STRATEGY STUDIO / NONPROFIT PEOPLE SEARCH

Stephens Memorial Hospital Assoc: Form 990, tax year 2012

View the entire original 990 at ProPublica ↗

Organization
Stephens Memorial Hospital Assoc (EIN 01-0219904)
Tax period
2012-10-01 to 2013-09-30
Filed
2014-08-13
IRS object ID
201402259349302010
Schema version
2012v2.3
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Timestamp2014-08-13T12:15:58-05:00Timestamp
Tax Period End Date2013-09-30TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1MAINEHEALTHBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line1110 FREE STAddressLine1
CityPORTLANDCity
StateMEState
ZIP Code041013908ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2012-10-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN010219904EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1STEPHENS MEMORIAL HOSPITAL ASSOCBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlSTEPNameControl
Phone2077435933Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1181 MAIN STREETAddressLine1
CityNORWAYCity
StateMEState
ZIP Code04268ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameJOHN COXName
TitleSENIOR VP - FISCALTitle
Phone2077435933Phone
Date Signed2014-08-06DateSigned
Authorize Third PartyfalseAuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
Date Prepared2014-08-13DatePrepared
FieldValueIRS element (for citing)
Tax Year2012TaxYear
Build TS2015-11-30 17:44:51ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonTIMOTHY CHURCHILLNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1181 MAIN STREETAddressLine1
CityNORWAYCity
StateMEState
ZIP Code04268ZIPCode
FieldValueIRS element (for citing)
Gross Receipts55323015GrossReceipts
Group Return For AffiliatesfalseGroupReturnForAffiliates
Organization501c3XOrganization501c3
Web SiteWWW.WMHCC.ORGWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1956YearFormation
State Legal DomicileMEStateLegalDomicile
Activity Or Mission DescriptionTO ENSURE A HIGH QUALITY, ACCESSIBLE, AFFORDABLE AND APPROPRIATE INTEGRATED HEALTH CARE SYSTEM TO IMPROVE THE HEALTH AND WELL BEING OF THE COMMUNITY.ActivityOrMissionDescription
Nbr Voting Members Governing Body19NbrVotingMembersGoverningBody
Nbr Independent Voting Members14NbrIndependentVotingMembers
Total Nbr Employees636TotalNbrEmployees
Total Nbr Volunteers77TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Contributions Grants Prior Year117000ContributionsGrantsPriorYear
Contributions Grants Current Year0ContributionsGrantsCurrentYear
Program Service Revenue Prior Year57376266ProgramServiceRevenuePriorYear
Program Service Revenue CY54199842ProgramServiceRevenueCY
Investment Income Prior Year35907InvestmentIncomePriorYear
Investment Income Current Year27541InvestmentIncomeCurrentYear
Other Revenue Prior Year912230OtherRevenuePriorYear
Other Revenue Current Year460592OtherRevenueCurrentYear
Total Revenue Prior Year58441403TotalRevenuePriorYear
Total Revenue Current Year54687975TotalRevenueCurrentYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year30218966SalariesEtcPriorYear
Salaries Etc Current Year30995677SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year6050TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY11798TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year85238TotalFundrsngExpCurrentYear
Other Expense Prior Year23543932OtherExpensePriorYear
Other Expenses Current Year21070147OtherExpensesCurrentYear
Total Expenses Prior Year53768948TotalExpensesPriorYear
Total Expenses Current Year52077622TotalExpensesCurrentYear
Revenues Less Expenses Prior Year4672455RevenuesLessExpensesPriorYear
Revenues Less Expenses CY2610353RevenuesLessExpensesCY
Total Assets BOY45798163TotalAssetsBOY
Total Assets EOY50529900TotalAssetsEOY
Total Liabilities BOY11824606TotalLiabilitiesBOY
Total Liabilities EOY17245167TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY33973557NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY33284733NetAssetsOrFundBalancesEOY
Mission DescriptionTO ENSURE A HIGH QUALITY, ACCESSIBLE, AFFORDABLE AND APPROPRIATE INTEGRATED HEALTH CARE SYSTEM TO IMPROVE THE HEALTH AND WELL BEING OF THE COMMUNITY.MissionDescription
Significant New Program ServicesfalseSignificantNewProgramServices
Significant ChangefalseSignificantChange
Expense39432162Expense
Revenue43070943Revenue
DescriptionOUTPATIENT SERVICES: STEPHENS MEMORIAL HOSPITAL ASSOCIATION PROVIDED CARE DURING THE COURSE OF 104,094 OUTPATIENT VISITS DURING 2013. SERVICES PROVIDED INCLUDE EMERGENCY SERVICES; DIAGNOSTIC IMAGING AND LAB TESTS; AMBULATORY SURGERY; AND PHYSICAL REHABILITATION.Description

