NORTHERN MAINE MEDICAL CENTER: Form 990, tax year 2011
View the entire original 990 at ProPublica ↗
- Organization
- NORTHERN MAINE MEDICAL CENTER (EIN 01-0234189)
- Tax period
- 2011-10-01 to 2012-09-30
- Filed
- 2013-08-14
- IRS object ID
- 201302269349300110
- Schema version
- 2011v1.5
- 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 G
- Schedule H
- Schedule J
- Schedule L
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2013-08-14T07:14:58-05:00 | Timestamp |
| Tax Period End Date | 2012-09-30 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 010523282 | EIN |
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Berry Dunn McNeil & Parker LLC | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO Box 1100 | AddressLine1 |
| City | Portland | City |
| State | ME | State |
| ZIP Code | 041041100 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2011-10-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 010234189 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Northern Maine Medical Center | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | NORT | NameControl |
| Phone | 2078343155 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 194 East Main Street | AddressLine1 |
| City | Fort Kent | City |
| State | ME | State |
| ZIP Code | 04743 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | Peter J Sirois | Name |
| Title | CEO | Title |
| Phone | 2078343155 | Phone |
| Date Signed | 2013-08-13 | DateSigned |
| Authorize Third Party | 1 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | Barbara J McGuan CPA | Name |
| PTIN | P00219457 | PTIN |
| Phone | 2077752387 | Phone |
| Date Prepared | 2013-08-13 | DatePrepared |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2011 | TaxYear |
| Build TS | 2016-02-24 21:20:13Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | Peter J Sirois | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 194 East Main Street | AddressLine1 |
| City | Fort Kent | City |
| State | ME | State |
| ZIP Code | 04743 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 53454942 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | www.nmmc.org | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1948 | YearFormation |
| State Legal Domicile | ME | StateLegalDomicile |
| Activity Or Mission Description | Acute care & long term care hospital and mental health services facility. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 11 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 8 | NbrIndependentVotingMembers |
| Total Nbr Employees | 582 | TotalNbrEmployees |
| Total Nbr Volunteers | 19 | TotalNbrVolunteers |
| Total Gross UBI | 31093 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | -32194 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 183185 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 326474 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 45886057 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 52577591 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 16282 | InvestmentIncomePriorYear |
| Investment Income Current Year | 13679 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 141455 | OtherRevenuePriorYear |
| Other Revenue Current Year | 532772 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 46226979 | TotalRevenuePriorYear |
| Total Revenue Current Year | 53450516 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 0 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 0 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 20381884 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 20365008 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp Prior Year | 0 | TotalProfFundrsngExpPriorYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 25786540 | OtherExpensePriorYear |
| Other Expenses Current Year | 24527970 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 46168424 | TotalExpensesPriorYear |
| Total Expenses Current Year | 44892978 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 58555 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 8557538 | RevenuesLessExpensesCY |
| Total Assets BOY | 30498280 | TotalAssetsBOY |
| Total Assets EOY | 41506381 | TotalAssetsEOY |
| Total Liabilities BOY | 15543089 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 17987370 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 14955191 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 23519011 | NetAssetsOrFundBalancesEOY |
| Mission Description | The mission of Northern Maine Medical Center is to provide, coordinate, or support access to high quality, affordable health care and to positively impact our communities' quality of life by improving health status. | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 35771164 | Expense |
| Revenue | 52964853 | Revenue |
| Description | Medical care & ancillary services, nursing home & skilled services, physician services. | Description |
| Total Program Service Expense | 35771164 | TotalProgramServiceExpense |
| Described In501 C3 | 1 | DescribedIn501C3 |
| Schedule B Required | 1 | ScheduleBRequired |
| Political Activities | 0 | PoliticalActivities |
| Lobbying Activities | 1 | LobbyingActivities |
| Subject To Proxy Tax | 0 | SubjectToProxyTax |
| Donor Advised Funds | 0 | DonorAdvisedFunds |
| Conservation Easements | 0 | ConservationEasements |
| Collections Of Art | 0 | CollectionsOfArt |
| Credit Counseling | 0 | CreditCounseling |
| Term Or Permanent Endowments | 0 | TermOrPermanentEndowments |
| Report Land Bldg Equip | 1 | ReportLandBldgEquip |
| Report Invest Oth Securities | 0 | ReportInvestOthSecurities |
| Report Prog Rel Invest | 0 | ReportProgRelInvest |
| Report Other Assets | 1 | ReportOtherAssets |
| Report Other Liabilities | 1 | ReportOtherLiabilities |
| Report Fin48 Footnote | 1 | ReportFin48Footnote |
| Independent Audit Financial Stmt | 0 | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | 1 | ConsolidatedAuditFinancialStmt |
| School | 0 | School |
| Foreign Office | 0 | ForeignOffice |
| Foreign Activities | 0 | ForeignActivities |
| More Than5000 K To Organizations | 0 | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividuals |
| Professional Fundraising | 0 | ProfessionalFundraising |
| Fundraising Activities | 1 | FundraisingActivities |
| Gaming | 0 | Gaming |
| Hospital | 1 | Hospital |
| Financial Stmt Attached | 1 | FinancialStmtAttached |
| Grants To Organizations | 0 | GrantsToOrganizations |
| Grants To Individuals | 0 | GrantsToIndividuals |
| Schedule J Required | 1 | ScheduleJRequired |
| Tax Exempt Bonds | 0 | TaxExemptBonds |
| Excess Benefit Transaction | 0 | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | 0 | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | 0 | LoanToOfficerOrDQP |
