Franklin Memorial Hospital: Form 990, tax year 2016
View the entire original 990 at ProPublica ↗
- Organization
- Franklin Memorial Hospital (EIN 01-0211503)
- Tax period
- 2016-10-01 to 2017-09-30
- Filed
- 2018-08-10
- IRS object ID
- 201832229349300318
- 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 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 | 2018-08-10T09:19:09-04:00 | 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 | 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 | 2018-08-01 | 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 | 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 | $77,519,804 | GrossReceiptsAmt |
| Group Return For Affiliates | false | 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 | 17 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 9 | VotingMembersIndependentCnt |
| Total Employee | 817 | TotalEmployeeCnt |
| Total Volunteers | 122 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| PY Contributions Grants | $252,360 | PYContributionsGrantsAmt |
| CY Contributions Grants | $1,657,842 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $75,719,828 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $75,704,281 | CYProgramServiceRevenueAmt |
| PY Investment Income | $51,395 | PYInvestmentIncomeAmt |
| CY Investment Income | $3,353 | CYInvestmentIncomeAmt |
| PY Other Revenue | $47,150 | PYOtherRevenueAmt |
| CY Other Revenue | $63,001 | CYOtherRevenueAmt |
| PY Total Revenue | $76,070,733 | PYTotalRevenueAmt |
| CY Total Revenue | $77,428,477 | CYTotalRevenueAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $46,486,808 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $49,479,534 | CYSalariesCompEmpBnftPaidAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $34,526,402 | PYOtherExpensesAmt |
| CY Other Expenses | $31,669,413 | CYOtherExpensesAmt |
| PY Total Expenses | $81,013,210 | PYTotalExpensesAmt |
| CY Total Expenses | $81,148,947 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$4,942,477 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$3,720,470 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $46,022,229 | TotalAssetsBOYAmt |
| Total Assets EOY | $45,668,255 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $29,494,297 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $27,805,114 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $16,527,932 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $17,863,141 | 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 | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $42,528,056 | ExpenseAmt |
| Revenue | $57,181,607 | RevenueAmt |
| Desc | 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, (CONTINUED AT SCHEDULE O) (CONTINUED FROM PART III, LINE 4A) DERMATOLOGY, PULMONOLOGY, PAIN MANAGEMENT, PEDIATRIC ENDOCRINOLOGY, PHYSICAL REHABILITATION, SPORTS MEDICINE AND WOUND CARE. DURING THE TWELVE MONTHS ENDING SEPTEMBER 30, 2017 THERE WERE 1,946 INPATIENT DISCHARGES, 1,734 OUTPATIENT SURGERIES, 234,442 OUTPATIENT LAB TESTS AND 40,862 OUTPATIENT IMAGING PROCEDURES. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $20,096,521 | ExpenseAmt |
| Revenue | $10,827,516 | 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, 2017 FRANKLIN MEMORIAL HOSPITAL PROVIDED 50,645 PRIMARY CARE VISITS AND 19,346 SPECIALTY CARE VISITS IN THE FRANKLIN HEALTH PHYSICIAN PRACTICES. | Desc |
Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $5,638,058 | ExpenseAmt |
| Revenue | $7,695,158 | 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, 2017 FRANKLIN MEMORIAL HOSPITAL HAD 15,664 EMERGENCY ROOM VISITS. | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expenses | $68,262,635 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (true) | 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 | Yes (true) | 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 | false | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | false | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| Info In Schedule O Part V | Yes (X) | InfoInScheduleOPartVInd |
| IRP Document | 137 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (true) | BackupWthldComplianceInd |
| Employee | 817 | 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 | 17 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 9 | 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 | ME | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | JOHN COX REGIONAL CFO | PersonNm |
| 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 (30 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 |
|---|---|---|---|---|---|---|---|---|---|
| CHRISTINE TROPEANO | |||||||||
| 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 | |||
| EVERETT O'NEILL | |||||||||
| DIRECTOR | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |||
| HEIDI DECKER MD | |||||||||
| FRMR MED STA | 50.00 | 0.00 | Yes (X) | $237,518 | $0 | $18,217 | |||
| 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 STAF | 50.00 | 0.00 | Yes (X) | $245,317 | $0 | $18,405 | |||
