2019-08-14T14:06:43-05:00 2018-09-30 990 2017-10-01 010238552 Maine Medical Center MAIN 2076622576 22 Bramhall Street Portland ME 04102 Lugene Inzana SVP of Finance/CFO 2076622576 2019-08-13 63.247.60.254 2019-08-14 15:01:06 ED P B45CD6F9D1811B9916B2A423673B63195B36551F 829AE4A393A3EE33A28B50D291306587A51708D5 2017 2019-02-21 02:37:17Z Richard W Petersen 22 Bramhall Street Portland ME 04102 2877105807 0 X www.mmc.org X 1951 ME MMC is a voluntary, not-for-profit community and referral hospital, dedicated to providing high quality health care services to all persons who seek care regardless of their sex, race, religion, age, color, sexual orientation, national origin, physical or emotional disability or social or economic status. MMC is also committed to education at the undergraduate, graduate, post-graduate and continuing education levels for physicians, nurses and allied health personnel, and in-service training for support staff all of which are essential to the delivery of quality patient care. Outreach education to other institutions and agencies is also vital to the fulfillment of the MMC's mission. MMC also supports basic and clinical research as essential to the advancement of health care. 19 13 15710 514 1472189 2222944 29816371 61054317 1118173174 1199064761 17030653 31294341 223559033 249398227 1388579231 1540811646 3856150 5162440 0 0 655990620 700690580 60000 0 2931338 578920915 626295490 1238827685 1332148510 149751546 208663136 1677908443 2015529466 838053570 993247994 839854873 1022281472 X See Schedule O 0 0 238413100 484613707 Routine Services - Adults, Pediatrics, Intensive Care, Neonatal Intensive Care, Coronary Care, Psychiatry, Nursery Total Patient Days - 161,753 191526760 773136937 Operating Room and Scarborough Surgery Center Total Visits - 31,710Through its 39 operative suites, Maine Medical Center (MMC) provides critical trauma, emergent, urgent, and elective surgical services to the community. Through its expansive array of surgical capabilities, MMC provides most surgical procedures within its community as a great convenience to its patients without regard to their ability to pay. 35174661 100809419 Emergency Department and Brighton First Care (BFC) Total Visits - 90,901 The Emergency Department and especially BFC serve as the primary care physician for a number of low income and indigent residents of greater Portland. Given MMC's commitment to access to care regardless of ability to pay, these emergency treatment centers serve a vital role in the community's health care network. 611935692 5162440 101078280 Laboratory, Education, Research, Radiology, Delivery and Labor Room, Anesthesiology, and other ancillary services. 611935692 5162440 101078280 1077050213 1 1 0 1 0 0 0 1 1 1 1 1 0 1 1 1 0 1 0 0 1 1 0 0 1 0 1 1 1 1 1 1 0 0 0 0 0 0 0 0 1 1 1 0 0 0 0 1 1 1 0 0 1 X 0 0 15710 1 1 1 0 0 0 0 1 1 0 0 0 0 X 19 13 1 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 1 1 ME X Chris Coon 2076622654 22 Bramhall Street Portland ME 04102 Adrian M Moran MD Trustee 50.00 0.00 X 0 0 0 Brett Loffredo MD Trustee 50.00 0.00 X 226405 0 39511 Brian H Noyes Trustee 1.00 0.00 X 0 0 0 Christopher Claudio Trustee 1.00 0.00 X 0 0 0 Christopher W Emmons Trustee 1.00 0.00 X 0 0 0 Daniel Loiselle MD Trustee 1.00 0.00 X 0 0 0 Frank H Frye Trustee 1.00 0.00 X 0 0 0 Heidi Hansen Trustee 1.00 0.00 X 0 0 0 Katherine B Coster Trustee 1.00 0.00 X 0 0 0 Katherine Pope MD Trustee 1.00 0.00 X 0 0 0 Lisa Almeder MD Trustee 50.00 0.00 X 210574 0 66918 Margaret Bush Trustee 1.00 0.00 X 0 0 0 Marie J McCarthy Trustee 1.00 0.00 X 0 0 0 Michael Q Simonds Trustee 1.00 0.00 X 0 0 0 Morris Fisher Trustee 1.00 0.00 X 0 0 0 William L Caron Jr Trustee 1.00 50.00 X 0 1324706 117120 William A Burke Chairman 1.00 0.00 X X 0 0 0 Jere G Michelson Vice Chairman 1.00 0.00 X X 0 0 0 Richard W Petersen President & CEO 50.00 0.00 X X 1368927 0 96892 Robert Frank Secretary 1.00 50.00 X 0 465991 71086 Beth Kelsch Asst Secretary 1.00 50.00 X 0 194925 53725 Lugene Inzana Sr VP of Finance/CFO 50.00 0.00 X 512956 0 41892 Jeffrey Sanders EVP & COO 50.00 0.00 X 587321 0 62836 Joel Botler MD CMO 50.00 0.00 X 647646 0 116430 Marjorie Wiggins SVP of Nursing & CNO 50.00 0.00 X 490408 0 83183 Matthew R Sanborn MD Surgeon 50.00 0.00 X 1327102 0 46331 Robert Ecker MD Surgeon 50.00 0.00 X 1322682 0 68770 Dougald MacGillivray MD Surgeon 50.00 0.00 X 1281757 0 73127 Joseph T Alexander MD Surgeon 50.00 0.00 X 1221855 0 78088 Konrad Barth MD Surgeon 50.00 0.00 X 1210143 0 82495 Peter Bates MD Sr Academic Advisor (Frmr VP Med Affairs) 50.00 0.00 X 415567 0 94873 10823343 1985622 1193277 969 1 1 0 Spectrum Medical Group 324 Gannett Drive 200 South Portland ME 04106 Medical Service 6281834 Chest Medicine Assoc 100 Foden Rd W Bldg Ste 103 S Portland ME 041062351 Medical Service 4301775 Healthcare Excellence Inst 21045 N 9th Place 205 Phoenix AZ 850245635 Consulting 3779317 USI Insurance Services 4605 Columbus St Virginia Beach VA 234622490 Consulting 2036024 Garrand 75 Washington Ave Ste 201 Portland ME 041012665 Marketing 1971119 89 1279766 1074642 308841 17124552 41266516 61054317 Net Patient Service Revenue 623000 1199064761 1199064761 1199064761 18723271 18723271 1347249180 1428630 1334791003 1315737 12458177 112893 12571070 12571070 110947 1074642 187421 -76474 -76474 HR and IS Shared Services Rev 900099 134577375 134577375 Other Revenue 900099 109835368 109835368 Gain on Cash Flow Hedges 900099 2789713 2789713 2272245 800056 1472189 249474701 1540811646 1459638343 1472189 18646797 3496826 3496826 1575202 1575202 90412 90412 5656270 886667 4769603 186589 186589 515918408 389170406 124585906 2162096 59120274 44783608 14336666 83590293 63319647 20270646 36218746 27327361 8748363 143022 2152128 2152128 