2019-05-14T12:00:30-05:00 2018-06-30 BKD LLP 910 E ST LOUIS 200/PO BOX 1190 SPRINGFIELD MO 658062523 990 2017-07-01 010130427 BRIDGTON HOSPITAL % DAVID THOMPSON BRID 2077952813 10 HOSPITAL DRIVE BRIDGTON ME 04009 DAVID THOMPSON TREASURER 2077952972 2019-03-02 true Brian D Todd P00422601 4178658701 167.68.126.162 43032920191345000017 2019-05-14 P 353840E92A19E57AE3D09FB5FB5D869273682438 39CBA67CBDC84C24964593991C1F330368A3BFFE 2017 2019-02-21 02:37:17Z X PETER WRIGHT 10 HOSPITAL DRIVE BRIDGTON ME 04009 54620376 false X WWW.BRIDGTONHOSPITAL.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. 9 8 428 30 0 18111 256364 115727 53416254 50329235 251451 578232 -116315 12387 53807754 51035581 0 0 0 0 23740170 21163180 0 0 0 29209464 30612243 52949634 51775423 858120 -739842 55816610 57596830 10274801 12723455 45541809 44873375 TO PROVIDE EXCEPTIONAL HEALTHCARE SERVICES IN A SAFE AND TRUSTFUL ENVIRONMENT THROUGH THE EXPERTISE, COMMITMENT, AND COMPASSION OF OUR FAMILY OF CAREGIVERS. false false 41652826 50329235 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 SUITES. 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. 41652826 true true false true false false false false false true true false false false true false false true false false false false false false true false true true false false true true false false false false false true false false false false false false false false false true false false false true X 43 0 true 428 true false false false false false true true 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 WILLIAM CHALMERS DIRECTOR END 01/18 1.0 1.0 X 0 0 0 PHILIP LIBBY CHAIRMAN END 01/18; DIRECTOR 1.0 3.0 X X 0 0 0 CAROL SUDDUTH DIRECTOR END 01/18 1.0 0.0 X 0 0 0 HOLLY DVORAK DIRECTOR END 01/18 1.0 0.0 X 0 0 0 MATTHEW FRANK VICE CHAIR END 01/18 1.0 0.0 X X 0 0 0 SUSAN COLE SECRETARY END 01/18 1.0 0.0 X X 0 0 0 VINCE OSGOOD 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 JESSICA PRIOLA DIRECTOR END 01/18 1.0 0.0 X 0 0 0 MARK ADAMS 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 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 JANET HALL DIRECTOR BEG 01/18 1.0 3.0 X 0 0 0 JOLAN IPPOLITO DIRECTOR BEG 01/18 1.0 3.0 X 0 0 0 WILLIAM LEE MD PHYSICIAN/DIRECTOR BEG 01/18 1.0 57.0 X 0 324839 45326 CRAIG TRIBUNO DIRECTOR BEG 01/18 1.0 3.0 X 0 0 0 R DAVID FRUM PRESIDENT OF BRIDGTON HOSPITAL 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 WENDA SAUNDERS PHYSICIAN CHIEF 45.0 0.0 X 237594 0 28398 ALAN LANGBURD PHYSICIAN 45.0 0.0 X 362181 0 31904 CRAIG SMITH MD PHYSICIAN 45.0 0.0 X 459671 0 30282 SHAYNA LEMKE PHYSICIAN 45.0 0.0 X 369418 0 28047 MAHNEE DINSMORE PHYSICIAN 45.0 0.0 X 297166 0 6259 BRUCE LASTRA PHYSICIAN 45.0 0.0 X 344432 0 26331 PHILIPPE MORISSETTE FORMER TREASURER/VICE PRES. 0.0 55.0 X 0 229117 51773 2070462 2483430 493662 34 true true false INSIGHT HEALTH