STRATEGY STUDIO / NONPROFIT PEOPLE SEARCH

ST JOSEPH AMBULATORY CARE INC: Form 990, tax year 2015

View the entire original 990 at ProPublica ↗

Organization
ST JOSEPH AMBULATORY CARE INC (EIN 22-2480373)
Tax period
2015-01-01 to 2015-12-31
Filed
2016-08-09
IRS object ID
201632229349300618
Schema version
2015v2.1
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 ReturnHeader

FieldValueIRS element (for citing)
Return2016-08-09T07:59:23-05:00ReturnTs
Tax Period End2015-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN010494526PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1Baker Newman & NoyesBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1PO Box 507AddressLine1Txt
CityPortlandCityNm
State AbbreviationMEStateAbbreviationCd
ZIP04112ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2015-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN222480373EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1St Joseph Ambulatory Care IncBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlSTJOBusinessNameControlTxt
Phone2072621000PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1360 Broadway PO Box 403AddressLine1Txt
CityBangorCityNm
State AbbreviationMEStateAbbreviationCd
ZIP044020403ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonMary PrybyloPersonNm
Person TitlePresident & CEOPersonTitleTxt
Phone2072621000PhoneNum
Signature2016-08-04SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonNicholas E PortoPreparerPersonNm
PTINP01310283PTIN
Phone2078792100PhoneNum
Preparation2016-08-04PreparationDt
FieldValueIRS element (for citing)
Tax2015TaxYr
Build TS2016-12-15 16:53:06ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerMary PrybyloPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1360 Broadway PO Box 403AddressLine1Txt
CityBangorCityNm
State AbbreviationMEStateAbbreviationCd
ZIP044020403ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$11,171,596GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressN/AWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1983FormationYr
Legal Domicile StateMELegalDomicileStateCd
Activity Or MissionVarious physician practicesActivityOrMissionDesc
Voting Members Governing Body18VotingMembersGoverningBodyCnt
Voting Members Independent16VotingMembersIndependentCnt
Total Employee243TotalEmployeeCnt
Total Volunteers0TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$0PYContributionsGrantsAmt
CY Contributions Grants$0CYContributionsGrantsAmt
PY Program Service Revenue$13,517,294PYProgramServiceRevenueAmt
CY Program Service Revenue$10,923,042CYProgramServiceRevenueAmt
PY Investment Income$17,348PYInvestmentIncomeAmt
CY Investment Income$17,352CYInvestmentIncomeAmt
PY Other Revenue$0PYOtherRevenueAmt
CY Other Revenue$0CYOtherRevenueAmt
PY Total Revenue$13,534,642PYTotalRevenueAmt
CY Total Revenue$10,940,394CYTotalRevenueAmt
PY Grants And Similar Paid$0PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$17,464,778PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$12,553,053CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$4,573,604PYOtherExpensesAmt
CY Other Expenses$4,222,624CYOtherExpensesAmt
PY Total Expenses$22,038,382PYTotalExpensesAmt
CY Total Expenses$16,775,677CYTotalExpensesAmt
PY Revenues Less Expenses-$8,503,740PYRevenuesLessExpensesAmt
CY Revenues Less Expenses-$5,835,283CYRevenuesLessExpensesAmt
Total Assets BOY$2,811,942TotalAssetsBOYAmt
Total Assets EOY$1,401,747TotalAssetsEOYAmt
Total Liabilities BOY$3,132,887TotalLiabilitiesBOYAmt
Total Liabilities EOY$2,409,016TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY-$320,945NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY-$1,007,269NetAssetsOrFundBalancesEOYAmt
MissionVarious physician practicesMissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$15,569,348ExpenseAmt
Revenue$10,923,042RevenueAmt
DescSt. Joseph's Ambulatory Care, Inc. provides ambulatory care, clinics and clinical advisory services in the vicinity of Bangor, Maine.Desc
Total Program Service Expenses$15,569,348TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B Required0ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying Activities0LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Temp Or Permanent Endowments0TempOrPermanentEndowmentsInd
Report Land Building EquipmentYes (1)ReportLandBuildingEquipmentInd
Report Investments Other SecYes (1)ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other Assets0ReportOtherAssetsInd
