Waldo County General Hospital: Form 990, tax year 2017
View the entire original 990 at ProPublica ↗
- Organization
- Waldo County General Hospital (EIN 01-0177170)
- Tax period
- 2017-10-01 to 2018-09-30
- Filed
- 2019-08-13
- IRS object ID
- 201922259349301317
- Schema version
- 2017v2.3
- 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 H
- Schedule I
- Schedule J
- Schedule K
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2019-08-13T11:40:54-05:00 | ReturnTs |
| Tax Period End | 2018-09-30 | TaxPeriodEndDt |
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2017-10-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 010177170 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Waldo County General Hospital | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | WALD | BusinessNameControlTxt |
| Phone | 2073382500 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 118 Northport Avenue | AddressLine1Txt |
| City | Belfast | CityNm |
| State Abbreviation | ME | StateAbbreviationCd |
| ZIP | 04915 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Linda Drinkwater | PersonNm |
| Person Title | CFO | PersonTitleTxt |
| Phone | 2073382500 | PhoneNum |
| Signature | 2019-08-12 | SignatureDt |
Filing Security Information FilingSecurityInformation
IP Address IPAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| I Pv4 Address | 63.247.60.254 | IPv4AddressTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IP | 2019-08-13 | IPDt |
| IP Tm | 12:36:33 | IPTm |
| IP Timezone | ED | IPTimezoneCd |
| Filing License Type | P | FilingLicenseTypeCd |
| At Submission Creation Device Id | B45CD6F9D1811B9916B2A423673B63195B36551F | AtSubmissionCreationDeviceId |
| At Submission Filing Device Id | 3BAD4420C644E26A0A4F69454799749AF4F84D03 | AtSubmissionFilingDeviceId |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2017 | TaxYr |
| Build TS | 2019-02-21 02:37:17Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | Mark Fourre MD | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO Box 287 | AddressLine1Txt |
| City | Belfast | CityNm |
| State Abbreviation | ME | StateAbbreviationCd |
| ZIP | 04915 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $118,846,796 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | www.wcgh.org | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1901 | FormationYr |
| Legal Domicile State | ME | LegalDomicileStateCd |
| Activity Or Mission | Waldo County General Hospital's mission is to be the BEST - Better, Empathy, Service and Teamwork. Our goal is to ensure quality, accessible and affordable health care services and to improve the health and well-being of our community. | ActivityOrMissionDesc |
| Voting Members Governing Body | 20 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 14 | VotingMembersIndependentCnt |
| Total Employee | 826 | TotalEmployeeCnt |
| Total Volunteers | 52 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $23,661 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $206,412 | PYContributionsGrantsAmt |
| CY Contributions Grants | $1,786,845 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $95,018,066 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $96,332,209 | CYProgramServiceRevenueAmt |
| PY Investment Income | $4,195,080 | PYInvestmentIncomeAmt |
| CY Investment Income | $4,584,914 | CYInvestmentIncomeAmt |
| PY Other Revenue | $5,113,608 | PYOtherRevenueAmt |
| CY Other Revenue | $6,481,565 | CYOtherRevenueAmt |
| PY Total Revenue | $104,533,166 | PYTotalRevenueAmt |
| CY Total Revenue | $109,185,533 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $10,466 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $15,562 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $53,033,138 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $54,704,331 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $39,573,958 | PYOtherExpensesAmt |
| CY Other Expenses | $43,560,984 | CYOtherExpensesAmt |
| PY Total Expenses | $92,617,562 | PYTotalExpensesAmt |
| CY Total Expenses | $98,280,877 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $11,915,604 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $10,904,656 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $156,987,635 | TotalAssetsBOYAmt |
| Total Assets EOY | $167,900,112 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $28,514,302 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $25,570,746 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $128,473,333 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $142,329,366 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | See Schedule O | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $73,973,519 | ExpenseAmt |
| Grant | $15,562 | GrantAmt |
| Revenue | $94,107,095 | RevenueAmt |
| Desc | Waldo County General Hospital provides quality and affordable health care services to improve the health and well being of the communities it serves, regardless of the patient's ability to pay. A broad spectrum of services are provided including hospital acute inpatient care; ancillary outpatient diagnostic services including physical therapy, speech, audiology, sleep and respiratory therapy, oncology clinics, emergency services, inpatient and outpatient care, inpatient hospice, and surgical inpatient and outpatient services. The hospital provided 6,294 days of adult, newborn, swing bed, and hospice inpatient care, and 59,424 outpatient visits including 175,248 outpatient procedures and exams. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $14,085,428 | ExpenseAmt |
| Revenue | $9,395,605 | RevenueAmt |
| Desc | Waldo County General Hospital employs many hospital-based physicians and provides the following spectrum of physician patient care services: cardiology, family medicine, general surgery, internal medicine, nephrology, neurology, OB/GYN, orthopedics, otolaryngology, podiatry, pulmonology, urology, rheumatology and primary care clinics. Our physicians provided care to patients during 52,149 physician-office patient visits. | Desc |
Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $2,862,249 | ExpenseAmt |
| Revenue | $1,753,957 | RevenueAmt |
| Desc | Waldo County General Hospital offers the community it serves four health centers: Arthur Jewell Community Health Center, Stockton Springs Regional Health Center, Donald S. Walker Health Center, and Lincolnville Regional Health Center. We provided healthcare services to patients during 15,200 health center visits. | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expenses | $90,921,196 | 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 | Yes (1) | 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 | 0 | 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 | Yes (1) | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | Yes (1) | TaxExemptBondsInd |
