2012-05-10T12:39:20-05:00 2011-06-30 BKD LLP 910 E ST LOUIS 200/PO BOX 1190 SPRINGFIELD MO 658062523 990 2010-07-01 010215227 RUMFORD HOSPITAL RUMF 2077952972 420 FRANKLIN STREET RUMFORD ME 04276 MATTHEW E COX 2012-04-17 true Brian D Todd 4178658701 2010 2016-02-24 21:20:13Z X JOHN WELSH 420 FRANKLIN STREET RUMFORD ME 04276 40261627 false X WWW.RUMFORDHOSPITAL.ORG X 1974 ME RUMFORD HOSPITAL STRIVES TO PROVIDE EXCEPTIONAL HEALTHCARE SERVICES. THE HOSPITAL DEPENDS ON THE EXPERTISE OF ITS CAREGIVERS IN ADDITION TO THE COMMITMENT AND COMPASSION THEY PROVIDE TO FULFILL ITS MISSION. 9 8 339 48 0 0 166668 146601 33943559 39320253 140255 155516 0 -101119 34250482 39521251 15000 17000 0 0 22464956 16060506 0 0 0 12791549 18789164 35271505 34866670 -1021023 4654581 23061721 23384186 8919210 4293450 14142511 19090736 TO PROVIDE EXCEPTIONAL HEALTHCARE SERVICES IN A SAFE AND TRUSTFUL ENVIRONMENT THROUGH THE EXPERTISE, COMMITMENT AND COMPASSION OF OUR FAMILY OF CAREGIVERS. false false 27687768 17000 39320253 RUMFORD HOSPITAL IS A CRITICAL ACCESS HOSPITAL, PROVIDING COMPREHENSIVE PRIMARY CARE & SOPHISTICATED DIAGNOSTIC SERVICES, INCLUDING CT SCANNING, ULTRASOUND AND NUCLEAR MEDICINE. THE HOSPITAL OFFERS MEDICAL SURGICAL NURSING SERVICES, A BIRTHING CENTER, WOMEN'S HEALTH SERVICES & AMBULATORY SURGERY. THE SWING BED PROGRAM PROVIDES CARE FOR PATIENTS WHO NEED SKILLED NURSING SERVICES. RUMFORD HOSPITAL ALSO MAINTAINS A 24 HOUR EMERGENCY DEPARTMENT AND STAFFS AN INTENSIVE CARE UNIT. 27687768 true true false true false false false false true true false false true false false false true false false false false false false false false true true true false true false false false true false false false false false false false false false true false false false false true 52 0 true 339 true false false false false false false false false false false X 9 8 true false false false true true true true true false false true true true true true true false false false ME X PHIL MORISSETTE 2077952972 29 LOWELL STREET LEWISTON ME 04240 X PETER E CHALKE 1.0 X 0 597235 112723 STUART R COOPER 1.0 X 0 0 0 JOLAN IPPOLITO 1.0 X X 0 0 0 ROGER ARSENAULT 1.0 X 0 0 0 RICHARD LOVEJOY 1.0 X X 0 0 0 JOSEPH A POIRIER 1.0 X 0 0 0 ROBERT STICKNEY 1.0 X X 0 0 0 LINDA CAMERON OD 1.0 X 0 0 0 DAVID DUGUAY 1.0 X 0 0 0 JOHN WELSH 55.0 X 0 240807 75178 JACOB LEDESMA MD 55.0 X 404219 0 21337 THOMAS DELUCA MD 55.0 X 318040 0 20618 DIETER KRECKEL MD 55.0 X 285659 0 22383 CAROLYN GARCIA MD 55.0 X 278805 0 17913 JOHN KROGER MD 55.0 X 257160 0 20005 1543883 838042 290157 15 false true false CPS INC MEDICAL SERVICES 410782 GE HEALTHCARE MAINTENANCE SERVICES 313128 COMPHEALTH MEDICAL STAFFING 130352 ARUP LABORATORIES LAB SERVICES 130085 VISTA STAFFING SOLUTIONS MEDICAL STAFFING 124251 8 9000 137601 146601 NET PATIENT SERVICE REVENUE 900099 