NORTHERN MAINE MEDICAL CENTER: Form 990, tax year 2014
View the entire original 990 at ProPublica ↗
- Organization
- NORTHERN MAINE MEDICAL CENTER (EIN 01-0234189)
- Tax period
- 2014-10-01 to 2015-09-30
- Filed
- 2016-08-12
- IRS object ID
- 201632259349301468
- Schema version
- 2014v6.0
- 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 G
- Schedule H
- Schedule J
- Schedule L
- Schedule M
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2016-08-12T12:29:26-05:00 | ReturnTs |
| Tax Period End | 2015-09-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 010523282 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Berry Dunn McNeil & Parker LLC | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO Box 1100 | AddressLine1Txt |
| City | Portland | CityNm |
| State Abbreviation | ME | StateAbbreviationCd |
| ZIP | 041041100 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2014-10-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 010234189 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Northern Maine Medical Center | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | NORT | BusinessNameControlTxt |
| Phone | 2078343155 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 194 East Main Street | AddressLine1Txt |
| City | Fort Kent | CityNm |
| State Abbreviation | ME | StateAbbreviationCd |
| ZIP | 04743 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Cindy Daigle | PersonNm |
| Person Title | CFO | PersonTitleTxt |
| Phone | 2078343155 | PhoneNum |
| Signature | 2016-08-12 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | Barbara J McGuan CPA | PreparerPersonNm |
| PTIN | P00219457 | PTIN |
| Phone | 2077752387 | PhoneNum |
| Preparation | 2016-08-12 | PreparationDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2014 | TaxYr |
| Build TS | 2016-09-27 15:27:22Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | Peter J Sirois | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 194 East Main Street | AddressLine1Txt |
| City | Fort Kent | CityNm |
| State Abbreviation | ME | StateAbbreviationCd |
| ZIP | 04743 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $48,497,511 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | www.nmmc.org | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1948 | FormationYr |
| Legal Domicile State | ME | LegalDomicileStateCd |
| Activity Or Mission | Acute care & long term care hospital and mental health services facility. | ActivityOrMissionDesc |
| Voting Members Governing Body | 11 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 9 | VotingMembersIndependentCnt |
| Total Employee | 567 | TotalEmployeeCnt |
| Total Volunteers | 65 | TotalVolunteersCnt |
| Total Gross UBI | $8,842 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | -$10,762 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $1,493,063 | PYContributionsGrantsAmt |
| CY Contributions Grants | $267,936 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $45,079,671 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $47,112,667 | CYProgramServiceRevenueAmt |
| PY Investment Income | -$28,811 | PYInvestmentIncomeAmt |
| CY Investment Income | $203,603 | CYInvestmentIncomeAmt |
| PY Other Revenue | -$1,102,134 | PYOtherRevenueAmt |
| CY Other Revenue | $386,266 | CYOtherRevenueAmt |
| PY Total Revenue | $45,441,789 | PYTotalRevenueAmt |
| CY Total Revenue | $47,970,472 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $28,081,024 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $29,106,154 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $17,003,967 | PYOtherExpensesAmt |
| CY Other Expenses | $17,611,228 | CYOtherExpensesAmt |
| PY Total Expenses | $45,084,991 | PYTotalExpensesAmt |
| CY Total Expenses | $46,717,382 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $356,798 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $1,253,090 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $42,813,880 | TotalAssetsBOYAmt |
| Total Assets EOY | $46,534,755 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $17,399,129 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $19,885,645 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $25,414,751 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $26,649,110 | NetAssetsOrFundBalancesEOYAmt |
| Mission | The mission of Northern Maine Medical Center is to provide, coordinate, or support access to high quality, affordable health care and to positively impact our communities' quality of life by improving health status. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $41,358,101 | ExpenseAmt |
| Revenue | $47,212,078 | RevenueAmt |
| Desc | Medical care & ancillary services, nursing home & skilled services, physician services. | Desc |
| Total Program Service Expenses | $41,358,101 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (1) | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Temp Or Permanent Endowments | 0 | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | Yes (1) | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | Yes (1) | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | Yes (1) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (1) | AuditedFinancialStmtAttInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | Yes (1) | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | Yes (1) | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | Yes (1) | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | Yes (1) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | Yes (1) | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 146 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 567 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | Yes (1) | UnrelatedBusIncmOverLimitInd |
| Form990 T Filed | Yes (1) | Form990TFiledInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 11 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 9 | IndependentVotingMemberCnt |
| Family Or Business Rln | Yes (1) | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | 0 | MembersOrStockholdersInd |
| Election Of Board Members | 0 | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | 0 | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | ME | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Cindy Daigle | PersonNm |
| Phone | 2078343155 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 194 East Main Street | AddressLine1Txt |
| City | Fort Kent | CityNm |
| State Abbreviation | ME | StateAbbreviationCd |
| ZIP | 04743 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (19 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|
| Norman Fournier | ||||||||
| President | 2.00 | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| John Ezzy | ||||||||
| Vice President | 1.00 | 0.50 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| Glenn Lamarr | ||||||||
| Past Treasurer | 1.00 | 0.50 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| Mark Morneault | ||||||||
| Treasurer | 1.00 | 0.50 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| James Thibodeau | ||||||||
| Secretary | 1.00 | 0.50 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| Ronald Daigle | ||||||||
| Director | 1.00 | 0.50 | Yes (X) | $0 | $0 | $0 | ||
| Dan Vaillancourt | ||||||||
| Director | 1.00 | 0.50 | Yes (X) | $0 | $0 | $0 | ||
| Robert Bellefleur | ||||||||
| Director | 1.00 | 0.50 | Yes (X) | $0 | $0 | $0 | ||
| Mark Chamberland | ||||||||
| Director | 1.00 | 0.50 | Yes (X) | $0 | $0 | $0 | ||
| Michael Sullivan MD | ||||||||
| Director | 50.00 | 0.50 | Yes (X) | $649,732 | $0 | $29,659 | ||
| David Desjardins | ||||||||
| Director | 1.00 | 0.50 | Yes (X) | $0 | $0 | $0 | ||
