EASTERN MAINE HEALTHCARE SYSTEMS: Form 990, tax year 2016
View the entire original 990 at ProPublica ↗
- Organization
- EASTERN MAINE HEALTHCARE SYSTEMS (EIN 04-3341666)
- Tax period
- 2016-09-25 to 2017-09-30
- Filed
- 2018-08-03
- IRS object ID
- 201822159349301122
- Schema version
- 2016v3.0
- 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 I
- Schedule J
- Schedule L
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2018-08-03T12:23:31-07:00 | ReturnTs |
| Tax Period End | 2017-09-30 | TaxPeriodEndDt |
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2016-09-25 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 043341666 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Eastern Maine Healthcare SystemsCADean | BusinessNameLine1Txt |
| Business Name Line2 | Charles A Dean Memorial HospitalCADean | BusinessNameLine2Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | EAST | BusinessNameControlTxt |
| Phone | 2076955200 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | Pritham Avenue PO Box 1129 | AddressLine1Txt |
| City | Greenville | CityNm |
| State Abbreviation | ME | StateAbbreviationCd |
| ZIP | 04441 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | John J Doyle | PersonNm |
| Person Title | EMHS VP of Finance | PersonTitleTxt |
| Signature | 2018-08-03 | SignatureDt |
| Discuss With Paid Preparer | false | DiscussWithPaidPreparerInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2016 | TaxYr |
| Build TS | 2022-09-23 18:48:47Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | John J Doyle | PrincipalOfficerNm |
| Gross Receipts | $25,516,419 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| All Affiliates Included | false | AllAffiliatesIncludedInd |
| Group Exemption | 5247 | GroupExemptionNum |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | www.cadean.org | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1996 | FormationYr |
| Legal Domicile State | ME | LegalDomicileStateCd |
| Activity Or Mission | The mission of Charles A. Dean Memorial Hospital is to provide a continuum of high quality holistic healthcare services. | ActivityOrMissionDesc |
| Voting Members Governing Body | 14 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 9 | VotingMembersIndependentCnt |
| Total Employee | 186 | TotalEmployeeCnt |
| Total Volunteers | 67 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| PY Contributions Grants | $143,323 | PYContributionsGrantsAmt |
| CY Contributions Grants | $280,492 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $19,234,672 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $22,081,113 | CYProgramServiceRevenueAmt |
| PY Investment Income | $12,788 | PYInvestmentIncomeAmt |
| CY Investment Income | $119,659 | CYInvestmentIncomeAmt |
| PY Other Revenue | $23,320 | PYOtherRevenueAmt |
| CY Other Revenue | $38,536 | CYOtherRevenueAmt |
| PY Total Revenue | $19,414,103 | PYTotalRevenueAmt |
| CY Total Revenue | $22,519,800 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $4,550 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $17,381 | CYGrantsAndSimilarPaidAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $10,907,913 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $11,270,196 | CYSalariesCompEmpBnftPaidAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $44,254 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $10,104,964 | PYOtherExpensesAmt |
| CY Other Expenses | $10,131,191 | CYOtherExpensesAmt |
| PY Total Expenses | $21,017,427 | PYTotalExpensesAmt |
| CY Total Expenses | $21,418,768 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$1,603,324 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $1,101,032 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $11,408,155 | TotalAssetsBOYAmt |
| Total Assets EOY | $11,436,448 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $10,201,885 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $9,345,164 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $1,206,270 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $2,091,284 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | The mission of Charles A. Dean Memorial Hospital is to provide a continuum of high quality holistic healthcare services. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $19,064,781 | ExpenseAmt |
| Grant | $17,381 | GrantAmt |
| Revenue | $22,115,402 | RevenueAmt |
| Desc | The Charles A. Dean Memorial Hospital is a 25 bed Critical Access Hospital in rural northwestern Maine providing emergency, ambulance, inpatient acute care, outpatient surgery, specialty physician clinics and nursing home services to patients regardless of ability to pay. Provided $511,441 other uncompensated care (at cost).Additional Statistics:Northwoods Healthcare Clinic visits 11,331Hospital diagnostic and rehabilitation visits 17,593Emergency room visits 2,890 Hospital admissions 313Surgery cases 234Ambulance runs 335 | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $271,198 | ExpenseAmt |
| Desc | Provided charity care, $271,198 (at cost). 136 persons served. | Desc |
Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $173,560 | ExpenseAmt |
| Desc | Experienced Medicare shortfall, $173,560 (at cost). 13,010 persons served. | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Prog Srvc Expense | $91,594 | TotalOtherProgSrvcExpenseAmt |
| Total Program Service Expenses | $19,601,133 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (true) | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (true) | LobbyingActivitiesInd |
| Subject To Proxy Tax | false | SubjectToProxyTaxInd |
| Donor Advised Fund | false | DonorAdvisedFundInd |
| Conservation Easements | false | ConservationEasementsInd |
| Collections Of Art | false | CollectionsOfArtInd |
| Credit Counseling | false | CreditCounselingInd |
| Temp Or Permanent Endowments | Yes (true) | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (true) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | false | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | Yes (true) | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (true) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (true) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | false | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (true) | ConsolidatedAuditFinclStmtInd |
| School Operating | false | SchoolOperatingInd |
| Foreign Office | false | ForeignOfficeInd |
| Foreign Activities | false | ForeignActivitiesInd |
| More Than5000 K To Org | false | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividualsInd |
| Professional Fundraising | false | ProfessionalFundraisingInd |
| Fundraising Activities | Yes (true) | FundraisingActivitiesInd |
| Gaming Activities | false | GamingActivitiesInd |
| Operate Hospital | Yes (true) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (true) | AuditedFinancialStmtAttInd |
| Grants To Organizations | Yes (true) | GrantsToOrganizationsInd |
| Grants To Individuals | false | GrantsToIndividualsInd |
| Schedule J Required | Yes (true) | ScheduleJRequiredInd |
| Tax Exempt Bonds | false | TaxExemptBondsInd |
| Invest Tax Exempt Bonds | false | InvestTaxExemptBondsInd |
| Escrow Account | false | EscrowAccountInd |
| On Behalf Of Issuer | false | OnBehalfOfIssuerInd |
| Engaged In Excess Benefit Trans | false | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | false | PYExcessBenefitTransInd |
| Loan Outstanding | false | LoanOutstandingInd |
| Grant To Related Person | false | GrantToRelatedPersonInd |
| Business Rln With Org Mem | false | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | Yes (true) | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | Yes (true) | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | false | DeductibleNonCashContriInd |
| Deductible Art Contribution | false | DeductibleArtContributionInd |
| Terminate Operations | false | TerminateOperationsInd |
| Partial Liquidation | false | PartialLiquidationInd |
| Disregarded Entity | false | DisregardedEntityInd |
| Related Entity | Yes (true) | RelatedEntityInd |
| Related Organization Ctrl Ent | Yes (true) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | Yes (true) | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | false | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| IRP Document | 39 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (true) | BackupWthldComplianceInd |
| Employee | 186 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (true) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | false | UnrelatedBusIncmOverLimitInd |
| Form990 T Filed | false | Form990TFiledInd |
| Foreign Financial Account | false | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | false | TaxablePartyNotificationInd |
| Nondeductible Contributions | false | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | false | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOfInd |
| Form8282 Filed | 0 | Form8282FiledCnt |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | false | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | false | PayPremiumsPrsnlBnftCntrctInd |
| Form8899 Filedind | false | Form8899Filedind |
| Form1098 C Filed | false | Form1098CFiledInd |
| DAF Excess Business Holdings | false | DAFExcessBusinessHoldingsInd |
| Taxable Distributions | false | TaxableDistributionsInd |
| Distribution To Donor | false | DistributionToDonorInd |
| Org Filed In Lieu Of Form1041 | false | OrgFiledInLieuOfForm1041Ind |
| Licensed More Than One State | false | LicensedMoreThanOneStateInd |
| Indoor Tanning Services | false | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 14 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 9 | IndependentVotingMemberCnt |
| Family Or Business Rln | false | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | false | DelegationOfMgmtDutiesInd |
| Change To Org Documents | Yes (true) | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (true) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (true) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (true) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (true) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (true) | MinutesOfCommitteesInd |
| Officer Mailing Address | false | OfficerMailingAddressInd |
| Local Chapters | false | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (true) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (true) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (true) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (true) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (true) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (true) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (true) | CompensationProcessCEOInd |
| Compensation Process Other | false | CompensationProcessOtherInd |
| Investment In Joint Venture | false | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | ME | StatesWhereCopyOfReturnIsFldCd |
| Own Website | Yes (X) | OwnWebsiteInd |
| Other Website | Yes (X) | OtherWebsiteInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | John J Doyle | PersonNm |
| Phone | 2079739081 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 43 Whiting Hill Road | AddressLine1Txt |
| City | Brewer | CityNm |
| State Abbreviation | ME | StateAbbreviationCd |
| ZIP | 044121006 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (26 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 |
|---|---|---|---|---|---|---|---|---|---|
| Marion Huntley | |||||||||
