2023-02-15T11:40:39-06:00 2022-09-30 010523282 Berry Dunn McNeil & Parker LLC 2211 Congress St Portland ME 04102 990 2021-10-01 010234189 Northern Maine Medical Center NORT 2078343155 194 East Main Street Fort Kent ME 04743 Jeff Zewe CEO 2078343155 2023-02-14 1 Jeff Zewe 999009999 Joseph R Byrne P01289281 2077752387 2023-02-14 3 AAL1 IAL1 2021 2023-03-07 01:45:13Z Jeff Zewe 194 East Main Street Fort Kent ME 04743 79561112 0 X www.nmmc.org X 1948 ME Acute care & long term care hospital and mental health services facility. 11 10 659 24 3922300 0 9855162 13652058 61744744 65238790 -33510 328310 61863 43817 71628259 79262975 2000 0 0 0 44288124 45844028 0 0 0 24296901 28118271 68587025 73962299 3041234 5300676 77654286 111511588 35610758 65365923 42043528 46145665 The mission of Northern Maine Medical Center is to provide, coordinate, or support access to high quality, affordable health care and to positively impact our communities' quality of life by improving health status. 0 0 65680348 65238790 Medical care & ancillary services, nursing home & skilled services, physician services. 65680348 1 1 0 1 0 0 0 0 0 0 1 0 0 1 1 1 0 1 0 0 0 0 0 0 1 0 1 1 0 0 1 1 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 1 1 0 0 0 1 158 0 1 659 1 1 1 0 0 0 0 0 0 0 0 0 0 0 X 11 10 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 ME X Aaron Teachout 2078343155 Treasurer/CFO Fort Kent ME 04743 Dr Erik St Pierre Director/Physician 50.00 0.00 X 710409 0 37135 Donald Guimond Chair 1.50 0.00 X X 0 0 0 Erin Soucy Vice-Chair 1.50 0.00 X X 0 0 0 Douglas Cyr Director 1.50 0.00 X 0 0 0 Gisele Dionne Director 1.50 0.00 X 0 0 0 John Ezzy Director 1.50 0.00 X 0 0 0 Norman Fournier Director 1.50 0.00 X 0 0 0 Steven Ouellette Director 1.50 0.00 X 0 0 0 Steven Pelletier Director 1.50 0.00 X 0 0 0 Lucie Tabor Director 1.50 0.00 X 0 0 0 Dan Vaillancourt Director 1.50 0.00 X 0 0 0 Mark Morneault Past Chair 1.50 0.00 X X 0 0 0 Peter J Sirois Past President/CEO 50.00 0.00 X 377573 0 35253 Alain Bois Secretary/COO 50.00 0.00 X 228403 0 5520 Aaron Teachout Treasurer/CFO 50.00 0.00 X 74417 0 20112 Jeff Zewe President/CEO 50.00 0.00 X 0 0 0 Dr Scott Drummond Radiologist 50.00 0.00 X 874569 0 25014 Dr Michael Sullivan Physician 50.00 0.00 X 655154 0 37283 Dr John Leblanc Orthopedic Surgeon 50.00 0.00 X 647265 0 34043 Dr Shahriar Anoushfar General Surgeon 50.00 0.00 X 643302 0 36237 Dr Mark Overton Psychiatrist 50.00 0.00 X 590698 0 24450 David Stob Former Interim CFO 0.00 0.00 X 270436 0 0 Cindy Daigle Former Treasurer/CFO 0.00 0.00 X 134665 0 7386 5206891 0 262433 78 1 1 1 The Sheridan Corporation PO Box 359 Fairfield ME 04937 Building Contractor 2418986 Cerner Corporation PO Box 959156 St Louis MO 631959156 Software Services 1582402 Thayer Corp 1400 Hotel Road Auburn ME 04210 Building Contractor 436722 SMRT Inc PO Box 618 Portland ME 04104 Architect & Engineering 425166 ABM Mechanical Inc 33 Down Road Bangor ME 04401 Building Contractor 391610 29 16251 5883803 7752004 13652058 Patient Service Revenue 623000 104852220 104852220 Retail Pharmacy 446110 3922300 3922300 Miscellaneous Revenue 623000 2104569 1890062 214507 Contractual/Char. Adj. 623000 -45640299 -45640299 65238790 179629 179629 49630 0 49630 49630 49630 439575 1430 284287 8037 155288 -6607 148681 148681 0 16251 5813 -5813 -5813 79262975 61101983 3922300 586634 1488822 747543 741279 37378117 33543432 3834685 503172 454705 48467 4034163 3633627 400536 2439754 2171381 268373 163337 163337 135167 120299 14868 46468 46468 3766403 3388882 377521 59188 59188 715107 350803 364304 1631904 1178657 453247 2821232 2612350 208882 66376 47252 19124 366333 329700 36633 3616809 3250501 366308 863194 776875 86319 Medical Supplies 11541762 11209378 332384 Healthcare Provider Tax 1172503 1172503 Miscellaneous 1041212 591844 449368 Dues & Subscriptions 111276 100616 10660 73962299 65680348 8281951 0 X 257526 344870 20907405 44438307 0 131004 8536471 7599785 182545 121423 1559553 1481480 568891 728171 76014496 40669082 32446291 35345414 744289 9196778 90024 90024 5171762 5599508 7189529 6434824 77654286 111511588 8585746 7728707 13709059 52266150 3185027 2398090 10130926 2972976 35610758 65365923 X 41029521 45108877 1014007 1036788 42043528 46145665 77654286 111511588 5300676 -1198539 0 X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 8525 8525 0 Part II-B, Line 1: The Hospital pays dues to various organizations, a portion of which is attributable to lobbying expenses. 