NORTHERN MAINE MEDICAL CENTER: Form 990, tax year 2018
View the entire original 990 at ProPublica ↗
- Organization
- NORTHERN MAINE MEDICAL CENTER (EIN 01-0234189)
- Tax period
- 2018-10-01 to 2019-09-30
- Filed
- 2020-06-12
- IRS object ID
- 202011649349300731
- Schema version
- 2018v3.1
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
- Return header
- Form 990
- Schedule A
- Schedule B
- Schedule C
- Schedule D
- Schedule G
- Schedule H
- Schedule J
- Schedule L
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2020-06-12T13:11:52-05:00 | ReturnTs |
| Tax Period End | 2019-09-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 010523282 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Berry Dunn McNeil & Parker LLC | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO Box 1100 | AddressLine1Txt |
| City | Portland | CityNm |
| State Abbreviation | ME | StateAbbreviationCd |
| ZIP | 041041100 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2018-10-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 010234189 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Northern Maine Medical Center | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | NORT | BusinessNameControlTxt |
| Phone | 2078343155 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 194 East Main Street | AddressLine1Txt |
| City | Fort Kent | CityNm |
| State Abbreviation | ME | StateAbbreviationCd |
| ZIP | 04743 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Cindy Daigle | PersonNm |
| Person Title | CFO | PersonTitleTxt |
| Phone | 2078343155 | PhoneNum |
| Signature | 2020-06-10 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | Joseph R Byrne | PreparerPersonNm |
| PTIN | P01289281 | PTIN |
| Phone | 2077752387 | PhoneNum |
| Preparation | 2020-06-10 | PreparationDt |
Filing Security Information FilingSecurityInformation
IP Address IPAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| I Pv4 Address | 69.49.157.66 | IPv4AddressTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IP | 2020-06-10 | IPDt |
| IP Tm | 10:30:45 | IPTm |
| IP Timezone | ED | IPTimezoneCd |
| Filing License Type | P | FilingLicenseTypeCd |
| At Submission Creation Device Id | E262D3C9A45A77A46A0A2832CF74466488750570 | AtSubmissionCreationDeviceId |
| At Submission Filing Device Id | E86B87CE19A618452E7D988FD4F1BB89485416DA | AtSubmissionFilingDeviceId |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2018 | TaxYr |
| Build TS | 2021-01-29 14:40:06Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | Peter J Sirois | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 194 East Main Street | AddressLine1Txt |
| City | Fort Kent | CityNm |
| State Abbreviation | ME | StateAbbreviationCd |
| ZIP | 04743 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $60,064,052 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | www.nmmc.org | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1948 | FormationYr |
| Legal Domicile State | ME | LegalDomicileStateCd |
| Activity Or Mission | Acute care & long term care hospital and mental health services facility. | ActivityOrMissionDesc |
| Voting Members Governing Body | 12 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 10 | VotingMembersIndependentCnt |
| Total Employee | 628 | TotalEmployeeCnt |
| Total Volunteers | 60 | TotalVolunteersCnt |
| Total Gross UBI | $2,621,862 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | -$402,093 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $190,974 | PYContributionsGrantsAmt |
| CY Contributions Grants | $201,868 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $54,926,458 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $58,655,111 | CYProgramServiceRevenueAmt |
| PY Investment Income | $131,272 | PYInvestmentIncomeAmt |
| CY Investment Income | $190,918 | CYInvestmentIncomeAmt |
| PY Other Revenue | $97,063 | PYOtherRevenueAmt |
| CY Other Revenue | $100,982 | CYOtherRevenueAmt |
| PY Total Revenue | $55,345,767 | PYTotalRevenueAmt |
| CY Total Revenue | $59,148,879 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $34,453,237 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $36,720,126 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $20,204,548 | PYOtherExpensesAmt |
| CY Other Expenses | $21,748,604 | CYOtherExpensesAmt |
| PY Total Expenses | $54,657,785 | PYTotalExpensesAmt |
| CY Total Expenses | $58,468,730 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $687,982 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $680,149 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $50,508,413 | TotalAssetsBOYAmt |
| Total Assets EOY | $50,243,775 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $14,352,224 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $13,388,655 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $36,156,189 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $36,855,120 | NetAssetsOrFundBalancesEOYAmt |
| Mission | The mission of Northern Maine Medical Center is to provide, coordinate, or support access to high quality, affordable health care and to positively impact our communities' quality of life by improving health status. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $52,331,797 | ExpenseAmt |
| Revenue | $58,655,111 | RevenueAmt |
| Desc | Medical care & ancillary services, nursing home & skilled services, physician services. | Desc |
| Total Program Service Expenses | $52,331,797 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (1) | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Temp Or Permanent Endowments | 0 | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | Yes (1) | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | Yes (1) | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | Yes (1) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (1) | AuditedFinancialStmtAttInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | Yes (1) | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | Yes (1) | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | Yes (1) | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | Yes (1) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | 0 | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 285 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 628 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | Yes (1) | UnrelatedBusIncmOverLimitInd |
| Form990 T Filed | Yes (1) | Form990TFiledInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | 0 | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | 0 | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 12 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 10 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | 0 | MembersOrStockholdersInd |