| Don Guimond | ||||||||
| Director | 1.00 | 0.50 | Yes (X) | $0 | $0 | $0 | ||
| Peter J Sirois | ||||||||
| CEO | 50.00 | 1.00 | Yes (X) | $249,593 | $0 | $29,526 | ||
| Cindy L Daigle | ||||||||
| CFO | 50.00 | 1.00 | Yes (X) | $144,257 | $0 | $25,183 | ||
| Mark Overton MD | ||||||||
| Psychiatrist | 50.00 | 0.00 | $612,101 | $0 | $19,743 | Yes (X) | ||
| John Hallberg MD | ||||||||
| Orthopedic Surgeon | 50.00 | 0.00 | $490,557 | $0 | $25,622 | Yes (X) | ||
| James Harris MD | ||||||||
| Physician | 50.00 | 0.00 | $471,795 | $0 | $29,082 | Yes (X) | ||
| Baharak Bagheri MD | ||||||||
| Radiologist | 50.00 | 0.00 | $455,338 | $0 | $12,615 | Yes (X) | ||
| David Coffman MD | ||||||||
| Surgeon | 50.00 | 0.00 | $454,732 | $0 | $14,339 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $3,528,105 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $185,769 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 37 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| The Sheridan Corporation | |||||
| PO Box 359 | Fairfield | ME | 04937 | Building Contractor | $903,715 |
| Medhost of Tennessee Inc | |||||
| 2739 Momentum Place | Chicago | IL | 60689 | Software & Support Services | $462,449 |
| Quest Diagnostics | |||||
| 12436 Collections Center Drive | Chicago | IL | 60693 | Off-Site Laboratory Services | $415,894 |
| Erik St Pierre | |||||
| 194 East Main St | Fort Kent | ME | 04743 | Physician Services | $382,612 |
| Cary Medical Center | |||||
| 163 Van Buren Rd Suite 1 | Caribou | ME | 04736 | Off-Site Laboratory Services | $289,469 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 14 | CntrctRcvdGreaterThan100KCnt |
| All Other Contributions | $267,936 | AllOtherContributionsAmt |
| Noncash Contributions | $155,000 | NoncashContributionsAmt |
| Total Contributions | $267,936 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (5 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt | Unrelated Business RevenueUnrelatedBusinessRevenueAmt | ExclusionExclusionAmt |
|---|---|---|---|---|---|
| Patient Service Revenue | 623000 | $77,578,327 | $77,578,327 | ||
| Miscellaneous Revenue | 623000 | $2,080,481 | $1,945,122 | $8,842 | $126,517 |
| Meaningful Use Revenue | 623000 | $167,373 | $167,373 | ||
| Provision for Bad Debt | 623000 | -$1,571,529 | -$1,571,529 | ||
| Contractual/Char. Adj. | 623000 | -$31,141,985 | -$31,141,985 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $47,112,667 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $40,582 | TotalRevenueColumnAmt |
| Exclusion | $40,582 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $101,676 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $0 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $101,676 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $101,676 | TotalRevenueColumnAmt |
| Exclusion | $101,676 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $164,854 | SecuritiesAmt |
| Other | $503,500 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $108,850 | SecuritiesAmt |
| Other | $396,483 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $56,004 | SecuritiesAmt |
| Other | $107,017 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $163,021 | TotalRevenueColumnAmt |
| Exclusion | $163,021 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fundraising Gross Income | $71,526 | FundraisingGrossIncomeAmt |
| Fundraising Direct Expenses | $21,706 | FundraisingDirectExpensesAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $49,820 | TotalRevenueColumnAmt |
| Exclusion | $49,820 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | Insurance Captive | Desc |
| Business | 900099 | BusinessCd |
| Total Revenue Column | $234,770 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $234,770 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $234,770 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $47,970,472 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $47,212,078 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $8,842 | UnrelatedBusinessRevenueAmt |
| Exclusion | $481,616 | ExclusionAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,127,950 | TotalAmt |
| Program Services | $679,391 | ProgramServicesAmt |
| Management And General | $448,559 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $23,692,482 | TotalAmt |
| Program Services | $20,814,063 | ProgramServicesAmt |
| Management And General | $2,878,419 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $352,285 | TotalAmt |
| Program Services | $315,116 | ProgramServicesAmt |
| Management And General | $37,169 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,367,212 | TotalAmt |
| Program Services | $2,088,174 | ProgramServicesAmt |
| Management And General | $279,038 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,566,225 | TotalAmt |
| Program Services | $1,359,033 | ProgramServicesAmt |
| Management And General | $207,192 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $103,634 | TotalAmt |
| Program Services | $89,925 | ProgramServicesAmt |
| Management And General | $13,709 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $49,565 | TotalAmt |
| Program Services | $43,008 | ProgramServicesAmt |
| Management And General | $6,557 | ManagementAndGeneralAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,642 | TotalAmt |
| Management And General | $1,642 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,645,609 | TotalAmt |
| Program Services | $1,427,916 | ProgramServicesAmt |
| Management And General | $217,693 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $49,558 | TotalAmt |
| Program Services | $43,002 | ProgramServicesAmt |
| Management And General | $6,556 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,148,299 | TotalAmt |
| Program Services | $2,731,819 | ProgramServicesAmt |
| Management And General | $416,480 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,016,661 | TotalAmt |
| Program Services | $1,749,882 | ProgramServicesAmt |
| Management And General | $266,779 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $91,594 | TotalAmt |
| Program Services | $79,477 | ProgramServicesAmt |
| Management And General | $12,117 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $370,316 | TotalAmt |
| Program Services | $321,328 | ProgramServicesAmt |
| Management And General | $48,988 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,630,836 | TotalAmt |
| Program Services | $2,282,809 | ProgramServicesAmt |
| Management And General | $348,027 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,212,386 | TotalAmt |
| Program Services | $1,052,003 | ProgramServicesAmt |
| Management And General | $160,383 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| Medical Supplies | $4,846,285 | $4,846,285 | |
| Health Care Provider Ta | $981,988 | $981,988 | |
| Valley Medical Associat | $387,463 | $387,463 | |
| Dues & Subscriptions | $75,392 | $65,419 | $9,973 |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $46,717,382 | TotalAmt |
| Program Services | $41,358,101 | ProgramServicesAmt |
| Management And General | $5,359,281 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part X | Yes (X) | InfoInScheduleOPartXInd |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $121,350 | BOYAmt |
| EOY | $207,129 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,291,835 | BOYAmt |
| EOY | $7,753,926 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,881,188 | BOYAmt |
| EOY | $6,645,339 | EOYAmt |
Receivables From Officers Etc ReceivablesFromOfficersEtcGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,796 | BOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $60,060 | BOYAmt |
