LINCOLNHEALTH: Form 990, tax year 2012
View the entire original 990 at ProPublica ↗
- Organization
- LINCOLNHEALTH (EIN 01-0153960)
- Tax period
- 2012-10-01 to 2013-09-30
- Filed
- 2014-08-04
- IRS object ID
- 201412169349300631
- 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
- Form 990
- Schedule A
- Schedule B
- Schedule C
- Schedule D
- Schedule H
- Schedule J
- Schedule K
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2014-08-04T15:55:34-05:00 | Timestamp |
| Tax Period End Date | 2013-09-30 | 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 | 2012-10-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 010153960 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ST ANDREWS HOSPITAL | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | STAN | NameControl |
| Phone | 2076338413 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 6 ST ANDREWS LANE | AddressLine1 |
| City | BOOTHBAY HARBOR | City |
| State | ME | State |
| ZIP Code | 04538 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | WAYNE PRINTY | Name |
| Title | CFO | Title |
| Phone | 2076338413 | Phone |
| Date Signed | 2014-06-12 | DateSigned |
| Authorize Third Party | false | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Date Prepared | 2014-08-04 | DatePrepared |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2012 | TaxYear |
| Build TS | 2015-11-30 17:44:51Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | WAYNE PRINTY CFO | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 35 MILES STREET | AddressLine1 |
| City | DARMARISCOTTA | City |
| State | ME | State |
| ZIP Code | 04543 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 18047500 | GrossReceipts |
| Group Return For Affiliates | false | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | WWW.LCHCARE.ORG | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1955 | YearFormation |
| State Legal Domicile | ME | StateLegalDomicile |
| Activity Or Mission Description | - TO ESTABLISH, OPERATE, & MAINTAIN FOR SCIENTIFIC, CHARITABLE, EDUCATIONAL & BENEVOLENT PURPOSES A PUBLIC HOSPITAL, CLINIC, INFIRMARY & RETIREMENT COMMUNITY FOR THE CARE & TREATMENT OF SICK, WOUNDED, INFIRM OR AGED PERSONS, A DOCTOR'S OFFICE BUILDING & A SCHOOL FOR THE EDUCATION & TRAINING OF NURSES, ALL WITHOUT DISCRIMINATION AS TO RACE, COLOR, CREED, NATIONAL ORIGIN, AGE, GENDER, SEXUAL ORIENTATION OR FINANCIAL STATUS. - TO BE OPERATED & MAINTAINED AS A CRITICAL ACCESS HOSPITAL IN ACCORDANCE WITH THE STANDARDS ESTABLISHED FROM TIME TO TIME FOR THE MEDICARE RURAL HOSPITAL FLEXIBILITY PROGRAM. - TO ENCOURAGE & CARRY ON EDUCATIONAL ACTIVITIES PURSUANT TO CONTINUALLY IMPROVING THE QUALITY OF CARE PROVIDED. - TO COOPERATE & PARTICIPATE WITH ALLIED AGENCIES IN ALL ACTIVITIES DESIGNED TO PROMOTE THE GENERAL HEALTH OF THE COMMUNITY IN THE AREAS SERVED BY THE HOSPITAL. - THIS CORPORATION SHALL NOT BE CONDUCTED FOR GAIN OR PROFIT, & NO PART OF THE NET EARNINGS SHALL INURE TO THE BENEFIT OF AN | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 21 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 14 | NbrIndependentVotingMembers |
| Total Nbr Employees | 240 | TotalNbrEmployees |
| Total Nbr Volunteers | 86 | TotalNbrVolunteers |
| Total Gross UBI | 154964 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | -70816 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 368279 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 504552 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 17332784 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 16557807 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 254681 | InvestmentIncomePriorYear |
| Investment Income Current Year | 128551 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 467919 | OtherRevenuePriorYear |
| Other Revenue Current Year | 271321 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 18423663 | TotalRevenuePriorYear |
| Total Revenue Current Year | 17462231 | TotalRevenueCurrentYear |
| Grants And Similar Amnts CY | 0 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 8534635 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 7887639 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 49986 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 10063950 | OtherExpensePriorYear |
| Other Expenses Current Year | 10236760 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 18598585 | TotalExpensesPriorYear |
| Total Expenses Current Year | 18124399 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | -174922 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | -662168 | RevenuesLessExpensesCY |
| Total Assets BOY | 28420254 | TotalAssetsBOY |
| Total Assets EOY | 28467777 | TotalAssetsEOY |
| Total Liabilities BOY | 14014297 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 14232371 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 14405957 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 14235406 | NetAssetsOrFundBalancesEOY |
| Info In Schedule O Part III | X | InfoInScheduleOPartIII |
| Mission Description | - TO ESTABLISH, OPERATE, & MAINTAIN FOR SCIENTIFIC, CHARITABLE, EDUCATIONAL & BENEVOLENT PURPOSES A PUBLIC HOSPITAL, CLINIC, INFIRMARY & RETIREMENT COMMUNITY FOR THE CARE & TREATMENT OF SICK, WOUNDED, INFIRM OR AGED PERSONS, A DOCTOR'S OFFICE BUILDING & A SCHOOL FOR THE EDUCATION & TRAINING OF NURSES, ALL WITHOUT DISCRIMINATION AS TO RACE, COLOR, CREED, NATIONAL ORIGIN, AGE, GENDER, SEXUAL ORIENTATION OR FINANCIAL STATUS. - TO BE OPERATED & MAINTAINED AS A CRITICAL ACCESS HOSPITAL IN ACCORDANCE WITH THE STANDARDS ESTABLISHED FROM TIME TO TIME FOR THE MEDICARE RURAL HOSPITAL FLEXIBILITY PROGRAM. - TO ENCOURAGE & CARRY ON EDUCATIONAL ACTIVITIES PURSUANT TO CONTINUALLY IMPROVING THE QUALITY OF CARE PROVIDED. - TO COOPERATE & PARTICIPATE WITH ALLIED AGENCIES IN ALL ACTIVITIES DESIGNED TO PROMOTE THE GENERAL HEALTH OF THE COMMUNITY IN THE AREAS SERVED BY THE HOSPITAL. - THIS CORPORATION SHALL NOT BE CONDUCTED FOR GAIN OR PROFIT, & NO PART OF THE NET EARNINGS SHALL INURE TO THE BENEFIT OF AN | MissionDescription |
| Significant New Program Services | false | SignificantNewProgramServices |
| Significant Change | false | SignificantChange |
| Expense | 11693972 | Expense |
| Revenue | 11203007 | Revenue |
| Description | ST. ANDREWS HOSPITAL IS A 25 BED CRITICAL ACCESS HOSPITAL. THE HOSPITAL OPERATIONS PROVIDE BOTH ACUTE CARE AND REHABILITATIVE CARE IN ITS INPATIENT SETTING. OUTPATIENT SERVICES INCLUDE EMERGENCY CARE, PHYSICAL THERAPY, OCCUPATIONAL THERAPY, SPEECH THERAPY, CARDIOPULMONARY SERVICES, DIAGNOSTIC IMAGING, LABORATORY, AND PHARMACY. (CONTINUED ON SCHEDULE O) PATIENT DAYS: ADULT & CHILDREN: 2,962 NURSING FACILITY: 10,481 DISCHARGES: 224 DEPARTMENT AMOUNT STATISTICS LABORATORY 24,510 TESTS CARDIOPULMONARY 1,090 PROCEDURES CT SCANS 978 PROCEDURES RADIOLOGY 2,333 PROCEDURES REHABILITATION SERVICES 6,553 VISITS PLEASE SEE ATTACHED COMMUNITY BENEFITS STATEMENT | Description |
Activity2 Activity2
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 4914968 | Expense |
| Revenue | 5354800 | Revenue |
| Description | ST. ANDREWS HOSPITAL OFFERS LONG TERM CARE SERVICES AT ST. ANDREWS VILLAGE COMMUNITY. IT INCLUDES 13 ASSISTED LIVING UNITS, 28 INDEPENDENT LIVING APARTMENTS, 11 DEMENTIA CARE BEDS, ADULT DAY SERVICES, AND 30 LONG-TERM CARE BEDS. STATISTICS FOR THE YEAR: ASSISTED LIVING 4,192 DAYS, INDEPENDENT LIVING 7,953 DAYS, DEMENTIA CARE 3,790 DAYS, AND ADULT DAY SERVICES 542 HOURS. | Description |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expense | 16608940 | 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 | false | ReportInvestOthSecurities |
| Report Prog Rel Invest | false | ReportProgRelInvest |
| Report Other Assets | true | ReportOtherAssets |
| Report Other Liabilities | true | ReportOtherLiabilities |