| Grant To Related Person | 0 | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | 0 | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | 1 | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | 1 | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | 0 | DeductibleNonCashContributions |
| Deductible Contributions Of Art | 0 | DeductibleContributionsOfArt |
| Terminated | 0 | Terminated |
| Partial Liquidation | 0 | PartialLiquidation |
| Disregarded Entity | 0 | DisregardedEntity |
| Related Entity | 1 | RelatedEntity |
| Related Org Controlled Entity | 1 | RelatedOrgControlledEntity |
| Transaction Related Entity | 0 | TransactionRelatedEntity |
| Transfers To Exempt Non Chrtbl Org | 0 | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | 0 | ActivitiesConductedPartnership |
| Schedule O Required | 1 | ScheduleORequired |
| Number Forms Transmitted With1096 | 74 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | 1 | ComplianceWithBackupWitholding |
| Number Of Employees | 582 | NumberOfEmployees |
| Employment Tax Returns Filed | 1 | EmploymentTaxReturnsFiled |
| Unrelated Business Income | 1 | UnrelatedBusinessIncome |
| Form990-T Filed | 1 | Form990-TFiled |
| Foreign Financial Account | 0 | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTrans |
| Taxable Party Notification | 0 | TaxablePartyNotification |
| Non Deductible Contributions | 0 | NonDeductibleContributions |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributions |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | 0 | FundsToPayPremiums |
| Premiums Paid | 0 | PremiumsPaid |
| Indoor Tanning Services | 0 | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 11 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 8 | NumberIndependentVotingMembers |
| Family Or Business Relationship | 1 | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | 0 | DelegationOfManagementDuties |
| Changes To Organizing Docs | 0 | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuse |
| Members Or Stockholders | 0 | MembersOrStockholders |
| Election Of Board Members | 0 | ElectionOfBoardMembers |
| Decisions Subject To Approval | 0 | DecisionsSubjectToApproval |
| Minutes Of Governing Body | 1 | MinutesOfGoverningBody |
| Minutes Of Committees | 1 | MinutesOfCommittees |
| Officer Mailing Address | 0 | OfficerMailingAddress |
| Local Chapters | 0 | LocalChapters |
| Form990 Provided To Governing Body | 1 | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | 1 | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | 1 | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | 1 | RegularMonitoringEnforcement |
| Whistleblower Policy | 1 | WhistleblowerPolicy |
| Document Retention Policy | 1 | DocumentRetentionPolicy |
| Compensation Process CEO | 1 | CompensationProcessCEO |
| Compensation Process Other | 1 | CompensationProcessOther |
| Investment In Joint Venture | 0 | InvestmentInJointVenture |
| States Where Copy Of Return Is Filed | ME | StatesWhereCopyOfReturnIsFiled |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | Cindy Daigle | NamePerson |
| Telephone Number | 2078343155 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 194 East Main Street | AddressLine1 |
| City | Fort Kent | City |
| State | ME | State |
| ZIP Code | 04743 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | X | InfoInScheduleOPartVII |
Form990 Part VII Section A Form990PartVIISectionA (19 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | OfficerOfficer | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | Highest Compensated EmployeeHighestCompensatedEmployee | FormerFormer |
|---|---|---|---|---|---|---|---|---|
| Dan Vaillancourt | ||||||||
| President | 1.00 | X | X | 0 | 0 | 0 | ||
| Ronald Daigle | ||||||||
| Vice-President | 1.00 | X | X | 0 | 0 | 0 | ||
| Clifford Ouellette | ||||||||
| Treasurer | 1.00 | X | X | 0 | 0 | 0 | ||
| Frances LaBrie | ||||||||
| Secretary | 1.00 | X | X | 0 | 0 | 0 | ||
| Glenn Lamarr | ||||||||
| Director | 1.00 | X | 0 | 0 | 0 | |||
| Guy Raymond MD | ||||||||
| Director | 50.00 | X | 409042 | 0 | 25824 | |||
| John Ezzy | ||||||||
| Director | 1.00 | X | 0 | 0 | 0 | |||
| Norman Fournier | ||||||||
| Director | 1.00 | X | 0 | 0 | 0 | |||
| James Thibodeau | ||||||||
| Director | 1.00 | X | 0 | 0 | 0 | |||
| Mark Morneault | ||||||||
| Director | 1.00 | X | 0 | 0 | 0 | |||
| Robert Bellefleur | ||||||||
| Director | 1.00 | X | 3015 | 0 | 0 | |||
| Peter J Sirois | ||||||||
| CEO | 50.00 | X | 198204 | 0 | 25020 | |||
| Cindy L Daigle | ||||||||
| CFO | 50.00 | X | 23574 | 0 | 1917 | |||
| Michael Sullivan MD | ||||||||
| ER Physician | 50.00 | 460694 | 0 | 22185 | X | |||
| David Jones MD | ||||||||
| ER Physician | 50.00 | 333425 | 0 | 9224 | X | |||
| Scott Richards | ||||||||
| Pharmacist | 45.00 | 130818 | 0 | 23506 | X | |||
| Joanne Fortin | ||||||||
| Director of Service Excellence & Communications | 45.00 | 122265 | 0 | 10417 | X | |||
| John Nahas | ||||||||
| Pharmacist | 50.00 | 120005 | 0 | 8839 | X | |||
| Martin Bernstein | ||||||||
| Former CEO | 50.00 | 151225 | 0 | 5652 | X | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 1952267 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 0 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 132584 | TotalOtherCompensation |
| Number Individuals GT100 K | 9 | NumberIndividualsGT100K |
| Formers Listed | 1 | FormersListed |
| Total Comp GT150 K | 1 | TotalCompGT150K |
| Compensation From Other Sources | 0 | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (5 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| QIR | |||||
| 105 Continental Place | Brentwood | TN | 370271018 | Management & Consulting Services | 528094 |
| Quest Diagnostics | |||||
| 12436 Collections Center Drive | Chicago | IL | 606932436 | Off-Site Laboratory Services | 350942 |
| Cary Medical Center | |||||
| 163 Van Buren Road Suite 1 | Caribou | ME | 04736 | Off-Site Laboratory Services | 298485 |
| Baker Newman & Noyes | |||||
| 280 Fore Street | Portland | ME | 04101 | Consulting and Auditing | 277244 |
| Erik St Pierre MD | |||||
| PO Box 32 | Fort Kent | ME | 04743 | ER Physician Coverage | 267068 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 9 | NumberOfContractorsGT100K |
| Government Grants | 214755 | GovernmentGrants |
| All Other Contributions | 111719 | AllOtherContributions |
| Total Contributions | 326474 | TotalContributions |
Program Service Revenue ProgramServiceRevenue (5 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome | Unrelated Business RevenueUnrelatedBusinessRevenue | ExclusionExclusionAmount |
|---|---|---|---|---|---|
| Patient Service Revenu | 623000 | 72463495 | 72463495 | ||
| MaineCare Rural Health | 623000 | 5000000 | 5000000 | ||