| Election Of Board Members | 0 | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | 0 | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | ME | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Cindy Daigle | PersonNm |
| Phone | 2078343155 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 194 East Main Street | AddressLine1Txt |
| City | Fort Kent | CityNm |
| State Abbreviation | ME | StateAbbreviationCd |
| ZIP | 04743 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (20 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|
| John Ezzy | ||||||||
| Chair | 1.50 | 0.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| Mark Morneault | ||||||||
| Vice-Chair | 1.50 | 0.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| David Desjardins | ||||||||
| Director | 1.50 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| James Thibodeau | ||||||||
| Director | 1.50 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| Robert Bellefleur | ||||||||
| Director | 1.50 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| Norman Fournier | ||||||||
| Director | 1.50 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| Donald Guimond | ||||||||
| Director | 1.50 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| Erin Soucy | ||||||||
| Director | 1.50 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| Dan Vaillancourt | ||||||||
| Director | 1.50 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| Steven Pelletier | ||||||||
| Director | 1.50 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| Gisele Dionne | ||||||||
| Director | 1.50 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| Erik St Pierre MD | ||||||||
| Director | 50.00 | 0.00 | Yes (X) | $702,653 | $0 | $33,026 | ||
| Peter J Sirois | ||||||||
| President/CEO | 50.00 | 0.00 | Yes (X) | $336,431 | $0 | $32,433 | ||
| Cindy L Daigle | ||||||||
| Treasurer/CFO | 50.00 | 0.00 | Yes (X) | $211,927 | $0 | $29,530 | ||
| Alain Bois | ||||||||
| Secretary/COO | 50.00 | 0.00 | Yes (X) | $174,451 | $0 | $16,703 | ||
| John Hallberg | ||||||||
| Orthopedic Surgeon | 50.00 | 0.00 | $571,172 | $0 | $31,269 | Yes (X) | ||
| Rodney Lahren | ||||||||
| General Surgeon | 50.00 | 0.00 | $558,553 | $0 | $32,669 | Yes (X) | ||
| John Hotchkiss | ||||||||
| Radiologist | 50.00 | 0.00 | $522,550 | $0 | $14,800 | Yes (X) | ||
| Mark Overton | ||||||||
| Psychiatrist | 50.00 | 0.00 | $508,562 | $0 | $22,330 | Yes (X) | ||
| James Harris | ||||||||
| Physician | 50.00 | 0.00 | $502,243 | $0 | $31,199 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $4,088,542 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $243,959 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 53 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| The Sheridan Corporation | |||||
| PO Box 359 | Fairfield | ME | 04937 | Building Contractor | $590,761 |
| Comphealth Medical Staffing | |||||
| PO Box 972670 | Dallas | TX | 75397 | Outsourced Physician Services | $524,088 |
| Cary Medical Center | |||||
| 163 Van Buren Rd | Caribou | ME | 04736 | Off-Site Laboratory Services | $382,169 |
| Medhost Of Tennessee Inc | |||||
| 2739 Momentum Place | Chicago | IL | 60689 | Software & Support Services | $370,115 |
| The Aroostook Medical Center | |||||
| 43 Whiting Hill Rd | Brewer | ME | 04412 | Outsourced Physician Services | $259,516 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 14 | CntrctRcvdGreaterThan100KCnt |
| All Other Contributions | $201,868 | AllOtherContributionsAmt |
| Total Contributions | $201,868 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (5 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt | Unrelated Business RevenueUnrelatedBusinessRevenueAmt | ExclusionExclusionAmt |
|---|---|---|---|---|---|
| Patient Service Revenue | 623000 | $92,247,713 | $89,625,851 | $2,621,862 | |
| Miscellaneous Revenue | 623000 | $6,199,256 | $6,029,778 | $169,478 | |
| Meaningful Use Revenue | 623000 | $59,500 | $59,500 | ||
| Provision for Bad Debt | 623000 | -$1,740,077 | -$1,740,077 | ||
| Contractual/Char. Adj. | 623000 | -$38,111,281 | -$38,111,281 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $58,655,111 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $190,433 | TotalRevenueColumnAmt |
| Exclusion | $190,433 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $55,987 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $0 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $55,987 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $55,987 | TotalRevenueColumnAmt |
| Exclusion | $55,987 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $879,543 | SecuritiesAmt |
| Other | $1,775 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $879,543 | SecuritiesAmt |
| Other | $1,290 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $0 | SecuritiesAmt |
| Other | $485 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $485 | TotalRevenueColumnAmt |
| Exclusion | $485 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fundraising Gross Income | $79,335 | FundraisingGrossIncomeAmt |
| Fundraising Direct Expenses | $34,340 | FundraisingDirectExpensesAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $44,995 | TotalRevenueColumnAmt |
| Exclusion | $44,995 | ExclusionAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $59,148,879 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $55,863,771 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $2,621,862 | UnrelatedBusinessRevenueAmt |
| Exclusion | $461,378 | ExclusionAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,537,154 | TotalAmt |
| Program Services | $735,679 | ProgramServicesAmt |
| Management And General | $801,475 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $30,315,708 | TotalAmt |
| Program Services | $27,727,706 | ProgramServicesAmt |
| Management And General | $2,588,002 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $461,994 | TotalAmt |
| Program Services | $424,397 | ProgramServicesAmt |
| Management And General | $37,597 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,470,618 | TotalAmt |
| Program Services | $2,252,008 | ProgramServicesAmt |
| Management And General | $218,610 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,934,652 | TotalAmt |
| Program Services | $1,721,840 | ProgramServicesAmt |
| Management And General | $212,812 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $116,869 | TotalAmt |
| Management And General | $116,869 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $53,139 | TotalAmt |
| Program Services | $47,294 | ProgramServicesAmt |
| Management And General | $5,845 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,784,552 | TotalAmt |
| Program Services | $3,200,562 | ProgramServicesAmt |
| Management And General | $583,990 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $68,136 | TotalAmt |
| Program Services | $61,322 | ProgramServicesAmt |
