HENRIETTA D GOODALL HOSPITAL INC: Form 990, tax year 2012
View the entire original 990 at ProPublica ↗
- Organization
- HENRIETTA D GOODALL HOSPITAL INC (EIN 01-0078060)
- Tax period
- 2012-06-01 to 2013-05-31
- Filed
- 2015-02-12
- IRS object ID
- 201530439349300303
- Schema version
- 2012v3.0
- 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 J
- Schedule K
- Schedule L
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2015-02-12T06:12:50-06:00 | Timestamp |
| Tax Period End Date | 2013-05-31 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MAINEHEALTH | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 110 FREE ST | AddressLine1 |
| City | PORTLAND | City |
| State | ME | State |
| ZIP Code | 041013908 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2012-06-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 010078060 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HENRIETTA D GOODALL HOSPITAL INC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | HENR | NameControl |
| Phone | 2074907337 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 25 JUNE STREET | AddressLine1 |
| City | SANFORD | City |
| State | ME | State |
| ZIP Code | 04073 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | NORMAN BELAIR | Name |
| Title | CFO | Title |
| Phone | 2074907337 | Phone |
| Date Signed | 2014-04-10 | DateSigned |
| Authorize Third Party | false | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Date Prepared | 2015-02-12 | DatePrepared |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2012 | TaxYear |
| Build TS | 2016-02-25 16:41:14Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | PARTICIA APRILE | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 25 JUNE STREET | AddressLine1 |
| City | SANFORD | City |
| State | ME | State |
| ZIP Code | 04073 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 88289204 | GrossReceipts |
| Group Return For Affiliates | false | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | WWW.GOODALLHOSPITAL.ORG | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1927 | YearFormation |
| State Legal Domicile | ME | StateLegalDomicile |
| Activity Or Mission Description | HENRIETTA D. GOODALL HOSPITAL'S, INC.'S MISSION IS TO SERVE AS A LEADER IN IMPROVING THE HEALTH AND WELL-BEING OF ITS COMMUNITY. HENRIETTA D. GOODALL HOSPITAL, INC. OWNS AND OPERATES H. D. GOODALL HOSPITAL, INC. (ACUTE CARE HOSPITAL), GOODALL HEALTH PARTNERS (A MULTI-SPECIALTY PHYSICIAL AND SURGEON GROUP), THE MEDICAL GROUP (A MULT-SPECIALTY PHYSICIAN AND SURGEON GROUP, GOODALL OUTPATIENT CLINIC (A FACILITY WHERE A VARIETY OF OUTPATIENT SERVICES ARE PERFORMED), GOODALL OUTPATIENT SERVICES-WATERBORO AND GOODALL ELDERCARE SERVICES (A LONG TERM CARE FACILITY) IN YORK COUNTY. YORK COUNTY CONSISTS OF 18 TOWNS AND CITIES LOCATED ON THE SOUTHERN MAINE COAST WITH A POPULATION OF OVER 200,000. HENRIETTA D. GOODALL HOSPITAL, INC. FURTHERS ITS MISSION AS A LEADER IN IMPROVING THE HEALTH AND WELL-BEING OF THE COMMUNITY AND PROVIDES ACCESS TO NEEDED HEALTHCARE SERVICES 365 DAYS A YEAR, 24 HOURS A DAY. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 19 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 11 | NbrIndependentVotingMembers |
| Total Nbr Employees | 1099 | TotalNbrEmployees |
| Total Nbr Volunteers | 197 | TotalNbrVolunteers |
| Total Gross UBI | 222387 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | -62174 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 2446041 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 2300781 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 87287884 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 78738132 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 776194 | InvestmentIncomePriorYear |
| Investment Income Current Year | 849234 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 1177360 | OtherRevenuePriorYear |
| Other Revenue Current Year | 1856255 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 91687479 | TotalRevenuePriorYear |
| Total Revenue Current Year | 83744402 | TotalRevenueCurrentYear |
| Grants And Similar Amnts CY | 0 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 49695968 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 50155652 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 30873 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 39812989 | OtherExpensePriorYear |
| Other Expenses Current Year | 33509553 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 89508957 | TotalExpensesPriorYear |
| Total Expenses Current Year | 83665205 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 2178522 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 79197 | RevenuesLessExpensesCY |
| Total Assets BOY | 85944028 | TotalAssetsBOY |
| Total Assets EOY | 85817795 | TotalAssetsEOY |
| Total Liabilities BOY | 36911735 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 34104463 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 49032293 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 51713332 | NetAssetsOrFundBalancesEOY |
| Info In Schedule O Part III | X | InfoInScheduleOPartIII |
| Mission Description | HENRIETTA D. GOODALL HOSPITAL'S, INC.'S MISSION IS TO SERVE AS A LEADER IN IMPROVING THE HEALTH AND WELL-BEING OF ITS COMMUNITY. HENRIETTA D. GOODALL HOSPITAL, INC. OWNS AND OPERATES H. D. GOODALL HOSPITAL, INC. (ACUTE CARE HOSPITAL), GOODALL HEALTH PARTNERS (A MULTI-SPECIALTY PHYSICIAL AND SURGEON GROUP), THE MEDICAL GROUP (A MULT-SPECIALTY PHYSICIAN AND SURGEON GROUP, GOODALL OUTPATIENT CLINIC (A FACILITY WHERE A VARIETY OF OUTPATIENT SERVICES ARE PERFORMED), GOODALL OUTPATIENT SERVICES-WATERBORO AND GOODALL ELDERCARE SERVICES (A LONG TERM CARE FACILITY) IN YORK COUNTY. YORK COUNTY CONSISTS OF 18 TOWNS AND CITIES LOCATED ON THE SOUTHERN MAINE COAST WITH A POPULATION OF OVER 200,000. HENRIETTA D. GOODALL HOSPITAL, INC. FURTHERS ITS MISSION AS A LEADER IN IMPROVING THE HEALTH AND WELL-BEING OF THE COMMUNITY AND PROVIDES ACCESS TO NEEDED HEALTHCARE SERVICES 365 DAYS A YEAR, 24 HOURS A DAY. | MissionDescription |
| Significant New Program Services | false | SignificantNewProgramServices |
| Significant Change | false | SignificantChange |
| Expense | 49658152 | Expense |
| Revenue | 63058668 | Revenue |
| Description | GOODALL HOSPITAL IS A 58 BED HOSPITAL WHICH STRIVES TO MEET THE HEALTH CARE NEEDS OF INDIVIDUALS AND FAMILIES THROUGHOUT YORK COUNTY. GOODALL HOSPITAL OFFERS A BROAD RANGE OF MEDICAL, SURGICAL, DIAGNOSTIC, CLINICAL AND REHABILITATION SERVICES, WELLNESS EDUCATION, SUPPORT GROUPS AND OTHER COMMUNITY OUTREACH PROGRAMS. GOODALL HOSPITAL HAD 21,394 EMERGENCY ROOMS VISITS, 46,963 RADIOLOGY PROCEDURES, 371,628 LABORATORY PROCEDURES, 149 INFANTS BORN, AND 2,506 SURGERY CASES. GOODALL HOSPITAL PROVIDED 1,729,454 IN CHARITY CARE TO THE COMMUNITY. THIS INCLUDES PATIENTS WHO ARE UNDERINSURED OR THOSE WITHOUT ANY INSURANCE. IN ADDITION TO THE CHARITABLE CARE SERVICES, WE ARE CONTINUALLY ABSORBING ALL THE COSTS (CONTINUED ON SCHEDULE O) ASSOCIATED WITH PROVIDING THE COMMUNITY WITH A VARIETY OF SPECIAL COMPLIMENTARY EDUCATIONAL AND INFORMATIONAL SERVICES. GOODALL PROUDLY SPONSORS COMMUNITY ORGANIZATIONS, SCHOOL GROUPS, CIVIC ORGANIZATIONS AND SPECIAL EVENTS (LIKE THE LOCAL BASEBALL TEAM). GOODALL HOSPITAL SPONSORS TWO TO FOUR FREE EDUCATION EVENTS EACH MONTH OF THE YEAR ALONG WITH DOZENS OF SUPPORT GROUPS. GOODALL HOSPITAL ALSO ROUTINELY PARTICIPATES IN HEALTH FAIRS AND BUSINESS EVENTS, PERFORMING BLOOD PRESSURE CHECKS, CHOLESTEROL SCREENINGS AND CPR TRAINING. GOODALL HOSPITAL'S SENIOR ADVOCATE PROVIDES FREE ADVICE AND SERVICES TO ELDERLY MEMBERS OF THE COMMUNITY. SERVICES INCLUDE HELP WITH INSURANCE AND MEDICAL ISSUES, AS WELL AS PERSONAL ISSUES INCLUDING TAX INFORMATION, FINANCES AND HOME NEEDS. | Description |
Activity2 Activity2
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 10005865 | Expense |
| Revenue | 8723782 | Revenue |
| Description | GOODALL HEALTH PARTNERS CONSISTS OF MANY PHYSICIANS WITH MULTI-SPECIALTY SERVICES IN DIFFERENT LOCATIONS THROUGHOUT YORK COUNTY. THESE PHYSICIANS COMPLIMENT THE HOSPITAL IN MAINTAINING ITS MISSIONS TO SERVE AS A LEADER IN IMPROVING THE HEALTH AND WELL-BEING OF OUR COMMUNITY BY SERVING THE POPULOUS. THESE SPECIALTIES INCLUDE (BUT ARE NOT LIMITED TO) CARDIOLOGY, EAR NOSE AND THROAT, FAMILY PRACTICES, WOMEN'S HEALTH, INTERNAL MEDICINE, PEDIATRICS, ORTHO AND GENERAL SURGERY. GOODALL HEALTH PARTNERS PROVIDED 44,569 IN CHARITY CARE TO THE COMMUNITY. THE NUMBER OF PATIENTS SEEN WERE 21,413 FOR A TOTAL NUMBER OF VISITS OF 60,122. | Description |
Activity3 Activity3
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 6629612 | Expense |
| Revenue | 7821962 | Revenue |
| Description | GOODALL HOSPITAL ELDERCARE SERVICES PROVIDE LONG-TERM CARE, MEDICAL SERVICES AND DAYCARE TO OUR SENIOR CITIZENS. ELDERCARE HAD A TOTAL OF 39,238 PATIENT DAYS. WE CONTINUE TO GROW AND ADAPT TO THE NEEDS OF OUR COMMUNITY WITH THIS SERVICE. GOODALL HOSPITAL ELDERCARE PRIDES THEMSELVES BY CREATING A HOME-LIKE, COMFORTABLE ENVIRONMENT FOR THE RESIDENTS AND STAFF. THE NEWTON CENTER FOR REHABILITATION AND NURSING CARE PROMOTES HIGH QUALITY CARE; WITH DEDICATED STAFF, FAMILY EDUCATION AND INVOLVEMENT MAKE THIS PROGRAM SPECIAL. GOODALL HOSPITAL ELDERCARE SERVICES PROVIDED 14,456 IN CHARITY CARE TO THE COMMUNITY. | Description |
