FURP.ORG / PUBLIC DATA EXPLORER

MAINE BEHAVIORAL HEALTHCARE: Form 990, tax year 2011

View the entire original 990 at ProPublica ↗

Organization
MAINE BEHAVIORAL HEALTHCARE (EIN 01-0524834)
Tax period
2011-10-01 to 2012-09-30
Filed
2013-08-05
IRS object ID
201302179349300815
Schema version
2011v1.2
Source
Download XML · Original 990 at ProPublica

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

Return header ReturnHeader

FieldValueIRS element (for citing)
Timestamp2013-08-05T11:59:47-05:00Timestamp
Tax Period End Date2012-09-30TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1MAINEHEALTHBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line1110 FREE STAddressLine1
CityPORTLANDCity
StateMEState
ZIP Code041013908ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2011-10-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN010524834EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1SPRING HARBOR HOSPITALBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlSPRINameControl
Phone2077612200Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line178 ATLANTIC PLACEAddressLine1
CitySOUTH PORTLANDCity
StateMEState
ZIP Code04106ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameMICHAEL ABBATIELLOName
TitleCHIEF FINANCIAL OFFICERTitle
Phone2077612200Phone
Date Signed2013-07-12DateSigned

Preparer Preparer

FieldValueIRS element (for citing)
Date Prepared2013-08-05DatePrepared
FieldValueIRS element (for citing)
Tax Year2011TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Address ChangeXAddressChange
Name Of Principal Officer PersonDENNIS P KINGNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1123 ANDOVER ROADAddressLine1
CityWESTBROOKCity
StateMEState
ZIP Code04092ZIPCode
FieldValueIRS element (for citing)
Gross Receipts33520941GrossReceipts
Group Return For AffiliatesfalseGroupReturnForAffiliates
Organization501c3XOrganization501c3
Web SiteWWW.SPRINGHARBOR.ORGWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1999YearFormation
State Legal DomicileMEStateLegalDomicile
Activity Or Mission DescriptionSPRING HARBOR HOSPITAL OFFERS PEOPLE IN MENTAL HEALTH CRISIS HIGH-QUALITY, FOCUSED TREATMENT TO SUPPORT THEIR ONGOING RECOVERY.ActivityOrMissionDescription
Nbr Voting Members Governing Body19NbrVotingMembersGoverningBody
Nbr Independent Voting Members15NbrIndependentVotingMembers
Total Nbr Employees498TotalNbrEmployees
Total Nbr Volunteers5TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Contributions Grants Prior Year413818ContributionsGrantsPriorYear
Contributions Grants Current Year511633ContributionsGrantsCurrentYear
Program Service Revenue Prior Year31742462ProgramServiceRevenuePriorYear
Program Service Revenue CY32947607ProgramServiceRevenueCY
Investment Income Prior Year55003InvestmentIncomePriorYear
Investment Income Current Year14581InvestmentIncomeCurrentYear
Other Revenue Prior Year13104OtherRevenuePriorYear
Other Revenue Current Year40173OtherRevenueCurrentYear
Total Revenue Prior Year32224387TotalRevenuePriorYear
Total Revenue Current Year33513994TotalRevenueCurrentYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year21316294SalariesEtcPriorYear
Salaries Etc Current Year20695405SalariesEtcCurrentYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year113240TotalFundrsngExpCurrentYear
Other Expense Prior Year10228131OtherExpensePriorYear
Other Expenses Current Year11950304OtherExpensesCurrentYear
Total Expenses Prior Year31544425TotalExpensesPriorYear
Total Expenses Current Year32645709TotalExpensesCurrentYear
Revenues Less Expenses Prior Year679962RevenuesLessExpensesPriorYear
Revenues Less Expenses CY868285RevenuesLessExpensesCY
Total Assets BOY37113459TotalAssetsBOY
Total Assets EOY34493242TotalAssetsEOY
Total Liabilities BOY28293180TotalLiabilitiesBOY
Total Liabilities EOY24790782TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY8820279NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY9702460NetAssetsOrFundBalancesEOY
Info In Schedule O Part IIIXInfoInScheduleOPartIII
Mission DescriptionSPRING HARBOR HOSPITAL OFFERS PEOPLE IN MENTAL HEALTH CRISIS HIGH-QUALITY, FOCUSED TREATMENT TO SUPPORT THEIR ONGOING RECOVERY.MissionDescription
Significant New Program ServicesfalseSignificantNewProgramServices
Significant ChangefalseSignificantChange
Expense13795579Expense
Revenue15965758Revenue
DescriptionADULT SERVICES - ADULT TREATMENT FOCUSES ON RAPID STABILIZATION OF SYMPTOMS AND APPROPRIATE AFTERCARE FOR EACH PATIENT. TREATMENT INCLUDES A COMPREHENSIVE EVALUATION OF PERTINENT PSYCHIATRIC, PSYCHOLOGICAL, DEVELOPMENTAL, AND MEDICAL FACTORS. THE TEAM DEVELOPS AND IMPLEMENTS INDIVIDUALIZED TREATMENT PLANS AND ENLISTS COMMUNITY SUPPORT TO ENSURE APPROPRIATE FOLLOW-UP CARE FOR EACH PATIENT. SEE ATTACHED COMMUNITY BENEFIT REPORT FOR MAINE MENTAL HEALTH PARTNERS & SUBSIDIARIES.Description

Activity2 Activity2

FieldValueIRS element (for citing)
Expense9699999Expense
Revenue11225904Revenue
DescriptionCHILD AND ADOLESCENT SERVICES -OUR 28 YOUTH BEDS SERVE CHILDREN AND ADOLESCENTS WHO REQUIRE ACUTE MENTAL HEALTHCARE AND SUBSTANCE ABUSE INTERVENTION. PROGRAMMING INCLUDES COMPREHENSIVE PSYCHIATRIC EVALUATION, INDIVIDUAL AND FAMILY THERAPY, RECREATIONAL AND GROUP THERAPY, MEDICATION MANAGEMENT, PARENT EDUCATION, AND ON-SITE ACADEMIC INSTRUCTION. THE UNITS SPECIALIZE IN THE TREATMENT OF DIAGNOSES COMMON TO YOUTH, INCLUDING ANXIETY,PSYCHOTIC OR DEPRESSIVE DISORDERS, OPPOSITIONAL/DEFIANT DISORDER, ATTENTION DEFICIT/HYPERACTIVITY DISORDER(ADD/ADHD), AND POST-TRAUMATIC STRESS DISORDER (PTSD).Description

Activity3 Activity3

FieldValueIRS element (for citing)
Expense4483378Expense
Revenue5188657Revenue
DescriptionDEVELOPMENTAL DISORDERS PROGRAM - THE STATE'S ONLY HOSPITAL PROGRAM FOR YOUTH WITH AUTISM AND MENTAL ILLNESS,THE DEVELOPMENTAL DISORDERS PROGRAM DELIVERS HIGH-QUALITY TREATMENT OUTCOMES THROUGH A COMBINATION OF EXPERT PROGRAMMING, SPECIALLY TRAINED CAREGIVERS, AND THE INDIVIDUAL POTENTIAL OF EACH PATIENT. THE PROGRAM OFFERS INTENSIVE TREATMENT FOR AGGRESSION, SELF-INJURY, IMPAIRMENT IN FUNCTIONING, AND MENTAL HEALTH CHALLENGES IN CHILDREN AGES 2 TO 21 WHO HAVE A DEVELOPMENTAL DISORDER AND CANNOT CURRENTLY FUNCTION SAFELY OUTSIDE THE HOSPITAL SETTING.Description

