MILLINOCKET REGIONAL HOSPITAL: Form 990, tax year 2011
View the entire original 990 at ProPublica ↗
- Organization
- MILLINOCKET REGIONAL HOSPITAL (EIN 01-0223482)
- Tax period
- 2011-07-01 to 2012-06-30
- Filed
- 2013-02-28
- IRS object ID
- 201320599349300427
- 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
- Form 990
- Schedule A
- Schedule B
- Schedule C
- Schedule D
- Schedule H
- Schedule I
- Schedule J
- Schedule K
- Schedule L
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2013-02-28T16:33:20-06:00 | Timestamp |
| Tax Period End Date | 2012-06-30 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 010523282 | EIN |
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Berry Dunn McNeil & Parker LLC | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO Box 1100 | AddressLine1 |
| City | Portland | City |
| State | ME | State |
| ZIP Code | 041041100 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2011-07-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 010223482 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Millinocket Regional Hospital | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | MILL | NameControl |
| Phone | 2077235161 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 200 Somerset Street | AddressLine1 |
| City | Millinocket | City |
| State | ME | State |
| ZIP Code | 04462 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | Christine McLaughlin | Name |
| Title | Chief Financial Officer | Title |
| Phone | 2077235161 | Phone |
| Date Signed | 2013-02-26 | DateSigned |
| Authorize Third Party | 1 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | Barbara J McGuan CPA | Name |
| PTIN | P00219457 | PTIN |
| Phone | 2077752387 | Phone |
| Date Prepared | 2013-02-26 | DatePrepared |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2011 | TaxYear |
| Build TS | 2016-02-25 16:41:14Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | Marie Vienneau | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 200 Somerset Street | AddressLine1 |
| City | Millinocket | City |
| State | ME | State |
| ZIP Code | 04462 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 30163717 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | www.mrhme.org | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1952 | YearFormation |
| State Legal Domicile | ME | StateLegalDomicile |
| Activity Or Mission Description | Critical Access Hospital | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 16 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 9 | NbrIndependentVotingMembers |
| Total Nbr Employees | 282 | TotalNbrEmployees |
| Total Nbr Volunteers | 1 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 0 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 59243 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 146101 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 26780666 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 27163666 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 202841 | InvestmentIncomePriorYear |
| Investment Income Current Year | 270536 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 3548 | OtherRevenuePriorYear |
| Other Revenue Current Year | -9637 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 27046298 | TotalRevenuePriorYear |
| Total Revenue Current Year | 27570666 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 36900 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 39800 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 16617176 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 17103221 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp Prior Year | 0 | TotalProfFundrsngExpPriorYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 9696489 | OtherExpensePriorYear |
| Other Expenses Current Year | 10601799 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 26350565 | TotalExpensesPriorYear |
| Total Expenses Current Year | 27744820 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 695733 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | -174154 | RevenuesLessExpensesCY |
| Total Assets BOY | 21802981 | TotalAssetsBOY |
| Total Assets EOY | 23423125 | TotalAssetsEOY |
| Total Liabilities BOY | 7215364 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 8949790 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 14587617 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 14473335 | NetAssetsOrFundBalancesEOY |
| Info In Schedule O Part III | X | InfoInScheduleOPartIII |
| Mission Description | Millinocket Regional Hospital is a 25 bed critical access hospital that serves as the primary care facility for the communities of Millinocket, Milo, Sherman, Staceyville, Patten, Island Falls and their surrounding territories. | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 25743425 | Expense |
| Grants | 39800 | Grants |
| Revenue | 27163666 | Revenue |
| Description | Millinocket Regional Hospital is a critical access hospital in Millinocket, ME. The hospital provided a wide range of medical services to its patients; 1,023 inpatients served, 1,367 operating room patients served, 22,847 laboratory patients served, 12,124 radiology patients served. 7,239 pharmacy patients served, 11,700 therapy patients served, 7,018 emergency room patients served, 16,829 clinic patients served.The following seminars, promotions, advertisements, and clinics were provided to the community throughout fiscal 2012:1. MRH held multiple flu shot and H1N1 flu shot clinics in October of 2012.2. MRH sponsored a Jr. Pro Hoop Classic in January of 2012. 