BLUE HILL MEMORIAL HOSPITAL INC: Form 990, tax year 2012
View the entire original 990 at ProPublica ↗
- Organization
- BLUE HILL MEMORIAL HOSPITAL INC (EIN 01-0227195)
- Tax period
- 2012-09-30 to 2013-09-28
- Filed
- 2014-08-11
- IRS object ID
- 201432239349301228
- Schema version
- 2012v2.0
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
- Return header
- Form 990
- Schedule A
- Schedule B
- Schedule C
- Schedule D
- Schedule H
- Schedule J
- Schedule K
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2014-08-11T14:18:18-07:00 | Timestamp |
| Tax Period End Date | 2013-09-28 | TaxPeriodEndDate |
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2012-09-30 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 010227195 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BLUE HILL MEMORIAL HOSPITAL | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | BLUE | NameControl |
| Phone | 2073742836 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 57 WATER STREET | AddressLine1 |
| City | BLUE HILL | City |
| State | ME | State |
| ZIP Code | 04614 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | Wendy J Jones | Name |
| Title | Interim CFO | Title |
| Date Signed | 2014-08-11 | DateSigned |
| Authorize Third Party | false | AuthorizeThirdParty |
| 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 | John Ronan | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 57 Water Street | AddressLine1 |
| City | Blue Hill | City |
| State | ME | State |
| ZIP Code | 04614 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 58196655 | GrossReceipts |
| Group Return For Affiliates | false | GroupReturnForAffiliates |
| All Affiliates Included | false | AllAffiliatesIncluded |
| Organization501c3 | X | Organization501c3 |
| Web Site | www.bhmh.org | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1924 | YearFormation |
| State Legal Domicile | ME | StateLegalDomicile |
| Activity Or Mission Description | Blue Hill Memorial Hospital is dedicated to improving the health and wellness of our communities by providing primary and specialty health care of outstanding quality and caring for our patients with respect and compassion. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 15 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 11 | NbrIndependentVotingMembers |
| Total Nbr Employees | 372 | TotalNbrEmployees |
| Total Nbr Volunteers | 117 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Contributions Grants Prior Year | 370967 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 484212 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 53090798 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 54749733 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 199254 | InvestmentIncomePriorYear |
| Investment Income Current Year | 305586 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 723997 | OtherRevenuePriorYear |
| Other Revenue Current Year | 481043 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 54385016 | TotalRevenuePriorYear |
| Total Revenue Current Year | 56020574 | TotalRevenueCurrentYear |
| Grants And Similar Amnts CY | 0 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 22325053 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 23331516 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 31109079 | OtherExpensePriorYear |
| Other Expenses Current Year | 30737586 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 53434132 | TotalExpensesPriorYear |
| Total Expenses Current Year | 54069102 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 950884 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 1951472 | RevenuesLessExpensesCY |
| Total Assets BOY | 35004678 | TotalAssetsBOY |
| Total Assets EOY | 38107193 | TotalAssetsEOY |
| Total Liabilities BOY | 13217169 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 13626199 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 21787509 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 24480994 | NetAssetsOrFundBalancesEOY |
| Info In Schedule O Part III | X | InfoInScheduleOPartIII |
| Mission Description | Blue Hill Memorial Hospital is dedicated to improving the health and wellness of our communities by providing primary and specialty health care of outstanding quality and caring for our patients with respect and compassion. | MissionDescription |
| Significant New Program Services | false | SignificantNewProgramServices |
| Significant Change | false | SignificantChange |
| Expense | 48009147 | Expense |
| Revenue | 55234686 | Revenue |
| Description | See Schedule O | Description |
Activity2 Activity2
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 1170416 | Expense |
| Description | Charity care provided (at cost) 527 persons served. | Description |
Activity3 Activity3
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 323607 | Expense |
| Description | Medicare shortfalls (at cost) 31,602 persons served. | Description |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expense | 49503170 | 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 | true | ReportFin48Footnote |
| Independent Audit Financial Stmt | true | 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 | true | RelatedOrgControlledEntity |
| Transaction Related Entity | true | TransactionRelatedEntity |
| Transfers To Exempt Non Chrtbl Org | false | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | false | ActivitiesConductedPartnership |
| Schedule O Required | true | ScheduleORequired |
| Number Forms Transmitted With1096 | 62 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | true | ComplianceWithBackupWitholding |
| Number Of Employees | 372 | NumberOfEmployees |
| Employment Tax Returns Filed | true | EmploymentTaxReturnsFiled |
| Unrelated Business Income | false | UnrelatedBusinessIncome |
| Form990-T Filed | false | 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 |
| Number Of8282 Filed | 0 | NumberOf8282Filed |
| Funds To Pay Premiums | false | FundsToPayPremiums |
| Premiums Paid | false | PremiumsPaid |
| Form8899 Filed | false | Form8899Filed |
| Form1098 C Filed | false | Form1098CFiled |
| Excess Business Holdings | false | ExcessBusinessHoldings |
| Taxable Distributions | false | TaxableDistributions |
| Distribution To Donor | false | DistributionToDonor |
| Filed Lieu1041 | false | FiledLieu1041 |
| Licensed More Than One State | false | LicensedMoreThanOneState |
| Indoor Tanning Services | false | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 15 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 11 | NumberIndependentVotingMembers |
| Family Or Business Relationship | true | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | false | DelegationOfManagementDuties |
| Changes To Organizing Docs | true | 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 | false | CompensationProcessOther |
| Investment In Joint Venture | false | InvestmentInJointVenture |
| States Where Copy Of Return Is Filed | ME | StatesWhereCopyOfReturnIsFiled |
| Own Website | X | OwnWebsite |
| Other Website | X | OtherWebsite |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | Wendy J Jones | NamePerson |
| Telephone Number | 2073743409 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 57 Water Street | AddressLine1 |
| City | Blue Hill | City |
| State | ME | State |
| ZIP Code | 04614 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (27 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 |
|---|---|---|---|---|---|---|---|---|---|
| Gordon Stewart | |||||||||
| Trustee | 2.00 | 0.00 | X | 0 | 0 | 0 | |||
| Jim Schatz | |||||||||
| Trustee | 2.00 | 0.00 | X | 0 | 0 | 0 | |||
| Stacey Henner Walden DO | |||||||||
| Trustee | 30.00 | 0.00 | X | 180623 | 0 | 23755 | |||
| Zoe Robbins Tenney | |||||||||
| Trustee | 25.00 | 0.00 | X | 55051 | 0 | 22085 | |||
| David Snow | |||||||||
| Trustee | 2.00 | 0.00 | X | 0 | 0 | 0 | |||
| Arthur Newkirk MD | |||||||||
| Chief of Staff | 40.00 | 0.00 | X | 148819 | 0 | 18531 | |||
| Danielle V Mutty MD | |||||||||
| Trustee | 2.00 | 0.00 | X | 0 | 0 | 0 | |||
| Andrew K Laslie CPA | |||||||||
| Secretary | 2.00 | 0.00 | X | 0 | 0 | 0 | X | ||
| Sally N Mills | |||||||||
| Vice Chair | 2.00 | 0.00 | X | 0 | 0 | 0 | X | ||
| Margaret Hannah | |||||||||
| Trustee | 2.00 | 0.00 | X | 0 | 0 | 0 | |||
| Gregory Roraff | |||||||||
| President & CEO | 40.00 | 0.00 | X | 274248 | 0 | 29435 | X | ||
| Christopher Young | |||||||||
| Trustee | 2.00 | 0.00 | X | 0 | 0 | 0 | |||
| Richard K Howe | |||||||||
| Treasurer | 2.00 | 0.00 | X | 0 | 0 | 0 | X | ||
| Charles Hatfield | |||||||||
| Trustee | 2.00 | 0.00 | X | 0 | 0 | 0 | |||
| Frank Wanning | |||||||||
| Chairman | 2.00 | 0.00 | X | 0 | 0 | 0 | X | ||
| John Ronan | |||||||||
| VP Ancillary Sv | 40.00 | 0.00 | 153620 | 0 | 10742 | X | |||
| Kathleen J Ober | |||||||||
| VP Med Affairs | 40.00 | 0.00 | 449456 | 0 | 31255 | X | |||
| Elizabeth Schidzick-Brunelle | |||||||||
| VP Phys Pract | 40.00 | 0.00 | 169198 | 0 | 9682 | X | |||
| Edward Olivier | |||||||||
| CFO | 40.00 | 0.00 | 158083 | 0 | 20372 | X | |||
| Constance Barrett | |||||||||
| VP/CNO | 40.00 | 0.00 | 139512 | 0 | 11864 | X | |||
| James White | |||||||||
| Surgeon | 40.00 | 0.00 | 451999 | 0 | 27251 | X | |||
| Mark Kaplan | |||||||||
| Physician | 40.00 | 0.00 | 360402 | 0 | 19426 | X | |||
| Joseph Babbitt | |||||||||
| Hospitalist | 40.00 | 0.00 | 400665 | 0 | 27788 | X | |||
| Thomas Bugbee | |||||||||
| Physician | 40.00 | 0.00 | 298982 | 0 | 31722 | X | |||
| Amy Tan | |||||||||
| Surgeon | 40.00 | 0.00 | 275372 | 0 | 32637 | X | |||
| Scott Oxley | |||||||||
| Former Interim CFO | 0.00 | 50.00 | 0 | 278914 | 41242 | X | |||
| Erik N Steele | |||||||||
| Former Interim CEO | 0.00 | 50.00 | 0 | 362861 | 51056 | X | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 3516030 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 641775 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 408843 | TotalOtherCompensation |
