FMH Wind-Down Company: Form 990, tax year 2014
View the entire original 990 at ProPublica ↗
- Organization
- FMH Wind-Down Company (EIN 02-0222131)
- Tax period
- 2014-10-01 to 2015-09-30
- Filed
- 2016-08-09
- IRS object ID
- 201602229349300410
- Schema version
- 2014v6.0
- 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 C
- Schedule D
- Schedule H
- Schedule J
- Schedule K
- Schedule L
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2016-08-09T06:13:12-07:00 | ReturnTs |
| Tax Period End | 2015-09-30 | TaxPeriodEndDt |
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2014-10-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 020222131 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Frisbie Memorial Hospital | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | FRIS | BusinessNameControlTxt |
| Phone | 6033325211 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 11 Whitehall Rd | AddressLine1Txt |
| City | Rochester | CityNm |
| State Abbreviation | NH | StateAbbreviationCd |
| ZIP | 03867 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | NICK SAMILO | PersonNm |
| Person Title | VP FINANCE/CFO | PersonTitleTxt |
| Phone | 6033325211 | PhoneNum |
| Signature | 2016-05-31 | SignatureDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2014 | TaxYr |
| Build TS | 2016-12-15 16:53:06Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | JOHN A MARZINZIK | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 11 Whitehall Rd | AddressLine1Txt |
| City | Rochester | CityNm |
| State Abbreviation | NH | StateAbbreviationCd |
| ZIP | 03867 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $151,952,329 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | www.frisbiehosiptal.com | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1941 | FormationYr |
| Legal Domicile State | NH | LegalDomicileStateCd |
| Activity Or Mission | To excel at caring for the community by providing safe, effective, equitable, timely healthcare services. We will ally ourselves with other community healcare providers to enhance our mutual ability to improve the health of our community and the quality of life for the people we serve. | ActivityOrMissionDesc |
| Voting Members Governing Body | 14 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 14 | VotingMembersIndependentCnt |
| Total Employee | 1050 | TotalEmployeeCnt |
| Total Volunteers | 226 | TotalVolunteersCnt |
| Total Gross UBI | $749,670 | TotalGrossUBIAmt |
| PY Contributions Grants | $131,296 | PYContributionsGrantsAmt |
| CY Contributions Grants | $105,274 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $124,638,231 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $129,746,157 | CYProgramServiceRevenueAmt |
| PY Investment Income | $2,459,904 | PYInvestmentIncomeAmt |
| CY Investment Income | $1,748,820 | CYInvestmentIncomeAmt |
| CY Other Revenue | $0 | CYOtherRevenueAmt |
| PY Total Revenue | $127,229,431 | PYTotalRevenueAmt |
| CY Total Revenue | $131,600,251 | CYTotalRevenueAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $70,119,016 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $73,413,667 | CYSalariesCompEmpBnftPaidAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $126,183 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $56,942,466 | PYOtherExpensesAmt |
| CY Other Expenses | $59,367,062 | CYOtherExpensesAmt |
| PY Total Expenses | $127,061,482 | PYTotalExpensesAmt |
| CY Total Expenses | $132,780,729 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $167,949 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$1,180,478 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $125,766,648 | TotalAssetsBOYAmt |
| Total Assets EOY | $120,840,917 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $39,871,181 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $37,889,299 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $85,895,467 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $82,951,618 | NetAssetsOrFundBalancesEOYAmt |
| Mission | To excel at caring for the community | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $116,050,837 | ExpenseAmt |
| Revenue | $129,746,157 | RevenueAmt |
| Desc | FRISBIE MEMORIAL HOSPITAL IS A NOT-FOR-PROFIT COMMUNITY HOSPITAL THAT CONTINUOSLY EVALUATES AND ADDRESSES THE COMPREHENSIVE HEALTHCARE NEEDS OF ROCHESTER, NH AND THE SURROUNDING COMMUNITIES. IN RESPONSE TO THESE HEALTHCARE NEEDS, THE HOSPITAL COORDINATES, DEVELOPS, AND PROVIDES HIGH QUALITY, AFFORADABLE, PREVENTATIVE, EDUACTIONAL, ACUTE AND CHRONIC CARE SERVICES. IN FY2015 28,973 PATIENTS WERE TREATED IN OUR EMERGENCY DEPARTMENT, 6,208 AMBULANCE CALLS WERE MADE, 3,655 INPATIENTS WERE CARED FOR, AND SURGERY PERFORMED ON 12,761 PATIENTS. 365 NEWBORNS WERE WELCOMED INTO THE WORLD,45,100 RADIOLOGY PROCEDURES/TESTS PROVIDED, GAVE 65,007 REHABILITATIVE TREATMENTS, PERFORMED 359,827 LABORATORY TESTS AND TREATED 5,011 ONCOLOGY PATIENTS. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $5,145,031 | ExpenseAmt |
