2017-05-08T14:22:32-05:00 2016-06-30 BKD LLP 910 E ST LOUIS 200/PO BOX 1190 SPRINGFIELD MO 658062523 990 2015-07-01 010211494 CENTRAL MAINE MEDICAL CENTER % DAVID THOMPSON CENT 2077952813 PO BOX 4500 LEWISTON ME 042434500 DAVID THOMPSON TREASURER 2017-01-31 true Brian D Todd P00422601 4178658701 2015 2021-01-29 14:40:06Z JEFF BRICKMAN 300 MAINE STREET LEWISTON ME 04240 405547675 false X WWW.CMMC.ORG X 1888 ME CMMC STRIVES TO PROVIDE EXCEPTIONAL HEALTHCARE SERVICES. THE HOSPITAL DEPENDS ON THE EXPERTISE OF ITS CAREGIVERS IN ADDITION TO THE COMMITMENT AND COMPASSION THE PROVIDE. 16 12 2612 1579 23438 -13064 3833350 2506212 375606175 401001958 833208 760636 -4540278 -324935 375732455 403943871 144300 72500 0 0 176178942 186768833 0 0 4582 191292211 223589550 367615453 410430883 8117002 -6487012 285929574 292216020 204747867 216589132 81181707 75626888 TO PROVIDE EXCEPTIONAL HEALTHCARE SERVICES IN A SAFE AND TRUSTFUL ENVIRONMENT THROUGH THE EXPERTISE, COMMITMENT AND COMPASSION OF OUR FAMILY OF CAREGIVERS. false false 333683535 72500 401001958 CENTRAL MAINE MEDICAL CENTER IS A 250-BED, NOT-FOR-PROFIT HOSPITAL LOCATED IN LEWISTON, MAINE OFFERING COMPREHENSIVE HEALTHCARE SERVICES TO THE RESIDENTS OF THE CENTRAL AND WESTERN MAINE REGION WITH AN ACTIVE MEDICAL STAFF OF MORE THAN 300 PHYSICIANS REPRESENTING SOME 30 SPECIALTIES OVER 2,000 HIGHLY SKILLED EMPLOYEES AND WITH THE SUPPORT OF THE LATEST TECHNOLOGIES, CMMC IS WELL POSITIONED TO MEET THE REGION'S HEALTHCARE NEEDS WITH THE UTMOST COMPASSION, KINDNESS, AND UNDERSTANDING. 333683535 true true false true false false false false false true true false false true true false false true false false false false false false true false true true true false true true false false false false false true false false true false true false false false false true true true false false true 156 0 true 2612 true true true false false false false true true false false false false X 16 12 true false false false true true true true true false false true true true true true true false false false ME X DAVID THOMPSON 2077952813 29 LOWELL STREET LEWISTON ME 04240 X RICHARD L ROY TRUSTEE 1.0 1.0 X 0 0 0 MARK A ADAMS CHAIRMAN 1.0 3.0 X X 0 0 0 SHARON BUCKLEY TRUSTEE 1.0 0.0 X 0 0 0 PETER E CHALKE SYSTEM EXECUTIVE 1.0 60.0 X X 0 796319 29344 MICHAEL TOMPKINS VICE CHAIRMAN 1.0 0.0 X X 0 0 0 LAWRENCE OLIVER TRUSTEE/PHYSICIAN 55.0 0.0 X 167501 0 36134 PHILIPPE NADEAU TRUSTEE ENDING 10/15 1.0 0.0 X 0 0 0 RONALD PEYSER TRUSTEE 1.0 0.0 X 0 0 0 MARK CARRIER TRUSTEE 1.0 0.0 X 0 0 0 CANDACE SANBORN TRUSTEE 1.0 0.0 X 0 0 0 SHARON POULIN TRUSTEE 1.0 0.0 X 0 0 0 AUSTIN ALBERT TRUSTEE 1.0 0.0 X 0 0 0 CHRISTINE BOSSE TRUSTEE 1.0 0.0 X 0 0 0 ADAM DUNBAR TRUSTEE 1.0 0.0 X 0 0 0 STEVE WALLACE TRUSTEE 1.0 0.0 X 0 0 0 MICHAEL GENDREAU TRUSTEE BEGINNING 2/16 1.0 0.0 X 0 0 0 JEFFREY GOSSELIN TRUSTEE BEGINNING 2/16 1.0 1.0 X 0 0 0 SAMANTHA GRANT SECRETARY 1.0 57.0 X 0 68418 25728 TINA-MARIE LEGERE PRESIDENT - CMMC 55.0 1.0 X 0 486588 84932 PHILIPPE MORISSETTE TREASURER 1.0 58.0 X 0 322734 82993 RICHARD GOLDSTEIN PHYSICIAN PRACTICE EXECUTIVE 55.0 5.0 X 0 572165 89342 JAMES LOGGINS MD PHYSICIAN DIVISION CHIEF 55.0 0.0 X 658541 0 43927 WILLIAM LEE MD PHYSICIAN DIVISION CHIEF 55.0 1.0 X 329214 0 51423 DAVID LAUVER MD PHYSICIAN DIVISION CHIEF 55.0 2.0 X 368022 0 42299 ALAN HARMATZ MD PHYSICIAN DIVISION CHIEF 55.0 0.0 X 483072 0 23977 JENAE LIMOGES PHYSICIAN DIVISION CHIEF 55.0 0.0 X 220981 0 16388 PAUL WELDNER MD PHYSICIAN 55.0 0.0 X 854632 0 46587 OSWALDO BISBAL MD PHYSICIAN 55.0 0.0 X 781424 0 43681 DANIEL LACERTE MD PHYSICIAN 55.0 0.0 X 1024697 0 24469 CARMINE FRUMIENTO MD PHYSICIAN 55.0 0.0 X 799707 0 23977 MICHAEL BROWN MD PHYSICIAN 55.0 0.0 X 765444 0 27087 LAIRD COVEY FORMER PRESIDENT OF CMMC 0.0 0.0 X 0 316649 0 6453235 2562873 692288 279 true true false WEATHERBY LOCUMS INC CARY NC 27513 MEDICAL STAFFING 5440287 UNITED AMBULANCE SERVICES LEWISTON ME 04240 MEDICAL TRANSIT 3568002 SODEXO INC PITTSBURGH PA 15251 FOOD SERVICES 3196758 CHG COMPANIES INC CARY NC 27513 MEDICAL STAFFING 3042444 ANESTHESIA ASSOCIATES LEWISTON ME 04240 MEDICAL SERVICES 2582904 45 X 1890852 198745 416615 92397 2506212 NET PATIENT SERVICE REVENUE 900099 370861291 370861291 PHARMACY REVENUE 446110 