| Management And General | $6,814 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $565,540 | TotalAmt |
| Program Services | $360,635 | ProgramServicesAmt |
| Management And General | $204,905 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $367,775 | TotalAmt |
| Program Services | $130,597 | ProgramServicesAmt |
| Management And General | $237,178 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,849,816 | TotalAmt |
| Program Services | $2,620,297 | ProgramServicesAmt |
| Management And General | $229,519 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $99,464 | TotalAmt |
| Program Services | $68,446 | ProgramServicesAmt |
| Management And General | $31,018 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $304,398 | TotalAmt |
| Program Services | $273,958 | ProgramServicesAmt |
| Management And General | $30,440 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,500,446 | TotalAmt |
| Program Services | $2,250,402 | ProgramServicesAmt |
| Management And General | $250,044 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,009,780 | TotalAmt |
| Program Services | $884,054 | ProgramServicesAmt |
| Management And General | $125,726 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| Medical Supplies | $8,042,345 | $7,971,994 | $70,351 |
| Healthcare Provider Tax | $1,023,290 | $1,023,290 | |
| Miscellaneous | $887,147 | $509,000 | $378,147 |
| Dues & Subscriptions | $75,907 | $68,316 | $7,591 |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $58,468,730 | TotalAmt |
| Program Services | $52,331,797 | ProgramServicesAmt |
| Management And General | $6,136,933 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part X | Yes (X) | InfoInScheduleOPartXInd |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $274,615 | BOYAmt |
| EOY | $278,009 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $17,869,592 | BOYAmt |
| EOY | $17,871,122 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,324,896 | BOYAmt |
| EOY | $6,888,390 | EOYAmt |
Receivables From Officers Etc ReceivablesFromOfficersEtcGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $27,564 | BOYAmt |
| EOY | $10,897 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $75,000 | BOYAmt |
| EOY | $163,502 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,190,113 | BOYAmt |
| EOY | $1,280,226 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $436,628 | BOYAmt |
| EOY | $498,392 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $54,103,511 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $34,457,212 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $19,449,839 | BOYAmt |
| EOY | $19,646,299 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $564,536 | BOYAmt |
| EOY | $751,868 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $206,429 | BOYAmt |
| EOY | $185,786 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,089,201 | BOYAmt |
| EOY | $2,669,284 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $50,508,413 | BOYAmt |
| EOY | $50,243,775 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,645,752 | BOYAmt |
| EOY | $5,053,783 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,612,309 | BOYAmt |
| EOY | $6,891,991 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,094,163 | BOYAmt |
| EOY | $1,442,881 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $14,352,224 | BOYAmt |
| EOY | $13,388,655 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $35,550,663 | BOYAmt |
| EOY | $36,120,938 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $605,526 | BOYAmt |
| EOY | $734,182 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $36,156,189 | BOYAmt |
| EOY | $36,855,120 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $50,508,413 | BOYAmt |
| EOY | $50,243,775 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $680,149 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $18,782 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | 0 | VolunteersInd |
| Paid Staff Or Management | 0 | PaidStaffOrManagementInd |
| Media Advertisements | 0 | MediaAdvertisementsInd |
| Mailings Members | 0 | MailingsMembersInd |
| Publications Or Broadcast | 0 | PublicationsOrBroadcastInd |
| Grants Other Organizations | 0 | GrantsOtherOrganizationsInd |
| Direct Contact Legislators | 0 | DirectContactLegislatorsInd |
| Rallies Demonstrations | 0 | RalliesDemonstrationsInd |
| Other Activities | Yes (1) | OtherActivitiesInd |
| Other Activities | $7,080 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $7,080 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | 0 | NotDescribedSection501c3Ind |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Part II-B, Line 1: | FormAndLineReferenceDesc |
| Explanation | The Hospital pays dues to various organizations, a portion of which is attributable to lobbying expenses. | ExplanationTxt |
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $235,224 | OtherCostOrOtherBasisAmt |
| Book Value | $235,224 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $29,406,472 | OtherCostOrOtherBasisAmt |
| Depreciation | $14,034,173 | DepreciationAmt |
| Book Value | $15,372,299 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $21,037,890 | OtherCostOrOtherBasisAmt |
| Depreciation | $19,655,221 | DepreciationAmt |
| Book Value | $1,382,669 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $3,423,925 | OtherCostOrOtherBasisAmt |
| Depreciation | $767,818 | DepreciationAmt |
| Book Value | $2,656,107 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $19,646,299 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp (4 entries)
| DescDesc | Book ValueBookValueAmt |
|---|---|
| Deferred Compensation | $1,442,881 |
| Cash Surrender Value of Life Insurance | $397,668 |
| Estimated Third-Party Payor Settlements | $728,735 |
| Insurance Claims Receivable | $100,000 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $2,669,284 | TotalBookValueOtherAssetsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | Deferred Compensation | Desc |
| Amt | $1,442,881 | Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $1,442,881 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Part X, Line 2: | FormAndLineReferenceDesc |
| Explanation | The Medical Center and VMA are not-for-profit corporations as described in Section 501(c)(3) of the Internal Revenue Code (the Code), and are exempt from federal income taxes on related income pursuant to Section 501(a) of the Code. Management evaluated the Medical Center's tax positions and concluded the Medical Center has maintained its tax-exempt status, does not have any significant unrelated business income and has taken no uncertain tax positions that require adjustment or disclosure in the consolidated financial statements. | ExplanationTxt |
Schedule G IRS990ScheduleG