| EOY | $24,571 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $742,033 | BOYAmt |
| EOY | $831,013 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $214,423 | BOYAmt |
| EOY | $324,342 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $45,860,827 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $24,954,877 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $19,695,317 | BOYAmt |
| EOY | $20,905,950 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $216,322 | BOYAmt |
| EOY | $2,005,563 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $489,785 | BOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,094,771 | BOYAmt |
| EOY | $7,836,922 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $42,813,880 | BOYAmt |
| EOY | $46,534,755 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,756,508 | BOYAmt |
| EOY | $7,330,411 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,895,738 | BOYAmt |
| EOY | $8,239,594 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,746,883 | BOYAmt |
| EOY | $4,315,640 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $17,399,129 | BOYAmt |
| EOY | $19,885,645 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $25,056,693 | BOYAmt |
| EOY | $26,302,703 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $358,058 | BOYAmt |
| EOY | $346,407 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $25,414,751 | BOYAmt |
| EOY | $26,649,110 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $42,813,880 | BOYAmt |
| EOY | $46,534,755 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $1,253,090 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | -$18,731 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule B IRS990ScheduleB
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 | 0 | VolunteersInd |
| Paid Staff Or Management | 0 | PaidStaffOrManagementInd |
| Media Advertisements | 0 | MediaAdvertisementsInd |
| Mailings Members | 0 | MailingsMembersInd |
| Publications Or Broadcast | 0 | PublicationsOrBroadcastInd |
| Grants Other Organizations | 0 | GrantsOtherOrganizationsInd |
| Direct Contact Legislators | 0 | DirectContactLegislatorsInd |
| Rallies Demonstrations | 0 | RalliesDemonstrationsInd |
| Other Activities | Yes (1) | OtherActivitiesInd |
| Other Activities | $8,058 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $8,058 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | 0 | NotDescribedSection501c3Ind |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Part II-B, Line 1: | FormAndLineReferenceDesc |
| Explanation | The Hospital pays dues to various organizations, a portion of which is attributable to lobbying expenses. | ExplanationTxt |
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $145,224 | OtherCostOrOtherBasisAmt |
| Book Value | $145,224 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $24,992,008 | OtherCostOrOtherBasisAmt |
| Depreciation | $9,852,958 | DepreciationAmt |
| Book Value | $15,139,050 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $17,293,150 | OtherCostOrOtherBasisAmt |
| Depreciation | $15,101,919 | DepreciationAmt |
| Book Value | $2,191,231 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $3,430,445 | OtherCostOrOtherBasisAmt |
| Book Value | $3,430,445 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $20,905,950 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp (7 entries)
| DescDesc | Book ValueBookValueAmt |
|---|---|
| Deferred Compensation | $798,260 |
| Cash Surrender Value of Life Insurance | $201,262 |
| Interest in Synernet Reinsurance | $905,593 |
| Meaningful Use Receivables | $157,037 |
| Estimated Third-Party Payor Settlements | $2,511,219 |
| Insurance Claim Receivable | $2,775,000 |
| Due from Related Parties | $488,551 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $7,836,922 | TotalBookValueOtherAssetsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)
| DescDesc | AmtAmt |
|---|---|
| Deferred Compensation | $798,260 |
| Estimated Third-Party Payor Settlements | $3,517,380 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $4,315,640 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Part X, Line 2: | FormAndLineReferenceDesc |
| Explanation | The Medical Center and VMA are not-for-profit corporations as described in Section 501(c)(3) of the Internal Revenue Code (the Code), and are exempt from federal income taxes on related income pursuant to Section 501(a) of the Code. Management evaluated the Medical Center's tax positions and concluded the Medical Center has maintained its tax-exempt status, does not have any significant unrelated business income and has taken no uncertain tax positions that require adjustment or disclosure in the consolidated financial statements. | ExplanationTxt |
Schedule G IRS990ScheduleG
Fundraising Event Information FundraisingEventInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Event1 | 2015 Cancer Fund Tour | Event1Nm |
| Gross Receipts Event1 | $24,528 | GrossReceiptsEvent1Amt |
| Gross Revenue Event1 | $24,528 | GrossRevenueEvent1Amt |
| Non Cash Prizes Event1 | $4,971 | NonCashPrizesEvent1Amt |
| Rent Facility Costs Event1 | $240 | RentFacilityCostsEvent1Amt |
| Other Direct Expenses Event1 | $2,266 | OtherDirectExpensesEvent1Amt |
| Event2 | Emergency Room Fundraiser | Event2Nm |
| Gross Receipts Event2 | $46,998 | GrossReceiptsEvent2Amt |
| Gross Revenue Event2 | $46,998 | GrossRevenueEvent2Amt |
| Cash Prizes Event2 | $600 | CashPrizesEvent2Amt |
| Non Cash Prizes Event2 | $5,188 | NonCashPrizesEvent2Amt |
| Rent Facility Costs Event2 | $2,994 | RentFacilityCostsEvent2Amt |
| Other Direct Expenses Event2 | $5,448 | OtherDirectExpensesEvent2Amt |
| Gross Receipts Total | $71,526 | GrossReceiptsTotalAmt |
| Gross Revenue Total Events | $71,526 | GrossRevenueTotalEventsAmt |
| Cash Prizes Total Events | $600 | CashPrizesTotalEventsAmt |
| Non Cash Prizes Total Events | $10,159 | NonCashPrizesTotalEventsAmt |
| Rent Fclty Costs Total Events | $3,234 | RentFcltyCostsTotalEventsAmt |
| Oth Direct Expnss Total Events | $7,714 | OthDirectExpnssTotalEventsAmt |
| Direct Expense Summary Events | $21,707 | DirectExpenseSummaryEventsAmt |
| Net Income Summary | $49,819 | NetIncomeSummaryAmt |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (1) | FinancialAssistancePolicyInd |
| Written Policy | Yes (1) | WrittenPolicyInd |
| All Hospitals Policy | Yes (X) | AllHospitalsPolicyInd |
| FPG Reference Free Care | Yes (1) | FPGReferenceFreeCareInd |
| Percent150 | Yes (X) | Percent150Ind |
| FPG Reference Discounted Care | Yes (1) | FPGReferenceDiscountedCareInd |
| Percent200 D | Yes (X) | Percent200DInd |
| Free Care Medically Indigent | 0 | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (1) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | 0 | ExpensesExceedBudgetInd |
| Annual Community Bnft Report | Yes (1) | AnnualCommunityBnftReportInd |
| Report Publically Available | Yes (1) | ReportPublicallyAvailableInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $394,152 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $394,152 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00840 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $2,949,217 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $1,893,789 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,055,428 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.02260 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $3,343,369 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $1,893,789 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,449,580 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.03100 | TotalExpensePct |
