Franklin Memorial Hospital: Form 990, tax year 2013
View the entire original 990 at ProPublica ↗
- Organization
- Franklin Memorial Hospital (EIN 01-0211503)
- Tax period
- 2013-07-01 to 2014-06-30
- Filed
- 2015-01-30
- IRS object ID
- 201510309349301656
- Schema version
- 2013v4.0
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
- Return header
- Form 990
- Schedule A
- Schedule B
- Schedule C
- Schedule D
- Schedule H
- Schedule I
- Schedule J
- Schedule K
- Schedule L
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2015-01-30T15:23:11-06:00 | ReturnTs |
| Tax Period End | 2014-06-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 010523282 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Berry Dunn McNeil & Parker LLC | BusinessNameLine1 |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO Box 1100 | AddressLine1 |
| City | Portland | City |
| State | ME | State |
| ZIP Code | 041041100 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2013-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 010211503 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Franklin Memorial Hospital | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | FRAN | BusinessNameControlTxt |
| Phone | 2077792500 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 111 Franklin Health Commons | AddressLine1 |
| City | Farmington | City |
| State | ME | State |
| ZIP Code | 04938 | ZIPCode |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Wayne Bennett | PersonNm |
| Person Title | CFO | PersonTitleTxt |
| Phone | 2077792500 | PhoneNum |
| Signature | 2015-01-30 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | Joseph R Byrne CPA | PreparerPersonNm |
| PTIN | P01289281 | PTIN |
| Phone | 2077752387 | PhoneNum |
| Preparation | 2015-01-30 | PreparationDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2013 | TaxYr |
| Build TS | 2016-02-25 16:41:14Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | Rebecca Arsenault | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 111 Franklin Health Commons | AddressLine1 |
| City | Farmington | City |
| State | ME | State |
| ZIP Code | 04938 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $74,752,917 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | www.fchn.org | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1926 | FormationYr |
| Legal Domicile State | ME | LegalDomicileStateCd |
| Activity Or Mission | Community Hospital | ActivityOrMissionDesc |
| Voting Members Governing Body | 18 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 12 | VotingMembersIndependentCnt |
| Total Employee | 890 | TotalEmployeeCnt |
| Total Volunteers | 149 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $1,794,711 | PYContributionsGrantsAmt |
| CY Contributions Grants | $812,719 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $76,263,965 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $73,856,393 | CYProgramServiceRevenueAmt |
| PY Investment Income | -$24,953 | PYInvestmentIncomeAmt |
| CY Investment Income | $0 | CYInvestmentIncomeAmt |
| PY Other Revenue | $28,298 | PYOtherRevenueAmt |
| CY Other Revenue | $68,010 | CYOtherRevenueAmt |
| PY Total Revenue | $78,062,021 | PYTotalRevenueAmt |
| CY Total Revenue | $74,737,122 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $10,000 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $8,889,836 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $52,994,819 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $48,638,178 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $31,169,437 | PYOtherExpensesAmt |
| CY Other Expenses | $29,010,111 | CYOtherExpensesAmt |
| PY Total Expenses | $84,174,256 | PYTotalExpensesAmt |
| CY Total Expenses | $86,538,125 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$6,112,235 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$11,801,003 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $68,577,137 | TotalAssetsBOYAmt |
| Total Assets EOY | $52,419,039 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $33,177,419 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $28,550,005 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $35,399,718 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $23,869,034 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | To provide high-quality, cost-effective, patient-centered healthcare to our west central Maine community. We work with our community and other healthcare providers to integrate services and ensure the health of our community. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $44,942,778 | ExpenseAmt |
| Grant | $8,889,836 | GrantAmt |
| Revenue | $58,437,492 | RevenueAmt |
| Desc | Routine Inpatient and Ancillary Outpatient ServicesFranklin Memorial Hospital is a non-for-profit community hospital which provides high-quality, cost-effective, patient-centered inpatient and outpatient healthcare services to west central Maine communities. The 65-bed hospital is fully qualified and accredited to handle a broad range of medical, surgical, pediatric, women's care and diagnostic services. Franklin Memorial Hospital offers top quality specialty care including routine adult, pediatric and intensive care inpatient services as well as a variety of outpatient services including oncology, hematology, cardiology, otolaryngology, orthopaedics, behavioral services, occupational health, dermatology, pulmonology, pain management, pediatric endocrinology, physical rehabilitation, sports medicine and wound care. During the fiscal year 2014 there were 2,400 inpatient discharges, 2,000 outpatient surgeries, 256,000 outpatient lab tests and 37,900 outpatient imaging procedures. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $21,092,587 | ExpenseAmt |
| Revenue | $8,646,417 | RevenueAmt |
| Desc | Franklin Health Physician PracticesFranklin Memorial Hospital identified access to primary care as a central community need and is committed to providing high quality physician services of family practice, internal medicine, pediatrics and women's care. In addition, Franklin Memorial Hospital offers a variety of specialty care services including dermatology, surgery, orthopaedics, and behavioral health services. During the year Franklin Memorial Hospital provided 56,0000 primary care visits and 21,700 specialty care visits in the Franklin Health physician practices. | Desc |
Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $5,475,374 | ExpenseAmt |
| Revenue | $6,772,484 | RevenueAmt |
| Desc | Emergency RoomFranklin Memorial Hospital operates an emergency department which operates 24 hours a day seven days a week. The Emergency Department serves as the primary care physician for a number of low income and indigent residents of the west central Maine communities. Given Franklin Memorial Hospital's commitment to access to care regardless of ability to pay, the Emergency Department serves a vital role in the community's health care network. During FY14 Franklin Memorial Hospital had 15,800 emergency room visits. | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expenses | $71,510,739 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (1) | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Temp Or Permanent Endowments | Yes (1) | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | Yes (1) | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | 0 | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | Yes (1) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (1) | AuditedFinancialStmtAttInd |
