Stephens Memorial Hospital Assoc: Form 990, tax year 2018
View the entire original 990 at ProPublica ↗
- Organization
- Stephens Memorial Hospital Assoc (EIN 01-0219904)
- Tax period
- 2018-10-01 to 2019-01-01
- Filed
- 2019-11-12
- IRS object ID
- 201933169349303563
- Schema version
- 2018v3.1
- 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
- Form 990
- Schedule A
- Schedule C
- Schedule H
- Schedule J
- Schedule L
- Schedule N
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2019-11-12T12:26:24-06:00 | ReturnTs |
| Tax Period End | 2019-01-01 | TaxPeriodEndDt |
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2018-10-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 010219904 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Stephens Memorial Hospital Assoc | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | STEP | BusinessNameControlTxt |
| Phone | 2077435933 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 181 Main Street | AddressLine1Txt |
| City | Norway | CityNm |
| State Abbreviation | ME | StateAbbreviationCd |
| ZIP | 04268 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | John Cox | PersonNm |
| Person Title | Regional CFO | PersonTitleTxt |
| Phone | 2077435933 | PhoneNum |
| Signature | 2019-11-06 | SignatureDt |
Filing Security Information FilingSecurityInformation
IP Address IPAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| I Pv4 Address | 63.247.60.254 | IPv4AddressTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IP | 2019-11-12 | IPDt |
| IP Tm | 13:20:45 | IPTm |
| IP Timezone | ES | IPTimezoneCd |
| Filing License Type | P | FilingLicenseTypeCd |
| At Submission Creation Device Id | 071534DF782BAFFC7F19FAE443616795F01F9B48 | AtSubmissionCreationDeviceId |
| At Submission Filing Device Id | 071534DF782BAFFC7F19FAE443616795F01F9B48 | AtSubmissionFilingDeviceId |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2018 | TaxYr |
| Build TS | 2020-03-31 21:24:44Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Final Return | Yes (X) | FinalReturnInd |
| Principal Officer | Timothy Churchill | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 181 Main Street | AddressLine1Txt |
| City | Norway | CityNm |
| State Abbreviation | ME | StateAbbreviationCd |
| ZIP | 04268 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $19,416,269 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | mainehealth.org/western-maine-health | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1956 | FormationYr |
| Legal Domicile State | ME | LegalDomicileStateCd |
| Activity Or Mission | To ensure a high quality, accessible, affordable and appropriate integrated health care system to improve the health and well being of the community. | ActivityOrMissionDesc |
| Contract Termination | Yes (X) | ContractTerminationInd |
| Voting Members Governing Body | 17 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 11 | VotingMembersIndependentCnt |
| Total Employee | 726 | TotalEmployeeCnt |
| Total Volunteers | 43 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $13,522 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $0 | PYContributionsGrantsAmt |
| CY Contributions Grants | $0 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $72,846,439 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $19,311,985 | CYProgramServiceRevenueAmt |
| PY Investment Income | $125,676 | PYInvestmentIncomeAmt |
| CY Investment Income | $37,471 | CYInvestmentIncomeAmt |
| PY Other Revenue | -$374,489 | PYOtherRevenueAmt |
| CY Other Revenue | -$87,407 | CYOtherRevenueAmt |
| PY Total Revenue | $72,597,626 | PYTotalRevenueAmt |
| CY Total Revenue | $19,262,049 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $38,939,585 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $10,223,811 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $8,726 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $29,820 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $31,883,789 | PYOtherExpensesAmt |
| CY Other Expenses | $8,371,284 | CYOtherExpensesAmt |
| PY Total Expenses | $70,832,100 | PYTotalExpensesAmt |
| CY Total Expenses | $18,595,095 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $1,765,526 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $666,954 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $70,000,976 | TotalAssetsBOYAmt |
| Total Assets EOY | $0 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $22,926,296 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $0 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $47,074,680 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $0 | NetAssetsOrFundBalancesEOYAmt |
| Mission | To ensure a high quality, accessible, affordable and appropriate integrated health care system to improve the health and well being of the community. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $14,387,761 | ExpenseAmt |
| Revenue | $14,893,481 | RevenueAmt |
| Desc | Outpatient Services: Stephens Memorial Hospital Association provided care during the course of 23,416 outpatient visits for the 3 months ended December 31, 2018. Services provided included emergency services; diagnostic imaging and lab tests;ambulatory surgery; and physical rehabilitation. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $3,544,755 | ExpenseAmt |
| Revenue | $3,669,351 | RevenueAmt |
| Desc | Inpatient Services: For the three months ended December 31, 2018 the hospital provided inpatient nursing services to 384 Adults/Pediatrics, Special Care, and Nursery patients with a total of 1,129 patient days. 54 inpatients were uninsured, 207 were covered by Medicare and 42 were covered by Medicaid. | Desc |
Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $0 | ExpenseAmt |
| Revenue | $749,153 | RevenueAmt |
| Desc | Other Revenue consists primarily of Meaningful Use Payments, 340b Contract Pharmacy Revenue,Physician Incentive Payments, VHA-Purchase Rebates and Other Operating Revenue. | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expenses | $17,932,516 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | 0 | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (1) | 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 |
