Stephens Memorial Hospital Assoc: Form 990, tax year 2011
View the entire original 990 at ProPublica ↗
- Organization
- Stephens Memorial Hospital Assoc (EIN 01-0219904)
- Tax period
- 2011-10-01 to 2012-09-30
- Filed
- 2013-08-12
- IRS object ID
- 201322249349301062
- 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 J
- Schedule L
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2013-08-12T09:54:13-05:00 | Timestamp |
| Tax Period End Date | 2012-09-30 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MAINEHEALTH | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 110 FREE ST | AddressLine1 |
| City | PORTLAND | City |
| State | ME | State |
| ZIP Code | 041013908 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2011-10-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 010219904 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | STEPHENS MEMORIAL HOSPITAL ASSOC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | STEP | NameControl |
| Phone | 2077435933 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 181 MAIN STREET | AddressLine1 |
| City | NORWAY | City |
| State | ME | State |
| ZIP Code | 04268 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | JOHN COX | Name |
| Title | SENIOR VP - FISCAL | Title |
| Phone | 2077435933 | Phone |
| Date Signed | 2013-08-07 | DateSigned |
| Authorize Third Party | false | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Date Prepared | 2013-08-07 | DatePrepared |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2011 | TaxYear |
| Build TS | 2016-02-24 21:20:13Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | TIMOTHY CHURCHILL | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 181 MAIN STREET | AddressLine1 |
| City | NORWAY | City |
| State | ME | State |
| ZIP Code | 04268 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 59157428 | GrossReceipts |
| Group Return For Affiliates | false | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | WWW.WMHCC.ORG | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1956 | YearFormation |
| State Legal Domicile | ME | StateLegalDomicile |
| Activity Or Mission Description | TO 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 Body | 18 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 14 | NbrIndependentVotingMembers |
| Total Nbr Employees | 608 | TotalNbrEmployees |
| Total Nbr Volunteers | 76 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Contributions Grants Prior Year | 50000 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 117000 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 51861419 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 57376266 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 67214 | InvestmentIncomePriorYear |
| Investment Income Current Year | 35907 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 134686 | OtherRevenuePriorYear |
| Other Revenue Current Year | 912230 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 52113319 | TotalRevenuePriorYear |
| Total Revenue Current Year | 58441403 | TotalRevenueCurrentYear |
| Grants And Similar Amnts CY | 0 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 25919792 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 30218966 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp Prior Year | 8931 | TotalProfFundrsngExpPriorYear |
| Total Prof Fundrsng Exp CY | 6050 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 66907 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 20836788 | OtherExpensePriorYear |
| Other Expenses Current Year | 23543932 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 46765511 | TotalExpensesPriorYear |
| Total Expenses Current Year | 53768948 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 5347808 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 4672455 | RevenuesLessExpensesCY |
| Total Assets BOY | 41764430 | TotalAssetsBOY |
| Total Assets EOY | 45798163 | TotalAssetsEOY |
| Total Liabilities BOY | 12321027 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 11824606 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 29443403 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 33973557 | NetAssetsOrFundBalancesEOY |
| Mission Description | TO 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 Services | false | SignificantNewProgramServices |
| Significant Change | false | SignificantChange |
| Expense | 40618774 | Expense |
| Revenue | 45657647 | Revenue |
| Description | OUTPATIENT SERVICES: STEPHENS MEMORIAL HOSPITAL ASSOCIATION PROVIDED CARE DURING THE COURSE OF 104,959 OUTPATIENT VISITS DURING 2012. SERVICES PROVIDED INCLUDE EMERGENCY SERVICES; DIAGNOSTIC IMAGING AND LAB TESTS; AMBULATORY SURGERY; AND PHYSICAL REHABILITATION. | Description |
Activity2 Activity2
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 10425327 | Expense |
| Revenue | 11718619 | Revenue |
| Description | INPATIENT SERVICES: IN 2012 THE HOSPITAL PROVIDED INPATIENT NURSING SERVICES TO 1,600 ADULTS/PEDIATRICS, INTENSIVE CARE, AND NURSERY PATIENTS WITH A TOTAL OF 5,109 PATIENT DAYS. 55 INPATIENTS (3%) WERE UNINSURED, 895 (56%) WERE COVERED BY MEDICARE AND 328 (21%) WERE COVERED BY MEDICAID. | Description |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expense | 51044101 | TotalProgramServiceExpense |
| Described In501 C3 | true | DescribedIn501C3 |
| Schedule B Required | true | ScheduleBRequired |
| Political Activities | false | PoliticalActivities |
| Lobbying Activities | true | LobbyingActivities |
| Subject To Proxy Tax | false | SubjectToProxyTax |
| Donor Advised Funds | false | DonorAdvisedFunds |
| Conservation Easements | false | ConservationEasements |
| Collections Of Art | false | CollectionsOfArt |
| Credit Counseling | false | CreditCounseling |
| Term Or Permanent Endowments | false | TermOrPermanentEndowments |
| Report Land Bldg Equip | true | ReportLandBldgEquip |
| Report Invest Oth Securities | false | ReportInvestOthSecurities |
| Report Prog Rel Invest | false | ReportProgRelInvest |
| Report Other Assets | true | ReportOtherAssets |
| Report Other Liabilities | true | ReportOtherLiabilities |
| Report Fin48 Footnote | true | ReportFin48Footnote |
| Independent Audit Financial Stmt | true | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | true | ConsolidatedAuditFinancialStmt |
| School | false | School |
| Foreign Office | false | ForeignOffice |
| Foreign Activities | false | ForeignActivities |
| More Than5000 K To Organizations | false | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividuals |
| Professional Fundraising | false | ProfessionalFundraising |
| Fundraising Activities | false | FundraisingActivities |
