MEMORIAL HOSPITAL: Form 990, tax year 2016
View the entire original 990 at ProPublica ↗
- Organization
- MEMORIAL HOSPITAL (EIN 02-0222156)
- Tax period
- 2016-10-01 to 2017-09-30
- Filed
- 2018-08-13
- IRS object ID
- 201812259349300631
- Schema version
- 2016v3.1
- 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 D
- Schedule H
- Schedule J
- Schedule K
- Schedule L
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2018-08-13T10:00:02-04:00 | ReturnTs |
| Tax Period End | 2017-09-30 | TaxPeriodEndDt |
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2016-10-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 020222156 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MEMORIAL HOSPITAL | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | MEMO | BusinessNameControlTxt |
| Phone | 6033565461 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 3073 WHITE MOUNTAIN HIGHWAY | AddressLine1Txt |
| City | NORTH CONWAY | CityNm |
| State Abbreviation | NH | StateAbbreviationCd |
| ZIP | 03860 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | JOHN COX | PersonNm |
| Person Title | REGIONAL CFO | PersonTitleTxt |
| Phone | 6033565461 | PhoneNum |
| Signature | 2018-08-02 | SignatureDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2016 | TaxYr |
| Build TS | 2022-09-23 18:48:47Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | SCOTT MCKINNON | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 3073 WHITE MOUNTAIN HIGHWAY | AddressLine1Txt |
| City | NORTH CONWAY | CityNm |
| State Abbreviation | NH | StateAbbreviationCd |
| ZIP | 03860 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $87,448,299 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.MEMORIALHOSPITALNH.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1910 | FormationYr |
| Legal Domicile State | NH | LegalDomicileStateCd |
| Activity Or Mission | CRITICAL ACCESS HOSPITAL | ActivityOrMissionDesc |
| Voting Members Governing Body | 14 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 8 | VotingMembersIndependentCnt |
| Total Employee | 610 | TotalEmployeeCnt |
| Total Volunteers | 82 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| PY Contributions Grants | $763,484 | PYContributionsGrantsAmt |
| CY Contributions Grants | $62,843 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $68,053,811 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $71,923,328 | CYProgramServiceRevenueAmt |
| PY Investment Income | -$312,727 | PYInvestmentIncomeAmt |
| CY Investment Income | $1,165,224 | CYInvestmentIncomeAmt |
| PY Other Revenue | $65,041 | PYOtherRevenueAmt |
| CY Other Revenue | -$140,199 | CYOtherRevenueAmt |
| PY Total Revenue | $68,569,609 | PYTotalRevenueAmt |
| CY Total Revenue | $73,011,196 | CYTotalRevenueAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $34,927,320 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $36,983,732 | CYSalariesCompEmpBnftPaidAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $121,282 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $34,610,499 | PYOtherExpensesAmt |
| CY Other Expenses | $33,923,953 | CYOtherExpensesAmt |
| PY Total Expenses | $69,537,819 | PYTotalExpensesAmt |
| CY Total Expenses | $70,907,685 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$968,210 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $2,103,511 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $76,473,057 | TotalAssetsBOYAmt |
| Total Assets EOY | $79,780,514 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $36,373,870 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $36,788,620 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $40,099,187 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $42,991,894 | NetAssetsOrFundBalancesEOYAmt |
| Mission | MEMORIAL HOSPITAL PROVIDES HEALTHCARE SERVICES TO THE RESIDENTS AND VISITORS OF THE MOUNT WASHINGTON VALLEY AREA OF NEW HAMPSHIRE AS WELL AS WESTERN MAINE. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $64,781,063 | ExpenseAmt |
| Revenue | $73,029,917 | RevenueAmt |
| Desc | MEMORIAL HOSPITAL PROVIDES HEALTHCARE SERVICES TO THE RESIDENTS AND VISITORS OF THE MOUNT WASHINGTON VALLEY AREA OF NEW HAMPSHIRE. MEMORIAL HOSPITAL IS A 25 BED CRITICAL ACCESS HOSPITAL AND A 45 BED INTERMEDIATE CARE FACILITY (MERRIMAN HOUSE). THE HOSPITAL PROVIDES MED/SURG, ICU, SURGICAL SERVICES, ICF, OBSTETRICS, RADIOLOGY/IMAGING, LAB DIABETES, ONCOLOGY/INFUSION, CARDIAC REHAB, WOUND CARE, SPECIALTY CARE, ED AND PRIMARY CARE SERVICES. THE HOSPITAL HAD 4,796 ACUTE INPATIENT DAYS, 12,735 ED OUTPATIENT VISITS, AND 458 SWING BED DAYS. | Desc |
| Total Program Service Expenses | $64,781,063 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | false | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (true) | LobbyingActivitiesInd |
| Subject To Proxy Tax | false | SubjectToProxyTaxInd |
| Donor Advised Fund | false | DonorAdvisedFundInd |
| Conservation Easements | false | ConservationEasementsInd |
| Collections Of Art | false | CollectionsOfArtInd |
| Credit Counseling | false | CreditCounselingInd |
| Temp Or Permanent Endowments | Yes (true) | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (true) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | false | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | false | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (true) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (true) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | false | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (true) | ConsolidatedAuditFinclStmtInd |
| School Operating | false | SchoolOperatingInd |
| Foreign Office | false | ForeignOfficeInd |
| Foreign Activities | false | ForeignActivitiesInd |
| More Than5000 K To Org | false | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividualsInd |
| Professional Fundraising | false | ProfessionalFundraisingInd |
| Fundraising Activities | false | FundraisingActivitiesInd |
| Gaming Activities | false | GamingActivitiesInd |
| Operate Hospital | Yes (true) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (true) | AuditedFinancialStmtAttInd |
| Grants To Organizations | false | GrantsToOrganizationsInd |
| Grants To Individuals | false | GrantsToIndividualsInd |
| Schedule J Required | Yes (true) | ScheduleJRequiredInd |
| Tax Exempt Bonds | Yes (true) | TaxExemptBondsInd |
| Invest Tax Exempt Bonds | false | InvestTaxExemptBondsInd |
| Escrow Account | false | EscrowAccountInd |
| On Behalf Of Issuer | false | OnBehalfOfIssuerInd |
