RUMFORD HOSPITAL: Form 990, tax year 2013
View the entire original 990 at ProPublica ↗
- Organization
- RUMFORD HOSPITAL (EIN 01-0215227)
- Tax period
- 2013-07-01 to 2014-06-30
- Filed
- 2015-05-12
- IRS object ID
- 201511329349303306
- Schema version
- 2013v4.0
- 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 H
- Schedule I
- Schedule J
- Schedule L
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2015-05-12T14:06:03-05:00 | ReturnTs |
| Tax Period End | 2014-06-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BKD LLP | BusinessNameLine1 |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 910 E ST LOUIS 200/PO BOX 1190 | AddressLine1 |
| City | SPRINGFIELD | City |
| State | MO | State |
| ZIP Code | 658062523 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2013-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 010215227 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RUMFORD HOSPITAL | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| In Care Of | % PHIL MORISSETTE | InCareOfNm |
| Business Name Control | RUMF | BusinessNameControlTxt |
| Phone | 2077952972 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 420 FRANKLIN STREET | AddressLine1 |
| Address Line2 | Suite | AddressLine2 |
| City | RUMFORD | City |
| State | ME | State |
| ZIP Code | 04276 | ZIPCode |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | R DAVID FRUM | PersonNm |
| Person Title | PRESIDENT | PersonTitleTxt |
| Phone | 2077952972 | PhoneNum |
| Signature | 2015-04-24 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | Brian D Todd | PreparerPersonNm |
| PTIN | P00422601 | PTIN |
| Phone | 2077952972 | PhoneNum |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2013 | TaxYr |
| Build TS | 2016-03-07 17:11:31Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | R DAVID FRUM | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 420 FRANKLIN STREET | AddressLine1 |
| City | RUMFORD | City |
| State | ME | State |
| ZIP Code | 04276 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $42,891,226 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.RUMFORDHOSPITAL.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1974 | FormationYr |
| Legal Domicile State | ME | LegalDomicileStateCd |
| Activity Or Mission | RUMFORD HOSPITAL STRIVES TO PROVIDE EXCEPTIONAL HEALTHCARE SERVICES. THE HOSPITAL DEPENDS ON THE EXPERTISE COMMITMENT AND COMPASSION OF ITS CAREGIVERS TO FULFILL ITS MISSION. | ActivityOrMissionDesc |
| Voting Members Governing Body | 9 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 8 | VotingMembersIndependentCnt |
| Total Employee | 347 | TotalEmployeeCnt |
| Total Volunteers | 62 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $55,786 | PYContributionsGrantsAmt |
| CY Contributions Grants | $91,991 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $36,221,486 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $40,756,841 | CYProgramServiceRevenueAmt |
| PY Investment Income | $186,375 | PYInvestmentIncomeAmt |
| CY Investment Income | $210,496 | CYInvestmentIncomeAmt |
| PY Other Revenue | -$23,687 | PYOtherRevenueAmt |
| CY Other Revenue | -$40,962 | CYOtherRevenueAmt |
| PY Total Revenue | $36,439,960 | PYTotalRevenueAmt |
| CY Total Revenue | $41,018,366 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $20,000 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $16,927,578 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $17,265,113 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $19,822,342 | PYOtherExpensesAmt |
| CY Other Expenses | $23,074,093 | CYOtherExpensesAmt |
| PY Total Expenses | $36,749,920 | PYTotalExpensesAmt |
| CY Total Expenses | $40,359,206 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$309,960 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $659,160 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $30,408,979 | TotalAssetsBOYAmt |
| Total Assets EOY | $29,019,425 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $12,025,243 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $9,747,183 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $18,383,736 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $19,272,242 | NetAssetsOrFundBalancesEOYAmt |
| Mission | TO PROVIDE EXCEPTIONAL HEALTHCARE SERVICES IN A SAFE AND TRUSTFUL ENVIRONMENT THROUGH THE EXPERTISE, COMMITMENT AND COMPASSION OF OUR FAMILY OF CAREGIVERS. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $32,767,659 | ExpenseAmt |
| Grant | $20,000 | GrantAmt |
| Revenue | $40,756,841 | RevenueAmt |
| Desc | RUMFORD HOSPITAL IS A CRITICAL ACCESS HOSPITAL, PROVIDING COMPREHENSIVE PRIMARY CARE & SOPHISTICATED DIAGNOSTIC SERVICES, INCLUDING CT SCANNING, ULTRASOUND AND NUCLEAR MEDICINE. THE HOSPITAL OFFERS MEDICAL SURGICAL NURSING SERVICES, A BIRTHING CENTER, WOMEN'S HEALTH SERVICES & AMBULATORY SURGERY. THE SWING BED PROGRAM PROVIDES CARE FOR PATIENTS WHO NEED SKILLED NURSING SERVICES. RUMFORD HOSPITAL ALSO MAINTAINS A 24 HOUR EMERGENCY DEPARTMENT AND STAFFS AN INTENSIVE CARE UNIT. | Desc |
| Total Program Service Expenses | $32,767,659 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (true) | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (true) | LobbyingActivitiesInd |
| Subject To Proxy Tax | false | SubjectToProxyTaxInd |
| Donor Advised Fund | false | DonorAdvisedFundInd |
| Conservation Easements | false | ConservationEasementsInd |
| Collections Of Art | false | CollectionsOfArtInd |
| Credit Counseling | false | CreditCounselingInd |
| Temp Or Permanent Endowments | Yes (true) | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (true) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | false | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | Yes (true) | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (true) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | false | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | false | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (true) | ConsolidatedAuditFinclStmtInd |
| School Operating | false | SchoolOperatingInd |
| Foreign Office | false | ForeignOfficeInd |
| Foreign Activities | false | ForeignActivitiesInd |
| More Than5000 K To Org | false | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividualsInd |
| Professional Fundraising | false | ProfessionalFundraisingInd |
| Fundraising Activities | false | FundraisingActivitiesInd |
| Gaming Activities | false | GamingActivitiesInd |
| Operate Hospital | Yes (true) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (true) | AuditedFinancialStmtAttInd |
| Grants To Organizations | Yes (true) | GrantsToOrganizationsInd |
| Grants To Individuals | false | GrantsToIndividualsInd |
| Schedule J Required | Yes (true) | ScheduleJRequiredInd |
| Tax Exempt Bonds | false | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | false | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | false | PYExcessBenefitTransInd |
| Loan Outstanding | Yes (true) | LoanOutstandingInd |
| Grant To Related Person | false | GrantToRelatedPersonInd |
| Business Rln With Org Mem | false | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | false | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | false | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | false | DeductibleNonCashContriInd |
| Deductible Art Contribution | false | DeductibleArtContributionInd |
| Terminate Operations | false | TerminateOperationsInd |
| Partial Liquidation | false | PartialLiquidationInd |
| Disregarded Entity | false | DisregardedEntityInd |
| Related Entity | Yes (true) | RelatedEntityInd |
| Related Organization Ctrl Ent | false | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | false | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| IRP Document | 46 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (true) | BackupWthldComplianceInd |