| WILLIAM L CARON JR | |||||||||
| MH CEO | 1.00 | 50.00 | Yes (X) | $0 | $1,174,972 | $160,862 | |||
| 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) | $14,788 | $0 | $5,262 | Yes (X) | ||
| TIMOTHY CHURCHILL | |||||||||
| PRESIDENT/CE | 1.00 | 50.00 | Yes (X) | $0 | $421,945 | $51,756 | Yes (X) | ||
| JOHN COX | |||||||||
| REGIONAL CFO | 1.00 | 50.00 | $0 | $228,890 | $29,783 | Yes (X) | |||
| JAY NALIBOFF MD | |||||||||
| VP MED. AFFA | 50.00 | 0.00 | $237,683 | $0 | $20,665 | Yes (X) | |||
| WAYNE BENNETT | |||||||||
| FORMER CFO | 50.00 | 0.00 | $224,595 | $0 | $20,027 | Yes (X) | |||
| GERALD CAYER | |||||||||
| FRMR VP PHYS | 50.00 | 0.00 | $163,585 | $0 | $17,084 | Yes (X) | |||
| JOSHUA D SPARLING MD | |||||||||
| DERMATOLOGIS | 50.00 | 0.00 | $592,368 | $0 | $21,752 | Yes (X) | |||
| ERIC GUNTHER MD | |||||||||
| GENERAL SURG | 50.00 | 0.00 | $367,243 | $0 | $20,122 | Yes (X) | |||
| JAY NEIL MD | |||||||||
| ANESTHESIOLO | 50.00 | 0.00 | $364,940 | $0 | $13,857 | Yes (X) | |||
| JAMES LANCASTER MD | |||||||||
| ANESTHESIOLO | 50.00 | 0.00 | $364,673 | $0 | $19,949 | Yes (X) | |||
| HEATHER DECAROLIS MD | |||||||||
| ANESTHESIOLO | 50.00 | 0.00 | $358,827 | $0 | $19,950 | Yes (X) | |||
| REBECCA ARSENAULT | |||||||||
| FRMR PRES/CE | 50.00 | 0.00 | $409,937 | $0 | $4,152 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $3,581,474 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $1,825,807 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $441,843 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 65 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | Yes (true) | 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 |
|---|---|---|---|---|---|
| NORDX INC | |||||
| 301A US ROUTE ONE | SCARBOROUGH | ME | 04074 | LAB SERVICES | $3,215,857 |
| WEATHERBY LOCUMS INC | |||||
| 6440 SOUTH MILLROCK DR SUITE 175 | SALT LAKE CITY | UT | 84121 | PHYS. STAFFING | $1,616,018 |
| LOCUMTENENSCOM LLC | |||||
| 3655 NOTHWINDS PARKWAY | ALPHARETTA | GA | 30009 | PHYS. STAFFING | $496,729 |
| MAINEGENERAL MEDICAL CENTER | |||||
| 10 WATER ST SUITE 213 | WATERVILLE | ME | 04901 | PHYS. STAFFING | $482,778 |
| COMPHEALTH | |||||
| 6440 SOUTH MILLROCK DR SUITE 175 | SALT LAKE CITY | UT | 841215027 | PHYS. STAFFING | $473,823 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 11 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $185,471 | GovernmentGrantsAmt |
| All Other Contributions | $1,472,371 | AllOtherContributionsAmt |
| Total Contributions | $1,657,842 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (4 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| PATIENT SERVICES | 621990 | $73,391,700 | $73,391,700 |
| OTHER | 621990 | $1,341,601 | $1,341,601 |
| AMBULANCE SUBSIDIES | 621910 | $825,070 | $825,070 |
| CAFETERIA | 722514 | $145,910 | $145,910 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $75,704,281 | TotalProgramServiceRevenueAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $108,881 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $45,880 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $63,001 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $63,001 | TotalRevenueColumnAmt |
| Exclusion | $63,001 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $48,800 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $45,447 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $3,353 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $3,353 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $3,353 | RelatedOrExemptFuncIncomeAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $77,428,477 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $75,707,634 | RelatedOrExemptFuncIncomeAmt |
| Exclusion | $63,001 | ExclusionAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,098,238 | TotalAmt |
| Program Services | $518,053 | ProgramServicesAmt |
| Management And General | $580,185 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $39,044,511 | TotalAmt |
| Program Services | $34,899,029 | ProgramServicesAmt |
| Management And General | $4,145,482 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $430,840 | TotalAmt |
| Program Services | $385,788 | ProgramServicesAmt |
| Management And General | $45,052 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,516,083 | TotalAmt |
| Program Services | $5,797,478 | ProgramServicesAmt |
| Management And General | $718,605 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,389,862 | TotalAmt |
| Program Services | $2,111,272 | ProgramServicesAmt |
| Management And General | $278,590 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $10,633 | TotalAmt |
| Management And General | $10,633 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $104,856 | TotalAmt |
| Management And General | $104,856 | ManagementAndGeneralAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $11,604 | TotalAmt |
| Management And General | $11,604 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,963,733 | TotalAmt |