| Engaged In Excess Benefit Trans | false | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | false | PYExcessBenefitTransInd |
| Loan Outstanding | false | LoanOutstandingInd |
| Grant To Related Person | false | GrantToRelatedPersonInd |
| Business Rln With Org Mem | false | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | Yes (true) | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | false | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | false | DeductibleNonCashContriInd |
| Deductible Art Contribution | false | DeductibleArtContributionInd |
| Terminate Operations | false | TerminateOperationsInd |
| Partial Liquidation | false | PartialLiquidationInd |
| Disregarded Entity | false | DisregardedEntityInd |
| Related Entity | Yes (true) | RelatedEntityInd |
| Related Organization Ctrl Ent | Yes (true) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | false | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | false | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| IRP Document | 79 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (true) | BackupWthldComplianceInd |
| Employee | 610 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (true) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | false | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | false | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | false | TaxablePartyNotificationInd |
| Nondeductible Contributions | false | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | false | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | false | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | false | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | false | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 14 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 8 | IndependentVotingMemberCnt |
| Family Or Business Rln | false | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | false | DelegationOfMgmtDutiesInd |
| Change To Org Documents | false | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (true) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (true) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (true) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (true) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (true) | MinutesOfCommitteesInd |
| Officer Mailing Address | false | OfficerMailingAddressInd |
| Local Chapters | false | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (true) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (true) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (true) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (true) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (true) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (true) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (true) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (true) | CompensationProcessOtherInd |
| Investment In Joint Venture | false | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | NH | StatesWhereCopyOfReturnIsFldCd |
| Other Website | Yes (X) | OtherWebsiteInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | JOHN COX | PersonNm |
| Phone | 6033565461 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 3073 WHITE MOUNTAIN HIGHWAY | AddressLine1Txt |
| City | NORTH CONWAY | CityNm |
| State Abbreviation | NH | StateAbbreviationCd |
| ZIP | 03860 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (24 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 |
|---|---|---|---|---|---|---|---|---|
| WILLIAM CARON | ||||||||
| MH CEO | 1.00 | 50.00 | Yes (X) | $0 | $1,174,972 | $160,862 | ||
| SCOTT MCKINNON | ||||||||
| PRESIDENT/CE | 50.00 | Yes (X) | $350,223 | $0 | $24,923 | Yes (X) | ||
| JAMES GLAZER MD FACSM | ||||||||
| BOARD MEMBER | 50.00 | Yes (X) | $349,860 | $0 | $24,532 | |||
| MARNI MADNICK MD | ||||||||
| MEDICAL STAF | 50.00 | Yes (X) | $337,094 | $0 | $45,172 | |||
| RAYMOND RABIDEAU MD | ||||||||
| CMO | 50.00 | Yes (X) | $306,146 | $0 | $24,857 | |||
| MARY VIGEANT | ||||||||
| NURSE PRACTI | 50.00 | Yes (X) | $203,164 | $0 | $14,604 | |||
| PHIL DAVIES | ||||||||
| PAST BOARD C | 1.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | ||
| LAURA JAWITZ | ||||||||
| BOARD CHAIR | 1.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | ||
| BARBARA HOPKINS | ||||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| THAIRE BRYANT | ||||||||
| PAST TREASUR | 1.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | ||
| ED KELLY | ||||||||
| TREASURER | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| JOAN AUBREY | ||||||||
| PAST BOARD M | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| BILL BECK | ||||||||
| SECRETARY | 1.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | ||
| MICHELLE O'DONNELL | ||||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| MARY DEVEAU | ||||||||
| 2ND VICE CHA | 1.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | ||
| JUSTINO FERNANDES MD | ||||||||
| 1ST VICE CHA | 1.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | ||
| BOB IRWIN | ||||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| JOHN COX | ||||||||
| REGIONAL CFO | 0.00 | 50.00 | $0 | $228,890 | $29,783 | Yes (X) | ||
| ETHNEE GARNER | ||||||||
| VP OF NURSIN | 50.00 | $162,425 | $0 | $21,695 | Yes (X) | |||
| DOUGLAS TAYLOR MD | ||||||||
| ORTHOPAEDIC | 50.00 | $555,222 | $0 | $25,199 | Yes (X) | |||
| JOHN IDOINE DO | ||||||||
| ORTHOPAEDIC | 50.00 | $518,225 | $0 | $43,414 | Yes (X) | |||
| MORICE DENNERY MD | ||||||||
| SURGEON | 50.00 | $468,127 | $0 | $23,936 | Yes (X) | |||
| WILLIAM MARTIN MD | ||||||||
| PRIMARY CARE | 50.00 | $398,432 | $0 | $46,881 | Yes (X) | |||
| BRIAN SPONSELLER MD | ||||||||
| PRIMARY CARE | 50.00 | $373,740 | $0 | $40,999 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $4,022,658 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $1,403,862 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $526,857 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 44 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | false | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (true) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| LANGFORD & LOW INC | |||||
| PO BOX 662 | PORTLAND | ME | 04104 | BLDG CONTRACTOR | $2,610,488 |
| MAINE RECOVERY SERVICES | |||||
| 37 DOUGLAS ROAD | LIMINGTON | ME | 04049 | BILLING/CODING | $757,396 |
| INSIGHT HEALTH CORP | |||||
| PO BOX 847689 | DALLAS | TX | 752847689 | RADIOLOGY | $533,610 |