20055716 20055716 CAFETERIA REVENUE 722514 786696 786696 OTHER REVENUE 900099 9298255 9298255 401001958 809184 809184 0 0 4259 4259 0 4259 4259 665396 45498 733518 25924 -68122 19574 -48548 -48548 235955 1890852 756633 -520678 -520678 0 111167 87729 23438 23438 EQUITY INVESTMENT 900099 168046 168046 168046 403943871 401001958 23438 412263 X 72500 72500 0 0 0 2441429 2441429 316524 316524 152372436 114636389 37736047 2049587 1522771 526816 20099185 15178617 4920568 9489672 7178083 2311589 0 189351 189351 86117 86117 0 0 5502 5502 59290582 44847989 14442593 1212211 916928 295283 18530818 14030761 4495475 4582 5863068 4434883 1428185 0 6223272 4707345 1515927 989078 748148 240930 0 424321 320961 103360 5245299 3967597 1277702 0 17832193 13488449 4343744 6219453 4704456 1514997 MEDICAL SUPPLIES & DRUGS 68854458 68854458 BAD DEBT 27266873 27266873 REPAIRS & MAINTENANCE 4284710 3240997 1043713 LICENSES, DUES, SUBSCRIPTIONS 795005 601350 193655 277239 206027 71212 410430883 333683535 76742766 4582 331332 282595 18427566 16612097 9941 79908 51147400 48448554 34629 27543 0 0 2871208 3005422 4063877 4889356 6329753 8487691 397132487 248730426 136067296 148402061 23996923 16213715 3330866 3498912 0 0 0 0 39318783 42268166 285929574 292216020 84143111 95682546 0 0 195176 454788 114347425 110935010 0 0 0 0 6062155 6522819 0 0 0 2993969 204747867 216589132 X 62328183 56011537 6579437 7625992 12274087 11989359 81181707 75626888 285929574 292216020 X -6487012 182379 749814 X false true X true true true X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false true 30495 30495 false SCHEDULE C, PART II-B, LINE 1(I) OTHER LOBBYING ACTIVITIES: PORTION OF DUES FOR PROFESSIONAL ASSOCIATIONS ATTRIBUTED TO LOBBYING EXPENSES - $30,495. 19465393 773841 20239234 19253603 578486 -37780 328916 19465393 16922085 47094 2342008 57584 19253603 16439401 1317335 490909 1325560 16922085 15497906 2327217 -115277 1270445 16439401 0.61120 0.38880 false true true 2368022 2368022 159420808 70466688 88954120 4945143 4258522 686621 203188028 167601120 35586908 27210486 6404096 20806390 148402061 DUE FROM AFFILIATES 16483 OTHER RECEIVABLES 4174067 DEPOSITS 5900 EST AMT DUE FROM 3RD PARTY 18456365 INTEREST IN RELATED PARTY 19615351 42268166 0 EST AMOUNT DUE TO THIRD PARTY 2993969 2993969 377691862 182379 5638 -27272375 -27084358 404776220 -832349 -832349 403943871 384008508 5638 844362 850000 383158508 5502 27266873 27272375 410430883 SCHEDULE D, PART V, LINE 4 INTENDED USE OF 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. SCHEDULE D, PART XI, LINE 2D AMOUNTS INCLUDED ON LINE 1, BUT NOT ON FORM 990, PART VIII, LINE 12: $ (27,266,873) BAD DEBT EXPENSE ( 5,502) INVESTMENT MANAGEMENT FEES ------------- $ (27,272,375) SCHEDULE D, PART XI, LINE 4B AMOUNTS INCLUDED ON FORM 990, PART VIII, LINE 12, BUT NOT ON LINE 1: $ (756,633) SPECIAL EVENTS EXPENSE 12,047 TEMPORARILY RESTRICTED INVESTMENT RETURN ( 34) PERMANENTLY RESTRICTED CONTRIBUTIONS ( 87,729) COGS -------------- $ (832,349) SCHEDULE D, PART XII, LINE 2D AMOUNTS INCLUDED ON LINE 1, BUT NOT ON FORM 990, PART IX, LINE 25: $ 756,633 SPECIAL EVENTS EXPENSE 87,729 COGS ------------- $ 844,362 SCHEDULE D, PART XII, LINE 4B AMOUNTS INCLUDED ON FORM 990, PART IX, LINE 25, BUT NOT ON LINE 1: $ 27,266,873 BAD DEBT EXPENSE DEMPSEY CHALLEN 1918073 1748065 170008 27882 85847 29964 13470 528876 SPRING GALA 110234 81934 28300 200 10282 3500 12249 3 98500 60853 37647 5000 3764 10300 5633 500 19166 2126807 1890852 235955 5000 31646 96347 45879 17470 560291 756633 -520678 SCHEDULE G, PART II, COLUMN A FUNDRAISING ACTIVITIES: DEMPSEY CHALLENGE - THIS EVENT OCCURS ANNUALLY IN OCTOBER AND OCCUPIES A YEAR-LONG PLANNING AND EXPENSE CYCLE. DUE TO THE OVERLAPPING YEAR CYCLE OF THIS EVENT, EACH REPORTED TAX YEAR WILL HAVE A PORTION OF REVENUE AND EXPENSES ATTRIBUTABLE TO THE EVENT OCCURRING WITHIN THE REPORTABLE TAX YEAR, AS WELL AS SOME EXPENSES, SPONSORSHIPS, REGISTRATIONS AND DONATIONS ASSOCIATED WITH THE FOLLOWING YEAR'S EVENT. AS SUCH, THE AMOUNT REPORTED WITH THIS RETURN IS NOT REPRESENTATIVE OF A SINGLE EVENT'S PROCEEDS; RATHER IT IS A REPORT OF ACTIVITY ENCOMPASSING OVERLAPPING PERIODS FOR AN EVENT THAT CROSSES A REPORTABLE TAX PERIOD. true true X true X false true true