CALAIS COMMUNITY HOSPITAL: Form 990, tax year 2021
View the entire original 990 at ProPublica ↗
- Organization
- CALAIS COMMUNITY HOSPITAL (EIN 86-2728785)
- Tax period
- 2021-03-03 to 2021-12-31
- Filed
- 2022-11-14
- IRS object ID
- 202213189349301626
- Schema version
- 2021v4.2
- 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2022-11-14T07:23:34-06:00 | ReturnTs |
| Tax Period End | 2021-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 010523282 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Berry Dunn McNeil & Parker LLC | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2211 Congress St | AddressLine1Txt |
| City | Portland | CityNm |
| State Abbreviation | ME | StateAbbreviationCd |
| ZIP | 04102 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2021-03-03 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 862728785 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Calais Community Hospital | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | CALA | BusinessNameControlTxt |
| Phone | 2074547521 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 24 Hospital Lane | AddressLine1Txt |
| City | Calais | CityNm |
| State Abbreviation | ME | StateAbbreviationCd |
| ZIP | 04619 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Lynnette Parr | PersonNm |
| Person Title | CFO | PersonTitleTxt |
| Phone | 2074547521 | PhoneNum |
| Signature | 2022-11-11 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | Lynnette | PersonFirstNm |
| Person Last | Parr | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | 999009999 | SSN |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | Joseph R Byrne | PreparerPersonNm |
| PTIN | P01289281 | PTIN |
| Phone | 2077752387 | PhoneNum |
| Preparation | 2022-11-11 | PreparationDt |
Additional Filer Information AdditionalFilerInformation
Trusted Customer TrustedCustomerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Trusted Customer | 0 | TrustedCustomerCd |
| Authentication Assurance Level | AAL1 | AuthenticationAssuranceLevelCd |
| Identity Assurance Level | IAL1 | IdentityAssuranceLevelCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2021 | TaxYr |
| Build TS | 2022-09-23 18:48:47Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Initial Return | Yes (X) | InitialReturnInd |
| Principal Officer | Steven Lail | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 24 Hospital Lane | AddressLine1Txt |
| City | Calais | CityNm |
| State Abbreviation | ME | StateAbbreviationCd |
| ZIP | 04619 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $11,332,836 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | www.calaishospital.org | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 2021 | FormationYr |
| Legal Domicile State | ME | LegalDomicileStateCd |
| Activity Or Mission | Critical Access Hospital | ActivityOrMissionDesc |
| Voting Members Governing Body | 16 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 13 | VotingMembersIndependentCnt |
| Total Employee | 201 | TotalEmployeeCnt |
| Total Volunteers | 21 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| CY Contributions Grants | $509,612 | CYContributionsGrantsAmt |
| CY Program Service Revenue | $10,821,581 | CYProgramServiceRevenueAmt |
| CY Investment Income | $1,643 | CYInvestmentIncomeAmt |
| CY Other Revenue | $0 | CYOtherRevenueAmt |
| CY Total Revenue | $11,332,836 | CYTotalRevenueAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| CY Salaries Comp Emp Bnft Paid | $5,543,339 | CYSalariesCompEmpBnftPaidAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| CY Other Expenses | $5,153,561 | CYOtherExpensesAmt |
| CY Total Expenses | $10,696,900 | CYTotalExpensesAmt |
| CY Revenues Less Expenses | $635,936 | CYRevenuesLessExpensesAmt |
| Total Assets EOY | $13,954,869 | TotalAssetsEOYAmt |
| Total Liabilities EOY | $11,209,454 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances EOY | $2,745,415 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | Provide access to quality healthcare and promote community wellness through the delivery of primary, emergency and ancillary inpatient and outpatient healthcare. The Hospital strives to improve the overall health of the communities we serve while exceeding customer expectations. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $217,801 | ExpenseAmt |
| Revenue | $1,608,785 | RevenueAmt |
| Desc | Emergency Services - Total visits July to Dec 2021 = 4,012 | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $120,682 | ExpenseAmt |
| Revenue | $1,529,742 | RevenueAmt |
| Desc | Laboratory services- performed 37,070 laboratory tests to inpatients and outpatients from July-December 2021 | Desc |
Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $118,259 | ExpenseAmt |
| Revenue | $3,187,656 | RevenueAmt |
| Desc | Imaging Services to inpatients and outpatients. 5,378 radiological exams were provided to inpatients and outpatients from July to December 2021. | Desc |
Prog Srvc Accom Acty Other ProgSrvcAccomActyOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $8,169,315 | ExpenseAmt |
| Revenue | $4,495,668 | RevenueAmt |
| Desc | Various other medical services supplied to patients. | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Prog Srvc Expense | $8,169,315 | TotalOtherProgSrvcExpenseAmt |