| Temp Or Permanent Endowments | 0 | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | 0 | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | 0 | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | 0 | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | 0 | 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 | Yes (1) | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | 0 | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | Yes (1) | 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 |
| Info In Schedule O Part V | Yes (X) | InfoInScheduleOPartVInd |
| IRP Document | 5 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 726 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | Yes (1) | UnrelatedBusIncmOverLimitInd |
| Form990 T Filed | Yes (1) | Form990TFiledInd |
| 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 |
| 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 | 17 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 11 | 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 | Yes (1) | 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 | John Cox | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 2077435933 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 181 Main Street | AddressLine1Txt |
| City | Norway | CityNm |
| State Abbreviation | ME | StateAbbreviationCd |
| ZIP | 04268 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (25 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 |
|---|---|---|---|---|---|---|---|---|
| Timothy Churchill | ||||||||
| President | 1.00 | 50.00 | Yes (X) | Yes (X) | $0 | $425,804 | $65,387 | |
| Tom Morton | ||||||||
| Chair | 1.00 | 0.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| Ted Moccia | ||||||||
| Trustee | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| Robin J Zinchuk | ||||||||
| Trustee | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| Pat Weigel | ||||||||
| Former Chair | 1.00 | 0.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| Kathleen A Herlihy MD | ||||||||
| Trustee | 50.00 | 0.00 | Yes (X) | $258,642 | $0 | $51,640 | ||
| Kevin Carleton | ||||||||
| Secretary/Treasurer | 1.00 | 0.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| Todd Gauger DVM | ||||||||
| Trustee | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| Lisa W Miller MD | ||||||||
| Trustee | 50.00 | 0.00 | Yes (X) | $204,694 | $0 | $29,865 | ||
| Brian M Nolan MD | ||||||||
| Trustee | 50.00 | 0.00 | Yes (X) | $254,974 | $0 | $37,394 | ||
| Holly Bancroft Brown | ||||||||
| Trustee | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| Sawin Millett | ||||||||
| Former Secretary/Treasurer | 1.00 | 0.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| Lance Bean | ||||||||
| Trustee | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| Gene Benner | ||||||||
| Vice Chair | 1.00 | 0.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| Marc West | ||||||||
| Trustee | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| Ryan R Knapp MD | ||||||||
| Trustee | 50.00 | 0.00 | Yes (X) | $305,986 | $0 | $27,477 | ||
| Jennifer Sunday | ||||||||
| Med Staff President | 50.00 | 0.00 | Yes (X) | $273,474 | $0 | $30,588 | ||
| Jack Sours | ||||||||
| Trustee | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| John Cox | ||||||||
| Regional CFO | 0.00 | 50.00 | Yes (X) | $0 | $264,618 | $46,424 | ||
| Margaret M Burns | ||||||||
| Sr VP-Clinical | 0.00 | 50.00 | Yes (X) | $0 | $173,967 | $22,227 | ||
| Jeannette L Andrews DO | ||||||||
| Physician | 50.00 | 0.00 | $320,611 | $0 | $30,490 | Yes (X) | ||
| Gregory J Hardy MD | ||||||||
| Physician | 50.00 | 0.00 | $383,395 | $0 | $44,739 | Yes (X) | ||
| Eric K Osborne DO | ||||||||
| Physician | 50.00 | 0.00 | $398,743 | $0 | $43,936 | Yes (X) | ||
| Noemi LeFranc MD | ||||||||
| Physician | 50.00 | 0.00 | $323,186 | $0 | $13,415 | Yes (X) | ||
| Peter R Siviski MD | ||||||||
| Physician | 50.00 | 0.00 | $319,435 | $0 | $22,200 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $3,043,140 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $864,389 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $465,782 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 50 | 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 |
|---|---|---|---|---|---|
| NorDx | |||||
| 102 Campus Drive | Scarborough | ME | 04074 | Lab processing | $2,389,850 |
| Maine Medical Partners | |||||
| 301c US Route 1 | Scarborough | ME | 04074 | Med billing & mgt | $1,577,449 |
| Langford & Low | |||||
| PO Box 662 | Portland | ME | 04104 | Construction svcs | $1,468,166 |
| Spectrum Medical Group PA | |||||
| 300 Professional Drive | Scarborough | ME | 04074 | Anesthesia svcs | $966,896 |
| Weatherby Locums Inc | |||||
| PO Box 972633 | Dallas | TX | 753972633 | Physician svcs | $541,011 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 9 | CntrctRcvdGreaterThan100KCnt |
Program Service Revenue ProgramServiceRevenueGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| Net patient service revenue | 623000 | $18,562,832 | $18,562,832 |
| Other revenue | 621990 | $749,153 | $749,153 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $19,311,985 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $37,471 | TotalRevenueColumnAmt |
| Exclusion | $37,471 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $66,813 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $154,220 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | -$87,407 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$87,407 | TotalRevenueColumnAmt |
| Exclusion | -$87,407 | ExclusionAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $19,262,049 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $19,311,985 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | -$49,936 | ExclusionAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $316,864 | TotalAmt |
| Program Services | $307,643 | ProgramServicesAmt |
| Management And General | $9,221 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,673,214 | TotalAmt |
| Program Services | $7,450,003 | ProgramServicesAmt |
| Management And General | $216,749 | ManagementAndGeneralAmt |
