2022-05-16T09:22:20-05:00 2021-06-30 381357951 PLANTE & MORAN PLLC 250 S HIGH ST SUITE 100 COLUMBUS OH 43215 990 2020-07-01 010211494 CENTRAL MAINE MEDICAL CENTER CENT 2077952813 PO BOX 4500 LEWISTON ME 04243 STEVEN LITTLESON PRESIDENT & CEO 2077952813 2022-05-12 1 STEVEN LITTLESON 999009999 AMY CIMINELLO P00796388 6148493000 2022-05-12 0 AAL1 IAL1 2020 2022-09-23 18:48:47Z STEVEN LITTLSON 300 MAIN STREET LEWISTON ME 04240 415757957 0 X WWW.CMMC.ORG X 1888 ME CMMC STRIVES TO PROVIDE EXCEPTIONAL HEALTHCARE SERVICES. THE HOSPITAL DEPENDS ON THE EXPERTISE OF ITS CAREGIVERS IN ADDITIONAL TO THE COMMITMENT AND COMPASSION THEY PROVIDE. 16 11 2439 1400 372109 0 22333854 11459320 381003958 403791420 1260350 490067 -7885130 17150 396713032 415757957 0 45206 0 0 228175035 123201313 0 0 0 187105759 311613925 415280794 434860444 -18567762 -19102487 300463191 261602490 280151244 182637707 20311947 78964783 TO PROVIDE EXCEPTIONAL HEALTHCARE SERVICES IN A SAFE AND TRUSTFULENVIRONMENT THROUGH THE EXPERTISE, COMMITMENT AND COMPASSION OF OURFAMILY OF CAREGIVERS. 0 0 375200809 45206 403436461 CENTRAL MAINE MEDICAL CENTER IS A 250-BED, NOT-FOR-PROFIT HOSPITAL LOCATED IN LEWISTON, MAINE OFFERING COMPREHENSIVE HEALTHCARE SERVICES TO THE RESIDENTS OF THE CENTRAL AND WESTERN MAINE REGION WITH AN ACTIVE MEDICAL STAFF OF MORE THAN 300 PHYSICIANS REPRESENTING SOME 30 SPECIALTIES OVER 2,000 HIGHLY SKILLED EMPLOYEES AND WITH THE SUPPORT OF THE LATEST TECHNOLOGIES, CMMC IS WELL POSITIONED TO MEET THE REGION'S HEALTHCARE NEEDS WITH THE UTMOST COMPASSION, KINDNESS, AND UNDERSTANDING. 375200809 1 1 0 1 0 0 0 0 0 1 1 1 0 0 1 0 0 1 0 0 0 0 0 0 0 0 1 1 0 0 1 1 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 1 1 1 0 0 1 117 0 1 2439 1 1 1 0 0 0 0 1 1 0 0 0 0 0 0 X 16 11 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 0 1 0 ME X KRISTEN ST PETER 2077952813 300 MAIN STREET LEWISTON ME 04240 X JEFF BRICKMAN PRESIDENT/DIRECTOR 3.00 60.00 X X 0 945603 219303 DAVID SALKO DIRECTOR BEG 1/21 55.00 3.00 X 333577 0 26982 JENNIFER WEINER-SMITH MD PHYSICIAN/DIRECTOR 55.00 3.00 X 315310 0 26723 HECTOR TARRAZA DIRECTOR BEG 1/21 55.00 3.00 X 233969 0 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 CORY BAGBY SECRETARY 3.00 60.00 X 0 415621 9842 ERWEY TENG PHYSICIAN DIVISION CHIEF 1.00 55.00 X 673473 0 34955 SHELDON STEVENSON PHYSICIAN DIVISION CHIEF 1.00 55.00 X 540227 0 32052 SCOTT JOHNSON PHYSICIAN DIVISION CHIEF 1.00 55.00 X 498654 0 25025 MICHAEL STADNICKI PHYSICIAN DIVISION CHIEF 1.00 55.00 X 390542 0 31039 CLAUDIA GEYER PHYSICIAN DIVISION CHIEF 1.00 55.00 X 343356 0 27921 BETHANY PICKER MD PHYSICIAN DIVISION CHIEF 55.00 3.00 X 247607 0 21346 TAREK RADWAN PHYSICIAN 55.00 0.00 X 1307097 0 23443 PAUL WELDNER PHYSICIAN 55.00 0.00 X 921805 0 6058 LISA RUTSTEIN PHYSICIAN 55.00 0.00 X 884306 0 21212 CARMINE FRUMIENTO PHYSICIAN 55.00 0.00 X 840161 0 22673 SEAN MCGARR PHYSICIAN 55.00 0.00 X 813872 0 5385 DAVID TUPPONCE FORMER PRESIDENT OF CMHC 0.00 1.00 X 0 557207 