Activity Other ActivityOther

FieldValueIRS element (for citing)
Expense490178Expense
Revenue567288Revenue
DescriptionOTHER PROGRAM SERVICES INCLUDE CAFETERIA AND VENDING UNITS SALES, OTHER REVENUE FROM MEDICAL RECORDS, RENT FROM A RELATED PARTY, AND EDUCATIONAL SERVICES.Description
FieldValueIRS element (for citing)
Total Of Other Program Service Exp490178TotalOfOtherProgramServiceExp
Total Of Other Program Service Rev567288TotalOfOtherProgramServiceRev
Total Program Service Expense28469134TotalProgramServiceExpense
Described In501 C3trueDescribedIn501C3
Schedule B RequiredtrueScheduleBRequired
Political ActivitiesfalsePoliticalActivities
Lobbying ActivitiestrueLobbyingActivities
Subject To Proxy TaxfalseSubjectToProxyTax
Donor Advised FundsfalseDonorAdvisedFunds
Conservation EasementstrueConservationEasements
Collections Of ArtfalseCollectionsOfArt
Credit CounselingfalseCreditCounseling
Term Or Permanent EndowmentstrueTermOrPermanentEndowments
Report Land Bldg EquiptrueReportLandBldgEquip
Report Invest Oth SecuritiesfalseReportInvestOthSecurities
Report Prog Rel InvestfalseReportProgRelInvest
Report Other AssetstrueReportOtherAssets
Report Other LiabilitiestrueReportOtherLiabilities
Report Fin48 FootnotetrueReportFin48Footnote
Independent Audit Financial StmtfalseIndependentAuditFinancialStmt
Consolidated Audit Financial StmttrueConsolidatedAuditFinancialStmt
SchoolfalseSchool
Foreign OfficefalseForeignOffice
Foreign ActivitiesfalseForeignActivities
More Than5000 K To OrganizationsfalseMoreThan5000KToOrganizations
More Than5000 K To IndividualsfalseMoreThan5000KToIndividuals
Professional FundraisingfalseProfessionalFundraising
Fundraising ActivitiestrueFundraisingActivities
GamingfalseGaming
HospitaltrueHospital
Financial Stmt AttachedtrueFinancialStmtAttached
Grants To OrganizationsfalseGrantsToOrganizations
Grants To IndividualsfalseGrantsToIndividuals
Schedule J RequiredtrueScheduleJRequired
Tax Exempt BondsfalseTaxExemptBonds
Excess Benefit TransactionfalseExcessBenefitTransaction
Prior Excess Benefit TransactionfalsePriorExcessBenefitTransaction
Loan To Officer Or DQPfalseLoanToOfficerOrDQP
Grant To Related PersonfalseGrantToRelatedPerson
Bsnss Rltnshp With OrganizationfalseBsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family MemberfalseBsnssRltnshpThruFamilyMember
Officer Entity With Bsnss RltnshpfalseOfficerEntityWithBsnssRltnshp
Deductible Non Cash ContributionsfalseDeductibleNonCashContributions
Deductible Contributions Of ArtfalseDeductibleContributionsOfArt
TerminatedfalseTerminated
Partial LiquidationfalsePartialLiquidation
Disregarded EntityfalseDisregardedEntity
Related EntitytrueRelatedEntity
Related Org Controlled EntityfalseRelatedOrgControlledEntity
Transaction Related EntityfalseTransactionRelatedEntity
Transfers To Exempt Non Chrtbl OrgfalseTransfersToExemptNonChrtblOrg
Activities Conducted PartnershipfalseActivitiesConductedPartnership
Schedule O RequiredtrueScheduleORequired
Number Forms Transmitted With109614NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup WitholdingtrueComplianceWithBackupWitholding
Number Of Employees498NumberOfEmployees
Employment Tax Returns FiledtrueEmploymentTaxReturnsFiled
Unrelated Business IncomefalseUnrelatedBusinessIncome
Foreign Financial AccountfalseForeignFinancialAccount
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTrans
Taxable Party NotificationfalseTaxablePartyNotification
Non Deductible ContributionsfalseNonDeductibleContributions
Quid Pro Quo ContributionsfalseQuidProQuoContributions
Form8282 Property Disposed OffalseForm8282PropertyDisposedOf
Funds To Pay PremiumsfalseFundsToPayPremiums
Premiums PaidfalsePremiumsPaid
Indoor Tanning ServicesfalseIndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members19NbrVotingGoverningBodyMembers
Number Independent Voting Members15NumberIndependentVotingMembers
Family Or Business RelationshipfalseFamilyOrBusinessRelationship
Delegation Of Management DutiesfalseDelegationOfManagementDuties
Changes To Organizing DocsfalseChangesToOrganizingDocs
Material Diversion Or MisusefalseMaterialDiversionOrMisuse
Members Or StockholderstrueMembersOrStockholders
Election Of Board MemberstrueElectionOfBoardMembers
Decisions Subject To ApprovaltrueDecisionsSubjectToApproval
Minutes Of Governing BodytrueMinutesOfGoverningBody
Minutes Of CommitteestrueMinutesOfCommittees
Officer Mailing AddressfalseOfficerMailingAddress
Local ChaptersfalseLocalChapters
Form990 Provided To Governing BodytrueForm990ProvidedToGoverningBody
Conflict Of Interest PolicytrueConflictOfInterestPolicy
Annual Disclosure Covered PersonstrueAnnualDisclosureCoveredPersons
Regular Monitoring EnforcementtrueRegularMonitoringEnforcement
Whistleblower PolicytrueWhistleblowerPolicy
Document Retention PolicytrueDocumentRetentionPolicy
Compensation Process CEOtrueCompensationProcessCEO
Compensation Process OthertrueCompensationProcessOther
Investment In Joint VenturefalseInvestmentInJointVenture
States Where Copy Of Return Is FiledMEStatesWhereCopyOfReturnIsFiled
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonMICHAEL ABBATIELLO CFONamePerson
Telephone Number2077612200TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line178 ATLANTIC PLACEAddressLine1
CitySOUTH PORTLANDCity
StateMEState
ZIP Code04106ZIPCode
FieldValueIRS element (for citing)
Info In Schedule O Part VIIXInfoInScheduleOPartVII

Form990 Part VII Section A Form990PartVIISectionA (31 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationOfficerOfficerHighest Compensated EmployeeHighestCompensatedEmployee
RICHARD PETERSEN
PRES. & CEO1.00X0109355690952
FRANCIS G MCGINTY
TREASURER1.00X067817374399X
DENNIS P KING
PRESIDENT/CE14.00X040837163898X
FRANK LAVOIE MD
TRUSTEE1.00X034289824355
DAVID LAKARI
CHAIR1.00X000X
SHERI BOULOS
TRUSTEE1.00X000
JANIS COHEN
TRUSTEE1.00X000
JAMES HARNAR
TRUSTEE1.00X000
NANCY HASENFUS MD
TRUSTEE1.00X000
TRACY HAWKINS
VICE CHAIR1.00X000X
LESTER W HODGDON
TRUSTEE1.00X000
LISA C HOOK
TRUSTEE1.00X000
NANCY POND
TRUSTEE1.00X000
ANNA H WELLS
SECRETARY1.00X000X
LESTER F WILKINSON JR
TRUSTEE1.00X000
JOHN SHOOS
TRUSTEE1.00X000
ROGER F WOODMAN JR
TRUSTEE1.00X000
MUKESH BHARGAVA
TRUSTEE1.00X000
RICHARD WHITE
TRUSTEE1.00X000
GIRARD ROBINSON MD
CHIEF MEDICA9.50046347559633X
DONALD E QUIGLEY
ASST. SECRET1.00032485871995X
GREGORY BOWERS
EXEC. VP & T1.00019425821259X
RICHARD HANLEY
COO40.00018403522296X
MICHAEL ABBATIELLO
CHIEF FINANC1.00013344216479X
GAIL WILKERSON
CHF PLAN. &8.00012600619225X
JOYCE COTTON
CCO & CNO40.00110116018724X
MARK FULTON
ASSOCIATE MD40.00211666022090X
JOHN MURPHY MD
PHYSICIAN40.00211304039096X
MATTHEW SIEGEL MD
PHYSICIAN40.00206414021796X
MELISSA M BOWKER-KINLEY
PHYSICIAN40.00189223021752X
WILLIAM BRENNAN MD
PHYSICIAN40.00176040016048X
FieldValueIRS element (for citing)
Total Reportable Comp From Org1104763TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs3949072TotalReportableCompFrmRltdOrgs
Total Other Compensation603997TotalOtherCompensation
Number Individuals GT100 K6NumberIndividualsGT100K
Formers ListedfalseFormersListed
Total Comp GT150 KtrueTotalCompGT150K
Compensation From Other SourcesfalseCompensationFromOtherSources