Activity2 Activity2

FieldValueIRS element (for citing)
Expense10188692Expense
Revenue11128899Revenue
DescriptionINPATIENT SERVICES: IN 2013 THE HOSPITAL PROVIDED INPATIENT NURSING SERVICES TO 1,606 ADULTS/PEDIATRICS, INTENSIVE CARE, AND NURSERY PATIENTS WITH A TOTAL OF 5,135 PATIENT DAYS. 58 INPATIENTS (4%) WERE UNINSURED, 898 (56%) WERE COVERED BY MEDICARE AND 346 (22%) WERE COVERED BY MEDICAID.Description
FieldValueIRS element (for citing)
Total Program Service Expense49620854TotalProgramServiceExpense
Described In501 C3trueDescribedIn501C3
Schedule B RequiredfalseScheduleBRequired
Political ActivitiesfalsePoliticalActivities
Lobbying ActivitiestrueLobbyingActivities
Subject To Proxy TaxfalseSubjectToProxyTax
Donor Advised FundsfalseDonorAdvisedFunds
Conservation EasementsfalseConservationEasements
Collections Of ArtfalseCollectionsOfArt
Credit CounselingfalseCreditCounseling
Term Or Permanent EndowmentsfalseTermOrPermanentEndowments
Report Land Bldg EquiptrueReportLandBldgEquip
Report Invest Oth SecuritiesfalseReportInvestOthSecurities
Report Prog Rel InvestfalseReportProgRelInvest
Report Other AssetstrueReportOtherAssets
Report Other LiabilitiestrueReportOtherLiabilities
Report Fin48 FootnotetrueReportFin48Footnote
Independent Audit Financial StmttrueIndependentAuditFinancialStmt
Consolidated Audit Financial StmttrueConsolidatedAuditFinancialStmt
SchoolfalseSchool
Foreign OfficefalseForeignOffice
Foreign ActivitiesfalseForeignActivities
More Than5000 K To OrganizationsfalseMoreThan5000KToOrganizations
More Than5000 K To IndividualsfalseMoreThan5000KToIndividuals
Professional FundraisingfalseProfessionalFundraising
Fundraising ActivitiesfalseFundraisingActivities
GamingfalseGaming
HospitaltrueHospital
Financial Stmt AttachedtrueFinancialStmtAttached
Grants To OrganizationsfalseGrantsToOrganizations
Grants To IndividualsfalseGrantsToIndividuals
Schedule J RequiredtrueScheduleJRequired
Tax Exempt BondsfalseTaxExemptBonds
Excess Benefit TransactionfalseExcessBenefitTransaction
Prior Excess Benefit TransactionfalsePriorExcessBenefitTransaction
Loan To Officer Or DQPfalseLoanToOfficerOrDQP
Grant To Related PersonfalseGrantToRelatedPerson
Bsnss Rltnshp With OrganizationfalseBsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family MemberfalseBsnssRltnshpThruFamilyMember
Officer Entity With Bsnss RltnshpfalseOfficerEntityWithBsnssRltnshp
Deductible Non Cash ContributionsfalseDeductibleNonCashContributions
Deductible Contributions Of ArtfalseDeductibleContributionsOfArt
TerminatedfalseTerminated
Partial LiquidationfalsePartialLiquidation
Disregarded EntityfalseDisregardedEntity
Related EntitytrueRelatedEntity
Related Org Controlled EntityfalseRelatedOrgControlledEntity
Transfers To Exempt Non Chrtbl OrgfalseTransfersToExemptNonChrtblOrg
Activities Conducted PartnershipfalseActivitiesConductedPartnership
Schedule O RequiredtrueScheduleORequired
Number Forms Transmitted With109633NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup WitholdingtrueComplianceWithBackupWitholding
Number Of Employees636NumberOfEmployees
Employment Tax Returns FiledtrueEmploymentTaxReturnsFiled
Unrelated Business IncomefalseUnrelatedBusinessIncome
Foreign Financial AccountfalseForeignFinancialAccount
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTrans
Taxable Party NotificationfalseTaxablePartyNotification
Non Deductible ContributionsfalseNonDeductibleContributions
Quid Pro Quo ContributionsfalseQuidProQuoContributions
Form8282 Property Disposed OffalseForm8282PropertyDisposedOf
Funds To Pay PremiumsfalseFundsToPayPremiums
Premiums PaidfalsePremiumsPaid
Indoor Tanning ServicesfalseIndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members19NbrVotingGoverningBodyMembers
Number Independent Voting Members14NumberIndependentVotingMembers
Family Or Business RelationshipfalseFamilyOrBusinessRelationship
Delegation Of Management DutiesfalseDelegationOfManagementDuties
Changes To Organizing DocsfalseChangesToOrganizingDocs
Material Diversion Or MisusefalseMaterialDiversionOrMisuse
Members Or StockholderstrueMembersOrStockholders
Election Of Board MemberstrueElectionOfBoardMembers
Decisions Subject To ApprovaltrueDecisionsSubjectToApproval
Minutes Of Governing BodytrueMinutesOfGoverningBody
Minutes Of CommitteestrueMinutesOfCommittees
Officer Mailing AddressfalseOfficerMailingAddress
Local ChaptersfalseLocalChapters
Form990 Provided To Governing BodytrueForm990ProvidedToGoverningBody
Conflict Of Interest PolicytrueConflictOfInterestPolicy
Annual Disclosure Covered PersonstrueAnnualDisclosureCoveredPersons
Regular Monitoring EnforcementtrueRegularMonitoringEnforcement
Whistleblower PolicytrueWhistleblowerPolicy
Document Retention PolicytrueDocumentRetentionPolicy
Compensation Process CEOtrueCompensationProcessCEO
Compensation Process OtherfalseCompensationProcessOther
Investment In Joint VenturefalseInvestmentInJointVenture
States Where Copy Of Return Is FiledMEStatesWhereCopyOfReturnIsFiled
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonSENIOR VP - FISCALNamePerson
Telephone Number2077435933TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1181 MAIN STREETAddressLine1
CityNORWAYCity
StateMEState
ZIP Code04268ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (28 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekAverage Hours Per Week RelatedAverageHoursPerWeekRelatedIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationOfficerOfficerHighest Compensated EmployeeHighestCompensatedEmployee
GREGORY HARDY MD
PHYSICIAN57.003.00X354341034441
TIMOTHY CHURCHILL
PRESID & CEO30.0030.00X032039556198X
JAMES ESHLEMAN DO
MED STAFF PR57.003.00X259415022304
WILLIAM L MEDD MD
PHYSICIAN1.0059.00X02454344346
DAVID KUMAKI MD
PHYSICIAN1.0059.00X022593322858
KATHLEEN HERLIHY MD
PHYSICIAN57.003.00X160069031582
ANDREA BURNS
TRUSTEE1.00X000
PETER CHAPMAN
SECRETARY/TR1.00X000X
C BRADLEY CUMMINGS
TRUSTEE1.00X000X
TOM MORTON
TRUSTEE1.00X000
LARRY FARMER OD
TRUSTEE1.00X000
DAVID HOISINGTON
CHAIR1.00X000X
OLA MELHUS MD
TRUSTEE1.00X000
LYNN HAMPER
TRUSTEE1.00X000
DAVID J PREBLE
VICE CHAIR1.00X000X
TED MOCCIA
TRUSTEE1.00X000
REV ANNE STANLEY
TRUSTEE1.00X000
ROBIN J ZINCHUK
TRUSTEE1.00X000
WENDY PENLEY
TRUSTEE1.00X000
PAT WEIGEL
TRUSTEE1.00X000
ALLEN CONNORS
TRUSTEE1.00X000
JOHN COX
SR VP-FISCAL30.0020.00018907830028X
M PATRICIA COOK
SR VP-CLINIC41.004.00015255240556X
ROBERT C NEILSEN
PHYSICIAN60.00377023053263X
ROBERT C KAHN
PHYSICIAN60.00367570045451X
CAROLYN P COSTANZI
PHYSICIAN60.00279144032019X
JAMES W GALLEA
PHYSICIAN60.00274731017036X
THOMAS J HEWSON
PHYSICIAN60.00261836023306X
FieldValueIRS element (for citing)
Total Reportable Comp From Org2334129TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs1133392TotalReportableCompFrmRltdOrgs
Total Other Compensation413388TotalOtherCompensation
Number Individuals GT100 K31NumberIndividualsGT100K
Formers ListedfalseFormersListed
Total Comp GT150 KtrueTotalCompGT150K
Compensation From Other SourcesfalseCompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
MAINE MEDICAL PARTNERS
301C US ROUTE 1SCARBOROUGHME04074MED BILL & MGT663663
SPECTRUM MEDICAL GROUP PA
300 PROFESSIONAL DRIVESCARBOROUGHME04074ANESTHESIA SVCS523273
MAINE ORTHOPAEDIC CENTER
1601 CONGRESS STREETPORTLANDME04102PHYSICIAN SVCS412856
MAYO COLLABORATIVE SERVICES
PO BOX 4100ROCHESTERMN55903LAB PROCESSING229733
CROSS COUNTRY STAFFING
PO BOX 404674ATLANTAGA30384NURSE STAFFING153852
FieldValueIRS element (for citing)
Number Of Contractors GT100 K10NumberOfContractorsGT100K

Program Service Revenue ProgramServiceRevenue

FieldValueIRS element (for citing)
DescriptionNET PATIENT SERVICE REVENUEDescription
Business Code623000BusinessCode
Total Revenue Column54199842TotalRevenueColumn
Related Or Exempt Function Income54199842RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Program Service Revenue54199842TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column22804TotalRevenueColumn
Exclusion$22,804ExclusionAmount

Gross Rents GrossRents

FieldValueIRS element (for citing)
Real426900Real

Less Rental Expenses LessRentalExpenses

FieldValueIRS element (for citing)
Real634202Real

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real-207302Real

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column-207302TotalRevenueColumn
Exclusion-$207,302ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Other5575Other

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Other838Other

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Other4737Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column4737TotalRevenueColumn
Related Or Exempt Function Income4737RelatedOrExemptFunctionIncome

Other Revenue Misc OtherRevenueMisc

FieldValueIRS element (for citing)
DescriptionOTHER REVENUEDescription
Business Code621990BusinessCode
Total Revenue Column667894TotalRevenueColumn
Related Or Exempt Function Income667894RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Other Revenue667894TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column54687975TotalRevenueColumn
Related Or Exempt Function Income54872473RelatedOrExemptFunctionIncome
Exclusion-$184,498ExclusionAmount

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total868642Total
Program Services833028ProgramServices
Management And General35614ManagementAndGeneral

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total23268816Total
Program Services22285602ProgramServices
Management And General931209ManagementAndGeneral
Fundraising52005Fundraising

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total864171Total
Program Services827677ProgramServices
Management And General36494ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total4451686Total
Program Services4263764ProgramServices
Management And General178899ManagementAndGeneral
Fundraising9023Fundraising