4127 ANDREW EISENHAUER FORMER PHYSICIAN DIVISION CHIEF 55.00 0.00 X 496141 0 24836 MICHAEL BLAKE FORMER PHYSICIAN DIVISION CHIEF 55.00 0.00 X 426952 0 5081 9267049 2827109 590455 52 1 1 0 SODEXO 9801 WASHINGTONIAN BLVD GAITHERSBURG MD 20878 FOOD & OP. PLNT SVCS 15228454 QUEST DIAGNOSTICS 500 PLAZA DR SECAUCUS NJ 07094 MEDICAL SERVICES 7823699 COMPREHENSIVE PHARMACY 655 METRO PLACE S SUITE 450 DUBLIN OH 43017 MEDICAL SERVICES 6394730 AYA HEALTHCARE INC 5930 CORNERSTONE CT W SUITE 300 SAN DIEGO CA 92121 MEDICAL SERVICES 4962049 UNITED AMBULANCE SERVICE 192 RUSSELL STREET LEWISTON ME 04240 MEDICAL SERVICES 2509941 52 11400636 58684 11459320 NET PATIENT REVENUE 621990 403419311 403419311 LABRATORY DIAGNOSTIC SERVICES 621500 372109 372109 403791420 144863 144863 327083 18121 0 0 327083 18121 345204 345204 SUSPENSE ACCOUNT 900099 17150 17150 17150 415757957 403436461 372109 490067 X 45206 45206 3273348 3273348 78494592 66720403 11774189 36809331 31287931 5521400 4624042 3930436 693606 533803 533803 66562570 66562570 592091 438147 153944 104085784 77023480 27062304 6435933 4762590 1673343 2965734 2194643 771091 318361 235587 82774 4365303 1440550 2924753 19043125 11235444 7807681 1275973 944220 331753 MEDICAL SUPPLIES 95855440 95855440 MEDICAID TAX EXPENSE 8301834 8301834 HOSPITALITY ITEMS 102737 76025 26712 TAXES PERSONAL PROPERTY 12607 12607 1162630 860348 302282 434860444 375200809 59659635 0 2012835 2380518 70442653 21798035 4080 39925804 54346613 15920 3337781 8872847 8833266 9416178 845494 5222643 431311793 325889897 119232403 105421896 4800121 20788637 4845260 33355123 2041758 44125816 300463191 261602490 130998969 73158674 637015 95070903 11657937 92860104 41786420 16618929 280151244 182637707 X 5433946 62086986 14878001 16877797 20311947 78964783 300463191 261602490 X -19102487 188179 1715027 75852117 X X 0 1 X 1 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 31899 31899 0 PART II-B, LINE 1: PORTION OF DUES FOR PROFESSIONAL ASSOCIATIONS ATTRIBUTED TO LOBBYING 15678635 1198552 16877187 17315925 -1633565 3725 15678635 17055708 260217 17315925 20450606 -3394898 17055708 20239234 211372 20450606 0.75700 0.24300 0 1 1 2318022 2318022 161370463 91435817 69934646 5112660 4803874 308786 253819987 226362160 27457827 8690661 3288046 5402615 105421896 CP BOND OBLIGATIONS -5528066 C DEPOSITS 5900 C LONG TERM PATIENT AR 302424 C UNREALIZED GAIN 339227 C ENDOWMENT FUND 691441 C RIGHT OF USE ASSET-FINANCE 845624 C DEBT SERVICE RESERVE 1007528 C CERNER INTANGIBLES 1161503 C LONG TERM MEDICAL STAFF AR 1679309 C DSRF MHHEFA 2019 3441800 C RIGHT OF USE ASSET- OPERATING 3872147 C WORKCOMP 4288447 C BONDS 9374697 C LONG TERM DUE FROM MEDICAID 11873142 C 33355123 OPERATING LEASE LIABILITY 2322460 FINANCE LEASE LIABILITY 3990533 WORKCOMP SELF INSURANCE 2056393 DEFERRED SOCIAL SECURITY EMPLOYER 4634135 DEFERRED PENSION -11460938 ASSET RETIREMENT OBLIGATION 2696324 LONG TERM CHOICE TIME RESERVE 1804689 CONTRACT LIABILITY 9939257 LONG TERM DUE TO MEDICARE 636076 16618929 PART V, LINE 4: INTENDED USE OF 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 MEDICAL EDUCATION, OR FREE CARE. OTHERS ARE DESIGNATED TO SUPPORT SPECIFIC DEPARTMENTS OF THE HOSPITAL. 