| Meaningful Use Revenue | 623000 | 1503185 | 1503185 | ||
| Miscellaneous Revenue | 623000 | 752343 | 603104 | 31093 | $118,146 |
| Contractual/Char. Adj. | 623000 | -27141432 | -27141432 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 52577591 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 13679 | TotalRevenueColumn |
| Exclusion | $13,679 | ExclusionAmount |
Gross Rents GrossRents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 94029 | Real |
Less Rental Expenses LessRentalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 0 | Real |
Rental Income Or Loss RentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 94029 | Real |
Net Rental Income Or Loss NetRentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 94029 | TotalRevenueColumn |
| Exclusion | $94,029 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Income Fundraising Events | 34530 | GrossIncomeFundraisingEvents |
| Fundraising Direct Expenses | 4426 | FundraisingDirectExpenses |
Net Income From Fundraising Events NetIncomeFromFundraisingEvents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 30104 | TotalRevenueColumn |
| Exclusion | $30,104 | ExclusionAmount |
Other Revenue Misc OtherRevenueMisc (2 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome | ExclusionExclusionAmount |
|---|---|---|---|---|
| Insurance Captive | 900099 | 536501 | 536501 | |
| Impairment Loss | 900099 | -127862 | -$127,862 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 408639 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 53450516 | TotalRevenueColumn |
| Related Or Exempt Function Income | 52964853 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 31093 | UnrelatedBusinessRevenue |
| Exclusion | $128,096 | ExclusionAmount |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 686596 | Total |
| Program Services | 434866 | ProgramServices |
| Management And General | 251730 | ManagementAndGeneral |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 15860129 | Total |
| Program Services | 11796491 | ProgramServices |
| Management And General | 4063638 | ManagementAndGeneral |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 130008 | Total |
| Program Services | 96449 | ProgramServices |
| Management And General | 33559 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2453612 | Total |
| Program Services | 1828649 | ProgramServices |
| Management And General | 624963 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1234663 | Total |
| Program Services | 913651 | ProgramServices |
| Management And General | 321012 | ManagementAndGeneral |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 121460 | Total |
| Program Services | 89880 | ProgramServices |
| Management And General | 31580 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 95893 | Total |
| Program Services | 70961 | ProgramServices |
| Management And General | 24932 | ManagementAndGeneral |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 627248 | Total |
| Program Services | 464164 | ProgramServices |
| Management And General | 163084 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 29940 | Total |
| Program Services | 22156 | ProgramServices |
| Management And General | 7784 | ManagementAndGeneral |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 8564605 | Total |
| Program Services | 6341082 | ProgramServices |
| Management And General | 2223523 | ManagementAndGeneral |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1530136 | Total |
| Program Services | 1132301 | ProgramServices |
| Management And General | 397835 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 70868 | Total |
| Program Services | 52442 | ProgramServices |
| Management And General | 18426 | ManagementAndGeneral |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 424862 | Total |
| Program Services | 314398 | ProgramServices |
| Management And General | 110464 | ManagementAndGeneral |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2181452 | Total |
| Program Services | 1614274 | ProgramServices |
| Management And General | 567178 | ManagementAndGeneral |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1085024 | Total |
| Program Services | 802918 | ProgramServices |
| Management And General | 282106 | ManagementAndGeneral |
Other Expenses OtherExpenses (3 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices |
|---|---|---|
| Valley Medical Associat | 7609181 | 7609181 |
| Health Care Provider Ta | 1118556 | 1118556 |
| Provision for Bad Debts | 1068745 | 1068745 |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 44892978 | Total |
| Program Services | 35771164 | ProgramServices |
| Management And General | 9121814 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1452018 | BOY |
| EOY | 1429127 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2046079 | BOY |
| EOY | 5155387 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 5574399 | BOY |
| EOY | 5956715 | EOY |
Other Notes Loans Receivable Net OtherNotesLoansReceivableNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 25291 | BOY |
| EOY | 67585 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 701365 | BOY |
| EOY | 785292 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 484039 | BOY |
| EOY | 264800 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 40392863 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 23711081 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 15729827 | BOY |
| EOY | 16681782 | EOY |
Investments Pub Traded Securities InvestmentsPubTradedSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 32952 | BOY |
| EOY | 73287 | EOY |
Intangible Assets IntangibleAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 28190 | BOY |
| EOY | 226141 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 4424120 | BOY |
| EOY | 10866265 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 30498280 | BOY |
| EOY | 41506381 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 4402224 | BOY |
| EOY | 5326367 | EOY |
Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 7892499 | BOY |
| EOY | 8525281 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3248366 | BOY |
| EOY | 4135722 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 15543089 | BOY |
| EOY | 17987370 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 14570814 | BOY |
| EOY | 23131004 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 384377 | BOY |
| EOY | 388007 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 14955191 | BOY |
| EOY | 23519011 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 30498280 | BOY |
| EOY | 41506381 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | 8557538 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | 6282 | ReconcilationOtherChanges |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | 0 | AccountantCompileOrReview |
