FURP.ORG / PUBLIC DATA EXPLORER

WESTERN MAINE NURSING HOME INC: Form 990, tax year 2011

View the entire original 990 at ProPublica ↗

Organization
WESTERN MAINE NURSING HOME INC (EIN 22-2842655)
Tax period
2011-10-01 to 2012-09-30
Filed
2013-08-12
IRS object ID
201312249349301036
Schema version
2011v1.5
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)
Timestamp2013-08-12T09:54:13-05:00Timestamp
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)
EIN222842655EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1WESTERN MAINE NURSING HOME INCBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlWESTNameControl
Phone2077437086Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line13 MARKET SQUAREAddressLine1
CitySOUTH PARISCity
StateMEState
ZIP Code04281ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameJOHN COXName
TitleSENIOR VP - FISCALTitle
Phone2077437086Phone
Date Signed2013-08-07DateSigned
Authorize Third PartyfalseAuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
Date Prepared2013-08-07DatePrepared
FieldValueIRS element (for citing)
Tax Year2011TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonTIMOTHY CHURCHILLNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line13 MARKET SQUAREAddressLine1
CitySOUTH PARISCity
StateMEState
ZIP Code04281ZIPCode
FieldValueIRS element (for citing)
Gross Receipts6384335GrossReceipts
Group Return For AffiliatesfalseGroupReturnForAffiliates
Organization501c3XOrganization501c3
Web SiteWWW.WMHCC.ORGWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1987YearFormation
State Legal DomicileMEStateLegalDomicile
Activity Or Mission DescriptionTO ENSURE A HIGH QUALITY, ACCESSIBLE, AFFORDABLE AND APPROPRIATE INTEGRATED HEALTH CARE SYSTEM TO IMPROVE THE HEALTH AND WELL BEING OF THE COMMUNITY.ActivityOrMissionDescription
Nbr Voting Members Governing Body18NbrVotingMembersGoverningBody
Nbr Independent Voting Members14NbrIndependentVotingMembers
Total Nbr Employees180TotalNbrEmployees
Total Nbr Volunteers19TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Contributions Grants Prior Year2168ContributionsGrantsPriorYear
Contributions Grants Current Year3379ContributionsGrantsCurrentYear
Program Service Revenue Prior Year6474634ProgramServiceRevenuePriorYear
Program Service Revenue CY6370002ProgramServiceRevenueCY
Investment Income Prior Year317InvestmentIncomePriorYear
Investment Income Current Year312InvestmentIncomeCurrentYear
Other Revenue Prior Year13736OtherRevenuePriorYear
Other Revenue Current Year10642OtherRevenueCurrentYear
Total Revenue Prior Year6490855TotalRevenuePriorYear
Total Revenue Current Year6384335TotalRevenueCurrentYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year4749777SalariesEtcPriorYear
Salaries Etc Current Year4487689SalariesEtcCurrentYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year2557880OtherExpensePriorYear
Other Expenses Current Year2496543OtherExpensesCurrentYear
Total Expenses Prior Year7307657TotalExpensesPriorYear
Total Expenses Current Year6984232TotalExpensesCurrentYear
Revenues Less Expenses Prior Year-816802RevenuesLessExpensesPriorYear
Revenues Less Expenses CY-599897RevenuesLessExpensesCY
Total Assets BOY1431104TotalAssetsBOY
Total Assets EOY1129143TotalAssetsEOY
Total Liabilities BOY663004TotalLiabilitiesBOY
Total Liabilities EOY617853TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY768100NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY511290NetAssetsOrFundBalancesEOY
Mission DescriptionTO ENSURE A HIGH QUALITY, ACCESSIBLE, AFFORDABLE AND APPROPRIATE INTEGRATED HEALTH CARE SYSTEM TO IMPROVE THE HEALTH AND WELL BEING OF THE COMMUNITY.MissionDescription
Significant New Program ServicesfalseSignificantNewProgramServices
Significant ChangefalseSignificantChange
Expense6630338Expense
Revenue6380644Revenue
DescriptionTHE ORGANIZATION PROVIDES LONG-TERM NURSING AND RELATED MEDICAL CARE TO ITS RESIDENTS. SERVICES INCLUDE A RESIDENTIAL CARE UNIT, SKILLED NURSING CARE AND INTERMEDIATE NURSING CARE. IN 2012 THE ORGANIZATION SERVED 30,611 RESIDENT DAYS, INCLUDING 22,616 MAINECARE DAYS. SEE COMMUNITY BENEFIT STATEMENT.Description
Total Program Service Expense6630338TotalProgramServiceExpense
Described In501 C3trueDescribedIn501C3
Schedule B RequiredfalseScheduleBRequired
Political ActivitiesfalsePoliticalActivities
Lobbying ActivitiestrueLobbyingActivities
Subject To Proxy TaxfalseSubjectToProxyTax
Donor Advised FundsfalseDonorAdvisedFunds
Conservation EasementsfalseConservationEasements
Collections Of ArtfalseCollectionsOfArt
Credit CounselingfalseCreditCounseling
Term Or Permanent EndowmentstrueTermOrPermanentEndowments
Report Land Bldg EquipfalseReportLandBldgEquip
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 ActivitiesfalseFundraisingActivities
GamingfalseGaming
HospitalfalseHospital
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 With10962NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup WitholdingtrueComplianceWithBackupWitholding
Number Of Employees180NumberOfEmployees
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 Members18NbrVotingGoverningBodyMembers
Number Independent Voting Members14NumberIndependentVotingMembers
Family Or Business RelationshiptrueFamilyOrBusinessRelationship
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 OtherfalseCompensationProcessOther
Investment In Joint VenturefalseInvestmentInJointVenture
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonSENIOR VP - FISCALNamePerson
Telephone Number2077435933TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line13 MARKET SQUAREAddressLine1
CitySOUTH PARISCity
StateMEState
ZIP Code04281ZIPCode
FieldValueIRS element (for citing)
Info In Schedule O Part VIIXInfoInScheduleOPartVII