1 1 X 1 X 0 1 1 0 0 9867599 6798782 3068817 0.00710 82884472 47348199 35536273 0.08170 92752071 54146981 38605090 0.08880 772751 9882 762869 0.00180 2760957 1565826 1195131 0.00270 3533708 1575708 1958000 0.00450 96285779 55722689 40563090 0.09330 30999017 3749915 36001619 37475272 -1473653 X 1 1 1 1 CENTRAL MAINE MEDICAL CENTER 300 MAIN STREET LEWISTON ME 04240 WWW.CMMC.ORG 38819 X X X X CENTRAL MAINE MEDICAL CENTER 1 0 0 1 X X X X X X X X X 18 1 1 1 1 X SEE PARTY V, PAGE 8 X SEE PARTY V, PAGE 8 X 1 18 1 SEE PARTY V, PAGE 8 0 1 X 200.000000000000 X X X 1 1 X X X 1 X HTTPS://WWW.CMHC.ORG/PATIENTS-VISITORS/BILLING-FINANCIAL-INFORMATION/ X HTTPS://WWW.CMHC.ORG/PATIENTS-VISITORS/BILLING-FINANCIAL-INFORMATION/ X HTTPS://WWW.CMHC.ORG/PATIENTS-VISITORS/BILLING-FINANCIAL-INFORMATION/ X X X X X X 1 X 0 X X X X 1 X 0 0 CENTRAL MAINE MEDICAL CENTER 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 FORUM WIDEVOTING 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 DURING THESE SMALLGROUPS WERE COLLATED AND PRESENTED TO THE LARGER PLENARY SESSION, WHEREEACH ATTENDEE VOTED FOR THEIR TOP FOUR PRIORITIES. VOTES WERE TALLIED ANDA HIERARCHY EMERGED.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 ANDROSCOGGIN COUNTY.THE COUNTY HEALTH RANKINGS HEALTH ACTION FORUM WAS HELD ON JUNE 27, 2018.THE PURPOSE OF THIS EVENT WAS TO SOLICIT COMMUNITY INFORMATION FROMIMMIGRANTS, REFUGEES AND ASYLUM SEEKERS ON HEALTH ISSUES SPECIFIC TO THISPOPULATION. A FURTHER GOAL WAS TO BUILD AND STRENGTHEN CONNECTIONSBETWEEN SMALL IMMIGRANT-LED ORGANIZATIONS WORKING IN PUBLIC HEALTH INMAINE AND THE DISTRICT AND STATE-LEVEL PUBLIC HEALTH ORGANIZATIONS.FINALLY, THIS EVENT HOPED TO GENERATE TAKEAWAY ACTION STEPS AND SUGGESTIONS FOR INTERVENTIONS AIMED AT IMPROVING HEALTH EQUITY IN MAINE.THERE WERE ONLY TWO COUNTY HEALTH RANKINGS HEALTH ACTION FORUMS HELD INMAINE. THE OTHER WAS HELD IN PORTLAND ON JUNE 25, 2018. THE KEY INFORMANTINTERVIEW GUIDE WAS DEVELOPED WITH INPUT FROM THE COMMUNITY ENGAGEMENTAND STEERING COMMITTEE MEMBERS AND CONSISTED OF FIVE QUESTIONS.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 THESE COLLECTION TOOLS WERE ONLINE SURVEYS WITHIN SURVEY MONKEY. OTHER DATACOLLECTION TOOLS INCLUDED TABLE FACILITATORS NOTES, FORUM REGISTRATIONS,AND SIGN-INS. CENTRAL MAINE MEDICAL CENTER 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. CENTRAL MAINE MEDICAL CENTER 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. CENTRAL MAINE MEDICAL CENTER 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 THE SPECIFIC IMPLEMENTATION PLANS TO THE STRATEGIC PLAN FOR CENTRAL MAINEMEDICAL CENTER. THIS PROCESS WAS FACILITATED BY THE CMMC LEADERSHIP TEAM,THE COMMUNITY PILLAR STEERING COMMITTEE, AND INCLUDED PARTICIPATION FROMTHE COMMUNITY