38902907 38902907 CAFETERIA REVENUE 722210 74885 74885 OTHER REVENUE 900099 342461 342461 39320253 63042 63042 0 0 1125 25993 -24868 -24868 -24868 806857 714383 92474 92474 92474 0 0 0 PENSION CURTAILMENT 900099 -76251 -76251 -76251 39521251 39320253 54397 17000 17000 0 0 0 0 0 13062057 9950022 3112035 711617 542074 169543 1448347 1103278 345069 838485 638716 199769 300 300 72811 72811 29872 29872 0 0 8169 8169 7159651 5460087 1699564 95814 72986 22828 1378014 1048511 329503 764816 582599 182217 0 725459 552618 172841 123574 94132 29442 0 0 46624 35516 11108 0 1255869 956658 299211 1113091 847897 265194 BAD DEBT 2074833 2074833 MEDICAL SUPPLIES & DRUGS 2966900 2966900 LICENSES, DUES, SUBSCRIPTIONS 101792 77540 24252 RECRUITING & RETENTION 33531 25542 7989 REPAIRS & MAINTENANCE 773236 589013 184223 64808 51846 12962 34866670 27687768 7178902 0 47530 784555 91656 567468 3717083 4152812 107112 65758 206143 207390 107782 136040 29076170 16473500 13602541 12602670 2642382 2644851 2539492 2222642 23061721 23384186 8025320 3540246 143203 31208 750687 721996 8919210 4293450 X 13643191 18599002 246195 235361 253125 256373 14142511 19090736 23061721 23384186 X 4654581 293644 X false true true X false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false true 6739 6739 false false LOBBYING EXPENSES SCHEDULE C, PART II-B, LINE 1I PORTION OF DUES FOR PROFESSIONAL ASSOCIATIONS ATTRIBUTED TO LOBBYING EXPENSES - $6,739 499320 9000 10970 27556 491734 463891 13532 23747 1850 499320 536730 11068 -79304 4603 463891 0.52050 0.47950 false true true 89148 89148 14094713 5302422 8792291 0 0 0 14518472 10961418 3557054 373837 209660 164177 12602670 DUE FROM AFFILIATES 13036 INVESTMENT IN CHARITABLE TRUST 67308 OTHER RECEIVABLES 36661 DEPOSITS 83459 EST AMT DUE TO 3RD PARTIES 2022178 2222642 39521251 34866670 4654581 290925 2719 293644 4948225 39833088 290925 -5081 285844 39547244 -25993 -25993 39521251 34884863 25993 25993 34858870 300 7500 7800 34866670 SCHEDULE D, PART V, LINE 4 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 EDUCATION, OR FREE CARE. OTHERS ARE DESIGNATED TO SUPPORT SPECIFIC DEPARTMENTS OF THE HOSPITAL. UNCERTAIN TAX POSITION SCHEDULE D, PART X, LINE 2 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. OTHER RECONCILING ITEMS SCHEDULE D, PART XI, LINE 5 $ 2,719 CHANGE IN BENEFICIAL INTEREST OF PERPETUAL TRUST OTHER RECONCILING ITEMS SCHEDULE D, PART XII, LINE 2D $ (7,500) GRANT PAID 2,719 CHANGE IN BENEFICIAL INTEREST OF PERPETUAL TRUST --------- (5,081) OTHER RECONCILING ITEMS SCHEDULE D, PART XII, LINE 4B $(25,993) RENTAL EXPENSE OTHER RECONCILING ITEMS SCHEDULE D, PART XIII, LINE 2D $ 25,993 RENTAL EXPENSES OTHER RECONCILING ITEMS SCHEDULE D, PART XIII, LINE 4B $ (7,500) GRANT PAID true true X true X 300. false true true true false false 192287 192287 0.00590 6438113 5194332 1243781 0.03790 6630400 5194332 1436068 0.04380 3090 350 2740 0.00000 17000 17000 0.00050 20090 350 19740 0.00050 6650490 5194682 1455808 0.04430 false 1052445 375042 12722865 12601926 120939 X true true 1 1 RUMFORD HOSPITAL

