Franklin Memorial Hospital: Form 990, tax year 2017
View the entire original 990 at ProPublica ↗
- Organization
- Franklin Memorial Hospital (EIN 01-0211503)
- Tax period
- 2017-10-01 to 2018-09-30
- Filed
- 2019-08-13
- IRS object ID
- 201932259349300733
- Schema version
- 2017v2.3
- 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 B
- Schedule C
- Schedule D
- Schedule H
- Schedule J
- Schedule K
- Schedule L
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2019-08-13T10:21:33-05:00 | ReturnTs |
| Tax Period End | 2018-09-30 | TaxPeriodEndDt |
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2017-10-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 010211503 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Franklin Memorial Hospital | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | FRAN | BusinessNameControlTxt |
| Phone | 2077792500 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 111 Franklin Health Commons | AddressLine1Txt |
| City | Farmington | CityNm |
| State Abbreviation | ME | StateAbbreviationCd |
| ZIP | 04938 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | JOHN COX | PersonNm |
| Person Title | REGIONAL CFO | PersonTitleTxt |
| Phone | 2077792500 | PhoneNum |
| Signature | 2019-08-07 | 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 | 2019-08-13 | IPDt |
| IP Tm | 11:17:31 | IPTm |
| IP Timezone | ED | IPTimezoneCd |
| Filing License Type | P | FilingLicenseTypeCd |
| At Submission Creation Device Id | B45CD6F9D1811B9916B2A423673B63195B36551F | AtSubmissionCreationDeviceId |
| At Submission Filing Device Id | 05B59A79989D8D80B3E3D119B5D3766651DA35E3 | AtSubmissionFilingDeviceId |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2017 | TaxYr |
| Build TS | 2019-02-21 02:37:17Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | Timothy Churchill | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 111 Franklin Health Commons | AddressLine1Txt |
| City | Farmington | CityNm |
| State Abbreviation | ME | StateAbbreviationCd |
| ZIP | 04938 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $81,579,926 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | www.fchn.org | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1926 | FormationYr |
| Legal Domicile State | ME | LegalDomicileStateCd |
| Activity Or Mission | Community Hospital | ActivityOrMissionDesc |
| Voting Members Governing Body | 18 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 10 | VotingMembersIndependentCnt |
| Total Employee | 812 | TotalEmployeeCnt |
| Total Volunteers | 112 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $1,657,842 | PYContributionsGrantsAmt |
| CY Contributions Grants | $1,047,070 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $75,704,281 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $80,422,412 | CYProgramServiceRevenueAmt |
| PY Investment Income | $3,353 | PYInvestmentIncomeAmt |
| CY Investment Income | $4,556 | CYInvestmentIncomeAmt |
| PY Other Revenue | $63,001 | PYOtherRevenueAmt |
| CY Other Revenue | $24,177 | CYOtherRevenueAmt |
| PY Total Revenue | $77,428,477 | PYTotalRevenueAmt |
| CY Total Revenue | $81,498,215 | 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 | $49,479,534 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $51,904,709 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $31,669,413 | PYOtherExpensesAmt |
| CY Other Expenses | $34,502,397 | CYOtherExpensesAmt |
| PY Total Expenses | $81,148,947 | PYTotalExpensesAmt |
| CY Total Expenses | $86,407,106 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$3,720,470 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$4,908,891 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $45,668,255 | TotalAssetsBOYAmt |
| Total Assets EOY | $50,598,315 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $27,805,114 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $29,742,862 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $17,863,141 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $20,855,453 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | TO PROVIDE HIGH-QUALITY, COST-EFFECTIVE, PATIENT-CENTERED HEALTHCARE TO OUR WEST CENTRAL MAINE COMMUNITY. WE WORK WITH OUR COMMUNITY AND OTHER HEALTHCARE PROVIDERS TO INTEGRATE SERVICES AND ENSURE THE HEALTH OF OUR COMMUNITY. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $46,704,200 | ExpenseAmt |
| Revenue | $61,412,995 | RevenueAmt |
| Desc | FMH ROUTINE INPATIENT AND ANCILLARY OUTPATIENT SERVICES FRANKLIN MEMORIAL HOSPITAL IS A NON-FOR-PROFIT COMMUNITY HOSPITAL WHICH PROVIDES HIGH-QUALITY, COST-EFFECTIVE, PATIENT-CENTERED INPATIENT AND OUTPATIENT HEALTHCARE SERVICES TO THE WEST CENTRAL MAINE COMMUNITY. THE 65-BED HOSPITAL IS FULLY QUALIFIED AND ACCREDITED TO HANDLE A BROAD RANGE OF MEDICAL, SURGICAL, PEDIATRIC, WOMEN'S CARE AND DIAGNOSTIC SERVICES. FRANKLIN MEMORIAL HOSPITAL OFFERS TOP QUALITY SPECIALTY CARE INCLUDING ROUTINE ADULT, PEDIATRIC AND INTENSIVE CARE INPATIENT SERVICES AS WELL AS A VARIETY OF OUTPATIENT SERVICES INCLUDING ONCOLOGY, HEMATOLOGY, CARDIOLOGY, OTOLARYNGOLOGY, ORTHOPEDICS, BEHAVIORAL SERVICES, OCCUPATIONAL HEALTH, PULMONOLOGY, PAIN MANAGEMENT, PEDIATRIC ENDOCRINOLOGY, PHYSICAL REHABILITATION AND SPORTS MEDICINE. DURING THE TWELVE MONTHS ENDING SEPTEMBER 30, 2018 THERE WERE 2,000 INPATIENT DISCHARGES, 1,758 OUTPATIENT SURGERIES, 250,437 OUTPATIENT LAB TESTS AND 40,994 OUTPATIENT IMAGING PROCEDURES. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $19,113,316 | ExpenseAmt |
| Revenue | $11,085,342 | RevenueAmt |
| Desc | FRANKLIN HEALTH PHYSICIAN PRACTICES FRANKLIN MEMORIAL HOSPITAL IDENTIFIED ACCESS TO PRIMARY CARE AS A CENTRAL COMMUNITY NEED AND IS COMMITTED TO PROVIDING HIGH QUALITY PHYSICIAN SERVICES OF FAMILY PRACTICE, INTERNAL MEDICINE, PEDIATRICS AND WOMEN'S CARE. IN ADDITION, FRANKLIN MEMORIAL HOSPITAL OFFERS A VARIETY OF SPECIALTY CARE SERVICES INCLUDING DERMATOLOGY, SURGERY, ORTHOPEDICS, UROLOGY AND BEHAVIORAL HEALTH SERVICES. DURING THE TWELVE MONTHS ENDING SEPTEMBER 30, 2018 FRANKLIN MEMORIAL HOSPITAL PROVIDED 54,074 PRIMARY CARE VISITS AND 17,166 SPECIALTY CARE VISITS IN THE FRANKLIN HEALTH PHYSICIAN PRACTICES. | Desc |
Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $6,259,852 | ExpenseAmt |
| Revenue | $7,928,631 | RevenueAmt |
| Desc | EMERGENCY ROOM FRANKLIN MEMORIAL HOSPITAL OPERATES AN EMERGENCY DEPARTMENT WHICH OPERATES 24 HOURS A DAY SEVEN DAYS A WEEK. THE EMERGENCY DEPARTMENT SERVES AS THE PRIMARY CARE PHYSICIAN FOR A NUMBER OF LOW INCOME AND INDIGENT RESIDENTS OF THE WEST CENTRAL MAINE COMMUNITY. GIVEN FRANKLIN MEMORIAL HOSPITAL'S COMMITMENT TO ACCESS TO CARE REGARDLESS OF THE ABILITY TO PAY, THE EMERGENCY DEPARTMENT SERVES A VITAL ROLE IN THE COMMUNITY'S HEALTH CARE NETWORK. DURING TWELVE MONTHS ENDING SEPTEMBER 30, 2018 FRANKLIN MEMORIAL HOSPITAL HAD 16,101 EMERGENCY ROOM VISITS. | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expenses | $72,077,368 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | 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 | Yes (1) | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | Yes (1) | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | 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 | Yes (1) | TaxExemptBondsInd |
