Franklin Memorial Hospital: Form 990, tax year 2012
View the entire original 990 at ProPublica ↗
- Organization
- Franklin Memorial Hospital (EIN 01-0211503)
- Tax period
- 2012-07-01 to 2013-06-30
- Filed
- 2014-05-15
- IRS object ID
- 201401359349304400
- Schema version
- 2012v2.1
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
- Return header
- Form 990
- Schedule A
- Schedule B
- Schedule C
- Schedule D
- Schedule H
- Schedule I
- Schedule J
- Schedule K
- Schedule L
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2014-05-15T11:17:07-05:00 | Timestamp |
| Tax Period End Date | 2013-06-30 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 010523282 | EIN |
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Berry Dunn McNeil & Parker LLC | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO Box 1100 | AddressLine1 |
| City | Portland | City |
| State | ME | State |
| ZIP Code | 041041100 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2012-07-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 010211503 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Franklin Memorial Hospital | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | FRAN | NameControl |
| Phone | 2077792500 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 111 Franklin Health Commons | AddressLine1 |
| City | Farmington | City |
| State | ME | State |
| ZIP Code | 04938 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | Wayne Bennett | Name |
| Title | CFO | Title |
| Phone | 2077792500 | Phone |
| Date Signed | 2014-05-05 | DateSigned |
| Authorize Third Party | 1 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | Barbara J McGuan CPA | Name |
| PTIN | P00219457 | PTIN |
| Phone | 2077752387 | Phone |
| Date Prepared | 2014-05-05 | DatePrepared |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2012 | TaxYear |
| Build TS | 2015-11-30 17:44:51Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | Rebecca Arsenault | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 111 Franklin Health Commons | AddressLine1 |
| City | Farmington | City |
| State | ME | State |
| ZIP Code | 04938 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 78141644 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | www.fchn.org | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1926 | YearFormation |
| State Legal Domicile | ME | StateLegalDomicile |
| Activity Or Mission Description | Community Hospital | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 18 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 13 | NbrIndependentVotingMembers |
| Total Nbr Employees | 1025 | TotalNbrEmployees |
| Total Nbr Volunteers | 164 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 0 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 761215 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 1794711 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 89240432 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 76263965 | ProgramServiceRevenueCY |
| Investment Income Prior Year | -17445 | InvestmentIncomePriorYear |
| Investment Income Current Year | -24953 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 3244 | OtherRevenuePriorYear |
| Other Revenue Current Year | 28298 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 89987446 | TotalRevenuePriorYear |
| Total Revenue Current Year | 78062021 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 20000 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 10000 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 56453831 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 52994819 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp Prior Year | 0 | TotalProfFundrsngExpPriorYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 33510034 | OtherExpensePriorYear |
| Other Expenses Current Year | 31169437 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 89983865 | TotalExpensesPriorYear |
| Total Expenses Current Year | 84174256 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 3581 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | -6112235 | RevenuesLessExpensesCY |
| Total Assets BOY | 76169004 | TotalAssetsBOY |
| Total Assets EOY | 68577137 | TotalAssetsEOY |
| Total Liabilities BOY | 34936190 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 33177419 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 41232814 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 35399718 | NetAssetsOrFundBalancesEOY |
| Info In Schedule O Part III | X | InfoInScheduleOPartIII |
| Mission Description | To provide high-quality, cost-effective, patient-centered healthcare to our west central Maine community. We work with our community and other healthcare providers to integrate services and ensure the health of our community. | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 40029439 | Expense |
| Grants | 10000 | Grants |
| Revenue | 59761828 | Revenue |
| Description | Routine Inpatient and Ancillary Outpatient ServicesFranklin Memorial Hospital is a non-for-profit community hospital which provides high-quality, cost-effective, patient-centered inpatient and outpatient healthcare services to west central Maine communities. The 65-bed hospital is fully qualified and accredited to handle a broad range of medical, surgical, pediatric, women's care and diagnostic services. Franklin Memorial Hospital offers top quality specialty care including routine adult, pediatric and intensive care inpatient services as well as a variety of outpatient services including oncology, hematology, cardiology, otolaryngology, orthopaedics, behavioral services, occupational health, dermatology, pulmonology, pain management, pediatric endocrinology, physical rehabilitation, sports medicine and wound care. During the fiscal year 2013 there were 2,680 inpatient discharges, 1,940 outpatient surgeries, 214,000 outpatient lab tests and 34,750 outpatient imaging procedures. | Description |
Activity2 Activity2
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 24534153 | Expense |
| Revenue | 9393744 | Revenue |
| Description | Franklin Health Physician PracticesFranklin Memorial Hospital identified access to primary care as a central community need and is committed to providing high quality physician services of family practice, internal medicine, pediatrics and women's care. In addition, Franklin Memorial Hospital offers a variety of specialty care services including dermatology, surgery, orthopaedics, ENT and behavioral health services. During the year Franklin Memorial Hospital provided 57,600 primary care visits and 27,000 specialty care visits in the Franklin Health physician practices. | Description |
Activity3 Activity3
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 5681698 | Expense |
| Revenue | 7108393 | Revenue |
| Description | Emergency RoomFranklin Memorial Hospital operates an emergency department which operates 24 hours a day seven days a week. The Emergency Department serves as the primary care physician for a number of low income and indigent residents of the west central Maine communities. Given Franklin Memorial Hospital's commitment to access to care regardless of ability to pay, the Emergency Department serves a vital role in the community's health care network. During FY13 Franklin Memorial Hospital had 14,700 emergency room visits. | Description |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expense | 70245290 | TotalProgramServiceExpense |
| Described In501 C3 | 1 | DescribedIn501C3 |
| Schedule B Required | 1 | ScheduleBRequired |
| Political Activities | 0 | PoliticalActivities |
| Lobbying Activities | 1 | LobbyingActivities |
| Subject To Proxy Tax | 0 | SubjectToProxyTax |
| Donor Advised Funds | 0 | DonorAdvisedFunds |
| Conservation Easements | 0 | ConservationEasements |
| Collections Of Art | 0 | CollectionsOfArt |
| Credit Counseling | 0 | CreditCounseling |
| Term Or Permanent Endowments | 1 | TermOrPermanentEndowments |
| Report Land Bldg Equip | 1 | ReportLandBldgEquip |
| Report Invest Oth Securities | 0 | ReportInvestOthSecurities |
| Report Prog Rel Invest | 0 | ReportProgRelInvest |
| Report Other Assets | 1 | ReportOtherAssets |
| Report Other Liabilities | 1 | ReportOtherLiabilities |
| Report Fin48 Footnote | 0 | ReportFin48Footnote |
| Independent Audit Financial Stmt | 0 | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | 1 | ConsolidatedAuditFinancialStmt |
| School | 0 | School |