| FS Audited | 1 | FSAudited |
| Audit Committee | 1 | AuditCommittee |
| Financial Statement Consolidated | X | FinancialStatementConsolidated |
| Federal Grant Audit Required | 1 | FederalGrantAuditRequired |
| Federal Grant Audit Performed | 1 | FederalGrantAuditPerformed |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital170b1 Aiii | X | Hospital170b1Aiii |
Schedule B IRS990ScheduleB
Contributor Info ContributorInfo
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor Number | RESTRICTED | ContributorNumber |
Contributor Name Business ContributorNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor Address US ContributorAddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Aggregate Contributions | RESTRICTED | AggregateContributions |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | 0 | Volunteers |
| Paid Staff Or Management | 0 | PaidStaffOrManagement |
| Media Advertisements | 0 | MediaAdvertisements |
| Mailings Members | 0 | MailingsMembers |
| Publications Or Broadcast | 0 | PublicationsOrBroadcast |
| Grants Other Organizations | 0 | GrantsOtherOrganizations |
| Direct Contact Legislators | 0 | DirectContactLegislators |
| Rallies Demonstrations | 0 | RalliesDemonstrations |
| Other Activities | 1 | OtherActivities |
| Other Activities | $7,920 | OtherActivitiesAmount |
| Total Lobbying Expenditures IIB | 7920 | TotalLobbyingExpendituresIIB |
| Not Described In501c3 | 0 | NotDescribedIn501c3 |
Form990 Schedule C Part IV Form990ScheduleCPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | Explanation of Lobbying Activities: | Identifier |
| Return Reference | Part II-B, Line 1: | ReturnReference |
| Explanation | The Hospital pays dues to various organizations, a portion of which is attributable to lobbying expenses. | Explanation |
Schedule D IRS990ScheduleD
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 196477 | OtherCostOrOtherBasis |
| Book Value | 196477 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 18827319 | OtherCostOrOtherBasis |
| Depreciation | 8245467 | Depreciation |
| Book Value | 10581852 | BookValue |
Leasehold Improvements LeaseholdImprovements
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 1769734 | OtherCostOrOtherBasis |
| Depreciation | 1115449 | Depreciation |
| Book Value | 654285 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 16363618 | OtherCostOrOtherBasis |
| Depreciation | 14350165 | Depreciation |
| Book Value | 2013453 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 3235715 | OtherCostOrOtherBasis |
| Book Value | 3235715 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 16681782 | TotalOfBookValueLandBuildings |
Other Assets OtherAssets (5 entries)
| DescriptionDescription | Book ValueBookValue |
|---|---|
| Deferred Compensation | 617833 |
| Cash Surrender Value of Life Insurance | 190196 |
| Interest in Synernet Reinsurance | 1339911 |
| Meaningful Use Receivables | 1160430 |
| Estimated Third-Party Payor Settlements | 7557895 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | 10866265 | TotalBookValueOtherAssets |
Other Liabilities OtherLiabilities (3 entries)
| DescriptionDescription | AmountAmount |
|---|---|
| Deferred Compensation | $617,833 |
| Estimated Third-Party Payor Settlements | $2,873,702 |
| Due to Affiliate | $644,187 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 4135722 | TotalOfAmounts |
Form990 Schedule D Part XIV Form990ScheduleDPartXIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Explanation | Part X, Line 2: The Medical Center and VMA are not-for-profit corporations as described in Section 501(c)(3) of the Internal Revenue Code (the Code), and are exempt from federal income taxes on related income pursuant to Section 501(a) of the Code. Management evaluated the Medical Center's tax positions and concluded the Medical Center has maintained its tax-exempt status, does not have any significant unrelated business income and has taken no uncertain tax positions that require adjustment or disclosure in the consolidated financial statements. | Explanation |
Schedule G IRS990ScheduleG
Events Information EventsInformation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Event1 | 2012 Cancer Fund Tour | NameOfEvent1 |
| Gross Receipts Event1 | 16775 | GrossReceiptsEvent1 |
| Gross Revenue Event1 | 16775 | GrossRevenueEvent1 |
| Non Cash Prizes Event1 | 3322 | NonCashPrizesEvent1 |
| Rent Facility Costs Event1 | 270 | RentFacilityCostsEvent1 |
| Food And Beverage Event1 | 255 | FoodAndBeverageEvent1 |
| Other Direct Expenses Event1 | 119 | OtherDirectExpensesEvent1 |
| Name Of Event2 | 2012 Tribute to Courage Walk | NameOfEvent2 |
| Gross Receipts Event2 | 17755 | GrossReceiptsEvent2 |
| Gross Revenue Event2 | 17755 | GrossRevenueEvent2 |
| Other Direct Expenses Event2 | 460 | OtherDirectExpensesEvent2 |
| Gross Receipts Total | 34530 | GrossReceiptsTotal |
| Gross Revenue Total Events | 34530 | GrossRevenueTotalEvents |
| Non Cash Prizes Total Events | 3322 | NonCashPrizesTotalEvents |
| Rent Facility Costs Total Events | 270 | RentFacilityCostsTotalEvents |
| Food And Beverage Total Events | 255 | FoodAndBeverageTotalEvents |
| Other Direct Expenses Total Events | 579 | OtherDirectExpensesTotalEvents |
| Direct Expense Summary Events | 4426 | DirectExpenseSummaryEvents |
| Net Income Summary | 30104 | NetIncomeSummary |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Charity Care Policy | 1 | CharityCarePolicy |
| Written Policy | 1 | WrittenPolicy |
| Policy Applied To All Hospitals | X | PolicyAppliedToAllHospitals |
| FPG Reference Free Care | 1 | FPGReferenceFreeCare |
| Pcent200 | X | Pcent200 |
| FPG Reference Discounted Care | 1 | FPGReferenceDiscountedCare |
| Pcent200 D | X | Pcent200D |
| Free Disc Care Medically Indigent | 0 | FreeDiscCareMedicallyIndigent |
| Amounts Budgeted For Charity Care | 1 | AmountsBudgetedForCharityCare |
| Expenses Exceeded Budget | 0 | ExpensesExceededBudget |
| Annual Community Benefit Report | 0 | AnnualCommunityBenefitReport |
Charity Care At Cost CharityCareAtCost
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 432025 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 432025 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00990 | PercentOfTotalExpense |
Unreimbursed Medicaid UnreimbursedMedicaid
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 4039492 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 1881812 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 2157680 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.04920 | PercentOfTotalExpense |
Total Charity Care TotalCharityCare