Subsidized Health Services SubsidizedHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $21,850,878 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $17,691,653 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $4,159,225 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.08900 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $21,850,878 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $17,691,653 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $4,159,225 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.08900 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $25,194,247 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $19,585,442 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $5,608,805 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.12000 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (1) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $884,614 | BadDebtExpenseAmt |
| Reimbursed By Medicare | $18,461,838 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $17,705,836 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | $756,002 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | Yes (X) | OtherInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (1) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | 0 | FinancialAssistancePrvsnInd |
| Hospital Facilities | 2 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp (2 entries)
| FacilityFacilityNum | Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | Website AddressWebsiteAddressTxt | State LicenseStateLicenseNum | Licensed HospitalLicensedHospitalInd | General Medical And SurgicalGeneralMedicalAndSurgicalInd | Emergency Room24 HrsEmergencyRoom24HrsInd | Emergency Room OtherEmergencyRoomOtherInd | OtherOtherDesc |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Northern Maine Medical Center | |||||||||||
| 1 | 194 East Maine Street | Fort Kent | ME | 04743 | www.nmmc.org | 38126 | Yes (X) | Yes (X) | Yes (X) | ||
| Forest Hill | |||||||||||
| 2 | 20 Bolduc Avenue | Fort Kent | ME | 04743 | Yes (X) | Licensed Hospital Related Facility | |||||
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Northern Maine Medical Center | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| First Licensed CY Or PY | 0 | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | 0 | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | Yes (1) | CHNAConductedInd |
| Community Definition | Yes (X) | CommunityDefinitionInd |
| Community Demographics | Yes (X) | CommunityDemographicsInd |
| Existing Resources | Yes (X) | ExistingResourcesInd |
| How Data Obtained | Yes (X) | HowDataObtainedInd |
| Community Health Needs | Yes (X) | CommunityHealthNeedsInd |
| Other Health Issues | Yes (X) | OtherHealthIssuesInd |
| Community Hlth Needs Id Process | Yes (X) | CommunityHlthNeedsIdProcessInd |
| Consulting Process | Yes (X) | ConsultingProcessInd |
| Other | Yes (X) | OtherInd |
| CHNA Conducted | 13 | CHNAConductedYr |
| Take Into Account Others Input | Yes (1) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | Yes (1) | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | 0 | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (1) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | www.nmmc.org | OwnWebsiteURLTxt |
| Rpt Available Thru Other Method | Yes (X) | RptAvailableThruOtherMethodInd |
| Implementation Strategy Adopt | Yes (1) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 14 | ImplementationStrategyAdptYr |
| Strategy Posted Website | 0 | StrategyPostedWebsiteInd |
| Strategy Attached | Yes (1) | StrategyAttachedInd |
| Organization Incur Excise Tax | 0 | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (1) | EligCriteriaExplainedInd |
| FPG Family Incm Lmt Free Dscnt | Yes (X) | FPGFamilyIncmLmtFreeDscntInd |
| FPG Family Incm Lmt Free Care | 150.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 200.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| Explained Basis | Yes (1) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (1) | AppFinancialAsstExplnInd |
| Described Info | Yes (X) | DescribedInfoInd |
| Described Suprt Doc | Yes (X) | DescribedSuprtDocInd |
| Provided Hospital Contact | Yes (X) | ProvidedHospitalContactInd |
| Includes Publicity Measures | Yes (1) | IncludesPublicityMeasuresInd |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | http://www.nmmc.org/billing/ | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | http://www.nmmc.org/billing/ | 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 |
| FAP Notice Displayed | Yes (X) | FAPNoticeDisplayedInd |
| FAP Actions On Nonpayment | Yes (1) | FAPActionsOnNonpaymentInd |
| Permit No Actions | Yes (X) | PermitNoActionsInd |
| Collection Activities | 0 | CollectionActivitiesInd |
| FAP Notified Upon Admission | Yes (X) | FAPNotifiedUponAdmissionInd |
| FAP Notified Before Discharge | Yes (X) | FAPNotifiedBeforeDischargeInd |
| FAP Notified All Patients | Yes (X) | FAPNotifiedAllPatientsInd |
| Documented Elig Determination | Yes (X) | DocumentedEligDeterminationInd |
| Nondis Emergency Care Policy | Yes (1) | NondisEmergencyCarePolicyInd |
| Other Method Used | Yes (X) | OtherMethodUsedInd |
| Amounts Generally Billed | 0 | AmountsGenerallyBilledInd |
| Gross Charges | 0 | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (11 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Northern Maine Medical Center | Part V, Section B, Line 3j: Northern Maine Medical Center (NMMC) is located in Fort Kent, Maine (Aroostook County). Aroostook County is considered rural by the State of Maine and the United States Census Bureau. The hospital service area is primarily the St. John Valley. The following towns make up the St. John Valley region: Allagash, Eagle Lake, Fort Kent, Fort Kent Mills, Frenchville, Grand Isle, Madawaska, St. Agatha, St. David, St. Francis, Sinclair, Wallagrass, Winterville Plt., Van Buren and several surrounding towns and unorganized territories. In 2009, the percentage of Fort Kent residents with income below the poverty level was 36.4%. The percentage of children below the poverty level was 36.7% in 2009. The percentage of the population aged 65 and over was 18% in Aroostook County. The unemployment rate in Aroostook County was 9.3% in 2011, which was higher than the State's rate of 7.8%. Of the individuals 25 years or older in Aroostook County, 23% do not have a high school diploma compared to 15% overall in the State.Northern Maine Medical Center utilizes an electronic medical record system and its related physician practices abstract data for reporting to the ACO they are now a part of, which provides a vast amount of data relative to patients in care. The needs assessment provides a much broader picture of the community as a whole, including the health status of individuals not in care, as well as functional health status and social demographics (such as employment, income and education levels). The local units of the State's public health infrastructure (known as "Healthy Maine Partnerships") are also integrated into the process so that their data relative to health, environmental and social measures are part of the community dissemination process.Northern Maine Medical Center distributed the EMHS Qualitative Stakeholder survey link to their employees, volunteers, board members, donors, and other stakeholders. In the Fort Kent service area, key collaborators going forward will include: Northern Maine Medical Center and its owned physician practices, Cary Medical Center, The Aroostook Medical Center, Fish River Rural Health Center, local schools, Aroostook Home Health Services/Valley Home Health Services, Aroostook Mental Health Center, UMFK, and Twin Rivers.EMHS, the primary tertiary center utilized by Northern Maine Medical Center, routinely conducts a community health needs assessment (hereafter referred to simply as "needs assessment") across the service area of all of its member hospitals. The most recent assessment, published in 2014, was developed by EMHS to support their member organizations and community partners in their work to develop strategies that will improve the health of the people they all serve. The report's findings were analyzed and compiled by representatives of Hart Consulting, Inc. The report relates findings from three data sources: The Qualitative Stakeholder Survey conducted by EMHS with its stakeholders (June 2014), the University of Wisconsin Population Health Institute's County Health Rankings (2014), and OneMaine Health's Community Health Needs Assessment (2011). |