| Desc | FRISBIE MEMORIAL HOSPITAL PROVIDED UNCOMPENSATED CARE FOR THOSE IN NEED. FRISBIE RANKS AMOUNG THE TOP IN NEW HAMPSHIRE FOR THE MONEY VALUE OF CHARITY CARE PROVIDED TO PATIENTS. | Desc |
Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $519,767 | ExpenseAmt |
| Desc | FRISBIE MEMORIAL HOSPITAL PRESENTED OR SPONSORED NUMEROUS COMMUNITY PROGRAMS WHICH ASSISTED WITH THE SPECIAL NEEDS OF OUR MOST VULNERABLE AT RISK POPULATION GROUPS. THESE PROGRAMS IMPROVED EDUCATION AND HEALTH AWARENESS IN THE COMMUNITY AND PROVIDED GREATER ACCESS TO HEALTH SERVICES. | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expenses | $121,715,635 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | false | 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 | false | 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 | false | FundraisingActivitiesInd |
| Gaming Activities | false | GamingActivitiesInd |
| Operate Hospital | Yes (true) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (true) | AuditedFinancialStmtAttInd |
| Grants To Organizations | false | GrantsToOrganizationsInd |
| Grants To Individuals | false | GrantsToIndividualsInd |
| Schedule J Required | Yes (true) | ScheduleJRequiredInd |
| Tax Exempt Bonds | Yes (true) | 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 | false | 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 | false | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | false | TransactionWithControlEntInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| IRP Document | 46 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 1050 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (true) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | Yes (true) | UnrelatedBusIncmOverLimitInd |
| Form990 T Filed | Yes (true) | 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 |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | false | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | false | PayPremiumsPrsnlBnftCntrctInd |
| DAF Excess Business Holdings | false | DAFExcessBusinessHoldingsInd |
| Taxable Distributions | false | TaxableDistributionsInd |
| Distribution To Donor | false | DistributionToDonorInd |
| Indoor Tanning Services | false | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 14 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 14 | IndependentVotingMemberCnt |
| Family Or Business Rln | Yes (true) | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | false | DelegationOfMgmtDutiesInd |
| Change To Org Documents | false | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | false | MembersOrStockholdersInd |
| Election Of Board Members | false | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | false | 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 | false | 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 | Yes (true) | CompensationProcessOtherInd |
| Investment In Joint Venture | false | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | NH | StatesWhereCopyOfReturnIsFldCd |
| Other Website | Yes (X) | OtherWebsiteInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | NICK SAMILO | PersonNm |
| Phone | 6033325211 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 11 Whitehall Rd | AddressLine1Txt |
| City | Rochester | CityNm |
| State Abbreviation | NH | StateAbbreviationCd |
| ZIP | 03867 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (25 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd | Key EmployeeKeyEmployeeInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|---|
| RONALD POULIN | |||||||||
| President | 3.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |||
| BRIAN HUGHES | |||||||||
| Vice Chair | 3.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |||
| PETER GOWELL | |||||||||
| Treasurer | 3.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |||
| WILLIAM CORMIER | |||||||||
| Secretary | 3.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |||
| ALVIN FELGAR | |||||||||
| CEO | 40.00 | Yes (X) | $523,993 | $0 | $90,962 | Yes (X) | |||
| JOHN MARZINZIK | |||||||||
| SVP Finance/CFO | 40.00 | Yes (X) | $291,384 | $0 | $53,643 | ||||
| JOSEPH BEHRE | |||||||||
| Trustee | 2.00 | Yes (X) | $0 | $0 | $0 | ||||
| JOHN BRITTON MD | |||||||||
| Trustee | 2.00 | Yes (X) | $0 | $0 | $0 | ||||
| SANDRA CONLEY | |||||||||