| Employee | 347 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (true) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | false | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | false | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | false | TaxablePartyNotificationInd |
| Nondeductible Contributions | false | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | false | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | false | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | false | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | false | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 9 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 8 | IndependentVotingMemberCnt |
| Family Or Business Rln | Yes (true) | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | false | DelegationOfMgmtDutiesInd |
| Change To Org Documents | false | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (true) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (true) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (true) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (true) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (true) | MinutesOfCommitteesInd |
| Officer Mailing Address | false | OfficerMailingAddressInd |
| Local Chapters | false | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (true) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (true) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (true) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (true) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (true) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (true) | DocumentRetentionPolicyInd |
| Compensation Process CEO | false | CompensationProcessCEOInd |
| Compensation Process Other | false | CompensationProcessOtherInd |
| Investment In Joint Venture | false | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | ME | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | PHIL MORISSETTE | PersonNm |
| Phone | 2077952972 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 29 LOWELL STREET | AddressLine1 |
| City | LEWISTON | City |
| State | ME | State |
| ZIP Code | 04240 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | Yes (X) | InfoInScheduleOPartVIIInd |
Form990 Part VII Section A Form990PartVIISectionAGrp (16 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 | Key EmployeeKeyEmployeeInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|---|
| PETER E CHALKE | |||||||||
| PRESIDENT OF CMHC | 1.0 | 60.0 | Yes (X) | Yes (X) | $0 | $635,098 | $29,571 | ||
| JOLAN IPPOLITO | |||||||||
| CHAIRMAN | 1.0 | Yes (X) | Yes (X) | $0 | $0 | $0 | |||
| ROGER ARSENAULT | |||||||||
| DIRECTOR | 1.0 | Yes (X) | $0 | $0 | $0 | ||||
| RICHARD LOVEJOY | |||||||||
| SECRETARY/TREASURER | 1.0 | 2.0 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| LINDA CAMERON OD | |||||||||
| DIRECTOR/VICE CHAIR | 1.0 | Yes (X) | Yes (X) | $0 | $0 | $0 | |||
| DAVID DUGUAY | |||||||||
| DIRECTOR | 1.0 | Yes (X) | $0 | $0 | $0 | ||||
| JANET HALL | |||||||||
| DIRECTOR | 1.0 | Yes (X) | $0 | $0 | $0 | ||||
| JERROLD COHEN | |||||||||
| DIRECTOR | 1.0 | Yes (X) | $0 | $0 | $0 | ||||
| THOMAS PUIIA | |||||||||
| DIRECTOR BEGINNING 1/14 | 1.0 | Yes (X) | $0 | $0 | $0 | ||||
| R DAVID FRUM | |||||||||
| PRESIDENT | 27.5 | 29.5 | Yes (X) | $0 | $303,687 | $59,199 | |||
| JOHN KROGER MD | |||||||||
| DIVISION CHIEF | 55.0 | $212,387 | $0 | $26,121 | Yes (X) | ||||
| JACOB LEDESMA MD | |||||||||
| PHYSICIAN | 55.0 | $408,690 | $0 | $28,375 | Yes (X) | ||||
| THOMAS DELUCA MD | |||||||||
| PHYSICIAN | 55.0 | $321,926 | $0 | $24,385 | Yes (X) | ||||
| SAID DAOUD MD | |||||||||
| PHYSICIAN | 55.0 | $289,340 | $0 | $25,492 | Yes (X) | ||||
| JEFFREY LYNDS MD | |||||||||
| PHYSICIAN | 55.0 | $338,897 | $0 | $13,006 | Yes (X) | ||||
| LARRY HOPPERSTEAD MD | |||||||||
| PHYSICIAN | 55.0 | $346,991 | $0 | $48,040 | Yes (X) | ||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $1,918,231 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $938,785 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $254,189 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 18 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | false | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (true) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| ServicesServicesDesc | CompensationCompensationAmt |
|---|---|
| CPS INC | |
| PHARMACY SERVICES | $506,592 |
| WEATHERBY LOCUMS INC | |
| MEDICAL STAFFING | $437,865 |
| CERNER CORPORATION | |
| IT SERVICES | $352,549 |
| CHG COMPANIES INC | |
| MEDICAL STAFFING | $222,891 |
| TRI COUNTY MENTAL HEALTH SERVICES | |
| MEDICAL STAFFING | $211,646 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 13 | CntrctRcvdGreaterThan100KCnt |
| All Other Contributions | $91,991 | AllOtherContributionsAmt |
| Total Contributions | $91,991 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| NET PATIENT SERVICE REVENUE | 900099 | $39,753,857 | $39,753,857 |
| CAFETERIA REVENUE | 722514 | $77,918 | $77,918 |
| OTHER REVENUE | 900099 | $925,066 | $925,066 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $40,756,841 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $83,759 | TotalRevenueColumnAmt |
| Exclusion | $83,759 | ExclusionAmt |
Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Royalties Revenue RoyaltiesRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $7,306 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $48,268 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | -$40,962 | RealAmt |
| Personal | $0 | PersonalAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$40,962 | TotalRevenueColumnAmt |
| Exclusion | -$40,962 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $1,944,818 | SecuritiesAmt |
| Other | $6,511 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $1,824,592 | SecuritiesAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $120,226 | SecuritiesAmt |
| Other | $6,511 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $126,737 | TotalRevenueColumnAmt |
| Exclusion | $126,737 | ExclusionAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Net Income From Gaming NetIncomeFromGamingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Net Income Or Loss NetIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $0 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $41,018,366 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $40,756,841 | RelatedOrExemptFuncIncomeAmt |
| Exclusion | $169,534 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $20,000 | TotalAmt |
| Program Services | $20,000 | ProgramServicesAmt |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Foreign Grants ForeignGrantsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Benefits To Members BenefitsToMembersGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $238,508 | TotalAmt |
| Program Services | $238,508 | ProgramServicesAmt |
Comp Disqual Persons CompDisqualPersonsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $13,907,578 | TotalAmt |
| Program Services | $10,613,249 | ProgramServicesAmt |
| Management And General | $3,294,329 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $313,692 | TotalAmt |
| Program Services | $239,235 | ProgramServicesAmt |
| Management And General | $74,457 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,889,023 | TotalAmt |
| Program Services | $1,443,470 | ProgramServicesAmt |
| Management And General | $445,553 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $916,312 | TotalAmt |
| Program Services | $702,527 | ProgramServicesAmt |
| Management And General | $213,785 | ManagementAndGeneralAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $45,573 | TotalAmt |
| Management And General | $45,573 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $13,240 | TotalAmt |
