2019-05-14T12:02:19-05:00 2018-06-30 BKD LLP 910 E ST LOUIS 200/PO BOX 1190 SPRINGFIELD MO 658062523 990 2017-07-01 010215227 RUMFORD HOSPITAL % DAVID THOMPSON RUMF 2077952813 420 FRANKLIN STREET RUMFORD ME 04276 DAVID THOMPSON TREASURER 2077952972 2019-03-07 true Brian D Todd P00422601 4178658701 167.68.126.162 43032920191345000014 2019-05-14 P 353840E92A19E57AE3D09FB5FB5D869273682438 39CBA67CBDC84C24964593991C1F330368A3BFFE 2017 2019-02-21 02:37:17Z PETER WRIGHT 420 FRANKLIN STREET RUMFORD ME 04276 45356583 false 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. 9 8 362 50 0 19410 105414 59811 44674220 43013513 133419 253740 -25201 -15151 44887852 43311913 18250 480 0 0 20015348 19481483 0 0 0 24746154 25171593 44779752 44653556 108100 -1341643 28508468 26983973 10206701 10009144 18301767 16974829 TO PROVIDE EXCEPTIONAL HEALTHCARE SERVICES IN A SAFE AND TRUSTFUL ENVIRONMENT THROUGH THE EXPERTISE, COMMITMENT AND COMPASSION OF OUR FAMILY OF CAREGIVERS. false false 36257061 480 43013513 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. 36257061 true true false true false false false false false true true false false true true false false true false false false false false false false false true true false false true false false false false false false false false false false false false false true false false false true X 29 0 true 362 true false false false false false false false false false false X 9 8 true false true false true true true true true false false true true true true true true false false false ME X DAVID THOMPSON 2077952813 300 MAIN STREET LEWISTON ME 04240 X JOLAN IPPOLITO CHAIR END 01/18; DIRECTOR 1.0 3.0 X X 0 0 0 ROGER ARSENAULT DIRECTOR END 01/18 1.0 0.0 X 0 0 0 RICHARD LOVEJOY SECRETARY END 01/18 1.0 1.0 X X 0 0 0 LINDA CAMERON OD VICE CHAIR/DIRECTOR END 01/18 1.0 0.0 X X 0 0 0 DAVID DUGUAY DIRECTOR END 01/18 1.0 0.0 X 0 0 0 JANET HALL DIRECTOR 1.0 3.0 X 0 0 0 JERROLD COHEN DIRECTOR END 01/18 1.0 0.0 X 0 0 0 THOMAS PUIIA DIRECTOR END 01/18 1.0 0.0 X 0 0 0 JEFF BRICKMAN DIRECTOR END 01/18; PRESIDENT 1.0 61.0 X X 0 866848 114974 MARK ADAMS DIRECTOR/VICE CHAIR BEG 01/18 1.0 5.0 X X 0 0 0 AUSTIN ALBERT DIRECTOR BEG 01/18 1.0 3.0 X 0 0 0 DEBORAH DUNLAP AVASTHI DIRECTOR/CHAIRPERSON BEG 01/18 1.0 3.0 X X 0 0 0 DOUGLAS M BOYD DIRECTOR BEG 01/18 1.0 3.0 X 0 0 0 WILLIAM LEE MD DIRECTOR BEG 01/18; PHYSICIAN 1.0 57.0 X 0 324839 45326 PHILLIP LIBBY DIRECTOR BEG 01/18 1.0 3.0 X 0 0 0 CRAIG TRIBUNO DIRECTOR BEG 01/18 1.0 3.0 X 0 0 0 R DAVID FRUM PRESIDENT 27.5 29.5 X 0 434019 72252 DAVID THOMPSON TREASURER 1.0 61.0 X 0 497762 58116 HOLLI BOCCELLI SECRETARY BEG 01/18 1.0 57.0 X 0 130845 0 DIETER KRECKEL PHYSICIAN CHIEF 45.0 0.0 X 246783 0 9946 THOMAS DELUCA PHYSICIAN 45.0 0.0 X 340226 0 46122 JACOB LEDESMA PHYSICIAN 45.0 0.0 X 458738 0 30122 JEFFREY LYNDS PHYSICIAN 45.0 0.0 X 378235 0 21497 STEPHANIE SINCLAIR PHYSICIAN 45.0 0.0 X 338462 0 26046 SAID DAOUD PHYSICIAN 45.0 0.0 X 353511 0 26886 PHILIPPE MORISSETTE FORMER TREASURER/VICE PRES. 0.0 55.0 X 0 229117 51773 2115955 2483430 503060 20 true true false SODEXO CLINICAL TECHNOLOGY 7100 COMMERCE WAY 280 NASHVILLE TN 37241 MAINTENANCE 275639 SODEXO INC 525 WILLIAM PENN PL PITTSBURGH PA 152516170 SUPPORT SERVICES 179362 CHG COMPANIES INC 5003 SOUTH MIAMI BLVD SUITE 400 DURHAM NC 27703 MEDICAL STAFFING 134770 INSIGHT HEALTH CORP 26250 ENTERPRISE COURT SUITE 100 LAKE FOREST CA 92630 MEDICAL IMAGING 277977 X RAY PROFESSIONAL ASSOCIATION 300 MAIN STREET LEWISTON ME 04240 MEDICAL IMAGING 121290 6 6789 13795 39227 59811 NET PATIENT SERVICE REVENUE 900099 41041186 41041186 CAFETERIA REVENUE 722514 77402 77402 OTHER REVENUE 900099 1894925 1894925 43013513 118652 118652 0 0 11086 26237 -15151 0 -15151 -15151 2153521 1967231 51202 186290 -51202 135088 135088 0 0 0 0 0 0 0 0 0 0 43311913 43013513 238589 X 480 480 0 0 0 256729 256729 0 15668574 11955362 3713212 343081 263037 80044 2187331 1674684 512647 1025768 786446 239322 0 1005 1005 14438 14438 0 0 9364 9364 8727478 6691270 2036208 