3. MRH provided a public awareness program about mammograms on KAT TV in September of 2011.4. MRH provided mammograms at a reduced rate during the Breast Cancer Awareness week in October 2011.5. MRH paid a sponsorship to Millinocket Little League in May of 2012 which paid for a team, the Yankees, and also a scoreboard sign.6. MRH sponsored a Cardiac Support Group the first Wednesday of each month.7. MRH sponsors a Diabetes Support Group, the first Tuesday of every month.8. MRH sponsored the Northern Timber Cruiser's Truck Pull in July of 2011.9. MRH sponsored the Stearns-Schenck Musical in October of 2011.10. MRH sponsored Millinocket School System Art Program and displayed the student's pumpkins in October of 2011.11. MRH sponsored the Millinocket Community Christmas Party.12. MRH sponsored East Millinocket's 2011 Summer Fest.13. MRH sponsored a chem-free party for Schenck's HS Winter Carnival in March of 2012.14. MRH sponsored a chem-free post prom party at Stearns HS in April 2012.15. MRH purchased ad space to raise money for multiple causes including: Schenck and Stearns' High School yearbook, Millinocket Historical Society 2012 calendars, VFW Convention Ad Book, and also ads for special sections of the Bangor Daily News that covered area football and basketball teams.16. MRH operates a grant funded Healthy Maine Partnership organization which provides education services to the community on alcohol misuse, tobacco cessation, proper nutrition and physical activity. The staff works with businesses, clubs and the schools to extend the message of healthy living and good wellness choices. The Organization uses local media to reach the large region.17. MRH provides meeting space for non-profits at no cost, for example to the American Cancer Society, Eastern Area on Aging, Martin's Point, Diabetic Support Group, Caring Connections, AA, and Weight Watchers.18. MRH participates in disaster preparedness regional committee with several other agencies including doctors' groups, other hospitals, local police and fire departments, schools and other organizations. The goal is to prepare for pandemic flu, natural disasters or other incidents that could affect our communites and work together to share resources to protect the community. | Description |
| Total Program Service Expense | 25743425 | TotalProgramServiceExpense |
| Described In501 C3 | 1 | DescribedIn501C3 |
| Schedule B Required | 1 | ScheduleBRequired |
| Political Activities | 0 | PoliticalActivities |
| Lobbying Activities | 1 | LobbyingActivities |
| Subject To Proxy Tax | 0 | SubjectToProxyTax |
| Donor Advised Funds | 0 | DonorAdvisedFunds |
| Conservation Easements | 0 | ConservationEasements |
| Collections Of Art | 0 | CollectionsOfArt |
| Credit Counseling | 0 | CreditCounseling |
| Term Or Permanent Endowments | 0 | TermOrPermanentEndowments |
| Report Land Bldg Equip | 1 | ReportLandBldgEquip |
| Report Invest Oth Securities | 1 | ReportInvestOthSecurities |
| Report Prog Rel Invest | 0 | ReportProgRelInvest |
| Report Other Assets | 0 | ReportOtherAssets |
| Report Other Liabilities | 0 | ReportOtherLiabilities |
| Report Fin48 Footnote | 0 | ReportFin48Footnote |
| Independent Audit Financial Stmt | 0 | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | 1 | ConsolidatedAuditFinancialStmt |
| School | 0 | School |
| Foreign Office | 0 | ForeignOffice |
| Foreign Activities | 0 | ForeignActivities |
| More Than5000 K To Organizations | 0 | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividuals |
| Professional Fundraising | 0 | ProfessionalFundraising |
| Fundraising Activities | 0 | FundraisingActivities |
| Gaming | 0 | Gaming |
| Hospital | 1 | Hospital |
| Financial Stmt Attached | 1 | FinancialStmtAttached |
| Grants To Organizations | 1 | GrantsToOrganizations |
| Grants To Individuals | 0 | GrantsToIndividuals |
| Schedule J Required | 1 | ScheduleJRequired |
| Tax Exempt Bonds | 1 | TaxExemptBonds |
| Invest Tax Exempt Bonds | 0 | InvestTaxExemptBonds |
| Escrow Account | 0 | EscrowAccount |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuer |
| Excess Benefit Transaction | 0 | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | 0 | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | 0 | LoanToOfficerOrDQP |
| Grant To Related Person | 0 | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | 0 | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | 1 | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | 0 | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | 0 | DeductibleNonCashContributions |
| Deductible Contributions Of Art | 0 | DeductibleContributionsOfArt |
| Terminated | 0 | Terminated |
| Partial Liquidation | 0 | PartialLiquidation |
| Disregarded Entity | 0 | DisregardedEntity |
| Related Entity | 1 | RelatedEntity |
| Related Org Controlled Entity | 1 | RelatedOrgControlledEntity |
| Transaction Related Entity | 0 | TransactionRelatedEntity |
| Transfers To Exempt Non Chrtbl Org | 0 | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | 0 | ActivitiesConductedPartnership |
| Schedule O Required | 1 | ScheduleORequired |
| Number Forms Transmitted With1096 | 85 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | 1 | ComplianceWithBackupWitholding |
| Number Of Employees | 282 | NumberOfEmployees |
| Employment Tax Returns Filed | 1 | EmploymentTaxReturnsFiled |
| Unrelated Business Income | 0 | UnrelatedBusinessIncome |
| Foreign Financial Account | 0 | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTrans |
| Taxable Party Notification | 0 | TaxablePartyNotification |
| Non Deductible Contributions | 0 | NonDeductibleContributions |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributions |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | 0 | FundsToPayPremiums |
| Premiums Paid | 0 | PremiumsPaid |
| Indoor Tanning Services | 0 | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 16 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 9 | NumberIndependentVotingMembers |
| Family Or Business Relationship | 0 | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | 0 | DelegationOfManagementDuties |
| Changes To Organizing Docs | 0 | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuse |
| Members Or Stockholders | 0 | MembersOrStockholders |
| Election Of Board Members | 0 | ElectionOfBoardMembers |
| Decisions Subject To Approval | 0 | DecisionsSubjectToApproval |
| Minutes Of Governing Body | 1 | MinutesOfGoverningBody |
| Minutes Of Committees | 1 | MinutesOfCommittees |
| Officer Mailing Address | 0 | OfficerMailingAddress |
| Local Chapters | 1 | LocalChapters |
| Policies Reference Chapters | 1 | PoliciesReferenceChapters |
| Form990 Provided To Governing Body | 1 | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | 1 | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | 1 | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | 1 | RegularMonitoringEnforcement |
