2013-08-05T11:59:47-05:00 2012-09-30 MAINEHEALTH 110 FREE ST PORTLAND ME 041013908 990 2011-10-01 010524834 SPRING HARBOR HOSPITAL SPRI 2077612200 78 ATLANTIC PLACE SOUTH PORTLAND ME 04106 MICHAEL ABBATIELLO 2077612200 2013-07-12 2013-08-05 2011 2016-02-24 21:20:13Z X DENNIS P KING 123 ANDOVER ROAD WESTBROOK ME 04092 33520941 false X WWW.SPRINGHARBOR.ORG X 1999 ME SPRING HARBOR HOSPITAL OFFERS PEOPLE IN MENTAL HEALTH CRISIS HIGH-QUALITY, FOCUSED TREATMENT TO SUPPORT THEIR ONGOING RECOVERY. 19 15 498 5 0 413818 511633 31742462 32947607 55003 14581 13104 40173 32224387 33513994 0 0 21316294 20695405 0 113240 10228131 11950304 31544425 32645709 679962 868285 37113459 34493242 28293180 24790782 8820279 9702460 X SPRING HARBOR HOSPITAL OFFERS PEOPLE IN MENTAL HEALTH CRISIS HIGH-QUALITY, FOCUSED TREATMENT TO SUPPORT THEIR ONGOING RECOVERY. false false 13795579 15965758 ADULT 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. 9699999 11225904 CHILD 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). 4483378 5188657 DEVELOPMENTAL 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. 490178 567288 OTHER PROGRAM SERVICES INCLUDE CAFETERIA AND VENDING UNITS SALES, OTHER REVENUE FROM MEDICAL RECORDS, RENT FROM A RELATED PARTY, AND EDUCATIONAL SERVICES. 490178 567288 28469134 true true false true false false true false false true true false false true true true false true false false false false false false true false true true false false true false false false false false false false false false false false false false true false false false false true 14 0 true 498 true false false false false false false false false false false X 19 15 false false false false true true true true true false false true true true true true true true true false ME X MICHAEL ABBATIELLO CFO 2077612200 78 ATLANTIC PLACE SOUTH PORTLAND ME 04106 X RICHARD PETERSEN 1.00 X 0 1093556 90952 FRANCIS G MCGINTY 1.00 X X 0 678173 74399 DENNIS P KING 14.00 X X 0 408371 63898 FRANK LAVOIE MD 1.00 X 0 342898 24355 DAVID LAKARI 1.00 X X 0 0 0 SHERI BOULOS 1.00 X 0 0 0 JANIS COHEN 1.00 X 0 0 0 JAMES HARNAR 1.00 X 0 0 0 NANCY HASENFUS MD 1.00 X 0 0 0 TRACY HAWKINS 1.00 X X 0 0 0 LESTER W HODGDON 1.00 X 0 0 0 LISA C HOOK 1.00 X 0 0 0 NANCY POND 1.00 X 0 0 0 ANNA H WELLS 1.00 X X 0 0 0 LESTER F WILKINSON JR 1.00 X 0 0 0 JOHN SHOOS 1.00 X 0 0 0 ROGER F WOODMAN JR 1.00 X 0 0 0 MUKESH BHARGAVA 1.00 X 0 0 0 RICHARD WHITE 1.00 X 0 0 0 GIRARD ROBINSON MD 9.50 X 0 463475 59633 DONALD E QUIGLEY 1.00 X 0 324858 71995 GREGORY BOWERS 1.00 X 0 194258 21259 RICHARD HANLEY 40.00 X 0 184035 22296 MICHAEL ABBATIELLO 1.00 X 0 133442 16479 GAIL WILKERSON 8.00 X 0 126006 19225 JOYCE COTTON 40.00 X 110116 0 18724 MARK FULTON 40.00 X 211666 0 22090 JOHN MURPHY MD 40.00 X 211304 0 39096 MATTHEW SIEGEL MD 40.00 X 206414 0 21796 MELISSA M BOWKER-KINLEY 40.00 X 189223 0 21752 WILLIAM BRENNAN MD 40.00 X 176040 0 16048 1104763 3949072 603997 6 false true false NORDX 301A US ROUTE ONE SCARBOROUGH ME 04074 LAB PROCESSING 194389 E-PHARM PRO 3605 EDGEMONT AVE BACK BUILDING SUITE 1 BROOKHAVEN PA 19015 PHARMACEUTICAL 155900 SYNERNET INC 110 FREE STREET PORTLAND ME 04102 TRANSCRIPTION 154771 3 511633 511633 ADULT SERVICES 623000 15965758 15965758 CHILD & ADOLESCENT 623000 11225904 11225904 DEVELOPMENTAL DISORDERS 623000 5188657 5188657 RENT INCOME 531120 284077 284077 CAFETERIA 722210 221009 221009 62202 62202 32947607 877 877 13704 13704 13704 13704 47120 6947 40173 33513994 32961311 877 121556 121556 16434568 16153171 191761 89636 398033 386092 11941 2549010 2472540 