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X X X X RUMFORD HOSPITAL 1 5 SWIFT RIVER CLINIC

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OUTPATIENT PHYSICIAN CLINIC RIVER VALLEY INTERNAL MEDICINE

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OUTPATIENT PHYSICIAN CLINIC DIXFIELD CLINIC

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OUTPATIENT PHYSICIAN CLINIC RUMFORD SURGICAL SPECIALISTS

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OUTPATIENT PHYSICIAN CLINIC RUMFORD SPECIALTY SUITES

431 FRANKLIN STREET RUMFORD ME 04276

OUTPATIENT PHYSICIAN CLINIC CRITERIA FOR ELIGIBILITY SCHEDULE H, PART I, LINE 3C CENTRAL MAINE MEDICAL CENTER CURRENTLY PROVIDES FREE CARE FOR PATIENTS UP TO 300% FPG LEVELS. THIS IS A LEVEL OF FREE CARE ELIGIBILITY HIGHER THAN THE AVERAGE AND IS SET AT THIS LEVEL INSTEAD OF OFFERING DISCOUNTED CARE TO PATIENTS AT 250% TO 300% FPG, WHICH IS A COMMON RANGE FOR DISCOUNTED CARE ELIGIBILITY. PERCENT OF TOTAL EXPENSE SCHEDULE H, PART I, LINE 7, COLUMN F TO ARRIVE AT THE PERCENT OF TOTAL EXPENSES, THE DENOMINATOR WHICH EQUALS TOTAL OPERATING EXPENSES PER PART IX, LINE 25, OF THE FORM 990 ($34,866,670) WAS REDUCED BY BAD DEBT EXPENSE ($2,074,833). THE COST-TO-CHARGE RATIO FROM WORKSHEET 2 WAS USED IN COMPUTING THE FIGURES ON LINE 7B. BAD DEBT EXPENSE SCHEDULE H, PART III, SECTION A, LINE 4 THERE IS NO FOOTNOTE IN THE CONSOLIDATED FINANCIAL STATEMENTS RELATING TO BAD DEBT EXPENSE. THE AMOUNT REPORTED ON LINE 2 OF SCHEDULE H, PART III IS BASED ON THE COST-TO-CHARGE RATIO CALCULATED IN SUPPORTING WORKSHEET 2, PROVIDED WITH THE INSTRUCTIONS TO SCHEDULE H. THE AMOUNT ON LINE 3, IN THE SAME SECTION, IS BASED UPON A COMPARISON OF EXPERIENCED CHARITY CARE COVERAGE AND US CENSUS BUREAU DATA FOR THE MOST RECENT YEAR AVAILABLE WHEN CHARITY CARE COVERAGE EXCEEDS THE CENSUS DATA, A MINIMAL AMOUNT OF BAD DEBT IS ASSUMED TO BE ELIGIBLE FOR CHARITY CARE TO ACCOUNT FOR THOSE PATIENTS WHO REFUSE TO PROVIDE INFORMATION DOCUMENTING ELIGIBILITY FOR THE PROGRAM. THESE ESTIMATES ARE BASED ON STATE-WIDE DATA AND DO NOT ACCOUNT FOR DIFFERENCES IN GEOGRAPHIC LOCATIONS WITHIN THE STATE. THE COSTING METHODOLOGY USED IN THE TABLE FOR PART 1, LINE 7 IS THE COST TO CHARGE RATIO DERIVED FROM WORKSHEET 2, "RATIO OF PATIENT CARE COST-TO-CHARGES", INCLUDED WITH THE SCHEDULE H INSTRUCTIONS. THIS RATIO WAS USED IN THE AMOUNTS ON LINES 7A AND 7B. COMMUNITY BENEFIT SCHEDULE H, PART III, SECTION B, LINES 8 THE COSTING METHODOLOGY USED TO DETERMINE PART III, LINE 6 IS THE COST TO CHARGE RATIO CALCULATED IN THE MEDICARE COST