| Northern Maine Medical Center | Part V, Section B, Line 5: The 2014 Community Health Needs Assessment was developed by the Eastern Maine Health System (EMHS) to support member organizations and community partners' work to develop strategies that will improve the health of the people we serve. The consultants who developed the survey tool worked with individuals from a broad spectrum of backgrounds as follows: the Maine Center for Disease Control and Prevention, the District Public Health Liaisons, Federally Qualified Health Centers, Bangor Public Health and Community Services, Portland Public Health, and others who provided generous support and insights.Target audience was anyone with a vested interest in public health and healthcare including medical staff, community board members, volunteers, donors and members of the general public. The online survey was distributed as a website link via email across the eight participating Maine Counties of Aroostook, Cumberland, Hancock, Kennebec, Penobscot, Piscataquis, Somerset, Washington) by 17 partnering Maine Hospitals, 5 local Public Health Districts and 11 Healthy Maine Partnerships.On January 7, 2016, the Northern Aroostook Community Engagement Forum was held jointly with the area Public Health District Coordinating Council. A total of 33 individuals participated in the session. The following sectors were represented at the public forum:- Healthy Aroostook- Northern Maine Medical Center- Public Health Nursing- Aroostook Mental Health Services- Wabanaki Public Health- Town of Madawaska- UMFK Student- Power of Prevention- Fish River Rural Health - Maine Quality Counts- U. Maine Cooperative Extension- Visiting Nurses of Aroostook- Town of Fort Kent- The Aroostook Medical Center- Fiddlehead Focus News- Maine CDC- Pines Health Services- University of Maine at Fort Kent- Northern Maine Development Commission- Community Voices- Community Members |
| Northern Maine Medical Center | Part V, Section B, Line 6a: The following hospitals were included in the collaborative community health assessment: Cary Medical Center, Down East Community Hospital, Houlton Regional Hospital, Maine Coast Memorial Hospital, Mayo Regional Hospital, Millinocket Regional Hospital, Mount Desert Island Hospital, Northern Maine Medical Center, Redington-Fairview General Hospital. |
| Northern Maine Medical Center | Part V, Section B, Line 7d: The St. John Valley assessment was posted on the NMMC website in late 2014, as soon as it became available. The report is also available upon request. In 2015, a news article was published to inform the public that the report is available and how they can access it. The report is on the NMMC website and in addition, contact information is provided on the website for individuals who wish to request a free paper copy. Additionally, individuals may call NMMC to request a free copy. |
| Northern Maine Medical Center | Part V, Section B, Line 11: NMMC adopted an implementation strategy to address the health needs of the hospital facility's community and prioritized the health needs of its communities using the St. John Valley and Aroostook County Community Health Needs Assessment of 2014 conducted by EMHS. A Steering Committee composed of Northern Maine Medical Center administrative leadership and governing board was formed to evaluate the findings from the 2014 Community Health Needs Assessment survey for the St. John Valley and Aroostook County. The Committee was educated in the principles to be considered when assessing the survey findings. A summary of the Affordable Care Act provisions aimed at improving community health through direct investments in wellness and prevention at the individual and community level was also provided to members. The Committee identified priorities which were approved by the full governing board that subsequently designated responsibility to two separate work groups to develop a plan to address the prioritized needs over the next three years. 2015 CHNA overarching goals:1. Identify key stakeholders and harness resources to form partnerships with existing St. John Valley and Aroostook County groups who may be sharing similar goals that benefit the communities served.2. Educate members of the communities and other key personnel such as medical providers regarding available resources Prioritization of health needs in its community.Priority #1 Substance AbuseThe 2014 CHNA survey results for the St. John Valley demonstrated mental health and substance abuse as one of the top unmet healthcare needs and so it was chosen as priority number one. a. Affordable options for people who are uninsured or under insuredb. Pain management alternatives to prescription drugs/opioidsc. Substance abuse treatment providersPreventive screenings that survey respondents did not feel were very accessible in this category included:- Alcohol misuse screening - Social concerns in the survey findings included substance abuse. - Gaps were identified by respondents in healthcare services related to substance abuse treatment & detoxification.Action plan for Priority #12015-20161. Actions are being addressed in three distinct categories: prevention, screening and treatment. 2. The hospital Chief Operating Office, in collaboration with community partners (Power of Prevention and the Aroostook Mental Health Center) is coordinating educational opportunities which will be offered to local schools and civic groups on the effects of substance abuse.3. The Power of Prevention is working with law enforcement to increase checkpoints to screen for drunk driving.4. The Medication Lock Boxes, in collaboration with the Healthy Maine Partnerships, were launched in Madawaska through the Primary Care offices. The program was introduced at a public event in November of 2015. Coordination to provide the boxes in the Fort Kent provider offices is in progress.5. Discussions were held with Power of Prevention representatives to plan for formal training of primary care practice employees on SBIRT, Screening, Brief Intervention, Referral and Treatment. The training is planned for Spring of this year (2016). SBIRT is an evidence-based practice used to identify, reduce, and prevent problematic use, abuse, and dependence on alcohol and illicit drugs. The SBIRT model, developed by the Institute of Medicine, is a recommendation that promotes community-based screening for health risk behaviors, including substance abuse. The next step will be to implement the screening process in the Emergency Department and inpatient units. 