| Number Individuals GT100 K | 30 | NumberIndividualsGT100K |
| Formers Listed | true | FormersListed |
| Total Comp GT150 K | true | TotalCompGT150K |
| Compensation From Other Sources | false | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (5 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| United Medical System | |||||
| 1500 West Park Drive | Westborough | MA | 01581 | Surgical Services | 126660 |
| Surapaneni P Ramanadha Rao | |||||
| PO Box 8117 | Bangor | ME | 04401 | Urology Phys Svcs | 781200 |
| Nurse Anesthesia of Maine | |||||
| 141 N Main Street Ste 205 | Brewer | ME | 04412 | Anesthesia Svcs | 651012 |
| NEHE MRI LLC | |||||
| 260 Main Street | Presque Isle | ME | 04769 | Imaging Services | 285261 |
| Dahl Chase Diagnostic Services | |||||
| 417 State Street Ste 541 | Bangor | ME | 04401 | Pathology Sevices | 130258 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 5 | NumberOfContractorsGT100K |
| Related Organizations | 53095 | RelatedOrganizations |
| Government Grants | 16179 | GovernmentGrants |
| All Other Contributions | 414938 | AllOtherContributions |
| Noncash Contributions | 19575 | NoncashContributions |
| Total Contributions | 484212 | TotalContributions |
Program Service Revenue ProgramServiceRevenue (3 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome | ExclusionExclusionAmount |
|---|---|---|---|---|
| Patient Care Service | 621990 | 54648335 | 54648335 | |
| Exempt Affiliate Rental | 532000 | 6000 | 6000 | |
| Cafeteria | 722210 | 95398 | $95,398 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 54749733 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 311776 | TotalRevenueColumn |
| Exclusion | $311,776 | ExclusionAmount |
Income From Invest Bond Proceeds IncomeFromInvestBondProceeds
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Royalties Revenue RoyaltiesRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Gross Rents GrossRents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 10720 | Real |
Less Rental Expenses LessRentalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 5308 | Real |
Rental Income Or Loss RentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 5412 | Real |
Net Rental Income Or Loss NetRentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 5412 | TotalRevenueColumn |
| Exclusion | $5,412 | ExclusionAmount |
Gross Amount Sales Assets GrossAmountSalesAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 2002696 | Securities |
| Other | 161887 | Other |
Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 1993374 | Securities |
| Other | 177399 | Other |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 9322 | Securities |
| Other | -15512 | Other |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -6190 | TotalRevenueColumn |
| Related Or Exempt Function Income | 9322 | RelatedOrExemptFunctionIncome |
| Exclusion | -$15,512 | ExclusionAmount |
Net Income From Fundraising Events NetIncomeFromFundraisingEvents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Net Income From Gaming NetIncomeFromGaming
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Net Income Or Loss NetIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Other Revenue Misc OtherRevenueMisc
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | Meaningful Use Incentives | Description |
| Business Code | 621990 | BusinessCode |
| Total Revenue Column | 475631 | TotalRevenueColumn |
| Related Or Exempt Function Income | 475631 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 475631 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 56020574 | TotalRevenueColumn |
| Related Or Exempt Function Income | 55139288 | RelatedOrExemptFunctionIncome |
| Exclusion | $397,074 | ExclusionAmount |
Grants To Domestic Orgs GrantsToDomesticOrgs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Grants To Domestic Individuals GrantsToDomesticIndividuals
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Foreign Grants ForeignGrants
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Benefits To Members BenefitsToMembers
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1906331 | Total |
| Program Services | 1279980 | ProgramServices |
| Management And General | 626351 | ManagementAndGeneral |
Comp Disqual Persons CompDisqualPersons
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 17265327 | Total |
| Program Services | 15571054 | ProgramServices |
| Management And General | 1694273 | ManagementAndGeneral |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 624326 | Total |
| Program Services | 561893 | ProgramServices |
| Management And General | 62433 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2454592 | Total |
| Program Services | 2205552 | ProgramServices |
| Management And General | 249040 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1080940 | Total |
| Program Services | 972846 | ProgramServices |
| Management And General | 108094 | ManagementAndGeneral |
Fees For Services Management FeesForServicesManagement
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 11298 | Total |
| Management And General | 11298 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 40985 | Total |
| Management And General | 40985 | ManagementAndGeneral |
Fees For Services Lobbying FeesForServicesLobbying
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Prof Fundraising FeesForServicesProfFundraising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 16041 | Total |
| Program Services | 642 | ProgramServices |
| Management And General | 15399 | ManagementAndGeneral |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3205272 | Total |
| Program Services | 2203536 | ProgramServices |
| Management And General | 1001736 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 108166 | Total |
| Program Services | 19365 | ProgramServices |
| Management And General | 88801 | ManagementAndGeneral |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1410253 | Total |
| Program Services | 1321243 | ProgramServices |
| Management And General | 89010 | ManagementAndGeneral |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 397563 | Total |
| Program Services | 304356 | ProgramServices |
| Management And General | 93207 | ManagementAndGeneral |
Royalties Royalties
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 771897 | Total |
| Program Services | 663953 | ProgramServices |
| Management And General | 107944 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 63898 | Total |
| Program Services | 46770 | ProgramServices |
| Management And General | 17128 | ManagementAndGeneral |
Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 101895 | Total |
| Program Services | 92983 | ProgramServices |
| Management And General | 8912 | ManagementAndGeneral |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 91781 | Total |
| Program Services | 91781 | ProgramServices |
Payments To Affiliates PaymentsToAffiliates
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1308769 | Total |
| Program Services | 1089960 | ProgramServices |
| Management And General | 218809 | ManagementAndGeneral |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 107986 | Total |
| Program Services | 84337 | ProgramServices |
| Management And General | 23649 | ManagementAndGeneral |
Other Expenses OtherExpenses (4 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices |
|---|---|---|
| Provision for uncollectible ac | 1614588 | 1614588 |
| Charity Care | 2076290 | 2076290 |
| Medical Supplies | 3458125 | 3458125 |
| Contractual Allowances | 14511828 | 14511828 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1440951 | Total |
| Program Services | 1332088 | ProgramServices |
| Management And General | 108863 | ManagementAndGeneral |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 54069102 | Total |
| Program Services | 49503170 | ProgramServices |
| Management And General | 4565932 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 62124 | BOY |
| EOY | 63415 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 4555017 | BOY |
| EOY | 4867079 | EOY |
Pledges And Grants Receivable PledgesAndGrantsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 7736 | BOY |
| EOY | 0 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 4928715 | BOY |
| EOY | 4291283 | EOY |
Receivables From Officers Etc ReceivablesFromOfficersEtc
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 0 | EOY |
Receivables From Disqual Persons ReceivablesFromDisqualPersons
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 0 | EOY |
Other Notes Loans Receivable Net OtherNotesLoansReceivableNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 0 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 149181 | BOY |
| EOY | 150696 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 490822 | BOY |
| EOY | 540607 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 27846683 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 19276484 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 8691710 | BOY |
| EOY | 8570199 | EOY |
Investments Pub Traded Securities InvestmentsPubTradedSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 0 | EOY |
Investments Other Securities InvestmentsOtherSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 0 | EOY |
Investments Program Related InvestmentsProgramRelated
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 0 | EOY |
Intangible Assets IntangibleAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 0 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 16119373 | BOY |
| EOY | 19623914 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 35004678 | BOY |
| EOY | 38107193 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 9878076 | BOY |
| EOY | 10239779 | EOY |
Deferred Revenue DeferredRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 4237 | BOY |
| EOY | 1576 | EOY |
Tax Exempt Bond Liabilities TaxExemptBondLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2122458 | BOY |
