2022-05-16T09:01:17-05:00 2021-06-30 381357951 PLANTE & MORAN PLLC 250 S HIGH ST SUITE 100 COLUMBUS OH 43215 990 2020-07-01 010215227 RUMFORD HOSPITAL RUMF 2077952813 420 FRANKLIN STREET RUMFORD ME 04276 STEVEN LITTLESON PRESIDENT & CEO 2077952813 2022-05-13 1 STEVEN LITTLESON 999009999 AMY CIMINELLO P00796388 6148493000 2022-05-13 0 AAL1 IAL1 2020 2022-09-23 18:48:47Z STEVE LITTLESON 420 FRANKLIN STREET RUMFORD ME 04276 52406600 0 X WWW.RUMFORDHOSPITAL.ORG X 1974 ME RUMFORD HOSPITAL STRIVES TO PROVIDE EXCEPTIONAL HEALTHCARE SERVICES. THE HOSPITAL DEPENDS ON THE EXPERTISE COMMITMENT AND COMPASSION OF ITS CAREGIVERS TO FULFILL ITS MISSION 12 8 343 50 0 0 1334121 365856 42824489 44714691 926959 1034504 -1419480 27253 43666089 46142304 0 0 0 0 24046675 19997011 0 0 0 17255203 22212040 41301878 42209051 2364211 3933253 35581182 25999903 16478282 12759423 19102900 13240480 TO PROVIDE EXCEPTIONAL HEALTHCARE SERVICES IN A SAFE AND TRUSTFULENVIRONMENT THROUGH THE EXPERTISE, COMMITMENT AND COMPASSION OF OURFAMILY OF CAREGIVERS. 0 0 36195153 44714691 RUMFORD HOSPITAL IS A CRITICAL ACCESS HOSPITAL, PROVIDING COMPREHENSIVE PRIMARY CARE AND SOPHISTICATED DIAGNOSTIC SERVICES, INCLUDING CT SCANNING, ULTRASOUND AND NUCLEAR MEDICINE. THE HOSPITAL OFFERS MEDICAL SURGICAL NURSING SERVICES, A BIRTHING CENTER, WOMEN'S HEALTH SERVICES AND 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. 36195153 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 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 29 0 1 343 1 0 0 0 0 0 0 0 0 0 0 0 0 X 12 8 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 0 0 0 ME X KRISTEN ST PETER 2077952813 300 MAIN STREET LEWISTON ME 04240 X JEFF BRICKMAN PRESIDENT/DIRECTOR 3.00 55.00 X X 0 945603 219303 DAVID SALKO DIRECTOR BEG 1/21 3.00 55.00 X 0 333577 26982 JENNIFER WEINER-SMITH MD PHYSICIAN/DIRECTOR 3.00 55.00 X 0 315310 26723 HECTOR TARRAZA DIRECTOR BEG 1/21 3.00 55.00 X 0 233969 0 DEBORAH DUNLAP AVASTHI CHAIR PERSON/ DIRECTOR END 1/21 1.00 3.00 X 0 0 0 AUSTIN ALBERT DIRECTOR 1.00 3.00 X 0 0 0 WILLIAM CLIFFORD DIRECTOR 1.00 3.00 X 0 0 0 DEVORE CULVER CHAIR PERSON/ DIRECTOR 1.00 3.00 X 0 0 0 JANET HALL KOSKI DIRECTOR 1.00 3.00 X 0 0 0 GEOFFREY SWIFT DIRECTOR 1.00 3.00 X 0 0 0 JOHN MCANUFF DIRECTOR 1.00 3.00 X 0 0 0 KEVIN MORNEAULT DIRECTOR END 7/20 1.00 3.00 X 0 0 0 SHERWOOD MOODY DIRECTOR 1.00 3.00 X 0 0 0 JOLAN IPPOLITO DIRECTOR 1.00 3.00 X 0 0 0 LOUIS SILVERMAN DIRECTOR BEG 1/21 1.00 3.00 X 0 0 0 MARNEY CHALMERS DIRECTOR BEG 1/21 1.00 3.00 X 0 0 0 ANN CONNELLY DIRECTOR BEG 1/21 1.00 3.00 X 0 0 0 JOHN WHITLOCK TREASURER END 6/21 3.00 60.00 X 0 478758 2850 STEVEN LITTLESON PRESIDENT CMMC/CMHCC 3.00 60.00 X 0 429920 19602 PETER WRIGHT PRESIDENT BRIDGTON HOSPITAL 55.00 3.00 X 0 436017 13176 CORY BAGBY SECRETARY 3.00 60.00 X 0 415621 9842 JEFFREY LYNDS PHYSICIAN 55.00 0.00 X 385259 0 20106 SAID DAOUD PHYSICIAN 55.00 0.00 X 380377 0 2487 STEPHANIE SINCLAIR PHYSICIAN 55.00 0.00 X 343194 0 26587 JOHN KROGER PHYSICIAN 55.00 0.00 X 308916 0 25033 DIETER KRECKEL PHYSICIAN 55.00 0.00 X 326773 0 2977 1744519 3588775 395668 5 1 1 0 SODEXO INC 6451 NORTH FEDERAL HIGHWAY SUITE 70 FORT LAUDERDALE FL 33308 SUPPORT SERVICES 1314564 QUEST DIAGNOSTICS 500 PLAZA DRIVE SECAUCUS NJ 07094 MEDICAL SERVICES 1131443 CPS PHARMACY SOLUTIONS 655 METRO PLACE SOUTH SUITE 450 DUBLIN OH 43017 MEDICAL STAFFING 571164 CHG COMPANIES INC 7259 S BINGHAM JUNCTION BLVD MIDVALE UT 84047 MEDICAL STAFFING 394210 MAINE IMAGING SERVICES LLC 700 CONGRESS ST- SUITE 204 QUINCY MA 02169 MEDICAL IMAGING 341204 12 174838 191018 365856 NET PATIENT SERVICE REVENUE 621990 44714691 44714691 44714691 107337 107337 9289 0 