| Trustee | 2.00 | Yes (X) | $0 | $0 | $0 | ||||
| ROBERT HARRINGTON MD | |||||||||
| Trustee | 2.00 | Yes (X) | $0 | $0 | $0 | ||||
| RICH HUSSEY | |||||||||
| Trustee | 2.00 | Yes (X) | $0 | $0 | $0 | ||||
| FRANK JONES | |||||||||
| Trustee | 2.00 | Yes (X) | $0 | $0 | $0 | ||||
| DAVID KEEFE | |||||||||
| Trustee | 2.00 | Yes (X) | $0 | $0 | $0 | ||||
| JEANETTE POULIN | |||||||||
| Trustee | 2.00 | Yes (X) | $0 | $0 | $0 | ||||
| JULIE REYNOLDS | |||||||||
| Trustee | 2 | Yes (X) | |||||||
| GREGORY SMITH | |||||||||
| Immed Past Chair | 2 | Yes (X) | |||||||
| CAROL THEMELIS | |||||||||
| VP Human Resources | 40 | $233,268 | $54,840 | Yes (X) | |||||
| PAULA MAHONEY | |||||||||
| VP Physician Practices | 40 | $188,543 | $45,349 | Yes (X) | |||||
| AMY DUMONT | |||||||||
| VP Patient Care Services | 40 | $194,903 | $44,411 | Yes (X) | |||||
| JOSEPH SHIELDS | |||||||||
| Senior VP | 40 | $164,621 | $35,698 | Yes (X) | |||||
| MATHURIN MALBY | |||||||||
| MD | 40 | $488,090 | $29,196 | Yes (X) | |||||
| SACHIN SAKSENA | |||||||||
| MD | 40 | $388,942 | $13,404 | Yes (X) | |||||
| MICHAEL METZGER | |||||||||
| MD | 40 | $389,045 | $18,480 | Yes (X) | |||||
| NICOLAS KARAM | |||||||||
| MD | 40 | $383,769 | $34,527 | Yes (X) | |||||
| JOHN FREESE | |||||||||
| MD | 40 | $410,675 | $18,578 | Yes (X) | |||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $3,657,233 | TotalReportableCompFromOrgAmt |
| Total Other Compensation | $439,088 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 11 | 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 |
|---|---|---|---|---|---|
| Crothall Facilities Mgmt | |||||
| 13028 Collections Ctr | Chicago | IL | 60693 | Facilities Management | $3,335,933 |
| Owens & Minor | |||||
| 135 Constitution Boulevard | Franklin | MA | 15251 | Medical Supplies | $2,850,977 |
| Unidine Corp | |||||
| 1000 Washington St | Boston | MA | 03867 | Dietary Services | $1,957,318 |
| Surgical Associates | |||||
| 21 Whitehall Road | Rochester | NH | 03867 | Physican Practice | $1,565,000 |
| Alliance Healthcare | |||||
| PO Box 96485 | Chicago | IL | 60693 | MRI/PET Imaging | $872,882 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 17 | CntrctRcvdGreaterThan100KCnt |
| Fundraising | $31,635 | FundraisingAmt |
| All Other Contributions | $73,639 | AllOtherContributionsAmt |
| Total Contributions | $105,274 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Unrelated Business RevenueUnrelatedBusinessRevenueAmt |
|---|---|---|---|
| Net Patient Service Revenue | 622110 | $126,865,901 | |
| Other Operating Revenue | 900099 | $2,462,377 | $749,670 |
| Meaningful Use | 900099 | $417,879 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $129,746,157 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $429,622 | TotalRevenueColumnAmt |
| Exclusion | $429,622 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $21,671,276 | SecuritiesAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $20,352,078 | SecuritiesAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $1,319,198 | SecuritiesAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $1,319,198 | TotalRevenueColumnAmt |
| Exclusion | $1,319,198 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contri Rpt Fundraising Event | $31,635 | ContriRptFundraisingEventAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $131,600,251 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $128,996,487 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $749,670 | UnrelatedBusinessRevenueAmt |
| Exclusion | $1,748,820 | ExclusionAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,618,927 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $1,618,927 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $55,638,635 | TotalAmt |
| Program Services | $54,219,769 | ProgramServicesAmt |
| Management And General | $1,327,582 | ManagementAndGeneralAmt |
| Fundraising | $91,284 | FundraisingAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,718,949 | TotalAmt |
| Program Services | $1,676,383 | ProgramServicesAmt |
| Management And General | $39,827 | ManagementAndGeneralAmt |
| Fundraising | $2,739 | FundraisingAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $10,800,314 | TotalAmt |
| Program Services | $10,573,296 | ProgramServicesAmt |
| Management And General | $212,413 | ManagementAndGeneralAmt |
| Fundraising | $14,605 | FundraisingAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,636,842 | TotalAmt |
| Program Services | $3,528,436 | ProgramServicesAmt |
| Management And General | $101,560 | ManagementAndGeneralAmt |