STAKEHOLDER GROUP AND OTHER COMMUNITY MEMBERS.THE STRATEGIES, ACTIVITIES, ACTIONS TAKEN, PROGRAMS AND RESOURCESCOMMITTED, COLLABORATION WITH OTHER ORGANIZATIONS, AND OUTCOMES CAN BEVIEWED ATHTTPS://WWW.CMHC.ORG/CMMC/ABOUT-CMMC/CENTRAL-MAINE-COMMUNITY-BENEFITS/ CENTRAL MAINE MEDICAL CENTER 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/CMMC/ABOUT-CMMC/CENTRAL-MAINE-COMMUNITY-BENEFITS/ PART V, SECTION B, LINE 7B HTTPS://WWW.CMHC.ORG/CMMC/ABOUT-CMMC/CENTRAL-MAINE-COMMUNITY-BENEFITS/ PART V, SECTION B, LINE 10A HTTPS://WWW.CMHC.ORG/CMMC/ABOUT-CMMC/CENTRAL-MAINE-COMMUNITY-BENEFITS/ 33 1 - CENTRAL MAINE GASTROENTEROLOGY ASSOCIATE 77 BATES STREET SUITE 202 LEWISTON ME 04240 OUTPATIENT PHYSICIAN CLINIC 2 - CENTRAL MAINE SURGICAL ASSOCIATES 12 HIGH STREET SUITE 401 LEWISTON ME 04240 OUTPATIENT PHYSICIAN CLINIC 3 - CENTRAL MAINE BARIATRIC SURGERY 10 HIGH STREET SUITE 105 LEWISTON ME 04240 OUTPATIENT PHYSICIAN CLINIC 4 - CENTRAL MAINE ENDOCRINOLOGY AND DIABETES O 10 HIGH STREET SUITE 105 LEWISTON ME 04240 OUTPATIENT PHYSICIAN CLINIC 5 - CENTRAL MAINE FAMILY HEALTH CARE ASSOC 190 STETSON ROAD AUBURN ME 04210 OUTPATIENT PHYSICIAN CLINIC 6 - CENTRAL MAINE FAMILY HEALTH RESIDENCY 76 HIGH STREET SUITE 100 LEWISTON ME 04240 OUTPATIENT PHYSICIAN CLINIC 7 - CENTRAL MAINE FAMILY PRACTICE 12 HIGH STREET SUITE 302 LEWISTON ME 04210 OUTPATIENT PHYSICIAN CLINIC 8 - CENTRAL MAINE GYNECOLOGY & UROGYNECOLOGY 12 HIGH STREET SUITE 200 LEWISTON ME 04210 OUTPATIENT PHYSICIAN CLINIC 10 - CENTRAL MAINE HEMATOLOGY ONCOLOGY 12 HIGH STREET SUITE 205 LEWISTON ME 04210 OUTPATIENT PHYSICIAN CLINIC 11 - CENTRAL MAINE INTERNAL MEDICINE 10 HIGH STREET SUITE 400 LEWISTON ME 04240 OUTPATIENT PHYSICIAN CLINIC 12 - CENTRAL MAINE NEUROLOGY 10 MINOT AVENUE AUBURN ME 04210 OUTPATIENT PHYSICIAN CLINIC 13 - CENTRAL MAINE OBGYN 12 HIGH STREET SUITE 200 LEWISTON ME 04240 OUTPATIENT PHYSICIAN CLINIC 14 - CENTRAL MAINE PAIN AND HEADACHE CENTER 77 BATES STREET LEWISTON ME 04240 OUTPATIENT PHYSICIAN CLINIC 15 - CENTRAL MAINE PEDIATRICS 12 HIGH STREET SUITE 301 LEWISTON ME 04240 OUTPATIENT PHYSICIAN CLINIC 17 - CENTRAL MAINE SPORTS MEDICINE 77 BATES STREET SUITE 101 LEWISTON ME 04240 OUTPATIENT PHYSICIAN CLINIC 18 - CENTRAL MAINE THERAPY SERVICES 77 BATES STREET SUITE 201 LEWISTON ME 04240 OUTPATIENT PHYSICIAN CLINIC 19 - CENTRAL MAINE UROLOGY 10 HIGH STREET SUITE 204 LEWISTON ME 04240 OUTPATIENT PHYSICIAN CLINIC 20 - GRAY FAMILY CLINIC 126 SHAKER ROAD GRAY ME 04039 OUTPATIENT PHYSICIAN CLINIC 21 - INFECTIOUS DISEASE ASSOCIATES 76 HIGH STREET SUITE 200 LEWISTON ME 04240 OUTPATIENT PHYSICIAN CLINIC 22 - LISBON FAMILY PRACTICE 2 BISBEE ROAD LISBON ME 04250 OUTPATIENT PHYSICIAN CLINIC 23 - MINOT AVENUE FAMILY MEDICINE 789 MINOT AVENUE AUBURN ME 04210 OUTPATIENT PHYSICIAN CLINIC 24 - POLAND COMMUNITY HEALTH CENTER 364 MAIN STREET POLAND ME 04274 OUTPATIENT PHYSICIAN CLINIC 25 - PULMONARY AND SLEEP MEDICINE 76 HIGH STREET SUITE 300 LEWISTON ME 04240 OUTPATIENT PHYSICIAN CLINIC 