3012 2309 703 2484711 1905890 578821 596485 457319 139166 0 925556 709615 215941 108825 83435 25390 0 17658 13538 4120 42127 32298 9829 0 1753502 1344392 409110 1247723 956617 291106 MEDICAL SUPPLIES & DRUGS 4676119 4676119 BAD DEBT 4066104 4066104 REPAIRS & MAINTENANCE 396433 303941 92492 LICENSES, DUES, SUBSCRIPTIONS 78846 60450 18396 22207 17026 5181 44653556 36257061 8396495 0 25619 26547 2259310 2280964 0 0 4157450 3846115 0 0 0 0 0 0 434404 559047 76280 49181 36502190 24288426 12412713 12213764 6076045 4169100 0 0 0 0 492423 394546 2574224 3444709 28508468 26983973 9227462 8234228 0 0 32667 33926 0 0 0 0 0 0 946572 884735 0 0 0 856255 10206701 10009144 X 17726024 16388636 321715 331071 254028 255122 18301767 16974829 28508468 26983973 X -1341643 13605 1100 X false true X true false X false false false false false false false false true 8451 8451 false SCHEDULE C, PART II-B, LINE 1I LOBBYING EXPENSES: PORTION OF DUES FOR PROFESSIONAL ASSOCIATIONS ATTRIBUTED TO LOBBYING EXPENSES - $8,451. 575743 9356 1094 586193 504309 70344 1090 575743 508032 11339 -3803 11259 504309 504227 4434 -629 508032 491674 9235 3518 200 504227 0.43520 0.56480 false true true 89148 89148 15018411 7985772 7032639 20977656 15994952 4982704 416975 307702 109273 12213764 EST AMT DUE FROM THIRD PARTIES 2883631 INVESTMENT IN CHARITABLE TRUST 65674 OTHER RECEIVABLES 494504 DEPOSITS 900 3444709 0 DUE TO AFFILIATES 856255 856255 SCHEDULE D, PART V, LINE 4 ENDOWMENT FUNDS: ENDOWMENT FUNDS ARE USED TO SUPPORT THE ORGANIZATION IN A VARIETY OF WAYS, DEPENDING UPON THE STATED PURPOSE OF EACH FUND. MANY OF THESE FUNDS HELP TO COVER COSTS OF CAPITAL EQUIPMENT PURCHASES, CONTINUING EDUCATION, OR FREE CARE. OTHER ARE DESIGNATED TO SUPPORT SPECIFIC DEPARTMENTS OF THE HOSPITAL. SCHEDULE D, PART X, LINE 2 UNCERTAIN TAX POSITION: MANAGEMENT HAS EVALUATED THEIR INCOME TAX POSITIONS UNDER THE GUIDANCE INCLUDED IN ASC 740. BASED ON THEIR REVIEW, MANAGEMENT HAS NOT IDENTIFIED ANY MATERIAL UNCERTAIN TAX POSITIONS TO BE RECORDED OR DISCLOSED IN THE FINANCIAL STATEMENTS. true true X true X false true true false false 504315 504315 0.01240 10172999 7848329 2324670 0.05730 10677314 7848329 2828985 0.06970 695 695 695 695 10678009 7848329 2829680 0.06970 false 4066104 628765 13192813 12809655 383158 X true true 1 1 RUMFORD HOSPITAL 420 FRANKLIN STREET RUMFORD ME 04276 WWW.RUMFORDHOSPITAL.ORG 38727 X X X X OUTPATIENT PHYSICIAN CLINICS 1 RUMFORD HOSPITAL 1 false false true X X X X X X X X X 15 true true true true X SEE PART V, SECTION C X WWW.MAINE.GOV/SHNAPP/ X true 15 true SEE PART V, SECTION C false true X 200. 0. X X X true true X X X true X SEE PART V, SECTION C X SEE PART V, SECTION C X SEE PART V, SECTION C X X X X X true X false X X X true X false false SCHEDULE H, PART V, SECTION B, LINE 5 COMMUNITY INPUT: QUALITATIVE DATA WERE COLLECTED THROUGH A STATEWIDE STAKEHOLDER SURVEY CONDUCTED IN MAY AND JUNE 2015 WITH 1,639 PEOPLE REPRESENTING MORE THAN 80 ORGANIZATIONS AND BUSINESSES IN MAINE. THE SURVEY WAS DEVELOPED USING A COLLABORATIVE PROCESS THAT INCLUDED MAINE SHNAPP PARTNERS, MARKET DECISIONS RESEARCH AND HART CONSULTING, AND A NUMBER OF OTHER STAKEHOLDERS AND HEALTH EXPERTS. IN OXFORD COUNTY, A TOTAL OF 61 STAKEHOLDERS RESPONDED TO THE SURVEY. THE OBJECTIVE OF THE SURVEY WAS TO PRODUCE QUALITATIVE DATA OF THE OPINIONS OF HEALTH PROFESSIONALS AND COMMUNITY STAKEHOLDERS ON THE HEALTH ISSUES AND NEEDS OF COMMUNITIES ACROSS THE STATE. GIVEN THIS PURPOSE, THE SURVEY USED A SNOWBALL SAMPLING APPROACH BY INVITING LEADERS OF MEMBER ORGANIZATIONS AND AGENCIES TO INVITE THEIR MEMBERS AND EMPLOYEES TO PARTICIPATE. A CONCERTED EFFORT WAS MADE TO RECRUIT PARTICIPANTS FROM A NUMBER OF DIFFERENT INDUSTRIES AND BACKGROUNDS ACROSS ALL COMMUNITIES IN THE STATE. SURVEY RESPONDENTS REPRESENTED PUBLIC HEALTH AND HEALTH CARE ORGANIZATIONS AS WELL AS BEHAVIORAL HEALTH, BUSINESS, MUNICIPALITIES, EDUCATION, PUBLIC SAFETY, AND NONGOVERNMENTAL ORGANIZATIONS. MORE THAN 80 ORGANIZATIONS AGREED TO SEND THE