9289 9289 9289 7191463 6264296 927167 927167 927167 TAX REFUNDS 900099 17964 17964 17964 46142304 44714691 0 1061757 X 17380428 14773364 2607064 -159097 -135232 -23865 1804723 1534015 270708 970957 825313 145644 24198 24198 18165 18165 9846 9846 10576109 9013502 1562607 190 141 49 375779 278076 97703 508651 376402 132249 848697 628036 220661 409 303 106 41347 30597 10750 43194 14254 28940 1752810 1034158 718652 190421 190421 MEDICAL SUPPLIES 6784114 6784114 MEDICAID TAX EXPENSE 1038110 1038110 42209051 36195153 6013898 0 26810 2490858 15206949 1339018 0 0 4137598 5264388 0 0 0 0 0 0 455532 533521 67666 276273 38120787 28536117 10897135 9584670 3928943 0 0 0 0 0 199196 0 661353 6511175 35581182 25999903 6753384 2665032 0 0 3499253 0 0 0 0 0 0 826713 494541 0 5398932 9599850 16478282 12759423 X 18658428 12929637 444472 310843 19102900 13240480 35581182 25999903 X 3933253 72289 -41 -9867921 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 3773 3773 0 PART II-B, LINE 1: PORTION OF DUES FOR PROFESSIONAL ASSOCIATIONS ATTRIBUTED TO LOBBYING 444472 17469 9392 160491 310842 591558 9277 207 156570 444472 586193 16246 -881 10000 591558 575743 9356 1094 586193 504309 70344 1090 575743 0.84944 0.15056 0 1 1 89148 89148 15174989 8989973 6185016 22276542 19038499 3238043 580108 507645 72463 9584670 DUE FROM MEDICARE 304122 FINANCE LEASE- NET 2149 DEBT RESERVE- KEY BANK 40203 INTERNALLY DESIGNATED ASSETS 4238568 RESTRICTED ASSETS 1751327 OTHER NONCURRENT ASSETS 174806 6511175 LEASE LIABILITIES- FINANCING 271597 PENSION LIABILITIES 516388 CONTRACT LIABILTIES 3782822 ASSET RETIREMENT OBLIGATIONS 503573 CARES CONTRACT LIABILITY 327013 COST REPORT SETTLEMENT 3634642 LONG TERM CHOICE TIME RESERVE 75433 DEFERRED SOCIAL SECURITY EMPLOYER PORTION 488382 9599850 PART V, LINE 4: 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 EQUIPTMENT PURCHASES, CONTINUING EDUCATION, OR FREE CARE. OTHER ARE DESIGNATED TO SUPPORT SPECIFIC DEPARTMENTS OF THE HOSPITAL. 1 1 X 1 X 0 1 1 0 0 1124089 528114 595975 0.01410 11128953 10192351 936602 0.02220 12253042 10720465 1532577 0.03630 12253042 10720465 1532577 0.03630 0 4586464 735344 10131195 10062411 68784 1 1 1 1 RUMFORD HOSPITAL 420 FRANKLIN STREET RUMFORD ME 04276 WWW.RUMFORDHOSPITAL.ORG 38727 X X X X OUTPATIENT PHYSICIAN CLINICS RUMFORD HOSPITAL 1 0 0 1 18 1 1 1 1 X SEE PART V, PAGE 8 X SEE PART V, PAGE 8 X 1 18 1 SEE PART V, PAGE 8 0 1 X 200.000000000000 0.000000000000 X X X 1 1 X X X 1 X HTTPS://WWW.CMHC.ORG/BILLING-AND-FINANCIAL-INFORMATION/ X HTTPS://WWW.CMHC.ORG/BILLING-AND-FINANCIAL-INFORMATION/ X HTTPS://WWW.CMHC.ORG/BILLING-AND-FINANCIAL-INFORMATION/ X X X X X X 1 X 0 X X X X 1 X 0 0 RUMFORD HOSPITAL PART V, SECTION B, LINE 5: COMMUNITY INPUT:COMMUNITY OUTREACH AND ENGAGEMENT FOR THE MAINE SHARED CHNA INCLUDEDCOORDINATION AT BOTH THE STATEWIDE, PUBLIC HEALTH DISTRICT, AND COUNTYLEVEL. THE STATEWIDE COMMUNITY ENGAGEMENT COMMITTEE MET MONTHLY FROMMARCH 2018 THROUGH JANUARY 2019 TO REVIEW AND PROVIDE INPUT ON EVERYASPECT OF ENGAGEMENT PROCESS.IN ADDITION TO THE STATE-LEVEL COMMUNITY ENGAGEMENT COMMITTEE, A LOCALCOMMUNITY ENGAGEMENT PLANNING COMMITTEE IN EACH OF MAINE'S 16 COUNTIESPLANNED AND IMPLEMENTED THE LOGISTICS OF COMMUNITY FORUMS AND EVENTSWITHIN EACH DISTRICT. THESE COMMITTEES WERE COMPRISED OF HOSPITALS,PUBLIC HEALTH DISTRICT LIAISONS, AND A VARIETY OF ADDITIONAL PARTNERS.THE 2018 COMMUNITY ENGAGEMENT TOOLKIT WAS DESIGNED TO ASSIST THE LOCALCOMMUNITY ENGAGEMENT PLANNING COMMITTEES IN THIS EFFORT.CRITERIA FOR VISUALIZING DATA INCLUDED AREAS IDENTIFIED AS A HEALTHPRIORITY IN THE LAST CHNA, SIGNIFICANT CHANGES IN THE DATA OVER TIME, ORWHERE A COUNTY'S DATA