RUMFORD HOSPITAL: Form 990, tax year 2015

View the entire original 990 at ProPublica ↗

Organization
RUMFORD HOSPITAL (EIN 01-0215227)
Tax period
2015-07-01 to 2016-06-30
Filed
2017-05-08
IRS object ID
201721289349301197
Schema version
2015v3.0
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Return2017-05-08T12:00:48-05:00ReturnTs
Tax Period End2016-06-30TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1BKD LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1910 E ST LOUIS 200/PO BOX 1190AddressLine1Txt
CitySPRINGFIELDCityNm
State AbbreviationMOStateAbbreviationCd
ZIP658062523ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2015-07-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN010215227EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1RUMFORD HOSPITALBusinessNameLine1Txt
FieldValueIRS element (for citing)
In Care Of% DAVID THOMPSONInCareOfNm
Business Name ControlRUMFBusinessNameControlTxt
Phone2077952972PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1420 FRANKLIN STREETAddressLine1Txt
CityRUMFORDCityNm
State AbbreviationMEStateAbbreviationCd
ZIP04276ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonR DAVID FRUMPersonNm
Person TitlePRESIDENTPersonTitleTxt
Signature2017-01-31SignatureDt
Discuss With Paid PreparerYes (true)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonBrian D ToddPreparerPersonNm
PTINP00422601PTIN
Phone4178658701PhoneNum
FieldValueIRS element (for citing)
Tax2015TaxYr
Build TS2021-01-29 14:40:06ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerR DAVID FRUMPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1420 FRANKLIN STREETAddressLine1Txt
CityRUMFORDCityNm
State AbbreviationMEStateAbbreviationCd
ZIP04276ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$45,878,822GrossReceiptsAmt
Group Return For AffiliatesfalseGroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.RUMFORDHOSPITAL.ORGWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1974FormationYr
Legal Domicile StateMELegalDomicileStateCd
Activity Or MissionRUMFORD HOSPITAL STRIVES TO PROVIDE EXCEPTIONAL HEALTHCARE SERVICES. THE HOSPITAL DEPENDS ON THE EXPERTISE COMMITMENT AND COMPASSION OF ITS CAREGIVERS TO FULFILL ITS MISSION.ActivityOrMissionDesc
Voting Members Governing Body9VotingMembersGoverningBodyCnt
Voting Members Independent8VotingMembersIndependentCnt
Total Employee373TotalEmployeeCnt
Total Volunteers64TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$41,333PYContributionsGrantsAmt
CY Contributions Grants$128,689CYContributionsGrantsAmt
PY Program Service Revenue$40,190,301PYProgramServiceRevenueAmt
CY Program Service Revenue$43,901,639CYProgramServiceRevenueAmt
PY Investment Income$94,230PYInvestmentIncomeAmt
CY Investment Income$60,991CYInvestmentIncomeAmt
PY Other Revenue-$38,800PYOtherRevenueAmt
CY Other Revenue-$41,521CYOtherRevenueAmt
PY Total Revenue$40,287,064PYTotalRevenueAmt
CY Total Revenue$44,049,798CYTotalRevenueAmt
PY Grants And Similar Paid$21,900PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$19,400CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$18,683,029PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$20,561,495CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$1,593CYTotalFundraisingExpenseAmt
PY Other Expenses$21,917,060PYOtherExpensesAmt
CY Other Expenses$24,342,461CYOtherExpensesAmt
PY Total Expenses$40,621,989PYTotalExpensesAmt
CY Total Expenses$44,923,356CYTotalExpensesAmt
PY Revenues Less Expenses-$334,925PYRevenuesLessExpensesAmt
CY Revenues Less Expenses-$873,558CYRevenuesLessExpensesAmt
Total Assets BOY$27,911,625TotalAssetsBOYAmt
Total Assets EOY$27,816,379TotalAssetsEOYAmt
Total Liabilities BOY$9,087,013TotalLiabilitiesBOYAmt
Total Liabilities EOY$9,789,995TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$18,824,612NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$18,026,384NetAssetsOrFundBalancesEOYAmt
MissionTO PROVIDE EXCEPTIONAL HEALTHCARE SERVICES IN A SAFE AND TRUSTFUL ENVIRONMENT THROUGH THE EXPERTISE, COMMITMENT AND COMPASSION OF OUR FAMILY OF CAREGIVERS.MissionDesc
Significant New Program SrvcfalseSignificantNewProgramSrvcInd
Significant ChangefalseSignificantChangeInd
Expense$36,085,932ExpenseAmt
Grant$19,400GrantAmt
Revenue$43,901,639RevenueAmt
DescRUMFORD HOSPITAL IS A CRITICAL ACCESS HOSPITAL, PROVIDING COMPREHENSIVE PRIMARY CARE AND SOPHISTICATED DIAGNOSTIC SERVICES, INCLUDING CT SCANNING, ULTRASOUND AND NUCLEAR MEDICINE. THE HOSPITAL OFFERS MEDICAL SURGICAL NURSING SERVICES, A BIRTHING CENTER, WOMEN'S HEALTH SERVICES AND AMBULATORY SURGERY. THE SWING BED PROGRAM PROVIDES CARE FOR PATIENTS WHO NEED SKILLED NURSING SERVICES. RUMFORD HOSPITAL ALSO MAINTAINS A 24 HOUR EMERGENCY DEPARTMENT AND STAFFS AN INTENSIVE CARE UNIT.Desc
Total Program Service Expenses$36,085,932TotalProgramServiceExpensesAmt
Described In Section501c3Yes (true)DescribedInSection501c3Ind
Schedule B RequiredYes (true)ScheduleBRequiredInd
Political Campaign ActyfalsePoliticalCampaignActyInd
Lobbying ActivitiesYes (true)LobbyingActivitiesInd
Subject To Proxy TaxfalseSubjectToProxyTaxInd
Donor Advised FundfalseDonorAdvisedFundInd
Conservation EasementsfalseConservationEasementsInd
Collections Of ArtfalseCollectionsOfArtInd
Credit CounselingfalseCreditCounselingInd
Temp Or Permanent EndowmentsYes (true)TempOrPermanentEndowmentsInd
Report Land Building EquipmentYes (true)ReportLandBuildingEquipmentInd
Report Investments Other SecfalseReportInvestmentsOtherSecInd
Report Program Related InvstfalseReportProgramRelatedInvstInd
Report Other AssetsfalseReportOtherAssetsInd
Report Other LiabilitiesYes (true)ReportOtherLiabilitiesInd
Include FIN48 FootnotefalseIncludeFIN48FootnoteInd
Independent Audit Fincl StmtfalseIndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (true)ConsolidatedAuditFinclStmtInd
School OperatingfalseSchoolOperatingInd
Foreign OfficefalseForeignOfficeInd
Foreign ActivitiesfalseForeignActivitiesInd
More Than5000 K To OrgfalseMoreThan5000KToOrgInd
More Than5000 K To IndividualsfalseMoreThan5000KToIndividualsInd
Professional FundraisingfalseProfessionalFundraisingInd
Fundraising ActivitiesfalseFundraisingActivitiesInd
Gaming ActivitiesfalseGamingActivitiesInd
Operate HospitalYes (true)OperateHospitalInd
Audited Financial Stmt AttYes (true)AuditedFinancialStmtAttInd
Grants To OrganizationsYes (true)GrantsToOrganizationsInd
Grants To IndividualsfalseGrantsToIndividualsInd
Schedule J RequiredYes (true)ScheduleJRequiredInd
Tax Exempt BondsfalseTaxExemptBondsInd
Engaged In Excess Benefit TransfalseEngagedInExcessBenefitTransInd
PY Excess Benefit TransfalsePYExcessBenefitTransInd
Loan OutstandingYes (true)LoanOutstandingInd
Grant To Related PersonfalseGrantToRelatedPersonInd
Business Rln With Org MemfalseBusinessRlnWithOrgMemInd
Business Rln With Fam MemfalseBusinessRlnWithFamMemInd
Business Rln With Officer EntfalseBusinessRlnWithOfficerEntInd
Deductible Non Cash ContrifalseDeductibleNonCashContriInd
Deductible Art ContributionfalseDeductibleArtContributionInd
Terminate OperationsfalseTerminateOperationsInd
Partial LiquidationfalsePartialLiquidationInd
Disregarded EntityfalseDisregardedEntityInd
Related EntityYes (true)RelatedEntityInd
Related Organization Ctrl EntfalseRelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd OrgfalseTrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted PrtshpfalseActivitiesConductedPrtshpInd
Schedule O RequiredYes (true)ScheduleORequiredInd
IRP Document42IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (true)BackupWthldComplianceInd
Employee373EmployeeCnt
Employment Tax Returns FiledYes (true)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over LimitfalseUnrelatedBusIncmOverLimitInd
Foreign Financial AccountfalseForeignFinancialAccountInd
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTransInd
Taxable Party NotificationfalseTaxablePartyNotificationInd
Nondeductible ContributionsfalseNondeductibleContributionsInd
Quid Pro Quo ContributionsfalseQuidProQuoContributionsInd
Form8282 Property Disposed OffalseForm8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft CntrctfalseRcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft CntrctfalsePayPremiumsPrsnlBnftCntrctInd
Indoor Tanning ServicesfalseIndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members9GoverningBodyVotingMembersCnt
Independent Voting Member8IndependentVotingMemberCnt
Family Or Business RlnfalseFamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesfalseDelegationOfMgmtDutiesInd
Change To Org DocumentsfalseChangeToOrgDocumentsInd
Material Diversion Or MisusefalseMaterialDiversionOrMisuseInd
Members Or StockholdersYes (true)MembersOrStockholdersInd
Election Of Board MembersYes (true)ElectionOfBoardMembersInd
Decisions Subject To ApprovaYes (true)DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (true)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (true)MinutesOfCommitteesInd
Officer Mailing AddressfalseOfficerMailingAddressInd
Local ChaptersfalseLocalChaptersInd
Form990 Provided To Gvrn BodyYes (true)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (true)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (true)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (true)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (true)WhistleblowerPolicyInd
Document Retention PolicyYes (true)DocumentRetentionPolicyInd
Compensation Process CEOfalseCompensationProcessCEOInd
Compensation Process OtherfalseCompensationProcessOtherInd
Investment In Joint VenturefalseInvestmentInJointVentureInd
States Where Copy Of Return Is FldMEStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