SURVEY TO THEIR MEMBERS OR STAKEHOLDERS. THE ONLINE SURVEY WAS APPROXIMATELY 25 MINUTES IN LENGTH AND CONTAINED A NUMBER OF QUESTIONS ABOUT IMPORTANT HEALTH ISSUES AND DETERMINANTS IN THE STATE, INCLUDING A RATING OF MOST CRITICAL ISSUES, THE ABILITY OF MAINE'S HEALTH SYSTEM (INCLUDING PUBLIC HEALTH) TO RESPOND TO ISSUES, AVAILABILITY OF RESOURCES AND ASSETS TO ADDRESS SPECIFIC HEALTH ISSUES, IMPACT ON DISPARATE POPULATIONS, AND IDENTIFICATION OF THE ENTITIES PRIMARILY RESPONSIBLE FOR ADDRESSING ISSUES AND DETERMINANTS. THE SURVEY ASKED ALL RESPONDENTS A BASIC SET OF QUESTIONS TO RATE THE IMPORTANCE OF HEALTH ISSUES AND IMPACT OF HEALTH FACTORS. IT THEN ALLOWED RESPONDENTS TO PROVIDE ANSWERS TO PROBING QUESTIONS ON THE THREE ISSUES AND FACTORS THAT THEY WERE MOST INTERESTED IN OR HAD THE MOST KNOWLEDGE ABOUT. RESPONDENTS PROVIDED OVER 12,000 OPEN-ENDED COMMENTS TO THESE IN-DEPTH PROBING QUESTIONS IN THE SURVEY. THE MARKET DECISIONS RESEARCH/HART CONSULTING TEAM REVIEWED, CODED, AND CLEANED ALL OPEN-ENDED COMMENTS FOR SIMILAR AND RECURRENT THEMES. NOT ALL RESPONDENTS SHARED COMMENTS FOR THE PROBING QUESTIONS. SCHEDULE H, PART V, SECTION B, LINE 6A HOSPITAL FACILITIES: THE CHNA WAS CONDUCTED WITH EASTERN MAINE HEALTHCARE SYSTEMS AND MAINE GENERAL MEDICAL CENTER. SCHEDULE H, PART V, SECTION B, LINE 6B NON-HOSPITAL FACILITIES: THE CHNA WAS ALSO CONDUCTED WITH MAINE HEALTH AND MAINE CENTER FOR DISEASE CONTROL AND PREVENTION. SCHEDULE H, PART V, SECTION B, LINE 7A HOSPITAL FACILITY'S WEBSITE: https://www.cmhc.org/rumford-hospital/about-us/community-benefits SCHEDULE H, PART V, SECTION B, LINE 10A IMPLEMENTATION STRATEGY WEBSITE: https://www.cmhc.org/rumford-hospital/about-us/community-benefits SCHEDULE H, PART V, SECTION B, LINE 11 ADDRESSING IDENTIFIED NEEDS: IN SUPPORT OF THE 2015 MAINE SHARED HEALTH NEEDS ASSESSMENT AND PLANNING PROCESS PROJECT, RUMFORD HOSPITAL ENGAGED IN AN ASSESSMENT OF THE HEALTH NEEDS OF OXFORD COUNTY. RUMFORD HOSPITAL'S GOAL IS TO RESPOND TO IDENTIFIED COMMUNITY HEALTH NEEDS, PROVIDE ACCESS AND IMPROVE HEALTH STATUS FOR ALL CITIZENS; ESPECIALLY THE VULNERABLE AND UNDERSERVED, AND BE A LEADING INSTITUTION OF IMPROVED HEALTH FOR THE COMMUNITIES WE SERVE. COMMUNITY FORUMS WERE HELD WITH CITIZENS OF OXFORD COUNTY ATTENDING A VARIETY OF FOCUS GROUPS TO DISCUSS THE CURRENT AND FUTURE HEALTH NEEDS IN OUR REGION. INPUT PROVIDED DURING THE DISCUSSION GROUPS WAS SUMMARIZED INTO THREE COMMUNITY HEALTH CONCERNS THAT HAVE BECOME RUMFORD HOSPITAL'S IMPLEMENTATION STRATEGY. - SUBSTANCE ABUSE: COMMUNITY OUTREACH, EDUCATIONAL SESSIONS, AND LOCAL DRUG/ALCOHOL COALITION INVOLVEMENT - MENTAL HEALTH: (FREE) EDUCATIONAL SESSIONS AND MENTAL HEALTH AWARENESS - HUNGER: EDUCATION ON HEALTHY EATING; WORKING WITH AGENCIES PRODUCING FOOD AVAILABILITY INCREASING HEALTH TO THE COMMUNITY WE SERVE. A LOCAL COMMUNITY STAKEHOLDER GROUP WORKED TOGETHER TO ANALYZE THE RESULTS FROM THE ONEMAINE CHNA FOR THE OXFORD COUNTY COMMUNITY WITH THE HEALTH CARE INDICATORS OF CONCERN BRIDGED WITH HEALTH 2020, SUPPORTING THE DEVELOPMENT OF THE RUMFORD HOSPITAL'S COMMUNITY BENEFIT IMPLEMENTATION PLAN. THE IMPLEMENTATION STRATEGY HAS BEEN ADJUSTED FOR FISCAL YEAR 6/30/2018. ADDRESSING FOOD INSECURITY THROUGH THE HUNGER VITAL SIGNS PROGRAM: TO ADDRESS FOOD INSECURITY, IDENTIFIED AS A TOP COMMUNITY HEALTH NEED IN THE PREVIOUS COMMUNITY HEALTH NEEDS ASSESSMENT, RUMFORD HOSPITAL LAUNCHED A PILOT PROGRAM WITH MAINES LEADING FOOD INSECURITY ORGANIZATION, GOOD SHEPHERD FOOD BANK. THE PILOT PROGRAM, CALLED HUNGER VITAL SIGNS, UTILIZES A TWO QUESTION INPATIENT SCREENING TO IDENTIFY PATIENTS WITHOUT ADEQUATE FOOD. PATIENTS NEEDING FOOD ASSISTANCE ARE PROVIDED REFERRALS TO LOCAL FOOD PANTRIES AND A BAG OF SHELF STABLE HEALTHY FOODS UPON HOSPITAL DISCHARGE. DURING THE PILOT PROGRAM, 696 FOOD INSECURITY SCREENINGS WERE CONDUCTED, 58 OR 8% OF PATIENTS IDENTIFIED AS FOOD INSECURE. 