| Foreign Office | 0 | ForeignOffice |
| Foreign Activities | 0 | ForeignActivities |
| More Than5000 K To Organizations | 0 | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividuals |
| Professional Fundraising | 0 | ProfessionalFundraising |
| Fundraising Activities | 0 | FundraisingActivities |
| Gaming | 0 | Gaming |
| Hospital | 1 | Hospital |
| Financial Stmt Attached | 1 | FinancialStmtAttached |
| Grants To Organizations | 1 | GrantsToOrganizations |
| Grants To Individuals | 0 | GrantsToIndividuals |
| Schedule J Required | 1 | ScheduleJRequired |
| Tax Exempt Bonds | 1 | TaxExemptBonds |
| Invest Tax Exempt Bonds | 0 | InvestTaxExemptBonds |
| Escrow Account | 0 | EscrowAccount |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuer |
| Excess Benefit Transaction | 0 | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | 0 | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | 0 | LoanToOfficerOrDQP |
| Grant To Related Person | 0 | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | 0 | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | 0 | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | 1 | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | 0 | DeductibleNonCashContributions |
| Deductible Contributions Of Art | 0 | DeductibleContributionsOfArt |
| Terminated | 0 | Terminated |
| Partial Liquidation | 0 | PartialLiquidation |
| Disregarded Entity | 0 | DisregardedEntity |
| Related Entity | 1 | RelatedEntity |
| Related Org Controlled Entity | 0 | RelatedOrgControlledEntity |
| Transfers To Exempt Non Chrtbl Org | 0 | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | 0 | ActivitiesConductedPartnership |
| Schedule O Required | 1 | ScheduleORequired |
| Number Forms Transmitted With1096 | 170 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | 1 | ComplianceWithBackupWitholding |
| Number Of Employees | 1025 | NumberOfEmployees |
| Employment Tax Returns Filed | 1 | EmploymentTaxReturnsFiled |
| Unrelated Business Income | 0 | UnrelatedBusinessIncome |
| Foreign Financial Account | 0 | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTrans |
| Taxable Party Notification | 0 | TaxablePartyNotification |
| Non Deductible Contributions | 0 | NonDeductibleContributions |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributions |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | 0 | FundsToPayPremiums |
| Premiums Paid | 0 | PremiumsPaid |
| Indoor Tanning Services | 0 | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 18 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 13 | NumberIndependentVotingMembers |
| Family Or Business Relationship | 0 | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | 0 | DelegationOfManagementDuties |
| Changes To Organizing Docs | 0 | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuse |
| Members Or Stockholders | 1 | MembersOrStockholders |
| Election Of Board Members | 1 | ElectionOfBoardMembers |
| Decisions Subject To Approval | 0 | DecisionsSubjectToApproval |
| Minutes Of Governing Body | 1 | MinutesOfGoverningBody |
| Minutes Of Committees | 1 | MinutesOfCommittees |
| Officer Mailing Address | 0 | OfficerMailingAddress |
| Local Chapters | 1 | LocalChapters |
| Policies Reference Chapters | 1 | PoliciesReferenceChapters |
| Form990 Provided To Governing Body | 1 | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | 1 | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | 1 | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | 1 | RegularMonitoringEnforcement |
| Whistleblower Policy | 1 | WhistleblowerPolicy |
| Document Retention Policy | 1 | DocumentRetentionPolicy |
| Compensation Process CEO | 1 | CompensationProcessCEO |
| Compensation Process Other | 1 | CompensationProcessOther |
| Investment In Joint Venture | 0 | InvestmentInJointVenture |
| States Where Copy Of Return Is Filed | ME | StatesWhereCopyOfReturnIsFiled |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Wayne Bennett | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 2077792613 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 111 Franklin Health Commons | AddressLine1 |
| City | Farmington | City |
| State | ME | State |
| ZIP Code | 04938 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (27 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Average Hours Per Week RelatedAverageHoursPerWeekRelated | Individual Trustee Or DirectorIndividualTrusteeOrDirector | OfficerOfficer | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | Highest Compensated EmployeeHighestCompensatedEmployee | FormerFormer |
|---|---|---|---|---|---|---|---|---|---|
| Rebecca Arsenault | |||||||||
| President/CEO | 33.00 | 7.00 | X | X | 362433 | 0 | 32836 | ||
| Carol Timberlake | |||||||||
| Director | 0.80 | 0.20 | X | 0 | 0 | 0 | |||
| Doug Walrath | |||||||||
| Director | 0.80 | 0.20 | X | 0 | 0 | 0 | |||
| Jef Howell | |||||||||
| Treasurer | 1.80 | 0.20 | X | X | 0 | 0 | 0 | ||
| Joseph Bujold | |||||||||
| Chair | 2.80 | 0.20 | X | X | 0 | 0 | 0 | ||
| Gilly Hitchcock | |||||||||
| Vice Chair | 0.80 | 0.20 | X | X | 0 | 0 | 0 | ||
| Meredith Tipton | |||||||||
| Director | 0.80 | 0.20 | X | 0 | 0 | 0 | |||
| Tim Wallace | |||||||||
| Director | 0.80 | 0.20 | X | 0 | 0 | 0 | |||
| Waine Whittier | |||||||||
| Director | 1.80 | 0.20 | X | 0 | 0 | 0 | |||
| Dr Wil Eastman | |||||||||
| Past Director | 0.80 | 0.20 | X | 0 | 0 | 0 | |||
| Peter Judkins | |||||||||
| Director | 0.80 | 0.20 | X | 0 | 0 | 0 | |||
| Sheena Bunnell | |||||||||
| Director | 0.80 | 0.20 | X | 0 | 0 | 0 | |||
| Ronald Aseltine | |||||||||
| Director | 0.80 | 0.20 | X | 1115 | 0 | 0 | |||
| Dr Connie Adler | |||||||||
| Secretary | 39.80 | 0.20 | X | X | 214067 | 0 | 19078 | ||
| Paul Soucie | |||||||||
| Director | 0.80 | 0.20 | X | 0 | 0 | 0 | |||
| Clint Boothby | |||||||||
| Director | 0.80 | 0.20 | X | 0 | 0 | 0 | |||
| Les Gatchell | |||||||||
| Director | 0.80 | 0.20 | X | 0 | 0 | 0 | |||
| Dr David Dixon | |||||||||
| Director | 0.80 | 0.20 | X | 0 | 0 | 0 | |||
| Dr Michael Fraley | |||||||||
| Medical Staff President | 39.80 | 0.20 | X | 340641 | 0 | 21844 | |||
| Gerald Cayer | |||||||||
| Executive VP | 39.00 | 1.00 | X | 218495 | 0 | 23710 | |||
| Wayne Bennett | |||||||||
| CFO | 36.00 | 4.00 | X | 250421 | 0 | 19093 | |||
| Nancy Cummings | |||||||||
| Ortho Surgeon | 40.00 | 0.00 | 447300 | 0 | 27584 | X | |||
| Joshua D Sparling | |||||||||
| Dermatologist | 32.00 | 0.00 | 535588 | 0 | 22305 | X | |||
| Heather DeCarolis | |||||||||
| Anesthesiologist | 40.00 | 0.00 | 343242 | 0 | 25742 | X | |||
| James C Lancaster | |||||||||
| Anesthesiologist | 40.00 | 0.00 | 334848 | 0 | 0 | X | |||
| Stephen P Zanella | |||||||||
| Emergency Medicine | 39.70 | 0.30 | 333871 | 0 | 29816 | X | |||
| Dr Armand Auger | |||||||||
| Former Officer | 40.00 | 0.00 | 193523 | 0 | 21912 | X | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 3575544 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 0 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 243920 | TotalOtherCompensation |
| Number Individuals GT100 K | 73 | NumberIndividualsGT100K |
| Formers Listed | 1 | FormersListed |
| Total Comp GT150 K | 1 | TotalCompGT150K |
| Compensation From Other Sources | 0 | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (5 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| Hebert Construction LLC | |||||
| 9 Gould Road | Lewiston | ME | 04240 | Construction | 1073803 |
| Weatherby Locums | |||||
| 6440 South Millrock Dr Suite 175 | Salt Lake City | UT | 84121 | Physician Contract Staffing | 556745 |
| Quest Diagnostics | |||||
| 415 Massachusetts Avenue | Cambridge | MA | 02139 | Lab Diagnostic Services | 554383 |
| CHG Companies Inc | |||||
| 6440 South Millrock Dr Suite 175 | Salt Lake City | UT | 84121 | Physician Contract Staffing | 424367 |
| Staff Care Inc | |||||
| 12400 High Bluff Drive | San Diego | CA | 92130 | Physician Contract Staffing | 291576 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 18 | NumberOfContractorsGT100K |
| Related Organizations | 1579980 | RelatedOrganizations |
| All Other Contributions | 214731 | AllOtherContributions |
| Total Contributions | 1794711 | TotalContributions |
Program Service Revenue ProgramServiceRevenue (5 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome |
|---|---|---|---|
| Patient Services | 621990 | 166927201 | 166927201 |
| Other | 621990 | 1086991 | 1086991 |