1590606 1590606 96617 96617 2160366 2160366 60036467 46026489 13887069 122909 1720074 1302956 417118 3440195 2495506 798891 145798 25649832 19429748 6220084 34575127 26190254 8384339 534 2858944 1949536 853563 55845 2584668 2399973 176002 8693 7152319 5417882 1734437 78601684 59540776 19060908 3253777 2464736 789041 Medical supplies 242625921 242625921 Other 67373010 50923734 16235590 213686 Outside medical service 49663365 49663365 Maintenance 20679302 15604914 4995633 78755 20081088 20081088 1332148510 1077050213 252166959 2931338 26805 164658308 440180452 7194574 20984622 120700599 128360555 695926 626341 20184145 22237803 7083046 8730348 1266440098 734667618 472185304 531772480 633602418 604528237 92052987 110757925 14128447 17380799 145422689 129943099 1677908443 2015529466 117376899 116818831 9929645 12792513 134414811 323667714 576332215 539968936 838053570 993247994 X 725371978 888632991 85853505 101731265 28629390 31917216 839854873 1022281472 1677908443 2015529466 X 208663136 -9603114 -16633423 X 0 1 X 1 1 1 X 0 0 0 0 0 0 0 0 1 96617 96617 0 Part II-B, Line 1: Portion of Dues paid that relate to lobbying expenses: Maine Hospital Association - $62,497 American Hospital Association - $19,195 National Association of Children's Hospitals - $14,925 12300 X X 0 0 0 100061713 2437017 6156967 5943575 102712122 93775123 254233 11533363 5501006 100061713 95914866 209664 3650641 6000048 93775123 109296215 1193188 -9299173 5275364 95914866 101567447 487484 10241284 3000000 109296215 0.30000 0.70000 1 0 20493199 20493199 566762664 306792593 259970071 8792878 3595212 5197666 597979511 424279813 173699698 72411846 72411846 531772480 Hedge Funds 57078847 C Limited Parnterships 53679078 C 110757925 AR under reimbursement regulations 19274823 Other assets 10735959 Due from affiliates 20771438 Charitable remainder trust 548622 Prepaid capital costs 73608500 Escrow of debt service 5003757 129943099 Accrued retirement benefits 203237931 Endowments held for members 116398207 A/P under reimbursement regs 73789318 Notes payable to affiliates 65793581 Due to affiliates 34942543 Self insurance reserves 17157959 Asset retirement obligation 17013629 Swap agreements 6330829 Leases payable 4087370 Other liabilities 1217569 539968936 X Part III, Line 4: MMC's artwork creates a healing and comfortable environment for our patients and visitors. Part V, Line 4: The endowed funds support the following types of activities: Tufts scholarship program, training and education of nurses, MMC research and education programs, supporting the salary of endowed Chair of Pediatrics and free bed funding. Part X, Line 2: The Internal Revenue Service has previously determined that Maine Medical Center (MMC) and Maine Medical Center Realty Co.(MMCRC) are organizations as described in Section 501(c)(3) of the Internal Revenue Code (RC) and are exempt from federal income taxes on related income pursuant to Section 501(a) of the IRC. Saint Joseph's Rehabilitation and Residence (SJRR) was previously covered under a group exemption issued to United States Conference of Catholic Bishops. SJRR will file its own tax exemption application during fiscal year 2019. Maine Medical Partners (MMP) had significant net operating loss carryovers at September 30, 2018 and 2017. A valuation allowance has been provided for the entire deferred tax benefit for the net operating losses, due to uncertainty of realization. MMP did not have taxable icome in 2018 or 2017. Accordingly, no provision for income taxes had been made in the accompanying consolidated financial statements. The Medical Center recognizes the effect of income tax positions only if those positions are more likely than not of being sustained. Recognized income tax positions are measured at the largest amount of benefit that is greater than fifty percent likely to be realized upon settlement. Changes in measurement are reflected in the period in which the change in judgement occurs. The Medical Center did not recognize the effect of any income tax positions in either 2018 or 2017. On December 22, 2017, the President signed into law H.R. 1, originally known as the Tax Cuts and Jobs Act. The new law includes several provisions that result in substantial changes to the tax treatment of tax-exempt organizations and their donors. The Institute has reviewed these provisions and the potential impact and concluded the enactment of H.R. 1 will not have a material effect on the operations of the organization. 0 Central America and the Caribbean 0 0 Investments 169194766 0 0 0 0 0 0 169194766 0 169194766 Sub-Saharan Africa Research 77235 Wire Transfer Sub-Saharan Africa - Angola, Benin, Botswana, Burkina Faso, Research 6090 Wire Transfer Sub-Saharan Africa Research 7087 Wire Transfer 3 0 0 0 0 0 0 Part I, Line 1 All subrecipient grants listed on Part II, Line 1 were recognized on the System for Award Managment website (sam.gov) as non-profit organizations. Radiothon 320824 320824 996 2093 26874 BBCH Golf Open 304750 238882 65868 4420 35300 12831 22523 10 560015 514936 45079 4000 3481 27154 2920 44829 1185589 1074642 110947 4000 8897 62454 17844 94226 187421 -76474 1 1 1 X 175.000000000000 0 1 1 0 1 1 19391181 19391181 0.01460 116878058 80785708 36092350 0.02710 136269239 80785708 55483531 0.04170 733526 733526 0.00060 87950044 11376822 76573222 0.05750 48115131 48115131 0.03610 29918306 19410399 10507907 0.00790 862443 862443 0.00060 167579450 30787221 136792229 0.10270 303848689 111572929 192275760 0.14440 240180 240180 0.00020 132310 132310 0.00010 32827 32827 0.00000 2078856 2078856 0.00160 2484173 2484173 0.00190 0 30464641 245204019 247679108 -2475089 X 1 1 1 1 Maine Medical Center 22 Bramhall Street Portland ME 04102 www.mmc.org 38910 X X X X X X Maine