2022-05-05T11:13:12-05:00 2021-12-31 010494526 Baker Newman & Noyes PO Box 507 Portland ME 04112 990 2021-01-01 010540180 Hospice of Southern Maine HOSP 2072893641 390 US Route 1 Scarborough ME 04074 Daryl J Cady CEO 2072893641 2022-05-04 1 Daryl Cady 999009999 Nicholas E Porto P01310283 2078792100 2022-05-04 3 AAL1 IAL1 2021 2022-09-23 18:48:47Z Daryl J Cady 390 US Route 1 Scarborough ME 04074 19318658 0 X www.hospiceofsouthernmaine.org X 2003 ME Hospice Services: To provide compassion, care, and comfort through end of life. 12 12 186 155 0 0 3845016 2048792 14741333 16845382 230403 281301 -64234 -44505 18752518 19130970 0 0 0 0 11921102 12728369 0 0 285250 4903768 5475998 16824870 18204367 1927648 926603 27715064 28517026 4137758 3722777 23577306 24794249 X Compassion, care, and comfort through end of life. 0 0 14655324 16845382 Hospice of Southern Maine's (HSM) Mission is to provide compassion, care, and comfort through end-of-life for patients with life-limiting illnesses and support for their families. Our stated vision is as follows: "As a leading provider of Hospice and Palliative Care in Southern Maine, our focus is quality and excellence in patient and family centered care. Striving to be the hospice provider of choice for patients and families, and the hospice employer of choice for healthcare professionals, we endeavor to positively shift societal attitudes concerning death and dying, grief and loss." To meet our Mission, HSM offers comprehensive hospice care to patients in York and Cumberland Counties by an interdisciplinary team of physicians, nurses, hospice aides, social workers, chaplains, grief counselors, and volunteers. Our patients have life-limiting illnesses with a prognosis of six months or less. In addition to providing medical, emotional, social and spiritual support to our patients, we also provide care before and after the death for their loved ones. Our core vision includes a focus on shifting societal attitudes concerning death and dying. To fulfill this vision, HSM organizes an annual regional conference on end-of-life topics; provides education to clinical staff in area hospitals; nursing homes; assisted living facilities; colleges and universities; businesses; churches; and the community. Our bereavement program, which is an important part of our mission, offers support for 13 months following the death of a loved one. Our program is unique in that it offers one-on-one counseling at no cost. We also offer eight-week group sessions for people who are interested in connecting with others in a similar situation. Additionally, we provide counseling and group support to anyone in the community who is grieving, whether or not their loved one died while under our care.Formed through a collaborative effort among York and Cumberland County community leaders and health care providers, HSM began providing direct patient services in 2004. In 2007, HSM opened the area's first inpatient hospice facility - the Gosnell Memorial Hospice House. Today, HSM is the only free-standing, state licensed, Medicare-certified nonprofit in Maine that is solely focused on providing professional and volunteer direct hospice services to dying patients and their families, regardless of their ability to pay. Demand for our services continues to grow. In 2021, we provided hospice care to 2,100 patients and their families. We employ approximately 160 staff and engage approximately 150 volunteers. Our highly skilled, multidisciplinary team includes physicians, nurses, social workers, home health aides, chaplains, occupational and physical therapists and grief counselors. This team works together to provide direct patient care in alignment with our mission to provide compassion, care and comfort through the end of life. 14655324 1 1 0 1 0 0 0 0 0 1 1 0 0 0 1 1 1 0 0 0 0 0 0 0 1 0 0 0 0 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 1 32 0 1 186 1 0 0 0 0 0 1 1 0 0 0 0 0 0 X 12 12 1 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 0 0 X Nick Paquette 2072893640 390 US Route 1 Scarborough ME 04074 Donna DeBlois Director 