FieldValueIRS element (for citing)
PersonDAVID THOMPSONPersonNm
Phone2077952813PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line129 LOWELL STREETAddressLine1Txt
CityLEWISTONCityNm
State AbbreviationMEStateAbbreviationCd
ZIP04240ZIPCd
FieldValueIRS element (for citing)
Info In Schedule O Part VIIYes (X)InfoInScheduleOPartVIIInd

Form990 Part VII Section A Form990PartVIISectionAGrp (16 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtKey EmployeeKeyEmployeeIndHighest Compensated EmployeeHighestCompensatedEmployeeInd
PETER E CHALKE
PRESIDENT OF CMHC1.060.0Yes (X)Yes (X)$0$796,319$29,344
JOLAN IPPOLITO
CHAIRPERSON1.01.0Yes (X)Yes (X)$0$0$0
ROGER ARSENAULT
DIRECTOR1.00.0Yes (X)$0$0$0
RICHARD LOVEJOY
SECRETARY/TREASURER1.02.0Yes (X)Yes (X)$0$0$0
LINDA CAMERON OD
DIRECTOR/VICE CHAIR1.00.0Yes (X)Yes (X)$0$0$0
DAVID DUGUAY
DIRECTOR1.00.0Yes (X)$0$0$0
JANET HALL
DIRECTOR1.00.0Yes (X)$0$0$0
JERROLD COHEN
DIRECTOR1.00.0Yes (X)$0$0$0
THOMAS PUIIA
DIRECTOR1.00.0Yes (X)$0$0$0
R DAVID FRUM
PRESIDENT27.529.5Yes (X)$0$391,705$65,281
JOHN KROGER MD
DIVISION CHIEF ENDING 01/1655.00.0$266,210$0$27,587Yes (X)
JACOB LEDESMA MD
PHYSICIAN55.00.0$429,868$0$28,087Yes (X)
THOMAS DELUCA MD
PHYSICIAN55.00.0$341,885$0$26,087Yes (X)
STEPHANIE SINCLAIR
PHYSICIAN55.00.0$346,595$0$23,720Yes (X)
JEFFREY LYNDS MD
PHYSICIAN55.00.0$413,069$0$29,111Yes (X)
ELLEN DAVIS
PHYSICIAN55.00.0$384,951$0$9,913Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$2,182,578TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$1,188,024TotReportableCompRltdOrgAmt
Total Other Compensation$239,130TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K22IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedfalseFormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (true)TotalCompGreaterThan150KInd
Compensation From Other SrcsfalseCompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
SODEXO CLINICAL
TECHNOLOGYNASHVILLETN37241MAINTENTANCE$267,653
LOCUMTENENSCOM
LLCATLANTAGA303845547MEDICAL STAFFING$248,592
CHG COMPANIES
INCCARYNC27513MEDICAL STAFFING$245,147
INSIGHT HEALTH
CORPDALLASTX74284MEDICAL IMAGING$171,900
CPS
INCATLANTAGA30368PHARMACY SERVICES$146,095
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K11CntrctRcvdGreaterThan100KCnt
All Other Contributions$128,689AllOtherContributionsAmt
Total Contributions$128,689TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (3 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
NET PATIENT SERVICE REVENUE900099$41,771,624$41,771,624
CAFETERIA REVENUE722514$76,822$76,822
OTHER REVENUE900099$2,053,193$2,053,193
FieldValueIRS element (for citing)
Total Program Service Revenue$43,901,639TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$108,708TotalRevenueColumnAmt
Exclusion$108,708ExclusionAmt

Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Royalties Revenue RoyaltiesRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Gross Rents GrossRentsGrp

FieldValueIRS element (for citing)
Real$13,106RealAmt

Less Rental Expenses LessRentalExpensesGrp

FieldValueIRS element (for citing)
Real$54,627RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real-$41,521RealAmt
Personal$0PersonalAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column-$41,521TotalRevenueColumnAmt
Exclusion-$41,521ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Securities$1,722,680SecuritiesAmt
Other$4,000OtherAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Securities$1,774,397SecuritiesAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities-$51,717SecuritiesAmt
Other$4,000OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column-$47,717TotalRevenueColumnAmt
Exclusion-$47,717ExclusionAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Net Income From Gaming NetIncomeFromGamingGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Net Income Or Loss NetIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt
FieldValueIRS element (for citing)
Other Revenue Total$0OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$44,049,798TotalRevenueColumnAmt
Related Or Exempt Func Income$43,901,639RelatedOrExemptFuncIncomeAmt
Exclusion$19,470ExclusionAmt
FieldValueIRS element (for citing)
Info In Schedule O Part IXYes (X)InfoInScheduleOPartIXInd

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$19,400TotalAmt
Program Services$19,400ProgramServicesAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Foreign Grants ForeignGrantsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Benefits To Members BenefitsToMembersGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$293,797TotalAmt
Program Services$293,797ProgramServicesAmt

Comp Disqual Persons CompDisqualPersonsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$16,388,806TotalAmt
Program Services$12,503,024ProgramServicesAmt
Management And General$3,885,782ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$404,523TotalAmt
Program Services$308,598ProgramServicesAmt
Management And General$95,925ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$2,400,679TotalAmt
Program Services$1,835,686ProgramServicesAmt
Management And General$564,993ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$1,073,690TotalAmt
Program Services$823,187ProgramServicesAmt
Management And General$250,503ManagementAndGeneralAmt

Fees For Services Management FeesForServicesManagementGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$280,198TotalAmt
Management And General$280,198ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$14,335TotalAmt
Management And General$14,335ManagementAndGeneralAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

FieldValueIRS element (for citing)
Total$7,928TotalAmt
Management And General$7,928ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$8,761,519TotalAmt
Program Services$6,717,369ProgramServicesAmt
Management And General$2,044,150ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$121,057TotalAmt
Program Services$92,813ProgramServicesAmt
Management And General$28,244ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$2,591,720TotalAmt
Program Services$1,987,596ProgramServicesAmt
Management And General$602,531ManagementAndGeneralAmt
Fundraising$1,593FundraisingAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$587,379TotalAmt
Program Services$450,338ProgramServicesAmt
Management And General$137,041ManagementAndGeneralAmt

Royalties RoyaltiesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$681,181TotalAmt
Program Services$522,255ProgramServicesAmt
Management And General$158,926ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$172,080TotalAmt
Program Services$131,932ProgramServicesAmt
Management And General$40,148ManagementAndGeneralAmt

Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$24,989TotalAmt
Program Services$19,159ProgramServicesAmt
Management And General$5,830ManagementAndGeneralAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$58,233TotalAmt
Program Services$44,647ProgramServicesAmt
Management And General$13,586ManagementAndGeneralAmt

Payments To Affiliates PaymentsToAffiliatesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$1,347,741TotalAmt
Program Services$1,033,300ProgramServicesAmt
Management And General$314,441ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$919,278TotalAmt
Program Services$704,801ProgramServicesAmt
Management And General$214,477ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
BAD DEBT$4,091,135$4,091,135
MEDICAL SUPPLIES & DRUGS$3,925,929$3,925,929
REPAIRS & MAINTENANCE$632,699$485,084$147,615
LICENSES, DUES, SUBSCRIPTIONS$99,718$76,453$23,265

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$25,342TotalAmt
Program Services$19,429ProgramServicesAmt
Management And General$5,913ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$44,923,356TotalAmt
Program Services$36,085,932ProgramServicesAmt
Management And General$8,835,831ManagementAndGeneralAmt
Fundraising$1,593FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$9,502BOYAmt
EOY$224,775EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$2,753,949BOYAmt
EOY$1,792,970EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$5,867,014BOYAmt
EOY$4,914,347EOYAmt