26 - TOPSHAM FAMILY MEDICINE 4 HORTON PLACE TOPSHAM ME 04086 OUTPATIENT PHYSICIAN CLINIC 27 - CENTRAL MAINE HEARING CENTER 12 HIGH STREET SUITE 102 LEWISTON ME 04240 OUTPATIENT PHYSICIAN CLINIC 28 - CENTRAL MAINE MEDICATION MANAGEMENT 10 HIGH STREET SUITE 103 LEWISTON ME 04240 OUTPATIENT PHYSICIAN CLINIC 29 - CENTRAL MAINE EAR NOSE AND THROAT 12 HIGH STREET SUITE 102 LEWISTON ME 04240 OUTPATIENT PHYSICIAN CLINIC 30 - CENTRAL MAINE PODIATRY 12 HIGH STREET LEWISTON ME 04240 OUTPATIENT PHYSICIAN CLINIC 31 - CENTRAL MAINE MENTAL HEALTH 10 HIGH STREET SUITE 301 LEWISTON ME 04240 OUTPATIENT PHYSICIAN CLINIC 32 - TOPSHAM CARE CENTER 105 TOPSHAM FAIR MALL ROAD TOPSHAM ME 04086 OUTPATIENT PHYSICIAN CLINIC 33 - CENTRAL MAINE RHEUMATOLOGY 77 BATES STREET SUITE 201 LEWISTON ME 04240 OUTPATIENT PHYSICIAN CLINIC 34 - AUGUSTA INTERNAL MEDICINE 12 SPRUCE STREET AUGUSTA ME 04330 OUTPATIENT PHYSICIAN CLINIC 35 - CENTRAL MAINE HEATHCARE ORTHOPEDICS 690 MINOT AVENUE AUBURN ME 04210 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 TOCALCULATE AMOUNTS ON IRS WORKSHEETS 1 AND 3. ALL OTHER WORKSHEETS USEDTHE ORGANIZATION'S COST ACCOUNTING SYSTEM. PART III, LINE 2: 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 EXPENSES 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 CONVERGE EXCEEDS THE CENSUS DATA, A MINIMAL AMOUNT 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 IS 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. THE SHORTFALL REPORTED ON LINE 7 COULD BE CONSIDERED COMMUNITY BENEFIT TO A LEVEL PROPORTIONAL TO THE POVERTYLEVELS INDICATED BY CENSUS BUREAU DATA. IF MAINE RESIDENTS, AGE 65 OROLDER, BELOW THE 200% FPG LEVEL WERE NOT COVERED BY MEDICARE, THEY WOULDQUALIFY UNDER CMMC'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 ISAVAILABLE TO HELP THE PATIENT WITH THE MEDICAID APPLICATION PROCESS. PART VI, LINE 2: NEEDS ASSESSMENT:CENTRAL MAINE MEDICAL CENTER PROVIDES A FULL RANGE OF SERVICES TO ITSPRIMARY SERVICES AREA, AS WELL AS THE EXTENDED AREA OF THE ENTIRE CENTRAL MAINE HEALTHCARE SYSTEM. IT ASSESSES THE NEEDS OF ITS VARIOUS COMMUNITIESFROM VARIOUS THIRD-PARTY SURVEYS AND REPORTS, OBSERVATIONS IN ITS PATIENTPOPULATION AND THE POPULATIONS OF ITS AFFILIATED SYSTEM HOSPITALS, ASWELL AS ASSISTING WITH STATE-WIDE INITIATES IN PREVENTATIVE MEDICINE ANDEDUCATION. PART VI, LINE 3: PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE:CENTRAL MAINE MEDICAL CENTER PROVIDES NOTICES ABOUT ITS FREE CARE POLICYIN ALL CLINICAL DEPARTMENTS AND MAJOR PATIENT AREAS. AN INPATIENTFINANCIAL COUNSELOR VISITS WITH ALL UNINSURED PATIENTS TO DISCUSSOPTIONS, INCLUDING GOVERNMENTAL PROGRAM ELIGIBILITY AND FREE CAREASSISTANCE IS AVAILABLE TO HELP PATIENTS WITH COMPLETION OF MEDICAIDAPPLICATIONS. ALL PATIENTS FINANCIAL SERVICES STAFF ARE TRAINED TO OFFERFREE CARE AS AN OPTION TO PATIENTS WHO INDICATE AN INABILITY ORDIFFICULTY IN PAYING FOR SERVICES. INFORMATION ABOUT FINANCIAL ASSISTANCEAVAILABILITY IS INCLUDED ON THE BACK OF EVERY PATIENT