Form990 Part VII Section A Form990PartVIISectionA (23 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationOfficerOfficerFormerFormer
GREGORY HARDY MD
MED STAFF PR1.00X035022024868
TIMOTHY CHURCHILL
PRESID & CEO5.00X031780834286X
EUGENE BENNER
CHAIR1.00X000X
ANDREA BURNS
TRUSTEE1.00X000
PETER CHAPMAN
SECRETARY/TR1.00X000X
C BRADLEY CUMMINGS
TRUSTEE1.00X000
TOM MORTON
TRUSTEE1.00X000
LARRY FARMER OD
TRUSTEE1.00X000
DAVID HOISINGTON
CHAIR1.00X000X
DAVID KUMAKI MD
TRUSTEE1.00X000
REV ANNE STANLEY
TRUSTEE1.00X000
WILLIAM L MEDD MD
TRUSTEE1.00X000
OLA MELHUS MD
TRUSTEE1.00X000
WENDY PENLEY
TRUSTEE1.00X000
LYNN HAMPER
TRUSTEE1.00X000
DAVID J PREBLE
VICE CHAIR1.00X000
TED MOCCIA
TRUSTEE1.00X000
ROBIN J ZINCHUK
TRUSTEE1.00X000
PAT WEIGEL
TRUSTEE1.00X000
JOHN COX
SR VP-FISCAL8.00016659823383X
M PATRICIA COOK
SR VP-CLINIC1.00014245026047X
ADAM M KAZIMIERCZAK
PHYSICIAN1.00021786722126X
KATHLEEN A HERLIHY
PHYSICIAN016733523306X
FieldValueIRS element (for citing)
Total Reportable Comp Frm Rltd Orgs1362278TotalReportableCompFrmRltdOrgs
Total Other Compensation154016TotalOtherCompensation
Formers ListedtrueFormersListed
Total Comp GT150 KtrueTotalCompGT150K
Compensation From Other SourcesfalseCompensationFromOtherSources

Contractor Compensation ContractorCompensation

Name Of Contractor NameOfContractor

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1SELECT REHABILITATIONBusinessNameLine1

Address Of Contractor AddressOfContractor

Address US AddressUS

FieldValueIRS element (for citing)
Address Line135338 EAGLE WAYAddressLine1
CityCHICAGOCity
StateILState
ZIP Code60678ZIPCode
FieldValueIRS element (for citing)
Description Of ServicesPT STAFFINGDescriptionOfServices
Compensation514710Compensation
FieldValueIRS element (for citing)
Number Of Contractors GT100 K1NumberOfContractorsGT100K
All Other Contributions3379AllOtherContributions
Total Contributions3379TotalContributions

