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Waldo County General Hospital: Form 990, tax year 2011

View the entire original 990 at ProPublica ↗

Organization
Waldo County General Hospital (EIN 01-0177170)
Tax period
2011-10-01 to 2012-09-30
Filed
2013-08-01
IRS object ID
201312139349300866
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 ReturnHeader

FieldValueIRS element (for citing)
Timestamp2013-08-01T15:14:46-05:00Timestamp
Tax Period End Date2012-09-30TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1MAINEHEALTHBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line1110 FREE STAddressLine1
CityPORTLANDCity
StateMEState
ZIP Code041013908ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2011-10-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN010177170EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1WALDO COUNTY GENERAL HOSPITALBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlWALDNameControl
Phone2073382500Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1118 NORTHPORT AVENUEAddressLine1
CityBELFASTCity
StateMEState
ZIP Code04915ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameLINDA B DRINKWATERName
TitleCFOTitle
Phone2073382500Phone
Date Signed2013-07-19DateSigned
Authorize Third PartyfalseAuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
Date Prepared2013-08-01DatePrepared
FieldValueIRS element (for citing)
Tax Year2011TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonLINDA B DRINKWATERNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1PO BOX 287AddressLine1
CityBELFASTCity
StateMEState
ZIP Code04915ZIPCode
FieldValueIRS element (for citing)
Gross Receipts89418498GrossReceipts
Group Return For AffiliatesfalseGroupReturnForAffiliates
Organization501c3XOrganization501c3
Web SiteWWW.WCHI.COMWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1901YearFormation
State Legal DomicileMEStateLegalDomicile
Activity Or Mission DescriptionWALDO 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 Body14NbrVotingMembersGoverningBody
Nbr Independent Voting Members12NbrIndependentVotingMembers
Total Nbr Employees713TotalNbrEmployees
Total Nbr Volunteers110TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Contributions Grants Prior Year610050ContributionsGrantsPriorYear
Contributions Grants Current Year2086956ContributionsGrantsCurrentYear
Program Service Revenue Prior Year75278011ProgramServiceRevenuePriorYear
Program Service Revenue CY72276223ProgramServiceRevenueCY
Investment Income Prior Year1599128InvestmentIncomePriorYear
Investment Income Current Year1786613InvestmentIncomeCurrentYear
Other Revenue Prior Year1222604OtherRevenuePriorYear
Other Revenue Current Year1203113OtherRevenueCurrentYear
Total Revenue Prior Year78709793TotalRevenuePriorYear
Total Revenue Current Year77352905TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year282810GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY77856GrantsAndSimilarAmntsCY
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year40681802SalariesEtcPriorYear
Salaries Etc Current Year41764649SalariesEtcCurrentYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year28447825OtherExpensePriorYear
Other Expenses Current Year28845041OtherExpensesCurrentYear
Total Expenses Prior Year69412437TotalExpensesPriorYear
Total Expenses Current Year70687546TotalExpensesCurrentYear
Revenues Less Expenses Prior Year9297356RevenuesLessExpensesPriorYear
Revenues Less Expenses CY6665359RevenuesLessExpensesCY
Total Assets BOY90900586TotalAssetsBOY
Total Assets EOY104978257TotalAssetsEOY
Total Liabilities BOY22069268TotalLiabilitiesBOY
Total Liabilities EOY24145111TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY68831318NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY80833146NetAssetsOrFundBalancesEOY
Info In Schedule O Part IIIXInfoInScheduleOPartIII
Mission DescriptionWALDO 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 ServicesfalseSignificantNewProgramServices
Significant ChangefalseSignificantChange
Expense53546180Expense
Grants77856Grants
Revenue63706815Revenue
DescriptionWALDO 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 LABORATORY AND RADIOLOGY; THERAPEUTIC SERVICES INCLUDING PHYSICAL THERAPY, SPEECH, AUDIOLOGY, SLEEP,AND RESPIRATORY THERAPY; ONCOLOGY CLINICS; EMERGENCY SERVICES; INPATIENT HOSPITALIST CARE, INPATIENT HOSPICE; AND SURGICAL INPATIENT AND OUTPATIENT SERVICES. THE HOSPITAL PROVIDED 5,832 DAYS OF ADULT, NEWBORN, SWING BED, AND HOSPICE INPATIENT CARE, AND 69,705 OUTPATIENT VISITS INCLUDING 537,411 OUTPATIENT PROCEDURES AND EXAMS. SEE ATTACHED COMMUNITY BENEFITS REPORT.Description

Activity2 Activity2

FieldValueIRS element (for citing)
Expense7419527Expense
Revenue6780328Revenue
DescriptionWALDO COUNTY GENERAL HOSPITAL EMPLOYS MANY HOSPITAL-BASED PHYSICIANS AND PROVIDES THE FOLLOWING SPECTRUM OF PHYSICIAN PATIENT CARE SERVICES: FAMILY MEDICINE, GENERAL SURGERY, INTERNAL MEDICINE, ORTHOPEDICS, NEUROLOGY, OB/GYN, PODIATRY, CARDIOLOGY, OTOLARYNGOLOGY, AND PULMONOLOGY. OUR PHYSICIANS PROVIDED CARE TO PATIENTS DURING 39,025 PHYSICIAN-OFFICE PATIENT VISITS.Description

