2014-05-14T13:24:44-05:00 2013-12-31 010242373 MACPAGE LLC 30 LONG CREEK DRIVE SOUTH PORTLAND ME 04106 990 2013-01-01 205150062 HEALTHINFONET HEAL 2075419250 125 PRESUMPSCOT STREET BOX 8 PORTLAND ME 04103 DEVORE CULVER CEO 2075419250 2014-05-14 1 PETER MONTANO P01200943 2077745701 2013 2015-11-30 17:44:51Z 125 PRESUMPSCOT STREET BOX 8 PORTLAND ME 04103 6425699 0 1 X WWW.HINFONET.ORG X 2008 ME TO OVERSEE THE IMPLEMENTATION AND OPERATION OF A STATEWIDE HEALTH INFORMATION TECHNOLOGY NETWORK. 20 20 26 0 0 0 0 0 5318880 6425303 851 396 0 0 5319731 6425699 0 0 0 0 1777897 2157743 0 0 0 3321121 3049899 5099018 5207642 220713 1218057 3530862 3638351 2480997 1370426 1049865 2267925 TO OVERSEE THE IMPLEMENTATION AND OPERATION OF A STATEWIDE HEALTH INFORMATION TECHNOLOGY NETWORK. 0 0 4399797 6425303 CONTINUED TO MOVE TOWARD FULL IMPLEMENTATION OF THE PROJECT AS SCHEDULED. 4399797 1 0 0 1 0 0 0 0 0 0 1 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 1 12 0 1 26 1 0 0 0 0 0 0 0 0 X 20 20 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 X KIM BUSTAMANTE 2075419250 125 PRESUMPSCOT STREET BOX 8 PORTLAND ME 04103 ANN CONWAY DIRECTOR 1.00 X 0 0 0 ARTHUR BLANK SECRETARY 1.00 X X 0 0 0 DAVID HOWES PAST CHAIR 1.00 X X 0 0 0 DOUGLAS JORGENSEN DIRECTOR 1.00 X 0 0 0 JOSH BRODER DIRECTOR 1.00 X 0 0 0 KARL TURNER TREASURER 1.00 X X 0 0 0 MARY MAYHEW DIRECTOR 1.00 X 0 0 0 NONA BOYINK CHAIRPERSON 1.00 X X 0 0 0 PETER MILLS DIRECTOR 1.00 X 0 0 0 RICHARD MARSTON MEMBER AT LARGE 1.00 X 0 0 0 RICHARD WHITE VICE CHAIRPERSO 1.00 X X 0 0 0 RODERICK PRIOR DIRECTOR 1.00 X 0 0 0 STEFANIE NADEAU DIRECTOR 1.00 X 0 0 0 STEPHEN SEARS DIRECTOR 1.00 X 0 0 0 WILLIAM CARON DIRECTOR 1.00 X 0 0 0 RICHARD FREEMAN DIRECTOR 1.00 X 0 0 0 DAWN GALLAGHER DIRECTOR 1.00 X 0 0 0 JAY YOE DIRECTOR 1.00 X 0 0 0 ANN SULLIVAN DIRECTOR 1.00 X 0 0 0 DEVORE CULVER CEO 40.00 X 322193 0 28376 PETER PIKE CFO 4.00 X 25508 0 0 SHAUN ALFREDS COO 40.00 X 196233 0 25088 PHILIP PROFENNO ONBOARDING MGR 40.00 X 110222 0 10759 TODD ROGOW DIRECTOR OF IT 40.00 X 142417 0 21415 796573 0 85638 4 0 1 0 ORION HEALTH INC PO BOX 2927 BUFFALO NY 142402927 SOFTWARE 672886 SYSTEMS ENGINEERING INC 120 EXCHANGE STREET PORTLAND ME 04101 LICENSING & SUPPORT 467728 IBM 11501 BURNET ROAD AUSTIN TX 78758 SOFTWARE 238516 SURESCRIPTS LLC 2800 CRYSTAL DRIVE ARLINGTON VA 22202 MED. HISTORY HOSTING 170766 HBI SOLUTIONS INC 530 LYTTON AVENUE SECOND FLOOR PALO ALTO CA 94301 SOFTWARE 131250 6 PARTICIPATION