2022-05-16T08:59:10-05:00 2021-06-30 381357951 PLANTE & MORAN PLLC 250 S HIGH ST SUITE 100 COLUMBUS OH 43215 990 2020-07-01 010130427 BRIDGTON HOSPITAL BRID 2077952813 10 HOSPITAL DRIVE BRIDGTON ME 04009 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 STEVEN LITTLESON 10 HOSPITAL DRIVE BRIDGTON ME 04009 55206126 0 X WWW.BRIDGTONHOSITAL.ORG X 1917 ME BRIDGTON HOSPITAL STRIVES TO PROVIDE EXCEPTIONAL HEALTHCARE SERVICES AND DEPENDS ON CAREGIVER EXPERTISE AND THE COMMITMENT AND COMPASSION THEY PROVIDE TO FULFILL ITS MISSION. 13 11 414 30 0 0 2590331 890887 44879020 52584956 1884973 1679109 20999 51174 49375323 55206126 0 0 0 0 22057022 21822856 0 0 0 23935023 26623174 45992045 48446030 3383278 6760096 65319453 42315863 19312581 18799123 46006872 23516740 TO PROVIDE EXCEPTIONAL HEALTHCARE SERVICES IN A SAFE AND TRUSTFULENVIRONMENT THROUGH THE EXPERTISE, COMMITMENT, AND COMPASSION OFOUR FAMILY OF CAREGIVERS. 0 0 43196489 52617756 BRIDGTON HOSPITAL IS A CRITICAL ACCESS HOSPITAL SERVING 20 SURROUNDING COMMUNITIES PLUS THE MOUNT WASHINGTON VALLEY COMMUNITIES OF NEW HAMPSHIRE. THE HOSPITAL HAS A MEDICAL/SURGICAL UNIT, CRITICAL CARE UNIT, AND OBSTETRICAL UNIT WITH TWO BIRTHING SUITS. OUR TWO OPERATING ROOMS HANDLE GENERAL, ORTHOPEDIC, AND AMBULATORY SURGERY. THE HOSPITAL HAS A 24 HOUR EMERGENCY DEPARTMENT AND NUMEROUS PROFESSIONAL SERVICES INCLUDING CT SCANNING, MRI, NUCLEAR MEDICINE SPECT SCANNING, TREADMILL INCLUDING THALLIUM ONCOLOGY CLINIC, INPATIENT AND OUTPATIENT PHYSICAL THERAPY AND MEDICAL SCIENCES LIBRARY. 43196489 1 1 0 1 0 0 0 0 0 1 1 0 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 0 0 0 0 0 0 0 0 1 0 0 0 1 34 0 1 414 1 0 0 0 0 0 1 1 0 0 0 0 0 0 X 13 11 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 JENNIFER WEINER-SMITH MD PHYSICIAN/DIRECTOR 3.00 55.00 X 0 315310 26723 DEBORAH DUNLAP AVASTHI CHAIR PERSON/ DIRECTOR END 1/21 1.00 3.00 X 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 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 DAVID SALKO DIRECTOR BEG 1/21 3.00 55.00 X 0 333577 26982 HECTOR TARRAZA DIRECTOR BEG 1/21 3.00 55.00 X 0 233969 0 JOHN WHITLOCK TREASURER END 6/21 3.00 60.00 X 0 478758 2850 CORY BAGBY SECRETARY 3.00 60.00 X 0 415621 9842 PETER WRIGHT PRESIDENT BRIDGTON HOSPITAL 55.00 3.00 X 0 436017 13176 STEVEN LITTLESON PRESIDENT CMMC/CMHCC 3.00 60.00 X 0 429920 19602 ALAN LANGBURD PHYSICIAN 55.00 0.00 X 254154 0 6462 BERNARD PERLMAN PHYSICIAN 55.00 0.00 X 254767 0 8168 JOSEPH BELL PHYSICIAN 55.00 0.00 X 370346 0 24936 KATRINA SINK PHYSICIAN 55.00 0.00 X 237882 0 22049 LISA BOLINGER PHYSICIAN 55.00 0.00 X 258512 0 11107 1375661 3588775 391200 5 1 1 0 QUEST DIAGNOSTICS 500 PLAZA DRIVE SECAUCUS NJ 07094 LAB SERVICES 1715695 SODEXO INC 9801 WASHINGTONIAN BLVD GAITHERSBURG MD 20878 SUPPORT SERVICES 1616370 COMPREHENSIVE PHARMACY 6409 QUAIL HOLLOW ROAD MEMPHIS TN 38120 MEDICAL STAFFING 636021 WEATHERBY LOCUMS INC 6451 NORTH FEDERAL HIGHWAY SUITE 70 FORT LAUDERDALE FL 33308 MEDICAL STAFFING 620742 MAINE IMAGING SERVICES LLC 700 CONGRESS ST- SUITE 204 QUINCY MA 02169 MEDICAL SERVICES 515328 12 14450 876437 890887 NET PATIENT SERVICE REVENUE 621990 50761441 50761441 340B PHARMACY/REBATES 621990 