| Gaming | false | Gaming |
| Hospital | true | Hospital |
| Financial Stmt Attached | true | FinancialStmtAttached |
| Grants To Organizations | false | GrantsToOrganizations |
| Grants To Individuals | false | GrantsToIndividuals |
| Schedule J Required | true | ScheduleJRequired |
| Tax Exempt Bonds | false | TaxExemptBonds |
| Excess Benefit Transaction | false | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | false | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | false | LoanToOfficerOrDQP |
| Grant To Related Person | false | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | false | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | false | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | true | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | false | DeductibleNonCashContributions |
| Deductible Contributions Of Art | false | DeductibleContributionsOfArt |
| Terminated | false | Terminated |
| Partial Liquidation | false | PartialLiquidation |
| Disregarded Entity | false | DisregardedEntity |
| Related Entity | true | RelatedEntity |
| Related Org Controlled Entity | false | RelatedOrgControlledEntity |
| Transaction Related Entity | false | TransactionRelatedEntity |
| Transfers To Exempt Non Chrtbl Org | false | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | false | ActivitiesConductedPartnership |
| Schedule O Required | true | ScheduleORequired |
| Number Forms Transmitted With1096 | 38 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | true | ComplianceWithBackupWitholding |
| Number Of Employees | 608 | NumberOfEmployees |
| Employment Tax Returns Filed | true | EmploymentTaxReturnsFiled |
| Unrelated Business Income | false | UnrelatedBusinessIncome |
| Foreign Financial Account | false | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTrans |
| Taxable Party Notification | false | TaxablePartyNotification |
| Non Deductible Contributions | false | NonDeductibleContributions |
| Quid Pro Quo Contributions | false | QuidProQuoContributions |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | false | FundsToPayPremiums |
| Premiums Paid | false | PremiumsPaid |
| Indoor Tanning Services | false | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 18 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 14 | NumberIndependentVotingMembers |
| Family Or Business Relationship | true | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | false | DelegationOfManagementDuties |
| Changes To Organizing Docs | false | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuse |
| Members Or Stockholders | true | MembersOrStockholders |
| Election Of Board Members | true | ElectionOfBoardMembers |
| Decisions Subject To Approval | true | DecisionsSubjectToApproval |
| Minutes Of Governing Body | true | MinutesOfGoverningBody |
| Minutes Of Committees | true | MinutesOfCommittees |
| Officer Mailing Address | false | OfficerMailingAddress |
| Local Chapters | false | LocalChapters |
| Form990 Provided To Governing Body | true | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | true | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | true | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | true | RegularMonitoringEnforcement |
| Whistleblower Policy | true | WhistleblowerPolicy |
| Document Retention Policy | true | DocumentRetentionPolicy |
| Compensation Process CEO | true | CompensationProcessCEO |
| Compensation Process Other | false | CompensationProcessOther |
| Investment In Joint Venture | false | InvestmentInJointVenture |
| States Where Copy Of Return Is Filed | ME | StatesWhereCopyOfReturnIsFiled |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | SENIOR VP - FISCAL | NamePerson |
| Telephone Number | 2077435933 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 181 MAIN STREET | AddressLine1 |
| City | NORWAY | City |
| State | ME | State |
| ZIP Code | 04268 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | X | InfoInScheduleOPartVII |
Form990 Part VII Section A Form990PartVIISectionA (28 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 | FormerFormer |
|---|---|---|---|---|---|---|---|---|
| GREGORY HARDY MD | ||||||||
| MED STAFF PR | 2.00 | X | 0 | 350220 | 24868 | |||
| TIMOTHY CHURCHILL | ||||||||
| PRESID & CEO | 30.00 | X | 0 | 317808 | 34286 | X | ||
| EUGENE BENNER | ||||||||
| CHAIR | 2.00 | X | 0 | 0 | 0 | X | ||
| ANDREA BURNS | ||||||||
| TRUSTEE | 2.00 | X | 0 | 0 | 0 | |||
| PETER CHAPMAN | ||||||||
| SECRETARY/TR | 2.00 | X | 0 | 0 | 0 | X | ||
| C BRADLEY CUMMINGS | ||||||||
| TRUSTEE | 2.00 | X | 0 | 0 | 0 | X | ||
| TOM MORTON | ||||||||
| TRUSTEE | 2.00 | X | 0 | 0 | 0 | |||
| LARRY FARMER OD | ||||||||
| TRUSTEE | 2.00 | X | 0 | 0 | 0 | |||
| DAVID HOISINGTON | ||||||||
| CHAIR | 2.00 | X | 0 | 0 | 0 | X | ||
| DAVID KUMAKI MD | ||||||||
| TRUSTEE | 2.00 | X | 0 | 0 | 0 | |||
| WILLIAM L MEDD MD | ||||||||
| TRUSTEE | 2.00 | X | 0 | 0 | 0 | |||
| OLA MELHUS MD | ||||||||
| TRUSTEE | 2.00 | X | 0 | 0 | 0 | |||
| LYNN HAMPER | ||||||||
| TRUSTEE | 2.00 | X | 0 | 0 | 0 | |||
| DAVID J PREBLE | ||||||||
| VICE CHAIR | 2.00 | X | 0 | 0 | 0 | X | ||
| TED MOCCIA | ||||||||
| TRUSTEE | 2.00 | X | 0 | 0 | 0 | |||
| REV ANNE STANLEY | ||||||||
| TRUSTEE | 2.00 | X | 0 | 0 | 0 | |||
| ROBIN J ZINCHUK | ||||||||
| TRUSTEE | 2.00 | X | 0 | 0 | 0 | |||
| WENDY PENLEY | ||||||||
| TRUSTEE | 2.00 | X | 0 | 0 | 0 | |||
| PAT WEIGEL | ||||||||
| TRUSTEE | 2.00 | X | 0 | 0 | 0 | |||
| JOHN COX | ||||||||
| SR VP-FISCAL | 30.00 | 0 | 166598 | 23383 | X | |||
| M PATRICIA COOK | ||||||||
| SR VP-CLINIC | 42.00 | 0 | 142450 | 26047 | X | |||
| THOMAS J HEWSON | ||||||||
| PHYSICIAN | 38.00 | 279603 | 0 | 21884 | X | |||
| TOBIN M PIKER | ||||||||
| PHYSICIAN | 34.00 | 239212 | 0 | 24777 | X | |||
| RUSSELL D FLORENZ | ||||||||
| PHYSICIAN | 30.00 | 238669 | 0 | 27737 | X | |||
| CLIFFORD R PECK | ||||||||
| PHYSICIAN | 32.00 | 224385 | 0 | 10815 | X | |||
| ROBERTA F METIVIER | ||||||||
| VP-HUMAN RES | 42.00 | 199162 | 0 | 24668 | X | |||
| ADAM M KAZIMIERCZAK | ||||||||
| PHYSICIAN | 0.00 | 0 | 217867 | 22126 | X | |||
| KATHLEEN A HERLIHY | ||||||||
| PHYSICIAN | 0.00 | 0 | 167335 | 23306 | X | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 1181031 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 1362278 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 263897 | TotalOtherCompensation |
| Number Individuals GT100 K | 18 | NumberIndividualsGT100K |
| Formers Listed | true | FormersListed |
| Total Comp GT150 K | true | TotalCompGT150K |
