2011-05-02T09:31:18-05:00 2010-06-30 Baker Newman & Noyes 280 Fore Street Portland ME 04101 990 2009-07-01 043369649 MaineGeneral Health MAIN 2076261000 6 East Chestnut Street Augusta ME 043305717 Michael Koziol 2076261230 2011-05-02 2078792100 2009 2016-02-24 21:20:13Z Scott B Bullock 6 East Chestnut Street Augusta ME 043305717 14895785 0 9706 X www.mainegeneral.org X 1997 ME MaineGeneral Health exercises general supervision over tax-exempt subsidiaries and develops and implements overall goals and strategies for the system-wide delivery of necessary health care services in an efficient and coordinated manner. 21 16 122 21 0 0 180038 224013 13174106 12364611 -1145769 503381 0 12208375 13092005 5750 0 0 9816890 9593419 0 699547 3128659 2925153 12951299 12518572 -742924 573433 15905107 16565227 10831412 11014276 5073695 5550951 MaineGeneral Health's mission is to enhance every day the health of the people of the greater Kennebec Valley Region. Management follows this mission with a forward-looking vision of focusing on clinical excellence, customer satisfaction, financial stability, and positively implements overall goals and strategies for the system-wide delivery of necessary health care services in an efficient and coordinated manner. 0 0 6947077 12364611 MaineGeneral Health exercises general supervision over and provides administrative services for tax-exempt subsidiaries. MaineGeneral Health develops and implements overall goals and strategies for the system-wide delivery of necessary health care services in an efficient and coordinated manner. MaineGeneral Health keenly focuses on preventive health and supports many ongoing health services throughout surrounding communities. 6947077 1 1 0 0 0 0 0 0 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 1 571 0 1 122 1 0 0 0 0 0 0 0 0 0 21 16 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 X X Mary Griswold Controller 2076261289 6 East Chestnut Street Augusta ME 043305717 William Adams PhD 1.00 X 0 0 0 Peter Alfond 1.00 X 0 0 0 Conrad Ayotte 2.00 X 0 0 0 Diane Campbell MD 1.00 X 0 33063 0 Douglas Cutchin 1.00 X 0 0 0 Charles Danielson MD 2.00 X 0 0 0 Margaret Griffin MD 1.00 X 0 0 0 Peter Guzzetti DO D 1.00 X 0 30075 100 Jeffrey Hubert CPA 1.00 X 0 0 0 Frederick LaRochelle M 1.00 X 0 199016 23400 Robert Marden 1.00 X 0 0 0 Barbara Mayer 2.00 X 0 0 0 Roy Miller MD 1.00 X 0 0 0 Elizabeth Mitchell 1.00 X 0 0 0 Gordon Pow 1.00 X 0 0 0 Brian Rines PhD 1.00 X 0 0 0 Tobi Schneider Esq 1.00 X 0 0 0 William Sprague 1.00 X 0 0 0 Kenneth Viens 1.00 X 0 0 0 Barbara Woodlee EdD 1.00 X 0 0 0 Scott B Bullock 50.00 X 585466 0 41537 Douglas Boyink MD 1.00 X 0 265934 30268 Douglas Terp 1.00 X 0 0 0 Karen Tobias 45.00 X 55678 0 13868 Michael Koziol 50.00 X 206744 0 14265 Barbara Crowley MD 50.00 X 297713 0 40520 Charles W Hays 50.00 X 250073 0 15661 Steven Diaz MD 50.00 X 230062 0 32053 Andrew Hertler MD 50.00 X 277234 0 24917 Gail M Evans 50.00 X 181700 0 20365 2084670 528088 256954 16 0 1 0 PricewaterhouseCoopers LLP PO Box 7247-8001 Philadelphia PA 191708001 Auditing 375516 1 224013 224013 Management Fee Revenue 561000 12364611 12364611 12364611 291298 291298 2015863 1803780 212083 212083 212083 13092005 12364611 0 503381 932796 321548 611248 6962848 3850888 2676672 435288 733668 405668 282121 45879 475437 262890 182817 29730 488670 270211 187902 30557 120305 120305 294178 294178 46508 46508 184111 48524 69446 66141 336413 144743 155016 36654 130415 75737 46709 7969 8847 947 7900 75588 75588 108766 87303 17972 3491 15763 15763 Consultant Fees 549116 457970 91146 Professional Membership 451605 446069 3681 1855 Purchased Services 179229 87853 68729 22647 Recruitment 80095 80095 Educational Assistance 78791 78791 265423 206691 47296 11436 12518572 6947077 4871948 699547 100 288102 1923078 4403693 651 24651 51779 27372 2199714 443856 454972 865571 378995 546183 486576 5443711 6231002 7495749 2449145 15905107 16565227 2034456 2524130 14756 25268 2917332 2258020 5864868 6206858 10831412 11014276 X 