Activity3 Activity3

FieldValueIRS element (for citing)
Expense2204498Expense
Revenue1789080Revenue
DescriptionWALDO 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 19,901 HEALTH CENTER VISITS.Description
FieldValueIRS element (for citing)
Total Program Service Expense63170205TotalProgramServiceExpense
Described In501 C3trueDescribedIn501C3
Schedule B RequiredtrueScheduleBRequired
Political ActivitiesfalsePoliticalActivities
Lobbying ActivitiestrueLobbyingActivities
Subject To Proxy TaxfalseSubjectToProxyTax
Donor Advised FundsfalseDonorAdvisedFunds
Conservation EasementsfalseConservationEasements
Collections Of ArtfalseCollectionsOfArt
Credit CounselingfalseCreditCounseling
Term Or Permanent EndowmentstrueTermOrPermanentEndowments
Report Land Bldg EquiptrueReportLandBldgEquip
Report Invest Oth SecuritiesfalseReportInvestOthSecurities
Report Prog Rel InvestfalseReportProgRelInvest
Report Other AssetstrueReportOtherAssets
Report Other LiabilitiestrueReportOtherLiabilities
Report Fin48 FootnotetrueReportFin48Footnote
Independent Audit Financial StmttrueIndependentAuditFinancialStmt
Consolidated Audit Financial StmttrueConsolidatedAuditFinancialStmt
SchoolfalseSchool
Foreign OfficefalseForeignOffice
Foreign ActivitiesfalseForeignActivities
More Than5000 K To OrganizationsfalseMoreThan5000KToOrganizations
More Than5000 K To IndividualsfalseMoreThan5000KToIndividuals
Professional FundraisingfalseProfessionalFundraising
Fundraising ActivitiesfalseFundraisingActivities
GamingfalseGaming
HospitaltrueHospital
Financial Stmt AttachedtrueFinancialStmtAttached
Grants To OrganizationstrueGrantsToOrganizations
Grants To IndividualstrueGrantsToIndividuals
Schedule J RequiredtrueScheduleJRequired
Tax Exempt BondsfalseTaxExemptBonds
Excess Benefit TransactionfalseExcessBenefitTransaction
Prior Excess Benefit TransactionfalsePriorExcessBenefitTransaction
Loan To Officer Or DQPfalseLoanToOfficerOrDQP
Grant To Related PersonfalseGrantToRelatedPerson
Bsnss Rltnshp With OrganizationfalseBsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family MemberfalseBsnssRltnshpThruFamilyMember
Officer Entity With Bsnss RltnshpfalseOfficerEntityWithBsnssRltnshp
Deductible Non Cash ContributionsfalseDeductibleNonCashContributions
Deductible Contributions Of ArtfalseDeductibleContributionsOfArt
TerminatedfalseTerminated
Partial LiquidationfalsePartialLiquidation
Disregarded EntityfalseDisregardedEntity
Related EntitytrueRelatedEntity
Related Org Controlled EntityfalseRelatedOrgControlledEntity
Transaction Related EntityfalseTransactionRelatedEntity
Transfers To Exempt Non Chrtbl OrgfalseTransfersToExemptNonChrtblOrg
Activities Conducted PartnershipfalseActivitiesConductedPartnership
Schedule O RequiredtrueScheduleORequired
Number Forms Transmitted With1096133NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Number Of Employees713NumberOfEmployees
Employment Tax Returns FiledtrueEmploymentTaxReturnsFiled
Unrelated Business IncomefalseUnrelatedBusinessIncome
Foreign Financial AccountfalseForeignFinancialAccount
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTrans
Taxable Party NotificationfalseTaxablePartyNotification
Non Deductible ContributionsfalseNonDeductibleContributions
Quid Pro Quo ContributionsfalseQuidProQuoContributions
Form8282 Property Disposed OffalseForm8282PropertyDisposedOf
Funds To Pay PremiumsfalseFundsToPayPremiums
Premiums PaidfalsePremiumsPaid
Indoor Tanning ServicesfalseIndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members14NbrVotingGoverningBodyMembers
Number Independent Voting Members12NumberIndependentVotingMembers
Family Or Business RelationshipfalseFamilyOrBusinessRelationship
Delegation Of Management DutiesfalseDelegationOfManagementDuties
Changes To Organizing DocsfalseChangesToOrganizingDocs
Material Diversion Or MisusefalseMaterialDiversionOrMisuse
Members Or StockholderstrueMembersOrStockholders
Election Of Board MemberstrueElectionOfBoardMembers
Decisions Subject To ApprovaltrueDecisionsSubjectToApproval
Minutes Of Governing BodytrueMinutesOfGoverningBody
Minutes Of CommitteestrueMinutesOfCommittees
Officer Mailing AddressfalseOfficerMailingAddress
Local ChaptersfalseLocalChapters
Form990 Provided To Governing BodytrueForm990ProvidedToGoverningBody
Conflict Of Interest PolicytrueConflictOfInterestPolicy
Annual Disclosure Covered PersonstrueAnnualDisclosureCoveredPersons
Regular Monitoring EnforcementtrueRegularMonitoringEnforcement
Whistleblower PolicytrueWhistleblowerPolicy
Document Retention PolicytrueDocumentRetentionPolicy
Compensation Process CEOtrueCompensationProcessCEO
Compensation Process OthertrueCompensationProcessOther
Investment In Joint VenturefalseInvestmentInJointVenture
States Where Copy Of Return Is FiledMEStatesWhereCopyOfReturnIsFiled
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonLINDA B DRINKWATERNamePerson
Telephone Number2073382500TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1125 NORTHPORT AVENUEAddressLine1
CityBELFASTCity
StateMEState
ZIP Code04915ZIPCode
FieldValueIRS element (for citing)
Info In Schedule O Part VIIXInfoInScheduleOPartVII