WAS NOTABLY BETTER OR WORSE THAN THE STATE OR THENATION. FORUM AGENDA ITEMS INCLUDED REMARKS FROM HEALTH LEADERS; A REVIEWOF PREVIOUS HEALTH IMPROVEMENT EFFORTS; A REVIEW OF COUNTY-LEVEL DATA,DISCUSSION, AND PRIORITIZATION IN SMALL GROUPS; AND AN OVERALL FORUMWIDEVOTING PROCESS. THE COMMUNITY ENGAGEMENT AND STEERING COMMITTEES CREATEDAND APPROVED A RUBRIC TO GUIDE THE SELECTION CRITERIA FOR THE SUBSET OFDATA TO BE PRESENTED IN EACH FORUM'S POWERPOINT PRESENTATIONS. SMALL GROUPS HAD 35-45 MINUTES TO DISCUSS THE DATA IN THE PRESENTATIONAND THE FULL COUNTY PROFILE, AND TO SHARE THEIR OWN EXPERIENCES IN ORDERTO IDENTIFY THEIR TOP COUNTY HEALTH PRIORITIES. TABLE FACILITATORS GUIDEDTHESE DISCUSSIONS USING KEY QUESTIONS AND WORKSHEETS FOR REPORTINGPURPOSES. HEALTH PRIORITIES IDENTIFIED DURING THESE SMALL GROUPS WERECOLLATED AND PRESENTED TO THE LARGER PLENARY SESSION, WHERE EACH ATTENDEEVOTED FOR THEIR TOP FOUR PRIORITIES. VOTES WERE TALLIED AND A HIERARCHYEMERGED.THE SUMMARY VOTES FOR EACH FORUM WERE USED TO DEVELOP THE COUNTY LEVELPRIORITIES. IF MULTIPLE FORUMS WERE HELD IN A COUNTY, THE FORUM RESULTSFOR FORUMS HELD WITH THE GENERAL COMMUNITY WERE INCLUDED IN THE TOTALVOTES FOR THE COUNTY. IN CASES WHERE A FORUM WAS HELD WITH A SPECIFICPOPULATION, FOR EXAMPLE, LGBTQ YOUTH OR OLDER ADULTS, THEN THE RESULTS OFTHEIR VOTING AND DISCUSSION WERE INCLUDED IN THE SECTION DESCRIBING THENEEDS OF THAT PARTICULAR POPULATION. TO ARRIVE AT THE TOP COUNTYWIDECOMMUNITY HEALTH ISSUES, VOTES FROM THE BROAD COMMUNITY FORUMS WERECOMBINED FOR EACH OF THE PRIORITY AREAS TO IDENTIFY PRIORITY AREAS WHICHFELL WITHIN 70% OF THE COMBINED VOTING TOTAL.THE COMMUNITY FORUM PARTICIPANTS ALSO SHARED KNOWLEDGE ON GAPS AND ASSETSAVAILABLE IN THEIR COMMUNITIES TO ADDRESS EACH OF THE TOP FOUR PRIORITIESIDENTIFIED. THE INFORMATION GATHERED IN THIS REPORT IS A START FORFURTHER ASSET AND GAP MAPPING FOR EACH PRIORITY SELECTED BY THE COUNTY. THREE COMMUNITY ENGAGEMENT ACTIVITIES WERE HELD IN OXFORD COUNTY. THE KEYINFORMANT INTERVIEW GUIDE WAS DEVELOPED WITH INPUT FROM THE COMMUNITYENGAGEMENT AND STEERING COMMITTEE MEMBERS AND CONSISTED OF FIVEQUESTIONS.THIRTY-ONE INTERVIEWS WERE CONDUCTED BY JSI AND 11 BY MEMBERS OF LOCALCOMMUNITY ENGAGEMENT PLANNING COMMITTEES. INFORMATION GATHERED FROM THEKEY INFORMANT INTERVIEWS IS INCLUDED IN DISCUSSIONS WHERE APPLICABLE INTHE COUNTY LEVEL REPORT WITHIN EACH OF THE COUNTY PRIORITIES. FOREXAMPLE, WHEN DISCUSSING SUBSTANCE USE, A DISCUSSION OF THE NEEDS OFVULNERABLE POPULATIONS WITHIN THIS PRIORITY WAS ALSO INCLUDED. THE STATELEVEL REPORT PROVIDES A SUMMARY OF KEY FINDINGS FROM THESE INTERVIEWS FOREACH OF THE TEN VULNERABLE POPULATIONS.ALL OUTCOMES FROM THESE EFFORTS WERE COLLECTED VIA THE COMMUNITY OUTREACHREPORTING TOOL OR THE KEY INFORMANT REPORTING TOOL. BOTH OF THESECOLLECTION TOOLS WERE ONLINE SURVEYS WITHIN SURVEY MONKEY. OTHER DATACOLLECTION TOOLS INCLUDED TABLE FACILITATORS NOTES, FORUM REGISTRATIONS,AND SIGN-INS. RUMFORD HOSPITAL PART V, SECTION B, LINE 6A: HOSPITAL FACILITIES:OTHER HOSPITAL FACILITIES PROVIDING FUNDING FOR THE MAINE SHARED CHNA ARECENTRAL MAINE HEALTHCARE (INCLUDING CENTRAL MAINE MEDICAL CENTER,BRIDGTON HOSPITAL, AND RUMFORD HOSPITAL), MAINEGENERAL HEALTH, MAINEHEALTH, AND NORTHERN LIGHT HEALTH. RUMFORD HOSPITAL PART V, SECTION B, LINE 6B: NON-HOSPITAL FACILITIES:OTHER NON-HOSPITAL FACILITIES INVOLVED IN THE MAINE SHARED CHNA ARE THEMAINE CENTER FOR DISEASE CONTROL AND PREVENTION, AN OFFICE OF THEDEPARTMENT OF HEALTH AND HUMAN SERVICES AND COUNTLESS COMMUNITY PARTNERSAND STAKEHOLDER GROUPS. THESE STAKEHOLDER GROUPS INCLUDE THE METRICSCOMMITTEE, DATA ANALYSIS