| Invest Tax Exempt Bonds | 0 | InvestTaxExemptBondsInd |
| Escrow Account | 0 | EscrowAccountInd |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuerInd |
| 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 | 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 |
| Info In Schedule O Part V | Yes (X) | InfoInScheduleOPartVInd |
| IRP Document | 118 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 812 | 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 |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 18 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 10 | 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 | 2077792265 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 111 Franklin Health Commons | AddressLine1Txt |
| City | Farmington | CityNm |
| State Abbreviation | ME | StateAbbreviationCd |
| ZIP | 04938 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (27 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | OfficerOfficerInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd | Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd |
|---|---|---|---|---|---|---|---|---|---|
| Madelyn Besse | |||||||||
| Director | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |||
| Connie Coggins | |||||||||
| Director | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |||
| Darryl Wood | |||||||||
| Director | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |||
| David Dixon MD | |||||||||
| Director | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |||
| Jack Peck | |||||||||
| Director | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |||
| Katherine Heer DMD | |||||||||
| Director | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |||
| Michael Cormier | |||||||||
| Director | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |||
| Michele McCormick MD | |||||||||
| Director | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |||
| Peter Judkins | |||||||||
| Director | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |||
| Ronald Aseltine Esq | |||||||||
| Director | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |||
| Sheena Bunnell | |||||||||
| Director | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |||
| Stephen Goss DO | |||||||||
| Medical Staff Pres. | 50.00 | 0.00 | Yes (X) | $232,174 | $0 | $32,131 | |||
| William L Caron Jr | |||||||||
| MH CEO | 1.00 | 50.00 | Yes (X) | $0 | $1,324,706 | $117,120 | |||
| Clint Boothby | |||||||||
| Chairman | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | ||
| Gilly Hitchcock | |||||||||
| Vice Chair | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | ||
| John Bogar | |||||||||
| Treasurer | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | ||
| Connie Adler MD | |||||||||
| Secretary | 1.00 | 0.00 | Yes (X) | $25,928 | $0 | $0 | Yes (X) | ||
| Timothy Churchill | |||||||||
| President/CEO | 1.00 | 50.00 | Yes (X) | $0 | $417,447 | $62,898 | Yes (X) | ||
| John Cox | |||||||||
| Regional CFO | 1.00 | 50.00 | $0 | $266,743 | $41,118 | Yes (X) | |||
| Christopher Renaud DO | |||||||||
| Anesthesiologist | 50.00 | 0.00 | $375,160 | $0 | $30,829 | Yes (X) | |||
| Eric Gunther MD | |||||||||
| General Surgeon | 50.00 | 0.00 | $322,567 | $0 | $33,581 | Yes (X) | |||
| Joanie Peter MD | |||||||||
| Physician | 50.00 | 0.00 | $343,398 | $0 | $30,922 | Yes (X) | |||
| James Lancaster MD | |||||||||
| Anesthesiologist | 50.00 | 0.00 | $363,838 | $0 | $32,098 | Yes (X) | |||
| Heather Decarolis MD | |||||||||
| Anesthesiologist | 50.00 | 0.00 | $358,062 | $0 | $34,155 | Yes (X) | |||
| Rebecca Arsenault | |||||||||
| Frmr Pres/CEO | 50.00 | 0.00 | $142,291 | $0 | $0 | Yes (X) | |||
| Jay Naliboff MD | |||||||||
| Frmr VP Med. Affairs | 50.00 | 0.00 | $235,092 | $0 | $29,501 | Yes (X) | |||
| Gerald Cayer | |||||||||
| Frmr VP Phys. & Comm. | 50.00 | 0.00 | $126,448 | $0 | $5,947 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $2,524,958 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $2,008,896 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $450,300 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 62 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | Yes (1) | 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 Inc | |||||
| 301A US Route One | Scarborough | ME | 04074 | Lab services | $3,225,098 |
| MaineGeneral Medical Center | |||||
| 10 Water St Suite 213 | Waterville | ME | 04901 | Phys. Staffing | $938,317 |
| Vista Staffing Solutions Inc | |||||
| 275 East 200 South | Salt Lake City | UT | 84111 | Phys. Staffing | $765,084 |
| Griffith R Batstone | |||||
| 126 Middle St | Farmington | ME | 04938 | Phys. Staffing | $720,257 |
| Weatherby Locums Inc | |||||
| 6440 S Millrock Dr Suite 175 | Salt Lake City | UT | 84121 | Phys. Staffing | $606,621 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 19 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $82,053 | GovernmentGrantsAmt |
| All Other Contributions | $965,017 | AllOtherContributionsAmt |
| Total Contributions | $1,047,070 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (4 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| Patient Services | 621990 | $77,633,246 | $77,633,246 |
| Other | 621990 | $2,022,980 | $2,022,980 |
| Ambulance Subsidies | 621910 | $601,140 | $601,140 |
| Cafeteria | 722514 | $165,046 | $165,046 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $80,422,412 | TotalProgramServiceRevenueAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $103,551 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $79,374 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $24,177 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $24,177 | TotalRevenueColumnAmt |
| Exclusion | $24,177 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $6,893 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $2,337 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $4,556 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $4,556 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $4,556 | RelatedOrExemptFuncIncomeAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $81,498,215 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $80,426,968 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $24,177 | ExclusionAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $719,757 | TotalAmt |
| Program Services | $552,048 | ProgramServicesAmt |
| Management And General | $167,709 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $41,925,799 | TotalAmt |
| Program Services | $37,194,269 | ProgramServicesAmt |
| Management And General | $4,731,530 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $561,236 | TotalAmt |
| Program Services | $500,112 | ProgramServicesAmt |