| Report Fin48 Footnote | false | 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 | false | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | false | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | false | 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 | 0 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Number Of Employees | 240 | 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 | 21 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 14 | NumberIndependentVotingMembers |
| Family Or Business Relationship | false | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | false | DelegationOfManagementDuties |
| Changes To Organizing Docs | false | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuse |
| Members Or Stockholders | true | MembersOrStockholders |
| Election Of Board Members | true | ElectionOfBoardMembers |
| Decisions Subject To Approval | true | DecisionsSubjectToApproval |
| Minutes Of Governing Body | true | MinutesOfGoverningBody |
| Minutes Of Committees | true | MinutesOfCommittees |
| Officer Mailing Address | false | OfficerMailingAddress |
| Local Chapters | false | LocalChapters |
| 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 | CFO | NamePerson |
| Telephone Number | 2076338413 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 6 ST ANDREWS LANE | AddressLine1 |
| City | BOOTHBAY HARBOR | City |
| State | ME | State |
| ZIP Code | 04538 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (25 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 | FormerFormer |
|---|---|---|---|---|---|---|---|---|---|
| GARTH MILLER MD | |||||||||
| TRUSTEE | 0.40 | 50.00 | X | 0 | 465323 | 28976 | |||
| MARK FOURRE MD | |||||||||
| TRUSTEE | 0.40 | 50.00 | X | 0 | 290300 | 27814 | |||
| JOHN MURRAY MD | |||||||||
| TRUSTEE | 0.40 | 50.00 | X | 0 | 250109 | 26033 | |||
| AQUILINO ALAMO MD | |||||||||
| TRUSTEE | 0.40 | 50.00 | X | 0 | 216819 | 26144 | |||
| STEVEN FEDER DO | |||||||||
| TRUSTEE | 0.40 | 50.00 | X | 0 | 159524 | 22705 | |||
| DANIEL FRIEDLAND MD | |||||||||
| TRUSTEE | 0.40 | 50.00 | X | 0 | 159151 | 26633 | |||
| ROBERT MCARTOR MD | |||||||||
| TRUSTEE | 0.40 | 50.00 | X | 0 | 157259 | 42548 | |||
| LESLIE BIRD | |||||||||
| TRUSTEE | 0.40 | X | 0 | 0 | 0 | ||||
| DAVID LAWRENCE | |||||||||
| TRUSTEE | 0.40 | X | 0 | 0 | 0 | ||||
| WILLIAM LOGAN | |||||||||
| SECRETARY | 0.40 | X | 0 | 0 | 0 | X | |||
| PETER MUNDY | |||||||||
| CHAIRMAN | 0.40 | X | 0 | 0 | 0 | X | |||
| MICHAEL CLARK MD | |||||||||
| TRUSTEE | 0.40 | X | 0 | 0 | 0 | ||||
| JAMES COSGROVE | |||||||||
| TRUSTEE | 0.40 | X | 0 | 0 | 0 | ||||
| BARBARA MITCHELL | |||||||||
| TRUSTEE | 0.40 | X | 0 | 0 | 0 | ||||
| CATHERINE GREGG | |||||||||
| TRUSTEE | 0.40 | X | 0 | 0 | 0 | ||||
| JANE G SMITH | |||||||||
| TRUSTEE | 0.40 | X | 0 | 0 | 0 | ||||
| JANE HURD | |||||||||
| TRUSTEE | 0.40 | X | 0 | 0 | 0 | ||||
| JEFFREY CURTIS | |||||||||
| VICE-CHAIRMA | 0.40 | X | 0 | 0 | 0 | X | |||
| NORMAN HOCHGRAF | |||||||||
| TRUSTEE | 0.40 | X | 0 | 0 | 0 | ||||
| PATRICK LYDON | |||||||||
| TREASURER | 0.40 | X | 0 | 0 | 0 | X | |||
| REV DR MARY JO ZIMMERLI | |||||||||
| TRUSTEE | 0.40 | X | 0 | 0 | 0 | ||||
| JAMES DONOVAN | |||||||||
| CEO LCH | 3.00 | 50.00 | 0 | 334958 | 29796 | X | |||
| WAYNE PRINTY | |||||||||
| CFO | 3.00 | 50.00 | 0 | 206034 | 25032 | X | |||
| PATRICE CARTER | |||||||||
| PHARMACIST | 50.00 | 139417 | 0 | 21383 | X | ||||
| ALAN BARKER MD | |||||||||
| FORMER TRUST | 50.00 | 0 | 135472 | 22395 | X | ||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 139417 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 2374949 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 299459 | TotalOtherCompensation |
| Number Individuals GT100 K | 1 | NumberIndividualsGT100K |
| Formers Listed | true | FormersListed |
| Total Comp GT150 K | true | TotalCompGT150K |
| Compensation From Other Sources | false | CompensationFromOtherSources |
| Government Grants | 19576 | GovernmentGrants |
| All Other Contributions | 484976 | AllOtherContributions |
| Total Contributions | 504552 | TotalContributions |
Program Service Revenue ProgramServiceRevenue (2 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome |
|---|---|---|---|
| NET PATIENT REVENUE | 623000 | 16188391 | 16188391 |
| RENTAL INCOME | 531390 | 369416 | 369416 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 16557807 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 80293 | TotalRevenueColumn |
| Exclusion | $80,293 | ExclusionAmount |
Gross Rents GrossRents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 16037 | Real |
Rental Income Or Loss RentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 16037 | Real |
Net Rental Income Or Loss NetRentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 16037 | TotalRevenueColumn |
| Unrelated Business Revenue | 16037 | UnrelatedBusinessRevenue |
Gross Amount Sales Assets GrossAmountSalesAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 611984 | Securities |
| Other | 21543 | Other |
Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 562923 | Securities |
| Other | 22346 | Other |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 49061 | Securities |
| Other | -803 | Other |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 48258 | TotalRevenueColumn |
| Related Or Exempt Function Income | 48258 | RelatedOrExemptFunctionIncome |
Other Revenue Misc OtherRevenueMisc (3 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome | Unrelated Business RevenueUnrelatedBusinessRevenue |
|---|---|---|---|---|
| MISCELLANEOUS INCOME | 900099 | 116357 | 116357 | |
| COTTAGE SERVICES | 531310 | 107776 | 107776 | |
| MANAGEMENT FEES | 531310 | 23723 | 23723 |
Miscellaneous Revenue MiscellaneousRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 7428 | TotalRevenueColumn |
| Unrelated Business Revenue | 7428 | UnrelatedBusinessRevenue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 255284 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 17462231 | TotalRevenueColumn |
| Related Or Exempt Function Income | 16722422 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 154964 | UnrelatedBusinessRevenue |
| Exclusion | $80,293 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | X | InfoInScheduleOPartIX |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 6243637 | Total |
| Program Services | 6239782 | ProgramServices |
| Management And General | 3855 | ManagementAndGeneral |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 145362 | Total |
| Program Services | 143908 | ProgramServices |
| Management And General | 1454 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1060325 | Total |
| Program Services | 1049722 | ProgramServices |
| Management And General | 10603 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 438315 | Total |
| Program Services | 433932 | ProgramServices |
| Management And General | 4383 | ManagementAndGeneral |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 502 | Total |
| Program Services | 502 | ProgramServices |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3294052 | Total |
| Program Services | 3202400 | ProgramServices |
| Management And General | 91652 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 16844 | Total |
| Program Services | 16844 | ProgramServices |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1011067 | Total |
| Program Services | 930523 | ProgramServices |
| Management And General | 80544 | ManagementAndGeneral |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 339048 | Total |
| Management And General | 339048 | ManagementAndGeneral |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 626290 | Total |
| Program Services | 584662 | ProgramServices |
| Management And General | 41628 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 18578 | Total |