Contractor Compensation ContractorCompensation (3 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensationAddress Line2AddressOfContractor/AddressUS/AddressLine2
NORDX
301A US ROUTE ONESCARBOROUGHME04074LAB PROCESSING194389
E-PHARM PRO
3605 EDGEMONT AVEBROOKHAVENPA19015PHARMACEUTICAL155900BACK BUILDING SUITE 1
SYNERNET INC
110 FREE STREETPORTLANDME04102TRANSCRIPTION154771
FieldValueIRS element (for citing)
Number Of Contractors GT100 K3NumberOfContractorsGT100K
All Other Contributions511633AllOtherContributions
Total Contributions511633TotalContributions

Program Service Revenue ProgramServiceRevenue (5 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
ADULT SERVICES6230001596575815965758
CHILD & ADOLESCENT6230001122590411225904
DEVELOPMENTAL DISORDERS62300051886575188657
RENT INCOME531120284077284077
CAFETERIA722210221009221009

Total Oth Program Service Revenue TotalOthProgramServiceRevenue

FieldValueIRS element (for citing)
Total Revenue Column62202TotalRevenueColumn
Related Or Exempt Function Income62202RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Program Service Revenue32947607TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column877TotalRevenueColumn
Exclusion$877ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities13704Securities

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities13704Securities

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column13704TotalRevenueColumn
Related Or Exempt Function Income13704RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Gross Income Fundraising Events47120GrossIncomeFundraisingEvents
Fundraising Direct Expenses6947FundraisingDirectExpenses

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

FieldValueIRS element (for citing)
Total Revenue Column40173TotalRevenueColumn

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column33513994TotalRevenueColumn
Related Or Exempt Function Income32961311RelatedOrExemptFunctionIncome
Exclusion$877ExclusionAmount

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total121556Total
Program Services121556ProgramServices

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total16434568Total
Program Services16153171ProgramServices
Management And General191761ManagementAndGeneral
Fundraising89636Fundraising

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total398033Total
Program Services386092ProgramServices
Management And General11941ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total2549010Total
Program Services2472540ProgramServices
Management And General76470ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total1192238Total
Program Services1156471ProgramServices
Management And General35767ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total58245Total
Management And General58245ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total8040Total
Management And General8040ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total935996Total
Program Services924138ProgramServices
Management And General4961ManagementAndGeneral
Fundraising6897Fundraising

Advertising Advertising

FieldValueIRS element (for citing)
Total17445Total
Program Services16922ProgramServices
Management And General523ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total589491Total
Program Services558399ProgramServices
Management And General16307ManagementAndGeneral
Fundraising14785Fundraising

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total15666Total
Program Services15196ProgramServices
Management And General470ManagementAndGeneral

Occupancy Occupancy

FieldValueIRS element (for citing)
Total1830449Total
Program Services1775536ProgramServices
Management And General54913ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total40850Total
Program Services40224ProgramServices
Management And General490ManagementAndGeneral
Fundraising136Fundraising

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total57603Total
Program Services54560ProgramServices
Management And General2733ManagementAndGeneral
Fundraising310Fundraising

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total1064338Total
Program Services1032408ProgramServices
Management And General31930ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total163371Total
Program Services159213ProgramServices
Management And General4158ManagementAndGeneral

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalManagement And GeneralManagementAndGeneralProgram ServicesProgramServices
MEMBER MANAGEMENT FEES32335203233520
PROVISION FOR BAD DEBT13112651311265
HOSPITAL TAX805383805383
PHARMACY SERVICES753114753114

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total1065528Total
Program Services732946ProgramServices
Management And General331106ManagementAndGeneral
Fundraising1476Fundraising

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total32645709Total
Program Services28469134ProgramServices
Management And General4063335ManagementAndGeneral
Fundraising113240Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY1665BOY
EOY1988EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY14381993BOY
EOY11170890EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY1139077BOY
EOY1252306EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

FieldValueIRS element (for citing)
BOY436797BOY
EOY390EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY262936BOY
EOY165398EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY57792BOY
EOY76071EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis28689848LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec9416398LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY19960917BOY
EOY19273450EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY638800BOY
EOY637355EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY233482BOY
EOY1915394EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY37113459BOY
EOY34493242EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY2911701BOY
EOY2488230EOY

Deferred Revenue DeferredRevenue

FieldValueIRS element (for citing)
EOY21933EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

FieldValueIRS element (for citing)
BOY21554118BOY
EOY21283877EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY3827361BOY
EOY996742EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY28293180BOY
EOY24790782EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY8309847BOY
EOY9085816EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY160432BOY
EOY266644EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY350000BOY
EOY350000EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY8820279BOY
EOY9702460EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY37113459BOY
EOY34493242EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses868285ReconcilationRevenueExpenses
Reconcilation Other Changes13896ReconcilationOtherChanges
Info In Schedule O Part XIIXInfoInScheduleOPartXII
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or ReviewfalseAccountantCompileOrReview
FS AuditedtrueFSAudited
Audit CommitteetrueAuditCommittee
Financial Statement SeparateXFinancialStatementSeparate
Federal Grant Audit RequiredtrueFederalGrantAuditRequired
Federal Grant Audit PerformedtrueFederalGrantAuditPerformed

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Hospital170b1 AiiiXHospital170b1Aiii

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Aggregate ContributionsRESTRICTEDAggregateContributions

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Form4720 Filed4955 TaxfalseForm4720Filed4955Tax
Correction MadefalseCorrectionMade
Form1120 Pol FiledfalseForm1120PolFiled
Form4720 FiledfalseForm4720Filed
VolunteersfalseVolunteers
Paid Staff Or ManagementfalsePaidStaffOrManagement
Media AdvertisementsfalseMediaAdvertisements
Mailings MembersfalseMailingsMembers
Publications Or BroadcastfalsePublicationsOrBroadcast
Grants Other OrganizationsfalseGrantsOtherOrganizations
Direct Contact LegislatorsfalseDirectContactLegislators
Rallies DemonstrationsfalseRalliesDemonstrations
Other ActivitiestrueOtherActivities
Other Activities$10,630OtherActivitiesAmount
Total Lobbying Expenditures IIB10630TotalLobbyingExpendituresIIB
Not Described In501c3falseNotDescribedIn501c3
Form4720 Filed4912 TaxfalseForm4720Filed4912Tax
Substantially All Dues NondeductfalseSubstantiallyAllDuesNondeduct
Only In House LobbyingfalseOnlyInHouseLobbying
Agree To Carryover Prior YearfalseAgreeToCarryoverPriorYear

Form990 Schedule C Part IV Form990ScheduleCPartIV

FieldValueIRS element (for citing)
Return ReferenceSCHEDULE C, PART II-B, LINE 1ReturnReference
ExplanationA PORTION OF MEMBERSHIP DUES PAID REPRESENTS LOBBYING ACTIVITIES. LOBBYING PORTION OF MAINE HOSPITAL ASSOCIATION DUES: 4,942 LOBBYING PORTION OF AMERICAN HOSPITAL ASSOCIATION DUES: 5,688 TOTAL DUES PAID REPRESENTING LOBBYING ACTIVITIES: 10,630Explanation