| Ambulance Subsidies | 621910 | 890652 | 890652 |
| Meaningful Use Revenue | 621990 | 42500 | 42500 |
| Contract/Char./Bad Dbt. | 621990 | -92683379 | -92683379 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 76263965 | TotalProgramServiceRevenue |
Gross Rents GrossRents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 77943 | Real |
Less Rental Expenses LessRentalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 49645 | Real |
Rental Income Or Loss RentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 28298 | Real |
Net Rental Income Or Loss NetRentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 28298 | TotalRevenueColumn |
| Exclusion | $28,298 | ExclusionAmount |
Gross Amount Sales Assets GrossAmountSalesAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | 5025 | Other |
Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | 29978 | Other |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | -24953 | Other |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -24953 | TotalRevenueColumn |
| Exclusion | -$24,953 | ExclusionAmount |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 78062021 | TotalRevenueColumn |
| Related Or Exempt Function Income | 76263965 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $3,345 | ExclusionAmount |
Grants To Domestic Orgs GrantsToDomesticOrgs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 10000 | Total |
| Program Services | 10000 | ProgramServices |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1719166 | Total |
| Program Services | 811063 | ProgramServices |
| Management And General | 908103 | ManagementAndGeneral |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 40875478 | Total |
| Program Services | 35267672 | ProgramServices |
| Management And General | 5607806 | ManagementAndGeneral |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 864075 | Total |
| Program Services | 773963 | ProgramServices |
| Management And General | 90112 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 6671670 | Total |
| Program Services | 5784577 | ProgramServices |
| Management And General | 887093 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2864430 | Total |
| Program Services | 2471452 | ProgramServices |
| Management And General | 392978 | ManagementAndGeneral |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 92363 | Total |
| Management And General | 92363 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 67657 | Total |
| Management And General | 67657 | ManagementAndGeneral |
Fees For Services Lobbying FeesForServicesLobbying
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 20986 | Total |
| Management And General | 20986 | ManagementAndGeneral |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 7694637 | Total |
| Program Services | 6153592 | ProgramServices |
| Management And General | 1541045 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 143892 | Total |
| Management And General | 143892 | ManagementAndGeneral |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1430748 | Total |
| Program Services | 986090 | ProgramServices |
| Management And General | 444658 | ManagementAndGeneral |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2445690 | Total |
| Program Services | 2222152 | ProgramServices |
| Management And General | 223538 | ManagementAndGeneral |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2050020 | Total |
| Program Services | 1761962 | ProgramServices |
| Management And General | 288058 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 124872 | Total |
| Program Services | 121029 | ProgramServices |
| Management And General | 3843 | ManagementAndGeneral |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 460190 | Total |
| Program Services | 340877 | ProgramServices |
| Management And General | 119313 | ManagementAndGeneral |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1180951 | Total |
| Program Services | 1018933 | ProgramServices |
| Management And General | 162018 | ManagementAndGeneral |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 4512293 | Total |
| Program Services | 3893241 | ProgramServices |
| Management And General | 619052 | ManagementAndGeneral |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1408186 | Total |
| Program Services | 1331153 | ProgramServices |
| Management And General | 77033 | ManagementAndGeneral |
Other Expenses OtherExpenses (3 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral |
|---|---|---|---|
| Medical Supplies | 6820681 | 6820681 | 0 |
| Hospital Tax and Match | 2031209 | 0 | 2031209 |
| Other | 685062 | 476853 | 208209 |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 84174256 | Total |
| Program Services | 70245290 | ProgramServices |
| Management And General | 13928966 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3580 | BOY |
| EOY | 3635 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 5553570 | BOY |
| EOY | 3827383 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 10470970 | BOY |
| EOY | 10333479 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1219194 | BOY |
| EOY | 1212571 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2459056 | BOY |
| EOY | 932802 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 85787883 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 50538491 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 38621125 | BOY |
| EOY | 35249392 | EOY |
Investments Other Securities InvestmentsOtherSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2497648 | BOY |
| EOY | 2771509 | EOY |
Intangible Assets IntangibleAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 306316 | BOY |
| EOY | 292145 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 15037545 | BOY |
| EOY | 13954221 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 76169004 | BOY |
| EOY | 68577137 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 6293976 | BOY |
| EOY | 7120921 | EOY |
Deferred Revenue DeferredRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 56111 | EOY |
Tax Exempt Bond Liabilities TaxExemptBondLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 21905514 | BOY |
| EOY | 21108267 | EOY |
Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3763867 | BOY |
| EOY | 3657629 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2972833 | BOY |
| EOY | 1234491 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 34936190 | BOY |
| EOY | 33177419 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 38723155 | BOY |
| EOY | 32562079 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1077560 | BOY |
| EOY | 1387990 | EOY |
Permanently Restricted Net Assets PermanentlyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1432099 | BOY |
| EOY | 1449649 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 41232814 | BOY |
| EOY | 35399718 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 76169004 | BOY |
| EOY | 68577137 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | -6112235 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | 279139 | ReconcilationOtherChanges |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | 0 | AccountantCompileOrReview |
| FS Audited | 1 | FSAudited |
FS Audited Basis FSAuditedBasis
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Statement Consolidated | X | FinancialStatementConsolidated |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | 1 | AuditCommittee |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequired |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital170b1 Aiii | X | Hospital170b1Aiii |
Schedule B IRS990ScheduleB
Contributor Info ContributorInfo
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor Number | RESTRICTED | ContributorNumber |
Contributor Name Business ContributorNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor Address US ContributorAddressUS
| 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) |
|---|---|---|
| Aggregate Contributions | RESTRICTED | AggregateContributions |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | 0 | Volunteers |
| Paid Staff Or Management | 1 | PaidStaffOrManagement |
| Media Advertisements | 0 | MediaAdvertisements |
| Mailings Members | 0 | MailingsMembers |
| Publications Or Broadcast | 0 | PublicationsOrBroadcast |
| Grants Other Organizations | 0 | GrantsOtherOrganizations |
| Direct Contact Legislators | 1 | DirectContactLegislators |
| Direct Contact Legislators | $10,159 | DirectContactLegislatorsAmount |
