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Franklin Memorial Hospital: Form 990, tax year 2010

View the entire original 990 at ProPublica ↗

Organization
Franklin Memorial Hospital (EIN 01-0211503)
Tax period
2010-07-01 to 2011-06-30
Filed
2012-04-13
IRS object ID
201201049349300900
Schema version
2010v3.4
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)
Timestamp2012-04-13T15:54:59-05:00Timestamp
Tax Period End Date2011-06-30TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1Berry Dunn McNeil & Parker LLCBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line1PO Box 1100AddressLine1
CityPortlandCity
StateMEState
ZIP Code041041100ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2010-07-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN010211503EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1Franklin Memorial HospitalBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlFRANNameControl
Phone2077792500Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1111 Franklin Health CommonsAddressLine1
CityFarmingtonCity
StateMEState
ZIP Code04938ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameWayne BennettName
TitleCFOTitle
Phone2077792500Phone
Date Signed2012-04-07DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameBarbara J McGuan CPAName
Phone2077752387Phone
Date Prepared2012-04-07DatePrepared
FieldValueIRS element (for citing)
Tax Year2010TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonRebecca RyderNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1111 Franklin Health CommonsAddressLine1
CityFarmingtonCity
StateMEState
ZIP Code04938ZIPCode
FieldValueIRS element (for citing)
Gross Receipts88842687GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501c3XOrganization501c3
Web Sitewww.fchn.orgWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1926YearFormation
State Legal DomicileMEStateLegalDomicile
Activity Or Mission DescriptionCommunity HospitalActivityOrMissionDescription
Nbr Voting Members Governing Body19NbrVotingMembersGoverningBody
Nbr Independent Voting Members14NbrIndependentVotingMembers
Total Nbr Employees957TotalNbrEmployees
Total Nbr Volunteers201TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year278062ContributionsGrantsPriorYear
Contributions Grants Current Year559721ContributionsGrantsCurrentYear
Program Service Revenue Prior Year85277281ProgramServiceRevenuePriorYear
Program Service Revenue CY88209148ProgramServiceRevenueCY
Investment Income Prior Year164817InvestmentIncomePriorYear
Investment Income Current Year-40911InvestmentIncomeCurrentYear
Other Revenue Prior Year-9846OtherRevenuePriorYear
Other Revenue Current Year23610OtherRevenueCurrentYear
Total Revenue Prior Year85710314TotalRevenuePriorYear
Total Revenue Current Year88751568TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year178421GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY420103GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year48015931SalariesEtcPriorYear
Salaries Etc Current Year50844233SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year34788722OtherExpensePriorYear
Other Expenses Current Year36090392OtherExpensesCurrentYear
Total Expenses Prior Year82983074TotalExpensesPriorYear
Total Expenses Current Year87354728TotalExpensesCurrentYear
Revenues Less Expenses Prior Year2727240RevenuesLessExpensesPriorYear
Revenues Less Expenses CY1396840RevenuesLessExpensesCY
Total Assets BOY71632680TotalAssetsBOY
Total Assets EOY71470727TotalAssetsEOY
Total Liabilities BOY31893484TotalLiabilitiesBOY
Total Liabilities EOY30225199TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY39739196NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY41245528NetAssetsOrFundBalancesEOY
Info In Schedule O Part IIIXInfoInScheduleOPartIII
Mission DescriptionTo provide high-quality, cost-effective, patient-centered healthcare to our west central Maine community. We work with our community and other healthcare providers to integrate services and ensure the health of our community.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense73785106Expense
Grants420103Grants
Revenue88209148Revenue
DescriptionFranklin Memorial Hospital is a progressive, friendly, non-for-profit community hospital which provides high-quality, cost-effective, patient-centered healthcare services to the west central Maine community. The 65-bed hospital is fully qualified and accredited to handle a broad range of medical, surgical, pediatric, women's care and diagnostic services. Franklin Memorial Hospital offers top quality specialty care including oncology, hematology, cardiology, orthopaedics, behavioral services, occupational health, dermatology, pulmonology, pain management, pediatric endocrinology, physical rehabilitation, sports medicine and wound care. During the fiscal year 2011 there were 2,850 discharges, 1,880 outpatient surgeries, 208,000 outpatient lab tests, 36,000 outpatient imaging procedures and 16,600 emergency room visits. Franklin Memorial Hospital identified access to primary care as a central community need and is committed to providing high quality physician services of family practice, internal medicine, pediatrics and womens care. During the year Franklin Memorial Hospital provided 68,750 primary care visits and 23,550 specialty care visits in the Franklin Health physician practices.Description
Total Program Service Expense73785106TotalProgramServiceExpense
Described In501 C31DescribedIn501C3
Schedule B Required1ScheduleBRequired
Political Activities0PoliticalActivities
Lobbying Activities1LobbyingActivities
Subject To Proxy Tax0SubjectToProxyTax
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling0CreditCounseling
Term Or Permanent Endowments1TermOrPermanentEndowments
Report Land Bldg Equip1ReportLandBldgEquip
Report Invest Oth Securities0ReportInvestOthSecurities
Report Prog Rel Invest0ReportProgRelInvest
Report Other Assets1ReportOtherAssets
Report Other Liabilities1ReportOtherLiabilities
Report Fin48 Footnote0ReportFin48Footnote
