FURP.ORG / PUBLIC DATA EXPLORER

WESTERN MAINE NURSING HOME INC: Form 990, tax year 2012

View the entire original 990 at ProPublica ↗

Organization
WESTERN MAINE NURSING HOME INC (EIN 22-2842655)
Tax period
2012-10-01 to 2013-09-30
Filed
2014-08-13
IRS object ID
201402259349301430
Schema version
2012v2.3
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Timestamp2014-08-13T09:56:00-05:00Timestamp
Tax Period End Date2013-09-30TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1MAINEHEALTHBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line1110 FREE STAddressLine1
CityPORTLANDCity
StateMEState
ZIP Code041013908ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2012-10-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN222842655EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1WESTERN MAINE NURSING HOME INCBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlWESTNameControl
Phone2077437086Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1181 MAIN STREETAddressLine1
CityNORWAYCity
StateMEState
ZIP Code04268ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameJOHN COXName
TitleSENIOR VP - FISCALTitle
Phone2077437086Phone
Date Signed2014-08-06DateSigned
Authorize Third PartyfalseAuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
Date Prepared2014-08-13DatePrepared
FieldValueIRS element (for citing)
Tax Year2012TaxYear
Build TS2015-11-30 17:44:51ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Address ChangeXAddressChange
Name Of Principal Officer PersonTIMOTHY CHURCHILLNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1181 MAIN STREETAddressLine1
CityNORWAYCity
StateMEState
ZIP Code04268ZIPCode
FieldValueIRS element (for citing)
Gross Receipts6538691GrossReceipts
Group Return For AffiliatesfalseGroupReturnForAffiliates
Organization501c3XOrganization501c3
Web SiteWWW.WMHCC.ORGWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1987YearFormation
State Legal DomicileMEStateLegalDomicile
Activity Or Mission DescriptionTO ENSURE A HIGH QUALITY, ACCESSIBLE, AFFORDABLE AND APPROPRIATE INTEGRATED HEALTH CARE SYSTEM TO IMPROVE THE HEALTH AND WELL BEING OF THE COMMUNITY.ActivityOrMissionDescription
Nbr Voting Members Governing Body19NbrVotingMembersGoverningBody
Nbr Independent Voting Members14NbrIndependentVotingMembers
Total Nbr Employees176TotalNbrEmployees
Total Nbr Volunteers17TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Contributions Grants Prior Year3379ContributionsGrantsPriorYear
Contributions Grants Current Year509ContributionsGrantsCurrentYear
Program Service Revenue Prior Year6370002ProgramServiceRevenuePriorYear
Program Service Revenue CY6521187ProgramServiceRevenueCY
Investment Income Prior Year312InvestmentIncomePriorYear
Investment Income Current Year-77794InvestmentIncomeCurrentYear
Other Revenue Prior Year10642OtherRevenuePriorYear
Other Revenue Current Year16804OtherRevenueCurrentYear
Total Revenue Prior Year6384335TotalRevenuePriorYear
Total Revenue Current Year6460706TotalRevenueCurrentYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year4487689SalariesEtcPriorYear
Salaries Etc Current Year4413020SalariesEtcCurrentYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year2496543OtherExpensePriorYear
Other Expenses Current Year2868240OtherExpensesCurrentYear
Total Expenses Prior Year6984232TotalExpensesPriorYear
Total Expenses Current Year7281260TotalExpensesCurrentYear
Revenues Less Expenses Prior Year-599897RevenuesLessExpensesPriorYear
Revenues Less Expenses CY-820554RevenuesLessExpensesCY