false false 7948506 7958506 0.02080 59744199 36858556 22885643 0.05990 67692705 36858556 30844149 0.08070 1531101 1531101 0.00400 1897170 924 1896246 0.00500 72500 72500 0.00020 3500771 924 3499847 0.00920 71193476 36859480 34343996 0.08990 false 27266873 3181875 82913748 95255396 -12341648 X true true 1 1 CENTRAL MAINE MEDICAL CENTER 300 MAIN STREET LEWISTON ME 04240 www.cmmc.org 38361 X X X X CENTRAL MAINE MEDICAL CENTER 1 false false true X X X X X X X X X 15 true true true true X WWW.CMMC.ORG/ABOUT-COMMUNITY-BENEFITS X true 15 true WWW.CMMC.ORG/ABOUT-COMMUNITY-BENEFITS false 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: COMMUNITY ENGAGEMENT USING SHARED CHNA REPORTS FOR LOCAL AND REGIONAL PLANNING IS A CRITICAL PART OF THE NEEDS ASSESSMENT AND HEALTH IMPROVEMENT PLANNING PROCESS. THE PROCESS, CO-LED BY MAINE CDC DISTRICT LIAISONS AND REPRESENTATIVES FROM MAINE SHNAPP NOT-FOR-PROFIT HOSPITALS, ACHIEVED THE FOLLOWING: -ENSURED BROAD INTERESTS OF THE LOCAL COMMUNITY WERE REPRESENTED; -OBTAINED STAKEHOLDER INPUT ON IDENTIFYING SIGNIFICANT HEALTH NEEDS BASED ON REVIEW OF DATA; -SOLICITED STAKEHOLDER FEEDBACK ON PRIORITIZING SIGNIFICANT HEALTH NEEDS; AND -IDENTIFIED LOCAL ASSETS AND RESOURCES THAT COULD ADDRESS LOCAL HEALTH PRIORITIES. PREPARING FOR COMMUNITY ENGAGEMENT SEPTEMBER 2014-SEPTEMBER 2015 THE SHNAPP COMMUNITY ENGAGEMENT PLANNING PROCESS INCLUDED THE DISTRICT LIAISON FROM THE MAINE CDC AND REPRESENTATIVES FROM PARTICIPATING MAINE SHNAPP HOSPITALS IN THE REGION (ST. MARYS REGIONAL MEDICAL CENTER AND CENTRAL MAINE MEDICAL CENTER IN LEWISTON.) IT WAS DECIDED THAT THE EXISTING COMMUNITY HEALTH STAKEHOLDER COALITION WOULD BE THE LOCAL GROUP TO COORDINATE COMMUNITY ENGAGEMENT SESSIONS IN ANDROSCOGGIN COUNTY. IN 2012, REPRESENTATIVES FROM THE TWO LOCAL HOSPITAL SYSTEMS CAME TOGETHER TO ESTABLISH THE COMMUNITY HEALTH STAKEHOLDER COALITION, A GROUP OF COMMUNITY HEALTH AGENCIES, THE PUBLIC HEALTH SECTOR AND HOSPITALS. THEY DEVELOPED THIS PURPOSE STATEMENT: IMPROVE THE HEALTH OF ANDROSCOGGIN COUNTY BY CONVENING COMMUNITY HEALTH STAKEHOLDERS TO COLLABORATE ON: -CONDUCTING COMMUNITY HEALTH NEEDS ASSESSMENTS -EDUCATING MEMBERS AND CONSTITUENTS ON FINDINGS OF COMMUNITY HEALTH NEEDS ASSESSMENTS -DEVELOPING STRATEGIES TO ADDRESS PRIORITIZED NEEDS -SHARING RELEVANT RESOURCES THROUGH NETWORKING ADDITIONALLY THE STAKEHOLDER GROUP CONTINUES TO ASSESS METHODS TO INCREASE THE COMMUNITIES KNOWLEDGE OF, AND ACCESS TO, RESOURCES IN OUR AREA SUCH AS 2-1-1 MAINE AND TO EXPLORE OPTIONS FOR DIRECT REFERRAL TO RESOURCES FROM WITHIN THE HEALTHCARE SYSTEMS. FOR THE MOST RECENT CHNA, COALITION MEMBERS INCLUDED: JAMIE PAUL, WESTERN MAINE DISTRICT COORDINATING COUNCIL OF THE MAINE CENTER FOR DISEASE CONTROL AND PREVENTION, CYNTHIA RICE, DIRECTOR OF COMMUNITY HEALTH, WELLNESS AND CARDIOPULMONARY REHAB, CENTRAL MAINE MEDICAL CENTER, ELIZABETH KEENE, VP OF MISSION INTEGRATION, ST. MARYS HEALTH SYSTEM, ERIN GUAY, EXECUTIVE DIRECTOR, HEALTHY ANDROSCOGGIN, CATHERINE RYDER, EXECUTIVE DIRECTOR, TRI-COUNTY MENTAL HEALTH SERVICES, GINNY ANDREWS, NUTRITION SERVICES PROGRAM MANAGER, WESTERN MAINE COMMUNITY ACTION, STEVE JOHNDRO, EXECUTIVE DIRECTOR, WESTERN MAINE COMMUNITY ACTION, BRENDA CZADO, DIRECTOR HOME CARE, ANDROSCOGGIN HOME CARE AND HOSPICE, REBECCA AUSTIN, DIRECTOR OF OUTREACH SERVICES, SAFE VOICES, SAM BOSS, HARWOOD CENTER AT BATES COLLEGE, JOAN CHURCHILL, EXECUTIVE DIRECTOR, COMMUNITY CLINICAL SERVICES, SHAWN YARDLEY, EXECUTIVE DIRECTOR, COMMUNITY CONCEPTS, LARRY MARCOUX, UNITED WAY AND QUINN GORMLEY, HEALTH EQUITY ALLIANCE. THESE MEMBERS REPRESENTED COMMUNITY HEALTH, PUBLIC HEALTH, HOSPITALS, MINORITY POPULATIONS, LOCAL COLLEGES, COMMUNITY ACTION AGENCIES AND THE LOCAL FEDERALLY QUALIFIED HEALTH CENTER (FQHC.) OBTAINING LOCAL COMMUNITY ENGAGEMENT INPUT OCTOBER 2015-MARCH 2016 IN ORDER TO OBTAIN LOCAL COMMUNITY INPUT, THE COMMUNITY HEALTH STAKEHOLDER COALITION REVIEWED THE DATA IN THE ANDROSCOGGIN COUNTY SHNAPP CHNA REPORT AND THEN DEVELOPED AN APPROACH TO COMMUNITY ENGAGEMENT TO MAXIMIZE PARTICIPATION OF A CROSS SECTION OF THE COMMUNITY. THE COMMUNITY HEALTH STAKEHOLDER COALITION COORDINATED TWO COMMUNITY FORUMS HELD IN MARCH 2016 AND 13 OTHER GROUP PRESENTATION/KEY INFORMANT INTERVIEWS