| EOY | 2016456 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1212398 | BOY |
| EOY | 1368388 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 13217169 | BOY |
| EOY | 13626199 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 20015484 | BOY |
| EOY | 22505639 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 375964 | BOY |
| EOY | 426683 | EOY |
Permanently Restricted Net Assets PermanentlyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1396061 | BOY |
| EOY | 1548672 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 21787509 | BOY |
| EOY | 24480994 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 35004678 | BOY |
| EOY | 38107193 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | 1951472 | ReconcilationRevenueExpenses |
| Reconciliation Unrealized Invest | 988370 | ReconciliationUnrealizedInvest |
| Reconcilation Other Changes | -246357 | 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 Both | X | FinancialStatementBoth |
| 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) |
|---|---|---|
| Form4720 Filed4955 Tax | false | Form4720Filed4955Tax |
| Correction Made | false | CorrectionMade |
Total Direct Lobbying TotalDirectLobbying
| Field | Value | IRS element (for citing) |
|---|---|---|
| Filing Organizations Totals | 7294 | FilingOrganizationsTotals |
Total Lobbying Expenditures TotalLobbyingExpenditures
| Field | Value | IRS element (for citing) |
|---|---|---|
| Filing Organizations Totals | 7294 | FilingOrganizationsTotals |
Other Exempt Purpose Expenditures OtherExemptPurposeExpenditures
| Field | Value | IRS element (for citing) |
|---|---|---|
| Filing Organizations Totals | 54061808 | FilingOrganizationsTotals |
Total Exempt Purpose Expenditures TotalExemptPurposeExpenditures
| Field | Value | IRS element (for citing) |
|---|---|---|
| Filing Organizations Totals | 54069102 | FilingOrganizationsTotals |
Lobbying Nontaxable LobbyingNontaxableAmount
| Field | Value | IRS element (for citing) |
|---|---|---|
| Filing Organizations Totals | 1000000 | FilingOrganizationsTotals |
Grassroots Nontaxable GrassrootsNontaxableAmount
| Field | Value | IRS element (for citing) |
|---|---|---|
| Filing Organizations Totals | 250000 | FilingOrganizationsTotals |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form4720 Filed | false | Form4720Filed |
Lobbying Nontaxable Amount2 LobbyingNontaxableAmount2
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Year Minus3 | 1000000 | CurrentYearMinus3 |
| Current Year Minus2 | 1000000 | CurrentYearMinus2 |
| Current Year Minus1 | 1000000 | CurrentYearMinus1 |
| Current Year | 1000000 | CurrentYear |
| Total | 4000000 | Total |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Lobbying Ceiling | $6,000,000 | LobbyingCeilingAmount |
Total Lobbying Expenditures2 TotalLobbyingExpenditures2
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Year Minus3 | 4301 | CurrentYearMinus3 |
| Current Year Minus2 | 6848 | CurrentYearMinus2 |
| Current Year Minus1 | 4649 | CurrentYearMinus1 |
| Current Year | 7294 | CurrentYear |
| Total | 23092 | Total |
Grassroots Nontaxable Amount2 GrassrootsNontaxableAmount2
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Year Minus3 | 250000 | CurrentYearMinus3 |
| Current Year Minus2 | 250000 | CurrentYearMinus2 |
| Current Year Minus1 | 250000 | CurrentYearMinus1 |
| Current Year | 250000 | CurrentYear |
| Total | 1000000 | Total |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grassroots Ceiling | $1,500,000 | GrassrootsCeilingAmount |
Schedule D IRS990ScheduleD
Current Year CurrentYear
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 558201 | BeginningOfYearBalance |
| Contributions | 109376 | Contributions |
| Investment Earnings Or Losses | 25314 | InvestmentEarningsOrLosses |
| End Of Year Balance | 692891 | EndOfYearBalance |
Current Year Minus1 Year CurrentYearMinus1Year
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 501206 | BeginningOfYearBalance |
| Contributions | 23900 | Contributions |
| Investment Earnings Or Losses | 33095 | InvestmentEarningsOrLosses |
| End Of Year Balance | 558201 | EndOfYearBalance |
Current Year Minus2 Years CurrentYearMinus2Years
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 430983 | BeginningOfYearBalance |
| Contributions | 65500 | Contributions |
| Investment Earnings Or Losses | 4723 | InvestmentEarningsOrLosses |
| End Of Year Balance | 501206 | EndOfYearBalance |
Current Year Minus3 Years CurrentYearMinus3Years
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 252141 | BeginningOfYearBalance |
| Contributions | 159113 | Contributions |
| Investment Earnings Or Losses | 19729 | InvestmentEarningsOrLosses |
| End Of Year Balance | 430983 | EndOfYearBalance |
Current Year Minus4 Years CurrentYearMinus4Years
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 252141 | BeginningOfYearBalance |
| End Of Year Balance | 252141 | EndOfYearBalance |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Designated EOY Balance | 0.00420 | BoardDesignatedEOYBalance |
| Permanent Endowment EOY Balance | 0.99580 | PermanentEndowmentEOYBalance |
| Endowments Held By Unrelated Orgs | false | EndowmentsHeldByUnrelatedOrgs |
| Endowments Held By Related Orgs | true | EndowmentsHeldByRelatedOrgs |
| Are Related Orgs Listed Schedule R | true | AreRelatedOrgsListedScheduleR |
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 447386 | OtherCostOrOtherBasis |
| Book Value | 447386 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 11523362 | OtherCostOrOtherBasis |
| Depreciation | 7811493 | Depreciation |
| Book Value | 3711869 | BookValue |
Leasehold Improvements LeaseholdImprovements
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 2810 | OtherCostOrOtherBasis |
| Depreciation | 2288 | Depreciation |
| Book Value | 522 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 14317660 | OtherCostOrOtherBasis |
| Depreciation | 11199969 | Depreciation |
| Book Value | 3117691 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 1555465 | OtherCostOrOtherBasis |
| Depreciation | 262734 | Depreciation |
| Book Value | 1292731 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 8570199 | TotalOfBookValueLandBuildings |
Other Assets OtherAssets (8 entries)
| DescriptionDescription | Book ValueBookValue |
|---|---|
| Temporarily Donor Restricted Funds | 426683 |
| Self Insurance Funds Held by Trustee | 60379 |
| Permanently Donor Restricted Funds | 607530 |
| Estimated Prof. Liab. Claims Receivable | 791199 |
| Board Designated Funds-Other | 8996529 |
| Board Designated Funds-Funded Deprec. | 7752036 |
| Beneficial Interest in Perpetual Trusts | 941142 |
| Assets Whose Use is Limited | 48416 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | 19623914 | TotalBookValueOtherAssets |
Other Liabilities OtherLiabilities (3 entries)
| DescriptionDescription | AmountAmount |
|---|---|
| Self-insurance Benefits | $13,959 |
| Reserve for Prof. Liab. Self Ins. | $791,199 |
| Deferred Compensation | $563,230 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 1368388 | TotalOfAmounts |
| Footnote In Part XIII | X | FootnoteInPartXIII |
| Tot Revenue Etc Audited Fincl Stmt | 38764093 | TotRevenueEtcAuditedFinclStmt |
| Net Unrealized Gains Investments | 988370 | NetUnrealizedGainsInvestments |
| Other Revenues | -18189826 | OtherRevenues |
| Revenue Not Rptd F990 | -17201456 | RevenueNotRptdF990 |
| Revenue Subtotal | 55965549 | RevenueSubtotal |
| Other Revenues Not Included | 55025 | OtherRevenuesNotIncluded |
| Revenue Not Rptd On Fin Stmt | 55025 | RevenueNotRptdOnFinStmt |
| Total Revenue Per Form990 | 56020574 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 35849981 | TotExpensesEtcAuditedFinclStmt |
| Expenses Subtotal | 35849981 | ExpensesSubtotal |
| Other Expenses Not Included | 18219121 | OtherExpensesNotIncluded |
| Expenses Not Rptd On Fin Stmt | 18219121 | ExpensesNotRptdOnFinStmt |
| Total Expenses Per Form990 | 54069102 | TotalExpensesPerForm990 |
Form990 Schedule D Part XIII Form990ScheduleDPartXIII (4 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| Part XII, Line 4b | Part XII, Line 4b: Other revenue amounts included on 990 but not included in F/S | Charity Care $2076290 Contractual Allowance $14511828 Restricted Expenses from Fund Balance $29295 Reimbursed Expenses Reclassed to Expense $-12880 Bad Debt Expense $1614588 |
| Part XI, Line 4b | Part XI, Line 4b: Other revenue amounts included on 990 but not included in F/S | Restricted Contributions from fund bal $54252 Restricted Investment Inc from fund bal $773 |
| Part X | Part X : FIN48 Footnote | Income TaxesThe Hospital has been determined by the Internal Revenue Service to be a tax-exempt charitable organization as described in Section 501(c)(3) of the Code and, accordingly, is exempt from federal income taxed on related income pursuant to Section 501(a) of the Code. Accordingly, no provision for federal income taxes has been recorded in the accompanying financial statements. |
| Part V, Line 4 | Part V, Line 4: Intended uses of the endowment fund. | Endowment funds are designated for purposes that align within this organization's exempt purpose. |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Charity Care Policy | true | CharityCarePolicy |
| Written Policy | true | WrittenPolicy |
| FPG Reference Free Care | true | FPGReferenceFreeCare |
| Pcent200 | X | Pcent200 |
| FPG Reference Discounted Care | true | FPGReferenceDiscountedCare |
| Pcent300 | X | Pcent300 |
| 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) |
|---|---|---|
| Persons Served | 527 | PersonsServed |
| Total Community Benefit Expense | 1184108 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 13692 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 1170416 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.03260 | PercentOfTotalExpense |
Unreimbursed Costs UnreimbursedCosts
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 131138 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 131138 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00370 | PercentOfTotalExpense |