| Compensation From Other Sources | false | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (5 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| OXFORD HILLS INTERNAL MEDICINE | |||||
| 193 MAIN STREET | NORWAY | ME | 04268 | PHYSICIAN SVCS | 702032 |
| SPECTRUM MEDICAL GROUP PA | |||||
| 300 PROFESSIONAL DRIVE | SCARBOROUGH | ME | 04074 | ANESTHESIA SVCS | 484308 |
| MAINE ORTHOPAEDIC CENTER | |||||
| 1601 CONGRESS STREET | PORTLAND | ME | 04102 | PHYSICIAN SVCS | 394900 |
| HP CUMMINGS CONSTRUCTION | |||||
| PO BOX 297 | WINTHROP | ME | 04364 | CONTRACTOR SVCS | 293063 |
| NORDX | |||||
| PO BOX 607 | SCARBOROUGH | ME | 04074 | LAB PROCESSING | 126597 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 7 | NumberOfContractorsGT100K |
| All Other Contributions | 117000 | AllOtherContributions |
| Total Contributions | 117000 | TotalContributions |
Program Service Revenue ProgramServiceRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | NET PATIENT SERVICE REVENUE | Description |
| Business Code | 623000 | BusinessCode |
| Total Revenue Column | 57376266 | TotalRevenueColumn |
| Related Or Exempt Function Income | 57376266 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 57376266 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 32340 | TotalRevenueColumn |
| Exclusion | $32,340 | ExclusionAmount |
Gross Rents GrossRents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 447911 | Real |
Less Rental Expenses LessRentalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 701339 | Real |
Rental Income Or Loss RentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | -253428 | Real |
Net Rental Income Or Loss NetRentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -253428 | TotalRevenueColumn |
| Exclusion | -$253,428 | ExclusionAmount |
Gross Amount Sales Assets GrossAmountSalesAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | 18253 | Other |
Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | 14686 | Other |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | 3567 | Other |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 3567 | TotalRevenueColumn |
| Exclusion | $3,567 | ExclusionAmount |
Other Revenue Misc OtherRevenueMisc
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | OTHER REVENUE | Description |
| Business Code | 621990 | BusinessCode |
| Total Revenue Column | 1165658 | TotalRevenueColumn |
| Related Or Exempt Function Income | 1165658 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 1165658 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 58441403 | TotalRevenueColumn |
| Related Or Exempt Function Income | 58541924 | RelatedOrExemptFunctionIncome |
| Exclusion | -$217,521 | ExclusionAmount |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 290190 | Total |
| Management And General | 290190 | ManagementAndGeneral |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 23112785 | Total |
| Program Services | 22042367 | ProgramServices |
| Management And General | 1026161 | ManagementAndGeneral |
| Fundraising | 44257 | Fundraising |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 966426 | Total |
| Program Services | 917547 | ProgramServices |
| Management And General | 48879 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 4281456 | Total |
| Program Services | 4066510 | ProgramServices |
| Management And General | 207267 | ManagementAndGeneral |
| Fundraising | 7679 | Fundraising |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1568109 | Total |
| Program Services | 1489704 | ProgramServices |
| Management And General | 75019 | ManagementAndGeneral |
| Fundraising | 3386 | Fundraising |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 73745 | Total |
| Management And General | 73745 | ManagementAndGeneral |
Fees For Services Prof Fundraising FeesForServicesProfFundraising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 6050 | Total |
| Fundraising | 6050 | Fundraising |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 7073835 | Total |
| Program Services | 6677228 | ProgramServices |
| Management And General | 396607 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 97108 | Total |
| Program Services | 92393 | ProgramServices |
| Management And General | 4715 | ManagementAndGeneral |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 6603707 | Total |
| Program Services | 6531446 | ProgramServices |
| Management And General | 68456 | ManagementAndGeneral |
| Fundraising | 3805 | Fundraising |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 973209 | Total |
| Program Services | 898680 | ProgramServices |
| Management And General | 74529 | ManagementAndGeneral |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1233723 | Total |
| Program Services | 1173058 | ProgramServices |
| Management And General | 60665 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 88950 | Total |
| Program Services | 83385 | ProgramServices |
| Management And General | 5565 | ManagementAndGeneral |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 133140 | Total |
| Program Services | 124582 | ProgramServices |
| Management And General | 7618 | ManagementAndGeneral |
| Fundraising | 940 | Fundraising |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 64937 | Total |
| Program Services | 61690 | ProgramServices |
| Management And General | 3247 | ManagementAndGeneral |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1830995 | Total |
| Program Services | 1739445 | ProgramServices |
| Management And General | 91550 | ManagementAndGeneral |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 701428 | Total |
| Program Services | 549203 | ProgramServices |
| Management And General | 152225 | ManagementAndGeneral |
Other Expenses OtherExpenses (4 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral | FundraisingFundraising |
|---|---|---|---|---|
| BAD DEBT | 2956753 | 2956753 | ||
| PROVIDER TAX | 1109651 | 1109651 | ||
| RECRUITMENT | 317631 | 273889 | 43742 | |
| DUES AND SUBSCRIPTIONS | 166945 | 154747 | 11408 | 790 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 118175 | Total |
| Program Services | 101823 | ProgramServices |
| Management And General | 16352 | ManagementAndGeneral |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 53768948 | Total |
| Program Services | 51044101 | ProgramServices |
| Management And General | 2657940 | ManagementAndGeneral |
| Fundraising | 66907 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1900 | BOY |
| EOY | 1900 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 9342947 | BOY |
| EOY | 9786771 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 6824644 | BOY |
| EOY | 6595627 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1093414 | BOY |