| Director | 0.50 | 0.00 | Yes (X) | $0 | $0 | $0 | |||
| Steven Bilodeau | |||||||||
| Director | 0.50 | 0.00 | Yes (X) | $0 | $0 | $0 | |||
| Darin M Peck MD | |||||||||
| CMO | 40.00 | 0.00 | Yes (X) | $302,477 | $0 | $44,147 | |||
| Dwight Foote Jr | |||||||||
| Director | 0.50 | 0.00 | Yes (X) | $0 | $0 | $0 | |||
| Stuart Watt | |||||||||
| Director | 0.50 | 0.00 | Yes (X) | $0 | $0 | $0 | |||
| Linda D Gilbert | |||||||||
| Chairman | 2.00 | 0.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | ||
| Diane K Bartley | |||||||||
| Director | 0.50 | 0.00 | Yes (X) | $0 | $0 | $0 | |||
| Terri Vieira | |||||||||
| President | 20.00 | 30.00 | Yes (X) | $103,671 | $155,508 | $87,365 | Yes (X) | ||
| Sharon Hastings | |||||||||
| Director | 0.50 | 0.00 | Yes (X) | $0 | $0 | $0 | |||
| David S Richards | |||||||||
| Vice Chairman | 2.00 | 0.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | ||
| Mary M Hood President CEO | |||||||||
| Ex-Officio | 1.00 | 50.00 | Yes (X) | $0 | $885,839 | $271,712 | Yes (X) | ||
| Eugene F Murray Jr | |||||||||
| Director | 40.00 | 0.00 | Yes (X) | $196,601 | $0 | $71,639 | Yes (X) | ||
| Ronald Pelletier | |||||||||
| Director | 0.50 | 0.00 | Yes (X) | $0 | $0 | $0 | |||
| Laurie Muzzy | |||||||||
| Director | 0.50 | 0.00 | Yes (X) | $0 | $0 | $0 | |||
| Gregg Christensen PA-C | |||||||||
| Director | 40.00 | 0.00 | Yes (X) | $109,335 | $0 | $20,079 | |||
| Lorraine Rodgerson RN | |||||||||
| VP/CNO | 40.00 | 0.00 | $154,054 | $0 | $19,887 | Yes (X) | |||
| Anthony J Filer | |||||||||
| Treasurer | 1.00 | 50.00 | $0 | $177,610 | $2,704 | Yes (X) | |||
| Yoosuf Siddiqui | |||||||||
| VP/HR Northwest | 0.50 | 40.00 | $0 | $126,728 | $32,816 | Yes (X) | |||
| Jennifer Goodrich | |||||||||
| VP/Finance | 40.00 | 0.00 | $140,519 | $0 | $25,755 | Yes (X) | |||
| Glenn Martin VPGeneral Couns | |||||||||
| Secretary | 1.00 | 50.00 | $0 | $368,621 | $90,480 | Yes (X) | |||
| Paul Potvin | |||||||||
| Physician | 40.00 | 0.00 | $287,278 | $0 | $44,079 | Yes (X) | |||
| Joseph Babbitt | |||||||||
| Physician | 40.00 | 0.00 | $350,619 | $0 | $45,411 | Yes (X) | |||
| Shannon M Meredith | |||||||||
| Physician | 40.00 | 0.00 | $191,585 | $0 | $20,119 | Yes (X) | |||
| Galen G Durose | |||||||||
| Physician | 40.00 | 0.00 | $187,962 | $0 | $30,799 | Yes (X) | |||
| Mario Turi | |||||||||
| Physician | 40.00 | 0.00 | $246,274 | $0 | $31,632 | Yes (X) | |||
| Tracy Bonney-Corson | |||||||||
| Former VP/CNO | 40.00 | 0.00 | $0 | $110,480 | $28,181 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $2,270,375 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $1,824,786 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $866,805 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 18 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | Yes (true) | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (true) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| Dunbar & Brawn Construction | |||||
| 223 Hildreth Street North | Bangor | ME | 04401 | Construction | $1,117,018 |
| Nurse Anesthesia of Maine | |||||
| 141 Main Street Suite 205 | Brewer | ME | 04412 | Anesthesia Services | $115,251 |
| American Healthcare Services Association | |||||
| PO BOX 945 | Traverse City | MI | 49685 | Temporary Staffing | $179,379 |
| American Mobile Nurse dba AMN Healthcare Inc | |||||
| 2735 Collection Center Drive | Chicago | IL | 60693 | Temporary Staffing | $124,647 |
| Vista Staffing Solutions Inc | |||||
| File 50834 | Los Angeles | CA | 900740834 | Locum Physician Staf | $114,387 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 5 | CntrctRcvdGreaterThan100KCnt |
| Fundraising | $11,949 | FundraisingAmt |
| Related Organizations | $7,094 | RelatedOrganizationsAmt |
| All Other Contributions | $261,449 | AllOtherContributionsAmt |
| Noncash Contributions | $3,447 | NoncashContributionsAmt |
| Total Contributions | $280,492 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | ExclusionExclusionAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|---|
| Cafeteria | 722210 | $7,545 | $7,545 | |
| Patient Care Services | 621990 | $22,073,568 | $22,073,568 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $22,081,113 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $6,871 | TotalRevenueColumnAmt |
| Exclusion | $6,871 | ExclusionAmt |
Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Royalties Revenue RoyaltiesRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $7,140 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $2,893 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $4,247 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $4,247 | TotalRevenueColumnAmt |
| Exclusion | $4,247 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $3,100,979 | SecuritiesAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $2,988,191 | SecuritiesAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $112,788 | SecuritiesAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $112,788 | TotalRevenueColumnAmt |
| Exclusion | $112,788 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fundraising Gross Income | $5,535 | FundraisingGrossIncomeAmt |
| Contri Rpt Fundraising Event | $11,949 | ContriRptFundraisingEventAmt |
| Fundraising Direct Expenses | $5,535 | FundraisingDirectExpensesAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Net Income From Gaming NetIncomeFromGamingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Net Income Or Loss NetIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Other Revenue Misc OtherRevenueMiscGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | Misc Revenue | Desc |
| Business | 621990 | BusinessCd |
| Total Revenue Column | $34,289 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $34,289 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $34,289 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $22,519,800 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $22,107,857 | RelatedOrExemptFuncIncomeAmt |
| Exclusion | $131,451 | ExclusionAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $14,881 | TotalAmt |
| Program Services | $14,881 | ProgramServicesAmt |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,500 | TotalAmt |
| Program Services | $2,500 | ProgramServicesAmt |
Foreign Grants ForeignGrantsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Benefits To Members BenefitsToMembersGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,223,110 | TotalAmt |
| Program Services | $649,979 | ProgramServicesAmt |
| Management And General | $573,131 | ManagementAndGeneralAmt |
Comp Disqual Persons CompDisqualPersonsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,535,995 | TotalAmt |
| Program Services | $7,172,069 | ProgramServicesAmt |
| Management And General | $363,926 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $449,504 | TotalAmt |
| Program Services | $429,213 | ProgramServicesAmt |
| Management And General | $20,291 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,523,075 | TotalAmt |
| Program Services | $1,452,701 | ProgramServicesAmt |
| Management And General | $70,374 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $538,512 | TotalAmt |
| Program Services | $514,202 | ProgramServicesAmt |
| Management And General | $24,310 | ManagementAndGeneralAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $499 | TotalAmt |
| Management And General | $499 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $43,186 | TotalAmt |
| Management And General | $43,186 | ManagementAndGeneralAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Prof Fundraising FeesForServicesProfFundraising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,618,892 | TotalAmt |
| Program Services | $1,268,635 | ProgramServicesAmt |
| Management And General | $350,068 | ManagementAndGeneralAmt |
| Fundraising | $189 | FundraisingAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $39,651 | TotalAmt |
| Management And General | $1,109 | ManagementAndGeneralAmt |
| Fundraising | $38,542 | FundraisingAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $535,258 | TotalAmt |
| Program Services | $445,800 | ProgramServicesAmt |
| Management And General | $87,870 | ManagementAndGeneralAmt |
| Fundraising | $1,588 | FundraisingAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $454,597 | TotalAmt |
| Program Services | $430,875 | ProgramServicesAmt |
| Management And General | $23,722 | ManagementAndGeneralAmt |
Royalties RoyaltiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $203,448 | TotalAmt |
| Program Services | $157,286 | ProgramServicesAmt |
| Management And General | $46,162 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $75,108 | TotalAmt |
| Program Services | $51,036 | ProgramServicesAmt |
| Management And General | $24,072 | ManagementAndGeneralAmt |
Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $29,056 | TotalAmt |
| Program Services | $27,011 | ProgramServicesAmt |
| Management And General | $2,045 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $89,444 | TotalAmt |
| Program Services | $89,444 | ProgramServicesAmt |
Payments To Affiliates PaymentsToAffiliatesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $453,624 | TotalAmt |
| Program Services | $349,754 | ProgramServicesAmt |
| Management And General | $103,870 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $371,567 | TotalAmt |
| Program Services | $364,877 | ProgramServicesAmt |
| Management And General | $6,690 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt |
|---|---|---|
| Contractual Allowances | $3,426,430 | $3,426,430 |
| Medical Supplies Expenses | $1,031,137 | $1,031,137 |
| Bad Debt Expense | $713,971 | $713,971 |
| Charity Care | $378,505 | $378,505 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $666,818 | TotalAmt |
| Program Services | $630,827 | ProgramServicesAmt |
| Management And General | $32,056 | ManagementAndGeneralAmt |
| Fundraising | $3,935 | FundraisingAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $21,418,768 | TotalAmt |
| Program Services | $19,601,133 | ProgramServicesAmt |
| Management And General | $1,773,381 | ManagementAndGeneralAmt |
| Fundraising | $44,254 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $10,834 | BOYAmt |
| EOY | $1,995,154 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $226,242 | BOYAmt |
| EOY | $451,191 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,553,727 | BOYAmt |
| EOY | $2,211,585 | EOYAmt |
Receivables From Officers Etc ReceivablesFromOfficersEtcGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $242,724 | BOYAmt |
| EOY | $227,196 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $53,261 | BOYAmt |
| EOY | $65,223 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $11,250,353 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $6,084,349 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,626,935 | BOYAmt |
| EOY | $5,166,004 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,694,432 | BOYAmt |
| EOY | $1,320,095 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $11,408,155 | BOYAmt |
| EOY | $11,436,448 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,528,017 | BOYAmt |
| EOY | $3,637,707 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $595 | EOYAmt |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $208,295 | BOYAmt |
| EOY | $173,117 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,465,573 | BOYAmt |
| EOY | $5,533,745 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $10,201,885 | BOYAmt |