Form990 Part VII Section A Form990PartVIISectionA (21 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationOfficerOfficerHighest Compensated EmployeeHighestCompensatedEmployee
D KENT CLARK MD
DIRECTOR/EMP35.00X266225027052
ANN HOOPER
DIRECTOR/EMP35.00X147739019791
JAMES C DELEHANTY MD
DIRECTOR1.00X648000
JENNESS ROBBINS
DIRECTOR1.00X000
PETER D HADDOCK
DIRECTOR1.00X000
JOHN D WORTH III
DIRECTOR1.00X000
FRANK MORONG
TREASURER1.00X000X
DALE KUHNERT
VICE PRES.1.00X000X
GREGOR DAVENS
DIRECTOR1.00X000
WAYNE HAMILTON
DIRECTOR1.00X000
LEE WOODWARD JR
PRESIDENT1.00X000X
JAMES PATTERSON PHD
SECRETARY1.00X000X
DAVID TASSONI
DIRECTOR1.00X000
CATHERINE REYNOLDS
DIRECTOR1.00X000
MARK BISCONE
CEO30.003598838065434777X
LINDA DRINKWATER
CFO35.0019948008308X
OWEN NELSON MD
ORTHOPEDIC M32.00487194020205X
RICHARD BOWER MD
ORTHOPEDIC M40.00420121019580X
TERRANCE SMITH MD
ANESTH. MD40.00405747034941X
JAMES DORSCH MD
ANESTH. MD40.00378936025348X
DENNIS DESILVEY MD
CARDIOLOGIST40.00365467025606X
FieldValueIRS element (for citing)
Total Reportable Comp From Org3037272TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs80654TotalReportableCompFrmRltdOrgs
Total Other Compensation215608TotalOtherCompensation
Number Individuals GT100 K57NumberIndividualsGT100K
Formers ListedfalseFormersListed
Total Comp GT150 KtrueTotalCompGT150K
Compensation From Other SourcesfalseCompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
SHERIDAN CORPORATION
PO BOX 359FAIRFIELDME04937CONSTRUCTION484369
MAINE CENTER FOR CANCER MEDICINE
100 CAMPUS DRIVE UNIT 308SCARBOROUGHME04074MED. STAFFING262913
WEATHERBY LOCUMS INC
PO BOX 972633DALLASTX75397MED. STAFFING164747
FREY'S CARPENTRY
661 SWAN LAKE AVENUESWANVILLEME04915CONSTRUCTION137439
MAINE GROUP
PO BOX 569BELFASTME04915CONSTRUCTION129213
FieldValueIRS element (for citing)
Number Of Contractors GT100 K5NumberOfContractorsGT100K
Government Grants1283994GovernmentGrants
All Other Contributions802962AllOtherContributions
Total Contributions2086956TotalContributions

Program Service Revenue ProgramServiceRevenue

FieldValueIRS element (for citing)
DescriptionNET PATIENT SERVICE REVENUEDescription
Business Code623000BusinessCode
Total Revenue Column72276223TotalRevenueColumn
Related Or Exempt Function Income72276223RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Program Service Revenue72276223TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column1270249TotalRevenueColumn
Exclusion$1,270,249ExclusionAmount

Gross Rents GrossRents

FieldValueIRS element (for citing)
Real180295Real

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real180295Real

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column180295TotalRevenueColumn
Related Or Exempt Function Income180295RelatedOrExemptFunctionIncome

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities12546457Securities
Other35500Other

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Securities11872214Securities
Other193379Other

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities674243Securities
Other-157879Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column516364TotalRevenueColumn
Related Or Exempt Function Income516364RelatedOrExemptFunctionIncome

Other Revenue Misc OtherRevenueMisc (3 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
MISCELLANEOUS REVENUE900099549748549748
MANAGEMENT FEE REVENUE561000257864257864
CAFETERIA REVENUE722210215206215206
FieldValueIRS element (for citing)
Total Other Revenue1022818TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column77352905TotalRevenueColumn
Related Or Exempt Function Income73995700RelatedOrExemptFunctionIncome
Exclusion$1,270,249ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total59938Total
Program Services59938ProgramServices

Grants To Domestic Individuals GrantsToDomesticIndividuals

FieldValueIRS element (for citing)
Total17918Total
Program Services17918ProgramServices

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total1214723Total
Program Services358625ProgramServices
Management And General856098ManagementAndGeneral

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total32947538Total
Program Services29777632ProgramServices
Management And General3169906ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total872971Total
Program Services769786ProgramServices
Management And General103185ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total4542171Total
Program Services4005286ProgramServices
Management And General536885ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total2187246Total
Program Services1928714ProgramServices
Management And General258532ManagementAndGeneral

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total560825Total
Management And General560825ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total8100Total
Management And General8100ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total161287Total
Management And General161287ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total5460658Total
Program Services4822234ProgramServices
Management And General638424ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total300Total
Management And General300ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total9496191Total
Program Services9274114ProgramServices
Management And General222077ManagementAndGeneral