| Fundraising | $6,462 | FundraisingAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $333,229 | TotalAmt |
| Program Services | $323,535 | ProgramServicesAmt |
| Management And General | $9,694 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,403,480 | TotalAmt |
| Program Services | $1,362,653 | ProgramServicesAmt |
| Management And General | $39,580 | ManagementAndGeneralAmt |
| Fundraising | $1,247 | FundraisingAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $497,024 | TotalAmt |
| Program Services | $482,566 | ProgramServicesAmt |
| Management And General | $13,964 | ManagementAndGeneralAmt |
| Fundraising | $494 | FundraisingAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $34,923 | TotalAmt |
| Management And General | $34,923 | ManagementAndGeneralAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,635 | TotalAmt |
| Management And General | $2,635 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,695,318 | TotalAmt |
| Program Services | $1,693,613 | ProgramServicesAmt |
| Management And General | $1,705 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $333,183 | TotalAmt |
| Program Services | $323,382 | ProgramServicesAmt |
| Management And General | $9,796 | ManagementAndGeneralAmt |
| Fundraising | $5 | FundraisingAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $266,401 | TotalAmt |
| Program Services | $258,651 | ProgramServicesAmt |
| Management And General | $7,750 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $36,804 | TotalAmt |
| Program Services | $35,537 | ProgramServicesAmt |
| Management And General | $1,267 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $48,055 | TotalAmt |
| Program Services | $46,657 | ProgramServicesAmt |
| Management And General | $1,170 | ManagementAndGeneralAmt |
| Fundraising | $228 | FundraisingAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $58,560 | TotalAmt |
| Program Services | $56,856 | ProgramServicesAmt |
| Management And General | $1,704 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $798,276 | TotalAmt |
| Program Services | $775,054 | ProgramServicesAmt |
| Management And General | $23,222 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $213,680 | TotalAmt |
| Program Services | $152,847 | ProgramServicesAmt |
| Management And General | $60,833 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt | FundraisingFundraisingAmt |
|---|---|---|---|---|
| Affiliate charges | $2,109,364 | $1,895,437 | $192,543 | $21,384 |
| Medical Supplies | $2,081,009 | $2,081,009 | ||
| Hospital tax | $339,050 | $339,050 | ||
| Maintenance contracts | $179,660 | $179,641 | $19 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $174,366 | TotalAmt |
| Program Services | $168,382 | ProgramServicesAmt |
| Management And General | $5,984 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $18,595,095 | TotalAmt |
| Program Services | $17,932,516 | ProgramServicesAmt |
| Management And General | $632,759 | ManagementAndGeneralAmt |
| Fundraising | $29,820 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,453,827 | BOYAmt |
| EOY | $0 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $20,285,223 | BOYAmt |
| EOY | $0 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,391,345 | BOYAmt |
| EOY | $0 | EOYAmt |
Receivables From Officers Etc ReceivablesFromOfficersEtcGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,340,189 | BOYAmt |
| EOY | $0 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $531,723 | BOYAmt |
| EOY | $0 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $0 | LandBldgEquipCostOrOtherBssAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $21,916,790 | BOYAmt |
| EOY | $0 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,921,548 | BOYAmt |
| EOY | $0 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $966,964 | BOYAmt |
| EOY | $0 | EOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $14,193,367 | BOYAmt |
| EOY | $0 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $70,000,976 | BOYAmt |
| EOY | $0 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,325,626 | BOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,916,081 | BOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $12,684,589 | BOYAmt |
| EOY | $0 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $22,926,296 | BOYAmt |
| EOY | $0 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $45,772,785 | BOYAmt |
| EOY | $0 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $743,484 | BOYAmt |
| EOY | $0 | EOYAmt |
Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $558,411 | BOYAmt |
| EOY | $0 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $47,074,680 | BOYAmt |
| EOY | $0 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $70,000,976 | BOYAmt |
| EOY | $0 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $666,954 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | -$436,153 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | -$47,305,481 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | 0 | FSAuditedInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | 0 | VolunteersInd |
| Paid Staff Or Management | 0 | PaidStaffOrManagementInd |
| Media Advertisements | 0 | MediaAdvertisementsInd |
| Mailings Members | 0 | MailingsMembersInd |
| Publications Or Broadcast | 0 | PublicationsOrBroadcastInd |
| Grants Other Organizations | 0 | GrantsOtherOrganizationsInd |
| Direct Contact Legislators | 0 | DirectContactLegislatorsInd |
| Rallies Demonstrations | 0 | RalliesDemonstrationsInd |
| Other Activities | Yes (1) | OtherActivitiesInd |
| Other Activities | $2,635 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $2,635 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | 0 | NotDescribedSection501c3Ind |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Part II-B, Line 1: | FormAndLineReferenceDesc |
| Explanation | Dues paid to the American Hospital Association of $4,330 and to the Maine Hospital Association of $8,130. The American Hospital Association and Maine Hospital Association used 22.73% and 20.30% respectively of their dues revenue for lobbying activity. | ExplanationTxt |
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 |