47 PATIENTS WERE PROVIDED A COMMUNITY FOOD RESOURCE HANDOUT AND A BAG OF FOOD. IN TOTAL, 750 POUNDS OF HEALTHY FOOD ITEMS WERE DISTRIBUTED. THE PILOT WAS SO SUCCESSFUL THAT IT CONTINUES INTO FY19. COMMUNITY HEALTH NEEDS ASSESSMENT PLANNING: DURING FY2018, RUMFORD HOSPITAL STAFF PARTICIPATED IN PLANNING FOR THE COMMUNITY HEALTH NEEDS ASSESSMENT PROCESS. RUMFORD HOSPITAL PARTICIPATES IN A COMMUNITY HEALTH NEEDS ASSESSMENT COLLABORATIVE CALLED THE MAINE SHARED CHNA WITH ALL OTHER MAINE HOSPITAL SYSTEMS AND THE STATE HEALTH DEPARTMENT. PLANNING INCLUDED HIRING A STATEWIDE CHNA COORDINATOR, IDENTIFYING WHICH QUANTITATIVE INDICATORS WOULD BE REPORTED AND PLANNING FOR QUALITATIVE DATA COLLECTION ACROSS THE STATE. OTHER COMMUNITY BENEFIT SUPPORT SERVICES: IN FY18, RUMFORD HOSPITAL PROVIDED A NUMBER OF SUPPORT SERVICES FOR THE COMMUNITY SUCH AS ADVANCE CARE PLANNING EDUCATION AND OPPORTUNITIES TO WALK WITH A DOC. SCHEDULE H, PART V, SECTION B, LINE 13H FAP ELIGIBILITY CRITERIA: PATIENTS MUST APPLY FOR MAINE FREE CARE IN ORDER TO BEING CONSIDERED FOR THE HOSPITAL'S FREE CARE PROGRAM. AS PART OF THE APPLICATION, PATIENTS MUST SUBMIT A COPY OF CURRENT MAINECARE DECISION LETTERS. PATIENTS WILL BE ASKED IF THEY HAVE INSURANCE OF ANY KIND TO HELP PAY FOR CARE AND ARE ALSO ASKED TO SHOW THAT INSURANCE OR A GOVERNMENT PROGRAM WILL NOT PAY FOR YOUR CARE. IF PATIENTS DO NOT QUALIFY FOR FREE HOSPITAL CARE, THEY ARE ALLOWED TO ASK FOR A FAIR HEARING OR APPEAL. SCHEDULE H, PART V, SECTION B, LINES 16A, 16B, & 16C MEASURES TO PUBLICIZE THE POLICY: https://www.cmhc.org/billing-and-financial-information/ SCHEDULE H, PART V, LINE 16I LEP TRANSLATIONS: THERE ARE NO GROUPS WITH LIMITED ENGLISH PROFICIENCY THAT RISE TO THE THRESHOLD REQUIRED UNDER THE IRC SECTION 501(R). 5 ELSEMORE DIXFIELD FAMILY MEDICINE 146 WELD STREET DIXFIELD ME 04224 OUTPATIENT PHYSICIAN CLINIC SWIFT RIVER FAMILY MEDICINE 430 FRANKLIN STREET RUMFORD ME 04276 OUTPATIENT PHYSICIAN CLINIC RIVER VALLEY INTERNAL MEDICINE 431 FRANKLIN STREET RUMFORD ME 04276 OUTPATIENT PHYSICIAN CLINIC RUMFORD SPECIALTY SERVICES CLINIC 431 FRANKLIN STREET RUMFORD ME 04276 OUTPATIENT PHYSICIAN CLINIC RUMFORD SURGICAL SPECIALISTS 431 FRANKLIN STREET RUMFORD ME 04276 OUTPATIENT PHYSICIAN CLINIC SCHEDULE H, PART I, LINE 1C FAP ELIGIBILITY CRITERIA: PATIENTS MUST APPLY FOR MAINE FREE CARE IN ORDER TO BE CONSIDERED FOR THE HOSPITAL'S FREE CARE PROGRAM. AS PART OF THE APPLICATION, PATIENTS MUST SUBMIT A COPY OF CURRENT MAINECARE DECISION LETTERS. PATIENTS WILL BE ASKED IF THEY HAVE INSURANCE OF ANY KIND TO HELP PAY FOR CARE AND ARE ALSO ASKED TO SHOW THAT INSURANCE OR A GOVERNMENT PROGRAM WILL NOT PAY FOR YOUR CARE. IF PATIENTS DO NOT QUALIFY FOR FREE HOSPITAL CARE, THEY ARE ALLOWED TO ASK FOR A FAIR HEARING OR APPEAL. SCHEDULE H, PART I, LINE 7, COLUMN F PERCENT OF TOTAL EXPENSE: TO ARRIVE AT THE PERCENT OF TOTAL EXPENSES, THE DENOMINATOR WHICH EQUALS TOTAL OPERATING EXPENSES PER PART I LINE 25 OF THE FORM 990, WAS REDUCED BY BAD DEBT OF $4,066,104. SCHEDULE H, 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. SCHEDULE H, PART III, SECTION A, LINE 2 BAD DEBT EXPENSE: LINE 2 REPORTS BAD DEBT EXPENSE FROM THE ORGANIZATION'S AUDITED FINANCIAL STATEMENTS. SCHEDULE H, PART III, SECTION A, LINE 3 BAD DEBT EXPENSE ATTRIBUTABLE TO CHARITY CARE: BAD DEBT ATTRIBUTABLE TO PATIENTS UNDER THE ORGANIZATION'S CHARITY CARE POLICY FOR LINE 3 WAS DETERMINED USING A COMPARISON OF EXPERIENCED CHARITY CARE COVERAGE AND US CENSUS BUREAU DATA FOR THE MOST RECENT YEAR AVAILABLE WHEN CHARITY CARE COVERAGE EXCEEDS THE CENSUS DATA, A MINIMAL AMOUNT OF BAD DEBT IS ASSUMED TO BE ELIGIBLE FOR CHARITY CARE TO ACCOUNT FOR THOSE PATIENTS WHO REFUSE TO PROVIDE INFORMATION DOCUMENTING ELIGIBILITY FOR THE PROGRAM. THESE ESTIMATES ARE BASED ON STATE-WIDE DATA AND DO NOT ACCOUNT FOR DIFFERENCES IN GEOGRAPHIC LOCATIONS WITHIN THE STATE. AS THIS AMOUNT IS RELATED TO PATIENTS ELIGIBLE UNDER THE FINANCIAL ASSISTANCE POLICY, IT SHOULD BE INCLUDED AS A COMMUNITY BENEFIT. SCHEDULE H, PART III, SECTION A, LINE 4 BAD DEBT EXPENSE FOOTNOTE: THE AUDITED FINANCIAL