Activity Other ActivityOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 5673646 | Expense |
| Revenue | 4139990 | Revenue |
| Description | THE MEDICAL GROUP CONSISTS OF MANY PHYSICIANS WITH MULTI-SPECIALTY SERVICES THAT EXTEND GOODALL HOSPITAL'S EXISTING SERVICES TO KENNEBUNK, ME. THESE PHYSICIANS COMPLEMENT THE HOSPITAL IN MAINTAINING ITS MISSION TO SERVE AS A LEADER IN IMPROVING THE HEALTH AND WELL-BEING OF OUR COMMUNITY. THESE SERVICES INCLUDE (BUT ARE NOT LIMITED TO) FULL SERVICE PRIMARY CARE, WOMEN'S HEALTH, GASTROENTEROLOGY, PULMONARY MEDICINE, ORTHOPEDICS AND PAIN MANAGEMENT. THE MEDICAL GROUP PROVIDED 12,846 IN CHARITY CARE TO THE COMMUNITY. THE NUMBER OF PATIENTS SEEN WERE 10,855 FOR A TOTAL NUMBER OF 27,633 PATIENT DAYS. | Description |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Other Program Service Exp | 5673646 | TotalOfOtherProgramServiceExp |
| Total Of Other Program Service Rev | 4139990 | TotalOfOtherProgramServiceRev |
| Total Program Service Expense | 71967275 | TotalProgramServiceExpense |
| Described In501 C3 | true | DescribedIn501C3 |
| Schedule B Required | true | ScheduleBRequired |
| Political Activities | false | PoliticalActivities |
| Lobbying Activities | true | LobbyingActivities |
| Subject To Proxy Tax | false | SubjectToProxyTax |
| Donor Advised Funds | false | DonorAdvisedFunds |
| Conservation Easements | false | ConservationEasements |
| Collections Of Art | false | CollectionsOfArt |
| Credit Counseling | false | CreditCounseling |
| Term Or Permanent Endowments | true | TermOrPermanentEndowments |
| Report Land Bldg Equip | true | ReportLandBldgEquip |
| Report Invest Oth Securities | true | ReportInvestOthSecurities |
| Report Prog Rel Invest | false | ReportProgRelInvest |
| Report Other Assets | true | ReportOtherAssets |
| Report Other Liabilities | true | ReportOtherLiabilities |
| Report Fin48 Footnote | true | ReportFin48Footnote |
| Independent Audit Financial Stmt | false | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | true | ConsolidatedAuditFinancialStmt |
| School | false | School |
| Foreign Office | false | ForeignOffice |
| Foreign Activities | false | ForeignActivities |
| More Than5000 K To Organizations | false | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividuals |
| Professional Fundraising | false | ProfessionalFundraising |
| Fundraising Activities | false | FundraisingActivities |
| Gaming | false | Gaming |
| Hospital | true | Hospital |
| Financial Stmt Attached | true | FinancialStmtAttached |
| Grants To Organizations | false | GrantsToOrganizations |
| Grants To Individuals | false | GrantsToIndividuals |
| Schedule J Required | true | ScheduleJRequired |
| Tax Exempt Bonds | true | TaxExemptBonds |
| Invest Tax Exempt Bonds | false | InvestTaxExemptBonds |
| Escrow Account | false | EscrowAccount |
| On Behalf Of Issuer | false | OnBehalfOfIssuer |
| Excess Benefit Transaction | false | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | false | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | false | LoanToOfficerOrDQP |
| Grant To Related Person | false | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | true | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | false | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | true | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | false | DeductibleNonCashContributions |
| Deductible Contributions Of Art | false | DeductibleContributionsOfArt |
| Terminated | false | Terminated |
| Partial Liquidation | false | PartialLiquidation |
| Disregarded Entity | false | DisregardedEntity |
| Related Entity | true | RelatedEntity |
| Related Org Controlled Entity | false | RelatedOrgControlledEntity |
| Transfers To Exempt Non Chrtbl Org | false | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | false | ActivitiesConductedPartnership |
| Schedule O Required | true | ScheduleORequired |
| Number Forms Transmitted With1096 | 531 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | true | ComplianceWithBackupWitholding |
| Number Of Employees | 1099 | NumberOfEmployees |
| Employment Tax Returns Filed | true | EmploymentTaxReturnsFiled |
| Unrelated Business Income | true | UnrelatedBusinessIncome |
| Form990-T Filed | true | Form990-TFiled |
| Foreign Financial Account | false | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTrans |
| Taxable Party Notification | false | TaxablePartyNotification |
| Non Deductible Contributions | false | NonDeductibleContributions |
| Quid Pro Quo Contributions | false | QuidProQuoContributions |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | false | FundsToPayPremiums |
| Premiums Paid | false | PremiumsPaid |
| Form8899 Filed | false | Form8899Filed |
| Form1098 C Filed | false | Form1098CFiled |
| Indoor Tanning Services | false | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 19 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 11 | NumberIndependentVotingMembers |
| Family Or Business Relationship | false | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | false | DelegationOfManagementDuties |
| Changes To Organizing Docs | true | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuse |
| Members Or Stockholders | false | MembersOrStockholders |
| Election Of Board Members | false | ElectionOfBoardMembers |
| Decisions Subject To Approval | false | DecisionsSubjectToApproval |
| Minutes Of Governing Body | true | MinutesOfGoverningBody |
| Minutes Of Committees | true | MinutesOfCommittees |
| Officer Mailing Address | false | OfficerMailingAddress |
| Local Chapters | true | LocalChapters |
| Policies Reference Chapters | true | PoliciesReferenceChapters |
| Form990 Provided To Governing Body | true | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | true | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | true | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | true | RegularMonitoringEnforcement |
| Whistleblower Policy | true | WhistleblowerPolicy |
| Document Retention Policy | true | DocumentRetentionPolicy |
| Compensation Process CEO | true | CompensationProcessCEO |
| Compensation Process Other | true | CompensationProcessOther |
| Investment In Joint Venture | false | InvestmentInJointVenture |
| States Where Copy Of Return Is Filed | ME | StatesWhereCopyOfReturnIsFiled |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | NORMAN BELAIR CFO | NamePerson |
| Telephone Number | 2073244310 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1 MEDICAL CENTER DRIVE | AddressLine1 |
| City | BIDDEFORD | City |
| State | ME | State |
| ZIP Code | 04005 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (26 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Average Hours Per Week RelatedAverageHoursPerWeekRelated | Individual Trustee Or DirectorIndividualTrusteeOrDirector | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | OfficerOfficer | Highest Compensated EmployeeHighestCompensatedEmployee |
|---|---|---|---|---|---|---|---|---|
| JOHN THOMPSON DO | ||||||||
| TRUSTEE | 41.00 | 1.00 | X | 492596 | 0 | 24340 | ||
| FRANK GOUDREAU DO | ||||||||
| TRUSTEE | 41.00 | 1.00 | X | 474462 | 0 | 24013 | ||
| MICHAEL CARROLL MD | ||||||||
| TRUSTEE | 1.00 | 40.00 | X | 0 | 459254 | 25652 | ||
| GINA QUINN-SKILLINGS MD | ||||||||
| TRUSTEE | 1.00 | 40.00 | X | 0 | 303808 | 25758 | ||
| MARY O'HARE MD | ||||||||
| TRUSTEE | 1.00 | 40.00 | X | 0 | 268489 | 25895 | ||
| DONALD BURGESS MD | ||||||||
| TRUSTEE | 1.00 | 40.00 | X | 0 | 229602 | 24610 | ||
| WILLIAM FRANK MD | ||||||||
| TRUSTEE | 5.00 | 1.00 | X | 19525 | 0 | 0 | ||
| ROBERT P BAUMAN | ||||||||
| TRUSTEE | 1.00 | 1.00 | X | 0 | 0 | 0 | ||
| LORI ANN BLACK | ||||||||
| TRUSTEE | 1.00 | 1.00 | X | 0 | 0 | 0 | ||
| JENNIFER CUTTS MD | ||||||||
| TRUSTEE | 1.00 | 1.00 | X | 0 | 0 | 0 | ||
| JOAN R FINK | ||||||||
| TRUSTEE | 1.00 | 1.00 | X | 0 | 0 | 0 | ||
| BERNARD GAINES | ||||||||
| CHAIRPERSON | 1.00 | 1.00 | X | 0 | 0 | 0 | X | |
| GEORGE HISSONG JR | ||||||||
| VICE-CHAIRPE | 1.00 | 2.00 | X | 0 | 0 | 0 | X | |
| RICHARD HULL | ||||||||
| TRUSTEE | 1.00 | 1.00 | X | 0 | 0 | 0 | ||
| MARK MICKERIZ | ||||||||
| TRUSTEE | 1.00 | 1.00 | X | 0 | 0 | 0 | ||
| BRADFORD C PAIGE | ||||||||
| TREASURER | 1.00 | 1.00 | X | 0 | 0 | 0 | X | |
| MERILEE PERKINS | ||||||||
| SECRETARY | 1.00 | 2.00 | X | 0 | 0 | 0 | X | |
| ROBERT C QUENTIN | ||||||||
| TRUSTEE | 1.00 | 1.00 | X | 0 | 0 | 0 | ||
| ROBERT REINKEN | ||||||||
| TRUSTEE | 1.00 | 1.00 | X | 0 | 0 | 0 | ||
| PATRICIA APRILE | ||||||||
| PRESIDENT/CE | 49.00 | 1.00 | 396254 | 0 | 17311 | X | ||
| DANIEL D FORGUES | ||||||||
| CFO | 40.00 | 0.00 | 215795 | 0 | 12141 | X | ||
| PETER L CLARK DO | ||||||||
| PHYSICIAN | 40.00 | 0.00 | 352468 | 0 | 22550 | X | ||
| JONATHAN P SHILL MDPHD | ||||||||
| PHYSICIAN | 40.00 | 0.00 | 332533 | 0 | 6729 | X | ||
| NINA SHERVIN MD | ||||||||
| PHYSICIAN | 40.00 | 0.00 | 327988 | 0 | 8778 | X | ||
| STEVEN E JOHNSON MD | ||||||||
| PHYSICIAN | 40.00 | 0.00 | 299221 | 0 | 23374 | X | ||
| ANDREW D POWELL MD | ||||||||
| PHYSICIAN | 40.00 | 0.00 | 282559 | 0 | 19538 | X | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 3193401 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 1261153 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 260689 | TotalOtherCompensation |
| Number Individuals GT100 K | 53 | NumberIndividualsGT100K |
| Formers Listed | false | FormersListed |