76470 1192238 1156471 35767 58245 58245 8040 8040 935996 924138 4961 6897 17445 16922 523 589491 558399 16307 14785 15666 15196 470 1830449 1775536 54913 40850 40224 490 136 57603 54560 2733 310 1064338 1032408 31930 163371 159213 4158 MEMBER MANAGEMENT FEES 3233520 3233520 PROVISION FOR BAD DEBT 1311265 1311265 HOSPITAL TAX 805383 805383 PHARMACY SERVICES 753114 753114 1065528 732946 331106 1476 32645709 28469134 4063335 113240 1665 1988 14381993 11170890 1139077 1252306 436797 390 262936 165398 57792 76071 28689848 9416398 19960917 19273450 638800 637355 233482 1915394 37113459 34493242 2911701 2488230 21933 21554118 21283877 3827361 996742 28293180 24790782 X 8309847 9085816 160432 266644 350000 350000 8820279 9702460 37113459 34493242 X 868285 13896 X X false true true X true true X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false false false false false true 10630 10630 false false false false false SCHEDULE C, PART II-B, LINE 1 A 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: 10,630 false false X 1 54 1 false 5 250 false false false false 350000 29974 29974 350000 350000 2093 2093 350000 350000 33229 33229 350000 350000 7350 7350 350000 1.00000 false true true 1212130 1212130 23539922 6186546 17353376 702299 974741 -272442 3082904 2255111 827793 152593 152593 19273450 DUE FROM AFFILIATES 1387083 DEFERRED FINANCING COST 445665 INSURANCE RECOVERIES 82646 1915394 AMOUNTS PAYABLE UNDER REIMB. REGS. 914096 INSURANCE CLAIMS 82646 DUE TO AFFILIATES 996742 ACCOUNTING FOR CONSERVATION EASEMENTS SCHEDULE D, PAGE 1, PART II, LINE 9 IN 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 FUNDS SCHEDULE D, PAGE 2, PART V, LINE 4 THE 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 FOOTNOTE SCHEDULE D, PAGE 3, PART X SPRING 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. SIGNS OF HOPE 47120 47120 6947 47120 47120 6947 6947 40173 true true true X 1.75000 false true true false true true 3332782 3332782 0.10640 3332782 3332782 0.10640 93754 93754 0.00290 103911 103911 0.00320 11558 11558 0.00040 209223 209223 0.00640 3542005 3542005 0.11280 false 769975 3777228 5196390 -1419162 X true true 1 1 SPRING HARBOR HOSPITAL

123 ANDOVER ROAD WESTBROOK ME 04092

X SPRING HARBOR HOSPITAL 1 true true 175.0 true 175.0 true X X X X true true X X X X true false true X false false OTHER TESTING METHODS FOR FREE OR DISCOUNTED CARE PART I LINE 3C SPRING HARBOR HOSPITAL DOES NOT PROVIDE DISCOUNTED CARE ONLY FREE CARE FOR WHICH THE FPG IS USED TO DETERMINE ELIGIBILITY RELATED ORGANIZATION INFORMATION PART I LINE 6A SPRING 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 EXPLANATION PART I LINE 7 CHARITY 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 EXPLANATION PART III LINE 4 SPRING 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 EXPLANATION PART III LINE 8 SPRING 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 EXPLANATION PART III LINE 9B SPRING 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 ASSESSMENT PART VI SPRING 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 ASSISTANCE PART VI SPRING 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 INFORMATION PART VI SPRING 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 PURPOSE PART VI SPRING 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 INFORMATION PART VI SPRING 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 FILED PART VI MAINE SPRING HARBOR HOSPITAL LINE NUMBER 1 PART V LINE 19D PART V LINE 19D CHARGES ARE BASED ON SPRING HARBOR HOSPITALS NORMAL FEE STRUCTURE WITH SUBSEQUENT WRITE