| Rallies Demonstrations | 0 | RalliesDemonstrations |
| Other Activities | 1 | OtherActivities |
| Other Activities | $10,827 | OtherActivitiesAmount |
| Total Lobbying Expenditures IIB | 20986 | TotalLobbyingExpendituresIIB |
| Not Described In501c3 | 0 | NotDescribedIn501c3 |
Form990 Schedule C Part IV Form990ScheduleCPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | Explanation of Lobbying Activities: | Identifier |
| Return Reference | Part II-B, Line 1: | ReturnReference |
| Explanation | Rebecca Arsenault, President/CEO of the Organization, spent time meeting with members of the congressional delegation. A proportional amount of her time spent engaging in these activities has been calculated to arrive at the total lobbying expense amount. In addition, The Organization pays dues to various associations, a portion of which is attributable to lobbying expenses. | Explanation |
Schedule D IRS990ScheduleD
Current Year CurrentYear
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 2325015 | BeginningOfYearBalance |
| Contributions | 126671 | Contributions |
| Investment Earnings Or Losses | 166297 | InvestmentEarningsOrLosses |
| Other Expenditures | 13828 | OtherExpenditures |
| End Of Year Balance | 2604155 | EndOfYearBalance |
Current Year Minus1 Year CurrentYearMinus1Year
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 2341310 | BeginningOfYearBalance |
| Contributions | 216215 | Contributions |
| Investment Earnings Or Losses | -63416 | InvestmentEarningsOrLosses |
| Other Expenditures | 169094 | OtherExpenditures |
| End Of Year Balance | 2325015 | EndOfYearBalance |
Current Year Minus2 Years CurrentYearMinus2Years
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 2007058 | BeginningOfYearBalance |
| Contributions | 12117 | Contributions |
| Investment Earnings Or Losses | 335279 | InvestmentEarningsOrLosses |
| Other Expenditures | 13144 | OtherExpenditures |
| End Of Year Balance | 2341310 | EndOfYearBalance |
Current Year Minus3 Years CurrentYearMinus3Years
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 1903822 | BeginningOfYearBalance |
| Contributions | 60144 | Contributions |
| Investment Earnings Or Losses | 135979 | InvestmentEarningsOrLosses |
| Other Expenditures | 93491 | OtherExpenditures |
| End Of Year Balance | 2007058 | EndOfYearBalance |
Current Year Minus4 Years CurrentYearMinus4Years
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 1895540 | BeginningOfYearBalance |
| Contributions | 120033 | Contributions |
| Investment Earnings Or Losses | -66109 | InvestmentEarningsOrLosses |
| Other Expenditures | 45642 | OtherExpenditures |
| End Of Year Balance | 1903822 | EndOfYearBalance |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Designated EOY Balance | 0.00000 | BoardDesignatedEOYBalance |
| Permanent Endowment EOY Balance | 0.56000 | PermanentEndowmentEOYBalance |
| Term Endowment EOY Balance | 0.44000 | TermEndowmentEOYBalance |
| Endowments Held By Unrelated Orgs | 0 | EndowmentsHeldByUnrelatedOrgs |
| Endowments Held By Related Orgs | 1 | EndowmentsHeldByRelatedOrgs |
| Are Related Orgs Listed Schedule R | 1 | AreRelatedOrgsListedScheduleR |
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 1268949 | OtherCostOrOtherBasis |
| Book Value | 1268949 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 48045614 | OtherCostOrOtherBasis |
| Depreciation | 21840762 | Depreciation |
| Book Value | 26204852 | BookValue |
Leasehold Improvements LeaseholdImprovements
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 10517 | OtherCostOrOtherBasis |
| Depreciation | 10517 | Depreciation |
| Book Value | 0 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 31498291 | OtherCostOrOtherBasis |
| Depreciation | 25958372 | Depreciation |
| Book Value | 5539919 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 4964512 | OtherCostOrOtherBasis |
| Depreciation | 2728840 | Depreciation |
| Book Value | 2235672 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 35249392 | TotalOfBookValueLandBuildings |
Other Assets OtherAssets (3 entries)
| DescriptionDescription | Book ValueBookValue |
|---|---|
| Estimated Settlements from MaineCare | 12608331 |
| Deferred Compensation Asset | 1234491 |
| Due from Related Parties | 111399 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | 13954221 | TotalBookValueOtherAssets |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | Deferred Compensation | Description |
| Amount | $1,234,491 | Amount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 1234491 | TotalOfAmounts |
Form990 Schedule D Part XIII Form990ScheduleDPartXIII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | Description of Intended Use of Endowment Funds: | Identifier |
| Return Reference | Part V, Line 4: | ReturnReference |
| Explanation | The Organization's endowment funds are held by the Franklin Community Health Network and are intended to support various programs offered by the Organization, such as the charity program, community outreach, education, medical library, Martha B. Webber Breast Care Center, and others. | Explanation |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Charity Care Policy | 1 | CharityCarePolicy |
| Written Policy | 1 | WrittenPolicy |
| FPG Reference Free Care | 1 | FPGReferenceFreeCare |
| Pcent200 | X | Pcent200 |
| FPG Reference Discounted Care | 1 | FPGReferenceDiscountedCare |
| Pcent300 | X | Pcent300 |
| Free Disc Care Medically Indigent | 0 | FreeDiscCareMedicallyIndigent |
| Amounts Budgeted For Charity Care | 1 | AmountsBudgetedForCharityCare |
| Expenses Exceeded Budget | 1 | ExpensesExceededBudget |
| Unable To Provide Care | 0 | UnableToProvideCare |
| Annual Community Benefit Report | 1 | AnnualCommunityBenefitReport |
| Report Publically Available | 1 | ReportPublicallyAvailable |
Charity Care At Cost CharityCareAtCost
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 3132948 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 0 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 3132948 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.03720 | PercentOfTotalExpense |
Unreimbursed Medicaid UnreimbursedMedicaid
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 16358549 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 14088868 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 2269681 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.02700 | PercentOfTotalExpense |
Total Charity Care TotalCharityCare
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 19491497 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 14088868 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 5402629 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.06420 | PercentOfTotalExpense |
Community Health Services CommunityHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 436169 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 58063 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 378106 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00450 | PercentOfTotalExpense |
Health Professions Education HealthProfessionsEducation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 272242 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 0 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 272242 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00320 | PercentOfTotalExpense |
Subsidized Health Services SubsidizedHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 11013473 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 6131922 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 4881551 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.05800 | PercentOfTotalExpense |
Cash And In Kind Contributions CashAndInKindContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 37900 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 0 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 37900 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00050 | PercentOfTotalExpense |
Total Other Benefits TotalOtherBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 11759784 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 6189985 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 5569799 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.06620 | PercentOfTotalExpense |
Total Community Benefits TotalCommunityBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 31251281 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 20278853 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 10972428 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.13040 | PercentOfTotalExpense |