| Management And General | $13,240 | ManagementAndGeneralAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Prof Fundraising FeesForServicesProfFundraising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,674 | TotalAmt |
| Management And General | $7,674 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $8,078,733 | TotalAmt |
| Program Services | $6,193,884 | ProgramServicesAmt |
| Management And General | $1,884,849 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $92,789 | TotalAmt |
| Program Services | $71,140 | ProgramServicesAmt |
| Management And General | $21,649 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,125,114 | TotalAmt |
| Program Services | $1,629,306 | ProgramServicesAmt |
| Management And General | $495,808 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $598,195 | TotalAmt |
| Program Services | $458,630 | ProgramServicesAmt |
| Management And General | $139,565 | ManagementAndGeneralAmt |
Royalties RoyaltiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $646,837 | TotalAmt |
| Program Services | $495,923 | ProgramServicesAmt |
| Management And General | $150,914 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $176,101 | TotalAmt |
| Program Services | $135,015 | ProgramServicesAmt |
| Management And General | $41,086 | ManagementAndGeneralAmt |
Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $62,838 | TotalAmt |
| Program Services | $48,177 | ProgramServicesAmt |
| Management And General | $14,661 | ManagementAndGeneralAmt |
Payments To Affiliates PaymentsToAffiliatesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,449,604 | TotalAmt |
| Program Services | $1,111,397 | ProgramServicesAmt |
| Management And General | $338,207 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $824,032 | TotalAmt |
| Program Services | $631,777 | ProgramServicesAmt |
| Management And General | $192,255 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| BAD DEBT | $4,808,549 | $4,808,549 | |
| MEDICAL SUPPLIES & DRUGS | $3,210,684 | $3,210,684 | |
| REPAIRS & MAINTENANCE | $806,853 | $618,606 | $188,247 |
| LICENSES, DUES, SUBSCRIPTIONS | $72,163 | $55,327 | $16,836 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $55,114 | TotalAmt |
| Program Services | $42,255 | ProgramServicesAmt |
| Management And General | $12,859 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $40,359,206 | TotalAmt |
| Program Services | $32,767,659 | ProgramServicesAmt |
| Management And General | $7,591,547 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $131,865 | BOYAmt |
| EOY | $37,884 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,213,440 | BOYAmt |
| EOY | $2,695,845 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,036,644 | BOYAmt |
| EOY | $6,731,378 | EOYAmt |
Receivables From Officers Etc ReceivablesFromOfficersEtcGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $16,106 | BOYAmt |
| EOY | $11,124 | EOYAmt |
Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $246,917 | BOYAmt |
| EOY | $269,166 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $731,154 | BOYAmt |
| EOY | $539,267 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $32,272,163 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $19,605,617 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $12,914,898 | BOYAmt |
| EOY | $12,666,546 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $4,334,966 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,117,955 | BOYAmt |
| EOY | $1,733,249 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $30,408,979 | BOYAmt |
| EOY | $29,019,425 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,234,553 | BOYAmt |
| EOY | $5,935,690 | EOYAmt |
Grants Payable GrantsPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $60,961 | BOYAmt |
| EOY | $27,365 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Escrow Account Liability EscrowAccountLiabilityGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Loans From Officers Directors LoansFromOfficersDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,629,794 | BOYAmt |
| EOY | $1,427,587 | EOYAmt |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,099,935 | BOYAmt |
| EOY | $2,356,541 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $12,025,243 | BOYAmt |
| EOY | $9,747,183 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $17,892,062 | BOYAmt |
| EOY | $18,768,015 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $237,935 | BOYAmt |
| EOY | $246,970 | EOYAmt |
Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $253,739 | BOYAmt |
| EOY | $257,257 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $18,383,736 | BOYAmt |
| EOY | $19,272,242 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $30,408,979 | BOYAmt |
| EOY | $29,019,425 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $659,160 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $225,828 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | $3,518 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | false | AccountantCompileOrReviewInd |
| FS Audited | Yes (true) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (true) | AuditCommitteeInd |
| Federal Grant Audit Required | false | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule 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) |
|---|---|---|
| Total Grassroots Lobbying | TotalGrassrootsLobbyingGrp | |
| Total Direct Lobbying | TotalDirectLobbyingGrp | |
| Total Lobbying Expend | TotalLobbyingExpendGrp | |
| Other Exempt Purpose Expend | OtherExemptPurposeExpendGrp | |
| Total Exempt Purpose Expend | TotalExemptPurposeExpendGrp | |
| Lobbying Nontaxable Amount | LobbyingNontaxableAmountGrp | |
| Grassroots Nontaxable | GrassrootsNontaxableGrp | |
| Tot Lbbyng Grassroot Mns Non Tx | TotLbbyngGrassrootMnsNonTxGrp | |
| Tot Lbby Expend Mns Lbbyng Non Tx | TotLbbyExpendMnsLbbyngNonTxGrp | |
| Volunteers | false | VolunteersInd |
| Paid Staff Or Management | false | PaidStaffOrManagementInd |
| Media Advertisements | false | MediaAdvertisementsInd |
| Mailings Members | false | MailingsMembersInd |
| Publications Or Broadcast | false | PublicationsOrBroadcastInd |
| Grants Other Organizations | false | GrantsOtherOrganizationsInd |
| Direct Contact Legislators | false | DirectContactLegislatorsInd |
| Rallies Demonstrations | false | RalliesDemonstrationsInd |
| Other Activities | Yes (true) | OtherActivitiesInd |
| Other Activities | $7,690 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $7,690 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | false | NotDescribedSection501c3Ind |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE C, PART II-B, LINE 1I | FormAndLineReferenceDesc |
| Explanation | PORTION OF DUES FOR PROFESSIONAL ASSOCIATIONS ATTRIBUTED TO LOBBYING EXPENSES - $7,690 | ExplanationTxt |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Art Public Exhibition Amounts | ArtPublicExhibitionAmountsGrp | |
| Held Works Art | HeldWorksArtGrp |
CY Endwmt Fund CYEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $491,674 | BeginningYearBalanceAmt |
| Contributions | $9,235 | ContributionsAmt |
| Investment Earnings Or Losses | $3,518 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $200 | OtherExpendituresAmt |
| End Year Balance | $504,227 | EndYearBalanceAmt |
CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $502,201 | BeginningYearBalanceAmt |
| Contributions | $6,910 | ContributionsAmt |
| Investment Earnings Or Losses | -$836 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $16,601 | OtherExpendituresAmt |
| End Year Balance | $491,674 | EndYearBalanceAmt |
CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $491,734 | BeginningYearBalanceAmt |
| Contributions | $12,735 | ContributionsAmt |