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Disclosed Orgs Legal ControlfalseDisclosedOrgsLegalControl
Disclosed For Charitable PurposesfalseDisclosedForCharitablePurposes
Preservation Of Open SpaceXPreservationOfOpenSpace
Total Number Of Easements1TotalNumberOfEasements
Total Acreage54TotalAcreage
Nmbr States In Which Easements Held1NmbrStatesInWhichEasementsHeld
Written Policy MonitoringfalseWrittenPolicyMonitoring
Staff Hours Spent On Enforcement5StaffHoursSpentOnEnforcement
Expenses Incurred For Enforcement250ExpensesIncurredForEnforcement
Sect170h Requirements SatisfiedfalseSect170hRequirementsSatisfied
Solicited Assets For SalefalseSolicitedAssetsForSale
Agent Trustee EtcfalseAgentTrusteeEtc
Included On FSfalseIncludedOnFS

Current Year CurrentYear

FieldValueIRS element (for citing)
Beginning Of Year Balance350000BeginningOfYearBalance
Investment Earnings Or Losses29974InvestmentEarningsOrLosses
Other Expenditures29974OtherExpenditures
End Of Year Balance350000EndOfYearBalance

Current Year Minus1 Year CurrentYearMinus1Year

FieldValueIRS element (for citing)
Beginning Of Year Balance350000BeginningOfYearBalance
Investment Earnings Or Losses2093InvestmentEarningsOrLosses
Other Expenditures2093OtherExpenditures
End Of Year Balance350000EndOfYearBalance

Current Year Minus2 Years CurrentYearMinus2Years

FieldValueIRS element (for citing)
Beginning Of Year Balance350000BeginningOfYearBalance
Investment Earnings Or Losses33229InvestmentEarningsOrLosses
Other Expenditures33229OtherExpenditures
End Of Year Balance350000EndOfYearBalance

Current Year Minus3 Years CurrentYearMinus3Years

FieldValueIRS element (for citing)
Beginning Of Year Balance350000BeginningOfYearBalance
Investment Earnings Or Losses7350InvestmentEarningsOrLosses
Other Expenditures7350OtherExpenditures
End Of Year Balance350000EndOfYearBalance
FieldValueIRS element (for citing)
Permanent Endowment EOY Balance1.00000PermanentEndowmentEOYBalance
Endowments Held By Unrelated OrgsfalseEndowmentsHeldByUnrelatedOrgs
Endowments Held By Related OrgstrueEndowmentsHeldByRelatedOrgs
Are Related Orgs Listed Schedule RtrueAreRelatedOrgsListedScheduleR

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis1212130OtherCostOrOtherBasis
Book Value1212130BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis23539922OtherCostOrOtherBasis
Depreciation6186546Depreciation
Book Value17353376BookValue

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Other Cost Or Other Basis702299OtherCostOrOtherBasis
Depreciation974741Depreciation
Book Value-272442BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis3082904OtherCostOrOtherBasis
Depreciation2255111Depreciation
Book Value827793BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis152593OtherCostOrOtherBasis
Book Value152593BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings19273450TotalOfBookValueLandBuildings

Other Assets OtherAssets (3 entries)

DescriptionDescriptionBook ValueBookValue
DUE FROM AFFILIATES1387083
DEFERRED FINANCING COST445665
INSURANCE RECOVERIES82646
FieldValueIRS element (for citing)
Total Book Value Other Assets1915394TotalBookValueOtherAssets

Other Liabilities OtherLiabilities (3 entries)

DescriptionDescriptionAmountAmount
AMOUNTS PAYABLE UNDER REIMB. REGS.$914,096
INSURANCE CLAIMS$82,646
DUE TO AFFILIATES
FieldValueIRS element (for citing)
Total Of Amounts996742TotalOfAmounts

Form990 Schedule D Part XIV Form990ScheduleDPartXIV (3 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
ACCOUNTING FOR CONSERVATION EASEMENTSSCHEDULE D, PAGE 1, PART II, LINE 9IN 2002 SPRING HARBOR HOSPITAL ACQUIRED A 54-ACRE PARCEL OF LAND DESIGNATED AS A CONSERVATION EASEMENT WHICH WAS CONVEYED AS PART OF A LAND PURCHASE UPON WHICH THE HOSPITAL WAS BUILT.
INTENDED USES FOR ENDOWMENT FUNDSSCHEDULE D, PAGE 2, PART V, LINE 4THE INCOME FROM THIS PERMANENT ENDOWMENT IS INTENDED TO BE USED PRIMARILY FOR THE SERVICES PROVIDED BY SPRING HARBOR HOSPITAL'S CHILD AND ADOLESCENT PROGRAMS.
LIABILITY UNDER FIN 48 FOOTNOTESCHEDULE D, PAGE 3, PART XSPRING HARBOR HOSPITAL IS A NOT-FOR-PROFIT ORGANIZATION AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE (IRC) AND ARE EXEMPT FROM FEDERAL INCOME TAXES ON RELATED INCOME PURSUANT TO SECTION 501(A) OF THE IRC.

Schedule G IRS990ScheduleG

Events Information EventsInformation

FieldValueIRS element (for citing)
Name Of Event1SIGNS OF HOPENameOfEvent1
Gross Receipts Event147120GrossReceiptsEvent1
Gross Revenue Event147120GrossRevenueEvent1
Other Direct Expenses Event16947OtherDirectExpensesEvent1
Gross Receipts Total47120GrossReceiptsTotal
Gross Revenue Total Events47120GrossRevenueTotalEvents
Other Direct Expenses Total Events6947OtherDirectExpensesTotalEvents
Direct Expense Summary Events6947DirectExpenseSummaryEvents
Net Income Summary40173NetIncomeSummary

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Charity Care PolicytrueCharityCarePolicy
Written PolicytrueWrittenPolicy
FPG Reference Free CaretrueFPGReferenceFreeCare

Other Percentage OtherPercentage

FieldValueIRS element (for citing)
OtherXOther
Free Other Percentage1.75000FreeOtherPercentage
FieldValueIRS element (for citing)
FPG Reference Discounted CarefalseFPGReferenceDiscountedCare
Free Disc Care Medically IndigenttrueFreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity CaretrueAmountsBudgetedForCharityCare
Expenses Exceeded BudgetfalseExpensesExceededBudget
Annual Community Benefit ReporttrueAnnualCommunityBenefitReport
Report Publically AvailabletrueReportPublicallyAvailable

Charity Care At Cost CharityCareAtCost

FieldValueIRS element (for citing)
Total Community Benefit Expense3332782TotalCommunityBenefitExpense
Net Community Benefit Expense3332782NetCommunityBenefitExpense
Percent Of Total Expense0.10640PercentOfTotalExpense

Total Charity Care TotalCharityCare

FieldValueIRS element (for citing)
Total Community Benefit Expense3332782TotalCommunityBenefitExpense
Net Community Benefit Expense3332782NetCommunityBenefitExpense
Percent Of Total Expense0.10640PercentOfTotalExpense

Community Health Services CommunityHealthServices

FieldValueIRS element (for citing)
Total Community Benefit Expense93754TotalCommunityBenefitExpense
Net Community Benefit Expense93754NetCommunityBenefitExpense
Percent Of Total Expense0.00290PercentOfTotalExpense

Health Professions Education HealthProfessionsEducation

FieldValueIRS element (for citing)
Total Community Benefit Expense103911TotalCommunityBenefitExpense
Net Community Benefit Expense103911NetCommunityBenefitExpense
Percent Of Total Expense0.00320PercentOfTotalExpense

Cash And In Kind Contributions CashAndInKindContributions

FieldValueIRS element (for citing)
Total Community Benefit Expense11558TotalCommunityBenefitExpense
Net Community Benefit Expense11558NetCommunityBenefitExpense
Percent Of Total Expense0.00040PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense209223TotalCommunityBenefitExpense
Net Community Benefit Expense209223NetCommunityBenefitExpense
Percent Of Total Expense0.00640PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense3542005TotalCommunityBenefitExpense
Net Community Benefit Expense3542005NetCommunityBenefitExpense
Percent Of Total Expense0.11280PercentOfTotalExpense
FieldValueIRS element (for citing)
Bad Debt Expense ReportedfalseBadDebtExpenseReported
Bad Debt Expense$769,975BadDebtExpenseAmount
Amount Reimbursed By Medicare3777228AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare5196390CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall-1419162MedicareSurplusOrShortfall