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 4471517 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 1881812 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 2589705 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.05910 | PercentOfTotalExpense |
Community Health Services CommunityHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 30801 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 10026 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 20775 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00050 | PercentOfTotalExpense |
Subsidized Health Services SubsidizedHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 22102257 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 17513685 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 4588572 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.10470 | PercentOfTotalExpense |
Total Other Benefits TotalOtherBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 22133058 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 17523711 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 4609347 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.10520 | PercentOfTotalExpense |
Total Community Benefits TotalCommunityBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 26604575 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 19405523 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 7199052 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.16430 | PercentOfTotalExpense |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | 0 | BadDebtExpenseReported |
| Bad Debt Expense | $625,053 | BadDebtExpenseAmount |
| Amount Reimbursed By Medicare | 18386419 | AmountReimbursedByMedicare |
| Cost Of Care Reimbursed By Medicare | 17057157 | CostOfCareReimbursedByMedicare |
| Medicare Surplus Or Shortfall | 1329262 | MedicareSurplusOrShortfall |
Costing Methodology Used CostingMethodologyUsed
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | X | Other |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | 1 | WrittenDebtCollectionPolicy |
| Provision For Charity Care | 0 | ProvisionForCharityCare |
| Number Of Hospital Facilities | 2 | NumberOfHospitalFacilities |
Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA (2 entries)
| Facility NumberFacilityNumber | Address Line1Address/AddressLine1 | CityAddress/City | StateAddress/State | ZIP CodeAddress/ZIPCode | Licensed HospitalLicensedHospital | General Medical And SurgicalGeneralMedicalAndSurgical | Er24 HoursEr24Hours | Er OtherErOther | OtherOther |
|---|---|---|---|---|---|---|---|---|---|
| Northern Maine Medical Center | |||||||||
| 1 | 194 East Maine Street | Fort Kent | ME | 04743 | X | X | X | ||
| Forest Hill | |||||||||
| 2 | 20 Bolduc Avenue | Fort Kent | ME | 04743 | X | Licensed Hospital Related Facility | |||
Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Northern Maine Medical Center | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital Facility Number | 1 | HospitalFacilityNumber |
| CHNA Conducted | 1 | CHNAConducted |
| Community Definition | X | CommunityDefinition |
| Community Demographics | X | CommunityDemographics |
| Existing Resources | X | ExistingResources |
| How Data Obtained | X | HowDataObtained |
| Community Health Needs | X | CommunityHealthNeeds |
| Other Health Issues | X | OtherHealthIssues |
| Identifying Process | X | IdentifyingProcess |
| Consulting Process | X | ConsultingProcess |
| Other | X | Other |
| Needs Assessment Conducted | 11 | NeedsAssessmentConducted |
| Take Into Account | 1 | TakeIntoAccount |
| Other Facilities | 1 | OtherFacilities |
| CHNA Widely Available | 1 | CHNAWidelyAvailable |
| On Request | X | OnRequest |
| Other Method | X | OtherMethod |
| Adopt Implement Strategy | X | AdoptImplementStrategy |
| Prioritize Health Needs | X | PrioritizeHealthNeeds |
| Prioritize Services | X | PrioritizeServices |
| Other Needs Addressed | X | OtherNeedsAddressed |
| All Needs Addressed | 0 | AllNeedsAddressed |
| Eligibility Criteria Explained | 1 | EligibilityCriteriaExplained |
| Uses FPG Free | 1 | UsesFPGFree |
| FPG Free Percent | 200.000000000000 | FPGFreePercent |
| Uses FPG Discounted | 1 | UsesFPGDiscounted |
| FPG Discount Percent | 200.000000000000 | FPGDiscountPercent |
| Explains Basis | 1 | ExplainsBasis |
| Income Level | X | IncomeLevel |
| Explains Application Method | 1 | ExplainsApplicationMethod |
| Includes Publicity Measures | 1 | IncludesPublicityMeasures |
| Posted In Emergency Room | X | PostedInEmergencyRoom |
| Posted In Admission Office | X | PostedInAdmissionOffice |
| Available On Request | X | AvailableOnRequest |
| Actions On Nonpayment | 1 | ActionsOnNonpayment |
| Permit Lawsuit | X | PermitLawsuit |
| Permit Lien On Residence | X | PermitLienOnResidence |
| Collection Activities | 1 | CollectionActivities |
| Lawsuit | X | Lawsuit |
| Lien On Residence | X | LienOnResidence |
| Notify Upon Admission | X | NotifyUponAdmission |
| Notify Before Discharge | X | NotifyBeforeDischarge |
| Notified All Patients | X | NotifiedAllPatients |
| Documented Determination | X | DocumentedDetermination |
| Nondiscrim Emergency Care Policy | 1 | NondiscrimEmergencyCarePolicy |
| Used Other Method | X | UsedOtherMethod |
| Amounts Generally Billed | 0 | AmountsGenerallyBilled |
| Gross Charges | 0 | GrossCharges |
Form990 Schedule H Part VI Form990ScheduleHPartVI (18 entries)
| Return ReferenceReturnReference | ExplanationExplanation | IdentifierIdentifier |
|---|---|---|
| Form 990, Part I, Line 3c: | Northern Maine Medical Center uses the Federal Poverty Guidelines to determine eligibility. | |
| Part I, Line 7: The amounts reported on Lines 7a & 7b were computed using a cost-to-charge ratio. Amounts on 7e & 7g are derived from internal financial/cost accounting systems. Subsidized health services on line 7g include physician clinics, rural health centers, a skilled nursing facility, and emergency room. | ||
| Part I, Line 7, Column (f): The Bad Debt expense included on Form 990, Part IX, Line 25, Column (A), but subtracted for purposes of calculating the percentage in this column is $ 1068745. | ||
| Part II: N/A | ||
| Part III, Line 4: The allowance for doubtful accounts is provided based on an analysis by management of the collectibility of outstanding balances. Management considers the age of outstanding balances and past collection efforts in determining the allowance for doubtful accounts. Accounts deemed uncollectible are charged off against the established allowance. | ||