WORKGROUP, COMMUNITY ENGAGEMENT COMMITTEE, LOCALPLANNING COMMITTEES, AND THE STEERING COMMITTEE, MAINE HEALTH DATAORGANIZATION FOR WORKING WITH US TO ACCESS THEIR DATA. SIGNIFICANTANALYSIS WAS CONDUCTED BY EPIDEMIOLOGISTS AT THE MAINE CDC AND THEUNIVERSITY OF SOUTHERN MAINE'S MUSKIE SCHOOL OF PUBLIC SERVICE. JOHNSNOW, INC. PROVIDED ANALYSIS, METHODOLOGY, AND DESIGN SUPPORT. RUMFORD HOSPITAL PART V, SECTION B, LINE 11: ADDRESSING IDENTIFIED NEEDS:THE COMMITMENT FROM CENTRAL MAINE MEDICAL CENTER AND ITS COMMUNITYPARTNERS WAS TO PRODUCE A DOCUMENT THAT REFLECTS THE VOICE OF OURCOMMUNITY. THE PRIORITIES THAT HAVE EMERGED INCLUDE:- SOCIAL DETERMINANTS OF HEALTH- MENTAL HEALTH- SUBSTANCE USE- ACCESS TO CARE- TOBACCO USETHE NEXT STEP IN THIS PROCESS WAS TO DEVELOP AN IMPLEMENTATION STRATEGYTHAT INCLUDED LONG-RANGE PLANS FOR THE PRIORITIZED NEEDS AND TIED THESPECIFIC IMPLEMENTATION PLANS TO THE STRATEGIC PLAN FOR CENTRAL MAINEMEDICAL CENTER. THIS PROCESS WAS FACILITATED BY THE CMMC LEADERSHIPTEAM, THE COMMUNITY PILLAR STEERING COMMITTEE, AND INCLUDED PARTICIPATIONFROM THE COMMUNITY STAKEHOLDER GROUP AND OTHER COMMUNITY MEMBERS.THE STRATEGIES, ACTIVITIES, ACTIONS TAKEN, PROGRAMS AND RESOURCESCOMMITTED, COLLABORATION WITH OTHER ORGANIZATIONS, AND OUTCOMES CAN BEVIEWED AT WWW.CMMC.ORG/ABOUT-COMMUNITY-BENEFITS. RUMFORD HOSPITAL PART V, SECTION B, LINE 13H: FAP ELIGIBILITY CRITERIA:PATIENTS MUST APPLY FOR MAINE FREE CARE IN ORDER TO BE CONSIDERED FOR THEHOSPITAL'S FREE CARE PROGRAM. AS PART OF THE APPLICATION, PATIENTS MUSTSUBMIT A COPY OF CURRENT MAINECARE DECISION LETTERS. PATIENTS WILL BEASKED IF THEY HAVE INSURANCE OF ANY KIND TO HELP PAY FOR CARE AND AREALSO ASKED TO SHOW THAT INSURANCE OR A GOVERNMENT PROGRAM WILL NOT PAYFOR YOUR CARE. IF PATIENTS DO NOT QUALIFY FOR FREE HOSPITAL CARE, THEYARE ALLOWED TO ASK FOR A FAIR HEARING OR APPEAL. PART V, SECTION B, LINE 7A HTTPS://WWW.CMHC.ORG/RUMFORD-HOSPITAL/ABOUT-RUMFORD-HOSPITAL/COMMUNITY-BENEFITS/ PART V, SECTION B, LINE 7B HTTPS://WWW.MAINE.GOV/DHHS/MECDC/PHDATA/MAINECHNA/ PART V, SECTION B, LINE 10A HTTPS://WWW.CMHC.ORG/RUMFORD-HOSPITAL/ABOUT-RUMFORD-HOSPITAL/COMMUNITY-BENEFITS/ 4 1 - ELSEMORE DIXFIELD FAMILY MEDICINE 146 WELD STREET PHYSICIAN CLINIC DIXFIELD ME 04224 OUTPATIENT PHYSICIAN CLINIC 2 - SWIFT RIVER FAMILY MEDICINE 430 FRANKLIN STREET RUMFORD ME 04276 OUTPATIENT PHYSICIAN CLINIC 3 - RUMFORD SPECIALTY SERVICES CLINIC 431 FRANKLIN STREET RUMFORD ME 04276 OUTPATIENT PHYSICIAN CLINIC 4 - RUMFORD SURGICAL SPECIALISTS 431 FRANKLIN STREET RUMFORD ME 04276 OUTPATIENT PHYSICIAN CLINIC PART I, LINE 3C: PATIENTS MUST APPLY FOR MAINE FREE CARE IN ORDER TO BE CONSIDERED FOR THEHOSPITAL'S FREE CARE PROGRAM. AS PART OF THE APPLICATION, PATIENTS MUSTSUBMIT A COPY OF CURRENT MAINECARE DECISION LETTERS. PATIENTS WILL BEASKED IF THEY HAVE INSURANCE OF ANY KIND TO HELP PAY FOR CARE AND AREALSO ASKED TO SHOW THAT INSURANCE OR A GOVERNMENT PROGRAM WILL NOT PAYFOR YOUR CARE. IF PATIENTS DO NOT QUALIFY FOR FREE HOSPITAL CARE, THEYARE ALLOWED TO ASK FOR A FAIR HEARING OR APPEAL.ELIGIBILITY FOR 100% FINANCIAL ASSISTANCE AS STATED IN THE FINANCIAL ASSISTANCE POLICY: A. FINANCIAL ASSISTANCE FOR MEDICALLY NECESSARY CARE IS AVAILABLE TO MAINE RESIDENTS WHO: HAVE NO HEALTH INSURANCE COVERAGE OR HAVE COVERAGE THAT PAYS ONLY PART OF THE BILL; AND MEET THE INCOME CRITERIA SET FORTH BELOW. B. FINANCIAL ASSISTANCE FOR EMERGENCY CARE IS AVAILABLE TO MAINE RESIDENTS AND NON-MAINE RESIDENTS WHO: HAVE NO HEALTH INSURANCE COVERAGE OR HAVE COVERAGE THAT PAYS ONLY PART OF THE BILL; AND MEET THE INCOME CRITERIA SET FORTH BELOW. C. CMH HOSPITALS PROVIDE 100% FINANCIAL ASSISTANCE BASED ON