Receivables From Officers Etc ReceivablesFromOfficersEtcGrp

FieldValueIRS element (for citing)
BOY$10,776BOYAmt
EOY$1,423EOYAmt

Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$339,970BOYAmt
EOY$442,980EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$532,545BOYAmt
EOY$430,482EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$35,562,989LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$21,959,700LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$12,172,029BOYAmt
EOY$13,603,289EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$5,267,812BOYAmt
EOY$5,367,353EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Intangible Assets IntangibleAssetsGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$958,028BOYAmt
EOY$1,038,760EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$27,911,625BOYAmt
EOY$27,816,379EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$5,851,530BOYAmt
EOY$7,592,731EOYAmt

Grants Payable GrantsPayableGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
BOY$30,282BOYAmt
EOY$29,889EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Escrow Account Liability EscrowAccountLiabilityGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Loans From Officers Directors LoansFromOfficersDirectorsGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$1,221,904BOYAmt
EOY$1,372,751EOYAmt

Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$1,983,297BOYAmt
EOY$794,624EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$9,087,013BOYAmt
EOY$9,789,995EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$18,316,580BOYAmt
EOY$17,522,075EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$251,404BOYAmt
EOY$251,434EOYAmt

Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$256,628BOYAmt
EOY$252,875EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$18,824,612BOYAmt
EOY$18,026,384EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$27,911,625BOYAmt
EOY$27,816,379EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss-$873,558ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst$79,138NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets-$3,808OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or ReviewfalseAccountantCompileOrReviewInd
FS AuditedYes (true)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Consolidated Basis Fincl StmtYes (X)ConsolidatedBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (true)AuditCommitteeInd
Federal Grant Audit RequiredfalseFederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
HospitalYes (X)HospitalInd

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Total ContributionsRESTRICTEDTotalContributionsAmt

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Total Grassroots LobbyingTotalGrassrootsLobbyingGrp
Total Direct LobbyingTotalDirectLobbyingGrp
Total Lobbying ExpendTotalLobbyingExpendGrp
Other Exempt Purpose ExpendOtherExemptPurposeExpendGrp
Total Exempt Purpose ExpendTotalExemptPurposeExpendGrp
Lobbying Nontaxable AmountLobbyingNontaxableAmountGrp
Grassroots NontaxableGrassrootsNontaxableGrp
Tot Lbbyng Grassroot Mns Non TxTotLbbyngGrassrootMnsNonTxGrp
Tot Lbby Expend Mns Lbbyng Non TxTotLbbyExpendMnsLbbyngNonTxGrp
VolunteersfalseVolunteersInd
Paid Staff Or ManagementfalsePaidStaffOrManagementInd
Media AdvertisementsfalseMediaAdvertisementsInd
Mailings MembersfalseMailingsMembersInd
Publications Or BroadcastfalsePublicationsOrBroadcastInd
Grants Other OrganizationsfalseGrantsOtherOrganizationsInd
Direct Contact LegislatorsfalseDirectContactLegislatorsInd
Rallies DemonstrationsfalseRalliesDemonstrationsInd
Other ActivitiesYes (true)OtherActivitiesInd
Other Activities$8,499OtherActivitiesAmt
Total Lobbying Expenditures$8,499TotalLobbyingExpendituresAmt
Not Described Section501c3falseNotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceSCHEDULE C, PART II-B, LINE 1IFormAndLineReferenceDesc
ExplanationLOBBYING EXPENSES: PORTION OF DUES FOR PROFESSIONAL ASSOCIATIONS ATTRIBUTED TO LOBBYING EXPENSES - $8,499ExplanationTxt

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Art Public Exhibition AmountsArtPublicExhibitionAmountsGrp
Held Works ArtHeldWorksArtGrp

CY Endwmt Fund CYEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$508,032BeginningYearBalanceAmt
Contributions$11,339ContributionsAmt
Investment Earnings Or Losses-$3,803InvestmentEarningsOrLossesAmt
Other Expenditures$11,259OtherExpendituresAmt
End Year Balance$504,309EndYearBalanceAmt

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$504,227BeginningYearBalanceAmt
Contributions$4,434ContributionsAmt
Investment Earnings Or Losses-$629InvestmentEarningsOrLossesAmt
End Year Balance$508,032EndYearBalanceAmt

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$491,674BeginningYearBalanceAmt
Contributions$9,235ContributionsAmt
Investment Earnings Or Losses$3,518InvestmentEarningsOrLossesAmt
Other Expenditures$200OtherExpendituresAmt
End Year Balance$504,227EndYearBalanceAmt

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$502,201BeginningYearBalanceAmt
Contributions$6,910ContributionsAmt
Investment Earnings Or Losses-$836InvestmentEarningsOrLossesAmt
Other Expenditures$16,601OtherExpendituresAmt
End Year Balance$491,674EndYearBalanceAmt

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$491,734BeginningYearBalanceAmt
Contributions$12,735ContributionsAmt
Investment Earnings Or Losses-$2,068InvestmentEarningsOrLossesAmt
Other Expenditures$200OtherExpendituresAmt
End Year Balance$502,201EndYearBalanceAmt
FieldValueIRS element (for citing)
Prmnnt Endowment Balance EOY0.50140PrmnntEndowmentBalanceEOYPct
Term Endowment Balance EOY0.49860TermEndowmentBalanceEOYPct
Endowments Held Unrelated OrgfalseEndowmentsHeldUnrelatedOrgInd
Endowments Held Related OrgYes (true)EndowmentsHeldRelatedOrgInd
Related Org List Sch RYes (true)RelatedOrgListSchRInd

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$89,148OtherCostOrOtherBasisAmt
Book Value$89,148BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$14,797,933OtherCostOrOtherBasisAmt
Depreciation$7,244,965DepreciationAmt
Book Value$7,552,968BookValueAmt
FieldValueIRS element (for citing)
Leasehold ImprovementsLeaseholdImprovementsGrp

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$18,405,047OtherCostOrOtherBasisAmt
Depreciation$14,434,801DepreciationAmt
Book Value$3,970,246BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$2,270,861OtherCostOrOtherBasisAmt
Depreciation$279,934DepreciationAmt
Book Value$1,990,927BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$13,603,289TotalBookValueLandBuildingsAmt
Federal Income Tax Liability$0FederalIncomeTaxLiabilityAmt

Other Liabilities Org OtherLiabilitiesOrgGrp

FieldValueIRS element (for citing)
DescDUE TO 3RD PARTYDesc
Amt$794,624Amt
FieldValueIRS element (for citing)
Total Liability$794,624TotalLiabilityAmt
Total Rev Etc Audited Fincl Stmt$40,014,864TotalRevEtcAuditedFinclStmtAmt
Net Unrealized Gains Invst$79,138NetUnrealizedGainsInvstAmt
Other Revenue-$4,157,360OtherRevenueAmt
Revenue Not Reported-$4,078,222RevenueNotReportedAmt
Revenue Subtotal$44,093,086RevenueSubtotalAmt
Other Revenues Not Included-$43,288OtherRevenuesNotIncludedAmt
Revenue Not Reported Fincl Stmt-$43,288RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990$44,049,798TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$40,809,364TotExpnsEtcAuditedFinclStmtAmt
Other Expenses Included$54,627OtherExpensesIncludedAmt
Expenses Not Reported$54,627ExpensesNotReportedAmt
Expenses Subtotal$40,754,737ExpensesSubtotalAmt
Investment Expenses Not Incld2$7,928InvestmentExpensesNotIncld2Amt
Other Expenses Not Included$4,160,691OtherExpensesNotIncludedAmt
Expenses Not Rpt Fincl Stmt$4,168,619ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990$44,923,356TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail (6 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
SCHEDULE D, PART V, LINE 4ENDOWMENT FUNDS: ENDOWMENT FUNDS ARE USED TO SUPPORT THE ORGANIZATION IN A VARIETY OF WAYS, DEPENDING UPON THE STATED PURPOSE OF EACH FUND. MANY OF THESE FUNDS HELP TO COVER COSTS OF CAPITAL EQUIPMENT PURCHASES, CONTINUING EDUCATION, OR FREE CARE. OTHER ARE DESIGNATED TO SUPPORT SPECIFIC DEPARTMENTS OF THE HOSPITAL.
SCHEDULE D, PART X, LINE 2UNCERTAIN TAX POSITION: MANAGEMENT HAS EVALUATED THEIR INCOME TAX POSITIONS UNDER THE GUIDANCE INCLUDED IN ASC 740. BASED ON THEIR REVIEW, MANAGEMENT HAS NOT IDENTIFIED ANY MATERIAL UNCERTAIN TAX POSITIONS TO BE RECORDED OR DISCLOSED IN THE FINANCIAL STATEMENTS.
SCHEDULE D, PART XI, LINE 2DAMOUNTS INCLUDED ON LINE 1, BUT NOT ON FORM 990, PART VIII, LINE 12: $ ( 4,091,135) BAD DEBT EXPENSE ( 7,928) INVESTMENT MANAGEMENT FEES ( 69,556) EXPENSES INCLUDED IN REVENUE 11,259 NET ASSETS RELEASED ------------- $ ( 4,157,360)
SCHEDULE D, PART XI, LINE 4BAMOUNTS INCLUDED ON FORM 990, PART VIII, LINE 12, BUT NOT ON LINE 1: $ ( 54,627) RENTAL EXPENSES 11,289 TEMPORARILY RESTRICTED CONTRIBUTIONS 50 PERMANENTLY RESTRICTED CONTRIBUTIONS ------------ $ ( 43,288)
SCHEDULE D, PART XII, LINE 2DAMOUNTS INCLUDED ON LINE 1, BUT NOT ON FORM 990, PART IX, LINE 25: $ 54,627 RENTAL EXPENSES
SCHEDULE D, PART XII, LINE 4BAMOUNTS INCLUDED ON FORM 990, PART IX, LINE 25, BUT NOT ON LINE 1: $ 4,091,135 BAD DEBT EXPENSE 69,556 EXPENSES INCLUDED IN REVENUE ------------ $ 4,160,691