CORP 26250 ENTERPRISE COURT SUITE 100 LAKE FOREST CA 92630 MEDICAL STAFFING 301973 SODEXO CLINICAL TECHNOLOGY 7100 COMMERCE WAY 280 NASHVILLE TN 37241 MEDICAL SERVICES 348593 LOCUMTENENSCOM LLC 2655 NORTHWINDS PARKWAY ATLANTA GA 30009 MEDICAL STAFFING 255934 COMPREHENSIVE PHARMACY SERVICE 6409 N QUAIL HOLLOW ROAD MEMPHIS TN 38120 PHARMACY SERVICES 231089 SODEXO INC 525 WILLIAM PENN PL PITTSBURGH PA 152516170 SUPPORT SERVICES 225063 10 22288 55017 38422 115727 NET PATIENT SERVICE REVENUE 900099 48115658 48115658 CAFETERIA REVENUE 722514 76775 76775 OTHER REVENUE 900099 2136802 2136802 50329235 287532 287532 0 0 18827 18827 0 18827 18827 3857420 3522239 44481 335181 -44481 290700 290700 11635 22288 18075 -6440 -6440 0 0 0 0 0 0 0 51035581 50329235 590619 X 0 0 0 0 265992 202154 63838 0 17260717 13118145 4142572 0 2469521 1876835 592686 1166950 886882 280068 0 4230 4230 26747 26747 0 0 3182 3182 11292470 8582277 2710193 29947 22760 7187 2951641 2243655 707986 775218 589166 186052 0 1015683 771919 243764 87524 66518 21006 0 42819 32542 10277 289144 219749 69395 0 2128297 1617506 510791 1628642 1237768 390874 BAD DEBT 5312635 5312635 MEDICAL SUPPLIES & DRUGS 4391524 4391524 REPAIRS & MAINTENANCE 460028 349621 110407 LICENSES, DUES, SUBSCRIPTIONS 147799 112388 35411 24713 18782 5931 51775423 41652826 10122597 0 354009 365574 21530857 23006945 158 7948 5458871 4860453 5940 27920 0 0 0 0 463872 481749 80176 58939 41670015 25724029 16100235 15945986 9541765 10015061 0 0 0 0 615529 493183 1665198 2333072 55816610 57596830 2867431 3473205 0 0 64941 69941 6150312 6324499 0 0 0 0 1004457 683140 0 0 187660 2172670 10274801 12723455 X 41120687 40267665 3223052 3366434 1198070 1239276 45541809 44873375 55816610 57596830 X -739842 23913 47495 X false true X true false X false false false false false false false false true 8372 8372 false SCHEDULE C, PART II-B, LINE 1I LOBBYING ACTIVITIES: PORTION OF DUES FOR PROFESSIONAL ASSOCIATIONS ATTRIBUTED TO LOBBYING EXPENSES - $8,372 4421122 75559 139533 30504 4605710 4296343 40152 138472 53845 4421122 4263881 91225 -1144 57619 4296343 3904263 384397 -2752 22027 4263881 3644303 129433 197906 67379 3904263 0.26907 0.73093 false true true 713543 713543 19050663 9119893 9930770 6767 6767 21326467 16075505 5250962 572575 521864 50711 15945986 0 EST AMTS DUE TO 3RD PTY PYRS 2172670 2172670 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 MEDICAL EDUCATION, OR FREE CARE. OTHERS ARE DESIGNATED TO SUPPORT SPECIFIC DEPARTMENTS OF THE HOSPITAL. SCHEDULE D, PART X, LINE 2 UNCERTAIN TAX POSITIONS: 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. GOLF TOURNAMENT 33923 22288 11635 3188 5440 3196 6251 0 33923 22288 11635 3188 5440 3196 6251 18075 -6440 true true X true X false true true false false 717710 717710 0.01540 8465816 7467305 998511 0.02150 9183526 7467305 1716221 0.03690 9183526 