2025-11-03T15:55:12-06:00 2024-12-31 010494526 Baker Newman & Noyes 650 Elm Street Suite 302 Manchester NH 03101 990 2024-01-01 010409788 Community Clinical Services Inc COMM 2075133897 Campus Avenue PO Box 7291 Lewiston ME 042407291 Coleen Elias CEO 2075133897 2025-10-31 1 0 Connor Smart P02285543 6036262200 2025-10-31 2024 2025-03-06 01:10:19Z Coleen Elias Campus Avenue PO Box 7291 Lewiston ME 042407291 12695583 0 X www.communityclinicalservices.com X 1984 ME Federally qualified health center providing quality primary and specialty care. 9 9 134 11 0 0 2104033 152222 13351740 12542622 -838 739 0 0 15454935 12695583 0 0 0 0 10003794 10955202 0 0 0 5159724 4123319 15163518 15078521 291417 -2382938 4166949 1968778 1578799 1788775 2588150 180003 X Community Clinical Services is committed to improve the health and well-being of our community through patient-centered care, advocacy, and community engagement. 0 1 6135229 0 3636574 Family Practice: Medical care for infants, children, and adults. The Organization received 16,603 medical visits in 2024 for family practices. 4169237 0 3461980 Behavioral Medicine: Psychiatric care for children and adults. The Organization received 20,410 pyschiatry visits in 2024 for behavioral medicine. 1776198 0 2427500 Outpatient Counseling: Counseling services for children and adults. The Organization received 10,439 visits in 2024 for outpatient counseling. 1921570 0 3016568 Other program services offered by Community Clinical Services Inc. include dental care and dental services (of which there were 3,769 visits in 2024), care management, 340B pharmacy programs, and electronic handbook and meaningful-use incentive programs. 1921570 0 3016568 14002234 1 1 0 1 0 0 0 0 0 0 1 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 134 1 0 0 0 0 0 0 0 0 0 0 0 0 X 9 9 0 0 1 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 ME X X Coleen Elias CEO 2075133897 57 Birch Street Lewiston ME 04240 Joseph Marino SMHS CFO; CCS Director (end 6/24) 0.30 40.00 X 0 306112 4942 Paige Hagerstrom Director (end 6/2024) 0.30 40.00 X 0 290016 36259 Abdi Abdalla Director 0.30 0.00 X 0 0 0 Joel Burian Director (start 4/2024) 0.30 0.00 X 0 0 0 Amanda Karomba Director 0.30 0.00 X 0 0 0 Azenaide Pedro Director (start 4/2024) 0.30 0.00 X 0 0 0 Abdulerim Said Director (end 3/2024) 0.30 0.00 X 0 0 0 Zamzam Saney Director (start 2/2024) 0.30 0.00 X 0 0 0 Lynn Ward Chair 0.50 0.00 X X 0 0 0 Hawo Abille Vice Chair 0.30 0.00 X X 0 0 0 Laura Gormley Treasurer 0.50 0.00 X X 0 0 0 Andrew Lunn Secretary 0.50 0.00 X X 0 0 0 Coleen Elias CEO 40.00 0.00 X 146351 0 12561 Megan Brewer MD CMO 40.00 0.00 X 284222 0 9633 Syed Fahd MD Dentist/Dental Director 40.00 0.00 X 292998 0 24380 Richard Kappelmann MD Physician (start 4/2024) 40.00 0.00 X 129066 0 16609 Jonathan M Libby DNP CPNP Pediatric Nurse Practitioner 40.00 0.00 X 139210 0 13653 David Schenk Psychiatrist (start 7/2024) 40.00 0.00 X 128923 0 21042 1120770 596128 139079 6 0 1 0 St Mary's Regional Med Ctr 93 Campus Avenue PO Box 7291 Lewiston ME 04243 Inter-Company Purchased Services 2203026 1 152222 25000 152222 Patient services 621110 12542622 12542622 12542622 739 739 12695583 12542622 0 739 X 452767 441644 11123 8395500 8191490 204010 186511 180968 5543 1513045 1468077 44968 407379 395272 12107 2625 2625 2108392 1876469 231923 615473 421445 194028 562524 385188 177336 297875 203970 93905 32668 22369 10299 6346 4345 2001 9229 9229 135004 60752 74252 Drugs/medical supplies 343358 343358 Minor equipment/repairs 9319 6381 2938 Food and dining 506 506 15078521 14002234 1076287 0 3076423 215128 170336 106722 655167 1253732 18508 18508 900 79735 234326 186475 57079 47851 45296 44557 143979 201806 4166949 1968778 584227 1605263 176799 176799 817773 6713 1578799 1788775 X 0 0 0 0 2588150 180003 2588150 180003 4166949 1968778 -2382938 -25209 0 X 0 0 0 X 484613 2380483 2742160 2104033 152222 7863511 11722281 12921440 12841516 13351740 12542622 63379599 12206894 15301923 15583676 15455773 12694844 71243110 0 0 0 71243110 984 750 825 1438 739 4736 984 750 825 1438 739 4736 12207878 15302673 15584501 15457211 12695583 71247846 0.99990 0.97940 0.00010 0.00010 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 1 9105 0 0 0 9105 0 Part II-B, Line 1: Part II-B, Line 1f: Community Clinical Servics, Inc. ("CCS") partners with various like-minded professional associations which support public policies and initiatives that focus on improving health outcomes and the experience of health