| Total Comp GT150 K | true | TotalCompGT150K |
| Compensation From Other Sources | false | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (5 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| MAK ANESTHESIA INC | |||||
| 156 COUNTRY CLUB ROAD | SANFORD | ME | 04073 | ANESTHESIA | 633342 |
| LEONID TEMKIN MD PA | |||||
| 239 ARUNDEL ROAD | KENNEBUNK | ME | 04046 | ANESTHESIA | 564679 |
| EDWARD BURZON PC | |||||
| 1 SARAH PAUL HILL | MADBURY | NH | 03823 | PHYSICIAN | 314379 |
| THOMAS MOORE MD | |||||
| 300 SLIGO ROAD | ROLLINSFORD | NH | 03869 | PHYSICIAN | 300000 |
| DONALD P LYON MD PA | |||||
| PO BOX 549 | LIMERICK | ME | 04048 | PHYSICIAN | 256060 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 13 | NumberOfContractorsGT100K |
| Government Grants | 1776927 | GovernmentGrants |
| All Other Contributions | 523854 | AllOtherContributions |
| Total Contributions | 2300781 | TotalContributions |
Program Service Revenue ProgramServiceRevenue (3 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome | Unrelated Business RevenueUnrelatedBusinessRevenue |
|---|---|---|---|---|
| NET PATIENT SERVICE REVENUE | 900099 | 77793830 | 77793830 | |
| MEDICARE MEANINGFUL USE | 900099 | 721915 | 721915 | |
| NET PATIENT SERVICE REVENUE | 621500 | 222387 | 222387 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 78738132 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 563752 | TotalRevenueColumn |
| Exclusion | $563,752 | ExclusionAmount |
Gross Rents GrossRents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 581477 | Real |
Less Rental Expenses LessRentalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 922107 | Real |
Rental Income Or Loss RentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | -340630 | Real |
Net Rental Income Or Loss NetRentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -340630 | TotalRevenueColumn |
| Related Or Exempt Function Income | -340630 | RelatedOrExemptFunctionIncome |
Gross Amount Sales Assets GrossAmountSalesAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 3902677 | Securities |
| Other | 5500 | Other |
Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 3599326 | Securities |
| Other | 23369 | Other |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 303351 | Securities |
| Other | -17869 | Other |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 285482 | TotalRevenueColumn |
| Exclusion | $285,482 | ExclusionAmount |
Other Revenue Misc OtherRevenueMisc (3 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome |
|---|---|---|---|
| EQUITY IN SUBSIDIARIES | 900099 | 841980 | 841980 |
| REBATE REVENUE | 900099 | 419606 | 419606 |
| CAFETERIA REVENUE | 900099 | 294775 | 294775 |
Miscellaneous Revenue MiscellaneousRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 640524 | TotalRevenueColumn |
| Related Or Exempt Function Income | 640524 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 2196885 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 83744402 | TotalRevenueColumn |
| Related Or Exempt Function Income | 80372000 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 222387 | UnrelatedBusinessRevenue |
| Exclusion | $849,234 | ExclusionAmount |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 641501 | Total |
| Management And General | 641501 | ManagementAndGeneral |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 39869149 | Total |
| Program Services | 35237002 | ProgramServices |
| Management And General | 4623798 | ManagementAndGeneral |
| Fundraising | 8349 | Fundraising |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 6922888 | Total |
| Program Services | 6021309 | ProgramServices |
| Management And General | 900160 | ManagementAndGeneral |
| Fundraising | 1419 | Fundraising |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2722114 | Total |
| Program Services | 2367517 | ProgramServices |
| Management And General | 353958 | ManagementAndGeneral |
| Fundraising | 639 | Fundraising |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 245222 | Total |
| Management And General | 245222 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 102577 | Total |
| Management And General | 102577 | ManagementAndGeneral |
Fees For Services Lobbying FeesForServicesLobbying
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 13125 | Total |
| Management And General | 13125 | ManagementAndGeneral |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 7331537 | Total |
| Program Services | 5175137 | ProgramServices |
| Management And General | 2156400 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 194071 | Total |
| Management And General | 193133 | ManagementAndGeneral |
| Fundraising | 938 | Fundraising |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 82827 | Total |
| Program Services | 35379 | ProgramServices |
| Management And General | 47369 | ManagementAndGeneral |
| Fundraising | 79 | Fundraising |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 490750 | Total |
| Program Services | 189205 | ProgramServices |
| Management And General | 301545 | ManagementAndGeneral |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1442117 | Total |
| Program Services | 559602 | ProgramServices |
| Management And General | 882515 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 14198 | Total |
| Program Services | 12234 | ProgramServices |
| Management And General | 1964 | ManagementAndGeneral |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 122518 | Total |
| Program Services | 94108 | ProgramServices |
| Management And General | 26621 | ManagementAndGeneral |
| Fundraising | 1789 | Fundraising |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 817718 | Total |
| Program Services | 760765 | ProgramServices |
| Management And General | 56953 | ManagementAndGeneral |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3511091 | Total |
| Program Services | 3511091 | ProgramServices |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 921617 | Total |
| Program Services | 809578 | ProgramServices |
| Management And General | 112039 | ManagementAndGeneral |
Other Expenses OtherExpenses (4 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral | FundraisingFundraising |
|---|---|---|---|---|
| SUPPLIES | 7916788 | 7831473 | 84880 | 435 |
| PHYSICIAN FEES | 4286457 | 4286457 | ||
| TAXES | 2144889 | 2144889 | ||
| RENTAL & LEASE | 1922525 | 1816970 | 105555 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1949526 | Total |
| Program Services | 1114559 | ProgramServices |
| Management And General | 817742 | ManagementAndGeneral |
| Fundraising | 17225 | Fundraising |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 83665205 | Total |
| Program Services | 71967275 | ProgramServices |
| Management And General | 11667057 | ManagementAndGeneral |
| Fundraising | 30873 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 5277 | BOY |
| EOY | 5277 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3957864 | BOY |
| EOY | 2455400 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 9091776 | BOY |
| EOY | 10344259 | EOY |
Other Notes Loans Receivable Net OtherNotesLoansReceivableNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 851677 | BOY |
| EOY | 851677 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1417919 | BOY |
| EOY | 1161471 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1529545 | BOY |
| EOY | 1015873 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 78090023 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 46076499 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 32760127 | BOY |
| EOY | 32013524 | EOY |
Investments Pub Traded Securities InvestmentsPubTradedSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 11664433 | BOY |
| EOY | 12893054 | EOY |
Investments Other Securities InvestmentsOtherSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 13142291 | BOY |
| EOY | 14032253 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 11523119 | BOY |
| EOY | 11045007 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 85944028 | BOY |
| EOY | 85817795 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 14711137 | BOY |
| EOY | 13061335 | EOY |
Tax Exempt Bond Liabilities TaxExemptBondLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 9396449 | BOY |
| EOY | 8889806 | EOY |
Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 12148451 | BOY |
| EOY | 10933682 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 655698 | BOY |
| EOY | 1219640 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 36911735 | BOY |
| EOY | 34104463 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 38367160 | BOY |
| EOY | 39731324 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1506154 | BOY |
| EOY | 1610349 | EOY |
Permanently Restricted Net Assets PermanentlyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 9158979 | BOY |
| EOY | 10371659 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 49032293 | BOY |
| EOY | 51713332 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 85944028 | BOY |
| EOY | 85817795 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | 79197 | ReconcilationRevenueExpenses |
| Reconciliation Unrealized Invest | 1357212 | ReconciliationUnrealizedInvest |
| Reconcilation Other Changes | 1244630 | ReconcilationOtherChanges |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | false | AccountantCompileOrReview |