| Invest Tax Exempt Bonds | 0 | InvestTaxExemptBondsInd |
| Escrow Account | 0 | EscrowAccountInd |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuerInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | 0 | 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 | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| Info In Schedule O Part V | Yes (X) | InfoInScheduleOPartVInd |
| IRP Document | 0 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 826 | 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 |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 20 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 14 | 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 | Yes (1) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (1) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (1) | 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
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Dorcas Riley | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 2073389378 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO Box 287 | AddressLine1Txt |
| City | Belfast | CityNm |
| State Abbreviation | ME | StateAbbreviationCd |
| ZIP | 049150287 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (29 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | OfficerOfficerInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd | Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd |
|---|---|---|---|---|---|---|---|---|---|
| Joanne Billington | |||||||||
| Trustee | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |||
| Carole Brand | |||||||||
| Vice President | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | ||
| James C Delehanty MD | |||||||||
| Trustee | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |||
| Gregory Dufour | |||||||||
| Trustee | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |||
| David Flanagan | |||||||||
| Treasurer | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | ||
| Syrena Gatewood | |||||||||
| Trustee | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |||
| Stephen Hanscom | |||||||||
| Secretary | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | ||
| Ann Hooper | |||||||||
| Trustee | 50.00 | 0.00 | Yes (X) | $139,832 | $0 | $20,070 | |||
| Paul Klainer MD | |||||||||
| Trustee | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |||
| Dale Kuhnert | |||||||||
| Trustee | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |||
| William Lambie MD | |||||||||
| Trustee | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |||
| Jennifer McKenna MD | |||||||||
| Trustee | 1.00 | 50.00 | Yes (X) | $0 | $316,339 | $29,454 | |||
| Deborah Peabody MD | |||||||||
| Trustee | 50.00 | 0.00 | Yes (X) | $188,074 | $0 | $27,394 | |||
| Catherine Reynolds | |||||||||
| Trustee | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |||
| JB Turner | |||||||||
| Trustee | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |||
| Lee Webb | |||||||||
| Trustee | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |||
| Lee Woodward Jr | |||||||||
| President | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | ||
| Cornelius Yetman DO | |||||||||
| Trustee | 1.00 | 50.00 | Yes (X) | $0 | $357,047 | $38,880 | |||
| Benjamin Mailloux MD | |||||||||
| Frmr Medical Staff President - WCGH | 50.00 | 0.00 | Yes (X) | $289,181 | $0 | $36,751 | |||
| Stephanie Lash MD | |||||||||
| Medical Staff President - PBMC | 1.00 | 50.00 | Yes (X) | $0 | $287,088 | $25,910 | |||
| Elizabeth Connolly DO | |||||||||
| Medical Staff President - WCGH | 50.00 | 0.00 | Yes (X) | $443,350 | $0 | $31,840 | |||
| Mark Fourre MD | |||||||||
| CEO | 1.00 | 50.00 | $0 | $429,171 | $30,594 | Yes (X) | |||
| Linda Drinkwater | |||||||||
| Regional CFO | 50.00 | 0.00 | $312,958 | $0 | $35,179 | Yes (X) | |||
| Owen Nelson MD | |||||||||
| Orthopedics | 50.00 | 0.00 | $548,908 | $0 | $20,751 | Yes (X) | |||
| Daniel Hebert MD | |||||||||
| Orthopedics | 50.00 | 0.00 | $484,330 | $0 | $32,075 | Yes (X) | |||
| Karen Miller MD | |||||||||
| Otolaryngologist | 50.00 | 0.00 | $517,486 | $0 | $32,470 | Yes (X) | |||
| David Ferguson MD | |||||||||
| Cardivasc. Disease | 50.00 | 0.00 | $441,694 | $0 | $33,552 | Yes (X) | |||
| Shane Lydon MD | |||||||||
| Surgeon | 50.00 | 0.00 | $457,112 | $0 | $36,110 | Yes (X) | |||
| Mark Biscone | |||||||||
| Former CEO | 0.00 | 0.00 | $112,151 | $129,927 | $2,928 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $3,935,076 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $1,519,572 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $433,958 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 75 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | Yes (1) | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (3 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| Rodney Voisine MD | |||||
| 75 John Roberts Rd B-10 | South Portland | ME | 04106 | Medical Service | $212,018 |
| Parenteaus Floor Covering | |||||
| 218 E Main Street | Searsport | ME | 04974 | Flooring Contractor | $170,790 |
| Weatherby Locums | |||||
| PO Box 972633 | Dallas | TX | 753972633 | Contracted Labor | $125,597 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 3 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $25,273 | GovernmentGrantsAmt |
| All Other Contributions | $1,761,572 | AllOtherContributionsAmt |
| Total Contributions | $1,786,845 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| Net patient service revenue | 623000 | $95,994,726 | $95,994,726 |
| Cafeteria revenue | 733310 | $337,483 | $337,483 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $96,332,209 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $2,142,031 | TotalRevenueColumnAmt |
| Exclusion | $2,142,031 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $176,904 | 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 | $176,904 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $176,904 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $176,904 | RelatedOrExemptFuncIncomeAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $12,063,605 | SecuritiesAmt |
| Other | $40,541 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $9,599,249 | SecuritiesAmt |
| Other | $62,014 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $2,464,356 | SecuritiesAmt |
| Other | -$21,473 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $2,442,883 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $2,442,883 | RelatedOrExemptFuncIncomeAmt |
Other Revenue Misc OtherRevenueMiscGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| Affiliate Revenue | 561000 | $3,022,149 | $3,022,149 |
| Pharmacy Sales | 446110 | $1,955,464 | $1,955,464 |