| Program Services | $3,530,381 | ProgramServicesAmt |
| Management And General | $1,433,352 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $130,162 | TotalAmt |
| Management And General | $130,162 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $838,930 | TotalAmt |
| Program Services | $571,872 | ProgramServicesAmt |
| Management And General | $267,058 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $208,094 | TotalAmt |
| Management And General | $208,094 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,809,645 | TotalAmt |
| Program Services | $1,806,540 | ProgramServicesAmt |
| Management And General | $3,105 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $109,241 | TotalAmt |
| Program Services | $99,704 | ProgramServicesAmt |
| Management And General | $9,537 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $364,696 | TotalAmt |
| Program Services | $311,819 | ProgramServicesAmt |
| Management And General | $52,877 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $799,853 | TotalAmt |
| Program Services | $706,613 | ProgramServicesAmt |
| Management And General | $93,240 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,674,003 | TotalAmt |
| Program Services | $3,245,718 | ProgramServicesAmt |
| Management And General | $428,285 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $876,489 | TotalAmt |
| Program Services | $853,088 | ProgramServicesAmt |
| Management And General | $23,401 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| AFFILIATE SERVICES | $7,769,940 | $3,666,023 | $4,103,917 |
| MEDICAL SUPPLIES | $7,266,913 | $7,266,913 | |
| HOSPITAL TAX | $1,939,192 | $1,939,192 | |
| OTHER | $791,429 | $553,152 | $238,277 |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $81,148,947 | TotalAmt |
| Program Services | $68,262,635 | ProgramServicesAmt |
| Management And General | $12,886,312 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,480 | BOYAmt |
| EOY | $3,755 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $371,796 | BOYAmt |
| EOY | $2,011,980 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,901,603 | BOYAmt |
| EOY | $8,070,663 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,574,206 | BOYAmt |
| EOY | $1,735,839 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,174,715 | BOYAmt |
| EOY | $803,060 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $90,865,490 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $64,508,711 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $28,764,907 | BOYAmt |
| EOY | $26,356,779 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,231,522 | BOYAmt |
| EOY | $6,686,179 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $46,022,229 | BOYAmt |
| EOY | $45,668,255 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,641,164 | BOYAmt |
| EOY | $5,546,777 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $270,937 | BOYAmt |
| EOY | $152,058 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $17,990,655 | BOYAmt |
| EOY | $17,180,941 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,591,541 | BOYAmt |
| EOY | $4,925,338 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $29,494,297 | BOYAmt |
| EOY | $27,805,114 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $13,608,548 | BOYAmt |
| EOY | $14,555,198 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,679,687 | BOYAmt |
| EOY | $2,149,809 | EOYAmt |
Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,239,697 | BOYAmt |
| EOY | $1,158,134 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $16,527,932 | BOYAmt |
| EOY | $17,863,141 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $46,022,229 | BOYAmt |
| EOY | $45,668,255 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | -$3,720,470 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | $5,055,679 | 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 | Yes (true) | FederalGrantAuditRequiredInd |
| Federal Grant Audit Performed | Yes (true) | FederalGrantAuditPerformedInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule 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 | $11,604 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $11,604 | 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 | DUES PAID TO THE MAINE HOSPITAL ASSOCIATION OF 39,173 AND THE AMERICAN HOSPITAL ASSOCATION OF 19,431. THE MAINE HOSPITAL ASSOCIATION AND THE AMERICAN HOSPITAL ASSOCIATION USED 20% AND 20% RESPECTIVELY OF THEIR DUES REVENUE FOR LOBBYING ACTIVITY. | ExplanationTxt |
Schedule D IRS990ScheduleD
CY Endwmt Fund CYEndwmtFundGrp
| 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 Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp
| 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 Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp
| 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 Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp
| 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 |
CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $2,604,155 | BeginningYearBalanceAmt |