Medical Center 1 0 0 1 X X X X X X X X X 16 1 1 0 1 X See Part V, Section C 1 16 1 See Part V, Section C 0 1 X 175.000000000000 X X 1 1 X X X 1 X See Part V, Section C X See Part V, Section C X See Part V, Section C X X X X X 1 X 0 X X X X 1 X 0 0 Maine Medical Center Part V, Section B, Line 5: Community input was taken into account when conducting the CHNA, including those with special knowledge of or expertise in public health. This included individuals from the following facilities: City of Portland - Health and Human Services Department, The Opportunity Alliance, Mercy Health System, VNA Home Health Hospice, Maine Centers for Disease Control, United Way of Greater Portland, MMC, MaineHealth, and Maine Behavioral Healthcare. Maine Medical Center Part V, Section B, Line 6a: The CHNA was conducted through a partnership between MaineHealth, Central Maine Healthcare, Eastern Maine Healthcare Systems (EMHS), MaineGeneral Health (MGH), and the Maine Department of Health and Human Services. Maine Medical Center Part V, Section B, Line 11: For the 2016-2018 CHNA, the organization has identified priorities and developed strategies to address the significant needs identified in its most recently conducted CHNA and provided reasons if identified needs are not being addressed. Please see the 2016-2018 Community Health Needs Assessment and Annual Implementation Report Update FY18 at https://mainehealth.org/ healthy-communities/community-health-needs-assessment for details of the activities undertaken by the organization. Part V, Section B, Line 7a & 10a: The CHNA and implementation strategy are posted on the following website: https://mainehealth.org/healthy-communities/community-health-needs-assessment Part V, Section B, Line 16a, 16b, 16c: The Financial Assistance Policy (Free Care Policy and Billing and Collection Policy), free care application and plain language summary are available on the following website: https://mainehealth.org/patients-visitors/billing-insurance/financial-assistance/free-care. 47 1 - MMC Scarborough Campus 100 Campus Drive Scarborough ME 04074 General Medical and Surgical 2 - MMC Scarborough Surgical Center 84 Campus Drive Scarborough ME 04074 General Medical and Surgical 3 - Neurosurgery & Spine and Neurology 49 Spring Street Scarborough ME 04074 Neurosurgery, Spine and Neurology Care 4 - MMC Brighton Campus 335 Brighton Avenue Portland ME 04102 Emergency Care 5 - Cardiology 99 Campus Drive Lewiston ME 04240 Cardiology 6 - Pediatric Surgery & Specialty Care 887 Congress Street Portland ME 04102 Pediatrics 7 - MMC Falmouth Campus 5 Bucknam Road Falmouth ME 04105 General Medicine 8 - Cardiology 96 Campus Drive Scarborough ME 04074 Cardiology 9 - Mental Health Services 66 Bramhall Street Portland ME 04102 Mental Health Services 10 - MMC Sanford IV Therapy 27 Industrial Avenue Sanford ME 04073 IV Therapy 11 - Orthopedics 119 Gannett Drive South Portland ME 04106 Orthopedic Care 12 - Women's Health 489 State Street Bangor ME 04401 Women's Healthcare 13 - Cardiothoracic Surgery 818 Congress Street Portland ME 04102 Cardiothoracic Surgery 14 - Coastal Cancer Treatment Center 175 Congress Avenue Bath ME 04350 Cancer Treatment Center 15 - Otolaryngology 1250 Forest Avenue Portland ME 04103 Otolaryngology 16 - Urology 199 Main Street Norway ME 04268 Urology 17 - McGeachy Hall 216 Vaughan Street Portland ME 04102 Mental Health Services 18 - Cape Elizabeth Internal Medicine 155 Spurwink Avenue Cape Elizabeth ME 04107 General Medicine 19 - MMC Family Medicine 272 Congress Street Portland ME 04101 General Medicine 20 - MMC Biddeford IV Therapy 26 West Cole Road Suite 101 Biddeford ME 04005 IV Therapy 21 - Urology 110 Brickhill Ave Suite 100 South Portland ME 04106 Urology 22 - Westbrook Primary Care 1 Harnois Avenue Suite 2A Westbrook ME 04092 General Medicine 23 - MMP Surgical Care Casco Bay 10 Andover Road Portland ME 04102 General Medical and Surgical 24 - Otolaryngology 43 Baxter Boulevard Portland ME 04101 Otolaryngology 25 - Endocrinology 175 US Route One Scarborough ME 04074 Endocrinology and Diabetes 26 - Maine Transplant Program 19 West Street Portland ME 04102 Kidney and Pancreas Transplant 27 - Scarborough Internal Family Medicine 300 Professional Drive Scarborough ME 04074 General Medicine 28 - Lakes Region Primary Care 584 Roosevelt Trail Windham ME 04062 General Medicine 29 - Cardiology 35 Medical Center Parkway Suite 101 Augusta ME 04330 Cardiology 30 - South Portland Primary Care 75B John Roberts Road South Portland ME 04106 General Medicine 31 - Women's Health 102 Campus Drive Unit 116 Scarborough ME 04074 Women's Healthcare 32 - ME Inst for Sleep & Breathing Disorders 930 Congress Street Portland ME 04102 Sleep and Breathing Disorders 33 - Pediatric Care 1577 Congress Street Portland ME 04102 Pediatrics 34 - Cardiology 4 Glen Cove Drive Suite 108 Rockport ME 04856 Cardiology 35 - Otolaryngology 30 West Cole Road Biddeford ME 04005 Otolaryngology 36 - Pediatric Surgery 46 First Park Drive Oakland ME 04963 Pediatrics 37 - Cardiology 149 North Street Waterville ME 04901 Cardiology 38 - Saco Pediatrics 4 Scamman Street Suite 51 Saco ME 04072 Pediatrics 39 - Yarmouth Pediatrics 45 Forest Falls Drive Suite 1A Yarmouth ME 04096 Pediatrics 40 - Endocrinology and Diabetes Center 963 Sabattus Street Lewiston ME 04240 Endocrinology and Diabetes 41 - Ambulatory Clinic Services 48-52 Gilman Street Portland ME 04102 General Medicine 42 - Center for Tobacco Independence 315 Park Avenue Second Floor Portland ME 04101 Tobacco Treatment Center 43 - Women's Health 84 Marginal Way Suite 900 Portland ME 04103 Women's Healthcare 44 - Otolaryngology 55 Main Street Bridgton ME 04009 Otolaryngology 45 - MMC Preble St Learning Collaborative 20 Portland Street Portland ME 04101 General Medicine 46 - Otolaryngology 193 Main Street Norway ME 04268 Otolaryngology 47 - Oncology 265 Western Avenue South Portland ME 04106 Oncology Part I, Line 7: The costing methodology for the amounts reported in Part I, Line 7 of the Schedule H is based on a ratio of patient care cost to charges. This cost to charge ratio was derived from Worksheet 2, Ratio of Patient Care Cost-to-Charges provided in the instructions for Schedule H. Part II, Community Building Activities: Community Support- MMC is deeply involved in disaster planning at the local and state levels. One of three state Regional Resource Centers for Emergency Preparedness is located at MMC, and the hospital has a full-time director of emergency preparedness.