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total1542362Total
Program Services1477274ProgramServices
Management And General61110ManagementAndGeneral
Fundraising3978Fundraising

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total89499Total
Management And General89499ManagementAndGeneral

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total11798Total
Fundraising11798Fundraising

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total5064049Total
Program Services4986643ProgramServices
Management And General77406ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total124028Total
Program Services118827ProgramServices
Management And General5201ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total6297483Total
Program Services6241571ProgramServices
Management And General47992ManagementAndGeneral
Fundraising7920Fundraising

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total1049209Total
Program Services1004932ProgramServices
Management And General44277ManagementAndGeneral

Occupancy Occupancy

FieldValueIRS element (for citing)
Total1162443Total
Program Services1113388ProgramServices
Management And General49055ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total82269Total
Program Services77935ProgramServices
Management And General4334ManagementAndGeneral

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total145854Total
Program Services138614ProgramServices
Management And General7240ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total56779Total
Program Services54383ProgramServices
Management And General2396ManagementAndGeneral

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total1839301Total
Program Services1761683ProgramServices
Management And General77618ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total733921Total
Program Services575381ProgramServices
Management And General158540ManagementAndGeneral

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
AFFILIATE CHARGES1272233121854553688
PROVIDER TAX11507561150756
MAINTENANCE CONTRACTS853569852929640
INTEGRATED SERVICES641269168721472548

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total507485Total
Program Services469201ProgramServices
Management And General37770ManagementAndGeneral
Fundraising514Fundraising

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total52077622Total
Program Services49620854ProgramServices
Management And General2371530ManagementAndGeneral
Fundraising85238Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY1900BOY
EOY41172EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY9786771BOY
EOY17718356EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY6595627BOY
EOY5292595EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY1064314BOY
EOY1168208EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY455794BOY
EOY475962EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis44164474LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec31020800LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY13455826BOY
EOY13143674EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY1295243BOY
EOY1495982EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
BOY528396BOY
EOY503665EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY12614292BOY
EOY10690286EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY45798163BOY
EOY50529900EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY4486912BOY
EOY4803949EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

FieldValueIRS element (for citing)
BOY3505479BOY
EOY3184845EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY3832215BOY
EOY9256373EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY11824606BOY
EOY17245167EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY32828109BOY
EOY32065296EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY593294BOY
EOY667283EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY552154BOY
EOY552154EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY33973557BOY
EOY33284733EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY45798163BOY
EOY50529900EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses2610353ReconcilationRevenueExpenses
Reconcilation Other Changes-3299177ReconcilationOtherChanges
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or ReviewfalseAccountantCompileOrReview
FS AuditedtrueFSAudited

FS Audited Basis FSAuditedBasis

FieldValueIRS element (for citing)
Financial Statement BothXFinancialStatementBoth
FieldValueIRS element (for citing)
Audit CommitteetrueAuditCommittee
Federal Grant Audit RequiredfalseFederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Hospital170b1 AiiiXHospital170b1Aiii

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
VolunteersfalseVolunteers
Paid Staff Or ManagementfalsePaidStaffOrManagement
Media AdvertisementsfalseMediaAdvertisements
Mailings MembersfalseMailingsMembers
Publications Or BroadcastfalsePublicationsOrBroadcast
Grants Other OrganizationsfalseGrantsOtherOrganizations
Direct Contact LegislatorsfalseDirectContactLegislators
Rallies DemonstrationsfalseRalliesDemonstrations
Other ActivitiestrueOtherActivities
Other Activities$9,666OtherActivitiesAmount
Total Lobbying Expenditures IIB9666TotalLobbyingExpendituresIIB
Not Described In501c3falseNotDescribedIn501c3

Form990 Schedule C Part IV Form990ScheduleCPartIV

FieldValueIRS element (for citing)
Return ReferenceSCHEDULE C, PART II-B, LINE 1ReturnReference
ExplanationDUES PAID TO THE AMERICAN HOSPITAL ASSOCIATION OF 15,802 AND TO THE MAINE HOSPITAL ASSOCIATION OF 31,258. THE AMERICAN HOSPITAL ASSOCIATION AND MAINE HOSPITAL ASSOCIATION USED 23.98% AND 18.80% RESPECTIVELY OF THEIR DUES REVENUE FOR LOBBYING ACTIVITY.Explanation

Schedule D IRS990ScheduleD

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis1230517OtherCostOrOtherBasis
Book Value1230517BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis20440020OtherCostOrOtherBasis
Depreciation12292748Depreciation
Book Value8147272BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis20825641OtherCostOrOtherBasis
Depreciation17448381Depreciation
Book Value3377260BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis1668296OtherCostOrOtherBasis
Depreciation1279671Depreciation
Book Value388625BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings13143674TotalOfBookValueLandBuildings

Other Assets OtherAssets (7 entries)

DescriptionDescriptionBook ValueBookValue
INTEREST IN NET ASSETS OF SCHC FOUND5951761
PREPAID CAPITAL COSTS4049048
DUE FROM AFFILIATES499357
OTHER RECEIVABLES173739
CSV-LIFE INSURANCE16381
WORKERS COMPENSATION FUNDING
AR UNDER REIMBURSEMENT REGULATIONS
FieldValueIRS element (for citing)
Total Book Value Other Assets10690286TotalBookValueOtherAssets

Other Liabilities OtherLiabilities (4 entries)

DescriptionDescriptionAmountAmount
AP UNDER REIMBURSEMENT REGULATIONS$6,552,390
DUE TO AFFILIATES$1,589,669
PROFESSIONAL LIABILITY CLAIM ACCRUAL$1,038,234
ACCRUED ASSET OBLIGATION$76,080
FieldValueIRS element (for citing)
Total Of Amounts9256373TotalOfAmounts
Footnote In Part XIIIXFootnoteInPartXIII
Tot Revenue Etc Audited Fincl Stmt51388798TotRevenueEtcAuditedFinclStmt
Other Revenues-3299177OtherRevenues
Revenue Not Rptd F990-3299177RevenueNotRptdF990
Revenue Subtotal54687975RevenueSubtotal
Total Revenue Per Form99054687975TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt52077622TotExpensesEtcAuditedFinclStmt
Expenses Subtotal52077622ExpensesSubtotal
Total Expenses Per Form99052077622TotalExpensesPerForm990

Form990 Schedule D Part XIII Form990ScheduleDPartXIII (2 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
LIABILITY UNDER FIN 48 FOOTNOTESCHEDULE D, PAGE 3, PART XTHE ORGANIZATION IS A NOT-FOR-PROFIT ORGANIZATION AND HAS BEEN RECOGNIZED AS TAX-EXEMPT PURSUANT TO SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. THE ORGANIZATION HAS EVALUATED THE POSITION TAKEN ON ITS FILED TAX RETURNS. THE ORGANIZATION HAS CONCLUDED NO UNCERTAIN INCOME TAX POSITIONS EXIST AT SEPTEMBER 30, 2013. THE ORGANIZATION'S TAX YEARS FROM 2011 THROUGH 2013 MAY BE SUBJECT TO EXAMINATION.
REVENUE AMOUNTS INCLUDED IN FINANCIALS - OTHERSCHEDULE D, PAGE 4, PART XI, LINE 2DCHANGE IN INTEREST-STEPHENS COMMUNITY HEALTHCARE FOUND 500,190 CHANGE IN VALUE OF INVESTMENTS 179,165 EQUITY TRANSFERS TO AFFILIATES -3,978,532

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Charity Care PolicytrueCharityCarePolicy
Written PolicytrueWrittenPolicy
FPG Reference Free CaretrueFPGReferenceFreeCare