363800 363800 44392459 19505810 24886649 25434020 20012072 5421948 5824217 1151200 4673017 35345414 Deferred Compensation 1764484 Cash Surrender Value of Life Insurance 422250 Estimated Third-Party Payor Settlements 2681924 Insurance Claims Receivable 1566166 6434824 Deferred Compensation 1764484 Medicare advanced payments 583043 CARES Act Funding 625449 2972976 X Part X, Line 2: The Medical Center and VMA are not-for-profit corporations as described in Section 501(c)(3) of the Internal Revenue Code (the Code), and are exempt from federal income taxes on related income pursuant to Section 501(a) of the Code. Management evaluated the Medical Center's tax positions and concluded the Medical Center has maintained its tax-exempt status, does not have any significant unrelated business income and has taken no uncertain tax positions that require adjustment or disclosure in the consolidated financial statements. Tour de la Vallee 16251 16251 500 1504 3809 16251 16251 500 1504 3809 5813 -5813 1 1 X 1 X 1 X 0 1 0 1 1 12683 12683 0.00020 8173252 2068011 6105241 0.08250 8185935 2068011 6117924 0.08270 30837221 27534927 3302294 0.04460 8147 8147 0.00010 30845368 27534927 3310441 0.04470 39031303 29602938 9428365 0.12740 1 0 17862973 19112072 -1249099 X 1 1 2 1 Northern Maine Medical Center 194 East Main Street Fort Kent ME 04743 www.nmmc.org 39318 X X X 2 Forest Hill 20 Bolduc Avenue Fort Kent ME 04743 X Licensed Hospital Related Facility Northern Maine Medical Center 1 0 0 1 X X X X X X X X X 20 1 1 1 1 X www.nmmc.org/community-health-needs-assessment X 1 20 1 www.nmmc.org/community-health-needs-assessment 1 0 1 X 150.000000000000 200.000000000000 1 1 X X X 1 X http://www.nmmc.org/billing/ X http://www.nmmc.org/billing/ X http://www.nmmc.org/billing/ X X X X X X 1 X 0 X X X 1 X 0 0 Northern Maine Medical Center Part V, Section B, Line 3j: The Community Health Needs Assessment (CHNA) was developed by a group of community members and hospital partners to conduct a needs assessment and to develop strategies to improve the health of the people we serve in the St. John Valley. The committee reviewed data from various documents in order to identify the priorities in the CHNA. Target audience was anyone with a vested interest in public health and healthcare including medical staff, community board members, volunteers, donors, and members of the general public. The following sectors were represented: - County of Aroostook- Northern Maine General- Greater Fort Kent Area Chamber of Commerce- Aroostook Mental Health Services- Aroostook County Action Program- Town of Madawaska- UMFK - St John Valley Chamber of Commerce- Fort Kent Senior Citizens Center - Madawaska Senior Citizens Center- U. Maine Cooperative Extension- Life by Design- Town of Fort Kent- St John Valley Associates- Valley Unified Schools- Aroostook Agency on Aging- Hope and Justice Project- Emergency and Rescue Leaders from Fort Kent and Madawaska- Community Members Northern Maine Medical Center Part V, Section B, Line 5: Attention was taken to include a broad representation from the community. This took place in two ways. First, the stakeholders were invited to participate in public forums. Second, four work groups were convened to address each of the four priorities selected. A facilitator was identified for each group to lead the ongoing discussion and work to address strategies and action plans for each of the priorities. The following sectors were represented:- AMHC- UMFK Nursing Division- NMMC Director of Nursing- NMMC Pharmacist- Life by Design- Agency on Aging- NMMC Care Manager- Valley School Substance Abuse Counselor- UMFK Behavioral Health- U. Maine Cooperative Extension- NMMC Social Worker- NMMC NDPP Trainer PA - Hope & Justice- NMMC Financial Counselor- NMMC Practice Coordinator- NMMC Community Educator- Power of Prevention- FK High School Wellness- NMMC Psych Unit Leader- FK Recreation Director- UMFK Student- NMMC Communications- Catholic Charities- FK Community Development- Frank Netter Medical School- Maine Health Center for Tobacco independence Northern Maine Medical Center Part V, Section B, Line 6a: The following hospitals were included in the collaborative community health assessment: Cary Medical Center, Down East Community Hospital, Houlton Regional Hospital, Maine Coast Memorial