| Management And General | $61,124 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,398,303 | TotalAmt |
| Program Services | $5,678,583 | ProgramServicesAmt |
| Management And General | $719,720 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,299,614 | TotalAmt |
| Program Services | $2,036,294 | ProgramServicesAmt |
| Management And General | $263,320 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $10,400 | TotalAmt |
| Management And General | $10,400 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $61,468 | TotalAmt |
| Management And General | $61,468 | ManagementAndGeneralAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $11,976 | TotalAmt |
| Management And General | $11,976 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,426,982 | TotalAmt |
| Program Services | $3,884,331 | ProgramServicesAmt |
| Management And General | $1,542,651 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $128,475 | TotalAmt |
| Management And General | $128,475 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $929,566 | TotalAmt |
| Program Services | $612,569 | ProgramServicesAmt |
| Management And General | $316,997 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $214,072 | TotalAmt |
| Management And General | $214,072 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,789,197 | TotalAmt |
| Program Services | $1,787,434 | ProgramServicesAmt |
| Management And General | $1,763 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $131,628 | TotalAmt |
| Program Services | $119,993 | ProgramServicesAmt |
| Management And General | $11,635 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $328,063 | TotalAmt |
| Program Services | $276,928 | ProgramServicesAmt |
| Management And General | $51,135 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $729,047 | TotalAmt |
| Program Services | $645,567 | ProgramServicesAmt |
| Management And General | $83,480 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,440,739 | TotalAmt |
| Program Services | $3,046,754 | ProgramServicesAmt |
| Management And General | $393,985 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $692,213 | TotalAmt |
| Program Services | $670,704 | ProgramServicesAmt |
| Management And General | $21,509 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| Affiliate services | $9,244,251 | $3,833,851 | $5,410,400 |
| Medical supplies | $8,987,445 | $8,987,445 | |
| Hospital tax | $1,576,535 | $1,576,535 | |
| Other | $800,340 | $673,951 | $126,389 |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $86,407,106 | TotalAmt |
| Program Services | $72,077,368 | ProgramServicesAmt |
| Management And General | $14,329,738 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,755 | BOYAmt |
| EOY | $2,955 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,011,980 | BOYAmt |
| EOY | $4,381,087 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,070,663 | BOYAmt |
| EOY | $7,623,618 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,735,839 | BOYAmt |
| EOY | $1,608,965 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $803,060 | BOYAmt |
| EOY | $922,072 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $90,977,088 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $66,338,825 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $26,356,779 | BOYAmt |
| EOY | $24,638,263 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,686,179 | BOYAmt |
| EOY | $11,421,355 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $45,668,255 | BOYAmt |
| EOY | $50,598,315 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,546,777 | BOYAmt |
| EOY | $6,066,717 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $152,058 | BOYAmt |
| EOY | $106,488 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $17,180,941 | BOYAmt |
| EOY | $16,298,788 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,925,338 | BOYAmt |
| EOY | $7,270,869 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $27,805,114 | BOYAmt |
| EOY | $29,742,862 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $14,555,198 | BOYAmt |
| EOY | $18,176,688 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,149,809 | BOYAmt |
| EOY | $1,510,999 | EOYAmt |
Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,158,134 | BOYAmt |
| EOY | $1,167,766 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $17,863,141 | BOYAmt |
| EOY | $20,855,453 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $45,668,255 | BOYAmt |
| EOY | $50,598,315 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | -$4,908,891 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | $7,901,203 | 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 | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule B IRS990ScheduleB
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 | $11,976 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $11,976 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | 0 | NotDescribedSection501c3Ind |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE C, PART II-B, LINE 1 | FormAndLineReferenceDesc |
| Explanation | DUES WERE PAID TO THE MAINE HOSPITAL ASSOCIATION FOR $39,173 AND THE AMERICAN HOSPITAL ASSOCIATION FOR $19,820. THE MAINE HOSPITAL ASSOCIATION AND THE AMERICAN HOSPITAL ASSOCIATION BOTH USED 20.3% OF THEIR DUES REVENUE FOR LOBBYING ACTIVITIES. | ExplanationTxt |
Schedule D IRS990ScheduleD
CY Endwmt Fund CYEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $3,210,572 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $102,538 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $66,268 | OtherExpendituresAmt |
| End Year Balance | $3,246,842 | EndYearBalanceAmt |
CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $2,826,394 | BeginningYearBalanceAmt |
| Contributions | $200,531 | ContributionsAmt |
| Investment Earnings Or Losses | $350,340 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $166,693 | OtherExpendituresAmt |
| End Year Balance | $3,210,572 | EndYearBalanceAmt |
CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $2,691,932 | BeginningYearBalanceAmt |
| Contributions | $112,614 | ContributionsAmt |
| Investment Earnings Or Losses | $182,291 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $160,443 | OtherExpendituresAmt |
| End Year Balance | $2,826,394 | EndYearBalanceAmt |
CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $2,799,451 | BeginningYearBalanceAmt |
| Contributions | $408,226 | ContributionsAmt |
| Investment Earnings Or Losses | -$187,776 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $327,969 | OtherExpendituresAmt |
| End Year Balance | $2,691,932 | EndYearBalanceAmt |
CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $2,874,474 | BeginningYearBalanceAmt |
| Contributions | $53,718 | ContributionsAmt |
| Investment Earnings Or Losses | -$71,709 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $57,032 | OtherExpendituresAmt |
| End Year Balance | $2,799,451 | EndYearBalanceAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Designated Balance EOY | 0.48000 | BoardDesignatedBalanceEOYPct |