CRITERIA AS DEFINED BELOW: GROSS INCOME IS BELOW 200% OF THE FPL, SUBJECT TO APPROVAL PATIENT IS A RESIDENT OF MAINE NON-MAINE RESIDENT SEEKING EMERGENCY CARE FOR SERVICES OR SUPPLIES THAT ARE A MEDICAL NECESSITY ALL THIRD-PARTY PAYER SOURCES HAVE BEEN EXHAUSTED D. NO INDIVIDUAL ELIGIBLE FOR FINANCIAL ASSISTANCE WILL BE CHARGED MORE FOR EMERGENCY OR OTHERWISE MEDICALLY NECESSARY CARE THAN THE CALCULATED AGB. PART I, LINE 7: COSTING METHODOLOGY:THE COST TO CHARGE RATIO CALCULATED ON IRS WORKSHEET 2 WAS USED TO CALCULATE AMOUNTS ON IRS WORKSHEETS 1 AND 3. ALL OTHER WORKSHEETS USEDTHE ORGANIZATION'S COST ACCOUNTING SYSTEM. PART I, LN 7 COL(F): PERCENT OF TOTAL EXPENSES:THE PERCENT OF TOTAL EXPENSE ON SCHEDULE H, PART I, LINE 7, COLUMN (F),WAS CALCULATED USING TOTAL EXPENSES ON FORM 990, PART IX, LINE 25,COLUMN(A). PART III, LINE 2: BAD DEBT EXPENSE:THE HOSPITAL HAS ADOPTED THE NEW REVENUE RECOGNITION STANDARD ASU2014-09. UNDER ASU 2014-09, THE ESTIMATED AMOUNTS DUE FROM PATIENTS FORWHICH THE HEALTH SYSTEMS DOES NOT EXPECT TO BE ENTITLED OR COLLECT FROMTHE PATIENTS ARE CONSIDERED IMPLICIT PRICE CONCESSIONS AND EXCLUDED FROMTHE HEALTH SYSTEM'S ESTIMATION OF THE TRANSACTION PRICE OR REVENUERECORDED. BAD DEBT EXPENSE WAS NOT SIGNIFICANT TO THE AUDITED FINANCIALSTATEMENTS FOR THE YEAR ENDED JUNE 30, 2020. HOWEVER, THE HOSPITALINTERNALLY TRACKS BAD DEBT EXPENSE CONSISTENT WITH HISTORICAL PRACTICESAND THAT AMOUNT HAS BEEN REPORTED ON SCHEDULE H, PART III, SECTION A,LINE 2. PART III, LINE 3: BAD DEBT EXPENSE ATTRIBUTABLE TO CHARITY CARE:BAD DEBT ATTRIBUTABLE TO PATIENTS UNDER THE ORGANIZATION'S CHARITY CAREPOLICY FOR LINE 3 WAS DETERMINED USING A COMPARISON OF EXPERIENCEDCHARITY CARE COVERAGE AND US CENSUS BUREAU DATA FOR THE MOST RECENT YEARAVAILABLE WHEN CHARITY CARE COVERAGE EXCEEDS THE CENSUS DATA, A MINIMALAMOUNT OF BAD DEBT IS ASSUMED TO BE ELIGIBLE FOR CHARITY CARE TO ACCOUNTFOR THOSE PATIENTS WHO REFUSE TO PROVIDE INFORMATION DOCUMENTINGELIGIBILITY FOR THE PROGRAM. THESE ESTIMATES ARE BASED ON STATE-WIDE DATAAND DO NOT ACCOUNT FOR DIFFERENCES IN GEOGRAPHIC LOCATIONS WITHIN THESTATE. AS THIS AMOUNT IS RELATED TO PATIENTS ELIGIBLE UNDER THE FINANCIALASSISTANCE POLICY, IT SHOULD BE INCLUDED AS A COMMUNITY BENEFIT. PART III, LINE 4: BAD DEBT EXPENSE FOOTNOTE:THE AUDITED FINANCIAL STATEMENTS DO NOT CONTAIN A FOOTNOTE THAT DESCRIBESBAD DEBT EXPENSE. THEY DO, HOWEVER, CONTAIN A FOOTNOTE THAT DESCRIBESPATIENTS ACCOUNTS RECEIVABLE:ACCOUNTS RECEIVABLE FOR PATIENTS, INSURANCE COMPANIES, AND GOVERNMENTAL AGENCIES ARE BASED ON GROSS CHARGES, REDUCED BY EXPLICIT PRICE CONCESSIONS PROVIDED TO THIRD-PARTY PAYORS, DISCOUNTS PROVIDED TO QUALIFYING INDIVIDUALS AS PART OF THE CORPORATION'S FINANCIAL ASSISTANCE POLICY, AND IMPLICIT PRICE CONCESSIONS PROVIDED PRIMARILY TO SELF-PAY PATIENTS. ESTIMATES FOR EXPLICIT PRICE CONCESSIONS ARE BASED ON PROVIDER CONTRACTS, PAYMENT TERMS FOR RELEVANT PROSPECTIVE PAYMENT SYSTEMS, AND HISTORICAL EXPERIENCE ADJUSTED FOR ECONOMIC CONDITIONS AND OTHER TRENDS AFFECTING THE CORPORATION'S ABILITY TO COLLECT OUTSTANDING AMOUNTS.FOR RECEIVABLES ASSOCIATED WITH SELF-PAY PATIENTS, WHICH INCLUDES BOTH PATIENTS WITHOUT INSURANCE AND PATIENTS WITH DEDUCTIBLE AND COPAYMENT BALANCES DUE FOR WHICH THIRD-PARTY COVERAGE EXISTS FOR PART OF THE BILL, THE CORPORATION RECORDS SIGNIFICANT IMPLICIT PRICE CONCESSIONS IN THE PERIOD OF SERVICE ON THE BASIS OF ITS PAST EXPERIENCE, WHICH INDICATES THAT MANY PATIENTS ARE UNABLE OR UNWILLING TO PAY THE PORTION OF THEIR BILL FOR WHICH THEY ARE FINANCIALLY RESPONSIBLE. PART III, LINE 8: COMMUNITY BENEFIT:THE COSTING METHODOLOGY USED FOR LINE 6 IS INFORMATION