Fundraising Event Information FundraisingEventInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Event1 | Annual Auction | Event1Nm |
| Gross Receipts Event1 | $54,957 | GrossReceiptsEvent1Amt |
| Gross Revenue Event1 | $54,957 | GrossRevenueEvent1Amt |
| Non Cash Prizes Event1 | $20,519 | NonCashPrizesEvent1Amt |
| Rent Facility Costs Event1 | $2,972 | RentFacilityCostsEvent1Amt |
| Food And Beverage Event1 | $7,286 | FoodAndBeverageEvent1Amt |
| Entertainment Event1 | $450 | EntertainmentEvent1Amt |
| Other Direct Expenses Event1 | $1,270 | OtherDirectExpensesEvent1Amt |
| Event2 | Cancer Fund Tour | Event2Nm |
| Gross Receipts Event2 | $24,378 | GrossReceiptsEvent2Amt |
| Gross Revenue Event2 | $24,378 | GrossRevenueEvent2Amt |
| Cash Prizes Event2 | $106 | CashPrizesEvent2Amt |
| Non Cash Prizes Event2 | $1,303 | NonCashPrizesEvent2Amt |
| Food And Beverage Event2 | $434 | FoodAndBeverageEvent2Amt |
| Gross Receipts Total | $79,335 | GrossReceiptsTotalAmt |
| Gross Revenue Total Events | $79,335 | GrossRevenueTotalEventsAmt |
| Cash Prizes Total Events | $106 | CashPrizesTotalEventsAmt |
| Non Cash Prizes Total Events | $21,822 | NonCashPrizesTotalEventsAmt |
| Rent Fclty Costs Total Events | $2,972 | RentFcltyCostsTotalEventsAmt |
| Food And Beverage Total Events | $7,720 | FoodAndBeverageTotalEventsAmt |
| Entertainment Total Events | $450 | EntertainmentTotalEventsAmt |
| Oth Direct Expnss Total Events | $1,270 | OthDirectExpnssTotalEventsAmt |
| Direct Expense Summary Events | $34,340 | DirectExpenseSummaryEventsAmt |
| Net Income Summary | $44,995 | NetIncomeSummaryAmt |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (1) | FinancialAssistancePolicyInd |
| Written Policy | Yes (1) | WrittenPolicyInd |
| All Hospitals Policy | Yes (X) | AllHospitalsPolicyInd |
| FPG Reference Free Care | Yes (1) | FPGReferenceFreeCareInd |
| Percent150 | Yes (X) | Percent150Ind |
| FPG Reference Discounted Care | Yes (1) | FPGReferenceDiscountedCareInd |
| Percent200 D | Yes (X) | Percent200DInd |
| Free Care Medically Indigent | 0 | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (1) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | 0 | ExpensesExceedBudgetInd |
| Annual Community Bnft Report | Yes (1) | AnnualCommunityBnftReportInd |
| Report Publically Available | Yes (1) | ReportPublicallyAvailableInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $174,439 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $174,439 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00300 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $2,598,539 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $2,169,988 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $428,551 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00730 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $2,772,978 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $2,169,988 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $602,990 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01030 | TotalExpensePct |
Subsidized Health Services SubsidizedHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $24,445,878 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $20,323,768 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $4,122,110 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.07050 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $24,445,878 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $20,323,768 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $4,122,110 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.07050 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $27,218,856 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $22,493,756 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $4,725,100 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.08080 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (1) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $967,758 | BadDebtExpenseAmt |
| Reimbursed By Medicare | $19,143,273 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $19,223,517 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$80,244 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | Yes (X) | OtherInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (1) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (1) | FinancialAssistancePrvsnInd |
| Hospital Facilities | 2 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp (2 entries)
| FacilityFacilityNum | Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | Website AddressWebsiteAddressTxt | State LicenseStateLicenseNum | Licensed HospitalLicensedHospitalInd | General Medical And SurgicalGeneralMedicalAndSurgicalInd | Emergency Room24 HrsEmergencyRoom24HrsInd | Emergency Room OtherEmergencyRoomOtherInd | OtherOtherDesc |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Northern Maine Medical Center | |||||||||||
| 1 | 194 East Main Street | Fort Kent | ME | 04743 | www.nmmc.org | 38986 | Yes (X) | Yes (X) | Yes (X) | ||
| Forest Hill | |||||||||||
| 2 | 20 Bolduc Avenue | Fort Kent | ME | 04743 | Yes (X) | Licensed Hospital Related Facility | |||||
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Northern Maine Medical Center | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| First Licensed CY Or PY | 0 | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | 0 | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | Yes (1) | CHNAConductedInd |
| Community Definition | Yes (X) | CommunityDefinitionInd |
| Community Demographics | Yes (X) | CommunityDemographicsInd |
| Existing Resources | Yes (X) | ExistingResourcesInd |
| How Data Obtained | Yes (X) | HowDataObtainedInd |
| Community Health Needs | Yes (X) | CommunityHealthNeedsInd |
| Other Health Issues | Yes (X) | OtherHealthIssuesInd |
| Community Hlth Needs Id Process | Yes (X) | CommunityHlthNeedsIdProcessInd |
| Consulting Process | Yes (X) | ConsultingProcessInd |
| Other | Yes (X) | OtherInd |
| CHNA Conducted | 17 | CHNAConductedYr |
| Take Into Account Others Input | Yes (1) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | Yes (1) | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | Yes (1) | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (1) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | www.nmmc.org/community-health-needs-assessment | OwnWebsiteURLTxt |
| Rpt Available Thru Other Method | Yes (X) | RptAvailableThruOtherMethodInd |
| Implementation Strategy Adopt | Yes (1) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 17 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (1) | StrategyPostedWebsiteInd |
| Strategy Website URL | www.nmmc.org/community-health-needs-assessment | StrategyWebsiteURLTxt |
| Organization Incur Excise Tax | 0 | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (1) | EligCriteriaExplainedInd |