Independent Audit Financial Stmt1IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt1ConsolidatedAuditFinancialStmt
School0School
Foreign Office0ForeignOffice
Foreign Activities0ForeignActivities
More Than5000 K To Organizations0MoreThan5000KToOrganizations
More Than5000 K To Individuals0MoreThan5000KToIndividuals
Professional Fundraising0ProfessionalFundraising
Fundraising Activities0FundraisingActivities
Gaming0Gaming
Hospital1Hospital
Financial Stmt Attached1FinancialStmtAttached
Grants To Organizations1GrantsToOrganizations
Grants To Individuals0GrantsToIndividuals
Schedule J Required1ScheduleJRequired
Tax Exempt Bonds1TaxExemptBonds
Invest Tax Exempt Bonds0InvestTaxExemptBonds
Escrow Account0EscrowAccount
On Behalf Of Issuer0OnBehalfOfIssuer
Excess Benefit Transaction0ExcessBenefitTransaction
Prior Excess Benefit Transaction0PriorExcessBenefitTransaction
Loan To Officer Or DQP0LoanToOfficerOrDQP
Grant To Related Person0GrantToRelatedPerson
Bsnss Rltnshp With Organization0BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member0BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp0OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions0DeductibleNonCashContributions
Deductible Contributions Of Art0DeductibleContributionsOfArt
Terminated0Terminated
Partial Liquidation0PartialLiquidation
Disregarded Entity0DisregardedEntity
Related Entity1RelatedEntity
Related Org Controlled Entity0RelatedOrgControlledEntity
Transaction Related Entity0TransactionRelatedEntity
Transfers To Exempt Non Chrtbl Org0TransfersToExemptNonChrtblOrg
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With1096155NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup Witholding1ComplianceWithBackupWitholding
Number Of Employees957NumberOfEmployees
Employment Tax Returns Filed1EmploymentTaxReturnsFiled
Unrelated Business Income0UnrelatedBusinessIncome
Foreign Financial Account0ForeignFinancialAccount
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTrans
Taxable Party Notification0TaxablePartyNotification
Non Deductible Contributions0NonDeductibleContributions
Quid Pro Quo Contributions0QuidProQuoContributions
Form8282 Property Disposed Of0Form8282PropertyDisposedOf
Funds To Pay Premiums0FundsToPayPremiums
Premiums Paid0PremiumsPaid
Indoor Tanning Services0IndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members19NbrVotingGoverningBodyMembers
Number Independent Voting Members14NumberIndependentVotingMembers
Family Or Business Relationship0FamilyOrBusinessRelationship
Delegation Of Management Duties0DelegationOfManagementDuties
Changes To Organizing Docs0ChangesToOrganizingDocs
Material Diversion Or Misuse0MaterialDiversionOrMisuse
Members Or Stockholders1MembersOrStockholders
Election Of Board Members1ElectionOfBoardMembers
Decisions Subject To Approval1DecisionsSubjectToApproval
Minutes Of Governing Body1MinutesOfGoverningBody
Minutes Of Committees1MinutesOfCommittees
Officer Mailing Address0OfficerMailingAddress
Local Chapters1LocalChapters
Policies Reference Chapters1PoliciesReferenceChapters
Form990 Provided To Governing Body1Form990ProvidedToGoverningBody
Conflict Of Interest Policy1ConflictOfInterestPolicy
Annual Disclosure Covered Persons1AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement1RegularMonitoringEnforcement
Whistleblower Policy1WhistleblowerPolicy
Document Retention Policy1DocumentRetentionPolicy
Compensation Process CEO1CompensationProcessCEO
Compensation Process Other1CompensationProcessOther
Investment In Joint Venture0InvestmentInJointVenture
States Where Copy Of Return Is FiledMEStatesWhereCopyOfReturnIsFiled
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1Wayne BennettBusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number2077792613TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1111 Franklin Health CommonsAddressLine1
CityFarmingtonCity
StateMEState
ZIP Code04938ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (27 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationHighest Compensated EmployeeHighestCompensatedEmployeeFormerFormer
Rebecca Ryder
President/CEO40.00XX034664130757
Joseph Bujold
Chair1.00XX000
Jef Howell
Treasurer1.00XX000
Waine Whittier
Director1.00X000
Dr Wil Eastman
Director1.00X000
Tim Wallace
Director1.00X000
Carol Timberlake
Vice Chair1.00XX000
Meredith Tipton
Director1.00X000
Gilly Hitchcock
Director1.00X000
Darryl Brown
Director1.00X000
Doug Walrath
Director1.00X000
Shannon Smith
Director1.00X000
Peter Judkins
Director1.00X000
Tom Saviello
Director1.00X000
Dr Peter Cordner
Director40.00X309227014330
Sheena Bunnell
Director1.00X000
Ronald Aseltine
Director1.00X1582400
Dr Connie Adler
Secretary40.00XX169209018015
Dr David Hyde
Past Secretary40.00XX267726020586
Gerald Cayer
Executive VP40.00X019194218214
Eric Martinsen
CFO40.00X017608617986
Nancy Cummings
Ortho Surgeon40.00425989023890X
Richard Batstone
Urologist40.00476241011228X
Eric Gunther
General Surgeon40.00342876022459X
Joshua D Sparling
Dermatologist40.00411364018806X
Larry Michael Fraley
Anesthesiologist40.00331327013765X
Dr Armand Auger
Former Trustee40.00189678017606X
FieldValueIRS element (for citing)
Total Reportable Comp From Org2939461TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs714669TotalReportableCompFrmRltdOrgs
Total Other Compensation227642TotalOtherCompensation
Number Individuals GT100 K61NumberIndividualsGT100K
Formers Listed1FormersListed
Total Comp GT150 K1TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
Cianbro
PO Box 8372WoburnMA01813Construction2692371
Weatherby Locums
PO Box 972633DallasTX75397Physician Contract Staffing688080
Synernet Inc
222 St John StreetPortlandME04102Transcription642052
Quest Diagnostics
5763 Collection Center DriveChicagoIL60693Lab Diagnostic Services463765
Maine Medical Center
22 Bramhall StreetPortlandME04102PACS/E-ICU413841
FieldValueIRS element (for citing)
Number Of Contractors GT100 K21NumberOfContractorsGT100K
Related Organizations213198RelatedOrganizations
Government Grants138538GovernmentGrants
All Other Contributions207985AllOtherContributions
Total Contributions559721TotalContributions