Economic Development EconomicDevelopment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Building Expense | 2000 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 2000 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00000 | PercentOfTotalExpense |
Total Total
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Building Expense | 2000 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 2000 | NetCommunityBuildingExpense |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | 1 | BadDebtExpenseReported |
| Bad Debt Expense | $2,516,848 | BadDebtExpenseAmount |
| Amount Attributable To | 0 | AmountAttributableTo |
| Amount Reimbursed By Medicare | 19636116 | AmountReimbursedByMedicare |
| Cost Of Care Reimbursed By Medicare | 22693211 | CostOfCareReimbursedByMedicare |
| Medicare Surplus Or Shortfall | -3057095 | MedicareSurplusOrShortfall |
Costing Methodology Used CostingMethodologyUsed
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | X | CostToChargeRatio |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | 1 | WrittenDebtCollectionPolicy |
| Provision For Charity Care | 1 | ProvisionForCharityCare |
Form990 Schedule H Part IV Form990ScheduleHPartIV (2 entries)
| Description Ent Primary ActivityDescriptionEntPrimaryActivity | Organization Profit Or OwnershipOrganizationProfitOrOwnership | Officers Etc Profit Or OwnershipOfficersEtcProfitOrOwnership | Physicans Profit Or OwnershipPhysicansProfitOrOwnership |
|---|---|---|---|
| 1 Western Maine PHO | |||
| Physician Hospital Organization | 0.50000 | 0.00000 | 0.00000 |
| 2 Scorekeeper LLC | |||
| Wellness Software | 0.40000 | 0.00000 | 0.00000 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Hospital Facilities | 1 | NumberOfHospitalFacilities |
Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility Number | 1 | FacilityNumber |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Franklin Memorial Hospital | BusinessNameLine1 |
Address Address
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 111 Franklin Health Commons | AddressLine1 |
| City | Farmington | City |
| State | ME | State |
| ZIP Code | 04938 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Licensed Hospital | X | LicensedHospital |
| General Medical And Surgical | X | GeneralMedicalAndSurgical |
| Er24 Hours | X | Er24Hours |
Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Franklin Memorial Hospital | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital Facility Number | 1 | HospitalFacilityNumber |
| CHNA Conducted | 1 | CHNAConducted |
| Community Definition | X | CommunityDefinition |
| Community Demographics | X | CommunityDemographics |
| Existing Resources | X | ExistingResources |
| How Data Obtained | X | HowDataObtained |
| Community Health Needs | X | CommunityHealthNeeds |
| Other Health Issues | X | OtherHealthIssues |
| Identifying Process | X | IdentifyingProcess |
| Consulting Process | X | ConsultingProcess |
| Needs Assessment Conducted | 12 | NeedsAssessmentConducted |
| Take Into Account | 1 | TakeIntoAccount |
| Other Facilities | 0 | OtherFacilities |
| CHNA Widely Available | 1 | CHNAWidelyAvailable |
| Own Website | X | OwnWebsite |
| On Request | X | OnRequest |
| Adopt Implement Strategy | X | AdoptImplementStrategy |
| Execute Implement Strategy | X | ExecuteImplementStrategy |
| Develop Community Plan | X | DevelopCommunityPlan |
| Participate Community Plan | X | ParticipateCommunityPlan |
| Adopt Budget | X | AdoptBudget |
| Prioritize Health Needs | X | PrioritizeHealthNeeds |
| Prioritize Services | X | PrioritizeServices |
| All Needs Addressed | 0 | AllNeedsAddressed |
| Organization Incur Excise Tax | 0 | OrganizationIncurExciseTax |
| Eligibility Criteria Explained | 1 | EligibilityCriteriaExplained |
| Uses FPG Free | 1 | UsesFPGFree |
| FPG Free Percent | 200.000000000000 | FPGFreePercent |
| Uses FPG Discounted | 1 | UsesFPGDiscounted |
| FPG Discount Percent | 300.000000000000 | FPGDiscountPercent |
| Explains Basis | 1 | ExplainsBasis |
| Medicaid Medicare | X | MedicaidMedicare |
| Explains Application Method | 1 | ExplainsApplicationMethod |
| Includes Publicity Measures | 1 | IncludesPublicityMeasures |
| Other Publicity | X | OtherPublicity |
| Actions On Nonpayment | 1 | ActionsOnNonpayment |
| Collection Activities | 0 | CollectionActivities |
| Nondiscrim Emergency Care Policy | 1 | NondiscrimEmergencyCarePolicy |
| Medicare Rate | X | MedicareRate |
| Amounts Generally Billed | 0 | AmountsGenerallyBilled |
| Gross Charges | 0 | GrossCharges |
Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Other Facilities | 19 | NumberOfOtherFacilities |
Other Facilities OtherFacilities (19 entries)
| Address Line1Address/AddressLine1 | CityAddress/City | StateAddress/State | ZIP CodeAddress/ZIPCode | Facility TypeFacilityType |
|---|---|---|---|---|
| Franklin Hlth Livermore Falls Fam Pract | ||||
| 21 Main Street | Livermore Falls | ME | 04254 | Family Practice |
| Franklin Health Wilton Family Practice | ||||
| 75 Allen Street | Wilton | ME | 04294 | Family Practice |
| Franklin Hlth Farmington Family Practice | ||||
| 111 Franklin Health Commons | Farmington | ME | 04938 | Family Practice |
| Franklin Health Internal Medicine | ||||
| 131 Franklin Health Commons | Farmington | ME | 04938 | Internal Medicine Practice |
| Franklin Health Pediatrics | ||||
| 111 Franklin Health Commons | Farmington | ME | 04938 | Pediatrician Practice |
| Franklin Health Orthopaedics | ||||
| 111 Franklin Health Commons | Farmington | ME | 04938 | Orthopaedic Practice |
| Franklin Health Surgery | ||||
| 111 Franklin Health Commons | Farmington | ME | 04938 | General Surgery Practice |
| Rangeley Region Physical Rehabilitation | ||||
| 25 Dallas Hill Road | Rangeley | ME | 04970 | Outpatient Physical Therapy |
| Outpatient Services at Livermore Falls | ||||
| 21 Main Street | Livermore Falls | ME | 04254 | Outpatient Clinic |
| NorthStar | ||||
| 15 School Street | Rangeley | ME | 04970 | Ambulance Base |
| NorthStar | ||||
| 138C Park Street | Phillips | ME | 04966 | Ambulance Base |
| NorthStar | ||||
| 119 Federal Road | Livermore | ME | 04254 | Ambulance Base |
| NorthStar | ||||
| 1001 Carriage Road | Carrabasset Valley | ME | 04947 | Ambulance Base |
| NorthStar | ||||
| 111 Franklin Health Commons | Farmington | ME | 04938 | Ambulance Base |
| Franklin Health Women's Care | ||||
| 111 Franklin Health Commons | Farmington | ME | 04938 | OB/GYN |
| Franklin Health Child Developmental Prog | ||||
| 131 Franklin Health Commons | Farmington | ME | 04938 | Child Developmental Program |
| Franklin Health Behavioral Services | ||||
| 131 Franklin Health Commons | Farmington | ME | 04938 | Behavioral Health Practice |
| Franklin Health Dermatology | ||||
| 111 Franklin Health Commons | Farmington | ME | 04938 | Dermatology Practice |
| Franklin Health Ear Nose & Throat | ||||
| 111 Franklin Health Commons | Farmington | ME | 04938 | ENT |
Form990 Schedule H Part VI Form990ScheduleHPartVI (14 entries)
| ExplanationExplanation | IdentifierIdentifier |
|---|---|
| Part I, Line 7: The costing methodology for the amounts reported in Part I, line 7 of the Schedule H is based on a ratio of patient care cost to charges. This cost to charge ratio was derived from Worksheet 2, Ratio of Patient Care Cost-to-Charges provided in the instructions for Schedule H. The cost to charge ratio was calculated using internal cost accounting data for the subsidized health services included in the community benefit. | |
| Part I, Line 7g: The Organization has included costs associated with primary care (Family practice, Pediatrics, Internal Medicine and Women's Care), Behavioral Services, Child & Adolescent Developmental Pediatrics and physical therapy services provided in Rangeley, ME as subsidized health services. | |
| Part II: See 990, Schedule H, Part VI, line 5. | |