Other Percentage OtherPercentage

FieldValueIRS element (for citing)
OtherXOther
Free Other Percentage1.75000FreeOtherPercentage
FieldValueIRS element (for citing)
FPG Reference Discounted CaretrueFPGReferenceDiscountedCare

Discounted Other DiscountedOther

FieldValueIRS element (for citing)
OtherXOther
Discounted Other Percentage2.25000DiscountedOtherPercentage
FieldValueIRS element (for citing)
Free Disc Care Medically IndigenttrueFreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity CaretrueAmountsBudgetedForCharityCare
Expenses Exceeded BudgetfalseExpensesExceededBudget
Annual Community Benefit ReporttrueAnnualCommunityBenefitReport
Report Publically AvailabletrueReportPublicallyAvailable

Charity Care At Cost CharityCareAtCost

FieldValueIRS element (for citing)
Total Community Benefit Expense1434088TotalCommunityBenefitExpense
Net Community Benefit Expense1434088NetCommunityBenefitExpense
Percent Of Total Expense0.02750PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

FieldValueIRS element (for citing)
Total Community Benefit Expense10584648TotalCommunityBenefitExpense
Direct Offsetting Revenue11028869DirectOffsettingRevenue
Net Community Benefit Expense-444221NetCommunityBenefitExpense

Total Charity Care TotalCharityCare

FieldValueIRS element (for citing)
Total Community Benefit Expense12018736TotalCommunityBenefitExpense
Direct Offsetting Revenue11028869DirectOffsettingRevenue
Net Community Benefit Expense989867NetCommunityBenefitExpense
Percent Of Total Expense0.02750PercentOfTotalExpense

Community Health Services CommunityHealthServices

FieldValueIRS element (for citing)
Total Community Benefit Expense154732TotalCommunityBenefitExpense
Direct Offsetting Revenue34485DirectOffsettingRevenue
Net Community Benefit Expense120247NetCommunityBenefitExpense
Percent Of Total Expense0.00230PercentOfTotalExpense

Health Professions Education HealthProfessionsEducation

FieldValueIRS element (for citing)
Total Community Benefit Expense100892TotalCommunityBenefitExpense
Direct Offsetting Revenue81050DirectOffsettingRevenue
Net Community Benefit Expense19842NetCommunityBenefitExpense
Percent Of Total Expense0.00040PercentOfTotalExpense

Subsidized Health Services SubsidizedHealthServices

FieldValueIRS element (for citing)
Total Community Benefit Expense8762554TotalCommunityBenefitExpense
Direct Offsetting Revenue7586931DirectOffsettingRevenue
Net Community Benefit Expense1175623NetCommunityBenefitExpense
Percent Of Total Expense0.02260PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense9018178TotalCommunityBenefitExpense
Direct Offsetting Revenue7702466DirectOffsettingRevenue
Net Community Benefit Expense1315712NetCommunityBenefitExpense
Percent Of Total Expense0.02530PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense21036914TotalCommunityBenefitExpense
Direct Offsetting Revenue18731335DirectOffsettingRevenue
Net Community Benefit Expense2305579NetCommunityBenefitExpense
Percent Of Total Expense0.05280PercentOfTotalExpense

Community Support CommunitySupport

FieldValueIRS element (for citing)
Total Community Building Expense11190TotalCommunityBuildingExpense
Net Community Building Expense11190NetCommunityBuildingExpense
Percent Of Total Expense0.00020PercentOfTotalExpense

Total Total

FieldValueIRS element (for citing)
Total Community Building Expense11190TotalCommunityBuildingExpense
Net Community Building Expense11190NetCommunityBuildingExpense
Percent Of Total Expense0.00020PercentOfTotalExpense
FieldValueIRS element (for citing)
Bad Debt Expense ReportedfalseBadDebtExpenseReported
Bad Debt Expense$2,096,698BadDebtExpenseAmount
Amount Reimbursed By Medicare15582211AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare15427932CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall154279MedicareSurplusOrShortfall

Costing Methodology Used CostingMethodologyUsed

FieldValueIRS element (for citing)
OtherXOther
FieldValueIRS element (for citing)
Written Debt Collection PolicytrueWrittenDebtCollectionPolicy
Provision For Charity CaretrueProvisionForCharityCare
Number Of Hospital Facilities1NumberOfHospitalFacilities

Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA

FieldValueIRS element (for citing)
Facility Number1FacilityNumber

Name Name

FieldValueIRS element (for citing)
Business Name Line1STEPHENS MEMORIAL HOSPITAL ASSOCBusinessNameLine1

Address Address

FieldValueIRS element (for citing)
Address Line1181 MAIN STREETAddressLine1
CityNORWAYCity
StateMEState
ZIP Code04268ZIPCode
FieldValueIRS element (for citing)
Licensed HospitalXLicensedHospital
Critical Access HospitalXCriticalAccessHospital
Er24 HoursXEr24Hours

Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1STEPHENS MEMORIAL HOSPITAL ASSOCBusinessNameLine1
FieldValueIRS element (for citing)
Hospital Facility Number1HospitalFacilityNumber
CHNA ConductedtrueCHNAConducted
Community DefinitionXCommunityDefinition
Community DemographicsXCommunityDemographics
Existing ResourcesXExistingResources
How Data ObtainedXHowDataObtained
Community Health NeedsXCommunityHealthNeeds
Other Health IssuesXOtherHealthIssues
Identifying ProcessXIdentifyingProcess
Consulting ProcessXConsultingProcess
Information GapsXInformationGaps
OtherXOther
Needs Assessment Conducted13NeedsAssessmentConducted
Take Into AccounttrueTakeIntoAccount
Other FacilitiestrueOtherFacilities
CHNA Widely AvailabletrueCHNAWidelyAvailable
Own WebsiteXOwnWebsite
On RequestXOnRequest
Adopt Implement StrategyXAdoptImplementStrategy
Execute Implement StrategyXExecuteImplementStrategy
Develop Community PlanXDevelopCommunityPlan
Participate Community PlanXParticipateCommunityPlan
Adopt BudgetXAdoptBudget
Prioritize Health NeedsXPrioritizeHealthNeeds
Prioritize ServicesXPrioritizeServices
All Needs AddressedfalseAllNeedsAddressed
Organization Incur Excise TaxfalseOrganizationIncurExciseTax
Eligibility Criteria ExplainedtrueEligibilityCriteriaExplained
Uses FPG FreetrueUsesFPGFree
FPG Free Percent175.0FPGFreePercent
Uses FPG DiscountedtrueUsesFPGDiscounted
FPG Discount Percent225.0FPGDiscountPercent
Explains BasisfalseExplainsBasis
Explains Application MethodtrueExplainsApplicationMethod
Includes Publicity MeasurestrueIncludesPublicityMeasures
Posted On WebsiteXPostedOnWebsite
Posted In Emergency RoomXPostedInEmergencyRoom
Posted In Admission OfficeXPostedInAdmissionOffice
Available On RequestXAvailableOnRequest
Actions On NonpaymenttrueActionsOnNonpayment
Collection ActivitiestrueCollectionActivities
Report To Credit AgencyXReportToCreditAgency
Notified All PatientsXNotifiedAllPatients
Documented DeterminationXDocumentedDetermination
Nondiscrim Emergency Care PolicytrueNondiscrimEmergencyCarePolicy
Lowest Negotiated RatesXLowestNegotiatedRates
Amounts Generally BilledfalseAmountsGenerallyBilled
Gross ChargesfalseGrossCharges