| Investment Earnings Or Losses | -$2,068 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $200 | OtherExpendituresAmt |
| End Year Balance | $502,201 | EndYearBalanceAmt |
CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $499,320 | BeginningYearBalanceAmt |
| Contributions | $9,000 | ContributionsAmt |
| Investment Earnings Or Losses | $10,970 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $27,556 | OtherExpendituresAmt |
| End Year Balance | $491,734 | EndYearBalanceAmt |
CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $463,891 | BeginningYearBalanceAmt |
| Contributions | $13,532 | ContributionsAmt |
| Investment Earnings Or Losses | $23,747 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $1,850 | OtherExpendituresAmt |
| End Year Balance | $499,320 | EndYearBalanceAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Prmnnt Endowment Balance EOY | 0.51020 | PrmnntEndowmentBalanceEOYPct |
| Term Endowment Balance EOY | 0.48980 | TermEndowmentBalanceEOYPct |
| Endowments Held Unrelated Org | false | EndowmentsHeldUnrelatedOrgInd |
| Endowments Held Related Org | Yes (true) | EndowmentsHeldRelatedOrgInd |
| Related Org List Sch R | Yes (true) | RelatedOrgListSchRInd |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $89,148 | OtherCostOrOtherBasisAmt |
| Book Value | $89,148 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $14,686,935 | OtherCostOrOtherBasisAmt |
| Depreciation | $6,509,179 | DepreciationAmt |
| Book Value | $8,177,756 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Leasehold Improvements | LeaseholdImprovementsGrp |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $17,052,000 | OtherCostOrOtherBasisAmt |
| Depreciation | $12,841,723 | DepreciationAmt |
| Book Value | $4,210,277 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $444,080 | OtherCostOrOtherBasisAmt |
| Depreciation | $254,715 | DepreciationAmt |
| Book Value | $189,365 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $12,666,546 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp (4 entries)
| DescDesc | Book ValueBookValueAmt |
|---|---|
| EST AMT DUE FROM 3RD PARTIES | $611,275 |
| INVESTMENT IN CHARITABLE TRUST | $67,922 |
| OTHER RECEIVABLES | $1,051,302 |
| DEPOSITS | $2,750 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $1,733,249 | TotalBookValueOtherAssetsAmt |
| Federal Income Tax Liability | $0 | FederalIncomeTaxLiabilityAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | DUE TO AFFILIATES | Desc |
| Amt | $2,356,541 | Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $2,356,541 | TotalLiabilityAmt |
| Total Rev Etc Audited Fincl Stmt | $41,275,753 | TotalRevEtcAuditedFinclStmtAmt |
| Net Unrealized Gains Invst | $225,828 | NetUnrealizedGainsInvstAmt |
| Other Revenue | -$7,474 | OtherRevenueAmt |
| Revenue Not Reported | $218,354 | RevenueNotReportedAmt |
| Revenue Subtotal | $41,057,399 | RevenueSubtotalAmt |
| Other Revenues Not Included | -$39,033 | OtherRevenuesNotIncludedAmt |
| Revenue Not Reported Fincl Stmt | -$39,033 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $41,018,366 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $40,399,800 | TotExpnsEtcAuditedFinclStmtAmt |
| Other Expenses Included | $48,268 | OtherExpensesIncludedAmt |
| Expenses Not Reported | $48,268 | ExpensesNotReportedAmt |
| Expenses Subtotal | $40,351,532 | ExpensesSubtotalAmt |
| Investment Expenses Not Incld2 | $7,674 | InvestmentExpensesNotIncld2Amt |
| Expenses Not Rpt Fincl Stmt | $7,674 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $40,359,206 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| SCHEDULE D, PART V, LINE 4 | ENDOWMENT FUNDS ENDOWMENT FUNDS ARE USED TO SUPPORT THE ORGANIZATION IN A VARIETY OF WAYS, DEPENDING UPON THE STATED PURPOSE OF EACH FUND. MANY OF THESE FUNDS HELP TO COVER COSTS OF CAPITAL EQUIPMENT PURCHASES, CONTINUING EDUCATION, OR FREE CARE. OTHERS ARE DESIGNATED TO SUPPORT SPECIFIC DEPARTMENTS OF THE HOSPITAL. |
| SCHEDULE D, PART X, LINE 2 | UNCERTAIN TAX POSITION MANAGEMENT HAS EVALUATED THEIR INCOME TAX POSITIONS UNDER THE GUIDANCE INCLUDED IN ASC 740. BASED ON THEIR REVIEW, MANAGEMENT HAS NOT IDENTIFIED ANY MATERIAL UNCERTAIN TAX POSITIONS TO BE RECORDED OR DISCLOSED IN THE FINANCIAL STATEMENTS. |
| SCHEDULE D, PART XI, LINE 2D | AMOUNTS INCLUDED ON LINE 1, BUT NOT ON FORM 990, PART VIII, LINE 12: $ 200 NET ASSETS RELEASED FROM RESTRICTION (7,674) INVESTMENT MANAGEMENT FEES ----------- $ (7,474) |
| SCHEDULE D, PART XI, LINE 4B | AMOUNTS INCLUDED ON FORM 990, PART VIII, LINE 12, BUT NOT ON LINE 1: $ 9,235 TEMPORARILY RESTRICTED CONTRIBUTIONS (48,268) RENTAL EXPENSES ------------ (39,033) |
| SCHEDULE D, PART XII, LINE 2D | AMOUNTS INCLUDED ON LINE 1, BUT NOT ON FORM 990, PART IX, LINE 25: $ 48,268 RENTAL EXPENSES |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (true) | FinancialAssistancePolicyInd |
| Written Policy | Yes (true) | WrittenPolicyInd |
| All Hospitals Policy | Yes (X) | AllHospitalsPolicyInd |
| FPG Reference Free Care | Yes (true) | FPGReferenceFreeCareInd |
| Percent150 | Yes (X) | Percent150Ind |
| FPG Reference Discounted Care | false | FPGReferenceDiscountedCareInd |
| Free Care Medically Indigent | Yes (true) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (true) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | Yes (true) | ExpensesExceedBudgetInd |
| Unable To Provide Care | false | UnableToProvideCareInd |
| Annual Community Bnft Report | false | AnnualCommunityBnftReportInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $905,099 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $905,099 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.02550 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $7,853,838 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $5,614,317 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $2,239,521 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.06300 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $8,758,937 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $5,614,317 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $3,144,620 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.08850 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $20,000 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $20,000 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00060 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $20,000 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $20,000 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00060 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $8,778,937 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $5,614,317 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $3,164,620 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.08910 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | false | BadDebtExpenseReportedInd |
| Bad Debt Expense | $4,808,549 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $653,963 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $8,376,427 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $8,301,213 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | $75,214 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | Yes (X) | CostToChargeRatioInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (true) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (true) | FinancialAssistancePrvsnInd |
| Hospital Facilities | 1 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RUMFORD HOSPITAL | BusinessNameLine1 |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 420 FRANKLIN STREET | AddressLine1 |
| City | RUMFORD | City |
| State | ME | State |
| ZIP Code | 04276 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | www.rumfordhospital.org | WebsiteAddressTxt |