| EOY | 1064314 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 458978 | BOY |
| EOY | 455794 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 43094281 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 29638455 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 14168421 | BOY |
| EOY | 13455826 | EOY |
Investments Pub Traded Securities InvestmentsPubTradedSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1193583 | BOY |
| EOY | 1295243 | EOY |
Investments Other Securities InvestmentsOtherSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 409752 | BOY |
| EOY | 528396 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 8270791 | BOY |
| EOY | 12614292 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 41764430 | BOY |
| EOY | 45798163 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 4185262 | BOY |
| EOY | 4486912 | EOY |
Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3816494 | BOY |
| EOY | 3505479 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 4319271 | BOY |
| EOY | 3832215 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 12321027 | BOY |
| EOY | 11824606 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 28418521 | BOY |
| EOY | 32828109 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 472728 | BOY |
| EOY | 593294 | EOY |
Permanently Restricted Net Assets PermanentlyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 552154 | BOY |
| EOY | 552154 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 29443403 | BOY |
| EOY | 33973557 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 41764430 | BOY |
| EOY | 45798163 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | 4672455 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | -142301 | ReconcilationOtherChanges |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | false | AccountantCompileOrReview |
| FS Audited | true | FSAudited |
| Audit Committee | true | AuditCommittee |
| Financial Statement Both | X | FinancialStatementBoth |
| Federal Grant Audit Required | false | FederalGrantAuditRequired |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital170b1 Aiii | X | Hospital170b1Aiii |
Schedule B IRS990ScheduleB
Contributor Info ContributorInfo
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor Number | RESTRICTED | ContributorNumber |
Contributor Name Business ContributorNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor Address US ContributorAddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Aggregate Contributions | RESTRICTED | AggregateContributions |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form4720 Filed4955 Tax | false | Form4720Filed4955Tax |
| Correction Made | false | CorrectionMade |
| Form1120 Pol Filed | false | Form1120PolFiled |
| Form4720 Filed | false | Form4720Filed |
| Volunteers | false | Volunteers |
| Paid Staff Or Management | false | PaidStaffOrManagement |
| Media Advertisements | false | MediaAdvertisements |
| Mailings Members | false | MailingsMembers |
| Publications Or Broadcast | false | PublicationsOrBroadcast |
| Grants Other Organizations | false | GrantsOtherOrganizations |
| Direct Contact Legislators | false | DirectContactLegislators |
| Rallies Demonstrations | false | RalliesDemonstrations |
| Other Activities | true | OtherActivities |
| Other Activities | $9,094 | OtherActivitiesAmount |
| Total Lobbying Expenditures IIB | 9094 | TotalLobbyingExpendituresIIB |
| Not Described In501c3 | false | NotDescribedIn501c3 |
| Form4720 Filed4912 Tax | false | Form4720Filed4912Tax |
| Substantially All Dues Nondeduct | false | SubstantiallyAllDuesNondeduct |
| Only In House Lobbying | false | OnlyInHouseLobbying |
| Agree To Carryover Prior Year | false | AgreeToCarryoverPriorYear |
Form990 Schedule C Part IV Form990ScheduleCPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Reference | SCHEDULE C, PART II-B, LINE 1 | ReturnReference |
| Explanation | DUES PAID TO THE AMERICAN HOSPITAL ASSOCIATION OF 15,492 AND TO THE MAINE HOSPITAL ASSOCIATION OF 31,258. THE AMERICAN HOSPITAL ASSOCIATION AND MAINE HOSPITAL ASSOCIATION USED 24.60% AND 16.90% RESPECTIVELY OF THEIR DUES REVENUE FOR LOBBYING ACTIVITY. | Explanation |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Disclosed Orgs Legal Control | false | DisclosedOrgsLegalControl |
| Disclosed For Charitable Purposes | false | DisclosedForCharitablePurposes |
| Written Policy Monitoring | false | WrittenPolicyMonitoring |
| Sect170h Requirements Satisfied | false | Sect170hRequirementsSatisfied |
| Solicited Assets For Sale | false | SolicitedAssetsForSale |
| Agent Trustee Etc | false | AgentTrusteeEtc |
| Included On FS | false | IncludedOnFS |
| Endowments Held By Unrelated Orgs | false | EndowmentsHeldByUnrelatedOrgs |
| Endowments Held By Related Orgs | false | EndowmentsHeldByRelatedOrgs |
| Are Related Orgs Listed Schedule R | false | AreRelatedOrgsListedScheduleR |
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 1230517 | OtherCostOrOtherBasis |
| Book Value | 1230517 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 19673329 | OtherCostOrOtherBasis |
| Depreciation | 11522839 | Depreciation |
| Book Value | 8150490 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 20544287 | OtherCostOrOtherBasis |
| Depreciation | 16927666 | Depreciation |
| Book Value | 3616621 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 1646148 | OtherCostOrOtherBasis |
| Depreciation | 1187950 | Depreciation |
| Book Value | 458198 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 13455826 | TotalOfBookValueLandBuildings |
Other Assets OtherAssets (7 entries)
| DescriptionDescription | Book ValueBookValue |
|---|---|
| INTEREST IN NET ASSETS OF SCHC FOUND | 5451571 |
| AR UNDER REIMBURSEMENT REGULATIONS | 5084000 |
| PREPAID CAPITAL COSTS | 1613772 |
| OTHER RECEIVABLES | 259084 |
| DUE FROM AFFILIATES | 189484 |
| CSV-LIFE INSURANCE | 16381 |
| WORKERS COMPENSATION FUNDING |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | 12614292 | TotalBookValueOtherAssets |
Other Liabilities OtherLiabilities (5 entries)
| DescriptionDescription | AmountAmount |
|---|---|
| AP UNDER REIMBURSEMENT REGULATIONS | $1,336,843 |
| DUE TO AFFILIATES | $1,331,328 |
| PROFESSIONAL LIABILITY CLAIM ACCRUAL | $1,087,964 |
| ACCRUED ASSET OBLIGATION | $76,080 |
| MISCELLANEOUS OTHER LIABILITES |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 3832215 | TotalOfAmounts |
| Total Revenue | 58441403 | TotalRevenue |
| Total Expenses | 53768948 | TotalExpenses |
| Excess Or Deficit For Year | 4672455 | ExcessOrDeficitForYear |
| Net Unrealized GL On Investments | 189066 | NetUnrealizedGLOnInvestments |