WITH EXISTING COMMUNITY GROUPS. THE OBJECTIVES OF THE FORUM INCLUDED: -PROVIDE AWARENESS AMONG COMMUNITY STAKEHOLDERS OF THE DATA/RESULTS FROM THE MAINE SHNAPP OR SUBSEQUENT RESEARCH BUILT ON THAT RESOURCE; -INVITE LOCAL INPUT ON WHAT THE DATA MEANS TO EACH LOCAL COMMUNITY/REGION; -SOLICIT LOCAL INPUT ON WHAT ISSUES SHOULD BE PRIORITIZED LOCALLY; -SOLICIT LOCAL IDEAS ON EXISTING RESOURCES, ASSETS, OR NEW INITIATIVES THAT SHOULD BE ALIGNED/DEVELOPED TO ADDRESS THE PRIORITIZED ISSUES; AND -CAPTURE AND SHARE INPUT FROM THE FORUM USING THE MODEL LOCAL SHNAPP COMMITTEE REPORTING FORM. THE COALITION ALSO DECIDED TO APPROACH EXISTING COMMUNITY GROUPS SUCH AS THE CHAMBER OF COMMERCE AND SENIORS PLUS AND INDIVIDUAL COMMUNITY MEMBERS TO OFFER GROUP PRESENTATIONS, KEY INFORMANT INTERVIEWS AND EVEN WRITTEN SURVEYS OFFERING THE ABOVE ELEMENTS. IN ALL, 520 PEOPLE PARTICIPATED IN EITHER THE COMMUNITY FORUMS, GROUP PRESENTATIONS, INTERVIEWS AND WRITTEN SURVEYS IN ANDROSCOGGIN COUNTY. THE SECTORS REPRESENTED INCLUDED: PUBLIC HEALTH, MEDICALLY UNDERSERVED, COMMUNITY HEALTH COALITION, NON-PROFIT AGENCIES, LOW INCOME, RACIAL/ETHNIC MINORITIES, BUSINESS AND EDUCATION. THE CONVERSATIONS LARGELY INFORMED BOTH THE IMPLEMENTATION STRATEGIES AND STRATEGIC PLANS FOR THE HOSPITALS. SCHEDULE H, PART V, SECTION B, LINE 6A HOSPITAL FACILITIES: THE CHNA WAS CONDUCTED WITH ST. MARY'S REGIONAL MEDICAL CENTER. IN ADDITION, CMMC USED DATA FROM THE MAINE SHARED CHNA FOR ANDROSCOGGIN COUNTY, WHICH WAS PREPARED IN CONJUNCTION WITH EASTERN MAINE HEALTHCARE SYSTEM AND MAINEGENERAL HEALTH. SCHEDULE H, PART V, SECTION B, LINE 6B NON-HOSPITAL FACILITIES: THE CHNA WAS ALSO CONDUCTED WITH HEALTHY ANDROSCOGGIN AND OTHER COMMUNITY HEALTH AGENCIES. IN ADDITION, CMMC USED DATA FROM THE MAINE SHARED CHNA FOR ANDROSCOGGIN COUNTY, WHICH WAS PREPARED IN CONJUNCTION WITH MAINEHEALTH AND MAINE CENTER FOR DISEASE CONTROL AND PREVENTION. SCHEDULE H, PART V, SECTION B, LINE 11 ADDRESSING IDENTIFIED NEEDS: THE COMMITMENT FROM CENTRAL MAINE MEDICAL CENTER AND ITS COMMUNITY PARTNERS WAS TO PRODUCE A DOCUMENT THAT REFLECTS THE VOICE OF OUR COMMUNITY. THE PRIORITIES THAT HAVE EMERGED INCLUDE: -MENTAL HEALTH -HEALTH CARE ACCESS -CHRONIC DISEASE (CARDIOVASCULAR DISEASE/HTN, DIABETES, RESPIRATORY DISEASE, DIABETES, CANCER) -PHYSICAL ACTIVITY, NUTRITION, OBESITY AND RELATED ISSUES -ENVIRONMENTAL HEALTH LEAD POISONING -SUBSTANCE AND ALCOHOL USE -TOBACCO USE THE NEXT STEP IN THIS PROCESS WAS TO DEVELOP AN IMPLEMENTATION STRATEGY THAT INCLUDED LONG-RANGE PLANS FOR THE PRIORITIZED NEEDS AND TIED THE SPECIFIC IMPLEMENTATION PLANS TO THE STRATEGIC PLAN FOR CENTRAL MAINE MEDICAL CENTER. THIS PROCESS WAS FACILITATED BY THE CMMC LEADERSHIP TEAM, THE COMMUNITY PILLAR STEERING COMMITTEE, AND INCLUDED PARTICIPATION FROM THE COMMUNITY STAKEHOLDER GROUP AND OTHER COMMUNITY MEMBERS. IT WAS COMPLETED IN QUARTER ONE OF FISCAL YEAR 17 USING EVIDENCE FROM USPTF AND HEALTH PEOPLE 2020 EVIDENCE-BASED RESOURCES. THE STRATEGIES, ACTIVITIES, ACTIONS TAKEN, PROGRAMS AND RESOURCES COMMITTED, COLLABORATION WITH OTHER ORGANIZATIONS, AND OUTCOMES CAN BE VIEWED AT https://www.cmmc.org/about-community-benefits. SCHEDULE H, PART V, SECTION B, LINE 13H FAP ELIGIBILITY CRITERIA: PATIENTS MUST APPLY FOR MAINE FREE CARE IN ORDER TO BEING CONSIDERED FOR THE HOSPITAL'S FREE CARE PROGRAM. AS PART OF THE APPLICATION, PATIENTS MUST SUBMIT A COPY OF CURRENT MAINECARE DECISION LETTERS. PATIENTS WILL BE ASKED IF THEY HAVE INSURANCE OF ANY KIND TO HELP PAY FOR CARE AND ARE ALSO ASKED TO SHOW THAT INSURANCE OR A GOVERNMENT PROGRAM WILL NOT PAY FOR YOUR CARE. IF PATIENTS DO NOT QUALIFY FOR FREE HOSPITAL CARE, THEY ARE ALLOWED TO ASK FOR A FAIR HEARING OR APPEAL. SCHEDULE H, PART V, SECTION B, LINES 16A, 16B, & 16C MEASURES TO PUBLICIZE THE POLICY: https://www.cmmc.org/billing-financial-services SCHEDULE H, PART V, SECTION B, LINE 22D MAXIMUM AMOUNTS CHARGED TO FAP-ELIGIBLE INDIVIDUALS: CENTRAL MAINE MEDICAL CENTER 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 29%. CENTRAL MAINE MEDICAL CENTER CALCULATED THE AGB PERCENTAGE OF 29% 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. 