Program Service Revenue ProgramServiceRevenue (5 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
Patient Services621990168401934168401934
Other621990877825877825
Ambulance Subsidies621910866247866247
Cafeteria Revenue621990130721130721
Contractual/Char. Adj.621990-82067579-82067579
FieldValueIRS element (for citing)
Total Program Service Revenue88209148TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column7883TotalRevenueColumn
Exclusion$7,883ExclusionAmount

Gross Rents GrossRents

FieldValueIRS element (for citing)
Real56090Real

Less Rental Expenses LessRentalExpenses

FieldValueIRS element (for citing)
Real32480Real

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real23610Real

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column23610TotalRevenueColumn
Exclusion$23,610ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Other9845Other

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Other58639Other

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Other-48794Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column-48794TotalRevenueColumn
Exclusion-$48,794ExclusionAmount

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column88751568TotalRevenueColumn
Related Or Exempt Function Income88209148RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion-$17,301ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total420103Total
Program Services420103ProgramServices

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total814917Total
Program Services799093ProgramServices
Management And General15824ManagementAndGeneral

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total40291191Total
Program Services34702704ProgramServices
Management And General5588487ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total1350145Total
Program Services1163192ProgramServices
Management And General186953ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total5597378Total
Program Services4831006ProgramServices
Management And General766372ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total2790602Total
Program Services2410576ProgramServices
Management And General380026ManagementAndGeneral

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total1098117Total
Management And General1098117ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total99231Total
Management And General99231ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total60665Total
Management And General60665ManagementAndGeneral

Fees For Services Lobbying FeesForServicesLobbying

FieldValueIRS element (for citing)
Total5953Total
Program Services5953ProgramServices

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total7207583Total
Program Services4819978ProgramServices
Management And General2387605ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total10338Total
Management And General10338ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total2143467Total
Program Services844480ProgramServices
Management And General1298987ManagementAndGeneral

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total2296146Total
Program Services1983456ProgramServices
Management And General312690ManagementAndGeneral

Occupancy Occupancy

FieldValueIRS element (for citing)
Total2376903Total
Program Services2070979ProgramServices
Management And General305924ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total150223Total
Program Services126456ProgramServices
Management And General23767ManagementAndGeneral

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total411566Total
Program Services271936ProgramServices
Management And General139630ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total1096903Total
Program Services947525ProgramServices
Management And General149378ManagementAndGeneral

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total4876192Total
Program Services4222325ProgramServices
Management And General653867ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total1507882Total
Program Services1502118ProgramServices
Management And General5764ManagementAndGeneral

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
Medical Supplies70780497078049
Provision for Bad Debt32061733206173
Hospital Tax and Match18394451839445
Other62555653955985997

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total87354728Total
Program Services73785106ProgramServices
Management And General13569622ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY4687BOY
EOY4722EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY10929929BOY
EOY9778896EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY8927992BOY
EOY10001878EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY1156595BOY
EOY1270140EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY1288234BOY
EOY1309548EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis79293269LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec43546733LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY35929604BOY
EOY35746536EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
BOY2170709BOY
EOY2507643EOY

Intangible Assets IntangibleAssets

FieldValueIRS element (for citing)
BOY283134BOY
EOY261950EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY10941796BOY
EOY10589414EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY71632680BOY
EOY71470727EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY6781663BOY
EOY5861337EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

FieldValueIRS element (for citing)
BOY23295288BOY
EOY22444495EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY1816533BOY
EOY1919367EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY31893484BOY
EOY30225199EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY37564349BOY
EOY38736147EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY773717BOY
EOY1063840EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY1401130BOY
EOY1445541EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY39739196BOY
EOY41245528EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY71632680BOY
EOY71470727EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses1396840ReconcilationRevenueExpenses
Reconcilation Other Changes109492ReconcilationOtherChanges
Info In Schedule O Part XIIXInfoInScheduleOPartXII
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited
Audit Committee1AuditCommittee
Financial Statement BothXFinancialStatementBoth
Federal Grant Audit Required0FederalGrantAuditRequired

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)
Volunteers0Volunteers
Paid Staff Or Management0PaidStaffOrManagement
Media Advertisements0MediaAdvertisements
Mailings Members0MailingsMembers
Publications Or Broadcast0PublicationsOrBroadcast
Grants Other Organizations0GrantsOtherOrganizations
Direct Contact Legislators0DirectContactLegislators
Rallies Demonstrations0RalliesDemonstrations
Other Activities1OtherActivities
Other Activities$5,953OtherActivitiesAmount
Total Lobbying Expenditures IIB5953TotalLobbyingExpendituresIIB
Not Described In501c30NotDescribedIn501c3

Form990 Schedule C Part IV Form990ScheduleCPartIV

FieldValueIRS element (for citing)
IdentifierExplanation of Other Lobbying Activities:Identifier
Return ReferencePart II-B, Line 1i:ReturnReference
ExplanationThe Organization pays dues to various associations, a portion of which is attributable to lobbying expenses.Explanation

Schedule D IRS990ScheduleD

Current Year CurrentYear

FieldValueIRS element (for citing)
Beginning Of Year Balance2007058BeginningOfYearBalance
Contributions12117Contributions
Investment Earnings Or Losses335279InvestmentEarningsOrLosses
Other Expenditures13144OtherExpenditures
End Of Year Balance2341310EndOfYearBalance

Current Year Minus1 Year CurrentYearMinus1Year

FieldValueIRS element (for citing)
Beginning Of Year Balance1903822BeginningOfYearBalance
Contributions60144Contributions
Investment Earnings Or Losses135979InvestmentEarningsOrLosses
Other Expenditures93491OtherExpenditures
End Of Year Balance2007058EndOfYearBalance