| Meaningful Use Revenue | 900099 | $960,858 | $960,858 |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $366,190 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $366,190 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $6,304,661 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $109,185,533 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $105,256,657 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $2,142,031 | ExclusionAmt |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $15,562 | TotalAmt |
| Program Services | $15,562 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,217,120 | TotalAmt |
| Program Services | $251,944 | ProgramServicesAmt |
| Management And General | $965,176 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $42,744,153 | TotalAmt |
| Program Services | $42,420,822 | ProgramServicesAmt |
| Management And General | $323,331 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,152,606 | TotalAmt |
| Program Services | $1,143,024 | ProgramServicesAmt |
| Management And General | $9,582 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,754,923 | TotalAmt |
| Program Services | $6,597,374 | ProgramServicesAmt |
| Management And General | $157,549 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,835,529 | TotalAmt |
| Program Services | $2,755,932 | ProgramServicesAmt |
| Management And General | $79,597 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $61,633 | TotalAmt |
| Management And General | $61,633 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $19,337 | TotalAmt |
| Management And General | $19,337 | ManagementAndGeneralAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,575 | TotalAmt |
| Management And General | $6,575 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $9,080,736 | TotalAmt |
| Program Services | $8,967,798 | ProgramServicesAmt |
| Management And General | $112,938 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $20,691 | TotalAmt |
| Program Services | $20,110 | ProgramServicesAmt |
| Management And General | $581 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,455,153 | TotalAmt |
| Program Services | $2,328,092 | ProgramServicesAmt |
| Management And General | $127,061 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,216,908 | TotalAmt |
| Program Services | $1,182,748 | ProgramServicesAmt |
| Management And General | $34,160 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $177,682 | TotalAmt |
| Program Services | $172,694 | ProgramServicesAmt |
| Management And General | $4,988 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $197,143 | TotalAmt |
| Program Services | $193,693 | ProgramServicesAmt |
| Management And General | $3,450 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $291,440 | TotalAmt |
| Program Services | $283,259 | ProgramServicesAmt |
| Management And General | $8,181 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,268,887 | TotalAmt |
| Program Services | $5,120,983 | ProgramServicesAmt |
| Management And General | $147,904 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $836,354 | TotalAmt |
| Program Services | $728,443 | ProgramServicesAmt |
| Management And General | $107,911 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| Medical Supplies | $11,366,400 | $11,366,400 | |
| Affiliate Services | $9,833,260 | $4,676,797 | $5,156,463 |
| State of ME Hospital Ta | $1,736,476 | $1,736,476 | |
| Miscellaneous Expenses | $992,309 | $959,045 | $33,264 |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $98,280,877 | TotalAmt |
| Program Services | $90,921,196 | ProgramServicesAmt |
| Management And General | $7,359,681 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,955,430 | BOYAmt |
| EOY | $3,188,796 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,146,497 | BOYAmt |
| EOY | $7,071,634 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $17,406 | BOYAmt |
| EOY | $0 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $10,024,912 | BOYAmt |
| EOY | $8,999,940 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,910,210 | BOYAmt |
| EOY | $1,369,482 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $117,677 | BOYAmt |
| EOY | $205,410 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $87,287,470 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $52,669,281 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $31,984,133 | BOYAmt |
| EOY | $34,618,189 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $61,833,365 | BOYAmt |
| EOY | $68,099,803 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $36,998,005 | BOYAmt |
| EOY | $44,346,858 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $156,987,635 | BOYAmt |
| EOY | $167,900,112 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,496,515 | BOYAmt |
| EOY | $7,804,301 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $98,125 | BOYAmt |
| EOY | $40,200 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,979,215 | BOYAmt |
| EOY | $4,542,702 | EOYAmt |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $34,090 | BOYAmt |
| EOY | $0 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $16,906,357 | BOYAmt |
| EOY | $13,183,543 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $28,514,302 | BOYAmt |
| EOY | $25,570,746 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $105,798,415 | BOYAmt |
| EOY | $117,541,376 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,036,036 | BOYAmt |
| EOY | $2,177,538 | EOYAmt |
Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $20,638,882 | BOYAmt |
| EOY | $22,610,452 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $128,473,333 | BOYAmt |
| EOY | $142,329,366 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $156,987,635 | BOYAmt |
| EOY | $167,900,112 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $10,904,656 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $1,739,484 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | $1,211,893 | 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
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 | $6,575 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $6,575 | 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 organization pays dues to the Maine Hospital Association. Maine Hospital Association used 20.3% of their dues revenue for lobbying activity. | ExplanationTxt |
Schedule D IRS990ScheduleD
CY Endwmt Fund CYEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $972,747 | BeginningYearBalanceAmt |
| Contributions | $10,788 | ContributionsAmt |
| Investment Earnings Or Losses | $69,123 | InvestmentEarningsOrLossesAmt |
| End Year Balance | $1,052,658 | EndYearBalanceAmt |
CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $888,192 | BeginningYearBalanceAmt |
| Contributions | $13,394 | ContributionsAmt |
| Investment Earnings Or Losses | $71,161 | InvestmentEarningsOrLossesAmt |