| Whistleblower Policy | 1 | WhistleblowerPolicy |
| Document Retention Policy | 1 | DocumentRetentionPolicy |
| Compensation Process CEO | 1 | CompensationProcessCEO |
| Compensation Process Other | 1 | CompensationProcessOther |
| Investment In Joint Venture | 1 | InvestmentInJointVenture |
| Written Policy Or Procedure | 1 | WrittenPolicyOrProcedure |
| States Where Copy Of Return Is Filed | ME | StatesWhereCopyOfReturnIsFiled |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Christine McLaughlin | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 2077235161 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 200 Somerset Street | AddressLine1 |
| City | Millinocket | City |
| State | ME | State |
| ZIP Code | 04462 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (23 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | OfficerOfficer | Highest Compensated EmployeeHighestCompensatedEmployee |
|---|---|---|---|---|---|---|---|
| Ronald Brown | |||||||
| Past President | 5.00 | X | 0 | 0 | 0 | ||
| Thomas Malcolm | |||||||
| President | 5.00 | X | 0 | 0 | 0 | X | |
| Mellissa Edwards | |||||||
| Vice President | 5.00 | X | 0 | 0 | 0 | X | |
| Don Casko | |||||||
| Secretary/Treasurer | 5.00 | X | 0 | 0 | 0 | X | |
| Kwaku Owusu MD | |||||||
| Med Staff President | 60.00 | X | 166374 | 0 | 21829 | X | |
| Herbert Clark | |||||||
| Director | 5.00 | X | 0 | 0 | 0 | ||
| Barry Davis | |||||||
| Director | 5.00 | X | 0 | 0 | 0 | ||
| Jack Dinsmore | |||||||
| Director | 5.00 | X | 0 | 0 | 0 | ||
| Gail Fanjoy | |||||||
| Director | 5.00 | X | 0 | 0 | 0 | ||
| Joyce Given | |||||||
| Hospital Aux. President | 5.00 | X | 0 | 0 | 0 | ||
| Patrick Hunt Esq | |||||||
| Director | 5.00 | X | 0 | 0 | 0 | ||
| Lee Lamson | |||||||
| Director | 5.00 | X | 0 | 0 | 0 | ||
| Fred Lewis | |||||||
| Director | 5.00 | X | 0 | 0 | 0 | ||
| Wallace Tapley | |||||||
| Director | 5.00 | X | 0 | 0 | 0 | ||
| Jason Campbell | |||||||
| Med Staff Vice President | 60.00 | X | 375339 | 0 | 50284 | X | |
| Venkataraman Munusamy | |||||||
| Med Staff Secretary | 60.00 | X | 179565 | 0 | 35777 | X | |
| Marie Vienneau | |||||||
| CEO | 40.00 | 203274 | 0 | 38390 | X | ||
| Christine McLaughlin | |||||||
| CFO | 40.00 | 103700 | 0 | 28202 | X | ||
| Daniel Herbert MD | |||||||
| Hospitalist | 60.00 | 253749 | 0 | 34171 | X | ||
| David Wexler | |||||||
| Surgeon | 60.00 | 424596 | 0 | 38674 | X | ||
| Mark Kowalski | |||||||
| Surgeon | 60.00 | 419361 | 0 | 52765 | X | ||
| Edward Dunstan | |||||||
| Family Practice M.D. | 60.00 | 176569 | 0 | 35116 | X | ||
| Joswph Aquilina | |||||||
| ER PA | 48.00 | 179103 | 0 | 29862 | X | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 2481630 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 0 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 365070 | TotalOtherCompensation |
| Number Individuals GT100 K | 19 | NumberIndividualsGT100K |
| Formers Listed | 0 | FormersListed |
| Total Comp GT150 K | 1 | TotalCompGT150K |
| Compensation From Other Sources | 0 | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (5 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| Sullivan & Merritt Inc | |||||
| 153 US Route 1 | Scarborough | ME | 04074 | Engineering | 1385586 |
| NEHE-MRI LLC | |||||
| PO Box 6600 | Newport | CA | 92658 | MRI Radiology | 307638 |
| Katahdin Shared Services Inc | |||||
| 200 Somerset Street | Millinocket | ME | 04462 | Ultrasound Services | 299557 |
| CPSI | |||||
| PO Box 850309 | Mobile | AL | 36685 | Computer Services | 237901 |
| Eastern Maine Medical Center | |||||
| 489 State Street | Bangor | ME | 04401 | Professional Services | 236740 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 10 | NumberOfContractorsGT100K |
| Government Grants | 124346 | GovernmentGrants |
| All Other Contributions | 21755 | AllOtherContributions |
| Total Contributions | 146101 | TotalContributions |
Program Service Revenue ProgramServiceRevenue (5 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome | ExclusionExclusionAmount |
|---|---|---|---|---|
| Ancillary Services | 621400 | 42112510 | 42112510 | |
| Routine Services | 621400 | 2660815 | 2660815 | |
| Miscellaneous Income | 621400 | 128789 | 94802 | $33,987 |
| Provision for Bad Debt | 621400 | -1113522 | -1113522 | |
| Contractual/Char. Adj. | 621400 | -16624926 | -16624926 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 27163666 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 206991 | TotalRevenueColumn |
| Exclusion | $206,991 | ExclusionAmount |
Gross Rents GrossRents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 36000 | Real |
Less Rental Expenses LessRentalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 19180 | Real |
Rental Income Or Loss RentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 16820 | Real |
Net Rental Income Or Loss NetRentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 16820 | TotalRevenueColumn |
| Exclusion | $16,820 | ExclusionAmount |
Gross Amount Sales Assets GrossAmountSalesAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 2615416 | Securities |
| Other | 22000 | Other |
Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 2532104 | Securities |
| Other | 41767 | Other |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 83312 | Securities |
| Other | -19767 | Other |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 63545 | TotalRevenueColumn |
| Exclusion | $63,545 | ExclusionAmount |
Other Revenue Misc OtherRevenueMisc
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | Loss on Investment of | Description |
| Business Code | 531120 | BusinessCode |
| Total Revenue Column | -26457 | TotalRevenueColumn |
| Exclusion | -$26,457 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | -26457 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 27570666 | TotalRevenueColumn |
| Related Or Exempt Function Income | 27129679 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $294,886 | ExclusionAmount |
Grants To Domestic Orgs GrantsToDomesticOrgs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 39800 | Total |