| WEATHERBY LOCUMS | |||||
| PO BOX 972633 | DALLAS | TX | 753972633 | CONT PHYS SVCS | $530,587 |
| COMPHEALTH | |||||
| PO BOX 972651 | DALLAS | TX | 75397 | CONTRACT PHYS | $448,507 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 15 | CntrctRcvdGreaterThan100KCnt |
| Related Organizations | $62,843 | RelatedOrganizationsAmt |
| Total Contributions | $62,843 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| PATIENT SERVICE REVENUE | 621110 | $70,368,378 | $70,368,378 |
| OTHER PATIENT SERVICE REVENUE | 621110 | $1,324,385 | $1,324,385 |
| CAFETERIA & PHARMACY REVENUE | 621110 | $230,565 | $230,565 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $71,923,328 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $141,094 | TotalRevenueColumnAmt |
| Exclusion | $141,094 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $179,617 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $97,158 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $82,459 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $82,459 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $82,459 | RelatedOrExemptFuncIncomeAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $15,364,075 | SecuritiesAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $14,339,945 | SecuritiesAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $1,024,130 | SecuritiesAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $1,024,130 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $1,024,130 | RelatedOrExemptFuncIncomeAmt |
Other Revenue Misc OtherRevenueMiscGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | LOSS ON REFINANCE OF DEBT | Desc |
| Business | 900099 | BusinessCd |
| Total Revenue Column | -$222,658 | TotalRevenueColumnAmt |
| Exclusion | -$222,658 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | -$222,658 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $73,011,196 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $73,029,917 | RelatedOrExemptFuncIncomeAmt |
| Exclusion | -$81,564 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,948,898 | TotalAmt |
| Program Services | $1,548,108 | ProgramServicesAmt |
| Management And General | $400,790 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $27,782,518 | TotalAmt |
| Program Services | $25,980,530 | ProgramServicesAmt |
| Management And General | $1,718,407 | ManagementAndGeneralAmt |
| Fundraising | $83,581 | FundraisingAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,385,327 | TotalAmt |
| Program Services | $5,051,228 | ProgramServicesAmt |
| Management And General | $334,099 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,866,989 | TotalAmt |
| Program Services | $1,745,646 | ProgramServicesAmt |
| Management And General | $115,461 | ManagementAndGeneralAmt |
| Fundraising | $5,882 | FundraisingAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $99,607 | TotalAmt |
| Management And General | $99,607 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $74,415 | TotalAmt |
| Management And General | $74,415 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $8,584,135 | TotalAmt |
| Program Services | $8,087,142 | ProgramServicesAmt |
| Management And General | $496,993 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $260,089 | TotalAmt |
| Program Services | $229,053 | ProgramServicesAmt |
| Management And General | $15,150 | ManagementAndGeneralAmt |
| Fundraising | $15,886 | FundraisingAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,548,889 | TotalAmt |
| Program Services | $1,441,597 | ProgramServicesAmt |
| Management And General | $95,350 | ManagementAndGeneralAmt |
| Fundraising | $11,942 | FundraisingAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,270,361 | TotalAmt |
| Program Services | $1,191,549 | ProgramServicesAmt |
| Management And General | $78,812 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $123,334 | TotalAmt |
| Program Services | $115,411 | ProgramServicesAmt |
| Management And General | $7,633 | ManagementAndGeneralAmt |
| Fundraising | $290 | FundraisingAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $861,769 | TotalAmt |
| Program Services | $808,306 | ProgramServicesAmt |
| Management And General | $53,463 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,392,197 | TotalAmt |
| Program Services | $4,392,197 | ProgramServicesAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $750,861 | TotalAmt |
| Program Services | $704,279 | ProgramServicesAmt |
| Management And General | $46,582 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt | FundraisingFundraisingAmt |
|---|---|---|---|---|
| MEDICAL SUPPLIES | $9,072,508 | $9,072,508 | ||
| MEDICAID TAX | $2,721,099 | $2,552,285 | $168,814 | |
| MMC INTEGRATED SERVICES | $2,176,658 | $2,176,658 | ||
| OTHER | $1,988,031 | $1,861,224 | $123,106 | $3,701 |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $70,907,685 | TotalAmt |
| Program Services | $64,781,063 | ProgramServicesAmt |
| Management And General | $6,005,340 | ManagementAndGeneralAmt |
| Fundraising | $121,282 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,340,650 | BOYAmt |
| EOY | $11,241,472 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $11,947,966 | BOYAmt |
| EOY | $6,801,081 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,292,542 | BOYAmt |
| EOY | $11,250,506 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,639,702 | BOYAmt |
| EOY | $2,106,130 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $399,477 | BOYAmt |
| EOY | $526,890 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $86,739,649 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $52,635,730 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $37,223,218 | BOYAmt |
| EOY | $34,103,919 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,457,955 | BOYAmt |
| EOY | $11,752,954 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,171,547 | BOYAmt |
| EOY | $1,997,562 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $76,473,057 | BOYAmt |
| EOY | $79,780,514 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,541,166 | BOYAmt |
| EOY | $4,357,350 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $208,856 | BOYAmt |
| EOY | $282,725 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $17,061,350 | BOYAmt |
| EOY | $14,868,811 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,821,911 | BOYAmt |
| EOY | $1,711,498 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $12,740,587 | BOYAmt |
| EOY | $15,568,236 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $36,373,870 | BOYAmt |