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Financial Assistance PolicyYes (true)FinancialAssistancePolicyInd
Written PolicyYes (true)WrittenPolicyInd
All Hospitals PolicyYes (X)AllHospitalsPolicyInd
FPG Reference Free CareYes (true)FPGReferenceFreeCareInd
Percent200Yes (X)Percent200Ind
FPG Reference Discounted CarefalseFPGReferenceDiscountedCareInd
Free Care Medically IndigentYes (true)FreeCareMedicallyIndigentInd
Financial Assistance BudgetYes (true)FinancialAssistanceBudgetInd
Expenses Exceed BudgetfalseExpensesExceedBudgetInd
Annual Community Bnft ReportfalseAnnualCommunityBnftReportInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$673,308TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$673,308NetCommunityBenefitExpnsAmt
Total Expense0.01650TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$7,981,745TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$5,637,110DirectOffsettingRevenueAmt
Net Community Benefit Expns$2,344,635NetCommunityBenefitExpnsAmt
Total Expense0.05740TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$8,655,053TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$5,637,110DirectOffsettingRevenueAmt
Net Community Benefit Expns$3,017,943NetCommunityBenefitExpnsAmt
Total Expense0.07390TotalExpensePct

Cash And In Kind Contributions CashAndInKindContributionsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$19,400TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$19,400NetCommunityBenefitExpnsAmt
Total Expense0.00050TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$19,400TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$19,400NetCommunityBenefitExpnsAmt
Total Expense0.00050TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$8,674,453TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$5,637,110DirectOffsettingRevenueAmt
Net Community Benefit Expns$3,037,343NetCommunityBenefitExpnsAmt
Total Expense0.07440TotalExpensePct
FieldValueIRS element (for citing)
Bad Debt Expense ReportedfalseBadDebtExpenseReportedInd
Bad Debt Expense$4,091,135BadDebtExpenseAmt
Bad Debt Expense Attributable$477,410BadDebtExpenseAttributableAmt
Reimbursed By Medicare$15,382,251ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr$15,720,707CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall-$338,456MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

FieldValueIRS element (for citing)
Cost To Charge RatioYes (X)CostToChargeRatioInd
FieldValueIRS element (for citing)
Written Debt Collection PolicyYes (true)WrittenDebtCollectionPolicyInd
Financial Assistance PrvsnYes (true)FinancialAssistancePrvsnInd
Hospital Facilities1HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp

FieldValueIRS element (for citing)
Facility1FacilityNum

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1RUMFORD HOSPITALBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1420 FRANKLIN STREETAddressLine1Txt
CityRUMFORDCityNm
State AbbreviationMEStateAbbreviationCd
ZIP04276ZIPCd
FieldValueIRS element (for citing)
Website AddressWWW.RUMFORDHOSPITAL.ORGWebsiteAddressTxt
State License38505StateLicenseNum
Licensed HospitalYes (X)LicensedHospitalInd
General Medical And SurgicalYes (X)GeneralMedicalAndSurgicalInd
Critical Access HospitalYes (X)CriticalAccessHospitalInd
Emergency Room24 HrsYes (X)EmergencyRoom24HrsInd
OtherOUTPATIENT PHYSICIAN CLINICOtherDesc

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1RUMFORD HOSPITALBusinessNameLine1Txt
FieldValueIRS element (for citing)
Facility1FacilityNum
First Licensed CY Or PYfalseFirstLicensedCYOrPYInd
Tax Exempt Hospital CY Or PYfalseTaxExemptHospitalCYOrPYInd
CHNA ConductedYes (true)CHNAConductedInd
Community DefinitionYes (X)CommunityDefinitionInd
Community DemographicsYes (X)CommunityDemographicsInd
Existing ResourcesYes (X)ExistingResourcesInd
How Data ObtainedYes (X)HowDataObtainedInd
Community Health NeedsYes (X)CommunityHealthNeedsInd
Other Health IssuesYes (X)OtherHealthIssuesInd
Community Hlth Needs Id ProcessYes (X)CommunityHlthNeedsIdProcessInd
Consulting ProcessYes (X)ConsultingProcessInd
Information GapsYes (X)InformationGapsInd
CHNA Conducted15CHNAConductedYr
Take Into Account Others InputYes (true)TakeIntoAccountOthersInputInd
CHNA Conducted With Other FcltsYes (true)CHNAConductedWithOtherFcltsInd
CHNA Conducted With Non FcltsYes (true)CHNAConductedWithNonFcltsInd
CHNA Report Widely AvailableYes (true)CHNAReportWidelyAvailableInd
Rpt Available On Own WebsiteYes (X)RptAvailableOnOwnWebsiteInd
Own Website URLSEE PART V, SECTION COwnWebsiteURLTxt
Other WebsiteYes (X)OtherWebsiteInd
Other Website URLWWW.MAINE.GOV/SHNAPP/OtherWebsiteURLTxt
Paper Copy Public InspectionYes (X)PaperCopyPublicInspectionInd
Implementation Strategy AdoptYes (true)ImplementationStrategyAdoptInd
Implementation Strategy Adpt15ImplementationStrategyAdptYr
Strategy Posted WebsiteYes (true)StrategyPostedWebsiteInd
Strategy Website URLSEE PART V, SECTION CStrategyWebsiteURLTxt
Strategy AttachedfalseStrategyAttachedInd
Organization Incur Excise TaxfalseOrganizationIncurExciseTaxInd
Elig Criteria ExplainedYes (true)EligCriteriaExplainedInd
FPG Family Incm Lmt Free DscntYes (X)FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care200.FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care0.FPGFamilyIncmLmtDscntCarePct
Medical Indigency CriteriaYes (X)MedicalIndigencyCriteriaInd
Insurance Status CriteriaYes (X)InsuranceStatusCriteriaInd
Other CriteriaYes (X)OtherCriteriaInd
Explained BasisYes (true)ExplainedBasisInd
App Financial Asst ExplnYes (true)AppFinancialAsstExplnInd
Described InfoYes (X)DescribedInfoInd
Described Suprt DocYes (X)DescribedSuprtDocInd
Provided Hospital ContactYes (X)ProvidedHospitalContactInd
Includes Publicity MeasuresYes (true)IncludesPublicityMeasuresInd
FAP Available On WebsiteYes (X)FAPAvailableOnWebsiteInd
FAP Available On Website URLSEE PART V, SECTION CFAPAvailableOnWebsiteURLTxt
FAP App Available On WebsiteYes (X)FAPAppAvailableOnWebsiteInd
FAP App Available On Website URLSEE PART V, SECTION CFAPAppAvailableOnWebsiteURLTxt
FAP Summary On WebsiteYes (X)FAPSummaryOnWebsiteInd
FAP Summary On Website URLSEE PART V, SECTION CFAPSummaryOnWebsiteURLTxt
FAP Avlbl On Request No ChargeYes (X)FAPAvlblOnRequestNoChargeInd
FAP App Avlbl On Request No ChrgYes (X)FAPAppAvlblOnRequestNoChrgInd
FAP Sum Avlbl On Request No ChrgYes (X)FAPSumAvlblOnRequestNoChrgInd
FAP Notice DisplayedYes (X)FAPNoticeDisplayedInd
Communtity Notified FAPYes (X)CommuntityNotifiedFAPInd
FAP Actions On NonpaymentYes (true)FAPActionsOnNonpaymentInd
Permit No ActionsYes (X)PermitNoActionsInd
Collection ActivitiesfalseCollectionActivitiesInd
FAP Notified Upon AdmissionYes (X)FAPNotifiedUponAdmissionInd
FAP Notified All PatientsYes (X)FAPNotifiedAllPatientsInd
Documented Elig DeterminationYes (X)DocumentedEligDeterminationInd
Nondis Emergency Care PolicyYes (true)NondisEmergencyCarePolicyInd
Other Method UsedYes (X)OtherMethodUsedInd
Amounts Generally BilledfalseAmountsGenerallyBilledInd
Gross ChargesfalseGrossChargesInd