PULLED FROM THEMEDICARE COST REPORT FILING. ANY SHORTFALL REPORTED ON LINE 7 COULD BECONSIDERED COMMUNITY BENEFIT TO A LEVEL PROPORTIONAL TO THE POVERTYLEVELS INDICATED BY CENSUS BUREAU DATA. IF THE PATIENTS FALLING UNDER200% FPG LEVEL WERE NOT COVERED BY MEDICARE THEY WOULD QUALIFY UNDERRUMFORD HOSPITAL'S FREE CARE POLICY. UNDER THAT CIRCUMSTANCE, THESEPATIENTS WOULD THEN APPEAR AS PART OF THE STATISTICS ON PART I, LINE 7A. PART III, LINE 9B: COLLECTION POLICY:COLLECTION PRACTICES FOR PATIENTS KNOWN TO BE ELIGIBLE FOR CHARITY CAREARE LIMITED TO COLLECTING FROM ANY AVAILABLE PAYMENT SOURCES SUCH ASMEDICARE OR MEDICAID. IF A PATIENT IS ELIGIBLE, BUT HAS NOT APPLIED FORMEDICAID COVERAGE, THE PATIENT IS REQUESTED TO APPLY. ASSISTANCE IS AVAILABLE TO HELP THE PATIENT WITH THE MEDICAID APPLICATION PROCESS. PART VI, LINE 2: NEEDS ASSESSMENT:AS A CRITICAL ACCESS HOSPITAL, RUMFORD HOSPITAL ATTEMPTS TO PROVIDE ANYNEEDED HEALTH CARE SERVICES NECESSARY TO TREAT THE POPULATION OF THISRURAL AREA OF MAINE, ADDITIONALLY, RUMFORD HOSPITAL FOCUSES ON STATE-WIDEINITIATIVES, SUCH AS HEART DISEASE AND DIABETES, AS WELL ASORGANIZATIONAL INITIATIVES BASED ON NEEDS OBSERVED WITHIN ITS PATIENTPOPULATION. MANY FORMS OF EDUCATION, PREVENTION AND EARLY DETECTION AREALSO, PART OF ITS COMMUNITY HEALTH CARE PLAN. PART VI, LINE 3: PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE:RUMFORD HOSPITAL PROVIDES NOTICES ABOUT ITS FREE CARE POLICY IN ALLCLINICAL DEPARTMENTS AND MAJOR PATIENT AREAS. AN INPATIENT FINANCIALCOUNSELOR 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. ALLPATIENT FINANCIAL SERVICES STAFF ARE TRAINED TO OFFER FREE CARE AS ANOPTION TO PATIENTS WHO INDICATE AN INABILITY OR DIFFICULTY IN PAYING FORSERVICES. INFORMATION ABOUT FINANCIAL ASSISTANCE AVAILABILITY IS INCLUDEDON THE BACK OF EVERY PATIENT STATEMENT. ADDITIONALLY, UNINSURED PATIENTSRECEIVE A SEPARATE INFORMATION SHEET WITH THEIR STATEMENTS, FURTHERINFORMING THEM ABOUT THE AVAILABLE OPTIONS. PART VI, LINE 4: COMMUNITY INFORMATION:RUMFORD HOSPITAL, LOCATED IN RUMFORD, MAINE, SERVES CENTRAL OXFORD COUNTYALONG THE WESTERN BORDER OF MAINE. A LIGHTLY POPULATED, RURAL AREA AGED65 OR OVER AND 14% OF THE POPULATION BELOW THE POVERTY LEVEL. PART VI, LINE 5: PROMOTION OF COMMUNITY HEALTH:RUMFORD HOSPITAL HAS AN OPEN MEDICAL STAFF, ALLOWING ANY NON-EMPLOYED ORAFFILIATED PHYSICIANS TO HAVE ADMITTING PRIVILEGES TO THE HOSPITAL. THE BOARD OF DIRECTORS IS MADE UP OF A MAJORITY OF LOCAL COMMUNITY MEMBERSALONG WITH SOME REPRESENTATION BY DIRECTORS FROM CENTRAL MAINEHEALTHCARE, THE PARENT OF THE HEALTHCARE SYSTEM WHICH RUMFORD HOSPITALBELONGS TO, HELPING TO BRING TOGETHER THE VISIONS OF THE LOCAL COMMUNITYWITH THE CAPABILITIES AND VISION OF THE SYSTEM AS A WHOLE FOR THE BENEFITOF RUMFORD AND SURROUNDING COMMUNITIES. PART VI, LINE 6: AFFILIATED HEALTH CARE SYSTEM:AS A MEMBER OF THE CENTRAL MAINE HEALTHCARE SYSTEM, RUMFORD HOSPITALPROVIDES HIGH QUALITY HEALTH CARE IN A RURAL SETTING WITH LIMITED HEALTHCARE OPTIONS. ITS AFFILIATION WITH CENTRAL MAINE MEDICAL CENTER PROVIDESACCESS 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 SPECIALISTPHYSICIANS 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 HOSPITALTO PERFORM AT A COST-EFFICIENT LEVEL WHICH WOULD NORMALLY BE UNACHIEVABLEIN A SMALL, RURAL HOSPITAL, ALLOWING FOR BROADER RANGE OF SERVICESAVAILABLE. 