Total Charity Care TotalCharityCare
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 527 | PersonsServed |
| Total Community Benefit Expense | 1315246 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 13692 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 1301554 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.03630 | PercentOfTotalExpense |
Community Health Services CommunityHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 7 | NumberOfActivitiesOrPrograms |
| Persons Served | 362 | PersonsServed |
| Total Community Benefit Expense | 260632 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 260632 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00730 | PercentOfTotalExpense |
Total Other Benefits TotalOtherBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 7 | NumberOfActivitiesOrPrograms |
| Persons Served | 362 | PersonsServed |
| Total Community Benefit Expense | 260632 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 260632 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00730 | PercentOfTotalExpense |
Total Community Benefits TotalCommunityBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 7 | NumberOfActivitiesOrPrograms |
| Persons Served | 889 | PersonsServed |
| Total Community Benefit Expense | 1575878 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 13692 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 1562186 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.04360 | PercentOfTotalExpense |
Community Support CommunitySupport
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 1 | NumberOfActivitiesOrPrograms |
| Total Community Building Expense | 766 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 766 | NetCommunityBuildingExpense |
Coalition Building CoalitionBuilding
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 1 | NumberOfActivitiesOrPrograms |
| Total Community Building Expense | 32956 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 32956 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00090 | PercentOfTotalExpense |
Total Total
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 2 | NumberOfActivitiesOrPrograms |
| Total Community Building Expense | 33722 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 33722 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00090 | PercentOfTotalExpense |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | true | BadDebtExpenseReported |
| Bad Debt Expense | $1,015,095 | BadDebtExpenseAmount |
| Amount Reimbursed By Medicare | 15429198 | AmountReimbursedByMedicare |
| Cost Of Care Reimbursed By Medicare | 15752805 | CostOfCareReimbursedByMedicare |
| Medicare Surplus Or Shortfall | -323607 | 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 | Blue Hill Memorial Hospital | BusinessNameLine1 |
Address Address
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 57 Water Street | AddressLine1 |
| City | Blue Hill | City |
| State | ME | State |
| ZIP Code | 04614 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Licensed Hospital | X | LicensedHospital |
| General Medical And Surgical | X | GeneralMedicalAndSurgical |
| Critical Access Hospital | X | CriticalAccessHospital |
| Er24 Hours | X | Er24Hours |
Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Blue Hill Memorial 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 |
| Other | X | Other |
| Needs Assessment Conducted | 11 | 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 |
| Include Operational Plans | X | IncludeOperationalPlans |
| Adopt Budget | X | AdoptBudget |
| Prioritize Health Needs | X | PrioritizeHealthNeeds |
| Prioritize Services | X | PrioritizeServices |
| Other Needs Addressed | X | OtherNeedsAddressed |
| All Needs Addressed | true | AllNeedsAddressed |
| Organization Incur Excise Tax | false | OrganizationIncurExciseTax |
| File Form4720 Report Excise Tax | false | FileForm4720ReportExciseTax |
| Eligibility Criteria Explained | true | EligibilityCriteriaExplained |
| Uses FPG Free | true | UsesFPGFree |
| FPG Free Percent | 200.0000 | FPGFreePercent |
| Uses FPG Discounted | true | UsesFPGDiscounted |
| FPG Discount Percent | 300.0000 | FPGDiscountPercent |
| Explains Basis | false | ExplainsBasis |
| Income Level | X | IncomeLevel |
| Explains Application Method | true | ExplainsApplicationMethod |
| Includes Publicity Measures | true | IncludesPublicityMeasures |
| Available On Request | X | AvailableOnRequest |
| Other Publicity | X | OtherPublicity |
| 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 | 8 | NumberOfOtherFacilities |
Other Facilities OtherFacilities (8 entries)
| Address Line1Address/AddressLine1 | CityAddress/City | StateAddress/State | ZIP CodeAddress/ZIPCode | Facility TypeFacilityType |
|---|---|---|---|---|
| Blue Hill Cardiovascular Medicine | ||||
| 65 Water Street | Blue Hill | ME | 04614 | Physician Offices |
| Island Family Medicine | ||||
| 354 Airport Road | Stonington | ME | 04681 | Physician Offices |
| Castine Community Health Services | ||||
| 102 Court Street | Castine | ME | 04421 | Physician Offices |
| Bucksport Family Medicine | ||||
| 58 Main Street | Bucksport | ME | 04416 | Physician Offices |
| Blue Hill Womens Healthcare | ||||
| 65 Water Street | Blue Hill | ME | 04614 | Physician Offices |
| Blue Hill Specialty Services | ||||
| 65 Water Street | Blue Hill | ME | 04614 | Physician Offices |
| Blue Hill Orthopedics | ||||
| 65 Water Street | Blue Hill | ME | 04614 | Physician Offices |
| Blue Hill Family Medicine | ||||
| 65 Water Street | Blue Hill | ME | 04614 | Physician Offices |
Form990 Schedule H Part VI Form990ScheduleHPartVI (21 entries)
| Return ReferenceReturnReference | ExplanationExplanation | IdentifierIdentifier |
|---|---|---|
| Part V - Explanation of Number of Facility Type | N/A | |
| Part VI - States Where Community Benefit Report Filed | ME | |
| Part VI - Affilated Health Care System Roles and Promotion | We are part of Eastern Maine Healthcare Systems and receive support from our parent organization for activities such as community forums. In addition, we rely upon other system members to help us provide specialized care for community members. For example, we rely upon Eastern Maine Medical Center and Acadia Hospital (both in Bangor) to provide specialized care that could never be provided in the context of a small community hospital. We use strong referral networks and technology to make a full range of services as convenient, safe, and effective as possible for patients in our area. | |
| Part VI - Explanation Of How Organization Furthers Its Exempt Purpose | We partner with many other non-profits, including Healthy Peninsula and the Jackson Laboratory to promote the health of our community. These partnerships are for the benefit of our community. | |
| Part VI - Community Building Activities | Our outreach to the community includes blood drives, blood pressure clinics, an educational presence at local fairs and festivals, ongoing work with local schools in areas such as H1N1 preparation, and special events such as our annual Fun Run. Our providers also assist with outreach by giving educational sessions on topics such as osteoporosis, women's health, healthy aging, and diabetes. We provide tours and "hands on" experiences to local school children in our emergency, radiology and rehabilitation departments. | |
| Part VI - Community Information | We serve a rural community that includes many senior citizens, i.e. 20% of our population is age 65 or older. With the exception of our wealthy seasonal residents, many of our patients are economically challenged. Our hospital and its primary care practices are impacted by the effects of chronic disease within the communities we serve. Depression, obesity, diabetes, and cardio-vascular disease are common problems. The rural, geographically isolated nature of our communities also means that many turn to our hospital and practices for assistance that might otherwise be provided by other agencies. Assistance for those with problems such as addiction, domestic violence, etc. is very limited particularly for those with transportation needs. We also have patients who live on offshore islands whose only transportation is the mailboat to the mainland. Our physician practices take this into consideration when a patient needs to be scheduled for an appointment. | |
| Part VI - Patient Education of Eligibility for Assistance | We have information available through our Web site, have financial counselors at the hospital, and equip our primary care practices with this information. In addition we have discharge planning personnel, including a licensed clinical social worker, who provide more extensive assistance to patients with complex financial issues. Further, our financial counselor screens our patients (using Hospital services) and personally meets with anyone listed as self-pay to help identify if financial assistance is needed. | |
| Part VI - Needs Assessment | Blue Hill Memorial Hospital is an affiliate of Eastern Maine Healthcare Systems. As a small rural hospital, we rely upon our system to help us assess the healthcare needs of the communities we serve. In 2001 and again in 2007, EMHS contracted with an academic partner to conduct a regional Community Health Needs Assessment (CHNA). In 2011, EMHS again invested in a significant study, this time in collaboration with OneMaine Health. The OneMaine Health Collaborative is a partnership of three of Maines largest health systems: EMHS (Eastern Maine Healthcare Systems), MaineHealth, and MaineGeneral. The study was conducted to identify the most important health issues in the state and by county, using a scientific method to validate health indicators and to compare results. The assessment identifies priority health issues in the areas we serve. In addition to the CHNA report, we assess the needs of our community on an ongoing basis by reviewing feedback from various advisory groups, community health partners, area businesses, local schools, and other organizations. | |