REPORT FOR THE REPORTABLE YEAR. COLLECTION POLICY SCHEDULE H, PART III, SECTION C, LINE 9B 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. NEEDS ASSESSMENT AS A CRITICAL ACCESS HOSPITAL, RUMFORD HOSPITAL ATTEMPTS TO PROVIDE ANY NEEDED HEALTH CARE SERVICES NECESSARY TO TREAT THE POPULATION OF THIS RURAL AREA OF MAINE. ADDITIONALLY, RUMFORD HOSPITAL FOCUSES ON STATE-WIDE INITIATIVES, SUCH AS HEART DISEASE AND DIABETES, AS WELL AS ORGANIZATIONAL INITIATIVES BASED ON NEEDS OBSERVED WITHIN ITS PATIENT POPULATION. MANY FORMS OF EDUCATION, PREVENTION AND EARLY DETECTION ARE ALSO PART OF ITS COMMUNITY HEALTH CARE PLAN. PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE RUMFORD HOSPITAL PROVIDES NOTICES ABOUT ITS FREE CARE POLICY IN ALL CLINICAL DEPARTMENTS AND MAJOR PATIENT AREAS. AN INPATIENT FINANCIAL COUNSELOR VISITS WITH ALL UNINSURED PATIENTS TO DISCUSS OPTIONS, INCLUDING GOVERNMENTAL PROGRAM ELIGIBILITY AND FREE CARE ASSISTANCE IS AVAILABLE TO HELP PATIENTS WITH COMPLETION OF MEDICAID APPLICATIONS. ALL PATIENT FINANCIAL SERVICES STAFF ARE TRAINED TO OFFER FREE CARE AS AN OPTION TO PATIENTS WHO INDICATE AN INABILITY OR DIFFICULTY IN PAYING FOR SERVICES. INFORMATION ABOUT FINANCIAL ASSISTANCE AVAILABILITY IS INCLUDED ON THE BACK OF EVERY PATIENT STATEMENT. ADDITIONALLY, UNINSURED PATIENTS RECEIVE A SEPARATE INFORMATION SHEET WITH THEIR STATEMENTS, FURTHER INFORMING THEM ABOUT THE AVAILABLE OPTIONS. COMMUNITY INFORMATION RUMFORD HOSPITAL, LOCATED IN RUMFORD, MAINE, SERVES CENTRAL OXFORD COUNTY ALONG THE WESTERN BORDER OF MAINE. A LIGHTLY POPULATED, RURAL AREA, THE REGION HAS A PRIMARILY CAUCASIAN POPULATION WITH 16% OF PERSONS AGED 65 OR OVER AND 14% OF THE POPULATION BELOW THE POVERTY LEVEL. PROMOTION OF COMMUNITY HEALTH RUMFORD HOSPITAL HAS AN OPEN MEDICAL STAFF, ALLOWING ANY NON-EMPLOYED OR AFFILIATED PHYSICIANS TO HAVE ADMITTING PRIVILEGES TO THE HOSPITAL. THE BOARD OF DIRECTORS IS MADE UP OF A MAJORITY OF LOCAL COMMUNITY MEMBERS ALONG WITH SOME REPRESENTATION BY DIRECTORS FROM CENTRAL MAINE HEALTHCARE, THE PARENT OF THE HEALTHCARE SYSTEM WHICH RUMFORD HOSPITAL BELONGS TO, HELPING TO BRING TOGETHER THE VISIONS OF THE LOCAL COMMUNITY WITH THE CAPABILITIES AND VISION OF THE SYSTEM AS A WHOLE FOR THE BENEFIT OF RUMFORD AND SURROUNDING COMMUNITIES. AFFILIATED HEALTH CARE SYSTEM AS A MEMBER OF THE CENTRAL MAINE HEALTHCARE SYSTEM, RUMFORD HOSPITAL PROVIDES HIGH QUALITY HEALTH CARE IN A RURAL SETTING WITH LIMITED HEALTH CARE OPTIONS. ITS AFFILIATION WITH CENTRAL MAINE MEDICAL CENTER PROVIDES ACCESS TO A MUCH LARGER, TERTIARY CARE HOSPITAL, INCLUDING TRAUMA CARE, NEONATAL INTENSIVE CARE, AND A SPECIALIZED CARDIAC CARE UNIT. ADDITIONALLY, CENTRAL MAINE MEDICAL CENTER PROVIDES ACCESS TO SPECIALIST PHYSICIANS FOR OUTPATIENT CARE IN THE RUMFORD AREA ON A REGULAR SCHEDULE. THE