STATEMENTS DO NOT CONTAIN A FOOTNOTE THAT DESCRIBES BAD DEBT EXPENSE. THEY DO, HOWEVER, CONTAIN A FOOTNOTE THAT DESCRIBES PATIENT ACCOUNTS RECEIVABLE. THAT FOOTNOTE READS AS FOLLOWS: ACCOUNTS RECEIVABLE ARE REDUCED BY AN ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS. IN EVALUATING THE COLLECTABILITY OF ACCOUNTS RECEIVABLE, THE CORPORATION ANALYZES ITS PAST HISTORY AND IDENTIFIES TRENDS FOR EACH OF ITS MAJOR PAYER SOURCES OF REVENUE TO ESTIMATE THE APPROPRIATE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS AND PROVISION FOR UNCOLLECTIBLE ACCOUNTS. MANAGEMENT REGULARLY REVIEWS DATA ABOUT THESE MAJOR PAYER SOURCES OF REVENUE IN EVALUATING THE SUFFICIENCY OF THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS. FOR RECEIVABLES ASSOCIATED WITH SERVICES PROVIDED TO PATIENTS WHO HAVE THIRD-PARTY COVERAGE, THE CORPORATION ANALYZES CONTRACTUALLY DUE AMOUNTS AND PROVIDES AN ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS AND A PROVISION FOR UNCOLLECTIBLE ACCOUNTS, IF NECESSARY (FOR EXAMPLE, FOR EXPECTED UNCOLLECTIBLE DEDUCTIBLES AND COPAYMENTS ON ACCOUNTS FOR WHICH THE THIRD-PARTY PAYER HAS NOT YET PAID, OR FOR PAYERS WHO ARE KNOWN TO BE HAVING FINANCIAL DIFFICULTIES THAT MAKE THE REALIZATION OF AMOUNTS DUE UNLIKELY). 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 A SIGNIFICANT PROVISION FOR UNCOLLECTIBLE ACCOUNTS 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. THE DIFFERENCE BETWEEN THE STANDARD RATES (OR THE DISCOUNTED RATES IF NEGOTIATED OR PROVIDED BY POLICY) AND THE AMOUNTS ACTUALLY COLLECTED AFTER ALL REASONABLE COLLECTION EFFORTS HAVE BEEN EXHAUSTED IS CHARGED OFF AGAINST THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS. SCHEDULE H, PART III, SECTION B, LINE 8 COMMUNITY BENEFIT: THE COSTING METHODOLOGY USED FOR LINE 6 IS INFORMATION PULLED FROM THE MEDICARE COST REPORT FILING. ANY SHORTFALL REPORTED ON LINE 7 COULD BE CONSIDERED COMMUNITY BENEFIT TO A LEVEL PROPORTIONAL TO THE POVERTY LEVELS INDICATED BY CENSUS BUREAU DATA. IF THE PATIENTS FALLING UNDER 200% FPG LEVEL WERE NOT COVERED BY MEDICARE THEY WOULD QUALIFY UNDER RUMFORD HOSPITAL'S FREE CARE POLICY. UNDER THAT CIRCUMSTANCE, THESE PATIENTS WOULD THEN APPEAR AS PART OF THE STATISTICS ON PART I, LINE 7A. SCHEDULE H, PART III, SECTION C, LINE 9B COLLECTION POLICY: COLLECTION PRACTICES FOR PATIENTS KNOWN TO BE ELIGIBLE FOR CHARITY CARE ARE LIMITED TO COLLECTING FROM ANY AVAILABLE PAYMENT SOURCES SUCH AS MEDICARE OR MEDICAID. IF A PATIENT IS ELIGIBLE, BUT HAS NOT APPLIED FOR MEDICAID COVERAGE, THE PATIENT IS REQUESTED TO APPLY. ASSISTANCE IS AVAILABLE TO HELP THE PATIENT WITH THE MEDICAID APPLICATION PROCESS. SCHEDULE H, PART VI, LINE 2 NEEDS ASSESSMENT: AS A CRITICAL ACCESS HOSPITAL, RUMFORD HOSPITAL ATTEMPTS TO PROVIDE ANY NEEDED HEALTH CARE SERVICES NECESSARY TO TREAT THE POPULATION OF THIS RURAL AREA OF MAINE, ADDITIONALLY, RUMFORD HOSPITAL FOCUSES ON STATE-WIDE INITIATIVES, SUCH AS HEART DISEASE AND DIABETES, AS WELL AS ORGANIZATIONAL INITIATIVES BASED ON NEEDS OBSERVED WITHIN ITS PATIENT POPULATION. MANY FORMS OF EDUCATION, PREVENTION AND EARLY DETECTION ARE ALSO PART OF ITS COMMUNITY HEALTH CARE PLAN. SCHEDULE H, PART VI, LINE 3 PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE: RUMFORD HOSPITAL PROVIDES NOTICES ABOUT ITS FREE CARE POLICY IN ALL CLINICAL DEPARTMENTS AND MAJOR PATIENT AREAS. AN INPATIENT FINANCIAL COUNSELOR VISITS WITH ALL UNINSURED PATIENTS TO DISCUSS OPTIONS, INCLUDING GOVERNMENTAL PROGRAM ELIGIBILITY AND FREE CARE ASSISTANCE IS AVAILABLE TO HELP PATIENTS WITH COMPLETION OF MEDICAID APPLICATIONS. ALL PATIENT FINANCIAL SERVICES STAFF ARE TRAINED TO OFFER FREE CARE AS AN OPTION TO PATIENTS WHO INDICATE AN INABILITY OR DIFFICULTY IN PAYING FOR SERVICES. INFORMATION ABOUT FINANCIAL ASSISTANCE AVAILABILITY IS INCLUDED ON THE BACK OF EVERY PATIENT STATEMENT. ADDITIONALLY, UNINSURED PATIENTS RECEIVE A SEPARATE INFORMATION SHEET WITH THEIR STATEMENTS, FURTHER INFORMING THEM ABOUT THE AVAILABLE OPTIONS. SCHEDULE H, PART