ST JOSEPH AMBULATORY CARE INC: Form 990, tax year 2014
View the entire original 990 at ProPublica ↗
- Organization
- ST JOSEPH AMBULATORY CARE INC (EIN 22-2480373)
- Tax period
- 2014-01-01 to 2014-12-31
- Filed
- 2015-07-31
- IRS object ID
- 201502129349300310
- Schema version
- 2014v5.0
- 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 ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2015-07-31T08:47:36-05:00 | ReturnTs |
| Tax Period End | 2014-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 010494526 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BAKER NEWMAN & NOYES | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 507 | AddressLine1Txt |
| City | PORTLAND | CityNm |
| State Abbreviation | ME | StateAbbreviationCd |
| ZIP | 04112 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2014-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 222480373 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | St Joseph Ambulatory Care Inc | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | STJO | BusinessNameControlTxt |
| Phone | 2072621000 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 360 Broadway PO Box 403 | AddressLine1Txt |
| City | Bangor | CityNm |
| State Abbreviation | ME | StateAbbreviationCd |
| ZIP | 044020403 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Mary Prybylo | PersonNm |
| Person Title | President & CEO | PersonTitleTxt |
| Phone | 2072621000 | PhoneNum |
| Signature | 2015-06-28 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | Nicholas E Porto | PreparerPersonNm |
| PTIN | P01310283 | PTIN |
| Phone | 2078792100 | PhoneNum |
| Preparation | 2015-06-28 | PreparationDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2014 | TaxYr |
| Build TS | 2016-03-07 17:11:31Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | Mary Prybylo | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 360 Broadway PO Box 403 | AddressLine1Txt |
| City | Bangor | CityNm |
| State Abbreviation | ME | StateAbbreviationCd |
| ZIP | 044020403 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $13,534,642 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | N/A | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1983 | FormationYr |
| Legal Domicile State | ME | LegalDomicileStateCd |
| Activity Or Mission | Various physician practices | ActivityOrMissionDesc |
| Voting Members Governing Body | 18 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 16 | VotingMembersIndependentCnt |
| Total Employee | 245 | TotalEmployeeCnt |
| Total Volunteers | 16 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $0 | PYContributionsGrantsAmt |
| CY Contributions Grants | $0 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $10,640,053 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $13,517,294 | CYProgramServiceRevenueAmt |
| PY Investment Income | $70,510 | PYInvestmentIncomeAmt |
| CY Investment Income | $17,348 | CYInvestmentIncomeAmt |
| PY Other Revenue | $0 | PYOtherRevenueAmt |
| CY Other Revenue | $0 | CYOtherRevenueAmt |
| PY Total Revenue | $10,710,563 | PYTotalRevenueAmt |
| CY Total Revenue | $13,534,642 | 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 | $13,572,981 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $17,464,778 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $4,699,800 | PYOtherExpensesAmt |
| CY Other Expenses | $4,573,604 | CYOtherExpensesAmt |
| PY Total Expenses | $18,272,781 | PYTotalExpensesAmt |
| CY Total Expenses | $22,038,382 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$7,562,218 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$8,503,740 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $2,452,791 | TotalAssetsBOYAmt |
| Total Assets EOY | $2,811,942 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $2,843,839 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $3,132,887 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | -$391,048 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | -$320,945 | NetAssetsOrFundBalancesEOYAmt |
| Mission | Various physician practices | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $20,452,938 | ExpenseAmt |
| Grant | $0 | GrantAmt |
| Revenue | $13,517,294 | RevenueAmt |
| Desc | St. Joseph's Ambulatory Care, Inc. provides ambulatory care, clinics and clinical advisory services in the vicinity of Bangor, Maine. | Desc |
| Total Program Service Expenses | $20,452,938 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | 0 | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | 0 | 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 | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | 0 | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | 0 | OperateHospitalInd |