SYSTEM PARENT, CENTRAL MAINE HEALTHCARE, PROVIDES STREAMLINED ADMINISTRATIVE FUNCTIONS AND BACKROOM SERVICES, ALLOWING RUMFORD HOSPITAL TO PERFORM AT A COST EFFICIENT LEVEL WHICH WOULD NORMALLY BE UNACHIEVABLE IN A SMALL, RURAL HOSPITAL, ALLOWING FOR BROADER RANGE OF SERVICES AVAILABLE. true X MONITORING THE USE OF GRANT FUNDS SCHEDULE I, PART I, LINE 2 THE GRANTS WERE AWARDED TO CHARITABLE ORGANIZATIONS EXEMPT UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE, FOR USE IN THEIR EXEMPT PURPOSE. THE MISSION OF THESE ORGANIZATIONS ALSO HELP SUPPORT COMMUNITY HEALTH OR HEALTHCARE, THEREBY HELPING TO FURTHER RUMFORD HOSPITAL'S EXEMPT PURPOSE AS WELL. SINCE THE GRANTS WERE NOT AWARDED WITH A SPECIFIC PURPOSE ATTACHED, NO TRACKING IS REQUIRED. false true false false false false false false false PETER E CHALKE 0 527048 0 0 0 70187 0 100000 0 12723 0 709958 JOHN WELSH 0 203163 0 0 0 37644 0 57256 0 17922 0 315985 JACOB LEDESMA MD 281473 0 105827 0 16919 0 0 0 21337 0 425556 0 THOMAS DELUCA MD 241388 0 68084 0 8568 0 0 0 20618 0 338658 0 DIETER KRECKEL MD 182513 0 88973 0 14173 0 0 0 22383 0 308042 0 CAROLYN GARCIA MD 252903 0 0 0 25902 0 7615 0 10298 0 296718 0 JOHN KROGER MD 165261 0 84418 0 7481 0 0 0 20005 0 277165 0 CEO COMPENSATION SCHEDULE J, PART I, LINE 3 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 SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN SCHEDULE J, PART I, LINE 4B A PARTICIPANT'S ENTITLEMENT TO BENEFITS WILL VEST ON THE PARTICIPANT'S VESTING DATE PROVIDED THE PARTICIPANT HAS REMAINED IN CONTINUOUS EMPLOYMENT IN THE SAME POSITION WHILE PARTICIPATING IN THIS PLAN. A PARTICIPANT WILL HAVE ONLY ONE VESTING DATE FOR ALL ELECTIVE DEFERRALS AND OTHER PLAN CONTRIBUTIONS MADE ON THE PARTICIPANT'S BEHALF DURING ALL PLAN YEARS. A PARTICIPANT'S ENTITLEMENT TO BENEFITS WILL ALSO VEST (A) IF THE PARTICIPANT DIES WHILE STILL EMPLOYED BY THE EMPLOYER, (B) IF THE PARTICIPANT'S EMPLOYMENT TERMINATES DUE TO TOTAL DISABILITY, OR (C) IF THE EMPLOYER TERMINATES THE PARTICIPANT'S EMPLOYMENT FOR ANY REASON OTHER THAN FOR "CAUSE". ANY PORTION OF THE PARTICIPANT'S ENTITLEMENT BENEFITS THAT IS NOT VESTED WHEN THE PARTICIPANT'S EMPLOYMENT WITH THE EMPLOYER TERMINATES, INCLUDING ELECTIVE DEFERRALS, WILL BE FORFEITED. THE EMPLOYER WILL DISTRIBUTE A PARTICIPANT'S BENEFITS UNDER THE PLAN AS SOON AS PRACTICABLE AFTER THE PARTICIPANT'S ENTITLEMENT BECOMES VESTED. THE FOLLOWING INDIVIDUALS PARTICIPATED IN A SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN THROUGH CENTRAL MAINE HEALTHCARE CORPORATION, A RELATED ENTITY. $ 40,756 JOHN WELSH (DEFERRAL) 100,000 PETER CHALKE (DEFERRAL) CAROLYN GARCIA TAIL INSURANCE X 187402 65758 false false true 65758 FAMILY OR BUSINESS RELATIONSHIPS FORM 990, PART VI, SECTION A, LINE 2 JOSEPH POIRIER HAS A FAMILY RELATIONSHIP WITH ROBERT