4456304 4868371 78995 154783 538396 527797 5073695 5550951 15905107 16565227 X 0 1 1 X 0 X X X X 0 0 0 MaineGeneral Medical Center 043369653 3 1 1 1 0 HealthReach Network 010524384 9 1 1 1 0 MaineGeneral Rehabilitation & Nursing Care 222789192 11 1 1 1 0 MaineGeneral Health Associates 222516766 11 1 1 1 0 MaineGeneral Retirement Community 010627194 9 1 1 1 0 5 0 RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 4909719 189201 697657 0 196257 0 5600320 6099484 127387 -1103372 17018 196762 0 4909719 0.87800 0.02800 0.09400 0 0 17946 17946 20948 11375 9573 148779 14165 134614 677898 353455 324443 486576 Due from affiliates 2449145 2449145 Accrued pension costs 2971357 Accrued deferred compensation 626949 Other long-term liabilities 50480 Self insurance reserve - health 2299498 Self insurance reserve - dental 195639 Workers compensation accrual 62935 6206858 13092005 12518572 573433 374348 -470525 -96177 477256 13466353 374348 374348 13092005 0 13092005 12989097 470525 470525 12518572 0 12518572 Part V, Line 4: Description of Intended Use of Endowment Funds: MaineGeneral Health's intended uses of endowment funds are as follow: 1. to fund community health projects; 2. to annually fund those projects considered to be of the highest priority; 3. to provide funds for scholarships; 4. to fund educational programs; 5. to provide a source of funds for an executive deferred compensation plan; 6. and to self-fund workers compensation claims and related expenses. Part X, Line 2 - There were no disclosures reporting MaineGeneral Health's liability for uncertain tax positions under FIN 48. Part XI, Line 8 - Pension-related changes other than net periodic pension cost X 1 1 X X X 0 1 0 0 0 0 0 1 0 Frederick LaRochelle MD 0 178588 0 17512 0 2916 0 10215 0 13185 0 222416 0 0 Scott B Bullock 386933 0 0 0 198533 0 20825 0 20712 0 627003 0 0 0 Douglas Boyink MD 0 245853 0 17362 0 2719 0 21643 0 8625 0 296202 0 0 Michael Koziol 206029 0 0 0 715 0 7547 0 6718 0 221009 0 0 0 Barbara Crowley MD 291952 0 0 0 5761 0 24418 0 16102 0 338233 0 0 0 Charles W Hays 244477 0 0 0 5596 0 12795 0 2866 0 265734 0 0 0 Steven Diaz MD 229375 0 365 0 322 0 13032 0 19021 0 262115 0 0 0 Andrew Hertler MD 276785 0 0 0 449 0 12951 0 11966 0 302151 0 0 0 Gail M Evans 180541 0 0 0 1159 0 10129 0 10236 0 202065 0 0 0 Part I, Line 1a Part I, Line 1a: Tax Gross-Up Payments Karen Tobias Yes $ 272 Treated as taxable compensation Scott Bullock Yes $2,082 Treated as taxable compensation Barbara Crowley Yes $ 65 Treated as taxable compensation Charles Hays Yes $ 64 Treated as taxable compensation Part I, Line 4a Scott Bullock has a supplemental defined benefit arrangement, and no contributions were made during the 2009 tax year that had not been included on Form W-2 as taxable compensation. Part I, Line 7 Part I, Line 7: A portion of compensation is at risk and variable and is based on the quality of job performance. Form 990, Part VI, Section B, line 11 All Forms 990 and related attachments were reviewed by appropriate members of senior management, the Finance Committee, and the Board of Directors before the filings were sent to the Internal Revenue Service. Final drafts of Forms 990 were available thirty days prior to the filing deadline in order to be formally reviewed by the Senior Vice President and Chief Financial Officer, the Compliance Officer, the entire senior management team, the Finance Committee, and the Board of Directors. Forms 990 and related attachments were provided to and reviewed by the Finance Committee in March 2011 and by the Board of Directors in April 2011. In addition, both the Finance Committee and Board were provided formal education on the contents and layouts of Forms 990 and of organizational policies and procedures related to Form 990. Form 990, Part VI, Section B, line 12c MaineGeneral Health's Conflict of Interest Policy requires disclosure of any actual or potential conflict of interest to the Board Chair. Interested persons are prohibited from participating