| Program Services | 39800 | ProgramServices |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1202734 | Total |
| Program Services | 829168 | ProgramServices |
| Management And General | 373566 | ManagementAndGeneral |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 12657777 | Total |
| Program Services | 12102903 | ProgramServices |
| Management And General | 554874 | ManagementAndGeneral |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 352248 | Total |
| Program Services | 339347 | ProgramServices |
| Management And General | 12901 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2020130 | Total |
| Program Services | 1941890 | ProgramServices |
| Management And General | 78240 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 870332 | Total |
| Program Services | 815525 | ProgramServices |
| Management And General | 54807 | ManagementAndGeneral |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 36689 | Total |
| Management And General | 36689 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 34429 | Total |
| Management And General | 34429 | ManagementAndGeneral |
Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 36008 | Total |
| Management And General | 36008 | ManagementAndGeneral |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3158094 | Total |
| Program Services | 2762322 | ProgramServices |
| Management And General | 395772 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 60266 | Total |
| Management And General | 60266 | ManagementAndGeneral |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 447519 | Total |
| Program Services | 286659 | ProgramServices |
| Management And General | 160860 | ManagementAndGeneral |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 17644 | Total |
| Management And General | 17644 | ManagementAndGeneral |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 700863 | Total |
| Program Services | 677502 | ProgramServices |
| Management And General | 23361 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 44198 | Total |
| Program Services | 24858 | ProgramServices |
| Management And General | 19340 | ManagementAndGeneral |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 243008 | Total |
| Program Services | 243008 | ProgramServices |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 738368 | Total |
| Program Services | 738368 | ProgramServices |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 326172 | Total |
| Program Services | 326172 | ProgramServices |
Other Expenses OtherExpenses (4 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral |
|---|---|---|---|
| Medical Supplies | 4107148 | 3980766 | 126382 |
| Medicaid Tax | 564704 | 564704 | |
| Dues & Subscriptions | 57245 | 47294 | 9951 |
| Miscellaneous Expenses | 29444 | 23139 | 6305 |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 27744820 | Total |
| Program Services | 25743425 | ProgramServices |
| Management And General | 2001395 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 880 | BOY |
| EOY | 930 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2901353 | BOY |
| EOY | 2658392 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2917038 | BOY |
| EOY | 2609103 | EOY |
Other Notes Loans Receivable Net OtherNotesLoansReceivableNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 64139 | BOY |
| EOY | 70941 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 454836 | BOY |
| EOY | 404073 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 453756 | BOY |
| EOY | 476887 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 18405913 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 11692968 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 5245319 | BOY |
| EOY | 6712945 | EOY |
Investments Pub Traded Securities InvestmentsPubTradedSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 8049837 | BOY |
| EOY | 8681763 | EOY |
Investments Other Securities InvestmentsOtherSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1684497 | BOY |
| EOY | 1600469 | EOY |
Intangible Assets IntangibleAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 31326 | BOY |
| EOY | 28820 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 178802 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 21802981 | BOY |
| EOY | 23423125 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3122937 | BOY |
| EOY | 2860539 | EOY |
Tax Exempt Bond Liabilities TaxExemptBondLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1545434 | BOY |
| EOY | 1443780 | EOY |
Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1617348 | BOY |
| EOY | 4645471 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 929645 | BOY |
| EOY | 0 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 7215364 | BOY |
| EOY | 8949790 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 14484815 | BOY |
| EOY | 14365302 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 97802 | BOY |
| EOY | 103033 | EOY |
Permanently Restricted Net Assets PermanentlyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 5000 | BOY |
| EOY | 5000 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 14587617 | BOY |
| EOY | 14473335 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 21802981 | BOY |
| EOY | 23423125 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | -174154 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | 59872 | ReconcilationOtherChanges |
| Info In Schedule O Part XII | X | InfoInScheduleOPartXII |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | 0 | AccountantCompileOrReview |
| FS Audited | 1 | FSAudited |
| Audit Committee | 1 | AuditCommittee |
| Financial Statement Consolidated | X | FinancialStatementConsolidated |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequired |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital170b1 Aiii | X | Hospital170b1Aiii |
Schedule B IRS990ScheduleB
Contributor Info ContributorInfo
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor Number | RESTRICTED | ContributorNumber |
Contributor Name Business ContributorNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor Address US ContributorAddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Aggregate Contributions | RESTRICTED | AggregateContributions |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | 0 | Volunteers |