Current Year Minus2 Years CurrentYearMinus2Years

FieldValueIRS element (for citing)
Beginning Of Year Balance1895540BeginningOfYearBalance
Contributions120033Contributions
Investment Earnings Or Losses-66109InvestmentEarningsOrLosses
Other Expenditures45642OtherExpenditures
End Of Year Balance1903822EndOfYearBalance
FieldValueIRS element (for citing)
Board Designated EOY Balance0.00000BoardDesignatedEOYBalance
Permanent Endowment EOY Balance0.62000PermanentEndowmentEOYBalance
Term Endowment EOY Balance0.38000TermEndowmentEOYBalance
Endowments Held By Unrelated Orgs0EndowmentsHeldByUnrelatedOrgs
Endowments Held By Related Orgs1EndowmentsHeldByRelatedOrgs
Are Related Orgs Listed Schedule R1AreRelatedOrgsListedScheduleR

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis1083333OtherCostOrOtherBasis
Book Value1083333BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis41430405OtherCostOrOtherBasis
Depreciation18345344Depreciation
Book Value23085061BookValue

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Other Cost Or Other Basis52674OtherCostOrOtherBasis
Depreciation52674Depreciation
Book Value0BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis30246883OtherCostOrOtherBasis
Depreciation22918270Depreciation
Book Value7328613BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis6479974OtherCostOrOtherBasis
Depreciation2230445Depreciation
Book Value4249529BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings35746536TotalOfBookValueLandBuildings

Other Assets OtherAssets (3 entries)

DescriptionDescriptionBook ValueBookValue
Estimated Settlements from MaineCare9801030
Deferred Compensation Asset628979
Due from Related Parties159405
FieldValueIRS element (for citing)
Total Book Value Other Assets10589414TotalBookValueOtherAssets

Other Liabilities OtherLiabilities (2 entries)

DescriptionDescriptionAmountAmount
Deferred Compensation$628,979
Estimated Third-Party Payor Settlements$1,290,388
FieldValueIRS element (for citing)
Total Of Amounts1919367TotalOfAmounts
Total Revenue88751568TotalRevenue
Total Expenses87354728TotalExpenses
Excess Or Deficit For Year1396840ExcessOrDeficitForYear
Other$109,492OtherAmount
Total Adjustments109492TotalAdjustments
Excess Or Deficit Per FS1506332ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt88483437TotRevenueEtcAuditedFinclStmt
Other Revenues366733OtherRevenues
Revenue Not Rptd F990366733RevenueNotRptdF990
Revenue Subtotal88116704RevenueSubtotal
Other Revenues Not Included634864OtherRevenuesNotIncluded
Revenue Not Rptd On Fin Stmt634864RevenueNotRptdOnFinStmt
Total Revenue Per Form99088751568TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt86977105TotExpensesEtcAuditedFinclStmt
Other Expenses Included32480OtherExpensesIncluded
Expenses Not Rptd F99032480ExpensesNotRptdF990
Expenses Subtotal86944625ExpensesSubtotal
Other Expenses Not Included410103OtherExpensesNotIncluded
Expenses Not Rptd On Fin Stmt410103ExpensesNotRptdOnFinStmt
Total Expenses Per Form99087354728TotalExpensesPerForm990

Form990 Schedule D Part XIV Form990ScheduleDPartXIV (6 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
Description of Intended Use of Endowment Funds:Part V, Line 4:The Organization's endowment funds are held by the Franklin Community Health Network and are intended to support various programs offered by the Organization, such as the charity program, community outreach, education, medical library, Martha B. Webber Breast Care Center, and others.
Part XI, Line 8 - Other Adjustments:Change in Net Assets of Affiliate 289,842. Net Change in Perpetual Trust 44,411. Equity Transfers from Affiliates -224,761.
Part XII, Line 2d - Other Adjustments:Change in Net Assets of Affiliate 289,842. Net Change in Perpetual Trust 44,411. Rental Expenses 32,480.
Part XII, Line 4b - Other Adjustments:Grants and Other Assistance 410,103. Equity Transfers to Affiliate 224,761.
Part XIII, Line 2d - Other Adjustments:Rental Expenses 32,480.
Part XIII, Line 4b - Other Adjustments:Grants and Other Assistance 410,103.

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Charity Care Policy1CharityCarePolicy
Written Policy1WrittenPolicy
FPG Reference Free Care1FPGReferenceFreeCare
Pcent200XPcent200
FPG Reference Discounted Care1FPGReferenceDiscountedCare
Pcent300XPcent300
Free Disc Care Medically Indigent0FreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity Care1AmountsBudgetedForCharityCare
Expenses Exceeded Budget1ExpensesExceededBudget
Unable To Provide Care0UnableToProvideCare
Annual Community Benefit Report1AnnualCommunityBenefitReport
Report Publically Available1ReportPublicallyAvailable

Charity Care At Cost CharityCareAtCost

FieldValueIRS element (for citing)
Total Community Benefit Expense3177487TotalCommunityBenefitExpense
Net Community Benefit Expense3177487NetCommunityBenefitExpense
Percent Of Total Expense0.03780PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

FieldValueIRS element (for citing)
Total Community Benefit Expense17398322TotalCommunityBenefitExpense
Direct Offsetting Revenue16431890DirectOffsettingRevenue
Net Community Benefit Expense966432NetCommunityBenefitExpense
Percent Of Total Expense0.01150PercentOfTotalExpense

Total Charity Care TotalCharityCare

FieldValueIRS element (for citing)
Total Community Benefit Expense20575809TotalCommunityBenefitExpense
Direct Offsetting Revenue16431890DirectOffsettingRevenue
Net Community Benefit Expense4143919NetCommunityBenefitExpense
Percent Of Total Expense0.04930PercentOfTotalExpense