7467305 1716221 0.03690 false 5312635 907600 15545892 15260672 285220 X true true 1 1 BRIDGTON HOSPITAL 10 HOSPITAL DRIVE BRIDGTON ME 04009 WWW.BRIDGTONHOSPITAL.ORG 38658 X X X X OUTPATIENT PHYSICIAN CLINICS BRIDGTON 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 CUMBERLAND COUNTY, A TOTAL OF 176 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 MAINEGENERAL MEDICAL CENTER. SCHEDULE H, PART V, SECTION B, LINE 6B NON-HOSPITAL FACILITIES: THE CHNA 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: WWW.CMHC.ORG/BRIDGTON-HOSPITAL/ABOUT-BRIDGTON/COMMUNITY-BENEFITS SCHEDULE H, PART V, SECTION B, LINE 10A IMPLEMENTATION STRATEGY WEBSITE: WWW.CMHC.ORG/BRIDGTON-HOSPITAL/ABOUT-BRIDGTON/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, BRIDGTON HOSPITAL ENGAGED IN AN ASSESSMENT OF THE HEALTH NEEDS OF CUMBERLAND COUNTY WITH A FOCUS ON THE LAKE REGION DISTRICT. BRIDGTON 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 CUMBERLAND 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 FOUR COMMUNITY HEALTH CONCERNS THAT HAVE BECOME BRIDGTON HOSPITAL'S IMPLEMENTATION STRATEGY. -SUBSTANCE ABUSE: COMMUNITY OUTREACH; EDUCATIONAL SESSIONS, AND LOCAL DRUG/ALCOHOL COALITION INVOLVEMENT. -YOUTH HEALTH/MENTAL HEALTH: (FREE) EDUCATIONAL SESSIONS, IMMUNIZATIONS, SPORTS MEDICINE, AND MENTAL HEALTH AWARENESS. -SENIOR HEALTH: (FREE) EDUCATION SESSIONS, (FREE) PRESCRIPTION ASSISTANCE FOR THE UNDERSERVED. -FOOD INSECURITY: (FREE) 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 CUMBERLAND COUNTY AND LAKE REGION COMMUNITY WITH THE HEALTH CARE INDICATORS OF CONCERN BRIDGED WITH HEALTHY 2020, SUPPORTING THE DEVELOPMENT OF THE BRIDGTON 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, BRIDGTON 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 PROVIDED A BAG OF SHELF STABLE HEALTHY FOODS UPON HOSPITAL DISCHARGE. DURING THE 6 MONTH PILOT PROGRAM, 467 FOOD INSECURITY SCREENINGS WERE CONDUCTED, 41 OR 9% OF PATIENTS IDENTIFIED AS FOOD INSECURE. 32 PATIENTS WERE PROVIDED A COMMUNITY FOOD RESOURCE HANDOUT AND 28 BAGS OF FOOD WERE PROVIDED. 12 REFERRALS WERE MADE TO OTHER NON-FOOD RELATED SUPPORT SERVICES SUCH AS HOUSING, TRANSPORTATION OR EMPLOYMENT. THE PILOT WAS SO SUCCESSFUL THAT IT WAS APPROVED TO CONTINUE FOR THE REMAINDER OF FY18. ADDRESSING HIGH ED USAGE, SENIOR HEALTH AND MENTAL HEALTH THROUGH PARAMEDIC HOME VISITS AND MENTAL HEALTH TREATMENT: CENTRAL MAINE HEALTHCARE DEVELOPED A PROGRAM TO ADDRESS HIGH EMERGENCY DEPARTMENT USAGE AND PROVIDE MORE APPROPRIATE CARE TO VULNERABLE MEMBERS OF THE BRIDGTON COMMUNITY THROUGH A RURAL HEALTH TRANSFORMATION PROJECT. DR. DERVILLA MCCANN, CMH DIRECTOR OF POPULATION HEALTH AND CARDIOLOGIST, LED THIS EFFORT WHICH INVESTIGATED THE FACTORS THAT LEAD TO HIGH UTILIZATION OF EMERGENCY SERVICES, AND EXPANDED A SYSTEM OF HOME CARE USING TRAINED PARAMEDICS TO