Hospital, Mayo Regional Hospital, Millinocket Regional Hospital, Mount Desert Island Hospital, Northern Maine Medical Center, and Redington-Fairview General Hospital. Northern Maine Medical Center Part V, Section B, Line 6b: Aroostook Mental Health Center - St. John Valley Public Schools - University of Maine, Fort Kent, Behavioral Health and Nursing Divisions - Fish River Rural Health Center - Healthy Maine Partnerships - University of Maine Cooperative Extension Service - Town Government and Recreation Departments - Life by Design Mental Health - Clergy - Aroostook Agency on Aging. Northern Maine Medical Center Part V, Section B, Line 7d: The St. John Valley assessment has been posted on the NMMC website since late 2014s. This report is also available free upon request. Each year, thereafter, 2015-2016, 2016-2017, 2017-2018 etc., an updated report was posted on the Northern Maine Medical Center website with instructions on how to access the updates. The four key priorities that NMMC has been working on and a brief description of the current actions taken are as follows:1-Addressing gaps in mental health servicesBehavioral and mental health is constantly on the action plan for NMMC. We have worked to decrease wait time for behavioral health (BH) patients in our ED by streamlining processes and working with other local BH experts in the area to assist with the streamlining, including increased crisis work in the ED. We have also established outreach with several stakeholders at different healthcare facilities statewide, creating the options for increased bed availability and better outpatient services. We partnered with a national BH specialist organization to aid in best practice process as well as recruitment of staff and in helping with bed availability. This also led to hiring a full time BH Position which was immediately filled an da Behavioral Health FNP with enhanced BH training. Last, our suicide prevention and awareness program include support groups and community engagement walks. 2-Reducing Substance abuseThrough our family practice office and the behavioral health office we have worked with the practitioners to increase access to aides such as suboxone and outpatient service to monitor and guide the patient to a hopeful recovery. Reducing substance abuse goes hand in hand with our mental health work and the plan of action to increase access by shortening wait times and offering more availability, directly increasing the quality of service. 3-Reduce of Alleviate PovertyPoverty and lower income support have evolved into a daily plan of action. We partnered with the Aroostook County Action Program (ACAP) in order to offer meals to low income and well as partnering with the United Way by offering a location for them to house their free tax prep program to low or lower income. We also supported the United Ways fundraising Turkey Drive through monetary donation, of which the money will be used to purchase food for local pantries. NMMC also donated a pallet of frozen turkeys to the local food pantries in the St. John Valley. In an effort to get community members out in public and involved in activities, we sponsored movie nights in the park, Halloween outing for children in our service area and a bike rally for all ages which in turn also raises money for local non-profits that benefit the area community members. 4- Improve Elder ServicesNMMC offers meals in the cafeteria for the elderly at no cost on different occasions throughout the year. Our increased support of the local pantries has also contributed to the safe eating of the elderly population. A majority of our work is tied to the construction of a new, 45 bed long term nursing home facility. This will include all private rooms, intergraded lift systems for the residents, centralized nursing station for better resident care, a hospice room for the best end of life care and new day room areas for optimal resident comfort, happiness and long term mental status.The hospital's Community Liaison Committee of the Board of Trustees is also provided a summary on an annual basis. In addition, contact information is provided on the website for individuals who wish to request a free paper copy. Individuals may also call NMMC to request a free copy. Northern Maine Medical Center Part V, Section B, Line 11: See attached Community Health Needs Assessment and