| Total Other Prog Srvc Revenue | $4,495,668 | TotalOtherProgSrvcRevenueAmt |
| Total Program Service Expenses | $8,626,057 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | 0 | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | 0 | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | 0 | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | Yes (1) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (1) | AuditedFinancialStmtAttInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | 0 | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 31 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 201 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | 0 | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | 0 | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 16 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 13 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (1) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (1) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (1) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | 0 | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | ME | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Lynnette Parr | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 2072550269 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 24 Hospital Lane | AddressLine1Txt |
| City | Calais | CityNm |
| State Abbreviation | ME | StateAbbreviationCd |
| ZIP | 04619 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | Yes (X) | InfoInScheduleOPartVIIInd |
Form990 Part VII Section A Form990PartVIISectionAGrp (23 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|
| Kathryn Land | ||||||||
| Chair | 1.25 | 1.75 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| Lisa Carlisle | ||||||||
| Vice Chair | 1.25 | 1.75 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| Michael Hennessey | ||||||||
| Treasurer | 1.25 | 1.75 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| Nate Martel | ||||||||
| Secretary | 1.25 | 1.75 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| Betty Marshall | ||||||||
| Trustee | 1.25 | 1.75 | Yes (X) | $0 | $0 | $0 | ||
| Christian Inegbenijie MD | ||||||||
| Trustee | 1.25 | 38.75 | Yes (X) | $0 | $406,310 | $31,067 | ||
| Corey Schwinn | ||||||||
| Trustee | 1.25 | 1.75 | Yes (X) | $0 | $0 | $0 | ||
| Gwendolyn Jones | ||||||||
| Trustee | 1.25 | 1.75 | Yes (X) | $0 | $0 | $0 | ||
| Ian Pratt | ||||||||
| Trustee | 1.25 | 1.75 | Yes (X) | $0 | $0 | $0 | ||
| Jacqueline O'Clair | ||||||||
| Trustee | 1.25 | 1.75 | Yes (X) | $0 | $0 | $0 | ||
| Jack Corrigan | ||||||||
| Trustee | 1.25 | 1.75 | Yes (X) | $0 | $0 | $0 | ||
| Judd Bragg | ||||||||
| Trustee | 1.25 | 1.75 | Yes (X) | $0 | $0 | $0 | ||
| Karen Eldridge | ||||||||
| Trustee | 1.25 | 1.75 | Yes (X) | $0 | $0 | $0 | ||
| Rita Ten MD | ||||||||
| Trustee | 1.25 | 38.75 | Yes (X) | $0 | $514,986 | $36,797 | ||
| Rose St Louis | ||||||||
| Trustee | 1.25 | 1.75 | Yes (X) | $0 | $0 | $0 | ||
| Eric Burke MD | ||||||||
| Past Trustee | 1.25 | 1.75 | Yes (X) | $0 | $0 | $0 | ||
| Wayne Peters | ||||||||
| Past Trustee | 1.25 | 1.75 | Yes (X) | $0 | $0 | $0 | ||
| Steven Lail | ||||||||
| CEO | 1.25 | 38.75 | Yes (X) | Yes (X) | $0 | $350,299 | $24,787 | |
| Lynnette Parr | ||||||||
| CFO | 1.25 | 38.75 | Yes (X) | $0 | $251,902 | $27,393 | ||
| Peter Wilkinson DO | ||||||||
| Physician | 40.00 | 0.00 | $170,772 | $0 | $88 | Yes (X) | ||
| Luis Santiagoo-Rosado | ||||||||
| Physician | 40.00 | 0.00 | $159,008 | $0 | $5,657 | Yes (X) | ||
| Nima Moghaddas DPM | ||||||||
| Physician | 40.00 | 0.00 | $117,941 | $0 | $6,607 | Yes (X) | ||
| Elizabeth Eliacin MD | ||||||||
| Physician | 40.00 | 0.00 | $117,519 | $0 | $5,028 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $565,240 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $1,523,497 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $137,424 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 4 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| Emcare Physician Services | |||||
| 7032 Collection Center Drive | Chicago | IL | 60693 | Physician Services | $511,252 |
| Medefis Consolidated | |||||
| PO Box 5068 | New York | NY | 100875068 | Locum Staffing Services | $426,171 |
| Cody Davis DO LLC | |||||
| 7322 Manatee Ave West 220 | Bradenton | FL | 34209 | Physician Services | $218,400 |
| Evident | |||||
| PO Box 11407 | Birmingham | AL | 35246 | EMR Software & Support | $217,745 |
| Weatherby Locums Inc | |||||
| 3400 Red Lion Rd | Philadelphia | PA | 19114 | Physician Locum Staffing | $104,894 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 6 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $506,785 | GovernmentGrantsAmt |
| All Other Contributions | $2,827 | AllOtherContributionsAmt |
| Total Contributions | $509,612 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt | ExclusionExclusionAmt |
|---|---|---|---|---|
| Patient Services | 622100 | $18,312,402 | $18,312,402 | |
| Other Revenue | 622100 | $358,847 | $355,230 | $3,617 |
| Contractual/Char. Adj. | 622100 | -$7,849,668 | -$7,849,668 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $10,821,581 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $1,643 | TotalRevenueColumnAmt |