Form990 Schedule H Part VI Form990ScheduleHPartVI (15 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
SUBSIDIZED HEALTH SERVICES EXPLANATIONPART I LINE 7GSUBSIDIZED HEALTH SERVICES INCLUDE THE NET OPERATING LOSS OF PACE PARAMEDIC SERVICE A DEPARTMENT OF STEPHENS MEMORIAL HOSPITAL AND DIRECT SUBSIDIES AND SUPPORT OF LOCAL SCHOOLBASED HEALTH CLINICS AND OTHER CLINICAL PROGRAMS THAT ARE NOT REVENUEPRODUCING IF THESE SERVICES WERE NOT PROVIDED OR SUBSIDIZED BY THE HOSPITAL THEY WOULD NOT BE AVAILABLE IN THE COMMUNITY
COMMUNITY BUILDING ACTIVITIESPART IIIN ADDITION TO THE SUBSIDIZED HEALTH SERVICES AND COMMUNITY HEALTH SERVICES DESCRIBED ABOVE WESTERN MAINE HEALTH CARE SPONSORS OR PARTICIPATES IN A VARIETY OF OTHER COMMUNITY ACTIVITIES AND PROGRAMS THESE COMMUNITYBUILDING ACTIVITIES INCLUDE WE ARE THE LEAD AGENCY FOR HEALTHY OXFORD HILLS A COMMUNITY COALITION TO PROMOTE PARTNERSHIPS POLICIES AND PROGRAMS TO PROTECT AND ENHANCE THE HEALTH OF RESIDENTS OF OXFORD HILLS OUR VIAL OF LIFE PROGRAM ALLOWS INDIVIDUALS IN THE COMMUNITY TO RECORD AND SAFELY STORE THEIR CURRENT HEALTH INFORMATION AT HOME IN CASE THAT INFORMATION NEEDS TO BE RETRIEVED IN AN EMERGENCY SITUATION SAFE SITTER COURSES A MEDICALLYACCURATE INSTRUCTIONAL PROGRAM DESIGNED FOR YOUNG ADOLESCENTS 11 TO 13 YEARS OF AGE COMMUNITYWIDE EMERGENCY PREPAREDNESS PLANNING REGIONAL HEALTH PLANNING AND PANDEMIC PLANNING WE PROVIDE A CLINICAL SITE FOR LOCAL REGISTERED NURSES AND CERTIFIED NURSES AIDE PROGRAMS ANNUAL CONFERENCE ALCOHOLISM AND DRUG ADDICTION DISEASE TREATMENT AND RECOVERY FREE COMMUNITY BLOOD PRESSURE SCREENINGS AND CLINICS BLOOD DRIVES SIBLING CLASSES FOR CHILDREN EXPECTING NEW FAMILY MEMBERS NUTRITION OPEN HOUSES FOR THE GENERAL PUBLIC RELAY FOR LIFE TO SUPPORT THE AMERICAN CANCER SOCIETY BOWL FOR KIDS SAKE TO BENEFIT THE LOCAL BIG BROTHERSBIG SISTERS PROGRAM WE PROVIDE COMMUNITY OUTREACH SERVICES TO EDUCATE FAMILIES ABOUT THE ALFOND SCHOLARSHIP FOR BABIES AND ASSIST FAMILIES IN PREPARING THE GRANT APPLICATION WE PROVIDE MEETING SPACE AT NO CHARGE FOR LOCAL NONPROFIT SUPPORT GROUPS INCLUDING ALCOHOLICS ANONYMOUS SMOKING CESSATION GEAR PARENT NETWORK SUPPORT GROUP TAKE OFF POUNDS SENSIBLY TOPS THE SHRINERS ANNUAL HEALTH SCREENING DAY AND SUPPORT GROUPS FOR THOSE AFFECTED BY DEPRESSIONBIPOLAR CONDITIONS DIABETES GRIEF AND PARKINSONS DISEASE
BAD DEBT EXPENSE EXPLANATIONPART III LINE 4THE HOSPITAL ACCEPTS ALL PATIENTS REGARDLESS OF THEIR ABILITY TO PAY A PATIENT QUALIFIES FOR FREE CARE BASED UPON CERTAIN ESTABLISHED POLICIES OF THE HOSPITAL THESE POLICIES DEFINE FREE CARE AS THOSE SERVICES FOR WHICH NO PAYMENT IS ANTICIPATED FREE CARE PROVIDED IS NOT INCLUDED IN NET PATIENT SERVICE REVENUE AND IS MEASURED BASED ON THE HOSPITALS CHARGES COSTS AND EXPENSES INCURRED IN PROVIDING THESE SERVICES ARE INCLUDED IN OPERATING EXPENSES CHARGES FOR SERVICES RENDERED TO INDIVIDUALS FROM WHOM PAYMENT IS EXPECTED AND ULTIMATELY NOT RECEIVED ARE WRITTEN OFF BAD DEBT EXPENSE REPRESENTS HEALTHCARE SERVICES THAT THE HOSPITAL HAS PROVIDED WITHOUT COMPENSATION AS A TAXEXEMPT HOSPITAL THE HOSPITAL PROVIDES NECESSARY PATIENT CARE REGARDLESS OF THE PATIENTS ABILITY TO PAY FOR THE SERVICES A PORTION OF THE HOSPITALS 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 THE 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 HOSPITAL FREE CARE POLICY IN ADDITION BAD DEBT EXPENSE ALSO INCLUDES AMOUNTS FOR SERVICES PROVIDED TO INDIVIDUALS EXPERIENCING DIFFICULT PERSONAL OR ECONOMIC CIRCUMSTANCES RELATED TO A PORTION OF OUR COMMUNITY BASED PATIENT POPULATION THEIR MEDICAL BILLS OFTEN PLACE THESE INDIVIDUALS IN UNTENABLE POSITIONS WHERE THEY ARE NOT ABLE TO HANDLE THEIR PERSONAL DEBT AND THEN THEIR NEW MEDICAL DEBT HOWEVER BECAUSE OF THEIR INCOME LEVEL THEY DO NOT QUALIFY FOR FREE CARE BY PROVIDING NECESSARY HEALTHCARE SERVICES TO THOSE INDIVIDUALS EITHER WHO FAIL TO APPLY FOR FINANCIAL ASSISTANCE OR WHO ARE EXPERIENCING DIFFICULT PERSONAL OR ECONOMIC CIRCUMSTANCES THE HOSPITAL BELIEVES THAT BAD DEBT EXPENSE SHOULD BE INCLUDED AS A COMMUNITY BENEFIT THE RESERVE FOR UNCOLLECTIBLE ACCOUNTS IS PROVIDED BASED ON AN ANALYSIS BY MANAGEMENT OF THE COLLECTABILITY OF OUTSTANDING BALANCES MANAGEMENT CONSIDERS THE AGE OF OUTSTANDING BALANCES AND PAST COLLECTION EFFORTS IN DETERMINING THE RESERVE FOR UNCOLLECTIBLE ACCOUNTS ACCOUNTS DEEMED UNCOLLECTIBLE ARE CHARGED OFF AGAINST THE ESTABLISHED RESERVE THE 2096698 OF BAD DEBT EXPENSE AT COST WAS CALCULATED USING THE HOSPITALS COST TO CHARGE RATIO
MEDICARE EXPLANATIONPART III LINE 8MEDICARE ALLOWABLE COSTS WERE TAKEN FROM THE HOSPITALS ASFILED 2013 MEDICARE COST REPORTS THE COST REPORT UTILIZES A SOPHISTICATED DETAILED STEPDOWN COST ALLOCATION APPROACH THE COST REPORT EXCLUDES REVENUE EXPENSES AND REIMBURSEMENT FOR PROFESSIONAL FEES SUCH AS EMERGENCY DEPARTMENT PHYSICIANS IF THE COST TO PROVIDE THESE SERVICES AND PAYMENTS FOR THE SERVICES WERE INCLUDED IN THE PART III SECTION B ANALYSIS THERE WOULD BE A MEDICARE SHORTFALL FOR THESE SERVICES
COLLECTION PRACTICES EXPLANATIONPART III LINE 9BPATIENTS WHO APPLY FOR AND QUALIFY FOR CHARITY CARE FINANCIAL ASSISTANCE BASED ON THE STATE OF MAINE FREE HOSPITAL CARE GUIDELINES WILL HAVE THE SELF PAY PORTION OF THEIR ACCOUNT BALANCE ADJUSTED AT TIME OF APPROVAL FUTURE SELF PAY BALANCES WILL BE ADJUSTED DURING THEIR ELIGIBILITY PERIOD AT THE POINT OF BILLING PRIOR TO SENDING BILLS TO PATIENTS FOR THOSE WHO APPLY FOR ASSISTANCE BUT WHOSE INCOME EXCEEDS THE LIMIT FOR 100 ASSISTANCE A 50 REDUCTION WILL BE APPLIED IF THEIR INCOME IS BETWEEN 176 AND 200 OF THE FEDERAL POVERTY LIMITS PATIENTS WHOSE FAMILY INCOME RANGES FROM 201 TO 225 OF THE FEDERAL POVERTY LIMITS QUALIFY FOR A 25 REDUCTION IF REQUESTED A MONTHLY PAYMENT PLAN WILL BE SET UP FOR THE REMAINDER OF THE PATIENTS BALANCE