| EOY | $36,788,620 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $40,099,187 | BOYAmt |
| EOY | $42,991,894 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $40,099,187 | BOYAmt |
| EOY | $42,991,894 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $76,473,057 | BOYAmt |
| EOY | $79,780,514 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $2,103,511 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $654,657 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | $134,539 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | false | AccountantCompileOrReviewInd |
| FS Audited | Yes (true) | 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 (true) | AuditCommitteeInd |
| Federal Grant Audit Required | false | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | false | VolunteersInd |
| Paid Staff Or Management | false | PaidStaffOrManagementInd |
| Media Advertisements | false | MediaAdvertisementsInd |
| Mailings Members | false | MailingsMembersInd |
| Publications Or Broadcast | false | PublicationsOrBroadcastInd |
| Grants Other Organizations | false | GrantsOtherOrganizationsInd |
| Direct Contact Legislators | false | DirectContactLegislatorsInd |
| Rallies Demonstrations | false | RalliesDemonstrationsInd |
| Other Activities | Yes (true) | OtherActivitiesInd |
| Other Activities | $13,536 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $13,536 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | false | NotDescribedSection501c3Ind |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE C, PART II-B, LINE 1 | FormAndLineReferenceDesc |
| Explanation | THE ORGANIZATION PAYS DUES TO THE NEW HAMPSHIRE HOSPITAL ASSOCIATION AND THE AMERICAN HOSPITAL ASSOCIATION, A PORTION OF WHICH IS ATTRIBUTABLE TO LOBBYING EXPENSES. | ExplanationTxt |
Schedule D IRS990ScheduleD
CY Endwmt Fund CYEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $12,273,762 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | -$329,178 | InvestmentEarningsOrLossesAmt |
| End Year Balance | $11,944,584 | EndYearBalanceAmt |
CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $11,560,341 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $713,421 | InvestmentEarningsOrLossesAmt |
| End Year Balance | $12,273,762 | EndYearBalanceAmt |
CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $12,849,408 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | -$1,289,067 | InvestmentEarningsOrLossesAmt |
| End Year Balance | $11,560,341 | EndYearBalanceAmt |
CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $12,735,234 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $114,174 | InvestmentEarningsOrLossesAmt |
| End Year Balance | $12,849,408 | EndYearBalanceAmt |
CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $7,872,190 | BeginningYearBalanceAmt |
| Contributions | $4,466,317 | ContributionsAmt |
| Investment Earnings Or Losses | $396,727 | InvestmentEarningsOrLossesAmt |
| End Year Balance | $12,735,234 | EndYearBalanceAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Designated Balance EOY | 1.00000 | BoardDesignatedBalanceEOYPct |
| Endowments Held Unrelated Org | false | EndowmentsHeldUnrelatedOrgInd |
| Endowments Held Related Org | Yes (true) | EndowmentsHeldRelatedOrgInd |
| Related Org List Sch R | Yes (true) | RelatedOrgListSchRInd |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $4,545,066 | OtherCostOrOtherBasisAmt |
| Book Value | $4,545,066 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $53,918,298 | OtherCostOrOtherBasisAmt |
| Depreciation | $31,035,903 | DepreciationAmt |
| Book Value | $22,882,395 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $27,965,937 | OtherCostOrOtherBasisAmt |
| Depreciation | $21,599,827 | DepreciationAmt |
| Book Value | $6,366,110 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $310,348 | OtherCostOrOtherBasisAmt |
| Book Value | $310,348 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $34,103,919 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (4 entries)
| DescDesc | AmtAmt |
|---|---|
| ESTIMATED THIRD PARTY SETTLEMENTS | $13,277,525 |
| DUE TO AFFILIATES | $1,467,866 |
| PROFESSIONAL INSURANCE PAYABLE | $804,353 |
| OTHER LIABILITIES | $18,492 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $15,568,236 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| SCHEDULE D, PAGE 2, PART V, LINE 4 | THE ENDOWED FUNDS SUPPORT COMMUNITY HEALTH INITIATIVES FOR THE MEMORIAL HOSPITAL SERVICE AREA AND PATIENTS, AND PROVIDE SUPPORT FOR PROGRAMS SUCH AS DIABETES TREATMENT, BED REPLACEMENT FOR THE MERRIMAN HOUSE AND THE MEDICAL/SURGICAL WING, AND TO PURCHASE NEW WHEELCHAIRS. OTHER FUNDS ARE DEDICATED TO THE GENERAL OPERATIONS OF THE HOSPITAL SUCH AS ONCOLOGY AND CARDIAC REHABILITATION. |
| SCHEDULE D, PAGE 3, PART X | THE HOSPITAL AND ITS SUBSIDIARY ARE NOT-FOR-PROFIT CORPORATIONS AND HAVE BEEN RECOGNIZED AS TAX-EXEMPT PURSUANT TO SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. TAX-EXEMPT ORGANIZATIONS COULD BE REQUIRED TO RECORD AN OBLIGATION FOR INCOME TAXES AS THE RESULT OF A TAX POSITION THEY HAVE HISTORICALLY TAKEN ON VARIOUS TAX EXPOSURE ITEMS INCLUDING UNRELATED BUSINESS INCOME OR TAX STATUS. UNDER GUIDANCE ISSUED BY THE FINANCIAL ACCOUNTING STANDARDS BOARD (FASB), ASSETS AND LIABILITIES ARE ESTABLISHED FOR UNCERTAIN TAX POSITIONS TAKEN OR POSITIONS EXPECTED TO BE TAKEN IN INCOME TAX RETURNS WHEN SUCH POSITIONS ARE JUDGED NOT TO MEET THE "MORE-LIKELY-THAN-NOT" THRESHOLD, BASED UPON THE TECHNICAL MERITS OF THE POSITION. ESTIMATED INTEREST AND PENALTIES, IF APPLICABLE, RELATED TO UNCERTAIN TAX POSITIONS ARE INCLUDED AS A COMPONENT OF INCOME TAX EXPENSE. THE HOSPITAL HAS EVALUATED THE POSITION TAKEN ON ITS FILED TAX RETURNS. THE HOSPITAL HAS CONCLUDED NO UNCERTAIN INCOME TAX POSITIONS EXIST AT SEPTEMBER 30, 2017. THE HOSPITAL'S TAX YEARS FROM 2014 THROUGH 2017 MAY BE SUBJECT TO EXAMINATION. |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (true) | FinancialAssistancePolicyInd |
| Written Policy | Yes (true) | WrittenPolicyInd |
| FPG Reference Free Care | Yes (true) | FPGReferenceFreeCareInd |
| Percent200 | Yes (X) | Percent200Ind |
| FPG Reference Discounted Care | Yes (true) | FPGReferenceDiscountedCareInd |
| Percent300 | Yes (X) | Percent300Ind |
| Free Care Medically Indigent | Yes (true) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (true) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | false | ExpensesExceedBudgetInd |