| Prmnnt Endowment Balance EOY | 0.36000 | PrmnntEndowmentBalanceEOYPct |
| Term Endowment Balance EOY | 0.16000 | TermEndowmentBalanceEOYPct |
| Endowments Held Unrelated Org | 0 | EndowmentsHeldUnrelatedOrgInd |
| Endowments Held Related Org | Yes (1) | EndowmentsHeldRelatedOrgInd |
| Related Org List Sch R | Yes (1) | RelatedOrgListSchRInd |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,252,337 | OtherCostOrOtherBasisAmt |
| Book Value | $1,252,337 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $51,247,061 | OtherCostOrOtherBasisAmt |
| Depreciation | $33,390,744 | DepreciationAmt |
| Book Value | $17,856,317 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Book Value | $0 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $32,810,823 | OtherCostOrOtherBasisAmt |
| Depreciation | $28,771,664 | DepreciationAmt |
| Book Value | $4,039,159 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $5,666,867 | OtherCostOrOtherBasisAmt |
| Depreciation | $4,176,417 | DepreciationAmt |
| Book Value | $1,490,450 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $24,638,263 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp (7 entries)
| DescDesc | Book ValueBookValueAmt |
|---|---|
| Est. Third Party Payor Settlements | $2,506,165 |
| Beneficial Int. in Perpetual Trust | $311,382 |
| Interest in Net Assets of FCHN | $2,367,382 |
| Other Assets | $872,659 |
| Prepaid SeHR | $3,104,411 |
| Prepaid Shared IS Capital | $663,522 |
| Due from Affiliates | $1,595,834 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $11,421,355 | TotalBookValueOtherAssetsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (3 entries)
| DescDesc | AmtAmt |
|---|---|
| Due to Related Parties | $6,370,869 |
| Medical Malpractice Tail Liab. | $600,000 |
| Insurance Claim Liability | $300,000 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $7,270,869 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Part V, Line 4: | THE ORGANIZATION'S ENDOWMENT FUNDS ARE HELD BY THE FRANKLIN COMMUNITY HEALTH NETWORK AND ARE INTENDED TO SUPPORT VARIOUS PROGRAMS OFFERED BY THE ORGANIZATION, SUCH AS THE CHARITY PROGRAM, COMMUNITY OUTREACH, EDUCATION, MEDICAL LIBRARY, MARTHA B. WEBBER BREAST CARE CENTER AND OTHERS. |
| Part X, Line 2: | FIN 48 FOOTNOTE THE COMPANY IS EXEMPT FROM FEDERAL INCOME TAXES UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. |
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 | 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 | $1,162,406 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $1,162,406 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01350 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $12,351,201 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $10,176,571 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $2,174,630 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.02520 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $13,513,607 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $10,176,571 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $3,337,036 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.03870 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $499,476 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $54,125 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $445,351 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00520 | TotalExpensePct |
Health Professions Education HealthProfessionsEducationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $88,810 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $82,053 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $6,757 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00010 | TotalExpensePct |
Subsidized Health Services SubsidizedHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $10,483,809 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $5,163,405 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $5,320,404 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.06160 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $21,275 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $21,275 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00020 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $11,093,370 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $5,299,583 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $5,793,787 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.06710 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $24,606,977 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $15,476,154 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $9,130,823 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.10580 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | 0 | BadDebtExpenseReportedInd |
| Bad Debt Expense | $3,096,094 | BadDebtExpenseAmt |
| Reimbursed By Medicare | $16,206,016 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $17,385,406 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$1,179,390 | 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 | Franklin Memorial Hospital | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 111 Franklin Health Commons | AddressLine1Txt |
| City | Farmington | CityNm |
| State Abbreviation | ME | StateAbbreviationCd |
| ZIP | 04938 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | See Part V, Section C | WebsiteAddressTxt |
| State License | ME State License #38930 | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Franklin Memorial Hospital | 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 |
| Other Publicity | Yes (X) | OtherPublicityInd |
| 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 |
|---|---|
| Part V, Section A: | Franklin Memorial Hospital:Part V, Section B, Line 7a & 10a: THE CHNA AND IMPLEMENTATION STRATEGY ARE POSTED ON THE FOLLOWING WEBSITE: HTTPS://MAINEHEALTH.ORG/HEALTHY-COMMUNITIES/COMMUNITY-HEALTH-NEEDS-ASSESSMENTFranklin Memorial Hospital:Part V, Section B, Line 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. |