| Other | -$331,367 | OtherAmount |
| Total Adjustments | -142301 | TotalAdjustments |
| Excess Or Deficit Per FS | 4530154 | ExcessOrDeficitPerFS |
| Tot Revenue Etc Audited Fincl Stmt | 58299102 | TotRevenueEtcAuditedFinclStmt |
| Net Unrealized Gains Investments | 189066 | NetUnrealizedGainsInvestments |
| Other Revenues | -331367 | OtherRevenues |
| Revenue Not Rptd F990 | -142301 | RevenueNotRptdF990 |
| Revenue Subtotal | 58441403 | RevenueSubtotal |
| Total Revenue Per Form990 | 58441403 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 53768948 | TotExpensesEtcAuditedFinclStmt |
| Expenses Subtotal | 53768948 | ExpensesSubtotal |
| Total Expenses Per Form990 | 53768948 | TotalExpensesPerForm990 |
Form990 Schedule D Part XIV Form990ScheduleDPartXIV (3 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| LIABILITY UNDER FIN 48 FOOTNOTE | SCHEDULE D, PAGE 3, PART X | THE ORGANIZATION IS A NOT-FOR-PROFIT ORGANIZATION 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 NO UNCERTAIN INCOME TAX POSITIONS EXIST AT SEPTEMBER 30, 2012. THE ORGANIZATION'S TAX YEARS FROM 2010 THROUGH 2012 MAY BE SUBJECT TO EXAMINATION |
| RECONCILIATION OF CHANGES - OTHER | SCHEDULE D, PAGE 4, PART XI, LINE 8 | CHANGE IN INTEREST-STEPHENS COMMUNITY HEALTHCARE FOUND 726,955 NET TRANSFER TO AFFILIATES -1,058,322 |
| REVENUE AMOUNTS INCLUDED IN FINANCIALS - OTHER | SCHEDULE D, PAGE 4, PART XII, LINE 2D | CHANGE IN INTEREST-STEPHENS COMMUNITY HEALTHCARE FOUND 726,955 NET TRANSFER TO AFFILIATES -1,058,322 |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Charity Care Policy | true | CharityCarePolicy |
| Written Policy | true | WrittenPolicy |
| FPG Reference Free Care | true | FPGReferenceFreeCare |
Other Percentage OtherPercentage
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | X | Other |
| Free Other Percentage | 1.75000 | FreeOtherPercentage |
| Field | Value | IRS element (for citing) |
|---|---|---|
| FPG Reference Discounted Care | true | FPGReferenceDiscountedCare |
Discounted Other DiscountedOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | X | Other |
| Discounted Other Percentage | 2.25000 | DiscountedOtherPercentage |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Free Disc Care Medically Indigent | true | FreeDiscCareMedicallyIndigent |
| Amounts Budgeted For Charity Care | true | AmountsBudgetedForCharityCare |
| Expenses Exceeded Budget | false | ExpensesExceededBudget |
| Annual Community Benefit Report | true | AnnualCommunityBenefitReport |
| Report Publically Available | true | ReportPublicallyAvailable |
Charity Care At Cost CharityCareAtCost
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 2213724 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 2213724 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.04120 | PercentOfTotalExpense |
Unreimbursed Medicaid UnreimbursedMedicaid
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 11167017 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 9694808 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 1472209 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.02740 | PercentOfTotalExpense |
Total Charity Care TotalCharityCare
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 13380741 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 9694808 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 3685933 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.06860 | PercentOfTotalExpense |
Community Health Services CommunityHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 161376 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 48670 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 112706 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00210 | PercentOfTotalExpense |
Health Professions Education HealthProfessionsEducation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 100162 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 90585 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 9577 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00020 | PercentOfTotalExpense |
Subsidized Health Services SubsidizedHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 8884047 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 7998808 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 885239 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.01650 | PercentOfTotalExpense |
Total Other Benefits TotalOtherBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 9145585 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 8138063 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 1007522 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.01880 | PercentOfTotalExpense |
Total Community Benefits TotalCommunityBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 22526326 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 17832871 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 4693455 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.08740 | PercentOfTotalExpense |
Community Support CommunitySupport
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Building Expense | 6210 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 6210 | NetCommunityBuildingExpense |
Total Total
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Building Expense | 6210 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 6210 | NetCommunityBuildingExpense |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | true | BadDebtExpenseReported |
| Bad Debt Expense | $1,552,320 | BadDebtExpenseAmount |
| Amount Reimbursed By Medicare | 15535825 | AmountReimbursedByMedicare |
| Cost Of Care Reimbursed By Medicare | 15382005 | CostOfCareReimbursedByMedicare |
| Medicare Surplus Or Shortfall | 153820 | MedicareSurplusOrShortfall |
Costing Methodology Used CostingMethodologyUsed
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | X | Other |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | true | WrittenDebtCollectionPolicy |
| Provision For Charity Care | true | ProvisionForCharityCare |
| Number Of Hospital Facilities | 1 | NumberOfHospitalFacilities |
Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility Number | 1 | FacilityNumber |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | STEPHENS MEMORIAL HOSPITAL ASSOC | BusinessNameLine1 |
Address Address
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 181 MAIN STREET | AddressLine1 |
| City | NORWAY | City |
| State | ME | State |
| ZIP Code | 04268 | 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 | STEPHENS MEMORIAL HOSPITAL ASSOC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital Facility Number | 1 | HospitalFacilityNumber |
