0 0 0 A Maine Health & Higher Ed Facilities Authority 010314384 560425G20 2006-09-07 15270692 MRI, Medical Office Building 0 0 1 B Maine Health & Higher Ed Facilities Authority 010314384 560427NM4 2011-11-30 10452958 Refunding of Series 2001A 0 0 1 A 2278874 15270692 631163 221065 13274282 2008 0 0 1 1 B 2336509 10452958 501489 117007 9633963 2002 1 0 1 1 A 0 0 0 0 0 0 0 B 0 0 0 0 0 0 0 A 1 0 0 0 0 0 B 0 0 0 0 0 0 0 0 0 A 0 B 0 Franklin Savings Bank Board member Peter Judkins is President of the bank 216054 Independent Contractor - Interest paid on loan extended to Organization by bank in an arms length transaction 0 Form 990, Part VI, Section A, line 6 The Organization consists of one Member, Franklin Community Health Network. Action of the Member shall be evidenced by written consents that are executed on its behalf by any officer of the Member who is authorized so to act by the board of directors of the Member. The written consent evidencing the annual meeting of the Member shall be adopted and effective as of a date immediately following the annual meeting of the board of directors of the Member or such later date as may be set forth in such written consent. The effective date set forth in such written consent shall be the date of the annual meeting of the year in question. Form 990, Part VI, Section A, line 7a The Member has rights and powers to establish the size of the board of directors of the Organization within the limits prescribed by the Articles of Incorporation and to elect and remove certain directors of the Organization in accordance with the Articles of Incorporation and Bylaws. Form 990, Part VI, Section B, line 11 A complete copy of the form 990 was distributed to each member of the board prior to filing with IRS. In addition, the 990 was 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, Part VI, Section B, 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, Part VI, Section B, line 15 Executive compensation is determined by the compensation committee which consists of the Board Chair and several board members. The compensation committee uses an independent executive search firm that assists with executive salary determination by providing compensation survey results, along with review of executive compensation reported by other health care organizations on their Form 990. The compensation committee approves the executive compensation package prior to contract execution. Form 990, Part VI, Section C, line 19 The Organization's governing documents, conflict of interest policy, and financial statements are available to the public upon request. Changes in Net Assets or Fund Balances: Form 990, Part XI, line 9: Change in Net Assets of Affiliate 261,589. Net Change in Perpetual Trust 17,550. Franklin Community Health Network 111 Franklin Health Commons Farmington ME 04938 223209406 Supporting Organization ME 501(c)(3) Line 11b, II N/A 0 Healthy Community Coalition 105 Mt Blue Circle Suite 1 Farmington ME 04938 223305743 Community Outreach ME 501(c)(3) Line 7 Franklin Community Health Network 0 Pine Tree Medical Associates 131 Franklin Health Commons Farmington ME 04938 010469478 Community Health Agency ME 501(c)(3) Line 9 Franklin Community Health Network 0 Evergreen Behavioral Services 131 Franklin Health Commons Farmington ME 04938 010492747 Mental Health Agency ME 501(c)(3) Line 9 Franklin Community Health Network 0 0 0 1 0 0 0 0 0 0 1 0 0 0 0 0 0 0 1 0