Total Assets BOY1129143TotalAssetsBOY
Total Assets EOY1748180TotalAssetsEOY
Total Liabilities BOY617853TotalLiabilitiesBOY
Total Liabilities EOY702444TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY511290NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY1045736NetAssetsOrFundBalancesEOY
Mission DescriptionTO ENSURE A HIGH QUALITY, ACCESSIBLE, AFFORDABLE AND APPROPRIATE INTEGRATED HEALTH CARE SYSTEM TO IMPROVE THE HEALTH AND WELL BEING OF THE COMMUNITY.MissionDescription
Significant New Program ServicesfalseSignificantNewProgramServices
Significant ChangefalseSignificantChange
Expense6931447Expense
Revenue6460006Revenue
DescriptionTHE ORGANIZATION PROVIDES LONG-TERM NURSING AND RELATED MEDICAL CARE TO ITS RESIDENTS. SERVICES INCLUDE A RESIDENTIAL CARE UNIT, SKILLED NURSING CARE AND INTERMEDIATE NURSING CARE. IN 2013 THE ORGANIZATION SERVED 31,451 RESIDENT DAYS, INCLUDING 21,799 MAINECARE DAYS. SEE COMMUNITY BENEFIT STATEMENT.Description
Total Program Service Expense6931447TotalProgramServiceExpense
Described In501 C3trueDescribedIn501C3
Schedule B RequiredfalseScheduleBRequired
Political ActivitiesfalsePoliticalActivities
Lobbying ActivitiestrueLobbyingActivities
Subject To Proxy TaxfalseSubjectToProxyTax
Donor Advised FundsfalseDonorAdvisedFunds
Conservation EasementsfalseConservationEasements
Collections Of ArtfalseCollectionsOfArt
Credit CounselingfalseCreditCounseling
Term Or Permanent EndowmentstrueTermOrPermanentEndowments
Report Land Bldg EquipfalseReportLandBldgEquip
Report Invest Oth SecuritiesfalseReportInvestOthSecurities
Report Prog Rel InvestfalseReportProgRelInvest
Report Other AssetstrueReportOtherAssets
Report Other LiabilitiestrueReportOtherLiabilities
Report Fin48 FootnotetrueReportFin48Footnote
Independent Audit Financial StmtfalseIndependentAuditFinancialStmt
Consolidated Audit Financial StmttrueConsolidatedAuditFinancialStmt
SchoolfalseSchool
Foreign OfficefalseForeignOffice
Foreign ActivitiesfalseForeignActivities
More Than5000 K To OrganizationsfalseMoreThan5000KToOrganizations
More Than5000 K To IndividualsfalseMoreThan5000KToIndividuals
Professional FundraisingfalseProfessionalFundraising
Fundraising ActivitiesfalseFundraisingActivities
GamingfalseGaming
HospitalfalseHospital
Grants To OrganizationsfalseGrantsToOrganizations
Grants To IndividualsfalseGrantsToIndividuals
Schedule J RequiredtrueScheduleJRequired
Tax Exempt BondsfalseTaxExemptBonds
Excess Benefit TransactionfalseExcessBenefitTransaction
Prior Excess Benefit TransactionfalsePriorExcessBenefitTransaction
Loan To Officer Or DQPfalseLoanToOfficerOrDQP
Grant To Related PersonfalseGrantToRelatedPerson
Bsnss Rltnshp With OrganizationfalseBsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family MemberfalseBsnssRltnshpThruFamilyMember
Officer Entity With Bsnss RltnshpfalseOfficerEntityWithBsnssRltnshp
Deductible Non Cash ContributionsfalseDeductibleNonCashContributions
Deductible Contributions Of ArtfalseDeductibleContributionsOfArt
TerminatedfalseTerminated
Partial LiquidationfalsePartialLiquidation
Disregarded EntityfalseDisregardedEntity
Related EntitytrueRelatedEntity
Related Org Controlled EntityfalseRelatedOrgControlledEntity
Transfers To Exempt Non Chrtbl OrgfalseTransfersToExemptNonChrtblOrg
Activities Conducted PartnershipfalseActivitiesConductedPartnership
Schedule O RequiredtrueScheduleORequired
Number Forms Transmitted With10963NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup WitholdingtrueComplianceWithBackupWitholding