| Exclusion | $1,643 | ExclusionAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $11,332,836 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $10,817,964 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $5,260 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,606,497 | TotalAmt |
| Program Services | $3,799,984 | ProgramServicesAmt |
| Management And General | $806,513 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $598,633 | TotalAmt |
| Program Services | $490,888 | ProgramServicesAmt |
| Management And General | $107,745 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $338,209 | TotalAmt |
| Program Services | $277,331 | ProgramServicesAmt |
| Management And General | $60,878 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $16,832 | TotalAmt |
| Management And General | $16,832 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,783,079 | TotalAmt |
| Program Services | $2,282,847 | ProgramServicesAmt |
| Management And General | $500,232 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $355 | TotalAmt |
| Management And General | $355 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $22,149 | TotalAmt |
| Program Services | $8,974 | ProgramServicesAmt |
| Management And General | $13,175 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $676,937 | TotalAmt |
| Program Services | $431,496 | ProgramServicesAmt |
| Management And General | $245,441 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $198 | TotalAmt |
| Program Services | $148 | ProgramServicesAmt |
| Management And General | $50 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $31,075 | TotalAmt |
| Program Services | $31,075 | ProgramServicesAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $127,658 | TotalAmt |
| Program Services | $127,658 | ProgramServicesAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $260,747 | TotalAmt |
| Program Services | $229,873 | ProgramServicesAmt |
| Management And General | $30,874 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (3 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| Supplies | $599,512 | $585,136 | $14,376 |
| Miscellaneous Expense | $328,092 | $53,720 | $274,372 |
| Service Provider Tax | $306,927 | $306,927 |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $10,696,900 | TotalAmt |
| Program Services | $8,626,057 | ProgramServicesAmt |
| Management And General | $2,070,843 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part X | Yes (X) | InfoInScheduleOPartXInd |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $658,166 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $5,614,190 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $1,669,576 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $366,124 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $166,856 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $5,607,615 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $127,658 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $5,479,957 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $13,954,869 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $2,439,147 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $7,537,527 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $1,232,780 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $11,209,454 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows FASB117 | Yes (X) | OrganizationFollowsFASB117Ind |
No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $2,745,415 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $2,745,415 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $13,954,869 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $635,936 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | $2,109,479 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | Yes (1) | FederalGrantAuditRequiredInd |
| Federal Grant Audit Performed | Yes (1) | FederalGrantAuditPerformedInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $205,517 | OtherCostOrOtherBasisAmt |
| Book Value | $205,517 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $4,194,483 | OtherCostOrOtherBasisAmt |
| Depreciation | $98,242 | DepreciationAmt |
| Book Value | $4,096,241 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,191,115 | OtherCostOrOtherBasisAmt |
| Depreciation | $29,416 | DepreciationAmt |
| Book Value | $1,161,699 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $16,500 | OtherCostOrOtherBasisAmt |
| Book Value | $16,500 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $5,479,957 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)
| DescDesc | AmtAmt |
|---|---|
| Estimated Third-Party Payor Settlements | $62,687 |
| CARES Act Funding | $1,170,093 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $1,232,780 | TotalLiabilityAmt |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (1) | FinancialAssistancePolicyInd |
| Written Policy | Yes (1) | WrittenPolicyInd |
| FPG Reference Free Care | Yes (1) | FPGReferenceFreeCareInd |
| Percent150 | Yes (X) | Percent150Ind |
| FPG Reference Discounted Care | Yes (1) | FPGReferenceDiscountedCareInd |
| Percent200 D | Yes (X) | Percent200DInd |