| EOY | $9,345,164 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $451,071 | BOYAmt |
| EOY | $1,154,494 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $394,716 | BOYAmt |
| EOY | $576,307 | EOYAmt |
Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $360,483 | BOYAmt |
| EOY | $360,483 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,206,270 | BOYAmt |
| EOY | $2,091,284 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $11,408,155 | BOYAmt |
| EOY | $11,436,448 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $1,101,032 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | -$94,100 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | -$121,918 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | false | AccountantCompileOrReviewInd |
| FS Audited | Yes (true) | 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 (true) | AuditCommitteeInd |
| Federal Grant Audit Required | false | 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) |
|---|---|---|
| Form4720 Filed Section4955 Tax | false | Form4720FiledSection4955TaxInd |
| Correction Made | false | CorrectionMadeInd |
| Volunteers | false | VolunteersInd |
| Paid Staff Or Management | false | PaidStaffOrManagementInd |
| Media Advertisements | false | MediaAdvertisementsInd |
| Mailings Members | false | MailingsMembersInd |
| Publications Or Broadcast | false | PublicationsOrBroadcastInd |
| Grants Other Organizations | false | GrantsOtherOrganizationsInd |
| Direct Contact Legislators | false | DirectContactLegislatorsInd |
| Rallies Demonstrations | false | RalliesDemonstrationsInd |
| Other Activities | Yes (true) | OtherActivitiesInd |
| Other Activities | $4,641 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $4,641 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | false | NotDescribedSection501c3Ind |
| Form4720 Filed4912 Tax | false | Form4720Filed4912TaxInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Part II-B, Line 1i - Other Activities Description | FormAndLineReferenceDesc |
| Explanation | Non-deductible portion of dues. | ExplanationTxt |
Schedule D IRS990ScheduleD
CY Endwmt Fund CYEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $1,005,313 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | -$294,567 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $2,325 | OtherExpendituresAmt |
| Administrative Expenses | $2,105 | AdministrativeExpensesAmt |
| End Year Balance | $706,316 | EndYearBalanceAmt |
CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $907,461 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $103,830 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $1,887 | OtherExpendituresAmt |
| Administrative Expenses | $4,091 | AdministrativeExpensesAmt |
| End Year Balance | $1,005,313 | EndYearBalanceAmt |
CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $919,597 | BeginningYearBalanceAmt |
| Contributions | $280 | ContributionsAmt |
| Investment Earnings Or Losses | -$6,564 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $1,960 | OtherExpendituresAmt |
| Administrative Expenses | $3,892 | AdministrativeExpensesAmt |
| End Year Balance | $907,461 | EndYearBalanceAmt |
CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $891,632 | BeginningYearBalanceAmt |
| Contributions | $350 | ContributionsAmt |
| Investment Earnings Or Losses | $32,946 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $1,630 | OtherExpendituresAmt |
| Administrative Expenses | $3,701 | AdministrativeExpensesAmt |
| End Year Balance | $919,597 | EndYearBalanceAmt |
CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $866,148 | BeginningYearBalanceAmt |
| Contributions | $9,001 | ContributionsAmt |
| Investment Earnings Or Losses | $20,820 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $855 | OtherExpendituresAmt |
| Administrative Expenses | $3,482 | AdministrativeExpensesAmt |
| End Year Balance | $891,632 | EndYearBalanceAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Designated Balance EOY | 0.46000 | BoardDesignatedBalanceEOYPct |
| Prmnnt Endowment Balance EOY | 0.54000 | PrmnntEndowmentBalanceEOYPct |
| Endowments Held Unrelated Org | false | EndowmentsHeldUnrelatedOrgInd |
| Endowments Held Related Org | Yes (true) | EndowmentsHeldRelatedOrgInd |
| Related Org List Sch R | Yes (true) | RelatedOrgListSchRInd |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $295,740 | OtherCostOrOtherBasisAmt |
| Book Value | $295,740 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $5,966,083 | OtherCostOrOtherBasisAmt |
| Depreciation | $3,234,744 | DepreciationAmt |
| Book Value | $2,731,339 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $4,988,530 | OtherCostOrOtherBasisAmt |
| Depreciation | $2,849,605 | DepreciationAmt |
| Book Value | $2,138,925 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $5,166,004 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp (6 entries)
| DescDesc | Book ValueBookValueAmt |
|---|---|
| Assets Held Under Trust Indenture | $30,066 |
| Board Designated Investments | $329,230 |
| Org costs & other long term investments | $12,552 |
| Permanently Donor Restricted Funds | $360,483 |
| Self-Insurance Funds Held by Trustee | $11,457 |
| Temporarily Donor Restricted Funds | $576,307 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $1,320,095 | TotalBookValueOtherAssetsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (3 entries)
| DescDesc | AmtAmt |
|---|---|
| Accrual for Post Retirement Benefit | $1,894,592 |
| Amounts due to Related Org | $3,606,729 |
| Capital Lease Obligation | $32,424 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $5,533,745 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Part V, Line 4: Intended uses of the endowment fund. | Endowment Funds are designated for purposes that align within this organization's exempt purpose. |
| Part X : FIN48 Footnote | EMHS, its hospitals, and certain other affiliates have been determined by the Internal Revenue Service to be tax-exempt charitable organizations as described in Section 501(c)(3) or 501(c)(2) of the Internal Revenue Code (the Code) and, accordingly, are exempt from federal income taxes on related income pursuant to Section 501(a) of the Code. Accordingly, no provision for federal income taxes has been recorded in the accompanying consolidated financial statements for these organizations.Tax-exempt charitable 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 System has evaluated its tax position taken or expected to be taken on income tax returns and concluded the impact to be not material.Certain of the System's affiliates are taxable entities. Deferred taxes related to these entities are based on the difference between the financial statement and tax basis of assets and liabilities using enacted tax rates in effect in the years the differences are expected to reverse. The deferred tax assets and liabilities for these entities are not material. |
Schedule G IRS990ScheduleG
| Field | Value | IRS element (for citing) |
|---|---|---|
| Agrmt Prof Fundraising Acty | false | AgrmtProfFundraisingActyInd |
Fundraising Event Information FundraisingEventInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Event1 | Golf Tournament | Event1Nm |
| Gross Receipts Event1 | $12,399 | GrossReceiptsEvent1Amt |
| Charitable Contri Event1 | $9,877 | CharitableContriEvent1Amt |
| Gross Revenue Event1 | $2,522 | GrossRevenueEvent1Amt |
| Food And Beverage Event1 | $500 | FoodAndBeverageEvent1Amt |
| Other Direct Expenses Event1 | $2,022 | OtherDirectExpensesEvent1Amt |
| Event2 | Bike 'n Boat | Event2Nm |
| Gross Receipts Event2 | $5,085 | GrossReceiptsEvent2Amt |
| Charitable Contri Event2 | $2,072 | CharitableContriEvent2Amt |
| Gross Revenue Event2 | $3,013 | GrossRevenueEvent2Amt |
| Food And Beverage Event2 | $275 | FoodAndBeverageEvent2Amt |
| Other Direct Expenses Event2 | $2,738 | OtherDirectExpensesEvent2Amt |
| Gross Receipts Total | $17,484 | GrossReceiptsTotalAmt |
| Charitable Contributions Tot | $11,949 | CharitableContributionsTotAmt |
| Gross Revenue Total Events | $5,535 | GrossRevenueTotalEventsAmt |
| Food And Beverage Total Events | $775 | FoodAndBeverageTotalEventsAmt |
| Oth Direct Expnss Total Events | $4,760 | OthDirectExpnssTotalEventsAmt |
| Direct Expense Summary Events | $5,535 | DirectExpenseSummaryEventsAmt |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (true) | FinancialAssistancePolicyInd |
| Written Policy | Yes (true) | WrittenPolicyInd |
| FPG Reference Free Care | Yes (true) | FPGReferenceFreeCareInd |
| Percent150 | Yes (X) | Percent150Ind |
| FPG Reference Discounted Care | Yes (true) | FPGReferenceDiscountedCareInd |
| Percent250 | Yes (X) | Percent250Ind |
| Free Care Medically Indigent | Yes (true) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (true) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | false | ExpensesExceedBudgetInd |
| Unable To Provide Care | false | UnableToProvideCareInd |
| Annual Community Bnft Report | Yes (true) | AnnualCommunityBnftReportInd |
| Report Publically Available | Yes (true) | ReportPublicallyAvailableInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 136 | PersonsServedCnt |
| Total Community Benefit Expns | $271,198 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $271,198 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01600 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 2988 | PersonsServedCnt |
| Total Community Benefit Expns | $781,384 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $689,790 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $91,594 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00540 | TotalExpensePct |
Unreimbursed Costs UnreimbursedCostsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $283 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $283 | NetCommunityBenefitExpnsAmt |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 3124 | PersonsServedCnt |
| Total Community Benefit Expns | $1,052,865 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $689,790 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $363,075 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.02140 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 5 | ActivitiesOrProgramsCnt |
| Persons Served | 1686 | PersonsServedCnt |
| Total Community Benefit Expns | $70,744 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $70,744 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00420 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 2 | ActivitiesOrProgramsCnt |
| Persons Served | 15 | PersonsServedCnt |
| Total Community Benefit Expns | $746 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $746 | NetCommunityBenefitExpnsAmt |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 7 | ActivitiesOrProgramsCnt |
| Persons Served | 1701 | PersonsServedCnt |
| Total Community Benefit Expns | $71,490 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $71,490 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00420 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 7 | ActivitiesOrProgramsCnt |
| Persons Served | 4825 | PersonsServedCnt |
| Total Community Benefit Expns | $1,124,355 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $689,790 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $434,565 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.02560 | TotalExpensePct |
Coalition Building CoalitionBuildingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 1 | ActivitiesOrProgramsCnt |