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total819402Total
Program Services696878ProgramServices
Management And General122524ManagementAndGeneral

Occupancy Occupancy

FieldValueIRS element (for citing)
Total1571187Total
Program Services1385473ProgramServices
Management And General185714ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total103774Total
Program Services82524ProgramServices
Management And General21250ManagementAndGeneral

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total207210Total
Program Services178926ProgramServices
Management And General28284ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total331866Total
Program Services292639ProgramServices
Management And General39227ManagementAndGeneral

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total3096520Total
Program Services2730511ProgramServices
Management And General366009ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total373513Total
Program Services257979ProgramServices
Management And General115534ManagementAndGeneral

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
PROVISION FOR BAD DEBTS43410004341000
STATE OF ME HOSPITAL TAX13367101336710
MISCELLANEOUS EXPENSES543121419941123180
DUES433377433377

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total70687546Total
Program Services63170205ProgramServices
Management And General7517341ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY3715BOY
EOY3615EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY8295540BOY
EOY7561067EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

FieldValueIRS element (for citing)
BOY38438BOY
EOY65322EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY6696824BOY
EOY5639738EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY2005526BOY
EOY2380723EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY206944BOY
EOY609959EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis61779328LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec37041422LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY21877375BOY
EOY24737906EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY31572037BOY
EOY40741683EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
BOY153534BOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY20050653BOY
EOY23238244EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY90900586BOY
EOY104978257EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY6881754BOY
EOY6884089EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

FieldValueIRS element (for citing)
BOY7103807BOY
EOY6505133EOY

Unsecured Notes Loans Payable UnsecuredNotesLoansPayable

FieldValueIRS element (for citing)
EOY402688EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY8083707BOY
EOY10353201EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY22069268BOY
EOY24145111EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY56172692BOY
EOY64646717EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY1456389BOY
EOY1599224EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY11202237BOY
EOY14587205EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY68831318BOY
EOY80833146EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY90900586BOY
EOY104978257EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses6665359ReconcilationRevenueExpenses
Reconcilation Other Changes5336469ReconcilationOtherChanges
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or ReviewfalseAccountantCompileOrReview
FS AuditedtrueFSAudited
Audit CommitteetrueAuditCommittee
Financial Statement BothXFinancialStatementBoth
Federal Grant Audit RequiredfalseFederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Hospital170b1 AiiiXHospital170b1Aiii

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Aggregate ContributionsRESTRICTEDAggregateContributions

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Form4720 Filed4955 TaxfalseForm4720Filed4955Tax
Correction MadefalseCorrectionMade
Form1120 Pol FiledfalseForm1120PolFiled
Form4720 FiledfalseForm4720Filed
VolunteersfalseVolunteers
Paid Staff Or ManagementfalsePaidStaffOrManagement
Media AdvertisementsfalseMediaAdvertisements
Mailings MembersfalseMailingsMembers
Publications Or BroadcastfalsePublicationsOrBroadcast
Grants Other OrganizationsfalseGrantsOtherOrganizations
Direct Contact LegislatorsfalseDirectContactLegislators
Rallies DemonstrationsfalseRalliesDemonstrations
Other ActivitiestrueOtherActivities
Other Activities$5,366OtherActivitiesAmount
Total Lobbying Expenditures IIB5366TotalLobbyingExpendituresIIB
Not Described In501c3falseNotDescribedIn501c3
Form4720 Filed4912 TaxfalseForm4720Filed4912Tax
Substantially All Dues NondeductfalseSubstantiallyAllDuesNondeduct
Only In House LobbyingfalseOnlyInHouseLobbying
Agree To Carryover Prior YearfalseAgreeToCarryoverPriorYear

Form990 Schedule C Part IV Form990ScheduleCPartIV

FieldValueIRS element (for citing)
Return ReferenceSCHEDULE C, PART II-B, LINE 1ReturnReference
ExplanationPERCENTAGE OF ANNUAL MAINE HOSPITAL ASSOCIATION DUES ALLOCATED TOWARDS LOBBYING EXPENSES: 5,366.Explanation

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Disclosed Orgs Legal ControlfalseDisclosedOrgsLegalControl
Disclosed For Charitable PurposesfalseDisclosedForCharitablePurposes
Written Policy MonitoringfalseWrittenPolicyMonitoring
Sect170h Requirements SatisfiedfalseSect170hRequirementsSatisfied
Solicited Assets For SalefalseSolicitedAssetsForSale
Agent Trustee EtcfalseAgentTrusteeEtc
Included On FSfalseIncludedOnFS

Current Year CurrentYear

FieldValueIRS element (for citing)
Beginning Of Year Balance652523BeginningOfYearBalance
Contributions13921Contributions
Investment Earnings Or Losses57126InvestmentEarningsOrLosses
End Of Year Balance723570EndOfYearBalance

Current Year Minus1 Year CurrentYearMinus1Year

FieldValueIRS element (for citing)
Beginning Of Year Balance646826BeginningOfYearBalance
Contributions15070Contributions
Investment Earnings Or Losses-9373InvestmentEarningsOrLosses
End Of Year Balance652523EndOfYearBalance

Current Year Minus2 Years CurrentYearMinus2Years

FieldValueIRS element (for citing)
Beginning Of Year Balance697111BeginningOfYearBalance
Contributions14173Contributions
Investment Earnings Or Losses-64458InvestmentEarningsOrLosses
End Of Year Balance646826EndOfYearBalance