| Program Services | 18578 | ProgramServices |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 477943 | Total |
| Program Services | 476629 | ProgramServices |
| Management And General | 1314 | ManagementAndGeneral |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1210253 | Total |
| Program Services | 1210253 | ProgramServices |
Other Expenses OtherExpenses (4 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral | FundraisingFundraising |
|---|---|---|---|---|
| INTEGRATED SERVICES | 1940069 | 999204 | 890879 | 49986 |
| HOSPITAL & PROVIDER TAXES | 520238 | 520238 | ||
| FOOD | 373584 | 373569 | 15 | |
| MISCELLANEOUS | 371576 | 371478 | 98 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 36716 | Total |
| Program Services | 36716 | ProgramServices |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 18124399 | Total |
| Program Services | 16608940 | ProgramServices |
| Management And General | 1465473 | ManagementAndGeneral |
| Fundraising | 49986 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 381343 | BOY |
| EOY | 291348 | EOY |
Pledges And Grants Receivable PledgesAndGrantsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 188818 | BOY |
| EOY | 76638 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1740671 | BOY |
| EOY | 1634333 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 187079 | BOY |
| EOY | 162883 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 78852 | BOY |
| EOY | 112001 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 31815218 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 15268725 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 17253074 | BOY |
| EOY | 16546493 | EOY |
Investments Pub Traded Securities InvestmentsPubTradedSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 6959386 | BOY |
| EOY | 6751154 | EOY |
Investments Other Securities InvestmentsOtherSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 563596 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1631031 | BOY |
| EOY | 2329331 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 28420254 | BOY |
| EOY | 28467777 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 787474 | BOY |
| EOY | 1458324 | EOY |
Deferred Revenue DeferredRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 185938 | BOY |
| EOY | 71511 | EOY |
Tax Exempt Bond Liabilities TaxExemptBondLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 7220776 | BOY |
| EOY | 6884019 | EOY |
Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3500958 | BOY |
| EOY | 3648259 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2319151 | BOY |
| EOY | 2170258 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 14014297 | BOY |
| EOY | 14232371 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 13601259 | BOY |
| EOY | 13362655 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 121618 | BOY |
| EOY | 161971 | EOY |
Permanently Restricted Net Assets PermanentlyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 683080 | BOY |
| EOY | 710780 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 14405957 | BOY |
| EOY | 14235406 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 28420254 | BOY |
| EOY | 28467777 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | -662168 | ReconcilationRevenueExpenses |
| Reconciliation Unrealized Invest | 397906 | ReconciliationUnrealizedInvest |
| Reconcilation Other Changes | 93711 | 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 | false | FederalGrantAuditRequired |
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 | false | 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 | $6,565 | OtherActivitiesAmount |
| Total Lobbying Expenditures IIB | 6565 | 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 | PORTION OF MEMBERSHIP DUES ATTRIBUTABLE TO LOBBYING ACTIVITIES: LOBBYING PORTION OF MAINE HOSPITAL ASSOCIATION DUES: 3,693 LOBBYING PORTION OF AMERICAN HOSPITAL ASSOCIATION DUES: 1,537 LOBBYING PORTION OF MAINE HEALTH CARE ASSOCIATION: 1,108 LOBBYING PORTION OF AMERICAN HEALTH CARE ASSOCIATION: 227 | Explanation |
Schedule D IRS990ScheduleD
Current Year CurrentYear
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 5210719 | BeginningOfYearBalance |
| Contributions | 375829 | Contributions |
| Investment Earnings Or Losses | 562818 | InvestmentEarningsOrLosses |
| Other Expenditures | -6340 | OtherExpenditures |
| Administrative Expenses | -21659 | AdministrativeExpenses |
| End Of Year Balance | 6121367 | EndOfYearBalance |
Current Year Minus1 Year CurrentYearMinus1Year
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 4545019 | BeginningOfYearBalance |
| Contributions | 900 | Contributions |
| Investment Earnings Or Losses | 720113 | InvestmentEarningsOrLosses |
| Other Expenditures | -36580 | OtherExpenditures |
| Administrative Expenses | -18733 | AdministrativeExpenses |
| End Of Year Balance | 5210719 | EndOfYearBalance |
Current Year Minus2 Years CurrentYearMinus2Years
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 4402289 | BeginningOfYearBalance |
| Contributions | 70055 | Contributions |
| Investment Earnings Or Losses | 91209 | InvestmentEarningsOrLosses |
| Administrative Expenses | -18534 | AdministrativeExpenses |
| End Of Year Balance | 4545019 | EndOfYearBalance |
Current Year Minus3 Years CurrentYearMinus3Years
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 3797878 | BeginningOfYearBalance |
| Investment Earnings Or Losses | 585966 | InvestmentEarningsOrLosses |
| Other Expenditures | 34289 | OtherExpenditures |
| Administrative Expenses | -15844 | AdministrativeExpenses |
| End Of Year Balance | 4402289 | EndOfYearBalance |
Current Year Minus4 Years CurrentYearMinus4Years
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 3708727 | BeginningOfYearBalance |
| Contributions | 77640 | Contributions |
| Investment Earnings Or Losses | 87588 | InvestmentEarningsOrLosses |
| Other Expenditures | -62499 | OtherExpenditures |
| Administrative Expenses | -13578 | AdministrativeExpenses |
| End Of Year Balance | 3797878 | EndOfYearBalance |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Designated EOY Balance | 0.90790 | BoardDesignatedEOYBalance |
| Permanent Endowment EOY Balance | 0.09210 | PermanentEndowmentEOYBalance |
| Endowments Held By Unrelated Orgs | true | EndowmentsHeldByUnrelatedOrgs |
| Endowments Held By Related Orgs | false | EndowmentsHeldByRelatedOrgs |
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 669009 | OtherCostOrOtherBasis |
| Book Value | 669009 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 21212689 | OtherCostOrOtherBasis |
| Depreciation | 7610696 | Depreciation |
| Book Value | 13601993 | BookValue |
Leasehold Improvements LeaseholdImprovements
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 55933 | OtherCostOrOtherBasis |
| Depreciation | 55933 | Depreciation |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 7407757 | OtherCostOrOtherBasis |
| Depreciation | 5713586 | Depreciation |
| Book Value | 1694171 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 2469830 | OtherCostOrOtherBasis |
| Depreciation | 1888510 | Depreciation |
| Book Value | 581320 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 16546493 | TotalOfBookValueLandBuildings |
Other Assets OtherAssets (5 entries)
| DescriptionDescription | Book ValueBookValue |
|---|---|
| DUE FROM AFFILIATE | 1531031 |
| INVESTMENT IN LCH & LCM | 597000 |
| PATIENT AND OTHER DEPOSITS | 107377 |
| DEFERRED FINANCING COSTS | 78307 |
| OTHER ASSETS | 15616 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | 2329331 | TotalBookValueOtherAssets |
Other Liabilities OtherLiabilities (6 entries)
| DescriptionDescription | AmountAmount |
|---|---|
| DUE TO AFFILIATE | $1,043,400 |
| AMOUNTS PAYABLE UNDER REIMB. REGS. | $897,000 |
| DEPOSITS PAYABLE | $107,377 |
| MALPRATICE INSURANCE RESERVE | $49,810 |
| OTHER LIABILITIES | $47,671 |