| Persons Served | 1605 | PersonsServedCnt |
| Total Community Benefit Expns | $23,738 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $23,738 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00140 | TotalExpensePct |
Total Communtity Building Acty TotalCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 1 | ActivitiesOrProgramsCnt |
| Persons Served | 1605 | PersonsServedCnt |
| Total Community Benefit Expns | $23,738 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $23,738 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00140 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (true) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $511,441 | BadDebtExpenseAmt |
| Reimbursed By Medicare | $7,229,920 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $7,403,480 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$173,560 | 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 (true) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (true) | 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 | CA Dean Memorial Hospital | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 364 Pritham Avenue | AddressLine1Txt |
| City | Greenville | CityNm |
| State Abbreviation | ME | StateAbbreviationCd |
| ZIP | 04441 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | www.cadean.org | WebsiteAddressTxt |
| State License | 37959 | 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 | CA Dean Memorial Hospital | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| First Licensed CY Or PY | false | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | false | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | Yes (true) | 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 (true) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | Yes (true) | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | Yes (true) | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (true) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | http://cadean.org/ | OwnWebsiteURLTxt |
| Other Website | Yes (X) | OtherWebsiteInd |
| Other Website URL | www.emhs.org/Community-Benefit/CHNA.aspx | OtherWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Implementation Strategy Adopt | Yes (true) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 16 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (true) | StrategyPostedWebsiteInd |
| Strategy Website URL | http://www.emhs.org/Community-Benefit/CHNA/ | StrategyWebsiteURLTxt |
| Strategy Attached | false | StrategyAttachedInd |
| Organization Incur Excise Tax | false | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (true) | EligCriteriaExplainedInd |
| FPG Family Incm Lmt Free Dscnt | Yes (X) | FPGFamilyIncmLmtFreeDscntInd |
| FPG Family Incm Lmt Free Care | 150.0000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 250.0000 | FPGFamilyIncmLmtDscntCarePct |
| Explained Basis | false | ExplainedBasisInd |
| App Financial Asst Expln | Yes (true) | AppFinancialAsstExplnInd |
| Described Info | Yes (X) | DescribedInfoInd |
| Described Suprt Doc | Yes (X) | DescribedSuprtDocInd |
| Provided Hospital Contact | Yes (X) | ProvidedHospitalContactInd |
| Includes Publicity Measures | Yes (true) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | See Part V, Line 16i-j for URL | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | See Part V, Line 16i-j for URL | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | See Part V, Line 16i-j for URL | 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 |
| Other Publicity | Yes (X) | OtherPublicityInd |
| FAP Actions On Nonpayment | Yes (true) | FAPActionsOnNonpaymentInd |
| Permit No Actions | Yes (X) | PermitNoActionsInd |
| Collection Activities | false | 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 (true) | NondisEmergencyCarePolicyInd |
| Look Back Medicare Private | Yes (X) | LookBackMedicarePrivateInd |
| Amounts Generally Billed | false | AmountsGenerallyBilledInd |
| Gross Charges | false | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Part V, Line 5 - Account Input from Persons Who Represent the Community | The Maine Shared CHNA research team conducted a statewide survey among stakeholders to identify and prioritize significant health issues in communities across the state. The survey, coordinated with the Maine CDC, engaged public health expertise throughout the process. The survey was administered using a snowball approach where stakeholder agencies agreed to send the surveys to their members and stakeholders for participation. 1,639 people, representing more than 80 organizations and businesses in Maine, completed the survey. Respondents represented health care agencies, public health agencies, law enforcement, municipalities, schools, local businesses, social service agencies, and nongovernmental organizations. In addition to the stakeholder survey, each county conducted a number of community engagement opportunities (forums) to ensure broad interests of the local community were represented; Obtain stakeholder input on identifying significant health needs based on review of shared CHNA data; Solicit stakeholder feedback on prioritizing significant health needs, and; Identify local assets and resources that potentially may address local health priorities. The local forums were conducted in collaboration with the Maine CDC to solicit input from individuals representing populations with health disparities. The following organizations were in attendance at the November 12, 2015 Piscataquis County Shared CHNA Community Engagement Input Forum and provided valuable feedback on the Shared CHNA.Details about organizations: Government - representation from DHHS (low income, medically under-served); Non-profit hospitals Mayo Regional Hospital, Eastern Maine Medical Center, EMHS, Charles A. Dean Memorial Hospital providing services to MaineCare populations (MaineCare-low income; free/low cost care through medical centers-medically under served); Piscataquis Public Health Coalition provide education and health promotion through educational programs, local health resources, and health and environmental policy change. |
| Part V, Line 6a - List Other Hospital Facilities that Jointly Conducted Needs Assessment | The Shared CHNA was conducted through the Maine Shared Health Needs Assessment Planning Process (SHNAPP) a collaborative effort among Maine's four largest health-care systems Central Maine Healthcare, Eastern Maine Healthcare Systems (EMHS), MaineGeneral Health, MaineHealth and the Maine Center for Disease Control and Prevention, an office of the Maine Department of Health and Human Services (DHHS). EMHS member organizations participating in the Shared CHNA included Acadia Hospital, Blue Hill Memorial Hospital, Charles A. Dean Memorial Hospital, Eastern Maine Medical Center, Inland Hospital, Maine Coast Memorial Hospital, Mercy Hospital, Sebasticook Valley Health, and TAMC. |
| Part V, Line 11 - Explanation of Needs Not Addressed and Reasons Why | Non-Selected priorities:TransportationLack of insurance/unable to pay for the careHunger/Food InsecuritiesWe did not choose the priorities listed because we know that theyre important, but we have current processes in place to help with these concerns. For transportation, CA Dean has purchased a courtesy van which is not advertised, but is used to pick up/drop off patients free of charge. The lack of insurance/unable to pay for care issue has been addressed by our newly certified patient financial counselor who is also a Certified Application Specialist for the Healthcare Marketplace. She also works to help those who do not have the means to pay fill out paperwork for MaineCare and Free Care if needed. We have worked with the local school to develop the backpack program which is a program that sends backpacks full of healthy food home with children who need it each night and over the weekends. |
| Part V, Line 13b - Criteria For Providing Discounted Care If Not FPG | Due to software glitch, this is in reference to Part V, Line 14 Explain Method for Applying for Financial Assistance - See Part VI, Additional Information for explanation. |
| Part V, Line 16i - Other Means Hospital Facility Publicized the Policy | Response for 16a, 16b, 16c (list url) is http://www.cadean.org/For-Patients.aspx under "Financial Assistance Program" |
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 |
|---|---|---|---|---|
| Northwoods Healthcare | ||||
| 364 Pritham Avenue | Greenville | ME | 04441 | Outpatient clinic |
| Northwoods Healthcare | ||||
| 7 Greenville Road | Monson | ME | 04464 | Outpatient clinic |
| Northwoods Healthcare | ||||
| 22 Haley Court Road | Sangerville | ME | 04479 | Outpatient clinic |
| Northwoods Healthcare | ||||
| 364 Pritham Avenue | Greenville | ME | 04441 | Specialty Clinics |
Supplemental Information Detail SupplementalInformationDetail (14 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Part I, Line 6a - Related Organization Community Benefit Report | The Charles A Dean Memorial Hospital community benefit report is contained in an annual community benefit report prepared by Eastern Maine Healthcare Systems which is the parent organization of all related organizations. |
| Part I, Line 7 - Explanation of Costing Methodology | Ratio of Patient Care Cost-to-Charges is used in calculations. |
| Part I, Line 7, Column F - Explanation of Bad Debt Expense | $713,971 of bad debt expense, $378,505 of charity care and $3,426,430 of contractual allowances is included on Form 990, Part IX, line 25, column (A) |
| Part III, Line 2 - Methodology Used To Estimate Bad Debt Expense | The costing methodology used to determine the amount is cost to charge ratio. |
| Part III, Line 4 - Bad Debt Expense | Patient and trade accounts receivable are stated at the amount management expects to collect from outstanding balances. Management provides for probable uncollectible amounts through a charge to earnings and a valuation allowance based on its assessment of the current status of individual accounts. Balances that are still outstanding after management has used reasonable collection efforts are written off through a charge to the valuation allowance and the applicable patient accounts receivable. Credit is extended without collateral. |
| Part III, Line 8 - Explanation Of Shortfall As Community Benefit | Medicare losses should be treated as a community benefit because the losses are incurred in performing an important public service, and Maine hospitals experience one of the lowest Medicare reimbursement rates in the country. |
| Part III, Line 9b - Provisions On Collection Practices For Qualified Patients | All account guarantors who express an inability to pay inpatient and outpatient services will be screened for eligibility for charity care using an application and guidelines established by CA Dean. An account may be reconsidered for charity care at any time when new information is available about a patient's inability to pay. |
| Part VI - Patient Education of Eligibility for Assistance | Charles A. Dean Memorial Hospital has a full time patient financial counselor who assists patients with determining eligibility for Mainecare and other payors. This employee also provides education and guidelines for the organizations financial assistance policy. |