Community Health Services CommunityHealthServices

FieldValueIRS element (for citing)
Total Community Benefit Expense671452TotalCommunityBenefitExpense
Direct Offsetting Revenue26668DirectOffsettingRevenue
Net Community Benefit Expense644784NetCommunityBenefitExpense
Percent Of Total Expense0.00770PercentOfTotalExpense

Health Professions Education HealthProfessionsEducation

FieldValueIRS element (for citing)
Total Community Benefit Expense305755TotalCommunityBenefitExpense
Net Community Benefit Expense305755NetCommunityBenefitExpense
Percent Of Total Expense0.00360PercentOfTotalExpense

Subsidized Health Services SubsidizedHealthServices

FieldValueIRS element (for citing)
Total Community Benefit Expense8884667TotalCommunityBenefitExpense
Direct Offsetting Revenue6221051DirectOffsettingRevenue
Net Community Benefit Expense2663616NetCommunityBenefitExpense
Percent Of Total Expense0.03170PercentOfTotalExpense

Cash And In Kind Contributions CashAndInKindContributions

FieldValueIRS element (for citing)
Total Community Benefit Expense470456TotalCommunityBenefitExpense
Net Community Benefit Expense470456NetCommunityBenefitExpense
Percent Of Total Expense0.00560PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense10332330TotalCommunityBenefitExpense
Direct Offsetting Revenue6247719DirectOffsettingRevenue
Net Community Benefit Expense4084611NetCommunityBenefitExpense
Percent Of Total Expense0.04860PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense30908139TotalCommunityBenefitExpense
Direct Offsetting Revenue22679609DirectOffsettingRevenue
Net Community Benefit Expense8228530NetCommunityBenefitExpense
Percent Of Total Expense0.09790PercentOfTotalExpense

Economic Development EconomicDevelopment

FieldValueIRS element (for citing)
Total Community Building Expense3500TotalCommunityBuildingExpense
Net Community Building Expense3500NetCommunityBuildingExpense
Percent Of Total Expense0.00000PercentOfTotalExpense

Total Total

FieldValueIRS element (for citing)
Total Community Building Expense3500TotalCommunityBuildingExpense
Net Community Building Expense3500NetCommunityBuildingExpense
FieldValueIRS element (for citing)
Bad Debt Expense Reported1BadDebtExpenseReported
Bad Debt Expense$1,479,198BadDebtExpenseAmount
Amount Attributable To295000AmountAttributableTo
Amount Reimbursed By Medicare20242268AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare22945336CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall-2703068MedicareSurplusOrShortfall

Costing Methodology Used CostingMethodologyUsed

FieldValueIRS element (for citing)
Cost To Charge RatioXCostToChargeRatio
FieldValueIRS element (for citing)
Written Debt Collection Policy1WrittenDebtCollectionPolicy
Provision For Charity Care0ProvisionForCharityCare

Form990 Schedule H Part IV Form990ScheduleHPartIV (2 entries)

Description Ent Primary ActivityDescriptionEntPrimaryActivityOrganization Profit Or OwnershipOrganizationProfitOrOwnershipOfficers Etc Profit Or OwnershipOfficersEtcProfitOrOwnershipPhysicans Profit Or OwnershipPhysicansProfitOrOwnership
1 Western Maine PHO
Physician Hospital Organization0.500000.000000.00000
2 Scorekeeper LLC
Wellness Software0.400000.000000.00000
FieldValueIRS element (for citing)
Number Of Hospital Facilities1NumberOfHospitalFacilities

Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA

FieldValueIRS element (for citing)
Facility Number1FacilityNumber

Name Name

FieldValueIRS element (for citing)
Business Name Line1Franklin Memorial HospitalBusinessNameLine1

Address Address

FieldValueIRS element (for citing)
Address Line1111 Franklin Health CommonsAddressLine1
CityFarmingtonCity
StateMEState
ZIP Code04938ZIPCode
FieldValueIRS element (for citing)
Licensed HospitalXLicensedHospital
General Medical And SurgicalXGeneralMedicalAndSurgical
Er24 HoursXEr24Hours

Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1Franklin Memorial HospitalBusinessNameLine1
FieldValueIRS element (for citing)
Hospital Facility Number1HospitalFacilityNumber

Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC

FieldValueIRS element (for citing)
Number Of Other Facilities19NumberOfOtherFacilities

Other Facilities OtherFacilities (19 entries)

Address Line1Address/AddressLine1CityAddress/CityStateAddress/StateZIP CodeAddress/ZIPCodeFacility TypeFacilityType
Franklin Hlth Livermore Falls Fam Pract
38 Union StreetLivermore FallsME04254Family Practice
Franklin Health Wilton Family Practice
75 Allen StreetWiltonME04294Family Practice
Franklin Hlth Farmington Family Practice
111 Franklin Health CommonsFarmingtonME04938Family Practice
Franklin Health Internal Medicine
131 Franklin Health CommonsFarmingtonME04938Internal Medicine Practice
Franklin Health Pediatrics
111 Franklin Health CommonsFarmingtonME04938Pediatrician Practice
Franklin Health Orthopaedics
111 Franklin Health CommonsFarmingtonME04938Orthopaedic Practice
Franklin Health Surgery
111 Franklin Health CommonsFarmingtonME04938General Surgery Practice
Franklin Health Urology
111 Franklin Health CommonsFarmingtonME04938Urology Practice
Rangeley Region Physical Rehabilitation
25 Dallas Hill RoadRangeleyME04970Outpatient Physical Therapy
Outpatient Services at Livermore Falls
76 Main StreetLivermore FallsME04254Outpatient Clinic
NorthStar
15 School StreetRangeleyME04970Ambulance Base
NorthStar
138C Park StreetPhillipsME04966Ambulance Base
NorthStar
119 Federal RoadLivermoreME04254Ambulance Base
NorthStar
1001 Carriage RoadCarrabasset ValleyME04947Ambulance Base
NorthStar
111 Franklin Health CommonsFarmingtonME04938Ambulance Base
Franklin Health Women's Care
111 Franklin Health CommonsFarmingtonME04938OB/GYN
Franklin Health Child Developmental Prog
131 Franklin Health CommonsFarmingtonME04938Child Developmental Program
Franklin Health Behavioral Services
131 Franklin Health CommonsFarmingtonME04938Behavioral Health Practice
Franklin Health Dermatology
111 Franklin Health CommonsFarmingtonME04938Dermatology Practice