| Eligibility Criteria Explained | true | EligibilityCriteriaExplained |
| Uses FPG Free | true | UsesFPGFree |
| FPG Free Percent | 175.0 | FPGFreePercent |
| Uses FPG Discounted | true | UsesFPGDiscounted |
| FPG Discount Percent | 225.0 | FPGDiscountPercent |
| Explains Basis | false | ExplainsBasis |
| Explains Application Method | true | ExplainsApplicationMethod |
| Includes Publicity Measures | true | IncludesPublicityMeasures |
| Posted On Website | X | PostedOnWebsite |
| Posted In Emergency Room | X | PostedInEmergencyRoom |
| Posted In Admission Office | X | PostedInAdmissionOffice |
| Available On Request | X | AvailableOnRequest |
| Actions On Nonpayment | true | ActionsOnNonpayment |
| Collection Activities | false | CollectionActivities |
| Notified All Patients | X | NotifiedAllPatients |
| Documented Determination | X | DocumentedDetermination |
| Nondiscrim Emergency Care Policy | true | NondiscrimEmergencyCarePolicy |
| Lowest Negotiated Rates | X | LowestNegotiatedRates |
| Amounts Generally Billed | false | AmountsGenerallyBilled |
| Gross Charges | false | GrossCharges |
Form990 Schedule H Part VI Form990ScheduleHPartVI (11 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| SUBSIDIZED HEALTH SERVICES EXPLANATION | PART I LINE 7G | SUBSIDIZED HEALTH SERVICES INCLUDE THE NET OPERATING LOSS OF PACE PARAMEDIC SERVICE A DEPARTMENT OF STEPHENS MEMORIAL HOSPITAL AND DIRECT SUBSIDIES AND SUPPORT OF LOCAL SCHOOLBASED HEALTH CLINICS A PSYCHIATRY CONSULTATION SERVICE AND OTHER CLINICAL PROGRAMS THAT ARE NOT REVENUEPRODUCING IF THESE SERVICES WERE NOT PROVIDED OR SUBSIDIZED BY THE HOSPITAL THEY WOULD NOT BE AVAILABLE IN THE COMMUNITY |
| EXCLUSIONS FROM PERCENT OF TOTAL EXPENSE | PART I LINE 7 COLUMN F | BAD DEBT EXPENSE OF 2956751 WAS REMOVED FROM TOTAL EXPENSES WHEN CALCULATING THE PERCENTAGE OF TOTAL EXPENSES IN COLUMN F |
| COMMUNITY BUILDING ACTIVITIES | PART II | IN ADDITION TO THE SUBSIDIZED HEALTH SERVICES AND COMMUNITY HEALTH SERVICES DESCRIBED ABOVE WESTERN MAINE HEALTH CARE SPONSORS OR PARTICIPATES IN A VARIETY OF OTHER COMMUNITY ACTIVITIES AND PROGRAMS THESE COMMUNITYBUILDING ACTIVITIES INCLUDE WE ARE THE LEAD AGENCY FOR HEALTHY OXFORD HILLS A COMMUNITY COALITION TO PROMOTE PARTNERSHIPS POLICIES AND PROGRAMS TO PROTECT AND ENHANCE THE HEALTH OF RESIDENTS OF OXFORD HILLS OUR VIAL OF LIFE PROGRAM ALLOWS INDIVIDUALS IN THE COMMUNITY TO RECORD AND SAFELY STORE THEIR CURRENT HEALTH INFORMATION AT HOME IN CASE THAT INFORMATION NEEDS TO BE RETRIEVED IN AN EMERGENCY SITUATION SAFE SITTER COURSES A MEDICALLYACCURATE INSTRUCTIONAL PROGRAM DESIGNED FOR YOUNG ADOLESCENTS 11 TO 13 YEARS OF AGE COMMUNITYWIDE EMERGENCY PREPAREDNESS PLANNING REGIONAL HEALTH PLANNING AND PANDEMIC PLANNING WE PROVIDE A CLINICAL SITE FOR LOCAL REGISTERED NURSES AND CERTIFIED NURSES AIDE PROGRAMS ANNUAL CONFERENCE ALCOHOLISM AND DRUG ADDICTION DISEASE TREATMENT AND RECOVERY FREE COMMUNITY BLOOD PRESSURE SCREENINGS AND CLINICS BLOOD DRIVES SIBLING CLASSES FOR CHILDREN EXPECTING NEW FAMILY MEMBERS NUTRITION OPEN HOUSES FOR THE GENERAL PUBLIC RELAY FOR LIFE TO SUPPORT THE AMERICAN CANCER SOCIETY BOWL FOR KIDS SAKE TO BENEFIT THE LOCAL BIG BROTHERSBIG SISTERS PROGRAM WE PROVIDE COMMUNITY OUTREACH SERVICES TO EDUCATE FAMILIES ABOUT THE ALFOND SCHOLARSHIP FOR BABIES AND ASSIST FAMILIES IN PREPARING THE GRANT APPLICATION WE PROVIDE MEETING SPACE AT NO CHARGE FOR LOCAL NONPROFIT SUPPORT GROUPS INCLUDING ALCOHOLICS ANONYMOUS SMOKING CESSATION GEAR PARENT NETWORK SUPPORT GROUP TAKE OFF POUNDS SENSIBLY TOPS THE SHRINERS ANNUAL HEALTH SCREENING DAY AND SUPPORT GROUPS FOR THOSE AFFECTED BY DEPRESSIONBIPOLAR CONDITIONS DIABETES GRIEF AND PARKINSONS DISEASE |
| BAD DEBT EXPENSE EXPLANATION | PART III LINE 4 | THE HOSPITAL ACCEPTS ALL PATIENTS REGARDLESS OF THEIR ABILITY TO PAY A PATIENT QUALIFIES FOR FREE CARE BASED UPON CERTAIN ESTABLISHED POLICIES OF THE HOSPITAL THESE POLICIES DEFINE FREE CARE AS THOSE SERVICES FOR WHICH NO PAYMENT IS ANTICIPATED FREE CARE PROVIDED IS NOT INCLUDED IN NET PATIENT SERVICE REVENUE AND IS MEASURED BASED ON THE HOSPITALS CHARGES COSTS AND EXPENSES INCURRED IN PROVIDING THESE SERVICES ARE INCLUDED IN OPERATING EXPENSES CHARGES FOR SERVICES RENDERED TO INDIVIDUALS FROM WHOM PAYMENT IS EXPECTED AND ULTIMATELY NOT RECEIVED ARE WRITTEN OFF AND INCLUDED IN EXPENSES AS PART OF THE PROVISION FOR BAD DEBTS BAD DEBT EXPENSE REPRESENTS HEALTHCARE SERVICES THAT THE HOSPITAL HAS PROVIDED WITHOUT COMPENSATION AS A TAXEXEMPT HOSPITAL THE HOSPITAL PROVIDES NECESSARY PATIENT CARE REGARDLESS OF THE PATIENTS ABILITY TO PAY FOR THE SERVICES A PORTION OF THE HOSPITALS BAD DEBT EXPENSE IS ATTRIBUTABLE TO PATIENTS ELIGIBLE FOR FINANCIAL ASSISTANCE THAT FOR A VARIETY OF REASONS DO NOT COMPLETE THE FINANCIAL ASSISTANCE APPLICATION PROCESS THE HOSPITAL CANNOT DETERMINE THE AMOUNT OF BAD DEBT EXPENSE THAT COULD BE REASONABLY ATTRIBUTABLE TO PATIENTS WHO LIKELY WOULD QUALIFY FOR FINANCIAL ASSISTANCE UNDER THE HOSPITAL FREE CARE POLICY IN ADDITION BAD DEBT EXPENSE ALSO INCLUDES AMOUNTS FOR SERVICES PROVIDED TO INDIVIDUALS EXPERIENCING 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 THE HOSPITAL BELIEVES THAT BAD DEBT EXPENSE SHOULD BE INCLUDED AS A COMMUNITY BENEFIT THE RESERVE FOR UNCOLLECTIBLE ACCOUNTS IS PROVIDED BASED ON AN ANALYSIS BY MANAGEMENT OF THE COLLECTABILITY 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 THE 1550817 OF BAD DEBT EXPENSE AT COST WAS CALCULATED USING THE HOSPITALS COST TO CHARGE RATIO |
| MEDICARE EXPLANATION | PART III LINE 8 | MEDICARE ALLOWABLE COSTS WERE TAKEN FROM THE HOSPITALS ASFILED 2012 MEDICARE COST REPORTS THE COST REPORT UTILIZES A SOPHISTICATED DETAILED STEPDOWN COST ALLOCATION APPROACH THE COST REPORT EXCLUDES REVENUE EXPENSES AND REIMBURSEMENT FOR PROFESSIONAL FEES SUCH AS EMERGENCY DEPARTMENT PHYSICIANS IF THE COST TO PROVIDE THESE SERVICES AND PAYMENTS FOR THE SERVICES WERE INCLUDED IN THE PART III SECTION B ANALYSIS THE MEDICARE SHORTFALL WOULD BE GREATER THAN AMOUNTS REPORTED STEPHENS MEMORIAL HOSPITAL ASSOCIATION 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 | PATIENTS WHO APPLY FOR AND QUALIFY FOR CHARITY CARE FINANCIAL ASSISTANCE BASED ON THE STATE OF MAINE FREE HOSPITAL CARE GUIDELINES WILL HAVE THE SELF PAY PORTION OF THEIR ACCOUNT BALANCE ADJUSTED AT TIME OF APPROVAL FUTURE SELF PAY BALANCES WILL BE ADJUSTED DURING THEIR ELIGIBILITY PERIOD AT THE POINT OF BILLING PRIOR TO SENDING BILLS TO PATIENTS FOR THOSE WHO APPLY FOR ASSISTANCE BUT WHOSE INCOME EXCEEDS THE LIMIT FOR 100 ASSISTANCE A 50 REDUCTION WILL BE APPLIED IF THEIR INCOME IS BETWEEN 176 AND 200 OF THE FEDERAL POVERTY LIMITS PATIENTS WHOSE FAMILY INCOME RANGES FROM 201 TO 225 OF THE FEDERAL POVERTY LIMITS QUALIFY FOR A 25 REDUCTION IF REQUESTED A MONTHLY PAYMENT PLAN WILL BE SET UP FOR THE REMAINDER OF THE PATIENTS BALANCE |