REVENUE 2628033 2628033 CONTRACTED SERVICES 2040590 2040590 GRANT REVENUE 1723792 1723792 COMMISSION 32888 32888 6425303 396 396 6425699 6425303 0 396 597397 454022 143375 1215038 916957 298081 80351 60915 19436 144233 109385 34848 120724 91584 29140 21851 18180 3671 23419 23419 85991 72431 13560 16792 14144 2648 28383 28383 708378 599286 109092 42982 30231 12751 VENDORS 1273638 1273638 SUBCONTRACTS 632087 632087 CONTRACTUAL SERVICES 96842 58105 38737 SUPPLIES 64501 22477 42024 55035 46355 8680 5207642 4399797 807845 0 861407 1244295 531762 464599 183741 215010 843843 312939 266021 530904 1687931 1183543 3530862 3638351 311010 269075 1801254 1101351 368733 0 2480997 1370426 X 1049865 2267925 1049865 2267925 3530862 3638351 X 1218057 3 X 0 1 X 1 1 1 X 1668357 1668357 969346 5291080 6076313 5318880 6425303 24080922 2637703 5291080 6076313 5318880 6425303 25749279 0 4648808 3562106 2360270 1530923 12102107 4648808 3562106 2360270 1530923 12102107 13647172 572 1667 983 851 396 4469 572 1667 983 851 396 4469 2348 2348 2640623 5292747 6077296 5319731 6425699 25756096 0.52990 0.00020 X 0 0 0 0 0 0 1 23161 0 0 23161 0 PART II-B, LINE 1: STRATEGIC COUNSEL AND A DAY-TO-DAY PRESENCE AT THE STATE HOUSE DURING THE LEGISLATIVE SESSION. 843843 312939 530904 530904 X 6425699 0 6425699 0 6425699 5207639 0 5207639 3 3 5207642 PART X, LINE 2: MANAGEMENT EVALUATED THE ORGANIZATION'S TAX POSITIONS AND CONCLUDED THAT THE ORGANIZATION HAD TAKEN NO UNCERTAIN TAX POSITIONS THAT REQUIRED ADJUSTMENT TO THE FINANCIAL STATEMENTS. AS A RESULT, THERE WAS NO CUMULATIVE EFFECT AND NO INTEREST OR PENALTIES RELATED TO UNCERTAIN TAX POSITIONS. WHEN NECESSARY, THE ORGANIZATION ACCOUNTS FOR INTEREST AND PENALTIES RELATED TO UNCERTAIN TAX POSITIONS AS PART OF ITS PROVISION FOR FEDERAL AND STATE INCOME TAXES. THE ORGANIZATION DOES NOT EXPECT THAT ANY UNRECOGNIZED TAX BENEFITS OR LIABILITIES ARISING FROM TAX POSITIONS WILL CHANGE SIGNIFICANTLY WITHIN THE NEXT TWELVE MONTHS. THE ORGANIZATION IS CURRENTLY OPEN TO AUDIT UNDER THE STATUTE OF LIMITATIONS BY THE INTERNAL REVENUE SERVICE AND STATE TAXING AUTHORITIES FOR THE YEARS ENDING DECEMBER 31, 2010 THROUGH 2013. PART XII, LINE 4B - OTHER ADJUSTMENTS: ROUNDING X 1 0 X X X 0 0 0 0 0 0 0 1 0 DEVORE CULVER CEO 305813 0 0 0 16380 0 0 0 28376 0 350569 0 0 0 SHAUN ALFREDS COO 196233 0 0 0 0 0 0 0 25088 0 221321 0 0 0 TODD ROGOW DIRECTOR OF IT 142417 0 0 0 0 0 0 0 21415 0 163832 0 0 0 PART I, LINE 1A CEO