STATEMENT.ADDITIONALLY, UNINSURED PATIENTS RECEIVED A SEPARATE INFORMATION SHEET WITH THEIR STATEMENTS, FURTHER INFORMING THEM ABOUT THE AVAILABLEOPTIONS. PART VI, LINE 4: COMMUNITY INFORMATION:CENTRAL MAINE MEDICAL CENTER, LOCATED IN LEWISTON, MAINE SERVES A PRIMARYAREA OF ANDROSCOGGIN COUNTY IN CENTRAL MAINE. ADDITIONALLY, IT SERVESPORTIONS OF CUMBERLAND, FRANKLIN, KENNEBEC, OXFORD, AND SAGADAHOCCOUNTIES. THE LEWISTON-AUBURN AREA IS URBAN, FOR MAINE STANDARDS, BUTQUICKLY BECOMES SUBURBAN TO ALMOST-RURAL QUICKLY OUTSIDE THE CITY LIMITS.ANDROSCOGGIN COUNTY HAS A POPULATION OF JUST UNDER 108,000 PERSONS, WHICHMAKES UP APPROXIMATELY 8% OF THE OVERALL MAINE POPULATION. WHILE ALMOST93% OF THE POPULATION IS MADE UP OF CAUCASIAN PERSONS, MORE THAN 16%SPEAK A LANGUAGE OTHER THAN ENGLISH AT HOME. THIRTEEN PERCENT OF THEPOPULATION IS BELOW THE POVERTY LEVEL, SPECIFICALLY IN LEWISTON, THESECOND LARGEST CITY IN MAINE, WITH A POPULATION OF APPROXIMATELY 36,600PERSONS, SIMILAR RACIAL DISTRIBUTIONS ARE OBSERVED, BUT MORE THAN 28%CLAIM A LANGUAGE OTHER THAN ENGLISH AS THEIR PRIMARY. FIFTEEN PERCENT ARE BELOW THE POVERTY LEVEL. PART VI, LINE 5: PROMOTION OF COMMUNITY HEALTH:CENTRAL MAINE MEDICAL CENTER HAS AN OPEN MEDICAL STAFF, ALLOWING ANYNON-EMPLOYED OR AFFILIATED PHYSICIANS TO HAVE ADMITTING PRIVILEGES TO THEHOSPITAL. THE BOARD OF DIRECTORS IS MADE UP OF A MAJORITY OF LOCALCOMMUNITY MEMBERS ALONG WITH SOME REPRESENTATION BY DIRECTORS FROMCENTRAL MAINE HEALTHCARE, THE PARENT OF THE HEALTHCARE SYSTEM WHICHCENTRAL MAINE MEDICAL CENTER BELONGS TO, HELPING TO BRING TOGETHER THEVISIONS OF THE LOCAL COMMUNITY WITH THE CAPABILITIES AND VISION OF THESYSTEM AS A WHOLE FOR THE BENEFIT OF LEWISTON AND SURROUNDINGCOMMUNITIES.DURING THE COVID-19 PANDEMIC, THE ORGANIZATION RESPONDED TO THE NEEDS OF THE COMMUNITY BY OPENING TESTING SITES AND A MASS VACCINE CLINIC. THE ORGANIZATION ALSO EXPANDED TELEHEALTH ACCESS. PART VI, LINE 6: AFFILIATED HEALTH CARE SYSTEM:CENTRAL MAINE MEDICAL CENTER (CMMC) IS A TERTIARY CARE HOSPITAL IN THECENTRAL MAINE HEALTHCARE SYSTEM. TWO RURAL, CRITICAL ACCESS HOSPITALS ARE ALSO MEMBERS OF THIS SYSTEM. CMMC PROVIDES A WIDE RANGE OF SPECIALISTPHYSICIANS AND SERVICES TO ITS COMMUNITY, AS WELL AS THE SYSTEM. CMMCPROVIDES PHYSICIANS TO STAFF SPECIALTY CLINICS IN THE RURAL COMMUNITIESSERVED BY THE CRITICAL ACCESS HOSPITALS ON A LIMITED, BUT REGULAR, BASIS.THESE SERVICES WOULD NOT NORMALLY BE SUPPORTED BY THE LIMITED POPULATIONSAND PATIENTS WOULD INSTEAD NEED TO TRAVEL MUCH LONGER DISTANCES TOCONSULT OR VISIT WITH A SPECIALIST. CMMC ALSO PROVIDES ACCESS TO TRAUMACARE, NEONATAL INTENSIVE CARE, AND SPECIALIZED CARDIAC CARE. THE SYSTEMPARENT, CENTRAL MAINE HEALTHCARE, PROVIDES STREAMLINED ADMINISTRATIVEFUNCTIONS AND BACKROOM SERVICES FOR THE ENTIRE SYSTEM, PROVIDING COSTEFFICIENCY AND OTHER BENEFITS TO ALL MEMBERS. THIS ALSO ALLOWS FOR EASYADMINISTRATIVE HANDLING OF TRANSFERS OF PATIENTS BETWEEN HOSPITALS, ASWELL AS A SINGLE POINT