6. NMMC fosters the community support group AA, Alcoholics Anonymous, in regards to their assistance with aftercare by allowing them to use physical meeting space at Forest Hill to hold meetings. Information about the support group is also provided to surrounding communities and included on NMMC's master list of support groups. 7. With a full complement of hospital social workers in 2016, there will be further collaboration with community partners to address the substance abuse priority as identified in the Community Health Needs Assessment. Specifically, an evidence- based tool will be adopted to screen patients for substance abuse in the hospital's inpatient Child and Adolescent Psychiatric Unit., (such as AC-OK which screens adolescents for co-occurring disorders). Priority #2 Healthy Food and NutritionThe 2014 CHNA survey results for the St. John Valley demonstrated top barriers that prevent healthy eating and thus was chosen as priority number two. a. Affordability of healthy food optionsb. Access to healthy food options in school/work environmentc. knowledge, attitudes and beliefs regarding nutritionPreventive screenings that survey respondents did not feel were very accessible included obesity screening.Action plan for Priority #22015-20161. Participation in the Let's Go! Program was pursued as planned. A meeting was held with the new Northern Aroostook County Let's Go! Program coordinator, Colette Thompson on 2/10/15. All three program components were considered for implementation: Healthy Workplace, Childhood Obesity Reduction, Support Healthy Families. It was determined that all three components add value and would be phased in over time to ensure the best success in each section and to create sustainability. By beginning with the Healthy Workplace, the benefit of engaging employees who will take home the message was seen as a first step to contributing to the community impact.2. A work session took place on 4/16/15 to define the level of commitment NMMC was prepared to undertake with the implementation of the Let's Go! Program. A formal training session was held for NMMC Department Directors and Supervisors as the first step. A Policy was drafted outlining nonfood or healthy food options for rewards. The philosophies of Let's Go are also supported in the community by offering healthy choices at events and making outdoor physical activity events available twice a year.3. Coordinate presentation to NMMC providers by Let's Go! Program director, Dr. Tory Rogers -Growing and Sustaining Let's Go! In Maine.Pediatrician, Dr. Tory Rogers, is scheduled to provide a CME program on 3/31/16 for NMMC Medical Staff related to the Let's Go! Childhood Obesity Reduction Program. If we decide to participate in the program, we may be able to utilize EHR data for tracking the impact of the program on reducing obesity. Dr. Rogers will also be meeting with the Chief Executive Officer on 3/31/16. 4. In January and February of 2016, partnerships continued to be developed with local organizations such as the Cooperative Extension Service, the University of Maine at Fort Kent, Healthy Maine Partnerships, the Power of Prevention, Public Health and the local food coop. 5. The Public Relations Director has become a member of the Clinical Community Linkages, a committee of the Power of Prevention. The committee is working on strategies to address food insecurities in the surrounding communities with the support of PICH, Partners in Community Health.6. A partnership was also created with Farm to Institution New England to begin a dialogue with local farmers to discuss strategies for affordability and access to fresh foods. Conference calls were held February 9, 16 & 24th. These calls were to identify key stakeholders in preparation for a roundtable presentation scheduled for March 9, 2016 where local institutions will identify needs and develop a plan to work with local farmers. Programs or resources to be used to address Priority #2Partners in Community HealthPower of Prevention, Clinical Community LinkagesHealthy Maine PartnershipLet's Go! MaineFarm to Institution Food ProgramSee continuation of Part V, Section B, Line 11 narrative on next page. |
| Northern Maine Medical Center | Part V, Section B, Line 22d: Individuals are billed at gross amounts and charges are adjusted accordingly, if they qualify for assistance. |
| Northern Maine Medical Center | Part V, Section B, Line 24: Individuals are billed at gross amounts and charges are adjusted accordingly, if they qualify for assistance. |
| Part V, Section B, Line 11 | Priority #3 Cardiovascular HealthThe 2014 CHNA survey results for the St. John Valley demonstrated top barriers that prevent people from being physically active. Aroostook County has the second highest prevalence of heart disease in Maine and so this need was selected as priority number three. a. Personal barriers (i.e., lack of time, motivation, values and beliefs)b. Weather conditionsc. Insufficient facilities or lack of access to facilities for exercisingAction plan for Priority #32015 -20161. A partnership was created with the Aroostook Area Agency on Aging to offer a Bone Builders class to local seniors. Bone Builders is a fitness program for people over the age of 50 which focuses on strength training, balance and includes such topics as fall prevention, osteoporosis, and nutrition. The partnership also involves the local Senior Citizen Center who will provide the space to offer the classes free of charge. The agreement was signed with the Aroostook Area Agency on Aging in early 2015. NMMC is providing hand and ankle weights free of charge to class participants. 2. A partnership was created with the Madawaska School system and the Recreation Department to open a Wellness Center which is open to the public. NMMC provided the equipment and start-up funds for renovating the physical space needed for the program. There are currently approximately 80 members.3. There is also a partnership in place with the Fort Kent School for a Wellness Center. The Center was open to the public for a period of time but is temporarily only open to school youth, school system staff and NMMC employees. The obstacle at this time is funding. The intent is to reopen to the public as soon as resources can be accessed.4. The NMMC Website upgrade was completed in the Spring of 2015. The site now offers a variety of health and wellness resources for members of the community. An electronic newsletter is also now available to subscribers on a quarterly basis. Two newsletters have been published. The NMMC website has over 80 subscribers to the electronic newsletter in addition to the distribution through a chamber of commerce database. An additional resource is also in the planning stages. The resource provides the public access to a user friendly, up to the day health, wellness and disease information site called Your Care Everywhere which links directly with NMMC's website and patient portals. 5. On a weekly basis, OffUGoAroostook, a service of the Aroostook Power of Prevention, circulates physical activity opportunities to subscribers to assist in broadening the availability of the health and wellness activities available around the St. John Valley and Aroostook County. NMMC's support comes in the form of expanding the circulation of the information to a broader population. 6. We are currently convening a community group to create a partnership that would offer more options to local seniors for free access to exercise facilities, especially for use during winter months. 