| Part V, Line 20d - Other Billing Determination of Individuals Without Insurance | Hospital charges are discounted at 100% for patients who qualify for free care with income at or below 200% FPL. The hospital also offers a partial discount for patients who fall within the 201% and 300% FPL. | Number of Hospital Faciltiy - 1 |
| Part V, Line 14g - Other Means Hospital Facility Publicized the Policy | Posted signs and individual notices containing information on the availability of free care are located in key public areas in the hospital. Signs and notices inform the patient of the availability of free care and include eligibility criteria, instructions on how to apply and how to obtain additional information or assistance.The "Billing Help" section of the hospital web pages provides a link to the free care application form, instructions and eligibility criteria. | Number of Hospital Faciltiy - 1 |
| Part V, Line 6i - Describe Other Needs Identified | 6a Blue Hill Memorial Hospital has adopted an implementation strategy that takes into account the CHNA report as well as other input from the community. Community benefit strategies are woven into our strategic plan as well as our master facility planning process.6b Our community relations office works closely with clinical personnel and community partners to execute our implementation strategy. The senior director of advancement is a member of the hospitals leadership team and also serves as staff to an Advancement Committee of the board (of Trustees) that provides feedback on community healthcare needs.6c Blue Hill Memorial Hospital staff interact with other community organizations (schools, nursing homes, retirement communities, businesses, home healthcare agencies etc.) to ensure that our community benefit plan takes into account the needs of various constituencies throughout our community. In addition, we recruited a Community Advisory Council that provides feedback on local healthcare needs and helps us assess the hospitals progress in helping meet these needs through targeted outreach programs.6d We are executing on our community-wide community benefit plan in conjunction with other partners, such as Healthy Peninsula, to co-sponsor programs that address community needs such as developmental delays in young children and substance abuse. 6e Our community benefit strategy and activities are in our operational plans through (i) duties described in job descriptions (ii) our budget (iii) our master facility and strategic planning processes iv) our communication plan, which includes media releases and Web content, for example.6f Our budget accommodates the financial assistance we provide to patients who receive charity care as part of our community benefit strategy. The annual operating budget provides for increased access to behavioral health providers and primary care providers, as well as programs targeted at obesity and community health screenings. Also included in the budget is a staff member whose time is committed to supporting community benefit activities such as screenings, talks, etc.6g The Community Health Needs Assessment (survey), our Community Advisory Council, and community healthcare partners have helped us identify the following healthcare needs as local priorities: (i) access to primary care (being addressed in an operational plan); (ii) chronic illnesses such as obesity, depression, cardiovascular disease, and diabetes; (iii) substance abuse. 6h We have prioritized the following services in response to 6g: (i) greater emphasis on early intervention and prevention for priority healthcare needs through screenings, education, etc.; (ii) delivery of programs outside of traditional settings (in retirement homes, local businesses, etc.); (iii) improved access to primary care through initiatives such as patient-centered medical come models ; (iv) improved public communication regarding various financial assistance programs for needy patients. | Number of Hospital Faciltiy - 1 |
| Part V, Line 5c - Description of Making Needs Assessment Widely Available | In conjunction with EMHS, Blue Hill Memorial Hospital hosted a community forum to present an overview of local assessment results and recommendations. Invitees included: Other area hospitals, Physician leaders, Federally Qualified Health Centers, Healthy Maine Partnerships, District Liaisons linked to Maine CDC, Home Health and Long Term Care leaders, Social Service Agencies, Leaders of the tribal communities, Business leaders, Legislative leaders, Representatives of the State administrationAttendees were provided an executive summary of the assessment as well as a summary table of data reflective of the service area. A presentation was made by EMHS staff who were members of the assessment development steering committee providing selected data results, trends over time and the priorities and recommendations as suggested by the research consultants.In addition to the community forums, the entire statewide assessment (both narrative and data sets) were posted to the EMHS website. After the forums, Power Point presentations used at the Forum as well as input collected in the breakout sessions were also posted on the website. Forum participants were encouraged to go to the website to review the assessment in detail, and access the data for local planning. Media releases were also sent to local news outlets in combination with the forums, encouraging new articles on the forum and inviting all members of the public to view the report on the website.Instructions on the website assist viewers to download and /or print sections of the report. Individuals without computer or printer access were provided a phone number where they can request a printed assessment. | Number of Hospital Faciltiy - 1 |
| Part V, Line 4 - List Other Hospital Facilities that Jointly Conducted Needs Assessment | The needs assessment was developed as a statewide collaborative between the states three largest health systems: EMHS (in central, eastern and northern Maine), MaineGeneral (in central Maine) and MaineHealth (in southern Maine). Multiple collaborators were involved in the dissemination of the assessment findings and establishment of priorities (see Section 5). | Number of Hospital Faciltiy - 1 |
| Part V, Line 3 - Account Input from Person Who Represent the Community | On a statewide basis, the research consultants developed an advisory committee that met two times during the assessment research and drafting of the publication. These individuals represented a broad spectrum of backgrounds, and they are named: Carol Bell, Healthy Maine Partnership Director; Kelly Bentley, Healthy Maine Partnership Director; Gail Dana-Sacco, Wabanaki Center (serving tribal populations); Patricia Hart, Maine Development Foundation; Barbara Leonard, MPH, Maine Health Access Foundation (philanthropic foundation focused on access to care in Maine); Becca Matusovich, Maine Center for Disease Control; Lisa Miller, Bingham Foundation (philanthropic foundation); Dora Ann Mills, MD, Maine Center for Disease Control; Elizabeth Mitchell, Maine Health Management Coalition (representing the states major employers, insurers and providers); Trish Riley, Governors Office of Health Policy and Finance (GOHPF); Brian Rines, Advisory Committee for Health System Development (overseen by GOHPF); Rachel Talbot-Ross, Maine Chapter, NAACP; Ted Trainer, Public Health Coordinating Council Shawn Yardley, City of Bangor, Department of Health and Welfare. | Number of Hospital Faciltiy - 1 |
| Part V, Line 1j - Description of Other Needs Assessment | 1a Blue Hill Memorial Hospital and its practices serve a rural area that includes island communities that can be reached only by mail boat, private vessel, or the Lifeflight helicopter. The primary communities that we serve include: Blue Hill, Bucksport, Brooklin, Brooksville, Cape Rosier, Castine, Harborside, Deer Isle, Penobscot, Sargentville, Sedgwick, Stonington. We serve also serve patients from other communities, such as Ellsworth as well as tourists and seasonal residents. Our area is considered a destination for some wealthy families. This wealth contrasts significantly with substantial poverty in our region.1b Blue Hill Memorial Hospital and its related physician practices utilize extensive electronic medical records, including disease registries, which provide a vast amount of data relative to patients in care. The needs assessment provides a much broader picture of the community as a whole, including the health status of individuals not in care, as well as functional health status and social-demographics (such as employment, income and education levels). The local units of the states public health infrastructure (known as Healthy Maine Partnerships) are also integrated into the process so that their data relative to health, environmental and social measures are part of the community dissemination process.1c Blue Hill Memorial Hospital engaged multiple health resource leaders in the community forum invitation list (as described in Section 1g). Additional resources and leaders needed were identified in the breakout sessions (see question for breakout participants, Section 1g). In the Blue Hill Memorial Hospital service area, key collaborators going forward will include: Bucksport Bay Healthy Communities, Healthy Island, and Healthy Peninsula. 