Implementation Strategy. Northern Maine Medical Center Part V, Section B, Line 24: Individuals are billed at gross amounts and charges are adjusted accordingly, if they qualify for assistance. Part I, Line 7: The amounts reported on Lines 7a & 7b were computed using a cost-to-charge ratio. Amounts on line 7g are derived from internal financial/cost accounting systems. Part I, Line 7g: Subsidized health services on line 7g include physician clinics, rural health centers, a skilled nursing facility, and emergency room. Part II, Community Building Activities: N/A Part III, Line 4: See footnote 2 (page 12, paragraph 1) in the attached financial statements. Part III, Line 9b: Our collection policy stipulates that NMMC makes reasonable efforts to identify those individuals that may qualify for assistance. In the first 120 days, patients may request to begin the Financial Assistance process and collection activity is put on hold until the process is completed. If the patient qualifies, no further collection activity will occur going forward for that account. If patient does not qualify, collection activity resumes from point it was put on hold. Part VI, Line 2: Please see Schedule H, Part V, Section B, Line 5 for a description of NMMC's assessment process. Part VI, Line 3: We notify patients and customers about access to assistance in various ways. The simplest way is the signage, pamphlets, and educational material located around the Organization and in various offices. In every patient access/patient financial services area is a sign explaining the availability of free/discounted care and the Federal Poverty Guidelines. There are also pamphlets located in the outpatient areas explaining free/discounted care and providing information on Mainecare. For inpatients, there is a book in each room which provides all the information on all programs available.Through the patient accounting department, we provide information about these statements. We also counsel patients on the phone about all the programs available whether it is Medicaid or a hospital program. Part VI, Line 4: Northern Maine Medical Center is a 94 licensed bed (27 A&P which includes swing beds, 6 ICU beds, 16 Psych beds, and 45 SNF beds), full-service, acute-care, not-for profit hospital located in Fort Kent, Maine (Aroostook County). The Hospital is accredited by the joint commission and its mission is to serve its communities with excellence in health care. Its services include acute inpatient, psych inpatient, SNF, 24-hour emergency center, diagnostic, and surgical services. Along with these hospital services, the Hospital employs/contracts with the majority of primary and specialty care physicians in the area. Part VI, Line 5: Northern Maine Medical Center is a local, not-for-profit hospital that serves its local communities and people regardless of their ability to pay. Northern Maine provides financial assistance and sliding scale discounts to self-pay and low-income patients. Also the Hospital participates in government-sponsored health care programs including Medicare, Medicaid, VA, and Tricare. The volunteer board of trustees sets the strategic direction for the Hospital and is comprised of community members from the Hospital's service area. This group is made up of local business owners, professionals, and retirees. Northern Maine's non-profit status allows the Hospital to reinvest any excess of revenues over expense back into the Hospital to continuously improve the medical care it delivers. The Hospital allows access to healthcare that would otherwise be difficult. The Hospital is the main employer for the local physicians, including specialty physicians that would otherwise have to be accessed out of the area. X X X 1 0 0 0 0 0 0 1 0 Dr Scott Drummond Radiologist 848734 0 0 0 25835 0 8700 0 16314 0 899583 0 0 0 Dr Erik St Pierre Director/Physician 690531 0 19188 0 690 0 8700 0 28435 0 747544 0 0 0 Dr Michael Sullivan Physician 645718 0 8746 0 690 0 8700 0 28583 0 692437 0 0 0 Dr John Leblanc Orthopedic Surgeon 518263 0 101750 0 27252 0 8700 0 25343 0 681308 0 0 0 Dr Shahriar Anoushfar General Surgeon 579787 0 12963 0 50552 0 8700 0 27537 0 679539 0 0 0 Dr Mark Overton Psychiatrist 577069 0 11649 0 1980 0 0 0 24450 0 615148 0 0 0 Peter J Sirois Past President/CEO 320771 0 30746 0 26056 0 8700 0 26553 0 412826 0 0 0 David Stob Former Interim CFO 