Supplemental Information SupplementalInformationGrp (9 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
SCHEDULE H, PART V, SECTION B, LINE 5COMMUNITY INPUT: QUALITATIVE DATA WERE COLLECTED THROUGH A STATEWIDE STAKEHOLDER SURVEY CONDUCTED IN MAY AND JUNE 2015 WITH 1,639 PEOPLE REPRESENTING MORE THAN 80 ORGANIZATIONS AND BUSINESSES IN MAINE. THE SURVEY WAS DEVELOPED USING A COLLABORATIVE PROCESS THAT INCLUDED MAINE SHNAPP PARTNERS, MARKET DECISIONS RESEARCH AND HART CONSULTING, AND A NUMBER OF OTHER STAKEHOLDERS AND HEALTH EXPERTS. IN OXFORD COUNTY, A TOTAL OF 61 STAKEHOLDERS RESPONDED TO THE SURVEY. THE OBJECTIVE OF THE SURVEY WAS TO PRODUCE QUALITATIVE DATA OF THE OPINIONS OF HEALTH PROFESSIONALS AND COMMUNITY STAKEHOLDERS ON THE HEALTH ISSUES AND NEEDS OF COMMUNITIES ACROSS THE STATE. GIVEN THIS PURPOSE, THE SURVEY USED A SNOWBALL SAMPLING APPROACH BY INVITING LEADERS OF MEMBER ORGANIZATIONS AND AGENCIES TO INVITE THEIR MEMBERS AND EMPLOYEES TO PARTICIPATE. A CONCERTED EFFORT WAS MADE TO RECRUIT PARTICIPANTS FROM A NUMBER OF DIFFERENT INDUSTRIES AND BACKGROUNDS ACROSS ALL COMMUNITIES IN THE STATE. SURVEY RESPONDENTS REPRESENTED PUBLIC HEALTH AND HEALTH CARE ORGANIZATIONS AS WELL AS BEHAVIORAL HEALTH, BUSINESS, MUNICIPALITIES, EDUCATION, PUBLIC SAFETY, AND NONGOVERNMENTAL ORGANIZATIONS. MORE THAN 80 ORGANIZATIONS AGREED TO SEND THE SURVEY TO THEIR MEMBERS OR STAKEHOLDERS. THE ONLINE SURVEY WAS APPROXIMATELY 25 MINUTES IN LENGTH AND CONTAINED A NUMBER OF QUESTIONS ABOUT IMPORTANT HEALTH ISSUES AND DETERMINANTS IN THE STATE, INCLUDING A RATING OF MOST CRITICAL ISSUES, THE ABILITY OF MAINE'S HEALTH SYSTEM (INCLUDING PUBLIC HEALTH) TO RESPOND TO ISSUES, AVAILABILITY OF RESOURCES AND ASSETS TO ADDRESS SPECIFIC HEALTH ISSUES, IMPACT ON DISPARATE POPULATIONS, AND IDENTIFICATION OF THE ENTITIES PRIMARILY RESPONSIBLE FOR ADDRESSING ISSUES AND DETERMINANTS. THE SURVEY ASKED ALL RESPONDENTS A BASIC SET OF QUESTIONS TO RATE THE IMPORTANCE OF HEALTH ISSUES AND IMPACT OF HEALTH FACTORS. IT THEN ALLOWED RESPONDENTS TO PROVIDE ANSWERS TO PROBING QUESTIONS ON THE THREE ISSUES AND FACTORS THAT THEY WERE MOST INTERESTED IN OR HAD THE MOST KNOWLEDGE ABOUT. RESPONDENTS PROVIDED OVER 12,000 OPEN-ENDED COMMENTS TO THESE IN-DEPTH PROBING QUESTIONS IN THE SURVEY. THE MARKET DECISIONS RESEARCH/HART CONSULTING TEAM REVIEWED, CODED AND CLEANED ALL OPEN-ENDED COMMENTS FOR SIMILAR AND RECURRENT THEMES. NOT ALL RESPONDENTS SHARED COMMENTS FOR THE PROBING QUESTIONS.
SCHEDULE H, PART V, SECTION B, LINE 6AHOSPITAL FACILITIES: THE CHNA WAS CONDUCTED WITH EASTERN MAINE HEALTHCARE SYSTEMS AND MAINE GENERAL MEDICAL CENTER.
SCHEDULE H, PART V, SECTION B, LINE 6BNON-HOSPITAL FACILITIES: THE CHNA WAS ALSO CONDUCTED WITH MAINE HEALTH AND MAINE CENTER FOR DISEASE CONTROL AND PREVENTION.
SCHEDULE H, PART V, SECTION B, LINE 7AHOSPITAL FACILITY'S WEBSITE: http://www.rumfordhospital.org/community-benefits
SCHEDULE H, PART V, SECTION B, LINE 10AIMPLEMENTATION STRATEGY WEBSITE: http://www.rumfordhospital.org/community-benefits
SCHEDULE H, PART V, SECTION B, LINE 11ADDRESSING NEEDS: IN SUPPORT OF THE 2015 MAINE SHARED HEALTH NEEDS ASSESSMENT AND PLANNING PROCESS PROJECT, RUMFORD HOSPITAL ENGAGED IN AN ASSESSMENT OF THE HEALTH NEEDS OF OXFORD COUNTY. RUMFORD HOSPITAL'S GOAL IS TO RESPOND TO IDENTIFIED COMMUNITY HEALTH NEEDS, PROVIDE ACCESS AND IMPROVE HEALTH STATUS FOR ALL CITIZENS; ESPECIALLY THE VULNERABLE AND UNDERSERVED, AND BE A LEADING INSTITUTION OF IMPROVED HEALTH FOR THE COMMUNITIES WE SERVE. COMMUNITY FORUMS WERE HELD WITH CITIZENS OF OXFORD COUNTY ATTENDING A VARIETY OF FOCUS GROUPS TO DISCUSS THE CURRENT AND FUTURE HEALTH NEEDS IN OUR REGION. INPUT PROVIDED DURING THE DISCUSSION GROUPS WAS SUMMARIZED INTO THREE COMMUNITY HEALTH CONCERNS THAT HAVE BECOME RUMFORD HOSPITAL'S IMPLEMENTATION STRATEGY. - SUBSTANCE ABUSE: COMMUNITY OUTREACH; EDUCATIONAL SESSIONS, AND LOCAL DRUG/ALCOHOL COALITION INVOLVEMENT - MENTAL HEALTH: (FREE) EDUCATIONAL SESSIONS AND MENTAL HEALTH AWARENESS. - HUNGER: EDUCATION ON HEALTHY EATING; WORKING WITH AGENCIES PRODUCING FOOD AVAILABILITY INCREASING HEALTH TO THE COMMUNITY WE SERVE. A LOCAL COMMUNITY STAKEHOLDER GROUP WORKED TOGETHER TO ANALYZE THE RESULTS FROM THE ONEMAINE CHNA FOR THE OXFORD COUNTY COMMUNITY WITH THE HEALTH CARE INDICATORS OF CONCERN BRIDGED WITH HEALTHY 2020, SUPPORTING THE DEVELOPMENT OF THE RUMFORD HOSPITAL'S COMMUNITY BENEFIT IMPLEMENTATION PLAN.
SCHEDULE H, PART V, SECTION B, LINE 13HFAP ELIGIBILITY CRITERIA: PATIENTS MUST APPLY FOR MAINE FREE CARE IN ORDER TO BEING CONSIDERED FOR THE HOSPITAL'S FREE CARE PROGRAM. AS PART OF THE APPLICATION, PATIENTS MUST SUBMIT A COPY OF CURRENT MAINECARE DECISION LETTERS. PATIENTS WILL BE ASKED IF THEY HAVE INSURANCE OF ANY KIND TO HELP PAY FOR CARE AND ARE ALSO ASKED TO SHOW THAT INSURANCE OR A GOVERNMENT PROGRAM WILL NOT PAY FOR YOUR CARE. IF PATIENTS DO NOT QUALIFY FOR FREE HOSPITAL CARE, THEY ARE ALLOWED TO ASK FOR A FAIR HEARING OR APPEAL.
SCHEDULE H, PART V, SECTION B, LINES 16A, 16B, & 16CMEASURES TO PUBLICIZE THE POLICY: https://www.cmmc.org/billing-financial-services
SCHEDULE H, PART V, SECTION B, LINE 22DMAXIMUM AMOUNTS CHARGED: RUMFORD HOSPITAL DETERMINES AGB BY MULTIPLYING THE GROSS CHARGES FOR ANY EMERGENCY OR OTHER MEDICALLY NECESSARY CARE IT PROVIDES TO A FAP-ELIGIBLE INDIVIDUAL BY AN AGB PERCENTAGE OF 33%. RUMFORD HOSPITAL CALCULATED THE AGB PERCENTAGE OF 33% BASED ON ALL CLAIMS ALLOWED BY MEDICARE OVER THE PERIOD FROM MAY 1, 2015 TO APRIL 30, 2016, DIVIDED BY THE ASSOCIATED GROSS CHARGES FOR THOSE CLAIMS.
FieldValueIRS element (for citing)
Facility5FacilityNum

Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp

Oth Hlth Care Fclts OthHlthCareFcltsGrp (5 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdFacilityFacilityTxt
ELSEMORE DIXFIELD FAMILY MEDICINE
146 WEL STREETDIXFIELDME04224OUTPATIENT PHYSICIAN CLINIC
SWIFT RIVER FAMILY MEDICINE
430 FRANKLIN STREETRUMFORDME04276OUTPATIENT PHYSICIAN CLINIC
RIVER VALLEY INTERNAL MEDICINE
431 FRANKLIN STREETRUMFORDME04276OUTPATIENT PHYSICIAN CLINIC
RUMFORD SPECIALTY SERVICES CLINIC
431 FRANKLIN STREETRUMFORDME04276OUTPATIENT PHYSICIAN CLINIC
RUMFORD SURGICAL SPECIALISTS
431 FRANKLIN STREETRUMFORDME04276OUTPATIENT PHYSICIAN CLINIC

Supplemental Information Detail SupplementalInformationDetail (13 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
SCHEDULE H, PART I, LINE 1CFAP ELIGIBILITY CRITERIA: PATIENTS MUST APPLY FOR MAINE FREE CARE IN ORDER TO BEING CONSIDERED FOR THE HOSPITAL'S FREE CARE PROGRAM. AS PART OF THE APPLICATION, PATIENTS MUST SUBMIT A COPY OF CURRENT MAINECARE DECISION LETTERS. PATIENTS WILL BE ASKED IF THEY HAVE INSURANCE OF ANY KIND TO HELP PAY FOR CARE AND ARE ALSO ASKED TO SHOW THAT INSURANCE OR A GOVERNMENT PROGRAM WILL NOT PAY FOR YOUR CARE. IF PATIENTS DO NOT QUALIFY FOR FREE HOSPITAL CARE, THEY ARE ALLOWED TO ASK FOR A FAIR HEARING OR APPEAL.
SCHEDULE H, PART I, LINE 7, COLUMN FPERCENT OF TOTAL EXPENSE: TO ARRIVE AT THE PERCENT OF TOTAL EXPENSES, THE DENOMINATOR WHICH EQUALS TOTAL OPERATING EXPENSES PER PART I LINE 25 OF THE FORM 990, WAS REDUCED BY BAD DEBT EXPENSE OF $4,091,135.
SCHEDULE H, PART I, LINE 7COSTING METHODOLOGY: THE COST TO CHARGE RATIO CALCULATED ON IRS WORKSHEET 2 WAS USED TO CALCULATE AMOUNTS ON IRS WORKSHEETS 1 AND 3.
SCHEDULE H, PART III, SECTION A, LINE 2BAD DEBT EXPENSE: LINE 2 REPORTS BAD DEBT EXPENSE FROM THE ORGANIZATION'S AUDITED FINANCIAL STATEMENTS.
SCHEDULE H, PART III, SECTION A, LINE 3BAD DEBT EXPENSE ATTRIBUTABLE TO CHARITY CARE: BAD DEBT ATTRIBUTABLE TO PATIENTS UNDER THE ORGANIZATION'S CHARITY CARE POLICY FOR LINE 3 WAS DETERMINED USING A COMPARISON OF EXPERIENCED CHARITY CARE COVERAGE AND US CENSUS BUREAU DATA FOR THE MOST RECENT YEAR AVAILABLE WHEN CHARITY CARE COVERAGE EXCEEDS THE CENSUS DATA, A MINIMAL AMOUNT OF BAD DEBT IS ASSUMED TO BE ELIGIBLE FOR CHARITY CARE TO ACCOUNT FOR THOSE PATIENTS WHO REFUSE TO PROVIDE INFORMATION DOCUMENTING ELIGIBILITY FOR THE PROGRAM. THESE ESTIMATES ARE BASED ON STATE-WIDE DATA AND DO NOT ACCOUNT FOR DIFFERENCES IN GEOGRAPHIC LOCATIONS WITHIN THE STATE. AS THIS AMOUNT IS RELATED TO PATIENTS ELIGIBLE UNDER THE FINANCIAL ASSISTANCE POLICY, IT SHOULD BE INCLUDED AS A COMMUNITY BENEFIT.
SCHEDULE H, PART III, SECTION A, LINE 4BAD 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 8COMMUNITY BENEFIT: THE COSTING METHODOLOGY USED FOR LINE 6 IS INFORMATION PULLED FROM THE MEDICARE COST REPORT FILING. ANY SHORTFALL REPORTED ON LINE 7 COULD BE CONSIDERED COMMUNITY BENEFIT TO A LEVEL PROPORTIONAL TO THE POVERTY LEVELS INDICATED BY CENSUS BUREAU DATA. IF THE PATIENTS FALLING UNDER 150% FPG LEVEL WERE NOT COVERED BY MEDICARE THEY WOULD QUALIFY UNDER CMMC'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 9BCOLLECTION 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 2NEEDS ASSESSMENT: AS A CRITICAL ACCESS HOSPITAL, RUMFORD HOSPITAL ATTEMPTS TO PROVIDE ANY NEEDED HEALTH CARE SERVICES NECESSARY TO TREAT THE POPULATION OF THIS RURAL AREA OF MAINE, ADDITIONALLY, RUMFORD HOSPITAL FOCUSES ON STATE-WIDE INITIATIVES, SUCH AS HEART DISEASE AND DIABETES, AS WELL AS ORGANIZATIONAL INITIATIVES BASED ON NEEDS OBSERVED WITHIN ITS PATIENT POPULATION. MANY FORMS OF EDUCATION, PREVENTION AND EARLY DETECTION ARE ALSO PART OF ITS COMMUNITY HEALTH CARE PLAN.
SCHEDULE H, PART VI, LINE 3PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE: RUMFORD HOSPITAL PROVIDES NOTICES ABOUT ITS FREE CARE POLICY IN ALL CLINICAL DEPARTMENTS AND MAJOR PATIENT AREAS. AN INPATIENT FINANCIAL COUNSELOR VISITS WITH ALL UNINSURED PATIENTS TO DISCUSS OPTIONS, INCLUDING GOVERNMENTAL PROGRAM ELIGIBILITY AND FREE CARE ASSISTANCE IS AVAILABLE TO HELP PATIENTS WITH COMPLETION OF MEDICAID APPLICATIONS. ALL PATIENT FINANCIAL SERVICES STAFF ARE TRAINED TO OFFER FREE CARE AS AN OPTION TO PATIENTS WHO INDICATE AN INABILITY OR DIFFICULTY IN PAYING FOR SERVICES. INFORMATION ABOUT FINANCIAL ASSISTANCE AVAILABILITY IS INCLUDED ON THE BACK OF EVERY PATIENT STATEMENT. ADDITIONALLY, UNINSURED PATIENTS RECEIVE A SEPARATE INFORMATION SHEET WITH THEIR STATEMENTS, FURTHER INFORMING THEM ABOUT THE AVAILABLE OPTIONS.
SCHEDULE H, PART VI, LINE 4COMMUNITY INFORMATION: RUMFORD HOSPITAL, LOCATED IN RUMFORD, MAINE, SERVES CENTRAL OXFORD COUNTY ALONG THE WESTERN BORDER OF MAINE. A LIGHTLY POPULATED, RURAL AREA AGED 65 OR OVER AND 14% OF THE POPULATION BELOW THE POVERTY LEVEL.
SCHEDULE H, PART VI, LINE 5PROMOTION OF COMMUNITY HEALTH: RUMFORD HOSPITAL HAS AN OPEN MEDICAL STAFF, ALLOWING ANY NON-EMPLOYED OR AFFILIATED PHYSICIANS TO HAVE ADMITTING PRIVILEGES TO THE HOSPITAL. THE BOARD OF DIRECTORS IS MADE UP OF A MAJORITY OF LOCAL COMMUNITY MEMBERS ALONG WITH SOME REPRESENTATION BY DIRECTORS FROM CENTRAL MAINE HEALTHCARE, THE PARENT OF THE HEALTHCARE SYSTEM WHICH RUMFORD HOSPITAL BELONGS TO, HELPING TO BRING TOGETHER THE VISIONS OF THE LOCAL COMMUNITY WITH THE CAPABILITIES AND VISION OF THE SYSTEM AS A WHOLE FOR THE BENEFIT OF RUMFORD AND SURROUNDING COMMUNITIES.
SCHEDULE H, PART VI, LINE 6AFFILIATED HEALTH CARE SYSTEM: AS A MEMBER OF THE CENTRAL MAINE HEALTHCARE SYSTEM, RUMFORD HOSPITAL PROVIDES HIGH QUALITY HEALTH CARE IN A RURAL SETTING WITH LIMITED HEALTH CARE OPTIONS. ITS AFFILIATION WITH CENTRAL MAINE MEDICAL CENTER PROVIDES ACCESS TO A MUCH LARGER, TERTIARY CARE HOSPITAL, INCLUDING TRAUMA CARE, NEONATAL INTENSIVE CARE, AND A SPECIALIZED CARDIAC CARE UNIT. ADDITIONALLY, CENTRAL MAINE MEDICAL CENTER PROVIDES ACCESS TO SPECIALIST PHYSICIANS FOR OUTPATIENT CARE IN THE RUMFORD AREA ON A REGULAR SCHEDULE. THE SYSTEM PARENT, CENTRAL MAINE HEALTHCARE, PROVIDES STREAMLINED ADMINISTRATIVE FUNCTIONS AND BACKROOM SERVICES, ALLOWING RUMFORD HOSPITAL TO PERFORM AT A COST EFFICIENT LEVEL WHICH WOULD NORMALLY BE UNACHIEVABLE IN A SMALL, RURAL HOSPITAL, ALLOWING FOR BROADER RANGE OF SERVICES AVAILABLE.