| FS Audited | true | FSAudited |
FS Audited Basis FSAuditedBasis
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Statement Consolidated | X | FinancialStatementConsolidated |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | true | AuditCommittee |
| Federal Grant Audit Required | true | FederalGrantAuditRequired |
| Federal Grant Audit Performed | true | FederalGrantAuditPerformed |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital170b1 Aiii | X | Hospital170b1Aiii |
Schedule B IRS990ScheduleB
Contributor Info ContributorInfo
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor Number | RESTRICTED | ContributorNumber |
Contributor Name Business ContributorNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor Address US ContributorAddressUS
| 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) |
|---|---|---|
| Aggregate Contributions | RESTRICTED | AggregateContributions |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | false | Volunteers |
| Paid Staff Or Management | true | PaidStaffOrManagement |
| Media Advertisements | false | MediaAdvertisements |
| Mailings Members | false | MailingsMembers |
| Publications Or Broadcast | false | PublicationsOrBroadcast |
| Grants Other Organizations | false | GrantsOtherOrganizations |
| Direct Contact Legislators | false | DirectContactLegislators |
| Rallies Demonstrations | false | RalliesDemonstrations |
| Other Activities | true | OtherActivities |
| Other Activities | $13,125 | OtherActivitiesAmount |
| Total Lobbying Expenditures IIB | 13125 | TotalLobbyingExpendituresIIB |
| Not Described In501c3 | false | NotDescribedIn501c3 |
Form990 Schedule C Part IV Form990ScheduleCPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Reference | SCHEDULE C, PART II-B, LINE 1 | ReturnReference |
| Explanation | HENRIETTA D. GOODALL GOODALL HOSPITAL IS A MEMBER OF THE MAINE HOSPITAL ASSOCIATION (MHA), THE AMERICAN HOSPITAL ASSOCIATION (AHA), AND THE MAINE HEALTHCARE ASSOCIATION (MEHCA). 18.80% OR 6,789 OF THE DUES PAID TO MHA, 23.65% OR 4,020 OF THE DUES PAID TO AHA, AND 31.00% OR 2,315 OF THE DUES PAID TO MEHCA ARE AVAILABLE FOR LOBBYING. | Explanation |
Schedule D IRS990ScheduleD
Current Year CurrentYear
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 19488835 | BeginningOfYearBalance |
| Contributions | 1714897 | Contributions |
| Investment Earnings Or Losses | 2998927 | InvestmentEarningsOrLosses |
| Other Expenditures | 1495981 | OtherExpenditures |
| End Of Year Balance | 22706678 | EndOfYearBalance |
Current Year Minus1 Year CurrentYearMinus1Year
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 21667901 | BeginningOfYearBalance |
| Contributions | 466220 | Contributions |
| Investment Earnings Or Losses | -1610061 | InvestmentEarningsOrLosses |
| Other Expenditures | 1035225 | OtherExpenditures |
| End Of Year Balance | 19488835 | EndOfYearBalance |
Current Year Minus2 Years CurrentYearMinus2Years
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 17085103 | BeginningOfYearBalance |
| Contributions | 1898375 | Contributions |
| Investment Earnings Or Losses | 2691423 | InvestmentEarningsOrLosses |
| Other Expenditures | 7000 | OtherExpenditures |
| End Of Year Balance | 21667901 | EndOfYearBalance |
Current Year Minus3 Years CurrentYearMinus3Years
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 14720200 | BeginningOfYearBalance |
| Contributions | 642735 | Contributions |
| Investment Earnings Or Losses | 1962857 | InvestmentEarningsOrLosses |
| Other Expenditures | 240689 | OtherExpenditures |
| End Of Year Balance | 17085103 | EndOfYearBalance |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Designated EOY Balance | 0.54000 | BoardDesignatedEOYBalance |
| Permanent Endowment EOY Balance | 0.46000 | PermanentEndowmentEOYBalance |
| Endowments Held By Unrelated Orgs | false | EndowmentsHeldByUnrelatedOrgs |
| Endowments Held By Related Orgs | false | EndowmentsHeldByRelatedOrgs |
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 2728106 | OtherCostOrOtherBasis |
| Book Value | 2728106 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 47028708 | OtherCostOrOtherBasis |
| Depreciation | 25549697 | Depreciation |
| Book Value | 21479011 | BookValue |
Leasehold Improvements LeaseholdImprovements
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 4549746 | OtherCostOrOtherBasis |
| Depreciation | 2132075 | Depreciation |
| Book Value | 2417671 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 20449773 | OtherCostOrOtherBasis |
| Depreciation | 16371635 | Depreciation |
| Book Value | 4078138 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 3333690 | OtherCostOrOtherBasis |
| Depreciation | 2023092 | Depreciation |
| Book Value | 1310598 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 32013524 | TotalOfBookValueLandBuildings |
Other Securities OtherSecurities (3 entries)
| DescriptionDescription | Book ValueBookValue | Method Of ValuationMethodOfValuation |
|---|---|---|
| BENEFICIAL INT. IN PERP. TR. | 9440011 | F |
| ALTERNATIVE INVESTMENTS | 2716855 | F |
| INVESTMENT IN REAL PROPERTY | 1875387 | F |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Securities | 14032253 | TotalOfBookValueSecurities |
Other Assets OtherAssets (11 entries)
| DescriptionDescription | Book ValueBookValue |
|---|---|
| ESTIMATED SETTLEMENTS WITH MAINECARE | 7108787 |
| INVESTMENTS IN SUBS & JOINT VENTURES | 1940829 |
| TRUSTEE HELD FUNDS (BOND FUNDS) | 650595 |
| INSURANCE CAPTIVE | 634401 |
| DUE FROM AFFILIATES | 393228 |
| DEFEREED FINANCING COSTS | 139488 |
| HDG CAPITAL RESERVE CASH | 100199 |
| SYNERNET WORKERS' COMP CAPITAL CONTR | 39633 |
| CONTRIBUTION REC FROM REMAINDER TR | 19955 |
| INTANGIBLE ASSET - ORTHO MED RECORDS | 17892 |
| HDG DUE FROM TEMP NET ASSETS |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | 11045007 | TotalBookValueOtherAssets |
Other Liabilities OtherLiabilities (3 entries)
| DescriptionDescription | AmountAmount |
|---|---|
| INSURANCE CAPTIVE LIABILITY | $634,401 |
| EST. SETTLEMENTS DUE TO 3RD PARTY | $585,239 |
| PAYORS |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 1219640 | TotalOfAmounts |
| Footnote In Part XIII | X | FootnoteInPartXIII |
Form990 Schedule D Part XIII Form990ScheduleDPartXIII (2 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| LIABILITY UNDER FIN 48 FOOTNOTE | SCHEDULE D, PAGE 3, PART X | THE ORGANIZATION ANNUALLY EVALUATES ITS TAX STATUS AND TAX POSITIONS TAKEN WITH RESPECT TO ITS OPERATIONS AND FINANCIAL STATEMENT POSTION. TAX YEARS FROM 2009 THROUGH THE CURRENT YEAR ARE OPEN FOR EXAMINATION BY FEDERAL AND STATE TAX AUTHORITIES. |
| SUPPLEMENTAL FINANCIAL INFORMATION | SCHEDULE D, PAGE 4, PART XIII | PART V, LINE IV: UNDER THE POLICY OF THE ORGANIZATION, THE ENDOWMENT ASSETS ARE INVESTED CONSERVATIVELY WITH THE INTENT OF PROVIDING A PREDICTABLE STREAM OF FUNDING TO THE ORGANIZATION FOR PURCHASES OF CAPITAL, EXPANSION PROJECTS AND TO SUPPLEMENT GENERAL OPERATIONS. |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Charity Care Policy | true | CharityCarePolicy |
| Written Policy | true | WrittenPolicy |
| FPG Reference Free Care | true | FPGReferenceFreeCare |
| Pcent200 | X | Pcent200 |
| FPG Reference Discounted Care | true | FPGReferenceDiscountedCare |
| Pcent250 | X | Pcent250 |
| Free Disc Care Medically Indigent | true | FreeDiscCareMedicallyIndigent |
| Amounts Budgeted For Charity Care | true | AmountsBudgetedForCharityCare |
| Expenses Exceeded Budget | false | ExpensesExceededBudget |
| Annual Community Benefit Report | false | AnnualCommunityBenefitReport |
Charity Care At Cost CharityCareAtCost
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 718749 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 718749 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00880 | PercentOfTotalExpense |
Unreimbursed Medicaid UnreimbursedMedicaid
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 14682383 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 10295560 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 4386823 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.05380 | PercentOfTotalExpense |
Total Charity Care TotalCharityCare
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 15401132 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 10295560 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 5105572 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.06260 | PercentOfTotalExpense |
Community Health Services CommunityHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 65518 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 65518 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00080 | PercentOfTotalExpense |
Health Professions Education HealthProfessionsEducation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 41320 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 41320 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00050 | PercentOfTotalExpense |
Cash And In Kind Contributions CashAndInKindContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 5120 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 5120 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00010 | PercentOfTotalExpense |
Total Other Benefits TotalOtherBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 111958 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 111958 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00140 | PercentOfTotalExpense |