NEEDS ASSESSMENTPART VISTEPHENS MEMORIAL HOSPITALS BOARD OF TRUSTEES IS MADE UP OF A DIVERSE SET OF COMMUNITY MEMBERS THE BOARD REQUIRES A THOROUGH COMMUNITY NEEDS ASSESSMENT ON BEHALF OF THE ORGANIZATION AND DIRECTS THE ORGANIZATION TO ANALYZE AND RESPOND TO THE CURRENT NEEDS ASSESSMENT STEPHENS MEMORIAL HOSPITAL AND ITS PARENT WESTERN MAINE HEALTH CARE ALSO PARTICIPATE IN VARIOUS INITIATIVES TO HELP SUPPORT AND PROVIDE UPDATES TO COMMUNITY NEEDS ASSESSMENT PLANNING SOME OF THESE INITIATIVES INCLUDE CLINICAL STRATEGIC PLANNING FINANCIAL STRATEGIC PLANNING FACILITY PLANNING MANPOWER PLANNING PHYSICIAN RECRUITMENT STRATEGIC PLANNING EMERGENCY PREPAREDNESS PLANNING ALONG WITH THE INTERNAL ASSESSMENTS MOST MEMBER ORGANIZATIONS ALSO REVIEW AND ACT ON MANY OF THE RECOMMENDATIONS PROVIDED BY EXTERNAL GROUPS SUCH AS THE MAINE CENTER FOR DISEASE CONTROL AND PREVENTION AND THE STATE HEALTH PLAN CREATED BY THE ADVISORY COMMITTEE FOR HEALTH SYSTEMS DEVELOPMENT IN ADDITION MAINEHEALTH AND ITS PARTNERS IN THE ONEMAINE HEALTH COLLABORATIVE EASTERN MAINE HEALTH SYSTEM AND MAINEGENERAL HEALTH RELEASED THE ONEMAINE HEALTH COMMUNITY HEALTH NEEDS ASSESSMENT REPORT IN MARCH 2011 THE REPORT WAS A COMPREHENSIVE COMPILATION AND ANALYSIS CONTAINING PRIMARY AND SECONDARY HEALTH DATA SOURCES THE REPORT CONTAINED A HEALTH STATUS PROFILE FOR THE STATE AS A WHOLE AND FOR EACH OF MAINES SIXTEEN COUNTIES THE PRIMARY DATA SOURCE WAS A RANDOMIZED TELEPHONE SURVEY THE SAMPLING METHODOLOGY WAS DESIGNED TO PERMIT COMPARISONS AT THE COUNTY LEVEL SECONDARY DATA SOURCES INCLUDE NUMEROUS STATE AND FEDERAL SOURCES THIS REPORT PROVIDES BASELINE DATA ON HUNDREDS OF HEALTH INDICATORS THAT ARE RELEVANT TO HOSPITALS AND COMMUNITIES TO INFORM PLANNING AND EVALUATION ACTIVITIES MAINEHEALTH HOLDS COMMUNITY FORUMS IN PARTNERSHIP WITH EACH MEMBER AND AFFILIATE HOSPITAL IN ORDER TO INCREASE UNDERSTANDING AND USE OF THE COMMUNITY NEEDS HEALTH ASSESSMENT AND TO INFORM IDENTIFICATION AND ACTION ON LOCAL COMMUNITYBASED HEALTH PRIORITIES PLANS CALL FOR THE COMMUNITY HEALTH NEEDS ASSESSMENT TO BE REPLICATED EVERY THREE YEARS IN THE SUMMER OF 2013 MAINEHEALTH CREATED CHNA AND IMPLEMENTATION PLAN REPORTS IN COLLABORATION WITH MEMBER HOSPITALS THESE DETAILED REPORTS COVERED THE TIME PERIOD OF 20132015 AND WERE FORMALLY ADOPTED BY EACH MEMBER ORGANIZATION BOARD FOR SUBMISSION WITH THE FY13 990 FILING ACA COMPLIANCE REQUIRED THESE REPORTS TO BE COMPLETED NO LATER THAN APRIL 2014
PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCEPART VISTEPHENS MEMORIAL HOSPITALS POLICY OF CHARITY CARE AND FINANCIAL ASSISTANCE IS EASILY UNDERSTOOD PROMINENTLY POSTED AND PUBLICLY AVAILABLE FOR PATIENTS WHOSE FAMILY INCOME IS AT OR BELOW 175 OF THE FEDERAL POVERTY LEVEL CHARITY CARE IS 100 OF THEIR BILLED AMOUNTS PATIENTS WHOSE FAMILY INCOME RANGES FROM 176 TO 200 OF THE FEDERAL POVERTY LEVEL QUALIFY FOR A 50 CHARITY CARE DISCOUNT PATIENTS WHOSE FAMILY INCOME RANGES FROM 201 TO 225 OF THE FEDERAL POVERTY LEVEL QUALIFY FOR A 25 CHARITY CARE DISCOUNT A PROCESS EXISTS FOR OFFERING CHARITY CARE OR FINANCIAL ASSISTANCE TO PATIENTS WHO ARE UNABLE TO PAY AFTER THEY HAVE ALREADY BEEN BILLED IN ADDITION TO MONITORING COLLECTION PRACTICES COPIES OF THE CHARITY CARE POLICY ARE MADE AVAILABLE TO PATIENTS AT ALL ENTRY POINTS REGISTRATION ED ETC AND WITH BILLCOLLECTION NOTICES THE ORGANIZATION USES SIMPLE APPLICATION PROCEDURES FOR CHARITY CARE OR FINANCIAL ASSISTANCE THAT DO NOT INTIMIDATE OR CONFUSE APPLICANTS STEPHENS MEMORIAL HOSPITALS EMPLOYEES WHO WORK IN ADMISSIONS BILLING ACCOUNTS RECEIVABLE OR PATIENT FINANCIAL SERVICES ARE FULLY INFORMED AND EDUCATED ABOUT ALL FINANCIAL ASSISTANCE POLICIES THESE STAFF MEMBERS IDENTIFY UNPAID BILLS WHERE PERSONS ARE UNABLE TO PAY AND SEPARATES THESE POTENTIAL CHARITY CARE BILLS FROM OTHER BAD DEBT ACCOUNTS
COMMUNITY INFORMATIONPART VISTEPHENS MEMORIAL HOSPITAL PRIMARILY SERVES SOUTHERN OXFORD COUNTY IN WESTERN MAINE TRADITIONALLY THE DEMOGRAPHICS OF THIS REGION REFLECT A POPULATION THAT IS OLDER AND POORER THAN THE STATE OF MAINE AVERAGE RECENT INDEPENDENT STUDIES FOUND OXFORD COUNTY TO BE THE SECOND LEAST HEALTHY COUNTY IN THE STATE
HEALTH OF COMMUNITY IN RELATION TO EXEMPT PURPOSEPART VIIN ORDER TO ENSURE ACCESS TO PRIMARY CARE AND CERTAIN SPECIALTY PHYSICIAN SERVICES WESTERN MAINE HEALTH CARE OWNS AND OPERATES ITS SUBSIDIARIES STEPHENS MEMORIAL HOSPITAL ASSOCIATION AND WESTERN MAINE MULTIMEDICAL SPECIALISTS WMMMSINCLUDING PHYSICIAN PRACTICES PROVIDING CARDIOLOGY FAMILY MEDICINE GENERAL SURGERY INTERNAL MEDICINE ONCOLOGY PEDIATRIC AND OBSTETRIC AND GYNECOLOGY SERVICES WMMMS ALSO HAS PARTNERED WITH PHYSICIAN GROUPS TO PROVIDE UROLOGY SERVICES TO THE COMMUNITY DUE TO THE DEMOGRAPHICS OF THE POPULATION IN OXFORD COUNTY MOST OF THESE SERVICES WOULD NOT BE AVAILABLE IF THEY WERE NOT PROVIDED BY A SYSTEM SUCH AS OURS MOST LOCAL PRIVATE PHYSICIANS HAVE CLOSED TO OR SIGNIFICANTLY LIMITED ACCESS FOR NEW MEDICAID PATIENTS OUR PRACTICES CONTINUE TO ACCEPT PATIENTS REGARDLESS OF THEIR INSURANCE COVERAGE OR LACK THEREOF IN THE AGGREGATE 23 OF PATIENTS SERVED BY WESTERN MAINE HEALTH CARES PHYSICIANS WERE COVERED BY THE STATE OF MAINE MEDICAID PROGRAM WESTERN MAINE HEALTH CARE OWNED AND OPERATED MARKET SQUARE HEALTH CARE CENTER A 98BED LONGTERM CARE FACILITY COMPRISED OF 76 NURSING HOMESKILLED NURSING FACILITY BEDS AND 22 RESIDENTIAL CARE BEDS MARKET SQUARE ACCEPTS PATIENTS AND RESIDENTS WHOSE CLINICAL NEEDS EXCEED THE CAPABILITIES OF OTHER AREA NURSING FACILITIES WHILE WE SERVE THESE PATIENTS AT A FINANCIAL LOSS IT IS AN IMPORTANT PART OF OUR MISSION TO PROVIDE HEALTH CARE SERVICES THAT KEEP OUR LOCAL PATIENTS IN THE COMMUNITY MARKET SQUARE ACCEPTS ALL RESIDENTS WHO MEET CLINICAL CRITERIA REGARDLESS OF THE SOURCE OF EXPECTED PAYMENT FOR SERVICES COMBINED OPERATING LOSSES RELATED TO NONHOSPITAL PRACTICES AND NURSING FACILITY WAS 1382000 IN 2013 THESE LOSSES WERE SUPPORTED BY STEPHENS MEMORIAL HOSPITAL THROUGH NET ASSET TRANSFERS
LIST OF STATES WHERE COMMUNITY BENEFIT REPORT IS FILEDPART VIMAINE
ADDITIONAL INFORMATIONPART VIPART V SECTION B LINE 5A HOSPITAL FACILITYS WEBSITE WEB ADDRESS WHERE COMMUNITY HEALTH NEEDS ASSESSMENT CAN BE LOCATED HTTPWWWMAINEHEALTHCOMMHBODYCFMID7301
STEPHENS MEMORIAL HOSPITAL ASSOC LINE NUMBER 1 PART V LINE 1JPART V LINE 1JALSO INCLUDED IN THE CHNA WAS A PRIORITIZED LIST OF HEALTH NEEDS IDENTIFIED AS WELL AS THE IMPLEMENTATION PLANS RELATED TO THESE NEEDS
STEPHENS MEMORIAL HOSPITAL ASSOC LINE NUMBER 1 PART V LINE 3PART V LINE 3COMMUNITY INPUT WAS TAKEN INTO ACCOUNT WHEN CONDUCTING THE CHNA INCLUDING THOSE WITH SPECIAL KNOWLEDGE OR EXPERTISE IN PUBLIC HEALTH THIS INCLUDED INDIVIDUALS FROM THE FOLLOWING ORGANIZATIONS STEPHENS MEMORIAL HOSPITAL HEALTHY OXFORD HILLS WESTERN MAINE PUBLIC HEALTH DISTRICT BESSEY MOTORS OXFORD HILLS SCHOOL DISTRICT AND MAINEHEALTH
STEPHENS MEMORIAL HOSPITAL ASSOC LINE NUMBER 1 PART V LINE 4PART V LINE 4THE CHNA WAS CONDUCTED THROUGH A PARTNERSHIP BETWEEN MAINEHEALTH EASTERN MAINE HEALTHCARE SYSTEMS AND MAINEGENERAL HEALTH
STEPHENS MEMORIAL HOSPITAL ASSOC LINE NUMBER 1 PART V LINE 7PART V LINE 7THE FOLLOWING IDENTIFIED COMMUNITY HEALTH NEEDS WERE NOT ADDRESSED DENTAL HEALTH ED VISITS HOSPITAL ADMISSIONS INFECTIOUS DISEASE RESPIRATORY DISEASE AND YOUTH ISSUES THESE PRIORITIES WERE NOT ADDRESSED DUE TO LACK OF CONSENSUS FROM COMMUNITY PARTNERS REGARDING THE IMPORTANCE OF THE ISSUE ANDOR LACK OF RESOURCES TO ADDRESS THE ISSUE

