2018-05-02T07:40:31-05:00 2017-12-31 010242373 MACPAGE LLC 30 LONG CREEK DRIVE SOUTH PORTLAND ME 04106 990 2017-01-01 205150062 HEALTHINFONET HEAL 2075419250 125 PRESUMPSCOT STREET BOX 8 PORTLAND ME 04103 SHAUN ALFREDS CEO/EXECUTIVE DIRECTOR 2075419250 2018-04-30 1 CHRISTIAN SMITH P00289576 2077745701 2018-04-30 X 2017 2022-09-23 18:48:47Z 125 PRESUMPSCOT STREET BOX 8 PORTLAND ME 04103 4702665 0 X WWW.HINFONET.ORG X 2008 ME TO OVERSEE THE IMPLEMENTATION AND OPERATION OF A STATEWIDE HEALTH INFORMATION TECHNOLOGY NETWORK. 18 18 22 0 0 0 8579 0 4919196 4699687 3037 2978 0 0 4930812 4702665 0 0 0 0 2772474 2505516 0 0 0 2635880 2089461 5408354 4594977 -477542 107688 3658188 3399227 758538 391889 2899650 3007338 TO OVERSEE THE IMPLEMENTATION AND OPERATION OF A STATEWIDE HEALTH INFORMATION TECHNOLOGY NETWORK. 0 0 3819050 4699687 CONTINUED TO MOVE TOWARD FULL IMPLEMENTATION OF THE PROJECT AS SCHEDULED. 3819050 1 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 1 8 0 1 22 1 0 0 0 0 0 0 0 0 X 18 18 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 X ALLISON MCBRIERTY 2075419250 125 PRESUMPSCOT STREET BOX 8 PORTLAND ME 04103 KYLE JOHNSON DIRECTOR 1.00 X 0 0 0 KEVIN LEWIS VICE CHAIR 1.00 X X 0 0 0 PETER MILLS MEMBER AT-LARGE 1.00 X X 0 0 0 KAREN BELL TREASURER 1.00 X X 0 0 0 STEPHEN SEARS SECRETARY 1.00 X X 0 0 0 KEN MCCALL DIRECTOR 1.00 X 0 0 0 MICHELLE PROBERT DIRECTOR 1.00 X 0 0 0 PAUL STEIN DIRECTOR 1.00 X 0 0 0 CAROL TIMBERLAKE DIRECTOR 1.00 X 0 0 0 ANN SULLIVAN CONSUMER REPRESENTATIVE 1.00 X X 0 0 0 LYNN DUBY DIRECTOR 1.00 X 0 0 0 DONALD KRAUSE DIRECTOR 1.00 X 0 0 0 ED KANE DIRECTOR 1.00 X 0 0 0 EDWARD TRAINER DIRECTOR 1.00 X 0 0 0 DERVILLA MCCANN DIRECTOR 1.00 X 0 0 0 MARCY DUNN DIRECTOR 1.00 X 0 0 0 DAVID HOWES CHAIR 1.00 X X 0 0 0 DIMITRI MICHAUD DIRECTOR 1.00 X 0 0 0 DEVORE CULVER FORMER CEO 40.00 X 272360 0 25520 SHAUN ALFREDS CEO/EXECUTIVE DIRECTOR 40.00 X 206526 0 31293 KIM BUSTAMANTE FORMER DIRECTOR OF FINANCE AND ADMINISTRATION 40.00 X 108587 0 25154 PHILIP PROFENNO DIRECTOR OF INFORMATION SE 40.00 X 123427 0 9599 KATIE SENDZE DIRECTOR OF CLIENT SERVICES 40.00 X 107273 0 14885 RICHARD WALLACE INTERGRATION DEVELOPER 40.00 X 105625 0 13867 923798 0 120318 6 0 1 0 ORION PO BOX 2927 BUFFALO NY 142402927 SOFTWARE AND SUPPORT 443715 SYSTEMS ENGINEERING 120 EXCHANGE STREET PORTLAND ME 04101 SERVICES 427230 SURESCRIPTS 2800 CRYSTAL DRIVE ARLINGTON VA 22202 SERVICES 131085 LEAN HEALTHCARE EAST 2 MAIN STREET TOPSHAM ME 04086 CONSULTING 128000 PORTLAND ROUNDHOUSE HOLDINGS LLC 125 PRESUMPSCOT STREET PORTLAND ME 04101 RENT 125582 5 PARTICIPATION REVENUE 900099 2855071 2855071 CONTRACTED SERVICES 900099 1832196 1832196 COMMISSION 900099 12420 12420 4699687 2978 2978 4702665 4699687 0 2978 546912 268572 278340 1550033 1381354 168679 97271 86426 10845 167470 140073 27397 143830 114277 29553 18744 15514 3230 141895 120610 21285 7551 6418 1133 9859 1647 8212 