| FPG Family Incm Lmt Free Dscnt | Yes (X) | FPGFamilyIncmLmtFreeDscntInd |
| FPG Family Incm Lmt Free Care | 150.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 200.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| Explained Basis | Yes (1) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (1) | AppFinancialAsstExplnInd |
| Described Info | Yes (X) | DescribedInfoInd |
| Described Suprt Doc | Yes (X) | DescribedSuprtDocInd |
| Provided Hospital Contact | Yes (X) | ProvidedHospitalContactInd |
| Includes Publicity Measures | Yes (1) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | http://www.nmmc.org/billing/ | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | http://www.nmmc.org/billing/ | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | http://www.nmmc.org/billing/ | FAPSummaryOnWebsiteURLTxt |
| FAP Avlbl On Request No Charge | Yes (X) | FAPAvlblOnRequestNoChargeInd |
| FAP App Avlbl On Request No Chrg | Yes (X) | FAPAppAvlblOnRequestNoChrgInd |
| FAP Sum Avlbl On Request No Chrg | Yes (X) | FAPSumAvlblOnRequestNoChrgInd |
| Notified FAP Copy Bill Display | Yes (X) | NotifiedFAPCopyBillDisplayInd |
| Communtity Notified FAP | Yes (X) | CommuntityNotifiedFAPInd |
| FAP Translated | Yes (X) | FAPTranslatedInd |
| FAP Actions On Nonpayment | Yes (1) | FAPActionsOnNonpaymentInd |
| Permit No Actions | Yes (X) | PermitNoActionsInd |
| Collection Activities | 0 | CollectionActivitiesInd |
| Provided Written Notice | Yes (X) | ProvidedWrittenNoticeInd |
| Made Effort Orally Notify | Yes (X) | MadeEffortOrallyNotifyInd |
| Processed FAP Application | Yes (X) | ProcessedFAPApplicationInd |
| Nondis Emergency Care Policy | Yes (1) | NondisEmergencyCarePolicyInd |
| Look Back Medicare Private | Yes (X) | LookBackMedicarePrivateInd |
| Amounts Generally Billed | 0 | AmountsGenerallyBilledInd |
| Gross Charges | 0 | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (7 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Northern Maine Medical Center | Part V, Section B, Line 3j: The Community Health Needs Assessment was developed by the Eastern Maine Health System (EMHS) utilizing a consulting firm called JSI to support member organizations and community partners' work to conduct the needs assessments and to develop strategies to improve the health of the people we serve. The consultants who developed the survey tool worked with individuals from a broad spectrum of backgrounds as follows: the Maine Center for Disease Control and Prevention, the District Public Health Liaisons, Federally Qualified Health Centers, Public Health and Community Services across the state of Maine and others who provided generous support and insights. Target audience was anyone with a vested interest in public health and healthcare including medical staff, community board members, volunteers, donors and members of the general public. The surveys were conducted across the eight participating Maine Counties of Aroostook, Cumberland, Hancock, Kennebec, Penobscot, Piscataquis, Somerset, Washington by 17 partnering Maine Hospitals, 5 local Public Health Districts and 11 Healthy Maine Partnerships. The following sectors were represented: - Healthy Aroostook- Northern Maine Medical Center- Public Health Nursing- Aroostook Mental Health Services- Wabanaki Public Health- Town of Madawaska- UMFK Student- Power of Prevention- Fish River Rural Health - Maine Quality Counts- U. Maine Cooperative Extension- Visiting Nurses of Aroostook- Town of Fort Kent- The Aroostook Medical Center- Fiddlehead Focus News- Maine CDC- Pines Health Services- University of Maine at Fort Kent- Northern Maine Development Commission- Community Voices- Community Members |
| Northern Maine Medical Center | Part V, Section B, Line 5: Attention was taken to include a broad representation from the community. This took place in two ways. First, the stakeholders were invited to participate in public forums. Second, four work groups were convened to address each of the four priorities selected. A facilitator was identified for each group to lead the ongoing discussion and work to address strategies and action plans for each of the priorities. The following sectors were represented:- AMHC- UMFK Nursing Division- NMMC Director of Nursing- NMMC Pharmacist- Life by Design- Agency on Aging- NMMC Care Manager- Valley School Substance Abuse Counselor- UMFK Behavioral Health- U. Maine Cooperative Extension- NMMC Social Worker- NMMC NDPP Trainer PA - Hope & Justice- NMMC Financial Counselor- NMMC Practice Coordinator- NMMC Community Educator- Power of Prevention- FK High School Wellness- NMMC Psych Unit Leader- FK Recreation Director- UMFK Student- NMMC Communications- Catholic Charities- FK Community Development |
| Northern Maine Medical Center | Part V, Section B, Line 6a: The following hospitals were included in the collaborative community health assessment: Cary Medical Center, Down East Community Hospital, Houlton Regional Hospital, Maine Coast Memorial Hospital, Mayo Regional Hospital, Millinocket Regional Hospital, Mount Desert Island Hospital, Northern Maine Medical Center, and Redington-Fairview General Hospital. |
| Northern Maine Medical Center | Part V, Section B, Line 6b: Aroostook Mental Health Center - St. John Valley Public Schools - University of Maine, Fort Kent, Behavioral Health and Nursing Divisions - Fish River Rural Health Center - Healthy Maine Partnerships - University of Maine Cooperative Extension Service - Town Government and Recreation Departments - Life by Design Mental Health - Clergy - Aroostook Agency on Aging |
| Northern Maine Medical Center | Part V, Section B, Line 7d: The St. John Valley assessment has been posted on the NMMC website since late 2014, as soon as it became available. The report is also available free upon request. Each year, thereafter, 2015-2016, 2016-2017, 2017-2018, an updated report was posted on the Northern Maine Medical Center website with instructions on how to access the updates. For the newest identified priorities for the start of the new cycle: 2017-2021, the same process will be used to keep the public apprised of the priorities and the actions. The hospital's Community Liaison Committee of the Board of Trustees is also provided a summary on an annual basis. In addition, contact information is provided on the website for individuals who wish to request a free paper copy. Individuals may also call NMMC to request a free copy. |