Free Care Oth Percentage FreeCareOthPercentageGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | Yes (X) | OtherInd |
| Free Care Other | 175.000000000000 | FreeCareOtherPct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| FPG Reference Discounted Care | 0 | FPGReferenceDiscountedCareInd |
| Free Care Medically Indigent | Yes (1) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (1) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | Yes (1) | ExpensesExceedBudgetInd |
| Unable To Provide Care | 0 | UnableToProvideCareInd |
| Annual Community Bnft Report | 0 | AnnualCommunityBnftReportInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $230,603 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $230,603 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01240 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $2,515,318 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $2,238,502 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $276,816 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01490 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $2,745,921 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $2,238,502 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $507,419 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.02730 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,202 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $1,253 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
Health Professions Education HealthProfessionsEducationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $16,669 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $16,669 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00090 | TotalExpensePct |
Subsidized Health Services SubsidizedHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $4,207,967 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $4,115,605 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $92,362 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00500 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $4,225,838 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $4,116,858 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $109,031 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00590 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $6,971,759 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $6,355,360 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $616,450 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.03320 | TotalExpensePct |
Community Support CommunitySupportGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $2,001 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $2,001 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00010 | TotalExpensePct |
Total Communtity Building Acty TotalCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $2,001 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $2,001 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00010 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | 0 | BadDebtExpenseReportedInd |
| Bad Debt Expense | $1,003,912 | BadDebtExpenseAmt |
| Reimbursed By Medicare | $7,879,688 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $7,800,891 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | $78,797 | 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 | Stephens Memorial Hospital Association | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 181 Main Street | AddressLine1Txt |
| City | Norway | CityNm |
| State Abbreviation | ME | StateAbbreviationCd |
| ZIP | 04268 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | mainehealth.org/western-maine-health | WebsiteAddressTxt |
| State License | 39022 | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| 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 | Stephens Memorial Hospital Association | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| First Licensed CY Or PY | 0 | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | 0 | 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 | 16 | CHNAConductedYr |
| Take Into Account Others Input | Yes (1) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | Yes (1) | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | 0 | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (1) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | See Part V, Section C | OwnWebsiteURLTxt |
| Implementation Strategy Adopt | Yes (1) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 16 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (1) | StrategyPostedWebsiteInd |
| Strategy Website URL | See Part V, Section C | 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 | 175.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| Medical Indigency Criteria | Yes (X) | MedicalIndigencyCriteriaInd |
| 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 | See Part V, Section C | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | See Part V, Section C | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | See Part V, Section C | 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 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 |
| Look Back Medicare Private | Yes (X) | LookBackMedicarePrivateInd |
| Amounts Generally Billed | 0 | AmountsGenerallyBilledInd |
| Gross Charges | 0 | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Stephens Memorial Hospital Association | Part V, Section B, Line 5: Community input was taken into account when conducting the CHNA, including those with special knowledge or expertise in public health. This included individuals from the following organizations: Community Concepts, Stephens Memorial Hospital, Western Maine Healthcare, River Valley Healthy Communities Coalition, Rumford Hospital, MaineHealth, Maine CDC, United Way of Oxford Hills, Bridgton Hospital, Tufts University School of Medicine and Oxford County Wellness Collaborative. |
| Stephens Memorial Hospital Association | Part V, Section B, Line 6a: The CHNA was conducted through a partnership between MaineHealth, Central Maine Healthcare, Eastern Maine Healthcare Systems, MaineGeneral Health and the Maine Department of Health and Human Services. |