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation CommitteeXCompensationCommittee
Independent ConsultantXIndependentConsultant
Written Employment ContractXWrittenEmploymentContract
Compensation SurveyXCompensationSurvey
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance PaymentfalseSeverancePayment
Supplemental Nonqual Retire PlanfalseSupplementalNonqualRetirePlan
Equity Based Comp ArrangementfalseEquityBasedCompArrangement
Comp Based On Revenue Of Filing OrgfalseCompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related OrgsfalseCompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing OrgfalseCompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate OrgsfalseCompBasedNetEarningsRelateOrgs
Any Non Fixed PaymentsfalseAnyNonFixedPayments
Initial Contract ExceptionfalseInitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (13 entries)

TitleTitleBase Compensation Filing OrgBaseCompensationFilingOrgOther Compensation Filing OrgOtherCompensationFilingOrgDeferred Comp Filing OrgDeferredCompFilingOrgNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgTotal Compensation Filing OrgTotalCompensationFilingOrgComp Based On Related OrgsCompBasedOnRelatedOrgsBonus Related OrgsBonusRelatedOrgsOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Related OrgsTotalCompensationRelatedOrgsBonus Filing OrgBonusFilingOrg
GREGORY HARDY MD
PHYSICIAN282136722051116223279388782
TIMOTHY CHURCHILL
PRESID & CEO26050041000188952738528813376593
JAMES ESHLEMAN DO
MED STAFF PRESIDENT180000680112230428171911404
WILLIAM L MEDD MD
PHYSICIAN225000204344346249780
DAVID KUMAKI MD
PHYSICIAN22500093322858248791
KATHLEEN HERLIHY MD
PHYSICIAN1545005569972521857191651
JOHN COX
SR VP-FISCAL17224316835767622352219106
M PATRICIA COOK
SR VP-CLINICAL135141174111874721809193108
ROBERT C NEILSEN
PHYSICIAN309000680232971323550430286
ROBERT C KAHN
PHYSICIAN309000585701976025691413021
CAROLYN P COSTANZI
PHYSICIAN2729506194874023279311163
JAMES W GALLEA
PHYSICIAN2250204971117036291767
THOMAS J HEWSON
PHYSICIAN2461411569558022726285142