Number Of Employees176NumberOfEmployees
Employment Tax Returns FiledtrueEmploymentTaxReturnsFiled
Unrelated Business IncomefalseUnrelatedBusinessIncome
Foreign Financial AccountfalseForeignFinancialAccount
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTrans
Taxable Party NotificationfalseTaxablePartyNotification
Non Deductible ContributionsfalseNonDeductibleContributions
Quid Pro Quo ContributionsfalseQuidProQuoContributions
Form8282 Property Disposed OffalseForm8282PropertyDisposedOf
Funds To Pay PremiumsfalseFundsToPayPremiums
Premiums PaidfalsePremiumsPaid
Indoor Tanning ServicesfalseIndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members19NbrVotingGoverningBodyMembers
Number Independent Voting Members14NumberIndependentVotingMembers
Family Or Business RelationshipfalseFamilyOrBusinessRelationship
Delegation Of Management DutiesfalseDelegationOfManagementDuties
Changes To Organizing DocsfalseChangesToOrganizingDocs
Material Diversion Or MisusefalseMaterialDiversionOrMisuse
Members Or StockholderstrueMembersOrStockholders
Election Of Board MemberstrueElectionOfBoardMembers
Decisions Subject To ApprovaltrueDecisionsSubjectToApproval
Minutes Of Governing BodytrueMinutesOfGoverningBody
Minutes Of CommitteestrueMinutesOfCommittees
Officer Mailing AddressfalseOfficerMailingAddress
Local ChaptersfalseLocalChapters
Form990 Provided To Governing BodytrueForm990ProvidedToGoverningBody
Conflict Of Interest PolicytrueConflictOfInterestPolicy
Annual Disclosure Covered PersonstrueAnnualDisclosureCoveredPersons
Regular Monitoring EnforcementtrueRegularMonitoringEnforcement
Whistleblower PolicytrueWhistleblowerPolicy
Document Retention PolicytrueDocumentRetentionPolicy
Compensation Process CEOtrueCompensationProcessCEO
Compensation Process OtherfalseCompensationProcessOther
Investment In Joint VenturefalseInvestmentInJointVenture
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonSENIOR VP - FISCALNamePerson
Telephone Number2077435933TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1181 MAIN STREETAddressLine1
CityNORWAYCity
StateMEState
ZIP Code04268ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (23 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekAverage Hours Per Week RelatedAverageHoursPerWeekRelatedIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationOfficerOfficerFormerFormer
GREGORY HARDY MD
TRUSTEE1.0059.00X035434134441
TIMOTHY CHURCHILL
PRESID & CEO5.0055.00X032039556198X
JAMES ESHLEMAN DO
MED STAFF PR1.0059.00X025941522304
WILLIAM L MEDD MD
TRUSTEE1.0059.00X02454344346
DAVID KUMAKI MD
TRUSTEE1.0059.00X022593322858
ALLEN CONNORS
TRUSTEE1.00X000
ANDREA BURNS
TRUSTEE1.00X000
PETER CHAPMAN
SECRETARY/TR1.00X000X
C BRADLEY CUMMINGS
TRUSTEE1.00X000
TOM MORTON
TRUSTEE1.00X000
LARRY FARMER OD
TRUSTEE1.00X000
DAVID HOISINGTON
CHAIR1.00X000X
REV ANNE STANLEY
TRUSTEE1.00X000
OLA MELHUS MD
TRUSTEE1.00X000
WENDY PENLEY
TRUSTEE1.00X000
LYNN HAMPER
TRUSTEE1.00X000
DAVID J PREBLE
VICE CHAIR1.00X000
TED MOCCIA
TRUSTEE1.00X000
ROBIN J ZINCHUK
TRUSTEE1.00X000
PAT WEIGEL
TRUSTEE1.00X000
JOHN COX
SR VP-FISCAL8.0042.00018907830028X
M PATRICIA COOK
SR VP-CLINIC1.0044.00015255240556X
KATHLEEN HERLIHY MD
TRUSTEE1.0059.00016006931582X
FieldValueIRS element (for citing)
Total Reportable Comp Frm Rltd Orgs1907217TotalReportableCompFrmRltdOrgs
Total Other Compensation242313TotalOtherCompensation
Formers ListedtrueFormersListed
Total Comp GT150 KtrueTotalCompGT150K
Compensation From Other SourcesfalseCompensationFromOtherSources