| Franklin Memorial Hospital | Part V, Section B, Line 5: IN 2015, A COLLABORATIVE CALLED THE MAINE SHARED HEALTH NEEDS ASSESSMENT PLANNING PROCESS (SHNAPP) WAS LAUNCHED TO CREATE A FRAMEWORK AND APPROACH FOR A SHARED CHNA THAT CAN: I) ADDRESS COMMUNITY BENEFIT REPORTING NEEDS OF HOSPITALS, II) SUPPORT STATE AND LOCAL PUBLIC HEALTH ACCREDITATION EFFORTS, AND III) PROVIDE VALUABLE POPULATION HEALTH ASSESSMENT DATA FOR VARIOUS ORGANIZATIONS CONCERNED WITH THE HEALTH OF MAINE'S COMMUNITIES AND CITIZENS. MAINEHEALTH, NORTHERN LIGHT HEALTH, CENTRAL MAINE HEALTHCARE, MAINEGENERAL HEALTH AND THE MAINE CENTER FOR DISEASE CONTROL AND PREVENTION ARE CONTRIBUTING FINANCIAL SUPPORT TO THE STUDY AND REPORTS.AS OF FY16, THE THREE-YEAR CYCLE OF THE CHNA PROCESS HAS BECOME ALIGNED WITH MAINEHEALTH MEMBER ORGANIZATIONS' STRATEGIC PLANNING PROCESSES (ALSO THREE-YEAR CYCLES). WE EXPECT THIS ALIGNMENT TO STRENGTHEN THE COORDINATION AND RESOURCE ALLOCATION FOR COMMUNITY HEALTH IMPROVEMENT EFFORTS ACROSS THE MAINEHEALTH ORGANIZATIONS.IN 2019, THIS PROCESS, NOW NAMED THE MAINE SHARED COMMUNITY NEEDS ASSESSMENT, WILL PRODUCE COUNTY-LEVEL CHNA REPORTS AND HELP COORDINATE COMMUNITY ENGAGEMENT PROCESSES THAT WILL ULTIMATELY RESULT IN THE PRIORITIZATION OF HEALTH ISSUES BY HOSPITALS, STATE/LOCAL GOVERNMENTS AND OTHER PARTNERS. IN COLLABORATION WITH MAINEHEALTH, EACH MEMBER HOSPITAL WILL PRODUCE A DETAILED CHNA REPORT AND IMPLEMENTATION PLAN COVERING THE TIME PERIOD OF 2019-2021. THESE REPORTS WILL BE FORMALLY ADOPTED BY EACH MEMBER ORGANIZATION BOARD FOR SUBMISSION WITH THEIR RESPECTIVE FY19 990 FILINGS.AT A LOCAL AND REGIONAL LEVEL, THE HEALTHY COMMUNITY COALITION OF FRANKLIN COMMUNITY HEALTH NETWORK, WILL CONVENE A DIVERSE PLANNING COMMITTEE TO REVIEW THE DATA COLLECTED FOR THE CHNA REPORT, PLAN COMMUNITY FORUM AND OTHER ENGAGEMENT ACTIVITIES, IDENTIFY PRIORITIES, AND DEVELOP IMPLEMENTATION STRATEGIES. |
| Franklin Memorial Hospital | 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. |
| Franklin Memorial Hospital | Part V, Section B, Line 11: THE ORGANIZATION HAS CONTINUED TO WORK ON ADDRESSING THE SIGNIFICANT NEEDS IDENTIFIED IN THE FORMER CHNA AND IMPLEMENTATION PLAN. THE CURRENT CHNA IMPLEMENTATION PLAN IS CURRENTLY IN DRAFT FORM AND WILL BE COMPLETED BY JUNE 2019. ONCE COMPLETE IT WILL GO THROUGH LOCAL AND ORGANIZATION APPROVAL PROCESSES. FOR THE 2019-2021 PLAN, 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 UPDATE FY18 AT HTTPS://MAINEHEALTH.ORG/HEALTHY-COMMUNITIES/COMMUNITY-HEALTH-NEEDS-ASSESSMENT FOR DETAILS OF THE ACTIVITIES UNDERTAKEN BY THE ORGANIZATION. |
| Franklin Memorial Hospital | Part V, Section B, Line 16j: FRANKLIN MEMORIAL HOSPITAL TAKES A NUMBER OF STEPS TO PUBLICIZE THE AVAILABILITY OF FINANCIAL ASSISTANCE TO PATIENTS.1. NOTICES OF THE AVAILABILITY OF FINANCIAL ASSISTANCE ARE POSTED IN LOCATIONS WITHIN THE HOSPITAL AT WHICH MEMBERS OF THE PUBLIC GENERALLY TRANSACT BUSINESS WITH THE HOSPITAL OR PRESENT THEMSELVES TO RECEIVE OR REQUEST HOSPITAL SERVICES, INCLUDING ADMITTING AREAS, WAITING ROOMS, BUSINESS OFFICES AND OUTPATIENT RECEPTION AREAS.2. WITH RESPECT TO INPATIENT ADMISSIONS, INDIVIDUAL WRITTEN NOTICE OF THE AVAILABILITY OF FINANCIAL ASSISTANCE IS PRESENTED TO EACH PATIENT UPON ADMISSION OR IN THE CASE OF EMERGENCY ADMISSION, BEFORE DISCHARGE. IN ADDITION, ALL INPATIENTS ARE VISITED BY A PATIENT FINANCIAL ADVOCATE TO DISCUSS AVAILABILITY OF FINANCIAL ASSISTANCE AND GOVERNMENT COVERAGE OPTIONS.3. AVAILABILITY OF FINANCIAL ASSISTANCE IS PUBLICIZED ON THE PATIENT INVOICES SUPPLYING PATIENTS WITH A CONTACT NUMBER TO OBTAIN FURTHER INFORMATION ABOUT AVAILABLE OPTIONS.4. FINANCIAL ASSISTANCE OPTIONS ARE OUTLINED ON THE HOSPITAL'S WEBSITE AND ARE READILY AVAILABLE TO THE PUBLIC.5. RACK CARDS AND FINANCIAL ASSISTANCE APPLICATIONS ARE LOCATED THROUGHOUT THE HOSPITAL AND THE PHYSICIAN PRACTICES.6. HOSPITAL BOOKLETS ARE AVAILABLE IN ALL PATIENT ROOMS WITH A SECTION REGARDING FINANCIAL ASSISTANCE.7. PATIENT FINANCIAL ADVOCATES WORK WITH ALL PATIENTS WITHOUT HEALTH INSURANCE COVERAGE TO NOTIFY THEM ABOUT AVAILABLE FINANCIAL ASSISTANCE RESOURCES AND ASSIST WITH MAINECARE APPLICATIONS FOR ELIGIBLE INDIVIDUALS. |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 16 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp (16 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | FacilityFacilityTxt |
|---|---|---|---|---|
| 1 - Franklin Health Livermore Falls Fam Prac | ||||
| 21 Main Street | Livermore Falls | ME | 04254 | Family Practice |
| 2 - Franklin Health Farmington Fam Practice | ||||
| 111 Franklin Health Commons | Farmington | ME | 04938 | Family Practice |
| 3 - Franklin Health Internal Medicine | ||||
| 111 Franklin Health Commons | Farmington | ME | 04938 | Internal Medicine Practice |
| 4 - Franklin Health Pediatrics | ||||
| 111 Franklin Health Commons | Farmington | ME | 04938 | Pediatrician Practice |
| 5 - Franklin Health Orthopaedics | ||||
| 111 Franklin Health Commons | Farmington | ME | 04938 | Orthopaedic Practice |
| 6 - Franklin Health Surgery | ||||
| 111 Franklin Health Commons | Farmington | ME | 04938 | General Surgery Practice |
| 7 - Outpatient Services at Livermore Falls | ||||
| 21 Main Street | Livermore Falls | ME | 04254 | Outpatient Clinic |
| 8 - NorthStar | ||||
| 15 School Street | Rangeley | ME | 04970 | Ambulance Base |
| 9 - NorthStar | ||||
| 138C Park Street | Phillips | ME | 04966 | Ambulance Base |
| 10 - NorthStar | ||||
| 119 Federal Road | Livermore | ME | 04254 | Ambulance Base |
| 11 - NorthStar | ||||
| 1001 Carriage Road | Carrabasset Valley | ME | 04947 | Ambulance Base |
| 12 - NorthStar | ||||
| 111 Franklin Health Commons | Farmington | ME | 04938 | Ambulance Base |
| 13 - Franklin Health Women's Care | ||||
| 111 Franklin Health Commons | Farmington | ME | 04938 | OB/GYN |
| 14 - Franklin Health Behavioral Services | ||||
| 131 Franklin Health Commons | Farmington | ME | 04938 | Behavioral Health Practice |
| 15 - Franklin Health Urology | ||||
| 126 Middle Street | Farmington | ME | 04938 | Urology Practice |
| 16 - Franklin Health Primary Care Practice | ||||
| 131 Franklin Health Commons | Farmington | ME | 04938 | Primary Care Practice |
Supplemental Information Detail SupplementalInformationDetail (12 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Part I, Line 7: | THE COSTING METHODOLOGY FOR THE AMOUNTS REPORTED IN PART I, LINE 7 OF THE SCHEDULE H IS BASED ON A RATIO OF PATIENT CARE COST TO CHARGES. THIS COST TO CHARGE RATIO WAS DERIVED FROM WORKSHEET 2, RATIO OF PATIENT CARE COST-TO-CHARGES PROVIDED IN THE INSTRUCTIONS FOR SCHEDULE H. |
| Part I, Line 7g | THE ORGANIZATION HAS INCLUDED COSTS ASSOCIATED WITH PRIMARY CARE (FAMILY PRACTICES, PEDIATRICS, INTERNAL MEDICINE, AND WOMEN'S CARE) AND BEHAVIORAL SERVICES. |
| Part III, Line 2: | SEE PART III, LINE 4 - BAD DEBT EXPENSE FOOTNOTE TO FINANCIAL STATEMENTS |
| Part III, Line 4: | BAD DEBT EXPENSE REPRESENTS HEALTHCARE SERVICES THAT FRANKLIN MEMORIAL HOSPITAL HAS PROVIDED WITHOUT COMPENSATION. AS A TAX EXEMPT HOSPITAL, FRANKLIN MEMORIAL HOSPITAL PROVIDES NECESSARY PATIENT CARE REGARDLESS OF THE PATIENT'S ABILITY TO PAY FOR THE SERVICES. A PORTION OF FRANKLIN MEMORIAL HOSPITAL'S BAD DEBT EXPENSE IS ATTRIBUTABLE TO PATIENTS ELIGIBLE FOR FINANCIAL ASSISTANCE THAT FOR A VARIETY OF REASONS, DO NOT COMPLETE THE FINANCIAL ASSISTANCE APPLICATION PROCESS. FRANKLIN MEMORIAL HOSPITAL CANNOT DETERMINE THE AMOUNT OF BAD DEBT EXPENSE THAT COULD BE REASONABLY ATTRIBUTABLE TO PATIENTS WHO LIKELY WOULD QUALIFY FOR FINANCIAL ASSISTANCE UNDER THE FRANKLIN MEMORIAL HOSPITAL'S FREE CARE POLICY.PAGES 8 AND 12-13 OF THE ATTACHED FINANCIAL STATEMENTS PROVIDE FOOTNOTES RELATED TO BAD DEBT EXPENSE AND BAD DEBT ALLOWANCE. |