| Free Care Medically Indigent | Yes (1) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (1) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | 0 | ExpensesExceedBudgetInd |
| Annual Community Bnft Report | Yes (1) | AnnualCommunityBnftReportInd |
| Report Publically Available | Yes (1) | ReportPublicallyAvailableInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $5,010 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $5,010 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00050 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $2,469,081 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $2,137,858 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $331,223 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.03100 | TotalExpensePct |
Unreimbursed Costs UnreimbursedCostsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $3,378,730 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $3,370,890 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $7,840 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00070 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $5,852,821 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $5,508,748 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $344,073 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.03220 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $4,598 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $4,598 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00040 | TotalExpensePct |
Health Professions Education HealthProfessionsEducationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $36,467 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $36,467 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00340 | TotalExpensePct |
Subsidized Health Services SubsidizedHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $324,794 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $324,794 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.03040 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $365,859 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $365,859 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.03420 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $6,218,680 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $5,508,748 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $709,932 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.06640 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (1) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $0 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $0 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $3,370,890 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $3,378,727 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$7,837 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | Yes (X) | CostToChargeRatioInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (1) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (1) | FinancialAssistancePrvsnInd |
| Hospital Facilities | 1 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Calais Community Hospital | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 24 Hospital Lane | AddressLine1Txt |
| City | Calais | CityNm |
| State Abbreviation | ME | StateAbbreviationCd |
| ZIP | 04619 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | www.calaishospital.org | WebsiteAddressTxt |
| State License | 39454 | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Critical Access Hospital | Yes (X) | CriticalAccessHospitalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Calais Community Hospital | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| First Licensed CY Or PY | 0 | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | Yes (1) | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | Yes (1) | CHNAConductedInd |
| Community Definition | Yes (X) | CommunityDefinitionInd |
| Community Demographics | Yes (X) | CommunityDemographicsInd |
| Existing Resources | Yes (X) | ExistingResourcesInd |
| How Data Obtained | Yes (X) | HowDataObtainedInd |
| Community Health Needs | Yes (X) | CommunityHealthNeedsInd |
| Other Health Issues | Yes (X) | OtherHealthIssuesInd |
| Community Hlth Needs Id Process | Yes (X) | CommunityHlthNeedsIdProcessInd |
| Consulting Process | Yes (X) | ConsultingProcessInd |
| Prior CHNA Impact | Yes (X) | PriorCHNAImpactInd |
| CHNA Conducted | 19 | CHNAConductedYr |
| Take Into Account Others Input | Yes (1) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | Yes (1) | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | Yes (1) | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (1) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | calaishospital.org/community-health-needs-assessment/ | OwnWebsiteURLTxt |
| Other Website | Yes (X) | OtherWebsiteInd |
| Other Website URL | http://www.mainechna.org | OtherWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Implementation Strategy Adopt | Yes (1) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 19 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (1) | StrategyPostedWebsiteInd |
| Strategy Website URL | calaishospital.org/community-health-needs-assessment/ | StrategyWebsiteURLTxt |
| Organization Incur Excise Tax | 0 | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (1) | EligCriteriaExplainedInd |