| Part VI - Community Information | Charles A. Dean Memorial Hospital immediately serves Greenville and the surrounding Moosehead Lake area. This area is completely rural. We have patients all throughout Piscataquis county. The population in the county is 17,124. Of that population, 18.5% are living in poverty with 28.9% of children living in poverty. The median household income is $36,646. The overall mortality rate per 100,000 population is 847.4. 14.4% are uninsured. |
| Part VI - Community Building Activities | CA Dean actively participates by fulfilling the needs of our civic, community and faith based organizations. We offer flu clinics and blood pressure clinics just to name a few. CA Dean works in collaboration with the school on a number of projects including; nutritious food 'back pack program', activities that promote health and wellness, and general health education. CA Dean sponsors a number of healthy lifestyle activities such as an annual triathlon and Bike and Boat. We also offer a Community Paramedicine Program in conjunction with ER, Inpatient, and the provider offices as a follow-up on patients in our communities. |
| Part VI - Explanation Of How Organization Furthers Its Exempt Purpose | Charles A. Dean Memorial Hospital Board of Directors majority is independent. CA Dean extends medical staff privileges to all qualified physicians in the community for the departments. We have offered CME programs on site and invited medical staff to participate at no charge to them. Weve been able to promote community health by opening up the physical therapy gym to the community and provide a fitness center for little cost. |
| Part VI - Affilated Health Care System Roles and Promotion | The 2016 Shared Community Health Needs Assessment conducted by EMHS (Eastern Maine Healthcare Systems) in collaboration with several member/affiliated hospitals and the many public health and community organizations across the state. The Shared Community Health Needs Assessment informs initiatives to promote community health across the system as well as within each member hospitals local service area. Each member hospital adopted a local implementation strategy and community health improvement plan, tailored to meet local needs. |
| Part VI - States Where Community Benefit Report Filed | N/A |
| Part VI - Additional Information | Disclosure in accordance with Revenue Procedure 2015-21:Part V Facility Information, Section B Facility Policies and PracticesIn accordance with Revenue Procedure 2015-21, CA Dean is disclosing the following information with respect to Section 501(r) issues that were discovered during the 2017 tax year and how these have been corrected to satisfy 501(r) requirements.For all items:A good-faith effort was made to implement the requirements of the Section 501(r) regulations. CA Dean obtained information about the requirements and sought to implement them accordingly, but later identified some compliance gaps due to the detailed nature of the regulations.The issues were discovered in fiscal year 2017 during an internal audit of CA Deans compliance with Sections 501(r)(3-4). The correction of these issues did not result in any changes to our overall processes and, therefore, CA Dean has not identified any persons directly affected by these issues. All individuals would have been in the same position had these issues not occurred.To ensure full compliance with Section 501(r) regulations, EMHS Community Health and Revenue Cycle Departments perform routine reviews to assure CA Dean is in compliance with Section 501(r). In addition, EMHS continues to engage EMHS Internal Audit to review CA Deans compliance with Section 501(r).Specific issues and corrections:1. Approval of the Community Health Needs Assessment (CHNA) and Implementation Strategy a. Requirement: The CHNA must be documented in a written report that is adopted for the hospital facility by an authorized body of the hospital facility. An authorized body of the hospital facility also must adopt an implementation strategy to meet the community health needs identified through the CHNA on or before the 15th day of the fifth month after the end of such taxable year. b. Condition: While the Board minutes and related meeting materials retained for CA Dean demonstrated the Boards intent to approve both the CHNA and implementation strategy, the Board vote(s) as documented in the minutes did not clearly demonstrate that the Board approved both items. c. Corrective Action: A resolution was passed by CA Deans Board to clarify the Boards intent to approve the CHNA and implementation strategy. d. Date Corrected: C.A. Dean: June 8, 20172. Information in the FAP regarding Amounts Generally Billed (AGB) a. Requirement: The FAP must include the method the hospital facility uses to determine the amounts generally billed to individuals who have insurance covering emergency or other medically necessary care and must state the AGB percentages or explain how members of the public may readily obtain such percentages.b. Condition: While the Plain Language Summary (PLS) indicated that AGB will be calculated using the look-back method, based on actual past claims paid to the hospital by Medicare and by other private insurers, the FAP did not adequately explain the method used to determine AGB, state the AGB percentages or explain how members of the public may readily obtain the AGB percentages (and these AGB percentages also were not otherwise readily available). c. Corrective Action: The FAP was updated to explain the method used to determine AGB. The FAP was also updated to state To request a free written description of how EMHS calculates the AGB or to find out the actual AGB for a particular EMHS hospital, please contact (207) 973-6473 or (207) 973-4483 or on the Web at http://emhs.org/Billing-help.aspx. CA Deans AGB percentage was added to this Web site. d. Date Corrected: These revisions to the FAP were approved by EMHS Leadership in Fiscal Year 2017 and the EMHS Board of Directors at its October 4, 2017 meeting. The updated FAP was widely publicized upon approval by the EMHS Board of Directors. The AGB percentages were added to the EMHS Web site in January 2018.3. Presumptive eligibilitya. Requirement: The FAP must include whether and under what circumstances prior FAP-eligibility determinations are used for presumptive eligibility.b. Condition: The FAP explained that approved applications from one EMHS Member Organization will be honored at another EMHS Member Organization, but did not fully describe the circumstances under which prior FAP-eligibility determinations are used for presumptive eligibility.c. Corrective Action: The FAP has been updated to fully describe whether and under what circumstances prior-FAP eligibility determinations are used for presumptive eligibility. d. Date Corrected: These revisions to the FAP were approved by EMHS Leadership on May 1, 2018 and the revised FAP has been widely publicized. 4. Emergency Medical Care Language in the FAPa. Requirement: A written policy must be established to require that care will be provided, without discrimination, for emergency medical conditions to individuals regardless of whether they are FAP-eligible.b. Condition: It was and is CA Deans practice to provide care for emergency conditions to individuals regardless of whether they are FAP-eligible; however, upon review of CA Deans FAP it was determined that this practice was not explicitly stated.c. Corrective Action: The FAP was updated to explicitly state that EMHS Hospitals will provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility for assistance under the FAP and as required under the EMHS Emergency Medical Care Policy. d. Date Corrected: These revisions to the FAP were approved by EMHS Leadership in Fiscal Year 2017 and the EMHS Board of Directors at its October 4, 2017 meeting. The updated FAP was widely publicized upon approval by the EMHS Board of Directors. 5. Billing and Collection Practicesa. Requirement: The FAP (or separate billing and collection policy) must include information on the actions the hospital will take to collect outstanding balances, including the reasonable efforts made to determine FAP eligibility. This information must be widely publicized along with the FAP.b. Condition: The billing and collection practices were adequately described in the Billing and Collections Policy which was referenced in the widely publicized FAP. However, the Billing and Collections Policy itself was not widely publicized.c. Corrective Action: The required billing and collection practices were added to the FAP. d. Date Corrected: These revisions to the FAP were approved by EMHS Leadership in Fiscal Year 2017 and the EMHS Board of Directors at its October 4, 2017 meeting. The updated FAP was widely publicized upon approval by the EMHS Board of Directors.6. Widely Publicized a. Requirement: In order to ensure the FAP is widely publicized , a hospital must take several actions, one of which is to include a conspicuous written notice on billing statements that notifies and informs recipients about the availability of financial assistance under the hospital facilitys FAP and includes the telephone number of the hospital facility office or department that can provide information about the FAP and FAP application process and the direct Web site address (or URL) where copies of the FAP, FAP application form and plain language summary of the FAP may be obtained.b. Condition: While CA Deans billing statements included a conspicuous written notice to notify recipients about the availability of financial assistance, telephone numbers to the department that can provide more information about financial assistance, and the EMHS billing help Web site address, the billing statements did not clearly state the FAP documents could be obtained from the Web site address provided.c. Corrective Action: Billing statements were updated in Fiscal Year 2017 to clarify that certain FAP-related documents may be obtained from the Web site address provided on the statement. In Fiscal Year 2018, CA Dean made additional revisions to further clarify the language included on the billing statements.d. Date Corrected: June 15, 2017 with additional revisions made in Fiscal Year 2018.7. PLSa. Requirement: The PLS must include certain information, including a statement of the availability of translations of the FAP, FAP application form and PLS in other languages, and a statement that a FAP-eligible individual will not be charged more than AGB for emergency or other medically necessary care.b. Condition: While the PLS met most of the requirements of the regulation, it did not include a statement of the availability of translations of the FAP, FAP application form and PLS in other languages, and also did not clearly state that a FAP-eligible individual will not be charged more than AGB for emergency or other medically necessary care.c. Corrective Action: The PLS was updated to include a statement of the availability of translations of the FAP, FAP application form and PLS in other languages, and to clearly state that a FAP-eligible individual will not be charged more than AGB for emergency or other medically necessary care. d. Date Corrected: After the revision |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (true) | GrantRecordsMaintainedInd |
Recipient Table RecipientTable
Recipient Business Name RecipientBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Piscataquis Regional YMCA | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 48 Park Street | AddressLine1Txt |
| City | DoverFoxcroft | CityNm |
| State Abbreviation | ME | StateAbbreviationCd |