OFF TO CHARITY CARE false true false false false false false false false RICHARD PETERSEN 625338 173500 294718 75608 15344 1184508 FRANCIS G MCGINTY 409398 75000 193775 59010 15389 752572 DENNIS P KING 279205 50000 79166 55033 8865 472269 FRANK LAVOIE MD 338060 4838 8575 15780 367253 GIRARD ROBINSON MD 308033 44665 110777 56052 3581 523108 DONALD E QUIGLEY 269359 38000 17499 56686 15309 396853 GREGORY BOWERS 174258 20000 5828 15431 215517 RICHARD HANLEY 171035 13000 5521 16775 206331 MARK FULTON 211666 6350 15740 233756 JOHN MURPHY MD 211304 22688 16408 250400 MATTHEW SIEGEL MD 202414 4000 6132 15664 228210 MELISSA M BOWKER-KINLEY 189223 5677 16075 210975 WILLIAM BRENNAN MD 176040 602 15446 192088 RELATED ORG METHODS USED FOR COMPENSATION EXPLANATION SCHEDULE J, PAGE 1, PART I, LINE 3 FOR 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 PAYMENTS SCHEDULE J, PAGE 1, PART I, LINE 4 RICHARD 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 INFORMATION SCHEDULE J, PART III THE NONQUALIFIED PAYMENTS SHOWN ABOVE ARE FROM RELATED ORGANIZATIONS WHERE THE INDIVIDUALS ARE EMPLOYED. ALL OTHER ACCOMPLISHMENT DESCRIPTION FORM 990, PAGE 2, PART III, LINE 4D OTHER 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 STOCKHOLDERS FORM 990, PAGE 6, PART VI, LINE 6 MAINE 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 RIGHTS FORM 990, PAGE 6, PART VI, LINE 7A THE 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 MEMBERS FORM 990, PAGE 6, PART VI, LINE 7B DECISIONS OF THE GOVERNING BODY SUCH AS BUDGETS, BUSINESS STRATEGIES, SIGNIFICANT FINANCIAL COMMITMENTS, AMENDMENTS TO THE ARTICLES OF INCORPORATION, AND ELECTION OF THE PRESIDENT/CEO AMONG OTHER DECISIONS, ARE SUBJECT TO THE APPROVAL OF THE SOLE MEMBER. ORGANIZATION'S PROCESS USED TO REVIEW FORM 990 FORM 990, PAGE 6, PART VI, LINE 11B THE 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 POLICY FORM 990, PAGE 6, PART VI, LINE 12C CONFLICT OF INTEREST STATEMENTS ARE OBTAINED ANNUALLY. THE ORGANIZATION REVIEWS THE RESPONSES TO THESE DOCUMENTS AND ADDRESSES ANY ISSUES IMMEDIATELY. COMPENSATION PROCESS FOR TOP OFFICIAL FORM 990, PAGE 6, PART VI, LINE 15A SPRING 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 OFFICERS FORM 990, PAGE 6, PART VI, LINE 15B THE 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 EXPLANATION FORM 990, PAGE 6, PART VI, LINE 19 DOCUMENTS THAT ARE REQUIRED TO BE OPEN FOR PUBLIC INSPECTION ARE MADE AVAILABLE UPON REQUEST. ADDITIONAL INFORMATION FORM 990, PART VII COLUMN 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 EXPLANATION FORM 990, PART XI, LINE 5 OTHER CHANGES TO NET ASSETS INCLUDE THE FOLLOWING: 29,593 - UNREALIZED GAIN ON INVESTMENTS (15,697) - OTHER CHANGES ADDITIONAL INFORMATION FORM 990, PART XII A-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). MAINEHEALTH 110 FREE STREET PORTLAND ME 04101 010431680 HEALTHCARE ME 501C3 11C NA false MAINE MENTAL HEALTH PARTNERS 78 ATLANTIC PLACE SOUTH PORTLAND ME 04106 263426990 HEALTHCARE ME 501C3 11C MAINEHLTH false SPRING HARBOR COMMUNITY SERVICES 78 ATLANTIC PLACE SOUTH PORTLAND ME 04106 010524835 HEALTHCARE ME 501C3 9 MMHP false COMMUNITY COUNSELING CENTER 78 ATLANTIC PLACE SOUTH PORTLAND ME 04106 010288362 HEALTHCARE ME 501C3 7 MMHP false COUNSELING SERVICES INC 78 ATLANTIC PLACE SOUTH PORTLAND ME 04106 010315038 HEALTHCARE ME 501C3 7 MMHP false INTEGRATED BEHAVIORAL HEALTH INC 78 ATLANTIC PLACE SOUTH PORTLAND ME 04106 208736290 HEALTHCARE ME N/A false false false true false false false true true false false true true true true true false false