1d-1e-1f EMHS, the parent company of Blue Hill Memorial Hospital, routinely conducts a community health needs assessment (Hereafter needs assessment) across the service area of all of its member hospitals. The most recent assessment, published in 2011, was conducted under a contract with the University of New England Center for Health Planning, Policy and Research (CHPPR) and the University of Southern Maines Muskie School for Public Health. Using a methodology developed by CHPPR over decades of work, the assessment integrates primary data from a telephone survey to heads of households with secondary data retrieved from state databases (ED usage, Mortality, Cancer Registry, etc.). That data is reviewed in the context of multiple health related domains to develop a composite view of health status, behavioral risks, and barriers to access and care. Results are compared to national and state benchmarks to produce priorities and recommendations as prepared by the consultants.1g See question #31h On a statewide basis, the research consultants developed an advisory committee that met two times during the assessment research and drafting of the publication. These individuals represented a broad spectrum of backgrounds, and they are named: Carol Bell, Healthy Maine Partnership Director; Kelly Bentley, Healthy Maine Partnership Director; Gail Dana-Sacco, Wabanaki Center (serving tribal populations); Patricia Hart, Maine Development Foundation; Barbara Leonard, MPH, Maine Health Access Foundation (philanthropic foundation focused on access to care in Maine); Becca Matusovich, Maine Center for Disease Control; Lisa Miller, Bingham Foundation (philanthropic foundation); Dora Ann Mills, MD, Maine Center for Disease Control; Elizabeth Mitchell, Maine Health Management Coalition (representing the states major employers, insurers and providers); Trish Riley, Governors Office of Health Policy and Finance (GOHPF); Brian Rines, Advisory Committee for Health System Development (overseen by GOHPF); Rachel Talbot-Ross, Maine Chapter, NAACP; Ted Trainer, Public Health Coordinating Council Shawn Yardley, City of Bangor, Department of Health and Welfare. In the local area served by the assessment, multiple parties were engaged in dissemination of the assessment findings and establishment of priorities (see Section 5). We also consult with persons regarding community health needs on an ongoing basis through mechanisms such as our Community Advisory Committee and healthcare partners in the area such as Healthy Peninsula, Healthy Acadia, Island Medical Center, and Bucksport Bay Healthy Communities. | Number of Hospital Faciltiy - 1 |
| Part III, Line 9b - Provisions On Collection Practices For Qualified Patients | All account guarantors who express an inability to pay inpatient and outpatient services will be screened for eligibility for charity care using an application and guidelines established by BHMH. An account may be reconsidered for charity care at any time when new information is available about a patients inability to pay. | |
| Part III, Line 8 - Explanation Of Shortfall As Community Benefit | Medicare losses should be treated as a community benefit because the losses are incurred in performing an important public service, and Maine hospitals experience one of the lowest Medicare reimbursement rates in the country. | |
| Part III, Line 4 - Bad Debt Expense | Patient accounts receivable are stated at the amount management expects to collect from outstanding balances. Management provides probable uncollectible amounts through a charge to earnings and a credit to a valuation allowance based on its assessment of the current status of individual accounts. Balances that are still outstanding after management has used reasonable collection efforts are written off throught a charge to the valuation allowance and a credit to patient accounts receivable. The costing methodology used to determine the amount reported on line two is cost to charge ratio. | |
| Part I, Line 7, Column F - Explanation of Bad Debt Expense | $1,614,588 of bad debt expense, $2,076,290 of charity care, $14,511,828 of contractuals is included on Form 990, Part IX, line 25, column (A). | |
| Part I, Line 7 - Explanation of Costing Methodology | Ratio of Patient Care Cost-to-Charges is used in calculations. | |
| Part I, Line 6a - Related Organization Community Benefit Report | The BHMH community benefit report is contained in an annual community benefit report prepared by Eastern Maine Healthcare Systems which is the parent organization of all related organizations. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | X | CompensationCommittee |
| Independent Consultant | X | IndependentConsultant |
| Written Employment Contract | X | WrittenEmploymentContract |
| Compensation Survey | X | CompensationSurvey |
| Board Or Committee Approval | X | BoardOrCommitteeApproval |
| Severance Payment | true | SeverancePayment |
| Supplemental Nonqual Retire Plan | false | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | false | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | false | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | false | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | false | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | false | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | false | AnyNonFixedPayments |
| Initial Contract Exception | false | InitialContractException |
| Rebuttable Presumption Procedure | false | RebuttablePresumptionProcedure |
Form990 Schedule J Part II Form990ScheduleJPartII (15 entries)
| TitleTitle | Base Compensation Filing OrgBaseCompensationFilingOrg | Other Compensation Filing OrgOtherCompensationFilingOrg | Deferred Comp Filing OrgDeferredCompFilingOrg | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg | Total Compensation Filing OrgTotalCompensationFilingOrg | Comp Based On Related OrgsCompBasedOnRelatedOrgs | Bonus Related OrgsBonusRelatedOrgs | Other Compensation Related OrgsOtherCompensationRelatedOrgs | Deferred Comp Related OrgsDeferredCompRelatedOrgs | Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs | Total Compensation Related OrgsTotalCompensationRelatedOrgs | Bonus Filing OrgBonusFilingOrg |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Thomas Bugbee | ||||||||||||
| Physician | 276089 | 22893 | 5538 | 26184 | 330704 | |||||||
| Stacey Henner Walden DO | ||||||||||||
| Trustee | 178351 | 2272 | 66 | 23689 | 204378 | |||||||
| Scott Oxley | ||||||||||||
| Former Interim CFO | 210233 | 32872 | 35809 | 18532 | 22710 | 320156 | ||||||
| Mark Kaplan | ||||||||||||
| Physician | 352816 | 7086 | 1133 | 18293 | 379828 | 500 | ||||||
| Kathleen J Ober | ||||||||||||
| VP Med Affairs | 423012 | 26444 | 5425 | 25830 | 480711 | |||||||
| Joseph Babbitt | ||||||||||||
| Hospitalist | 330390 | 69775 | 4815 | 22973 | 428453 | 500 | ||||||
| John Ronan | ||||||||||||
| VP Ancillary Sv | 150331 | 2789 | 2831 | 7911 | 164362 | 500 | ||||||
| James White | ||||||||||||
| Surgeon | 450781 | 1218 | 4278 | 22973 | 479250 | |||||||
| Gregory Roraff | ||||||||||||
| President & CEO | 221495 | 10273 | 5000 | 24435 | 303683 | 42480 | ||||||
| Erik N Steele | ||||||||||||
| Former Interim CEO | 302402 | 52382 | 8077 | 22150 | 28906 | 413917 | ||||||
| Elizabeth Schidzick-Brunelle | ||||||||||||
| VP Phys Pract | 167089 | 1984 | 9682 | 178880 | 125 | |||||||
| Edward Olivier | ||||||||||||
| CFO | 143378 | 1394 | 10644 | 9728 | 178455 | 13311 | ||||||
| Constance Barrett | ||||||||||||
| VP/CNO | 137375 | 1887 | 2797 | 9067 | 151376 | 250 | ||||||
| Arthur Newkirk MD | ||||||||||||
| Chief of Staff | 111144 | 37675 | 2411 | 16120 | 167350 | |||||||
| Amy Tan | ||||||||||||
| Surgeon | 274842 | 530 | 5663 | 26974 | 308009 | |||||||
Form990 Schedule J Part III Form990ScheduleJPartIII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | Sch J, Part III, Additional Information | Identifier |
| Return Reference | Part III, Additional Information | ReturnReference |
| Explanation | Gregory E. RoraffThis officer is employed by the system parent organization, Eastern Maine Healthcare Systems. 100% of his time is dedicated to Blue Hill Memorial Hospital. As a result his compensation is reported in Form 990, Part VII, column D and Schedule J, Part II, Line A(i).Edward J. OlivierThis officer is employed by the system parent organization, Eastern Maine Healthcare Systems. 100% of his time is dedicated to Blue Hill Memorial Hospital (BHMH). As a result his compensation is reported in Form 990, Part VII, column D and Schedule J, Part II, Line A(i).Erik N. SteeleThis former officer is employed by the system parent organization, Eastern Maine Healthcare Systems and is responsible for system-wide operations of seven hospitals and other related health care activities, including Blue Hill Memorial Hospital.Scott OxleyThis former officer is employed by Affiliated Healthcare Management, a related organization of Blue Hill Memorial Hospital.Compensation for employees of Blue Hill Memorial Hospital listed in Form 990, Part VII and Schedule J, Part II are for administrative services. Board members are not compensated for the time devoted on the board. | Explanation |
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 | Maine Health & Higher Ed Facilities Authority | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Issuer EIN | 010314384 | IssuerEIN |
| CUSIP Number | 560427JA5 | CUSIPNumber |
| Date Issued | 2010-06-24 | DateIssued |
| Issue Price | 2533045 | IssuePrice |
| Description Of Purpose | Refund 1998A Series Bonds | DescriptionOfPurpose |
| Defeased | false | Defeased |
| On Behalf Of Issuer | false | OnBehalfOfIssuer |
| Pool Financing | true | PoolFinancing |
Form990 Schedule K Part II Form990ScheduleKPartII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Amount Retired | 295000 | AmountRetired |
| Total Proceeds | 2917294 | TotalProceeds |
| Amount In Reserve Fund | 202081 | AmountInReserveFund |
| Refunding Escrow | 2130000 | RefundingEscrow |
| Issuance Costs From Proceeds | 39023 | IssuanceCostsFromProceeds |
| Other Spent Proceeds | 546190 | OtherSpentProceeds |
| Year Of Subst Completion | 1998 | YearOfSubstCompletion |
| Current Refunding | false | CurrentRefunding |
| Advance Refunding | true | 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 |
| Change In Use Bond Financed Prop | false | ChangeInUseBondFinancedProp |