| ASSET RETIREMENT OBLIGATIONS | $25,000 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 2170258 | TotalOfAmounts |
Form990 Schedule D Part XIII Form990ScheduleDPartXIII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | SUPPLEMENTAL FINANCIAL INFORMATION | Identifier |
| Return Reference | SCHEDULE D, PAGE 4, PART XIII | ReturnReference |
| Explanation | ENDOWMENT FUNDS CONSIST OF A BENEFICIAL INTEREST IN PERPETUAL TRUST, BOARD DESIGNATED FUNDS, AND BEQUESTS THAT HAVE BEEN VOTED ON BY THE BOARD OF TRUSTEES TO BE UNRESTRICTED ENDOWMENT FUNDS. | Explanation |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Charity Care Policy | true | CharityCarePolicy |
| Written Policy | true | WrittenPolicy |
| FPG Reference Free Care | true | FPGReferenceFreeCare |
Other Percentage OtherPercentage
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | X | Other |
| Free Other Percentage | 1.75000 | FreeOtherPercentage |
| Field | Value | IRS element (for citing) |
|---|---|---|
| FPG Reference Discounted Care | true | FPGReferenceDiscountedCare |
Discounted Other DiscountedOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | X | Other |
| Discounted Other Percentage | 2.25000 | DiscountedOtherPercentage |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Free Disc Care Medically Indigent | true | FreeDiscCareMedicallyIndigent |
| Amounts Budgeted For Charity Care | true | AmountsBudgetedForCharityCare |
| Expenses Exceeded Budget | true | ExpensesExceededBudget |
| Unable To Provide Care | false | UnableToProvideCare |
| Annual Community Benefit Report | true | AnnualCommunityBenefitReport |
| Report Publically Available | true | ReportPublicallyAvailable |
Charity Care At Cost CharityCareAtCost
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 311371 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 311371 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.01720 | PercentOfTotalExpense |
Unreimbursed Medicaid UnreimbursedMedicaid
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 3419158 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 2215941 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 1203217 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.06640 | PercentOfTotalExpense |
Total Charity Care TotalCharityCare
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 3730529 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 2215941 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 1514588 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.08360 | PercentOfTotalExpense |
Community Health Services CommunityHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 10547 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 10547 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00030 | PercentOfTotalExpense |
Health Professions Education HealthProfessionsEducation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 18370 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 18370 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00100 | PercentOfTotalExpense |
Subsidized Health Services SubsidizedHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 14023 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 1770 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 12253 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00070 | PercentOfTotalExpense |
Cash And In Kind Contributions CashAndInKindContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 273150 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 273150 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.01510 | PercentOfTotalExpense |
Total Other Benefits TotalOtherBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 316090 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 1770 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 314320 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.01710 | PercentOfTotalExpense |
Total Community Benefits TotalCommunityBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 4046619 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 2217711 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 1828908 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.10070 | PercentOfTotalExpense |
Community Support CommunitySupport
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Building Expense | 5164 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 5164 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00030 | PercentOfTotalExpense |
Total Total
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Building Expense | 5164 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 5164 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00030 | PercentOfTotalExpense |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | false | BadDebtExpenseReported |
| Bad Debt Expense | $355,643 | BadDebtExpenseAmount |
| Amount Reimbursed By Medicare | 7254205 | AmountReimbursedByMedicare |
| Cost Of Care Reimbursed By Medicare | 7197783 | CostOfCareReimbursedByMedicare |
| Medicare Surplus Or Shortfall | 56422 | 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 |
| 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 | ST ANDREWS HOSPITAL | BusinessNameLine1 |
Address Address
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 6 ST ANDREWS LANE | AddressLine1 |
| City | BOOTHBAY HARBOR | City |
| State | ME | State |
| ZIP Code | 04538 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Licensed Hospital | X | LicensedHospital |
| Critical Access Hospital | X | CriticalAccessHospital |
Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ST ANDREWS HOSPITAL | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital Facility Number | 1 | HospitalFacilityNumber |
| CHNA Conducted | true | CHNAConducted |
| Community Definition | X | CommunityDefinition |
| Community Demographics | X | CommunityDemographics |
| Existing Resources | X | ExistingResources |
| How Data Obtained | X | HowDataObtained |
| Community Health Needs | X | CommunityHealthNeeds |
| Other Health Issues | X | OtherHealthIssues |
| Identifying Process | X | IdentifyingProcess |
| Consulting Process | X | ConsultingProcess |
| Information Gaps | X | InformationGaps |
| Other | X | Other |
| Needs Assessment Conducted | 13 | NeedsAssessmentConducted |
| Take Into Account | true | TakeIntoAccount |
| Other Facilities | true | OtherFacilities |
| CHNA Widely Available | true | CHNAWidelyAvailable |
| Own Website | X | OwnWebsite |
| On Request | X | OnRequest |
| Other Method | X | OtherMethod |
| Adopt Implement Strategy | X | AdoptImplementStrategy |
| Execute Implement Strategy | X | ExecuteImplementStrategy |
| Develop Community Plan | X | DevelopCommunityPlan |
| Participate Community Plan | X | ParticipateCommunityPlan |
| Adopt Budget | X | AdoptBudget |
| Prioritize Health Needs | X | PrioritizeHealthNeeds |
| Prioritize Services | X | PrioritizeServices |
| All Needs Addressed | false | AllNeedsAddressed |
| Organization Incur Excise Tax | false | OrganizationIncurExciseTax |
| Eligibility Criteria Explained | true | EligibilityCriteriaExplained |
| Uses FPG Free | true | UsesFPGFree |
| FPG Free Percent | 175.0 | FPGFreePercent |
| Uses FPG Discounted | true | UsesFPGDiscounted |
| FPG Discount Percent | 225.0 | FPGDiscountPercent |
| Explains Basis | true | ExplainsBasis |
| Income Level | X | IncomeLevel |
| Medical Indigency | X | MedicalIndigency |
| Medicaid Medicare | X | MedicaidMedicare |
| State Regulation | X | StateRegulation |
| Other Factors | X | OtherFactors |
| Explains Application Method | true | ExplainsApplicationMethod |
| Includes Publicity Measures | true | IncludesPublicityMeasures |
| Posted In Emergency Room | X | PostedInEmergencyRoom |
| Posted In Admission Office | X | PostedInAdmissionOffice |
| Provided On Admission | X | ProvidedOnAdmission |