- MMC is a dues paying member of Greater Portland Chamber of Commerce and Maine State Chamber of Commerce- SARSSM (Sexual Assault Response Services of Maine)- Southern Maine Regional Resource Center for Health Emergency Preparedness - Coordinated all Emergency Preparedness Activities of the Southern 4 Counties of Maine including: York, Cumberland, Sagadahoc and Lincoln. This includes both regional Hospitals, and over 300 Medical Centers, Laboratories, Clinics Ambulatory Center, Physician Practices, Long Term Care Centers, Home Health Agencies in our region. This includes Public Healthcare Emergency Preparedness.- Community Nurse Support - Nurse Liaison for the Town of Scarborough teaching Basic Life Support and attending panel discussions. Physicians from Falmouth and South Portland Pediatrics offices providing educational opportunity and open discussion for local school RNs.Leadership Development and Training for Community Members- Doc4aDay Program- Medical Explorers- Project Medical Education (PME)- Heathcare Professional Pipeline ProgramWorkforce Development- CNA training program- Summer volunteers- Nutrition & food students from Maine colleges- Hanley leadership development- UNE elective course on medication transactions at MMC- Introductory pharmacy student experiential learning program- Nurse practitioners and physician assistant clinical intership site- Portland Family Medicine medical assistant extern mentoring site- Student mursing precepting- Training of nurse practitioner students - psychiatry- Rehab medicine educational program- UNE trauma and recovery class for social work- Course instruction at USM for social work and psychiatry- Social work student intership supervision- Outpatient psychiatry training Part III, Line 2: See Part III, Line 4 - Bad Debt Expense Footnote to the Financial Statements. Part III, Line 4: MMC does not have a specific footnote in the financial statements that describes "bad debt expense." However, reference is made within the footnotes to a bad debt policy in a couple of instances. Within the footnote describing "Net Patient Service Revenue", the following explains the Provision for Bad Debts:"For receivables associated with self-pay patients, the Medical Center records a significant provision for bad debts 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 and the amounts actually collected after all reasonable collection efforts have been exhausted is written off against the allowance for bad debts."The amount of expense associated with the provision of services, ultimately written off as bad debt at MMC, has been calculated at $30,464,641 for the current fiscal year. This amount was calculated using a cost to charge ratio. Bad debt expense represents healthcare services MMC has provided without compensation. As a tax-exempt organization, MMC provides necessary patient care regardless of the patient's ability to pay for the services. MMC cannot determine the amount of bad debt expense that could be reasonably attributable to patients who likely would qualify for financial assistance under the Hospital's free care policy. In addition, bad debt expense also includes amounts for services provided to individuals experiencing difficult personal or economic circumstances related to a portion of our community based patient population. Their medical bills often place these individuals in untenable positions where they are not able to handle their personal debt and then their new medical debt. However, because of their income level, they do not qualify for free care. By providing necessary healthcare services to those individuals either who fail to apply for financial assistance or who are experiencing difficult personal or economic circumstances, MMC believes that bad debt expense should be included as a community benefit. Part III, Line 8: Medicare allowable costs were calculated using a cost to charge ratio. MMC believes that the Medicare shortfall should be included as a community benefit because MMC has a clear mission commitment to serving elderly patients and adults with disabilities through the provision of specific subsidized programs developed to help improve the health status of these patients. If these critical subsidized programs were not provided by MMC, they would become the obligation of the Federal Government. Part III, Line 9b: Patients who qualify for free care have their account balance adjusted accordingly once free care has been approved. As a tax-exempt hospital, MMC provides necessary patient care regardless of the patient's ability to pay for the services. Part VI, Line 2: The organization prepares a Community Health Needs Assessment (CHNA) every three years. See https://mainehealth.org/healthy-communities/community-health-needs-assessment for the completed CHNA. Part VI, Line 3: Free Care information is provided in the Admitting and Emergency Registration locations in the following manner:- Postings including Free Care and Monthly Payment Plan- Handouts- InterviewsIf the patient is self-pay, under insured or can't afford to pay theirhospital bill, they may receive a Financial Counseling Packet and/orreferred to financial counseling from the registration staff or ChangeHealthcare, an outside vendor who helps manage the self- pay accounts. Thepacket includes:- Information on MaineHealth's financial policies- Financial assistance information including Free Care Program, MonthlyPayment Plan Program, and Care Partners, MedAccess and other communityresource needs.