Contractor Compensation ContractorCompensation

Name Of Contractor NameOfContractor

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1SELECT REHABILITATIONBusinessNameLine1

Address Of Contractor AddressOfContractor

Address US AddressUS

FieldValueIRS element (for citing)
Address Line135338 EAGLE WAYAddressLine1
CityCHICAGOCity
StateILState
ZIP Code60678ZIPCode
FieldValueIRS element (for citing)
Description Of ServicesPT STAFFINGDescriptionOfServices
Compensation620429Compensation
FieldValueIRS element (for citing)
Number Of Contractors GT100 K1NumberOfContractorsGT100K
All Other Contributions509AllOtherContributions
Total Contributions509TotalContributions

Program Service Revenue ProgramServiceRevenue

FieldValueIRS element (for citing)
DescriptionPATIENT SERVICE REVENUEDescription
Business Code623000BusinessCode
Total Revenue Column6521187TotalRevenueColumn
Related Or Exempt Function Income6521187RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Program Service Revenue6521187TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column191TotalRevenueColumn
Exclusion$191ExclusionAmount

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Other77985Other

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Other-77985Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column-77985TotalRevenueColumn
Related Or Exempt Function Income-77985RelatedOrExemptFunctionIncome

Other Revenue Misc OtherRevenueMisc (2 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
OTHER REVENUE9000991356313563
MEAL DELIVERY PROGRAM62421032413241
FieldValueIRS element (for citing)
Total Other Revenue16804TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column6460706TotalRevenueColumn
Related Or Exempt Function Income6460006RelatedOrExemptFunctionIncome
Exclusion$191ExclusionAmount
FieldValueIRS element (for citing)
Info In Schedule O Part IXXInfoInScheduleOPartIX

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total3329483Total
Program Services3169354ProgramServices
Management And General160129ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total106994Total
Program Services101848ProgramServices
Management And General5146ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total741524Total
Program Services705861ProgramServices
Management And General35663ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total235019Total
Program Services223716ProgramServices
Management And General11303ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total22012Total
Management And General22012ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total1197291Total
Program Services1136954ProgramServices
Management And General60337ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total560Total
Program Services560ProgramServices

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total620383Total
Program Services615375ProgramServices
Management And General5008ManagementAndGeneral

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total18863Total
Program Services17956ProgramServices
Management And General907ManagementAndGeneral

Occupancy Occupancy

FieldValueIRS element (for citing)
Total229239Total
Program Services218214ProgramServices
Management And General11025ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total1072Total
Program Services1072ProgramServices

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total5471Total
Program Services5471ProgramServices

Interest Interest

FieldValueIRS element (for citing)
Total127275Total
Program Services121154ProgramServices
Management And General6121ManagementAndGeneral

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total213557Total
Program Services203286ProgramServices
Management And General10271ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total28274Total
Program Services6383ProgramServices
Management And General21891ManagementAndGeneral

Other Expenses OtherExpenses (3 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServices
PROVIDER TAX379832379832
MISCELLANEOUS2428124281
DUES AND SUBSCRIPTIONS130130

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total7281260Total
Program Services6931447ProgramServices
Management And General349813ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY370BOY
EOY370EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY56251BOY
EOY335071EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY956305BOY
EOY1184516EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY13887BOY
EOY12377EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY3660BOY
EOY2854EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
BOY289BOY
EOY348EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY98381BOY
EOY212644EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY1129143BOY
EOY1748180EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY511576BOY
EOY467038EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY106277BOY
EOY235406EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY617853BOY
EOY702444EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY511001BOY
EOY1045388EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY289BOY
EOY348EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY511290BOY
EOY1045736EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY1129143BOY
EOY1748180EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses-820554ReconcilationRevenueExpenses
Reconcilation Other Changes1355000ReconcilationOtherChanges
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or ReviewfalseAccountantCompileOrReview
FS AuditedtrueFSAudited