| Stephens Memorial Hospital Association | Part V, Section B, Line 11: For the 2016-2018 CHNA, the organization has identified priorities and developed strategies to address the significant needs identified in its most recently conducted CHNA and provided reasons if identified needs are not being addressed. Please see the 2016-2018 CHNA and Annual Implementation Report Update FY18 at https://mainehealth.org/healthy-communities/community-health-needs-assessment for details of the activities undertaken by the organization. |
| Stephens Memorial Hospital Association - Part V, Section B, Line 7a and 10a | The CHNA and implementation strategy are posted on the following website:https://mainehealth.org/healthy-communities/community-health-needs-assessment |
| Stephens Memorial Hospital Assoc. - Part V, Section B, Lines 16a, 16b, 16c | The Financial Assistance Policy (Free Care Policy and Billing and Collection Policy), free care application and plain language summary are available on the following website: https://mainehealth.org/patients-visitors/billing-insurance/financial-assistance/free-care |
Supplemental Information Detail SupplementalInformationDetail (12 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Part I, Line 7g: | Subsidized health services include the net operating loss of PACEParamedic Service, a department of Stephens Memorial Hospital, and directsubsidies and support of local school-based health clinics and otherclinical programs that are not revenue-producing. If these services werenot provided or subsidized by the Hospital, they would not be available inthe community. |
| Part II, Community Building Activities: | In addition to the subsidized health services and community health services described above, Western Maine Health Care sponsors or participates in a variety of other community activities and programs. These community building activities include:-We are the lead agency for Healthy Oxford Hills, a community coalition to promote partnerships, policies and programs to protect and enhance the health of residents of Oxford Hills-Our Vial of Life Program allows individuals in the community to record and safely store their current health information at home, in case that information needs to be retrieved in an emergency situation-Safe Sitter courses, a medically-accurate instructional program designed for young adolescents 11 to 13 years of age-Community-wide emergency preparedness planning-Regional health planning and pandemic planning-We provide a clinical site for local Registered Nurses and Certified Nurses Aide programs-Annual Conference - Alcoholism and Drug Addiction: Disease, Treatment and Recovery-Free community blood pressure screenings and clinics-Blood drives-Sibling classes for children expecting new family members-Nutrition open houses for the general public-"Relay for Life" to support the American Cancer Society-"Bowl for Kids Sake" to benefit the local Big Brothers/Big Sisters program-We provide community outreach services to educate families about the Alfond Scholarship for babies, and assist families in preparing the grant application-We provide meeting space at no charge for local non-profit support groups including smoking cessation, Gear Parent Network Support Group, Take Off Pounds Sensibly (TOPS), the Shriners annual health screening day and support groups for those affected by depression/bipolar conditions, diabetes, grief, and Parkinson's Disease |
| Part III, Line 2: | See Part III, Line 4 - Bad Debt Expenses Footnote to Financial Statements |
| Part III, Line 4: | See Part III, Line 4 - Bad Debt Expenses Footnote to Financial Statements. Stephens Memorial Hospital Association (SMH) does not have a specificfootnote in the financial statements that describes "bad debt expense."However, reference is made within the footnotes to a bad debt policy in acouple of instances. Within the footnote describing "Net Patient ServiceRevenue", the following explains the Provision for Bad Debts:"For receivables associated with self-pay patients, the Hospital records aprovision for bad debts in the period of service based on its pastexperience, which indicates that many patients are unable or unwilling topay the portion of their bill for which they are financially responsible.The difference between the standard rates and the amounts actuallycollected after all reasonable collection efforts have been exhausted ischarged off against the reserve for uncollectible accounts."The amount of expense associated with the provision of services,ultimately written off as bad debt at SMH, has been calculated at$1,003,834 for the current short period ending 1/1/2019. This amount was calculated using a cost to charge ratio. Bad debt expense represents healthcare services SMH has provided without compensation. As a tax-exempt organization, SMH provides necessary patient care regardless of the patient's ability to pay for the services. SMH cannot determine the amount of bad debt expense that could be reasonably attributable to patients who likely would quality for financial assistance under the SMH free care policy. In addition, bad debt expense also includes amounts for services provided to individuals experiencing difficult personal or economic circumstances related to a portion of our community based patient population. Their medical bills often place these individuals in untenable positions where they are not able to handle their personal debt and then their new medical debt. However, because of their income level, they do not qualify for free care. By providing necessary healthcare services to those individuals either who fail to apply for financial assistance or who are experiencing difficult personal or economic circumstances, SMH believes that bad debt expense should be included as a community benefit. |
| Part III, Line 8: | Medicare allowable costs were taken from SMH's as-filed 2018 Medicare cost reports. The cost report utilizes a sophisticated, detailed step-down cost allocation approach. The cost report excludes revenue, expenses and reimbursement for professional fees such as Emergency Department Physicians. If the cost to provide these services and payments for the services were included in the Part III Section B analysis, there would be a Medicare shortfall for these services. |