0.70 X 0 0 0 Theresa Desfosses Director (end Mar 21) 1.30 X 0 0 0 Annette Gosnell Director 1.00 X 0 0 0 Mark Jones Director 1.30 X 0 0 0 Laura Madigan-McCown Director 0.70 X 0 0 0 Frank McGinty Director 1.20 X 0 0 0 Edward J McGeachey Director (end Oct 21) 0.70 X 0 0 0 Pat Weigel Director 1.20 X 0 0 0 Nathan Wilson MD Director 0.70 X 0 0 0 Mark Wrona Director 0.70 X 0 0 0 Paul Wolf Director/Chair 4.60 X X 0 0 0 Melanie Feinberg Director/Vice Chair 1.30 X X 0 0 0 Chris Coon Director/Treasurer 1.30 X X 0 0 0 Heidi N Hansen Director/Secretary 0.70 X X 0 0 0 Daryl J Cady CEO/Ex Officio 55.00 X 268688 0 22266 Mary Pinto Finance Director (end Dec 21) 45.00 X 124211 0 6620 Nick Paquette Finance Director (start Dec 21) 45.00 X 5577 0 0 Kyra Chamberlain Clinical Operations Director 45.00 X 126396 0 15057 Jason Libby NP Supervisor 40.00 X 128390 0 11869 Stewart Steel IT Director 45.00 X 134515 0 1841 Loretta Moody On Call/Triage RN 50.00 X 109430 0 6618 Michelle Malo Quality & Compliance Director 45.00 X 108582 0 2520 1005789 0 66791 14 0 1 0 Maine Medical Center 22 Bramhall Street Portland ME 04102 Physicians, IP & OP/ER Services 574987 Netsmart Technologies PO Box 71359 Philadelphia PA 19171 IT Services 154200 Partners Printing Inc 800 Main Street South Portland ME 04106 Printing Services 115074 Crows Nest Property Management 7 Wright Way Falmouth ME 04105 Property Management Services 101673 4 125052 859706 1064034 59723 2048792 Patient Services 621610 16842812 16842812 Education and Outreach 621610 2570 2570 16845382 91384 91384 282212 50888 143183 0 139029 50888 189917 189917 0 125052 44505 -44505 -44505 19130970 16845382 0 236796 427362 355942 71420 9951918 7803632 1934604 213682 187354 156044 31310 1317295 1097152 220143 844440 703319 141121 53099 53099 29150 29150 29109 29109 99879 16930 82949 93853 93853 352995 143864 137811 71320 424732 418870 5862 374946 275381 99565 220268 199876 20144 248 77163 26046 51117 45833 44698 1135 817027 582138 234889 72909 46397 26512 Patient Related Expense 2554937 2554937 Bad Debt Expense 230098 230098 18204367 14655324 3263793 285250 9496080 10506781 319753 723677 1159645 439908 1899212 2249192 183366 319700 15771767 5270540 11144965 10501227 3466043 3705118 46000 71423 27715064 28517026 2016507 2071611 859706 550200 1215545 1029543 46000 71423 4137758 3722777 X 20347140 22011087 3230166 2783162 23577306 24794249 27715064 28517026 X 926603 280242 10098 X X 0 1 X 1 0 X 1044546 4200289 3845104 3845016 2048792 14983747 1044546 4200289 3845104 3845016 2048792 14983747 2831373 12152374 74965 102853 158648 94160 91384 522010 15505757 74679437 0.78370 0.74470 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 1 3216 0 0 0 3216 0 Part II-B, Line 1: National Hospice and Palliative Care Organization portion of dues paid allocated to lobbying activities was $98. Home Care and Hospice Alliance of Maine portion of dues paid allocated to lobbying activities was $3,118. 3230166 263129 296095 1006228 2783162 8025443 1014174 296768 6106219 3230166 4718373 3268351 366805 328086 8025443 2394426 3432689 -131012 977730 4718373 2120957 468897 223993 419421 2394426 0.40382 0.50874 0.08744 0 0 1269950 1269950 10805709 3352129 7453580 3696108 1918411 1777697 10501227 457b Plan 71423 71423 X 19196510 280242 44505 324747 18871763 29109 230098 259207 19130970 17989665 44505 44505 17945160 29109 230098 259207 18204367 Part V, Line 4: To ensure the long-term financial viability of the Organization Part X, Line 2: The Organization is exempt from income taxes under Section 501(c)(3) of the Internal Revenue Code. Tax-exempt organizations could be required to record an obligation for income taxes as the result of a tax position they have historically taken on various tax exposure items including unrelated business income or tax status. Under guidance issued by the Financial Accounting Standards Board, assets and liabilities are established for uncertain tax positions taken or positions expected to be taken in income tax returns when such positions are judged to not meet the "more-likely-than-not" threshold, based upon the