OF CONTACT FOR PATIENTS TO ADDRESS BILLS ANDINSURANCE ISSUES. X X X X 1 1 0 0 0 0 0 1 0 TAREK RADWAN PHYSICIAN 1302966 0 0 0 4131 0 8205 0 15238 0 1330540 0 0 0 JEFF BRICKMAN PRESIDENT/DIRECTOR 0 780191 0 146241 0 19171 0 190423 0 28880 0 1164906 0 0 PAUL WELDNER PHYSICIAN 898350 0 0 0 23455 0 6058 0 0 0 927863 0 0 0 LISA RUTSTEIN PHYSICIAN 581322 0 284599 0 18385 0 5911 0 15301 0 905518 0 0 0 CARMINE FRUMIENTO PHYSICIAN 820070 0 0 0 20091 0 5640 0 17033 0 862834 0 0 0 SEAN MCGARR PHYSICIAN 736990 0 400 0 76482 0 5385 0 0 0 819257 0 0 0 ERWEY TENG PHYSICIAN DIVISION CHIEF 646676 0 15831 0 10966 0 6429 0 28526 0 708428 0 0 0 SHELDON STEVENSON PHYSICIAN DIVISION CHIEF 446112 0 51051 0 43064 0 3533 0 28519 0 572279 0 0 0 DAVID TUPPONCE FORMER PRESIDENT OF CMHC 0 91479 0 0 0 465728 0 2116 0 2011 0 561334 0 0 SCOTT JOHNSON PHYSICIAN DIVISION CHIEF 472144 0 9964 0 16546 0 3549 0 21476 0 523679 0 0 0 ANDREW EISENHAUER FORMER PHYSICIAN DIVISION CHIEF 476387 0 0 0 19754 0 5783 0 19053 0 520977 0 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 MICHAEL BLAKE FORMER PHYSICIAN DIVISION CHIEF 347827 0 50483 0 28642 0 2281 0 2800 0 432033 0 0 0 CORY BAGBY SECRETARY 0 279318 0 50000 0 86303 0 2980 0 6862 0 425463 0 0 MICHAEL STADNICKI PHYSICIAN DIVISION CHIEF 377594 0 0 0 12948 0 2463 0 28576 0 421581 0 0 0 CLAUDIA GEYER PHYSICIAN DIVISION CHIEF 331800 0 0 0 11556 0 2386 0 25535 0 371277 0 0 0 DAVID SALKO DIRECTOR BEG 1/21 259379 0 65637 0 8561 0 2406 0 24576 0 360559 0 0 0 JENNIFER WEINER-SMITH MD PHYSICIAN/DIRECTOR 295035 0 16618 0 3657 0 2422 0 24301 0 342033 0 0 0 BETHANY PICKER MD PHYSICIAN DIVISION CHIEF 238883 0 0 0 8724 0 1683 0 19663 0 268953 0 0 0 HECTOR TARRAZA DIRECTOR BEG 1/21 229239 0 0 0 4730 0 0 0 0 0 233969 0 0 0 PART I, LINE 4A THE FOLLOWING INDIVIDUALS RECEIVED NET TAXABLE SEVERANCE PAYMENTS FROM CENTRAL MAINE MEDICAL CENTER: DAVID TUPPONCE: $460,184 SEAN MCGARR: $30,770 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. A MAINE HEALTH & HIGHER EDUCATIONAL FACILITIES AUTH 010314384 56042RTR3 2019-07-31 52604797 REFUND SERIES 2009A BOND 0 0 1 B MAINE HEALTH & HIGHER EDUCATIONAL FACILITIES AUTH 010314384 560427WV4 2013-05-23 41071242 REFUND SERIES 2003A BOND 0 0 1 C MAINE HEALTH & HIGHER EDUCATIONAL FACILITIES AUTH 010314384 56042RLG5 2017-06-27 12279914 REFUND SERIES 2005B BOND 0 0 1 A 52604797 392011 48710108 2019 1 0 0 0 B 8665000 41071242 2957944 302888 42862476 2013 1 0 1 1 C 3485000 12279914 138533 12141381 2017 1 0 1 1 A 0 0 0 0 0.00000 0.00000 0.00000 0 0 1 B 0 0 0 0 0.00000 0.00000 0.00000 0 0 1 C 0 0 0 0 0.00000 0.00000 0.00000 0 0 1 A 0 0 0 0 0 0 0 0 B 0 0 0 0 0 0 0 0 C 0 0 0 0 0 0 0 0 A 0 B 0 C 0 TIFFANY EISENHAUER RELATIVE OF EISENHAUER 89973 SALARY AND WAGERS 0 FORM 990, PART VI, SECTION A, LINE 6 THE SOLE MEMBER OF CENTRAL MAINE MEDICAL CENTER IS CENTRAL MAINE HEALTHCARE CORPORATION. (CMHC) THE BOARD SHALL CONSIST OF THE SAME INDIVIDUALS SERVING AS MEMBERS OF THE MEMBER'S BOARD OF DIRECTORS OF CMHC. THE