Total Community Benefits TotalCommunityBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 15513090 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 10295560 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 5217530 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.06400 | PercentOfTotalExpense |
Coalition Building CoalitionBuilding
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Building Expense | 1800 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 1800 | NetCommunityBuildingExpense |
Total Total
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Building Expense | 1800 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 1800 | NetCommunityBuildingExpense |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | true | BadDebtExpenseReported |
| Bad Debt Expense | $3,290,967 | BadDebtExpenseAmount |
| Amount Reimbursed By Medicare | 23002541 | AmountReimbursedByMedicare |
| Cost Of Care Reimbursed By Medicare | 30177600 | CostOfCareReimbursedByMedicare |
| Medicare Surplus Or Shortfall | -7175059 | MedicareSurplusOrShortfall |
Costing Methodology Used CostingMethodologyUsed
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | X | CostToChargeRatio |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | true | WrittenDebtCollectionPolicy |
| Provision For Charity Care | true | ProvisionForCharityCare |
Form990 Schedule H Part IV Form990ScheduleHPartIV (3 entries)
| Description Ent Primary ActivityDescriptionEntPrimaryActivity | Organization Profit Or OwnershipOrganizationProfitOrOwnership |
|---|---|
| PINE TREE INSURANCE | |
| PROVIDE MALPRACTICE INSURANCE FOR A | 0.25000 |
| A RECIPROCAL RISK | |
| GROUP OF HEALTHCARE PROVIDERS | |
| RENTENTION GROUP | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Hospital Facilities | 1 | NumberOfHospitalFacilities |
Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility Number | 1 | FacilityNumber |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HENRIETTA D GOODALL HOSPITAL INC | BusinessNameLine1 |
Address Address
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 25 JUNE STREET | AddressLine1 |
| City | SANFORD | City |
| State | ME | State |
| ZIP Code | 04073 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | WWWGOODALLHOSPITALORG | WebsiteAddress |
| Licensed Hospital | X | LicensedHospital |
| General Medical And Surgical | X | GeneralMedicalAndSurgical |
| Er24 Hours | X | Er24Hours |
Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HENRIETTA D GOODALL HOSPITAL INC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital Facility Number | 1 | HospitalFacilityNumber |
| CHNA Conducted | true | CHNAConducted |
| Community Definition | X | CommunityDefinition |
| Community Demographics | X | CommunityDemographics |
| How Data Obtained | X | HowDataObtained |
| Community Health Needs | X | CommunityHealthNeeds |
| Identifying Process | X | IdentifyingProcess |
| Consulting Process | X | ConsultingProcess |
| Needs Assessment Conducted | 11 | NeedsAssessmentConducted |
| Take Into Account | true | TakeIntoAccount |
| Other Facilities | false | OtherFacilities |
| CHNA Widely Available | true | CHNAWidelyAvailable |
| Own Website | X | OwnWebsite |
| On Request | X | OnRequest |
| Other Method | X | OtherMethod |
| Adopt Implement Strategy | X | AdoptImplementStrategy |
| Adopt Budget | X | AdoptBudget |
| All Needs Addressed | true | AllNeedsAddressed |
| Organization Incur Excise Tax | false | OrganizationIncurExciseTax |
| Eligibility Criteria Explained | true | EligibilityCriteriaExplained |
| Uses FPG Free | true | UsesFPGFree |
| FPG Free Percent | 200.0 | FPGFreePercent |
| Uses FPG Discounted | true | UsesFPGDiscounted |
| FPG Discount Percent | 250.0 | FPGDiscountPercent |
| Explains Basis | true | ExplainsBasis |
| Income Level | X | IncomeLevel |
| Uninsured Discount | X | UninsuredDiscount |
| Explains Application Method | false | ExplainsApplicationMethod |
| Includes Publicity Measures | true | IncludesPublicityMeasures |
| Attached To Invoices | X | AttachedToInvoices |
| Posted In Emergency Room | X | PostedInEmergencyRoom |
| Posted In Admission Office | X | PostedInAdmissionOffice |
| Available On Request | X | AvailableOnRequest |
| Actions On Nonpayment | true | ActionsOnNonpayment |
| Collection Activities | false | CollectionActivities |
| Nondiscrim Emergency Care Policy | true | NondiscrimEmergencyCarePolicy |
| Used Other Method | X | UsedOtherMethod |
| Amounts Generally Billed | false | AmountsGenerallyBilled |
| Gross Charges | false | GrossCharges |
Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Other Facilities | 9 | NumberOfOtherFacilities |
Other Facilities OtherFacilities (9 entries)
| Address Line1Address/AddressLine1 | CityAddress/City | StateAddress/State | ZIP CodeAddress/ZIPCode | Facility TypeFacilityType |
|---|---|---|---|---|
| NEWTON CENTER (ELDER CARE) | ||||
| 35 JULY STREET | SANFORD | ME | 04073 | NURSING HOME |
| GOODALL HEALTH PARTNERS | ||||
| 25 JUNE STREET | SANFORD | ME | 04073 | PHYSICIAN PRACTICES |
| WELLNESS CENTER | ||||
| 13 JULY STREET | SANFORD | ME | 04073 | CLINIC |
| GOODALL HEALTH PARTNERS | ||||
| 10 GOODALL DRIVE | EAST WATERBORO | ME | 04070 | PHYSICIAN PRACTICES |
| GOODALL HEALTH PARTNERS | ||||
| 272 COTTAGE STREET | SANFORD | ME | 04073 | PHYSICIAN PRACTICES |
| THE MEDICAL GROUP | ||||
| 2 LIVEWELL DRIVE | KENNEBUNK | ME | 04043 | PHYSICIAN PRACTICES |
| COMMUNITY SERVICES | ||||
| 15 DAIGLE STREET | SANFORD | ME | 04073 | COMMUNITY PROGRAMS |
| OCCUPATIONAL HEALTH SERVICES | ||||
| 2 LIVEWELL DRIVE | KENNEBUNK | ME | 04043 | CLINIC |
| GOODALL HEALTH CLINICS | ||||
| 2 LIVEWELL DRIVE | KENNEBUNK | ME | 04043 | CLINIC |
Form990 Schedule H Part VI Form990ScheduleHPartVI (12 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| COSTING METHODOLOGY EXPLANATION | 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 COSTTO CHARGES PROVIDED IN THE INSTRUCTIONS FOR SCHEDULE H |
| BAD DEBT EXPENSE EXPLANATION | PART III LINE 4 | HENRIETTA D GOODALL HOSPITAL DOES NOT HAVE A SPECIFIC FOOTNOTE IN THE FINANCIAL STATEMENTS THAT DESCRIBES BAD DEBT EXPENSE HENRIETTA D GOODALL HOSPITAL REPORTS ACCOUNTS RECEIVABLE FOR SERVICES RENDERED NET OF ALLOWANCES FOR CONTRACTUAL ADJUSTMENTS THIRD PARTY REIMBURSING AGENCIES FREE CARE AND BAD DEBTS A BAD DEBT ALLOWANCE IS ESTABLISHED FOR ACCOUNTS THE HOSPITAL BELIEVES WILL BECOME UNCOLLECTIBLE THE ALLOWANCE IS ESTABLISHED BY EXAMINING HISTORICAL DATA AGING TRENDS OF COMMERCIAL INSURANCE AND SELFPAY BALANCES AND ECONOMIC TRENDS THE OFFSET TO THE ALLOWANCE ACCOUNT IS TO BAD DEBT EXPENSE ON THE STATEMENT OF OPERATIONS RECOVERIES ON ACCOUNTS PREVIOUSLY WRITTEN OFF ARE ACCOUNTED FOR ON A CASH BASIS AND ARE APPLIED DIRECTLY TO THE PROVISION FOR BAD DEBTS ON THE STATEMENT OF OPERATIONS AMOUNTS WRITTEN OFF OR RECOVERED FROM BAD DEBTS DURING THE YEAR ARE CHARGED AGAINST THE ALLOWANCE ACCOUNT ON THE BALANCE SHEET BAD DEBT EXPENSE REPRESENTS HEALTHCARE SERVICES HENRIETTA D GOODALL HOSPITAL HAS PROVIDED WITHOUT COMPENSATION AS A TAX EXEMPT HOSPITAL HENRIETTA D GOODALL HOSPITAL PROVIDES NECESSARY PATIENT CARE REGARDLESS OF THE PATIENTS ABILITY TO PAY FOR THE SERVICES A PORTION OF HENRIETTA D GOODALL HOSPITALS 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 HENRIETTA D GOODALL 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 HOSPITALS FREE CARE POLICY IN ADDITION BAD DEBT EXPENSE ALSO INCLUDES AMOUNTS FOR SERVICES PROVIDED TO INDIVIDUALS EXPERIENCING DIFFICULT PERSONAL OR ECONOMIC CIRCUMSTANCES RELATED TO A PORTION OF OUR COMMUNITY BASED PATIENT POPULATION THEIR MEDICAL BILLS OFTEN PLACE THESE INDIVIDUALS IN UNTENABLE POSITIONS WHERE THEY ARE NOT ABLE TO HANDLE THEIR PERSONAL DEBT AND THEN THEIR NEW MEDICAL DEBT HOWEVER BECAUSE OF THEIR INCOME LEVELS THEY DO NOT QUALIFY FOR FREE CARE BY PROVIDING NECESSARY HEALTHCARE SERVICES TO THOSE INDIVIDUALS WHO FAIL TO APPLY FOR FINANCIAL ASSISTANCE OR WHO ARE EXPERIENCING PERSONAL OR ECONOMIC CIRCUMSTANCES HENRIETTA D GOODALL HOSPITAL BELIEVES THAT BAD DEBT EXPENSE SHOULD BE INCLUDED AS A COMMUNITY BENEFIT |
| MEDICARE EXPLANATION | PART III LINE 8 | MEDICARE ALLOWABLE COSTS WERE CALCULATED USING A COST TO CHARGE RATIO HENRIETTA D GOODALL HOSPITAL BELIEVES THAT THE MEDICARE SHORTFALL SHOULD BE INCLUDED AS A COMMUNITY BENEFIT BECAUSE GOODALL HOSPITAL HAS A CLEAR MISSION COMMITTMENT TO SERVING ELDERLY PATIENTS AND ADULTS WITH DISABILITIES THROUGH THE PROVISION OF SPECIFIC SUBSIDIZED PROGRAMS DEVELOPED TO HELP IMPROVE THE HEALTH STATUS OF THESE PATIENTS IF THESE CRITICAL SUBSIDIZED PROGRAMS WERE NOT PROVIDED BY H D GOODALL HOSPITAL THEY WOULD BECOME THE OBLIGATION OF THE FEDERAL GOVERNMENT |