Form990 Schedule H Part VI Form990ScheduleHPartVI (12 entries)

ExplanationExplanation
Part I, Line 7: The Organization used an overall cost to charge ratio for lines 7a and 7b. A cost to charge ratio using the internal financial accounting of the practices by group was used to calculate the amount reported on line 7g.
Part I, Line 7g: The Organization has included costs associated with primary care (Family practice, Pediatrics, Internal Medicine and Women's Care), Behavioral Services, Child & Adolescent Developmental Pediatrics and physical therapy services provided in Rangeley, ME as subsidized health services.
Part I, L7 Col(f): Amount of bad debt expense included on Form 990, Part IX, line 25 but subtracted for purposes of calculating the percentage in column 7f: $3,206,173.
Part II: See 990, Schedule H, Part VI, line 5.
Part III, Line 4: Patient accounts receivable are stated at the amount management expects to collect from outstanding balances. Management provides for probable uncollectible amounts through a charge to operations and a credit to a valuation allowance based on its assessment of individual accounts and historical adjustments. Balances that are still outstanding after management has used reasonable collection efforts are written off through a charge to the valuation allowance and a credit to patient accounts receivable.Franklin Memorial Hospital used the RCC calculated from Worksheet 2 and multiplied it by the bad debts expense per the financials. Bad debts include 100% of the charges written off due to no payment. If a payment is made on a bad debt account, then that payment reduces the bad debt expense in the year received. FMH has estimated that approximately 20% of the bad debt accounts is attributable to patients who are likely to qualify for charity care. This estimate is based on discussion with financial counselors regarding the number of denied applications due to incomplete documentation as well as overall demographic situation in the service area.
Part III, Line 8: The Medicare Principles of Reimbursement were used to determine the Medicare inpatient and outpatient costs based on the Organization's cost report.
Part III, Line 9b: Patient balances are screened for eligibility for financial assistance by outside collection agency and are transferred back to Franklin Memorial Hospital for follow up with a counselor as needed. Balances that are owed to the Hospital after applying any financial assistance are collected in the same manner as any other self pay balances.
Part VI, Line 2: The Franklin Memorial Hospital Network conducts a health visioning process every two years that is used to identify needs and perceived priorities in the community. A physician survey is conducted periodically to assist in gathering information about clinical care needs, referral patterns, specialist needs, etc. The Long-Range Planning Committee, board of directors, and senior leadership use this and other data in developing goals and priorities, making decisions, and setting long-term goals and strategies. The Organization seeks to meet the needs of the population whenever feasible through direct provision of services, contractual relationships, or through referral.
Part VI, Line 3: When patients are registered there are brochures available that describe Franklin Memorial Hospital's charity care programs. When a patient is admitted with no insurance, registration sends a financial counselor up to the patient's room to meet the patient. Each bill provided to a patient has the phone number to call if the patient needs financial assistance. The Organization's billers also refer patients to the Organization's financial counselors when a patient is identified as needing assistance. The Organization's pre-collection and collection agencies also educate patients and help to set them up with financial assistance when needed.
Part VI, Line 4: Franklin Memorial Hosptial's service area covers 2,200 square miles which extends to the Canadian border. It is one of the most rural and economically challenged regions in Maine, including several areas that have been federally designated as health professional shortage and medically underserved areas.
Part VI, Line 6: Community BuildingPhysical Improvements and Housing:1. Development and maintenance of the rail trail which is on FMH property - available to the public to encourage health and wellness. Economic Development:1. Member of Greater Franklin Development Corporation - an organization committed to economic developmentCommunity Support:1. Provided Safe Voices, a Women's Advocacy Program with low cost rental space.2. Perform disaster drills with the community 1-2 times a year3. Community Dental (provide low cost rental space)During 2011, Franklin Memorial Hospital donated two vacated buildings to local organizations in support of their services provided to the community. One of the buildings was donated to Safe Voices, a 501(c)(3) not for profit organization providing services to victims of domestic abuse. Another building was donated to the Town of Farmington to house the police department which was in need of larger space to support their operations. Both buildings were vacated by physician practices which were moved to the newly constructed Medical Arts Building located on hospital campus.Coalition building:1. Provided by HCC a subsidiary of FCHN - HCC's mission is to measurably improve the health and well-being of all people in Greater Franklin County using a coordinated approach of education, health promotion, and outreach. HCC offers health screenings, health information, and programs and events to support healthy lifestyles that prevent disease and improve quality of life.2. AHEC Education Center - Established in 2004 the Franklin AHEC program was developed out of great interest from employees and community members requesting local opportunities to pursue careers in the health field and educational programs for retention and professional growth. The Franklin AHEC allows us to meet the needs of the rural population. It also brings to the Maine AHEC Network the resources of a large innovative rural health system that include a community hospital, Maine's oldest Healthy Community Coalition and the Ben Franklin Center which houses a state of the art education center, medical library facilities, and distance learning opportunities. The program has greatly expanded to include many aspects and activities for retention and recruitment forhealth careers in our vast rural catchment area. Becoming an AHEC center allows us to partner with youth programs, public schools, multiple colleges, adult education, a local career center and other health career programs to offer community members, displaced workers and current healthcare employees the opportunity to continue or pursue careers.3. HealthInfoNet: Since August 15 hospitals including FMH, and more than 2,000 health care providers in Maine now have access to a new consolidated electronic health record made possible by HealthInfoNet that contains critical information drawn from records that have traditionally been separately maintained in physician practices, hospitals and other settings. Armed with more complete and timely information about a patient, clinicians can provide better quality care and improve the coordination of care, particularly for those patients who see several providers and receive care in more than one community or setting.
Part VI, Line 7: Franklin Communith Health Network: Supporting OrganizationFranklin Memorial Hospital: Community hospitalHealthy Community Coalition: A subsidiary of FCHN - HCC's mission is to measurably improve the health and well-being of all people in Greater Franklin County using a coordinated approach of education, health promotion, and outreach. HCC offers health screenings, health information, and programs and events to support healthy lifestyles that prevent disease and improve quality of life.Evergreen Behavioral Services: Operates 24/7 emergency mental health response services for the Greater Franklin County area as well as bordering towns of Androscoggin & Oxford counties.

