Waldo County General Hospital: Form 990, tax year 2012
View the entire original 990 at ProPublica ↗
- Organization
- Waldo County General Hospital (EIN 01-0177170)
- Tax period
- 2012-10-01 to 2013-09-30
- Filed
- 2014-08-13
- IRS object ID
- 201422259349301757
- 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
- Form 990
- Schedule A
- Schedule B
- Schedule C
- Schedule D
- Schedule H
- Schedule I
- Schedule J
- Schedule M
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2014-08-13T13:32:17-05:00 | Timestamp |
| Tax Period End Date | 2013-09-30 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MAINEHEALTH | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 110 FREE ST | AddressLine1 |
| City | PORTLAND | City |
| State | ME | State |
| ZIP Code | 041013908 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2012-10-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 010177170 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | WALDO COUNTY GENERAL HOSPITAL | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | WALD | NameControl |
| Phone | 2073382500 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 118 NORTHPORT AVENUE | AddressLine1 |
| City | BELFAST | City |
| State | ME | State |
| ZIP Code | 04915 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | LINDA B DRINKWATER | Name |
| Title | CFO | Title |
| Phone | 2073382500 | Phone |
| Date Signed | 2014-07-28 | DateSigned |
| Authorize Third Party | false | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Date Prepared | 2014-08-13 | 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 | LINDA B DRINKWATER | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 287 | AddressLine1 |
| City | BELFAST | City |
| State | ME | State |
| ZIP Code | 04915 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 85032807 | GrossReceipts |
| Group Return For Affiliates | false | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | WWW.WCHI.COM | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1901 | YearFormation |
| State Legal Domicile | ME | StateLegalDomicile |
| Activity Or Mission Description | WALDO COUNTY GENERAL HOSPITAL'S MISSION IS TO BE THE BEST - BETTER, EMPATHY, SERVICE AND TEAMWORK. OUR GOAL IS TO ENSURE QUALITY, ACCESSIBLE AND AFFORDABLE HEALTH CARE SERVICES AND TO IMPROVE THE HEALTH AND WELL-BEING OF OUR COMMUNITY. PLEASE SEE ATTACHED COMMUNITY BENEFITS REPORT. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 15 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 12 | NbrIndependentVotingMembers |
| Total Nbr Employees | 726 | TotalNbrEmployees |
| Total Nbr Volunteers | 51 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Contributions Grants Prior Year | 2086956 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 739863 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 72276223 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 70800502 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 1786613 | InvestmentIncomePriorYear |
| Investment Income Current Year | 2086928 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 1203113 | OtherRevenuePriorYear |
| Other Revenue Current Year | 1500925 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 77352905 | TotalRevenuePriorYear |
| Total Revenue Current Year | 75128218 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 77856 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 36637 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 41764649 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 42693198 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 28845041 | OtherExpensePriorYear |
| Other Expenses Current Year | 27359594 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 70687546 | TotalExpensesPriorYear |
| Total Expenses Current Year | 70089429 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 6665359 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 5038789 | RevenuesLessExpensesCY |
| Total Assets BOY | 104978257 | TotalAssetsBOY |
| Total Assets EOY | 118380385 | TotalAssetsEOY |
| Total Liabilities BOY | 24145111 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 29548845 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 80833146 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 88831540 | NetAssetsOrFundBalancesEOY |
| Info In Schedule O Part III | X | InfoInScheduleOPartIII |
| Mission Description | WALDO COUNTY GENERAL HOSPITAL'S MISSION IS TO BE THE BEST - BETTER, EMPATHY, SERVICE AND TEAMWORK. OUR GOAL IS TO ENSURE QUALITY, ACCESSIBLE AND AFFORDABLE HEALTH CARE SERVICES AND TO IMPROVE THE HEALTH AND WELL-BEING OF OUR COMMUNITY. PLEASE SEE ATTACHED COMMUNITY BENEFITS REPORT. | MissionDescription |
| Significant New Program Services | false | SignificantNewProgramServices |
| Significant Change | false | SignificantChange |
| Expense | 51216898 | Expense |
| Grants | 16637 | Grants |
| Revenue | 64222457 | Revenue |
| Description | WALDO COUNTY GENERAL HOSPITAL PROVIDES QUALITY AND AFFORDABLE HEALTH CARE SERVICES TO IMPROVE THE HEALTH AND WELL BEING OF THE COMMUNITIES IT SERVES, REGARDLESS OF THE PATIENT'S ABILITY TO PAY. A BROAD SPECTRUM OF SERVICES ARE PROVIDED INCLUDING HOSPITAL ACUTE INPATIENT CARE; ANCILLARY OUTPATIENT DIAGNOSTIC SERVICES INCLUDING PHYSICAL THERAPY, SPEECH, AUDIOLOGY, SLEEP AND RESPIRATORY THERAPY, ONCOLOGY CLINICS, EMERGENCY SERVICES, INPATIENT AND OUTPATIENT CARE, INPATIENT HOSPICE, AND SURGICAL INPATIENT AND OUTPATIENT SERVICES. THE HOSPITAL PROVIDED 5,961 DAYS OF ADULT, NEWBORN, SWING BED, AND HOSPICE INPATIENT CARE, AND 69,446 OUTPATIENT VISITS INCLUDING 496,426 OUTPATIENT PROCEDURES AND EXAMS. SEE ATTACHED COMMUNITY BENEFITS REPORT. | Description |
Activity2 Activity2
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 8198801 | Expense |
| Revenue | 7066197 | Revenue |
| Description | WALDO COUNTY GENERAL HOSPITAL EMPLOYS MANY HOSPITAL-BASED PHYSICIANS AND PROVIDES THE FOLLOWING SPECTRUM OF PHYSICIAN PATIENT CARE SERVICES: CARDIOLOGY, FAMILY MEDICINE, GENERAL SURGERY, INTERNAL MEDICINE, NEPHROLOGY, NEUROLOGY, OB/GYN, ORTHOPEDICS, OTOLARYNGOLOGY, PODIATRY, PULMONOLOGY AND UROLOGY. OUR PHYSICIANS PROVIDED CARE TO PATIENTS DURING 38,628 PHYSICIAN-OFFICE PATIENT VISITS. | Description |
Activity3 Activity3
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 2262815 | Expense |
| Revenue | 1765265 | Revenue |
| Description | WALDO COUNTY GENERAL HOSPITAL OFFERS THE COMMUNITY IT SERVES FIVE HEALTH CENTERS: ARTHUR JEWELL COMMUNITY HEALTH CENTER, STOCKTON SPRINGS REGIONAL HEALTH CENTER, DONALD S. WALKER HEALTH CENTER, LINCOLNVILLE REGIONAL HEALTH CENTER AND SEARSPORT HEALTH CENTER. WE PROVIDED HEALTHCARE SERVICES TO PATIENTS DURING 18,875 HEALTH CENTER VISITS. | Description |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expense | 61678514 | TotalProgramServiceExpense |