technical merits of the position. Estimated interest and penalties, if applicable, related to uncertain tax positions are included as a component of income tax expense. The Organization has evaluated the positions taken on its filed tax returns. The Organization has concluded no uncertain income tax positions exist at December 31, 2021. Part XI, Line 2d - Other Adjustments: Special Events Expense 44,505. Part XI, Line 4b - Other Adjustments: Bad Debt Expense 230,098. Part XII, Line 2d - Other Adjustments: Special Events Expense 44,505. Part XII, Line 4b - Other Adjustments: Bad Debt Expense 230,098. Twilight In The Park 54910 54910 1320 17002 Hike For Hospice 41292 41292 54 18207 1 28850 28850 1525 6397 125052 125052 2845 54 41606 44505 -44505 X X 0 0 0 0 0 0 0 1 0 Daryl J Cady CEO/Ex Officio 212574 0 55718 0 396 0 19500 0 2766 0 290954 0 0 0 Part I, Line 7 In 2021, seven individuals listed in Form 990, Part VII were paid a bonus. The payment of these awards is discretionary and is subject to meeting the pre-determined goals of the Organization. X 4 59723 Stock Exchange Price 0 1 1 Part I, Line 32b: The Organization processes gifts of stock through a third party investment management firm. Form 990, Part VI, Section A, line 2 Donna DeBlois, Chris Coon, Nathan Wilson, Heidi Hansen, Frank McGinty and Laura Madigan-McCown have a business relationship with each other through their affiliation with Maine Health, a 501(c)(3) public charity, and its affiliates. Form 990, Part VI, Section A, line 6 Initial Members of the Corporation were established in 2003. Thereafter, Members shall include all other persons who may be admitted to membership from time to time by vote of the Members at an annual or special meeting. The Governance Committee of the Board of Directors shall present a report to propose new Members to be admitted for membership. Form 990, Part VI, Section A, line 7a Provisions in bylaws pertaining to Members of the Corporation: -individuals may be admitted to membership from time to time by vote of Members at annual or special meetings -Nominating Committee of the Board of Directors proposes new members -Members must have an interest in, and ability to contribute to, the advancement of the mission and goals of the Corporation -powers include election of Board of Directors, election of new members, changes in the corporate structure, and action on any matters brought to them by the BOD, at the annual meeting or at special meetings Purpose: to strengthen links to the community, and ensure that effective governing bodies are elected Responsibilities: -understanding and affirmation of HSM's mission, principles and objectives. -advocacy in the community, fostering of public awareness and support for the Organization's goals and programs and its fundraising efforts -attendance at the annual meeting, election of Board and Members of the Corporation, and action on any other matters brought by the Board. Form 990, Part VI, Section A, line 7b See response for Form 990, Part VI, line 7a. Form 990, Part VI, Section B, line 11b The Form 990 was reviewed by the finance committee. Then a complete copy of the Form 990 was distributed to the full Board of Directors before filing with the IRS. Form 990, Part VI, Section B, line 12c Annually all persons are required to review and sign the conflict of interest policy statement, which is then kept on file. Form 990, Part VI, Section B, line 15a The process for determining compensation for the CEO was as follows: Review of candidate's current responsibilities and compensation, and their expectations and performance as CEO of HSM; review of national and regional market data; discussion and decision by the Executive Committee of the Board. Form 990, Part VI, Section C, line 19 All public financial and governing documents are made available upon request. Form 990, Part XI, line 9: Present Value Discount on Pledges Receivable 10,098. Form 990, Part XI, line 2c: The responsibility of the audit committee for overseeing the audit and selecting the independent accountant has not changed from prior years.