| Grants To Organizations | Yes (1) | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | Yes (1) | TaxExemptBondsInd |
| Invest Tax Exempt Bonds | 0 | InvestTaxExemptBondsInd |
| Escrow Account | 0 | EscrowAccountInd |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuerInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | Yes (1) | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | 0 | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 143 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 890 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 18 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 12 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (1) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (1) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | 0 | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | Yes (1) | LocalChaptersInd |
| Policies Reference Chapters | Yes (1) | PoliciesReferenceChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | ME | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Wayne Bennett | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 2077792613 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 111 Franklin Health Commons | AddressLine1 |
| City | Farmington | City |
| State | ME | State |
| ZIP Code | 04938 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionAGrp (30 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Highest Compensated EmployeeHighestCompensatedEmployeeInd | Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd |
|---|---|---|---|---|---|---|---|---|---|
| Rebecca Arsenault | |||||||||
| President/CEO | 33.00 | 7.00 | Yes (X) | Yes (X) | $368,907 | $0 | $32,145 | ||
| Carol Timberlake | |||||||||
| Director | 0.80 | 0.20 | Yes (X) | $0 | $0 | $0 | |||
| Doug Walrath | |||||||||
| Past Director | 0.80 | 0.20 | Yes (X) | $0 | $0 | $0 | |||
| Jef Howell | |||||||||
| Past Treasurer | 1.80 | 0.20 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| Joseph Bujold | |||||||||
| Chair | 2.80 | 0.20 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| Gilly Hitchcock | |||||||||
| Vice Chair | 0.80 | 0.20 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| Meredith Tipton | |||||||||
| Director | 0.80 | 0.20 | Yes (X) | $0 | $0 | $0 | |||
| Tim Wallace | |||||||||
| Past Director | 0.80 | 0.20 | Yes (X) | $0 | $0 | $0 | |||
| Waine Whittier | |||||||||
| Past Director | 1.80 | 0.20 | Yes (X) | $0 | $0 | $0 | |||
| Peter Judkins | |||||||||
| Director | 0.80 | 0.20 | Yes (X) | $0 | $0 | $0 | |||
| Sheena Bunnell | |||||||||
| Director | 0.80 | 0.20 | Yes (X) | $0 | $0 | $0 | |||
| Ronald Aseltine | |||||||||
| Director | 0.80 | 0.20 | Yes (X) | $28,192 | $0 | $0 | |||
| Dr Connie Adler | |||||||||
| Secretary | 39.80 | 0.20 | Yes (X) | Yes (X) | $211,872 | $0 | $12,518 | ||
| Paul Soucie | |||||||||
| Director | 0.80 | 0.20 | Yes (X) | $0 | $0 | $0 | |||
| Clint Boothby | |||||||||
| Director | 0.80 | 0.20 | Yes (X) | $0 | $0 | $0 | |||
| Les Gatchell | |||||||||
| Director | 0.80 | 0.20 | Yes (X) | $0 | $0 | $0 | |||
| Dr David Dixon | |||||||||
| Director | 0.80 | 0.20 | Yes (X) | $0 | $0 | $0 | |||
| Dr Michael Fraley | |||||||||
| Medical Staff President | 39.80 | 0.20 | Yes (X) | $360,594 | $0 | $23,451 | |||
| Darryl Wood | |||||||||
| Director | 0.80 | 0.20 | Yes (X) | $0 | $0 | $0 | |||
| Michael Cormier | |||||||||
| Director | 0.80 | 0.20 | Yes (X) | $0 | $0 | $0 | |||
| Christine Tropeano | |||||||||
| Director | 0.80 | 0.20 | Yes (X) | $0 | $0 | $0 | |||
| John Bogar | |||||||||
| Treasurer | 0.80 | 0.20 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| Gerald Cayer | |||||||||
| Executive VP | 39.00 | 1.00 | Yes (X) | $217,603 | $0 | $21,366 | |||
| Wayne Bennett | |||||||||
| CFO | 36.00 | 4.00 | Yes (X) | $222,975 | $0 | $21,973 | |||
| Nancy Cummings | |||||||||
| Ortho Surgeon | 40.00 | 0.00 | $458,808 | $0 | $24,117 | Yes (X) | |||
| Joshua D Sparling | |||||||||
| Dermatologist | 32.00 | 0.00 | $577,105 | $0 | $24,351 | Yes (X) | |||
| Heather DeCarolis | |||||||||
| Anesthesiologist | 40.00 | 0.00 | $357,656 | $0 | $23,451 | Yes (X) | |||
| James C Lancaster | |||||||||
| Anesthesiologist | 40.00 | 0.00 | $356,194 | $0 | $23,451 | Yes (X) | |||
| Shane P Lydon | |||||||||
| Surgeon | 40.00 | 0.00 | $376,038 | $0 | $23,403 | Yes (X) | |||
| Dr Armand Auger | |||||||||
| Former Officer | 40.00 | 0.00 | $230,897 | $0 | $19,226 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $3,766,841 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $249,452 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 68 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | Yes (1) | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1 | CityContractorAddress/USAddress/City | StateContractorAddress/USAddress/State | ZIP CodeContractorAddress/USAddress/ZIPCode | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| Quest Diagnostics | |||||
| 415 Massachusetts Ave | Cambridge | MA | 02139 | Lab Diagnostics | $522,027 |
| Synernet Inc | |||||
| 110 Free Street | Portland | ME | 04101 | Transcription, Credential Verification | $473,586 |
| Dahl-Chase Diagnostic Services | |||||
| 417 State Street Suite 441 | Bangor | ME | 04401 | Lab Diagnostics | $443,527 |
| MaineGeneral Medical Center | |||||
| 33 Stone Street | Augusta | ME | 04330 | Physician Contract Staffing | $424,576 |
| Nason Mechanical Systems Inc | |||||
| 194 Merrow Road | Auburn | ME | 04210 | Mechanical Contracting | $373,979 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 24 | CntrctRcvdGreaterThan100KCnt |
| All Other Contributions | $812,719 | AllOtherContributionsAmt |
| Total Contributions | $812,719 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (5 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt | ExclusionExclusionAmt |
|---|---|---|---|---|
| Patient Services | 621990 | $159,246,277 | $159,246,277 | |
| Meaningful Use Revenue | 621990 | $1,335,748 | $1,335,748 | |
| Other | 621990 | $1,086,904 | $970,025 | $116,879 |
| Ambulance Subsidies | 621910 | $912,015 | $912,015 | |
| Contract/Char./Bad Dbt. | 621990 | -$88,724,551 | -$88,724,551 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $73,856,393 | TotalProgramServiceRevenueAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $83,805 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $15,795 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $68,010 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $68,010 | TotalRevenueColumnAmt |
| Exclusion | $68,010 | ExclusionAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $74,737,122 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $73,739,514 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $184,889 | ExclusionAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $8,889,836 | TotalAmt |
| Program Services | $8,889,836 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,771,719 | TotalAmt |
| Program Services | $858,558 | ProgramServicesAmt |
| Management And General | $913,161 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $37,453,041 | TotalAmt |
| Program Services | $32,217,826 | ProgramServicesAmt |