care, while also aiming to reduce the overall cost of receiving that care. One such membership-association is the Maine Primary Care Association. To maintain this partnership, CCS pays membership dues back to the Association. A portion of the dues paid to the Association have been designated as available for lobbying expenditures (in 2024, the portion eligible for lobbying purposes has been deemed to be up to 80% of total dues paid). Any lobbying expenditures paid by the Association is incurred to help track and discuss legislation affecting health care policy on behalf of its members. The specific dues paid by CCS to association in 2024, as well as the portion of those dues that were estimated to be available for lobbying expenditures, are detailed below: Maine Primary Care Association - Total 2024 dues: $11,381 - Portion of dues available for lobbying: $9,105 54858 36568 18290 179468 149907 29561 47851 Due from former affiliated entities 201806 201806 Due to former affiliated entities 6713 6713 X X X X 1 0 0 0 0 0 0 1 0 Paige Hagerstrom Director (end 6/2024) 0 289301 0 0 0 715 0 8650 0 27609 0 326275 0 0 Syed Fahd MD Dentist/Dental Director 272583 0 0 0 20415 0 0 0 24380 0 317378 0 0 0 Joseph Marino SMHS CFO; CCS Director (end 6/24) 0 304012 0 0 0 2100 0 3741 0 1201 0 311054 0 0 Megan Brewer MD CMO 267389 0 16469 0 364 0 0 0 9633 0 293855 0 0 0 Coleen Elias CEO 146351 0 0 0 0 0 0 0 12561 0 158912 0 0 0 Jonathan M Libby DNP CPNP Pediatric Nurse Practitioner 129658 0 7924 0 1628 0 0 0 13653 0 152863 0 0 0 Part I, Line 3 For part of this tax year, some of the Organization's officers and employees were compensated by or through the Covenant Health System, a group of formerly related entities. However, as of the end of this tax year, the Organization is no longer affiliated with or related to St. Mary's Health System of Lewiston or Covenant Health, Inc. During the period that the Organization was a member of the Covenant Health System, any compensation paid to the trustees, directors, officers or key employees of the Organization was subject to the oversight and decisions of Covenant Health. While a member of the Covenant Health System, the Compensation Committee of the Covenant Health Board of Directors would engage an external consultant to provide competitive market data from various survey sources, which is then used to develop recommendations for changes to the compensation program. However, since ending its affiliation with St. Mary's Health System and Covenant Health, the Organization relies on its own Board and its own Compensation Committee for any decisions or analysis regarding compensation or benefits to be paid to officers, trustees, directors, or key employees. Furthermore, the Organization will now independently determine if outside, third-party resources or advice is necessary when evaluating and adjusting compensation packages. Lastly, since its disaffiliation with Covenant Health, any such changes to compensation policies and procedures are subject to the review and approval of the Organization's Board of Directors directly. Part I, Line 7 From time-to-time the Organization may provide for bonuses, incentive awards, or other non-fixed compensation payments. These payments are made based on the achievement of certain identified performance metrics, as approved by the Board, and subject to budgetary allowances. Form 990, Part III, line 3 In July 2024, Community Clinical Services ("CCS") disaffiliated from the St. Mary's Health System of Lewiston and from Covenant Health, Inc. Accordingly, as of the end of this tax year, CCS is no longer legally affiliated to or related to either the St. Mary's System or Covenant Health more broadly. Though its legal affiliation with St. Mary's has ended, the two organizations will still partner to coordinate patient care when needed. As a federally qualified health center "look alike," meaning it does not receive grant funding, Community Clinical Services has been working toward independence from St. Mary's for several years as required by Health Resources and Services Administration. Community Clinical Services is applying for a grant application to become a 330 grantee federally qualified health center. To achieve this goal, CCS has made important operational decisions that have led the organization to become more financially solvent without financial support from St. Mary's. St. Mary's will remain a strong partner to CCS, sharing a strong mission of service to the