Report Other Liabilities0ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (1)IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt0IndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (1)ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising Activities0FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate Hospital0OperateHospitalInd
Grants To Organizations0GrantsToOrganizationsInd
Grants To Individuals0GrantsToIndividualsInd
Schedule J RequiredYes (1)ScheduleJRequiredInd
Tax Exempt Bonds0TaxExemptBondsInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam Mem0BusinessRlnWithFamMemInd
Business Rln With Officer Ent0BusinessRlnWithOfficerEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded Entity0DisregardedEntityInd
Related EntityYes (1)RelatedEntityInd
Related Organization Ctrl Ent0RelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd OrgYes (1)TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document20IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (1)BackupWthldComplianceInd
Employee243EmployeeCnt
Employment Tax Returns FiledYes (1)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit0UnrelatedBusIncmOverLimitInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo Contributions0QuidProQuoContributionsInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct0RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct0PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services0IndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members18GoverningBodyVotingMembersCnt
Independent Voting Member16IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or StockholdersYes (1)MembersOrStockholdersInd
Election Of Board MembersYes (1)ElectionOfBoardMembersInd
Decisions Subject To ApprovaYes (1)DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn BodyYes (1)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (1)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (1)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (1)WhistleblowerPolicyInd
Document Retention PolicyYes (1)DocumentRetentionPolicyInd
Compensation Process CEOYes (1)CompensationProcessCEOInd
Compensation Process OtherYes (1)CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
Other WebsiteYes (X)OtherWebsiteInd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Michael HendrixBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone2079071200PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1360 Broadway PO Box 403AddressLine1Txt
CityBangorCityNm
State AbbreviationMEStateAbbreviationCd
ZIP044020403ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (23 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtOfficerOfficerIndHighest Compensated EmployeeHighestCompensatedEmployeeInd
Robert Clark
Trustee0.100.40Yes (X)$0$0$0
Joseph Cyr
Trustee0.100.40Yes (X)$0$0$0
L William Demaso
Trustee0.100.40Yes (X)$0$0$0
Glenn Goodwin
Trustee0.100.40Yes (X)$0$0$0
Ned Jennings
Trustee0.100.40Yes (X)$0$0$0
Bernard LaBree
Trustee0.100.40Yes (X)$0$0$0
Sister Nancy Marie CSSF
Trustee0.100.40Yes (X)$0$0$0
Noelle Merrill
Trustee0.100.40Yes (X)$0$0$0
Sheila Pechinski
Trustee0.100.40Yes (X)$0$0$0
Patricia Quirk
Trustee0.100.40Yes (X)$0$0$0
Adrien Roy
Trustee0.100.40Yes (X)$0$0$0
Bradley Ryder
Trustee0.100.40Yes (X)$0$0$0
Cynthia Self MD
Trustee0.100.40Yes (X)$0$0$0
Michael Starks MD
Trustee0.100.40Yes (X)$0$0$0
William Lucy
President0.100.40Yes (X)$0$0$0Yes (X)
Gen Nelson Durgin
Vice President0.100.40Yes (X)$0$0$0Yes (X)
Mary Prybylo Ex Officio
President/CEO0.1040.00Yes (X)$0$354,199$26,681Yes (X)
Michael Hendrix
Treasurer/VP Finance0.1040.00Yes (X)$0$186,573$26,624Yes (X)
Angeli Chopra MD
Physician40.00$394,282$0$9,173Yes (X)
Vrinda Sardana MD
Physician40.00$353,337$0$11,249Yes (X)
Kshitij Kakar MD
Physician40.00$340,569$0$9,173Yes (X)
Prafull Raheja MD
Physician40.00$212,224$0$149Yes (X)
Jalal Mukhtar MD
Physician40.00$227,189$0$15,038Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$1,527,601TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$540,772TotReportableCompRltdOrgAmt
Total Other Compensation$98,087TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K29IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (3 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
Spectrum Medical Group
20 Mussey Road Suite 2ScarboroughME04074Physician services$323,454
Integra Health
PO Box 1124HoldenME04429Physician services$279,554
Penobscot Respiratory
417 State StreetBangorME04401Physician services$231,550
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K3CntrctRcvdGreaterThan100KCnt