238143 103901 134242 46739 31073 15666 VENDORS 1162427 1162427 CONTRACTUAL SERVICES 219455 168300 51155 SUBCONTRACTS 170000 170000 MISC AND OTHER EXPENSES 28090 15480 12610 46558 32978 13580 4594977 3819050 775927 0 2321547 2079182 361006 615173 299025 178550 1337472 923677 458398 413795 218212 112527 3658188 3399227 334055 265532 424483 126357 758538 391889 X 2899650 3007338 2899650 3007338 3658188 3399227 107688 0 X 0 1 X 1 0 X 41764 8579 50343 6425303 6666193 6198691 4919196 4699687 28909070 6425303 6707957 6198691 4927775 4699687 28959413 0 1530923 919779 2450702 1530923 919779 2450702 26508711 396 935 2202 3037 2978 9548 396 935 2202 3037 2978 9548 6425699 6708892 6200893 4930812 4702665 28968961 0.91510 0.83710 0.00030 0.00030 X 1337472 923677 413795 413795 4702665 0 4702665 0 4702665 4594977 0 4594977 0 4594977 PART XII, LINE 4B - OTHER ADJUSTMENTS: ROUNDING X 1 0 X X X 1 0 0 0 0 0 0 1 0 DEVORE CULVER FORMER CEO 258710 0 0 0 13650 0 0 0 25520 0 297880 0 0 0 SHAUN ALFREDS CEO/EXECUTIVE DIRECTOR 206526 0 0 0 0 0 0 0 31293 0 237819 0 0 0 PART I, LINE 1A CEO RECEIVES A HOUSING ALLOWANCE OF $13,650 ANNUALLY; IT IS INCLUDED IN HIS W-2 WAGES BUT IS NOT PART OF HIS BASE SALARY. PART I, LINE 3 THE EXECUTIVE COMMITTEE PERFORMS INDEPENDENT THIRD-PARTY COMPENSATION REVIEWS EVERY THREE YEARS FOR THE OFFICERS. THE EXECUTIVE COMMITTEE DETERMINES AMOUNT OF COMPENSATION AND ANNUAL BONUS FOR THE CEO. THE CEO HAS THE AUTHORITY TO DETERMINE AMOUNT OF COMPENSATION AND ANNUAL BONUS AMOUNTS FOR OTHER OFFICERS BASED UPON GUIDELINES DETERMINED BY THE EXECUTIVE COMMITTEE. BONUSES ARE BASED ON ORGANIZATIONAL AND EMPLOYEE PERFORMANCE. PART I, LINE 4A INCLUDED IN THE BASE COMPENSATION PAID TO THE CEO DEVORE CULVER, IS A SEVERANCE PAYMENT FOR $8,982. PART I, LINE 7 EMPLOYEES INCLUDING THE CEO ARE ELIGIBLE TO RECEIVE MERIT BONUSES FROM THE ORGANIZATION AT THEIR ANNUAL REVIEWS. THIS IS INCLUDED ON THE W-2S. KYLE JOHNSON CHIEF INFORMATION OFFICER AT EASTERN MAINE HEALTHCARE BOD MEMBER 804000 SCHEDULE O - HIN REVENUE 0 PAUL STEIN COO AT MAINEGENERAL MEDICAL CENTER BOD MEMBER 175340 SCHEDULE O - HIN REVENUE 0 DONALD KRAUSE MD ST JOSEPH HEALTHCARE BOD MEMBER 147890 SCHEDULE O - HIN REVENUE 0 DERVILLA MCCANN CHIEF OF POPULATION HEALTH CENTRAL MAINE HEALTH CARE BOD MEMBER 183750 SCHEDULE O - HIN REVENUE 0 DIMITRI MICHAUD MARY MAYHEW DHHS MAINE CDC BOD MEMBER 1515104 SCHEDULE O - HIN REVENUE 0 MARCY DUNN CIO MAINEHEALTH BOD MEMBER 579500 SCHEDULE O - HIN REVENUE 0 DAVID HOWES PRESIDENT AND CEO MARTIN'S POINT BOD MEMBER 52500 SCHEDULE O - HIN REVENUE 0 FORM 990, PART VI, SECTION B, LINE 11B LINE 11A EXPLANATION - THE IRS 990 REPORT IS AN INFORMATIONAL TAX FILING FOR ORGANIZATIONS EXEMPT FROM FEDERAL INCOME TAX. THESE REPORTS ARE DUE TO THE IRS BY MAY FOLLOWING THE CLOSED FISCAL YEAR. THE INDEPENDENT AUDIT FIRM REQUIRES VARIOUS INTERNAL DOCUMENTS TO COMPLETE THE 990 REPORT INCLUDING