ASSESS, TRIAGE, TREAT AND REFER PATIENTS IN THE RURAL HEALTH SETTING OF BRIDGTON, MAINE. FROM MAY 2017 THROUGH MAY 2018, JUST OVER 160 ER PATIENTS WERE SCREENED AS BEING HIGH RISK USING A HEALTH RISK ASSESSMENT TOOL AND CHART REVIEW TO IDENTIFY WHICH HIGH RISK PATIENTS WOULD BENEFIT FROM A PARAMEDIC HOME VISIT. THE HOME VISIT THEN INCLUDED A PHYSICAL EXAM, HOME SAFETY ASSESSMENT, MEDICATION RECONCILIATION, ASSISTANCE WITH MEDICATION DOSING AND ORGANIZATION, MEDICATION EDUCATION, AND NAVIGATION ASSISTANCE TO ENSURE THE PATIENT WAS CONNECTED TO A PRIMARY CARE PROVIDER. BASED ON THE HOME VISIT, REFERRAL TO OTHER COMMUNITY BASED CARE WAS MADE; BOTH SOCIAL SERVICES THROUGH THE BRIDGTON COMMUNITY CENTER AND BEHAVIORAL HEALTH CARE THROUGH A LOCAL BEHAVIORAL HEALTH HOME WERE OBTAINED DURING THE PROJECT, SUPPORTED BY GRANT FUNDING. 27 PATIENTS ACCEPTED HOME VISITS WITH AN AVERAGE AGE OF 67 YEARS. THE PARAMEDICS PROVIDED 277 HOME VISITS TO THIS COHORT OF 27 PATIENTS. THE MOST FREQUENTLY DELIVERED SERVICES WERE BLOOD SUGAR MONITORING, WOUND CARE, HOME SAFETY CHECKS, ASTHMA EDUCATION, AND PRESCRIPTION PILL BOX EDUCATION. THE PARAMEDICS AND A PATIENT NAVIGATOR ALSO MADE REFERRALS TO COMMUNITY RESOURCES SUCH AS MENTAL HEALTH TREATMENT, FINANCIAL INSECURITY, TRANSPORTATION, SUBSTANCE MISUSE, AND FOOD INSECURITY. IN SOME CASES MENTAL HEALTH TREATMENT WAS PROVIDED TO THE PATIENT THROUGH THIS PROGRAM, FREE OF CHARGE. COMMUNITY HEALTH NEEDS ASSESSMENT PLANNING: DURING FY2018, BRIDGTON HOSPITAL STAFF PARTICIPATED IN PLANNING FOR THE COMMUNITY HEALTH NEEDS ASSESSMENT PROCESS. BRIDGTON 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, BRIDGTON HOSPITAL PROVIDED OUTPATIENT DIABETES SELF-MANAGEMENT CLASSES, PROVIDED OPPORTUNITIES FOR COMMUNITY MEMBERS TO WALK WITH A DOC AND PARTNERED WITH THE LAKE REGION SUBSTANCE ABUSE COALITION TO HOST A RESOURCE FAIR AND PANEL DISCUSSION ABOUT THE OPIOID EPIDEMIC. SCHEDULE H, PART V, SECTION B, LINE 13H 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 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). 11 BRIDGTON INTERNAL MEDICINE 25 HOSPITAL DRIVE BRIDGTON ME 04009 OUTPATIENT PHYSICIAN CLINIC BRIDGTON GENERAL SURGERY 25 HOSPITAL DRIVE BRIDGTON ME 04009 OUTPATIENT PHYSICIAN CLINIC BRIDGTON OBGYN 15 HOSPITAL DRIVE BRIDGTON ME 04009 OUTPATIENT PHYSICIAN CLINIC BRIDTON GASTROENTEROLOGY 15 HOSPITAL DRIVE BRIDGTON ME 04009 OUTPATIENT PHYSICIAN CLINIC BRIDGTON SPORTS MEDICINE 25 HOSPITAL DRIVE BRIDGTON ME 04009 OUTPATIENT PHYSICIAN CLINIC BRIDGTON FAMILY PRACTICE 25 HOSPITAL DRIVE BRIDGTON ME 04009 OUTPATIENT PHYSICIAN CLINIC PONDICHERRY FAMILY PRACTICE 15 HOSPITAL DRIVE BRIDGTON ME 04009 OUTPATIENT PHYSICIAN CLINIC NAPLES FAMILY PRACTICE 410 ROOSEVELT TRAIL NAPLES ME 04055 OUTPATIENT PHYSICIAN CLINIC BRIDGTON PEDIATRICS 25 HOSPITAL DRIVE BRIDGTON ME 04009 OUTPATIENT PHYSICIAN CLINIC NORTH BRIDGTON FAMILY PRACTICE 14 WYONEGONIC ROAD BRIDGTON ME 04009 OUTPATIENT PHYSICIAN CLINIC FRYEBURG FAMILY MEDICINE 253 BRIDGTON ROAD FRYEBURG ME 04037 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 IX, LINE 25 OF THE FORM 990, WAS REDUCED BY BAD DEBT EXPENSE OF $5,312,635. 