Costing Methodology Used CostingMethodologyUsed

FieldValueIRS element (for citing)
Cost To Charge RatioXCostToChargeRatio
FieldValueIRS element (for citing)
Written Debt Collection PolicytrueWrittenDebtCollectionPolicy
Provision For Charity CaretrueProvisionForCharityCare
Number Of Hospital Facilities1NumberOfHospitalFacilities

Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA

FieldValueIRS element (for citing)
Facility Number1FacilityNumber

Name Name

FieldValueIRS element (for citing)
Business Name Line1SPRING HARBOR HOSPITALBusinessNameLine1

Address Address

FieldValueIRS element (for citing)
Address Line1123 ANDOVER ROADAddressLine1
CityWESTBROOKCity
StateMEState
ZIP Code04092ZIPCode
FieldValueIRS element (for citing)
Licensed HospitalXLicensedHospital

Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1SPRING HARBOR HOSPITALBusinessNameLine1
FieldValueIRS element (for citing)
Hospital Facility Number1HospitalFacilityNumber
Eligibility Criteria ExplainedtrueEligibilityCriteriaExplained
Uses FPG FreetrueUsesFPGFree
FPG Free Percent175.0FPGFreePercent
Uses FPG DiscountedtrueUsesFPGDiscounted
FPG Discount Percent175.0FPGDiscountPercent
Explains BasistrueExplainsBasis
Income LevelXIncomeLevel
Asset LevelXAssetLevel
Medical IndigencyXMedicalIndigency
Medicaid MedicareXMedicaidMedicare
Explains Application MethodtrueExplainsApplicationMethod
Includes Publicity MeasurestrueIncludesPublicityMeasures
Posted In Emergency RoomXPostedInEmergencyRoom
Posted In Admission OfficeXPostedInAdmissionOffice
Provided On AdmissionXProvidedOnAdmission
Available On RequestXAvailableOnRequest
Actions On NonpaymenttrueActionsOnNonpayment
Collection ActivitiesfalseCollectionActivities
Nondiscrim Emergency Care PolicytrueNondiscrimEmergencyCarePolicy
Used Other MethodXUsedOtherMethod
Amounts Generally BilledfalseAmountsGenerallyBilled
Gross ChargesfalseGrossCharges