| Fundraising | $6,846 | FundraisingAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $167,770 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $167,770 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $102,132 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $102,132 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $15,010,555 | TotalAmt |
| Program Services | $12,658,211 | ProgramServicesAmt |
| Management And General | $2,346,078 | ManagementAndGeneralAmt |
| Fundraising | $6,266 | FundraisingAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $421,464 | TotalAmt |
| Program Services | $13,810 | ProgramServicesAmt |
| Management And General | $407,654 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $972,691 | TotalAmt |
| Program Services | $440,242 | ProgramServicesAmt |
| Management And General | $531,659 | ManagementAndGeneralAmt |
| Fundraising | $790 | FundraisingAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,658,691 | TotalAmt |
| Program Services | $4,309,068 | ProgramServicesAmt |
| Management And General | $349,623 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $30,554 | TotalAmt |
| Program Services | $15,532 | ProgramServicesAmt |
| Management And General | $13,852 | ManagementAndGeneralAmt |
| Fundraising | $1,170 | FundraisingAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $249,907 | TotalAmt |
| Program Services | $233,511 | ProgramServicesAmt |
| Management And General | $16,364 | ManagementAndGeneralAmt |
| Fundraising | $32 | FundraisingAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $888,775 | TotalAmt |
| Program Services | $888,775 | ProgramServicesAmt |
| Management And General | $0 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,851,613 | TotalAmt |
| Program Services | $5,851,613 | ProgramServicesAmt |
| Management And General | $0 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,957,027 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $1,957,027 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt | FundraisingFundraisingAmt |
|---|---|---|---|---|
| Repair & Maintenance | $2,996,407 | $1,659,332 | $1,337,075 | $0 |
| Supplies | $20,278,971 | $20,081,810 | $194,910 | $2,251 |
| Equip Maint/Dues&Subs | $1,071,318 | $856,660 | $214,458 | $200 |
| Medicaid Enhancement Tax | $4,618,119 | $4,618,119 | $0 | $0 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $91,068 | TotalAmt |
| Program Services | $91,068 | ProgramServicesAmt |
| Management And General | $0 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $132,780,729 | TotalAmt |
| Program Services | $121,715,635 | ProgramServicesAmt |
| Management And General | $10,938,911 | ManagementAndGeneralAmt |
| Fundraising | $126,183 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,293,153 | BOYAmt |
| EOY | $3,390,346 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,354,060 | BOYAmt |
| EOY | $1,361,058 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $16,525,555 | BOYAmt |
| EOY | $19,528,619 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,225,639 | BOYAmt |
| EOY | $3,231,018 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,070,228 | BOYAmt |
| EOY | $1,616,273 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $136,724,845 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $79,543,876 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $59,612,743 | BOYAmt |
| EOY | $57,180,969 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $34,163,143 | BOYAmt |
| EOY | $29,464,678 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,522,127 | BOYAmt |
| EOY | $5,067,956 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $125,766,648 | BOYAmt |
| EOY | $120,840,917 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $13,417,408 | BOYAmt |
| EOY | $12,198,521 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $26,453,773 | BOYAmt |
| EOY | $25,690,778 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $39,871,181 | BOYAmt |
| EOY | $37,889,299 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $84,037,516 | BOYAmt |
| EOY | $80,900,580 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $58,259 | BOYAmt |
| EOY | $250,346 | EOYAmt |
Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,799,692 | BOYAmt |
| EOY | $1,800,692 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $85,895,467 | BOYAmt |
| EOY | $82,951,618 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $125,766,648 | BOYAmt |
| EOY | $120,840,917 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | -$1,180,478 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | -$1,763,371 | 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 |
| Public Support Total170 | $0 | PublicSupportTotal170Amt |
