2014-06-23T15:48:50-05:00 2013-12-31 010494526 Baker Newman & Noyes PO Box 507 Portland ME 04112 990 2013-01-01 010540180 Hospice of Southern Maine HOSP 2072893641 180 US Route 1 Scarborough ME 04074 Elaine Brady Interim CEO 2072893641 2014-06-23 Nicholas E Porto P01310283 2078792100 2013 2015-11-30 17:44:51Z Elaine Brady 180 US Route 1 Scarborough ME 04074 11818788 0 X www.hospiceofsouthernmaine.org X 2003 ME Hospice services: To provide compassion, care, and comfort through end of life. 19 19 179 180 0 0 2237885 2014940 10231554 9723645 20242 44711 -3293 -2921 12486388 11780375 0 0 0 0 6243274 6604534 0 0 293047 3899476 3826652 10142750 10431186 2343638 1349189 11271962 12530602 3278573 2905476 7993389 9625126 X Hospice services 0 0 8842742 9723645 Hospice of Southern Maine's mission is to provide compassion, care, and comfort through end of life, with a stated vision as follows: As a leading provider of Hospice and Palliative Care, we are a role model and standard setter for end of life care. We are positively shifting societal attitudes concerning death and dying.With a mission to provide compassion, care and comfort through the end of life, Hospice of Southern Maine offers comprehensive hospice care to patients in York and Cumberland Counties. All of our patients have a life-limiting illness and a prognosis of six months or less. Besides providing medical, emotional, social and spiritual support to our patients, we also provide care before (Continued on Schedule O)and after the death for their loved ones. An important activity for our organization over the past couple of years has been a focus on shifting societal attitudes concerning death and dying. In order to fulfill this mission, HSM offers an annual conference on end-of-life issues, provides guidance to staff in area hospitals and nursing homes on patient care at end of life, and provides community information sessions in businesses, at educational facilities, at churches and other community locations. Our bereavement program, which is an important part of our mission, offers support for 13 months following the death of a loved one. Our program is unique in that it offers one-on-one counseling for as long as it's needed, at no cost. We also offer eight-week group sessions for people who are interested in connecting with others who are in a similar situation. Additionally, we provide counseling and group support to anyone in the community who is grieving, whether or not their loved one died while under our care.Formed through a collaborative effort among York and Cumberland County community leaders and health care providers, HSM began providing direct patient services in 2004. In 2007, HSM opened the area's first inpatient hospice facility-the Gosnell Memorial Hospice House. Today, HSM is the only free-standing, state licensed, Medicare-certified, nonprofit in Maine that is solely focused on providing professional and volunteer direct hospice services to dying patients and their families, regardless of their ability to pay. Demand for our services continues to grow. In 2013, we provided hospice care to a record 1,385 individuals. Our highly skilled, multidisciplinary team of 140 employees-physicians, nurses, social workers, home health aides, chaplains, occupational and physical therapists and grief counselors-and 160 volunteers provide direct patient care in alignment with our mission to provide compassion, care and comfort through the end of life. 8842742 1 1 0 1 0 0 0 0 0 1 1 0 0 0 1 1 1 0 0 0 0 0 0 0 1 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 33 0 1 179 1 0 0 0 0 0 0 0 0 0 0 X 19 19 1 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 0 0 X Mary Pinto 2072893640 180 US Route 1 Scarborough ME 04074 Maryanna Arsenault Director 0.20 X 0 0 0 Kendall Reed Director 0.50 X 0 0 0 Elaine Brady RN Director 0.60 X 0 0 0 William Caron Director 0.70 X 0 0 0 Sally Daggett Esq Director 0.40 X 0 0 0 Roland Eon Director 0.70 X 0 0 0 Annette Gosnell Director 1.30 X 0 0 0 Laurence Gross Director 0.40 X 0 0 0 Daniel Hayes MD Director 0.20 X 0 0 0 Holly LeBlanc Director 0.60 X 0 0 0 Elizabeth McCandless Esq Director 0.60 X 0 0 0 Tracey Weisberg Director 0.50 X 0 0 0 Bob Schools Director 1.30 X 0 0 0 Ann Stockbridge Director 0.60 X 0 0 0 David Perkins Esq Director/Past Chair 1.30 X 0 0 0 Miriam Leonard Director/Chair 3.30 X X 0 0 0 Edward J McGeachey Director/Vice Chair 1.00 X X 0 0 0 Kevin Montminy Director/Treasurer 1.40 X X 0 0 0 Karl Turner Director/Secretary 1.50 X X 0 0 0 Arlene Wing CEO/Ex Officio 40.00 X 138638 0 14162 Mark Wrona MD part year Medical Director/Ex Officio 40.00 X 76084 0 2107 Cynthia Burnham MD Interim Medical Director/Ex Officio 40.00 X 109890 0 3463 324612 0 19732 2 0 1 0 0 22300 1992640 5618 2014940 Patient services 621610 9658874 9658874 Education and outreach programs 621610 40271 40271 Palliative Consultative Services 621610 24500 24500 9723645 41535 41535 14380 14158 10424 14938 3956 -780 3176 3176 10130 22300 13051 -2921 -2921 11780375 9723645 0 41790 344344 191544 152800 5063927 4356760 540161 167006 52379 48858 3521 614301 510271 66697 37333 529583 460737 68846 94119 94119 344470 256937 64234 23299 60350 60350 325827 224429 43241 58157 146352 127326 19026 376708 274997 101711 240866 220517 20349 26820 22191 3316 1313 133374 129372 4002 322608 307169 9500 5939 43524 43524 Patient related expense 1525150 1525150 Bad debt 186484 186484 10431186 8842742 1295397 293047 27596 43926 5238384 5293652 50000 1266200 1601561 1319783 160314 118476 5681799 1868525 3682681 3813274 511426 675291 11271962 12530602 984271 851877 1702746 1710839 67506 16636 524050 326124 3278573 2905476 X 6187167 6559418 1536022 1589308 270200 1476400 7993389 9625126 11271962 12530602 X 1349189 84622 197926 X X 0 1 X 1 0 X 704525 713145 718434 2237885 2014940 6388929 704525 713145 718434 2237885 2014940 6388929 3081522 3307407 16836 19220 25105 20136 41535 122832 6511761 43457725 0.50790 0.55770 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 1 842 0 0 0 842 0 Part II-B, Line 1: National Hospice and Palliative Care Organization portion of dues paid allocated to lobbying activities was $512. Home Care and Hospice Alliance of Maine portion of dues paid allocated to lobbying activities was $330. 