Program Service Revenue ProgramServiceRevenueGrp (3 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
Patient services621990$7,067,759$7,067,759
Non-patient services621990$2,699,645$2,699,645
Affiliated income621990$1,155,638$1,155,638
FieldValueIRS element (for citing)
Total Program Service Revenue$10,923,042TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$14,579TotalRevenueColumnAmt
Exclusion$14,579ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Other$233,975OtherAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Other$231,202OtherAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Other$2,773OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$2,773TotalRevenueColumnAmt
Exclusion$2,773ExclusionAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$10,940,394TotalRevenueColumnAmt
Related Or Exempt Func Income$10,923,042RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$17,352ExclusionAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$10,630,502TotalAmt
Program Services$9,907,628ProgramServicesAmt
Management And General$722,874ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$42,004TotalAmt
Program Services$39,148ProgramServicesAmt
Management And General$2,856ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$1,223,650TotalAmt
Program Services$1,140,442ProgramServicesAmt
Management And General$83,208ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$656,897TotalAmt
Program Services$612,228ProgramServicesAmt
Management And General$44,669ManagementAndGeneralAmt

Fees For Services Management FeesForServicesManagementGrp

FieldValueIRS element (for citing)
Total$550,695TotalAmt
Program Services$513,248ProgramServicesAmt
Management And General$37,447ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$98,880TotalAmt
Management And General$98,880ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$1,084,756TotalAmt
Program Services$1,010,993ProgramServicesAmt
Management And General$73,763ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$511,050TotalAmt
Program Services$476,299ProgramServicesAmt
Management And General$34,751ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$615,128TotalAmt
Program Services$573,299ProgramServicesAmt
Management And General$41,829ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$11,964TotalAmt
Program Services$11,150ProgramServicesAmt
Management And General$814ManagementAndGeneralAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$118,737TotalAmt
Program Services$110,663ProgramServicesAmt
Management And General$8,074ManagementAndGeneralAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$40,000TotalAmt
Program Services$37,280ProgramServicesAmt
Management And General$2,720ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$167,897TotalAmt
Program Services$156,480ProgramServicesAmt
Management And General$11,417ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$282,796TotalAmt
Program Services$263,566ProgramServicesAmt
Management And General$19,230ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (2 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
Provision for bad debt$390,766$390,766
Maintenance and repairs$187,703$174,939$12,764

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$162,252TotalAmt
Program Services$151,219ProgramServicesAmt
Management And General$11,033ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$16,775,677TotalAmt
Program Services$15,569,348ProgramServicesAmt
Management And General$1,206,329ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$100,659BOYAmt
EOY$14,893EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$1,359,614BOYAmt
EOY$445,399EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$122,343BOYAmt
EOY$51,614EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$744,041LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$559,185LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$526,685BOYAmt
EOY$184,856EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$697,085BOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

FieldValueIRS element (for citing)
EOY$704,985EOYAmt

Intangible Assets IntangibleAssetsGrp

FieldValueIRS element (for citing)
BOY$5,556BOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$2,811,942BOYAmt
EOY$1,401,747EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$1,132,887BOYAmt
EOY$409,016EOYAmt

Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp

FieldValueIRS element (for citing)
BOY$2,000,000BOYAmt
EOY$2,000,000EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$3,132,887BOYAmt
EOY$2,409,016EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY-$320,945BOYAmt
EOY-$1,007,269EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY-$320,945BOYAmt
EOY-$1,007,269EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$2,811,942BOYAmt
EOY$1,401,747EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss-$5,835,283ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst-$9,360NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets$5,158,319OtherChangesInNetAssetsAmt
Info In Schedule O Part XIIYes (X)InfoInScheduleOPartXIIInd
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Consolidated Basis Fincl StmtYes (X)ConsolidatedBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (1)AuditCommitteeInd
Federal Grant Audit Required0FederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Supporting Organization509a3Yes (X)SupportingOrganization509a3Ind
Supporting Org Type2Yes (X)SupportingOrgType2Ind
Supported Organizations1SupportedOrganizationsCnt

Supported Org Information SupportedOrgInformationGrp

Supported Organization Name SupportedOrganizationName

FieldValueIRS element (for citing)
Business Name Line1St Joseph HospitalBusinessNameLine1Txt
FieldValueIRS element (for citing)
EIN010212435EIN
Organization Type3OrganizationTypeCd
Governing Document Listed0GoverningDocumentListedInd
Support$0SupportAmt
Other Support$0OtherSupportAmt
FieldValueIRS element (for citing)
Supported Organizations Total1SupportedOrganizationsTotalCnt
Support Sum$0SupportSumAmt
Other Support Sum$0OtherSupportSumAmt