7. NMMC Patient Educator was trained in February of 2015 along with two other RN's by the Pfizer Company to be able to offer 'Beat the Pack' smoking cessation program. The program has been offered twice since the training was completed. Advertising of the support is posted on the NMMC website and information about the program was offered at two community events in 2015; Twin Rivers Paper Company August 2015 and the Acadia Family Health Center Open House in November where they spoke with the public about smoking cessation opportunities.Programs or resources to be used to address Priority #3Aroostook Area Agency on AgingTown of Madawaska School SystemTown of Madawaska Recreation DepartmentTown of Fort Kent School SystemPower of Prevention, Off-U-Go AroostookNMMC believes the following community health needs are important however they were prioritized as secondary level priorities for various reasons. It is also important to note, as will be outlined further in this section, some work is being done to positively impact these needs. 1. Social concerns that include -Unemployment/economic opportunity -Domestic violence -Physical and social isolation -began partnering with the Aroostook Area Agency on Aging's Thrive in Place program for elders. On 1/29/15, clinical staff was trained to broaden their knowledge in the area of home environmental assessments which can also provide some socialization. We are working closely with the Aroostook Area Agency on Aging to address some of the physical and social isolation identified. -Affordable housing2. Preventive screenings and immunizations that survey respondents did not feel were very accessible. Those include: -Oral health -Depression screening - All primary care providers are using the PHQ depression screening tool as a first line depression screening. -Aging related screening - We have begun working with the Power of Prevention, Healthy Aroostook Coalition to address aging related screening and the possibility of educating providers on the use of CMS screening tools. -Tobacco use screening -this screening is done organization wide; the NMMC Patient Educator was trained last year along with two other RN's by the Pfizer Company to be able to offer 'Beat the Pack' smoking cessation program. The program has been offered twice since the training was completed. Advertising of the support is posted on the NMMC website and information about the program was offered at two community events in 2015. 3. Gaps in Healthcare Services: -Dental care -'First Tooth' program has been presented to the Family Practice Team for their consideration of adding this assessment tool to their patient visits. -Behavioral/mental health services for adults4. Issues Preventing Access to Care: -Out of pocket costs associated with insurance plans -Lack of insurance and unable to pay for the carea. A new section was added to the NMMC website to provide more access to information to assist the public. The website includes the Charity Care Eligibility and application and other resources to assist the public. A Patient Financial Counselor position was added as a means of support to patients as well. -Transportation -NMMC is partnering with the Aroostook Area Agency on Aging to address the issue of transportation. -Don't understand or value the importance of seeking care -Negative prior experiences -several initiatives have been undertaken to provide transparency to the people served by NMMC and to encourage open communication. a. Community Liaison Committee of the Board of Trustees was convened and is in its second year. b. We're Listening Campaign was launched in 2015 to inform the public of the importance of their feedback directly to NMMC. |
| Part V, Section B, Line 16 | Financial Assistance Policy Website Availability |
| Northern Maine Medical Center Part V, Section B, line 16b website: | http://www.nmmc.org/billing/ |
| Northern Maine Medical Center Part V, Section B, line 16c website: | http://www.nmmc.org/billing/ |
Supplemental Information Detail SupplementalInformationDetail (8 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Part I, Line 7: | The amounts reported on Lines 7a & 7b were computed using a cost-to-charge ratio. Amounts on line 7g are derived from internal financial/cost accounting systems. |
| Part I, Line 7g: | Subsidized health services on line 7g include physician clinics, rural health centers, a skilled nursing facility, and emergency room. |
| Part II, Community Building Activities: | N/A |
| Part III, Line 4: | In evaluating the collectibility of accounts receivable, the Medical Center analyzes past results and identifies trends for each of its major payor sources of revenue to estimate the appropriate allowance for doubtful accounts and provision for doubtful accounts. Management regularly reviews data about these major payor sources in evaluating the sufficiency of the allowance for doubtful accounts. For receivables associated with services provided to patients who have third-party coverage, the Medical Center analyzes contractually due amounts and provides an allowance for doubtful accounts and a provision for doubtful accounts, if necessary. For receivables associated with self-pay patients (which include both patients without insurance and patients with deductible and copayment balances due for which third-party coverage exists for part of the bill), the Medical Center records a provision for doubtful accounts in the period of service based on past experience, which indicates that many patients are unable or unwilling to pay amounts for which they are financially responsible. The difference between the standard rates (or the discounted rates if negotiated or eligible) and the amounts actually collected after all reasonable collection efforts have been exhausted is charged against the allowance for doubtful accounts. |
| Part VI, Line 2: | Please see Schedule H, Part V, Section B, Line 5 for a description of NMMC's assessment process. |
| Part VI, Line 3: | We notify patients and customers about access to assistance in various ways. The simplest way is the signage, pamphlets, and educational material located around the Organization and in various offices. In every patient access/patient financial services area is a sign explaining the availability of free/discounted care and the Federal Poverty Guidelines. There are also pamphlets located in the outpatient areas explaining free/discounted care and providing information on Mainecare. For inpatients, there is a book in each room which provides all the information on all programs available.Through the patient accounting department, we provide information aboutthese statements. We also counsel patients on the phone about all theprograms available whether it is Medicaid or a hospital program. |
| Part VI, Line 4: | Northern Maine Medical Center is a 94 licensed bed (29 A&P which includes swing beds, 6 ICU beds, 14 Psych beds, and 45 SNF beds), full-service, acute-care, not-for profit hospital located in Fort Kent, Maine (Aroostook County). The Hospital is accredited by the joint commission and its mission is to serve its communities with excellence in health care. Its services include acute inpatient, psych inpatient, SNF, 24-hour emergency center, diagnostic, and surgical services. Along with these hospital services, the Hospital employs/contracts with the majority of primary and specialty care physicians in the area. |