| NEEDS ASSESSMENT | PART VI | STEPHENS MEMORIAL HOSPITALS BOARD OF TRUSTEES IS MADE UP OF A DIVERSE SET OF COMMUNITY MEMBERS THE BOARD REQUIRES A THOROUGH COMMUNITY NEEDS ASSESSMENT ON BEHALF OF THE ORGANIZATION AND DIRECTS THE ORGANIZATION TO ANALYZE AND RESPOND TO THE CURRENT NEEDS ASSESSMENT STEPHENS MEMORIAL HOSPITAL AND ITS PARENT WESTERN MAINE HEALTH CARE ALSO PARTICIPATE IN VARIOUS INITIATIVES TO HELP SUPPORT AND PROVIDE UPDATES TO COMMUNITY NEEDS ASSESSMENT PLANNING SOME OF THESE INITIATIVES INCLUDE CLINICAL STRATEGIC PLANNING FINANCIAL STRATEGIC PLANNING FACILITY PLANNING MANPOWER PLANNING PHYSICIAN RECRUITMENT STRATEGIC PLANNING EMERGENCY PREPAREDNESS PLANNING ALONG WITH THE INTERNAL ASSESSMENTS MOST MEMBER ORGANIZATIONS ALSO REVIEW AND ACT ON MANY OF THE RECOMMENDATIONS PROVIDED BY EXTERNAL GROUPS SUCH AS THE MAINE CENTER FOR DISEASE CONTROL AND PREVENTION AND THE STATE HEALTH PLAN CREATED BY THE ADVISORY COMMITTEE FOR HEALTH SYSTEMS DEVELOPMENT IN ADDITION MAINEHEALTH AND ITS PARTNERS IN THE ONEMAINE HEALTH COLLABORATIVE EASTERN MAINE HEALTH SYSTEM AND MAINEGENERAL HEALTH RELEASED THE ONEMAINE HEALTH COMMUNITY HEALTH NEEDS ASSESSMENT REPORT IN MARCH 2011 THE REPORT IS A COMPREHENSIVE COMPILATION AND ANALYSIS CONTAINING PRIMARY AND SECONDARY HEALTH DATA SOURCES THE REPORT CONTAINS A HEALTH STATUS PROFILE FOR THE STATE AS A WHOLE AND FOR EACH OF MAINES SIXTEEN COUNTIES THE PRIMARY DATA SOURCE WAS A RANDOMIZED TELEPHONE SURVEY THE SAMPLING METHODOLOGY WAS DESIGNED TO PERMIT COMPARISONS AT THE COUNTY LEVEL SECONDARY DATA SOURCES INCLUDE NUMEROUS STATE AND FEDERAL SOURCES THIS REPORT PROVIDES BASELINE DATA ON HUNDREDS OF HEALTH INDICATORS THAT ARE RELEVANT TO HOSPITALS AND COMMUNITIES TO INFORM PLANNING AND EVALUATION ACTIVITIES PLANS CALL FOR THE COMMUNITY HEALTH NEEDS ASSESSMENT TO BE REPLICATED EVERY THREE YEARS MAINEHEALTH WILL HOLD COMMUNITY FORUMS IN PARTNERSHIP WITH EACH MEMBER AND AFFILIATE HOSPITAL IN ORDER TO INCREASE UNDERSTANDING AND USE OF THE COMMUNITY HEALTH NEEDS ASSESSMENT AND TO INFORM IDENTIFICATION AND ACTION ON LOCAL COMMUNITYBASED HEALTH PRIORITIES |
| PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE | PART VI | STEPHENS MEMORIAL HOSPITALS POLICY OF CHARITY CARE AND FINANCIAL ASSISTANCE IS EASILY UNDERSTOOD PROMINENTLY POSTED AND PUBLICLY AVAILABLE FOR PATIENTS WHOSE FAMILY INCOME IS AT OR BELOW 175 OF THE FEDERAL POVERTY LEVEL CHARITY CARE IS 100 OF THEIR BILLED AMOUNTS PATIENTS WHOSE FAMILY INCOME RANGES FROM 176 TO 200 OF THE FEDERAL POVERTY LEVEL QUALIFY FOR A 50 CHARITY CARE DISCOUNT PATIENTS WHOSE FAMILY INCOME RANGES FROM 201 TO 225 OF THE FEDERAL POVERTY LEVEL QUALIFY FOR A 25 CHARITY CARE DISCOUNT A PROCESS EXISTS FOR OFFERING CHARITY CARE OR FINANCIAL ASSISTANCE TO PATIENTS WHO ARE UNABLE TO PAY AFTER THEY HAVE ALREADY BEEN BILLED IN ADDITION TO MONITORING COLLECTION PRACTICES COPIES OF THE CHARITY CARE POLICY ARE MADE AVAILABLE TO PATIENTS AT ALL ENTRY POINTS REGISTRATION ED ETC AND WITH BILLCOLLECTION NOTICES THE ORGANIZATION USES SIMPLE APPLICATION PROCEDURES FOR CHARITY CARE OR FINANCIAL ASSISTANCE THAT DO NOT INTIMIDATE OR CONFUSE APPLICANTS STEPHENS MEMORIAL HOSPITALS EMPLOYEES WHO WORK IN ADMISSIONS BILLING ACCOUNTS RECEIVABLE OR PATIENT FINANCIAL SERVICES ARE FULLY INFORMED AND EDUCATED ABOUT ALL FINANCIAL ASSISTANCE POLICIES THESE STAFF MEMBERS IDENTIFY UNPAID BILLS WHERE PERSONS ARE UNABLE TO PAY AND SEPARATES THESE POTENTIAL CHARITY CARE BILLS FROM OTHER BAD DEBT ACCOUNTS |
| COMMUNITY INFORMATION | PART VI | STEPHENS MEMORIAL HOSPITAL PRIMARILY SERVES SOUTHERN OXFORD COUNTY IN WESTERN MAINE TRADITIONALLY THE DEMOGRAPHICS OF THIS REGION REFLECT A POPULATION THAT IS OLDER AND POORER THAN THE STATE OF MAINE AVERAGE RECENT INDEPENDENT STUDIES FOUND OXFORD COUNTY TO BE THE SECOND LEAST HEALTHY COUNTY IN THE STATE |
| HEALTH OF COMMUNITY IN RELATION TO EXEMPT PURPOSE | PART VI | IN ORDER TO ENSURE ACCESS TO PRIMARY CARE AND CERTAIN SPECIALTY PHYSICIAN SERVICES WESTERN MAINE HEALTH CARE OWNS AND OPERATES ITS SUBSIDIARIES STEPHENS MEMORIAL HOSPITAL ASSOCIATION AND WESTERN MAINE MULTIMEDICAL SPECIALISTS WMMMSINCLUDING PHYSICIAN PRACTICES PROVIDING CARDIOLOGY FAMILY MEDICINE GENERAL SURGERY ONCOLOGY PEDIATRIC AND OBSTETRIC AND GYNECOLOGY SERVICES WMMMS ALSO HAS PARTNERED WITH PHYSICIAN GROUPS TO PROVIDE UROLOGY SERVICES TO THE COMMUNITY DUE TO THE DEMOGRAPHICS OF THE POPULATION IN OXFORD COUNTY MOST OF THESE SERVICES WOULD NOT BE AVAILABLE IF THEY WERE NOT PROVIDED BY A SYSTEM SUCH AS OURS MOST LOCAL PRIVATE PHYSICIANS HAVE CLOSED TO OR SIGNIFICANTLY LIMITED ACCESS FOR NEW MEDICAID PATIENTS OUR PRACTICES CONTINUE TO ACCEPT PATIENTS REGARDLESS OF THEIR INSURANCE COVERAGE OR LACK THEREOF IN THE AGGREGATE 28 OF PATIENTS SERVED BY WESTERN MAINE MULTI MEDICAL SPECIALISTS AND STEPHENS MEMORIAL HOSPITAL WERE COVERED BY THE STATE OF MAINE MEDICAID PROGRAM AT SEPTEMBER 30 2012 PHYSICIANS EMPLOYED BY STEPHENS MEMORIAL HOSPITAL INCLUDED FIVE FAMILY PRACTITIONERS THREE GENERAL SURGEONS FOUR PEDIATRICIANS AND THREE OBSTETRICIAN GYNECOLOGISTS THERE WERE FIVE INTERNISTS EMPLOYED BY WESTERN MAINE MULTI MEDICAL SPECIALISTS WESTERN MAINE HEALTH CARE OWNS AND OPERATES MARKET SQUARE HEALTH CARE CENTER A 98BED LONGTERM CARE FACILITY COMPRISED OF 76 NURSING HOMESKILLED NURSING FACILITY BEDS AND 22 RESIDENTIAL CARE BEDS MARKET SQUARE ACCEPTS PATIENTS AND RESIDENTS WHOSE CLINICAL NEEDS EXCEED THE CAPABILITIES OF OTHER AREA NURSING FACILITIES WHILE WE SERVE THESE PATIENTS AT A FINANCIAL LOSS IT IS AN IMPORTANT PART OF OUR MISSION TO PROVIDE HEALTH CARE SERVICES THAT KEEP OUR LOCAL PATIENTS IN THE COMMUNITY MARKET SQUARE ACCEPTS ALL RESIDENTS WHO MEET CLINICAL CRITERIA REGARDLESS OF THE SOURCE OF EXPECTED PAYMENT FOR SERVICES COMBINED OPERATING LOSSES RELATED TO THE MISSIONCRITICAL PHYSICIAN PRACTICES AND NURSING FACILITY EXCEEDED 1168000 IN 2012 THESE LOSSES WERE SUPPORTED BY STEPHENS MEMORIAL HOSPITAL THROUGH NET ASSET TRANSFERS |
| LIST OF STATES WHERE COMMUNITY BENEFIT REPORT IS FILED | PART VI | MAINE |
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 | false | SeverancePayment |
| Supplemental Nonqual Retire Plan | false | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | false | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | false | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | false | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | false | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | false | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | false | AnyNonFixedPayments |