| Form 990, Part III, Line 9b: | When a patient is referred out to collections but then applies for free or discounted care, the account is pulled back from collections when it is determined that they qualify for one of the programs. If the collection agency suspects that someone may need to apply for one of the programs, it refers the patient back to us. If a patient contacts us after being sent to collections, and qualifies for financial assistance, we then notify the agency to stop the collection process. We make every effort to screen as many people as possible before we send them to collections. | |
| Part V, Section B, Line 1j: Northern Maine Medical Center (NMMC) islocated in Fort Kent, Maine (Aroostook County). Aroostook County isconsidered rural by the State of Maine and the United States CensusBureau. The hospital service area (HSA) as defined by the Maine HealthData Organization (MHDO) uses the statistical method to determine wherethe greatest proportion of residents received their inpatient care. Thefollowing towns make up the NMMC HSA as defined by the MHDO: Allagash,Eagle Lake, Fort Kent, Frenchville, Grand Isle, Madawaska, New Canada, St.Agatha, St. Francis, St. John Plt, Wallagrass, Winterville Plt., Big Twenty Twp and several surrounding unorganized territories. In 2009, thepercentage of Fort Kent residents with income below the poverty level was36.4%. The percentage of children below the poverty level was 36.7% in2009. The percentage of the population aged 65 and over was 18% inAroostook County. The unemployment rate in Aroostook County was 9.3% in2011, which was higher than the State's rate of 7.8%. Of the individuals25 years or older in Aroostook County, 23% do not have a high schooldiploma compared to 15% overall in the State.Northern Maine Medical Center utilizes an electronic medical recordsystem and its related physician practices abstract data for inclusion indisease registries, which provide a vast amount of data relative topatients in care. The needs assessment provides a much broader picture ofthe community as a whole, including the health status of individuals notin care, as well as functional health status and social demographics (suchas employment, income and education levels). The local units of theState's public health infrastructure (known as "Healthy MainePartnerships") are also integrated into the process so that their datarelative to health, environmental and social measures are part of thecommunity dissemination process.Northern Maine Medical Center engaged multiple health resource leadersin the community forum invitation list. Additional resources and leaders needed were identified in the breakout sessions. In the Fort Kent service area, key collaborators going forward will include: Northern Maine Medical Center and its owned physician practices, Cary Medical Center, The Aroostook Medical Center, Fish River Rural Health Center, local schools, Aroostook Home Health Services/Valley Home Health Services, Aroostook Mental Health Center, UMFK, and Twin Rivers.EMHS, the primary tertiary center utilized by Northern MaineMedical Center, routinely conducts a community health needs assessment(hereafter referred to simply as "needs assessment") across the servicearea of all of its member hospitals. The most recent assessment,published in 2011, was conducted under a contract with the University ofNew England Center for Health Planning, Policy and Research (CHPPR) andthe University of Southern Maine's Muskie School for Public Health. Usinga methodology developed by CHPPR over decades of work, the assessmentintegrates primary data from a telephone survey to heads of householdswith secondary data retrieved from state databases (ED usage, Mortality,Cancer Registry, etc.). That data is reviewed in the context of multiplehealth related domains to develop a composite view of health status,behavioral risks, and barriers to access and care. Results are compared tonational and state benchmarks to produce priorities and recommendations asprepared by the consultants. | Northern Maine Medical Center | |
| Part V, Section B, Line 3: On a statewide basis, the research consultants developed an advisory committee that met two times during the assessment research and drafting of the publication. These individuals represented a broad spectrum of backgrounds, and include: Carol Bell, Healthy Maine Partnership director; Kelly Bentley, Healthy Maine Partnership director; Gail Dana-Sacco, Wabanaki Center (serving tribal populations); Patricia Hart, Maine Development Foundation; Barbara Leonard, MPH, Maine Health Access Foundation (philanthropic foundation focused on access to care in Maine); Becca Matusovich, Maine Center for Disease Control; Lisa Miller, Bingham Foundation (philanthropic foundation); Dora Ann Mills, MD, Maine Center for Disease Control; Elizabeth Mitchell, Maine Health Management Coalition (representing the state's major employers, insurers and providers); Trish Riley, Governor's Office of Health Policy and Finance (GOHPF); Brian Rines, Advisory Committee for Health System Development (overseen by GOHPF); RachelTalbot-Ross, Maine Chapter, NAACP; and, Ted Trainer, Public HealthCoordinating Council Shawn Yardley, City of Bangor, Department of Healthand Welfare. | Northern Maine Medical Center | |
| Part V, Section B, Line 4: The needs assessment was developed as astatewide collaborative between the state's three largest health systems:EMHS (in central, eastern and northern Maine), MaineGeneral (in centralMaine) and MaineHealth (in southern Maine). Multiple collaborators wereinvolved in the dissemination of the assessment findings and establishmentof priorities. | Northern Maine Medical Center | |
| Part V, Section B, Line 5c: In conjunction with EMHS, Northern MaineMedical Center co-hosted a community forum with The Aroostook MedicalCenter and Cary Medical Center to present an overview of local assessmentresults and recommendations. Invitees included: other area hospitals,physician leaders, federally qualified health centers, healthy Mainepartnerships, district liaisons linked to Maine CDC, home health and longterm care leaders, social service agencies, leaders of the tribalcommunities, business leaders, legislative leaders, and representatives ofthe State administration.Attendees were provided an executive summary of the assessment as well asa summary table of data reflective of the service area. A presentation wasmade by EMHS staff who were members of the assessment development steeringcommittee providing selected data results, trends over time and thepriorities and recommendations as suggested by the research consultants.In addition to the community forums, the entire statewide assessment (bothnarrative and data sets) was posted to the EMHS website. After the forums,power point presentations used at the forum, as well as input collected inthe breakout sessions, were also posted on the website. Forum participantswere encouraged to go to the website to review the assessment in detail,and access the data for local planning. Media releases were also sent tolocal news outlets in combination with the forums, encouraging newarticles on the forum and inviting all members of the public to view thereport on the website.Instructions on the website assist viewers to download and/or printsections of the report. Individuals without computer or printer accesswere provided a phone number where they can request a printed assessment. | Northern Maine Medical Center | |