| Management And General | $5,235,215 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $576,560 | TotalAmt |
| Program Services | $524,072 | ProgramServicesAmt |
| Management And General | $52,488 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,156,878 | TotalAmt |
| Program Services | $5,325,379 | ProgramServicesAmt |
| Management And General | $831,499 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,679,980 | TotalAmt |
| Program Services | $2,305,370 | ProgramServicesAmt |
| Management And General | $374,610 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $248,976 | TotalAmt |
| Management And General | $248,976 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $61,961 | TotalAmt |
| Management And General | $61,961 | ManagementAndGeneralAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $11,582 | TotalAmt |
| Management And General | $11,582 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,728,506 | TotalAmt |
| Program Services | $3,925,851 | ProgramServicesAmt |
| Management And General | $1,802,655 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $107,433 | TotalAmt |
| Management And General | $107,433 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,084,094 | TotalAmt |
| Program Services | $633,103 | ProgramServicesAmt |
| Management And General | $450,991 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,367,171 | TotalAmt |
| Program Services | $804,700 | ProgramServicesAmt |
| Management And General | $1,562,471 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,971,187 | TotalAmt |
| Program Services | $1,693,445 | ProgramServicesAmt |
| Management And General | $277,742 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $126,984 | TotalAmt |
| Program Services | $121,821 | ProgramServicesAmt |
| Management And General | $5,163 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $235,886 | TotalAmt |
| Program Services | $143,838 | ProgramServicesAmt |
| Management And General | $92,048 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $983,664 | TotalAmt |
| Program Services | $846,167 | ProgramServicesAmt |
| Management And General | $137,497 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,050,233 | TotalAmt |
| Program Services | $3,484,088 | ProgramServicesAmt |
| Management And General | $566,145 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,333,839 | TotalAmt |
| Program Services | $1,253,979 | ProgramServicesAmt |
| Management And General | $79,860 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (3 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| Medical Supplies | $8,088,933 | $8,088,933 | |
| Hospital Tax and Match | $1,961,500 | $1,961,500 | |
| Other | $648,162 | $393,773 | $254,389 |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $86,538,125 | TotalAmt |
| Program Services | $71,510,739 | ProgramServicesAmt |
| Management And General | $15,027,386 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,635 | BOYAmt |
| EOY | $3,615 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,827,383 | BOYAmt |
| EOY | $3,846,314 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $10,333,479 | BOYAmt |
| EOY | $8,137,314 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,212,571 | BOYAmt |
| EOY | $1,273,667 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $932,802 | BOYAmt |
| EOY | $1,092,910 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $86,934,002 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $54,495,459 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $35,249,392 | BOYAmt |
| EOY | $32,438,543 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,771,509 | BOYAmt |
| EOY | $3,041,828 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $292,145 | BOYAmt |
| EOY | $277,973 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $13,954,221 | BOYAmt |
| EOY | $2,306,875 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $68,577,137 | BOYAmt |
| EOY | $52,419,039 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,120,921 | BOYAmt |
| EOY | $6,466,991 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $56,111 | BOYAmt |
| EOY | $56,057 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $21,108,267 | BOYAmt |
| EOY | $20,446,020 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,657,629 | BOYAmt |
| EOY | $0 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,234,491 | BOYAmt |
| EOY | $1,580,937 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $33,177,419 | BOYAmt |
| EOY | $28,550,005 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $32,562,079 | BOYAmt |
| EOY | $20,886,955 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,387,990 | BOYAmt |
| EOY | $1,705,324 | EOYAmt |
Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,449,649 | BOYAmt |
| EOY | $1,276,755 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $35,399,718 | BOYAmt |
| EOY | $23,869,034 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $68,577,137 | BOYAmt |
| EOY | $52,419,039 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | -$11,801,003 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | $270,319 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | 0 | VolunteersInd |
| Paid Staff Or Management | 0 | PaidStaffOrManagementInd |
| Media Advertisements | 0 | MediaAdvertisementsInd |
| Mailings Members | 0 | MailingsMembersInd |
| Publications Or Broadcast | 0 | PublicationsOrBroadcastInd |
| Grants Other Organizations | 0 | GrantsOtherOrganizationsInd |
| Direct Contact Legislators | 0 | DirectContactLegislatorsInd |
| Rallies Demonstrations | 0 | RalliesDemonstrationsInd |
| Other Activities | Yes (1) | OtherActivitiesInd |
| Other Activities | $11,582 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $11,582 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | 0 | NotDescribedSection501c3Ind |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Part II-B, Line 1: | FormAndLineReferenceDesc |
| Explanation | The Organization pays dues to various associations, a portion of which is attributable to lobbying expenses. | ExplanationTxt |
Schedule D IRS990ScheduleD
CY Endwmt Fund CYEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $2,604,155 | BeginningYearBalanceAmt |
| Contributions | $11,967 | ContributionsAmt |
| Investment Earnings Or Losses | $316,743 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $58,391 | OtherExpendituresAmt |
| End Year Balance | $2,874,474 | EndYearBalanceAmt |
CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $2,325,015 | BeginningYearBalanceAmt |
| Contributions | $126,671 | ContributionsAmt |
| Investment Earnings Or Losses | $166,297 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $13,828 | OtherExpendituresAmt |
| End Year Balance | $2,604,155 | EndYearBalanceAmt |
CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $2,341,310 | BeginningYearBalanceAmt |
| Contributions | $216,215 | ContributionsAmt |
| Investment Earnings Or Losses | -$63,416 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $169,094 | OtherExpendituresAmt |
| End Year Balance | $2,325,015 | EndYearBalanceAmt |
CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $2,007,058 | BeginningYearBalanceAmt |
| Contributions | $12,117 | ContributionsAmt |
| Investment Earnings Or Losses | $335,279 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $13,144 | OtherExpendituresAmt |
| End Year Balance | $2,341,310 | EndYearBalanceAmt |
CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $1,903,822 | BeginningYearBalanceAmt |
| Contributions | $60,144 | ContributionsAmt |
| Investment Earnings Or Losses | $135,979 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $93,491 | OtherExpendituresAmt |
| End Year Balance | $2,007,058 | EndYearBalanceAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Designated Balance EOY | 0.00000 | BoardDesignatedBalanceEOYPct |
| Prmnnt Endowment Balance EOY | 0.44000 | PrmnntEndowmentBalanceEOYPct |
| Term Endowment Balance EOY | 0.56000 | TermEndowmentBalanceEOYPct |
| Endowments Held Unrelated Org | 0 | EndowmentsHeldUnrelatedOrgInd |
| Endowments Held Related Org | Yes (1) | EndowmentsHeldRelatedOrgInd |
| Related Org List Sch R | Yes (1) | RelatedOrgListSchRInd |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,268,949 | OtherCostOrOtherBasisAmt |
| Book Value | $1,268,949 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $48,523,414 | OtherCostOrOtherBasisAmt |
| Depreciation | $23,805,085 | DepreciationAmt |
| Book Value | $24,718,329 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $10,517 | OtherCostOrOtherBasisAmt |
| Depreciation | $10,517 | DepreciationAmt |
| Book Value | $0 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $32,143,118 | OtherCostOrOtherBasisAmt |
| Depreciation | $27,718,519 | DepreciationAmt |
| Book Value | $4,424,599 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $4,988,004 | OtherCostOrOtherBasisAmt |
| Depreciation | $2,961,338 | DepreciationAmt |
| Book Value | $2,026,666 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $32,438,543 | TotalBookValueLandBuildingsAmt |
Other Securities OtherSecuritiesGrp (3 entries)
| DescDesc | Book ValueBookValueAmt | Method ValuationMethodValuationCd |
|---|---|---|
| Beneficial Interest in Perpetual Trust | $320,372 | F |
| Interest in FCHN Net Assets | $2,554,102 | F |
| WMPHO Investment | $167,354 | F |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Securities | $3,041,828 | TotalBookValueSecuritiesAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | Deferred Compensation | Desc |
| Amt | $1,580,937 | Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $1,580,937 | TotalLiabilityAmt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Part V, Line 4: | FormAndLineReferenceDesc |
| Explanation | The Organization's endowment funds are held by the Franklin Community Health Network and are intended to support various programs offered by the Organization, such as the charity program, community outreach, education, medical library, Martha B. Webber Breast Care Center, and others. | ExplanationTxt |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (1) | FinancialAssistancePolicyInd |
| Written Policy | Yes (1) | WrittenPolicyInd |
| FPG Reference Free Care | Yes (1) | FPGReferenceFreeCareInd |
| Percent150 | Yes (X) | Percent150Ind |
| FPG Reference Discounted Care | Yes (1) | FPGReferenceDiscountedCareInd |
| Percent250 | Yes (X) | Percent250Ind |
| Free Care Medically Indigent | 0 | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (1) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | 0 | ExpensesExceedBudgetInd |
| Annual Community Bnft Report | Yes (1) | AnnualCommunityBnftReportInd |
| Report Publically Available | Yes (1) | ReportPublicallyAvailableInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $2,608,000 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $2,608,000 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.03010 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $14,176,568 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $11,313,173 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $2,863,395 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.03310 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $16,784,568 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $11,313,173 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $5,471,395 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.06320 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $511,766 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $58,063 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $453,703 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00520 | TotalExpensePct |
Health Professions Education HealthProfessionsEducationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $235,973 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $235,973 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00270 | TotalExpensePct |
Subsidized Health Services SubsidizedHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $11,621,456 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $6,409,698 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $5,211,758 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.06020 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $18,950 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $18,950 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00020 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $12,388,145 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $6,467,761 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $5,920,384 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.06830 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $29,172,713 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $17,780,934 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $11,391,779 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.13150 | TotalExpensePct |
Economic Development EconomicDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $2,000 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $2,000 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
Total Communtity Building Acty TotalCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $2,000 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $2,000 | NetCommunityBenefitExpnsAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (1) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $2,343,919 | BadDebtExpenseAmt |
| Reimbursed By Medicare | $18,035,724 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $22,488,725 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$4,453,001 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | Yes (X) | CostToChargeRatioInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (1) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (1) | FinancialAssistancePrvsnInd |
Management Co And Jnt Ventures ManagementCoAndJntVenturesGrp (2 entries)
| Primary ActivitiesPrimaryActivitiesTxt | Org Profit Or OwnershipOrgProfitOrOwnershipPct | Ofcr Etc Profit Or OwnershipOfcrEtcProfitOrOwnershipPct | Physicians Profit Or OwnershipPhysiciansProfitOrOwnershipPct |
|---|---|---|---|
| 1 Western Maine PHO | |||
| Physician Hospital Organization | 0.50000 | 0.00000 | 0.00000 |
| 2 Scorekeeper LLC | |||
| Wellness Software | 0.40000 | 0.00000 | 0.00000 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| 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 | Franklin Memorial Hospital | BusinessNameLine1 |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 111 Franklin Health Commons | AddressLine1 |
| City | Farmington | City |
| State | ME | State |