| End Year Balance | $972,747 | EndYearBalanceAmt |
CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $831,991 | BeginningYearBalanceAmt |
| Contributions | $11,551 | ContributionsAmt |
| Investment Earnings Or Losses | $44,650 | InvestmentEarningsOrLossesAmt |
| End Year Balance | $888,192 | EndYearBalanceAmt |
CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $832,332 | BeginningYearBalanceAmt |
| Contributions | $12,526 | ContributionsAmt |
| Investment Earnings Or Losses | -$12,867 | InvestmentEarningsOrLossesAmt |
| End Year Balance | $831,991 | EndYearBalanceAmt |
CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $773,048 | BeginningYearBalanceAmt |
| Contributions | $13,032 | ContributionsAmt |
| Investment Earnings Or Losses | $46,252 | InvestmentEarningsOrLossesAmt |
| End Year Balance | $832,332 | EndYearBalanceAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Prmnnt Endowment Balance EOY | 1.00000 | PrmnntEndowmentBalanceEOYPct |
| Endowments Held Unrelated Org | Yes (1) | EndowmentsHeldUnrelatedOrgInd |
| Endowments Held Related Org | 0 | EndowmentsHeldRelatedOrgInd |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | $805,499 | InvestmentCostOrOtherBasisAmt |
| Book Value | $805,499 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | $39,544,916 | InvestmentCostOrOtherBasisAmt |
| Depreciation | $21,184,376 | DepreciationAmt |
| Book Value | $18,360,540 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | $40,217,026 | InvestmentCostOrOtherBasisAmt |
| Depreciation | $30,220,334 | DepreciationAmt |
| Book Value | $9,996,692 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | $6,720,029 | InvestmentCostOrOtherBasisAmt |
| Depreciation | $1,264,571 | DepreciationAmt |
| Book Value | $5,455,458 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $34,618,189 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp (7 entries)
| DescDesc | Book ValueBookValueAmt |
|---|---|
| Beneficial Interest in Perpetual Trusts | $22,197,901 |
| Beneficial Interest in Charitable Remainder Trusts | $1,150,143 |
| Prepaid Capital Costs | $7,618,368 |
| Insurance Receivable | $1,408,197 |
| Escrow for Debt Service - SeHR Loan | $166,676 |
| Other Receivables | $2,495,192 |
| Due from Affiliates | $9,310,381 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $44,346,858 | TotalBookValueOtherAssetsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (3 entries)
| DescDesc | AmtAmt |
|---|---|
| Third Party Payor Settlements | $1,664,276 |
| Insurance Reserve Payable | $2,530,738 |
| Due to Affiliates | $8,988,529 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $13,183,543 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Part V, Line 4: | Two of the endowment funds are intended for the earnings to be used in the general operations of the hospital. Others are intended for the emergency department, inpatient hospice, cancer patients, crippled children and needy residents. |
| Part X, Line 2: | The Corporation and its subsidiaries are not-for-profit corporations and have been recognized as tax-exempt pursuant to Section 501(c)(3) of the Internal Revenue Code. Tax-exempt organizations could be required to record an obligation for income taxes as the result of a tax position they have historically taken on various tax exposure items including unrelated business income or tax status. Under guidance issued by the Financial Accounting Standards Board (FASB), assets and liabilities are established for uncertain tax positions taken or positions expected to be taken in income tax returns when such positions are judged to not meet the "more-likely-than-not" threshold, based upon the technical merits of the position. Estimated interest and penalties, if applicable, related to uncertain tax positions are included as a component of income tax expense. The Corporation has evaluated the position taken on its filed tax returns. The Corporation has concluded no uncertain income tax positions exist at September 30, 2018. The Corporation's tax years from 2015 through 2018 may be subject to examination. |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (1) | FinancialAssistancePolicyInd |
| Written Policy | Yes (1) | WrittenPolicyInd |
| FPG Reference Free Care | Yes (1) | FPGReferenceFreeCareInd |
Free Care Oth Percentage FreeCareOthPercentageGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | Yes (X) | OtherInd |
| Free Care Other | 175.000000000000 | FreeCareOtherPct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| FPG Reference Discounted Care | 0 | FPGReferenceDiscountedCareInd |
| Free Care Medically Indigent | Yes (1) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (1) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | Yes (1) | ExpensesExceedBudgetInd |
| Unable To Provide Care | 0 | UnableToProvideCareInd |
| 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 | $3,144,793 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $3,144,793 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.03200 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $13,840,547 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $13,713,540 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $127,007 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00130 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $16,985,340 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $13,713,540 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $3,271,800 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.03330 | TotalExpensePct |
Subsidized Health Services SubsidizedHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $20,694,954 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $11,507,233 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $9,187,721 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.09350 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $20,694,954 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $11,507,233 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $9,187,721 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.09350 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $37,680,294 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $25,220,773 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $12,459,521 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.12680 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | 0 | BadDebtExpenseReportedInd |
| Bad Debt Expense | $3,233,648 | BadDebtExpenseAmt |
| Reimbursed By Medicare | $30,338,339 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $30,806,149 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$467,810 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | Yes (X) | CostToChargeRatioInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (1) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (1) | FinancialAssistancePrvsnInd |