VI, LINE 4 COMMUNITY INFORMATION: RUMFORD HOSPITAL, LOCATED IN RUMFORD, MAINE, SERVES CENTRAL OXFORD COUNTY ALONG THE WESTERN BORDER OF MAINE. A LIGHTLY POPULATED, RURAL AREA AGED 65 OR OVER AND 14% OF THE POPULATION BELOW THE POVERTY LEVEL. SCHEDULE H, PART VI, LINE 5 PROMOTION OF COMMUNITY HEALTH: RUMFORD HOSPITAL HAS AN OPEN MEDICAL STAFF, ALLOWING ANY NON-EMPLOYED OR AFFILIATED PHYSICIANS TO HAVE ADMITTING PRIVILEGES TO THE HOSPITAL. THE BOARD OF DIRECTORS IS MADE UP OF A MAJORITY OF LOCAL COMMUNITY MEMBERS ALONG WITH SOME REPRESENTATION BY DIRECTORS FROM CENTRAL MAINE HEALTHCARE, THE PARENT OF THE HEALTHCARE SYSTEM WHICH RUMFORD HOSPITAL BELONGS TO, HELPING TO BRING TOGETHER THE VISIONS OF THE LOCAL COMMUNITY WITH THE CAPABILITIES AND VISION OF THE SYSTEM AS A WHOLE FOR THE BENEFIT OF RUMFORD AND SURROUNDING COMMUNITIES. SCHEDULE H, PART VI, LINE 6 AFFILIATED HEALTH CARE SYSTEM: AS A MEMBER OF THE CENTRAL MAINE HEALTHCARE SYSTEM, RUMFORD HOSPITAL PROVIDES HIGH QUALITY HEALTH CARE IN A RURAL SETTING WITH LIMITED HEALTH CARE OPTIONS. ITS AFFILIATION WITH CENTRAL MAINE MEDICAL CENTER PROVIDES ACCESS TO A MUCH LARGER, TERTIARY CARE HOSPITAL, INCLUDING TRAUMA CARE, NEONATAL INTENSIVE CARE, AND A SPECIALIZED CARDIAC CARE UNIT. ADDITIONALLY, CENTRAL MAINE MEDICAL CENTER PROVIDES ACCESS TO SPECIALIST PHYSICIANS FOR OUTPATIENT CARE IN THE RUMFORD AREA ON A REGULAR SCHEDULE. THE SYSTEM PARENT, CENTRAL MAINE HEALTHCARE, PROVIDES STREAMLINED ADMINISTRATIVE FUNCTIONS AND BACKROOM SERVICES, ALLOWING RUMFORD HOSPITAL TO PERFORM AT A COST EFFICIENT LEVEL WHICH WOULD NORMALLY BE UNACHIEVABLE IN A SMALL, RURAL HOSPITAL, ALLOWING FOR BROADER RANGE OF SERVICES AVAILABLE. false true false false false false false false false R DAVID FRUM PRESIDENT 0 316949 0 80325 0 36745 0 50755 0 21497 0 506271 0 27134 JEFF BRICKMAN DIRECTOR END 01/18; PRESIDENT 0 659404 0 195000 0 12444 0 94125 0 20849 0 981822 0 0 DAVID THOMPSON TREASURER 0 379692 0 92500 0 25570 0 45125 0 12991 0 555878 0 0 WILLIAM LEE MD DIRECTOR BEG 01/18; PHYSICIAN 0 299378 0 18317 0 7144 0 24625 0 20701 0 370165 0 0 THOMAS DELUCA PHYSICIAN 311915 0 23867 0 4444 0 24625 0 21497 0 386348 0 0 0 JACOB LEDESMA PHYSICIAN 351689 0 103443 0 3606 0 6625 0 23497 0 488860 0 0 0 JEFFREY LYNDS PHYSICIAN 284729 0 90466 0 3040 0 0 0 21497 0 399732 0 0 0 STEPHANIE SINCLAIR PHYSICIAN 242576 0 93227 0 2659 0 6625 0 19421 0 364508 0 0 0 SAID DAOUD PHYSICIAN 296755 0 51725 0 5031 0 5389 0 21497 0 380397 0 0 0 DIETER KRECKEL PHYSICIAN CHIEF 235956 0 5192 0 5635 0 6486 0 3460 0 256729 0 0 0 PHILIPPE MORISSETTE FORMER TREASURER/VICE PRES. 0 226974 0 0 0 2143 0 43774 0 7999 0 280890 0 0 SCHEDULE J, PART I, LINE 3 EXECUTIVE COMPENSATION: THE COMPENSATION OF THE ORGANIZATION'S PRESIDENT IS DETERMINED BY THE PARENT CORPORATION'S BOARD OF DIRECTORS' EXECUTIVE COMPENSATION COMMITTEE USING THE FOLLOWING: -COMPENSATION COMMITTEE -INDEPENDENT COMPENSATION CONSULTANT -COMPENSATION SURVEY OR STUDY -APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE SCHEDULE J, 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 PARTICIPANT'S EMPLOYMENT FOR ANY REASON OTHER THAN FOR CAUSE ANY PORTION OF THE PARTICIPANT'S ENTITLEMENT BENEFITS THAT IS NOT VESTED WHEN THE PARTICIPANT'S EMPLOYMENT WITH THE EMPLOYER TERMINATES, INCLUDING ELECTIVE DEFERRALS, WILL BE FORFEITED. THE EMPLOYER WILL DISTRIBUTE A PARTICIPANT'S BENEFITS UNDER THE PLAN AS SOON AS PRACTICABLE AFTER THE PARTICIPANT'S ENTITLEMENT BECOMES VESTED. THE FOLLOWING INDIVIDUALS PARTICIPATED IN A SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN THROUGH CENTRAL MAINE HEALTHCARE CORPORATION, A RELATED ENTITY. $ 27,134 R. DAVID FRUM (DISTRIBUTION) 26,130 R. DAVID FRUM (DEFERRAL) 69,500 JEFF BRICKMAN (DEFERRAL) 20,500 DAVID THOMPSON (DEFERRAL) 38,000 PHILIPPE MORISSETTE (DEFERRAL) SCHEDULE J, PART II, COLUMN F COMPENSATION REPORTED IN PRIOR FORM 990: COMPENSATION IS REPORTED ON THE FORM 990 IN THE YEAR THAT THE COMPENSATION IS EARNED BY OR AWARDED TO AN INDIVIDUAL, EVEN IF