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (8 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
CLASSES OF MEMBERS OR STOCKHOLDERSFORM 990, PAGE 6, PART VI, LINE 6WESTERN MAINE HEALTH CARE, CORP. (EIN 01-0411788) IS THE SOLE MEMBER OF THE ORGANIZATION.
ELECTION OF MEMBERS AND THEIR RIGHTSFORM 990, PAGE 6, PART VI, LINE 7ATHE SOLE MEMBER HAS THE RESPONSIBILITY FOR THE ELECTION OF THE MEMBERS OF THE GOVERNING BODY.
DECISIONS SUBJECT TO APPROVAL OF MEMBERSFORM 990, PAGE 6, PART VI, LINE 7BALL DECISIONS BY THE STEPHENS MEMORIAL HOSPITAL ASSOCIATION'S GOVERNING BODY ARE APPROVED BY DEFAULT BY THE MEMBER ORGANIZATION'S GOVERNING BODY SINCE THESE TWO ORGANIZATIONS SHARE A COMMON GOVERNING BODY.
ORGANIZATION'S PROCESS USED TO REVIEW FORM 990FORM 990, PAGE 6, PART VI, LINE 11BTHE 990 WAS REVIEWED IN DETAIL BY A COMMITTEE OF THE BOARD OF TRUSTEES. THE PRESIDENT AND SENIOR VICE PRESIDENT - FISCAL LED THE DISCUSSION. SUBSEQUENT TO THAT REVIEW, A COPY OF THE ORGANIZATION'S 990 WAS DISTRIBUTED TO ALL TRUSTEES. THE 990 WAS REVIEWED IN SUMMARY AT A BOARD MEETING PRIOR TO FILING.
ENFORCEMENT OF CONFLICTS POLICYFORM 990, PAGE 6, PART VI, LINE 12CCONFLICT OF INTEREST STATEMENTS ARE OBTAINED ANNUALLY. THE PRESIDENT'S OFFICE COLLECTS AND REVIEWS THE RESPONSES. WHERE ANY REAL OR PERCEIVED CONFLICTS EXIST, OFFICERS AND TRUSTEES ARE EXPECTED TO RECUSE THEMSELVES (1) FROM MEETINGS DURING TIMES WHEN THE TOPICS OF POTENTIAL CONFLICT ARE DISCUSSED AND (2) FROM VOTING ON SUCH MATTERS. KEY EMPLOYEES MAY NOT USE THEIR POSITIONS TO PROFIT PERSONALLY OR TO ASSIST OTHERS IN PROFITING IN ANY WAY AT THE EXPENSE OF STEPHENS MEMORIAL HOSPITAL ASSOCIATION.
COMPENSATION PROCESS FOR TOP OFFICIALFORM 990, PAGE 6, PART VI, LINE 15ATHE PARENT COMPANY OF STEPHENS MEMORIAL HOSPITAL ASSOCIATION IS WESTERN MAINE HEALTH CARE, CORP. (EIN 01-0411788)WHO THROUGH ITS PARENT COMPANY MAINEHEALTH, HAS A FORMAL WRITTEN COMPENSATION POLICY IN PLACE. IN CONSULTATION WITH SULLIVAN COTTER, THE MAINEHEALTH BOARD COMPENSATION COMMITTEE ESTABLISHES APPROPRIATE COMPENSATION PARAMETERS FOR EACH ORGANIZATION'S CEO AND CERTAIN MEMBERS OF THEIR SENIOR MANAGEMENT TEAM. WORKING WITHIN THESE PARAMETERS, THE WESTERN MAINE HEALTH CARE BOARD DETERMINES THE LEVEL OF COMPENSATION FOR ITS CEO. THE FINDINGS OF THE COMPENSATION COMMITTEE ARE MADE TRANSPARENT TO, AND VOTED ON BY, THE FULL GOVERNING BOARD. THE "TOTAL EXECUTIVE COMPENSATION" IS FILED PUBLICLY BY THE ORGANIZATION, AND INCLUDES "TOTAL CASH COMPENSATION" AND "TOTAL VALUE OF ALL BENEFITS AND PERQUISITES" ASSOCIATED WITH THE POSITION. THE BOARD TAKES NECESSARY ACTION TO PREVENT THE CEO FROM VOTING OR DIRECTLY PARTICIPATING IN THE FINAL COMMITTEE DETERMINATION OF HIS OWN COMPENSATION. THE ORGANIZATION'S EXECUTIVE COMPENSATION PROCEDURES RELY UPON APPROPRIATE DATA FOR COMPARABILITY (E.G. COMPENSATION LEVELS PAID BY BOTH TAXABLE AND TAX-EXEMPT SIMILARLY SITUATED ORGANIZATIONS AND INDEPENDENT SURVEYS BY NATIONALLY RECOGNIZED INDEPENDENT FIRMS). FINALLY, THE ORGANIZATION REFRAINS FROM ALLOWING EXECUTIVE COMPENSATION TO EVER BE BASED SOLELY ON WESTERN MAINE HEALTH CARE, CORP.'S REVENUES OR OTHER SIMILAR PROFIT-SHARING STRATEGIES.
GOVERNING DOCUMENTS DISCLOSURE EXPLANATIONFORM 990, PAGE 6, PART VI, LINE 19DOCUMENTS THAT ARE REQUIRED TO BE OPEN FOR PUBLIC INSPECTION ARE MADE AVAILABLE UPON REQUEST.
RECONCILIATION OF CHANGES - OTHERFORM 990, PART XI, LINE 9CHANGE IN INTEREST-STEPHENS COMMUNITY HEALTHCARE FOUND 500,190 CHANGE IN VALUE OF INVESTMENTS 179,165 EQUITY TRANSFERS TO AFFILIATES -3,978,532

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (6 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Controlled OrgControlledOrg
WESTERN MAINE HEALTH CARE CORP
181 MAIN STREETNORWAYME04268010411788HEALTHCAREME501C311CMEHEALTHfalse
MAINEHEALTH
110 FREE STREETPORTLANDME04101010431680HEALTHCAREME501C311CNAfalse
WESTERN MAINE MULTI-MEDICAL SPECIAL
181 MAIN STREETNORWAYME04268010489824PHYS PRACTME501C39WMHCCfalse
WESTERN MAINE NURSING HOME INC
3 MARKET SQUARESOUTH PARISME04281222842655NURSING HOME501C39WMHCCfalse
STEPHENS COMMUNITY HEALTHCARE FOUND
181 MAIN STREETNORWAYME04268311644144SUPP ORGME501C311AWMHCCfalse
CHAPEL VALLEY BOARDING HOME CORP
181 MAIN STREETNORWAYME04268010433206HEALTHCAREME501C37WMHCCfalse
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents RoyaltiesfalseReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other OrgfalseGiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other OrgfalseGiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other OrgfalseLoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other OrgfalseLoansOrGuaranteesFromOtherOrg
Dividends Related OrganizationfalseDividendsRelatedOrganization
Sale Of Assets To Other OrgfalseSaleOfAssetsToOtherOrg
Purchase Of Assets From Other OrgfalsePurchaseOfAssetsFromOtherOrg
Exchange Of AssetsfalseExchangeOfAssets
Rental Of Facilities To Other OrgstrueRentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other OrgsfalseRentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other OrgstruePerformOfServicesForOtherOrgs
Perform Of Services By Other OrgstruePerformOfServicesByOtherOrgs
Sharing Of FacilitiesfalseSharingOfFacilities
Sharing Of Paid EmployeesfalseSharingOfPaidEmployees
Reimbursement Paid To Other OrgtrueReimbursementPaidToOtherOrg
Reimbursement Paid By Other OrgtrueReimbursementPaidByOtherOrg
Other Transfer To Other OrgtrueOtherTransferToOtherOrg
Other Transfer From Other OrgtrueOtherTransferFromOtherOrg