| NEEDS ASSESSMENT | PART VI | GOODALL HOSPITALS BOARD OF TRUSTEES IS MADE UP OF A DIVERSE GROUP OF COMMUNITY MEMBERS THE BOARD OF TRUSTEES REQUIRES A THOROUGH COMMUNITY NEEDS ASSESSMENT ON BEHALF OF THE ORGANIZATION AND DIRECTS THE ORGANIZATION TO ANALYZE AND RESPOND TO THE CURRENT NEEDS ASSESSMENT MAINEHEALTH ALSO PARTICIPATES IN VARIOUS INITIATIVES TO HELP SUPPORT AND PROVIDE UPDATES TO COMMUNITY NEEDS ASSESSMENT PLANNING SOME OF THESE INITIATIVES INCLUDE CLINICAL STARTEGIC PLANNING FINANCIAL PLANNING MANPOWER PLANNING PHYSICIAN RECRUITMENT STRATEGIC PLANNING EMERGENCY PREPAREDNESS PLANNING ALONG WITH THE INTERNAL ASSESSMENTS MOST MEMBER ORGANIZATIONS ALSO REVIEW AND ACT ON MANY OF THE RECOMMENDATIONS PROVIDED BY EXTERNAL GROUPS SUCH AS THE MAINE CENTER FOR DISEASE CONTROL AND PREVENTION AND THE STATE HEALTH PLAN CREATED BY THE ADVISORY COMMITTEE FOR HEALTH SYSTEMS DEVELOPMENT THE CURRENT COMMUNITY NEEDS ASSESSMENT WAS OBTAINED THROUGH PARTICIPATING WITH MAINEHEALTH GOODALLSS PARENT COMPANY AND ITS PARTNERS IN THE ONEMAINE HEALTH COLLABORATIVE EASTERN MAINE HEALTH SYSTEM AND MAINEGENERAL HEALTH THE ONEMAINE HEALTH COMMUNTIY NEEDS ASSESSMENT REPORT WAS RELEASED IN MARCH 2011 THE REPORT IS A COMPREHENSIVE COMPILATION AND ANALYSIS CONTAINING PRIMARY AND SECONDARY HEALTH DATA SOURCES THE REPORT CONTAINS A HEALTH STATUS PROFILE FOR THE STATE AS A WHOLE AND FOR EACH OF MAINES SIXTEEN COUNTIES THE PRIMARY DATA SOURCE WAS A RANDOMIZED TELEPHONE SURVEY THE SAMPLING METHODOLOGY WAS DESIGNED TO PERMIT COMPARISONS AT THE COUNTY LEVEL SECONDARY DATA SOURCES INCLUDE NUMEROUS STATE AND FEDERAL SOURCES THIS REPORT PROVIDES BASELINE DATA ON HUNDREDS OF HEALTH INDICATORS THAT ARE RELEVANT TO HOSPITALS AND COMMUNITIES TO INFORM PLANNING AND EVALUATION ACTIVITIES PLANS CALL FOR THE COMMUNITY HEALTH NEEDS ASSESSMENT TO BE REPLICATED EVERY THREE YEARS MAINEHEALTH WILL HOLD COMMUNITY FORUMS IN PARTNERSHIP WITH EACH MEMBERAND AFFILIATE HOSPITAL IN ORDER TO INCREASE UNDERSTANDING AND USE OF THE COMMUNITY HEALTH NEEDS ASSESSMENT AND TO INFORM IDENTIFICATION AND ACTION ON LOCAL COMMUNITYBASED HEALTH PRIORITIES |
| PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE | PART VI | GOODALL HOSPITAL EMPLOYS A FINANCIAL COUNSELOR WHO ASSISTS AND EDUCATES PATIENTS AND THEIR FAMILIES ON FINANCIAL MATTERS CONCERNING THE HOSPITAL CHARITY CARE POLICY AND ELIGIBILITY FOR STATE AND FEDERAL PROGRAMS THIS ASSISTANCE CAN BE AS SPECIFIC AS ASSISTING THE PATIENT ANDOR FAMILIES IN COMPLETING THE VARIOUS FORMS REQUIRED BY MEDICAID AND MEDICARE POSTING OF THE FINANCIAL ASSISTANCE CONTACT INFORMATION IS PRESENT IN ADMISSION AREAS EMERGENCY ROOMS AND OTHER AREAS OF THE ORGANIZATIONS FACILITIES WHERE ELIGIBLE PATIENTS ARE LIKELY TO BE PRESENT PATIENT BILLS INCLUDE A SUMMARY OF THE POLICY ALONG WITH FINANCIAL ASSITANCE CONTACT INFORMATION GOODALL HOSPITAL WORKS WITH GOODALLSS SELF PAY PATIENTS ADVANCED PATIENT ADVOCACY PROGRAM THAT SCREEN FOR ALL INPATIENT AND OUTPATIENTS THAT MEET THE APPROPRIATE CRITERIA THIS PROGRAM EFFECTIVELY EDUCATES PATIENTS ABOUT THEIR COVERAGE OPTIONS NAVIGATE COMPLEX PROGRAM CRITERIA AND ENROLL MORE UNINSURED IN PROGRAMS THAT BEST MATCH THEIR NEEDS THE HOSPITALS SENIOR ADVOCATE PROGRAM PROVIDES FREE ADVICES AND SERVICES TO THE ELDERLY MEMBERS OF THE COMMUNITY THIS PROGRAM IS DESIGNED TO BE A CENTRAL POINT OF ACCESS FOR SENIOR CITIZENS TO OBTAIN INFORMATION RESOURCES AND ADVOCACY PROGRAM RESOURCES INCLUDE BUT ARE NOT LIMITED TO MEDICARE RETIREMENT PLANNING HOUSING FINANCIAL ASSISTANCE INSURANCE COUNSELING FRAUD PROTECTION AS WELL AS COMPREHENSIVE ELIGIBLITY SCREENING FROM A HOST OF GOVERNMENT STATE ASSISTANCE PROGRAMS AND OTHER LOCAL FUNDING SOURCES GOODALLS PRESCRIPTION ASSISTANCE PROGRAM IS DESIGNED TO ASSIST THOSE WHO DO NOT QUALIFY FOR OTHER TRADITIONAL ASSISTANCE PROGRAMS SUCH AS MEDICARE PART D OR MAINECARE BUT WHOSE FINANCIAL SITUATION QUALIFIES THEM TO RECEIVE SUPPORT THE COORDINATOR SERVES AS A LIASON BETWEEN THE HEALTHCARE PROVIDER PHARMACEUTICAL COMPANIES AND THE PATIENT THE GOALS OF THIS PROGRAM ARE TO ASSIST INDIVIDUALS WITHOUT PRESCRIPTION DRUG COVERAGE IN NAVIGATING THE SYSTEM OBTAINING THEIR PRESCRIBED MEDICATIONS AND DEVELOPING LONGTERM SOLUTIONS TOWARDS ACQUIRING MEDICATIONS IN THE FUTURE |
| COMMUNITY INFORMATION | PART VI | GOODALL HOSPITAL SERVICES THE POPULATION OF WESTERN YORK COUNTY MAINE SANFORD IS THE TOWN WITH THE LARGEST POPULATION IN THE HOSPITALS SERVICE AREA WITH A POPULATION OF APPROXIMATELY 21000 WITH AN ELDERLY POPULATION RATE OF 15 AND FAMILIES REPRESENTING 64 OF THIS POPULATION WITH 93 BEING CAUCASIAN THE HOSPITALS MEDICAID VOLUME IS 18 AND IS AMONGST THE HIGHEST IN THE STATE AND REFLECTS THE HIGH PERCENTAGE OF FAMILIES WITH INCOME LESS THAN 100 OF THE FEDERAL POVERTY LEVEL SANFORDS POVERTY RATE IS 17 WHILE THE STATE OF MAINE IS AT 12 72 OF SANFORDS ELEMENTARY SCHOOL CHILDREN ARE ELIGIBLE TO RECEIVE FREE OR SUBSIDIZED MEALS |
| HEALTH OF COMMUNITY IN RELATION TO EXEMPT PURPOSE | PART VI | A MAJORITY OF THE ORGANIZATIONS GOVERNING BODY IS COMPRISED OF PERSONS WHO RESIDE IN THE ORGANIZATIONS PRIMARY SERVICE AREA WHO ARE NEITHER EMPLOYEES NOR CONTRACTORS OF THE ORGANIZATION NOR FAMILY MEMBERS THEREOF OUR DIRECTORSMANAGERSCOORDINATORS AND EMPLOYEES OF GOODALL HOSPITAL ARE ENCOURAGED TO PARTICIPATE IN THE COMMUNITYS ACTIVIES AND SUPPORT GROUPS THAT BENEFIT THE COMMUNITY AT LARGE EXAMPLES OF THESE ACTIVITIES ARE AS FOLLOWS COLLABORATING WITH THE TOWN LIBRARY TO PRESENT EVENTS AROUND HEALTH AND LITERACY OF THE PERSONS SUPPORT INTRODUCE AND COACH FAMILIES TO PROGRAMS IN WHICH THEY CAN UNDERSTAND THEIR OWN HEALTH AND SAFETY WHICH RESULT ON A FOCUS ON REDUCING PREVENTABLE ILLNESSES AND INJURIES THUS REDUCING HEALTHCARE TREATMENT COSTS AND IMPROVING LIVES LINKING FAMILIES WITH OTHER FAMILIES THAT ARE EXPERIENCING SIMILAR LIFE CIRCUMSTANCES THROUGH COMMUNITY EVENTS THAT INCLUDE THE PARENT AND CHILD PARTICIPATION LEAD SCREENING AND PREVENTION EDUCATION TEST KIT MAILERS AND INFORMATION TO ALERT THE COMMUNITIES OF THE IMPORTANCE OF LEASE TESTING AND TREATMENT IF APPROPRIATE AT YOUNG AGES |
| AFFILIATED HEALTH CARE INFORMATION | PART VI | MAINEHEALTH IS A NOTFORPROFIT FAMILY OF LEADING HIGHQUALITY PROVIDERS AND OTHER HEALTHCARE ORGANIZATIONS WORKING TOGETHER SO THEIR COMMUNITIES ARE THE HEALTHIEST IN AMERICA RANKED AMONG THE NATIONS TOP 100 INTEGRATED HEALTHCARE DELIVERY NETWORKS MAINEHEALTH IS GOVERNED BY A BOARD OF TRUSTEES CONSISTING OF COMMUNITY AND BUSINESS LEADERS FROM ITS SOUTHERN CENTRAL AND WESTERN REGIONAL SERVICE AREAS THE COLLABORATION OF MAINEHEALTH MEMBERS MAKES IT POSSIBLE TO OFFER A EXTENSIVE RANGE OF CLINICAL INTEGRATION AND COMMUNITY HEALTH PROGRAMS MANY AIMED AT IMPROVING ACCESS TO PREVENTATIVE AND PRIMARY CARE SERVICES MAINEHEALTH INCLUDES THE FOLLOWING MEMBER ORGANIZATIONS LINCOLN COUNTY HEALTHCARE MAINE MEDICAL CENTER MAINE MENTAL HEALTH PARTNERS SPRING HARBOR HOSPITAL PEN BAY HEALTHCARE PEN BAY MEDICAL CENTER SOUTHERN MAINE MEDICAL CENTER HENRIETTA D GOODALL HOSPITAL WALDO COUNTY HEALTHCARE WALDO COUNTY GENERAL HOSPITAL WESTERN MAINE HEALTH CARE STEPHENS MEMORIAL HOSPITAL HOMEHEALTH VISITING NURSES OF SOUTHERN MAINE MAINE PHYSICIAN HOSPITAL ORGANIZATION NORDX LABS SYNERNET MAINEHEALTH ACCOUNTABLE CARE ORGANIZATION AND MAINEHEALTH CARDIOLOGY AFFILIATES OF MAINEHEALTH INCLUDE MAINEGENERAL MEDICAL CENTER MID COAST HOSPITAL NEW ENGLAND REHABILITATION HOSPITAL OF PORTLAND AND ST MARYS REGIONAL HOSPITAL |
| LIST OF STATES WHERE COMMUNITY BENEFIT REPORT IS FILED | PART VI | MAINE |
| HENRIETTA D GOODALL HOSPITAL INC LINE NUMBER 1 PART V LINE 3 | PART V LINE 3 | OVER 3100 YORK DISTRICT RESIDENTS PARTICIPATED IN THIS PROCESS EITHER BY RESPONDING TO A COUNTYWIDE SURVEY ANDOR PARTICIPATING IN COMMUNITY MEETINGS TO IDENTIFY KEY HEALTH ISSUES AND COMMUNITY CONCERNS THIS INFORMATION WAS COLLECTED TO INFORM THE DEVELOPMENT OF COMMUNITY HEALTH IMPROVEMENT PLAN THAT MAXIMIZES RESOURCES TAKES INTO ACCOUNT UNIQUE CIRCUMSTANCES AND NEEDS AND FORMS EFFECTIVE PARTNERSHIPS FOR STRATEGIC ACTION |
| HENRIETTA D GOODALL HOSPITAL INC LINE NUMBER 1 PART V LINE 5C | PART V LINE 5C | THE ASSESSMENT WAS ALSO MADE AVAILABLE THROUGH OTHER NONHOSPITAL FACILITIES AND ON THE WEB HTTPWWWCTBHORGDOCUMENTSYORKDISTRICTSTRATEGICPLANAPRIL2011PDF |
| HENRIETTA D GOODALL HOSPITAL INC LINE NUMBER 1 PART V LINE 20D | PART V LINE 20D | THE HOSPITAL USES COST AS THE BASIS FOR MARKUP THE MARKUP TO CHARGE INCLUDES DIFFERING PERCENTAGES BASED ON A TIER COSTING SYSTEM |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | X | CompensationCommittee |
| Independent Consultant | X | IndependentConsultant |
| Written Employment Contract | X | WrittenEmploymentContract |
| Compensation Survey | X | CompensationSurvey |
| Board Or Committee Approval | X | BoardOrCommitteeApproval |
| Severance Payment | false | SeverancePayment |
| Supplemental Nonqual Retire Plan | false | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | false | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | false | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | false | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | false | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | false | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | false | AnyNonFixedPayments |
| Initial Contract Exception | false | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (13 entries)
| TitleTitle | Base Compensation Filing OrgBaseCompensationFilingOrg | Deferred Comp Filing OrgDeferredCompFilingOrg | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg | Total Compensation Filing OrgTotalCompensationFilingOrg | Comp Based On Related OrgsCompBasedOnRelatedOrgs | Bonus Related OrgsBonusRelatedOrgs | Other Compensation Related OrgsOtherCompensationRelatedOrgs | Deferred Comp Related OrgsDeferredCompRelatedOrgs | Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs | Total Compensation Related OrgsTotalCompensationRelatedOrgs | Bonus Filing OrgBonusFilingOrg |
|---|---|---|---|---|---|---|---|---|---|---|---|
| JOHN THOMPSON DO | |||||||||||