| Part III, Line 8: | THE MEDICARE PRINCIPLES OF REIMBURSEMENT WERE USED TO DETERMINE THE MEDICARE INPATIENT AND OUTPATIENT COSTS BASED ON THE ORGANIZATION'S COST REPORT.FRANKLIN MEMORIAL HOSPITAL BELIEVES THAT THE MEDICARE SHORTFALL SHOULD BE INCLUDED AS A COMMUNITY BENEFIT BECAUSE THE HOSPITAL HAS A CLEAR MISSION COMMITMENT TO SERVING ELDERLY PATIENTS AND ADULTS WITH DISABILITIES THROUGH THE PROVISION OF SPECIFIC SUBSIDIZED PROGRAMS DEVELOPED TO HELP IMPROVE THE HEALTH STATUS OF THESE PATIENTS. IF THESE CRITICAL SUBSIDIZED PROGRAMS WERE NOT PROVIDED BY THE HOSPITAL, THEY WOULD BECOME THE OBLIGATION OF THE FEDERAL GOVERNMENT. |
| Part III, Line 9b: | COLLECTION AGENCIES WORK WITH PATIENTS WHO MIGHT BE ELIGIBLE FOR FINANCIAL ASSISTANCE AND REFER PATIENTS WHO INQUIRE ABOUT FINANCIAL ASSISTANCE BACK TO FRANKLIN MEMORIAL HOSPITAL FOR FOLLOW UP WITH A PATIENT FINANCIAL ADVOCATE AS NEEDED. BALANCES THAT ARE OWED TO THE HOSPITAL AFTER APPLYING ANY FINANCIAL ASSISTANCE ARE COLLECTED IN THE SAME MANNER AS ANY OTHER SELF PAY BALANCES. |
| Part VI, Line 2: | THE FRANKLIN COMMUNITY HEALTH NETWORK PARTICIPATES IN THE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) PROCESS EVERY THREE YEARS TO IDENTIFY THE PRIORITY HEALTH NEEDS OF THE COMMUNITY. THIS PROCESS UTILIZES A COMMITTEE COMBINED OF KEY PARTNERS FROM MULTIPLE ORGANIZATION INCLUDING FRANKLIN COMMUNITY HEALTH NETWORKS EMPLOYEES, LOCAL SOCIAL SERVICE AGENCIES AND INDEPENDENT PROVIDERS WHO SERVE FRANKLIN COUNTY. THROUGH COMMUNITY FORUMS, SURVEYS, FOCUS GROUPS AND KEY INFORMANT INTERVIEWS, INFORMATION IS COLLECTED AS PART OF THE MAINE SHARED COMMUNITY NEEDS ASSESSMENT PROCESS. A REPORT WITH THE COLLECTED DATA IS CREATED TO SHARE WITH THE COMMUNITY AND TO THE STATE. THE LAST CHNA PROCESS WILL START COLLECTING INFORMATION IN EARLY FALL OF 2018 AND ALL DATA WILL BE SUBMITTED PRIOR TO THE END OF DECEMBER 2018. THE FINAL REPORT FOR FRANKLIN COUNTY WILL BE RELEASED IN APRIL 2019. UTILIZING THE REPORTS AND OTHER DATA, IMPLEMENTATION PLANS ARE CREATED AND SUBMITTED TO THE FRANKLIN COMMUNITY HEALTH NETWORK BOARD FOR APPROVAL. THE IMPLEMENTATION PLANS CONTAIN STRATEGIES FOR IMPROVEMENT SPECIFIC TO THE TOP HEALTH PRIORITIES IDENTIFIED THROUGH THE CHNA PROCESS INCLUDING THE METRICS TO MEASURE PROGRESS, PARTNERS AND THE YEAR(S) IN WHICH THE STRATEGY WILL BE ADDRESSED. IMPLEMENTATION PLANS WILL BE FINALIZED BY FALL 2019 IN PREPARATION FOR THE 2019-2021 STRATEGIC PLANS. |
| Part VI, Line 3: | WHEN PATIENTS ARE REGISTERED THERE ARE BROCHURES AVAILABLE THAT DESCRIBE FRANKLIN MEMORIAL HOSPITAL'S CHARITY CARE PROGRAM. WHEN A PATIENT IS ADMITTED WITH NO INSURANCE, REGISTRATION SENDS A PATIENT FINANCIAL ADVOCATE UP TO THE PATIENT'S ROOM TO MEET THE PATIENT. EACH BILL PROVIDED TO A PATIENT HAS THE PHONE NUMBER TO CALL IF THE PATIENT NEEDS FINANCIAL ASSISTANCE. THE ORGANIZATION'S BILLERS ALSO REFER PATIENTS TO THE ORGANIZATION'S PATIENT FINANCIAL ADVOCATE WHEN A PATIENT IS IDENTIFIED AS NEEDING ASSISTANCE. |
| Part VI, Line 4: | FRANKLIN MEMORIAL HOSPITAL'S SERVICE AREA COVERS 2,200 SQUARE MILES WHICH EXTENDS TO THE CANADIAN BORDER. IT IS ONE OF THE MOST RURAL AND ECONOMICALLY CHALLENGED REGIONS IN MAINE, INCLUDING SEVERAL AREAS THAT HAVE BEEN FEDERALLY DESIGNATED AS HEALTH PROFESSIONAL SHORTAGE AND MEDICALLY UNDERSERVED AREAS. |
| Part VI, Line 5: | PROMOTION OF COMMUNITY HEALTH:THE TAX-EXEMPT PURPOSE OF THE ORGANIZATION TO IMPROVE THE HEALTH OF THE COMMUNITY IS PROMOTED AND ENHANCED IN THE FOLLOWING WAYS:1. 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.2. MEDICAL STAFF PRIVILEGES ARE AVAILABLE TO ALL QUALIFIED PHYSICIANS IN THE COMMUNITY.3. SOLICITATION OF COMMUNITY INPUT IN THE STRATEGIC PLANNING PROCESS.4. COMMON GOVERNANCE OF THE HOSPITAL AND PHYSICIAN SERVICES PROVIDED IN THE COUNTY TO PROMOTE COMMON HEALTH CARE AND IMPROVEMENT PLANNING AND CONTROL COSTS.5. SURPLUS FUNDS ARE REINVESTED IN CAPITAL EQUIPMENT AND IMPROVEMENTS TO ENSURE HIGH QUALITY CARE.6. EACH YEAR A PORTION OF RETAINED EARNINGS ARE DISTRIBUTED TO OUR PARENT, MAINEHEALTH, FOR THE SPECIFIC PURPOSE OF HEALTH STATUS IMPROVEMENT PROGRAMS THROUGHOUT THE MAINEHEALTH SERVICE AREA. COMMUNITY BUILDING:PHYSICAL IMPROVEMENTS AND HOUSING:1. DEVELOPMENT AND MAINTENANCE OF THE RAIL TRAIL WHICH IS ON FMH PROPERTY AND IS AVAILABLE TO THE PUBLIC TO ENCOURAGE HEALTH AND WELLNESS.ECONOMIC DEVELOPMENT:1. MEMBER OF GREATER FRANKLIN DEVELOPMENT CORPORATION - AN ORGANIZATION COMMITTED TO ECONOMIC DEVELOPMENT.COMMUNITY SUPPORT:1. PERFORM DISASTER DRILLS WITH THE COMMUNITY 1-2 TIMES A YEAR.2. COMMUNITY DENTAL (PROVIDE LOW COST RENTAL SPACE).COALITION BUILDING:1. HEALTHY COMMUNITY COALITION OF GREATER FRANKLIN COUNTY, FOUNDED IN 1989, IS ONE OF THE OLDEST HEALTH COALITIONS IN THE COUNTRY. ITS MISSION IS TO MEASURABLY IMPROVE THE WELL-BEING OF ALL PEOPLE IN GREATER FRANKLIN COUNTY AND NEIGHBORING TOWNS USING A COORDINATED PUBLIC HEALTH APPROACH OF EDUCATION, PROMOTION, AND OUTREACH. WITH ITS QUALIFIED STAFF OF PUBLIC HEALTH PROFESSIONALS, HEALTHY COMMUNITY COALITION OFFERS HEALTH SCREENINGS, HEALTH INFORMATION, AND PROGRAMS AND EVENTS TO SUPPORT HEALTHY LIFESTYLES THAT PREVENT DISEASE AND IMPROVE QUALITY OF LIFE. ITS COMMUNITY OUTREACH EFFORTS APPEAR IN EVERY TOWN AND CORNER OF THE REGION. IN THE PAST YEAR, MORE THAN 2,000 INDIVIDUALS BENEFITED FROM OUTREACH ACTIVITIES PROVIDED THROUGH THE MOBILE HEALTH UNIT WHERE HEALTH RISK APPRAISALS (HRAS) ARE ROUTINELY OFFERED. HRAS INCLUDE A BLOOD PRESSURE AND CHOLESTEROL CHECK AND INDIVIDUALIZED HEALTH EDUCATION. ADDITIONAL OUTREACH EVENTS WERE HELD THROUGHOUT THE REGION SUCH AS: BONE DENSITY SCREENINGS, FLU IMMUNIZATIONS, BODY COMPOSITION ANALYSIS, FREE CLINICAL BREAST EXAMS, EDUCATION ON TOBACCO, NUTRITION, PHYSICAL ACTIVITY AND SUBSTANCE ABUSE, AND EDUCATION ON THE PREVENTION OF BREAST, CERVICAL, COLON, LUNG, PROSTATE, AND SKIN CANCER.2. AHEC EDUCATION CENTER - ESTABLISHED IN 2004, THE FRANKLIN AHEC PROGRAM WAS DEVELOPED OUT OF GREAT INTEREST FROM EMPLOYEES AND COMMUNITY MEMBERS REQUESTING LOCAL OPPORTUNITIES TO PURSUE CAREERS IN THE HEALTH FIELD AND EDUCATIONAL PROGRAMS FOR RETENTION AND PROFESSIONAL GROWTH. THE FRANKLIN AHEC ALLOWS US TO MEET THE NEEDS OF THE RURAL POPULATION. IT ALSO BRINGS TO THE MAINE AHEC NETWORK THE RESOURCES OF A LARGE INNOVATIVE RURAL HEALTH SYSTEM THAT INCLUDES A COMMUNITY HOSPITAL, MAINE'S OLDEST HEALTHY COMMUNITY COALITION AND THE BEN FRANKLIN CENTER WHICH HOUSES A STATE OF THE ART EDUCATION CENTER, MEDICAL LIBRARY FACILITIES, AND DISTANCE LEARNING OPPORTUNITIES. THE PROGRAM HAS GREATLY EXPANDED TO INCLUDE MANY ASPECTS AND ACTIVITIES FOR RETENTION AND RECRUITMENT FOR HEALTH CAREERS IN OUR VAST RURAL CATCHMENT AREA. BECOMING AN AHEC CENTER ALLOWS US TO PARTNER WITH YOUTH PROGRAMS, PUBLIC SCHOOLS, MULTIPLE COLLEGES, ADULT EDUCATION, A LOCAL CAREER CENTER AND OTHER HEALTH CAREER PROGRAMS TO OFFER COMMUNITY MEMBERS, DISPLACED WORKERS AND CURRENT HEALTHCARE EMPLOYEES THE OPPORTUNITY TO CONTINUE OR PURSUE CAREERS.3. HEALTHINFONET: FMH, ALONG WITH ALL OTHER MAINE HOSPITALS AND HUNDREDS OF PHYSICIAN PRACTICES IN MAINE NOW HAVE ACCESS TO A NEW, CONSOLIDATED ELECTRONIC HEALTH RECORD MADE POSSIBLE BY HEALTHINFONET THAT CONTAINS CRITICAL INFORMATION DRAWN FROM RECORDS THAT HAVE TRADITIONALLY BEEN SEPARATELY MAINTAINED IN PHYSICIAN PRACTICES, HOSPITALS AND OTHER SETTINGS. ARMED WITH MORE COMPLETE AND TIMELY INFORMATION ABOUT A PATIENT, CLINICIANS CAN PROVIDE BETTER QUALITY CARE AND IMPROVE THE COORDINATION OF CARE, PARTICULARLY FOR THOSE PATIENTS WHO SEE SEVERAL PROVIDERS AND RECEIVE CARE IN MORE THAN ONE COMMUNITY OR SETTING. |