| 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 | 1 | NumberOfOtherFacilities |
Other Facilities OtherFacilities
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ST ANDREWS HOSPITAL | BusinessNameLine1 |
Address Address
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | DBA ST ANDREWS VILLAGE | AddressLine1 |
| Address Line2 | 145 EMERY LANE | AddressLine2 |
| City | BOOTHBAY HARBOR | City |
| State | ME | State |
| ZIP Code | 04538 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility Type | LONG-TERM CARE FACILITY | FacilityType |
Form990 Schedule H Part VI Form990ScheduleHPartVI (20 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| SUBSIDIZED HEALTH SERVICES EXPLANATION | PART I LINE 7G | SUBSIDIZED HEALTH SERVICES INCLUDE SCHOOL BASED HEALTH CENTERS WHERE LINCOLN COUNTY HEALTH CARE INC LCH AND ITS SUBSIDIARIES MILES MEMORIAL HOSPITAL MMH AND ST ANDREWS HOSPITAL SAH PROVIDE PHYSICIANS OR NURSE PRACTITIONERS TO CONSULT AND PROVIDE SERVICES WITHIN THE SCHOOL CLINICS ARE ALSO OFFERED THROUGHOUT THE YEAR TO PROVIDE SUBSIDIZED SERVICES SUCH AS MAMMOGRAPHY BLOOD PRESSURE SCREENINGS ETC TO ENCOURAGE ITS RESIDENTS TO OBTAIN THESE HEALTH SERVICES PHYSICIAN PRACTICES OFFERING SERVICES SUCH AS FAMILY MEDICINE INTERNAL MEDICINE AND PEDIATRICS OPERATE AT A LOSS IN ORDER TO ENSURE HEALTHCARE FOR ITS COMMUNITY MEMBERS REGARDLESS OF THEIR ABILITY TO PAY 12253 IN 2012 1512 OF EXPENSES RELATED TO OUTPATIENT CLINICS ARE INCLUDED IN THE SUBSIDIZED HEALTH SERVICES TOTAL IN PART I LINE 7G |
| EXCLUSIONS FROM PERCENT OF TOTAL EXPENSE | PART I LINE 7 COLUMN F | IN 2013 BAD DEBT IS A DEDUCTION FROM REVENUE AND IS NOT INCLUDED IN TOTAL EXPENSES |
| COSTING METHODOLOGY EXPLANATION | PART I LINE 7 | CHARITY CARE AND MEANSTESTED GOVERNMENT PROGRAMS UTILIZE A COST TO CHARGE RATIO IN DETERMINING THE COST OF THE ACTUAL CHARITY CARE WRITEOFF THE COST TO CHARGE RATIO IS CALCULATED USING WORKSHEET 2 RATIO OF PATIENT CARE COST TO CHARGES LOCATED IN THE SCHEDULE H INSTRUCTIONS |
| COMMUNITY BUILDING ACTIVITIES | PART II | LINCOLN COUNTY HEALTH CARE INC AND ITS SUBSIDIARY HOSPITAL ORGANIZATIONS MILES MEMORIAL HOSPITAL AND ST ANDREWS HOSPITAL PARTNER WITH VARIOUS COMMUNITY GROUPS SUCH AS THE HEALTHY LINCOLN COUNTY A HEALTHY MAINE PARTNERSHIP AND LINCOLN COUNTY ABUSE TASK FORCE TO IMPROVE AND PROTECT THE HEALTH OF ITS COMMUNITY MEMBERS MEALS ARE PREPARED BY ITS STAFF AS PART OF THE LOCAL MEALS ON WHEELS PROGRAMS WHICH DELIVERS MEALS TO THE ELDERLY POPULATION TO ASSIST WITH THEIR NUTRITIONAL NEEDS LCH PARTICIPATES IN THE COMMUNITY DISASTER TRAINING HELD ON A REGULAR BASIS THROUGHOUT THE COUNTY PART III LINE 4 BAD DEBT EXPLANATION FROM THE LCH AUDITED FINANCIAL STATEMENTS CHARITY CARE AND BAD DEBTS MMH AND SAH THE HOSPITALS ACCEPT ALL PATIENTS REGARDLESS OF THEIR ABILITY TO PAY A PATIENT IS CLASSIFIED AS A CHARITY PATIENT BY REFERENCE TO CERTAIN ESTABLISHED POLICIES OF THE HOSPITALS ESSENTIALLY THESE POLICIES DEFINE CHARITY CARE AS THOSE SERVICES FOR WHICH LIMITED OR NO PAYMENT IS ANTICIPATED IN ASSESSING A PATIENTS ABILITY TO PAY THE HOSPITALS UTILIZE GENERALLY RECOGNIZED POVERTY INCOME LEVELS CHARITY CARE IS MEASURED BASED ON THE HOSPITALS ESTABLISHED RATES THE HOSPITALS UTILIZE ANNUAL FEDERAL GUIDELINES AND ADJUST ACCOUNT FOR THOSE WHOSE INCOME IS 225 OF THE POVERTY LEVEL TAKING FAMILY SIZE INTO CONSIDERATION THE COSTS AND EXPENSES INCURRED IN PROVIDING THESE SERVICES ARE INCLUDED IN OPERATING EXPENSES REVENUE FOR SERVICES RENDERED TO INDIVIDUALS FROM WHO PAYMENT IS EXPECTED AND ULTIMATELY NOT RECEIVED IS WRITTEN OFF AND INCLUDED AS PART OF THE ALLOWANCE FOR BAD DEBTS THE COSTING METHODOLOGY USED IN DETERMINING THE AMOUNTS REPORTED ON PART III LINE 2 AND 3 FOLLOW THE WORKSHEETS PROVIDED IN THE SCHEDULE H INSTRUCTIONS AND UTILIZES COSTS TO CHARGE INFORMATION DERIVED DIRECTLY OFF THE ANNUAL COST REPORTS BAD DEBT EXPENSE REPRESENTS HEALTHCARE SERVICES ST ANDREWS HOSPITAL HAS PROVIDED WITHOUT COMPENSATION AS A TAXEXEMPT HOSPITAL SAH PROVIDES NECESSARY PATIENT CARE REGARDLESS OF THE PATIENTS ABILITY TO PAY FOR THE SERVICES A PORTION OF SAH 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 SAH CANNOT DETERMINE THE AMOUNT OF BAD DEBT EXPENSE THAT COULD BE REASONABLY ATTRIBUTABLE TO PATIENTS WHO LIKELY WOULD QUALIFY FOR FINANCIAL ASSISTANCE UNDER THE SAH 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 THEIR NEW MEDICAL DEBT HOWEVER BECAUSE OF THEIR INCOME LEVEL THEY DO NOT QUALIFY FOR FREE CARE BY PROVIDING NECESSARY HEALTHCARE SERVICES TO THOSE INDIVIDUALS EITHER WHO FAIL TO APPLY FOR FINANCIAL ASSISTANCE OR WHO ARE EXPERIENCING DIFFICULT PERSONAL OR ECONOMIC CIRCUMSTANCES SAH 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 SAH BELIEVES THAT THE MEDICARE SHORTFALL SHOULD BE INCLUDED AS A COMMUNITY BENEFIT BECAUSE SAH HAS A CLEAR MISSION COMMITMENT 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 IMPROVED BY SAH THEY WOULD BECOME THE OBLIGATION OF THE FEDERAL GOVERNMENT |
| COLLECTION PRACTICES EXPLANATION | PART III LINE 9B | COLLECTION POLICY EXCERPT REGARDING SELFPAY ACCOUNTS FOR SELFPAY BALANCES PAYMENTS MUST BE ARRANGED BY THE FINANCIAL COUNSELOR OR PATIENT ACCOUNTS STAFF USING THE FOLLOWING CRITERIA BALANCES UNDER 100 25MONTH MINIMUM BALANCES L00500 50MONTH MINIMUM BALANCES OVER 500 100MONTH MINIMUM IF THE PATIENT CANNOT MEET THE GUIDELINES ABOVE THE FINANCIAL COUNSELOR OR PATIENT ACCOUNTS STAFF WILL REQUEST PROOF OF INCOME AND REASON WHY THEY CANNOT MAKE REGULAR PAYMENTS THE PATIENT WILL BE OFFERED FINANCIAL ASSISTANCE IF CRITERIA IS MET WITH FREE CARE GUIDELINES AND OTHER ASSISTANCE THAT IS AVAILABLE WHEN IT IS DETERMINED THAT THE GUARANTOR CANNOT REALISTICALLY MEET THE EXTENDED PAYMENT PLAN TERMS DUE TO INSUFFICIENT INCOME LIMITED OR NEGLIGIBLE ASSETS OR OTHER EXTENUATING CIRCUMSTANCES BEYOND THE GUARANTORS CONTROL THE HOSPITAL MAY REDUCE THE TOTAL INDEBTEDNESS THROUGH FREE CARE UNDER THE SUPERVISION OF THE DIRECTOR OF PATIENT ACCOUNTS THE FINANCIAL COUNSELORS WILL FOLLOW THE FREE CARE GUIDELINES FOR APPROVAL OF FREE CARE A FREE CARE WRITEOFF MAY BE UTILIZED ONLY AFTER ALL THIRD PARTY BENEFIT POSSIBILITIES HAVE BEEN EXHAUSTED AND WHEN IT IS DETERMINED THAT NO OTHER HOSPITAL ASSISTANCE PROGRAMS OR FUNDS ARE APPLICABLE OR AVAILABLE TO THE GUARANTOR ONCE APPROVED THE HOSPITAL WILL ALLOW FULL OR PARTIAL ADJUSTMENTS ON BALANCES UP TO 225 OF THE FREE CARE GUIDELINES SET BY THE STATE OF MAINE |
| NEEDS ASSESSMENT | PART VI | SEE THE ATTACHED COMMUNITY HEALTH NEEDS ASSESSMENT IMPLEMENTATION PLAN FOR A DESCRIPTION OF HOW THE ORGANIZATION ASSESSES THE HEALTH CARE NEEDS OF THE COMMUNITIES IT SERVES THE HEALTH NEEDS OF THE COMMUNITY ARE ASSESSED BY UTILIZING THE MAINE STATE HEALTH PLAN AND ASSESSMENT COMMUNITY FORUMS INVOLVEMENT IN COMMUNITY BASED HEALTH STATUS IMPROVEMENT PROGRAMS AND IN CONJUNCTION WITH MAINEHEALTH OUR HEALTH CARE SYSTEM MAINEHEALTH ALSO PARTICIPATES IN VARIOUS INITIATIVES TO HELP SUPPORT AND PROVIDE UPDATES TO COMMUNITY NEEDS ASSESSMENT PLANNING SOME OF THESE INITIATIVES INCLUDE CLINICAL STRATEGIC PLANNING FINANCIAL STRATEGIC PLANNING FACILITY PLANNING MANPOWER PLANNING PHYSICIAN RECRUITMENT STRATEGIC PLANNING EMERGENCY PREPAREDNESS PLANNING ALONG WITH THE INTERNAL ASSESSMENTS 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 IN ADDITION MAINEHEALTH AND ITS PARTNERS IN THE ONEMAINE HEALTH COLLABORATIVE EASTERN MAINE HEALTH SYSTEM AND MAINEGENERAL HEALTH RELEASED THE ONEMAINE HEALTH COMMUNITY HEALTH NEEDS ASSESSMENT REPORT IN 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 HOLDS COMMUNITY FORUMS IN PARTNERSHIP WITH EACH MEMBER AND 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 | PATIENTS AND OTHER PERSONS WHO ARE BILLED FOR PATIENT CARE ARE INFORMED ABOUT ELIGIBILITY CRITERIA FOR FREE CARE GOVERNMENTAL ASSISTANCE IE MEDICAID AND OTHER ASSISTANCE PROGRAMS SUCH NOTIFICATION IS ACCOMPLISHED IN THE FOLLOWING WAYS ALL SELFPAY PATIENTS ARE PROVIDED A PACKET THAT DESCRIBES AVAILABLE PROGRAMS ELIGIBILITY AND THE APPLICATION PROCESS NOTIFICATIONS ARE POSTED AT NUMEROUS LOCATIONS THROUGHOUT THE HOSPITAL IN PATIENT CARE AREAS AS WELL AS THE HOSPITAL ENTRANCE INPATIENTS WITHOUT INSURANCE RECEIVE FINANCIAL COUNSELING AT WHICH TIME FINANCIAL ASSISTANCE OPPORTUNITIES ARE DISCUSSED HOSPITAL STAFF WILL ASSIST PATIENTS IN THE APPLICATION PROCESS PATIENT BILLS AND STATEMENTS PROVIDE A TELEPHONE NUMBER TO CALL FOR INFORMATION ABOUT FINANCIAL ASSISTANCE PROGRAMS AND HELP IN QUALIFYING FOR THEM |