FS Audited Basis FSAuditedBasis

FieldValueIRS element (for citing)
Financial Statement ConsolidatedXFinancialStatementConsolidated
FieldValueIRS element (for citing)
Audit CommitteetrueAuditCommittee
Federal Grant Audit RequiredfalseFederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Publicly Supported Org509a2XPubliclySupportedOrg509a2

Gifts Grants Contrib Received509 GiftsGrantsContribReceived509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years180CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years10CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years2168CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year3379CurrentTaxYearMinus1Year
Current Tax Year509CurrentTaxYear
Total6246Total

Gross Receipts From Admissions GrossReceiptsFromAdmissions

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years6488950CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years6510309CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years6488370CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year6380644CurrentTaxYearMinus1Year
Current Tax Year6537991CurrentTaxYear
Total32406264Total

Total509 Total509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years6489130CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years6510319CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years6490538CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year6384023CurrentTaxYearMinus1Year
Current Tax Year6538500CurrentTaxYear
Total32412510Total
FieldValueIRS element (for citing)
Public Support Total50932412510PublicSupportTotal509

Gross Investment Income509 GrossInvestmentIncome509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years2404CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years695CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years317CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year312CurrentTaxYearMinus1Year
Current Tax Year191CurrentTaxYear
Total3919Total

Investment Income And UBTI InvestmentIncomeAndUBTI

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years2404CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years695CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years317CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year312CurrentTaxYearMinus1Year
Current Tax Year191CurrentTaxYear
Total3919Total

Total Support Total TotalSupportTotal

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years6491534CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years6511014CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years6490855CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year6384335CurrentTaxYearMinus1Year
Current Tax Year6538691CurrentTaxYear
Total32416429Total
FieldValueIRS element (for citing)
Public Support Percentage5090.99990PublicSupportPercentage509
Prior Year Support Percentage0.99980PriorYearSupportPercentage
Investment Income Percentage0.00000InvestmentIncomePercentage
Thirty Three Percnt Tests CY509XThirtyThreePercntTestsCY509

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
VolunteersfalseVolunteers
Paid Staff Or ManagementfalsePaidStaffOrManagement
Media AdvertisementsfalseMediaAdvertisements
Mailings MembersfalseMailingsMembers
Publications Or BroadcastfalsePublicationsOrBroadcast
Grants Other OrganizationsfalseGrantsOtherOrganizations
Direct Contact LegislatorsfalseDirectContactLegislators
Rallies DemonstrationsfalseRalliesDemonstrations
Other ActivitiestrueOtherActivities
Other Activities$1,967OtherActivitiesAmount
Total Lobbying Expenditures IIB1967TotalLobbyingExpendituresIIB
Not Described In501c3falseNotDescribedIn501c3

Form990 Schedule C Part IV Form990ScheduleCPartIV

FieldValueIRS element (for citing)
Return ReferenceSCHEDULE C, PART II-B, LINE 1ReturnReference
ExplanationALLOCATED PERCENTAGE OF MEMBERSHIP DUES PAID TO MAINE HEALTH CARE ASSOCIATION AND AMERICAN HEALTH CARE ASSOCIATION.Explanation

Schedule D IRS990ScheduleD

Current Year CurrentYear

FieldValueIRS element (for citing)
Beginning Of Year Balance289BeginningOfYearBalance
Contributions59Contributions
End Of Year Balance348EndOfYearBalance

Current Year Minus1 Year CurrentYearMinus1Year

FieldValueIRS element (for citing)
Beginning Of Year Balance1913BeginningOfYearBalance
Contributions289Contributions
Other Expenditures1913OtherExpenditures
End Of Year Balance289EndOfYearBalance

Current Year Minus2 Years CurrentYearMinus2Years

FieldValueIRS element (for citing)
Contributions1913Contributions
End Of Year Balance1913EndOfYearBalance

Current Year Minus3 Years CurrentYearMinus3Years

FieldValueIRS element (for citing)
Beginning Of Year Balance6235BeginningOfYearBalance
Other Expenditures6235OtherExpenditures