| Annual Community Bnft Report | Yes (true) | AnnualCommunityBnftReportInd |
| Report Publically Available | Yes (true) | ReportPublicallyAvailableInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $663,284 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $663,284 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00940 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $13,814,427 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $14,093,699 | DirectOffsettingRevenueAmt |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $14,477,711 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $14,093,699 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $663,284 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00940 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $387,698 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $387,698 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00550 | TotalExpensePct |
Subsidized Health Services SubsidizedHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $4,398,092 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $759,792 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $3,638,300 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.05130 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $4,785,790 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $759,792 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $4,025,998 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.05680 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $19,263,501 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $14,853,491 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $4,689,282 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.06610 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | false | BadDebtExpenseReportedInd |
| Bad Debt Expense | $3,109,503 | BadDebtExpenseAmt |
| Reimbursed By Medicare | $25,031,912 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $24,784,071 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | $247,841 | MedicareSurplusOrShortfallAmt |
| Written Debt Collection Policy | Yes (true) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (true) | 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 | MEMORIAL HOSPITAL | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 3073 WHITE MOUNTAIN HIGHWAY | AddressLine1Txt |
| City | NORTH CONWAY | CityNm |
| State Abbreviation | NH | StateAbbreviationCd |
| ZIP | 03860 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | WWW.MEMORIALHOSPITALNH.ORG | WebsiteAddressTxt |
| State License | 00009 | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Critical Access Hospital | Yes (X) | CriticalAccessHospitalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MEMORIAL HOSPITAL | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| First Licensed CY Or PY | false | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | false | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | Yes (true) | 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 |
| Other | Yes (X) | OtherInd |
| CHNA Conducted | 16 | CHNAConductedYr |
| Take Into Account Others Input | Yes (true) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | Yes (true) | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | false | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (true) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | SEE PART V, SECTION C | OwnWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Implementation Strategy Adopt | Yes (true) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 16 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (true) | StrategyPostedWebsiteInd |
| Strategy Website URL | SEE PART V, SECTION C | StrategyWebsiteURLTxt |
| Organization Incur Excise Tax | false | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (true) | EligCriteriaExplainedInd |
| FPG Family Incm Lmt Free Dscnt | Yes (X) | FPGFamilyIncmLmtFreeDscntInd |
| FPG Family Incm Lmt Free Care | 200.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 300.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| Asset Level Criteria | Yes (X) | AssetLevelCriteriaInd |
| Insurance Status Criteria | Yes (X) | InsuranceStatusCriteriaInd |
| Explained Basis | Yes (true) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (true) | AppFinancialAsstExplnInd |
| Described Info | Yes (X) | DescribedInfoInd |
| Described Suprt Doc | Yes (X) | DescribedSuprtDocInd |
| Provided Hospital Contact | Yes (X) | ProvidedHospitalContactInd |
| Includes Publicity Measures | Yes (true) | IncludesPublicityMeasuresInd |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | REFER TO SECTION C | FAPSummaryOnWebsiteURLTxt |
| FAP Avlbl On Request No Charge | Yes (X) | FAPAvlblOnRequestNoChargeInd |
| FAP App Avlbl On Request No Chrg | Yes (X) | FAPAppAvlblOnRequestNoChrgInd |
| Communtity Notified FAP | Yes (X) | CommuntityNotifiedFAPInd |
| FAP Translated | Yes (X) | FAPTranslatedInd |
| FAP Actions On Nonpayment | Yes (true) | FAPActionsOnNonpaymentInd |
| Permit No Actions | Yes (X) | PermitNoActionsInd |
| Collection Activities | false | CollectionActivitiesInd |
| Nondis Emergency Care Policy | Yes (true) | NondisEmergencyCarePolicyInd |
| Look Back Medicare | Yes (X) | LookBackMedicareInd |
| Amounts Generally Billed | false | AmountsGenerallyBilledInd |
| Gross Charges | false | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FACILITY 1, MEMORIAL HOSPITAL - PART V, LINE 5 | THE PLANNING COMMITTEE INCLUDED TWO REPRESENTATIVES FROM POPULATION HEALTH AT MEMORIAL HOSPITAL AND ONE REPRESENTATIVE FROM MAINEHEALTH. ADDITIONAL UNRELATED MEMBERS OF THE COMMITTEE INCLUDED REPRESENTATIVES FROM THE FOLLOWING ENGAGED ORGANIZATIONS: -WHITE MOUNTAIN COMMUNITY HEALTH CENTER: PRIMARY CARE SERVICES AND HEALTH EDUCATION REGARDLESS OF ABILITY TO PAY -NORTHERN HUMAN SERVICES: MENTAL HEALTH CARE AND INDIVIDUALIZED SERVICES FOR DEVELOPMENTALLY DISABLED OR SUBSTANCE ABUSE COUNSELING -T MURRAY WELLNESS CENTER: DIET, EXERCISE, NUTRITION, AND TREATMENT SERVICES -CARROLL COUNTY COALITION FOR PUBLIC HEALTH -VISITING NURSE HOME CARE & HOSPICE OF CARROLL COUNTY & WESTERN MAINE: PERSONAL CARE, SKILLED NURSING, REHABILITATION, AND PALLIATIVE CARE AND HOSPICE SERVICES. -MINERAL SPRINGS: LONG-TERM CARE, ASSISTED LIVING, AND REHABILITATION CENTER THE PLANNING COMMITTEE HELD A FORUM REPRESENTING THE FOLLOWING SECTORS: PUBLIC HEALTH, HEALTHCARE PROVIDERS, LOCAL/STATE GOVERNMENT, MEDICALLY UNDERSERVED, COMMUNITY HEALTH COALITION, NON-PROFIT AGENCIES, LOW INCOME, BUSINESS/CIVIC LEADERSHIP, COLLEGE/UNIVERSITY, PROFESSIONAL MEMBER ORGS, MINORITIES (RACIAL/ETHNIC), AND PUBLIC SCHOOLS. A NUMBER OF ADDITIONAL ENGAGEMENT ACTIVITIES WERE HELD IN SMALLER GROUPS. IN ADDITION TO THE ABOVE, AN ONLINE STAKEHOLDER SURVEY WAS DISSEMINATED TO CAPTURE OPINIONS OF HEALTH PROFESSIONALS AND COMMUNITY STAKEHOLDERS ON HEALTH ISSUES AND NEEDS OF COMMUNITIES ACROSS THE STATE. |