| Described In501 C3 | true | DescribedIn501C3 |
| Schedule B Required | true | ScheduleBRequired |
| Political Activities | false | PoliticalActivities |
| Lobbying Activities | true | LobbyingActivities |
| Subject To Proxy Tax | false | SubjectToProxyTax |
| Donor Advised Funds | false | DonorAdvisedFunds |
| Conservation Easements | false | ConservationEasements |
| Collections Of Art | false | CollectionsOfArt |
| Credit Counseling | false | CreditCounseling |
| Term Or Permanent Endowments | true | TermOrPermanentEndowments |
| Report Land Bldg Equip | true | ReportLandBldgEquip |
| Report Invest Oth Securities | false | ReportInvestOthSecurities |
| Report Prog Rel Invest | false | ReportProgRelInvest |
| Report Other Assets | true | ReportOtherAssets |
| Report Other Liabilities | true | ReportOtherLiabilities |
| Report Fin48 Footnote | true | ReportFin48Footnote |
| Independent Audit Financial Stmt | true | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | true | ConsolidatedAuditFinancialStmt |
| School | false | School |
| Foreign Office | false | ForeignOffice |
| Foreign Activities | false | ForeignActivities |
| More Than5000 K To Organizations | false | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividuals |
| Professional Fundraising | false | ProfessionalFundraising |
| Fundraising Activities | false | FundraisingActivities |
| Gaming | false | Gaming |
| Hospital | true | Hospital |
| Financial Stmt Attached | true | FinancialStmtAttached |
| Grants To Organizations | true | GrantsToOrganizations |
| Grants To Individuals | true | GrantsToIndividuals |
| Schedule J Required | true | ScheduleJRequired |
| Tax Exempt Bonds | false | TaxExemptBonds |
| Excess Benefit Transaction | false | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | false | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | false | LoanToOfficerOrDQP |
| Grant To Related Person | false | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | false | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | false | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | false | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | false | DeductibleNonCashContributions |
| Deductible Contributions Of Art | true | DeductibleContributionsOfArt |
| Terminated | false | Terminated |
| Partial Liquidation | false | PartialLiquidation |
| Disregarded Entity | false | DisregardedEntity |
| Related Entity | true | RelatedEntity |
| Related Org Controlled Entity | false | RelatedOrgControlledEntity |
| Transfers To Exempt Non Chrtbl Org | false | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | false | ActivitiesConductedPartnership |
| Schedule O Required | true | ScheduleORequired |
| Number Forms Transmitted With1096 | 123 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | true | ComplianceWithBackupWitholding |
| Number Of Employees | 726 | NumberOfEmployees |
| Employment Tax Returns Filed | true | EmploymentTaxReturnsFiled |
| Unrelated Business Income | false | UnrelatedBusinessIncome |
| Foreign Financial Account | false | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTrans |
| Taxable Party Notification | false | TaxablePartyNotification |
| Non Deductible Contributions | false | NonDeductibleContributions |
| Quid Pro Quo Contributions | false | QuidProQuoContributions |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | false | FundsToPayPremiums |
| Premiums Paid | false | PremiumsPaid |
| Indoor Tanning Services | false | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 15 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 12 | NumberIndependentVotingMembers |
| Family Or Business Relationship | false | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | false | DelegationOfManagementDuties |
| Changes To Organizing Docs | false | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuse |
| Members Or Stockholders | true | MembersOrStockholders |
| Election Of Board Members | true | ElectionOfBoardMembers |
| Decisions Subject To Approval | true | DecisionsSubjectToApproval |
| Minutes Of Governing Body | true | MinutesOfGoverningBody |
| Minutes Of Committees | true | MinutesOfCommittees |
| Officer Mailing Address | false | OfficerMailingAddress |
| Local Chapters | false | LocalChapters |
| Form990 Provided To Governing Body | true | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | true | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | true | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | true | RegularMonitoringEnforcement |
| Whistleblower Policy | true | WhistleblowerPolicy |
| Document Retention Policy | true | DocumentRetentionPolicy |
| Compensation Process CEO | true | CompensationProcessCEO |
| Compensation Process Other | true | CompensationProcessOther |
| Investment In Joint Venture | false | InvestmentInJointVenture |
| States Where Copy Of Return Is Filed | ME | StatesWhereCopyOfReturnIsFiled |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | LINDA B DRINKWATER | NamePerson |
| Telephone Number | 2073382500 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 125 NORTHPORT AVENUE | AddressLine1 |
| City | BELFAST | City |
| State | ME | State |
| ZIP Code | 04915 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (22 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Average Hours Per Week RelatedAverageHoursPerWeekRelated | Individual Trustee Or DirectorIndividualTrusteeOrDirector | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | OfficerOfficer | Highest Compensated EmployeeHighestCompensatedEmployee |
|---|---|---|---|---|---|---|---|---|
| WILLIAM CARON | ||||||||
| MAINEHEALTH | 1.00 | 50.00 | X | 0 | 1193562 | 75811 | ||
| D KENT CLARK MD | ||||||||
| DIRECTOR/EMP | 35.00 | 5.00 | X | 296147 | 0 | 28088 | ||
| ANN HOOPER | ||||||||
| DIRECTOR/EMP | 35.00 | 5.00 | X | 126021 | 0 | 20060 | ||
| JAMES C DELEHANTY MD | ||||||||
| DIRECTOR | 1.00 | X | 6280 | 0 | 0 | |||
| JENNESS ROBBINS | ||||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | |||
| PETER D HADDOCK | ||||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | |||
| JOHN D WORTH III | ||||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | |||
| FRANK MORONG | ||||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | |||
| DALE KUHNERT | ||||||||
| VICE PRES. | 1.00 | X | 0 | 0 | 0 | X | ||
| GREGOR DAVENS | ||||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | |||
| WAYNE HAMILTON | ||||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | |||
| LEE WOODWARD JR | ||||||||
| PRESIDENT | 1.00 | X | 0 | 0 | 0 | X | ||
| JAMES PATTERSON PHD | ||||||||
| SECRETARY | 1.00 | X | 0 | 0 | 0 | X | ||
| CATHERINE REYNOLDS | ||||||||
| TREASURER | 1.00 | X | 0 | 0 | 0 | X | ||
| DAVID TASSONI | ||||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | |||