| Part III, Line 9b: | Patients who qualify for free care have their account balance adjusted accordingly once free care has been approved. As a tax-exempt hospital, SMH provides necessary patient care regardless of the patient's ability to pay for the services. |
| Part VI, Line 2: | The organization prepares a Community Health Needs Assessment (CHNA) every three years. See https://mainehealth.org/healthy-communities/community-health-needs-assessment for the completed CHNA. |
| Part VI, Line 3: | Free Care information is provided in the Admitting and Emergency Registration locations in the following manner:- Postings including Free Care and Monthly Payment Plan- Handouts- InterviewsIf the patient is self-pay, underinsured or can't afford to pay their hospital bill, they may receive a Financial Counseling Packet and/or referred to financial counseling from the registration staff or Change Healthcare, an outside vendor who helps manage the self-pay accounts. The packet includes:- Information on MaineHealth's financial policies- Information on MaineHealth's Free Care Program, Monthly Payment Plan Program, Care Partners, MedAccess and other community resource needs - Program applications and instructions for MaineHealth's Free Care Program, and Monthly Payment Plan Application- Contact information for assistance with applications, bills or financial concernsSelf-pay or underinsured patients registering in person or via a phone interview receive financial counseling including information on our financial assistance programs. Registration staff or Change Healthcare provide forms and assist with completing financial assistance applications and providing follow up contact information.MaineHealth's web site includes online Registration and Patient Billing information:- Billing Process- Free Care- Monthly Payment Plan- Patient Statement- Price Information- Contact Us and QuestionsPrimary language, deaf and hard of hearing and interpreter needs are assessed during the registration interview and services are provided as needed.If a patient does not respond at pre-registration, registration, or while receiving care, all of these programs are explained again by the Single Billing Office staff. The intent of these efforts is to ensure that the patient is fully informed of and able to take advantage of these assistance programs. |
| Part VI, Line 4: | The CHNA describes the geographic area and demographic constituents it services. Seehttps://mainehealth.org/healthy-communities/community-health-needs-assessment for the completed CHNA. |
| Part VI, Line 5: | The tax exempt purpose of the organization to improve the health of thecommunity is promoted and enhanced in the following ways:-The majority of the governing body is composed of persons living within the hospital service area that are neither employed by, nor have contractual relationships with, the hospital or its affiliates.-Medical staff privileges are available to all qualified physicians in the community.-Solicitation of community input in the strategic planning process.-Common governance of the hospital and physician services provided in the county to promote common health care and improvement planning and control costs.-Voluntary cap on Income from Operations to restrain prices and to fund health care and health improvement activities.-Surplus funds are reinvested in capital equipment and improvements to ensure high quality care.-Each year a portion of Retained Earnings is distributed to our parent, MaineHealth, for the specific purpose of health status improvement programs throughout the MaineHealth service area. |
| Part VI, Line 6: | Maine Healthcare (EIN 01-0431680) is a not-for-profit family of leading high-quality providers and other healthcare organizations working together so their communities are the healthiest in America. Ranked among the nation's top 100 integrated healthcare delivery networks, Maine Healthcare is governed by a board of trustees consisting of community and business leaders from its southern, central and western Maine regional service areas. The collaboration of Maine Healthcare members makes it possible to offer an extensive range of clinical integration and community health programs, many aimed at improving access to preventive and primary care services. Maine Healthcare includes the following member organizations: LincolnHealth Group, MaineHealth, Maine Behavioral Healthcare (Spring Harbor Hospital), Coastal Healthcare Alliance (Pen Bay Medical Center and Waldo County General Hospital), Southern Maine Health Care (Southern Maine Medical Center and Goodall campuses), Western Maine Health Care (Stephens Memorial Hospital), The Memorial Hospital at North Conway, N.H., MaineHealth Care at Home, NorDx, Synernet and MaineHealth Accountable Care Organization. The strategic affiliates of Maine Healthcare are MaineGeneral Medical Center, Mid Coast Hospital and St. Mary's Regional Medical Center. |
| Part VI, Line 7, Reports Filed With States | ME |
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 | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (13 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Timothy Churchill | ||||||||||||||
| President | $0 | $349,225 | $0 | $57,000 | $0 | $19,579 | $0 | $35,023 | $0 | $30,364 | $0 | $491,191 | $0 | $0 |
| Kathleen A Herlihy MD | ||||||||||||||
| Trustee | $215,964 | $0 | $11,250 | $0 | $31,428 | $0 | $25,251 | $0 | $26,389 | $0 | $310,282 | $0 | $0 | $0 |
| Lisa W Miller MD | ||||||||||||||
| Trustee | $163,259 | $0 | $8,568 | $0 | $32,867 | $0 | $4,008 | $0 | $25,857 | $0 | $234,559 | $0 | $0 | $0 |
| Brian M Nolan MD | ||||||||||||||
| Trustee | $237,316 | $0 | $9,358 | $0 | $8,300 | $0 | $12,690 | $0 | $24,704 | $0 | $292,368 | $0 | $0 | $0 |
| Ryan R Knapp MD | ||||||||||||||
| Trustee | $287,102 | $0 | $0 | $0 | $18,884 | $0 | $2,310 | $0 | $25,167 | $0 | $333,463 | $0 | $0 | $0 |
| Jennifer Sunday | ||||||||||||||
| Med Staff President | $211,664 | $0 | $11,250 | $0 | $50,560 | $0 | $4,199 | $0 | $26,389 | $0 | $304,062 | $0 | $0 | $0 |
| John Cox | ||||||||||||||