| Part VI, Line 5: | Northern Maine Medical Center is a local, not-for-profit hospital that serves its local communities and people regardless of their ability to pay. Northern Maine provides financial assistance and sliding scale discounts to self-pay and low-income patients. Also the Hospital participates in government-sponsored health care programs including Medicare, Medicaid, CHAMPUS, and Tricare. The volunteer board of trustees sets the strategic direction for the Hospital and is comprised of community members from the Hospital's service area. This group is made up of local business owners, professionals, and retirees. Northern Maine's non-profit status allows the Hospital to reinvest any excess of revenues over expense back into the Hospital to continuously improve the medical care it delivers. The Hospital allows access to healthcare that would otherwise be difficult. The Hospital is the main employer for the local physicians, including specialty physicians that would otherwise have to be accessed out of the area. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Employment Contract | Yes (X) | WrittenEmploymentContractInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | 0 | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | Yes (1) | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (8 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Michael Sullivan MD | ||||||||||||||
| Director | $607,232 | $0 | $25,000 | $0 | $17,500 | $0 | $7,800 | $0 | $21,859 | $0 | $679,391 | $0 | $0 | $0 |
| Peter J Sirois | ||||||||||||||
| CEO | $225,593 | $0 | $24,000 | $0 | $0 | $0 | $7,667 | $0 | $21,859 | $0 | $279,119 | $0 | $0 | $0 |
| Cindy L Daigle | ||||||||||||||
| CFO | $139,257 | $0 | $5,000 | $0 | $0 | $0 | $4,394 | $0 | $20,789 | $0 | $169,440 | $0 | $0 | $0 |
| Mark Overton MD | ||||||||||||||
| Psychiatrist | $612,101 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $19,743 | $0 | $631,844 | $0 | $0 | $0 |
| John Hallberg MD | ||||||||||||||
| Orthopedic Surgeon | $490,557 | $0 | $0 | $0 | $0 | $0 | $5,878 | $0 | $19,744 | $0 | $516,179 | $0 | $0 | $0 |
| James Harris MD | ||||||||||||||
| Physician | $454,295 | $0 | $0 | $0 | $17,500 | $0 | $7,800 | $0 | $21,282 | $0 | $500,877 | $0 | $0 | $0 |
| Baharak Bagheri MD | ||||||||||||||
| Radiologist | $455,338 | $0 | $0 | $0 | $0 | $0 | $2,854 | $0 | $9,761 | $0 | $467,953 | $0 | $0 | $0 |
| David Coffman MD | ||||||||||||||
| Surgeon | $454,732 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $14,339 | $0 | $469,071 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Part I, Line 7 | FormAndLineReferenceDesc |
| Explanation | The bonus paid to Peter Sirois, CEO, has set point criteria for earning specific bonus levels/amounts. The Board awards points based on the accomplishment of pre-established objectives/targets. Points are tabulated with the final score determining bonus level achieved. The Board meets with the CEO to discuss performance including those objectives/targets and based on that meeting award the points and derive the bonus amount. The bonus payment made to Cindy Daigle, CFO, was paid at the discretion of the Organization's CEO. The CEO communicates the bonus and amount directly with the Human Resources Director. The bonus paid to Michael Sullivan, M.D. was for reaching the goal of improving Accountable Care Organization measures by 25%. | ExplanationTxt |
Schedule L IRS990ScheduleL
Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp (6 entries)
| Relationship DescriptionRelationshipDescriptionTxt | TransactionTransactionAmt | TransactionTransactionDesc | Sharing Of RevenuesSharingOfRevenuesInd |
|---|---|---|---|
| Daigle Oil Company | |||
| Entity of which Dan Vaillancourt, Board Member, is an officer | $123,249 | Independent Contractor Arrangement | 0 |
| Nola Sirois | |||
| Family member of Peter Sirois, Hospital CEO | $24,008 | Employment | 0 |
| Michelle L Plourde | |||
| Family member of Peter Sirois, Hospital CEO | $69,033 | Employment | 0 |
| Nicole Marquis | |||
| Family member of Peter Sirois, Hospital CEO | $39,367 | Employment | 0 |
| Robin Werntgen | |||
| Family member of Glenn Lamarr, Past Board Treasurer | $59,153 | Employment | 0 |
| James Daigle | |||
| Family member of Cindy Daigle, CFO | $13,819 | Employment | 0 |
Schedule M IRS990ScheduleM
Real Estate Residential RealEstateResidentialGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | Yes (X) | NonCashCheckboxInd |
| Contribution | 1 | ContributionCnt |
| Noncash Contributions Rpt F990 | $155,000 | NoncashContributionsRptF990Amt |
| Method Of Determining Revenues | Appraisal | MethodOfDeterminingRevenuesTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form8283 Received | 1 | Form8283ReceivedCnt |
| Any Property That Must Be Held | 0 | AnyPropertyThatMustBeHeldInd |
| Review Process Unusual NC Gifts | Yes (1) | ReviewProcessUnusualNCGiftsInd |
| Third Parties Used | 0 | ThirdPartiesUsedInd |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (6 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Form 990, Part VI, Section A, line 2 | Peter Sirois and Glenn Lamarr have a family relationship. |
| Form 990, Part VI, Section B, line 11 | The Form 990 is prepared by the Organization's independent public accounting firm and thoroughly reviewed by the CFO and Controller. The completed form was sent electronically to Board members prior to the form being filed. |
| Form 990, Part VI, Section B, line 12c | The enforcement of the conflict of interest policy is achieved through annual reporting and ongoing monitoring. |
| Form 990, Part VI, Section B, line 15 | The Board of Directors determines the compensation of the CEO using compensation studies and comparability data. The CEO determines the compensation of other officers and key employees in a similar manner. |
| Form 990, Part VI, Section C, line 19 | The Organization makes its governing documents, conflict of interest policy, and financial statements available to the public upon request. |
| Form 990, Part X, Line 10: Land, Buildings, and Equipment | Section 1.263(a)-3(n) Election: Northern Maine Medical Center 194 East Main Street Fort Kent, ME 04743 EIN: 01-0234189 Northern Maine Medical Center is electing to capitalize repair and maintenance costs under Regulation Section 1.263(a)-3(n). |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp
Disregarded Entity Name DisregardedEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Valley Medical Association | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 194 East Maine Street | AddressLine1Txt |
| City | Fort Kent | CityNm |
| State Abbreviation | ME | StateAbbreviationCd |
| ZIP | 04743 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 223245434 | EIN |
| Primary Activities | Medical Physician Practice | PrimaryActivitiesTxt |
| Legal Domicile State | ME | LegalDomicileStateCd |
| Exempt Code Section | 501(c)(3) | ExemptCodeSectionTxt |
| Public Charity Status | Line 3 | PublicCharityStatusTxt |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Northern Maine Medical Center | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Controlled Organization | Yes (1) | ControlledOrganizationInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | 0 | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | 0 | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | 0 | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | 0 | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (1) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | Yes (1) | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp
Other Organization Name OtherOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Valley Medical Association | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Transaction Type | R | TransactionTypeTxt |
| Involved | $387,463 | InvolvedAmt |
| Method Of Amount Determination | Actual Outlay | MethodOfAmountDeterminationTxt |