| Hospital Facilities | 1 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Waldo County General Hospital | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 118 Northport Ave | AddressLine1Txt |
| City | Belfast | CityNm |
| State Abbreviation | ME | StateAbbreviationCd |
| ZIP | 04915 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | www.wcgh.org | WebsiteAddressTxt |
| State License | 38905 | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Critical Access Hospital | Yes (X) | CriticalAccessHospitalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Waldo County General Hospital | 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 |
| Prior CHNA Impact | Yes (X) | PriorCHNAImpactInd |
| CHNA Conducted | 16 | CHNAConductedYr |
| Take Into Account Others Input | Yes (1) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | Yes (1) | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | 0 | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (1) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | See Part V, Section C | OwnWebsiteURLTxt |
| Implementation Strategy Adopt | Yes (1) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 16 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (1) | StrategyPostedWebsiteInd |
| Strategy Website URL | See Part V, Section C | 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 | 175.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| Medical Indigency Criteria | Yes (X) | MedicalIndigencyCriteriaInd |
| Residency Criteria | Yes (X) | ResidencyCriteriaInd |
| 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 | See Part V, Section C | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | See Part V, Section C | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | See Part V, Section C | 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 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 |
| Made Presumptive Elig Determ | Yes (X) | MadePresumptiveEligDetermInd |
| 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 (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Waldo County General Hospital | Part V, Section B, Line 5: The organization convened a planning group made up of people representing the broad interests of the community prior to holding the forums. The organizations, individual experts and individual leaders/representatives involved in the planning group for Waldo included: Program Manager, Community Health Improvement, MaineHealth; Midcoast District Public Health Liaison, Maine CDC; Manager, Community Health & Wellness, Waldo County General Hospital; Regional Director of Community Health & Wellness, Pen Bay Medical Center & Waldo County General Hospital; Manager, Population Health, Waldo County General Hospital; and Program Administrator, Healthy Waldo County. |
| Waldo County General Hospital | Part V, Section B, Line 6a: The CHNA was conducted through a partnership between MaineHealth, Central Maine Healthcare, Eastern Maine Healthcare Systems, MaineGeneral Health and the Maine Department of Health and Human Services. |
| Waldo County General Hospital | Part V, Section B, Line 11: For the 2016-2018 CHNA, the organization has identified priorities and developed strategies to address the significant needs identified in its most recently conducted CHNA and provided reasons if identified needs are not being addressed. Please see the 2016-2018 CHNA and Annual Implementation Report Update FY18 at https://mainehealth.org/healthy-communities/community-health-needs-assessment for details of the activities undertaken by the organization. |
| Waldo County general Hospital - Part V, Section B, Line 7a and 10a | The CHNA and implementation strategy are posted on the following website:https://mainehealth.org/healthy-communities/community-health-needs-assessment |
| Waldo County General Hospital - Part V, Section B, Lines 16a, 16b, 16c | The Financial Assistance Policy (Free Care Policy and Billing and Collection Policy), free care application and plain language summary are available on the following website: https://mainehealth.org/patients-visitors/billing-insurance/financial-assistance/free-care |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 4 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp (4 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | FacilityFacilityTxt |
|---|---|---|---|---|
| 1 - Arthur Jewell Community Health Ctr | ||||
| 55 Reynolds Rd | Brooks | ME | 04921 | General medical |
| 2 - Donald S Walker Health Center | ||||
| 43 West Main Street | Liberty | ME | 04949 | General medical |
| 3 - Lincolnville Health Center | ||||
| 2399 Atlantic Highway | Lincolnville | ME | 04849 | General medical |
| 4 - Stockton Springs Reg Health Center | ||||
| 11 Cape Jellison Rd | Stockton Springs | ME | 04981 | General medical |
Supplemental Information Detail SupplementalInformationDetail (12 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Part I, Line 7: | The amounts reported in the table were calculated using the worksheets provided in the Schedule H instructions. The cost-to-charge ratio was used as the costing methodology and was also calculated using Worksheet 2 of the Schedule H instructions. |
| Part I, Line 7g: | Physician clinic costs were included as subsidized health services in the amount of $9,187,921. |
| Part III, Line 2: | See Part III, Line 4 - Bad Debt Expense Footnote to Financial Statements |
| Part III, Line 4: | Waldo County General Hospital(WCGH) does not have a specific footnote in the financial statements that describes "bad debt expense." However, reference is made within the footnotes to a bad debt policy in a couple of instances. Within the footnote describing "Net Patient Service Revenue", the following explains the Provision for Bad Debts: "For receivables associated with self-pay patients (which includes both patients without insurance and patients with deductible and copayment balances due for which third-party coverage exists for part of the bill), the Corporation records a provision for bad debts 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." The amount of expense associated with the provision of services, ultimately written off as bad debt at WCGH, has been calculated at $3,233,648 for the current fiscal year. This amount was calculated using a cost to charge ratio. Bad debt expense represents healthcare services WCGH has provided without compensation. As a tax-exempt organization, WCGH provides necessary patient care regardless of the patient's ability to pay for the services. WCGH cannot determine the amount of bad debt expense that could be reasonably attributable to patients who likely would qualify for financial assistance under the WCGH free care policy. In addition, bad debt expense also includes amounts for services provided to individuals experiencing difficult personal or economic circumstances related to a portion of our community based patient population. Their medical bills often place these individuals in untenable positions where they are not able to handle their personal debt and then their new medical debt. However, because of their income level, they do not qualify for free care. By providing necessary healthcare services to those individuals either who fail to apply for financial assistance or who are experiencing difficult personal or economic circumstances, WCGH believes that bad debt expense should be included as a community benefit. |