Lewiston-Auburn community. Form 990, Part VI, Section A, line 4 In September 2024, the Organization revised its bylaws to change the designation of corporate members and expand the powers of the Board. Previously, the bylaws stated that St. Mary's Health System was the sole corporate member. In the revised bylaws, the corporate member designation has been removed, and the Board is now granted full authority over the Corporation. Under the new bylaws, the Board has all rights related to the management, control, business, and operations of the Corporation. Additionally, the Board is empowered to approve funding applications and determine the locations and hours of operation for all Corporation sites. Furthermore, and related to these changes, St. Mary's Health System no longer has any powers or responsibilities over the Organization's governance or Board composition. As of the end of this tax year, the Organization has ended its legal affiliation with St. Mary's Health System and with Covenant Health, Inc. more broadly. This change in the Organization's relationships is reflected within the amended governing documents. Form 990, Part VI, Section B, line 11b The Form 990 is provided to the governing body for their review and approval prior to filing. Form 990, Part VI, Section B, line 12c The purpose of the Organization's Conflict-of-Interest policy is to protect the interest of Community Clinical Services (CCS) when it is contemplating entering a transaction or arrangement that might benefit the personal interest of a director, officer, committee member or key employee of CCS. Directors, officers, committee members and key employees of CCS owe a fiduciary duty to CCS and are required to fulfill their responsibilities with care, obedience, and loyalty. All decisions and actions of directors, officers, committee members and key employees are to be made for the sole purpose of advancing the best interests of CCS and the public good. The fiduciary relationship of directors, officers, committee members and key employees to CCS must be respected in both actuality and appearance. All directors, officers, committee members and key employees of CCS shall exercise good faith in all transactions and arrangements related to their duties on behalf of CCS and its affiliates. In connection with any actual or possible conflicts of interest, an interested person must disclose the existence and nature of his or her personal interest to the board or the committee with board delegated powers considering the proposed transaction or arrangement. After disclosure of the personal interest, the remaining board or committee members who do not have a personal interest in the matter shall decide if a conflict of interest exists. If requested by the chairperson of the board or committee or any other director or committee member, the interested person shall leave the board or committee meeting while board or committee determines whether a conflict of interest exists. If the board or any committee has reasonable cause to believe that an interested person has failed to disclose actual or possible conflicts of interest, it shall inform the person of the basis for such belief and afford the person an opportunity to explain the alleged failure to disclose. If, after hearing the response of the person and making such further investigation as may be warranted in the circumstances, the board or committee determines that the person has in fact failed to disclose an actual or possible conflict of interest, it shall take appropriate disciplinary and corrective action. Corrective action can include, for board members or committee members verbal or written warning, or removal from the board or committee; for staff corrective actions can include verbal, written warning, or dismissal. Form 990, Part VI, Section B, line 15 Any compensation paid to the trustees, directors, officers or key employees of the Organization is subject to the oversight of the Board of Directors, and any such compensation or benefits are only to paid in accordance with the Organization's conflict-of-interest policy. To ensure that CCS operates in a manner consistent with its charitable purpose and that does not engage in activities that could jeopardize its status as an organization exempt from federal income tax, periodic reviews shall be conducted under supervision of the Finance & Audit Committee. The periodic review shall, at a minimum, include the following subjects: - Whether