| ZIP Code | 04938 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Franklin Memorial Hospital | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| CHNA Conducted | Yes (1) | CHNAConductedInd |
| Community Definition | Yes (X) | CommunityDefinitionInd |
| Community Demographics | Yes (X) | CommunityDemographicsInd |
| Existing Resources | Yes (X) | ExistingResourcesInd |
| How Data Obtained | Yes (X) | HowDataObtainedInd |
| Community Health Needs | Yes (X) | CommunityHealthNeedsInd |
| Other Health Issues | Yes (X) | OtherHealthIssuesInd |
| Community Hlth Needs Id Process | Yes (X) | CommunityHlthNeedsIdProcessInd |
| Consulting Process | Yes (X) | ConsultingProcessInd |
| CHNA Conducted | 12 | CHNAConductedYr |
| Take Into Account Others Input | Yes (1) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | 0 | CHNAConductedWithOtherFcltsInd |
| CHNA Report Widely Available | Yes (1) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Rpt Available Upon Request | Yes (X) | RptAvailableUponRequestInd |
| Adopt Implementation Strategy | Yes (X) | AdoptImplementationStrategyInd |
| Exec Implementation Strategy | Yes (X) | ExecImplementationStrategyInd |
| Develop Community Wide Plan | Yes (X) | DevelopCommunityWidePlanInd |
| Exec Community Wide Plan | Yes (X) | ExecCommunityWidePlanInd |
| Include Operational Plan | Yes (X) | IncludeOperationalPlanInd |
| Adopt Budget | Yes (X) | AdoptBudgetInd |
| Prioritize Health Needs | Yes (X) | PrioritizeHealthNeedsInd |
| Prioritize Services | Yes (X) | PrioritizeServicesInd |
| All Needs Addressed | Yes (1) | AllNeedsAddressedInd |
| Organization Incur Excise Tax | 0 | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (1) | EligCriteriaExplainedInd |
| FPG Used Deter Elig Free Care | Yes (1) | FPGUsedDeterEligFreeCareInd |
| FPG Family Incm Lmt Free Care | 150.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Used Determ Elig Dscnt Care | Yes (1) | FPGUsedDetermEligDscntCareInd |
| FPG Family Incm Lmt Dscnt Care | 250.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| Explained Basis | Yes (1) | ExplainedBasisInd |
| Medicaid Medicare | Yes (X) | MedicaidMedicareInd |
| App Financial Asst Expln | Yes (1) | AppFinancialAsstExplnInd |
| Includes Publicity Measures | Yes (1) | IncludesPublicityMeasuresInd |
| Other Publicity | Yes (X) | OtherPublicityInd |
| FAP Actions On Nonpayment | Yes (1) | FAPActionsOnNonpaymentInd |
| Collection Activities | 0 | CollectionActivitiesInd |
| Nondis Emergency Care Policy | Yes (1) | NondisEmergencyCarePolicyInd |
| Medicare Rates | Yes (X) | MedicareRatesInd |
| Amounts Generally Billed | 0 | AmountsGenerallyBilledInd |
| Gross Charges | 0 | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Franklin Memorial Hospital | Part V, Section B, Line 3: The working group for developing the community health needs assessment consisted of persons who are considered public health experts, such as Meredith Tipton, PhD MPH ,Associate Dean for Community Programs, University of New England, FCHN Board Member; Sarah Martin, PhD Epidemiology, Healthy Community Coalition, Husson College School of Pharmacy; and Michael Rowland, MD MPH, Vice President Medical Affairs, Franklin Memorial Hospital. The working group took input from various community groups interested in promoting wellbeing of the population in our community, including:-FCHN Board, representing communities in Franklin county-Healthy Community Coalition Board, representing diverse groups involved with health improvement -Franklin Health Collaborative, representing health-related organizations and initiatives county-wide (Long-term care, home health, public health nursing, mental health agencies, school districts, domestic violence victim advocacy, emergency response services, University of Maine at Farmington, Franklin County Children's Task Force, Western Mountains Alliance)-FMH Primary Care service, representing primary care providers in Franklin county-Western Maine Public Health District, coordinating regional health improvement work with Maine CDCIn addition to numerous face-to-face meetings with the community groups identified above, direct input from community members was obtained via community survey, conducted by Healthy Community Coalition in 2013, meetings with Franklin Health Patient Advisory group and Community Visioning public meetings conducted every 2 years. |
| Franklin Memorial Hospital | Part V, Section B, Line 14g: Franklin Memorial Hospital takes a number of steps to publicize the availability of the financial assistance to patients: 1. Notices of the availability of financial assistance are posted in locations within the hospital at which members of the public generally transact business with the Hospital or present themselves to receive or request hospital services, including admitting areas, waiting rooms, business offices and outpatient reception areas. 2. With respect with inpatient admissions, individual written notice of the availability of financial assistance is presented to each patient upon admission or in the case of emergency admission before discharge. In addition, all inpatients are visited by a Patient Financial Advocate to discuss availability of financial assistance and government coverage options. 3. Availability of financial assistance is publicized on the patient invoices supplying patients with a contact number to obtain further information about available options. 4. Financial assistance options are outlined on the hospitals' website and are readily available to the public. 5. Rack cards & Financial Assistance Applications are located throughout the Hospital & physician practices6. Hospital booklets are available in all patient rooms with a section regarding Financial Assistance7. Patient Financial Advocates work with all patients without health insurance coverage to notify them about available financial assistance resources and assist with MaineCare applications for eligible individuals. |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 18 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp (18 entries)
| Address Line1USAddress/AddressLine1 | CityUSAddress/City | StateUSAddress/State | ZIP CodeUSAddress/ZIPCode | FacilityFacilityTxt |
|---|---|---|---|---|
| Franklin Hlth Livermore Falls Fam Pract | ||||
| 21 Main Street | Livermore Falls | ME | 04254 | Family Practice |
| Franklin Health Wilton Family Practice | ||||
| 75 Allen Street | Wilton | ME | 04294 | Family Practice |
| Franklin Hlth Farmington Family Practice | ||||
| 111 Franklin Health Commons | Farmington | ME | 04938 | Family Practice |
| Franklin Health Internal Medicine | ||||
| 131 Franklin Health Commons | Farmington | ME | 04938 | Internal Medicine Practice |
| Franklin Health Pediatrics | ||||
| 111 Franklin Health Commons | Farmington | ME | 04938 | Pediatrician Practice |
| Franklin Health Orthopaedics | ||||
| 111 Franklin Health Commons | Farmington | ME | 04938 | Orthopaedic Practice |
| Franklin Health Surgery | ||||
| 111 Franklin Health Commons | Farmington | ME | 04938 | General Surgery Practice |
| Rangeley Region Physical Rehabilitation | ||||
| 25 Dallas Hill Road | Rangeley | ME | 04970 | Outpatient Physical Therapy |
| Outpatient Services at Livermore Falls | ||||
| 21 Main Street | Livermore Falls | ME | 04254 | Outpatient Clinic |
| NorthStar | ||||
| 15 School Street | Rangeley | ME | 04970 | Ambulance Base |
| NorthStar | ||||