0 1 0 0 0 0 0 0 0 JEFF BRICKMAN PRESIDENT/DIRECTOR 0 780191 0 146241 0 19171 0 190423 0 28880 0 1164906 0 0 JOHN WHITLOCK TREASURER END 6/21 0 401238 0 36560 0 40960 0 2850 0 0 0 481608 0 0 STEVEN LITTLESON PRESIDENT CMMC/CMHCC 0 328265 0 35000 0 66655 0 0 0 19602 0 449522 0 0 PETER WRIGHT PRESIDENT BRIDGTON HOSPITAL 0 362649 0 34996 0 38372 0 2709 0 10467 0 449193 0 0 CORY BAGBY SECRETARY 0 279318 0 50000 0 86303 0 2980 0 6862 0 425463 0 0 JEFFREY LYNDS PHYSICIAN 319355 0 63215 0 2689 0 2905 0 17201 0 405365 0 0 0 SAID DAOUD PHYSICIAN 370108 0 0 0 10269 0 2487 0 0 0 382864 0 0 0 STEPHANIE SINCLAIR PHYSICIAN 312609 0 28450 0 2135 0 2271 0 24316 0 369781 0 0 0 DAVID SALKO DIRECTOR BEG 1/21 0 259379 0 65637 0 8561 0 2406 0 24576 0 360559 0 0 JENNIFER WEINER-SMITH MD PHYSICIAN/DIRECTOR 0 295035 0 16618 0 3657 0 2422 0 24301 0 342033 0 0 JOHN KROGER PHYSICIAN 306028 0 0 0 2888 0 1737 0 23296 0 333949 0 0 0 DIETER KRECKEL PHYSICIAN 316736 0 5172 0 4865 0 2209 0 768 0 329750 0 0 0 HECTOR TARRAZA DIRECTOR BEG 1/21 0 229239 0 0 0 4730 0 0 0 0 0 233969 0 0 PART I, LINE 4B SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN: 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 PARTICIPANTS 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. JEFF BRICKMAN PARTICIPATED IN A SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN THROUGH CENTRAL MAINE HEALTHCARE CORPORATION, A RELATED ENTITY. THE AMOUNT WAS $185,248. FORM 990, PART VI, SECTION A, LINE 6 THE SOLE MEMBER OF THE CORPORATION SHALL BE CENTRAL MAINE HEALTHCARE CORPORATION ACTING THROUGH THE MEMBER'S BOARD OF DIRECTORS. THE BOARD OF DIRECTORS OF THE CORPORATION SHALL CONSIST OF THE SAME INDIVIDUALS SERVING AS MEMBERS OF THE MEMBER'S BOARD OF DIRECTORS. THE MEMBER MAY MAKE, AMEND OR REPEAL THE BYLAWS IN A WHOLE OR IN PART. FORM 990, PART VI, SECTION A, LINE 7A THE SOLE MEMBER OF THE CORPORATION SHALL BE CENTRAL MAINE HEALTHCARE CORPORATION ACTING THROUGH THE MEMBER'S BOARD OF DIRECTORS. THE BOARD OF DIRECTORS OF THE CORPORATION SHALL CONSIST OF THE SAME INDIVIDUALS SERVING AS MEMBERS OF THE MEMBER'S BOARD OF DIRECTORS. THE MEMBER MAY MAKE, AMEND OR REPEAL THE BYLAWS IN A WHOLE OR IN PART. FORM 990, PART VI, SECTION A, LINE 7B THE SOLE MEMBER OF THE CORPORATION SHALL BE CENTRAL MAINE HEALTHCARE CORPORATION ACTING THROUGH THE MEMBER'S BOARD OF DIRECTORS. THE BOARD OF DIRECTORS OF THE CORPORATION SHALL CONSIST OF THE SAME INDIVIDUALS SERVING AS MEMBERS OF THE MEMBER'S BOARD OF DIRECTORS. THE MEMBER MAY MAKE, AMEND OR REPEAL THE BYLAWS IN A WHOLE OR IN PART. 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 VICE PRESIDENT 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. 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 SEPERATE QUESTIONNAIRE IS PROVIDED, WHICH INCLUDES DISTRUBUTION TO KEY EMPLOYEES, COVERING REPORTING AREAS OF LOANS, GRANTS, BUSINESS RELATIONSHIPS, AND OTHER CONCLICTS. THESE QUESTIONAIRES ARE REVIEWED BY THE FINANCE DEPARTMENT FOR REPORTABLE ITEMS FOR THE FORM 990. IN THE CASE OF POSSIBLE CONFLICT, THE BOARD WOULD REVIEW THE SITUATION AND TAKE ACTIONS DEEMED APPROPRIATE FOR THE POSSIBLE OR ACTUALCONFLICTS 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. FORM 990, PART VI, SECTION B, LINE 15 CENTRAL MAINE HEALTHCARE (CMHC) HAS ESTABLISHED AND FOLLOWS A DELIBERATIVE TRANSPARENT PROCESS WHICH MEETS IRS REGULATIONS FOR " REBUTTABLE" PRESUMPTION OF REASONABLENESS. 