Current Year Minus3 Years CurrentYearMinus3Years

FieldValueIRS element (for citing)
Beginning Of Year Balance606116BeginningOfYearBalance
Contributions106512Contributions
Investment Earnings Or Losses-15517InvestmentEarningsOrLosses
End Of Year Balance697111EndOfYearBalance
FieldValueIRS element (for citing)
Permanent Endowment EOY Balance1.00000PermanentEndowmentEOYBalance
Endowments Held By Unrelated OrgstrueEndowmentsHeldByUnrelatedOrgs
Endowments Held By Related OrgsfalseEndowmentsHeldByRelatedOrgs
Are Related Orgs Listed Schedule RfalseAreRelatedOrgsListedScheduleR

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis230009OtherCostOrOtherBasis
Book Value230009BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis30401391OtherCostOrOtherBasis
Depreciation12985800Depreciation
Book Value17415591BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis28604891OtherCostOrOtherBasis
Depreciation23143853Depreciation
Book Value5461038BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis2543037OtherCostOrOtherBasis
Depreciation911769Depreciation
Book Value1631268BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings24737906TotalOfBookValueLandBuildings

Other Assets OtherAssets (10 entries)

DescriptionDescriptionBook ValueBookValue
BENEFICIAL INTEREST-PERPETUAL TRUST14174654
INSURANCE RECEIVABLES3543545
PREPAID CAPITAL COSTS2912174
THIRD PARTY SETTLEMENTS1100000
BENEFICIAL INTEREST-CHARITABLE TRUST1053784
OTHER CURRENT ASSETS271307
INVESTMENT IN MAINEHEALTH ACO108000
DEFERRED FINANCING FEES74780
SUNDRY RECEIVABLES
ASSETS LIMITED TO USE - INVEST DEPR
FieldValueIRS element (for citing)
Total Book Value Other Assets23238244TotalBookValueOtherAssets

Other Liabilities OtherLiabilities (5 entries)

DescriptionDescriptionAmountAmount
DUE TO THIRD PARTIES$6,567,121
INSURANCE RESERVE PAYABLE$3,078,693
DUE TO RELATED PARTIES$707,387
CAPITALIZED LEASE
OTHER L/T LIABILITES
FieldValueIRS element (for citing)
Total Of Amounts10353201TotalOfAmounts
Total Revenue77352905TotalRevenue
Total Expenses70687546TotalExpenses
Excess Or Deficit For Year6665359ExcessOrDeficitForYear
Net Unrealized GL On Investments3390651NetUnrealizedGLOnInvestments
Other$1,945,818OtherAmount
Total Adjustments5336469TotalAdjustments
Excess Or Deficit Per FS12001828ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt82482034TotRevenueEtcAuditedFinclStmt
Net Unrealized Gains Investments3390651NetUnrealizedGainsInvestments
Other Revenues1738478OtherRevenues
Revenue Not Rptd F9905129129RevenueNotRptdF990
Revenue Subtotal77352905RevenueSubtotal
Total Revenue Per Form99077352905TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt70480206TotExpensesEtcAuditedFinclStmt
Expenses Subtotal70480206ExpensesSubtotal
Other Expenses Not Included207340OtherExpensesNotIncluded
Expenses Not Rptd On Fin Stmt207340ExpensesNotRptdOnFinStmt
Total Expenses Per Form99070687546TotalExpensesPerForm990

Form990 Schedule D Part XIV Form990ScheduleDPartXIV (5 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
INTENDED USES FOR ENDOWMENT FUNDSSCHEDULE D, PAGE 2, PART V, LINE 4TWO 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 FOOTNOTESCHEDULE D, PAGE 3, PART XTHE 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, 2012. THE ORGANIZATION'S TAX YEARS 2009 THROUGH 2012 ARE OPEN AND SUBJECT TO EXAMINATION.
RECONCILIATION OF CHANGES - OTHERSCHEDULE D, PAGE 4, PART XI, LINE 8CHANGE IN VALUE OF PERPETUAL AND CHARITABLE TRUSTS 2,833,392 EQUITY TRANSFER TO AFFILIATES -887,574 GRANT EXPENSE INCLUDED IN OTHER REVENUE -207,340 GRANT EXPENSE INCLUDED IN OTHER REVENUE 207,340
REVENUE AMOUNTS INCLUDED IN FINANCIALS - OTHERSCHEDULE D, PAGE 4, PART XII, LINE 2DCHANGE IN VALUE OF PERPETUAL AND CHARITABLE TRUSTS 2,833,392 EQUITY TRANSFER TO AFFILIATES -887,574 GRANT EXPENSE INCLUDED IN OTHER REVENUE -207,340
EXPENSE AMOUNTS INCLUDED ON RETURN - OTHERSCHEDULE D, PAGE 4, PART XIII, LINE 4BGRANT EXPENSE INCLUDED IN OTHER REVENUE 207,340

Schedule H IRS990ScheduleH

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

Other Percentage OtherPercentage

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

Discounted Other DiscountedOther

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

Charity Care At Cost CharityCareAtCost

FieldValueIRS element (for citing)
Total Community Benefit Expense2263930TotalCommunityBenefitExpense
Net Community Benefit Expense2263930NetCommunityBenefitExpense
Percent Of Total Expense0.03420PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