RECEIVES A HOUSING ALLOWANCE OF $16,380 ANNUALLY; IT IS INCLUDED IN HIS W-2 WAGES BUT IS NOT PART OF HIS BASE SALARY. PART I, LINE 3 THE EXECUTIVE COMMITTEE CONDUCTED AN ANNUAL PERFORMANCE EVALUATION AND REVIEWED THE COMPENSATION PACKAGE (BASED ON CONSULTANT SURVEY PERFORMED LAST YEAR). A CONSULTANT SURVEY WILL BE PERFORMED EVERY THREE YEARS. PART I, LINE 7 EMPLOYEES INCLUDING THE CEO ARE ELIGIBLE TO RECEIVE MERIT BONUSES FROM THE ORGANIZATION AT THEIR ANNUAL REVIEWS. THIS IS INCLUDED ON THE W-2S. RICHARD FREEMAN SENIOR VP & CHIEF TRANSFORMATION OFFICER AT EMHS BOD MEMBER 671581 SCHEDULE O - HIN REVENUE 0 RICHARD WHITE FORMER GM EMPLOYER AND PROVIDERMPHC BOD OFFICER 50000 SCHEDULE O - HIN REVENUE 0 NONA BOYINKPRESIDENT HEALTHREACH NETWORK AND MAINEGENERAL REHAB & NURSIN BOD OFFICER 150000 SCHEDULE O - HIN REVENUE 0 WILLIAM CARON PRESIDENT MAINEHEALTH BOD MEMBER 513590 SCHEDULE O - HIN REVENUE 0 ARTHUR BLANK CEO MDI HOSPITAL BOD OFFICER 25000 SCHEDULE O - HIN REVENUE 0 STEPHEN SEARS MARY MAYHEW DIR ME CDC BOD MEMBER 230446 SCHEDULE O - HIN REVENUE 0 STEPHANIE NADEAU DAWN GALLAGHER JAY YOE DIR DHHS BOD MEMBER 1849650 SCHEDULE O - HIN REVENUE 0 WILLIAM CARON PRESIDENT MAINEHEALTH BOD MEMBER 1183 SCHEDULE O-HIN PAYMENT 0 RICHARD FREEMAN SENIOR VP & CHIEF TRANSFORMATION OFFICER AT EMHS BOD MEMBER 107653 SCHEDULE O-HIN PAYMENT 0 FORM 990, PART VI, SECTION B, LINE 11 LINE 11A EXPLANATION - THE IRS 990 REPORT IS AN INFORMATIONAL TAX FILING FOR ORGANIZATIONS EXEMPT FROM FEDERAL INCOME TAX. THESE REPORTS ARE DUE TO THE IRS BY MAY FOLLOWING THE CLOSED FISCAL YEAR. THE INDEPENDENT AUDIT FIRM REQUIRES VARIOUS INTERNAL DOCUMENTS TO COMPLETE THE 990 REPORT INCLUDING INCOME, EXPENSES, GRANT AWARDS, PAYROLL, EQUIPMENT INVENTORY, ETC. THE 990 TAX RETURN IS SUBMITTED TO THE CFO TO REVIEW PRIOR TO SIGNING BY THE CEO. THE BOARD OF DIRECTORS REVIEWS AND APPROVES THE 990 PRIOR TO FILING WITH THE IRS. COPIES OF EACH YEARS 990 REPORTS ARE MAINTAINED IN ACTIVE FINANCE OFFICE FILES WITH ORIGINALS MAILED TO THE IRS. FORM 990, PART VI, SECTION B, LINE 12C THE BOARD MEMBERS SIGN A CONFLICT OF INTEREST STATEMENT ANNUALLY AND DISCLOSE ANY CONFLICT OF INTEREST ISSUES AT MEETINGS WHEN APPLICABLE. FORM 990, PART VI, SECTION B, LINE 15 THE EXECUTIVE DIRECTOR CONDUCTS AN ANNUAL REVIEW OF KEY EMPLOYEES. SALARIES FOR OFFICERS ARE DETERMINED BY THE BOARD OF DIRECTORS. AN INDEPENDENT COMPENSATION CONTRACTOR HAS BEEN USED TO DETERMINE APPROPRATE SALRY