| Contributions | $11,967 | ContributionsAmt |
| Investment Earnings Or Losses | $316,743 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $58,391 | OtherExpendituresAmt |
| End Year Balance | $2,874,474 | EndYearBalanceAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Prmnnt Endowment Balance EOY | 0.36000 | PrmnntEndowmentBalanceEOYPct |
| Term Endowment Balance EOY | 0.64000 | TermEndowmentBalanceEOYPct |
| 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 | $1,252,337 | OtherCostOrOtherBasisAmt |
| Book Value | $1,252,337 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $50,503,585 | OtherCostOrOtherBasisAmt |
| Depreciation | $30,158,153 | DepreciationAmt |
| Book Value | $20,345,432 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $33,571,435 | OtherCostOrOtherBasisAmt |
| Depreciation | $30,533,874 | DepreciationAmt |
| Book Value | $3,037,561 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $5,538,133 | OtherCostOrOtherBasisAmt |
| Depreciation | $3,816,684 | DepreciationAmt |
| Book Value | $1,721,449 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $26,356,779 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp (7 entries)
| DescDesc | Book ValueBookValueAmt |
|---|---|
| INTEREST IN NET ASSETS OF FCHN | $2,908,822 |
| EST. THIRD PARTY PAYOR SETTLEMENTS | $1,348,338 |
| PREPAID SEHR | $785,399 |
| PREPAID SHARED IS CAPITAL | $535,754 |
| DUE FROM AFFILIATES | $486,289 |
| OTHER ASSETS | $319,826 |
| BENEFICIAL INT. IN PERPETUAL TRUST | $301,751 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $6,686,179 | TotalBookValueOtherAssetsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (3 entries)
| DescDesc | AmtAmt |
|---|---|
| DUE TO RELATED PARTIES | $4,025,338 |
| MEDICAL MALPRACTICE TAIL LIAB. | $600,000 |
| INSURANCE CLAIM LIABILITY | $300,000 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $4,925,338 | 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 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. |
| SCHEDULE D, PAGE 3, PART X | 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 (true) | FinancialAssistancePolicyInd |
| Written Policy | Yes (true) | WrittenPolicyInd |
| FPG Reference Free Care | Yes (true) | FPGReferenceFreeCareInd |
Free Care Oth Percentage FreeCareOthPercentageGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | Yes (X) | OtherInd |
| Free Care Other | 1.750000000000 | FreeCareOtherPct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| FPG Reference Discounted Care | false | FPGReferenceDiscountedCareInd |
| 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 | $1,250,773 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $1,250,773 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01540 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $11,707,842 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $9,625,277 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $2,082,565 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.02570 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $12,958,615 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $9,625,277 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $3,333,338 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.04110 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $483,885 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $55,413 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $428,472 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00530 | TotalExpensePct |
Health Professions Education HealthProfessionsEducationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $213,993 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $103,194 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $110,799 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00140 | TotalExpensePct |
Subsidized Health Services SubsidizedHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $10,138,356 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $4,301,834 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $5,836,522 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.07190 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $21,276 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $21,276 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00030 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $10,857,510 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $4,460,441 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $6,397,069 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.07880 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $23,816,125 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $14,085,718 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $9,730,407 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.11990 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | false | BadDebtExpenseReportedInd |
| Bad Debt Expense | $2,792,035 | BadDebtExpenseAmt |