Gross Investment Income170 GrossInvestmentIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support CY170 | 0 | PublicSupportCY170Pct |
| Public Support Total509 | $0 | PublicSupportTotal509Amt |
| Public Support CY509 | 0 | PublicSupportCY509Pct |
| Investment Income CY | 0 | InvestmentIncomeCYPct |
Schedule C IRS990ScheduleC
Schedule D IRS990ScheduleD
CY Endwmt Fund CYEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $34,288,142 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | -$4,823,464 | InvestmentEarningsOrLossesAmt |
| End Year Balance | $29,464,678 | EndYearBalanceAmt |
CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $31,227,443 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $3,323,272 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $262,573 | OtherExpendituresAmt |
| End Year Balance | $34,288,142 | EndYearBalanceAmt |
CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $28,491,800 | BeginningYearBalanceAmt |
| Contributions | $78,472 | ContributionsAmt |
| Investment Earnings Or Losses | $2,898,384 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $241,213 | OtherExpendituresAmt |
| End Year Balance | $31,227,443 | EndYearBalanceAmt |
CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $24,732,265 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $3,759,535 | InvestmentEarningsOrLossesAmt |
| End Year Balance | $28,491,800 | EndYearBalanceAmt |
CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $25,552,520 | BeginningYearBalanceAmt |
| Contributions | $59,916 | ContributionsAmt |
| Investment Earnings Or Losses | -$816,743 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $63,428 | OtherExpendituresAmt |
| End Year Balance | $24,732,265 | EndYearBalanceAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Designated Balance EOY | 0.99990 | BoardDesignatedBalanceEOYPct |
| Prmnnt Endowment Balance EOY | 0.00010 | PrmnntEndowmentBalanceEOYPct |
| Term Endowment Balance EOY | 0.00000 | TermEndowmentBalanceEOYPct |
| Endowments Held Unrelated Org | Yes (true) | EndowmentsHeldUnrelatedOrgInd |
| Endowments Held Related Org | false | EndowmentsHeldRelatedOrgInd |
| Related Org List Sch R | false | RelatedOrgListSchRInd |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $181,776 | OtherCostOrOtherBasisAmt |
| Book Value | $181,776 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $75,251,888 | OtherCostOrOtherBasisAmt |
| Depreciation | $30,488,366 | DepreciationAmt |
| Book Value | $44,763,522 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $3,312,813 | OtherCostOrOtherBasisAmt |
| Depreciation | $2,123,572 | DepreciationAmt |
| Book Value | $1,189,241 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $42,332,787 | OtherCostOrOtherBasisAmt |
| Depreciation | $32,846,720 | DepreciationAmt |
| Book Value | $9,486,067 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $15,645,581 | OtherCostOrOtherBasisAmt |
| Depreciation | $14,085,218 | DepreciationAmt |
| Book Value | $1,560,363 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $57,180,969 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp (4 entries)
| DescDesc | Book ValueBookValueAmt |
|---|---|
| Other Assets | $2,109,182 |
| Deferred Finance Costs | $246,395 |
| Investment in Affiliates | $2,712,379 |
| Funds held by trustee under bond indenture agreement |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $5,067,956 | TotalBookValueOtherAssetsAmt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Pt V, Line 4 | FormAndLineReferenceDesc |
| Explanation | To further the hospital's charitable mission | ExplanationTxt |
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 |
| Percent200 | Yes (X) | Percent200Ind |
| FPG Reference Discounted Care | false | FPGReferenceDiscountedCareInd |
| Free Care Medically Indigent | false | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (true) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | false | ExpensesExceedBudgetInd |
| 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) |
|---|---|---|
| Total Community Benefit Expns | $5,145,031 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $5,145,031 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.03870 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $7,717,222 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $1,766,647 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $5,950,575 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.04480 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $12,862,253 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $1,766,647 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $11,095,606 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.08350 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $519,767 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $519,767 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00390 | TotalExpensePct |