Program Service Revenue ProgramServiceRevenue

FieldValueIRS element (for citing)
DescriptionPATIENT SERVICE REVENUEDescription
Business Code623000BusinessCode
Total Revenue Column6370002TotalRevenueColumn
Related Or Exempt Function Income6370002RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Program Service Revenue6370002TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column312TotalRevenueColumn
Exclusion$312ExclusionAmount

Other Revenue Misc OtherRevenueMisc (2 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
OTHER REVENUE90009981968196
MEAL DELIVERY PROGRAM62421024462446
FieldValueIRS element (for citing)
Total Other Revenue10642TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column6384335TotalRevenueColumn
Related Or Exempt Function Income6380644RelatedOrExemptFunctionIncome
Exclusion$312ExclusionAmount

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total3361199Total
Program Services3193040ProgramServices
Management And General168159ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total101544Total
Program Services96464ProgramServices
Management And General5080ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total789224Total
Program Services749739ProgramServices
Management And General39485ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total235722Total
Program Services223929ProgramServices
Management And General11793ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total10744Total
Management And General10744ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total855315Total
Program Services800967ProgramServices
Management And General54348ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total1066Total
Program Services1066ProgramServices

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total537466Total
Program Services528126ProgramServices
Management And General9340ManagementAndGeneral

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total19318Total
Program Services18351ProgramServices
Management And General967ManagementAndGeneral

Occupancy Occupancy

FieldValueIRS element (for citing)
Total270972Total
Program Services236815ProgramServices
Management And General34157ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total622Total
Program Services622ProgramServices

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total7647Total
Program Services7647ProgramServices

Interest Interest

FieldValueIRS element (for citing)
Total143703Total
Program Services136514ProgramServices
Management And General7189ManagementAndGeneral

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total252648Total
Program Services240016ProgramServices
Management And General12632ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total25548Total
Program Services25548ProgramServices

Other Expenses OtherExpenses (2 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServices
PROVIDER TAX367788367788
MISCELLANEOUS37063706

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total6984232Total
Program Services6630338ProgramServices
Management And General353894ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY370BOY
EOY370EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY124080BOY
EOY56251EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY1099270BOY
EOY956305EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY25916BOY
EOY13887EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY3740BOY
EOY3660EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
BOY1913BOY
EOY289EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY175815BOY
EOY98381EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY1431104BOY
EOY1129143EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY473529BOY
EOY511576EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY189475BOY
EOY106277EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY663004BOY
EOY617853EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY766187BOY
EOY511001EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY1913BOY
EOY289EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY768100BOY
EOY511290EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY1431104BOY
EOY1129143EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses-599897ReconcilationRevenueExpenses
Reconcilation Other Changes343087ReconcilationOtherChanges
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or ReviewfalseAccountantCompileOrReview
FS AuditedtrueFSAudited
Audit CommitteetrueAuditCommittee
Financial Statement SeparateXFinancialStatementSeparate
Federal Grant Audit RequiredfalseFederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Publicly Supported Org509a2XPubliclySupportedOrg509a2

Gifts Grants Contrib Received509 GiftsGrantsContribReceived509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years7560CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years180CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years10CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year2168CurrentTaxYearMinus1Year
Current Tax Year3379CurrentTaxYear
Total13297Total

Gross Receipts From Admissions GrossReceiptsFromAdmissions

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years6178476CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years6488950CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years6510309CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year6488370CurrentTaxYearMinus1Year
Current Tax Year6380644CurrentTaxYear
Total32046749Total

Total509 Total509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years6186036CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years6489130CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years6510319CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year6490538CurrentTaxYearMinus1Year
Current Tax Year6384023CurrentTaxYear
Total32060046Total
FieldValueIRS element (for citing)
Public Support Total50932060046PublicSupportTotal509

Gross Investment Income509 GrossInvestmentIncome509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years2745CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years2404CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years695CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year317CurrentTaxYearMinus1Year
Current Tax Year312CurrentTaxYear
Total6473Total

Investment Income And UBTI InvestmentIncomeAndUBTI

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years2745CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years2404CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years695CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year317CurrentTaxYearMinus1Year
Current Tax Year312CurrentTaxYear
Total6473Total