| MARK BISCONE | ||||||||
| CEO | 30.00 | 10.00 | 301274 | 84512 | 38990 | X | ||
| LINDA DRINKWATER | ||||||||
| CFO | 35.00 | 5.00 | 188410 | 0 | 8448 | X | ||
| OWEN NELSON MD | ||||||||
| ORTHOPEDIC M | 32.00 | 463910 | 0 | 20958 | X | |||
| JAMES DORSCH MD | ||||||||
| ANESTH. MD | 40.00 | 435248 | 0 | 27766 | X | |||
| RICHARD BOWER MD | ||||||||
| ORTHOPEDIC M | 40.00 | 417386 | 0 | 19869 | X | |||
| DAVID FERGUSON MD | ||||||||
| CARDIOLOGIST | 40.00 | 391671 | 0 | 18953 | X | |||
| TERRANCE SMITH MD | ||||||||
| ANESTH. MD | 40.00 | 374531 | 0 | 28366 | X | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 3000878 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 1278074 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 287309 | TotalOtherCompensation |
| Number Individuals GT100 K | 53 | NumberIndividualsGT100K |
| Formers Listed | false | FormersListed |
| Total Comp GT150 K | true | TotalCompGT150K |
| Compensation From Other Sources | false | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (5 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| SHERIDAN CORPORATION | |||||
| PO BOX 359 | FAIRFIELD | ME | 04937 | CONSTRUCTION | 1913055 |
| FREY'S CARPENTRY | |||||
| 661 SWAN LAKE AVENUE | SWANVILLE | ME | 04915 | CONSTRUCTION | 641723 |
| MAINE CENTER FOR CANCER MEDICINE | |||||
| 100 CAMPUS DRIVE UNIT 308 | SCARBOROUGH | ME | 04074 | MED. STAFFING | 392925 |
| ROOF SYSTEMS OF MAINE | |||||
| PO BOX 1134 | BANGOR | ME | 04402 | CONSTRUCTION | 320997 |
| WEATHERBY LOCUMS INC | |||||
| PO BOX 972633 | DALLAS | TX | 75397 | MED. STAFFING | 242962 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 9 | NumberOfContractorsGT100K |
| Government Grants | 268686 | GovernmentGrants |
| All Other Contributions | 471177 | AllOtherContributions |
| Total Contributions | 739863 | TotalContributions |
Program Service Revenue ProgramServiceRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | NET PATIENT SERVICE REVENUE | Description |
| Business Code | 623000 | BusinessCode |
| Total Revenue Column | 70800502 | TotalRevenueColumn |
| Related Or Exempt Function Income | 70800502 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 70800502 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 1334436 | TotalRevenueColumn |
| Exclusion | $1,334,436 | ExclusionAmount |
Gross Rents GrossRents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 205419 | Real |
Rental Income Or Loss RentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 205419 | Real |
Net Rental Income Or Loss NetRentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 205419 | TotalRevenueColumn |
| Related Or Exempt Function Income | 205419 | RelatedOrExemptFunctionIncome |
Gross Amount Sales Assets GrossAmountSalesAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 10635981 | Securities |
| Other | 21100 | Other |
Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 9844618 | Securities |
| Other | 59971 | Other |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 791363 | Securities |
| Other | -38871 | Other |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 752492 | TotalRevenueColumn |
| Related Or Exempt Function Income | 752492 | RelatedOrExemptFunctionIncome |
Other Revenue Misc OtherRevenueMisc (3 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome |
|---|---|---|---|
| MISCELLANEOUS REVENUE | 900099 | 765874 | 765874 |
| MANAGEMENT FEE REVENUE | 561000 | 296063 | 296063 |
| CAFETERIA REVENUE | 722210 | 233569 | 233569 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 1295506 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 75128218 | TotalRevenueColumn |
| Related Or Exempt Function Income | 73053919 | RelatedOrExemptFunctionIncome |
| Exclusion | $1,334,436 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | X | InfoInScheduleOPartIX |
Grants To Domestic Orgs GrantsToDomesticOrgs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 20000 | Total |
| Program Services | 20000 | ProgramServices |
Grants To Domestic Individuals GrantsToDomesticIndividuals
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 16637 | Total |
| Program Services | 16637 | ProgramServices |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1193070 | Total |
| Program Services | 247217 | ProgramServices |
| Management And General | 945853 | ManagementAndGeneral |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 33984108 | Total |
| Program Services | 31206080 | ProgramServices |
| Management And General | 2778028 | ManagementAndGeneral |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 789899 | Total |
| Program Services | 726942 | ProgramServices |
| Management And General | 62957 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 4501549 | Total |
| Program Services | 4081810 | ProgramServices |
| Management And General | 419739 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2224572 | Total |
| Program Services | 1992499 | ProgramServices |
| Management And General | 232073 | ManagementAndGeneral |
Fees For Services Management FeesForServicesManagement
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 498142 | Total |
| Management And General | 498142 | ManagementAndGeneral |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 38945 | Total |
| Management And General | 38945 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 136345 | Total |
| Management And General | 136345 | ManagementAndGeneral |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 7999027 | Total |
| Program Services | 6599709 | ProgramServices |
| Management And General | 1399318 | ManagementAndGeneral |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 8441858 | Total |
| Program Services | 8162171 | ProgramServices |
| Management And General | 279687 | ManagementAndGeneral |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1999782 | Total |
| Program Services | 1787113 | ProgramServices |
| Management And General | 212669 | ManagementAndGeneral |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1438206 | Total |
| Program Services | 1288169 | ProgramServices |
| Management And General | 150037 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 100475 | Total |
| Program Services | 82345 | ProgramServices |
| Management And General | 18130 | ManagementAndGeneral |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 214651 | Total |
| Program Services | 190720 | ProgramServices |
| Management And General | 23931 | ManagementAndGeneral |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 333494 | Total |
| Program Services | 298703 | ProgramServices |
| Management And General | 34791 | ManagementAndGeneral |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3081428 | Total |
| Program Services | 2759965 | ProgramServices |