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 CHMC 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 ATTORNEY'S FACTORS USED IN DETERMINING COMPARABILITY TO THE ORGANIZATION INCLUDING GEOGRAPHY, ORGANIZATIONAL COMPLEXITY, FACILITY TYPE, OWNERSHIP TYPE, AND ANY OTHER FACTORS DEEMED RELEVANT BY THE COMMITTEE'S 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 IRS GUIDANCE. THE COMPENSATION PAID TO KEY EMPLOYEES IS REVIEWED BY THE VICE PRESIDENT OF HUMAN RESOURCES AND ORGANIZATIONAL DEVELOPMENT. DURING THE REVIEW PROCESS, THE CENTRAL MAINE HEALTHCARE COMPENSATION MANAGER PROVIDERS MARKET DATA ON COMPARABLE POSITIONS FROM COMPARATIVE GROUPS OF HEALTHCARE ORGANIZATIONS THAT ARE APPROPRIATELY SIMILAR IN TERMS OF THEIR REVENUE, GEOGRAPHIC LOCATION, NUMBER OF EMPLOYEES, NUMBER OF STAFFED HOSPITAL BEDS, ETC. HUMAN RESOURCES PROVIDES AT A MINIMUM FOUR SETS OF COMPARABILITY DATA FROM THE MOST RECENT NATIONAL HEALTHCARE SPECIFIC COMPENSATION SURVEYS ( E. G. WATSON & WYATT, SULLIVAN & COTTER, THE HAY GROUP, MERCER, ETC) FOR REFERENCE. THESE SURVEYS REPORT PAY RATE DATA THAT IS TYPICALLY AGED LESS THAN 6 MONTHS. CENTRAL MAINE HEALTHCARE AND AFFILIATES STRIVE TO PAY AT THE MARKET AVERAGE OR SLIGHTLY ABOVE IT FOR KEY EMPLOYEES. ONCE THE COMPENSATION MANAGER AND THE VICE PRESIDENT OF HUMAN RESOURCES AND ORGANIZATIONAL DEVELOPMENT HAVE FINALIZED RECOMMENDATIONS BASED ON THIS EMPIRICAL DATA, THEY ARE PRESENTED TO THE PRESIDENTS OF EACH HOSPITAL THAT SUPERVISE THE KEY EMPLOYEES, AND THE CEO OF CENTRAL MAINE HEALTHCARE, FOR REVIEW, EDITS, AND APPROVAL. THIS PROCESS TYPICALLY OCCURS DURING THE LAST MONTH OF THE FISCAL YEAR IN PREPARATION FOR THE NEXT FISCAL YEAR. CENTRAL MANE HEALTHCARE DOCUMENTS THE BASIS FOR ITS DETERMINATION FOR KEY EMPLOYEES' COMPENSATION AND MAINTAINS THIS CONTEMPORANEOUSLY SUBSTANTIATED MATERIAL IN THE HUMAN RESOURCES DEPARTMENT. 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 APPROPRIATELY. FORM 990, PART VII, SECTION A BOARD MEMBER COMPENSATION: NO BOARD MEMBERS RECEIVE COMPENSATION FOR THEIR DUTIES AS DIRECTORS. JEFF BRICKMAN WAS EMPLOYED AS PRESIDENT OF CENTRAL MAINE HEALTHCARE CORPORATION AND NOW STEVEN LITTLESON IS IN THAT POSITION. BOTH JEFF BRICKMAN AND STEVEN LITTLESON WERE COMPENSATED BASED ON THEIR ROLE AS PRESIDENT. FORM 990, PART IX, LINE 11G OTHER FEES: PROGRAM SERVICE EXPENSES 9,013,502. MANAGEMENT AND GENERAL EXPENSES 1,562,607. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 10,576,109. FORM 990, PART XI, LINE 9: EQUITY TRANSFER -10,554,984. CHANGE IN DEFINED BENEFIT PENSION PLAN GAINS AND LOSSES 820,693. RESTRICTED DONATIONS 17,469. CHANGE IN INTEREST OF RESTRICTED NET ASSETS OF OUTSIDE TRUST 9,392. NET ASSETS RELEASED FROM RESTRICTION -160,491. CENTRAL MAINE COMMUNITY HEALTH CORP PO BOX 4500 LEWISTON ME 04243 010386912 PUBLIC EDUCATION ME 501(C)(3) LINE 7 CMHC 0 CENTRAL MAINE MEDICAL CENTER PO BOX 4500 LEWISTON ME 04243 010211494 HEALTHCARE ME 501(C)(3) LINE 3 CMHC 0 CENTRAL MAINE HEALTHCARE CORPORATION PO BOX 4500 LEWISTON ME 04243 010386913 HEALTHCARE ME 501(C)(3) LINE 7 N/A 0 MAINE COLLEGE OF HEALTH PROFESSIONS PO BOX 4500 LEWISTON ME 04243 010356077 EDUCATION ME 501(C)(3) LINE 2 CMMC 0 CENTRAL MAINE REAL ESTATE MGMT CORP PO BOX 4500 LEWISTON ME 04243 010387674 REAL ESTATE ME 501(C)(2) CMHC 0 RUMFORD COMMUNITY FAMILY HEALTH CENTER 430 FRANKLIN STREET RUMFORD ME 04276 010481000 HEALTHCARE ME 501(C)(3) LINE 3 CMHC 0 RUMFORD COMMUNITY HOME CORPORATION 11 JOHN F KENNEDY LANE RUMFORD ME 04276 222844951 NURSING HOME ME 501(C)(3) LINE 10 CMHC 0 BRIDGTON HOSPITAL 10 HOSPITAL DRIVE BRIDGTON ME 04009 010130427 HEALTHCARE ME 501(C)(3) LINE 3 CMHC 0 BRIDGTON HOSPITAL PHYSICIANS GROUP SOUTH HIGH STREET BRIDGTON ME 04009 010493083 FUNDING ME 501(C)(3) PF CMHC 0 ELIAS E TUCKER TRUST FUND 300 MAIN STREET LEWISTON ME 04009 016042343 FUNDING ME 501(C)(3) LINE 12A, I CMMC 0 CENTRAL MAINE HEALTH VENTURES INC 300 MAIN STREET LEWISTON ME 04240 010430016 HEALTHCARE ME N/A C 0 CWM INSURANCE LTD GENESIS BUILDING PO BOX 1363 BWI PO BOX BWI CJ 980220891 INSURANCE CJ N/A C 0 CENTRAL MAINE ACO 300 MAIN STREET LEWISTON ME 04240 274604314 ACCOUNTABLE CARE ME N/A C 0 0 0 0 0 0 0 0 0 0 0 1 0 1 0 1 1 1 0 0