| 138C Park Street | Phillips | ME | 04966 | Ambulance Base |
| NorthStar | ||||
| 119 Federal Road | Livermore | ME | 04254 | Ambulance Base |
| NorthStar | ||||
| 1001 Carriage Road | Carrabasset Valley | ME | 04947 | Ambulance Base |
| NorthStar | ||||
| 111 Franklin Health Commons | Farmington | ME | 04938 | Ambulance Base |
| Franklin Health Women's Care | ||||
| 111 Franklin Health Commons | Farmington | ME | 04938 | OB/GYN |
| Franklin Health Child Developmental Prog | ||||
| 131 Franklin Health Commons | Farmington | ME | 04938 | Child Developmental Program |
| Franklin Health Behavioral Services | ||||
| 131 Franklin Health Commons | Farmington | ME | 04938 | Behavioral Health Practice |
| Franklin Health Dermatology | ||||
| 111 Franklin Health Commons | Farmington | ME | 04938 | Dermatology Practice |
Supplemental Information Detail SupplementalInformationDetail (11 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Part I, Line 7: | The costing methodology for the amounts reported in Part I, line 7 of the Schedule H is based on a ratio of patient care cost to charges. This cost to charge ratio was derived from Worksheet 2, Ratio of Patient Care Cost-to-Charges provided in the instructions for Schedule H. The cost to charge ratio was calculated using internal cost accounting data for the subsidized health services included in the community benefit. |
| Part I, Line 7g: | The Organization has included costs associated with primary care (Family practice, Pediatrics, Internal Medicine and Women's Care), Behavioral Services, Child & Adolescent Developmental Pediatrics and physical therapy services provided in Rangeley, ME as subsidized health services. |
| Part II, Community Building Activities: | See 990, Schedule H, Part VI, line 5. |
| Part III, Line 4: | Franklin Memorial Hospital used the RCC calculated from Worksheet 2 and multiplied it by the bad debts expense per the financials. Bad debts include 100% of the charges written off due to no payment. If a payment is made on a bad debt account, then that payment reduces the bad debt expense in the year received.Bad debt expense represents healthcare services that Franklin Memorial Hospital has provided without compensation. As a tax-exempt hospital, Franklin Memorial Hospital provides necessary patient care regardless of the patient's ability to pay for the services. A portion of Franklin Memorial Hospital's bad debt expense is attributable to patients eligible for financial assistance that for a variety of reasons, do not complete the financial assistance application process. Franklin Memorial Hospital cannot determine the amount of bad debt expense that could be reasonably attributable to patients who likely would qualify for financial assistance under the Franklin Memorial Hospital's free care policy. |
| Part III, Line 8: | The Medicare Principles of Reimbursement were used to determine the Medicare inpatient and outpatient costs based on the Organization's cost report. |
| Part III, Line 9b: | Collection agencies work with patients who might be eligible for financial assistance and refer patients who inquire about financial assistance back to Franklin Memorial Hospital for follow up with a Patient Financial Advocate as needed. Balances that are owed to the Hospital after applying any financial assistance are collected in the same manner as any other self pay balances. |
| Part VI, Line 2: | The Franklin Memorial Hospital Network conducts a health visioning process every two years that is used to identify needs and perceived priorities in the community. A physician survey is conducted periodically to assist in gathering information about clinical care needs, referral patterns, specialist needs, etc. The Long-Range Planning Committee, board of directors, and senior leadership use this and other data in developing goals and priorities, making decisions, and setting long-term goals and strategies. The Organization seeks to meet the needs of the population whenever feasible through direct provision of services, contractual relationships, or through referral. |
| Part VI, Line 3: | When patients are registered there are brochures available that describe Franklin Memorial Hospital's charity care programs. When a patient is admitted with no insurance, registration sends a Patient Financial Advocate up to the patient's room to meet the patient. Each bill provided to a patient has the phone number to call if the patient needs financial assistance. The Organization's billers also refer patients to the Organization's Patient Financial Advocate when a patient is identified as needing assistance. |
| Part VI, Line 4: | Franklin Memorial Hosptial's service area covers 2,200 square miles which extends to the Canadian border. It is one of the most rural and economically challenged regions in Maine, including several areas that have been federally designated as health professional shortage and medically underserved areas. |
| Part VI, Line 5: | Community BuildingPhysical Improvements and Housing:1. Development and maintenance of the rail trail which is on FMH property - available to the public to encourage health and wellness. Economic Development:1. Member of Greater Franklin Development Corporation - an organization committed to economic developmentCommunity Support:1. Perform disaster drills with the community 1-2 times a year2. Community Dental (provide low cost rental space)Coalition building:1. Healthy Community Coalition of Greater Franklin County, founded in 1989, is one of the oldest health coalitions in the country. Its mission is to measurably improve the well-being of all people in Greater Franklin County and neighboring towns using a coordinated public health approach of education, promotion, and outreach. With its qualified staff of public health professionals, Healthy Community Coalition offers health screenings, health information, and programs and events to support healthy lifestyles that prevent disease and improve quality of life. Its community outreach efforts appear in every town and corner of the region.In the past year, more than 8,000 individuals benefited from the outreach activities of the Coalition with 2,500 seeking services of the Mobile Health Unit, where health risk appraisals (HRAs) are routinely offered. HRAs include a blood pressure and cholesterol check and individualized health education. Additional outreach events were held throughout the region such as: bone density screenings, flu immunizations, body composition analyzation, free clinical breast exams, education on tobacco, nutrition, physical activity and substance abuse, and education on the prevention of breast, cervical, colon, lung, prostate, and skin cancer.2. AHEC Education Center - Established in 2004 the Franklin AHEC program was developed out of great interest from employees and community members requesting local opportunities to pursue careers in the health field and educational programs for retention and professional growth. The Franklin AHEC allows us to meet the needs of the rural population. It also brings to the Maine AHEC Network the resources of a large innovative rural health system that include a community hospital, Maine's oldest Healthy Community Coalition and the Ben Franklin Center which houses a state of the art education center, medical library facilities, and distance learning opportunities. The