| Part III, Line 8: | The costing methodology used to determine the Medicare allowable costs reported in the hospital's Medicare Cost Report is the Medicare cost-to-charge ratio, which incorporates Medicare allowable cost. Medicare did not reimburse $467,810 of the allowed costs. The hospital has made a clear mission commitment to serving elderly patients: therefore this amount should be considered as a community benefit. |
| Part III, Line 9b: | Patients who qualify for free care have their account balance adjusted accordingly once financial assistance has been approved. As a tax-exempt hospital, Waldo County General Hospital provides necessary patient care regardless of the patient's ability to pay for the services. |
| Part VI, Line 2 - Needs Assessment | The organization prepares a Community Health Needs Assessment (CHNA) every three years. See https://mainehealth.org/healthy-communities/community-health-needs-assessment for the completed CHNA. |
| Part VI, Line 3 - Patient Education of Eligibility for Assistance | Free care information is provided in the Admitting and Emergency Registration locations in the following manner:- Postings including Free Care and Monthly Payment Plan- Handouts- InterviewsIf the patient is self-pay, underinsured or can't afford to pay their hospital bill, they may receive a Financial Counseling Packet and/or referred to financial counseling from the registration staff or Change Healthcare, an outside vendor who helps manage the self-pay accounts. The packet includes: - Information on MaineHealth's financial policies- Information on MaineHealth's Free Care Program, Monthly Payment Plan Program, Care Partners, MedAccess and other community resource needs. - Program applications and instructions for MaineHealth's Free Care Program, and Monthly Payment Plan Application- Contact information for assistance with applications, bills or financial concernsSelf-pay or underinsured patients registering in person or via a phone interview receive financial counseling including information on our financial assistance programs. Registration staff or Change Healthcare provide forms and assist with completing financial assistance applications and providing follow up contact information. MaineHealth's Website includes on line Registration and Patient Billing information:- Billing Process- Free Care- Monthly Payment Plan- Patient Statement- Price Information- Contact Us and QuestionsPrimary language, deaf and hard of hearing and interpreter needs are assessed during the registration interview and services are provided as needed. If a patient does not respond at pre-registration, registration, or while receiving care, all of these programs are explained again by the Single Billing Office staff. The intent of these efforts is to ensure that the patient is fully informed of and able to take advantage of these assistance programs. |
| Part VI, Line 4 - Community Information | The CHNA describes the geographic area and demographic constituents it services. See https://mainehealth.org/healthy-communities/community-health-needs-assessment for the completed CHNA. |
| Part VI, Line 5 - Promotion of Community Health | The tax exempt purpose of the organization to improve the health of the community is promoted and enhanced in the following ways: - The majority of the governing body comprises people living within the hospital's service area that are neither employed by, nor have contractual relationships with, the hospital or its affiliates.- Medical staff privileges are available to all qualified physicians in the community.- Solicitation of community input in the strategic planning process.- Common governance of the hospital and physician services provided in the county to promote common health care and control costs. - Annual investment in capital equipment and building improvements to ensure high quality care.- Each year a portion of Net Assets is distributed to our parent, MaineHealth, for the specific purpose of promoting health status improvement programs throughout the MaineHealth service area. |
| Part VI, Line 6 - Affiliated Health Care System | MaineHealth is a not-for-profit family of leading high-quality providers and other healthcare organizations working together so their communities are the healthiest in America. Ranked among the nation's top 100 integrated healthcare delivery networks, MaineHealth is governed by a board of trustees consisting of community and business leaders from its southern, central and western Maine regional service areas. The collaboration of MaineHealth members makes it possible to offer an extensive range of clinical integration and community health programs, many aimed at improving access to preventive and primary care services. MaineHealth includes the following member organizations: LincolnHealth Group, Maine Medical Center, Maine Behavioral Healthcare (Spring Harbor Hospital), Coastal Healthcare Alliance (Pen Bay Medical Center and Waldo County General Hospital), Southern Maine Health Care (Southern Maine Medical Center and Goodall campuses), Western Maine Health Care (Stephens Memorial Hospital), The Memorial Hospital at North Conway, N.H., MaineHealth Care at Home, Maine Physician Hospital Organization, NorDx, Synernet and MaineHealth Accountable Care Organization. The strategic affiliates of MaineHealth are MaineGeneral Medical Center, Mid Coast Hospital and St. Marys Regional Medical Center. |
| Part VI, Line 7 - State Filing of Community Benefit Report | Maine |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (1) | GrantRecordsMaintainedInd |
Grants Other Asst To Indiv In US GrantsOtherAsstToIndivInUSGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Type | Scholarships to students | GrantTypeTxt |
| Recipient | 14 | RecipientCnt |
| Cash Grant | $15,562 | CashGrantAmt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Part I, Line 2: | FormAndLineReferenceDesc |