Total Support Total TotalSupportTotal

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years6188781CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years6491534CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years6511014CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year6490855CurrentTaxYearMinus1Year
Current Tax Year6384335CurrentTaxYear
Total32066519Total
FieldValueIRS element (for citing)
Public Support Percentage5090.99980PublicSupportPercentage509
Prior Year Support Percentage0.99950PriorYearSupportPercentage
Investment Income Percentage0.00000InvestmentIncomePercentage
Thirty Three Percnt Tests CY509XThirtyThreePercntTestsCY509

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$1,936OtherActivitiesAmount
Total Lobbying Expenditures IIB1936TotalLobbyingExpendituresIIB
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
ExplanationALLOCATED PERCENTAGE OF MEMBERSHIP DUES PAID TO MAINE HEALTH CARE ASSOCIATION AND AMERICAN HEALTH CARE ASSOCIATION.Explanation

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Disclosed Orgs Legal ControlfalseDisclosedOrgsLegalControl
Disclosed For Charitable PurposesfalseDisclosedForCharitablePurposes
Written Policy MonitoringfalseWrittenPolicyMonitoring
Sect170h Requirements SatisfiedfalseSect170hRequirementsSatisfied
Solicited Assets For SalefalseSolicitedAssetsForSale
Agent Trustee EtcfalseAgentTrusteeEtc
Included On FSfalseIncludedOnFS

Current Year CurrentYear

FieldValueIRS element (for citing)
Beginning Of Year Balance1913BeginningOfYearBalance
Contributions289Contributions
Other Expenditures1913OtherExpenditures
End Of Year Balance289EndOfYearBalance

Current Year Minus1 Year CurrentYearMinus1Year

FieldValueIRS element (for citing)
Contributions1913Contributions
End Of Year Balance1913EndOfYearBalance

Current Year Minus2 Years CurrentYearMinus2Years

FieldValueIRS element (for citing)
Beginning Of Year Balance6235BeginningOfYearBalance
Other Expenditures6235OtherExpenditures

Current Year Minus3 Years CurrentYearMinus3Years

FieldValueIRS element (for citing)
Beginning Of Year Balance5235BeginningOfYearBalance
Contributions1000Contributions
End Of Year Balance6235EndOfYearBalance
FieldValueIRS element (for citing)
Term Endowment EOY Balance1.00000TermEndowmentEOYBalance
Endowments Held By Unrelated OrgsfalseEndowmentsHeldByUnrelatedOrgs
Endowments Held By Related OrgsfalseEndowmentsHeldByRelatedOrgs
Are Related Orgs Listed Schedule RfalseAreRelatedOrgsListedScheduleR

Other Assets OtherAssets (3 entries)

DescriptionDescriptionBook ValueBookValue
CASH SURRENDER VALUE-LIFE INSURANCE88846
DUE FROM AFFILIATE9535
AR UNDER REIMBURSEMENT AGREEMENTS
FieldValueIRS element (for citing)
Total Book Value Other Assets98381TotalBookValueOtherAssets

Other Liabilities OtherLiabilities (3 entries)

DescriptionDescriptionAmountAmount
DUE TO AFFILIATES$78,288
PROFESSIONAL LIABILITY CLAIM ACCRUAL$17,520
AP UNDER REIMBURSEMENT AGREEMENTS$10,469
FieldValueIRS element (for citing)
Total Of Amounts106277TotalOfAmounts

Form990 Schedule D Part XIV Form990ScheduleDPartXIV (2 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
INTENDED USES FOR ENDOWMENT FUNDSSCHEDULE D, PAGE 2, PART V, LINE 4TEMPORARILY RESTRICTED GIFTS ARE UTILIZED ACCORDING TO SPECIFIC DONOR SPECIFICATIONS. THESE INCLUDE EXPENDITURES FOR CAPITAL IMPROVEMENTS.
LIABILITY UNDER FIN 48 FOOTNOTESCHEDULE D, PAGE 3, PART XTHE ORGANIZATION IS A NOT-FOR-PROFIT CORPORATION AND HAS BEEN RECOGNIZED AS TAX EXEMPT PURSUANT TO SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. THE ORGANIZATION HAS EVALUATED THE POSITION TAKEN ON ITS FILED TAX RETURNS. THE ORGANIZATION HAS CONCLUDED THAT NO UNCERTAIN INCOME TAX POSITIONS EXIST AT SEPTEMBER 30, 2012. THE ORGANIZATION'S TAX RETURNS FROM 2010 THROUGH 2012 MAY BE SUBJECT TO EXAMINATION.