- Program applications and instructions for MaineHealth's Free CareProgram, and Monthly Payment Plan Application- Contact information for assistance with applications, bills or financialconcernsSelf-pay or underinsured patients registering in person or via a phoneinterview receive financial counseling including information on ourfinancial assistance programs. Registration staff or Change Healthcareprovide forms and assist with completing financial assistance applicationsand providing follow up contact information.MaineHealth's Web site includes on line Registration and Patient Billinginformation:- Billing Process- Free Care- Monthly Payment Plan- Patient Statement- Price Information- Contact Us and QuestionsPrimary language, deaf and hard of hearing and interpreter needs are assessed during the registration interview and services are provided as needed.If a patient does not respond at pre-registration, registration, or whilereceiving care, all of these programs are explained again by the Single Billing Office staff. The intent of these efforts is to ensure that the patient is fully informed of and able to take advantage of these assistance programs. Part VI, Line 4: The Community Health Needs Assessment describes the geographic area anddemographic constituents it services. See https://mainehealth.org/healthy-communities/community-health-needs-assessment for the completed CHNA. Part VI, Line 5: MMC's day-to-day operations as a tax-exempt organization include many system-wide initiatives in Cumberland County and in the state of Maine and the Northern New England region. Clinical services range fromoutpatient clinics for a diverse population to full inpatient and surgicalservices to a regional trauma center and a neuroscience institute. Many ofour services and specialties are not available elsewhere in the state or in our region. We have programs in undergraduate, graduate, post-graduate, and continuing education, engage in clinical research, and support organizations and efforts whose missions augment or complement ours. We strive to be a good "institutional citizen" of our region and state. With these programs, MMC hopes to fill existing local gaps while making a positive impact in the communities we serve. These programs include: Subsidized Health Services, Community-Based Clinical Services, Community Education Services, Health Care Support Services, Community Building Activities, Medical Education and Research.MMC made a net asset transfer to its wholly owned subsidiary, Maine Medical Partners, in the amount of $68,866,000 to cover the losses related to mission-critical physician practices to ensure access for the community to such specialties as trauma surgery, neurosurgery, urology, various pediatric specialties, and high-risk obstetrics. Part VI, Line 6: MaineHealth is a not-for-profit family of leading high-quality providersand other healthcare organizations working together so their communitiesare the healthiest in America. Ranked among the nation's top 100 integrated healthcare delivery networks, MaineHealth is governed by a board of trustees consisting of community and business leaders from its southern, central and western Maine regional service areas. The collaboration of MaineHealth members makes it possible to offer an extensive range of clinical integration and community health programs, many aimed at improving access to preventive and primary care services. MaineHealth includes the following member organizations: LincolnHealth Group, Maine Medical Center, Maine Behavioral Healthcare (Spring Harbor Hospital), Coastal Healthcare Alliance (Pen Bay Medical Center and Waldo County General Hospital), Southern Maine Health Care (Southern Maine Medical Center and Goodall campuses), Western Maine Health Care (Stephens Memorial Hospital), The Memorial Hospital at North Conway, N.H., MaineHealth Care at Home, NorDx, Synernet and MaineHealth Accountable Care Organization. The strategic affiliates of MaineHealth are MaineGeneral Medical Center, Mid Coast Hospital and St. Marys Regional Medical Center. Part VI, Line 7, Reports Filed With States ME Part V, Section B, Line 16i: Internal Revenue Code Section 501(r)(4) requires that translations of the financial assistance policy, financial assistance application form and plain language summary be available on the hospital's website. For FY 2018, these three documents were not available on the hospital's website for the entirety of the twelve months ending September 30, 2018. During July, 2018, the plain language policy and the free care application were translated into the required languages and posted on the website. The free care and billing and collection policies (collectively the financial assistance policy) were translated into the required languages and posted to the website in March 2019. The organization has established an annual process to evaluate its demographic patient information to ensure that the required documents are translated into the necessary languages (the lesser of 1,000 or 5% of the community served by the hospital).Despite not meeting the requirements of 501(r)(4) for the entirety of the fiscal year, patients and families with limited English proficiency did have access to several interpreter services options to provide assistance with their health care encounters, including assistance with various forms and applications. These options include oral telephonic capabilities, remote video services as well as live interpreters through multiple contracts with outside agencies. 