| Initial Contract Exception | false | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (11 entries)
| Comp Based On Related OrgsCompBasedOnRelatedOrgs | Other Compensation Related OrgsOtherCompensationRelatedOrgs | Deferred Comp Related OrgsDeferredCompRelatedOrgs | Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs | Total Compensation Related OrgsTotalCompensationRelatedOrgs | Bonus Related OrgsBonusRelatedOrgs | Base Compensation Filing OrgBaseCompensationFilingOrg | Other Compensation Filing OrgOtherCompensationFilingOrg | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg | Total Compensation Filing OrgTotalCompensationFilingOrg | Deferred Comp Filing OrgDeferredCompFilingOrg |
|---|---|---|---|---|---|---|---|---|---|---|
| GREGORY HARDY MD | ||||||||||
| 277465 | 72755 | 2996 | 21872 | 375088 | ||||||
| TIMOTHY CHURCHILL | ||||||||||
| 252000 | 18808 | 7349 | 26937 | 352094 | 47000 | |||||
| JOHN COX | ||||||||||
| 166234 | 364 | 2082 | 21301 | 189981 | ||||||
| M PATRICIA COOK | ||||||||||
| 130958 | 11492 | 5312 | 20735 | 168497 | ||||||
| THOMAS J HEWSON | ||||||||||
| 263148 | 16455 | 21884 | 301487 | |||||||
| TOBIN M PIKER | ||||||||||
| 236982 | 2230 | 23459 | 263989 | 1318 | ||||||
| RUSSELL D FLORENZ | ||||||||||
| 209821 | 28848 | 21836 | 266406 | 5901 | ||||||
| CLIFFORD R PECK | ||||||||||
| 222253 | 2132 | 10815 | 235200 | |||||||
| ROBERTA F METIVIER | ||||||||||
| 144208 | 54954 | 20850 | 223830 | 3818 | ||||||
| ADAM M KAZIMIERCZAK | ||||||||||
| 164800 | 15154 | 880 | 21246 | 239993 | 37913 | |||||
| KATHLEEN A HERLIHY | ||||||||||
| 161766 | 5569 | 2344 | 20962 | 190641 | ||||||
Schedule L IRS990ScheduleL
Form990 Schedule L Part IV Form990ScheduleLPartIV (3 entries)
| RelationshipRelationship | Amount Of TransactionAmountOfTransaction | Description Of TransactionDescriptionOfTransaction | Sharing Of RevenuesSharingOfRevenues |
|---|---|---|---|
| DAVID KUMAKI MD | |||
| MED PRACTICE | 356501 | PROF MEDICAL FEES | false |
| WILLIAM MEDD MD | |||
| > 35% JOINTLY | false | ||
| (no name) | |||
| OWNED | false | ||
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (10 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| RELATED PARTY INFORMATION AMONG OFFICERS | FORM 990, PAGE 6, PART VI, LINE 2 | DAVID KUMAKI, M.D. WILLIAM MEDD, M.D. SHAREHOLDER SHAREHOLDER SHAREHOLDERS IN A MEDICAL PRAC THE MEDICAL PRACTICE WAS |
| CLASSES OF MEMBERS OR STOCKHOLDERS | FORM 990, PAGE 6, PART VI, LINE 6 | WESTERN MAINE HEALTH CARE, CORP. (EIN 01-0411788) IS THE SOLE MEMBER OF THE ORGANIZATION. |
| ELECTION OF MEMBERS AND THEIR RIGHTS | FORM 990, PAGE 6, PART VI, LINE 7A | THE SOLE MEMBER HAS THE RESPONSIBILITY FOR THE ELECTION OF THE MEMBERS OF THE GOVERNING BODY. |
| DECISIONS SUBJECT TO APPROVAL OF MEMBERS | FORM 990, PAGE 6, PART VI, LINE 7B | ALL DECISIONS BY THE STEPHENS MEMORIAL HOSPITAL ASSOCIATION'S GOVERNING BODY ARE APPROVED BY DEFAULT BY THE MEMBER ORGANIZATION'S GOVERNING BODY SINCE THESE TWO ORGANIZATIONS SHARE A COMMON GOVERNING BODY. |
| ORGANIZATION'S PROCESS USED TO REVIEW FORM 990 | FORM 990, PAGE 6, PART VI, LINE 11B | THE 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 POLICY | FORM 990, PAGE 6, PART VI, LINE 12C | CONFLICT 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 STEPHENS MEMORIAL HOSPITAL ASSOCIATION. |
| COMPENSATION PROCESS FOR TOP OFFICIAL | FORM 990, PAGE 6, PART VI, LINE 15A | THE PARENT COMPANY OF STEPHENS MEMORIAL HOSPITAL ASSOCIATION 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 EXPLANATION | FORM 990, PAGE 6, PART VI, LINE 19 | DOCUMENTS THAT ARE REQUIRED TO BE OPEN FOR PUBLIC INSPECTION ARE MADE AVAILABLE UPON REQUEST. |
| RELATED ORGANIZATIONS | FORM 990, PAGE 7, PART VII | GREGORY HARDY 58 HOURS TIMOTHY CHURCHILL 30 HOURS JOHN COX 30 HOURS M. PATRICIA COOK 3 HOURS KATHLEEN HERLIHY 60 HOURS ADAM KAZIMIERCZAK 60 HOURS |
| OTHER CHANGES IN NET ASSETS EXPLANATION | FORM 990, PART XI, LINE 5 | OTHER CHANGES IN NET ASSETS OF 142,301 IS COMPRISED OF THE FOLLOWING: NET TRANSFERS TO AFFILIATES (1,058,322) CHANGE IN INTEREST-SCHCF 726,955 RETURN ON INVESTMENTS 189,066 |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII (6 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivities | Legal Domicile StateLegalDomicileState | Exempt Code SectionExemptCodeSection | Public Charity StatusPublicCharityStatus | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Controlled OrgControlledOrg |
|---|---|---|---|---|---|---|---|---|---|---|
| WESTERN MAINE HEALTH CARE CORP | ||||||||||
| 181 MAIN STREET | NORWAY | ME | 04268 | 010411788 | HEALTHCARE | ME | 501C3 | 11C | MEHEALTH | false |
| MAINEHEALTH | ||||||||||
| 110 FREE STREET | PORTLAND | ME | 04101 | 010431680 | HEALTHCARE | ME | 501C3 | 11C | NA | false |
| WESTERN MAINE MULTI-MEDICAL SPECIAL | ||||||||||
| 181 MAIN STREET | NORWAY | ME | 04268 | 010489824 | PHYS PRACT | ME | 501C3 | 3 | WMHCC | false |
| WESTERN MAINE NURSING HOME INC | ||||||||||
| 3 MARKET SQUARE | SOUTH PARIS | ME | 04281 | 222842655 | NURSING HO | ME | 501C3 | 9 | WMHCC | false |
| STEPHENS COMMUNITY HEALTHCARE FOUND | ||||||||||
| 181 MAIN STREET | NORWAY | ME | 04268 | 311644144 | SUPP ORG | ME | 501C3 | 11A | WMHCC | false |
| CHAPEL VALLEY BOARDING HOME CORP | ||||||||||
| 181 MAIN STREET | NORWAY | ME | 04268 | 010433206 | HEALTHCARE | ME | 501C3 | 7 | WMHCC | false |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | false | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | false | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | false | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | false | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | false | LoansOrGuaranteesFromOtherOrg |
| Sale Of Assets To Other Org | false | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | false | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | false | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | true | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | false | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | true | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | true | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | false | SharingOfFacilities |
| Sharing Of Paid Employees | false | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | true | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | true | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | true | OtherTransferToOtherOrg |
| Other Transfer From Other Org | true | OtherTransferFromOtherOrg |