| FACILITY 1, MEMORIAL HOSPITAL - PART V, LINE 6A | THE CHNA WAS CONDUCTED THROUGH A PARTNERSHIP BETWEEN MEMORIAL HOSPITAL, MAINEHEALTH AND MEMBERS OF COMMUNITY HEALTH COLLABORATIVE. |
| FACILITY 1, MEMORIAL HOSPITAL - PART V, LINE 7D | THE CHNA AND IMPLEMENTATION STRATEGY ARE POSTED ON THE FOLLOWING WEBSITE: HTTPS://MAINEHEALTH.ORG/HEALTHY-COMMUNITIES/COMMUNITY-HEALTH-NEEDS- ASSESSMENT |
| FACILITY 1, MEMORIAL HOSPITAL - PART V, 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 COMMUNITY HEALTH NEEDS ASSESSMENT AND ANNUAL IMPLEMENTATION REPORT UPDATE FY17 AT HTTPS://MAINEHEALTH.ORG/HEALTHY-COMMUNITIES/COMMUNITY-HEALTH-NEEDS- ASSESSMENT FOR DETAILS OF THE ACTIVITIES UNDERTAKEN BY THE ORGANIZATION. |
| FACILITY 1, MEMORIAL HOSPITAL - PART V, LINE 16J | A PLAIN LANGUAGE SUMMARY IS PROVIDED AT THE FOLLOWING LOCATION: HTTP://MAINEHEALTH.ORG/MEMORIAL-HOSPITAL/PATIENTS-VISITORS/FINANCIAL- ASSISTANCE |
Supplemental Information Detail SupplementalInformationDetail (11 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 7 - COSTING METHODOLOGY EXPLANATION | A COST REPORTING SYSTEM WAS USED TO CALCULATE THE AMOUNTS REPORTED IN THE TABLE. THE COST ACCOUNTING SYSTEM ADDRESSES ALL PATIENT SEGMENTS. A COST-TO-CHARGE RATIO WAS USED. |
| PART III, LINE 2 - BAD DEBT EXPENSE METHODOLOGY | SEE PART III, LINE 4 - BAD DEBT EXPENSE FOOTNOTE TO FINANCIAL STATEMENTS |
| BAD DEBT EXPENSE FOOTNOTE TO FINANCIAL STATEMENTS | MEMORIAL HOSPITAL DOES NOT HAVE A SPECIFIC FOOTNOTE IN THE FINANCIAL STATEMENTS THAT DESCRIBES "BAD DEBT EXPENSE." HOWEVER, REFERENCE IS MADE WITHIN THE FOOTNOTES TO A BAD DEBT POLICY IN A COUPLE OF INSTANCES. WITHIN THE FOOTNOTE DESCRIBING "NET PATIENT SERVICE REVENUE", THE FOLLOWING EXPLAINS THE PROVISION FOR BAD DEBTS: "IN EVALUATING THE COLLECTABILITY OF ACCOUNTS RECEIVABLE, THE HOSPITAL ANALYZES PAST RESULTS AND IDENTIFIES TRENDS FOR EACH MAJOR PAYOR SOURCE OF REVENUE TO ESTIMATE THE APPROPRIATE ALLOWANCE FOR DOUBTFUL ACCOUNTS AND PROVISION FOR BAD DEBTS. MANAGEMENT REGULARLY REVIEWS DATA ABOUT THESE MAJOR PAYOR SOURCES IN EVALUATING THE SUFFICIENCY OF THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. FOR RECEIVABLES ASSOCIATED WITH SELF-PAY PATIENTS (WHICH INCLUDES BOTH PATIENTS WITHOUT INSURANCE AND PATIENTS WITH DEDUCTIBLE AND COPAYMENT BALANCES DUE FOR WHICH THIRD-PARTY COVERAGE EXISTS FOR PART OF THE BILL), THE HOSPITAL RECORDS A PROVISION FOR BAD DEBTS IN THE PERIOD OF SERVICE BASED ON PAST EXPERIENCE, WHICH INDICATES THAT MANY PATIENTS ARE UNABLE OR UNWILLING TO PAY AMOUNTS FOR WHICH THEY ARE FINANCIALLY RESPONSIBLE. THE DIFFERENCE BETWEEN THE STANDARD RATES (OR THE DISCOUNTED RATES IF NEGOTIATED OR ELIGIBLE) AND THE AMOUNTS ACTUALLY COLLECTED AFTER ALL REASONABLE EFFORTS HAVE BEEN EXHAUSTED IS CHARGED AGAINST THE ALLOWANCE FOR DOUBTFUL ACCOUNTS." THE AMOUNT OF EXPENSE ASSOCIATED WITH THE PROVISION OF SERVICES, ULTIMATELY WRITTEN OFF AS BAD DEBT AT MEMORIAL, HAS BEEN CALCULATED AT 5,546,467 FOR THE CURRENT FISCAL YEAR. THIS AMOUNT WAS CALCULATED USING A COST TO CHARGE RATIO. BAD DEBT EXPENSE REPRESENTS HEALTHCARE SERVICES MEMORIAL HAS PROVIDED WITHOUT COMPENSATION. AS A TAX-EXEMPT ORGANIZATION, MEMORIAL PROVIDES NECESSARY PATIENT CARE REGARDLESS OF THE PATIENT'S ABILITY TO PAY FOR THE SERVICES. MEMORIAL CANNOT DETERMINE THE AMOUNT OF BAD DEBT EXPENSE THAT COULD BE REASONABLY ATTRIBUTABLE TO PATIENTS WHO LIKELY WOULD QUALIFY FOR 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, MEMORIAL BELIEVES THAT BAD DEBT EXPENSE SHOULD BE INCLUDED AS A COMMUNITY BENEFIT. |
| PART III, LINE 9B - COLLECTION PRACTICES EXPLANATION | WITH THE EXCEPTION OF INSURANCE COVERAGE THE COLLECTION ACTIVITY SHALL NOT BE INITIATED OR PURSUED FOR ANY AMOUNT APPROVED UNDER THE MEMORIAL HOSPITAL HEALTHCARE ASSISTANCE PROGRAM. |
| PART VI, LINE 2 - NEEDS ASSESSMENT | 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 - PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE | MEMORIAL HOSPITAL'S POLICY OF CHARITY CARE AND FINANCIAL ASSISTANCE IS EASILY UNDERSTOOD, PROMINENTLY POSTED, AND PUBLICLY AVAILABLE. A PROCESS EXISTS FOR OFFERING CHARITY CARE OR FINANCIAL ASSISTANCE TO PATIENTS WHO ARE UNABLE TO PAY AFTER THEY HAVE ALREADY BEEN BILLED. IN ADDITION TO MONITORING COLLECTION PRACTICES, COPIES OF THE CHARITY CARE POLICY ARE MADE AVAILABLE TO PATIENTS AT ALL ENTRY POINTS (REGISTRATION, ED, ETC.) AND WITH BILL/COLLECTION NOTICES. MEMORIAL HOSPITAL USES SIMPLE APPLICATION PROCEDURES FOR CHARITY CARE OR FINANCIAL ASSISTANCE THAT DO NOT INTIMIDATE OR CONFUSE APPLICANTS. MEMORIAL HOSPITAL'S EMPLOYEES WHO WORK IN ADMISSIONS, BILLING, ACCOUNTS RECEIVABLE, OR PATIENT SERVICES ARE FULLY INFORMED AND EDUCATED ABOUT ALL FINANCIAL ASSISTANCE POLICIES. THESE STAFF MEMBERS IDENTIFY UNPAID BILLS WHERE PERSONS ARE UNABLE TO PAY, AND SEPARATE THESE POTENTIAL "CHARITY CARE" BILLS FROM OTHER BAD DEBT ACCOUNTS. MEMORIAL HOSPITAL PROVIDES ASSISTANCE, ON A SLIDING PERCENTAGE BASIS, FOR THOSE INDIVIDUALS THAT QUALIFY WITH AN INCOME UP TO 300% OF THE FEDERAL POVERTY GUIDELINES. ON A CASE-BY-CASE BASIS, WE HAVE ALSO GRANTED ASSISTANCE TO INDIVIDUALS THAT MAY EARN ABOVE THE 175% OF THE FEDERAL POVERTY GUIDELINES BUT HAVE MET THE CATASTROPHIC ILLNESS PARAMETERS. |
| PART VI, LINE 4 - COMMUNITY INFORMATION | THE COMMUNITY HEALTH NEEDS ASSESSMENT DESCRIBES THE GEOGRAPHIC AREA AND DEMOGRAPHIC CONSTITUENTS IT SERVICES. SEE HTTPS://MAINEHEALTH.ORG/HEALTHY-COMMUNITIES/COMMUNITY-HEALTH-NEEDS- ASSESSMENT FOR THE COMPLETED CHNA. |
| 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: -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, LONG-TERM CARE 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 ARE DISTRIBUTED TO OUR PARENT, MAINEHEALTH, FOR THE SPECIFIC PURPOSE OF HEALTH STATUS IMPROVEMENT PROGRAMS THROUGHOUT THE MAINEHEALTH SERVICE AREA. |
| PART VI, LINE 6 - AFFILIATED HEALTH CARE SYSTEM | 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, MAINE PHYSICIAN HOSPITAL ORGANIZATION, NORDX, SYNERNET AND MAINEHEALTH ACCOUNTABLE CARE ORGANIZATION. THE STRATEGIC AFFILIATES OF MAINEHEALTH ARE MAINEGENERAL MEDICAL CENTER, MID COAST HOSPITAL AND ST. MARYS REGIONAL MEDICAL CENTER. |