| State License | 38031 | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Critical Access Hospital | Yes (X) | CriticalAccessHospitalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
| Other | OUTPATIENT PHYSICIAN CLINIC | OtherDesc |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RUMFORD HOSPITAL | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| CHNA Conducted | Yes (true) | CHNAConductedInd |
| Community Definition | Yes (X) | CommunityDefinitionInd |
| Community Demographics | Yes (X) | CommunityDemographicsInd |
| Existing Resources | Yes (X) | ExistingResourcesInd |
| How Data Obtained | Yes (X) | HowDataObtainedInd |
| Community Health Needs | Yes (X) | CommunityHealthNeedsInd |
| Other Health Issues | Yes (X) | OtherHealthIssuesInd |
| Community Hlth Needs Id Process | Yes (X) | CommunityHlthNeedsIdProcessInd |
| Consulting Process | Yes (X) | ConsultingProcessInd |
| Information Gaps | Yes (X) | InformationGapsInd |
| CHNA Conducted | 12 | CHNAConductedYr |
| Take Into Account Others Input | Yes (true) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | false | CHNAConductedWithOtherFcltsInd |
| CHNA Report Widely Available | Yes (true) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | rumfordhospital.org/community-benefits | OwnWebsiteURLTxt |
| Rpt Available Upon Request | Yes (X) | RptAvailableUponRequestInd |
| Adopt Implementation Strategy | Yes (X) | AdoptImplementationStrategyInd |
| Exec Implementation Strategy | Yes (X) | ExecImplementationStrategyInd |
| Develop Community Wide Plan | Yes (X) | DevelopCommunityWidePlanInd |
| Exec Community Wide Plan | Yes (X) | ExecCommunityWidePlanInd |
| Include Operational Plan | Yes (X) | IncludeOperationalPlanInd |
| Prioritize Health Needs | Yes (X) | PrioritizeHealthNeedsInd |
| Prioritize Services | Yes (X) | PrioritizeServicesInd |
| All Needs Addressed | false | AllNeedsAddressedInd |
| Organization Incur Excise Tax | false | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (true) | EligCriteriaExplainedInd |
| FPG Used Deter Elig Free Care | Yes (true) | FPGUsedDeterEligFreeCareInd |
| FPG Family Incm Lmt Free Care | 150. | FPGFamilyIncmLmtFreeCarePct |
| FPG Used Determ Elig Dscnt Care | false | FPGUsedDetermEligDscntCareInd |
| Explained Basis | Yes (true) | ExplainedBasisInd |
| Medical Indigency | Yes (X) | MedicalIndigencyInd |
| State Regulation | Yes (X) | StateRegulationInd |
| App Financial Asst Expln | Yes (true) | AppFinancialAsstExplnInd |
| Includes Publicity Measures | Yes (true) | IncludesPublicityMeasuresInd |
| Posted On Website | Yes (X) | PostedOnWebsiteInd |
| Posted In Emergency Room | Yes (X) | PostedInEmergencyRoomInd |
| Posted In Admission Office | Yes (X) | PostedInAdmissionOfficeInd |
| Provided On Admission | Yes (X) | ProvidedOnAdmissionInd |
| Available On Request | Yes (X) | AvailableOnRequestInd |
| FAP Actions On Nonpayment | Yes (true) | FAPActionsOnNonpaymentInd |
| Collection Activities | false | CollectionActivitiesInd |
| FAP Notified Upon Admission | Yes (X) | FAPNotifiedUponAdmissionInd |
| Documented Elig Determination | Yes (X) | DocumentedEligDeterminationInd |
| Nondis Emergency Care Policy | Yes (true) | NondisEmergencyCarePolicyInd |
| Other Method Used | Yes (X) | OtherMethodUsedInd |
| Amounts Generally Billed | false | AmountsGenerallyBilledInd |
| Gross Charges | false | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| SCHEDULE H, PART V, SECTION B, LINE 3 | COMMUNITY INPUT ON A STATEWIDE BASIS, THE RESEARCH CONSULTANTS DEVELOPED AN ADVISORY COMMITTEE THAT MET TWO TIMES DURING THE ASSESSMENT RESEARCH AND DRAFTING OF THE PUBLICATION. THESE INDIVIDUALS REPRESENTED A BROAD SPECTRUM OF BACKGROUNDS, AND THEY ARE NAMED: CAROL BELL, HEALTHY MAINE PARTNERSHIP DIRECTOR; KELLY BENTLEY, HEALTHY MAINE PARTNERSHIP DIRECTOR, GAIL DANA-SACCO, WABANAKI CENTER (SERVING TRIBAL POPULATIONS); PATRICIA HART, MAINE DEVELOPMENT FOUNDATION; BARBARA LEONARD, MPH, MAINE HEALTH ACCESS FOUNDATION (PHILANTHROPIC FOUNDATION FOCUSED ON ACCESS TO CARE IN MAINE); BECCA MATUSOVICH, MAINE CENTER FOR DISEASE CONTROL; LISA MILLER, BINGHAM FOUNDATION (PHILANTHROPIC FOUNDATION); DORA ANN MILLS, MD, MAINE CENTER FOR DISEASE CONTROL; ELIZABETH MITCHELL, MAINE HEALTH MANAGEMENT COALITION (REPRESENTING THE STATE'S MAJOR EMPLOYERS, INSURERS AND PROVIDERS); TRISH RILEY, GOVERNOR'S OFFICE OF HEALTH POLICY AND FINANCE (GOHPF); BRIAN RINES, ADVISORY COMMITTEE FOR HEALTH SYSTEM DEVELOPMENT (OVERSEEN BY GOHPF); RACHEL TALBOT-ROSS, MAINE CHAPTER, NAACP; TED TRAINER, PUBLIC HEALTH COORDINATING COUNCIL; SHAWN YARDLEY, CITY OF BANGOR, DEPARTMENT OF HEALTH AND WELFARE. IN THE LOCAL AREA SERVED BY THE ASSESSMENT, MULTIPLE PARTIES WERE ENGAGED IN DISSEMINATION OF THE ASSESSMENT FINDINGS AND ESTABLISHMENT OF PRIORITIES. |
| SCHEDULE H, PART V, SECTION B, LINE 6 | IMPLEMENTATION STRATEGY IN RESPONSE TO THE RESULTS OF RUMFORD HOSPITAL'S MOST RECENTLY CONDUCTED COMMUNITY HEALTH NEEDS ASSESSMENT, THE ORGANIZATION ADOPTED AN IMPLEMENTATION STRATEGY. THE IMPLEMENTATION STRATEGY CAN BE FOUND AT THE FOLLOWING URL: http://www.rumfordhospital.org/community-benefits RUMFORD HOSPITAL HAS CREATED AN IMPLEMENTATION STRATEGY TO DIRECTLY ADDRESS SEVERAL HEATH ISSUES, INCLUDING CANCER, CARDIOVASCULAR DISEASE AND DIABETES. RUMFORD HOSPITAL INDIRECTLY ADDRESSES MENTAL HEALTH BY EMBEDDING EXTERNAL MENTAL HEALTH AGENCY STAFF WITHIN PRIMARY CARE PRACTICES. |
| SCHEDULE H, PART V, SECTION B, LINE 7 | ADDRESSING IDENTIFIED NEEDS RUMFORD HOSPITAL IS NOT DIRECTLY ADDRESSING MENTAL HEALTH AS THIS IS WIDELY COVERED BY MENTAL HEALTH AGENCIES IMBEDDED WITHIN OUR PRIMARY CARE PRACTICES. |
| SCHEDULE H, PART V, LINE 14G | OTHER METHODS USED TO PUBLICIZE THE FINANCIAL ASSISTANCE POLICY THE FAP IS POSTED IN ALL OUTPATIENT DEPARTMENTS INCLUDING PROVIDER BASED PHYSICIANS' OFFICES, PATIENT FINANCIAL SERVICES, AND IS OFFERED TO ANY PATIENTS INDICATING A FINANCIAL NEED WHEN THEY CALL CUSTOMER SERVICE OR PRESENT THEMSELVES IN THE PATIENT FINANCIAL SERVICES DEPARTMENT. |
| SCHEDULE H, PART V, SECTION B, LINE 20D | MAXIMUM AMOUNTS CHARGED TO FAP-ELIGIBLE INDIVIDUALS FAP-ELIGIBLE PATIENTS ULTIMATELY RECEIVE FREE CARE. IF THE PATIENT HAS INSURANCE, THE INSURANCE COMPANY WOULD BE BILLED AND ONLY THE PATIENT RESPONSIBILITY PORTION, UNDER THAT CARRIER'S CONTRACT, WOULD BE BILLED TO THE PATIENT. IF THE PATIENT IS UNINSURED, THE PATIENT WOULD BE BILLED WITH A 20% UNINSURED DISCOUNT FROM GROSS CHARGES. ONCE A PATIENT'S ELIGIBILITY IS CONFIRMED THROUGH THE FAP'S APPLICATION PROCESS, A FAP ADJUSTMENT WOULD BE APPLIED TO THE PATIENT'S ACCOUNT, BRINGING THE BALANCE TO ZERO. |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 5 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp (5 entries)
| Address Line1USAddress/AddressLine1 | CityUSAddress/City | StateUSAddress/State | ZIP CodeUSAddress/ZIPCode | FacilityFacilityTxt |
|---|---|---|---|---|
| RIVER VALLEY INTERNAL MEDICINE | ||||
| 431 FRANKLIN STREET | RUMFORD | ME | 04276 | OUTPATIENT PHYSICIAN CLINIC |
| RUMFORD SURGICAL SPECIALISTS | ||||
| 431 FRANKLIN STREET | RUMFORD | ME | 04276 | OUTPATIENT PHYSICIAN CLINIC |
| SWIFT RIVER FAMILY MEDICINE | ||||
| 430 FRANKLIN STREET | RUMFORD | ME | 04276 | OUTPATIENT PHYSICIAN CLINIC |
| ELSEMORE DIXFIELD FAMILY MEDICINE | ||||
| 146 WELD STREET | DIXFIELD | ME | 04224 | OUTPATIENT PHYSICIAN CLINIC |
| RUMFORD SPECIALTY SERVICES CLINIC | ||||
| 431 FRANKLIN STREET | RUMFORD | ME | 04276 | OUTPATIENT PHYSICIAN CLINIC |
Supplemental Information Detail SupplementalInformationDetail (12 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| SCHEDULE H, PART I, LINE 7, COLUMN F | PERCENT OF TOTAL EXPENSE TO ARRIVE AT THE PERCENT OF TOTAL EXPENSES, THE DENOMINATOR WHICH EQUALS TOTAL OPERATING EXPENSES PER PART IX, LINE 25 OF THE FORM 990, WAS REDUCED BY BAD DEBT EXPENSE OF $4,808,549. |