| 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 | 0 | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | 0 | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | Yes (1) | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 21 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 245 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| 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 | 18 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 16 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (1) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (1) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (1) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| Other Website | Yes (X) | OtherWebsiteInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Michael Hendrix | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 2079071200 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 360 Broadway PO Box 403 | AddressLine1Txt |
| City | Bangor | CityNm |
| State Abbreviation | ME | StateAbbreviationCd |
| ZIP | 044020403 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (24 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | OfficerOfficerInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|
| Robert Clark | ||||||||
| Trustee | 0.10 | 0.40 | Yes (X) | $0 | $0 | $0 | ||
| Joseph Cyr | ||||||||
| Trustee | 0.10 | 0.40 | Yes (X) | $0 | $0 | $0 | ||
| L William Demaso | ||||||||
| Trustee | 0.10 | 0.40 | Yes (X) | $0 | $0 | $0 | ||
| Glenn Goodwin | ||||||||
| Trustee | 0.10 | 0.40 | Yes (X) | $0 | $0 | $0 | ||
| Ned Jennings | ||||||||
| Trustee | 0.10 | 0.40 | Yes (X) | $0 | $0 | $0 | ||
| Bernard LaBree | ||||||||
| Trustee | 0.10 | 0.40 | Yes (X) | $0 | $0 | $0 | ||
| Sister Nancy Marie CSSF | ||||||||
| Trustee | 0.10 | 0.40 | Yes (X) | $0 | $0 | $0 | ||
| Noelle Merrill | ||||||||
| Trustee | 0.10 | 0.40 | Yes (X) | $0 | $0 | $0 | ||
| Sheila Pechinski | ||||||||
| Trustee | 0.10 | 0.40 | Yes (X) | $0 | $0 | $0 | ||
| Patricia Quirk | ||||||||
| Trustee | 0.10 | 0.40 | Yes (X) | $0 | $0 | $0 | ||
| Adrien Roy | ||||||||
| Trustee | 0.10 | 0.40 | Yes (X) | $0 | $0 | $0 | ||
| Bradley Ryder | ||||||||
| Trustee | 0.10 | 0.40 | Yes (X) | $0 | $0 | $0 | ||
| Cynthia Self MD | ||||||||
| Trustee | 0.10 | 0.40 | Yes (X) | $0 | $0 | $0 | ||
| Michael Starks MD | ||||||||
| Trustee | 0.10 | 0.40 | Yes (X) | $0 | $0 | $0 | ||
| William Lucy | ||||||||
| President | 0.10 | 0.40 | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| Gen Nelson Durgin | ||||||||
| Vice President | 0.10 | 0.40 | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| Mary Prybylo Ex Officio | ||||||||
| President/CEO | 0.10 | 40.00 | Yes (X) | $0 | $337,013 | $28,319 | Yes (X) | |
| Michael Hendrix | ||||||||
| Treasurer/VP Finance (eff. 1/14) | 0.10 | 40.00 | Yes (X) | $0 | $175,970 | $27,749 | Yes (X) | |
| Kevin Sedgwick | ||||||||
| Treasurer/VP Finance (thru 1/14) | 0.10 | 40.00 | Yes (X) | $0 | $104,152 | $8,693 | Yes (X) | |
| Angel Fernandez MD | ||||||||
| Physician | 40.00 | $391,756 | $0 | $12,781 | Yes (X) | |||
| Mark Lena MD | ||||||||
| Physician | 40.00 | $400,754 | $0 | $21,369 | Yes (X) | |||
| Jason Borque MD | ||||||||
| Physician | 40.00 | $424,727 | $0 | $20,131 | Yes (X) | |||
| Ganesha Santhyadka MD | ||||||||
| Physician | 40.00 | $534,372 | $0 | $25,984 | Yes (X) | |||
| Hatem Shoukeir MD | ||||||||
| Physician | 40.00 | $386,566 | $0 | $29,337 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $2,138,175 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $617,135 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $174,363 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 33 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (3 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| Spectrum Medical Group | |||||
| 20 Mussey Road Suite 2 | Scarborough | ME | 04074 | Physician services | $323,454 |
| Integra Health | |||||
| PO Box 1124 | Holden | ME | 04429 | Physician services | $258,846 |
| Penobscot Respiratory | |||||
| 417 State Street | Bangor | ME | 04401 | Physician services | $235,900 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 3 | CntrctRcvdGreaterThan100KCnt |
Program Service Revenue ProgramServiceRevenueGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| Patient services | 621990 | $10,798,974 | $10,798,974 |
| Non-patient services | 621990 | $2,604,354 | $2,604,354 |
| Affiliated income | 621990 | $113,966 | $113,966 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $13,517,294 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $15,416 | TotalRevenueColumnAmt |