1116152 1116152 INTERCOMPANY REVENUE 111085 707363 707363 52584956 176746 176746 32800 0 32800 32800 32800 1502363 0 1502363 1502363 1502363 TAX REFUNDS 900099 16658 16658 ADJUSTMENT ACCOUNTS 900099 1716 1716 18374 55206126 52617756 0 1697483 X 18900512 16065435 2835077 1826959 1552915 274044 1095385 931077 164308 46278 46278 12509601 12509601 1040 770 270 668861 494957 173904 780446 577530 202916 825331 610745 214586 1015 751 264 55609 41151 14458 194534 64196 130338 2189169 1291610 897559 235272 235272 MEDICAL SUPPLIES 7923750 7923750 MEDICAID TAX EXPENSE 1131960 1131960 LOAN FORGIVENESS 55472 55472 TAXES- PERSONAL PROPERT 4795 4795 41 41 48446030 43196489 5249541 0 376374 5390051 34535442 2061778 10640 4921321 6879540 0 0 0 0 0 0 557150 630954 85827 207342 42885082 30300104 14365847 12584978 7742643 12551026 0 0 0 0 248995 64985 2475214 1945209 65319453 42315863 4459171 3136917 1955175 0 259756 5662208 5454756 0 0 0 0 681468 3394686 0 0 6294803 6812764 19312581 18799123 X 42733572 20418808 3273300 3097932 46006872 23516740 65319453 42315863 X 6760096 117048 -29367276 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 1 0 0 0 0 0 1 7641 7641 0 PART II-B, LINE 1: PORTION OF DUES FOR PROFESSIONAL ASSOCIATIONS ATTRIBUTED TO LOBBYING 3273300 11634 521949 708951 3097932 3864503 28890 -10731 609362 3273300 4605710 508441 178303 1427951 3864503 4421122 75559 139533 30504 4605710 4296343 40152 138472 53845 4421122 0.60710 0.39290 0 1 1 737725 737725 20439382 11342604 9096778 21703203 18957500 2745703 4772 4772 12584978 CONTRACT LIABILITIES 4942044 CURRENT PORTION OF LEASE LIABILITIES- OPERATING 30155 CURRENT PORTION OF LEASE LIABILITIES- FINANCE 40999 LEASE LIABILITIES- OPERATING 31071 LEASE LIABILITIES- FINANCE 363343 ASSET RETIREMENT OBLIGATIONS 745387 OTHER LONG-TERM LIABILITIES 659765 6812764 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. OTHERS ARE DESIGNATED TO SUPPORT SPECIFIC DEPARTMENTS OF THE HOSPITAL. 1 1 X 1 X 0 1 1 0 0 1277848 701320 576528 0.01190 10970942 9308888 1662054 0.03430 12248790 10010208 2238582 0.04620 98788 95527 3261 0.00010 98788 95527 3261 0.00010 12347578 10105735 2241843 0.04630 0 5343568 892686 1329660 1316495 13165 X 1 1 1 1 BRIDGTON HOSPITAL 10 HOSPITAL DRIVE BRIDGTON ME 04009 WWW.BRIDGTONHOSPITAL.ORG 38658 X X X X OUTPATIENT PHYSICIAN CLINICS BRIDGTON HOSPITAL 1 0 0 1 X X X X X X X X X 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/PATIENTS-VISITORS/BILLING-FINANCIAL-INFORMATION/FINANC X HTTPS://WWW.CMHC.ORG/PATIENTS-VISITORS/BILLING-FINANCIAL-INFORMATION/FINANC X HTTPS://WWW.CMHC.ORG/PATIENTS-VISITORS/BILLING-FINANCIAL-INFORMATION/FINANC X X X X X X 1 X 0 X X X X 1 X 0 0 BRIDGTON 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 CUMBERLAND COUNTY. THECOUNTY HEALTH RANKINGS HEALTH ACTION FORUM WAS HELD ON JUNE 27, 2018. THEPURPOSE 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 IN MAINE. 