Form990 Schedule H Part VI Form990ScheduleHPartVI (13 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
OTHER TESTING METHODS FOR FREE OR DISCOUNTED CAREPART I LINE 3CSPRING HARBOR HOSPITAL DOES NOT PROVIDE DISCOUNTED CARE ONLY FREE CARE FOR WHICH THE FPG IS USED TO DETERMINE ELIGIBILITY
RELATED ORGANIZATION INFORMATIONPART I LINE 6ASPRING HARBORS ANNUAL COMMUNITY BENEFIT REPORT INFORMATION IS CONTAINED IN A REPORT PREPARED BY SPRING HARBORS PARENT ORGANIZATION MAINE MENTAL HEALTH PARTNERS SEE ATTACHED REPORT
COSTING METHODOLOGY EXPLANATIONPART I LINE 7CHARITY CARE COST DATA PRESENTED IN THIS SECTION HAS BEEN CALCULATED BY ASSIGNING THE AVERAGE OVERALL SPRING HARBOR RATIO OF COST TO CHARGES TO THE ACTUAL GROSS AMOUNT OF CHARITY CARE CHARGES RECORDED BY THE HOSPITAL DURING THE PERIOD OTHER BENEFIT COST DATA HAS BEEN CALCULATED THROUGH THE USE OF A COMBINATION OF ACTUAL GENERAL LEDGER SPECIFIC COST DATA AND THE USE OF EMPLOYEE TIME STUDIES ALL OTHER BENEFIT COST DATA IN PART I LINE 7 MATCHES THE DATA PRESENTED FOR SPRING HARBOR HOSPITAL IN MAINE MENTAL HEALTH PARTERS ANNUAL COMMUNITY BENEFIT REPORT
BAD DEBT EXPENSE EXPLANATIONPART III LINE 4SPRING HARBOR HOSPITAL DOES NOT HAVE A SPECIFIC FOOTNOTE IN THE FINANCIAL STATEMENTS THAT DESCRIBES BAD DEBT EXPENSE HOWEVER REFERENCE IS MADE WITHIN THE FOOTNOTES TO A BAD DEBT POLICY IN A COUPLE OF INSTANCES WITHIN THE FOOTNOTE DESCRIBING SIGNIFICANT ACCOUNTING POLICES IS THE SECTION TITLED ACCOUNTS RECEIVABLE WHERE THE FOLLOWING EXPLAINS THE BAD DEBT RESERVE THE RESERVE FOR UNCOLLECTIBLE ACCOUNTS IS PROVIDED BASED ON AN ANALYSIS BY MANAGEMENT OF THE COLLECTIBILITY OF OUTSTANDING BALANCES MANAGEMENT CONSIDERS THE AGE OF OUTSTANDING BALANCES AND PAST COLLECTION EFFORTS IN DETERMINING THE RESERVE FOR UNCOLLECTIBLE ACCOUNTS ACCOUNTS DEEMED UNCOLLECTIBLE ARE CHARGED OFF AGAINST THE ESTABLISHED RESERVE ALSO WITHIN THE SIGNIFICANT ACCOUNTING POLICIES IS THE SECTION TITLED CHARITY CARE AND BAD DEBTS WHERE THE FOLLOWING DESCRIBES THE BAD DEBT EXPENSE REVENUE FOR SERVICES RENDERED TO INDIVIDUALS FROM WHOM PAYMENT IS EXPECTED AND ULTIMATELY NOT RECEIVED IS WRITTEN OFF AND INCLUDED AS PART OF THE ALLOWANCE FOR BAD DEBTS THE AMOUNT OF EXPENSE ASSOCIATED WITH THE PROVISION OF SERVICES ULTIMATELY WRITTEN OFF AS BAD DEBT AT SPRING HARBOR HAS BEEN CALCULATED AT 769975 FOR THE CURRENT FISCAL YEAR THIS AMOUNT WAS CALCULATED BY ASSIGNING THE AVERAGE OVERALL SPRING HARBOR RATIO OF COST TO CHARGES TO THE GROSS AMOUNT OF CHARGES WRITTEN OFF AS BAD DEBT DURING THE FISCAL PERIOD BAD DEBT EXPENSE REPRESENTS HEALTHCARE SERVICES SPRING HARBOR HAS PROVIDED WITHOUT COMPENSATION AS A TAXEXEMPT HOSPITAL SPRING HARBOR PROVIDES NECESSARY PATIENT CARE REGARDLESS OF THE PATIENTS ABILITY TO PAY FOR THE SERVICES SPRING HARBOR CANNOT DETERMINE THE AMOUNT OF BAD DEBT EXPENSE THAT COULD BE REASONABLY ATTRIBUTABLE TO PATIENTS WHO LIKELY WOULD QUALIFY FOR DIFFICULT PERSONAL OR ECONOMIC CIRCUMSTANCES RELATED TO A PORTION OF OUR COMMUNITY BASED PATIENT POPULATION THEIR MEDICAL BILLS OFTEN PLACE THESE INDIVIDUALS IN UNTENABLE POSITIONS WHERE THEY ARE NOT ABLE TO HANDLE THEIR PERSONAL DEBT AND THEN THEIR NEW MEDICAL DEBT HOWEVER BECAUSE OF THEIR INCOME LEVEL THEY DO NOT QUALIFY FOR FREE CARE BY PROVIDING NECESSARY HEALTHCARE SERVICES TO THOSE INDIVIDUALS EITHER WHO FAIL TO APPLY FOR FINANCIAL ASSISTANCE OR WHO ARE EXPERIENCING DIFFICULT PERSONAL OR ECONOMIC CIRCUMSTANCES SPRING HARBOR BELIEVES THAT BAD DEBT EXPENSE SHOULD BE INCLUDED AS A COMMUNITY BENEFIT
MEDICARE EXPLANATIONPART III LINE 8SPRING HARBOR HOSPITAL IS CURRENTLY REIMBURSED BY MEDICARE PART A FOR INPATIENT SERVICES THROUGH A PROSPECTIVE PAYMENT SYSTEM PPS DAY RATE METHODOLOGY WHILE MEDICARE PART B REIMBURSES THE HOSPITAL FOR PROFESSIONAL SERVICES RENDERED THROUGH A FEE SCHEDULE FOR EACH SERVICE PROVIDED IN BOTH CASES PART A AND PART B THE REIMBURSEMENT PROVIDED DOES NOT FULLY COVER THE HOSPITALS COSTS TO PROVIDE SERVICES TO MEDICARE BENEFICIARIES ACTUAL FY11 COSTS TO PROVIDE CARE FOR MEDICARE PATIENTS HAS BEEN CALCULATED AT 5196390 WHILE TOTAL ACTUAL MEDICARE REIMBURSEMENT PROVIDED TOTALED 3777228 THE COST CALCULATION WAS DETERMINED USING STANDARD MEDICARE PART A COST REPORTING METHODOLOGIES COST TO CHARGE RATIOS COUPLED WITH INHOUSE SPRING HARBOR ANALYSIS OF PART B COSTS THE DIFFERENCE BETWEEN ACTUAL COST AND MEDICARE REIMBURSEMENT OF 1419162 REPRESENTS THE COST OF ACTUAL UNREIMBURSED CARE PROVIDED TO MEDICARE BENEFICIARIES SPRING HARBOR HOSPITAL BELIEVES THAT THE MEDICARE SHORTFALL SHOULD BE INCLUDED AS A COMMUNITY BENEFIT BECAUSE THE HOSPITAL HAS A CLEAR MISSION COMMITMENT TO SERVING ELDERLY PATIENTS AND ADULTS WITH DISABILITIES THROUGH THE PROVISION OF SPECIFIC SUBSIDIZED PROGRAMS DEVELOPED TO HELP IMPROVE THE HEALTH STATUS OF THESE PATIENTS IF THESE CRITICAL SUBSIDIZED PROGRAMS WERE NOT PROVIDED BY THE HOSPITAL THEY WOULD BECOME THE OBLIGATION OF THE FEDERAL GOVERNMENT
COLLECTION PRACTICES EXPLANATIONPART III LINE 9BSPRING HARBOR HOSPITAL OFFERS FINANCIAL ASSISTANCE TO PATIENTS WHO HAVE NO MEANS TO PAY FOR THEIR CARE BY MAINTAINING CHARITYINDIGENT CARE PROGRAMS CHARITY CARE IS PROVIDED TO THOSE PATIENTS WHO COMPLETE AN APPLICATION AND WHO OFFER EVIDENCE THAT THEY MEET THE ELIGIBILITY REQUIREMENTS THOSE PATIENTS WHO REFUSE APPLICATION OR WHO FAIL TO MEET THE REQUIREMENTS FOR UNCOMPENSATED CARE ARE PURSUED FOR COLLECTION UNSUCCESSFUL ATTEMPTS AT COLLECTION MAY RESULT IN THE ACCOUNT BEING WRITTEN OFF AS BAD DEBT FOR THOSE PATIENTS THAT DO QUALIFY FOR CHARITY CARE ACCOUNT BALANCES ARE ADJUSTED ACCORDINGLY ONCE THEIR CHARITY CARE APPLICATION HAS BEEN APPROVED MORE DETAILS REGARDING THE CHARITY CARE PROCESS AT SPRING HARBOR ARE MAINTAINED IN THE HOSPITALS WRITTEN AND PUBLICLY AVAILABLE CHARITY CARE POLICY
NEEDS ASSESSMENTPART VISPRING HARBOR HOSPITAL IS A MEMBER OF MAINEHEALTH WHICH CONDUCTS A THOROUGH COMMUNITY NEEDS ASSESSMENT AND DIRECTS ITS MEMBER ORGANIZATIONS TO RESPOND TO THE NEEDS IDENTIFIED MAINEHEALTH MEMBERS ALSO PARTICIPATE IN VARIOUS INITIATIVES TO KEEP THOSE ASSESSMENTS UP TO DATE SOME OF THESE INITIATIVES INCLUDE CLINICAL STRATEGIC PLANNING FINANCIAL STRATEGIC PLANNING FACILITY PLANNING HUMAN RESOURCE PLANNING STAFF DEVELOPMENT PLANNING PHYSICIAN RECRUITMENT STRATEGIC PLANNING EMERGENCY PREPAREDNESS PLANNING IN ADDITION TO THESE INTERNAL ASSESSMENTS MAINEHEALTH MEMBER ORGANIZATIONS ALSO REVIEW AND ACT ON MANY OF THE RECOMMENDATIONS PROVIDED BY EXTERNAL GROUPS AND STATE HEALTH PLANNING INITIATIVES SUCH AS THE MAINE DEPARTMENT OF HEALTH AND HUMAN SERVICES HEALTHY MAINE 2010 AND AUTISM SPECTRUM DISORDERS REPORT THE MAINE CENTER FOR DISEASE CONTROL AND PREVENTION AND THE STATE HEALTH PLAN CREATED BY THE ADVISORY COMMITTEE FOR HEALTH SYSTEMS DEVELOPMENT
PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCEPART VISPRING HARBOR HOSPITAL DISTRIBUTES A PATIENT FINANCIAL POLICIES BROCHURE TO EACH PATIENT UPON ADMISSION WHICH INCLUDES BUT IS NOT LIMITED TO INFORMATION ON HOW TO ACCESS AND APPLY FOR SPRING HARBOR HOSPITALS FINANCIAL ASSISTANCE PROGRAM FINANCIAL COUNSELING SERVICES MAINECARE MEDICARE AND SOCIAL SECURITY
COMMUNITY INFORMATIONPART VISPRING HARBOR HOSPITALS SERVICE REGION ENCOMPASSES THE SOUTHERNMOST 11 COUNTIES OF MAINE AND ITS APPROXIMATELY 960000 RESIDENTS THREE QUARTERS OF THE STATE POPULATION OF THIS NUMBER IT IS ESTIMATED THAT 7 OF CHILDREN AND 23 OF ADULTS HAVE A DIAGNOSABLE MENTAL ILLNESS THIS EQUATES TO A POTENTIAL POPULATION SERVED OF 190000 MAINE RESIDENTS
HEALTH OF COMMUNITY IN RELATION TO EXEMPT PURPOSEPART VISPRING HARBOR HOSPITAL IN PARTNERSHIP WITH MAINEHEALTH DEVELOPED A PROGRAM TO IMPROVE PRIMARY CAREMENTAL HEALTH INTEGRATION AND HELPS PEOPLE WITH DEPRESSION AND THOSE WHO CARE FOR AND ABOUT THEM THE PROGRAM TRAINS PRIMARY CARE PROVIDERS ON THE DIAGNOSIS AND TREATMENT OF PATIENTS AND MANY PHYSICIANS USE AN ELECTRONIC REGISTRY TO TRACK OUTCOME MEASURES THE PROGRAM CONDUCTS A COLLABORATIVE LEARNING COMMUNITY EXPLORING THE EFFECTIVENESS EFFICIENCY AND COSTBENEFIT OF INTEGRATION WITH PRIMARY CAREMENTAL HEALTH PARTNERS
AFFILIATED HEALTH CARE INFORMATIONPART VISPRING HARBOR HOSPITAL IS A MEMBER OF MAINE MENTAL HEALTH PARTNERS MAINE MENTAL HEALTH PARTNERS MISSION IS TO BUILD HEALTHIER COMMUNITIES BY TRANSFORMING HEALTHCARE DELIVERY AND SERVICE EXPERIENCES BY PROMOTING INDIVIDUALS SUCCESSFUL FUNCTIONING IN THE COMMUNITY IE RECOVERY SUPPORTING ACCESS TO SAFE HIGHQUALITY CARE DELIVERED AS CLOSE AS POSSIBLE TO AN INDIVIDUALS HOME AND AT THE BEST POSSIBLE COST DESIGNING DEVELOPING AND SUPPORTING A CONTINUUM OF CARE THAT FULFILLS EACH REGIONS MENTAL HEALTH NEEDS ADVOCATING LOCALLY STATEWIDE REGIONALLY AND NATIONALLY TO ENHANCE MENTAL HEALTH FOR MAINE PEOPLE CREATING A MODEL SYSTEM OF LEADERSHIP CLINICAL EXCELLENCE INNOVATION AND EXPERTISE
LIST OF STATES WHERE COMMUNITY BENEFIT REPORT IS FILEDPART VIMAINE
SPRING HARBOR HOSPITAL LINE NUMBER 1 PART V LINE 19DPART V LINE 19DCHARGES ARE BASED ON SPRING HARBOR HOSPITALS NORMAL FEE STRUCTURE WITH SUBSEQUENT WRITE OFF TO CHARITY CARE