| PART VI, LINE 7 - STATE FILING OF COMMUNITY BENEFIT REPORT | NEW HAMPSHIRE |
| ADDITIONAL INFORMATION | PART I, LINE 3C - CHARITY CARE LEVELS ARE DETERMINED BY A THREE PRONG TEST FOR ELIGIBILITY. INCOME LEVEL, CASH IN BANK, AND ASSETS ARE ALL EXAMINED TO DETERMINE LEVEL OF ELIGIBILITY. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | false | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | false | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | false | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | false | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | false | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | false | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | false | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | false | AnyNonFixedPaymentsInd |
| Initial Contract Exception | false | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (13 entries)
| TitleTitleTxt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|
| WILLIAM CARON | |||||||||||
| MH CEO | $841,603 | $228,000 | $105,369 | $141,114 | $19,748 | $1,335,834 | |||||
| SCOTT MCKINNON | |||||||||||
| PRESIDENT/CEO | $299,223 | $51,000 | $7,950 | $16,973 | $375,146 | ||||||
| JAMES GLAZER MD FACSM | |||||||||||
| BOARD MEMBER | $349,860 | $7,950 | $16,582 | $374,392 | |||||||
| MARNI MADNICK MD | |||||||||||
| MEDICAL STAFF PRES | $337,094 | $7,950 | $37,222 | $382,266 | |||||||
| RAYMOND RABIDEAU MD | |||||||||||
| CMO | $280,871 | $25,275 | $7,950 | $16,907 | $331,003 | ||||||
| MARY VIGEANT | |||||||||||
| NURSE PRACTITIONER | $203,164 | $5,538 | $9,066 | $217,768 | |||||||
| JOHN COX | |||||||||||
| REGIONAL CFO | $197,868 | $31,022 | $13,490 | $16,293 | $258,673 | ||||||
| ETHNEE GARNER | |||||||||||
| VP OF NURSING | $162,425 | $5,133 | $16,562 | $184,120 | |||||||
| DOUGLAS TAYLOR MD | |||||||||||
| ORTHOPAEDIC SURGEON | $555,222 | $7,950 | $17,249 | $580,421 | |||||||
| JOHN IDOINE DO | |||||||||||
| ORTHOPAEDIC SURGEON | $518,225 | $7,950 | $35,464 | $561,639 | |||||||
| MORICE DENNERY MD | |||||||||||
| SURGEON | $301,901 | $166,226 | $7,950 | $15,986 | $492,063 | ||||||
| WILLIAM MARTIN MD | |||||||||||
| PRIMARY CARE MD | $388,363 | $10,069 | $7,950 | $38,931 | $445,313 | ||||||
| BRIAN SPONSELLER MD | |||||||||||
| PRIMARY CARE MD | $373,740 | $7,950 | $33,049 | $414,739 | |||||||
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE J, PAGE 1, PART I, LINE 3 | FormAndLineReferenceDesc |
| Explanation | SEE DESCRIPTION OF PROCESS IN SCHEDULE O - FORM 990, PART VI, LINE 15A - COMPENSATION OF TOP OFFICIAL. | ExplanationTxt |
Schedule K IRS990ScheduleK
Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
Issuer Name IssuerName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | NH HEALTH AND EDUC FACILITIES AUTH | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Issuer EIN | 020279866 | BondIssuerEIN |
| CUSIP | 644614QC6 | CUSIPNum |
| Bond Issued | 2016-12-22 | BondIssuedDt |
| Issue Price | $14,875,000 | IssuePriceAmt |
| Purpose | REFUNDING ISSUE | PurposeDesc |
| Defeased | false | DefeasedInd |
| On Behalf Of Issuer | false | OnBehalfOfIssuerInd |
| Pool Financing | false | PoolFinancingInd |
Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Retired | $430,000 | RetiredAmt |
| Total Proceeds | $14,875,000 | TotalProceedsAmt |
| Issuance Costs From Proceeds | $479,284 | IssuanceCostsFromProceedsAmt |
| Credit Enhancement | $920,685 | CreditEnhancementAmt |
| Other Spent Proceeds | $15,316,401 | OtherSpentProceedsAmt |
| Substantial Completion | 2016 | SubstantialCompletionYr |
| Current Refunding | Yes (true) | CurrentRefundingInd |
| Advance Refunding | false | AdvanceRefundingInd |
| Final Allocation Made | Yes (true) | FinalAllocationMadeInd |
| Adequate Books And Rec Maint | Yes (true) | AdequateBooksAndRecMaintInd |
Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Owning Bond Financed Property | false | OwningBondFinancedPropertyInd |
| Any Lease Arrangements | false | AnyLeaseArrangementsInd |
| Mgmt Contract Bond Fincd Prop | false | MgmtContractBondFincdPropInd |
| Any Research Agreements | false | AnyResearchAgreementsInd |
| Bond Iss Meet Prvt Sec Pymt Test | false | BondIssMeetPrvtSecPymtTestInd |
| Change In Use Bond Financed Prop | false | ChangeInUseBondFinancedPropInd |
| Procs Nonqualified Bond Remdtd | false | ProcsNonqualifiedBondRemdtdInd |
Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Form8038 T Filed | false | Form8038TFiledInd |
| Rebate Not Due Yet | Yes (true) | RebateNotDueYetInd |
| Exception To Rebate | false | ExceptionToRebateInd |
| No Rebate Due | false | NoRebateDueInd |
| Variable Rate Issue | false | VariableRateIssueInd |
| Hedge Identified In Bks And Rec | false | HedgeIdentifiedInBksAndRecInd |
| Gross Proceeds Invested In GIC | false | GrossProceedsInvestedInGICInd |
| Gross Proceeds Invested | false | GrossProceedsInvestedInd |
| Written Proc To Monitor Reqs | false | WrittenProcToMonitorReqsInd |
Procedures Corrective Action ProceduresCorrectiveActionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Procedures Corrective Action | false | ProceduresCorrectiveActionInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE K - ADDITIONAL INFORMATION | FormAndLineReferenceDesc |
| Explanation | NH HEALTH AND EDUC FACILITIES AUTH A TAX EXEMPT BOND POLICY WAS ENDORSED BY THE MAINEHEALTH FINANCE COUNCIL IN JULY 2018. THIS POLICY IS EXPECTED TO BE ADOPTED BY ALL INDIVIDUAL MEMBER ORGANIZATIONS BEFORE 9/30/18. | ExplanationTxt |
Schedule L IRS990ScheduleL
Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp
Name Of Interested NameOfInterested
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | PAMELA RABIDEAU | PersonNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Relationship Description | SPOUSE | RelationshipDescriptionTxt |
| Transaction | $13,299 | TransactionAmt |
| Transaction | PAYROLL COMPENSATION | TransactionDesc |
| Sharing Of Revenues | false | SharingOfRevenuesInd |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (10 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PAGE 6, PART VI, LINE 6 | THE SOLE MEMBER OF THE ORGANIZATION IS MAINEHEALTH (EIN 01-0431680). |
| FORM 990, PAGE 6, PART VI, LINE 7A | THE SOLE MEMBER OF THE ORGANIZATION ELECTS THE TRUSTEES OF THE ORGANIZATION |
| FORM 990, PAGE 6, PART VI, LINE 7B | DECISIONS OF THE GOVENING BODY SUCH AS BUDGETS, BUSINESS AND MARKETING STRATEGIC PLANS, SIGNIFICANT FINANCIAL COMMITMENTS, AMENDMENTS TO THE ARTICLES OF INCORPORATION , AND ELECTION OF THE PRESIDENT/CEO AMONG OTHER DECISIONS, ARE SUBJECT TO APPROVAL BY MAINEHEALTH (EIN 01-0431680). |