| Management And General | 321463 | ManagementAndGeneral |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 732805 | Total |
| Program Services | 408411 | ProgramServices |
| Management And General | 324394 | ManagementAndGeneral |
Other Expenses OtherExpenses (4 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral |
|---|---|---|---|
| STATE OF ME HOSPITAL TAX | 1449081 | 1449081 | |
| MISCELLANEOUS EXPENSES | 446519 | 347355 | 99164 |
| AFFILIATE ASSESSMENTS | 435249 | 435249 | |
| DUES | 13587 | 13587 |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 70089429 | Total |
| Program Services | 61678514 | ProgramServices |
| Management And General | 8410915 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3615 | BOY |
| EOY | 3615 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 7561067 | BOY |
| EOY | 10275853 | EOY |
Pledges And Grants Receivable PledgesAndGrantsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 65322 | BOY |
| EOY | 20004 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 5639738 | BOY |
| EOY | 6489783 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2380723 | BOY |
| EOY | 2578577 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 609959 | BOY |
| EOY | 205615 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 65298741 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 39424571 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 24737906 | BOY |
| EOY | 25874170 | EOY |
Investments Pub Traded Securities InvestmentsPubTradedSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 40741683 | BOY |
| EOY | 45573430 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 23238244 | BOY |
| EOY | 27359338 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 104978257 | BOY |
| EOY | 118380385 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 6884089 | BOY |
| EOY | 8016934 | EOY |
Tax Exempt Bond Liabilities TaxExemptBondLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 6505133 | BOY |
| EOY | 6231055 | EOY |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 402688 | BOY |
| EOY | 371174 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 10353201 | BOY |
| EOY | 14929682 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 24145111 | BOY |
| EOY | 29548845 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 64646717 | BOY |
| EOY | 70415447 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1599224 | BOY |
| EOY | 1654134 | EOY |
Permanently Restricted Net Assets PermanentlyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 14587205 | BOY |
| EOY | 16761959 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 80833146 | BOY |
| EOY | 88831540 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 104978257 | BOY |
| EOY | 118380385 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expenses | 5038789 | ReconcilationRevenueExpenses |
| Reconciliation Unrealized Invest | 2367359 | ReconciliationUnrealizedInvest |
| Reconcilation Other Changes | 592246 | ReconcilationOtherChanges |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | false | AccountantCompileOrReview |
| FS Audited | true | FSAudited |
FS Audited Basis FSAuditedBasis
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Statement Both | X | FinancialStatementBoth |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | true | AuditCommittee |
| Federal Grant Audit Required | false | 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 | false | Volunteers |
| Paid Staff Or Management | false | PaidStaffOrManagement |
| Media Advertisements | false | MediaAdvertisements |
| Mailings Members | false | MailingsMembers |
| Publications Or Broadcast | false | PublicationsOrBroadcast |
| Grants Other Organizations | false | GrantsOtherOrganizations |
| Direct Contact Legislators | false | DirectContactLegislators |
| Rallies Demonstrations | false | RalliesDemonstrations |
| Other Activities | true | OtherActivities |
| Other Activities | $5,970 | OtherActivitiesAmount |
| Total Lobbying Expenditures IIB | 5970 | TotalLobbyingExpendituresIIB |
| Not Described In501c3 | false | NotDescribedIn501c3 |
Form990 Schedule C Part IV Form990ScheduleCPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Reference | SCHEDULE C, PART II-B, LINE 1 | ReturnReference |
| Explanation | PERCENTAGE OF ANNUAL MAINE HOSPITAL ASSOCIATION DUES ALLOCATED TOWARDS LOBBYING EXPENSES: 5,970. | Explanation |
Schedule D IRS990ScheduleD
Current Year CurrentYear
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 723570 | BeginningOfYearBalance |
| Contributions | 14464 | Contributions |
| Investment Earnings Or Losses | 45014 | InvestmentEarningsOrLosses |
| Administrative Expenses | 10000 | AdministrativeExpenses |
| End Of Year Balance | 773048 | EndOfYearBalance |
Current Year Minus1 Year CurrentYearMinus1Year
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 652523 | BeginningOfYearBalance |
| Contributions | 13921 | Contributions |
| Investment Earnings Or Losses | 57126 | InvestmentEarningsOrLosses |
| End Of Year Balance | 723570 | EndOfYearBalance |
Current Year Minus2 Years CurrentYearMinus2Years
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 646826 | BeginningOfYearBalance |
| Contributions | 15070 | Contributions |
| Investment Earnings Or Losses | -9373 | InvestmentEarningsOrLosses |
| End Of Year Balance | 652523 | EndOfYearBalance |
Current Year Minus3 Years CurrentYearMinus3Years
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 697111 | BeginningOfYearBalance |
| Contributions | 14173 | Contributions |
| Investment Earnings Or Losses | -64458 | InvestmentEarningsOrLosses |
| End Of Year Balance | 646826 | EndOfYearBalance |
Current Year Minus4 Years CurrentYearMinus4Years
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 606116 | BeginningOfYearBalance |
| Contributions | 106512 | Contributions |
| Investment Earnings Or Losses | -15517 | InvestmentEarningsOrLosses |
| End Of Year Balance | 697111 | EndOfYearBalance |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Permanent Endowment EOY Balance | 1.00000 | PermanentEndowmentEOYBalance |
| Endowments Held By Unrelated Orgs | true | EndowmentsHeldByUnrelatedOrgs |
| Endowments Held By Related Orgs | false | EndowmentsHeldByRelatedOrgs |
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 230009 | OtherCostOrOtherBasis |
| Book Value | 230009 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 32637322 | OtherCostOrOtherBasis |
| Depreciation | 14268684 | Depreciation |
| Book Value | 18368638 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 30840884 | OtherCostOrOtherBasis |
| Depreciation | 24191554 | Depreciation |
| Book Value | 6649330 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 1590526 | OtherCostOrOtherBasis |
| Depreciation | 964333 | Depreciation |