Health Professions Education HealthProfessionsEducationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $69,000 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $69,000 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00050 | TotalExpensePct |
Subsidized Health Services SubsidizedHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,679,245 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $1,468,935 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $210,310 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00160 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $111,000 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $111,000 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00080 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $2,379,012 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $1,468,935 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $910,077 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00680 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $15,241,265 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $3,235,582 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $12,005,683 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.09030 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (true) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $3,639,335 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $363,934 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $29,193,988 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $41,145,496 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$11,951,508 | 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 | Frisbie Memorial Hospital | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 11 Whitehall Rd | AddressLine1Txt |
| City | Rochester | CityNm |
| State Abbreviation | NH | StateAbbreviationCd |
| ZIP | 03867 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
| Other | Geropsychiatric Unit | OtherDesc |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Frisbie 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 |
| CHNA Conducted | 15 | CHNAConductedYr |
| Take Into Account Others Input | Yes (true) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | false | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | false | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (true) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | www.frisbiehospital.com | OwnWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Implementation Strategy Adopt | Yes (true) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 15 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (true) | StrategyPostedWebsiteInd |
| Strategy Website URL | www.frisbiehospital.com | 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 | 2.00000000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 0 | FPGFamilyIncmLmtDscntCarePct |
| Income Level Criteria | Yes (X) | IncomeLevelCriteriaInd |
| Insurance Status Criteria | Yes (X) | InsuranceStatusCriteriaInd |
| Underinsurance Stat Criteria | Yes (X) | UnderinsuranceStatCriteriaInd |
| Explained Basis | Yes (true) | 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 |
| Provided Nonprofit Contact | Yes (X) | ProvidedNonprofitContactInd |
| Includes Publicity Measures | Yes (true) | IncludesPublicityMeasuresInd |
| FAP Avlbl On Request No Charge | Yes (X) | FAPAvlblOnRequestNoChargeInd |
| FAP Actions On Nonpayment | Yes (true) | FAPActionsOnNonpaymentInd |
| Permit Report To Credit Agency | Yes (X) | PermitReportToCreditAgencyInd |
| Permit Selling Debt | Yes (X) | PermitSellingDebtInd |
| Collection Activities | false | CollectionActivitiesInd |
| FAP Notified Upon Admission | Yes (X) | FAPNotifiedUponAdmissionInd |
| FAP Notified Before Discharge | Yes (X) | FAPNotifiedBeforeDischargeInd |
| FAP Notified All Patients | Yes (X) | FAPNotifiedAllPatientsInd |
| Documented Elig Determination | Yes (X) | DocumentedEligDeterminationInd |
| Nondis Emergency Care Policy | Yes (true) | NondisEmergencyCarePolicyInd |
| Other Method Used | Yes (X) | OtherMethodUsedInd |
| Amounts Generally Billed | false | AmountsGenerallyBilledInd |
| Gross Charges | false | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Frisbie Memorial Hospital Pt V Line 23 | The maximum amount charged to FAP-eligible individuals is gross charge less 15% |