| SCHEDULE H, PART I, LINE 7 | COSTING METHODOLOGY THE COST TO CHARGE RATIO CALCULATED ON IRS WORKSHEET 2 WAS USED TO CALCULATE AMOUNTS ON IRS WORKSHEETS 1 AND 3. ALL OTHER WORKSHEETS USED THE ORGANIZATION'S COST ACCOUNTING SYSTEM. |
| SCHEDULE H, PART III, SECTION A, LINE 4 | BAD DEBT EXPENSE LINE 2 REPORTS BAD DEBT EXPENSE FROM THE ORGANIZATION'S AUDITED FINANCIAL STATEMENTS. |
| SCHEDULE H, PART III, SECTION A, LINE 3 | BAD DEBT EXPENSE ATTRIBUTABLE TO CHARITY CARE BAD DEBT ATTRIBUTABLE TO PATIENTS UNDER THE ORGANIZATION'S CHARITY CARE POLICY FOR LINE 3 WAS DETERMINED USING A COMPARISON OF EXPERIENCED CHARITY CARE COVERAGE AND US CENSUS BUREAU DATA FOR THE MOST RECENT YEAR AVAILABLE WHEN CHARITY CARE CONVERGE EXCEEDS THE CENSUS DATA, A MINIMAL AMOUNT OF BAD DEBT IS ASSUMED TO BE ELIGIBLE FOR CHARITY CARE TO ACCOUNT FOR THOSE PATIENTS WHO REFUSE TO PROVIDE INFORMATION DOCUMENTING ELIGIBILITY FOR THE PROGRAM. THESE ESTIMATES ARE BASED ON STATE-WIDE DATA AND DO NOT ACCOUNT FOR DIFFERENCES IN GEOGRAPHIC LOCATIONS WITHIN THE STATE. AS THIS AMOUNT IS RELATED TO PATIENTS ELIGIBLE UNDER THE FINANCIAL ASSISTANCE POLICY, IT IS INCLUDED AS A COMMUNITY BENEFIT. |
| SCHEDULE H, PART III, SECTION A, LINE 4 | BAD DEBT EXPENSE FOOTNOTE THE AUDITED FINANCIAL STATEMENTS DO NOT CONTAIN A FOOTNOTE THAT DESCRIBES BAD DEBT EXPENSE. THEY DO, HOWEVER, CONTAIN A FOOTNOTE THAT DESCRIBES PATIENT ACCOUNTS RECEIVABLE. THAT FOOTNOTE READS AS FOLLOWS: THE CORPORATION REPORTS PATIENT ACCOUNTS RECEIVABLE FOR SERVICES RENDERED AT NET REALIZABLE AMOUNTS FROM THIRD-PARTY PAYERS, PATIENTS AND OTHERS. THE CORPORATION PROVIDES AN ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS BASED UPON A REVIEW OF OUTSTANDING RECEIVABLES, HISTORICAL COLLECTION INFORMATION AND EXISTING ECONOMIC CONDITIONS. AS A SERVICE TO THE PATIENT, THE CORPORATION BILLS THIRD-PARTY PAYERS DIRECTLY AND BILLS THE PATIENT WHEN THE PATIENT'S LIABILITY IS DETERMINED. PATIENT ACCOUNTS RECEIVABLE ARE DUE IN FULL WHEN BILLED. ACCOUNTS ARE CONSIDERED DELINQUENT AND SUBSEQUENTLY WRITTEN OFF AS BAD DEBTS BASED ON INDIVIDUAL CREDIT EVALUATION AND SPECIFIC CIRCUMSTANCES OF THE ACCOUNT. |
| SCHEDULE H, PART III, SECTION B, LINE 8 | COMMUNITY BENEFIT THE COSTING METHODOLOGY USED FOR LINE 6 IS INFORMATION PULLED FROM THE MEDICARE COST REPORT FILING. THE SHORTFALL REPORTED ON LINE 7 COULD BE CONSIDERED COMMUNITY BENEFIT TO A LEVEL PROPORTIONAL TO THE POVERTY LEVELS INDICATED BY CENSUS BUREAU DATA. IF THE PATIENTS FALLING UNDER 150% FPG LEVEL WERE NOT COVERED BY MEDICARE THEY WOULD QUALIFY UNDER CMMC'S FREE CARE POLICY. UNDER THAT CIRCUMSTANCE, THESE PATIENTS WOULD THEN APPEAR AS PART OF THE STATISTICS ON PART I, LINE 7A. |
| SCHEDULE H, PART III, SECTION C, LINE 9B | COLLECTION POLICY COLLECTION PRACTICES FOR PATIENTS KNOWN TO BE ELIGIBLE FOR CHARITY CARE ARE LIMITED TO COLLECTING FROM ANY AVAILABLE PAYMENT SOURCES SUCH AS MEDICARE OR MEDICAID. IF A PATIENT IS ELIGIBLE, BUT HAS NOT APPLIED FOR MEDICAID COVERAGE, THE PATIENT IS REQUESTED TO APPLY. ASSISTANCE IS AVAILABLE TO HELP THE PATIENT WITH THE MEDICAID APPLICATION PROCESS. |
| SCHEDULE H, PART VI, LINE 2 | NEEDS ASSESSMENT AS A CRITICAL ACCESS HOSPITAL, RUMFORD HOSPITAL ATTEMPTS TO PROVIDE ANY NEEDED HEALTH CARE SERVICES NECESSARY TO TREAT THE POPULATION OF THIS RURAL AREA OF MAINE. ADDITIONALLY, RUMFORD HOSPITAL FOCUSES ON STATE-WIDE INITIATIVES, SUCH AS HEART DISEASE AND DIABETES, AS WELL AS ORGANIZATIONAL INITIATIVES BASED ON NEEDS OBSERVED WITHIN ITS PATIENT POPULATION. MANY FORMS OF EDUCATION, PREVENTION AND EARLY DETECTION ARE ALSO PART OF ITS COMMUNITY HEALTH CARE PLAN. |
| SCHEDULE H, PART VI, LINE 3 | PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE RUMFORD HOSPITAL PROVIDES NOTICES ABOUT ITS FREE CARE POLICY IN ALL CLINICAL DEPARTMENTS AND MAJOR PATIENT AREAS. AN INPATIENT FINANCIAL COUNSELOR VISITS WITH ALL UNINSURED PATIENTS TO DISCUSS OPTIONS, INCLUDING GOVERNMENTAL PROGRAM ELIGIBILITY AND FREE CARE ASSISTANCE IS AVAILABLE TO HELP PATIENTS WITH COMPLETION OF MEDICAID APPLICATIONS. ALL PATIENT FINANCIAL SERVICES STAFF ARE TRAINED TO OFFER FREE CARE AS AN OPTION TO PATIENTS WHO INDICATE AN INABILITY OR DIFFICULTY IN PAYING FOR SERVICES. INFORMATION ABOUT FINANCIAL ASSISTANCE AVAILABILITY IS INCLUDED ON THE BACK OF EVERY PATIENT STATEMENT. ADDITIONALLY, UNINSURED PATIENTS RECEIVE A SEPARATE INFORMATION SHEET WITH THEIR STATEMENTS, FURTHER INFORMING THEM ABOUT THE AVAILABLE OPTIONS. |
| SCHEDULE H, PART VI, LINE 4 | COMMUNITY INFORMATION RUMFORD HOSPITAL, LOCATED IN RUMFORD, MAINE, SERVES CENTRAL OXFORD COUNTY ALONG THE WESTERN BORDER OF MAINE. A LIGHTLY POPULATED, RURAL AREA, THE REGION HAS A PRIMARILY CAUCASIAN POPULATION WITH 16% OF PERSONS AGED 65 OR OVER AND 14% OF THE POPULATION BELOW THE POVERTY LEVEL. |
| SCHEDULE H, PART VI, LINE 5 | PROMOTION OF COMMUNITY HEALTH RUMFORD HOSPITAL HAS AN OPEN MEDICAL STAFF, ALLOWING ANY NON-EMPLOYED OR AFFILIATED PHYSICIANS TO HAVE ADMITTING PRIVILEGES TO THE HOSPITAL. THE BOARD OF DIRECTORS IS MADE UP OF A MAJORITY OF LOCAL COMMUNITY MEMBERS ALONG WITH SOME REPRESENTATION BY DIRECTORS FROM CENTRAL MAINE HEALTHCARE, THE PARENT OF THE HEALTHCARE SYSTEM WHICH RUMFORD HOSPITAL BELONGS TO, HELPING TO BRING TOGETHER THE VISIONS OF THE LOCAL COMMUNITY WITH THE CAPABILITIES AND VISION OF THE SYSTEM AS A WHOLE FOR THE BENEFIT OF RUMFORD AND SURROUNDING COMMUNITIES. |
| SCHEDULE H, PART VI, LINE 6 | AFFILIATED HEALTH CARE SYSTEM AS A MEMBER OF THE CENTRAL MAINE HEALTHCARE SYSTEM, RUMFORD HOSPITAL PROVIDES HIGH QUALITY HEALTH CARE IN A RURAL SETTING WITH LIMITED HEALTH CARE OPTIONS. ITS AFFILIATION WITH CENTRAL MAINE MEDICAL CENTER PROVIDES ACCESS TO A MUCH LARGER, TERTIARY CARE HOSPITAL, INCLUDING TRAUMA CARE, NEONATAL INTENSIVE CARE, AND A SPECIALIZED CARDIAC CARE UNIT. ADDITIONALLY, CENTRAL MAINE MEDICAL CENTER PROVIDES ACCESS TO SPECIALIST PHYSICIANS FOR OUTPATIENT CARE IN THE RUMFORD AREA ON A REGULAR SCHEDULE. THE SYSTEM PARENT, CENTRAL MAINE HEALTHCARE, PROVIDES STREAMLINED ADMINISTRATIVE FUNCTIONS AND BACKROOM SERVICES, ALLOWING RUMFORD HOSPITAL TO PERFORM AT A COST EFFICIENT LEVEL WHICH WOULD NORMALLY BE UNACHIEVABLE IN A SMALL, RURAL HOSPITAL, ALLOWING FOR BROADER RANGE OF SERVICES AVAILABLE. |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (true) | GrantRecordsMaintainedInd |
Recipient Table RecipientTable (2 entries)
| Address Line1USAddress/AddressLine1 | CityUSAddress/City | StateUSAddress/State | ZIP CodeUSAddress/ZIPCode | Recipient EINRecipientEIN | IRC SectionIRCSectionDesc | Cash GrantCashGrantAmt | Purpose Of GrantPurposeOfGrantTxt |
|---|---|---|---|---|---|---|---|
| BLACK MOUNTAIN OF MAINE | |||||||
| 39 GLOVER ROAD | RUMFORD | ME | 04276 | 550831957 | 501(C)(3) | $10,000 | OPERATIONS |
| LIFEFLIGHT FOUNDATION | |||||||
| 13 MAIN ST 2N FL | CAMDEN | ME | 04843 | 522377085 | 501(C)(3) | $10,000 | OPERATIONS |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total501c3 Org | 2 | Total501c3OrgCnt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE I, PART I, LINE 2 | FormAndLineReferenceDesc |
| Explanation | MONITORING THE USE OF GRANT FUNDS THE GRANTS WERE AWARDED TO CHARITABLE ORGANIZATIONS EXEMPT UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE, FOR USE IN THEIR EXEMPT PURPOSE. THE MISSION OF THESE ORGANIZATIONS ALSO HELP SUPPORT COMMUNITY HEALTH OR HEALTHCARE, THEREBY HELPING TO FURTHER RUMFORD HOSPITAL'S EXEMPT PURPOSE AS WELL. SINCE THE GRANTS WERE NOT AWARDED WITH A SPECIFIC PURPOSE ATTACHED, NO TRACKING IS REQUIRED. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | false | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (true) | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | false | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | false | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | false | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | false | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | false | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | false | AnyNonFixedPaymentsInd |