| Part V, Section B, Line 6i: Northern Maine Medical Center made progress on the following initiatives that were undertaken to meet the prioritized needs identified by the community needs assessment:-NMMC continues work towards implementing a wellness program. Once the results of a baseline health assessment of employees on the health insurance is available, NMMC will be able to use the overall results to develop a wellness program appropriate to the needs of the employees.-NMMC has obtained certification of its diabetes education program and has made strides in rebuilding its diabetes education programs and support group.-NMMC has implemented an electronic medical record in its physician practices. The software has the ability to generate reports to better monitor patients with chronic conditions and the completion/status of recommended treatment plans. The staff have recently received training on how to generate those reports and is starting to use them to improve management of these patients with chronic conditions. In addition, the hospital has entered into an Accountable Care Strategic Contractor Agreement whereby the ACO has entered into a contract with a payor to perform population health management services for covered lives some of which receive services at NMMC.-NMMC has collaborated with other local hospitals and providers to ensure the necessary specialty services are available. The following specialty services were obtained through agreements with other hospitals either on an interim basis or on-going: Anesthesia Director Services, Sleep Medicine professional and technical services, orthopedic surgeon coverage, and radiologist services. NMMC continues to look for opportunities to work with other hospitals to provide specialty services in our community.-NMMC continues to make other health care providers aware of the mental health services it offers on both an inpatient and outpatient basis. -NMMC has signed a contract with Health Info Net, Maine's Health Information Exchange to improve quality and effectiveness through better information exchange. At this time, NMMC and Health Info Net have started working on establishing integration between NMMC's information system and Health Info Net. NMMC also has entered into an agreement with the closest tertiary facility, EMMC, for certain access to their PowerChart, which can benefit the transition of care from the tertiary back to the local, primary care providers. | Northern Maine Medical Center | |
| Part V, Section B, Line 7: Northern Maine Medical Center was unable toaddress all needs identified due to limited staff and financial resources.Certain needs, such as increased insurance coverage and improved Medicaidreimbursement for dental services, have not been addressed since NMMC canonly be a portion of the solution; other entities will need to be involvedto address all of the needs. NMMC is in the process of rebuilding itspatient education component, so certain needs, such as community levelprevention programs and primary care and ED education tools, will beaddressed once the education framework is in place again. | Northern Maine Medical Center | |
| Part V, Section B, Line 19d: Individuals are billed at gross amounts andcharges are adjusted accordingly, if they qualify for assistance. | Northern Maine Medical Center | |
| Part V, Section B, Line 21: Individuals are billed at gross amounts andcharges are adjusted accordingly, if they qualify for assistance. | Northern Maine Medical Center | |
| Part VI, Line 2: Please see Schedule H, Part v, Section B, Line 1 fora description of NMMC's assessment process. | ||
| Part VI, Line 3: We notify patients and customers about access toassistance in various ways. The simplest way is the signage, pamphlets,and educational material located around the Organization and in variousoffices. In every patient access/patient financial services area is a signexplaining the availability of free/discounted care and the FederalPoverty Guidelines. There are also pamphlets located in the outpatientareas explaining free/discounted care and providing information onMainecare. For inpatients, there is a book in each room which provides allthe information on all programs available.Through the patient accounting department, we provide information aboutthese statements. We also counsel patients on the phone about all theprograms available whether it is Medicaid or a hospital program. | ||
| Part VI, Line 4: Northern Maine Medical Center is a 94 licensed bed(29 A&P beds, 6 ICU beds, 14 Psych beds, and 45 SNF beds), full-service,acute-care, not-for profit hospital located in Fort Kent, Maine (AroostookCounty). The Hospital is accredited by the joint commission and itsmission is to serve its communities with excellence in health care. Itsservices include acute inpatient, psych inpatient, SNF, 24-hour emergencycenter, diagnostic, and surgical services. Along with these hospitalservices, the Hospital employs/contracts with the majority of primary andspecialty care physicians in the area. | ||
| Form 990, Part VI, Line 5: | Northern Maine Medical Center is a local, not-for-profit hospital that serves its local communities and people regardless of their ability to pay. Northern Maine provides financial assistance and sliding scale discounts to self-pay and low-income patients. Also the Hospital participates in government-sponsored health care programs including Medicare, Medicaid, CHAMPUS, and Tricare. The volunteer board of trustees sets the strategic direction for the Hospital and is comprised of community members from the Hospital's service area. This group is made up of local business owners, professionals, and retirees. Northern Maine's non-profit status allows the Hospital to reinvest any excess of revenues over expense back into the Hospital to continuously improve the medical care it delivers. The Hospital allows access to healthcare that would otherwise be difficult. The Hospital is the main employer for the local physicians, including specialty physicians that would otherwise have to be accessed out of the area. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Employment Contract | X | WrittenEmploymentContract |