| ZIP | 04426 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Recipient EIN | 222592628 | RecipientEIN |
| IRC Section | 501(c)(3) | IRCSectionDesc |
| Cash Grant | $11,881 | CashGrantAmt |
| Non Cash Assistance | $0 | NonCashAssistanceAmt |
| Purpose Of Grant | Greenville Childcare Program | PurposeOfGrantTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total501c3 Org | 0 | Total501c3OrgCnt |
| Total Other Org | 1 | TotalOtherOrgCnt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Grantmaker's Description of How Grants are Used | FormAndLineReferenceDesc |
| Explanation | Received periodic program reports. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Idemnification Gross Up Pmts | Yes (X) | IdemnificationGrossUpPmtsInd |
| Written Policy Ref T And E Expnss | Yes (true) | WrittenPolicyRefTAndEExpnssInd |
| Substantiation Required | Yes (true) | SubstantiationRequiredInd |
| Severance Payment | false | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (true) | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | false | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | false | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | false | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | false | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | false | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | false | AnyNonFixedPaymentsInd |
| Initial Contract Exception | false | InitialContractExceptionInd |
| Rebuttable Presumption Proc | false | RebuttablePresumptionProcInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (15 entries)
| TitleTitleTxt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Bonus Related OrganizationsBonusRelatedOrganizationsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Anthony J Filer | ||||||||||||
| Treasurer | $57,283 | $120,327 | $2,704 | $180,314 | ||||||||
| Darin M Peck MD | ||||||||||||
| CMO | $222,803 | $77,601 | $2,073 | $18,081 | $26,066 | $346,624 | ||||||
| Eugene F Murray Jr | ||||||||||||
| Director | $181,151 | $9,885 | $5,565 | $44,962 | $26,677 | $268,240 | ||||||
| Galen G Durose | ||||||||||||
| Physician | $174,098 | $13,046 | $818 | $3,861 | $26,938 | $218,761 | ||||||
| Glenn Martin VPGeneral Couns | ||||||||||||
| Secretary | $362,009 | $6,612 | $20,591 | $459,101 | $69,889 | |||||||
| Jennifer Goodrich | ||||||||||||
| VP/Finance | $137,473 | $3,046 | $8,605 | $17,150 | $166,274 | |||||||
| Joseph Babbitt | ||||||||||||
| Physician | $345,897 | $4,722 | $18,550 | $26,861 | $396,030 | |||||||
| Lorraine Rodgerson RN | ||||||||||||
| VP/CNO | $151,877 | $2,177 | $1,575 | $18,312 | $173,941 | |||||||
| Mario Turi | ||||||||||||
| Physician | $243,745 | $2,529 | $20,785 | $10,847 | $277,906 | |||||||
| Mary M Hood President CEO | ||||||||||||
| Ex-Officio | $870,512 | $15,327 | $20,855 | $1,157,551 | $250,857 | |||||||
| Paul Potvin | ||||||||||||
| Physician | $284,056 | $3,222 | $21,200 | $22,879 | $331,357 | |||||||
| Shannon M Meredith | ||||||||||||
| Physician | $190,894 | $691 | $5,550 | $14,569 | $211,704 | |||||||
| Terri Vieira | ||||||||||||
| President | $140,732 | $6,862 | $11,895 | $207,927 | $93,820 | $5,276 | $4,575 | $27,016 | $7,930 | $138,617 | $40,524 | $7,914 |
| Tracy Bonney-Corson | ||||||||||||
| Former VP/CNO | $105,781 | $4,699 | $25,250 | $138,661 | $2,931 | |||||||
| Yoosuf Siddiqui | ||||||||||||
| VP/HR Northwest | $124,953 | $1,775 | $24,859 | $159,544 | $7,957 | |||||||
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Part I, Line 1a: Relevant information in regards to selections on 1a. | FormAndLineReferenceDesc |
| Explanation | The following received a wellness program incentive:Joseph Babbitt, highest compensated employee $232Jennifer Goodrich, officer 177Eugene F. Murray, Jr., director/officer 47Darin Peck, director 407Terri Vieira, director/officer 197This benefit is available for all employees.The following received a gift card:Galen Durose, highest compensated employee $ 20Shannon Meredith, highest compensated employee 20Eugene F. Murray, Jr., director/officer 20Darin Peck, director 20Lorraine Rodgerson, officer 20Mario Turi, highest compensated employee 20 | ExplanationTxt |
Schedule L IRS990ScheduleL
Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp (3 entries)
| Relationship DescriptionRelationshipDescriptionTxt | TransactionTransactionAmt | TransactionTransactionDesc | Sharing Of RevenuesSharingOfRevenuesInd |
|---|---|---|---|
| Linda D Gilbert VP at Bank | |||
| VP=Chair Brd | $173,117 | unsec note w/bank | false |
| Thomas Murray | |||
| fam mem of offic | $85,491 | compensation | false |
| Christine Christensen | |||
| fam mem of brd mem | $76,651 | compensation | false |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Schedule L, Part V Supplemental Information | FormAndLineReferenceDesc |
| Explanation | Linda D. Gilbert, Charles A. Dean Board Chairman is a Camden National Bank VP. Camden National Bank is Charles A. Dean's primary bank, holding deposits of $735,055 and a note for $173,117.Thomas Murray is a family member of an officer/director and is an employee of Charles A. Dean.Christine Christensen is a family member of a director and is an employee of Charles A. Dean. | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (16 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Form 990, Part III, Line 4d: Other Program Services Description | OTHER PROGRAM SERVICES 4: The Charles A. Dean Memorial Hospital is a 25 bed Critical Access Hospital in rural northwestern Maine providing emergency, ambulance, inpatient acute care, outpatient surgery, specialty physician clinics and nursing home services to patients regardless of ability to pay. Provided $511,441 other uncompensated care (at cost).Additional Statistics:Northwoods Healthcare Clinic visits 11,331Hospital diagnostic and rehabilitation visits 17,593Emergency room visits 2,890 Hospital admissions 313Surgery cases 234Ambulance runs 335 OTHER PROGRAM SERVICES 5: Please see the following excerpt from the EMHS Annual Report to the Community for details of community benefit projects at EMHS members:Coming together is a beginning; keeping together is progress; working together is success. The man who spoke these words understood the value of teamwork. He embraced technology in a way that nobody else had before him. His vision, passion, and innovation revolutionized the world. He made it possible for families to feel more connected despite living long distances apart. In many ways, EMHS shares the same goals championed 100 years ago by industrialist and automaker, Henry Ford.Like Ford, we know that we are succeeding by working together. Our new integrated, systemwide electronic health record (EHR) will allow all our hospitals, primary care practices, and other members within the EMHS family to share information seamlessly. Using this system, we can collaborate more effectively and improve patient care.By mass-producing the automobile, Ford helped rural Americans feel connected. We are connecting people through technology, too. People who live in rural communities can talk one-on-one through a computer screen with doctors who may be several states away, thanks to our investments in telemedicine. Patients have access to specialists that would have been out of reach without this technology. OTHER PROGRAM SERVICES 6: Ford was an innovator. We too are embracing innovation in the way we deliver care. Our partnership with Dana-Farber Cancer Institute affords opportunities for cancer patients to access clinical trials closer to home at our Lafayette Family Cancer Center in Brewer. We are using paramedics to make routine house calls in our rural communities to perform wellness checks. This service is helping patients avoid trips to the hospital or doctors office while getting compassionate care in the comfort of their own homes.Of course, all of these initiatives require dedicated people who are committed to teamwork. Its the very reason why we take extraordinary measures to recruit and retain our employees. We have added a new nurse residency program, which is already showing signs of success in addressing a critical statewide nursing shortage and providing our nurses the tools they need to thrive. By working together, we can continue to do great things.To borrow another line from Henry Ford, If everyone is moving forward together, then success takes care of itself. In the pages that follow are numerous testaments to the innovative spirit underscoring many successes this past year throughout our system. While the hard work will continue, we are pleased to share with you the progress we are making towards achieving our vision to be a nationally recognized model of excellence in healthcare.M. Michelle Hood, FACHEEMHS President and CEOBarry McCrumEMHS Board Chair OTHER PROGRAM SERVICES 7: CONNECTING WORLD CLASS CARETerry White longs for the day that she can return to the sandy shores of Myrtle Beach to feel the warm Carolina sunshine on her face and the ocean waves splashing upon her feet. She has plans to go back to visit family and wont let cancer slow her down. My journey is not over just because I have this disease, Terry said. It doesnt mean life doesnt go on. I definitely have a lot of life to live.Terry was diagnosed with breast cancer a decade ago. I was 38 when I found a lump in my breast in the shower one morning and immediately called my primary care physician. Unfortunately, the cancer became metastatic, meaning it spread to other parts of her body. I went from being a survivor to a lifer because I live with cancer every day, and Ill live with it every day until the end, she said. Terry has gone through several treatments of radiation and chemotherapy over the years.During a recent visit to EMMC Cancer Care at the Lafayette Family Cancer Center in Brewer, she was comfortably dressed in jeans and a maroon blouse, and wore a hat on her head. Because the cancer spread to the bone marrow in her leg, she wore a knee brace to alleviate pain. Whats remarkable about Terry is how she projects a positive attitude. A powerful storm that day was toppling trees and knocking down power lines outsideit wasnt enough to stop her from making the 30-minute ride to the treatment center from her home in Pittsfield or to diminish her optimism. Research today has given us treatments that are light years ahead of what we used to have, she said. OTHER PROGRAM SERVICES 8: Terry is hopeful because she is taking part in a clinical trial thanks to a collaborative partnership between Dana-Farber Cancer Institute in Boston and EMMC Cancer Care. She is taking an experimental drug under the coordinated care of her medical team in Brewer and the Dana-Farber specialists in Boston. The treatment I come for is administered by a syringe. I dont have to sit there for four hours waiting for this to be over and waiting for the side effects, she said.Eric Winer, MD, is chief clinical strategy officer at Dana-Farber and director of the Breast Oncology Center. He and other members of the Dana-Farber team visited EMMC Cancer Care last fall for a tour. Dana-Farber only partners with cancer centers that already deliver excellent care, Dr. Winer said. The goal of the collaborative for Dana-Farber is to extend its reach and bring clinical trials to people living in rural areas. When people participate in clinical trials, the hope is that they will do better than they might with standard care, but no matter what, they are contributing to the future of cancer care, he said.The staff at EMMC Cancer Care also benefits by being in the collaborative. They have more educational opportunities and access to medical specialists at Dana-Farber for rapid consultation on complex cases. Dana-Farber clinical care is provided in Boston and this collaborative brings their expertise to the heart of Maine, explained Thomas Openshaw, MD, medical director, Oncology Research at EMMC Cancer Care. The staff at EMMC and Dana-Farber have a firm resolve to help not only current patients, but also future patients to live better lives. Our whole goal is to try to cure whatever patients can be cured, and thats a large proportion of patients, and for the others to give them the best and the longest life that they can have, Dr. Winer said.That seems to be working for Terry White, whos already making travel plans to Myrtle Beach. It gives you a reason to go through what youre going through. Weve got to learn from it for the future, she said, adding, I want to be healthy for my family, I want to participate in life with my family and my friends, and continue to enjoy life. OTHER PROGRAM SERVICES 9: CONNECTING WITH TECHNOLOGYCharles A. Dean Memorial Hospital (CA Dean) in Greenville sits along the scenic shores of Moosehead Lake, one of Maines most treasured natural resources. Its a peaceful, idyllic spot that draws tourists from far and away who are eager to get away from the hustle and bustle of their daily grind. But beneath the hum of motorboats cruising along Moosehead Lake in the summer, or the snowmobiles skirting across its icy surface in winter; beneath the laughter of kids splashing in the water on a hot August day or pulling a trophy trout through the ice on a frigid February morning, there is a rural health problem that those visitors do not see. To be fair, it affects communities throughout Maine but has been more problematic in those towns and hamlets tucked far away from urban centers.There is very little rural mental health period, explains Joseph Babbitt, MD, an emergency room physician and hospitalist at CA Dean. Historically people in rural communities have had to travel hours to access psychiatric services. If they showed up at any rural hospital emergency room with a mental health crisis, they had to wait hours for an evaluation. Youve got an emotionally unstable patient who is in a very disruptive emergency waiting room environment, waiting 18 hours to have a mental health professional come assess them. That doesnt help anyone, Dr. Babbitt said. But technology is bridging the gap and allowing those who live in rural communities to have the same access to psychiatric services as their urban counterparts. Telemedicine is a medium that connects a patient with a practitioner via a screen, explained Gavin Ducker, MD, chief medical officer at Inland Hospital in Waterville. OTHER PROGRAM S |
| Form 990, Part VI, Line 4: Description of Significant Changes to Organizational Documents | Amended Article IV (Officers), Section 5 (President) - to remove President as the chief executive officer of the Corporation.Amended Article IV (Officers), Section 7 (Treasurer & Assistant Treasurer) - to change the title of Chief Financial Officer to VP of Finance.Amended Article V (Committees), Section 7 (Governance Committee) to change the title President/CEO to President.Amended Article V (Committees), Section 10 (Finance Committee) to change the title of Chief Financial Officer to Assistant Treasurer.Amended Article VIII (Fiduciary Duty; Prohibited Transactions; Divided Loyalty; Independence), Section 5 (Independent Trustees), Subsection (a) and Subsection (b) to change the reference to interim chief executive officer to President. |
| Form 990, Part VI, Line 6: Explanation of Classes of Members or Shareholder | The Charles A. Dean Memorial Hospital (the "Corporation") is a Maine nonprofit corporation. Eastern Maine Healthcare Systems ("EMHS"), also a Maine nonprofit corporation, is the sole voting corporate member of the Corporation. |
| Form 990, Part VI, Line 7a: How Members or Shareholders Elect Governing Body | Each year at their annual meeting, the directors elect replacements for those directors whose terms are expiring. Election of directors is subject to ratification by the EMHS Board of Directors. |
| Form 990, Part VI, Line 7b: Describe Decisions of Governing Body Approval by Members or Shareholders | The EMHS President has authority to appoint and remove the SVP, President of the Corporation. EMHS also has joint and superior authority to approve, disapprove or initiate action with respect to the following matters: I.amendments to the corporations Articles of Incorporation or Bylaws;II.changes in legal form of organization of the Corporation;III.election of the Directors/Trustees of the Corporation;IV.action concerning the Corporations operating budget and capital expenditures;V.the Corporations acquisition of assets or assumption of liabilities of an unaffiliated third party;VI.transfer of 5% or more of the assets of the Corporation;VII.financing transactions concerning the Corporation; VIII.merger, consolidation, sale, lease, mortgage, pledge or other disposition of all or substantially all assets of the Corporation; IX.add or revise a health care service of the Corporation;X.discontinue or close a health care service of the Corporation;XI.action concerning the Corporations role in the EMHS Strategic Plan;XII.action concerning the Corporations participation in key strategic affiliations with third parties not affiliated with EMHS; andXIII.dissolution of the Corporation. |
| Form 990, Part VI, Line 11b: Form 990 Review Process | Form 990 is reviewed by the SVP, President and VP, Finance of CA Dean Memorial Hospital. It is provided to each board member either electronically or in hard copy with an opportunity to ask questions prior to filing with the IRS. |
| Form 990, Part VI, Line 12c: Explanation of Monitoring and Enforcement of Conflicts | The organization requests updates of potential conflicts and relationships from the officers and Board members on an annual basis. The request requires disclosure of all business relationships, board memberships, and family relationships. A database is maintained that is compared to payroll records and the accounts payable vendor list to identify any potential conflicts of interest. Transactions are reviewed for reasonableness as an arm's length transaction. The first agenda item for board meetings and board committee meetings is for members to declare any conflict of interest with upcoming agenda items or deliberations. At any point when consideration is being given to purchase/contract with a party in interest, the member with the conflict is either excused from the discussion and consideration process or abstains from voting on the matter. All transactions identified with parties in interest are disclosed within the Form 990. All are deemed to be arm's length transactions. |
| Form 990, Part VI, Line 15a: Compensation Review & Approval Process - CEO, Top Management | The SVP, President of The Charles A. Dean Memorial Hospital (C.A. Dean), who is employed by C.A. Dean, reports directly to the system parent, Eastern Maine Healthcare Systems (EMHS) President/CEO (President) who serves on the board ex-officio. The EMHS Executive Performance Management Committee (the Committee) is responsible to monitor and evaluate the performance of the EMHS President, to set compensation of the EMHS President, and to review recommendations of the EMHS President with respect to compensation of the Chief Executive Officer of the direct subsidiaries, and other direct reports to the President. The Committee is comprised entirely of independent Directors per EMHS bylaws. Process:The Committee meets regularly throughout the fiscal year at the discretion of the Committee chair as well as on call of the Chair of the EMHS board. In carrying out its duties pursuant to the Bylaws, the Committee:-Assures that the executive compensation program is administered in a manner consistent with the EMHS executive compensation philosophy.-Reviews and updates the EMHS executive compensation philosophy which serves as the foundation on which all current and future executive compensation decisions are made.-Assures that value of compensation provided by EMHS does not exceed the value of services provided by the executive.-Reviews annual incentive compensation criteria for eligible executives, as defined by the EMHS President.-Reviews periodic compensation survey information and provides expert input to proposed changes to the executive compensation program.-Assures that a formal and timely performance management system is in place for executives.-Reviews incentive compensation criteria scoring and associated pay schedules for officers and key employees.-Provides any public statements regarding executive compensation practices at EMHS deemed appropriate.-Maintains minutes of the meetings and communicates actions to the EMHS Board of Directors.To accomplish this, the committee uses an external consultant with access to comparative data from independent sources and include national as well as regional data points. The EMHS President reviews all direct report compensation actions with the committee. In addition, the EMHS President ensures that any subsidiary policies and practices governing executive compensation are consistent with the committee's philosophy and practices statement.Form 990, Part VI, Line 15b - Compensation Review & Approval Process for Officers & Key EmployeesCompensation of other officers and key employees of the organization is established by the Human Resources department who utilize external market research to establish compensation ranges for specific positions. On an annual basis, the compensation ranges are compared to the updated survey information. The hiring manager will determine where the employee will fall within the ranges established by the Human Resources department based on experience and credentials. |
| Form 990, Part VI, Line 19: Other Organization Documents Publicly Available | The Charles A. Dean Memorial Hospital makes its governing documents, conflict of interest policy and financial statements available to the public upon request. |
| Other Changes In Net Assets Or Fund Balances - Other Decreases | = -$0 |
| Other Changes In Net Assets Or Fund Balances - Other Increases | Change in net assets held @ EMHS Foundation = $906705 |
| Other Changes In Net Assets Or Fund Balances - Other Decreases | Contribution To Strat Pool Per Affiliation Agreement = -$103553 |
| Other Changes In Net Assets Or Fund Balances - Other Increases | Post Retirement Health Benefit FAS158 = $97840 |
| Other Changes In Net Assets Or Fund Balances - Other Decreases | Transfer to exempt parent-Eastern Maine Healthcare Systems = -$429576 |
| Other Changes In Net Assets Or Fund Balances - Other Decreases | Transfer to exempt subsidiary - EMHSF = -$593334 |
| SCHEDULE H PART VI SUPPLEMENTAL INFORMATION | Continuation of Disclosure in accordance with Revenue Procedure 2015-21:Schedule H, Part V Facility Information, Section B Facility Policies and Practices8. PLS Eligibility Requirementsa. Requirement: The PLS must include certain information, including a brief description of the eligibility requirements and assistance offered under the FAP.b. Condition: Although patients from any state could be eligible to receive financial assistance under the FAP, the PLS indicated that financial assistance or free care was only available for medically necessary or emergency care services received by Maine residents. c. Corrective Action: The PLS was updated to indicate that non-Maine residents were eligible to receive financial assistance or free care for emergency care services. d. Date Corrected: After the revisions to the FAP were approved by EMHS Leadership in Fiscal Year 2017 and the EMHS Board of Directors at its October 4, 2017 meeting, the PLS was updated and was widely publicized in October 2017. 9. Translationsa. Requirement: To widely publicize its FAP, a hospital facility must accommodate all significant populations that have limited English proficiency (LEP) by translating its FAP, FAP application form and PLS into the primary language(s) spoken by such populations.b. Condition: While the FAP, FAP application and PLS were translated into the primary languages spoken by the populations served by CA Dean, the instructions to the FAP application and the title and one paragraph of the Provider List attached to the FAP (i.e., the list of providers covered by the hospitals FAP) were not translated into these languages.c. Corrective Action: The FAP application instructions and the applicable language on the Provider List were translated into the required languages.d. Date Corrected: After the revisions to the FAP were approved by EMHS Leadership in Fiscal Year 2017 and the EMHS Board of Directors at its October 4, 2017 meeting, the FAP application instructions and Provider List were updated and were widely publicized in October 2017. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (28 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Direct Controlling NADirectControllingNACd | Controlled OrganizationControlledOrganizationInd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Eastern Maine Healthcare Systems EMHS | |||||||||||
| 43 Whiting Hill Road | Brewer | ME | 04412 | 010527066 | Supporting organization for healthcare affiliates | ME | 501(c)(3) | 12 Type II | N/A | Yes (true) | |
| Eastern Maine Medical Center EMMC | |||||||||||
| PO Box 404 489 State Street | Bangor | ME | 044020404 | 010211501 | Provide healthcare services | ME | 501(c)(3) | 3 | Yes (true) | Eastern Maine Healthcare Systems | |
| Eastern Maine Healthcare Real Estate | |||||||||||
| 43 Whiting Hill Road | Brewer | ME | 04412 | 010391036 | Leases real estate | ME | 501(c)(2) | Yes (true) | Eastern Maine Healthcare Systems | ||
| Rosscare | |||||||||||
| 43 Whiting Hill Road Ste 400 | Brewer | ME | 04412 | 010391038 | Provide services to elderly | ME | 501(c)(3) | PF | Yes (true) | Eastern Maine Healthcare Systems | |
| Rosscare Nursing Homes Inc | |||||||||||
| 43 Whiting Hill Road Ste 400 | Brewer | ME | 04412 | 010430751 | Operation of nursing homes | ME | 501(c)(3) | 10 | Yes (true) | Rosscare | |
| Acadia Hospital Corp AHC | |||||||||||
| 43 Whiting Hill Road | Brewer | ME | 04412 | 010459837 | Provide healthcare services | ME | 501(c)(3) | 3 | Yes (true) | Eastern Maine Healthcare Systems | |
| Eastern Maine Medical Center Auxiliary | |||||||||||
| 43 Whiting Hill Road | Brewer | ME | 04412 | 010377901 | Fund raising for exempt Eastern Maine Medical Center | ME | 501(c)(3) | 10 | Yes (true) | Eastern Maine Medical Center | |
| Acadia Healthcare Inc AHI | |||||||||||
| 43 Whiting Hill Road | Brewer | ME | 04412 | 223183888 | Provide healthcare services | ME | 501(c)(3) | 10 | Yes (true) | Acadia Hospital Corp | |
| EMHS Foundation | |||||||||||
| 43 Whiting Hill Road Ste 400 | Brewer | ME | 04412 | 222514163 | Raise and manage funds for exempt organizations | ME | 501(c)(3) | 12 Type II | Yes (true) | Eastern Maine Healthcare Systems | |
| Norumbega Medical Specialists LTD | |||||||||||
| 43 Whiting Hill Road Ste 400 | Brewer | ME | 04412 | 010465231 | Provide patient care and education | ME | 501(c)(3) | 10 | Yes (true) | Eastern Maine Medical Center | |
| Inland Hospital | |||||||||||
| 200 Kennedy Memorial Drive | Waterville | ME | 04901 | 010217211 | Provide healthcare services | ME | 501(c)(3) | 3 | Yes (true) | Eastern Maine Healthcare Systems | |
| Lakewood | |||||||||||
| 220 Kennedy Memorial Drive | Waterville | ME | 04901 | 010421234 | Provide skilled and long-term nursing care | ME | 501(c)(3) | 3 | Yes (true) | Inland Hospital | |
| Sebasticook Valley Health SVH | |||||||||||
| 447 North Main Street | Pittsfield | ME | 04967 | 010263628 | Critical care hospital | ME | 501(c)(3) | 3 | Yes (true) | Eastern Maine Healthcare Systems | |
| The Aroostook Medical Center TAMC | |||||||||||
| PO Box 151 140 Academy Street | Presque Isle | ME | 047690151 | 010372148 | Provide healthcare services | ME | 501(c)(3) | 3 | Yes (true) | Eastern Maine Healthcare Systems | |
| TAMC Title Corp | |||||||||||
| PO Box 151 140 Academy Street | Presque Isle | ME | 047690151 | 010389226 | Real estate holding company | ME | 501(c)(2) | Yes (true) | The Aroostook Medical Center | ||
| Horizons Health Services | |||||||||||
| PO Box 151 140 Academy Street | Presque Isle | ME | 047690151 | 010504393 | Provide patient care | ME | 501(c)(3) | 3 | Yes (true) | The Aroostook Medical Center | |
| Blue Hill Memorial Hospital | |||||||||||
| 57 Water Street | Blue Hill | ME | 046145231 | 010227195 | Provide healthcare services | ME | 501(c)(3) | 3 | Yes (true) | Eastern Maine Healthcare Systems | |
| Meadow Wood LLC | |||||||||||
| 43 Whiting Hill Road | Brewer | ME | 04412 | 272935243 | Provide patient care | ME | 501(c)(3) | 10 | Yes (true) | AHI | |
| Sebasticook Valley Family Practice Assoc | |||||||||||
| 447 North Main Street | Pittsfield | ME | 04967 | 010357854 | Provide patient care | ME | 501(c)(3) | 10 | Yes (true) | SVH | |
| Restoration Health LLC | |||||||||||
| 43 Whiting Hill Road | Brewer | ME | 04412 | 352449986 | Provide mental & behavioral hlth srvcs | ME | 501(c)(3) | 10 | Yes (true) | Acadia Healthcare Inc | |
| Mercy Hospital | |||||||||||
| 144 State Street | Portland | ME | 04101 | 010211534 | Provide healthcare services | ME | 501(c)(3) | 3 | Yes (true) | Eastern Maine Healthcare Systems | |
| Mercy Health System of Maine | |||||||||||
| 144 State Street | Portland | ME | 04101 | 010484074 | Supporting org for healthcare affiliates | ME | 501(c)(3) | 12 Type III Func Int | Yes (true) | Eastern Maine Healthcare Systems | |
| VNA Home Health & Hospice | |||||||||||
| 50 Foden Road | South Portland | ME | 04106 | 010246804 | Provide home health and hospice services | ME | 501(c)(3) | 10 | Yes (true) | Eastern Maine Healthcare Systems | |
| WorkHealth LLC | |||||||||||
| 43 Whiting Hill Road | Brewer | ME | 04412 | 474315094 | Provide healthcare services | ME | 501(c)(3) | 12 Type II | Yes (true) | EMHS | |
| Maine Coast Healthcare Corporation | |||||||||||
| 50 Union Street | Ellsworth | ME | 04605 | 223176167 | Provide dental services | ME | 501(c)(3) | 12 Type II | Yes (true) | EMHS | |
| Maine Coast Regional Health Facilities | |||||||||||
| 50 Union Street | Ellsworth | ME | 04605 | 010198331 | Provide healthcare services | ME | 501(c)(3) | 3 | Yes (true) | EMHS | |
| Maine Coast Medical Realty | |||||||||||
| 50 Union Street | Ellsworth | ME | 04605 | 010390918 | Lease medical facilities | ME | 501(c)(3) | 12 Type 1 | Yes (true) | MCMH | |
| Lifestages Physician Services LLC | |||||||||||
| 50 Foden Road | South Portland | ME | 04106 | 821043752 | Provide home health and hospice services | ME | 501(c)(3) | 10 | Yes (true) | VNA | |
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (5 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Predominant Income TypePredominantIncomeTypeTxt | Disproportionate AllocationsDisproportionateAllocationsInd | General Or Managing PartnerGeneralOrManagingPartnerInd |
|---|---|---|---|---|---|---|---|---|---|---|
| Beacon Health LLC | ||||||||||
| 43 Whiting Hill Road | Brewer | ME | 04412 | 452967056 | Accountable care organization | ME | EMHS | NA | false | false |
| Beacon Rural Health LLC | ||||||||||
| 43 Whiting Hill Road | Brewer | ME | 04412 | 474483187 | Accountable care organization | ME | EMHS | false | false | |
| Meridian Mobile Health LLC | ||||||||||
| 43 Whiting Hill Road | Brewer | ME | 04412 | 010512673 | Ambulance | ME | AHS | false | false | |
| M Drug LLC | ||||||||||
| 43 Whiting Hill Road | Brewer | ME | 04412 | 272175482 | Pharmacy | ME | AHS | false | false | |
| Alliance Health Documentation LLC | ||||||||||
| 43 Whiting Hill Road | Brewer | ME | 04412 | 462751855 | Transcription | ME | AHS | false | false | |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (6 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Entity TypeEntityTypeTxt | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|
| Affiliated Healthcare Systems AHS | |||||||||
| 43 Whiting Hill Road | Brewer | ME | 04412 | 010385322 | Holding Co. | ME | EMHS | C | Yes (true) |
| Affiliated Healthcare Management | |||||||||
| 43 Whiting Hill Road | Brewer | ME | 04412 | 010349339 | Hlthcr mgmnt | ME | AHS | C | Yes (true) |
| Affiliated Laboratory Inc | |||||||||
| 43 Whiting Hill Road | Brewer | ME | 04412 | 010381283 | Clinicl lab | ME | AHS | C | Yes (true) |
| Affiliated Materiel Services | |||||||||
| 43 Whiting Hill Road | Brewer | ME | 04412 | 010381189 | Purchasing | ME | AHS | C | Yes (true) |
| Maine Coast Physician Affiliates | |||||||||
| 50 Union Street | Ellsworth | ME | 04605 | 010479952 | Patient Care | ME | MCMH | C | Yes (true) |
| Beacon Direct | |||||||||
| 43 Whiting Hill Road | Brewer | ME | 04412 | 371864965 | Healthcare Self-funded TPA | ME | EMHS | C | Yes (true) |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | false | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | false | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | false | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | false | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | false | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | false | DivRelatedOrganizationInd |
| Asset Sale To Other Org | false | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | false | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | false | AssetExchangeInd |
| Rental Of Facilities To Oth Org | false | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | false | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | Yes (true) | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | Yes (true) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | false | SharingOfFacilitiesInd |
| Paid Employees Sharing | false | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (true) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | false | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | Yes (true) | TransferToOtherOrgInd |
| Transfer From Other Org | Yes (true) | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp (10 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|
| Eastern Maine Healthcare Systems EMHS | ||
| m | $1,157,124 | FMV |
| Eastern Maine Healthcare Systems EMHS | ||
| p | $2,143,044 | FMV |
| Eastern Maine Healthcare Systems EMHS | ||
| r | $533,129 | FMV |
| Eastern Maine Medical Center EMMC | ||
| m | $165,817 | FMV |
| EMHS Foundation | ||
| m | $64,000 | FMV |
| EMHS Foundation | ||
| r | $593,334 | FMV |
| Sebasticook Valley Health SVH | ||
| m | $116,493 | FMV |
| Beacon Health LLC | ||
| m | $99,506 | FMV |
| Affiliated Laboratory Inc | ||
| m | $155,078 | FMV |
| Affiliated Materiel Services | ||
| p | $122,930 | FMV |
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