| Frisbie Memorial Hospital Pt V Line 5 | Members of the committee were chosen based on their knowledge of local healthcare |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 0 | FacilityNum |
Supplemental Information Detail SupplementalInformationDetail (9 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Pt VI Line 7 | NH |
| Pt I Line 3c | Organization uses 200% FPG to determine eligibility |
| Pt I Line 6a | A community benefit report is prepared yearly and is available on the organization public website |
| Pt III Line 2 | The Medicare cost report ratio of cost to charge is used to determine cost of bad debt expense |
| Pt III Line 9b | Collection policy provides for accounts known to qualify for free care be removed from transfer to an outside agency for further collection activity |
| Pt III Line 4 | Financial Statement footnote: Patient Accounts Receivable are stated at the amount expects to collect from outstanding balances. Management provides for probable uncollectable amounts through a charge to operations and a credit to a valuation allowance based on its assessment of individual accounts and historical judgements. |
| Pt III Line 8 | Medicare shortfall is reported on the annual Community Benefit Report to the state of New Hampshire under "unreimbursed costs" government sponsored healthcare. |
| Pt VI Line 2 | Frisbie Memorial Hospital conducts a Community Needs Assessment every five years, the most recent completed in 2013. FMH worked with Health Strategies Plus to bring together healthcare and public service stakeholders, collecting quantative and qualitative data. |
| Pt VI Line 4 | FMH's PSA is urban consisting of Northern Strafford, NH and western York, ME counties. Population served is over 64,000 with a medium income of $52,662 and 10.9% community residents living below the federal poverty guidelines. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | Yes (X) | CompensationCommitteeInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| 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 |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (11 entries)
| Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount |
|---|---|---|---|---|---|---|
| ALVIN FELGAR | ||||||
| $434,274 | $89,719 | $89,505 | $1,457 | $614,955 | $89,505 | |
| JOHN MARZINZIK | ||||||
| $258,884 | $27,332 | $26,311 | $345,027 | $27,332 | $32,500 | |
| CAROL THEMELIS | ||||||
| $181,876 | $36,392 | $39,081 | $15,759 | $288,108 | $39,081 | $15,000 |
| PAULA MAHONEY | ||||||
| $168,352 | $16,500 | $21,984 | $23,365 | $245,201 | $21,984 | $15,000 |
| AMY DUMONT | ||||||
| $179,903 | $22,400 | $22,000 | $22,411 | $261,714 | $15,000 | |
| JOSEPH SHIELDS | ||||||
| $149,621 | $18,000 | $8,643 | $27,055 | $218,319 | $8,643 | $15,000 |
| MATHURIN MALBY | ||||||
| $307,612 | $29,196 | $517,286 | $180,478 | |||
| SACHIN SAKSENA | ||||||
| $388,342 | $13,404 | $402,346 | $600 | |||
| MICHAEL METZGER | ||||||
| $388,445 | $18,480 | $407,525 | $600 | |||
| NICOLAS KARAM | ||||||
| $383,169 | $34,527 | $418,296 | $600 | |||
| JOHN FREESE | ||||||
| $226,530 | $18,578 | $429,253 | $184,145 | |||
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Pt I Line 4b | FormAndLineReferenceDesc |
| Explanation | The hospital has a 457(f) deffered compensation plan which covers highly compensated employees. The organization incurred liabilities related to salary continuation agreements with highly compensated employees. Under the terms of the agreements they are entitled to receive a lump sum of their account balance, including earnings, within 30 days after the employee's date certain, which is elected by the employee. Alvin Felgar, Carol Themelis and Amy Dumont received lump sums distributions in the amount of $89,719, $36,392 and $22,400 respectively in calendar year 2014. | ExplanationTxt |
Schedule K IRS990ScheduleK
Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
Issuer Name IssuerName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | NHHEFA | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Issuer EIN | 020279866 | BondIssuerEIN |
| CUSIP | 644614QD4 | CUSIPNum |
| Bond Issued | 2014-08-01 | BondIssuedDt |
| Issue Price | $22,475,000 | IssuePriceAmt |
| Purpose | Refunding Series 2006 Bonds | PurposeDesc |
| Defeased | false | DefeasedInd |
| On Behalf Of Issuer | false | OnBehalfOfIssuerInd |
| Pool Financing | false | PoolFinancingInd |
Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Total Proceeds | $22,475,000 | TotalProceedsAmt |
| Refunding Escrow | $22,475,000 | RefundingEscrowAmt |
| Substantial Completion | 2014 | SubstantialCompletionYr |
| Current Refunding | Yes (true) | CurrentRefundingInd |