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Grant Records MaintainedYes (true)GrantRecordsMaintainedInd

Recipient Table RecipientTable (2 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdRecipient EINRecipientEINIRC SectionIRCSectionDescCash GrantCashGrantAmtPurpose Of GrantPurposeOfGrantTxt
COMMUNITY DENTAL
366 US ROUTE 1FALMOUTHME04105237129502501(C)(3)$7,500SUPPORT
LIFEFLIGHT FOUNDATION
PO BOX 899 13TH MAIN ST 2ND FLOORCAMDENME04843522377085501(C)(3)$11,000SUPPORT
FieldValueIRS element (for citing)
Total501c3 Org2Total501c3OrgCnt

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceSCHEDULE I, PART I, LINE 2FormAndLineReferenceDesc
ExplanationMONITORING THE USE OF GRANT FUNDS: THE GRANTS WERE AWARDED TO CHARITABLE ORGANIZATIONS EXEMPT UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE, FOR USE IN THEIR EXEMPT PURPOSE. THE MISSION OF THESE ORGANIZATIONS ALSO HELP SUPPORT COMMUNITY HEALTH OR HEALTHCARE, THEREBY HELPING TO FURTHER RUMFORD HOSPITAL'S EXEMPT PURPOSE AS WELL. THE GRANT TO THE LIFEFLIGHT FOUNDATION IS FOR ASSISTANCE IN PURCHASING A NEW AIRCRAFT. UPDATES ARE PERIODICALLY GIVEN TO THE PUBLIC REGARDING THE STATUS OF THE PENDING AIRCRAFT PURCHASE.ExplanationTxt

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Severance PaymentfalseSeverancePaymentInd
Supplemental Nonqual Rtr PlanYes (true)SupplementalNonqualRtrPlanInd
Equity Based Comp ArrngmfalseEquityBasedCompArrngmInd
Comp Based On Revenue Of Flng OrgfalseCompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related OrgsfalseCompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng OrgfalseCompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd OrgsfalseCompBsdNetEarnsRltdOrgsInd
Any Non Fixed PaymentsfalseAnyNonFixedPaymentsInd
Initial Contract ExceptionfalseInitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (8 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
PETER E CHALKE
PRESIDENT OF CMHC$0$659,155$0$88,750$0$48,414$0$22,881$0$6,463$0$825,663$0$33,952
R DAVID FRUM
PRESIDENT$0$299,068$0$52,200$0$40,437$0$46,225$0$19,056$0$456,986$0$29,397
JACOB LEDESMA MD
PHYSICIAN$344,922$0$81,036$0$3,910$0$6,625$0$21,462$0$457,955$0$0$0
THOMAS DELUCA MD
PHYSICIAN$298,358$0$42,060$0$1,467$0$6,625$0$19,462$0$367,972$0$0$0
STEPHANIE SINCLAIR
PHYSICIAN$200,376$0$118,552$0$27,667$0$6,625$0$17,095$0$370,315$0$0$0
JEFFREY LYNDS MD
PHYSICIAN$234,615$0$144,340$0$34,114$0$6,625$0$22,486$0$442,180$0$0$0
ELLEN DAVIS
PHYSICIAN$298,923$0$27,000$0$59,028$0$2,586$0$7,327$0$394,864$0$0$0
JOHN KROGER MD
DIVISION CHIEF ENDING 01/16$217,470$0$44,536$0$4,204$0$6,625$0$20,962$0$293,797$0$0$0

Supplemental Information Detail SupplementalInformationDetail (3 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
SCHEDULE J, PART I, LINE 3EXECUTIVE COMPENSATION: THE COMPENSATION OF THE ORGANIZATION'S PRESIDENT IS DETERMINED BY THE PARENT CORPORATION'S BOARD OF DIRECTORS' EXECUTIVE COMPENSATION COMMITTEE USING THE FOLLOWING: -COMPENSATION COMMITTEE -INDEPENDENT COMPENSATION CONSULTANT -COMPENSATION SURVEY OR STUDY -APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE
SCHEDULE J, PART I, LINE 4BSUPPLEMENTAL 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. $ 24,000 R. DAVID FRUM (DEFERRAL) 33,952 PETER CHALKE (DISTRIBUTION) 29,397 R. DAVID FRUM (DISTRIBUTION)
SCHEDULE J, PART II, COLUMN FCOMPENSATION REPORTED IN PRIOR FORM 990: COMPENSATION IS REPORTED ON THE FORM 990 IN THE YEAR THAT THE COMPENSATION IS EARNED BY OR AWARDED TO AN INDIVIDUAL, EVEN IF THE COMPENSATION IS NOT PAID TO THE INDIVIDUAL, IS NOT FULLY VESTED, OR IS SUBJECT TO SUBSTANTIAL RISK OF FORFEITURE. IF COMPENSATION IS EARNED OR AWARDED IN ONE YEAR BUT PAID IN A LATER YEAR, THEN THE COMPENSATION IS REPORTED A SECOND TIME ON THE FORM 990 IN THE YEAR THE COMPENSATION IS VESTED OR PAID TO THE INDIVIDUAL.

Schedule L IRS990ScheduleL

Loans Btwn Org Interested Prsn LoansBtwnOrgInterestedPrsnGrp (2 entries)