| Reimbursed By Medicare | $16,533,559 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $19,072,098 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$2,538,539 | 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 (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 | 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 LIC. 38728 | 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 | 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 |
| 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 | 175.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| Medical Indigency Criteria | Yes (X) | MedicalIndigencyCriteriaInd |
| Residency Criteria | Yes (X) | ResidencyCriteriaInd |
| 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 Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | SEE PART V, SECTION C | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | SEE PART V, SECTION C | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | SEE PART V, SECTION C | FAPSummaryOnWebsiteURLTxt |
| FAP Avlbl On Request No Charge | Yes (X) | FAPAvlblOnRequestNoChargeInd |
| FAP App Avlbl On Request No Chrg | Yes (X) | FAPAppAvlblOnRequestNoChrgInd |
| FAP Sum Avlbl On Request No Chrg | Yes (X) | FAPSumAvlblOnRequestNoChrgInd |
| Notified FAP Copy Bill Display | Yes (X) | NotifiedFAPCopyBillDisplayInd |
| Communtity Notified FAP | Yes (X) | CommuntityNotifiedFAPInd |
| FAP Actions On Nonpayment | Yes (true) | FAPActionsOnNonpaymentInd |
| Permit No Actions | Yes (X) | PermitNoActionsInd |
| Collection Activities | false | 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 (true) | NondisEmergencyCarePolicyInd |
| Look Back Medicare Private | Yes (X) | LookBackMedicarePrivateInd |
| Amounts Generally Billed | false | AmountsGenerallyBilledInd |
| Gross Charges | false | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FACILITY 1, FRANKLIN MEMORIAL HOSPITAL - PART V, LINE 5 | THE HOSPITAL CONVENED A GROUP OF PEOPLE WHO REPRESENTED THE BROAD INTERESTS OF THE COMMUNITY SERVED PRIOR TO HOLDING FORUMS. MEMBERS OF THE PLANNING COMMITTEE AND ENGAGED ORGANIZATIONS INCLUDE THE FOLLOWING: - JERRY CAYER; MPH; VP OF PHYSICIAN AND COMMUNITY SERVICES; FRANKLIN COMMUNITY HEALTH NETWORK (FCHN) - DAVID DIXON, MD; RETIRED SURGEON; FCHN - JILL GRAY; COMMUNICATIONS, MARKETING & FUND DEVELOPMENT MGR; FCHN - TRACY HARTY, RN, BSN; SENIOR PROGRAM DIRECTOR/NURSE NAVIGATOR; HEALTHY COMMUNITY COALITION (HCC) - CELINE BOURKE-KUHN, MS; PROGRAM MANAGER, COMMUNITY HEALTH IMPROVEMENT; MAINEHEALTH - JENNIFER MCCORMACK, RN, BSN, MBA; EXECUTIVE DIRECTOR; HCC - MICHELE MCCORMICK, MD; PEDIATRIC HOSPITALIST; FCHN - JAMIE PAUL; WESTERN DISTRICT PUBLIC HEALTH LIAISON; MAINE CDC - DOUG SAUNDERS; COMMUNITY COORDINATOR; FRANKLIN COUNTY CHILDREN'S TASK FORCE - JANIS WALKER; PROGRAM MANAGER; HCC |
| FACILITY 1, FRANKLIN MEMORIAL HOSPITAL - PART V, 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. |
| FACILITY 1, FRANKLIN 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, FRANKLIN 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 PLAN UPDATE FY17 AT HTTPS://MAINEHEALTH.ORG/HEALTHY-COMMUNITIES/COMMUNITY-HEALTH-NEEDS- ASSESSMENT FOR DETAILS OF THE ACTIVITIES UNDERTAKEN BY THE ORGANIZATION. |
| FACILITY 1, FRANKLIN MEMORIAL HOSPITAL - PART V, LINE 16J | THE FINANCIAL ASSISTANCE POLICY (FAP)/FREE CARE POLICY, FAP/FREE CARE APPLICATION AND THE PLAIN LANGUAGE SUMMARY ARE AVAILABLE ON THE FOLLOWING WEBSITE: HTTPS://MAINEHEALTH.ORG/PATIENTS-VISITORS/BILLING- INSURANCE/FINANCIAL-ASSISTANCE/FREE-CARE FACILITY 1, FRANKLIN MEMORIAL HOSPITAL - PART V, LINE 16I THE FAP, FAP APPLICATION AND PLAIN LANGUAGE SUMMARY WERE TRANSLATED INTO THE PRIMARY LANGUAGES SPOKEN BY LIMITED ENGLISH PROFICIENCY POPULATIONS AND MADE AVAILABLE AS OF JULY, 2018. |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 17 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp (17 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | FacilityFacilityTxt |
|---|---|---|---|---|
| FRANK HLTH LIVERMORE FALLS FAM PRAC | ||||
| 21 MAIN STREET | LIVERMORE FALLS | ME | 04254 | FAMILY PRACTICE |
| FRANKLIN HLTH FARMINGTON FAM PRACT | ||||
| 111 FRANKLIN HEALTH COMMONS | FARMINGTON | ME | 04938 | FAMILY PRACTICE |
| FRANKLIN HEALTH INTERNAL MEDICINE | ||||
| 111 FRANKLIN HEALTH COMMONS | FARMINGTON | ME | 04938 | INTERNAL MEDICINE PRACTICE |
| FRANKLIN HEALTH PEDIATRICS | ||||
| 111 FRANKLIN HEALTH COMMONS | FARMINGTON | ME | 04938 | PEDIATRICIAN PRACTICE |
| FRANKLIN HEALTH ORTHOPAEDICS | ||||
| 111 FRANKLIN HEALTH COMMONS | FARMINGTON | ME | 04938 | ORTHOPAEDIC PRACTICE |
| FRANKLIN HEALTH SURGERY | ||||
| 111 FRANKLIN HEALTH COMMONS | FARMINGTON | ME | 04938 | GENERAL SURGERY PRACTICE |
| OUTPATIENT SVCS AT LIVERMORE FALLS | ||||
| 21 MAIN STREET | LIVERMORE FALLS | ME | 04254 | OUTPATIENT CLINIC |
| NORTHSTAR | ||||
| 15 SCHOOL STREET | RANGELEY | ME | 04970 | AMBULANCE BASE |
| NORTHSTAR | ||||
| 138C PARK STREET | PHILLIPS | ME | 04966 | AMBULANCE BASE |
| NORTHSTAR | ||||
| 119 FEDERAL ROAD | LIVERMORE | ME | 04254 | AMBULANCE BASE |
| NORTHSTAR | ||||
| 1001 CARRIAGE ROAD | CARRABASSET VALLEY | ME | 04947 | AMBULANCE BASE |