| Part III, Line 4: Franklin Memorial Hospital used the RCC calculated from Worksheet 2 and multiplied it by the bad debts expense per the financials. Bad debts include 100% of the charges written off due to no payment. If a payment is made on a bad debt account, then that payment reduces the bad debt expense in the year received.Bad debt expense represents healthcare services that Franklin Memorial Hospital has provided without compensation. As a tax-exempt hospital, Franklin Memorial Hospital provides necessary patient care regardless of the patient's ability to pay for the services. A portion of Franklin Memorial Hospital's bad debt expense is attributable to patients eligible for financial assistance that for a variety of reasons, do not complete the financial assistance application process. Franklin Memorial Hospital cannot determine the amount of bad debt expense that could be reasonably attributable to patients who likely would qualify for financial assistance under the Franklin Memorial Hospital's free care policy. | |
| Part III, Line 8: The Medicare Principles of Reimbursement were used to determine the Medicare inpatient and outpatient costs based on the Organization's cost report. | |
| Part III, Line 9b: Patient balances are screened for eligibility for financial assistance by outside collection agency and are transferred back to Franklin Memorial Hospital for follow up with a counselor as needed. Balances that are owed to the Hospital after applying any financial assistance are collected in the same manner as any other self pay balances. | |
| Part V, Section B, Line 3: The working group for developing the community health needs assessment consisted of persons who are considered public health experts, such as Meredith Tipton, PhD MPH ,Associate Dean for Community Programs, University of New England, FCHN Board Member; Sarah Martin, PhD Epidemiology, Healthy Community Coalition, Husson College School of Pharmacy; and Michael Rowland, MD MPH, Vice President Medical Affairs, Franklin Memorial Hospital. The working group took input from various community groups interested in promoting wellbeing of the population in our community, including:-FCHN Board, representing communities in Franklin county-Healthy Community Coalition Board, representing diverse groups involved with health improvement -Franklin Health Collaborative, representing health-related organizations and initiatives county-wide (Long-term care, home health, public health nursing, mental health agencies, school districts, domestic violence victim advocacy, emergency response services, University of Maine at Farmington, Franklin County Children's Task Force, Western Mountains Alliance)-FMH Primary Care service, representing primary care providers in Franklin county-Western Maine Public Health District, coordinating regional health improvement work with Maine CDCIn addition to numerous face-to-face meetings with the community groups identified above, direct input from community members was obtained via community survey, conducted by Healthy Community Coalition in 2013, meetings with Franklin Health Patient Advisory group and Community Visioning public meetings conducted every 2 years. | Franklin Memorial Hospital |
| Part V, Section B, Line 7: CHNA identified several community needs for which other agencies are taking a leading role with Franklin Memorial Hospital taking a supporting role. Domestic violence - 3 organizations are actively working in this area; Children's Task Force, Sexual Assault Victims Emergency Services, and Safe Voices. FCHN coordinates with these organizations through the primary care practices, and mutual inclusion of leadership at the board level. Dental Care access - Community Dental is the lead agency for providing dental care to low income residents. FCHN has provided support through provision of low-cost dental office space. High rate of Motor Vehicle Fatalities - Our research indicated that poor winter road conditions and large wildlife were the root cause in most cases. Only 6% of highway fatalities involved intoxication. The lead agency to address these issues is the Maine Highway administration. | Franklin Memorial Hospital |
| Part V, Section B, Line 14g: Franklin Memorial Hospital takes a number of steps to publicize the availability of the financial assistance to patients: 1. Notices of the availability of financial assistance are posted in locations within the hospital at which members of the public generally transact business with the Hospital or present themselves to receive or request hospital services, including admitting areas, waiting rooms, business offices and outpatient reception areas. 2. With respect with inpatient admissions, individual written notice of the availability of financial assistance is presented to each patient upon admission or in the case of emergency admission before discharge. In addition, all uninsured inpatients are visited by an Advanced Patient Advocacy representative to discuss availability of financial assistance and government coverage options. 3. Availability of financial assistance is publicized on the patient invoices supplying patients with a contact number to obtain further information about available options. 4. Financial assistance options are outlined on the hospitals' website and are readily available to the public. 5. Rack cards & Financial Assistance Applications are located throughout the Hospital & physician practices6. Hospital booklets are available in all patient rooms with a section regarding Financial Assistance7. Business office staff and contracted third party collection agency notify all patients with self pay balances about Hospital's financial assistance resources and encourages them to apply for such assistance. | Franklin Memorial Hospital |
| Part VI, Line 2: The Franklin Memorial Hospital Network conducts a health visioning process every two years that is used to identify needs and perceived priorities in the community. A physician survey is conducted periodically to assist in gathering information about clinical care needs, referral patterns, specialist needs, etc. The Long-Range Planning Committee, board of directors, and senior leadership use this and other data in developing goals and priorities, making decisions, and setting long-term goals and strategies. The Organization seeks to meet the needs of the population whenever feasible through direct provision of services, contractual relationships, or through referral. | |
| Part VI, Line 3: When patients are registered there are brochures available that describe Franklin Memorial Hospital's charity care programs. When a patient is admitted with no insurance, registration sends a financial counselor up to the patient's room to meet the patient. Each bill provided to a patient has the phone number to call if the patient needs financial assistance. The Organization's billers also refer patients to the Organization's financial counselors when a patient is identified as needing assistance. The Organization's pre-collection and collection agencies also educate patients and help to set them up with financial assistance when needed. | |
| Part VI, Line 4: Franklin Memorial Hosptial's service area covers 2,200 square miles which extends to the Canadian border. It is one of the most rural and economically challenged regions in Maine, including several areas that have been federally designated as health professional shortage and medically underserved areas. | |
| Part VI, Line 5: Community BuildingPhysical Improvements and Housing:1. Development and maintenance of the rail trail which is on FMH property - available to the public to encourage health and wellness. Economic Development:1. Member of Greater Franklin Development Corporation - an organization committed to economic developmentCommunity Support:1. Perform disaster drills with the community 1-2 times a year2. Community Dental (provide low cost rental space)Coalition building:1. Healthy Community Coalition of Greater Franklin County, founded in 1989, is one of the oldest health coalitions in the country. Its mission is to measurably improve the well-being of all people in Greater Franklin County and neighboring towns using a coordinated public health approach of education, promotion, and outreach. With its qualified staff of public health professionals, Healthy Community Coalition offers health screenings, health information, and programs and events to support healthy lifestyles that prevent disease and improve quality of life. Its community outreach efforts appear in every town and corner of the region.In the past year, more than 8,000 individuals benefited from the outreach activities of the Coalition with 2,500 seeking services of the Mobile Health Unit, where health risk appraisals (HRAs) are routinely offered. HRAs include a blood pressure and cholesterol check and