Current Year Minus4 Years CurrentYearMinus4Years

FieldValueIRS element (for citing)
Beginning Of Year Balance5235BeginningOfYearBalance
Contributions1000Contributions
End Of Year Balance6235EndOfYearBalance
FieldValueIRS element (for citing)
Term Endowment EOY Balance1.00000TermEndowmentEOYBalance
Endowments Held By Unrelated OrgsfalseEndowmentsHeldByUnrelatedOrgs
Endowments Held By Related OrgsfalseEndowmentsHeldByRelatedOrgs

Other Assets OtherAssets (4 entries)

DescriptionDescriptionBook ValueBookValue
CASH SURRENDER VALUE-LIFE INSURANCE88846
AR UNDER REIMBURSEMENT AGREEMENTS87251
DUE FROM AFFILIATE35949
OTHER598
FieldValueIRS element (for citing)
Total Book Value Other Assets212644TotalBookValueOtherAssets

Other Liabilities OtherLiabilities (3 entries)

DescriptionDescriptionAmountAmount
DUE TO AFFILIATES$222,394
PROFESSIONAL LIABILITY CLAIM ACCRUAL$13,012
AP UNDER REIMBURSEMENT AGREEMENTS
FieldValueIRS element (for citing)
Total Of Amounts235406TotalOfAmounts
Footnote In Part XIIIXFootnoteInPartXIII

Form990 Schedule D Part XIII Form990ScheduleDPartXIII (2 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
INTENDED USES FOR ENDOWMENT FUNDSSCHEDULE D, PAGE 2, PART V, LINE 4TEMPORARILY RESTRICTED GIFTS ARE UTILIZED ACCORDING TO SPECIFIC DONOR STIPULATIONS. THESE INCLUDE EXPENDITURES FOR CAPITAL IMPROVEMENTS.
LIABILITY UNDER FIN 48 FOOTNOTESCHEDULE D, PAGE 3, PART XTHE ORGANIZATION IS A NOT-FOR-PROFIT CORPORATION AND HAS BEEN RECOGNIZED AS TAX EXEMPT PURAUANT TO SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. THE ORGANIZATION HAS EVALUATED THE POSITION TAKEN ON ITS FILED TAX RETURNS. THE ORGANIZATION HAS CONCLUDED THAT NO UNCERTAIN TAX POSITIONS EXIST AT SEPTEMBER 30, 2013. THE ORGANIZATION'S TAX RETURNS FROM 2011 THROUGH 2013 MAY BE SUBJECT TO EXAMINATION.

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation CommitteeXCompensationCommittee
Independent ConsultantXIndependentConsultant
Written Employment ContractXWrittenEmploymentContract
Compensation SurveyXCompensationSurvey
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance PaymentfalseSeverancePayment
Supplemental Nonqual Retire PlanfalseSupplementalNonqualRetirePlan
Equity Based Comp ArrangementfalseEquityBasedCompArrangement
Comp Based On Revenue Of Filing OrgfalseCompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related OrgsfalseCompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing OrgfalseCompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate OrgsfalseCompBasedNetEarningsRelateOrgs
Any Non Fixed PaymentsfalseAnyNonFixedPayments
Initial Contract ExceptionfalseInitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (8 entries)

TitleTitleComp Based On Related OrgsCompBasedOnRelatedOrgsOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Related OrgsTotalCompensationRelatedOrgsBonus Related OrgsBonusRelatedOrgs
GREGORY HARDY MD
TRUSTEE282136722051116223279388782
TIMOTHY CHURCHILL
PRESID & CEO26050018895273852881337659341000
JAMES ESHLEMAN DO
MED STAFF PRESIDENT180000680112230428171911404
WILLIAM L MEDD MD
TRUSTEE225000204344346249780
DAVID KUMAKI MD
TRUSTEE22500093322858248791
JOHN COX
SR VP-FISCAL17224316835767622352219106
M PATRICIA COOK
SR VP-CLINICAL135141174111874721809193108
KATHLEEN HERLIHY MD
TRUSTEE1545005569972521857191651