1 Brown University Controllers Office Box J Providence RI 02912 050258809 501(c)(3) 59944 Research DiMagi Inc 585 Massachusetts Ave Suite 4 Cambridge MA 02139 830343298 32810 Research Harvard Pilgrim Health Care Inc 93 Worcester Street Wellesley MA 024819181 042452600 501(c)(3) 61832 Research Indiana University 400 E 7th Street Rm 501 Bloomington IN 474053004 356001673 501(c)(3) 12266 Research Massachusetts General Hospital 55 Fruit Street Boston MA 02114 042697983 501(c)(3) 403316 Research President and Fellows of Harvard College 1033 Massachusetts Avenue 3rd Fl Cambridge MA 02138 042103580 501(c)(3) 25448 Research Regents of the University of Michigan 500 S State Street Ann Arbor MI 48109 386006309 501(c)(3) 350749 Research Tufts University 169 Holland Street Attn Tax Dept Somerville MA 02144 042103634 501(c)(3) 238528 Research University California San Francisco 220 Montogmery St Fl 5 San Francisco CA 94104 946036493 501(c)(3) 130356 Research University of New England 11 Hills Beach Road Biddeford ME 04005 010211810 501(c)(3) 117458 Research University of Southern Maine 5703 Alumni Hall Ste 101 Orono ME 04469 016000769 501(c)(3) 232729 Research University of Texas Southwestern Medical Center 5323 Harry Hines Blvd Dallas TX 75390 752556007 501(c)(3) 711033 Research University of Vermont 85 S Prospect St Rm 333 Burlington VT 05405 030179440 501(c)(3) 1045075 Research Yale University PO Box 208239 New Haven CT 065208239 060646973 501(c)(3) 52662 Research Children's Museum & Theatre of Maine PO Box 4041 Portland ME 04101 010352258 501(c)(3) 18000 Support for "Be Well Center" 14 1 Scholarship 185 1575202 Part I, Line 2: For the Research Grants to Organizations, these represent subrecipient grants. A subrecipient agreement is signed by both MMC and the subrecipient stating the amount of the award, the award name, the name of the Federal Agency, requirements imposed by laws, regulations and the provisions of the grant agreement. The monthly subrecipient invoices are reviewed and approved by the Principal Investigator prior to payment to verify the Federal funds are used for authorized purposes and are included in the award budget. Other contributions are reviewed by Senior Management and are granted to organizations within our community that promote our shared values. For the Nursing Scholarships, as an application requirement, each scholarship applicant must provide confirmation of enrollment in a program of studies in Nursing. For the Medical Education Scholarships for students in the Maine Track of the MMC.TUSM Medical School Program, MMC transfers the scholarship funds to the Tufts School of Medicine (Tufts) financial aid department for distribution to the students. Tufts handles any oversignt to ensure that the funds are used as intended. MMC's role is limited to matching eligible students with scholarship selection criteria and determining who receives each scholarship award. 0 0 0 0 0 0 0 0 0 Brett Loffredo MD Trustee 215103 0 10575 0 727 0 25282 0 14229 0 265916 0 0 0 Lisa Almeder MD Trustee 178901 0 30775 0 898 0 38561 0 28357 0 277492 0 0 0 William L Caron Jr Trustee 0 961824 0 260010 0 102872 0 80881 0 36239 0 1441826 0 0 Richard W Petersen President & CEO 824401 0 220000 0 324526 0 67231 0 29661 0 1465819 0 0 0 Robert Frank Secretary 0 394418 0 56000 0 15573 0 55308 0 15778 0 537077 0 0 Beth Kelsch Asst Secretary 0 189442 0 5069 0 414 0 29755 0 23970 0 248650 0 0 Lugene Inzana Sr VP of Finance/CFO 443691 0 66943 0 2322 0 10800 0 31092 0 554848 0 0 0 Jeffrey Sanders EVP & COO 489209 0 93414 0 4698 0 35641 0 27195 0 650157 0 0 0 Joel Botler MD CMO 450872 0 57740 0 139034 0 86497 0 29933 0 764076 0 0 0 Marjorie Wiggins SVP of Nursing & CNO 341276 0 49886 0 99246 0 71221 0 11962 0 573591 0 0 0 Matthew R Sanborn MD Surgeon 1162763 0 153391 0 10948 0 10800 0 35531 0 1373433 0 0 0 Robert Ecker MD Surgeon 1164089 0 153391 0 5202 0 34961 0 33809 0 1391452 0 0 0 Dougald MacGillivray MD Surgeon 1067410 0 204205 0 10142 0 38079 0 35048 0 1354884 0 0 0 Joseph T Alexander MD Surgeon 1018484 0 134113 0 69258 0 47554 0 30534 0 1299943 0 0 0 Konrad Barth MD Surgeon 1012998 0 134113 0 63032 0 47963 0 34532 0 1292638 0 0 0 Peter Bates MD Sr Academic Advisor (Frmr VP Med Aff 329077 0 46773 0 39717 0 71561 0 23312 0 510440 0 0 0 Part III - Other Additional Information Top management officials that are compensated by related organizations used one or more of the methods at Part I, Line 3 to establish the compensation of top management. A Maine Health & Higher Educational Facilities Authority 010314384 560427LW4 2011-08-31 17998986 See Part VI 0 0 0 B Maine Health & Higher Educational Facilities Authority 010314384 560427Y75 2015-01-07 85963004 See Part VI 0 0 0 C Maine Health & Higher Educational Facilities Authority 010314384 56042RQW5 2018-07-18 183854035 See Part VI 0 0 0 D Maine Health & Higher Educational Facilities Authority 010314384 000000000 2018-08-01 36735000 See Part VI 0 0 0 A 4845000 17998986 1748784 186573 17812413 1 0 1 1 B 85967554 948945 1271033 41929758 42754483 2016 1 0 1 1 C 184199699 1996687 39935115 142267897 0 0 0 1 D 36735000 537368 36197632 1 0 1 1 B 0 1 0 0 0.00100 0.00000 0.00100 0 0 0 C 0 0 0 0 0.00000 0.00000 0.00000 0 0 0 D 0 1 0 0 0.00100 0.00000 0.00100 0 0 0 A 0 0 0 1 0 0 0 0 0 B 0 1 0 0 0 0 0 0 0 C 0 1 0 0 0 0 0 0 0 D 0 1 0 0 1 1 See Part VI 17.900000000000 0 0 0 0 0 A 0 B 0 C 0 D 0 Date Rebate Computation Performed Issuer Name: Maine