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 CONVERGE 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 IS 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. THE 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 BRIDGTON 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, BRIDGTON HOSPITAL ATTEMPTS TO PROVIDE ANY NEEDED HEALTH CARE SERVICES NECESSARY TO TREAT THE POPULATION OF THIS RURAL AREA OF MAINE. ADDITIONALLY, BRIDGTON 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: BRIDGTON 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: BRIDGTON HOSPITAL, LOCATED IN BRIDGTON, MAINE, SERVES 21 TOWNS IN THE "LAKES REGION" OF WESTERN MAINE, AS WELL AS THE WESTERN MOUNTAINS OF MAINE AND THE MOUNT WASHINGTON VALLEY REGION OF NEW HAMPSHIRE. THE REGION IS RURAL IN NATURE AND IS PRIMARILY MADE UP OF WESTERN CUMBERLAND AND SOUTHERN OXFORD COUNTIES IN MAINE, AS WELL AS CARROLL COUNTY IN NEW HAMPSHIRE. THE REGION IS PRIMARILY MADE UP OF CAUCASIAN PERSONS AND HAS A VARIABLE POPULATION. THE REGION IS A SUMMER TOURIST DESTINATION AND THE POPULATION SWELLS DRAMATICALLY DURING THAT SEASON, MAKING DEMOGRAPHICS SOMEWHAT FLUID. APPROXIMATELY 14% OF THE YEAR ROUND POPULATION IS BELOW THE POVERTY LEVEL. SCHEDULE H, PART VI, LINE 5 PROMOTION OF COMMUNITY HEALTH: BRIDGTON 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 BRIDGTON 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 BRIDGTON AND SURROUNDING COMMUNITIES. SCHEDULE H, PART VI, LINE 6 AFFILIATED HEALTH CARE SYSTEM: AS A MEMBER OF THE CENTRAL MAINE HEALTHCARE SYSTEM, BRIDGTON 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 BRIDGTON AREA ON A REGULAR SCHEDULE. THE SYSTEM PARENT, CENTRAL MAINE HEALTHCARE, PROVIDES STREAMLINED ADMINISTRATIVE FUNCTIONS AND BACKROOM SERVICES, ALLOWING BRIDGTON 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 OF BRIDGTON HOSPITAL 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 PHYSICIAN/DIRECTOR BEG 01/18 0 299378 0 18317 0 7144 0 24625 0 20701 0 370165 0 0 ALAN LANGBURD PHYSICIAN 328612 0 28300 0 5269 0 24625 0 7279 0 394085 0 0 0 CRAIG SMITH MD PHYSICIAN 296823 0 159343 0 3505 0 6625 0 23657 0 489953 0 0 0 SHAYNA LEMKE PHYSICIAN 177427 0 159527 0 32464 0 6438 0 21609 0 397465 0 0 0 MAHNEE DINSMORE PHYSICIAN 209785 0 74427 0 12954 0 0 0 6259 0 303425 0 0 0 BRUCE LASTRA PHYSICIAN 280740 0 46560 0 17132 0 6625 0 19706 0 370763 0 0 0 WENDA SAUNDERS PHYSICIAN CHIEF 104295 0 131623 0 1676 0 6242 0 22156 0 265992 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, R. DAVID FRUM, 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) 