| FPG Family Incm Lmt Free Dscnt | Yes (X) | FPGFamilyIncmLmtFreeDscntInd |
| FPG Family Incm Lmt Free Care | 150.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 200.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| Residency Criteria | Yes (X) | ResidencyCriteriaInd |
| Explained Basis | Yes (1) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (1) | AppFinancialAsstExplnInd |
| Described Info | Yes (X) | DescribedInfoInd |
| Described Suprt Doc | Yes (X) | DescribedSuprtDocInd |
| Provided Hospital Contact | Yes (X) | ProvidedHospitalContactInd |
| Includes Publicity Measures | Yes (1) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | calaishospital.org/financial-assistance/ | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | calaishospital.org/financial-assistance/ | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | calaishospital.org/financial-assistance/ | FAPSummaryOnWebsiteURLTxt |
| FAP Avlbl On Request No Charge | Yes (X) | FAPAvlblOnRequestNoChargeInd |
| FAP App Avlbl On Request No Chrg | Yes (X) | FAPAppAvlblOnRequestNoChrgInd |
| FAP Sum Avlbl On Request No Chrg | Yes (X) | FAPSumAvlblOnRequestNoChrgInd |
| Notified FAP Copy Bill Display | Yes (X) | NotifiedFAPCopyBillDisplayInd |
| Communtity Notified FAP | Yes (X) | CommuntityNotifiedFAPInd |
| FAP Translated | Yes (X) | FAPTranslatedInd |
| FAP Actions On Nonpayment | Yes (1) | FAPActionsOnNonpaymentInd |
| Permit No Actions | Yes (X) | PermitNoActionsInd |
| Collection Activities | 0 | CollectionActivitiesInd |
| Provided Written Notice | Yes (X) | ProvidedWrittenNoticeInd |
| Made Effort Orally Notify | Yes (X) | MadeEffortOrallyNotifyInd |
| Processed FAP Application | Yes (X) | ProcessedFAPApplicationInd |
| Made Presumptive Elig Determ | Yes (X) | MadePresumptiveEligDetermInd |
| Nondis Emergency Care Policy | Yes (1) | NondisEmergencyCarePolicyInd |
| Prospective Medicare Medicaid | Yes (X) | ProspectiveMedicareMedicaidInd |
| Amounts Generally Billed | 0 | AmountsGenerallyBilledInd |
| Gross Charges | 0 | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Calais Community Hospital | Part V, Section B, Line 2: On February 19, 2021, Down East Community Hospital (DECH) filed a motion with the United States Bankruptcy Court District of Maine, together with the creditors' committee, to allow DECH to purchase substantially all of the assets of Calais Regional Hospital (CRH) a not-for-profit acute care hospital in Calais, Maine. A formal plan was filed on February 24, 2021 and at a hearing on March 24, 2021, the plan was approved. The purpose of the acquisition is to maintain and improve access to quality health care services in Washington County. A Plan Officer was appointed and authorized to take all actions necessary to implement the approved plan. In anticipation of the purchase, DECH formed Calais Community Hospital (CCH), a wholly owned subsidiary, to hold the purchased assets. On March 25, 2021, DECH took over management at CRH. Calais Community Hospital began services effective July 1, 2021. Closing of the transaction was subject to various approvals, including the receipt of an approved Emergency Certificate of Need from the State of Maine Department of Health and Human Services. The closing occurred on June 30, 2021. |
| Calais Community Hospital | Part V, Section B, Line 5: The 2019 Maine Shared Community Health Needs Assessment was born out of a unique public-private partnership. The partnership began as the OneMaine Health Collaborative in 2007, involving Northern Light Health (formerly Eastern Maine Healthcare Systems), MaineGeneral Health, and MaineHealth. After conversations with the Statewide Coordinating Council for Public Health, the Maine Center for Disease Control and Prevention, an office of the Department of Health and Human Services joined in 2012. In 2013, Central Maine Healthcare joined the group and in 2014 a charter was drafted by all five partners to guide a statewide assessment process. The shared CHNA includes a large set of statistics on health status and risk factors from existing surveillance and health data sets.This 2019 CHNA includes input from a broad set of stakeholders from across the state as facilitated by the Steering Committee, Metrics Committee & Community Engagement Committee. Community outreach and engagement for the Maine Shared CHNA included coordination at the statewide, public health district & county level. In addition to the state-level Community Engagement Committee, a local community engagement planning committee for Washington County planned and implemented the logistics of community forums within the county. The committee was compromised of hospitals, public health district liaisons and a variety of additional partners. |