| Book Value | 626193 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 25874170 | TotalOfBookValueLandBuildings |
Other Assets OtherAssets (8 entries)
| DescriptionDescription | Book ValueBookValue |
|---|---|
| BENEFICIAL INTEREST-PERPETUAL TRUST | 16349408 |
| PREPAID CAPITAL COSTS | 4998836 |
| INSURANCE RECEIVABLES | 4492282 |
| BENEFICIAL INTEREST-CHARITABLE TRUST | 1072120 |
| OTHER CURRENT ASSETS | 196856 |
| INVESTMENT IN MAINEHEALTH ACO | 180000 |
| DEFERRED FINANCING FEES | 69836 |
| THIRD PARTY SETTLEMENTS |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | 27359338 | TotalBookValueOtherAssets |
Other Liabilities OtherLiabilities (3 entries)
| DescriptionDescription | AmountAmount |
|---|---|
| DUE TO THIRD PARTIES | $9,435,717 |
| INSURANCE RESERVE PAYABLE | $3,710,559 |
| DUE TO RELATED PARTIES | $1,783,406 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 14929682 | TotalOfAmounts |
| Footnote In Part XIII | X | FootnoteInPartXIII |
| Tot Revenue Etc Audited Fincl Stmt | 78087823 | TotRevenueEtcAuditedFinclStmt |
| Net Unrealized Gains Investments | 2367359 | NetUnrealizedGainsInvestments |
| Other Revenues | 592246 | OtherRevenues |
| Revenue Not Rptd F990 | 2959605 | RevenueNotRptdF990 |
| Revenue Subtotal | 75128218 | RevenueSubtotal |
| Total Revenue Per Form990 | 75128218 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 70089429 | TotExpensesEtcAuditedFinclStmt |
| Expenses Subtotal | 70089429 | ExpensesSubtotal |
| Total Expenses Per Form990 | 70089429 | TotalExpensesPerForm990 |
Form990 Schedule D Part XIII Form990ScheduleDPartXIII (3 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| INTENDED USES FOR ENDOWMENT FUNDS | SCHEDULE D, PAGE 2, PART V, LINE 4 | TWO OF THE ENDOWMENT FUNDS ARE INTENDED FOR THE EARNINGS TO BE USED IN THE GENERAL OPERATIONS OF THE HOSPITAL. OTHERS ARE INTENDED FOR THE EMERGENCY DEPARTMENT, INPATIENT HOSPICE, CANCER PATIENTS, CRIPPLED CHILDREN AND NEEDY RESIDENTS. |
| LIABILITY UNDER FIN 48 FOOTNOTE | SCHEDULE D, PAGE 3, PART X | THE ORGANIZATION IS EXEMPT FROM FEDERAL AND STATE INCOME TAXES UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. ACCORDINGLY, THERE IS NO PROVISION FOR INCOME TAXES WITHIN THE FINANCIAL STATEMENTS. THE ORGANIZATION HAS EVALUATED THE POSITIONS TAKEN ON ITS FILED TAX RETURNS AND HAS CONCLUDED THAT NO UNCERTAIN INCOME TAX POSITIONS EXIST AT SEPTEMBER 30, 2013. THE ORGANIZATION'S TAX YEARS 2011 THROUGH 2013 ARE OPEN AND SUBJECT TO EXAMINATION. |
| REVENUE AMOUNTS INCLUDED IN FINANCIALS - OTHER | SCHEDULE D, PAGE 4, PART XI, LINE 2D | CHANGE IN VALUE OF PERPETUAL AND CHARITABLE TRUSTS 2,193,090 EQUITY TRANSFER TO AFFILIATES -1,600,844 |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Charity Care Policy | true | CharityCarePolicy |
| Written Policy | true | WrittenPolicy |
| FPG Reference Free Care | true | FPGReferenceFreeCare |
Other Percentage OtherPercentage
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | X | Other |
| Free Other Percentage | 1.75000 | FreeOtherPercentage |
| Field | Value | IRS element (for citing) |
|---|---|---|
| FPG Reference Discounted Care | true | FPGReferenceDiscountedCare |
Discounted Other DiscountedOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | X | Other |
| Discounted Other Percentage | 2.25000 | DiscountedOtherPercentage |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Free Disc Care Medically Indigent | true | FreeDiscCareMedicallyIndigent |
| Amounts Budgeted For Charity Care | true | AmountsBudgetedForCharityCare |
| Expenses Exceeded Budget | true | ExpensesExceededBudget |
| Unable To Provide Care | false | UnableToProvideCare |
| Annual Community Benefit Report | true | AnnualCommunityBenefitReport |
| Report Publically Available | true | ReportPublicallyAvailable |
Charity Care At Cost CharityCareAtCost
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 2904886 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 2904886 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.04140 | PercentOfTotalExpense |
Unreimbursed Medicaid UnreimbursedMedicaid
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 13319645 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 12727879 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 591766 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00840 | PercentOfTotalExpense |
Total Charity Care TotalCharityCare
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 16224531 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 12727879 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 3496652 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.04980 | PercentOfTotalExpense |
Community Health Services CommunityHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 219061 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 50840 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 168221 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00240 | PercentOfTotalExpense |
Health Professions Education HealthProfessionsEducation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 247368 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 247368 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00350 | PercentOfTotalExpense |
Subsidized Health Services SubsidizedHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 12898990 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 8398678 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 4500312 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.06420 | PercentOfTotalExpense |
Cash And In Kind Contributions CashAndInKindContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 18837 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 685 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 18152 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00030 | PercentOfTotalExpense |
Total Other Benefits TotalOtherBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 13384256 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 8450203 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 4934053 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.07040 | PercentOfTotalExpense |
Total Community Benefits TotalCommunityBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 29608787 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 21178082 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 8430705 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.12020 | PercentOfTotalExpense |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | false | BadDebtExpenseReported |
| Bad Debt Expense | $3,065,595 | BadDebtExpenseAmount |
| Amount Reimbursed By Medicare | 23873448 | AmountReimbursedByMedicare |
| Cost Of Care Reimbursed By Medicare | 23873448 | CostOfCareReimbursedByMedicare |
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 | true | WrittenDebtCollectionPolicy |