38 CENTRAL MAINE GASTROENTEROLOGY ASSOCIATE 77 BATES STREET SUITE 202 LEWISTON ME 04240 OUTPATIENT PHYSICIAN CLINIC CENTRAL MAINE SURGICAL ASSOCIATES 12 HIGH STREET SUITE 401 LEWISTON ME 04240 OUTPATIENT PHYSICIAN CLINIC BRUNSWICK FAMILY MEDICINE 33 BATH ROAD BRUNSWICK ME 04011 OUTPATIENT PHYSICIAN CLINIC BRUNSWICK PRIMARY CARE 329 MAIN STREET SUITE H BRUNSWICK ME 04011 OUTPATIENT PHYSICIAN CLINIC COASTAL PLASTIC SURGERY 4 HORTON PLACE TOPSHAM ME 04086 OUTPATIENT PHYSICIAN CLINIC CENTRAL MAINE BARIATRIC SURGERY 10 HIGH STREET SUITE 105 LEWISTON ME 04240 OUTPATIENT PHYSICIAN CLINIC CENTRAL MAINE ENDOCRINOLOGY & DIABETES 287 MAIN STREET SUITE 301 LEWISTON ME 04240 OUTPATIENT PHYSICIAN CLINIC CENTRAL MAINE FAMILY HEALTH CARE ASSOC 190 STETSON ROAD AUBURN ME 04210 OUTPATIENT PHYSICIAN CLINIC CENTRAL MAINE FAMILY HEALTH RESIDENCY 76 HIGH STREET SUITE 100 LEWISTON ME 04240 OUTPATIENT PHYSICIAN CLINIC CENTRAL MAINE FAMILY PRACTICE 12 HIGH STREET SUITE 302 LEWISTON ME 04240 OUTPATIENT PHYSICIAN CLINIC CENTRAL MAINE GYNECOLOGY & UROGYNECOLOGY 287 MAIN STREET SUITE 201 LEWISTON ME 04240 OUTPATIENT PHYSICIAN CLINIC CENTRAL MAINE CARDIOLOGY 2 GREAT FALLS PLAZA AUBURN ME 04210 OUTPATIENT PHYSICIAN CLINIC CENTRAL MAINE HEMATOLOGY ONCOLOGY 12 HIGH STREET SUITE 205 LEWISTON ME 04240 OUTPATIENT PHYSICIAN CLINIC CENTRAL MAINE INTERNAL MEDICINE 10 HIGH STREET SUITE 400 LEWISTON ME 04240 OUTPATIENT PHYSICIAN CLINIC CENTRAL MAINE NEUROLOGY 10 MINOT AVENUE AUBURN ME 04210 OUTPATIENT PHYSICIAN CLINIC CENTRAL MAINE OBGYN 12 HIGH STREET SUITE 200 LEWISTON ME 04240 OUTPATIENT PHYSICIAN CLINIC CENTRAL MAINE PAIN & HEADACHE CENTER 77 BATES STREET LEWISTON ME 04240 OUTPATIENT PHYSICIAN CLINIC CENTRAL MAINE PEDIATRICS 12 HIGH STREET SUITE 301 LEWISTON ME 04240 OUTPATIENT PHYSICIAN CLINIC CENTRAL MAINE PLASTIC SURGERY 287 MAIN STREET SUITE 302 LEWISTON ME 04240 OUTPATIENT PHYSICIAN CLINIC CENTRAL MAINE RADIOLOGY - OP 77 BATES STREET SUITE 201 LEWISTON ME 04240 OUTPATIENT PHYSICIAN CLINIC CENTRAL MAINE SPORTS MEDICINE 77 BATES STREET SUITE 101 LEWISTON ME 04240 OUTPATIENT PHYSICIAN CLINIC CENTRAL MAINE THERAPY SERVICES 77 BATES STREET SUITE 201 LEWISTON ME 04240 OUTPATIENT PHYSICIAN CLINIC CENTRAL MAINE UROLOGY 287 MAIN STREET SUITE 404 LEWISTON ME 04240 OUTPATIENT PHYSICIAN CLINIC GRAY FAMILY CLINIC 116 SHAKER ROAD GRAY ME 04039 OUTPATIENT PHYSICIAN CLINIC INFECTIOUS DISEASE ASSOCIATES 76 HIGH STREET SUITE 200 LEWISTON ME 04240 OUTPATIENT PHYSICIAN CLINIC LISBON FAMILY PRACTICE 2 BISBEE ROAD LISBON ME 04250 OUTPATIENT PHYSICIAN CLINIC MECHANIC FALLS FAMILY PRACTICE 22 PLEASANT STREET MECHANIC FALLS ME 04256 OUTPATIENT PHYSICIAN CLINIC MINOT AVENUE FAMILY MEDICINE 789 MINOT AVENUE AUBURN ME 04210 OUTPATIENT PHYSICIAN CLINIC POLAND COMMUNITY HEALTH CENTER 364 MAIN STREET POLAND ME 04274 OUTPATIENT PHYSICIAN CLINIC PULMONARY AND SLEEP MEDICINE 76 HIGH STREET SUITE 300 LEWISTON ME 04240 OUTPATIENT PHYSICIAN CLINIC TOPSHAM FAMILY MEDICINE 4 HORTON PLACE TOPSHAM ME 04086 OUTPATIENT PHYSICIAN CLINIC CENTRAL MAINE HEARING CENTER 12 HIGH STREET SUITE 102 LEWISTON ME 04240 OUTPATIENT PHYSICIAN CLINIC CENTRAL MAINE MEDICATION MANAGEMENT 10 HIGH STREET SUITE 103 LEWISTON ME 04240 OUTPATIENT PHYSICIAN CLINIC CENTRAL MAINE EAR NOSE & THROAT 12 HIGH STREET SUITE 102 LEWISTON ME 04240 OUTPATIENT PHYSICIAN CLINIC SPRUCE MOUNTAIN HEALTH CENTER 38 UNION STREET LIVERMORE FALLS ME 04254 OUTPATIENT PHYSICIAN CLINIC CENTRAL MAINE PODIATRY 287 MAIN STREET LEWISTON ME 04240 OUTPATIENT PHYSICIAN CLINIC BRUNSWICK CARDIOLOGY 329 MAINE STREET SUITE C BRUNSWICK ME 04011 OUTPATIENT PHYSICIAN CLINIC HIGH STREET FAMILY MEDICINE 10 HIGH STREET SUITE 301 LEWISTON ME 04240 OUTPATIENT PHYSICIAN CLINIC SCHEDULE H, PART I, LINE 1C FAP ELIGIBILITY CRITERIA: PATIENTS MUST APPLY FOR MAINE FREE CARE IN ORDER TO BEING CONSIDERED FOR THE HOSPITAL'S FREE CARE PROGRAM. AS PART OF THE APPLICATION, PATIENTS MUST SUBMIT A COPY OF CURRENT MAINECARE DECISION LETTERS. PATIENTS WILL BE ASKED IF THEY HAVE INSURANCE OF ANY KIND TO HELP PAY FOR CARE AND ARE ALSO ASKED TO SHOW THAT INSURANCE OR A GOVERNMENT PROGRAM WILL NOT PAY FOR YOUR CARE. IF PATIENTS DO NOT QUALIFY FOR FREE HOSPITAL CARE, THEY ARE ALLOWED TO ASK FOR A FAIR HEARING OR APPEAL. SCHEDULE H, PART 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 $27,266,873. 