STICKNEY. MEMBERS OR STOCKHOLDERS FORM 990, PART VI, SECTION A, LINES 6, 7A AND 7B THE MEMBER OF THE CORPORATION SHALL BE CENTRAL MAINE HEALTHCARE CORPORATION, A CORPORATION DULY ORGANIZED UNDER THE LAWS OF THE STATE OF MAINE. THE MEMBER SHALL HAVE THE RIGHT TO (A) APPROVE THE ELECTION OF MEMBERS OF THE BOARD OF DIRECTORS, (B) REMOVE MEMBERS OF THE BOARD OF DIRECTORS, AND (C) APPROVE CERTAIN DECISIONS OF THE BOARD OF DIRECTORS, AS DETAILED IN THE BYLAWS OF THE CORPORATION. THERE SHALL BE NINE (9) DIRECTORS OF THE CORPORATION WHO SHALL BE ENTITLED TO VOTE. ONE (1) OF THE NINE (9) VOTING DIRECTORS SHALL BE APPOINTED BY THE MEMBER, AND THE BALANCE OF VOTING DIRECTORS SHALL BE ELECTED BY THE BOARD OF DIRECTORS. IN ADDITION, THE BYLAWS MAY BE AMENDED OR REPEALED ONLY BY VOTE OF THE MEMBER IN ACCORDANCE WITH THE BYLAWS. FORM 990 REVIEW PROCESS FORM 990, PART VI, SECTION B, LINE 11B ALL AFFILIATED FORM 990's AND APPLICABLE SCHEDULES ARE PREPARED BY AN INDEPENDENT PUBLIC ACCOUNTING FIRM IN COOPERATION WITH THE FINANCE DEPARTMENT. THE COMPLETED RETURNS ARE REVIEWED WITH THE DIRECTOR OF FINANCE THEN WITH THE CFO FOLLOWING THAT REVIEW; THEY ARE PRESENTED TO THE FINANCE COMMITTEE OF THE CENTRAL MAINE HEALTHCARE BOARD OF DIRECTORS, WHICH HAS REPRESENTATIVES FROM ALL AFFILIATED BOARDS. ONCE THIS REVIEW IS COMPLETED, ANY NECESSARY CHANGES ARE MADE AND THE FINAL RETURN IS PRESENTED TO ITS RESPECTIVE BOARD WITH THE FINANCE COMMITTEE MEMBER TAKING AND ANSWERING QUESTIONS. A FINANCE DEPARTMENT REPRESENTATIVE, KNOWLEDGEABLE OF THE RETURN, IS AVAILABLE TO ASSIST DURING PRESENTATIONS, IF REQUESTED BY THE FINANCE COMMITTEE MEMBER IN THE EVENT THAT THE NEXT BOARD MEETING IS NOT SCHEDULED UNTIL AFTER THE FILING DATE, THE FINAL RETURN IS MAILED TO ALL BOARD MEMBERS AND THE PRESENTATION OCCURS AT THE NEXT SCHEDULED BOARD MEETING. CONFLICT OF INTEREST POLICY FORM 990, PART VI, SECTION B, LINE 12C 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. CEO COMPENSATION REVIEW FORM 990, PART VI, SECTION B, LINE 15A 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, PRESIDENT OF RUMFORD HOSPITAL, AND PRESIDENT OF BRIDGTON HOSPITAL. THE PROCESS GUIDELINES AND AUTHORITY OF THE ECC ARE SET OUT IN THE EXECUTIVE COMPENSATION PHILOSOPHY AND RESPONSIBILITIES CHARTER WHICH WAS APPROVED BY THE CMHC BOARD. THE ENTIRE CMHC BOARD PARTICIPATES IN THE ANNUAL PERFORMANCE EVALUATION OF EACH EXECUTIVE, INCLUDING A REVIEW OF ACCOMPLISHMENTS RELATIVE TO GOALS AND OBJECTIVES DERIVED FROM THE STRATEGIC PLAN. THE ECC REVIEWS THE RESULTS OF THE ANNUAL PERFORMANCE EVALUATION AND APPROPRIATE COMPARABILITY DATA BASED ON SEVERAL FACTORS RECOMMENDED BY AN INDEPENDENT EXECUTIVE COMPENSATION CONSULTANT, WHO SPECIALIZES IN NOT-FOR-PROFIT HOSPITALS AND HEALTH SYSTEMS, AND OUR ATTORNEYS. FACTORS USED IN DETERMINING COMPARABILITY TO THE