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (9 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
CLASSES OF MEMBERS OR STOCKHOLDERSFORM 990, PAGE 6, PART VI, LINE 6WESTERN MAINE HEALTH CARE, CORP. (EIN 01-0411788) IS THE SOLE MEMBER OF THE ORGANIZATION.
ELECTION OF MEMBERS AND THEIR RIGHTSFORM 990, PAGE 6, PART VI, LINE 7ATHE SOLE MEMBER HAS THE RESPONSIBILITY FOR THE ELECTION OF THE MEMBERS OF THE GOVERNING BODY.
DECISIONS SUBJECT TO APPROVAL OF MEMBERSFORM 990, PAGE 6, PART VI, LINE 7BALL DECISIONS BY THE WESTERN MAINE NUSING HOME, INC.'S GOVERNING BODY ARE APPROVED BY DEFAULT BY THE MEMBER ORGANIZATION'S GOVERNING BODY. THIS IS BECAUSE THESE TWO ORGANIZATIONS SHARE A COMMON GOVERNING BODY.
ORGANIZATION'S PROCESS USED TO REVIEW FORM 990FORM 990, PAGE 6, PART VI, LINE 11BTHE 990 WAS REVIEWED IN DETAIL BY A COMMITTEE OF THE BOARD OF TRUSTEES. THE PRESIDENT AND SENIOR VICE PRESIDENT - FISCAL LED THE DISCUSSION. SUBSEQUENT TO THAT REVIEW, A COPY OF THE ORGANIZATION'S 990 WAS DISTRIBUTED TO ALL TRUSTEES. THE 990 WAS REVIEWED IN SUMMARY AT A BOARD MEETING PRIOR TO FILING.
ENFORCEMENT OF CONFLICTS POLICYFORM 990, PAGE 6, PART VI, LINE 12CCONFLICT OF INTEREST STATEMENTS ARE OBTAINED ANNUALLY. THE PRESIDENT'S OFFICE COLLECTS AND REVIEWS THE RESPONSES. WHERE ANY REAL OR PERCEIVED CONFLICTS EXIST, OFFICERS AND TRUSTEES ARE EXPECTED TO RECUSE THEMSELVES (1) FROM MEETINGS DURING TIMES WHEN THE TOPICS OF POTENTIAL CONFLICT ARE DISCUSSED AND (2) FROM VOTING ON SUCH MATTERS. KEY EMPLOYEES MAY NOT USE THEIR POSITIONS TO PROFIT PERSONALLY OR TO ASSIST OTHERS IN PROFITING IN ANY WAY AT THE EXPENSE OF WESTERN MAINE NURSING HOME, INC.
COMPENSATION PROCESS FOR TOP OFFICIALFORM 990, PAGE 6, PART VI, LINE 15ATHE PARENT COMPANY OF WESTERN MAINE NURSING HOME, INC. IS WESTERN MAINE HEALTH CARE, CORP. (EIN 01-0411788) WHO THROUGH ITS PARENT COMPANY MAINEHEALTH, HAS A FORMAL WRITTEN COMPENSATION POLICY IN PLACE. IN CONSULTATION WITH SULLIVAN COTTER, THE MAINEHEALTH BOARD COMPENSATION COMMITTEE ESTABLISHES APPROPRIATE COMPENSATION PARAMETERS FOR EACH ORGANIZATION'S CEO AND CERTAIN MEMBERS OF THEIR SENIOR MANAGEMENT TEAM. WORKING WITHIN THESE PARAMETERS, THE WESTERN MAINE HEALTH CARE BOARD DETERMINES THE LEVEL OF COMPENSATION FOR ITS CEO. THE FINDINGS OF THE COMPENSATION COMMITTEE ARE MADE TRANSPARENT TO, AND VOTED ON BY, THE FULL GOVERNING BOARD. THE "TOTAL EXECUTIVE COMPENSATION" IS FILED PUBLICLY BY THE ORGANIZATION, AND INCLUDES "TOTAL CASH COMPENSATION" AND "TOTAL VALUE OF ALL BENEFITS AND PERQUISITES" ASSOCIATED WITH THE POSITION. THE BOARD TAKES NECESSARY ACTION TO PREVENT THE CEO FROM VOTING OR DIRECTLY PARTICIPATING IN THE FINAL COMMITTEE DETERMINATION OF HIS OWN COMPENSATION. THE ORGANIZATION'S EXECUTIVE COMPENSATION PROCEDURES RELY UPON APPROPRIATE DATA FOR COMPARABILITY (E.G. COMPENSATION LEVELS PAID BY BOTH TAXABLE AND TAX-EXEMPT SIMILARLY SITUATED ORGANIZATIONS AND INDEPENDENT SURVEYS BY NATIONALLY RECOGNIZED INDEPENDENT FIRMS). FINALLY, THE ORGANIZATION REFRAINS FROM ALLOWING EXECUTIVE COMPENSATION TO EVER BE BASED SOLELY ON WESTERN MAINE HEALTH CARE, CORP.'S REVENUES OR OTHER SIMILAR PROFIT-SHARING STRATEGIES.
GOVERNING DOCUMENTS DISCLOSURE EXPLANATIONFORM 990, PAGE 6, PART VI, LINE 19DOCUMENTS THAT ARE REQUIRED TO BE OPEN FOR PUBLIC INSPECTION ARE MADE AVAILABLE UPON REQUEST.
OTHER FEES FOR SERVICESFORM 990, PART IX, LINE 11GNURSING SERVICES 305,875 0 0 PT, OT AND ST SVCS 585,056 0 0 MEDICAL SERVICES 232,526 0 0 PHARMACY 8,354 0 0 PAYROLL AND ADMIN SVCS 0 60,337 0 OTHER 5,143 0 0
OTHER CHANGES IN NET ASSETS EXPLANATIONFORM 990, PART XI, LINE 9EQUITY TRANSFER FROM AFFILIATES 1,355,000