| TRUSTEE | 492596 | 2500 | 21840 | 516936 | |||||||
| FRANK GOUDREAU DO | |||||||||||
| TRUSTEE | 474462 | 2500 | 21513 | 498475 | |||||||
| MICHAEL CARROLL MD | |||||||||||
| TRUSTEE | 365724 | 92569 | 961 | 10000 | 15652 | 484906 | |||||
| GINA QUINN-SKILLINGS MD | |||||||||||
| TRUSTEE | 303071 | 737 | 10000 | 15758 | 329566 | ||||||
| MARY O'HARE MD | |||||||||||
| TRUSTEE | 267842 | 647 | 9548 | 16347 | 294384 | ||||||
| DONALD BURGESS MD | |||||||||||
| TRUSTEE | 229293 | 309 | 9184 | 15426 | 254212 | ||||||
| PATRICIA APRILE | |||||||||||
| PRESIDENTCEO | 357297 | 2500 | 14811 | 413565 | 38957 | ||||||
| DANIEL D FORGUES | |||||||||||
| CFO | 195795 | 2046 | 10095 | 227936 | 20000 | ||||||
| PETER L CLARK DO | |||||||||||
| PHYSICIAN | 352468 | 2500 | 20050 | 375018 | |||||||
| JONATHAN P SHILL MDPHD | |||||||||||
| PHYSICIAN | 312533 | 3750 | 2979 | 339262 | 20000 | ||||||
| NINA SHERVIN MD | |||||||||||
| PHYSICIAN | 327988 | 2500 | 6278 | 336766 | |||||||
| STEVEN E JOHNSON MD | |||||||||||
| PHYSICIAN | 299221 | 2581 | 20793 | 322595 | |||||||
| ANDREW D POWELL MD | |||||||||||
| PHYSICIAN | 282559 | 2581 | 16957 | 302097 | |||||||
Schedule K IRS990ScheduleK
Form990 Schedule K Part I Form990ScheduleKPartI (2 entries)
| Bond ReferenceBondReferenceCd | Business Name Line2IssuerName/BusinessNameLine2 | Issuer EINIssuerEIN | CUSIP NumberCUSIPNumber | Date IssuedDateIssued | Issue PriceIssuePrice | Description Of PurposeDescriptionOfPurpose | DefeasedDefeased | On Behalf Of IssuerOnBehalfOfIssuer | Pool FinancingPoolFinancing |
|---|---|---|---|---|---|---|---|---|---|
| MAINE HEALTH AND HIGHER EDUCATIONAL | |||||||||
| A | FACILITIES AUTHORITY | 010314384 | 560425D49 | 2006-09-07 | 6020317 | RENOVATE & EQUIPMENT | false | false | false |
| MAINE HEALTH AND HIGHER EDUCATIONAL | |||||||||
| B | FACILITIES AUTHORITY | 010314385 | 560425H37 | 2007-07-18 | 5108908 | REFI MHHEFA BD 1996A | false | false | false |
Form990 Schedule K Part II Form990ScheduleKPartII (2 entries)
| Bond ReferenceBondReferenceCd | Total ProceedsTotalProceeds | Amount In Reserve FundAmountInReserveFund | Issuance Costs From ProceedsIssuanceCostsFromProceeds | Capital ExpendituresCapitalExpenditures | Amount UnspentAmountUnspent | Year Of Subst CompletionYearOfSubstCompletion | Current RefundingCurrentRefunding | Advance RefundingAdvanceRefunding | Final Allocation MadeFinalAllocationMade | Adequate Books And Recds MaintaindAdequateBooksAndRecdsMaintaind |
|---|---|---|---|---|---|---|---|---|---|---|
| A | 6020317 | 522453 | 55514 | 5836740 | 293000 | 2007 | false | false | true | true |
| B | 5108908 | 451093 | 56115 | false | true | true | true |
Form990 Schedule K Part III Form990ScheduleKPartIII (2 entries)
| Bond ReferenceBondReferenceCd | Owning Bond Financed PropertyOwningBondFinancedProperty | Any Lease ArrangementsAnyLeaseArrangements | Mngment Cntrct Bond Financd PrprtyMngmentCntrctBondFinancdPrprty | Any Research AgreementsAnyResearchAgreements | Bond Iss Meet Prvt Security Pay TestBondIssMeetPrvtSecurityPayTest | Change In Use Bond Financed PropChangeInUseBondFinancedProp | Remedial Action TakenRemedialActionTaken | Non Qualified Bond Remed ProcdrsNonQualifiedBondRemedProcdrs |
|---|---|---|---|---|---|---|---|---|
| A | false | false | false | false | false | false | false | false |
| B | false | false | false | false | false | false | false | false |
Form990 Schedule K Part IV Form990ScheduleKPartIV (2 entries)
| Bond ReferenceBondReferenceCd | Form8038 T FiledForm8038TFiled | Variable Rate IssueVariableRateIssue | Hedge Identified In Books And RecdsHedgeIdentifiedInBooksAndRecds | Gross Proceeds Invested In GICGrossProceedsInvestedInGIC | Gross Proceeds InvestedGrossProceedsInvested | Written Proc To Monitor ReqsWrittenProcToMonitorReqs | Rebate Not Due YetRebateNotDueYet | Exception To RebateExceptionToRebate | No Rebate DueNoRebateDue |
|---|---|---|---|---|---|---|---|---|---|
| A | true | false | false | false | false | false | |||
| B | false | false | false | false | false | false | false | false | false |
Form990 Schedule K Part V Form990ScheduleKPartV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Proc To Undertk Corrective Action | false | ProcToUndertkCorrectiveAction |
Form990 Schedule K Part VI Form990ScheduleKPartVI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | ADDITIONAL INFORMATION | Identifier |
| Return Reference | SCHEDULE K | ReturnReference |
| Explanation | MAINE HEALTH AND HIGHER EDUCATIONAL SCHEDULE K PART I BOND ISSUES A ISSUER NAME MAINE HEALTH AND HIGHER EDUCATIONAL FACILITIES AUTHORITY B DESCRIPTION OF PURPOSE RENOVATE HOSPITAL AND PURCHASE EQUIPMENT MAINE HEALTH AND HIGHER EDUCATIONAL SCHEDULE K PART I BOND ISSUES A ISSUER NAME MAINE HEALTH AND HIGHER EDUCATIONAL FACILITIES AUTHORITY B DESCRIPTION OF PURPOSE REFINANCE MHHEFA BOND 1996A | Explanation |
Schedule L IRS990ScheduleL
Form990 Schedule L Part IV Form990ScheduleLPartIV (2 entries)
| Amount Of TransactionAmountOfTransaction | Description Of TransactionDescriptionOfTransaction | Sharing Of RevenuesSharingOfRevenues |
|---|---|---|
| MARK MICKERIZ | ||
| 3869068 | SANFORD INST FOR SAV | false |
| WILLIAM FRANK | ||
| 19525 | GOODALL HOSPITAL | false |
Form990 Schedule L Part V Form990ScheduleLPartV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | ADDITIONAL INFORMATION | Identifier |
| Return Reference | SCHEDULE L PART V | ReturnReference |
| Explanation | SCHEDULE L PART IV BUSINESS TRANSACTIONS INVOLVING INTERESTED PERSONS A NAME OF PERSON MARK MICKERIZ B RELATIONSHIP BETWEEN INTERESTED PERSON AND ORGANIZATION MEMBER OF GOODALL HOSPITALS BOARD AND PRESIDENT OF SANFORD INSTITUTE FOR SAVINGS D DESCRIPTION OF TRANSACTION SANFORD INSTITUTE FOR SAVINGS SIS HAS FOUR OUTSTANDING LOANS WITH HENRIETTA D GOODALL HOSPITAL INC THE ORIGINAL AMOUNT OF THE LOANS WERE 7368000 AND AS OF MAY 31 2013 THE OUTSTANDING BALANCE ON THE LOANS WERE 3869680 A NAME OF PERSON WILLIAM FRANK B RELATIONSHIP BETWEEN INTERESTED PERSON AND ORGANIZATION MEMBER OF GOODALL HOSPITALS BOARD OF TRUSTEES D DESCRIPTION OF TRANSACTION GOODALL HOSPITAL CONTRACTS WITH DR FRANK TO PERFORM VARIOUS DUTIES AT THE HOSPITAL SUCH AS ON CALL IMPACT COVERAGE AND SOME COMMITTIES | Explanation |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (10 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| ORGANIZATION'S MISSION | FORM 990 - ORGANIZATION'S MISSION | HENRIETTA D. GOODALL HOSPITAL'S, INC.'S MISSION IS TO SERVE AS A LEADER IN IMPROVING THE HEALTH AND WELL-BEING OF ITS COMMUNITY. HENRIETTA D. GOODALL HOSPITAL, INC. OWNS AND OPERATES H. D. GOODALL HOSPITAL, INC. (ACUTE CARE HOSPITAL), GOODALL HEALTH PARTNERS (A MULTI-SPECIALTY PHYSICIAL AND SURGEON GROUP), THE MEDICAL GROUP (A MULT-SPECIALTY PHYSICIAN AND SURGEON GROUP, GOODALL OUTPATIENT CLINIC (A FACILITY WHERE A VARIETY OF OUTPATIENT SERVICES ARE PERFORMED), GOODALL OUTPATIENT SERVICES-WATERBORO AND GOODALL ELDERCARE SERVICES (A LONG TERM CARE FACILITY) IN YORK COUNTY. YORK COUNTY CONSISTS OF 18 TOWNS AND CITIES LOCATED ON THE SOUTHERN MAINE COAST WITH A POPULATION OF OVER 200,000. HENRIETTA D. GOODALL HOSPITAL, INC. FURTHERS ITS MISSION AS A LEADER IN IMPROVING THE HEALTH AND WELL-BEING OF THE COMMUNITY AND PROVIDES ACCESS TO NEEDED HEALTHCARE SERVICES 365 DAYS A YEAR, 24 HOURS A DAY. |
| FIRST ACCOMPLISHMENT DESCRIPTION | FORM 990, PAGE 2, PART III, LINE 4A | ASSOCIATED WITH PROVIDING THE COMMUNITY WITH A VARIETY OF SPECIAL COMPLIMENTARY EDUCATIONAL AND INFORMATIONAL SERVICES. GOODALL PROUDLY SPONSORS COMMUNITY ORGANIZATIONS, SCHOOL GROUPS, CIVIC ORGANIZATIONS AND SPECIAL EVENTS (LIKE THE LOCAL BASEBALL TEAM). GOODALL HOSPITAL SPONSORS TWO TO FOUR FREE EDUCATION EVENTS EACH MONTH OF THE YEAR ALONG WITH DOZENS OF SUPPORT GROUPS. GOODALL HOSPITAL ALSO ROUTINELY PARTICIPATES IN HEALTH FAIRS AND BUSINESS EVENTS, PERFORMING BLOOD PRESSURE CHECKS, CHOLESTEROL SCREENINGS AND CPR TRAINING. GOODALL HOSPITAL'S SENIOR ADVOCATE PROVIDES FREE ADVICE AND SERVICES TO ELDERLY MEMBERS OF THE COMMUNITY. SERVICES INCLUDE HELP WITH INSURANCE AND MEDICAL ISSUES, AS WELL AS PERSONAL ISSUES INCLUDING TAX INFORMATION, FINANCES AND HOME NEEDS. |
| ALL OTHER ACCOMPLISHMENT DESCRIPTION | FORM 990, PAGE 2, PART III, LINE 4D | THE MEDICAL GROUP CONSISTS OF MANY PHYSICIANS WITH MULTI-SPECIALTY SERVICES THAT EXTEND GOODALL HOSPITAL'S EXISTING SERVICES TO KENNEBUNK, ME. THESE PHYSICIANS COMPLEMENT THE HOSPITAL IN MAINTAINING ITS MISSION TO SERVE AS A LEADER IN IMPROVING THE HEALTH AND WELL-BEING OF OUR COMMUNITY. THESE SERVICES INCLUDE (BUT ARE NOT LIMITED TO) FULL SERVICE PRIMARY CARE, WOMEN'S HEALTH, GASTROENTEROLOGY, PULMONARY MEDICINE, ORTHOPEDICS AND PAIN MANAGEMENT. THE MEDICAL GROUP PROVIDED 12,846 IN CHARITY CARE TO THE COMMUNITY. THE NUMBER OF PATIENTS SEEN WERE 10,855 FOR A TOTAL NUMBER OF 27,633 PATIENT DAYS. |
| SIGNIFICANT CHANGES TO ORGANIZATIONAL DOCUMENTS | FORM 990, PAGE 6, PART VI, LINE 4 | HENRIETTA D. GOODALL HOSPITAL AMENDED ITS ARTICLES OF INCORPORTATION AND BYLAWS SO THAT SOUTHERN MAINE HEALTH CARE (SMHC) SERVES AS THE PARENT ORGANIZATION AND SOLE CORPORATE MEMBER OF THE HOSPITAL AND SOUTHERN MAINE MEDICAL CENTER. |
| ORGANIZATION'S PROCESS USED TO REVIEW FORM 990 | FORM 990, PAGE 6, PART VI, LINE 11B | THE FORM 990 WAS MADE AVAILABLE TO THE FULL BOARD OF TRUSTEES. THE CFO OF SOUTHERN MAINE HEALTH CARE REVIEWS THE FORM 990 IN DETAIL BEFORE SIGNING THE RETURN. |