| FORM 990, PAGE 6, PART VI, LINE 11B | HIGHLIGHTS OF THE 990 ARE REVIEWED WITH THE GOVERNANCE COMMITTEE OF THE BOARD OF DIRECTORS. THE 990 IS REVIEWED IN DETAIL BY THE SENIOR DIRECTOR OF FINANCE AND MADE AVAILABLE TO THE FULL BOARD OF DIRECTORS PRIOR TO FILING. |
| FORM 990, PAGE 6, PART VI, LINE 12C | CONFLICT OF INTEREST DECLARATION FORMS ARE SUBMITTED IN JANUARY BY MEMBERS OF THE BOARD OF TRUSTEES AND ARE SHARED WITH THE FULL BOARD FOR INFORMATION PURPOSES AND REVIEWED IN DEPTH BY THE GOVERNANCE COMMITTEE. IT IS THE MEMBER'S RESPONSIBILITY TO NOTIFY THE BOARD OF ANY CONFLICTS THAT THEY BECOME AWARE OF AND TO RECUSE THEMSELVES FROM DISCUSSIONS AND VOTES ON THE ISSUE. |
| FORM 990, PAGE 6, PART VI, LINE 15A | THE PROCESS FOLLOWED FOR DETERMINING COMPENSATION OF THE CEO AND OTHER KEY ADMINISTRATIVE EMPLOYEES 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 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. |
| FORM 990, PAGE 6, PART VI, LINE 15B | AT THE TIME OF HIRE THE COMPENSATION DEPARTMENT UTILIZES MARKET DATA TO PROVIDE 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, PAGE 6, PART VI, LINE 19 | DOCUMENTS THAT ARE REQUIRED TO BE OPEN FOR PUBLIC INSPECTION ARE MADE AVAILABLE UPON REQUEST. |
| FORM 990, PART IX, LINE 11G | PURCHASED SERVICES 3,460,132 228,860 0 CONTRACT SERVICES 3,949,923 261,256 0 LAB SERVICES 529,136 0 0 CONSULTANTS 103,968 6,877 0 PHYSICIAN RECRUITMENT 43,983 0 0 TOTAL 8,087,142 496,993 0 |
| FORM 990, PART XI, LINE 9 | TRANSFER FROM MAINEHEALTH 134,539 |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (13 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 | Business Name Line2DirectControllingEntityName/BusinessNameLine2Txt | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|---|---|
| MEMORIAL HOSPITAL FOUNDATION | |||||||||||
| 3073 WHITE MOUNTAIN HIGHWAY | NORTH CONWAY | NH | 03860 | 462137291 | FUNDRAISIN | NH | 501C3 | 12A | 02-0222156 | 02-0222156 | Yes (true) |
| MAINEHEALTH | |||||||||||
| 110 FREE STREET | PORTLAND | ME | 04101 | 010431680 | HEALTHCARE | ME | 501C3 | 12C | NA | false | |
| MAINE MEDICAL CENTER | |||||||||||
| 22 BRAMHALL STREET | PORTLAND | ME | 04102 | 010238552 | HOSPITAL | ME | 501C3 | 3 | 01-0431680 | false | |
| NORDX | |||||||||||
| 301A US ROUTE ONE | SCARBOROUGH | ME | 04074 | 010511356 | LAB | ME | 501C3 | 10 | 01-0431680 | false | |
| LINCOLNHEALTH GROUP | |||||||||||
| 6 ST ANDREWS LANE | BOOTHBAY HARBOR | ME | 04538 | 261475629 | HEALTHCARE | ME | 501C3 | 12B | 01-0431680 | false | |
| MAINEHEALTH CARE AT HOME | |||||||||||
| 15 INDUSTRIAL PARK | SACO | ME | 04072 | 222571902 | HOME HLTH | ME | 501C3 | 10 | 01-0431680 | false | |
| MAINEHEALTH CARDIOLOGY | |||||||||||
| 110 FREE STREET | PORTLAND | ME | 04101 | 452525629 | HEALTHCARE | ME | 501C3 | 10 | 01-0431680 | false | |
| MAINE BEHAVIORAL HEALTHCARE | |||||||||||
| 78 ATLANTIC PLACE | SOUTH PORTLAND | ME | 04106 | 010524834 | HOSPITAL | ME | 501C3 | 3 | 01-0431680 | false | |
| SOUTHERN MAINE HEALTH CARE | |||||||||||
| PO BOX 626 | BIDDEFORD | ME | 04005 | 010179500 | HOSPITAL | ME | 501C3 | 3 | 01-0431680 | false | |
| WESTERN MAINE HEALTH CARE CORP | |||||||||||
| 181 MAIN ST | NORWAY | ME | 04268 | 010411788 | HEALTHCARE | ME | 501C3 | 12B | 01-0431680 | false | |
| FRANKLIN COMMUNITY HEALTH NETWORK | |||||||||||
| 111 FRANKLIN COMMONS | FARMINGTON | ME | 04938 | 223209406 | HEALTHCARE | ME | 501C3 | 12B | 01-0431680 | false | |
| GERIATRIC RESOURCE NETWORK | |||||||||||
| 110 FREE STREET | PORTLAND | ME | 04101 | 010542842 | HEALTHCARE | ME | 501C3 | 7 | 01-0431680 | false | |
| COASTAL HEALTHCARE ALLIANCE | |||||||||||
| 4 WHITE STREET | ROCKLAND | ME | 04841 | 222494475 | HEALTHCARE | ME | 501C3 | 12B | 01-0431680 | false | |
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp
Related Organization Name RelatedOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MAINEHEALTH ACO | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 110 FREE STREET | AddressLine1Txt |
| City | PORTLAND | CityNm |
| State Abbreviation | ME | StateAbbreviationCd |
| ZIP | 04101 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 452929273 | EIN |
| Primary Activities | ACO | PrimaryActivitiesTxt |
| Legal Domicile State | ME | LegalDomicileStateCd |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | 01-0238552 | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Predominant Income Type | RELATED | PredominantIncomeTypeTxt |
| Share Of Total Income | $10,815 | ShareOfTotalIncomeAmt |
| Share Of EOY Assets | $275,068 | ShareOfEOYAssetsAmt |
| Disproportionate Allocations | false | DisproportionateAllocationsInd |
| General Or Managing Partner | false | GeneralOrManagingPartnerInd |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (2 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Direct Controlling NADirectControllingNACd | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|
| SYNERNET INC | ||||||||
| 110 FREE STREET | PORTLAND | ME | 04101 | 010539789 | ADMIN SVCS | ME | N/A | false |
| MAINE PHYSICIAN HOSPITAL ORG | ||||||||
| 110 FREE STREET | PORTLAND | ME | 04101 | 010527540 | HEALTHCARE | ME | N/A | false |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | false | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | false | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | Yes (true) | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | false | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | false | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | false | DivRelatedOrganizationInd |
| Asset Sale To Other Org | false | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | false | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | false | AssetExchangeInd |
| Rental Of Facilities To Oth Org | false | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | false | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | false | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | false | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | false | SharingOfFacilitiesInd |
| Paid Employees Sharing | false | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | false | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | false | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | false | TransferToOtherOrgInd |
| Transfer From Other Org | false | TransferFromOtherOrgInd |