in the governing body's deliberations and decisions regarding any transations when they have a conflict of interest. If the Board or Committee has reasonable cause to believe that a member has failed to disclose actual or possible conflicts of interest, the Board or Committee shall investigate and then determine by a majority vote whether a conflict of interest exists and whether the violation is grounds for removal from the Board or Committee. There are formal records of these proceedings. In addition, each director, officer, and member of the Board is required to annually complete and sign a Conflict of Interest Disclosure Statement. Employees must disclose in writing to their supervisors any conflicts of interest prior to engaging in transactions or taking positions with MaineGeneral Health. In addition, these disclosures must be approved by the supervisor's manager or, as applicable, the Board Chair, in conjunction with the Human Resources Compliance Officer. If management has reasonable cause to believe that an employee has intentionally failed to disclose a conflict of interest, appropriate disciplinary or corrective action up to and including termination shall be taken. In addition, upon hire or promotion to a management position, all management employees shall complete a Conflict of Interest Disclosure Statement, which will be submitted to the Ethics and Compliance Department for review and reporting to the Chief Compliance Officer, who will record and report each validated conflict of interest to the Board. Form 990, Part VI, Section B, line 15 The Board of Directors is responsible for determining the compensation package for the chief executive officer. An independent compensation consultant advises the Board using comparability data, expert compensation studies and other means. Paid executives who hold voting privileges may not vote or participate in discussions regarding their compensation; however, they may answer questions that will help the Board in its deliberations. For other officer and key employee positions, salary structures are developed and maintained based on national compensation data for healthcare organizations. The Chief Executive Officer's compensation was last reviewed in 2009 and will be reviewed again in November 2011. Form 990, Part VI, Section C, line 19 MaineGeneral Health makes its governing documents, conflict of interest policy and financial statements, whether or not audited, available to the general public by providing copies immediately upon request. In addition, the Controller distributes financial statements and budgets on a quarterly and annual basis to designated third parties. Form 990, Part XI, Line 2c Change in oversight or selection process during the tax year MaineGeneral Health did not change its oversight process or selection process during the tax year. MaineGeneral Medical Center 6 East Chestnut Street Augusta ME 04330 043369653 Hospital ME 170(b)(1)(A)(ii) 501(c)(3) MaineGeneral Health HealthReach Network 6 East Chestnut Street Augusta ME 04330 010524384 Provider of homecare, hospice, and community support services ME 509(a)(2) 501(c)(3) MaineGeneral Health MaineGeneral Rehabilitation & Nursing Care 6 East Chestnut Street Augusta ME 04330 222789192 Provider of long term and residential care services ME 509(a)(3) 501(c)(3) MaineGeneral Health MaineGeneral Health Associates 6 East Chestnut Street Augusta ME 04330 222516766 Provider of primary and specialty care physician services ME 509(a)(3) 501(c)(3) MaineGeneral Health MaineGeneral Retirement Community 6 East Chestnut Street Augusta ME 04330 010627194 Provider of assisted and residential living services ME 509(a)(2) 501(c)(3) MaineGeneral Health 1 0 0 1 0 0 0 0 0 0 1 0 0 0 0 0 0 0 (1) MaineGeneral Medical Center A 67209 (2) MaineGeneral Rehabilitation & Nursing Care A 18220 (3) HealthReach Network A 697 (4) MaineGeneral Medical Center K 12008405 (5) MaineGeneral Rehabilitation & Nursing Care K 58000 (6) HealthReach Network K 327000