| Part VI, Line 6: | MAINEHEALTH 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, MAINEHEALTH 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 MAINEHEALTH 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. MAINEHEALTH INCLUDES THE FOLLOWING MEMBER ORGANIZATIONS: LINCOLNHEALTH GROUP, MAINE MEDICAL CENTER, 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 MAINEHEALTH 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 | Yes (1) | 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 (12 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Stephen Goss DO | ||||||||||||||
| Medical Staff Pres. | $210,790 | $0 | $16,250 | $0 | $5,134 | $0 | $4,600 | $0 | $27,531 | $0 | $264,305 | $0 | $0 | $0 |
| William L Caron Jr | ||||||||||||||
| MH CEO | $0 | $961,824 | $0 | $260,010 | $0 | $102,872 | $0 | $80,881 | $0 | $36,239 | $0 | $1,441,826 | $0 | $0 |
| Timothy Churchill | ||||||||||||||
| President/CEO | $0 | $337,012 | $0 | $54,000 | $0 | $26,435 | $0 | $33,788 | $0 | $29,110 | $0 | $480,345 | $0 | $0 |
| John Cox | ||||||||||||||
| Regional CFO | $0 | $227,867 | $0 | $16,000 | $0 | $22,876 | $0 | $15,631 | $0 | $25,487 | $0 | $307,861 | $0 | $0 |
| Christopher Renaud DO | ||||||||||||||
| Anesthesiologist | $360,159 | $0 | $0 | $0 | $15,001 | $0 | $5,400 | $0 | $25,429 | $0 | $405,989 | $0 | $0 | $0 |
| Eric Gunther MD | ||||||||||||||
| General Surgeon | $272,437 | $0 | $43,887 | $0 | $6,243 | $0 | $5,400 | $0 | $28,181 | $0 | $356,148 | $0 | $0 | $0 |
| Joanie Peter MD | ||||||||||||||
| Physician | $330,338 | $0 | $0 | $0 | $13,060 | $0 | $5,400 | $0 | $25,522 | $0 | $374,320 | $0 | $0 | $0 |
| James Lancaster MD | ||||||||||||||
| Anesthesiologist | $359,216 | $0 | $0 | $0 | $4,622 | $0 | $5,400 | $0 | $26,698 | $0 | $395,936 | $0 | $0 | $0 |
| Heather Decarolis MD | ||||||||||||||
| Anesthesiologist | $357,159 | $0 | $0 | $0 | $903 | $0 | $5,400 | $0 | $28,755 | $0 | $392,217 | $0 | $0 | $0 |
| Rebecca Arsenault | ||||||||||||||
| Frmr Pres/CEO | $0 | $0 | $0 | $0 | $142,291 | $0 | $0 | $0 | $0 | $0 | $142,291 | $0 | $0 | $0 |
| Jay Naliboff MD | ||||||||||||||
| Frmr VP Med. Affairs | $227,875 | $0 | $0 | $0 | $7,217 | $0 | $4,509 | $0 | $24,992 | $0 | $264,593 | $0 | $0 | $0 |
| Gerald Cayer | ||||||||||||||
| Frmr VP Phys. & Comm. | $41,719 | $0 | $0 | $0 | $84,729 | $0 | $260 | $0 | $5,687 | $0 | $132,395 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Part I, Line 4a | REBECCA ARSENAULT WAS PAID SEVERANCE TOTALING $142,291. GERALD CAYER WAS PAID SEVERANCE TOTALING $84,500. |
| Part I, Line 3 | 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 15A - COMPENSATION FOR TOP OFFICIAL |
Schedule K IRS990ScheduleK
Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp (2 entries)
| Bond ReferenceBondReferenceCd | Bond Issuer EINBondIssuerEIN | CUSIPCUSIPNum | Bond IssuedBondIssuedDt | Issue PriceIssuePriceAmt | PurposePurposeDesc | DefeasedDefeasedInd | On Behalf Of IssuerOnBehalfOfIssuerInd | Pool FinancingPoolFinancingInd |
|---|---|---|---|---|---|---|---|---|
| Maine Health & Higher Education Facilities Authority | ||||||||
| A | 010314384 | 560427NM4 | 2011-11-30 | $10,452,958 | Refund bonds issued 02/22/2001 | 0 | 0 | Yes (1) |
| Maine Health & Higher Education Facilities Authority | ||||||||
| B | 010314384 | 56042REW8 | 2016-06-28 | $12,359,721 | Refund bonds issued 09/07/2006 | 0 | 0 | Yes (1) |
Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp (2 entries)
| Bond ReferenceBondReferenceCd | RetiredRetiredAmt | Total ProceedsTotalProceedsAmt | In Reserve FundInReserveFundAmt | Issuance Costs From ProceedsIssuanceCostsFromProceedsAmt | Other Spent ProceedsOtherSpentProceedsAmt | Current RefundingCurrentRefundingInd | Advance RefundingAdvanceRefundingInd | Final Allocation MadeFinalAllocationMadeInd | Adequate Books And Rec MaintAdequateBooksAndRecMaintInd |
|---|---|---|---|---|---|---|---|---|---|
| A | $2,605,000 | $9,438,683 | $715,621 | $113,744 | $9,149,774 | Yes (1) | 0 | Yes (1) | Yes (1) |
| B | $835,000 | $12,359,721 | $875,151 | $112,509 | $12,032,499 | Yes (1) | 0 | Yes (1) | Yes (1) |
Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | B | BondReferenceCd |
| Owning Bond Financed Property | 0 | OwningBondFinancedPropertyInd |
| Any Lease Arrangements | 0 | AnyLeaseArrangementsInd |
| Mgmt Contract Bond Fincd Prop | 0 | MgmtContractBondFincdPropInd |
| Any Research Agreements | 0 | AnyResearchAgreementsInd |
| Bond Iss Meet Prvt Sec Pymt Test | 0 | BondIssMeetPrvtSecPymtTestInd |
| Change In Use Bond Financed Prop | 0 | ChangeInUseBondFinancedPropInd |
| Procs Nonqualified Bond Remdtd | 0 | ProcsNonqualifiedBondRemdtdInd |
Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp (2 entries)
| Bond ReferenceBondReferenceCd | Form8038 T FiledForm8038TFiledInd | Rebate Not Due YetRebateNotDueYetInd | Exception To RebateExceptionToRebateInd | No Rebate DueNoRebateDueInd | Variable Rate IssueVariableRateIssueInd | Hedge Identified In Bks And RecHedgeIdentifiedInBksAndRecInd | Gross Proceeds Invested In GICGrossProceedsInvestedInGICInd | Gross Proceeds InvestedGrossProceedsInvestedInd | Written Proc To Monitor ReqsWrittenProcToMonitorReqsInd |
|---|---|---|---|---|---|---|---|---|---|
| A | 0 | 0 | 0 | Yes (1) | 0 | 0 | 0 | 0 | 0 |
| B | 0 | Yes (1) | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
Procedures Corrective Action ProceduresCorrectiveActionGrp (2 entries)
| Bond ReferenceBondReferenceCd | Procedures Corrective ActionProceduresCorrectiveActionInd |
|---|---|
| A | 0 |
| B | 0 |
Supplemental Information Detail SupplementalInformationDetail (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Part III Line 9, Part IV Line 7, Part V | DURING THIS FISCAL YEAR, THE INSTITUTION WAS IN THE PROCESS OF IMPLEMENTING WRITTEN COMPLIANCE PROCEDURES. |
| Part VI | THESE BOND ISSUES ARE BOTH POOLED FINANCINGS, AND FRANKLIN'S PORTION CONSTITUTES LESS THAN 100% OF EACH ISSUE. PART I COLUMNS (E) AND (F), AND ALL OF PARTS II AND III, HAVE BEEN ANSWERED WITH RESPECT TO FRANKLIN'S SHARE OF SUCH POOLED FINANCINGS, NOT WITH RESPECT TO 100% OF EACH ISSUE. |
| Part II, Line 4 | - BOND ISSUED 11/30/11: THE AMOUNT SHOWN HERE CONSISTS OF $543,719 IN DEBT SERVICE RESERVE FUND, PLUS 171,902 OF DEBT SERVICES DEPOSITS. - BOND ISSUED 6/28/16: THE AMOUNT SHOWN HERE CONSISTS OF $660,375 IN DEBT SERVICE RESERVE FUND, PLUS 214,776 OF DEBT SERVICES DEPOSITS. |
| Part III | PART III HAS NOT BEEN COMPLETED WITH RESPECT TO THE REFUNDING BONDS ISSUED 11/30/11, SINCE THE BONDS BEING REFINANCED BY SUCH BONDS WERE ISSUED BEFORE 2003. |