| Non Qualified Bond Remed Procdrs | true | 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 | false | RebateNotDueYet |
| Hedge Identified In Books And Recds | false | HedgeIdentifiedInBooksAndRecds |
Name Of Hedge Provider NameOfHedgeProvider
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | NA | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Proceeds Invested In GIC | false | GrossProceedsInvestedInGIC |
Name Of GIC Provider NameOfGICProvider
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | NA | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| 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 | true | ProcToUndertkCorrectiveAction |
Form990 Schedule K Part VI Form990ScheduleKPartVI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | Supplemental Information | Identifier |
| Return Reference | Part VI | ReturnReference |
| Explanation | Part II, line 3, column A, does not equal Part I, line A, column E as a result of other sources of funds from DSF-Interest, DSF-Principal, and DSRF balance totaling $384,249.Part IV, Line 7, The issuer(MHHEFA) has established written procedures to monitor the requirements of Section 148. The organization has entered into a tax regulatory agreement with the issuer that requires the organization to comply with the requirements of Section 148. The organization is working to establish its own written procedures to monitor such requirements. | Explanation |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (14 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| Form 990, Part XI, Line 9 | Other Changes In Net Assets Or Fund Balances - Other Decreases | Transfer to exempt parent - Eastern Maine Healthcare Systems = -$270675 |
| Form 990, Part XI, Line 9 | Other Changes In Net Assets Or Fund Balances - Other Decreases | Post Retirement Health Benefit FAS 158 = -$161067 |
| Form 990, Part XI, Line 9 | Other Changes In Net Assets Or Fund Balances - Other Increases | Increase in beneficial trust = $43235 |
| Form 990, Part XI, Line 9 | Other Changes In Net Assets Or Fund Balances - Other Increases | Change in net assets held @ EMHS Foundation = $142150 |
| Form 990, Part VI, Line 19 | Form 990, Part VI, Line 19: Other Organization Documents Publicly Available | Blue Hill Memorial Hospital makes its governing documents, conflict of interest policy and financial statements available to the public upon request. |
| Form 990, Part VI, Line 15a | Form 990, Part VI, Line 15a: Compensation Review & Approval Process - CEO, Top Management | The CEO of Blue Hill Memorial Hospital is employed by the system parent, Eastern Maine Healthcare Systems (EMHS), and reports directly to the EMHS President/CEO (President). The EMHS Executive Performance Management Committee (the Committee) is responsible to monitor and evaluate the performance of the EMHS President, to set compensation of the EMHS President, and to review recommendations of the EMHS President with respect to compensation of the Chief Executive Officer of the direct subsidiaries, and other direct reports to the President. The Committee is comprised entirely of independent Directors per EMHS bylaws.Process:The Committee meets regularly throughout the fiscal year at the discretion of the Committee chair as well as on call of the Chair of the EMHS board. In carrying out its duties pursuant to the Bylaws, the Committee:-Assures that the executive compensation program is administered in a manner consistent with the EMHS executive compensation philosophy.-Reviews and updates the EMHS executive compensation philosophy which serves as the foundation on which all current and future executive compensation decisions are made.-Assures that value of compensation provided by EMHS does not exceed the value of services provided by the executive.-Reviews annual incentive compensation criteria for eligible executives, as defined by the EMHS President.-Reviews periodic compensation survey information and provides expert input to proposed changes to the executive compensation program.-Assures that a formal and timely performance management system is in place for executives.-Reviews incentive compensation criteria scoring and associated pay schedules for officers and key employees.-Provides any public statements regarding executive compensation practices at EMHS deemed appropriate.-Maintains minutes of the meetings and communicates actions to the EMHS Board of Directors.To accomplish this, the committee uses an external consultant with access to comparative data from independent sources and include national as well as regional data points. The EMHS President reviews all direct report compensation actions with the committee. In addition, the EMHS President ensures that any subsidiary policies and practices governing executive compensation are consistent with the committee's philosophy and practices statement.Form 990, Part VI, Line 15b - Compensation Review & Approval Process for Officers & Key EmployeesCompensation of other officers and key employees of the organization is established by the Human Resources department who utilizes external market research to establish compensation ranges for specific positions. The compensation of officers and key employees are reviewed by the BHMH President/CEO and the VP of Human Resources.On an annual basis, the compensation ranges are compared to the updated survey information. The hiring manager will determine where the employee will fall within the ranges established by the Human Resources department based on experience and credentials. |
| Form 990, Part VI, Line 12c | Form 990, Part VI, Line 12c: Explanation of Monitoring and Enforcement of Conflicts | The organization requests updates of potential conflicts and relationships from the officers and Board members on an annual basis. The request requires disclosure of all business relationships, board memberships, and family relationships. A database is maintained that is compared to payroll records and the accounts payable vendor list to identify any potential conflicts of interest. Transactions are reviewed for reasonableness as an arm's length transaction. The first agenda item for board meetings and board committee meetings is for members to declare any conflict of interest with upcoming agenda items or deliberations. At any point when consideration is being given to purchase/contract with a party in interest, the member with the conflict is either excused from the discussion and consideration process or abstains from voting on the matter. All transactions identified with parties in interest are disclosed within the Form 990. All are deemed to be arm's length transactions. |
| Form 990, Part VI, Line 11b | Form 990, Part VI, Line 11b: Form 990 Review Process | Form 990 is reviewed by the CFO of Blue Hill Memorial Hospital. It is provided to each board member either electronically or in hard copy with an opportunity to ask questions prior to filing with the IRS. |
| Form 990, Part VI, Line 7b | Form 990, Part VI, Line 7b: Describe Decisions of Governing Body Approval by Members or Shareholders | EMHS has authority to appoint and remove the CEO of the Corporation. EMHS also has joint and superior authority to approve, disapprove or initiate action with respect to the following matters: I. amendments to the corporations Articles of Incorporation or Bylaws;II. changes in legal form of organization of the Corporation;III. election of the Directors/Trustees of the Corporation;IV. action concerning the Corporations operating budget and capital expenditures;V. the Corporations acquisition of assets or assumption of liabilities of an unaffiliated third party;VI. transfer of 5% or more of the assets of the Corporation;VII. financing transactions concerning the Corporation; VIII. merger, consolidation, sale, lease, mortgage, pledge or other disposition of all or substantially all assets of the Corporation; IX. add or revise a health care service of the Corporation;X. discontinue or close a health care service of the Corporation;XI. action concerning the Corporations role in the EMHS Strategic Plan;XII. action concerning the Corporations participation in key strategic affiliations with third parties not affiliated with EMHS; andXIII. dissolution of the Corporation. |
| Form 990, Part VI, Line 7a | Form 990, Part VI, Line 7a: How Members or Shareholders Elect Governing Body | Each year at their annual meeting, the directors elect replacements for those directors whose terms are expiring. Election of directors is subject to ratification by EMHS Board of Directors. |
| Form 990, Part VI, Line 6 | Form 990, Part VI, Line 6: Explanation of Classes of Members or Shareholder | Blue Hill Memorial Hospital (the "Corporation") is a Maine nonprofit corporation. Eastern Maine Healthcare Systems ("EMHS"), also a Maine nonprofit corporation, is the sole corporate member of the Corporation. |
| Form 990, Part VI, Line 4 | Form 990, Part VI, Line 4: Description of Significant Changes to Organizational Documents | In December 2012 Eastern Maine Healthcare Systems (EMHS), the parent of this corporation, and this corporation together with other direct subsidiaries of EMHS, modernized their governance structure by replacing a traditional reserved powers model for EMHS control over its subsidiaries with a joint initiatory powers model of control. Under the traditional reserved powers model, in addition to the EMHS CEO having exclusive authority to appoint and remove the CEO of the subsidiaries, EMHS exercised control exclusively through approval rights over important subsidiary action. The new joint initiatory powers model gives EMHS authority not only to approve or disapprove important subsidiary action, but also to actually initiate action on behalf of the subsidiaries with respect to the following matters: I. amendments to the corporations Articles of Incorporation or Bylaws;II. changes in legal form of organization of the Corporation;III. election of the Directors/Trustees of the Corporation;IV. action concerning the Corporations operating budget and capital expenditures;V. the Corporations acquisition of assets or assumption of liabilities of an unaffiliated third party;VI. transfer of 5% or more of the assets of the Corporation;VII. financing transactions concerning the Corporation; VIII. merger, consolidation, sale, lease, mortgage, pledge or other disposition of all or substantially all assets of the Corporation; IX. add or revise a health care service of the Corporation;X. discontinue or close a health care service of the Corporation;XI. action concerning the Corporations role in the EMHS Strategic Plan;XII. action concerning the Corporations participation in key strategic affiliations with third parties not affiliated with EMHS; andXIII. dissolution of the Corporation |