| Northern Maine Medical Center | Part V, Section B, Line 11: The CHNA cycle completed in 2017 reported several successes related to the three priorities from the previous CHNA cycle of: substance abuse, healthy food and nutrition and cardiovascular health. With similar priorities, with the addition of a new priority in the area of mental health, requiring continued strategies for improvement, actions will be expanded based on need, community interaction and lessons learned. The NMMC Board of Trustee approved high level action plan has begun moving forward as follows:Priority #1 Physical Activity, Nutrition and Weight- Focus on gaps identified to provide physical activity opportunities and develop a plan to engage local students- Expand food insecurity assessments in order to identify and serve a greater portion of the population- Create a mechanism to better communicate available physical activity and nutrition programsPriority #2 Mental Health and Access- Create community partnerships to support the school age population dealing with mental illness- Promote public education through interagency collaboration- Develop a framework of agency resources- Utilize local university for grant writing resources- Create more opportunities to screen for mental illness- Develop community-wide speaker's bureauPriority #3 Substances and Alcohol Use (includes tobacco use)- Collaborate with the National Alliance on Mental Health for services not currently in place- Funnel community events through a central point to reach more of the public- Offer an annual retreat to convene community partners for brainstorming and strategic planning to address substance and alcohol usePriority #4 Cardiovascular Disease- Create a network of public education using multiple formats- Implement a collaborative tobacco cessation program- Implement a feasibility study for reintroducing cardiac rehabilitation- Promote heart health in conjunction with American Heart Association initiativesPriority #1 Physical Activity, Nutrition and Weight2018-2019 Actions1. Through an education outreach program at a hospital owned community retail pharmacy, monthly education is provided to the public, free of charge, on topics that included: selecting herbal and natural supplements 6/25/19, summer health and wellness 7/16/19, healthy holiday eating on 11/19/19, healthy eating and understanding food labels 12/17/19. 2. Community events were hosted to encourage physical activity at all age levels: Superhero 5K walk and run event and Summer Rally in the Valley mountain bike festival. 3. NMMC participated in Rumpus for Reading with the local elementary school. The event focused around physical activity to raise money for books. 4. An additional site (in St. Agatha, ME) was added to offer free Bone Builder classes. NMMC provided the instructor training and the weights (at no cost) for all participants. 5. Access to diabetes education classes was expanded using available technology to make it easier for more participants to attend the classes, removing the barrier of travel to attend classes. To support diabetes awareness, weekly diabetes education segments were posted on NMMC social media. Priority #2 Mental Health and Access2018-2019 Actions1. Through an education outreach program at a hospital owned community retail pharmacy, monthly education is provided to the public, free of charge, on topics that included mental health wellness.2. An NMMC mental health provider was the guest speaker at a hospital Guild meeting in March 2019 where she spoke on mental health wellness. 3. In June 2019, NMMC Psychiatrist, Dr. Mark Overton and Nurse Practitioner, Ryan Conley, taught a mental health class for the nursing students at the University of Maine at Fort Kent. 4. NMMC social workers hosted the annual Suicide Awareness Walk on 9/7/19. 5. In April of 2019, NMMC, along with community partners, launched the Yellow Tulip Project, community-wide. The event was covered by local media and will continue annually. The purpose of the project is to raise awareness for suicide prevention and to 'smash the stigma' of mental illness. 6. Mental health Nurse Practitioner, Melissa Stoliker, offered a free public presentation on Seasonal Affective Disorder in partnership with the University of Maine at Fort Kent Student Nurses Organization. Priority #3 Substances and Alcohol Use (includes tobacco use)2018-2019 Actions1. On March 11, 2019, Family Practitioner, Dr. Silwana Sidorczuk and Licensed Substance Abuse Counselor, Katia Sirois, were part of a guest panel at the University of Maine at Fort Kent. The topic for the free program to educate the public covered the topic of the opioid epidemic. 2. Through an education outreach program at a hospital owned community retail pharmacy, monthly education is provided to the public, free of charge, on topics that included opioid resources and tobacco cessation 7/23/19.3. NMMC partnered with the local schools to host a presentation for school aged children about the dangers of the opioid epidemic. 4. The head of Maine's opioid program, Gordon Smith, was a guest speaker on 9/9/19 when he spoke with the medical community on the status of the epidemic and strategies to stem the increasing epidemic.5. Medical student from the Frank Netter Medical School visited the Madawaska high school to speak with students on the dangers of vaping. 6. NMMC's Opioid Committee created a comprehensive booklet of resources for patients on the effects of opioids along with resources available in Aroostook County.7. NMMC partnered with the University of Maine at Fort Kent and the local mental health agency, AMHC, to host a recovery event to coincide with National Recovery Month in September 2019. The event was free to the public and included activities for individuals of all ages to attend the event. Priority #4 Cardiovascular Disease2018-2019 Actions1. On 1/5/19, Beat the Pack tobacco cessation classes were offered to the public free of charge. 2. Through an education outreach program at a hospital owned community retail pharmacy, monthly education is provided to the public, free of charge, on topics that included heart health and knowledge about how to identify one's risks in February 2019, free blood sugar screening during National Diabetes Month in November 2019.3. One of NMMC's ED physicians provided free Citizen CPR classes to the public in June 2019. The use of automated defibrillator devices was also included in the education. 4. NMMC clinical personnel had a presence at a health and safety fair held at the Madawaska high school. 5. In May of 2019, NMMC clinical staff and providers were provided training in tobacco intervention skills by Karina Alexander. 