Health & Higher Educational Facilities Authority Date the Rebate Computation was Performed: 09/30/2016 Schedule K - Additional Information Maine Health and Higher Educational Facilities Authority (MHHEFA) - Part I, column (f), bond A - Refund bonds issued 7/9/1988,12/10/1998,5/19/1999, and 11/15/2001 - Part I, column (f), bond B - Refund bonds issued 5/22/2008; build, renovate, and equip hospital facility - Part I, column (f), bond C - Build, renovate, and equip hospital facility - Series 2011A bonds - With respect to Part I column (e), and Part II lines 1-12 (column A), the institution is reporting its allocable portion of this bond issue, the remainder of which is allocable to affiliated entities. For purposes of Part I, column (i), the institution has assumed that this arrangement does not constitute a "pooled financing." - Series 2014 bonds (issued 1/7/2015) - With respect to Part I column (e), and Part II lines 1-12 (column B), the institution is reporting its allocable portion of this bond issue, the remainder of which is allocable to affiliated entities. For purposes of Part I column (i), the institution has assumed that this arrangement does not constitute a "pooled financing." - Series 2014 bonds (issued 1/7/2015) and Series 2018A bonds (issued 7/18/2018) - The difference between the issue price (Part I) and total proceeds (Part II, line 3) is due to investment earnings. - Part II, line 4, column A - The amount shown here consists of $1,402,045 in a debt service reserve fund, plus $346,739 of debt service fund deposits. - Part II, line 4, column B through D - The amount shown here consists of debt service fund deposits - Part III has not been completed with respect to the bonds shown in column A, since the bonds being refinanced by such bonds were issued before 2003 - Part IV, lines 4b and 4c, column D - There are two separate hedging contracts identified with these bonds, both with Morgan Stanley Capital Services LLC and each having a term of 17.9 years Schedule K, Part II Line 17, Part III Line 9, Part IV Line 7, Part V During the fiscal year, the institution was in the process of implementing written compliance procedures. Christopher Claudio See Part V 157850 See Part V 0 Jennifer Caron See Part V 93620 See Part V 0 Elliot Bates See Part V 92969 See Part V 0 Substantial Contributor Sub. Contributor 2767514 Vendor 0 Substantial Contributor Sub. Contributor 449015 Employment 0 Substantial Contributor Sub. Contributor 988329 Employment 0 Substantial Contributor Sub. Contributor 248237 Employment 0 Substantial Contributor Sub. Contributor 747669 Employment 0 Substantial Contributor Sub. Contributor 290984 Employment 0 Substantial Contributor Sub. Contributor 487827 Employment 0 Substantial Contributor Sub. Contributor 516993 Employment 0 Substantial Contributor Sub. Contributor 196241 Employment 0 Substantial Contributor Sub. Contributor 600697 Employment 0 Substantial Contributor Sub. Contributor 591269 Employment 0 Substantial Contributor Sub. Contributor 711927 Employment 0 Substantial Contributor Sub. Contributor 287848 Employment 0 Substantial Contributor Sub. Contributor 671736 Employment 0 Substantial Contributor Sub. Contributor 565827 Employment 0 Substantial Contributor Sub. Contributor 734082 Vendor 0 Substantial Contributor Sub. Contributor 4282718 Vendor 0 Substantial Contributor Sub. Contributor 159260 Vendor 0 Substantial Contributor Sub. Contributor 2519701 Vendor 0 Substantial Contributor Sub. Contributor 5870728 Vendor 0 Schedule L, Part IV, Column (b) and (d) Peter Bates' son, Elliot Bates is a Senior Project Manager employed by MMCWilliam Caron is an ex-officio Trustee of MMC. His daughter in law, Jennifer Caron, is a Research Associate employed by MMC.Christopher Claudio is a member of the Board of Trustees of MMC as well as CEO of Winxnet. Winxnet provides IT services to MMC. All transactions were at arms length, for fair value, and in the routine course of business. X 21 5342135 Fair Market Value 0 1 0 Part I, Column (b): The organzation has reported the number of gifts in Part I Column b, consistent with the IRS instructions for contributions of publicly traded securities. Form 990, Part V, Line 1a Maine Medical Center(EIN 01-0238552), acting on behalf of MaineHealth (EIN 01-0431680), filed 1,030 Form 1099s for the calendar year 2017 on behalf of the following organizations: MaineHealth, Maine Medical Center, Southern Maine Health Care, Pen Bay Medical Center, Waldo County General Hospital, Franklin Memorial Hospital, LincolnHealth Group, Memorial Hospital, Western Maine Health Care, Maine Behavioral Healthcare, NorDx, MaineHealth Care at Home. Form 990, Part V, Line 2a Maine Medical Center (EIN 01-0238552) filed Form W-3, reporting 15,710 employees, for the calendar year 2017 on behalf of the following organizations: MaineHealth, Maine Medical Center, MMC Realty, Maine Medical Partners, NorDx, MaineHealth Care at Home, MaineHealth Cardiology, Southern Maine Health Care and Maine Behavioral Healthcare. Form 990, Part VI, Section A, line 2 Katherine Coster, Christopher Claudio, and Jere Michelson are board members of MMC and Gorham Savings Bank. Christopher Emmons is a board member of MMC, and CEO of Gorham Savings Bank. Form 990, Part VI, Section A, line 6 MaineHealth (EIN #01-0431680) is the sole Member of the organization. Form 990, Part VI, Section A, line 7a The sole Member of the organization has the responsibility for the election of the members of the governing body. Form 990, Part VI, Section A, line 7b There are decisions by the governing body that require the approval of its sole member. They include: 1. The adoption of operating and capital budgets 2. The approval of any significant strategic plan for programs