INCOME, EXPENSES, GRANT AWARDS, PAYROLL, EQUIPMENT INVENTORY, ETC. THE 990 TAX RETURN IS SUBMITTED TO THE DIRECTOR OF ADMINISTRATION & FINANCE TO REVIEW PRIOR TO SIGNING BY THE CEO. THE BOARD OF DIRECTORS REVIEWS AND APPROVES THE 990 PRIOR TO FILING WITH THE IRS. COPIES OF EACH YEAR'S 990 REPORTS ARE MAINTAINED IN ACTIVE FINANCE OFFICE FILES WITH ORIGINALS MAILED TO THE IRS. FORM 990, PART VI, SECTION B, LINE 12C THE BOARD MEMBERS SIGN A CONFLICT OF INTEREST STATEMENT ANNUALLY AND DISCLOSE ANY CONFLICT OF INTEREST ISSUES AT MEETINGS WHEN APPLICABLE. FORM 990, PART VI, SECTION B, LINE 15 THE EXECUTIVE COMMITTEE PERFORMS INDEPENDENT THIRD-PARTY COMPENSATION REVIEWS EVERY THREE YEARS FOR THE OFFICERS. THE EXECUTIVE COMMITTEE DETERMINES AMOUNT OF COMPENSATION AND ANNUAL BONUS FOR THE CEO. THE CEO HAS THE AUTHORITY TO DETERMINE AMOUNT OF COMPENSATION AND ANNUAL BONUS AMOUNTS FOR OTHER OFFICERS BASED UPON GUIDELINES DETERMINED BY THE EXECUTIVE COMMITTEE. BONUSES ARE BASED ON ORGANIZATIONAL AND EMPLOYEE PERFORMANCE. FORM 990, PART VI, SECTION C, LINE 19 FINANCIAL STATEMENTS, GOVERNING DOCUMENTS AND POLICIES ARE PROVIDED UPON REQUEST. SCHEDULE L, SUPPLEMENTAL INFORMATION HEALTHINFONET RECEIVES REVENUE FROM SEVERAL ENTITIES WHICH HAVE REPRESENTATIVES SERVING ON THE BOARD OF DIRECTORS. IN ADDITION, HEALTHINFONET MAKES PAYMENTS TO SEVERAL OF THESE ENTITIES WHICH PARTICIPATE IN A PROGRAM FUNDED BY A FEDERAL GRANT. PART IV (1) KYLE JOHNSON, MD, CHIEF INFORMATION OFFICER OF EASTERN MAINE HEALTHCARE SYSTEMS. EASTERN MAINE HEALTHCARE SYSTEM MADE GRANTS AND PAYMENTS TO HEALTHINFONET TOTALING REVENUE OF $804,000 AND $4,167 IN DEFERRED REVENUE. PART IV (2) PAUL STEIN, CHIEF OPERATING OFFICER, MAINEGENERAL MEDICAL CENTER (MEMBER MAINEGENERAL HEALTH). MAINEGENERAL HEALTH PROVIDED HEALTHINFONET WITH REVENUE TOTALING $175,340 IN 2017. HEALTHINFONET HAD ACCOUNTS RECEIVABLE TOTALING $17,840 DUE FROM MAINEGENERAL MEDICAL CENTER AT DEC.31, 2017. PART IV (3) DONALD KRAUSE, MD, ST. JOSEPH'S HEALTHCARE. ST. JOSEPH'S HEALTHCARE PROVIDED HEALTHINFONET WITH REVENUE TOTALING $147,890 IN 2017 AND $31,500 IN DEFERRED REVENUE. PART IV (4) DERVILLA MCCANN, CHIEF OF POPULATION HEALTH, CENTRAL MAINE HEALTH CARE. CENTRAL MAINE HEALTH CARE PROVIDED HEALTHINFONET WITH REVENUE TOTALING $183,750; HEALTHINFONET HAD ACCOUNTS RECEIVABLE TOTALING $67,188 DUE FROM CENTRAL MAINE HEALTH CARE AT DEC. 31, 2017. PART IV (5) DIMITRI MICHAUD, DIRECTOR, MAINE DEPARTMENT OF HEALTH AND HUMAN SERVICES. THE MAINE DHHS MADE GRANTS TO HEALTHINFONET TOTALING $1,515,104 IN 2017; HEALTHINFONET HAD ACCOUNTS RECEIVABLE TOTALING $176,487 DUE FROM THE MAINE DHHS AT DEC. 31, 2017. PART IV (6) MARCY DUNN, CIO, MAINEHEALTH. MAINEHEALTH PROVIDED HEALTHINFONET WITH REVENUE TOTALING $579,500 IN 2017. PART IV (7) DAVID HOWES, PRESIDENT AND CEO, MARTIN'S POINT. MARTIN'S POINT PROVIDED HEALTHINFONET WITH REVENUE TOTALING $52,500 IN 2017.