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Severance PaymentfalseSeverancePayment
Supplemental Nonqual Retire PlantrueSupplementalNonqualRetirePlan
Equity Based Comp ArrangementfalseEquityBasedCompArrangement
Comp Based On Revenue Of Filing OrgfalseCompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related OrgsfalseCompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing OrgfalseCompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate OrgsfalseCompBasedNetEarningsRelateOrgs
Any Non Fixed PaymentsfalseAnyNonFixedPayments
Initial Contract ExceptionfalseInitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (13 entries)

Comp Based On Related OrgsCompBasedOnRelatedOrgsBonus Related OrgsBonusRelatedOrgsOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Related OrgsTotalCompensationRelatedOrgsBase Compensation Filing OrgBaseCompensationFilingOrgDeferred Comp Filing OrgDeferredCompFilingOrgNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgTotal Compensation Filing OrgTotalCompensationFilingOrgBonus Filing OrgBonusFilingOrg
RICHARD PETERSEN
62533817350029471875608153441184508
FRANCIS G MCGINTY
409398750001937755901015389752572
DENNIS P KING
2792055000079166550338865472269
FRANK LAVOIE MD
3380604838857515780367253
GIRARD ROBINSON MD
30803344665110777560523581523108
DONALD E QUIGLEY
26935938000174995668615309396853
GREGORY BOWERS
17425820000582815431215517
RICHARD HANLEY
17103513000552116775206331
MARK FULTON
211666635015740233756
JOHN MURPHY MD
2113042268816408250400
MATTHEW SIEGEL MD
2024146132156642282104000
MELISSA M BOWKER-KINLEY
189223567716075210975
WILLIAM BRENNAN MD
17604060215446192088

Form990 Schedule J Part III Form990ScheduleJPartIII (3 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
RELATED ORG METHODS USED FOR COMPENSATION EXPLANATIONSCHEDULE J, PAGE 1, PART I, LINE 3FOR KEY ADMINISTRATIVE EMPLOYEES THAT ARE SHARED WITH MMHP, COMPENSATION IS EVALUATED BY THE MMHP GOVERNANCE COMMITTEE AND APPROVED BY THE ORGANIZATION'S BOARD OF DIRECTORS. IN ADDITION, THE ORGANIZATION UTILIZES THE SERVICES OF AN INDEPENDENT COMPENSATION CONSULTING FIRM AND INDUSTRY SURVEY.
SEVERANCE, NONQUALIFIED, AND EQUITY-BASED PAYMENTSSCHEDULE J, PAGE 1, PART I, LINE 4RICHARD PETERSEN 0 272,888 0 FRANCIS G. MCGINTY 0 190,136 0 DENNIS P. KING 0 65,602 0 FRANK LAVOIE, MD 0 4,838 0 GIRARD ROBINSON, MD 0 107,213 0 DONALD E. QUIGLEY 0 10,480 0
OTHER ADDITIONAL INFORMATIONSCHEDULE J, PART IIITHE NONQUALIFIED PAYMENTS SHOWN ABOVE ARE FROM RELATED ORGANIZATIONS WHERE THE INDIVIDUALS ARE EMPLOYED.