| Regional CFO | $0 | $237,275 | $0 | $24,720 | $0 | $2,623 | $0 | $19,787 | $0 | $26,637 | $0 | $311,042 | $0 | $0 |
| Margaret M Burns | ||||||||||||||
| Sr VP-Clinical | $0 | $171,304 | $0 | $0 | $0 | $2,663 | $0 | $18,528 | $0 | $3,699 | $0 | $196,194 | $0 | $0 |
| Jeannette L Andrews DO | ||||||||||||||
| Physician | $298,515 | $0 | $0 | $0 | $22,096 | $0 | $3,569 | $0 | $26,921 | $0 | $351,101 | $0 | $0 | $0 |
| Gregory J Hardy MD | ||||||||||||||
| Physician | $293,301 | $0 | $0 | $0 | $90,094 | $0 | $19,787 | $0 | $24,952 | $0 | $428,134 | $0 | $0 | $0 |
| Eric K Osborne DO | ||||||||||||||
| Physician | $327,191 | $0 | $0 | $0 | $71,552 | $0 | $16,809 | $0 | $27,127 | $0 | $442,679 | $0 | $0 | $0 |
| Noemi LeFranc MD | ||||||||||||||
| Physician | $286,894 | $0 | $0 | $0 | $36,292 | $0 | $1,134 | $0 | $12,281 | $0 | $336,601 | $0 | $0 | $0 |
| Peter R Siviski MD | ||||||||||||||
| Physician | $142,449 | $0 | $0 | $0 | $176,986 | $0 | $20,105 | $0 | $2,095 | $0 | $341,635 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Part I, Line 3 | FormAndLineReferenceDesc |
| Explanation | Top management officials are compensated by related organizations. These organizations used one or more of the methods shown at Part 1, Line 3 to establish the compensation of top management. See description of process in Schedule O - Form 990, Part VI, Line 15 | ExplanationTxt |
Schedule L IRS990ScheduleL
Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp
Name Of Interested NameOfInterested
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Jewel Nolan | PersonNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Relationship Description | Family Member | RelationshipDescriptionTxt |
| Transaction | $56,491 | TransactionAmt |
| Transaction | Employment | TransactionDesc |
| Sharing Of Revenues | 0 | SharingOfRevenuesInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Schedule L, Part V - Additional Information | FormAndLineReferenceDesc |
| Explanation | Jewel Nolan is employed by Stephens Memorial Hospital Association. Her husband, Brian Nolan, is a Board Member. | ExplanationTxt |
Schedule N IRS990ScheduleN
Liquidation Of Assets Table LiquidationOfAssetsTableGrp
Liquidation Of Assets Detail LiquidationOfAssetsDetail (16 entries)
| Assets Distri Or Expnss PaidAssetsDistriOrExpnssPaidDesc | DistributionDistributionDt | Fair Market Value Of AssetFairMarketValueOfAssetAmt | Method Of FMV DeterminationMethodOfFMVDeterminationTxt | EINEIN | Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | IRC SectionIRCSectionTxt |
|---|---|---|---|---|---|---|---|---|---|
| MaineHealth | |||||||||
| Cash & Cash Equivalents | 2019-01-01 | $24,585,710 | Book Value | 010238552 | 22 Bramhall Street | Portland | ME | 04102 | 501(c)3 |
| MaineHealth | |||||||||
| Patient AR, Net | 2019-01-01 | $5,004,222 | Book Value | 010238552 | 22 Bramhall Street | Portland | ME | 04102 | 501(c)3 |
| MaineHealth | |||||||||
| Inventory , Prepaids & Other Current Assets | 2019-01-01 | $1,701,644 | Book Value | 010238552 | 22 Bramhall Street | Portland | ME | 04102 | 501(c)3 |
| MaineHealth | |||||||||
| Property, Plant, Equipment - Net | 2019-01-01 | $22,432,171 | Book Value | 010238552 | 22 Bramhall Street | Portland | ME | 04102 | 501(c)3 |
| MaineHealth | |||||||||
| Investments | 2019-01-01 | $10,558,423 | Book Value | 010238552 | 22 Bramhall Street | Portland | ME | 04102 | 501(c)3 |
| MaineHealth | |||||||||
| AWUIL - Current Portion | 2019-01-01 | $259,636 | Book Value | 010238552 | 22 Bramhall Street | Portland | ME | 04102 | 501(c)3 |
| MaineHealth | |||||||||
| Other Assets | 2019-01-01 | $6,428,093 | Book Value | 010238552 | 22 Bramhall Street | Portland | ME | 04102 | 501(c)3 |
| MaineHealth | |||||||||
| Accounts Payable & Other Current Liabilities | 2019-01-01 | -$2,800,984 | Book Value | 010238552 | 22 Bramhall Street | Portland | ME | 04102 | 501(c)3 |
| MaineHealth | |||||||||
| Accrued Payroll, Payroll Taxes, & Amounts Withheld | 2019-01-01 | -$3,147,046 | Book Value | 010238552 | 22 Bramhall Street | Portland | ME | 04102 | 501(c)3 |
| MaineHealth | |||||||||
| Other Current Liabilities | 2019-01-01 | -$6,334,987 | Book Value | 010238552 | 22 Bramhall Street | Portland | ME | 04102 | 501(c)3 |
| MaineHealth | |||||||||
| Due to MH & Other Members,Net | 2019-01-01 | -$6,490,994 | Book Value | 010238552 | 22 Bramhall Street | Portland | ME | 04102 | 501(c)3 |
| MaineHealth | |||||||||
| Long-term Debt less current portion | 2019-01-01 | -$4,539,173 | Book Value | 010238552 | 22 Bramhall Street | Portland | ME | 04102 | 501(c)3 |
| MaineHealth | |||||||||
| Other Long-term Liabilities | 2019-01-01 | -$822,396 | Book Value | 010238552 | 22 Bramhall Street | Portland | ME | 04102 | 501(c)3 |
| MaineHealth | |||||||||
| Net Assets Unrestricted | 2019-01-01 | -$45,491,967 | Book Value | 010238552 | 22 Bramhall Street | Portland | ME | 04102 | 501(c)3 |
| MaineHealth | |||||||||
| Net Assets Temporarily Restricted | 2019-01-01 | -$783,941 | Book Value | 010238552 | 22 Bramhall Street | Portland | ME | 04102 | 501(c)3 |
| MaineHealth | |||||||||
| Net Assets Permanently Restricted | 2019-01-01 | -$558,411 | Book Value | 010238552 | 22 Bramhall Street | Portland | ME | 04102 | 501(c)3 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Director Of Successor | Yes (1) | DirectorOfSuccessorInd |
| Employee Of Successor | Yes (1) | EmployeeOfSuccessorInd |
| Owner Of Successor | 0 | OwnerOfSuccessorInd |
| Receive Compensation | 0 | ReceiveCompensationInd |
| Assets Distributed | Yes (1) | AssetsDistributedInd |
| Required To Notify AG | Yes (1) | RequiredToNotifyAGInd |
| Attorney General Notified | Yes (1) | AttorneyGeneralNotifiedInd |
| Liabilities Paid | Yes (1) | LiabilitiesPaidInd |
| Bonds Outstanding | Yes (1) | BondsOutstandingInd |
| Bond Liabilities Discharged | 0 | BondLiabilitiesDischargedInd |
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Part I, Line 2e: | Person(s) Involved: Kathleen A. Herlihy, MD; Timothy Churchill; Lisa W. Miller, MD; Brian MNolan MD; Ryan Knapp MD; Margaret M. Burns; Jennifer D. Sunday and John Cox. |