| Provision For Charity Care | true | ProvisionForCharityCare |
| 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 | WALDO COUNTY GENERAL HOSPITAL | BusinessNameLine1 |
Address Address
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 118 NORTHPORT AVENUE | AddressLine1 |
| City | BELFAST | City |
| State | ME | State |
| ZIP Code | 04915 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Licensed Hospital | X | LicensedHospital |
| General Medical And Surgical | X | GeneralMedicalAndSurgical |
| Critical Access Hospital | X | CriticalAccessHospital |
| 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 | WALDO COUNTY GENERAL HOSPITAL | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital Facility Number | 1 | HospitalFacilityNumber |
| CHNA Conducted | true | 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 |
| Information Gaps | X | InformationGaps |
| Other | X | Other |
| Needs Assessment Conducted | 13 | NeedsAssessmentConducted |
| Take Into Account | true | TakeIntoAccount |
| Other Facilities | true | OtherFacilities |
| CHNA Widely Available | true | 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 |
| Include Operational Plans | X | IncludeOperationalPlans |
| Adopt Budget | X | AdoptBudget |
| Prioritize Health Needs | X | PrioritizeHealthNeeds |
| Prioritize Services | X | PrioritizeServices |
| All Needs Addressed | false | AllNeedsAddressed |
| Organization Incur Excise Tax | false | OrganizationIncurExciseTax |
| Eligibility Criteria Explained | true | EligibilityCriteriaExplained |
| Uses FPG Free | true | UsesFPGFree |
| FPG Free Percent | 175.0 | FPGFreePercent |
| Uses FPG Discounted | true | UsesFPGDiscounted |
| FPG Discount Percent | 225.0 | FPGDiscountPercent |
| Explains Basis | true | ExplainsBasis |
| Income Level | X | IncomeLevel |
| Explains Application Method | true | ExplainsApplicationMethod |
| Includes Publicity Measures | true | IncludesPublicityMeasures |
| Posted On Website | X | PostedOnWebsite |
| Attached To Invoices | X | AttachedToInvoices |
| Posted In Emergency Room | X | PostedInEmergencyRoom |
| Posted In Admission Office | X | PostedInAdmissionOffice |
| Provided On Admission | X | ProvidedOnAdmission |
| Available On Request | X | AvailableOnRequest |
| Actions On Nonpayment | true | ActionsOnNonpayment |
| Permit Report To Credit Agency | X | PermitReportToCreditAgency |
| Collection Activities | false | CollectionActivities |
| Notify Upon Admission | X | NotifyUponAdmission |
| Notify Before Discharge | X | NotifyBeforeDischarge |
| Notified All Patients | X | NotifiedAllPatients |
| Documented Determination | X | DocumentedDetermination |
| Nondiscrim Emergency Care Policy | true | NondiscrimEmergencyCarePolicy |
| Used Other Method | X | UsedOtherMethod |
| Amounts Generally Billed | false | AmountsGenerallyBilled |
| Gross Charges | false | GrossCharges |
Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Other Facilities | 5 | NumberOfOtherFacilities |
Other Facilities OtherFacilities (5 entries)
| Address Line1Address/AddressLine1 | CityAddress/City | StateAddress/State | ZIP CodeAddress/ZIPCode | Facility TypeFacilityType |
|---|---|---|---|---|
| ARTHUR JEWELL COMMUNITY HEALTH CTR | ||||
| 55 REYNOLDS ROAD | BROOKS | ME | 04921 | GENERAL MEDICAL |
| DONALD S WALKER HEALTH CENTER | ||||
| 43 WEST MAIN STREET | LIBERTY | ME | 04949 | GENERAL MEDICAL |
| LINCOLNVILLE HEALTH CENTER | ||||
| 2399 ATLANTIC HIGHWAY | LINCOLNVILLE | ME | 04849 | GENERAL MEDICAL |
| SEARSPORT HEALTH CENTER | ||||
| 37 MORTLAND ROAD | SEARSPORT | ME | 04974 | GENERAL MEDICAL |
| STOCKTON SPRING REG HEALTH CENTER | ||||
| 11 CAPE JELLISON ROAD | STOCKTON SPRINGS | ME | 04981 | GENERAL MEDICAL |
Form990 Schedule H Part VI Form990ScheduleHPartVI (16 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| SUBSIDIZED HEALTH SERVICES EXPLANATION | PART I LINE 7G | PHYSICIAN CLINIC COSTS WERE INCLUDED AS SUBSIDIZED HEALTH SERVICES IN THE AMOUNT OF 12899000 |
| COSTING METHODOLOGY EXPLANATION | PART I LINE 7 | THE AMOUNTS REPORTED IN THE TABLE WERE CALCULATED USING THE WORKSHEETS PROVIDED IN THE SCHEDULE H INSTRUCTIONS THE COSTTOCHARGE RATIO WAS USED AS THE COSTING METHODOLOGY AND WAS ALSO CALCULATED USING WORKSHEET 2 OF THE SCHEDULE H INSTRUCTIONS |
| BAD DEBT EXPENSE EXPLANATION | PART III LINE 4 | THE ORGANIZATION USES A COSTTOCHARGE RATIO METHODOLOGY THE AMOUNT REPORTED ON PART III LINE 2 WAS DETERMINED USING THE COSTTOCHARGE RATIO METHODOLOGY DISCOUNTS PROVIDED TO PATIENTS ARE NOT INCLUDED IN BAD DEBT EXPENSE AN AMOUNT THAT COULD BE ATTRIBUTABLE TO PATIENTS WHO LIKELY WOULD QUALIFY FOR FINANCIAL ASSISTANCE UNDER THE HOSPITALS CHARITY CARE POLICY IF SUFFICIENT INFORMATION HAD BEEN AVAILABLE TO MAKE A DETERMINATION OF THEIR ELIGIBILITY COULD NOT BE REASONABLE DETERMINED PART III LINE 4 BAD DEBT FOOTNOTE IN THE ORGANIZATIONS FINANCIAL STATEMENTS CHARGES FOR SERVICES RENDERED TO INDIVIDUALS FROM WHOM PAYMENT IS EXPECTED AND ULTIMATELY NOT RECEIVED ARE WRITTEN OFF AND INCLUDED IN EXPENSES AS PART OF THE PROVISION FOR BAD DEBTS BAD DEBT EXPENSE REPRESENTS HEALTHCARE SERVICES WALDO COUNTY GENERAL HOSPITAL HAS PROVIDED WITHOUT COMPENSATION AS A TAXEXEMPT HOSPITAL WALDO COUNTY GENERAL 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 WALDO COUNTY GENERAL 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 HOSPITALS 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 WHO EITHER FAIL TO APPLY FOR FINANCIAL ASSISTANCE OR WHO ARE EXPERIENCING DIFFICULT PERSONAL OR ECONOMIC CIRCUMSTANCES WALDO COUNTY GENERAL HOSPITAL BELIEVES THAT BAD DEBT EXPENSE SHOULD BE INCLUDED AS A COMMUNITY BENEFIT |
| MEDICARE EXPLANATION | PART III LINE 8 | THE COSTING METHODOLOGY USED TO DETERMINE THE MEDICARE ALLOWABLE COSTS REPORTED IN THE HOSPITALS MEDICARE COST REPORT IS THE MEDICARE COSTTOCHARGE RATIO WHICH INCORPORATES MEDICARE ALLOWABLE COST THE HOSPITAL HAS MADE A CLEAR MISSION COMMITMENT TO SERVING ELDERLY PATIENTS |
| COLLECTION PRACTICES EXPLANATION | PART III LINE 9B | ONCE A PATIENT HAS BEEN DETERMINED TO QUALIFY FOR FREE CARE THE PATIENT IS NOT BILLED FOR SERVICES PROVIDED NOR IS THE PATIENT BILLED FOR AMOUNTS NOT PAID BY AN INSURER |
| NEEDS ASSESSMENT | PART VI | SEE ATTACHED COMMUNITY BENEFITS REPORT |
| PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE | PART VI | SEE ATTACHED COMMUNITY BENEFITS REPORT |
| COMMUNITY INFORMATION | PART VI | SEE ATTACHED COMMUNITY BENEFITS REPORT |
| HEALTH OF COMMUNITY IN RELATION TO EXEMPT PURPOSE | PART VI | SEE ATTACHED COMMUNITY BENEFITS REPORT |
| AFFILIATED HEALTH CARE INFORMATION | PART VI | SEE ATTACHED COMMUNITY BENEFITS REPORT |
| LIST OF STATES WHERE COMMUNITY BENEFIT REPORT IS FILED | PART VI | MAINE |