RANGES. THE EXECUTIVE COMMITTEE OF THE BOARD OF DIRECTORS CONDUCTS AN ANNUAL PERFORMANCE EVALUATION OF THE CEO AND DETERMINES COMPENSATION, WHICH IS APPROVED BY THE FULL BOARD OF DIRECTORS. FORM 990, PART VI, SECTION C, LINE 19 FINANCIAL STATEMENTS, GOVERNING DOCUMENTS AND POLICIES ARE PROVIDED UPON REQUEST. FORM 990, PART XI, LINE 9: ROUNDING 3. SCHEDULE L, SUPPLEMENTAL INFORMATION HEALTHINFONET RECEIVES REVENUE FROM SEVERAL ENTITIES WHICH HAVE REPRESENTATIVES SERVING ON THE BOARD OF DIRECTORS. IN ADDITION, HEALTHINFONET MAKES PAYMENTS TO SEVERAL OF THESE ENTITIES WHICH PARTICIPATE IN A PROGRAM FUNDED BY A FEDERAL GRANT. PART IV (1)RICHARD FREEMAN, MD, SENIOR VP & CHIEF TRANSFORMATION OFFICER OF EASTERN MAINE HEALTHCARE SYSTEMS. EASTERN MAINE HEALTHCARE SYSTEM MADE GRANTS AND PAYMENTS TO HEALTHINFONET TOTALING REVENUE OF $671,581 AND DEFERRED REVENUE OF $343,334. HEALTHINFONET MADE PAYMENTS TOTALING $107,653 TO EASTERN MAINE HEALTHCARE SYSTEMS IN 2013. PART IV (2) RICHARD WHITE, FORMER GENERAL MANAGER OF EMPLOYER AND PROVIDER PARTNERSHIPS, MARTIN'S POINT HEALTH CARE. MARTIN'S POINT HEALTH CARE PROVIDED HEALTHINFONET WITH REVENUE TOTALING $50,000 IN 2013. PART IV (3) NONA BOYINK, MD, PRESIDENT, HEALTHREACH NETWORK AND MAINEGENERAL REHAB & NURSING CARE (MEMBER MAINEGENERAL HEALTH). MAINEGENERAL HEALTH PROVIDED HEALTHINFONET WITH REVENUE TOTALING $150,000 AND $150,000 DEFERRED REVENUE IN 2013. PART IV (4)AND (8) WILLIAM CARON,PRESIDENT, MAINEHEALTH. MAINEHEALTH AND MAINE MEDICAL CENTER PROVIDED REVENUE TOTALING $513,590 AND $25,000 DEFERRED REVENUE TO HEALTHINFONET IN 2013. HEALTHINFONET MADE PAYMENTS TOTALING $1,183 TO MAINEHEALTH AND MAINE MEDICAL CENTER IN 2013. PART IV (5) ARTHUR J. BLANK, PRESIDENT & CEO, MT. DESERT ISLAND HOSPITAL. MT. DESERT ISLAND HOSPITAL PROVIDED HEALTHINFONET WITH REVENUE TOTALING $25,000 IN 2013 AND $333 DEFERRED REVENUE. PART IV (6) STEPHEN D. SEARS, MD, STATE EPIDEMIOLOGIST, MAINE CDC, MARY MAYHEW, COMMISSIONER, DEPARTMENT OF HEALTH AND HUMAN SERVICES, JAY YOE, DIRECTOR, MAINECARE, DHHS. THE MAINE CDC MADE GRANTS TO HEALTHINFONET TOTALING $230,446 IN 2013; HEALTHINFONET HAD ACCOUNTS RECEIVABLE TOTALING $93,697 DUE FROM THE MAINE CDC AT DEC. 31, 2013. PART IV (7)STEPHANIE NADEAU, DIRECTOR OF MAINECARE, DAWN GALLAGHER, DIRECTOR, OFFICE OF STATE COORDINATOR FOR HIT, MAINECARE. THIS OFFICE MADE GRANTS TOTALING $1,849,650 IN REVENUE TO HEALTHINFORNET IN 2013 AND $167,529 DEFERRED REVENUE.