| Calais Community Hospital | Part V, Section B, Line 6a: The Hospital participated in the statewide community health needs assessment along with the following Maine hospitals: Northern Light Health Member Organizations: Acadia Hospital; Blue Hill Memorial Hospital; Charles A Dean Memorial Hospital; Eastern Maine Medical Center, Inland Hospital, Mercy Hospital; Sebasticook Valley Hospital, Maine Coast Hospital, AR Gould Hospital; Maine Health Affiliated: Southern Maine Healthcare, Maine Medical Center, Spring Harbor, Stephens Memorial Hospital, Franklin Memorial Hospital, Lincoln Health, Waldo County General Hospital, Pen Bay Medical Center; CMHC Affiliated: Bridgton Hospital, Central Maine Medical Center, Rumford Hospital; York Hospital; NE Rehabilitation; St. Mary's Regional Medical Center; Mid Coast Hospital; Maine General Health; Reddington-Fairview General Hospital; Millinocket Regional Hospital; Penobscot Valley Hospital; St. Joseph Hospital; Mayo Regional Hospital; Calais Regional Hospital; Mt. Desert Island Hospital; Cary Medical Center; Houlton Regional Hospital and Northern Maine Medical CenterThe Maine Shared Health Needs Assessment and Planning Process (SHNAPP) Project is a collaborative effort among Maine's four largest healthcare systems - Central Maine HealthCare, Northern Light Health, Maine General Health, and Maine Health - as well as the Maine Center for Disease Control and Prevention (Maine CDC), an office of the Maine Department of Health and Human Services (Maine DHHS). CCH's Parent company was an active participant representing Washington County. CCH is an active participant in current planning. |
| Calais Community Hospital | Part V, Section B, Line 6b: The Hospital's CHNA was conducted with the following community non-hospital organizations:Aroostook Mental Health Center; Calais Regional Medical Services; City of Calais; City of Eastport; Community Health & Counseling Services; County of Washington; Downeast Hospice; Downeast Public Health District; Eastern Area Agency on Aging; Eastern Maine Development Corp.; Eastport Healthcare; Healthways Regional Medical Center Lubec; Healthy Acadia; I Care; Maine CDC; Public Health Nursing; Maine Seacoast Mission; Maine State Legislature; Maine Veterans Homes; Marshall Healthcare Facility; National Alliance of Mental Illness (NAMI); Next Step Domestic Violence Project; Northern Light Health; Office of Aging & Disability Services, DHHS; St. Croix Regional Family Health Center; Sunrise County Economic Council; Sunrise Opportunities; Sunrise Senior College; The Quoddy Tides; Town of Baileyville, Town of Machias; United Way of Eastern Maine, Washington County Emergency Management. |
| Calais Community Hospital | Part V, Section B, Line 11: CCH addressed the needs of the most recent CHNA by preparing and adopting an implementation strategy. CCH plans to address all priorities identified through the management and budget of community benefit activities. In addition, CCH also takes advantage of partnering with other community plans by participating, supporting or promoting programs which support community health needs. No needs are not addressed. CCH's detailed implementation strategy can be found on the hospital website. |
Supplemental Information Detail SupplementalInformationDetail (8 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Part I, Line 6a: | The senior leadership team, with approval by the board of trustees, manages the community benefit activities of the Hospital. An expense budget is identified annually for community benefit activities. Community benefit activities are reported each year in the Hospital's annual report. |
| Part III, Line 4: | See Pages 13-14 of the attached audited financial statements for footnote disclosure. In 2019, the Hospital adopted FASB ASU No. 2014-09, Revenue from Contracts with Customers (Topic 606), and related guidance, which supersedes accounting standards that previously existed under GAAP and provides a single revenue model to address revenue recognition to be applied by all companies. Under the new standard, companies recognize revenue when a customer obtains control of promised goods or services in an amount that reflects the consideration to which the company expects to be entitled in exchange for those goods and services. As a result of the adoption, the Hospital is recording $0 of bad debt expense for 2021. In 2021, $575,672 was estimated to be uncollectible from patients at the time services were rendered utilizing the adopted method of revenue recognition. |
| Part III, Line 8: | The Organization used the Hospital's as-filed cost reports to obtain Medicare and Medicaid costs and expected reimbursement. |
| Part III, Line 9b: | The financial assistance policy that is referred to in the billing & collection policy states that based on the financial assistance level approved, an eligible individual will not be billed for services or any amount not paid by an insurer or medical assistance program if the person has been qualified for financial assistance. |
| Part VI, Line 2: | See Schedule H, Part V, Section C. |
| Part VI, Line 3: | CCH has a financial assistance policy that outlines all the discounted cost opportunities that the Hospital has to offer. The complete financial assistance policy, plain language summary, and free care application is located on the Hospital's website at www.calaishospital.org. Copies of the plain language summary is also posted in all main waiting areas of the facility and satellite locations and full copies of the policy can be obtained per request and without charge. Annually, CCH also advertises its plain language summary in local media outlets. Each patient is given the Hospital's financial assistance policy plain language summary prior to the commencement of each date of service. The summary and contact information to obtain a free care application is also listed on the patient's bill. At every opportunity, the Hospital's billing specialists and financial counselors will communicate our policies to patients after billing and encourage patients to apply for financial assistance. During discussions, if patients are identified to be eligible for other governmental insurances, CCH will assist the patient with the application process if requested by the patient. |