program has greatly expanded to include many aspects and activities for retention and recruitment forhealth careers in our vast rural catchment area. Becoming an AHEC center allows us to partner with youth programs, public schools, multiple colleges, adult education, a local career center and other health career programs to offer community members, displaced workers and current healthcare employees the opportunity to continue or pursue careers.3. HealthInfoNet: FMH, along with all other Maine hospitals and hundreds of physician practices in Maine now have access to a new consolidated electronic health record made possible by HealthInfoNet that contains critical information drawn from records that have traditionally been separately maintained in physician practices, hospitals and other settings. Armed with more complete and timely information about a patient, clinicians can provide better quality care and improve the coordination of care, particularly for those patients who see several providers and receive care in more than one community or setting.4. Health Works! Worksite Wellness Award Program is a new and free aware program offered by Healthy Community Coalition of Greater Franklin County. The award program provides businesses and organizations with the opportunity to be recognized as a community leader in health promotion. The purpose of the Healthy Maine Works (HMW) is to guide and support Maine employers in developing worksite wellness programs that support the health of employees. HWM is a project of Maine's Center for Disease Control, Office of Substance Abuse, and Department of Education and is delivered in collaboration with local Healthy Maine Partnerships across the state. |
| Part VI, Line 6: | Franklin Communith Health Network: Supporting OrganizationFranklin Memorial Hospital: Community hospitalHealthy Community Coalition: A subsidiary of FCHN - HCC's mission is to measurably improve the health and well-being of all people in Greater Franklin County using a coordinated approach of education, health promotion, and outreach. HCC offers health screenings, health information, and programs and events to support healthy lifestyles that prevent disease and improve quality of life.Evergreen Behavioral Services: Operates 24/7 emergency mental health response services for the Greater Franklin County area as well as bordering towns of Androscoggin & Oxford counties. |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (1) | GrantRecordsMaintainedInd |
Recipient Table RecipientTable (2 entries)
| Address Line1USAddress/AddressLine1 | CityUSAddress/City | StateUSAddress/State | ZIP CodeUSAddress/ZIPCode | Recipient EINRecipientEIN | IRC SectionIRCSectionDesc | Cash GrantCashGrantAmt | Purpose Of GrantPurposeOfGrantTxt |
|---|---|---|---|---|---|---|---|
| Safe Voices | |||||||
| PO Box 713 | Auburn | ME | 04212 | 010352658 | 501(c)(3) | $5,000 | Organizational Support |
| Franklin Community Health Network | |||||||
| 111 Franklin Health Commons | Farmington | ME | 04938 | 223209406 | 501(c)(3) | $8,884,836 | Organizational Support |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total501c3 Org | 2 | Total501c3OrgCnt |
| Total Other Org | 0 | TotalOtherOrgCnt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Part I, Line 2: | FormAndLineReferenceDesc |
| Explanation | All assistance is given to either 501(c)(3) public charities or governmental units and their affiliates. Therefore, additional monitoring is not deemed necessary. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | Yes (X) | CompensationCommitteeInd |
| Independent Consultant | Yes (X) | IndependentConsultantInd |
| Form990 Of Other Organizations | Yes (X) | Form990OfOtherOrganizationsInd |
| Written Employment Contract | Yes (X) | WrittenEmploymentContractInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | 0 | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | Yes (1) | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (11 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Rebecca Arsenault | ||||||||||||||
| President/CEO | $368,907 | $0 | $0 | $0 | $0 | $0 | $24,181 | $0 | $7,964 | $0 | $401,052 | $0 | $0 | $0 |
| Dr Connie Adler | ||||||||||||||
| Secretary | $203,810 | $0 | $8,062 | $0 | $0 | $0 | $4,215 | $0 | $8,303 | $0 | $224,390 | $0 | $0 | $0 |
| Dr Michael Fraley | ||||||||||||||
| Medical Staff President | $360,594 | $0 | $0 | $0 | $0 | $0 | $6,864 | $0 | $16,587 | $0 | $384,045 | $0 | $0 | $0 |
| Gerald Cayer | ||||||||||||||
| Executive VP | $217,603 | $0 | $0 | $0 | $0 | $0 | $5,587 | $0 | $15,779 | $0 | $238,969 | $0 | $0 | $0 |
| Wayne Bennett | ||||||||||||||
| CFO | $205,475 | $0 | $0 | $0 | $17,500 | $0 | $5,573 | $0 | $16,400 | $0 | $244,948 | $0 | $0 | $0 |
| Nancy Cummings | ||||||||||||||
| Ortho Surgeon | $453,908 | $0 | $4,900 | $0 | $0 | $0 | $7,383 | $0 | $16,734 | $0 | $482,925 | $0 | $0 | $0 |
| Joshua D Sparling | ||||||||||||||
| Dermatologist | $416,607 | $0 | $143,078 | $0 | $17,420 | $0 | $7,650 | $0 | $16,701 | $0 | $601,456 | $0 | $0 | $0 |
| Heather DeCarolis | ||||||||||||||
| Anesthesiologist | $357,656 | $0 | $0 | $0 | $0 | $0 | $6,864 | $0 | $16,587 | $0 | $381,107 | $0 | $0 | $0 |
| James C Lancaster | ||||||||||||||
| Anesthesiologist | $356,194 | $0 | $0 | $0 | $0 | $0 | $6,864 | $0 | $16,587 | $0 | $379,645 | $0 | $0 | $0 |
| Shane P Lydon | ||||||||||||||
| Surgeon | $344,798 | $0 | $31,240 | $0 | $0 | $0 | $6,923 | $0 | $16,480 | $0 | $399,441 | $0 | $0 | $0 |
| Dr Armand Auger | ||||||||||||||
| Former Officer | $207,676 | $0 | $23,221 | $0 | $0 | $0 | $5,360 | $0 | $13,866 | $0 | $250,123 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Part I, Line 7 | FormAndLineReferenceDesc |
| Explanation | Physicians and mid level providers participate in a productivity based incentive bonus program. Bonuses are determined based on certain benchmarks established by the Organization. Amounts fluctuate based on productivity volumes. | ExplanationTxt |
Schedule K IRS990ScheduleK
Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp (2 entries)
| Bond ReferenceBondReferenceCd | Bond Issuer EINBondIssuerEIN | CUSIPCUSIPNum | Bond IssuedBondIssuedDt | Issue PriceIssuePriceAmt | PurposePurposeDesc | DefeasedDefeasedInd | On Behalf Of IssuerOnBehalfOfIssuerInd | Pool FinancingPoolFinancingInd |
|---|---|---|---|---|---|---|---|---|
| Maine Health & Higher Ed Facilities Authority | ||||||||
| A | 010314384 | 560425G20 | 2006-09-07 | $15,270,692 | MRI, Medical Office Building | 0 | 0 | Yes (1) |
| Maine Health & Higher Ed Facilities Authority | ||||||||
| B | 010314384 | 560427NM4 | 2011-11-30 | $10,452,958 | Refunding of Series 2001A | 0 | 0 | Yes (1) |
Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp (2 entries)
| Bond ReferenceBondReferenceCd | RetiredRetiredAmt | Total ProceedsTotalProceedsAmt | In Reserve FundInReserveFundAmt | Issuance Costs From ProceedsIssuanceCostsFromProceedsAmt | Capital ExpendituresCapitalExpendituresAmt | Substantial CompletionSubstantialCompletionYr | Current RefundingCurrentRefundingInd | Advance RefundingAdvanceRefundingInd | Final Allocation MadeFinalAllocationMadeInd | Adequate Books And Rec MaintAdequateBooksAndRecMaintInd |
|---|---|---|---|---|---|---|---|---|---|---|
| A | $2,619,819 | $15,270,692 | $634,664 | $221,065 | $13,274,282 | 2008 | 0 | 0 | Yes (1) | Yes (1) |