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (12 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
ALL OTHER ACCOMPLISHMENT DESCRIPTIONFORM 990, PAGE 2, PART III, LINE 4DOTHER PROGRAM SERVICES INCLUDE CAFETERIA AND VENDING UNITS SALES, OTHER REVENUE FROM MEDICAL RECORDS, RENT FROM A RELATED PARTY, AND EDUCATIONAL SERVICES.
CLASSES OF MEMBERS OR STOCKHOLDERSFORM 990, PAGE 6, PART VI, LINE 6MAINE MENTAL HEALTH PARTNERS (MMHP) IS THE SOLE MEMBER OF SPRING HARBOR HOSPITAL. MAINEHEALH (EIN 01-0431680), AS THE SOLE MEMBER OF MMHP, HAS THE RIGHT TO APPROVE SIGNIFICANT DECISIONS OF THE GOVERNING BODY OF MMHP AND ITS SUBSIDIARIES.
ELECTION OF MEMBERS AND THEIR RIGHTSFORM 990, PAGE 6, PART VI, LINE 7ATHE SOLE MEMBER, MAINE MENTAL HEALTH PARTNERS MAY ELECT THE BOARD OF DIRECTORS FROM A SLATE OF NOMINEES SUBMITTED BY THE CORPORATION. THE OFFICERS ARE ELECTED BY THE BOARD OF TRUSTEES, EXCEPT THAT THE CFO, COO, CHIEF MEDICAL OFFICER AND CHIEF CLINICAL & NURSING OFFICER ARE APPOINTED BY THE BOARD OF TRUSTEES BASED UPON A RECOMMENDATION OF THE CEO.
DECISIONS SUBJECT TO APPROVAL OF MEMBERSFORM 990, PAGE 6, PART VI, LINE 7BDECISIONS OF THE GOVERNING BODY SUCH AS BUDGETS, BUSINESS STRATEGIES, SIGNIFICANT FINANCIAL COMMITMENTS, AMENDMENTS TO THE ARTICLES OF INCORPORATION, AND ELECTION OF THE PRESIDENT/CEO AMONG OTHER DECISIONS, ARE SUBJECT TO THE APPROVAL OF THE SOLE MEMBER.
ORGANIZATION'S PROCESS USED TO REVIEW FORM 990FORM 990, PAGE 6, PART VI, LINE 11BTHE FULL BOARD PERFORMS A REVIEW OF THE FORM 990. A FINAL DETAILED REVIEW OF THE FORM 990 IS PERFORMED BY THE CHIEF FINANCIAL OFFICER BEFORE SIGNING AND PRIOR TO FILING.
ENFORCEMENT OF CONFLICTS POLICYFORM 990, PAGE 6, PART VI, LINE 12CCONFLICT OF INTEREST STATEMENTS ARE OBTAINED ANNUALLY. THE ORGANIZATION REVIEWS THE RESPONSES TO THESE DOCUMENTS AND ADDRESSES ANY ISSUES IMMEDIATELY.
COMPENSATION PROCESS FOR TOP OFFICIALFORM 990, PAGE 6, PART VI, LINE 15ASPRING HARBOR HOSPITAL BOARD OF DIRECTORS ARE RESPONSIBLE FOR AN ANNUAL EVALUATION OF THE PRESIDENT/CEO AND THE OTHER KEY ADMINISTRATIVE EMPLOYEES OF THE ORGANIZATION. FOR THOSE KEY ADMINISTRATIVE EMPLOYEES THAT ARE SHARED WITH MMHP, COMPENSATION IS EVALUATED BY THE MMHP GOVERNANCE COMMITTEE AND APPROVED BY THE ORGANIZATION'S BOARD OF DIRECTORS. IN ADDITION, THE ORGANIZATION UTILIZES THE SERVICES OF AN INDEPENDENT COMPENSATION CONSULTING FIRM, AND INDUSTRY SURVEY.
COMPENSATION PROCESS FOR OFFICERSFORM 990, PAGE 6, PART VI, LINE 15BTHE MEMBER IS RESPONSIBLE FOR AN ANNUAL EVALUATION OF THE PRESIDENT/CEO AND THE OTHER KEY ADMINISTRATIVE EMPLOYEES OF THE ORGANIZATION. COMPENSATION IS EVALUATED BY THE COMPENSATION COMMITTEE APPOINTED BY THE MEMBER, AND THE ORGANIZATION'S BOARD OF TRUSTEES MUST APPROVE OF THE COMPENSATION. IN ADDITION, THE ORGANIZATION UTILIZES THE SERVICES OF AN INDEPENDENT COMPENSATION CONSULTING FIRM, AND INDUSTRY SURVEY.
GOVERNING DOCUMENTS DISCLOSURE EXPLANATIONFORM 990, PAGE 6, PART VI, LINE 19DOCUMENTS THAT ARE REQUIRED TO BE OPEN FOR PUBLIC INSPECTION ARE MADE AVAILABLE UPON REQUEST.
ADDITIONAL INFORMATIONFORM 990, PART VIICOLUMN B - AVERAGE HOURS WORKED AT RELATED ORGANIZATIONS RICHARD PETERSEN IS THE PRESIDENT & CEO OF MAINE MEDICAL CENTER, A RELATED ORGANIZATION. HE SPENDS THE MAJORITY OF HIS TIME IN THIS ROLE. DENNIS KING IS THE CEO OF MMHP AND SPENDS APPROXIMATELY 36 HOURS A WEEK DOING WORK FOR ALL OF THE MMHP ENTITIES. HE IS ALSO THE SENIOR VICE PRESIDENT OF BEHAVIORAL HEALTH FOR MAINEHEALTH, A REALTED ORGANIZATION, AND SPENDS APPROXIMATELY 4 HOURS A WEEK IN THIS ROLE. FRANCIS MCGINTY IS THE EXECUTIVE VP & TREASURER OF MAINEHEALTH, A RELATED ORGANIZATION. HE DIVIDES HIS TIME BETWEEN ALL OF THE ENTITIES WITHIN MAINEHEALTH. GIRARD ROBINSON IS THE CMO FOR BOTH SHH AND SPRING HARBOR COMMUNITY SERVICES AND THE VICE PRESIDENT OF MEDICAL AFFAIRS FOR MMHP AND MAINEHEALTH, A RELATED ORGANIZATION. HE SPENDS APPROXIMATELY 1 HOUR A WEEK AS CMO OF SHCS, 9.5 HOURS PER WEEK AS VP OF MEDICAL AFFAIRS FOR MMHP AND 20 HOURS PER WEEK AS VP OF MEDICAL AFFAIRS FOR MAINEHEALTH. DONALD QUIGLEY IS THE SENIOR VICE PRESIDENT & GENERAL COUNSEL FOR MAINEHEALTH AND DIVIDES HIS TIME BETWEEN ALL OF THE MAINEHEALTH ENTITIES. GREGORY BOWERS IS THE EXECUTIVE VICE PRESIDENT & TREASURER OF MMHP AND DIVIDES HIS TIME AMONG ALL OF THE MMHP ENTITIES. RICHARD HANLEY RETIRED ON SEPTEMBER 30, 2012. PRIOR TO THIS DATE, HE WAS THE CHIEF OPERATING OFFICER OF MMHP AND ALSO DIVIDED HIS TIME AMONG THE MMHP ENTITIES. GAIL WILKERSON IS THE CHIEF OPERATING OFFICER AT SPRING HARBOR COMMUNITY SERVICES AND SPENDS APPROXIMATELY 24 HOURS PER WEEK IN THAT ROLE. SHE IS ALSO THE VP OF STRATEGY & SYSTEM DEVELOPMENT FOR MMHP AND SPENDS APPROXIMATELY 8 HOURS DOING WORK FOR THAT ORGANIZATION. MICHAEL ABBATIELLO IS CHIEF FINANCIAL OFFICER FOR ALL OF THE MMHP ENTITIES. HE SPENDS APPROXIMATELY 36 HOURS IN THIS ROLE AT MMHP AND APPROXIMATELY 1 HOUR AT EACH OF THE OTHER ENTITIES.
OTHER CHANGES IN NET ASSETS EXPLANATIONFORM 990, PART XI, LINE 5OTHER CHANGES TO NET ASSETS INCLUDE THE FOLLOWING: 29,593 - UNREALIZED GAIN ON INVESTMENTS (15,697) - OTHER CHANGES
ADDITIONAL INFORMATIONFORM 990, PART XIIA-133 AUDIT - THE ORGANIZATION DID NOT HAVE A SEPARATE A-133 AUDIT. IT WAS PART OF THE CONSOLIDATED A-133 AUDIT OF ITS PARENT COMPANY, MAINE MENTAL HEALTH PARTNERS (EIN 26-3426990).

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (5 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Controlled OrgControlledOrg
MAINEHEALTH
110 FREE STREETPORTLANDME04101010431680HEALTHCAREME501C311CNAfalse
MAINE MENTAL HEALTH PARTNERS
78 ATLANTIC PLACESOUTH PORTLANDME04106263426990HEALTHCAREME501C311CMAINEHLTHfalse
SPRING HARBOR COMMUNITY SERVICES
78 ATLANTIC PLACESOUTH PORTLANDME04106010524835HEALTHCAREME501C39MMHPfalse
COMMUNITY COUNSELING CENTER
78 ATLANTIC PLACESOUTH PORTLANDME04106010288362HEALTHCAREME501C37MMHPfalse
COUNSELING SERVICES INC
78 ATLANTIC PLACESOUTH PORTLANDME04106010315038HEALTHCAREME501C37MMHPfalse

Form990 Schedule R Part IV Form990ScheduleRPartIV

Name Of Related Org NameOfRelatedOrg

FieldValueIRS element (for citing)
Business Name Line1INTEGRATED BEHAVIORAL HEALTH INCBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line178 ATLANTIC PLACEAddressLine1
CitySOUTH PORTLANDCity
StateMEState
ZIP Code04106ZIPCode
FieldValueIRS element (for citing)
EIN208736290EIN
Primary ActivityHEALTHCAREPrimaryActivity
Legal Domicile StateMELegalDomicileState
Direct Controlling Entity NAN/ADirectControllingEntityNA
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents RoyaltiesfalseReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other OrgfalseGiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other OrgfalseGiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other OrgtrueLoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other OrgfalseLoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other OrgfalseSaleOfAssetsToOtherOrg
Purchase Of Assets From Other OrgfalsePurchaseOfAssetsFromOtherOrg
Exchange Of AssetstrueExchangeOfAssets
Rental Of Facilities To Other OrgstrueRentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other OrgsfalseRentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other OrgsfalsePerformOfServicesForOtherOrgs
Perform Of Services By Other OrgstruePerformOfServicesByOtherOrgs
Sharing Of FacilitiestrueSharingOfFacilities
Sharing Of Paid EmployeestrueSharingOfPaidEmployees
Reimbursement Paid To Other OrgtrueReimbursementPaidToOtherOrg
Reimbursement Paid By Other OrgtrueReimbursementPaidByOtherOrg
Other Transfer To Other OrgfalseOtherTransferToOtherOrg
Other Transfer From Other OrgfalseOtherTransferFromOtherOrg