| Exclusion | $15,416 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $1,932 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $0 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $1,932 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $1,932 | TotalRevenueColumnAmt |
| Exclusion | $1,932 | ExclusionAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $13,534,642 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $13,517,294 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $17,348 | ExclusionAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $14,757,433 | TotalAmt |
| Program Services | $13,753,927 | ProgramServicesAmt |
| Management And General | $1,003,506 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $49,997 | TotalAmt |
| Program Services | $46,597 | ProgramServicesAmt |
| Management And General | $3,400 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,780,909 | TotalAmt |
| Program Services | $1,659,807 | ProgramServicesAmt |
| Management And General | $121,102 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $876,439 | TotalAmt |
| Program Services | $816,841 | ProgramServicesAmt |
| Management And General | $59,598 | ManagementAndGeneralAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $333,647 | TotalAmt |
| Program Services | $310,959 | ProgramServicesAmt |
| Management And General | $22,688 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $15,000 | TotalAmt |
| Management And General | $15,000 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $98,880 | TotalAmt |
| Management And General | $98,880 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,174,804 | TotalAmt |
| Program Services | $1,094,917 | ProgramServicesAmt |
| Management And General | $79,887 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $258 | TotalAmt |
| Program Services | $240 | ProgramServicesAmt |
| Management And General | $18 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $639,595 | TotalAmt |
| Program Services | $596,103 | ProgramServicesAmt |
| Management And General | $43,492 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $772,989 | TotalAmt |
| Program Services | $720,426 | ProgramServicesAmt |
| Management And General | $52,563 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $16,341 | TotalAmt |
| Program Services | $15,230 | ProgramServicesAmt |
| Management And General | $1,111 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $175,427 | TotalAmt |
| Program Services | $163,498 | ProgramServicesAmt |
| Management And General | $11,929 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $40,000 | TotalAmt |
| Program Services | $37,280 | ProgramServicesAmt |
| Management And General | $2,720 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $303,302 | TotalAmt |
| Program Services | $282,677 | ProgramServicesAmt |
| Management And General | $20,625 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $244,445 | TotalAmt |
| Program Services | $227,823 | ProgramServicesAmt |
| Management And General | $16,622 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (2 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| Provision for bad debt | $283,867 | $283,867 | |
| Maintenance and repairs | $210,944 | $196,600 | $14,344 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $264,105 | TotalAmt |
| Program Services | $246,146 | ProgramServicesAmt |
| Management And General | $17,959 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $22,038,382 | TotalAmt |
| Program Services | $20,452,938 | ProgramServicesAmt |
| Management And General | $1,585,444 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $206,673 | BOYAmt |
| EOY | $100,659 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $914,975 | BOYAmt |
| EOY | $1,359,614 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $110,636 | BOYAmt |
| EOY | $122,343 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $1,069,202 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $542,517 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $463,958 | BOYAmt |
| EOY | $526,685 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $684,327 | BOYAmt |
| EOY | $697,085 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $72,222 | BOYAmt |
| EOY | $5,556 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,452,791 | BOYAmt |
| EOY | $2,811,942 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $843,839 | BOYAmt |
| EOY | $1,132,887 | EOYAmt |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,000,000 | BOYAmt |
| EOY | $2,000,000 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,843,839 | BOYAmt |
| EOY | $3,132,887 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -$391,048 | BOYAmt |
| EOY | -$320,945 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -$391,048 | BOYAmt |
| EOY | -$320,945 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,452,791 | BOYAmt |