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 MAINE RESIDENTS, AGE 65 OR OLDER, BELOW THE 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 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: CENTRAL MAINE MEDICAL CENTER PROVIDES A FULL RANGE OF SERVICES TO ITS PRIMARY SERVICE AREA, AS WELL AS THE EXTENDED AREA OF THE ENTIRE CENTRAL MAINE HEALTHCARE SYSTEM. IT ASSESSES THE NEEDS OF ITS VARIOUS COMMUNITIES FROM VARIOUS THIRD-PARTY SURVEYS AND REPORTS, OBSERVATIONS IN ITS PATIENT POPULATION AND THE POPULATIONS OF ITS AFFILIATED SYSTEM HOSPITALS, AS WELL AS ASSISTING WITH STATE-WIDE INITIATES IN PREVENTATIVE MEDICINE AND EDUCATION. SCHEDULE H, PART VI, LINE 3 PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE: CENTRAL MAINE MEDICAL CENTER 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: CENTRAL MAINE MEDICAL CENTER, LOCATED IN LEWISTON, MAINE SERVES A PRIMARY AREA OF ANDROSCOGGIN COUNTY IN CENTRAL MAINE. ADDITIONALLY, IT SERVES PORTIONS OF CUMBERLAND, FRANKLIN, KENNEBEC, OXFORD, AND SAGADAHOC COUNTIES. THE LEWISTON-AUBURN AREA IS URBAN, FOR MAINE STANDARDS, BUT QUICKLY BECOMES SUBURBAN TO ALMOST-RURAL QUICKLY OUTSIDE THE CITY LIMITS. ANDROSCOGGIN COUNTY HAS A POPULATION OF JUST UNDER 108,000 PERSONS, WHICH MAKES UP APPROXIMATELY 8% OF THE OVERALL MAINE POPULATION. WHILE ALMOST 93% OF THE POPULATION IS MADE UP OF CAUCASIAN PERSONS, MORE THAN 16% SPEAK A LANGUAGE OTHER THAN ENGLISH AT HOME. THIRTEEN PERCENT OF THE POPULATION IS BELOW THE POVERTY LEVEL, SPECIFICALLY IN LEWISTON, THE SECOND LARGEST CITY IN MAINE, WITH A POPULATION OF APPROXIMATELY 36,600 PERSONS, SIMILAR RACIAL DISTRIBUTIONS ARE OBSERVED, BUT MORE THAN 28% CLAIM A LANGUAGE OTHER THAN ENGLISH AS THEIR PRIMARY. FIFTEEN PERCENT ARE BELOW THE POVERTY LEVEL. SCHEDULE H, PART VI, LINE 5 PROMOTION OF COMMUNITY HEALTH: CENTRAL MAINE MEDICAL CENTER 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 CENTRAL MAINE MEDICAL CENTER 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 LEWISTON AND SURROUNDING COMMUNITIES. SCHEDULE H, PART VI, LINE 6 AFFILIATED HEALTH CARE SYSTEM: CENTRAL MAINE MEDICAL CENTER (CMMC) IS A TERTIARY CARE HOSPITAL IN THE CENTRAL MAINE HEALTHCARE SYSTEM. TWO RURAL, CRITICAL ACCESS HOSPITALS ARE ALSO MEMBERS OF THIS SYSTEM. CMMC PROVIDES A WIDE RANGE OF SPECIALIST PHYSICIANS AND SERVICES TO ITS COMMUNITY, AS WELL AS THE SYSTEM. CMMC PROVIDES PHYSICIANS TO STAFF SPECIALTY CLINICS IN THE RURAL COMMUNITIES SERVED BY THE CRITICAL ACCESS HOSPITALS ON A LIMITED, BUT REGULAR, BASIS. THESE SERVICES WOULD NOT NORMALLY BE SUPPORTED BY THE LIMITED POPULATIONS AND PATIENTS WOULD INSTEAD NEED TO TRAVEL MUCH LONGER DISTANCES TO CONSULT OR VISIT WITH A SPECIALIST. CMMC ALSO PROVIDES ACCESS TO TRAUMA CARE, NEONATAL INTENSIVE CARE, AND SPECIALIZED CARDIAC CARE. THE SYSTEM PARENT, CENTRAL MAINE HEALTHCARE, PROVIDES STREAMLINED ADMINISTRATIVE FUNCTIONS AND BACKROOM SERVICES FOR THE ENTIRE SYSTEM, PROVIDING COST EFFICIENCY AND OTHER BENEFITS TO ALL MEMBERS. THIS ALSO ALLOWS FOR EASY ADMINISTRATIVE HANDLING OF TRANSFERS OF PATIENTS BETWEEN HOSPITALS, AS WELL AS A SINGLE POINT OF CONTACT FOR PATIENTS TO ADDRESS BILLS AND INSURANCE ISSUES. true AMERICAN HEART ASSOCIATION PO BOX 4002012 DES MOINES IA 503402012 135613797 501(C)(3) 25000 HEARTWALK SPONSORSHIP MUSEUM L-A 35 CANAL STREET BOX A7 LEWISTON ME 04240 010504257 501(C)(3) 10000 GENERAL DFD RUSSELL MEDICAL CENTERS 180 CHURCH HILL ROAD LEEDS ME 04263 237423047 501(C)(3) 30000 GENERAL 3 SCHEDULE I, PART I, LINE 2 GRANT MONITORING: THE GRANTS ARE AWARDED TO CHARITABLE ORGANIZATIONS UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE, FOR USE IN THEIR EXEMPT PURPOSE. THE MISSION OF THESE ORGANIZATIONS ALSO HELPS SUPPORT COMMUNITY HEALTH OR HEALTHCARE, THEREBY HELPING TO FURTHER CENTRAL MAINE MEDICAL CENTER'S EXEMPT PURPOSE AS WELL. SINCE THE GRANTS ARE NOT AWARDED WITH A SPECIFIC PURPOSE ATTACHED, NO TRACKING IS REQUIRED. false true false false false false false false false PETER E CHALKE SYSTEM EXECUTIVE 0 659155 0 88750 0 48414 0 22881 0 6463 0 825663 0 33952 LAWRENCE OLIVER TRUSTEE/PHYSICIAN 134533 0 28272 0 4696 0 20690 0 15444 0 203635 0 0 0 TINA-MARIE LEGERE PRESIDENT - CMMC 0 391734 0 73600 0 21254 0 63633 0 21299 0 571520 0 15096 PHILIPPE MORISSETTE