6. On 9/16, 9/18 and 9/30/19, NMMC Community Educator, Erin Pelletier and Family Practice provider, Dr. Silwana Sidorczuk launched the annual Tar Wars tobacco awareness program in all St. John Valley schools at the fifth-grade level. The program includes continues work in the classroom after the initial presentations and a poster project to follow which is recognized at the state of Maine level.7. Third year medical students from the Netter School of Medicine participated in a large health and wellness event geared toward school age children. The day-long program promoted fun with physical activity, facts about sugary drinks and the effects of tobacco. The program was held in partnership with the Student Nurses Organization of the University of Maine at Fort Kent. Other areas of need identified for the most recent CHNA cycle, besides the top four priorities listed above, will remain on the table to be addressed as resources become available. These are: cancer care, diabetes and elder health. In terms of cancer care, the data reported reduced cases. Related to diabetes, priority #1 indirectly addresses this area with the education and resources on healthy eating and physical activity. Lastly, elder health was not specifically listed, however, several of the physical activity and healthy eating initiatives do address the older population so although it was not selected as a top priority, it is being addressed on multiple fronts. |
| Northern Maine Medical Center | Part V, Section B, Line 24: Individuals are billed at gross amounts and charges are adjusted accordingly, if they qualify for assistance. |
Supplemental Information Detail SupplementalInformationDetail (9 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Part I, Line 7: | The amounts reported on Lines 7a & 7b were computed using a cost-to-charge ratio. Amounts on line 7g are derived from internal financial/cost accounting systems. |
| Part I, Line 7g: | Subsidized health services on line 7g include physician clinics, rural health centers, a skilled nursing facility, and emergency room. |
| Part II, Community Building Activities: | N/A |
| Part III, Line 4: | In evaluating the collectibility of accounts receivable, the Medical Center analyzes past results and identifies trends for each of its major payor sources of revenue to estimate the appropriate allowance for doubtful accounts and provision for doubtful accounts. Management regularly reviews data about these major payor sources in evaluating the sufficiency of the allowance for doubtful accounts. For receivables associated with services provided to patients who have third-party coverage, the Medical Center analyzes contractually due amounts and provides an allowance for doubtful accounts and a provision for doubtful accounts, if necessary. For receivables associated with self-pay patients (which include both patients without insurance and patients with deductible and copayment balances due for which third-party coverage exists for part of the bill), the Medical Center records a provision for doubtful accounts in the period of service based on past experience, which indicates that many patients are unable or unwilling to pay amounts for which they are financially responsible. The difference between the standard rates (or the discounted rates if negotiated or eligible) and the amounts actually collected after all reasonable collection efforts have been exhausted is charged against the allowance for doubtful accounts. |
| Part III, Line 9b: | Our collection policy stipulates that NMMC makes reasonable efforts to identify those individuals that may qualify for assistance. In the first 120 days, patients may request to begin the Financial Assistance process and collection activity is put on hold until the process is completed. If the patient qualifies, no further collection activity will occur going forward for that account. If patient does not qualify, collection activity resumes from point it was put on hold. |
| Part VI, Line 2: | Please see Schedule H, Part V, Section B, Line 5 for a description of NMMC's assessment process. |
| Part VI, Line 3: | We notify patients and customers about access to assistance in various ways. The simplest way is the signage, pamphlets, and educational material located around the Organization and in various offices. In every patient access/patient financial services area is a sign explaining the availability of free/discounted care and the Federal Poverty Guidelines. There are also pamphlets located in the outpatient areas explaining free/discounted care and providing information on Mainecare. For inpatients, there is a book in each room which provides all the information on all programs available.Through the patient accounting department, we provide information aboutthese statements. We also counsel patients on the phone about all theprograms available whether it is Medicaid or a hospital program. |
| Part VI, Line 4: | Northern Maine Medical Center is a 94 licensed bed (29 A&P which includes swing beds, 6 ICU beds, 14 Psych beds, and 45 SNF beds), full-service, acute-care, not-for profit hospital located in Fort Kent, Maine (Aroostook County). The Hospital is accredited by the joint commission and its mission is to serve its communities with excellence in health care. Its services include acute inpatient, psych inpatient, SNF, 24-hour emergency center, diagnostic, and surgical services. Along with these hospital services, the Hospital employs/contracts with the majority of primary and specialty care physicians in the area. |
| Part VI, Line 5: | Northern Maine Medical Center is a local, not-for-profit hospital that serves its local communities and people regardless of their ability to pay. Northern Maine provides financial assistance and sliding scale discounts to self-pay and low-income patients. Also the Hospital participates in government-sponsored health care programs including Medicare, Medicaid, VA, and Tricare. The volunteer board of trustees sets the strategic direction for the Hospital and is comprised of community members from the Hospital's service area. This group is made up of local business owners, professionals, and retirees. Northern Maine's non-profit status allows the Hospital to reinvest any excess of revenues over expense back into the Hospital to continuously improve the medical care it delivers. The Hospital allows access to healthcare that would otherwise be difficult. The Hospital is the main employer for the local physicians, including specialty physicians that would otherwise have to be accessed out of the area. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Employment Contract | Yes (X) | WrittenEmploymentContractInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | 0 | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | Yes (1) | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (9 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Erik St Pierre MD | ||||||||||||||
| Director | $678,413 | $0 | $4,867 | $0 | $19,373 | $0 | $8,250 | $0 | $24,776 | $0 | $735,679 | $0 | $0 | $0 |
| Peter J Sirois | ||||||||||||||
| President/CEO | $294,638 | $0 | $40,000 | $0 | $1,793 | $0 | $8,250 | $0 | $24,183 | $0 | $368,864 | $0 | $0 | $0 |