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 OUTREACH REPORTING TOOL OR THE KEY INFORMANT REPORTING TOOL. BOTH OF THESE COLLECTION TOOLS WERE ONLINE SURVEYS WITHIN SURVEY MONKEY. OTHER DATA COLLECTION TOOLS INCLUDED TABLE FACILITATORS NOTES, FORUM REGISTRATIONS, AND SIGN-INS. BRIDGTON 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. BRIDGTON 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. BRIDGTON 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 THE SPECIFIC 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. BRIDGTON 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/BRIDGTON-HOSPITAL/ABOUT-BRIDGTON-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/BRIDGTON-HOSPITAL/ABOUT-BRIDGTON-HOSPITAL/COMMUNITY-BENEFITS/ 11 1 - BRIDGTON INTERNAL MEDICINE 25 HOSPITAL DRIVE BRIDGTON ME 04009 OUTPATIENT PHYSICIAN CLINIC 2 - BRIDGTON GENERAL SURGERY 25 HOSPITAL DRIVE BRIDGTON ME 04009 OUTPATIENT PHYSICIAN CLINIC 3 - BRIDGTON OBGYN 15 HOSPITAL DRIVE BRIDGTON ME 04009 OUTPATIENT PHYSICIAN CLINIC 4 - BRIDTON GASTROENTEROLOGY 15 HOSPITAL DRIVE BRIDGTON ME 04009 OUTPATIENT PHYSICIAN CLINIC 5 - BRIDGTON SPORTS MEDICINE 25 HOSPITAL DRIVE BRIDGTON ME 04009 OUTPATIENT PHYSICIAN CLINIC 6 - BRIDGTON PRIMARY CARE 25 HOSPITAL DRIVE BRIDGTON ME 04009 OUTPATIENT PHYSICIAN CLINIC 7 - PONDICHERRY FAMILY PRACTICE 15 HOSPITAL DRIVE BRIDGTON ME 04009 OUTPATIENT PHYSICIAN CLINIC 8 - NAPLES FAMILY PRACTICE 410 ROOSEVELT TRAIL NAPLES ME 04055 OUTPATIENT PHYSICIAN CLINIC 9 - BRIDGTON PEDIATRICS 25 HOSPITAL DRIVE BRIDGTON ME 04009 OUTPATIENT PHYSICIAN CLINIC 10 - NORTH BRIDGTON FAMILY PRACTICE 14 WYONEGONIC ROAD BRIDGTON ME 04009 OUTPATIENT PHYSICIAN CLINIC 11 - FRYEBURG FAMILY MEDICINE 253 BRIDGTON ROAD FRYEBURG ME 04037 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 USED THE ORGANIZATION'S COST ACCOUNTING SYSTEM. PART I, LN 7 COL(F): 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 CONVERGE 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 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. IF THE PATIENTS FALLING UNDER200% FPG LEVEL WERE NOT COVERED BY MEDICARE THEY WOULD QUALIFY UNDERBRIDGTON 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, BRIDGTON HOSPITAL ATTEMPTS TO PROVIDE ANYNEEDED HEALTH CARE SERVICES NECESSARY TO TREAT THE POPULATION OF THISRURAL AREA OF MAINE. ADDITIONALLY, BRIDGTON HOSPITAL FOCUSES ONSTATE-WIDE INITIATIVES, 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:BRIDGTON 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:BRIDGTON HOSPITAL, LOCATED IN BRIDGTON, MAINE, SERVES 21 TOWNS IN THE"LAKES REGION" OF WESTERN MAINE, AS WELL AS THE WESTERN MOUNTAINS OFMAINE AND THE MOUNT WASHINGTON VALLEY REGION OF NEW HAMPSHIRE. THE REGIONIS RURAL IN NATURE AND IS PRIMARILY MADE UP OF WESTERN CUMBERLAND ANDSOUTHERN OXFORD COUNTIES IN MAINE, AS WELL AS CARROLL COUNTY IN NEWHAMPSHIRE. THE REGION IS PRIMARILY MADE UP OF CAUCASIAN PERSONS AND HAS AVARIABLE POPULATION. THE REGION IS A SUMMER TOURIST DESTINATION AND THEPOPULATION SWELLS DRAMATICALLY DURING THAT SEASON, MAKING DEMOGRAPHICS SOMEWHAT FLUID. APPROXIMATELY 14% OF THE YEAR-ROUND POPULATION IS BELOWTHE POVERTY LEVEL. PART VI, LINE 5: PROMOTION OF COMMUNITY HEALTH:BRIDGTON HOSPITAL HAS AN OPEN MEDICAL STAFF, ALLOWING ANY NON-EMPLOYED ORAFFILIATED PHYSICIANS TO HAVE ADMITTING PRIVILEGES TO THE HOSPITAL. THEBOARD 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 BRIDGTON 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 