| Explanation | Scholarships are awarded to students residing in Waldo County and pursuing a career in a healthcare related program. There is a scholarship application process overseen by the Scholarship Committee. Recipients must have completed one semester of schooling with a predetermined minimum GPA, be enrolled in the second semester, and have a financial need. Payments are made directly to the school or as reimbursement to the recipient when appropriate documentation is provided. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| 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 | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (15 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Ann Hooper | ||||||||||||||
| Trustee | $138,885 | $0 | $0 | $0 | $947 | $0 | $4,331 | $0 | $15,739 | $0 | $159,902 | $0 | $0 | $0 |
| Jennifer McKenna MD | ||||||||||||||
| Trustee | $0 | $315,077 | $0 | $0 | $0 | $1,262 | $0 | $8,100 | $0 | $21,354 | $0 | $345,793 | $0 | $0 |
| Deborah Peabody MD | ||||||||||||||
| Trustee | $186,949 | $0 | $0 | $0 | $1,125 | $0 | $5,472 | $0 | $21,922 | $0 | $215,468 | $0 | $0 | $0 |
| Cornelius Yetman DO | ||||||||||||||
| Trustee | $0 | $356,500 | $0 | $0 | $0 | $547 | $0 | $8,100 | $0 | $30,780 | $0 | $395,927 | $0 | $0 |
| Benjamin Mailloux MD | ||||||||||||||
| Frmr Medical Staff President - WCGH | $288,990 | $0 | $0 | $0 | $191 | $0 | $8,100 | $0 | $28,651 | $0 | $325,932 | $0 | $0 | $0 |
| Stephanie Lash MD | ||||||||||||||
| Medical Staff President - PBMC | $0 | $284,623 | $0 | $0 | $0 | $2,465 | $0 | $8,100 | $0 | $17,810 | $0 | $312,998 | $0 | $0 |
| Elizabeth Connolly DO | ||||||||||||||
| Medical Staff President - WCGH | $437,346 | $0 | $0 | $0 | $6,004 | $0 | $8,100 | $0 | $23,740 | $0 | $475,190 | $0 | $0 | $0 |
| Mark Fourre MD | ||||||||||||||
| CEO | $0 | $371,456 | $0 | $54,000 | $0 | $3,715 | $0 | $0 | $0 | $30,594 | $0 | $459,765 | $0 | $0 |
| Linda Drinkwater | ||||||||||||||
| Regional CFO | $311,612 | $0 | $0 | $0 | $1,346 | $0 | $8,100 | $0 | $27,079 | $0 | $348,137 | $0 | $0 | $0 |
| Owen Nelson MD | ||||||||||||||
| Orthopedics | $548,908 | $0 | $0 | $0 | $0 | $0 | $8,100 | $0 | $12,651 | $0 | $569,659 | $0 | $0 | $0 |
| Daniel Hebert MD | ||||||||||||||
| Orthopedics | $483,113 | $0 | $0 | $0 | $1,217 | $0 | $8,100 | $0 | $23,975 | $0 | $516,405 | $0 | $0 | $0 |
| Karen Miller MD | ||||||||||||||
| Otolaryngologist | $514,279 | $0 | $0 | $0 | $3,207 | $0 | $8,100 | $0 | $24,370 | $0 | $549,956 | $0 | $0 | $0 |
| David Ferguson MD | ||||||||||||||
| Cardivasc. Disease | $436,269 | $0 | $0 | $0 | $5,425 | $0 | $8,100 | $0 | $25,452 | $0 | $475,246 | $0 | $0 | $0 |
| Shane Lydon MD | ||||||||||||||
| Surgeon | $456,375 | $0 | $0 | $0 | $737 | $0 | $8,100 | $0 | $28,010 | $0 | $493,222 | $0 | $0 | $0 |
| Mark Biscone | ||||||||||||||
| Former CEO | $112,151 | $129,836 | $0 | $0 | $0 | $91 | $2,928 | $0 | $0 | $0 | $115,079 | $129,927 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Part I, Line 3 | FormAndLineReferenceDesc |
| Explanation | See description of process in Schedule O - Form 990, Part VI, Line 15 | ExplanationTxt |
Schedule K IRS990ScheduleK
Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
Issuer Name IssuerName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Maine Health & Higher Ed Facilities | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Issuer EIN | 010314384 | BondIssuerEIN |
| CUSIP | 560427W77 | CUSIPNum |
| Bond Issued | 2014-07-24 | BondIssuedDt |
| Issue Price | $6,774,309 | IssuePriceAmt |
| Purpose | Refund bonds issued 12/10/1998 | PurposeDesc |
| Defeased | 0 | DefeasedInd |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuerInd |
| Pool Financing | Yes (1) | PoolFinancingInd |
Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Retired | $1,395,000 | RetiredAmt |
| Total Proceeds | $6,774,309 | TotalProceedsAmt |
| In Reserve Fund | $760,327 | InReserveFundAmt |
| Issuance Costs From Proceeds | $80,234 | IssuanceCostsFromProceedsAmt |
| Other Spent Proceeds | $6,694,075 | OtherSpentProceedsAmt |
| Current Refunding | Yes (1) | CurrentRefundingInd |
| Advance Refunding | 0 | AdvanceRefundingInd |
| Final Allocation Made | Yes (1) | FinalAllocationMadeInd |
| Adequate Books And Rec Maint | Yes (1) | AdequateBooksAndRecMaintInd |
Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Owning Bond Financed Property | 0 | OwningBondFinancedPropertyInd |
| Any Lease Arrangements | 0 | AnyLeaseArrangementsInd |
| Mgmt Contract Bond Fincd Prop | 0 | MgmtContractBondFincdPropInd |
| Any Research Agreements | 0 | AnyResearchAgreementsInd |
| Private Bus Use By Others | 0.00000 | PrivateBusUseByOthersPct |
| Private Bus Concerning UBI | 0.00000 | PrivateBusConcerningUBIPct |
| Total Private Business Use | 0.00000 | TotalPrivateBusinessUsePct |
| Bond Iss Meet Prvt Sec Pymt Test | 0 | BondIssMeetPrvtSecPymtTestInd |
| Change In Use Bond Financed Prop | 0 | ChangeInUseBondFinancedPropInd |
| Procs Nonqualified Bond Remdtd | 0 | ProcsNonqualifiedBondRemdtdInd |
Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Form8038 T Filed | 0 | Form8038TFiledInd |
| Rebate Not Due Yet | Yes (1) | RebateNotDueYetInd |
| Exception To Rebate | 0 | ExceptionToRebateInd |
| No Rebate Due | 0 | NoRebateDueInd |
| Variable Rate Issue | 0 | VariableRateIssueInd |
| Hedge Identified In Bks And Rec | 0 | HedgeIdentifiedInBksAndRecInd |
| Gross Proceeds Invested In GIC | 0 | GrossProceedsInvestedInGICInd |
| Gross Proceeds Invested | 0 | GrossProceedsInvestedInd |
| Written Proc To Monitor Reqs | 0 | WrittenProcToMonitorReqsInd |
Procedures Corrective Action ProceduresCorrectiveActionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Procedures Corrective Action | 0 | ProceduresCorrectiveActionInd |
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Schedule K Part I column (e), and Part II lines 1-12 | The bond issue is a pooled financing. The institution's share of the pooled financing constitutes less than 100% of the issue. Part I columns (e) and (f), and all of Parts II and III have been answered with respect to the institution's share of the pooled financing, not with respect to 100% of the issue. |
| Schedule K Part II Line 4 | The amount shown here consists of $612,600 in a debt service reserve fund, plus $147,727 of debt service fund deposits. |
| Schedule K Part III Line 9, Part IV Line 7, Part V | During this fiscal year, the institution was in the process of implementing written compliance procedures. |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (9 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Form 990, Part V - Additional Information | Line 1a - Maine Medical Center (EIN 01-0238552), acting on behalf of MaineHealth (EIN 01-0431680), filed 1,030 Form 1099s for the calendar year 2017 on behalf of the following organizations: MaineHealth, Maine Medical Center, Southern Maine Health Care, Pen Bay Medical Center, Waldo County General Hospital, Franklin Memorial Hospital, LincolnHealth Group, Memorial Hospital, Western Maine Healthcare, Maine Behavioral Healthcare, NorDx, MaineHealth Care at Home. |