| NORTHSTAR | ||||
| 111 FRANKLIN HEALTH COMMONS | FARMINGTON | ME | 04938 | AMBULANCE BASE |
| FRANKLIN HEALTH WOMEN'S CARE | ||||
| 111 FRANKLIN HEALTH COMMONS | FARMINGTON | ME | 04938 | OB/GYN |
| FRANKLIN HEALTH BEHAVIORAL SERVICES | ||||
| 131 FRANKLIN HEALTH COMMONS | FARMINGTON | ME | 04938 | BEHAVIORAL HEALTH PRACTICE |
| FRANKLIN HEALTH DERMATOLOGY | ||||
| 111 FRANKLIN HEALTH COMMONS | FARMINGTON | ME | 04938 | DERMATOLOGY PRACTICE |
| FRANKLIN HEALTH UROLOGY | ||||
| 126 MIDDLE STREET | FARMINGTON | ME | 04938 | UROLOGY PRACTICE |
| FRANKLIN HEALTH INTOWN MEDICINE | ||||
| 107 BOX SHOP HILL ROAD | FARMINGTON | ME | 04938 | INTERNAL MEDICINE PRACTICE |
Supplemental Information Detail SupplementalInformationDetail (12 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 7 - COSTING METHODOLOGY EXPLANATION | 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 III, LINE 2 - BAD DEBT EXPENSE METHODOLOGY | SEE PART III, LINE 4 - BAD DEBT EXPENSE FOOTNOTE TO THE FINANCIAL STATEMENTS. |
| BAD DEBT EXPENSE FOOTNOTE TO FINANCIAL STATEMENTS | 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. WITHIN THE FOOTNOTES DESCRIBING "PATIENT ACCOUNTS RECEIVABLE," THE FOLLOWING EXPLAINS THE PROVISION FOR BAD DEBTS: "FOR RECEIVABLES RELATING TO SELF-PAY PATIENTS, A PROVISION FOR DOUBTFUL ACCOUNTS AND CORRESPONDING ALLOWANCE FOR DOUBTFUL ACCOUNTS IS MADE IN THE PERIOD SERVICES ARE RENDERED BASED ON EXPERIENCE INDICATING THE INABILITY OR UNWILLINGNESS OF PATIENTS TO PAY AMOUNTS FOR WHICH THEY ARE FINANCIALLY RESPONSIBLE. THE HOSPITAL ESTABLISHED A DISCOUNT POLICY FOR UNINSURED PATIENTS." PRIOR TO BILLING, 100% OF THE CHARGE IS APPLIED AS A DISCOUNT FOR QUALIFYING PATIENTS. ACTUAL WRITE-OFFS ARE CHARGED AGAINST THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. PAGES 12-14 OF THE ATTACHED FINANCIAL STATEMENTS ALSO PROVIDE FOOTNOTES RELATED TO BAD DEBT EXPENSE AND BAD DEBT ALLOWANCE. |
| PART III, LINE 8 - MEDICARE EXPLANATION | 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 PRACTICES EXPLANATION | PATIENTS WHO QUALIFY FOR FINANCIAL ASSISTANCE HAVE THEIR ACCOUNT BALANCE ADJUSTED ACCORDINGLY ONCE FINANCIAL ASSISTANCE HAS BEEN APPROVED. MONTHLY PAYMENT ARRANGEMENTS CAN BE ESTABLISHED BY THE RESPONSIBLE PARTY BY CONTACTING THE PATIENT FINANCIAL SERVICES CUSTOMER SERVICE DEPARTMENT. AS A TAX-EXEMPT HOSPITAL, FRANKLIN MEMORIAL HOSPITAL PROVIDES NECESSARY PATIENT CARE REGARDLESS OF THE PATIENT'S ABILITY TO PAY FOR THE SERVICES. |
| PART VI, LINE 2 - NEEDS ASSESSMENT | THE FRANKLIN MEMORIAL HOSPITAL NETWORK CONDUCTS A HEALTH VISIONING PROCESS EVERY TWO YEARS THAT IS USED TO IDENTIFY NEEDS AND PERCEIVED PRIORITIES IN THE COMMUNITY. A PHYSICIAN SURVEY IS CONDUCTED PERIODICALLY TO ASSIST IN GATHERING INFORMATION ABOUT CLINICAL CARE NEEDS, REFERRAL PATTERNS, SPECIALIST NEEDS, ETC. THE LONG-RANGE PLANNING COMMITTEE, BOARD OF DIRECTORS AND SENIOR LEADERSHIP USE THIS AND OTHER DATA IN DEVELOPING GOALS AND PRIORITIES, MAKING DECISIONS, AND SETTING LONG-TERM GOALS AND STRATEGIES. THE ORGANIZATION SEEKS TO MEET THE NEEDS OF THE POPULATION WHENEVER FEASIBLE THROUGH DIRECT PROVISION OF SERVICES, CONTRACTUAL RELATIONSHIPS, OR THROUGH REFERRAL. |
| PART VI, LINE 3 - PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE | FINANCIAL ASSISTANCE INFORMATION IS PROVIDED IN THE ADMITTING AND EMERGENCY REGISTRATION LOCATIONS IN THE FOLLOWING MANNER: - POSTINGS INCLUDING FREE CARE AND MONTHLY PAYMENT PLAN - HANDOUTS - INTERVIEWS PATIENTS RECEIVE MAINEHEALTH'S FREE CARE GUIDELINES AND FINANCIAL POLICIES BROCHURE EXPLAINING OUR BILLING POLICIES AND CONTACT INFORMATION UPON REQUEST. IF THE PATIENT IS SELF-PAY, UNDER INSURED OR CAN'T AFFORD TO PAY THEIR HOSPITAL BILL, THEY MAY RECEIVE A FINANCIAL COUNSELING PACKET AND/OR REFERRED TO FINANCIAL COUNSELING FROM THE REGISTRATION STAFF OR CHANGE HEALTHCARE, AN OUTSIDE VENDOR WHO HELPS MANAGE THE SELF- PAY ACCOUNTS. THE PACKET INCLUDES: - INFORMATION ON MAINEHEALTH'S FINANCIAL POLICIES - FINANCIAL ASSISTANCE INFORMATION INCLUDING FREE CARE PROGRAM, MONTHLY PAYMENT PLAN PROGRAM, AND CARE PARTNERS, MEDACCESS AND OTHER COMMUNITY RESOURCE NEEDS. - PROGRAM APPLICATIONS AND INSTRUCTIONS FOR MAINEHEALTH'S FREE CARE PROGRAM, AND MONTHLY PAYMENT PLAN APPLICATION - CONTACT INFORMATION FOR ASSISTANCE WITH APPLICATIONS, BILLS OR FINANCIAL CONCERNS SELF-PAY OR UNDERINSURED PATIENTS REGISTERING IN PERSON OR VIA A PHONE INTERVIEW RECEIVE FINANCIAL COUNSELING INCLUDING INFORMATION ON OUR FINANCIAL ASSISTANCE PROGRAMS. REGISTRATION STAFF OR CHANGE HEALTHCARE PROVIDE FORMS AND ASSIST WITH COMPLETING FINANCIAL ASSISTANCE APPLICATIONS AND PROVIDING FOLLOW UP CONTACT INFORMATION. MAINEHEALTH'S WEB SITE INCLUDES ON LINE REGISTRATION AND PATIENT BILLING INFORMATION: - BILLING PROCESS - FREE CARE - MONTHLY PAYMENT PLAN - PATIENT STATEMENT - PRICE INFORMATION - CONTACT US AND QUESTIONS PRIMARY LANGUAGE, DEAF AND HARD OF HEARING AND INTERPRETER NEEDS ARE ASSESSED DURING THE REGISTRATION INTERVIEW AND SERVICES ARE PROVIDED AS NEEDED. IF A PATIENT DOES NOT RESPOND AT PRE-REGISTRATION, REGISTRATION, OR WHILE RECEIVING CARE, ALL OF THESE PROGRAMS ARE EXPLAINED AGAIN BY THE SINGLE BILLING OFFICE STAFF. THE INTENT OF THESE EFFORTS IS TO ENSURE THAT THE PATIENT IS FULLY INFORMED OF AND ABLE TO TAKE ADVANTAGE OF THESE ASSISTANCE PROGRAMS. |