| Part I, Line 2e: | Explanation of Involvement: Kathleen A. Herlihy, MD, trustee became a member of MaineHealth's (EIN: 01-0238552) board of trustees upon Stephen Memorial Hospital's merger with MaineHealth on 1/1/2019.Timothy Churchill, Lisa W. Miller, MD, Brian M. Nolan, MD, Ryan Knapp, MD,John Cox, Margaret M. Burns, Jennifer D. Sunday and Kathleen A. Herlihy, MDbecame employees of MaineHealth upon the 1/1/2019 merger date. |
| Part I, Line 6c: | MaineHealth (EIN: 01-0238552) assumed the liability of Stephens Memorial Hospital's tax-exempt bond upon the merger date. |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (9 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Form 990, Part V - Additional Information | Line 1a - Prior to consolidating accounts payable operations with MaineHealth (EIN 01-0238552), the entity filed 5 Form 1099s for the calendar year 2018. MaineHealth (EIN 01-0238552), acting on behalf of Maine Healthcare (EIN 01-0431680), filed 1,645 Form 1099s for the calendar year 2018 on behalf of the following organizations: MaineHealth, Maine Healthcare, Southern Maine Health Care, Pen Bay Medical Center, Waldo County General Hospital, Franklin Memorial Hospital, LincolnHealth Group, Memorial Hospital, Western Maine Healthcare, Maine Behavioral Healthcare, NorDx, MaineHealth Care at Home. |
| Form 990, Part VI, Section A, line 6 | Western Maine Health Care, Corp. (EIN# 01-0411788) is the sole member of the organization. |
| Form 990, Part VI, Section A, line 7a | The sole member has the responsibility for the election of the members of the governing body. |
| Form 990, Part VI, Section A, line 7b | All decisions by the Stephens Memorial Hospital Association's (SMH) governing body are approved by default by the member organization's governing body since these two organizations share a common governing body. |
| Form 990, Part VI, Section B, line 11b | A detailed review of the Form 990 was performed by the Regional Chief Financial Officer prior to signing the return. The Form 990 was then made available to the full board prior to filing. |
| Form 990, Part VI, Section B, line 12c | Conflict of Interest statements are obtained annually. The President's Office collects and reviews the responses. Where any real or perceived conflicts exist, officers and trustees are expected to recuse themselves (1) from meetings during times when the topics of potential conflict are discussed and (2) from voting on such matters. Key employees may not use their positions to profit personally or to assist others in profiting in any way at the expense of SMH. |
| Form 990, Part VI, Section B, line 15 | Compensation Process for Top Official: The parent company of SMH is Western Maine Health Care, Corp. (EIN# 01-0411788) who through its parent company Maine Healthcare (EIN# 01-0431680), has a formal written compensation policy in place. In consultation with Sullivan Cotter, the MaineHealth Board Compensation Committee establishes appropriate compensation parameters for each organization's CEO and certain members of their Senior Management Team. Working within these parameters, the Western Maine Health Care Board determines the level of compensation for its CEO. The findings of the Compensation Committee are made transparent to, and voted on by, the full Governing Board. The "total executive compensation" is filed publicly by the organization, and includes "total cash compensation and "total value of all benefits and perquisites" associated with the position. The Board takes necessary action to prevent the CEO from voting or directly participating in the final Committee determination of his own compensation. The organization's executive compensation procedures rely upon appropriate data for comparability (e.g. compensation levels paid by both taxable and tax-exempt similarly situated organizations and independent surveys by nationally recognized independent firms). Finally, the organization refrains from allowing executive compensation to ever be based solely on Western Maine Health Care, Corp.'s revenues or other similar profit-sharing strategies. Compensation Process for Officers: At the time of hire the compensation department utilizes market data toprovide an accurate, competitive and appropriate offer. Annual merit increases are determined by the CEO, subject to guidelines established on a system wide basis. |
| Form 990, Part VI, Section C, line 19 | Documents that are required to be open for public inspection are made available upon request. |
| Form 990, Part XI, line 9: | Merger of Assets in to MaineHealth (EIN:01-0238552) -46,834,319. Change in interest of SCHF -471,162. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (5 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Stephens Community Healthcare Found | |||||||||||
| 181 Main Street | Norway | ME | 04268 | 311644144 | Healthcare | ME | 501(c)(3) | Line 12a, I | Western Maine Health Care Corp | 0 | |
| Western Maine Health Care Corp | |||||||||||
| 181 Main Street | Norway | ME | 04268 | 010411788 | Healthcare | ME | 501(c)(3) | Line 12b, II | MaineHealth | 0 | |
| Western Maine Multi-Medical Specialists | |||||||||||
| 181 Main Street | Norway | ME | 04268 | 010489824 | Physician practices | ME | 501(c)(3) | Line 10 | Western Maine Health Care Corp | 0 | |
| Western Maine Nursing Home Inc | |||||||||||
| 181 Main Street | Norway | ME | 04268 | 222842655 | Nursing home | ME | 501(c)(3) | Line 10 | Western Maine Health Care Corp | 0 | |
| Maine Healthcare | |||||||||||
| 110 Free Street | Portland | ME | 04101 | 010431680 | Healthcare | ME | 501(c)(3) | Line 12c, III-FI | 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 | 0 | 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 | Yes (1) | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | Yes (1) | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | Yes (1) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | 0 | SharingOfFacilitiesInd |
| Paid Employees Sharing | 0 | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (1) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | Yes (1) | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | Yes (1) | TransferToOtherOrgInd |
| Transfer From Other Org | Yes (1) | TransferFromOtherOrgInd |