| Cindy L Daigle | ||||||||||||||
| Treasurer/CFO | $196,061 | $0 | $13,608 | $0 | $2,258 | $0 | $5,951 | $0 | $23,579 | $0 | $241,457 | $0 | $0 | $0 |
| Alain Bois | ||||||||||||||
| Secretary/COO | $170,427 | $0 | $3,826 | $0 | $198 | $0 | $1,675 | $0 | $15,028 | $0 | $191,154 | $0 | $0 | $0 |
| John Hallberg | ||||||||||||||
| Orthopedic Surgeon | $526,400 | $0 | $23,332 | $0 | $21,440 | $0 | $8,250 | $0 | $23,019 | $0 | $602,441 | $0 | $0 | $0 |
| Rodney Lahren | ||||||||||||||
| General Surgeon | $551,982 | $0 | $3,524 | $0 | $3,047 | $0 | $8,250 | $0 | $24,419 | $0 | $591,222 | $0 | $0 | $0 |
| John Hotchkiss | ||||||||||||||
| Radiologist | $522,292 | $0 | $0 | $0 | $258 | $0 | $8,250 | $0 | $6,550 | $0 | $537,350 | $0 | $0 | $0 |
| Mark Overton | ||||||||||||||
| Psychiatrist | $479,610 | $0 | $27,178 | $0 | $1,774 | $0 | $0 | $0 | $22,330 | $0 | $530,892 | $0 | $0 | $0 |
| James Harris | ||||||||||||||
| Physician | $479,370 | $0 | $3,183 | $0 | $19,690 | $0 | $8,250 | $0 | $22,949 | $0 | $533,442 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Part I, Line 7 | FormAndLineReferenceDesc |
| Explanation | The bonus paid to Peter Sirois, CEO, has set point criteria for earning specific bonus levels/amounts. The Board awards points based on the accomplishment of pre-established objectives/targets. Points are tabulated with the final score determining bonus level achieved. The Board meets with the CEO to discuss performance including those objectives/targets and based on that meeting award the points and derive the bonus amount. Dr. Erik St. Pierre, Dr. Rodney Lahren, Dr. John Hallberg, Dr. Mark Overton, and Dr. James Harris received annual bonuses based on their performance. Dr. John Hallberg and Dr. Mark Overton also received sign-on bonuses upon renewal of their contracts. Cindy Daigle and Alain Bois received Christmas bonuses. | ExplanationTxt |
Schedule L IRS990ScheduleL
Loans Btwn Org Interested Prsn LoansBtwnOrgInterestedPrsnGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Erik St Pierre | PersonNm |
| Relationship With Org | Employee and serves on the Board of Directors | RelationshipWithOrgTxt |
| Loan Purpose | Purchase of a house | LoanPurposeTxt |
| Loan From Organization | Yes (X) | LoanFromOrganizationInd |
| Original Principal | $50,000 | OriginalPrincipalAmt |
| Balance Due | $10,897 | BalanceDueAmt |
| Default | 0 | DefaultInd |
| Board Or Committee Approval | 0 | BoardOrCommitteeApprovalInd |
| Written Agreement | Yes (1) | WrittenAgreementInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Balance Due | $10,897 | TotalBalanceDueAmt |
Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp (5 entries)
| Relationship DescriptionRelationshipDescriptionTxt | TransactionTransactionAmt | TransactionTransactionDesc | Sharing Of RevenuesSharingOfRevenuesInd |
|---|---|---|---|
| Daigle Oil Company | |||
| Entity of which Dan Vaillancourt, Board Member, is an officer | $138,236 | Independent Contractor Arrangement | 0 |
| Nola Sirois | |||
| Family member of Peter Sirois, Hospital CEO | $10,875 | Employment | 0 |
| Michelle L Plourde | |||
| Family member of Peter Sirois, Hospital CEO | $94,255 | Employment | 0 |
| Nicole Marquis | |||
| Family member of Peter Sirois, Hospital CEO | $93,981 | Employment | 0 |
| Robin Werntgen | |||
| Family member of Peter Sirois, Hospital CEO | $81,650 | Employment | 0 |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Form 990, Part VI, Section B, line 11b | The Form 990 is prepared by the Organization's independent public accounting firm and thoroughly reviewed by the CFO and Controller. The completed form is sent electronically to Board members prior to the form being filed. In addition, CEO has documents for review prior to sending to the Board members and has opportunity to request any edits. When the forms are sent to Board members, they are instructed to contact CEO or CFO with questions. Any questions are responded to and at the following Finance or Board meetings, CFO provides ability for anyone to ask any additional questions. Finance Committee may request a formal/detailed presentation by consultants if deemed necessary but have not requested that level of review recently. |
| Form 990, Part VI, Section B, line 12c | On an annual basis, Board Members must read the Organization's conflict of interest policy, disclose any potential conflicts, and return the signed statement to Administration. If topics arise where a Member has an actual or potential conflict, the group will determine the level to which the individual may be involved in discussions and the member with the conflict will not have a vote. In some instances, the member will be excused from the meeting and can only rejoin when the Board has moved on to a different topic. |
| Form 990, Part VI, Section B, line 15 | The Board of Directors determines the compensation of the CEO using compensation studies and comparability data. The CEO determines the compensation of other officers and key employees in a similar manner. |
| Form 990, Part VI, Section C, line 19 | The Organization makes its governing documents, conflict of interest policy, and financial statements available to the public upon request. |
| Form 990, Part X, Line 10: Land, Buildings, and Equipment | Section 1.263(a)-3(n) Election: Northern Maine Medical Center 194 East Main Street Fort Kent, ME 04743 EIN: 01-0234189 Northern Maine Medical Center is electing to capitalize repair and maintenance costs under Regulation Section 1.263(a)-3(n). |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp
Disregarded Entity Name DisregardedEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Valley Medical Association | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 194 East Main Street | AddressLine1Txt |
| City | Fort Kent | CityNm |
| State Abbreviation | ME | StateAbbreviationCd |
| ZIP | 04743 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 223245434 | EIN |
| Primary Activities | Medical Physician Practice | PrimaryActivitiesTxt |
| Legal Domicile State | ME | LegalDomicileStateCd |
| Exempt Code Section | 501(c)(3) | ExemptCodeSectionTxt |
| Public Charity Status | Line 3 | PublicCharityStatusTxt |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Northern Maine Medical Center | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Controlled Organization | Yes (1) | ControlledOrganizationInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | 0 | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | 0 | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | 0 | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | 0 | SharingOfFacilitiesInd |
| Paid Employees Sharing | 0 | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |
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