| B | $2,657,811 | $10,452,958 | $496,500 | $117,007 | 2002 | Yes (1) | 0 | Yes (1) | Yes (1) |
Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp (2 entries)
| Bond ReferenceBondReferenceCd | Owning Bond Financed PropertyOwningBondFinancedPropertyInd | Any Lease ArrangementsAnyLeaseArrangementsInd | Mgmt Contract Bond Fincd PropMgmtContractBondFincdPropInd | Any Research AgreementsAnyResearchAgreementsInd | Bond Iss Meet Prvt Sec Pymt TestBondIssMeetPrvtSecPymtTestInd | Change In Use Bond Financed PropChangeInUseBondFinancedPropInd | Procs Nonqualified Bond RemdtdProcsNonqualifiedBondRemdtdInd |
|---|---|---|---|---|---|---|---|
| A | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
| B | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp (2 entries)
| Bond ReferenceBondReferenceCd | Form8038 T FiledForm8038TFiledInd | Variable Rate IssueVariableRateIssueInd | Hedge Identified In Bks And RecHedgeIdentifiedInBksAndRecInd | Gross Proceeds Invested In GICGrossProceedsInvestedInGICInd | Gross Proceeds InvestedGrossProceedsInvestedInd | Written Proc To Monitor ReqsWrittenProcToMonitorReqsInd | Rebate Not Due YetRebateNotDueYetInd | Exception To RebateExceptionToRebateInd | No Rebate DueNoRebateDueInd |
|---|---|---|---|---|---|---|---|---|---|
| A | Yes (1) | 0 | 0 | 0 | 0 | 0 | |||
| B | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
Procedures Corrective Action ProceduresCorrectiveActionGrp (2 entries)
| Bond ReferenceBondReferenceCd | Procedures Corrective ActionProceduresCorrectiveActionInd |
|---|---|
| A | 0 |
| B | 0 |
Schedule L IRS990ScheduleL
Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp (3 entries)
| Relationship DescriptionRelationshipDescriptionTxt | TransactionTransactionAmt | TransactionTransactionDesc | Sharing Of RevenuesSharingOfRevenuesInd |
|---|---|---|---|
| Rebecca Wood | |||
| Family Member of Darryl Wood, Board Director | $105,983 | Employment | 0 |
| Michael Rowland | |||
| Family Member of Dr. Connie Adler, Board Secretary | $249,350 | Employment | 0 |
| Kyes Insurance | |||
| An entity of which John Bogar, Board Treasurer, is an officer | $1,090,647 | The Hospital purchases several incurance policies through Kyes Insurance agency. | 0 |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (7 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Form 990, Part VI, Section A, line 6 | The Organization consists of one Member, Franklin Community Health Network. Action of the Member shall be evidenced by written consents that are executed on its behalf by any officer of the Member who is authorized so to act by the board of directors of the Member. The written consent evidencing the annual meeting of the Member shall be adopted and effective as of a date immediately following the annual meeting of the board of directors of the Member or such later date as may be set forth in such written consent. The effective date set forth in such written consent shall be the date of the annual meeting of the year in question. |
| Form 990, Part VI, Section A, line 7a | The Member has rights and powers to establish the size of the board of directors of the Organization within the limits prescribed by the Articles of Incorporation and to elect and remove certain directors of the Organization in accordance with the Articles of Incorporation and Bylaws. |
| Form 990, Part VI, Section B, line 11 | A complete copy of the form 990 was distributed to each member of the board prior to filing with IRS. In addition, the 990 was reviewed with the board of directors prior to filing the tax return in a form of a presentation and a Q&A session to address any questions or concerns. |
| Form 990, Part VI, Section B, line 12c | On an annual basis board members and officers are required to submit a conflict of interest statement which is then reviewed by the compliance committee. The compliance committee is responsible for regularly and consistently monitoring and enforcing compliance with the conflict of interest policy. |
| Form 990, Part VI, Section B, line 15 | Executive compensation is determined by the compensation committee which consists of the Board Chair and several board members. The compensation committee uses an independent executive search firm that assists with executive salary determination by providing compensation survey results, along with review of executive compensation reported by other health care organizations on their Form 990. The compensation committee approves the executive compensation package prior to contract execution. |
| Form 990, Part VI, Section C, line 19 | The Organization's governing documents, conflict of interest policy, and financial statements are available to the public upon request. |
| Form 990, Part XI, line 9: | Change in Net Assets of Affiliate 243,213. Net Change in Perpetual Trust 27,106. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (4 entries)
| Address Line1USAddress/AddressLine1 | CityUSAddress/City | StateUSAddress/State | ZIP CodeUSAddress/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Direct Controlling NADirectControllingNACd | Controlled OrganizationControlledOrganizationInd | Business Name Line1DirectControllingEntityName/BusinessNameLine1 |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Franklin Community Health Network | |||||||||||
| 111 Franklin Health Commons | Farmington | ME | 04938 | 223209406 | Supporting Organization | ME | 501(c)(3) | Line 11b, II | N/A | 0 | |
| Healthy Community Coalition | |||||||||||
| 105 Mt Blue Circle Suite 1 | Farmington | ME | 04938 | 223305743 | Community Outreach | ME | 501(c)(3) | Line 7 | 0 | Franklin Community Health Network | |
| Pine Tree Medical Associates | |||||||||||
| 131 Franklin Health Commons | Farmington | ME | 04938 | 010469478 | Community Health Agency | ME | 501(c)(3) | Line 9 | 0 | Franklin Community Health Network | |
| Evergreen Behavioral Services | |||||||||||
| 131 Franklin Health Commons | Farmington | ME | 04938 | 010492747 | Mental Health Agency | ME | 501(c)(3) | Line 9 | 0 | Franklin Community Health Network | |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp
Related Organization Name RelatedOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | William A Howell Trust Fund co Bank of America NA | BusinessNameLine1 |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO Box 830269 | AddressLine1 |
| City | Dallas | City |
| State | TX | State |
| ZIP Code | 75283 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 016032170 | EIN |
| Primary Activities | Perpetual Trust | PrimaryActivitiesTxt |
| Legal Domicile State | ME | LegalDomicileStateCd |
| Direct Controlling NA | N/A | DirectControllingNACd |
| Entity Type | T | EntityTypeTxt |
| Share Of EOY Assets | $320,372 | ShareOfEOYAssetsAmt |
| Ownership | 1.00000 | OwnershipPct |
| Controlled Organization | 0 | ControlledOrganizationInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | 0 | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | Yes (1) | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | Yes (1) | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | 0 | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | 0 | SharingOfFacilitiesInd |
| Paid Employees Sharing | 0 | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | Yes (1) | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |
Comments