| Paid Staff Or Management | 0 | PaidStaffOrManagement |
| Media Advertisements | 0 | MediaAdvertisements |
| Mailings Members | 0 | MailingsMembers |
| Publications Or Broadcast | 0 | PublicationsOrBroadcast |
| Grants Other Organizations | 0 | GrantsOtherOrganizations |
| Direct Contact Legislators | 0 | DirectContactLegislators |
| Rallies Demonstrations | 0 | RalliesDemonstrations |
| Other Activities | 1 | OtherActivities |
| Other Activities | $7,760 | OtherActivitiesAmount |
| Total Lobbying Expenditures IIB | 7760 | TotalLobbyingExpendituresIIB |
| Not Described In501c3 | 0 | NotDescribedIn501c3 |
Form990 Schedule C Part IV Form990ScheduleCPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | Explanation of Lobbying Activities: | Identifier |
| Return Reference | Part II-B, Line 1: | ReturnReference |
| Explanation | The Organization pays dues to various organizations, a portion of which are attributable to lobbying expenses. | Explanation |
Schedule D IRS990ScheduleD
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 49951 | OtherCostOrOtherBasis |
| Book Value | 49951 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 9055719 | OtherCostOrOtherBasis |
| Depreciation | 5320786 | Depreciation |
| Book Value | 3734933 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 7896428 | OtherCostOrOtherBasis |
| Depreciation | 5894010 | Depreciation |
| Book Value | 2002418 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 1403815 | OtherCostOrOtherBasis |
| Depreciation | 478172 | Depreciation |
| Book Value | 925643 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 6712945 | TotalOfBookValueLandBuildings |
Other Securities OtherSecurities (2 entries)
| DescriptionDescription | Book ValueBookValue | Method Of ValuationMethodOfValuation |
|---|---|---|
| Investment in First Millinocket Regional Investment Corp | 1559913 | C |
| Investment in Katahdin Shared Services | 40556 | C |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Securities | 1600469 | TotalOfBookValueSecurities |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Charity Care Policy | 1 | CharityCarePolicy |
| Written Policy | 1 | WrittenPolicy |
| FPG Reference Free Care | 1 | FPGReferenceFreeCare |
| Pcent150 | X | Pcent150 |
| FPG Reference Discounted Care | 1 | FPGReferenceDiscountedCare |
| Pcent400 | X | Pcent400 |
| Free Disc Care Medically Indigent | 1 | FreeDiscCareMedicallyIndigent |
| Amounts Budgeted For Charity Care | 1 | AmountsBudgetedForCharityCare |
| Expenses Exceeded Budget | 1 | ExpensesExceededBudget |
| Unable To Provide Care | 0 | UnableToProvideCare |
| Annual Community Benefit Report | 0 | AnnualCommunityBenefitReport |
Charity Care At Cost CharityCareAtCost
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 1366779 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 1366779 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.04930 | PercentOfTotalExpense |
Unreimbursed Medicaid UnreimbursedMedicaid
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 755798 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 180000 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 575798 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.02080 | PercentOfTotalExpense |
Total Charity Care TotalCharityCare
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 2122577 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 180000 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 1942577 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.07010 | PercentOfTotalExpense |
Subsidized Health Services SubsidizedHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 1410526 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 916620 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 493906 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.01780 | PercentOfTotalExpense |
Cash And In Kind Contributions CashAndInKindContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 39800 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 39800 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00140 | PercentOfTotalExpense |
Total Other Benefits TotalOtherBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 1450326 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 916620 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 533706 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.01920 | PercentOfTotalExpense |
Total Community Benefits TotalCommunityBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 3572903 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 1096620 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 2476283 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.08930 | PercentOfTotalExpense |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | 1 | BadDebtExpenseReported |
| Bad Debt Expense | $631,884 | BadDebtExpenseAmount |
| Amount Reimbursed By Medicare | 11035043 | AmountReimbursedByMedicare |
| Cost Of Care Reimbursed By Medicare | 11675257 | CostOfCareReimbursedByMedicare |
| Medicare Surplus Or Shortfall | -640214 | MedicareSurplusOrShortfall |
Costing Methodology Used CostingMethodologyUsed
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost Accounting System | X | CostAccountingSystem |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | 1 | WrittenDebtCollectionPolicy |
| Provision For Charity Care | 0 | ProvisionForCharityCare |
| Number Of Hospital Facilities | 1 | NumberOfHospitalFacilities |
Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility Number | 1 | FacilityNumber |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Millinocket Regional Hospital | BusinessNameLine1 |
Address Address
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 200 Somerset Street | AddressLine1 |
| City | Millinocket | City |
| State | ME | State |
| ZIP Code | 04462 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Licensed Hospital | X | LicensedHospital |
| Critical Access Hospital | X | CriticalAccessHospital |
| Er24 Hours | X | Er24Hours |
Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Millinocket Regional Hospital | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital Facility Number | 1 | HospitalFacilityNumber |