TREASURER 0 315340 0 0 0 7394 0 75625 0 7368 0 405727 0 0 RICHARD GOLDSTEIN PHYSICIAN PRACTICE EXECUTIVE 0 475750 0 83232 0 13183 0 72125 0 17217 0 661507 0 6000 PAUL WELDNER MD PHYSICIAN 841034 0 0 0 13598 0 24625 0 21962 0 901219 0 0 0 OSWALDO BISBAL MD PHYSICIAN 773353 0 609 0 7462 0 24625 0 19056 0 825105 0 0 0 DANIEL LACERTE MD PHYSICIAN 795029 0 221000 0 8668 0 6625 0 17844 0 1049166 0 0 0 CARMINE FRUMIENTO MD PHYSICIAN 756920 0 38000 0 4787 0 6625 0 17352 0 823684 0 0 0 MICHAEL BROWN MD PHYSICIAN 542479 0 178368 0 44597 0 6625 0 20462 0 792531 0 0 0 JAMES LOGGINS MD PHYSICIAN DIVISION CHIEF 433547 0 209184 0 15810 0 24625 0 19302 0 702468 0 0 0 WILLIAM LEE MD PHYSICIAN DIVISION CHIEF 275550 0 43319 0 10345 0 32575 0 18848 0 380637 0 0 0 DAVID LAUVER MD PHYSICIAN DIVISION CHIEF 238533 0 125254 0 4235 0 23000 0 19299 0 410321 0 0 0 ALAN HARMATZ MD PHYSICIAN DIVISION CHIEF 466116 0 0 0 16956 0 6625 0 17352 0 507049 0 0 0 JENAE LIMOGES PHYSICIAN DIVISION CHIEF 217578 0 -418 0 3821 0 5612 0 10776 0 237369 0 0 0 LAIRD COVEY FORMER PRESIDENT OF CMMC 0 0 0 0 0 316649 0 0 0 0 0 316649 0 316649 SCHEDULE J, PART I, LINE 3 CEO COMPENSATION: THE COMPENSATION OF THE ORGANIZATION'S PRESIDENT IS DETERMINED BY THE PARENT CORPORATION'S BOARD OF DIRECTORS' EXECUTIVE COMPENSATION COMMITTEE USING THE FOLLOWING: -COMPENSATION COMMITTEE -INDEPENDENT COMPENSATION CONSULTANT -COMPENSATION SURVEY OR STUDY -APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE SCHEDULE J, PART I, LINE 4B SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN: A PARTICIPANT'S ENTITLEMENT TO BENEFITS WILL VEST ON THE PARTICIPANT'S VESTING DATE PROVIDED THE PARTICIPANT HAS REMAINED IN CONTINUOUS EMPLOYMENT IN THE SAME POSITION WHILE PARTICIPATING IN THIS PLAN. A PARTICIPANT WILL HAVE ONLY ONE VESTING DATE FOR ALL ELECTIVE DEFERRALS AND OTHER PLAN CONTRIBUTIONS MADE ON THE PARTICIPANT'S BEHALF. DURING ALL PLAN YEARS, A PARTICIPANT'S ENTITLEMENT TO BENEFITS WILL ALSO VEST (A) IF THE PARTICIPANT DIES WHILE STILL EMPLOYED BY THE EMPLOYER, (B) IF THE PARTICIPANT'S EMPLOYMENT TERMINATES DUE TO TOTAL DISABILITY; OR (C) IF THE EMPLOYER TERMINATES THE PARTICIPANT'S EMPLOYMENT FOR ANY REASON OTHER THAN FOR "CAUSE". ANY PORTION OF THE PARTICIPANTS ENTITLEMENT TO 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. $ 316,649 LAIRD COVEY (DISTRIBUTION) 33,952 PETER CHALKE (DISTRIBUTION) 15,096 TINA-MARIE LEGERE (DISTRIBUTION) 6,000 RICHARD GOLDSTEIN (DISTRIBUTION) 47,500 RICHARD GOLDSTEIN (DEFERRAL) 39,008 TINA-MARIE LEGERE (DEFERRAL) 69,000 PHILIPPE MORISSETTE (DEFERRAL) SCHEDULE J, PART II, COLUMN F COMPENSATION REPORTED IN PRIOR FORM 990: COMPENSATION IS REPORTED ON THE FORM 990 IN THE YEAR THAT THE COMPENSATION IS EARNED BY OR AWARDED TO AN INDIVIDUAL, EVEN IF THE COMPENSATION IS NOT PAID TO THE INDIVIDUAL, IS NOT FULLY VESTED, OR IS SUBJECT TO SUBSTANTIAL RISK OF FORFEITURE. IF COMPENSATION IS EARNED OR AWARDED IN ONE YEAR BUT PAID IN A LATER YEAR, THEN THE COMPENSATION IS REPORTED A SECOND TIME ON THE FORM 990 IN THE YEAR THE COMPENSATION IS VESTED OR PAID TO THE INDIVIDUAL. A MAINE HEALTH & HIGHER EDUCATIONAL FACILITIES AUTH 010314384 560427GE0 2009-12-10 56033554 FACILITY EXPANSION/CONSTRUCTION false false true B MAINE HEALTH & HIGHER EDUCATION FACILITIES AUTH 010314384 560425WW6 2005-12-29 28435783 REFUND BOND SERIES 1993D, BLDG false false false C MAINE HEALTH & HIGHER EUDCATIONAL FACILITIES AUTH 010314384 560427WV4 2013-05-23 41071242 REFUND SERIES 2003A BOND false false true A 0 0 56033554 6631632 1923331 0 639410 0 1675000 32010671 0 0 2011 false false true true B 0 0 28435783 2325648 0 12082042 370150 80000 0 13577565 0 0 2006 false true true true C 0 0 41071242 2957944 0 42862476 302888 0 0 0 0 0 false true true true A false false false false 0 false false false true B false false false false 0 false false false true C false false false false 0 false false false true A false false false true false false 0 false 0 false false B true false false 0 true FSA 25. true false false C false true false false 0 false false false 0 false false A false B false C false SCHEDULE K, PART IV, LINE 2C, COLUMN A DATE OF REBATE COMPUTATION: THE REBATE COMPUTATION WAS PERFORMED 12/10/2014. PAUL WELDNER EMPLOYEE SALARY