| COMMUNITY INFORMATION | PART VI | OUR SERVICE AREA IS LINCOLN COUNTY MAINE WHICH WAS INCORPORATED JUNE 19 1760 LINCOLN COUNTY CONTAINS 457 SQUARE MILES OF LAND 451 MILES OF COASTLINE AND SIX RIVERS MARINE INTERESTS SUCH AS COMMERCIAL FISHING LOBSTERING CLAMMING EELING BOAT BUILDING ALONG WITH FORESTRY AND AGRICULTURE CONSTITUTED THE MAJORITY OF OUR EARLY ECONOMIC BASE IN MORE RECENT TIMES SERVICE INDUSTRIES AND TOURISM ALSO SERVE AS OUR ECONOMIC BASE ACCORDING TO 20062008 AMERICAN COMMUNITY SURVEY OF THE US CENSUS BUREAU LINCOLN COUNTY HAS A TOTAL POPULATION OF 34730 THIS POPULATION ALMOST DOUBLES IN THE SUMMER AS WE ARE A VERY BUSY TOURIST DESTINATION ON THE COAST TEN PERCENT OF OUR RESIDENTS ARE BELOW THE POVERTY LEVEL MAINE HAS THE THIRD HIGHEST PERCENTAGE OF RESIDENTS OVER 65 156 VERSUS 129 NATIONALLY WITHIN MAINE LINCOLN COUNTY HAS THE HIGHEST PERCENTAGE OF RESIDENTS OVER 65 200 LINCOLN COUNTY ALSO HAS A HIGHER MEDIAN AGE 456 VS 367 THAN IN THE UNITED STATES AS COMPARED TO THE UNITED STATES 652 A SMALLER PERCENT OF RESIDENTS AT LEAST 16 YEARS OF AGE ARE IN THE LABOR FORCE 642 LINCOLN COUNTY IS AN ECONOMICALLY POOR COUNTY THE US DEPARTMENT OF LABOR REPORTS THAT THE WEEKLY WAGE IN LINCOLN COUNTY DURING THE THIRD QUARTER OF 2009 WAS ONLY 542 AS COMPARED TO THE AVERAGE WEEKLY WAGE OF 840 IN THE UNITED STATES IN FACT LINCOLN COUNTY HAS THE SECOND LOWEST WEEKLY WAGE OF ALL COUNTIES IN MAINE THESE POPULATION AND ECONOMIC DATA POINT OUT THE DEPENDENCE OF ST ANDREWS HOSPITAL ON MEDICARE AND MEDICAID AND EXPLAIN THE LARGE AMOUNT OF UNCOMPENSATED CARE PROVIDED MILES MEMORIAL HOSPITAL IS A SOLE COMMUNITY HOSPITAL LOCATED IN DAMARISCOTTA IT IS THE ONLY OTHER HOSPITAL IN LINCOLN COUNTY THE PROVISION OF CARE TO LINCOLN COUNTY RESIDENTS IS COORDINATED BETWEEN MILES AND ST ANDREWS AND THEY SHARE COMMON GOVERNANCE MANAGEMENT AND ADMINISTRATIVE SERVICES IN AN EFFORT TO CONTROL COSTS PORTIONS OF LINCOLN COUNTY HAVE BEEN DESIGNATED AS MEDICALLY UNDERSERVED |
| HEALTH OF COMMUNITY IN RELATION TO EXEMPT PURPOSE | PART VI | THE TAX EXEMPT PURPOSE OF THE ORGANIZATION TO IMPROVE THE HEALTH OF THE COMMUNITY IS PROMOTED AND ENHANCED IN THE FOLLOWING WAYS THE MAJORITY OF THE GOVERNING BODY IS COMPOSED OF PERSONS LIVING WITHIN THE HOSPITAL SERVICE AREA THAT ARE NEITHER EMPLOYED BY NOR HAVE CONTRACTUAL RELATIONSHIPS WITH THE HOSPITAL OR ITS AFFILIATES MEDICAL STAFF PRIVILEGES ARE AVAILABLE TO ALL QUALIFIED PHYSICIANS IN THE COMMUNITY SOLICITATION OF COMMUNITY INPUT IN THE STRATEGIC PLANNING PROCESS COMMON GOVERNANCE OF THE HOSPITALS LONGTERM CARE HOME HEALTH HOSPICE AND PHYSICIAN SERVICES PROVIDED IN THE COUNTY TO PROMOTE COMMON HEALTH CARE AND IMPROVEMENT PLANNING AND CONTROL COSTS VOLUNTARY CAP ON INCOME FROM OPERATIONS TO RESTRAIN PRICES AND TO FUND HEALTH CARE AND HEALTH IMPROVEMENT ACTIVITIES SURPLUS FUNDS ARE REINVESTED IN CAPITAL EQUIPMENT AND IMPROVEMENTS TO ENSURE HIGH QUALITY CARE EACH YEAR A PORTION OF RETAINED EARNINGS ARE DISTRIBUTED TO OUR PARENT MAINEHEALTH FOR THE SPECIFIC PURPOSE OF HEALTH STATUS IMPROVEMENT PROGRAMS THROUGHOUT THE MAINEHEALTH SERVICE AREA |
| AFFILIATED HEALTH CARE INFORMATION | PART VI | THE HOSPITAL IS PART OF LINCOLN COUNTY HEALTH CARE INC WHICH INCLUDES THE FOLLOWING SERVICES PROVIDED IN LINCOLN COUNTY A CRITICAL ACCESS HOSPITAL A SOLE COMMUNITY PROVIDER HOSPITAL TWO NURSING FACILITIES TWO ASSISTED LIVING FACILITIES TWO DEMENTIA CARE FACILITIES RURAL HEALTH CLINICS AT SEVERAL SITES GENERAL SURGERY PRACTICE ORTHOPEDIC SURGERY PRACTICE OBGYN PHYSICIAN PRACTICE PEDIATRICS HOME HEALTH CARE AND HOSPICE LINCOLN COUNTY HEALTH CARE LCH IN TURN IS PART OF THE MAINEHEALTH SYSTEM THE ABILITY TO IMPROVE HEALTH CARE AND THE HEALTH STATUS IN LINCOLN COUNTY IS ENHANCED BY THE COMMON GOVERNANCE MANAGEMENT AND ADMINISTRATION OF THESE DIVERSE HEALTH CARE SERVICES THE SYSTEMS COORDINATED APPROACH TO THE FOLLOWING ENHANCES THE RESOURCES THAT CAN BE ALLOCATED TO DIRECT PATIENT CARE AND HEALTH STATUS IMPROVEMENT ACCOUNTING ANALYSIS AND BUDGETING PATIENT BILLING MEDICAL RECORDS SUPPLY CHAIN MANAGEMENTPURCHASING HUMAN RESOURCES INFORMATION SERVICES MEDICAL STAFF EDUCATION COMMUNITY STAFF SHARED CLINICAL DEPARTMENT MANAGEMENT HOSPITALS THE SYSTEM APPROACH PROVIDES A MORE HOLISTIC APPROACH TO COMMUNITY NEEDS ASSESSMENT AND TO THE IMPLEMENTATION OF PROGRAMS TO IMPROVE COMMUNITY HEALTH STRATEGIC PLANNING AND BUDGETING CAN BETTER ALLOCATE RESOURCES ACROSS THE SPECTRUM OF CARE TO ACHIEVE BETTER OVERALL OUTCOMES 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 MAINE REGIONAL SERVICE AREAS THE COLLABORATION OF MAINEHEALTH MEMBERS MAKES IT POSSIBLE TO OFFER AN EXTENSIVE RANGE OF CLINICAL INTEGRATION AND COMMUNITY HEALTH PROGRAMS MANY AIMED AT IMPROVING ACCESS TO PREVENTIVE AND PRIMARY CARE SERVICES MAINEHEALTH INCLUDES THE FOLLOWING MEMBER ORGANIZATIONS LINCOLN COUNTY HEALTH CARE MILES MEMORIAL HOSPITAL AND ST ANDREWS HOSPITAL MAINE MEDICAL CENTER MAINE MENTAL HEALTH PARTNERS SPRING HARBOR HOSPITAL PEN BAY HEALTHCARE PEN BAY MEDICAL CENTER SOUTHERN MAINE HEALTH CARE SOUTHERN MAINE MEDICAL CENTER AND HENRIETTA D GOODALL HOSPITAL INC WALDO COUNTY HEALTHCARE WALDO COUNTY GENERAL HOSPITAL WESTERN MAINE HEALTHCARE STEPHENS MEMORIAL HOSPITAL HOMEHEALTH VISITING NURSES MAINE PHYSICIAN HOSPITAL ORGANIZATION NORDX AND SYNERNET AFFILIATES OF MAINEHEALTH INCLUDE MAINEGENERAL MEDICAL CENTER MID COAST HOSPITAL NEW ENGLAND REHABILITATION HOSPITAL AND ST MARYS REGIONAL MEDICAL CENTER |
| LIST OF STATES WHERE COMMUNITY BENEFIT REPORT IS FILED | PART VI | MAINE |
| ADDITIONAL INFORMATION | PART VI | THE COMMUNITY BENEFIT REPORT IS CONTAINED WITHIN THE REPORT PREPARED BY LINCOLN COUNTY HEALTH CARE INC SEE SCHEDULE O PART I LINE 3B ELIGIBILITY FOR FREE OR DISCOUNTED CARE IS BASED ON INCOME CRITERIA AS OUTLINED BELOW 175 FPL 100 WRITEOFF 200 FPL 50 WRITEOFF 225 FPL 25 WRITEOFF FEDERAL POVERTY LEVELS FPL TAKE INTO ACCOUNT FAMILY SIZE NO ASSET TEST OR OTHER CRITERIA IS EVALUATED FOR ELIGIBILITY THESE LEVELS SURPASS THE MINIMUM STATE REQUIREMENTS FOR FREE CARE ELIGIBILITY AT 150 OF FPL |
| ST ANDREWS HOSPITAL LINE NUMBER 1 PART V LINE 1J | PART V LINE 1J | ALSO INCLUDED IN THE CHNA WAS A PRIORITIZED LIST OF HEALTH NEEDS IDENTIFIED AS WELL AS THE IMPLEMENTATION PLANS RELATED TO THESE NEEDS |
| ST ANDREWS HOSPITAL LINE NUMBER 1 PART V LINE 3 | PART V LINE 3 | COMMUNITY INPUT WAS TAKEN INTO ACCOUNT WHEN CONDUCTING THE CHNA INCLUDING THOSE WITH SPECIAL KNOWLEDGE OF OR EXPERTISE IN PUBLIC HEALTH THIS INCLUDED INDIVIDUALS FROM THE FOLLOWING FACILITIES HEALTHY LINCOLN COUNTY MAINEHEALTH MIDCOAST MAINE CENTER FOR DISEASE CONTROL MAINE PRIMARY CARE ASSOCIATION AND LINCOLN COUNTY HEALTHCARE |
| ST ANDREWS HOSPITAL LINE NUMBER 1 PART V LINE 4 | PART V LINE 4 | THE CHNA WAS CONDUCTED THROUGH A PARTNERSHIP WITH MAINEHEALTH EASTERN MAINE HEALTHCARE SYSTEMS AND MAINEGENERAL HEALTH |
| ST ANDREWS HOSPITAL LINE NUMBER 1 PART V LINE 5C | PART V LINE 5C | THE CHNA REPORT CAN BE FOUND AT HTTPWWWMAINEHEALTHCOMMHBODYCFM ID7301 |
| ST ANDREWS HOSPITAL LINE NUMBER 1 PART V LINE 7 | PART V LINE 7 | THE FOLLOWING IDENTIFIED COMMUNITY HEALTH NEEDS WERE NOT ADDRESSED CANCER HOSPITAL ADMISSIONS REPRODUCTIVE HEALTH SMOKING AND YOUTH ISSUES THESE PRIORITIES WERE NOT ADDRESSED DUE TO LACK OF CONSENSUS FROM COMMUNITY PARTNERS REGARDING THE IMPORTANCE OF THE ISSUE ANDOR A LACK OF RESOURCES TO ADDRESS THE ISSUE |