| Part VI, Line 4: | Demographics:Washington County is one of two counties in the Downeast Public Health District. The population of Washington County is 31,925 and 21.9% of the population is 65 years of age or older. The population is predominantly white (91.4%); 1.8% are Hispanic, and 2.6% are two or more races. The median household income is $39,469, over $10,000 less than the state average. The high school graduation rate (87.7%) is higher than the state overall, while the percent of the population with an associates' degree or higher (29.1%) is lower.Quantitative Evidence:In Washington County:The percentage of the population that was uninsured was higher than the state overall (12.7% vs. 9.5%) in 2012-2016.The percentage of the population who reported an inability to access healthcare due to cost was higher than the state overall (12.1% vs. 10.3%) from 2014-2016.The percentage of the population with a usual primary care provider was significantly lower than the state overall (81.6% vs. 87.6%) in 2014-2016.The percentage of the population with a primary care visit to any provider in the past year was significantly lower than the state overall (65.8% vs. 71.8%) in 2014-2016. |
| Part VI, Line 5: | The Hospital furthers its exempt purpose by promoting the health of the community. The board consists of volunteer community members that are elected by the Corporators of the Hospital.The Hospital has an open medical staff where all applicants have the opportunity to obtain membership as long as the guidelines as determined by the medical staff bylaws are met. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | 0 | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | Yes (1) | AnyNonFixedPaymentsInd |
| Initial Contract Exception | Yes (1) | InitialContractExceptionInd |
| Rebuttable Presumption Proc | Yes (1) | RebuttablePresumptionProcInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (6 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Rita Ten MD | ||||||||||||||
| Trustee | $0 | $514,361 | $0 | $625 | $0 | $0 | $0 | $14,500 | $0 | $22,297 | $0 | $551,783 | $0 | $0 |
| Christian Inegbenijie MD | ||||||||||||||
| Trustee | $0 | $405,685 | $0 | $625 | $0 | $0 | $0 | $14,500 | $0 | $16,567 | $0 | $437,377 | $0 | $0 |
| Steven Lail | ||||||||||||||
| CEO | $0 | $315,657 | $0 | $25,625 | $0 | $9,017 | $0 | $11,600 | $0 | $13,187 | $0 | $375,086 | $0 | $0 |
| Lynnette Parr | ||||||||||||||
| CFO | $0 | $241,953 | $0 | $5,625 | $0 | $4,324 | $0 | $15,273 | $0 | $12,120 | $0 | $279,295 | $0 | $0 |
| Peter Wilkinson DO | ||||||||||||||
| Physician | $155,879 | $0 | $14,893 | $0 | $0 | $0 | $0 | $0 | $88 | $0 | $170,860 | $0 | $0 | $0 |
| Luis Santiagoo-Rosado | ||||||||||||||
| Physician | $67,133 | $0 | $91,875 | $0 | $0 | $0 | $0 | $0 | $5,657 | $0 | $164,665 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Part I, Line 3 | The Organization's CEO is compensated by Down East Community Hospital, a related organization. The Hospital uses the following to establish the compensation for the CEO: 1. Compensation committee 2. Written employment contract 3. Compensation survey or study 4. Approval by the board or compensation committee |
| Part I, Line 7 | Peter Wilkinson & Nima Moghaddas, physicians, received WRVU based incentive bonuses and a retention bonus during 2021. The Organization also paid bonuses to all full-time employees during 2021. |
| Part I, Line 8 | Luis Santiago-Rosado, general surgeon, received a sign on bonus during 2021. |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (11 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Form 990, Part VI, Section A, line 6 | The sole Member of the Organization is Down East Community Hospital. |
| Form 990, Part VI, Section A, line 7a | Down East Community Hospital, the sole member of the Organization, has the sole power to appoint and remove Trustees serving on the Board of Trustees of the Organization. |