THE COMPENSATION IS NOT PAID TO THE INDIVIDUAL, IS NOT FULLY VESTED, OR IS SUBJECT TO SUBSTANTIAL RISK OF FORFEITURE. IF COMPENSATION IS EARNED OR AWARDED IN ONE YEAR BUT PAID IN A LATER YEAR, THEN THE COMPENSATION IS REPORTED A SECOND TIME ON THE FORM 990 IN THE YEAR THE COMPENSATION IS VESTED OR PAID TO THE INDIVIDUAL. FORM 990, PART V, LINE 1A & 2A COMMON PAYMASTER: RUMFORD HOSPITAL IS A TAX EXEMPT ORGANIZATION WHICH FILES ITS PAYROLL FORMS AND REPORTS WITH THE IRS AND DOL ON A CONSOLIDATED BASIS UNDER ITS PARENT, CENTRAL MAINE HEALTHCARE CORPORATION, USING THE PARENT'S EIN. THIS INCLUDES FORM 941'S, W-2'S AND OTHER RELATED FILINGS. FORM 990, PART VI, SECTION A, LINE 2 BUSINESS RELATIONSHIP: JEFF BRICKMAN, R. DAVID FRUM, WILLIAM LEE, MD, HOLLI BOCCELLI, PHILIPPE MORISSETTE, AND DAVID THOMPSON HAVE A BUSINESS RELATIONSHIP THROUGH THEIR EMPLOYMENT WITH A RELATED ORGANIZATION. FORM 990, PART VI, SECTION A, LINE 4 SIGNIFICANT CHANGES TO BYLAWS: THE BYLAWS AND ARTICLES OF INCORPORATION WERE AMENDED DURING THE YEAR AND CONTAINED THE FOLLOWING SIGNIFICANT CHANGES: - THE ARTICLE FOR PURPOSE WAS AMENDED TO STATE: THE CORPORATION IS ORGANIZED AS A PUBLIC BENEFIT CORPORATION FOR THE FOLLOWING PURPOSES: A) TO ESTABLISH AND MAINTAIN A GENERAL HOSPITAL AND MEDICAL CENTER FOR THE CARE OF PERSONS SUFFERING FROM ILLNESSES OR DISABILITIES WHICH REQUIRE THAT THE PATIENTS RECEIVE IN OR OUT PATIENT HOSPITAL CARE. B) TO CARRY ON ANY EDUCATIONAL ACTIVITIES RELATED TO RENDERING CARE TO THE SICK AND INJURED OR THE PROMOTION OF HEALTH WHICH, IN THE OPINION OF THE BOARD OF DIRECTORS MAY BE JUSTIFIED BY THE FACILITIES, PERSONNEL, FUNDS OR OTHER REQUIREMENTS THAT ARE, OR CAN BE MADE, AVAILABLE. C) TO PROMOTE AND CARRY ON SCIENTIFIC RESEARCH RELATED TO THE CARE OF THE SICK AND INJURED INSOFAR AS, IN THE OPINION OF THE BOARD OF DIRECTORS, SUCH RESEARCH CAN BE CARRIED ON IN, OR IN CONNECTION WITH, THE CORPORATION. D) TO PARTICIPATE, SO FAR AS CIRCUMSTANCES MAY WARRANT, IN ANY ACTIVITY DESIGNED AND CARRIED ON TO PROMOTE THE GENERAL HEALTH OF PERSONS IN THE AREAS SERVED BY THE CORPORATION. - THE BOARD SHALL CONSIST OF THE SAME INDIVIDUALS SERVING AS MEMBERS OF THE BOARD OF DIRECTORS OF CENTRAL MAINE HEALTHCARE CORPORATION (CMHC). THE ARTICLES STATE THE NUMBER OF BOARD MEMBERS SHALL BE BETWEEN 9 AND 15. FORM 990, PART VI, SECTION A, LINE 6, 7A, & 7B MEMBERS OR STOCKHOLDERS: 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 WHOLE OR IN PART. FORM 990, PART VI, SECTION B, LINE 11B FORM 990 REVIEW PROCESS: 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 WITH THE FINANCE COMMITTEE MEMBER TAKING AND ANSWERING QUESTIONS. A FINANCE DEPARTMENT REPRESENTATIVE, KNOWLEDGEABLE OF THE RETURN, IS AVAILABLE TO ASSIST DURING PRESENTATIONS, IF REQUESTED BY THE FINANCE COMMITTEE MEMBER. IN THE EVENT THAT THE NEXT BOARD MEETING IS NOT SCHEDULED UNTIL AFTER THE FILING DATE, THE FINAL RETURN IS MAILED TO ALL BOARD MEMBERS AND THE PRESENTATION OCCURS AT THE NEXT SCHEDULED BOARD MEETING. FORM 990, PART VI, SECTION B, LINE 12C EXECUTIVE COMPENSATION REVIEW: CENTRAL MAINE HEALTHCARE (CMHC), A RELATED ORGANIZATION, 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, AND PRESIDENT OF RUMFORD AND BRIDGTON HOSPITALS. THE PROCESS GUIDELINES AND AUTHORITY OF THE ECC ARE SET OUT IN THE EXECUTIVE COMPENSATION PHILOSOPHY AND RESPONSIBILITIES CHARTER WHICH WAS APPROVED BY THE CMHC BOARD. THE ENTIRE CMHC BOARD PARTICIPATES IN THE ANNUAL PERFORMANCE EVALUATION OF EACH EXECUTIVE, INCLUDING A REVIEW OF ACCOMPLISHMENTS RELATIVE TO GOALS AND OBJECTIVES DERIVED FROM THE STRATEGIC PLAN. THE ECC REVIEWS THE RESULTS OF THE ANNUAL PERFORMANCE EVALUATION AND APPROPRIATE COMPARABILITY DATA BASED ON SEVERAL FACTORS RECOMMENDED BY AN INDEPENDENT EXECUTIVE COMPENSATION CONSULTANT, WHO SPECIALIZES IN NOT-FOR-PROFIT HOSPITALS AND HEALTH SYSTEMS, AND OUR ATTORNEYS. FACTORS USED IN DETERMINING COMPARABILITY TO THE ORGANIZATION INCLUDE SIZE, GEOGRAPHY, ORGANIZATIONAL COMPLEXITY, FACILITY TYPE, OWNERSHIP TYPE, AND ANY OTHER FACTORS DEEMED RELEVANT BY THE COMMITTEE, ITS CONSULTANTS, OR ITS ATTORNEYS. USING THIS INFORMATION, THE ECC ANNUALLY REVIEWS THE EXECUTIVES' COMPENSATION TO DETERMINE IF MODIFICATION TO BASE SALARY IS WARRANTED, AND REVIEWS THE EXECUTIVES' ACCOMPLISHMENTS TO DETERMINE IF ANY VARIABLE PAY IS TO BE AWARDED. THE ENTIRE PROCESS IS THEN DOCUMENTED CONTEMPORANEOUSLY WITH THE DECISION-MAKING PROCESS AND APPROVED THEREAFTER IN ACCORDANCE WITH THE REQUIREMENTS OF THE IRS. 