| Part I, Column F | - BOND ISSUED 11/30/11: REFUND BONDS ISSUED 2/15/01 - BOND ISSUED 6/28/16: REFUND BONDS ISSUED 9/7/06 |
Schedule L IRS990ScheduleL
Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp (3 entries)
| Relationship DescriptionRelationshipDescriptionTxt | TransactionTransactionAmt | TransactionTransactionDesc | Sharing Of RevenuesSharingOfRevenuesInd |
|---|---|---|---|
| Rebecca Wood | |||
| Family Member | $149,648 | Employment | 0 |
| Adam Dixon | |||
| Family Member | $45,050 | Employment | 0 |
| Stacy Hershfeld | |||
| Family Member | $219,078 | Employment | 0 |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE L, PART V - ADDITIONAL INFORMATION | FormAndLineReferenceDesc |
| Explanation | REBECCA WOOD WAS EMPLOYED BY FRANKLIN MEMORIAL HOSPITAL AS CHIEF NURSING OFFICER. HER HUSBAND, DARRYL WOOD, IS A BOARD MEMBER. ADAM DIXON WAS EMPLOYED BY FRANKLIN MEMORIAL HOSPITAL AS A RADIOGRAPHER. HIS FATHER, DAVID DIXON IS A BOARD MEMBER. STACY HERSHFELD, DO WAS EMPLOYED BY FRANKLIN MEMORIAL HOSPITAL AS A PHYSICIAN. HER HUSBAND, STEPHEN GOSS, MD IS A BOARD MEMBER. | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (10 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART V, LINE 1A | MAINE MEDICAL CENTER (EIN 01-0238552), ACTING ON BEHALF OF MAINEHEALTH (EIN 01-0431680), FILED 1,030 FORM 1099S FOR THE CALENDAR YEAR 2017 ON BEHALF OF THE FOLLOWING ORGANIZATIONS: MAINEHEALTH, MAINE MEDICAL CENTER, SOUTHERN MAINE HEALTH CARE, PEN BAY MEDICAL CENTER, WALDO COUNTY GENERAL HOSPITAL, FRANKLIN MEMORIAL HOSPITAL, LINCOLNHEALTH GROUP, MEMORIAL HOSPITAL, WESTERN MAINE HEALTH CARE, MAINE BEHAVIORAL HEALTHCARE, NORDX, MAINEHEALTH CARE AT HOME. PRIOR TO CONSOLIDATING ACCOUNTS PAYABLE OPERATIONS WITH MAINE MEDICAL CENTER (EIN 01-0238552), THE ENTITY FILED 118 FORM 1099S FOR THE CALENDAR YEAR 2017. |
| FORM 990, PART V, LINE 2A | FRANKLIN MEMORIAL HOSPITAL (EIN 01-0211503) FILED FORM W-3, REPORTING 812 EMPLOYEES FOR THE CALENDAR YEAR 2017 ON BEHALF OF THE FOLLOWING ORGANIZATIONS: FRANKLIN MEMORIAL HOSPITAL, EVERGREEN BEHAVIORAL SERVICES, AND HEALTHY COMMUNITY COALITION. |
| Form 990, Part VI, Section A, line 6 | MAINEHEALTH (EIN: 01-0431680), IS THE SOLE MEMBER OF FRANKLIN COMMUNITY HEALTH NETWORK (FCHN) (EIN: 22-3209406). FCHN IS THE SOLE MEMBER OF FRANKLIN MEMORIAL HOSPITAL (FMH). |
| Form 990, Part VI, Section A, line 7a | MAINEHEALTH AND FRANKLIN COMMUNITY HEALTH NETWORK HAVE THE RESPONSIBILITY FOR THE ELECTION OF THE MEMBERS OF THE GOVERNING BODY. |
| Form 990, Part VI, Section A, line 7b | DECISIONS OF THE GOVERNING BODY SUCH AS BUDGETS, BUSINESS STRATEGIES, SIGNIFICANT FINANCIAL COMMITMENTS, AMENDMENTS TO THE ARTICLES OF INCORPORATION AND ELECTION OF THE PRESIDENT/CEO AMONG OTHER DECISIONS, ARE SUBJECT TO APPROVAL OF THE SOLE MEMBER. |
| Form 990, Part VI, Section B, line 11b | THE PRESIDENT AND THE REGIONAL CHIEF FINANCIAL OFFICER REVIEWED KEY COMPONENTS WITH THE BOARD OF TRUSTEES. 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 | ON AN ANNUAL BASIS BOARD MEMBERS AND OFFICERS ARE REQUIRED TO SUBMIT A CONFLICT OF INTEREST STATEMENT WHICH IS THEN REVIEWED BY THE COMPLIANCE COMMITTEE. THE COMPLIANCE COMMITTEE IS RESPONSIBLE FOR REGULARLY AND CONSISTENTLY MONITORING AND ENFORCING COMPLIANCE WITH THE CONFLICT OF INTEREST POLICY. |
| Form 990, Part VI, Section B, line 15 | COMPENSATION FOR CEO THE PROCESS FOLLOWED FOR DETERMINING COMPENSATION OF THE CEO COMPENSATED BY THIS OR OTHER RELATED ORGANIZATION IS A FORMAL PROCESS PERFORMED ANNUALLY BY THE EXECUTIVE COMMITTEE OF THE BOARD OF DIRECTORS. A RELATED ORGANIZATION USES AN OUTSIDE FIRM, SULLIVAN COTTER, TO PERFORM AN INDEPENDENT BENCHMARK ANALYSIS FOR THE CEO OF FRANKLIN MEMORIAL HOSPITAL, ALONG WITH OTHER EXECUTIVES IN THE MAINEHEALTH SYSTEM. THE FIRM MEETS WITH THE EXECUTIVE COMMITTEE TO REVIEW EACH EXECUTIVE'S BENCHMARK REPORT. THE COMMITTEE THEN DELIBERATES ON MAINEHEALTH'S WRITTEN SALARY AND INCENTIVE PLAN PHILOSOPHY BEFORE MAKING A FINAL DECISION. ALL DECISIONS AND MEETINGS ARE CAPTURED IN MINUTES AND THERE ARE APPROPRIATE APPROVALS AT ALL LEVELS. COMPENSATION FOR OFFICERS THE MEMBER IS RESPONSIBLE FOR AN ANNUAL EVALUATION OF THE OTHER KEY ADMINISTRATIVE EMPLOYEES OF THE ORGANIZATION. COMPENSATION IS EVALUATED BY THE COMPENSATION COMMITTEE APPOINTED BY THE MEMBER, AND THE ORGANIZATION'S BOARD OF TRUSTEES MUST APPROVE OF THE COMPENSATION. IN ADDITION, THE ORGANIZATION UTILIZES THE SERVICES OF AN INDEPENDENT COMPENSATION CONSULTING FIRM AND INDUSTRY SURVEY. |
| 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: | CHANGE IN INTEREST OF RELATED PARTY NET ASSETS -643,907. CHANGE IN INTEREST IN PERPETUAL TRUST 9,632. NET TRANSFER FROM AFFILIATES 8,535,478. |
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 |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Evergreen Behavioral Services | |||||||||||
| 131 Franklin Health Commons | Farmington | ME | 04938 | 010492747 | Mental health | ME | 501(c)(3) | Line 10 | Franklin Community Health Network | 0 | |
| Franklin Community Health Network | |||||||||||
| 111 Franklin Health Commons | Farmington | ME | 04938 | 223209406 | Healthcare | ME | 501(c)(3) | Line 12b, II | MaineHealth | 0 | |
| Healthy Community Coalition Inc | |||||||||||
| 105 Mt Blue Circle | Farmington | ME | 04938 | 223305743 | Community services | ME | 501(c)(3) | Line 7 | Franklin Community Health Network | 0 | |
| MaineHealth | |||||||||||
| 110 Free Street | Portland | ME | 04101 | 010431680 | Healthcare | ME | 501(c)(3) | Line 12c, III-FI | 0 | N/A | |
| Pine Tree Medical Associates | |||||||||||
| 131 Franklin Health Commons | Farmington | ME | 04938 | 010469478 | Cm Hth Ag | ME | 501(c)(3) | Line 10 | Franklin Community Health Network | 0 | |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp
Related Organization Name RelatedOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | William A Howell Trust Fund | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO Box 830269 | AddressLine1Txt |
| City | Dallas | CityNm |
| State Abbreviation | TX | StateAbbreviationCd |
| ZIP | 75283 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 016032170 | EIN |
| Primary Activities | Perpetual Trust | PrimaryActivitiesTxt |
| Legal Domicile State | ME | LegalDomicileStateCd |
| Direct Controlling NA | N/A | DirectControllingNACd |
| Entity Type | T | EntityTypeTxt |
| Share Of Total Income | $9,631 | ShareOfTotalIncomeAmt |
| Share Of EOY Assets | $311,382 | ShareOfEOYAssetsAmt |
| Ownership | 1.00000 | OwnershipPct |
| Controlled Organization | 0 | ControlledOrganizationInd |
| 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 | Yes (1) | 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 | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | 0 | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | 0 | SharingOfFacilitiesInd |
| Paid Employees Sharing | 0 | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | Yes (1) | TransferToOtherOrgInd |
| Transfer From Other Org | Yes (1) | TransferFromOtherOrgInd |