ORGANIZATION INCLUDE SIZE, GEOGRAPHY, ORGANIZATIONAL COMPLEXITY, FACILITY TYPE, OWNERSHIP TYPE, AND ANY OTHER FACTORS DEEMED RELEVANT BY THE COMMITTEE, ITS CONSULTANTS, OR ITS ATTORNEYS. USING THIS INFORMATION, THE ECC ANNUALLY REVIEWS THE EXECUTIVES' COMPENSATION TO DETERMINE IF MODIFICATION TO BASE SALARY IS WARRANTED, AND REVIEWS THE EXECUTIVES' ACCOMPLISHMENTS TO DETERMINE IF ANY VARIABLE PAY IS TO BE AWARDED. THE ENTIRE PROCESS IS THEN DOCUMENTED CONTEMPORANEOUSLY WITH THE DECISION-MAKING PROCESS AND APPROVED THEREAFTER IN ACCORDANCE WITH THE REQUIREMENTS OF THE IRS. PUBLIC DISCLOSURE FORM 990, PART VI, SECTION C, LINE 19 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. COMPENSATION PART VII, SECTION A, COLUMN B JOHN WELSH IS EMPLOYED BY CENTRAL MAINE HEALTHCARE AND SERVES AS THE PRESIDENTS OF RUMFORD HOSPITAL, RUMFORD COMMUNITY HOME CORPORATION, AND RUMFORD COMMUNITY FAMILY HEALTH CENTER. PETER CHALKE IS EMPLOYED BY CENTRAL MAINE HEALTHCARE AS ITS PRESIDENT/CEO AND ALSO SITS ON SEVERAL SUBSIDIARY BOARDS. STUART COOPER IS A MEMBER OF THE BOARDS OF RUMFORD HOSPITAL AND RUMFORD COMMUNITY HOME CORPORATION. RICHARD LOVEJOY IS A MEMBER OF THE BOARDS OF RUMFORD HOSPITAL AND CENTRAL MAINE HEALTHCARE. DIETER KRECKEL IS AN EMPLOYEE OF RUMFORD HOSPITAL AND ALSO SERVES AS A MEMBER OF THE BOARD FOR RUMFORD COMMUNITY FAMILY HEALTH CENTER. OTHER CHANGES IN NET ASSETS FORM 990, PART XI, LINE 5 $ 290,925 UNREALIZED GAINS 2,719 CHANGE IN BENEFICIAL INTEREST OF PERPETUAL TRUST ---------- $ 293,644 CENTRAL MAINE COMMUNITY HEALTH CORP PO BOX 4500 LEWISTON ME 04243 010386912 PUBLIC EDUCAT ME 501(C)(3) 7 NA CENTRAL MAINE MEDICAL CENTER PO BOX 4500 LEWISTON ME 04243 010211494 HEALTHCARE ME 501(C)(3) 3 NA CMMC COLLEGE OF NURSING & HEALTH PROF PO BOX 4500 LEWISTON ME 04243 010356077 EDUCATION MH 501(C)(3) 2 NA CENTRAL MAINE REAL ESTATE MGMT CORP PO BOX 4500 LEWISTON ME 04243 010387674 REAL ESTATE ME 501(C)(2) NA CENTRAL MAINE HEALTHCARE CORPORATION PO BOX 4500 LEWISTON ME 04243 010386913 HEALTHCARE ME 501(C)(3) 11 B II NA RUMFORD COMMUNITY FAMILY HEALTH CENTER 430 FRANKLIN STREET RUMFORD ME 04276 010481000 HEALTHCARE ME 501(C)(3) 3 NA RUMFORD COMMUNITY HOME CORPORATION 11 JOHN F KENNEDY LANE RUMFORD ME 04276 222844951 NURSING HOME ME 501(C)(3) 9 NA BRIDGTON HOSPITAL 10 HOSPITAL DRIVE BRIDGTON ME 04009 010130427 HEALTHCARE ME 501(C)(3) 3 NA BRIDGTON HOSPITAL PHYSICIANS GROUP SOUTH HIGH STREET BRIDGTON ME 04009 010493083 HEALTHCARE ME 501(C)(3) 9 NA CENTRAL MAINE HEART AND VASCULAR INST 300 MAINE STREET LEWISTON ME 04240 542078282 HEALTHCARE ME 501(C)(3) 9 NA CENTRAL MAINE HEALTH VENTURES INC 300 MAINE STREET LEWISTON ME 04240 010430016 HEALTHCARE ME NA C CORP 0 0 0.00000 CWM INSURANCE LTD GENESIS BUILDING PO BOX 1363 GRAND CAYMAN B.W.I. 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