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation CommitteeXCompensationCommittee
Independent ConsultantXIndependentConsultant
Written Employment ContractXWrittenEmploymentContract
Compensation SurveyXCompensationSurvey
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance PaymentfalseSeverancePayment
Supplemental Nonqual Retire PlanfalseSupplementalNonqualRetirePlan
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 (6 entries)

Comp Based On Related OrgsCompBasedOnRelatedOrgsOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Related OrgsTotalCompensationRelatedOrgsBonus Related OrgsBonusRelatedOrgs
GREGORY HARDY MD
27746572755299621872375088
TIMOTHY CHURCHILL
2520001880873492693735209447000
JOHN COX
166234364208221301189981
M PATRICIA COOK
13095811492531220735168497
ADAM M KAZIMIERCZAK
164800151548802124623999337913
KATHLEEN A HERLIHY
1617665569234420962190641

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (10 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
RELATED PARTY INFORMATION AMONG OFFICERSFORM 990, PAGE 6, PART VI, LINE 2DAVID KUMAKI WILLIAM MEDD SHAREHOLDER SHAREHOLDER SHAREHOLDERS IN A MEDICAL PRACTICE
CLASSES OF MEMBERS OR STOCKHOLDERSFORM 990, PAGE 6, PART VI, LINE 6WESTERN MAINE HEALTH CARE, CORP. (EIN 01-0411788) IS THE SOLE MEMBER OF THE ORGANIZATION.
ELECTION OF MEMBERS AND THEIR RIGHTSFORM 990, PAGE 6, PART VI, LINE 7ATHE SOLE MEMBER HAS THE RESPONSIBILITY FOR THE ELECTION OF THE MEMBERS OF THE GOVERNING BODY.
DECISIONS SUBJECT TO APPROVAL OF MEMBERSFORM 990, PAGE 6, PART VI, LINE 7BALL DECISIONS BY THE WESTERN MAINE NUSING HOME, INC.'S GOVERNING BODY ARE APPROVED BY DEFAULT BY THE MEMBER ORGANIZATION'S GOVERNING BODY. THIS IS BECAUSE THESE TWO ORGANIZATIONS SHARE A COMMON GOVERNING BODY.
ORGANIZATION'S PROCESS USED TO REVIEW FORM 990FORM 990, PAGE 6, PART VI, LINE 11BTHE 990 WAS REVIEWED IN DETAIL BY A COMMITTEE OF THE BOARD OF TRUSTEES. THE PRESIDENT AND SENIOR VICE PRESIDENT - FISCAL LED THE DISCUSSION. SUBSEQUENT TO THAT REVIEW, A COPY OF THE ORGANIZATION'S 990 WAS DISTRIBUTED TO ALL TRUSTEES. THE 990 WAS REVIEWED IN SUMMARY AT A BOARD MEETING PRIOR TO FILING.
ENFORCEMENT OF CONFLICTS POLICYFORM 990, PAGE 6, PART VI, LINE 12CCONFLICT OF INTEREST STATEMENTS ARE OBTAINED ANNUALLY. THE PRESIDENT'S OFFICE COLLECTS AND REVIEWS THE RESPONSES. WHERE ANY REAL OR PERCEIVED CONFLICTS EXIST, OFFICERS AND TRUSTEES ARE EXPECTED TO RECUSE THEMSELVES (1) FROM MEETINGS DURING TIMES WHEN THE TOPICS OF POTENTIAL CONFLICT ARE DISCUSSED AND (2) FROM VOTING ON SUCH MATTERS. KEY EMPLOYEES MAY NOT USE THEIR POSITIONS TO PROFIT PERSONALLY OR TO ASSIST OTHERS IN PROFITING IN ANY WAY AT THE EXPENSE OF WESTERN MAINE NURSING HOME, INC.
COMPENSATION PROCESS FOR TOP OFFICIALFORM 990, PAGE 6, PART VI, LINE 15ATHE PARENT COMPANY OF WESTERN MAINE NURSING HOME, INC. IS WESTERN MAINE HEALTH CARE, CORP. (EIN 01-0411788) WHO THROUGH ITS PARENT COMPANY MAINEHEALTH, HAS A FORMAL WRITTEN COMPENSATION POLICY IN PLACE. IN CONSULTATION WITH SULLIVAN COTTER, THE MAINEHEALTH BOARD COMPENSATION COMMITTEE ESTABLISHES APPROPRIATE COMPENSATION PARAMETERS FOR EACH ORGANIZATION'S CEO AND CERTAIN MEMBERS OF THEIR SENIOR MANAGEMENT TEAM. WORKING WITHIN THESE PARAMETERS, THE WESTERN MAINE HEALTH CARE BOARD DETERMINES THE LEVEL OF COMPENSATION FOR ITS CEO. THE FINDINGS OF THE COMPENSATION COMMITTEE ARE MADE TRANSPARENT TO, AND VOTED ON BY, THE FULL GOVERNING BOARD. THE "TOTAL EXECUTIVE COMPENSATION" IS FILED PUBLICLY BY THE ORGANIZATION, AND INCLUDES "TOTAL CASH COMPENSATION" AND "TOTAL VALUE OF ALL BENEFITS AND PERQUISITES" ASSOCIATED WITH THE POSITION. THE BOARD TAKES NECESSARY ACTION TO PREVENT THE CEO FROM VOTING OR DIRECTLY PARTICIPATING IN THE FINAL COMMITTEE DETERMINATION OF HIS OWN COMPENSATION. THE ORGANIZATION'S EXECUTIVE COMPENSATION PROCEDURES RELY UPON APPROPRIATE DATA FOR COMPARABILITY (E.G. COMPENSATION LEVELS PAID BY BOTH TAXABLE AND TAX-EXEMPT SIMILARLY SITUATED ORGANIZATIONS AND INDEPENDENT SURVEYS BY NATIONALLY RECOGNIZED INDEPENDENT FIRMS). FINALLY, THE ORGANIZATION REFRAINS FROM ALLOWING EXECUTIVE COMPENSATION TO EVER BE BASED SOLELY ON WESTERN MAINE HEALTH CARE, CORP.'S REVENUES OR OTHER SIMILAR PROFIT-SHARING STRATEGIES.
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.
RELATED ORGANIZATIONSFORM 990, PAGE 7, PART VIIGREGORY HARDY 59 HOURS TIMOTHY CHURCHILL 55 HOURS JOHN COX 42 HOURS M. PATRICIA COOK 44 HOURS KATHLEEN HERLIHY 59 HOURS ADAM KAZIMIERCZAK 59 HOURS
OTHER CHANGES IN NET ASSETS EXPLANATIONFORM 990, PART XI, LINE 5THIS REPRESENTS AN EQUITY TRANSFER FROM AFFILIATE.