| EOY | $2,811,942 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | -$8,503,740 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | -$4,591 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | $8,578,434 | OtherChangesInNetAssetsAmt |
| Info In Schedule O Part XII | Yes (X) | InfoInScheduleOPartXIIInd |
| 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) |
|---|---|---|
| Supporting Organization509a3 | Yes (X) | SupportingOrganization509a3Ind |
| Supporting Org Type2 | Yes (X) | SupportingOrgType2Ind |
| Supported Organizations | 1 | SupportedOrganizationsCnt |
Supported Org Information SupportedOrgInformationGrp
Supported Organization Name SupportedOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | St Joseph Hospital | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 010212435 | EIN |
| Organization Type | 3 | OrganizationTypeDesc |
| Governing Document Listed | 0 | GoverningDocumentListedInd |
| Support | $0 | SupportAmt |
| Other Support | $0 | OtherSupportAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Supported Organizations Total | 1 | SupportedOrganizationsTotalCnt |
| Support Sum | $0 | SupportSumAmt |
Form990 Sch A Supporting Org Form990SchASupportingOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Listed By Name Governing Doc | 0 | ListedByNameGoverningDocInd |
| Suprt Org No IRS Determination | 0 | SuprtOrgNoIRSDeterminationInd |
| Supported Org Section C456 | 0 | SupportedOrgSectionC456Ind |
| Supported Org Not Organized US | 0 | SupportedOrgNotOrganizedUSInd |
| Organization Change Suprt Org | 0 | OrganizationChangeSuprtOrgInd |
| Support Non Supported Org | 0 | SupportNonSupportedOrgInd |
| Payment Substantial Contribtr | 0 | PaymentSubstantialContribtrInd |
| Loan Disqualified Person | 0 | LoanDisqualifiedPersonInd |
| Controlled Disqualified Prsn | 0 | ControlledDisqualifiedPrsnInd |
| Disqualified Prsn Controll Int | 0 | DisqualifiedPrsnControllIntInd |
| Disqualified Prsn Ownr Int | 0 | DisqualifiedPrsnOwnrIntInd |
| Excess Business Holdings Rules | 0 | ExcessBusinessHoldingsRulesInd |
| Contribution Controller | 0 | ContributionControllerInd |
| Contribution Family | 0 | ContributionFamilyInd |
| Contribution35 Controlled | 0 | Contribution35ControlledInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Majority Dir Trst Supported Org | Yes (1) | MajorityDirTrstSupportedOrgInd |
Form990 Schedule A Part VI Form990ScheduleAPartVIGrp (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| 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 support cannot be accurately estimated. |
| 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
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $162,078 | OtherCostOrOtherBasisAmt |
| Depreciation | $27,227 | DepreciationAmt |
| Book Value | $134,851 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $907,124 | OtherCostOrOtherBasisAmt |
| Depreciation | $515,290 | DepreciationAmt |
| Book Value | $391,834 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $526,685 | TotalBookValueLandBuildingsAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $13,530,051 | TotalRevEtcAuditedFinclStmtAmt |
| Net Unrealized Gains Invst | -$4,591 | NetUnrealizedGainsInvstAmt |
| Revenue Not Reported | -$4,591 | RevenueNotReportedAmt |
| Revenue Subtotal | $13,534,642 | RevenueSubtotalAmt |
| Revenue Not Reported Fincl Stmt | $0 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $13,534,642 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $22,038,382 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Not Reported | $0 | ExpensesNotReportedAmt |
| Expenses Subtotal | $22,038,382 | ExpensesSubtotalAmt |
| Expenses Not Rpt Fincl Stmt | $0 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $22,038,382 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Part X, Line 2: | FormAndLineReferenceDesc |
| Explanation | Covenant and its member organizations 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. CHIL, a wholly-owned subsidiary, is subject to taxation in the Cayman Islands. No income taxes are levied in the Cayman Islands and CHIL 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, 2014. Under Internal Revenue Service regulations, the System's tax years from 2011 through 2014 are open and subject to examination. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | Yes (1) | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | 0 | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | Yes (1) | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (7 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Mary Prybylo Ex Officio | ||||||||||||||
| President/CEO | $0 | $314,013 | $0 | $0 | $0 | $23,000 | $0 | $0 | $0 | $28,319 | $0 | $365,332 | $0 | $0 |