| Initial Contract Exception | false | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| PETER E CHALKE | ||||||||||||||
| PRESIDENT OF CMHC | $0 | $592,913 | $0 | $0 | $0 | $42,185 | $0 | $16,674 | $0 | $12,897 | $0 | $664,669 | $0 | $0 |
| JACOB LEDESMA MD | ||||||||||||||
| PHYSICIAN | $343,165 | $0 | $47,458 | $0 | $18,067 | $0 | $6,375 | $0 | $22,000 | $0 | $437,065 | $0 | $0 | $0 |
| THOMAS DELUCA MD | ||||||||||||||
| PHYSICIAN | $284,275 | $0 | $30,822 | $0 | $6,829 | $0 | $6,375 | $0 | $18,010 | $0 | $346,311 | $0 | $0 | $0 |
| SAID DAOUD MD | ||||||||||||||
| PHYSICIAN | $257,286 | $0 | $27,750 | $0 | $4,304 | $0 | $4,946 | $0 | $20,546 | $0 | $314,832 | $0 | $0 | $0 |
| JEFFREY LYNDS MD | ||||||||||||||
| PHYSICIAN | $158,076 | $0 | $139,353 | $0 | $41,468 | $0 | $6,375 | $0 | $6,631 | $0 | $351,903 | $0 | $0 | $0 |
| JOHN KROGER MD | ||||||||||||||
| DIVISION CHIEF | $195,465 | $0 | $12,705 | $0 | $4,217 | $0 | $5,440 | $0 | $20,681 | $0 | $238,508 | $0 | $0 | $0 |
| R DAVID FRUM | ||||||||||||||
| PRESIDENT | $0 | $263,929 | $0 | $0 | $0 | $39,758 | $0 | $39,375 | $0 | $19,824 | $0 | $362,886 | $0 | $30,351 |
| LARRY HOPPERSTEAD MD | ||||||||||||||
| PHYSICIAN | $338,819 | $0 | $0 | $0 | $8,172 | $0 | $23,873 | $0 | $24,167 | $0 | $395,031 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| SCHEDULE J, PART I, LINE 3 | EXECUTIVE COMPENSATION THE COMPENSATION OF THE ORGANIZATION'S PRESIDENT IS DETERMINED BY THE PARENT CORPORATION'S BOARD OF DIRECTORS' EXECUTIVE COMPENSATION COMMITTEE USING THE FOLLOWING: -COMPENSATION COMMITTEE -INDEPENDENT COMPENSATION CONSULTANT -COMPENSATION SURVEY OR STUDY -APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE |
| SCHEDULE J, PART I, LINE 4B | SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN A PARTICIPANT'S ENTITLEMENT TO BENEFITS WILL VEST ON THE PARTICIPANT'S VESTING DATE PROVIDED THE PARTICIPANT HAS REMAINED IN CONTINUOUS EMPLOYMENT IN THE SAME POSITION WHILE PARTICIPATING IN THIS PLAN. A PARTICIPANT WILL HAVE ONLY ONE VESTING DATE FOR ALL ELECTIVE DEFERRALS AND OTHER PLAN CONTRIBUTIONS MADE ON THE PARTICIPANT'S BEHALF DURING ALL PLAN YEARS. A PARTICIPANT'S ENTITLEMENT TO BENEFITS WILL ALSO VEST (A) IF THE PARTICIPANT DIES WHILE STILL EMPLOYED BY THE EMPLOYER, (B) IF THE PARTICIPANT'S EMPLOYMENT TERMINATES DUE TO TOTAL DISABILITY, OR (C) IF THE EMPLOYER TERMINATES THE PARTICIPANT'S EMPLOYMENT FOR ANY REASON OTHER THAN FOR "CAUSE". ANY PORTION OF THE PARTICIPANT'S ENTITLEMENT BENEFITS THAT IS NOT VESTED WHEN THE PARTICIPANT'S EMPLOYMENT WITH THE EMPLOYER TERMINATES, INCLUDING ELECTIVE DEFERRALS, WILL BE FORFEITED. THE EMPLOYER WILL DISTRIBUTE A PARTICIPANT'S BENEFITS UNDER THE PLAN AS SOON AS PRACTICABLE AFTER THE PARTICIPANT'S ENTITLEMENT BECOMES VESTED. THE FOLLOWING INDIVIDUALS PARTICIPATED IN A SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN THROUGH CENTRAL MAINE HEALTHCARE CORPORATION, A RELATED ENTITY. $ 21,000 R. DAVID FRUM (DEFERRAL) 30,351 R. DAVID FRUM (PAYOUT) |
| SCHEDULE J, PART II, COLUMN F | COMPENSATION REPORTED IN PRIOR FORM 990 COMPENSATION IS REPORTED ON THE FORM 990 IN THE YEAR THAT THE COMPENSATION IS EARNED BY OR AWARDED TO AN INDIVIDUAL, EVEN IF THE COMPENSATION IS NOT PAID TO THE INDIVIDUAL, IS NOT FULLY VESTED, OR IS SUBJECT TO SUBSTANTIAL RISK OF FORFEITURE. IF COMPENSATION IS EARNED OR AWARDED IN ONE YEAR BUT PAID IN A LATER YEAR, THEN THE COMPENSATION IS REPORTED A SECOND TIME ON THE FORM 990 IN THE YEAR THE COMPENSATION IS VESTED OR PAID TO THE INDIVIDUAL. |
Schedule L IRS990ScheduleL
Loans Btwn Org Interested Prsn LoansBtwnOrgInterestedPrsnGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | JEFFREY LYNDS | PersonNm |
| Relationship With Org | EMPLOYEE | RelationshipWithOrgTxt |
| Loan Purpose | ADVANCE | LoanPurposeTxt |
| Loan From Organization | Yes (X) | LoanFromOrganizationInd |
| Original Principal | $25,000 | OriginalPrincipalAmt |
| Balance Due | $11,124 | BalanceDueAmt |
| Default | false | DefaultInd |
| Board Or Committee Approval | false | BoardOrCommitteeApprovalInd |
| Written Agreement | Yes (true) | WrittenAgreementInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Balance Due | $11,124 | TotalBalanceDueAmt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (8 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINES 6, 7A AND 7B | MEMBERS OR STOCKHOLDERS THE MEMBER OF THE CORPORATION SHALL BE CENTRAL MAINE HEALTHCARE CORPORATION, A CORPORATION DULY ORGANIZED UNDER THE LAWS OF THE STATE OF MAINE. THE MEMBER SHALL HAVE THE RIGHT TO (A) APPROVE THE ELECTION OF MEMBERS OF THE BOARD OF DIRECTORS, (B) REMOVE MEMBERS OF THE BOARD OF DIRECTORS, AND (C) APPROVE CERTAIN DECISIONS OF THE BOARD OF DIRECTORS, AS DETAILED IN THE BYLAWS OF THE CORPORATION. THERE SHALL BE NINE (9) DIRECTORS OF THE CORPORATION WHO SHALL BE ENTITLED TO VOTE ONE (1) OF THE NINE (9) VOTING DIRECTORS SHALL BE APPOINTED BY THE MEMBER, AND THE BALANCE OF VOTING DIRECTORS SHALL BE ELECTED BY THE BOARD OF DIRECTORS. |
| FORM 990, PART VI, SECTION B, LINE 11B | FORM 990 REVIEW PROCESS ALL AFFILIATED FORM 990's AND APPLICABLE SCHEDULES ARE PREPARED BY AN INDEPENDENT PUBLIC ACCOUNTING FIRM IN COOPERATION WITH THE FINANCE DEPARTMENT. THE COMPLETED RETURNS ARE REVIEWED WITH THE DIRECTOR OF FINANCE THEN WITH THE CFO FOLLOWING THAT REVIEW; THEY ARE PRESENTED TO THE FINANCE COMMITTEE OF THE CENTRAL MAINE HEALTHCARE BOARD OF DIRECTORS, WHICH HAS REPRESENTATIVES FROM ALL AFFILIATED BOARDS. ONCE THIS REVIEW IS COMPLETED, ANY NECESSARY CHANGES ARE MADE AND THE FINAL RETURN IS PRESENTED TO ITS RESPECTIVE BOARD WITH THE FINANCE COMMITTEE MEMBER TAKING AND ANSWERING QUESTIONS. A FINANCE DEPARTMENT REPRESENTATIVE, KNOWLEDGEABLE OF THE RETURN, IS AVAILABLE TO ASSIST DURING PRESENTATIONS, IF REQUESTED BY THE FINANCE COMMITTEE MEMBER. IN THE EVENT THAT THE NEXT BOARD MEETING IS NOT SCHEDULED UNTIL AFTER THE FILING DATE, THE FINAL RETURN IS MAILED TO ALL BOARD MEMBERS AND THE PRESENTATION OCCURS AT THE NEXT SCHEDULED BOARD MEETING. |
| FORM 990, PART VI, SECTION B, LINE 12C | MONITORING COMPLIANCE WITH CONFLICT OF INTEREST POLICY OFFICERS AND DIRECTORS COMPLETE AN ANNUAL CONFLICT OF INTEREST STATEMENT WHICH IS REVIEWED BY THE CHAIRMAN OF THE BOARD AND CONFORMS TO THE CONDITIONS CONTAINED WITHIN THE CORPORATION'S BYLAWS, WHICH MEET OR EXCEED THE CURRENT IRS REPORTING THRESHOLDS. IN AREAS OF CONFLICT BY THE CHAIRMAN, THE VICE-CHAIRMAN REVIEWS. ADDITIONALLY, AS PART OF THE ANNUAL FORM 990 PREPARATION PROCESS, A SEPARATE QUESTIONNAIRE IS PROVIDED, WHICH INCLUDES DISTRIBUTION TO KEY EMPLOYEES, COVERING REPORTING AREAS OF LOANS, GRANTS, BUSINESS RELATIONSHIPS, AND OTHER CONFLICTS. THESE QUESTIONNAIRES ARE REVIEWED BY THE FINANCE DEPARTMENT FOR REPORTABLE ITEMS FOR THE FORM 990. IN THE CASE OF A POSSIBLE CONFLICT, THE BOARD WOULD REVIEW THE SITUATION AND TAKE ACTIONS DEEMED APPROPRIATE FOR THE POSSIBLE OR ACTUAL CONFLICTS OF MEMBERS OF THE BOARD OR THE EXECUTIVE OFFICERS. IN THE CASE OF KEY EMPLOYEES, THE REVIEW AND ACTIONS TAKEN WOULD BE PERFORMED BY THEIR DIRECT SUPERVISOR. |