MEMBERS 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 CENTRAL MAINE MEDICAL CENTER IS CENTRAL MAINE HEALTHCARE CORPORATION. (CMHC) THE BOARD SHALL CONSIST OF THE SAME INDIVIDUALS SERVING AS MEMBERS OF THE MEMBER'S BOARD OF DIRECTORS OF CMHC. THE MEMBERS 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 CENTRAL MAINE MEDICAL CENTER IS CENTRAL MAINE HEALTHCARE CORPORATION. (CMHC) THE BOARD SHALL CONSIST OF THE SAME INDIVIDUALS SERVING AS MEMBERS OF THE MEMBER'S BOARD OF DIRECTORS OF CMHC. THE MEMBERS 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 A 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 COMMITTE 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 MONITORING 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 PAST OF THE ANNUAL FORM 990 PREPARATION PROCESS, A SEPERATE QUEATIONNAIRE IS PROVIDED, WHICH INCLUDES DISTRUBUTION TO KEY EMPLOYEES, COVERING REPORTING AREAS OF LOANS, GRANTS, BUSINESS RELATIONSHIPS, AND OTHER CONFLICTS. THESE QUESTIONNAIRS 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 APPROPRAITE 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. FORM 990, PART VI, SECTION B, LINE 15B 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 RECENTLY FILED FORM 990 AND PROVIDED, UPON REQUEST. IN THAT FORMAT UNLESS THE SPECIFIC REQUEST DEEMS A DIFFERENT FORMAT MORE APPROPRIATE. 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 MEDICAL SERVICES : PROGRAM SERVICE EXPENSES 66,562,570. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 66,562,570. FORM 990, PART XI, LINE 9: EQUITY TRANSFER TO AFFLIATE 71,471,628. DEFERRED PENSION 4,315,691. RESTRICTED INVESTMENT INCOME 11,145. CHANGE IN UNREALIZED GAINS AND LOSSES -422. TRANSFER TO PARENT 54,075. 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 1 RUMFORD COMMUNITY FAMILY HEALTH CENTER 430 FRANKLIN STREET RUMFORD ME 04276 010481000 HEALTHCARE ME 501(C)(3) LINE 3 CMHC 0 RUMFORD HOSPITAL 420 FRANKLIN STREET RUMFORD ME 04276 010215227 HEALTHCARE ME 501(C)(3) LINE 3 CMHC 0 CENTRAL MAINE REAL ESTATE MANAGEMENT CO01-0387674 PO BOX 4500 LEWISTON ME 04243 010387674 REAL ESTATE ME 501(C)(2) 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 CENTRAL MAINE COMMUNITY HEALTH CORP PO BOX 4500 LEWISTON ME 04243 010386912 PUBLIC ED ME 501(C)(3) LINE 7 CMHC 0 BRIDGTON HOSPITAL 10 HOSPITAL DRIVE BRIDGTON ME 04009 010130427 HEALTHCARE ME 501(C)(3) LINE 3 CMHC 0 ELIAS E TUCKER TRUST FUND CO CMMC 300 MAIN STREET LEWISTON ME 04240 016042343 FUNDING ME 501(C)(3) LINE 12A, I CMMC 1 BRIDGTON HOSPITAL PHYSICIANS GROUP SOUTH HIGH STREET BRIDGTON ME 04009 010493083 FUNDING ME 501(C)(3) PF CMHC 0 CWM INSURANCE LTD GENESIS BUILDING PO BOX CJ 980220891 INSURANCE CJ N/A C 0 CENTRAL MAINE HEALTH VENTURES INC 300 MAIN STREET LEWISTON ME 04240 010430016 HEALTHCARE ME N/A C 0 CENTRAL MAINE ACO 300 MAIN STREET LEWISTON ME 04240 274604314 ACCOUNTABLE CARE ME N/A C 0 0 0 1 0 0 0 0 0 0 1 0 1 0 0 1 1 1 0 0 MAINE COLLEGE OF HEALTH PROFESSIONS O 2025691 COST