20,500 DAVID THOMPSON (DEFERRAL) 69,500 JEFF BRICKMAN (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 THAT COMPENSATION IS NOT PAID TO THE INDIVIDUAL, IS NOT FULLY VESTED, OR IS SUBJECT TO SUBSTANTIAL RISK OR 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. A MAINE HEALTH AND HIGHER EDUCATIONAL FACILITIES AUT 010314384 56042RLG5 2017-06-27 6150311 REFUND BOND SERIES 2001A false false true A 285000 0 6150311 0 0 0 66878 0 0 0 6083433 0 2017 true false true true A 0 A false true false false false false 0 false 0 false false A false BRUCE LASTRA HIGH COMP EE SAL ADVANCE X 40000 27920 false false true 27920 FORM 990, PART V, LINE 1A & 2A COMMON PAYMASTER: BRIDGTON 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 MEMBERS 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 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 B, LINE 15A & 15B EXECUTIVE COMPENSATION POLICY: 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 EFF 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 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 ATTORNEY'S. USING THIS INFORMATION, THE ECC ANNUALLY REVIEWS THE EXECUTIVE'S 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 A 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 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 FO 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 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: $ 39,706 CHANGE IN BENEFICIAL INTEREST IN PERPETUAL TRUST 7,789 CHANGE IN PLEDGE DISCOUNT -------- $ 47,495 FORM 990 PART IX LINE 11G DESCRIPTION:PURCHASED SERVICES TOTAL FEES:4413183 FORM 990 PART IX LINE 11G DESCRIPTION:PURCHASED LABOR - PHYSICIANS TOTAL FEES:3488029 FORM 990 PART IX LINE 11G DESCRIPTION:OUTSIDE SERVICES TOTAL FEES:1885332 FORM 990 PART IX LINE 11G DESCRIPTION:PURCHASED LABOR - OTHER TOTAL FEES:1438793 FORM 990 PART IX LINE 11G DESCRIPTION:PURCHASED LABOR - NURSES TOTAL FEES:50021 FORM 990 PART IX LINE 11G DESCRIPTION:CONSULTING SERVICES TOTAL FEES:15073 FORM 990 PART IX LINE 11G DESCRIPTION:INTERPRETING SERVICES TOTAL FEES:1840 FORM 990 PART IX LINE 11G DESCRIPTION:PROFESSIONAL FEES TOTAL FEES:199 CENTRAL MAINE COMMUNITY HEALTH CORP PO BOX 4500 LEWISTON ME 04243 010386912 PUBLIC ED ME 501(C)(3) 10 CMHC false CENTRAL MAINE MEDICAL CENTER PO BOX 4500 LEWISTON ME 04243 010211494 HEALTHCARE ME 501(C)(3) 3 CMHC 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 MANAGEMENT COR PO BOX 4500 LEWISTON ME 04243 010387674 REAL ESTATE ME 501(C)(2) CMHC false CENTRAL MAINE HEALTHCARE CORPORATION PO BOX 4500 LEWISTON ME 04243 010386913 HEALTHCARE ME 501(C)(3) 7 NA 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 RUMFORD HOSPITAL 420 FRANKLIN STREET RUMFORD ME 04276 010215227 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 016042343 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