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Records Maintained1RecordsMaintained

Recipient Table RecipientTable (3 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEIN Of RecipientEINOfRecipientIRC SectionIRCSectionAmount Of Non Cash AssistanceAmountOfNonCashAssistanceMethod Of ValuationMethodOfValuationDescription Of Non Cash AssistanceDescriptionOfNonCashAssistancePurpose Of GrantPurposeOfGrantAmount Of Cash GrantAmountOfCashGrant
Town of Farmington
153 Farmington Falls RoadFarmingtonME04938016000163Government271233Book ValueDonated BuildingTo support community services
Safe Voices
PO Box 713AuburnME04212010352658501(c)(3)138870Book ValueDonated BuildingTo support community services
LifeFlight Foundation
PO Box 940BangorME044020940522377085501(c)(3)Organizational Support10000
FieldValueIRS element (for citing)
Total Nbr Of501 C3 And Govt Grants3TotalNbrOf501C3AndGovtGrants
Total Nbr Of Other Organizations0TotalNbrOfOtherOrganizations

Form990 Schedule I Part IV Form990ScheduleIPartIV

FieldValueIRS element (for citing)
IdentifierProcedure for Monitoring Grants in the U.S.:Identifier
Return ReferencePart I, Line 2:ReturnReference
ExplanationSchedule I, Part I, Line 2: All assistance is given to either 501(c)(3) public charities or governmental units and their affiliates. Therefore, additional monitoring is not deemed necessary.Explanation

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation CommitteeXCompensationCommittee
Independent ConsultantXIndependentConsultant
Form990 Of Other OrganizationsXForm990OfOtherOrganizations
Written Employment ContractXWrittenEmploymentContract
Compensation SurveyXCompensationSurvey
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance Payment0SeverancePayment
Supplemental Nonqual Retire Plan0SupplementalNonqualRetirePlan
Equity Based Comp Arrangement0EquityBasedCompArrangement
Comp Based On Revenue Of Filing Org0CompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related Orgs0CompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing Org0CompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate Orgs0CompBasedNetEarningsRelateOrgs
Any Non Fixed Payments0AnyNonFixedPayments
Initial Contract Exception0InitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (12 entries)

Base Compensation Filing OrgBaseCompensationFilingOrgComp Based On Related OrgsCompBasedOnRelatedOrgsBonus Filing OrgBonusFilingOrgBonus Related OrgsBonusRelatedOrgsOther Compensation Filing OrgOtherCompensationFilingOrgOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Filing OrgDeferredCompFilingOrgDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Filing OrgTotalCompensationFilingOrgTotal Compensation Related OrgsTotalCompensationRelatedOrgsComp Report Prior990 Filing OrgCompReportPrior990FilingOrgComp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
Rebecca Ryder
03246410220000002201308744037739800
Dr Peter Cordner
302380068470005219091110323557000
Dr Connie Adler
160327088820009196088190187224000
Dr David Hyde
2677260000082720123140288312000
Gerald Cayer
0191942000005907012307021015600
Eric Martinsen
01595860001650007308010678019407200
Nancy Cummings
4180390795000098000140900449879000
Richard Batstone
4197190565220006130106150487469000
Eric Gunther
31366102921500098000126590365335000
Joshua D Sparling
32850908285500051900136160430170000
Larry Michael Fraley
331327000006130131520345092000
Dr Armand Auger
1612590284190009070085360207284000

Schedule K IRS990ScheduleK

Form990 Schedule K Part I Form990ScheduleKPartI

Issuer Name IssuerName

FieldValueIRS element (for citing)
Business Name Line1Maine Health & Higher Ed Facilities AuthorityBusinessNameLine1
FieldValueIRS element (for citing)
Issuer EIN010314384IssuerEIN
CUSIP Number560425G20CUSIPNumber
Date Issued2006-09-07DateIssued
Issue Price15270692IssuePrice
Description Of PurposeMRI, Medical Office BuildingDescriptionOfPurpose
Defeased0Defeased
On Behalf Of Issuer0OnBehalfOfIssuer
Pool Financing0PoolFinancing

Form990 Schedule K Part II Form990ScheduleKPartII

FieldValueIRS element (for citing)
Total Proceeds15270692TotalProceeds
Amount In Reserve Fund1775346AmountInReserveFund
Issuance Costs From Proceeds221065IssuanceCostsFromProceeds
Capital Expenditures13274282CapitalExpenditures
Year Of Subst Completion2008YearOfSubstCompletion
Current Refunding0CurrentRefunding
Advance Refunding0AdvanceRefunding
Final Allocation Made1FinalAllocationMade
Adequate Books And Recds Maintaind1AdequateBooksAndRecdsMaintaind