| FORM 990, PART VI, SECTION B, LINES 15A & 15B | EXECUTIVE COMPENSATION REVIEW CENTRAL MAINE HEALTHCARE (CMHC), A RELATED ORGANIZATION, HAS ESTABLISHED AND FOLLOWS A DELIBERATIVE TRANSPARENT PROCESS WHICH MEETS IRS REGULATIONS FOR "REBUTTABLE" PRESUMPTION OF REASONABLENESS. A STANDING EXECUTIVE COMPENSATION COMMITTEE (ECC), COMPRISED OF INDEPENDENT MEMBERS OF BOARD LEADERSHIP, EXISTS TO UNDERTAKE THE PROCESS OF DETERMINING COMPENSATION FOR THE CHIEF EXECUTIVE OFFICER, CHIEF FINANCIAL OFFICER, CHIEF MEDICAL OFFICER, PRESIDENT OF CENTRAL MAINE MEDICAL CENTER, PHYSICIAN PRACTICE EXECUTIVE, AND PRESIDENT OF RUMFORD AND BRIDGTON HOSPITALS. THE PROCESS GUIDELINES AND AUTHORITY OF THE ECC ARE SET OUT IN THE EXECUTIVE COMPENSATION PHILOSOPHY AND RESPONSIBILITIES CHARTER WHICH WAS APPROVED BY THE CMHC BOARD. THE ENTIRE CMHC BOARD PARTICIPATES IN THE ANNUAL PERFORMANCE EVALUATION OF EACH EXECUTIVE, INCLUDING A REVIEW OF ACCOMPLISHMENTS RELATIVE TO GOALS AND OBJECTIVES DERIVED FROM THE STRATEGIC PLAN. THE ECC REVIEWS THE RESULTS OF THE ANNUAL PERFORMANCE EVALUATION AND APPROPRIATE COMPARABILITY DATA BASED ON SEVERAL FACTORS RECOMMENDED BY AN INDEPENDENT EXECUTIVE COMPENSATION CONSULTANT, WHO SPECIALIZES IN NOT-FOR-PROFIT HOSPITALS AND HEALTH SYSTEMS, AND OUR ATTORNEYS. FACTORS USED IN DETERMINING COMPARABILITY TO THE ORGANIZATION INCLUDE SIZE, GEOGRAPHY, ORGANIZATIONAL COMPLEXITY, FACILITY TYPE, OWNERSHIP TYPE, AND ANY OTHER FACTORS DEEMED RELEVANT BY THE COMMITTEE, ITS CONSULTANTS, OR ITS ATTORNEYS. USING THIS INFORMATION, THE ECC ANNUALLY REVIEWS THE EXECUTIVES' COMPENSATION TO DETERMINE IF MODIFICATION TO BASE SALARY IS WARRANTED, AND REVIEWS THE EXECUTIVES' ACCOMPLISHMENTS TO DETERMINE IF ANY VARIABLE PAY IS TO BE AWARDED. THE ENTIRE PROCESS IS THEN DOCUMENTED CONTEMPORANEOUSLY WITH THE DECISION-MAKING PROCESS AND APPROVED THEREAFTER IN ACCORDANCE WITH THE REQUIREMENTS OF THE IRS. THE COMPENSATION PAID TO KEY EMPLOYEES IS REVIEWED BY THE VICE PRESIDENT OF HUMAN RESOURCES AND ORGANIZATIONAL DEVELOPMENT. DURING THE REVIEW PROCESS, THE CENTRAL MAINE HEALTHCARE COMPENSATION MANAGER PROVIDES MARKET DATA ON COMPARABLE POSITIONS FROM COMPARATIVE GROUPS OF HEALTHCARE ORGANIZATIONS THAT ARE APPROPRIATELY SIMILAR IN TERMS OF THEIR REVENUE, GEOGRAPHIC LOCATION, NUMBER OF EMPLOYEES, NUMBER OF STAFFED HOSPITAL BEDS, ETC. HUMAN RESOURCES PROVIDES AT A MINIMUM FOUR SETS OF COMPARABILITY DATA FROM THE MOST RECENT NATIONAL HEALTHCARE SPECIFIC COMPENSATION SURVEYS (E. G. WATSON & WYATT, SULLIVAN & COTTER, THE HAY GROUP, MERCER, ETC) FOR REFERENCE. THESE SURVEYS REPORT PAY RATE DATA THAT IS TYPICALLY AGED LESS THAN 6 MONTHS. CENTRAL MAINE HEALTHCARE AND AFFILIATES STRIVE TO PAY AT THE MARKET AVERAGE OR SLIGHTLY ABOVE IT FOR KEY EMPLOYEES. ONCE THE COMPENSATION MANAGER AND THE VICE PRESIDENT OF HUMAN RESOURCES AND ORGANIZATIONAL DEVELOPMENT HAVE FINALIZED RECOMMENDATIONS BASED ON THIS EMPIRICAL DATA, THEY ARE PRESENTED TO THE PRESIDENTS OF EACH HOSPITAL THAT SUPERVISE THE KEY EMPLOYEES, AND THE CEO OF CENTRAL MAINE HEALTHCARE, FOR REVIEW, EDITS, AND APPROVAL. THIS PROCESS TYPICALLY OCCURS DURING THE LAST MONTH OF THE FISCAL YEAR IN PREPARATION FOR THE NEXT FISCAL YEAR CENTRAL MAINE HEALTHCARE DOCUMENTS THE BASIS FOR ITS DETERMINATION OF KEY EMPLOYEES' COMPENSATION AND MAINTAINS THIS CONTEMPORANEOUSLY SUBSTANTIATED MATERIAL IN THE HUMAN RESOURCES DEPARTMENT. |
| FORM 990, PART VI, SECTION C, LINE 19 | PUBLIC DISCLOSURE THE ORGANIZATION'S GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY ARE AVAILABLE UPON REQUEST IN THE ORGANIZATION'S ADMINISTRATIVE OFFICES. THE FINANCIAL STATEMENTS OF THE ORGANIZATION ARE INCLUDED IN THE MOST RECENTLY FILED FORM 990 AND PROVIDED, UPON REQUEST, IN THAT FORMAT UNLESS THE SPECIFIC REQUEST DEEMS A DIFFERENT FORMAT MORE APPROPRIATE. |
| FORM 990, PART VII, SECTION A, COLUMN B | BOARD MEMBER COMPENSATION NO BOARD MEMBERS RECEIVE COMPENSATION FOR THEIR DUTIES AS DIRECTORS. PETER CHALKE IS EMPLOYED AS PRESIDENT OF CENTRAL MAINE HEALTHCARE CORPORATION. HIS COMPENSATED TIME IS SPENT IN THAT CAPACITY. |
| FORM 990, PART IX, LINE 11G | OTHER FEES FOR SERVICES $ 4,188,080 PURCHASED LABOR 2,444,252 LABOR SERVICES 942,174 OUTSIDE SERVICES 487,639 PURCHASED SERVICES 10,271 CONSULTING SERVICES 6,035 PROFESSIONAL FEES 282 INTERPRETING SERVICES ------------- $ 8,078,733 |
| FORM 990, PART XI, LINE 9 | OTHER CHANGES IN NET ASSETS $ 3,518 CHANGE IN BENEFICIAL INTEREST OF PERPETUAL TRUST |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (11 entries)
| Address Line1USAddress/AddressLine1 | CityUSAddress/City | StateUSAddress/State | ZIP CodeUSAddress/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|---|
| CENTRAL MAINE COMMUNITY HEALTH CORP | ||||||||||
| PO BOX 4500 | LEWISTON | ME | 04243 | 010386912 | PUBLIC ED | ME | 501(C)(3) | 7 | CMHC | false |
| CENTRAL MAINE MEDICAL CENTER | ||||||||||
| PO BOX 4500 | LEWISTON | ME | 04243 | 010211494 | HEALTHCARE | ME | 501(C)(3) | 3 | CMHC | false |
| MAINE COLLEGE OF HEALTH PROFESSIONS | ||||||||||
| PO BOX 4500 | LEWISTON | ME | 04243 | 010356077 | EDUCATION | ME | 501(C)(3) | 2 | CMMC | false |
| CENTRAL MAINE REAL ESTATE MGMT CORP | ||||||||||
| PO BOX 4500 | LEWISTON | ME | 04243 | 010387674 | REAL ESTATE | ME | 501(C)(2) | CMHC | false | |
| CENTRAL MAINE HEALTHCARE CORPORATION | ||||||||||
| PO BOX 4500 | LEWISTON | ME | 04243 | 010386913 | HEALTHCARE | ME | 501(C)(3) | 11 B II | NA | false |
| RUMFORD COMMUNITY FAMILY HEALTH CENTER | ||||||||||
| 430 FRANKLIN STREET | RUMFORD | ME | 04276 | 010481000 | HEALTHCARE | ME | 501(C)(3) | 3 | CMHC | false |
| RUMFORD COMMUNITY HOME CORPORATION | ||||||||||
| 11 JOHN F KENNEDY LANE | RUMFORD | ME | 04276 | 222844951 | NURSING HOME | ME | 501(C)(3) | 9 | CMHC | false |
| BRIDGTON HOSPITAL | ||||||||||
| 10 HOSPITAL DRIVE | BRIDGTON | ME | 04009 | 010130427 | HEALTHCARE | ME | 501(C)(3) | 3 | CMHC | false |
| BRIDGTON HOSPITAL PHYSICIANS GROUP | ||||||||||
| SOUTH HIGH STREET | BRIDGTON | ME | 04009 | 010493083 | HEALTHCARE | ME | 501(C)(3) | 9 | CMHC | false |
| CENTRAL MAINE HEART AND VASCULAR INST | ||||||||||
| 300 MAINE STREET | LEWISTON | ME | 04240 | 542078282 | HEALTHCARE | ME | 501(C)(3) | 9 | CMHC | false |
| ELIAS E TUCKER TRUST FUND | ||||||||||
| C/O CMMC 300 MAIN STREET | LEWISTON | ME | 04240 | 010493083 | NURSING ED | ME | 501(C)(3) | 11 A I | CMMC | false |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (2 entries)
| Address Line1USAddress/AddressLine1 | CityUSAddress/City | StateUSAddress/State | ZIP CodeUSAddress/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Entity TypeEntityTypeTxt | Controlled OrganizationControlledOrganizationInd | Address Line1ForeignAddress/AddressLine1 | CityForeignAddress/City | Province Or StateForeignAddress/ProvinceOrState | CountryForeignAddress/Country | Legal Domicile Foreign CountryLegalDomicileForeignCountryCd |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| CENTRAL MAINE HEALTH VENTURES INC | ||||||||||||||
| 300 MAINE STREET | LEWISTON | ME | 04240 | 010430016 | HEALTHCARE | ME | CMHC | C CORP | false | |||||
| CWM INSURANCE LTD | ||||||||||||||
| 980220891 | INSURANCE | CMHC | C CORP | false | GENESIS BUILDING PO BOX 1363 | GRAND CAYMAN | B.W.I. | CJ | CJ | |||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | false | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | false | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | false | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | false | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | false | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | false | DivRelatedOrganizationInd |
| Asset Sale To Other Org | false | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | false | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | false | AssetExchangeInd |
| Rental Of Facilities To Oth Org | false | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | Yes (true) | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | false | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | Yes (true) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | false | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (true) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (true) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | Yes (true) | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | false | TransferToOtherOrgInd |
| Transfer From Other Org | false | TransferFromOtherOrgInd |