FieldValueIRS element (for citing)
Total Community Benefit Expense12788429TotalCommunityBenefitExpense
Direct Offsetting Revenue10870557DirectOffsettingRevenue
Net Community Benefit Expense1917872NetCommunityBenefitExpense
Percent Of Total Expense0.02890PercentOfTotalExpense

Total Charity Care TotalCharityCare

FieldValueIRS element (for citing)
Total Community Benefit Expense15052359TotalCommunityBenefitExpense
Direct Offsetting Revenue10870557DirectOffsettingRevenue
Net Community Benefit Expense4181802NetCommunityBenefitExpense
Percent Of Total Expense0.06310PercentOfTotalExpense

Community Health Services CommunityHealthServices

FieldValueIRS element (for citing)
Total Community Benefit Expense247085TotalCommunityBenefitExpense
Direct Offsetting Revenue34936DirectOffsettingRevenue
Net Community Benefit Expense212149NetCommunityBenefitExpense
Percent Of Total Expense0.00320PercentOfTotalExpense

Health Professions Education HealthProfessionsEducation

FieldValueIRS element (for citing)
Total Community Benefit Expense81682TotalCommunityBenefitExpense
Net Community Benefit Expense81682NetCommunityBenefitExpense
Percent Of Total Expense0.00120PercentOfTotalExpense

Subsidized Health Services SubsidizedHealthServices

FieldValueIRS element (for citing)
Total Community Benefit Expense12486000TotalCommunityBenefitExpense
Direct Offsetting Revenue8536153DirectOffsettingRevenue
Net Community Benefit Expense3949847NetCommunityBenefitExpense
Percent Of Total Expense0.05950PercentOfTotalExpense

Cash And In Kind Contributions CashAndInKindContributions

FieldValueIRS element (for citing)
Total Community Benefit Expense15280TotalCommunityBenefitExpense
Net Community Benefit Expense15280NetCommunityBenefitExpense
Percent Of Total Expense0.00020PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense12830047TotalCommunityBenefitExpense
Direct Offsetting Revenue8571089DirectOffsettingRevenue
Net Community Benefit Expense4258958NetCommunityBenefitExpense
Percent Of Total Expense0.06410PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense27882406TotalCommunityBenefitExpense
Direct Offsetting Revenue19441646DirectOffsettingRevenue
Net Community Benefit Expense8440760NetCommunityBenefitExpense
Percent Of Total Expense0.12720PercentOfTotalExpense
FieldValueIRS element (for citing)
Bad Debt Expense ReportedtrueBadDebtExpenseReported
Bad Debt Expense$2,491,734BadDebtExpenseAmount
Amount Reimbursed By Medicare23761153AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare23761153CostOfCareReimbursedByMedicare
Written Debt Collection PolicytrueWrittenDebtCollectionPolicy
Provision For Charity CaretrueProvisionForCharityCare
Number Of Hospital Facilities6NumberOfHospitalFacilities

Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA (6 entries)

Facility NumberFacilityNumberAddress Line1Address/AddressLine1CityAddress/CityStateAddress/StateZIP CodeAddress/ZIPCodeLicensed HospitalLicensedHospitalGeneral Medical And SurgicalGeneralMedicalAndSurgicalCritical Access HospitalCriticalAccessHospitalEr24 HoursEr24Hours
WALDO COUNTY GENERAL HOSPITAL
1118 NORTHPORT AVENUEBELFASTME04915XXXX
ARTHUR JEWELL COMMUNITY HEALTH CTR
255 REYNOLDS ROADBROOKSME04921X
DONALD S WALKER HEALTH CENTER
343 WEST MAIN STREETLIBERTYME04949X
LINCOLNVILLE HEALTH CENTER
42399 ATLANTIC HIGHWAYLINCOLNVILLEME04849X
SEARSPORT HEALTH CENTER
537 MORTLAND ROADSEARSPORTME04974X
STOCKTON SPRING REG HEALTH CENTER
611 CAPE JELLISON ROADSTOCKTON SPRINGSME04981X

Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB (6 entries)

Hospital Facility NumberHospitalFacilityNumberEligibility Criteria ExplainedEligibilityCriteriaExplainedUses FPG FreeUsesFPGFreeFPG Free PercentFPGFreePercentUses FPG DiscountedUsesFPGDiscountedFPG Discount PercentFPGDiscountPercentExplains BasisExplainsBasisIncome LevelIncomeLevelExplains Application MethodExplainsApplicationMethodIncludes Publicity MeasuresIncludesPublicityMeasuresPosted On WebsitePostedOnWebsiteAttached To InvoicesAttachedToInvoicesPosted In Emergency RoomPostedInEmergencyRoomPosted In Admission OfficePostedInAdmissionOfficeProvided On AdmissionProvidedOnAdmissionAvailable On RequestAvailableOnRequestActions On NonpaymentActionsOnNonpaymentCollection ActivitiesCollectionActivitiesNotify Upon AdmissionNotifyUponAdmissionNotify Before DischargeNotifyBeforeDischargeNotified All PatientsNotifiedAllPatientsDocumented DeterminationDocumentedDeterminationNondiscrim Emergency Care PolicyNondiscrimEmergencyCarePolicyUsed Other MethodUsedOtherMethodAmounts Generally BilledAmountsGenerallyBilledGross ChargesGrossCharges
WALDO COUNTY GENERAL HOSPITAL
1truetrue175.0true225.0trueXtruetrueXXXXXXfalsefalseXXXXtrueXfalsefalse
ARTHUR JEWELL COMMUNITY HEALTH CTR
2truetrue175.0true225.0trueXtruetrueXXXXXXfalsefalseXXXXtrueXfalsefalse
DONALD S WALKER HEALTH CENTER
3truetrue175.0true225.0trueXtruetrueXXXXXXfalsefalseXXXXtrueXfalsefalse
LINCOLNVILLE HEALTH CENTER
4truetrue175.0true225.0trueXtruetrueXXXXXXfalsefalseXXXXtrueXfalsefalse
SEARSPORT HEALTH CENTER
5truetrue175.0true225.0trueXtruetrueXXXXXXfalsefalseXXXXtrueXfalsefalse
STOCKTON SPRING REG HEALTH CENTER
6truetrue175.0true225.0trueXtruetrueXXXXXXfalsefalseXXXXtrueXfalsefalse