| Form 990, Part VI, Section A, line 7b | Down East Community Hospital, the sole member of the Organization, has the sole power to take any necessary actions related to the following: 1. Adopting and implementing a system-wide strategic plan for this Corporation and its affiliates, as well as preparing any annual or other reports required to update that plan; 2. Ensuring the financial viability of this Corporation; 3. Overseeing the development of a continuum of integrated health care services; 4. Approving plans with respect to the development of any new programs and/or consolidation of existing programs; 5. Approving plans for clinical initiatives that involve any capital expenditure or the development of any new facility; 6. Amending the Articles of Incorporation or Bylaws of this Corporation; 7. Employing a Chief Executive Officer; 8. Appointing and removing Trustees serving on the Board of Trustees of this Corporation; 9. Approving the operational structure of this Corporation; and 10. Approving the sale of all or substantially all of the assets of this Corporation. The following actions, when taken by the Board of Trustees of this Corporation, shall require the approval of the Member, and any such action shall not be effective until such approval is granted: 1. Adoption of annual operating and capital budgets, or substantial changes thereto, including but not limited to the addition of new health services; 2. Unbudgeted debt instruments, notes, guarantees, mortgages, or pledges in excess of such limits as the Member shall specify from time to time; 3. Authorization or material amendment of contracts for the sale, lease, exchange, or other disposition or acquisition or divestiture of real property or other substantial corporate assets in excess of such amounts as the Member shall specify from time to time; 4. The filing of any petition for voluntary dissolution; 5. The filing of any petition for voluntary bankruptcy; 6. Affiliation, consolidation, or merger with, or acquisition of, any other organization; 7. Establishment, termination, or relocation of any major clinical service; and 8. Selection of any outside auditor or legal counsel. |
| Form 990, Part VI, Section B, line 11b | The 990 is reviewed by the CEO and CFO and a copy is provided to the full board before filing. |
| Form 990, Part VI, Section B, line 12c | In order to monitor compliance with the conflict of interest policy for the Organization, each member of the board of trustees is required annually to submit a conflict of interest document and the compliance officer verifies the receipt of these documents. The compliance officer also reviews payments issued to the board of trustees and any contracts in effect with board members. All new employees sign a conflict of interest statement at the time of hire. |
| Form 990, Part VI, Section B, line 15a | The Organization has a CEO Search & Compensation committee to recruit and hire the CEO. This committee is responsible for organizing a search, interviewing prospective candidates & evaluating compensation. Committee meetings are documented with minutes. The CEO for the Organization is determined by a vote of the full Board of Trustees and the existence of a legal contract. |
| Form 990, Part VI, Section C, line 19 | The financial statements and annual report are made available to the public upon request. The annual report is also available on the hospital website. The Organization's governing documents and conflict of interest policy are not made available to the public. |
| Form 990, Part VII: | The compensation reported on Part VII and Schedule J, Part II of the 990 for the Highest Compensated Employees represents July - Decmeber of 2021. This is the total compensation paid to these employees by Calais Community Hospital, after the sale of the Hospital was completed on June 30th, 2021. The Directors and Officers listed on Part VII of the 990 were compensated by Down East Community Hospital, a related organization. The compensation reported for these officers and directors on Part VII and Schedule J, Part II of the 990 represents all of Calendar Year 2021. |
| Form 990, Part IX, line 11g | Purchased Services: Program service expenses 479,398. Management and general expenses 500,232. Fundraising expenses 0. Total expenses 979,630. Temporary Personnel: Program service expenses 677,113. Management and general expenses 0. Fundraising expenses 0. Total expenses 677,113. Physician Fees: Program service expenses 1,126,336. Management and general expenses 0. Fundraising expenses 0. Total expenses 1,126,336. |
| Form 990, Part X, Line 10: Land, Buildings, and Equipment | Section 1.263(a)-3(n) Election: Calais Community Hospital 24 Hospital Lane Calais, ME 04619 EIN: 86-2728785 Calais Community Hospital is electing to capitalize repair and maintenance costs under Regulation Section 1.263(a)-3(n). |
| Form 990, Part XI, line 9: | Net Assets acquired in Purchase of Calais Regional Hospital 2,109,479. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (2 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Controlled OrganizationControlledOrganizationInd | Direct Controlling NADirectControllingNACd |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Sunrise Healthcare | |||||||||||
| 11 Hospital Drive | Machias | ME | 04645 | 222582949 | Community Healthcare | ME | 501(c)(3) | Line 7 | Down East Community Hospital | 0 | |
| Down East Community Hospital | |||||||||||
| 11 Hospital Drive | Machias | ME | 04645 | 010263198 | Hospital | ME | 501(c)(3) | Line 3 | 0 | N/A | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | 0 | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | 0 | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | Yes (1) | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | 0 | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | 0 | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (1) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (1) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |