MEMORIAL HOSPITAL: Form 990, tax year 2015

View the entire original 990 at ProPublica ↗

Organization
MEMORIAL HOSPITAL (EIN 02-0222156)
Tax period
2015-10-01 to 2016-09-30
Filed
2017-08-11
IRS object ID
201742239349301859
Schema version
2015v3.0
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 ReturnHeader

FieldValueIRS element (for citing)
Return2017-08-11T15:12:29-04:00ReturnTs
Tax Period End2016-09-30TaxPeriodEndDt
Return Type990ReturnTypeCd
Tax Period Begin2015-10-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN020222156EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1MEMORIAL HOSPITALBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlMEMOBusinessNameControlTxt
Phone6033565461PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line13073 WHITE MOUNTAIN HIGHWAYAddressLine1Txt
CityNORTH CONWAYCityNm
State AbbreviationNHStateAbbreviationCd
ZIP03860ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonDIANA MCLAUGHLINPersonNm
Person TitleSR DIRECTOR FINANCEPersonTitleTxt
Phone6033565461PhoneNum
Signature2017-08-07SignatureDt
FieldValueIRS element (for citing)
Tax2015TaxYr
Build TS2021-01-29 14:40:06ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerSCOTT MCKINNONPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line13073 WHITE MOUNTAIN HIGHWAYAddressLine1Txt
CityNORTH CONWAYCityNm
State AbbreviationNHStateAbbreviationCd
ZIP03860ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$72,460,865GrossReceiptsAmt
Group Return For AffiliatesfalseGroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.MEMORIALHOSPITALNH.ORGWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1910FormationYr
Legal Domicile StateNHLegalDomicileStateCd
Activity Or MissionCRITICAL ACCESS HOSPITALActivityOrMissionDesc
Voting Members Governing Body15VotingMembersGoverningBodyCnt
Voting Members Independent9VotingMembersIndependentCnt
Total Employee585TotalEmployeeCnt
Total Volunteers80TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
PY Contributions Grants$337,595PYContributionsGrantsAmt
CY Contributions Grants$763,484CYContributionsGrantsAmt
PY Program Service Revenue$66,513,367PYProgramServiceRevenueAmt
CY Program Service Revenue$68,053,811CYProgramServiceRevenueAmt
PY Investment Income$441,838PYInvestmentIncomeAmt
CY Investment Income-$312,727CYInvestmentIncomeAmt
PY Other Revenue$84,008PYOtherRevenueAmt
CY Other Revenue$65,041CYOtherRevenueAmt
PY Total Revenue$67,376,808PYTotalRevenueAmt
CY Total Revenue$68,569,609CYTotalRevenueAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$25,068,265PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$34,927,320CYSalariesCompEmpBnftPaidAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$144,843CYTotalFundraisingExpenseAmt
PY Other Expenses$40,444,022PYOtherExpensesAmt
CY Other Expenses$34,610,499CYOtherExpensesAmt
PY Total Expenses$65,512,287PYTotalExpensesAmt
CY Total Expenses$69,537,819CYTotalExpensesAmt
PY Revenues Less Expenses$1,864,521PYRevenuesLessExpensesAmt
CY Revenues Less Expenses-$968,210CYRevenuesLessExpensesAmt
Total Assets BOY$77,678,781TotalAssetsBOYAmt
Total Assets EOY$76,473,057TotalAssetsEOYAmt
Total Liabilities BOY$36,733,735TotalLiabilitiesBOYAmt
Total Liabilities EOY$36,373,870TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$40,945,046NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$40,099,187NetAssetsOrFundBalancesEOYAmt
MissionMEMORIAL HOSPITAL PROVIDES HEALTHCARE SERVICES TO THE RESIDENTS AND VISITORS OF THE MOUNT WASHINGTON VALLEY AREA OF NEW HAMPSHIRE.MissionDesc
Significant New Program SrvcfalseSignificantNewProgramSrvcInd
Significant ChangefalseSignificantChangeInd
Expense$62,514,277ExpenseAmt
Revenue$67,600,067RevenueAmt
DescMEMORIAL HOSPITAL PROVIDES HEALTHCARE SERVICES TO THE RESIDENTS AND VISITORS OF THE MOUNT WASHINGTON VALLEY AREA OF NEW HAMPSHIRE. MEMORIAL HOSPITAL IS A 25 BED CRITICAL ACCESS HOSPITAL AND A 45 BED INTERMEDIATE CARE FACILITY (MERRIMAN HOUSE). THE HOSPITAL PROVIDES MED/SURG, ICU, ICF, OBSTETRICS, RADIOLOGY/IMAGING, ONCOLOGY/INFUSION, CARDIAC REHAB, WOUND CARE, SPECIALTY CARE, ED AND PRIMARY CARE. THE HOSPITAL HAD 5,242 ACUTE INPATIENT DAYS, 12,483 ED OUTPATIENT VISITS, AND 578 SWING BED DAYS.Desc
Total Program Service Expenses$62,514,277TotalProgramServiceExpensesAmt
Described In Section501c3Yes (true)DescribedInSection501c3Ind
Schedule B RequiredYes (true)ScheduleBRequiredInd
Political Campaign ActyfalsePoliticalCampaignActyInd
Lobbying ActivitiesYes (true)LobbyingActivitiesInd
Subject To Proxy TaxfalseSubjectToProxyTaxInd
Donor Advised FundfalseDonorAdvisedFundInd
Conservation EasementsfalseConservationEasementsInd
Collections Of ArtfalseCollectionsOfArtInd
Credit CounselingfalseCreditCounselingInd
Temp Or Permanent EndowmentsYes (true)TempOrPermanentEndowmentsInd
Report Land Building EquipmentYes (true)ReportLandBuildingEquipmentInd
Report Investments Other SecfalseReportInvestmentsOtherSecInd
Report Program Related InvstfalseReportProgramRelatedInvstInd
Report Other AssetsfalseReportOtherAssetsInd
Report Other LiabilitiesYes (true)ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (true)IncludeFIN48FootnoteInd
Independent Audit Fincl StmtfalseIndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (true)ConsolidatedAuditFinclStmtInd
School OperatingfalseSchoolOperatingInd
Foreign OfficefalseForeignOfficeInd
Foreign ActivitiesfalseForeignActivitiesInd
More Than5000 K To OrgfalseMoreThan5000KToOrgInd
More Than5000 K To IndividualsfalseMoreThan5000KToIndividualsInd
Professional FundraisingfalseProfessionalFundraisingInd
Fundraising ActivitiesfalseFundraisingActivitiesInd
Gaming ActivitiesfalseGamingActivitiesInd
Operate HospitalYes (true)OperateHospitalInd
Audited Financial Stmt AttYes (true)AuditedFinancialStmtAttInd
Grants To OrganizationsfalseGrantsToOrganizationsInd
Grants To IndividualsfalseGrantsToIndividualsInd
Schedule J RequiredYes (true)ScheduleJRequiredInd
Tax Exempt BondsYes (true)TaxExemptBondsInd
Invest Tax Exempt BondsfalseInvestTaxExemptBondsInd
Escrow AccountfalseEscrowAccountInd
On Behalf Of IssuerfalseOnBehalfOfIssuerInd
Engaged In Excess Benefit TransfalseEngagedInExcessBenefitTransInd
PY Excess Benefit TransfalsePYExcessBenefitTransInd
Loan OutstandingfalseLoanOutstandingInd
Grant To Related PersonfalseGrantToRelatedPersonInd
Business Rln With Org MemfalseBusinessRlnWithOrgMemInd
Business Rln With Fam MemfalseBusinessRlnWithFamMemInd
Business Rln With Officer EntfalseBusinessRlnWithOfficerEntInd
Deductible Non Cash ContrifalseDeductibleNonCashContriInd
Deductible Art ContributionfalseDeductibleArtContributionInd
Terminate OperationsfalseTerminateOperationsInd
Partial LiquidationfalsePartialLiquidationInd
Disregarded EntityfalseDisregardedEntityInd
Related EntityYes (true)RelatedEntityInd
Related Organization Ctrl EntYes (true)RelatedOrganizationCtrlEntInd
Transaction With Control EntfalseTransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd OrgfalseTrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted PrtshpfalseActivitiesConductedPrtshpInd
Schedule O RequiredYes (true)ScheduleORequiredInd
IRP Document109IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (true)BackupWthldComplianceInd
Employee585EmployeeCnt
Employment Tax Returns FiledYes (true)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over LimitfalseUnrelatedBusIncmOverLimitInd
Foreign Financial AccountfalseForeignFinancialAccountInd
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTransInd
Taxable Party NotificationfalseTaxablePartyNotificationInd
Nondeductible ContributionsfalseNondeductibleContributionsInd
Quid Pro Quo ContributionsfalseQuidProQuoContributionsInd
Form8282 Property Disposed OffalseForm8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft CntrctfalseRcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft CntrctfalsePayPremiumsPrsnlBnftCntrctInd
Indoor Tanning ServicesfalseIndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members15GoverningBodyVotingMembersCnt
Independent Voting Member9IndependentVotingMemberCnt
Family Or Business RlnfalseFamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesfalseDelegationOfMgmtDutiesInd
Change To Org DocumentsfalseChangeToOrgDocumentsInd
Material Diversion Or MisusefalseMaterialDiversionOrMisuseInd
Members Or StockholdersYes (true)MembersOrStockholdersInd
Election Of Board MembersYes (true)ElectionOfBoardMembersInd
Decisions Subject To ApprovaYes (true)DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (true)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (true)MinutesOfCommitteesInd
Officer Mailing AddressfalseOfficerMailingAddressInd
Local ChaptersfalseLocalChaptersInd
Form990 Provided To Gvrn BodyYes (true)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (true)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (true)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (true)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (true)WhistleblowerPolicyInd
Document Retention PolicyYes (true)DocumentRetentionPolicyInd
Compensation Process CEOYes (true)CompensationProcessCEOInd
Compensation Process OtherYes (true)CompensationProcessOtherInd
Investment In Joint VenturefalseInvestmentInJointVentureInd
States Where Copy Of Return Is FldNHStatesWhereCopyOfReturnIsFldCd
Other WebsiteYes (X)OtherWebsiteInd

Books In Care Of Detail BooksInCareOfDetail

FieldValueIRS element (for citing)
PersonDIANA MCLAUGHLINPersonNm
Phone6033565461PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line13073 WHITE MOUNTAIN HIGHWAYAddressLine1Txt
CityNORTH CONWAYCityNm
State AbbreviationNHStateAbbreviationCd
ZIP03860ZIPCd
FieldValueIRS element (for citing)
Info In Schedule O Part VIIYes (X)InfoInScheduleOPartVIIInd

Form990 Part VII Section A Form990PartVIISectionAGrp (25 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtOfficerOfficerIndHighest Compensated EmployeeHighestCompensatedEmployeeInd
WILLIAM CARON
MH CEO1.0050.00Yes (X)$0$1,080,292$150,277
SCOTT MCKINNON
PRESIDENT/CE50.00Yes (X)$514,717$0$24,358Yes (X)
MARNI MADNICK MD
MEDICAL STAF50.00Yes (X)$329,324$0$39,294
RAYMOND RABIDEAU MD
CMO50.00Yes (X)$313,608$0$24,343
JAMES GLAZER MD FACSM
BOARD MEMBER50.00Yes (X)$288,499$0$23,447
LEONA CLOUTIER
BOARD MEMBER50.00Yes (X)$154,880$0$30,406
PHIL DAVIES
CHAIR1.00Yes (X)$0$0$0Yes (X)
LAURA JAWITZ
1ST VICE CHA1.00Yes (X)$0$0$0Yes (X)
DAPHNE WALL
PAST 2ND VIC1.00Yes (X)$0$0$0Yes (X)
BARBARA HOPKINS
PAST SECRETA1.00Yes (X)$0$0$0Yes (X)
THAIRE BRYANT
TREASURER1.00Yes (X)$0$0$0Yes (X)
ED KELLY
BOARD MEMBER1.00Yes (X)$0$0$0
JOAN AUBREY
BOARD MEMBER1.00Yes (X)$0$0$0
BILL BECK
2ND VICE CHA1.00Yes (X)$0$0$0Yes (X)
MICHELLE O'DONNELL
BOARD MEMBER1.00Yes (X)$0$0$0
MARY DEVEAU
BOARD MEMBER1.00Yes (X)$0$0$0
JUSTINO FERNANDES MD
SECRETARY1.00Yes (X)$0$0$0Yes (X)
ETHNEE GARNER
VP OF NURSIN50.00$146,690$0$21,227Yes (X)
DIANA MCLAUGHLIN
SR DIRECTOR0.0050.00$0$124,337$21,368Yes (X)
DIANE MAHEUX
FRMR VP OF F50.00$118,434$0$30,019Yes (X)
MORICE DENNERY MD
SURGEON50.00$479,874$0$24,370Yes (X)
DOUGLAS TAYLOR MD
ORTHOPAEDIC50.00$478,122$0$24,675Yes (X)
JOHN IDOINE DO
ORTHOPAEDIC50.00$443,372$0$48,547Yes (X)
WILLIAM MARTIN MD
PRIMARY CARE50.00$384,982$0$54,429Yes (X)
BRIAN SPONSELLER MD
PRIMARY CARE50.00$373,310$0$54,929Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$4,025,812TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$1,204,629TotReportableCompRltdOrgAmt
Total Other Compensation$571,689TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K38IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedfalseFormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (true)TotalCompGreaterThan150KInd
Compensation From Other SrcsfalseCompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
MAINE RECOVERY SERVICES
37 DOUGLAS ROADLIMINGTONME04049BILLING/CODING$517,945
LANGFORD & LOW INC
PO BOX 662PORTLANDME04104BLDG CONTRACTOR$443,815
DIVERSIFIED CLINICAL SERVICES
4500 SALISBURY RD 300JACKSONVILLEFL32216WOUND CARE$373,126
NORDX
301 US RTE 1 SUITE ASCARBOROUGHME040744401LAB SERVICES$301,232
WEATHERBY LOCUMS
PO BOX 972633DALLASTX753972633CONT PHYS SVCS$289,023
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K13CntrctRcvdGreaterThan100KCnt
Info In Schedule O Part VIIIYes (X)InfoInScheduleOPartVIIIInd
All Other Contributions$763,484AllOtherContributionsAmt
Total Contributions$763,484TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (3 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
PATIENT SERVICE REVENUE621110$66,760,706$66,760,706
OTHER PATIENT SERVICE REVENUE621110$1,049,160$1,049,160
CAFETERIA & PHARMACY REVENUE621110$243,945$243,945
FieldValueIRS element (for citing)
Total Program Service Revenue$68,053,811TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$206,058TotalRevenueColumnAmt
Exclusion$206,058ExclusionAmt

Gross Rents GrossRentsGrp

FieldValueIRS element (for citing)
Real$181,242RealAmt

Less Rental Expenses LessRentalExpensesGrp

FieldValueIRS element (for citing)
Real$116,201RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real$65,041RealAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$65,041TotalRevenueColumnAmt
Related Or Exempt Func Income$65,041RelatedOrExemptFuncIncomeAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Securities$3,252,348SecuritiesAmt
Other$3,922OtherAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Securities$3,775,055SecuritiesAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities-$522,707SecuritiesAmt
Other$3,922OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column-$518,785TotalRevenueColumnAmt
Related Or Exempt Func Income-$518,785RelatedOrExemptFuncIncomeAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$68,569,609TotalRevenueColumnAmt
Related Or Exempt Func Income$67,600,067RelatedOrExemptFuncIncomeAmt
Exclusion$206,058ExclusionAmt
FieldValueIRS element (for citing)
Info In Schedule O Part IXYes (X)InfoInScheduleOPartIXInd

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$1,741,584TotalAmt
Program Services$1,218,631ProgramServicesAmt
Management And General$522,953ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$26,276,675TotalAmt
Program Services$24,978,868ProgramServicesAmt
Management And General$1,215,264ManagementAndGeneralAmt
Fundraising$82,543FundraisingAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$464,403TotalAmt
Program Services$429,760ProgramServicesAmt
Management And General$32,462ManagementAndGeneralAmt
Fundraising$2,181FundraisingAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$4,691,530TotalAmt
Program Services$4,285,345ProgramServicesAmt
Management And General$385,413ManagementAndGeneralAmt
Fundraising$20,772FundraisingAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$1,753,128TotalAmt
Program Services$1,639,150ProgramServicesAmt
Management And General$108,112ManagementAndGeneralAmt
Fundraising$5,866FundraisingAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$39,500TotalAmt
Management And General$39,500ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$72,759TotalAmt
Management And General$72,759ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$8,916,445TotalAmt
Program Services$7,389,359ProgramServicesAmt
Management And General$1,527,086ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$249,082TotalAmt
Program Services$2,314ProgramServicesAmt
Management And General$246,768ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$2,011,285TotalAmt
Program Services$1,708,338ProgramServicesAmt
Management And General$301,917ManagementAndGeneralAmt
Fundraising$1,030FundraisingAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$7,625TotalAmt
Management And General$7,625ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$1,614,761TotalAmt
Program Services$1,535,613ProgramServicesAmt
Management And General$79,148ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$75,474TotalAmt
Program Services$66,030ProgramServicesAmt
Management And General$9,323ManagementAndGeneralAmt
Fundraising$121FundraisingAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$998,539TotalAmt
Program Services$998,539ProgramServicesAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$4,365,410TotalAmt
Program Services$4,365,410ProgramServicesAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$742,568TotalAmt
Program Services$553,765ProgramServicesAmt
Management And General$188,803ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmtFundraisingFundraisingAmt
MEDICAL SUPPLIES$9,004,354$9,004,354
MEDICAID TAX$2,553,230$2,553,230
MMC INTEGRATED SERVICES$1,967,696$1,967,696
EQUIPMENT LEASE$679,685$659,273$19,513$899

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$1,312,086TotalAmt
Program Services$1,126,298ProgramServicesAmt
Management And General$154,357ManagementAndGeneralAmt
Fundraising$31,431FundraisingAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$69,537,819TotalAmt
Program Services$62,514,277ProgramServicesAmt
Management And General$6,878,699ManagementAndGeneralAmt
Fundraising$144,843FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$4,159,682BOYAmt
EOY$5,340,650EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$16,829,110BOYAmt
EOY$11,947,966EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$9,101,742BOYAmt
EOY$9,292,542EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$1,533,544BOYAmt
EOY$1,639,702EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$494,869BOYAmt
EOY$399,477EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$85,547,238LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$48,324,020LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$35,644,989BOYAmt
EOY$37,223,218EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$9,198,085BOYAmt
EOY$9,457,955EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$716,760BOYAmt
EOY$1,171,547EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$77,678,781BOYAmt
EOY$76,473,057EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$5,651,911BOYAmt
EOY$4,541,166EOYAmt

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
BOY$156,333BOYAmt
EOY$208,856EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$17,534,962BOYAmt
EOY$17,061,350EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$1,352,444BOYAmt
EOY$1,821,911EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$12,038,085BOYAmt
EOY$12,740,587EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$36,733,735BOYAmt
EOY$36,373,870EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$40,945,046BOYAmt
EOY$40,099,187EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$40,945,046BOYAmt
EOY$40,099,187EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$77,678,781BOYAmt
EOY$76,473,057EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss-$968,210ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst$1,055,351NetUnrlzdGainsLossesInvstAmt
Prior Period Adjustments-$664,000PriorPeriodAdjustmentsAmt
Other Changes In Net Assets-$269,000OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or ReviewfalseAccountantCompileOrReviewInd
FS AuditedYes (true)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Consolidated Basis Fincl StmtYes (X)ConsolidatedBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (true)AuditCommitteeInd
Federal Grant Audit RequiredfalseFederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
HospitalYes (X)HospitalInd

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Total ContributionsRESTRICTEDTotalContributionsAmt

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
VolunteersfalseVolunteersInd
Paid Staff Or ManagementfalsePaidStaffOrManagementInd
Media AdvertisementsfalseMediaAdvertisementsInd
Mailings MembersfalseMailingsMembersInd
Publications Or BroadcastfalsePublicationsOrBroadcastInd
Grants Other OrganizationsfalseGrantsOtherOrganizationsInd
Direct Contact LegislatorsfalseDirectContactLegislatorsInd
Rallies DemonstrationsfalseRalliesDemonstrationsInd
Other ActivitiesYes (true)OtherActivitiesInd
Other Activities$10,668OtherActivitiesAmt
Total Lobbying Expenditures$10,668TotalLobbyingExpendituresAmt
Not Described Section501c3falseNotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceSCHEDULE C, PART II-B, LINE 1FormAndLineReferenceDesc
ExplanationTHE ORGANIZATION PAYS DUES TO THE NEW HAMPSHIRE HOSPITAL ASSOCIATION AND THE AMERICAN HOSPITAL ASSOCIATION, A PORTION OF WHICH IS ATTRIBUTABLE TO LOBBYING EXPENSES.ExplanationTxt

Schedule D IRS990ScheduleD

CY Endwmt Fund CYEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$11,560,341BeginningYearBalanceAmt
Investment Earnings Or Losses$713,421InvestmentEarningsOrLossesAmt
End Year Balance$12,273,762EndYearBalanceAmt

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$12,849,408BeginningYearBalanceAmt
Investment Earnings Or Losses-$1,289,067InvestmentEarningsOrLossesAmt
End Year Balance$11,560,341EndYearBalanceAmt

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$12,735,234BeginningYearBalanceAmt
Investment Earnings Or Losses$114,174InvestmentEarningsOrLossesAmt
End Year Balance$12,849,408EndYearBalanceAmt

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$7,872,190BeginningYearBalanceAmt
Contributions$4,466,317ContributionsAmt
Investment Earnings Or Losses$396,727InvestmentEarningsOrLossesAmt
End Year Balance$12,735,234EndYearBalanceAmt

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$6,740,032BeginningYearBalanceAmt
Investment Earnings Or Losses$1,132,158InvestmentEarningsOrLossesAmt
End Year Balance$7,872,190EndYearBalanceAmt
FieldValueIRS element (for citing)
Board Designated Balance EOY1.00000BoardDesignatedBalanceEOYPct
Endowments Held Unrelated OrgfalseEndowmentsHeldUnrelatedOrgInd
Endowments Held Related OrgYes (true)EndowmentsHeldRelatedOrgInd
Related Org List Sch RYes (true)RelatedOrgListSchRInd

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$4,545,066OtherCostOrOtherBasisAmt
Book Value$4,545,066BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$53,896,650OtherCostOrOtherBasisAmt
Depreciation$28,738,729DepreciationAmt
Book Value$25,157,921BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$26,914,407OtherCostOrOtherBasisAmt
Depreciation$19,585,291DepreciationAmt
Book Value$7,329,116BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$191,115OtherCostOrOtherBasisAmt
Book Value$191,115BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$37,223,218TotalBookValueLandBuildingsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (3 entries)

DescDescAmtAmt
ESTIMATED THIRD PARTY SETTLEMENTS$11,558,550
PROFESSIONAL INSURANCE PAYABLE$805,000
OTHER LIABILITIES$377,037
FieldValueIRS element (for citing)
Total Liability$12,740,587TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
SCHEDULE D, PAGE 2, PART V, LINE 4THE ENDOWED FUNDS SUPPORT COMMUNITY HEALTH INITIATIVES FOR THE MEMORIAL HOSPITAL SERVICE AREA AND PATIENTS, AND PROVIDE SUPPORT FOR PROGRAMS SUCH AS DIABETES TREATMENT, BED REPLACEMENT FOR THE MERRIMAN HOUSE AND THE MEDICAL/SURGICAL WING, AND TO PURCHASE NEW WHEELCHAIRS. OTHER FUNDS ARE DEDICATED TO THE GENERAL OPERATIONS OF THE HOSPITAL SUCH AS ONCOLOGY AND CARDIAC REHABILITATION.
SCHEDULE D, PAGE 3, PART XTHE HOSPITAL AND ITS SUBSIDIARY ARE NOT-FOR-PROFIT CORPORATIONS AND HAVE BEEN RECOGNIZED AS TAX-EXEMPT PURSUANT TO SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. TAX-EXEMPT ORGANIZATIONS COULD BE REQUIRED TO RECORD AN OBLIGATION FOR INCOME TAXES AS THE RESULT OF A TAX POSITION THEY HAVE HISTORICALLY TAKEN ON VARIOUS TAX EXPOSURE ITEMS INCLUDING UNRELATED BUSINESS INCOME OR TAX STATUS. UNDER GUIDANCE ISSUED BY THE FINANCIAL ACCOUNTING STANDARDS BOARD (FASB), ASSETS AND LIABILITIES ARE ESTABLISHED FOR UNCERTAIN TAX POSTIIONS TAKEN OR POSITIONS EXPECTED TO BE TAKEN IN INCOME TAX RETURNS WHEN SUCH POSITIONS ARE JUDGED NOT TO 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 HOSPITAL HAS EVALUATED THE POSITION TAKEN ON ITS FILED TAX RETURNS. THE HOSPITAL HAS CONCLUDED NO UNCERTAIN INCOME TAX POSITIONS EXIST AT SEPTEMBER 30, 2016. THE HOSPITAL'S TAX YEARS FROM 2013 THROUGH 2016 MAY BE SUBJECT TO EXAMINATION.

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Financial Assistance PolicyYes (true)FinancialAssistancePolicyInd
Written PolicyYes (true)WrittenPolicyInd
FPG Reference Free CareYes (true)FPGReferenceFreeCareInd
Percent200Yes (X)Percent200Ind
FPG Reference Discounted CareYes (true)FPGReferenceDiscountedCareInd
Percent300Yes (X)Percent300Ind
Free Care Medically IndigentYes (true)FreeCareMedicallyIndigentInd
Financial Assistance BudgetYes (true)FinancialAssistanceBudgetInd
Expenses Exceed BudgetfalseExpensesExceedBudgetInd
Annual Community Bnft ReportYes (true)AnnualCommunityBnftReportInd
Report Publically AvailableYes (true)ReportPublicallyAvailableInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$640,475TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$640,475NetCommunityBenefitExpnsAmt
Total Expense0.00920TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$14,119,598TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$14,307,001DirectOffsettingRevenueAmt

Total Financial Assistance Typ TotalFinancialAssistanceTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$14,760,073TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$14,307,001DirectOffsettingRevenueAmt
Net Community Benefit Expns$640,475NetCommunityBenefitExpnsAmt
Total Expense0.00920TotalExpensePct

Community Health Services CommunityHealthServicesGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$396,942TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$396,942NetCommunityBenefitExpnsAmt
Total Expense0.00570TotalExpensePct

Subsidized Health Services SubsidizedHealthServicesGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$5,737,180TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$3,543,556DirectOffsettingRevenueAmt
Net Community Benefit Expns$2,193,624NetCommunityBenefitExpnsAmt
Total Expense0.03150TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$6,134,122TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$3,543,556DirectOffsettingRevenueAmt
Net Community Benefit Expns$2,590,566NetCommunityBenefitExpnsAmt
Total Expense0.03730TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$20,894,195TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$17,850,557DirectOffsettingRevenueAmt
Net Community Benefit Expns$3,231,041NetCommunityBenefitExpnsAmt
Total Expense0.04650TotalExpensePct
FieldValueIRS element (for citing)
Bad Debt Expense ReportedfalseBadDebtExpenseReportedInd
Bad Debt Expense$5,595,063BadDebtExpenseAmt
Reimbursed By Medicare$24,792,633ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr$24,547,161CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall$245,472MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

FieldValueIRS element (for citing)
Cost To Charge RatioYes (X)CostToChargeRatioInd
FieldValueIRS element (for citing)
Written Debt Collection PolicyYes (true)WrittenDebtCollectionPolicyInd
Financial Assistance PrvsnYes (true)FinancialAssistancePrvsnInd
Hospital Facilities1HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp

FieldValueIRS element (for citing)
Facility1FacilityNum

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1MEMORIAL HOSPITALBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line13073 WHITE MOUNTAIN HIGHWAYAddressLine1Txt
CityNORTH CONWAYCityNm
State AbbreviationNHStateAbbreviationCd
ZIP03860ZIPCd
FieldValueIRS element (for citing)
Website AddressWWW.MEMORIALHOSPITALNH.ORGWebsiteAddressTxt
State License00009StateLicenseNum
Licensed HospitalYes (X)LicensedHospitalInd
General Medical And SurgicalYes (X)GeneralMedicalAndSurgicalInd
Critical Access HospitalYes (X)CriticalAccessHospitalInd
Emergency Room24 HrsYes (X)EmergencyRoom24HrsInd

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1MEMORIAL HOSPITALBusinessNameLine1Txt
FieldValueIRS element (for citing)
Facility1FacilityNum
First Licensed CY Or PYfalseFirstLicensedCYOrPYInd
Tax Exempt Hospital CY Or PYfalseTaxExemptHospitalCYOrPYInd
CHNA ConductedYes (true)CHNAConductedInd
Community DefinitionYes (X)CommunityDefinitionInd
Community DemographicsYes (X)CommunityDemographicsInd
Existing ResourcesYes (X)ExistingResourcesInd
How Data ObtainedYes (X)HowDataObtainedInd
Community Health NeedsYes (X)CommunityHealthNeedsInd
Other Health IssuesYes (X)OtherHealthIssuesInd
Community Hlth Needs Id ProcessYes (X)CommunityHlthNeedsIdProcessInd
Consulting ProcessYes (X)ConsultingProcessInd
Information GapsYes (X)InformationGapsInd
OtherYes (X)OtherInd
CHNA Conducted16CHNAConductedYr
Take Into Account Others InputYes (true)TakeIntoAccountOthersInputInd
CHNA Conducted With Other FcltsYes (true)CHNAConductedWithOtherFcltsInd
CHNA Conducted With Non FcltsfalseCHNAConductedWithNonFcltsInd
CHNA Report Widely AvailableYes (true)CHNAReportWidelyAvailableInd
Rpt Available On Own WebsiteYes (X)RptAvailableOnOwnWebsiteInd
Own Website URLSEE PART V, SECTION COwnWebsiteURLTxt
Other WebsiteYes (X)OtherWebsiteInd
Other Website URLSEE PART V, SECTION COtherWebsiteURLTxt
Paper Copy Public InspectionYes (X)PaperCopyPublicInspectionInd
Implementation Strategy AdoptYes (true)ImplementationStrategyAdoptInd
Implementation Strategy Adpt16ImplementationStrategyAdptYr
Strategy Posted WebsiteYes (true)StrategyPostedWebsiteInd
Strategy Website URLSEE PART V, SECTION CStrategyWebsiteURLTxt
Strategy AttachedfalseStrategyAttachedInd
Organization Incur Excise TaxfalseOrganizationIncurExciseTaxInd
Elig Criteria ExplainedYes (true)EligCriteriaExplainedInd
FPG Family Incm Lmt Free DscntYes (X)FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care200.000000000000FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care300.000000000000FPGFamilyIncmLmtDscntCarePct
Asset Level CriteriaYes (X)AssetLevelCriteriaInd
Insurance Status CriteriaYes (X)InsuranceStatusCriteriaInd
Explained BasisYes (true)ExplainedBasisInd
App Financial Asst ExplnYes (true)AppFinancialAsstExplnInd
Described InfoYes (X)DescribedInfoInd
Described Suprt DocYes (X)DescribedSuprtDocInd
Provided Hospital ContactYes (X)ProvidedHospitalContactInd
Includes Publicity MeasuresYes (true)IncludesPublicityMeasuresInd
FAP Avlbl On Request No ChargeYes (X)FAPAvlblOnRequestNoChargeInd
FAP App Avlbl On Request No ChrgYes (X)FAPAppAvlblOnRequestNoChrgInd
FAP Notice DisplayedYes (X)FAPNoticeDisplayedInd
Communtity Notified FAPYes (X)CommuntityNotifiedFAPInd
FAP Actions On NonpaymentYes (true)FAPActionsOnNonpaymentInd
Permit No ActionsYes (X)PermitNoActionsInd
Collection ActivitiesYes (true)CollectionActivitiesInd
FAP Notified Upon AdmissionYes (X)FAPNotifiedUponAdmissionInd
FAP Notified All PatientsYes (X)FAPNotifiedAllPatientsInd
Documented Elig DeterminationYes (X)DocumentedEligDeterminationInd
Nondis Emergency Care PolicyYes (true)NondisEmergencyCarePolicyInd
Other Method UsedYes (X)OtherMethodUsedInd
Amounts Generally BilledfalseAmountsGenerallyBilledInd
Gross ChargesfalseGrossChargesInd

Supplemental Information SupplementalInformationGrp (5 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FACILITY 1, MEMORIAL HOSPITAL - PART V, LINE 5THE PLANNING COMMITTEE INCLUDED TWO REPRESENTATIVES FROM POPULATION HEALTH AT MEMORIAL HOSPITAL AND ONE REPRESENTATIVE FROM MAINEHEALTH. ADDITIONAL UNRELATED MEMBERS OF THE COMMITTEE INCLUDED REPRESENTATIVES FROM THE FOLLOWING ENGAGED ORGANIZATIONS: -WHITE MOUNTAIN COMMUNITY HEALTH CENTER: PRIMARY CARE SERVICES AND HEALTH EDUCATION REGARDLESS OF ABILITY TO PAY -NORTHERN HUMAN SERVICES: MENTAL HEALTH CARE AND INDIVIDUALIZED SERVICES FOR DEVELOPMENTALLY DISABLED OR SUBSTANCE ABUSE COUNSELING -T MURRAY WELLNESS CENTER: DIET, EXERCISE, NUTRITION, AND TREATMENT SERVICES -CARROLL COUNTY COALITION FOR PUBLIC HEALTH -VISITING NURSE HOME CARE & HOSPICE OF CARROLL COUNTY & WESTERN MAINE: PERSONAL CARE, SKILLED NURSING, REHABILITATION, AND PALLIATIVE CARE AND HOSPICE SERVICES. -MINERAL SPRINGS: LONG-TERM CARE, ASSISTED LIVING, AND REHABILITATION CENTER THE PLANNING COMMITTEE HELD A FORUM REPRESENTING THE FOLLOWING SECTORS: PUBLIC HEALTH, HEALTHCARE PROVIDERS, LOCAL/STATE GOVERNMENT, MEDICALLY UNDERSERVED, COMMUNITY HEALTH COALITION, NON-PROFIT AGENCIES, LOW INCOME, BUSINESS/CIVIC LEADERSHIP, COLLEGE/UNIVERSITY, PROFESSIONAL MEMBER ORGS, MINORITIES (RACIAL/ETHNIC), AND PUBLIC SCHOOLS. A NUMBER OF ADDITIONAL ENGAGEMENT ACTIVITIES WERE HELD IN SMALLER GROUPS. IN ADDITION TO THE ABOVE, AN ONLINE STAKEHOLDER SURVEY WAS DISSEMINATED TO CAPTURE OPINIONS OF HEALTH PROFESSIONALS AND COMMUNITY STAKEHOLDERS ON HEALTH ISSUES AND NEEDS OF COMMUNITIES ACROSS THE STATE.
FACILITY 1, MEMORIAL HOSPITAL - PART V, LINE 6ATHE CHNA WAS CONDUCTED THROUGH A PARTNERSHIP BETWEEN MAINEHEALTH, EASTERN MAINE HEALTHCARE SYSTEMS AND MAINEGENERAL HEALTH.
FACILITY 1, MEMORIAL HOSPITAL - PART V, LINE 7DHTTPS://MAINEHEALTH.ORG/ABOUT/HEALTH-INDEX-INITIATIVE/COMMUNITY-HEALTH- NEEDS-ASSESSMENT
FACILITY 1, MEMORIAL HOSPITAL - PART V, LINE 11THE ORGANIZATION HAS COMPLETED ITS WORK ON ADDRESSING THE SIGNIFICANT NEEDS IDENTIFIED IN ITS 2013-2015 CHNA AND IMPLEMENTATION PLAN. PLEASE SEE THE ATTACHED IMPLEMENTATION PLAN UPDATE FOR 2015-2016 FOR DETAILS OF THE ACTIVITIES UNDERTAKEN BY THE ORGANIZATION TO MEET THE IDENTIFIED NEEDS OF ITS COMMUNITY. FOR THE 2016-2018 CHNA, THE ORGANIZATION HAS IDENTIFIED PRIORITIES AND DEVELOPED STRATEGIES TO ADDRESS THE SIGNIFICANT NEEDS IDENTIFIED IN ITS MOST RECENTLY CONDUCTED CHNA AND PROVIDED REASONS IF IDENTIFIED NEEDS ARE NOT BEING ADDRESSED. SEE HTTPS://MAINEHEALTH.ORG/ABOUT/HEALTH-INDEX- INITIATIVE/COMMUNITY-HEALTH-NEEDS-ASSESSMENT FOR DETAILS.
FACILITY 1, MEMORIAL HOSPITAL - PART V, LINE 22DUNINSURED INDIVIDUALS RECEIVED A DISCOUNT OF 20% AUTOMATICALLY (THE AVERAGE DISCOUNT ON CHARGES OF THE THREE LARGEST VOLUME COMMERCIAL PAYORS). INDIVIDUALS THAT APPLIED AND RECEIVED ASSISTANCE WERE GRANTED DISCOUNTS BASED UPON INCOME LEVEL AND ASSET LEVEL.

Supplemental Information Detail SupplementalInformationDetail (11 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART I, LINE 7 - COSTING METHODOLOGY EXPLANATIONA COST REPORTING SYSTEM WAS USED TO CALCULATE THE AMOUNTS REPORTED IN THE TABLE. THE COST ACCOUNTING SYSTEM ADDRESSES ALL PATIENT SEGMENTS. A COST-TO-CHARGE RATIO WAS USED.
PART III, LINE 2 - BAD DEBT EXPENSE METHODOLOGYSEE PART III, LINE 4 - BAD DEBT EXPENSE FOOTNOTE TO FINANCIAL STATEMENTS
BAD DEBT EXPENSE FOOTNOTE TO FINANCIAL STATEMENTSMEMORIAL HOSPITAL DOES NOT HAVE A SPECIFIC FOOTNOTE IN THE FINANCIAL STATEMENTS THAT DESCRIBES "BAD DEBT EXPENSE." HOWEVER, REFERENCE IS MADE WITHIN THE FOOTNOTES TO A BAD DEBT POLICY IN A COUPLE OF INSTANCES. WITHIN THE FOOTNOTE DESCRIBING "NET PATIENT SERVICE REVENUE", THE FOLLOWING EXPLAINS THE PROVISION FOR BAD DEBTS: "IN EVALUATING THE COLLECTABILITY OF ACCOUNTS RECEIVABLE, THE HOSPITAL ANALYZES PAST RESULTS AND IDENTIFIES TRENDS FOR EACH MAJOR PAYOR SOURCE OF REVENUE TO ESTIMATE THE APPROPRIATE ALLOWANCE FOR DOUBTFUL ACCOUNTS AND PROVISION FOR BAD DEBTS. MANAGEMENT REGULARLY REVIEWS DATA ABOUT THESE MAJOR PAYOR SOURCES IN EVALUATING THE SUFFICIENCY OF THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. FOR RECEIVABLES ASSOCIATED WITH SELF-PAY PATIENTS (WHICH INCLUDES BOTH PATIENTS WITHOUT INSURANCE AND PATIENTS WITH DEDUCTIBLE AND COPAYMENT BALANCES DUE FOR WHICH THIRD-PARTY COVERAGE EXISTS FOR PART OF THE BILL), THE HOSPITAL RECORDS A PROVISION FOR BAD DEBTS IN THE PERIOD OF SERVICE BASED ON PAST EXPERIENCE, WHICH INDICATES THAT MANY PATIENTS ARE UNABLE OR UNWILLING TO PAY AMOUNTS FOR WHICH THEY ARE FINANCIALLY RESPONSIBLE. THE DIFFERENCE BETWEEN THE STANDARD RATES (OR THE DISCOUNTED RATES IF NEGOTIATED OR ELIGIBLE) AND THE AMOUNTS ACTUALLY COLLECTED AFTER ALL REASONABLE EFFORTS HAVE BEEN EXHAUSTED IS CHARGED AGAINST THE ALLOWANCE FOR DOUBTFUL ACCOUNTS." THE AMOUNT OF EXPENSE ASSOCIATED WITH THE PROVISION OF SERVICES, ULTIMATELY WRITTEN OFF AS BAD DEBT AT MEMORIAL, HAS BEEN CALCULATED AT 5,595,063 FOR THE CURRENT FISCAL YEAR. THIS AMOUNT WAS CALCULATED USING A COST TO CHARGE RATIO. BAD DEBT EXPENSE REPRESENTS HEALTHCARE SERVICES MEMORIAL HAS PROVIDED WITHOUT COMPENSATION. AS A TAX-EXEMPT ORGANIZATION, MEMORIAL PROVIDES NECESSARY PATIENT CARE REGARDLESS OF THE PATIENT'S ABILITY TO PAY FOR THE SERVICES. MEMORIAL CANNOT DETERMINE THE AMOUNT OF BAD DEBT EXPENSE THAT COULD BE REASONABLY ATTRIBUTABLE TO PATIENTS WHO LIKELY WOULD QUALIFY FOR DIFFICULT PERSONAL OR ECONOMIC CIRCUMSTANCES RELATED TO A PORTION OF OUR COMMUNITY BASED PATIENT POPULATION. THEIR MEDICAL BILLS OFTEN PLACE THESE INDIVIDUALS IN UNTENABLE POSITIONS WHERE THEY ARE NOT ABLE TO HANDLE THEIR PERSONAL DEBT AND THEN THEIR NEW MEDICAL DEBT. HOWEVER, BECAUSE OF THEIR INCOME LEVEL, THEY DO NOT QUALIFY FOR FREE CARE. BY PROVIDING NECESSARY HEALTHCARE SERVICES TO THOSE INDIVIDUALS EITHER WHO FAIL TO APPLY FOR FINANCIAL ASSISTANCE OR WHO ARE EXPERIENCING DIFFICULT PERSONAL OR ECONOMIC CIRCUMSTANCES, MEMORIAL BELIEVES THAT BAD DEBT EXPENSE SHOULD BE INCLUDED AS A COMMUNITY BENEFIT.
PART III, LINE 8 - MEDICARE EXPLANATIONMEDICARE ALLOWABLE COSTS WERE CALCULATED USING A COST TO CHARGE RATIO. MEMORIAL HOSPITAL BELIEVES THAT MEDICARE SHORTFALL SHOULD BE INCLUDED AS A COMMUNITY BENEFIT BECAUSE THE HOSPITAL HAS A CLEAR MISSION TO SERVING ELDERLY PATIENTS AND ADULTS WITH DISABILITIES THROUGH TH EPROVISION OF SPECIFIC SUBSIDIZED PROGRAMS DEVELOPED TO HELP IMPROVE THE HEALTH STATUS OF THESE PATIENTS. IF THESE CRITICAL SUBSIDIZED PROGRAMS WERE NOT PROVIDED BY THE HOSPITAL, THEY WOULD BECOME THE OBLIGATION OF THE FEDERAL GOVERNMENT.
PART III, LINE 9B - COLLECTION PRACTICES EXPLANATIONWITH THE EXCEPTION OF INSURANCE COVERAGE THE COLLECTION ACTIVITY SHALL NOT BE INITIATED OR PURSUED FOR ANY AMOUNT APPROVED UNDER THE MEMORIAL HOSPITAL HEALTHCARE ASSISTANCE PROGRAM.
PART VI, LINE 2 - NEEDS ASSESSMENTTHE MEMORIAL HOSPITAL BOARD IS MADE UP OF A DIVERSE SET OF COMMUNITY MEMBERS. EACH MAINEHEALTH MEMBER BOARD REQUIRES A THOROUGH COMMUNITY NEEDS ASSESSMENT AND DIRECTS ITS ORGANIZATION TO RESPOND TO THE NEEDS IDENTIFIED. ALL HOSPITALS WITHIN THE MAINEHEALTH SYSTEM HAVE CONDUCTED COMMUNITY HEALTH NEEDS ASSESSMENTS (CHNA) TO MEET FEDERAL REGULATIONS THAT WERE CREATED AS PART OF THE AFFORDABLE CARE ACT. MAINEHEALTH ALSO PARTICIPATES IN VARIOUS INITIATIVES TO HELP SUPPORT AND PROVIDE UPDATES TO COMMUNITY NEEDS ASSESSMENT PLANNING. SOME OF THESE INITIATIVES INCLUDE: - CLINICAL STRATEGIC PLANNING - FINANCIAL STRATEGIC PLANNING - FACILITY PLANNING - MANPOWER PLANNING - PHYSICIAN RECRUITMENT STRATEGIC PLANNING - EMERGENCY PREPAREDNESS PLANNING ALONG WITH THE INTERNAL ASSESSMENTS, MEMBER ORGANIZATIONS ALSO REVIEW AND ACT ON RECOMMENDATIONS PROVIDED BY LOCAL AND STATE PARTNERS, SUCH AS THE MAINE CENTER FOR DISEASE CONTROL AND PREVENTION (MCDC). SUPPORTED BY MAINEHEALTH AND WORKING WITH OUR COMMUNITY HEALTH COLLABORATIVE AND OTHER NH ORGANIZATION MEMORIAL CONDUCTED A COMMUNITY HEALTH NEEDS ASSESEEMENT. COUNTY-LEVEL CHNA REPORT WERE PRODUCED IN 2016 FOR CARROLL COUNTY NH AND WESTERN MAINE AND USED TO INFORM COMMUNITY ENGAGEMENT AND ACTION BY HOSPITALS, STATE/LOCAL GOVERNMENTS AND OTHER PARTNERS. PLANS CALL FOR A CHNA TO BE REPLICATED BY ALL MAINEHEALTH MEMBERS EVERY THREE YEARS. IN 2016, EACH MEMBER AND AFFILIATE HOSPITAL HELD COMMUNITY FORUMS IN PARTNERSHIP WITH LOCAL AND REGIONAL ORGANIZATIONS TO INCREASE UNDERSTANDING AND USE OF THE COMMUNITY HEALTH NEEDS ASSESSMENT AND TO INFORM ACTION ON LOCAL, COMMUNITY-BASED HEALTH PRIORITIES. CHNA AND IMPLEMENTATION PLAN REPORTS WERE PRODUCED BY EACH MAINEHEALTH MEMBER HOSPITAL, IN COLLABORATION WITH MAINEHEALTH. THESE DETAILED REPORTS COVERED THE TIME PERIOD OF 2016-2018 AND WERE FORMALLY ADOPTED BY EACH MEMBER ORGANIZATION BOARD FOR SUBMISSION WITH THEIR RESPECTIVE FY15 990 FILINGS.
PART VI, LINE 3 - PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCEMEMORIAL HOSPITAL'S POLICY OF CHARITY CARE AND FINANCIAL ASSISTANCE IS EASILY UNDERSTOOD, PROMINENTLY POSTED, AND PUBLICLY AVAILABLE. A PROCESS EXISTS FOR OFFERING CHARITY CARE OR FINANCIAL ASSISTANCE TO PATIENTS WHO ARE UNABLE TO PAY AFTER THEY HAVE ALREADY BEEN BILLED. IN ADDITION TO MONITORING COLLECTION PRACTICES, COPIES OF THE CHARITY CARE POLICY ARE MADE AVAILABLE TO PATIENTS AT ALL ENTRY POINTS (REGISTRATION, ED, ETC.) AND WITH BILL/COLLECTION NOTICES. MEMORIAL HOSPITAL USES SIMPLE APPLICATION PROCEDURES FOR CHARITY CARE OR FINANCIAL ASSISTANCE THAT DO NOT INTIMIDATE OR CONFUSE APPLICANTS. MEMORIAL HOSPITAL'S EMPLOYEES WHO WORK IN ADMISSIONS, BILLING, ACCOUNTS RECEIVABLE, OR PATIENT SERVICES ARE FULLY INFORMED AND EDUCATED ABOUT ALL FINANCIAL ASSISTANCE POLICIES. THESE STAFF MEMBERS IDENTIFY UNPAID BILLS WHERE PERSONS ARE UNABLE TO PAY, AND SEPARATE THESE POTENTIAL "CHARITY CARE" BILLS FROM OTHER BAD DEBT ACCOUNTS. MEMORIAL HOSPITAL PROVIDES ASSISTANCE, ON A SLIDING PERCENTAGE BASIS, FOR THOSE INDIVIDUALS THAT QUALIFY WITH AN INCOME UP TO 300% OF THE FEDERAL POVERTY GUIDELINES. ON A CASE-BY-CASE BASIS, WE HAVE ALSO GRANTED ASSISTANCE TO INDIVIDUALS THAT MAY EARN ABOVE THE 175% OF THE FEDERAL POVERTY GUIDELINES BUT HAVE MET THE CATASTROPHIC ILLNESS PARAMETERS.
PART VI, LINE 4 - COMMUNITY INFORMATIONTHE PRIMARY SERVICE AREA IS NORTHERN CARROLL COUNTY AND SEVERAL BORDERING TOWNS IN THE OXFORD COUNTY, MAINE AREA. THE MEDIAN AGE OF THE POPULATION IS 47. THE COMMUNITY EXPERIENCED A POPULATION INCREASE OF 9.5% IN CARROLL COUNTY AND 5.6% IN OXFORD COUNTY IN THE YEARS 2000 TO 2010. MORE THAN 20% OF CARROLL COUNTY'S POPULATION AND 17% OF OXFORD COUNTY'S POPULATION ARE AGED 65 YEARS OR OLDER.
PART VI, LINE 6 - AFFILIATED HEALTH CARE SYSTEMMAINEHEALTH IS A NOT-FOR-PROFIT FAMILY OF LEADING HIGH-QUALITY PROVIDERS AND OTHER HEALTHCARE ORGANIZATIONS WORKING TOGETHER SO THEIR COMMUNITIES ARE THE HEALTHIEST IN AMERICA. RANKED AMONG THE NATION'S TOP 100 INTEGRATED HEALTHCARE DELIVERY NETWORKS, MAINEHEALTH IS GOVERNED BY A BOARD OF TRUSTEES CONSISTING OF COMMUNITY AND BUSINESS LEADERS FROM ITS SOUTHERN, CENTRAL AND WESTERN MAINE REGIONAL SERVICE AREAS, AS WELL AS EASTERN NEW HAMPSHIRE. THE COLLABORATION OF MAINEHEALTH MEMBERS MAKES IT POSSIBLE TO OFFER AN EXTENSIVE RANGE OF CLINICAL INTEGRATION AND COMMUNITY HEALTH PROGRAMS, MANY AIMED AT IMPROVING ACCESS TO PREVENTIVE AND PRIMARY CARE SERVICES. MAINEHEALTH INCLUDES THE FOLLOWING MEMBER ORGANIZATIONS: LINCOLN HEALTH GROUP (LINCOLN HEALTH), MAINE MEDICAL CENTER, MAINE BEHAVIORAL HEALTHCARE (SPRING HARBOR HOSPITAL), COASTAL HEALTHCARE ALLIANCE (PENOBSCOT BAY MEDICAL CENTER, WALDO COUNTY GENERAL HOSPITAL), SOUTHERN MAINE HEALTH CARE (SOUTHERN MAINE MEDICAL CENTER AND GOODALL CAMPUSES), WESTERN MAINE HEALTH CARE (STEPHENS MEMORIAL HOSPITAL), THE MEMORIAL HOSPITAL AT NORTH CONWAY, N.H., MAINEHEALTH CARE AT HOME, MAINE PHYSICIAN HOSPITAL ORGANIZATION, NORDX, SYNERNET AND MAINEHEALTH ACCOUNTABLE CARE ORGANIZATION. THE STRATEGIC AFFILIATES OF MAINEHEALTH ARE MAINEGENERAL MEDICAL CENTER, MID COAST HOSPITAL AND ST. MARYS REGIONAL MEDICAL CENTER.
PART VI, LINE 7 - STATE FILING OF COMMUNITY BENEFIT REPORTNEW HAMPSHIRE
ADDITIONAL INFORMATIONPART I, LINE 3C - CHARITY CARE LEVELS ARE DETERMINED BY A THREE PRONG TEST FOR ELIGIBILITY. INCOME LEVEL, CASH IN BANK, AND ASSETS ARE ALL EXAMINED TO DETERMINE LEVEL OF ELIGIBILITY.

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Severance PaymentfalseSeverancePaymentInd
Supplemental Nonqual Rtr PlanfalseSupplementalNonqualRtrPlanInd
Equity Based Comp ArrngmfalseEquityBasedCompArrngmInd
Comp Based On Revenue Of Flng OrgfalseCompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related OrgsfalseCompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng OrgfalseCompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd OrgsfalseCompBsdNetEarnsRltdOrgsInd
Any Non Fixed PaymentsfalseAnyNonFixedPaymentsInd
Initial Contract ExceptionfalseInitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (12 entries)

TitleTitleTxtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtBase Compensation Filing OrgBaseCompensationFilingOrgAmtBonus Filing OrganizationBonusFilingOrganizationAmountOther Compensation Filing OrgOtherCompensationFilingOrgAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmt
WILLIAM CARON
MH CEO$775,547$207,000$97,745$131,363$18,914$1,230,569
SCOTT MCKINNON
PRESIDENT/CEO$447,251$65,000$2,466$7,950$16,408$539,075
MARNI MADNICK MD
MEDICAL STAFF PRES$267,764$61,019$541$7,950$31,344$368,618
RAYMOND RABIDEAU MD
CMO$278,750$28,000$6,858$7,950$16,393$337,951
JAMES GLAZER MD FACSM
BOARD MEMBER$237,959$50,000$540$7,519$15,928$311,946
LEONA CLOUTIER
BOARD MEMBER$144,741$10,000$139$4,352$26,054$185,286
ETHNEE GARNER
VP OF NURSING$145,472$1,218$4,636$16,591$167,917
MORICE DENNERY MD
SURGEON$479,064$810$7,950$16,420$504,244
DOUGLAS TAYLOR MD
ORTHOPAEDIC SURGEON$475,800$2,322$7,950$16,725$502,797
JOHN IDOINE DO
ORTHOPAEDIC SURGEON$442,886$486$5,095$43,452$491,919
WILLIAM MARTIN MD
PRIMARY CARE MD$384,496$486$7,950$46,479$439,411
BRIAN SPONSELLER MD
PRIMARY CARE MD$372,824$486$7,950$46,979$428,239

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceSCHEDULE J, PAGE 1, PART I, LINE 3FormAndLineReferenceDesc
ExplanationSEE DESCRIPTION OF PROCESS IN SCHEDULE O - FORM 990, PART VI, LINE 15A - COMPENSATION OF TOP OFFICIAL.ExplanationTxt

Schedule K IRS990ScheduleK

Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd

Issuer Name IssuerName

FieldValueIRS element (for citing)
Business Name Line1NH HEALTH AND EDUC FACILITIES AUTHBusinessNameLine1Txt
FieldValueIRS element (for citing)
Bond Issuer EIN020279866BondIssuerEIN
CUSIP644614QC6CUSIPNum
Bond Issued2006-06-14BondIssuedDt
Issue Price$20,955,000IssuePriceAmt
PurposeTO CONSTRUCT AND RENOVATE HOSPITAL FACILITY AND PAY OFF EXISTING DEBT.PurposeDesc
DefeasedfalseDefeasedInd
On Behalf Of IssuerfalseOnBehalfOfIssuerInd
Pool FinancingfalsePoolFinancingInd

Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Retired$3,228,296RetiredAmt
Total Proceeds$20,955,000TotalProceedsAmt
In Reserve Fund$2,080,881InReserveFundAmt
Issuance Costs From Proceeds$324,775IssuanceCostsFromProceedsAmt
Capital Expenditures$20,630,225CapitalExpendituresAmt
Substantial Completion2009SubstantialCompletionYr
Current RefundingfalseCurrentRefundingInd
Advance RefundingfalseAdvanceRefundingInd
Final Allocation MadeYes (true)FinalAllocationMadeInd
Adequate Books And Rec MaintYes (true)AdequateBooksAndRecMaintInd

Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Owning Bond Financed PropertyfalseOwningBondFinancedPropertyInd
Any Lease ArrangementsfalseAnyLeaseArrangementsInd
Mgmt Contract Bond Fincd PropfalseMgmtContractBondFincdPropInd
Any Research AgreementsfalseAnyResearchAgreementsInd
Bond Iss Meet Prvt Sec Pymt TestfalseBondIssMeetPrvtSecPymtTestInd
Change In Use Bond Financed PropfalseChangeInUseBondFinancedPropInd
Procs Nonqualified Bond RemdtdfalseProcsNonqualifiedBondRemdtdInd

Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Form8038 T FiledfalseForm8038TFiledInd
Rebate Not Due YetfalseRebateNotDueYetInd
Exception To RebateYes (true)ExceptionToRebateInd
No Rebate DuefalseNoRebateDueInd
Variable Rate IssuefalseVariableRateIssueInd
Hedge Identified In Bks And RecfalseHedgeIdentifiedInBksAndRecInd
Gross Proceeds Invested In GICfalseGrossProceedsInvestedInGICInd
Gross Proceeds InvestedfalseGrossProceedsInvestedInd
Written Proc To Monitor ReqsfalseWrittenProcToMonitorReqsInd

Procedures Corrective Action ProceduresCorrectiveActionGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Procedures Corrective ActionfalseProceduresCorrectiveActionInd