ADV X 50000 24703 false false true MICHAEL BROWN EMPLOYEE SALARY ADV X 20000 2840 false false true 27543 PATRICIA E ROY RELATIVE OF R. ROY 127990 SALARY AND WAGES false JULIA LAUVER RELATIVE OF D. LAUVER 80726 SALARY AND WAGES false CYNTHIA HARRADON RELATIVE OF S. POULIN 107808 SALARY AND WAGES false X 43 12680 FMV X MISCELLANEOUS 101 79717 FMV false true false SCHEDULE M, PART I, COLUMN B NUMBER OF CONTRIBUTIONS: THE NUMBER IN COLUMN B REPRESENTS THE NUMBER OF CONTRIBUTORS FOR EACH LINE ITEM. FORM 990, PART VI, SECTION A, LINE 2 BUSINESS RELATIONSHIP: JEFFREY GOSSELIN HAS A BUSINESS RELATIONSHIP WITH RICHARD ROY. FORM 990, PART VI, SECTION A, LINE 6, 7A, & 7B MEMBERS OF THE ORGANIZATION: THE SOLE MEMBER OF CENTRAL MAINE MEDICAL CENTER IS CENTRAL MAINE HEALTHCARE CORPORATION. UP TO THREE TRUSTEES SHALL BE APPOINTED BY THE CHAIRMAN OF CENTRAL MAINE HEALTHCARE CORPORATION FOR A TERM OF ONE YEAR, AND NINE TO FIFTEEN TRUSTEES SHALL BE NOMINATED BY VOTE OF THE BOARD OF TRUSTEES OF THIS CORPORATION AND ELECTED BY THE SOLE MEMBER TO SERVE A TERM OF THREE YEARS. NO MORE THAN FOUR TRUSTEES CAN SIMULTANEOUSLY BE DIRECTORS OF THE CENTRAL MAINE HEALTHCARE CORPORATION. THE SOLE MEMBER HAS THE POWER AND AUTHORITY TO REMOVE ANY TRUSTEES OF CENTRAL MAINE MEDICAL CENTER WITH OR WITHOUT CAUSE. THE MEMBER ALSO APPOINTS THE EXECUTIVE COMPENSATION COMMITTEE. IN ADDITION, THE MEMBER HAS THE SOLE AUTHORITY TO ALTER, AMEND, OR REPEAL THE BYLAWS AT ANY TIME. THE MEMBER SHALL HAVE THE RIGHT TO APPROVE CERTAIN DECISIONS OF THE BOARD OF TRUSTEES, AS DETAILED IN THE BYLAWS OF THE CORPORATION. FORM 990, PART VI, SECTION B, LINE 11B FORM 990 REVIEW PROCESS: ALL AFFILIATED FORM 990'S AND APPLICABLE SCHEDULES ARE PREPARED BY A PUBLIC ACCOUNTING FIRM IN COOPERATION WITH THE FINANCE DEPARTMENT. THE COMPLETED RETURNS ARE REVIEWED WITH THE VICE PRESIDENT OF FINANCE, THEN 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 REVIEW: 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. 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 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. LAWRENCE OLIVER IS AN EMPLOYEE OF CENTRAL MAINE MEDICAL CENTER. HIS COMPENSATED TIME IS SPENT IN THAT CAPACITY. FORM 990, PART IX, LINE 11G OTHER FEES FOR SERVICES: $ 18,028,863 OUTSIDE SERVICES 14,505,152 LABOR SERVICES 19,476,150 PURCHASED LABOR 6,377,612 PURCHASED SERVICES 690,561 CONSULTING 171,567 PROFESSIONAL FEES 3,101 INTERPRETING SERVICES 15,310 MEDICAL DIRECTOR FEES 22,266 DATA PROCESSING FEES ------------- $ 59,290,582 FORM 990, PART XI, LINE 9 OTHER CHANGES IN NET ASSETS: $ 749,814 CHANGE IN INTEREST IN RELATED PARTY MAINE COLLEGE OF HEALTH PROFESSIONS PO BOX 4500 LEWISTON ME 04243 010356077 EDUCATION ME 501(C)(3) 2 CMMC true CENTRAL MAINE REAL ESTATE MANAGEMENT COR PO BOX 4500 LEWISTON ME 04243 010387674 REAL ESTATE ME 501(C)(2) CMHC false CENTRAL MAINE COMMUNITY HEALTH CORP PO BOX 4500 LEWISTON ME 04243 010386912 PUBLIC ED ME 501(C)(3) 7 CMHC false RUMFORD COMMUNITY FAMILY HEALTH CENTER 430 FRANKLIN STREET RUMFORD ME 04276 010481000 HEALTHCARE ME 501(C)(3) 3 CMHC false RUMFORD COMMUNITY HOME CORPORATION 11 JOHN F KENNEDY DRIVE RUMFORD ME 04276 222844951 NURSING HOME ME 501(C)(3) 9 CMHC false RUMFORD HOSPITAL PO BOX 619 RUMFORD ME 04276 010215227 HEALTHCARE ME 501(C)(3) 3 CMHC false BRIDGTON HOSPITAL 10 HOSPITAL DRIVE BRIDGTON ME 04009 010130427 HEALTHCARE ME 501(C)(3) 3 CMHC false BRIDGTON HOSPITAL PHYSICIANS GROUP SOUTH HIGH STREET BRIDGTON ME 04009 010493083 HEALTHCARE ME 501(C)(3) 3 CMHC false CENTRAL MAINE HEALTHCARE CORPORATION PO BOX 4500 LEWISTON ME 04243 010386913 HEALTHCARE ME 501(C)(3) 7 NA false ELIAS E TUCKER TRUST FUND C/O CMMC 300 MAIN STREET LEWISTON ME 04240 016042343 NURSING ED ME 501(C)(3) 11 A I CMMC true CENTRAL MAINE HEALTH VENTURES INC 300 MAIN STREET LEWISTON ME 04240 010430016 HEALTHCARE ME CMHC C CORP false CWM INSURANCE LTD GENESIS BUIDLING PO BOX 1363 GRAND CAYMAN B.W.I. 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 true false false false false false false false false true false false true false true true true false false MAINE COLLEGE OF HEALTH PROFESSIONS O 784782 COST MAINE COLLEGE OF HEALTH PROFESSIONS Q 161334 COST MAINE COLLEGE OF HEALTH PROFESSIONS A 147888 COST