Form990 Sch A Supporting Org Form990SchASupportingOrgGrp

FieldValueIRS element (for citing)
Listed By Name Governing Doc0ListedByNameGoverningDocInd
Suprt Org No IRS Determination0SuprtOrgNoIRSDeterminationInd
Supported Org Section C4560SupportedOrgSectionC456Ind
Supported Org Not Organized US0SupportedOrgNotOrganizedUSInd
Organization Change Suprt Org0OrganizationChangeSuprtOrgInd
Support Non Supported Org0SupportNonSupportedOrgInd
Payment Substantial Contribtr0PaymentSubstantialContribtrInd
Loan Disqualified Person0LoanDisqualifiedPersonInd
Controlled Disqualified Prsn0ControlledDisqualifiedPrsnInd
Disqualified Prsn Controll Int0DisqualifiedPrsnControllIntInd
Disqualified Prsn Ownr Int0DisqualifiedPrsnOwnrIntInd
Excess Business Holdings Rules0ExcessBusinessHoldingsRulesInd
Contribution Controller0ContributionControllerInd
Contribution Family0ContributionFamilyInd
Contribution35 Controlled0Contribution35ControlledInd
FieldValueIRS element (for citing)
Majority Dir Trst Supported OrgYes (1)MajorityDirTrstSupportedOrgInd

Form990 Schedule A Part VI Form990ScheduleAPartVIGrp (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Schedule A, Part I, Line 11g:St. Joseph Ambulatory Care, Inc. supports its affiliated tax-exempt organization by providing ambulatory health care services through the operation of physician practices in the Bangor, Maine area. The monetary value of this can be approximated by the total amount of the Organization's expenses due to the fact that but for St. Joseph Ambulatory Care, Inc. these functions would be otherwise performed by the Hospital.
Part IV, Section A, Line 1:Both the filing organization, St. Joseph Ambulatory Care, Inc. (ACI), and its supported organization, St. Joseph Hospital (the Hospital), have as their sole member St. Joseph Healthcare Foundation. The Board of Trustees for St. Joseph Healthcare Foundation, in its entirety, also serves as the Board of Trustees for St. Joseph Ambulatory Care, Inc. and St. Joseph Hospital. Through its relationship with its common parent, ACI has been designated in its role to provide support to the Hospital. Since its inception in 1983, ACI and the Hospital have maintained a close and continuous working relationship by working in conjunction to meet the health care needs of the Bangor, Maine area. ACI supports the Hospital by providing ambulatory care services through the operation of various physician practices in the area that if not for ACI would otherwise be facilitated by the Hospital.

Schedule D IRS990ScheduleD

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$744,041OtherCostOrOtherBasisAmt
Depreciation$559,185DepreciationAmt
Book Value$184,856BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$184,856TotalBookValueLandBuildingsAmt

Other Securities OtherSecuritiesGrp

FieldValueIRS element (for citing)
DescProvidentia PrimaDesc
Book Value$704,985BookValueAmt
Method ValuationFMethodValuationCd
FieldValueIRS element (for citing)
Total Book Value Securities$704,985TotalBookValueSecuritiesAmt
Footnote TextYes (X)FootnoteTextInd
Total Rev Etc Audited Fincl Stmt$10,931,034TotalRevEtcAuditedFinclStmtAmt
Net Unrealized Gains Invst-$9,360NetUnrealizedGainsInvstAmt
Revenue Not Reported-$9,360RevenueNotReportedAmt
Revenue Subtotal$10,940,394RevenueSubtotalAmt
Revenue Not Reported Fincl Stmt$0RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990$10,940,394TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$16,775,677TotExpnsEtcAuditedFinclStmtAmt
Expenses Not Reported$0ExpensesNotReportedAmt
Expenses Subtotal$16,775,677ExpensesSubtotalAmt
Expenses Not Rpt Fincl Stmt$0ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990$16,775,677TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePart X, Line 2:FormAndLineReferenceDesc
ExplanationCovenant and its member organizations (except for entities as noted following) are considered not-for-profit corporations as described in Section 501(c)(3) of the Internal Revenue Code and are exempt from federal income taxes on related income pursuant to Section 501(a) of the Code, except as noted below. St. Joseph Hospital Corporate Services, Inc., a wholly-owned subsidiary of Nashua, is a for-profit organization, which is subject to federal and state income taxes. St. Joseph Hospital Corporate Services, Inc. has net operating loss (NOL) carryforwards for tax purposes. The NOLs are not anticipated to be utilized so the amounts have been fully offset with a reserve. CHSIL, a wholly-owned subsidiary, is subject to taxation in the Cayman Islands. No income taxes are levied in the Cayman Islands and CHSIL has been granted an exemption for any taxes that might be introduced. Accordingly, no provision for income taxes has been made in the accompanying financial statements. 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, 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 to not 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 System has evaluated the position taken on its filed tax returns. The System has concluded no uncertain income tax positions exist at December 31, 2015. Under Internal Revenue Service regulations, the System's tax years from 2012 through 2015 are open and subject to examination.ExplanationTxt