individualized health education. Additional outreach events were held throughout the region such as: bone density screenings, flu immunizations, body composition analyzation, free clinical breast exams, education on tobacco, nutrition, physical activity and substance abuse, and education on the prevention of breast, cervical, colon, lung, prostate, and skin cancer.2. AHEC Education Center - Established in 2004 the Franklin AHEC program was developed out of great interest from employees and community members requesting local opportunities to pursue careers in the health field and educational programs for retention and professional growth. The Franklin AHEC allows us to meet the needs of the rural population. It also brings to the Maine AHEC Network the resources of a large innovative rural health system that include a community hospital, Maine's oldest Healthy Community Coalition and the Ben Franklin Center which houses a state of the art education center, medical library facilities, and distance learning opportunities. The program has greatly expanded to include many aspects and activities for retention and recruitment forhealth careers in our vast rural catchment area. Becoming an AHEC center allows us to partner with youth programs, public schools, multiple colleges, adult education, a local career center and other health career programs to offer community members, displaced workers and current healthcare employees the opportunity to continue or pursue careers.3. HealthInfoNet: Thirty-four out of thirty-eight Maine hospitals, including FMH, and hundreds of physician practices in Maine now have access to a new consolidated electronic health record made possible by HealthInfoNet that contains critical information drawn from records that have traditionally been separately maintained in physician practices, hospitals and other settings. Armed with more complete and timely information about a patient, clinicians can provide better quality care and improve the coordination of care, particularly for those patients who see several providers and receive care in more than one community or setting.4. ScoreHealth Screenings - ScoreHealth is a health risk assessment program that helps individuals evaluate many different areas affecting their health, including but not limited to diabetes, cancer, asthma and osteoporosis. The screenings are offered part of the mobile health outreach program conducted by the Healthy Community Coalition of Greater Franklin County and offer cholesterol, blood pressure, BMI and bone density assessments along with counseling on tobacco use and exposure, benefits of physical activity, healthy nutrition and stress management.5. Health Works! Worksite Wellness Award Program is a new and free aware program offered by Healthy Community Coalition of Greater Franklin County. The award program provides businesses and organizations with the opportunity to be recognized as a community leader in health promotion. The purpose of the Healthy Maine Works (HMW) is to guide and support Maine employers in developing worksite wellness programs that support the health of employees. HWM is a project of Maine's Center for Disease Control, Office of Substance Abuse, and Department of Education and is delivered in collaboration with local Healthy Maine Partnerships across the state. | |
| Part VI, Line 6: Franklin Communith Health Network: Supporting OrganizationFranklin Memorial Hospital: Community hospitalHealthy Community Coalition: A subsidiary of FCHN - HCC's mission is to measurably improve the health and well-being of all people in Greater Franklin County using a coordinated approach of education, health promotion, and outreach. HCC offers health screenings, health information, and programs and events to support healthy lifestyles that prevent disease and improve quality of life.Evergreen Behavioral Services: Operates 24/7 emergency mental health response services for the Greater Franklin County area as well as bordering towns of Androscoggin & Oxford counties. |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Records Maintained | 1 | RecordsMaintained |
Recipient Table RecipientTable
Recipient Name Business RecipientNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | LifeFlight Foundation | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO Box 940 | AddressLine1 |
| City | Bangor | City |
| State | ME | State |
| ZIP Code | 044020940 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN Of Recipient | 522377085 | EINOfRecipient |
| IRC Section | 501(c)(3) | IRCSection |
| Amount Of Cash Grant | 10000 | AmountOfCashGrant |
| Purpose Of Grant | Organizational Support | PurposeOfGrant |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Nbr Of501 C3 And Govt Grants | 1 | TotalNbrOf501C3AndGovtGrants |
| Total Nbr Of Other Organizations | 0 | TotalNbrOfOtherOrganizations |
Form990 Schedule I Part IV Form990ScheduleIPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | Procedure for Monitoring Grants in the U.S.: | Identifier |
| Return Reference | Part I, Line 2: | ReturnReference |
| Explanation | Schedule I, Part I, Line 2: All assistance is given to either 501(c)(3) public charities or governmental units and their affiliates. Therefore, additional monitoring is not deemed necessary. | Explanation |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | X | CompensationCommittee |
| Independent Consultant | X | IndependentConsultant |
| Form990 Of Other Organizations | X | Form990OfOtherOrganizations |
| Written Employment Contract | X | WrittenEmploymentContract |
| Compensation Survey | X | CompensationSurvey |
| Board Or Committee Approval | X | BoardOrCommitteeApproval |
| Severance Payment | 0 | SeverancePayment |
| Supplemental Nonqual Retire Plan | 0 | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | 0 | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | 0 | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | 0 | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | 0 | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | 0 | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | 0 | AnyNonFixedPayments |
| Initial Contract Exception | 0 | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (11 entries)
| TitleTitle | Base Compensation Filing OrgBaseCompensationFilingOrg | Comp Based On Related OrgsCompBasedOnRelatedOrgs | Bonus Filing OrgBonusFilingOrg | Bonus Related OrgsBonusRelatedOrgs | Other Compensation Filing OrgOtherCompensationFilingOrg | Other Compensation Related OrgsOtherCompensationRelatedOrgs | Deferred Comp Filing OrgDeferredCompFilingOrg | Deferred Comp Related OrgsDeferredCompRelatedOrgs | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg | Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs | Total Compensation Filing OrgTotalCompensationFilingOrg | Total Compensation Related OrgsTotalCompensationRelatedOrgs | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrg | Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Rebecca Arsenault | ||||||||||||||
| President/CEO | 356109 | 0 | 6324 | 0 | 0 | 0 | 23038 | 0 | 9798 | 0 | 395269 | 0 | 0 | 0 |
| Dr Connie Adler | ||||||||||||||
| Secretary | 213927 | 0 | 140 | 0 | 0 | 0 | 8043 | 0 | 11035 | 0 | 233145 | 0 | 0 | 0 |
| Dr Michael Fraley | ||||||||||||||
| Medical Staff President | 340641 | 0 | 0 | 0 | 0 | 0 | 5939 | 0 | 15905 | 0 | 362485 | 0 | 0 | 0 |
| Gerald Cayer | ||||||||||||||
| Executive VP | 218495 | 0 | 0 | 0 | 0 | 0 | 8089 | 0 | 15621 | 0 | 242205 | 0 | 0 | 0 |
| Wayne Bennett | ||||||||||||||
| CFO | 218421 | 0 | 15000 | 0 | 17000 | 0 | 5308 | 0 | 13785 | 0 | 269514 | 0 | 0 | 0 |
| Nancy Cummings | ||||||||||||||
| Ortho Surgeon | 435649 | 0 | 11651 | 0 | 0 | 0 | 10340 | 0 | 17244 | 0 | 474884 | 0 | 0 | 0 |
| Joshua D Sparling | ||||||||||||||
| Dermatologist | 337074 | 0 | 182915 | 0 | 15599 | 0 | 5954 | 0 | 16351 | 0 | 557893 | 0 | 0 | 0 |
| Heather DeCarolis | ||||||||||||||
| Anesthesiologist | 343242 | 0 | 0 | 0 | 0 | 0 | 9582 | 0 | 16160 | 0 | 368984 | 0 | 0 | 0 |
| James C Lancaster | ||||||||||||||
| Anesthesiologist | 334848 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 334848 | 0 | 0 | 0 |
| Stephen P Zanella | ||||||||||||||
| Emergency Medicine | 333871 | 0 | 0 | 0 | 0 | 0 | 13506 | 0 | 16310 | 0 | 363687 | 0 | 0 | 0 |
| Dr Armand Auger | ||||||||||||||
| Former Officer | 189263 | 0 | 4260 | 0 | 0 | 0 | 7910 | 0 | 14002 | 0 | 215435 | 0 | 0 | 0 |
Schedule K IRS990ScheduleK