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 PROVIDES MARKET DATA ON COMPARABLE POSITIONS FOR 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 AND WYATT, SULLIVAN AND 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 THAT LAST MONTH OF FISCAL YEAR IN PREPARATION FOR THE NEXT FISCAL YEAR CENTRAL MAINE HEALTHCARE DOCUMENTS THE BASIS FOR ITS DETERMINATION OF KEY EMPLOYEES' COMPENSATION AND MAINTAINS THIS CONTEMPORANEOUSLY SUBSTANTIATED MATERIAL IN THE HUMAN RESOURCES DEPARTMENT. FORM 990 PART VI, SECTION B, LINES 15A & 15B MONITORING COMPLIANCE WITH CONFLICT OF INTEREST POLICY: 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 C, LINE 19 PUBLIC DISCLOSURE: THE ORGANIZATION'S GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY ARE AVAILABLE UPON REQUEST IN THE ORGANIZATION'S ADMINISTRATIVE OFFICES. THE FINANCIAL STATEMENTS OF THE ORGANIZATION ARE INCLUDED IN THE MOST RECENTLY FILED FORM 990 AND PROVIDED, UPON REQUEST, IN THAT FORMAT UNLESS THE SPECIFIC REQUEST DEEMS A DIFFERENT FORMAT MORE APPROPRIATE. FORM 990, PART VII, SECTION A BOARD MEMBER COMPENSATION: NO MEMBERS OF THE BOARD OF DIRECTORS RECEIVED COMPENSATION FOR THEIR DUTIES AS DIRECTORS. JEFF BRICKMAN IS EMPLOYED AS PRESIDENT OF CENTRAL MAINE HEALTHCARE CORPORATION AND HIS COMPENSATED TIME IS SPENT IN THAT CAPACITY. WILLIAM LEE, M.D. IS A PHYSICIAN AND HIS COMPENSATED TIME IS SPENT IN THAT CAPACITY. FORM 990, PART XI, LINE 9 OTHER CHANGES IN NET ASSETS: $ 1,100 CHANGE IN BENEFICIAL INTEREST IN PERPETUAL TRUST FORM 990 PART IX LINE 11G DESCRIPTION:PURCHASED LABOR TOTAL FEES:3644320 FORM 990 PART IX LINE 11G DESCRIPTION:LABOR SERVICES TOTAL FEES:2502425 FORM 990 PART IX LINE 11G DESCRIPTION:OUTSIDE SERVICES TOTAL FEES:1406543 FORM 990 PART IX LINE 11G DESCRIPTION:PURCHASED SERVICES TOTAL FEES:1162865 FORM 990 PART IX LINE 11G DESCRIPTION:CONSULTING FEES TOTAL FEES:8523 FORM 990 PART IX LINE 11G DESCRIPTION:PROFESSIONAL FEES TOTAL FEES:2802 CENTRAL MAINE COMMUNITY HEALTH CORP PO BOX 4500 LEWISTON ME 04243 010386912 PUBLIC EDUCAT ME 501(C)(3) 7 CMHC false CENTRAL MAINE MEDICAL CENTER PO BOX 4500 LEWISTON ME 04243 010211494 HEALTHCARE ME 501(C)(3) 3 CMHC false CENTRAL MAINE HEALTHCARE CORPORATION PO BOX 4500 LEWISTON ME 04243 010386913 HEALTHCARE ME 501(C)(3) 7 NA false MAINE COLLEGE OF HEALTH PROFESSIONS PO BOX 4500 LEWISTON ME 04243 010356077 EDUCATION ME 501(C)(3) 2 CMMC false CENTRAL MAINE REAL ESTATE MGMT CORP PO BOX 4500 LEWISTON ME 04243 010387674 REAL ESTATE ME 501(C)(2) CMHC false RUMFORD COMMUNITY FAMILY HEALTH CENTER 430 FRANKLIN STREET RUMFORD ME 04276 010481000 HEALTHCARE ME 501(C)(3) 3 CMHC false RUMFORD COMMUNITY HOME CORPORATION 11 JOHN F KENNEDY LANE RUMFORD ME 04276 222844951 NURSING HOME ME 501(C)(3) 10 CMHC false BRIDGTON HOSPITAL 10 HOSPITAL DRIVE BRIDGTON ME 04009 010130427 HEALTHCARE ME 501(C)(3) 3 CMHC false BRIDGTON HOSPITAL PHYSICIANS GROUP SOUTH HIGH STREET BRIDGTON ME 04009 010493083 HEALTHCARE ME 501(C)(3) PF CMHC false ELIAS E TUCKER TRUST FUND C/O CMMC 300 MAIN STREET LEWISTON ME 04240 010493083 NURSING ED ME 501(C)(3) 12 A I CMMC false CENTRAL MAINE HEALTH VENTURES INC 300 MAIN STREET LEWISTON ME 04240 010430016 HEALTHCARE ME CMHC C CORP false CWM INSURANCE LTD GENESIS BUILDING PO BOX 1363 BWI GRAND CAYMAN CJ 980220891 INSURANCE CJ CMHC C CORP false CENTRAL MAINE ACO 300 MAIN STREET LEWISTON ME 04240 274604314 ACCOUNTABLE CARE ME CMHC C CORP false false false false false false false false false false false true false true false true true true false false