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Severance Payment0SeverancePaymentInd
Supplemental Nonqual Rtr Plan0SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm0EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org0CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs0CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org0CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs0CompBsdNetEarnsRltdOrgsInd
Any Non Fixed PaymentsYes (1)AnyNonFixedPaymentsInd
Initial Contract Exception0InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (7 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
Mary Prybylo Ex Officio
President/CEO$0$354,199$0$0$0$0$0$0$0$26,681$0$380,880$0$0
Michael Hendrix
Treasurer/VP Finance$0$186,573$0$0$0$0$0$0$0$26,624$0$213,197$0$0
Angeli Chopra MD
Physician$394,282$0$0$0$0$0$0$0$9,173$0$403,455$0$0$0
Vrinda Sardana MD
Physician$353,337$0$0$0$0$0$0$0$11,249$0$364,586$0$0$0
Kshitij Kakar MD
Physician$249,272$0$91,297$0$0$0$0$0$9,173$0$349,742$0$0$0
Prafull Raheja MD
Physician$212,224$0$0$0$0$0$0$0$149$0$212,373$0$0$0
Jalal Mukhtar MD
Physician$227,189$0$0$0$0$0$0$0$15,038$0$242,227$0$0$0

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Part I, Line 3The CEO/Executive Director of St. Joseph Ambulatory Care, Inc. is an employee of St. Joseph Hospital, a related organization, and Ambulatory Care, Inc. does not maintain any procedures to establish her compensation. However, the Hospital uses a compensation committee, compensation survey/study, and approval by their Board and compensation committee.
Part I, Line 7Various physician employees of the Organization received an incentive bonus in 2015. The payment of these bonuses are discretionary and is subject to meeting the pre-determined goals of the Organization.