| PART VI, LINE 4 - 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 | 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 - 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. MARY'S REGIONAL MEDICAL CENTER. |
| PART VI, LINE 7 - STATE FILING OF COMMUNITY BENEFIT REPORT | MAINE |
| ADDITIONAL INFORMATION | 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. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | Yes (true) | 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 (14 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| HEIDI DECKER MD | ||||||||||||
| FRMR MED STAFF PRES. | $202,094 | $34,167 | $1,257 | $2,814 | $15,403 | $255,735 | ||||||
| STEPHEN GOSS DO | ||||||||||||
| MEDICAL STAFF PRES. | $211,318 | $30,227 | $3,772 | $2,875 | $15,530 | $263,722 | ||||||
| WILLIAM L CARON JR | ||||||||||||
| MH CEO | $841,603 | $228,000 | $105,369 | $141,114 | $19,748 | $1,335,834 | ||||||
| TIMOTHY CHURCHILL | ||||||||||||
| PRESIDENT/CEO | $279,588 | $98,000 | $44,357 | $33,262 | $18,494 | $473,701 | ||||||
| JOHN COX | ||||||||||||
| REGIONAL CFO | $197,868 | $31,022 | $13,490 | $16,293 | $258,673 | |||||||
| JAY NALIBOFF MD | ||||||||||||
| VP MED. AFFAIRS | $228,663 | $9,020 | $2,523 | $18,142 | $258,348 | |||||||
| WAYNE BENNETT | ||||||||||||
| FORMER CFO | $222,224 | $2,371 | $2,482 | $17,545 | $244,622 | |||||||
| GERALD CAYER | ||||||||||||
| FRMR VP PHYS. & COMM | $161,449 | $2,136 | $1,820 | $15,264 | $180,669 | |||||||
| JOSHUA D SPARLING MD | ||||||||||||
| DERMATOLOGIST | $450,204 | $141,574 | $590 | $5,300 | $16,452 | $614,120 | ||||||
| ERIC GUNTHER MD | ||||||||||||
| GENERAL SURGEON | $348,037 | $14,000 | $5,206 | $3,956 | $16,166 | $387,365 | ||||||
| JAY NEIL MD | ||||||||||||
| ANESTHESIOLOGIST | $363,698 | $1,242 | $3,983 | $9,874 | $378,797 | |||||||
| JAMES LANCASTER MD | ||||||||||||
| ANESTHESIOLOGIST | $363,431 | $1,242 | $3,983 | $15,966 | $384,622 | |||||||
| HEATHER DECAROLIS MD | ||||||||||||
| ANESTHESIOLOGIST | $357,878 | $949 | $3,984 | $15,966 | $378,777 | |||||||
| REBECCA ARSENAULT | ||||||||||||
| FRMR PRES/CEO | $74,593 | $9,000 | $326,344 | $2,203 | $1,949 | $414,089 | ||||||
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| SCHEDULE J, PAGE 1, PART I, LINE 3 | TOP MANAGEMENT OFFICIALS ARE COMPENSATED BY THIS OR RELATED ORGANIZATIONS. THESE ORGANIZATIONS USE ONE OR MORE OF THE METHODS SHOWN ABOVE TO ESTABLISH THE COMPENSATION OF TOP MANAGEMENT. |
| SCHEDULE J, PAGE 1, PART I, LINE 4 | REBECCA ARSENAULT 254,177 0 0 |
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 ED FAC AUTH | ||||||||
| A | 010314384 | 560427NM4 | 2011-11-30 | $10,452,958 | REF. OF SERIES 2001A | false | false | Yes (true) |
| MAINE HEALTH & HIGHER ED FAC AUTH | ||||||||
| B | 010314384 | 56042REW8 | 2016-06-28 | $12,359,721 | REF. OF SERIES 2006F | false | false | Yes (true) |
Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp (2 entries)
| Bond ReferenceBondReferenceCd | RetiredRetiredAmt | Total ProceedsTotalProceedsAmt | In Reserve FundInReserveFundAmt | Issuance Costs From ProceedsIssuanceCostsFromProceedsAmt | Capital ExpendituresCapitalExpendituresAmt | Substantial CompletionSubstantialCompletionYr | Current RefundingCurrentRefundingInd | Advance RefundingAdvanceRefundingInd | Final Allocation MadeFinalAllocationMadeInd | Adequate Books And Rec MaintAdequateBooksAndRecMaintInd |
|---|---|---|---|---|---|---|---|---|---|---|
| A | $4,054,032 | $10,452,958 | $169,449 | $117,007 | $9,633,963 | 2002 | Yes (true) | false | Yes (true) | Yes (true) |
| B | $445,173 | $12,359,721 | $222,360 | $58,709 | $12,359,721 | 2016 | Yes (true) | false | Yes (true) | Yes (true) |
Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp (2 entries)
| Bond ReferenceBondReferenceCd | Owning Bond Financed PropertyOwningBondFinancedPropertyInd | Any Lease ArrangementsAnyLeaseArrangementsInd | Mgmt Contract Bond Fincd PropMgmtContractBondFincdPropInd | Any Research AgreementsAnyResearchAgreementsInd | Bond Iss Meet Prvt Sec Pymt TestBondIssMeetPrvtSecPymtTestInd | Change In Use Bond Financed PropChangeInUseBondFinancedPropInd | Procs Nonqualified Bond RemdtdProcsNonqualifiedBondRemdtdInd |
|---|---|---|---|---|---|---|---|
| A | false | false | false | false | false | false | false |
| B | false | false | false | false | false | false | false |
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 | false | false | false | Yes (true) | false | false | false | false | false |
| B | false | Yes (true) | false | false | false | false | false | false | false |
Procedures Corrective Action ProceduresCorrectiveActionGrp (2 entries)
| Bond ReferenceBondReferenceCd | Procedures Corrective ActionProceduresCorrectiveActionInd |