| ADDITIONAL INFORMATION | PART VI | PARTV SECTION B LINE 5A URL FOR COMMUNITY HEALTH NEEDS ASSESSMENT HTTPWWWMAINEHEALTHORGWORKFILESMHCOMMUNITYWALDOCHNAANDIMPLEMENTA TIONPLANFY2013FY2015PDF |
| WALDO COUNTY GENERAL HOSPITAL LINE NUMBER 1 PART V LINE 3 | PART V LINE 3 | THE ORGANIZATION CONVENED A PLANNING GROUP MADE UP OF PEOPLE REPRESENTING THE BROAD INTERESTS OF THE COMMUNITY PRIOR TO HOLDING THE FORUMS THE OBJECTIVES OF THE MEETINGS OVER A PERIOD OF SEVERAL MONTHS INCLUDED THE FOLLOWING REVIEW OF THE DATA IN COMMUNITY HEALTH NEEDS ASSESSMENT REPORT DISCUSSION OF PRIORITY AREAS AMONG THE ORGANIZATIONS REPRESENTED IN THE PLANNING GROUP DEFINE AN APPROACH TO THE COMMUNITY FORUM TO MAXIMIZE PARTICIPATING BY A CROSS SECTION OF THE COMMUNITY DEVELOP THE FORUM AGENDA RELATIONSHIP AND NETWORK BUILDING FOR FUTURE COLLABORATION IF NOT ALREADY IN EXISTENCE SUCCESSFUL EXECUTION OF THE FORUMS FORUM DEBRIEF AND DISCUSSION OF THE NEXT STEPS SEE COMMUNITY NEEDS ASSESSMENT IMPLEMENTATION PLAN HTTPWWWMAINEHEALTHORGWORKFILESMHCOMMUNITYWALDOCHNAANDIMPLEMENTA TIONPLANFY2013FY2015PDF |
| WALDO COUNTY GENERAL HOSPITAL LINE NUMBER 1 PART V LINE 4 | PART V LINE 4 | THE CHNA WAS FACILITATED BY ONEMAINE HEALTH A COLLABORATION BETWEEN EASTERN MAINE HEALTHCARE SYSTEMS MAINEGENERAL HEALTH AND MAINEHEALTH THE THREE HEALTH SYSTEMS WORKED WITH MAINE HOSPITALS AND HEALTHY MAINE PARTNERSHIPS TO HOST LOCAL FORUMS TO SHARE THE INFORMATION BEGIN DISCUSSIONS AND DEVELOP HEALTHY ACTION PLANS BASED ON THE REPORTS FINDINGS |
| WALDO COUNTY GENERAL HOSPITAL LINE NUMBER 1 PART V LINE 7 | PART V LINE 7 | REPRODUCTIVE HEALTH NEEDS WERE NOT ADDRESSED DUE TO LACK OF CONCENSUS FROM COMMUNITY PARTNERS REGARDING THE IMPORTANCE OF THE ISSUE ANDOR A LACK OF RESOURCES TO ADDRESS THE ISSUE |
| WALDO COUNTY GENERAL HOSPITAL LINE NUMBER 1 PART V LINE 20D | PART V LINE 20D | ALL PATIENTS REGARDLESS OF PAYOR CLASS ARE BILLED THE SAME |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Records Maintained | true | RecordsMaintained |
Recipient Table RecipientTable
Recipient Name Business RecipientNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HOSPICE VOLUNTEERS OF WALDO COUNTY | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 772 | AddressLine1 |
| City | BELFAST | City |
| State | ME | State |
| ZIP Code | 04915 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN Of Recipient | 222668307 | EINOfRecipient |
| IRC Section | 501C3 | IRCSection |
| Amount Of Cash Grant | 20000 | AmountOfCashGrant |
| Purpose Of Grant | SUPPORT HOSPICE | PurposeOfGrant |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Nbr Of501 C3 And Govt Grants | 1 | TotalNbrOf501C3AndGovtGrants |
Form990 Schedule I Part III Form990ScheduleIPartIII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Type Of Grant | SCHOLARSHIPS TO STUDENTS | TypeOfGrant |
| Number Of Recipients | 18 | NumberOfRecipients |
| Amount Of Cash Grant | 16637 | AmountOfCashGrant |
Form990 Schedule I Part IV Form990ScheduleIPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | ADDITIONAL INFORMATION | Identifier |
| Return Reference | SCHEDULE I, PAGE 4, PART IV | ReturnReference |
| Explanation | SCHOLARSHIPS ARE AWARDED TO STUDENTS RESIDING IN WALDO COUNTY AND PURSUING A CAREER IN A HEALTHCARE RELATED PROGRAM. THERE IS A SCHOLARSHIP APPLICATION PROCESS OVERSEEN BY THE SCHOLARSHIP COMMITTEE. RECIPIENTS MUST HAVE COMPLETED ONE SEMESTER OF SCHOOLING WITH A PREDETERMINED MINIMUM GPA, BE ENROLLED IN THE SECOND SEMESTER, AND HAVE A FINANCIAL NEED. PAYMENTS ARE MADE DIRECTLY TO THE SCHOOL OR AS REIMBURSEMENT TO THE RECIPIENT WHEN APPROPRIATE DOCUMENTATION IS PROVIDED. | Explanation |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | X | CompensationCommittee |
| Independent Consultant | X | IndependentConsultant |
| Written Employment Contract | X | WrittenEmploymentContract |
| Compensation Survey | X | CompensationSurvey |
| Board Or Committee Approval | X | BoardOrCommitteeApproval |
| Severance Payment | false | SeverancePayment |
| Supplemental Nonqual Retire Plan | true | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | false | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | false | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | false | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | false | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | false | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | false | AnyNonFixedPayments |
| Initial Contract Exception | false | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (9 entries)
| TitleTitle | Comp Based On Related OrgsCompBasedOnRelatedOrgs | Bonus Related OrgsBonusRelatedOrgs | Other Compensation Related OrgsOtherCompensationRelatedOrgs | Deferred Comp Related OrgsDeferredCompRelatedOrgs | Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs | Total Compensation Related OrgsTotalCompensationRelatedOrgs | Base Compensation Filing OrgBaseCompensationFilingOrg | Other Compensation Filing OrgOtherCompensationFilingOrg | Deferred Comp Filing OrgDeferredCompFilingOrg | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg | Total Compensation Filing OrgTotalCompensationFilingOrg | Bonus Filing OrgBonusFilingOrg |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| WILLIAM CARON | ||||||||||||
| MAINEHEALTH CEO | 693849 | 165000 | 334713 | 55175 | 20636 | 1269373 | ||||||
| D KENT CLARK MD | ||||||||||||
| DIRECTOREMP | 295947 | 200 | 7500 | 20588 | 324235 | |||||||
| MARK BISCONE | ||||||||||||
| CEO | 84512 | 84512 | 252442 | 16832 | 7500 | 31490 | 340264 | 32000 | ||||
| LINDA DRINKWATER | ||||||||||||
| CFO | 170802 | 17608 | 5691 | 2757 | 196858 | |||||||
| OWEN NELSON MD | ||||||||||||
| ORTHOPEDIC MD | 420175 | 43735 | 7500 | 13458 | 484868 | |||||||
| JAMES DORSCH MD | ||||||||||||
| ANESTH MD | 334250 | 100998 | 7500 | 20266 | 463014 | |||||||
| RICHARD BOWER MD | ||||||||||||
| ORTHOPEDIC MD | 414527 | 2859 | 7500 | 12369 | 437255 | |||||||
| DAVID FERGUSON MD | ||||||||||||
| CARDIOLOGIST | 329171 | 44300 | 7500 | 11453 | 410624 | 18200 | ||||||
| TERRANCE SMITH MD | ||||||||||||
| ANESTH MD | 347137 | 27394 | 7500 | 20866 | 402897 | |||||||
Form990 Schedule J Part III Form990ScheduleJPartIII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | SEVERANCE, NONQUALIFIED, AND EQUITY-BASED PAYMENTS | Identifier |
| Return Reference | SCHEDULE J, PAGE 1, PART I, LINE 4 | ReturnReference |
| Explanation | WILLIAM CARON 0 322,266 0 | Explanation |
Schedule M IRS990ScheduleM
Works Of Art WorksOfArt
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | X | NonCashCheckbox |
| Number Of Contributions | 3 | NumberOfContributions |
Clothing And Household Goods ClothingAndHouseholdGoods
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | X | NonCashCheckbox |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Any Property That Must Be Held | false | AnyPropertyThatMustBeHeld |