| Eligibility Criteria Explained | 1 | EligibilityCriteriaExplained |
| Uses FPG Free | 1 | UsesFPGFree |
| FPG Free Percent | 150.000000000000 | FPGFreePercent |
| Uses FPG Discounted | 1 | UsesFPGDiscounted |
| FPG Discount Percent | 400.000000000000 | FPGDiscountPercent |
| Explains Basis | 1 | ExplainsBasis |
| Income Level | X | IncomeLevel |
| Explains Application Method | 0 | ExplainsApplicationMethod |
| Includes Publicity Measures | 1 | IncludesPublicityMeasures |
| Attached To Invoices | X | AttachedToInvoices |
| Posted In Emergency Room | X | PostedInEmergencyRoom |
| Posted In Admission Office | X | PostedInAdmissionOffice |
| Provided On Admission | X | ProvidedOnAdmission |
| Available On Request | X | AvailableOnRequest |
| Actions On Nonpayment | 1 | ActionsOnNonpayment |
| Permit Report To Credit Agency | X | PermitReportToCreditAgency |
| Permit Lawsuit | X | PermitLawsuit |
| Permit Lien On Residence | X | PermitLienOnResidence |
| Collection Activities | 1 | CollectionActivities |
| Report To Credit Agency | X | ReportToCreditAgency |
| Lawsuit | X | Lawsuit |
| Lien On Residence | X | LienOnResidence |
| Notify Upon Admission | X | NotifyUponAdmission |
| Notify Before Discharge | X | NotifyBeforeDischarge |
| Notified All Patients | X | NotifiedAllPatients |
| Documented Determination | X | DocumentedDetermination |
| Nondiscrim Emergency Care Policy | 1 | NondiscrimEmergencyCarePolicy |
| Used Other Method | X | UsedOtherMethod |
| Amounts Generally Billed | 0 | AmountsGenerallyBilled |
| Gross Charges | 0 | GrossCharges |
Form990 Schedule H Part VI Form990ScheduleHPartVI (9 entries)
| ExplanationExplanation | IdentifierIdentifier |
|---|---|
| Part I, Line 3c: Income guidelines as set by Hospital Finance Rules will be used in determining eligibility. Percentage of balance discounted will be determined based on patient's income level relative to the Federal Poverty Level guidelines. These guidelines are updated annually by the Financial Counselor.Up to 150% FPL 100% Balance Discounted151% to 200% FPL 50% Balance Discounted201% to 250% FPL 25% Balance Discounted251% to 300% FPL 10% Balance Discounted301% to 400% FPL 5% Balance Discounted | |
| Part I, Line 7: Expenses calculated on Lines 7a & 7b were calculated using a cost-to-charge ratio while actual expenses were used in calculating the amount reported on line 7i. | |
| Part I, Line 7g: Subsidized health services include laboratory and physician services. | |
| Part III, Line 4: Patient accounts receivable are stated at the amount management expects to collect from outstanding balances. Management provides for probable uncollectible amounts through a charge to operations and a credit to a valuation allowance based on its assessment of individual accounts and historical adjustments. Balances that are still outstanding, after management has used reasonable collection efforts, are written off through a charge to the valuation allowance and a credit to patient accounts receivable.In evaluating the collectability of accounts receivable, the Hospital analyzes past results and identifies trends for each major payor source of revenue for the purposes of estimating the appropriate amounts of the allowance for doubtful accounts and the provision for bad debts. Data in each major payor source are regularly reviewed to evaluate the adequacy of the allowance for doubtful accounts. Specifically, for receivables relating to services provided to patients having third-party coverage, an allowance for doubtful accounts and a corresponding provision for bad debts are established at varying levels based on the age of the receivables and payor source. For receivables relating to self-pay patients, a provision for bad debts is made in the period services are rendered based on experience indicating the inability or unwillingness of patients to pay amounts for which they are financially responsible. | |
| Part III, Line 8: The Organization used accounting methodology prescribed by the Medicare cost report as its costing methodology to determine the amount of Medicare allowable costs. | |
| Part V, Section B, Line 19d: The Hospital billed amounts to individuals who did not have insurance at cost. | Millinocket Regional Hospital |
| Part VI, Line 2: A formal community needs assessment is done every 2-3 years. These assessments are conducted to obtain information on successes, failures, weaknesses and strengths to be used for guidance in the vision for the future of healthcare delivery in our service areas. | |
| Part VI, Line 3: Inpatients: In order to identify those patients who would be eligible for financial assistance, all uninsured inpatients are referred to the Financial Counselor by pre-registration or registration personnel. The Financial Counselor will do an initial screening for payment options prior to the patient leaving the hospital, if possible. If the patient has left the hospital, the Financial Counselor will attempt to contact the patient for information. All inpatients are given a copy of Patient Free Care and Discount Arrangements guidelines at time of admission.Surgical outpatients: The Financial Counselor will provide information about Patient Free Care, Discount Arrangements and term payment arrangements to all uninsured surgical outpatients. All surgical outpatients are provided a copy of Patient Free Care and Discount Arrangements guidelines at time of registration. Emergency room patients: All emergency room patients are provided a copy of Patient Free Care and Discount Arrangements guidelines at time of registration. All other outpatients: All other outpatients are provided a copy of the Patient Free Care/Discount Arrangements guidelines at time of registration. All patients will receive notice of availability of financial assistance included in their first-time statement. Patient Financial Services employees and Physician Practice employees receive training on patient free care and discount arrangements guidelines and are expected to be able to provide contact information about free care and discount arrangements. | |