| Form 990, Part VI, Section A, line 6 | Coastal Healthcare Alliance (CHA) (EIN# 22-2494475) is the sole member of Waldo County General Hospital (WCGH). MaineHealth (EIN# 01-0431680), is the sole member of CHA. As the sole member of CHA, MaineHealth has the right to approve significant decisions of the governing body of CHA and its subsidiaries. |
| Form 990, Part VI, Section A, line 7a | MaineHealth (EIN# 01-0431680) may elect members of the Board of Directors from a slate of nominees submitted by the Corporation. |
| Form 990, Part VI, Section A, line 7b | Decisions of the governing body such as budgets, business strategies, significant financial commitments, amendments to the articles of incorporation, and election of the President/CEO among other decisions, are subject to approval by MaineHealth (EIN# 01-0431680). |
| Form 990, Part VI, Section B, line 11b | A detailed review of the Form 990 is performed by the Controller. The Form 990 is reviewed in detail with the Finance Committee. It is then made available to the full Board prior to filing. |
| Form 990, Part VI, Section B, line 12c | Waldo County General Hospital's conflict of interest policy is incorporated as part of the by-laws of this corporation. The organization consistently reviews all transactions to assure compliance in accordance with the by-laws. |
| Form 990, Part VI, Section B, line 15 | Compensation Process for Top Official: The process followed for determining compensation of the CEO compensated by this or other related organizations is a formal process performed annually by the Executive Committee of the Board of Directors. A related organization uses an outside firm, Sullivan Cotter, to perform an independent benchmark analysis for the CEO of WCGH, along with other executives in the MaineHealth system. The firm meets with the Executive Committee to review each executive's benchmark report. The Committee then deliberates on MaineHealth's written salary and incentive plan philosophy before making a final decision. All decisions and meetings are captured in minutes and there are appropriate approvals at all levels. Compensation Process for Officers: At the time of hire MaineHealth Compensation department utilizes market data to provide an accurate, competitive and appropriate offer. On an annual basis officers receive a merit increase related to the results of their annual performance appraisal performed by the CEO. At this time it is evaluated if an additional bonus will be provided based upon budget and performance, this is at the discretion of the CEO, CFO and HR Director. |
| Form 990, Part VI, Section C, line 19 | Documents that are required to be open for public inspection are made available upon request. |
| Form 990, Part XI, line 9: | Change in Fair Value of Perpetual Trust 1,971,570. Market appreciation - Charitable Remainder Trust 35,367. Net Asset Transfers to Related Parties -591,780. Transfer SPF to Brooks Ambulance -57,957. Equity Transf. from Belfast Public Health Nursing Assoc. -22,986. Equity Transf. from Waldo County Home Healthcare Services -122,321. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (12 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Controlled OrganizationControlledOrganizationInd | Direct Controlling NADirectControllingNACd |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Belfast Public Health Nursing | |||||||||||
| PO Box 287 | Belfast | ME | 04915 | 043359810 | Public health | ME | 501(c)(3) | Line 10 | Coastal Healthcare Alliance | 0 | |
| Coastal Healthcare Alliance | |||||||||||
| PO Box 287 | Belfast | ME | 04915 | 222494475 | Healthcare | ME | 501(c)(3) | Line 12b, II | MaineHealth | 0 | |
| Coastal Medical Care | |||||||||||
| PO Box 287 | Belfast | ME | 04915 | 010487091 | Medical services | ME | 501(c)(3) | Line 10 | Coastal Healthcare Alliance | 0 | |
| Kno-Wal-Lin Help at Home Inc | |||||||||||
| PO Box 287 | Belfast | ME | 04915 | 222968726 | Home services | ME | 501(c)(3) | Line 10 | Coastal Healthcare Alliance | 0 | |
| Kno-Wal-Lin Home Care and Hospice | |||||||||||
| PO Box 287 | Belfast | ME | 04915 | 010340947 | Home health | ME | 501(c)(3) | Line 10 | Coastal Healthcare Alliance | 0 | |
| Pen Bay Behavioral Health | |||||||||||
| PO Box 287 | Belfast | ME | 04915 | 010277794 | Behavioral health | ME | 501(c)(3) | Line 10 | Coastal Healthcare Alliance | 0 | |
| Penobscot Bay Medical Center | |||||||||||
| PO Box 287 | Belfast | ME | 04915 | 010285286 | Hospital | ME | 501(c)(3) | Line 3 | Coastal Healthcare Alliance | 0 | |
| Pen Bay Waldo Healthcare Foundation | |||||||||||
| PO Box 287 | Belfast | ME | 04915 | 222482325 | Fundraising | ME | 501(c)(3) | Line 7 | Coastal Healthcare Alliance | 0 | |
| Penobscot Bay Physicians & Assoc | |||||||||||
| PO Box 287 | Belfast | ME | 04915 | 010530517 | Physician services | ME | 501(c)(3) | Line 12b, II | Pen Bay Medical Center | 0 | |
| Quarry Hill | |||||||||||
| PO Box 287 | Belfast | ME | 04915 | 010213976 | Long term care | ME | 501(c)(3) | Line 10 | Coastal Healthcare Alliance | 0 | |
| Waldo County Home Healthcare Svcs | |||||||||||
| PO Box 287 | Belfast | ME | 04915 | 222864960 | Hospice | ME | 501(c)(3) | Line 10 | Coastal Healthcare Alliance | 0 | |
| MaineHealth | |||||||||||
| 110 Free Street | Portland | ME | 04101 | 010431680 | Healthcare | ME | 501(c)(3) | Line 12c, III-FI | 0 | N/A | |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (2 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Direct Controlling NADirectControllingNACd | Entity TypeEntityTypeTxt | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|
| Waldo County Healthcare Mgmt Co | |||||||||
| PO Box 287 | Belfast | ME | 04915 | 010485133 | Mgmt Svcs | ME | N/A | C | 0 |
| PBH Management Company | |||||||||
| PO Box 287 | Belfast | ME | 04915 | 010537278 | Management | ME | N/A | C | 0 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | Yes (1) | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | Yes (1) | 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 | Yes (1) | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | Yes (1) | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | Yes (1) | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | Yes (1) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | Yes (1) | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (1) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (1) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | Yes (1) | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | Yes (1) | TransferToOtherOrgInd |
| Transfer From Other Org | Yes (1) | TransferFromOtherOrgInd |
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