Relationship With OrgRelationshipWithOrgTxtLoan PurposeLoanPurposeTxtLoan From OrganizationLoanFromOrganizationIndOriginal PrincipalOriginalPrincipalAmtBalance DueBalanceDueAmtDefaultDefaultIndBoard Or Committee ApprovalBoardOrCommitteeApprovalIndWritten AgreementWrittenAgreementInd
JEFFREY LYNDS
EMPLOYEEADVANCEYes (X)$25,000$872falsefalseYes (true)
STEPHANIE SINCLAIR
EMPLOYEEADVANCEYes (X)$20,000$551falsefalseYes (true)
FieldValueIRS element (for citing)
Total Balance Due$1,423TotalBalanceDueAmt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (8 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART VI, SECTION A, LINES 6, 7A & 7BMEMBERS OR STOCKHOLDERS: THE MEMBER OF THE CORPORATION SHALL BE CENTRAL MAINE HEALTHCARE CORPORATION, A CORPORATION DULY ORGANIZED UNDER THE LAWS OF THE STATE OF MAINE. THE MEMBER SHALL HAVE THE RIGHT TO (A) APPROVE THE ELECTION OF MEMBERS OF THE BOARD OF DIRECTORS, (B) REMOVE MEMBERS OF THE BOARD OF DIRECTORS, AND (C) APPROVE CERTAIN DECISIONS OF THE BOARD OF DIRECTORS, AS DETAILED IN THE BYLAWS OF THE CORPORATION. THERE SHALL BE NINE (9) DIRECTORS OF THE CORPORATION WHO SHALL BE ENTITLED TO VOTE ONE (1) OF THE NINE (9) VOTING DIRECTORS SHALL BE APPOINTED BY THE MEMBER, AND THE BALANCE OF VOTING DIRECTORS SHALL BE ELECTED BY THE BOARD OF DIRECTORS.
FORM 990, PART VI, SECTION B, LINE 11BFORM 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 12CMONITORING 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, LINES 15A & 15BEXECUTIVE COMPENSATION REVIEW: CENTRAL MAINE HEALTHCARE (CMHC), A RELATED ORGANIZATION, HAS ESTABLISHED AND FOLLOWS A DELIBERATIVE TRANSPARENT PROCESS WHICH MEETS IRS REGULATIONS FOR "REBUTTABLE" PRESUMPTION OF REASONABLENESS. A STANDING EXECUTIVE COMPENSATION COMMITTEE (ECC), COMPRISED OF INDEPENDENT MEMBERS OF BOARD LEADERSHIP, EXISTS TO UNDERTAKE THE PROCESS OF DETERMINING COMPENSATION FOR THE CHIEF EXECUTIVE OFFICER, CHIEF FINANCIAL OFFICER, CHIEF MEDICAL OFFICER, PRESIDENT OF CENTRAL MAINE MEDICAL CENTER, PHYSICIAN PRACTICE EXECUTIVE, AND PRESIDENT OF RUMFORD AND BRIDGTON HOSPITALS. THE PROCESS GUIDELINES AND AUTHORITY OF THE ECC ARE SET OUT IN THE EXECUTIVE COMPENSATION PHILOSOPHY AND RESPONSIBILITIES CHARTER WHICH WAS APPROVED BY THE CMHC BOARD. THE ENTIRE CMHC BOARD PARTICIPATES IN THE ANNUAL PERFORMANCE EVALUATION OF EACH EXECUTIVE, INCLUDING A REVIEW OF ACCOMPLISHMENTS RELATIVE TO GOALS AND OBJECTIVES DERIVED FROM THE STRATEGIC PLAN. THE ECC REVIEWS THE RESULTS OF THE ANNUAL PERFORMANCE EVALUATION AND APPROPRIATE COMPARABILITY DATA BASED ON SEVERAL FACTORS RECOMMENDED BY AN INDEPENDENT EXECUTIVE COMPENSATION CONSULTANT, WHO SPECIALIZES IN NOT-FOR-PROFIT HOSPITALS AND HEALTH SYSTEMS, AND OUR ATTORNEYS. FACTORS USED IN DETERMINING COMPARABILITY TO THE ORGANIZATION INCLUDE SIZE, GEOGRAPHY, ORGANIZATIONAL COMPLEXITY, FACILITY TYPE, OWNERSHIP TYPE, AND ANY OTHER FACTORS DEEMED RELEVANT BY THE COMMITTEE, ITS CONSULTANTS, OR ITS ATTORNEYS. USING THIS INFORMATION, THE ECC ANNUALLY REVIEWS THE EXECUTIVES' COMPENSATION TO DETERMINE IF MODIFICATION TO BASE SALARY IS WARRANTED, AND REVIEWS THE EXECUTIVES' ACCOMPLISHMENTS TO DETERMINE IF ANY VARIABLE PAY IS TO BE AWARDED. THE ENTIRE PROCESS IS THEN DOCUMENTED CONTEMPORANEOUSLY WITH THE DECISION-MAKING PROCESS AND APPROVED THEREAFTER IN ACCORDANCE WITH THE REQUIREMENTS OF THE IRS. THE COMPENSATION PAID TO KEY EMPLOYEES IS REVIEWED BY THE VICE PRESIDENT OF HUMAN RESOURCES AND ORGANIZATIONAL DEVELOPMENT. DURING THE REVIEW PROCESS, THE CENTRAL MAINE HEALTHCARE COMPENSATION MANAGER PROVIDES MARKET DATA ON COMPARABLE POSITIONS FROM COMPARATIVE GROUPS OF HEALTHCARE ORGANIZATIONS THAT ARE APPROPRIATELY SIMILAR IN TERMS OF THEIR REVENUE, GEOGRAPHIC LOCATION, NUMBER OF EMPLOYEES, NUMBER OF STAFFED HOSPITAL BEDS, ETC. HUMAN RESOURCES PROVIDES AT A MINIMUM FOUR SETS OF COMPARABILITY DATA FROM THE MOST RECENT NATIONAL HEALTHCARE SPECIFIC COMPENSATION SURVEYS (E.G. WATSON & WYATT, SULLIVAN & COTTER, THE HAY GROUP, MERCER, ETC) FOR REFERENCE. THESE SURVEYS REPORT PAY RATE DATA THAT IS TYPICALLY AGED LESS THAN 6 MONTHS. CENTRAL MAINE HEALTHCARE AND AFFILIATES STRIVE TO PAY AT THE MARKET AVERAGE OR SLIGHTLY ABOVE IT FOR KEY EMPLOYEES. ONCE THE COMPENSATION MANAGER AND THE VICE PRESIDENT OF HUMAN RESOURCES AND ORGANIZATIONAL DEVELOPMENT HAVE FINALIZED RECOMMENDATIONS BASED ON THIS EMPIRICAL DATA, THEY ARE PRESENTED TO THE PRESIDENTS OF EACH HOSPITAL THAT SUPERVISE THE KEY EMPLOYEES, AND THE CEO OF CENTRAL MAINE HEALTHCARE, FOR REVIEW, EDITS, AND APPROVAL. THIS PROCESS TYPICALLY OCCURS DURING THE LAST MONTH OF THE FISCAL YEAR IN PREPARATION FOR THE NEXT FISCAL YEAR CENTRAL 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 19PUBLIC 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, COLUMN BBOARD MEMBER COMPENSATION: NO BOARD MEMBERS RECEIVE COMPENSATION FOR THEIR DUTIES AS DIRECTORS. PETER CHALKE IS EMPLOYED AS PRESIDENT OF CENTRAL MAINE HEALTHCARE CORPORATION. HIS COMPENSATED TIME IS SPENT IN THAT CAPACITY.
FORM 990, PART IX, LINE 11GOTHER FEES FOR SERVICES: $ 4,255,000 PURCHASED LABOR 2,503,825 LABOR SERVICES 1,302,446 OUTSIDE SERVICES 690,872 PURCHASED SERVICES 5,624 CONSULTING 3,752 PROFESSIONAL FEES ----------- $ 8,761,519
FORM 990, PART XI, LINE 9OTHER CHANGES IN NET ASSETS: $ (3,808) CHANGE IN BENEFICIAL INTEREST OF PERPETUAL TRUST

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (10 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtControlled OrganizationControlledOrganizationInd
CENTRAL MAINE COMMUNITY HEALTH CORP
PO BOX 4500LEWISTONME04243010386912PUBLIC EDUCATME501(C)(3)7CMHCfalse
CENTRAL MAINE MEDICAL CENTER
PO BOX 4500LEWISTONME04243010211494HEALTHCAREME501(C)(3)3CMHCfalse
MAINE COLLEGE OF HEALTH PROFESSIONS
PO BOX 4500LEWISTONME04243010356077EDUCATIONME501(C)(3)2CMMCfalse
CENTRAL MAINE REAL ESTATE MGMT CORP
PO BOX 4500LEWISTONME04243010387674REAL ESTATEME501(C)(2)CMHCfalse
CENTRAL MAINE HEALTHCARE CORPORATION
PO BOX 4500LEWISTONME04243010386913HEALTHCAREME501(C)(3)7NAfalse
RUMFORD COMMUNITY FAMILY HEALTH CENTER
430 FRANKLIN STREETRUMFORDME04276010481000HEALTHCAREME501(C)(3)3CMHCfalse
RUMFORD COMMUNITY HOME CORPORATION
11 JOHN F KENNEDY LANERUMFORDME04276222844951NURSING HOMEME501(C)(3)9CMHCfalse
BRIDGTON HOSPITAL
10 HOSPITAL DRIVEBRIDGTONME04009010130427HEALTHCAREME501(C)(3)3CMHCfalse
BRIDGTON HOSPITAL PHYSICIANS GROUP
SOUTH HIGH STREETBRIDGTONME04009010493083HEALTHCAREME501(C)(3)9CMHCfalse
ELIAS E TUCKER TRUST FUND
C/O CMMC 300 MAIN STREETLEWISTONME04240010493083NURSING EDME501(C)(3)11 A ICMMCfalse

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (3 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtEntity TypeEntityTypeTxtControlled OrganizationControlledOrganizationIndAddress Line1ForeignAddress/AddressLine1TxtCityForeignAddress/CityNmProvince Or StateForeignAddress/ProvinceOrStateNmCountryForeignAddress/CountryCdLegal Domicile Foreign CountryLegalDomicileForeignCountryCd
CENTRAL MAINE HEALTH VENTURES INC
300 MAINE STREETLEWISTONME04240010430016HEALTHCAREMECMHCC CORPfalse
CWM INSURANCE LTD
980220891INSURANCECMHCC CORPfalseGENESIS BUILDING PO BOX 1363GRAND CAYMANB.W.I.CJCJ
CENTRAL MAINE ACO
300 MAIN STREETLEWISTONME04240274604314ACCOUNTABLE CAREMECMHCC CORPfalse
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts RyltsfalseReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth OrgfalseGiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth OrgfalseGiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other OrgfalseLoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth OrgfalseLoansOrGuaranteesFromOthOrgInd
Div Related OrganizationfalseDivRelatedOrganizationInd
Asset Sale To Other OrgfalseAssetSaleToOtherOrgInd
Asset Purchase From Other OrgfalseAssetPurchaseFromOtherOrgInd
Asset ExchangefalseAssetExchangeInd
Rental Of Facilities To Oth OrgfalseRentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth OrgYes (true)RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth OrgfalsePerformOfServicesForOthOrgInd
Perform Of Services By Other OrgYes (true)PerformOfServicesByOtherOrgInd
Sharing Of FacilitiesfalseSharingOfFacilitiesInd
Paid Employees SharingYes (true)PaidEmployeesSharingInd
Reimbursement Paid To Other OrgYes (true)ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other OrgYes (true)ReimbursementPaidByOtherOrgInd
Transfer To Other OrgfalseTransferToOtherOrgInd
Transfer From Other OrgfalseTransferFromOtherOrgInd

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