or facilities 3. The authorization of debt incurred, assumed, or guaranteed by MMC in excess of $1,000,000 and its subsidiaries in excess of $1,000,000 other than as provided for in annual capital and operating budgets 4. The authorization for any acquisition, disposition, organization or investment in any other corporation, partnership, limited liability company or joint venture 5. The authorization for any sale, assignment, transfer, mortgage or encumbrance of any properties or assets having an aggregate value in excess of $1,000,000 6. The authorization for any merger or consolidation involving MMC or its subsidiaries as a constituent entity or any sale or other disposition of substantially all of the assets of MMC or its subsidiaries 7. The authorization for the institution of any bankruptcy, insolvency or reorganization proceedings 8. The authorization for the capital investment in any individual, entity, or project in the form of cash or either tangible or intangible property in excess of $1,000,000 9. The amendment of the Articles of Incorporation; 10. The selection, annual election, evaluation, and termination of MMC's CEO 11. The authorization for the commencement of litigation by the MMC other than routine collection actions 12. The adoption of MMC's Bylaws and any amendments and modifications to MMC's Bylaws Form 990, Part VI, Section B, line 11b The Sr. Vice President of Finance/CFO reviewed the 990 in detail. The Form 990 is then reviewed by the MMC Finance Committee. Subsequent to the meeting, the 990 was also made available to the full Board of Trustees for MMC. The Board was then given an opportunity to ask questions of the Chairman of the Board, the CEO, or the Sr. Vice President of Finance/CFO. Form 990, Part VI, Section B, line 12c Conflicts of Interest statements are obtained annually. MaineHealth's Audit & Compliance Services Department collects and reviews the responses to these documents and addresses any issues immediately. The results are shared with Board leadership. Form 990, Part VI, Section B, line 15 Compensation for Top Official & Officers MMC uses an outside firm, Sullivan Cotter, to perform an independent benchmark analysis for the CEO and other key administrative employees. The firm meets with the Executive Committee of the Board of Directors to review each executive's benchmark report. The Executive Committee then deliberates on MaineHealth's written salary and incentive plan philosophy before making a final decision. All decisions and meetings are captured in minutes and there are appropriate approvals at all levels. Form 990, Part VI, Section C, line 19 Documents that are required to be open for public inspection are made available upon request. Form 990, Part XI, line 9: Equity Transfers to Affiliates -68,213,501. Retirement Benefit Plan Adjustments 51,580,078. MaineHealth 110 Free Street Portland ME 04101 010431680 Healthcare ME 501(c)(3) Line 12c, III-FI N/A 0 Maine Medical Center Realty Corp 22 Bramhall Street Portland ME 04102 010434215 Property management ME 501(c)(3) Line 12a, I Maine Medical Center 1 Maine Behavioral Healthcare 78 Atlantic Place South Portland ME 04106 010524834 Hospital ME 501(c)(3) Line 3 MaineHealth 0 LincolnHealth Group 6 St Andrews Lane Boothbay Harbor ME 04538 261475629 Healthcare ME 501(c)(3) Line 12b, II MaineHealth 0 Western Maine Health Care Corp 181 Main Street Norway ME 04268 010411788 Healthcare ME 501(c)(3) Line 12b, II MaineHealth 0 Geriatric Resource Network 110 Free Street Portland ME 04101 010542842 Healthcare ME 501(c)(3) Line 7 MaineHealth 0 MaineHealth Care at Home 15 Industrial Park Saco ME 04072 222571902 Home health ME 501(c)(3) Line 10 MaineHealth 0 NorDx 301A US Route One Scarborough ME 04074 010511356 Lab ME 501(c)(3) Line 10 MaineHealth 0 Coastal Healthcare Alliance PO Box 287 Belfast ME 04915 222494475 Healthcare ME 501(c)(3) Line 12b, II MaineHealth 0 MaineHealth Cardiology 110 Free Street Portland ME 04101 452525629 Healthcare ME 501(c)(3) Line 10 MaineHealth 0 The Memorial Hospital 3073 White Mountain Highway North Conway NH 03860 020222156 Hospital NH 501(c)(3) Line 3 MaineHealth 0 Southern Maine Health Care PO Box 626 Biddeford ME 04005 010179500 Hospital ME 501(c)(3) Line 3 MaineHealth 0 Franklin Community Health Network 111 Franklin Health Commons Farmington ME 04938 223209406 Healthcare ME 501(c)(3) Line 12b, II MaineHealth 0 St Joseph's Rehab & Residence 1133 Washington Avenue Portland ME 04103 010339489 Nursing home ME 501(c)(3) Line 10 Maine Medical Center 1 MaineHealth Accountable Care Organization 110 Free Street Portland ME 04101 452929273 Accountable Care Organization ME Maine Medical Center Related 569432 5070187 0 1 0.53410 GSM Realty LLC 22 Bramhall Street Portland ME 04102 204582952 Real Estate ME Southern Maine Healthcare Related 183722 0 0 0.33330 Maine Medical Partners 22 Bramhall Street Portland ME 04102 010442142 Healthcare ME Maine Medical Center C 189748924 16849921 1.00000 1 Synernet Inc 110 Free Street Portland ME 04101 010539789 Administrative services ME N/A C 0 0 0 1 1 0 0 0 0 1 1 1 0 0 0 1 1 1 1 0 Maine Medical Partners J 49909968 Fair Market Value Maine Medical Partners O 139241976 Fair Market Value Maine Medical Partners P 24530069 Fair Market Value Maine Medical Partners Q 39600296 Fair Market Value Maine Medical Partners R 184911578 Fair Market Value Maine Medical Center Realty Corp K 2970019 Fair Market Value Maine Medical Center Realty Corp Q 1174633 Fair Market Value Maine Medical Center Realty Corp O 172133 Fair Market Value Maine Medical Center Realty Corp I 6331798 Fair Market Value Saint Joseph's Rehabilitation and Residence I 1023921 Fair Market Value Saint Joseph's Rehabilitation and Residence R 3775000 Fair Market Value