1806222 1502100 52454 295068 3065708 344207 1752246 19606 309837 1806222 361752 239503 109 257157 344207 454893 153052 68 246261 361752 351905 211462 41 108515 454893 0.00000 0.48160 0.51840 0 0 440000 440000 4055520 1274222 2781298 1186279 594303 591976 3813274 Interest rate swap liability 326124 326124 X 12075974 84622 210977 295599 11780375 0 11780375 10444237 13051 13051 10431186 0 10431186 Part V, Line 4: To ensure the long-term financial viability of the organization Part X, Line 2: The Organization is exempt from income taxes under Section 501(c)(3) of the Internal Revenue Code. Tax-exempt organizations could be required to record an obligation for income taxes as the result of a tax position they have historically taken on various tax exposure items including unrelated business income or tax status. Under guidance issued by the Financial Accounting Standards Board, assets and liabilities are established for uncertain tax positions taken or positions expected to be taken in income tax returns when such positions are judged to not meet the "more-likely-than-not" threshold, based upon the technical merits of the position. Estimated interest and penalties, if applicable, related to uncertain tax positions are included as a component of income tax expense. The Organization has evaluated the positions taken on its filed tax returns. The Organization has concluded no uncertain income tax positions exist at December 31, 2013. The Organization's tax years from 2010 through 2013 are open and subject to examination. Part XI, Line 2d - Other Adjustments: Special Events Expense 13,051. Interest Rate Swap 197,926. Part XII, Line 2d - Other Adjustments: Special Events Expense 13,051. Twilight in the Park 32430 22300 10130 4785 20 257 7268 32430 22300 10130 4785 20 257 7268 12330 -2200 X X 0 0 0 0 0 0 0 0 0 Arlene Wing CEO/Ex Officio 138638 0 0 0 0 0 4070 0 10092 0 152800 0 0 0 Form 990, Part VI, Section A, line 2 --Directors William Caron and Edward McGeachey have a business relationship with each other; --Directors William Caron and Maryanna Arseneault have a business relationship with each other; --Directors William Caron and Kevin Montminy have a business relationship with each other; and --Directors William Caron and Miriam Leonard have a business relationship with each other. Form 990, Part VI, Section A, line 6 Initial Members of the Corporation were established in 2003. Thereafter, Members shall include all other persons who may be admitted to membership from time to time by vote of the Members at an annual or special meeting. The Governance Committee of the Board of Directors shall present a report to propose new Members to be admitted for membership. Form 990, Part VI, Section A, line 7a Provisions in bylaws pertaining to Members of the Corporation: -individuals may be admitted to membership from time to time by vote of Members at annual or special meetings -Nominating Committee of the Board of Directors proposes new members -Members must have an interest in, and ability to contribute to, the advancement of the mission and goals of the Corporation -powers include election of Board of Directors, election of new members, changes in the corporate structure, and action on any matters brought to them by the BOD, at the annual meeting or at special meetings Purpose: to strengthen links to the community, and ensure that effective governing bodies are elected Responsibilities: -understanding and affirmation of HSM's mission, principles and objectives. -advocacy in the community, fostering of public awareness and support for the Organization's goals and programs and its fundraising efforts -attendance at the annual meeting, election of Board and Members of the Corporation, and action on any other matters brought by the Board. Form 990, Part VI, Section A, line 7b See line 7a Form 990, Part VI, Section B, line 11 The 990 was reviewed by the finance committee. Then a complete copy of the 990 was distributed to the full Board of Directors. Form 990, Part VI, Section B, line 12c Annually all persons are required to review and sign the conflict of interest policy statement, which is then kept on file. Form 990, Part VI, Section B, line 15a The process for determining compensation for the CEO was as follows: Review of candidate's current responsibilities and compensation, and her expectations and performance as CEO of HSM Review of national and regional market data Discussion and decision by the Executive Committee of the Board Form 990, Part VI, Section C, line 19 All documents that are required to be made available are made available upon request. Form 990, Part XI, line 9: Change in fair value of interest rate swap 197,926. Form 990, Part XI, line 2c: The responsibility of the audit committee for overseeing the audit and selecting the independent accountant has not changed from prior years.