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (6 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Controlled OrgControlledOrg
WESTERN MAINE HEALTH CARE CORP
181 MAIN STREETNORWAYME04268010411788HEALTHCAREME501C311CMEHEALTHfalse
MAINEHEALTH
110 FREE STREETPORTLANDME04101010431680HEALTHCAREME501C311CNAfalse
WESTERN MAINE MULTI-MEDICAL SPECIAL
181 MAIN STREETNORWAYME04268010489824PHYS PRACTME501C33WMHCCfalse
STEPHENS MEMORIAL HOSPITAL ASSOC
181 MAIN STREETNORWAYME04268010219904HOSPITALME501C33WMHCCfalse
STEPHENS COMMUNITY HEALTHCARE FOUND
181 MAIN STREETNORWAYME04268311644144SUPP ORGME501C311AWMHCCfalse
CHAPEL VALLEY BOARDING HOME CORP
181 MAIN STREETNORWAYME04268010433206HEALTHCAREME501C37WMHCCfalse
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 OrgfalseLoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other OrgfalseLoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other OrgfalseSaleOfAssetsToOtherOrg
Purchase Of Assets From Other OrgfalsePurchaseOfAssetsFromOtherOrg
Exchange Of AssetsfalseExchangeOfAssets
Rental Of Facilities To Other OrgsfalseRentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other OrgsfalseRentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other OrgsfalsePerformOfServicesForOtherOrgs
Perform Of Services By Other OrgsfalsePerformOfServicesByOtherOrgs
Sharing Of FacilitiesfalseSharingOfFacilities
Sharing Of Paid EmployeesfalseSharingOfPaidEmployees
Reimbursement Paid To Other OrgtrueReimbursementPaidToOtherOrg
Reimbursement Paid By Other OrgtrueReimbursementPaidByOtherOrg
Other Transfer To Other OrgfalseOtherTransferToOtherOrg
Other Transfer From Other OrgtrueOtherTransferFromOtherOrg