BRIDGTON AND SURROUNDING COMMUNITIES. PART VI, LINE 6: AFFILIATED HEALTH CARE SYSTEM:AS A MEMBER OF THE CENTRAL MAINE HEALTHCARE SYSTEM, BRIDGTON HOSPITALPROVIDES HIGH QUALITY HEALTH CARE IN A RURAL SETTING WITH LIMITED HEALTH CARE 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 BRIDGTON AREA ON A REGULARSCHEDULE. THE SYSTEM PARENT, CENTRAL MAINE HEALTHCARE, PROVIDESSTREAMLINED ADMINISTRATIVE FUNCTIONS AND BACKROOM SERVICES, ALLOWINGBRIDGTON HOSPITAL TO PERFORM AT A COST-EFFICIENT LEVEL WHICH WOULDNORMALLY BE UNACHIEVABLE IN A SMALL, RURAL HOSPITAL, ALLOWING FOR BROADERRANGE OF SERVICES AVAILABLE. 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 JOSEPH BELL PHYSICIAN 343858 0 0 0 26488 0 2356 0 22580 0 395282 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 LISA BOLINGER PHYSICIAN 249646 0 0 0 8866 0 1748 0 9359 0 269619 0 0 0 BERNARD PERLMAN PHYSICIAN 228894 0 0 0 25873 0 1515 0 6653 0 262935 0 0 0 ALAN LANGBURD PHYSICIAN 249330 0 0 0 4824 0 2389 0 4073 0 260616 0 0 0 KATRINA SINK PHYSICIAN 175088 0 28564 0 34230 0 1523 0 20526 0 259931 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. A MAINE HEALTH AND HIGHER EDUCATIONAL FACILITIES 010314384 56042RLG5 2001-06-27 6150311 REFUND BOND SERIES 2001A 0 0 1 A 590000 6150311 68878 6083433 2017 1 0 1 1 A 0 1 0 0 0 0 0 0 0 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 SEPARATE QUESTIONNAIRE IS PROVIDED, WHICH INCLUDES DISTRIBUTION TO KEY EMPLOYEES, COVERING REPORTING AREAS OF LOANS, GRANTS, BUSINESS RELATIONSHIPS, AND OTHER CONFLICTS. THESE QUESTIONNAIRES ARE REVIEWED BY THE FINANCE DEPARTMENT FOR REPORTABLE ITEMS FOR THE FORM 990. IN THE CASE OF A POSSIBLE CONFLICT, THE BOARD WOULD REVIEW THE SITUATION AND TAKE ACTIONS DEEMED APPROPRIATE FOR THE POSSIBLE OR ACTUAL CONFLICTS OF MEMBERS OF THE BOARD OR THE EXECUTIVE OFFICERS. IN THE CASE OF KEY EMPLOYEES, THE REVIEW AND ACTIONS TAKEN WOULD BE PERFORMED BY THEIR DIRECT SUPERVISOR. 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 MEDICAL PROFESSIONAL SERVICES: PROGRAM SERVICE EXPENSES 12,509,601. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 12,509,601. FORM 990, PART XI, LINE 9: TRANSFER TO AFFILIATE -29,191,908. RESTRICTED CONTRIBUTIONS 11,634. RESTRICTED INVESTMENT INCOME 36,693. CHANGE IN UNREALIZED GAINS AND LOSSES ON INVESTMENTS 25,463. CHANGE IN INTEREST OF NET ASSETS OF CHARITABLE FOUNDATION 326,079. CHANGE IN RESTRICTED NET ASSETS OF OUTSIDE TRUST 133,714. NET ASSETS RELEASED FROM RESTRICTION -708,951. CENTRAL MAINE MEDICAL CENTER PO BOX 4500 LEWISTON ME 04243 010211494 HEALTHCARE ME 501(C)(3) LINE 3 CMHC 0 MAINE COLLEGE OF HEALTH PROFESSIONS PO BOX 4500 LEWISTON ME 04243 010356077 EDUCATION ME 501(C)(3) LINE 2 CMMC 0 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 EDUCATION ME 501(C)(3) LINE 7 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 0 BRIDGTON HOSPITAL PHYSICIANS GROUP SOUTH HIGH STREET BRIDGTON ME 04009 010493083 FUNDING ME 501(C)(3) PF CMHC 0 CENTRAL MAINE HEALTHCARE CORPORATION PO BOX 4500 LEWISTON ME 04243 010386913 HEALTHCARE ME 501(C)(3) LINE 7 N/A 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 B.W.I 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