Form990 Schedule K Part I Form990ScheduleKPartI (2 entries)
| Bond ReferenceBondReferenceCd | Issuer EINIssuerEIN | CUSIP NumberCUSIPNumber | Date IssuedDateIssued | Issue PriceIssuePrice | Description Of PurposeDescriptionOfPurpose | DefeasedDefeased | On Behalf Of IssuerOnBehalfOfIssuer | Pool FinancingPoolFinancing |
|---|---|---|---|---|---|---|---|---|
| Maine Health & Higher Ed Facilities Authority | ||||||||
| A | 010314384 | 560425G20 | 2006-09-07 | 15270692 | MRI, Medical Office Building | 0 | 0 | 1 |
| Maine Health & Higher Ed Facilities Authority | ||||||||
| B | 010314384 | 560427NM4 | 2011-11-30 | 10452958 | Refunding of Series 2001A | 0 | 0 | 1 |
Form990 Schedule K Part II Form990ScheduleKPartII (2 entries)
| Bond ReferenceBondReferenceCd | Amount RetiredAmountRetired | Total ProceedsTotalProceeds | Amount In Reserve FundAmountInReserveFund | Issuance Costs From ProceedsIssuanceCostsFromProceeds | Capital ExpendituresCapitalExpenditures | Year Of Subst CompletionYearOfSubstCompletion | Current RefundingCurrentRefunding | Advance RefundingAdvanceRefunding | Final Allocation MadeFinalAllocationMade | Adequate Books And Recds MaintaindAdequateBooksAndRecdsMaintaind |
|---|---|---|---|---|---|---|---|---|---|---|
| A | 2278874 | 15270692 | 631163 | 221065 | 13274282 | 2008 | 0 | 0 | 1 | 1 |
| B | 2336509 | 10452958 | 501489 | 117007 | 9633963 | 2002 | 1 | 0 | 1 | 1 |
Form990 Schedule K Part III Form990ScheduleKPartIII (2 entries)
| Bond ReferenceBondReferenceCd | Owning Bond Financed PropertyOwningBondFinancedProperty | Any Lease ArrangementsAnyLeaseArrangements | Mngment Cntrct Bond Financd PrprtyMngmentCntrctBondFinancdPrprty | Any Research AgreementsAnyResearchAgreements | Bond Iss Meet Prvt Security Pay TestBondIssMeetPrvtSecurityPayTest | Change In Use Bond Financed PropChangeInUseBondFinancedProp | Non Qualified Bond Remed ProcdrsNonQualifiedBondRemedProcdrs |
|---|---|---|---|---|---|---|---|
| A | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
| B | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
Form990 Schedule K Part IV Form990ScheduleKPartIV (2 entries)
| Bond ReferenceBondReferenceCd | Form8038 T FiledForm8038TFiled | Variable Rate IssueVariableRateIssue | Hedge Identified In Books And RecdsHedgeIdentifiedInBooksAndRecds | Gross Proceeds Invested In GICGrossProceedsInvestedInGIC | Gross Proceeds InvestedGrossProceedsInvested | Written Proc To Monitor ReqsWrittenProcToMonitorReqs | Rebate Not Due YetRebateNotDueYet | Exception To RebateExceptionToRebate | No Rebate DueNoRebateDue |
|---|---|---|---|---|---|---|---|---|---|
| A | 1 | 0 | 0 | 0 | 0 | 0 | |||
| B | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
Form990 Schedule K Part V Form990ScheduleKPartV (2 entries)
| Bond ReferenceBondReferenceCd | Proc To Undertk Corrective ActionProcToUndertkCorrectiveAction |
|---|---|
| A | 0 |
| B | 0 |
Schedule L IRS990ScheduleL
Form990 Schedule L Part IV Form990ScheduleLPartIV
Name Of Interested Person NameOfInterestedPerson
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Franklin Savings Bank | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Relationship | Board member Peter Judkins is President of the bank | Relationship |
| Amount Of Transaction | 216054 | AmountOfTransaction |
| Description Of Transaction | Independent Contractor - Interest paid on loan extended to Organization by bank in an arms length transaction | DescriptionOfTransaction |
| Sharing Of Revenues | 0 | SharingOfRevenues |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (7 entries)
| Return ReferenceReturnReference | ExplanationExplanation | IdentifierIdentifier |
|---|---|---|
| Form 990, Part VI, Section A, line 6 | The Organization consists of one Member, Franklin Community Health Network. Action of the Member shall be evidenced by written consents that are executed on its behalf by any officer of the Member who is authorized so to act by the board of directors of the Member. The written consent evidencing the annual meeting of the Member shall be adopted and effective as of a date immediately following the annual meeting of the board of directors of the Member or such later date as may be set forth in such written consent. The effective date set forth in such written consent shall be the date of the annual meeting of the year in question. | |
| Form 990, Part VI, Section A, line 7a | The Member has rights and powers to establish the size of the board of directors of the Organization within the limits prescribed by the Articles of Incorporation and to elect and remove certain directors of the Organization in accordance with the Articles of Incorporation and Bylaws. | |
| Form 990, Part VI, Section B, line 11 | A complete copy of the form 990 was distributed to each member of the board prior to filing with IRS. In addition, the 990 was reviewed with the board of directors prior to filing the tax return in a form of a presentation and a Q&A session to address any questions or concerns. | |
| Form 990, Part VI, Section B, line 12c | On an annual basis board members and officers are required to submit a conflict of interest statement which is then reviewed by the compliance committee. The compliance committee is responsible for regularly and consistently monitoring and enforcing compliance with the conflict of interest policy. | |
| Form 990, Part VI, Section B, line 15 | Executive compensation is determined by the compensation committee which consists of the Board Chair and several board members. The compensation committee uses an independent executive search firm that assists with executive salary determination by providing compensation survey results, along with review of executive compensation reported by other health care organizations on their Form 990. The compensation committee approves the executive compensation package prior to contract execution. | |
| Form 990, Part VI, Section C, line 19 | The Organization's governing documents, conflict of interest policy, and financial statements are available to the public upon request. | |
| Form 990, Part XI, line 9: | Change in Net Assets of Affiliate 261,589. Net Change in Perpetual Trust 17,550. | Changes in Net Assets or Fund Balances: |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII (4 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivities | Legal Domicile StateLegalDomicileState | Exempt Code SectionExemptCodeSection | Public Charity StatusPublicCharityStatus | Direct Controlling Entity NADirectControllingEntityNA | Controlled OrgControlledOrg | Business Name Line1DirectControllingEntityName/BusinessNameLine1 |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Franklin Community Health Network | |||||||||||
| 111 Franklin Health Commons | Farmington | ME | 04938 | 223209406 | Supporting Organization | ME | 501(c)(3) | Line 11b, II | N/A | 0 | |
| Healthy Community Coalition | |||||||||||
| 105 Mt Blue Circle Suite 1 | Farmington | ME | 04938 | 223305743 | Community Outreach | ME | 501(c)(3) | Line 7 | 0 | Franklin Community Health Network | |
| Pine Tree Medical Associates | |||||||||||
| 131 Franklin Health Commons | Farmington | ME | 04938 | 010469478 | Community Health Agency | ME | 501(c)(3) | Line 9 | 0 | Franklin Community Health Network | |
| Evergreen Behavioral Services | |||||||||||
| 131 Franklin Health Commons | Farmington | ME | 04938 | 010492747 | Mental Health Agency | ME | 501(c)(3) | Line 9 | 0 | Franklin Community Health Network | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | 0 | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | 0 | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | 1 | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | 0 | LoansOrGuaranteesFromOtherOrg |
| Dividends Related Organization | 0 | DividendsRelatedOrganization |
| Sale Of Assets To Other Org | 0 | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | 0 | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | 0 | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | 1 | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | 0 | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | 0 | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | 0 | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | 0 | SharingOfFacilities |
| Sharing Of Paid Employees | 0 | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | 1 | OtherTransferToOtherOrg |
| Other Transfer From Other Org | 0 | OtherTransferFromOtherOrg |