| Review Process Unusual NC Gifts | false | ReviewProcessUnusualNCGifts |
| Third Parties Used | false | ThirdPartiesUsed |
Form990 Schedule M Part II Form990ScheduleMPartII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | SUPPLEMENTAL INFORMATION | Identifier |
| Return Reference | SCHEDULE M, PAGE 2, PART II | ReturnReference |
| Explanation | THE ORGANIZATION RECEIVED THREE PIECES OF ART. | Explanation |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (11 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| ORGANIZATION'S MISSION | FORM 990 - ORGANIZATION'S MISSION | WALDO COUNTY GENERAL HOSPITAL'S MISSION IS TO BE THE BEST - BETTER, EMPATHY, SERVICE AND TEAMWORK. OUR GOAL IS TO ENSURE QUALITY, ACCESSIBLE AND AFFORDABLE HEALTH CARE SERVICES AND TO IMPROVE THE HEALTH AND WELL-BEING OF OUR COMMUNITY. PLEASE SEE ATTACHED COMMUNITY BENEFITS REPORT. |
| CLASSES OF MEMBERS OR STOCKHOLDERS | FORM 990, PAGE 6, PART VI, LINE 6 | WALDO COUNTY HEALTHCARE, INC. (WCHI)- (EIN 22-2864961) IS THE SOLE MEMBER OF WALDO COUNTY GENERAL HOSPITAL. MAINEHEALTH (EIN 01-0431680), IS THE SOLE MEMBER OF WCHI. AS THE SOLE MEMBER OF WCHI, MAINEHEALTH HAS THE RIGHT TO APPROVE SIGNIFICANT DECISIONS OF THE GOVERNING BODY OF WCHI AND ITS SUBSIDIARIES. |
| ELECTION OF MEMBERS AND THEIR RIGHTS | FORM 990, PAGE 6, PART VI, LINE 7A | MAINEHEALTH (EIN 01-0431680) MAY ELECT MEMBERS OF THE BOARD OF DIRECTORS FROM A SLATE OF NOMINEES SUBMITTED BY THE CORPORATION. |
| DECISIONS SUBJECT TO APPROVAL OF MEMBERS | FORM 990, PAGE 6, PART VI, LINE 7B | DECISIONS OF THE GOVERNING BODY SUCH AS BUDGETS, BUSINESS STRATEGIES, SIGNIFICANT FINANCIAL COMMITMENTS, AMENDMENTS TO THE ARTICLES OF INCORPORATION, AND ELECTION OF THE PRESIDENT/CEO AMONG OTHER DECISIONS, ARE SUBJECT TO APPROVAL BY MAINEHEALTH (EIN 01-0431680). |
| ORGANIZATION'S PROCESS USED TO REVIEW FORM 990 | FORM 990, PAGE 6, PART VI, LINE 11B | THE FINANCE COMMITTEE PERFORMS A DETAILED REVIEW OF THE FORM 990. THE FORM 990 IS THEN PROVIDED TO THE FULL BOARD. THE CONTROLLER AND CFO PERFORM A DETAILED REVIEW OF THE FORM 990 AND ITS SCHEDULES AND ATTACHMENTS BEFORE FILING. |
| ENFORCEMENT OF CONFLICTS POLICY | FORM 990, PAGE 6, PART VI, LINE 12C | WALDO COUNTY GENERAL HOSPITAL'S CONFLICT OF INTEREST POLICY IS INCORPORATED AS PART OF THE BY-LAWS OF THIS CORPORATION. THE ORGANIZATION CONSISTENTLY REVIEWS ALL TRANSACTIONS TO ASSURE COMPLIANCE IN ACCORDANCE WITH THE BY-LAWS. |
| COMPENSATION PROCESS FOR TOP OFFICIAL | FORM 990, PAGE 6, PART VI, LINE 15A | THE PROCESS FOLLOWED FOR DETERMINING COMPENSATION OF THE EXECUTIVE DIRECTOR IS A FORMAL PROCESS PERFORMED ANNUALLY BY THE EXECUTIVE COMMITTEE OF THE BOARD OF DIRECTORS. THIS COMMITTEE USES THE SULLIVAN COTTER ANNUAL EXECUTIVE COMPENSATION ANALYSIS TO COMPARE MARKET ANALYSIS IN SETTING THE COMPENSATION FOR THE CHIEF EXECUTIVE OFFICER AS WELL AS THE OTHER KEY ADMINISTRATIVE EMPLOYEES OF THE ORGANIZATION. |
| COMPENSATION PROCESS FOR OFFICERS | FORM 990, PAGE 6, PART VI, LINE 15B | THE PROCESS FOLLOWED FOR DETERMINING COMPENSATION OF THE EXECUTIVE DIRECTOR IS A FORMAL PROCESS PERFORMED ANNUALLY BY THE EXECUTIVE COMMITTEE OF THE BOARD OF DIRECTORS. THIS COMMITTEE USES THE SULLIVAN COTTER ANNUAL EXECUTIVE COMPENSATION ANALYSIS TO COMPARE MARKET ANALYSIS IN SETTING THE COMPENSATION FOR THE CHIEF EXECUTIVE OFFICER AS WELL AS THE OTHER KEY ADMINISTRATIVE EMPLOYEES OF THE ORGANIZATION. |
| GOVERNING DOCUMENTS DISCLOSURE EXPLANATION | FORM 990, PAGE 6, PART VI, LINE 19 | DOCUMENTS THAT ARE REQUIRED TO BE OPEN FOR PUBLIC INSPECTION ARE MADE AVAILABLE UPON REQUEST. |
| OTHER FEES FOR SERVICES | FORM 990, PART IX, LINE 11G | CONRACT LABOR 4,246,870 0 0 PURCHASED SERVICES 2,304,079 1,240,758 0 PHYSICIAN RECRUITMENT 0 158,560 0 OTHER 48,760 0 0 |
| RECONCILIATION OF CHANGES - OTHER | FORM 990, PART XI, LINE 9 | CHANGE IN VALUE OF PERPETUAL AND CHARITABLE TRUSTS 2,193,090 EQUITY TRANSFER TO AFFILIATES -1,600,844 |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII (5 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivities | Legal Domicile StateLegalDomicileState | Exempt Code SectionExemptCodeSection | Public Charity StatusPublicCharityStatus | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Controlled OrgControlledOrg |
|---|---|---|---|---|---|---|---|---|---|---|
| WALDO COUNTY HEALTHCARE INC | ||||||||||
| PO BOX 287 | BELFAST | ME | 04915 | 222864961 | COMM. EDUC | ME | 501C3 | 11B | MEHLTH | false |
| COASTAL MEDICAL CARE | ||||||||||
| PO BOX 287 | BELFAST | ME | 04915 | 010487091 | MED. SERV. | ME | 501C3 | 9 | WCHI | false |
| BELFAST PUBLIC HEALTH NURSING | ||||||||||
| PO BOX 287 | BELFAST | ME | 04915 | 043359810 | PUB. HLTH. | ME | 501C3 | 9 | WCHI | false |
| WALDO COUNTY HOME HEALTHCARE SERV | ||||||||||
| PO BOX 287 | BELFAST | ME | 04915 | 222864960 | HHLTH&HOSP | ME | 501C3 | 9 | WCHI | false |
| MAINEHEALTH | ||||||||||
| 110 FREE STREET | PORTLAND | ME | 04101 | 010431680 | HEALTHCARE | ME | 501C3 | 11C | NA | false |
Form990 Schedule R Part IV Form990ScheduleRPartIV
Name Of Related Org NameOfRelatedOrg
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | WALDO COUNTY HEALTHCARE MGMT CO | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 287 | AddressLine1 |
| City | BELFAST | City |
| State | ME | State |
| ZIP Code | 04915 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 010485133 | EIN |
| Primary Activity | MGMT SVCS | PrimaryActivity |
| Legal Domicile State | ME | LegalDomicileState |
| Direct Controlling Entity NA | N/A | DirectControllingEntityNA |
| Controlled Org | false | ControlledOrg |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | false | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | false | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | false | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | false | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | false | LoansOrGuaranteesFromOtherOrg |
| Dividends Related Organization | false | DividendsRelatedOrganization |
| Sale Of Assets To Other Org | false | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | false | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | true | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | true | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | true | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | true | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | true | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | false | SharingOfFacilities |
| Sharing Of Paid Employees | true | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | true | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | true | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | true | OtherTransferToOtherOrg |
| Other Transfer From Other Org | true | OtherTransferFromOtherOrg |