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (6 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Controlled OrgControlledOrg
WESTERN MAINE HEALTH CARE CORP
181 MAIN STREETNORWAYME04268010411788HEALTHCAREME501C311CMEHEALTHfalse
MAINEHEALTH
110 FREE STREETPORTLANDME04101010431680HEALTHCAREME501C311CNAfalse
WESTERN MAINE MULTI-MEDICAL SPECIAL
181 MAIN STREETNORWAYME04268010489824PHYS PRACTME501C33WMHCCfalse
STEPHENS MEMORIAL HOSPITAL ASSOC
181 MAIN STREETNORWAYME04268010219904HOSPITALME501C33WMHCCfalse
STEPHENS COMMUNITY HEALTHCARE FOUND
181 MAIN STREETNORWAYME04268311644144SUPP ORGME501C311AWMHCCfalse
CHAPEL VALLEY BOARDING HOME CORP
181 MAIN STREETNORWAYME04268010433206HEALTHCAREME501C37WMHCCfalse
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents RoyaltiesfalseReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other OrgfalseGiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other OrgfalseGiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other OrgfalseLoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other OrgfalseLoansOrGuaranteesFromOtherOrg
Dividends Related OrganizationfalseDividendsRelatedOrganization
Sale Of Assets To Other OrgfalseSaleOfAssetsToOtherOrg
Purchase Of Assets From Other OrgfalsePurchaseOfAssetsFromOtherOrg
Exchange Of AssetsfalseExchangeOfAssets
Rental Of Facilities To Other OrgsfalseRentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other OrgsfalseRentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other OrgsfalsePerformOfServicesForOtherOrgs
Perform Of Services By Other OrgsfalsePerformOfServicesByOtherOrgs
Sharing Of FacilitiesfalseSharingOfFacilities
Sharing Of Paid EmployeesfalseSharingOfPaidEmployees
Reimbursement Paid To Other OrgtrueReimbursementPaidToOtherOrg
Reimbursement Paid By Other OrgtrueReimbursementPaidByOtherOrg
Other Transfer To Other OrgfalseOtherTransferToOtherOrg
Other Transfer From Other OrgtrueOtherTransferFromOtherOrg