| Form 990, Part VI, Line 2 | Form 990, Part VI, Line 2: Description of Business or Family Relationship of Officers, Directors, Et | Frank Wanning, trustee/chairman and Margaret Hannah, trustee are trustees of George Stevens Academy board. |
| Form 990, Part III, Line 4d | Form 990, Part III, Line 4d: Other Program Services Description | OTHER PROGRAM SERVICES 4: Charity care provided (at cost) 527 persons served. |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII (24 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 |
|---|---|---|---|---|---|---|---|---|---|---|
| Restoration Health LLC | ||||||||||
| 43 Whiting Hill Road | Brewer | ME | 04412 | 352449986 | Provide mental & behavioral hlth srvs | ME | 501(c)(3) | 9 | AHI | true |
| Sebasticook Valley Work Health LLC | ||||||||||
| 447 North Main Street | Pittsfield | ME | 04967 | 453359446 | Provide patient care | ME | 501(c)(3) | 3 | SVH | true |
| Horizons Health Services | ||||||||||
| PO Box 151 140 Academy Street | Presque Isle | ME | 047690151 | 010504393 | Provide patient care | ME | 501(c)(3) | 3 | TAMC | true |
| TAMC Endowments | ||||||||||
| PO Box 151 140 Academy Street | Presque Isle | ME | 047690151 | 010389222 | Raise funds for exempt organizations | ME | 501(c)(3) | 11 Type I | TAMC | true |
| TAMC Title Corp | ||||||||||
| PO Box 151 140 Academy Street | Presque Isle | ME | 047690151 | 010389226 | Real estate holding company | ME | 501(c)(2) | TAMC | true | |
| The Aroostook Medical Center TAMC | ||||||||||
| PO Box 151 140 Academy Street | Presque Isle | ME | 047690151 | 010372148 | Provide healthcare services | ME | 501(c)(3) | 3 | EMHS | true |
| Sebasticook Valley Family Practice Assoc | ||||||||||
| 447 North Main Street | Pittsfield | ME | 04967 | 010357854 | Provide patient care | ME | 501(c)(3) | 9 | SVH | true |
| Sebasticook Valley Health SVH | ||||||||||
| 447 North Main Street | Pittsfield | ME | 04967 | 010263628 | Critical care hospital | ME | 501(c)(3) | 3 | EMHS | true |
| Eastern Maine HomeCare | ||||||||||
| PO Box 688 | Caribou | ME | 04736 | 010328442 | Provide home health & hospice svcs | ME | 501(c)(3) | 9 | EMHS | true |
| CA Dean Memorial Hospital | ||||||||||
| Pritham Ave PO Box 1129 | Greenville | ME | 044411129 | 043341666 | Provide healthcare services | ME | 501(c)(3) | 3 | EMHS | true |
| Lakewood A Continuing Care Center | ||||||||||
| 220 Kennedy Memorial Drive | Waterville | ME | 04901 | 010421234 | Provide skilled and long-term nursing care | ME | 501(c)(3) | 3 | Inland Hospital | true |
| Inland Hospital | ||||||||||
| 200 Kennedy Memorial Drive | Waterville | ME | 04901 | 010217211 | Provide healthcare services | ME | 501(c)(3) | 3 | EMHS | true |
| Rosscare Nursing Home Inc | ||||||||||
| 43 Whiting Hill Road Ste 400 | Brewer | ME | 04412 | 010430751 | Operation of nursing homes | ME | 501(c)(3) | 9 | Rosscare | true |
| Rosscare | ||||||||||
| 43 Whiting Hill Road Ste 400 | Brewer | ME | 04412 | 010391038 | Provide services to elderly | ME | 501(c)(3) | PF | EMHS | true |
| ME Institute for Human Genetics & Health | ||||||||||
| 43 Whiting Hill Road | Brewer | ME | 04412 | 550894346 | Biomedical research and development | ME | 501(c)(3) | 9 | EMHS | true |
| EMHS Foundation | ||||||||||
| 43 Whiting Hill Road Ste 400 | Brewer | ME | 04412 | 222514163 | Raise and manage funds for exempt organizations | ME | 501(c)(3) | 11 Type II | EMHS | true |
| Norumbega Medical Specialists LTD | ||||||||||
| 43 Whiting Hill Road Ste 400 | Brewer | ME | 04412 | 010465231 | Provide patient care & education | ME | 501(c)(3) | 9 | EMMC | true |
| Eastern Maine Medical Center Auxiliary | ||||||||||
| 43 Whiting Hill Road | Brewer | ME | 04412 | 010377901 | Fund raising for exempt Eastern Maine Medical Center | ME | 501(c)(3) | 9 | EMMC | true |
| Eastern Maine Medical Center EMMC | ||||||||||
| PO Box 404 489 State Street | Bangor | ME | 044020404 | 010211501 | Provide healthcare services | ME | 501(c)(3) | 3 | EMHS | true |
| Meadow Wood LLC | ||||||||||
| 43 Whiting Hill Road | Brewer | ME | 04412 | 272935243 | Provide patient care | ME | 501(c)(3) | 9 | AHI | true |
| Acadia Healthcare Inc AHI | ||||||||||
| 43 Whiting Hill Road | Brewer | ME | 04412 | 223183888 | Provide healthcare services | ME | 501(c)(3) | 9 | AHC | true |
| Acadia Hospital Corp AHC | ||||||||||
| 43 Whiting Hill Road | Brewer | ME | 04412 | 010459837 | Provide healthcare services | ME | 501(c)(3) | 3 | EMHS | true |
| Eastern Maine Healthcare Systems EMHS | ||||||||||
| 43 Whiting Hill Road | Brewer | ME | 04412 | 010527066 | Supporting organization for healthcare affiliates | ME | 501(c)(3) | 11 Type III Func Int | NA | true |
| Eastern Maine Healthcare Real Estate | ||||||||||
| 43 Whiting Hill Road | Brewer | ME | 04412 | 010391036 | Leases real estate | ME | 501(c)(2) | EMHS | true | |
Form990 Schedule R Part III Form990ScheduleRPartIII
Name Of Related Org NameOfRelatedOrg
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Beacon Health LLC | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 43 Whiting Hill Road | AddressLine1 |
| City | Brewer | City |
| State | ME | State |
| ZIP Code | 04412 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 452967056 | EIN |
| Primary Activity | Accountable care organization | PrimaryActivity |
| Legal Domicile State | ME | LegalDomicileState |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | EMHS | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Disproportionate Allocations | false | DisproportionateAllocations |
| General Or Managing Partner | false | GeneralOrManagingPartner |
Form990 Schedule R Part IV Form990ScheduleRPartIV (14 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivityPrimaryActivity | Legal Domicile StateLegalDomicileState | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Type Of EntityTypeOfEntity | Controlled OrgControlledOrg |
|---|---|---|---|---|---|---|---|---|---|
| Alliance Health Documentation LLC | |||||||||
| 9 Central Street Ste 205 | Bangor | ME | 04401 | 460420522 | Transcription | ME | AHS | C | true |
| Miller Drug LLC | |||||||||
| PO Box 1779 | Bangor | ME | 044021779 | 272175482 | Pharmacy | ME | AHS | C | true |
| Dirigo Pines Development Company LLC | |||||||||
| 9 Alumni Drive | Orono | ME | 04473 | 010537924 | RetCottag | ME | AHS | C | true |
| Dirigo Funding LLC | |||||||||
| 9 Alumni Drive | Orono | ME | 04473 | 010599968 | Prov finance | ME | AHS | C | true |
| Dirigo Pines Inn LLC | |||||||||
| 9 Alumni Drive | Orono | ME | 04473 | 020547749 | Contin care | ME | Rosscare | C | true |
| Dirigo Pines Retirement Community LLC | |||||||||
| 9 Alumni Drive | Orono | ME | 04473 | 010537924 | Holding co. | ME | AHS | C | true |
| Maine Network for Health | |||||||||
| PO Box 2813 | Bangor | ME | 044022813 | 010496352 | Support srv | ME | EMHS | C | true |
| Meridian Mobile Health LLC | |||||||||
| 931 Union Street PO Box 940 | Bangor | ME | 044020940 | 010512673 | Ambulance | ME | AHS | C | true |
| DE Collections DBA ACI | |||||||||
| PO Box 2759 | Bangor | ME | 044022759 | 010366209 | Collections | ME | AHS | C | true |
| Affiliated Pharmacy Services | |||||||||
| 917 Union St Suite 7 | Bangor | ME | 04401 | 010587230 | Pharmacy | ME | AHS | C | true |
| Affiliated Materiel Services | |||||||||
| PO Box 1300 | Bangor | ME | 044021300 | 010381189 | Purchasing | ME | AHS | C | true |
| Affiliated Laboratory Inc | |||||||||
| PO Box 638 | Bangor | ME | 044020638 | 010381283 | Clinical lab | ME | AHS | C | true |
| Affiliated Healthcare Management | |||||||||
| PO Box 811 | Bangor | ME | 044020811 | 010349339 | Hlthcr mgmt | ME | AHS | C | true |
| Affiliated Healthcare Systems AHS | |||||||||
| PO Box 940 | Bangor | ME | 044020940 | 010385322 | Holding co. | ME | EMHS | C | true |
| 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 | false | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | false | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | true | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | true | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | false | SharingOfFacilities |
| Sharing Of Paid Employees | false | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | true | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | false | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | true | OtherTransferToOtherOrg |
| Other Transfer From Other Org | true | OtherTransferFromOtherOrg |
Transactions Related Orgs Table TransactionsRelatedOrgsTable (10 entries)
| Transaction TypeTransactionType | Amount InvolvedAmountInvolved | Method Of Amt DeterminationMethodOfAmtDetermination |
|---|---|---|
| Affiliated Materiel Services | ||
| p | 408673 | FMV |
| Affiliated Laboratory Inc | ||
| m | 295592 | FMW |
| Affiliated Healthcare Management | ||
| m | 134861 | FMV |
| Beacon Health LLC | ||
| l | 109179 | FMV |
| EMHS Foundation | ||
| s | 53095 | FMV |
| EMHS Foundation | ||
| m | 220000 | FMV |
| Eastern Maine Medical Center EMMC | ||
| p | 385249 | FMV |
| Eastern Maine Medical Center EMMC | ||
| m | 477312 | FMV |
| Eastern Maine Healthcare Systems EMHS | ||
| r | 270675 | FMV |
| Eastern Maine Healthcare Systems EMHS | ||
| m | 4751915 | FMV |
Comments