| ST ANDREWS HOSPITAL LINE NUMBER 1 PART V LINE 12H | PART V LINE 12H | PRESUMPTIVE ELIGIBILITY INTENDED FOR THOSE PATIENTS WHO NEVER COMPLETED A FREE CARE APPLICATION BUT THE PATIENT ACCOUNTS DEPARTMENT HAS SUFFICIENT INFORMATION TO DETERMINE THAT THE PATIENT WOULD QUALIFY FOR FREE CARE IF THEY APPLIED EXAMPLES INCLUDE THE FOLLOWING PATIENT IS HOMELESS AND DID NOT COMPLETE AN APPLICATION PATIENT IS COVERED BY AN OUT OF STATE MEDICAID PLAN THAT THE PROVIDER IS NOT CREDENTIALED WITH AND THE PATIENTS BALANCE DOES NOT JUSTIFY COMPLETION OF THE BURDENSOME PAPERWORK ASSOCIATED WITH CREDENTIALING PATIENT HAS BEEN IN THE HOSPITAL WITHOUT INCOME FOR MORE THAN 3 MONTHS AND EXPIRES BEFORE AN APPLICATION CAN BE COMPLETED PATIENT IS INCARCERATED CONSISTENT WITH THE SECTION ON MEDICAL INDIGENCE PRESUMPTIVE ELIGIBILITY PATIENTS WILL BE APPROVED FOR ADJUSTMENT BY SUPERVISORY OR MANAGEMENT STAFF IN THE PATIENT ACCOUNTS DEPARTMENT UPON RECOMMENDATION BY COLLECTION OR CUSTOMER SERVICE STAFF |
| ST ANDREWS HOSPITAL LINE NUMBER 1 PART V LINE 20D | PART V LINE 20D | THE HOSPITAL FACILITY USED GROSS CHARGES TO CALCULATE DISCOUNTS ITEMS 19AC ARE BEING EVALUATED FOR WHICH IS MOST PRACTICABLE FOR FUTURE IMPLEMENTATION |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | false | SeverancePayment |
| Supplemental Nonqual Retire Plan | true | 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 (11 entries)
| TitleTitle | Comp Based On Related OrgsCompBasedOnRelatedOrgs | Other Compensation Related OrgsOtherCompensationRelatedOrgs | Deferred Comp Related OrgsDeferredCompRelatedOrgs | Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs | Total Compensation Related OrgsTotalCompensationRelatedOrgs | Bonus Related OrgsBonusRelatedOrgs | Base Compensation Filing OrgBaseCompensationFilingOrg | Bonus Filing OrgBonusFilingOrg | Other Compensation Filing OrgOtherCompensationFilingOrg | Deferred Comp Filing OrgDeferredCompFilingOrg | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg | Total Compensation Filing OrgTotalCompensationFilingOrg |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| GARTH MILLER MD | ||||||||||||
| TRUSTEE | 367323 | 98000 | 8125 | 20851 | 494299 | |||||||
| MARK FOURRE MD | ||||||||||||
| TRUSTEE | 288067 | 2233 | 8125 | 19689 | 318114 | |||||||
| JOHN MURRAY MD | ||||||||||||
| TRUSTEE | 234909 | 15200 | 6424 | 19609 | 276142 | |||||||
| AQUILINO ALAMO MD | ||||||||||||
| TRUSTEE | 198319 | 18500 | 7202 | 18942 | 242963 | |||||||
| STEVEN FEDER DO | ||||||||||||
| TRUSTEE | 139168 | 20356 | 5187 | 17518 | 182229 | |||||||
| DANIEL FRIEDLAND MD | ||||||||||||
| TRUSTEE | 119851 | 39300 | 5481 | 21152 | 185784 | |||||||
| ROBERT MCARTOR MD | ||||||||||||
| TRUSTEE | 135663 | 21596 | 28729 | 13819 | 199807 | |||||||
| JAMES DONOVAN | ||||||||||||
| CEO LCH | 253508 | 40450 | 8125 | 21671 | 364754 | 41000 | ||||||
| WAYNE PRINTY | ||||||||||||
| CFO | 185759 | 20275 | 6203 | 18829 | 231066 | |||||||
| PATRICE CARTER | ||||||||||||
| PHARMACIST | 124866 | 9654 | 4897 | 4473 | 16910 | 160800 | ||||||
| ALAN BARKER MD | ||||||||||||
| FORMER TRUSTEE | 135472 | 4523 | 17872 | 157867 | ||||||||
Form990 Schedule J Part III Form990ScheduleJPartIII (2 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| SEVERANCE, NONQUALIFIED, AND EQUITY-BASED PAYMENTS | SCHEDULE J, PAGE 1, PART I, LINE 4 | ROBERT MCARTOR, M.D. 0 16,876 0 |
| OTHER ADDITIONAL INFORMATION | SCHEDULE J, PART III | PART I, LINE 4: THE NONQUALIFIED PAYMENTS ARE FROM RELATED ORGANIZATIONS WHERE THE INDIVIDUAL IS EMPLOYED. SEE SCHEDULE O PART VI, LINE 15A, FOR DESCRIPTION OF METHODS USED TO DETERMINE THE COMPENSATION FOR TOP OFFICIALS. |
Schedule K IRS990ScheduleK
Form990 Schedule K Part I Form990ScheduleKPartI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
Issuer Name IssuerName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MHHEFA REVENUE BOND SERIES 2011A | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Issuer EIN | 010314384 | IssuerEIN |
| CUSIP Number | 560427LW4 | CUSIPNumber |
| Date Issued | 2011-08-31 | DateIssued |
| Issue Price | 8469460 | IssuePrice |
| Description Of Purpose | REFINANCE BONDS | DescriptionOfPurpose |
| Defeased | false | Defeased |
| On Behalf Of Issuer | false | OnBehalfOfIssuer |
| Pool Financing | false | PoolFinancing |
Form990 Schedule K Part II Form990ScheduleKPartII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Amount Retired | 690000 | AmountRetired |
| Total Proceeds | 8469460 | TotalProceeds |
| Amount In Reserve Fund | 834237 | AmountInReserveFund |
| Issuance Costs From Proceeds | 88736 | IssuanceCostsFromProceeds |
| Other Spent Proceeds | 8380724 | OtherSpentProceeds |
| Current Refunding | true | CurrentRefunding |
| Advance Refunding | false | AdvanceRefunding |
| Final Allocation Made | true | FinalAllocationMade |
| Adequate Books And Recds Maintaind | true | AdequateBooksAndRecdsMaintaind |
Form990 Schedule K Part III Form990ScheduleKPartIII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Owning Bond Financed Property | false | OwningBondFinancedProperty |
| Any Lease Arrangements | false | AnyLeaseArrangements |
| Mngment Cntrct Bond Financd Prprty | false | MngmentCntrctBondFinancdPrprty |
| Any Research Agreements | false | AnyResearchAgreements |
| Bond Iss Meet Prvt Security Pay Test | false | BondIssMeetPrvtSecurityPayTest |
| Change In Use Bond Financed Prop | false | ChangeInUseBondFinancedProp |
| Remedial Action Taken | false | RemedialActionTaken |
| Non Qualified Bond Remed Procdrs | false | NonQualifiedBondRemedProcdrs |
Form990 Schedule K Part IV Form990ScheduleKPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Form8038 T Filed | false | Form8038TFiled |
| Rebate Not Due Yet | true | RebateNotDueYet |
| Exception To Rebate | false | ExceptionToRebate |
| No Rebate Due | false | NoRebateDue |
| Variable Rate Issue | false | VariableRateIssue |
| Hedge Identified In Books And Recds | false | HedgeIdentifiedInBooksAndRecds |
| Gross Proceeds Invested In GIC | false | GrossProceedsInvestedInGIC |
| Gross Proceeds Invested | false | GrossProceedsInvested |
| Written Proc To Monitor Reqs | false | WrittenProcToMonitorReqs |
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 | MHHEFA REVENUE BOND SERIES 2011A SERIES 2011 BONDS WITH RESPECT TO PART I COLUMN E AND PART II LINES 112 THE INSTITUTION IS REPORTING ITS ALLOCABLE PORTION OF THIS BOND ISSUE THE REMAINDER OF WHICH IS ALLOCABLE TO AFFILAITED ENTITIES FOR PURPOSES OF PART I COLUMN I THE INSTITUTION HAS ASSUMED THAT THIS ARRANGEMENT DOES NOT CONSTITUTE A POOLED FINANCING | Explanation |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (13 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| ORGANIZATION'S MISSION | FORM 990 - ORGANIZATION'S MISSION | - TO ESTABLISH, OPERATE, & MAINTAIN FOR SCIENTIFIC, CHARITABLE, EDUCATIONAL & BENEVOLENT PURPOSES A PUBLIC HOSPITAL, CLINIC, INFIRMARY & RETIREMENT COMMUNITY FOR THE CARE & TREATMENT OF SICK, WOUNDED, INFIRM OR AGED PERSONS, A DOCTOR'S OFFICE BUILDING & A SCHOOL FOR THE EDUCATION & TRAINING OF NURSES, ALL WITHOUT DISCRIMINATION AS TO RACE, COLOR, CREED, NATIONAL ORIGIN, AGE, GENDER, SEXUAL ORIENTATION OR FINANCIAL STATUS. - TO BE OPERATED & MAINTAINED AS A CRITICAL ACCESS HOSPITAL IN ACCORDANCE WITH THE STANDARDS ESTABLISHED FROM TIME TO TIME FOR THE MEDICARE RURAL HOSPITAL FLEXIBILITY PROGRAM. - TO ENCOURAGE & CARRY ON EDUCATIONAL ACTIVITIES PURSUANT TO CONTINUALLY IMPROVING THE QUALITY OF CARE PROVIDED. - TO COOPERATE & PARTICIPATE WITH ALLIED AGENCIES IN ALL ACTIVITIES DESIGNED TO PROMOTE THE GENERAL HEALTH OF THE COMMUNITY IN THE AREAS SERVED BY THE HOSPITAL. - THIS CORPORATION SHALL NOT BE CONDUCTED FOR GAIN OR PROFIT, & NO PART OF THE NET EARNINGS SHALL INURE TO THE BENEFIT OF ANY MEMBER. |