Form990 Schedule H Part VI Form990ScheduleHPartVI (17 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
SUBSIDIZED HEALTH SERVICES EXPLANATIONPART I LINE 7GPHYSICIAN CLINIC COSTS WERE INCLUDED AS SUBSIDIZED HEALTH SERVICES IN THE AMOUNT OF 12486000
COSTING METHODOLOGY EXPLANATIONPART I LINE 7THE 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
COMMUNITY BUILDING ACTIVITIESPART IISEE ATTACHED COMMUNITY BENEFITS STATEMENT
BAD DEBT EXPENSE EXPLANATIONPART III LINE 4THE 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 EXPLANATIONPART III LINE 8THE 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 EXPLANATIONPART III LINE 9BONCE 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 ASSESSMENTPART VISEE ATTACHED COMMUNITY BENEFITS STATEMENT
PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCEPART VISEE ATTACHED COMMUNITY BENEFITS STATEMENT
COMMUNITY INFORMATIONPART VISEE ATTACHED COMMUNITY BENEFITS STATEMENT
HEALTH OF COMMUNITY IN RELATION TO EXEMPT PURPOSEPART VISEE ATTACHED COMMUNITY BENEFITS STATEMENT
AFFILIATED HEALTH CARE INFORMATIONPART VISEE ATTACHED COMMUNITY BENEFITS STATEMENT
WALDO COUNTY GENERAL HOSPITAL LINE NUMBER 1 PART V LINE 19DPART V LINE 19DALL PATIENTS REGARDLESS OF PAYOR CLASS ARE BILLED THE SAME
ARTHUR JEWELL COMMUNITY HEALTH CTR LINE NUMBER 2 PART V LINE 19DPART V LINE 19DALL PATIENTS REGARDLESS OF PAYOR CLASS ARE BILLED THE SAME
DONALD S WALKER HEALTH CENTER LINE NUMBER 3 PART V LINE 19DPART V LINE 19DALL PATIENTS REGARDLESS OF PAYOR CLASS ARE BILLED THE SAME
LINCOLNVILLE HEALTH CENTER LINE NUMBER 4 PART V LINE 19DPART V LINE 19DALL PATIENTS REGARDLESS OF PAYOR CLASS ARE BILLED THE SAME
SEARSPORT HEALTH CENTER LINE NUMBER 5 PART V LINE 19DPART V LINE 19DALL PATIENTS REGARDLESS OF PAYOR CLASS ARE BILLED THE SAME
STOCKTON SPRING REG HEALTH CENTER LINE NUMBER 6 PART V LINE 19DPART V LINE 19DALL PATIENTS REGARDLESS OF PAYOR CLASS ARE BILLED THE SAME

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Records MaintainedtrueRecordsMaintained

Recipient Table RecipientTable (2 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEIN Of RecipientEINOfRecipientIRC SectionIRCSectionAmount Of Cash GrantAmountOfCashGrantPurpose Of GrantPurposeOfGrant
SPRING HARBOR COMM SERVICE
78 ATLANTIC PLACESOUTH PORTLANDME0410601052483550147450SUB MENTAL HEALTH
HOSPICE VOLUNTEERS OF WALDO COUNTY
PO BOX 772BELFASTME0491522266830750110000SUPPORT HOSPICE
FieldValueIRS element (for citing)
Total Nbr Of501 C3 And Govt Grants2TotalNbrOf501C3AndGovtGrants

Form990 Schedule I Part III Form990ScheduleIPartIII

FieldValueIRS element (for citing)
Type Of GrantSCHOLARSHIPS TO STUDENTSTypeOfGrant
Number Of Recipients14NumberOfRecipients
Amount Of Cash Grant17918AmountOfCashGrant

Form990 Schedule I Part IV Form990ScheduleIPartIV

FieldValueIRS element (for citing)
IdentifierADDITIONAL INFORMATIONIdentifier
Return ReferenceSCHEDULE I, PAGE 4, PART IVReturnReference
ExplanationSCHOLARSHIPS 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

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

Form990 Schedule J Part II Form990ScheduleJPartII (9 entries)