270436 0 0 0 0 0 0 0 0 0 270436 0 0 0 Alain Bois Secretary/COO 190396 0 7746 0 30261 0 0 0 5520 0 233923 0 0 0 Cindy Daigle Former Treasurer/CFO 67947 0 0 0 66718 0 1557 0 5829 0 142051 0 0 0 Part I, Line 4a During the calendar year 2021, Cindy Daigle, Former Treasurer/CFO, received a severance payment in the amount of $57,979. Part I, Line 7 Dr. Erik St. Pierre, Dr. Shahriar Anoushfar, Dr. Mark Overton received annual bonuses based on their performace. Dr. Michael Sullivan, Peter Sirois, Aaron Teachout and Alain Bois received a COVID related bonus. Dr. Erik St. Pierre, Dr. Michael Sullivan, Dr. John Leblanc, Dr. Shahriar, Dr. Mark Overton, Peter Sirois, Aaron Teachout, Alain Bois, received a retention bonus (COVID related). Dr. John Leblanc received a sign-on bonus. Peter Sirois received a retention bonus. Form 990, Part VII, Line 5: David Stob, Former Interim CFO, was compensated by Rudish Healthcare, an unrelated organization, for services rendered to the Hospital. Rudish Healthcare was paid $270,436 for services rendered by Mr. Stob. Pursuant to IRS instructions, the Hospital is disclosing the amount paid to Rudish Healthcare as compensation to Mr. Stob. The actual amount of compensation paid to Mr. Stob by Rudish Healthcare is unknown to the Organization. A Maine Health and Higher Education Facilities Authority 010314384 56042RUP5 2019-11-06 15820042 To refinance existing debt and fund new construction 0 0 1 B Maine Health and Higher Education Facilities Authority 010314384 56042R5P3 2022-06-02 42339170 New Money & Refunding 0 0 1 A 2571873 15820042 981150 293305 209443 7361187 6974957 2020 1 0 1 1 B 3321188 42339170 2685563 4100272 460452 154670 5537883 1817 29398513 0 0 1 1 A 0 0 0 0 0 0 1 B 0 0 0 0 0 0 1 A 0 1 0 0 0 0 0 0 1 B 0 1 0 0 0 0 0 0 1 A 0 B 0 Michelle L Plourde Family member of Peter Sirois, Past Hospital CEO 109225 Employment 0 Nicole Marquis Family member of Peter Sirois, Past Hospital CEO 150849 Employment 0 Robin Lamarr Family member of Peter Sirois, Past Hospital CEO 91111 Employment 0 Nola Sirois Family member of Peter Sirois, Past Hospital CEO 27467 Employment 0 Form 990, Part VI, Section B, line 11b The Form 990 is prepared by the Organization's independent public accounting firm and thoroughly reviewed by the CFO and Controller. The completed form is sent electronically to Board members prior to the form being filed. In addition, CEO has documents for review prior to sending to the Board members and has opportunity to request any edits. When the forms are sent to Board members, they are instructed to contact CEO or CFO with questions. Any questions are responded to and at the following Finance or Board meetings, CFO provides ability for anyone to ask any additional questions. Finance Committee may request a formal/detailed presentation by consultants if deemed necessary but have not requested that level of review recently. Form 990, Part VI, Section B, line 12c On an annual basis, Board Members must read the Organization's conflict of interest policy, disclose any potential conflicts, and return the signed statement to Administration. If topics arise where a Member has an actual or potential conflict, the group will determine the level to which the individual may be involved in discussions and the member with the conflict will not have a vote. In some instances, the member will be excused from the meeting and can only rejoin when the Board has moved on to a different topic. Form 990, Part VI, Section B, line 15 The Board of Directors determines the compensation of the CEO using compensation studies and comparability data. The CEO determines the compensation of other officers and key employees in a similar manner. Form 990, Part VI, Section C, line 19 The Organization makes its governing documents, conflict of interest policy, and financial statements available to the public upon request. Form 990, Part X, Line 10: Land, Buildings, and Equipment Section 1.263(a)-3(n) Election: Northern Maine Medical Center 194 East Main Street Fort Kent, ME 04743 EIN: 01-0234189 Northern Maine Medical Center is electing to capitalize repair and maintenance costs under Regulation Section 1.263(a)-3(n). Valley Medical Association 194 East Main Street Fort Kent ME 04743 223245434 Medical Physician Practice ME 501(c)(3) Line 3 Northern Maine Medical Center 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0