| FIRST ACCOMPLISHMENT DESCRIPTION | FORM 990, PAGE 2, PART III, LINE 4A | PATIENT DAYS: ADULT & CHILDREN: 2,962 NURSING FACILITY: 10,481 DISCHARGES: 224 DEPARTMENT AMOUNT STATISTICS LABORATORY 24,510 TESTS CARDIOPULMONARY 1,090 PROCEDURES CT SCANS 978 PROCEDURES RADIOLOGY 2,333 PROCEDURES REHABILITATION SERVICES 6,553 VISITS PLEASE SEE ATTACHED COMMUNITY BENEFITS STATEMENT |
| CLASSES OF MEMBERS OR STOCKHOLDERS | FORM 990, PAGE 6, PART VI, LINE 6 | ST. ANDREWS HOSPITAL AND MILES MEMORIAL HOSPITAL SHARE LINCOLN COUNTY HEALTH CARE INC. (LCH) AS THEIR SOLE CORPORATE MEMBER. MAINEHEALTH (EIN 01-0431680), AS THE SOLE MEMBER OF LCH, HAS THE RIGHT TO APPROVE SIGNIFICANT DECISIONS OF THE GOVERNING BOARD OF LCH AND ITS SUBSIDIARIES. |
| ELECTION OF MEMBERS AND THEIR RIGHTS | FORM 990, PAGE 6, PART VI, LINE 7A | THE MEMBER ELECTS THE BOARD OF TRUSTEES. ALL OFFICERS OF THE BOARD OF TRUSTEES ARE ELECTED BY THE BOARD, AND EACH MUST BE A TRUSTEE. OFFICERS OF THE CORPORATION ARE ELECTED ANNUALLY BY THE BOARD. |
| DECISIONS SUBJECT TO APPROVAL OF MEMBERS | FORM 990, PAGE 6, PART VI, LINE 7B | DECISIONS OF THE GOVERNING BODY SUCH AS BUDGETS, BUSINESS STRATEGIES, SIGNIFICANT FINANCIAL COMMITMENTS, AMENDMENTS TO THE ARTICLES OF INCORPORATION, AND ELECTION OF THE PRESIDENT/CEO AMONG OTHER DECISIONS, ARE SUBJECT TO THE APPROVAL OF THE SOLE MEMBER. |
| ORGANIZATION'S PROCESS USED TO REVIEW FORM 990 | FORM 990, PAGE 6, PART VI, LINE 11B | THE FINANCE COMMITTEE PERFORMED A DETAILED REVIEW OF THE FORM 990. THE FORM 990 IS THEN MADE AVAILABLE TO THE FULL BOARD. THE CHIEF FINANCIAL OFFICER ALSO PERFORMS A DETAILED REVIEW OF THE ENTIRE FORM 990 BEFORE SIGNING AND PRIOR TO FILING. |
| ENFORCEMENT OF CONFLICTS POLICY | FORM 990, PAGE 6, PART VI, LINE 12C | ANY DUALITY OF INTEREST OR POSSIBLE CONFLICT OF INTEREST ON THE PART OF A TRUSTEE, PHYSICIAN, OFFICER OR MANAGER (E.G., A MEMBER OF LINCOLN COUNTY HEALTHCARE LEADERSHIP TEAM, DIRECTOR, MANAGER OR PERSON RESPONSIBLE FOR PURCHASING) MUST BE DISCLOSED TO THE APPLICABLE BOARD, BOARD COMMITTEE OR, IN THE CASE OF AN ADMINISTRATIVE DECISION THAT IS NOT SUBJECT TO BOARD OR COMMITTEE APPROVAL, TO THE MANAGER'S IMMEDIATE SUPERVISOR. SUCH DISCLOSURES SHALL BE MADE A MATTER OF RECORD. DISCLOSURE WILL BE MADE AT THE TIME OF INITIAL AFFILIATION WITH LINCOLN COUNTY HEALTH CARE ANNUALLY AND WHEN THE INTEREST BECOMES A MATTER FOR BOARD OR COMMITTEE ACTION OR ADMINISTRATIVE DECISION. DISCLOSURE FORMS SHALL BE COMPLETED ANNUALLY BY TRUSTEES AND OFFICERS AT THE TIME OF THE ANNUAL MEETING, AND ANNUALLY BY VICE PRESIDENTS, DIRECTORS, AND MANAGERS IN CONJUNCTION WITH THEIR ANNUAL PERFORMANCE REVIEW. |
| COMPENSATION PROCESS FOR TOP OFFICIAL | FORM 990, PAGE 6, PART VI, LINE 15A | IN CONSULTATION WITH SULLIVAN COTTER, THE MAINEHEALTH EXECUTIVE COMMITTEE ESTABLISHES APPROPRIATE COMPENSATION PARAMETERS FOR EACH MEMBER ORGANIZATION'S CEO AND CERTAIN MEMBERS OF THEIR SENIOR MANAGEMENT TEAM. WORKING WITHIN THOSE PARAMETERS, THE LCH COMPENSATION COMMITTEE 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. THIS "TOTAL EXECUTIVE COMPENSATION" IS FILED PUBLICLY BY THE ORGANIZATION, AND INCLUDES "TOTAL CASH COMPENSATION" AND "TOTAL VALUE OF ALL BENEFITS AND PERQUISITES ASSOCIATED WITH POSITION (SUCH AS HOUSING ALLOWANCES, SOCIAL CLUB MEMBERSHIPS, SIGNING BONUSES, ETC.)". THE BOARD TAKES NECESSARY ACTION TO PREVENT THE CEO FROM VOTING OR DIRECTLY PARTICIPATING IN THE FINAL COMMITTEE DETERMINATION OF (HER/HIS) OWN COMPENSATION. THE ORGANIZATION'S EXECUTIVE COMPENSATION PROCEDURE RELIES UPON APPROPRIATE DATA FOR COMPARABILITY (E.G. COMPENSATION LEVELS PAID BY BOTH TAXABLE AND TAX-EXEMPT SIMILARLY SITUATED ORGANIZATIONS AND INDEPENDENT COMPENSATION SURVEYS BY NATIONALLY RECOGNIZED INDEPENDENT FIRMS). FINALLY, THE ORGANIZATION REFRAINS FROM ALLOWING EXECUTIVE COMPENSATION TO EVER BE BASED SOLELY ON LCH'S REVENUES OR OTHER SIMILAR PROFIT-SHARING STRATEGIES. |
| COMPENSATION PROCESS FOR OFFICERS | FORM 990, PAGE 6, PART VI, LINE 15B | IN CONSULTATION WITH SULLIVAN COTTER, THE MAINEHEALTH EXECUTIVE COMMITTEE ESTABLISHES APPROPRIATE COMPENSATION PARAMETERS FOR EACH MEMBER ORGANIZATION'S CEO AND CERTAIN MEMBERS OF THEIR SENIOR MANAGEMENT TEAM. WORKING WITHIN THOSE PARAMETERS, THE LCH COMPENSATION COMMITTEE 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. THIS "TOTAL EXECUTIVE COMPENSATION" IS FILED PUBLICLY BY THE ORGANIZATION, AND INCLUDES "TOTAL CASH COMPENSATION" AND "TOTAL VALUE OF ALL BENEFITS AND PERQUISITES ASSOCIATED WITH POSITION (SUCH AS HOUSING ALLOWANCES, SOCIAL CLUB MEMBERSHIPS, SIGNING BONUSES, ETC.)". THE BOARD TAKES NECESSARY ACTION TO PREVENT THE CEO FROM VOTING OR DIRECTLY PARTICIPATING IN THE FINAL COMMITTEE DETERMINATION OF (HER/HIS) OWN COMPENSATION. THE ORGANIZATION'S EXECUTIVE COMPENSATION PROCEDURE RELIES UPON APPROPRIATE DATA FOR COMPARABILITY (E.G. COMPENSATION LEVELS PAID BY BOTH TAXABLE AND TAX-EXEMPT SIMILARLY SITUATED ORGANIZATIONS AND INDEPENDENT COMPENSATION SURVEYS BY NATIONALLY RECOGNIZED INDEPENDENT FIRMS). FINALLY, THE ORGANIZATION REFRAINS FROM ALLOWING EXECUTIVE COMPENSATION TO EVER BE BASED SOLELY ON LCH'S REVENUES OR OTHER SIMILAR PROFIT-SHARING STRATEGIES. |
| 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 FEES FOR SERVICES | FORM 990, PART IX, LINE 11G | PURCHASED SERVICES 3,202,400 91,652 0 |
| ADDITIONAL INFORMATION | FORM 990, PART XI | THE FINANCIAL RESULTS OF THE ORGANIZATION WERE PART OF A CONSOLIDATED FINANCIAL STATEMENT AUDIT PREPARED FOR LINCOLN COUNTY HEALTH CARE, INC. (EIN 26-1475629) AND ITS SUBSIDIARIES. |
| OTHER CHANGES IN NET ASSETS EXPLANATION | FORM 990, PART XI, LINE 9 | EQUITY TRANSFERS TO AFFILIATE 66,840 CHANGE IN PERPETUAL TRUSTS 26,871 |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII (5 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 | Controlled OrgControlledOrg | Business Name Line2NameOfDisregardedEntity/BusinessNameLine2 |
|---|---|---|---|---|---|---|---|---|---|---|---|
| LINCOLN COUNTY MEDICAL GROUP | |||||||||||
| 6 ST ANDREWS LANE | BOOTHBAY HARBOR | ME | 04538 | 263878235 | PHYS SVC | ME | 501C3 | 3 | LCH | false | |
| LINCOLN COUNTY HEALTH CARE INC | |||||||||||
| 6 ST ANDREWS LANE | BOOTHBAY HARBOR | ME | 04538 | 261475629 | HEALTH SVC | ME | 501C3 | 11C | MH | false | (LCH) |
| MILES MEMORIAL HOSPITAL | |||||||||||
| 35 MILES STREET | DAMARISCOTTA | ME | 04543 | 010211796 | HOSP SVC | ME | 501C3 | 3 | LCH | false | |
| COVES EDGE INC | |||||||||||
| 26 SCHOONER STREET | DAMARISCOTTA | ME | 04543 | 010382340 | LT CARE SV | ME | 501C3 | 3 | LCH | false | |
| MAINEHEALTH (MH) | |||||||||||
| 110 FREE STREET | PORTLAND | ME | 04101 | 010431680 | HEALTHCARE | ME | 501C3 | 11C | NA | false | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | false | 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 | false | 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 | false | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | true | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | true | SharingOfFacilities |
| Sharing Of Paid Employees | true | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | true | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | true | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | true | OtherTransferToOtherOrg |
| Other Transfer From Other Org | true | OtherTransferFromOtherOrg |
Form990 Schedule R Part VII Form990ScheduleRPartVII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | ADDITIONAL INFORMATION | Identifier |
| Return Reference | SCHEDULE R | ReturnReference |
| Explanation | LINCOLN COUNTY MEDICAL GROUP HAS APPLIED FOR PUBLIC CHARITY TAXEXEMPT STATUS WITHIN THE DUE DATE REQUIRED TO RECEIVE IRS APPROVAL RETROACTIVE TO THE LEGAL DATE OF FORMATION | Explanation |
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