| Compensation Survey | X | CompensationSurvey |
| Board Or Committee Approval | X | BoardOrCommitteeApproval |
| Severance Payment | 0 | SeverancePayment |
| Supplemental Nonqual Retire Plan | 0 | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | 0 | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | 0 | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | 0 | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | 0 | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | 0 | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | 1 | AnyNonFixedPayments |
| Initial Contract Exception | 0 | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (6 entries)
| Base Compensation Filing OrgBaseCompensationFilingOrg | Comp Based On Related OrgsCompBasedOnRelatedOrgs | Bonus Filing OrgBonusFilingOrg | Bonus Related OrgsBonusRelatedOrgs | Other Compensation Filing OrgOtherCompensationFilingOrg | Other Compensation Related OrgsOtherCompensationRelatedOrgs | Deferred Comp Filing OrgDeferredCompFilingOrg | Deferred Comp Related OrgsDeferredCompRelatedOrgs | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg | Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs | Total Compensation Filing OrgTotalCompensationFilingOrg | Total Compensation Related OrgsTotalCompensationRelatedOrgs | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrg | Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Guy Raymond MD | |||||||||||||
| 398642 | 0 | 0 | 0 | 10400 | 0 | 3639 | 0 | 22185 | 0 | 434866 | 0 | 0 | 0 |
| Peter J Sirois | |||||||||||||
| 158204 | 0 | 40000 | 0 | 0 | 0 | 1607 | 0 | 23413 | 0 | 223224 | 0 | 0 | 0 |
| Michael Sullivan MD | |||||||||||||
| 460694 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 22185 | 0 | 482879 | 0 | 0 | 0 |
| David Jones MD | |||||||||||||
| 317559 | 0 | 0 | 0 | 15866 | 0 | 0 | 0 | 9224 | 0 | 342649 | 0 | 0 | 0 |
| Scott Richards | |||||||||||||
| 130818 | 0 | 0 | 0 | 0 | 0 | 1321 | 0 | 22185 | 0 | 154324 | 0 | 0 | 0 |
| Martin Bernstein | |||||||||||||
| 141687 | 0 | 0 | 0 | 9538 | 0 | 1125 | 0 | 4527 | 0 | 156877 | 0 | 0 | 0 |
Form990 Schedule J Part III Form990ScheduleJPartIII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Reference | Part I, Line 7 | ReturnReference |
| Explanation | CEO received bonus payments based on his performance. | Explanation |
Schedule L IRS990ScheduleL
Form990 Schedule L Part IV Form990ScheduleLPartIV (4 entries)
| RelationshipRelationship | Amount Of TransactionAmountOfTransaction | Description Of TransactionDescriptionOfTransaction | Sharing Of RevenuesSharingOfRevenues |
|---|---|---|---|
| Daigle Oil Company | |||
| Entity of which Dan Vaillancourt, Board President, is an officer | 128667 | Independent Contractor Arrangement | 0 |
| Nola Sirois | |||
| Family member of Peter Sirois, Hospital CEO | 21812 | Employment | 0 |
| Michelle L Plourde | |||
| Family member of Peter Sirois, Hospital CEO | 58230 | Employment | 0 |
| Robin Werntgen | |||
| Family member of Glenn Lamarr, Director | 54993 | Employment | 0 |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (7 entries)
| Return ReferenceReturnReference | ExplanationExplanation | IdentifierIdentifier |
|---|---|---|
| Form 990, Part VI, Section A, line 2 | Peter Sirois and Glenn Lamarr have a family relationship. | |
| Form 990, Part VI, Section B, line 11 | The Form 990 is prepared by the Organization's independent public accounting firm and thoroughly reviewed by the CFO and Controller. The completed form was sent electronically to Board members prior to the form being filed. | |
| Form 990, Part VI, Section B, line 12c | The enforcement of the conflict of interest policy is achieved through annual reporting and ongoing monitoring. | |
| Form 990, Part VI, Section B, line 15 | The Board of Directors determines the compensation of the CEO using compensation studies and comparability data. The CEO determines the compensation of other officers and key employees in a similar manner. | |
| Form 990, Part VI, Section C, line 19 | The Organization makes its governing documents, conflict of interest policy, and financial statements available to the public upon request. | |
| Form 990, Part VII, Section A: | Guy Raymond shows reportable compensation on Form 990, Part VII, Section A for services performed in his capacity as an employee of Northern Maine Medical Center. His compensation does not reflect payment for his services as a board member of the Hospital or any related organization. | |
| Form 990, Part XI, line 5: | Net unrealized gains on investments: 6,282. | Changes in Net Assets or Fund Balances: |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII
Name Of Disregarded Entity NameOfDisregardedEntity
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Valley Medical Association | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 194 East Maine Street | AddressLine1 |
| City | Fort Kent | City |
| State | ME | State |
| ZIP Code | 04743 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 223245434 | EIN |
| Primary Activities | Medical Physician Practice | PrimaryActivities |
| Legal Domicile State | ME | LegalDomicileState |
| Exempt Code Section | 501(c)(3) | ExemptCodeSection |
| Public Charity Status | Line 3 | PublicCharityStatus |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Northern Maine Medical Center | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Controlled Org | 1 | ControlledOrg |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | 0 | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | 0 | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | 0 | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | 0 | LoansOrGuaranteesFromOtherOrg |
| Sale Of Assets To Other Org | 0 | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | 0 | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | 0 | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | 0 | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | 0 | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | 0 | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | 0 | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | 0 | SharingOfFacilities |
| Sharing Of Paid Employees | 1 | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | 1 | OtherTransferToOtherOrg |
| Other Transfer From Other Org | 0 | OtherTransferFromOtherOrg |
Transactions Related Orgs Table TransactionsRelatedOrgsTable
Name Of Other Organization NameOfOtherOrganization
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Valley Medical Association | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Transaction Type | Q | TransactionType |
| Amount Involved | 7609181 | AmountInvolved |
| Method Of Amt Determination | Actual Outlay | MethodOfAmtDetermination |