| ENFORCEMENT OF CONFLICTS POLICY | FORM 990, PAGE 6, PART VI, LINE 12C | AS INDICATED IN LINE 12B, GOODALL HOSPTIAL REQUIRES CURRENT AND FORMER OFFICERS, DIRECTORS, TRUSTEES, AND KEY EMPLOYEES TO COMPLETE AN ANNUAL QUESTIONAIRE CONCERNING ANY POTENTIAL CONFLICTS OF INTEREST. THE ORGANIZATION REVIEWS THE REPSONSES TO THESE DOCUMENTS AND ADDRESSES ANY ISSUES IMMEDIATELY. IN ADDITION, WE HAVE ADDED ANOTHER QUESTIONAIRE THAT SPECIFICALLY ADDRESSES THE CONCERNS REGARDING TRANSACTIONS INVOLVING CURRENT AND FORMER OFFICERS, DIRECTORS, TRUSTEES, AND KEY EMPLOYEES AND CERTAIN PARTIES THAT ARE RELATED TO THESE INDIVIDUALS. |
| COMPENSATION PROCESS FOR TOP OFFICIAL | FORM 990, PAGE 6, PART VI, LINE 15A | THE BOARD OF DIRECTORS APPROVES COMPENSATION FOR THE CEO AFTER CAREFUL REVEIW OF INDUSTRY SALARY INFORMATION (COMPENSATION STUDY) WITH AN OUTSIDE COMPENSATION CONSULTANT. |
| COMPENSATION PROCESS FOR OFFICERS | FORM 990, PAGE 6, PART VI, LINE 15B | UNDER THE GUIDANCE OF PROFESSIONAL COMPENSATION CONSULTANTS, THE HR DIRECTOR REVIEWS THE PAY MODEL WITH THE CEO AND COO TO ENSURE THAT THE ORGANIZATION IS ABLE TO RECRUIT AND RETAIN A HIGH QUALIFIED WORKFORCE, WHILE PROVIDING THE NECESSARY STRUCTURE TO EFFECTIVELY MANAGE THE COMPETETIVE ADVANTAGE OF PRODUCTIVITY, TOTAL QUALITY, CUSTOMER SERVICE AND COSTS. |
| GOVERNING DOCUMENTS DISCLOSURE EXPLANATION | FORM 990, PAGE 6, PART VI, LINE 19 | DOCUMENTS THAT ARE REQUIRED TO BE OPEN FOR PUBLIC INSPECTION ARE MADE AVAILABLE UPON REQUEST. |
| OTHER CHANGES IN NET ASSETS EXPLANATION | FORM 990, PART XI, LINE 9 | INCREASE IN BENEFICIAL INTEREST IN PERPETUAL TRUST 1,212,004 UNREALIZED GAIN ON TEMPORARY NET ASSETS 122,707 EQUITY TRANSFERS 53,712 LOSS ON EXTINGUISHMENT OF DEBT 143,793 TOTAL OTHER CHANGES IN NET ASSETS: 1,244,630 |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII (4 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivities | Legal Domicile StateLegalDomicileState | Exempt Code SectionExemptCodeSection | Public Charity StatusPublicCharityStatus | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Business Name Line2DirectControllingEntityName/BusinessNameLine2 | Controlled OrgControlledOrg | Business Name Line2NameOfDisregardedEntity/BusinessNameLine2 | Direct Controlling Entity NADirectControllingEntityNA |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| MANOR AT PHILLIPSTOWN PLACE INC | |||||||||||||
| 25 JUNE STREET | SANFORD | ME | 04073 | 010473857 | ELDER CARE | ME | 501C3 | 9 | HD GOODALL | D GOODALL HOSPITAL INC | false | ||
| THE WEBBER HOSPITAL ASSOC DBA | |||||||||||||
| PO BOX 626 | BIDDEFORD | ME | 04005 | 010179500 | HOSPITAL | ME | 501C3 | 3 | SMHC | false | SMMC | ||
| CANCER CARE CENTER OF YORK COUNTY | |||||||||||||
| 22 BRAMHALL STREET | PORTLAND | ME | 04102 | 201600381 | MED SVCS | ME | 501C3 | 3 | SMHC | false | |||
| MAINEHEALTH | |||||||||||||
| 110 FREE STREET | PORTLAND | ME | 04101 | 010431680 | HEALTHCARE | ME | 501C3 | 11C | false | N/A | |||
Form990 Schedule R Part III Form990ScheduleRPartIII
Name Of Related Org NameOfRelatedOrg
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | GSM REALTY LLC | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 22 BRAMHALL STREET | AddressLine1 |
| City | PORTLAND | City |
| State | ME | State |
| ZIP Code | 04102 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 204582952 | EIN |
| Primary Activity | REAL EST. | PrimaryActivity |
| Legal Domicile State | ME | LegalDomicileState |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SMHC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Predominant Income Type | RELATED | PredominantIncomeType |
| Share Of Total Income | 6750 | ShareOfTotalIncome |
| Share Of EOY Assets | 439834 | ShareOfEOYAssets |
| Disproportionate Allocations | false | DisproportionateAllocations |
| General Or Managing Partner | false | GeneralOrManagingPartner |
| Percentage Ownership | 0.33330 | PercentageOwnership |
Form990 Schedule R Part IV Form990ScheduleRPartIV (3 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivityPrimaryActivity | Legal Domicile StateLegalDomicileState | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Business Name Line2DirectControllingEntityName/BusinessNameLine2 | Type Of EntityTypeOfEntity | Share Of Total IncomeShareOfTotalIncome | Share Of EOY AssetsShareOfEOYAssets | Percentage OwnershipPercentageOwnership | Controlled OrgControlledOrg | Direct Controlling Entity NADirectControllingEntityNA |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| JUNE STREET PHARMACY LLC | ||||||||||||||
| 25 JUNE STREET | SANFORD | ME | 04073 | 020765952 | PHARMACY | ME | HD GOODALL | D GOODALL HOSPITAL INC | C CORP | 963495 | 17822 | 1.00000 | false | |
| SOUTHERN MAINE HEALTH CARE | ||||||||||||||
| PO BOX 626 | BIDDEFORD | ME | 04005 | 461211705 | HEALTHCARE | ME | false | N/A | ||||||
| SMMC PRIMECARE PHYSICIAN SERVICES | ||||||||||||||
| PO BOX 626 | BIDDEFORD | ME | 04005 | 263345134 | MED SVCS | ME | false | N/A | ||||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | true | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | false | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | false | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | true | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | false | LoansOrGuaranteesFromOtherOrg |
| Dividends Related Organization | false | DividendsRelatedOrganization |
| Sale Of Assets To Other Org | false | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | false | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | false | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | true | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | false | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | true | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | false | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | false | SharingOfFacilities |
| Sharing Of Paid Employees | true | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | false | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | true | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | false | OtherTransferToOtherOrg |
| Other Transfer From Other Org | false | OtherTransferFromOtherOrg |
Transactions Related Orgs Table TransactionsRelatedOrgsTable (39 entries)
| Transaction TypeTransactionType | Amount InvolvedAmountInvolved | Method Of Amt DeterminationMethodOfAmtDetermination |
|---|---|---|
| MANOR AT PHILLIPSTOWN PLACE INC | ||
| K | 96648 | COST INCURRED HEALTH INS |
| MANOR AT PHILLIPSTOWN PLACE INC | ||
| N | 18000 | COST INCURRED FOR MGT SVC |
| MANOR AT PHILLIPSTOWN PLACE INC | ||
| P | 55952 | ACTUAL COSTS INCURRED |
| MANOR AT PHIILIPSTOWN PLACE INC | ||
| K | 27550 | COST INCURRED OTHER EXP |
| JUNE STREET PHARMACY LLC | ||
| A | 6642 | ACTUAL INTEREST CHARGED |
| JUNE STREET PHARMACY LLC | ||
| K | 43284 | COST INCURRED HEALTH INS |
| JUNE STREET PHARMACY LLC | ||
| N | 14998 | COST INCURRED FOR MGT SVC |
| JUNE STREET PHARMACY LLC | ||
| K | 17887 | COST INCURRED OTHER EXP |
| JUNE STREET PHARMACY LLC | ||
| D | 637589 | ACTUAL PRINCIPAL DUE NOTE |
| JUNE STREET PHARMACY LLC | ||
| I | 32420 | COST INCURRED RENT |
| JUNE STREET PHARMACY LLC | ||
| P | 478884 | REIMBURSEMENT OF EXPENSES |
| JUNE STREET PHARMACY LLC | ||
| R | 161717 | EXTINGUISHMENT OF DEBT |
| JUNE STREET PHARMACY LLC | ||
| D | 17873 | ACTUAL LOAN AMOUNT |
| MANOR AT PHILLIPSTOWN PLACE INC | ||
| K | 96648 | COST INCURRED HEALTH INS |
| MANOR AT PHILLIPSTOWN PLACE INC | ||
| N | 18000 | COST INCURRED FOR MGT SVC |
| MANOR AT PHILLIPSTOWN PLACE INC | ||
| P | 55952 | ACTUAL COSTS INCURRED |
| MANOR AT PHIILIPSTOWN PLACE INC | ||
| K | 27550 | COST INCURRED OTHER EXP |
| JUNE STREET PHARMACY LLC | ||
| A | 6642 | ACTUAL INTEREST CHARGED |
| JUNE STREET PHARMACY LLC | ||
| K | 43284 | COST INCURRED HEALTH INS |
| JUNE STREET PHARMACY LLC | ||
| N | 14998 | COST INCURRED FOR MGT SVC |
| JUNE STREET PHARMACY LLC | ||
| K | 17887 | COST INCURRED OTHER EXP |
| JUNE STREET PHARMACY LLC | ||
| D | 637589 | ACTUAL PRINCIPAL DUE NOTE |
| JUNE STREET PHARMACY LLC | ||
| I | 32420 | COST INCURRED RENT |
| JUNE STREET PHARMACY LLC | ||
| P | 478884 | REIMBURSEMENT OF EXPENSES |
| JUNE STREET PHARMACY LLC | ||
| R | 161717 | EXTINGUISHMENT OF DEBT |
| JUNE STREET PHARMACY LLC | ||
| D | 17873 | ACTUAL LOAN AMOUNT |
| MANOR AT PHILLIPSTOWN PLACE INC | ||
| K | 96648 | COST INCURRED HEALTH INS |
| MANOR AT PHILLIPSTOWN PLACE INC | ||
| N | 18000 | COST INCURRED FOR MGT SVC |
| MANOR AT PHILLIPSTOWN PLACE INC | ||
| P | 55952 | ACTUAL COSTS INCURRED |
| MANOR AT PHIILIPSTOWN PLACE INC | ||
| K | 27550 | COST INCURRED OTHER EXP |
| JUNE STREET PHARMACY LLC | ||
| A | 6642 | ACTUAL INTEREST CHARGED |
| JUNE STREET PHARMACY LLC | ||
| K | 43284 | COST INCURRED HEALTH INS |
| JUNE STREET PHARMACY LLC | ||
| N | 14998 | COST INCURRED FOR MGT SVC |
| JUNE STREET PHARMACY LLC | ||
| K | 17887 | COST INCURRED OTHER EXP |
| JUNE STREET PHARMACY LLC | ||
| D | 637589 | ACTUAL PRINCIPAL DUE NOTE |
| JUNE STREET PHARMACY LLC | ||
| I | 32420 | COST INCURRED RENT |
| JUNE STREET PHARMACY LLC | ||
| P | 478884 | REIMBURSEMENT OF EXPENSES |
| JUNE STREET PHARMACY LLC | ||
| R | 161717 | EXTINGUISHMENT OF DEBT |
| JUNE STREET PHARMACY LLC | ||
| D | 17873 | ACTUAL LOAN AMOUNT |
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