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (9 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Form 990, Part VI, Section A, line 6St. Joseph Healthcare Foundation, a Maine nonprofit corporation, shall be the sole member of St. Joseph Ambulatory Care, Inc.
Form 990, Part VI, Section A, line 7aThe Member of St. Joseph Ambulatory Care, Inc. shall elect the trustees of the Organization and may remove them with or without cause.
Form 990, Part VI, Section A, line 7bSt. Joseph Healthcare Foundation, the Member of St. Joseph Ambulatory Care, Inc. (the Organization), shall have the following powers and rights, as outlined in its articles of incorporation and bylaws: (a) To approve any change in the written statements of philosophy and mission of the Organization or any subsidiary of the Organization, and to monitor compliance with same; (b) To amend and to repeal the articles of incorporation and the bylaws of the Organization, and to approve the adoption, amendment or repeal of the governing instruments of any subsidiary of the Organization; (c) To elect the Trustees of the Organization and to remove them with or without cause; (d) To appoint and remove the President of the Organization, including a President secured by management contract; (e) To ratify the Board of Trustees' election of the Chairperson of the Board of Trustees; (f) To approve all plans of merger, consolidation, reorganization or dissolution of the Organization or any subsidiary of the Organization, or the sale, lease, assignment or transfer of substantially all of the assets of the Organization or any subsidiary of the Organization, or the purchase or acquisition by the Organization or any subsidiary of the Organization of an interest in any corporation, partnership, joint venture or other entity, whether newly created or previously existing, which interest, in the case of a for profit entity, represents 25 percent or more of the voting power thereof or equity interest therein, or, in the case of a nonprofit entity, represents 25 percent or more of the voting power thereof or membership interest therein; (g) To approve all Board-approved long-range strategic plans of the Organization before their implementation; (h) To approve the acquisition, sale or encumbrance by the Organization or any subsidiary of the Organization of any real estate valued in excess of the amount set by the Member in writing from time to time; (i) To approve all Board approved capital budgets of the Organization and non-budgeted expenses which are in excess of the amount set by the Member in writing from time to time, and to approve the Organization's operating budget in accordance with policies set by the Member in writing from time to time; (j) To approve all debt of the Organization, not part of the approved budget, in excess of limits set by the Member in writing from time to time before such debt is incurred; (k) To appoint the auditors of the Organization and any subsidiary of the Organization; (l) To approve the sale, assignment or transfer by the Organization or any subsidiary of the Organization of any equity interest or membership interest in any subsidiary of the Organization; (m) To approve any reclassification or other change of any capital stock or other equity security of any subsidiary of the Organization, or any recapitalization of any subsidiary of the Organization; and (n) To approve the issuance of, or the creation of any obligation to issue, any equity security of any subsidiary of the Organization, or any increase or decrease in the total number of shares of authorized capital stock or other equity security of any subsidiary of the Organization.
Form 990, Part VI, Section B, line 11There is a formal presentation of the 990 to the Finance Committee and copies are provided to all Board members.
Form 990, Part VI, Section B, line 12cEach Board member is required to complete a form disclosing any conflict of interest. When these conflicts are known, any Board member with a conflict of interest is asked to leave the meeting or abstain from voting or both.
Form 990, Part VI, Section B, line 15St. Joseph Ambulatory Care, Inc. does not compensate its officers or top management officials and thus does not administer a review/determination process for those positions. However, through compensation surveys/studies and employment contracts, compensation is determined for the Organization's CEO, officers, and top management officials by the compensation committee of St. Joseph Hospital, a related organization, and approved by the Hospital's Board.
Form 990, Part VI, Section C, line 19The Organization makes its governing documents, conflict of interest policy, and financial statements available to the public upon each individual request. Forms 990 and 990-T are also available on the website of Covenant Health, Inc., a related organization (www.covenanthealth.net).
Form 990, Part XI, line 9:Transfer from affiliate 5,158,319.
Form 990, Part XII, line 2c:The audit process has not changed from the prior year.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (5 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtControlled OrganizationControlledOrganizationIndDirect Controlling NADirectControllingNACd
St Joseph Healthcare Foundation
360 BroadwayBangorME044020403222480149Diversified holistic health care servicesME501(c)(3)Line 7Covenant Health Inc0
St Joseph Hospital
360 BroadwayBangorME044020403010212435Community hospitalME501(c)(3)Line 3St Joseph Healthcare Foundation0
M & J Company
360 BroadwayBangorME044020403222480150Real estate holding companyME501(c)(2)St Joseph Healthcare Foundation0
Alternative Health Services
360 BroadwayBangorME044020403010422885Home health agencyME501(c)(3)Line 3St Joseph Healthcare Foundation0
Covenant Health Inc
100 Ames Pond DriveTewksburyMA01876222484505Sponsoring and operating a health care systemMA501(c)(3)Line 90N/A

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp

Related Organization Name RelatedOrganizationName

FieldValueIRS element (for citing)
Business Name Line1Strauss IncBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1360 BroadwayAddressLine1Txt
CityBangorCityNm
State AbbreviationMEStateAbbreviationCd
ZIP044020403ZIPCd
FieldValueIRS element (for citing)
EIN010391369EIN
Primary ActivitiesMedical transcriptionPrimaryActivitiesTxt
Legal Domicile StateMELegalDomicileStateCd
Direct Controlling NAN/ADirectControllingNACd
Entity TypeCEntityTypeTxt
Controlled Organization0ControlledOrganizationInd
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts Rylts0ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org0GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth Org0GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org0LoansOrGuaranteesFromOthOrgInd
Div Related Organization0DivRelatedOrganizationInd
Asset Sale To Other Org0AssetSaleToOtherOrgInd
Asset Purchase From Other Org0AssetPurchaseFromOtherOrgInd
Asset ExchangeYes (1)AssetExchangeInd
Rental Of Facilities To Oth Org0RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth OrgYes (1)RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth OrgYes (1)PerformOfServicesForOthOrgInd
Perform Of Services By Other OrgYes (1)PerformOfServicesByOtherOrgInd
Sharing Of Facilities0SharingOfFacilitiesInd
Paid Employees Sharing0PaidEmployeesSharingInd
Reimbursement Paid To Other OrgYes (1)ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other OrgYes (1)ReimbursementPaidByOtherOrgInd
Transfer To Other Org0TransferToOtherOrgInd
Transfer From Other OrgYes (1)TransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp

Other Organization Name OtherOrganizationName

FieldValueIRS element (for citing)
Business Name Line1M & J CompanyBusinessNameLine1Txt
FieldValueIRS element (for citing)
Transaction TypeKTransactionTypeTxt
Involved$148,780InvolvedAmt
Method Of Amount DeterminationActual amount paidMethodOfAmountDeterminationTxt