| Advance Refunding | false | AdvanceRefundingInd |
| Final Allocation Made | Yes (true) | FinalAllocationMadeInd |
| Adequate Books And Rec Maint | Yes (true) | AdequateBooksAndRecMaintInd |
Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Owning Bond Financed Property | false | OwningBondFinancedPropertyInd |
| Any Lease Arrangements | false | AnyLeaseArrangementsInd |
| Mgmt Contract Bond Fincd Prop | false | MgmtContractBondFincdPropInd |
| Any Research Agreements | false | AnyResearchAgreementsInd |
| Procs Nonqualified Bond Remdtd | Yes (true) | ProcsNonqualifiedBondRemdtdInd |
Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Form8038 T Filed | false | Form8038TFiledInd |
| Variable Rate Issue | false | VariableRateIssueInd |
| Hedge Identified In Bks And Rec | false | HedgeIdentifiedInBksAndRecInd |
| Gross Proceeds Invested In GIC | false | GrossProceedsInvestedInGICInd |
| Regulatory Safe Harbor Stsfd | false | RegulatorySafeHarborStsfdInd |
| Gross Proceeds Invested | false | GrossProceedsInvestedInd |
Schedule L IRS990ScheduleL
Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp (2 entries)
| Relationship DescriptionRelationshipDescriptionTxt | TransactionTransactionAmt | TransactionTransactionDesc | Sharing Of RevenuesSharingOfRevenuesInd |
|---|---|---|---|
| JOHN BRITTON MD | |||
| Trustee | $1,826,506 | Subsidy | false |
| JOHN BRITTON MD | |||
| Trustee | -$1,300,449 | Transfer of AR | Yes (true) |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (8 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Pt VI, Line 11b | The final form 990 is reviewed by each member of the board audit/finance committee and CFO. |
| Pt VI, Line 11b | The form 990 is made available to the board of directors prior to filing. |
| Pt VI, Line 12c | In accordance with the written conflict of interest policy the office of the President annually secures a signed copy of the Trustee/Officer Conflict of Interest statement and maintains on file. |
| Pt VI, Line 15a | Each year the executive compensation committee comprised of four members of the FMH Board reviews the hospital CEO performance and compensation. The VP of Human Resources presents the compensation committee with comparative salary and benefit data. |
| Pt VI, Line 19 | The Hospital will provide its governing documents, financial statements, and conflict of interest policy upon written request based on the intent and purpose of the request. |
| Pt VI, Line 2 | Trustees Ronald Poulin and Jeanette Poulin are husband and wife. |
| Pt VI, Line 15b | Senior management compensation is also reviewed by the committee, but compensation is determined by the CEO. |
| Other | Part IX Line 24d - The New Hampshire Medicaid Edhancement (MET) tax is a 5.5% tax on net patient service revenue paid by hospitals to the State of New Hampshire. Unlike previous years where the State provided hospitals with uncompensated care payments towards the cost of care of patients without insurance from matching federal funds, uncompensated care payments were reduced or eliminated to hospitals. The FY2015 impact to Frisbie Memorial Hospital was payment of MET in the amount of $4,618,119. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp
Disregarded Entity Name DisregardedEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Frisbie Foundation | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 11 whitehall Rd | AddressLine1Txt |
| City | Rochester | CityNm |
| State Abbreviation | NH | StateAbbreviationCd |
| ZIP | 03867 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 020465942 | EIN |
| Primary Activities | Coordinate Funds raised for hospital | PrimaryActivitiesTxt |
| Legal Domicile State | NH | LegalDomicileStateCd |
| Exempt Code Section | 501(c)(3) | ExemptCodeSectionTxt |
| Public Charity Status | 11 | PublicCharityStatusTxt |
| 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 | Yes (true) | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | false | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | false | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | false | SharingOfFacilitiesInd |
| Paid Employees Sharing | false | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | false | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | Yes (true) | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | false | TransferToOtherOrgInd |
| Transfer From Other Org | false | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp (2 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|
| Frisbie Foundation | ||
| k | $2,524,128 | FMV |
| Frisbie Foundation | ||
| q | $204,060 | FMV |
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