| Michael Hendrix | ||||||||||||||
| Treasurer/VP Finance (eff. 1/14) | $0 | $158,470 | $0 | $0 | $0 | $17,500 | $0 | $0 | $0 | $27,749 | $0 | $203,719 | $0 | $0 |
| Angel Fernandez MD | ||||||||||||||
| Physician | $360,098 | $0 | $0 | $0 | $31,658 | $0 | $0 | $0 | $12,781 | $0 | $404,537 | $0 | $0 | $0 |
| Mark Lena MD | ||||||||||||||
| Physician | $378,323 | $0 | $0 | $0 | $22,431 | $0 | $0 | $0 | $21,369 | $0 | $422,123 | $0 | $0 | $0 |
| Jason Borque MD | ||||||||||||||
| Physician | $400,143 | $0 | $15,000 | $0 | $9,584 | $0 | $0 | $0 | $20,131 | $0 | $444,858 | $0 | $0 | $0 |
| Ganesha Santhyadka MD | ||||||||||||||
| Physician | $314,964 | $0 | $184,408 | $0 | $35,000 | $0 | $0 | $0 | $25,984 | $0 | $560,356 | $0 | $0 | $0 |
| Hatem Shoukeir MD | ||||||||||||||
| Physician | $369,094 | $0 | $0 | $0 | $17,472 | $0 | $0 | $0 | $29,337 | $0 | $415,903 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Part I, Line 3 | The 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 4a | Kevin Sedgwick served as the Treasurer and VP of Finance until early January of 2014. He was paid a severance of compensation and benefits through July of 2014. Total salary and benefits paid to Mr. Sedgwick that constitutes severance compensation is $112,845. |
| Part I, Line 7 | Ganesha Santhyadka and Jason Bourque received incentive bonuses in 2014. |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (9 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Form 990, Part VI, Section A, line 6 | St. 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 7a | The 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 7b | St. 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 11 | There 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 12c | Each 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 15 | St. 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 19 | The 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 8,578,434. |
| 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/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Controlled OrganizationControlledOrganizationInd | Direct Controlling NADirectControllingNACd |
|---|---|---|---|---|---|---|---|---|---|---|---|
| St Joseph Healthcare Foundation | |||||||||||
| 360 Broadway | Bangor | ME | 044020403 | 222480149 | Diversified holistic health care services | ME | 501(c)(3) | Line 7 | Covenant Health Inc | 0 | |
| St Joseph Hospital | |||||||||||
| 360 Broadway | Bangor | ME | 044020403 | 010212435 | Community hospital | ME | 501(c)(3) | Line 3 | St Joseph Healthcare Foundation | 0 | |
| M & J Company | |||||||||||
| 360 Broadway | Bangor | ME | 044020403 | 222480150 | Real estate holding company | ME | 501(c)(2) | St Joseph Healthcare Foundation | 0 | ||
| Alternative Health Services | |||||||||||
| 360 Broadway | Bangor | ME | 044020403 | 010422885 | Home health agency | ME | 501(c)(3) | Line 3 | St Joseph Healthcare Foundation | 0 | |
| Covenant Health Inc | |||||||||||
| 100 Ames Pond Drive | Tewksbury | MA | 01876 | 222484505 | Sponsoring and operating a health care system | MA | 501(c)(3) | Line 9 | 0 | N/A | |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp
Related Organization Name RelatedOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Strauss Inc | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 360 Broadway | AddressLine1Txt |
| City | Bangor | CityNm |
| State Abbreviation | ME | StateAbbreviationCd |
| ZIP | 044020403 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 010391369 | EIN |
| Primary Activities | Medical transcription | PrimaryActivitiesTxt |
| Legal Domicile State | ME | LegalDomicileStateCd |
| Direct Controlling NA | N/A | DirectControllingNACd |
| Entity Type | C | EntityTypeTxt |
| Controlled Organization | 0 | ControlledOrganizationInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | 0 | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | 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 | Yes (1) | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | Yes (1) | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | Yes (1) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | 0 | SharingOfFacilitiesInd |
| Paid Employees Sharing | 0 | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (1) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | Yes (1) | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp
Other Organization Name OtherOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | M & J Company | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Transaction Type | K | TransactionTypeTxt |
| Involved | $283,374 | InvolvedAmt |
| Method Of Amount Determination | Actual amount paid | MethodOfAmountDeterminationTxt |