Base Compensation Filing OrgBaseCompensationFilingOrgDeferred Comp Filing OrgDeferredCompFilingOrgNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgTotal Compensation Filing OrgTotalCompensationFilingOrgComp Based On Related OrgsCompBasedOnRelatedOrgsBonus Filing OrgBonusFilingOrgOther Compensation Filing OrgOtherCompensationFilingOrgTotal Compensation Related OrgsTotalCompensationRelatedOrgs
D KENT CLARK MD
266225735019702293277
ANN HOOPER
147739458915202167530
MARK BISCONE
24557673502742739466080654320008230780654
LINDA DRINKWATER
1600556010229820778839425
OWEN NELSON MD
41053179841222150739976663
RICHARD BOWER MD
39848373501223043970121638
TERRANCE SMITH MD
33936273502759144068866385
JAMES DORSCH MD
32678073501799840428425051906
DENNIS DESILVEY MD
30241173501825639107325062806

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (11 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
ORGANIZATION'S MISSIONFORM 990 - ORGANIZATION'S MISSIONWALDO 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 STOCKHOLDERSFORM 990, PAGE 6, PART VI, LINE 6WALDO 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 RIGHTSFORM 990, PAGE 6, PART VI, LINE 7AMAINEHEALTH (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 MEMBERSFORM 990, PAGE 6, PART VI, LINE 7BDECISIONS 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 990FORM 990, PAGE 6, PART VI, LINE 11BTHE FINANCE COMMITTEE PERFORMS A DETAILED REVIEW OF THE FORM 990. THE FORM 990 IS THEN PRESENTED TO THE FULL BOARD. THE CFO PERFORMS A DETAILED REVIEW OF THE FORM 990 PRIOR TO SIGNING AND FILING THE RETURN.
ENFORCEMENT OF CONFLICTS POLICYFORM 990, PAGE 6, PART VI, LINE 12CWALDO COUNTY GENERAL HOSPITAL'S CONFLICT OF INTEREST POLICY IS INCORPORATED AS PART OF THE BY-LAWS OF THESE CORPORATIONS. THE ORGANIZATION CONSISTENTLY REVIEWS ALL TRANSACTIONS TO ASSURE COMPLIANCE IN ACCORDANCE WITH THE BY-LAWS.
COMPENSATION PROCESS FOR TOP OFFICIALFORM 990, PAGE 6, PART VI, LINE 15ATHE 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 OFFICERSFORM 990, PAGE 6, PART VI, LINE 15BTHE 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 EXPLANATIONFORM 990, PAGE 6, PART VI, LINE 19DOCUMENTS THAT ARE REQUIRED TO BE OPEN FOR PUBLIC INSPECTION ARE MADE AVAILABLE UPON REQUEST.
RELATED ORGANIZATIONSFORM 990, PAGE 7, PART VIID. KENT CLARK, MD 5 HOURS ANN HOOPER 5 HOURS MARK BISCONE 10 HOURS LINDA DRINKWATER 5 HOURS
OTHER CHANGES IN NET ASSETS EXPLANATIONFORM 990, PART XI, LINE 5CHANGE IN VALUE OF PERPETUAL AND CHARITABLE TRUSTS 2,833,392 CHANGE IN MARKET VALUE OF INVESTMENTS 3,390,651 EQUITY TRANSFERS TO AFFILIATES -887,574

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (5 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Controlled OrgControlledOrg
WALDO COUNTY HEALTHCARE INC
PO BOX 287BELFASTME04915222864961COMM. EDUCME501C311BMEHLTHfalse
COASTAL MEDICAL CARE
PO BOX 287BELFASTME04915010487091MED. SERV.ME501C39WCHIfalse
BELFAST PUBLIC HEALTH NURSING
PO BOX 287BELFASTME04915043359810PUB. HLTH.ME501C39WCHIfalse
WALDO COUNTY HOME HEALTHCARE SERV
PO BOX 287BELFASTME04915222864960HOSPICEME501C39WCHIfalse
MAINEHEALTH
110 FREE STREETPORTLANDME04101010431680HEALTHCAREME501C311CNAfalse

Form990 Schedule R Part IV Form990ScheduleRPartIV

Name Of Related Org NameOfRelatedOrg

FieldValueIRS element (for citing)
Business Name Line1WALDO COUNTY HEALTHCARE MGMT COBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1PO BOX 287AddressLine1
CityBELFASTCity
StateMEState
ZIP Code04915ZIPCode
FieldValueIRS element (for citing)
EIN010485133EIN
Primary ActivityMGMT SVCSPrimaryActivity
Legal Domicile StateMELegalDomicileState
Direct Controlling Entity NAN/ADirectControllingEntityNA
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents RoyaltiesfalseReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other OrgfalseGiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other OrgfalseGiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other OrgfalseLoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other OrgfalseLoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other OrgfalseSaleOfAssetsToOtherOrg
Purchase Of Assets From Other OrgfalsePurchaseOfAssetsFromOtherOrg
Exchange Of AssetsfalseExchangeOfAssets
Rental Of Facilities To Other OrgstrueRentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other OrgstrueRentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other OrgstruePerformOfServicesForOtherOrgs
Perform Of Services By Other OrgstruePerformOfServicesByOtherOrgs
Sharing Of FacilitiesfalseSharingOfFacilities
Sharing Of Paid EmployeestrueSharingOfPaidEmployees
Reimbursement Paid To Other OrgtrueReimbursementPaidToOtherOrg
Reimbursement Paid By Other OrgtrueReimbursementPaidByOtherOrg
Other Transfer To Other OrgtrueOtherTransferToOtherOrg
Other Transfer From Other OrgtrueOtherTransferFromOtherOrg