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceSCHEDULE K - ADDITIONAL INFORMATIONFormAndLineReferenceDesc
ExplanationNH HEALTH AND EDUC FACILITIES AUTH PART I, A, (A) - ISSUER NAME: NEW HAMPSHIRE HEALTH AND EDUCATION FACILITIES AUTHORITY. PART I, A, (F) - DESCRIPTION OF PURPOSE: TO CONSTRUCT AND RENOVATE HOSPITAL FACILITY AND PAY OFF EXISTING DEBT.ExplanationTxt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (12 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PAGE 6, PART VI, LINE 6THE SOLE MEMBER OF THE ORGANIZATION IS MAINEHEALTH (EIN 01-0431680).
FORM 990, PAGE 6, PART VI, LINE 7ATHE SOLE MEMBER OF THE ORGANIZATION ELECTS THE TRUSTEES OF THE ORGANIZATION
FORM 990, PAGE 6, PART VI, LINE 7BDECISIONS OF THE GOVENING BODY SUCH AS BUDGETS, BUSINESS AND MARKETING STRATEGIC PLANS, SIGNIFICANT FINANCIAL COMMITMENTS, AMENDMENTS TO THE ARTICLES OF INCORPORATION , AND ELECTION OF THE PRESIDENT/CEO AMONG OTHER DECISIONS, ARE SUBJECT TO APPROVAL BY MAINEHEALTH (EIN 01-0431680).
FORM 990, PAGE 6, PART VI, LINE 11BTHE 990 IS REVIEWED WITH THE GOVERNANCE COMMITTEE OF THE BOARD OF DIRECTORS. THE 990 IS ALSO SENT TO THE FULL BOARD OF DIRECTORS VIA ELECTRONIC MEANS.
FORM 990, PAGE 6, PART VI, LINE 12CCONFLICT OF INTEREST DECLARATION FORMS ARE SUBMITTED IN JANUARY BY MEMBERS OF THE BOARD OF TRUSTEES AND ARE SHARED WITH THE FULL BOARD FOR INFORMATION PURPOSES AND REVIEWED IN DEPTH BY THE GOVERNANCE COMMITTEE. IT IS THE MEMBER'S RESPONSIBILITY TO NOTIFY THE BOARD OF ANY CONFLICTS THAT THEY BECOME AWARE OF AND TO RECUSE THEMSELVES FROM DISCUSSIONS AND VOTES ON THE ISSUE.
FORM 990, PAGE 6, PART VI, LINE 15ATHE PROCESS FOLLOWED FOR DETERMINING COMPENSATION OF THE CEO AND OTHER KEY ADMINISTRATIVE EMPLOYEES COMPENSATED BY THIS OR OTHER RELATED ORGANIZATION IS A FORMAL PROCESS PERFORMED ANNUALLY BY THE EXECUTIVE COMMITTEE OF THE BOARD OF DIRECTORS. A RELATED ORGANIZATION USES AN OUTSIDE FIRM, SULLIVAN COTTER, TO PERFORM AN INDEPENDENT BENCHMARK ANALYSIS FOR THE CEO OF MEMORIAL HOSPITAL, ALONG WITH OTHER EXECUTIVES IN THE MAINEHEALTH SYSTEM. THE FIRM MEETS WITH THE EXECUTIVE COMMITTEE TO REVIEW EACH EXECUTIVE'S BENCHMARK REPORT. THE COMMITTEE THEN DELIBERATES ON MAINEHEALTH'S WRITTEN SALARY AND INCENTIVE PLAN PHILOSOPHY BEFORE MAKING A FINAL DECISION. ALL DECISIONS AND MEETINGS ARE CAPTURED IN MINUTES AND THERE ARE APPROPRIATE APPROVALS AT ALL LEVELS.
FORM 990, PAGE 6, PART VI, LINE 15BSEE 990, PART VI, SECTION B, LINE 15A FOR COMPENSATION PROCESS.
FORM 990, PAGE 6, PART VI, LINE 19DOCUMENTS THAT ARE REQUIRED TO BE OPEN FOR PUBLIC INSPECTION ARE MADE AVAILABLE UPON REQUEST.
FORM 990, PART VIICOMPENSATION FOR SCOTT MCKINNON, PRESIDENT & CEO, HAS INCREASED FROM PRIOR YEAR DUE TO A ONE-TIME SERP DISTRIBUTION.
FORM 990, PART VIIICONTRIBUTIONS INCLUDE TRANSFERS OF 590,243 FROM MEMORIAL HOSPITAL FOUNDATION.
FORM 990, PART IX, LINE 11GPURCHASED SERVICES 1,598,477 1,199,786 0 CONTRACT SERVICES 4,613,384 59,734 0 MAINTENANCE CONTRACTS 554,489 80,571 0 LAB SERVICES 552,677 0 0 CONSULTANTS 7,917 186,995 0 PHYSICIAN RECRUITMENT 56,594 0 0 OTHER 5,821 0 0
FORM 990, PART XI, LINE 9TRANSFER TO MAINEHEALTH -269,000 TOTAL -269,000

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (14 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtBusiness Name Line2DirectControllingEntityName/BusinessNameLine2TxtControlled OrganizationControlledOrganizationInd
MEMORIAL HOSPITAL FOUNDATION
3073 WHITE MOUNTAIN HIGHWAYNORTH CONWAYNH03860462137291HEALTHCARENH501C311A02-022215602-0222156Yes (true)
MAINEHEALTH
110 FREE STREETPORTLANDME04101010431680HEALTHCAREME501C311CNAfalse
MAINE MEDICAL CENTER
22 BRAMHALL STREETPORTLANDME04102010238552HOSPITALME501C3301-0431680false
NORDX
301A US ROUTE ONESCARBOROUGHME04074010511356LABME501C3901-0431680false
WALDO COUNTY HEALTHCARE INC
PO BOX 287BELFASTME04915222864961HEALTHCAREME501C311B01-0431680false
LINCOLNHEALTH GROUP
6 ST ANDREWS LANEBOOTHBAY HARBORME04538261475629HEALTHCAREME501C311B01-0431680false
MAINEHEALTH CARE AT HOME
15 INDUSTRIAL PARKSACOME04072222571902HOME HLTHME501C3901-0431680false
MAINEHEALTH CARDIOLOGY
110 FREE STREETPORTLANDME04101452525629HEALTHCAREME501C3901-0431680false
MAINE BEHAVIORAL HEALTHCARE
78 ATLANTIC PLACESOUTH PORTLANDME04106010524834HOSPITALME501C3301-0431680false
SOUTHERN MAINE HEALTH CARE
PO BOX 626BIDDEFORDME04005010179500HOSPITALME501C3301-0431680false
WESTERN MAINE HEALTH CARE CORP
181 MAIN STNORWAYME04268010411788HEALTHCAREME501C311B01-0431680false
FRANKLIN COMMUNITY HEALTH NETWORK
111 FRANKLIN COMMONSFARMINGTONME04938223209406HEALTHCAREME501C311B01-0431680false
GERIATRIC RESOURCE NETWORK
110 FREE STREETPORTLANDME04101010542842HEALTHCAREME501C3701-0431680false
COASTAL HEALTHCARE ALLIANCE
4 WHITE STREETROCKLANDME04841222494475HEALTHCAREME501C311B01-0431680false

Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp

Related Organization Name RelatedOrganizationName

FieldValueIRS element (for citing)
Business Name Line1MAINEHEALTH ACOBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1110 FREE STREETAddressLine1Txt
CityPORTLANDCityNm
State AbbreviationMEStateAbbreviationCd
ZIP04101ZIPCd
FieldValueIRS element (for citing)
EIN452929273EIN
Primary ActivitiesACOPrimaryActivitiesTxt
Legal Domicile StateMELegalDomicileStateCd

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line101-0238552BusinessNameLine1Txt
FieldValueIRS element (for citing)
Predominant Income TypeRELATEDPredominantIncomeTypeTxt
Share Of Total Income$46,139ShareOfTotalIncomeAmt
Share Of EOY Assets$276,258ShareOfEOYAssetsAmt
Disproportionate AllocationsfalseDisproportionateAllocationsInd
General Or Managing PartnerfalseGeneralOrManagingPartnerInd
Ownership0.03460OwnershipPct

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (2 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdDirect Controlling NADirectControllingNACdControlled OrganizationControlledOrganizationInd
SYNERNET INC
110 FREE STREETPORTLANDME04101010539789ADMIN SVCSMEN/Afalse
MAINE PHYSICIAN HOSPITAL ORG
110 FREE STREETPORTLANDME04101010527540HEALTHCAREMEN/Afalse
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts RyltsfalseReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth OrgYes (true)GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth OrgYes (true)GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other OrgfalseLoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth OrgfalseLoansOrGuaranteesFromOthOrgInd
Div Related OrganizationfalseDivRelatedOrganizationInd
Asset Sale To Other OrgfalseAssetSaleToOtherOrgInd
Asset Purchase From Other OrgfalseAssetPurchaseFromOtherOrgInd
Asset ExchangefalseAssetExchangeInd
Rental Of Facilities To Oth OrgfalseRentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth OrgfalseRentalOfFcltsFromOthOrgInd
Perform Of Services For Oth OrgfalsePerformOfServicesForOthOrgInd
Perform Of Services By Other OrgfalsePerformOfServicesByOtherOrgInd
Sharing Of FacilitiesfalseSharingOfFacilitiesInd
Paid Employees SharingYes (true)PaidEmployeesSharingInd
Reimbursement Paid To Other OrgYes (true)ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other OrgfalseReimbursementPaidByOtherOrgInd
Transfer To Other OrgfalseTransferToOtherOrgInd
Transfer From Other OrgfalseTransferFromOtherOrgInd

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