compensation arrangements and benefits are reasonable and are the result of arm's length bargaining. - Whether acquisitions or other arrangements with clinical providers or employees result in inurement or impermissible private benefit. - Whether partnership and joint venture arrangements and arrangements with other organizations conform to written policies, are properly recorded, reflect reasonable payments for goods and services, further CCS, and its' affiliates' charitable purposes, and do not result in inurement or impermissible private benefit. - Whether agreements to provide health care and agreements with other health care providers, employees, and third-party payors further CCS and its' affiliates' charitable purposes and do not result in inurement or impermissible private benefit. In conducting the periodic reviews provided for above, CCS may, but need not, use outside advisors. If outside experts are used their use shall not relieve the board of its responsibility for ensuring that periodic reviews are conducted. When evaluating compensation policies, a voting member of the Board of Directors who receives compensation, directly or indirectly, from CCS for services is precluded from voting on matters pertaining to that member's compensation. Furthermore, physician who is a voting member of the Board of Directors and receives compensation, directly or indirectly, from the Corporation for services is precluded from discussing and voting on matters pertaining to that member's and other physicians' compensation. Form 990, Part VI, Section C, line 19 The Organization's Form 990, governing documents, conflict of interest policy, and financial statements are made available to the public upon request. Form 990, Part IX, line 11g Purchased medical and physician services: Program service expenses 1,001,886. Management and general expenses 0. Fundraising expenses 0. Total expenses 1,001,886. Administrative and other fees: Program service expenses 874,583. Management and general expenses 231,923. Fundraising expenses 0. Total expenses 1,106,506. Alternative Health Services 360 Broadway Bangor ME 04402 010422885 Home health and hospice ME 501(c)(3) Line 10 St Joseph Healthcare Foundation 0 Bangor Nursing and Rehabilitation Center 103 Texas Avenue Bangor ME 04401 010538534 Long-term care nursing facility ME 501(c)(3) Line 10 Covenant Health Inc 0 CHS of Waltham Inc dba Maristhill Nursing & Rehab Center 66 Newton Street Waltham MA 02453 043333609 Nursing home and restorative facility MA 501(c)(3) Line 10 Covenant Health Inc 0 CHS of Worcester Inc dba St Mary Care Center 39 Queen Street Worchester MA 01610 043419625 Nursing home and restorative facility MA 501(c)(3) Line 10 Covenant Health Inc 0 Covenant Health Foundation Inc 40 Shattuck Road Suite 317 Andover MA 01810 800199674 Charitable foundation MA 501(c)(3) Line 12a, I Covenant Health Inc 0 Covenant Health Investment Trust 40 Shattuck Road Suite 317 Andover MA 01810 046835128 Investment trust MA 501(c)(3) Line 12a, I Covenant Health Inc 0 Covenant Health Inc 40 Shattuck Road Suite 317 Andover MA 01810 222484505 Health care management and resource organization MA 501(c)(3) Line 10 N/A 0 Fanny Allen Corporation Inc 40 Shattuck Road Suite 317 Andover MA 01810 222495808 Charitable foundation VT 501(c)(3) Line 12a, I Covenant Health Inc 0 Fanny Allen Holdings Inc 40 Shattuck Road Suite 317 Andover MA 01810 030181052 Real estate holding company VT 501(c)(3) Line 12a, I Covenant Health Inc 0 Helping Hands of St Marguerite Inc 799 Concord Avenue Cambridge MA 02138 800199674 Private home-care health services MA 501(c)(3) Line 10 Covenant Health Inc 0 M & J Company 360 Broadway Bangor ME 04402 222480150 Lease holding company ME 501(c)(2) St Joseph Healthcare Foundation 0 Mary Immaculate Guild Inc 172 Lawrence Street Lawrence MA 01841 463073987 Supporting grants and donations MA 501(c)(3) Line 12a, I Covenant Health Inc 0 MI Adult Day Health Care Center Inc 189 Maple Street Lawrence MA 01841 042921888 Adult day care services MA 501(c)(3) Line 10 Covenant Health Inc 0 MI Management Inc 172 Lawrence Street Lawrence MA 01841 042857794 Assisted living services MA 501(c)(3) Line 12a, I Covenant Health Inc 0 MI Nursing Restorative Center Inc 172 Lawrence Street Lawrence MA 01841 042104851 Nursing home and restorative facility MA 501(c)(3) Line 10 Covenant Health Inc 0 MI Residential Community Inc 189 Maple Street Lawrence MA 01841 042647207 HUD low income housing MA 501(c)(3) Line 10 