|---|---|
| A | false |
| B | false |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| SCHEDULE K - DATE REBATE COMPUTATION PERFORMED | MAINE HEALTH & HIGHER ED FAC. AUTH. 11/30/16 |
| SCHEDULE K - ADDITIONAL INFORMATION | MAINE HEALTH & HIGHER ED FAC. 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. |
Schedule L IRS990ScheduleL
Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp (3 entries)
| Relationship DescriptionRelationshipDescriptionTxt | TransactionTransactionAmt | TransactionTransactionDesc | Sharing Of RevenuesSharingOfRevenuesInd |
|---|---|---|---|
| STACY HERSHFELD | |||
| FAMILY MEMBER | $238,007 | EMPLOYMENT | false |
| REBECCA WOOD | |||
| FAMILY MEMBER | $133,844 | EMPLOYMENT | false |
| ADAM DIXON | |||
| FAMILY MEMBER | $44,710 | EMPLOYMENT | false |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE L, PART V | FormAndLineReferenceDesc |
| Explanation | REBECCA WOOD WAS EMPLOYEED BY FRANKLIN MEMORIAL HOSPITAL AS CHIEF NURSING OFFICER / VP OF PATIENT CARE SERVICES. 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 (12 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990 - ORGANIZATION'S 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. |
| FORM 990, PAGE 2, PART III, LINE 4A | (CONTINUED FROM PART III, LINE 4A) DERMATOLOGY, PULMONOLOGY, PAIN MANAGEMENT, PEDIATRIC ENDOCRINOLOGY, PHYSICAL REHABILITATION, SPORTS MEDICINE AND WOUND CARE. DURING THE TWELVE MONTHS ENDING SEPTEMBER 30, 2017 THERE WERE 1,946 INPATIENT DISCHARGES, 1,734 OUTPATIENT SURGERIES, 234,442 OUTPATIENT LAB TESTS AND 40,862 OUTPATIENT IMAGING PROCEDURES. |
| FORM 990, PART V | 990 PART V, LINE 2A FRANKLIN MEMORIAL HOSPITAL(EIN 01-0211503) FILED FORM W-3, REPORTING 817 EMPLOYEES FOR THE CALENDAR YEAR 2016 ON BEHALF OF THE FOLLOWING ORGANIZATIONS: FRANKLIN MEMORIAL HOSPITAL, FRANKLIN COMMUNITY HEALTH NETWORK, EVERGREEN BEHAVIORAL SERVICES, AND HEALTH COMMUNITY COALITION. |
| FORM 990, PAGE 6, PART VI, 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 FMH. |
| FORM 990, PAGE 6, PART VI, LINE 7A | MAINEHEALTH AND FRANKLIN COMMUNITY HEALTH NETWORK HAVE THE RESPONSIBILITY FOR THE ELECTION OF THE MEMBERS OF THE GOVERNING BODY. |
| FORM 990, PAGE 6, PART VI, 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 THE APPROVAL OF THE SOLE MEMBER. |
| FORM 990, PAGE 6, PART VI, LINE 11B | A COMPLETE COPY OF THE FORM 990 WAS DISTRIBUTED TO EACH MEMBER OF THE BOARD OF DIRECTORS PRIOR TO FILING WITH IRS. IN ADDITION, KEY COMPONENTS OF THE 990 WERE REVIEWED WITH THE BOARD OF DIRECTORS PRIOR TO FILING THE TAX RETURN IN A FORM OF A PRESENTATION AND A Q&A SESSION TO ADDRESS ANY QUESTIONS OR CONCERNS. |
| FORM 990, PAGE 6, PART VI, 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, PAGE 6, PART VI, LINE 15A | 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. |
| FORM 990, PAGE 6, PART VI, LINE 15B | 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 COMPENATION CONSULTING FIRM AND INDUSTRY SURVEY. |
| 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 XI, LINE 9 | CHANGE IN INTEREST OF RELATED PARTY NET ASSETS 365,742 CHANGE IN INTEREST IN PERPETUAL TRUST 18,437 NET TRANSFERS FROM AFFILIATES 4,671,500 TOTAL 5,055,679 |
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 | Address Line2USAddress/AddressLine2Txt |
|---|---|---|---|---|---|---|---|---|---|---|---|
| FRANKLIN COMMUNITY HEALTH NETWORK | |||||||||||
| 111 FRANKLIN HEALTH COMMONS | FARMINGTON | ME | 04938 | 223209406 | HEALTHCARE | ME | 501C3 | 12B | 01-0431680 | false | |
| HEALTHY COMMUNITY COALITION INC | |||||||||||
| 105 MT BLUE CIRCLE | FARMINGTON | ME | 04938 | 223305743 | COMMUNITY | ME | 501C3 | 7 | 22-3209406 | false | SUITE 1 |
| PINE TREE MEDICAL ASSOCIATES | |||||||||||
| 131 FRANKLIN HEALTH COMMONS | FARMINGTON | ME | 04938 | 010469478 | CM HTH AG | ME | 501C3 | 10 | 22-3209406 | false | |
| EVERGREEN BEHAVIORAL SERVICES | |||||||||||
| 131 FRANKLIN HEALTH COMMONS | FARMINGTON | ME | 04938 | 010492747 | MNTL HLTH | ME | 501C3 | 10 | 22-3209406 | false | |
| MAINEHEALTH | |||||||||||
| 110 FREE STREET | PORTLAND | ME | 04101 | 010431680 | HEALTHCARE | ME | 501C3 | 12C | NA | false | |
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 |
| Business Name Line2 | C/O BANK OF AMERICA NA | BusinessNameLine2Txt |
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 | PERP. TRST | PrimaryActivitiesTxt |
| Legal Domicile State | ME | LegalDomicileStateCd |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | NA | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Entity Type | TRUST | EntityTypeTxt |
| Share Of Total Income | $23,628 | ShareOfTotalIncomeAmt |
| Share Of EOY Assets | $301,751 | ShareOfEOYAssetsAmt |
| Ownership | 1.00000 | OwnershipPct |
| Controlled Organization | false | ControlledOrganizationInd |
| 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 | Yes (true) | 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 | Yes (true) | TransferToOtherOrgInd |
| Transfer From Other Org | Yes (true) | TransferFromOtherOrgInd |