| Part VI, Line 4: Millinocket Regional Hospital serves a tri town community, which consists of Millinocket, East Millinocket and Medway. The total population of these three communities is 8,074 and is projected to decrease 3% by 2012. The communities are rural, aging and economically challenged. The senior population is projected to grow 7.4% for our service area by 2012. The average median household income is 42% behind the state average. The largest employers in the communities are the hospital, paper mill and school system. The percent of population with post secondary education is lower than the state or nation. |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Records Maintained | 1 | RecordsMaintained |
Recipient Table RecipientTable
Recipient Name Business RecipientNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Health Access Network | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 175 W Broadway | AddressLine1 |
| City | Lincoln | City |
| State | ME | State |
| ZIP Code | 04457 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN Of Recipient | 113650708 | EINOfRecipient |
| IRC Section | 501(c)(3) | IRCSection |
| Amount Of Non Cash Assistance | 34800 | AmountOfNonCashAssistance |
| Method Of Valuation | FMV | MethodOfValuation |
| Description Of Non Cash Assistance | Rent Forgiveness | DescriptionOfNonCashAssistance |
| Purpose Of Grant | Operational Support | PurposeOfGrant |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Nbr Of501 C3 And Govt Grants | 1 | TotalNbrOf501C3AndGovtGrants |
| Total Nbr Of Other Organizations | 0 | TotalNbrOfOtherOrganizations |
Form990 Schedule I Part IV Form990ScheduleIPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | Procedure for Monitoring Grants in the U.S.: | Identifier |
| Return Reference | Part I, Line 2: | ReturnReference |
| Explanation | Schedule I, Part I, Line 2: Assistance provided was in the form of rent forgiveness. No additional monitoring of funds was required. | Explanation |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | X | CompensationCommittee |
| Independent Consultant | X | IndependentConsultant |
| Written Employment Contract | X | WrittenEmploymentContract |
| Compensation Survey | X | CompensationSurvey |
| Board Or Committee Approval | X | BoardOrCommitteeApproval |
| Severance Payment | 0 | SeverancePayment |
| Supplemental Nonqual Retire Plan | 0 | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | 0 | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | 0 | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | 0 | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | 0 | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | 0 | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | 0 | AnyNonFixedPayments |
| Initial Contract Exception | 0 | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (9 entries)
| Base Compensation Filing OrgBaseCompensationFilingOrg | Comp Based On Related OrgsCompBasedOnRelatedOrgs | Bonus Filing OrgBonusFilingOrg | Bonus Related OrgsBonusRelatedOrgs | Other Compensation Filing OrgOtherCompensationFilingOrg | Other Compensation Related OrgsOtherCompensationRelatedOrgs | Deferred Comp Filing OrgDeferredCompFilingOrg | Deferred Comp Related OrgsDeferredCompRelatedOrgs | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg | Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs | Total Compensation Filing OrgTotalCompensationFilingOrg | Total Compensation Related OrgsTotalCompensationRelatedOrgs | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrg | Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Kwaku Owusu MD | |||||||||||||
| 166374 | 0 | 0 | 0 | 0 | 0 | 6718 | 0 | 15111 | 0 | 188203 | 0 | 0 | 0 |
| Jason Campbell | |||||||||||||
| 375339 | 0 | 0 | 0 | 0 | 0 | 12163 | 0 | 38121 | 0 | 425623 | 0 | 0 | 0 |
| Venkataraman Munusamy | |||||||||||||
| 179565 | 0 | 0 | 0 | 0 | 0 | 7600 | 0 | 28177 | 0 | 215342 | 0 | 0 | 0 |
| Marie Vienneau | |||||||||||||
| 203274 | 0 | 0 | 0 | 0 | 0 | 7665 | 0 | 30725 | 0 | 241664 | 0 | 0 | 0 |
| Daniel Herbert MD | |||||||||||||
| 221649 | 0 | 32100 | 0 | 0 | 0 | 7839 | 0 | 26332 | 0 | 287920 | 0 | 0 | 0 |
| David Wexler | |||||||||||||
| 424596 | 0 | 0 | 0 | 0 | 0 | 11162 | 0 | 27512 | 0 | 463270 | 0 | 0 | 0 |
| Mark Kowalski | |||||||||||||
| 419361 | 0 | 0 | 0 | 0 | 0 | 12553 | 0 | 40212 | 0 | 472126 | 0 | 0 | 0 |
| Edward Dunstan | |||||||||||||
| 176569 | 0 | 0 | 0 | 0 | 0 | 7247 | 0 | 27869 | 0 | 211685 | 0 | 0 | 0 |
| Joswph Aquilina | |||||||||||||
| 179103 | 0 | 0 | 0 | 0 | 0 | 6982 | 0 | 22880 | 0 | 208965 | 0 | 0 | 0 |
Schedule K IRS990ScheduleK
Form990 Schedule K Part I Form990ScheduleKPartI
Issuer Name IssuerName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Maine Health and Higher Educational Facilities Authority | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Issuer EIN | 010314384 | IssuerEIN |
| CUSIP Number | 560425QS2 | CUSIPNumber |
| Date Issued | 2003-09-01 | DateIssued |
| Issue Price | 2320000 | IssuePrice |
| Description Of Purpose | To repay balance of outstanding bonds, to fund certain capital expenditures. | DescriptionOfPurpose |
| Defeased | 0 | Defeased |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuer |
| Pool Financing | 0 | PoolFinancing |
Form990 Schedule K Part II Form990ScheduleKPartII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Amount Retired | 876220 | AmountRetired |
| Total Proceeds | 2320000 | TotalProceeds |
| Amount In Reserve Fund | 364321 | AmountInReserveFund |
| Issuance Costs From Proceeds | 50151 | IssuanceCostsFromProceeds |
| Capital Expenditures | 2269849 | CapitalExpenditures |
| Year Of Subst Completion | 2003 | YearOfSubstCompletion |
| Current Refunding | 0 | CurrentRefunding |
| Advance Refunding | 1 | AdvanceRefunding |
| Final Allocation Made | 1 | FinalAllocationMade |
| Adequate Books And Recds Maintaind | 1 | AdequateBooksAndRecdsMaintaind |
Form990 Schedule K Part III Form990ScheduleKPartIII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Owning Bond Financed Property | 0 | OwningBondFinancedProperty |
| Any Lease Arrangements | 0 | AnyLeaseArrangements |
| Mngment Cntrct Bond Financd Prprty | 0 | MngmentCntrctBondFinancdPrprty |
| Any Research Agreements | 0 | AnyResearchAgreements |