Covenant Health Inc 0 MI Transportation Inc 189 Maple Street Lawrence MA 01841 042921889 Elderly transportation services MA 501(c)(3) Line 10 Covenant Health Inc 0 Mount St Rita Health Centre 15 Sumner Brown Road Cumberland RI 02864 050342330 Nursing home RI 501(c)(3) Line 10 Covenant Health Inc 0 Neighborhood Housing Initiative PO Box 7291 Lewiston ME 04243 010539730 Affordable housing services ME 501(c)(3) Line 10 St Mary's Health System 0 Penacook Place Inc 150 Water Street Haverhill MA 01830 237090088 Nursing home MA 501(c)(3) Line 10 Covenant Health Inc 0 Souhegan Nursing Association 24 North River Road Milford NH 03055 020222795 Home health and hospice NH 501(c)(3) Line 10 St Joseph Hospital of Nashua NH Inc 0 St Joseph Ambulatory Care Inc 360 Broadway Bangor ME 04402 222480373 Physician practice ME 501(c)(3) Line 10 St Joseph Healthcare Foundation 0 St Andre Health Care 407 Pool Street Biddeford ME 04005 010342399 Nursing home and restorative facility ME 501(c)(3) Line 10 Covenant Health Inc 0 St Joseph Healthcare Foundation 360 Broadway Bangor ME 04402 222480149 Healthcare foundation ME 501(c)(3) Line 10 Covenant Health Inc 0 St Joseph Hospital 360 Broadway Bangor ME 04402 010212435 Hospital and health care facility ME 501(c)(3) Line 3 St Joseph Healthcare Foundation 0 St Joseph Manor Health Care 215 Thatcher Street Brockton MA 02302 042565937 Nursing home and restorative facility MA 501(c)(3) Line 10 Covenant Health Inc 0 St Joseph's Hospital of Nashua NH Inc 172 Kinsley Street Nashua NH 03061 020222215 Hospital and health care facility NH 501(c)(3) Line 3 Covenant Health Inc 0 St Mary's D'Youville Pavilion PO Box 7291 Lewiston ME 04243 010211558 Nursing home and restorative facility ME 501(c)(3) Line 10 St Mary's Health System 0 St Mary's Health System PO Box 7291 Lewiston ME 04243 222504349 Hospital and health care facility ME 501(c)(3) Line 12a, I Covenant Health Inc 0 St Mary's Regional Medical Center PO Box 7291 Lewiston ME 04243 010211551 Hospital and health care facility ME 501(c)(3) Line 3 St Mary's Health System 0 St Mary's Residences PO Box 7291 Lewiston ME 04243 222504356 Low income housing ME 501(c)(3) Line 10 St Mary's Health System 0 St Mary's Villa Nursing Home Inc 675 St Marys Villa Road Moscow PA 18444 232057177 Nursing home and restorative facility PA 501(c)(3) Line 10 Covenant Health Inc 0 The Surgicenter at St Joseph Hospital Inc 172 Kinsley Street Nashua NH 03061 020222215 Healthcare and surgery center NH 501(c)(3) Line 10 St Joseph Hospital of Nashua NH Inc 0 Youville Hospital and Rehabilitation Center Inc 1575 Cambridge Street Cambridge MA 02138 043239563 Hospital and health care facility MA 501(c)(3) Line 10 Youville Lifecare Inc 0 Youville House Inc 1573 Cambridge Street Cambridge MA 02138 043239593 Assisted living services MA 501(c)(3) Line 10 Youville Lifecare Inc 0 Youville Lifecare Inc 1575 Cambridge Street Cambridge MA 02138 042103582 Hospital and health care facility MA 501(c)(3) Line 10 Covenant Health Inc 0 Youville Place 10 Pelham Road Lexington MA 02421 043297834 Assisted living services MA 501(c)(3) Line 10 Covenant Health Inc 0 Campus Holding PO Box 7291 Lewiston ME 04240 010406049 Holding company ME N/A C 0 Covenant Health Insurance LTD PO Box 69 Grand Cayman CJ KY1-1102 043360127 Self-insurance company CJ N/A C 0 GNM Corporation 172 Kinsley Street Nashua NH 03060 020400550 Real estate holding company NH N/A C 0 SJ Physicians Services 172 Kinsley Street Nashua NH 03060 020522234 Physician practice NH N/A C 0 St Joseph Corporate Services Inc 172 Kinsley Street Nashua NH 03060 020405197 Holding company NH N/A C 0 Strauss Incorporated 360 Broadway Bangor ME 04402 010391369 Repairs and transcriptions ME N/A C 0 0 0 0 1 1 0 0 0 0 0 1 1 1 0 1 1 0 0 0 Form 990, Schedule R, Change in Related Organizations: In July 2024, Community Clinical Services ("CCS") disaffiliated from the St. Mary's Health System of Lewiston and from Covenant Health, Inc. Accordingly, as of the end of this tax year, CCS is no longer legally affiliated to or related to either the St. Mary's System or Covenant Health more broadly. As CCS was related to these healthcare systems for part of its 2024 tax year, they are still listed on this Form 990, Schedule R. Pending any further change in CCS's relationship with these entities, these organizations will no longer be "related" to CCS in its 2025 tax year, and so will be subject for removal from CCS's Form 990, Schedule R, for its year ending December 31, 2025.