Form990 Schedule K Part III Form990ScheduleKPartIII

FieldValueIRS element (for citing)
Owning Bond Financed Property0OwningBondFinancedProperty
Any Lease Arrangements0AnyLeaseArrangements
Mngment Cntrct Bond Financd Prprty0MngmentCntrctBondFinancdPrprty
Any Research Agreements0AnyResearchAgreements
Bond Counsel Routinely Engaged1BondCounselRoutinelyEngaged
Post Issuance Compliance Procdrs1PostIssuanceComplianceProcdrs

Form990 Schedule K Part IV Form990ScheduleKPartIV

FieldValueIRS element (for citing)
Form8038 T Filed0Form8038TFiled
Variable Rate Issue0VariableRateIssue
Hedge Identified In Books And Recds0HedgeIdentifiedInBooksAndRecds
Gross Proceeds Invested In GIC0GrossProceedsInvestedInGIC
Gross Proceeds Invested0GrossProceedsInvested
Exception To Rebate0ExceptionToRebate

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (9 entries)

IdentifierIdentifierExplanationExplanationReturn ReferenceReturnReference
Form 990, Part VI, Section A, line 6The Organization consists of one Member, Franklin Community Health Network. Action of the Member shall be evidenced by written consents that are executed on its behalf by any officer of the Member who is authorized so to act by the board of directors of the Member. The written consent evidencing the annual meeting of the Member shall be adopted and effective as of a date immediately following the annual meeting of the board of directors of the Member or such later date as may be set forth in such written consent. The effective date set forth in such written consent shall be the date of the annual meeting of the year in question.
Form 990, Part VI, Section A, line 7aThe Member has rights and powers to establish the size of the board of directors of the Organization within the limits prescribed by the Articles of Incorporation and to elect and remove certain directors of the Organization in accordance with the Articles of Incorporation and Bylaws.
Form 990, Part VI, Section A, line 7bThe Member has the following rights and powers: 1. To amend or restate the Articles of Incorporation and Bylaws of the Organization 2. To approve any merger or consolidation of the Organization 3. To approve the dissolution of the Organization 4. To authorize any sale of all, or substantially all, of the assets of the Organization 5. To approve any mortgage, lien, pledge or security interest in all or substantially all, of the assets of the Organization 6. To annually establish the number of seats on the board of directors within the range established by the Articles of Incorporation and to elect or remove directors of the Organization 7. To approve any fundraising activity conducted by the Organization 8. To designate the auditor, corporate counsel and registered agent for the Organization 9. To approve the commencement of any new venture, or major capital acquisitions, by the Organization 10. To approve any capital or operating budgets of the Organization 11. To approve the selection or dismissal of the President of the Organization and establish the compensation and other terms and conditions of employment of the President 12. To make and revoke any elections available under Section 501(h) of the Internal Revenue Code of 1986
Form 990, Part VI, Section B, line 11The Organization reviewed the Form 990 with the officers of the board of directors prior to filing the tax return in a form of a presentation and a Q&A session to address any questions or concerns.
On an annual basis board members and officers are required to submit a conflict of interest statement which is then reviewed by the compliance committee. The compliance committee is responsible for regularly and consistently monitoring and enforcing compliance with the conflict of interest policy.Form 990, Part VI, Section B, line 12c
Executive compensation is determined by the compensation committee which consists of the Board Chair and several board members. The compensation committee uses an independent executive search firm that assists with executive salary determination by providing compensation survey results, along with review of executive compensation reported by other health care organizations on their Form 990. The compensation committee approves the executive compensation package prior to contract execution.Form 990, Part VI, Section B, line 15
The Organization's governing documents, conflict of interest policy, and financial statements are available to the public upon request.Form 990, Part VI, Section C, line 19
Changes in Net Assets or Fund Balances:Change in Net Assets of Affiliate 289,842. Net Change in Perpetual Trust 44,411. Equity Transfers from Affiliates -224,761. Total to Form 990, Part XI, Line 5: 109,492.Form 990, Part XI, line 5:
Oversight of AuditThe audit process has not changed from the prior year.Form 990, Part XI, Line 2c:

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (4 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusDirect Controlling Entity NADirectControllingEntityNAControlled OrgControlledOrgBusiness Name Line1DirectControllingEntityName/BusinessNameLine1
Franklin Community Health Network
111 Franklin Health CommonsFarmingtonME04938223209406Supporting OrganizationME501(c)(3)Line 11b, IIN/A0
Healthy Community Coalition
105 Mt Blue Circle Suite 1FarmingtonME04938223305743Community OutreachME501(c)(3)Line 70Franklin Community Health Network
Pine Tree Medical Associates
131 Franklin Health CommonsFarmingtonME04938010469478Community Health AgencyME501(c)(3)Line 90Franklin Community Health Network
Evergreen Behavioral Services
131 Franklin Health CommonsFarmingtonME04938010492747Mental Health AgencyME501(c)(3)Line 90Franklin Community Health Network
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents Royalties0ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org1GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org1GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org0LoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other Org0SaleOfAssetsToOtherOrg
Purchase Of Assets From Other Org0PurchaseOfAssetsFromOtherOrg
Exchange Of Assets0ExchangeOfAssets
Rental Of Facilities To Other Orgs1RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs0RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs0PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs0PerformOfServicesByOtherOrgs
Sharing Of Facilities0SharingOfFacilities
Sharing Of Paid Employees0SharingOfPaidEmployees
Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrg
Other Transfer To Other Org1OtherTransferToOtherOrg
Other Transfer From Other Org0OtherTransferFromOtherOrg