| Post Issuance Compliance Procdrs | 1 | PostIssuanceComplianceProcdrs |
Form990 Schedule K Part IV Form990ScheduleKPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form8038 T Filed | 0 | Form8038TFiled |
| Variable Rate Issue | 0 | VariableRateIssue |
| Hedge Identified In Books And Recds | 0 | HedgeIdentifiedInBooksAndRecds |
| Gross Proceeds Invested In GIC | 0 | GrossProceedsInvestedInGIC |
| Gross Proceeds Invested | 0 | GrossProceedsInvested |
| Exception To Rebate | 0 | ExceptionToRebate |
Schedule L IRS990ScheduleL
Form990 Schedule L Part IV Form990ScheduleLPartIV (5 entries)
| RelationshipRelationship | Amount Of TransactionAmountOfTransaction | Description Of TransactionDescriptionOfTransaction | Sharing Of RevenuesSharingOfRevenues |
|---|---|---|---|
| Julie Brown | |||
| Family Member of Ronald Brown, Past Board President | 37537 | Employment | 0 |
| Rose Ann Hunt | |||
| Family Member of Patrick Hunt, member of Board of Directors | 129069 | Employment | 0 |
| Dale McLaughlin | |||
| Family Member of Christine McLaughlin, CFO of Organization | 95667 | Employment | 0 |
| Ona McAvoy | |||
| Family Member of Mellissa Edwards, Board Vice President | 61844 | Employment | 0 |
| Cynthia Morneault | |||
| Family Member of Joyce Given, member of Board of Directors | 29718 | Employment | 0 |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (7 entries)
| Return ReferenceReturnReference | ExplanationExplanation | IdentifierIdentifier |
|---|---|---|
| Form 990, Part I, Lines 8-18: | Prior year amounts have been adjusted to reflect revenue net of provision for bad debts. | |
| Form 990, Part VI, Section B, line 11 | Prior to the document's filing, the Organization's finance department reviews the inital draft. After any necessary changes, the Organization's board members are presented with a copy. The finalized document is subject to the board's approval. | |
| Form 990, Part VI, Section B, line 12c | Each board member is required to sign a conflict of interest disclosure form on an annual basis. In connection with any actual or possible conflicts of interest, an interested individual must disclose the existence of his or her conflict annually and whenever the conflict arises for action at a meeting. After receiving all annual attestations, the CEO will provide the signed statements to the Hospital's attorney for review. After review, the attorney will determine if a conflict exists and inform the CEO and Board chair of the conflicted individuals. There is a listing of Board, Medical Staff and Manager conflicts available at all meetings for reference. The Agenda for every Board, Medical Staff or Department meeting will clearly list the discussion items that require action during the meeting. At the beginning of the meeting, the President will ask the members to review the list of action items and declare whether or not they have a conflict. All conflicted members will be required to excuse themselves and leave the room during the discussion and vote. If the board or committee has reasonable cause to believe that a member has failed to disclose actual or possible conflicts of interest, it shall inform the member of the basis for such belief and afford the member an opportunity to explain the alleged failure to disclose. | |
| Form 990, Part VI, Section B, line 15 | The Organization works with an independent compensation consultant to determine appropriate compensation levels. The Organization's executive committee reviews data used to determine compensation for its respective members. Any compensation related changes must be approved by the board of directors or the executive board. | |
| Form 990, Part VI, Section C, line 19 | The Organization makes its governing documents, conflict of interest policy, and financial statements available to the public upon request. | |
| Form 990, Part XI, line 5: | Net unrealized gains on investments: 59,872. | Changes in Net Assets or Fund Balances: |
| Form 990, Part XI, Line 2c: | The audit process has not changed from the prior year. | Oversight of Audit |
Schedule R IRS990ScheduleR
Form990 Schedule R Part IV Form990ScheduleRPartIV
Name Of Related Org NameOfRelatedOrg
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | First Millinocket Regional Investment Corp | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 200 Somerset Street | AddressLine1 |
| City | Millinocket | City |
| State | ME | State |
| ZIP Code | 04462 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 010396196 | EIN |
| Primary Activity | Physician Program Operations | PrimaryActivity |
| Legal Domicile State | ME | LegalDomicileState |
| Direct Controlling Entity NA | N/A | DirectControllingEntityNA |
| Type Of Entity | C | TypeOfEntity |
| Share Of Total Income | 211842 | ShareOfTotalIncome |
| Share Of EOY Assets | 1564342 | ShareOfEOYAssets |
| Percentage Ownership | 1.00000 | PercentageOwnership |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | 0 | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | 0 | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | 0 | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | 0 | LoansOrGuaranteesFromOtherOrg |
| Sale Of Assets To Other Org | 0 | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | 0 | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | 0 | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | 0 | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | 1 | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | 0 | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | 0 | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | 0 | SharingOfFacilities |
| Sharing Of Paid Employees | 0 | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | 1 | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | 0 | OtherTransferToOtherOrg |
| Other Transfer From Other Org | 0 | OtherTransferFromOtherOrg |
Transactions Related Orgs Table TransactionsRelatedOrgsTable (2 entries)
| Transaction TypeTransactionType | Amount InvolvedAmountInvolved | Method Of Amt DeterminationMethodOfAmtDetermination |
|---|---|---|
| First Millinocket Regional Investment Corp | ||
| J | 173660 | FMV |
| First Millinocket Regional Investment Corp | ||
| P | 173660 | FMV |